Objective To study the risk factors and strain resistance of Escherichia coli with extended-spectrum β-lactamases(ESBL)-producing bloodstream infection,so as to provide clinical basis for rational use of antibiotics and effective prevention and control of bloodstream infection.Methods The clinical data of patients with bloodstream infections caused by Escherichia coli in a tertiary hospital in Chongqing from January 2018 to December 2022 were retrospectively collected.The clinical characteristics and drug resistance of bloodstream infections caused by Escherichia coli were statistically analysed.According to the ESBL confirmation test of Escherichia coli strains,the patients were divided into the ESBL-producing group and the non-ESBL-producing group.The chi-square test was used to compare the differences in influencing factors between the two groups,and then the independent influencing factors of ESBL production were analyzed through multivariate Logistic regression.Results A total of 408 patients were included.The detection rate of ESBL-producing strains was 60.3％(246/408),and the detection rates in the nephrology department and the intensive care unit were relatively high(both＞76.0％).Diabetes[OR=1.98,95％CI(1.24,3.17)]and urinary tract intubation[OR=1.60,95％CI(1.02,2.51)]were independent influencing factors for bloodstream infection with ESBL-producing Escherichia coli.The resistance rate of ESBL-producing Escherichia coli to levofloxacin and ceftriaxone was＞90.0％.Moreover,the resistance rates of the second-generation cephalosporins(except ceftazidime),compound sulfamethoxazole,ciprofloxacin and amtronam were significantly higher than those in the non-ESBL-producing group(P＜0.05).Both groups of strains showed high sensitivity to amikacin and carbapenem drugs.Conclusion The severe current situation of bloodstream infections caused by ESBL-producing Escherichia coli in this region showing a high prevalence of drug resistance characteristics.Diabetes and urinary tract intubation,as independent risk factors,suggest that key monitoring should be implemented for such high-risk populations in clinical practice.Given that ESBL-producing strains remain sensitive to carbapenems and amikacin,it can be recommended as the first empirical medication.It is of great public health significance to achieve the effect of curbing the spread of such multi-drug resistant bacteria by establishing an early warning system based on risk factor assessment and standardized management of invasive operations.

The air supply and pressure regulating system is a basic part of the physical and chemical regenerative life protection and non-regenerative life protection of manned spacecraft.One of the key systems for the smooth operation of the system.In order to ensure the on-orbit safety and reliability of the high-pressure gas source in the gas supply and pressure regulation system,a two-stage pressure reducing valve is often used to reduce and stabilize the pressure,so as to provide downstream products with low-pressure gas with stable flow and velocity;therefore the pressure reducing valve is an important part to ensure the safety of the gas source.In this paper,based on the structure and principle of a certain type of double-stage pressure reducing valve,the simulation model of the double-stage pressure reducing valve is established by using the pneumatic and pneumatic component design library of AMESim,and the model is compared and verified by experimental data.The results show that the simulation model predicts the working process of the pressure reducing valve well,and the simulation scheme and model are accurate and effective.On this basis,the AMESim simulation model is used to analyze the key process design parameters such as spring stiffness,spool mass and damping hole cross-sectional area of the pressure reducing valve,and the influence laws on the output pressure of the pressure reducing valve and the structural dynamic characteristics are obtained.The findings presented in this paper offer valuable research insights and theoretical support for enhancing the performance of the two-stage pressure reducing valve,as well as providing useful references for future design improvements and on-orbit upgrades.

Objective To study the risk factors and strain resistance of Escherichia coli with extended-spectrum β-lactamases(ESBL)-producing bloodstream infection,so as to provide clinical basis for rational use of antibiotics and effective prevention and control of bloodstream infection.Methods The clinical data of patients with bloodstream infections caused by Escherichia coli in a tertiary hospital in Chongqing from January 2018 to December 2022 were retrospectively collected.The clinical characteristics and drug resistance of bloodstream infections caused by Escherichia coli were statistically analysed.According to the ESBL confirmation test of Escherichia coli strains,the patients were divided into the ESBL-producing group and the non-ESBL-producing group.The chi-square test was used to compare the differences in influencing factors between the two groups,and then the independent influencing factors of ESBL production were analyzed through multivariate Logistic regression.Results A total of 408 patients were included.The detection rate of ESBL-producing strains was 60.3％(246/408),and the detection rates in the nephrology department and the intensive care unit were relatively high(both＞76.0％).Diabetes[OR=1.98,95％CI(1.24,3.17)]and urinary tract intubation[OR=1.60,95％CI(1.02,2.51)]were independent influencing factors for bloodstream infection with ESBL-producing Escherichia coli.The resistance rate of ESBL-producing Escherichia coli to levofloxacin and ceftriaxone was＞90.0％.Moreover,the resistance rates of the second-generation cephalosporins(except ceftazidime),compound sulfamethoxazole,ciprofloxacin and amtronam were significantly higher than those in the non-ESBL-producing group(P＜0.05).Both groups of strains showed high sensitivity to amikacin and carbapenem drugs.Conclusion The severe current situation of bloodstream infections caused by ESBL-producing Escherichia coli in this region showing a high prevalence of drug resistance characteristics.Diabetes and urinary tract intubation,as independent risk factors,suggest that key monitoring should be implemented for such high-risk populations in clinical practice.Given that ESBL-producing strains remain sensitive to carbapenems and amikacin,it can be recommended as the first empirical medication.It is of great public health significance to achieve the effect of curbing the spread of such multi-drug resistant bacteria by establishing an early warning system based on risk factor assessment and standardized management of invasive operations.

Objective To explore whether the ability of intertemporal choice is impaired in schizophrenic patients and in their unaffected siblings.Methods Twenty-five schizophrenia patients,twenty-five unaffected siblings of patients and thirty healthy controls were recruited in the study."Delay-discounting" task and a battery of cognitive neuropsychological assessment were used to examine the intertemporal decision-making.Results (1) the value of k was ((0.005±0.009 in schizophrenia,0.011±0.014 in unaffected siblings and 0.024±0.029 in healthy controls,respectively.There was significant difference in k value among these three groups (F=9.487,P＜0.001).There were significant differences in k value between patients group and healthy controls,and between unaffected siblings and healthy controls (P＜0.05).There was no significant difference between schizophrenia and their unaffected siblings (P＜0.05).(2) Pearson correlation analysis not showed any relationship between neuropsychological test and the value of k.Conclusion The ability of intertemporal choices is impaired in schizophrenia and their unaffected siblings to a great degree.

Objective To investigate whether there are changes in the ability of intertemporal choices in migraine sufferers. Method Thirty migraine sufferers and thirty healthy controls were investigated by Delay?discount Test. Results (1)The ratio of later?large (LL) choice in migraine suffers((18.15± 17.53)%) was significantly lower than that in the healthy controls((35.37±20.70)%),and the difference was statistically significant(t=3.31, P<0.05).Under the immediate option for now selection conditions and no immediate option for not?now selection conditions,the ratio of later?large (LL) choice in migraine suffers ((18.33±21.00)% ,(17.96±18.09)%) was also significantly lower than that in the healthy controls ((35.56±21.52)%,(35.19±22.05)%),and the difference was statistically significant(t=3.31, P<0.05;t=3.14, P<0.05).(2) Pearson correlation analysis showed that the Stroop Test of migraineurs was positively correlated with LL selection ratio under now conditions (r=0.49, P=0.006) and total LL selection (r=0.42, P=0.021) . Conclusion The ability of intertemporal choices in migraine sufferers has been impaired,which is correlated with executive function.

Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Humans ; Lymphoma, Follicular ; drug therapy ; Rituximab

OBJECTIVEA prospective, multicenter and non-interventional prospective study was conducted to evaluate the clinical features of rituximab combined with chemotherapy (R-Chemo) as first-line treatment on newly diagnosed Chinese patients with diffuse large B-cell lymphoma (DLBCL).

METHODSThis was a single arm, prospective, observational multicenter and phase IV clinical trial for 279 patients, who were newly diagnosed as CD20-positive DLBCL from 24 medical centers in China 2011 and 2012, no special exclusion criteria were used. All patients received rituximab based R-Chemo regimes, such as R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisolone) and other regimes as the first-line treatment. The treatment strategies were determined by physicians and patients without detailed description for treatment course, dose, interval time and examination. Clinical response and safety of all patients were investigated in 120 days after completion of last dose of rituximab.

RESULTSOf 279 patients, 258 with stage I-IV who received at least 1 cycle of rituximab treatment and completed at least one time of tumor assessment were enrolled into intention-to-treat analysis, including 148 male and 110 female. The median age of all patients was 57.2(12.8-88.4) years. ECOG performance statuses of 0 or 1 were observed in 91.1% of patients, international prognostic index levels in the low-risk and low-middle-risk groups in 76.4% of patients, the tumor diameters smaller than 7.5 cm in 69.0% of patients. All patients received 6 median cycles of R-Chemo treatment every 24.4 days. R-CHOP treatment was shown to improve the clinical response with overall response rates of 94.2%. Common adverse events included anemia, marrow failure, leukopenia, thrombocytopenia, digestive diseases, infection and liver toxicity. All adverse events are manageable.

CONCLUSIONNon-interventional clinical trial of R-Chemo remains the standard first-line treatment for newly diagnosed patients with DLBCL in real clinical practice, which is consistent with international treatment recommendations for DLBCL patients. R-Chemo can provide the clinical evidence and benefit as the first-line standard treatment for Chinese patients with DLBCL.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; Male ; Middle Aged ; Prospective Studies ; Rituximab ; Treatment Outcome