Objective To examine the anti-central-fatigue function of maca and its underlying mechanism.Methods Forty Sprague-Dawley rats were divided randomly into a negative control group,model control group,and low-,medium-,and high-dose maca groups(0.6,1.2,and 2.4 g/kg·body weight).Rats in all groups except the negative control group were subjected to multi-factor stimulation,including cold-water swimming,sleep deprivation,restraining,and tail-clamping,to establish central fatigue rat models.Rats in the low-,medium-,and high-dose maca groups received 0.6,1.2,or 2.4 g/kg maca,respectively,by gavage for 35 days.Behavioral testing was carried out using the Morris water-maze,sucrose-preference,and tail-suspension tests.Markers of oxidative stress in the hippocampus,including superoxide dismutase(SOD),malondialdehyde(MDA),and catalase(CAT),were detected using test kits.Proteins connected with the AMP-activated protein kinase(AMPK)/sirtuin 1(SIRT1)/peroxisome proliferator-activated receptor γ coactivator 1-α(PGC-1α)signaling pathway in the hippocampus were detected by Western blot.Results Rats in the low-,medium-,and high-dose maca groups spent significantly more time in the target quadrant compared with the model control group(P＜0.05 or P＜0.01),but there was no significant dose-effect relationship.Rats in the medium-and high-dose maca groups showed decreased escape latency(P＜0.05),increased time crossing the platform location(P＜0.05),increased sucrose preference(P＜0.05),decreased tail suspension time(P＜0.05),increased the activities of CAT(P＜0.01)and SOD(P＜0.05),and decreased MDA content(P＜0.01).Rats in the low-,medium-,and high-dose maca groups also showed significantly increased protein expression levels of AMPK and nuclear respiratory factor 1(P＜0.01 or P＜0.05),but no significant dose-effect relationship was observed.Rats in the medium-and high-dose maca groups showed increased protein expression of PGC-1α(P＜0.05 or P＜0.01),and rats in the high-dose maca group showed increased protein expression of SIRT1 and mitochondrial transcription factor A(P＜0.05 or P＜0.01).Conclusions Maca can improve the indicators of central fatigue in rats,determined by behavioral testing and oxidative stress-related factors.The underlying mechanism may be related to its regulatory effects on the AMPK/SIRT1/PGC-1α signaling pathway.

Objective To examine the anti-central-fatigue function of maca and its underlying mechanism.Methods Forty Sprague-Dawley rats were divided randomly into a negative control group,model control group,and low-,medium-,and high-dose maca groups(0.6,1.2,and 2.4 g/kg·body weight).Rats in all groups except the negative control group were subjected to multi-factor stimulation,including cold-water swimming,sleep deprivation,restraining,and tail-clamping,to establish central fatigue rat models.Rats in the low-,medium-,and high-dose maca groups received 0.6,1.2,or 2.4 g/kg maca,respectively,by gavage for 35 days.Behavioral testing was carried out using the Morris water-maze,sucrose-preference,and tail-suspension tests.Markers of oxidative stress in the hippocampus,including superoxide dismutase(SOD),malondialdehyde(MDA),and catalase(CAT),were detected using test kits.Proteins connected with the AMP-activated protein kinase(AMPK)/sirtuin 1(SIRT1)/peroxisome proliferator-activated receptor γ coactivator 1-α(PGC-1α)signaling pathway in the hippocampus were detected by Western blot.Results Rats in the low-,medium-,and high-dose maca groups spent significantly more time in the target quadrant compared with the model control group(P＜0.05 or P＜0.01),but there was no significant dose-effect relationship.Rats in the medium-and high-dose maca groups showed decreased escape latency(P＜0.05),increased time crossing the platform location(P＜0.05),increased sucrose preference(P＜0.05),decreased tail suspension time(P＜0.05),increased the activities of CAT(P＜0.01)and SOD(P＜0.05),and decreased MDA content(P＜0.01).Rats in the low-,medium-,and high-dose maca groups also showed significantly increased protein expression levels of AMPK and nuclear respiratory factor 1(P＜0.01 or P＜0.05),but no significant dose-effect relationship was observed.Rats in the medium-and high-dose maca groups showed increased protein expression of PGC-1α(P＜0.05 or P＜0.01),and rats in the high-dose maca group showed increased protein expression of SIRT1 and mitochondrial transcription factor A(P＜0.05 or P＜0.01).Conclusions Maca can improve the indicators of central fatigue in rats,determined by behavioral testing and oxidative stress-related factors.The underlying mechanism may be related to its regulatory effects on the AMPK/SIRT1/PGC-1α signaling pathway.

To analyze the prevalence, genomic characteristics and clinical relevance of carbapenem-resistant bacteria in untreated hospital wastewater, and to provide a reference basis for in-hospital assessment of public health situation and prevention of cross-infection. In March 2023, untreated wastewater in the wastewater treatment station of the Second Affiliated Hospital of Soochow University and wastewater in the U-shaped wastewater pipes of the hand-washing sinks in 26 wards were collected, centrifuged and diluted, and the drug-resistant bacteria were isolated by using LB solid plates containing meropenem (2 μg/ml) for species identification, drug sensitivity analysis, carbapenenase gene PCR detection and whole genome sequencing. The genome sequence was identified for drug resistance genes. Retrospective research was used, combining multilocus sequence typing (MLST) and single nucleotide polymorphism (SNP) analysis, to compare their homology with clinical isolates of the same quarter. The results showed that 56 carbapenem-resistant gram-negative bacteria were isolated from hospital wastewater, originating from 13 genera, of which 17 were isolated from the total hospital wastewater, with Aeromonas spp. as the most dominant genus (35.3%, 6/17), and 39 were isolated from the wastewater of 17 wards, with Pseudomonas spp. as the most dominant genus (30.8%, 12/39). All common wastewater isolates from our hospital were multidrug-resistant bacteria, with up to 100% resistant to some second-and third-generation cephalosporins. A total of 8 carbapenemase genes originated from wastewater isolates, including blaKPC, blaNDM, blaIMP, blaVIM, blaIND, blaOXA-58-like, blaOXA-48-like, and blaOXA-427-like. 39 wastewater isolates carried the carbapenemase genes, and the total wastewater of the hospital carried the highest isolation rate of blaKPC-2 bacteria (35.3%, 6/17) and the highest isolation rate of blaIMP-8 bacteria (31.8%, 7/22) were found in the wastewater from 26 wards. 14 wastewater isolates were found to carry both carbapenemase genes, with a total of 6 combinations. A new blaIMP-101 isoform was also identified for the first time. 4 wastewater isolates and 11 clinical isolates were screened for inclusion in the SNP analysis, in which only 15 SNPs differed between the two strains of ST11 Klebsiella pneumoniae of clinical and wastewater origin, which was highly homologous. In conclusion, the presence of multiple multi-drug resistant conditionally pathogenic bacteria in untreated hospital wastewater has the potential risk of spreading drug-resistant genes in the environment. The highly homologous Klebsiella pneumoniae isolated from hospital wastewater and clinics indicates the close association between hospital wastewater and clinical infections. Hospitals need to strengthen the monitoring of drug-resistant bacteria and drug-resistant genes in the wastewater environment, to prevent the widespread dissemination of drug-resistant bacteria and drug-resistant genes in hospital wastewater and to prevent nosocomial infections caused by drug-resistant bacteria in wastewater.

To analyze the prevalence, genomic characteristics and clinical relevance of carbapenem-resistant bacteria in untreated hospital wastewater, and to provide a reference basis for in-hospital assessment of public health situation and prevention of cross-infection. In March 2023, untreated wastewater in the wastewater treatment station of the Second Affiliated Hospital of Soochow University and wastewater in the U-shaped wastewater pipes of the hand-washing sinks in 26 wards were collected, centrifuged and diluted, and the drug-resistant bacteria were isolated by using LB solid plates containing meropenem (2 μg/ml) for species identification, drug sensitivity analysis, carbapenenase gene PCR detection and whole genome sequencing. The genome sequence was identified for drug resistance genes. Retrospective research was used, combining multilocus sequence typing (MLST) and single nucleotide polymorphism (SNP) analysis, to compare their homology with clinical isolates of the same quarter. The results showed that 56 carbapenem-resistant gram-negative bacteria were isolated from hospital wastewater, originating from 13 genera, of which 17 were isolated from the total hospital wastewater, with Aeromonas spp. as the most dominant genus (35.3%, 6/17), and 39 were isolated from the wastewater of 17 wards, with Pseudomonas spp. as the most dominant genus (30.8%, 12/39). All common wastewater isolates from our hospital were multidrug-resistant bacteria, with up to 100% resistant to some second-and third-generation cephalosporins. A total of 8 carbapenemase genes originated from wastewater isolates, including blaKPC, blaNDM, blaIMP, blaVIM, blaIND, blaOXA-58-like, blaOXA-48-like, and blaOXA-427-like. 39 wastewater isolates carried the carbapenemase genes, and the total wastewater of the hospital carried the highest isolation rate of blaKPC-2 bacteria (35.3%, 6/17) and the highest isolation rate of blaIMP-8 bacteria (31.8%, 7/22) were found in the wastewater from 26 wards. 14 wastewater isolates were found to carry both carbapenemase genes, with a total of 6 combinations. A new blaIMP-101 isoform was also identified for the first time. 4 wastewater isolates and 11 clinical isolates were screened for inclusion in the SNP analysis, in which only 15 SNPs differed between the two strains of ST11 Klebsiella pneumoniae of clinical and wastewater origin, which was highly homologous. In conclusion, the presence of multiple multi-drug resistant conditionally pathogenic bacteria in untreated hospital wastewater has the potential risk of spreading drug-resistant genes in the environment. The highly homologous Klebsiella pneumoniae isolated from hospital wastewater and clinics indicates the close association between hospital wastewater and clinical infections. Hospitals need to strengthen the monitoring of drug-resistant bacteria and drug-resistant genes in the wastewater environment, to prevent the widespread dissemination of drug-resistant bacteria and drug-resistant genes in hospital wastewater and to prevent nosocomial infections caused by drug-resistant bacteria in wastewater.

Objective:To survey the prevalence and comorbidity of patients with chronic thromboembolic pulmonary hypertension (CTEPH) in Shanxi province from 2018 to 2021.Methods:The data of patients with CTEPH from 2018 to 2021 were extracted from the Health Statistics Direct Reporting System of Shanxi Provincial Health Commission; the population data of Shanxi Province was obtained from the Statistical Yearbook of Shanxi Province. The prevalence rate of CTEPH in Shanxi Province in 2018, 2019, 2020 and 2021 was calculated. The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) was used to identity the specific Charlson comorbidity from other diagnosis on the medical record. The severity of the comorbidity scale was classified as mild (aCCI≤2 points), moderate (aCCI=3-5 points), moderate-severe (aCCI=6-8 points), and severe (aCCI≥9 points).Result:A total of 300 patients with CTEPH were identified in the whole province during the period with the mean age of(65.5±11.5)years, there were 31, 65, 83 and 121 cases in 2018, 2019, 2020 and 2021, and the corresponding prevalence rates were 0.9/10 6, 1.9/10 6, 2.4/10 6 and 3.5/10 6, respectively showing an increasing trend. The patients with CTEPH in this study involved 14 Charlson comorbidities, among which the chronic lung disease was in the highest proportion (198/300, 66.0%), followed by peripheral vascular disease (126/300, 42.0%) and chronic congestive heart failure (121/300, 40.3%). There were 16.3% (49/300) of patients with mild comorbidity, 56.3% (169/300) with moderate comorbidity, 22.3% (67/300) with moderate-severity comorbidity, and 5.0% (15/300) with severity comorbidity. Conclusions:The prevalence of CTEPH in Shanxi province from 2018 to 2021 was 0.9-3.5/10 6 showing an upward trend. The chronic lung disease, peripheral vascular disease and chronic congestive heart failure are the main comorbidities of patients with CTEPH, and mostly with moderate comorbidity.