Objective To explore the effect of Rhizoma Polygonati(RP)on arterial aging in naturally aging Wistar rats.Methods SPF Wistar rats aged 72 weeks were divided randomly divided into 4 groups:an old group and RP low,medium,and high-dose groups(n=14 rats per group).Another 14 male SPF Wistar rats aged 8～12 weeks were selected as the young group.Rats in the RP high,medium,and low-dose groups were administered with 4,2,and 1 g/kg RP,respectively,by gavage,and rats in the old and young groups were given the same amount of distilled water once a day for 12 weeks.Seven rats from each group were sacrificed under anesthesia at weeks 4 and 12 and aortas were isolated.The relative smooth muscle cell(SMC)and collagen fiber(CF)contents were analyzed,total antioxidant capacity(T-AOC),glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),and malondialdehyde(MDA)levels were measured,and the expression levels of cell cycle-associated proteins in arterial tissue were detected by Western Blot.Results Rats in the old group showed obvious signs of vascular aging but there was no significant changes in arterial vascular tissue indexes in the old group with increased age.Aortas were obviously injured,relative contents of SMC and CF were significantly increased(P＜0.01),T-AOC,SOD,and GSH-Px contents were significantly decreased and MDA was increased(P＜0.01)in the old group compared with the young group at 4 and 8 weeks,and expression levels of cell cycle-associated proteins were significantly up-regulated(P＜0.01).RP intervention significantly decreased the relative SMC and CF contents and MDA levels(P＜0.05 or P＜0.01)and significantly increased T-AOC,SOD,and GSH-Px(P＜0.05 or P＜0.01).Expression levels of cell cycle-associated proteins were also significantly decreased(P＜0.05 or P＜0.01).High-dose RP had the greatest effect.Conclusions Arterial aging is relatively stable in the short term in naturally aging rats.RP could delay arterial aging in naturally aging rats by regulating the level of oxidative stress and the expression of cell cycle-associated proteins.

Objective To investigate the clinical manifestations and prognosis of patients with anti-leucine rich glioma inactivated 1（LGI1）antibody encephalitis. Methods A retrospective analysis was performed for the data of patients with anti-LGI1 antibody encephalitis who were hospitalized in Department of Neurology，Xuanwu Hospital，Capital Medical University，from September 2019 to December 2023，including clinical features，treatment，and prognosis. Results A total of 80 patients were enrolled，including 48 male patients and 32 female patients. Of all 80 patients，51（63.8%）had the initial symptom of epilepsy，13（16.3%）had the initial symptom of faciobrachial dystonic seizures，26（32.5%）had the initial symptom of cognitive impairment，and 12（15%）had the initial symptom of mental and behavioral disorders. As for comorbidities，there were 28 patients（35%）with hyponatremia，22（27.5%）with Hashimoto's thyroiditis，and 5（6.25%）with tumor. All 80 patients tested positive for serum LGI1 antibody，and 69（86.3%）tested positive for LGI1 antibody in cerebrospinal fluid. Among the 80 patients，37（46.25%）had abnormalities on magnetic resonance imaging，and 30 had abnormalities on 18F-FDG PET/CT. There were 50 patients with abnormalities on video electroencephalography. A total of 77 patients received first-line immunotherapy，and after follow-up for 1 year，19.4% of the patients had the sequela of seizure，59.7% of the patients had deterioration of the memory，and 48.6% of the patients had mental and behavioral disorders. Conclusion Epilepsy，cognitive impairment，and mental and behavior disorders are the most common manifestations of anti-LGI1 antibody encephalitis. There is generally a good prognosis after immunotherapy，with the sequelae of cognitive impairment and mental and behavioral disorders.

Objective To observe the cardioprotection of Rhizoma Polygonati(RP)in natural aging rat and its molecular mechanism.Methods 16 SD rats aged 2 months were selected as the young group,another 64 SD rats aged 18 months were randomly divided into 4 groups:an old group,a RP-low,a RP-medium and a RP-high dose group,with 16 rats in each group.The RP-low,RP-medium and RP-high dose groups were administered of RP(1,2,4 g·kg-1)by gavage,the old and young groups were given the same amount of distilled water once a day for 12 weeks.At week 4 and 12,eight rats from each group were sacrificed under anesthesia and hearts were isolated.Then cardiac weight index(CI)were measured and the histopathologic observation was assessed.The contents of total antioxidant capacity(T-AOC),glutathione peroxidase(GSH-Px),superoxide dismutase(SOD)and malondialdehyde(MDA)were measured,and the expression of ataxia-telangiectasia mutated gene(ATM),ATM and Rad3-related kinase(ATR)-related protein in cardiac tissue were detected.Results With the increase of weeks of age,the fibrosis area in the old group was increased.The content of GSH-Px was decreased while MDA was increased;the expressions of Chk1 and Chk2 were also up-regulated(P<0.05).At week 4 or 12,compared to the young group,the CI was reduced,and the contents of T-AOC,SOD,GSH-Px were decreased while MDA was increased;the expression of ATM,ATR-related proteins were all significantly up-regulated in cardiac tissue of old group(P<0.05).After RP treatment,the CI was elevated,the structure of cardiomyocytes were intact and the myocardial fibers were arranged neatly,the fibrosis area was lowered.The contents of T-AOC,GSH-Px,SOD were increased while MDA was decreased.The expression of ATM,ATR-related proteins were significantly down-regulated in cardiac tissue(P<0.05).Conclusion RP could protect the heart in natural aging rats,and its mechanism may be related to the regulation of DNA damage response ATM,ATR signaling pathway.

Objective To explore the effect of Rhizoma Polygonati(RP)on arterial aging in naturally aging Wistar rats.Methods SPF Wistar rats aged 72 weeks were divided randomly divided into 4 groups:an old group and RP low,medium,and high-dose groups(n=14 rats per group).Another 14 male SPF Wistar rats aged 8～12 weeks were selected as the young group.Rats in the RP high,medium,and low-dose groups were administered with 4,2,and 1 g/kg RP,respectively,by gavage,and rats in the old and young groups were given the same amount of distilled water once a day for 12 weeks.Seven rats from each group were sacrificed under anesthesia at weeks 4 and 12 and aortas were isolated.The relative smooth muscle cell(SMC)and collagen fiber(CF)contents were analyzed,total antioxidant capacity(T-AOC),glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),and malondialdehyde(MDA)levels were measured,and the expression levels of cell cycle-associated proteins in arterial tissue were detected by Western Blot.Results Rats in the old group showed obvious signs of vascular aging but there was no significant changes in arterial vascular tissue indexes in the old group with increased age.Aortas were obviously injured,relative contents of SMC and CF were significantly increased(P＜0.01),T-AOC,SOD,and GSH-Px contents were significantly decreased and MDA was increased(P＜0.01)in the old group compared with the young group at 4 and 8 weeks,and expression levels of cell cycle-associated proteins were significantly up-regulated(P＜0.01).RP intervention significantly decreased the relative SMC and CF contents and MDA levels(P＜0.05 or P＜0.01)and significantly increased T-AOC,SOD,and GSH-Px(P＜0.05 or P＜0.01).Expression levels of cell cycle-associated proteins were also significantly decreased(P＜0.05 or P＜0.01).High-dose RP had the greatest effect.Conclusions Arterial aging is relatively stable in the short term in naturally aging rats.RP could delay arterial aging in naturally aging rats by regulating the level of oxidative stress and the expression of cell cycle-associated proteins.

Objective To observe the cardioprotection of Rhizoma Polygonati(RP)in natural aging rat and its molecular mechanism.Methods 16 SD rats aged 2 months were selected as the young group,another 64 SD rats aged 18 months were randomly divided into 4 groups:an old group,a RP-low,a RP-medium and a RP-high dose group,with 16 rats in each group.The RP-low,RP-medium and RP-high dose groups were administered of RP(1,2,4 g·kg-1)by gavage,the old and young groups were given the same amount of distilled water once a day for 12 weeks.At week 4 and 12,eight rats from each group were sacrificed under anesthesia and hearts were isolated.Then cardiac weight index(CI)were measured and the histopathologic observation was assessed.The contents of total antioxidant capacity(T-AOC),glutathione peroxidase(GSH-Px),superoxide dismutase(SOD)and malondialdehyde(MDA)were measured,and the expression of ataxia-telangiectasia mutated gene(ATM),ATM and Rad3-related kinase(ATR)-related protein in cardiac tissue were detected.Results With the increase of weeks of age,the fibrosis area in the old group was increased.The content of GSH-Px was decreased while MDA was increased;the expressions of Chk1 and Chk2 were also up-regulated(P<0.05).At week 4 or 12,compared to the young group,the CI was reduced,and the contents of T-AOC,SOD,GSH-Px were decreased while MDA was increased;the expression of ATM,ATR-related proteins were all significantly up-regulated in cardiac tissue of old group(P<0.05).After RP treatment,the CI was elevated,the structure of cardiomyocytes were intact and the myocardial fibers were arranged neatly,the fibrosis area was lowered.The contents of T-AOC,GSH-Px,SOD were increased while MDA was decreased.The expression of ATM,ATR-related proteins were significantly down-regulated in cardiac tissue(P<0.05).Conclusion RP could protect the heart in natural aging rats,and its mechanism may be related to the regulation of DNA damage response ATM,ATR signaling pathway.

Catheter associated urinary tract infection (CAUTI) refer to urinary system infections that occur after the insertion of a urinary catheter or within 48 hours after its removal. CAUTI exacerbate patient conditions, prolong hospital stays, increase medical costs and economic burdens on patients, and can be life-threatening in severe cases. The Asia Pacific Society of Infection Control (APSIC) convened a working group of infection prevention and control experts from the Asia-Pacific region to publish the APSIC guideline for prevention of catheter associated urinary tract infections (CAUTIs) (referred to as the "APSIC Guideline"). This guideline encompasses the prevention and management of CAUTI in patients with indwelling catheters, covering the entire process from catheter insertion, maintenance, to removal, and are characterized by their practicability and directive nature. This article interprets the APSIC Guideline from aspects such as risk factors of CAUTI, diagnosis, development of prevention strategies, monitoring, and implementation of prevention plans, aiming to provide scientific guidance for clinical healthcare professionals in preventing CAUTI.

New Delhi metallo-β-lactamase-1 (NDM-1) is capable of hydrolyzing nearly all β-lactam antibiotics, posing an emerging threat to public health. There are currently less effective treatment options for treating NDM-1 positive “superbug”, and no promising NDM-1 inhibitors were used in clinical practice. In this study, structure–activity relationship based on thiosemicarbazone derivatives was systematically characterized and their potential activities combined with meropenem (MEM) were evaluated. Compounds 19bg and 19bh exhibited excellent activity against 10 NDM-positive isolate clinical isolates in reversing MEM resistance. Further studies demonstrated compounds 19bg and 19bh were uncompetitive NDM-1 inhibitors with Ki = 0.63 and 0.44 μmol/L, respectively. Molecular docking speculated that compounds 19bg and 19bh were most likely to bind in the allosteric pocket which would affect the catalytic effect of NDM-1 on the substrate meropenem. Toxicity evaluation experiment showed that no hemolysis activities even at concentrations of 1000 mg/mL against red blood cells. In vivo experimental results showed combination of MEM and compound 19bh was markedly effective in treating infections caused by NDM-1 positive strain and prolonging the survival time of sepsis mice. Our finding showed that compound 19bh might be a promising lead in developing new inhibitor to treat NDM-1 producing superbug.

The epidemic of coronavirus disease 2019 (COVID-19) puts higher demands on critical care medicine. Lots of studies have been conducted to solve COVID-19-related problems. Therefore, we reviewed the annual progress for COVID-19-related issues including antivirals threapies, respiratory support and immunomodulatory therapies and other critical issues, including the effect of antibiotic on mitochondrial damage and its relationship with sepsis, the goal and direction of antimicrobial de-escalation, drug prophylaxis of constipation, bleeding in gastrointestinal disorders and management of critical illness in the informalization era and so on. We hope to provide reference for clinical and scientific research work of the intensivists.

OBJECTIVE:To investigate the protective effects of insulin-glucose on myocardium in patients receiving cardiac valve replacement under cardiopulmonary bypass. METHODS:Totally 120 patients receiving combined cardiac valve replacement under cardiopulmonary bypass were divided into control group and observation group according to random number table,with 60 cases in each group. All patients were given routine operation. Control group was given Thomas cardioplegia and oxygenated blood with a ratio of 1:4(V:V)to protect myocardium at 4 ℃. Besides that,the observation group was additionally given Insulin injec-tion 10 IU/L and Glucose injection 10 g/L added into Thomas cardioplegia at 4 ℃ to protect myocardium. The levels of plasma brain natriuretic peptide(BNP)and cardiac troponinⅠ(cTnⅠ)before anesthesia induction(T0),at the end of cardiopulmonary by-pass(T1),12 h(T2),24 h(T3),48 h(T4),and 72 h(T5)after surgery,the rate of recovery of automatic heartbeat after opening aor-ta,the application of vasoactive agent(dopamine)at T1 and the occurrence of postoperative complications were observed and com-pared between 2 groups. RESULTS:At T0,there was no statistical significance in the levels of plasma BNP and cTnⅠ between 2 groups(P>0.05). The levels of plasma BNP and cTnⅠin 2 groups at T1-5 were significantly higher than T0,with statistical signifi-cance(P<0.05);the levels of cTnⅠ began to decrease at T4 and cTnⅠbegan to decrease at T5. However,the levels of BNP and cTnⅠwere significantly lower in observation group than in control group at T1-5,with statistical significance(P<0.05). After open-ing aorta,there was no statistical significance in the rate of recovery of automatic heartbeat between 2 groups(P>0.05). The dos-age of dopamine (at T1) and the incidence of complications in observation group were statistically lower than control group,with statistical significance(P<0.05). No severe ADR was found in 2 groups during or after surgery. CONCLUSIONS:Insulin-glucose can alleviate myocardial damage, reduce the dosage of vasoactive agent and the incidence of postoperative complications in pa-tients receiving combined cardiac valve replacement under cardiopulmonary bypass with significant protective effect on myocardium with good safety.

As the largest hospital group,performance payment distribution system directly affects the work enthusiasm of nurses.It analyzed and summarized the current 8 deficiencies and defects existing in the wage distribution.It proposed 5 measures and methods to focus on the performance payment so as to improve the enthusiasm of nurses work and promote the medical service quality and the comprehensive performance of hospitals.