Objective To investigate the clinical features,imaging features,diagnosis and treatment of empyema caused by Streptococcus constellatus for improving early diagnosis and treatment and reduce mortality rate.Methods The clinical data of 11 patients with empyema caused by S.constellatus who were treated in Fuding Hospital of Fujian Province from February 2021 to August 2024 were retrospectively analyzed.Results All the 11 patients were male,51 to 78 years old.Underlying disease was reported in 9 patients.The main clinical manifestations were chest tightness and dyspnea.Fever may not be present.The white blood cell count,neutrophil ratio,C-reactive protein,procalcitonin,fibrinogen and D-dimer were significantly increased in 11 patients.Chest imaging showed unilateral encapsulated effusion,more common on the right side(9/11),and sometimes accompanied by pneumothorax(2/10).The lung lobes of the same side of empyema were mostly accompanied by exudation and consolidation,and cavities were common(6/10)in the consolidation lesions.White blood cells,multinucleated cells,lactate dehydrogenase(LDH)and adenosine deaminase(ADA)were significantly increased in pleural effusion of 11 patients.The positive rate of pleural effusion culture in aerobic bottle(10/11)and anaerobic bottle(6/7)was higher than that in blood plate culture(1/7).All the 11 patients were treated with antibiotics combined with thoracentesis and drainage.Ten patients improved after treatment.One patient died of septic shock in a short time.Conclusions Drainage of pleural effusion and pleural fluid culture should be performed as soon as possible for middle-aged and elderly male patients with underlying diseases,acute or subacute onset of chest distress,dyspnea,associated with significantly increased blood inflammatory markers,and chest imaging suggesting pleural effusion.Pleural fluid can be injected into the blood culture bottle to improve the detection of S.constellatus.At the same time,antimicrobial therapy should be prescribed reasonably according to the results of antimicrobial susceptibility test.

Objective To investigate the clinical features,imaging features,diagnosis and treatment of empyema caused by Streptococcus constellatus for improving early diagnosis and treatment and reduce mortality rate.Methods The clinical data of 11 patients with empyema caused by S.constellatus who were treated in Fuding Hospital of Fujian Province from February 2021 to August 2024 were retrospectively analyzed.Results All the 11 patients were male,51 to 78 years old.Underlying disease was reported in 9 patients.The main clinical manifestations were chest tightness and dyspnea.Fever may not be present.The white blood cell count,neutrophil ratio,C-reactive protein,procalcitonin,fibrinogen and D-dimer were significantly increased in 11 patients.Chest imaging showed unilateral encapsulated effusion,more common on the right side(9/11),and sometimes accompanied by pneumothorax(2/10).The lung lobes of the same side of empyema were mostly accompanied by exudation and consolidation,and cavities were common(6/10)in the consolidation lesions.White blood cells,multinucleated cells,lactate dehydrogenase(LDH)and adenosine deaminase(ADA)were significantly increased in pleural effusion of 11 patients.The positive rate of pleural effusion culture in aerobic bottle(10/11)and anaerobic bottle(6/7)was higher than that in blood plate culture(1/7).All the 11 patients were treated with antibiotics combined with thoracentesis and drainage.Ten patients improved after treatment.One patient died of septic shock in a short time.Conclusions Drainage of pleural effusion and pleural fluid culture should be performed as soon as possible for middle-aged and elderly male patients with underlying diseases,acute or subacute onset of chest distress,dyspnea,associated with significantly increased blood inflammatory markers,and chest imaging suggesting pleural effusion.Pleural fluid can be injected into the blood culture bottle to improve the detection of S.constellatus.At the same time,antimicrobial therapy should be prescribed reasonably according to the results of antimicrobial susceptibility test.

Objective To construct a uricase-deficient mouse model with stable inheritance using the CRISPR/Cas9 system,and evaluate its ability to simulate the disease characteristics of patients with hyperuricemia.Methods Double single guide RNAs(sgRNAs)were designed on both sides of exon 2～4 of the Uox gene.sgRNA and Cas9 mRNA for gene knockout were microinjected into the fertilized eggs of mice.After culture for 2～4 h,the embryos were transferred to surrogate mother mice to produce an F0 generation.Uox-knockout mice were identified by polymerase chain reaction and sequencing analysis.Positive mice were then mated with wild-type(WT)mice to produce an F1 generation,and heterozygous female and male F1 mice were then selected to obtain homozygous F2 mice.Serum and urine levels of uric acid,creatinine,and urea,and serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels were detected and compared between homozygous and wild-type mice.Pathological changes in kidney and liver tissues were observed by hematoxylin and eosin and Masson staining.Results Urine levels of serum uric acid(male:(4116.8±1928.1)μmol/L,P＜0.001;female:(2998.0±547.7)μmol/L,P＜0.01)and serum levels of uric acid(male:(478.4±114.6)μmol/L,P＜0.001;female:(507.7±129.6)μmol/L,P＜0.001),creatinine((91.8±55.6)μmol/L,P＜0.001),urea((28.6±13.9)mmol/L,P＜0.05),ALT((53.3±23.3)U/L,P＜0.01),and AST((203.3±70.3)U/L,P＜0.001)were significantly increased in Uox-/-mice compared with WT mice.Histopathological examination showed moderate hepatocyte degeneration in the liver,moderate-to-severe tubular cystic dilation,degeneration,and fibrosis in the kidney,glomerular hypertrophy and hyperplasia,small-vessel dilation and congestion,and infiltration of stromal monocytes and lymphocytes in Uox-/-mice.Conclusions We successfully established a homozygous uricase-deficient mouse strain using CRISPR/Cas9 technology,as a suitable animal model for research in the field of hyperuricemia.

Objective To construct a uricase-deficient mouse model with stable inheritance using the CRISPR/Cas9 system,and evaluate its ability to simulate the disease characteristics of patients with hyperuricemia.Methods Double single guide RNAs(sgRNAs)were designed on both sides of exon 2～4 of the Uox gene.sgRNA and Cas9 mRNA for gene knockout were microinjected into the fertilized eggs of mice.After culture for 2～4 h,the embryos were transferred to surrogate mother mice to produce an F0 generation.Uox-knockout mice were identified by polymerase chain reaction and sequencing analysis.Positive mice were then mated with wild-type(WT)mice to produce an F1 generation,and heterozygous female and male F1 mice were then selected to obtain homozygous F2 mice.Serum and urine levels of uric acid,creatinine,and urea,and serum alanine aminotransferase(ALT)and aspartate aminotransferase(AST)levels were detected and compared between homozygous and wild-type mice.Pathological changes in kidney and liver tissues were observed by hematoxylin and eosin and Masson staining.Results Urine levels of serum uric acid(male:(4116.8±1928.1)μmol/L,P＜0.001;female:(2998.0±547.7)μmol/L,P＜0.01)and serum levels of uric acid(male:(478.4±114.6)μmol/L,P＜0.001;female:(507.7±129.6)μmol/L,P＜0.001),creatinine((91.8±55.6)μmol/L,P＜0.001),urea((28.6±13.9)mmol/L,P＜0.05),ALT((53.3±23.3)U/L,P＜0.01),and AST((203.3±70.3)U/L,P＜0.001)were significantly increased in Uox-/-mice compared with WT mice.Histopathological examination showed moderate hepatocyte degeneration in the liver,moderate-to-severe tubular cystic dilation,degeneration,and fibrosis in the kidney,glomerular hypertrophy and hyperplasia,small-vessel dilation and congestion,and infiltration of stromal monocytes and lymphocytes in Uox-/-mice.Conclusions We successfully established a homozygous uricase-deficient mouse strain using CRISPR/Cas9 technology,as a suitable animal model for research in the field of hyperuricemia.

Objective:To explore the risk factors for post-stroke anxiety and depression, and analyze the therapeutic effect of Jiangqi Dayu Decoction on on post-stroke anxiety and depression.Methods:A total of 201 patients with post-stroke anxiety and depression admitted to the Wuhan First Hospital from October 2019 to October 2022 were selected and included in the anxiety and depression group. They were randomly divided into a control group ( n=100, treated with conventional western medicine) and an observation group ( n=101, treated with Jiangqi Dayu decoction on the basis of conventional western medicine) using a random number table method. The clinical efficacy, Hamilton Anxiety Scale (HAMA) scores, Hamilton Depression Scale (HAMD) scores, norepinephrine (NE), brain derived neurotrophic factor (BDNF), 5-hydroxytryptamine (5-HT), and adverse reactions were compared between the control group and the observation group. During the same period, 50 patients without anxiety and depression after stroke were selected and included in the non anxiety and depression group. The general information and laboratory indicators of patients in the non anxiety and depression group were compared with those in the anxiety and depression group. Univariate and multivariate logistic regression models were used to analyze the risk factors for anxiety and depression after stroke. Results:The total effective rate of clinical efficacy in the observation group was significantly higher than that in the control group (95.05% vs 76.00%) ( P<0.05). After treatment, the HAMA and HAMD scores of both groups were lower than before treatment (all P<0.05), and the serum levels of BDNF, NE, and 5-HT were higher than before treatment (all P<0.05); After treatment, the HAMA and HAMD scores of the observation group were lower than those of the control group (all P<0.05), and the serum levels of BDNF, NE, and 5-HT were higher than those of the control group (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P>0.05). The age, proportion of females, National Institutes of Health Stroke Scale (NIHSS) score, proportion of family care<7, and number of comorbidities>2 were significantly higher in the anxiety and depression group than those in the non anxiety and depression group (all P<0.05). The education level and per capita monthly income of families were significantly lower than those in the non anxiety and depression group (all P<0.05). The body mass index (BMI), smoking history, drinking history, white blood cells, total cholesterol, and glycated hemoglobin of both groups were significantly higher There was no statistically significant difference in disease type and stroke site (all P>0.05). The multivariate logistic regression model showed that high NIHSS score, low per capita monthly income, female gender, family care score<7 points, and the number of comorbidities>2 were risk factors for post-stroke anxiety and depression (all P<0.05). Conclusions:NIHSS score, per capita monthly income of families, gender, family care level, and the number of comorbidities can all affect the occurrence of post-stroke anxiety and depression. Jiangqi Dayu decoction has a good therapeutic effect on patients with post-stroke anxiety and depression, helping to improve anxiety and depression symptoms. It upregulates NE, BDNF, and 5-HT levels, has high safety, and is worth promoting.

Objective:To investigate the clinical characteristics of bipolar disorder patients who present with depressive symptoms at their first episode.Methods:A total of 1 600 bipolar disorder patients with the first episode of depression who participated in the clinical pathway survey of bipolar disorder were included in this study. Demographic data, clinical phenotype, and symptomatic characteristics when they presented with their first mania were described. One-way analysis of variance was applied to compare the clinical characteristics between patients who visited the general hospitals and the ones who visited the mental health centers, and chi-square test was applied to compare symptomatology of patients at the first hypomania/mania episode and their mania relapse.Results:The average time from the first depressive episode to the first hypomanic/manic episode was 3.63 years. It took an average of 1.83 years from the first hypomanic/manic episode to the diagnosis of bipolar mania, and only 45.4% (728 cases) were diagnosed as bipolar disorder when they presented with depression at their first episode; It was an average of 5.45 years from the first depressive episode to the diagnosis of bipolar disorder; There were statistically significant differences in the number of previous depressive episodes ( F=7.119, P=0.008) and the total number of previous episodes ( F=3.980, P=0.046) between bipolar disorder patients seen in the mental health centres and general hospitals. The top three symptoms of the first manic episode were mood elation (83%, 215 cases); increased activity (81.5%, 211 cases); increased speech (79.9%, 207 cases). Compared with recurrent manic episodes, patients at their first manic episode were more likely to report more gregarious (χ2=13.277, P<0.01), eloquent/humorous (χ2=10.665, P=0.001), and less likely to report excessive use of psychoactive substances (χ2=3.990, P=0.046). Conclusions:It takes a long time for the diagnosis of bipolar disorder who presents with the depressive mood in their first episode. The first manic episode is not easy to identify, and the patients treated in general hospitals have more frequent depressive episodes, while the first manic episode shows some different symptoms from the recurrent manic episodes.

Objective:To investigate the clinical characteristics of bipolar disorder patients who present with depressive symptoms at their first episode.Methods:A total of 1 600 bipolar disorder patients with the first episode of depression who participated in the clinical pathway survey of bipolar disorder were included in this study. Demographic data, clinical phenotype, and symptomatic characteristics when they presented with their first mania were described. One-way analysis of variance was applied to compare the clinical characteristics between patients who visited the general hospitals and the ones who visited the mental health centers, and chi-square test was applied to compare symptomatology of patients at the first hypomania/mania episode and their mania relapse.Results:The average time from the first depressive episode to the first hypomanic/manic episode was 3.63 years. It took an average of 1.83 years from the first hypomanic/manic episode to the diagnosis of bipolar mania, and only 45.4% (728 cases) were diagnosed as bipolar disorder when they presented with depression at their first episode; It was an average of 5.45 years from the first depressive episode to the diagnosis of bipolar disorder; There were statistically significant differences in the number of previous depressive episodes ( F=7.119, P=0.008) and the total number of previous episodes ( F=3.980, P=0.046) between bipolar disorder patients seen in the mental health centres and general hospitals. The top three symptoms of the first manic episode were mood elation (83%, 215 cases); increased activity (81.5%, 211 cases); increased speech (79.9%, 207 cases). Compared with recurrent manic episodes, patients at their first manic episode were more likely to report more gregarious (χ2=13.277, P<0.01), eloquent/humorous (χ2=10.665, P=0.001), and less likely to report excessive use of psychoactive substances (χ2=3.990, P=0.046). Conclusions:It takes a long time for the diagnosis of bipolar disorder who presents with the depressive mood in their first episode. The first manic episode is not easy to identify, and the patients treated in general hospitals have more frequent depressive episodes, while the first manic episode shows some different symptoms from the recurrent manic episodes.

Objective To explore the feasibility of establishing a tree shrew model of chronic gastrointestinal mucosal injury. Methods A total of 12 adult male tree shrews were randomly divided into 3 groups. The experimental groups 1 and 2 were administered with intraperitoneal injection of 2 mg/(kg·d)and 1 mg/(kg·d)of 1-methyl-4-phenyl-1,2, 3,6-tetrahydropyridine(MPTP)once every day for 56 days, respectively. The control group was given the same volume of sterile saline at the corresponding time points. Changes in the body weight of the tree shrews were observed. The contents of dopamine in the cerebrospinal fluid were detected. Gastrointestinal morphology was observed by stereoscope and histopathological changes of the gastrointestinal mucosa were examined by HE staining. Results The body weight and the contents of dopamine in the cerebrospinal fluid of the tree shrews in the model group were significantly decreased(P< 0.05 for both). Pathological changes to some extent of the gastric antrum, the gastric body and the duodenum were observed, without obvious differences between the 2 mg/kg group and the 1 mg/kg group. No obvious changes were found in the control group. Conclusions Long-term intraperitoneal injection with a low dose of MPTP is a feasible method for the establishment of a tree shrew model of chronic gastrointestinal mucosal injury. The optimal dose is 2 mg/(kg·d)every day for 56 days.

Objective To establish a safe and effective method of rhesus monkey biopsy to take liver and kidney samples under B-mode ultrasound guidance. Methods A total of 4 adult monkeys(weight:8-12 kg; sex: male; age:11 -12 years old)were anaesthetized with 5 -10 mg/kg of ketamine hydrochloride for each through intramuscular injection. After successful anesthesia, abdominal shaving and iodophor disinfection, they were monitored from intercostal area of right upper quadrant or lateral waist subcostal abdomen portions to find liver or kidney organ by MyLab 30CV B-mode ultrasonography with 3.5 Hz transducer which was fixed with a guiding frame. Large vessels such as the portal vein and inferior vena cava were carefully avoided. The range of the biopsy gun was set to 15 mm. When the puncture target and the puncture needle were positioned in the guide line, the puncture target was perpendicular to the puncture needle, and then the trigger button of the puncture needle was pressed to obtain the liver or kidney tissue samples respectively. After puncture,the needle was pulled out quickly. The obtained liver and kidney tissues were used to extract RNA. Results About 13 mg of liver or kidney tissue was obtained by each puncture with volume convertion. This method was fast,reliable and safe,and the total RNA had high purity and integrity. There was no postoperative bleeding and infection. Conclusions This is a very important method for obtaining liver and kidney tissue samples of rhesus monkeys with the guidance of ultrasound. With this method, the research cost can be reduced, the life quality and animal welfare of laboratory non-human primates can be improved,and the accuracy of experimental result can be ensured.

Objective To provide reference values for bone mineral density(BMD)in different skeletal regions of female Wistar rats at different ages. Methods Thirty SPF female Wistar rats were selected. The BMD of different skeletal regions(skull,upper limbs,thighs,trunk,ribs,pelvis,spine and the whole body)was measured by dual energy X-ray absorptiometry(DXA)at 6,10,12,24 and 30 months of age. The bone mineral densities between different age groups and that of different skeletal regions in the same age groups were compared. Results The BMD of the skull,upper limbs,thighs,trunk,ribs,pelvis, spine and the whole body was increased rapidly with age, and reached a peak at 10 months of age. The BMD of the skull,upper limbs,thighs,trunk,ribs were significantly higher than the whole body BMD in the same month-age group(P< 0.05 or P< 0.01). However,there was no significant difference between the pelvic, spine and the whole body BMD(P> 0.05). There was a significant positive correlation among the three correlations(P<0.01). Conclusions Some background data are provided for the bone biology studies of female Wistar rats, and provide useful supplementary reference for the studies of bone metabolism in rats and their application in biomedicine.