Objective:To delve deeply into the dynamic trajectories of cell subpopulations and the communication network among immune cell subgroups during the malignant progression of glioblastoma(GBM),and to endeavor to unearth key risk biomarkers in the GBM malignancy progression,so as to provide a more profound understanding for the treatment and prognosis of this disease by integrating tran-scriptomic data and clinical information of the GBM patients.Methods:Utilizing single-cell sequencing data analysis,we constructed a cell subgroup atlas during the malignant progression of GBM.The Mono-cle2 tool was employed to build dynamic progression trajectories of the tumor cell subgroups in GBM.Through gene enrichment analysis,we explored the biological processes enriched in genes that significant-ly changed with the malignancy progression of GBM tumor cell subpopulations.CellChat was used to identify the communication network between the different immune cell subgroups.Survival analysis helped in identifying risk molecular markers that impacted the patient prognosis during the malignant pro-gression of GBM.This methodological approach offered a comprehensive and detailed examination of the cellular and molecular dynamics within GBM,providing a robust framework for understanding the disease's progression and potential therapeutic targets.Results:The analysis of single-cell sequencing data identified 6 different cell types,including lymphocytes,pericytes,oligodendrocytes,macrophages,glioma cells,and microglia.The 27 151 cells in the single-cell dataset included 3 881 cells from the pa-tients with low-grade glioma(LGG),10 166 cells from the patients with newly diagnosed GBM,and 13 104 cells from the patients with recurrent glioma(rGBM).The pseudo-time analysis of the glioma cell subgroups indicated significant cellular heterogeneity during malignant progression.The cell interaction analysis of immune cell subgroups revealed the communication network among the different immune sub-groups in GBM malignancy,identifying 22 biologically significant ligand-receptor pairs across 12 key bio-logical pathways.Survival analysis had identified 8 genes related to the prognosis of the GBM patients,among which SERPINE1,COL6A1,SPP1,LTF,C1S,AEBP1,and SAA1L were high-risk genes in the GBM patients,and ABCC8 was low-risk genes in the GBM patients.These findings not only provided new theoretical bases for the treatment of GBM,but also offered fresh insights for the prognosis assessment and treatment decision-making for the GBM patients.Conclusion:This research comprehensively and pro-foundly reveals the dynamic changes in glioma cell subpopulations and the communication patterns among the immune cell subgroups during the malignant progression of GBM.These findings are of significant im-portance for understanding the complex biological processes of GBM,providing crucial new insights for precision medicine and treatment decisions in GBM.Through these studies,we hope to provide more ef-fective treatment options and more accurate prognostic assessments for the patients with GBM.

The Omicron family of SARS-CoV-2 variants are currently driving the COVID-19 pandemic. Here we analyzed the clinical laboratory test results of 9911 Omicron BA.2.2 sublineages-infected symptomatic patients without earlier infection histories during a SARS-CoV-2 outbreak in Shanghai in spring 2022. Compared to an earlier patient cohort infected by SARS-CoV-2 prototype strains in 2020, BA.2.2 infection led to distinct fluctuations of pathophysiological markers in the peripheral blood. In particular, severe/critical cases of COVID-19 post BA.2.2 infection were associated with less pro-inflammatory macrophage activation and stronger interferon alpha response in the bronchoalveolar microenvironment. Importantly, the abnormal biomarkers were significantly subdued in individuals who had been immunized by 2 or 3 doses of SARS-CoV-2 prototype-inactivated vaccines, supporting the estimation of an overall 96.02% of protection rate against severe/critical disease in the 4854 cases in our BA.2.2 patient cohort with traceable vaccination records. Furthermore, even though age was a critical risk factor of the severity of COVID-19 post BA.2.2 infection, vaccination-elicited protection against severe/critical COVID-19 reached 90.15% in patients aged ≽ 60 years old. Together, our study delineates the pathophysiological features of Omicron BA.2.2 sublineages and demonstrates significant protection conferred by prior prototype-based inactivated vaccines.
Humans ; Aged ; Middle Aged ; COVID-19/prevention & control* ; SARS-CoV-2 ; Pandemics/prevention & control* ; China/epidemiology* ; Disease Outbreaks/prevention & control* ; Vaccination

Objective To study the clinical efficacy of the treatment of traditional Chinese medicine combined with western medicine for extended -spectrum β-lactamase (ESBLs ) bacterial infection associated pneumonia.Methods 80 patients with ESBLs bacterial infection associated pneumonia in our hospital from January 2015 to June 2016 were randomized into the control group (western medicine routine treatment)and the observation group (treatment of traditional Chinese medicine combined with western medicine)according to the random number method,40 patients in each group.The disappearance time of clinical symptoms and signs and hospitalization time, sputum culture results,and the clinical efficacy of treatment in the two groups were compared.Results Compared with the control group,the disappearance time of cough[(6.5 ±1.3)d vs (8.2 ±1.5)d],t=4.38,P<0.05],fever [(5.1 ±1.2)d vs (6.8 ±1.4)d,t=4.19,P<0.05],pulmonary rales[(6.2 ±1.3)d vs (7.8 ±1.6)d,t=4.27,P<0.05]and the hospitalization time[(9.1 ±1.3)d vs (11.8 ±1.6)d,t=5.06,P<0.05]were significantly reduced in the observation group.Compared with the control group,the negative rates of pneumonia klebsiella (25.0% vs 8.0%,χ2 =4.30,P<0.05)and Escherichia coli (70.0%vs 60.0%,χ2 =4.75,P<0.05)in sputum were obviously increased in the observation group.Compared with the control group,the markedly effective rate of treatment was significantly improved in the observation group(92.5%vs 75.0%,χ2 =4.50,P<0.05).Conclusion The treatment of traditional Chinese medicine combined with western medicine can significantly increase the clinical efficacy of ESBLs bacterial infection associated pneumonia,improve the negative rates of sputum bacteria,and it is worthy of clinical promotion.

Objective To evaluate the value of i-Scan in the diagnosis of Barrett′s esophagus.Methods 52 patients diagnosed with Barrett′s esophagus by gastroscopies and pathological examinations were observed under the ordinary edoscopy and i-Scan respectively.Besides,the Barrett's esophageal mucosa were classified by Endo with i-scan mode, the target lesions was taken to be biopsied and pathologically examined.Results ( 1 ) In the 52 patients,mucosal lesions were found in 46 cases (88.5%) under i-Scan and 35 cases (67.3%) under ordinary edoscopy respectively,mucosal lesion detection rate in i-Scan was significantly higher than normal white mode( P<0.01).In the 33 patients which found mucosal lesions in the two modes,the definition of lesion margins,morphology of lesion cryptaeand mucosa capillaries revealed by i-Scan were superior to that by white lighted endoscopy ( P<0.05);(2) Under i-scan mode,the detection of specific intestinal metaplasia ( SIM) of typeⅣ,type V in sensitivi-ty,accuracy,specificity were respectively 90.0%,93.5%,94.4%.Conclusion i-Scan is very easy to operate and has a clear lesion of Barrett′s esophagus,which helps to target the lesion at pathological biopsy.

Objective To evaluate the synergy effect of panipenem combined sulbactam on vitro antibacterial activity of acinetobacter baumannii. Methods Forty strains of panipenem-susceptible and panipenem resistant acinetobacter bau-mannii were randomly selected respectively, and the minimum inhibitory concentration (MIC) values of panipenem and/or sulbactam were determined using microbroth dilution method and checkerboard method. The fractional inhibitory in-dex (ΣFIC) were calculated, and then the vitro combination effect of panipenem and sulbactam were determined. Re-sults Compared with the single drug group, in the combination group of panipenem and sulbactam, the MIC50 and MIC90 of panipenem-susceptible acinetobacter baumannii decreased two times in dilution, while the MIC50 and MIC90 de-creased one times in dilution in panipenem-resistant strains. For the panipenem-susceptible strains, The combination of panipenem and sulbactam demonstrated 30.0% (12/40) synergism, 45.0% (18/40) partial synergism, 15.0%(6/40) addi tive, For the panipenem-resistant strains, the synergistic effect was 10.0%(4/40), partially synergistic effect was 57.5%(23/40), the additive effect was 22.5% (9/40), and indifference effect of the two groups was 10.0% (4/40). No strain had antagonistic effect. Conclusion In vitro tests, panipenem and sulbactam combination show synergism or partial syner-gism against most acinetobacter. baumannii isolates. Compared with the alone use, the combination of panipenem and sulbactam is more effective in inhibiting the growth of acinetobacter baumannii.

The Delphi method was called into play to determine the level-1 indicator,level-2 indicator and plus-minus indicator for evaluating clinicians of various academic titles,while the ranking method was used to determine the weight of these indicators.The Chi-square test found P＞0.05,proving this indicators system as consistent for clinicians at all levels; the t test found the majority as P＞0.05,indicating the weight of level-2 indicators for dimciam of different titles as different with partial consistence.This system is proved to be scientific,comprehensive,objective and authentic in evaluating clinicians of various levels Targeted evaluation and appraisal system guarantees quality of care and medical safety,which functions as an efficient meansfor better hospital management and better quality of care,paving the wayfor reforms in income distribution system and personnel system in the hospital.

To explore how to create and optimize a promotion index system of medical quality evaluation, this article focuses on the hospital visiting process from patients, using analyzing collected those index system from couples of Grade Ⅲ hospitals in Beijing, and combining the results of literal study, field study and specialist consult, according to the different situation of general hospitals and specially hospitals, with the spirit of "maintaining the patients benefits, safeguarding the patients safety,and enhancing the medical quality", introduces the framework of the promotion index system, the rules to select the indicator, and so on, and discusses several problerns related to creating the index system.

OBJECTIVE To explore pathogens and drug resistance in ventilator-associated pneumonia caused by Acinetobacter baumannii,and to provide the corresponding clinical prevention strategies.METHODS The clinical resords and the bacterial susceptibility results of sputum cultivation in 62 cases with VAP caused by A.baumannii between from 2003 and 2006 in ICU of our hospital were reviewed.RESULTS All of the patients suffered from severe underlying diseases,the aged accounted for 77.4%.At least one kind of antibiotic was used in all cases before occurrence of VAP.30.6% of the cases had mixed infection.VAP caused by A.baumannii had the rise trend year by year.The results of bacterial susceptibility showed that A.baumannii had multiple drug resistance,but was lowly resistant to cefoperazone/sulbactam and imipenem.CONCLUSIONS The reasonable choice for antibiotic of VAP caused by A.baumannii should be based on the latest local surveillance on etiology and drug resistance.

Objective To investigate drug resistance,especially the resistance to aminoglycoside and the prevalence of the genes for aminoglycoside-modifying enzymes in Escherichia coli producing ESBLs.Methods VITEK-32 GNI+ cards and K-B methods were used to identify E.coli and detect the resistance to 18 kinds of antibiotics such as aminoglycoside and ?-lactams respectively in E.coli isolated from our hospital from January to December,2006.PCR method was used to detect the genes for aminoglycoside-modifying enzymes such as aac(3)-Ⅰ,aac(3)-Ⅱ,aac(6')-Ⅰb,aac(6')-Ⅱ,ant(3″)-Ⅰ and ant(2″)-Ⅰ in those 17 strains producing ESBLs.Results Resistance rates were 100.0%,100.0%,41.6%,100.0%,69.5%,30.5%,98.2%,81.0%,81.0%,79.6%,79.2%,34.8%,15.4%,7.1%,7.9%,5.4% and 81.0% for ampicillin,ampicillin/sulbactam,aztreonam,cefazolin,cefepime,ceftazidime,ceftriaxone,ciprofloxacin,levofloxacin,gentamicin,tobramycin,amikacin,cifoxitin,nitrofurantoin,piperacillin/tazobactam,cefoperazone/sulbactam and co-trimoxazole respectively in E.coli producing ESBLs.No drug-resistant strain imepenem was found.Positive rate was 46.4% for ESBLs.Resistance rates were 52.9%(9/17),100.0%(17/17) and 100%(17/17) for amikacin,gentamycin and tobmycin respectively in those 17 strains producing ESBLs.The most genotype for aminoglycoside-modifying enzymes was aac(3)-Ⅱ(94.1%),the second was aac(6')-Ⅰb(35.3%).The positive rates of aac(3″)-Ⅰ and ant(2″)-Ⅰ were 11.8% and 5.9% respectively.of them,one strain was resistant to aminoglycoside on phenotype,but no genes mentioned above was detected.4strains were classical on genotype,one with aac(6')-Ⅰb-Cr,the other one with a new subtype among the 6 strains of E.coli with aac(6')-Ⅰb.Conclusions Drug resistance in E.coli is rather serious.Typically,E.coli producing ESBLs shows multi-drug resistance.Positive rate for aac(3)-Ⅱ takes the first place,followed by aac(6')-Ⅰb among the genes for aminoglycoside-modifying enzymes.Aac(3″)-Ⅰand ant(2″)-Ⅰ show both lower positive rates.Aac(3)-Ⅰ and aac(6')-Ⅱ were not found.There exist at least 3 sub-types of aac(6')-Ⅰb,one kind of gene for aminoglycoside-modifying enzymes in strains of E.coli.Among those sub-types,the classical type is the main,accompanied by aac(6')-Ⅰb-Cr and its new sub-type.

OBJECTIVE To compare and analyze the drug resistance of Chryseobacterium meningosepticum which producing metallo-?-lactamase(MBL) and extended-spectrum-?-lactamases(ESBLs) from ICU patients′ and non ICU patients′ specimens of sputa so as to guide the rational application of antibiotics.METHODS Identified the strains with VITEK 32,MBL and ESBLs were also screened by double disk synergy;the antimicrobial sensitivity of clinical isolates was tested by VITEK GNS143 and the antimicrobial sensitivity was added and tested by K-B method.RESULTS As a result the rate of producing MBL of C.meningosepticum was 49.0% from ICU patients′ specimens of sputa which was higher than the rate of 13.8% from non ICU patients′;the rate of producing ESBLs of C.meningosepticum was 37.2% from ICU patients′ specimens of sputa which was higher than the rate of 30.6% from non ICU patients′;the rate of drug resistance to AMP/SUB,TZP,CEP,CIP,and LEV from ICU patients′ was higher than that from non ICU patients.CONCLUSIONS Why the high resistance rate of C.mengingosepticum in ICU patients′ specimens of sputa might be due to the high producing ?-lactamases(MBL and ESBLs).