ObjectiveTo evaluate pharmacological effects of Shengmai injection（SMI）on cerebral ischemia and study its neuroprotective mechanism. MethodsMale specific pathogen-free （SPF） Sprague-Dawley （SD） rats were randomly divided into a sham group， a model group， a low-dose SMI group（3 mL·kg^-1）， a middle-dose SMI group（6 mL·kg^-1）， a high-dose SMI group（12 mL·kg^-1）， and a Ginaton group（4 mL·kg^-1）according to the random number table method， with 12 rats in each group. The rat model of cerebral ischemia-reperfusion（MCAO/R）was prepared via the suture method. The administration groups were intraperitoneally injected with corresponding concentrations of SMI or Ginaton injection after reperfusion， which was conducted for 3 consecutive days. The sham group and model group were administered the equivalent volume of physiological saline. The pharmacological effects of SMI on brain injury in MCAO/R rats were evaluated by neurological function scores， cerebral infarction area， hematoxylin-eosin （HE） staining， Nissl staining， terminal deoxynucleotidyl transferase dUTP nick-end labeling （TUNEL） staining， and Western blot. The dominant link and key protein of SMI treating cerebral injury were explored using proteomic analysis. The related mechanisms of SMI were further validated using enzyme-linked immunosorbent assay （ELISA）， Western blot， and chloride ion fluorescence probe with oxygen-glucose deprivation/reoxygenation（OGD/R）-treated PC12 cells and MCAO/R rats. ResultsCompared with the sham group， the model group showed significantly increased neurological function scores， cerebral infarction area， neuronal apoptosis rate， and expression levels of apoptosis related proteins （P<0.05， P<0.01）and significantly decreased density of Nissl bodies and neurons（P<0.01）. Compared with the model group， the SMI groups exhibited significantly decreased neurological function scores， cerebral infarction area， neuronal apoptosis rate， and expression levels of apoptosis related proteins （P<0.05， P<0.01）and significantly increased density of Nissl bodies and neurons （P<0.05）. The proteomic analysis results showed that oxidative stress and inflammatory response were important processes of SMI intervening in MCAO/R injury， and the chloride intracellular channel protein 1 （CLIC1） was one of key proteins in its action network. The levels of representative indicators of oxidative stress and inflammatory response in the MCAO/R rats of the SMI groups were significantly reduced， compared with those in the model group（P<0.05， P<0.01）， and the expression levels of CLIC1 and downstream NOD-like receptor protein 3 （NLRP3） decreased （P<0.01）. In addition， the experimental results based on the OGD/R PC12 cells showed that SMI significantly increased the cell survival rate（P<0.01） and significantly decreased the intracellular chloride ion concentration（P<0.05）. ConclusionSMI has neuroprotective effects. Oxidative stress and inflammatory response are key processes of SMI intervening in MCAO/R injury. The potential mechanism is closely related to the regulation of CLIC1.

Objective To overcome the limitations of existing human respiratory syncytial virus(hRSV)animal models,such as semi-permissiveness and short duration of infection,this study established an IL2rg gene knockout(IL2rg-/-)rat model using TALEN gene editing technology.Methods The animal model was infected with hRSV intranasally.Clinical characteristics,body weight,and temperature changes were observed over the infection period(0～35 days).The total viral loads in respiratory organs,such as the nasal tissue,trachea,and lungs,were measured at various time points(4,11,20,and 35 days post-infection).Pathological analysis was conducted on target organs at the endpoint of observation(35 days post-infection).Changes in peripheral blood T,B,NK,and NKT cells and various cytokines were assessed at various time points(4,20,and 35 days post-infection).Results(1)IL2rg/-knockout rats sustained high viral loads in the nasal cavity upon intranasal inoculation with hRSV.The average peak titer rapidly reached 1 × 1010 copies/g in nasal tissue and 1 × 107 copies/g up to 5 weeks post-infection.(2)However,no significant pathological changes were noted in nasal,tracheal,or lung tissues.(3)An increase was observed in the content of peripheral blood B cells in hRSV-infected IL2rg--rats.(4)IL-6 and MCP-1 were increased in the early stage of infection and then decreased at the end of the observation period.Conclusions This study established a new IL2rg-/-rat model using TALEN technology and found that this model effectively supported high-level replication and long-term infection of hRSV,providing a good basis for antiviral drug screening and in vivo efficacy evaluation of anti-hRSV antibodies.

【Objective】 To investigate the characteristics of HIV-1 infection among voluntary blood donors in Huzhou City from 2016 to 2022. 【Methods】 A total of 233 552 voluntary blood donors in Huzhou, Zhejiang from January 2016 to December 2022 were retrospectively analyzed. Blood donors who were qualified for health examination were required to take EDTA-K2 anticoagulant blood samples by bypass during blood donation. Enzyme-linked immunosorbent assay (ELISA) was used for initial screening and re-examination of HIV antigen / antibody. The results were determined in strict accordance with the criteria in National AIDS Testing Technical Specification(2015 Revision). HIV-1 antibody-positive samples were detected by HIV-1 new infection enzyme immunoassay kit, and the restricted antigen affinity method was used to detect whether the samples were new infections. Samples with CD4 cells > 200 / L and the viral load > 1 000 copies / mL were defined as new infection. The positive rate of HIV-1 antibody in each year was compared. With the positive rate of HIV-1 antibody used as the base, the incidence of new HIV-1 infections among subgroups of HIV-1 antibody positive patients of different types (gender, age, occupation, etc.) was compared. 【Results】 From 2016 to 2022, there were 233 552 blood samples from voluntary blood donors in Huzhou, including 15 HIV-1 antibody positive samples, with infection rate of 6.42/100 000, among which 40.00% were newly infected and 60.00% were previously infected. From 2016 to 2022, the HIV-1 infection rate showed a downward trend year by year as 1.62%, 1.24%, 0.63%, 0.31%, 0.30%, 0.28% and 0.27%, respectively. The comparision of new infection rate of HIV-1 in different subgroups of 15 HIV-1 antibody positive patients showed that the new infection rate of HIV-1 in repeated blood donation subgroup was higher than that in the first-time blood donation subgroup, with no statistical difference(P>0.05). The incidence of new HIV-1 infections in males was higher than that in females, but there was no statistically significant difference between groups (P>0.05). Among HIV-1 antibody positive blood donors with different educational backgrounds, the proportion of newly infected individuals with junior high school or below was relatively high, but there was no difference compared to other educational subgroups (P>0.05). There was no statistically significant difference in the incidence of new HIV-1 infections among different occupational subgroups (P>0.05). 【Conclusion】 In recent years, the incidence of HIV-1 new infections in Huzhou has decreased year by year, and there is no obvious distribution characteristics of new infections in the subgroups of first-time blood donation and repeated blood donation subgroups, as well as subgroups of different genders, educational backgrounds and occupations.

To explore the general clinical features and treatment outcomes of patients with AIDS-related diffuse large B-cell lymphoma (AIDS-DLBCL) and provide a theoretical basis for diagnosis and treatment, survival prognosis, prevention and management of AIDS-DLBCL patients. AIDS-DLBCL patients who received combined antiretroviral therapy (cART) at Changsha First Hospital from January 2017 to January 2020 were selected in this study. The survival curves were plotted using the Kaplan-Meier method, and the Cox proportional hazards regression model was used to analyze the association between AIDS-DLBCL specific variables and progression-free survival and overall survival. Correlation analysis was conducted based on the clinical features of the patients. A total of 50 AIDS-DLBCL patients were included. Their median age ( Q 1, Q 3) was 52 (44, 59) years, of whom 46 (92%) were male. About 20 (40%) patients received treatment with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), while 23 patients (46%) received treatment with rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP). Survival curve analysis showed that the 2-year progression-free survival rate and overall survival rate of AIDS-DLBCL patients were 56.9% and 61.6%, respectively. Patients with RCHOP protocol combined with EBV-DNA≥1 000 copies/ml had higher progression-free survival rate (χ 2=3.844, P=0.043) and overall survival rate (χ 2=4.662, P=0.031) than those with CHOP protocol combined with EBV-DNA≥1 000 copies/ml. A multivariate analysis showed that male ( HR=2.70, 95% CI:1.10-6.80), EB viral load≥1 000 copies/ml ( HR=1.75, 95% CI:1.12-2.84), HIV-RNA≥200 copies/ml ( HR=4.64, 95% CI: 1.73-12.15), ECOG PS score of 2 to 4 points ( HR=3.54, 95% CI:1.62-7.33), and international prognostic index (IPI) score of 3 to 5 points ( HR=5.21, 95% CI:1.39-20.14) were at a higher risk of disease progression. Patients with EB viral load≥1 000 copies/ml ( HR=0.07, 95% CI:0.05-0.93) on the RCHOP regimen had a small risk of disease progression. Males ( HR=2.87, 95% CI:1.65-9.17), EB viral load≥1 000 copies/ml ( HR=1.61, 95% CI:4.02-9.36), HIV-RNA≥200 copies/ml ( HR=1.19, 95% CI:1.58-2.74), ECOG PS score of 2 to 4 ( HR=6.42, 95% CI:2.55-14.33), IPI score of 3 to 5 points ( HR=2.78, 95% CI:1.41-12.96) had a high risk of mortality. Patients with EB viral load≥1 000 copies/ml ( HR=0.24, 95% CI:0.64-0.90) on the RCHOP regimen had a low risk of mortality. In summary, males, ECOG physical status score of 2 to 4 points, IPI score of 3 to 5 points, EB viral load≥1 000 copies/ml and HIV viral load≥200 copies/ml are risk factors affecting progression-free survival and overall survival of AIDS-DLBCL patients. RCHOP regimen combined with EB viral load≥1 000 copies/ml is a protective factor affecting progression-free survival and overall survival in AIDS-DLBCL patients.

Objective To explore the clinical efficacy of low molecular weight heparin combined with insulin in the treatment of hyper-triglyceridemic-acute pancreatitis(HTG-AP).Methods A total of 106 patients diagnosed with HTG-AP who were admitted to the department of gastroenterology of Huaibei People's Hospital from May 2022 to July 2023 were selected as the research objects.According to the random number table method,the low-molecular heparin group(35 cases,received a 5 000 U subcutaneous injection low-molecular heparin once every 12 hours for 6 days),the insulin group(35 cases,received intravenous insulin pumping at a rate of 2 U/h,with careful monitoring of the patient's random blood glucose levels to prevent hypoglycemia),and the combination therapy group(36 cases,received both low-molecular heparin and insulin).Before treatment and at 1,2,and 6 days after treatment,the difference of serum triacylglycerol(TG),total cholesterol(TC),blood amylase,inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6)],calcium ions,and creatinine levels among the three groups were compared.The modified computed tomography severity index(MCTSI)scores,acute physiology and chronic health evaluationⅡ(APACHEⅡ),hospital length of stay,and hospital costs before and after 6 days of treatment were observed.Results After treatment,the TC of all three groups significantly decreased compared to before treatment(P<0.05),but there was no significant difference among the three groups.The calcium ion levels of the three groups did not show a statistically significant difference before and after treatment.After 6 days of treatment,the creatinine levels of the three groups significantly decreased compared to before treatment,but there was no significant difference among the three groups.After 2 days of treatment,serum TG levels were significantly lower in the combination therapy group and insulin group compared to the low-molecular heparin group(mmol/L:4.6±1.7,4.4±1.8 vs.5.6±2.0,both P<0.05).However,there was no statistically significant difference between the combination therapy group and the insulin group.After 6 days of treatment,the combination therapy group showed significantly lower levels of serum TG,blood amylase,CRP,and IL-6 compared to the insulin group and the low-molecular heparin group[TG(mmol/L):2.8±1.9 vs.4.3±1.9,5.0±2.2,blood amylase(U/L):36.0(32.0,45.0)vs.59.0(43.0,71.0),52.0(45.0,64.0),CRP(mg/L):12.9(8.8,29.7)vs.35.3(21.7,50.3),31.4(23.0,45.1),IL-6(ng/L):15.4(9.8,23.5)vs.25.6(16.4,51.5),32.9(14.7,41.4),all P<0.05].After 6 days of treatment,the APACHEⅡscores of all three groups decreased significantly(all P<0.05).The MCTSI scores of the insulin group and the combined treatment group also decreased significantly compared to before treatment.Furthermore,the MCTSI and APACHEⅡscores of the combination therapy group were significantly lower than those of the low-molecular heparin group and the insulin group(MCTSI score:2.3±0.7 vs.3.3±1.7,2.9±1.3,APACHEⅡscore:1.3±1.2 vs.2.5±2.4,2.6±2.5,all P<0.05).The combination therapy group had significantly lower length of hospital stay and treatment cost compared to the low molecular heparin and insulin groups[length of hospital stay(days):6.9±1.6 vs.8.8±3.4,8.5±2.8,and cost of treatment(yuan):6 040.5(5 239.4,7 105.9)vs.6 696.4(5 791.5,11 026.2),6 918.5(6 087.9,10 080.8),all P<0.05].Conclusions The combination of low-molecular heparin and insulin treatment can significantly reduce serum TG and inflammatory factor levels,as well as the severity and duration of the disease.This approach can also reduce the cost of treatment.Therefore,it is worth promoting and applying in clinical settings.

Objective To construct and apply a multidrug-resistant bacteria information management system,and evaluate its effectiveness and accuracy in the management of patients with multidrug-resistant bacteria infection.Methods A system construction team was established to develop a multidrug-resistant bacteria information management system,which includes 4 modules:early warning,execution,monitoring,and statistical decision-making.Patients with positive detection of multidrug-resistant bacteria admitted to a tertiary A obstetrics and gynecology hospital in Zhejiang Province from January to December 2022,members of the system construction team,and clinical medical staff were selected as the research subjects.The execution efficiency of multidrug-resistant bacteria management,as well as the system's accuracy,usability,and satisfaction were compared before(January to June 2022)and after(July to December 2022)the application of the system.Results After the implementation of the system,the immediate feedback rate of multidrug-resistant bacteria early warning information increased from 62.87％to 89.78％;the rate of issuing isolation medical orders rose from 61.07％to 93.33％;the accuracy of the implementation of isolation measures for patients increased from 66.67％to 98.01％;all differences are statistically significant(P＜0.001).The accuracy rate of the system in making decisions is 88.44％;the usability score given by medical staff for the system is 44.04 points,and the satisfaction score of the system construction team members and medical staff to the system is 121.25 points,both at a high level.Conclusion The multidrug-resistant information management system is equipped with features such as immediate alerts,multi-channel notifications,infection control department supervision,and auxiliary decision-making,which can provide medical staff with accurate decision reports.Preliminary application results show that the system has a high level of accuracy and good usability.

To explore the general clinical features and treatment outcomes of patients with AIDS-related diffuse large B-cell lymphoma (AIDS-DLBCL) and provide a theoretical basis for diagnosis and treatment, survival prognosis, prevention and management of AIDS-DLBCL patients. AIDS-DLBCL patients who received combined antiretroviral therapy (cART) at Changsha First Hospital from January 2017 to January 2020 were selected in this study. The survival curves were plotted using the Kaplan-Meier method, and the Cox proportional hazards regression model was used to analyze the association between AIDS-DLBCL specific variables and progression-free survival and overall survival. Correlation analysis was conducted based on the clinical features of the patients. A total of 50 AIDS-DLBCL patients were included. Their median age ( Q 1, Q 3) was 52 (44, 59) years, of whom 46 (92%) were male. About 20 (40%) patients received treatment with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), while 23 patients (46%) received treatment with rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone (RCHOP). Survival curve analysis showed that the 2-year progression-free survival rate and overall survival rate of AIDS-DLBCL patients were 56.9% and 61.6%, respectively. Patients with RCHOP protocol combined with EBV-DNA≥1 000 copies/ml had higher progression-free survival rate (χ 2=3.844, P=0.043) and overall survival rate (χ 2=4.662, P=0.031) than those with CHOP protocol combined with EBV-DNA≥1 000 copies/ml. A multivariate analysis showed that male ( HR=2.70, 95% CI:1.10-6.80), EB viral load≥1 000 copies/ml ( HR=1.75, 95% CI:1.12-2.84), HIV-RNA≥200 copies/ml ( HR=4.64, 95% CI: 1.73-12.15), ECOG PS score of 2 to 4 points ( HR=3.54, 95% CI:1.62-7.33), and international prognostic index (IPI) score of 3 to 5 points ( HR=5.21, 95% CI:1.39-20.14) were at a higher risk of disease progression. Patients with EB viral load≥1 000 copies/ml ( HR=0.07, 95% CI:0.05-0.93) on the RCHOP regimen had a small risk of disease progression. Males ( HR=2.87, 95% CI:1.65-9.17), EB viral load≥1 000 copies/ml ( HR=1.61, 95% CI:4.02-9.36), HIV-RNA≥200 copies/ml ( HR=1.19, 95% CI:1.58-2.74), ECOG PS score of 2 to 4 ( HR=6.42, 95% CI:2.55-14.33), IPI score of 3 to 5 points ( HR=2.78, 95% CI:1.41-12.96) had a high risk of mortality. Patients with EB viral load≥1 000 copies/ml ( HR=0.24, 95% CI:0.64-0.90) on the RCHOP regimen had a low risk of mortality. In summary, males, ECOG physical status score of 2 to 4 points, IPI score of 3 to 5 points, EB viral load≥1 000 copies/ml and HIV viral load≥200 copies/ml are risk factors affecting progression-free survival and overall survival of AIDS-DLBCL patients. RCHOP regimen combined with EB viral load≥1 000 copies/ml is a protective factor affecting progression-free survival and overall survival in AIDS-DLBCL patients.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

Pulmonary hypertension(PH)is a progressive disease characterized by pulmonary vascular remodeling.Current treatments for PH remain suboptimal,and there is an urgent need to better decipher the underlying pathomechanisms to identify new therapeutic targets.MicroRNA(miRNA)are key components in the post-transcriptional machinery that mediates cellular functions and mainly act by regulating the expression of downstream target genes.Numerous in vivo and in vitro studies have demonstrated the involvement of miRNA and their regulators in PH development.However,there is no unified model for the mechanism of miRNA's regulation of pulmonary vascular remodeling.Therefore,this article provides a review on the mechanisms of miRNA in PH characterized in recent years.

Objective:To explore the effect of getting out of bed activity 6 hours after silicone breast augmentation surgery on the comfort of patients.Methods:From May 2019 to August 2020, 84 female patients aged 20-37 (28.34±6.27) years who underwent silicone breast augmentation surgery at the Department of Plastic Surgery and Cosmetology at the Second People′s Hospital of Guangdong Province were randomly divided into a control group and an observation group, with 42 patients in each group, using a random number table method. The control group got out of bed 24 hours after surgery, while the observation group got out of bed 6 hours after surgery. The chest drainage and fixation patency, comfort, silicone prosthesis displacement, and incision bleeding rate between the two groups of patients were compared 24 hours after surgery.Results:The extraction time of the thoracic drainage tube in the observation group was (82.64±11.78 hours), which was shorter than that in the control group (90.67±12.44 hours), and the difference was statistically significant ( t=5.369, P<0.01). The comfort scores of the observation group patients at 6 hours after surgery (95.07±4.14) and 24 hours after surgery (97.52±4.07) were higher than those of the control group at 6 hours (91.14±4.03) and 24 hours (94.19±3.93), and the difference was statistically significant ( t=4.413, 3.832, both P<0.01); 7 days after surgery, there were 2 cases of silicone prosthesis displacement in the observation group, with an incidence rate of 4.76% (2/42); there were 2 cases of silicone prosthesis displacement in the control group, with an incidence rate of 4.76% (2/42); there were 6 cases of incision bleeding, with an incidence rate of 14.29% (6/42); there were 5 cases of incision bleeding in the control group, with an incidence rate of 11.90% (5/42). There was no statistically significant difference in the incidence of silicone implant displacement and incision bleeding between the two groups (χ 2=0.21, 0.10, P>0.05). Conclusions:Getting out of bed and moving around 6 hours after silicone breast augmentation surgery can help improve the patient′s physical comfort, ensure smooth fixation of the chest drainage tube, and do not increase the occurrence of incision bleeding in patients.