Objective To discuss the significance and feasibility of infodemiology researches in hospital library.Methods This paper analyzed the background,significance,advantages,constraints,research direction and themes of the hospital library's researches on infodemiology.Results Hospital library had the advantages of disciplinary background and convenient resources to carry out researches on infodemiology,and can carry out researches in many aspects such as network health information evaluation,network health information monitoring,medical intervention measures evaluation,public opinion analysis and management.Conclusion It is feasible for hospital libraries to carry out infodemiology researches to promote their own transformation and to help hospital make decisions.

Objective To use metabolomics method to study the metabolic profiles of amino acids and lysophosphatidylcholine(LPC)in the serum of rats with nonalcoholic fatty liver disease(NAFLD),to identify biomarkers for NAFLD,and to speculate on the possible mechanism responsible for its occurrence.Methods NAFLD rats were prepared by feeding a high-fat diet and intraperitoneal injection of carbon tetrachloride.Levels of 15 LPCs and 18 amino acids in the serum were determined in control and NAFLD rats by liquid chromatography-mass spectrometry.Changes in serum LPC and amino acid metabolic profiles in NAFLD rats were analyzed by principal component analysis and orthogonal partial least squares discriminant analysis.Correlations between biomarkers and NAFLD were analyzed by Pearson's correlation analysis.Results The metabolic profiles of serum LPC and amino acids differed significantly between the NAFLD group and the control group and were completely distinct.LPC(20∶1),arginine,and glutamic acid had significant contributions to NAFLD and were identified as biomarkers.Furthermore,LPC(20∶1)and arginine were significantly correlated with serum biochemical indicators such as aspartate transaminase,alanine transaminase,low-density lipoprotein,and total bilirubin.Conclusions The metabolic profiles of serum LPC and amino acids may be closely related to NALFD.

Objective To investigate the effect of Angelica polysaccharide(APS)on the differentiation and function of M2 macrophages and underlying molecular mechanism.Methods Mouse bone marrow derived macrophages(BMDM)and M2 macrophages were induced and treated with APS(0,80,160,320 μg/mL);Mouse peritoneal macrophages were isolated and treated with APS(0,160 μg/mL).Flow cytometry(FCM)was used to detect mannose receptor(MR),CD11b,F4/80,CD163,and ARG-1 expression levels,apoptosis,and phagocytic ability of M2 macrophages and peritoneal macrophages.Mice were randomly divided into APS gavage group and control group,APS was intragastrically administered to mice,and macrophage MR expression level in blood and spleen were detected by FCM.Fluorescence microscopy was used to observe the morphology of BMDM-differentiated M2 macrophages.RT-qPCR was employed to detect the mRNA expression levels of MR and ARG-1 in M2 macrophages.Immunofluorescence assay was performed to detect the expression of the proteins related to molecular mechanism of differentiation and function of M2 macrophages.Results Compared with the 0 μg/mL APS group,the MR expression level in the M2 macrophages was decreased with the increase of APS concentration within a certain concentration range(80～320 μg/mL),and the MR expression level in peritoneal macrophages was also decreased in the 160 μg/mL APS treatment group(P＜0.01).The expression level of macrophage MR was also significantly decreased in peripheral blood and spleen in the APS gavage mice than the control group(P＜0.05).Compared with the 0 μg/mL APS group,the expression levels of CD11b,F4/80,and CD163 in the macrophages were increased in the 80～320 μg/mL APS treatment groups(P＜0.01).The morphology of macrophage had changed,from mostly spindle-shaped and pseudopodia to mostly round or irregular,and even a few cells with pseudopodia.APS induced apoptosis in M2 macrophages(P＜0.05).Compared with the 0 μg/mL APS group,M2 macrophages treated with 160 μg/mL APS had an increased ability to phagocytose fluorescent microspheres(P＜0.01),but the expression level of ARG-1 was decreased(P＜0.01).The mRNA expression of MR and ARG-1 in M2 macrophages was decreased(P＜0.05).The mean fluorescence intensity of phosphate acidified-signal transducers and activators of transcription 6(p-STAT6)-positive signals in M2 macrophages was significantly reduced in the 160 μg/mL APS-treated group(P＜0.05).Conclusion APS has bidirectional regulation on the differentiation and function of M2 macrophages,which may be associated with its downregulation of signal transducers and activators of transcription 6(STAT6)signaling pathway.

Myeloid-derived suppressor cells (MDSCs) are a heterogeneous cell population of myeloid origin with immunosuppressive function. MDSCs can inhibit the normal immune response of the host to tumor by inhibiting the activity of T cells, natural killer cells, macrophage, B cells, and promoting the proliferation of Treg and other mechanisms. Therefore, MDSCs are potential targets for tumor immunotherapy. However, whether immunotherapy or other treatments, the effectiveness of monotherapy is limited, so immunotherapy combined with other treatments is a breakthrough combination. In recent years, immunotherapy combined with other treatments has shown initial results, with better results than monotherapy. It has become a research hotspot in tumor treatment and a new treatment method in the future. This article summarized the research progress on the effects of immunotherapy combined with chemotherapy, radiotherapy, Chinese herbal extract and Immunotherapy combination on MDSCs, in order to provide theoretical support for the clinical application of immunotherapy based combined tumor treatment measures.

Objective To investigate the prevalence of pulmonary fungal infection and drug resist-ance of the pathogenic fungi among children with severe diseases in pediatric intensive care unit(PICU). Methods From July 2013 to June 2017,the complete clinical data,results of fungal culture and drug sensi-tivity of bronchoalveolar lavage fluid in 112 critically ill children with pulmonary fungus infection of PICU hospitalization in our hospital were collected. Samples of peripheral venous blood were collected meantime, including blood routine examination,C reactive protein,G test and GM test. Results One hundred and twen-ty-six fungi were isolated from sputum samples in 112 critically ill children. Severe pulmonary infection (30. 36%,34/112) was the most common form of the primary diseases, the next were severe sepsis (16. 07%,18/112)and severe malnutrition(15. 18%,17/112). Classified based on age difference,the first one was ＜1 year old (43. 75%,49/112),the second one was 1 to 3 years old(29. 46%,33/112). The fun-gal strains were predominantly Candida albicans (61. 90%) and Candida tropicalis (16. 67%),among the infectious cases 14 were diagnosed as mixed infection. Two cases of 3 cryptococcal infectious children were HIV infection,another one was malignant tumor,Cryptococcus was cultured in both sputum,pleural effusion and cerebrospinal fluid. The drug resistance rate of fluconazol in 126 strains of fungi was 12. 70%,the rate of itraconazole was 7. 14%. Generally,the fungi cultured were with very low resistance to 5-fluorocytosine,vori-conazole and amphotericin B. However,the strains of Aspergillus fumigates,Candida kruse,Candida parapsi-losis and Cryptococcus were highly resistant to fluconazol and itraconazole,but with very low resistance to 5-fluorocytosine and amphotericin B. Conclusion Candida albicans is the main pathogenic fungus of pulmo-nary fungal infection among children in PICU,and we could choose voriconazole and amphotericin B as treat-ment of critically ill children with pulmonaty fungal infection.

Objective To explore the role and effectiveness of flexible fiberoptic brochoscopy ( FFB) in critically ill children with continuous invasive respiratory support. Methods From July 2014 to June 2017,135 critically ill children with severe pneumonia had received continuous invasive respiratory sup-port and undergone FFB in the pediatric intensive care unit( PICU) of our hospital. These patients were en-rolled into the therapy group. Another 104 severe pneumonia patients who had not received FFB were enrolled into the control group. Clinical characteristics of both groups were collected and compared. Results No sig-nificant differences were detected in patients′gender, age, PCIS, usage of antibiotics, and the levels of CRP and PCT assayed at the time of admission to PICU between the therapy group and control group(P>0. 05). The positive rate of bacteria culture of the bronchoscopic lavage was 78. 52％( 106 cases ) in the therapy group,and it was significantly higher than that in the control group(60. 58％,63 cases) (χ2 =5. 681,P <0. 005). For 106 cases in the therapy group,117 bacteria strains were identified,while there were 72 bacteria strains found in 63 cases with positive bacteria culture in the control group. Gram negative bacteria were the most common type,followed by Gram positive bacteria. The third most common pathogenic microbes were fungi,with a significantly higher frequency in the therapy group. No significant differences were found in PaO2 and oxygenation index between both groups before FFB. However,in a half hour after FFB,the PaO2 and oxygenation index significantly increased in the therapy group,and higher than those in the control group (P<0. 005). The levels of CRP and PCT assayed before and the first day after FFB were not significantly changed(P>0. 05). But the levels of CRP and PCT in the therapy group significantly decreased in the third day after FFB,and more than those in the control group. Furthermore,duration of invasive respiratory sup-port,and the stay of PICU were significantly shorter in the therapy group(P<0. 005). Conclusion FFB can play an important role in the collection of pathogenic microbes. It also achieves better results in the treatment of severe pneumonia for children in PICU. Therefore,it is worthwhile to be recommended as a safe and feasi-ble intervention in PICU.

Objective: To explore heart rate variability (HRV) and arrhythmia in patients with resistant hypertension.
Methods: Our work included 3 groups:Resistant hypertension (RH) group, n=39, Non-resistant hypertension (NRH) group, the hypertension could be controlled by 1-3 medications, n=42 and Control group, composed of 40 healthy subjects. The 24h ambulatory blood pressure and electrocardiogram were monitored, the time-domain of HRV and arrhythmia parameters were compared among 3 groups which including standard deviation of all normal RR intervals (SDNN), standard deviation of the average normal RR intervals for all 5-min segments (SDANN), the mean of standard deviation of all 5-minute RR intervals (SDNN Index), the root mean square of the differences between adjacent R-R intervals (rMSSD) and the percentage of adjacent R-R intervals varied by more than 50 ms (pNN50).
Results: Compared with Control group, both RH and NRH groups showed decreased time-domain HRV parameters, all P<0.05. Compared with NRH group, RH group had the lower time-domain HRV parameters, all P<0. 05, while the rMSSD was similar between 2 groups (t=-1.5048, P=0.1364). The rates of arrhythmia in both RH and NRH groups were higher than Control group. The incidences of premature atrial contraction and atrial tachycardia were higher in RH group than NRH group, P<0.05, while the premature ventricular contraction, ventricular tachycardia and A-V block were similar between 2 groups, all P>0.05.
Conclusion: RH patients had decreased HRV and increased arrhythmia, especially with the higher incidence of atrial arrhythmia.

Objective To evaluate the effect of alginate polysaccharide JM on rats impaired by brain ischemia,and to elucidate its mechanisms.Methods By using the middle cerebral artery occlusion(MCAO) induced by nylon surgical thread inserted through the internal carotid artery into the anterior cerebral artery in rats,the effects of JM on neurological dysfunction and infarct volumn in rats brain were investigated.Neuroblastoma SH-SY5Y cells were employed to study the inhibitory effects of JM on cytotoxicity induced by hypoxia-hypoglycemia.Results JM at the doses of 12.5 and 25 mg?kg-1,iv,30 min before ischemia impressed neurological dysfunction,characterized by the decreased behavioral obstacle scores of MCAO rats.The infarct volumn declined 24h after ischemia as well.Further investigation by flow cytometry revealed that JM significantly reduces the overloading of intracellular free calcium on and suppresses apoptosis induced by hypoxia-hypoglycemia in human neuroblastoma SH-SY5Y cells.Conclusion JM showed protective effects on brain ischemia,probably related to its inhibitory effect on the overloading of intracellular free calcium ion(\i) and cell apoptosis.