Extracorporeal membrane oxygenation is an extracorporeal life support technique used to rescue patients with respiratory and (or) heart failure. Infection is one of the most serious complications of extracorporeal membrane oxygenation, which can affect patients' clinical outcomes. This article reviews the definition, diagnosis, incidence, site of infection, pathogenic bacteria, risk factors, prevention and treatment measures of extracorporeal membrane oxygenation associated nosocomial infection, so as to provide reference for the prevention and treatment of extracorporeal membrane oxygenation associated nosocomial infection.

Objective:To analyze the differences of Saponins in different parts of Panax ginseng, which couldprovide reference for a comprehensive quality evaluation.Methods:UFLC- Triple-TOF-MS/MS was used to analyze the Saponins in Ginseng Radix et Rhizoma, Ginseng Folium and Ginseng Flos,The analysis was carried out on a SynergiTM Hydro-RP 100A column, Gradient elution of water (containing 0.1% formic acid) (A)-acetonitrile (B). Principal component analysis (PCA) was used to analyze the grouping of samples, and partial least squares regression (PLS-DA) was used to classify the samples to find the differences of chemical components in different medicinal parts of Panax ginseng. Significant differences in saponins and its rules were found by multivariate statistical analysis.Results:PCA indicated that there was remarkable difference in saponins of Ginseng Radix et Rhizoma, Ginseng Folium and Ginseng Flos, ten different components were found by PLS-DA. Conclusion:There exists obvious differences of different medicinal parts of Panax Ginseng which could provide foundation for the further research and rathional use of Panax ginseng.

Objective:To investigate the accuracy and feasibility of 3D-printing individualized template-guided and CT-guided 192Ir interstitial brachytherapy in the central recurrent gynecologic tumors by comparing pre-plan and intraoperative physical dosimetric parameters. Methods:This study involved 38 patients with central recurrent gynecologic tumors who underwent 3D printing individual template (3D-PIT)-assisted and CT-guided 192Ir interstitial brachytherapy in the Department of Radiation Oncology of the Peking University Third Hospital from Jan 2018 to Dec 2019.The prescription doses for the target tumor areas were 10-36 Gy to be delivered at 5-6 Gy/fraction for 2-6 fractions.The pre-plan and intraoperative dosimetric parameters were compared, including the minimum prescription doses delivered to 90% and 100% of target volume( D90, D100)and the mean percentage of volume receiving 100% of the prescription doses ( V100). Meanwhile, the doses delivered to 2 cm 3 ( D2 cm 3) of organs at risk (bladders, rectums, and colons) were analyzed.The quality parameters of the brachytherapy were studied, including conformity index (CI), homogeneity index (HI), and external index (EI) of the target volume.Perioperative complications were also observed. Results:A total of 194 treatments were included.During the treatment, 5-13 (median 6) needles were inserted, with a prescription dose of 5-6 Gy per fraction.There were no statistical differences between pre-plan and intraoperative D90, D100, V100, CI, HI, and EI as well as the D2 cm 3 of bladders and colons at risk ( P>0.05). In contrast, for the D2 cm 3 of rectums, the intraoperative dose was slightly higher than the pre-plan dose, showing a statistical difference ( t=-0.335, P=0.027). Conclusions:The 3D-PIT-assisted and CT-guided 192Ir interstitial brachytherapy at a high dose rate is accurate and feasible in the treatment of recurrent gynecologic tumors, meeting the pre-plan dose requirement.

A new coronavirus (SARS-CoV-2) has been identified as the etiologic agent for the COVID-19 outbreak. Currently, effective treatment options remain very limited for this disease; therefore, there is an urgent need to identify new anti-COVID-19 agents. In this study, we screened over 6,000 compounds that included approved drugs, drug candidates in clinical trials, and pharmacologically active compounds to identify leads that target the SARS-CoV-2 papain-like protease (PLpro). Together with main protease (M
Antiviral Agents/therapeutic use* ; Binding Sites ; COVID-19/virology* ; Coronavirus Papain-Like Proteases/metabolism* ; Crystallography, X-Ray ; Drug Evaluation, Preclinical ; Drug Repositioning ; High-Throughput Screening Assays/methods* ; Humans ; Imidazoles/therapeutic use* ; Inhibitory Concentration 50 ; Molecular Dynamics Simulation ; Mutagenesis, Site-Directed ; Naphthoquinones/therapeutic use* ; Protease Inhibitors/therapeutic use* ; Protein Structure, Tertiary ; Recombinant Proteins/isolation & purification* ; SARS-CoV-2/isolation & purification*

Emerging and re-emerging RNA viruses occasionally cause epidemics and pandemics worldwide, such as the on-going outbreak of the novel coronavirus SARS-CoV-2. Herein, we identified two potent inhibitors of human DHODH, S312 and S416, with favorable drug-likeness and pharmacokinetic profiles, which all showed broad-spectrum antiviral effects against various RNA viruses, including influenza A virus, Zika virus, Ebola virus, and particularly against SARS-CoV-2. Notably, S416 is reported to be the most potent inhibitor so far with an EC of 17 nmol/L and an SI value of 10,505.88 in infected cells. Our results are the first to validate that DHODH is an attractive host target through high antiviral efficacy in vivo and low virus replication in DHODH knock-out cells. This work demonstrates that both S312/S416 and old drugs (Leflunomide/Teriflunomide) with dual actions of antiviral and immuno-regulation may have clinical potentials to cure SARS-CoV-2 or other RNA viruses circulating worldwide, no matter such viruses are mutated or not.
Animals ; Antiviral Agents ; pharmacology ; therapeutic use ; Betacoronavirus ; drug effects ; physiology ; Binding Sites ; drug effects ; Cell Line ; Coronavirus Infections ; drug therapy ; virology ; Crotonates ; pharmacology ; Cytokine Release Syndrome ; drug therapy ; Drug Evaluation, Preclinical ; Gene Knockout Techniques ; Humans ; Influenza A virus ; drug effects ; Leflunomide ; pharmacology ; Mice ; Mice, Inbred BALB C ; Orthomyxoviridae Infections ; drug therapy ; Oseltamivir ; therapeutic use ; Oxidoreductases ; antagonists & inhibitors ; metabolism ; Pandemics ; Pneumonia, Viral ; drug therapy ; virology ; Protein Binding ; drug effects ; Pyrimidines ; biosynthesis ; RNA Viruses ; drug effects ; physiology ; Structure-Activity Relationship ; Toluidines ; pharmacology ; Ubiquinone ; metabolism ; Virus Replication ; drug effects

OBJECTIVE： To study the effects of serglycan （SRGN） on drug resistance of ovarian cancer and its mechanism. METHODS： Gene expression profile interactive analysis tool （GEPIA） was used to extract related data set of ovarian cancer and analyze the difference of mRNA expression of SRGN between normal ovary tissue and ovarian cancer tissue. Gene expression database （GEO） was adopted to obtain the difference of the mRNA expression of SRGN in cisplatin sensitive and cisplatin resistant cell lines （A2780）. STRING online database was used to screen proteins interacting with SRGN （confidence degree： 0.900， interactors： 10）. Adopted biological information annotation database （DAVID） to analysis Kyoto encyclopedia of genes and genomers（KEGG）metabolism pathway to predict the potential pathways of SRGN regulating drug resistance of ovarian cancer. Medical ontology information retrieval platform COREMINE was used to mine the biological processes of significant relationship of SRGN and ovarian cancer with drug resistance. RESULTS： mRNA expression of SRGN in ovarian cancer tissue was significantly higher than normal ovarian tissue （P＜0.05）. mRNA expression of SRGN in cisplatin resistant ovarian cancer was significantly higher than cisplatin sensitive ovarian cancer （P＜0.001）. 10 proteins interacting with SRGN were screened， including albumin， transforming growth factor β1， platelet factor 4， fibrinolysin and vascular endothelial growth factor A. SRGN participated in KEGG metabolism pathway of regulating drug resistance of ovarian cancer， including HIF1α pathway， cytokine-cytokine receptor pathway， coagulation and complement cascades pathway， etc. Biological processes included gene expression， cell growth， apoptosis and cell death. CONCLUSION： SRGN mediates drug resistance of ovarian cancer， which is associated with HIF1α signaling pathway and cytokine-cytokine receptor pathway.

OBJECTIVETo compare the effect differences between auricular intradermal needling combined with erjian (HX) bloodletting and oral administration of western medicine, and to explore the efficacy of neuroendocrine level in patients with perimenopausal insomnia.

METHODSNinety patients were randomized into an observation group and a control group, 45 cases in each one. In the observation group, auricular intradermal needling combined with erjian (HX) bloodletting were adopted alternately in the two ears. The auricular points were shen (CO), xin (CO), gan (CO), shenmen (TF), jiaogan (AH), neifenmi (CO) and erjian (HX). The treatment was required once 3 days on the auricular points of one side alternatively. Oral administration of estazolam (1mg each day) was applied in the control group for 2 courses, 4 weeks as 1 course, once a day. The scores of Pittsburgh sleep quality index (PSQI), the levels of serum estrogen (E), 5-hydroxy tryptamine (5-HT) and norepinephrine (NE) were valuated in the two groups before and after treatment.

RESULTSAfter treatment, the total scores of PSQI reduced in the two groups (both <0.05), and the improvements of sleeping quality, sleeping time, sleeping difficulty, daytime dysfunction and the total PSQI score in the observation group were superior to those in the control group (all <0.05). There was no significant difference in serum E before and after treatment in the two groups，and between the two groups after treatment (all >0.05). After treatment, 5-HT contents increased and NE levels decreased in the two groups (all <0.05), with better results in the observation group (both <0.05). The total effective rate was 95.6% (43/45) in the observation group, which was higher than 82.2% (37/45) in the control group (<0.05).

CONCLUSIONAuricular intradermal needling combined with erjian (HX) bloodletting can improve the sleep quality of patients with perimenopausal insomnia, and adjust the neurotransmitter level, which achieves better effect than western medication.

Objective To use Meta-analysis to compare the roles of bispectral index (BIS) monitoring and subjective rating scale in Intensive Care Unit (ICU) mechanical ventilation patients, and to provide a reference for selecting better sedation assessment tools in clinical practice. Methods Randomized controlled trials in ICU mechanical ventilation patients were collected from Scopus, Web of Science, PubMed, CNKI, Cochrane Library, VIP, WanFang Date, and CBM from database establishing to 2018 by BIS monitoring. The literatures were selected according to inclusion and exclusion criteria, data were extracted and the quality of the trials was evaluated. Meta-analysis was performed using RevMan5 software. Results Eleven randomized controlled studies were screened out. The total sample had 1354 cases, including 664 in the BIS group and 690 in the subjective rating scale group. Meta-analysis showed that sedative drug use (standardized mean difference [SMD]=0.28, 95％CI: -0.20-0.76), duration of sedation (mean difference [MD]=0.84, 95％CI: 2.00-3.67), arousal time after discontinuation (MD=-6.20, 95％CI: 19.76-7.35), mechanical ventilation time (MD=-0.33, 95％CI:-1.20-0.54]), ICU hospitalization stay (MD=-0.82, 95％CI: -3.94-2.30), and mortality (odds ratio [OR]=0.83, 95％CI: 0.52-1.32) showed no significant differences between the two groups (P>0.05). The incidence of unplanned extubation in the BIS group (OR=0.20, 95％ CI: 0.10-0.42) was significantly lower than that in the subjective rating scale group (P<0.05). Conclusion There is currently insufficient evidence to show that BIS monitoring is superior to subjective rating scale in sedative drug use and disease prognosis in ICU mechanical ventilation.