Objective:To evaluate the value of metagenomic Next Generation Sequencing (mNGS) for the pathogenetic diagnosis of bloodstream infections in patients with sepsis.Methods:A retrospective analysis was performed on 105 sepsis cases who received blood mNGS and blood culture tests during their hospitalization in the Intensive Care Department of the Affiliated Hospital of North Sichuan Medical College from September 2021 to August 2023, and the results were compared and analyzed. According to mNGS and blood culture results, the cases were divided into the positive group and negative group.The distribution of pathogens in the enrolled patients were analyzed, and the diagnostic performance and consistency of blood culture and mNGS were compared. The differences in clinical characteristics of patients in each group were analyzed, and the pathogenic diagnostic value of mNGS for bloodstream infections in patients with sepsis was evaluated.Results:①Among 105 blood samples, 61 cases (58.10%) had positive results of mNGS, and 32 cases (30.48%) had positive results of blood culture. The positive rate of mNGS was higher than that of blood culture, and the difference was statistically significant ( P < 0.05).The accuracy of mNGS was lower than that of blood culture②The mean values of ESR, PCT and CRP in positive group were higher than those in negative group, and the proportion of septic shock was higher than that in negative group, and the differences were statistically significant ( P < 0.05). There was no significant difference in 28-day mortality rate between the two groups ( P > 0.05). Conclusions:mNGS is beneficial to the etiological diagnosis and treatment of bloodstream infection in patients with sepsis.

Objective:To analyze the clinical characteristics and risk factors for severe disease of hemorrhagic fever with renal syndrome (HFRS) in underage patients, and to construct the severe disease risk model.Methods:A total of 170 HFRS patients (<18 years old) from the Second Affiliated Hospital of Air Force Medical University (153 cases) and the Second Affiliated Hospital of Xi′an Jiaotong University (17 cases) from January 2009 to December 2021 were included. According to the severity of the disease, the patients were divided into mild and severe groups. Baseline demographic data, symptoms, signs, laboratory examination on admission and prognosis were analyzed between the two groups. Statistical comparisons were performed using the Mann-Whitney U test and chi-square test.Binary logistic regression was used to analyze the independent risk factors of patients with severe disease, and the severe disease risk model was built.The receiver operator characteristic curve was used to analyze the value of the risk model in predicting severity of disease. Results:Among the 170 underage patients, 132 (77.6%) were males, aged (14.9±3.1) years, including 124 cases in mild group and 46 cases in severe group. One hundred and sixty-nine cases (99.4%) had fever, 119 cases (70.0%) had headache, 106 cases (62.4%) had lumbago, 158 cases (92.9%) had skin and mucous congestion, and 101 cases (59.4%) had nausea and vomiting. Renal percussive pain was found in 139(81.8%) patients. The incidence of nausea and vomiting and bleeding of skin and mucosa in the severe group were 71.7%(33/46) and 67.4%(31/46), respectively, which were both higher than those in the mild group (54.8%(68/124) and 44.4%(55/124), respectively), and the differences were statistically significant ( χ2=3.97 and 7.12, respectively, both P<0.05). There were significant differences in platelet count, activated partial thromboplastin time (APTT), serum creatinine (SCr), aspartate aminotransferase, alanine aminotransferase, leukocyte count, total bilirubin and albumin levels between the two groups ( Z=-4.14, -4.04, -4.87, -3.90, -4.07, -2.60, -2.78 and t=2.50, respectively, all P<0.05). Binary logistic regression analysis showed that chemosis (odds ratio ( OR)=8.035, 95% confidence interval (95% CI) 2.946 to 21.916), SCr ( OR=1.010, 95% CI 1.006 to 1.015) and APTT ( OR=1.049, 95% CI 1.003 to 1.098) were the independent risk factors for severe HFRS in the underage patients. The risk model was constructed as: Logit(P)=-10.323+ 2.084×chemosis (no=0, grade Ⅰ=1, grade Ⅱ=2, grade Ⅲ=3)+ 0.010×SCr (μmol/L)+ 0.048×APTT (s). The area under the curve to predict severity of disease in underage HFRS patients was 0.868, with an optimal cut-off value of -4.39, with a sensitivity of 73.90% and a specificity of 91.10%. According to the internal verification of the data of the study based on the severe disease risk model, 34 out of 46 patients with severe disease were severe (sensitivity, 73.91%), 113 out of 124 patients with mild disease were mild (specificity, 91.13%). Conclusions:The clinical manifestations of the underage HFRS patients are not typical.The main manifestations are fever, headache and lumbago, nausea and vomiting, and the incidences of skin and mucous congestion and renal percussive pain are high.Chemosis, SCr and APTT are independent risk factors for severe disease in underage patients with HFRS. The severe disease risk model could effectively predict the severity of disease.

Objective:To investigate the effect and mechanism of bone marrow mesenchymal stem cell (BMSC) on pyroptosis of rats with kidney injury.Methods:Bone marrow of 4-5 week-old female Sprague-Dawley (SD) rats was isolated in vitro and BMSC was obtained. The third generations of BMSC were used to further experiments. Fifteen 6 week-old SD rats were cluster-randomized divided into control group, kidney injury group and BMSC group (5 rats in each group). Rats in kidney injury group were injected with lipopolysaccharide (LPS) 1 mg/kg via tail vein; the control group was given the same amount of normal saline. BMSC group was injected with 0.5 mL BMSC (including 2×10 6 BMSC) via tail vein after modeling; the kidney injury group received the same amount of normal saline. On day 3 after these injections, serum creatinine (SCr) was detected by picric acid method, and blood urea nitrogen (BUN) was detected by diacetyl monoxime. The levels of cystatin C (Cys C), interleukins (IL-1β and IL-18) in blood were detected by enzyme-linked immunosorbent assay (ELISA). The rats were then sacrificed and their kidneys were removed for subsequent detection. The mRNA expression levels of NOD-like receptor protein 3 (NLRP3) and cysteinyl aspartate-specific protease-1 (caspase-1) of kidney were detected by quantificational real-time quantitative polymerase chain reaction (qRT-PCR). The protein expression levels of NLRP3 and caspase-1 of kidney were detected by Western blotting. Results:In vitro, after bone marrow cell suspension was cultured for 24 hours, a large number of round adherent cells and suspended cells appeared in each culture flask. After 4-5 days of culture, a large number of long spindle cells adhered to the wall, and there were still obvious impurity cells. After trypsin digestion and passage to the third generation, the long spindle adherent cells grew mainly in the culture flask and were basically purified as BMSC. In vivo, compared with the control group, the levels of SCr, BUN, Cys C, IL-1β and IL-18 in kidney injury group were increased [SCr (μmol/L): 85.22±2.29 vs. 21.80±0.59, BUN (mmol/L): 11.50±0.64 vs. 5.86±0.83, Cys C (mg/L): 0.13±0.01 vs. 0.11±0.02, IL-1β (ng/L): 31.49±1.42 vs. 4.74±0.49, IL-18 (ng/L): 29.01±1.95 vs. 1.52±0.03, all P < 0.05]. The mRNA and protein expression levels of NLRP3, caspase-1 were significantly increased [NLRP3 mRNA (2 -ΔΔCt): 3.635±0.296 vs. 1.000±0.002, caspase-1 mRNA (2 -ΔΔCt): 4.020±0.228 vs. 1.001±0.003; NLRP3 protein (NLRP3/β-actin): 1.560±0.868 vs. 0.902±0.036, caspase-1 protein (caspase-1/β-actin): 1.392±0.097 vs. 0.895±0.046, all P < 0.05]. Compared with kidney injury group, the levels of SCr, BUN, IL-1β and IL-18 in BMSC group were significantly decreased [SCr (μmol/L): 51.64±3.84 vs. 85.22±2.29, BUN (mmol/L): 9.90±0.46 vs. 11.50±0.64, IL-1β (ng/L): 24.20±1.45 vs. 31.49±1.42, IL-18 (ng/L): 12.97±1.25 vs. 29.01±1.95, all P < 0.05]. The mRNA and protein expression levels of NLRP3, caspase-1 were significantly decreased [NLRP3 mRNA (2 -ΔΔCt): 1.488±0.136 vs. 3.635±0.296, caspase-1 mRNA (2 -ΔΔCt): 1.643±0.143 vs. 4.020±0.228; NLRP3 protein (NLRP3/β-actin): 1.227±0.053 vs. 1.560±0.868, caspase-1 protein (caspase-1/β-actin): 1.159±0.107 vs. 1.392±0.097, all P < 0.05]. Conclusion:In vivo, BMSC may attenuate pyroptosis in LPS-induced kidney injury rats.

Objective: The current investigation aimed to determine the appropriate dosage form by comparing solid dispersion and liposome to achieve the purpose of improving the solubility and bioavailability of linarin. Methods: Linarin solid dispersion (LSD) and linarin liposome (LL) were developed via the solvent method and the thin film hydration method respectively. The Transwell chamber model of Caco-2 cells was established to evaluate the absorption of drug. The pharmacokinetics of linarin, LSD and LL in rats after ig administration were carried out by high performance liquid chromatography (HPLC) method. Results: The solubility of LSD and LL was severally 3.29 times and 3.09 times than that of linarin. The permeation coefficients of LSD and LL were greater than 10

Objective:To explore the research hotspots and development trends in the field of domestic disinfection supply in the past 10 years.Methods:We systematically searched the article in the field of disinfection supply included in the core journal database of China National Knowledge Infrastructure (CNKI) . The search subject was "disinfection supply" and "Supply Room", and the search time limit was from January 1, 2011 to September 1, 2021. The CiteSpace software was used to conduct keyword co-occurrence, keyword clustering, time-line map and keyword emergence analysis, and explore the research hotspots and development trends in the field of disinfection supply.Results:A total of 1 126 articles were retrieved. The bibliometric analysis showed that the domestic research in the field of disinfection supply in the past 10 years mainly focused on 10 aspects. Cleaning quality, disinfection and sterilization quality control, and nosocomial infection in Central Sterile Supply Department were still current research hotspots. The prevention and control of the COVID-19 epidemic was the focus of research in 2020 and 2021.Conclusions:The overall number of publications in the field of disinfection supply tends to be stable, and the prevention and control of nosocomial infection has been the focus of researchers in the past 10 years. It is recommended that future researchers strengthen multi-center cooperation and conduct experimental research and qualitative research on practitioners in the field of disinfection supply.

Objective:To analyze the clinical characteristics and prognosis of pregnant women with hemorrhagic fever with renal syndrome (HFRS).Methods:A total of 11 pregnant women with HFRS admitted to The Second Affiliated Hospital of Xi′an Jiaotong University (four cases), The Second Affiliated Hospital of Air Force Medical University (four cases), The First Affiliated Hospital of Xi′an Jiaotong University (one case) and Central Hospital of Xianyang City (two cases) between November 2009 and February 2019 were included as the study group, and 24 age-matched non-pregnant women with HFRS were selected as the control group. The age, complications, clinical classification and laboratory indexes of the two groups were analyzed retrospectively, and the clinical outcomes of pregnant women and their fetuses in the study group were followed up. The data between two groups were compared using Mann-Whitney U test or chi-square test. Results:Patients in the study and control groups were 29 (22, 33) and 32 (24, 37) years old, respectively. Seven of 11 patients in study group were severe and critical cases, which was significantly higher than that in the control group (16.7%(4/24), χ2=7.722, P=0.015). In the study group, 10 patients had hypervolemic syndrome, 10 patients had pulmonary edema and six patients had overlapping hypotension shock phase and oliguria phase, which were all higher than those in the control group ((2/24, 8.3%), (2/24, 8.3%) and (2/24, 8.3%), respectively; χ2=22.828, 22.828 and 9.135, respectively, all P<0.01). Compared with the control group, the pregnant patients in study group had a higher urea nitrogen maximum and serum creatinine maximum, and the differences were both statistically significant ( Z=-2.453 and -2.336, respectively, both P<0.05), while they had a lower serum albumin minimum, hemoglobin maximum and hemoglobin minimum, and the differences were all statistically significant ( Z=-3.742, -3.350 and -4.034, respectively, all P<0.01). All pregnant women with HFRS recovered. Nine pregnant women gave birth to nine healthy infants. All of them received breastfeeding and the feeding duration were more than six months. No abnormal growth and development were found during an average follow-up of three years. Conclusions:Pregnancy can aggravate the severity of HFRS, and pregnant women have higher risk of the multiple stages overlap and the complications such as hypervolemic syndrome and acute pulmonary edema. After recovery from HFRS, mother may carry to full-term pregnancy.

Objective:To study the real-world outcome of China FDA-approved Sofosbuvir (SOF)/Velpatasvir (VEL) in Northwest China.Methods:In this multicenter, prospective, real-world cohort study, we recruited patients from 10 sites from Northwest China, who were chronically infected with HCV GTs 1-6 from 06/2018 to 09/2019. Patients received SOF (400mg)/VEL (100mg) for 12 weeks, and with ribavirin 900-1200 mg for GT3 cirrhosis and for any genotype decompensated cirrhosis. The primary endpoint was sustained virological response at 12-weeks post-treatment (SVR12) and safety. The secondary endpoint was the change of liver function after the achievement of SVR12.Results:Totally, 143 patients were enrolled in the study, four patients were lost to follow-up and one died during the follow-up, 138 patients were included in per-protocol analysis. Of the 138 patients, the mean age 53 years, 53.6% male, 94.2% Han nationality, 53.6% liver cirrhosis, 10.1% HBsAg +, 6.5% renal dysfunction, 5.1% treatment-experienced, and 16.7% patients received ribavirin treatment. The genotype distribution was as follows: 35.5% GT1, 42.8% GT2, 15.9% GT3, and 5.8% un-typed. The SVR12 rate was 96.5% (138/143, 95% CI: 93.5%-99.6%) for intention-to-treat analysis, and in per-protocol analysis, all 138 patients obtained SVR12 (100%). Compared with baseline, the serum total bilirubin, ALT and AFP levels decreased (all P < 0.05), as well as increased ALB and platelet count (all P < 0.001) at post-treatment 12-weeks. Overall adverse events (AEs) rate is 29.0%, and the most common AEs were anemia (14.5%) and fatigue (8.0%). Severe side effects (edema and fatigue) occurred in 2 patients, one of whom needed a short-term interruption of treatment due to fatigue. Conclusion:In this real-world cohort study, 12-week SOF/VEL regimen with or without ribavirin achieved high SVR12 rates (96.5%-100% overall) with excellent safety profile among patients with HCV GT1/2/3 infection including patients with GT3 and cirrhosis, and led to improvement of liver function.

Objective: To explore the application value of serum cystatin C (Cys-C) and β2-microglobulin (β2-MG) in the diagnosis and short-term efficacy evaluation of multiple myeloma (MM). Methods: A total of 450 patients with MM admitted to Anqing Hospital of Chinese People′s Liberation Army Navy and Jinhua Central Hospital of Zhejiang Province from October 2016 to October 2018 were selected as subjects (MM group), according to the Durie-Salmon staging criteria, including 150 patients in stage Ⅰ, Ⅱ and Ⅲ. A total of 150 healthy subjects were selected as the control group. The levels of Cys-C and β2-MG in the serum of the subjects were determined. The differences of Cys-C and β2-MG levels between the two groups and the MM patients with different Durie-Salmon stages were compared. The differences of Cys-C and β2-MG levels between the patients with different short-term efficacy were compared. The receiver operating characteristic (ROC) curve was used to analyze the value of the two indicators in the evaluation of MM efficacy, and the correlation between Cys-C and β2-GM was analyzed. Logistic regression analysis was used to analyze the multiple factors affecting the clinical efficacy of MM patients. Results: The levels of Cys-C and β2-MG in the serum of the patients with MM were (2.11±0.78) mg/L and (6.07±3.08) g/L respectively, and those in the control group were (0.75±0.20) mg/L and (1.78±0.59) g/L, with significant differences (t=33.848, P<0.001; t=28.084, P<0.001). The Cys-C levels of Durie-Salmon stage Ⅰ, Ⅱ and Ⅲ patients were (0.99±0.21) mg/L, (1.36±0.17) mg/L and (3.07±1.02) mg/L respectively, and the difference was statistically significant (F=44.157, P<0.001). The β2-MG levels in the serum of patients with stage Ⅰ, Ⅱ and Ⅲ were (2.57±0.75) g/L, (4.66±1.43) g/L, (8.63±2.26) g/L respectively, and the difference was statistically significant (F=57.285, P<0.001). In all the patients, 338 patients were effective, accoun-ting for 75.11%, and 112 patients were ineffective, accounting for 24.89%. The levels of Cys-C and β2-MG in the serum of the effective MM patients were (1.28±0.23) mg/L and (2.82±0.78) g/L, and those of ineffective patients were (2.97±0.77) mg/L and (6.22±1.92) g/L, with statistically significant differences (t=35.874, P<0.001; t=26.633, P<0.001). The sensitivity of serum Cys-C for predicting short-term efficacy was 83.0%, the specificity was 76.6%, and those of serum β2-MG were 89.3% and 73.6%. The area under curve (AUC) of the serum Cys-C was 0.813 (95%CI: 0.764-0.862), and the AUC of serum β2-MG was 0.865 (95%CI: 0.825-0.906), with a statistically significant difference (Z=2.490, P=0.011). Spearman correlation analysis showed a positive correlation between serum Cys-C and β2-MG (r=0.539, P=0.041). Logistic regression analysis showed that both β2-MG (95%CI: 2.386-5.144, P<0.001) and Cys-C (95%CI: 2.367-9.702, P<0.001) were independent factors affecting the short-term efficacy of MM. Multivariate analysis showed that β2-MG (95%CI: 3.549-13.739, P=0.001) was an independent factor affecting the efficacy of MM. Conclusion The levels of serum Cys-C and β2-M in MM patients are significantly higher than those in healthy people, and they show an increasing trend with the progression of MM disease, which can be used as markers for the pathological staging diagnosis of MM patients. The short-term efficacy of the patients can be evaluated by using the two indicators, and the clinical significance in efficacy evaluation of β2-MG is slightly better than that of Cys-C.

To develop an enzyme-linked immunosorbent assay (ELISA)-based high throughput screening (HTS) method for β-catenin/Lef1 interaction antagonists screening, Escherichia coli Rosetta (DE3) competent cells were transformed with β-catenin-pET-30a(+) plasmid. β-catenin protein was expressed after induction and purified using affinity chromatography. The biological activity of purified β-catenin was further analyzed by GST Pulldown assay. The β-catenin/GST-Lef1 binding model was established using ELISA principle, and the ELISA-based HTS method was further optimized through determination of an optimal coated concentration of GST-Lef1 and working concentration of β-catenin. The results showed that β-catenin protein was successfully expressed and purified. The GST Pulldown assay demonstrated a perfect biological activity for purified β-catenin. Subsequently, the ELISA-based HTS method was performed using 10 μg/mL GST-Lef1 and 6 μg/mL β-catenin, with the Z factor of 0.76. Taken together, we have successfully developed a simple, robust and reliable ELISA-based HTS method for screening of novel Wnt inhibitors targeting β-catenin/Lef1 interaction.
Antineoplastic Agents ; Enzyme-Linked Immunosorbent Assay ; High-Throughput Screening Assays ; Lymphoid Enhancer-Binding Factor 1 ; beta Catenin

To prepare polyclonal antibody (PcAb) against Escherichia coli filamentous thermosensitive protein Z (Ec-FtsZ), the artificially synthesized gene fragment coding Ec-FtsZ was subcloned into pET-22b(+) plasmid, and Ec-FtsZ protein was expressed in E. coli BL21(DE3) cell under an optimal bacterial expression condition. Then Ec-FtsZ protein was purified by HisTrap affinity chromatography, and the GTPase (Guanosine triphosphatase) activity of purified Ec-FtsZ protein was further analyzed by malachite green assay. Subsequently, the purified Ec-FtsZ protein was used to immunize rat subcutaneously for preparation of anti-Ec-FtsZ PcAb. The results of enzyme-linked immunosorbent assay (ELISA), Western blotting analysis and immunofluorescence assay showed that the titer of PcAb was 1:256 000, and PcAb exhibited a perfect antigenic specificity against purified and endogenous Ec-FtsZ protein. All these data indicated that the anti-Ec-FtsZ PcAb is successfully prepared, which can be used for further cellular function study and biochemical analysis of Ec-FtsZ protein in vivo.
Animals ; Antibodies ; Antibody Specificity ; Bacterial Proteins ; Blotting, Western ; Cytoskeletal Proteins ; Enzyme-Linked Immunosorbent Assay ; Escherichia coli ; Plasmids ; Rats