Objective:To investigate the clinical characteristics of non-perinatal adult patients with Listeria monocytogenes (LM) infection. Methods:Twenty-five non-perinatal adult patients who were etiologically confirmed as listeriosis in Tangdu Hospital, Fourth Military Medical University during January 2010 and July 2023 were enrolled in this study. The characteristics of demographic data, underlying diseases, clinical manifestations, laboratory indicators, cranial imaging examination, anti-microbial therapeutic schemes and clinical outcomes were retrospectively analyzed. The clinical characteristics were compared between patients with Listeria septicemia and Listerial meningoencephalitis, as well as between survival and death patients. Independent samples t test and Mann-Whitney U test were used for statistical analysis. Results:The age of enrolled patients was (52.84±12.17) years. Eighteen patients were male, and seven patients were female. The major clinical manifestations included fever (23/25(92%)), headache (15/25 (60%)), disorder of consciousness (12/25(48%)) and vomiting (8/25(32%)). Thirteen (52%) patients had underlying diseases (including hematological diseases, autoimmune disorders, solid neoplasms, and liver cirrhosis, etc). There were no significant differences in blood routine test, aminotransferase, protein levels, renal function, electrolyte, blood glucose, and inflammatory indicators between patients with Listeria septicemia and Listerial meningoencephalitis (all P>0.05). The platelet count in the death group was significantly higher than that in the recovery group ((243.10±92.96)×10 9/L vs (157.80±75.55)×10 9/L, t=2.45, P=0.022). There were also no significant differences in blood biochemical index and inflammatory indicators between these two groups (all P>0.05). Cranial imaging examination of patients with Listerial meningoencephalitis manifested as intracranial infection, cerebral edema/hydrocephalus or cerebral hernia. All nineteen patients with Listerial meningoencephalitis had elevated cerebrospinal fluid (CSF) pressure (220.0(130.0, 290.0) mmH 2O (1 mmH 2O=0.009 8 kPa)), elevated CSF total cell count (522.0(350.0, 783.0)×10 6/L), elevated CSF white blood cell count (356.0(266.0, 668.0)×10 6/L), and CSF protein level (1 817.0(822.5, 6 000.0) mg/L). Fifteen patients had reduced CSF chloride level ((111.70±8.51) mmol/L). Ten patients had decreased CSF glucose level (3.71(1.45, 7.11) mmol/L). The drug sensitivity results of blood and CSF cultures revealed that LM was sensitive to ampicillin. One case was resistance to penicillin, three cases were resistance to meropenem, while three cases were resistance to trimethoprim-sulfonamide. Thirteen cases out of seventeen recovery patients were administered with ampicillin or penicillin-based therapy. Conclusions:When patients with underlying diseases or immune dysfunction suffered with clinical symptoms such as high fever, central nervous system infection, they should be alert to the possibility of listeriosis. Early administration of ampicillin-based therapeutic strategy is beneficial for clinical recovery of the patients.

This paper aims to explore the effective methods for training outstanding medical talents through medical education and research collaboration under the background of new medical science education. Firstly, based on the background of new medical science education, this paper summarizes the latest trends in the field of medical education and research, analyzes its impact on the training of medical talents, and explores how to lead the development of outstanding medical talents. Secondly, this paper introduces the characteristics of the collaborative training mode of medical talents under the background of new medical science education, as well as the benefits and methods of cross-field collaborative training. In addition, according to the actual situation, this paper also analyzes the advantages and disadvantages of the medical education and research collaborative training mode and discusses the effective training mode.

Objective To systematically evaluate the risk factors for pulmonary infection in patients with lung cancer after chemotherapy.Methods CNKI,Wanfang Data,VIP,PubMed,Embase,and the Cochrane Library were searched from inception to October 2022 to collect case-control studies and cohort studies about risk factors for pulmonary infection in patients with lung cancer after chemotherapy.Two researchers independently conducted literature screening,data extraction,and quality assessment.Rev Man 5.3 software was used for Meta-analysis.Results A total of 15 literatures were included,including 3960 patients with lung cancer after chemotherapy.Meta analysis results showed that age≥60 years,smoking history,drinking history,hypertension,diabetes mellitus,atelectasis,hypoproteinaemia,TNM staging of stage Ⅲ-Ⅳ,central lung cancer,small cell lung cancer,invasive operation,Karnofsky performance status score＜80 points before chemotherapy,combined chemotherapy drugs,duration of chemotherapeutic ?2 weeks,white blood cell count≤3.0×109/L after chemotherapy,albumin＜30g/L after chemotherapy,and hospital stay>20 days were risk factors for pulmonary infection in patients with lung cancer after chemotherapy(P＜0.05).Conclusion There were many risk factors for pulmonary infection in patients with lung cancer after chemotherapy.Prevention and control measures should be taken based on the related risk factors to reduce the incidence rate of pulmonary infection.

Objective To establish a method using supramolecular solvent and gas chromatography-tandem mass spectrometry （GC-MS/MS） to analyze 9 benzodiazepines in urines. Methods Urine samples containing 9 benzodiazepines reference substance were subjected to liquid-liquid extractions with supramolecular solvent, which consisted of tetrahydrofuran and 1-hexanol. The solvent layer was evaporated to dryness by stream of nitrogen. The residue was reconstituted with methanol, and GC-MS/MS analysis was performed on it. The way of data collection was multiple reaction monitoring （MRM） mode; internal standard method was employed for quantification. Results In urine samples, when the range of mass concentration was 1-100 ng/mL for diazepam, midazolam, flunitrazepam and clozapine, 5-100 ng/mL for lorazepam and alprazolam, 2-100 ng/mL for nitrazepam and clonazepam, and 0.2-100 ng/mL for estazolam, respectively, good linearities were obtained, correlation coefficients were 0.999 1-0.999 9, the lower limits of the quantifications ranged from 0.2 to 5 ng/mL, the extraction recovery rates were 81.12%-99.52%. The intra-day precision ［relative standard deviation （RSD）］ and accuracy （bias） were lower than 9.86% and 9.51%, respectively; the inter-day precision （RSD） and accuracy （bias） were lower than 8.74% and 9.98%, respectively. Nine drugs in urine samples showed good stability at ambient temperature and -20 ℃ within 15 days. The mass concentrations of alprazolam in urine samples obtained from 8 volunteers who took alprazolam tablets orally within 8-72 h after ingestions ranged from 6.54 to 88.28 ng/mL. Conclusion The supramolecular solvent extraction GC-MS/MS method for analysis of 9 benzodiazepines in urines provided by this study is simple, fast, accurate and sensitive, which can provide technical support for monitoring of poisoning by benzodiazepines for clinical treatment and judicial identification.
Benzodiazepines ; Chromatography, Liquid ; Gas Chromatography-Mass Spectrometry ; Humans ; Solvents ; Tandem Mass Spectrometry

Objective: To explore the association between the frequency of prenatal care in childbearing aged women and risk of small for gestational age (SGA) among neonatal twins in Shaanxi Province. Methods: From July to December 2013, a total of 30 027 childbearing aged women, who were pregnant from January 2010 to November 2013 and had definite outcomes, were selected from 30 districts (counties) of Shaanxi Province by using the multi-stage random sampling method. The questionnaires with a face-to-face survey method were used to retrospectively collect demographic information, pregnancy history, lifestyle during pregnancy, disease history, nutritional supplements, and health care during pregnancy. Information on the gestational age and birth weight of the newborn were obtained by consulting the medical certificate of birth and were registered as twin A and twin B by birth order. Finally, 356 childbearing aged women and their twin babies with complete data were included in the analysis. A generalized estimation equation model was used to analyze the association between the frequency of prenatal care and the risk of SGA among neonatal twins. Results: The age of childbearing aged women was (27.44±4.68) years old, of which 79.49% (283 women) were rural residents and 44.38% (158 women) had seven or more times prenatal care. The gestational age and birth weight were (37.64±2.51) weeks and (2 510±497) g, respectively. The prevalence of SGA was 51.40% (183/356) for twin A and 53.37% (190/356) for twin B, respectively. The prevalence of SGA was 44.30% (70/158) for twin A with seven or more times prenatal care and 42.41% (67/158) for twin B with seven or more times prenatal care, which was lower than that for twins with less than seven times prenatal care, respectively [57.07% (113/198) and 62.12% (123/198)] (P values were 0.017 and <0.001). The results of generalized estimation equation model suggested that compared to those with less than seven times prenatal care, after adjusting for parity, birth order, place of residence, maternal age, occupation, education, family wealth index, passive smoking, pregnancy-induced hypertension syndrome, folic acid, and iron supplement during perinatal period, and gender of the newborn, the OR (95%CI) of risk of SGA among childbearing aged women with seven or more times prenatal care was 0.60 (0.40-0.91). Conclusion Seven or more times prenatal care could reduce the risk of SGA among neonatal twins in Shanxi Province.

Objective To explore the morbidity of surgery in connection with laparoscopic sleeve gastrectomy (LSG) and its effect on obese T2DM.Methods 106 obese T2DM patientes undergoing LSG were divided into 2 groups in group 125 patients did not have oversewing the staple line and group 281 patients had the staple line oversewn in order to reduce bleeding.Results The differences in intraoperative blood loss (35 ± 15) ml vs.(28 ± 18) ml,postoperative recovery time (2.4 ± 0.9) d vs.(2.3 ± 0.9) d,time to taking liquid food (4.7 ± 1.0) d vs.(4.6 ± 1.0) d between two groups were not significant.There were no significant difference of complication between 2 groups (x2 =3.271,P =0.071).Comparing before surgery to 6 month after surgery,the BMI in group 1,was from (39 ± 5) to (29 ±4) kg/m2;in group 2,from (40 ±6) to (31 ±5) kg/m2,FPG in group 1,from (8.4 ± 1.4) to (6.4 ±1.2) mmol/L;in group 2,from (8.2 ± 2.0) to (6.8 ± 1.5) mmol/L,2 hour post-meal blood sugar [group 1,(13.2±4.1) to (9.6±3.2) mmol/L;group 2,(12.2±3.2) to (10.6±2.8) mmol/L] and HbAlc (group 1,7.2％ ±1.2％ to5.5％ ±1.1％;group 2,7.1％ ±1.1％ to 5.9％ ±1.2％) decreased significantly in both groups (P ＜ 0.01).There was 72 (68％) remission cases of T2DM in 106 patients,there were no significant differences of T2DM remission and BMI between 2 groups at 6 months after surgery (P =0.617).Conclusions LSG leads to significant weight loss and T2DM control.

[Abstract] Objective: To prepare GNS (gold nanostars) loading photosensitizer chlorin e6 (Ce6) and to investigate its photodynamic effects on lung cancerA549 cells. Methods: GNS was firstly modified by SH-PEG-NH2 and then mixed with Ce6 and shaken overnight to prepare GNS-PEG@Ce6, which had photodynamic therapy effects. The characterization, morphology and encapsulation rate were detected. The difference between the phagocytosis of Ce6 and GNS-PEG@Ce6 by A549 cells were observed with a Leical TCS SP8 confocal laser scanning microscope. MTT assay was used to examine the inhibitory effect of GNS-PEG@Ce6 on the proliferation of A549 cells while FCM was used to detect the effect of probe GNS-PEG@Ce6 on the apoptosis ofA549 cells. Results: The particle size of the GNS-PEG@Ce6 was about 100 nm. The prepared GNS-PEG@Ce6 nanoparticles exhibited good dispersion and stability and the encapsulation rate of Ce6 was about 50%. GNS-PEG@Ce6 entered the cells by endocytosis and mainly distributed in the cytoplasm; compared with Ce6, GNS-PEG@Ce6 could enter the cells more effectively. The proliferation-suppression effect of GNS-PEG@Ce6 on A549 cells was significantly stronger than that of Ce6 (P<0.05). The results of flow cytometry showed that the probe exhibited strong apoptotic effect on A549 cells. Conclusion: GNS, as the drug carrier, could effectively increase the Ce6 uptake efficacy in A549 cells, thus further enhancing the killing effects of Ce6 on lung cancerA549 cells.

UNLABELLEDObjective：To explore the effect of tyrosine phosphorylation sites Tyr644 and Tyr664 in oncogenic protein NPM-ALK on cell cycle and its related mechanisms.

METHODSTransiently transfected 293T cells and stably transfected Jurkat cells were used for analysis of cell cycle and protein after the transfection with the constructed recombinant plasmid pEGFP-N1, pEGFP-N1-NPM-ALK and pEGFP-N1-NPM-ALK(644, 664); soft agar assay for colony formation was performed to examine the different carcinogenicity of stable cell lines; cell viability of stable cell lines was examined by CCK-8 after the treatment with PPP.

RESULTSThe S arrest occurred in both NPM-ALK(644,664) transfected 293T and Jurkat cells; the susceptibility of NPM-ALK transfected Jurkat cells to PPP was highest among the 3 stable cell lines; the phosphorylated levels of AKT, ERK and STAT3 were decreased in NPM-ALK(644,664) cells compared with the NPM-ALK ones. Additionally, the double mutation induced the increase of CDK2 and the decrease of P27 (P<0.05).

CONCLUSIONThe mutation of Tyr644 and 664 sites in NPM-ALK can induce cell cycle arrest in S phase and lower susceptibility to PPP that may be related with the phosphorylation change of cell growth related molecules in the downstream of NPM-ALK.

Cell Cycle ; Cell Proliferation ; Cell Survival ; Humans ; Jurkat Cells ; Oncogenes ; Phosphorylation ; Protein-Tyrosine Kinases ; Signal Transduction ; Transfection ; Tyrosine

ObjectiveTo evaluate treatment of type 2 diabetes mellitus (T2DM) by laparoscopic Roux-en-Y gastric bypass (LRYGB) using different amastomoses. MethodsTwenty one T2DM patients were divided into two groups:transoral EEA (OrVil) and Endo-GIA according to ways of gastrointestinal anatomosis andunderwentLRYGB. Clinicaldataincluding outcomeof operation, complications,preoperative and postoperative oral glucose tolerance test (OGTT),Homa-IR,Homa-β,blood lipid and nutrition status were analyzed.ResultsLRYGB procedures were successfully performed in all the 21 patients with no conversion to open surgery.The difference of intraoperative blood loss,postoperative recovery time between two groups was not significant.The mean operation time in OrVil group ( 126 ± 29 )mins was shorter than that in Endo-GIA group ( 156 ± 28 ) mins ( P ＜ 0.05 ),but at the same time,the mean expenditure was higher. Evaluated on three months after operation,the T2DM cure rate was 78％,and effective rate was 100％ in OrVil goup and those were 83％,100％ respectively in Endo-GIA group.No postoperative malnutrition, anemia or severe complication occurred.ConclusionsThe efficiency of laparoscopic Roux-en-Y gastric bypass using different amastomoses was same in the treatment of type 2 diabetes mellitus.The operation time was shorter in OrVil group but the expenditure was higher.