Objective To analyze the characteristics of postoperative hospital-acquired infections and drug sensitivity in lung transplant recipients over the past 5 years in a single center. Methods A total of 724 lung transplant recipients at Wuxi People's Hospital from January 2019 to December 2023 were selected. Based on the principles of hospital-acquired infection diagnosis, a retrospective analysis was conducted on the hospital infection situation and infection sites of lung transplant recipients, and an analysis of the distribution of hospital-acquired infection pathogens and their antimicrobial susceptibility test status was performed. Results Among the 724 lung transplant recipients, 275 cases of hospital-acquired infection occurred, with an infection rate of 38.0%. The case-time infection rate decreased from 54.2% in 2019 to 22.8% in 2023, showing a downward trend year by year (Z=30.98, P<0.001). The main infection site was the lower respiratory tract, accounting for 73.6%. The pathogens were mainly Gram-negative bacteria, with the top four being Acinetobacter baumannii (37.1%), Pseudomonas aeruginosa (17.3%), Klebsiella pneumoniae (13.7%), and Stenotrophomonas maltophilia (13.4%), with imipenem resistance rates of 89%, 53%, 58% and 100%, respectively. Gram-positive bacteria were mainly Staphylococcus aureus (3.6%), with a methicillin resistance rate of 67%. Conclusions Over the past 5 years, the hospital-acquired infections in lung transplant recipients have shown a downward trend, mainly involving lower respiratory tract infections, with the main pathogens being Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae, all of which have high resistance rates to imipenem.

Objective:To investigate the clinical significance of tumor budding as an indicator of postoperative distant organ metastasis after radical gastrectomy in elderly patients diagnosed with gastric cancer.Methods:The clinical and pathological data of 124 elderly patients who experienced metastasis after undergoing radical gastrectomy were retrospectively analyzed.The analysis was conducted from March 2015 to June 2022, focusing on the clinicopathological factors that influenced the occurrence of postoperative distant metastasis in these patients.Tumor budding in gastric cancer tissues was assessed using hematoxylin-eosin staining, and its clinical significance was analyzed.Results:The tumor budding grade of gastric cancer tissues showed a significant correlation with vascular invasion( χ2=6.731, P=0.009), the number of lymph node metastases( rs=0.481, P<0.001), and the time of distant metastasis( rs=-0.450, P<0.001).In the univariate analysis, factors such as tumor budding grade, tumor size, vascular invasion, postoperative chemotherapy, cancerous nodule, preoperative serum carbohydrate antigen 125, and the number of lymph node metastases were found to influence distant metastasis-free survival after radical gastrectomy in elderly patients(all P<0.05).The multifactorial analysis also indicated that tumour outgrowth grade was an important independent prognostic factor for postoperative distant metastasis in elderly gastric cancer patients( HR=3.731, P<0.001). Conclusions:The findings of this study indicate that tumor budding may serve as a potential marker for predicting distant organ metastasis in elderly patients who have undergone radical gastrectomy.This discovery holds significant clinical implications.

BACKGROUND: The HELIOS stent is a sirolimus-eluting stent with a biodegradable polymer and titanium oxide film as the tie-layer. The study aimed to evaluate the safety and efficacy of HELIOS stent in a real-world setting. METHODS: The HELIOS registry is a prospective, multicenter, cohort study conducted at 38 centers across China between November 2018 and December 2019. A total of 3060 consecutive patients were enrolled after application of minimal inclusion and exclusion criteria. The primary endpoint was target lesion failure (TLF), defined as a composite of cardiac death, non-fatal target vessel myocardial infarction (MI), and clinically indicated target lesion revascularization (TLR) at 1-year follow-up. Kaplan-Meier methods were used to estimate the cumulative incidence of clinical events and construct survival curves. RESULTS: A total of 2998 (98.0%) patients completed the 1-year follow-up. The 1-year incidence of TLF was 3.10% (94/2998, 95% closed interval: 2.54-3.78%). The rates of cardiac death, non-fatal target vessel MI and clinically indicated TLR were 2.33% (70/2998), 0.20% (6/2998), and 0.70% (21/2998), respectively. The rate of stent thrombosis was 0.33% (10/2998). Age ≥60 years, diabetes mellitus, family history of coronary artery disease, acute myocardial infarction at admission, and device success were independent predictors of TLF at 1 year. CONCLUSION: The 1-year incidence rates of TLF and stent thrombosis were 3.10% and 0.33%, respectively, in patients treated with HELIOS stents. Our results provide clinical evidence for interventional cardiologists and policymakers to evaluate HELIOS stent. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, NCT03916432.
Humans ; Middle Aged ; Sirolimus/therapeutic use* ; Drug-Eluting Stents/adverse effects* ; Prospective Studies ; Cohort Studies ; Treatment Outcome ; Risk Factors ; Time Factors ; Percutaneous Coronary Intervention/adverse effects* ; Cardiovascular Agents/therapeutic use* ; Coronary Artery Disease/therapy* ; Myocardial Infarction/etiology* ; Thrombosis/complications* ; Polymers ; Registries

ObjectiveTo investigate the clinical features of hepatic follicular dentritic cell sarcoma (FDCS).MethodsClinical data of a patient with hepatic FDCS treated in Cancer Hospital Affiliated to Zhengzhou University in 2004 were retrospectively analyzed. The informed consent of the patient was obtained and the local ethical committee approval had been received. The patient, female, 49-year-old, was admitted to the hospital for the complaint of abdominal pain for 1 month . A 12 cm×12 cm in diameter, hard, poor activity tumor was found below xiphoid by physical examination. Abdominal tenderness was positive and laboratory examinations were essentially normal. CT scan showed a 20 cm in diameter solid lesion in the left lobe of liver. The tumor was observed irregularly enhanced in the arterial phase by enhanced CT scan. The enhancement faded away in the delayed phase, and the tumor revealed a low-density lesion. The initial diagnosis was primary liver cancer.ResultsAfter an active preoperative preparation, the patient underwent left lobectomy under endotracheal general anesthesia on August 31, 2004. A tough tumor measuring 23 cm×20 cm in diameter was found in the left lobe of liver during the surgery. Nodule foci were found beside the tumor and no obvious metastasis was found within the abdomen, pelvic cavity and peritonium. Postoperative pathological examination indicated inlfammatory pseudotumor FDCS and Immunohistochemistry indicated positive CD21, CD23, CD35 and vimentin (VIM). Tumor recurrence and matastasis were observed in the liver, abdomen cavity and chest wall etc. repeatedly and was resected during 2006 to 2014. The patient is currently in stable condition and no recurrence or metastasis was observed during regular follow-up till submission date. ConclusionsHepatic FDCS is a very rare disease. The diagnosis relies on the results of pathological examination. Surgical resection is a reliable treatment and the prognosis is favorable.

OBJECTIVETo investigate the influence of miR-148a on cell proliferation of human gastric cancer cell lines MKN45.

METHODSExpression level of miR-148a was detected by qRT-PCR in the carcinoma tissues and the tissues adjacent to carcinoma of 60 patients with gastric cancer. Lentivirus packaging was used to establish MKN45 gastric cancer cell line expressing stable miR-148a as transfection group,and the untransfected MKN45 cell line as the control group. Gastric cancer MKN45 cell proliferation was detected by CCK8 method. The target gene of miR-148a was predicted by targetscan. Expression of target gene was examined by Western blotting.

RESULTExpression of miR-148a in gastric cancer tissues of 54 cases(90.0%, 54/60) decreased, and among them, 37 tissue samples(61.7%, 37/60) decreased by 2 times. mir-148a expression in cancer tissues of patients with lymph node metastasis, vascular invasion and TNM stage III(-IIII( was down-regulated more obviously(P<0.05). From the third day after transfection, the growth of MKN45 cells was significantly inhibited(P<0.01). Gene CDC25B might be the target gene of miR-148a according to the results of targetscan. Western blot showed that CDC25B expression in transfection group was lower as compared to control group.

CONCLUSIONMiR-148a expression is down-regulated in gastric cancer tissues and inhibits gastric cancer cell proliferation. CDC25B may be the target gene of miR-148a that plays a role in tumor suppressor.

Cell Line, Tumor ; Cell Proliferation ; Down-Regulation ; Humans ; Lymphatic Metastasis ; MicroRNAs ; genetics ; Neoplasm Staging ; Reverse Transcriptase Polymerase Chain Reaction ; Stomach Neoplasms ; genetics ; Transfection

Objective To investigate the effect of rectal washout on prevention of local recurrence in patients with resectable rectal cancer.Methods Relevant studies published on PubMed,Embase database and Google between January 1980 and June 2013 were identified and reviewed.A meta-analysis was performed to compute the risk ratio (RR) and evaluate the effect of rectal washout on local recurrence in patients included in the reviewed studies.Results Eight studies were included in the meta-analysis,in which a total of 427 patients underwent rectal washout and 492 did not during rectal cancer resection.The patients had an overall local recurrence (LR) rate of 6.64 ％ (61/919).Rectal washout,no matter which type of washout solution was used,significantly reduced the risks of local recurrence (3.75 ％,16/427 vs 9.15 ％,45/492,RR =0.46,95 ％ CI =0.26-0.82,P =0.008).Patients with rectal washout showed a low LR rate,when compared with those in the three subgroups who underwent total mesorectal excision (TME) (5.18 ％,10/193 vs 5.32 ％,10/188).However,there was no statistically significant difference in the risk of LR among the three subgroups (RR =0.99,95 ％ CI =0.42-2.30,P =0.98; RR =0.44,95 ％ CI =0.18-1.04,P =0.06; RR =0.46,95 ％ CI =0.20-1.04,P =0.06,respectively).Conclusions The intra-operative rectal washout largely reduces local recurrence after anterior resection of rectal cancer.Rectal washout should be applied routinely during anterior resection.

Objective To investigate the influence of miR-148a on cell proliferation of human gastric cancer cell lines MKN45. Methods Expression level of miR-148a was detected by qRT-PCR in the carcinoma tissues and the tissues adjacent to carcinoma of 60 patients with gastric cancer. Lentivirus packaging was used to establish MKN45 gastric cancer cell line expressing stable miR-148a as transfection group,and the untransfected MKN45 cell line as the control group. Gastric cancer MKN45 cell proliferation was detected by CCK8 method . The target gene of miR-148a was predicted by targetscan. Expression of target gene was examined by Western blotting. Result Expression of miR-148a in gastric cancer tissues of 54 cases (90.0%, 54/60) decreased, and among them, 37 tissue samples (61.7%, 37/60) decreased by 2 times. mir-148a expression in cancer tissues of patients with lymph node metastasis , vascular invasion and TNM stage Ⅲ-Ⅳ was down-regulated more obviously(P<0.05). From the third day after transfection, the growth of MKN45 cells was significantly inhibited (P<0.01). Gene CDC25B might be the target gene of miR-148a according to the results of targetscan. Western blot showed that CDC25B expression in transfection group was lower as compared to control group. Conclusion MiR-148a expression is down-regulated in gastric cancer tissues and inhibits gastric cancer cell proliferation. CDC25B may be the target gene of miR-148a that plays a role in tumor suppressor.

Objective To investigate the influence of miR-148a on cell proliferation of human gastric cancer cell lines MKN45. Methods Expression level of miR-148a was detected by qRT-PCR in the carcinoma tissues and the tissues adjacent to carcinoma of 60 patients with gastric cancer. Lentivirus packaging was used to establish MKN45 gastric cancer cell line expressing stable miR-148a as transfection group,and the untransfected MKN45 cell line as the control group. Gastric cancer MKN45 cell proliferation was detected by CCK8 method . The target gene of miR-148a was predicted by targetscan. Expression of target gene was examined by Western blotting. Result Expression of miR-148a in gastric cancer tissues of 54 cases (90.0%, 54/60) decreased, and among them, 37 tissue samples (61.7%, 37/60) decreased by 2 times. mir-148a expression in cancer tissues of patients with lymph node metastasis , vascular invasion and TNM stage Ⅲ-Ⅳ was down-regulated more obviously(P<0.05). From the third day after transfection, the growth of MKN45 cells was significantly inhibited (P<0.01). Gene CDC25B might be the target gene of miR-148a according to the results of targetscan. Western blot showed that CDC25B expression in transfection group was lower as compared to control group. Conclusion MiR-148a expression is down-regulated in gastric cancer tissues and inhibits gastric cancer cell proliferation. CDC25B may be the target gene of miR-148a that plays a role in tumor suppressor.

Objective The purpose of this study was to use diffusion tensor imaging (DTI) and resting-state functional magnetic resonance imaging (rs-fMRI) alone or in combination to observe the distribution of white matter lesions and cortical malfunctional areas in human immunodeficiency virus (HIV) infected patients with mild cognitive decline and to explore the relationship between the DTI and the rs-fMRI methods.Methods Twenty-six HIV infected patients with mild cognitive impairment and 30 healthy volunteers were selected by Montreal Cognitive Asessment (MoCA) scale evaluation.DTI data and rs-fMRI data were obtained,fractional anisotropy (FA) value images were obtained with voxel based analysis and the resting-state default mode network (DMN),functional connectivity images were obtained with cingulate gyrus as a seed point.Overlay images were obtained with FA,DMN and Ch2 standard images.Results Compared with the control group,the white matter FA values were significantly decreased in the left precuneus(t=4.0499,P＜0.005) and right precuneus (t=5.1553,P＜0.005),right superior frontal gyrus(t=5.1517,5.1484,P＜0.005),right middle frontal gyrus (t=4.1444,P＜0.005),right precentral gyrus (t=3.7395,P＜0.005),right occipital lobe (t=7.2236,P＜0.005),and right inferior parietal lobule (t=4.1450,P＜0.005) in acquired immunodeficiency syndrome (AIDS) patients.In resting-state default mode network,areas significantly related to cingulate gyrus seed point included the left cingulate gyrus (t =32.78,P＜0.005),left precuneus (t =4.51,P＜0.005),left superior frontal gyrus (t =14.33,4.53,P＜0.005),left middle temporal gyrus (t =10.01,5.72,P＜ 0.005),left inferior temporal gyrus (t =5.99,P＜0.005),left parahippocampal gyrus (t =7.63,P＜0.005),right posterior cingulate (t =34.81,P＜0.005),right precuneus (t=32.09,P＜0.005),right superior frontal gyrus(t =14.12,P＜0.005),right middle frontal gyrus (t=17.71,P＜0.005),right superior temporal gyrus (t=14.59,P＜0.005),and right middle temporal gyrus (t=11.83,P＜0.005); while areas not significantly related to the cingulate gyrus seed point included the left precuneus (t =5.39,P＜0.01),left anterior cingulate gyrus (t =3.66,P＜0.01),left cerebellar tonsils (t =7.51,P＜0.01),right superior parietal lobule (t=4.44,P＜0.01),right parahippocampa gyrus (t =3.69,P＜0.01),and right cerebellar tonsil (t=6.15,P＜0.01).Overlayed images showed that the white matter FA value of the left precuneus were decreased and the functional activitis of the corresponding cortex were significantly decreased; while the white matter FA values of the left precuneus,right precuneus,right superior frontal gyrus,right middle frontal gyrus were decreased without affection of the functional activity of the corresponding cortex in AIDS patients.Conclusion White matter nerve fiber disconnection of multiple brain regions and its corresponding cortical function decline with compensatory activity co-participated in the pathogenesis of AIDS mild cognitive decline.

Objective To evaluate the characteristics and efficacy of microscope-assisted bilateral decompression via unilateral approach for the treatment of lumbar stenosis. Methods From June 2007 to June 2010, Sixty case lumbar stenosis with bilateral decompression were treated via unilateral approach under microscopy. Patients were followed up from 6 to 24 months, average (12 ± 4.7) months. Results The pain level of each patient was assessed both before and after the opeartion, using a visual analogue scale (VAS). Intermittent claudication was completely relieved in 57 out of 60 cases, moderately relieved in 3 cases. VAS score decreased from pre-operational 9.08 ± 0.76 to post-operational 2.33 ± 1.43, and there was significantly difference between them. There was no recurrent case during the whole follow-up. Conclusion Bilateral decompression via unilateral approach under microscope is proved to be an effective and safe procedure for the treatment of lumbar stenosis, and have the advantages of minimal invasion, less pain, quick recovery, better effect, little influence on the spinal stability.