italic>Anoectochilus roxburghii liquid (spray, a hospital preparation of Wu Mengchao Hepatobiliary Hospital of Fujian Medical University) has shown a good clinical treatment effect during the COVID-19 pandemic, but its material basis and mechanism of action are still unclear. In this study, network pharmacology and molecular docking methods were used to predict the molecular mechanism of A. roxburghii liquid against COVID-19, and pharmacodynamic experiments in vitro were conducted to study the interaction between the current targets with clear preventive and therapeutic effects and the key components of A. roxburghii liquid. UPLC-MS and database were used to compare and analyze the active ingredients in the liquid, and 17 potential active ingredients with good drug-like properties were screened by in vivo pharmacokinetics process in SwissADME database. SwissTargetPrediction and GeneCards were searched to find 93 common targets. Cytoscape 3.8.2 software was used to construct the "component-target" network map, and the Metascape platform was used for gene function annotation and pathway enrichment analysis. It was found that the extract could regulate the positive response to external stimuli, inflammatory response, cytokine production and other biological processes by binding the active ingredients such as isorhamnetin, kaempferol, luteolin, quercetin and apigenin to the common targets (NOS3, MPO, MMP3, etc.), and play an anti-COVID-19 role. In the angiotensin-converting enzyme 2 (ACE2) activity inhibition assay, it was found that the stock solution of A. roxburghii liquid (for spray), and the supernatant after removing polysaccharides (mainly containing flavonoids) could to some extent inhibit the activity of ACE2. Crucially, in the experiment of 2019-nCOV-S pseudovirus infecting HEK-293T-ACE2 cells, we found that A. roxburghii liquid may exert anti-COVID-19 effects by blocking the binding of SARS-CoV-S protein to ACE2.

Objective To investigate the toxicokinetic differences of 3,4-methylenedioxy-N-methylamphetamine(MDMA)and its metabolite 4,5-methylene dioxy amphetamine(MDA)in rats af-ter single and continuous administration of MDMA,providing reference data for the forensic identifica-tion of MDMA.Methods A total of 24 rats in the single administration group were randomly divided into 5,10 and 20 mg/kg experimental groups and the control group,with 6 rats in each group.The ex-perimental group was given intraperitoneal injection of MDMA,and the control group was given intraperi-toneal injection of the same volume of normal saline as the experimental group.The amount of 0.5 mL blood was collected from the medial canthus 5 min,30 min,1 h,1.5 h,2 h,4 h,6 h,8 h,10 h,12 h after administration.In the continuous administration group,24 rats were randomly divided into the experi-mental group(18 rats)and the control group(6 rats).The experimental group was given MDMA 7 d by continuous intraperitoneal injection in increments of 5,7,9,11,13,15,17 mg/kg per day,respectively,while the control group was given the same volume of normal saline as the experimental group by in-traperitoneal injection.On the eighth day,the experimental rats were randomly divided into 5,10 and 20 mg/kg dose groups,with 6 rats in each group.MDMA was injected intraperitoneally,and the con-trol group was injected intraperitoneally with the same volume of normal saline as the experimental group.On the eighth day,0.5 mL of blood was taken from the medial canthus 5 min,30 min,1 h,1.5 h,2 h,4 h,6 h,8 h,10 h,12 h after administration.Liquid chromatography-triple quadrupole tandem mass spectrometry was used to detect MDMA and MDA levels,and statistical software was employed for data analysis.Results In the single-administration group,peak concentrations of MDMA and MDA were reached at 5 min and 1 h after administration,respectively,with the largest detection time limit of 12 h.In the continuous administration group,peak concentrations were reached at 30 min and 1.5 h af-ter administration,respectively,with the largest detection time limit of 10 h.Nonlinear fitting equations for the concentration ratio of MDMA and MDA in plasma and administration time in the single-administration group and continuous administration group were as follows:T=10.362C-1.183,R2=0.974 6;T=7.397 3C-0.694,R2=0.961 5(T:injection time;C:concentration ratio of MDMA to MDA in plasma).Conclusions The toxicokinetic data of MDMA and its metabolite MDA in rats,obtained through single and continuous administration,including peak concentration,peak time,detection time limit,and the relationship between concentration ratio and administration time,provide a theoretical and data foundation for relevant forensic identification.

Objective: To investigate the immune reconstitution of HIV/AIDS patients and its influencing factors after receiving antiviral therapy (ART) in Hangzhou City, so as to provide insights into improving the treatment effects and quality of life in HIV/AIDS patients. Methods: A retrospective cohort of HIV/AIDS patients who began antiviral treatment between January 1, 2016 and August 31, 2021 and had a baseline CD4+T lymphocyte (CD4) counts of less than 500 cells/μL or a baseline CD4/CD8+T lymphocyte (CD8) ratio of less than 0.8 in Hangzhou City was followed up until August 31, 2023. Demographic information, antiviral therapy in formation, CD4 counts, and CD4/CD8 were collected from the Chinese Disease Prevention and Control Information System. A good immune reconstitution was defined as having CD4≥500 cells/μL and CD4/CD8≥0.8. The immune reconstitution status of HIV/AIDS patients were analyzed, and factors affecting immune reconstitution were identified using a multivariable Cox proportional risk regression model. Results: A total of 3 349 HIV/AIDS patients were enrolled, with a median age at ART of 31 (interquartile range, 20) years. There were 3 075 males (91.82%), 1 600 cases with college education and above (47.78%) and 2 455 cases at WHO clinical stage Ⅰ-Ⅱ(73.31%). There were 1 368 cases with good immune reconstitution, accounting for 40.85%, and the proportion of HIV/AIDS patients with good immune reconstitution that began ART in 2016 was the highest, reaching 51.90%. Multivariable Cox proportional risk regression model identified WHO clinical stage (Ⅰ-Ⅱ, HR=2.529, 95%CI: 2.023-3.162), timely ART (HR=1.196, 95%CI: 1.027-1.394), initial treatment regimen (TDF+3TC+NVP/EFV, HR=2.185, 95%CI: 1.891-2.524; integrase inhibitors, HR=8.509, 95%CI: 6.706-10.795), baseline CD4/CD8 (≥0.1, HR: 1.600-4.515, 95%CI: 1.061-6.661), baseline hemoglobin (<90 mg/dL, HR=0.327, 95%CI: 0.121-0.880), hepatitis B infection (HR=0.619, 95%CI: 0.457-0.840) and hepatitis C infection (HR=0.308, 95%CI: 0.099-0.956) as factors affecting immune reconstitution in HIV/AIDS patients. Conclusion The immune reconstitution in HIV/AIDS patients after ART is associated with WHO clinical stage, timely ART, initial treatment regimen, baseline CD4/CD8, baseline hemoglobin and hepatitis B or C infection.

Objective Bevacizumab has been clinically used in colorectal cancer,ovarian cancer,cervical cancer,non-small cell lung cancer and other tumor diseases.Common adverse reactions during bevacizumab treatment include albuminuria,thrombosis,bleeding,gastrointestinal perforation and hypertension,among which the incidence of hypertension is as high as 19％-47％.The occurrence of hypertension affects the quality of life of patients,hinds the normal development of tumor treatment,and even induces serious cardiovascular diseases and increases the risk of death,which requires clinical attention.In this paper,the mechanism,influencing factors,prognosis and related treatment of bevacizumab associated hypertension were reviewed,so as to provide reference for clinical rational drug use.

Objective:To understand the serotype distribution, drug resistance and molecular characterization of invasive non-typhoid Salmonella (iNTS) in Guangdong Province from 2018 to 2022 and provide scientific evidence for the prevention and treatment of blood flow infection caused by Salmonella. Methods:Serological identification, antimicrobial susceptibility testing, multilocus sequence typing (MLST), and whole genome sequencing were performed on Salmonella isolated from blood and stool samples in Guangdong from 2018 to 2022. Simultaneously, annotated the sequencing results for drug resistance genes and virulence factors by a microbial gene annotation system. Results:The 136 iNTS strains were divided into 25 serotypes, and Salmonella enteritidis accounted for 38.24% (52/136). The OR of other iNTS serotypes were calculated with Salmonella typhimurium as the control. The OR values of Oreninburg, Rysson, and Pomona serotypes were the highest, which were 423.50, 352.92, and 211.75, respectively. The drug resistance rate of iNTS was 0.74%-66.91%, which was lower than that of non-iNTS (3.90%-77.21%). The main iNTS of drug resistance were ampicillin and tetracycline, with resistance rates of 66.91% (91/136) and 50.00% (68/136), respectively, while the resistance rates to ciprofloxacin (5.88%,8/136), ceftazidime (5.88%,8/136), gentamicin (5.13%,7/136) and cefoxitin (0.74%, 1/136) were relatively low. iNTS carried a variety of drug-resistance genes and virulence factors, but no standard virulence factor distribution has been found. MLST cluster analysis showed that iNTS was divided into 26 sequence types, and ST11 accounted for 38.24% (52/136). Conclusions:The iNTS strains in Guangdong were dominated by Salmonella enteritidis, of which three serotypes, Oreninburg, Rison, and Pomona, may be associated with a higher risk of invasive infection during 2018 to 2022 . iNTS was sensitive to clinical first-line therapeutic drugs (cephalosporins and fluoroquinolones), with highly diverse sequences and clear phylogenetic branches. ST11 was the local dominant clone group.

Objective To design a novel oxygenator to solve the existing problems of extracorporeal membrane oxygenation(ECMO)machine in high transmembrane pressure difference,low efficiency of blood oxygen exchange and susceptibility to thrombosis.Methods The main body of the oxygenator vascular access flow field was gifted with a flat cylindrical shape.The topology of the vascular access was modeled in three dimensions,and the whole flow field was cut into a blood inlet section,an inlet buffer,a heat exchange zone,a blood oxygen exchange zone,an outlet buffer and a blood outlet section.The oxygenator was compared with Quadrox oxygenator by means of ANSYS FLUENT-based simulation and prototype experiments.Results Simulation calculations showed the oxygenator designed was comparable to the clinically used ones in general,and gained advantages in transmembrane pressure difference,blood oxygen exchange and flow uniformity.Experimental results indicated that the oxygenator behaved better than Quadrox oxygenator in transmembrane pressure difference and blood oxygen exchange.Conclusion The oxygenator has advantages in transmem-brane pressure difference,temperature change,blood oxygen ex-change and low probability of thrombosis.[Chinese Medical Equipment Journal,2024,45(3):23-28]

One patient was admitted to a hospital due to"sepsis,chronic kidney disease,type 2 diabetes,shock,and cerebral infarction".Patient's blood specimen was taken for clinical examination.Aerobic and anaerobic culture results of catheter blood and venous blood were both positive.The pathogen was identified as Staphylococcus pas-teuri by VITEK MS,and the patient was diagnosed as catheter-related bloodstream infection caused by Staphylo-coccus pasteuri.Clinical empirical use of piperacillin for anti-infection treatment was ineffective,and vancomycin was eventually used for treatment based on in vitro antimicrobial susceptibility testing.Patient's condition improved after removing the venous catheter.There are currently no reported cases of Staphylococcus pasteuri in China.Ear-ly identification of pathogen and adjustment of treatment plans based on antimicrobial susceptibility testing results are crucial for effective treatment of this case.

This study was aimed at understanding the detection rate,drug resistance characteristics,virulence characteris-tics,multi-locus sequence typing,and other molecular epidemic and pathogenic characteristics of Campylobacter jejuni and Campylobacter coli in children in Guangdong Province from 2020 to 2022.Anal swabs or stool samples of suspected infection cases in children from 2020 to 2022 were collected from two hospitals in Guangzhou,Guangdong Province.Campylobacter was isolated and cultured through the filtration method,and identified with a microbial mass spectrometry system;antibiotic resist-ance was analyzed with the agar dilution method;bacterial genome nucleic acids were extracted,and whole-genome sequencing was conducted;and drug resistance genes,virulence genes,multi-locus sequence typing,and phylogenetic analysis based on whole-genome single nucleotide polymorphisms were analyzed from whole-genome sequencing results.First,53 strains of Campy-lobacter were detected through continuous routine monitoring in this study,with a positive detection rate of 2.94％.Among them,Campylobacter jejuni accounted for 81.13％(43/53)and Campylobacter coli accounted for 18.87％(10/53).In addition,16 strains of Campylobacter were screened through multi-pathogen surveillance,including 11 strains of Campylobacter jejuni and 5 strains of Campylobacter coli.Drug resistance ex-periments and whole genome sequencing were conducted on 46 Campylobacter isolates,including 33 isolates of Campylobacter jejuni and 13 isolates of Campylobacter coli.The resistance rate of Campylobacter to erythromycin,a widely used clinical treatment,was21.73％(10/46);that to tetracycline was 80.43％(37/46);those to the quinolone antibiotics nalidixic acid and ciprofloxacin were 76.08％(35/46)and 71.73％(33/46)respectively;and that to chloramphenicol was lowest,at 2.17％(1/46).The drug resistance rate was generally higher for Campylobacter coli than Campylobacter jejuni,and the differences in the indicators of erythromycin,gentamicin,streptomycin,telithromycin,and clindamycin were statistically significant.A total of 30 isolates of multidrug-resistant Campylobacter were detected,including nine multidrug-resistant phenotypes.Whole-ge-nome sequence analysis indicated that 46 Campylobacter isolates carried antibiotic resistance genes for antibiotics such as quino-lones,tetracyclines,β-lactams,and aminoglycosides,and carried 128 virulence factor genes in five categories.All 46 isolates of Campylobacter were identified as 35 ST type through MLST typing,and phylogenetic analysis indicated no obvious dominant ST type.Campylobacter coli had more SNPs than Campylobacter jejuni.In conclusion,the positive detection rate of Campy-lobacter in Guangzhou City,Guangdong Province stabilized from 2020 to 2022,and the detection rate of Campylobacter jejuni was higher than that of Campylobacter coli.Campylobacter isolates were resistant to tetracyclines and quinolone,and showed a wide spectrum of multi-drug resistance,which was relatively severe among Campylobacter coli.Resistance genes and drug-resistant phenotypes were correlated and had predictive significance.The virulence genes of Campylobacter jejuni were more a-bundant than those of Campylobacter coli,possibly because of the higher detection rate and pathogenicity of Campylobacter jejuni.The phylogenetic tree showed clear branches with high genetic diversity and no clearly dominant clonal group.

Objective To study the expression of amplified in breast cancer 1(AIB1)and ankyrin repeat domain containing11(ANKRD11/ANCO1)in human papillomavirus(HPV)positive cervical cancer and their relationship with clinicopathological characteristics and their predictive value for postoperative recurrence.Methods Cancer tissues and paracancer tissues of 94 HPV positive cervical cancer patients who visited the Third People's Hospital of Mianyang from January 2018 to January 2020 were selected,while 50 HPV negative cervical cancer tissues during this period were taken as controls.Real-time qPCR(RT-qPCR)was conducted to detect AIB1 mRNA and ANCO1 mRNA expression in cancer tissue and paracancer tissues of HPV positive cervical cancer and cancer tissue of HPV negative cervical.Pearson analysis of the correlation between AIB1 mRNA and ANCO1 mRNA expression in HPV positive cervical cancer tissues.Logistic regression analysis was used to identify the risk factors for postoperative recurrence of HPV-positive cervical cancer patients.The predictive value of AIB1 mRNA,ANCO1 mRNA,and their combination in predicting postoperative recurrence in HPV positive cervical cancer patients was analyzed by receiver operating characteristic curve.Results Compared to the adjacent tissues of HPV positive cervical cancer and cancer tissues of HPV negative cervical cancer,AIB1 mRNA(3.04±0.37 vs 0.87±0.21,1.02±0.33)in HPV positive cervical cancer tissues was higher,while ANCO1 mRNA(1.13±0.26 vs 1.91±0.35,1.82±0.36)was lower,with significant differences(t=68.499,53.137;23.649,17.434,all P<0.05).The expression of AIB1 mRNA and ANCO1 mRNA in HPV positive cervical cancer tissues showed a negative correlation(r=-0.714,P<0.001).Compared to patients with FIGO stage ⅡA～ⅡB and without lymph node metastasis,AIB1 mRNA(3.88±0.32 vs 2.04±0.41,4.46±0.33 vs 2.16±0.46)in HPV positive cervical cancer tissues with FIGO stage ⅡA and lymph node metastasis was higher,while ANCO1 mRNA(0.67±0.29 vs 1.68±0.20,0.49±0.24 vs 1.53±0.32)was lower,with significant differences(t=24.425,26.097;19.288,16.777,all P<0.001).FIGO stage ⅡA,lymph node metastasis,and high AIB1 mRNA[OR(95％CI)=1.644(1.223～2.210),1.779(1.295～2.444),1.247(1.050～1.728)]were risk factors for postoperative recurrence in HPV positive cervical cancer patients,while high ANCO1 mRNA[(OR(95％CI):0.634(0.451～0.891)]was a protective factor.The AUC(95％CI)of AIB1 mRNA and ANCO11 mRNA combined for predicting postoperative recurrence in HPV positive cervical cancer patients was 0.914(0.863～0.952),which was higher than the single indicator detection of 0.821(0.782～0.869)and 0.794(0.763～0.847),and the differences were significant(Z=4.123,4.432,all P<0.001).Conclusion The expression of AIB1 mRNA is increased and the expression of ANCO1 mRNA is reduced in HPV positive cervical cancer tissue,which are related to the occurrence and progression of cancer.The combination of the two has a high predictive value for evaluating postoperative recurrence.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.