Objective The aim of this study is to analyze the characteristics and risk factors of community-acquired infectious pathogens in our hospital's outpatient and emergency department from 2020 to 2022, in order to develop targeted prevention and control measures. Methods A retrospective analysis of 17 423 pathogen specimens from patients with community-acquired infections admitted to the outpatient and emergency departments of our hospital from January 2020 to December 2022 was conducted. Detailed information about the infection site was recorded, and the etiological characteristics and influencing factors were analyzed. Results From 2020 to 2022, the specimens sent for inspection in our hospital mainly included blood, sputum and urine, with a total of 6 613 non-duplicate pathogenic strains detected, yielding a detection rate of 37.95%. The top five detected pathogenic organisms were Escherichia coli (19.16%), Klebsiella pneumoniae (9.56%), Acinetobacter baumannii (7.38%), Candida albicans (7.35%), and Staphylococcus aureus (6.77%). Among them, the detection rate of Escherichia coli showed a decreasing trend year by year (2=13.051, P=0.001), while the detection rate of Acinetobacter baumannii showed an increasing trend year by year (2=24.392, P<0.001). Multivariate Logistic regression analysis showed that age ≥60 years, presence of underlying diseases,invasive medical procedures within 1 month, skin injuries within 1 month, history of hemodialysis within 3 months, and History of antibiotic use within 3 months were independent risk factors for community-acquired infections in our hospital. Conclusion From 2020 to 2022, the main pathogens causing community-acquired infections in our hospital were Gram-negative bacteria. In view of the specific distribution of pathogenic species and infection risk factors, clinicians should implement more targeted prevention and control measures against relevant risk factors.

OBJECTIVE To s tudy the impr ovement effects of tilianin on the atherosclerosis （AS）model mice and its potential mechanism. METHODS Eight C 57BL/6J mice were taken as the normal group. Forty ApoE－/－ mice were randomly divided into model group ，tilianin low-dose ，medium-dose and high-dose groups [ 2.1，3.5，7.0 mg/（kg·d）] and simvastatin group [positive control drug ，3.5 mg/（kg·d）]，with 8 mice in each group. Normal group was given normal diet ，and other groups were given high-lipid diet to induce AS model. At the same time ，normal group and model group were given normal saline intragastrically ， administration groups were given relevant drug intragastrically ，once a day ，for 12 consecutive weeks. The levels of TC ，TG， LDL-C，HDL-C，Ox-LDL，IL-1β，IL-6，MCP-1 and TNF-α in plasma were determined. The pathomorphological changes of the aorta in mice were observed. The positive rate of ICAM- 1，VCAM-1 and PCNA in the aorta were determined. mRNA expressions of MMP- 2，MMP-9，TGF-β1，Smad2 and Smad 3 as well as protein expressions of TGF-β1，Smad2/3 and p-Smad 2/3 were also determined in aorta of mice. RESULTS Compared with normal group ，the plasma levels of TC ，TG，LDL-C，Ox-LDL，IL-1β， IL-6，MCP-1 and TNF-α in model group were increased significantly（P＜0.01），while HDL-C level was significantly reduced （P＜0.01）. Lipid plaques were formed in the aorta ，and the plaque area was large and caused severe stenosis of the lumen. mRNA expressions of MMP- 2，MMP-9，TGF-β1，Smad2 and Smad 3 as well as positive rate of ICAM- 1，VCAM-1，PCNA and protein expression TGF-β1，Smad2/3，and p-Smad 2/3 in the aorta were significantly increased （P＜0.01）. Compared with model group ， most of above indexes of medication groups were improved significantly （P＜0.05 or P＜0.01）. CONCLUSIONS Tilianin can inhibit the activation of TGF-β1/Smads signaling pathway and then inhibit the proliferation of vascular smooth muscle cells ，reduce ， inflammation and regulate lipid metabolism to inhibit the No.81960766） formation of AS.

Objective To investigate the immune regulation and prognosis of hepatitis B virus (HBV) infection in infected patients, and to analyze the relationship between immune regulation and clinical outcome. Methods The data of 633 cases of HBV infection in Huhhot from January 2015 to December 2018 were retrospectively analyzed. At the same time, healthy people from the Affiliated Hospital of Inner Mongolia Medical University were selected as the control group. Immune cell regulatory factors and lymphocyte subsets in blood of HBV infected and healthy people were tested. The results of one-year clinical outcomes were calculated. The relationship between immune cell regulatory factors and lymphocytes and the clinical outcomes of patients was analyzed by multiple logistics regression. Results The levels of CD4+T cells, CD8+T cells, NK cells, IL-2, and IL-12 in the blood of patients with HBV infection were significantly lower than those in the control group, and decreased as the patients’ clinical outcome deteriorated (P<0.05). The levels of IL-4 and IL-10 in the blood of patients with HBV infection were significantly higher than those in the control group, and increased significantly with the deterioration of the clinical outcome of the patients (P<0.05). There was no significant difference in the levels of INF-γ, B cells and CD4+/CD8+ between the two groups (P>0.05). Low CD4+ T cells, low CD8+ T cells, low NK cells, low IL-2, low IL-12, high IL- 4 and high IL-10 were independent risk factors leading to the deterioration of clinical outcomes (P<0.05). Conclusion The immune regulation of patients with HBV infection is in a state of suppression, which is an independent factor affecting the clinical outcome of patients.

Objective: To investigate the expressions of miR-144 and lncRNA DNAJC3-AS1 in breast cancer tissues and their effects on chemo-resistance of breast cancer MCF-7 cells. Methods: A total of 196 pairs of breast cancer tissues and corresponding adjacent normal tissues collected between January, 2012 and December, 2016 in Department of Oncology, 3201 Hospital were used for this study. The relative expressions of DNAJC3-AS1, DNAJC3 and miR-144 in collected tissues were determined using qPCR, and their impact on the survival of BC patients was also analyzed. The targeted binding relationship between DNAJC3-AS1 and miR-144 was verified by Luciferase reporter gene assay. DNAJC3-AS1 over-expression plasmid and miR-144 mimics were transfected into MCF-7 cell lines respectively, and qPCR was used to verify the transfection efficiency. The effects of DNAJC3-AS1 and miR-144 overexpression on proliferation and cisplatin sensitivity of MCF-7 cells were verified by CCK-8 assay. Results: DNAJC3-AS1 and its host gene DNAJC3 were highly expressed in BC tissues (all P<0.01), and these two were positively correlated (r=0.451, P<0.01); in addition, patients with high expressions of DNAJC3-AS1 and DNAJC3 had a shorter survival period (all P<0.01). miR-144 was highly expressed in BC tissues (P<0.01) and negatively correlated with DNAJC3-AS1 (r=-0.524, P<0.01). The average over-expressionfold for DNAJC3-AS1 was 13.47 (P<0.01), while the fold for miR-144 was 20.27 (P<0.01). Bioinformatics analysis and fluorescence reporter gene assay confirmed that DNAJC3-AS1 could specifically bind to miR-144. MCF-7 cell lines over-expressing DNAJC3-AS1 and miR-14 were successfully constructed; compared with control group, cells in DNAJC3-AS1 over-expression group exhibited significantly enhanced proliferation and reduced cisplatin-sensitivity (all P<0.01), while the cells in miR-144 over-expression group showed significantly enhanced drug sensitivity (P<0.01). Conclusion: miR-144 and lncDNAJC3-AS1 were highly expressed in BC tissues, miR-144 promotes cisplatin sensitivity of BC MCF-7 cells through targeting DNAJC3-AS1.

Objective: To analyze the clinical characteristics caused by acute poisoning by inhalation of hydrogen chloride (HCl) and to raise awareness and treatment level of the disease. Methods: The clinical manifestations, imaging features, diagnosis, treatment and prognosis of 5 patients with acute HCl poisoning were analyzed retrospectively. Results: Among the 5 cases of HCl poisoning, 2 cases were severe poisoning, 3 cases were moderate poisoning. All patients were treated with corticosteroids and symptomatic treatment, one of them was treated with venovenous extracorporeal membrane oxygenation (VV-ECMO) . All patients were recovered and discharged from hospital. Conclusion The lung damage of acute poisoning by inhalation of HCl is rapidly progressing, early detection and timely medical treatment can obtain a better prognosis.

Objective To evaluate the efficacy and safety of different antimicrobial regimens in patients with bloodstream infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP).Methods The clinical date of patients with CRKP bloodstream infections were retrospectively analyzed at the First Affiliated Hospital of Zhejiang University Medical College between January 2017 and January 2018.All subjects were separated into three groups based on antibiotics regimens over 72 hours,including meropenem 2.0 g every 8 hours,tigecycline 200 mg as initial dose and 100 mg every 12 hours,and polymyxin B 1.25 mg/kg every 12 hours as salvage treatment of tigecycline.Results A total of 86 patients were finally recruited,including 14,52 and 20 patients in groups of meropenem,tigecycline and polymyxin B salvage,respectively.All of the strains were resistant to meropenem and susceptible to tigecycline and polymyxin B initially,while 2 of them became resistant to tigecycline during treatment.The 28-day mortality was significantly higher in meropenem group (13/14) than that in tigecycline group and polymyxin B salvage group (61.5％,32/52) and (12/20),respectively (P＜0.01),while as no significant difference was seen in the last two groups (x2=0.014,P＞0.05).The incidences of hepatic impairment [3.8％(2/52) vs.1/20] and renal dysfunction (0 vs.1/20) between tigecycline group and polymyxin B salvage group were both comparable (P＞0.05).Conclusion The meropenem-based therapy is not recommended for CRKP-related bloodstream infections.Tigecycline-based therapy is still disappointing despite salvage use of polymyxin B after 72 hours.Hepatic and nephretic toxicities caused by additional polymyxin B are acceptable.

Objective To investigate the prognostic value of serum P-cadherin( P-cad)level in patients with non-small cell lung cancer(NSCLC). Methods A total of 80 patients with NSCLC in Hanzhong 3201 Hospital of Shaanxi Province from January 2012 to December 2013 were selected as study subjects. The relationships between serum P-cad level and clinicopathological characteristics were analyzed. The Cox regres-sion analysis was used to analyze the risk factors affecting prognosis of NSCLC patients. The survival curve was drawn by Kaplan-Meier method and the difference test was carried out by log-rank method. Results There were significant differences in lymph node metastasis(χ2 = 14. 31,P < 0. 001),vascular invasion(χ2 = 5. 56, P = 0. 018)among NSCLC patients with different levels of serum P-cad. Multivariate Cox regression analysis showed that lymph node metastasis(HR = 0. 856,95％ CI:0. 702-0. 955,P = 0. 012),TNM stage(ⅢA HR =1. 315,95％ CI:1. 058-1. 991,P = 0. 024;ⅢB HR = 1. 448,95％ CI:1. 124-2. 215,P = 0. 011;Ⅳ HR =1. 569,95％ CI:1. 182-2. 441,P < 0. 001)and high level of serum P-cad(HR = 1. 815,95％ CI:1. 224-3. 562,P < 0. 001)were risk factors for progression-free survival in NSCLC patients,and lymph node metasta-sis(HR = 0. 755,95％ CI:0. 652-0. 915,P = 0. 022),poor differentiation(HR = 1. 622,95％ CI:1. 112-2. 015,P < 0. 001),TNM stage(ⅢA HR = 1. 335,95％ CI:1. 064-2. 014,P = 0. 011;ⅢB HR = 1. 489, 95％ CI:1. 129-2. 297,P < 0. 001;Ⅳ HR = 1. 622,95％ CI:1. 192-2. 501,P < 0. 001)and high level of serum P-cad(HR = 1. 677,95％ CI:1. 193-2. 668,P < 0. 001)were risk factors for overall survival of NSCLC patients. The results of Kaplan-Meier survival curve showed that the overall survival and progression-free survival of patients with high level of serum P-cad were shorter than those of patients with low level of serum P-cad(χ2 = 5. 18,P = 0. 015;χ2 = 5. 48,P = 0. 011). Conclusion High level of serum P-cad is closely related to poor prognosis in NSCLC patients.

Objective To investingate the effect of SGK1 expression level on the prognosis of patients with NSCLC,and provide new biological predictors for the prognosis assessment of patients with NSCLS.Methods One hundred and twenty patients with NSCLC received radical resection in Hanzhong 3201 hospital from Jan 2011 to Dec 2013 were selected.There were 75 males and 45 females,age (63.15 ± 16.44) years,age range 45-80 years.According to the results of immunohistochemical staining,the SGK1 cut-off value determined by the integral was determined,and NSCLC patients were divided into SGK1 high expression group (n =70) and SGK1 low expression group(n =50).The relationship between the expression of SGK1 and clinicopathological features (age,sex,smoking history,alcoholism history,BMI,tissue type,tumor diameter,T stage,N stage,TNM stage,differentiation degree) in NSCLC were analyzed,and the overall survival rate in NSCLC were also analyzed.Followup was carried out by telephone or patient admission.The follow-up period was up to June 1,2018.Chest X-ray and ultrasonography were reviewed every 3 to 6 months after operation,and enhanced CT or MRI were performed if the results were abnormal.The measurement data conforming to normal distribution were expressed by t test and showed by (Mean ± SD);the counting data were tested by x2 test;the 5-year overall survival rate was used as the endpoint event for univariate analysis,and the significant variables for univariate analysis were analyzed by COX risk ratio model for multivariate analysis.The cumulative survival curve was drawn by Kaplan-Meier method,and the difference was tested by Log-rank method.Results The expression level of SGK1 in tissues was not related to age,sex,smoking history,alcoholism,BMI,tissue type and tumor diameter (P ＞ 0.05),but it was related to T stage,N stage,TNM stage and differentiation degree (P ＜ 0.05).The univariate and multivariate COX risk ratio model showed that TNM stage and SGK1 expression were independent factors affecting the 5-year overall survival rate of NSCLC patients (P ＜ 0.05).The results of Kaplan-Meier survival curve showed that the 5-year overall survival rate in NSCLC with low expression of SGK1 was significantly higher than that in NSCLC with high expression of SGK1 (P ＜ 0.05).Conclusions The expression of SGK1 in tissues is closely related to the prognosis of patients with NSCLC.The high expression of SGK1 in tissues is not conducive to the prognosis of patients with NSCLC.

Objective The multiple malformation of upper eyelid,including the excessive width of fold line,sunken and/or multiple folded upper eyelid are the common complications after blepharoplasty.The aim of this study was to investigate the clinical effect of orbital septum fat redistribution on correcting these deformities.Methods From September 2015 to September 2017,38 patients with multiple malformations of upper eyelid were treated.The incision of upper eyelid and the excessive skin was designed and resected.After completely relieving the scar adhesion zones,we set the lateral orbital septum fat free and transposed it to the inner side of orbital septum or superior border of tarsus with suturing fixation.Then we routinely completed the double eyelid operation.Results Thirty-eight patients with multiple malformations of upper eyelid were treated successfully.The patients were followed up for 6 months to one year,and the results were totally satisfactory.The operation was not performed again.Conclusions The orbital septum fat redistribution can successfully correct the multi ple malformation of upper eyelid.It should become a regular procedure in blepharoplasty.

Objective To screen the pathogenic locus and gene in a primary open angle glaucoma(POAG),and to provide a basis for molecular genetic study of POAG.Methods A POAG pedigree with 35 members was diagnosed in Sichuan peoples' Hospital from January to August 2005.The disease history and clinical data were collected.Genome-wide scan was performed for the families.Specific software was used to calculate the LOD value,which based on the allele (haploid) typing result with two-point method to definite the positive loci by the largest LOD value.Results The POAG family had 35 members of 4 generations.18 patients were diagnosed as juvenile open angle glaucoma from visual disc shape abnormality and loss of typical visual field.All of the patients in this family suffered various degrees of binocular vision loss and vision loss in childhood,with poorly visual function.The LOD values of 3 short tandom repeat (STR) markers on chromosome 2 were greater than 3.0,they were D2S2369 (LOD value 4.0033),D2S2332 (LOD value 3.8402) and D2S337 (LOD value 4.7520).There was a genetic linkage near the three genetic markers in the family.The primary glaucoma positive locus was a in chromosome p15 to chromosome p16.2,and the genetic distance was about 9 Mb,locating in between the markers D2S2369 and D2S2397.Conclusions GLCIH is a pathogenic locus for this POAG pedigree,which supplies an evidence for elucidating the pathogenesis of POAG.