Objective To investigate the clinical features and risk factors for deep vein thrombosis(DVT)of the lower ex-tremities in burn patients.Methods The clinical data of 155 burn patients admitted to Wuhan Third Hospital from January 2021 to January 2023 were retrospectively analyzed.The patients were divided into DVT group and non-DVT group according to whether they had concurrent DVT during hospitalization.Two groups of baseline data were compared[sex,age,body mass in-dex(BMI),coexisting diseases,smoking,drinking,DVT history of the lower limbs,burn cause,burn site,burn degree,central venous catheter retention in the femoral vein,wound infection,low-molecular-weight heparin application,time in bed,and labora-tory indicators[D-dimer(D-d),fibrinogen(FIB),homocysteine(Hey)].The levels of tumor necrosis factor α(TNF-α)and C-reac-tive protein(CRP)differed,and the risk factors for DVT in burn patients were determined via multivariate logistic regression a-nalysis.Finally,this study analyzed the value of BMI,time in bed,D-dimer,fibrinogen,Hcy,TNF-α,and CRP in predicting DVT in burn patients via receiver operating characteristic(ROC)curves.Results There were no significant differences between the two groups in terms of sex,combined disease,smoking or drinking,or cause of burn(all P＞0.05).The following risk factors were found to be significantly greater in the group with deep vein thrombosis(DVT)than in the group without DVT:age 60 years or older,history of lower limb DVT,lower limb burn of degree Ⅱ or above covering 30％or more of the area,femoral vein indentation central venous catheter,wound infection,and lack of low-molecular-weight heparin treatment.Additionally,BMI,D-dimer levels,fibrinogen levels(FIB),homocysteine(Hcy)levels,TNF-α levels,and C-reactive protein(CRP)levels were signifi-cantly higher in the DVT group than in the non-DVT group.The time in bed was significantly longer in the DVT group than in the non-DVT group(P＜0.01).Multivariate logistic regression analysis confirmed that the risk factors for DVT in burn pa-tients included age ≥60 years,history of lower extremity DVT,lower extremity burn,burn degree Ⅱ or above,burn area≥30％,femoral vein indwelling central venous catheter,wound inf ection,lack of low-molecular-weight heparin application,increased BMI,elevated levels of D-dimer,FIB,Hcy,TNF-α,and CRP,and prolonged time in bed.ROC analysis confirmed that BMI,time in bed,D-d,FIB,Hcy,TNF-α and CRP could all be used to predict DVT in burn patients,and the areas under the curve were 0.844,0.853,0.890,0.817,0.892,0.962 and 0.776,respectively,(all P＜0.01).Conclusion Burn patients complicated with DVT are affected by many factors.Moreover,ROC analysis confirmed that BMI,time in bed,D-d,FIB,Hcy,TNF-α and CRP could be indicators for predic-ting DVT,which should be considered in the subsequent clinical treatment of such patients.

Objective:To investigate the intention to stay on among primary health care workers (PHWs) during the COVID-19 epidemics and its influencing factors.Methods:An online questionnaire survey was conducted among PHWs from 62 primary health institutions in 31 provinces, autonomous regions and municipalities across China selected by multi-stage whole cluster random sampling method between May and October 2022. According to the job position, the PHWs were divided into 5 categories: general practitioners (GPs), nurses, public health doctors, managers and support staff. Intention to stay was measured using the Chinese version of the Intention to Stay Questionnaire. Multiple linear regression model was used to analyze the influencing factors of the intention to stay in PHWs of different occupational categories, including personal factors, work factors, factors related to the COVID-19 and psychological reactions.Results:A total of 3 769 PHWs from 44 community health service centers, 18 township hospitals of 27 provinces/autonomous regions and 4 municipalities participated in this survey. The mean age of participants was (37.4±9.2) years, including 2 971(78.8%) women. The mean score of intention to stay of participants was 21.7±4.1. Compared with GPs, managers had lower intention to stay ( P=0.004). Age, female, in marriage, monthly income, years of primary care service, self-evaluation of unit support function, MSQ-SF score, and PA score were positively correlated with the score of intention to stay (all P<0.05), while PHQ-9 score, EE score, and DP score were negatively correlated with the score of intention to stay (all P<0.05). The MSQ-SF scores of all occupational categories were positively correlated with the scores of intention to stay (all P<0.01). In addition, among GPs, monthly income, years of service in primary care, self-evaluation of unit support function, and PA scores were positively correlated with the score of intention to stay (all P<0.05), while PHQ-9 scores and EE scores were negatively correlated with the score of intention to stay (all P<0.05). Among nurses, age, female gender, monthly income, self-evaluation of unit support function, and PA score were positively correlated with the score of intention to stay (all P<0.05), while EE scores and retention will score were negatively associated with ( P<0.001). Among public health doctors, in marriage was positively correlated with the score of intention to stay ( P=0.018). Among managers, DP score was negatively correlated with the score of intention to stay ( P=0.001). Among support staff, female gender, monthly income, years of primary care service, self-evaluation of unit support function, and PA scores were positively correlated with the score of intention to stay (all P<0.05), while EE score and DP score were negatively correlated with intention to stay (all P<0.05). Conclusions:The intention to stay of PHWs in China during the COVID-19 was at an intermediate level, which was affected by many factors. Among them, job satisfaction was positively correlated with the intention to stay of all occupational categories, and the influencing factors of different occupational categories have some variations.

Objective To explore the factors influencing the pregnancy rate after fallopian tube recanalization(FTR),and to construct and validate a nomogram prediction model.Methods The clinical data of a total of 322 female patients with tubal obstructive infertility,who received FTR at the Wuhan Municipal Third Hospital of China between January 2018 and December 2022,were retrospectively analyzed.According to whether the female patient had natural pregnancy or not within 12 months after FTR treatment,the female patients were divided into the pregnant group and the non-pregnant group.Logistic regression analysis was used to determine the independent factors influencing pregnancy.The female patients were randomly divided into training group and validation group at 1∶1 ratio.A nomogram model was constructed in the training group,and the predictive efficacy of the model was verified in the validation group by using receiver operating characteristic(ROC)curves,calibration curves and decision curve analysis(DCA).Results The natural pregnancy rate at one year after FTR was 45.34％(146/322).Age＞35 years,primary infertility,duration of infertility＞3 years,distal fallopian tube obstruction,and moderate to severe tubal lesion were the independent risk factors affecting the pregnancy rate after FTR(all P＜0.05).The constructed nomogram model had a good differentiation and calibration ability and it carried a high degree of clinical utility.Conclusion The nomogram model constructed in this study can effectively predict the risk of infertility within one year after FTR treatment,which is helpful for formulating the individualized therapeutic scheme for infertility female patients.

Humans ; Cytomegalovirus ; Cytomegalovirus Infections ; Antigens, Viral ; Immunity ; Autoimmune Diseases ; CD8-Positive T-Lymphocytes

The current linear economy model relies on fossil energy and increases CO₂ emissions, which contributes to global warming and environmental pollution. Therefore, there is an urgent need to develop and deploy technologies for carbon capture and utilization to establish a circular economy. The use of acetogens for C1-gas (CO and CO₂) conversion is a promising technology due to high metabolic flexibility, product selectivity, and diversity of the products including chemicals and fuels. This review focuses on the physiological and metabolic mechanisms, genetic and metabolic engineering modifications, fermentation process optimization, and carbon atom economy in the process of C1-gas conversion by acetogens, with the aim to facilitate the industrial scale-up and carbon negative production through acetogen gas fermentation.
Fermentation ; Gases/metabolism* ; Carbon Dioxide/metabolism* ; Metabolic Engineering ; Carbon/metabolism*

Objective:To investigate the distribution and molecular characteristics of Yersinia isolated from diarrhea patients in Jiangsu Province. Methods:From 2017 to 2021, the stool samples of diarrhea patients were collected in Tongshan District of Xuzhou City and Dongtai City of Yancheng City, Jiangsu Province, where the national active monitoring sites of Yersinia enterocolitica, then Yersinia was isolated; meanwhile, suspected Yersinia strains were collected from sentinel hospitals in the province. The DNA of isolated strains was extracted for whole genome resequencing, and the data were uploaded to the EnteroBase database for Yersinia species identification; the original data were cleaned and processed for 16S ribosomal RNA (16S rRNA) gene polymorphism analysis. Five virulence genes (ail, ystA, ystB, yadA, virF) were scanned through the National Center for Biotechnology Information (NCBI) and Pathogen Virulence Factor Database (VFDB), and K-mer Tree was constructed and genomic characteristics were analyzed. Results:From 2017 to 2021, a total of 2 058 stool samples from diarrhea patients were collected, and 57 strains of Yersinia were isolated and identified; meanwhile, two Yersinia strains were collected from the sentinel hospital. Compared with EnteroBase database, 51 strains were identified as Yersinia enterocolitica, 4 strains as Yersinia proxima, 1 strain each as Yersinia aleksiciae, Yersinia massiliensis, Yersinia intermedia and Yersinia canariae. The 16S rRNA gene polymorphism analysis showed that all strains were clustered into 3 groups, which could distinguish Yersinia enterocolitica from other Yersinia. Among the 51 strains of Yersinia enterocolitica, 49 strains were virulence genotype Ⅲ(ail-, ystA-, ystB+, yadA-, virF-), two strains were virulence genotype Ⅱ(ail+, ystA+, ystB-, yadA-, virF-); and 8 other Yersinia strains were virulence genotype Ⅳ (ail-, ystA-, ystB-, yadA-, virF-). K-mer analysis could distinguish Yersinia enterocolitica from other Yersinia, JS-XZ-2020001 strain was far away from other Yersinia enterocolitica isolates, and serotype O8 strains were more concentrated. Conclusions:The clinical isolates of Yersinia enterocolitica from diarrhea patients are mainly Yersinia and other Yersinia co-exist in a small amount in Jiangsu Province, two new Yersinia species ( Yersinia proxima and Yersinia canariae) are discovered. The virulence genotype of Yersinia enterocolitica is mainly type Ⅲ. The 16S rRNA gene polymorphism analysis and K-mer analysis can effectively distinguish Yersinia enterocolitica from other Yersinia.

Objective:To explore the observation of the short-term recanalization rate and safety of acute thrombosis of arteriovenous fistula by dual-channel urokinase thrombolysis.Methods:A total of 52 dialysis patients with acute thrombosis of arteriovenous fistula in the Department of Nephrology, Shenzhen Hospital of Southern Medical University from January 2017 to January 2020 were selected. They were divided into control group and observation group by random number table. Twenty-seven cases in the test group used inflow arterial puncture and venous thrombosis, hereinafter referred to as dual channel, and bolus injection of urokinase for thrombolysis. Twenty-five cases in the control group were treated with tradi) ional peripheral intravenous bolus injection of urokinase for thrombolysis, and the recanalization time of internal fistula, adverse reactions and safety of thrombolysis were compared between the two groupsResults::The early (2 hours) reopening rate of the test group was 92.6% (25/27), which was higher than that of the control group by 44.0% (11/25) ( χ2 value was 14.389, P<0.05), which was statistically significant. The embolization site of the two groups of patients ( χ2 value was 2.989, P>0.05), the access situation of the two groups of patients ( χ2 value was 0.277, P>0.05), no statistical significance. There was no statistical significance in subcutaneous ecchymosis ( χ2 value was 0.088, P>0.05), bleeding at the puncture point ( χ2 value was 0.003, P>0.05), and puncture injury ( χ2 value was 0.944, P>0.05) in both groups. Conclusions:The double-channel urokinase thrombolysis method has the characteristics of high (2 hours) early recanalization rate, safe and effective in the treatment of acute arteriovenous fistula thrombosis.

CRISPR/ Cas9 gene editing system is a new tool of gene editing technology based on the im-mune mechanism of archaea against foreign nucleic acid invasion. Due to its high efficiency and accuracy, CRISPR/ Cas9 genome editing technology has been widely used in tumor therapeutic research,such as targeted knockout of oncogenes,repair of tumor suppressor genes,breaking immune tolerance,and construction of tumor models,which brings revolutionary development to tumor gene therapy.

OBJECTIVE:To study the effects of regular iron supplementation on hemoglobin and perinatal complication of pregnant women and neonates. METHODS:In retrospective analysis,the information of 606 pregnancy women were collected from Chongqing People’s Hospital during May 2016-May 2017. According to the regularity of iron supplementation,they were divided into regular iron supplementation group (142 cases),irregular iron supplementation group (218 cases) and no iron supplementation group(246 cases). The levels of hemoglobin in pregnant women were determined in 3 groups before childbirth and 3-7 d after childbirth. The incidence of gestational hypertension,premature rupture of membranes and puerperal infection in pregnant women were recorded in 3 groups. Birth weights of neonates delivered by pregnant women were recorded in 3 groups, and the levels of hemoglobin in umbilical cord blood of neonates were also detected. Apgar score was used to evaluate whether neonates were born with hypoxia or asphyxia. The average days of hospitalization were counted for pregnant women of 3 groups. RESULTS:The levels of hemoglobin in regular ion supplementation group before and after childbirth were significantly higher than irregular ion supplementation group and no ion supplementation group;the incidence of gestational hypertension,premature rupture of membranes and puerperal infection were significantly lower than irregular ion supplementation group and no ion supplementation group,average hospitalization days were significantly less than irregular ion supplementation group and no ion supplementation group, the levels of hemoglobin in umbilical cord blood of neonates and birth weight in regular ion supplementation group were significantly higher than irregular ion supplementation group and no ion supplementation group,with statistical significance(P＜0.05). There was no statistical significance in the incidence of constipation in pregnant women and the ratio of Apgar score of the neonates＜7 among 3 groups (P＞0.05). CONCLUSIONS:Regular iron supplementation can remarkably decrease the incidence of anemia,gestational hypertension,premature rupture of membrane and puerperal infection in pregnant women,shorten average hospitalization time,and increase average birth weight of neonates and the level of hemoglobin in umbilical cord blood.

Objective To evaluate the diagnostic efficacy of narrow band imaging (NBI) international colorectal endoscopic (NICE) classification in distinguishing neoplastic from non-neoplastic colorectal polyps during routine clinical practice. Methods A total of 224 lesions detected by white light colonoscopy by non-expert endoscopists were collected in this retrospective study. Each lesion was assessed by NBI and classified by NICE classification. The results were compared with pathological findings from endoscopic or surgical resected specimen. Results Among these 224 polyps, there were 59 of type 1, 159 of type 2 and 6 of type 3 according to NICE classification. There were 58 non-tumorous and 166 tumorous polyps according to pathological diagnosis. The total diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy of NICE classification for colorectal tumor were 91. 6%, 77. 6%, 92. 1%,76. 3%and 87. 9%, respectively.Diagnostic sensitivity and accuracy in big (＞10 mm in diameter), small (＞5-10 mm in diameter) and mini (≤5 mm in diameter) polyp groups were 100. 0%, 97. 0% and 80. 9%, as well as 95. 7%, 87. 8%, and 83. 3%, respectively. Diagnostic accuracy showed a decreasing tendency on polyp size, without significant difference between the three groups ( P＝0. 694). Conclusion NICE classification with non-magnified NBI is effective in distinguishing neoplastic and non-neoplastic colorectal polyps by non-expert endoscopists and is potentially worth popularizing for routine clinical practice.