Background: and Purpose Guillain–Barré syndrome (GBS) is an autoimmune-mediated disorder characterized by demyelinating or axonal injury of the peripheral nerve. Our aim is to determine whether serum amyloid A (SAA) is a biomarker of demyelinating injury and disease severity in patients with GBS. Methods: This study retrospectively enrolled 40 patients with either the demyelinating or axonal GBS and sex- and age-matched controls with other neurological diseases as well as healthy subjects. The demographic and clinical features at entry were collected. The serum levels of the SAA isoforms SAA1, SAA2, and SAA4 were determined in the patients with GBS and the controls using the enzyme-linked immunosorbent assay and analyzed for the associations between levels of different SAA isoforms and the clinical features of the patients. Results: The levels of SAA2 and SAA4 were significantly higher in patients with GBS than in both the other neurological disease controls and the healthy subjects (p<0.05 for all). The level of SAA1 did not differ between patients with GBS and the controls. The level of SAA2 was considerably higher in GBS patients with antecedent infection than in those without infection (p=0.020). The levels of different SAA isoforms were not associated with the disease severity or other clinical features of patients with GBS (p>0.05 for all). Conclusions Increased levels of SAA2 and SAA4 may only represent the acute inflammatory status and so cannot be utilized as biomarkers of the disease severity or demyelinating injury in patients with GBS.

Background: and Purpose Guillain–Barré syndrome (GBS) is an autoimmune-mediated disorder characterized by demyelinating or axonal injury of the peripheral nerve. Our aim is to determine whether serum amyloid A (SAA) is a biomarker of demyelinating injury and disease severity in patients with GBS. Methods: This study retrospectively enrolled 40 patients with either the demyelinating or axonal GBS and sex- and age-matched controls with other neurological diseases as well as healthy subjects. The demographic and clinical features at entry were collected. The serum levels of the SAA isoforms SAA1, SAA2, and SAA4 were determined in the patients with GBS and the controls using the enzyme-linked immunosorbent assay and analyzed for the associations between levels of different SAA isoforms and the clinical features of the patients. Results: The levels of SAA2 and SAA4 were significantly higher in patients with GBS than in both the other neurological disease controls and the healthy subjects (p<0.05 for all). The level of SAA1 did not differ between patients with GBS and the controls. The level of SAA2 was considerably higher in GBS patients with antecedent infection than in those without infection (p=0.020). The levels of different SAA isoforms were not associated with the disease severity or other clinical features of patients with GBS (p>0.05 for all). Conclusions Increased levels of SAA2 and SAA4 may only represent the acute inflammatory status and so cannot be utilized as biomarkers of the disease severity or demyelinating injury in patients with GBS.

Background: and Purpose Guillain–Barré syndrome (GBS) is an autoimmune-mediated disorder characterized by demyelinating or axonal injury of the peripheral nerve. Our aim is to determine whether serum amyloid A (SAA) is a biomarker of demyelinating injury and disease severity in patients with GBS. Methods: This study retrospectively enrolled 40 patients with either the demyelinating or axonal GBS and sex- and age-matched controls with other neurological diseases as well as healthy subjects. The demographic and clinical features at entry were collected. The serum levels of the SAA isoforms SAA1, SAA2, and SAA4 were determined in the patients with GBS and the controls using the enzyme-linked immunosorbent assay and analyzed for the associations between levels of different SAA isoforms and the clinical features of the patients. Results: The levels of SAA2 and SAA4 were significantly higher in patients with GBS than in both the other neurological disease controls and the healthy subjects (p<0.05 for all). The level of SAA1 did not differ between patients with GBS and the controls. The level of SAA2 was considerably higher in GBS patients with antecedent infection than in those without infection (p=0.020). The levels of different SAA isoforms were not associated with the disease severity or other clinical features of patients with GBS (p>0.05 for all). Conclusions Increased levels of SAA2 and SAA4 may only represent the acute inflammatory status and so cannot be utilized as biomarkers of the disease severity or demyelinating injury in patients with GBS.

Group B Streptococcus(GBS)is a major member of the Gram-positive Streptococcus family,which occupies a dominant position in the infection spectrum of newborns and young infants.GBS infections occurring 0?6 days after birth are called GBS early-onset disease(GBS-EOD),and those occurring 7?89 days are called GBS late-onset disease(GBS-LOD).With the use of intrapartum antibiotic prophylaxis,the incidence of neonatal GBS-EOD has declined without a notable impact on GBS-LOD,which brings great pressure and challenge to clinical diagnosis and nursing work.However,the specific mechanisms by which GBS transmission triggers illness in newborns and young infants are not fully elucidated.Some factors,such as maternal GBS colonization,maternal characteristics(age,weight and ethnicity),preterm birth,GBS infection in multiple births,and exposure to human immunodeficiency virus,have been identified as risk factors for GBS-LOD.To prevent maternal and infant GBS infection,some measures,such as vaccination of pregnant women,gut microbiota regulation and lactoferrin supplementation,are developing.In addition,strengthening maternal health care and health education,along with some other conventional infection control strategies(including enhancing hand hygiene awareness among caregivers and making good disinfection of the environment and equipment)is also effective in the prevention of GBS-LOD.This review elaborates the prevalence,transmission,risk factors and prevention of GBS-LOD in infants,aiming to improve the understanding and clinical practice ability of the medical staff.

Objective : To investigate the effect of high concentration of Caerulomycin A (Cae A) on HK2 in renal tubular epithelial cells and to explore the role of cytoplasmic nucleotide⁃binding oligomerization domain⁃like receptor protein 3 (NLRP3) in this process. Methods : The effect of different concentrations of Cae A on the viability of HK2 cells was determined by MTT; the expression of kidney injury molecule (KIM⁃1) and NLRP3 was detected by real⁃time quantitative PCR , Western blot and immunofluorescence , while the effect of Cae A on the mRNA expression of IL⁃1β , IL⁃18 , IL⁃33 , MCP⁃1 , TNF⁃α was also measured by real⁃time quantitative PCR. HK2 cells were divided into control group , high concentration of Cae A group and high concentration of Cae A plus NLRP3 inhibitor CY⁃09 group , and the expression of KIM⁃1 and NLRP3 protein was detected by Western blot. Results : The results of MTT showed that high concentration of Cae A could inhibit HK2 cell viability. Real⁃time quantitative PCR , Western blot and immunofluorescence assays showed that high concentration of Cae A upregulated the expression of KIM⁃1 and NLRP3 , as well as the mRNA levels of IL⁃1β , IL⁃18 , IL⁃33 , MCP⁃1 , TNF⁃α , while CY⁃09 could down⁃regulate the expression of NLRP3 and KIM⁃1. Conclusion High concentration of Cae A significantly inhibited the viability of HK2 cells and induced damage and inflammatory response to HK2 with some nephrotoxicity that might be achieved via NLRP3 pathway.

Objective: To investigate the role of Portulaca oleracea (POL) in promoting revascularization and re-epithelization as well as inhibiting iron aggregation and inflammation of deep tissue pressure injury (DTPI). Methods: The hydroalcoholic extract of POL (P) and aqueous phase fraction of POL (PD) were prepared based on maceration and liquid–liquid extraction. The number of new blood vessels and VEGF-A expression level were assessed using H&E stain and Western blot on injured muscle to examine the role of POL different extracts in vascularization. The iron distribution and total elemental iron of injured muscle were detected using laser ablation inductively coupled plasma mass spectrometry (ICP-MS) and Perls’ staining to determine whether POL extracts can inhibit the iron accumulation. Besides, the ability of POL extracts to promote wound healing by combining re-epithelization time, inflammation degree and collagen deposition area were comprehensively evaluated. Results: In vitro, we observed a significant increase in HUVEC cell viability, migration rate and the number of the tube after P and PD treatment (P < 0.05). In vivo, administration of P and PD impacted vascularization and iron accumulation on injured tissue, evident from more new blood vessels, higher expression of VEGF-A and decreased muscle iron concentration of treatment groups compared with no-treatment groups (P < 0.05). Besides, shorter re-epithelization time, reduced inflammatory infiltration and distinct collagen deposition were associated with administration of P and PD (P < 0.05). Conclusion: POL extract administration groups have high-quality wound healing, which is associated with increased new blood vessels, collagen deposition and re-epithelization, along with decreased iron accumulation and inflammatory infiltration. Our results suggest that that POL extract is beneficial to repair injured muscle after ischemia–reperfusion, highlighting the potential of POL in the DTPI treatment.

Objective:To explore the application value of artificial intelligence (AI) in image post-processing of reconstructed CTA based on CT cerebral perfusion (CTP).Methods:Clinical and radiological data of 100 patients suspected of cerebrovascular diseases in Hebei General Hospital from January to July 2020 were retrospectively selected. All patients were divided into A and B group on average according to the different examination schemes. Cerebral CTP examination was performed in group A (the temporal maximum intensity projective data set generated by the first 5 time phases in the maximum period of the difference between arteriovenous CT values selected as subgroup A1, and the corresponding original thin-layer images selected as subgroup A2), single phase CTA examination was performed in group B, manual and AI image post-processing were performed respectively. Subjective scoring of the image data was performed, and the objective bid evaluation indexes such as CT value, noise (SD), signal-to-noise ratio (SNR), contrast to noise ratio (CNR) were measured, the qualified rate of artificial and AI vascular segmentation was counted, and post-processing time were recorded. The objective evaluation indexes were compared between three groups using one-way ANOVA, and the Kruskal-Wallis H test was used to compare the difference of subjective scores.Results:Statistically significant differences were observed in subjective score and objective evaluation index of original images among group A1, group A2 and group B (all P<0.05). Among them, arterial enhancement, arteriolar detail display score, cerebral artery CT value, SNR and CNR in group A1 were higher than those in group A2 and group B (all P<0.05). In a total of 100 patients with 1 100 blood vessels, the qualified rates of AI vascular segmentation in group A1 [98.4% (541/550)] and group B [98.7% (543/550)] were higher than those of manual [82.9% (456/550), 87.1% (479/550), χ2=77.392, 56.521, P<0.001], but the qualified rate of AI vascular segmentation of group A2 [78.4% (431/550)] was lower than that of manual [85.6% (471/550), χ2=9.855, P=0.002]. The completion time of AI post-processing were reduced by 56.30%, 49.63%, 50.81%, respectively than those with manual. Conclusion:Compared with manual image post-processing, AI has certain advantages in image quality and work efficiency of reconstructed CTA post-processing based on CTP de-noising dataset, and it is worth popularizing and applying in the image post-processing of cerebrovascular disease, combined with artificial quality control.

OBJECTIVE：To study the potential ris k of Chinese patent medicine for the treatment of stable chronic obstructive pulmonary disease （COPD），and to provide reference for the safety of clinical drug use. METHODS ：Retrieved from Chinese journal full-text database ，CBM，Wanfang database and VIP ，using“stable”“Chronic obstructive pulmonary disease ”“COPD” “Chinese patent medicine ”as retrieval words ，relative literatures about Chinese patent medicine in the treatment of stable COPD were retrieved ，and retrieval time limitation was from their establishment to Sept. 2019. The type and components of Chinese patent medicine were collected. The potential risk of Chinese patent medicine was analyzed in terms of the contraindications of traditional Chinese medicines ，the interaction between traditional Chinese medicines and chemical medicines ，and its effects on stable COPD with other common chronic diseases. RESULTS ：Eleven related studies covering 29 kinds of Chinese patent medicines for the treatment of stable COPD were included in this study. There were several incompatibility between two Chinese patent medicines containing Aconitum carmichaelii and eleven Chinese patent medicines containing “Pinellia ternata ，Trichosanthes kirilowii ， Bolbostemma paniculatum ，Ampelopsis japonica ，Bletilla striata ”as an ancient rule of traditional Chinese medicine incompatibility “Eighteen antagonisms ”and“Nineteen mutual ”inhibitors. Meanwhile ，it should be avoided that four Chinese patent medicines containing ephedra combined with β2 receptor agonists or theophylline. Moreover ，oral antibiotics and 14 kinds of Chinese patent medicine containing licorice would reduce the curative effect. In addition ，patients with stable COPD who also had hypertension ， hyperlipidemia or diabetes should be careful to use Chinese patent medicines containing ingredients such as Glycyrrhiza uralensis ， A. carmichaelii ，Ephedra sinica ，Citrus aurantium ，Cornus officinalis ，Fritillaria cirrhosa ，Panax ginseng （Panax notoginseng ）. CONCLUSIONS：There are many potential risks （such as combined use ，compatibility）in the use of Chinese patent medicines for stable COPD. It is suggested to comprehensively evaluate the patient ’s previous medical history and medication before using Chinese patent medicines ，so as to provide scientific guide for clinical rational medication.

Objective To develop a logistic regression model for differential diagnosis of the malignant ovarian tumor by combining transvaginal conventional ultrasonography and 3D power Doppler ultrasound(3D-PDUS) techniques. Methods The transvaginal ultrasonography and 3D-PDUS data were collected from 291 patients with ovarian tumors received clinical pathological diagnosis.According to the pathological resuts,the 291 patients were divided in to benign group(GB) and borderline/malignant group (GM). Univariate and multivariate logistic regression analyses were applied to establish models for predicting malignant tumor. Results ① Within the 291 ovarian tumor patients,175 (60.14% ) were classified as the GB and 116 (39.86% ) were considered as the GM,the number for postmenopausal cases and the serum CA125 level in GB group were significantly lower than those in GM group ( P <0.001); ②The tansvaginal conventional ultrasound analysis suggested that borderline/malignant tumor often presented as larger volume,more irregular shape,and higher incidence in the blood flow within a solid papillary projection and ascites (P< 0.05,compared with GB group);In 3D-PDSU data,the vascularization index (VI) was lower than that in GB group( P <0.001,compared with GM group),but there was no significant difference between GB group and GM group in flow index (FI) and vascularization-flow index (VFI) ( P =0.559,0.454); ③ Multivariate logistic regression analysis showed that postmenopausal status,serum CA125 levels,tumor echo,papillary with blood flow,ascites and 3D-PDUS VI parameters were independent risk factors for the progression of borderline/malignant tumor.The ROC curve showed that the established regression model accuracy was 92.0%,sensitivity was 86.2%,specificity was 95.7%,positive predictive value was 92.6% and negative predictive value was 91.7%. Conclusions Combining multi-model transvaginal conventional ultrasound and 3D-PDUS analyses is a useful non-invasive technique for the differential diagnosis of ovarian tumor.

Objective: To investigate the incidence and pathogen distribution of ventilator-associated pneumonia (VAP) among preterm infants admitted to level Ⅲ neonatal intensive care units (NICU) in China. Method: A prospective study was conducted in 25 level Ⅲ NICU, enrolling all preterm infants <34 weeks gestational age admitted to the participating NICU within the first 7 days of life from May 2015 to April 2016. Chi-square test, t test and Mann-Whitney U test were used for statistical analysis. Result: A total of 7 918 patients were enrolled, within whom 4 623(58.4%) were males. The birth weight was (1 639±415) g and the gestational age was (31.4±2.0) weeks; 4 654(58.8%) infants required non-invasive mechanical ventilation and 2 154(27.2%) required intubation. Of all the mechanically ventilated patients, VAP occurred in 95 patients. The overall VAP rate was 7.0 episodes per 1 000 ventilator days, varying from 0 to 34.4 episodes per 1 000 ventilator days in different centers. The incidence of VAP was 9.6 and 6.0 per 1 000 ventilator days in children′s hospitals and maternity-infant hospitals respectively, without significant differences (t=1.002, P=0.327). Gram-negative bacilli (76 strains, 91.6%) were the primary VAP microorganisms, mainly Acinetobacter baumannii (24 strains, 28.9%), Klebsiella pneumonia (23 strains, 27.7%), and Pseudomonas aeruginosa (10 strains, 12.0%). Conclusion The incidence of VAP in China is similar to that in developed counties, with substantial variability in different NICU settings. More efforts are needed to monitor and evaluate the preventable factors associated with VAP and conduct interventions that could effectively reduce the occurrence of VAP.