Abstract: Objective To compare the application value of metagenomic next generation sequencing (mNGS) with traditional culture in diagnosis of pulmonary infection pathogens. Methods　The clinical documents of 310 patients with suspected pulmonary infection admitted to the General Hospital of Center Theater Command from February 2021 to September 2022 were retrospectively analyzed. The results of mNGS and traditional culture were analyzed, followed by comparison on the positive rate, sensitivity, specificity, accuracy (ACC), positive predictive value (PPV) and negative predictive value (NPV) between the two methods. Results　 The study revealed that mNGS can simultaneously detect multiple pathogens, with the highest efficiency of detection for bacteria and the lowest for fungi. And the sequencing numbers of bacteria, fungi and viruses shown by mNGS were significantly different (H=70.361, P<0.001). In comparison, mNGS displayed a higher positive detection rate (88.40%) than traditional culture (29.70%) (χ2=162.373, P<0.001), but the consistency between the two methods was not significant (Kappa = -0.003, P=0.902). The sensitivity, specificity, ACC, PPV and NPV of mNGS were 91.29%, 28.26%, 81.94%, 87.96%, and 36.11% respectively, compared to corresponding 30.30%, 73.91%, 36.77%, 86.96% and 15.60% of traditional culture respectively. Through analysis, it is confirmed that the sensitivity and specificity between the two methods were statistically significant (91.29% vs 30.30%, χ2=148.120, P<0.001 and 28.26% vs 73.91, χ2=13.793, P<0.001). Conclusions　mNGS can significantly improve the detection rate of pathogens in pulmonary infections and provide a complementary tool besides to traditional culture method for accurate anti-infection therapy. Furthermore, both traditional culture and mNGS pathogen detection methods are highly dependent on sample quality and detection quality control. mNGS requires the correct interpretation of comprehensive, non-destructive pathogenic genetic information to accurately identify pathogens.

ObjectiveIn the treatment of acute gouty arthritis （AGA）， western medicine is mostly used for anti-inflammatory and analgesic purposes to control the blood uric acid level， but some patients are still at risk of poor control and recurrent attacks. Chinese medicinal prescriptions， potent in resisting inflammation and relieving pain， are able to stabilize the blood uric acid level， reduce acute attacks， and improve the clinical efficacy of western medicine. However， there is a lack of evidence to support their use as evidence-based medicine. This study employed network Meta-analysis （NMA） to evaluate the efficacy and safety of common Chinese medicinal prescriptions in the treatment of AGA， aiming to provide evidence-based medical evidence for the clinical use of Chinese medicinal prescriptions in the treatment of AGA. MethodChinese and English databases were searched for prospective cohort studies and randomized controlled trials （RCTs） on Chinese medicinal prescriptions against AGA from database inception to December 1， 2022. Stata software and Review Manager were used for statistical analysis. ResultForty-four papers with 3 564 cases involved were included in the current NMA. In terms of reducing blood uric acid， the cumulative probability results showed that Mahuang Lianyao Chixiaodou Tang showed optimal efficacy （87.60%）. In terms of relieving joint pain， Danggui Niantongtang and Guizhi Shaoyao Zhimutang showed optimal efficacy （92.00% and 82.30%）. In terms of improving erythrocyte sedimentation rate （ESR）， Simiaowan was superior to other prescriptions （87.00%）. In terms of reducing C-reactive protein （CRP）， Simiaowan and Baihutang modified with Guizhitang showed superior efficacy （76.00% and 66.10%）. In terms of safety， except for the basic treatment group， Mahuang Lianyao Chixiaodou Tang had the lowest probability of adverse events， and Danggui Niantongtang had the highest probability of adverse reactions during treatment. According to the results of cluster analysis， Mahuang Lianyao Chixiaodou Tang and Simiaowan are effective and safe. ConclusionAccording to the results of NMA， Chinese medicinal prescriptions can assist in the treatment of AGA and improve the effectiveness of western medicine. For patients with AGA， clinicians can choose Mahuang Lianyao Chixiaodou Tang or Simiaowan as an auxiliary drug for routine western medicine treatment.

The choice of initial anti-infection empirical therapy is the key to the successful treatment of community-acquired pneumonia in adults.This review is aimed at interpretation of the 2016 edition of Guidelines for the Initial Anti-infection Empiric Therapy Management of Chinese Adult Patients with Community-Acquired Pneumonia based on the different characteristics of antimicrobial agents.It may be useful for clinical physicians and pharmacists understand and master the guidance theoretically and practically,and also help thegn to select the empirical anti-infection treatment of adult patients with community-acquired pneumonia in combining regional epidemiological characteristics reasonably.

Objective To investigate the quality of life and its influencing factors of families primary caregivers of dementia patients .Methods The typically self made questionnaire ,WHO quality of life measurement profile (WHOQOL‐BREF) ,zarit bur‐den of care scale(ZBI) ,social support rating scale (SSRS) et al were adopted to investigate 64 caregivers of AD patients .Results (1) The overall quality of life of family caregivers of total subjective feelings were significantly lower than the general health status of subjective feeling score (t= -2 .217 ,P=0 .030) .The field of physiological and psychology points have no statistically significant difference in comparison with Chinese norm (t= -0 .252 ,-1 .994 ,P=0 .801 ,0 .050);the field of social and environment points have statistically significant difference compared with norm(t= -3 .830 ,3 .658 ,P=0 .000 ,0 .001) .(2) caregiver who have spouse , poor parent child relationship and patients with somatic diseases and mental behavior symptoms have lower quality of life(P<0 .05) .(3)Total score of Quality of life was negatively associated with total score of care burden (r= -0 .433 ,P=0 .000) ,while was significant positive associated with total score of the social support (r=0 .346 ,P=0 .005) .(4)Marital status ,parent‐child rela‐tionship ,physical illness and social support were the main factors affecting the quality of life(r2 =0 .409) .Conclusion Strengthen the social support and psychological intervention of dementia caregivers who has a spouse ,poor parent-child relationship and poor physical condition may help to improve the quality of life .

OBJECTIVETo understand the characteristics of recreational drug users' behaviors and social network, as well as their potential impact to the transmission of sexual transmitted infections (STI).

METHODSQualitative interview was used to collect information on rough estimation of population size and behavior change before and after recreational drug use. A total of 120 participants were recruited by convenient sampling from April to October, 2013 in a community of Qingdao city. Blood specimens were taken for HIV/syphilis serological testing and social network analysis was performed to understand the characteristics of their behavior and social network.

RESULTSAll participants used methamphetamine and 103 of them showed social connection. The prevalence of syphilis and HIV were 24.2% (29/120) and 2.5% (3/120) respectively. The estimated size of recreational drug users was big with a wide diversity of occupations and age range, and males were more frequent than females. Drug use may affect condom use and frequent drug users showed symptom of psychosis and neuro-toxicities. The size of social network was 2.45 ± 1.63 in the past 6 months, which indicated an increasing trend of the sexual partner number and risky behaviors.

CONCLUSIONRecreational drug use could increase the size of social network among sex partners, the frequency of risky sexual behaviors and syphilis prevalence, which indicate a high risk of HIV/STI among this population as well as a huge burden of disease prevention and control in the future.

Adolescent ; Drug Users ; Female ; HIV Infections ; Humans ; Male ; Methamphetamine ; Prevalence ; Risk-Taking ; Sexual Partners ; Social Support ; Syphilis ; Unsafe Sex

The laparoscopic approach is rapidly becoming the preferred method of treatment for patients with early gastric cancer due to advantages of minimally invasive surgery. As laparoscopic experience has accumulated, laparoscopy-assisted distal gastrectomy (LADG) with D2 lymphadenectomy has become a valuable alternative for the treatment of patients with advanced gastric cancer. However, laparoscopic gastric surgery is demanding from a technical point of view, especially when a D2 lymphadenectomy is performed. Surgeons seeking to undertake LADG are concerned about unpredictable intraoperative bleeding that may occur during LADG. Comprehensive knowledge of the perigastric vascular anatomy is essential for LADG with D2 lymphadenectomy.
Gastroenterostomy ; Humans ; Laparoscopy ; Lymph Node Excision ; Stomach Neoplasms ; blood supply ; pathology ; surgery

Objective To understand the characteristics of recreational drug users′behaviors and social network, as well as their potential impact to the transmission of sexual transmitted infections (STI). Methods Qualitative interview was used to collect information on rough estimation of population size and behavior change before and after recreational drug use.A total of 120 participants were recruited by convenient sampling from April to October , 2013 in a community of Qingdao city.Blood specimens were taken for HIV/syphilis serological testing and social network analysis was performed to understand the characteristics of their behavior and social network.Results All participants used methamphetamine and 103 of them showed social connection.The prevalence of syphilis and HIV were 24.2%( 29/120 ) and 2.5%(3/120) respectively.The estimated size of recreational drug users was big with a wide diversity of occupations and age range , and males were more frequent than females .Drug use may affect condom use and frequent drug users showed symptom of psychosis and neuro-toxicities.The size of social network was 2.45 ± 1.63 in the past 6 months, which indicated an increasing trend of the sexual partner number and risky behaviors .Conclusion Recreational drug use could increase the size of social network among sex partners , the frequency of risky sexual behaviors and syphilis prevalence , which indicate a high risk of HIV/STI among this population as well as a huge burden of disease prevention and control in the future .

Objective To understand the characteristics of recreational drug users′behaviors and social network, as well as their potential impact to the transmission of sexual transmitted infections (STI). Methods Qualitative interview was used to collect information on rough estimation of population size and behavior change before and after recreational drug use.A total of 120 participants were recruited by convenient sampling from April to October , 2013 in a community of Qingdao city.Blood specimens were taken for HIV/syphilis serological testing and social network analysis was performed to understand the characteristics of their behavior and social network.Results All participants used methamphetamine and 103 of them showed social connection.The prevalence of syphilis and HIV were 24.2%( 29/120 ) and 2.5%(3/120) respectively.The estimated size of recreational drug users was big with a wide diversity of occupations and age range , and males were more frequent than females .Drug use may affect condom use and frequent drug users showed symptom of psychosis and neuro-toxicities.The size of social network was 2.45 ± 1.63 in the past 6 months, which indicated an increasing trend of the sexual partner number and risky behaviors .Conclusion Recreational drug use could increase the size of social network among sex partners , the frequency of risky sexual behaviors and syphilis prevalence , which indicate a high risk of HIV/STI among this population as well as a huge burden of disease prevention and control in the future .

Objective To observe the effect of treating generalized anxiety disorder with clearing heart and relieving rstlessness acupuncture combined with western medicine. Methods 87 patients with generalized anxiety disorder were randomly recruited into a control group and a treatment group. Both groups received conventional western medical treatment. On this basis, the control group was given conventional acupuncture therapy, while the treatment was given clearing heart and relieving restlessness acupuncture. The efficacies were evaluated with Hamailton anxiety (HAMA)scale and clinical global impression scale (CGI). The adverse reaction was evaluated with treatment emergent symptoms scale (TESS). Results One week after treatment, the efficacies and adverse reaction in the treatment group markedly decreased comparing with those before the treatment(P<0.05). Two weeks after treatment, the efficacies and adverse reaction of both groups decreased comparing with those before the treatment(P<0.01). Besides, the decrease continues with time passing by. One week after treatment, the HAMA score in the control group markedly decreased comparing with that of the control group (P<0.05), and the CGI score in the treatment group had no significant difference comparing with that of the control group(P<0.05). Conclusion The treatment of clearing heart and relieving restlessness acupuncture on generalized anxiety disorder has rapid effect and good compliance.

Objective To investigate the effect and mechanism of compound glycyrrhizin on airway inflammation in asthmatic rats. Methods Forty wistar rats were randomly divided into health group (group Ⅰ), asthma group(group Ⅱ), treating group (group Ⅲ) and treating control group (group Ⅳ) (n=10 in each group). Group Ⅱ, group Ⅲ and group Ⅳ received intraperitoneal injection of ovalbumin (OVA) and aluminum hydroxide gel for sensitization and OVA aerosol by ultrasonic nebulization for challenge, in addition, group Ⅲ re-ceived intraperioneal injection of 200 μg of compound glycyrrhizin 1 hour before OVA aerosol challenging every time, and group Ⅳ were in-jected with normal saline instead of compound glycyrrhizin. Group Ⅰ were injected and nebulizated with normal saline instead of OVA and alu-minlum hydroxide. All rats were sacrificed at the 6th hour after the last challenging, venous blood and bronchoalveolar lavage fluid(BALF) were collected, the IgE in venous blood were determined and the concentration of IL-4, IL-5, IL-13 and IFN-γ in BALF were detected, the cells in BALF were counted and detached. Results The concentration of IgE, IL-4, IL-5, IL-13 and the count of neutrophilic granulocytcs, lymphocytes, cosinophils in group Ⅱ were significantly higher than those in group Ⅰ and group Ⅲ(P<0.01), and the concentration of IFN-γ in group Ⅰ and group Ⅳ were significantly lower than those in group Ⅰ and group Ⅲ(P <0.01). There was no significant difference be-tween group Ⅱ and group Ⅳ(P >0. 05). The concentration of IgE, IL-4, IL-5, IL-13 and the count of neutrophilic granulocytes, lympho-cytes, cosinophils in group Ⅲ were higher than those in group Ⅰ, and the concentration of IFN-γ and the count of mononucleat macroplile cells in group Ⅲ were lower than those in group Ⅰ, but there were no significant difference(P>0.05). Conclusion Compound giycyrrhiz-in alleviated the airway inflammation and reduced the airway hyperresponsiveness in asthmatic rats, which mechanism may be related to regu-lating the balance of Th1/Th2 cytokines, suppressing the immune ability of Th2 and promoting the immune ability of Th1.