A comparative study of the efficacy and safety of high-flow nasal cannula and nasal continuous positive airway pressure in neonatal respiratory distress syndrome: A protocol for systematic review and meta-analysis

Background:When it comes to preterm newborns, respiratory distress syndrome (RDS) is the most frequent respiratory condition. Despite the fact that it is well acknowledged that preterm delivery plays a significant role, the causes of lung damage are still not completely understood. In newborns with extremely low birth weight and neonatal RDS, nasal continuous positive airway pressure has been suggested as the first respiratory assistance for spontaneous breathing. In the current research, we aim to carry out a meta-analysis to assess the effectiveness and safety of high-flow nasal cannula (HFNC) and non-invasive continuous positive airway pressure (nCPAP) in patients with neonatal respiratory distress syndrome (NRDS).Methods:We intend to search the following databases: PubMed, EMBASE, Cochrane Library, Wanfang database, China National Knowledge Infrastructure (CNKI), and Google Scholar, starting from their initial publication until February 2022, to identify randomized controlled trials comparing HFNC to nCPAP in patients with NRDS. The suitable papers will be chosen by 2 writers who will work independently of one another. Using the Cochrane updated technique for risk of bias, each included article will be subjected to an independent data extraction process by the 2 writers who will then independently evaluate the risk of bias. Consequently, a third author will be asked to address any discrepancies that may arise between the writers. It will be necessary to pool the data and do a meta-analysis with the help of the RevMan 5.3 software.Results:In this study, the effectiveness and safety of HFNC will be compared with those of nCPAP in patients with NRDS.Conclusion:If the results of this research are confirmed, they may serve as a summary of the most recent data for non-invasive respiratory assistance in NRDS.Ethics and dissemination:The study will require ethical approval.Registration number:DOI 10.17605/OSF.IO/BKSQ5     

Clinical application of metagenomic next‐generation sequencing technology in the diagnosis and treatment of pulmonary infection pathogens: A prospective single‐center study of 138 patients

IntroductionRapid and accurate pathogen identification is essential for the treatment of pneumonia. Metagenomic next‐generation sequencing (mNGS) is a newly developed technology to obtain microbial nucleic acid sequence information quickly, efficiently, and without bias.MethodsWe performed shotgun metagenomic next‐generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) for pathogen identification in pneumonia in a prospective study with 138 patients from a single center. We compared the results of mNGS with standard methods including culture, staining, and targeted PCR and evaluated the clinical applicability of mNGS.ResultsMost of the patients (128/138, 92.75%) were cured or improved. One patient (1/138, 0.72%) died because of acute gastrointestinal bleeding, and 9 patients (9/138, 6.52%) showed no improvement. mNGS identified more bacteria (53 versus 27), fewer fungi (8 versus 31), and more viruses (16 versus 1) than standard methods. In total, treatment in 34 out of 138 cases (24.64%) was adjusted and optimized because of mNGS results. Positive mNGS results contributed to a definitive diagnosis in 23 cases (16.67%), which helped guide treatment decision by either adjusting the antibiotics without de‐escalation or continuing the empirical treatment. mNGS also confirmed no active infection in 11 cases (7.97%) allowed for antibiotic de‐escalation.ConclusionThis prospective clinical study evaluated the clinical utility of mNGS for the diagnosis of pneumonia and showed that mNGS of BALF provides valuable information for effective treatment.     

代谢组学在妇科常见肿瘤治疗和预后评估中的应用

卵巢癌、子宫内膜癌和宫颈癌是妇科常见的三大恶性肿瘤,尽管随着手术、放化疗等综合治疗的不断发展,妇科常见恶性肿瘤患者的预后得到了大幅提升,但由于早期没有明显症状且缺乏准确诊断或发现时已是晚期,仍有相当比例的患者预后不佳,生命受到严重威胁。因此,寻找新的治疗靶点和监测疗效的有效标志物至关重要。代谢组学（metabonomics）是肿瘤研究领域颇受关注的研究方法,其理论基础是肿瘤存在有别于正常组织的代谢特征,肿瘤独特的代谢特征与生物表型存在紧密的关联。代谢组学通过对生物系统中内源性代谢物进行全面分析,阐明肿瘤在发生和进展过程中某些关键生化途径的重塑机制,并对其进行解析与精准干预。综述代谢组学在妇科常见肿瘤治疗和预后评估中的应用,预期其可为妇科常见肿瘤的个性化、精准化治疗提供潜在靶点,为妇科常见肿瘤筛选预后生物标志物提供重要参考。     

Cell membrane-camouflaged PLGA biomimetic system for diverse biomedical application

The emerging cell membrane (CM)-camouflaged poly(lactide-co-glycolide) (PLGA) nanoparticles (NPs) (CM@PLGA NPs) have witnessed tremendous developments since coming to the limelight. Donning a novel membrane coat on traditional PLGA carriers enables combining the strengths of PLGA with cell-like behavior, including inherently interacting with the surrounding environment. Thereby, the in vivo defects of PLGA (such as drug leakage and poor specific distribution) can be overcome, its therapeutic potential can be amplified, and additional novel functions beyond drug delivery can be conferred. To elucidate the development and promote the clinical transformation of CM@PLGA NPs, the commonly used anucleate and eukaryotic CMs have been described first. Then, CM engineering strategies, such as genetic and nongenetic engineering methods and hybrid membrane technology, have been discussed. The reviewed CM engineering technologies are expected to enrich the functions of CM@PLGA for diverse therapeutic purposes. Third, this article highlights the therapeutic and diagnostic applications and action mechanisms of PLGA biomimetic systems for cancer, cardiovascular diseases, virus infection, and eye diseases. Finally, future expectations and challenges are spotlighted in the concept of translational medicine.     

双侧肺大疱经电视胸腔镜同期手术切除（附32例报告）

目的探讨电视胸腔镜（VATS）行双侧肺大疱同期切除的应用与疗效。方法收集2000年以来电视胸腔镜对32例双侧肺大疱行同期手术切除患者的临床资料。回顾性分析手术方法、手术时间、术中出血量、术后引流量、引流时间等情况。结果 32例均痊愈。随访2～4年无复发。结论经电视胸腔镜行双侧肺大疱同期手术切除是安全、可行的,具有创伤小、痛苦轻、出血少、并发症少、康复期短、符合美容要求等优点。     

多囊卵巢综合征患者口服炔雌醇环丙孕酮片致过敏反应

摘 要 目的：探讨临床药师在多囊卵巢综合征患者口服炔雌醇环丙孕酮片抗雄激素治疗中出现过敏反应的处理方法及药学监护。方法: 临床药师通过综合分析患者过敏史及用药史,结合患者用药时间和不良反应的发生时间,判断所用药物与过敏反应的相关性,并对其后续治疗替代药物提出用药建议。结果: 最终判定炔雌醇环丙孕酮片与此次不良反应的关联性评价为很可能,其中两种成分炔雌醇和醋酸环丙孕酮都不能排除为此次过敏反应的发生原因,建议选用屈螺酮炔雌醇片或含天然雌激素成分的口服避孕药进行后续替代治疗。结论:临床药师针对药物致过敏反应展开的病例分析及药学监护,有助于促进多囊卵巢综合征患者的个体化治疗,在保证用药安全,提高患者依从性方面发挥重要作用。     

柱前衍生HPLC法结合固相萃取测定血浆中卡托普利

目的:建立测定血浆中卡托普利浓度的方法,用于卡托普利人体药动学及相对生物利用度研究。方法:以对溴苯甲酸甲基溴为衍生化试剂,固相萃取法从生物样本中提取纯化衍生化产物,以反相高效液相色谱法测定衍生物含量而确定卡托普利血药浓度。结果:卡托普利血药浓度在10～1000ng·mL~(-1)范围内线性良好,相关系数为0.9987,测得平均回收率为98.65％,日内、日间RSD均小于10％。结论:本方法简便、准确、干扰小,适合用于卡托普利血药浓度监测及药动学研究。     

Association of Gut Microbiota Enterotypes with Blood Trace Elements in Women with Infertility

Infertility is defined as failure to achieve pregnancy within 12 months of unprotected intercourse in women. Trace elements, a kind of micronutrient that is very important to female reproductive function, are affected by intestinal absorption, which is regulated by gut microbiota. Enterotype is the classification of an intestinal microbiome based on its characteristics. Whether or not Prevotella-enterotype and Bacteroides-enterotype are associated with blood trace elements among infertile women remains unclear. The study aimed to explore the relationship between five main whole blood trace elements and these two enterotypes in women with infertility. This retrospective cross-sectional study recruited 651 Chinese women. Whole blood copper, zinc, calcium, magnesium, and iron levels were measured. Quantitative real-time PCR was performed on all fecal samples. Patients were categorized according to whole blood trace elements (low levels group, <5th percentile; normal levels group, 5th‒95th percentile; high levels group, >95th percentile). There were no significant differences in trace elements between the two enterotypes within the control population, while in infertile participants, copper (P = 0.033), zinc (P < 0.001), magnesium (P < 0.001), and iron (P < 0.001) in Prevotella-enterotype was significantly lower than in Bacteroides-enterotype. The Chi-square test showed that only the iron group had a significant difference in the two enterotypes (P = 0.001). Among infertile patients, Prevotella-enterotype (Log(P/B) > −0.27) predicted the low levels of whole blood iron in the obesity population (AUC = 0.894; P = 0.042). For the high levels of iron, Bacteroides-enterotype (Log(P/B) <−2.76) had a predictive power in the lean/normal group (AUC = 0.648; P = 0.041) and Log(P/B) <−3.99 in the overweight group (AUC = 0.863; P = 0.013). We can infer that these two enterotypes may have an effect on the iron metabolism in patients with infertility, highlighting the importance of further research into the interaction between enterotypes and trace elements in reproductive function.     

aveD基因失活提高阿维菌素工业菌株B组分产量

目的 破坏除虫链霉菌aveD基因,提高阿维菌素B1a的发酵单位.方法 将aveD基因内部364bp的SmaⅠ-SmaⅠ片段以相反的方向插入到原位置,构建重组质粒pUAmT-D7,并转化到阿维菌素工业生产菌Streptinomyces avermitilis G-8,筛选得到ave基因失活的基因工程菌G8-17.结果 发酵结果表明,G8-17不产维菌素A组分,而B组分的发酵单位则有相应的提高,其中有效组分B1a的发酵单位提高了33.6％.结论 aveD基因内部片段倒位没有影响下游与之共转录的基因aveF的表达,同时能有效阻断阿维菌素A组分的产生,提高B组分的发酵单位.