长期卧床引起尿路感染患者细菌分布和耐药性分析

目的调查因行动不便长期卧床患者引起尿路感染的原因。方法收集长期卧床的患者的中段尿做细菌培养及药敏试验,如果阳性,则收集患者的粪便,分离相应的细菌并做药敏试验。把同一患者尿液和粪便中分离到的两株相同细菌做脉冲电场凝胶电泳（PFGE）进行同源性分析。结果收集的123例患者中,大肠埃希菌为90对占73．2％,粪肠球菌为9对占7．3％,屎肠球菌为6对占4．9％,奇异变形杆菌6对占4．9％,肺炎克雷伯菌4对占3.3％。90对大肠埃希菌中有同源性的为63对占70％。结论院内长期卧床的患者尿路感染的发生率较高,且以自身清洁消毒不严、从肛门-尿道感染的可能性最大。建议加强自身的清洁和消毒隔离工作。     

健脾理气化湿方配方颗粒治疗脾虚湿热型非酒精性脂肪性肝炎患者疗效及对FFA，HOMA-IR，APRI的影响

目的:观察健脾理气化湿配方颗粒治疗脾虚湿热型非酒精性脂肪性肝炎(NASH)患者的疗效,及对患者游离脂肪酸(FFA),胰岛素抵抗指数(HOMA-IR)和天门冬氨酸氨基转移酶/血小板指数(APRI)的影响。方法:根据标准募集96例符合纳入标准的脾虚湿热型NASH患者,采用随机数字表将患者按1∶1比例分配至对照组和治疗组,每组48例。在运动和饮食调整基础上,对照组予安慰剂颗粒剂,治疗组予健脾理气化湿方颗粒剂口服,疗程共24周。分别于治疗前后进行相关检查,评估疗效并观察FFA,HOMA-IR和APRI的变化。结果:治疗组临床总有效率为82.5%,对照组为52.5%,治疗组高于对照组(P0.01)。两组患者治疗后FFA水平均较治疗前明显下降(P0.05,P0.01),治疗组下降更为显著(P0.01);两组治疗后HOMA-IR均较治疗前显著下降(P0.01),治疗组下降更为显著(P0.01)。与治疗前比较,对照组治疗后APRI略有下降,差异无统计学意义;治疗组APRI显著下降(P0.01),且显著低于对照组(P0.01)。结论:健脾理气化湿方对脾虚湿热型NASH患者具有较好疗效,能够显著降低FFA水平,改善胰岛素抵抗和肝纤维化。     

Effects of viral infection and microbial diversity on patients with sepsis: A retrospective study based on metagenomic next-generation sequencing

BACKGROUND: The study aims to investigate the performance of a metagenomic next-generationsequencing (NGS)-based diagnostic technique for the identifi cation of potential bacterial and viral infectionsand eff ects of concomitant viral infection on the survival rate of intensive care unit (ICU) sepsis patients.METHODS: A total of 74 ICU patients with sepsis who were admitted to our institution from February1, 2018 to June 30, 2019 were enrolled. Separate blood samples were collected from patients for bloodcultures and metagenomic NGS when the patients’ body temperature was higher than 38 °C. Patients’demographic data, including gender, age, ICU duration, ICU scores, and laboratory results, were recorded.The correlations between pathogen types and sepsis severity and survival rate were evaluated.RESULTS: NGS produced higher positive results (105 of 118;88.98%) than blood cultures(18 of 118;15.25%) over the whole study period. Concomitant viral infection correlated closelywith sepsis severity and had the negative effect on the survival of patients with sepsis. However,correlation analysis indicated that the bacterial variety did not correlate with the severity of sepsis.CONCLUSIONS: Concurrent viral load correlates closely with the severity of sepsis and thesurvival rate of the ICU sepsis patients. This suggests that prophylactic administration of antiviraldrugs combined with antibiotics may be benefi cial to ICU sepsis patients.     

全球运动处方研究热点、发展趋势与启示：基于CiteSpace Ⅴ的分析

对青少年社交孤立领域文献进行可视化分析,以期为我国青少年社交孤立的研究提供参考。

检索2013年9月—2022年9月Web of Science核心合集数据库中收录的青少年社交孤立相关文献,使用CiteSpace 6.1.R3软件对发文量、发文机构、关键词聚类、关键词突显、热点词时间线图谱进行文献计量学分析。

共筛选出相关文献1 347篇,总体发文量自2013年呈上升趋势。发文量最多的国家是美国,累计发文量521篇（占38.68%）;中国排名第6位,累计发文量79篇（占5.86%）。发文量排前3位的机构分别是美国的哥伦比亚大学（29篇）、英国的伦敦国王学院（28篇）和英国的伦敦大学（27篇）。研究热点主要集中在社交孤立、身心健康、孤独感、生活质量及其综合干预措施。

近年来青少年社交孤立受到国外学者持续关注,应立足我国国情,对特殊青少年群体进行社交孤立的相关筛查,通过预防性评估达到早期管理和干预的目的。

     

急性冠脉综合征患者经皮冠状动脉介入术后院内MACE发作风险预测模型构建

目的 探讨急性冠脉综合征患者经皮冠状动脉介入术后院内MACE发生的独立危险因素，并构建风险预测模型。 方法 选取2019年6月～2021年6月我院治疗的276例急性冠脉综合征患者，依据患者经皮冠状动脉介入术后院内是否发生MACE分为MACE组（73例）和非MACE组（203例）。单因素分析两组患者的临床病理特征，多因素Logistic回归分析急性冠脉综合征患者经皮冠状动脉介入术后院内发生MACE的危险因素，使用ROC曲线来评价模型。 结果 276例急性冠脉综合征患者经皮冠状动脉介入术后院内MACE的发生率为26.45%；两组患者的临床资料比较，结果发现，MACE组患者年龄≥60（P<0.05）、吸烟（P<0.05）、饮酒史（P<0.05）、高血压（P<0.01）、心功能Killip分级≥3（P<0.05）、糖尿病（P<0.05）占比均高于非MACE组；BMI（P<0.05）、中性粒细胞计数（P<0.05）、WBC（P<0.05）、NT-Pro BNP（P<0.01）、LDL-C（P<0.05）、Scr（P<0.01）、C反应蛋白（P<0.01）、总胆固醇（P<0.05）、甘油三酯（P<0.01）、血糖（P<0.05）、D-二聚体（P<0.01）、肌钙蛋白（P<0.01）显著高于非MACE组；淋巴细胞计数（P<0.01）、红细胞计数（P<0.01）、血红蛋白浓度（P<0.01）、血钠（P<0.05）、血钙（P<0.01）、尿酸（P<0.05）、白蛋白（P<0.01）显著低于非MACE组。多因素Logistic回归分析结果表明年龄（P<0.05）、吸烟（P<0.05）、WBC（P<0.01）、NT-proBNP（P<0.05） 以及Scr（P<0.01）是ACS患者PCI术后院内发生MACE的独立危险因素，LVEF是保护因素（P<0.05）。6项独立影响因素总分为279.14，对应风险值为0.82，预测ACS患者PCI术后院内发生MACE的概率为82 %。ROC曲线分析显示，模型ROC曲线下面积为0.846，95 %置信区间为0.781~0.878，灵敏度与特异度分别为85.36 %和87.74 %，表明该模型预测能力较强。 结论 年龄、吸烟、WBC、NT-proBNP及Scr是ACS患者PCI术后院内发生MACE的独立危险因素，LVEF是保护因素。     

Working memory studies among individuals with intellectual disability: An integrative research review

BackgroundIntegrative research review infers generalizations about a substantive subject, summarizes the accumulated knowledge that research has left unresolved and generates a new framework on these issues. Due to methodological issues emerging from working memory (WM) studies in the population with non-specific intellectual disability (NSID) (N = 64) between 1990–2014, it is difficult to conclude on WM performance in this population.AimThis integrative research review aimed to resolve literature conflicts on WM performance among individuals with NSID and to identify the conditions/moderators that govern their WM performance compared to controls with Typical development.Method/procedureWe used the six stages of integrative research review: problem formulation, data collection, evaluation, data analysis, results, interpretation and discussion.Outcomes and resultsThe findings indicate two types of moderators that determine WM performance in the population with NSID: Participants’ moderators (criteria for matching the ID and TD groups, CA and MA), and task moderators [the three WM components of Baddeley and Hitch’s (1974) model and task load]. Only an interaction between the two moderators determines WM performance in this population. The findings indicate a hierarchy (from more to less preserved) in WM performance of individuals with NSID: The visuospatial tasks, then some of the executive functions tasks, and the phonological loop tasks being less preserved. Furthermore, at a low level of control, the performance of participants with NSID was preserved beyond the modality and vice versa.Conclusions and implicationsModality and MA/intelligence determine WM performance of individuals with ID. Educators should prepare intervention programs take the impact of the two moderators into account.     

Finite element analysis of locking plate and two types of intramedullary nails for treating mid-shaft clavicle fractures

BackgroundBoth plate and intramedullary nail fixations, including straight and anatomic nails, have been clinically adopted for the treatment of displaced mid-shaft clavicle fractures. However, the biomechanical performances of these fixations and implants have not been well evaluated. This study aims to compare the construct stability, stress distribution and fracture micro-motion of three fixations based on finite element (FE) method.MethodsThe FE model of clavicle was reconstructed from CT images of a male volunteer. A mid-shaft fracture gap was created in the intact clavicle. Three fixation styles were simulated including locking plate (LP), anatomic intramedullary nail (CRx), and straight intramedullary nail (RCP). Two loading scenarios (axial compression and inferior bending) were applied at the distal end of the clavicle to simulate arm abduction, while the sternal end was fixed.ResultsUnder both conditions, the LP was the stiffest, followed by the CRx, and the RCP was the weakest. LP also displayed a more evenly stress distribution for both implant and bone. RCP had a higher stress compared with CRx in both conditions. Moreover, all implants sustained higher stress level under the loading condition of bending than compression.ConclusionsThe plate fixation significantly stabilizes the fracture gap, reduces the implant stress, and serves as the recommended fixation for the mid-shaft clavicle fracture. The CRx is an alternative device to treat clavicle shaft fracture, but the shoulder excessive activities should be avoided after operation.     

Silencing TRIM37 inhibits the proliferation and migration of non-small cell lung cancer cells

Tripartite motif containing 37 (TRIM37), a member of the tripartite motif (TRIM) family, has been involved in the development and progression of several tumors. However, its role in non-small cell lung cancer (NSCLC) is still unclear. Therefore, the aim of this study was to investigate the expression pattern and role of TRIM37 in NSCLC. Our results showed that TRIM37 was highly expressed in human NSCLC cell lines. Knockdown of TRIM37 obviously inhibited the proliferation in vitro and xenografted tumor growth in vivo. Furthermore, knockdown of TRIM37 suppressed NSCLC cell migration and invasion by inhibiting the epithelial–mesenchymal transition (EMT) phenotype. Lastly, knockdown of TRIM37 greatly down-regulated the protein expression levels of β-catenin, cyclinD1 and c-myc in A549 cells. In conclusion, the present study revealed that TRIM37 plays an important role in the development and progression of NSCLC. Thus, TRIM37 may act a potential therapeutic target for treating NSCLC.

Tripartite motif containing 37 (TRIM37), a member of the tripartite motif (TRIM) family, has been involved in the development and progression of several tumors.     

多模式MRI指导的急性期脑梗死rt-PA静脉溶栓后的出血转化及相关因素分析

目的探讨多模式MRI指导的颈内动脉系统急性期脑梗死患者接受重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓后发生出血转化的相关危险因素。方法对103例急性期颈内动脉系统脑梗死患者在标准时间窗(4.5h内)进行rt-PA静脉溶栓治疗。观察患者性别、年龄、吸烟、饮酒、高血压病、糖尿病、房颤、血脂、NIHSS评分及ASPECT评分与溶栓后出血的相关性。结果溶栓后发生出血转化的患者共17例,其中症状性脑出血患者有5例,占所有溶栓患者的4.85%、所有出血患者的29.41%。溶栓后脑出血与房颤、NIHSS评分及ASPECT评分均有相关性(P<0.05)。结论有房颤、NIHSS评分高及ASPECT评分低者行rt-PA静脉溶栓容易发生出血转化。     

月腺大戟素A抗乳腺癌活性

目的 从中药狼毒药材中分离、纯化化合物月腺大戟素A,探讨其抗乳腺癌活性。方法 采用回流提取、溶剂萃取和吸附色谱法从狼毒药材中分离、纯化月腺大戟素A,通过质谱和核磁共振谱解析其化学结构。以乳腺癌细胞SUM149（三阴型）、MCF-7（luminal A型）、ZR-75-1（luminal B型）、SK-BR-3（HER2阳性型）为测试细胞株,用MTT法测定月腺大戟素A的抗乳腺癌细胞增殖活性,用流式细胞术检测月腺大戟素A对SUM149细胞周期的影响,用裸鼠移植SUM149细胞建立肿瘤模型并评价月腺大戟素A对肿瘤的抑制效果。结果 月腺大戟素A结构为3,3’-二乙酰基-2,4’-二甲氧基-2’,4,6,6’-四羟基-5’-甲基二苯基甲烷;对SUM149、MCF-7、ZR-75-1和SK-BR-3细胞的半数抑制浓度分别为5.50、6.16、7.08、8.64 μmol/L。月腺大戟素A作用SUM149细胞12、24和48 h后,随着月腺大戟素A浓度（2.5、5、10 μmol/L）的升高,G₀/G₁期细胞比例下降（P<0.05,P<0.01）,S期细胞比例上升（P<0.05,P<0.01）。给予35 mg/kg腹腔注射月腺大戟素A后,裸鼠肿瘤体积和质量的抑制率分别为37.94%和41.38%。结论 月腺大戟素A对4种乳腺癌细胞增殖均有抑制作用,并可抑制裸鼠SUM149细胞移植肿瘤生长,其机制可能与抑制SUM149细胞周期从S期到G₂/M期的转换有关。