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Background The percentage of older population of the total population is increasing in developed areas of developing countries, and the impact and contribution of population composition factors towards cancer mortality are still unclear. Objective To analyze the epidemiological characteristics and trend of cancer mortality among community-living residents in central Pudong New Area of Shanghai from 2007 to 2020. Methods From January to December 2021, we retrospectively collected the death data during 2007 to 2020 of registered permanent residents living in Dongming Road Community of Pudong New Area from the all-cause death monitoring database, and population composition data from Pudong New Area Public Security Bureau. We used the crude mortality rate (CMR) , standardized mortality rate (SMR, with reference to the SMR of the general Chinese population in 2010) , and average annual percent change (AAPC) to analyze the status and trends of cancer mortality, and used the decomposition method to estimate the contribution rates of demographic and non-demographic factors to the change of cancer mortality. Results From 2007 to 2020, a total of 2 446 cancer-induced deaths were reported by the Dongming Road Community, accounting for 28.48% of the total reported deaths (8 589 cases) . The CMR of cancers was 268.56/105, in which the CMR due to lung cancer, colorectal cancer, and gastric cancer was 69.61/105, 33.05/105 and 31.84/105, respectively. The SMR of cancers was 71.46/105 , in which the SMR due to lung cancer, colorectal cancer, and gastric cancer was 33.12/105, 15.46/105, and 15.29/105, respectively. During this period, the CMR for cancers among men, women and the whole population remained stable (Z=1.82, -0.54, 0.87, P>0.05) . The CMR and SMR in men were higher than those in women (u=6.69, P0.05) . As in the whole population, it showed a downward trend year by year (AAPC=-1.73%, Z=-3.09, P=0.010) . Furthermore, the CMR for cancers in those aged 65-79 showed a downward trend gradually (AAPC=-4.17%, Z=-1.80, P

Objective To investigate the effect of type Ⅰ interferons (IFN-α and IFN-β) and type Ⅱ interferon (IFN-γ) on the expression of adenosine deaminase acting on RNA 1 (ADAR1, P110 and P150) and hepatitis B virus (HBV) replication in hepatocellular carcinoma (HCC) cells. Methods Western blotting and qRT-PCR were used to detect the expression of ADAR1 in human HCC cell lines HepG2 and Huh7 following treatment with different concentrations of IFN-α, IFN-β or IFN-γ. Southern blotting was employed to detect the changes in HBV DNA level in response to IFN-α treatment in Huh7 and HepG2 cells transfected with HBV replication plasmids. Results In Huh7 and HepG2 cells, treatments with IFN-α and IFN-β significantly increased the protein expression of ADAR1 P150 in a time- and dose-dependent manner (P < 0.01) and also obviously augmented the protein level of ADAR1 P110; IFN-γ did not significantly affected the expression of either ADAR1 P110 or ADAR1 P150. IFN-α treatment dose-dependently inhibited HBV DNA replication in Huh7 cells (P < 0.05). Conclusion Type Ⅰ interferons time- and dose-dependently increase the expression of ADAR1 in Huh7 and HepG2 cells, suggesting a possible role of ADAR1 in mediating the anti-HBV effect of IFN-α.

Impervious surface is a key factor to measure the urban ecological environment. It is of great significance for urban development planning to grasp the dynamic changes of impervious surfaces timely and accurately. Taking the Chenggong District of Kunming City as an example' based on the Landsat images in 2007' 2011' 2015' and 2019' the comparative study of normalized difference impervious surface index ( NDISI) and modified soil adjusted vegetation index ( MSAVI) was carried out to analyze the spatial and temporal evolution characteristics of impervious surface. The results showed that: !As the extraction accuracy and Kappa coefficient of NDISI were 87. 01% and 0. 81' respectively' which were beUer than MSAVI's 81. 78% and 0. 75 ' this paper selected the NDISI method to extract impervious surfaces in the Chenggong District the impervious surface area extracted in this paper increased from 46. 12 km2 in 2007 to 72. 64 km2 in 2011' 146. 94 km2 in 2015 and 164. 42 km2 in 2019' especially from 2011 to 2015' the impervious surface area had the fastest growth rate and nearly doubled. The changes to the impervious surface in Chenggong District are mainly influenced by such factors as national policies' urban planning' topographic factors' and traffic development. The impervious surface area along the Dianchi Lake in the west of Chenggong District and several administrative regions in the middle of Chenggong District developed rapidly' which brings certain preesure on the prevention and control of waterlogging in urban areas and the Dianchi Lake area. In the process of future urban planning' the expansion scope and speed of impervious surfaces should be wen controlled to avoid ecological and environmental problems caused by the unreasonable spatial patterns of impervious sur&aces. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of the morinda officinalis-containing serum on the mRNA expressions of the OPG and RANKL in osteoblast and osteoclast co-culture system. Methods Twelve 5-week-old healthy SD rats (165 - 172g) were randomly assigned to 4 groups. Rats in each group were given different concentrations of morinda officinalis-containing serum or normal saline. The blood of the animals was extracted. Bone marrow cells were harvested from the femurs and tibiae of 6 5-week- old SD rats (165 - 172g). The cells were induced to osteoclasts. Osteoblasts were separated from the cranium of 4 24h newborn SD rats (5 - 6g). The osteoblasts were added to 5-day osteoclast culture. After 2-day co-culture, the different concentrations of morinda officinalis-containing serum or normal saline-containing serum were added to the culture plates. After intervention 3 days, total RNA was extracted from cells in high, middle, and low concentrations of morinda officinalis groups and control groups. The OPG and RANKL mRNA expressions were detected using real-time PCR. Results The results of RT-PCR indicated that RANKL mRNA expression was lower in all concentrations of morinda officinalis-containing serum groups than in the control group (P < 0.05), but OPG expression was higher than in the control group (P < 0. 001). Conclusion Morinda officinalis-containing serum up-regulates the expression of OPG mRNA, but down-regulates the expression of RANKL mRNA in the co-culture system, leading to the decrease of osteoclast differentiation and activity of bone resorption. [ABSTRACT FROM AUTHOR]

Objective: To investigate the correlation factors of complete clinical response in idiopathic inflammatory myopathies (IIMs) patients receiving conventional treatment., Methods: Patients diagnosed with IIMs hospitalized in Peking University People's Hospital from January 2000 to June 2023 were included. The correlation factors of complete clinical response to conventional treatment were identified by analyzing the clinical characteristics, laboratory features, peripheral blood lymphocytes, immunological indicators, and therapeutic drugs., Results: Among the 635 patients included, 518 patients finished the follow-up, with an average time of 36.8 months. The total complete clinical response rate of IIMs was 50.0% (259/518). The complete clinical response rate of dermatomyositis (DM), anti-synthetase syndrome (ASS) and immune-mediated necrotizing myopathy (IMNM) were 53.5%, 48.9% and 39.0%, respectively. Fever ( P =0.002) and rapid progressive interstitial lung disease (RP-ILD) ( P =0.014) were observed much more frequently in non-complete clinical response group than in complete clinical response group. The aspartate transaminase (AST), lactate dehydrogenase (LDH), D-dimer, erythrocyte sedimentation rate (ESR), C-reaction protein (CRP) and serum ferritin were significantly higher in non-complete clinical response group as compared with complete clinical response group. As for the treatment, the percentage of glucocorticoid received and intravenous immunoglobin (IVIG) were significantly higher in non-complete clinical response group than in complete clinical response group. Risk factor analysis showed that IMNM subtype ( P =0.007), interstitial lung disease (ILD) ( P =0.001), eleva-ted AST ( P =0.012), elevated serum ferritin ( P =0.016) and decreased count of CD4 + T cells in peripheral blood ( P =0.004) might be the risk factors for IIMs non-complete clinical response., Conclusion: The total complete clinical response rate of IIMs is low, especially for IMNM subtype. More effective intervention should be administered to patients with ILD, elevated AST, elevated serum ferritin or decreased count of CD4 + T cells at disease onset.

Polyphosphate kinase plays an important role in the catalytic synthesis of ATP in vitro . In order to find a polyphosphate kinase that can efficiently synthesize ATP using short-chain polyphosphate (polyP) as substrate, the polyphosphate kinase 2 (PPK2) from Sphingobacterium siyangensis was cloned and expressed in Escherichia coli BL21(DE3). As an enzyme for ATP regeneration, PPK2 was used in combination with l-amino acid ligase (YwfE) to produce l-alanyl-l-glutamine (Ala-Gln). The length of ppk2 of S . siyangensis is 810 bp, encoding 270 amino acids. The SDS-PAGE showed that PPK2 was expressed correctly and its molecular weight was 29.7 kDa as expected. The reaction conditions of PPK2 were optimized. PPK2 could maintain good activity in the range of 22-42 ℃ and pH 7-10. The highest enzyme activity was observed at 37 ℃, pH 7, 30 mmol/L magnesium ion (Mg 2+ ), 5 mmol/L ADP and 10 mmol/L sodium hexametaphosphate, and the yield of ATP reached 60% of the theoretical value in 0.5 hours at this condition. When used in combination with YwfE to produce Ala-Gln, the PPK2 showed a good applicability as an ATP regeneration system, and the effect was similar to that of direct addition of ATP. The PPK2 from S . siyangensis shows good performance in a wide range of temperature and pH, synthesizes ATP with cheap and readily available short chain polyP as substrate. The PPK2 thus provides a new enzyme source for ATP dependent catalytic reaction system.

Influenza virus is one of the common pathogens causing acute respiratory infectious diseases, and is easy to cause acute respiratory distress syndrome (ARDS) after infecting human body, which is an important cause of death of influenza patients. Influenza-induced ARDS results from a combination of overwhelming inflammation and immune response, causing tissue damage and apoptosis. Furthermore, virus-mediated oxidative stress is another important mechanism. Viral infection can produce excessive reactive oxygen species, which damage the epithelial-endothelial barrier with pulmonary edema. In this content, numerous studies have highlighted the importance of antioxidants as a new therapy aimed at blocking both viral replication and virus-induced inflammation. Therefore, this paper summarizes the epidemiology and mechanisms of influenza-induced ARDS, the role of oxidative stress in the occurrence and development of influenza-related ARDS and the role of antioxidants in anti influenza virus infection, in order to provide reference for effective treatment of influenza patients, reducing mortality, developing new anti influenza drugs and preventing and controlling influenza epidemic.

Objective: To evaluate the effect of Xuebijing injection on the improvement of pneumonia severity index (PSI) and prognosis in patients with severe coronavirus disease 2019 (COVID-19)., Methods: A multicenter prospective cohort study was designed. Adult patients with COVID-19 admitted to the intensive care unit (ICU) of 28 designated COVID-19 hospitals in 15 provinces and cities of China from January to March 2020 were enrolled. All patients were treated according to the standard treatment plan of COVID-19 issued by the National Health Commission of the People's Republic of China. They were divided into Xuebijing group and standard treatment group according to whether they received Xuebijing injection or not. In the standard treatment group, routine medical care measures such as antiviral, respiratory support, circulatory support and symptomatic treatment were taken. In the Xuebijing group, on the basis of standard treatment, Xuebijing was used within 12 hours of admission to the ICU, 100 mL each time, twice daily. The minimum duration of Xuebijing administration was 1 day. The improvement rate of PSI risk rating on the 8th day and clinical outcome on the 28th day were recorded., Results: A total of 276 COVID-19 patients were screened continuously, and the data of 144 severe patients who met PSI risk rating III-V were analyzed. Seventy-two cases were involved each in standard treatment group and Xuebijing group. The average age of the standard treatment group and Xuebijing group were (65.7±7.9) years old and (63.5±10.9) years old, and male accounted for 75.0% (54/72) and 70.8% (51/72), respectively. There were no significant differences in general conditions, comorbidities, PSI risk rating and score, sequential organ failure assessment (SOFA) score, oxygenation index (PaO 2 /FiO 2 ), respiratory support mode and other baseline indicators between the two groups. Compared with the standard treatment group, the improvement rate of PSI risk rating in Xuebijing group on the 8th day after admission was significantly improved [56.9% (41/72) vs. 20.8% (15/72), between-group difference and 95% confidence interval (95%CI) was 36.1% (21.3% to 50.9%), P < 0.01], PSI score, SOFA score and PaO 2 /FiO 2 were significantly improved [PSI score: 83.7±34.8 vs. 108.2±25.6, between-group difference (95%CI) was -24.5 (-34.9 to -14.1); SOFA score: 2.0 (1.0, 4.0) vs. 7.0 (4.0, 10.0), between-group difference (95%CI) was -3.5 (-5.0 to -2.0); PaO 2 /FiO 2 (mmHg, 1 mmHg = 0.133 kPa): 289.4±111.6 vs. 188.5±98.1, between-group difference (95%CI) was 100.9 (65.3 to 136.5); all P < 0.01]. The 28-day discharge rate of Xuebijing group was 44.5% higher than that of standard treatment group [66.7% (48/72) vs. 22.2% (16/72), P < 0.01], and the 28-day survival rate was 9.8% [91.7% (66/72) vs. 81.9% (59/72), P < 0.01]. There was no significant difference in the combination of antiviral drugs, antibiotics, anticoagulants and vasopressor drugs between the two groups. There was no significant difference in the incidence of adverse events between the Xuebijing group and standard treatment group [41.7% (30/72) vs. 43.1% (31/72), P > 0.05], and no serious adverse events and adverse reactions of Xuebijing were reported., Conclusions: Standard treatment combined with Xuebijing injection can significantly improve the PSI risk score and clinical prognosis of patients with severe COVID-19 without increasing drug safety risk.

Objective: To describe the long-term outcomes of intensive care unit (ICU) survivors of mechanical ventilation, and investigate the views of survivors on ICU rehabilitation clinics., Methods: A single-center cross-sectional descriptive study was designed. ICU survivors of mechanical ventilation admitted to the First Affiliated Hospital of Guangzhou Medical University from January to December 2016 were enrolled. Data were collected from August 2017 to March 2018. The general information questionnaire, Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and ICU rehabilitation clinics questionnaire were used to evaluate ICU survivors social-demographic factors, social and economic outcomes, clinical data, quality of life and the views on ICU rehabilitation clinics., Results: A total of 248 ICU survivors of mechanical ventilation were included in the study, 130 (52.4%) of them were followed up successfully. The mean time from ICU discharge to follow-up day was (19.64±3.20) months. The average age of the survivors was (60.09±15.42) years old, and 55.4% of them were over 60 years old. Among 130 ICU survivors, severe pneumonia was the dominant ICU admission diagnosis (23.1%), followed by surgical operations (cardiac surgery 16.9%, other surgical operations 20.8%), lung transplantation (13.1%), and acute exacerbation of chronic obstructive pulmonary disease (AECOPD, 12.3%), etc. The first APACHE II score after ICU admission was 16.88±7.37, the mechanical ventilation time was (12.52±12.34) days, and the length of ICU stay was (16.71±15.11) days. In terms of social and economic outcomes, the proportion of having full-time or part-time jobs decreased from 32.3% (42/130) before ICU admission to 25.4% (33/130) by the date of follow-up, while the unemployed rate increased from 6.9% (9/130) to 18.5% (24/130). Only 45.1% (23/51) of the ICU survivors returned to the post before ICU admission. 36.2% (47/130) of the ICU survivors reported that they needed care from others, and 86.9% (113/130) reported that their treatment experiences in ICU had an impact on their lives. In terms of quality of life, physiological function dimension, which was 34.62±33.15, scored the lowest and suffered the most. The physical pain dimension and mental health dimension suffered the least, and the scores were 90.19±16.98 and 75.28±15.15, respectively. Furthermore, physical component summary (PCS) score was 61.12±17.09, and mental component summary (MCS) score was 65.97±21.85. In terms of the views of ICU rehabilitation clinics, 68.5% (89/130) of the subjects believed that the establishment of ICU rehabilitation clinics was very helpful or helpful., Conclusions: The long-term outcomes of ICU survivors of mechanical ventilation are not optimistic. Their quality of life is lower than that of general people. It is necessary to set up ICU rehabilitation clinics.

Objective: To study the risk factors and the clinical characteristics of non-tuberculous mycobacterial (NTM) pulmonary diseases in patients with mechanical ventilation., Methods: Retrospective survey was carried out in the patients with mechanical ventilation who combined with NTM pulmonary disease admitted to intensive care unit (ICU) of the First Affiliated Hospital of Guangzhou Medical University from May 2016 to May 2019. The general information, basic diseases, symptoms, signs, biochemical examinations, acid-fast stain test, mycobacterium culture and strain identification results, and chest CT data were collected to summarize the clinical characteristics of patients with mechanical ventilation combined with NTM pulmonary disease., Results: There were 12 patients with mechanical ventilation combined with NTM pulmonary disease, 6 males and 6 females, 37-82 years old, with an average age of 65 years. In these 12 cases, patients with cancer (lung cancer were 4 cases, mediastinal tumor was 1 case) and after lung transplantation (use of anti-rejection drugs at the same time) were 5 and 2 respectively. Patients with at least 3 underlying diseases [included hypertension, diabetes, coronary heart disease, chronic obstructive pulmonary disease (COPD), bronchiectasis, chronic renal insufficiency] were 5. Clinical symptoms of the 12 cases were non-specific. The CT findings were not characteristic, including nodules, patchy infiltrations and fibrous streak. Pleural effusion was common among these subjects but nodular bronchiectatic patterns were absence. Routine laboratory indicators of bacterial infection were non-specific. But the number of lymphocytes of all cases decreased. Mycobacteria cultures were positive with the rapid growth of mycobacteria in these 12 cases. Mycobacterium avium (4 cases), Mycobacterium chelonae (4 cases), Mycobacterium chelonae-abscessus complex (2 cases) and Mycobacterium intracellulare (2 cases) were isolated. Anti-NTM therapy was given to the patients when the acid-fast staining test of their airway secretion was positive and the TB-DNA test was negative, including oral levofloxacin and clarithromycin. Finally, all patients were successfully weaned and discharged from ICU., Conclusions: The clinical symptoms of NTM patients with pulmonary disease are non-specific, and the imaging features of chest CT are varied. Patients with mechanical ventilation in ICU, who have the risk of immune dysfunction or underlying structural lung diseases, and who have difficult controlled lung infection, accompanied by pleural effusion and with decreased lymphocytes, should be aware that pneumonia may be caused by non-tuberculous mycobacteria.

With the discovery of the significant medicinal value of alginate oligosaccharides and bioethanol produced by microalgae, alginate lyase has been the focus of research in all fields. Five alginate lyase genes in cluster from Vibrio alginolyticus were cloned and expressed in Escherichia coli. SDS-PAGE and enzyme activity showed that four of the five genes have the activity to degrade alginate. Optimization of the induction conditions, protein purification and enzyme properties of rAlgV3 with the highest enzyme activity were studied. The results showed that the enzyme activity of recombinant enzyme rAlgV3 increased from 2.34×10⁴ U/L to 1.68×10⁵ U/L, which was 7.3 times higher than before. The optimal reaction temperature was 40 °C, and the enzyme was relatively stable between 4 °C and 20 °C. The enzyme had a higher activity between pH 6.5 and 9.0, with the optimum pH 8.0. It showed a wide range of pH that the alginate lyase can exist stably between pH 4.5 and 9.5. Appropriate concentrations of NaCl and Fe²⁺, Fe³⁺ ions promoted enzyme activity. SDS and Cu²⁺ ions inhibited the enzyme activity. The enzyme degraded Poly-M fragments and Poly-G fragments, with a wide range of substrate properties. The degraded product of sodium alginate of rAlgV3 analyzed by ESI-MS mainly was oligosaccharides with a polymerization degree of 2 to 3, which means that rAlgV3 was an endo-type alginate lyase. This enzyme has the potential in the development of third-generation bioethanol and the production of alginate oligosaccharides.

Objective: To investigate the cause of massive hemoptysis in critical patients, and to evaluate the effect of bronchial artery embolization (BAE) on critical patients with massive hemoptysis., Methods: A retrospective controlled analysis was conducted. The clinical data of 35 patients with life-threatening massive hemoptysis admitted to intensive care unit (ICU) of the First Hospital Affiliated to Guangzhou Medical University from January 2009 to December 2017 were analyzed. The patients were divided into BAE and non-BAE group according to whether receiving BAE or not. BAE patients were subdivided into subgroups: hemoptysis after ventilation and hemoptysis before ventilation subgroups, as well as survival and non-survival subgroups. The etiology of all massive hemoptysis was analyzed. The gender, age, acute physiology and chronic health evaluation II (APACHE II) score, amount of hemoptysis, whether presence of pleural thickening in chest CT, the length of ICU stay, total length of hospital stay, the duration of mechanical ventilation (MV), clinical effective and prognostic indicators of patients were recorded. The correlation between variables was analyzed by Spearman correlation analysis., Results: All 35 patients were enrolled in the finally analysis. The main cause of critical patients with massive hemoptysis was fungal infection [37.1% (13/35)], followed by pneumonia and abnormal coagulation [17.1% (6/35)], bronchiectasis [11.4% (4/35)], tumor [8.6% (3/35)], etc. In all 35 patients, 27 were treated with BAE and 8 were treated without BAE. There was no difference in gender, age, the length of ICU stay, total length of hospital stay, the duration of MV, amount of hemoptysis, APACHE II score, whether use antiplatelet agents or anticoagulants, or whether presence of pleural thickening in chest CT between the two groups. The rate of hemoptysis remission in BAE group was significantly higher than that of non-BAE group [92.6% (25/27) vs. 25.0% (2/8), P < 0.01], but there was no statistically significant difference in hospital survival as compared with that of non-BAE group [48.1% (13/27) vs. 25.0% (2/8), P > 0.05]. Subgroup analysis showed that 64.3% (9/14) of patients with hemoptysis after ventilation was caused by pulmonary fungal infection, which was significantly higher than those with hemoptysis before ventilation [15.4% (2/13), P = 0.018]. Compared with hemoptysis after ventilation group, the length of ICU stay and the duration of MV in hemoptysis before ventilation group were significantly shortened [the length of ICU stay (days): 12.0 (14.0) vs. 30.0 (81.8), the duration of MV (days): 10.0 (16.0) vs. 25.0 (68.3)], the patients using antiplatelet drugs or anticoagulant drugs was decreased significantly (case: 1 vs. 9, all P < 0.05). However, there was no statistically significant difference in gender, age, total length of hospital stay, amount of hemoptysis, APACHE II score, whether presence of pleural thickening in chest CT, the rate of hemoptysis remission, the incidence of secondary BAE or hospital survival rate between the two groups. Compared with the survival subgroup (n = 13), more patients in the non-survival subgroup (n = 14) were treated with antiplatelet or anticoagulants (P < 0.05); and Spearman correlation analysis showed that the survival of the patients with BAE was negatively correlated with the use of antiplatelet or anticoagulants (r = -0.432, P = 0.024). There was no significant difference in the gender, age, the length of ICU day, total length of hospitalization, duration of MV, estimated hemoptysis, APACHE II score, or the proportion of pleural thickening between the two groups., Conclusions: The study indicated that the etiology of massive hemoptysis in critical patients was complicated. Fungal infection was the main cause in patients with hemoptysis after ventilation. BAE was effective in the control of massive hemoptysis in ICU, but it was not ideal for patients with abnormal coagulation function or abnormal platelet count or platelet dysfunction from antiplatelet or anticoagulant drugs, the overall survival rate was still low.

Objective: To study the accuracy of lactic dehydrogenase (LDH) in the diagnosis of pneumocystis pneumonia (PCP)., Methods: The data of this systemic review was retrieved from the PubMed, China Biology Medicine disc, Wanfang, Weipu and China National Knowledge Infrastructure (CNKI) databases from establishment till to October 31st, 2017. Case-control studies about the diagnosis of PCP were enrolled. Enrolled studies were required that patients in case group ware PCP and patients in control group were lung diseases other than PCP. The QUADAS tool was used to evaluate the quality of studies. The RevMan 5.3 software was used to draw a forest plot. The StataMP 14 software was used to make subgroup analyses by drawing receiver operator characteristic (SROC) curves for the whole group, the acquired immune deficiency syndrome (AIDS) group, and the not all-AIDS group, and calculating their diagnostic odds ratio (DOR) and 95% confidential interval (95%CI)., Results: Thirteen studies, all in English, were included. There were 825 patients in the case group, in which 650 patients were AIDS. There were 1 341 patients in control group, in which 888 patients were AIDS and most of them were Pulmonary Kaposi Sarcoma, bacterial pneumonia, pulmonary tuberculosis etc. Although there were different positive values of LDH in different studies, from 200 U/L to 598 U/L, sensitivities were good, especially in AIDS patients all values were above 80% (80%-100%). The specificities had big fluctuations, from 6% to 85%, which made them poor. The DOR (95%CI) of LDH in PCP diagnosis of all patients, AIDS patients and not-all AIDS patients were 6.73 (3.19-14.21), 9.17 (3.79-22.18) and 5.07 (1.30-19.80) respectively., Conclusions: The sensitivity of LDH in the diagnosis of PCP is high, especially in AIDS group. In practice if LDH is negative, there should be more evidences to support the treatment of PCP.

Kluyveromyces marxianus, as unconventional yeast, attracts more and more attention in the biofuel fermentation. Although this sort of yeasts can ferment pentose sugars, the fermentation capacity differs largely. Xylose and arabinose fermentation by three K. marxianus strains (K. m 9009, K. m 1911 and K. m 1727) were compared at different temperatures. The results showed that the fermentation performance of the three strains had significant difference under different fermentation temperatures. Especially, the sugar consumption rate and alcohol yield of K. m 9009 and K. m 1727 at 40 ℃ were better than 30 ℃. This results fully reflect the fermentation advantages of K. marxianus yeast under high-temperature. On this basis, five genes (XR, XDH, XK, AR and LAD) coding key metabolic enzymes in three different yeasts were amplified by PCR, and the sequence were compared by Clustalx 2.1. The results showed that the amino acid sequences coding key enzymes have similarity of over 98% with the reference sequences reported in the literature. Furthermore, the difference of amino acid was not at the key site of its enzyme, so the differences between three stains were not caused by the gene level, but by transcribed or translation regulation level. By real-time PCR experiment, we determined the gene expression levels of four key enzymes (XR, XDH, XK and ADH) in the xylose metabolism pathway of K. m 1727 and K. m 1911 at different fermentation time points. The results showed that, for thermotolerant yeast K. m 1727, the low expression level of XDH and XK genes was the main factors leading to accumulation of xylitol. In addition, according to the pathway of Zygosaccharomyces bailii, which have been reported in NCBI and KEGG, the xylose and arabinose metabolic pathways of K. marxianus were identified, which laid foundation for further improving the pentose fermentation ability by metabolic engineering.

Objective: To detect the cytotoxicity of fine particulate matter treated on human bronchial epithelial cells( BEAS-2B) and human embryonic lung fibroblasts( MRC-5) by using the method of real time cell analyze( RTCA) and Alamar Blue., Methods: Seed the BEAS-2B cells and MRC-5 cells in the 16-well plates for RTCA analyzer and commonly 96-well plates respectively. After 24 hours, the BEAS-2B cells and the MRC-5 cells were treated by the fine particulate matter respectively in different doses( 2500, 1250, 625, 312. 5, 156. 25 and 78. 125 μg / m L). Calculating the IC50 values which determined by the two methods on different times( 3, 12, 24, 36 and 48 h). Using paired t test by SPSS 16. 0 analyse the IC50 values from two methods and estimate the correlation., Results: There was correlation between the two methods, but there was no obvious difference between the two results by RTCA and Alamar Blue., Conclusion: There is certain cytotoxicity of fine particulate matter. At the same time, the RTCA real-time monitoring technology can be used on determination of cytotoxicity in vitro.

Objective: To investigate the possibility of improving the prognosis of patients with severe sepsis by different kinds of intravenous immunoglobulin (IVIG)., Methods: PubMed database, EMBase, Cochrane clinical trial database, CNKI, and Wangfang database etc were retrieved. The search time was from database creation to September 2015,which included all prospective studies of the effectiveness of IVIG compared with non-IVIG in all adult patients with severe sepsis. Main end-point parameter was total mortality rate; secondary end-point parameters were short-term (＜ 7 days) mortality,28-day mortality, length of intensive care unit (ICU) and hospital stay, and mortality due to septic shock or multiple organ failure (MOF). RevMan 5.3 was used for Meta analysis., Results: Finally,16 prospective studies including 12 randomized controlled trails (RCT) and 4 prospective cohort studies were enrolled, referred to 1 819 patients, 892 patients were in IVIG group, 927 patients receiving human albumin, placebo or blank control were in control group. Compared with the control group, IVIG could reduce the total mortality rate of patients with severe sepsis [relative risk (RR) =0.71,95％ confidence interval (95％CI) =0.57-0.87,P =0.001].After the high-risk research was eliminated, it was shown that the IVIG could reduce the total mortality rate in patients with severe sepsis (RR =0.80, 95％CI =0.65-0.98, P =0.03).But IVIG could not reduce the 28-day mortality rate (RR =0.60, 95％CI =0.35-1.04, P =0.07), short-term mortality rate (RR =1.06, 95％CI =0.76-1.46,P =0.74), the mortality rate of septic shock (RR =0.55, 95％CI =0.29-1.03, P =0.06) and the mortality rate of MOF (RR =0.91, 95％CI =0.63-1.33, P =0.64).In fact, the length of stay in ICU [weighted mean difference (WMD) =-0.02, 95％CI =-0.03-0.25, P =0.86] and the total length of stay in hospital (WMD =-2.34,95％CI =-7.05-2.37,P =0.33) were similar. In subgroup, the 28-day mortality rate of patients with severe sepsis in the IgM group (RR =0.50, 95％CI =0.25-1.01, P =0.05) was significantly lower than that of IgG group (RR =0.72, 95％CI =0.40-1.30, P =0.28)., Conclusions: IVIG can reduce the total mortality rate of patients with severe sepsis. Compared with IgG, IgM-enriched IVIG has certain advantages in patients with severe sepsis, but cannot reduce the short-term mortality rate, mortality rate of septic shock and MOF, and also cannot shorten the length of ICU stay and the total length of hospital day.

Objective: To establish an in vitro culture model of single human hair follicle, and observe their morphological and histological changes., Methods: Human hair follicles were isolated from the volunteer patients. After dissecting follicles into single, follicles in growth phase were cultured in Williams E without any serum. This experiment included 3 groups: single follicle without sebaceous gland and other surrounding tissue (control group); single follicle with sebaceous gland and without the other surrounding tissue( experiment group A); single follicles with sebaceous gland and the other surrounding tissue (experiment group B). The survival rate, survival time, growth rate, multiplication capacity and apoptosis of cultured follicles and their morphological and histological changes were observed sequentially., Results: The hair follicles in experiment groups showed a better viability and a higher growth rate than those in control group. And the follicles in group B could keep growing for more than 25 days, which was longer than those in group A. Moreover, the sebaceous gland and the other surrounding tissue in group B showed great induction effect on follicle-cell proliferation and anti-apoptosis., Conclusion: The in vitro culture model of signal human hair follicles (single follicles including epidermis, sebaceous gland and the other surrounding tissue) had optimized internal environment which is similar to in vivo internal environment.

Objective: To investigate the value of N-terminal pro-B type natriuretic peptide (NT-proBNP) in predicting the outcome of spontaneous breathing trial (SBT) in ventilated elderly renal dysfunction patients., Methods: The clinical data of patients who received mechanical ventilation in the Department of Critical Care Medicine of the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease from January 2011 to December 2014 were analyzed retrospectively. AU the patients conformed to the following criteria: age > 65 years, endogenous creatinine clearance rate (CCr) < 60 mL×min(-1)×1.73 m(-2), the duration of mechanical ventilation > 72 hours and undergone at least one SBT. The patients were assigned to a SBT success group and a SBT failure group according to the outcome of first SBT. The following factors were recorded: gender, age, the underlying disease [chronic obstructive pulmonary disease (COPD), heart failure (HF) and others], body mass index (BMI), serum pre-albumin (pre-ALB), and acute physiology and chronic health evaluation II (APACHE II) score, CCr and the concentration of the plasma NT-proBNP before SBT. Receiver operator characteristic curve (ROC) was plotted, and the predict value of NT-proBNP for the outcome of SBT in elder patients with kidney dysfunction was determined., Results: A total of 58 patients with complete data were enrolled, with 41 cases in SBT success group, and 17 in SBT failure group. There were no significant differences in gender [male/female (cases): 26/15 vs. 13/4, χ (2) = 0.930, P = 0.335], age (years: 70.2±7.4 vs. 74.6±10.1, t = 0.833, P = 0.339), the stratification of underlying diseases [COPD/HF/COPD+HF/others (cases): 15/9/13/4 vs. 7/3/5/2, χ (2) = 0.242, P = 0.971], BMI (kg/m(2): 25.2±11.3 vs. 27.4±6.43, t = 1.038, P = 0.221), pre-ALB (mg/L: 201.0±13.2 vs. 189.0±7.6, t = 0.688, P = 0.519), and APACHE II score (12.2±3.2 vs. 13.5±6.3, t = 1.482, P = 0.147) and CCr (mL×min(-1)×1.73 m(-2): 51.3±7.7 vs. 54.2±6.4, t = 0.711, P = 0.487) before SBT between SBT success group and SBT failure group. The concentration of plasma NT-proBNP in SBT failure group was significantly higher than that of the SBT success group (μg/L: 4.162±1.128 vs. 2.284±1.399, t = 4.905, P = 0.000). The area under ROC curve for plasma NT-proBNP in predicting successful SBT among elder patients with kidney dysfunction was 0.878, with 95% confidence interval (95%CI) 0.786 - 0.970. The cut-off method was used, and it was identified that the concentration of NT-proBNP < 3.350 μg/L as a predictor for successful SBT, with sensitivity of 82.4%, specificity of 87.8%, positive prediction value of 88.1% and negative predictive value of 76.5%., Conclusions: The concentration of plasma NT-proBNP may increase in elderly kidney dysfunction patients undergoing ventilation, and NT-proBNP < 3.350 μg/L can serve as a good predictor for SBT success.

Objective: To explore the effect of prone position ventilation (PPV) on respiratory mechanics and prognosis in patients with acute respiratory distress syndrome (ARDS) concurrent with interstitial lung disease (ILD)., Methods: The data of 36 severe ARDS patients admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Guangzhou Medical University from February 2013 to January 2015, were retrospectively analyzed. They were then divided into two groups according to the presence of ILD or not. The changes in respiratory mechanics and oxygenation indexes were compared before and after PPV treatment in all the patients. Kaplan-Meier method was applied to draw the 60-day survival curves of both groups., Results: There were 17 cases with ILD among these 36 severe ARDS patients. (1) No significant difference was found in baseline data between ILD group and non-ILD group. (2) Respiratory mechanics and oxygenation pre-PPV and post-PPV: compared with pre-PPV, oxygenation index (PaO2/FiO2, mmHg, 1 mmHg = 0.133 kPa) post-PPV was significantly increased in both groups [ILD group : 132.0 (93.5, 172.0) vs. 118.7 (92.0, 147.8); non-ILD group: 126.1 (100.9, 170.0) vs. 109.2 (89.0, 135.0), both P < 0.05]. Compared with pre-PPV, positive end-expiratory pressure (PEEP, cmH2O, 1 cmH2O = 0.098kPa) post-PPV was significantly higher in ILD group [10.0 (10.0, 12.0) vs. 10.0 (9.2, 12.0), P < 0.05], and respiratory rate (RR, times/min) was significantly lower in non-ILD group [24.5 (22.0, 27.0) vs. 25.5 (22.8, 28.0), P < 0.05]. The compliance of the respiratory system (Crs, mL/cmH2O) post-PPV in non-ILD group was significantly lower than that of the ILD group [19.7 (16.1, 28.6) vs. 23.0 (19.0, 29.7), P < 0.05]. (3) Respiratory mechanics and oxygenation pre-PPV and post-PPV in total: after all the PPV therapy, PaO2/FiO2 (mmHg) was significantly increased in non-ILD group [135.0 (86.0, 200.0) vs. 97.4 (69.2, 127.5), P < 0.05], PaO2/FiO2 after all the PPV therapy in non-ILD group was also higher than that in ILD group [135.0 (86.0, 200.0) vs. 78.7 (59.3, 114.9), P < 0.05]. No significant difference in Crs (mL/cmH2O) before PPV treatment was found between non-ILD and ILD groups [24.3 (15.9, 48.9) vs. 18.9 (12.7, 27.3), P > 0.05], and Crs was lower after PPV treatment in both groups, but without significant difference [non-ILD group: 22.7 (15.2, 27.1) vs. 24.3 (15.9, 48.9); ILD group: 16.2 (12.8, 25.6) vs. 18.9 (12.7, 27.3), both P > 0.05]. (4) The 60-day mortality in ILD group was significantly higher than that in non-ILD group [88.2% (15/17) vs. 57.9% (11/19), P = 0.047). It was shown by Kaplan-Meier curves that 60-day survival patients in ILD group was significantly lower than those in non-ILD group (χ2 = 5.658, P = 0.017)., Conclusions: PPV can improve oxygenation in severe ARDS. Compared with non-ILD group, though the compliance of respiratory system in ILD group is increased during PPV, long-term effect is better in non-ILD group.

To improve the inulinase application in biotechnology, the characteristic of inulinase from Kluyveromyces marxianus YX01 was investigated. The inu gene of K. marxianus YX01 was transformed into Pichiapastoris GS115 host cells with molecular biology techniques. Then we achieved the heterologous expression of exo-inulinase whose molecular mass was about 86.0 kDa by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Furthermore, six His-tag was added to the inulinase and a two-step method was applied in the purification of inulinase, including concentration via dialysis by polyethylene glycol 20 000 and metal Ni-NTA Agarose affinity adsorption. The purification factor of purified protein was 3.6 and the recovery rate of enzyme activity was 33.1%. We characterized the purified inulinase. The optimum temperature was 60 degrees C and pH was 4.62. When inulin and sucrose were used as substrates, the K(m) and V(max) values were 80.53 g/L vs 4.49 g/(L x min) and 183.10 g/L vs 20.20 g/(L x min), respectively. In addition, metal ions including Mn2+, Ca2+, Cu2+, Zn2+ and Fe2+ exhibited different degrees of inhibition on the enzyme activity, and Cu2+, Zn2+ and Fe2+ exhibited the most significant inhibition. Our findings might lay a good foundation for industrial application of inulinase.

Objective: To investigate the value of the application of fibrobronchoscopy in extubation for patients suffering from acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with low cough peak expiratory flow (CPEF)., Methods: A single-center prospective controlled study was conducted. The ventilated AECOPD patients who were cooperative at the time of extubation in Department of Critical Care Medicine of Guangzhou Institute of Respiratory Disease of Guangzhou Medical University from June 2009 to May 2014 were enrolled. All patients successfully passed the spontaneous breathing trial (SBT). Extubation was performed after determination of CPEF following energetic coughing. According to the CPEF, the patients were divided into CPEF ≥ 60 L/min group (high CPEF group) and CPEF<60 L/min group (low CPEF group). After extubation, fibrobronchoscopic drainage was given to the patients in high CPEF group when necessary. Fibrobronchoscopic drainage was given to the patients in low CPEF group at least once a day, and the frequency of such treatment could be increased according to the patient's condition. If the patients did not require re-intubation within 48 hours,extubation was recorded as successful. The gender, age, acute physiology and chronic health evaluationII (APACHEII) score before extubation, ventilation time, the time of intensive care unit (ICU) stay, the mortality in ICU, the rate of re-intubation, the ability to cough and the frequency of application of fibrobronchoscopy after extubation were recorded., Results: A total of 102 patients with AECOPD were enrolled, 58 patients in high CPEF group and 44 in low CPEF group. Compared with high CPEF group, the mean age in low CPEF group was older (years: 74.3 ± 15.2 vs. 69.5 ± 11.4, t=2.164, P=0.041), the time of ICU stay was significantly longer (days: 20.1 ± 11.2 vs. 17.4±7.3, t=2.274, P=0.030), but there was no significant difference in gender [male/female (cases):35/9 vs. 45/13, χ² = 0.057, P=0.812], APACHEII score (11.9 ± 1.9 vs. 10.3 ± 4.2, t=1.290, P=0.200), mechanical ventilation time (days: 14.8 ± 10.8 vs. 13.3 ± 9.6, t=0.677, P=0.501) and the rate of re-intubation [18.18% (8/44) vs. 12.07% (7/58), χ² = 1.412, P=0.235] between low CPEF group and high CPEF group. The cough strength of patients in high CPEF group was almost always "strong" (52 cases), and in the low CPEF group, most of them was "moderate" (14 cases) or "weak" (26 cases). The frequency of application of fibrobronchoscopy in low CPEF group was higher than that in high CPEF group (times: 4.1 ± 1.8 vs. 1.3 ± 0.9, t=2.626, P=0.011). All patients underwent weaning successfully, and no death occurred., Conclusions: The application of fibrobronchoscopy in the extubated AECOPD patients with low CPEF can reduce the rate of re-intubation, avoid the prolonged ventilation, but cannot reduce the time of ICU stay.

This research was aimed to find the skin irritation and burns treatment effect of wound dressing with mi- crospheres containing levofloxacin. We used reference GB/T16886. 10-2005 to evaluate the dressing skin irritation. We prepared rabbit models divided into three groups. The control group was rapped with Vaseline gauze bandage, while the positive control group was rapped with the wounds of nano-silver paste bandage. The experimental sample group was rapped with wound dressing with microspheres containing levofloxacin. We measured the wound without healing area and the hydroxyproline content at the ends of 3 d, 6 d, 9 d, 14 d, 21 d, 28 d. and meanwhile performed histopathological examination. The experimental results showed that the dressing primary irritation index was 0. The nonhealing wound area of theexperimental sample group and positive control group at the ends of 6 d, 9 d, 14 d, 21 d were less than that of the control group (P<0. 05). The nonhealing wound area of the experimental sample group at the ends of 9 d and 14 d was significantly lower than that of the positive control group (P < 0.05). The hydroxyproline content of the experimental sample group at the ends of 6 d, 9 d and 14 d was significantly higher than that of the positive control group and blank control group (P<0. 05). The pathology observed of the experimental sample group at 21 d were the earliest appendages. The wound dressing with microspheres containing levofloxacin has minimal skin irritation, effectively promote wound healing of burn.