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Impact of next-generation sequencing on antimicrobial treatment in immunocompromised adults with suspected infections

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World Journal of Emergency Medicine 2024年第2期15卷 105-110页

作者： Jia Li Jiazhen Luo Tao Hu Ling Cheng Weiwei shang Li yan Department of Intensive Care Unit Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Department of Emergency Medicine Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China Tongji Medical College Huazhong University of Science and TechnologyWuhan 430030China Department of Geriatrics Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

BACKGROUND:Prompt pathogen identification can have a substantial impact on the optimization of antimicrobial treatment.The objective of the study was to assess the diagnostic value of next-generation sequencing(NGS)for identifying pathogen and its clinical impact on antimicrobial intervention in immunocompromised patients with suspected infections.METHODS:This was a retrospective study.Between January and August 2020,47 adult immunocompromised patients underwent NGS testing under the following clinical conditions:1)prolonged fever and negative conventional cultures;2)new-onset fever despite empiric antimicrobial treatment;and 3)afebrile with suspected infections on imaging.Clinical data,including conventional microbial test results and antimicrobial treatment before and after NGS,were collected.Data were analyzed according to documented changes in antimicrobial treatment(escalated,no change,or deescalated)after the NGS results.RESULTS:The median time from hospitalization to NGS sampling was 19 d.Clinically relevant pathogens were detected via NGS in 61.7% of patients(29/47),more than half of whom suffered from fungemia(n=17),resulting in an antimicrobial escalation in 53.2% of patients(25/47)and antimicrobial de-escalation in 0.2% of patients(1/47).Antimicrobial changes were mostly due to the identification of fastidious organisms such as Legionella,Pneumocystis jirovecii,and Candida.In the remaining three cases,NGS detected clinically relevant pathogens also detected by conventional cultures a few days later.The antimicrobial treatment was subsequently adjusted according to the susceptibility test results.Overall,NGS changed antimicrobial management in 55.3%(26/47)of patients,and conventional culture detected clinically relevant pathogens in 14.9% of the patients(7/47).CONCLUSION:With its rapid identification and high sensitivity,NGS could be a promising tool for identifying relevant pathogens and enabling rapid appropriate treatment in immunocompromised patients with suspected infections.

关键词： Immunocompromised patients Next-generation sequencing Antimicrobial management

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A deoxidation thermodynamic model for 304 stainless steel considering multiple-components coupled reactions

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Journal of Iron and Steel Research(International) 2024年第1期31卷 74-91页

作者： yan yan Guang-hao shang Li-ping Zhang Shao-ying Li Han-jie Guo School of Metallurgical and Ecological Engineering University of Science and Technology BeijingBeijing100083China Beijing Key Laboratory of Special Melting and Preparation of High-End Metal Materials Beijing100083China Henan Jinhui Stainless Steel Industry Group Co. Ltd.Xuchang461500HenanChina Changge Jinhui Recycling Metal R&D Co. Ltd.Xuchang461500HenanChina

A thermodynamic model for predicting the equilibrium oxygens of 304 stainless steel was developed based on the theory of slag-steel equilibrium,the law of mass conservation,and the ion and molecule coexistence theory.In the developed model,the Fe-Cr-Mn-Si-Al-S-O-melts reaction system and CaO-MgO-CaF_(2)-FeO-MnO-Al_(2)O_(3)-SiO_(2)-Cr2O_(3)slags were considered.The oxygen contents calculated by the model are in good agreement with experimental results and reference data.The equilibrium oxygen contents in 304 stainless steel mainly decrease with increasing binary basicity(w(CaO)/w(SiO_(2)),where w(i)is the mass percentage of component i)and decreasing temperature.Controlling binary basicity at 2.0 while maintaining temperatures lower than 1823 K will keep the oxygen contents in the 304 stainless steel lower than 15×10^(-6).The equilibrium oxygen contents may also be decreased with increasing content of MgO in slags,which is more significant at lower binary basicity.Besides,a small amount of FeO,MnO,and Al_(2)O_(3)(about 0-2.5 wt.%)in slags has little effect on equilibrium oxygen contents.Furthermore,it is found that the[C]-[O]reaction may occur during refining process but will not significantly affect the equilibrium oxygen contents.

关键词： Complex deoxidation Thermodynamic model Ion and molecule coexistence theory 304 stainless steel Slag-steel reaction

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Application of Isogeometric Analysis Method in Three-Dimensional Gear Contact Analysis

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Computer Modeling in Engineering & Sciences 2024年第4期139卷 817-846页

作者： Long Chen yan Yu yanpeng shang Zhonghou Wang Jing Zhang School of Mechanical Engineering University of Shanghai for Science and TechnologyShanghai200093China Zhejiang Fine-Motion Robot Joint Technology Co. Ltd.Taizhou317600China

Gears are pivotal in mechanical drives,and gear contact analysis is a typically difficult problem to solve.Emerging isogeometric analysis(IGA)methods have developed new ideas to solve this problem.In this paper,a threedimensional body parametric gear model of IGA is established,and a theoretical formula is derived to realize single-tooth contact analysis.Results were benchmarked against those obtained from commercial software utilizing the finite element analysis(FEA)method to validate the accuracy of our approach.Our findings indicate that the IGA-based contact algorithmsuccessfullymet theHertz contact test.When juxtaposed with the FEA approach,the IGAmethod demonstrated fewer node degrees of freedomand reduced computational units,all whilemaintaining comparable accuracy.Notably,the IGA method appeared to exhibit consistency in analysis accuracy irrespective of computational unit density,and also significantlymitigated non-physical oscillations in contact stress across the tooth width.This underscores the prowess of IGA in contact analysis.In conclusion,IGA emerges as a potent tool for addressing contact analysis challenges and holds significant promise for 3D gear modeling,simulation,and optimization of various mechanical components.

关键词： Contact analysis involute gear isogeometric analysis finite element analysis

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High-precision parallel computing model of solute transport based on GPU acceleration

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Journal of Hydrodynamics 2024年第1期36卷 202-212页

作者： shang-hong Zhang Rong-qi Zhang Wen-da Li Xi-yan yang yang Zhou School of Water Resources and Hydropower Engineering North China Electric Power UniversityBeijing102206China Hubei Key Laboratory of Intelligent yangtze and Hydroelectric Science China Yangtze Power Co.Ltd.Yichang443133China

The scenario simulation analysis of water environmental emergencies is very important for risk prevention and control,and emergency response.To quickly and accurately simulate the transport and diffusion process of high-intensity pollutants during sudden environmental water pollution events,in this study,a high-precision pollution transport and diffusion model for unstructured grids based on Compute Unified Device Architecture(CUDA)is proposed.The finite volume method of a total variation diminishing limiter with the Kong proposed r-factor is used to reduce numerical diffusion and oscillation errors in the simulation of pollutants under sharp concentration conditions,and graphics processing unit acceleration technology is used to improve computational efficiency.The advection diffusion process of the model is verified numerically using two benchmark cases,and the efficiency of the model is evaluated using an engineering example.The results demonstrate that the model perform well in the simulation of material transport in the presence of sharp concentration.Additionally,it has high computational efficiency.The acceleration ratio is 46 times the single-thread acceleration effect of the original model.The efficiency of the accelerated model meet the requirements of an engineering application,and the rapid early warning and assessment of water pollution accidents is achieved.

关键词： Pollution transport and diffusion model parallel computing Compute Unified Device Architecture(CUDA) pollution event

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Monotropein Induced Apoptosis and Suppressed Cell Cycle Progression in Colorectal Cancer Cells

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Chinese Journal of Integrative Medicine 2024年第1期30卷 25-33页

作者： GAO Quan LI Lin ZHANG Qi-man SHENG Qin-song ZHANG Ji-liang JIN Li-jun shang Rui-yan School of Pharmacy and Department of Medical Oncology the Affiliated Hospital of Hangzhou Normal UniversityHangzhou Normal UniversityHangzhou(311121)China Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines Engineering Laboratory of Development and Application of Traditional Chinese MedicinesCollaborative Innovation Center of Traditional Chinese Medicines of Zhejiang ProvinceHangzhou Normal UniversityHangzhou(311121)China Department of Colorectal Surgery the First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhouChina Beijing Tong Ren Tang Chinese Medicine Co. Ltd.Beijing(100000)China Department of Traditional Chinese Medicine Hangzhou Shangcheng District People's HospitalHangzhou(310006)China Department of Gynecology Hangzhou Women's HospitalHangzhou(310008)China

Objective: To determine whether monotropein has an anticancer effect and explore its potential mechanisms against colorectal cancer(CRC) through network pharmacology and molecular docking combined with experimental verification. Methods: Network pharmacology and molecular docking were used to predict potential targets of monotropein against CRC. Cell counting kit assay, plate monoclonal assay and microscopic observation were used to investigate the antiproliferative effects of monotropein on CRC cells HCT116, HT29 and LoVo. Flow cytometry and scratch assay were used to analyze apoptosis and cell cycle, as well as cell migration, respectively in HCT116, HT29, and LoVo cells. Western blotting was used to detect the expression of proteins related to apoptosis, cell cycle, and cell migration, and the expression of proteins key to the Akt pathway. Results: The Gene Ontology and Reactome enrichment analyses indicated that the anticancer potential of monotropein against CRC might be involved in multiple cancer-related signaling pathways. Among these pathways, RAC-beta serine/threonine-protein kinase(Akt1, Akt2), cyclin-dependent kinase 6(CDK6), matrix metalloproteinase-9(MMP9), epidermal growth factor receptor(EGFR), cell division control protein 42 homolog(CDC42) were shown as the potential anticancer targets of monotropein against CRC. Molecular docking suggested that monotropein may interact with the 6 targets(Akt1, Akt2, CDK6, MMP9, EGFR, CDC42). Subsequently, cell activity of HCT116, HT29 and LoVo cell lines were significantly suppressed by monotropein(P<0.05). Furthermore, our research revealed that monotropein induced cell apoptosis by inhibiting Bcl-2 and increasing Bax, induced G_1–S cycle arrest in colorectal cancer by decreasing the expressions of CyclinD1, CDK4 and CDK6, inhibited cell migration by suppressing the expressions of CDC42 and MMP9(P<0.05), and might play an anticancer role through Akt signaling pathway. Conclusions: Monotropein exerts its antitumor effects primarily by arresting the cell cycle,

关键词： monotropein Chinese medicine anticancer activity colorectal cancer cells network pharmacology

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Organic Integration of Traditional Chinese and Western Medicines—Future of Clinical Practice Guidelines of Integrated Traditional Chinese and Western Medicines

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Chinese Journal of Integrative Medicine 2024年第4期30卷 359-365页

作者： XIE Ying-lan HAN Fei JIN Ying-hui DING yan-bing GUO Jing JI Dong-xiao ZHANG Teng CHENXiao-min shang Hong-cai Department of Traditional Chinese Medicine Encephalopathy Hubei Provincial Hospital of Traditional Chinese MedicineWuhan(430074)China Department of Traditional Chinese Medicine Encephalopathy Hubei Province Traditional Chinese Medicine Research InstituteWuhan(430074)China Xuanwu Hospital of Traditional Chinese Medicine Beijing(100000)China Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhan(430074)China College of Acupuncture and Massage College of Health and RehabilitationNanjing University of Chinese MedicineNanjing(210023)China Department of Ophthalmology Huaihe Hospital of Henan UniversityKaifengHenan Province(475000)China Ministry of Education and Beijing Key Laboratory of Internal Medicine of Traditional Chinese Medicine Dongzhimen Hospital of Beijing University of Traditional Chinese Medicine/Ministry of Education and Beijing Key Laboratory of Internal Medicine of Traditional Chinese MedicineBeijing(100700)China

The transformation and implementation of clinical practice guidelines for integrated traditional Chinese medicine(TCM)and Western medicine(WM)is crucial to the adoption of medical science and technological findings and is an important way for TCM to be made available to the world.First,clinical practice guidelines(CPGs)of TCM and WM integration in recent years was analyzed to clarify the current situation and problems in the existing guidelines according to the following four perspectives:(1)perspective of TCM and WM integration in guidelines,(2)diagnosis Using integrated TCM and WM,(3)integration of TCM and WM treatment,(4)promoting TCM and WM integration.Secondly,the information and quality evaluation of CPGs for integrated Chinese and Western medicine in 2020–2022 were analyzed to explore the degree and methods of integration of Chinese and Western medicine guidelines.And last this study aimed to lay a foundation for the further establishment of Chinese characteristic,repeatable,and calculable clinical practice guidelines of TCM and WM integration.

关键词： clinical practice guidelines integrated traditional Chinese and Western medicine organic integration

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Updated prevalence of latent prostate cancer in Chinese population and comparison of biopsy results: An autopsy-based study

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The Innovation 2024年第1期5卷 80-87页

作者： Yuliang Chen Zhien Zhou Yi Zhou Zhipeng Mai Shijie Jin Zhen Liang Zhiyuan shang Yuzhi Zuo Yu Xiao Wenze Wang Haibo Wang Weigang yan Department of Urology Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijing 100730China Department of Gynaecology and Obstetrics Beijing HospitalNational Centre of GerontologyBeijing 100730China Department of Pathology Peking Union Medical College HospitalChinese Academy of Medical SciencesBeijing 100730China Peking University Clinical Research Institute Peking University First HospitalBeijing 100034China

Prostate cancer detected by autopsy is named latent prostate cancer.As the repertoire of clinical prostate cancer,latent cancer may better reflect the disease burden.Unlike clinical prostate specimens,which are obtained exclusively from biopsy-positive cases,prostate specimens obtained through autopsy provide information on biopsy-negative cases,helping calculate the true sensitivity of prostate biopsy.From 2014 to 2021,we collected autopsy specimens of the prostate from body donors in China and performed transperineal and transrectal biopsies on specimens before step-sectioning and pathological measurements.We found that the crude prevalence of latent prostate cancer in middle-aged and elderly men was 35.1%(81/231),which was higher than previous estimates for Chinese populations.The overall per-patient sensitivities of transperineal and transrectal biopsies were not significantly different(33.3%vs.32.1%,p=0.82),but the two approaches differed in preferential sampling area along the proximal-distal axis of the prostate.Transperineal biopsy had a higher sensitivity for detecting clinically significant lesions in the distal third(34.7%vs.16.3%,p=0.02)and distal half(30.6%vs.18.1%,p=0.04),while transrectal biopsy had a higher sensitivity for lesions in the proximal half(25.0%vs.13.9%,p=0.046).Both transperineal and transrectal methods of biopsy missed most small lesions(0.5 mL).In conclusion,the prevalence of latent prostate cancer in China has increased over the past 2 decades.Systematic transperineal and transrectal methods of biopsy had comparable sensitivities but had different preferential sampling areas.Both approaches miss one-third of large lesions.

关键词： biopsy prevalence latent

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Babao Dan Inhibits Gastric Cancer Progression in vivo Through Multiple Signaling Pathways

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World Journal of Traditional Chinese Medicine 2024年第1期10卷 14-21页

作者： Hai-Xia shang Yi Fang Bin Guan Jian-Hua Guan Jun Peng Jin-yan Zhao Jiu-Mao Lin Institute of Oncology of Academy of Integrative Medicine Fujian University of Traditional Chinese MedicineFuzhouFujianChina Key Laboratory of Integrative Medicine of Fujian Province University Fujian University of Traditional Chinese MedicineFuzhouFujianChina Fujian Key Laboratory of Integrative Medicine on Geriatric Fujian University of Traditional Chinese MedicineFuzhouFujianChina Innovation and Transformation Center Fujian University of Traditional Chinese MedicineFuzhouFujianChina Xiamen Traditional Chinese Medicine Co. Ltd.XiamenFujianChina

Objective:The aim of this study was to explore the effects of Babao dan(BBD),a traditional Chinese medicine,on gastric cancer(GC)progression in vivo.Materials and Methods:A subcutaneous xenograft mouse model of GC was established using MGC80-3 cells.The terminal deoxynucleotidyl transferase-mediated dUTP:2'-deoxyuridine 5'-triphosphate-biotin nick-end labeling method was adopted to detect cell apoptosis in vivo.The expression levels of proteins associated with proliferation,apoptosis,and angiogenesis were measured by immunohistochemical staining or western blotting(WB).The activation and protein levels of p-c-Jun N-terminal kinase(JNK),p-p38,p-extracellular-regulated kinase 1/2,p-nuclear factor-κB(NF-κB),and p-STAT3 were examined by Bio-plex and WB.Results:BBD significantly inhibited tumor growth in GC mouse models with no adverse effect on body weight or organ function.It was also found that BBD significantly suppressed the proliferation of GC tumor cells,induced the apoptosis of tumor cells,and inhibited angiogenesis through inactivating with mitogen-activated protein kinase,NF-κB,and STAT3 pathways.Conclusions:BBD exerts suppressive effects on GC tumor growth by regulating multiple pathways in vivo,which may provide a novel treatment option for GC therapy.

关键词： Babao dan gastric cancer multiple signaling pathways proliferation traditional Chinese medicine

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Comparing the efficacy and safety of low,medium,and high dosages of selexipag for treating pulmonary hypertension:A systematic review and meta-analysis

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Animal Models and Experimental Medicine 2024年第1期7卷 56-70页

作者： shang Wang Yi yan Jian Zhang Ping Yuan Ci-Jun Luo Hong-Ling Qiu Hui-Ting Li Jian Xu Lan Wang Tian-Lan Li Rong Jiang Department of Cardio-Pulmonary Circulation Shanghai Pulmonary HospitalSchool of MedicineTongji UniversityShanghaiChina Heart Center and shanghai Institute of Pediatric Congenital Heart Disease Shanghai Children's Medical CenterNational Children's Medical CenterShanghai Jiaotong University School of MedicineShanghaiChina Department of Respiratory and Critical Care Medicine The 416 Hospital of Nuclear IndustryThe Second Affiliated Hospital of Chengdu Medical CollegeChengduChina Department of Hematology The Affiliated Hospital of Qingdao UniversityQingdaoChina

Background:The maintenance dosage of selexipag is categorized as low,medium or high.In order to assess the efficacy and safety of different dosages of selexipag for the risk stratification of pulmonary arterial hypertension(PAH),we performed a sys-tematic review and meta-analysis.Methods:Studies assessing PAH risk stratification indices,such as the World Health Organization functional class(WHO-FC),six-minute walk distance(6MWD),N-terminal pro-B-type natriuretic peptide(NT-proBNP)level,right atrial pressure(RAP),cardiac index(CI)and mixed venous oxygen saturation(SvO2),were included.Results:Thirteen studies were included.Selexipag led to improvements in the 6MWD(MD:24.20 m,95%CI:10.74-37.67),NT-proBNP(SMD:-0.41,95%CI:-0.79-0.04),CI(MD:0.47 L/min/m^(2),95%CI:0.17-0.77)and WHO-FC(OR:0.564,95%CI:0.457-0.697).Subgroup analysis demonstrated that all three dosages improved the 6MWD.A moderate dosage led to improvements in the CI(MD:0.30 L/min/m^(2),95%CI:0.15-0.46)and WHO-FC(OR:0.589,95%CI:0.376-0.922).Within 6 months of treatment,only the WHO-FC and CI were significantly improved(OR:0.614,95%CI:0.380-0.993;MD:0.30 L/min/m^(2),95%CI:0.16-0.45,respectively).More than 6 months of treatment significantly improved the 6MWD,WHO-FC and NT-proBNP(MD:40.87 m,95%CI:10.97-70.77;OR:0.557,95%CI:0.440-0.705;SMD:-0.61,95%CI:-1.17-0.05,respectively).Conclusions:Low,medium,and high dosages of selexipag all exhibited good effects.When treatment lasted for more than 6 months,selexipag exerted obvious effects,even in the low-dosage group.This finding is important for guiding individualized treatments.

关键词： individualized treatments meta-analysis prostacyclin receptor agonist risk stratification systematic review

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Preparation,Characterization and Photothermal Study of PVA/Ti_(2)O_(3) Composite Films

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Journal of Wuhan University of Technology(Materials Science) 2024年第3期39卷 658-663页

作者：尚蒙娅 HE yanyan YU Jianhui yan Jiahui XIE Haodi 李金玲 School of Material Science&Engineering Henan University of TechnologyZhengzhou 450001China College of Advanced Interdis-ciplinary Science and Technology Henan University of TechnologyZhengzhou 450001China

In this work,flexible photothermal PVA/Ti_(2)O_(3) composite films with different amount(0 wt%,5 wt%,10 wt%,15 wt%)of Ti_(2)O_(3) particles modified by steric acid were prepared by a simple solution casting method.The microstructures,XRD patterns,FTIR spectra,UV-Vis-NIR spectra thermo-conductivity,thermo-stability and photothermal effects of these composite films were all characterized.These results indicated that Ti_(2)O_(3) particles were well dispersed throughout the polyvinyl alcohol(PVA)matrix in the PVA/Ti_(2)O_(3) composite films.And Ti_(2)O_(3) particles could also effectively improve the photothermal properties of the composite films which exhibited high light absorption and generated a high temperature(about 57.4℃for film with 15 wt%Ti_(2)O_(3) amount)on the surface when it was irradiated by a simulated sunlight source(1 kW/m^(2)).

关键词： Ti_(2)O_(3)particles solution casting method composite film photothermal conversion

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