To evaluate the effect of intestinal carbapenem-resistant Enterobacteriaceae (CRE) active screening combined with enhanced intervention in the prevention and control of nosocomial infection in ...patients admitted to the hematological ward.
Patients who were admitted to the Department of Hematology in a tertiary-care general hospital from March 1, 2017 to December 31, 2019 and underwent chemotherapy or immunosuppressive therapy comprised the intervention group. They were screened for intestinal CRE at least thrice. From December 1, 2016 to February 28, 2017, patients who underwent chemotherapy or immunosuppressive therapy without active intestinal CRE screening in the Department of Hematology formed the control group. Both the patient groups were monitored for CRE infection in real time. The
(2) test was used to compare the changes in the CRE infection rate and mortality in high-risk patients before and after the active screening.
During the intervention period, the CRE colonization rate of patients was 16.46% (
Summary
Background : Traditional Chinese Medicine was frequently used by patients with irritable bowel syndrome.
Aim : To evaluate the agreement on diagnoses and prescription of irritable bowel ...syndrome among Traditional Chinese Medicine practitioners.
Methods : Consecutive irritable bowel syndrome patients were interviewed independently by four Traditional Chinese Medicine practitioners. The study was divided into three phases: (i) blinded individual assessment, (ii) discussion to achieve consensus on diagnosis and treatment, (iii) individual assessment based on consensual diagnostic criteria. Patients with other causes of diarrhoea were recruited as controls in phase (iii). Percentage agreement and kappa‐value in diagnosis, treatment principle and regime were determined.
Results : Thirty‐nine irritable bowel syndrome patients were assessed in phase (i) whereas 65 irritable bowel syndrome patients and 17 non‐irritable bowel syndrome controls were studied in phase (iii). The mean agreement rates in diagnosis, treatment principle and regimen were: 57, 58 and 52% for phase (i) and 80, 81 and 80% for phase (iii) (P = 0.002). Accordingly, there was significant improvement in the mean kappa‐values in diagnosis (0.11–0.34, P = 0.015) and treatment principle (0.16–0.37, P = 0.002) but not in treatment regime.
Conclusions : Variations in diagnosis and treatment principles do exist among Traditional Chinese Medicine practitioners. Concordant diagnosis can be reached by mutual understanding and converging opinion among Traditional Chinese Medicine practitioners.
Pulmonary rehabilitation (PR) is now considered fundamental when managing patients with chronic respiratory disease. The individual variation in functional exercise capacity (FEC) response to PR ...within the cohort is unknown. The purpose of this study was to identify FEC patterns in response to PR in patients with chronic respiratory disease using the trajectory modeling method.
The data of 67 patients with the chronic respiratory disease were retrospectively reviewed and analyzed in this study. All patients received once-weekly supervised training for 8 weeks. Six-minute walk distance (6MWD) was used to measure FEC. Muscle strength and 6MWD were assessed at baseline, Week 4, Week 8 and monthly for two months after PR completion. Group-based trajectory modeling (GBTM) was used to identify patterns in 6MWD in response to PR. The generalized estimating equation method was then used to detect the differences within and between the trajectories of identified groups across time.
Patients were grouped into low- (n=13), moderate- (n=34) and high- (n=20) FEC group based on GBTM analysis. All groups demonstrated significant improvements in 6MWD and leg muscle strength after 8-week PR. Compared to the high-FEC group, a greater proportion of the patients in the low-FEC group required oxygen supplementation during training and had worse baseline leg muscle strength.
Patients showed distinct patterns of 6MWD changes in response to 8-week PR. Distinct characteristics for the low-FEC group included poor lower extremity strength and a greater proportion of required oxygen use at home and during training.
A novel ternary solid solution (1-
y
)((1-
x
)BiFeO
3
–
x
Bi
0.5
Na
0.5
TiO
3
)–
y
CaTiO
3
(0 ≤
x
≤ 0.3, 0.15 ≤
y
≤ 0.25) is designed to present a rhombohedral–orthorhombic morphotropic phase ...boundary (MPB) with enhanced ferroelectricity, canted ferromagnetism, and room-temperature magnetoelectric responses. The addition of Bi
0.5
Na
0.5
TiO
3
can generate a distinct MPB region and make BiFeO
3
–CaTiO
3
-based ceramics more denser. Therefore, superior ferroelectric properties with the remanent polarization of 37µC/cm
2
can be obtained in the
x
= 0.3,
y
= 0.15 sample with the presence of rhombohedral–orthorhombic MPB. However, weak ferromagnetism is observed in both the rhombohedral and orthorhombic phases due to a destruction of the spiral spin structure of BiFeO
3
. The MPB with canted ferromagnetism is constructed. The maximum magnetoelectric interaction constant is found in the MPB compositions with
x
= 0.2,
y
= 0.2 which is related with the multiferroic phase boundary.
Tingting Zheng,1 Wenjuan Hu,1 Hao Wang,1 Xiaoli Xie,2 Lang Tang,3 Weiyan Liu,4 Pu-Yeh Wu,5 Jingjing Xu,1 Bin Song1 1Department of Radiology, Minhang Hospital, Fudan University, Shanghai, People’s ...Republic of China; 2Department of Pathology, Minhang Hospital, Fudan University, Shanghai, People’s Republic of China; 3Department of Ultrasound, Minhang Hospital, Fudan University, Shanghai, People’s Republic of China; 4Department of General Surgery, Minhang Hospital, Fudan University, Shanghai, People’s Republic of China; 5GE Healthcare, MR Research China, Beijing, People’s Republic of China Correspondence: Bin Song; Jingjing Xu, Department of Radiology, Minhang Hospital, Fudan University, No. 170, Xinsong Road, Minhang District, Shanghai, 201199, People’s Republic of China, Email email protected; email protected View the original paper by Miss Zheng and colleagues This is in response to the Letter to the Editor
In this paper, the synergistic effects of Ce
4+
ions incorporation into the (Bi
2
O
2
)
2+
layer and Mo
6+
ions at the Nb site on the electrical properties of CaBi
2−
x
Ce
x
Nb
2−
x
Mo
x
O
9
...high-temperature piezoelectric ceramics were studied. The appearance of pseudo-tetragonal phase owing to the introduction of Ce
4+
ions is beneficial to the polarization switching, and thus, an enhanced piezoelectric response (
d
33
= 19 pC/N) was obtained in the
x
= 0.03 sample. Both the ferroelectric and dielectric properties of the doped samples are enhanced. Moreover, the reduction of the oxygen vacancies of the samples resulting from Mo
6+
cations could also facilitate the improvement of electrical properties. As a result, a high Curie temperature (
T
C
= 941 °C) and good electrical properties (
P
r
=14.3 µC/cm
2
,
ρ
= 1.1 × 10
5
Ω cm at 600 °C) were obtained in Ce/Mo-co-substituted CaBi
2
Nb
2
O
9
ceramics. The results are rather important to explore the piezoelectric ceramics used in high-temperature environment.
Evidence is lacking regarding the efficacy of macrolides and oral corticosteroids in chronic rhinosinusitis with nasal polyps (CRSwNP) after endoscopic sinus surgery (ESS). Therefore, we examined the ...benefits of adding clarithromycin to oral pred- nisolone as post-ESS medical therapy in patients with CRSwNP.
In this randomised, double-blind, placebo-controlled trial, patients were enrolled and allocated to three study groups receiving different post-ESS medical therapies: group A (placebo for 14 weeks), group B (oral prednisolone 15 mg twice daily for 2 weeks, followed by placebo for 12 weeks), and group C (oral prednisolone 15 mg twice daily for 2 weeks, followed by clari- thromycin 500 mg daily for 12 weeks). All enrolled patients received the perioperative care following a routine protocol, which included oral amoxicillin/clavulanate, and intranasal corticosteroid spray. The baseline and post-operative visual analogue scale (VAS) scores, Sino-nasal Outcome Test (SNOT-22) scores, and Lund-Kennedy endoscopy scores (LKES) were determined as the primary outcomes.
One hundred twenty-six patients who received ESS for bilateral CRSwNP were randomised into group A (n=43), B (n=42), or C (n=41). Compared to groups A and B, group C showed greater VAS and SNOT-22 score improvement at 12 weeks after ESS. Group C showed significantly better LKES than did groups A and B at 8, 12, and 24 weeks after ESS. On stratifying the LKES results according to the presence/absence of tissue eosinophilia, greater add-on effects of clarithromycin were observed in the patient subgroup without tissue eosinophilia.
Adding low-dose clarithromycin to oral corticosteroids as post-ESS therapy was well tolerated and showed benefi- cial subjective and objective outcomes in patients with CRSwNP, especially those without tissue eosinophilia.
Amyloid fibrils are components of proteinaceous plaques that are associated with conformational diseases such as Alzheimer's disease, transmissible spongiform encephalopathies, and familial ...amyloidosis. Amyloid polypeptides share a specific quarternary structure element known as cross-β structure. Commonly, fibrillar aggregates are modified by advanced glycation end products (AGE). In addition, AGE formation itself induces protein aggregation. Both amyloid proteins and protein-AGE adducts bind multiligand receptors, such as receptor for AGE, CD36, and scavenger receptors A and B type I, and the serine protease tissue-type plasminogen activator (tPA). Based on these observations, we hypothesized that glycation induces refolding of globular proteins, accompanied by formation of cross-β structure. Using transmission electron microscopy, we demonstrate here that glycated albumin condensates into fibrous or amorphous aggregates. These aggregates bind to amyloid-specific dyes Congo red and thioflavin T and to tPA. In contrast to globular albumin, glycated albumin contains amino acid residues in β-sheet conformation, as measured with circular dichroism spectropolarimetry. Moreover, it displays cross-β structure, as determined with x-ray fiber diffraction. We conclude that glycation induces refolding of initially globular albumin into amyloid fibrils comprising cross-β structure. This would explain how glycated ligands and amyloid ligands can bind to the same multiligand “cross-β structure” receptors and to tPA.
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