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Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by the accumulation of large amounts of phospholipid protein-like surfactant material in the alveolar spaces, leading to severe hypoxemia and respiratory failure. The disease has an insidious onset and is difficult to diagnose in the early stages. Its clinical manifestations primarily include progressive dyspnea and coughing. Currently, whole lung lavage (WLL) is the preferred and effective treatment for PAP, as it improves alveolar ventilation function. Granulocyte colony-stimulating factor is used clinically in the treatment of a variety of disease. Nebulized granulocyte–macrophage colony-stimulating factor (GM-CSF) has a certain therapeutic effect on PAP. Here, we report a case of PAP treated with WLL combined with nebulized GM-CSF, which achieved good therapeutic effects during a 4-year follow-up period, to enhance understanding of the disease.

Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by the accumulation of large amounts of phospholipid protein-like surfactant material in the alveolar spaces, leading to severe hypoxemia and respiratory failure. The disease has an insidious onset and is difficult to diagnose in the early stages. Its clinical manifestations primarily include progressive dyspnea and coughing. Currently, whole lung lavage (WLL) is the preferred and effective treatment for PAP, as it improves alveolar ventilation function. Granulocyte colony-stimulating factor is used clinically in the treatment of a variety of disease. Nebulized granulocyte-macrophage colony-stimulating factor (GM-CSF) has a certain therapeutic effect on PAP. Here, we report a case of PAP treated with WLL combined with nebulized GM-CSF, which achieved good therapeutic effects during a 4-year follow-up period, to enhance understanding of the disease. [ABSTRACT FROM AUTHOR]

Using the transfer matrix method, the absorption, reflection, and nonreciprocity of the cylindrical photonic crystals (CPCs) consisting of graphene and two layers of ordinary medium cascaded by a periodic sequence and a Rudin–Shapiro quasiperiodic sequence are investigated under a large incidence angle of electromagnetic wave. By comparing the cascade of two periodic structures and the case of a single periodic structure, it is concluded that the structure proposed in this paper has better nonreciprocal phenomena and wider relative absorption bandwidth at a large incidence angle, reaching 162.2%, which is also much higher than the general planar photonic crystals. The absorption performance of this structure in TE and TM modes is compared at different angles and it is found that TM mode has a wider absorption bandwidth and has an ideal bandwidth in a large range of incident angle from 20° to 80°. Meanwhile, the optimum parameters of chemical potential and medium thickness are discussed, which can meet the requirements of large absorption bandwidth and significant nonreciprocity at a large incident angle. The CPCs embedded in graphene adopted in this paper are structures that have never been studied before. The electrical conductivity of graphene can be adjusted by the chemical potential, which can more conveniently realize many optical phenomena and provide reference and application values for optical sensing, optical filtering, and optical detection. [ABSTRACT FROM AUTHOR]

In order to develop a new type compound thorn pear -double protein milk tea beverage, thorn pear, milk, soybean milk, double protein (casein and whole-soybean protein complex) and tea were used as the main raw materials, according to the sensory indexes of milk tea, such as color, smell, taste and texture, on the basis of single factor experiment, response surface experiment was used to optimize the formula of thorn pear double protein milk tea beverage. The results showed that the optimal formula was as follows: granulated sugar 0.8%, thorrn pear juice 3%, double protein 6%, cow milk 25%, soybean milk 10%, acesulfame 0.06% and tea 56%. In the milk tea beverage prepared with the above formula, the content of reducing sugar, crude protein and crude fat was 0.175%, 2.3%, and 0.58%, respectively, the total number of colonies was 29 CFU/mL. No pathogenic bacteria were detect ed. The drink had thorn pear taste,bright color and no odor. [ABSTRACT FROM AUTHOR]

Objective To study the bacteriologic profile and drug resistance of respiratory infection in children, and to provide a basis for etiological diagnosis and rational use of antimicrobial agents. Methods A retrospective analysis was performed for 15 047 children who attended the hospital due to respiratory infection from January 2016 to December 2018. Their sputum samples were collected, and the Phoenix-100 automatic microbial identification system was used for the identification and drug sensitivity analysis of the isolated pathogenic bacteria. Results Of all 17 174 sputum samples detected, there were 2 395 positive samples, with a positive rate of 13.95%; a total of 2 584 strains of pathogenic bacteria were isolated, among which there were 1 577 (61.03%) Gram-negative strains, 967 (37.42%) Gram-positive strains, and 40 (1.55%) fungal strains. The most common pathogen was Haemophilus influenzae (33.90%), followed by Streptococcus pneumoniae (33.55%), Moraxella catarrhalis (19.20%), and Staphylococcus aureus (3.64%). Among the 2 331 children with positive infection, 251 had mixed infection, most commonly with Haemophilus influenzae and Streptococcus pneumoniae. The detection rate of pathogenic bacteria was higher in winter and spring and lower in summer and autumn. There was a significant difference in the detection rate of pathogenic bacteria between different age groups (P<0.05), with the highest detection rate in infants aged 1 month to <1 year. Streptococcus pneumoniae and Staphylococcus aureus had a sensitivity rate of 100% to vancomycin, linezolid, and teicoplanin, and Haemophilus influenzae had a lower sensitivity rate to ampicillin, compound sulfamethoxazole and cefuroxime and a higher sensitivity rate to other drugs. Conclusions Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis are the main pathogenic bacteria of respiratory infection in children, and mixed infection is the most common type of infection. The detection rate of pathogenic bacteria varies across seasons and ages. Different pathogenic bacteria have different features of drug resistance, and antibiotics should be selected based on drug sensitivity results. [ABSTRACT FROM AUTHOR]

Background Benign paroxysmal positional vertigo (BPPV) is a common clinical disease characterized by self-limiting and easy recurrence. Manual reduction is effective but residual symptoms may occur in some patients after reduction. In recent years, there have been many studies focus on the influencing factors of therapeutic efficiency of BPPV, while the comparison among specific causes and factors influencing residual symptoms remain to be further investigated. Objective To analyze the clinical features of secondary BPPV, investigate the effect of etiological classification of BPPV on the recurrence rate, and clarify the risk factors of residual symptoms after BPPV reduction. Methods A total of 340 patients diagnosed with BPPV were enrolled in the vertigo clinic of the Department of Otorhinolaryngology Head and Neck Surgery and Otology Department of the First Hospital of Jilin University from April 2019 to April 2021, and all of them agreed to manual reduction. The included patients were divided into the primary BPPV (the primary group) and secondary BPPV (the secondary group) groups according to the presence or absence of primary disease. The secondary group was further divided into five subgroups according to different etiologies, including sudden sensorineural hearing loss (SSNHL), vestibular migraine (VM), Meniere disease (MD), vestibular neuritis (VN), and others (such as cranial and ear surgery, Hunt syndrome, temporal bone fracture, etc.). The clinical features and prognosis were compared between the primary group and the secondary group. Follow-up to 3 months after the first reduction, the patients were divided into the residual symptom group and non-residual symptom group according to the occurrence of residual symptoms. The differences were compared in clinical characteristics and scores of Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) at different periods (at diagnosis, 4 weeks after treatment, and 3 months after treatment) between the two groups, and the independent risk factors of residual symptoms after BPPV reduction were analyzed. Results Among the 340 patients, 184 (54.1%) were in the primary group and 156 (45.9%) were in the secondary group. Compared with the primary group, the patients of the secondary group were younger, and the proportion of patients who underwent more than two reductions was higher, the success rate of the first reduction was lower; and the recurrence rate within 3 months, incidence of residual symptoms, SAS score at diagnosis, and SDS score at diagnosis in the primary group were higher than those in the secondary group, with significant differences (P0.05). There were 133 patients in residual symptom group and 207 patients in the non-residual symptom group. The main residual symptoms were dizziness (59.40%, 79/133), instability (24.06%, 32/133) and head and neck discomfort (9.77%, 13/133), and 6.77% (9/133) had two or more symptoms. The proportion of secondary BPPV and more than two reductions in the residual symptom group was higher than that in the non-residual symptom group (P

Objectives. Anti-fungal agents are increasingly becoming less effective due to the development of resistance. In addition, it is difficult to treat Candida organisms that form biofilms due to a lack of ability of drugs to penetrate the biofilms. We are attempting to assess the effect of a new therapeutic agent, N -acetylcysteine (NAC), on adhesion and biofilm formation in Candida parapsilosis clinical strains. Meanwhile, to detect the transcription level changes of adhesion and biofilm formation-associated genes ( CpALS6, CpALS7, CpEFG1 and CpBCR1 ) when administrated with NAC in C. parapsilosis strains, furthermore, to explore the mechanism of drug interference on biofilms. Hypothesis/Gap statement. N-acetylcysteine (NAC) exhibits certain inhibitory effects on adhesion and biofilm formation in C. parapsilosis clinical strains from CRBSIs through: (1) down-regulating the expression of the CpEFG1 gene, making it a highly potential candidate for the treatment of C. parapsilosis catheter-related bloodstream infections (CRBSIs), (2) regulating the metabolism and biofilm -forming factors of cell structure. Methods. To determine whether non-antifungal agents can exhibit inhibitory effects on adhesion, amounts of total biofilm formation and metabolic activities of C. parapsilosis isolates from candidemia patients, NAC was added to the yeast suspensions at different concentrations, respectively. Reverse transcription was used to detect the transcriptional levels of adhesion-related genes ( CpALS6 and CpALS7 ) and biofilm formation-related factors ( CpEFG1 and CpBCR1 ) in the BCR1 knockout strain, CP7 and CP5 clinical strains in the presence of NAC. To further explore the mechanism of NAC on the biofilms of C. parapsilosis , RNA sequencing was used to calculate gene expression, comparing the differences among samples. Gene Ontology (GO) enrichment analysis helps to illustrate the difference between two particular samples on functional levels. Results. A high concentration of NAC reduces the total amount of biofilm formation in C. parapsilosis . Following co-incubation with NAC, the expression of CpEFG1 in both CP7 and CP5 clinical strains decreased, while there were no significant changes in the transcriptional levels of CpBCR1 compared with the untreated strain. GO enrichment analysis showed that the metabolism and biofilm-forming factors of cell structure were all regulated after NAC intervention. Conclusions. The non-antifungal agent NAC exhibits certain inhibitory effects on clinical isolate biofilm formation by down-regulating the expression of the CpEFG1 gene, making it a highly potential candidate for the treatment of C. parapsilosis catheter-related bloodstream infections.

Cricothyroid membrane puncture and incision,the key techniques to save the lives of the patients in the Can't Intubate,Can't Oxygenate (CICO) emergency,need to be mastered by all the airway management staff.However,the decision to carry out cricothyroid membrane puncture or incision is often delayed due to the unfamiliarity with the adjacent anatomical structure of the cricothyroid membrane and the inability to accurately locate the cricothyroid membrane.As a result,serious complications and rescue failure occur.Therefore,airway management staff should be familiar with the adjacent structure and positioning methods of the cricothyroid membrane,so as to improve the success rate of emergency airway rescue,reduce complications,and protect the airway and life safety of the patients.