Objective To investigate the association of the polymorphism of the N-acetyltransferase 2 (NAT2 )gene with isoniazid-induced hepatotoxicity and anti-tuberculous treatment efficacy in Chinese Han patients with tuberculosis(TB).Methods A total of 108 TB patients who received initial anti-TB treatment were followed up prospectively.A polymerase chain reaction direct sequencing approach was used to detect genetic polymorphisms of the NAT2 gene.Associations between NAT2 genotype and isoniazid-induced hepatitis/early treatment were analyzed.Chi-square test was used for statistical analysis. Results Among the 108 TB patients, intermediate-acetylators (IA ) was the most frequent NAT2 genotype with the proportion of 54.63%(59/108).The proportion of rapid-acetylators(RA)was 33.33%(36/108),slow-acetylators (SA)was 10.19%(11/108)and super-rapid acetylators was 1 .85 % (2/108). Among the 20 patients who developed drug-induced hepatitis,2 were RA,5 were SA and 13 were IA. Regarding NAT2 genotype,RA patients had a lower incidence of hepatotoxicity (OR =0.176,95 %CI :0.038-0.809,P =0.014)and SA patients were more likely to developed drug-induced hepatic injury (OR=4.556,95 %CI :1 .231 -16.854,P =0.044 ).Statistical analysis revealed that the frequency of variant diplotypes,NAT2*4/*6A (OR=7.741 ,95 %CI :2.653-22.586,P <0.01 )and NAT2 *6A/*6A (OR=15 .353,95 %CI :1 .506 -156.552,P =0.020)were significantly increased in TB patients with hepatotoxicity.NAT2 *4/*4 was less likely to developed hepatic injury (OR =0.176,95 %CI :0.038-0.809,P =0.014).Among the 58 culture-positive patients,12(31 .03%)were persistent culture positive after 2 months standard therapy.Early treatment failure was observed with significantly higher incidence rate in RA than other genotypes (OR = 7.200, 95 % CI :1 .794-28.900, P = 0.008). Conclusions In Chinese Han TB patients,IA is the most frequent NAT2 genotype.The SA status of NAT2 is a risk factor of isoniazid-induced hepatotoxicity.The diplotype of NAT2 *6A has clearly high risk of isoniazid-induced hepatotoxicity.In contrast,NAT2 * 4/* 4 is protective diplotype.RA is associated with early treatment failure in culture-positive patients.

Objective To investigate the epidemiology of adults acute viral gastroenteritis in Shanghai Changning district. Methods All of 1 554 stool specimens of adults acute gastroenteritis in Shanghai Changning district from June 2010 to December 2013, and the enzyme-linked immunosorbent assay and multiple polymerase chain reaction was used to detecte different viruses. Results In all of 1 554 cases, the average age was (46.19 ± 15.59) years. Among them, 691 persons were male, 863 persons were female. Virus infection was detected in 407 cases, and the detection rate was 26.19%. Among them, 395 cases (97.05%) were single virus infection, and 12 cases (2.95%) were mixed infection. The peak of epidemic was from every November to next February. The incidence of watery diarrhea, vomiting and fever in virus positive group was significantly higher than that in virus negative group:95.09%(387/407) vs. 88.14%(1 011/1 147), 31.20%(127/407) vs. 18.83%(216/1 147), and 11.06%(45/407) vs. 7.59%(87/1147), P<0.01 or<0.05. Conclusions Rotavirus infection is common in adults with acute viral gastroenteritis. Patients with positive virus infection had a higher incidence of watery diarrhea, vomiting and fever. The peak of epidemic is winter.

Background:Acute gastroenteritis is the second largest public health problem in the world. Rotavirus(RV)is one of the pathogens of acute gastroenteritis in adults,researches focusing on RV infection may provide the basis for prevention and control of the disease. Aims:To determine the epidemiological characteristics of RV infection in adults with acute gastroenteritis in Shanghai,China. Methods:From Jun. 2010 to Dec. 2013,stool samples and clinical data in adults with acute gastroenteritis in a designated hospital in Shanghai Changning District were collected. ELISA and PCR were used to detect RV infection and its genotypes. Results:A total of 1 554 eligible stool samples from acute gastroenteritis patients were recruited,of them 691 were males and 863 were females,the mean age was(46. 19 ± 15. 59)years old. RV was detected in 189 patients with a detection rate of 12. 2% ,163(10. 5% )were categorized as group A RV and 26(1. 7% ) were group B/ C RV;the most common genotypes in group A RV were G9(30. 1% )and G1(25. 2% ). Watery stool and vomiting were more prevalent in RV-positive patients than in RV-negative patients(P < 0. 05). The detection rates in years 2010,2011,2012 and 2013 were 12. 2% ,14. 9% ,6. 8% and 16. 3% ,respectively. When analyzed by age group,the detection rate was significantly lower in 18-39 years group than those in 40-59,60-79,and ≥80 years groups(8. 7% vs. 14. 8% ,14. 2% ,and 17. 1% ,P < 0. 05). The peak of epidemic was from Nov. to next Feb. Conclusions:RV infection in adults with acute gastroenteritis is more popular in middle aged and elderly people and shows a winter seasonality in Shanghai,China. The most common genotypes of group A RV are G9 and G1.

OBJECTIVE: To evaluate the efficacy and safety of Dinggui Oil Capsule in treating irritable bowel syndrome (IBS) with stagnation of qi and cold. METHODS: A prospective, randomized, placebo-controlled, double-blind clinical study was undertaken. One hundred and ninety-eight patients with IBS and syndrome of stagnation of qi and cold were randomly divided into high-dose Dinggui Oil group (DGO-H, 1.2 g, 3 times daily; n=66), low-dose Dinggui Oil group (DGO-L, 0.8 g, 3 times daily, n=66), and placebo group (placebo, 5.0 g, 3 times daily, n=66). Patients in the three groups were all treated for 2 weeks. RESULTS: The total significant effective rates for IBS were 54.1%, 28.8% and 21.9% in the DGO-H, DGO-L, and placebo groups, and the total effective rates for the syndrome of stagnation of qi and cold were 54.1%, 25.8% and 23.4% in the three groups, respectively. Dinggui Oil Capsule showed a higher efficacy than the placebo in relieving the abdominal pain (P<0.01). No adverse effects were found in this trial. CONCLUSION: Dinggui Oil Capsule is effective and safe in relieving abdominal pain due to IBS with stagnation of qi and cold.

Objective:To observe the effect of non-vitrectomy in the treatment of idiopathic macular epiretinal membranes (IMEM).Methods:This study is a randomized controlled trial. From December 2017 to December 2018, 60 IMEM patients (60 eyes) diagnosed in Weifang Eye Hospital were included in the study. BCVA, intraocular pressure (IOP) and OCT were performed in all patients. The BCVA examination was performed using the international standard visual acuity chart, which was converted to logMAR. The CMT was measured by OCT. According to the surgical methods, the patients were divided into non-vitrectomy group and control group, 30 patients (30 eyes) in each group. The age ( t=1.723), logMAR BCVA ( t=1.703), CMT ( t=-0.956), IOP ( t=-1.434) were not significantly different between the two groups ( P=0.090, 0.094, 0.343, 0.157). 23G vitreous cutting system was used in all eyes. The macular epiretinal membranes was removed by non-vitrectomy in the non-vitrectomy group and by vitrectomy in the control group. The relevant examination with the same equipment and methods before the operation at 1 week and 1, 3, 6 months after operation. The time of surgery, the changes of BCVA, CMT and postoperative complications in the two groups were observed comparatively. Variance analysis of repeated measurements was performed for the comparison of BCVA, CMT and IOP after surgery in the two groups. Wilcoxon rank sum test of two independent samples was performed for the degree of vision improvement. The incidence of postoperative complications was compared by χ2 test. Results:At 6 months after operation, BCVA increased in 24 eyes (80%) and unchanged in 6 eyes (20%) in the non-vitrectomy group. Compared with preoperative BCVA, the difference was statistically significant ( P<0.05). BCVA increased in 25 eyes (83.4%), unchanged in 4 eyes (13.3%) and decreased in 1 eye (3.3%) in the control group. Compared with preoperative BCVA, the difference was statistically significant ( P<0.05). There was no significant difference between the two groups in BCVA improvement degree after operation ( Z=-0.26, P>0.05). At 6 months after operation, the average logMAR BCVA was statistically significant compared with the preoperative in the non-vitrectomy group ( P=0.002, 0.005) and control group ( P=0.004, <0.001). Visual stability occurred 1 month after operation in the non-vitrectomy group and 3 months after operation in the control group. The effective operative time of the non-vitrectomy group and control group was 4.50±1.41 and 15.50±2.33 min, respectively. The difference of effective operation time between the two groups was statistically significant ( t=-22.12, P <0.05). After surgery, no significant complications were found in the non-vitrectomy group. In the control group, there were 3 eyes with low IOP and 1 eye with macular hole during operation. Conclusions:Non-vitrectomy and vitrectomy have similar effects on IMEM. Non-vitrectomy has short effective operation time, faster recovery after surgery and no obvious complications.

Objective To study the status of filial piety and anxiety among adults, explore the relationship between filial piety and anxiety, and analyze the factors that affect anxiety. Methods A total of 915 adults from Jiangsu and Anhui provinces were selected using the General Information Questionnaire, the Chinese Filial Values Index scale (FVI) and Zung Self-rating Anxiety Scale (SAS), through the online platform and on-site payment, recovery of the questionnaire to investigate. Results The overall level of filial piety was 85.23 ± 9.22 , among which the care dimension was 84.60 ± 9.75 and the respect dimension was 86.12 ± 11.76;111 adults were with anxiety (12.13％), and patients with mild and moderate anxiety respectively were 88 (9.62％) and 23 (2.51％) cases. The overall level of filial piety was negatively correlated with the level of anxiety (r=-0.403, P<0.01), and the level of filial piety is an independent factor affecting the level of anxiety in adults(B=-0.299,P<0.01). Other factors also include the quality of sleep, illness, duration, beliefs, occupational stability. Conclusion The high level of filial piety in adults is moderately correlated with anxiety and is an independent risk factor for anxiety in this population. The adult's education of filial piety should be strengthened and the positive adjustment of filial piety to anxiety should be strengthened in order to better solve the physical and mental health problems caused by the pension burden.

OBJECTIVETo analyze virulence genes and molecular characteristics of Vibrio parahaemolyticus isolated from sporadic cases with diarrhea in tow sentinel hospitals of Shanghai, 2010-2012.

METHODSA total of 2 729 stool samples were collected from two surveillance sentinel hospitals in Shanghai 2010-2012. Vibrio parahaemolyticus strains were isolated and identified from diarrhea out patients using TCBS agar plates and biochemical reactions. Thermostable direct hemolysingene (tdh), thermostable-related hemolysin gene (trh), hemolysin gene (tlh) were detected by multiplex PCR method. Isolates were analyzed by PFGE and MLST. The PFGE profiles were analyzed using BioNumerics software.

RESULTSA total of 30 clinical Vibrio parahaemolyticus strains isolated from 2 729 stool samples. The anually Vibrio parahaemolyticus isolation rate during 2010 to 2012 were 1.1%(11/973), 1.0%(11/1 120) and 1.3%(8/636) respectively. The PCR positive rates of virulence genes tlh, tdh and trh were 100%, 97% and 0 respectively. The Vibrio parahaemolyticus strains were divided into 13 PFGE types (P1-P13)and 3 ST types (ST-189, ST-799, ST-3). Among 13 PFGE types, P4 was the main PFGE type, accounting for 30%(9/30). P9, P10 were accounting for 12% (4/30) respectively, P1, P2, P12, P13 were accounting for 7%(2/30) respectively, the others types were 3%(1/30) respectively. MLST analysis results showed there are three ST types, ST3 was 84%(25/30), ST189 and ST799 were accounting for 13% (4/30) and 3% (1/30) respectively.

CONCLUSIONThe infection rate of Vibrio parahaemolyticus was not very high from 2010-2012 in Shanghai, all strains were positive for tlh and negative for trh. ST3 was the major type of Vibrio parahaemolyticus.

China ; Diarrhea ; Genotype ; Hemolysin Proteins ; Hospitals ; Humans ; Multilocus Sequence Typing ; Outpatients ; Polymerase Chain Reaction ; Sentinel Surveillance ; Vibrio Infections ; Vibrio parahaemolyticus ; Virulence

【Objective】 To investigate the efficacy of the adjustable "paper clip" techniques in the suture of dorsal vein complex (DVC) and retention of urethral function in robot-assisted laparoscopic radical prostatectomy (RALRP). 【Methods】 A total of 30 cases of prostate cancer treated with RALRP were enrolled, all of which used the adjustable "paper clip" techniques. During operation, the DVC was sewed with barbed suture, and then a reverse suture was made through two sides of the prostatic ligaments. A Hem-o-lock was used to fasten the suture, which would be flexible to control the degree of tightness for the ligature. Perioperative and follow-up data of urinary continence and symptoms were collected and analyzed. 【Results】 All operations were successful. The estimated blood loss was (123.3±80.7) mL, 53.6% patients recovered continence in 1 month, and the continence rate increased to 92.9% and 96.3% at month 3 and 6. 92.9 of patients had no risk of incontinence 3 months after surgery. 【Conclusion】 The adjustable "paper clip" techniques have advantages in reducing blood loss, maintaining clear surgical field, preserving urethral function, and improving urinary continence.