Objective To present a retrospective analysis of the clinical outcome in patients treated by local intra-arterial thrombolysis (LITT). Using urokinase for acute ischemic stroke of the anterior or posterior arterial circulation.Methods Twenty-six patients were treated with LITT using urokinase. The effects all patients were assessed by using angiography, brain CT and stroke scale before and after treatment. Results Among 26 patients, the complete reperfusion of blood vessel appeared in 7 and partial reperfusion in 11.The efficiency rate reached 78%.Conclusions Cerebral arterial thrombolysis with UK can improve neurologic function defect in 84% of patients with acute ischemic stroke after 15 days, suggesting one of the best ways for treatment.

OBJECTIVE To know the clinical antibacterial use by line category in pediatric outpatients and emergency departments.METHODS The antibacterial use by line category from the 38998 prescriptions of pediatric outpatient and emergency departments of a hospital from Jul 1st to Dec 31st 2008 according to the medicament amount and frequency were surveyed and analyzed.RESULTS First-line antibacterial drug DDDs accounted for 37.4% and 24.7% of the total amount;second-line drug DDDs accounted for 48.7% and 40.8% of the total amount and the third-line drug DDDs accounted for 13.9% and 35.0% of the total amount.The top three by total amount were cefmetazole sodium injection,azithromycin sodium injection and Cefuroxime sodium injection.According to the sorting method of DDDs,the top three were cefprozil dry suspension,azithromycin sodium injection and amoxicillin sodium clavulanate potassium injection.CONCLUSIONS Frequency of the third-line antibacterial drug using is relatively high.Clinicians have a tendency to skip a line category in using drugs.Effective measures should be taken to strengthen the management of antibacterials.

Objective To explore the molecular mechanisms involved in hypokalemic salt-losing tubulopathies ( SLTs) through genetic screening of WNK gene in patients with SLTs. Methods Forty-four kindreds of SLTs were diagnosed Batter's syndrome or Gitelman's syndrome after CLCNKB and SLC12A3 sequencing and analysis, 8 of whose phenotype can not be simply attributed to CLCNKB or SLC12A3 mutations. Primers for PCR-amplified exons of WNK4 and WNK1 gene in genomic DNA were designed, and direct sequencing was performed to analyse the PCR products. Results Two missense mutations of WNK1, Ile~(1172)→ Met (I1172M) and Ser~(2047) → Asn (S2047N), were identified. Both of these 2 mutations segregated with the disease in SLTs kindred. Conclusion Two heterozygote missense mutations of WNK1 gene (I1172 M and S2047N) were found in 8 SLTs kindreds, indicating that WNK1 might be another gene responsible for hypokalemic salt-losing tubulopathies.

OBJECTIVE: To investigate 18β-sodium glycyrrhetinic acid impact on nasal mucosa epithelial cilia in rat models of allergic rhinitis (AR). METHOD: AR models were established by ovalbumin-induction. Wister rats were randomly divided into groups as normal group, model group, budesonide (0.2 mg/kg) group and sodium glycyrrhetinic acid (20 mg/kg and 40 mg/kg) group after the success of AR models. At 2 weeks and 4 weeks after treatment, the behavioral changes of rats were observed and recorded, and nasal septum mucosae were collected after 2 week and 4 week intervention, and the morphological changes of nasal mucosae were observed by electron microscope. RESULT: Model group developed typical AR symptoms, the total score in all animals was > 5. With budesonide and sodium glycyrrhetinic acid treatment, the AR symptoms were relieved, and the total scores were reduced significantly (P < 0.01). Compared with the model group: after 2 weeks' intervention, thick mucous secretions on the top of columnar epithelium cilia in rat nasal mucosa was significantly reduced, and cilia adhesion, lodging, shedding were relieved in budesonide group and sodium glycyrrhetinic acid group, the relieve in budesonide group was slightly better than that in sodium glycyrrhetinic acid group; after 4 week intervention, Cilia adhesion, lodging, shedding were completely vanished, and the cilia were ranged in regular direction in budesonide group and sodium glycyrrhetinic acid group. Cilia in sodium glycyrrhetinic acid (20 mg/kg) group was more orderly, smooth than that in budesonide group and sodium glycyrrhetinic acid group (40 mg/kg), and the condition of cilia in sodium glycyrrhetinic acid group (20 mg/kg) was similar to the normal group. CONCLUSION 18β-sodium glycyrrhetinic acid is effective to restrain the pathological changes of nasal mucosa cilia in rat models of AR.
Animals ; Budesonide ; pharmacology ; Cilia ; drug effects ; Disease Models, Animal ; Glycyrrhetinic Acid ; analogs & derivatives ; pharmacology ; Nasal Mucosa ; drug effects ; Ovalbumin ; Random Allocation ; Rats ; Rhinitis, Allergic ; drug therapy

OBJECTIVE: To observe 18β-glycyrrhetinic acid (GA) impact on ultrastructure of tight junctions (TJs) of nasal mucosa epithelial cells in rats models of allergic rhinitis (AR). METHOD: Ninety-six Wistar rats were randomly divided into control group, model group, loratadine group, and 18β-glycyrrhetinic acid group, and each group had 24 rats. Ovalbumin was used to establish a rat AR model. The behavioral changes and the tight junctions of nasal epithelial were observed and compared in different groups after 2,4,6 and 10 weeks intervention. RESULT: The length of TJs in allergic rhinitis model became shorter, electron-high-density plasma membrane became thicker, number of the integration loci reduced and gap of TJs widened or even ruptured. With the consistent effect of allergens,the changes of TJs in the model group aggravated gradually,and the changes of ultrastructure of TJs in 18β-glycyrrhetinic acid group was relieved apparently compared to model group and even were close to the control model with time. CONCLUSION 18β-glycyrrhetinic acid can recover the ultrastructure of the tight junctions of AR rat nasal epithelial cells.
Animals ; Cell Count ; Epithelial Cells ; ultrastructure ; Glycyrrhetinic Acid ; analogs & derivatives ; pharmacology ; Nasal Mucosa ; cytology ; Ovalbumin ; Rats ; Rats, Wistar ; Rhinitis, Allergic ; drug therapy ; Tight Junctions ; drug effects

In this study, we investigated the mechanism of transformation by Bacillus subtilis strain 168 by proteomic analysis. B. subtilis strain 168 was able to stereoselectively transform cis-propenylphosphonic acid (cPPA) to fosfomycin. The maximal fosfomycin production was 816.6 microg/mL after two days cultivation, with a conversion rate of 36.05%. We separated the whole cellular proteins by two-dimensional gel electrophoresis (2-DE) method, and 562 protein spots were detected in the presence of cPPA in the medium, while 527 protein spots were detected in the absence of cPPA. Of them, 98 differentially expressed protein spots were found. Among them, 52 proteins were up-regulated whereas 20 were down-regulated in the presence of cPPA in the medium, and 26 induced at the presence of cPPA. The differentially expressed proteins were analyzed by combined MS and MS/MS methods. Eighty protein spots, including 45 up-regulated proteins, 17 down-regulated proteins, and 18 induced by cPPA were identified. Based on the results of proteomic analysis, we postulated two steps of transformation: in the first step, cPPA was hydrated to 2-hydroxypropylphosphonic acid; in the second step, 2-hydroxypropylphosphonic acid was transformed to fosfomycin via a dehydrogenation reaction.
Bacillus subtilis ; genetics ; growth & development ; metabolism ; Bacterial Proteins ; metabolism ; Biotransformation ; Fosfomycin ; metabolism ; Organophosphorus Compounds ; metabolism ; Proteome ; metabolism ; Proteomics

The ratio of nonsynonymous substitution rate(Ka)to synonymous substitution rate(Ks)is widely used as an indicator of selective pressure at sequence level among different species, and diverse mutation models have been incorporated into several computing methods. We have previously developed a new γ/-MYN method by capturing a key dynamic evolution trait of DNA nucleotide sequences, in consideration of varying mutation rates across sites. We now report a further improvement of NG, LWL, MLWL, LPB, MLPB, and YN methods based on an introduction of gamma distribution to illustrate the variation of raw mutation rate over sites. The novelty comes in two ways:(1)we incorporate an optimal gamma distribution shape parameter a into γ-NG, γ-LWL, γ-MLWL, γ-LPB, γ-MLPB, and γ-YN methods;(2)we investigate how variable substitution rates affect the meth-ods that adopt different models as well as the interplay among four evolutional features with respect to Ka/Ks computations. Our results suggest that variable substitution rates over sites under negative selection exhibit an opposite effect on ω estimates compared with those under positive selection. We believe that the sen-sitivity of our new methods has been improved than that of their original methods under diverse conditions and it is advantageous to introduce novel parameters for Ka/Ks computation.

Purpose To construct a nomogram model based on ultrasonographic features and to evaluate its value in differentiating benign from malignant bladder neoplasms.Materials and Methods A total of 538 consecutive bladder neoplasm patients(including 84 benign cases and 454 malignant cases)confirmed by surgery or biopsy pathology from January 2016 to January 2022 were retrospectively enrolled,the ultrasonographic features(including lesion number,location,maximum diameter,echogenicity,morphology,basement,calcification,color Doppler flow imaging signal)and brief clinical data(gender,age,urinary tract malignant tumors history and gross haematuria)were all collected for univariate and multivariate Logistic regression analysis.Independent predictors for malignant bladder neoplasm were screened and nomogram model based on univariate Logistic regression analysis was constructed.Internal validation was performed by Bootstrap resampling.Meanwhile,the receiver operating characteristic curve,calibration curve and decision curve were drawn.Results Univariate and multivariate Logistic regression analysis showed patient gender(OR=1.822,P=0.038),age(OR=1.044,P=0.000),lesion location(OR=0.359,P=0.000)and color Doppler flow imaging signal(OR=2.052,P=0.007)were independent factors in predicting the malignancy of bladder lesions.Area under the curve of the nomogram prediction model based on univariate Logistic regression analysis were 0.780,the sensitivity,specificity and accuracy of the prediction model were 72.91%,71.43%and 72.68%,respectively.The calibration curve and decision curve showed good consistency and clinical practicability of the model.Conclusion The nomogram model based on ultrasonographic features and simple clinical characteristics shows good predictive accuracy in differentiating bladder neoplasms and has potential clinical application value.

Objective To form the expert consensus on the limb management of patients with transvenous temporary cardiac pacing,standardize the limb management of patients with transvenous temporary cardiac pacing,and reduce complications related to the limb.Methods Using evidence-based methods,the evidence in this field was searched,evaluated and summarized,and relevant recommendations and research conclusions were extracted and classified by the level of evidence quality,and then the first draft of the consensus was formed.From December 2023 to January 2024,through 2 rounds of expert consultation and 4 rounds of expert meetings,the content was adjusted and the consensus was reached.Results Totally 16 experts participated in the consultation.The positive coefficient is 100%;the authoritative coefficient is 0.847 and 0.836;the average value of each index is more than＞3.8;the coefficient of variation is less than 0.21.The Kendall's harmony coefficient of the 2 rounds of expert consultation is 0.372 and 0.314,respectively,which were statistically significant.The consensus covers the preoperative,intraoperative and postoperative on limb management of patients with transvenous temporary cardiac pacing.Totally 11 themes were involved,including the preoperative preparation,position and catheter fixation in operation,position and catheter fixation in postoperative,activity,turn and transfer,duty shift on limb,nursing care after withdrawal of the catheter,prevention of deep vein thrombosis of the operative limb and prevent infection.Conclusion The consensus is highly scientific,and it is helpful to standardize the limb management of patients with transvenous temporary cardiac pacing.

Objective: To investigate the association between nonalcoholic fatty liver disease (NAFLD) and serum magnesium level in patients with type 2 diabetic mellitus (T2DM). Methods: Clinical data of 1 273 consecutive patients with T2DM admitted in hospital from June 2013 to June 2017 were retrospectively analyzed. According to the quartile of serum magnesium levels, patients were divided into 4 groups: Q₁ group (≤ 0.79 mmol/L, n=376), Q₂ group (0.80-0.84 mmol/L, n=296), Q₃ group (0.85-0.89 mmol/L, n=287) , and Q₄ group (≥0.90 mmol/L, n=314). Logistic regression was used to analyze the association between NAFLD and serum magnesium level. Results: The average age of the study population was (56.4±13.8) years, males accounted for 52.7%(671/1 273), NAFLD patients accounted for 58.4%(743/1 273). The prevalence of NAFLD in Q₄, Q₃, Q₂ and Q₁ groups was 53.8%(169/314), 52.6%(151/287), 57.4%(170/296) and 67.3%(253/376), respectively (χ²=19.00, P=0.000). Logistic regression showed that compared with the Q₄ group, OR(95%CI) for NAFLD in the Q₁ group was 1.49 (1.03-2.16), P_trend=0.011 after adjusting for age, sex, duration of diabetes, BMI, systolic blood pressure, alcohol consumption, TG, glycosylated hemoglobin and serum uric acid. After further adjusting for estimated glomerular filtration rate (eGFR), OR(95%CI) for NAFLD was 1.33 (0.92-1.94) and P_trend=0.065 in the Q₁ group compared with the Q₄ group. Conclusion Reduction in serum magnesium is associated with an increased risk of NAFLD in T2DM patients, and eGFR may be a confounding factor.