Objective To evaluate the efficacy of PGE_1 for the treatment of hyperbilirubinemia due to viral hepatitis.Methods A prospective,randomized,single blind and parallel control clinical study enrolled 100 patients with icterohepatitis,who were randomized 1∶1 to two treatment groups;Each group was intravenously infused daily over a six-week treatment period:(1)200?g of PGE_1 injection;(2)20ml of potassium-magnesium aspartate injection.Results The PGE_1 treated patients were more superior in the recoveries of physical characteristics,icteric index and liver functions to the control group.The statistical difference of the PGE_1 group from the potassium-magnesium aspartate in the treatment of icterohepatitis occurred in the 3rd week of the therapy(P0.05).Conclusion PGE_1 is effective in the treatment of the acute or chronic viral hepatitis and the hyperbilirubinemia caused by early stage severe hepatitis.

Objective To study clinical features and its diagnosis and treatment of alcoholic cirrhosis.Methods 68 cases with alcoholic cirrhosis were retrospectively analyzed,with cirrhosis from hepatitis B as control.Results Alcoholic cirrhosis accounted for 8.5% of in-patient cirrhosis in the correspomding period,mean age being(53.5?14.6),and with more than 135g alcohol intake per day which persisted over 10 years.Such signs significantly increased as dark complexion,liver palms,spider naevi,hepatomegaly,ynecomastia,hypertrophy of parotid gland,?-glutamyltansferase(GGT),ratio of aspartate aminotransferase(AST) to alanine aminotransferase(ALT),mean corpuscular volume(MCV),uric acid(UA),serum ferritin(SF) rose apparently,usually combined with hepatogenic diabetes,peptic ulcer,hyperuricemia,hyperlipemia.Peculiar complication were alcohol withdrawal syndrome,gort,gouty arthritis,aseptic necrosis of femur.Among them,53 cases(77.9%) improved clinically,9 cases(13.2%) showed no effect,6 cases(8.8%) died.Conclusions Occurrence of dark complexion,liver palms,spider naevi,hepatomegaly,ynecomastia,hypertrophy of parotid gland and test of GGT,AST/ALT,MCV,UA,SF are helpful to clinic and differentiation diagnosis of alcoholic cirrhosis,abstinence are not able to prevent its development.Long-term therapy aiming at endotoxin toxemia might improve prognosis of alcoholic cirrhosis.

Objective To investigate the efficacy of PEG-INF alpha-2a(PEG-INF-2a)on patients with chronic hepatitis C.Methods 60 patients with hepatitis C were included in this study.30 patients were treated with PEGINF-2a(180μg or 135μg/week)and RBV 900mg/d,30 patients were treated with IFNα-2a(5 MIU/qod)and RBV 900 mg/d.The time of treatment was 48 weeks,and all the patients were followed up for 24 weeks after treatment.There was no significant difference between the two groups in pretreatment HCV-RNA,HCV genotype and other clinical data.The main parameters to evaluate the efficacy were virological and biochemical responses.The side effects were intensively observed.Results Sustained vimlogical response(SVR)rate in PEG-IFNα-2a group was significantly higher than that in IFNα-2a group(56.5%and 19.5%respectively,P＜0.01).As the patients were divided according to HCV genotype 1 and high virus load.the SVR rate of PEG-IFNα-2a group Was higher than IFNα-2a group(P＜0.01).However,there was no significant difference between two groups in the patients with non-genotype 1 and low viral load(P=0.664,0.116).Similar side-effects were observed in PEG IFNα-2a group and IFNα-2a group,but the rate of weisht decline and the degree of leukocyte decrease were more significant in PEG IFNα-2a group than in IFNα-2a group(P＜0.01).Conclusion The efficacy of PEG IFNα-2a in the treatment of chromic hepatitis C is superior to that of conventional IFNα-2a,PEG-IFNα-2a had good tolerance and safety profiles.

Objective To compare the analgesic effect ofHuamoyan Keli(HMYKL) between Kunming mice and BALB/c mice.Methods Eighty Kunming mice and eighty BALB/c mice were randomly divided into five groups, respectively: a control group, a ibuprofen group, a HMYKL high-dose group(13.98 g crude dru g/kg), HMYKL middle-dose group(6.99 g crude drug/kg)and a HMYKL low-dose group(3.50 g crude dru g/kg). There were 16 mice in each group with 8 male mice and 8 female mice. Drugs were administered intragastrically daily for 5 days. After 1 h of drug treatment on day 4, the latency of tail-flick response was evaluated using illuminated pain measurement instrument. After the last drug treatment, pain model was established by i.p. acetic acid, writhing latency and writhing times were recorded to evaluate the analgesic effect of HMYKL.Results In tail-flick test, there was no statistical difference among male and female Kunming mice in the HMYKL groups. Among male BALB/c mice, the latency in HMYKL middle-dose group was significantly longer than that in the control group(4.84±1.16 minvs. 3.93±0.76 min,P<0.05). In writhing test, compared with control group(19.06±6.34), the writhing times among BALB/c mice were decreased in HMYKL high-dose group(8.56±6.19), HMYKL middle-dose group(5.73±3.17), HMYKL low-dose group(6.88±4.59)(allP<0.01).Conclusion All dose groups of HMYKL showed good analgesic effect on the pain induced by chemical stimulation and there was no sex difference. Kunming mice were not suitable for the evaluation of the analgesic pharmacodynamics because of their large individual difference. On contrast, BALB/c mice which had less individual difference could be used to produce the model of pain.

Objective The purpose of this study was to investigate the anti-inflammatory effects on acute and chronic inflammation ofHuamoyan Granules(HMYG).Methods KM mice and SD rats were randomly divided into model group, ibuprofen group and HMYG high, middle and low three dosages groups. The Ibuprofen group was administrated drug by gavage, mice 0.13 g/kg and rats 0.093 g/kg. The HMYG groups were administrated orally, mice 12, 6 and 3g/kg, rats 4, 4.2 and 2.1 g/kg. The model group was given the same volume distilled water, once a day, 3 or 10 continuous days. The increased permeability of mice abdominal capillary was induced by acetic acid, edema of rat hind paw was induced by albumen and carrageenin, which both were adopted to observe the acute anti-inflammatory effects; and cotton pellet granuloma was to observe the chronic anti- inflammation effects of HMYG.Results Compared with the model group, the ibuprofen group, the HMYG high and middle group showed anti-inflammatory actions of mice induced by acetic acid (0.185 ± 0.046, 0.177 ± 0.055, 0.190 ± 0.052vs. 0.246 ± 0.050,P<0.05 orP<0.01); after 0.5, 1, 2, 4 and 6 hrs inflammation, HMYG high dosage group had significant inhibition for the edema of rats hind paw induced byalbumen model, the inhibitory rate was 22.46%, 19.20% and 24.32%, 33.75%, 24.19%; 4 and 6 hrs after inflammation, HMYG high dosage group could reduce rats paw edema induced by carrageenin, the inhibitory rate was 32.05%, 30.56% and 19.23%, 20.83%.Conclusion HMYG has evident anti-inflammatory effects on acute inflammation.

Objective:To compare the antiosteoporosis effect of conventional treatment and conventional treatment combined with Denosumab after percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCF).Methods:A retrospective cohort study was conducted to analyze the clinical data of 211 patients with OVCF admitted to the Second Affiliated Hospital of Soochow University from September 2020 to September 2022. All the patients were female, aged 56-90 years [(71.4±8.1)years]. The bone mineral density T-score of the lumbar spine was (-2.6±1.0)SD before operation. Fracture segments included T 1-T 9 in 45 patients, T 10-L 2 in 146, and L 3-L 5 in 69. Of all, 174 patients were treated with single-segment surgery, 25 with two-segment surgery and 12 with surgery involving three or more segments. According to the wishes of the patients, 107 patients were treated with daily oral administration of calcium and active Vitamin D after PKP (conventional treatment group) and 104 patients with Denosumab combined with the conventional treatment after PKP (Denosumab therapy group). The bone mineral density T-scores of the lumbar spine of the two groups were compared before surgery and at the last follow-up. The visual analogue scale (VAS) and Oswestry disability index (ODI) before surgery, at 3 days, 6 months after surgery, and at the last follow-up were evaluated and the refracture rate after surgery was detected. Possible adverse effects after medication during anti-osteoporosis treatment were observed in two the groups. Results:All the patients were followed up for 12-24 months [(13.5±2.0)months]. Before surgery, the bone mineral density T-score of the lumbar spine was (-2.7±1.1)SD in the Denosumab therapy group and (-2.5±0.8)SD in the conventional treatment group ( P>0.05). At the last follow-up, the bone mineral density T-score of the lumbar spine was (-2.1±1.1)SD in the Denosumab therapy group, significantly higher than (-2.5±0.9)SD in the conventional treatment group ( P<0.05). In the Denosumab therapy group, the bone mineral density T-score of the lumbar spine at the last follow-up was significantly increased compared to that before surgery ( P<0.01), while there was no significant difference in the conventional treatment group ( P<0.05). Before surgery and at 3 days after surgery, the VAS scores and ODI values were (8.5±0.9)points, (2.8±0.8)points, 48.7±4.8 and 25.6±4.0 in the Denosumab therapy group, which was not statistically different from those in the conventional treatment group [(8.5±1.3)points and (2.8±0.9)points, 47.9±7.0 and 25.9±3.7] ( P>0.05). At 6 months after surgery and at the last follow-up, the VAS scores and ODI values were (2.2±0.8)points, (1.7±0.8)points, 24.2±3.6 and 23.2±4.1 in the Denosumab therapy group, significantly lower than those of the conventional treatment group [(2.8±0.9)points, (2.8±1.1)points, 26.4±3.2 and 27.3±4.0] ( P<0.01). The VAS scores at each time point after surgery in both groups decreased significantly compared with those before surgery ( P<0.05). The VAS scores continued to decrease after surgery in the Denosumab therapy group ( P<0.05), while no significant difference was found among those at different time points in the conventional treatment group ( P>0.05). The ODI values at each time point after surgery in both groups significantly decreased compared to those before surgery ( P<0.05). The ODI values continued to decrease after surgery in the Denosumab therapy group ( P<0.05), while in the conventional treatment group, no significant difference was found between those at 6 months after surgery and those at 3 days after surgery ( P>0.05) and they were improved at the last follow-up compared with those at 3 days after surgery ( P<0.05). The refracture rate after surgery was 6.7% (7/104) in the Denosumab therapy group, significantly lower than 16.8% (18/107) in the conventional treatment group ( P<0.05). No serious complications were observed during the antiosteoporosis period in either group. Conclusion:Compared with daily oral administration of Calcium and active Vitamin D after PKP, the conventional treatment combined with Denosumab after PKP can effectively increase the bone density, relieve pain continuously, improve functional restoration, and reduce the risk of refracture in OVCF patients.

Objective:To examine the clinical value of rapid detection of drug-resistant bacteria by immunochromatography and the effects of rapid detection on the prognosis of patients with severe intra-abdominal infection complicated by carbapenem-resistant Enterobacteriaceae (CRE) bloodstream infection.Methods:This was a retrospective cohort study. We analyzed clinical data of 73 patients with severe abdominal infections with sepsis or septic shock complicated by CRE bloodstream infection admitted to the general surgery department of Jinling Hospital between February 2022 and February 2023. Patients were divided into a colloidal gold immunochromatographic assay (GICA) group (17 patients) and conventional testing group (56 patients) based on whether a GICA for CRE had been performed on the patients' first blood culture sample during the diagnosis and treatment process. There were no statistically significant differences between the GICA and conventional testing groups in age ([55.9±17.3] vs. [47.6±16.4] years), sex ([16 men vs. one woman ] vs. [41 men vs. 15 women]), median Charlson comorbidity index (3.0[2.0,4.0] vs. 3.0[2.0, 4.8]), septic shock (10 vs. 39), or acute kidney injury (8 vs. 40) (all P>0.05). Both groups routinely underwent traditional bacterial identification and drug susceptibility testing. Additionally, patients in the GICA group were tested directly for positive blood cultures using a GICA carbapenemase test kit. The main outcomes were mortality rates on Days 28 and 90 after the first identification of CRE bloodstream infection in both groups. We also compared the microbial clearance rate, duration of hospitalization and intensive care unit stay, and time from onset of CRE bloodstream infection to initiation of targeted and appropriate antibiotics between the two groups. Results:The rate of microbial clearance of bloodstream infection was significantly greater in the GICA group than in the conventional testing group (15/17 vs. 34/56 [60.7%], χ 2=4.476, P=0.034), whereas the 28-day mortality tended to be lower in the GICA than conventional testing group [5/17 vs. 44.6% [25/56], χ 2=1.250, P=0.264). The 90-day mortality (8/17 vs. 53.6% [30/56], χ 2=0.222, P=0.638), median duration of hospitalization (37.0 [18.0, 46.5] days vs. 45.5 [32.2, 64.8] days, Z=-1.867, P=0.062), and median duration of intensive care unit stay (18.0 [6.5, 35.0] days vs. 32.0 [5.0, 51.8] days, Z=-1.251, P=0.209). The median time between the onset of bloodstream infection and administration of antibiotics was 49.0 (38.0, 69.0) hours in the GICA group, which is significantly shorter than the 163.0 (111.8, 190.0) hours in the conventional testing group ( Z=-5.731, P<0.001). The median time between the onset of bloodstream infection and administration of appropriate antibiotics was 40.0 (34.0, 80.0) hours in the GICA group, which is shorter than in the conventional testing group (68.0 [38.2, 118.8]) hours; however, this difference is not statistically significant ( Z=-1.686, P=0.093). Conclusions:GICA can provide information on carbapenemase- producing pathogens faster than traditional drug sensitivity testing, enabling early administration of the optimal antibiotics. The strategy of 'carbapenemase detection first' for managing bacterial infection has the potential to improve prognosis of patients and reduce mortality rate.

Objective:To examine the clinical value of rapid detection of drug-resistant bacteria by immunochromatography and the effects of rapid detection on the prognosis of patients with severe intra-abdominal infection complicated by carbapenem-resistant Enterobacteriaceae (CRE) bloodstream infection.Methods:This was a retrospective cohort study. We analyzed clinical data of 73 patients with severe abdominal infections with sepsis or septic shock complicated by CRE bloodstream infection admitted to the general surgery department of Jinling Hospital between February 2022 and February 2023. Patients were divided into a colloidal gold immunochromatographic assay (GICA) group (17 patients) and conventional testing group (56 patients) based on whether a GICA for CRE had been performed on the patients' first blood culture sample during the diagnosis and treatment process. There were no statistically significant differences between the GICA and conventional testing groups in age ([55.9±17.3] vs. [47.6±16.4] years), sex ([16 men vs. one woman ] vs. [41 men vs. 15 women]), median Charlson comorbidity index (3.0[2.0,4.0] vs. 3.0[2.0, 4.8]), septic shock (10 vs. 39), or acute kidney injury (8 vs. 40) (all P>0.05). Both groups routinely underwent traditional bacterial identification and drug susceptibility testing. Additionally, patients in the GICA group were tested directly for positive blood cultures using a GICA carbapenemase test kit. The main outcomes were mortality rates on Days 28 and 90 after the first identification of CRE bloodstream infection in both groups. We also compared the microbial clearance rate, duration of hospitalization and intensive care unit stay, and time from onset of CRE bloodstream infection to initiation of targeted and appropriate antibiotics between the two groups. Results:The rate of microbial clearance of bloodstream infection was significantly greater in the GICA group than in the conventional testing group (15/17 vs. 34/56 [60.7%], χ 2=4.476, P=0.034), whereas the 28-day mortality tended to be lower in the GICA than conventional testing group [5/17 vs. 44.6% [25/56], χ 2=1.250, P=0.264). The 90-day mortality (8/17 vs. 53.6% [30/56], χ 2=0.222, P=0.638), median duration of hospitalization (37.0 [18.0, 46.5] days vs. 45.5 [32.2, 64.8] days, Z=-1.867, P=0.062), and median duration of intensive care unit stay (18.0 [6.5, 35.0] days vs. 32.0 [5.0, 51.8] days, Z=-1.251, P=0.209). The median time between the onset of bloodstream infection and administration of antibiotics was 49.0 (38.0, 69.0) hours in the GICA group, which is significantly shorter than the 163.0 (111.8, 190.0) hours in the conventional testing group ( Z=-5.731, P<0.001). The median time between the onset of bloodstream infection and administration of appropriate antibiotics was 40.0 (34.0, 80.0) hours in the GICA group, which is shorter than in the conventional testing group (68.0 [38.2, 118.8]) hours; however, this difference is not statistically significant ( Z=-1.686, P=0.093). Conclusions:GICA can provide information on carbapenemase- producing pathogens faster than traditional drug sensitivity testing, enabling early administration of the optimal antibiotics. The strategy of 'carbapenemase detection first' for managing bacterial infection has the potential to improve prognosis of patients and reduce mortality rate.

OBJECTIVE To explore the discrimination of processing degree of Zingiber officinale charcoal and the correlation between color and component content based on machine vision system， and provide reference for quality evaluation and processing degree control of Z. officinale charcoal. METHODS High-performance liquid chromatography method was used to determine the contents of 5 components in Z. officinale charcoal and its different processed products， such as 6-gingerol， 8-gingerol， 10-gingerol， 6-shogaol， gingerone. Machine vision system was used to obtain the image of the decoction pieces and extract the color features of the decoction pieces in RGB， L*a*b* and HSV color spaces. Machine learning methods， such as principal component analysis （PCA）， linear discriminant analysis （LDA）， partial least squares-discriminant analysis （PLS-DA） and support vector machine （SVM）， were used to establish qualitative identification model for Z. officinale charcoal processed products of different processing degree. The correlation between the color eigenvalues and the contents of measured 5 components were analyzed， and the color- component content prediction model was established.RESULTS With the deepening of processing， gingerone was produced after processing and the content firstly increased and then decreased， and the content of gingerone in standard carbon was the highest； the contents of 6-gingerol， 8-gingerol and 10-gingerol decreased gradually； the content of 6-shogaol increased firstly and then decreased. The prediction accuracy of qualitative discriminant model， which was established on the basis of objective quantization of image and color combined with LDA and SVM of supervised discriminant pattern recognition method， reached 100% in cross-validation training and 95.83% in the external validation. Content prediction model of 5 components was established on the basis of objective quantization of image and color combined with SVM， the RPD values were all greater than 2， the R2P and R2C values of gingerone were 0.633 9 and 0.683 3， and the values of other components were all greater than 0.75， indicating SVM had good prediction ability for the contents of 4 components except for gingerone. CONCLUSIONS The machine vision system is excellent for the discrimination of the processing degree of Z. officinale charcoal and the content prediction， which can provide a reference for the quality control of Z. officinale charcoal decoction pieces and the judgment of the processing degree.