Objective To investigate the prevalence of Toxoplasma gondii infection and awareness of toxoplasmosis?related knowledge among women with poor pregnant outcomes in Wuxi City. Methods A total of 217 women with poor pregnant out?comes from Wuxi City during the period of January 2011 to December 2015 were randomly selected as the study subjects( a study group),while 250 women with normal pregnancy were served as controls(a control group). The sero?prevalence of T. gon?dii infection was detected by using ELISA and compared between the study and control groups. The awareness of toxoplasmosis?related knowledge was investigated by using a self?designed questionnaire and compared between the study and control groups. Results The positive rate of anti?Toxoplasma antibody was 30.88%in the study group,which was significantly higher than that (8.8%)in the control group(χ2 =36.7,P<0.01). The positive rates of anti?Toxoplasma IgG and IgM antibodies were 20.74%and 10.14% in the study group respectively,which were significantly higher than those(6% and 2.8%)in the control group (χ2=22.53 and 10.74,both P values<0.01). In addition,the positive rates of anti?Toxoplasma,anti?Toxoplasma IgG and IgM antibodies were significantly higher in the women with missed miscarriage,natural abortion,stillbirth and birth defect than those in the women with normal pregnancy(all P values<0.05). The awareness rates of“Do you hear about Toxoplasma or toxo?plasmosis?”(P<0.01),“Do you know that breeding pet cats or dogs may cause Toxoplasma infection?”(P<0.05)and“Do you know that pregnancy women require the detection of Toxoplasma infection?”(P<0.01)were significantly lower in the study group than those in the control group,while no significant differences were seen in the awareness rates of“Do you know that eat?ing hot pot may cause Toxoplasma infection?”,“Do you know that the use of chopping block in regardless of cooked and un?cooked food may cause Toxoplasma infection?”,“Do you know that Toxoplasma infection may transfer from mother to fetus?”,“Do you know that Toxoplasma infection may cause adverse pregnant outcomes like abortion,stillbirth or fetal abnormalities ?”, and“Do you know that the women infected with T. gondii during pregnancy require treatment?”between the two groups(all P values>0.05). Conclusions This study demonstrates higher prevalence of T. gondii infection in women with poor pregnant out?comes than in those with normal pregnancy in Wuxi City. Considering the harm of T. gondii infection during pregnancy and the low awareness of toxoplasmosis?related knowledge in pregnant women,the health education of toxoplasmosis?related knowledge should be strengthened,especially for pregnant women,so as to reduce the prevalence of T. gondii infection among pregnant women to improve the better child?bearing and rearing level.

Objective To evaluate the efficacy of puerarin for prevention of brain injury in the patients undergoing open heart surgery under cardiopulmonary bypass (CPB).Methods Thirty ASA physical status Ⅲ patients of both sexes,aged 50-64 yr,weighing 50-75 kg,scheduled for elective cardiac valve replacement under general anesthesia,were randomly divided into 2 groups (n =15 each) using a random number table:control group(group C) and puerarin group (group P).Puerarin 400 mg was infused intravenously over 30 min immediately at skin incision in group P and the equal volume of 5％ glucose-sodium chloride injection was given in group C.Before induction of anesthesia (T0),at 30 min of CPB (T1),immediately after aortic unclamping (T2),and at 6,12 and 24 h after termination of CPB (T3.5),blood samples were collected from the jugular venous bulb for determination of the plasma concentration of neuron-specific enolase (NSE) and S-100 β protein.P300 eventrelated potential latency and amplitude were determined and cognitive function was assessed by Mini-Mental State Examination (MMSE) score at 1 day before surgery and 7 days after surgery.The patients were diagnosed as having post-operative cognitive dysfunction when MMSE score before surgery-MMSE score after surgery ≥ 2,or when M MSE score≤ 24.Results Compared with group C,the concentrations of plasma NSE and S-100 β protein were significantly decreased at T15,and P300 event-related potential latency was shortened,P300 event-related potential amplitude was increased,and the incidence of postoperative cognitive dysfunction was decreased at 7 days after operation in group P.Conclusion Puerarin can prevent the brain injury in the patients undergoing open heart surgery under CPB.

Objective To assess the clinicopathological and confocal microscopic features of porokeratosis.Methods This study included 186 patients with porokeratosis.The clinical and pathological findings from the patients were retrospectively analyzed.Confocal laser scanning microscopy(CLSM)was used to observe the lesions of disseminated superficial porokeratosis in 16 patients.Results Most of the patients had characteristic lesions of porokeratosis,i.e.,papules or plaques with a thread-like elevated border.Comoid lamella was observed in all of the cases,which was unassociated with sweat glands or hair follicles in most cases(171/186),and located in sweat pore or hair follicles in a few cases(15/186).There were dyskeratocytes as well as vacuolized and degenerated basal cells beneath the cornoid lamella.Varying amounts of lymphocytes and melanophages were observed in the superficial dermis.Amyloid was deposited in the papilla dermis in 2 cases.CLSM showed dyskeratocytes in a characteristic arcuate arrangement in spinous cell layer.Conclusions The CLSM images of porokeratosis are consistent with its histopathological manifestations,and CLSM may serve as a sensitive and specific noninvasive method for the diagnosis of porokeratosis.

The main constituents of a typical medicinal herb,Polygonum muMflorum (Heshouwu in Chinese),that induces idiosyncratic liver injury remain unclear.Our previous work has shown that cotreatment with a nontoxic dose of lipopolysaccharide (LPS) and therapeutic dose of Heshouwu can induce liver injury in rats,whereas the solo treatment cannot induce observable injury.In the present work,using the constituent "knock-out" and "knock-in" strategy,we found that the ethyl acetate (EA) extract of Heshouwu displayed comparable idiosyncratic hepatotoxicity to the whole extract in LPS-treated rats.Results indicated a significant elevation of plasma alanine aminotransferase,aspartate aminotransferase,and liver histologic changes,whereas other separated fractions failed to induce liver injury.The mixture of EA extract with other separated fractions induced comparable idiosyncratic hepatotoxicity to the whole extract in LPS-treated rats.Chemical analysis further revealed that 2,3,5,4'-tetrahydroxy trans-stilbene-2-O-β-glucoside (trans-SG) and its cis-isomer were the two major compounds in EA extract.Furthermore,the isolated cis-,and not its trans-isomer,displayed comparable idiosyncratic hepatotoxicity to EA extract in LPS-treated rats.Higher contents of cis-SG were detected in Heshouwu liquor or preparations from actual liver intoxication patients associated with Heshouwu compared with general collected samples.In addition,plasma metabolomics analysis showed that cis-SG-disturbing enriched pathways remarkably differed from trans-SG ones in LPS-treated rats.All these results suggested that cis-SG was closely associated with the idiosyncratic hepatotoxicity of Heshouwu.Considering that the cis-trans isomerization of transSG was mediated by ultraviolet light or sunlight,our findings serve as reference for controlling photoisomerization in drug discovery and for the clinical use of Heshouwu and stilbene-related medications.

Objective:To evaluate the efficacy and safety of hypomethylating agents (HMA) in patients with myelodysplastic syndromes (MDS) .Methods:A total of 409 MDS patients from 45 hospitals in Zhejiang province who received at least four consecutive cycles of HMA monotherapy as initial therapy were enrolled to evaluate the efficacy and safety of HMA. Mann-Whitney U or Chi-square tests were used to compare the differences in the clinical data. Logistic regression and Cox regression were used to analyze the factors affecting efficacy and survival. Kaplan-Meier was used for survival analysis. Results:Patients received HMA treatment for a median of 6 cycles (range, 4-25 cycles) . The complete remission (CR) rate was 33.98% and the overall response rate (ORR) was 77.02%. Multivariate analysis revealed that complex karyotype ( P=0.02, OR=0.39, 95% CI 0.18-0.84) was an independent favorable factor for CR rate. TP53 mutation ( P=0.02, OR=0.22, 95% CI 0.06-0.77) was a predictive factor for a higher ORR. The median OS for the HMA-treated patients was 25.67 (95% CI 21.14-30.19) months. HMA response ( P=0.036, HR=0.47, 95% CI 0.23-0.95) was an independent favorable prognostic factor, whereas complex karyotype ( P=0.024, HR=2.14, 95% CI 1.10-4.15) , leukemia transformation ( P<0.001, HR=2.839, 95% CI 1.64-4.92) , and TP53 mutation ( P=0.012, HR=2.19, 95% CI 1.19-4.07) were independent adverse prognostic factors. There was no significant difference in efficacy and survival between the reduced and standard doses of HMA. The CR rate and ORR of MDS patients treated with decitabine and azacitidine were not significantly different. The median OS of patients treated with decitabine was longer compared with that of patients treated with azacitidine (29.53 months vs 20.17 months, P=0.007) . The incidence of bone marrow suppression and pneumonia in the decitabine group was higher compared with that in the azacitidine group. Conclusion:Continuous and regular use of appropriate doses of hypomethylating agents may benefit MDS patients to the greatest extent if it is tolerated.