0.05), while there was significant difference in RI and S/D between the group without UCAN and the groups of UCAN with two loops and with three loops (P

OBJECTIVE To investigate the prevalence of PER-1 type ESBLs-producing Enterobacteriaceae and their antimicrobial-resistance profile. METHODS Totally 167 strains of Escherichia coli, 154 strains of Klebsiella pneumoniae and 67 strains of Enterobacter cloacae were tested. All of them were isolated from all kinds of clinical specimens in four hospitals of Nanchang city from Aug 2003 to Jun 2004. Antimicrobial susceptibility test(AST) was determined by K-B disk diffusion test. double-disk test(CTX, CTX/CA and CAZ, CAZ/CA)and three- dimension extract test were used to determine ESBLs. PER-1 genes were amplified by PCR. The products of PCR were sequenced to identify its ?-lactamase encoding gene. RESULTS Sixteen isolates were PER-1 gene positive. The PER-1 gene positive rates of E. coli, K. pneumoniae and E. cloacae were 3.6%, 3.2% and 9.0% , respectively . The antimicrobial-resistant rates of isolates harboring blaPER-1 to cefotaxime, ceftaxidime, amikacin , cefoxitin , cefepime and imipenem were 100%,100%, 56%, 94%, 31% and 0%, respectively. CONCLUSIONS blaPER-1 is detected in E. coli, K. pneumoniae and E. cloacace, and has diffused in Enterobacteriaceae . Imipenem and amikacin may be used to treat the infection caused by bacteria harboring blaPER -1.

ObjectiveTo observe the clinical efficacy and safety of Chinese medicinal mixture for dispelling stasis and resolving phlegm combined with western medicine in the treatment of epilepsy combined with cognitive impairment by randomized， double-blind， placebo-controlled， parallel-group trial. MethodA total of 123 inpatients and outpatients with epilepsy complicated with cognitive impairment admitted to the department of neurology at Longhua Hospital from October 2020 to October 2021 were randomly assigned into a control group （62 cases， carbamazepine + placebo） and a treatment group （61 cases， carbamazepine + Quyu Dingxian Zhengtong mixture） by random number table method. In the treatment group， 4 cases were exfoliated and eliminated. In the control group， 3 cases fell off. Finally， 57 cases in the treatment group and 59 cases in the control group were included. The total course of treatment for both groups was 12 weeks. The clinical efficacy， efficacy for traditional Chinese medicine （TCM） syndromes， and incidence of adverse reactions were compared between two groups. The changes of seizure frequency， abnormal rate of electroencephalogram （EEG）， cognitive function score， serum homocysteine （HCY）， folic acid， and vitamin B₁₂ （B₁₂） were measured and compared before and after treatment. ResultAfter 12 weeks of treatment， the treatment group had higher clinical efficacy ［92.98% （53/57） vs 79.66% （47/59）， χ²=4.327， P<0.05］ and efficacy for TCM syndromes ［96.49% （55/57） vs 84.75% （50/59）， χ²=4.660， P<0.05］ than the control group. The treatment group was superior to the control group in reducing the seizure frequency （Z=-3.938， P<0.01） and improving the Montreal cognitive assessment （MoCA） score （t=4.333， P<0.01） and mini-mental state examination （MMSE） score （t=9.531， P<0.01）. The variations in serum HCY， folic acid， and B₁₂ in the treatment group were less than those in the control group （t=-7.233， t=-7.972， t=-6.871， P<0.01）. After treatment， the abnormal rate of EEG in the treatment group was lower than that in the control group （χ²=4.437， P<0.05）. The incidence of adverse reactions in the treatment group （1.75%， 1/57） was lower than that （13.56%， 8/59） in the control group （corrected χ²=4.116， P<0.05）. ConclusionChinese medicinal mixture for dispelling stasis and resolving phlegm in combination with western medicine had better efficacy and safety than western medicine alone in the treatment of epilepsy complicated with cognitive impairment. Specifically， the combination outperformed western medicine alone in terms of clinical efficacy， efficacy for TCM syndromes， reduction in seizure frequency， abnormal rate of EEG， adverse reactions， improvement of cognitive function， and variations in serum folic acid， B₁₂， and HCY values. Chinese medicinal mixture for dispelling stasis and resolving phlegm may improve the clinical efficacy and safety by changing the metabolism of folic acid， B₁₂， and HCY in serum of the patients with epilepsy complicated with cognitive impairment.

As a malignancy with the highest morbidity and mortality in the world， lung cancer poses a huge threat to the health and life safety of all human beings. Most lung cancer patients are already in the advanced stage when they are diagnosed， and the treatment of advanced lung cancer often brings heavy mental pressure and economic burden to patients but has little effect. Therefore， the early diagnosis and treatment of lung cancer has become a major problem for medical researchers. At present， chemotherapy， immunotherapy， targeted therapy， and other treatment methods still have problems such as intolerance of patients and drug resistance， so there is an urgent need for human beings to seek new methods to treat lung cancer. Currently， the relationship between gut microbiota and disease occurrence， development， and prognosis， and the treatment of diseases by regulating gut microbiota have become a hot field of medical research. There are significant differences in gut microbiota between lung cancer patients and healthy people. Intestinal microorganisms can act on the respiratory system through the gut-lung axis， thereby affecting the occurrence， development， and prognosis of lung cancer and other respiratory diseases. As a peculiar means of treatment in China， Chinese medicine can effectively delay tumor progression， prevent postoperative recurrence and metastasis， reduce complications in the course of treatment， improve the quality of life， and prolong the survival of patients. Therefore， Chinese medicine is widely involved in the treatment of malignancies. Some Chinese medicine monomers， compounds， and active components have been found to regulate the gut microbiota. They can regulate the metabolism of the body， control the inflammatory response， build an immune barrier， or play a synergistic effect with various lung cancer treatments by affecting gut microbiota， so as to achieve the anti-tumor purpose. This article systematically reviewed the research on Chinese medicine and effective components in regulating gut microbiota， creating tumor-suppressing microenvironment， and intervening in the treatment of lung cancer， in order to provide new research ideas for the treatment of lung cancer.

Artificial intelligence (AI) has become a national strategy in developed countries. AI has been a great success in many scenarios of medicine and health fields, including virtual assistant, medical imaging, drug mining, nutrition, hospital management, health management, mental illness, wearable devices, risk management, pathology and clinical diagnosis and treatment. Here, we reviewed and commented the recent progresses on the application of AI in the pathological diagnosis, ocular diseases, skin disorders, medical imaging, traditional Chinese medicine, electrocardiographic monitoring, medical robots, oncotherapy and translational researches, and summed up and prospected the problems of AI application in medicine and health fields. With the development of technology, AI will lead to a revolutionary progress in medical treatment.

OBJECTIVE: This study aimed to investigate the application of acellular dermal matrix and acellular bone matrix in the management of oro-antral fistula. METHODS: Nine patients with oro-antral fistula (with defect greater than 5 mm×5 mm) after maxillary cyst resection or maxillary molar extraction were selected. The defects were repaired by the simultaneous implantation of acellular dermal matrix and acellular bone matrix. RESULTS: The incisions of nine patients were all primary healing. After 6 months of follow-up, the oro-antral communication healed well, and no symptom such as nasal congestion or runny nose was observed. The clinical and CT examinations confirmed wound healing. CONCLUSIONS The usage of acellular dermal matrix and acellular bone matrix is a reliable repairing method for ora-antral fistula.
Acellular Dermis ; Bone Matrix ; Fistula ; surgery ; Humans ; Wound Healing

Objective To investigate the mechanism of Qizhenziyin mixture in the treatment of hypogonadism by using the network pharmacology approach. Methods The active components of Qizhenziyin mixture were obtained by searching TCMSP ，TCMID and HIT databases.The related targets of candidate compounds were obtained by searching STITCH databases. The potential targets of Qizhenziyin mixture in the treatment of hypogonadism were obtained by mapping the disease genes of hypogonadism with Genecards and DisGeNet databases. The protein interaction platform database (STRING) was used to construct the interaction relationship between action targets. The target protein interaction （PPI） network was constructed by introducing Cytoscape software. The mechanism of Qizhenziyin mixture in the treatment of hypogonadism was explained through the enrichment analysis of GO, KEGG and molecular docking technology. Results A total of 148 drug-disease chemical compounds, 96 drug-disease intersection targets, 1085 disease targets were obtained；the components for treating diseases are: quercetin，kaempferol, luteolin, etc; enrichment analysis of GO revealed 1792 biological processes （BP）, 31 cellular components (CC) and 79 molecular functions (MF)；the results of KEGG pathway enrichment analysis indicated such as FOXO signaling pathway, prostate cancer, AGE-RAGE signaling pathway in diabetic complications, HIF-1 signaling pathway, etc.The results of molecular docking showed that kaempferol and LEP had the best and stable binding energy. Conclusion The active components of Qizhenziyin mixture may play a role of the treatment of hypogonadism by improving insulin resistance and the expression of testosterone synthetase of Leydig cells.

Chronic urticaria （CU） is a common skin disease worldwide， and its incidence is increasing year by year in various regions. Clinical manifestations such as severe itching can affect normal work， sleep， and daily life and increase the negative psychological burden caused by stress， anxiety， and depression. Mast cell activation and degranulation induced by immunoglobulin（Ig）E hypersensitivity is one of the core pathogenic mechanisms of CU， and there is no cure. Antihistamines such as cetirizine and loratadine are preferred for the clinical treatment of CU. Although they can effectively improve clinical manifestations such as itchiness， long-term application can increase the risk of adverse reactions and drug resistance. The phosphatidylinositol kinase/serine-threonine protein kinase B（PI3K/Akt） signaling pathway， as a classical signaling pathway regulated by phosphatidylinositol and tyrosine kinase receptor （RTK）， is a key target regulating the production and release of cytokines in macrophages and affecting the migration of leukocytes and the activation of mast cells and inflammation， and it can be involved in a variety of metabolic processes， such as mast cell activation and degranulation induced by IgE hypersensitivity and abnormal activation of the complement system so that the PI3K/Akt molecular pathway could be an important target for the future eradication of CU. However， the mechanism and potential role of the PI3K/Akt signaling pathway in the treatment of CU are less reported in China. Now， this paper reviewed the molecular mechanism of PI3K/Akt signaling pathway regulation in the treatment of CU and provided corroborative evidence and therapeutic strategy choices for the treatment of CU with traditional Chinese medicine （TCM） from the perspectives of molecular regulation and network pharmacology analysis.

Central venous lesion is a difficult problem in the vascular access complications of hemodialysis, which can cause serious clinical symptoms and affect the quality of hemodialysis and life of patients. We established arteriovenous fistula of the contralateral graft blood vessel with the used vein on the diseased side of the central vein of the patient. The arteriovenous fistula of the graft blood vessel was successfully punctured and hemodialysis was performed 2 weeks later. In this way, we not only solved the problem of venous hypertension and subsequent vascular access in the patient, but also reserved more vascular resources.
Humans ; Arteriovenous Shunt, Surgical/adverse effects* ; Blood Vessel Prosthesis Implantation ; Treatment Outcome ; Renal Dialysis ; Arteriovenous Fistula

OBJECTIVETo study the effect of Qinggan Huoxue recipe (QGHXR) in treating alcoholic liver disease (ALD).

METHODSBy adopting the multi-centered, randomized and controlled method, the patients were divided in to the QGHXR group (60 patients) treated orally by QGHXR, the XCHG group (30 patients) treated orally by Xiaochaihu granule and the control group (30 patients) treated orally by conventional therapy such as glucurolactone, vitamin C. The changes in symptoms, signs, liver function, blood lipid, liver fibrosis markers, cytokines, lipid superoxidation parameters and B-untrasonographic figure after treatment of the two groups were observed.

RESULTSThe total therapeutic efficacy of QGHXR, improvements in anorexia, nausea, vomiting and jaundice as well as effect in reducing blood levels of alanine transaminase (ALT), aspartate aminotransferase (AST) and triglyceride (TG) were superior in the QGHXR group to those in the other two groups (P < 0.01), and the effect in decreasing gamma-glutamyl transferase (GGT) and very low-density lipoprotein (VLDL) in the QGHXR group was more significant than that in the control group (P < 0.01). QGHXR also showed effects in lowering levels of liver fibrosis markers and cytokines, alleviating the anti-lipid superoxidation damage in liver, and could markedly improve the degree of fatty liver.

CONCLUSIONQGHXR shows obvious therapeutic effect in treating ALD, the mechanism could possibly be related with its effects in antagonizing lipid superoxidation, stabilizing hepatic cell membrane, adjusting the lipid metabolic disturbance of liver, regulating immune function, anti-liver fibrosis and promoting the intrahepatic metabolism of alcohol.

Adult ; Aged ; Aged, 80 and over ; Drugs, Chinese Herbal ; therapeutic use ; Fatty Liver, Alcoholic ; drug therapy ; Female ; Humans ; Liver Cirrhosis, Alcoholic ; drug therapy ; Liver Diseases, Alcoholic ; drug therapy ; Male ; Middle Aged ; Phytotherapy