ObjectiveTo analyze the clinical characteristics and treatment of severe acute respiratory syndrome (SARS).MethodsDuring epidemic period of SARS,all suspected patients were isolated and treated at very early stage. Clinical symptoms, signs and changes of the chest film were observed carefully to make early diagnosis and begin early intervention. 14 SARS cases with definite diagnosis were treated by Western Medicine combined with Chinese Traditional Medicine.3 cases of them with severe type were treated by timely technical ventilation,which was nasotracheal intubition guided with fibronchoscope,with the principle of low tide volume and high PEEP to improve oxygen combination.ResultsAll patients were cured to discharge. Only two cases of mild pulmonary fibrosis were found after 2 months' follow-up. None of the medical workers taking part in rescuing and treating SARS patients and none of the family members of the patients were infected.ConclusionDuring SARS epidemic period,early isolation,early diagnosis,early combined treatment of Western Medicine and Chinese Traditional Medicine,and prompt technical ventilation intervention on severe cases are important factors to successfully rescue and treat SARS patients.

OBJECTIVETo observe the effect of pricking blood at Neiyingxiang (EX-HN 9) on the intraocular pressure of patients of primary open angle glaucoma (POAG).

METHODSNinty-six cases (166 eyes) were randomly divided into an observation group (44 cases) and a control group (52 cases). The observation group was treated with pricking blood at Neiyingxiang (EX-HN 9), and the control group was treated with 0.5% Timolol Maleate drops in eyes. The changes of patients' intraocular pressure in both groups were observed before and after treatment.

RESULTSThe intraocular pressure were (29.81 +/- 3.49) mmHg and (23.18 +/- 3.61) mmHg before and after treatment in the observation group, and (29.94 +/- 3.64) mmHg and (23.88 +/- 3.96) mmHg in the control group respectively, there were significant differences after treatment in the two groups (both P<0.01), while there was no significant difference in decreasing the intraocular pressure between the two groups (P>0.05).

CONCLUSIONPricking blood at Neiyingxiang (EX-HN 9) can effectively decrease the intraocular pressure and the effect is equivalent to Timolol Maleate drops.

Acupuncture Points ; Adult ; Aged ; Bloodletting ; Female ; Glaucoma, Open-Angle ; physiopathology ; therapy ; Humans ; Intraocular Pressure ; Male ; Middle Aged

Objective:To analyze the clinical characteristics and prognostic factors of acquired immunodeficiency syndrome (AIDS) patients with cytomega-lovirus retinitis (CMVR).Methods:The basic information, clinical features, fundus manifestations, treatment and prognosis of AIDS patients complicated with CMVR from January 2016 to December 2019 in Chongqing Public Health Medical Center were collected. Logistic single factor regression and multivariate regression analysis were used to analyze the factors affecting the prognosis of patients.Results:A total of 73 AIDS patients with CMVR were enrolled, including 54 males and 19 females. They were (41.3±12.1) years old. The median of CD4 + T lymphocyte counts was 34.0/μL, and there were five cases (6.85%) with CD4 + T lymphocyte counts> 200.0/μL. Forty cases (54.79%) were positive for cytomegalovirus (CMV) DNA in blood. Thirty-five patients (47.95%) were admitted with ocular symptoms, and monocular involvement was common (53.42%, 39/73). The results of ophthalmoscope showed that 41 cases (56.16%) had central lesions, 63 cases (86.30%) had exudative lesions and 52 (71.23%) had bleeding lesions. Sixty-seven patients were treated with anti-CMV therapy, and 46 patients were discharged with improved after treatment, and two patients were improved without treatment during follow-up. The median hospitalization time was 25 days. Logistic single factor regression analysis showed that the prognosis of patients with combination of anti-CMV drugs and dexamethasone was better than that of patients who were treated with anti-CMV drugs (sodium phosphonate or ganciclovir) alone (odds ratio ( OR)=0.308, P=0.038). Compared with patients aged <30 years old, the prognosis of patients aged> 50 years old was worse ( OR=14.667, P=0.009). The multivariate analysis showed that age>50 years old was the independent risk factor influencing the prognosis of CMVR ( OR=18.183, P=0.009). Conclusions:CMVR is frequently found in AIDS patients with low CD4 + T lymphocyte counts, but CMVR may still occur in patients with CD4 + T lymphocyte counts >200.0/μL. However, not all patients have positive CMV DNA results in blood. Therefore, it is necessary for AIDS patients to receive examination of ocular fundus. The overall prognosis of CMVR is good. Age>50 years old is an independent risk factor affecting prognosis. Appropriate use of dexamethasone combined with anti-CMV treatment can improve the prognosis.

BACKGROUNDCandida albicans (C. albicans) infection, often occurring in genital candidiasis, has increased dramatically recently. Developing an efficient C. albicans typing method may contribute to understanding its epidemiological characteristics and guiding efficient treatment. We used rapid microsatellite genotyping assay for interstrain differentiation of C. albicans isolates and explored some characteristics of its spread.

METHODSDNA was extracted from C. albicans isolates from gentalia, recta and mouths of 39 female cases and 27 male cases of genital candidiasis. Three fluorescent primers for the microsatellite markers in conserved genes (CDC3, EF3 and HIS3) of C. albicans were used to amplify the isolates DNA by PCR. Fluorescent signals were read with an automatic sequencer and analyzed with GeneScan software.

RESULTSAnalysis of the three microsatellites markers showed 18 gene allelic associations in genital C. albicans infected patients: 10 allelic associations in female and 11 allelic associations in male, of which 3 allelic associations shared by both genders covered 71% of infections. The most dominant allele association of pathogenic strains for both genders was 116:124, 122:131, 160:200 that covered about 50% of infection. Gentalia and recta shared the same strains in 80% of female patients, but in only 3.8% of male patients. There were 2.7% female patients, but no males, with same strain in both gentalia and mouths. Five of seven genital C. albicans infected couples had the same allelic associations of which 4 were the dominant pathogenic C. albicans susceptible for both genders.

CONCLUSIONSThe predominant allelic association of the pathogenic strain in genital C. albicans infection is 116:124, 122:131, 160:200. Vaginal pathogenic strains are probably maintained from the rectal reservoir. Pathogenic strains of male patients are probably from frequent sexual intercourse. The aggressiveness of some strains varies with gender.

Adult ; Candida albicans ; classification ; genetics ; Candidiasis ; diagnosis ; Candidiasis, Vulvovaginal ; diagnosis ; Female ; Genital Diseases, Male ; diagnosis ; Genotype ; Humans ; Male ; Microsatellite Repeats ; Rectum ; microbiology ; Sensitivity and Specificity ; Tongue ; microbiology

Objective To evaluate the performance of MRI in predicting pathological response of different breast cancer subtypes after neoadjuvant chemotherapy(NAC).Methods The MRI images and postoperative pathological results of 91 patients with breast cancer after NAC were analyzed retrospectively.The correlation between the imaging features of different molecular subtypes of breast cancer and postoperative pathological results was studied,and the diagnostic performance of MRI in predicting pathological response after NAC was evaluated,with postoperative pathological results referred as the diagnostic standard.Results Of 91 patients,27(29.7％)and 35(38.5％)cases were diagnosed as imaging complete response(iCR)and pathological complete response(pCR),respectively.The accuracy of MRI in predicting pathological response after NAC was 84.62％,with 94.64％sensitivity,68.57％specificity,and positive predictive value(PPV)and negative predictive value(NPV)of 82.81％and 88.89％,respectively.Conclusion MRI can accurately predict the pathological response of the human epidermal growth factor receptor-2(HER-2)+and triple-negative breast cancer after NAC.

Objective:To investigate predictive factors for successful endovascular recanalization in patients with non-acute symptomatic internal carotid artery occlusion (SICAO), to develop a decision tree model using the Classification and Regression Tree (CART) algorithm, and to evaluate the predictive performance of the model.Methods:Patients with non-acute SICAO received endovascular therapy at 8 comprehensive stroke centers in China were included retrospectively. They were randomly assigned to a training set and a validation set. In the training set, the least absolute shrinkage and selection operator (LASSO) algorithm was used to screen important variables, and a decision tree prediction model was constructed based on CART algorithm. The model was evaluated using the receiver operating characteristic (ROC) curve, Hosmer-Lemeshow goodness-of-fit test and confusion matrix in the validation set.Results:A total of 511 patients with non-acute SICAO were included. They were randomly divided into a training set ( n=357) and a validation set ( n=154) in a 7:3 ratio. The successful recanalization rates after endovascular therapy were 58.8% and 58.4%, respectively. There was no statistically significant difference ( χ2=0.007, P=0.936). A CART decision tree model consisting of 5 variables, 5 layers and 9 classification rules was constructed using the six non-zero-coefficient variables selected by LASSO regression. The predictive factors for successful recanalization included fewer occluded segments, proximal tapered stump, ASITN/SIR collateral grading of 1-2, ischemic stroke, and a recent event to endovascular therapy time of 1-30 d. ROC analysis showed that the area under curve of the decision tree model in the training set was 0.810 (95% confidence interval 0.764-0.857), and the optimal cut-off value for predicting successful recanalization was 0.71. The area under curve in the validation set was 0.763 (95% confidence interval 0.687-0.839). The accuracy was 70.1%, precision was 81.4%, sensitivity was 63.3%, and specificity was 79.7%. The Hosmer-Lemeshow test in both groups showed P>0.05. Conclusion:Based on the type of ischemic event, the time from the latest event to endovascular therapy, proximal stump morphology, the number of occluded segments, and the ASITN/SIR collateral grading constructed the decision tree model can effectively predict successful recanalization after non-acute SICAO endovascular therapy.

Background/Aims: Low educational attainment is a well-established risk factor for nonalcoholic fatty liver disease (NAFLD) in developed areas. However, the association between educational attainment and the risk of NAFLD is less clear in China. Methods: A cross-sectional study including over 200,000 Chinese adults across mainland China was conducted. Information on education level and lifestyle factors were obtained through standard questionnaires, while NAFLD and advanced fibrosis were diagnosed using validated formulas. Outcomes included the risk of NAFLD in the general population and high probability of fibrosis among patients with NAFLD. Logistic regression analysis was employed to estimate the risk of NAFLD and fibrosis across education levels. A causal mediation model was used to explore the potential mediators. Results: Comparing with those receiving primary school education, the multi-adjusted odds ratios (95% confidence intervals) for NAFLD were 1.28 (1.16 to 1.41) for men and 0.94 (0.89 to 0.99) for women with college education after accounting for body mass index. When considering waist circumference, the odds ratios (95% CIs) were 0.94 (0.86 to 1.04) for men and 0.88 (0.80 to 0.97) for women, respectively. The proportions mediated by general and central obesity were 51.00% and 68.04% for men, while for women the proportions were 48.58% and 32.58%, respectively. Furthermore, NAFLD patients with lower educational attainment showed an incremental increased risk of advanced fibrosis in both genders. Conclusions In China, a low education level was associated with a higher risk of prevalent NAFLD in women, as well as high probability of fibrosis in both genders.

Objective:In order to systematically clarify the chemical composition of Jiechangyan Qixiao granules， the main chemical components in this preparation were rapidly identified and assigned by ultra-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry （UPLC-Q-TOF/MS^E）. Method:ACQUITY UPLC BEH C₁₈ column （2.1 mm×100 mm， 1.8 μm） was employed for UPLC analysis with the mobile phase of 0.1% formic acid aqueous solution （A）-acetonitrile （B） for gradient elution （0-2 min， 5%B； 2-16 min， 5%-21%B； 16-30 min， 21%-95%B； 30-33 min， 95%B； 33-34 min， 95%-5%B； 34-37 min， 5%B）. The flow rate was 0.3 mL·min^-1， the column temperature was 30 ℃， and the volume of sample injection was 2 μL. Electrospray ionization （ESI） was applied for scanning under positive and negative ion modes with the scanning range of m/z 60-1 200. MS^E mode was used to collect mass spectral data. The ion peaks were identified by comparing with the information of control substances， literature references and self-built database. Result:A total of 102 chemical components were separated and identified in Jiechangyan Qixiao granules， including organic acids， flavonoids and its glycosides， triterpenes， phenylethanoid glycosides， tannins， iridoid glycosides and other components， among which flavonoids and its glycosides were from Drynariae Rhizoma and Crataegi Fructus， phenylethanoid glycosides and iridoid glycosides were from Plantaginis Semen， triterpenoids and tannins were from Crataegi Fructus and Chebulae Fructus. Among the identified chemical constituents， there were 28 from Drynariae Rhizoma， 31 from Plantaginis Semen， 53 from Chebulae Fructus and 58 ingredients from Crataegi Fructus. Conclusion:The established UPLC-Q-TOF/MS^E can comprehensively and rapidly analyze the chemical constituents in Jiechangyan Qixiao granules， and preliminarily elucidates the chemical composition profile of this granules， which can lay a foundation for further research on the pharmacodynamic material basis and quality control of Jiechangyan Qixiao granules.

ObjectiveIn order to explore the changes of chemical constituents in Plantaginis Semen before and after stir-frying， ultra-high performance liquid chromatography-quadrupole-time-of-flight mass spectrometry （UPLC-Q-TOF/MS^E） was used to rapidly identify and semi-quantitatively analyze the differential components in Plantaginis Semen processed at different stir-frying time. MethodWaters ACQUITY UPLC BEH C₁₈ column （2.1 mm×100 mm， 1.8 μm） was employed with the mobile phase of 0.1% formic acid aqueous solution （A）-acetonitrile （B） for gradient elution （0-1 min， 5%-10%B； 1-2 min， 10%-15%B； 2-10 min， 15%-20%B； 10-12 min， 20%-40%B； 12-13 min， 40%-100%B； 13-14 min， 100%-5%B； 14-15 min， 5%B）， the flow rate was 0.3 mL·min^-1， the column temperature was 40 ℃， and the injection volume was 3 μL. Electrospray ionization （ESI） was applied for mass spectrometric analysis under positive and negative ion modes， and the scanning range was m/z 50-1 500. MarkerLynx 4.1 software was used to find the differential compounds， and the intensity of each ion peak in samples with different stir-frying time was compared to study the content variations of these compounds. ResultA total of 20 components with potential significant differences were found， among which 17 were identified and 3 were unknown， mainly including phenylethanoid glycosides， iridoid glycosides， alkaloids and others. After processing， the peak intensities of 7 compounds， such as sucrose， geniposidic acid， verbascoside and plantagoguanidinic acid A， in Plantaginis Semen decreased. The peak intensities of orobanchoside， dianthoside and plantain D increased first and then decreased during the stir-frying process. The peak intensities of 10 compounds （decaffeoylacteoside， calceolarioside A， isoacteoside， etc.） increased， and 9 of them were newly generated components. ConclusionThe content and composition of the chemical components in Plantaginis Semen changed significantly after stir-frying， which may be related to the reduction of laxative effect and the enhancement of antidiarrheal and diuretic activities of Plantaginis Semen after stir-frying.

Paris is commonly used in traditional Chinese medicine and its resource is in shortage, a variety of related plants are acquired as Paris. This study compared pharmacological activity in anti-inflammatory and hemostatic and blood rheology of P. vietnamensis with pharmacopoeial Paridis Rhizoma to expand its range of Paris medicinal resources and protect wild resources of Paris and meet market demand. The experimental study showed that P. vietnamensis and P. polyphylla var. yunnanensis and P. polyphylla var. chinensis had anti-inflammatory and hemostatic effect and improved blood rheolog. They can significantly inhibit rat foot swelling induced by carrageenan and short the bleeding time and clotting time and reduce the blood viscosity in rats with acute blood stasis model, P. vietnamensis and P. polyphylla var. yunnanensis can inhibit mice capillary permeability induced by acetic acid.