Abstract: Superior mesenteric veinous thrombosis (SMVT) is a rare complication that often occurs in conjunction with intra-abdominal diseases such as diverticulitis, appendicitis, inflammatory bowel disease, etc. Its clinical symptoms are non-specific and include fevers, abdominal pain; it has no specific symptoms, and the diagnosis depends on clinical laboratory tests and imaging studies. The occurrence of superior mesenteric veinous thrombophlebitis is related to septic phlebitis caused by the sloughing of the embolus containing bacteria into the portal vein with blood flow. Due to the nonspecific clinical features of this disease, diagnosing it based on clinical characteristics and microbiological aspects is a challenge. A case of superior mesenteric veinous septic thrombophlebitis caused by Bacteroides fragilis infection is reported and to provide a reference for the diagnosis and treatment of such diseases. The patient was a 34-year-old man who was admitted the hospital with intermittent abdominal pain and fever. Computed tomography (CT) showed partial thrombosis of the superior mesenteric vein, colonoscopy revealed diverticulitis in the ileoceca, and the blood culture grew Bacteroides fragilis. The patient was treated with anti-infection (ceftazidime 2.0 g q12h intravenous infusion for 11 days; metronidazole 0.5 g, q8h intravenous infusion for 3 days) and anticoagulation (rivaroxaban 20 mg qd orally for 8 days. On the 11th day of hospitalization, the patient's condition improved, and he was discharged. In this case, for patients with fever and abdominal pain, superior mesenteric venous thrombophlebitis should be included in the differential diagnosis. Through auxiliary examination, blood sample culture and other technologies, clear diagnosis should be made in time to improve patient outcomes.

As we known,serum creatinine(Scr),serum urea nitrogen(SUN) and creatinine clearance rate(Ccr),the most established marker of renal function,are affected by age,gender,muscle mass or nutritional status.Scr determines the glomerular filtration rate(GFR) improperly.Serum Cystatin C(sCys C) is freely filtered at the glomerulus and then resorbed and fully catabolised by proximal renal tubules,ma-king it an ideal marker of GFR.It is not affected by gender,muscle mass or malignancy,its production rate is usually constant and its plasma concentration therefore is dependent only on GFR.sCys C has been demonstrated to be more accurate and sensitive than Scr in the detection of early renal impairment and in specific populations may allow for early detection of renal disease.The aim is to discuss the advantages and limitations of sCys C and of established GFR methods.

Objective:To investigate the mechanism of PE_PGRS60 protein in the pathogenesis of Mycobacterium tuberculosis infection. Methods:The cloned and purified PE_PGRS60 protein from Mycobacterium tuberculosis was used to stimulate RAW264.7 cells. The expression of cyclooxygenase 2(COX2) mRNA and protein was detected by qRT-PCR and Western blot, respectively. The signal pathways that may regulate the expression of COX2 were screened, and the expression of inflammatory cytokines induced by PE_PGRS60 was detected by ELISA. The level of cell death was measured by lactate dehydrogenase(LDH) release test and flow cytometry PI staining. Western blot was used to detect the expression of COX2 in Peripheral blood mononuclear cell(PBMC) from active tuberculosis patients. Results:PE_PGRS60 protein was found to promote the expression of COX2 in RAW264.7 cells and activate the three major members of the mitogen-activated protein kinase(MAPK) family: extracellular regulated protein kinase(ERK), p38 and c-Jun N-terminal kinase(JNK). Interestingly, only JNK-IN-7, the inhibitor of JNK was observed to suppress the up-regulation expression of COX2 induced by PE_PGRS60. This up-regulated expression of COX2 was also found in PBMCs from active tuberculosis patients. The COX2 inhibitor celecoxib can effectively block the expression of the inflammatory factors IL-1β, TNF-α and IL-6 induced by PE_PGRS60 and promote macrophage death.Conclusions:PE_PGRS60 can promote macrophages to release inflammatory factors by activating JNK/COX2 signal axis. Some macrophages still die under the protection of COX2.

Background Nitrosamines (NAms) are highly carcinogenic and frequently detected in drinking water systems in China, indicating potential human health risk through drinking water. Objective To analyze the distribution of NAms in drinking water in Shanghai and to evaluate relevant human health risk. Methods A total of 94 samples of source water and 120 samples of finished water were collected in February (dry period) and August (wet period) of 2021 from 30 drinking water plants in Shanghai, and eight NAms were quantitatively analyzed by gas chromatography tandem mass spectrometry after solid phase extraction. Cancer risks for different age groups caused by NAms exposure through water were evaluated using Monte Carlo probabilistic method and carcinogens risk assessment model recommended by the United States Environmental Protection Agency. Results The concentrations of total NAms in source and finished water were 12.56-65.86 ng·L⁻¹ and 8.52-57.38 ng·L⁻¹, respectively. The average concentration of total NAms was higher in source water (33.50 ng·L⁻¹) than in finished water (22.07 ng·L⁻¹, P<0.05) during dry season, and lower in source water (16.90 ng·L⁻¹) than in finished water (21.02 ng·L⁻¹, P<0.05) during wet season. The average concentration of total NAms in source water during dry season was twice of that during wet season. The positive rate of N-nitrosodimethylamine (NDMA) was the highest (100%) among the eight NAms. The cancer risk of exposure to NAms in finished water in Shanghai was mainly from the ingestion route, which was mostly caused by NDMA. The cancer risk from exposure to NAms in water for children (median=4.32×10⁻⁵) was slightly higher than that for adults (median=3.34×10⁻⁵) and adolescents (median=2.27×10⁻⁵). The cancer risks of exposure to NAms in water for people of different ages were mainly (80% - 95%) at an acceptable level (1×10⁻⁶ - 1×10⁻⁴). Conclusion NAms contamination is positive in Shanghai’s drinking water and NDMA is the main contaminant. The removal of NAms in water by current water treatment process is season-dependent. The cancer risk of children exposed to NAms in water was slightly higher than that of adults and adolescents, but all at acceptable levels.

Objective To analyze the VP1 and VP4 genetic region of enterovirus 71 (EV71)isolated from severe cases and mild cases with hanD-foot-mouth disease (HFMD) in Shanghai in 2011.Methods Five EV71 strains isolated from severe cases and five EV71 strains from mild cases in 2011 were included.Reverse transcription-polymerase chain reaction (RT-PCR) method was used to amplify and sequence the VP1 and VP4 genes of EV71,and then the sequencing results were compared with those of A,B,C genotype reference EV71 strains from GenBank by nucleotide alignment,amino acid alignment and phylogenetic tree analyses.Results The homogeneity between EV71 strains from severe cases and mild cases was 96.0％-98.1％ and 93.7％-99.5％ for VP1 and VP4 nucleotide sequences,respectively.The VP1 nucleotide sequences of 5 strains isolated from severe cases and 5 strains from mild cases in Shanghai shared 86.9％-98.2％ and 87.4％ 98.5％ identity with genotype C,respectively,while the homogeneity of VP4 nucleotide sequence was 85.5％-100.0％and 84.5％-99.5％,respectively.In addition,compared with the Fuyang EV71 strains (representative of C4 subtype),the strains from mild and severe cases shared homogeneity of 97.0％-98.2％ and 97.9％-98.5％ for VP1 gene,respectively,96.1％-100.0％ and 97.1％-99.5％ for VP4 gene,respectively.Among 3 strains isolated from severe cases,mutations at the residue 282 in the VP1 protein (N→S) and residue 7 in the VP4 protein (T→A) were discovered simultaneously.Conclusions The 10 EV71 strains isolated from severe and mild cases in Shanghai belong to subgenogroup C4.Among 3 strains isolated from severe cases,mutations at the residue 282 in the VP1 protein (N→S) and residue 7 in the VP4 protein(T→A) are discovered simultaneously.

The data mining technology was introduced, and the law and peculiarity of TCM syndrome and treatment were analyzed in this paper. Concurrently, the application of the data mining in TCM researches on rule of syndrome and treatment was roughly summarized and its advantages and existing problems were pointed out. In order to enhance the efficiency and the appliance value of the mining technology and to accelerate the development of TCM research, the method for integrating multi-algorithms to make the mining was proposed.
Biomedical Research ; Data Mining ; methods ; Diagnosis, Differential ; Drug Therapy ; Humans ; Medicine, Chinese Traditional

Objective To analyze the screening results of yon Willebrand factor among patients before blood transfusion in Ruijin Hospital and discuss von Willebrand factor in ABO blood group and the relationship between age and gender,refine the classification of vWF antigen and activity by reference factors.Methods The von Willebrand factor among 247 cases of patients before blood transfusion in Ruijin Hospital with no clinical manifestations of abnormal blood clots and routine coagulation as laboratory tests for normal surgical patients.The vWF:Ag and vWF:Act were measured by immune turbidimetric method and ABO blood group was identified by blood type serology.Furthermore,the differences between A,B,O,AB different blood groups,sex and high (≥40 years) and low age group (＜40 years) were compared by statistical methods.Results The levels of vWF:Ag in different blood groups were as follows:A blood type:98.5-142.00,B blood type:97.90-160.30,O blood type:82.13-125.45,A B blood type:103.00-135.80.The levels of vWF:Act in different blood groups were as follows:A blood type:76-130.14,B blood type:78.06-144.3,O blood type:60.89-116.11,AB blood type:88.99-124.09.O blood type vWF:Ag and vWF:Act were lower significantly (P＜0.05) than non-O blood type,the difference was.Besides,young vWF:Ag and vWF:Act were lower significantly than in the elderly.There was no significant difference in vWF:Ag and vWF:Act levels between male and female groups.At last,the reference range of four groups of vWF activity (antigen) was obtained.Conclusion Plasma vWF antigen and activity levels were significantly affected by ABO blood type and age,and the refined reference range established for these influencing factors was beneficial for more detailed diagnosis of VWD and predicting vWF levels associated with bleeding and thrombosis risk.

Jin's three-needle technique is named after Professor JIN Rui. The connotation of Jin's three-needle technique is summarized by his followers through long-term teaching and clinical practice. His principle and method of point combination are based on syndrome differentiation of acupuncture. And his unique needling technique and treating principle of mental tranquilization also play an important role in his clinical practice.
Acupuncture Therapy ; instrumentation ; methods ; Humans ; Needles

OBJECTIVETo verify the clinical efficacy and safety of the proven Chinese Compound Changjitai (CJT), in treating the diarrheic irritable bowel syndrome (DIBS).

METHODSRandomized controlled open clinical trial design was adopted, 45 patients were randomly divided into two groups, CJT and pinaverium bromide (PVB) were given as treated and control agent respectively. IBS scoring system (BSS), defecation state questionnaire (DSQ) were used to record the changes of the patients' main symptoms before and after treatment.

RESULTSThe total effective rate of CJT group was 83.3%, while that of PVB was 73.3%. CJT was superior in efficacy to that of PVB in improving stool quality, reducing defecation episodes of diarrheic patients, alleviating tenesmus symptoms, decreasing bellyache days and ameliorating abdominal distention. Any drug-related adverse reaction was not seen.

CONCLUSIONThe efficacy of CJT in treating DIBS is definite and without any toxic and adverse effects.

Adult ; Diarrhea ; drug therapy ; etiology ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Irritable Bowel Syndrome ; complications ; drug therapy ; Male ; Middle Aged ; Morpholines ; therapeutic use ; Phytotherapy

Objective To evaluate the diagnostic value of urine Cystatin C(Cys C) for renal function impairment in neonates with hypoxic-ischemic encephalopathy(HIE).Methods The urine Cys C concentration was measured by enzyme linked immunosorbent assay(ELISA) in 47 cases of HIE newborns(25 cases were mild HIE and 22 cases were moderate-severe HIE) within 3 days after their birth.Twenty-three cases without perinatal asphyxia or other factors which could result in renal function impairment were selected as control group.Urine Cys C with urine retinal-bindingprotein(RBP),?2-microglobulin(?2-MG) and fractional sodium excretion(FENa%) were analyzed by kolmogorov-smirno in each group.Results Compared with control group,the concentration of urine Cys C,RBP and the levels of FENa% in HIE newborns were significantly elevated.The levels of urine Cys C in moderate-severe HIE newborns were significantly higher than those in mild HIE newborns(Pa