0.05),but the clinical cure rate in group A was higher than that in group B(P0.05),but the clinical cure and markedly effective rate in group A was higher than that in group B(P0.05),but decreased in group A(P0.05).Conclusion Liver-soothing and spleen-strengthening therapy can improve the gastric emptying and regulate plasma VIP content in patients with dysmotility-like functional dyspepsia(D-FD).

BACKGROUND:Previous studies have confirmed the presence of bis-(3'-5')-cyclic dimeric guanosine
monophosphate signaling pathway in Streptococcus mutans, which construct the streptococcus mutans gcp gene knockout strains.
OBJECTIVE:To compare the gene expression differences between Streptococcus mutans wild strains and gcp mutant strains, and to screen the biofilm-related genes from them for the fol ow-up study.
METHODS:The total RNA of two kinds of strains were extracted and stained with cy3 and cy5 respectively after reverse transcription. The gene chip was scanned after hybridization and the differential gene were obtained
through the data analysis. The different expression genes were verified by real-time PCR.
RESULTS AND CONCLUSION:Differential genes were mainly relative about glucose metabolism and biofilm formation. We selected two genes for real-time PCR verification. The PCR results were consistent with the
microarray results. After Streptococcus mutans gcp gene knockout, the gene expressions of gcp mutant strains were upregulated and the gene expressions of phosphotransferase system were downregulated, this result
suggested that two different genes were related with the c-di-GMP signal pathway downstream.

Objective To explore the change of serum high-sensitivity cardiac troponin T(hs-cTnT),myoglobin(MYO),creatine kinase isoenzyme(CK-MB)mass(CK-MB mass)and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels in the patients with renal dysfunction.Methods The inpatients with renal dysfunction(excluding cardiac and skeletal muscle diseases)in our hos-pital were collected and divided into the compensation period group(30 cases),decompensation period group(24 cases)and uremia group(22 cases)according to serum urea and creatine concentration,and 36 healthy individuals were selected as the control group. Venous blood was collected on an empty stomach and separated for obtaining serum.Serum levels of hs-cTnT,MYO,CK-MB mass and NT-proBNP were measured by the electrochemiluminescent immunoassay.Results Serum hs-cTnT levels in the compensation period group,decompensation period group,uremia group and the control group were 16.4(10.9-24.2),17.0(13.0-25.5),25.9 (16.5-33.8),13.7(9.4 -19.7 )pg/mL respectively.Serum MYO levels were 52.4 (40.0 -96.5 ),87.9 (57.7 -118.3 ),115.7 (94.2-175.8),34.8(24.3-48.1)ng/mL,respectively.Serum CK-MB mass levels were 1.03(0.82 -1.75),1.31 (1.08 -1.69), 1.66(1.01-2.46),1.88(1.63-2.43)ng/mL,respectively.Serum NT-proBNP levels were 292.5(123.3-576.2),363.3(192.3-893.3),1 357.2(536.5 -4 662.9),110.3 (70.1 -196.3)ng/mL,respectively.The serum hs-cTnT,MYO and NT-proBNP levels were increased with renal function decrease.The nonparametric Kruskal-Wallis H test showed statistically significant difference a-mong groups(H =14.46,49.81 and 35.00,P <0.05 ).The CK-MB mass level had no statistically significant difference among groups(P >0.05).Conclusion The patients with renal dysfunction have the higher risk rate for complicating the cardiovascular e-vents.Early detection of cardiac markers conduces to the diagnosis of myocardial injury,the evaluation of the risk rate of myocardial infarction occurrence in future and the diagnosis of heart failure and evaluation of the risk rate of heart failure occurrence in future.

OBJECTIVETo analyze the clinical phenotype of a Chinese pedigree affected with hereditary dentinogenesis imperfecta and mutation of dentin sialophosphoprotein (DSPP) gene.

METHODSAffected members underwent intraoral photography, dental film and panoramic radiography. Genomic DNA was extracted from peripheral venous blood samples. Coding regions of the DSPP gene were subjected to PCR amplification and Sanger sequencing. Functional effect of the mutation was predicted with SIFT and PolyPhen-2. The tertiary structure of wild type and mutant proteins were predicted by Swiss-Port.

RESULTSA heterozygous c.50C to T (p.P17L) mutation was identified in exon 2 of the DSPP gene in the proband and her father. The same mutation was not found among 200 unrelated healthy controls. The Pro-17 residues and its surrounding positions in DSPP are highly conserved across various species. The mutation was predicted to be damaging to the structure of DSPP protein.

CONCLUSIONThe c.50C to T (p.P17L) mutation of the DSPP gene probably underlies the disease in this pedigree. Above finding has expanded the spectrum of DSPP gene mutations and provided a basis for genetic counseling and prenatal diagnosis for this family.

Objective The aim of this study was to evaluate the long-term efficacy and safety of tocilizumab (TCZ) in Chinese patients with Takayasu's arteritis (TA).Methods We retrospectively studied the active TA patients treated with TCZ from January 2014 to April 2016 in our hospital.The demographic and clinical data,laboratory tests and vascular images were collected.Doppler ultrasonography was used to track vascular changes during TCZ treatment.The data were analyzed by t test and rank sum test.The data were analyzed by Fisher exact test or Chi square test.Results Eighteen patients with a median age of 25.5 (range 18,47) were analyzed.Seventeen patients had taken a median of 3 (range 1,5) immune suppressants before TCZ therapy.Three patients withdrew TCZ after receiving 1 infusion each due to unbearable neck pain.The other 15 patients were treated with TCZ for a median of 13 (range 6,26) months.After TCZ treatment,the median ESR level,hsCRP level,mural thickness of common carotid artery and subclavical artery decreased from 45.5 (range 7-101) mm/1 h (Z=6.731,P＜0.01),37.40 (range 7.6-163.12) mg/L,0.25 (range 0.06-0.59) cm,0.18 (range 0.07-0.47) cm to 7 (range 1-44) mm/l h (Z=6.731,P＜0.01),0.94 (range 0.08-93.21) mg/L (Z=3.212,P=0.016),0.18 (range 0.04-0.53) cm (Z=4.873,P=0.001),and 0.12 (range 0.07-0.18) cm (Z=5.568,P＜ 0.01) respectively,with median glucocorticoid dosage being successfully tapered.One patient discontinued TCZ for unsatisfactory response after 6 TCZ infusions.One episode of urinary infection was recorded and relieved after antibiotic therapy.Neither neutropenia nor abnormal liver enzyme was observed.Conclusion Our study suggests that tocilizumab is a safe and effective agent for long term use among Chinese TA patients,especially for those refractory cases.

Model informed precision dosing (MIPD) is a new concept to guide precision dosing for individual patient by modeling and simulation based on the available information about the individual patient, medications and the disease. Compared to the empirical dosing, MIPD could improve the efficacy, safety, economics and adherence of the pharmacotherapy according to the individual's pathophysiology, genotyping and disease progression. This consensus report provides a brief account of the concept, methodology and implementation of MIPD as well as clinical decision supporting systems for MIPD. The status and future advancing of MIPD was also discussed to facilitate the appropriate application and development of MIPD in China.

OBJECTIVES: Contrast-induced acute kidney injury (CI-AKI) is the third cause of hospital-acquired AKI, and existing clinical prevention and treatment measures such as hydration therapy and/or administration of antioxidants N-acetylcysteine treatment and other treatments still show little effect on the prevention and treatment of CI-AKI. This study aims to explore the effect of Danhong injection on prevention of CI-AKI. METHODS: A total of 12 867 patients, who received coronary angiography, percutaneous coronary intervention, enhanced CT or vascular intervention in a tertiary hospital, were enrolled for this study. Among them, 423 in the treatment group received intravenous drip of Danhong injection, and 12 444 in the control group received routine medicine. Propensity score matching was conducted to balance confounding factors between the 2 groups and then the prevention effect of Danhong injection on CI-AKI was compared between them. RESULTS: A total of 423 pairs of patients were matched successfully. The incidence of CI-AKI in the non-Danhong control group was higher than that in the Danhong treatment group (5.7% vs 2.4%). The difference between the 2 groups was statistically significant ( CONCLUSIONS The results of this study support the use of Danhong injection in the prevention of the Stage 1 of CI-AKI.
Acute Kidney Injury/prevention & control* ; Contrast Media/adverse effects* ; Drugs, Chinese Herbal ; Humans ; Injections ; Percutaneous Coronary Intervention ; Propensity Score ; Risk Factors ; Treatment Outcome

Polymyxin B, which is a last-line antibiotic for extensively drug-resistant Gram-negative bacterial infections, became available in China in Dec. 2017. As dose adjustments are based solely on clinical experience of risk toxicity, treatment failure, and emergence of resistance, there is an urgent clinical need to perform therapeutic drug monitoring (TDM) to optimize the use of polymyxin B. It is thus necessary to standardize operating procedures to ensure the accuracy of TDM and provide evidence for their rational use. We report a consensus on TDM guidelines for polymyxin B, as endorsed by the Infection and Chemotherapy Committee of the Shanghai Medical Association and the Therapeutic Drug Monitoring Committee of the Chinese Pharmacological Society. The consensus panel was composed of clinicians, pharmacists, and microbiologists from different provinces in China and Australia who made recommendations regarding target concentrations, sample collection, reporting, and explanation of TDM results. The guidelines provide the first-ever consensus on conducting TDM of polymyxin B, and are intended to guide optimal clinical use.
Humans ; Anti-Bacterial Agents/therapeutic use* ; China ; Drug Monitoring/methods* ; Polymyxin B ; Practice Guidelines as Topic