To observe the clinical effect of Yangxue Zhitong pills combined with Shuangbaisan on the treatment of children with hip synovitis in.Methods 60 children with hip synovitis from November 2013 to May 2015 were randomly divided into the observation group and the control group,30 cases in each group.The observation group were given conventional treatment and the control group was given Yangxuezhitong pills combined with Shuangbaisan.Hip VAS and blood flow index in the two groups were followed-up and compared.Results (5 days after treatment,hip VAS in the observation group(3.50±0.46),was lower than that of the control group(4.51±0.55)(P<0.05).②CRP,TNF-α,IL-6,IL-1 level in the observation group were(3.01±1.73mg/L,15.58±5.46pg/mlL,74.9±19.4pg/mL,22.57±4.01ng/L),which were lower than those in the control group(5.69±2.05mg/L,32.47±4.16pg/mL,97.6±24.2pg/mL,32.17±4.38ng/L)(P<0.05).③After treatment,total effective rate in the observation group(93.3％)was higher than that in the control group 66.7％(P<0.05).Conclusion The clinical therapeutic effect of Yangxue Zhitong pill combined with Shuangbaisan on the treatment of children with hip synovitis is exact,which is worthy of further clinical research and application.

Objective To explore the relationship of cuprotosis-related genes with survival rate and prognosis in patients with liver cancer. Methods By collecting clinical information and corresponding RNA-seq data of patients with liver cancer in the TCGA database, the differential expression levels of 10 cuprotosis-related genes in liver cancer and normal tissues was analyzed. Novel liver cancer subtypes were identified through consistent clustering, and differences in overall survival and clinicopathological factors were compared between the two subtypes. Univariate Cox regression analysis was used in screening cuprotosis genes associated with prognosis, and LASSO regression analysis was used in constructing a risk model. Results FDX1 was down-regulated, and the other nine genes were up-regulated in HCC tissues compared with normal tissues. Cluster analysis showed that the prognosis of Cluster1 was poor. Five prognostic genes (LIPT1, DLAT, MTF1, GLS, and CDKN2A) were screened out through univariate Cox regression analysis and LASSO regression analysis for risk model construction. The risk score of this prognostic model was identified as an independent prognostic factor compared with other clinical features. Conclusion Through bioinformatics analysis, a liver cancer prognosis model of five cuprotosis-related genes is constructed, which may be used as molecular markers for tumor diagnosis and are potential therapeutic targets.

Objective To analyze the variations of PTPS gene in patients with suspected 6-pyruvoyl-tetra hydropterin synthase deficiency (PTPSD) and to make prenatal diagnosis in high-risk families. Methods Chemiluminescence was used for phenylalanine detection in blood or dried blood spots.Patients with phenylalanine concentration over 120μmol/L were detected by urine pterin analysis, and the activity of dihydropteridine reductase (DHPR) was detected. tetrahydrobiopterin loading tests were performed in suspected patients with abnormal urinary pterin profiles. PTPS gene variation analysis was performed by direct Sanger sequencing based on PCR amplification. Prenatal diagnosis in 7 high-risk families was performed by chorionic villus sampling when the genotype was identified. Results In 656 patients with hyperphenylalanine, 22 cases were diagnosed as PTPSD clinically. 16 variations were detected in the 22 PTPSD cases. The 5 variations, p.Lys77Arg, p.Ile84Phe, c.315-2A>G, c.244-2A>T, c.187-1G>T, were identified as novel variations. Two fetuses carried the same mutation with the proband and therefore were thought to be PTPSD fetuses. Three fetuses carried only one mutant allele and thus were thought to be PTPSD carriers.

Objective To investigate the clinical distribution situation and drug resistance change of Klebsiella pneumoniae in the Navy General Hospital during 2011‐2015 in order to provide reference for rational use of antibacterial agents in clinic .Methods The clinically isolated Klebsiella pneumoniae in this hospital during 2011‐2015 were selected and performed the analysis on the de‐tection rate ,department distribution ,specimens source ,resistance of antibacterial drugs and change trend of resistance to carbapen‐em antibacterial drugs .Results The number the detected Klebsiella pneumoniae strains and isolation rate during 2011 -2015 showed an increasing trend year by year ,the specimens sources were mainly from 10 departments of intensive care units(ICU) ,hy‐perbaric oxygen department ,respiratory department ,radiation oncology department ,kidney disease department ,etc .;the submitted specimens were dominated by sputum and urine ,accounting for 59 .7% and 21 .4% of submitted specimens ;the drug resistance of Klebsiella pneumoniae during 2011‐2015 showed the increasing trend year by year .Klebsiella pneumoniae had higher resistance rates to piperacillin ,ampicillin ,ampicillin/sulbactam and cefuroxime and had lower resistance rate to amikacin ,imipenem ,meropen‐em and tobramycin ;the resistance rates to imipenem and meropenem were increased year by year ,and pan‐drug resistant Klebsiella pneumoniae showed a rapidly rising trend .Conclusion The drug resistance of Klebsiella pneumonia is serious ,especially carbapene‐ms‐resistant Klebsiella pneumoniae is significantly increased in the recent years ,therefore its drug resistance monitoring should be strengthened for guiding rational drug use in clinic .

Objective: To evaluate the effects of total extraperitonal herniorrhaphy on pain and effusion in patients with surgical area. Methods: The clinical data of 58 cases of inguinal hernia admitted to the First Hospital of Shanxi Medical University from January 2017 to January 2018 were retrospectively analyzed.Complete extraperitoneal inguinal oblique hernia repair was performed under laparoscopy under general anesthesia.The patients were divided into two groups by the single or double of admission date number.The observation group(A group, 32 cases) received post-operative intraoperative pressure homemade ice bags, the control group(B group, 26 patients) was placed in normal temperature saline bag after operation.The degree of pain in patients was evaluated by numerical scoring method.The time of exit, discharge, accumulation rate and recurrence rate of hernia were analyzed. Results: The differences in pain score, pain score during floor movement, and regional efflux rate between A group and B group were statistically significant[(2.11±0.97)points vs.(2.45±1.21)points, (2.63±1.89)points vs.(2.76±1.95)points, 0 case vs.2 cases, t=2.745, 4.189; χ²=1.15, all P<0.05]. The time of discharge from hospital and discharge after surgery in A group and B group were (19.16±9.22)h vs.(19.76±10.52)h, (34.85±7.43)h vs.(37.56±8.91)h, the difference was not statistically significant(t=1.790, 0.834, all P>0.05). Conclusion After laparoscopic repair of total extraperitonal herniorrhaphy, the area ice pack can achieve the purpose of relieving pain in the surgical area and reducing the accumulation of fluid in the surgical area.

Objective:To establish cell lines stably expressing Rab5a and its the inactive mutant Rab5aN133I,analyze the effect of Rab5a on the expression of cytokines in LPS-stimulated RAW264.7 cells .Methods:RAW264.7 cells were transfected with Rab5a and its inactive mutant vector Rab5a N133I separately,and then screened by G418.Rab5a stable expressing cell lines were identified by Real time-PCR.The growth of the stable cell lines was analyzed by MTT assay.After the stable cell lines were stimulated by LPS for different time periods,the expression of iNOS,TNF-αand IL-6 was detected.Results:Rab5a and Rab5aN133I transfection resulted in elevated Rab5a mRNA expression compared with the control cells ( P<0.05 ).Rab5a overexpression enhanced the proliferation of RAW264.7 cells.However,the proliferation of Rab5aN133I cells was significantly slower than the control cells ( P<0.05).Overexpression of Rab5a promoted LPS-induced production of iNOS,TNF-αand IL-6 in RAW264.7 cells (P<0.01). Conversely,overexpression of Rab5aN133I abolished the stimulating effects of Rab5a.Conclusion: Rab5a promoted LPS-induced expression of iNOS,TNF-αand IL-6 in RAW264.7 macrophages in a GTP-binding ability-dependent manner.

Objective: To study the prevalence, clinical and genetic characteristics of primary carnitine deficiency (PCD). Methods: From January 2013 to December 2017, 720 667 newborns and their mothers were tested for PCD by tandem mass spectrometry. Potential mutations of carnitine transporter gene SLC22A5 among suspected PCD patients were analyzed. Dietary guidance and L-carnitine supplementation were provided to the parents. Growth and intelligence development were surveyed during follow-up. Results: In total 21 neonates and 6 mothers were diagnosed with PCD, which yielded an incidence of 1 in 34 317. Eighteen SLC22A5 mutations were detected, which included 4 novel mutations, namely c. 1484T>C, c. 394-1G>T, c. 431T>C and c. 265-266insGGCTCGCCACC. Eighteen patients were found to carry compound heterozygous mutations and 3 have carried homozygous SLC22A5 mutations. Three mothers carried compound heterozygous mutations and 2 carried homozygous mutations. Common mutations included c. 1400C>G (42.3%), c. 760C>T (11.5%) and c. 51C>G (7.7%). During the 8 ~ 42 month follow-up, neonates with PCD showed no clinical symptoms but normal growth. Blood level of free carnitine was raised in all mothers after the treatment. Conclusion The incidence of neonatal PCD in Henan is 1 in 34 317, with the most common mutation being c. 1400C>G. Above finding has enriched the spectrum of SLC22A5 gene mutations.

OBJECTIVETo delineate the mutation spectrum of phenylalanine hydroxylase (PAH) gene among patients affected with phenylalanine hydroxylase deficiency (PAHD) in Henan Province of China, and to explore the correlation between the genotype and the phenotype.

METHODSA total of 155 affected children were recruited. Potential mutation of the PAH gene were analyzed by direct sequencing. The genotype-phenotype correlation was analyzed by matching the expected and observed phenotypes.

RESULTSOver 72 mutations and 108 genotypes have been identified. There were 7 homozygous mutations, including 1 case with EX6-96A>G/EX6-96A>G, 1 with R241C/R241C, 1 with R413P/R413P, and 4 with R243Q/R243Q. Among these, 6 patients have presented classic PKU phenotypes, except for a R241C/R241C genotype which has led to mild PKU. In 104 patients carrying compound PAH mutations, 52 were classic, 34 were mild and 39 had mild HPA. Patients who were heterozygous for EX6-96A>G/R241C, R243Q/A434D, EX6-96A>G/R413P and EX6-96A>G/ R241C were found with both the classic PKU and mild PKU phenotypes. Common mutations associated with mild HPA have included R53H, R243Q, V399V and H107R. The common mutations associated with mild PKU included R243Q, R241C, EX6-96A>G, and IVS4-1G>A. The prevalent mutations in classic PKU were R243Q, EX6-96A>G and V399V. The consistency between prediction of the biochemical genotype and observed phenotype was 77.78%, especially in classic PKU, the consistency was up to 82.14%. Significant correlations were disclosed between pretreatment levels of phenylalanine and AV sum (r=-0.6729, P < 0.01).

CONCLUSIONThe mutation spectrum of PAH gene in Henan seems to differ from that of other regions. Independent assortment of mutant alleles may result in a complex genotype-phenotype correlation, but the genotypes of PAHD patients have correlated with the phenotype.

Female ; Genotype ; Humans ; Male ; Mutation ; Phenotype ; Phenylalanine Hydroxylase ; genetics ; Phenylketonurias ; genetics

Objective To investigate the correlation between serum adropin protein and homocysteine (Hcy) level in the patients with coronary artery disease (CAD) ,and to study their relationship with CAD se-verity .Methods One hundred and seventy cases of CAD in this hospital from August 2015 to October 2016 were selected as the research subjects .Peripheral blood was collected for measuring serum adropin protein , Hcy and other conventional biochemical indicators ,and the coronary artery lesion was detected by coronary an-giography ,the severity of coronary artery lesion was assessed by SYNTAX score .Results In 170 cases of CAD ,mean serum Hcy level was (15 .92 ± 8 .31)μmol/L ,the adropin protein level in the hyperhomocysteine-mia group was lower than that in the non-hyperhomocysteinemia group ,the difference was statistically signifi-cant(P<0 .05) .Mean SYNTAX score in all cases was (21 .51 ± 11 .20) points ,and serum adropin protein was negatively correlated with Hcy level (r= -0 .169 ,P= 0 .028) ,serum Hcy level had no obvious correlation with SYNTAX score (r= 0 .124 ,P=0 .108) ,the adropin protein level was negatively correlated with SYN-TAX score (r= -0 .181 ,P=0 .018) .Generalized structural equation model showed that with the decrease of adropin protein level ,the SYNTAX score was increased (P=0 .019) ,compared with the patients without com-plicating hyperhomocysteinemia ,the SYNTAX score in the patients with hyperhomocysteinemia was much higher(P=0 .005) .Conclusion The lower the adropin protein level ,the higher the Hcy level and the severe the coronary artery lesion .

Objective To compare and explore the differences of clinical characteristics between human adenovirus type 7 (HAdV7) and type 55 (HAdV55) infections in adults,and to provide evidences for clinical management.Methods The data of clinical manifestations,laboratory examinations,chest computed tomography and prognosis of 214 cases with HAdV7 and 235 cases with HAdV55 infections from 2012 to 2018 were retrospectively collected and analyzed.The chi-square test was used for the categorical variables,and the rank sum test was used for the continuous variables of non-normal distribution.Results Compared with patients in HAdV55,those in HAdV7 group displayed more diarrhea (12.1％ [26/214] vs 2.6％ [6/235],x2 =15.583),more laryngeal lymphatic follicles (33.2％ [71/214] vs 17.9％ [42/235],x2 =23.566),more tonsil enlargement (56.5％ [121/214] vs 20.0％ [47/235],x2 =63.870) with secretions (33.2％ [71/214] vs 11.5％ [27/235],x2 =30.878),more leukocytosis (24.8％ [53/214] vs 14.0％ [33/235],x2 =8.318),more monocytosis (78.0％ [167/214] vs 52.8％ [124/235],x2 =31.364),more thrombocytosis (7.1％ [15/212] vs 3.8％ [9/235],x2 =5.835),more elevated level of C-reactive protein (80.8％ [97/120] vs 64.3％ [137/213],x2 =10.020),more abnormalities of liver function (alamne aminotransferase [ALT]:13.5％ [28/207] vs 5.6％ [13/232],x2 =8.111) and myocardial enzymes (creatine kinase [CK]:37.6％ [77/205] vs 26.4％ [61/231],x2 =6.246),creatine kinase isoenzymes ([CK-MB]:35.6％ [73/205] vs 11.1％ [24/216],x2 =35.600),and all the differences were statistically significant (all P ＜ 0.05,0.01).Compared with patients in HAdV7 group,those in HAdV55 group displayed longer duration of diseases (7 [5]days vs 6[5] days,Z=-2.632),more sore throat (72.8％ [171/235] vs 62.1％ [133/214],x2 =0.016),more headache (62.1％ [146/235] vs 16.4％ [35/214],x2 =97.527),more pharyngeal congestion (93.6％ [220/235]vs 74.8％ [160/214],x2 =30.602),more leukopenia (14.0％ [33/235] vs 24.8％ [53/214],x2 =8.318),and more elevated level of lactate dehydrogenase (12.6％ [29/230] vs 6.3％ [13/205],x2 =4.881),more pneumonia (71.5％ [168/235] vs31.8％ [68/214],x2 =70.846) (all P＜0.05,0.01).Conclusions The clinical characteristics of HAdV7 and HAdV55 infections in adults are different.The type 55 infection is more likely to develop to pneumonia,while the type 7 infection has wider tissue tropism.