Objective:To evaluate the effectiveness and safety of most common used regimens against brucellosis.Methods: Search PubMed and CENTRAL database of Cochrane library for all literatures written in English about treatment of brucellosis and CBM database for all RCTs for Brucellosis in Chinese from the year 1985 till now.Assess the quality of the included literatures using Cochrane Collaboration Risk of Bias form.Combine data of relapse,total therapeutic failure,and adverse reaction of regimens for treating human brucellosis.Results: 17 literatures were included.Combined antibiotic therapeutic regimens such as DR,DS,QR and DG were compared.Rate of total therapeutic failure(RRcb:2.53,95%CI:1.51-4.23) and relapse(RRcb:2.69,95%CI:1.46-4.98) of DS regimen was lower than those of DR regimen,while adverse reaction did not show any significant differences between them(RRcb:1.40,95%CI:0.97-2.01).No significant differences were seen in rate of relapse(RRcb:1.24,95%CI:0.67-2.30) and total therapeutic failure(RRcb:1.41,95%CI:0.86-2.32) between QR and DR regimen.QR regimen had lower rate of adverse reaction than DR regimen(RRcb:1.79,95%CI:1.17-2.74).Conclusion: DS regimen priors to DR regimen.QR equals DR in treatment outcome,has fewer adverse reactions meanwhile.Triple antimicrobial based on double regimens seemed to provide better outcomes without a significant increase in adverse reaction,but more clinical evidences are still needed.

Objective:To investigate the expression pattern of 14 innate immunity related microRNAs ( miRNAs) in brucellosis patients.Methods:By using Real time PCR assay, expression levels of 14 miRNAs in serum samples from brucellosis patients and healthy volunteers were analyzed.Results: Of the 14 miRNAs tested, 13 showed decreased expression in brucellosis patients.And significant Ct differences over one were observed for nine of the miRNAs.In them,five miRNAs,including miR-122,miR-145a,miR-155,miR-301a and miR-146a levels significantly decreased in brucellosis patients (P<0.01).Conclusion:Decreased serum levels of miR-122,miR-145a,miR-155,miR-301a and miR-146a are confirmed and may serve as novel biomarkers for human brucellosis diagno-sis.

Objective:To investigate the expression pattern of microRNA-146a in Brucella patients and its correlation with antibody titers.Methods: By using real time PCR assay, expression levels of microRNA-146a in sera samples from 20 brucellosis patients and 20 healthy volunteers were analyzed.The correlation between expression level of microRNA-146a and serum antibody titers were analyzed with SPSS17.0.Results: A quantification curve of microRNA-146a was constructed with synthesized standard.Expression levels of microRNA-146a among brucellosis patients were significantly lower than those in 20 healthy volunteers (P<0.001).For brucellosis patients,the expression level of microRNA-146a was negatively related with antibody titers (P<0.05). Conclusion:Expression of miRNA-146a in brucellosis patients was significantly inhibited and negatively related with antibody titer.

Objective:To investigate the effects of Liuweidihuang pill on the insulin levels in sera and pancreatic islets from spontaneous mouse models of human type 2 diabetes administrated with different doses .Methods:The 6-8 week-old KK-Ay mice were randomly divided into three groups including no drug control group ,low-dose group and high-dose group,in addition C57BL/6J mice were used as a genetic control group .All the animals were given with different dose Liuweidihuang pill solutions or sterile distilled water by intragastrical administration for fifteen weeks .The fasting blood glucose ,body mass and food consumption were measured weekly .The serum insulin levels were surveyed by ELISA .And the insulin levels in the pancreas islets were detected by immunofluorescence and immunohistochemistry .Results:Decreased fasting blood glucose ,controlled body mass and food consumption ,and lower levels of insulin in the sera and pancreas islets were confirmed from the KK-Ay mice administered with Liuweidihuang pill .Furthermore,the low dose program exhibits a stronger effect .Conclusion:Liuweidihuang pill has exhibited relatively therapeutic effects in the spontaneous type 2 diabetes mice including controls of hyperglycemia and body mass and relieving insulin resistance .In addition , the low-dose regimen showed even better treatment in controlling insulin levels in the sera and pancreas islets .

Objective To find the effective quantitative parameters for the differentiation of the breast lesions using the post-processing of time.signal curve of 3D dynamic-enhanced MRI.Methods Thirty patients with 35 lesions underwent 3D dynamic-enhanced MRI and the time-signal cHIve was deduced.The four quantitative parameters including SImax,PH,Slope and SlopeR were analyzed in benign andmalignant lesions of the breast.Independent samples t test and rank sum test were used for the statistics.Results Seyenteen benign lesions and 18 malignant lesions were included in this study.The SImax(M)of benign and malignant lesions were 375.2 and 158.1,the 95% confidence intervals of SImax were 278.2-506.0 and 160.5-374.8.The PH(M)of benign and malignant lesions were 114.4 and 87.8,the 95% confidence intervals of PH were 73.7-196.5 and 71.3-162.9.The Slope(M) of benign and malignant lesions were 22.3×10-3 and 44.0×10-3,the 95% confidence intervals of Slope were 13.7×10-3-41.1×10-3 and 46.1×10-3-81.8×10-3.The Slope"(M) of benign and malignant lesions were 2.6 and11.4,the 95% confidence intervals of SlopeR were 1.9-3.4 and 9.8-14.5.There were no significant differences on SImax and PH between benign and malignant lesions(P>0.05).The significant differences existed on Slope(P<0.01)and SlopeR(P<0.01)between benign and malignant lesions of the breast.Conclusion SlopeR is a very effective parameter in t}le differential diagnosis of breast lesions.

OBJECTIVETo analyze the serological features and related blood group genes of a donor with A subtype of the ABO blood type.

METHODSThe ABO blood group of the sample was determined, in addition with the activity of blood group glycosyltransferase and blood group secretory substances. Sanger sequencing was adopted to analyze the genotype of the blood group.

RESULTSThe proband was identified as A subtype (non-secretory type), with no detectable activities of a 1, 3-N-acetylgalactosyltransferase. DNA sequencing has identified a number of mutations including nt.261del/G and 297A/A of exon 6, and nt.467C/T, 806T/C and 1009A/G of exon 7. Clone sequencing has confirmed that the nt.806T>C exists at one allele and was a novel mutation. The proband genotype was A205/Onew (806T>C). The nt.806T>C of the exon 7 was confirmed to be a novel mutation, which was given a GenBank accession number KP341759. Family study showed that the genotype of the proband's father was Onew (806T>C)/O02, and that of his mother was A101/A205. The novel mutation of the proband has derived from his father.

CONCLUSIONThe reduced A antigenicity of the sample was due to the A205 subtype allele and the presence of a novel O allele.

ABO Blood-Group System ; genetics ; Adult ; Base Sequence ; Blood Grouping and Crossmatching ; Exons ; Female ; Genotype ; Humans ; Male ; Molecular Sequence Data ; Mutation ; N-Acetylgalactosaminyltransferases ; genetics ; metabolism

Nearly a decade of curriculum update in American medical colleges and universities are summarized in this paper. This paper introduces the situation of sampling survey of colleges and universities. The results show the diversity of medical curriculum integration, reflecting the concept of multi-disciplinary integration of basic disciplines, clinical disciplines and public health and social sciences, and giving experiences such as early clinical practice, providing personalized talent cultivation approaches, and designing competency-oriented curriculum system. Combined with the current situation of medical education curriculum reform in China, it's suggested to explore the construction of medical curriculum system with Chinese characteristics, so as to contribute to the cultivation of excellent physicians for implementing Healthy China Initiative.

Objective:To observe the efficacy and safety of urokinase arterial thrombolysis in the treatment of central retinal artery occlusion (CRAO) at different time window.Methods:A retrospective study. From January 2014 to November 2019, 157 eyes (157 CRAO patients) in the Xi’an People's Hospital (Xi’an Fourth Hospital) were included in the study. There were 120 males and 37 females, with the average age of 54.87±12.12 years. The mean onset time was 65.66±67.44 h. All patients were tested with BCVA using international standard visual acuity chart, and the results were converted into logMAR visual acuity record. The arm-retinal circulation time (A-Rct) and the filling time (FT) of retinal arterial trunk-terminal filling time were measured by FFA. The mean logMAR BCVA was 2.44±0.46, the mean A-Rct and FT were 27.72±9.78 and 13.58±14.92 s respectively. According to the time window, the patients were divided into the onset 3-72 h group and the onset 73-240 h group, which were 115 patients and 42 patients respectively. There were no statistically significant difference between the 3-72 h group and the 73-240 h group in age, A-Rct and LogMR BCVA before treatment ( χ2=-0.197, -1.242, -8.990; P=0.844, 0.369, 0.369); the difference was statistically significant in FT comparison ( χ2=-3.652, P=0.000). Urokinase artery thrombolytic therapy was performed at different time window of 3-24 h, 25-72 h, 73-96 h, 97-120 h, 121-240 h after the onset of onset. Age and A-Rct of patients with different treatment time windows were compared, and the differences were not statistically significant ( χ2=6.588, 6.679; P=0.253, 0.246).In comparison of FT and logMAR BCVA, the difference was statistically significant ( χ2 =30.150, 71.378; P=0.000, 0.000). FFA was rechecked 24 hours after treatment, BCVA was rechecked 30 days after treatment. The changes of A-Rct, FT and BCVA before and after treatment were compared and analyzed. The occurrence of adverse reactions during and after treatment were observed. The two groups of measurement data were compared. The t test was used for those with normal distribution and χ2 test was used for those with non-normal distribution. Spearman correlation analysis was used to analyze the correlation between onset time and the difference of A-Rct, FT shortening time and logMAR BCVA after treatment. Results:At 24 h after CRAO treatment, A-Rct and FT of 157 cases were 19.64±6.50 and 6.48±7.36 s respectively, which were significantly shorter than those before treatment, and the differences were statistically significant ( χ2=-16.236, -14.703; P=0.000, 0.000). The logMAR BCVA at 30 d after treatment was 1.72±0.76, which was significantly higher than that before treatment. The difference was statistically significant ( χ2=-14.460, P=0.000). After CRAO urokinase arterial thrombolysis at different time window, there were statistically significant differences in A-Rct shortening time, FT shortening time, and logMAR BCVA difference ( χ2=12.408, 24.200, 104.388; P=0.030, 0.000, 0.000). There was no statistically significant difference between the 3-72 h group and the 73-240 h group ( χ2 =-1.042, P=0.297) in shortening time of A-Rct after treatment. The difference of FT shortening time was statistically significant ( χ2=-3.581, P=0.000). The difference of logMAR BCVA was statistically significant ( χ2=-9.905, P=0.000). The results of Spearman correlation analysis showed that there was no correlation between the onset time and the shortening time of A-Rct and FT after treatment ( rp=-0.040, -0.081; P=0.436, 0.115), and negative correlation with the logMAR BCVA difference ( rp=-0.486, P=0.000). One case of intracranial hemorrhage occurred after treatment, and it improved after dehydration to reduce cerebral edema, scavenging free radicals and brain protection. Conclusions:Urokinase arterial thrombolytic therapy is effective for CRAO within time window of 3-240 h, A-Rct, FT and LogMRA BCVA are all improved. However, with the prolongation of thrombolytic therapy time window, the therapeutic effect of urokinase arterial thrombolytic therapy is decreased. The therapeutic effect of Urokinase arterial thrombolytic therapy was better within 72 h.

Aristolochic acid (AA), extracted from Aristolochiaceae plants, plays an essential role in traditional herbal medicines and is used for different diseases. However, AA has been found to be nephrotoxic and is known to cause aristolochic acid nephropathy (AAN).AA-induced acute kidney injury (AKI) is a syndrome in AAN with a high morbidity that manifests mitochondrial damage as a key part of its pathological progression. Melatonin primarily serves as a mitochondria-targeted antioxidant. However, its mitochondrial protective role in AA-induced AKI is barely reported. In this study, mice were administrated 2.5 mg/kg AA to induce AKI. Melatonin reduced the increase in Upro and Scr and attenuated the necrosis and atrophy of renal proximal tubules in mice exposed to AA. Melatonin suppressed ROS generation, MDA levels and iNOS expression and increased SOD activities in vivo and in vitro. Intriguingly, the in vivo study revealed that melatonin decreased mitochondrial fragmentation in renal proximal tubular cells and increased ATP levels in kidney tissues in response to AA. In vitro, melatonin restored the mitochondrial membrane potential (MMP) in NRK-52E and HK-2 cells and led to an elevation in ATP levels. Confocal immunofluorescence data showed that puncta containing Mito-tracker and GFP-LC3A/B were reduced, thereby impeding the mitophagy of tubular epithelial cells. Furthermore, melatonin decreased LC3A/B-II expression and increased p62 expression. The apoptosis of tubular epithelial cells induced by AA was decreased. Therefore, our findings revealed that melatonin could prevent AA-induced AKI by attenuating mitochondrial damage, which may provide a potential therapeutic method for renal AA toxicity.