Objective To study the therapeutic effect of Danshen injection combined with conventional therapy on children with recurrent asthmatic bronchitis. Methods A prospective study was conducted. Fifty-five children with asthmatic bronchitis admitted in People's Hospital of Henan Province from January 2012 to July 2014 were enrolled and randomly divided into a integrative Chinese and western medicine group(30 cases)and a conventional therapy group(25 cases);in the same period,18 healthy children having passed physical examinations were chosen as the healthy control group. In the conventional therapy group,rest,oxygen inspiration,anti-infection, fluid supplement and aerosol inhalation,etc. were given,while in the integrative Chinese and western medicine group,based on the similar conventional therapies,additionally Danshen injection 0.4 mL · kg-1 · d-1 was given,once per day for a total of 14 days. The wheezing remission time and the pulmonary rale extinction time were observed in the two patient groups,and the fractional exhaled nitric oxide(FeNO)content was investigated in the three groups. Results The wheezing remission time and the pulmonary rale extinction time of the integrative Chinese and western medicine group were obviously shortened compared with those in the conventional therapy group〔the wheezing remission time(days):2.3±0.8 vs. 5.2±1.1,the pulmonary rale extinction time(days):6.8±1.5 vs. 8.4±1.1,both P<0.01〕. The contents of FeNO in the integrative Chinese and western medicine group and the conventional therapy group before treatment were significantly higher than those in the healthy control group(×10-9:30.3±9.5,30.4±8.2 vs. 13.6±3.4,both P<0.01),but after treatment the FeNO levels of both patient groups were markedly lowered,and the degree of change in integrative Chinese and western medicine group was more significant(×10-9:18.6±4.7 vs. 24.0±6.8,P<0.01). Conclusion Danshen injection combined with conventional therapy can obviously down-regulate the FeNO content,alleviate the airway inflammation,effectively relieve the children recurrence of asthmatic bronchitis.

Type 2 diabetes mellitus (T2DM) is a common chronic metabolic disorder,it results from an interaction of environmental as well as genetic factors.There were several kinds of oral antidiabetic drugs (OADs),including biguanides,sulfonylureas,thiazolidinediones,and meglitinides,etc.Several genes have been identified to be associated with disease development and therapeutic outcomes.Inter-individual variations in the human genome affect both,risk of T2DM development and personalized response to identical drug therapies.Pharmacogenomics approaches focus on single nucleotide polymorphisms and their influence on individual drug response,efficacy and toxicity.Therefore,pharmacogenomics in T2DM is of great importance towards precision medicine which will greatly improve the efficacy of diabetes treatment.In this paper,antidiabetic drugs and related gene polymorphism researches are reviewed.

Objective To identify and rename one strain stored in National Center for Medicine Culture Collections ( CMCC) and used for tracheitis vaccine production. Methods The test strain CMCC (B)29108 and the type strain DSM30007T were cultured on NA medium. Characteristics in morphology, physiology, biochemistry and fatty acid profile were compared between the two strains. Phylogenetic analysis was based on 16S rRNA and rpoB gene sequences, together with the DNA-DNA hybridization assay. Results A Comparative analysis of a partial sequence of the 16S rRNA gene sequence revealed that the CMCC( B) 29108 strain was closed to the Acinetobacter species and showed the highest similarity with the type strain Acinetobacter baumannii DSM30007T. Moreover, the CMCC(B)29108 strain was highly similar to type strain DSM30007T in morphology, physiology, biochemistry and fatty acid profile. On the phylogenetic tree based on 16S rRNA and rpoB gene of all Acinetobacter members, the CMCC(B)29108 strain steadily clustered into one independent branch only with the DSM30007 T strain with a DNA-DNA hybridization value of 100%. Conclusion The CMCC(B)29108 strain that is one of the strains used for the production of tracheitis vac-cine should be assigned to the species of Acinetobacter baumannii based on its phenotypic, phylogenetic and chemotaxonomic characteristics.

Objective To explore the impact of broad antigen HLA-Bw4 on disease progression in HIV-1 infected subjects. Methods Three hundred and forty subjects chronically infected with HIV-1 and 69 HIV-1 negative subjects were recruited and HLA-B alleles were typed with sequence-based high resolution typing assay. HLA-Bw genotypes of these HIV-1 infected subjects were determined and their association with CD4+ T cell counts and viral loads were analyzed. Results Sixty-five HLA-B alleles were detected in HIV-1 positive subjects. Subjects with Bw4 (Bw4 homozygotes and Bw4Bw6 heterozygotes ) had higher CD4+ T cell counts ( P = 0. 004 ) and lower plasma viral load ( P = 0.003 ) than subjects without Bw4 ( Bw6 homozygotes). When compared with HIV-1 postive subjects with CD4+ T cell counts above 500 celis/μl, those with CD4+ T cell counts below 500 cells/μl were observed with decreased percentage of Bw4Bw6 heterozygote ( P =0.0002) and increased percentage of Bw6 homozygotes ( P < 0. 0001 ). There is no significant difference in CD4+ T cell counts between Bw4 homozygotes and Bw4Bw6 heterozygote, but lower viral loads were observed in Bw4Bw6 heterozygotes( P = 0. 037 ). Conclusion HLA-Bw4 can confer pretective effects on H1V-1 infected subjects by maintaining higher CD4+ T cell counts and lower viral load, the mechanism behind this effect need further exploration.

AIM: To study the effects of ultraviolet (UV) on mitochondrial functions and apoptosis in HaCaT cells.METHODS: After irradiation by UV at low dose(UVA 2 J/cm~2,UVB 10 mJ/cm~2) and high dose(UVA 6 J/cm~2,UVB(30 mJ/cm~2),) HaCaT cells were cultured for 15 hours.Flow cytometry was used to measure mitochondrial membrane potential,mitochondrial mass and apoptotic rate.Annexin V-FITC/PI staining of apoptotic cells was analyzed by laser confocal microscopy.RESULTS: After UV irradiation,cell proportion with low mitochondrial membrane potential increased with irradiation doses.The proportion of control group,low dose group and high dose group were 7.94%?1.02%,25.87%?4.55% and 39.27%?5.32%,respectively.Cells proportion with low mitochondrial mass increased with irradiation doses.The proportion of control group,low dose group and high dose group were 15.19%?1.58%,40.36%?4.41% and 68.79%?5.46%,respectively.The hypodiploid peaks of DNA content analysis represented the apoptotic rate of HaCaT cells.The apoptotic rate of control group,low dose group and high dose group were 1.82%?0.51%,30.16%?5.47% and 58.49%?5.98%,respectively.To analyze the cells apoptosis by staining with annexin V-FITC and PI,the results were consistent with those of DNA content analysis.Cells in control group showed almost no positive staining cells.Single annexin V-FITC positive cells in low dose group and double positive cells in high dose group were predominant,respectively.CONCLUSION: UV irradiation induces HaCaT cell mitochondrial depolarization,as well as mitochondrial mass loss.These changes are related to cell apoptosis.

Objective　To understand the impact of early and timely treatment and initial antiviral treatment regimen on mortality and attrition of antiretroviral therapy. Methods A retrospective cohort study was conducted using download data on antiretroviral therapy for HIV-infected patients in Liuzhou City, Guangxi Province, from the database of the Basic Information System for AIDS Control and Prevention (BISAC) from 2010 to 2020. The Cox proportional risk regression model was used to analyze the influencing factors of mortality and attrition. Results A total of 15 713 infected patients were included, including 53.4% aged 18-<50 years, 69.4% male, 61.0% farmer, 75.1% CD4 count <350 cells /μL before initial antiviral treatment, the overall mortality rate was 4.30/100 person-years, and the overall attrition was 2.42/100 person-years. The results of Cox regression analysis showed that the influencing factors of mortality were pretreatment CD4 counts of 350-<500 cells/μL(AHR=0.72, 95%CI: 0.63-0.81) and ≥500 cells/μL (AHR= 0.64, 95%CI: 0.55-0.76); duration from diagnosis to initial antiviral treatment 91-180 days (AHR=1.25, 95%CI: 1.08-1.45), 181-365 days (AHR=1.26, 95%CI: 1.08-1.47), and ≥365 days (AHR=1.26, 95%CI: 1.11-1.44); initial antiviral treatment regimens of D4T+3TC+EFV/NVP (AHR=1.47, 95%CI: 1.32-1.63) and AZT/D4T/TDF+3TC+LPV/r (AHR=1.73, 95%CI: 1.50-1.99). Factors affecting attrition were pretreatment CD4 counts of 350-499 cells/μL (AHR=1.32, 95%CI: 1.16-1.50) and ≥500 cells/μL (AHR=1.28, 95%CI: 1.10-1.50); interval from HIV positivity confirmation to initial dosing ≥365 days (AHR=1.21, 95%CI: 1.04-1.40), initial antiviral treatment regimens of TDF+3TC+NVP (AHR=1.32, 95%CI: 1.13-1.55), AZT+3TC+EFV/NVP (AHR=1.43, 95%CI: 1.26-1.62) and AZT/D4T/TDF+3TC+LPV/r (AHR=1.33, 95CI%: 1.06-1.67). Conclusions　Early and timely treatment and the initial antiviral treatment regimen of TDF+3TC+EFV have good efficacy, but attention should be paid to the high risk of attrition of HIV-infected people with high CD4 count before treatment.

Objective:To investigate the consistency of reports of adverse reactions to chemotherapy in patients with stomach neoplasms, main caregivers and nursing records.Methods:By convenient sampling method, a total of 102 pairs of patients who underwent radical gastrectomy and received chemotherapy in the First Affiliated Hospital of Zhengzhou University from June 2018 to June 2019 and their main caregivers were selected. After the second and fourth cycles of chemotherapy, the incidence of adverse reactions to chemotherapy in patients was collected from records patients themselves, main caregivers and nursing staff, and the severity of adverse reactions was assessed using the Chinese version of M.D. Anderson Symptom Inventory (MDASI) . At the same time, Kappa test was used to analyze the consistency of reports of patients, their main caregivers and nursing staff to the 13 adverse reactions of chemotherapy in the scale.Results:After the second chemotherapy cycle, except for the two adverse reactions of fatigue and distress, the severity of other adverse reactions reported by the patients was not statistically significantly different compared with the records of the main caregivers and nursing staff ( P>0.05) . The incidence of fatigue, distress, sleep disturbance, nausea and dry mouth reported by the patients was higher than that recorded by the primary caregivers and nursing staff, and the differences were statistically significant ( P<0.05) . The patients showed good consistency with main caregivers in 10 aspects such as appetite loss, shortness of breath, sleep disturbance, vomiting, pain, nausea, dry mouth, drowsiness, forgetfulness and numbness ( P<0.05) . The patients showed good consistency with the nursing staff in 9 aspects such as appetite loss, shortness of breath, vomiting, pain, nausea, dry mouth, lethargy, forgetfulness and numbness ( P<0.05) . The main caregivers showed good consistency with the nursing staff in 10 aspects such as appetite loss, distress, shortness of breath, vomiting, pain, nausea, dry mouth, lethargy, forgetfulness and numbness ( P<0.05) . After the fourth chemotherapy cycle, the self-reported severities of fatigue, distress, sleep disturbance and sadness of patients were higher than those recorded by the main caregivers and nursing staff, and the differences were statistically significant ( P<0.05) . The incidence of fatigue, distress, sleep disturbance, sadness and dry mouth reported by patients were higher than those recorded by the main caregivers and nursing staff, and the differences were statistically significant ( P<0.05) . The patients showed good consistency with the primary caregivers in 8 aspects such as appetite loss, shortness of breath, vomiting, pain, nausea, dry mouth, forgetfulness and numbness ( P<0.05) , and they showed good consistency with the nursing staff in 7 aspects such as appetite loss, vomiting, pain, nausea, dry mouth, forgetfulness and numbness ( P<0.05) . The primary caregivers showed good consistency with the caregivers in 8 aspects such as appetite loss, sleep disturbance, vomiting, pain, nausea, dry mouth, forgetfulness and numbness ( P<0.05) . Conclusions:Nursing staff and the main caregivers of patients underestimate the incidence and severity of chemotherapy-related adverse reactions in patients with stomach neoplasms. Simple nursing records cannot accurately reflect the patients' chemotherapy symptoms, so self-reports of patients should be considered as one of the reference data.

Objective: To explore drug resistance of different viral loads, and investigate the relationship between drug resistance and CD4⁺T cell counts in patients with HIV antiretroviral therapy (ART) in China from 2003 to 2015. Methods: Data were extracted from the Chinese National HIVDR Surveillance database from 2003 to 2015. For this study, the data collected were as follows: having received ART for ≥12 months; 18 years or older; demographic characteristics, information of ART, CD4⁺T cell counts, viral load (VL) and HIV drug resistance of a total of 8 362 patients were collected. Multi-variables non-conditional logistic regression model was used to study the relationship between viral load, HIV drug resistance and CD4⁺T cell counts. Results: Participants with age of (41.8±10.5) years were enrolled in this study. Among them, 59.9% (5 009 cases) were men. The percentage of CD4⁺T cell counts <200 cells/μl in the total population was 17.9% (1 496 cases), the highest was in VL ≥1 000 copies/ml with drug resistance, which was 43.0% (397/923) , followed by VL 50-999 copies/ml with drug resistance, which was 31.1% (69/222), and the lowest was in VL 50-999 copies/ml without drug resistance 13.2% (273/2 068). Compared to VL 50-999 copies/ml without drug resistance, VL<50 copies/ml, VL 50-999 with drug resistance, VL≥1 000 copies/ml without drug resistance, and VL ≥1 000 copies/ml with drug resistance, the OR (95%CI) of CD4 <200 cells/μl were 0.9 (0.7-1.0), 3.2 (2.3-4.4), 2.6 (2.1-3.2), and 4.9 (4.0-5.9), respectively. Among 222 patients with VL 50-999 and HIVDR, the most frequent antiretroviral drugs were EFV and NVP, both of which were NNRTI, and whose percentage both were 94.1% (209 cases). The most frequent mutations were M184V/I (NNRTI), and the percentage was 26.1% (58 cases). The second one was K103N (NNRTI), and the percentage was 22.5% (50 cases). The percentage of V32L/E (PI) and V82A (PI) were lower, they were 0.9% (2 cases) and 0.5% (1 case) respectively. Conclusion Decreased CD4⁺T cell counts were associated with HIV drug resistance at low viraemia. In the case of low viral load, the most vulnerable were the NNRTI antiviral drugs such as EFV and NVP.

Objective:To understand influencing factors on the deaths of HIV/AIDS patients receiving antireviral treatment in Butuo county of Liangshan Yi Autonomous Prefecture (Liangshan) from 2010 to 2019, to provide data for drug replacement and sustainable antiviral treatment strategy.Methods:A matched case-control study was used to collect basic and follow-up information on AIDS death patients receiving antiviral treatment in Butuo county of Liangshan from 2010 to 2019. The control group was formed by sampling twice the number of cases. The logistic regression model was used to analyze the risk factors affecting mortality.Results:In 3 355 patients of HIV/AIDS treated with antiviral therapy, 1 179 cases in the death group and 2 176 cases in the control group. Including 81.34% were 30-49 years old, 69.09％males, 99.55% Yi nationality, 91.12% were married or cohabitated, 95.77% had junior high school education or below, and 88.41% peasants. Amultivariate logistic stepwise regression model showed that among the death risk factors, age ≥50 years old was 5.08 times (95% CI:3.05-8.48) that of the 18-29, female was 0.70 times (95% CI: 0.52-0.94) than male, the transmission rate of intravenous drug use was 1.43 times (95% CI: 1.06-1.91) that of heterosexual transmission, CD4 +T lymphocyte (CD4) count ≥350 cells/μl before treatment was 0.38 times (95% CI: 0.30-0.48) that of CD4 <200 cells/μl before treatment, the most recent antiviral treatment regimen containing LPV/r was 0.04 times (95% CI: 0.01-0.18) than that of stavudine (d4T) + lamivudine (3TC) + nevirapine (NVP)/efavirenz (EFV) regimen, drug resistance was 3.40 times (95% CI: 2.13-5.42) of non-drug resistance, non-viral load and non-drug resistance test results were 12.98 times (95% CI: 10.28-16.40) of non-drug resistance. Conclusions:Age, gender, transmission route, CD4 before treatment, the latest antiviral treatment program, and drug resistance test after antiviral therapy were the influencing factors of HIV/AIDS death in Butuo county. It is necessary to expand the coverage of viral load and drug resistance test to change the antiviral therapeutic schedule scientifically and carry out publicity and education on the compliance of patients with antiviral treatment and medical staff training in order to reduce the mortality of patients with antiviral treatment.

Objective To select NRS to record and analyze influencing factors and management effects of pain for patients with upper limp fracture.Methods Totals of 164 patients with upper limp fracture had been chosen from February 2012 to February 2013, and all of them received PCIA combining with transfused flurbiprofen to relieve pain.We analyzed influencing factors of pain by Logistic regression analysis and recorded the maximum of pain score assessed by NRS at 24 h and 48 h after trauma and compared the pain score during break at 24 h, 48 h and 72 h after operation.Results The gender, age, length of fracture, position of fracture and fracture of AO type brought out different level of pain and those of pain had statistical difference ( P <0.05).The gender (female), age (beyond 60 years old), position of fracture (proximal humerus fracture) and fracture of C type were severe risks to cause pain (P <0.05).The pain scores of proximal humerus fracture, distal end of humerusfracture, radial fracture and ulnar fracture,which assessed by NRS, had statistical difference at 24 h and 48 h after fracture (F=81.756,84.288, respectively;P<0.05), while different position of fracture had high pain score at 24 h than 48 h (t=4.720,5.703,5.888, respectively;P<0.05).Under analgesia after operation at 24 h,48 h and 72 h, female patients had more effective pain control result than males (t=2.857,P<0.05).After 72hrs operation, there were ninety two cases satisfaction, fifty nine cases certain satisfaction and thirteen cases dissatisfaction for the result of pain control.Conclusions Because different gender, age, position of fracture and fracture type result in different level of pain, medical staff should provide reasonable pain management for fracture patient in order to enhance patient’ s satisfactory.