Radix et Rhizoma Rhei, the major usage of which is purgation, is widely used in clinical therapy among different prescriptions. According to present reports, researches on herbal compatibility mechanism were mainly fo-cused on the comparison of content changes of active ingredients before and after. In oder to provide references, this review was made on researches of compatibility mechanism of prescriptions and paired drugs for ingredients of Radix et Rhizoma Rhei from research actuality.

Abstract: Objective　To investigate the impacts of vaccination with inactivated SARS-COV-2 vaccine on the clinical manifestations and serological responses of COVID-19 patients infected by Delta and Alpha variants. Methods　Clinical and experimental data of 341 confirmed SARS-COV-2 patients were collected from The Eighth Affiliated Hospital of Guangzhou Medical University May 1- September 30, 2021. The subjects were divided into Delta and Alpha variant group according to virus variants, and were divided into vaccinated group and unvaccinated group according to whether they had received inactivated COVID-19 vaccine or not. The clinical manifestations and serological responses of patients with Delta and Alpha variant, and vaccinated and unvaccinated patients with Delta and Alpha variants were compared. Results　Totally 253 patients were infected with Delta variant (103 vaccinated and 150 unvaccinated patients), and 88 patients were infected with Alpha variant (21 vaccinated and 67 unvaccinated patients). The proportion of asymptomatic infection in Delta variants group was significantly lower than that in Alpha variants group (P<0.01). Delta variant group of vaccination rates and vaccine breakthrough infection rate was 40.7% (103/253) and 22.9% (58/253), were higher than Alpha variant group was 23.9% (21/88) and 8.0% (7/88), difference was statistically significant (χ2= 8.009, 9.484, P<0.01). The proportion of cough and fever in Delta variant group was higher than that in Alpha variant group (both P<0.01), the peak viral load was higher than that of Alpha variant group (P<0.01), the virus duration was longer than that of Alpha variant group (P<0.01), the levels of SAA, CRP and IFN were higher than those of Alpha variant group (all P<0.05), CD4+T cell count was lower than that of Alpha variant group (P<0.05), IgG and IgM levels were lower than those of Alpha variant group (both P<0.01). The proportion of moderate COVID-19 in the vaccinated group was lower than that in the unvaccinated group (P<0.01). In these two variants, the peak viral load of vaccinated group was lower than that of the unvaccinated group (both P<0.01), the duration of virus was shorter than that of unvaccinated group (both P<0.01). The levels of SAA, CRP and IL-6 in the vaccinated group were lower than those in the unvaccinated group (all P<0.05), CD4+T cell level was higher than that of unvaccinated group (both P<0.05), IgG and IgM level were higher than those in unvaccinated group (both P<0.05). Conclusions　Delta variant can lead to higher viral load and more severe disease course, which is associated with vaccine breakthrough infection. Inactivated vaccines for COVID-19 can reduce severe illness and death by reducing viral load, disease duration and inflammatory response through humoral and cellular immune mechanisms.

The compatibility of traditional Chinese medicines (TCMs) formulae containing enormous information, is a complex component system. Applications of mathematical statistics methods on the compatibility researches of traditional Chinese medicines formulae have great significance for promoting the modernization of traditional Chinese medicines and improving clinical efficacies and optimizations of formulae. As a tool for quantitative analysis, data inference and exploring inherent rules of substances, the mathematical statistics method can be used to reveal the working mechanisms of the compatibility of traditional Chinese medicines formulae in qualitatively and quantitatively. By reviewing studies based on the applications of mathematical statistics methods, this paper were summarized from perspective of dosages optimization, efficacies and changes of chemical components as well as the rules of incompatibility and contraindication of formulae, will provide the references for further studying and revealing the working mechanisms and the connotations of traditional Chinese medicines.
Chemistry, Pharmaceutical ; statistics & numerical data ; Data Interpretation, Statistical ; Drug Incompatibility ; Drugs, Chinese Herbal ; analysis ; Medicine, Chinese Traditional

BACKGROUND: The evaluation of stereoacuity can provide an unambiguous assessment of haplopia. It is valuable in assessing the diagnosticaccuracy and the therapeutic effect in strabismus, amblyopia and ametropia. OBJECTIVE: This investigation was designed to evaluate the stereopticdevelopment and the occurrence rate of strabismus in 3-6 years old children, and so that to provide objective data for prevention and treatment of strabismus and steropsis. DESIGN: It was a randomized sampling investigation. SETTING: Department of Ophthalmology,Haikou People's Hospital. PARTICIPANTS:Totally 8326 children in 25 urban and suburban kindergartens, with an age of 3-6 years old, were selected randomly in Haikou city from June 2000 to April 2002. METHODS: 8 326 3-6 years old children in Haikou city underwent vision examinations on hyperopia, eye position and the myopia. Those having eyesight lower than 1.0D or abnormal eye position received atropine drops to dilate the pupil of the eye for optometry. ① 4-6 years old children were examined using standard visual chart and logMAR chart (logarithm of the minimum angle of resolution chart), 3 years old children were examined using hroken wheel acuity cards or symbols chart. The results of the exminations were conversed and recorded in form of decimal fraction uniformly. ②The corneal reflection and the cover test procedure were used for the position of gaze. ③ Stereoacuity were examined using the stereoptic visual testing cards (made by the Institute of Biophysics, Chinese Academy of Sciences). Stereoacuity were defined as normal when the test value was ≤ 60 s and were defined as abnormal when it was ≥ 100 s. Each examination was performed by same selected physicians. MAIN OUTCOME MEASURFS: The main outcome measurements included ① results of eye position examination and stereoptic examination in children in all age brackets, ② results of optometry in children with strabismus, ③ The relation between eyesight and stereopsis in participants,④Stereoacuity of children in all age brackets, ⑤and possible causations involve in stereopsis. RESULTS: Practically, 8326 participants receiving examinations of eysight and eye position entered the statistical analysis procedure, while an other 662 children were omitted for their poor expression for the examinations. ① Results of stereoptic examination and eye position examination for participants in all age brackets: 165 (2％) with strabismus, in which 89.7％were first diagnosed; 2016 (27.5) with myopia, whose stereoptic value were ≥ 100 s. ②Results of optometry in children with strabismus: 93.5％ esotropia occurred in children with hyperopia. The rate of hyperopia/myopia was not significantly different between exotropia and vertical strabismus.③ Relation between eyesight and stereoacuity of participants: 75.5％ children have a normal stereoacuity.With a decreasing in eyesight,the stereoacuity decreased (P ＜ 0.05 or P ＜ 0.01). ④ Stereoacuity of the children in all age brackets: With an increasing age, the rate of children with normal stereoacuity increased. ⑤ Possible causations involved in stereopsis: strabismal amblyopia might have the greatest influence on stereopsis. CONCLUSION: ①About 90％ children with strabismus were firstly diagnosed in the investigation. Causations responsible for abnormal stereopsis include ametropia, strabismus, and amblyopia, and so on. ② Concomitant esotropia has close relation with binocular accommodation, while exotropia and vertical strabismus are not linked to refractions. Stereoacuity decreases with a decreasing in eyesight. ③ The results of the investigation support the view that mature stereopsis is achieved early than 4 years old although certain variance of stereoptic development can be observed among individuals.

Objective To investigate the specimen source and gene phenotype of ESBLs in ESBLs-producing Klebsiella pneumonia of people′s hospital of Sanya city,so as to provide basis for clinical use of drugs and nosocomial infection.Methods Klebsiella pneumoniae was isolated from specimens during January 2013 to December 2014,bacteria identification and susceptibility tests were detected by Phoenix-100 system biochemical,supplementary susceptibility test was confined by K-B method according to 2014 CLSI standards.WHONET 5.6was used in the statistical analysis of all data.Results Totally 213 strains Klebsiella pneumoniae were isolated.The detection rates were 78.4％ of the respiratory secretions,8.92％ and 5.2％ respectively of the secretion and the midstream urine.The strains had a certain resistance to commonly used antimicrobial.The highest resistance rate was 98.1％ to cefotaxime,and the lowest resistance rate was 2.86％ to imipenem.There were 195 in 213 ESBLs producing Klebsiella pneumoniae strain were detect one or more drug resistance gene.The detecting rates of 6 p-lactamase gene of CMY,CTX,TEM,SHV,DHA1 and KPC were 6.10％,76.53％,59.62％,76.06％,12.21％ and 2.82％.Conclusion Klebsiella pneumoniae is mainly isolated from respiratory secretions in the hospital,has a certain resistance to commonly used antimicrobial.We should learn more about the distribution of resistance genes of ESBLs strains,improve the efficiency of the treatment of the infection and to control nosocomial infection and the incidence of multi-drug resistance.

Objective To investigate the influence of synangio-excision-restruction in pancreatic cancer radical operation on the complications,living quality and survival status in the patients with pancreatic cancer.Methods A total of 255 patients with pancreatic cancer in our hospitals from January 2010 to October 2015 were selected and divided into 3 groups according to different operation modes:41 cases in the Synangio-excision-restruction group(A),113 cases in the non-synangio-excision-restruction group (B) and 101 cases in the palliative by-pass operation group(C).The clinical data in 3 groups were analyzed.The influence of Synangio-excision-restruction on operative complications,living quality and survival status was investigated.Results The incidence rate of complications in the group A was 56.10％,which was obviously higer than 34.51％ in the group 1β and 20.79％ in the group C,and the difference was statistically significant(P＜0.05).In the group A,the incidence rates of belly ache and body weight gain were 36.59％ and 51.22％ respectively,which comparing with 91.09％ and 9.09％ in the group C showed statistically significant difference(P＜0.05).The median survival time(MST) in the group A was 11.83 months,which in the group B and C were 15.43 months and 7.50 months,the difference between the group A and C was statistically significant(x2 =4.27,P＜0.05);while the difference between the group A and B was not statistically significant(x2=3.67,P＞0.05).Conclusion For the pancreatic cancer patients with affected portal vein and inferior mesenteric vein,the synangio-excision-restruction radical operation can obviously prolong the patients' survival time and improves their living quality.

Objective To study compatibility rule of herb-pair in rhubarb after compatibilities with fructus aurantii Immaturus,Chinese goldthread rhizome,moutan cortex,peach seed and kansui radix stir-baked with vinegar, and to observe its anti-inflammation and acute toxicity. Methods Mice were gavaged by 15,30 g?kg-1 rhubarb and rhubarb, rhubarb frutus aurantii immaturus rhizoma coptidis, radix et rhizoma rhei peony, rhubarb, semen persicae and rhubarb extracts from euphorbia kansui, respectively, in the morning and evening once, for 7 d.The effects of five different compatibility of Rhubarb on acute inflammation were observed in the mouse paw swelling induced by carrageenan. The classical method were used to determine acute toxicity of rhubarb and the contents of five different compatibility of rhubarb. Results Compared with the control group, the contents of five different compatibility of rhubarb with high and low dosage groups(30,15 g?kg-1 ) could inhibit the paw edema in mice,reduce NO and MDA production and enhanced activity of SOD in mice inflammatory tissue. The LD50 was not determined. Calculated by crude drug content, the MLD of rhubarb compatibilities with fructus aurantii immaturus, Chinese goldthread rhizome,moutan cortex,peach seed and kansui radix stir-baked with vinegar were 145.33,142.30,117.53,103.45, 113.09,182.36 g?kg-1 respectively, which were respectively equal to 581,569,470,418,452 ,729 times of people, s daily dried medicinal herb dosage. Conclusion The five different herb-pair have anti-inflammation effects after compatibility of Rhubarb, and it got best effects when rhubarb compatibility with kansui radix stir-baked, the next were rhubarb compatibility with Chinese goldthread rhizome and moutan cortex. It was basic security and low toxicity of herb-pair in rhubarb after compatibilities.

OBJECTIVETo investigate the incidence of nosocomial infections of newborn infants in neonates and to explore the risk factors and strategies of infection control.

METHODSThere were 433 confirmed cases of nosocomial infection in the neonatal ward of the authors' hospital from January 2007 to December 2009. Their data of epidemiological and clinical characteristics, results of etiological examinations and antibiotic resistance were retrospectively analyzed.

RESULTSDuring the study, the number of hospitalizations were 6437. Nosocomial infection occurred in 433 patients 513 times. The overall nosocomial infection rate was 6.82%. The overall hospitalization days were 73 663 and nosocomial infection patient-day rates were 6.96‰. The VAP infection rate was 28.7‰. The CRBSI rate was 3.5‰. Gestational age (OR = 1.049), mechanical ventilation (OR = 1.810), umbilical vein catheter (OR = 1.106), hospitalization days (OR = 1.081), premature rupture of membrane (OR = 1.433) were the risk factors for the development of nosocomial infection. There were 197 (38.4%) cases of pneumonia, which was the most common nosocomial infection in Neonatal Ward. There were 129 cases of ventilator-associated pneumonia (VAP), which accounts for 65.5% of pneumonia and 24.4% of cases treated with ventilator. The next was sepsis, 124 cases (24.2%) and 64 cases of diarrheal disease (12.7%). One hundred and eighty two (54.4%) strains of isolates were Gram-negative bacteria, which accounted for the highest proportion. The predominant pathogens of Gram-negative bacteria were Klebsiella pneumoniae (19.6%), followed by Acinetobacter baumannii (8.1%), Pseudomonas aeruginosa (7.2%), Stenotrophomonas maltophilia (4.8%) and Escherichia coli (4.8%). The isolation rates of Klebsiella pneumoniae and Escherichia coli with positive extended-spectrum beta-lactamases (ESBLs) were 91.4% and 75%, respectively. Those two bacteria were universally resistant to cephalosporins. The rate of resistance to imipenem of Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa were 1.5%, 11.1% and 41.7%. The isolation rates of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative Staphylococcus were 28.6% and 95.5%.

CONCLUSIONIt is important to identify the high risk factors for nosocomial infections in newborn infants. To shorten time for mechanical ventilation and hospitalization days, removal of the central venous catheter as early as possible would be conducive to reducing the morbidity of nosocomial infection. The main pathogens were Gram-negative bacteria. The multidrug resistance of Enterobacteriaceae and Non-fermenters is serious.

Cross Infection ; epidemiology ; microbiology ; Female ; Humans ; Incidence ; Infant, Newborn ; Intensive Care Units, Neonatal ; Retrospective Studies ; Risk Factors

Objective To investigate the carrying status and characteristics of Clostridium difficile isolated from infants.Methods Two hundred and thirty-eight stool specimens were collected from infant younger than 1 year old,that were hospitalized or outpatient from August to November 2015.Immunochromatography targeted GDH and toxin A&B of C.difficile was used for C.difficile screening,and those positive specimens were inoculated in CDIF and anaerobic culture.C.difficile isolates were genotyped by using slpA sequence typing (slpA ST),and tcdA,tcdB,cdtA and cdtB of C.difficile isolates were detected by PCR.Results Fifty C.difficile strains were isolated from 238 stool samples,and the isolated rates of C.difficile from <3 months,3 months to <6 months,and 6 months to 1 years old groups were 9.3%,17.6% and 27.3%(χ2=6.940,P=0.031<0.05),respectively.52.0%(26/50) of the C.difficile isolates were toxigenic,and 69.2% (18/26) toxigenic isolates harbored tcdA+tcdB+cdtA-cdtB-.Fifty C.difficile isolates were genotyped as 11 slpA STs,slpA ST fr-02 and kr-02 were the commonest genotypes in toxigenic C.difficile isolates;however,that was slpA ST xr-03 in non-toxigenic isolates.Conclusion High C.difficile carriage is found in infants younger than 1 year old,and more than half of C.difficile isolates are toxigenic.Most of toxigenic isolates harbored toxin A and B.The genotype of C.difficile isolates is different between toxigenic isolates and non-toxigenic isolates.

BACKGROUND: Recently the prevalence rate of mass in mammary gland increases significantly than before. To use which kind of technology is not only related with the post-operation recurrence, but also related with the reconstruction of their confidence. Therefore, how to reduce the trauma physically and psychologically in patients to the maximal degree has become the chief factor to choose technology by surgeons.OBJECTIVE: To observe the effects of transverse rectus abdominis musculocutaneous (TRAM) flap, latissimus dorsi musculocutaneous flap with breast prothesis, local flap and simple breast prothesis after skin-sparing mastectomy with immediate breast reconstruction.DESIGN: Case analysis.SETTING: Department of Plastic Surgery, Shenzhen People's Hospital,Second Clinical Medical College of Jinan University.PARTICIPANTS: A total of 15 ductal carcinoma in situ (DCIS) and huge breast benign tumor patients were enrolled into Shenzhen People's Hospital between October 1997 and May 2004, aged from 20 to 46 years. They all got disease in single breast, and 8 of them had preoperative diagnosis of DCIS, T1N0M0 and 7 of them had huge breast benign tumor. Operation program was informed to the patients before operation so as to gain their agreement.METHODS: Skin-sparing mastectomy was performed with circular shape incision at areola and using TRAM flap, latissimus dorsi musculocutaneous flap with breast prothesis, local flap and simple breast prothesis to fill breast. Slight skin of musculo-cutaneous flap could compensate the nipple and areola when performing reconstruction. At the reoperation, nipple was made at the transferred flap.MAIN OUTCOME MEASURES: To observe the patients with or without recurrence or transfer after operation and local healing of wound.RESULTS: With the cooperation of general surgeons the operation was done in 15 cases and 14 cases of them were followed up for more than 1 year. The reconstructed breasts were with good symmetry with the opposite one, normal skin sensation, natural shape and inconspicuous scar.CONCLUSION: This is an excellent alternative method for mastectomy and breast reconstruction based on the avoidance of recurrence of breast cancer in severe operation.