Objective To compare the efficacy of highly active anti-retroviral treatment (HAART) with and with AZT. Methods Data of 235 HIV patients accepted from Oct. 2010 to Nov. 2013 who took AZT (133) or TDF (102) containing regimen as first-line HAART are analyzed retrospectively. CD4+ T cell counts acted as the base line after 12 months of HAART. Increase in CD4+ T cell count number after the HAART, virological failures and drug resistance were compared between the two groups. Results The two groups had comparable baseline CD4+T cell count, gender ratio, and HIV transmision mode; after 12 months of HARRT, no statistically differences were found between the two groups with regard to CD4 + T cell count and increase in CD4+ T cell count after the 12-month HAART (P > 0.05); AZT-containing group had more virological failure (3/0). Meanwhile AZT-containing group had one thymidine analog mutation (TAMs) which confers resistance to AZT (P > 0.05 for both). Conculsion The two HAARTs have same immunological effects; AZT-containing group exhibits 2.2% viralogial failure, but its direct relationship with AZT has not been confirmed.

This paper introduces the development and implementation of hospital-community interactive nursing mode for patients with diabetes. The interactive mode between community and hospital,specialist nurses and community nurses,as well as patients and nurses was formed to provide timely,convenient,continuous and whole-process nursing care for diabetic patients through the setting up and services of hespital-based diabetes care team,two-way transfer center between hospital and commu-nity,hospital-based education and community-based visit team,community-based self-management group as well as green chan-nel of priority treatment,inspection and hospitalization for diabetic patients. The implementation of the interactive mode achieved good effect and was approved by the patients. The patient satisfaction rate was 96.5%.

This study was aimed to investigate the effects of high-dose strictosamide injection on cardiovascular sys-tem of anesthetized beagle dogs and to examine the inhibition of strictosamide on ion channels in vitro. Indexes such as changes of systolic blood pressure (Sys), diastolic blood pressure (Dia), mean blood pressure (MBP), heart rate (HR), PR, QRS, QT, QTcb and QTcv at different time points before and after strictosamide injection in dogs were monitored by the polygraph system. The inhibition of strictosamide at different concentrations on hERG potassium channel in CHO-hERG cells and Nav1.5 sodium channel in HEK-293-Nav1.5 cells were measured by whole-cell patch-clamp method. The results showed that compared with the blank control group, Sys, Dia, MBP and HR were obviously declined 15 min after medication in the strictosamide (60, 18 mg·kg-1) group and the vehicle-control group (containing tween-80) (P < 0.05). After medication, all indexes were recovered. Compared to the vehicle-control group, there were no significant differences at different time points in each medication groups. Compared with the blank control group and before medication, the QT interval, QTcb and QTcv were significantly prolonged 15 min af-ter medication in the strictosamide (60, 18, 6 mg·kg-1) group and the vehicle-control group (P< 0.05). When medi-cation stopped, indexes were recovered at certain level. Compared with the vehicle-control group, there were no sig-nificant differences of QT interval, QTcb and QTcv of each medication group at different time points (P> 0.05). The inhibition of strictosamide on hERG potassium channel and Nav1.5 sodium channel were weak with IC50 values of 560.8 μM and > 900 μM, respectively, which were far greater than the positive controls. It was concluded that sin-gle, high-dose intravenous injection of strictosamide may lead to a lower blood pressure, a slower heart rate and a prolongation on the QT interval in beagle dogs, which returned to basal levels when medication stopped. It was spec-ulated that the reduction of blood pressure and the slowing of heart rate were related to tween-80 contained in the vehicle control group. No significant inhibitory effects were detected on hERG potassium channel and Nav1.5 sodium channel in vitro, which suggested that other mechanisms may be involved in strictosamide-induced QT interval pro-longation in animals.

Objective To summarize the characteristics of common carotid arterial wave intensity (WI) in healthy volunteers and offer the normal reference values of WI. Methods Common carotid arteries (CCA) in 525 healthy volunteers were examined using Aloka Prosound α10 equipped with wave intensity software. The volunteers were divided into six group according to age,group A,＜20 years old;group B,20 - 29 years old;group C,30 - 39 years old;group D,40 - 49 years old;group E,50 - 59 years old and group F,≥60 years old. Carotid arterial wave intensity in normal subjects had two positive peaks, the first peak,W1 ,and the second peak, W2. Between the two positive peaks, a negative area (NA), the time interval between the R-wave of ECG and the first peak(R-W1 ) and that between the first and second peaks (W1-W2) were observed. Results ① 1050 common carotid arteries in 525 volunteers were studied. The mean values of W1,W2,NA,R-W1,and W1-W2 were (8332±4796) mmHg · m-1 · s-3,(1853±1143)mmHg · m-1 · s-3,(38 ± 26) mmHg · m-1 · s-2, (102 ± 19)ms and (266 ± 42)ms,respectively. ②These values were no significant between the left and right CCA in same group. W1 and NA were correlated with age ( r = - 0. 204 and r = -0.301, P ＜0. 001). W1 and NA in group A and B were significant increased than those in other groups( P ＜0. 05 or P ＜0. 001 ). ③There were statistical significances in W1 and W1-W2 of CCA between male and female. ④There were no statistical significances in all values in common carotid arteries of both sides (P ＞0. 05). ConclusionsWI technique is useful for evaluating the dynamic behavior of the heart and the vascular system and their interaction. W1 is very sensitive to the changes in the working condition of the cardiovascular system.

This study aimed at investigating the antiviral constituents from the active fractions of Tong-An (TA) injection.In this study,the active constituents of TA injection were screened by LPS-induced PGE2 production mode to detect the contents of PGE2.The chemical constituents were isolated by HP-20 macroporous resin,silica gel column chromatography,ODS column chromatography,Sephadex LH-20 column chromatography and preparative and semi-preparative HPLC.The structures were identified by spectral data and physicochemical property.As a result,the 95％ ethanol eluate of TA injection on the macroporous adsorption resin column was proved to be the active fraction of TA injection.Seventeen compounds were isolated from TA injection and identified as syringaresinol (1),N-Trans-Feruloyltyramine (2),chelerythrine (3),sinomenine (4),coptisine (5),sanguinarine (6),chelidoniny (7),magnoflorine (8),allocryptopine (9),protopine (10),farrerol (11),dihydrosanguinarine (12),heptadec-(9Z)-enoic acid (13),chlorogenic acid (14),cryptochlorogenin acid (15),3,5-di-O-caffeoylquinic acid (16) and 4,5-di-O-caffeoylquinic acid (17).PGE2 inhibitory activities of these compounds were determined,among which six compounds presented inhibitory activities against PGE2.It was concluded that all the isolated compounds from TA injection were firstly reported with the favorable inhibitory activities of compounds 2,5,9,10,11,12 against PGE2.

Objective To validate the effectiveness of nursing intervention on alleviating negative emotions and improving quality of cancer patients′ life based on story theory. Methods This study adopted the method of quasi-experimental research,100 patients with cancer chemotherapy were divided into the experimental group(50 cases),and the control group(50 cases).Based on conventional care,the experimental group received 3 weeks of nursing intervention based on story theory.The scores of mood and quality of life were collected in the 1st day and 23rd day after chemotherapy by using Profile of Mood States-Short Form(POMS-SF)and Quality of Life Questionnaire-core(QLQ-C30),thus evaluated the effect of intervention. Results The scores of POMS-SF in the 1st day and 23rd day after chemotherapy were (17.28±5.41),(35.84±12.35)points in the experimental group,and the difference was significant(t=7.54, P<0.05).The scores of QLQ-C30 in the 1st day and 23rd day after chemotherapy were(7.72±1.53),(8.17± 0.94) points in the control group, and the difference was significant(t =-4.07, P<0.05). There was no statistical difference in the scores of POMS-SF and QLQ-C30 between the 1st day and 23rd day after chemotherapy in the control group(P>0.05). Conclusions The nursing intervention based on story theory demonstrated significant improvement of negative emotions and quality of life, which is a quite practical psychological care for cancer chemotherapy patients.

BACKGROUND: Our study was to investigate the prevalence of carbapenemase genes in strains of Enterobacteriaceae species exhibiting decreased susceptibility to carbapenems in our hospital. METHODS: The carbapenemase producing Enterobacteriaceae species were confirmed by modified Hodge test (MHT) and EDTA-disc synergy test which indicating the production of class B carbapenemases. PCR and sequencing analysis were used to identify the drug-resistant genes. DNA fingerprinting based on enterobacterial repetitive intergenic consensus (ERIC)-PCR was applied to investigate the homology of Enterobacteriaceae species. RESULTS: From a collection of 1,472 Enterobacteriaceae species, 18 isolates with decreased susceptibility to carbapenem treatment were identified and 9 of which were positive by MHT, and 6 of which produced class B carbapenemases. PCR and sequencing analysis of the 18 isolates revealed 4 different carbapenemase genes (blaIMP-8, blaoxa-1, blaIMP-26, and blaoxa-47) in 10 isolates, with the blaIMP-8 and blaoxa-1 genes being the most common (60-70% prevalence). ERIC-PCR showed 5, 2, and 2 unique genotypes for Enterobacter cloacae, Escherichia coli, and Klebsiella pneumoniae, respectively. Three E. coli strains isolated from different patients from the urologic surgery department exhibited the same DNA banding pattern, suggesting a possible clonal dissemination. Majority (17/18) of the carbapenem-unsusceptible Enterobacteriaceae species isolates was obtained from the surgery department of our hospital. CONCLUSIONS: The main carbapenemase genes of Enterobacteriaceae species in our hospital were blaIMP-8 and blaoxa-1. Prevalence of carbapenem resistance may be existed in surgery department and infection control should be taken for preventing further dissemination of drug-resistant strains.
Anti-Bacterial Agents/*pharmacology ; Bacterial Proteins/*genetics ; Carbapenems/*pharmacology ; China ; DNA Fingerprinting ; Drug Resistance, Bacterial/drug effects/genetics ; Enterobacteriaceae/*drug effects/*enzymology/isolation & purification ; Enterobacteriaceae Infections/microbiology ; Genotype ; Hospitals, University ; Humans ; Microbial Sensitivity Tests ; Sequence Analysis, DNA ; beta-Lactamases/*genetics

Objective:To investigate the incidence of asthma and the characteristics of acute attacks in children aged 3-14 in different administrative areas of Wuxi, and to analyze the correlation of asthma with the outdoor environmental factors.Methods:A total of 10 175 children aged 3-14 were randomly selected from 5 different administrative regions in Wuxi City, Jiangsu Province for childhood asthma epidemiological survey from January to December in 2017.Results:The complete questionnaires were collected from 8 318 children with a response rate of 81.70%.There were 6 734 valid questionnaires.Asthma occurred to 259 children, and the prevalence rate was 3.84%.The prevalence of asthma in male and female children was 4.89% (163 cases) and 2.82% (96 cases), respectively.The ratio of male patients to female patients was 1.70∶1.00, and the difference was significant ( χ2=19.72, P<0.01). Children were most prone to suffer from asthma attacks at the turn of seasons (87/259 cases, 33.59%). The frequency of asthma was the lowest from June to August (9/259 cases, 3.47%). Among 244 cases attacked by acute asthma, the prevailing time period of acute attacks was irregular in 88 patients (36.07%), bedtime in 64 cases (26.23%). In different regions of the city, the lowest prevalence rate of asthma was found in Binhu District (50/1 830 cases, 2.73%), the highest prevalence rate of asthma was found in Xinwu District (71/1 502 cases, 4.72%), the difference between the highest and lowest prevalence rates of asthma was significant ( χ2=13.19, P<0.05). In terms of the air quality in different admi-nistrative regions of Wuxi, the nitrogen dioxide (NO 2) concentration, the carbon monoxide (CO) concentration, PM 10 and PM 2.5 in Binhu District were lower than other 4 regions.In different seasons in Wuxi city, the sulfur dioxide(SO 2) concentration, the NO 2 concentration, the CO concentration, PM 10 and PM 2.5 from June to August were significantly lower than those in other months.The prevalence of asthma in children in different administrative districts of Wuxi was weakly positively correlated with the SO 2 concentration, the NO 2 concentration and PM 10 ( r=0.10, P<0.01; r=0.22, P<0.01; r=0.06, P<0.01, respectively). The prevalence of asthma was weakly negatively associated with the ozone(O 3) concentration ( r=-0.06, P<0.01). Acute asthma attacks were weakly positively correlated with the SO 2 concentration ( r=0.22, P<0.01), the NO 2 concentration ( r=0.28, P<0.01), the CO concentration ( r=0.23, P<0.01), PM 10 ( r=0.18, P<0.01) and PM 2.5 ( r=0.18, P<0.01), and weakly negatively correlated with the O 3 concentration ( r=-0.40, P<0.01). Conclusions:The prevalence of asthma in Wuxi is higher in boys than in girls, and the frequency of asthma attacks is related to the season.The SO 2, NO 2, CO, PM 10, PM 2.5 and O 3 concentration affect the prevalence and acute attacks of asthma.

Objective:To explore the therapeutic effect of multi-mode sequential combination of artificial liver in the treatment of hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF).Methods:The clinical data of HBV-ACLF patients treated with artificial liver in Wuxi Fifth People′s Hospital from January 2018 to June 2021 were retrospectively analyzed. Eighty-six patients were divided into artificial liver multi-mode sequential combination therapy group (sequential combination group) and conventional treatment group. The cytokine level changes and model for end-stage liver disease (MELD) score were analyzed at 14 days of disease duration. The survival outcome and complications of artificial liver were analyzed after 30 days of follow-up. Two independent samples t test and chi-square test were used for statistical analysis. Cox regression analysis was used to analyze the risk factors of death, and Kaplan-Meier method was used to analyze the survival rate of patients. Results:A total of 86 patients were enrolled, including 48 patients in sequential combination group with the average number of artificial liver of 4.68 times/person, and 38 patients in conventional treatment group with the average number of artificial liver of 3.17 times/person. At 14 days of disease duration, interleukin (IL)-6, IL-8, interferon γ-inducible protein (IP)-10 level and MELD score in sequential combination group decreased significantly than those in the conventional treatment group ( t=3.80, 3.62, 4.95 and 1.11, respectively, all P<0.050). After 30 days of follow-up, 63 patients survived and 23 patients died. Cox regression analysis showed that baseline international normalized ratio (hazard ratio ( HR)=0.558, 95% confidence interval ( CI) 0.193 to 0.856, P=0.027), baseline antithrombin Ⅲ activity ( HR=0.876, 95% CI 0.824 to 0.932, P<0.001), artificial liver mode ( HR=0.819, 95% CI 0.236 to 0.992, P=0.005), spontaneous peritonitis ( HR=0.170, 95% CI 0.045 to 0.647, P=0.009) and hepatic encephalopathy ( HR=0.004, 95% CI 0.001 to 0.030, P<0.001) were independent influencing factors for 30-day survival outcome. The cumulative survival rate of sequential combination group was higher than that of conventional treatment group, and the difference was statistically significant ( χ2=5.45, P=0.020). There were no significant differences in the proportions of bleeding, deep vein thrombosis, heart rate and blood pressure instability between the two groups ( χ2=0.63, 1.20 and 0.54, respectively, all P>0.050). The platelet decline of patients in sequential combination group was slighter than that in conventional treatment group, and the difference was statistically significant ( t=-4.17, P=0.002). Conclusions:Multi-mode sequential combination therapy of artificial liver could eliminate cytokines and reduce MELD score more effectively in patients with HBV-ACLF, and prolong the survival time of patients and have little effect on platelet count.

Background: There is no standard cut-off value of serum IgG4 concentration and serum IgG4/total IgG ratio for the diagnosis of IgG4-related disease (IgG4-RD) or as a marker of treatment responses. We aimed to explore this issue through a retrospective cohort analysis of adults in southwest China. Methods: The diagnostic performance of serum IgG4 concentration and IgG4/IgG ratio for IgG4-RD was evaluated in a retrospective analysis of 177 adults newly diagnosed as having IgG4-RD and 877 adults without IgG4-RD. Dynamic analysis was performed to evaluate the significance of serum IgG4 concentration on IgG4-RD treatment responses. Results: The serum IgG4 concentration differed according to sex. The optimal cut-off values of serum IgG4 concentration and IgG4/IgG ratio for IgG4-RD diagnosis were 1.92 g/L and 0.12 in males and 1.83 g/L and 0.11 in females, respectively. For patients with serum IgG4 concentration >2.01 g/L, the cut-off values in the total population were >3.00 g/L and 0.19, respectively. The median serum IgG4 concentration decreased over time, and the decrease rate increased over time. The serum IgG4 concentration significantly decreased at >1 week post-treatment (P=0.004), and the median decrease rate was close to 50% at >4 weeks post-treatment. Conclusions Serum IgG4 can be a good indicator for IgG4-RD diagnosis; however, different diagnostic cut-off values should be determined according to sex. The decreasing rate is more conducive than the serum IgG4 concentration to monitor treatment efficacy. The IgG4/IgG ratio did not improve the diagnostic efficacy for IgG4-RD.