OBJECTIVETo study the clinical characteristics of neonatal sepsis caused by Klebsiella pneumoniae and the antibiotic sensitivity pattern of Klebsiella pneumoniae strains.

METHODSThe clinical data of 42 cases of neonatal sepsis caused by Klebsiella pneumoniae from January, 2000 to August, 2009 were retrospectively studied.

RESULTSThe clinical presentations were non-specific, including fever or hypothermia, tachypnea, apnea and feeding intolerance. C-reactive protein (CRP) level increased in 95% of the cases. The mortality was 21%. In neonates with early onset sepsis, Klebsiella pneumoniae strains were sensitive to amoxicillin/clavulanic-acid, piperacillin/tazobactam, cefoxitin, imipenem, cefoperazone/and sulbactam. In neonates with late onset sepsis, the sensitive antibiotics of Klebsiella pneumoniae strains were less, including cefoxitin, piperacillin/tazobactam and imipenem. Klebsiella pneumoniae strains were not sensitive to penicillins and cephalosporins in either neonates with early onset sepsis or late onset sepsis. The extended spectrum β-lactamases (ESBLs)-producing strains were found in 92% of the cases. The neonates with late onset sepsis presented a higher prevalence of ESBLs-producing strains than those with early onset sepsis (100% vs 70%; P<0.05).

CONCLUSIONSThe clinical manifestations of neonatal sepsis caused by Klebsiella pneumoniae are usually non-specific. CRP detection is valuable for early diagnosis of sepsis. There are differences in the antibiotic sensitivity of strains between the neonates with early onset and late onset Klebsiella pneumoniae sepsis.

Anti-Bacterial Agents ; pharmacology ; Bacteremia ; diagnosis ; drug therapy ; C-Reactive Protein ; analysis ; Female ; Humans ; Infant, Newborn ; Klebsiella pneumoniae ; drug effects ; Male

This study aims to systematically review the efficacy and safety of different traditional Chinese medicine injections combined with conventional treatment for patients with post-acute myocardial infarction heart failure. The relevant randomized controlled trial(RCT) was retrieved from CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library with the time interval from inception to May 13, 2023. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Network Meta-analysis was then performed in RevMan 5.3 and Stata 15.1. A total of 68 RCTs involving 11 traditional Chinese medicine injections and 5 995 patients were included. The results were explained based on the surface under the cumulative ranking curve(SUCRA).(1) In terms of reducing major adverse cardiovascular event(MACE), the therapies followed the trend of Xinmailong Injection+conventional treatment(83.8%) > Yiqi Fumai Injection+conventional treatment(57.1%) > Xuebijing Injection+conventional treatment(56.6%) > Shenmai Injection+conventional treatment(53.1%) > Shenfu Injection+conventional treatment(45.3%) > conventional treatment(4.0%).(2) In terms of increasing left ventricular ejection fraction(LVEF), the therapies followed the trend of Yiqi Fumai Injection+conventional treatment(84.0%) > Shenmai Injection+conventional treatment(69.6%) > Shenfu Injection+conventional treatment(62.7%) > Xinmailong Injection+conventional treatment(61.6%) > Shuxuening Injection+conventional treatment(54.8%) > Shenqi Fuzheng Injection+conventional treatment(46.7%) > Shengmai Injection+conventional treatment(45.9%) > Breviscapine Injection+conventional treatment(39.9%) > Danhong Injection+conventional treatment(38.8%) > Huangqi Injection+conventional treatment(38.7%) > conventional treatment(7.3%).(3) In terms of reducing B-type natriuretic peptide(BNP), the therapies followed the trend of Xinmailong Injection+conventional treatment(98.6%) > Shenmai Injection+conventional treatment(57.7%) > Shenfu Injection+conventional treatment(52.5%) > Shengmai Injection+conventional treatment(30.1%) > conventional treatment(11.0%).(4) In terms of reducing cardiac troponin Ⅰ(cTnⅠ), the therapies followed the trend of Shenmai Injection+conventional treatment(92.3%) > Yiqi Fumai Injection+conventional treatment(61.5%) > Shenfu Injection+conventional treatment(51.2%) > Shengmai Injection+conventional treatment(48.1%) > Xinmailong Injection+conventional treatment(26.6%) > conventional treatment(20.3%).(5) In terms of reducing high-sensitivity C-reactive protein(hs-CRP), the therapies followed the trend of Shenmai Injection+conventional treatment(79.9%) > Xinmailong Injection+conventional treatment(68.1%) > Shenfu Injection+conventional treatment(63.1%) > Xuebijing Injection+conventional treatment(56.7%) > Shengmai Injection+conventional treatment(51.1%) > Shenqi Fuzheng Injection+conventional treatment(42.8%) > Huangqi Injection+conventional treatment(34.7%) > conventional treatment(3.5%).(6) A total of 22 RCTs reported the occurrence of adverse reactions, mainly involving the damage of the circulatory system, digestive system, and coagulation function. The current evidence suggested that Xinmailong Injection+conventional treatment may have the best therapeutic effect in reducing MACE and BNP; Yiqi Fumai Injection+conventional treatment may be the best in increasing LVEF; Shenmai Injection+conventional treatment may be the best in reducing cTnI and hs-CRP. The safety needs further quantitative research and analysis. However, more high-quality RCT is required to validate the above conclusions due to limitations in the quality and quantity of the included studies.
Humans ; Medicine, Chinese Traditional ; Stroke Volume ; Network Meta-Analysis ; C-Reactive Protein ; Ventricular Function, Left ; Drugs, Chinese Herbal/adverse effects* ; Myocardial Infarction/drug therapy* ; Heart Failure/drug therapy*

OBJECTIVETo provide in vitro evidence of Psorinum treatment against cancer cells in a controlled study.

METHODSEffects of homeopathic Psorinum 6× on cell viability were initially determined in several cancer cell lines, including A549, HepG2 and MCF-7, using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, and an ethanol 6× control. The cell line that exhibited highest inhibition was selected and used in the following experiments. A range of Psorinum 6× doses was used to explore treatment effects on cell cycle arrest, cell death (apoptosis), generation of reactive oxygen species (ROS) and change in mitochondrial membrane potential (MMP) using flow cytometry and fluorescence microscopy, respectively. Expression of several signal proteins related to apoptosis and cell survival were quantified with Western blotting and confocal microscopy. Further, circular dichroism (CD) spectroscopy was used to determine possible drug-DNA interactions, as well as the induction of conformational changes.

RESULTSTreatment of cancer cell lines with Psorinum showed greater anticancer effects in A549 cells than in others. In A549 cells Psorinum treatment inhibited cell proliferation at 24 h after treatment, and arrested cell cycle at sub-G1 stage. It also induced ROS generation, MMP depolarization, morphological changes and DNA damage, as well as externalization of phosphatidyl serine. Further, increases in p53 expression, Bax expression, cytochrome c release, along with reduction of Bcl-2 level and caspase-3 activation were observed after Psorinum 6× treatment, which eventually drove A549 cells towards the mitochondria-mediated caspase-3-dependent pathway. CD spectroscopy revealed direct interaction of Psorinum with DNA, using calf thymus-DNA as target.

CONCLUSIONPsorinum 6× triggered apoptosis in A549 cells via both up- and down-regulations of relevant signal proteins, including p53, caspase-3, Bax and Bcl-2.

Caspase 3 ; metabolism ; Cell Cycle Checkpoints ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Homeopathy ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Reactive Oxygen Species ; metabolism ; bcl-2-Associated X Protein ; analysis

OBJECTIVES: Chronic inflammation is now thought to play a key pathogenetic role in the associations of obesity with insulin resistance and diabetes. Based on our recent findings on persistent organic pollutants (POPs) including the lack of an association between obesity and either insulin resistance or diabetes prevalence among subjects with very low concentrations of POPs, we hypothesized that POP concentrations may be associated with inflammation and modify the associations between inflammation and insulin resistance in non-diabetic subjects. METHODS: Cross-sectional associations among serum POPs, C-reactive protein (CRP), and homeostasis model assessment of insulin resistance (HOMA-IR) were investigated in 748 non-diabetic participants aged > or =20 years. Nineteen types of POPs in 5 subclasses were selected because the POPs were detectable in > or =60% of the participants. RESULTS: Among the five subclasses of POPs, only organochlorine (OC) pesticides showed positive associations with CRP concentrations, while polychlorinated biphenyls (PCBs) showed inverse associations with CRP concentrations. There were statistically significant interactions between CRP and OC pesticides and between CRP and PCBs, in estimating HOMA-IR (P for interaction <0.01 and <0.01, respectively). CRP was not associated with HOMA-IR among subjects with low concentrations of OC pesticides or PCBs, while CRP was strongly associated with HOMA-IR among subjects with high concentrations of these POPs. CONCLUSIONS: In the current study, OC pesticides were associated with increased levels of CRP, a marker of inflammation, and both OC pesticides and PCBs may also modify the associations between CRP and insulin resistance.
Adult ; C-Reactive Protein/analysis/*drug effects ; Environmental Pollutants/adverse effects/*blood ; Female ; Humans ; Hydrocarbons, Chlorinated/adverse effects/*blood ; Inflammation/*chemically induced ; Insulin Resistance/*physiology ; Male ; Middle Aged ; Nutrition Surveys ; Pesticides/adverse effects/blood ; Polychlorinated Biphenyls/adverse effects/*blood

OBJECTIVETo investigate the effects of Ginkgo leaf extract (GLE) on function of dendritic cells (DC) and Th1/Th2 cytokines in patients with unstable angina pectoris (UAP).

METHODSFifty-four patients with UAP were equally assigned into two groups, the treated group and the control group, both treated with conventional Western medicine, but with GLE given additionally to the treated group. Blood of all patients was taken before and 4 weeks after treatment to prepare the peripheral mononuclear cells, then which were incubated in the completed medium containing granulocyte-macrophage colony stimulatory factor (GM-CSF) and interleukin-4 (IL-4) to induce mature DC. The expression of co-stimulating factor CD86 (B7-2) on the surface of DC was detected by flow cytometry, and the stimulating capacity of DC was determined by mixed lymphocyte reaction (MLR). The blood levels of cytokines, interferon-gamma (IFN-gamma), and IL-4, were analyzed by ELISA, and blood C-reactive protein (CRP) level by turbidimetry. Moreover, the direct effect of Ginkgolide B on CD86 expression on DC were also tested in vitro.

RESULTSAfter treatment, CD86 expression on DC, the stimulating capacity of DC as well as levels of IFN-gamma and CRP were lowered in both groups (P < 0.05 or P < 0.01), but the changes were much more significant in the treated group than those in the control group. Ginkgolide B showed a direct inhibitory effect on the CD86 expression on DC.

CONCLUSIONThe inhibition of GLE on DC and thereby the suppression on inflammatory reaction may be one of the mechanisms of GLE in treating patients with UAP.

Adult ; Aged ; Angina, Unstable ; immunology ; B7-2 Antigen ; analysis ; C-Reactive Protein ; analysis ; Cells, Cultured ; Dendritic Cells ; cytology ; drug effects ; immunology ; Diterpenes ; pharmacology ; Female ; Ginkgolides ; Humans ; Interferon-gamma ; analysis ; Interleukin-4 ; analysis ; Lactones ; pharmacology ; Male ; Middle Aged

OBJECTIVETo summarize the clinical features of Enterococcus faecium meningitis in children.

METHODSThe clinical data of nine children with Enterococcus faecium meningitis were analyzed.

RESULTSIn all the nine children, Enterococcus faecium was isolated from blood, cerebrospinal fluid, or peripherally inserted central catheters; 6 (67%) patients were neonates, 2 (22%) patients were younger than 6 months, and 1 (11%) patient was three years and four months of age. In those patients, 56% had high-risk factors before onset, which included intestinal infection, resettlement of drainage tube after surgery for hydrocephalus, skull fracture, perinatal maternal infection history, and catheter-related infection. The main symptoms were fever and poor response. In those patients, 22% had seizures; no child had meningeal irritation sign or disturbance of consciousness. The white blood cell count and level of C-reactive protein were normal or increased; the nucleated cell count in cerebrospinal fluid was normal or mildly elevated; the protein level was substantially elevated; the glucose level was decreased. The drug sensitivity test showed that bacteria were all sensitive to vancomycin and the vancomycin treatment was effective. Only one child had the complication of hydrocephalus.

CONCLUSIONSEnterococcus faecium meningitis occurs mainly in neonates and infants. The patients have atypical clinical features. A high proportion of patients with Enterococcus faecium meningitis have high-risk factors. Enterococcus faecium is sensitive to vancomycin.

C-Reactive Protein ; analysis ; Enterococcus faecium ; drug effects ; Female ; Gram-Positive Bacterial Infections ; blood ; diagnosis ; drug therapy ; etiology ; Humans ; Infant ; Infant, Newborn ; Male ; Meningitis, Bacterial ; blood ; diagnosis ; drug therapy ; etiology ; Vancomycin ; pharmacology

Chronic gastritis is a kind of chronic gastric mucosal inflammation caused by many factors.Intestinal metaplasia refers to the transformation of gastric mucosal epithelial cells into small/large intestinal mucosal epithelium containing Panette or goblet cells.Chronic gastritis has the highest incidence among stomach diseases,while intestinal metaplasia is the serious manifestation of chronic gastritis.In this experiment,the therapeutic effect of modified Zhengqi Powder on mild intestinal metaplasia in chronic gastritis and on patients' quality of life and inflammatory reaction was investigated to analyze the efficacy and mechanism of traditional Chinese medicine prescription.From April 2016 to April 2017,120 patients of chronic gastritis with mild intestinal metaplasia were selected and divided into two groups according to the envelope method.The control group(60 cases) was treated with famoxetine.After one month of continuous treatment,the total effective rate of treatment in the observation group was 93.3%,which was much higher than 80.0% in the control group.Health questionnaire(SF-36),serum C-reactive protein(CRP),interleukin-8(IL-8) and tumor necrosis factor-α(TNF-α) levels were significantly higher than those in the control group(P<0.05).The results showed that modified Zhengqi Powder has a significant efficacy in treat chronic gastritis with mild intestinal metaplasia,and can obviously alleviate clinical symptoms and intestinal metaplasia,remove inflammatory factors and improve the quality of life of patients,and is worth promotion.
C-Reactive Protein ; analysis ; Drugs, Chinese Herbal ; therapeutic use ; Gastric Mucosa ; drug effects ; Gastritis, Atrophic ; drug therapy ; Humans ; Interleukin-8 ; blood ; Metaplasia ; drug therapy ; Quality of Life ; Tumor Necrosis Factor-alpha ; blood

BACKGROUND: The present study was aimed at investigating the predictive parameters of erythropoietin (epoetin) hyporesponsiveness in patients on continous ambulatory peritoneal dialysis (CAPD). METHODS: We studied 40 patients with end-stage renal disease who had been receiving CAPD for at least 6 months and epoetin therapy for at least more than 2 months. Pearson's simple correlation and multiple stepwise linear regression analysis was used to discover what parameter can predict epoetin resistance. We expressed epoetin resistance index (ERI) as 'weekly epoetin dose/hematocrit/ body weight'. The dose of epoetin is titrated by about 25% every 2 to 4 weeks to maintain a target hematocrit level between 33% and 36%. RESULTS: We analyzed the relationship between ERI and other predictive parameters by Pearson's correlation. These results showed ERI has a statistically significant correlation with transferrin saturation (TS) (r=-0.327, p=0.042), total weekly Kt/Vurea (r=-0.423, p=0.018), serum albumin level (r=-0.458, p= 0.003), normalized protein catabolic rate (nPCR) (r=-0.479, p=0.006), normalized protein equivalent of total nitrogen appearance (nPNA) (r=-0.488, p=0.005) and serum C-reactive protein (CRP) (r=0.332, p=0.036). Regression analysis was performed using stepwise linear regression for multiple variables to discover the most independent variable which is correlated with ERI. ERI was entered as a dependent variable, whereas the other parameters (age, duration of peritoneal dialysis, serum albumin level, CRP, serum ferritin, total weekly Kt/Vurea, nPCR, nPNA, serum iPTH, serum aluminium, TS) were entered as independent variables. This analysis showed CRP is the most significant variable and, if CRP is excluded, nPNA is the significant variable. CRP has a statistically significant correlation with serum albumin level (r=-0.418, p=0.007) and total weekly Kt/Vurea (r=-0.366, p=0.043). High CRP group has more increased level of ERI (p<0.05), age (p<0.05) and serum creatinine level (p<0.05) than normal control, but more decreased level of serum albumin (p<0.01) and serum iron levels (p<0.05). CONCLUSION: These results indicate that CRP is the most important predictor of epoetin hyporesponsiveness.
Adult ; Anemia/*drug therapy/etiology/prevention & control ; Blood Chemical Analysis ; C-Reactive Protein/analysis/drug effects ; Comparative Study ; Dose-Response Relationship, Drug ; Drug Administration Schedule ; Drug Resistance ; Erythropoietin/*administration & dosage ; Female ; Human ; Kidney Failure, Chronic/*therapy ; Linear Models ; Male ; Middle Age ; Multivariate Analysis ; Peritoneal Dialysis, Continuous Ambulatory/*adverse effects/methods ; Predictive Value of Tests ; Prospective Studies ; Regression Analysis ; Treatment Outcome

BACKGROUND/AIMS: The efficacy and safety of a combination of ezetimibe and low-dose statin as primary treatment for dyslipidemia in renal transplant patients were evaluated prospectively. METHODS: The study enrolled 77 renal transplant recipients with dyslipidemia. They were given ezetimibe (10 mg) and simvastatin (10 mg) for 6 months as the initial treatment for dyslipidemia. Efficacy and safety were evaluated using lipid profiles, trough calcineurin inhibitor levels, allograft function, and adverse effects. The effects on proteinuria and high sensitivity C-reactive protein (hsCRP) levels were also evaluated. RESULTS: Ezetimibe and low-dose simvastatin significantly decreased the levels of total cholesterol (34.6%), triglyceride (16.0%), and low-density lipoprotein cholesterol (LDL-C) (47.6%), and 82.5% of the patients reached the target LDL-C level of <100 mg/dL. No significant change in the trough calcineurin inhibitor levels or allograft function occurred, and no serious adverse effects were observed. Fourteen patients (18.2%) discontinued treatment; eight patients (11.7%) developed muscle pain or weakness without an increase in creatinine kinase levels, and two patients (2.6%) developed elevated liver transaminase levels. The proteinuria and hsCRP levels did not change significantly. CONCLUSIONS: Ezetimibe and low-dose statin treatment is safe and effective as a primary treatment for dyslipidemia in renal transplant patients.
Adult ; Azetidines/*administration & dosage/adverse effects ; C-Reactive Protein/analysis ; Cholesterol, LDL/blood ; Dyslipidemias/blood/*drug therapy ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage ; *Kidney Transplantation ; Male ; Middle Aged ; Prospective Studies ; Simvastatin/*administration & dosage/adverse effects

Antimetabolites, Antineoplastic ; adverse effects ; therapeutic use ; C-Reactive Protein ; analysis ; Child ; Child, Preschool ; Cytarabine ; adverse effects ; therapeutic use ; Diagnosis, Differential ; Female ; Fever ; blood ; chemically induced ; diagnosis ; Humans ; Infant ; Male ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; blood ; drug therapy ; Teniposide ; therapeutic use