Objective Comparison the coincidence rate in the colloidal gold method and the passive agglu-tination method to detect mycoplasma pneumoniae (MP) infection, discuss the clinical value in rapid diagnosis of MP infection in the two methods. Methods Two-hundred patients with MP infection, including 100 cases in the the children group, and 100 cases in the adult group, were detected in MP-IgM antibody in serum with the colloidal gold method and the passive agglutination method. Results The positive rate of MP-IgM antibody with the passive agglutination method were slightly higher than that of the colloidal gold method in the children group (P > 0.05), While the positive rate of MP-IgM antibody with the passive agglutination method in the adult group were signifi-cantly higher than that of the colloidal gold method (P<0.05). When the antibody titer of MP-IgM antibody were 1:60, ≥1:320 in the children group, the coincidence rate of the positive results with the colloidal gold method and the passive agglutination method were 95.40%, 95.30%;When the antibody titer of MP-IgM antibody were 1:80, 1:160,≥1:320 in the adult group, the coincidence rate of the positive results with the colloidal gold method and the passive agglutination method were 0, 61.90%, 63.80%. Conclusions In the pediatric MP infection, for the high an-tibody titer of MP-IgM antibody, the positive coincidence rate with the colloidal gold method can reach clinical diag-nostic requirements. Clinical physicians according to the age and disease process of patients choose the appropriate method in order to realize the simple, rapid and accurate diagnosis of mycoplasma pneumoniae infection.

Objective To investigate antimicrobial prophylaxis in clean operation,and provide evidence for formu-lating antimicrobial management measures.Methods 12 types of clean operation cases who discharged from a tertia-ry first-class hospital in May of 2011 -2014 were selected,120 cases were selected each year,patients were divided into group I and group II according to the types of operation,survey forms were designed,assessment criteria for the rationality of antimicrobial use was formulated, antimicrobial use in different years was compared. Results Prophylactic use of antimicrobial agents for clean operation decreased from 93.33% in 2011 to 35.00% in 2013 and 2014;rates of correct medication time increased from 43.75% in 2011 to 97.62% in 2013 and 92.86% in 2014 respectively;rates of medication according to indications,rational choice of antimicrobial agents,and rational treatment course increased from 42.86%,60.71 %,and 21 .43% in 2011 to 100.00% in 2014 (all P < 0.05 ). Conclusion Special rectification activities of antimicrobial use effectively promoted the standard application of anti-microbial agents for clean operation.

Objective To investigate the malnutrition status among the elderly in age care institutions in Shanghai suburb and analyze its potential influential factors.Methods The MiniNutritional Assessment (MNA) was adopted to evaluate the nutritional status of the 190 elderly people in age care institutions.The dietary supply by the institution canteen and the quantity of residual food left by the malnourished elderly people were weighted.Results In the age care institutions,the malnutrition rate reached 23.7％,47.9％ of the elderly people were at the risk of malnutrition,and only 28.4％ of the elderly people were well nourished.Logistic regression analysis showed that the major influential factors for malnutrition in the elderly people were food intake ability,mobile capability,chewing and swallowing ability,ageing and mental Illness.The malnourished elderly people had the most residual meat and vegetables,and insufficiency of nutrient intake was the main cause for the malnutrition in the elderly people.Conclusions The elderly people in age care institutions in Shanghai suburb have the higher risk of malnutrition.The malnutrition occurs under influence of many factors,of which some are unavoidable,however,some factors like dietary factors can be changed to improve the nutritional status of the elderly people in age care institutions.

Objective To investigate the distribution and antimicrobial resistance of bacteria isolates from intensive care units(ICUs) in Shandong Province.Methods Antimicrobial susceptibility data about clinical strains isolated from ICUs of 101 hospitals and general wards(non-ICUs) of 106 hospitals in Shandong Province in 2014 were analyzed statistically.Results A total of 24 458 strains of bacteria were isolated, of which gram-negative and gram-positive bacteria accounted for 80.37% and 19.63% respectively.The top five pathogens in ICUs were Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus.Resistance rates of Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, and Serratia marcescens obtained from ICUs to carbapenems, piperacillin/tazobactam, cefoperazone/sulbactam, and amikacin were all higher than those from non-ICUs(all P<0.01).Resistance rates of Acinetobacter baumannii, Pseudomonas aeruginosa, and Staphylococcus spp.from ICUs were all higher than those from non-ICUs(P<0.05).Resistance rates of Acinetobacter baumannii isolated from ICUs to imipenem and meropenem were 78.0% and 79.0% respectively;while Pseudomonas aeruginosa were 25.5% and 21.6% respectively, resistance rates to other antimicrobial agents were all <30.0%.Isolation rate of methicillin-resistant Staphylococcus aureus from ICUs was higher than that from non-ICUs(39.7% vs 26.0%, P<0.05).Conclusion Antimicrobial resistance of bacteria isolated from ICUs is serious, rational use of antimicrobial agents should be guided according to the results of antimicrobial susceptibility testing result, so as to prevent the spread of drug-resistant bacteria.

Objective To investigate the effects of glutamine (Gln) on proliferation and survival of small cell lung cancer H446 cells, and further to explore the potential mechanism. Methods The proliferation of H446 cells was detected at different time points (0, 24, 48, 72 and 96 h) by CCK-8 assay in Gln (+) group and Gln (-) group, and an optimal time was selected. Under the optimal time, Annexin V-FITC/PI staining, CellTiter-Glo? assay kit and flow cytometer were used to detect cell survival, cellular adenosine triphosphate (ATP) and reactive oxygen species (ROS) levels. Gln (-) group was used as the control group, under the condition of Gln deficiency, cellular ATP, cell proliferation and survival were detected after adding oxaloacetic acid (OAA) or dimethyl-α-ketoglutarate (DM-αKG). Gln (-) group was used as the control group, cellular ROS, cell proliferation, colony and survival were detected after treated with ROS scavenger N- acetyl cysteine (NAC). With different concentrations (0, 2, 5, 10 μmol/L) of glutaminase inhibitor BPTES, the optimal concentration was selected through the colony assay. The cellular ATP and ROS levels and cell proliferation were detected under the optimal concentration. H446 cells were treated with bis-2-(5-phenylacetamido-1,2,4-thiadiazol-2-yl) ethyl sulfide (BPTES), ROS inducer hydrogen peroxide (H2O2) or the combination of them, and cell survival ratio was compared between two groups. Results The proliferation levels of H446 cells at 24, 48, which were decreased most significantly in 72 h in Gln (-) group. When 72 h was used as the optimal time, the cell survival ratio and ATP level were decreased, and the ROS level was increased, in Gln (-) group compared with those of Gln (+) group (P<0.05). There was a higher survival ratio in H446 cells in Gln (-)+OAA group and Gln (-)+DM-αKG group than that of Gln (-) group (P<0.05), but there were no significant differences in cell proliferation and ATP levels between Gln (-) group, Gln (-)+OAA group and Gln (-)+DM-αKG group. The ROS level was reduced, the cell proliferation, colony level and survival ratio were increased in Gln (-)+NAC group compared with those of Gln (-) group (P<0.05). Cloning assay showed that 10μmol/L was the optional concentration. Under this concentration, the proliferation and ATP level were decreased in Gln(+)+BPTES group (P<0.05), and cellular ROS level was up-regulated compared with Gln(+) group. The survival ratio was significantly lower in BPTES+H 2O2 group compared with BPTES (+) group or H2O2 (+) group. Conclusion Glutamine deficiency inhibits the proliferation and survival ratio of H446 cells through enhancing ROS level. BPTES and H2O2 show synergistically inhibitory effect on the survival of H446 cells.

Objective To evaluate the effect and safetyof Yupingfeng Powdercombined with antihistamines for the treatment of patients with chronic urticaria.Methods Searched all randomized controlled trials (RCTs)of Yupingfeng Powder for treatment of chronic urticaria from the databases of CENTRAL,Pubmed,Embase,CNKI,CBM,VIP and Wanfang.Two researchers independently searched the literature and used the Cochrane system evaluation method to evaluate the quality of the study,and used RevMan 5.3 for meta-analysis.Results A total of 10 RCTs involving 964 patients were included in this study.Meta-analysis showed that compared with antihistamines alone,Yupingfeng Powder combined with antihistamines could improve the clinical effective rate (OR=2.83,95 ％ CI:1.89-4.25,P ＜ 0.01),reduce relapse rate (OR =0.13,95 ％ CI:0.07-0.24,P＜0.01) and reduce the incidence of adverse reactions (OR=0.40,95％CI:0.19-0.83,P=0.01).Conclusion Yupingfeng Powder combined with antihistamines has superior clinical effective rate,lower recurrence rate and incidence of adverse reactions.

Objective To observe the effect of miR-145 on pain threshold and explore the pos-sible underlying positive role of miR-145 in rats with diabetic neuropathic pain.Methods The total of 36 rats with diabetic neuropathic pain were randomly divided into three groups respectively with nor-mal control group (group N)(n=12 for each group):diabetic neuropathic pain(DNP)group (group D),DNP-NC group (group DN)and DNP-agomiR-145 group (group agomiR-145).The rats received agomiR-145 intrathecal injection in group agomiR-145 (10 μl,1×106TU/ml),or the negative control virus in group DN (10 μl,1×106TU/ml),or equal volume of normal saline in other two groups. Paw mechanical withdrawal threshold(MWT)and paw withdrawal latency(TWL)were measured on the day before intrathecal injection and day 1,days 3,7 and 14 after intrathecal injection.On the days 14 after pain-related behavioral test,the RNA expression of miR-145 in the dorsal root ganglion (DRG)was detected using reverse transcription-quantitative polymerase chain reaction(RT-PCR)as-say and the expression of Nav 1.8 in DRG were detected by fluorescent immunofluorescence.In addi-tion,a dual luciferase activity assay was used to testify the target genes of miR-145.Results MWT and TWL were decreased at 1 d before intrathecal injectionin groups D,DN and agomiR-145 than that in group N (P<0.05).The significant increase of MWT was observed in group agomiR-145 on day 3,7,14 than those in group D and group DN (P<0.05).TWL in group agomiR-145 was increased significantly on day 7 and day 14 compared with those in groups D and DN (P<0.05).Compared with group N,miR-145 expression level in DRG in groups D and DN were significantly lower (P<0.05).In addition,the protein expression of Nav1.8 was significantly increased in group D and DN compared with that in group N (P<0.05).Compared with groups D and DN,miR-145 expression was increased significantly and the expression of Nav1.8 in DRG was decreased significantly in group agomiR-145 (P<0.05).In addition,a dual luciferase reporter assay demonstrated that miR-145 can bind with the 3'-UTR region of Nav1.8 and regulate its expression.Conclusion Intrathecal agomiR-145 can effectively attenuate neuropathic pain of DNP rats,which may be related with down-regulation of Nav1.8 in DRG..

Objective To evaluate it' s prognosis according to the follow-up statistics of coronary reimplantation of anomalous left coronary artery originating from the pulmonary artery (ALCAPA).Methods Analyze the preoperative,peri-operative and postoperative data of 20 ALCAPA patients having undergone coronary artery reimplantation.Results After coronary reimplantation,patient' s cardiothoracic ratio was obviously decreased,the degree of myocardial ischemia was improved according to electrocardiogram,the left ventricular ejection fraction and fractional shortening showed a trend of rise,mostof the patients recover in 6 months to 1 year after coronary artery reimplantation.Left ventricular end-diastolic volume index over time gradually returned to normal,mitral regurgitation gradually.improved.Conclusion ALCAPA is rare and fatal,therefore it should be diagnosed and treated as early as possible.It is also significant to avoid missed diagnosis and misdiagnosis.After coronary reimplantation,cardiac function can be gradually restored with low mortality and good prognosis result.The left ventricularejection fraction of most patients recovers to the normal standard in six months to one year' s time.

OBJECTIVE To analyze the clinical characteristics of nephrotic syndrome induced by sunitinib， and to provide reference for clinical rational drug use. METHODS Retrieved from CNKI， VIP， Wanfang data， PubMed， Web of Science and Medline， case report about sunitinib-induced nephrotic syndrome were collected from the inception to Oct. 30th， 2022. Those case reports were analyzed statistically in terms of gender， age， primary disease， drug use， clinical manifestations， treatment and outcome. RESULTS A total of 15 pieces of literature were collected and 17 patients were involved， including 10 males and 7 females. The average age of patients was （59.35±15.72） years. Among 17 patients， there were 10 patients with renal cell carcinoma and 7 patients with gastrointestinal stromal tumor， all of whom received evidence-based medication； the dosage of sunitinib in 15 cases was recorded， and all of them were within the recommended range of the instructions； 9 patients received combined therapy； the time from sunitinib application to the occurrence of nephrotic syndrome was 21 days-52 months， of which 11 cases were ≤2 years. The clinical manifestations in 13 patients were described， including edema， oliguria， foamy urine， weight gain， fatigue， dyspnea on exertion， etc. Eight patients had other adverse reactions induced by sunitinib before suffering from nephrotic syndrome， including new hypertension or worsening of original hypertension， and hand-foot syndrome. Renal biopsy mainly manifested as thrombotic microangiopathy， focal segmental glomerular sclerosis and immune complex glomerulonephritis. Sunitinib withdrawal or dosage reduction was adopted in all patients， and they were given symptomatic treatment such as glucocorticoids and antihypertensive agents. Symptoms of 16 patients were improved， and renal function of one patient deteriorated and hemodialysis was started. Sunitinib was re-challenged in 6 patients， elevated creatinine and substantial proteinuria recurred in 5 patients. CONCLUSIONS In clinical use of sunitinib， it is advisable to periodically monitor renal function. In case of deterioration of renal function， albuminuria， edema， etc.， relevant examinations should be implemented in time， and symptomatic intervention should be taken as soon as possible. Besides， we should be alert to the recurrence of nephrotic syndrome after sunitinib rechallenge.

OBJECTIVE To analyze the clinical characteristics of liraglutide-induced pancreatitis， and to provide reference for clinical rational drug use. METHODS Retrieved from CNKI， VIP， Wanfang database， PubMed， Web of Science and Medline， case reports about liraglutide-induced pancreatitis were collected from the inception to December 31st， 2022. Demographic characteristics， drug use， clinical manifestations， intervention and outcome were analyzed using descriptive statistical method. RESULTS A total of 17 pieces of literature were collected and 17 patients were involved， including 7 males and 10 females. The patients aged from 25 to 75 years. All 17 patients had drug indications， including 14 cases of type 2 diabetes mellitus， 3 cases of obesity or overweight. Among 17 patients， liraglutide was used alone in 5 cases， and combined with other drugs in 12 cases. Time from liraglutide administration to pancreatitis occurrence ranged from 1 day to 11 months after medication in 17 patients， with 14 cases less than 6 months. The clinical manifestations mainly included abdominal pain， nausea and vomiting， etc. After the diagnosis of pancreatitis， liraglutide discontinuation occurred in 16 patients； 1 case did not receive any other interventions and the other 15 cases were managed with symptomatic supportive treatment； the symptoms of all 16 patients resolved； however， 2 patients suffered from second episode of severe pancreatitis several weeks after liraglutide discontinuation， pancreatitis recurred after liraglutide rechallenge in 1 case. The results of correlation evaluation showed that 1 case was “positive”， 4 cases were “possible”， and the remaining patients were “very likely”. CONCLUSIONS Liraglutide-induced pancreatitis mainly occurred within 6 months after drug administration. The majority of liraglutide-induced pancreatitis cases are mild to moderate， but there are also severe and even fatal cases. It is advisable to periodically monitor the level of pancreatic enzymes and closely observe patients’ clinical mani-festations. In case of suspected liraglutide-induced pancreatitis，drug withdrawal and symptomatic treatment should be taken immediately.