Abstract: Objective　To investigate the clinical and laboratory characteristics of pulmonary infection caused by Nocardia otitidiscaviarum. Methods　The clinical data of a patient with pulmonary infection caused by Nocardia otitidiscaviarum were reported, and the clinical characteristics, laboratory characteristics and drug sensitivity of pulmonary infection caused by Nocardia otitidiscaviarum were summarized in combination with the relevant literature at home and abroad from January 2010 to December 2022. Results　A 67-year-old female patient was admitted to the hospital on June 30, 2020 because of "repeated chest tightness and shortness of breath for 3 years, aggravated cough, expectoration and fever". The sputum, alveolar lavage fluid and blood of the patient were collected for culture, and the detected pathogenic bacteria were identified. There are pathogenic bacteria growing in sputum and alveolar lavage fluid, which are identified as Nocardia otitidiscaviarum by Autof ms mass spectrometer. According to the results of pathogenic bacteria and the patient's condition, meropenem combined with compound sulfamethoxazole tablets were given anti-infection treatment, and the patient's condition improved and discharged. Conclusion　The clinical manifestations and imaging features of nocardiosis are lack of specificity, and are prone to misdiagnosis and missed diagnosis. Etiology is the key to disease diagnosis, and clinical examination and culture should be conducted in time.

OBJECTIVETo study the effect of Chinese herbal compound (CHC) on the expression of hepatocyte cytochrome P450IIE1 in rat model of alcoholic fatty liver (AFL).

METHODSThe AFL rats models were established by administering the drinking water with 40%(v/v) ethanol, and the changes of pathology in liver and hepatocyte P450IIE1 expression, as well as the contents of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione (GSH), vitamin E (VitE) in liver were detected and compared with those in the control group.

RESULTSFatty degeneration in liver recovered normally in the CHC-treated group. Immunohistochemical and in situ hybridization examination showed that CHC could inhibit the hepatocyte cytochrome P450IIE1 expression markedly, and restore the contents of MDA, SOD, GSH, VitE to nearly normal range.

CONCLUSIONCHC can prevent AFL through inhibiting the hepatocyte cytochrome P450IIE1 expression markedly

Animals ; Cytochrome P-450 CYP2E1 ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Fatty Liver, Alcoholic ; pathology ; Gene Expression ; Hepatocytes ; drug effects ; enzymology ; Immunohistochemistry ; Rats ; Rats, Sprague-Dawley

Objective To detect the mutations of ATP2C1 gene in patients with Hailey-Hailey dis- ease (HHD).Methods PCR and direct sequencing were performed in 17 patients and 120 healthy controls to screen the mutations in the exons of ATP2C1 gene.Results Eight mutations were identified in nine probands, including three deletion mutations (nt1464-1487 del/nt1462-1485del,1523delAT,2375delTTGT),three splice site mutations (360—2A→G,1415—2A→T,2243+2T→C) and two missence mutations (C920T and G1942T).None of the above mutations was found in the controls.Conclusion Eight specific novel mutations were identified in nine probands of HHD,which could be causative factors of the disease.

Objective To study the sources and the relationship between the management and the outcome of hemorrhage after cephalic pancreatoduodenectomy.Methods The clinical data of 370 patients who underwent pancreatic resection at the Lihuili Hospital and the Second Affiliated Hospital of Zhejiang University were retrospectively analyzed.Results Postoperative bleeding occurred in 35 patients with 11 deaths.Among those intraabominal bleeding occurred in 14 cases and gastrointestinal hemorrhage occurred in 22,with one case suffering from both.Bleediug developing within 72 hours after operation in 12 cases (early-stage group),which was caused by improper intraoperative homeostasis.In other 23 cases,bleeding 72 hours after operation(later stage group)was caused by the erosion following pancreatic and/or bile leakage.Relaparotomy was performed in 13 cases and endoscopic homeostasis was performed in 3. Relaparotomy or endoscopic homeostasis was superior to that of conservative therapy in the early-stage group (P0.05).Pancreatic or bile leakage was identified as the significant risk factors for the postoperative bleeding.Conclusions In order to prevent the postoperative hemorrhage and to reduce the mortality of pancreatic resection,skillful techniques,expeditious homeostasis,proper management of stump pancreas and the prevention of pancreatic and bile leakage are essential.

OBJECTIVETo evaluate the incidence of Ketoconazole associated hepatotoxicity and related factor.

METHODSLiterature retrieval was conducted by using multi-databases for meta-analysis on Ketoconazole associated hepatotoxicity. The data were collected with a standardized form. Overall estimation of incidence of hepatotoxicity for specific study type was calculated by using a DerSimonian-Laird random-effects model owing to the substantial differences among the studies.

RESULTSTotally 204 eligible studies were included in the analysis. The incidence of Ketoconazole associated hepatotoxicity was 3.6%-4.2%. The dosage and duration specific subgroup analyses did not show any significant difference among groups, while the age specific subgroup analysis showed the incidence in children and people aged >60 years was 1.4% (95% CI: 0.5%-4.2%) and 3.2% (95% CI: 1.1%-8.7%) respectively. Additionally, the incidence of the hepatotoxicity was higher in people who had oral administration of ketoconazole beyond the provisions of the usage instructions, and the incidence was 5.7% (95% CI: 4.5%-7.2%).

CONCLUSIONKetoconazole associated hepatotoxicity was common. Off-label use might increase the risk of liver damage. Well-designed large sample studies are needed to identify the risk factors in future.

Antifungal Agents ; administration & dosage ; adverse effects ; Chemical and Drug Induced Liver Injury ; etiology ; Humans ; Ketoconazole ; administration & dosage ; adverse effects ; Off-Label Use

OBJECTIVETo observe the therapeutic effect of fire-needle therapy on lumbar intervertebral disc herniation.

METHODSSixty cases were randomly divided into a fire-needle group and an electroacupuncture group, 30 cases in each group. The fire-needle group was treated with fire-needle therapy and routine acupuncture, i.e., the fire-needle was given to the points on the lesion segments, and Jiaji (EX-B 2) and Ashi points above and bellow the segments, and routine acupuncture was given at Shenshu (BL 23), Zhibian (BL 54), Huantiao (GB 30), etc.; the electroacupuncture group was treated with electroacupuncture at the points as those in the fire-needle group. The scores of McGill Pain Rating Scale, Visual Analogous Scale (VAS) and present pain intensity (PPI) were compared before and after treatment for 2 weeks in the two groups.

RESULTSAfter treatment, all of the scores of McGill Pain Rating Scale, VAS and PPI were significantly decreased (all P < 0.01); the scores of emotion in the McGill Pain Rating Scale, VAS and PPI in the fire-needle group were significantly decreased as compared with those of the electroacupuncture group (P < 0.05, P < 0.01).

CONCLUSIONBoth fire-needle therapy and electroacupuncture can effectively relieve pain in the patients with lumbar intervertebral disc herniation, but the former is better than the latter.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Adolescent ; Adult ; Electroacupuncture ; methods ; Female ; Hot Temperature ; Humans ; Intervertebral Disc Displacement ; therapy ; Lumbar Vertebrae ; Male ; Middle Aged ; Needles ; Treatment Outcome ; Young Adult

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Leukemia, Prolymphocytic, B-Cell ; diagnosis ; Male ; Middle Aged ; Retrospective Studies

Objective To determine the clinical features,neurophysiological characteristics and cervical magnetic resonance imaging of sensory neumnopathy,and to describe the pathology of skin nerve, sural nerve and spinal dorsal columns.Methods Two patients who died from sensory neuron disease (SND)after infection of digestive tract were discussed including clinical features and ancillary tests which included neurophysiology and pathology of peripheral nerve and spinal dorsal columns.Associated documents are reviewed.Results Early ataxia,widespread sensory symptoms and global loss of deep tendon reflex were the distinctive signs of SND,which was characterized by non-length-dependent abnormalities of sensory nerve action potentials,a hallmark of ganglionopathies.The second patient showed normal cervical magnetic resonance imaging possibly because of short course of disease,while diffuse hyperintensity in the spinal posterior columns of SND was reported.Demyelination of spinal posterior columns and loss of mostly large diameter nerve fibers without regeneration clusters were the main pathological features.Conclusions The distinctive clinical features and neurophysiological characteristics of SND indicate that peripheral sensory nerve fibers are widely damaged.Pathology of spinal posterior columns confirm that central sensory pathway are impaired which allow the localization of the pathologic site to the dorsal root ganglion neurons.Cervical spinal MRI of SND are possibly normal at early phase.

Objective Toevaluatetheeffectsofwholecranberrypowder(Pacranpowder)onimmunefunctionsofICR miceinvivo.Methods FemaleICRmice(18-22g)wererandomlydividedintocontrolgroupandlow,mediumandhigh dose groups of whole cranberry powder (83,1 66,and 332 mg/kgbw).Whole cranberry powder was treated with by gavage for 30 days continuously.Control mice were treated with distilled water only.Their immune functions were analyzed, including serum hemolysin analysis, antibody -producing cells (APCs ), conA -induced splenic lymphocyte transformation,SRBC-induced delayed type hypersensitivity,natural killer cell activity assay,peritoneal macrophages phagocytosed chicken red blood cells (CRBC),carbon clearance test and thymus or spleen /body weight ratio.Results Ascomparedwiththecontrols,wholecranberrypowdertreatmentincreasedthenumberofplagueformingcells(PFCs)at 83 mg/kgbw group(P<0.05 ).There were no statistical difference in the total production of antibodies,the activity of conA-induced splenic lymphocyte transformation,the left-hind voix pedis thickness,NK cytoactivity,the phagocytosis index and ratio of peritoneal macrophages, the carbon clearance ability between the groups treated with different concentrationsofwholecranberrypowderandthecontrolgroup(P>0.05).Conclusion Wholecranberrypowdercan enhance mouse the number of plague forming cells (PFCs).

Background:Mutations in the isocitrate dehydrogenase 1 (IDH1) and IDH2 genes are important for both the integrated diagnosis and the prognosis of diffuse gliomas.The p.R132H mutation of IDH1 is the most frequently observed IDH mutation,while IDH2 mutations were relatively rarely studied.The aim of the study was to determine the pathological and genetic characteristics of lowergrade gliomas that carry IDH2 mutations.Methods:Data from 238 adult patients with lower-grade gliomas were retrospectively analyzed.The status of IDH1/2 gene mutations,telomerase reverse transcriptase (TERT) promoter mutations,O6-methylguanine-DNA-methyltransferase (MGMT) promoter methylation,1p/19q co-deletion and the expressions of IDH1 R132H,alpha-thalassemia X-linked mental retardation,and p53 were evaluated.Progression-free survival (PFS) and overall survival (OS) were calculated via Kaplan-Meier estimation using the log-rank test.Results:Totally,71％ (169/238) of patients were positive for IDH mutations,including 12 patients harboring mutations in IDH2.Among the 12 patients with IDH2 mutations,ten patients harbored the R172K mutation,one patient harbored the R172S mutation and one harbored the R172W mutation.Of these,11 tumors occurred in the frontal lobe and showed morphology typical of oligodendroglioma.The proportion of grade Ⅱ tumors was higher than that of grade Ⅲ tumors in IDH2 mutant-gliomas.IDH2 mutations were frequently associated with TERT promoter mutations,1p/19q co-deletion and MGMT promoter methylation.IDH2 mutations were associated with better outcomes compared with IDH wild-type gliomas (P ＜ 0.05).However,the PFS and OS did not differ from that of IDH1 mutant patients (P =0.95 and P =0.60,respectively).Conclusions:IDH2 mutations are more frequent in oligodendrogliomas and associated with a better prognosis.IDH2 mutations may segregate in distinct clinico-pathological and genetic subtypes of gliomas,and therefore may merit routine investigation.