Objective To analyze the positive rate of autoantibodies in Xinjiang Uygur patients with different types of auto‐immune liver disease and its diagnostic value .Methods Fifty‐one Uygur outpatients and inpatients with of autoimmune liver disease in our hospital from October 2012 to October 2014 were selected ,including 20 cases of autoimmune hepatitis (AIH ,AIH group) and 31 cases of primary biliary cirrhosis (PBC ,PBC group) .The indirect immunofluorescence and Western blotting were used to detect the serum biochemical indexes and autoantobodies ,and the comparative analysis was performed .Results The levels of various bio‐chemical indexes in the two groups were increased ,in which ALT ,γ‐GT ,ALP and IgM levels had statistical difference between the two groups(P<0 .05) .The positive rates of ANA ,SMA ,LKM‐1 antibody ,LC‐1 antibody ,SDLA/LP antibody and AMA in the AIH group were 65 .0% ,40 .0% ,10 .0% ,5 .0% ,10 .0% and 5 .0% respectively ;the positive rates of ANA ,AMA and M2 subtype (AMA‐M2) in the PBC group were 61 .3% ,100 .0% and 96 .8% respectively .Conclusion The autoantibodies spectrum in Xinjiang Uygur patients with autoimmune liver diseases has certain characteristics .The autoantibodies spectrum detection has an important significance for the diagnosis ,classification and differential diagnosis of autoimmune liver diseases .

Objectives To identify the spectrum of pathogens causing bloodstream infection and their resistance profiles. Methods We examined records with positive blood culture from Jan. 1998 to Mar. 2003 in a teaching hospital in Shanghai. The contaminants were excluded according to the CDC definition of bloodstream infection. Bacteria were collected from April 1, 2002 to March 31, 2003 and MIC to the most commonly used antimicrobial agents was performed. Results 276 episodes occurred during the study period. Of all the BSI episodes, about 74.3% BSI were hospital-acquired and 37.3% were community-acquired. Gram-positive organisms accounted for 38% of isolates, while gram-negative for 44.2% and fungus for 13.8%. The commonest pathogens causing bloodstream infection in hospital-acquired BSI were coagulase-negative staphylococcus (16.9%) and Escherichia coli (16.6%), followed by Candida species (14.1%), Staphylococcus aureus (13.7%) and Klebsiella pneumoniae (13.2%). Streptococcus spp., Escherichia coli, coagulase-negative staphylococcus and Staphylococcus aureus are the leading pathogens causing community-acquired bloodstream infection, which accounted for 16.9%, 15.5%, 15.5%, 11.3% respectively. Susceptibility tests in vitro shows that methicillin resistance in S. aureus was 56%, while in coagulase-negative staphylococcus was 88%. Among the prevalent Gram-negative BSI isolates, resistance rates for most of the antimi-crobial agents were high. However, it is encouraging to note that the carbapenems retained potency against almost all the Enterobacteriaceae, including those resistant to the third-generation cephalosporins and extended-broad-spectrum penicillins. The crude mortality rate of BSI was 24.4%. Conclusion The rate of Coagulase-negative staphylococcus, Klebsiella pneumoniae and fungus in BSI have increased in the past years. Enterobacteriaceae, acinetobacter spp and fungus are more common in hospital-acquired BSI than community-acquired BSI.

Objective To discuss effects of anti-inflammatory mechanism of amygdalin on rats with type II collagen-induced arthritis (CIA). Methods Wistar rats were randomized into normal group, model group, amygdalin group, and tripterygium group. Type II CIA rat models were established. From the 15th day after the modeling establishment, each administration group was given corresponding dose of medicine for continuous 28 days. Levels of TNF-αand sICAM-1 were detected by ELISA in serum of rats, and expression of TNF-α was detected by immuno-histochemical method. Results TNF-α positive expression in amygdalin group and tripterygium group was similar and significantly reduced compared with model group. Levels TNF-α and sICAM-1 in amygdalin group and tripterygium group significantly decreased compared with those in model group (P<0.05), without significant difference compared with normal group (P>0.05). Conclusion Amygdalin can inhibit the expression of TNF-α and levels of TNF-α and sICAM-1, in order to treat rheumatoid arthritis.

BACKGROUND:The majority of rheumatoid arthritis treatment is chronic anti-arthritis drugs, biological agents and plant drugs. Among them, plant drugs have been widely concerned due to low cost and few adverse effects. OBJECTIVE:To observe the expression of tumor necrosis factor-α(TNF-α) and interleukin-1β(IL-1β) in the
synovium of col agen-induced arthritis rats, and explore the effect of Aconitum leucostomum Worosch. on the expression.
METHODS:Forty-five rats were randomly divided into normal control group (8 rats) and model group (37 rats). The col agen-induced arthritis model was established with the injection of type II bovine col agen into the end of the tail and paws. After the success of modeling, the 24 successful model rats were randomly selected and divided into model group (8 rats), Tripterygium wolfprdi polyglycoside group (8 rats) and Aconitum leucostomum Worosch. group (8 rats). The arthritis index of the rats in the three intervention groups and one control group were evaluated weekly. After treated by intragastric administration for 4 weeks (Tripterygium wolfprdi polyglycoside group and Aconitum leucostomum Worosch. group were taken by the corresponding drug solution, model group and normal control group were taken by the same volume of physiological saline), the expressions of TNF-αand IL-1βin the synovium were tested by immunohistochemistry.
RESULTS AND CONCLUSION:Compared with the model group, the arthritis index of mice in Tripterygium wolfprdi polyglycoside group and Aconitum leucostomum Worosch. group was decreased significantly after treatment (P<0.05). The expression levels of TNF-αand IL-1βin the synovium of model group were significantly higher than those of the normal control group (P<0.05). After treatment with Aconitum leucostomum Worosch. and Tripterygium wolfprdi polyglycoside, the expression levels of TNF-αand IL-1βin the synovium was decreased compared with the model group (P<0.05). Experimental findings indicated that, the mechanism that Aconitum leucostomum Worosch. treats rheumatoid arthritis is related to the inhibition of TNF-αand IL-1β.

Objective:To observe the clinical outcomes of continued pregnancy in pregnant women with cesarean scar pregnancy (CSP).Methods:A retrospective analysis was performed on the pregnancy outcomes of 55 pregnant women who were diagnosed with CSP at the Second Affiliated Hospital of Army Medical University during the first trimester of pregnancy from August 1st, 2018 to October 31st, 2021 and strongly requested to continue the pregnancy.Results:Of the 55 pregnant women, 15 terminated the pregnancy in the first trimester, 1 underwent hysterotomy at 23 weeks of gestation due to cervical dilation, and 39 (71%, 39/55) continued pregnancy to the third trimester achieving live births via cesarean section. The gestational age of the 39 pregnant women delivered by cesarean section was 35 +6 weeks (range: 28 +5-39 +2 weeks), of whom 7 cases at 28 +5-33 +6 weeks, 20 cases at 34-36 +6 weeks, and 12 cases at 37-39 +2 weeks. The results of pathological examination were normal placenta in 3 cases (8%, 3/39), placenta creta in 4 cases (10%, 4/39), placenta increta in 9 cases (23%, 9/39) and placenta percreta in 23 cases (59%, 23/39). Among the 36 pregnant women who were pathologically confirmed as placenta accreta spectrum disorders (PAS) after surgery, the last prenatal ultrasonography showed placenta previa in 27 cases (75%, 27/36) and not observed placenta previa in 9 cases. The median intraoperative blood loss, autologous blood transfusion, and allogeneic suspended red blood cell infusion of 39 pregnant women during cesarean section were 1 000 ml (300-3 500 ml), 300 ml (0-2 000 ml) and 400 ml (0-2 400 ml), respectively. The uterine preservation rate was 100% (39/39), and only 1 case received cystostomy due to intracystic hemorrhage. The birth weight of the newborn was 2 580 g (1 350-3 800 g), and 1 case of mild asphyxia. Conclusions:Pregnant women with CSP who continue pregnancy under close monitoring after adequate ultrasound evaluation and doctor-patient communication could achieve better maternal and infant outcomes, but pregnant women with CSP are highly likely to continue pregnancy and develop into PAS. Effective hemostasis means and multidisciplinary team cooperation are needed in perinatal period for ensuring maternal and fetal safety.

OBJECTIVE To systematically evaluate the adverse effects of drug-resistant tuberculosis （DR-TB） drugs on pregnant women and fetuses ，so as to provide evidence-based reference for clinical medication. METHODS PubMed，Cochrane Library，Embase，CBM，CNKI，Wanfang database and VIP were searched by computer to collect randomized controlled trials （RCTs），cohort studies ，case-control studies ，case series and case reports about pregnant women exposed to DR-TB drugs. The retrieval time limit was from the establishment of each database to August 20，2021. After selecting the literature and extracting the data，the bias risk assessment tool recommended by 6.2 version of Cochrane system evaluator manual was used to evaluate the quality of the included RCTs ；Newcastle-Ottawa scale was used to evaluate the quality of the included cohort studies and case-control studies ；IHE scale issued by the Canadian Institute of Health Economics （IHE）was used to evaluate the quality of the included case series and case reports. RevMan 5.1 software was used for Meta-analysis of non-comparative binary data. RESULTS A total of 13 literature were included ，including 7 case series and 6 case reports ，involving 203 patients and 204 newborns；among them，there were 6 literature about non-comparative binary data. The results of meta-analysis showed that after exposure to DR-TB drugs，no newborn had birth defects ；the mortality of pregnant women was 0.09[95％CI（0.06，0.15），P＜0.000 01]；the neonatal mortality was 0.02[95％CI（0，0.06），P＜0.000 01]；the incidence of preterm birth was 0.14[95％CI（0.03，0.43），P＝0.02]；the incidence of infants with low birth weight was 0.17[95％CI（0.04，0.51），P＝0.06]；the incidence of growth retardation was 0.15[95％CI（0.09，0.22），P＜0.000 01]；the incidence of stillbirth was 0.05[95％CI（0.02，0.09），P＜0.000 01]；the incidence of abortion was 0.08[95％CI（0.05，0.14），P＜0.000 01]. CONCLUSIONS Pregnant women exposed to DR-TB drugs can cause pregnant women ’s death and abortion ，neonatal death ，premature birth ，infants with low birth weight ，growth retardation and stillbirth，but there is no neonatal birth defect ；these adverse outcomes may be related to the history of DR-TB.