Objective To investigate serum interferon-inducible protein 16 (IFI16) level in the patients with preeclampsia (PE) and its correlation with PE pathogenesis.Methods Forty-five PE pregnant women in the Third Affiliated Hospital of Zhengzhou University from August 2015 to March 2016 were selected as the PE group and contemporaneous 30 healthy pregnant women undergoing the routine pregnant examination were selected as the control group.The biochemical indexes of serum urea,uric acid,creatinine,etc.were detected by using the automatic biochemical analyzer.The serum levels of IFI16 and ET-1 were measured by ELISA.Then the correlations between serum IFI16 level with these detected indicators were analyzed.The receiver operating characteristic (ROC) curve analysis was performed to evaluate the value of serum IFI16 for predicting PE disease.Results The serum IFI16 and ET-1 levels in the PE group were significantly higher than those in the control group (P<0.01).Furthermore the serum IFI16 level in severe PE was significantly higher than that in mild PE (P<0.01).Serum IFI16 level in PE was positively correlated with systolic blood pressure,diastolic blood pressure,24-h urine protein quantitation and serum ET-1 level,and negatively correlated with serum albumin.Serum IFI16 levels 14.47 ng/mL and 17.09 ng/mL as the critical values for predicting preeclampsia and discriminating between mild preeclampsia and severe preeclampsia has a higher sensitivity and specificity.Conclusion The high level of serum IFI16 in pregnant women has a certain correlation with PE pathogenesis and may be a novel biomarker for predicting PE occurrence.

OBJECTIVE:To establish the method for the detection of the known glucagon-like peptide 1 receptor (GLP1R) gene mutation site rs3765467(NT_007592.16,position:39065819),and to evaluate its accuracy and practicability. METHODS:Peripheral venous blood samples of 72 healthy subjects were collected in medical examination center of our hospital during Oct. 2015-Feb. 2016. The whole blood DNA was extracted by column extraction method. After amplified by touch down PCR,high reso-lution melting(HRM)method was adopted to analyze amplified product. Sequencing verification by double stranded chain termina-tion method(Sanger sequencing method)was performed for 38 test samples. The results of 2 methods were compared. RESULTS:The results of mutation scanning showed that there were 39065817 and 39065819 polymorphism sites in amplified segments. Four types of mutations were detected by HRM method [GCG/GCG,GCA/GCG or ACG/GCG,GCA/GCA or ACG/ACG,A(G) CA(G)],but 6 types of mutations was detected by Sanger sequencing method [GCG/GCG,ACG/GCG,ACG/ACG,A(G)CA (G),GCA/GCG,GCA/GCA]. CONCLUSIONS:HRM method can identify GCG/GCG and A(G)CA(G)genotype,but can not identify GCA/GCG and ACG/GCG heterozygous mutation,GCA/GCA and ACG/ACG homozygous mutation. The method is not suitable for the detection of single nucleotide polymorphism for multiple neighboring sites. In the detection of single nucleotide mu-tation,economical and simple method should be selected after comprehensive analysis of sequence.

OBJECTIVE:To provide reference for formulating related provisions,guidelines and regulations for off-label drug use,standardizing medical behavior in medical health institutions. METHODS:According to the connotation of off-label drug use,Questionnaire for off-label drug use was developed for medical institutions,in which drug name,treatment disease,the type and use evidence ofoff-label drug usewere included. The questionnaires were delivered to pharmacists who participatedClinical phar-macist practice skills training in Sichuan province to collect the related information of off-label drug use for statistical analysis, and suggestions were put forward. RESULTS:Totally 150 questionnaires were sent out,124 were effectively received with effec-tively recovery of 82.7%;the surveyed pharmacists came from 22 medical institutions,including 18 tertiary hospitals and 4 second-ary hospitals;there were 128 information about off-label drug use,including 14 (10.9%) with incomplete reporting information. The another 114 information were major in“super indication”(61) and“super administration”(43),accounting for 53.5% and 37.7%,respectively,and there are 8 other drug overdose(7.0%),2 super object(1.8%). The relevant off-label drug use mainly included anti-infection drugs (34 information,29.8%),anti-tumor drugs (16 information,14.0%),TCM injections (8 informa-tion,7.0%),and etc.;the relative concentration of varieties were metronidazole,dexamethasone,gentamicin,methotrexate, azithromycin,irinotecan,vancomycin,nystatin,etc.. Some medical institutions were absence of effective regulatory measures. CONCLUSIONS:Off-label drug use is quite common in medical institutions of Sichuan province,some of them exist obvious med-ication risk. It is suggested that the state should be as soon as possible to develop related provisions,guidelines and regulations for off-label drug use,endowing legal force for off-label drug use;medical staff should avoid no evidence-based drug use,unreason-able or even unnecessary off-label drug use;pharmaceutical production enterprises should strengthen communication with medical institutions and pay attention to collect information related to the clinical medication,timely update the drug instructions to ensure the legitimate rights for patients and the interests for medical staff.

For patients with abnormal thyroid function,the detection of peripheral blood coagulation indicators may be irregular,and there is a potential risk of thrombosis or bleeding.Patients with hyperthyroidism have significant endothelial dysfunction and risk of thrombosis.However,the reports on the effect of hypothyroidism on coagulation function are still controversial.The potential risk of abnormal thyroid function to the coagulation system may interfere with the safety of anticoagulant therapy,and the interaction between thyroid disease treatment drugs and anticoagulant drugs also affects the safety of the patient's medication.Therefore,this article is based on previous research literature,analyzes the correlation between abnormal thyroid function and coagulation function,and evaluates and discusses the impact of abnormal thyroid function on the coagulation system and related therapeutic drug interactions.It is expected to provide a reference for diagnosing and treating patients with thyroid dysfunction and abnormal coagulation function.

Objective:To investigate the phenotypes, molecular types and drug-resistance genes of erythromycin (ERY)-resistant group B Streptococcus (GBS) in pregnant women in late pregnancy in Zhengzhou and provide basic data for the prevention, control and treatment of GBS infection. Methods:This study retrospectively collected 86 GBS strains isolated from the vaginal secretions of pregnant women in late pregnancy at Maternal and Child Health Hospital of Henan Province from 2021 to 2022. ERY-resistant GBS strains were selected using the ERY disk diffusion method, and their susceptibility to 10 different antibiotics was tested. Whole-genome sequencing was performed to analyze their molecular features including molecular types, clonal complex groups and drug-resistance genes. Drug-resistance genes carried by GBS strains belonging to different clonal complex groups were compared.Results:There were 70 ERY-resistant GBS strains. Among them, 7.14%(5/70) exhibited an inducible resistance phenotype to macrolide-lincosamide-streptogramin B (MLSB) antibiotics; 84.29%(59/70) showed constitutive resistance to MLSB antibiotics; 8.57%(6/70) were resistant to macrolides but susceptible to lincosamides. The resistance rates of these strains to clindamycin (CLI), tetracycline (TE) and levofloxacin (LEV) were 91.43%(64/70), 54.29%(38/70) and 60.00%(42/70), respectively. These ERY-resistant strains exhibited multidrug resistance patterns with 40.00%(28/70) showing ERY-CLI-LEV resistance phenotype and 30.00%(21/70) showing ERY-CLI-TE resistance phenotype. The major drug-resistance genes carried by the 70 GBS strains were macrolide/lincosamide resistance genes mreA (100.00%) and ermB (53/70, 75.71%), aminoglycoside resistance genes ant (6)-Ⅰ a (22/70, 31.43%) and aph(3′)-Ⅲ (18/70, 25.71%), and tetracycline resistance genes tetM (22/70, 31.43%) and tetO (13/70, 18.57%). These strains belonged to 12 sequence types derived from seven clonal complexes (CCs) and 48.57%(34/70) of them were clustered into CC12. All CC12 strains harbored ermB, but none carried ermA. The positive rates of lsaE, lunB, and aac (6′)- aph(2" ) in CC19 and CC651 strains, ant (6)-Ⅰ a in CC651 and CC452 strains, and mefA and msrD in CC19 and CC23 strains were significantly higher than those in CC12 strains ( P<0.001). Conclusions:ERY-resistant GBS in Zhengzhou exhibited diverse drug resistance phenotypes and molecular types. CC12 was the most prevalent clonal complex in this region. The constitutive MLSB resistance phenotype and ermB gene were the most common ERY resistance phenotype and genotype, respectively, and tetM gene was related to tetracycline resistance. Furthermore, the drug-resistance genes varied in GBS strains of different clonal complexes. This study suggested that close attention should be paid to the epidemiological situation of GBS in this region and the effectiveness of antibiotics used for clinical prevention and treatment of GBS infection should be carefully evaluated.

TORCH, which is considered as a series of pathogens, including the Toxoplasma gondii, Rubella virus, Cytomegalovirus or Herpes simplex virus, often infects the pregnant women to induce the the fetus or newborn infection by transplacental infection or exposure to contaminated genital tract secretions at delivery. Increasing evidence have been confirmed that the infection of TORCH may cause the miscarriage, premature birth, malformed fetus, stillbirth, intrauterine growth retardation, neonatal multiple organ dysfunction and other adverse pregnancy outcomes. For most TORCH-infections cases may lacking the effective treatments during pregnancy, and it is important to achieve the effacing monitoring of TORCH infections before and during pregnancy. The laboratory testing of TORCH has the great significance. However, the consensus opinions still need to improve the the standardization of TORCH testing process and the correct interpretation. Based on the characteristics of the TORCH detection method, this article gives a consensus opinion on the standardized detection and clinical application of TORCH from the laboratory perspective according to the characteristics and types of infection of different pathogens.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.