Objective To investigate the value of creatine kinase and computed tomography(CT)angiography to evaluate short-term prognosis of patients with superior mesenteric artery embolism(SMAE).Methods The retrospective cross-sectional study was adopted.The clinical data of 26 patients with SMAE who were admitted to the first Affiliated Hospital of Wenzhou Medical University between January 2008 and October 2015 were collected.The patients received serologic examination and CT angiography firstly,and then medicinal conservative method and surgical method were respectively conducted according to the results of above examinations.Observation indices:(1)clinical features,(2)serum indicators results,(3)CT angiography results:①location(main stem and non-main stem)of SMAE and development of distal branches of superior mesenteric artery(SMA),②indirect signs,such as bowel wall thickening,bowel dilatation combined with effusion and air accumulation and pneumatosis intestinalis,(4)therapy and prognosis.Measurement data with normal distribution were presented as-x±s,comparisons among groups were analyzed by one-way ANOVA.Measurement data with skewed distribution were presented as M(range)and analyzed by the Kruskal-Wallis rank sum test,and pairwise comparison was done using the Nemenyi test.Results(1)Clinical features:of 26 patients with SMAE,6 patients had intestinal ischemia,8 patients had partial intestinal necrosis and 12 patients had long segmental intestinal necrosis(postoperative short bowel syndrome in 5 patients and total small intestinal necrosis and partial colonic necrosis in 7 patients).Duration of symptoms before diagnosis was(1.7±0.8)days in 6 patients with intestinal ischemia and(2.1±1.1)days in 8 patients with partial intestinal necrosis and(1.5±0.7)days in 12 patients with long segmental intestinal necrosis,with no statistically significant difference(F=1.27,P＞0.05).(2)Serum indicators results:levels of serum creatine kinase in patients with intestinal ischemia,partial intestinal necrosis and long segmental intestinal necrosis were 68 U/L(range,50-86 U/L),98 U/L(range,54-244 U/L)and 300 U/L(range,40-873 U/L),respectively,with a statistically significant difference among patients(H=7.32,P＜0.05)and between patients with intestinal ischemia and with long segmental intestinal necrosis(H=7.21,P＜0.05),and with no statistically significant difference between patients with partial intestinal necrosis and with intestinal ischemia or long segmental intestinal necrosis(H=1.53,2.07,P＞0.05).(3)CT angiography results:①developments of SMAE(main stem and non-main stem)and distal branches of SMA:main stem embolism of SMA in 13 patients demonstrated hypodense shadow,with non-contrast of distal branches of artery,including 1 with intestinal ischemia,1 with partial intestinal necrosis and 11 with long segmental intestinal necrosis.Main stem embolism of SMA in 8 patients demonstrated hypodense shadow,with contrast of distal branches of SMA,including 3 with intestinal ischemia,4 with partial intestinal necrosis and 1 with long segmental intestinal necrosis.Main stem embolism of SMA in 2 patients demonstrated hypodense shadow,with non-contrast of distal branches of SMA,showing partial intestinal necrosis.Non-main stem embolism of SMA in 3 patients demonstrated hypodense shadow,with contrast of distal branches of SMA,including 2 with intestinal ischemia and 1 with partial intestinal necrosis.②Indirect signs:5 patients had bowel wall thickening,including 3 with intestinal ischemia and 2 with long segmental intestinal necrosis.Seventeen patients had bowel dilatation combined with effusion and air accumulation,with gas fluid level in local intestinal canal,including 2 with intestinal ischemia,5 with partial intestinal necrosis and 10 with long segmental intestinal necrosis.Two patients had pneumatosis intestinalis,with bubble shadow of bowel wall,showing long segmental intestinal necrosis.(4)Therapy and prognosis:of 6 patients with intestinal ischemia,1 underwent embolectomy of SMA and 5 underwent low-molecular-weight heparin anticoagulation and vasodilator alprostadil therapy.Eight patients with partial intestinal necrosis received resection of necrotic intestine.Of 12 patients with long segmental intestinal necrosis,5 with postoperative short bowel syndrome received resection of necrotic intestine combined with postoperative parenteral hyperalimentation.The above-mentioned patients were improved and discharged from hospital after symptomatic treatment and surgery.Twelve patients with long segmental intestinal necrosis,7 with total small bowel necrosis and partial colonic necrosis underwent only exploratory laparotomy and then were dead in a short time.Conclusion Elevated creatine kinase and main stem embolism of SMA combined with non-contrast of distal branches using CT angiography maybe predict poor short-term prognosis of patients with SMAE.

Objective To compare butorphanol or midazolam alone and combination of the two drugs in preventing etomidate-induced myoclonus during anesthesia induction.Methods One hundred sixty patients, aged 40-64 yr, with body mass index of 20-25 kg/m2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ , scheduled for elective operations under general anesthesia, were randomly allocated into 4 groups with 40 patients in each group: control group (group C), butorphanol group (group B) , midazolam group (group M) , and butorphanol combined with midazolam group (group BM).Before induction of anesthesia, butorphanol 15.0 μg/kg, midazolam 50 μg/kg, and butorphanol 7.5 μg/kg combined with midazolam 25 μg/kg were injected intravenously over 30 s in B, M and BM groups, respectively.The equal volume of normal saline was given in group C.And 2 min later, etomidate 0.3 mg/kg was injected intravenously over 1 min.The occurrence of myoclonus was recorded within 2 min after administration of etomidate, and the severity of myoclonus was assessed.Results Compared with group C, the incidence and severity of myoclonus were significantly decreased in B, M and BM groups (P＜0.05).Compared with B and M groups, the incidence and severity of myoclonus were significantly decreased in group BM (P＜0.05).There was no significant difference in the incidence and severity of myoclonus between group B and group M (P ＞ 0.05).Conclusion Butorphanol or midazolam alone produces similar efficacy in preventing etomidate-induced myoclonus during anesthesia induction, and the combination of the two drugs provides better efficacy than either alone in the patients.

Objective To trace changes in the transcript level of the Treponema pallidum(Tp)protein Tp0751 in skin lesions of a rabbit model of early syphilis. Methods Three New Zealand white rabbits were intracutaneously injected with 0.1 ml of Tp (Nichols Seattle strains)suspensions (107 treponemes/ml)at 10 sites on the shaved back to establish a model of early syphilis. All the rabbits received a single injection with the total amount of treponemes being 107. Then, skin changes at injection sites were observed, and the size of skin rashes was recorded on a daily basis. Skin specimens sized 0.4 cm × 0.4 cm were excised from an injection site and a non-injection site(negative control)separately every 3 days for the detection of Tp0751 and Tp0574 mRNAs. The whole experiment lasted 30 days, and a total of 11 skin biopsies were carried out. Fluorescence-based quantitative PCR was performed to measure the mRNA expressions of Tp0751 and Tp0574 continuously and dynamically during the development of chancre. Results After intracutaneous injection of Tp suspensions, red papules occurred on the back of rabbits on day 6, and reached maximum size on day 19 with the formation of ulcer and chancre. On day 25, disseminated secondary syphilides gradually appeared all over the body surface of the rabbits. The mRNA expression levels of Tp0574 and Tp0751 increased at the early stage, peaked onday 15 (compared with the other time points, all P < 0.05), thereafter rapidly declined, but rose slightly on day 27. The standardized expression level of Tp0751 mRNA increased gradually after day 15, and peaked on day 24 (compared with the other time points, all P < 0.05). Conclusion The transcript level of Tp0751 was high in rabbits at the late stage of Tp clearance when generalized disseminated secondary syphilides had not appeared, suggesting that Tp0751 may be involved in the systemic spread of Tp.

Objective:To analyze the epidemiological characteristics of respiratory syncytial virus (RSV) infection in children in Tianjin, and provide reference for the prevention and treatment of RSV infection in children.Methods:Clinical data of 2 743 children with acute respiratory infections treated at the Tianjin Fifth Central Hospital from January 2022 to January 2024 were collected. Multiplex fluorescent PCR was used to detect the nucleic acid fragments of six respiratory pathogens including Mycoplasma pneumoniae, human rhinovirus, adenovirus, influenza A virus, influenza B virus and RSV in the throat swabs of the patients. A retrospective analysis was performed on the epidemiological and clinical data of RSV-RNA positive cases. Results:The positive rate of RSV-RNA in the 2 743 children was 15.09% (414/2 743). The positive rate of RSV-RNA was 9.29% (73/786) in 2022 and 16.53% (302/1 827) in 2023, with a statistically significant difference between the two years (χ 2=23.45, P<0.05). The incidence of RSV infection in winter and spring was significantly different from that in summer and autumn (χ 2=19.46, P<0.05). The highest and the lowest infection rates of RSV were found in winter (19.32%, 193/999) and autumn (9.43%, 45/477), respectively. There was a significant difference in RSV infection rate among different age groups (χ 2=71.38, P<0.05), with the highest infection rate in the age group of 0-2 years (21.18%, 230/1 086), and the lowest infection rate in the age group of 6-8 years (6.29%, 27/429). Among the 414 children with RSV infection, 359 cases (84.97%) were infected with RSV alone, while the other 55 cases (13.29%) were infected with mixed pathogens. Fifty-two cases had co-infection of RSV and one other pathogen. The most common pathogens in co-infection cases were human rhinovirus (4.83%, 20/414) and Mycoplasma pneumoniae (6.04%, 25/414). Conclusions:The RSV infection rate among children with acute respiratory tract infection in Tianjin from 2022 to 2024 was 15.09%, with the highest infection rate in spring and the lowest infection rate in autumn. RSV infection can occur in children of all ages, with the highest infection rate in children aged 0-2 years and the lowest infection rate in children aged 6-8 years. RSV infection is often complicated by other respiratory pathogens, and the most common pathogens are human rhinovirus and Mycoplasma pneumoniae.

Objective:To explore the effect of nursing based on Peplau's interpersonal relationship theory in rectal cancer patients with permanent colostomy.Methods:From January 2019 to December 2020, convenience sampling was used to select rectal cancer 90 patients with permanent colostomy in the Affiliated Hospital of Shaoxing University as the research object. The patients were divided into the control group and the observation group by random number table method, with 45 cases in each group. The control group was given routine nursing, and the observation group received nursing based on Peplau's interpersonal relationship theory. The Self-efficacy Subscale of the Chronic Disease Self-management Measuring Scale and the City of Hope-Quality of Life-Ostomy Questionnaire-Chinese Version (COH-QOL-OQ) were used to evaluate the intervention effect.Results:After the intervention, the scores of each item of the Self-efficacy Subscale and the total COH-QOL-OQ score of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Nursing based on Peplau's interpersonal relationship theory can improve self-efficacy and quality of life in rectal cancer patients with permanent colostomy.

Objective To investigate the expression of TP 0155 mRNA in rabbits with early infection of Treponema pallidum ( T.pallidum ). Methods Three New Zealand white rabbits were subcutaneously injected with T.pallidum Nichols Seattle strains.Each rabbit was inoculated at ten sites with 106 T.pallidum/site.Skin lesions at the primary stage of syphilis were observed at different time points. Biopsy from one of the lesions was obtained from each rabbit every three days for detection of TP 0155 mRNA and house keeping gene TP 0574 mRNA.TP0155 plasmid standard was constructed by molecular cloning technique , and the quantitative PCR was used to continuously detect the expression of TP 0155 mRNA and TP0574 mRNA from lesion at different time points.Kruskal Wallis test and Bonferroni method were used to analyze the data.Results On d6, red papules appeared on the dorsal skins of rabbits ,there were ulcers in the center of the lesions on d19,presenting typical appearance of syphilis chancre.On d24 the scab of ulcer became smaller; on d25 the rabbits showed disseminated secondary syphilis , which became smaller and disappeared on d30.The copy numbers of TP0155 plasmid standards were 7.48 ×109 copies/μL.There were significant differences in expression of both TP 0155 mRNA and TP0574 mRNA at different time points (χ2 =32.756 and 52.344,both P<0.01).The expression levels of TP0155 mRNA and TP0574 mRNA increased in the early stage, and both reached the peak at d15 (both P<0.05), and then rapidly declined. There were significant differences in normalized TP 0155 mRNA ( TP0155 ×1000/TP0574 mRNA ) at different time points(χ2 =19.758,P<0.05),which reached the peak on d24 and d30,respectively (all P<0.05).Conclusion The level of TP0155 mRNA increases with the disappearance of chancre and secondary syphilis lesions , suggesting that TP0155 might be involved in immune escape of T.pallidum.

Objective To isolate and culture a clinical strain (GDI) of Treponema pallidum (Tp) in Guangdong province,and to investigate the difference in nonsynonymous single nucleotide polymorphisms (nsSNPs) between the GD1 strain and Tp Nichols strain.Methods The GD1 strain was isolated from the hard chancre in a patient with primary syphilis in Guangdong province,and continuously subcultured in the testes of New Zealand white rabbit.The serial subcultivation of GD1 was multi-verified by dark-field microscopy,polymerase chain reaction (PCR) for TP0548 gene,DNA sequencing and genotyping.Meglumine diatrizoate density gradient centrifugation was performed to isolate rabbit tissues and concentrate GD1,and DNA sequencing was used to verify the nsSNPs in the TP0443 and TP0584 genes.Results The GD1 strain was successfully isolated from the lesions of the patient with syphilis,and classified as a subtype f of TP0548.Compared with the American Tp (Nichols strain),there were nsSNP mutations in the GD1 strain.One mutation was located in the TP0443 gene,leading to the the substitution of threonine by alanine at amino acid position 120,and another one was located in the TP0584 gene,which caused a change from alanine to threonine at amino acid position 314.Conclusion The GD1 strain was successfully isolated firstly from the lesions in a patient with syphilis in Guangdong province,and nsSNP mutations were confirmed in the GD 1 strain on the etiology.

Objective:To explore the profile and gene functional changes of gut microbiota (GM) in women with postmenopausal osteoporosis (PMOP) in Northwest China, and the correlations between GM and bone mineral density (BMD).Methods:From November 2018 to October 2019, postmenopausal women were screened on their initial visits to our hospital, and 24 new osteoporosis (OP) patients, 30 new osteopenia patients and nine negative controls were recruited. Fecal samples were collected for GM DNA extraction, and Illumina platforms were used for high-throughput sequencing of 16S rRNA and metagenome. Species annotation, GM profile and gene functions were viewed and analyzed.Results:GM profiles were significatly different in different groups, and the LDA scores of Peptostreptococcaceae, Romboutsia, unidentified Clostridiales, Megamonas, Erysipelatoclostridium, Klebsiella and Erysipelatoclostridium ramosum were more than 3 in OP group. Metagenomic sequencing analysis indicated that gene numbers were positively correlated with BMD, and metabolism, carbohydrate metabolism, starch and sucrose metabolism and oxidative phosphorylation were negatively correlated with BMD. Receiver operating characteristic curve(ROC) showed that carbohydrate metabolism, starch and sucrose metabolism, amino sugar and nucleotide sugar metabolism, oxidative phosphorylation, respectively, could identify OP with preferable sensitivity and specificity (areas under curve were 0.70, 0.72, 0.73 and 0.75, respectively). Conclusions:High-throughput sequencing had great potential for GM analysis of postmenopausal women with OP, providing evidence of the correlations between GM and BMD.

Objective:To establish ultra performance liquid chromatography (UPLC) characteristic chromatogram of Pulsatilla chinensis; To provide reference for the origin identification and quality control of Pulsatilla chinensis. Methods:UPLC Method was adopted. The determination was performed on a column of Agilent SB C18 (2.1 mm×100 mm, 1.8 μm) . The mobile phase was acetonitrile-methanol (2:1) -0.1% phosphoric acid solution by fradient elution at a flow rate of 0.30ml/min. The column temperature was 30 ℃. The detection wavelength was 215 nm. The injection volume was 2 μl. The common counterfeit products and medicinal herbs of Pulsatilla chinensis from different areas were evaluated by comparison of characteristic chromatogram, principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA). Results:There were 9 characteristic peaks in the characteristic chromatogram of Pulsatilla chinensis, and 8 common peaks were identified by high resolution mass spectrometry and comparison of reference materials. Through PCA analysis, it was possible to clearly distinguish the medicinal herbs of Pulsatilla chinensis from different areas. Combined with OPLS-DA analysis, it was found that peak 2, peak 3, peak 6 were the main markers of Pulsatilla chinensis from different producing areas. Conclusion:The established method has good specificity, repeatability and durability, and it can effectively distinguish the common counterfeits of Pulsatilla chinensis, and provide the basis of quality control and selection of origin for Pulsatilla chinensis.

Male ; Humans ; Liquid Chromatography-Mass Spectrometry ; Chromatography, Liquid ; Tandem Mass Spectrometry ; Varicocele/diagnosis* ; Biomarkers