ObjectivesTo summarize the application ofGuidelines for the Management of Community-Acquired Pneu-monia (CAP) (2013 edition) in the diagnosis and treatment of children with CAP.MethodsThe clinical features of 209 children with non-severe CAP at different age stages were retrospectively analyzed. The curative effect of azythromycin was summarized which was used as ifrst-line antibiotics in the CAP treatment.ResultsIn 209 CAP children, the onset of 94 children was occurred in spring and summer and 115 occurred in autumn and winter. The white blood cell counts (WBC) in 51 CAP children (24.4%) were more than 10.0×109/L and absolute neutrophil counts (ANC) in 91 CAP children (43.5%) were more than 5.0×109/L. C-reactive protein levels in 199 CAP children (95.7%) were increased and MP-IgM showed positive in 94 CAP children (45.0%). 173 CAP children (82.8%) presented unilateral inlfammatory lesions in chest X-ray, and the right side was predominant. There was no difference in onset season among different age groups (P>0.05). However, the percentage of WBC≥10×109/L among different age groups were signiifcantly different (P=0.002) and the percentage of WBC≥10×109/L was highest in infants and young children group. The proportion of onset in spring and summer was signiifcantly higher in MP-IgM positive group than that in MP-IgM negative group (P<0.01). The total effective rate of azithromycin used as ifrst-line antibiotics was 98.1% (205/209), and there was no signiifcant difference in total effective rate of azithromycin between MP and non-MP pneumonia groups.Con-clusionsThe Guidelines for the Management of CAP (2013 edition) have a reference value in the diagnosis and treatment of CAP in our region where the CAP in children has some different features.

Objective To analyze the recent condition on medication safety of the elderly with chronic diseases in poor areas of Liaoning Province, the structural equation model(SEM) was used to investigate the influencing factors of the medication safety in order to provide the scientific basis for medication safety and the rational use of drugs. Methods The 1 690 elderly with chronic diseases in poor areas of Liaoning Province were selected by the multi-stage random sampling and investigated with the self-designed questionnaire, the database was established on SPSS17.0, the model of structural equation modeling was built by AMOS17.0. Results The four common factors, which were the knowledge,attitude, practice and adherence of medication safety, were extracted by confirmation factor analysis, and the data of the four common factors was fitted, the fitting parameters were: χ2/DF=2.254, GFI=0.913, NFI=0.909, CFI=0.925, AGFI=0.825, RMSEA=0.062, the model fitting was ideal. Conclusions The medication of the elderly with chronic diseases in poor areas of Liaoning Province exists potential security risks, the knowledge, attitude, practice and adherence of medication safety are the important factors which affect the medication safety, the health education about medication safety should be conducted in the elderly with chronic diseases in the poor areas, to develop the safety, effectiveness and economy of medication among the elderly.

To investigate the effect of prostaglandin E_1 (PGE_1) on the liver function following laparotomy, 55 adult patients with normal liver function, undergoing elective laparotomy for gastric cancer under total intravenous anesthesia ,were randomly allocated to receiving intravenous infusion of PGE_1 at rate of 20 to 60ng?kg~(-1). min~(-1)(group PGE_(1,n)=27), or normal saline (group control, n=28 )from the opening of abdomen to the end of operation,respectively. The serum concentrations of glutamin-pyruvic transaminase (GPT)and glutamic-oxaloacetic transaminase (GOT)were measured postoperatively. The results showed that as compared with the values before the operation,the levels of GPT and GOT increased significantly in both groups on the first postoperative day (P

BACKGROUND:Studies have found that epithelial-mesenchymal transition is closely related with tumor invasion, metastasis, and drug resistance, but studies on the role of epithelial-mesenchymal transition in the transformation process of gastric cancer cels SGC7901 to gastric cancer stem-like cels are rarely reported.
OBJECTIVE: To explore the effect of epithelial-mesenchymal transition in the transformation process of gastric cancer cels SGC7901 to gastric cancer stem-like cels.
METHODS:Vincristine-induced SGC7901 cels were cultured and screened to prepare gastric cancer stem-like cels. CD44 phenotype, morphological changes, stem cel-related markers, and epithelial-mesenchymal transition related molecules were detected.
RESULTS AND CONCLUSION:After passage, vincristine-induced SGC7901 cels presented with morphological changes, and clonal cel spheres generated after serum-free suspension culture. Meanwhile, the proportion of SGC7901 cels positive for CD44 was decreased. Expression levels of SOX2, OCT4, Snail1 mRNA, Twist mRNA and Vimentin mRNA were significantly higher in the gastric cancer stem-like cels than SGC7901 cels, but the expression level of E-caderin was lower in the gastric cancer stem-like cels than SGC7901 cels. These findings indicate that gastric cancer cels SGC7901 can be successfuly transformed into gastric cancer stem-like cels, and the epithelial-mesenchymal transition is involved in this transforming progress.

Objective To analyze the distribution of clinically isolated pathogenic bacteria in Xi′an area during 2014 and their drug resistant characteristics in order to provide the data of pathogenic bacterial drug resistance for medical pharmaceutical adminis ‐tration departments and clinical rational use of antibacterial drugs .Methods The pathogenic bacteria of nosocomial infections were cultured and isolated by using the routine method .The bacterial species was identified by using the semi‐automatic or full‐automatic bacterial identification and analysis systems .The drug susceptibility test was conducted according to CLSI standards .The data sta‐tistics and analysis were performed by using the WHONET 5 .6 software .Results 31 013 strains of pathogenic bacteria were isola‐ted in 2014 ,including 20 029 strains (64 .58% ) of Gram‐negative bacilli ,9 888 strains (31 .88% ) of Gram‐positive cocci and 1 096 strains (3 .54% ) of fungi ;the top bacteria was E .coli(20 .29% ) ,vancomycin resistant Staphylococcus aureus was not be found ;the resistance rates of Enterococcus faecium and faecalis against Vancomycin were 3 .00% ,1 .00% ,which against to linezolid was 1 .00% ;the generation rates of extended‐spectrum beta‐lactamase(ESBLs) in E .coli and Klebsiella pneumoniae were 65 .0% and 56 .0% respectively .Conclusion The important pathogenic bacteria ,including MRSA ,vancomycin resistant enterococcus ,carbapen‐em resistant Enterobacteriaceae bacteria ,pan‐drug resistant Pseudomonas aeruginosa and Acinetobacter baumannii ,in nosocomial infection should be performed the intensive monitoring and the communication with clinic should be strengthened in order to make the detection results serve the clinic well .

At present, the clinical research of Huanglian-Ejiao Decoction for anti-anxiety mainly focuses on the treatment of western medicine combined with the addition and subtraction of Huanglian-Ejiao Decoction. By observing the generalized anxiety patients with heart kidney disharmony or secondary anxiety symptoms of yin deficiency and fire hyperactivity type after taking Huanglian-Ejiao Decoction, all the studies show that this prescription can effectively improve the anxiety state of patients, and has long-term effect, low incidence of adverse reactions and low recurrence rate. However, there are also some deficiencies in the study, such as in the study of generalized anxiety, most clinical observation of TCM syndrome differentiation has no authoritative standard, some of the inclusion criteria for generalized anxiety and panic disorder are not clear, and the course of generalized anxiety is persistent, the observation of long-term efficacy and recurrence rate of diseases is obviously insufficient; in the study of anxiety syndrome, for anxiety disorder The diagnostic criteria of the disease are often not clear, the evaluation criteria of anxiety improvement are not unified, and there lacks the evaluation of safety. At the same time, the mechanism research on Huanglian-Ejiao Decoction is not perfect.

OBJECTIVE: To detect potential variants in eight Chinese pedigrees affected with autosomal dominant polycystic kidney disease (ADPKD) and provide prenatal diagnosis for two of them. METHODS: Whole exome sequencing and high-throughput sequencing were carried out to detect variants of PKD1 and PKD2 genes in the probands. Sanger sequencing was used to validate the variants, and their pathogenicity was predicted by searching the ADPKD and protein variation databases. RESULTS: Eight PKD1 variants were detected, which have included five nonsense mutations and three missense mutations. Among these, four nonsense variants (PKD1: c.7555C>T, c.7288C>T, c.4957C>T, c.11423G>A) were known to be pathogenic, whilst one missense variant (PKD1: c.2180T>G) was classified as likely pathogenic. Three novel variants were detected, which included c.6781G>T (p.Glu2261*), c.109T>G (p.Cys37Gly) and c.8495A>G (p.Asn2832Ser). Prenatal testing showed that the fetus of one family has carried the same mutation as the proband, while the fetus of another family did not. CONCLUSION PKD1 variants, including three novel variants, have been identified in the eight pedigrees affected with ADPKD. Based on these results, prenatal diagnosis and genetic counseling have been provided.
DNA Mutational Analysis/methods* ; Female ; Humans ; Mutation ; Pedigree ; Polycystic Kidney, Autosomal Dominant/genetics* ; Pregnancy ; Prenatal Diagnosis ; TRPP Cation Channels/genetics*

Objective:To explore the genetic etiology of two children with Spinal muscular atrophy with respiratory distress type 1 (SMARD1), and prevent the recurrence of birth defects.Methods:Two unrelated families who had visited the Obstetrics and Gynecology Medical Center of Drum Tower Hospital from August to November 2021 were selected as the study subjects. Copy number of SMN1 gene exon 7 for the probands and their parents was detected by multiple ligation-dependent probe amplification (MLPA). and whole exome sequencing (WES) was carried out to screen the variants in the probands. Sanger sequencing was used to validate the variants within the families. Pathogenecity of the variants were predicted by bioinformatic analysis. Based on the results, prenatal diagnosis was performed for the fetuses. Results:Both probands were found to harbor compound heterozygous variants of the IGHMBP2 gene, which were inherited from their parents. Among these, c. 1144C>T, c. 866delG and c. 1666C>G were previously unreported and respectively classified as pathogenic variant (PVS1+ PM2_Supporting+ PP3+ PP4), likely pathogenic variant (PM1+ PM2_Supporting+ PM4+ PP3+ PP4) and likely pathogenic variant (PM1+ PM2_Supporting+ PP2+ PP3+ PP4) based on the ACMG guidelines. Through preimplantation genetic testing for monogenic (PGT-M) and interventional prenatal diagnosis, transmission of the variants within the families was successfully blocked. Conclusion:The SMARD1 in both children may be attributed to the compound heterozygous variants of the IGHMBP2 gene, which has facilitated the genetic diagnosis and counselling, and provided reference for delineating the molecular pathogenesis of this disease.

Objective: To explore the application of septoplasty and cheiloplasty in complete unilateral cleft lip repairment, and evaluate the effect on nasal shape correction. Methods: Twenty-four infants with complete unilateral cleft lip were divided into two groups: the correction group and the control group. Both groups underwent cheiloplasty by Mohler′s technique, septoplasty was performed in the correction group during the primary cheiloplasty. Six-month follow-up was taken to evaluate the nasal shape with the three dimensional images. Independent-samples t Test was performed using SPSS 21.0, to compare the nasal morphology between two groups. Results: All patients healed in the first stage, and were followed for 6 months after operations. There were no complication, including nasal septum perforation, occurred in either group.There were statistically significant differences in nasal parameters between the correction group and controls (P<0.05). The columellar width, nostril width on the affected side, and columella deviation of the correction group were smaller, than those of controls. The nose tip height, columellar height and nostril height on the affected side of the correction group were greater than those of the control group. Conclusions Septoplasty associated with the primary cheiloplasty in complete unilateral cleft lip repairment, shows better results in the elongation of the nasal columella, and the correction of septum deviation, and provides a stable nasal structure.

Objective:To analyze the influence of CD19 isoforms to the efficacy of CD19/CD3 Bispecific T-cell Engager (BiTE) antibody, and explore the resistance mechanism of BiTE immunotherapy.Methods:Semi-quantitative RT-PCR (qRT-PCR) was used to detect the expression of CD19 mRNA isoforms before and after BiTE treatment in a patient with CD19 + B cell acute lymphoblastic leukemia (ALL) . CD19 isoforms were analyzed by Sanger sequencing. Flow cytometry and transcriptome sequencing were performed to analyze the expression of cell lineage specific molecules before and after BiTE treatment. Results:The expression of CD19 isoform with exon 2 deletion was identified at diagnosis. After relapsed and treatment of BiTE antibody, the patient did not achieve remission and CD19 antigen on leukemic cells turned negative detected by flow cytometry after BiTE treatment. However the expression ratio of CD19 isoform with exon 2 deletion was not increased. Flow cytometry phenotype and transcriptome sequencing confirmed that no linage switching developed, which suggested the expression of CD19 isoform caused by exon alternative splicing and lineage switching was not related to CD19 epitope loss in this patient. This patient achieved complete remission by sequential administration of self-developed CD22 CAR-T and CD19 CAR-T after disease progression.Conclusion:Targeting or combining an alternative antigen specific CAR-T may be a promising treatment option after losing CD19 expression in relapsed ALL.