Objective To explore the reason of serious interference red blood cell(RBC)parameters in blood routine test and correct method.Methods 30 cases of patients whose results of blood routine RBC parameters obviously abnormal ,According to the interference factors were divided into four groups:cold agglutination (7 cases),severe hemolysis(13 cases),high triglycerides (8 cases),high white blood cell(WBC)(2 例).Take appropriate corrective action for processing respectively.The difference of red blood cell parameters were compared with t test.Results To analysis of interference factors and take appropriate corrective meas-ures,RBC parameters could be more close to the real results.Conclusion We should pay attention to the changes of the RBC pa-rameters,analysis of interference factors,and to take appropriate measures to correct,in order to avoid clinical misdiagnosis and mi-stherapy.

Objective To investigate the genetic characteristic of whole-genome of influenza A/H3N2 viruses in severe acute respiratory infection cases in Beijing area.Methods From 2014 to 2016,the viral RNA was extracted from 32 strains isolated from SARI cases,then sequenced by Ion Torrent PGM Sequencer.The phylogeny and molecular features of whole-genome were analyzed by Mega and Consurf software.Results The HA gene of tested strains isolated in 2014-2015 influenza season belonged to lineage 3C.3a and 3C.2a,while those isolated in 2015-2016 influenza season belonged to cluster 3C.2a.Moreover,compared with the vaccine strains,7 variant amino acids of protein of HA1 were identified,and two of them were located in antigenic sites.All isolates were sensitive to neuraminidase inhibitors while showed resistance to blockers for M2 ion channel.Conclusion The phylogenetic features of isolates studied in this study are similar with that of current circulating strains.However,the difference between isolates and vaccines should not be overlooked.

Objective To explore the relationship between superantigen and M protein gene (emm)-types genes of Group A Streptococcus pyogenes (GAS) isolated from patients with scarlet fever in Beijing from May 2012 to July 2013 .Methods GAS was isolated from specimens of patients with scarlet fever . Superantigen genes (speA ,speB ,speC ,speF ,speG ,speH ,speI ,speJ ,speL ,speK ,speM ,ssa ,and smeZ) ,and emm gene were amplified by polymerase chain reaction .Rate and proportion were compared by chi-square test .Results Of the 423 GAS strains isolated from patients with scarlet fever from 2012 to 2013 ,most of the isolates possessed speB (97 .6% ) ,speC (99 .8% ) ,speF (98 .3% ) ,speG (99 .8% ) , smeZ (94 .1% ) and ssa (88 .4% ) ,and some of them possessed speH (54 .6% ) ,speI (53 .4% ) ,speA (45 .2% ) and speJ (43 .5% ) ,but very few isolates possessed speK (2 .4% ) ,speL (1 .4% ) and speM (1 .7% ) .Type emm12 (59 .5% ) and type emm1 (37 .4% ) were the main types of GAS .Most of the emm12-type isolates possessed speH (84 .8% ) and speI (84 .0% ) compared with only 4 .0% of speH and 3 .4% of speI in type emm1 .Most of type emm1 possessed speA (95 .3% ) and speJ gene (94 .6% ) compared with only 17 .3% of speA and 14 .8% of speJ in type emm12 .The superantigen genes profiles were significant different between emm 1-type and emm 12-type isolates (P< 0 .05) .Conclusion Type emm1 and type emm12 are epidemic strains in patients with scarlet fever from 2012 to 2013 in Beijing ,and emm gene-types are associated with superantigen genes profiles .

Chronic osteomyelitis is a common disease. Traditionally, osteomyelitis is treated with parenteral antibiotics for 4 to 6 weeks after thorough debridement. However, this antibiotic treatment course has no documented superiority over other courses of antibiotic treatment. As this disease has been understood more deeply and various treatment technologies have been explored recently, the use of antibiotics has also changed. This article reviews the latest progress concerning the course of antibiotic treatment for chronic osteomyelitis.

OBJECTIVETo investigate chemical constituents of Iodes cirrhosa.

METHODConstituents were isolated by using a combination of various chromatographic techniques including column chromatography over silica gel, Sephadex LH-20, and C-18, as well as reversed-phase HPLC. Structures of the isolates were identified by spectroscopic and chemical methods.

RESULTTwenty-four compounds were obtained from a H2O-soluble portion of an ethanolic extract of the root of lodes cirrhosa Turcz. Structures of the isolates were identified as (-)-(7R,8S,7'E) -4,7,9,9'-tetrahydroxy-3,3'-dimethoxy-8,4'-oxyneolign-7'-ene-9'-O-beta-D-glucopyra-noside (1), (-)-(7S,8S,7'E)-4,7,9,9'-tetrahydroxy-3,3'-dimethoxy-8,4'-oxyneolign-7'-ene-9'-O-beta-D-glucopyranoside(2), (+)-(7S,8S)-syringylglycerol 8-O-beta-D-glucopyranoside (3), (+)-(7S, 8S)-guaiacylglycerol 8-O-P-D-glucopyranoside (4), (-)-(7S, 8S)-4,7,9, 9'-tetrahydroxy-3,3'-dimethoxy-8,4'-oxyneolignan-7-O-beta-D-glucopyranoside (5),(-)-alaschanisoside A (6), (-)-(2R)-1-O-beta-D-glucopyranosyl-2-(2-methoxy-4-[1-(E)-propen-3-ol] phenoxyl propane-3-ol(7), (-)-(2R)-1-O-beta-D-glucopyranosyl-2-{2,6-dimethoxy-4-[1-(E)-propen-3-ol] phenoxyl} propane-3-ol(8), (-)-liriodendrin(9), (-)-(7S, 8R)-guaiacylglycerol 9-O-beta-D-glucopyranoside(10), (-)-(7R, 8R)-guaiacylglycerol 9-O-beta-D-glucopyranoside(11),(-)-(7R,8R)-syringylglycerol 9-O-beta-D-glucopyranoside(12), (-)-(7R,8R)-guaiacylglycerol 7-O-beta-D-glucopyranoside(13), (-)-11,13-dihydrodeacylcynaropicrin 3-O-beta-D-glucopyranoside(14), (-)-sweroside (15), (-)-2-hydroxy-5-(2-hydroxyethyl) phenyl beta-D-glucopyranoside(16), (-)-(1'R)-1'-(3-hydroxy-4-methoxyphenyl) ethane-1',2'-diol-3-O-beta-D-glucopyranoside(17), (-)-tachioside(18), (-)-3,5-dimethoxy-4-hydroxyphenyl beta-D-glucopyranoside(19), (-)-3-hydroxy-1-(4-hydroxy-3-methoxyphenyl)-1-propanone-3-O-beta-D-glucopy ranoside(20), (-)-2-methoxy4-(1-propionyl) phenyl beta-D-glucopyranoside(21), (-)-4-propionyl-3, 5-dimethoxyphenyl beta-D-glucopyranoside(22), erigeside C(23), and scopoletin beta-D-xylopyranosyl-(1-->6)-beta-D-glucopyranoside(24).

CONCLUSIONCompounds 1-24 were obtained from the genus for the first time.

Drugs, Chinese Herbal ; analysis ; Ethanol ; chemistry ; Glucosides ; analysis ; Isomerism ; Magnoliopsida ; chemistry ; Plant Roots ; chemistry ; Solubility ; Water ; chemistry

OBJECTIVETo investigate the chemical constituents of tuber of Gymnadenia conopsea.

METHODThe constituents were isolated by using a combination of various chromatographic techniques including column chromatography over silica gel, Sephadex LH-20, and C-18, as well as reversed-phase HPLC. Structures of the isolates were identified by spectroscopic data analysis.

RESULTThirty-four compounds were isolated. Their structures were identified as six 2-isobutyltartrate benzyl ester glucosides: coelovirin A (1), coelovirin B (2), coelovirin E (3), coelovirin D (4), dactylorhin B (5) and loroglossin (6). Three 2-isobutylmalate benzyl ester glucosides: dactylorhin A (7), dactylorhin E (8) and militarine (9). Three lignans: arctigenin (10), lappaol A (11) and lappaol F (12). Six aromatic acid (alhyde or alcohol) derivatives: 4-beta-D-glucopyranosyloxyl-trans-phenylpropenoic acid (13), 4-beta-D-glucopyranosyloxyl-cis-phenylpropenoic acid (14), gastrodin (15), 4-beta-D-glucopyranosyloxylphenylaldehyde (16), 4-beta-D-glucopyranosyloxylbenzyl methyl ether (17), 4-beta-D-glucopyranosyloxyloxylbenzyl ethyl ether (18), and bis(4-hydroxybenzyl) ether mono 4-O-beta-D-glucopyranoside (19). Four cyclodipeptides: cyclo(L-Leu-L-Tyr) (20), cyclo(L-Leu-L-Pro) (21), cyclo(L-Val-L-Tyr) (22), and cyclo(L-Ala-D-Phe) (23). One N6-substituted andenosine: N6-(4-hydroxybenzyl)-adenine riboside (24). An aromatic amide: N-trans-feruloyltyramine (25). Nine aromatic acids (or aldehyde or alcohol): 3-hydroxybenzoic acid (26), 4-hydroxyisophthalic acid (27), 4-hydroxybenzyl alcohol (28), 4-hydroxybenzyl methyl ether (29), 4-hydroxybenzylaldehyde (30), 4-hydroxybenzoic acic (31), 4-hydroxy-3-methoxybenzoic acid (32), trans-p-hydroxyphenylpropenoic acid (33), and cis-p-hydroxyphenylpropenoic acid (34). At a concentration of 1.0 x 10(-6) mol x L(-1), compounds 10-12 showed antioxidative activity inhibiting Fe(+2) -cystine induced rat liver microsomal lipid peroxidation with inhibitory rates of 53%, 59%, and 52%, respectively(positive control VE with 35% inhibition).

CONCLUSIONThese compounds were obtained from the genus Gymnadenia for the first time except for 5-7, 9, 15, 28-34. Compounds 10-12 possess antioxidant activity.

Animals ; Lipid Peroxidation ; drug effects ; Microsomes, Liver ; drug effects ; metabolism ; Orchidaceae ; chemistry ; Plant Extracts ; analysis ; isolation & purification ; pharmacology ; Rats

Objective:To investigate the correlation between triglyceride-glucose (TyG) index on admission and unfavorable outcomes of patients with moderate-to-severe traumatic brain injury (msTBI) at 6 months postinjury.Methods:A retrospective cohort study was conducted to analyze the clinical data of 277 patients with msTBI admitted to Affiliated Jiangyin Hospital of Nantong University from January 2019 to December 2022, including 208 males and 69 females, aged 18-88 years [(57.0±15.1)years]. Glasgow Coma Scale (GCS) scores on admission were 3-8 points in 168 patients and 9-12 points in 109. According to the Glasgow Outcome Scale-Extended (GOSE) assessment at 6 months after injury, there were 121 patients with unfavorable outcomes (GOSE≤4 points) and 156 with favorable outcomes (GOSE≥5 points). The following indicators of the patients were recorded, including gender, age, history of diabetes, cause of injury, admission GCS, GCS motor score (GCSM), pupillary light reflex, worst Marshall CT classification within the first 24 hours after admission, admission TyG index, Mean Amplitude of Glycemic Excursions (MAGE) within 24 hours after admission, GCSM decline≥2 points within 72 hours after admission, craniotomy or not after admission, and prognosis, etc. TyG index served as the exposure variable focused in this study, which was calculated with fasting triglycerides and fasting blood glucose within 24 hours after admission. The 6-month prognosis of the patients was designated as the outcome variable of the study. After the patients were divided into different groups according to the three quantiles of the TyG index and unfavorable or favorable outcomes, the univariate analysis was conducted on watch variables, and variables with statistically significant differences were included in directed acyclic graphs (DAGs) for further identification of confounding variables. Factors which were found with no statistical significance in the univariate analysis but might affect insulin resistance after injury according to the authors′ previous researches were also included in the DAGs analysis. Three Logistic regression models were designed (Model 1 without correction, Model 2 with core variables of International Mission for Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) corrected, and Model 3 with confounding variables screened by DAGs corrected) to analyze whether the TyG index was an independent risk factor for the prognosis of msTBI patients. The optimal Logistic regression model was selected and then restricted cubic spline (RCS) was employed to investigate the relationship between the TyG index and the unfavorable outcomes.Results:The univariate analysis suggested that there were significant differences in gender, history of diabetes, MAGE, GCSM decline, and prognosis among the three quantiles of the TyG index ( P<0.05 or 0.01). Significant differences in age, history of diabetes, GCSM, pupillary light reflex, Marshall CT classification, TyG index, MAGE and GCSM decline were observed between unfavorable and favorable outcome groups ( P<0.05 or 0.01). The results of Logistic regression analysis that identified the confounding variables that influenced the correlation between the TyG index and unfavorable prognosis with DAGs suggested that a high TyG index level was significantly correlated with unfavorable outcomes in msTBI patients. Moreover, Model 3 that was corrected with confounding variables screened by DAGs had an optimal goodness-of-fit and adaptability. Model 3-based further RCS analysis indicated that the risk of unfavorable outcomes following msTBI may increase approximately linearly with the increase in TyG index within a certain range (TyG index<9.79). Conclusions:A high TyG index level on admission is the identified as an independent risk factor for unfavorable outcomes of patients with msTBI at 6 months postinjury. As the TyG index level increases, the risk of unfavorable outcomes also rises and may show a linear increasing trend within a certain range (TyG index<9.79).

Objective:To understand the epidemic situation of Redondoviridae in Beijing and analyze its epidemiologic characteristics.Methods:Pharyngeal swab samples of healthy people and patients with acute respiratory infection in Beijing, including influenza like cases and severe acute respiratory infection (SARI) cases in hospitals were collected. Real time PCR was used to detect the nucleic acid of Redondoviridae. The positive samples were amplified and sequenced to analyze their species. The age and sex distribution of patients and species distribution of Redondoviridae were obtained through statistical analysis. Multiplex PCR was used to detect other common respiratory pathogens in the positive samples of Redondoviridae in influenza like cases and SARI cases, and the pathogenicity of Redondoviridae was analyzed.Results:The positive rates of Redondoviridae in healthy people and acute respiratory infection cases were 20.48% (189/923) and 11.23% (43/390), respectively, with a statistically significant difference ( P<0.05). The positive rate of male was higher than that of female in the healthy population, and the positive rate of the elderly group was higher than that of the adult group and the underage group, with a statistically significant difference ( P<0.05). The positive rate of male patients with acute respiratory tract infection was higher than that of female patients, but there was no significant difference. The proportion of Vientovirus in the positive samples of Redondoviridae was higher than that of Brisavirus, and the difference was statistically significant ( P<0.05). Among the throat swabs of respiratory tract infection cases, 43 were positive for Redondoviridae, of whom 24 were not detected for other pathogens. Conclusions:Redondoviridae widely exists in healthy people of all age groups in Beijing, and is also found in acute respiratory infection cases. The positive rate of Redondoviridae is different in different ages and genders. Both Vientovirus and Brisavirus were detected, and the proportion of Vientovirus was significantly higher than Brisavirus.

Objective:To characterize the epidemic of influenza in Beijing from 2022 to 2023 and the variation of gene and antigenicity of hemagglutinin (HA) of influenza A H3N2 virus, so as to provide scientific basis for influenza prevention and control in Beijing.Methods:Statistical analysis was carried out on the result of influenza pathogenic monitoring in Beijing from week 14, 2022 to week 20, 2023, and 79 strains of influenza A H3N2 virus were selected at different time and population sources, and their genetic variation and evolution characteristics were analyzed through HA gene amplification sequencing and antigenicity analysis.Results:From week 14, 2022 to week 20, 2023, 24 244 throat swabs of influenza like cases were collected in Beijing, and 4 987 influenza virus nucleic acid positive cases were detected, including 2 749 influenza A H3N2 positive cases, with a detection rate of 11.34%. Among the 79 strains, 50 strains (63.29%) showed low response, 94.44% of the strains from August to November 2022 had low response, and 54.10% of the strains from February to March 2023 had low response, with a statistically significant difference ( χ2=8.079, P=0.004). Compared with the vaccine strain A/Darwin/9/2021, the HA gene sequence of 79 strains of influenza A H3N2 showed nucleotide similarity of 97.47% to 98.47% and amino acid similarity of 97.05% to 98.17%. Genetic evolution analysis showed that the 18 strains isolated from August to November 2022 were all distributed in the 3C.2a1b.2a.1a.1 branch, while the 61 strains isolated from February to March 2023 all belonged to the 3C.2a1b.2a.3a.1 branch. Compared with the vaccine strain, there were multiple site mutations distributed at multiple antigenic determinants and receptor binding sites in A, B, C, D, and E. All strains had potential glycosylation sites of 8NST, 22NGT, 38NAT, 45NSS, 63NCT, 126NWT, 133NGT, 246NST, 285NGS, 483NET, while one strain missed 165NVT glycosylation sites; 55 strains between February and March 2023 missed 122NES glycosylation sites. Conclusions:The HA gene locus of influenza A H3N2 virus detected in Beijing from week 14, 2022 to week 20, 2023 showed multiple mutations, continuous monitoring of this subtype variation is crucial.

Severe acute pancreatitis(SAP)is a critical condition in general surgery settings,characterized by high mortality and poor prognosis.On February 28,2024,the Department of Hepatobiliary Surgery at the First Affiliated Hospital of Harbin Medical University admitted a 36-year-old male patient.The patient presented with"upper abdominal pain accompanied by fever for three months and jaundice of the skin and sclera for one week."Physical examination revealed 11 puncture tubes,and a palpable mass measuring 3 cm × 5 cm in the upper abdomen.Enhanced CT and magnetic resonance cholangiopancreatography indicated acute pancreatitis.The patient was diagnosed with"SAP,infectious pancreatic necrosis,and biliary stenosis."He had severe abdominal infection and complex postoperative complications,making treatment challenging.Consequently,a multidisciplinary team(MDT)consultation was initiated.After three rounds of MDT consulfation and freating,the patient ultimately recovered successfully and was discharged.This article reviews the MDT treatment process for this patient and summarizes the characteristics of this condition based on relevant literature to provide insights and experience for clinical practice.