OBJECTIVETo study the efficacy of Xiaoyao Powder (XYP) combined with interferon alpha (IFN-alpha) in treating HBeAg positive chronic hepatitis B (CHB) patients and the effect on their quality of life (QOL).

METHODSTotally 193 patients with HBeAg-positive CHB confirmed by liver biopsy were randomly assigned to 2 groups, Group A (94 cases) and Group B (99 cases). IFN-alpha1b was subcutaneously injected to patients in Group A at the dose of 50 microg, thrice per week. Those in Group B additionally took XYP. The therapeutic course for all was 24 weeks. Clinical efficacy was observed by assessing ALT restoration rate, HBeAg negative rate, HBeAg conversion rate, HBV DNA negative rate, complete response rate, partial response rate, and symptoms integral. The evaluation of QOL was performed by using chronic liver disease questionnaire (CLDQ) score. Adverse reaction occurrence rate was observed in the two groups.

RESULTSBetter effects were obtained in Group A on ALT restoration rate, HBeAg negative rate, HBV DNA negative rate, complete response rate, partial response rate, TCM symptoms integral, the total effective rate of TCM sysmptoms, CLDQ score, and adverse reaction rates, showing statistical difference when compared with Group B (P < 0.05, P < 0.01).

CONCLUSIONXYP could elevate the efficacy of TCM symptoms of HBeAg-positive CHB patients and anti-viral effect, improve their QOL, and reduce adverse reaction of IFN-alpha.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hepatitis B e Antigens ; Hepatitis B, Chronic ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Male ; Quality of Life ; Treatment Outcome

OBJECTIVETo observe the efficacy of Zaozhu Yinchen Recipe (ZZYCR) on non-alcoholic steatohepatitis (NASH) patients, and to explore its effect on serum free fatty acid (FFA) and tumor necrosis factor alpha (TNF-alpha).

METHODSTotally 120 patients with NASH were randomly assigned to the treatment group (60 cases, treated with ZZYCR, one dose per day) and the control group (60 cases, treated with Silibin Meglumine Tablets, 20 mg each time, thrice per day). The therapeutic course for all was 24 weeks. Serum levels of ALT and AST activities, TC and TG levels were detected before and after treatment. Peritoneal CT was performed in all patients, and CT ratios of liver and spleen calculated. NAFLD activity score (NAS) and degree of hepatic fibrosis were assessed using pathological examinations of liver tissue, and efficacy also evaluated. Serum contents of FFA and TNF-alpha were also detected.

RESULTSCompared with before treatment in the same group, activities of ALT and AST, serum levels of TC, TG, FFA, and TNF-alpha, NAS, scores of symptoms and signs all obviously decreased, degree of hepatic fibrosis was obviously improved in the two groups (P < 0.05, P < 0.01). These changes were more obviously seen in the treatment group (P < 0.05). After 24-week treatment, the total effective rate and total clinical efficacy were 80.00% (48/60 cases) and 85.00% (51/60 cases) in the treatment group, obviously higher than those in the control group [60.00% (36/60 cases) and 73.33% (44/60 cases) respectively], with significant difference (P < 0.05, P < 0.01).

CONCLUSIONZZYCR could improve the clinical efficacy of NASH patients, and its mechanism might be associated with inhibiting serum levels of FFA and TNF-alpha.

Drugs, Chinese Herbal ; therapeutic use ; Fatty Acids, Nonesterified ; blood ; Humans ; Non-alcoholic Fatty Liver Disease ; drug therapy ; Tumor Necrosis Factor-alpha ; blood

Objective Analysis the epidemiological characteristics on rabies cases occurred in Guangxi from 2004 to 2008 and summarize the result of healthy-dog infection rabies virus investigation from 2006 to 2008.Exploring the high-occurrence and correlated factors on rabies in Guangxi.Methods Data collected from the National Disease Surveillance System and the National Active Surveillance System for Rabies from 2004 to 2008 and Data of healthy-dog infection rabies virus investigation from 2006 to 2008 were analyzed.Results The total rabies cases were 2463 in Guangxi from 2004-2008 and average incidence rate was 0.98 per 100 thousand per year.There were 95 counties had rabies case reported,anyway more than 10 cases occurred county number was declined while less than 5 cases rose year by year.The rabies case incidence area was expanded and the cases in middle and west area of Guangxi rose significantly.Rabies cases were reported whole year and no seasonal peak.Human rabies eases mainly were farmers,students and children.Yanger than 20 years old and elder 40 years old were the highest age groups in the population of the investigation,83.79% cases were attacked by dogs.78.5% cases classification category Ⅲ.83.17% cases had exposed on the upper and lower limbs,10.56% exposed to the head,face or neck.But 67.88% cases did not received any PEP and only 18.31% cases vaccinated and 3.63% category Ⅲ exposure cases combined administration of RIG.The incubation median was 60 days.The rabies virus infection rate among randomly collection healthy-dog brain samples from 2006 to 2008 was 1.92%,0.93% and 0.89%.Conclusion Unsuccessful and inadequate PEP of patients were the main factors leading to the high-occurrence of human rabies in Guangxi.And there axe a lot of infection rabies virus healthy-dogs alive in Guangxi also as a high-occurrence factor.

Adolescent ; Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; Bacteria ; drug effects ; Child ; Chronic Disease ; drug therapy ; Corydalis ; chemistry ; Drug Administration Routes ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Osteomyelitis ; drug therapy ; microbiology ; Perfusion ; Treatment Outcome

In this study, Actin, 18S rRNA, PAL, GAPDH and CPR of Artemisia annua were selected as candidate reference genes, and their gene-specific primers for real-time PCR were designed, then geNorm, NormFinder, BestKeeper, Delta CT and RefFinder were used to evaluate their expression stability in the leaves of A. annua under treatment of different concentrations of Cd, with the purpose of finding a reliable reference gene to ensure the reliability of gene-expression analysis. The results showed that there were some significant differences among the candidate reference genes under different treatments and the order of expression stability of candidate reference gene was Actin > 18S rRNA > PAL > GAPDH > CPR. These results suggested that Actin, 18S rRNA and PAL could be used as ideal reference genes of gene expression analysis in A. annua and multiple internal control genes were adopted for results calibration. In addition, differences in expression stability of candidate reference genes in the leaves of A. annua under the same concentrations of Cd were observed, which suggested that the screening of candidate reference genes was needed even under the same treatment. To our best knowledge, this study for the first time provided the ideal reference genes under Cd treatment in the leaves of A. annua and offered reference for the gene expression analysis of A. annua under other conditions.
Artemisia annua ; drug effects ; genetics ; metabolism ; Cadmium ; pharmacology ; Plant Leaves ; drug effects ; genetics ; metabolism ; Plant Proteins ; genetics ; metabolism ; Real-Time Polymerase Chain Reaction ; methods ; standards ; Reference Standards

Objective To estimate the application value of a standard operating procedure (SOP) in the detection of syphilitic anticardiolipin reagin. Methods Clinical laboratories from 9 local hospitals in Shanghai participated the program. Quality control samples with unknown target value were qualitatively and quantitatively examined according to the uniform SOP in these laboratories with the same reagent and facility of horizontal reaction. External quality assessment (EQA) was carried out by using seven serum samples with no, or low (1∶ 128 dilution) to high (1∶1 dilution) concentrations of target before and after the implementation of SOP. The test results were statistically analyzed and the reasons for the detecting error were assessed. Results A total of 388 tests were performed in the 9 clinical laboratories. The total accuracy rate was 93.0%, including 40.2% in the detection of samples with 1 ∶ 8 dilution of target, 49.2% in the detection of samples with 1 ∶ 16 dilution of target, and 3.6% in the detection of samples with 1 ∶ 32 dilution of target. No forward bias was observed in these tests. There was a significant difference in the accuracy rate between the two times of EQA before and after the implementation of SOP (x2 = 4.17, P < 0.05). Conclusions The improved standard procedure for nontreponemal antigen test is beneficial to the decrease of testing error, and may provide a basis for the establishment of SOP and implementation of internal quality assessment.

Objective To investigate the clinical features and pathogenic types of suspected pertussis syndrome in infants,so as to provide reference for the treatment. Methods Seventy-one infants of suspected pertussis in Shanghai Children′s Medical Center from Nov 2016 to Aug 2017 were detected by the Filmarray which can detect Bordetella pertussis and 17 viruses. According to the results,the infants were divided into two groups:pertussis group(n=29) and pertussis-like group(n=42). According to the severity of the dis-ease,they were divided into mild group(n=50) and severe group(n=21). Clinical data was retrospectively analyzed and compared. Results All 71 infants came to the hospital with cough. Paroxysmal cough happened in 18 cases(62. 1％)in pertussis group,more common than that in pertussis-like group[9 cases(21. 4％)] (χ2 =12. 023,P<0. 01),and the WBC count,lymphocyte ratio,the mixed virus infection rate were higher in pertussis group than those in pertussis-like group[(20. 00 ± 8. 62) × 109/L vs. (13. 42 ± 6. 58) × 109/L,t=-3. 647,P<0. 01;(70. 38 ± 8. 97)％ vs. (56. 26 ± 20. 38)％,t = -3. 967,P <0. 01;22 cases(75. 9％) vs. 16 cases(38. 1％),χ2 =9. 836,P<0. 01]. The cases of mixed bacterial infection in pertussis-like group were 13(31. 0％),which was higher than that in pertussis group[3(10. 3％)](χ2 =4. 173,P<0. 05). The incidence of cyanosis was found in 12 cases(57. 1％)in severe group,which was more common than that of mild group[12 cases(24. 0％)](χ2 =7. 260,P<0. 01), and hospitalization days were(14. 5 ± 7. 8) days, which was higher than that in mild group[(7. 0 ± 3. 1)days] (t= -4. 250, P<0. 01). The infants in the pertussis group were given macrolides antibiotics and sulfamethoxazole complex,and the infants in the pertus-sis-like group were treated with antiviral and other specific treatment. Among 71 infants, 67 cases (94. 4％) were cured and 3 cases (4. 2％) were improved. Conclusion The clinical features of suspected pertussis in infants are not typical, so the early pathogenic diagnosis is very important. Filmarray detection system for multi PCR system can detect 20 kinds of pathogens with short operation time,which is very helpful for the early and rapid diagnosis of pathogens and rational use of drugs. It is worthy of clinical promotion.

Aim To investigate whether Linggui Zhugan Decoction ( LGZGD) can inhibit ventricular remodeling and prevent heart failure in rats after myocardial infarction by regulating Nrf2/BNIP3 pathway. Methods The model of heart failure after myocardial infarction was established by left coronary artery ligation in rats. Two weeks after modeling, all rats were randomly divided into model group, LGZGD group, and captopril group. Meanwhile sham operation group was set up. The rats were given continuous intragastric administration with drug or distilled water for 28 days, once a day. The behavioral signs of rats in each group were observed. The cardiac function of rats in each group was examined by echocardiography. Serum BNP and NT-ProBNP content were detected by enzyme -linked immunoassay; The changes of myocardial his-topathological and collagen fibers in rats were detected using sirius staining. The contents of oxidative stress index including ROS, SOD in myocardial tissue of rats in each group were observed by DCFH-DA fluorescent probe and Enzyme-linked immunoassay. The ultra-structure of mitochondria was observed by transmission electron microscopy. Expressions of apoptotic proteins ( mitochondrial CytC, cytoplasmic CytC) were detected by Western blot. Expression of proteins related to the Nrf2/BNIP3 pathway were examined by immunofluorescence and Western blot. Results LGZGD could significantly improve the cardiac function of rats, reduce the contents of BNP and NT-ProBNP, inhibit the excessive deposition of collagen in myocardial interstiti-um, reduce ROS, increase the content of SOD, improve mitochondrial structure damage, up-regulate the expression of Nrf2 and nuclear translocation, and reduce the expression of BNIP3. Conclusions LGZGD can inhibit the ventricular remodeling and prevent the occurrence of heart failure after myocardial infarction. Its pharmacological effects are mainly related to regulating the Nrf2/BNIP3 pathway, activating Nrf2, promoting its nuclear transfer, and further down-regulating BNIP3, protecting mitochondrial function, and reducing cardiomyocyte apoptosis.

OBJECTIVETo study the audiological characteristics of newborns and infants who failed hearing screening.

METHODSOne hundred and six infants failed hearing screening received follow-up study with routine audiological evaluations (auditory brainstem response, distortion product otoacoustic emission, tympanometry and visual reinforcement audiometry).

RESULTSSixty-five infants (61.3%) of this group were normal hearing subjects and 39(36. 8% ) of the infants had hearing loss. Two cases (1.9%) received follow-up by phone. Fifteen cases (14.2%) with conductive hearing loss and 24 cases (22.6%) with sensorineural hearing loss. Thirteen (12.3%), 14 (13.2%), 6 (5.7%), and 6 (5.7%) cases were found to be mild, moderate, severe and profound hearing loss respectively. Diagnosis of hearing loss in the thirty-nine infants conducted a prevalence of 0.264% (39/14 785) of congenital hearing loss (both binaural and monaural). The hearing level of those cases with severe and profound hearing loss basically did not change, but that of cases with mild and moderate hearing loss changed.

CONCLUSIONSEarly identification and intervention of infants with severe and profound hearing loss by 6 months of age were successful. Infants with mild and moderate hearing loss should be followed up to six or eight months and received routine audiologic evaluations.

Audiometry, Evoked Response ; China ; Evoked Potentials, Auditory, Brain Stem ; Female ; Follow-Up Studies ; Hearing Loss ; diagnosis ; epidemiology ; Humans ; Infant ; Infant, Newborn ; Male ; Neonatal Screening ; Prevalence

OBJECTIVETo study the clinical, pathologic and radiologic features of chondroblastoma occurring in sites other than epiphysis and apophysis of long bones, and to investigate possible reasons for misdiagnosis.

METHODSThe clinical, pathologic and radiologic data of 18 chondroblastoma cases occurring in atypical sites were collected from 5 major hospitals in Shanghai during the past 12 years. S-100 immunostaining was performed to confirm the cartilaginous differentiation of the tumor cells.

RESULTSChondroblastoma occurred in small bones of feet in 10 of the 18 cases (55.6%) studied, being commonest in the talus and calcaneus bones. Mean age of the patients was 27.8 years, with 55.6% over 25 years of age. Radiologic examination revealed expansive, multilocular and well-demarcated radiolucent lesions in most cases. There was local cortical destruction in 5 cases (28%) and soft tissue infiltration in 1 case. In 10 cases (55.6%), the tumor was associated with aneurismal bone cyst or simple bone cyst formation. None of the cases studied was accurately diagnosed clinically before the operation. In 2 cases, the pathology was also misdiagnosed, often being diagnosed as aneurismal bone cyst or giant cell tumor.

CONCLUSIONSChondroblastoma occurring in atypical sites are often associated with atypical age, radiologic features and pathologic findings at presentation. Thorough understanding of the potential pitfalls is essential in order to avoid misdiagnosis.

Adolescent ; Adult ; Bone Cysts, Aneurysmal ; diagnosis ; diagnostic imaging ; pathology ; Bone Diseases ; diagnosis ; diagnostic imaging ; pathology ; Bone Neoplasms ; diagnosis ; diagnostic imaging ; pathology ; Calcaneus ; Child ; Chondroblastoma ; diagnosis ; diagnostic imaging ; pathology ; Diagnostic Errors ; Female ; Giant Cell Tumor of Bone ; diagnostic imaging ; pathology ; Humans ; Male ; Radiography ; Talus