Objective: To investigate the role of Toll-like receptor 4(TLR4) in the inflammatory reaction in the mouse model of Chlamydia pneumoniae(Cpn) infection.Methods: We divided 60 TLR4 mutant C3H/HeJ and 60 wild type C3H/HeN male mice into 4 groups: a mutant control(M),a mutant infection(M+I),a wild type control(W) and a wild type infection(W+I) group,each randomly assigned to 5 scheduled time points(1 d,4 d,7 d,14 d and 21 d).The animals in the M and W groups were intranasally inoculated with 2-sucrose phosphate(2SP) buffer,while those in the M+I and W+I groups with Cpn.All the mice were killed and their lung tissues were sampled on the above time points.The levels of TNF-? and IL-10 in the lung tissues were detected by enzyme-linked immunosobent assay(ELISA),histopathological examinations were performed,and the wet / dry weight(W / D) ratio was determined.Results: After Cpn inoculation,the lung tissues were characterized by patchy interstitial pneumonitis,predominantly infiltrated with neutrophil leukocytes in the earlier(7 d) stage and with lymphocytes in the later(14 d) stage.In the M+I group,the levels of TNF-? were elevated at 1 d([0.78?0.06] pg/mg),peaked at 4 d([1.22 ? 0.12] pg/mg) and then began to decrease,but was still higher than normal at 21 d;they were(1.10 ? 0.12,0.72 ? 0.12 and 0.52 ? 0.10) pg/mg at 7,14 and 21 d,significantly lower than in the W+I group([1.30 ? 0.16],[1.01 ? 0.19] and [0.71 ? 0.08] pg/mg,P

ObjectiveTo compare the sedative effect and safety of dexmedetomidine and midazolam in the intensive care unit (ICU) patients undergoing ventilator bundle treatment.MethodsA prospective single-blind randomized controlled trial (RCT) was conducted. Ninety patients receiving ICU ventilator-assisted therapy and ventilator bundle treatments for more than 3 days in the First Department of Critical Care Medicine of the Second Hospital of Lanzhou University from January 2013 to December 2014 were enrolled. The patients were randomly divided into two groups for sedative treatment. The patients in dexmedetomidine group (n = 42) were given dexmedetomidine 0.2-0.7μg·kg-1·h-1 to achieve a goal of satisfactory sedation [Richmond agitation-sedation scale (RASS) score 0 to - 2 during the day, and -1 to -3 at night). The patients in midazolam group (n = 48) were given midazolam 2-3 mg intravenously first, and then 0.05 mg·kg-1·h-1 for maintenance. The drug dose was adjusted according to RASS every 4 hours to maintain the appropriate sedation depth. The patients in both groups received continuous intravenous infusion of fentanyl for analgesia. Ventilator bundle treatments included the head of a bed up 30°to 45°, awaken and extubation appraisal, daily use of proton pump inhibitors for peptic ulcer prevention, prevention of deep vein thrombosis (DVT), chlorhexidine mouth nursing, and removal of sputum by suction from subglottic area. When the patients in both groups obtained satisfactory target sedation, daily awakening was conducted, and spontaneous breathing test (SBT) was carried out to determine optional weaning time. When the condition was optimal, weaning was conducted, otherwise ventilator bundle treatments were continued. The systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), respiratory frequency (RR) were monitored before and 15, 30, 60, 120, 180 minutes after the treatment, and at the moment of extubation and 30 minutes after extubation. The duration of mechanical ventilation, extubation time, length of ICU stay, and the incidence of adverse events were also recorded. Results Both dexmedetomidine and midazolam could give rise to sedation with same score of analgesia in patients in both groups, and similar effect of sedation and analgesia could be achieved. Compared with midazolam, dexmedetomidine could significantly reduce the duration of mechanical ventilation (hours: 108.33±21.96 vs. 119.85±20.29,t = -2.586, P = 0.011), earlier extubation time (hours: 112.95±22.20 vs. 128.58±26.18,t = -3.031,P = 0.003), length of ICU stay (hours: 149.21±20.47 vs. 163.88±33.59,t = -2.457,P = 0.016), the incidence of delirium [9.5% (4/42) vs. 31.2% (15/48),χ2 = 6.349,P = 0.012], but it would elevate the incidence of severe hypotension [28.6% (12/42) vs. 8.3% (4/48),χ2 = 6.277,P = 0.012] and severe bradycardia [19.0% (8/42) vs. 8.3% (4/48),χ2 = 2.225,P = 0.136]. Both drugs could lower SBP, DBP, MAP, and HR, and the effect in dexmedetomidine group was more significant from 60 minutes after treatment [SBP (mmHg, 1 mmHg = 0.133 kPa): 113.12±14.42 vs. 124.40±15.79, DBP (mmHg): 69.02±9.62 vs. 76.94±10.41, MAP (mmHg): 83.76±10.50 vs. 92.77±11.87, HR (bpm): 79.19±12.28 vs. 87.42±17.77,P< 0.05 orP< 0.01]. Both sedatives could significantly lower the rate of spontaneous breathing, and the effect of midazolam group was more significant from 60 minutes after treatment compared with dexmedetomidine group (times/min: 18.27±4.29 vs. 20.07±4.11,P< 0.05).Conclusions The sedative effects of dexmedetomidine in the ICU patients treated with ventilator bundle treatment are satisfactory, and it can shorten the duration of mechanical ventilation, extubation time and length of ICU stay, reduce the incidence of delirium. However, monitoring should be strengthened in order to prevent and control the adverse effects such as severe hypotension and severe bradycardia.

Ebola virus (EBOV) and Marburg virus (MARV) belong to the family Filoviridae. Filoviruses cause severe filovirus hemorrhagic fever (FHF) in humans, with high case fatality rates, and represent potential agents for bioterrorism and biological weapons. It is necessary to keep surveillance of filoviruses, even though there is no report of their isolation and patients in China so far. To characterize MARV morphology, the Lake Victoria marburgvirus--Leiden was stained negatively and observed under a transmission electron microscope which is one of important detection methods for filoviruses in emergencies and bioterrorism. MARV showed pleomorphism, with filamentous, rod-shaped, cobra-like, spherical, and branch-shaped particles of uniform diameter but different lengths. Pleomorphism of negatively stained MARV is summarized in this article, so as to provide useful information for possible electron microscopic identification of filoviruses in China.
Animals ; Humans ; Marburg Virus Disease ; virology ; Marburgvirus ; growth & development ; ultrastructure ; Microscopy, Electron, Transmission ; Virion ; growth & development ; ultrastructure

Objective:To evaluate the status quo and influencing factors of hyperlipidemia management in patients with contracted family doctor service in the community.Method:The baseline data and blood lipid testing results of 752 hyperlipidemia patients (334 males and 418 females) with contracted family doctor service in Yuetan Community Health Service Center from November?2019 to May 2020 were collected. The hyperlipidemic patients were managed by family doctors based on atherosclerotic cardiovascular diseases(ASCVD) riks assessment. The ASCVD risk levels and low-density lipoprotein cholesterol (LDL-C) compliance rate of patients with different general data were compared, and the influencing factors of LDL-C control failure were analyzed by logistic regression.Results:The ASCVD risk assessment showed that among 752 patients there were 172 cases of low risk(22.87%), 167 cases of moderate risk(22.21%),352 cases of high risk(46.81%) and 61 cases of extremely high risk(8.11%). A significant difference was detected in sex,rate of smoking,incidence of overweight or obesity among patients with different ASCVD risk levels ( P<0.05).The overall control rate of LDL-C was 48.8% (367/752), that for low, moderate, high and extremely high risk patients were 83.73% (144/172), 53.89% (90/167), 34.38% (121/352) and 19.67%(12/61), respectively. A significant difference was detected in sex(female: 52.87%, 221/418),age(aged over 80: 58.82%, 110/187), rate of smoking (non-smoking:52.40%, 327/624) and medication compliance (good compliance:52.87%,221/418) between LDL-C control and uncontrol groups (χ2=6.323,11.816,19.022,25.274; P<0.05). Multiple logistic regression analysis revealed that male gender ( OR=1.800,95% CI:1.325-2.419), smoking ( OR=2.630,95% CI:1.726-4.007) and poor medication compliance ( OR= 2.179, 95% CI: 1.581-3.003) were independent risk factors for uncontrolled LDL-C levels. Conclusion:Patients with hyperlipidemia have a relatively high risk of cardiovascular diseases, and their blood lipids are not well controlled. The management of blood lipid should be enhanced in patients with chronic diseases, particularly for male patients with smoking and poor medication compliance.

Objective:To study the stability of compound Kushen mixed liquid to provide reliable evidence for safe clinical drug application.Methods:Compound Kushen injection was mixed respectively with 0.9% sodium chloride injection and 5% glucose injection,and then placed under the different conditions for 0,1,2,4,8,12,24 and 48 h.HPLC was conducted to determine the content changes of four components in compound Kushen mixed liquid,and the appearance,pH and insoluble particles were observed as well.Results:The mixed liquid of compound Kushen with 0.9% sodium chloride injection was stable in 48 h without the influence of light and temperature.However,the mixed liquid of compound Kushen with 5% glucose injection had poorer stability with storage time shorter than 12 h at room temperature and 2 h at high temperature.Conclusion:The stability of the mixed liquid of compound Kushen is closely related to the pH value of solvent.0.9% Sodium chloride injection is recommended as the solvent,and the mixed liquid should be used up in 48 h.

Objective To evaluate the correlation and difference of reversed phase high performance liquid chromatography (RP-HPLC) and fluorescence polarization immunoassay (FPIA) on determining serum concentration of carbamazepine.Methods Fifty serum samples were collected,both RP-HPLC and FPIA methods were employed to determine the concentration of carbamazepine.The results were analyzed by paired t test,Bland-Altman and Deming regression methods,respectively.Results The results of measuring 50 samples by the two methods showed that FPIA datas were significantly higher than RP-HPLC datas,and there was statistically significant difference(P<0.05) and poorer consistency between two methods;There was good correlation between carbamazepine concentrations determined by the two methods.Deming regression equation was CFPIA=1.195 3 CRP-HPLC-0.144 0,and Pearson correlation coefficient was 0.968 5.Conclusion Clinicians should pay more attention to the difference of carbamazepine concentration determination by different methods when carbamazepine individualized dosage regimen was adjusted according to therapeutic drug monitoring.

Objective To develop a rapid ultra high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/ MS) for determination of 11 sedative-hypnotics in human plasma. Methods The plasma samples were extracted with dichloromethane:n-hexane:acetoacetate (5∶4∶1). The separation was performed on a Waters ACQUITY UPLC HSS T3 column (2.1 mm×100 mm,1.8 μm) using the mobile phase composed of acetonitrile-0.1% ammonium solution at a flow rate of 0.2 mL?min-1 in gradient elution mode. The detection was performed on a triple quadrupole tandem mass spectrometer by multiple reaction monitoring (MRM) via electrospray ionization (ESI) source in positive mode. Results Good linear relation was obtained over the investigated concentration range, with all correlation coefficients higher than 0.99. The limit of detection was 200 pg?mL-1 for dexzopiclone,and 10- 20 pg?mL-1 for other sedative-hypnotics. The intra- and inter-day RSD of 11 sedative-hypnotics were no more than 15.0%. The recoveries were in the range of 72.3%-108.0%, and the matrix effects were approximately 0.86- 1. 12. Conclusion The method is rapid, sensitive and reliable, and suitable for the simultaneous determination of 11 sedative-hypnotics in human plasma.

In this study, the COI barcode was used to identify the Scolopendra medicinal materials and its adulterants in order to provide a new method for the identification of Scolopendra. Genomic DNA was extracted from the experimental samples. The COI sequences were amplified and sequenced bi-directionally. Sequence alignment and NJ tree construction was carried out by MEGA6.0 software. The results showed that the COI sequences can be obtained from all experimental samples. The average inter-specific K2P distance of Scolopendra was 0.222 and the minimum inter-specific distance was 0.190. All the Scolopendra subspinipes mutilans medicinal samples clustered into a clade in the NJ tree and can be distinguished from its adulterants. In a conclusion, COI can be used to correctly identify Scolopendra medicinal materials, and it will be a potential DNA barcode for identifying other animal medicinal materials.
Animals ; Arthropod Proteins ; genetics ; DNA Barcoding, Taxonomic ; methods ; Drug Contamination ; prevention & control ; Electron Transport Complex IV ; genetics ; Medicine, Chinese Traditional ; Molecular Sequence Data ; Phylogeny ; Quality Control ; Scorpions ; classification ; enzymology ; genetics

Objective To investigate the clinical efficacy of sequential acupuncture in treating post-stroke dysphagia. Methods One hundred and ten patients with post-stroke dysphagia were randomly allocated to treatment and control groups, 55 cases each. The control group received routine medication and the treatment group, “cortex-pharynx-tongue root” sequential acupuncture in addition. The pre-/post-treatment difference in the Kubota’s water drinking test score was observed in the two groups and the clinical therapeutic effects were compared between the two groups after 14 days of treatment.Results There was a statistically significant pre-/post-treatment difference in the Kubota’s water drinking test score in the two groups (P<0.01,P<0.05). There was a statistically significant post-treatment differences in the Kubota’s water drinking test score between the treatment and control groups (P<0.05). The total efficacy rate was 89.1% in the treatment group and 67.3% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Sequential acupuncture is an effective way to treat post-stroke dysphagia.

Objective:To analyze the result of smooth pursuit test(SPT) in unilateral vestibular peripheral vertigo and investigate its influencing factors.Method:Smooth pursuit test (SPT) and spontaneous nystagmus (SN)were examined in one hundred and eighty-five patients with unilateral peripheral vertigo(case group) and 51 normal persons(control group) by Video-Nystagmography (Synapsys, France), and the gain of SPT and SN were selected as the observation parameters in order to analyze the waveform and gain of SPT and the relativity between SN and the gain of SPT.Result:Of the 185 patients, 105(56.8%),72(38.9%) and 8(4.3%) cases producedⅠ,Ⅱ and Ⅲ waveforms respectively. Of these patients, 58(31.4%) demonstrated SN and none had Ⅳ waveform. While of 51 normal persons, 38(74.5%), 13(25.5%) persons producedⅠand Ⅱwaveforms repectively and there were no Ⅲ, Ⅳ waveforms or SN. There was statistical significance between the stong and weak gain of SPT in these two groups. Weak gain was significantly different between two groups. The stong and weak gain of SPT in case group were 0.86±0.06,0.80±0.06; 0.78±0.09, 0.65±0.1; 0.68±0.13, 0.45±0.12. The relativity between SN and the gain of SPT was positive when they had same direction(r_s=-0.63,P＜0.05)and negative when opposite (r_s=0.34,P＜0.05).Conclusion:Ⅰ,Ⅱ,Ⅲ three waveforms of SPT could appear in unilateral vestibular peripheral vertigo and the corresponding gains are gradually decreasing.SN is the influencing factor of SPT.