Liquid-assisted surface desorption atmospheric pressure chemical ionization mass spectrometry (LA-DAPCI-MS)was used directly for the analysis of healthy rat liver (normal control group);acute alcoholic injury rat liver(alcohol model group)and Zhizi Dahuang decoction-treated rat liver (ZZDHD group)sections with the mass spectrometry images obtained simultaneously.Principal component analysis (PCA)was employed for the differentiation of livers of the groups;and 3 phospholipids;PC (34 ∶2);PC(36 ∶4)and PC(38 ∶4);were found to be the main factors.LA-DAPCI mass spectrometry images showed that the 3 phospholipids were evenly distrib-uted in liver under the spatial resolution of 0.01 mm2.Contents of 3 PCs in the model group were decreased in alcohol model group compared to the normal control group and the ZZDHD group;which revealed the relationship between acute alcoholic liver injury and intrahepatic phospholipid variation.The results showed that ZZDHD had protective effect on acute alcoholic liver injury-induced intrahepatic phospholipid variations at the molecular level.

Objective To investigate expression of 4-1BB and lymphocyte subsets in peripheral blood of children with acute infectious lymphocytosis. Methods Flow cytometry (FCM) was applied to detect the expression of 4-1BB and lymphocyte subsets in peripheral blood of 15 cases of acute infectious lymphocytosis and 20 cases of acute upper respiratory infection, and 20 healthy children. Results The expression of 4-1BB and CD3+, CD4+and CD8+lymphocytes were higher in acute infectious lymphocytosis group than those in acute upper respiratory infection group and healthy control group (P<0.05). There was no sig-niifcant difference of CD19+CD23+lymphocytes among three groups (P>0.05). A positive correlation was found between 4-1BB expression and CD3+ lymphocytes expression in acute infectious lymphocytosis group (r=0.73, P<0.05). Conclusions The abnormal expression of 4-1BB may play a pathological role in the development of acute infectious lymphocytosis. T cells in chil-dren with acute infectious lymphocytosis may not function to activate B cells.

Objective To investigate the incidence of healthcare-associated infection (HAI)in patients in a respiratory in-tensive care unit (RICU)of a teaching hospital,and provide reference for HAI prevention and control.Methods All pa-tients admitted to this RICU from January to December 2014 were surveyed with prospective targeted monitoring method, surveyed data were analyzed statistically.Results A total of 561 patients were surveyed,43 patients developed 44 times HAI,HAI rate and HAI case rate were 7.66% and 7.84% respectively,incidence of HAI and adjusted incidence of HAI per 1 000 patient-days were 6.26‰ and 1.79‰ respectively.The main infection site was urinary tract (45.46%,n=20). Incidence of ventilator-associated pneumonia (VAP ),catheter-related bloodstream infection (CRBSI),and catheter-associat-ed urinary tract infection (CAUTI)per 1 000 catheter-days were 2.73‰(n=13),1.57‰(n=2),and 3.78‰(n=18)re-spectively.Incidence of HAI per 1 000 patient-days between the first and second half year of 2014 was significantly differ-ent(4.59‰ vs 7.89‰;u=-1.75,P =0.04).A total of 47 pathogenic strains were isolated,the main pathogens were gram-negative bacteria(n=26,55.32%).Conclusion The major HAI in RICU is device-associated infection,it is necessary to strengthen the management of invasive procedures;targeted monitoring can find the weak links of infection control prac-tice and helpful for taking effective prevention and control measures to reduce the incidence of HAI in ICU.

Objective To survey the prevalence of elderly asthmatics among urban and rural residents of Liaoning Province and to provide data for preventive and therapeutic policies of asthma. Methods Stratified cluster disproportional 2.5‰ random sampling survey for 116 276 re sidents was performed using uniform scheme, procedures and questionnaire. Among them 12 735 cases were over 60 years old. Results Totally 522 cases (207 male and 315 female) were diagnosed as asthma, the overa ll prevalence was 1 25% and that of elderly was 4 09% ( male 3 26%, female 4 92%, P

Objective:To analyze the characteristics of clinical manifestation, auxiliary examination and gene mutation of 3-hydroxy-isobutyryl-coenzyme A hydrolase (HIBCH) deficiency to better understand this disease.Methods:The clinical manifestations and genetic results of a patient with HIBCH deficiency were analyzed. The clinical features and genetic characteristics of HIBCH deficiency were summarized based on the literature review.Results:The proband, female, one year and four months old, was admitted to Children′s Hospital Affiliated to Zhengzhou University for “vomiting and diarrhea for 15 days, dyspnea and intermittent convulsions for 13 days after digestive tract infection”. The intelligence was normal, however, the motor development was slightly delayed before onset. Physical examination showed light coma, poor response and insensitivity to light. She also had shortness of breath, weak positive three concave signs and coarse breath sound in both lungs with sputum purrs. In addition, the muscle tension of extremities was increased. Bilateral Brudzinski′s sign, Babinski′s sign and Kernig′s sign were negative. Serum hydroxybutyryl carnitine (C4OH) was increased. Cranial magnetic resonance imaging (MRI) showed atrophy in bilateral cerebral hemispheres and abnormal symmetry signals in bilateral globus pallidus and cerebral peduncle. Novel compound heterozygous variants of HIBCH, c.489T>A (p. C163*) and c.740A>G (p. Y247C), were found in the patient, which respectively inherited from her healthy parents. Her symptoms were relieved after“cocktail”therapy and symptomatic treatment. Literature related to HIBCH deficiency published all around the world was reviewed. As a result, 17 articles, including 24 cases, had been reported. The majority of patients presented with poor feeding, dystonia and progressive motor developmental delay in early infancy. Cranial MRI showed lesions in bilateral basal ganglia. Serum C4OH concentration was elevated. And compound heterozygous or homozygous variants of HIBCH gene were found in patients with HIBCH deficiency.Conclusions:The detection of serum amino acids and acylcarnitine profiles on HIBCH deficiency was relatively specific and it was helpful to make a clear diagnosis by combining with cranial MRI and genetic tests. In this study, a case of HIBCH deficiency was confirmed, which expanded the mutation spectrum of HIBCH gene. Meanwhile, summarizing the clinical and genetic characteristics of cases reported improved understanding of HIBCH deficiency.

Objective To learn the clinical manifestations and pathogenic situation of hand foot and mouth disease (HFMD) in Changchun children's hospital from 2009 to 2010.Methods We collected the faeces specimen and oropharyngeal swabs of 1 862 children patients who consulted in Changchun children's hospital from May 2009 to Nov 2010.The enterovirus 71 ( EV71 ) and Coxsackie virus A16 (CoxA16) of 1 514 faeces specimens were amplified with RT-PCR,and 530 oropharyngeal swabs' virus were isolated with rhabdomyosarcoma cell.Results The total HFMD patients were 1 175 in 2010,687 in 2009.The rate of serious patients was 6.26％ (43/687) in 2009,and 16.51％ ( 194/1 175 ) in 2010.The season of peak incidence in 2009 was June,and in 2010 were June,July and August.The gender distribution was 1 241 males and 621females.The average age of HFMD patients was ( 28.32 ± 15.22 ) months.And the distribution in city and countryside was 1:1.05.Total of 1 862 cases ( 100％ ) had rash,55.69％ ( 1 037/1 862) had fever,6.07％(113/1 862) had neurologic symptom and 1.41％ (26/1 862) had vomiting when the patients admitted in our hospital.And there were 547 cases ( 29.41％ ) emerging myocardium injury,548 cases (29.43％ ) emerging neurologic complications and 82 cases (4.39％ ) emerging respiratory complications during treatment.There were 166 positive with positive rate 31.32％ in virus isolation.The positive rate of EV71 and CoxA16 were 9.62％ and 10.57 in 2009,and 32.52％ and 39.53％ in 2010.Conclusion There were more HFMD patients in 2010 than 2009,and the proportion of serious patients was increased too.In summer and autumn,we should pay more attention to HFMD for fever children.HFMD could damage digestive system,respiratory system,circulatory system and nervous system.The nervous system of serious patients is more likely to be damaged.The pathogens of HFMD are diversity,but mainly are EV71 and CoxA16,and the pathogen of serious patients is mostly EV71.

OBJECTIVEA RP-HPLC method was developed for simultaneous determination of bigelovin, ergolide and tomentosin in Inula hupehensis.

METHODAn Agilent C18 column (4.6 mm x 250 mm, 5 microm) was used for separation at 40 degrees C. The mobile phase was acetonitrile-water, and the flow rate was 1.2 mL x min(-1). The detection wavelength was set at 210 nm.

RESULTThe method has good linearity in the ranges of 0.01792-0.1792 g x L(-1) (r =0.9999) for bigelovin, 0.0424-0.4240 g x L(-1) (r =0.9996) for ergolide, and 0.044 8-0.4480 g x L(-1) (r = 0.9996) for tomentosin. The average recoveries of bigelovin, ergolide, and tomentosin were 98.5%, 98.2%, 98.4%, with the RSD of 1. 3%, 1.3%, 1.7%, respectively. The results demonstrated that there was a significant difference in the contents of three sequterpene lactones among the tested Inulae Flos.

CONCLUSIONThe results indicated that the present RP-HPLC method is simple, quick and accurate, and can be used for the quality control of I. hupehensis, especially for the authentication of Inulae Flos.

ObjectiveTo investigate the association between thromboelastography (TEG) parameters and bleeding in patients with liver cirrhosis and whether TEG can be used to predict the risk of spontaneous bleeding in patients with liver cirrhosis, and to provide a basis for its preventive treatment. MethodsA retrospective analysis was performed for the clinical data of 174 patients with liver cirrhosis who attended Huadu People’s Hospital from May 2018 to April 2020 and did not receive invasive procedure, and according to the condition of bleeding, they were divided into non-bleeding group(n=64), gastrointestinal bleeding group(n=61), and mucocutaneous/oronasal bleeding group(n=49). The medical record system and laboratory information system were used to collect related information and laboratory test results for statistical analysis. The t-test was used for comparison of normally distributed continuous data between two groups; an analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, and the Kruskal-Wallis H test was used for comparison between multiple groups. MedCalc software was used for receiver operating characteristic (ROC) curve analysis, and the area under the ROC curve (AUC) was calculated for commonly used coagulation markers and TEG parameters in predicting the risk of bleeding in patients with liver cirrhosis. Cut-off value, sensitivity, specificity, positive predictive value, and negative predictive value were determined, and the Z test was used for comparison of indices in predicting mucocutaneous/oronasal bleeding. ResultsOf all 174 patients, 110 (63.2%) experienced spontaneous bleeding, among whom 61 (55.5%) had gastrointestinal bleeding and 49 (44.5%) had mucocutaneous/oronasal bleeding. There were significant differences in maximum amplitude (MA) and K between the bleeding group and the non-bleeding group (t=2.241 and -2.605, both P＜0.05). There were significant differences between the mucocutaneous/oronasal bleeding group and the non-bleeding/gastrointestinal bleeding groups in platelet count (PLT) and the TEG parameters of clot formation time, a-angle, MA, and coagulation index (CI) (F=3.947, H=12.867, F=4.007, F=8.498, F=5.420, all P＜0.05). Among the TEG parameters, reaction time and Lys30 were generally within the normal range, while there was a prolonged kinetics (K) time and reductions in a-angle, MA, and CI. PLT ≤40×109/L, MA ≤357 mm, K time ＞4.2 minutes, a-angle ≤51.6, and CI ≤-5.9 could be used to predict spontaneous mucocutaneous/oronasal bleeding in patients with liver cirrhosis (all AUC ＞0.7), with positive predictive values of 82.4, 88.9, 81.0, 72.7, and 73.7, respectively, and negative predictive values of 68.3, 72.5, 73.0, 69.4, and 66.7, respectively. ConclusionPLT and the TEG parameters of K time, a-angle, MA, and CI can predict spontaneous bleeding caused by abnormal coagulation in liver cirrhosis, while conventional coagulation parameters prothrombin time and activated partial thromboplastin time cannot predict such bleeding, which provides a basis for the treatment of coagulation disorder and transfusion of blood components for patients with liver cirrhosis.

OBJECTIVE: To assess the value of detecting the rearrangement of mixed lineage leukemia (MLL) gene in children with acute mononuclear leukemia (AML). METHODS: Dual-color fluorescence in situ hybridization (FISH) probe was used to detect MLL gene rearrangement in 68 children with AML by interphase FISH. The results were compared with that of conventional G banding chromosomal analysis. RESULTS: Among the 68 children, 28 were detected by FISH with positive hybridization signals, with a detection rate for MLL gene rearrangement being 41.2%. Twelve (17.6%) reciprocal translocations and interruption of 11q23 were detected by G banding analysis. The difference in the detection rates between the two methods was statistically significant (P< 0.05). CONCLUSION The sensitivity of FISH assay for MLL gene rearrangement was significantly higher than that of G banding chromosomal karyotyping. Combined use of both methods for children with AML can improve the detection rate of MLL gene rearrangements and provide crucial clues for clinical diagnosis, treatment and prognosis.
Child ; Chromosomes, Human, Pair 11 ; Gene Rearrangement ; Histone-Lysine N-Methyltransferase ; genetics ; Humans ; In Situ Hybridization, Fluorescence ; Leukemia, Monocytic, Acute ; genetics ; Myeloid-Lymphoid Leukemia Protein ; genetics ; Translocation, Genetic

Objective To explore the dynamic changes and significance of costimulatory molecules CD40 and lymphocyte subsets in peripheral blood of children with eosinophilic gastroenteritis (EG). Methods The CD40 expression and lymphocyte subsets in peripheral blood were detected by flow cytometry (FCM) in 15 children with EG (acute stage and remission stage) and 15 healthy controls. The level of serum interleukin (IL) -4 was detected by enzyme-linked immunosorbent assay (ELISA). The eosinophil (EOS) was count by blood cell analyzer. Results In acute stage, the children with EG had significantly higher expression of CD40, CD3+, CD4+, CD4+/CD8+, and CD19+CD23+ in peripheral blood, higher serum IL-4 level, higher EOS count and lower CD8+ than in remission stage and control group (P all<0.05). There were no differences between remission stage and control group (P>0.05). In acute stage, the expression of CD40 in peripheral blood in children with EG was positively correlated with the expression of CD4+ and IL-4 (P all<0.05). Conclusions CD40 may be involved in the pathogenesis of EG. That the increase of IL-4 secreted by CD4+ T cells that were induced by CD40 results in abnormal increase of EOS may be one of mechanisms of the pathogenesis of EG.