Objective To study the efficacy and side effects of Ganciclovir combined with L-ornithine-L-aspartate on infant cytomegalovirus(CMV) hepatitis.Methods Sixty infants with CMV hepatitis hospitalized in our hospital from Dec.2009 to Dec.2010 were treated with ganciclovir combined with L-ornithine-L- aspartate.The parameters observed in the study included the pre-and post-treatment data on total Bilirubin (TBIL),alanine aminotransferase (ALT),alkaline Phosphatase (AKP)and the retraction of liver and spleen,as well as the adverse reactions of the treatment.Results The treatment significantly decreased serum TBIL (t =5.74,P ＜ 0.05 ),ALT( t =2.92,P ＜ 0.05 ) and liver( t =8.27 P ＜ 0.05 ) and spleen volume ( t =5.03,P ＜0.05).However,side effects such as liver damage and rash occurred occasionally during the ganciclovir treatment.Intravenous infusion of L-omithine-L-aspartate caused side effects such as vomiting and other mild gastrointestinal reactions.Conclusion The treatment of Ganciclovir combined with L-ornithine-L-aspartate on infant cytomegalovirus hepatitis created good efficacy and can be considered as the first treatment choice.Though it is relatively safe,adverse reactions should be monitored during the treatment.

BACKGROUND:Bone marrow mesenchymal stem cels have a therapeutic effect on acute lung injury, but the mechanism is unclear. If the mechanism is understood, the majority of patients with acute lung injury can obtain a benefit. OBJECTIVE:To explore the possible mechanism underlying bone marrow mesenchymal stem cels in the treatment of acute lung injury with sepsis in rats. METHODS: (1) Thirty-six adult Wistar rats were randomly divided into three groups, sham operation group (sham group), sepsis group and bone marrow mesenchymal stem cels group (cel treatment group). In the sepsis and cel treatment groups, animal models of sepsis with acute lung injury were established by cecal ligation and puncture, while in the sham group, the cecum was not ligated and punctured. Then, 1 mL normal saline was injected via the femoral vein in the sepsis and sham groups, and 1 mL bone marrow mesenchymal stem cel suspension (1×109/L) was injected into the cel treatment group. After 6 hours, interleukin 10 and macrophage inflammatory protein-2 levels in serum were measured in the three groups. Lung tissues were taken for pathological observation using hematoxylin-eosin staining. (2) Rat alveolar macrophages were obtained by bronchoalveolar lavage, seeded into 24-wel culture plates, and divided into three groups: control group (group A), sepsis model group (group B) and intervention group of bone marrow mesenchymal stem cels (group C). Normal saline, septic plasma, and co-intervention of septic plasma and mesenchymal stem cels were used in the groups A, B, C, respectively. Then, cels in the three groups were cultured in a 5% CO2 incubator at 37℃ for 1 hour. After that, alveolar macrophages were taken to detect whether nuclear factor-κB (P65) protein entered into the nucleus using laser scanning confocal microscopy. RESULTS AND CONCLUSION: (1) The results of animal experiments showed that compared with the sham group, the macrophage inflammatory protein-2 levels in the sepsis group and cel treatment group were significantly increased (P < 0.05), but the macrophage inflammatory protein-2 level in the cel treatment group was significantly lower than that in the sepsis group (P < 0.05); there were no significant differences in serum interleukin 10 levels among the three groups (P > 0.05); inflammatory cel infiltration, interstitial pulmonary edema and pulmonary hemorrhage existed in the sepsis and cel treatment groups, but these symptoms were significantly reduced in the cel treatment group compared with the sepsis group. (2) Results from cel experiments showed that compared with the group A, in group B and group C, the number of nuclear factor-κB (P65) proteins into the nucleus was significantly higher (P < 0.05), but it was lower in the group C than the group B (P < 0.05). These findings indicate that bone marrow mesenchymal stem cels in acute lung injury with sepsis can regulate nuclear factor-κB (P65) protein of alveolar macrophages into the nucleus, reduce expression of macrophage inflammatory protein-2, and thereby play a protective role in the lungvia reducing neutrophil infiltration. Temporarily, this study cannot explain whether bone marrow mesenchymal stem cels have an effect on interleukin 10.

This study aims to clarify out the anti-inflammatory mechanism of Qingfei Xiaoyan Wan. Chemical constituents of Qingfei Xiaoyan Wan identified by UPLC Q-TOF, were submit to Molinspiration, PharmMapper and KEGG bioinformatics softwares for predicting their absorption parameters, target proteins and related pathways respectively; and the gene chip and real time-PCR were carried out to investigate the expression of inflammatory genes on lung tissue of guinea pigs or human bronchial epithelial cell lines. The predicted results showed that 19 of the 24 absorbable constituents affected at 9 inflammation-related pathways through 11 protein targets; Qingfei Xiaoyan Wan treatment can significantly reduce the infiltration of cytokines through ERK1 gene and 5 inflammatory pathways (Focal adhesion, Fc epsilon RI, Toll-like receptors, NK cell-mediated cytotoxic, and ERK/MAPK). The results of real time-PCR further confirmed that the anti-inflammatory effects of Qingfei Xiaoyan Wan were due to active ingredients such as arctigenin, cholic acid and sinapic acid intervened focal adhesion, Fc epsilon RI signaling and ERK/MAPK pathways. The novel approach of 'drug-target-pathway' will present an effective strategy for the study of traditional Chinese medicines.

AIM:To investigate the correlation between demodex infection with corneal cell density changes and ocular surface function in patients with blepharo kerato conjunctivitis(BKC).

METHODS: Ninety-four patients with BKC(BKC group)at Department of Ophthalmology of our hospital from July 2019 to July 2020 were selected as the research objects, in addition, 80 matched healthy volunteers were selected as control group. The BKC patients were divided into infected group(45 cases)and uninfected group(49 cases)according to whether they were infected with demodex. According to the number of demodex detected in eyelashes, there were 17 cases of suspicious infection, 18 cases of moderate infection and 10 cases of severe infection. All subjects were examined by laser confocal microscopy, and the cell density in the superficial stromal layer of the central cornea and peripheral cornea was calculated. The ocular surface function \〖Schirmer test, Ocular Surface Disease Index(OSDI)\〗, eyelid margin abnormality score, corneal fluorescence stain and tear film break-up time(TF-BUT)of patients with BKC were examined, and the correlation between demodex infection with corneal cell density and ocular surface function in patients with BKC was analyzed.

RESULTS: Compared with those in the control group, the cell density in the superficial stromal layer of the central cornea and peripheral cornea was lower in the BKC group(P<0.05), and the OSDI, eyelid margin abnormality score and corneal fluorescence stain score were higher(P<0.05); the cell density in the superficial stromal layer of the central cornea and peripheral cornea of patients in uninfected group, patients with suspicious demodex infection, moderate demodex infection and severe demodex infection decreased in turn(P<0.05), and the OSDI, eyelid margin abnormality score and corneal fluorescence stain score increased significantly in turn(P<0.05); the degree of demodex infection was negatively correlated with the cell density in the superficial stromal layer of the central cornea and peripheral cornea in patients with BKC(P<0.05), and was positively correlated with OSDI, eyelid margin abnormality score and corneal fluorescence stain score(P<0.05).

CONCLUSION: The severity of demodex infection has a significant negative correlation with the cell density in the superficial stromal layer of the central cornea and peripheral cornea in patients with BKC, has a significant positive correlation in patients with ocular surface dysfunction.

AIM:To investigate the correlation between demodex infection with corneal cell density changes and ocular surface function in patients with blepharo kerato conjunctivitis(BKC).

METHODS: Ninety-four patients with BKC(BKC group)at Department of Ophthalmology of our hospital from July 2019 to July 2020 were selected as the research objects, in addition, 80 matched healthy volunteers were selected as control group. The BKC patients were divided into infected group(45 cases)and uninfected group(49 cases)according to whether they were infected with demodex. According to the number of demodex detected in eyelashes, there were 17 cases of suspicious infection, 18 cases of moderate infection and 10 cases of severe infection. All subjects were examined by laser confocal microscopy, and the cell density in the superficial stromal layer of the central cornea and peripheral cornea was calculated. The ocular surface function \〖Schirmer test, Ocular Surface Disease Index(OSDI)\〗, eyelid margin abnormality score, corneal fluorescence stain and tear film break-up time(TF-BUT)of patients with BKC were examined, and the correlation between demodex infection with corneal cell density and ocular surface function in patients with BKC was analyzed.

RESULTS: Compared with those in the control group, the cell density in the superficial stromal layer of the central cornea and peripheral cornea was lower in the BKC group(P<0.05), and the OSDI, eyelid margin abnormality score and corneal fluorescence stain score were higher(P<0.05); the cell density in the superficial stromal layer of the central cornea and peripheral cornea of patients in uninfected group, patients with suspicious demodex infection, moderate demodex infection and severe demodex infection decreased in turn(P<0.05), and the OSDI, eyelid margin abnormality score and corneal fluorescence stain score increased significantly in turn(P<0.05); the degree of demodex infection was negatively correlated with the cell density in the superficial stromal layer of the central cornea and peripheral cornea in patients with BKC(P<0.05), and was positively correlated with OSDI, eyelid margin abnormality score and corneal fluorescence stain score(P<0.05).

CONCLUSION: The severity of demodex infection has a significant negative correlation with the cell density in the superficial stromal layer of the central cornea and peripheral cornea in patients with BKC, has a significant positive correlation in patients with ocular surface dysfunction.

To detect levels of platelet glycoprotein-specific autoantibody in idiopathic thrombocytopenic purpura (ITP), chronic aplastic anemia (CAA), hematologic malignancies and healthy volunteers, and evaluate the clinical significance of platelet glycoprotein-specific autoantibody level in diagnosis for ITP, anti-GPIb/IX, anti-GPIIb/IIIa, anti-GPIV and anti-GPV auto-antibodies were detected contemporaneously by a modified monoclonal antibody immobilization of platelet antigen assay (modified MAIPA). The results showed that the total positive rate of antibodies against platelet GPIb/IX, GPIIb/IIIa, GPIV, GPV were 69.99%, 10%, 20% and 0% in ITP, CAA, hematologic malignancy group and healthy volunteers respectively. There was significant difference between ITP and CAA (chi(2) = 20.71, P < 0.005), between ITP and hematologic malignancy group (chi(2) = 12.22, P < 0. 005). There was no positive finding in the healthy control. It is concluded that platelet glycoprotein-specific autoantibody has high value for the diagnosis of ITP,many kinds of antibodies detection at one time can enhance sensitivity, MAIPA is a specific assay for the diagnosis of idiopathic thrombocytopenic purpura.
Adolescent ; Adult ; Aged ; Autoantibodies ; blood ; Child ; Female ; Humans ; Male ; Middle Aged ; Platelet Membrane Glycoproteins ; immunology ; Purpura, Thrombocytopenic, Idiopathic ; diagnosis ; immunology ; Sensitivity and Specificity

OBJECTIVETo observe the outcome of percutaneous balloon mitral valvuloplasty (PBMV) in patients with rheumatic mitral valve stenosis.

METHODSFrom April 1992 to November 2008, 1768 patients underwent PBMV in our hospital.Clinical and echocardiographic follow up data were analyzed in 426 patients from April 1992 to August 1998. Left atrial pressure and the mitral valve gradient (MVG) were measured before and immediately after PBMV in all patients.

RESULTSPBMV was successful in 1748 out of 1768 patients (98.86%). Left atrial pressure decreased from (38 +/- 7) mm Hg (1 mm Hg = 0.133 kPa) to (12 +/- 4) mm Hg (P < 0.001), MVG decreased from (28 +/- 6) mm Hg to (8 +/- 3) mm Hg (P < 0.001) and the area of the mitral valve increased from (0.98 +/- 0.26) cm(2) to (1.97 +/- 0.39) cm(2) (P < 0.001) post PBMV. The main complications included death (n = 2), acute pericardial effusion (n = 1), severe mitral regurgitation (n = 12), cerebral embolism (n = 2) and pulmonary edema (n = 1). Ten years follow up was finished in 426 patients and 288 patients (67.6%) were still in NYHA class Ior II without mitral valve replace operation or repeated PBMV, restenosis was evidenced in 140 patients (33.3%) and 31 patients dead (7.5%).

CONCLUSIONPBMV was an effective therapy option for patients with rheumatic mitral valve stenosis.

Catheterization ; adverse effects ; Echocardiography ; Follow-Up Studies ; Humans ; Mitral Valve Stenosis ; therapy ; Rheumatic Heart Disease ; therapy ; Treatment Outcome

Sepsis is the main cause of death in intensive care unit (ICU). Sepsis and septic shock seriously affect the prognosis of patients and increase the mortality and re-morbidity of patients. Early and timely intervention can reduce the mortality and recurrence rate of patients with sepsis. The occurrence of sepsis may be related to the phosphorylation of connexin 43 (Cx43), which needs to be realized through various signal pathways. The related sites of connexin 43 are phosphorylated through different signal pathways to achieve the precise regulation of sepsis, these sites may be related targets for the treatment of sepsis and provide a direction for accurate treatment of sepsis. This paper mainly analyzes the role of Cx43-related signal pathways such as protein kinase A (PKA), protein kinase C (PKC), mitogen-activated protein kinase (MAPK) and phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) in the pathogenesis of sepsis.

ObjectiveTo explore the cerebral cortex activation in different swallowing periods using functional near-infrared spectroscopy (fNIRS). MethodsFrom October to December 2023, a total of 18 healthy adults were recruited to perform four tasks of visual stimulation, chewing, tongue tip sliding and repeated swallowing during fNIRS acquisition, to calculate the cortical activation β values covering a total of 41 channels in frontal, parietal and occipital lobes. ResultsDuring the preoral period, the bilateral pre-motor and supplementary motor cortex (PSMC), bilateral inferior prefrontal gyrus, right visual association cortex (AVC), and left primary motor cortex (PMC) were significantly activated (P < 0.05). During oral preparation, the right pars triangularis (PTG), right frontal polar area (FPA), right dorsolateral prefrontal cortex (DPC), left primary somatosensory cortex (PSC), left PSMC and left PMC were significantly activated (P < 0.05). During the transition between oral and pharyngeal phases, bilateral PSMC and bilateral PMC were significantly activated (P < 0.05). Bilateral PSC, bilateral PTG, bilateral FPA, bilateral orbitofrontal area, bilateral PSMC, bilateral DPC and bilateral PMC were significantly activated during two consecutive periods of oral and pharyngeal phases (P < 0.05). ConclusionThe swallowing movement requires the coordination of the frontal, parietal and occipital cortex. The main activated brain areas are different in different swallowing stages, and the PSMC and PMC are involved in most swallowing stages.

Objective: To investigate the effect of mechanical ventilation in prone position combined with lung recruitment on severe acute respiratory distress syndrome (ARDS). Methods: From February 2015 to February 2017, 82 patients with ARDS admitted to ICU of the Second Hospital of Shanxi Medical University were divided into two groups according to random number table, with 41 cases in each group.The study group was treated with mechanical ventilation in prone position combined with lung recruitment therapy, and the control group was treated with mechanical ventilation in supine position combined with lung recruitment therapy.The differences of heart rate (HR), central venous pressure (CVP), mean arterial pressure (MAP), partial pressure of oxygen (PaO₂), oxygenation index (PaO₂/FiO₂), plateau pressure (Pplat), and static pulmonary compliance (Cst) were compared between the two groups before treatment (T0), and 1h (T1), 2h (T2), 6h (T3) after treatment. Results: The PaO₂ and PaO₂/FiO₂ levels of the two groups increased significantly after lung recruitment.In the study group at different time after treatment, PaO₂[(69.17±7.51)mmHg, (74.64±6.78)mmHg, (82.52±10.37)mmHg], PaO₂/FiO₂ [(116.91±15.57)mmHg, (123.06±16.34)mmHg, (135.23±18.41)mmHg]were higher than those in the control group[PaO₂: (64.23±7.72)mmHg, (68.51±8.05)mmHg, (73.43±9.12)mmHg; PaO₂/FiO₂: (106.50±12.97)mmHg, (115.42±13.19)mmHg, (123.42±14.95)mmHg], the differences were statistically significant (t=3.225, 3.254, 4.245, 3.954, 3.886, 4.135, all P<0.05). HR and CVP increased at T2-T3, T3 decreased, MAP decreased at T2-T3, and T3 increased in both two groups.HR at T1-T3 in the study group were (123.17±13.41)times/min, (114.64±10.08)times/min, (102.52±6.57)times/min, which were lower than those in the control group[(129.23±12.75)times/min, (117.51±10.35)times/min, (108.43±9.77)times/min], the differences between the two groups were statistically significant (t=3.884, 4.215, 4.667, all P<0.05). Conclusion Prone position mechanical ventilation combined with lung recruitment can effectively improve the oxygenation status of severe ARDS, and has less effect on hemodynamics, and the effect is better than supine position mechanical ventilation combined with lung recruitment.