AIM: To establish an HPLC method for determining sophocarpine,sophoridine and oxymatrine in Sophora flavescens Ait,so as to investigate their contents in different years and different parts. METHODS: An Elite Hypersil NH2 column(250 mm ? 4. 6 mm,5 ?m) was used with the mobile phase being acetonitrile-absolute alcohol-3% phosphoric acid solution(82 ∶ 10 ∶ 8),flow rate being 1 mL/min,determinating wavelength being 220 nm,the column temperature being 26 ℃,The injection volume was 5 ?L. RESULTS: The calibration curves of sophocarpine,sophoridine and oxymatrine were in good linearity over the ranges of 0. 004 99 - 0. 149 7 ?g(r = 0. 999 9),0. 025 08 - 0. 752 25 ?g(r = 0. 999 9),0. 075 38 - 2. 261 25 ?g(r = 0. 999 9); and the average recovery of sophocarpine,sophoridine and oxymatrine was 99. 91% ,99. 26% ,100. 27% with RSD of 1. 11% , 0. 82% ,2. 18% respectively. CONCLUSION: The HPLC method shows a good separation,reproducibility and accuracy,there are obvious differences in the contents of three alkaloids in different years and different parts of Sophora flavescens Ait. The results provide important data for quality evaluation and utilization of Sophora flavescens materials.

Objective To observe the efficacy of de novo combination therapy lamivudine plus adefovir , lamivudine monotherapy and entecavir monotherapy in HBeAg-positive CHB patients with genotype B/C. Methods A total of 182 treatment-naive CHB patients in line with treatment standards of Chinese CHB prevention and treatment guidelines were randomly assigned to three groups and treated with lamivudine plus adefovir or lamivudine monotherapy or entecavir monotherapy for 48 weeks. Results Patients in three groups presented no difference in baseline levels. After treatment by three therapies , the group of lamivudine plus adefovir showed a higher biochemical response rates (12 week P < 0.01, 24 week P < 0.01, 48 week P < 0.01), HBeAg-serological rates(12 week P < 0.01, 24 week P < 0.05, 48 week P < 0.05) and completely virological response rates (12 week P < 0.05, 24 week P < 0.05, 48 week P < 0.05) than lamivudine group. In terms of biochemical response rates , the group of lamivudine plus adefovir had certain advantages when compared with entecavir group. Conclusion De novo combination therapy lamivudine plus adefovir is a good antiviral strategy for chronic hepatitis B patients with B/C genotype viral infection in China.

Objective To understand the coronary characteristic of acute coronary syndrome patients with ischemic J wave. Methods Comparison was made between 60 acute coronary syndrome patients with ischemic J wave and 60 acute coronary syndrome patients without ischemic J wave. All patients were examined by Holter monitoring electrocardiogram and coronary arteriongraphy. To distinguish the stenosis degree was defined in three degree based on Genisini score of 0, 1-80, and 81-160. Plaque types were divided into Ⅰ,Ⅱ, Ⅲ by Ambrose classification,the coronary and plaque characteristics of acute coronary patients were observed with ischemic J wave. Results There were no significant difference of stenosis degree between the two groups ( U = 3. 0686, P = 0. 0022), whereas there were significant difference of plaque types (x2 =16. 0890, P = 0. 0003) and coronary vessel numbers(x2 =12. 1045, P = 0. 0024). The degree of stenosis, the plaque types, and number of stent in coronary vessel were positively correlated with ischemic J wave(r =0. 44,0. 34,0. 31 ;P <0. 05). Conclusions The acute coronary syndrome with ischemic J wave patients is often not only accompanied with serious coronary stenosis and high incidence rate of multivessel disease,but also high probability of unstabilized plaque. Ischemic J wave can be a predictor of super-acute ischemic of myocardium.

Tau protein, a kind of microtubule-associated protein, plays an important role in the pathogenesis of Alzheimer's disease (AD) and other tauopathies, and has drawn more and more attention of scientific researchers. Appropriate animal models of mutated tau protein are important in the studies of the pathogenesis and drug therapy of tauopathies. So far, some transgenic animal models expressing human tau protein have been established, among which the transgenic animal model overexpressing P301L mutated form of tau protein has been widely used because of its obvious pathological changes. In this review, we will review the research progress in the pathological manifestations of the P301L tau transgenic animal model and its applications in pharmacological studies.

Objective To investigate the role of COOH-terminus tensin like molecule (CTEN) in epithelial-mesenchymal transformation of gastric cancer and its prognostic factors.Methods The expressions of CTEN,E-cadherin and Vimentin in 220 patients with gastric cancer were detected by immunohistochemical staining.Results The positive expression rate of CTEN was 61.8％ (136/220) in gastric cancer specimens,higher than 15％ (3/20) in adjacent tissues (x2 =16.488,P ＜0.01);the positive expression rate of E-cadherin in gastric cancer specimens was 25.5％ (56/220),lower than 85％ (17/20) in adjacent tissues (x2 =30.713,P ＜0.01);and the positive expression rate of Vimentin in gastric cancer specimens was 35.0％ (77/220),higher than 10％ (2/20) in adjacent tissues.There was no significant difference in the expression of CTEN between different genders,ages,size of tumors and histopathological types (P ＞ 0.05).In different infiltration depth,the CTEN expression difference were statistically significant (x2 =54.058,P ＜0.01),CTEN expression rate in lymph node metastasis group was obviously higher than without lymph node metastasis group (x2 =15.989,P ＜0.01),and CTEN expression rate in distant metastasis group was obviously higher than without distant metastasis group (x2 =4.143,P ＜0.01).CTEN and E-cadherin expression in gastric cancer tissue showed a negative correlation (r =0.357,P ＜ 0.01),while CTEN and Vimentin expression were positively correlated (r =0.498,P ＜0.01).220 cases of patients with gastric cancer received follow-up.Median survival time of CTEN negative express group was 48.2 months (95％ confidence interal,44.0-52.5 months),69.0％ for the 5-year cumulative survival rate.The survival analysis showed median survival time of CTEN positive expression group was 41.8 months (95％ confidence interal,38.3-45.3 months),48.5 ％ for the 5-year cumulative survival rate,which were lower than that in negative group (x2 =4.884,P ＜ 0.05).Multifactor analysis showed CTEN expression,lymph node metastasis and distant metastasis were independent risk factors for the prognosis of gastric cancer patients (P ＜ 0.05).Conclusions CTEN was positively correlated with gastric cancer invasion and metastasis,and played an important role in gastric cancer epithelial mesenchymal transformation.CTEN is independent risk factor for prognosis of gastric cancer,detection of CTEN gene mutation has important significance to evaluate the treatment and prognosis of gastric cancer.

An 85-year-old woman with gross hematuria for 10 days was presented to Wuxi No.2 People′s Hospital on Dec 10th, 2018.The images showed bladder mass. Pathological analysis of transurethrally resected tissue showed primary malignant melanoma with less pigmentations of urinary bladder. Without any following treatment, it grew again after 17 months. After the second surgery, she died of cachexia half a month later. Primary malignant melanoma with less pigmentations of urinary bladder is rare. It is vulnerable to misdiagnosis without immunohistochemical staining. The prognosis is poor.

Objective:To investigate the construction and application of telemedicine system in Tibet Autonomous Region.Methods:From June to July 2020, medical institutions at all levels in Tibet Autonomous Region were visited. Relevant information was collected through discussion, questionnaires and field visits, and the data of effective questionnaires were statistically analyzed.Results:A total of 125 medical institutions were visited, covering 7 regions of Tibet Autonomous Region, of which 74 medical institutions were able to realize audio-video two-way communication with the telemedicine platform of the PLA General Hospital. Seventy-three valid questionnaires were collected, and 64(88%)hospitals had software or hardware audio and video terminals. Twenty-five hospitals had never carried out remote consultation, accounting for 34%. The annual remote consultation amount of 35 hospitals was less than 10 cases, and that of 11 hospitals was 11-100 cases. Only 2 hospitals had carried out remote ECG and remote ultrasound diagnosis, with an annual consultation volume of more than 100 cases.Conclusions:The hospitals at or above the county level in Tibet Autonomous Region have established telemedicine system, but there are few remote services, the system idle rate is high, and the distance education resources are not matched.

Objective To investigate the distribution and antimicrobial resistance profiles of the common pathogens isolated from urine from 2015 to 2021 in the CHINET Antimicrobial Resistance Surveillance Program.Methods The bacterial strains were isolated from urine and identified routinely in 51 hospitals across China in the CHINET Antimicrobial Resistance Surveillance Program from 2015 to 2021.Antimicrobial susceptibility was determined by Kirby-Bauer method,automatic microbiological analysis system and E-test according to the unified protocol.Results A total of 261 893 nonduplicate strains were isolated from urine specimen from 2015 to 2021,of which gram-positive bacteria accounted for 23.8％(62 219/261 893),and gram-negative bacteria 76.2％(199 674/261 893).The most common species were E.coli(46.7％),E.faecium(10.4％),K.pneumoniae(9.8％),E.faecalis(8.7％),P.mirabilis(3.5％),P.aeruginosa(3.4％),SS.agalactiae(2.6％),and E.cloacae(2.1％).The strains were more frequently isolated from inpatients versus outpatients and emergency patients,from females versus males,and from adults versus children.The prevalence of ESBLs-producing strains in E.coli,K.pneumoniae and P.mirabilis was 53.2％,52.8％and 37.0％,respectively.The prevalence of carbapenem-resistant strains in E.coli,K.pneumoniae,P.aeruginosa and A.baumannii was 1.7％,18.5％,16.4％,and 40.3％,respectively.Lower than 10％of the E.faecalis isolates were resistant to ampicillin,nitrofurantoin,linezolid,vancomycin,teicoplanin and fosfomycin.More than 90％of the E.faecium isolates were ressitant to ampicillin,levofloxacin and erythromycin.The percentage of strains resistant to vancomycin,linezolid or teicoplanin was＜2％.The E.coli,K.pneumoniae,P.aeruginosa and A.baumannii strains isolated from ICU inpatients showed significantly higher resistance rates than the corresponding strains isolated from outpatients and non-ICU inpatients.Conclusions E.coli,Enterococcus and K.pneumoniae are the most common pathogens in urinary tract infection.The bacterial species and antimicrobial resistance of urinary isolates vary with different populations.More attention should be paid to antimicrobial resistance surveillance and reduce the irrational use of antimicrobial agents.

Objective To understand the distribution and changing resistance profiles of clinical isolates of Enterococcus in hospitals across China from 2015 to 2021.Methods Antimicrobial susceptibility testing was conducted for the clinical isolates of Enterococcus according to the unified protocol of CHINET program by automated systems,Kirby-Bauer method,or E-test strip.The results were interpreted according to the Clinical & Laboratory Standards Institute(CLSI)breakpoints in 2021.WHONET 5.6 software was used for statistical analysis.Results A total of 124 565 strains of Enterococcus were isolated during the 7-year period,mainly including Enterococcus faecalis(50.7％)and Enterococcus faecalis(41.5％).The strains were mainly isolated from urinary tract specimens(46.9％±2.6％),and primarily from the patients in the department of internal medicine,surgery and ICU.E.faecium and E.faecalis strains showed low level resistance rate to vancomycin,teicoplanin and linezolid(≤3.6％).The prevalence of vancomycin-resistant E.faecalis and E.faecium was 0.1％and 1.3％,respectively.The prevalence of linezolid-resistant E.faecalis increased from 0.7％in 2015 to 3.4％in 2021,while the prevalence of linezolid-resistant E.faecium was 0.3％.Conclusions The clinical isolates of Enterococcus were still highly susceptible to vancomycin,teicoplanin,and linezolid,evidenced by a low resistance rate.However,the prevalence of linezolid-resistant E.faecalis was increasing during the 7-year period.It is necessary to strengthen antimicrobial resistance surveillance to effectively identify the emergence of antibiotic-resistant bacteria and curb the spread of resistant pathogens.

Objective To examine the changing antimicrobial resistance profile of Enterobacter spp.isolates in 53 hospitals across China from 2015 t0 2021.Methods The clinical isolates of Enterobacter spp.were collected from 53 hospitals across China during 2015-2021 and tested for antimicrobial susceptibility using Kirby-Bauer method or automated testing systems according to the CHINET unified protocol.The results were interpreted according to the breakpoints issued by the Clinical & Laboratory Standards Institute(CLSI)in 2021(M100 31st edition)and analyzed with WHONET 5.6 software.Results A total of 37 966 Enterobacter strains were isolated from 2015 to 2021.The proportion of Enterobacter isolates among all clinical isolates showed a fluctuating trend over the 7-year period,overall 2.5％in all clinical isolates amd 5.7％in Enterobacterale strains.The most frequently isolated Enterobacter species was Enterobacter cloacae,accounting for 93.7％(35 571/37 966).The strains were mainly isolated from respiratory specimens(44.4±4.6)％,followed by secretions/pus(16.4±2.3)％and urine(16.0±0.9)％.The strains from respiratory samples decreased slightly,while those from sterile body fluids increased over the 7-year period.The Enterobacter strains were mainly isolated from inpatients(92.9％),and only(7.1±0.8)％of the strains were isolated from outpatients and emergency patients.The patients in surgical wards contributed the highest number of isolates(24.4±2.9)％compared to the inpatients in any other departement.Overall,≤ 7.9％of the E.cloacae strains were resistant to amikacin,tigecycline,polymyxin B,imipenem or meropenem,while ≤5.6％of the Enterobacter asburiae strains were resistant to these antimicrobial agents.E.asburiae showed higher resistance rate to polymyxin B than E.cloacae(19.7％vs 3.9％).Overall,≤8.1％of the Enterobacter gergoviae strains were resistant to tigecycline,amikacin,meropenem,or imipenem,while 10.5％of these strains were resistant to polycolistin B.The overall prevalence of carbapenem-resistant Enterobacter was 10.0％over the 7-year period,but showing an upward trend.The resistance profiles of Enterobacter isolates varied with the department from which they were isolated and whether the patient is an adult or a child.The prevalence of carbapenem-resistant E.cloacae was the highest in the E.cloacae isolates from ICU patients.Conclusions The results of the CHINET Antimicrobial Resistance Surveillance Program indicate that the proportion of Enterobacter strains in all clinical isolates fluctuates slightly over the 7-year period from 2015 to 2021.The Enterobacter strains showed increasing resistance to multiple antimicrobial drugs,especially carbapenems over the 7-year period.