Objective To study the separation ability of AB-8 macroporous resin in the purification of arctinin in Fructus arctii. Methods HPLC was used to measure the content of arctinin, and the adsorption performance and the elution parameters were investigated. Results The optimal separation conditions were as follows: the concentration of Arctinin was 5.5 mg/ml with a flow rate of 2 BV/h, and 50% alcohol was used as eluant. The adsorption of Arctinin was 52.08 mg/g, and the elution ratio of arctinin was 93.8%, and the purity of arctinin reached 65.2%. Conclusion AB-8 resin can be used to refine the arctinin in the extraction of Fructus arctii.

Objective To observe the therapeutic effects of the co-administration of γ-aminobutyric acid (CABA), sodium dimercaptopropane sulfonate (Na-DMPS) and vitamin B6 in large doses on liver and heart of rats with acute tetramine intoxication, and compare their separate effects of either GABA or Na-DMPS alone with those of the triad combination. Method Thirty rats were randomized into control group (n = 6), tetramine intoxication without treatment group (n = 6), tetramine intoxication treated with GABA group (n = 6), tetramine intoxication treated with Na-DMPS group (n = 6) and tetramine intoxication treated with triad combination (GABA + Na-DMPS + vitamin B6, GNDV n = 6) group. Samples of blood, liver tissue and heart tissue of rats with acute tetramine intoxication were collected immediately two hours after medication with different drugs. Serum alanine aminotrasferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) were measured, and the pathological changes of liver tissue and heart tissue were observed under microscope. Results The symptoms of poisoning were apparently relieved and the latency for convulsion/muscular twitch were obviously delayed in poisoned rats treated with GABA, Na-DMPS and GNDV separately. Furthermore, combination group showed the latent period delayed longer than either GABA or Na-DMPS groups The GABA, Na-DMPS and GNDV significantly lowered the serum levels of ALT, AST, CK and CK-MB in rats with tetramine intoxication, and those serum levels of enzymes were lower in GNDV group than those in either GABA group or Na-DMPS group. However, there were no difference in those serum enzymes between GABA group and Na-DMPS group. Moreover, the intoxicated rats treated with combination treatment had the slightest pathological changes in liver and heart (GNDV < GABA or Na-DMPS). Conclusions The co-administration of γ-aminobutyric acid, sodium demercaptopropane sulfonate and vitamin B6 in large doses for the treatment of tetramine intoxication is a method of choice.

OBJECTIVE:To provide reference for rational use of antibiotics in clinic. METHODS:A total of 162 inpatients with infective endocarditis(IE)selected from our hospital during Jan. 2014-Jun. 2016 were analyzed retrospectively in respects of general information of patients,distribution of neoplasm,clinical manifestations,examination indexes,sample type,pathogenic composition,drug resistance,treatment and outcome. RESULTS:Among 162 IE patients,the ratio of male to female was 1.9:1, and the age of patients were mainly 41-60 years old.Totally 146 patients suffered from cardiac basic disease(90.1%). One hundred and forty-five patients suffered from positive neoplasm,which mainly involved left ventricular system. Aortic valve neoplasm was the most common(59 cases,40.7%). One hundred and thirty patients suffered from fever.Among them,white blood cell count of 66 cases and neutrophil percentage of 104 cases were increased,while red blood cell count of 69 cases and hemoglobin of 100 cas-es were decreased. ALT of 22 cases,AST of 45 cases and serum creatinine of 16 cases were increased. Among 162 IE patients, 696 blood samples and 282 positive samples were detected(positive rate of 40.5%). Blood culture of 78 patients were positive (48.1%). Eighty-eight strains of pathogens were detected,including 84 strains of Gram-positive bacteria(95.5%,mainly being Streptococcus)and 4 strains of Gram-negative bacteria(4.5%). Resistance rate of Streptococcus to penicillin was 30.4%. Twelve strains of Staphylococcus were resistant to penicillin,and resistance rates of them to oxacillin were 50.0%. Enterococcus was resis-tant to penicillin,oxacillin and amikacin.Above bacteria were all sensitive to vancomycin,teicoplanin and linezolid,with resistant rate of 0.Among 162 IE patients,140 patients underwent cardiac surgery to clear neoplasm(86.4%),158 patients were cured or recovered,2 cases died and 2 cases were discharged from hospital voluntarily. CONCLUSIONS:In our hospital,IE patients are mainly male and suffered from cardiac basic disease. Most of the patients have cardiac neoplasm,which were mainly left cardiac neoplasm. Fever patients are the majority,accompanied by anemia,liver and kidney dysfunction and other symptoms. The patho-genic bacteria causing IE are mainly Gram-positive bacteria;Streptococcus is still the most common bacteria,and drug resistance is not optimistic. Antibiotics should be selected according to local etiological data,and medication plan should be adjusted in time according to the results of drug sensitivity test so as to guaran-tee the effectiveness and safety of anti-infection treatment.

Exosome,being a kind of extracellular vesicles transporting the bioactive substances,is featured by the physiological function of anti-tumor immunity and promoting angiogenesis.Different types of cells can release different kinds of exosomes that can play a key role in the occurrence and development of a variety of diseases.In recent years,domestic and foreign research has showed that the amount and type of exosome are associated with the disease state and prognosis of multiple myeloma patients,which provides a new way for diagnosis,prognosis assessment and target therapy for multiple myeloma.This paper reviews the recent progress of exosomes in multiple myeloma.

Objective:To summarize the clinical features and genetic characteristics of Zellweger spectrum disorder caused by PEX6 gene variation.Methods:This was a case series research. Clinical date and genetic results of 2 neonatal cases of Zellweger syndrome caused by PEX6 gene variation in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology and Affiliated Hospital of Guangdong Medical University from July 2021 to July 2022 were retrospectively collected and analyzed. Literature up to August 2023 was searched from electronic databases of China National Knowledge Infrastructure (CNKI), Wanfang Data and PubMed with the combined keywords of "Zellweger syndrome" "Zellweger spectrum disorder", and "PEX6 gene" both in Chinese and English. The main clinical features and genetic characteristics of Zellweger spectrum disorder caused by PEX6 gene variation were summarized.Results:The 2 male neonates both developed clinical manifestations as dyspnea, hypotonia, feeding difficulties, enlarged fontanelle, and high palatine arch after birth. Biochemical parameters indicated elevated bile acids, and the cranial ultrasound showed the enlarged bilateral ventricles and subependymal cyst in both 2 neonates. Zellweger syndrome was confirmed by whole exome sequencing, and the results revealed PEX6 gene variation in the 2 neonates, including compound heterozygous variants c.315G>A and c.2095-3T>G, and homozygous variant c.506_507del. Case 1 was hospitalized for 5 days, and case 2 for 32 days; they both died shortly after being discharged (the specific time is unknown). Literature review found 26 patients, including 2 neonates in this study, with Zellweger spectrum disorder caused by PEX6 gene defect reported in 1 Chinese article and 11 English articles. Clinical features included hearing loss (19 cases), developmental delay (19 cases), vision impairment (19 cases), elevated very long chain fatty acids (17 cases), brain malformations (15 cases), hypotonia (12 cases), hepatic insufficiency (12 cases), distinctive facies (10 cases), and dental impairment (9 cases). Compound heterozygous variations dominated the variation types (15 cases), and the frameshift variations (16 cases) were the main pathogenic variations.Conclusions:Zellweger spectrum disorder should be considered when neonates show hypotonia, feeding difficulty, distinctive facial appearance, brain malformations and failure of hearing screening, or when older children show retinitis pigmentosa, sensorineural hearing loss, amelogenesis imperfecta and developmental delays. Detection of genetic variation in the PEX gene is crucial for definitive diagnosis.

Objective To compare the application valuable of flexible spatial scan statistics and kulldorff scanning window in the cluster detection and early warning of hepatitis A.Methods The case numbers and incidence data of hepatitis A in 2012 for all the counties( cities, districts) in Yunnan province were collected from China Information System for Disease Control and Prevention and the total number was 1 335.By extracting the time length by month, the flexible spatial scan statistics was tested by retrospective analyses of hepatitis A data in Yunnan in 2012 and compared the results with the Kulldorff circular scan statistic analyses.Results The results of flexible scanning window showed that there were fifteen hepatitis A spatial clusters in Yunnan province in 2012 and in July, these areas including Gejiu county, Mengzi county and Wenshan county had the strongest clusters(the log likelihood ratio(LLR) =52.66,P=0.001). The results of Kulldorff scanning window showed that there were twenty hepatitis A spatial clusters and these areas including Gejiu county, Hekou county, Maguan county, Mengzi county, Pingbian county, Wenshan county had the strongest clusters (LLR=47.82,P=0.001).The results of the flexible scanning window were the same as the actual monitoring results.But the results of Kulldorff scanning window showed that in May and June some areas without incidence had the clusters.Conclusion Flexible scanning window can detect the monthly clusters of the Hepatitis A.Flexible scanning window had a higher accuracy than Kulldorff irregular circular scanning window. Flexible spatial scan statistics had the value in the use of spatial aggregation detecting on hepatitis A.

Objective:To explore the clinical phenotype and genetic etiology of a child with Developmental epileptic encephalopathy type 104 (DEE 104).Methods:A child who had presented at the Children′s Medical Center of the Affiliated Hospital of Guangdong Medical University in February 2021 for recurrent seizures over 1 month was selected as the study subject. Clinical data of the child was collected. Peripheral blood samples of the child and his parents were collected and subjected to whole exome sequencing (WES). Candidate variant was verified by Sanger sequencing.Results:The child, a five-month-old male, had presented with frequent focal seizures with severe developmental retardation from infancy. Physical examination showed emaciation, microcephaly, oblique palpebral fissures, Stahl′s ears, and hypotonia in the limbs. Electroencephalogram revealed multi-focal sharp waves, slow waves and slow spinal waves. Cranial magnetic resonance imaging revealed enlargement of bilateral lateral ventricles and the third ventricle, along with widening of brain sulci, fissure and cisterna. WES revealed that he had harbored a heterozygous c. 2401C>T (p.His801Tyr) missense variant of the ATP6V0A1 gene. Sanger sequencing showed that both of his parents were of the wild type. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was predicted to be likely pathogenic (PS2+ PM2_Supporting+ PP3). The proband was diagnosed with DEE 104. Early treatment with sodium valproate has failed, but the child had become seizure free after the addition of levetiracetam and topiramate. He still had abnormal EEG discharges and severe psychomotor retardation. Combining our case and a review of literature, DEE104 is mainly caused by de novo heterozygous variants of the ATP6V0A1 gene with an autosomal dominant inheritance. The patients may show refractory epilepsy and severe global developmental delay from infancy. Conclusion:The c. 2401C>T (p.His801Tyr) variant probably underlay the DEE104 in this child.

Objective To compare the application valuable of flexible spatial scan statistics and kulldorff scanning window in the cluster detection and early warning of hepatitis A.Methods The case numbers and incidence data of hepatitis A in 2012 for all the counties( cities, districts) in Yunnan province were collected from China Information System for Disease Control and Prevention and the total number was 1 335.By extracting the time length by month, the flexible spatial scan statistics was tested by retrospective analyses of hepatitis A data in Yunnan in 2012 and compared the results with the Kulldorff circular scan statistic analyses.Results The results of flexible scanning window showed that there were fifteen hepatitis A spatial clusters in Yunnan province in 2012 and in July, these areas including Gejiu county, Mengzi county and Wenshan county had the strongest clusters(the log likelihood ratio(LLR) =52.66,P=0.001). The results of Kulldorff scanning window showed that there were twenty hepatitis A spatial clusters and these areas including Gejiu county, Hekou county, Maguan county, Mengzi county, Pingbian county, Wenshan county had the strongest clusters (LLR=47.82,P=0.001).The results of the flexible scanning window were the same as the actual monitoring results.But the results of Kulldorff scanning window showed that in May and June some areas without incidence had the clusters.Conclusion Flexible scanning window can detect the monthly clusters of the Hepatitis A.Flexible scanning window had a higher accuracy than Kulldorff irregular circular scanning window. Flexible spatial scan statistics had the value in the use of spatial aggregation detecting on hepatitis A.

OBJECTIVETo compare the application valuable of flexible spatial scan statistics and kulldorff scanning window in the cluster detection and early warning of hepatitis A.

METHODSThe case numbers and incidence data of hepatitis A in 2012 for all the counties (cities, districts)in Yunnan province were collected from China Information System for Disease Control and Prevention and the total number was 1 335. By extracting the time length by month, the flexible spatial scan statistics was tested by retrospective analyses of hepatitis A data in Yunnan in 2012 and compared the results with the Kulldorff circular scan statistic analyses.

RESULTSThe results of flexible scanning window showed that there were fifteen hepatitis A spatial clusters in Yunnan province in 2012 and in July, these areas including Gejiu county, Mengzi county and Wenshan county had the strongest clusters (the log likelihood ratio (LLR) = 52.66, P = 0.001). The results of Kulldorff scanning window showed that there were twenty hepatitis A spatial clusters and these areas including Gejiu county, Hekou county, Maguan county, Mengzi county, Pingbian county, Wenshan county had the strongest clusters (LLR = 47.82, P = 0.001). The results of the flexible scanning window were the same as the actual monitoring results. But the results of Kulldorff scanning window showed that in May and June some areas without incidence had the clusters.

CONCLUSIONFlexible scanning window can detect the monthly clusters of the Hepatitis A. Flexible scanning window had a higher accuracy than Kulldorff irregular circular scanning window. Flexible spatial scan statistics had the value in the use of spatial aggregation detecting on hepatitis A.