Adult ; Endocarditis ; microbiology ; Humans ; Male ; Mycoses ; Recurrence

Abstract: Occupational epidemiology aims to explore the effect of occupational hazards on the health of workers and understand ， their mechanisms. It plays an important role in occupational health and occupational medicine.Currently occupational ， ， exposures in the workplace are complex and diverse and multiple factors affect workers´ health at the same time. Therefore it is important to elucidate the pathogenesis of occupational disease caused by occupational hazards and implement early - - intervention. System epidemiology collects data on multi level exposure and multi omics information to conduct network analysis - on the relationship amongrisk factors. and to study the mechanisms of exposures and health outcomes based on multi level data. ， ， ， ， Using the study design of system epidemiology occupational environmental lifestyle and social factors are combined as a ， system to evaluate the health of workers which can better evaluate the adverse health effects caused by occupational hazards. - ， ， The studies base on multi omics design will explore the pathogenesis of occupational diseases at the molecular cellular and tissue levels to evaluate the impact of occupational hazards on workers´ health and to explore interventions from multiple - perspectives to reduce the occurrence of occupational or work related diseases.

Objective Sirolimus is a new, potent immunosuppreasant considered to be nonnephrotoxic. There is limited experience with the use of sirolimus in liver transplant recipients. This study was to investigate the clinical experience of conversion from tacrolimus-based to sirolimus-based immunosuppression in liver transplant recipients. Patients switched to cyclosporine-based immunosuppression during the same period were also enrolled as controls. Methods This retrospective study examined liver transplant recipients who had been switched from tacrelimus-based to sirolimus-based or cyelosporine-based immunosuppressive therapy between January 2004 and January 2008 in the First Affiliated Hospital of Sun Yat-sen University. Patients were divided into 2 groups: those switched to sirolimus-based immunosuppression (group A; n=32); and those switched to cyclosporine-based immunosuppression (group B; n=15). Results The rate of successful conversion was 34.5% in group A (10/32) compared with 45.5% in group B (7/15); this difference was not statistically significant (P>0.05). After conversion, renal function in patients in group A remained normal, while the renal function in patients in group B become abnormal 4 months after conversion (P<0.05). In group A, some simlimus-associated adverse effects occurred but were mild and easy to control. Conclusion Sirolimus can be used safely in place of tacrolimus in liver transplant recipients.

Objective To observe the clinical efficacy and safety of Danshen dripping pill combined with atorvastatin calcium tablets and metformin hydrochloride tablets in the treatmem of diabetic coronary heart disease.Methods Ninety-four patients with diabetic coronary heart diseases were randomly divided into control group (n =47 cases) and treatment group (n =47 cases).Control group was treated with atorvastatin calcium 20 mg qd + metformin hydrochloride 0.5 g tid.Treatment group was given Danshen dripping pill 270 mg per time,tid,on the basis of the control group.Two groups were treated for 3 months.The clinical efficacy,the levels of serum total cholesterol (TC),triglycerides (TG),low-density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol(HDL-C),hemoglobinA1 c (HbA1 c),fasting blood glucose (FBG) and adverse drug reactions were compared between two groups,and the homeostasis model assessment insulin resistance (HOMA-IR) were calculated.Results After treatment,the total effective rates in treatment and control groups were 91.49％ (43/47 cases) and 74.47％ (35/47 cases) with significant difference(P ＜ 0.05).After treatment,the main indexes in treatment and control groups were compared:TC were (3.05 ±0.21),(3.55 ±0.16)mmol · L-1;TG were(1.14 ± 0.16),(1.45 ± 0.14) mmol · L-1;LDL-C were(1.42 ±0.19),(1.74±0.19) mmol · L-1;HDL-C were(1.11 ±0.12),(1.40 ±0.15) mmol · L-1;HbA1c were (4.09 ± 0.50) ％,(5.06 ± 0.71) ％;FBG were (4.68 ± 0.61),(5.42 ± 0.93) mmol · L-1;HOMA-IR were (2.63 ±0.60),(3.66 ±0.59),the differences were statistically significant(P ＜0.05).The adverse drug reactions in two groups were based on increasing transaminase,flatulence,constipation,acute myocardial infarction,and so on.The incidences of treatment and control groups were 31.94％ and 34.04％ without significant difference (P ＞ 0.05).Conclusion Danshen dripping pill combined with atorvastatin calcium tablets and mefformin hydrochloride tablets has a definitive clinical efficacy in the treatment of diabetic coronary heart disease,which can improve the levels of blood lipid and function of islet cells,decrease blood glucose,without increasing the incidence of adverse drug reactions.

Background: We found microRNA (miR)-1246 to be significantly differentially expressed between severe active alopecia areata (AA) patients and healthy individuals. Objective: To explore the role and mechanism of miR-1246 in severe AA. Methods: Expression of miR-1246, dual-specific tyrosine phosphorylation-regulated kinase 1A (DYRK1A), and nuclear factor of activated T cells 1c (NFATc1) in peripheral CD4+ T cells and in scalp tissues of patients were detected using RT-qPCR, Western blot, and immunohistochemistry assays. Peripheral CD4+ T cells from the AA patients were transfected with lentiviral vectors overexpressing miR-1246. RT-qPCR and Western blot analysis were used to measure mRNA or protein expression of retinoic-acid-receptor-related orphan nuclear receptor gamma (ROR-γt), interleukin (IL)-17, DYRK1A, NFATc1, and phosphorylated NFATc1. Flow cytometry was used to assay the CD4+ IL-17+ cells proportion. ELISA was used to measure cytokine levels. Results: miR-1246 levels decreased and DYRK1A and NFATc1 mRNA levels significantly increased in the peripheral CD4+ T cells and scalp tissues of severe active AA samples.NFATc1 protein expression was also significantly increased in the peripheral CD4+ T cells but not in the scalp tissues. NFATc1 positive cells were mainly distributed among infiltrating inflammatory cells around hair follicles. In peripheral CD4+ T cells of severe active AA, overexpression of miR-1246 resulted in significant downregulation of DYRK1A, NFATc1, ROR-γt, and IL-17 mRNA and phosphorylated NFATc1 protein, as well as a decrease in the CD4+ IL-17+ cells proportion and the IL-17F level. Conclusion miR-1246 can inhibit NFAT signaling and Th17 cell activation, which may be beneficial in the severe AA treatment.

Objective: To observe the clinical effect of Modified Taohong Siwu Decoction (MTSD) in treating pediatric intractable nephropathy (PIN). Methods: Ninety-five patients with PIN were divided into 2 groups at random. The 60 patients in the treated group were treated with MTSD and the 35 patients in the control group were treated with heparin. The clinical therapeutic effect and levels of thromboxane B2 (TXB2) and 6-keto-prostacyclin F1α (6-keto-PGF1α) before and after treatment were observed. Results: The total effective rate in the treated group was 81.7%, which was similar to that in the control group (80.0%, P>0.05). The levels of TXB2 and TXB2/6-keto-PGF1α ratio were higher in both groups of the patients as compared with those of the healthy control (P<0.01). After treatment, the two criteria were significantly improved in the two treated groups, as compared with those before treatment, the difference was significant (P<0.01), while in comparison between the MTSD treated group and the control group, no significant difference was found (P>0.05). Conclusion: MTSD has good effect in treating PIN, it could improve the metabolic unbalance of thromboxane and prostacyclin.

Objective To identify the infection and the replication of Tick-borne encephalitis virus(TBEV) in human neuroblastoma cells.Methods After being inffected with TBEV,the cell culture supernatant of human neuroblastoma cell line SK-N-SH was collected and assayed at different time points.Byusing real-time RT-PCR and plaque assay to measure the titer of virus in the supernatant,the replication andproliferation of TBEV in human neuroblastoma cell was identified.Meanwhile,the morphological change of SK-N-SH after TBEV infection was also visualized by observation under microscope and immunmquorescenceassay.Results Real-time RT-PCR and plaque assay both demonstrated that TBEV could replicate effectively in SK-N-SH cells,the peak titer could reach 2.92× 107 PFU/ml on 3 days post-inoculation.And significant morphological change occured on infected SK-N-SH cells after 2 days post inoculation.By immunofluorescence assay,the virus particles could be detected and visualized.Conclusion TBEV can replicate andproliferate effcctively and cause significant cell morphological changes in human neuroblastoma cell SK-N-SH,which demonstrated that SK-N-SH could be a suitable cell model for TBEV culture.

OBJECTIVE: The study was carried out on time limit of ACP and sperm positive-detected in mixed spot. METHODS: 600 vaginal swabs from living body after sexual intercourse were tested by routine and three-blindness methods. RESULTS: The longest time limit of ACP which was positively detected is 255 h, average time limit is 52 h, 41.3% of those samples was ACP-detected in positive degree (++). The longest time limit of sperm positively detected is 132 h, average time limit is 29 h. The number of sperms observed in 34.3% of those samples with positive result, is from 6 to 10/HP. CONCLUSION This study is helpful to forensic identification of sex cases.
Acid Phosphatase/analysis* ; Coitus ; Female ; Forensic Medicine ; Humans ; Male ; Spermatozoa ; Time Factors ; Vaginal Smears

This systematic review aimed to evaluate the efficacy and safety of assisted hatching (AH) performed in couples with advanced maternal age.We searched for randomized controlled trials (RCTs) in electronic databases,including MEDLINE,EMBASE and CENTRAL (from inception to January 2018);in addition,we hand-searched the reference lists of included studies and similar reviews.We included RCTs comparing AH versus no treatment (control).The meta-analysis was performed by RevMan 5.3 software.The search retrieved 943 records and 8 RCTs were included,comprising 870 cycles (n=440 for AH,and n=430 for control).There was no significant difference in the rates of live birth (RR 0.88,95％ CI 0.65 to 1.18,3 RCTs,n=427,I2=0％),clinical pregnancy (RR 1.00,95％ CI 0.83 to 1.19,8 RCTs,n=870,I2=22％),implantation (RR 1.07,95％ CI 0.83 to 1.39,4 RCTs,n=1359,I2=0％),miscarriage (RR 1.13,95％ CI 0.66 to 1.94,2 RCTs,n=116,I2=0％) and multiple pregnancy (RR 0.89,95％ CI 0.31 to 2.52,1 RCT,n=97,I2=not applicable) between the treatment group and control group.No reasonable conclusions could be drawn regarding reproductive outcomes after AH in patients with advanced maternal age due to the small sample pooled in meta-analyses.Studies of high methodological quality and with adequate power are necessary to further investigate the value of AH in assisted conception of those patients.

Functional abdominal pain is one of the most common problems in functional gastrointestinal disorders,and it's also one of the diseases benefit most from traditional Chinese medicine (TCM) treatment.This paper illustrates some key considerations on the study design of traditional Chinese medicine intended for the treatment of FAP based on the latest treatment and evaluation guidelines,technical guidance,professional authority works as well as the latest clinical studies,and combined with experience of clinical trial design.It hopes to offer helps for research designers in this genera.