SAbstact:Objective To establish a method for detecting t he pharmacokinetic parameters of te tramethylpyragine(TMPz ),the main active component in Xiongbing nasal spray(A),Chuanxiong nasal spray(B)and Xiongbing decoction(C),in the rat brain .Methods Gas chromatography was applied for pharmacokinetic analysis of TMPz in v arious time after nasal administration or gastr ic infusion.Results The concentration -time process of A can be described in an open two -department model,which is simi lar to the process of intravenous adm inistration.As compared with B and C,A has its characteristics:quick absorpt ion,quick distribution and quick excretion of TMPz.TMPz passed through blood -brain barrier almost right after administration,and reach the peak concentra tion 1minute after the administrati on.95.7%of TMPz was cleared from brain within 1.5h.Conclusion The application of Borneolum makes T MPz of A enter into the rebral tissue easily.Therefore Xiongbing nasal spray is a quick -effective pre paration for acute ischemic stoke an d can be medicated repeatedly.

We transformed the fip-fve gene into Pichia pastoris GS115 for inducible and constitutive expression to obtain feasible bioactvie recombinant Fip-fve. The fip-fve gene was cloned from Flammulina velutipes fruting body by PCR and ligated to pPIC9 to construct inducible expression vector pPIC9-FIP-fve, and promotor pgap was used to replace the paox1 to construct constitutive expression vector pPIC9-PGAP-FIP-fve. These two vectors were used to transform P. pastoris by PEG method. The fip-fve was expressed after histamine-absence screening and yeast colony PCR. The inducible expression level reached 158.2 mg/L at the fourth day and the constitutive expression level was 46.3 mg/L and 29.5 mg/L using glucose and glycerol, respectively. The SDS-PAGE and Western blotting both proved the correctness of rFip-fve, and the hemagglutination test indicats the rFip-fve's bioactivity.
Electrophoresis, Polyacrylamide Gel ; Flammulina ; chemistry ; Fungal Proteins ; biosynthesis ; Genetic Vectors ; Pichia ; metabolism ; Polymerase Chain Reaction ; Promoter Regions, Genetic ; Recombinant Proteins ; biosynthesis

Objective Toobservetheindication, safetyandefficacyofanew immunosuppressant Rituximab in kidney transplantation. MethodsFive patients, who were diagnosed as antibody mediated rejection (AMR) from December 2010 to June 2011, were treated with single dose of Rituximab (500 mg) and followed up for 6 months. The clinical data, such as age, gender, onset of illness, induction therapy, maintaining therapy, allograft function, change of PRA, opportunistic infection and other complications were collected and retrospectively analyzed to evaluate the safety and efficacy of Rituximab used in AMR patients. ResultsAfter Rituximab therapy, all the patients had improved renal function measured by sera creatinine level: 4 cases retumed to normal, and 1 keep stable. Series of allograft biopsy demonstrated obviously reduced C4d deposition in nephridial tissue after treatment. One patient developed CMV viremia, another had urinary infection, but no one had lifethreatening infection during the follow-up period. The survival rate of human and allograft was both 100 ％. Conclusion Rituximab has a good efficacy and safety in treatment of AMR after renal transplantation.

Objective:To investigate the diagnosis and clinical characteristics of five elderly patients with Chlamydia psittaci-caused severe pneumonia.Methods:Through retrospective analysis, diagnosis and treatment process and clinical characteristics of five elderly inpatients with severe pneumonia caused by Chlamydia psittaci were summarized in the Department of Critical Care Medicine, Quanzhou First Hospital East Street Branch Area, affiliated to Fujian Medical University between January to June 2021.Results:Five patients with severe pneumonia caused by Chlamydia psittaci were aged from 64 to 74 years, with various underlying diseases such as coronary heart disease, chronic heart failure, chronic obstructive pulmonary disease, etc.All patients had an established history of poultry exposure.These cases had high fever, cough, spitting, and dyspnea as the main clinical manifestations.Some of them also had systemic symptoms or weakness of the limbs as the prodromal symptoms.The disease progressed rapidly, with severe respiratory failure, acute kidney injury, and shock appearing soon, accompanied by different degrees of muscle injury, and damage to the heart, liver, blood coagulation, and immune systems at the same time.Laboratory examination showed that levels of inflammatory indicators were increased: at 3, 5, 7 d after admission, the level of C reactive protein was 214.6(153.9-256.3)mg/L, 199.2(115.8-333.8)mg/L, 151.0(11.19-173.7)mg/L, respectively; and interleukin 6 level was 1 241.0(912.1-6822.0)ng/L, 779.1(451.2-7122.0)ng/L, 631.2(7.0-4 321.0)ng/L, respectively.And monitoring results of nutritional index indicated a high metabolic state.The imaging examinations showed that consolidation and ground-glass shadows spreaded to both lungs, may accompany the miliary and nodular shadows, and may also involve pleural which caused pleural effusion.After the clinical use of metagenomic next-generation sequencing(mNGS), mNGS has been confirmed as an important method for the diagnosis of Chlamydia psittaci infection.The disease course and prognosis were related to the severity of the disease, advanced age, underlying diseases, and timely diagnosis and effective treatment.Conclusions:The progression of Chlamydia psittaci pneumonia to severe disease may be related to advanced age, more basic diseases such as chronic cardiopulmonary disease, smoking, and timely diagnosis and treatment.Generally, laboratory and imaging examinations have no diagnostic specificity, but mNGS is of great significance for early diagnosis, transition to target treatment and improvement of prognosis.

Three cases of vibrio vulnificus-associated necrotizing fasciitis are presented. All patients showed a rapidly progressing, swelling, redness in the limb after eating seafood. Additionally, they presented with multiple organ dysfunction syndromes affecting the heart, lung, liver, kidney, coagulation, and blood. Vibrio vulnificus related necrotizing fasciitis is a fatal soft-tissue infection with high mortality. These are essential to improve survival by early clinical suspicion and immediate surgical intervention.

Objective:To observe the susceptibility factors of elderly patients with corynebacterium striata in sputum of lower respiratory tract and analyze its clinical therapeutic effect.Methods:The clinical data of 192 elderly inpatients infected with corynebacterium striatum detected in sputum of lower respiratory tract were retrospectively analyzed in Quanzhou First Hospital Affiliated to Fujian Medical University from January 2019 to June 2021.The detection rate of corynebacterium striata was calculated, and the susceptibility factors and clinical efficacy were compared between the infection group(n=102)and the colonization group(n=90).Results:The detection rate of corynebacterium striata(detected cases / numbers of qualified lower respiratory tract sputum specimen)was 0.8%(72/8976)from January to December 2019, 2.3%(134/5877)from January to December 2020, and 3.0%(121/4 039)from January to June 2021, the difference was statistically significant( χ2=93.93, P<0.01). The detection rates of corynebacterium striatum during three corresponding periods in elderly patients were 0.6%(57/8 976), 1.4%(81/5 877)and 1.9%(78/4 039), respectively, with statistically significant differences( χ2=45.57, P<0.01). The incidences or values of following indexes were higher in infection group than in colonization group: age of patients, admission of intensive care unit, malnutrition, use of hormones, combined use of antibiotics, use of invasive mechanical ventilation, use of fiber bronchoscope, reduced cough reflex, other basic diseases, and so on, but the differences were not statistically significant(all P>0.05). The clinical effective rates were 41.2%(42/102)in the infection group and 48.9%(44/90)in the colonization group, respectively, and the differences was not statistically significant( P>0.05). Only 25 patients(24.5%)in the infected group were treated on corynebacterium striatum according to drug sensitivity results.Among them, the clinical effective rate of the treatment group and the untreated group was 68.0%(17/25)and 32.5%(25/77), respectively, the difference was statistically significant( χ2=9.84, P<0.01). The clinical effective rate of untreated group was lower than that of colonization group, the difference was statistically significant( χ2=4.62, P<0.05). Conclusions:The detection rate of corynebacterium striatum in elderly patients is high, and increases year by year.Patients infected with corynebacterium striatum usually has a variety of susceptibility factors, if not taking effective treatment measures, may have adverse outcomes.In clinical work, it is necessary to pay attention to and reduce the susceptibility factors of corynebacterium striatum, and to correctly interpret the etiological reports, so as to adopt a reasonable and effective therapeutic schedule.

Objective:To investigate the biomechanical properties of a new pediatric femoral neck system in the fixation of pediatric femoral neck fractures with a free fracture fragment.Methods:Ten Sawbones model bones were randomly divided into 2 even groups ( n=5), all of which were made into Delbet Type Ⅱ femoral neck fractures with a Pauwels angle of 70°. A free bone block was removed from the bottom at the proximal end of the fracture to simulate a femoral neck fracture with a free fragment. Group A were fixed with traditional inverted triangle cannulated screws, and group B with a new pediatric femoral neck system. After the 2 groups of specimens were placed on a biomechanical testing machine, each specimen was subjected to a static axial compression test, an anti-torsion test and a cyclic load test in turn. The biomechanical results were compared between groups A and B in aspects of axial compression stiffness, torsional stiffness and maximum displacement difference. Results:The axial compression stiffness [(321.718±5.770) N/mm] and torsional rigidity [(1.448±0.079) N·m/°] in group B were significantly higher than those in group A [(266.722±4.788) N/mm and (1.282±0.023) N·m/°] ( P<0.05). The maximum displacement difference in the cyclic load test in group B [(0.063±0.038) mm] was also significantly smaller than that in group A [(0.117±0.056) mm] ( P<0.05). Conclusion:In fixation of pediatric femoral neck fractures with a free fracture fragment, the new pediatric femoral neck system can lead to better biomechanical stability than the traditional inverted triangle cannulated screws.

Objective:To compare the therapeutic effects of cannulated screws and Kirschner wires in the treatment of medial malleolar fractures of Salter-Harris types Ⅲ and Ⅳ in children.Methods:A retrospective study was conducted to analyze the data of 48 and 16 children who had been treated respectively at Department of Pediatric Orthopaedics, Fuzhou Second General Hospital, and Department of Pediatric Orthopaedics, Foshan Hospital of Traditional Chinese Medicine for medial malleolar fractures of Salter-Harris types Ⅲ and Ⅳ from June 2016 to June 2022. There were 32 males and 32 females with an age of 12 (10, 14) years; 31 left and 33 right sides were affected. By the Salter-Harris classification: type Ⅲ in 45 cases, and type Ⅳ in 19 cases. The patients were divided into 2 groups according to their internal fixation methods. Group A (44 cases) was subjected to internal fixation with cannulated screws and group B (20 cases) to internal fixation with Kirschner wires. At the last follow-up, anteroposterior and lateral X-ray films of their ankle joints were taken for imaging evaluation. Functional recovery of the affected limbs was evaluated based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scoring, and related complications were recorded.Results:The 2 groups were comparable because there were no significant differences in their preoperative general data except laterality ( P>0.05). All the patients were followed up for (37.3±21.5) months and achieved bony union. At the last follow-up, for groups A and B respectively, the distal lateral angle of the tibia was 89.0° (89.0°, 90.0°) and 89.0° (89.0°, 90.0°), the range of ankle motion was 73.5° (67.8°, 76.0°) and 70.0° (70.0°, 75.0°), and the good and excellent rate by the AOFAS ankle-hindfoot scoring was 97.7% (43/44) and 95.0% (19/20), showing no significant difference between the 2 groups ( P>0.05). There was a significant difference between the 2 groups in the incidence of premature physeal closure [36.4% (16/44) versus 65.0% (13/20)] ( P=0.033). Conclusions:In the treatment of medial malleolar fractures of Salter-Harris types Ⅲ and Ⅳ in children, internal fixation with both cannulated screws and Kirschner wires can lead to comparable efficacy in good functional recovery and imaging evaluation. However, fixation with cannulated screws may be more advantageous in reducing the risk of early closure of the epiphysis.

Objective:To explore the clinical features and surgical outcomes of greater trochanteric fractures of the femoral neck in children.Methods:A retrospective study was conducted to analyze the 5 children with greater trochanteric fracture of the femoral neck who had been treated at Department of Pediatric Orthopaedics, Fuzhou Second General Hospital from January 2011 to December 2020. There were 1 boy and 4 girls, with an age of (11.0±1.9) years. By the Delbet classification, all were type Ⅲ fractures. The time from injury to operation was (4.4±2.1) days. The children were treated with cannulated screws (1 case) or fixation with a pediatric hip plate (4 cases). The clinical features of such fractures were analyzed; the fracture union time and hip function and complications at the last follow-up were recorded.Results:The clinical features of greater trochanteric fractures of the femoral neck in children were: (1) involvement of 2 anatomic sites in a narrow region, (2) comminuted fractures, and (3) all Delbet type Ⅲ fractures. The follow-up time was (22.8±6.0) months. All the 5 children obtained bony union. The union time was (5.2±1.8) weeks for greater trochanteric fractures, and 8.0 (8.0,10.0) weeks for femoral neck fractures. Follow-up observed no necrosis of the femoral head, premature closure of the femoral head epiphysis, hip varus deformity, or length disparity between the lower limbs. Premature closure of the greater trochanteric epiphysis occurred in 2 children after surgery. According to the Ratliff scoring, the hip function was excellent in 3 cases and good in 2.Conclusions:Greater trochanteric fractures of the femoral neck in children are a special kind of proximal femoral comminuted fractures that affect 2 anatomic sites in a narrow region and belong all to Delbet type Ⅲ fractures. Open reduction and internal fixation with cannulated screws or a pediatric hip plate is a safe and effective treatment for such fractures.

Objective: To analyze the current status of work-related musculoskeletal disorders (WMSDs), work fatigue and musculoskeletal pain in Chinese occupational population, and to study the relationship between work fatigue and musculoskeletal pain and WMSDs. Methods: A total of 66 961 employees from 323 enterprises in 15 key industries in China were selected as the study subjects using stratified cluster sampling method. The incidence of WMSDs in the past year was investigated using the Chinese version of the Musculoskeletal Disorders Questionnaire, and the work fatigue and musculoskeletal pain were investigated using Borg 6-20 Rating of Perceived Exertion Scale and visual analogue scale. The data were standardized using the age composition data of 18 to 60 years from the seventh national population census. Results: The standardized annual incidence of WMSDs was higher in the front-line workers than that in the administrative and other supportive staff (38.82% vs 36.30%). The detection rates of work fatigue and musculoskeletal pain in the study subjects were 44.54% and 63.08%, respectively. The result of S-curve fitting showed that the risk of WMSDs increased with the level of work fatigue (P<0.01). Among the front-line workers, the average of monthly fatigue frequency in the neck, shoulder, lower back, upper back, wrist/hand, foot and ankle, knee, leg, and elbow were higher in the group with WMSDs compared to those without WMSDs (all P<0.01). The pain degree of musculoskeletal pain was higher in all nine sites in the fatigued group than in the no-fatigue group (all P<0.01). The standardized detection rate of musculoskeletal pain was higher in the fatigued group than in the non-fatigued group (80.38% vs 25.71%). The work fatigue was moderate and positively correlated with musculoskeletal pain in all seven sites except the lower back and elbow, with Kendall Tau-b correlation coefficients ranging from 0.423 to 0.546 (all P<0.01). Conclusion: There is a good correlation between work fatigue and local musculoskeletal pain, work fatigue and WMSDs in Chinese occupational population. Implementing ergonomic interventions to control the development of work fatigue can be an effective measure for preventing WMSDs.