OBJECTIVES: To investigate the application value of targeted next-generation sequencing (tNGS) in the etiological diagnosis of moderate to severe respiratory distress syndrome (RDS) in neonates. METHODS: A prospective randomized controlled trial was conducted, enrolling 81 term and late-preterm neonates with moderate to severe RDS admitted to Fujian Children's Hospital between December 2023 and December 2024. Patients were randomly assigned to the conventional microbiological test (CMT) group (n=42) or the tNGS group (n=39). For routine pathogen detection, bronchoalveolar lavage fluid was obtained via bronchoscopy, and lower respiratory tract specimens were collected via the endotracheal tube; all specimens underwent culture, and some specimens additionally underwent polymerase chain reaction or antigen testing. In the tNGS group, tNGS was performed in addition to routine pathogen detection on the same specimen types. The detection rate of pathogens, the detection rate of co-infections, and the duration of antibiotic use were compared between the two groups. RESULTS: The pathogen detection rate in the tNGS group (18/39, 46%) was significantly higher than that in the CMT group (8/42, 19%) (P=0.009). The co-infection detection rate was 13% (5/39) in the tNGS group, while no co-infections were identified in the CMT group (P=0.024). Regarding treatment, the duration of antibiotic use in the tNGS group was shorter than that in the CMT group [(12±4) days vs (15±5) days, P=0.003]. CONCLUSIONS tNGS significantly improves the pathogen detection rate in neonates with moderate to severe RDS and offers advantages in the rapid identification of co-infections and reduction of antibiotic treatment duration, suggesting it has clinical utility and potential for wider adoption.
Humans ; Prospective Studies ; Infant, Newborn ; Female ; Respiratory Distress Syndrome, Newborn/etiology* ; Male ; High-Throughput Nucleotide Sequencing/methods*

We report one case of estimated glomerular filtration rate (eGFR) decline after taking unilateral adrenalectomy due to aldosterone adenoma. A 60-year-old male with 23-year history of hypertension was reported to the endocrinologist due to hypokalemia (serum potassium 3.01 mmol/L). Urine microalbumin/creatinine (ALB/CR) was 70.15 mg/g, serum creatinine was 82 μmol/L and eGFR was 89.79 mL/(min·1.73 m²). Random serum aldosterone was 172.2-203.5 ng/L, and random plasma rennin activity was 0-0.17 μg/(L·h). His captopril challenge test suggested that his aldosterone le-vels were suppressed by 8% (< 30%) and the adrenal enhanced computed tomography scan revealed a left adrenal tumor. The patient was diagnosed with primary hyperaldosteronism (PA), aldosterone adenoma and underwent left laparoscopic adrenalectomy. Histological examination confirmed adrenal cortical adenoma. One week after the operation, his serum creatinine was increased to 127 μmol/L compared with preoperative level; eGFR was 32.34 mL/(min·1.73 m²). His systolic blood pressure (SBP) was 110 mmHg and diastolic blood pressure (DBP) was 60 mmHg (hypotensive drugs discontinued), and serum potassium level was 5.22 mmol/L. At the end of the 2-year follow up, the serum creatinine of this patient remained at 109-158 μmol/L and eGFR fluctuated from 63.28-40.12 mL/(min·1.73 m²). PA is one of the most common causes of secondary hypertension. Several studies have reported renal function deterioration of PA patients after unilateral adrenalectomy, like the patient in this article. Age, preoperative plasma aldosterone concentration, albuminuria and preoperative potassium level might be significant predictors of a decrease in the eGFR. Growing evidence suggests that aldosterone could contribute to structural kidney damage, arterial injury and hemodynamic disorder. At the same time, patients with PA exhibit glomerular hyperfiltration and glomerular vascular hypertension, leading to the misinterpretation of renal function in PA patients as subtle kidney damage may be masked by the glomerular hyperfiltration before treatment. After a unilateral adrenalectomy, glomerular hyperfiltration by aldosterone excess is resolved and renal damage can be unmasked. In conclusion, kidney function deterioration after adrenalectomy can be detected in some patients with PA. Thus, accurate evaluation of kidney function in patients with PA may be essential, especially for those with preoperative risk factors for postoperative renal impairment. After unilateral adrenalectomy, close monitoring of renal function and adequate management are required for PA patients.
Adrenal Gland Neoplasms/surgery* ; Adrenalectomy ; Glomerular Filtration Rate ; Humans ; Hyperaldosteronism/surgery* ; Male ; Middle Aged ; Renal Insufficiency, Chronic

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause acute respiratory distress syndrome, hypercoagulability, hypertension, and multiorgan dysfunction. Effective antivirals with safe clinical profile are urgently needed to improve the overall prognosis. In an analysis of a randomly collected cohort of 124 patients with COVID-19, we found that hypercoagulability as indicated by elevated concentrations of D-dimers was associated with disease severity. By virtual screening of a U.S. FDA approved drug library, we identified an anticoagulation agent dipyridamole (DIP) , which suppressed SARS-CoV-2 replication . In a proof-of-concept trial involving 31 patients with COVID-19, DIP supplementation was associated with significantly decreased concentrations of D-dimers ( < 0.05), increased lymphocyte and platelet recovery in the circulation, and markedly improved clinical outcomes in comparison to the control patients. In particular, all 8 of the DIP-treated severely ill patients showed remarkable improvement: 7 patients (87.5%) achieved clinical cure and were discharged from the hospitals while the remaining 1 patient (12.5%) was in clinical remission.

OBJECTIVE: To study the anti-inflammatory active constituents of Mangifera indica L. seed kernel. METHODS: The compounds were isolated by silica gel column chromatography, Sephadex LH-20 column chromatography and ODS column chromatography.Their structures were elucidated by spectral analyses and physicochemical properties. The anti-inflammatory activities of selected isolated compounds were evaluated as inhibitory activities against lipopolysaccharide (LPS)-induced nitric oxide (NO) production in RAW264.7 cell lines by Griess reaction. RESULTS: Eight compounds were obtained from n-butanol fraction oi Mangifera indica L. seed kernel, whose structures were elucidated as 4-O-ethylgallic acid (1), gallic acid (2), citric acid(3), 1,2,3,4,6-penta-O-galloylglucose(4),1,3, 6-tri-O-galloylglucose(5), hyperoside(6), quercetin-3-O-rhamnopyranoside(7), and mangiferin(8). Compounds 1, 2 and 4-8 exhibited potent inhibitory effect on NO production in LPS-induced macrophages, especially compounds 6 and 8 showed the best inhibitory activity with IC50 values of 16.5 and 19.5 μmol·L-1, respectively. CONCLUSION: Compounds 1 and 3-8 were obtained from Mangifera indica L.seed kernel for the first time.Compounds 1, 2 and 4-8 are the anti-inflammatory active constituents oi Mangifera indica L.seed kernel.Compounds 6 and 8 are the most potent anti-inflammatory active constituents.

OBJECTIVETo evaluate the effect of Shexiang Baoxin Pill (SBP) on coronary vasodilation by analysis of coronary angiography (CAG).

METHODSA consecutive cohort of 300 patients who underwent CAG between January 2013 and July 2013 were recruited and randomly assigned to 2 groups before operation. Patients in the SBP group sublingually took SBP, while those in the control group sublingually took placebos. All patients repeatedly underwent CAG 5 min after administration. The vascular diameter was calculated by quantitative angiography analysis method. The diameter of the left anterior descending coronary artery was measured in patients whose coronary arteries had no stenosis. The narrowest vascular diameter was measured in patients whose coronary arteries had stenosis. The heart rate, blood pressure, and the vascular diameter were compared between before and after administration in the two groups.

RESULTSIn the two groups, there was no significant difference in changes of heart rate, systolic pressure, or diastolic pressure between before and after administration (all P > 0.05). There were 64 patients with normal CAG in the two groups, 30 in the control group and 34 in the SBP group. CAG showed there were 236 patients with stenotic coronary artery, 110 in the control group and 126 in the SBP group. The vascular diameter was obviously larger in patients in the SBP group with normal or abnormal CAG after administration (all P < 0.01). It was also obviously larger than that of the control group after administration (P < 0.05, P < 0.01).

CONCLUSIONSBP could dilate both normal coronary artery and lesioned coronary arteries, but did not lead to fastened heart rate and decreased blood pressure.

Blood Pressure ; Coronary Angiography ; Coronary Vessels ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Heart Rate ; Humans ; Tablets ; Vasodilation ; drug effects

OBJECTIVETo investigate the effects of glucocorticoid receptor antagonist-M8046 on the behavior and the cyclooxygenase-2/prostaglandin E2( COX-2/PGE2) expression in spinal cord dorsal horn and dorsal root ganglia (DRG) in chronic constrictive injury (CCI) rats.

METHODSOne hundred and forty-four male SD rats were randomly divided into 4 groups, 36 rats in each group: Sham operation group (Sham), chronic constrictive group (CCI), M8046 treated group (M8046) and solvent controlled group (Sc). M8046 3 mg/(kg x d) intraperitoneal injection was given after operation in group M8046. Paw thennal withdrawal (PTWL) and paw mechanical withdrawal threshold (PMWT) of rats were measured on 2 pre-operative and 1, 3, 7, 10, 14 post-operative days. The spinal cord and L15 DRG of the operated side was removed at 3, 7, 14 days after surgery. The change of COX-2 and PGE2 expression was determined by immunohistochemical staining and ELISA separately.

RESULTSPTWL and PMWT in CCI group were significantly lower than those in Sham group on every post-operative day (P < 0.05). PTWL and PMWT in M8046 group were significantly higher than those in CCI group on 7, 10, 14 post-operative day (P < 0.05). In spinal dorsal horn, the level of COX-2 and PGE2 expression in CCI group was significantly higher than that in Sham group (P < 0.05). M8046 could significantly attenuate the activation of COX-2 and PGE2 induced by CCI (P < 0.05). The expression of COX-2 and PGE2 in DRG was similar to that in spinal dorsal horn.

CONCLUSIONThe effects of M8046 ameliorate the CCI-induced neuropathic pain may be related to attenuate the expression of COX-2 and PGE2 in spinal cord and DRG.

Animals ; Cyclooxygenase 2 ; metabolism ; Dinoprostone ; metabolism ; Ganglia, Spinal ; drug effects ; metabolism ; Male ; Neuralgia ; metabolism ; Rats ; Rats, Sprague-Dawley ; Receptors, Glucocorticoid ; antagonists & inhibitors ; Spinal Cord ; drug effects ; metabolism

Objective To investigate of the clinical effects of the combined use of all-trans retinoic acid compound and capsule of total glucosideof paeony on reticular oral lichen planus.Methods A total of 120 patients were randomly divided into 3 groups:experimental group (group E),control group 1 (group C1),and control group 2 (group C2).Topical application of alltrans-tretioin compound and systematic administration of capsule of total glucosides of paeony were applied in group E.The group C1 only received topical application of alltrans-tretioin compound and the group C2 only took oral administration of capsule of total glucosides of paeony.The clinical effects were evaluated 3 months and 6 months after application of these medicines.The clinical results were followed up for 6 months.Results A total of 107 patients completed the follow-up.The total effective rates were 78％ (29/37),75％ (27/36) and 56％ (19/34) in group E,C1,and C2 respectively after the administrations for 3 months.There was significant difference between group E and group C2 (x2 =4.094,P =0.043).No significant difference between group E and group C1 was found (x2 =0.117,P =0.733).After 6 months,the total effective rate of group E(86％) was significantly higher than that of group C1 (64％) (x2 =4.303,P =0.038) or C2 (62％) (x2 =5.722,P =0.017).Conclusions The combined application of topical all-trans retinoic acid compound and capsule of total glucosideof paeony could improve the clinical symptoms of reticular oral lichen planus.

OBJECTIVE: To introduce the method of avuncular index (AI) calculation. METHODS: Identity by decent coefficient, coancestry coefficient and AI law were employed in identification of uncle-niece relationship, when autosomal STR loci were detected to determine controversial uncle-niece relationship. RESULTS: The results of AI calculation were coincidental using identity by descent coefficien, coancestry coefficient and AI law. CONCLUSION The results are coincidental using three methods in the different situations. AI index is higher with participation of children's mother.
Algorithms ; Alleles ; Chromosomes, Human/genetics* ; Family ; Female ; Forensic Genetics/methods* ; Genotype ; Heterozygote ; Humans ; Male ; Models, Genetic ; Paternity ; Probability ; Tandem Repeat Sequences/genetics*

Child ; Humans ; Treatment Outcome

Adolescent ; Anal Canal ; physiopathology ; Child ; Constipation ; physiopathology ; Female ; Gastrointestinal Motility ; physiology ; Humans ; Male ; Rectum ; physiopathology