Objective To explore the clinical effect of Xiyanping injection combined with bifidobacterium in the treatment of infantile virus diarrhea.Methods 80 cases of infantile virus diarrhea were selected,they were randomly divided into control group and research group according to the digital table,40 cases in each group.The control group received intravenous drip ribavirin treatment,the research group received treatment of intravenous drip Xiyanping injection combined with bifidobacterium at the same time.The symptoms disappear time(time of diarrhoea,antifebrile time),length of hospital stay and clinical curative effect were observed and compared between the two groups.Results The indicator of symptoms disappear time (time of diarrhoea,antifebrile time) and length of hospital stay of the research group were (2.19 ±0.43)d,(1.75 ±0.36)d,(4.13 ±0.85)d,respectively,which were shorter than those of the control group [(4.89 ± 0.61) d,(3.68 ± 0.52) d,(7.91 ± 1.13) d],the differences were statistically significant(t =22.89,19.30,16.90,all P ＜ 0.01).The total effective rate of the research group was 97.5％,which was significantly higher than 72.5％ of the control group (x2 =24.5,P ＜ 0.01).Conclusion Xiyanping injection combined with bifidobacterium in the treatment of infantile virus diarrhea has significantly shorter antidiarrheal time,antifebrile time,length of hospital stay than ribavirin,the clinical curative effect is distinct,which is worthy of clinical popularization and application.

Objective To assess the histopathological characteristics of tumors arising in nevus sebaceous.Methods The clinical and pathological data on 16 patients with tumors arising in nevus sebaceous were collected and retrospectively reviewed.Histopathological characteristics were analyzed.Results Of the 16 patients,12 aged ≥ 18 years,4 aged 11 to 17 years; 7 had syringocystadenoma papilliferum(SCAP),4 tubular apocrine adenoma (TAA),3 trichilemmoma,2 basal cell carcinoma (BCC),1 porokeratotic eccrine ostial and dermal duct nevus,and 1 nevus flammeus.Six patients suffered from more than one kind of tumor,of these tumors,concurrent syringocystadenoma papilliferum and apocrine adenoma predominated and were observed in 4 of these patients.Conclusion Any tumor arising from nevus sebaceous should be closely followed up.

Objective To investigate the regulative role of N-Acetyl-D-glucosamine(GlcNAc) on the stressed mice macrophages function.Methods The stressed mice model was established by electric footshock method.The mice were divided into 5 groups:normal control group,stressed mice model group,low dose Glc-NAc treatment group(0.25 ml 15% GlcNAc),medium-dose GlcNAc treatment group(0.5 ml 15% GlcNAc) and high-dose GlcNAc treatment group(1 ml 15% GlcNAc).GlcNAc was intragastrically injected to corresponding mice 2 h before the electrical stimulation.Peritoneal macrophage(PM?) phagocytosis capability was detected by phagocytosis saccharomycete assay,and PM? energy metabolism was detected by MTT assay.Results Compared with normal control group,stressed mice PM? phagocytosis capability was significantly lower(P

Objective:To develop a rating scale on the knowledge, attitude and practice of stroke-dysphagia for nurses, and to test the reliability and validity.Methods:Based on theoretical framework of the Knowledge, Attitude, Practice (KAP), the scale items were determined through literature review, expert consultation, pre-investigation, and qualitative interviews. 633 nurses in the department of stroke that from 18 hospitals in Hubei Province were selected for the survey, to further screen the items and test reliability and validity of the scale.Results:The positive coefficient of the two-round expert consultation were both 100%; the expert authority coefficient was 0.930; the level of coordination of experts ′ opinions was good. Exploratory factor analysis extracted 4 factors, the accumulative variance contribution rate was 44.278%, Content validity index S-CVI was 0.984, I-CVI was 0.857-1.000; the Cronbach α coefficient of scale was 0.855, test-retest reliability was 0.909. Eventually, the scale was consisted of 3 dimensions, 32 items. Conclusion:The scale has good reliability and validity, and can be used as a survey tool to test the current knowledge, attitude, practice of clinical nurses about patient with stroke-dysphagia.

Objective:To explore the DNA methylation patterns and methylation differential genes of patients with coal-burning-borne endemic fluorosis, and to provide a basis for study of the pathogenesis of fluoride-induced body injury.Methods:A case-control study was conducted in Shuicheng County, Liupanshui, Guizhou Province, ten patients with severe fluorosis were selected as the fluorosis group in Douqing Township, where people burning high fluorine coal in open range all year round; and ten people without fluorosis phenotype were selected as the control group in Huaga Township, where firewood was the main fuel. Peripheral blood samples were collected from the two groups of people. Reduced representation bisulfite sequencing (RRBS) technique was used to detect the whole genome DNA methylation pattern ( n = 4) and DNA differentially methylated region (DMR), the DMR differential degree (log 2Ratio) and KEGG pathway enrichment analysis were used to screen the methylation differential genes, and real-time PCR was used to verify the mRNA expression levels of the candidate methylation differential genes( n = 10). Results:The methylation pattern analysis results showed that the methylation levels of all C bases in the genome DNA of the fluorosis group and the control group were (61.53 ± 0.59)% and (62.48 ± 1.53)%, respectively; among them, the methylated levels at CG sites were (63.75 ± 0.65)%, (64.36 ± 1.01)%, at CHG sites were (13.79 ± 0.72)%, (16.69 ± 4.06)%, and at CHH sites were (25.12 ± 1.72)%, (29.77 ± 3.97)%. Compared with the control group, patients in the fluorosis group had 1 000 DMR distributed on different autosomes; and the chromosome 19 was the most with 104 segments. There were 978 DMR-related genes, including 265 hypermethylation genes and 713 hypomethylation genes; KEGG pathway enrichment analysis showed that methylation differential genes were mainly involved in cell metabolism, cancers, and phosphatidylinositol 3-kinase-protein kinase B (PI3K-AKT) and other signaling pathways; combined with the differential degree of DMR, the hypermethylated succinate dehydrogenase complex flavoprotein subunit A pseudogene 3 (SDHAP3, log 2Ratio = 3.487) and hypomethylated nuclear factor κB inhibitor kinase regulatory subunit γ (IKBKG, log 2Ratio =-4.436) were selected as the candidate genes. There were statistically significant differences in the mRNA expression levels of SDHAP3 (0.54 ± 0.08, 1.00 ± 0.00) and IKBKG (1.32 ± 0.39, 1.00 ± 0.00) between fluorosis group and control group ( F = 22.94, 15.09, P < 0.01 or < 0.05). Conclusion:There are a large number of methylation differential genes in the genomes of patients with coal-burning-borne endemic fluorosis and controls, the hypermethylated SDHAP3 and hypomethylated IKBKG may be involved in fluoride induced body injury.

Objective To investigate the dynamic changes of transcription profiles of mouse thymus gene expression in different times after 6 Gy γ-irradiation.Methods High-flux cDNA microarray technique was used irradiation,the numbers and types of differentially expressed genes were gradually decreased,for instance,the induced differential expression genes were involved in cell cycle,immunity and stress,apeptosis,signal transduction,transcription regulation,DNA synthesis and recombination,cystoskeleton,ion channel and transportation,metabolism,protein translation and synthesis,development and cell differentiation,etc.correlated cell cycle(3 up-regulating:Cyclin G,Anxal,Fgf1 and 2 down-regulating:Cdc2a,Cdc25b),5 genes correlated immune stress(4 up-regulating:IL-18,Casp1,IL-15,IL-7 and 1 down-regulating:Cd28),7 genes correlated apoptosis(4 up-regulating:Caspl,Anxal,Perp,IL-7 and 3 down-regulating:Pten,Api5 and Fas).Conclusions After 6 Gy irradiation,differentially expressed genes in mouse thymus is not only involved in many targets,levels and pathways,but also displayed an obvious difference in times.This reveals the regular pattern of differential expression genes in the process of injury and reconstitution in moderate dose irradiated mouse thymus.

OBJECTIVETo investigate the cloning and expression of Treponema pallidum (TP) specific antigen TpN17 and an epitope of TpN44.5 and the clinical application of this fusion antigen.

METHODSTpN17 gene was amplified from the genome of TP and an epitope of TpN44.5 was spliced to the 5' end of TpN17 gene. This modified TpN17 gene was cloned into the expression vector pGEX4T-2. The recombinant fusion antigen was purified by affinity chromatography and then an enzyme-linked immunosorbent assay (ELISA) kit was prepared. With this kit, the sera of 10 normal persons and 10 TP patients were tested.

RESULTSThe molecular weight of the purified fusion antigen was 45,000. Tested with ELISA, 10 serum samples of the TP patients were positive and another 10 of the normal persons were negative. ELISA equipped with the GST-epi-TpN17 antigen showed higher sensitivity and specificity as compared with routine methods.

CONCLUSIONThe recombinant fusion TP specific antigen GST-epi-TpN17 was suitable for the preparation of ELISA kit in clinical examinations.

Antigens, Bacterial ; biosynthesis ; genetics ; Cloning, Molecular ; Enzyme-Linked Immunosorbent Assay ; Humans ; Immunodominant Epitopes ; Polymerase Chain Reaction ; Recombinant Fusion Proteins ; biosynthesis ; Sensitivity and Specificity ; Syphilis ; diagnosis ; Treponema pallidum ; immunology

Objective:To observe the changing characteristics of pharmacokinetic and pharmacodynamic (PK-PD) parameters of vancomycin in critical patients under different drug regimens and to further explore the influencing factors.Methods:The clinical data of patients who treated with vancomycin and recorded by steady-state through concentration (C min) admitted to intensive care unit (ICU) of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2011 to December 2018 were analyzed retrospectively. The patients were divided into three groups according to the dosing interval (groups of q12 h, q8 h and q6 h respectively) and C min was collected. The serum concentration of vancomycin before (0 hour) and 1, 2, 4, 6, 8, 12 and 24 hours after administration were estimated by JPKD Ver 3.1. Area under the curve (AUC 0-24 h) was estimated by trapezoidal area method. Minimum inhibitory concentration (MIC) of pathogenic microorganisms in the same period was retrieved, thus AUC 0-24 h/MIC was calculated. Results:285 patients with 529 records of C min were enrolled in the study, including 375 data in q12 h group, 121 data in q8 h group and 33 data in q6 h group. After unifying daily dose by JPKD Ver 3.1, the C min (10-20 mg/L) reaching rate of q12 h group, q8 h group, q6 h group were 35.7%, 43.8% and 60.6%, respectively, while only q12 h group was statistically significant compared with q6 h group ( P < 0.01). q6 h group and q8 h group showed higher C min than q12 h group (mg/L: 13.8±5.2, 13.5±7.3 vs. 11.4±7.9, both P < 0.05) and lower peak concentration (C max) than q12 h group (mg/L: 19.4±5.3, 21.5±7.3 vs. 23.9±8.1, both P < 0.05). However, there was no significant difference in terms of percentage of PD target (AUC 0-24 h/MIC≥400) among the three groups (q12 h group, q8 h group, q6 h group were 38.1%, 41.3%, 45.5%, P > 0.05). Multiple linear regression analysis showed that creatinine clearance (CCr) and vancomycin clearance (CLvancomycin) were the main influencing factors of vancomycin PD parameters such as C min and AUC 0-24 h/MIC ( r values of CCr were -0.391, -0.424, and rvalues of CLvancomycin were -0.673, -0.663, all P < 0.01), and were negatively correlated with age ( r values were -0.432 and -0.488, respectively, both P < 0.01). Conclusions:At the same daily dose, C min can be increased and C max can be decreased by increasing the frequency of vancomycin administration, thus minimize the fluctuation of vancomycin serum concentration, but AUC 0-24 h/MIC is not affected. Vancomycin administration regimen in severe patients should be optimized according to CCr, CLvancomycin and age.

Objective:To observe the changes of renal function in critically ill patients after using vancomycin and analyze the renal protective effect of reduced glutathione (GSH) on vancomycin nephrotoxicity.Methods:The clinical data of patients with severe infection who were administered with vancomycin or plus infusion of GSH admitted to intensive care unit (ICU) of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2012 to October 2019 were collected during the study period, and the patients were divided into only vancomycin group and vancomycin combined with GSH group. The gender, age, body weight, underlying diseases, clinical diagnosis, severity score, renal function before and after taking the medicine, average daily dose and treatment duration of vancomycin and GSH, length of ICU stay and clinical outcomes were recorded and analyzed.Results:A total of 217 patients were enrolled, with 127 patients in the only vancomycin group, and 90 in the combination with GSH group. There was no statistically significant difference between the two groups in terms of gender, body weight, duration of vancomycin treatment, history of chronic kidney disease, and ICU mortality. The main causes of 217 patients admitted to the ICU were lung infection, sepsis/septic shock, and severe acute pancreatitis (SAP) and so on. The majority of patients in only vancomycin group had lung infections (63.0%), while the main etiology in combination with GSH group was SAP (46.7%). Compared with the only vancomycin group, the acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score in the combination with GSH group significantly decreased [15.0 (10.5, 21.0) vs. 27.0 (20.0, 31.0), P < 0.01], but the quick sequential organ failure assessment (qSOFA) score was significantly higher [1.0 (0, 1.0) vs. 0 (0, 0.2), P < 0.01], the basic renal function was poorer [serum creatinine (SCr, μmol/L): 102.0 (64.7, 178.0) vs. 56.0 (42.0, 71.0), blood urea nitrogen (BUN, mmol/L): 11.5 (6.7, 18.4) vs. 4.70 (3.5, 8.1), both P < 0.05], and the average daily dose of vancomycin was lower (mg·kg -1·d -1: 22.22±10.09 vs. 25.51±9.56, P < 0.05). The renal function of patients was getting worse significantly after vancomycin usage as compared with before [SCr (μmol/L): 68.0 (50.3, 103.4) vs. 56.0 (42.0, 71.0), BUN (mmol/L): 5.4 (3.6, 9.6) vs. 4.7 (3.5, 8.1), both P < 0.05]. However, the renal function indexes of the combination with GSH group were better than those before treatment [SCr (μmol/L): 81.0 (61.0, 129.0) vs. 102.0 (64.7, 178.0), P < 0.05; BUN (mmol/L): 8.4 (6.2, 17.8) vs. 11.5 (6.7, 18.4), P > 0.05], and the length of ICU stay was significantly shorter than that in the only vancomycin group [days: 29.0 (14.0, 54.2) vs. 37.0 (25.0, 55.0), P < 0.05]. Conclusions:The incidence of drug-induced renal injury caused by vancomycin is high. The GSH can significantly reduce their renal toxicity and shorten the length of hospital stay.

OBJECTIVE:To evaluate the risk factors for antibiotic-associated diarrhea (AAD) in Chinese adult patients systematically,and to provide evidence-based reference in clinic. METHODS:Retrieved from CNKI,VIP,CBM,Wanfang database,PubMed and Embase,etc.,disease control studies about AAD risk factors of Chinese adult patients were collected.The retrieval time limit ranged from Jan. 2000 to Jan. 2018. Meta-analysis was performed by using Rev Man 5.2 software after data extraction and quality evaluation of included literatures with NOS scale. RESULTS:A total of 14 literatures were included, involving 20 914 patients. The result of Meta-analysis showed that age ≥65 years [OR＝2.36,95%CI(1.99,2.79),P＜0.001], fasting [OR＝4.65,95%CI(3.79,5.69),P＜0.001],use of acid suppressant [OR＝5.82,95%CI(3.77,8.98),P＜0.001],serum albumin ≤30 g/L [OR＝2.40,95%CI(2.00,2.88),P＜0.001],invasive operation [OR＝3.95,95%CI(3.03,5.15),P＜0.001], stay in ICU [OR＝2.93,95%CI(2.38,3.60),P＜0.001],hospitalization time ≥10 d [OR＝4.08,95%CI(3.31,5.03),P＜0.001], antibiotic species ≥3 kinds [OR＝1.98,95%CI(1.56,2.51),P＜0.001] and duration of antibiotics use ≥10 d [OR＝6.16,95%CI (3.22,11.76),P＜0.001] were significantly correlated with the occurrence of AAD. CONCLUSIONS:Age ≥65 years,fasting, use of acid suppressant,serum albumin ≤30 g/L,invasive operation,stay in ICU,time of hospitalization ≥10 d,antibiotic species≥3 kinds and duration of antibiotics use≥10 d are risk factors for AAD in Chinese adult patients.