Hemoglobinuria, Paroxysmal ; therapy ; Humans

Objective To share our experience in the placement of a peripherally inserted central cathe -ter ( PICC) in critically ill patients intensive care unit ( ICU) .Method The clinical data of a critically ill pa-tient placed with PICC from neurosurgery department were collected and analyzed .Result A 78-year-old male patient diagnosed with type I respiratory failure , aspiration pneumonia , hypertension , and cerebral infarction sequelae successfully received ultrasound-guided modified Seldinger puncture technique for PICC and was trea-ted with intravenous nutrition after repeatedly vascular puncturing failure .Conclusion PICC placement is an effective method for patients in ICU to protect the peripheral vein and lower the incidence of catheter related in -fections.

Objective To investigate the levels of serum chemerin in the acute myocardial infarction (AMI) patients and explore the clinical significance.Methods A total of 76 AMI patients from January 2013 to December 2013 were inrolled and 30 healthy patients were included as normal control(NC) group.Chemerin, tumor necrosis factor α(TNF-α), adiponectin were asessed by enzyme linked immunosorbent assay(ELlSA).The clinical data of high sensitivity C reactive protein (hs-CRP), body mass index (BMI), blood lipids, underlying diseases et al were collected.Results Serum levels of chemerin in AMI patients was higher than the NC group significantly((12.97±4.17) μg/L vs.(30.96± 17.16) μg/L, t =5.642, P＜0.001).The Serum levels of Chemerin in single vessel disease group, two vessel disease group and triple vessel disease group were (22.25 ± ±6.93) μg/L, (28.57 ± 15.92) μg/L, (37.95 ± 16.52) μg/L respectively and was linearly increasing relationship with increasing AMI severity (P＜0.001, F =22.84, r2 =0.397).Serum levels of Chemerin positively correlated with TNF-α, hs-CRP level(r2=0.347,0.455 ,P＜0.001) and negative correlated with adiponectin(r2 =0.396,P＜0.001).Logistic regression analysis showed that chemerin was an independent risk factor for AMI (OR =4.822,95％ CI 4.422-7.141, P =0.032).Conclusion The results showed that serum chemerin levels were significantly elevated in AMI patients,and chemerin may be involved in the development process of AMI.

OBJECTIVE:To prepare Xuangui zhitong dispersible tablets and optimize its formulation technology. METHODS:Using disintegration time as index,single factor test was conducted for filler,disintegrating agent,the types and amount of adhe-sives and compression pressure. The amount of mixed disintegrating agent,avicel and gum arabic were optimized by orthogonal test. The tablet quality by optimized formulation was detected,and disintegration time,the content and dissolution rate of tetrahy-dropalmatine were determined;the similarity of in vitro dissolution rate of dispersible tablets and dropping pills were evaluated by similarity factor test. RESULTS:The optimized formulation was composed of 25% MCC as fillers,9% PVPP and 9% L-HPC as mixed disintegrants,85% ethanol solution as adhesives,micro-silica gel 2%,compression pressure of 3.0 kg/cm2. The average dis-integration time was 1.22 min,and the content of tetrahydropalmatine was 1.097 mg/g. The accumulative dissolution rate was more than 80% at 10 min and more than 90% at 15 min. The similarity factor f2 of dissolution curve was 62,using dropping pills as ref-erence preparation. CONCLUSIONS:Xuangui zhitong dispersible tablet had a rapid disintegration and the behavior of dissolution is similar to Xuangui zhitong dropping pills.

Objective To evaluate the value of contrast-enhanced ultrasound (CEUS) in diagnosing ischemic-type biliary lesion (ITBL) and analyze the relation between the enhancement patterns of bile duct wall of ITBL and its outcome.Methods 36 patients confirmed with ITBL (24 cases),anastomotic biliary stricture (3 cases),cholangitis (4 cases),biliarysludge (1 cases),and acute rejection (4 cases),who underwent CEUS examination,were enrolled in this study.The images were retrospectively analyzed in consensus by 2 readers.After reviewing the images,the readers were asked to make a diagnosis of ITBL.The diagnostic standard was hypo-or non-enhancement of hilar bile duct wall in arterial phase on CEUS.Results The diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 66.7％,83.3％,72.2％,88.9％,and 55.6％ for reader 1;62.5％,83.3％,69.4％,88.2％,and 52.6 ％ for reader 2,respectively.The interobserver agreement was good (κ =0.83).In 24 ITBL patients,the ratio of mortality or retransplantation with non enhancing hilar bile duct wall in arterial phase was much higher than that with enhancing hilar bile duct wall (non-enhancement 54.5％,hypo-enhancement 20％,hyper-or iso-enhancement 12.5％).Conclusions CEUS had diagnostic value of ITBL.Non-enhancing hilar bile duct wall in arterial phase on CEUS predicated the poor outcome.

OBJECTIVE: To investigate the clinical characteristics of the coal workers' pneumoconiosis( CWP) complicated with both tuberculosis and nosocomial infection of stenotrophomonas maltophilia. METHODS: The clinical data of 36 CWP patients complicated with tuberculosis and nosocomial infection of stenotrophomonas maltophilia were collected and retrospectively analyzed. RESULTS: The results of sputum cultured for more than 3 times showed positive stenotrophomonas maltophilia. The main clinical manifestations were cough,sputum,fever and wet rale of lung. Most of the chest X-rays showed light and patchy infiltrated shadows. Drug susceptibility testing indicated that this kind of bacteria was extensively drug-resistant. The drug resistance rates to imipenem,cefepime,aztreonam and cefoperazone were 100. 0%,96. 1%,94. 5% and 89. 8%,respectively. The sensitivity of patients to sulfanilamide methyl isopropyl pbo, ciprofloxacin,levofloxacin and gentamicin were > 60. 0%. After antituberculosis therapy combined with 2 or more sensitive antibiotics treatment based on the sputum cultured results,there were 21 cases( 58. 3%) cured,2 cases( 5. 6%) improved,3 cases( 8. 3%) ineffective and 10 cases( 27. 8%) dead. CONCLUSION: The clinical features of tuberculopneumoconiosis combined with the nosocomial infection of stenotrophomonas maltophilia are un-typical. This disease is severely antibiotic-resistant.Timely pathogenic bacteria culture and drug sensitivity test have important significance in diagnosis and treatment.

Objective To analyze the epidemiological characteristics and related traditional Chinese medicine (TCM) constitution and emotional characteristics.Methods The convenient sampling method was adopted,and sub-healthy subjects receiving outpatient physical examinations served as the respondents.The Individual Physical and Moral Health Investigation Scale was used to conduct the questionnaire investigation.The Epidata3.0 software was used to build the database and SPSS18.0 was used to do statistical analysis.Results The psychological sub-health was mainly concentrated in young people below 35 years old,which accounted for 74.10％;385 cases (63.00％) were female;562 cases (92.40％) were the college degree or above.And the number of people with general economic status was 475 (78.60％).In the TCM constitution classification of the mental sub-health population,384 cases (62.85 ％) of biased constitution were significantly higher than those of somatic sub-health (P＜0.05).The biased constitution was dominated by qi-deficiency,yangdeficiency and qi-stagnation.In the aspect of emotional characteristics,the psychological sub-healthy population mainly manifested by anxiety,depression,compulsion and fear,the difference between these four emotional problems and somatic sub-health was statistically significant (P＜0.05),but in the emotional problems of hostility,interpersonal sensitivity and paranoid,which had no statistically significant differences compared with somatic sub-healthy people (P＞0.05).Conclusion The psychological healthy intervention needs to play emphasis on the emotional problems occurred in young females with higher educational background and general economic status and pay attention to regulate qi-deficiency and yang-deficiency by TCM.

Abstract: Objective　To understand the distribution and drug resistance of bacteria in clinical blood culture specimens in Ningxia in recent years, and to provide a basis for the prevention and treatment of bloodstream infection diseases. 　　　Methods　The blood culture isolation bacteria and drug resistance of Ningxia bacterial resistance monitoring network hospitals from 2018 to 2020 were statistically analyzed by WHONET5.6 software. Results　In the past three years, a total of 6 757 strains of bacteria were isolated from blood samples, including 3 697 strains (54.7%) of gram-negative bacteria and 3 060 (45.3%) of gram-positive bacteria. Among the gram-negative bacteria, Escherichia coli (2 074 strains,30.7%), Klebsiella pneumoniae (696 strains), Pseudomonas aeruginosa (139 strains), and Acinetobacter baumannii (121 strains). Among the gram-positive bacteria, coagulase-negative Staphylococcus (1 691 strains,25.0%), Staphylococcus aureus (442 strains), Streptococcus spp. (431 strains), Enterococcus spp. (379 strains). Resistance to Escherichia coli and Klebsiella pneumoniae was 56.6% and 22.6% against third-generation cephalosporins, and resistance to carbapenems was 1.0% and 3.7%, respectively. Pseudomonas aeruginosa and Acinetobacter baumannii were resistant to carbapenems at 9.0%（12/139） and 80.7%（71/121）. Methicillin-resistant Staphylococcus aureus (MRSA) was detected at 26.8%, methicillin-resistant coagulase-negative Staphylococcus was detected at 70%, and no Staphylococcus bacteria resistant to vancomycin and linezolid were found. For three years, only 1 strain of vancomycin-resistant Enterococcus faecalis was detected, and no linezolid-resistant Staphylococcus and Enterococcus were detected. Conclusions　Ningxia clinical blood specimen isolates of Escherichia coli, coagulase-negative Staphylococcus, and Klebsiella pneumoniae are more common. Among them, the resistance rate of Escherichia coli and Klebsiella pneumoniae to the third generation of cephalosporins is relatively stable, and the resistance rate to carbapenems is low. Acinetobacter baumannii is highly resistant to carbapenems, and methicillin-resistant Staphylococcus aureus detection rates are on the rise and should be closely monitored.

OBJECTIVETo observe the dynamic expression changes of p38 mitogen-activated protein kinase (p38MAPK), nucler facter kappa B (NF-κB) and cyclooxygenase-2 (COX-2) in myocardial tissue after an exhausted exercise and study the impact of p38MAPK, NF-κB and COX-2 on its myocardial damage.

METHODSSixty Wister male rats were randomly divided into the control group (n = 10) and the exhausted exercise group (n = 50). Then the exhausted exercise group was further divided into 5 subgroups, namely 0 h, 3 h, 6 h, 12 h, 24 h after an exhausted exercise (n = 10). The myocardial injury animal model was set up by using an exhausted swimming exercise and the expression of p-p38MAPK, NF-κB and COX-2 were examined by Western blot.

RESULTSCompared with the control group, the expression of p-p38MAPK were increased significantly (P < 0.01) in all the groups and the 3 h group was the highest( P < 0.01); The expression of NF-κB were increased significantly (P < 0.05) in all the groups but 0 h P > 0.05) and the 6h group was increased significantly compared with the other groups( P < 0.05); The expression of COX-2 were increased significantly( P < 0.05) in all the groups but 0 h and the 24 h groups was increased significantly compared with the other groups(P < 0.05).

CONCLUSIONp38MAPK was activated in an acute exhausted exercise, p-p38MAPK may play an important role in modulating NF-κB and COX-2 expression and mediating the exhausted exercise induced myocardial damage.

Animals ; Blotting, Western ; Cyclooxygenase 2 ; metabolism ; Fatigue ; Male ; Myocardium ; pathology ; NF-kappa B ; metabolism ; Physical Conditioning, Animal ; Rats ; Rats, Wistar ; Swimming ; p38 Mitogen-Activated Protein Kinases ; metabolism

A sesquiterpene synthase (AsSS4) full-length open reading frame (ORF) cDNA was cloned from wounded stems of Aquilaria sinensis by RT-PCR method. The result showed that the ORF of AsSS4 was 1,698 bp encoding 565 amino acids. Prokaryotic expression vector pET28a-AsSS4 was constructed and transformed into E. coli BL21 (DE3) pLysS. Recombinant AsSS4 protein was obtained after induction by IPTG and SDS-PAGE analysis with a MW of 64 kD. Enzymatic reactions using farnesyl pyrophosphate showed that recombinant AsSS4 protein purified by Ni-agarose gel yielded five sesquiterpene compounds, cyclohexane, 1-ethenyl-1-methyl-2, 4-bis(1-methylethenyl)-, β-elemene, α-guaiene, α-caryophyllene and δ-guaiene. This paper reported the first cloning and functional characterization of AsSS4 gene from A. sinensis, which will establish a foundation for future studies on the molecular mechanisms of wound-induce agarwood formation in A. sinensis
Alkyl and Aryl Transferases ; biosynthesis ; genetics ; Azulenes ; Cloning, Molecular ; DNA, Complementary ; Escherichia coli ; Open Reading Frames ; Polyisoprenyl Phosphates ; Recombinant Proteins ; biosynthesis ; Sesquiterpenes ; metabolism ; Sesquiterpenes, Guaiane ; Thymelaeaceae ; enzymology ; genetics