OBJECTIVE:To observe the clinical efficacy and safety of vitamin C with large dose combined with diphosphate in the treatment of myocardial injury after neonatal asphyxia and the effects on creatine kinase isoenzyme (CK-MB) level. METH-ODS:Totally 76 children with myocardial injury after neonatal asphyxia were randomly divided into control group and observation group. Control group was given routine treatment,including oxygen inhalation,sedation,cardiotonic,Danshen injection and ener-gy mixture,etc. Based on the treatment of control group,the observation group was added diphosphate 100-150 mg/(kg·d),iv infu-sion,qd;and vitamin C 250 mg/(kg·d)adding into 10%glucose injection 20 ml,iv infusion,qd. 10 d was a course. The clinical ef-ficacy,cardiac troponin T(cTnI),CK-MB level and incidence of adverse reactions before and after treatment were observed. RE-SULTS:The total effective rate in observation group was significantly higher than control group,with significant difference(P<0.05). After treatment,the cTnI and CK-MB level in 2 groups were significantly lower than before,and observation group was low-er than control group,with significant differences (P<0.05). There were no adverse reactions in 2 groups during the treatment. CONCLUSIONS:Based on the routine treatment,Vitamin C with large dose combined with diphosphate has good efficacy in the treatment of myocardial injury after neonatal asphyxia and can effectively reduce the CK-MB level,with good safety.

Objective:To investigate the anti-inflammatory and analgesic effects of Rupixiao granules. Methods:Activity of Rupixi-ao granules against xylene-induced ear edema in mice was measured to evaluate the anti-inflammatory effect, while the analgesic effect was evaluated by acetic acid induced writhing test and hot plate test in mice. Results:Compared with the control group, Rupixiao gran-ules groups (1. 0, 2. 0 and 4. 0 g·kg·d-1) could significantly inhibit ear swelling in mice(P<0. 05 or 0. 001), and reduce the acetic acid induced writhing times(P<0. 01 or 0. 001). Rupixiao granules at medium and high dose could significantly increase the pain thresh-old of mice in the hot plate test. Conclusion:Rupixiao granules exhibit significant anti-inflammatory and analgesic activities.

Objective:To compare the differences of children’ s health in different area, and to confirm if the prevalence of respiratory diseases and symptoms among children are closely associated with the air pollution. Methods:A cross-sectional study was conducted in an urban area A and a suburban area B with different levels of air pollution in Beijing. Using a cluster sampling method, we recruited 4 564 chil-dren from 3 primary schools in urban A and 4 primary schools in suburban B. Respiratory symptoms were investigated using an international standardized questionnaire including characteristics of children, living conditions, respiratory diseases and symptoms and situation of parents. The concentrations of air pollu-tants for recent five years were obtained from Reports on the Quality of the Beijing Environment. SPSS 16. 0 was used to analyze data. Results: The prevalence of cough, persistent cough, phlegm, persistent phlegm, wheeze and asthma in A area were higher than those in B area[(62. 2% vs. 59. 9%), (6. 3%vs. 3. 1%), (42. 4% vs. 37. 4%),(3. 6% vs. 2. 4%),(13. 3% vs. 9. 9%) and(9. 5% vs. 5. 4%)]. Except for cough, cough with cold, cough without cold, the prevalence of respiratory diseases and symp-toms in A area were significantly higher than those in B area ( P <0 . 05 ) . Logistic regression analysis showed the prevalence of persistent cough, phlegm without cold, asthma in A area were significantly higher than those in B area ( P<0 . 05 ) . Conclusion:Respiratory diseases and symptoms among school-age children were closely associated with the level of air pollution.

Objective To evaluate the value of perineal pelvic ultrasonography in assessing the pelvic floor function of the elderly patients after total hysterectomy.Methods The clinical data of 56 cases of cervical cancer treated by hysterectomy in Zhejiang Taizhou Hospital from June 2014 to June 2017 were retrospectively analyzed.The results of perineal pelvic ultrasonography and various kinds of ultrasound examinations before and after surgery were analyzed.Results Among the 56 patients,31 cases(55.4％) were diagnosed as pelvic floor dysfunction after hysterectomy.Post-operation group versus pre-operation group showed that posterior urethrovesical angle in resting state was[(123.5 ± 9.3) ° vs.(90.4 ± 8.6)°,P ＜ 0.05],posterior urethrovesical angle in the Valsalva movement was [(135.7±13.5)° vs.(109.1±10.5)°,P＜0.05],urethral rotation angle was[(60.8±17.0)° vs.(27.0 ± 12.1) °,P ＜ 0.05],bladder neck descent was [(18.9 ± 8.4) mm vs.(12.5 ± 8.2) mm,P ＜ 0.05],bladder neck-symphyseal distance was[(2.7±0.5)cm vs.(2.2±0.2)cm,P＜0.05],with statistically significant differences in above parameters.Moreover,the statistically significant differences between post-operation group versus pre-operation group were found in detrusor wall thickness[(4.4±0.8)mm vs.(3.8±0.6)mm,P＜0.05],in the degree of bladder neck movement[(0.6±0.1)cm vs.(0.4±0.2) cm,P＜0.05],in the residual urinary volume[(13.1 ± 3.0) ml vs.(4.4 ± 1.3) ml,P＜0.05] and in bladder rotation angle[(12.0 ± 2.7)°vs.(4.3 ± 1.5)°,P＜0.05].Conclusions The incidence of pelvic floor dysfunction is higher after hysterectomy in patients with cervical cancer,and pelvic floor function can be accurately evaluated by perineal pelvic ultrasonography,which is worthy of clinical reference.

Objective:To explore the correlation between the semiquantitative score of bone ultrasound and the WOMAC OA index in knee osteoarthritis.Methods:From March 2017 to December 2018, 118 patients with knee osteoarthritis diagnosed and treated in Taizhou Hospital of Traditional Chinese Medicine were selected in the research.The patients' bone erosion, joint effusion, synovium hyperplasia and meniscus were evaluated by ultrasound semiquantitative scoring system.Osteoarthritis index of the patients was investigated at the same time.The correlation between the semiquantitative score of myoskeletal ultrasound and WOMAC OA index in knee osteoarthritis was analyzed.Results:In 118 patients with knee osteoarthritis, the semiquantitative scores of myoskeletal ultrasound of bone erosion was (2.33±0.37)points, joint effusion was (2.05±0.26)points, synovial hyperplasia was (2.24±0.15)points, abnormal meniscus position was (1.67±0.28)points, meniscus shape and signal was (1.15±0.14)points.The WOMAC OA index scores of patients' pain was (29.52±6.68)points, stiffness was (11.43±3.78)points, dysfunction was (93.85±18.73)points, and total score was (134.80±29.19)points.The scores of bone erosion, joint effusion, synovium hyperplasia and meniscus in semiquantitative score of muscle and bone ultrasound were positively correlated with the total score of WOMAC OA index( r=0.435, 0.317, 0.429, 0.294, 0.282, all P<0.05). Conclusion:Semiquantitative score of muscle and bone ultrasound can better reflect the degree of knee joint injury, which is positively correlated with WOMAC OA index.We can use the semiquantitative score of muscle and bone ultrasound and WOMAC OA index to predict the condition of patients with knee osteoarthritis.

With the development of molecular biology research, targeted therapy has become the fourth effective method for the treatment of malignant tumors after surgery, radiotherapy, and chemotherapy. Unlike the traditional chemotherapeutic drugs, molecular targeted drugs possess the advantages of high specificity, definite curative effects, and less adverse effects. CLDN18.2 protein is a transmembrane protein that is highly selective and stably overexpressed during the development of various malignant tumors, especially gastrointestinal tumors, and metastases. A specific antibody against this protein, claudiximab (zolbetuximab/IMAB362), has achieved great success in recent clinical trials. Thus, CLDN18.2 protein is expected to be a safe and effective molecular target for targeted therapy in some malignancies.

OBJECTIVETo study the in vitro antibacterial activity of meropenem combined with doxycycline, ciprofloxacin, sulbactam or cefoperazone/sulbactam against clinically isolated extensively drug-resistant Acinetobacter baumannii (XDRAB).

METHODSUsing a checker board synergy design, the minimal inhibitory concentration (MIC) of antibiotics against 50 isolates of XDRAB was determined by broth microdilution antifungal susceptibility test. The fractional inhibitory concentration (FIC) index was calculated to determine the combined effect of the antibiotics.

RESULTSMeropenem showed significantly reduced MIC50 and enhanced antimicrobial activities when combined with doxycycline, sulbactam or cefoperazone/sulbactam. The FIC results suggested that the main actions of doxycycline, sulbactam, and cefoperazone/sulbactam were synergistic (38%, 26%, and 10%, respectively) and addictive (62%, 74%, and 90%, respectively) without indifferent or antagonistic effects. The main actions of meropenem combined with ciprofloxacin were additive (56%) and indifference (44%) with synergistic and antagonistic effects.

CONCLUSIONMeropenem combined with doxycycline, sulbactam or cefoperazone/sulbactam shows excellent activity against clinical isolates of XDRAB.

Vitiligo is an acquired depigmented disease, and neurological factors may play an important role in its pathogenesis. Neurogenic inflammatory factors released by sensory nerves that control the skin can directly or indirectly regulate functions of keratinocytes, melanocytes, Langerhans cells, dermal dendritic cells, mast cells, dermal microvascular endothelial cells and immune cells. This review summarizes roles of several relevant neurogenic inflammatory factors in the occurrence and development of vitiligo, including neuropeptide Y, calcitonin gene-related peptide, catecholamines and nerve growth factor, with a view to providing new ideas for clinical treatment of vitiligo.

Objective:To investigate the clinical features and associated influencing factors of cognitive impairment in middle-aged and elderly Chinese adult patients undergoing maintenance hemodialysis (HD).Methods:A cross-sectional study was conducted among HD patients from 11 centers in Beijing city from April 2017 to June 2017. A neuropsychological battery covering domains of attention/processing speed, executive function, memory, language, and visuospatial function was applied in cognitive function assessment. Patients were classified as normal cognitive function group and cognitive impairment group according to the fifth version of the diagnostic and statistical manual of mental disorders criteria (DSM-V). Multivariate binary logistic regression was used to analyze the independent influencing factors of cognitive impairment. Results:A total of 613 HD patients were included in the study, and the prevalence of cognitive impairment was 80.91% (496/613). Attention impairment (81.05%) and memory impairment (63.51%) were the most common impaired domains, and 79.23% was concomitant impairment across two or more cognitive domains among those with cognitive impairment. Compared with the patients in the normal cognitive function group, the patients in the cognitive impairment group had senior age, longer dialysis vintage, higher proportion of diabetes, hypertension, and stroke, higher level of serum intact parathyroid hormone (iPTH), lower education level, and lower urea clearance index (Kt/V) (all P<0.05). Factors were independently associated with cognitive impairment including increasing age ( OR=1.110, 95% CI 1.072-1.150, P<0.001), education time>12 years (with education time<6 years as reference, OR=0.323, 95% CI 0.115-0.909, P=0.032), history of diabetes ( OR=2.151, 95% CI 1.272-3.636, P=0.004), history of stroke ( OR=2.546, 95% CI 1.244-5.210, P=0.011), increased dialysis vintage ( OR=1.016, 95% CI 1.010-1.022, P<0.001), reduced Kt/V( OR=0.008, 95% CI 0.002-0.035, P<0.001), and increased iPTH level ( OR=1.002, 95% CI 1.002-1.003, P=0.012). Conclusions:The prevalence of cognitive impairment in middle-aged and elderly adult Chinese patients undergoing HD is high. Memory and attention are the most commonly impaired domains. Increasing age, low education level, history of diabetes and stroke, increased dialysis vintage, reduced Kt/V and increased serum iPTH are the independent influencing factors associated with cognitive impairment.

Objective:To investigate the association between cognitive impairment and all-cause mortality in middle and elderly adult patients undergoing maintenance hemodialysis (HD).Methods:A prospective cohort study was conducted. Patients from 11 HD centers in Beijing between April and June 2017 were enrolled. Baseline data were collected, and a series of neuropsychological batteries covered 5 domains of cognitive function were applied for the assessment of cognitive function. The patients were then classified as normal and cognitive impairment groups according to the fifth version of the Diagnostic and Statistical Manual of Mental Disorders criteria (DSM-V) and followed-up until June 2018. The clinical characteristics of the two groups of patients were compared. Kaplan-Meier survival analysis was used to compare the difference in the cumulative survival rate between the two groups. Multivariate Cox regression model was used to analyze the independent influencing factors of all-cause mortality, to determine the relationship between cognitive impairment and different cognitive domain impairments and all-cause death.Results:A total of 613 patients were enrolled, of which 496(80.91%) patients had cognitive impairment. Compared with the normal cognitive function group, the patients in the cognitive impairment group tended to be older, longer dialysis vintage, a higher proportion of diabetes, hypertension, and stroke, increased serum iPTH level, and lower education level and urea clearance index (Kt/V) (all P<0.05). After (49.53±8.42) weeks of follow-up, Kaplan-Meier survival analysis showed that the cumulative survival rate of cognitive impairment group was significantly lower than that of cognitive normal group (Log-rank χ2=8.610, P=0.003). Multivariate Cox regression analysis showed that history of diabetes ( HR=2.742, 95% CI 1.598-4.723, P<0.001), coronary heart disease ( HR=1.906, 95% CI 1.169-3.108, P=0.010), dialysis vintage (every increase of 1 month, HR=1.007, 95% CI 1.003-1.011, P=0.001), serum level of albumin (every increase of 1 g/L, HR=0.859, 95% CI 0.809-0.912, P<0.001), cognitive impairment ( HR=2.719, 95% CI 1.088-6.194, P=0.032) were independently associated with all-cause mortality. Multivariate Cox regression analysis on different cognitive domains also indicated that memory impairment ( HR=2.571, 95% CI 1.442-4.584, P<0.001), executive function impairment ( HR=3.311, 95% CI 1.843-5.949, P=0.001) and three, four, five domains combined impairment ( HR=5.746, 95% CI 1.880-17.565, P=0.002; HR=12.420, 95% CI 3.690-41.802, P<0.001; HR=13.478, 95% CI 3.381-53.728, P<0.001) were independently related to all-cause mortality. Conclusions:Cognitive impairment is an independent risk factor of all-cause mortality in middle and elderly adult patients undergoing maintenance hemodialysis, and the risk is significantly increased in patients with the impairment of the domains of memory, executive function, or in the combination of three to five cognitive domains.