ObjectiveThe clinical features, bacteria distribution and antibiotic resistance proifle of blood stream infection(BSI) were investigated in the patients with decompensated liver cirrhosis for better management of such infections.MethodsThe clinical data of BSI were collected in the patients with decompensated liver cirrhosis between January, 2012 and December, 2014, and reviewed retrospectively in terms of risk factors, diagnosis and treatment, pathogen distribution and prognosis.ResultsOf the 1 071 patients with decompensated liver cirrhosis and suspected bacterial infection, 154 (14.4%) were diagnosed as BSI evidenced by blood culture. Of these patients, the leukocyte count in the peripheral blood was higher than 10×109/L in only 48 (31.2%) patients; neutrophil proportion>0.75 in 133 patients (86.4%); serum procalcitonin level>0.5 ng/mL in 74 patients (68.5%). A total of 155 bacterial strains were isolated, including 115 strains of gram-negative bacilli and 40 strains of gram-positive cocci. Most patients (68.8%) recovered and 31.2% died or discharged from hospital voluntarily. All these BSI patients had Child-Pugh grade C liver function. Some patients also had other serious systemic diseases or repeated hospitalization.ConclusionThe prevalence of BSI is high in the decompensated liver cirrhosis patients with poor prognosis. Gram-negative bacilli are the major pathogens of such septicemia. Early diagnosis and proper use of antibiotics based on antimicrobial susceptibility testing are important to improve patient outcome.

Heme oxygenase-1 (HO-1) is a cellular stress protein, and its expression plays an important regulatory role in a lot of physiological and pathological processes. Although the expression of HO-1 in most tissues of body is low, a number of clinical and pharmacological experiments have proved that many compounds can induce HO-1 expression. The increase of HO-1 expression is the result of regulating different signaling pathways and transcription factors, and this induction of HO-1 is suggested to be partially therapeutic efficacy of these compounds. This article summarizes some kinds of compounds in this field of research at home and abroad over the last 10 years, and provides a brief analysis of the mechanism.
Animals ; Antineoplastic Agents ; pharmacology ; Antioxidants ; pharmacology ; Coumarins ; pharmacology ; Drugs, Chinese Herbal ; pharmacology ; Enzyme Induction ; drug effects ; Gene Expression Regulation, Enzymologic ; Heme Oxygenase-1 ; genetics ; metabolism ; Humans ; Lovastatin ; pharmacology ; Nitric Oxide ; pharmacology ; Peptide Hormones ; pharmacology ; Probucol ; pharmacology ; Signal Transduction ; Transcription Factors ; metabolism

Objective To study the function of core protein (CORE) of genotype 1b hepatitis C virus (HCV) of different strains (T: derived from tumor tissues; NT: derived from non-tumor tissues; C191: HCV-J6) and different domains (1-172, 1-126, 1-58, 59-126, 127-172 AA) of T CORE in the pathogenesis of HCV infection and to find the therapy target. Methods Different truncated genotype 1b HCV CORE eukaryotic expression plasmids (T, NT, C191) and different domains of T CORE were constructed and transfected to HepG2 cells. Cell apoptosis and necrosis were quantified by flow cytometry. Cell growth curves were observed with real time cell growth instrument. Results COREs from different strains of genotype 1b and different domains of CORE induced cell apoptosis and necrosis, and inhibited HepG2 cell growth at different levels. CORE derived from T induced apoptosis and necrosis and inhibited cell growth higher than that derived NT and C191. N terminal 1-58 AA of CORE derived from T induced cell apoptosis and necrosis and inhibited cell growth higher than any other domains. Conclusion COREs from different strains of genotype 1b HCV and different domains of CORE from the same HCV strain play different roles in their molecular pathogenesis of HCV. Among different domains of CORE, N terminal 1-58 AA might play an important role in its pathogenesis and be one target of gene therapy.

Objective This study was to investigate the role of lactoferrin and C-reactive protein (CRP)assay in ascitic fluid for diagnosis of spontaneous bacterial peritonitis (SBP)in the patients with decompensated liver cirrhosis.Methods Ascites was collected from the inpatients with decompensated liver cirrhosis before and after treatment from May to December 2011 for anal-ysis of polymorphonuclear cells (PMN)and bacterial culture.The level of lactoferrin and C-reactive protein in the ascites were determined.Results A total of 117 ascites samples were collected from 66 patients.Twenty-six patients met the criteria of SBP with PMN ≥ 250×106/L in ascites,were assigned to SBP group.Of these patients,11 presented with fever 37.3℃ to 38℃, and 11 patients had elevated peripheral blood white cell count > 10 × 109/L.Eleven patients had neutrophil cell percentage >0.75.Only 8 patients in this group had positive bacterial culture.Another 12 patients met the criteria of suspected SBP,and assigned to suspected SBP group.The remaining 28 patients did not satisfy the criteria of SBP,and assigned to non-SBP group.The pretreatment lactoferrin level was (768.46 ± 611 .70)ng/mL and (98.28 ± 56.81 )ng/mL in SBP and non-SBP group,respectively.The pretreatment CRP level was (9.397 ±3.737 )mg/L and (1 .786 ±0.52 )mg/L in SBP and non-SBP group,respectively.The lactoferrin and CRP levels decreased sharply after antibacterial and support-ive treatment in SBP group,which were 657.05 ng/mL and 8.13 mg/L,respectively.The cut-off value of lactoferrin for diagnosis of SBP was 233 ng/mL with sensitivity 96.2% and spe-cificity 97.5%.The cut-off value of CRP for diagnosis of SBP was 4.390 mg/L with sensitivity 92.3% and specificity 92.5%. However,lactoferrin combined with CRP had a sensitivity of 99.70% and specificity of 90.18% for diagnosis of SBP.Conclu-sions Lactoferrin and CRP levels in the ascites of patients with liver cirrhosis are useful for diagnosis of SBP with high specifici-ty and sensitivity.

Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Histiocytic Necrotizing Lymphadenitis ; diagnosis ; drug therapy ; pathology ; Humans ; Lymph Nodes ; pathology ; Male ; Retrospective Studies ; Treatment Outcome

BACKGROUND:Studies have demonstrated that tetrandrine has protection on acute spinal cord injury,but the specific mechanism remains poorly understood.OBJECTIVE:To study the protection of tetrandrine on rat acute spinal cord injury and to study its mechanism from apoptosis pathway.METHODS:A total of 100 rats were randomly divided into 4 groups.All rats were prepared for spinal cord injury models using modified Allen method except that in the sham-surgery group.Methylprednisolone and tetrandrine was injected into rats in the methylprednisolone and tetrandrine groups by tail intravenous injection prior to and at 24,48 hours after model preparation.The same volume of physiological saline was injected in the sham-surgery and model groups.Basso-BeatUe-Bresnahan(BBB score)was recorded at 8 hours,1,3,7 and 14 days after model preparation.The morphological changes of spinal cord injury sites were observed by hematoxylin-eosin staining and the expressions of bcl-2 and bax were determined by immunohistochemistry.RESULTS AND CONCLUSION:The BBB score of methylpradnisolone and tetrandrine groups were significantly higher than that model group at 7 and 14 days(P<0.05),but there were no significant difference between the methylprednisolone group and tetrandrine group(P>0.05).Hematoxylin-eosin staining showed that the spinal cord injured severely at 3-7 days,the injury degree in the methylpradnisolone group and tetrandrine group was slighter than that of the model group,with smaller bax expression and greater bcl-2 expression(P<0.01).The findings demonstrated that,tetrandrine is able to protect neurons from apoptosis and promote the nerve function recovery by inhibiting the expression of Bax and promoting the expression of Bcl-2.Its effect is not inferior to methylprednisolone.

Objective To investigate the clinical effect of traditional Chinese medicine(TCM)for treating HBeAg positive chron-ic hepatitis B virus(HBV)carriers with liver stagnation and spleen deficiency syndrome.Methods The patients with HBeAg and HBV DNA positive,normal serum ALT and AST for successive 3 times within 1-year follow up,complicating different degrees of symptoms were included.Among them,the patients with liver stagnation and spleen deficiency syndrome according to the TCM dif-ferentiation were selected as the treatment obj ects and treated by the prescription of soothing the liver,tonifying spleen and detoxifi-cation.The changes of clinical symptoms and HBV markers after 6-month therapy were observed and followed up for 3 months for evaluating the effect persistance.348 cases were recruited,161 cases in the control group and the other 187 cases in the treatment group.Treatment group underwent traditional Chinese medicine treatment.Results 168 cases finished the therapy with the total effective rate of 80.3%(135/168),6 cases were HBeAg negative conversion and 14 cases were HBV DNA decrease greater than or equal to 2 logarithmic grades;157 patients finished 3-month follow-up and the effective rate was 80.9%(127/157),4 cases were HBeAg negative conversion and 1 1 cases were HBV DNA decrease greater than or equal to 2 logarithmic grades.The curative effect of treatment group was higher than that of control group.Conclusion The TCM prescription of soothing the liver,tonifying spleen and detoxification has definite effect for treating HBeAg positive chronic HBV carriers with liver stagnation and spleen deficiency syndrome,the symptoms can be significantly improved.

Animals ; Calcium Channel Blockers ; therapeutic use ; Dogs ; Hypothermia ; complications ; Male ; Nimodipine ; therapeutic use ; Ventricular Fibrillation ; etiology ; prevention & control

This article elaborates key points of the PACS and RIS project: its overall planning, implementation step by step, integration of PACS and HIS based on IHE, and the prudent selection of partners and so on.
Hospital Information Systems ; Humans ; Information Storage and Retrieval ; methods ; Radiology Information Systems ; Software ; Systems Integration

OBJECTIVETo compare the efficacy of different points combination in the treatment of menopausal insomnia.

METHODSNinety-six cases of menopausal insomnia were randomized into 3 groups, Xinshu (BL 15), Shenshu (BL 23), Sishencong (EX-HN 1), Shenmen (HT 7), Sanyinjiao (SP 6) were chosen in the restore interaction between the heart and the kidney group (group A, 32 cases); Zhaohai (KI 6), Jiaoxin (KI 8), Shenmai (BL 62), Pucan (BL 61) were chosen in the acupuncturing qiao mai group (group B, 32 cases); auricular Shenmen (TF4) and sensitive spot at the distribution area of auricular vagus nervus were chosen in the ear acupuncture group (group C, 32 cases). Six days made one session and the treatments were finished after 4 courses. The polysomnography (PSG) and Pittsburgh sleep quality index (PSQI) were employed before and after treatment to evaluate the alleviation of insomnia.

RESULTSThe parameters of the sleep latency (SL), rapid wave sleep latency (RL) and sleep efficiency (SE) were significantly improved in the three groups, and the differences were statistically significant (P < 0.05, P < 0.01). The SL and awaking time (AT) in group C [SL (401.08 +/- 16.54) min and AT (4.87 +/- 2.64) times] were significantly superior to those in the other two groups [SL (50.36 +/- 18.47) min, (54.87 +/- 20.92) min, AT (5.98 +/- 2.11) times, (6.13 +/- 3.04) times, all P < 0.05]. The S(3+4) (%) in group C was also significantly higher than those in the other two groups (both P < 0.05). It was indicated by PSQI that the sleep quality of group C (0.78 +/- 0.12) was significantly superior to that in group B (1.32 +/- 0.29), the total score and cured and markedly effective rate in group C [(4.34 +/- 1.43), 68.8% (22/32)] were superior to those in group A [(7.48 +/- 3.09), 53.1% (17/32), both P < 0.05].

CONCLUSIONEar acupuncture has a better curative effect than the restore interaction between the heart and the kidney group and acupuncturing qiao mai group, it is worth of being promoted.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Humans ; Menopause ; psychology ; Middle Aged ; Sleep ; Sleep Initiation and Maintenance Disorders ; therapy ; Treatment Outcome