Objective:To investigate the effects of metronidazole and vulvar cleaning with 0.1% benzalkonium bromide solution on vaginal environment, etiology, and interleukin-6 and Toll-like receptor 2 levels in lavage fluid of patients with bacterial vaginosis.Methods:A total of 114 patients with bacterial vaginosis who were admitted to Jinan 2 nd People's Hospital from February 2021 to February 2024 were included in this prospective study. These patients were randomly divided into a control group and an observation group, with 57 patients in each group, following a 1:1 ratio. The control group received treatment with metronidazole, while the observation group received metronidazole in combination with vulvar cleaning using a 0.1% benzalkonium bromide solution, for a total of 14 days. The clinical efficacy was evaluated by comparing the vaginal environment (including vaginal pH, cleanliness, and microbial density), microbiological outcomes (lactobacilli detection rate and pathogenic bacteria detection rate), and interleukin-6 and Toll-like receptor 2 levels in the vaginal lavage fluid between the two groups before and after treatment. Adverse drug reactions were recorded. Patients were followed up for 3 months after treatment to record recurrence rates. Results:The total response rate in the observation group was significantly higher than that in the control group [92.98% (53/57) vs. 78.95% (45/57), χ2 = 4.65 P < 0.05]. After treatment, improvements of vaginal pH, vaginal cleanliness, and bacterial density were greater in the observation group than those in the control group ( χ2 = 4.61, Z = 4.92, 4.29, all P < 0.05). After treatment, the detection rate of lactobacilli in the observation group was significantly higher than that in the control group [63.16% (36/57) vs. 42.11% (24/57), χ2 = 5.07, P < 0.05]. The detection rate of pathogenic bacteria in the observation group was significantly lower than that in the control group [5.26% (3/57) vs. 17.54% (10/57), χ2 = 4.25, P < 0.05]. After treatment, lavage fluid levels of interleukin-6 [(8.70 ± 2.13) ng/L vs. (13.52 ± 3.36) ng/L] and Toll-like receptor 2 [(5.06 ± 1.34) ng/L vs. (7.84 ± 1.22) ng/L] in the observation group were significantly lower than those in the control group ( t = 9.15, 11.58, both P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( χ2 = 1.37, P > 0.05). After 3 months of treatment, the recurrence rate of bacterial vaginosis in the observation group was significantly lower than that in the control group [4.55% (1/22) vs. 27.78% (5/18), χ2 = 4.19, P < 0.05]. Conclusions:The combination of metronidazole and vulvar cleaning with a 0.1% benzalkonium chloride solution is effective for treating bacterial vaginosis. This approach helps regulate the vaginal environment, increases the levels of lactobacilli, reduces the levels of pathogenic bacteria, and decreases the levels of interleukin-6 and Toll-like receptor 2 in the lavage fluid. Additionally, it decreases the risk of recurrence of bacterial vaginosis and is highly safe.

Objective:To investigate the effects of metronidazole and vulvar cleaning with 0.1% benzalkonium bromide solution on vaginal environment, etiology, and interleukin-6 and Toll-like receptor 2 levels in lavage fluid of patients with bacterial vaginosis.Methods:A total of 114 patients with bacterial vaginosis who were admitted to Jinan 2 nd People's Hospital from February 2021 to February 2024 were included in this prospective study. These patients were randomly divided into a control group and an observation group, with 57 patients in each group, following a 1:1 ratio. The control group received treatment with metronidazole, while the observation group received metronidazole in combination with vulvar cleaning using a 0.1% benzalkonium bromide solution, for a total of 14 days. The clinical efficacy was evaluated by comparing the vaginal environment (including vaginal pH, cleanliness, and microbial density), microbiological outcomes (lactobacilli detection rate and pathogenic bacteria detection rate), and interleukin-6 and Toll-like receptor 2 levels in the vaginal lavage fluid between the two groups before and after treatment. Adverse drug reactions were recorded. Patients were followed up for 3 months after treatment to record recurrence rates. Results:The total response rate in the observation group was significantly higher than that in the control group [92.98% (53/57) vs. 78.95% (45/57), χ2 = 4.65 P < 0.05]. After treatment, improvements of vaginal pH, vaginal cleanliness, and bacterial density were greater in the observation group than those in the control group ( χ2 = 4.61, Z = 4.92, 4.29, all P < 0.05). After treatment, the detection rate of lactobacilli in the observation group was significantly higher than that in the control group [63.16% (36/57) vs. 42.11% (24/57), χ2 = 5.07, P < 0.05]. The detection rate of pathogenic bacteria in the observation group was significantly lower than that in the control group [5.26% (3/57) vs. 17.54% (10/57), χ2 = 4.25, P < 0.05]. After treatment, lavage fluid levels of interleukin-6 [(8.70 ± 2.13) ng/L vs. (13.52 ± 3.36) ng/L] and Toll-like receptor 2 [(5.06 ± 1.34) ng/L vs. (7.84 ± 1.22) ng/L] in the observation group were significantly lower than those in the control group ( t = 9.15, 11.58, both P < 0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( χ2 = 1.37, P > 0.05). After 3 months of treatment, the recurrence rate of bacterial vaginosis in the observation group was significantly lower than that in the control group [4.55% (1/22) vs. 27.78% (5/18), χ2 = 4.19, P < 0.05]. Conclusions:The combination of metronidazole and vulvar cleaning with a 0.1% benzalkonium chloride solution is effective for treating bacterial vaginosis. This approach helps regulate the vaginal environment, increases the levels of lactobacilli, reduces the levels of pathogenic bacteria, and decreases the levels of interleukin-6 and Toll-like receptor 2 in the lavage fluid. Additionally, it decreases the risk of recurrence of bacterial vaginosis and is highly safe.

Objective:To evaluate the efficacy of transgastric combined with percutaneous endoscopic treatment for infected pancreatic necrosis (IPN).Methods:Clinical data of 19 IPN patients who received transgastric combined with percutaneous endoscopy at the Gastroenterology Intensive Care Unit of Nanjing Drum Tower Hospital from August 2015 to August 2020 were retrospectively studied. The clinical efficacy and the procedure-related complications were analyzed.Results:The mean procedure of endoscopic transmural drainage (ETD) was 1.1±0.3 times. During ETD procedure, lumen-apposing metal stents (LAMS) were placed in 9 patients, metal coated stents in 2 patients, double pigtail plastic stents in 7 patients, and only a nasal cyst drainage tube in 1 patient. All 19 patients received 12-14 F drainage catheters for drainage during the first percutaneous catheter drainage (PCD) treatment with the mean number of catheters of 1.8±1.2. Double cannulas was subsequently replaced in 3 of them for continuous drainage, and a percutaneous metal coated stent was replaced in 1 patient. The culture results of drainage fluid were 11 cases of gram-negative bacilli and gram-positive cocci, 4 cases of gram-positive cocci, 1 case of gram-positive bacilli, 3 cases of gram-negative bacilli. Among 19 patients, 4 cases had concurrent fungal infections. The mean number of debridement was 3.1±1.8 times, 2 cases of which were treated with endoscopic transluminal necrosectomy combined with percutaneous endoscopic necrosectomy. The mean procedure per patient was 6.1±2.4 times. Bleeding occurred in 1 case (5.3%) after the operation. But the bleeding was successfully stopped after endoscopic hemostasis. No serious complications such as gastrointestinal fistula, perforation or pancreatic fistula occurred. One patient died due to sepsis, and 18 other patients showed significant absorption of IPN after the treatment. None of the 19 patients were transferred to laparotomy.Conclusion:Transgastric combined with percutaneous endoscopic approach is safe and effective for IPN.

Extra-articular distal tibial fractures as a result of high-energy damage are often comminuted or displaced, frequently accompanied by severe soft tissue injuries.Poor blood supply and various complications make the treatment more difficult,affecting life quality of the patients.The main goals of the treatment are to abtain a healed,well-aligned fracture,functional range of motion of the ankle joint and minimizing complications.It is generally recommended that surgical treatment be performed in the proper context of local conditions to facilitate early functional exercise.Plate fixation and intramedullary nail fixation are the common options for closed fractures.This article focuses on the two treatment methods and some important auxiliary technologies in both domestic and foreign, hoping to provide some references for clinical treatment.

Objective To investigate the hepatoprotective effects of total flavonoids in Scorzonera austriaca Wild (TFSA) in vivo and in vitro. Methods In vivo, ICR mice were randomly divided into negative, model, positive, TFSA’s low-dose, medium-dose and high-dose groups,and acute chemical liver injury models were constructed with CCl4 and acute autoimmune liver injury models with Bacillus Calmette-Guerin vaccine ( BCG ) and lipopolysaccharide (LPS).The activity of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) was detected and liver tissue was used as biopsy.In vitro, liver cells of Wistar rat were extracted and isolated by orthotopic collagenase digestion method, and liver cell damage was induced with CCl4.Then the liver cells were cultured with TFSA solution and the contents of AST, ALT, LDH, nitric oxide (NO), superoxide dismutase (SOD) in the supernatant and malondialdehyde (MDA) in rat hepatocyte were detected.Results The results of CCl4-and BCG+LPS-induced acute chemical liver injury models in mice showed that there were less microstructures damage of liver tissue in TFSA groups compared with model group in liver pathological sections (HE), AST, ALT and LDH levels in model group were significantly higher than those in negative group (P<0.01), the above indexes in positive drug group were significantly lower than those in negative group (P<0.01,P<0.05), and the above indexes in TFSA’s low-dose, medium-dose and high-dose groups were significantly lower than those in model group(P<0.01,P<0.05).The results of CCl4-induced rat hepatocyte injury in vitro showed that AST, ALT, LDH, MDA and NO levels were significantly higher and SOD level was lower in model group than those in negative group (P<0.01), AST, ALT, LDH, MDA and NO levels were significantly lower and SOD level was higher in positive drug group than those in model group (P<0.01, P<0.05), and AST, ALT, LDH, MDA and NO levels were significantly lower and SOD level was higher in TFSA ’ s low-dose, medium-dose and high-dose groups were significantly lower than those in model group ( P <0.01, P <0.05 ) .Conclusion TFSA have hepatoprotective effects on CCl4-induced chemical liver injury and BCG+LPS-induced immune liver injury in mice, and rat hepatocyte damage.This study provides experimental data for the development and utilization of Scorzonera austriaca Wild resources and new hepatoprotective medicines.

Objective To investigate anti-HBV effect of total flavonoids in Scorzonera austriaca wild (TFSA) in vitro.Methods MTT assay was used to observe the effect of TFSA on HepG2.2.15 cells, ELISA assay was used to detect the inhibition on HBsAg and HBeAg secretion from HepG2.2.15 cells and RTFQ-PCR assay was used to detect the inhibition rates of HBV-DNA.ResuIts The TC50 of TFSA on HepG2.2.15 cells was 0.603 mg/mL . TFSA significantly reduced the content of HBsAg and HBeAg and the numbers of HBV-DNA in the HepG2.2.15 cell cultural supernatants under nontoxic concentrations (0.062, 0.125, 0.250 mg/mL), and the maximal inhibitory rate was 89%, 33% and 43%, respectively. ConcIusion TFSA have anti-HBV effects in vitro.

Objective:To establish the qualitative and quantitative methods for Gubaoxinshen Tablets. Method: Soy bean, and epimedium herb were identified by TLC, and the content of genistein and icarrin were determined by HPLC. Result: The developed TLC sports were was fairly clear, the HPLC method showed good repeatability. The average recovery of genistein was 98.9% with RSD 0.9%, and the average recovery of icarrin the was 98.0% with RSD 1.0%. Conclusion: The method is simple, accurate and can becauseofon control quality of Gubaoxinshen Tablets.

OBJECTIVETo observe the relationship between the amount of HBV DNA in serum/liver tissue and HGV infection in patients with chronic hepatitis B (CH-B) for exploring the effect of HGV infection on hepatitis B virus (HBV) replication of CH-B.

METHODSHGV RNA in serum, HGV nonstructural region 5 (NS5) antigen (HGV Ag) in liver tissue and the amount of HBV DNA in serum, liver tissue were detected for 56 patients with CH-B by reverse transcription-polymerase chain reaction (RT-PCR) assay, peroxidase antiperoxidase (PAP) immunohistochemical method and fluorescence quantitative PCR assay, respectively. Then the relationship between HGV Ag expression in liver tissue and HGV RNA expression in serum was analysed and the amount of HBV DNA in serum and liver tissues from the serum HGV RNA or liver tissue HGV Ag positive patients were compared with those of the serum HGV-RNA or liver tissue HGV Ag negative patients, respectively.

RESULTSTen (17.9%) and eight (14.3%) patients were positive for serum and liver tissues,respectively.HGV RNA expression in serum was closely related to HGV Ag expression in liver tissues, but there was HGV RNA in serum from some of the liver tissues HGV Ag negative patients ?cases of HGV RNA and HGV Ag positive or negative,HGV RNA positive but HGV Ag negative, HGV RNA negative but HGV Ag positive, respectively: 5,43,5,3,(P<0.01). There was no significant difference in the amount of HBV DNA in serum and liver tissues between HGV RNA or HGV Ag positive and negative patients (P>0.05).

CONCLUSIONSHGV infection may not affect HBV replication. Liver is the site of HGV replication, but HGV probably also replicates in extrahepatic tissues. HGV hepatic pathogenicity is probably mild and further studies are still needed.

Adult ; DNA, Viral ; analysis ; blood ; Female ; Flaviviridae Infections ; complications ; virology ; GB virus C ; genetics ; immunology ; pathogenicity ; Hepatitis Antigens ; analysis ; Hepatitis B virus ; genetics ; physiology ; Hepatitis B, Chronic ; complications ; virology ; Hepatitis, Viral, Human ; virology ; Humans ; Liver ; virology ; Male ; RNA, Viral ; blood ; Virus Replication

Objective To investigate the association of the absence or presence of aspartic acid at position 57 of the HLA-DQ β chain (NA or A) with susceptibility or resistance to insulin-dependent diabetes mellitus (IDDM) in a Southern Chinese population.Methods Sixty-nine IDDM patients and 47 healthy controls in a Southern Chinese population were HLA-DQB1 genotyped by one-step sequence specific polymerase chain reaction (ssPCR).Results The frequencies of NA and A were 64.5% and 35.5% in the IDDM patients, and 40.4% and 59.6% in the control subjects respectively (RR for NA was 2.68, P<0.01). The frequencies of NA/NA, NA/A and A/A phenotypes were 47.8%, 33.3% and 18.8% in the IDDM patients, and 31.9%, 17.0% and 51.1% in the controls respectively (P<0.01). The frequency of A/A phenotype was significantly lower in the IDDM patients than in the control subjects (RR=0.22, P<0.01). DQB1* 0302 and DQB1* 0201 were more frequent in IDDM patients than in control subjects. The younger the age of IDDM onset, the higher the allele frequencies of DQB1* 0201 and DQB1* 0302.Conclusion The present study suggests that the NA confers the susceptibility to IDDM, while the A confers the protection against IDDM in patients of Southern Chinese origin. These associations are more clearcut in childhood-onset IDDM patients.

The clinical data and HE stain sections of 70 PHC cases and 7 bile-capillary carcinoma patients were reviewed. Victoria blue stain was used for all these liver samples,. Our observations showed that the detection rates of HBsAg in liver cells without a history of positive serum HBsAg test and either with serum HBsAg negative or positive were rather high, 85.7%. 75.0% and 90.2% respectively. There was no significant difference among them. It is worthy to note that HBsAg could be detected in liver cells sections with Victoria blue stain in 75.0% of liver samples whose serum HBsAg was negative. The positive rates of HBsAg in liver cells of serum HBsAg negative and positive patients were without obvious difference. It seemed to suggest that the posibility of HBV infection and its carcinogenic role could not be excluded in the serum HBsAg negative patient. In addition, HBsAg could be detected in the carcinoma cells in 34.3% of liver samples, and also in the abnormal cells between the carcinoma and liver tissue sections in 9.8% with Victoria blue stain. However, neither HBsAg could be found in all the 7 bile-capillary carcinoma sections with in Victoria blue stain, norground-glass cells could be seen in the HE stain sections. These results seemed to further prove that there might be a close cause and effect relationship between the HBV infection and PHC.