Objective: To explore the mechanism of action of Zangjiangzhi capsule (ZJZC) in treating hyperlipidemia (HLP). Methods: The components of ZJZC were analyzed and identified using ultra-high performance liquid chromatography with Q-Exactive Orbitrap tandem mass spectrometry (UHPLC-Q-Exactive-Orbitrap-MS/MS). Network pharmacology analysis was used to explore the mechanism of action of ZJZC in HLP treatment. The SwissTargetPrediction database was used to predict compound targets, and GeneCards, DisGeNet, OMIM, and DRUGBANK databases were used to identify HLP-related targets. Protein–protein interaction diagrams were constructed using the STRING database. The targets were subjected to gene ontology and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. The “herb-ingredient-target” network was visualized using Cytoscape. Preliminary validation was performed using molecular docking and enzyme-linked immunosorbent assay. Results: Ninety compounds were identified in ZJZC, including 34 flavonoids, 12 phenols, 10 terpenoids, 10 alkaloids, 8 organic acids, 8 anthraquinones, and 9 other compounds. In total, 904 targets were identified for these compounds. Among them, 158 targets intersected with the HLP target network. Network pharmacology analysis showed that MAPK1, PPAR-α, RXRA, HSP90AA1, PIK3R1, AKT1, PIK3CA, IL6, TNF, and ESR1 are the key targets of action. KEGG enrichment analysis identified 164 pathways. Among these, the AGE-RAGE signaling pathway in diabetic complications, lipid and atherosclerosis pathways, regulation of lipids in adipocytes, and insulin resistance are related to HLP. Molecular docking showed good affinity between the key targets and ingredients. Further, ZJZC treatment in mice resulted in lower expression of MAPK1 protein and increased expression of PPAR-α protein, which have been shown to be strongly associated with HLP. Conclusions This study showed that ZJZC contains various active ingredients and can modulate multiple targets and pathways associated with HLP, providing evidence at the molecular level for its clinical application in the treatment of HLP.

Objective: To explore the recovery time and risk factors of coagulopathy caused by rodenticide poisoning through analyzing and following up the confirmed cases, and to provide more useful guidance information for the clinic practice. Methods: A total of 96 cases with coagulation dysfunction caused by anticoagulant rodenticide poiso-ning in Children′s Hospital, Chongqing Medical University from January 2014 to December 2016, were analyzed retrospectively.The recovery time of coagulation function and the relationship between recovery time and drug involved way, dysfunction organs and poison concentration were studied respectively. Results: (1) A total of 96 patients were hospitalized because of severe coagulopathy caused by the poisoning of second generation anticoagulant rodenticide.Brodifacoum was detected from 33 blood samples and the median concentration was 364 μg/L (55-4 654 μg/L). Bromadiolone was detected from 7 blood samples and the median concentration was 130 μg/L (18-652 μg/L). Brodifacoum and Bromadiolone were both detected from 8 cases and the median concentration was 741 μg/L (63-6 000 μg/L) and 11 μg/L (3-3 694 μg/L), respectively.(2) A total of 57 cases of the patients were successfully followed up.A total of 18 cases were confirmed with oral poisoning, 16 cases with dermal poisoning, while 23 cases denied any involved ways of poisoning, and 7 cases had organs dysfunction.The follow-up time was 12-54 months.All the hospitalized patients were given specific antidote Vitamin K treatment and recovered successfully without any sequelae.(3) The median recovery time of coagulopathy caused by rodenticide poisoning was 2.5 months.(4) The recovery time of coagulation function was positively correlated with the plasma concentration of Brodifacoum(r=0.619, P<0.01). (5) There was no significant correlation between recovery time and organ dysfunction or drug involved ways of poisoning involvement (all P>0.05). Conclusions The recovery time of coagulation dysfunction caused by anticoagulant rodenticide in children is much longer.The higher the concentration of Brodifacoum poison is, the longer the recovery time.Enough supplementation course of Vitamin K should be given according to the follow-up of coagulation function.

Objective To investigate the clinical distribution and drug resistance of carbapenemsresistant Klebsiella pneumoniae (CRKP).Methods A total of 134 clinical strains of CRKP were collected from inpatients in our hospital from January 2014 to December 2016.VITEK-2 compact automatic microbiological analyzer was used to identify the bacteria and the supporting gram-negative bacterial drug susceptibility card was used for susceptibility testing.The sensitivity of other clinical commonly used antimicrobial agents was measured by K-B method.And the clinical distribution of CRKP and its resistance to antimicrobial agents were investigated and analyzed.Results The clinical strains of CRKP were isolated mainly from urine (n=70,52.2％) and sputum (n=38,28.4％).Klebsiella pneumoniae was identified in samples from the department of neurosurgery,including neurosurgery ICU (47.8％,64/134),ICU (23.9％,32/134),department of hepatobiliary surgery (8.2％,11/134) and department of urology (6.0％,8/134).Among all 22 antimicrobial agents tested,the resistant rates of CRKP to 16 antimicrobial agents were ＞90％,especially for ampicillin it was 100％,and those to 19 antibiotics were ＞80％,only for tigecycline it was 23.1％.There were 16 strains of CRKP with positive extended spectrum β-lactamases (ESBLs) (11.9％).All the CRKP strains were resistant to more than three kinds of antimicrobial agents,except one strain that was resistant to two kinds.Conclusion There is a wide range of clinical distribution of CRKP,which is resistant to most of antimicrobial agents,while tigecycline still has a strong antibacterial activity to CRKP.

Objective To analyze the diagnostic status of haemophilia in Chinese children in recent years,and to provide information for increasing the life quality of children with haemophilia in China.Methods The pediatric haemophilia cases registration data were collected and analyzed by using questionnaire,from January 1,2008 to March 30,2014 in 13 haemophilia treatment centers of haemophilia treatment center collaboration network of China pediatric group.These centers were from 12 provinces / municipalities.Results A total of 554 cases were collected;median age was 7.0 years old(0.1 to 17.9 years old);among them,481 cases(86.8％) were hemophilia A,and 73 cases were hemophilia B (13.2％);55 mild cases (9.9％),290 moderate cases (52.4％),and 209 severe cases (37.7％);162 cases(29.2％) had family history,the other 392 cases(70.8％) had no family history.The diagnosis was made at a median age of 12.0 month-old(0 to 180.0 months);the diagnosis time was 0.5 months(0 to 144.0 months) after the first bleeding;diagnosis timing with short interval was in 356 cases(64.3％),long interval was in 198 cases(35.7％).The diagnostic timing was not correlated with disease severity (P =0.812) or the family history (P =0.243);but correlated with the severity of first bleeding(P =0.027) and per capita gross domestic product (P ＜ 0.01) in patients' residence.From 1996 to 2013,the annual number of newly diagnosed cases was increasing year by year,with a higher proportion of short interval of diagnose timing.Conclusions With development of hemophilia work in China,the number of diagnosis of haemophilia children is increasing year by year.Moderate and severe hemorrhage are both taken seriously and diagnosed timely.But the diagnosis is delayed in some children.Chinese haemophilia work still need to be strengthen and the propaganda and diagnostic technology are to be popularized.

Objective To establish a method for detection of serum urocanic acid (UCA) by high performance liquid chromatography (HPLC),and explore the clinical significance of serum UCA concentration for children acute leukemia.Methods The chromatographic conditions of HPLC were set up and optimized,and the linearity of standard curve,precision,accuracy and stability were validated.Then the serum from ninety acute leukemia children and ninety non-tumor blood disease children was collected,the concentration of serum UCA was detected with HPLC,and the differences of two groups were compared to study the clinical significance of UCA in children acute leukemia.Results The HPLC method for detecting serum UCA was successfully established and optimized.The standard curves of trans-UCA and cis-UCA both showed good linearities(R2=0.999 6 and 0.999 9) at the condition of the mobile phase of acetonitrile-20 mmol/L KH2PO4,pH 3.7(5:95,V/V),flow rate of 1.2 mL/min,detection wavelength of 264 nm in HPLC.The relative standard deviation RSD％ of intra-assay and inter-assay were lower than 5％.Compared with non-tumor blood disease,the serum concentration of cis urocanic acid (cis-UCA) and trans urocanic acid (trans-UCA) of children with acute leukemia were significantly increased (P＜0.001).Compared with cis-UCA,trans-UCA was more valuable for risk classification of acute lymphoblastic leukemia (ALL).Conclusions HPLC is a good technology to titrate of UCA in serum.The concentration of serum UCA in children with acute leukemia may provide the clues for diagnosis and prognosis,with important clinical significance.

Objective To investigate the clinical efficacy and safety of high-frequency electric snare for the treatment of main airway neoplasm through bronchoscopy. Methods The clinical datas of 18 patients from July 2013 to April 2016, who had main airway neoplasm and were treated with high-frequency electric snare through bronchoscopy, were retrospectively analyzed. Meanwhile, the interventional bronchoscopic techniques partly included argon plasma coagulation and cryoablation. After operarion, the relief of symptoms and complications were observed. Results After operarion, the clinical symptoms, shortness of breath, dyspnea index score and the degree of airway stenosis were improved significantly. No serious complications such as massive hemoptysis occurred in all patients. Conclusion High-frequency electric snare is an effective and safe approach for the treatment of main airway neoplasm.

OBJECTIVETo explore the effect and mechanism of electroacupuncture (EA) for Z syndrome without organic lesion (metabolic syndrome combined with obstructive sleep apnea hypopnea syndrome).

METHODSFifty-eight patients with Z syndrome were divided into three groups according to mild,moderate and severe degree. Acupuncture and EA were used at Daimai (GB 26), Zhongwan (CV 12), Xiawan (CV 10), Zusanli ST 36), Qihai (CV 6) and Huaroumen (ST 24), etc., once a day and five times a week. The treatment of ten times was a course, and two courses were acquired continuously. Sleep respiration monitoring (PSG) was done before EA and in one week after treatment respectively. Triacylglycerol (TG) fasting blood glucose (FBG) fasting insulin (INS) and serum leptin (Lep) were tested before and after treatment in the three groups.

RESULTSAfter treatment apnea hypopnea index (AHI) and the percentage of the time of arterial oxygen saturation (SaO₂) less than 90% taken in the total sleep time (SLT 90%) were improved apparently than those before treatment in the three groups (all P < 0.05). The levels of TG, FPG, INS and Lep were decreased after treatment in all groups (all P < 0.05).

CONCLUSIONEA can improve AHI and nocturnal hypoxia of Z syndrome, and the mechanism may be related to decreasing the indices of metabolism syndrome and leptin.

Acupuncture Therapy ; Adult ; Female ; Humans ; Insulin ; blood ; Leptin ; blood ; Male ; Metabolic Syndrome ; blood ; physiopathology ; therapy ; Middle Aged ; Sleep ; Sleep Apnea, Obstructive ; blood ; physiopathology ; therapy ; Treatment Outcome ; Triglycerides ; blood ; Young Adult

OBJECTIVETo explore the risk factors, and control measures of cytomegalovirus (CMV) infection after hematopoietic stem cell transplantion (HSCT) in children with primary immunodeficiency diseases(PID).

METHODSWe retrospectively analyzed results of 26 patients with PID-Wiskott-Aldrich syndrome (WAS, n=20), severe combined immunodeficiency (SCID, n=1) , X-linked chronic granulomatous disease (XCGD, n=2) and X-linked hyper-immunoglobulin M (IgM) syndrome (XHIM, n=3)-who underwent HSCT from June 2007 to December 2012 in our center. Serologic studies (ELISA) and weekly CMV infection surveillance (quantitative PCR, qPCR) were routinely performed before and after HSCT. Ganciclovir or forcarnet was used for pre-emptive and curative therapy.

RESULTSAll 26 patients were male with the median age at HSCT of 27 months (range 7-77 months). At a median follow up of 24 months (range 5-66 months), the 5-year overall survival rate was (75.0 ± 9.0) %. CMV infection occurred in 42.3% (11 of 26) of the patients, two of them developed CMV interstitial pneumonia (CMVIP). Univariate analysis revealed that the incidence of pre-transplant CMV infection between with and without CMV activation groups after HSCT was significantly different (62.5% vs 10.0%, P=0.010). Additional variables not associated with CMV infection were stem-cell sources, donor type, HLA disparity and acute GVHD (all P values>0.05).

CONCLUSIONCMV infection was a major complication of HSCT. Sensitive monitoring, early diagnosis, timely treatment may improve the survival rate for these PID undergoing HSCT.

Child ; Child, Preschool ; Cytomegalovirus Infections ; virology ; Graft vs Host Disease ; Granulomatous Disease, Chronic ; therapy ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Infant ; Male ; Retrospective Studies ; Risk Factors ; Severe Combined Immunodeficiency ; therapy ; Tissue Donors ; Wiskott-Aldrich Syndrome ; therapy

OBJECTIVETo investigate the incidence, clinical symptoms, signs and laboratory features of childhood hemophagocytic lymphohistiocytosis (HLH) in China.

METHODSA retrospective study was performed on 217 pediatric patients with HLH who were admitted to Children's Hospital of Chongqing Medical University from January 2006 to April 2013. All patients'medical records were reviewed and analyzed.

RESULTSThe Male to female ratio was 1.11:1. The median onset age was 3 years and 5 months old (range of 6 months old to 16 years and 9 months old), and the age of onset peaked between 1-5 years old (61.3%). The most common causes of HLH was infection, especially Epstein-Barr virus-associated HLH (71.0%). Other causes included malignant hemophagocytic syndrome (MAHS), macrophage activation syndrome (MAS) and so on. The outstanding clinical manifestations including persistent fever (100.0%), hepatomegaly (92.6%), splenomegaly (88.4%), and more than half of cases with central nervous system involvement and pulmonary manifestations. Laboratory data indicated that the most prominent abnormality was elevated ferritin (98.0%), and the others were hemophagocytosis in bone marrow (90.7%) and coagulation abnormalities (76.5%). Abnormal lymphocytes classification is very common in HLH.

CONCLUSIONHLH is a heterogeneous disease, with a variety of the etiology and clinical manifestations. HLH-2004 diagnostic protocol had theoretical basis and clinical operability. The hepatitis damages related indicators, lymphocytes classification, central nervous system involvement and pulmonary performance can be used as reference value for HLH diagnosis.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Lymphohistiocytosis, Hemophagocytic ; diagnosis ; Male ; Retrospective Studies

Objevtive:This study was aimed to investigate the effect of 5-aza-cytidine on the proliferation,cell cycles distribution profile and apoptosis of human promyelocytic cell line HL60.Methods: The human promyelocytic cell line HL-60 was cultured in RPMI 1640 medium.3-(4,5-Dimethylthiazol-2-y)l-2,5-diphenylte trazolium(MTT)reduction by cells was used to assess drug-induced cell growth inhibition.Cells were treated with 0.25,0.5,1,2.5?mol/L of freshly prepared 5-aza-cytidine for 48 hours before they were harvested for analyzing distribution of cell cycle phases and apoptosis by flow cytometer.Results:5-aza-cytidine inhibited HL60 cell proliferation in a time-and concentration-dependent manner.Apoptosis was induced as detected by flow cytometry.Determination of the cell cycle distribution by flow cytometry revealed an accumulation of cells in G1 phase.Conclusion:DNA methylation inhibitor 5-aza-cytidine has effects on proliferation of human promyelocytic cell line HL60.Possible mechanism of this inhibition is induction of apoptosis.