Objective:To investigate changes in skin microecological structures and functions between acute and remission phases in adult patients with severe atopic dermatitis (AD) .Methods:From October 2019 to November 2020, skin scale specimens were collected from 5 body sites (cheeks, cubital fossa, back of the hand, abdomen, lower limbs) of 4 adult patients with severe AD in the acute and remission phases, who visited the outpatient clinic of Guangzhou Institute of Dermatology. The next-generation high-throughput sequencing was performed for metagenomic sequencing to construct the microbial gene catalogue of these specimens, followed by gene annotation and bioinformatics analysis for each sample.Results:A total of 18 phyla, 37 classes, 73 orders, 142 families, 237 genera, and 331 species were identified in the skin specimens from the 4 patients with severe AD. The patients with AD in the remission phase showed significantly increased diversity of skin microbiota and markedly different relative abundance of skin microorganisms compared with those in the acute phase (both P < 0.05). At the microbial species level, Staphylococcus aureus showed the highest impact on the acute phase of AD, while Staphylococcus epidermidis, Moraxella osloensis, Francisella sp., Staphylococcus cohnii, Staphylococcus warneri, Malassezia globosa and Malassezia restricta were enriched in the remission phase of AD with the absolute value of the common logarithm of the linear discriminant analysis score > 2 (Kruksal-Wallis test, all P < 0.05). As KEGG pathway enrichment analysis showed, the differentially abundant genes were annotated into a total of 355 functional pathways, of which 38 pathways were significantly enriched (all P < 0.05), mainly involving Staphylococcus aureus infection, tryptophan metabolism, histidine metabolism, nitrogen metabolism, metabolism of arginine and proline, biosynthesis and degradation of valine, leucine and isoleucine, fatty acid degradation, peroxisome proliferator-activated receptor signaling pathway, etc. Conclusion:The skin microecological structure significantly differed between the acute and remission phases among the patients with severe AD, which may be related to multiple functional pathways, such as Staphylococcus aureus infection, tryptophan metabolism, histidine metabolism and nitrogen metabolism.

Objective:To make a self-made fall/fall protection cover and explore its application effect.Methods:Five high-risk fall wards in Songjiang District Central Hospital were selected as the pilot wards. According to the length of stay, 80 elderly patients treated from June to December in 2020 were selected as the control group and 80 patients treated from January to June in 2021 were selected as the experimental group. The control group was treated with routine fall prevention / bed falling intervention measures, and the experimental group was treated with self-made fall prevention / bed falling protective cover on the basis of routine intervention measures. The incidence of falling/falling bed, physical restraint rate, comfort and satisfaction of hospitalized patients were compared between the two groups.Results:During the study period, there was no fall in the experimental group and one patient in the control group. The incidence of fall was 0.125 ‰ (1/8 000) ( t=-0.06, P>0.05). The rate of physical restraint was 8.75%(875/10 000) in the experimental group, and 26.25%(2 100/8 000) in the control group, the difference was statistically significant( t=-5.51, P<0.05). The scores of comfort and satisfaction were (93.43 ± 13.01), (134.50 ± 15.56) points in the experimental group and (81.68 ± 13.41), (111.88 ± 16.22) points in the control group, the differences were statistically significant ( t=8.03, 12.92, both P<0.05). Conclusions:The self-made fall / fall protection cover can reduce the utilization rate of physical constraints, improve the overall comfort of patients, improve patients′ satisfaction.It has clinical promotion value.

Objective: To retrospectively analyze the differential diagnosis and treatment strategy of neonatal intestinal perforation caused by neonatal necrotizing enterocolitis (NEC) and Hirschsprung′s disease (HD). Methods: The clinical data of 42 cases with NEC and 22 cases with HD combined with intestinal perforation from Ja-nuary 2012 to January 2017 admitted at Fujian Provincial Maternity and Children′s Hospital were collected, the proportion of premature infants, and the proportion of low birth weight infants, age of onset, preoperative clinical symptoms and surgical treatment was compared between the two groups. Results: The proportion of premature infants[95.23%(40/42 cases) vs.27.27%(6/22 cases)], the proportion of low birth weight infant[90.48%(38/42 cases) vs.45.45%(10/22 cases)]and the age of onset [(14.48± 10.51) d vs.(3.18±3.43) d]were statistically different between the NEC group and the HD group, and the differences were statistically significant(all P<0.05). There were significant differences in the presence of normal defecation before the operation[71.4% (30/42 cases)vs.27.3%(6/22 cases)], and in the the defecation characteristics at the onset[95.2% (40/42 cases)vs.9.1%(2/22 cases)]between the NEC group and HD group(all P<0.05). Among 42 cases of NEC patients, 8 cases underwent intestinal anastomosis, and 34 cases underwent enterostomy because of the high risk of anastomosis.All of 22 patients with HD underwent double-lumen enterostomy. Conclusions The general conditions, preoperative manifestations and intraoperative fin-dings of the children should be comprehensively analyzed for identification.Enterostomy is recommended for NEC intestinal perforation, but if the risk of anastomosis is high, then fistula should be performed.Double-lumen fistula should be recommended for HD intestinal perforation, and enterostomy should be recommended if the two cannot be clearly distinguished.

Objective To systematically evaluate the therapeutic effect of pulse high volume hemofiltration (PHVHF) for treatment of patients with sepsis. Methods Databases such as PubMed in American National Medical Library, Holland medical abstract Embase, the Cochrane Library, China National Knowledge Internet (CNKI), China Biological Medical Literature Database (CBM), VIP, WanFang databases, etc. were searched by computer to retrieve randomized controlled trials (RCTs) on PHVHF for treatment of patients with sepsis, and the retrieval time ranged from the creation of database to March 25, 2017. Both groups of patients received conventional treatments, including antibiotics, fluid resuscitation, vasoactive agents as well as other organ function support treatments to maintain the basic vital signs stable. Patients in PHVHF group received PHVHF besides conventional treatment, while the patients in control group received conventional treatment or any other continuous renal replacement therapy (CRRT) mode with PHVHF excluded. The literatures accepted should at least include one of the following changes of outcome indicators, such as overall mortality, the levels of inflammatory mediators eliminated, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score, service life of filter, amount of replacement fluids used. Two researchers independently screened literatures, extracted data, and assessed the methodological quality of included studies. Meta-analysis was conducted by using RevMan 5.3 software and the publication bias was evaluated by visually inspecting funnel plots. Results A total of 11 RCTs involving 410 patients met eligibility criteria, of which 204 patients in the PHVHF group and 206 patients in the control group. In the control group 5 RCTs used other CRRT modes, and 6 RCTs applied the conventional therapy. Meta-analyses showed that interleukin-6 [IL-6, standard mean difference (SMD) = -0.80, 95% confidence interval (95%CI) = -1.56 to -0.06, P = 0.04], tumor necrosis factor-α (TNF-α, SMD = -0.78, 95%CI = -1.33 to -0.23, P = 0.006), APACHE Ⅱ scores [mean difference (MD) = -3.80, 95%CI = -5.08 to -2.52, P < 0.000 01] were obviously lower than those in control group, but no significant statistical significance in mortality was seen between the two groups [relative risk (RR) = 0.72, 95%CI = 0.49 - 1.07, P = 0.10]. Further subgroup analyses suggested that compared with conventional treatment group, in PHVHF group mortality (RR = 0.40, 95%CI = 0.16 - 0.95, P = 0.04), IL-6 (SMD =-1.87, 95%CI = -3.58 to -0.16, P = 0.03), TNF-α (SMD = -1.32, 95%CI = -2.24 to -0.40, P = 0.005), and APACHE Ⅱscore (MD = -4.29, 95%CI = -6.02 to -2.56, P < 0.000 01) were significantly decreased; however, only a significantly decreased APACHE Ⅱ score (MD = -2.95, 95%CI = -4.56 to -1.35, P = 0.000 3) was observed in PHVHF group compared to that in subgroup of other CRRT modes. Conclusions Compared with using conventional therapy alone, using PHVHF combined with conventional therapy for treatment of patients with sepsis can more effectively improve their prognosis, and PHVHF can be the efficacious alternatives of other CRRT modes especially the HVHF. However, due to the limited quantity and quality of the included studies, further high-quality, multicenter, large-scale RCTs are needed to verify the above conclusion.

Stroke remains the major complication among patients on dialysis.In chronic hemodialysis patients,prevalence and incidence of stroke are higher than those in general population.This article provides an overview of stroke in patients on dialysis,including clinical features,early warning and recognition,prevention and treatment.

Objective To compare the differences in the intestinal microflora of WHBE rabbit and JW rabbit models of diarrhea-predominant irritable bowel syndrome(IBS). Methods 16 WHBE rabbits and 16 JW rabbits were randomly divided into normal control(NC)group and IBS model group, respectively(n=8). The diarrhea-predominant IBS model was established by wet-heat stress combined with intragastric gavage of senna decoction. The abdominal circumference index,water content of feces and colonic transit function were observed. After sacrifice,colon tissue samples were taken for histopathological examination and colon contents for intestinal flora diversity analysis. Results Compared with the NC group,the IBS model rabbits showed an increased abdominal circumference index and fecal water content,and a shortened colon transit time, but no obvious pathological changes were observed in the colon tissues. Meanwhile, the Shannon index and Chao1 index of IBS model rabbits were significantly decreased(P<0.05). According to the result of OTU classification analysis,Firmicutes and Bacteroidetes are the dominant bacteria in the intestinal microflora of rabbits. Compared with the NC group, the Firmicutes, Verrucomicrobia, Chloroflexi, Akkermansia, and Streptococcus in the WHBE rabbit IBS model group were significantly reduced(P < 0.05, P < 0.01), while Bacteroidetes and rc4-4 significantly increased(P < 0.05, P < 0.01). However, in the JW rabbit IBS model group, Eubacterium and Subdoligranulum were significantly increased(P< 0.05),while Lactobacillus,Coprobacter,Veillonella and Streptococcus were markedly decreased(P<0.05). Compared with the JW rabbit NC group,the abundance of Firmicutes,Odoribacter, Veillonella,Streptococcus,Oscillospira and Pseudoflavonifractor were significantly decreased(P<0.05, P<0.01), but Bacteroidetes,Verrucomicrobia,Eubacterium,Akkermansia and Coprobacter were significantly increased(P<0.05,P<0.01)in the WHBE rabbit NC group. Compared with the JW rabbit IBS model group, the abundance of rc4-4, Bacteroidetes,Coprobacter and Clostridium were significantly higher(P < 0.05, P < 0.01), while the Firmicutes, Dorea, Coprococcus and Subdoligranulum were significantly lower(P <0.05)in the WHBE rabbit IBS model group. Conclusions There is an intestinal microflora imbalance in rabbits with IBS, resulting in a decrease of microflora diversity. The changes of intestinal microflora in the WHBE rabbits and JW rabbits with IBS have their own characteristics, and have apparent differences.

Objective To investigate the effects of maternal behaviors in the rats with neuropathic pain (NP) on emotions of offspring rats and the relationship with DNA methylation in the amygdala.Methods Forty-eight healthy adult Sprague-Dawley rats (24 males and 24 females),weighing 200-250 g,were used in the study.Twelve female and 12 male rats were randomly selected,and NP was induced by chronic constriction injury (CCI).Each female rat was mated with one male rat at 10 days after CCI.Fortyeight F1 generation rats of maternal rats with NP were randomly divided into 2 groups (n =24 each) using a random number table:NP1 group and NP2 group.Forty-eight F1 generation rats of normal maternal rats were randomly divided into 2 groups (n=24 each) using a random number table:S1 group and S2 group.The F1 generation rats were cross-fed immediately after birth between group NP2 and group S2,and fed by their own mother rats in NP1 and S1 groups.All the offspring rats were fed to 21 days after birth by the maternal rats selected,and separately fed to 30 days after birth,and then subjected to behavioral testing.Retrieving and licking pups were recorded after delivery in maternal rats to evaluate the maternal behaviors.The mechanical and thermal paw withdrawal thresholds were measured in the offspring rats.Elevated plus maze and open field tests were conducted to detect anxiety and depression behaviors in the offspring rats.At 1 day after completion of behavioral testing,the expression of DNA methyltransferase 1 (DNMT1) and DNA methyltransferase 3a and 3b in the amygdala was detected by Western blot analysis.Results Compared with S1 or S2 groups,the latency to lick pups,latency to retrieve pups,and total retrieval time were significantly prolonged,and the total time spent licking pups was significantly shortened in NP1 group or NP2 group (P＜0.05 or 0.01).There was no significant difference in the mechanical and thermal paw withdrawal thresholds in the offspring rats between the four groups (P＞0.05).Compared with group S1,the ratios of time spent in the open arm to the closed arm and of time spent in the central square to the peripheral square were significantly decreased,DNMT1 expression in the amygdala was significantly up-regulated,and the total DNA methylation was increased in the offspring rats in S2 and NP1 groups (P＜0.05).Compared with group NP2,the ratios of time spent in the open arm to the closed arm and of time spent in the central square to the peripheral square were significantly decreased,DNMT1 expression in the amygdala was significantly up-regulated,and the total DNA methylation was increased in the offspring rats in S2 and NP1 groups (P＜0.05).Conclusion Decreased maternal behaviors in the rats with NP results in negative emotions including anxiety and depression in the offspring rats,and the mechanism is related to increased DNA methylation in the amygdala of the offspring rats.

Background and purpose:Fallopian tube carcinosarcoma is a rare malignant tumor that is prone to metastasis and recurrence. Patients with the malignancy often have poor prognosis. This paper retrospectively analyzed the clinical manifestation, pathology, treatment and prognosis of fallopian tube carcinosarcoma.Methods:The clinical manifestations, pathological features, treatment and survival time of 7 cases of fallopian tube carcinosarcoma were retrospectively analyzed.Results:The most common symptoms of 7 cases of fallopian tube carcinosarcoma were irregular vaginal bleeding (4/7, 57.1%). Among 7 cases, one case was stageⅠa, 1 stageⅡa, 1 stageⅡb, 1 stageⅢb, and 3 stageⅢc. Four cases (57.1%) were heterologous and found to have cartilage components whereas 3 cases (42.9%) were homologous. Seven cases were performed with tumor volume reduction surgery, and 6 cases with chemotherapy, while no one received radiotherapy. Five patients survived and 2 were dead. The survival time of 3 patients was more than 5 years. The longest survival time to the end of the follow-up was 114 months.Conclusion:The pathological examination is the diagnostic means of fallopian tube carcinosarcoma. The prognosis of the patients with the pathological characteristics of the homologous is better than that of the heterologous. Satisfactory reduction of tumor, postoperative chemotherapy with adequate TP regimen, combined with systemic chemotherapy and intraperitoneal chemotherapy may be an effective treatment for fallopian tube carcinosarcoma.

OBJECTIVETo investigate the chemical constituents from Hedyotis diffusa.

METHODThe compounds were isolated and purified by various chromatographic techniques and identified by their physicochemical properties and spectral data.

RESULTEight compounds had been reported in last paper, and this time eight more compounds were isolated and identified as 6-hydroxystigmasta-4,22-dien-3-one (1), 3-hydroxystigmasta-4,22-dien-7-one (2), 2-hydroxy-3-methylanthraquinone (3), 2,6-dihydroxy-3-methyl-4-methoxyanthraquinone (4), iso-scutellarein (5), isoetin (6), aesculetin (7), gypsogenic acid (8).

CONCLUSIONCompounds 1-3, 5-8 were obtained from the genus Hedyotis for the first time.

OBJECTIVE To discuss the related factors of toxigenic Helicobacter pylori(Hp) infection among adult population in Futian District,Shenzhen.METHODS A total of 1164 adults who had health examination in community centers were investigated through questionnaire and detected Hp antibodies.RESULTS The Hp and toxigenic Hp infection rates among them were 45.5% and 14.2%.Among them 46.3% and 14.8% were in males,and 44.7% and 13.4% in females.People less than 60 years old had higher incidence of Hp and toxigenic Hp,but decrease in people rnore than 60 years old.Hp and toxigenic Hp infection rate in married people were higher than those of unmarried.In workers,farmers and doctors were higher than staff and other occupations.The incidence were higher in drinking raw water than those drinking boiling water.in taking antibiotics before serologic examination were lower than no taking antibiotics;in peptic ulcer disease were higher than in no peptic ulcer disease;in per capita housing area over 6 m2 were higher than less 6 m2.CONCLUSIONS The infection rates of Hp and toxigenic Hp among our adult population are low,and positively correlated with age but gender.The social environment such as living condition,economic income,culture level and residential density maybe influence the infection of Hp.The route of transmission of Hp is unknown yet,water perhaps is an important dissemination medium.