ObjectiveTo observe the clinical efficacy and safety of Tianmeng Lingjiao Formula（天礞羚角方， TLF） as an adjunctive therapy for paroxysmal atrial fibrillation （PAF） with phlegm-heat harassing the interior syndrome. MethodsNinety patients with PAF and phlegm-heat harassing the interior syndrome were enrolled and randomly assigned in a 2∶1 ratio to test group （60 cases） and control group （30 cases）. The control group received conventional western medicine， while the test group received TLF in addition to the conventional treatment， with one dose administered daily. The treatment course for both groups was 4 weeks. The efficacy of traditional Chinese medicine （TCM） syndrome and the rate of atrial fibrillation （AF） conversion were compared between groups. Assessments included AF burden， frequency and duration of AF episodes， TCM syndrome scores， and European Heart Rhythm Association （EHRA） AF symptom classification before and after treatment. Safety indicators such as blood routine， urine routine， stool routine， liver function， kidney function， and electrolytes were also monitored. Adverse events were recorded. ResultsA total of 82 patients completed the study （54 in the test group and 28 in the control group）. After treatment， AF burden， the frequency and duration of AF episodes， and TCM syndrome scores were significantly reduced in both groups， and the test group showed lower indicators than the control group （P＜0.01 or P＜0.05）. The AF conversion rate was 25.93% （14/54） in the test group， significantly higher than 3.57% （1/28） in the control group （P＜0.05）. The total effective rate for TCM syndrome efficacy was 83.33% （45/54） in the test group， which was significantly higher than 67.86% （19/28） in the control group （P＜0.05）. After treatment， the EHRA atrial fibrillation symptom severity in the test group showed significant improvement， and the improvement in atrial fibrillation symptoms was superior to that in the control group （P＜0.01or P＜0.05）. No significant abnormalities were observed in safety indicators， and no adverse events occurred during the trial. ConclusionTLF as an adjunctive therapy can reduce AF burden， enhance the conversion rate of AF， decrease the frequency and duration of episodes， and improve clinical symptoms in patients with paroxysmal atrial fibrillation presenting with phlegm-heat harassing the interior syndrome， with a favorable safety profile.

Objective:To establish a classification model for rapid identification of hypervirulent subtype ST17 clones of Group B Streptococcus (GBS) using matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF MS).Methods:In a retrospective study, 235 strains of GBS strains were selected from multiple centers in China during 2015-2018. For model generation,45 strains of ST17 and 50 strains of non-ST17 (20 ST19, 15 ST12 and 15 ST10 strains) were enrolled as the modeling group. The remaining 90 main ST strains (40 ST17, 16 ST10, 17 ST12 and 17 ST19) were served as validation group. 50 GBS strains classified as other minor ST subtypes were regarded as taxonomic groups. MS spectra were collected by Bruker mass spectrometry, and then loaded for model generation and verification, and screening of differential peptide peaks by genetic algorithm (GA) and model verification on ClinProTools 3.0 software.Results:The recognition rate for ST17-GA model were 99.4% with cross validation value of 96.9%. Among the ten differential peptide peaks for the classification model, the weights of both two main peptide peaks m/z 2 956 and m/z 5 912 were greater than 1, while the weights of the all other eight peptide peaks were less than 0.5. Model validation showed only one of the ST17 was misjudged as non-ST17 strain, resulting in diagnostic accuracy of 98.9%, sensitivity of 97.5% and specificity of 100%, positive predictive value of 100% and negative predictive value of 98.0%, respectively. For other sporadic STs, 42.0% (21/50) of them were misdiagnosed as ST17 subtype.Conclusion:A MALDI-TOF MS classification model for hypervirulent subtype of ST17 GBS strains has been successfully established with good diagnostic efficacy.

Objective To explore the sample type and drug resistance characteristics of Streptococcus pneu-monia(Spn)isolated from pediatric patients in Guangzhou district,and their age distribution to offer instruc-tions for prevention and clinical treatment.Methods Spn isolates were cultured and identified according to the national standard procedure for clinical laboratory operation,followed by analysis of sample type and age dis-tribution of pediatric patients with positive isolates of Spn in Guangzhou Women and Children′s Medical Cen-ter from 2013 Jan 1st to 2015 Dec 31st,drug resistance status was determined by MIC test.Results Totally, 1 243 strains of Spn were isolated,which were mainly from pediatric patients under 1 year old(42.80%).Spn isolates were mainly isolated from respiratory tract(72.81%),ear secretions(15.37%),blood(5.63%),cere-brospinal fluid(3.06%)and hydrothorax(2.01%).For all Spn isolates,the resistance rate to erythromycin, tetracycline and sulfamethoxazole was especially high as 94.93%,85.76%,73.53% respectively,with relative high resistance to penicillin G(24.70%),amoxicillin(39.59%),ceftriaxone(24.05%),meropenem(22.85%) and cefotaxime(19.89%),low resistance to quinolone antibiotics(<10.00%),and no resistance to vancomycin and linezolid.Conclusion The major age group of children with Spn infection is infants under one year old in Guangzhou,clinicians should be serious about the high resistant rate of Spn to erythromycin,tetracycline and sulfamethoxazole,the significantly increased resistant rate to penicillin,amoxicillin and ceftriaxone.Clinicians should choose antibiotics rationally according to the characteristics of drug sensitivity for better treatment.

Objective To explore the infection rate of hepadnaviruses and non-hepatotropic virus in infants with biliary atresia(BA)and their relationship between the onset and development of BA.Methods The data and pathogen test records from 184 BA infants who were hospitalized at Guangzhou Women and Children's Medical Center from January 1,2010 to December 31,2014 were reviewed,and the infection rates caused by 3 hepadnaviruses including hepatitis A virus(HAV),hepatitis B virus(HBV),hepatitis E virus(HEV)as well as 5 non-hepatotropic viruses including cytomegalovirus(CMV),Epstein-Barr virus(EBV),herpes simplex virus(HSV),enterovirus(EV),Coxsackie-virus were analyzed.The outpatients or inpatients without BA and immunodeficiency were selected as controls.Results In BA patients,the infection rates of CMV were highest(40.21％,39/97 cases)caused by 3 hepadnaviruses(HAV,HBV,HEV)and 5 non-hepatotropic viruses(CMV,EBV,HSV,EV,Cox),while the infection rates of HAV,HEV,HBV,EBV,HSV,EV or Coxsackievirus were all low,and mixed virus infection was found in 9 patients.The positive rate of CMV IgM in BA group[34.94％(29/83 cases)] was significantly higher than that in the control group[15.69％(8/51 cases)],and the difference was statistically significant(x2=5.86,P<0.05);and the positive rate of CMV DNA in BA group[28.57％(20/70 cases)] was significantly higher than that in the control group[3.70％(1/27 cases)],and the difference was statistically significant(x2=7.10,P<0.05).In BA infants under 60 days,the detection rate of CMV DNA was 45.45％(15/33 cases),which was higher than that in the ones over 60 days[25.48％(5/37 cases)],and the difference was statistically significant(x2=8.72,P<0.01);while the positive rate of CMV IgM had no significant difference among≤60 d group,60-90 d group and ≥90 d group[47.22％(17/36 cases),20.00％(6/30 cases),35.29％(6/17 cases)](x2=5.62,P>0.05).No statistical difference in age was found in BA patients on detection between the positive and the negative group,and the consistency of CMV DNA and CMV IgM was not ideal(Kappa value<0.4).Conclusions Infection of CMV is quite common in BA patients,BA infants under 60 days old show higher detection rate of CMV DNA than the older ones,but there is no difference in detection rate of CMV IgM among different ages,CMV is not supported as a secondary infection and may play a role in the occurrence and development of BA.

Objective To explore the prenatal care before pregnant for women having plan to get second child, and to provide references for the development and guidance of the nursing work for the second pregnant women.Methods From January to October 2015, 1028 pregnant ages women who had plan to have second child were randomly selected and divided into control group and experimental group according to the order of entry into Maternal and Child Health Care Center. The control group (n=514) received routine pre-pregnancy care, while the experimental group (n=514) were given combined nursing intervention. All the women were followed up for 18 to 24 months. The results of the two groups before and after the intervention were analyzed in preconception eugenic health examination related knowledge of the situation. Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) were used to evaluate the mental state and the compliance of pre-pregnancy health examination were compared.Results Compared with the control group, the knowledge of prenatal health examination was significantly higher in the experimental group than that in the control group, as well as health examination, inherited diseases, risk assessment, and pregnant related health knowledge (P<0.05). After the intervention, the scores of the two groups were significantly lower than that before intervention in SDS and SAS, and the difference was statistically significant (P<0.05); after intervention, SDS, SAS and other psychological scores in the experimental group were significantly lower than those of the control group, and the differences were statistically significant (P<0.05). The compliance of the experimental group after intervention was significantly higher than that of the control group (P<0.05).Conclusions Nursing intervention can significantly improve the health knowledge of women having second child plan, and the awareness rate is improved after intervention. The effect of nursing intervention on improving the psychological status of pregnant women is satisfactory.

Objective To explore the effect of nursing intervention of national free progestation eugenic health examination on service objects planned to pregnancy.Methods A total of 872 couples in Panyu District of Guangzhou were selected from January 2014 to January 2016 based on convenient sampling. All of them complied with family planning policy, planned to pregnancy and received national free progestation eugenic health examination. The participants were divided into control group (n=436) and observation group (n=436) according to the method of lottery. The control group received national free eugenic health examination, and the observation group received additional nursing care and comprehensive guidance based on the control group. The distribution of high-risk factors of the couples was recorded. The knowledge of birth defects and progestational eugenics and the pregnancy outcomes were observed.Results There were no statistically significant differences in the incidence of reproductive tract infection, pre-pregnancy virus screening, abnormal pre-pregnancy laboratory findings, adverse pregnancy outcome, family history of high risk, wife/husband environmental exposure, and other high-risk factors between two groups (P>0.05). There were significant differences in health and nutrition during pregnancy, the optimal reproductive age, the importance of progestation examination, the normal physiological process of pregnancy, the time of folic acid supplementation, and the prevention of birth defects between two groups (P<0.05). The observation group had significantly higher normal pregnancy rate and lower miscarriage and stillbirth rate compared with the control group (95.15% vs. 85.82% for normal pregnancy; 2.99% vs. 13.42% for miscarriage; 0.75% vs. 1.87% for stillbirth;P<0.05).Conclusions Nursing intervention in progestation eugenic health examination can effectively improve the eugenic knowledge, attitude and behavior, and the outcome of pregnancy. It can reduce the risk of birth defects.

AIM: To observe the antifungal action of Huanglian Pikang tincture (HPT). METHODS: An anifungal experiment was performed in vitro. RESULTS: HPT had obvious antibacterial actions for the trichophyton rubrum, T. interdigital, epidermophyton floccosum, candida albicans and lessened the colonies (n=5, P

Aim To establish a new paclitaxel resistant human mammary adenocarcinoma cell subline(MCF-7/Taxol) and investigate its characteristics.Methods A paclitaxel resistant human mammary adenocarcinoma cell subline(MCF-7/Taxol) was developed by gradually increasing the concentration of Taxol from the parent cell line MCF-7 in vitro.The multidrug resistance of MCF-7/Taxol to anticancer agents was evaluated by SRB assay;the distribution of their cell cycles was detected by flow cytometry;the positive expression rate of P-gP、LRP、ToPoII、GST?、ER and PR was measured by S-P immunohistochemistry;the intracellular accumulation of Taxol was assessed by HPLC;the morphological features and the celluar ultrastructure characteristics were observed respectively by light microscopy and scanning electron microscopy.Results MCF-7/Taxol was resistant to several chemotherapy agents,such as Hydroxycamptothecine,Epirubicin,Doxorubicin,Mitoxantone and so on.The IC50 of MCF-7/Taxol to Taxol was 525 times higher than that of MCF-7,and the IC50 of MCF-7/Taxol stopped administrating Taxol for three months was 150 times higher than that of MCF-7.The multiplication time of MCF-7/Taxol was longer than that of the natural cell and the proportion of cells in S-phase increased while that in G1-phase decreased.The expression levels of P-gp、LRP and GST? increased,and ER and PR were not observed.The morphology of MCF-7/Taxol became larger and irregular,and the surface of natural cell was in the shape of floss,but MCF-7/Taxol was in the shape of bead.The intracellular of Taxol was observed in both MCF-7/Taxol and stoppage administrating.Conclusions MCF-7/Taxol cell subline was a typical multidrug resistant cell line which had basic characteristics of drug resistance cells.It was supposed that there was a cell subline which was tumor stem cell of MCF-7 included in this multidrug resistant cell line.