The paper reported a patient under maintained hemodialysis for 11 years, with a large mass appeared in the right thigh after local injury. The mass was clinically considered as tumoral calcinosis combined with clinical, imaging and pathological findings. Several treatments such as enhancing dialysis adequacy, low calcium dialysate, calcimimetic agent, non-calcium- phosphorus binding agents, parathyroidectomy and intravenous infusion of sodium thiosulfate could not vanish the mass. Finally, the lump was surgically removed. The treatment of tumoral calcinosis in the hemodialysis patient can provide a instruction for similar situations in clinical practice.

Objective:To explore the serotype, antibiotic resistance and β-lactamase gene of Haemophilus influenzae strains isolated from hospitalized children, thus providing reference for clinical diagnosis and treatment. Methods:A total of 148 Haemophilus influenzae strains collected from January 2016 to December 2018 in hospitalized children of Children′s Hospital, Capital Institute of Pediatrics were retrospectively analyzed.The serotype and genotype of Haemophilus influenzae strains were examined by slide agglutination test and PCR, respectively.The sensitivity of isolates to Ampicillin and other antimicrobials was detected by the E-test and disk diffusion methods.The β-lactamase phenotype was tested by nitrocefin disk method.The carrying of β-lactamase gene TEM-1 and ROB-1 were detected by PCR.The drug resistance rate was compared by χ2 test. Results:All the 148 strains were nontypeable Haemophilus influenzae (NTHi), and capsular gene was not amplified.The rate of resistance to Ampicillin, Ampicillin/Sulbactam, Cefuroxime, and Azithromycin were 68.9%(102/148 strains), 40.5%(60/148 strains), 53.4%(79/148 strains) and 56.1%(83/148 strains), respectively.The Haemophilus influenzae isolates showed the highest resistance rate to Trimethoprim-sulfamethoxazole, which was up to 91.9%(136/148 strains). The sensitive rate of isolates to Ceftriaxone, Meropenem and Levofloxacin were all 100.0%(148/148 strains). The prevalence of β-lactamase was 64.8%(96/148 strains) in Haemophilus influenzae and the genotype was TEM-1.The drug resistance rates of β-lactamase positive strains to Ampicillin, Ampicillin/Sulbactam and Azithromycin were significantly higher than those of other strains( χ2=123.222, 27.973, 70.273, all P<0.01). Conclusions:The most prevalent serotype of Haemophilus influenzae is NTHi in children. Haemophilus influenzae carried TEM-1 gene had a high positive rate of β-lactamase production, which was the main mechanism of drug resistance to Ampicillin.Ceftriaxone and Meropenem were the most active agents against Haemophilus influenzae.

The phenomenon of phase separation of intracellular biological macromolecules is an emerging research field that has received great attention in recent years. As an aggregation and compartment mechanism of cell biochemical reactions, it widely exists in nature and participates in important physiological processes such as gene transcription and regulation, as well as influences organism's response to external stimuli. Disequilibrium of phase separation may lead to the occurrence of some major diseases. Researchers in cross-cutting fields are trying to examine dementia and other related diseases from a new perspective of phase separation, exploring its molecular mechanism and the potential possibility of intervention and treatment. This review intends to introduce the latest research progress in this field, summarize the major research directions, biochemical basis, its relationship with disease occurrence, and giving a future perspective of key problems to focus on.
Animals ; Chemistry Techniques, Analytical ; trends ; Cytoplasm ; chemistry ; metabolism ; Humans ; Macromolecular Substances ; isolation & purification ; Research ; trends

To investigate the inhibitory effect of sildenafil on Caco-2 cell proliferation and its anti-inflammatory effect on menadione-induced NCM460 cell inflammation model, MTT assay was used to determine cell proliferation. Intracellular reactive oxygen species(ROS)and nitric oxide(NO)levels were detected by fluorescent probe. Western blot was used to detect the expression of eNOS/ERK/JNK pathway related proteins in Caco-2 cells and correlated inflammatory cytokines in NCM460 cells. The effect of sildenafil on the growth of two probiotics was determined by spectrophotometry. Results showed that sildenafil signi-ficantly inhibited the proliferation of Caco-2 cells and enhanced the expression levels of eNOS, p-eNOS, p-JNK1/2 and p-ERK1/2 proteins in Caco-2 cells; while after adding NG-nitro-L-arginine methyl ester(L-NAME), the expression levels of eNOS, p-eNOS, p-JNK1/2 and p-ERK1/2 proteins were significantly lower than those of the sildenafil group. Compared with the menadione group, sildenafil significantly reduced ROS levels in NCM460 cells and inhibited the expression levels of IL-6, IL-1β, p62, and TNF-α. Moreover, high concentrations of sildenafil had no obvious toxic effects on Lactobacillus casei and Lactobacillus rhamnosus. Thus, the results indicated that sildenafil could effectively inhibit the intestinal inflammatory response without affecting the balance of the intestinal flora, and prevent colorectal cancer by reducing the oxidative stress responses in the intestinal cells.

Objective: To summarize the clinical features of immunodeficiency diseases with interstitial lung disease (ILD) as major clinical manifestations and to improve understanding etiology of ILD. Methods: The clinical features and clinical clues for diagnosis of six cases with immunodeficiency presented with ILD in Shenzhen Children′s Hospital from January 2014 to December 2016 were retrospectively analyzed. Results: The patients′ age ranged from 3 months to 5 years and 9 months, 5 cases were male. All cases had cough and tachypnea, 3 cases had lung infection and respiratory failure, 2 cases had chronic hypoxia and one had clubbing. Three cases had skin rashes; 5 cases had failure to thrive. Chest CT scan showed diffuse ground glass opacity in all the 6 cases, and 2 cases had cystic changes and one had "crazy-paving" pattern. Five patients were suspected to have surfactant dysfunction and genetic testing was performed before diagnosis of immunodeficiency, of which the results were negative. With human immunodeficiency virus antibody test or immunologic laboratory testing and/or immune genetic panel, acquired immune deficiency syndrome was confirmed in one case, hyper-IgM syndrome was confirmed in two cases and hyper-IgE syndrome in one case, Wiskott-Aldrich syndrome in one and STAT3 gain of function genetic mutation in another. All cases had clinical clues indicative of underlying immunocompromise. Conclusions The clinical features of immunodeficiency diseases with ILD are cough, tachypnea or hypoxia, respiratory failure with infection, diffuse ground glass opacity in Chest CT imaging. With thorough medical history and immunology screening, there would be clinical clues indicative of underlying immunocompromise. Screening for immunodeficiency disease should be emphasized in the differential diagnosis of ILD, otherwise it may lead to misdiagnosis or unnecessary testing.

Objective:To study the effects of conservative treatment versus percutaneous interventional treatment(PCI)on symptoms and prognosis of chronic coronary syndrome patients aged over 75 years with fractional flow reserve(FFR)in the grey zone(0.75≤FFR≤0.80).Methods:A total of 96 coronary heart disease(CHD)patients aged over 75 years undergone FFR examination in our hospital from January 2011 to December 2017 were retrospectively selected.All patients showed stenosis of 50%-90% in at least one main coronary artery and had FFR values within the range of 0.75-0.80(0.75≤FFR≤0.80). According to the treatment, patients were divided into the optimized medication group(OMT group, n=35)and the PCI group(n=61). The degree of angina alleviation assessed by the Seattle Angina Questionnaire(SAQ)and the incidence of major adverse cardiovascular endpoints(death, myocardial infarction, stroke, and repeated revascularization)were recorded during the one-year follow-up after treatment.Results:There was no significant difference in baseline data including age, gender and comorbidities between the OMT and PCI groups( P>0.05). The incidence of previous myocardial infarction, and the basal level of low-density lipoprotein cholesterol(LDL-C)were higher in the PCI group than in the OMT group( P<0.05). One-year follow-up showed that there was no significant difference between the OMT and PCI groups in the score of SAQ(77.6 ± 19.5 vs. 83.1 ± 22.8, P>0.05)and the incidence of composite MACEs(11.4% or 4 / 35 vs. 9.8% or 6/61, P>0.05). However, the incidence of repeated target vessel revascularization was lower in the PCI group than in the OMT group(1.6% or 1 case vs. 5.8% or 2 cases, P<0.05). Conclusions:In elderly CHD patients aged over 75 years with FFR values between 0.75-0.8 in the grey zone, optimal medication treatment has similar effects as the PCI on symptom alleviation, and no significant increase in composite MACEs is found at one-year follow-up.

Objective To analyze the bacterial etiology and drug resistance of pathogens from the outpatients with acute infectious diarrhea in the Children's Hospital Capital Institute of Pediatrics.Methods The children with acute infectious diarrhea in the outpatient department of our hospital were randomly enrolled in the period of August 2017 to July 2018.Enteric pathogenic bacteria were cultured and isolated from the fresh stool specimens.The serum of Salmonella spp were identified while five types of diarrheagenic Escherichia coli were detected by PCR method.Antibiotic susceptibility of Salmonella spp and diarrheagenic Escherichia coli were tested by Kirby-Bauer disk diffusion method.Chi-square or Fisher exact test was done for statistical analysis.Results Of the 356 stool specimens,103 strains of 6 pathogenic bacterial species were detected.The positive rate was 27.8％ (99/356),and 2 strains were detected in four stool samples.The isolation rate of Salmonella spp,which was the highest in this study,was 10.7％ (38/356).The isolation rate of Staphylococcus aureus,diarrheagenic Escherichia coli and Pseudomonas aeruginosa were 8.4％ (30/356),5.6％ (20/356) and 3.7％ (13/356),respectively.No Shigella spp strain was isolated.Salmonella enteritidis and Salmonella typhimurium were the dominant serotype for 38 Salmonella spp stains with the isolation rate of 63.2％ (24 / 38).Each 10 Enteropathogenic Escherichia coli and 10 Enteroaggregative Escherichia coli isolates were detected among the diarrheagenic Escherichia coli.Enterohemorrhagic Escherichia coli,Enteroinvasive Escherichia coli and Enterotoxigenic Escherichia colistrain was not found in this study.The resistant rates of Salmonella spp to ampicillin and ceftriaxone were 52.6％ (20/38) and 13.2％ (5/38),while the diarrheagenic Escherichia coli were 11/20 and 1/20,respectively.Three diarrheagenic Escherichia coli isolates produced extended spectrum beta-lactamase.Conclusions Salmonella spp was the major bacterial pathogen among the outpatients with infectious diarrhea in the hospital.The study indicated that the infection ratios of Staphylococcus aureus,diarrheagenic Escherichia coli and Pseudomonas aeruginosa increased.Shigella spp was no long the main pathogenic agent.The resistant rates of Salmonella spp and diarrheagenic Escherichia coli to ampicillin were high,but low resistant rates to ceftriaxone were found among these two kinds of bacteria.The third-generation cephalosporins should be the first choice for the treatment of childhood bacterial diarrhea.

Objective To investigate the effect of the transcatheter closure of patent foramen ovale (PFO) on the treatment of migraine.Methods This prospective clinical trial enrolled 43 consecutive migraine patients with PFO from Department of Neurology,Beijing Anzhen Hospital from March 2014 to March 2015,in which PFO was diagnosed by transesophageal echocardiography (TEE) and contrast-enhanced transcranial Doppler (c-TCD).We grouped subjects according to their selection or refusal of PFO closure.Nine patients were allocated to treatment with PFO closure.Thirty-four patients were given with medical treatment and were assigned to control group.Basal clinical data,frequency of migraine,duration of migraine and scores of Headache Impact Test-6 (HIT-6) were collected.c-TCD was performed after procedure of PFO closure transthoracic echocardiography.Changes of HIT-6 scores were analyzed after closure of PFO in the follow-up period.Results Successful PFO procedure was achieved in all patients without any complications both in hospital and in follow-up period.Only one patient had residual Ⅱ-grade right-to-left shunt (RLS) tested by c-TCD.Mean scores of HIT-6 in the surgical group were reduced significantly (49.3 ± 3.6 vs 67.5 ± 4.9,t =15.129,P =0.000).There were statistically significant differences in mean reduction of HIT-6 scores in the following one year for the female (48.8 ± 3.1 vs 69.8 ± 2.6,t =15.674,P=0.002),constant RLS (47.8 ±2.1 vs 67.9 ±3.5,t =8.572,P=0.043),RLS Ⅲ (50.6±2.3 vs65.4±2.7,t=7.663,P=0.039)/RLS 1V(48.2 ±1.9 vs 68.5 ±3.9,t=8.924,P=0.028)as well as migraine with aura subgroup (47.9± 1.6 vs 68.3 ±3.8,t=13.532,P=0.001).Conclusion Our results suggest that transcatheter PFO closure is a safe and effective approach for the treatment of migraine,espeecially for female migraineur with aura and with constant serious RLS.

Objective To compare iso-osmolar iodixanol and low-osmolar iohexol for the incidence of contrast- induced nephropathy(CIN) in patients with chronic congestive heart failure undergoing coronary interventional therapy. Methods The study included 220 consecutive patients with chronic congestive heart failure and undergoing coronary angiography (CAG) with or without percutaneous coronary intervention (PCI) bewteen Janurary 2015 and May 2016. Study participants were divided into two groups by random digits table:iso-osmolar group (110 patients) and low-osmolar group (110 patients). The patients in iso-osmolar group were given iodixanol, and the patients in low-osmolar group were given iohexol. Serum creatinine (SCr), glomerular filtration rate (GFR) and cystatin C (CysC) were detected before the procedure and on the first, third day after the procedure. Then, the incidence of contrast-induced nephropathy (CIN) in two groups within 72 h of the procedure were observed and compared. Results The levels of SCr, GFR, CysC before operation had no significant differences (P>0.05). The levels of SCr in two groups on the first day after operation were increased, but there was no significant difference between two groups (P>0.05). On the first day after operation, the level of GFR in iso-osmolar group was higher than that in low-osmolar group, the level of CysC in iso-osmolar group was lower than that in low-osmolar group, and there were significant differences (P<0.05). On the third day after operation, the level of GFR in iso-osmolar group was higher than that in low-osmolar group, the level of CysC in iso-osmolar group was lower than that in low-osmolar group, and there were significant differences (P<0.01). The overall incidence of CIN was 20.9%(46/220). The incidence of CIN in low-osmolar group was 29.1%(32/110), in iso-osmolar group was 12.7%(14/110), and there was significant difference (P<0.05). Conclusions In chronic congestive heart failure patients undergoing coronary interventional therapy, the iso-osmolar contrast iodixanol is associated with a lower incidence of CIN compared with low-osmolar iohexol.

Objective To investigate the status of medication adherence of secondary prevention after acute ischemic stroke and influence on prognosis in Qingdao area , including antithrombotic drugs , lipid-lowering drugs , antihypertensive drugs and glucose-lowering drugs , to provide the basis for making medical policy.Methods We examined patients with acute cerebral infarction and transient ischemic attack in the Department of Neurology of Affiliated Hospital of Qingdao University from December 2014 to January 2016.Patients′medication status and recurrence of stroke events were registered by using telephone and clinic follow-up within six months after the patients discharged from hospital .The standard of good and bad drug adherence was as follows:good adherence was defined as proportion of days covered ( PDC) ≥80%, bad adherence was defined as PDC <80%.SPSS 19.0 statistical software was used to analyze the influence factors of medication adherence and the influence of medication adherence on prognosis .Results Finally, 444 cases (88.62%) were analyzed.A total of 352 cases (79.28%) had high medication adherence at six months after discharging from hospital .The following factors can improve the adherence of drug treatment:history of diabetes (108 cases (30.68%) in good medication adherence group , 16 cases (17.39%) in poor medication adherence group,χ2 =6.401, P=0.011), having employee health insurance (186 cases (52.84%) in good medication adherence group , 33 cases (35.87%) in poor medication adherence group ,χ2 =8.405, P=0.004), endovascular stent implantation (29 cases(8.24%) in good medication adherence group, 0 case in poor medication adherence group ,χ2 =8.109, P=0.004), staying in hospital more than 10 days ( 230 cases ( 65.34%) in good medication adherence group , 49 cases ( 53.26%) in poor medication adherence group ,χ2 =4.558, P=0.033).Six months later , the modified Rankin Scale ( mRS) score of poor medication adherence group was significantly higher than that in good adherence group ( mRS score≥3,50 cases (14.20%) in good medication adherence group , 22 cases (23.91%) in poor medication adherence group,χ2 =5.060, P=0.024) .After six months, a total of 13 cases had recurrent cerebral infarction, with two cases ( 0.57%) in good adherence group , 11 cases ( 11.96%) in poor adherence group.High medication adherence was an independent protective factor of recurrent stroke ( OR=0.042, 95%CI 0.008 -0.210, P<0.01 ) .At one, three, six months after discharging from hospital , the medication adherence of antihypertensive and glucose-lowering drugs was better than that of antiplatelet agents and lipid-lowering drugs (all P<0.05).Conclusions The persistence and adherence to secondary preventive medication in ischemic stroke patients was generally well at 6th month after discharging from hospital.History of diabetes , having employee health insurance , stent implantation and longer hospital stay are the influencing factors to high medication adherence .High medication adherence is an independent protective factor for ischemic stroke recurrence .The medication adherence of antihypertensive and glucose-lowering drugs is better than that of antithrombotic drugs and lipid-lowering drugs.