Objective To explore the effect of Rhubarb ultrasonic electrical conduction target penetration therapy on the gastrointestinal function of sepsis patients.Methods A total of 88 cases of inpatient sepsis patients diagnosed and treated at the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from October 2021 to June 2023 were selected as the participants and the patients were divided into the treatment group and the control group by a simple random method.Both groups were given routine treatments such as anti-infection,fluid resuscitation,nutritional support,blood sugar management,and prevention of stress ulcers,while the treatment group was treated with ultrasonic conductance target penetration Rhubarb therapy at Shenque point and Zhongwan point on the basis of the control group.The main observational indexes were the number of bowel sounds in the two groups before treatment and after 3 days,and 7 days of treatment.The secondary observational indexes were gastric retention,serum C-reactive protein(CRP),procalcitonin(PCT),acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ),the first defecation time,time to mechanical ventilation,length of stay in the intensive care unit(ICU),hospitalization cost,and 28 days readmission rate of the two groups.The gastric retention was evaluated and recorded every 4 hours before treatment and 3 days and 7 days after treatment,CRP and APACHE Ⅱ score were evaluated before treatment and 7 days after treatment,the 28-day readmission was followed up by telephone.Results A total of 44 cases in the treatment group and 43 cases in the control group completed the intervention.The difference between the bowel sounds and the amount of gastric retention of the two groups was not statistically significant before treatment,with the prolongation of time,the bowel sounds of the two groups gradually increased and the amount of gastric retention gradually decreased,and the number of bowel sounds in the treatment group increased significantly compared to the control group 3 days and 7 days after treatment[beats/minute:4.49(4.23,4.74)vs.3.07(2.80,3.33)3rd day of and 4.79(4.49,5.10)vs.3.36(3.06,3.66)on the 7th day of treatment,both P<0.01],and the amount of gastric retention was significantly reduced compared with the control group[mL:20.93(9.22,32.64)vs.53.52(41.16,65.88)for 3rd day of and 3.72(0.17,7.28)vs.31.59(24.87,38.31)on the 7th day of treatment,both P<0.01].The first defecation time was significantly shorter in the treatment group than in the control group(hours:25.67±9.99 vs.33.64±11.30,P<0.01).After 7 days treatment,the CRP,PCT,and APACHE Ⅱ score were significantly reduced in the treatment group compared to those in the control group[CRP(mg/L):45.97(35.68,56.26)vs.77.30(57.20,97.38),PCT(μg/L):0.94(0.56,1.31)vs.2.73(1.36,4.09),APACHE Ⅱ score:24.11±7.01 vs.28.06±9.25,all P<0.05],the mechanical ventilation time and ICU length of stay were significantly shortened[mechanical ventilation time(hours):107.05±70.76 vs.168.83±136.62,ICU stay time(days):7.58±3.72 vs.9.70±5.15,both P<0.05],the hospitalization cost and 28-day readmission rate were significantly reduced[hospitalization cost(yuan):80337.89±36483.72 vs.109100.24±87080.84,28-day readmission rate:9.1％(4/44)vs.27.9％(12/43),both P<0.05].Conclusion Rhubarb ultrasonic conductive target penetration therapy is a safe,simple,and effective characteristic therapy of external Chinese medicine that can provide a new basis for the protection of gastrointestinal function in patients with sepsis.

OBJECTIVE To identify Ginseng Flos and their confounds by using the high-throughput sequencing technology, and to verify the accuracy of high-throughput sequencing technology in species identification by using ITS2 sequencing technology. METHODS High-throughput sequencing was performed on the amplified products of Ginseng Flos adulterated samples, use cutadapt, PEAR, PRINSEQ, Usearch, RDP classifier, SINTAX software to obtain operational taxonomic unit(OUT) sequences, remove fungi, unclassified and other non-green plant sequences. To avoid false positives, delete OTU sequences with a sequence number <100 or base numbers <200 bp. The ITS2 amplification products of Ginseng Flos, Quinquefolii Flos, and Notoginseng Flos were sequenced. To verify the accuracy of high-throughput sequencing technology for species identification, MEGA 11.0 was used to construct neighbor joining system cluster tree, genetic distance, interspecific information loci and Blast analysis of ITS2 and OTU base sequences of Ginseng Flos, Quinquefolii Flos, and Notoginseng Flos. RESULTS A total of 54 653 valid sequences were obtained by high-throughput sequencing, the serial numbers of Ginseng Flos, Quinquefolii Flos, and Notoginseng Flos were OTU1, OTU2, OTU3, respectively, and the corresponding effective sequences were 31 325, 857 and 442, respectively. By performing a Blast search of ITS2 and OTU base sequences of each species, each species was supported. The genetic distance between Ginseng Flos and Quinquefolii Flos and Notoginseng Flos was 0.010 and 0.033, respectively. Ginseng Flos and Quinquefolii Flos, Notoginseng Flos had 2 and 7 information sites, respectively. The neighbor join system cluster tree showed that the species were clustered independently into one branch, with Ginseng Flos, and Quinquefolii Flos clustered as a large branch and juxtaposed with Notoginseng Flos. Ginseng Flos was the same as Quinquefolii Flos secondary structure, but with Notoginseng Flos there were three different positions but there were A, B and C differences between arm Ⅳ and arm Ⅰ of Notoginseng Flos. CONCLUSION The high-throughput sequencing technology can accurately identify Ginseng Flos, Quinquefolii Flos and Notoginseng Flos, and has a strong ability to identify adulterated samples, which provides a certain idea for the identification of commercial Ginseng Flos.

Objective:To analyze the pathogen of 3 pediatric cases of scrub typhus without the eschar using metagenomics next-generation sequencing (mNGS), and the clinical application value of mNGS.Methods:Clinical data of 3 pediatric cases of severe scrub typhus without the eschar in the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University from June 2018 to October 2019 were analyzed retrospectively.Among them, 2 cases were 5-year-old males and 1 case was 6-year-old female.Peripheral blood samples of 3 children were detected via mNGS technology.Results:Through mNGS detection, all 3 children were diagnosed with Orientia tsutsugamushi infection and were not complicated with other pathogenic infections.Case 1 died, and case 2 and case 3 were cured.Conclusions:Early diagnosis of scrub typhus without the eschar is difficult.Clinical infectious diseases, especially complicated and critical infectious diseases are difficult to be diagnosed at an early stage, mNGS can provide fast and accurate pathogenic diagnosis support for precise treatment.

【Objective】 To evaluate the safety and effectiveness of Perioperative Transfusion Trigger Score (POTTS) in guiding surgical patients blood transfusion intraoperatively and postoperatively. 【Methods】 A total of 900 patients(perioperative Hb 60~100 g/L) from December 2017 to March 2021 were collected, including 251 males and 649 females, with ASA grading Ⅰ~Ⅳ, and randomly divided into experimental group and controls. In the experimental group, the allogeneic RBC transfusion trigger(Hb threshold) and transfusion units in anemia patients was determined by POTTS. While those in the controls were decided by physicians according to current guidelines concerning transfusion. The proportion and units of allogeneic RBC transfusion, the incidence of postoperative complications, the mortality of hospitalization and discharge for 4 weeks, Hb value, healing of surgical incision, ICU admission rate and ICU length of stay, length of hospitalization, etc were recorded. 【Results】 The proportion of allogeneic RBC transfusion in the experimental group(35.3%)were less than the controls(42.2%)(P<0.05). The units of allogeneic RBC transfused, incidence of postoperative complications and mortality in hospital and 4 weeks after surgery, healing of surgical incision (grade A/ grade B/ grade C), the Hb level 24 h after surgery and at discharge, the ICU admission rate and ICU length of stay, length of hospitalization were not significantly different between the groups. 【Conclusion】 The peri-operative allogeneic red blood cells transfusion guided by POTTS can reduce the proportion of allogeneic RBC transfusion, and is safe and effective.

The regulator of expression of virion(Rev)protein binds specifically to the Rev-responsive element(RRE)RNA in order to regulate the expression of the human immunodeficiency virus(HIV)-1 genes.Fluores-cence indicator displacement assays have been used to identify ligands that can inhibit the Rev-RRE interaction;however,the small fluorescence indicators cannot fully replace the Rev peptide or protein.As a result,a single rhodamine B labeled Rev(RB-Rev)model peptide was utilized in this study to develop a direct and efficient Rev-RRE inhibitor screening model.Due to photon-induced electron transfer quenching of the tryptophan residue on the RB fluorophore,the fluorescence of RB in Rev was weakened and could be dramatically reactivated by interaction with RRE RNA in ammonium acetate buffer(approximately six times).The interaction could reduce the electron transfer between tryptophan and RB,and RRE could also increase RB fluorescence.The inhibitor screening model was evaluated using three known positive Rev-RRE inhibitors,namely,proflavin,6-chloro-9-[3-(2-chloroethylamino)pro-pylamino]-2-methoxyacridine(ICR 191),and neomycin,as well as a negative drug,arginine.With the addition of the positive drugs,the fluorescence of the Rev-RRE decreased,indicating the displacement of RB-Rev.This was confirmed using atomic force microscopy(AFM)and the fluorescence was essentially unaffected by the addition of arginine.The results demonstrated that RB-Rev can be used as a fluorescent probe for recognizing small ligands that target RRE RNA.The Rev-RRE inhibitor screening model offers a novel approach to evaluating and identifying long-acting Rev inhibitors.

Objective:To explore the application value of bacterial culture and antibody detection of pertussis in children.Methods:A total of 262 children diagnosed with pertussis at the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University from January 2018 to January 2020 were collected as the research objects.Bacterial culture and serum antibody test for pertussis were performed in all cases.According to the gender, age, course of the disease, and whether the children were vaccinated with pertussis vaccine, the patients were divided into different groups and we compared the detection results of different groups.Results:The high incidence age of pertussis was less than 1 year old, mainly less than 6 months old(62.2%). The positive rate of bacterial culture was 82.4%, and the highest positive rate was found in the group of ≤6 months old (94.5%). The positive rate of bacterial culture decreased with the increase of age and course of disease, and the positive rate of children without pertussis vaccination was higher than children with pertussis vaccination( P<0.001). The positive rate of pertussis antibody test was 23.3%.The positive rate of antibody test increased with the increase of age and course of disease and the positive rate of children without pertussis vaccination was lower than children with pertussis vaccination( P<0.001). Conclusion:The high incidence age of pertussis is mainly less than 6 months old.Bacterial culture of pertussis has a good diagnostic value in the early stage of the course, and enzyme linked immunosorbent assay is more helpful in the late stage of the disease.

Objective To analyze the changes in follicular helper T (Tfh) cells during HIV-1 in-fection, to investigate the influences of Tfh cells and Tfh-related molecules on HIV-1 progression and to pro-vide references for further research on using Tfh cells in highly active antiretroviral therapy ( HAART) and vaccines. Methods This study enrolled 33 patients with HIV-1 infection, including 11 long-term nonpro-gressors (LTNP), 10 rapid progressors (RP) and 12 typical progressors (TP), and 11 healthy subjects (normal controls, NC). Peripheral blood mononuclear cells were isolated from each subject. Multicolor flow cytometry was performed to detect CD4+CD45RA-CXCR5+Tfh and CD4+CD45RA-CXCR3-CXCR5+PD-1+Tfh subsets and the levels of inducible costimulatory molecule (ICOS), IFN-γ and IL-21. Moreover, the levels of IL-10 and the percentages of CD19+B cells in plasma samples of each group were also analyzed. Relationships among Tfh, CD4 and B cells were analyzed. Results The percentages of both Tfh subsets were higher in patients with HIV-1 infection than in NC. Compared with NC, LTNP had the highest percent-age of CD4+CD45RA-CXCR3-CXCR5+PD-1+Tfh cells (P<0. 05). Expression of Tfh-related molecules ICOS, IFN-γ and IL-21 were enhanced significantly upon Staphylococcus enterotoxin B ( SEB) stimulation, ICOS+Tfh cells were negatively related with HIV-1 progression, but had a positive correlation with CD19+B cells (r=-0. 49, P<0. 01; r=0. 60, P<0. 05). IL-10 level in plasma increased significantly in patients withHIV-1 infection , especially in TP and RP ( TP vs NC : P＜0. 01 ; RP vs NC : P<0. 05 ) . Conclusion HIV-1 patients and NC had significant differences in the expression of Tfh cells and Tfh-related molecules in peripheral blood. ICOS+Tfh cells were closely related to the progression of HIV-1 infection and the function of B cells.

Objective To investigate the effect of coupled plasma filtration adsorption (CPFA) on plasma cytokines:TNF-α,IL-1β,IL-6,cellular immunity,blood lactate acid concentration,heart rate,respiration rate,oxygenation index,hemodynamics,blood cells counts,and prognosis in patients with multiple organ dysfunction syndromes (MODS).Methods This was a prospective,randomized clinical trial in 45 patients diagnosed as MODS.Patients were randomly assigned to hemoperfution with resin adsorption (HP) + continuous venous-venous hemofiltration (CVVH) group,CPFA group and CVVH group.The general clinical data,APACHE Ⅱ score,number of failure organ and previous mentioned biomarkers were documented.Blood samples were collected before and after blood filtration with any one of these procedures.The plasma samples were isolated and stored with frozen at-60 ℃.Data were statistically analyzed with SPSS 13.0 version software.Results In CPFA group,plasma cytokines,TNF-α、IL-1β、IL-6,decreased markedly after plasma adsorption for two hours (P ＜ 0.01);and plasma concentrations of IL-6 were further descended after subsequent CVVH for 10 hours (P ＜ 0.05).In HP + CVVH group,plasma cytokines,TNF-α、IL-1β、IL-6,decreased markedly after HP (P ＜ 0.01),and plasma concentrations of IL-6 were further descended after subsequent CVVH for 10 hours (P ＜ 0.05).In CVVH group,plasma cytokines,TNF-α、IL-1β、IL-6,decreased after CVVH for 12 hours (P ＜ O.05).Blood lactate acid concentration,heart rate,respiration rate,oxygenation index,T-lymphocytes subgroups (CD3 +,CD4 +,CD8 +,CD4 +/CD8 + ratio),clinical symptoms were improved and dose of vasoactive agent was reduced in the patients of three groups without differences among them.The counts of red blood cells,white blood cells and platelets after CPFA and CVVH showed no significant changes.There was no significant difference in blood cell counts between CPFA and CVVH groups.After HP + CVVH,there was a trend of decrease in platelet count (P ＜ 0.05).Platelet counts were significanfly higher in patients treated with CPFA and CVVH group than those in patients treated with HP + CVVH group (P ＜ 0.05).There were 6 patients died in HP + CVVH group,6 patients died in CPFA group and 5 patients died in CVVH group within 28days.Conclusions The comparison of efficacy of blood filtration among 3 modalities of HP + CVVH,CPFA and CVVH showed CPFA had higher capacity of Inflammatory medium scavenging than CVVH,and had less damage effect on blood visible component,especially on platelet compared with HP + CVVH.CPFA was an effective and safety modality in the treatment of the patients with multiple organ dysfunction syndrome.

Objective: To investigate the effect of cannabinoid receptor-2 (CB2) agonist AM1241 on the mRNA and protein expression of platelet-derived growth factor (PDGF) and collagen-III (Col-III) in the liver tissue of mice with experimental liver fibrosis induced by carbon tetrachloride (CCl₄). Methods: Totally 38 8-week-old male C57BL/6J mice were randomly divided into control group, model group, 3 mg/kg CB2 receptor agonist (AM1241) group, and 9 mg/kg AM1241 group. All mice, except for the control group, were treated with 30% CCl₄ (three times a week, 5 ml/kg body weight, 16 weeks) to establish a liver fibrosis model. Meanwhile, 3 and 9 mg/kg AM1421 was intraperitoneally injected for daily intervention, respectively. The dosage was adjusted according to actual body weight. The same solvent was given in the control group. The serum level of aspartate aminotransferase (AST) was measured by serum enzyme digestion. The liver inflammation and fibrosis were observed by HE staining of tissue slices. The mRNA and protein expression of PDGF and Col-III in hepatic tissue was determined by real-time PCR and immunohistochemistry. Results: Compared with the control group, the mice in model group showed severe liver fibrosis, significantly elevated serum AST level (742 ± 300.8 U/L vs 118.1 ± 31.1 U/L, P < 0.05), and significantly increased mRNA and protein expression of PDGF and Col-III in liver tissue (P < 0.05). Compared with the model group, the mice in 3 mg/kg AM1241 group and 9 mg/kg AM1241 group had less severe liver fibrosis, and significantly reduced serum AST levels (116.6 ± 13.68 U/L vs 742 ± 300.8 U/L, P < 0.05; 113.8 ± 16.01 U/L vs 742 ± 300.8 U/L, P < 0.05) and mRNA and protein expression of PDGF and Col-III in liver tissue (P < 0.05). Conclusion CB2 receptor agonist AM1241 can inhibit the mRNA and protein expression of PDGF in the liver tissue of mice with hepatic fibrosis, and reduce extracellular matrix synthesis.

Objective: To evaluate the usefulness of retroauricular hairline incision (RAHI) in partial superficial parotidectomy (PSP) by comparison with modified Blair incision (MBI). Methods: A retrospective analysis of 64 medical records for patients with benign parotid tumors who underwent partial superficial parotidectomy was undertaken (28 were in MBI group, 36 in RAHI group). Size and location of tumors, operative time, occurrence of facial nerve paralysis and Frey′s syndrome, and cosmetic outcomes were compared between RAHI and MBI groups. Results: Compared with MBI group, RAHI group showed better cosmetic results for benign parotid tumors in mean satisfaction score(P<0.001). There were no significant differences in size and location of tumors, operative time, incidence of transient or permanent facial nerve paralysis and Frey′s syndrome between two groups (P>0.05). Conclusions Partial superficial parotidectomy can be performed safely via RAHI in most cases of benign parotid tumors. Compared with MBI, RAHI for benign parotid tumorscan improve the cosmetic outcome, without increasing the operative time or operative morbidity.