Objective:To analyze the epidemiological and clinical features of patients with visceral leishmaniasis (VL), and to improve the understanding of the disease and standardize the diagnosis and treatment.Methods:The clinical data and diagnosis and treatment process of 62 patients with VL admitted to The First Hospital of Lanzhou University from January 2010 to December 2020 were retrospectively analyzed. The clinical symptoms and laboratory data, including aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and procalcitonin (PCT) were compared between children and adults. Chi-square test was used for statistical analysis.Results:Of the 62 patients, 31(50.0%) patients were males, 38(61.3%) patients were children and 24(38.7%) were adults. There were 32 cases (51.6%) living in Longnan City, and 11 cases (17.7%) living in Gannan Tibetan Autonomous Prefecture. Forty-seven cases (75.8%) had a delay over 30 days from onset to diagnosis. All patients had fever and chills, 34 cases (54.8%) had fatigue and poor appetite, 30(48.4%) had cough and expectoration, 10 cases (16.1%) had headache and dizziness, 45 cases (72.6%) had splenomegaly, 40 cases (64.5%) had anemia, and 29 cases (46.8%) had hepatomegaly. There were 32 cases (51.6%) accompanied with respiratory infection, 11 cases (17.7%) accompanied with hemophagocytic lymphohistiocytosis and 10 cases (16.1%) accompanied with abnormal liver function. Of the 60 patients who received treatment, 14 were recurrent cases who had received at least one course of pentavalent antimony monotherapy before admission. Forty-six patients received standard antimony monotherapy, 14 patients received standard antimony combined with amphotericin B therapy. Thirteen patients discontinued amphotericin B due to impaired renal function, and 50 patients were followed up for half a year without recurrence. The proportions of splenomegaly and hepatomegaly in children were 86.8%(33/38) and 65.8%(25/38), respectively, and the corresponding numbers in adults were 50.0%(12/24) and 16.7%(4/24), respectively. The differences were statistically significant ( χ2=10.03 and 14.26, respectively, both P<0.050). Thirty-three cases (86.8%) in children and 14 cases (58.3%) in adults had a delay over 30 days from onset to diagnosis. The difference was statistically significant ( χ2=6.52, P=0.011). The proportions of patients who had elevated AST, LDH and PCT were 76.3%(29/38), 94.3%(33/35) and 73.9%(17/23) in children, respectively, while 45.8%(11/24), 71.4%(15/21) and 5/17 in adults, respectively, and the differences were all statistically significant ( χ2=5.97, 3.89 and 7.82, respectively, all P<0.050). Conclusions:Patients with VL are tend to have complications and be severe. Early diagnosis and standardized treatment are important measures to improve the prognosis. Patients who have failed antimony treatment can be treated with amphotericin B or combination therapy, but kidney injury and other adverse reactions should be closely monitored.

Objective:To explore the correlation between the serum 25-(OH)D 3, adiponectin (APN), and chemerin levels of pregnant women with gestational diabetes mellitus (GDM) and insulin resistance. Methods:28 pregnant women with GDM were selected for the study group from May 2020 to December 2021, and 45 pregnant women with normal glucose tolerance were selected for the control group. 25-(OH)D 3, APN, chemerin, islet resistance index (HOMA-IR), fasting blood glucose, fasting insulin, and HbA1c were compared between the two groups. The correlation between 25-(OH)D 3, APN, chemerin, and GDM insulin resistance was analyzed. Results:Fasting blood glucose, fasting insulin, HOMA-IR, and chemerin in the GDM group were higher than those in the control group (all P<0.05), while 25-(OH)D 3 and APN were lower than those in the control group (all P<0.05). There was no statistical difference in HbA1c between the two groups. Logistic regression analysis showed that serum 25-(OH)D 3, APN, and chemerin were all related influencing factors of GDM (all P<0.05). Spearman's correlation analysis showed that serum 25-(OH)D 3 was negatively correlated with fasting blood glucose and HOMA-IR (all P<0.05), chemerin was positively correlated with fasting insulin and HOMA-IR (all P<0.05). ROC curve analysis showed that the AUC of 25-(OH)D 3 was 0.841 (95% CI: 0.746~0.967). AUC of APN was 0.678 (95% CI: 0.545~0.812). AUC of chemerin AUC was 0.360 (95% CI: 0.233~0.487). Conclusions:The levels of 25-(OH)D 3, APN, and chemerin have a certain correlation with the pathogenesis of GDM, which has a certain reference value for the prediction of GDM.

Objective To evaluate the efficacy and safety of TurboHawk plaque resection system in the treatment of lower extremity arteriosclerosis obliterans.Methods Clinical data of 36 patients with atherosclerotic occlusion of lower extremity treated with TurboHawk from January 2016 to August 2017 were retrospectively collected.The characteristics of lesion,improvement of symptoms,ankle brachial index (ABI) and postoperative complications were analyzed.The measurement data were expressed as ((x) ± s),All patients were reviewed every 3 months after operation,followed up for 3-18 months,with an average of (9 ± 0.5) months.And the ABI comparison before and after treatment were performed by paired t test;the counting data were expressed as rate (％),and the comparison of different stages was performed by chi-square test.Results In 36 patients,the technical success rate was 100％,and the symptoms of lower limbs were significantly improved.The ABI (0.85 ±0.07) and ABI (0.75 ±0.10) were significantly better in 3 days and in 3 months after operation than before operation (0.29 ±0.10)(t =37.76,P ＜0.001).Postoperative complications occurred in 2 cases,in one case,the artery dissection was covered with a bare scaffold,and in the other case,the blood vessel was ruptured after resection,and was closured by using balloon angioplasty.Conclusion TurboHawk plaque resection system is an effective,less traumatic and safer option for the treatment of lower extremity arteriosclerosis obliterans.

PURPOSE: There is increasing epidemiological evidence of an association between childhood obesity and atopic dermatitis, but little is known about the underlying mechanism(s). In the present study, we used a rat model of atopic dermatitis to assess whether juvenile obesity, induced by reduction of litter size, aggravated the signs of atopic dermatitis and, if so, whether this aggravation was associated with changes in plasma concentration of adipokines, such as leptin and adiponectin. METHODS: Dermatitis was induced by neonatal capsaicin treatment. Body weight, dermatitis score, serum IgE, skin nerve growth factor (NGF), serum leptin and adiponectin, and cytokine mRNA expression in the skin lesion were compared between small (SL, 5 pups) and large litters (LL, 15 pups). RESULTS: The body weight of juvenile rats up to 6 weeks of age was significantly heavier in the SL group, compared with those in the LL group. The SL group showed more robust development of dermatitis, and higher levels of serum IgE and skin NGF than the LL group. Additionally, the SL group demonstrated higher levels of leptin and pro-inflammatory cytokine mRNA but lower levels of adiponectin than the LL group. CONCLUSIONS: These results suggest a causal link between a decrease in immunological tolerance, induced by juvenile obesity, and aggravation of atopic dermatitis.
Adipokines ; Adiponectin ; Animals ; Body Weight ; Capsaicin ; Dermatitis ; Dermatitis, Atopic* ; Immunoglobulin E ; Leptin ; Litter Size ; Models, Animal* ; Nerve Growth Factor ; Obesity* ; Pediatric Obesity ; Plasma ; Rats ; RNA, Messenger ; Skin

BACKGROUND:Many domestic and foreign scholars and institutions are studying how to relieve radiation damage and to find the most suitable drug, while ginsenosides as the main pharmacological ingredient of ginseng show significant antioxidant effect. OBJECTIVE:To investigate the ease effect of ginsenosides on human hematopoietic stem cels under different intensities of ionizing radiations. METHODS: The CD34+ hematopoietic stem cels were isolated from the healthy cord blood. Then the cels were divided into normal group and ginsenoside-pretreated group, respectively, exposed under 1, 2, 5 Gy of X-ray irradiations for 24 hours. Cel viability was detected in irradiated hematopoietic stem cels by MTT assay. Apoptosis was estimated using the folowing assays: Annexin-V assay, caspase-3 mRNA and protein levels. The generation of reactive oxygen species was evaluated, in the presence or absence of ginsenoside in liquid cultures of CD34+ human hematopoietic stem cels irradiated with 1-, 2- and 5-Gy X-rays, using a flow cytometry assay. The Nrf-2 mRNA and protein levels were also studied by western blot analysis and RT-PCR, respectively. RESULTS AND CONCLUSION: Ionizing radiation at the therapeutic dose could decrease the viability of CD34+ cels and induce the cel apoptosis, and meanwhile, the activity of intracelular reactive oxygen species also showed a progressive increase that was correlated with the dose of ionizing radiation. However, ginsenoside pretreatment could relieve these above-mentioned effects. Ginsenoside inhibited the increase in caspase-3 activity induced by ionizing radiation, and additionaly, enhanced the mRNA and protein expressions of Nrf-2 in CD34+cels. In conclusion, ginsenoside protects CD34+ hematopoietic stem cels from radiation effects, which is probably correlated with anti-apoptosis and anti-oxidant roles of ginsenosides.

OBJECTIVETo explore the effect and safety of topical propranolol hydrochloride gel for treatment of infantile hemangioma. METHODS Thirty nude mice (BALA/c, nu/nu) were divided into three groups, experimental group, control group and normal group. Human hemangioma endothelial cells cultured in vitro were injected subcutaneously in experimental group and control group to establish infantile hemangioma model. Topical propranolol hydrochloride gel was applied on the surface of the hemangioman in experimental group and normal group. Tumor volumn change and the skin situations (edema, erythema, ulceration) were observed at different periods. 45 days after cell injection, the mice were killed and plasma concentration was detected in the experimental group and the control group by high performance liquid chromatography with evaporative light scattering detector, and tumors were subjected to histopathologic examination and immunohistochemistry for CD31 and CD34. The correlation between volumes and plasma concentration was statistically analyzed with SPSS 13.0 paired samples t test with α = 0.05 as statistical standard.

RESULTSAt 45 days, the volume of the tumor in control group was (366.57 ± 17.08) mm³, which has a significant difference as compared to the experimental group (13.36 ± 2.09) mm³ (P < 0.05); and the plasma concentration was (16.83 ± 1.53) ng/ml in experimental group, and (18.42 ± 2.21) ng/ ml in normal group (P > 0.05 ). Topical propranolol hydrochloride gel (3%) has no irritation to nude mice's skin.

CONCLUSIONSTopical application of 3% propranolol hydrochloride gel is effective and safe for the treatment of infantile hemangioma.

Animals ; Gels ; administration & dosage ; Hemangioma ; drug therapy ; pathology ; Humans ; Immunohistochemistry ; Mice ; Mice, Nude ; Propranolol ; administration & dosage ; Skin Neoplasms ; drug therapy ; pathology ; Tumor Burden ; drug effects

Objective To evaluate the ability of Vitek 2 Compact YST identification cards and pyrosequencing analysis for identifying the clinical isolates of yeast-like fungi.Methods Vitek 2 Compact YST identification cams and ITS1 region pyrosequencing analysis were used to identify the clinical isolates of yeast-like fungi at Jinan Military General Hospital in 2011.The strains which could not be identified to species by pyrosequencing analysis were identified again by the method of ITS1 region Sanger sequencing.The strains with inconsistent identified results by YST and pyrosequencing were identified again using API 20C.Results A total of 282 srtains were isolated from various clinical specimens for culturing in 2011.In addition to the three which could only be identified to similar species,other strains could be clearly identified to species by the method of ITS1 reverse pyrosequencing.Three strains which failed identified to species by pyrosequencing couldn't be distinguished fully by the method of Sanger sequencing.There were 7 strains unidentified,14 strains low discrimination(％ id ＜ 80％),and 6 strains misidentification using YST cams.The identification coincidence rate was 90.4％.The identification coincidence rates were various in different species of yeast-like fungi using YST cards.Conclusions The vast majority of clinical isolates of yeast-like fungi could be identified by ITS1 reverse pyrosequencing analysis.Vitek 2 Compact YST caRD basically meets the needs.But attention should be paid to the standard operating and regular internal quality control.For some rare species it is also needed to combine the source of specimen,colonies and characteristics to determine the identification results for the rare stains.

Objective To compare the efficacy of patient-controlled epidural analgesia (PCEA) with different concentrations of sufentanil plus levobupivacaine after caesarean section.Methods Ninety ASA Ⅰ or Ⅱ nulliparous patients who were at full term with a singleton fetus,aged 22-35 yr,weighing 60-85 kg,undergoing elective caesarean section under combined spinal-epidural anesthesia,were randomly divided into 3 groups (n =30each):0.125％ levobupivacaine plus sufentanil 0.4,0.6 and 0.8μg/ml groups (groups Ⅰ,Ⅱ and Ⅲ).The patients received 48 h of PCEA after operation.PCEA pump was set up with a background infusion of 2 ml/h,and a bolus dose of 2 ml with a lockout-interval of 15 min after a loading dose of 5 ml.VAS score was used to assess the intensity of pain (0 =no pain,10 =worst pain).VAS score ≤ 3 was considered as effective analgesia.VAS score ≥4 was considered as failure of analgesia,and the rescue analgesic was given.Venous blood samples were taken before operation and at 24 and 48 h after operation to detect the serum prolactin (PRL) concentration using radioimmunoassay.The degree of motor block of lower extremities was assessed and scored using modified Bromage scale.Maternal colostrum time,the number of attempts,and adverse effects including nausea and vomiting,pruritus,somnolence,respiratory depression,bradycardia,hypotension and urinary retention were recorded after operation.Results Compared with group Ⅰ,the number of attempts and rate of failure of analgesia were significantly decreased,the maternal colostrum time was shortened,and the serum PRL concentration at 24 and 48 h after operation was significantly increased in groups Ⅱ and Ⅲ,and the incidences of adverse effects such as nausea,vomiting and bradycardia were increased in group Ⅲ (P ＜ 0.05).Compared with group Ⅱ,no significant change was found in the number of attempts,rate of failure of analgesia,maternal colostrum time,and serum PRL concentration at 24 and 48 h after operation (P ＞ 0.05),and the incidences of adverse effects such as nausea,vomiting and bradycardia were increased in group Ⅲ (P ＜ 0.05).There was no significant difference in the modified Bromage scores among the three groups (P ＞ 0.05).Conclusion When sufentanil plus 0.125 ％ levobupivacaine are used for PCEA,the recommonded concentration of sufentanil is 0.6 μg/ml.

Because of hardness to heal and easiness to recurrence,chronic ulcer of lower limp has become one of the hardest diseases in clinic,which brings physical and mental pain to the patients.Although medical technology develops rapidly,to find a simple,effective and economic method is still the focus.Here,progress and current situation of treatment were summarized for chronic ulcer of lower limp.

The clinical efficacy and safety of topical propranolol hydrochloride gel in the treatment of superficial infantile hemangiomas (IHs) were assessed. Fifty-one cases of IHs from Oct. 2010 to Sept. 2011 were subjected to the topical propranolol hydrochloride gel intervention in Fuzhou General Hospital of Nanjing Military Commands, China. Changes in size, texture, color, peak systolic velocity of the hemangiomas, resistance index and adverse effects were observed. The results were evaluated by using Achauer system, and responses of IHs to pranpronolol were considered scale II (poor) in 4 patients (17.24%), scale II (moderate) in 18 patients (24.14%), scale III (good) in 22 patients (44.83%) and scale IV (excellent) in 7 patients (13.79%). The response of superficial hemangiomas was significantly better than other hemangiomas (P<0.05), and no differences in response were found among different primary sites (P>0.05). Our study indicates that topical application of 3% propranolol hydrochloride gel is effective and safe in treating IHs.
Female ; Gels ; administration & dosage ; Hemangioma ; drug therapy ; Humans ; Infant ; Infant, Newborn ; Male ; Propranolol ; administration & dosage