Objective:To investigate the clinical application status and safety of systemic administration of Levofloxacin.Methods:Hospitalized children treated with Levofloxacin from January 1, 2017 to December 31, 2022 in Beijing Children′s Hospital, Capital Medical University and Baoding Hospital of Beijing Children′s Hospital were retrospectively recruited.Clinical data like the gender, age, weight, discharge diagnosis, drug name, dosage, route of administration, course of treatment, pathogenic microorganisms, and adverse events were collected.Results:A total of 220 children were included.The age of Levofloxacin use ranged from 1 month and 14 days to 16 years, 7 months and 27 days.The use of Levofloxacin in children was mainly distributed in school age (70 cases), preschool age (65 cases), and early childhood (44 cases), accounting for 81.37% of all children.Children treated with Levofloxacin were admitted in a total of 13 departments, mainly included the respiratory department (77 cases), hematology department (49 cases), infectious medicine department (47 cases), pediatric intensive care unit (14 cases), and stem cell transplantation department (9 cases), accounting for 89.08% of all children.The use of Levofloxacin was mainly applied to children with pneumonia (150 cases), systemic disseminated tuberculosis (25 cases), sepsis (20 cases) and blood disease complicated with infection (16 cases). The common pathogens were Mycoplasma pneumoniae (102 cases), Klebsiella pneumoniae (14 cases), Stenotrophomonas maltophilia (14 cases), Acinetobacter baumannii complex (10 cases), Staphylococcus aureus(9 cases), and Pseudomonas aeruginosa (9 cases). The use and dosage of Levofloxacin were concerned, including insufficient single dose(25 cases), overdose(9 cases), incorrect dosing frequency (9 cases). There were 3 cases of adverse drug reaction of Levofloxacin, including 2 cases of gastrointestinal reactions (1 case of diarrhea, a single dose of 15 mg/kg, clinically cured; 1 case of nausea, clinically improved), and 1 case of rash (clinically improved). Serious adverse drug reactions were not reported. Conclusions:Levofloxacin is relatively safe for short- and medium-term use in children.It should be administered according to the correct usage and dosage.During the administration period of Levofloxacin, the gastrointestinal system, rash, liver and kidney functions, blood system, blood sugar, heart system, nervous system and other indicators should be closely concerned.

OBJECTIVES: Idiopathic intracranial hypertension (IIH) is a syndrome that excludes secondary causes such as intracranial space-occupying lesion, hydrocephalus, cerebrovascular disease, and hypoxic ischemic encephalopathy. If not be treated promptly and effectively, IIH can cause severe, permanent vision disability and intractable, disabling headache. This study aims to explore the clinical and image features for IIH, to help clinicians to understand this disease, increase the diagnose rate, and improve the outcomes of patients. METHODS: We retrospectively analyzed 15 cases of IIH that were admitted to Xiangya Hospital, Central South University, during January 2015 to September 2020. The diagnosis of IIH was based on the updated modified Dandy criteria. We analyzed clinical data of patients and did statistical analysis, including age, gender, height, weight, medical history, physical examination, auxiliary examination, treatment and outcome. RESULTS: There were 10 females and 5 males. Female patients were 22 to 42 years old with median age of 39.5. Male patients were 27 to 52 years old with the median age of 44.0. The BMI was 24.14-34.17 (28.71±2.97) kg/m CONCLUSIONS IIH primarily affects women of childbearing age who are overweight. The major hazard of IIH is the severe and permanent visual loss. Typical image signs have high specificity in IIH diagnosis. Prompt diagnosis and effective treatment are significantly important to improve the outcomes of patients.
Adult ; Anemia, Iron-Deficiency ; Female ; Humans ; Intracranial Hypertension ; Male ; Middle Aged ; Pseudotumor Cerebri/diagnostic imaging* ; Retrospective Studies ; Ventriculoperitoneal Shunt ; Young Adult

Peking Union Medical College Hospital, as one of the most stressful medical institutions in China, is facing the problem of emergency department overcrowding. In order to effectively alleviate the emergency overcrowding, improve the medical quality and patients′ medical experience, the hospital firmly grasped the two incremental links of " throughput" and " output" factors, established a multidisciplinary and multi-department cooperation team, constructed a close medical alliance cooperation mode, and innovated and explored a harmonious emergency overcrowding relief mode with the goal of unblocking the " exit" of patients. The practice showed that the comprehensive measures could effectively alleviate the problem of emergency overcrowding, and improve the medical environment and medical quality.

Objective:To investigate the status of shift nurses′ circadian rhythm, sleep quality and job burnout in 3A-level hospitals, and analyze the influence of circadian rhythm and sleep quality on job burnout, so as to provide theoretical basis for reducing the level of job burnout of shift nurses.Methods:A total of 491 shift nurses were investigated with General Information Questionnaire, Circadian Type Questionnaire(CTI-11), Pittsburgh Sleep Quality Index (PSQI) and Maslach Burnout Inventory General Survey(MBI-GS).Results:The Flexibility or Rigidity score of shift nurses was 10.64±4.14, the Languid or Vigorous score was 17.67±4.80, the PSQI score was 7.47±3.66, the MBI-GS score was 51.14±15.11. The results of multiple regression analysis showed that flexibility or rigidity, languid or vigorous, sleep quality were the influencing factors of emotional exhaustion( t value was 7.415, - 5.281, 7.153, P<0.01); flexibility or rigidity, languid or vigorous, sleep quality were the influencing factors of depersonalization ( t value was 4.828, - 4.079, 4.959, P<0.01); flexibility or rigidity was the influencing factors of professional efficacy( t value was - 3.887, P<0.01). Conclusions:The job burnout of shift nurses in Tianjin 3A-level hospitals were serious. The circadian rhythm and sleep quality are the important factors that affect the job burnout of shift nurses. According to the type of circadian rhythm and sleep quality of nurses, nursing managers can take personalized measures to reduce their level of job burnout.

Objective:To investigate the protective effect of lactoferrin(Lf) on lung injury in mice exposed to irradiation.Methods:C57BL/6 J mice were randomly divided into control group, 15 Gy irradiation group (IR group) and lactoferrin combined 15 Gy irradiation group (Lf+ IR group), with 5 mice in each group. The mice in the Lf+ 15 Gy group drank lactoferrin solution (10 mg/ml) from 3 days before irradiation and contained the whole experiments. Then, single chest 15 Gyirradiation was performed both in the IR and Lf+ IR groups. The body weight and other characteristics were monitored during the experiment. The mice were killed at day 14 after irradiation. The lung histopathology was observed by HE staining. Serum inflammatory cytokine such as HMGB1, TNF-α, IL-1β and IL-6 was determined by ELISA method . The expression of inflammatory related protein in lung tissue including HMGB1, TLR4, MyD88 and NF-κB were performed by immune histochemistry and Western blot method.Results:Compared with the control group, lung weight was significantly increased ( t=3.20, P<0.05), pulmonary hyperemia and inflammatory cell infiltration was observed in the IR group. Exposure also significantly increased serum level of TNF-α[(291.80±5.49) vs.(332.25±22.18)pg/ml]( t=3.07, P<0.05), up-regulated the expression of inflammatory related protein in lung tissue ( t=4.04, 4.78, 3.77, 6.14, P<0.05). Lactoferrin intervention (Lf+ IR group) significantly decreased lung weight ( t=2.18, P<0.05), alleviated histopathologic changes, decrease serum levels of HMGB1, TNF-α and IL-1β ( t=4.67, 2.97, 3.49, P<0.05). On the other hand, lactoferrin intervention decreased the positive cell number of HMGB1 and NF-κB, and down-regulated the protein expression of HMGB1, TLR4, MyD88 and NF-κB in lung tissues, with significant difference with the IR group ( t=8.06, 9.80, 3.07, 5.56, P<0.05). Conclusions:Lactoferrin plays the protective effect of radiation-induced lung injury through the downregulation of inflammatory response, such as HMGB1/TLR4/MyD88/NF-κB signaling pathway.

Objective:To investigate the risk factors for hemorrhagic transformation (HT) in patients with acute posterior circulation ischemic stroke (PCIS) and its impact on outcomes.Methods:From July 2016 to October 2019, patients admitted to the Department of Neurology, the People's Hospital of Zhengzhou and diagnosed as PCIS were enrolled retrospectively. Their demography, clinical data, laboratory and imaging findings were collected. HT was defined as no intracranial hemorrhage detected by the first head CT/MRI after onset, and intracranial hemorrhage was found during head CT/MRI reexamination within 10 d after onset. Symptomatic HT was defined as intracranial hemorrhage indicated by imaging reexamination and the National Institutes of Health Stroke Scale (NIHSS) score was higher than the baseline. The outcome was evaluated by the modified Rankin Scale at 3 months after onset, and >2 were defined as poor outcome. Multivariate logistic regression analysis was used to identify the independent risk factors for HT, symptomatic HT, and poor outcomes. Results:A total of 242 patients with PCIS were enrolled. Their age was 68.02±12.0 years, and 111 were females (45.9%). The baseline median NIHSS score was 5.9 (interquartile range: 3.1-8.8). HT occurred in 19 patients (7.9%), and 14 of them (73.7%) were symptomatic HT. Follow-up at 3 months showed that 74 patients (30.58%) had poor outcomes, of which 12 died. Multivariate logistic regression analysis showed that higher baseline systolic blood pressure (odds ratio [ OR] 1.076, 95% confidence interval [ CI] 1.021-1.135, P=0.006; OR 1.161, 95% CI 1.087-1.240, P<0.001) and larger infarct volume ( OR 31.293, 95% CI 4.542-215.592, P<0.001; OR 2.084, 95% CI 1.414-3.073, P<0.001) were the independent risk factors for HT and symptomatic HT. The higher NIHSS score ( OR 1.511, 95% CI 1.307-1.746; P<0.001), diabetes mellitus ( OR 2.041, 95% CI 1.054-3.952; P=0.034) and symptomatic HT ( OR 4.514, 95% CI 1.458-13.979; P=0.009) were the independent risk factors for poor outcomes. Conclusions:HT is rare in patients with PCIS. Higher baseline systolic blood pressure and larger infarct volume are the independent risk factors for HT in patients with PCIS. Higher baseline NIHSS scores, diabetes mellitus, and symptomatic HT are the independent risk factors for poor outcomes in patients with PCIS.

Objective:To investigate the influence of echinoside on the expressions of inducible nitric oxide synthase (iNOS) and transforming growth factor-β1 (TGF-β1) in renal tissues of diabetic nephropathy rats.Methods:A total of 60 male SD rats were randomly divided into the normal group, model group, glibenclamide group and low-, medium-, high-dose echinoside treatment group. the rat model of diabetic nephropathy was established through the streptozocin induction and the glibenclamide treatment was applied as control. After molding, glibenclamide group was given 5 mg/(kg?d) of glibenclamide, and low-, medium-, high-dose echinoside treatment group was given 50, 100 and 200 mg/(kg?d) of echinacoside solution. The normal group and model group were intragastrically given equal volume of normal saline. After 4 weeks, the change rate of body weight, kidney weight/body weight, blood glucose, serum TC, TG, BUN, SCR and 24 h urinary protein levels were measured, and the NO release concentration in renal tissue cell culture medium was measured, the renal pathology was observed by HE staining, the expression of iNOS and TGF-β1 proteins in renal tissues was detected by Western blotting.Results:Compared with the model group, the body weight of rats in the medium-dose group significantly increased ( P<0.05); the weight change rate and kidney weight/body weight of rat in the medium-, high-dose group significantly decreased ( P<0.05), and the NO release concentration in the medium-, high-dose group decreased ( P<0.05); the level of blood glucose, TC, TG, BUN, SCr, and 24-hour urinary protein in the low-, medium- and high-dose groups significantly decreased ( P<0.05), and iNOS in renal tissue of rats in the low-, medium- and high-dose groups was significantly lower ( P<0.05). Compared with the model group, the relative expression levels of TGF-β1 (1.35 ± 0.06, 1.15 ± 0.05, 0.91 ± 0.04 vs. 4.58 ± 0.09) and TGF-β1 (1.24 ± 0.04, 1.41 ± 0.05, 0.89 ± 0.04 vs. 3.04 ± 0.05) in the low-, medium- and high-dose groups significantly decreased ( P<0.05). Conclusions:The echinoside can prevent weight loss, reduce blood glucose and triglyceride, inhibit the production of NO in renal tissues, reduce the expression of iNOS and TGF-β1 among diabetic nephropathy rats. It has been proved to play a protective role in diabetic nephropathy pathological tissues.

Objective:To investigate the effect of water-fat separation (Dixon) and spectrally selective attenuated inversion recovery (SPAIR) on fat suppression in the neck.Methods:From June to December 2018, 35 patients, including 16 males and 19 females, aged 23-75 (46±13) years old underwent MRI examinations of cervical vertebrae in Sir Run Run Hospital Affiliated to Nanjing Medical University. The imaging data of Dixon and SPAIR fat suppression scanning were prospectively collected. The scanning sequences included Dixon VIBE-T 1WI, SPAIR VIBE-T 1WI, Dixon TSE-T 2WI and SPAIR TSE-T 2WI. According to the subjective evaluation, the quality of fat suppression was divided into 0-4 grades. The cases with clear depiction of the thyroid tissue on Dixon or SPAIR were counted. Fisher exact test and paired t test or rank sum test were used to compare the noise, SNR and CNR of mandible angle, glottis, thyroid and sternoclavicular joint. Results:There were 29 cases of grade 0, 4 cases of grade 1, 2 cases of grade 2 on Dixon VIBE-T 1WI, 4 cases of grade 3 and 31 cases of grade 4 on SPAIR VIBE-T 1WI group, and the difference was statistically significant ( P<0.05); 28 cases of grade 0, 5 cases of grade 1 and 2 cases of grade 2 on Dixon TSE-T 2WI, 33 cases of grade 3 and 4 on SPAIR TSE-T 2WI, and the difference was statistically significant ( P<0.05). There were 35 cases with clear depiction of the thyroid tissues on DIXON and 4 cases on SPAIR VIBE-T 1WI ( P<0.05); there were 35 cases on DIXON and 3 cases on SPAIR TSE-T 2WI ( P<0.05). At the level of mandible angle, for the SNR of sternocleidomastoid muscle, SNR and CNR of splenius capitis muscle on VIBE-T 1WI, Dixon images were better than those on SPAIR images, and the difference was statistically significant ( P<0.05); the noise, SNR of sternocleidomastoid and splenius capitis muscle on TSE-T 2WI images were more than those in SPAIR images, and the difference was statistically significant ( P<0.05). At the level of glottis, the SNR of sternocleidomastoid muscle and levator scapulae muscle in the sequence of VIBE-T 1WI and Dixon images were significantly higher than those on the images of SPAIR ( P<0.05); the noise and SNR of sternocleidomastoid muscle on Dixon TSE-T 2WI images were significantly higher than those on the images of SPAIR ( P<0.05). At the thyroid level, the noise of Dixon VIBE-T 1WI image was less than that of SPAIR image, the SNR of sternocleidomastoid muscle and levator scapulae muscle on Dixon images was greater than that of SPAIR image, and the difference was statistically significant ( P<0.05); For TSE-T 2WI sequence, the SNR of sternocleidomastoid muscle on Dixon image was greater than that on SPAIR image, and the difference was statistically significant ( P<0.05). At the level of sternoclavicular joint, there were no significant differences for noise, SNR and CNR between the two groups ( P>0.05). Conclusion:Dixon outperforms SPAIR in obtaining better image quality and suppression effect in terms of neck MRI scanning.

Exosomes are spherical microvesicles(30-100 nm)secreted by a variety of cells and contain a variety of proteins, lipids, mRNAs, and microRNAs.These molecules into exosomes can be transferred to adjacent cells and distant tissues or cells by exosomes to develop full effects.Exosomes-released microRNAs are involved in the pathogenesis of Alzheimer's disease(AD)by regulating the abnormal expression of amyloid β-protein(Aβ)and p-Tau protein, initiating the inflammatory response by interacting with toll-like receptors.In addition, exosomal microRNAs can be used as a potential therapeutic target for AD.Exosomes as good carriers have great research values.This review summarized the literatures related to the role of exosomal microRNAs in the development of AD and the potential therapeutic effect on AD.A large amount of evidence indicates that expression disorder of exosomal microRNA plays an important role in the pathogenesis of AD and can be used as a new potential biomarker and therapeutic target for the diagnosis and treatment of AD.

Objective: To investigate the effects of scleral crosslinking using genipin on ocular biological parameters and scleral biomechanics of form-deprivation myopia rabbits. Methods: Sixty healthy New Zealand rabbits of 14 days old were collected.The right eyes were selected as experimental eye.The rabbits were randomly divided into three groups: control group with no treatment; myopia model group with eyelid suture procedure performed on the right eye; genipin injection group with eyelid suture procedure performed on the right eye combined with subconjunctival injection of genipin.The suture was removed 60 days after the eyelid suture procedure.The diopter, length of vitreous cavity, and axial length were measured.The sclera at 1: 00 and 7: 00 position of the experimental eye was used to make a scleral strip.The thickness, elastic modulus, creep rate, ultimate stress and ultimate strain of the sclera were measured.This study was approved by the animal experimental Ethics Committee of Bethune International Peace Hospital (2018-ky-09). Results: The diopters of genipin injection group, myopia model group and control group were (2.50±1.38), (0.33±0.52) and (2.08±0.52)D, respectively, the axial lengths of the three groups were (15.33±0.82), (15.83±0.41) and (15.00±0.43)mm, respectively; the changes in vitreous cavity lengths were (1.50±0.79), (2.59±0.83) and (1.48±0.66)mm, respectively; and the ratios of vitreous cavity length to axial length were 0.46±0.02, 0.51±0.02 and 0.47±0.02, respectively.The diopter in myopia model group was significantly lower than those in control group and genipin injection group, the axial length in myopia model group was significantly longer than that in control group, the change in vitreous cavity lengths and ratio of vitreous cavity length to axial length in myopia model group were significantly higher than those in control group and genipin injection group, the axial length in myopia model group was significantly longer than that in control group, the differences were statistically significant (all at P<0.05). The elasticity modulus was (9.10±3.12)MPa and ultimate stress was (1.42±0.57)MPa in genipin injection group, which were significantly higher than (6.98±3.30)MPa and (1.15±0.57)MPa in control group, and (6.25±3.17)MPa and (0.82±0.38)MPa in myopia model group (all at P<0.05). The ultimate strain was (20.99±5.60)% in genipin injection group, which was significantly lower than (25.08±6.35)% in control group and (27.78±8.20)% in myopia model group, with significant differences between them (both at P<0.05). Conclusions Posterior sub-Tenon capsule injection of genipin for collagen crosslinking in the sclera increases the biomechanical strength of sclera and effectively prevents the development of form-deprivation myopia in rabbits, which provides a new idea for the prevention and treatment of myopia in the future.