Influence of perioperative oral nutritional supplementation on short-term efficacy of laparos-copic sleeve gastrectomy for obesity patients: a prospective study / 中华消化外科杂志

Objective:To investigate the influence of perioperative oral nutritional supple-mentation on short-term efficacy of laparoscopic sleeve gastrectomy (LSG) for obesity patients.Methods:The prospective study was conducted. The clinical data of 218 obesity patients who underwent LSG in the General Hospital of Ningxia Medical University from January 2018 to December 2021 were selected. Patients receiving perioperative oral nutritional supplementation were allocated into the experiment group, and patients receiving perioperative conventional treatment were allo-cated into the control group, respectively. Observation indicators: (1) grouping situations of the enrolled patients; (2) postoperative situations and follow-up; (3) nutrition related indicators; (4) dietary compliance; (5) weight loss related indicators. Follow-up was conducted using telephone interview, WeChat communication and outpatient examination to detect albumin (ALB), hemoglobin (HB), dietary compliance and weight loss related indicators of patients up to February 2022. Patients were followed up once every 30 days after discharge. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the indepen-dent sample t test. Measurement data with skewed distribution were represented as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers or percentages, and comparison between groups was performed using the chi-square test. Repeated measurement data were analyzed using the repeated ANOVA. Comparison of ordinal data was analyzed using the rank sum test. Results:(1) Grouping situations of the enrolled patients. A total of 218 patients were selected for eligibility. There were 42 males and 176 females, aged (32±9)years with body mass index (BMI) as (39±7)kg/m 2. Of the 218 patients, there were 109 patients in the experiment group and 109 patients in the control group. Gender(male, female), age, BMI, preoperative albumin (Alb), preoperative hemoglobin (Hb) were 17, 92, (33±9)years, (39±7)kg/m 2, (40.6±4.8)g/L, (141.7±13.9)g/L in the experiment group, versus 25, 84, (31±8)years, (39±8)kg/m 2, (40.9±4.2)g/L, (142.9±9.7)g/L in the control group, showing no signifi-cant difference in the above indicators between the two groups ( χ2=1.89, t=?1.52, 0.51, 0.40, 0.71, P>0.05). (2) Postoperative situations and follow-up. The duration of initial hospital stay, the cost of initial hospital stay were (9.1±2.9)days, (3.6±0.5)ten thousand yuan in the experiment group, versus(11.6±3.7)days, (4.9±1.0)ten thousand yuan in the control group,showing significant differences in the above indicators between the two groups ( t=5.58, 12.38, P<0.05). Of the 218 patients,119 patients were followed up,including 62 patients in the experiment group and 57 patients in the control group,with the follow up time as 31.0(range, 25.0?38.0)days. Of the 218 patients, 14 cases were read-mitted for postoperative complications. There were 2 cases in the experiment group including 1 case with nausea and vomiting and 1 case with ileus, and there were 12 cases in the control group including 10 cases with nausea and vomiting and 2 cases with gastric fistula. There was a significant difference in the readmission between the two groups ( χ2=7.63, P<0.05). The interval between readmission and initial discharge of the 14 patients was(22.0±6.7)days. (3) Nutrition related indica-tors. The Alb and Hb of the 62 patients being followed up in the experiment group were (40.4±5.5)g/L, (35.9±3.8)g/L, (45.4±2.9)g/L and (140.8±13.9)g/L, (130.5±16.9)g/L, (147.8±17.2)g/L before opera-tion, before the first discharge and one month after operation, respectively. The above indicators of the 57 patients being followed up in the control group were (41.2±3.9)g/L, (34.2±3.9)g/L, (42.7±5.3)g/L and (143.0±9.7)g/L, (122.9±12.8)g/L, (139.0±11.4)g/L before operation, before the first discharge and one month after operation, respectively. There were significant differences in change trends of Alb and Hb before operation to one month after operation between the two groups ( Fgroup=4.27, 5.72, P<0.05). There were significant differences in Alb and Hb before operation to one month after operation between the two groups ( Ftime=187.46, 85.13, P<0.05). There were interaction effects in change trends of Alb and Hb before operation to one month after operation between the two groups ( Finteraction=7.25, 9.13, P<0.05). Results of individual effect shown that there was no significant difference in the intervention effect of Alb and Hb before operation between the two groups ( t=?0.90, ?0.99, P>0.05), and there were significant differences in the intervention effect of Alb and Hb before the first discharge and one month after operation ( t=2.45, 3.34, 2.75, 3.34, P<0.05). (4) Dietary compliance. Cases with dietary complete compliance, partial compliance, non-compliance of the 62 patients being followed up in the experiment group were 28, 19, 15, respectively. The above indicators of the 57 patients being followed up in the control group were 17, 16, 24, respectively. There was a signifi-cant difference in the dietary compliance between the two groups ( Z=?2.14, P<0.05). (5) Weight loss related indicators. The body mass, body fat mass, skeletal muscle mass, body fat ratio, waist hip fat ratio, visceral fat area of the 62 patients being followed up in the experiment group were (111.0±23.0)kg, (50.0±15.0)kg, (34.0±7.0)kg, 45%±6%, 0.99±0.08, (178±53)cm 2, respectively, before opera-tion. The above indicators of the 57 patients being followed up in the control group were (108.0±22.0)kg, (49.0±13.0)kg, (33.0±7.0)kg, 45%±5%, 0.98±0.09, (174±51)cm 2, respectively, before opera-tion. There was no significant difference in the above indicators between the two groups ( t=?0.71, ?0.48, ?1.04, 0.70, ?0.80, ?0.46, P>0.05). The body mass loss, body fat mass loss, skeletal muscle mass loss, body fat ratio loss, waist hip fat ratio loss, visceral fat area loss of the 62 patients being followed up in the experiment group were 13.8(range, 11.8?16.5)kg, 7.5(range, 6.3?10.1)kg, 3.4(range, 2.5?4.6)kg, 2.05%(range, 1.19%?3.21%), 0.04(range, 0.03?0.06), 31.5(range, 24.4?41.0)cm 2, respectively, one month after operation. The above indicators of the 57 patients being followed up in the control group were 10.8(range, 8.5?13.1)kg, 5.9(range, 4.8?8.0)kg, 4.0(range, 3.0?5.2)kg, 2.0%(range, 0.75%?3.20%), 0.04(range, 0.03?0.05), 29.1(range, 21.8?37.9)cm 2, respectively, one month after operation. There were significant differences in the body mass loss and body fat mass loss between the two groups ( Z=?4.99, ?3.54, P<0.05), and there was no significant difference in skeletal muscle mass loss, body fat ratio loss, waist hip fat ratio loss, visceral fat area loss between the two groups ( P>0.05). Conclusion:Perioperative supplement of oral nutritional can reduce the incidence of post-operative complications and readmission and enhance the postoperative nutritional status and short-term efficacy of obesity patients undergoing LSG.

Genetic Analysis and Prenatal Diagnosis of a Family with Hereditary Spherocytosis Caused by a Novel Compound Heterozygous Mutation of SPTB Gene / 中国实验血液学杂志

OBJECTIVE@#To investigate the clinical and genetic characteristics of a family with hereditary spherocytosis (HS), to clarify the cause of the disease, and to provide the basis for genetic counseling and prenatal diagnosis.@*METHODS@#The clinical data of proband and his parents were collected, and HS-related pathogenic genovariation of the proband was detected by high throughput sequencing. Suspected pathogenic mutation sites were verified by PCR-Sanger sequencing, and the fetus were conceived by a proband mother underwent prenatal diagnosis.@*RESULTS@#Clinical manifestations of the proband showed moderate anemia, mild splenomegaly, and jaundice (an indirect increase of bilirubin). The gene detection showed that the proband showed compound heterozygous mutations of SPTB gene c. 6095T > C (p.Leu2032Pro) and c. 6224A > G (p.Glu2075Gly), which was inherited from the asymptomatic mother and father, respectively. Both mutations were detected rarely in the common population. Prenatal diagnosis revealed that the fetus inherited a mutant gene of the mother.@*CONCLUSION@#The compound heterozygous mutations of SPTB genes c.6095T>C (p.Leu2032Pro) and c.6224A>G (p.Glu2075Gly) were the causes of the family disease, which provides a basis for family genetic counseling and prenatal diagnosis. This report is the first one found in the HGMD,1000G and EXAC database, which provides an addition to the mutation profile of the SPTB gene.

Effects of sleeve gastrectomy on body composition and glucose and lipid metabolism in early postoperative patients / 中华临床营养杂志

Objective:To observe early postoperative changes in body composition in patients receiving laparoscopic sleeve gastrectomy (LSG) and to explore the relationship between body composition and glycolipid metabolism, so as to provide stage-specific information for doctors in the weight loss team on metabolic surgery effect assessment and postoperative follow-up and guidance.Methods:The study was a retrospective cohort study. According to inclusion and exclusion criteria, a total of 44 patients who underwent LSG in the Department of Gastrointestinal Surgery, General Hospital of Ningxia Medical University from December 1, 2017 to May 30, 2021 were included. Body composition was measured using bio-electrical impedance analysis at baseline and after surgery.Results:The patients' body composition changed significantly at 1 month and 3 months after surgery, and glucose and lipid metabolism indicators improved significantly. Body composition indicators, including body mass index (BMI), the amount of moisture in the body, inorganic salts, body fat, skeletal muscle mass, fat free mass, body fat percentage, waist-to-hip fat ratio, visceral fat, basal metabolic rate and bone mineral content, decreased significantly within 3 months after surgery ( P<0.05). The ratio of upper and lower limb muscle to body weight (U/W, L/W) increased significantly after surgery ( P<0.05). The ratio of trunk muscle to body weight (T/W) decreased within 3 months after surgery ( P<0.05). Pearson and Spearman correlation analyses showed that skeletal muscle mass and U/W were positively correlated with triglyceride ( r=0.637 and 0.304, respectively, both P<0.05) in 3 months after operation. L/W was positively correlated with fasting blood glucose ( r=0.454, P<0.05). T/W was negatively correlated with triglyceride ( r=-0.643, P<0.05). Conclusions:Patients undergoing LSG displayed significant changes in body composition in the early postoperative period. Changes in muscle mass of different body parts varies and showed different effects on glucose and lipid metabolism parameters. The trunk muscle mass is negatively correlated with glucose and lipid metabolism indicators, while limb muscle mass and skeletal muscle mass are positively. It is suggested that the changes of body composition in different parts should be observed when evaluating patient outcomes after LSG and the trunk body mass should be preserved as far as possible.

Effect of Ulinastatin on T-cytoimmunity in patients with infetility undergoing laparoscopic surgery / 实用医学杂志

Objective To research the effect of ulinastatin on T-cytoimmunity in patients with infertility undergoing laparoscopic surgery. Methods Forty patients scheduled for receiving laparoscopic surgery were equally randomized into two groups, ulinastatin group (Group U) and control group (Group C). Ulinastatin was given to patients in the Group U at a dose of 20 × 104 U before anesthetic. No ulinastatin was given to patients in the Group C. Patients′venous blood samples for T-lymphocyte subset (CD3+,CD3+CD4+,CD3+CD8+) and CD3+CD4+/ CD3+CD8+ ratio calculation were collected before the surgery (T0) and at 0 h (T1),1st day (T2),3rd day (T3) after the surgery. Results CD3+ had less difference at T1~3 compared with T0 in the Group C but raised obviously at T2~3 in the Group U. CD3+CD4+ were only raised at T3 compared with T0 but raised obviously at T2~3 in the Group U. CD3+CD8+ were raised obviously at T2~3 compared with T0 in the Group C but had less difference in the Group U. CD3+CD4+/CD3+CD8+ had less difference at T1~3 compared with T0 in the Group C but raised obviously at T3 in the Group U. Conclusion The application of ulinastatin in laparoscopic surgery could significantly produce protective effect on T-cytoimmunity.

Advances in the research of anti-CD20 therapeutic monoclonal antibodies / 药学学报

As targeted drugs to B-cell malignancies, anti-CD20 monoclonal antibodies have been proved to be important in therapeutic antibody field. With three generations in more than ten years' development, the structures of these drugs have been improved, and many new indications have been found. Nowadays, these kinds of antibodies are not only used in the treatment of lymphoid malignancies, but also been proved to be useful in some autoimmune diseases treatment, and their new indications are still being expanded. With the optimization of their clinical dosage regimens, drug reaction has been increased, thus, therapeutic and side effects of anti-CD20 monoclonal antibody have been further improved as well. However, the exact mechanism of action of their combination therapy with other chemical drugs is still unclear, which remains to be further studied. This article reviewed new development of anti-CD20 therapeutic monoclonal antibodies research in recent years.

Effects of ligustrazine injection on IL-2, IL-10, and IFN-gamma in patients undergoing spinal operation after autologous blood transfusion / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the regulatory effect of Ligustrazine Injection (LI) on the cellular immune function in patients undergoing autologous blood transfusion (ABT).</p><p><b>METHODS</b>Enrolled were 60 patients scheduled for receiving selective lumbar surgery at the Department of Spinal Orthopedics, First Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine during October 2009 to June 2010. They were equally randomized into two groups, the trial group and the control group. LI was given to patients in the trial group by intravenous dripping at the dose of 2 mg/kg 30 min before autologous blood collection. The LI (at the final concentration of 0.005%) was added in the heparin saline solution and the washing saline for recycle blood. No LI was given to patients in the control group. They received the same treatment of the trial group. The operation time, the amount of blood loss and blood transfusion were recorded. Patients' venous blood samples were collected for determining cytokines including interleukin-2 (IL-2), interleukin-10 (IL-10), interferon-gamma (IFN-gamma) by ELISA and calculating IL-2/IL-10 ratio before surgery (T1), 1 h (T2), 1 day (T3), and 5 days (T4) after ABT.</p><p><b>RESULTS</b>There was no statistical difference in the amount of blood loss and blood transfusion, the levels of IL-2, IL-10, IFN-gamma, or IL-2/IL-10 at T1 between the two groups (P>0.05). Compared with T1 of the same group, the level of IL-2 decreased at T(2-4), IL-10 increased and IL-2/IL-10 decreased at T(2-3) in the two groups. The level of IFN-gamma decreased at T(2-4), IL-2/IL-10 increased at T4, the level of IL-10 decreased at T4 in the control group (P<0.05, P<0.01). The level of IL-10 decreased at T4 in the trial group with statistical difference (P<0.05, P<0.01). Compared with the control group, the level of IL-2, IFN-gamma, and IL-2/IL-10 at T(2-4) were obviously higher in the trial group. But the IL-10 level was lower in the trial group than in the control group at T(2-4) (P<0.05, P<0.01).</p><p><b>CONCLUSION</b>The application of LI in ABT had regulatory effects on the balance of cytokines.</p>

Magnetic activated cell sorting and its application in the studies of male infertility / 中华男科学杂志

Magnetic activated cell sorting (MACS) is considered as a flexible, fast, specific and simple cell sorting system that can separate target cells effectively according to specific markers on the cell surface, for which it has won a wide clinical application. MACS offers a new platform for male infertility research, as well as a novel idea for applying this technology in the optimization of semen quality and the isolation of germ cells. This article briefly introduces the basic principles of MACS, and summaries its present and potential clinical application in male infertility research, as in spermatozoa selection and cryopreservation, and the isolation of spermatogonial stem cells and germ cells.

Molecular characteristics of methicillin resistant Staphylococcus aureus isolated from Chinese children / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the molecular characteristics of methicillin-resistant Staphylococcus aureus (MRSA) isolates from Chinese children in seven cities.</p><p><b>METHOD</b>A total of 134 MRSA isolates were collected from nine hospitals. Multilocus sequence typing and spa typing were analyzed by polymerase chain reaction (PCR), and staphylococcal chromosomal cassette mec (SCCmec) type was analyzed by multiplex PCR. The Panton-Valentine leukocidin (pvl) gene was also detected.</p><p><b>RESULT</b>Most MRSA strains were isolated from pneumonia and skin and soft tissue infection (SSTIs) patients, accounting for 82.1%. Overall, 16 sequence types (STs) were obtained, and CC59 (51.7%) was found to be the most prevalent, which included ST 59 and ST 338, followed by ST239 (16.4%). SCCmec types II, III, IV, and V were also identified in the current study. SCCmec type IV was the most predominant type at 50.0%, followed by SCCmec type V at 23.9% and III at 23.9%. SCCmec subtypes IVa, IVc, and IVg were found among SCCmec type IV strains, whereas IVa was the main subtype at 77.6%. Twenty-six spa types were also identified, among which the predominant type was t437 (47.8%). The prevalence of pvl genes and the SCCmec type of strain was relevant, and the pvl gene positive rate was higher in SCCmec type IV and V-type strains than in SCCmec type II and III strains (58.6% vs. 14.3%, P < 0.05); there was a significant difference between them. In the strains isolated from pneumonia and SSTIs, ST59-MRSA-IVa(t437) was the predominant clone. There were five clones detected from the strains isolated from septicemia, with ST59-MRSA-IVa(t437) and ST59-MRSA-V(t437) as the main clones (57.1%). Various predominant clones existed in different regions. ST59-MRSA-IVa(t437) was the prevalent clone in the Guangzhou, Beijing, Chongqing, and Shenzhen areas, whereas ST239-MRSA-III(t037) was the prevalent clone in the Shanghai area. Fifty percent of the isolates from the Wenzhou area belonged to ST910-MRSA-V(t318), whereas three clinical strains isolated from the Shenyang region belonged to three different types.</p><p><b>CONCLUSION</b>The results indicate that MRSA isolates from Chinese children are largely associated with the ST59-MRSA-IV(t437) and ST239-MRSA-III(t037) clones. These two may belong to community-acquired MRSA and hospital-acquired ones, respectively. Different prevalent clones were detected in different diseases and different regions. Therefore, there is a need to conduct further research on clinical isolates, which can guide the choice of antibiotic treatment and the examination of MRSA prevalence.</p>

Effect of ligustrazine on T-lymphocyte immunity in patients undergoing autologous blood transfusion / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the protective effect of ligustrazine on T-lymphocyte immunity of patients undergoing autologous blood transfusion (ABT).</p><p><b>METHODS</b>Forty American Society of Anesthesiologist (ASA) I - II patients scheduled for receiving selective lumbar surgery, with pre-operational anticipatory blood loss > 400 mL and without any diseases of blood or endocrinal system were enrolled. They were equally randomized into two groups, the trial group and the control group. Ligustrazine was given to patients in the trial group by intravenous dripping at the dose of 2 mg/kg, 30 min before auto-blood collection, also by mixed in the washing saline and heparinized saline solution to make the final concentration of ligustrazine 0.005%. No ligustrazine was given to patients in the control group. The amount of blood loss and autotransfused were measured and recorded; and patients' venous blood samples for T-lymphocyte subsets (CD3, CD4, CD8) determination and CD4/CD8 ratio calculation were collected at different time points, i. e. before surgery (T0) and at 1 h (T1), 1st day (T2) and 5th day (T3) after ABT.</p><p><b>RESULTS</b>CD3 decreased obviously at T1 and T2 in both groups (P < 0.05 or P < 0.01), while at T3, it restored to baseline in the trial group, but remained at the low level in the control group (P < 0.05). Moreover, levels of CD3 at T1-T3 were lower in the control group than those in the trial group respectively (P < 0.05 or P < 0.01). CD4 decreased obviously at T1 (P < 0.01) in both groups, it recovered at T2 in the trial group, but the recovering in the control group was T3, so comparison of CD4 level between groups showed significant difference at T1 and T2 (P < 0.05 or P < 0.01). As for CD4/CD8 ratio, it decreased obviously at T2 and T3 in the control group (P < 0.05), but unchanged in the trial group, showing statistical difference between groups (P < 0.05).</p><p><b>CONCLUSION</b>Ligustrazine had definite protective effect on T-lymphocyte immunity in patients undergoing ABT, which was presented by the milder inhibition and quicker recovery of immunity.</p>

Observation on therapeutic effect of acupoint sticking at Neiguan (PC 6) and Xinshu (BL 15) for treatment of bradycardia / 中国针灸

<p><b>OBJECTIVE</b>To observe the therapeutic effect of acupoint sticking of Wuzhuyu (Evodia Rutaecarpa) for treatment of bradycardia.</p><p><b>METHODS</b>Sixty cases were randomly divided into an observation group and a control group, 30 cases in each group. The observation group was treated with acupoint sticking of Wuzhugu (Evodia Rutaecarpa) at Neiguan (PC 6) and Xinshu (BL 15) once each day. The control group was treated with oral administration of Xinbao pills, 3 pills each time, thrice each day. The therapeutic effects and changes of 24 hours' holter were observed after 4 weeks.</p><p><b>RESULTS</b>After treatment, 24 hours' average heart rate was significantly improved in the two groups, with significant differences as compared with those before treatment (both P<0.01) and with no significant difference between the two groups (P>0.05). The total effective rate was 86.7% (26/30) in the observation group and 83.3% (25/30) in the control group, their therapeutic effect being similar.</p><p><b>CONCLUSION</b>Acupoint sticking of Wuzhugu (Evodia Rutaecarpa) can significantly raise the levels of 24 hours' average heart rate in the patients of bradycardia. This therapy and Xinbao pills have similar therapeutic effect on the improvement of clinical symptom and heart rate levels.</p>

Investigation of campylobacter jejuni infection in children with diarrhea in Guangzhou / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the incidence of campylobacter jejuni (CJ) infection and the drug resistance of CJ in children with diarrhea in Guangzhou.</p><p><b>METHODS</b>The fecal samples of 3,351 children with diarrhea between July 2005 and June 2008 were collected for CJ culture. The species of CJ strains were identified by Lior methods. The drug susceptibility tests were performed by the Kirby-Bauer method.</p><p><b>RESULTS</b>Two hundred and sixty-seven CJ strains (8.0%) were isolated from 3,351 samples. The children at age of 1 month to 1 year were susceptible to CJ, accounting for 91.0%. A higher incidence of CJ infection (76.8%) was found in summer and autumn. The CJ strains were susceptible to imipenem, amikacin, cefoperazone/sulbactam, chloramphenicol, macrolides and lincomycins. Parts of CJ strains (20%-40%) were resistant to ampicillin, quinolones and ambramycin. All CJ strains were resistant to sulfamethoxazole/trimethoprim and cefditoren. Two hundred and one strains (75.3%) were CJ biotype I.</p><p><b>CONCLUSIONS</b>CJ is an important pathogen of diarrhea in children from Guangzhou. CJ is resistant to some antibiotics used often in clinical practice, and so it is thus important to use antibiotics based on the results of drug susceptibility tests in children with CJ infection.</p>

Distribution and antibiotic resistance of pathogens isolated from children with infectious diarrhea in Guangzhou / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the distribution and antibiotic resistance of the isolated pathogens from children with infectious diarrhea in Guangzhou.</p><p><b>METHODS</b>The fecal samples of 2 409 children with infectious diarrhea between January 2006 and December 2007 were collected and cultured. Pathogenic bacterium were isolated and identified by biochemical and serological methods. The antibiotic susceptibilities were tested by the Kirby-Bauer method.</p><p><b>RESULTS</b>A total of 448 isolates of pathogenic bacterium (18.6%) were obtained, including Shigella (n=159), enteropathogenic Escherichia coli (n=141), Salmonella (n=76), Vibrion (n=11), fungus (n=41), and C jejuni (n=20). All of isolates of the three major pathogenic bacterium, Shigella, enteropathogenic Escherichia coli and Salmonella, were susceptible to imipenem and less than 10% of the isolates were resistant to the third generation cephalosporins and beta-lactamase inhibitors. However, the isolates showed a high resistance to ampicillin and sulfamethoxazole/trimethoprim (>75%).</p><p><b>CONCLUSIONS</b>Shigella, enteropathogenic Escherichia coli and Salmonella were major pathogenic bacterium of diarrhea in children from Guangzhou. The major isolates were susceptible to imipenem, the third generation cephalosporins and beta -lactamase inhibitors, but were resistant to ampicillin and sulfamethoxazole/trimethoprim.</p>

Cloning and sequence analysis of UreB of Helicobacter pylori isolated from children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To clone UreB gene of Helicobacter pylori (H. pylori) isolated from children to pGEX-4T-1 expression plasmid, and do sequence analysis.</p><p><b>METHODS</b>A pair of specific primer was designed according to H. pylori UreB gene in the GenBank. Using H. pylori strains isolated from children as a template, a UreB gene was obtained by PCR. After EcoR I and Not I digestion, the PCR production was linked with pGEX-4T-1 which was digested with the same enzymes. The recombinant plasmid was transformed into E.coli BL21 and identified by double enzyme digestion and sequence analysis. The sequence results were compared with the gene sequence in the GenBank.</p><p><b>RESULTS</b>A UreB gene was successfully amplified from children's H. pylori strain GZCH1. It was 1710 bp in size. The objective band was identified by double enzyme digestion. DNA sequence showed that UreB was in the correct open reading frame. The sequence comparison analysis showed that DNA and amino acid sequence identities of UreB gene with other strains were 98%. The sequence of UreB of H. pylori strain GZCH1 was submitted to GenBank (accession number:FJ455126).</p><p><b>CONCLUSIONS</b>UreB of H. pylori strain GZCH1 is successfully cloned to pGEX-4T-1, which provides a basis for research of oral H. pylori vaccine.</p>

Antimicrobial resistance and penicillin resistance-associated genes of Streptococcus pneumoniae isolated from children with respiratory tract infection / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the antimicrobial resistance and penicillin resistance-associated genes (TEM and pbp2B) of Streptococcus pneumoniae (S. pneumoniae) isolated from sputum specimens of Guangzhou children with respiratory tract infection.</p><p><b>METHODS</b>E-test and Kirby-Bauer methods were applied to detect the antibiotic susceptibility of 44 strains of S. pneumoniae. PCR was used to detect resistance genes pbp2B and TEM, followed by DNA sequence analysis of pbp2B gene. The sequence results were compared to those of penicillin-susceptible S. pneumoniae R6.</p><p><b>RESULTS</b>Of the 44 isolates of S. pneumoniae, only 5 (11.4%) were susceptible to penicillin. All strains were resistant to erythromycin but susceptible to ofloxacin and vancomycin. The resistance rate of the isolates to clindamycin and trimoxazole was more than 90%. The S. pneumoniae isolates showed a high susceptibility to amoxicillin, imipenem and ceftriaxone, with a resistance rate of 0, 2.6% and 3.9%, respectively. The sequence analysis showed that more than 99% nucleotide sequence of pbp2B gene of five penicillin-susceptible isolates was the same as penicillin-susceptible S. pneumoniae R6, without any amino acid replacement. Site mutation was found in the remaining 39 penicillin-nonsusceptible isolates with a nucleotide mutation rate ranging from 13.2% to 23.1% and amino acid replacement rate from 6.5% to 10.9%. The 39 penicillin-nonsusceptible isolates were classified into 4 types according to the mutation site between Ser391 and Thr492 of pbp2B: type I (n=30), type II (n=7), type III (n=1) and type IV (n=1). No TEM gene was detected in all the 44 S. pneumoniae isolates.</p><p><b>CONCLUSIONS</b>The S.pneumoniae isolates from Guangzhou children with respiratory tract infection are resistant to penicillin and erythromycin. Amoxicillin and the third generation cephalosporin may be recommended for treating S. pneumoniae infection. The mutation of pbp2B gene plays an important role in the development of S. pneumoniae resistance to penicillin.</p>

Surveillance of antibiotic resistance of Streptococcus pneumoniae isolated from hospitalized patients with pneumonia in four children's hospitals in China / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the antimicrobial resistance of Streptococcus pneumoniae (S.pneumoniae) isolated from Chinese children with pneumonia.</p><p><b>METHODS</b>Hypopharyngeal aspirate specimens were collected from hospitalized children with pneumonia who were admitted to the children's hospital located in Beijing, Shanghai, Guangzhou or Shanghai from February 16, 2006 to February 16, 2007. The minimum inhibitory concentration (MIC) of S.pneumoniae isolates against penicillin, amoxicillin, cefuroxime (sodium), ceftriaxone, erythromycin, vancomycin, ofloxacin and imipenem was determined by E-test method.</p><p><b>RESULTS</b>A total of 279 S.pneumoniae isolates were obtained. Eighty-six percent of the isolates were not susceptive to penicillin, and 23.3% was resistant to penicillin. The rate of susceptibility of the isolates to amoxicillin was 92.1%, and to cefuroxime and ceftriaxone was 19.0% and 75.3%, respectively. The isolates also showed a high susceptibility to vancomycin (99.6%) and ofloxacin (97.8%). Seventeen point six percent of the isolates were not susceptive to imipenem, and most of those were intermediate. Almost of all isolates were resistant to erythromycin. There were some distinct regional differences in the susceptibility to antimicrobials tested except for erythromycin, vancomycin and ofloxacin.</p><p><b>CONCLUSIONS</b>The S.pneumoniae isolates from Chinese children with pneumonia were susceptive to amoxicillin, vancomycin and ofloxacin, but were not susceptive or resistant to penicillin, cefuroxime and erythromycin. The isolates kept susceptibility to ceftriaxone and imipenem to a certain extent.</p>

Diagnostic value of ischemia-modified albumin in patients with acute coronary syndrome / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the diagnostic value of ischemia-modified albumin (IMA) for patients with acute coronary syndrome (ACS).</p><p><b>METHODS</b>We detected the IMA levels by albumin cobalt-binding (ACB) test and observed its dynamic changes in 492 patients with ACS, 74 patients with high blood pressure, 78 patients with viral myocarditis (VMC), 395 patients with acute chest pain (133 patients with acute ACS and 262 follow-up patients due to chest pain), 68 patients underwent percutaneous coronary intervention (PCI) and 830 healthy controls. Cardiac troponin I (cTnI) levels were assayed and electrocardiogram (ECG) recorded in patients with ACS.</p><p><b>RESULTS</b>The optimal diagnostic cutoff point for IMA in this study population was found to be 0.45 ABSU by ROC analysis. The IMA level (ABSU) in ACS group (0.55 +/- 0.11) was significantly higher than that in VMC group (0.38 +/- 0.11) and IMA levels in ACS and VMC groups were both higher than that in control and high blood pressure groups (0.34 +/- 0.08 and 0.35 +/- 0.08, all P < 0.05). IMA levels and the positive rates in patients with ACS were significantly higher (0.54 +/- 0.12 vs 0.44 +/- 0.12, 77.4% vs 39.3%, all P < 0.01) than those in chest pain follow-up group. In 133 patients with ACS, positive rate for IMA was significantly higher than that for cTnI within 1 h of admission (82.0% vs 40.6%, P < 0.01), and was similar at 6 - 24 h after admission (96.2% vs. 95.5%, P > 0.05). In 72 patients presenting to the emergency center within 3 h of acute chest pain and with negative cTnI, positive rate for IMA was 86.1% and for ECG 72.2%, the sensitivity for ACS diagnosis rised to 93.1% with both methods. The IMA leve was higher immediately after PCI than that before PCI (P < 0.05). IMA levels peaked 1d after hospitalization, then decreased gradually and returned to normal 14 days later.</p><p><b>CONCLUSIONS</b>IMA was a useful biochemical marker for the early diagnosis of ACS.</p>

Surveillance of antimicrobial susceptibility of Streptococcus pneumoniae and Hemophilus influenzae isolated from children in Guangzhou area between 2003 and 2004 / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the situation of antibiotic resistance of Streptococcus pneumoniae (Sp) and Hemophilus influenzae (Hi) clinical isolates from children in Guangzhou area.</p><p><b>METHODS</b>The authors cultured, isolated and identified the Sp and Hi strains from nasopharyngeal secretion of patients who visited Guangzhou Children's Hospital for upper respiratory tract infection between 2003 and 2004. K-B disc diffusion and E-test for antibiotic susceptibility were performed for these clinical isolates.</p><p><b>RESULTS</b>Totally 172 and 484 strains of Sp and Hi were respectively isolated from nasopharyngeal secretions in the hospital. For Sp strains, the rates of resistance to penicillin, amoxicillin/clavulanic acid, ceftriaxone, cefuroxime, cefaclor, erythromycin, tetracycline, chloramphenicol, sulfamethoxazole/trimethoprim (SMZ/TMP), clindamycin and ofloxacin were 32.0%, 11.1%, 32.6%, 18.1%, 39.5%, 82.6%, 78.5%, 24.4%, 87.2%, 69.2% and 3.1%, respectively. The penicillin non-susceptible Sp (PNSSP) isolates showed higher rates of resistance to other antimicrobial agents such as other beta-lactam antimicrobial agents, erythromycin, and SMZ/TMP than those of penicillin susceptible Sp (PSSP) isolates. More than 90% of PNSSP were multidrug resistant strains. The average rate of beta-lactamase production among 484 strains of Hi was 29.5% (143/484). For Hi isolates, the rates of resistance to ampicillin, amoxicillin/clavulanic acid, ceftriaxone, cefuroxime, cefaclor, SMZ/TMP, tetracycline, chloramphenicol, azithromycin, and ofloxacin were 40.1%, 3.4%, 4.1%, 1.9%, 5.6%, 56.2%, 52.1%, 17.4%, 2.1%, and 0.6%, respectively.</p><p><b>CONCLUSION</b>The antimicrobials resistant Sp and Hi isolated from children with respiratory tract infection in the area have become a severe problem. The rate of resistance to penicillin of Sp had been decreased compared with the last three years, but the rate of resistance to ceftriaxone of Sp increased, and the multidrug resistance rates of PNSSP was rather high. PNSSP was characterized by a multidrug-resistance to erythromycin, tetracycline and SMZ/TMP. beta-lactamase production and ampicillin resistance among the Hi isolates from children in the area had increased generally during the period 2003 - 2004. The Hi isolates were more susceptible to the second and the third generation cephalosporins, amoxicillin/clavulanic acid and azithromycin.</p>

Serotype distribution and resistance to beta-lactams of Streptococcus pneumoniae isolated from children in Beijing, Shanghai and Guangzhou, 2000 - 2002 / 中华儿科杂志

<p><b>OBJECTIVE</b>The present study was designed to investigate the situation of serotype distribution and beta-lactam antibiotics resistance of Streptococcus pneumoniae (S. pneumoniae) isolated from Chinese children, and to further understand the significance of vaccine for preventing infection caused by the bactria and controlling the resistance to antibiotics.</p><p><b>METHODS</b>Nasopharageal swab specimens were collected from randomly selected less than 5-year-old out-patients with upper respiratory infection in Beijing, Shanghai and Guangzhou, 2000 - 2002. Capsular typing was performed by the Quellung reaction tested using a simplified chessboard system for typing of S. pneumoniae. The coverage rate of the 7-valent pneumococcal conjugate vaccine (4, 6B, 9V, 14, 18C, 19F and 23F) was calculated. Antibiotic susceptibility was determined by E-test MIC method for beta-lactam antibiotics (penicillin, amoxicillin/clavulanic acid, cefaclor, cefuroxime and ceftriaxone).</p><p><b>RESULTS</b>Totally 625 pneumococcal strains were typed. Serogroup 19, including 121 strains, was the most frequent serogroup observed (19.4%). Other frequently observed serotypes/serogroups in decreasing order of frequency were serotype/serogroups 23 (15.4%), 6 (13.3%), 14 (6.6%) and 15 (4.3%). Of all these isolates, about 57.6% (360/625) were in the 7-valent conjugate vaccine. Only 1, 6 and 12 strains were serotypes/serogroups 4, 9 and 18, respectively. The coverage rate for the 7-valent vaccine of penicillin nonsusceptible S. pneumoniae (PNSP) was higher than penicillin susceptible S. pneumoniae (PSSP) (73.2% and 46.1%). Serogroups 19 and 23, without other serotypes/serogroups, were significantly associated with PNSP (serogroup 19 accounted for 29.1% of PNSP and 12.2% of PSSP; serogroup 23 accounted for 23.8% of PNSP to 9.2% of PSSP). Overall, 140 strains (22.4%) could not be typed by using the chessboard system, and 117 strains (18.7%) were identified as other 28 kinds of serotype/serogroup. The strains showed different resistance change for beta-lactam antibiotics according to different serotype/serogroup during the three years.</p><p><b>CONCLUSIONS</b>Serotype/Serogroup 19, 23, 6, 14 and 15 were the common types among the pneumococcal strains isolated from Chinese children. Serogroups 19 and 23 were significantly associated with PNSP. The 7-valent pneumococcal conjugate vaccine could cover most of the islotes.</p>

Relationship between collagen Ⅰ,MMP-2 and TIMP-2 gene expression and atrial fibrosis and fibrillation during heart failure in dogs / 中华老年医学杂志

Objective To study the relationship between Couagen Ⅰ,MMP-2,TIMP-2 gene expression and atrial fibrosis during heart failure(HF)in dog.Methods Fourteen dogs were used and randomized into HF induced by ventricular tachypacing and control group.Burst atrial pacing was used to induce atrial fibrillation(AF).And the mRNA and protein level of collagen Ⅰ,MMP-2 and TIMP-2 were detected by RT-PCR and immunohistochemical technique.Tissue samples were stained with Mallory trichrome.Results Left ventricular ejection fraction (LVEF) decreased from (67.4? 6.0)% to (29.2?7.8)%,the inducible rate of AF(7/7 vs 2/7) and sustained AF(5/7 vs 0/7) increased and duration of AF stabeatrial fibrillation(SAF) [(462.12?181.43)s vs(0.57?0.57) s] prolonged significantly in HF group.Atrial fibrous tissue content and atrial size of HF group were significantly greater than the controls dogs(268.8% in lefe atria and 190.3% in right atria).The mRNA and protein level of collagen Ⅰ(56.2% and 132.2% in lefe atria,37.4% and 78.0% in right atria)and MMP-2 (100.0% and 115.7% in lefe atria,65.7% and 96.8% in right atria) increased evidently in both lefe atria and right atria,TIMP-2 mRNA decreased 46.3% in lefe atria and had no change in right atria and that its protein had no change in both atrium,whereas the ratio of MMP-2/ TIMP-2 of mRNA and protein increased markedly in both lefe atria (285.3% and 148.8%)and right atria (106.1% and 134.7%)of HF group.SAF had a positive correlation with fibrosis and the gene level of collagen Ⅰ in lefe atria,the ratio of MMP-2/TIMP-2 had a positive correlation with fibrosis and collagen Ⅰ gene level in lefe atria during HF.Conclusions The changes of collagen Ⅰ,MMP-2 and TIMP-2 gene expression appear to be a molecular mechanism of AF, and the molecular remodeling of collagen Ⅰ induced by regulation unbalance of MMP-2/TIMP-2 appears to be an important mechanism of atrial fibrosis during HF.