Clinical characteristics of human adenovirus infection in hospitalized children with acute respiratory infection in Beijing / 中华儿科杂志

Objective: To compare the clinical characteristics of different types of human adenovirus (HAdV) infection in hospitalized children with acute respiratory infection in Beijing, and to clarify the clinical necessity of adenovirus typing. Methods: In a cross-sectional study, 9 022 respiratory tract specimens collected from hospitalized children with acute respiratory infection from November 2017 to October 2019 in Affiliated Children's Hospital, Capital Institute of Pediatrics were screened for HAdV by direct immunofluorescence (DFA) and (or) nucleic acid detection. Then the Penton base, Hexon and Fiber gene of HAdV were amplified from HAdV positive specimens to confirm their HAdV types by phylogenetic tree construction. Clinical data such as laboratory results and imaging data were analyzed for children with predominate type HAdV infection using t, U, or χ2 test. Results: There were 392 cases (4.34%) positive for HAdV among 9 022 specimens from hospitalized children with acute respiratory infection. Among those 205 cases who were successfully typed, 131 were male and 74 were female, age of 22.6 (6.7, 52.5) months,102 cases (49.76%) were positive for HAdV-3 and 86 cases (41.95%), HAdV-7, respectively, while 17 cases were confirmed as HAdV-1, 2, 4, 6, 14 or 21. In comparison of clinical characteristics between the predominate HAdV type 7 and 3 infection, significant differences were shown in proportions of children with wheezing (10 cases (11.63%) vs. 25 cases (24.51%)), white blood cell count >15 ×109/L (4 cases (4.65%) vs.14 cases (13.73%)), white blood cell count <5×109/L (26 cases (30.23%) vs.11 cases (10.78%)), procalcitonin level>0.5 mg/L (43 cases (50.00%) vs. 29 cases (28.43%)), multilobar infiltration (45 cases (52.33%) vs.38 cases (37.25%)), pleural effusion (23 cases (26.74%) vs. 10 cases (9.80%)), and severe adenovirus pneumonia (7 cases (8.14%) vs. 2 cases (1.96%)) with χ²=5.11, 4.44, 11.16, 9.19, 4.30, 9.25, 3.91 and P=0.024, 0.035, 0.001, 0.002, 0.038, 0.002, 0.048, respectively, and also in length of hospital stay (11 (8, 15) vs. 7 (5, 13) d, Z=3.73, P<0.001). Conclusions: HAdV-3 and 7 were the predominate types of HAdV infection in hospitalized children with acute respiratory tract infection in Beijing. Compared with HAdV-3 infection, HAdV-7 infection caused more obvious inflammatory reaction, more severe pulmonary symptoms, longer length of hospital stay, suggesting the clinical necessity of further typing of HAdVs.

The postictal state in epilepsy and its clinical significance / 中华神经科杂志

The postictal state refers to the abnormal condition occurring between the end of an epileptic seizure and return to baseline condition,including a variety of cognitive, motor, sensory, autonomic, mental and behavioral impairments. The symptoms which may last from seconds to days are various and the severity is different. It also may exert great impact on patients′ health and quality of life. However, the lack of relevant studies at home and abroad, along with the absence of correct understanding of this in clinical practice, may lead to frequent misdiagnosis and mistreatment. This article will review the concepts, pathophysiological mechanisms, clinical manifestations, diagnosis, differential diagnosis, clinical significance and intervention strategies, aiming at deepening the understanding of the phenomenon, as well as providing references for further clinical research.

Clinical characteristics of influenza A virus-induced pneumonia in renal transplantation recipients / 中华器官移植杂志

Objective:To explore the clinical characteristics, outcomes and influencing factors of influenza A virus-induced pneumonia in renal allograft recipients.Methods:During the 2015-2019 influenza season, 21 patients with influenza A virus-induced pneumonia after renal transplantation(RT)were prospectively recruited with 42 matched non-immunocompromised inpatients with influenza A virus-induced pneumonia.Clinical data, outcomes and follow-up observations after discharge were collected for analyzing the clinical characteristics of influenza A virus-induced pneumonia after RT.Continuous variables were compared by t-test or Mann-Whitney U test.And categorical variables were compared by Chi-Square test.Results:The median time after RT was 5(0.88, 10.50)years for RT recipients.In RT group, none received seasonal influenza vaccination with a vaccination rate of zero.The influenza vaccination rate of non-immunocompromised patients in current season was 42.86%(18/42)and inter-group difference was statistically significant( P<0.001). The levels of hemoglobin, aspartate aminotransferase, alanine aminotransferase and lactate dehydrogenase in RT recipients were(108.47±22.39)g/L, 21.00(16.00, 46.50)U/L, 15.00(12.00, 21.00)U/L and 314.00(207.25, 374.00)U/L.And the values were lower than those of non-immunocompromised patients[(130.24±21.74)g/L, 48.50(36.00, 79.50)U/L, 32.00(20.00, 52.25)U/L and 466.00(227.00, 781.75)U/L]. The differences were statistically significant( P=0.001, P<0.001, P<0.001, P=0.005). The levels of blood urea nitrogen and serum creatinine were 8.27(6.69, 12.48)mmol/L and 130.30(94.15, 204.70)mmol/L versus 5.42(3.37, 7.65)mmol/L and 65.90(48.98, 82.13)mmol/L in non-immunocompromised patients.The differences were statistically significant(all P< 0.001). No significant differences existed in the levels of C-reactive protein and procalcitonin between RT recipients and non-immunocompromised patients( P=0.774 and 0.821). The level of ESR and oxygenation index at admission were 39.00(13.00, 53.00)mm/h and(306.95±90.97)in renal recipients and 18.00(11.50, 23.00)mm/h and(200.17±116.35)in non-immunocompromised patients.The differences were statistically significant( P=0.045 and 0.001). Imaging studies indicated that multiple lobar involvement was a major imaging feature in both renal recipients and non-immunocompromised patients.The probability of pulmonary consolidation was 33.33%(7/21)in renal recipients and it was lower than that in non-immunocompromised patients.And the probability of pleural effusion was 42.86%(9/21)and it was higher than control.The inter-group differences were statistically significant( P=0.020 & 0.024). Rate of mechanical ventilation, CRRT and mortality were 42.86%(9/21), 23.81%(5/21)and 28.57%(6/21). All of them were higher than non-immunocompromised patients[21.43%(9/42), 9.52%(4/42)and 9.52%(4/42)]. However, there was no significant inter-group difference( P=0.076, 0.252 & 0.113). The median score of CURB-65 was 1(0.5, 1). Conclusions:Renal damage is prominent in hospitalized patients with influenza A virus-induced pneumonia after RT.There are a high rate of mechanical ventilation and CRRT during hospitalization and a high mortality.The prognosis remains poor for hospitalized patients with influenza A virus-induced pneumonia after RT.No matter how serious their conditions are at admission, they need to be closely monitored and aggressively treated.

Efficacy and safety of autologous hematopoietic stem cell transplantation in elderly multiple myeloma patients: a single center retrospective study / 中华血液学杂志

Objective: To evaluate the efficacy and safety of autologous hematopoietic stem cell transplantation (auto-HSCT) in elderly patients (≥65 years old) with multiple myeloma (MM) . Methods: From June 1, 2006 to July 31, 2020, 22 MM patients (≥65 years old) who were diagnosed in the First Affiliated Hospital, Sun Yat-sen University and received novel drug induction followed by auto-HSCT were analyzed retrospectively. These patients were evaluated for important organ functions before transplantation, and the International Myeloma Working Group frail score was used in 2016 to screen out transplant-eligible patients. Results: The median (interquartile range, IQR) age at the time of transplantation of the 22 patients was 66.75 (IQR 4.50) years. A total of 20 patients received stem cell mobilization. The median number of mononuclear cells collected was 4.53×10(8)/kg, that of CD34(+) cells was 3.37×10(6)/kg, and the median number of apheresis procedures performed was 2. After stem cell transfusion, the median time of neutrophil implantation was 11 days, that of platelet implantation was 13 days, and the treatment-related mortality was 0 at 100 days after transplantation. The median follow-up was 48.7 months. The median time to progression time was not reached, and the median overall survival time was 111.8 months. Conclusion: Auto-HSCT is a safe and effective treatment for selected elderly patients of 65 years or older with MM.

Analysis of Volatile Organic Compounds in Rhizosphere Soil of Rehmannia glutinosa Under Intercropping Zea mays Based on GC-MS Metabonomics / 中国实验方剂学杂志

Objective:To explore the composition characteristics of rhizosphere soil under <italic>Rehmannia glutinosa-Zea mays</italic> intercropping model，and screen out special signal substances in rhizosphere soil of <italic>R. glutinosa</italic> under intercropping <italic>Z. mays</italic>， so as to provide the basis for the study of allelopathic substances in continuous cropping obstacle of <italic>R. glutinosa</italic>. Method:In this experiment，rhizosphere soils of <italic>R. glutinosa</italic> under <italic>Z. mays </italic>intercropping and <italic>R. glutinosa </italic>single cropping models in July，August，September and October were taken as the research objects， and the volatile organic compounds in ethyl acetate fraction were analyzed by gas chromatography-mass spectrometry （GC-MS）. Principal component analysis （PCA）， hierachical cluster analysis （HCA） and orthogonal partial least squares discriminant analysis （OPLS-DA） analysis were performed on the data by SIMCA 14.1 to screen out potential differences in volatile organic compounds between the two models. Result:The types of volatile organic compounds in intercropping and single cropping models were mainly hydrocarbons， alcohols， esters， ketones， amides， acids and other substances. Specifically， the average relative contents of hydrocarbons，esters and amides in intercropping model were 58.46%，32.15% and 5.42% respectively，while the relative contents of hydrocarbons，esters and amides in single cropping model were 37.27%，36.11% and 21.13%. The results of PCA and HCA showed that the characteristics of volatile organic compounds in the ethyl acetate fraction of rhizosphere soil under intercropping and single cropping models could be clearly divided into two categories，the screening results of potential differential components based on OPLS-DA analysis indicated that various components， such as dibutyl phthalate，（<italic>Z</italic>）-9-oleamide，<italic>β</italic>-caryophyllene，dioctyl iso-phthalate， phthalate （2-propylamyl） diester， <italic>n</italic>-hexadecane，octodecane， <italic>n</italic>-heneicosane， were screened from rhizosphere soil under the two models. Conclusion:The <italic>R. glutinosa-Z. mays</italic> intercropping model has certain effects on the volatile organic compounds in the rhizosphere soil of <italic>R. glutinosa</italic>，and the effect of the selected components on the growth and quality characteristics of <italic>R. glutinosa</italic> still need to be further studied.

The Effect and Mechanism of Novel Telomerase Inhibitor Nilo 22 on Leukemia Cells / 中国实验血液学杂志

OBJECTIVE@#To investigate the cytotoxic effect and its mechanism of the micromolecule compound on the leukemia cells.@*METHODS@#The cytotoxic effects of 28 Nilotinib derivatives on K562, KA, KG, HA and 32D cell lines were detected by MTT assays, and the compound Nilo 22 was screen out. Cell apoptosis and cell cycle on leukemia cells were detected by flow cytometry. The effect of compound screened out on leukemogenesis potential of MLL-AF9 leukemia mice GFP@*RESULTS@#Nilo 22 serves as the most outstanding candidate out of 28 Nilotinib derivatives, which impairs leukemia cell lines, but spares normal hematopoietic cell line. Comparing with Nilotinib, Nilo 22 could induce the apoptosis of GFP@*CONCLUSION@#Nilo 22 shows a significant cytotoxic effect on mice and human leukemia cells, especially for drug resistance cells. Nilo 22 is a promising anti-leukemia agent to solve the common clinical problems of drug resistance and relapse of leukemia.

A multicenter retrospective study on survival rate and complications of very preterm infants / 中国当代儿科杂志

OBJECTIVES@#To study the survival rate and the incidence of complications of very preterm infants and the factors influencing the survival rate and the incidence of complications.@*METHODS@#The medical data of the very preterm infants with a gestational age of <32 weeks and who were admitted to the Department of Neonatology in 11 hospitals of Jiangsu Province in China from January 2018 to December 2019 were retrospectively reviewed. Their survival rate and the incidence of serious complications were analyzed. A multivariate logistic regression analysis was used to evaluate the risk factors for death and serious complications in very preterm infants.@*RESULTS@#A total of 2 339 very preterm infants were enrolled, among whom 2 010 (85.93%) survived and 1 507 (64.43%) survived without serious complications. The groups with a gestational age of 22-25@*CONCLUSIONS@#The survival rate is closely associated with gestational age in very preterm infants. A low 1-minute Apgar score (≤3) may increase the risk of death in very preterm infants, while high gestational age, high birth weight, and prenatal use of glucocorticoids are associated with the reduced risk of death. A low 5-minute Apgar score (≤3) and maternal chorioamnionitis may increase the risk of serious complications in these infants, while high gestational age and high birth weight may reduce the risk of serious complications.

Effects of density on growth and gene transcription characteristics of Rehmannia glutinosa / 中国中药杂志

The present study analyzed the effects of planting density on the development, quality, and gene transcription characte-ristics of Rehmannia glutinosa using 85-5 and J9 as materials with three planting densities of 5 000, 25 000, and 50 000 plants/Mu(1 Mu≈667 m~2). The agronomic characteristics of leaves and tuberous roots, the content of catalpol and acteoside, and the changes of gene expression were determined. The results showed that the leaf size, the diameter of tuberous root, leaf biomass, tuberous root number, and tuberous root biomass per plant at low density were significantly higher than those of medium and high densities. The content of catalpol and acteoside in leaves was higher at high density. The content of catalpol in tuberous roots was higher at low density, and the change trend was similar to that in leaves, while the content of acteoside in tuberous roots was higher at high density. Transcriptome analysis found that about 1/2 of the expansin genes could change regularly in response to density treatment, which was rela-ted to the development of tuberous roots. The change trend of the gene expression of multiple catalytic enzymes involved in the biosynthesis of catalpol and acteoside was consistent with that of their content, which was presumedly involved in the accumulation and regulation of density-responsive medicinal components. Based on the analysis of the development, medicinal components, and gene expression characteristics of R. glutinosa at different densities, this study is expected to provide an important basis for regulating the quality and yield of medicinal materials of R. glutinosa by managing the planting density.

Identification and expression analysis of NRT1 family genes in Rehmannia glutinosa / 中国中药杂志

NRT1 family proteins play an important roles for absorbing and transporting of nitrate in different plants. In order to identify the NRT1 family genes of Rehmannia glutinosa, this study used 11 NRT1 homologous proteins of Arabidopsis as probe sequences and aligned with the transcriptome data of R. glutinosa by using NCBI BLASTN software. Resulting there were 18 NRT1 proteins were identified in R. glutinosa. On basis of this, a series of the molecular characteristics of R. glutinosa NRT1 proteins including the conserved domains, the transmembrane structure, the subcellular location and phylogenetic features were in detail analyzed. At same time, it were systematically analyzed that the temporal and spatial expression patterns and characteristics of R. glutinosa NRT1 family genes in response to different stress factors. The results indicated that 18 R. glutinosa NRT1 family genes with the length of coding region from 1 260 bp to 1 806 bp, encoded proteins ranging from 419 to 601 amino acids, and all of they owned the domains of typical peptide transporter with 7 to 12 transmembrane domains. These R. glutinosa NRT1 family proteins mostly were found to locate on cellular plasma membrane, and belonged to the hydrophobic proteins. Furthermore, the evolutionary analysis found that the 18 R. glutinosa NRT1 protein family could be divided into two subfamilies, of which 14 NRT1 family genes might occur the positive selection, and 4 genes occur the passivation selection during the evolution process of R. glutinosa. In addition the expression analysis showed that 18 R. glutinosa NRT1 family genes have the distinct expression patterns in different tissues of R. glutinosa, and their expression levels were also obvious difference in response to various stress. These findings infield that 18 R. glutinosa NRT1 family proteins might have obviously different functional roles in nitrate transport of R. glutinosa. In conclusion, this study lays a solid theoretical foundation for clarifying the absorption and transport molecular mechanism of N element during R. glutinosa growth and development, and at same time for deeply studying the molecular function of R. glutinosa NRT1 proteins in absorption and transport of nitrate.

Risk factors for bronchial asthma in children with allergic rhinitis / 中国学校卫生

Objective@#To explore the risk factors of bronchial asthma in children with allergic rhinitis, and to provide evidence for the early diagnosis, treatment and prevention of asthma in children with allergic rhinitis.@*Methods@#Children with allergic rhinitis and children with allergic rhinitis and asthma, who attended the Allergy Clinic of the Capital Institute of Pediatrics from November 2019 to October 2020, were recruited for the study. Medical history, clinical characteristics, allergen types and risk factors were collected and analyzed.@*Results@#A total of 117 children with allergic rhinitis and 111 children with allergic rhinitis that subsequently developed into asthma were included. The results of the univariate analysis showed that the occurrence of asthma in children with allergic rhinitis was associated with the course of rhinitis, severity of rhinitis, type of rhinitis, seasonal onset, history of pet contact, family history of allergic diseases, mold, ragweed, dermatophagoides culinae and dust mite sensitization( χ 2=6.15, 8.79, 3.99, 9.44, 5.17, 4.43, 8.48, 10.38, 6.18, 5.31, P <0.05). The Logistic regression analysis showed that rhinitis severity( OR = 7.03 ), family history of allergic diseases( OR =8.24), mold( OR =5.19), and household dust mite sensitization ( OR =25.25) were positively correlated with the occurrence of asthma in children with allergic rhinitis( P <0.05), and dust mite sensitization was the strongest risk factor.@*Conclusion@#The development of asthma in children with allergic rhinitis is affected by many factors, among which the severity of rhinitis, family history of allergic diseases and dust mite sensitization are the most important factors.

Prognosis and its influencing factors of patients with seizure recurrence after anti-epileptic drug withdrawal / 中华神经科杂志

Objective:To explore the seizure recurrence and prognosis of epilepsy in relapse after anti-epileptic drugs (AEDs) withdrawal, and the influencing factors for these conditions.Methods:From December 2009 to August 2018, patients from the Affiliated Brain Hospital of Nanjing Medical University who relapsed after AEDs withdrawal were collected and followed up for at least 18 months. The seizure recurrence and prognosis of these patients were prospectively observed. The Kaplan-Meier method was used for survival analysis. The associated risk factors of the second relapse in the enrolled patients were analyzed by multivariate Cox analysis. The included patients were divided into good prognosis group and poor prognosis group according to whether they had achieved seizure freedom for at least one year after the first relapse. A multivariate Cox regression model was used to analyze the independent risk factors affecting their prognosis.Results:A total of 56 patients with epilepsy in relapse after AEDS withdrawal were collected. The average follow-up period was 46.23 months (18-120 months) from the initial time of seizure recurrence, and 21 patients (37.5%) had the second seizure recurrence. The relapsing risk in patients who continued to be observed without adding AEDs was higher than those who were treated immediately with drugs [9/16 vs 30.0% (12/40)], but without statistically significant difference (χ2=2.220, P=0.071). The results of univariate analysis showed that focal seizures, seizure frequency more than once per month before remission and poly-drug therapy before AEDs withdrawal were associated with high risk of the second relapse. Poly-drug therapy was an independent risk factor for the second relapse by multivariate Cox analysis ( HR=3.383, 95% CI 1.257-9.105). Of the 56 patients with epilepsy in relapse after AEDs withdrawal, 47 patients (83.9%) had a good prognosis without seizure for at least one year, and of 33 patients who were followed up for three years or more, 26 (78.8%) had no seizure for at least two years. Between the group retreated immediately after the first recurrence and the group without immediate treatment [87.5% (35/40) vs 12/16],there were no statistically significant differences on the proportions of good prognosis (χ2=2.333, P=0.258). Univariate analysis showed that the course of epilepsy>6 months before initial treatment, the frequency of seizures>1/month before remission, symptomatic epilepsy and poly-drug therapy were associated with the poor prognosis. However, none of independent risk factors was found for the poor prognosis through the multivariate analysis. Conclusions:The prognosis of patients with epilepsy in relapse after AEDs withdrawal is well, and about 2/3 patients with epilepsy in relapse after AEDs withdrawal have no more seizure recurrences. The poly-drug therapy before AEDs withdrawal may be an independent risk factor for the second seizure relapse.

Research progress on bidirectional effect of microRNA on Alzheimer's disease and intervention with traditional Chinese medicine / 中国中药杂志

Alzheimer's disease(AD) is a chronic progressive neurodegenerative disease with recent memory impairment as the main clinical manifestation and senile plaques and neurofibrillary tangles as the main pathological changes. In recent years, the effect of microRNAs on AD has attracted widespread attention. Patients with AD have abnormal expression of miRNA, which is closed related to regulation of AD pathophysiology-related genes. Therefore, this paper first elaborated neuroprotective and toxic effects of microRNA in AD, and then explored relevant traditional Chinese medicines that can regulate miRNA in the treatment of AD, so as to provide basis for revealing the pathogenesis relationship between miRNA and AD and provide ideas for further development of anti-AD traditional Chinese medicine.

Investigation on occupational hazards in a lubricant research and development laboratory, 2017-2019 / 公共卫生与预防医学

Objective To investigate the occupational hazards and health status of laboratory staff in a lubricant research and development (R & D) laboratory, and to provide a basis for formulating occupational health protection measures for laboratory staff. Methods The types of occupational hazard factors in the laboratory were determined by field investigation of occupational health, and the concentrations or intensities of occupational hazard factors were obtained by on-site sampling and laboratory testing. The health status of laboratory staff was evaluated through occupational health examination. Results The main occupational hazards in the lubricant laboratory were benzene, toluene, xylene, pentane, hexane, heptane, ethylene glycol, methanol, isopropanol, chlorobenzene, dichloromethane, chloroform, aniline, oxolane, sodium hydroxide, potassium hydroxide, nitrogen oxide, carbon monoxide and noise. The test results showed that the hazard levels of all kinds of chemical toxicants met the national standards from 2017 to 2019. The sample test results were lower than the detection limit, which were 94.00%, 96.89% and 97.41%, respectively, from 2017 to 2019. There were no significant differences (χ2=4.324, P=0.115). Results of noise detection showed that the noise levels did not exceed the standard from 2017 to 2019. A laboratory worker with high-frequency hearing impairment was found through the medical examination in 2019. The re-examination rates of occupational health examination in 2017-2019 were 3.26%, 1.12% and 1.18%, respectively, and there were no significant differences (χ2=1.618, P=0.445). Conclusion The occupational hazards that the laboratory staff of the lubricant research and development was exposed to were characterized by a wide variety of chemical poisons, with low concentrations and low exposure levels. However, the occupational health examination should not be ignored.

Imported falciparum malaria in Suzhou City: a report of two cases in 2019 / 中国血吸虫病防治杂志

The demographic features, epidemiology, diagnosis and treatment of two cases with falciparum malaria imported into Suzhou City in 2019 were reported. These findings indicate a risk of imported malaria in visitors besides high prevalence in migrant labors, and much attention should be paid to children that are at a high risk of infections.

Characterization of Echinostoma miyagawai in domestic ducks in Wuhu City / 中国血吸虫病防治杂志

Objective To investigate the morphological characteristics of Echinostoma miyagawai in domestic ducks in Wuhu area, and to explore the feasibility of the cytochrome oxidase subunit-1 (Cox1) gene as a molecular marker for the identification of E. miyagawai. Methods E. miyagawai was isolated from free-ranged domestic ducks in Wuhu area, and the parasites were stained and identified. In addition, the mitochondrial Cox1 gene of E. miyagawai was amplified using a PCR assay, and the amplification product was sequenced and aligned with the GenBank database to yield the homology for the identification of parasite species in combination with morphological findings. Intra-species comparison was done based on the Cox1 gene sequence. Results The prevalence of E. miyagawai infection was 16.67% in domestic ducks in Wuhu area, and the adult E. miyagawai was 6.6 to 13.2 mm in length. The size of the E. miyagawai Cox1 gene was approximately 660 bp, which had a 99.68% homology to the E. miyagawai accessed in GenBank. The morphological findings were in agreement with molecular identification. Conclusion E. miyagawai infection is common in domestic ducks in Wuhu area, and the mitochondrial Cox1 gene is a feasible marker of intra- and inter-species molecular identification of Echinostoma.

Randomized double-blind parallel controlled multicenter trial of Reyanning Mixture in treatment of acute tonsillitis / 中国中药杂志

This study is a randomized controlled trial of Reyanning Mixture in the treatment of acute tonsillitis. According to the ratio of 1∶1∶1, a total of 144 patients were randomly divided into Reyanning Mixture group(RYN), Reyanning Mixture+Amoxicillin Capsules group(RYN+Amoxil) and Amoxicillin Capsules group(Amoxil), with 48 cases in each group, in order to evaluate the efficacy and safety of RYN alone or combined with Amoxil in the treatment of acute tonsillitis, and provided high-quality evidences for treatment of infectious diseases with traditional Chinese medicine and reduced use of antibiotics. The dosage of RYN was 20 mL, 3 times a day, 100 mL/bottle, oral for 7 days, and Amoxil dosage was 0.5 g, 3 times a day, 0.5 g×12 tablets/plate, oral for 7 days. A total of 144 cases were included, 3 cases were excluded(1 case was mistakenly included, 2 cases did not take drugs after inclu-ded), and a total of 141 cases were included in the full analysis set(FAS). The results showed statistical differences in the recovery time of the disease, the disappearance rate of fever on the 3 rd day and the disappearance rate of tonsillar redness and swelling between RYN and Amoxil. There were statistical differences in the cure rate of disease, recovery time of disease, body temperature recovery time, fever disappearance rate on the 3 rd day, pharynx swelling and pain disappearance rate and tonsil swelling disappearance rate between the RYN+Amoxil and Amoxil, but with no significant difference in the above aspects compared with RYN. The DDD of antibiotic use in RYN+Amoxil was significantly lower than that in Amoxil(P<0.01). According to the findings, when RYN was used alone in the treatment of acute tonsillitis, it was superior to Amoxil in time of recovery, short-term improvement of fever and redness and swelling of tonsil. Compared with RYN+Amoxil, there was no difference in cure rate of disease, recovery time of disease, body temperature recovery time, short-term improvement of fever, swelling of pharynx and swelling of tonsil, with a better efficacy than Amoxil. The clinical effect of RYN was similar to that of combined Amoxil in the treatment of acute tonsillitis, and RYN was superior to Amoxil in the time of recovery, short-term improvement of fever and redness and swelling of tonsil, with no adverse event or adverse reaction. RYN+Amoxil can significantly reduce the DDD value of antibiotics in the treatment of acute tonsillitis, with significant clinical advantages over Amoxil.

Analysis of drug susceptibility and risk factors for drug resistance of Escherichia coli in elderly patients with urinary tract infection / 中华老年医学杂志

Objective@#To investigate the risk factors for drug resistance of urinary tract infections-causing Escherichia coli producing extended spectrum beta-Lactamases (ESBLs) in elderly people (≥65 years old), in order to provide evidence for rational use of antibiotics in clinic.@*Methods@#Clinical data of elderly patients diagnosed as urinary tract infections in Beijing Chao-Yang Hospital from January 2016 to December 2017 were retrospectively analyzed. According to whether ESBLs were produced by Escherichia coli isolated from urine samples, the patients were divided into the ESBLs-producing E. Coli group (ESBLs group) and the control group. Single factor analysis was performed by Chi-square test.Logistic regression analysis was used to analyze the risk factors for ESBLs-producing Escherichia coli infections in urinary tract on the basis of statistical significance.@*Results@#A total of 452 strains of Escherichia coli were isolated, including 253 strains (55.97%) producing ESBLs, and 199 strains (44.03%) not producing ESBLs. The ureteral calculi (OR=2.675, 95%CI: 1.129-6.341), urinary obstructive diseases (≥ 2 kinds) (OR=8.680, 95%CI: 2.508-30.040), indwelling catheters (OR=5.762, 95%CI: 2.698-12.155), antibiotic treatment more than 2 weeks for urinary tract infections within one year (OR=3.461, 95%CI: 1.766-6.784) were independent risk factors for ESBLs-producing Escherichia coli urinary tract infections. The incidence rate of Escherichia coli resistance to various antibiotics was higher in elderly patients with urinary tract infection than in non-elderly patients.@*Conclusions@#Escherichia coli producing ESBLs can be easily isolated from elderly patients with urinary tract obstructive diseases, indwelling catheters and repeated long-term administration of broad-spectrum antibiotics. The proportion of ESBLs Escherichia coli-caused urinary tract infections is higher in elderly patients. Thereby, carbapenems or piperacillin/tazobactam is the reasonable antibiotics. Ampicillin, piperacillin, levofloxacin and ciprofloxacin should not be the first choice for the treatment of urinary tract infections in the elderly.

Analysis of drug susceptibility and risk factors for drug resistance of Escherichia coli in elderly patients with urinary tract infection / 中华老年医学杂志

Objective To investigate the risk factors for drug resistance of urinary tract infections-causing Escherichia coli producing extended spectrum beta-Lactamases (ESBLs) in elderly people (≥65 years old),in order to provide evidence for rational use of antibiotics in clinic.Methods Clinical data of elderly patients diagnosed as urinary tract infections in Beijing Chao-Yang Hospital from January 2016 to December 2017 were retrospectively analyzed.According to whether ESBLs were produced by Escherichia coli isolated from urine samples,the patients were divided into the ESBLs-producing E.Coli group (ESBLs group) and the control group.Single factor analysis was performed by Chi-square test.Logistic regression analysis was used to analyze the risk factors for ESBLs-producing Escherichia coli infections in urinary tract on the basis of statistical significance.Results A total of 452 strains of Escherichia coli were isolated,including 253 strains (55.97％)producing ESBLs,and 199 strains (44.03％) not producing ESBLs.The ureteral calculi (OR =2.675,95％CI:1.129-6.341),urinary obstructive diseases (≥ 2 kinds) (OR =8.680,95％CI:2.508-30.040),indwelling catheters (OR =5.762,95％ CI:2.698-12.155),antibiotic treatment more than 2 weeks for urinary tract infections within one year (OR =3.461,95％CI:1.766-6.784)were independent risk factors for ESBLs-producing Escherichia coli urinary tract infections.The incidence rate of Escherichia coli resistance to various antibiotics was higher in elderly patients with urinary tract infection than in non-elderly patients.Conclusions Escherichia coli producing ESBLs can be easily isolated from elderly patients with urinary tract obstructive diseases,indwelling catheters and repeated long-term administration of broad-spectrum antibiotics.The proportion of ESBLs Escherichia coli-caused urinary tract infections is higher in elderly patients.Thereby,carbapenems or piperacillin/tazobactam is the reasonable antibiotics.Ampicillin,piperacillin,levofloxacin and ciprofloxacin should not be the first choice for the treatment of urinary tract infections in the elderly.

Expression and Significance of Serum Mir-132 in Patients with Obstructive Sleep Apnea with Cognitive Impairment / 中山大学学报(医学科学版)

@#【Objective】To explore the relationship between the miR- 132 expression in serum and cognitive deficits of OSA. 【Methods】 66 Chinese adults age 30 to 60 years old were enrolled and categorized into two groups based on Montreal Cognitive Assessment（MoCA）scores： OSA patients with cognitive impairment（OSAI，n=36），OSA patients without cognitive impairment（OSAN，n=30），and thirty adults without OSA as healthy control group（HC，n=30）. Out- of- center cardiopulmonary sleep testing （OCST） and MoCA assessment were performed and the relative expression of miR-132 in serum was detected by PCR.【Results】No significant difference was observed in age，education，gender and hypertension（P>0.05）. The relative expression level of miR-132 was significantly up-regulated in OSAI patient′s serum compared to the OSAN and HC patients （P<0.001），and had a positive correlation with MoCA score （r=- 0.726，P<0.001）. ROC analyses showed that the areas under the curve（AUC）were statistically significant from the line of identity in OSA with cognitive impairment（AUC=0.935，95% CI：0.890- 0.981，P<0.001）and in OSA（AUC=0.787，95% CI：0.695-0.879，P<0.001）.【Conclusions】Elevated serum miR-132 expression levels are closely related to the diagnosis of OSA and its cognitive dysfunction. Detection of serum miR- 132 may be a potential indicator of cognitive dysfunction and diagnosis in OSA patients.

Secretory breast carcinoma: a clinicopathological study of 6 cases / 临床与实验病理学杂志

Purpose To describe the clinicopathologic features, diagnosis and differential diagnosis, and prognosis of secretory breast carcinoma (SBC). Methods Clinicopathological and follow-up data of six SBC patients were collected. Histopathologic analysis was performed on hematoxylin and eosinstained (HE) section. Immunohistochemical staining was performed by En Vision two-step method and ETV6 gene detected by fluorescence in situ hybridization (FISH), then relevant literatures were reviewed. Results The ages of the patients ranged from 6 to 76 years with a mean age of 38.7 years, including one male and five female patients. The right breast was involved in 4 cases, and the left, in 2 cases. Five cases showed painless breast mass while one presented with a nipple discharge. The tumor size ranged from 1.0 to 3.1 cm with a mean size of 2.0 cm. Most of the tumors were circumscribed, solid gray white to light brown. Histologically, tumor showed solid nested microcystic, glandular or papillary pattern separating by hyaline fibrous tissue and growed in multiple nodular from. The cytoplasm contains abundant eosinophilic secretions or secretory vesicles. Immunhistochemistry, all cases were positive for CK7, S-100 and CEA, but negative for estrogen and progesterone receptors (ER and PR) and HER-2, and the proliferation index Ki-67 ranged from 10％ to 40％. Molecular testing confirmed the presence of the EVT6 gene translocation in one case. Lumpectomy was performed in 2 cases and modified radical mastectomy in 4 cases, two of them had lymph node metastasis (3/15, 1/16). Five cases were followed up for 6 months to 20 years, 1 case had lung metastasis. Conclusion SBC is a rare breast tumor with relatively indolent clinical and good prognosis. It can be diagnosed according to typical pathological morphology and immunohistochemical characteristics. The characteristic EVT6 gene translocation also has important differential diagnostic value.