The predictive value of warning scores for intensive care unit admission in coronavirus disease 2019 patients / 中华内科杂志

To evaluate the predictive value of early warning scores for intensive care unit (ICU) admission in patients with coronavirus disease 2019 (COVID-19). For COVID-19 patients who were admitted to Shijiazhuang People's Hospital from January 2021 to February 2021, national early warning score (NEWS), national early warning score 2 (NEWS2), rapid emergency medicine score (REMS), quick sepsis-related organ failure (qSOFA), altered consciousness, blood urea nitrogen, respiratory rate, blood pressure, and age-65 (CURB-65) were used to evaluate the inpatient condition and the predictive value for ICU admission. A total of 368 patients were included, and 32 patients (8.7%) were transferred to the ICU. The median age was 49.0 (34.0,61.0) years. The scores of NEWS, NEWS2, REMS, and CURB-65 were 1 (0, 2), 1 (0, 2), 4 (2, 6) and 0 (0, 1), respectively. The receiver operating characteristic (ROC) cure (AUC) was used to evaluate the predictive value in detecting patients who are at risk of being transferred to the ICU. Area under the ROC AUC of NEWS was 0.756, sensitivity 65.6%, and specificity 71.3%. ROC AUC of NEWS2 was 0.732, sensitivity 62.5%, and specificity 61.3%. ROC AUC of REMS was 0.787, sensitivity 84.4%, and specificity 64.6%. ROC AUC of CURB-65 was 0.814, sensitivity 81.3%, and specificity 76.8%. The predictive value of NEWS and NEWS2 combined with age were significantly improved. The ROC AUC of NEWS combined with age was 0.885, sensitivity 85.1%, and specificity 75.0%. The ROC AUC of NEWS2 combined with age was 0.883, sensitivity 84.2%, and specificity 75.0%. NEWS and NEWS2 combined with age can be used as a predictive tool for whether COVID-19 patients will be admitted to the ICU.

Progress of the development of anti-COVID-19 drugs / 药学学报

Since the outbreak of the novel coronavirus (SARS-CoV-2) disease COVID-19 (also known as 2019-nCoV) caused by SARS-CoV-2 in the end of 2019, it has spread rapidly in worldwide. Besides developing effective vaccines, it is urgent to develop safe and effective anti-SARS-CoV-2 drugs to fight this disease. Paxlovid, molnupiravir, sotrovimab and bebtelovimab are urgently authorized by FDA have been proved to be effective against Omicron. This manuscript mainly reviews the recent progress of effective inhibitors against the virus in the world, including receptor inhibitors, antibodies, natural product inhibitors, synthetic inhibitors and broad-spectrum antiviral drugs that are effective against other RNA viruses.

Intestinal microbiome and its relationship with necrotizing enterocolitis in very low birth weight preterm infants / 中华儿科杂志

Objective: To explore the composition of intestinal microflora prior to onset of necrotizing enterocolitis (NEC) in very low birth weight preterm infants. Methods: This was a multicenter prospective nested case-control study. A total of 46 very low birth weight preterm infants (birth weight <1 500 g and gestional age <35 weeks) within 24 h of life admitted into Neonatal Intensive Care Unit of Children's Hospital of Soochow University and Suzhou Municipal Hospital from April 20 to November 20, 2018 were enrolled. Baseline clinical data and fecal samples of these infants were collected. The subsequent sampling time points were 1st, 4th and 7th day in the first week of life then once per week consecutively. The endpoint of sampling was NEC occurrence, patient discharge or the 8th week post-discharge, whichever came first. Fecal samples were analyzed by 16 S rDNA high-throughput nucleotide sequencing. The control cases were infants without NEC who were matched to the NEC cases with a ratio of 1∶1. The operational taxonomic units (OTU), sequence number and shannon diversity index of the fecal samples were analyzed. Continuous variables were compared with t-test or non-parametric test, and χ2 test or Fisher's exact test was used for categorical variables. Results: There were 23 patients in each group. The gestational age was (29.4±1.8) weeks in NEC group and (29.9±1.6) weeks in control group, including 13 males (57%) and 11 males (48%) in each group, respectively. Species abundance showed that the Firmicutes in both groups decreased temporarily at 7 days of age and then increased with age in control group, but not in NEC group, the Proteobacteria in both groups increased at 7 days of age and then decreased in control group, but kept increasing in NEC group. Regarding the other levels of taxonomy, compared with that of the control group, the NEC group had lower abundance of Proteobacteria, γ-proteobacteria and Enterobacteriaceae at 7 days of age, while higer abundance of Faecalibacterium at 14 days of age, meanwhile, lower Clostridium and Streptococcus at 21 days of age, lower Firmicutes, Clostridia and Clostridium perfringens and higher Proteobacteria and γ-proteobacteria at 28 days of age, these differences were all statistically significant (U=43.00, 43.00, 45.00, 80.00, 74.00, 76.00, 19.00, 8.00, 36.00, 25.00, 25.00,all P<0.05). The shannon index of NEC group was both lower than that of the controls at 21 days of age (2.4 (1.4, 3.0) vs. 3.1 (2.6, 4.0), U=67.00, P=0.027) and 28 days of age (2.4 (1.4, 2.8) vs. 3.9 (3.3, 4.2), U=12.00, P=0.001). Conclusions: The intestinal microflora profile of very low birth weight preterm infants has already changed prior to NEC development. The emergence of differential flora and the reduction of microflora diversity may facilitate early identification and prevention of NEC.

Research progress of microglia in eye disease / 国际眼科杂志(Guoji Yanke Zazhi)

@#Microglia are the resident macrophages of the central nervous system(CNS). Microglia constantly monitor the pathological changes of the surrounding microenvironment. Activated microglia play key roles in tissue protection and injury under the stimulation of various injury factors. Abnormal activation of microglia mediates retinal inflammation and aggravates the original ophthalmic diseases. Our growing understanding of the mechanisms of the interaction between microglia and retinal cells is identifying potential cellular and molecular targets for therapeutic interventions that may be apply to optic nerve injury, diabetic retinopathy, glaucoma and other diseases in the future. In this review, potential links between ophthalmic diseases and microglial activity will be explored.

Predictive value of N-terminal B-type natriuretic peptide on outcome of elderly hospitalized non-heart failure patients / 中华心血管病杂志

Objective: To investigate the predictive value of N-terminal type B natriuretic peptide（NT-proBNP) on the prognosis of elderly hospitalized patients without heart failure（non-heart failure). Method: Elderly patients aged 65 years or older, who were admitted to Beijing Hospital from September 2018 to February 2019, were enrolled in this study. Patients with clinical diagnosis of heart failure or left ventricular ejection fraction（LVEF)<50% were excluded. The patients were divided into 2 groups based on the serum NT-proBNP level: low NT-proBNP group （<125 ng/L) and high NT-proBNP group（≥125 ng/L). Patients were followed up at 3, 6, and 12 months after enrollment, and the major adverse events were recorded. The composite endpoint events included all-cause mortality, readmission or Emergency Department visits. Cardiovascular events include death, readmission or emergency room treatment due to cardiogenic shock, myocardial infarction, angina pectoris, arrhythmia, heart failure or stroke/transient ischemic attack. Results: A total of 600 elderly patients with non-heart failure were included in the analysis. The average age was （74.9±6.5) years, including 304（50.7%) males. The median follow-up time was 344（265, 359) days. One hundred and seventy-eight（29.7%) composite endpoint events were recorded during the follow-up, 19（3.2%) patients died, and 12（2.0%) patients were lost to follow-up. There were 286(47.7%) cases in low NT-proBNP group and 314 cases（52.3%) in high NT-proBNP group. Patients were older, prevalence of atrial fibrillation and myocardial infarction was higher; MMSE scores and ADL scores, albumin and creatinine clearance rate were lower in high NT-proBNP group than in low NT-proBNP group（all P<0.05). At 1-year follow-up, the incidence of composite endpoint events was significantly higher in high NT-proBNP group than in low NT-proBNP group（33.4%（105/314) vs. 24.8%（71/286), P = 0.02). Cardiovascular events were more common in high NT-proBNP group than in low NT-proBNP group（17.5%（55/314) vs. 8.4%（24/286), P = 0.001). Kaplan-Meier survival analysis showed both composite endpoint events（Log-rank P=0.016) and cardiovascular events（Log-rank P=0.001) were higher in high NT-proBNP group than in low NT-proBNP group. All-cause mortality was also significantly higher in highNT-proBNP group than in lowNT-proBNP group（4.8%（15/314) vs. 1.4%（4/286), P = 0.020), and Kaplan-Meier survival analysis demonstrated borderline statistical significance（Log-rank P = 0.052). Cox proportional hazard regression analysis showed that after adjusting for age, sex, creatinine clearance rate, myocardial infarction, and atrial fibrillation, NT-proBNP remained as an independent risk factor for composite endpoint events（HR=1.376，95%CI 1.049-1.806, P=0.021), and cardiovascular events（HR=1.777, 95%CI 1.185-2.664, P=0.005), but not for all-cause mortality（P=0.206). Conclusions: NT-proBNP level at admission has important predictive value on rehospitalization and cardiovascular events for hospitalized elderly non-heart failure patients. NT-proBNP examination is helpful for risk stratification in this patient cohort.

Prevalence and influencing factors of main chronic diseases among urban residents in Liaoning Province / 预防医学

Objective To investigate the prevalence of main chronic diseases and explore its influencing factors among urban residents in Liaoning Province. Methods Using multistage stratified and cluster random sampling method, 30 953 urban residents of 14 districts were investigated with a standard questionnaire and physical examination. The logistic regression was applied to explore the influencing factors of main chronic diseases. Results The prevalence rate of chronic diseases was 39.25% and the standardized prevalence rate was 32.29%. The top three chronic diseases were hypertension, diabetes mellitus, and dyslipidemia, and the standardized prevalence rates were 21.13%, 9.48% and 5.25%. The results of the logistic regression analysis showed that the three chronic diseases shared older age(OR: 1.266-7.325)and overweight or obesity(OR:1.107-2.982)as the risk factors .In addition, there existed certain interactions among hypertension, diabetes mellitus and dyslipidemia(OR: 2.424-3.121). Conclusion Hypertension, diabetes mellitus and dyslipidemia which shared older age, overweight and obesity as the risk factors are the main chronic diseases to damage the health of urban residents in Liaoning. The corresponding prevention and treatment strategies should be taken based on the key groups and related influencing factors.

Analyses of the short-term prognostic factors for recovery of independent walking in Guillain Barre syndrome in children / 临床儿科杂志

Objective To explore the prognostic factors in Guillain Barre syndrome (GBS) in children. Methods A total of 125 children with GBS were included and grouped according to their independent walking at two and six months after discharge, and their clinical data were analyzed. Results In 125 children (74 males, 51 females) the average age was 84.49±25.32 months, and 41 were under 6 years old. 102 children had a history of prodromal infections. 32 children had cranial nerve involvement and 35 had autonomic nerve involvement. 12 children need assisted respiration. At 2 and 6 months after discharge, when compared with children who could walk independently, the rates of functional score > 3, cranial nerve involvement, and neuroelectrophysiology as denervation potential were higher in children who could not walk independently, and the differences were statistically significant (P all<0.05). Conclusions The factors that affect the short-term prognosis are denervation potential in neuroelectrophysiology, cranial nerve involvement, and functional score > 3. Early identification of uniqueness in patients and subsequent development of targeted rehabilitation training should be carried out to improve the prognosis.

Analysis of risk factors and the prognostic risk factors in aged patients with coronary heart disease / 心血管康复医学杂志

Objective:To analyze risk factors and prognostic risk factors in aged patients with coronary heart disease (CHD).Methods:Clinical data of 412 aged patients,who were suspected of CHD in our hospital,were retrospec-tively analyzed.According to results of coronary angiography,they were divided into CHD group (n=283 )and non-CHD group (n=129);risk factors and prognostic risk factors for aged CHD patients were analyzed.Results:Compared with non-CHD group,there were significant rise in percentages of >80 years (13.95% vs.28.98%),di-abetes mellitus (DM,37.98% vs.66.78%)and smoking history (32.56% vs.59.72%)in CHD group,levels of to-tal cholesterol [TC,(5.06±1.53)mmol/L vs.(5.41±1.36)mmol/L],triglyceride [TG,(1.53±0.82)mmol/L vs.(2.02±0.95)mmol/L]and low density lipoprotein cholesterol [LDL-C,(2.05±0.86)mmol/L vs.(2.57 ±1.15)mmol/L],and significant reduction in high density lipoprotein cholesterol level [HDL-C, (1.65 ±0.52) mmol/L vs.(0.86±0.38)mmol/L]in CHD group,P <0.05 or <0.01. Multi-factor Logistic regression analysis indicated that age,DM,hypertension history,smoking,high total cholesterol (TC)and hypertriglyceridemia were independent risk factors for CHD (OR= 1.38 ~8.65,P <0.05 or <0.01 );while serum total bilirubin and high density lipoprotein cholesterol were independent protective factors for CHD (OR=0.224,P =0.002);multi-factor Cox model analysis indicated that smoking history,high TC and hypertension were risk factors affecting prognosis of CHD patients (RR= 1.563 ~ 2.315,P < 0.05 all).Conclusion:In clinic,attention should be paid to reduce or eliminaterelated risk factors of aged CHD patients to improve prognosis.

Analysis of risk factors and the prognostic risk factors in aged patients with coronary heart disease / 心血管康复医学杂志

Objective:To analyze risk factors and prognostic risk factors in aged patients with coronary heart disease (CHD).Methods:Clinical data of 412 aged patients,who were suspected of CHD in our hospital,were retrospec-tively analyzed.According to results of coronary angiography,they were divided into CHD group (n=283 )and non-CHD group (n=129);risk factors and prognostic risk factors for aged CHD patients were analyzed.Results:Compared with non-CHD group,there were significant rise in percentages of >80 years (13.95% vs.28.98%),di-abetes mellitus (DM,37.98% vs.66.78%)and smoking history (32.56% vs.59.72%)in CHD group,levels of to-tal cholesterol [TC,(5.06±1.53)mmol/L vs.(5.41±1.36)mmol/L],triglyceride [TG,(1.53±0.82)mmol/L vs.(2.02±0.95)mmol/L]and low density lipoprotein cholesterol [LDL-C,(2.05±0.86)mmol/L vs.(2.57 ±1.15)mmol/L],and significant reduction in high density lipoprotein cholesterol level [HDL-C, (1.65 ±0.52) mmol/L vs.(0.86±0.38)mmol/L]in CHD group,P <0.05 or <0.01. Multi-factor Logistic regression analysis indicated that age,DM,hypertension history,smoking,high total cholesterol (TC)and hypertriglyceridemia were independent risk factors for CHD (OR= 1.38 ~8.65,P <0.05 or <0.01 );while serum total bilirubin and high density lipoprotein cholesterol were independent protective factors for CHD (OR=0.224,P =0.002);multi-factor Cox model analysis indicated that smoking history,high TC and hypertension were risk factors affecting prognosis of CHD patients (RR= 1.563 ~ 2.315,P < 0.05 all).Conclusion:In clinic,attention should be paid to reduce or eliminaterelated risk factors of aged CHD patients to improve prognosis.

Relationship between hepatitis B virus X protein and hepatic cellular cancer / 药学学报

Hepatic cellular cancer (HCC) is one of the most common cancers in the world, which is a serious threat to human health and life quality. More than 700 000 people die of HCC each year on average, and its incidence increases in many countries. Chronic hepatitis B virus (HBV) infection has been identified as a dominant risk factor for HCC. The pathogenesis of HBV-induced hepatocarcinogenesis is, however, incom-pletely understood. Evidence currently available supports a key role of the HBV X protein (HBx) in the cancer transformation and malignant tumor metastasis. HBx is a multifunctional regulator that may cooperate with the host factors to exert its effects on transcription, signal transduction, cell cycle progression, apoptosis, protein degradation, expression of oncogene and anti-oncogene. This review presents the current knowledge in the molecular pathogenesis of HBx in the induction of HCC.

Evidence of perineural invasion on early-stage cervical cancer and prognostic significance / 中华妇产科杂志

Objective To evaluate the incidence and significance of perineural invasion (PNI) in cervical cancer. Methods Retrospective chart review of patients with cervical cancer (stages Ⅰa2-Ⅱb) who underwent radical hysterectomy and pelvic lymphadenectomy from 2007 to 2012. To evaluate the incidence and significance of PNI in cervical and uterine tissues by microscopic examination. Results A total of 238 patients were included, 9.2% (22/238) patients with PNI in the cervical stroma. Patients with PNI were more likely to have adverse histopathologic features, including lymphoma vascular space invasion, parametrical invasion, depth of invasion, tomor size and lymph nodes metastases (all P0.05). Patients with PNI had shorter disease-free and overall survival (P=0.002 and P=0.008, respectively). On multivariate analysis, risk factors for recurrence and death included parametrical invasion and depth of invasion (P0.05). Conclusions PNI exists in early cervical cancer. PNI is associated with tumor size, depth of invasion, parametrical invasion, lymphoma vascular space invasion and lymph nodes metastases. PNI represente a decreasing disease-free and overall survival in patients with early-stage cervical cancer, and is independently associated with multiple high-risk factors, which be informed management decisions regarding adjuvant therapy.

Differentiating Benign from Malignant Bone Tumors Using Fluid-Fluid Level Features on Magnetic Resonance Imaging

OBJECTIVE: To analyze different fluid-fluid level features between benign and malignant bone tumors on magnetic resonance imaging (MRI). MATERIALS AND METHODS: This study was approved by the hospital ethics committee. We retrospectively analyzed 47 patients diagnosed with benign (n = 29) or malignant (n = 18) bone tumors demonstrated by biopsy/surgical resection and who showed the intratumoral fluid-fluid level on pre-surgical MRI. The maximum length of the largest fluid-fluid level and the ratio of the maximum length of the largest fluid-fluid level to the maximum length of a bone tumor in the sagittal plane were investigated for use in distinguishing benign from malignant tumors using the Mann-Whitney U-test and a receiver operating characteristic (ROC) analysis. Fluid-fluid level was categorized by quantity (multiple vs. single fluid-fluid level) and by T1-weighted image signal pattern (high/low, low/high, and undifferentiated), and the findings were compared between the benign and malignant groups using the chi2 test. RESULTS: The ratio of the maximum length of the largest fluid-fluid level to the maximum length of bone tumors in the sagittal plane that allowed statistically significant differentiation between benign and malignant bone tumors had an area under the ROC curve of 0.758 (95% confidence interval, 0.616-0.899). A cutoff value of 41.5% (higher value suggests a benign tumor) had sensitivity of 73% and specificity of 83%. CONCLUSION: The ratio of the maximum length of the largest fluid-fluid level to the maximum length of a bone tumor in the sagittal plane may be useful to differentiate benign from malignant bone tumors.

Value of multidetector CT on aiding intraoperative judgement of serosal invasion of gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the value of multidetector CT on aiding intraoperative judgement of serosal invasion of gastric cancer.</p><p><b>METHODS</b>Clinical data of 206 cases of gastric cancer undergoing radical surgery in the First Hosptial of China Medical University from August 2009 to June 2011 were analyzed retrospectively. Preoperative CT findings and intraoperative judgement of serosal invasion in gastric cancer were compared with pathological results in order to investigate their values.</p><p><b>RESULTS</b>The sensitivity and specificity of preoperative CT findings and intraoperative judgement of serosal invasion were 88.5%, 81.5% and 98.9%, 61.3%, respectively. The accuracy of preoperative CT in diagnosing serosal invasion was higher than that of intraoperative judgement, while the difference was not statistically significant (84.5% vs. 77.2%, P=0.060). The rates of serosal invasion of normal type, reactive type, nodular type, tendonoid type and color-diffused type were 0 (0/29), 2.5% (1/40), 40.5% (15/37), 59.2% (29/49), and 82.4% (42/51) respectively. The accuracy of preoperative CT in diagnosing serosal invasion of gastric cancer with tendonoid type was higher than that of intraoperative judgement, and the difference was statistically significant (61.2% vs. 87.8%, P=0.002).</p><p><b>CONCLUSIONS</b>Multidetector CT plays an important role in aiding intraoperation judgement of serosal invasion of gastric cancer. For gastric cancer with tendonoid and color-diffused macroscopic serosal appearance, surgeons should pay attention to the value of preoperative CT findings.</p>

Cell death of THP-1 induced by puried Rv3671c protein of tuberculosis and the detection of TNF-α and IL-1β in Mycobacterium tuberculosis / 中华预防医学杂志

<p><b>OBJECTIVE</b>To assess the response in THP-1 treated with Rv3671c protein in Mycobacterium tuberculosis (M.tuberculosis).</p><p><b>METHODS</b>The gene encoding Rv3671c protein of M.tuberculosis was cloned into pET-28a vector and then expressed in Escherichia coli. The Rv3671c was purified with Ni-NTA affinity and ion exchange chromatography. The detection of protein concentration was by Lowry method.THP-1 cell was stimulated with Rv3671c protein and cells were analyzed by Hochest staining under fluorescence microscopy to assay cell death (apoptosis and necrosis). TNF-α and IL-1β were detected by ELISA at each stimulating time.</p><p><b>RESULTS</b>The Rv3671c protein of M.tuberculosis was successfully expressed in Escherichia coli. The purity of recombinant Rv3671c protein was 95%, and the protein concentration was up to 0.4 mg/ml. The nucleus of THP-1 was isolated and necrosis-like under fluorescence when cells were stimulated by Rv3671c protein. The levels of TNF-α and IL-1β in supernatant were 19 000 and 16 500 pg/ml respectively, and were significantly higher than control cells with the levels of 2100 and 3800 pg/ml separately.</p><p><b>CONCLUSION</b>The necrosis of THP-1 cells could be stimulated by Rv3671c protein of M.tuberculosis and it was probably associated with high cytokines TNF-α and IL-1β levels.</p>

Immediately effects of inhaled aerosolised iloprost in adult patients with severe pulmonary hypertension secondary to congenital heart diseases / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the immediately effects of inhaled aerosolized iloprost in adult patients with severe pulmonary arterial hypertension (PAH) secondary to congenital heart diseases (CHD).</p><p><b>METHODS</b>Adult patients with severe PAH secondary to CHD (n = 165) were included in this study. Right heart catheterization was performed, Pulmonary and systemic blood flow, the oxygen consumption VO(2) (ml/min) were calculated using Fick's principle. Pulmonary vascular resistances (PVR) were calculated with standard formulas and indexed to body surface area. Hemodynamic parameters were measured before and after iloprost inhalation (20 µg).</p><p><b>RESULTS</b>Post iloprost inhalation, heart rate, mean aortic pressure, pulmonary systolic pressure to aortic systolic pressure ratio all remained un changed (P > 0.05), while pulmonary artery pressure (PAP) were significantly reduced and Qp significantly increased from (7.2 ± 4.8) L/min to (9.9 ± 7.2) L/min (P < 0.01), PVR was also significantly reduced from (13.4 ± 8.7) Wood units to (9.5 ± 6.6) Wood units (P < 0.01), and left-to-right shunt volume increased from (3.2 ± 4.4) L/min to (5.5 ± 7.0) L/min (P < 0.01) and right-to-left shunt volume decreased from (1.0 ± 1.0) L/min to (0.7 ± 0.7) L/min (P < 0.01). Subgroup analysis showed that adult patients with patent ductus arteriosus and/or ventricular septal defects are more likely to develop severe pulmonary arterial hypertension or Eisenmenger syndrome than patients with atrial septal defects.</p><p><b>CONCLUSIONS</b>Inhaled Aerosolised iloprost use is effective and safe for adult patients with severe pulmonary arterial hypertension secondary to congenital heart diseases.</p>

Fast identification of mycobacteria in microtiter liquid culture / 中华预防医学杂志

<p><b>OBJECTIVE</b>This research was to establish a method for fast identification of mycobacteria in microtiter liquid culture and to evaluate its clinical value.</p><p><b>METHODS</b>2-thiophenecarboxylic acid hydrazide (TCH) and paranitrobenzoic acid (PNB) at different concentrations were added into liquid culture in 96-well plate. Different mycobacterium standard strains were incubated in liquid culture with PNB and TCH for 7 to 10 days. According to the growth assay for 15 mycobacterium strains and 30 mycobacterium tuberculosis strains, the best PNB and TCH concentration were determined. A total of 424 clinical mycobacterium isolates were identified by microtiter liquid culture at the best PNB and TCH concentration. The results of microtiter liquid culture were compared with those of PCR and DNA sequencing.</p><p><b>RESULTS</b>The best concentration of PNB was 200 µg/ml in microtiter liquid culture. Compared with the results of PCR, the sensitivity and specificity for identification of mycobacterium tuberculosis complex in microtiter liquid culture were 97.8% (306/313) and 100.0% (107/107) respectively and those for non-tuberculosis mycobacteria in microtiter liquid culture were 100.0% (107/107) and 96.5% (306/317) respectively. The best concentration of TCH was 0.5 µg/ml. Compared with the results of PCR, the sensitivity of mycobacterium tuberculosis in microtiter liquid culture was 100.0% (305/305). The specificity remained under and more studies were needed.</p><p><b>CONCLUSION</b>In microtiter liquid culture with PNB and TCH, mycobacteria can be identified in 7 to 10 days. The results were accurate and the process was simple without expensive equipments. This method meets clinical needs and can be used in all level hospitals in China.</p>

Evaluation of microscopic observation drug susceptibility for drug susceptibility testing of mycobacterium tuberculosis in smear-positive sputum / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate microscopic observation drug susceptibility (MODS) for mycobacterium tuberculosis drug susceptibility in smear-positive sputum.</p><p><b>METHODS</b>Drug susceptibility of mycobacterium tuberculosis in 275 smear-positive sputum samples collected from TB patients were detected directly by MODS. The susceptibility of seven antimicrobials including streptomycin, isoniazid, rifampicin, ethambutol, levofloxacin, amikacin and capromycin were detected MODS. At the same time the sputum sample were cultured in MGIT 960 tube and the positive isolates were tested for drug susceptibility by MGIT 960 system. The results of MODS were analyzed and compared with that of MGIT 960.</p><p><b>RESULTS</b>Of 275 smear-positive sputum, MODS detected 235 (85.45%). Results of MODS were obtained in a median time of 18 days (5 - 39 d). For the 235 MODS-positive samples, the compliance rates of MODS to MGIT of 7 drugs were 90.21% (212/235), 88.09% (207/235), 93.62% (220/235), 87.23% (205/235), 92.34% (217/235), 88.51% (208/235) and 86.81% (204/235) respectively. The sensitivity of MODS method were 83.33% (90/108), 85.11% (120/141), 90.74% (98/108), 85.71% (78/91), 86.73% (85/98), 76.92% (40/52) and 77.08% (37/48). The specificities of MODS method were 96.06% (122/127), 92.55% (87/94), 96.06% (122/127), 88.19% (127/144), 96.35% (132/137), 91.80% (168/183) and 89.30% (167/187) respectively.</p><p><b>CONCLUSION</b>MODS is an optimal alternative method for direct and rapid drug susceptibility of sputum with high accuracy in a timely and affordable way in resource-limited settings.</p>

Prevalence trend of neural tube defect in Zhengzhou city, 1996-2005 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To describe the prevalence trend and epidemiological characteristics of neural tube defects (NTDs) in perinatal in Zhengzhou city from 1996 to 2005.</p><p><b>METHODS</b>Data collected from hospital were used to depict the epidemiology of NTDs in Zhengzhou. All perinatal fetuses born in hospitals had an access within 7 days after delivery. The prevalence were calculated by perinatal'year, sex, birth area (urban versus rural) and maternal age. All monitored perinatal (162,074) accounted for 32.66% from totals (496,203).</p><p><b>RESULTS</b>All 238 cases were found NTDs, and the overall prevalence rate was 14.68/10,000. The annual prevalence rate presented a decreasing trend during that period. The rates in rural and urban area, in male and female birth were 29.28/10,000 and 9.63/10,000, 11.42/10,000 and 17.74/10,000 respectively. There were significant differences among maternal-age-specific prevalence rates (chi2 = 22.952, P = 0.000). The rates of <20 years group(53.76/10,000) and >35 years group(21.74/10,000) were higher than others.</p><p><b>CONCLUSION</b>The prevalence rates of NTDs in rural area is higher than that in urban, female's is higher than male's in Zhengzhou. The annual prevalence rates of NTDs presents a decreasing trend in the past ten years.</p>

A randomized, controlled, double-blind trial of Huannao Yicong capsule in senile patients with mild cognitive impairment / 中西医结合学报

OBJECTIVE: To observe the effect and explore the mechanism of Huannao Yicong capsule in treating senile patients with mild cognitive impairment (MCI). METHODS: The investigational drugs were packed by blind method. A randomized, double-blind and controlled trial was conducted on ninety senile patients with MCI. Other forty-five senile healthy persons were recruited to the healthy control group. The ninety senile patients were randomly divided into the Huannao Yicong capsule-treated group (45 patients administered with three Huannao Yicong capsules and two aniracetam capsule analogues) and aniracetam-treated group (45 patients treated with two aniracetam capsules and three Huannao Yicong capsule analogues). Patients in the two groups were treated three times daily for 16 weeks. Memory, traditional Chinese medicine syndrome, cerebral blood flow, free radicals and inflammatory mediators, such as superoxide dismutase (SOD), malondialdehyde (MDA), acetylcholinesterase (AchE), interleukin-1alpha (IL-1alpha) and interleukin-6 (IL-6) were determined before and after the treatment. Blood lipids, including triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), apolipoprotein A-1 (ApoA-1) and apolipoprotein B-100 (ApoB-100), were detected before and after the treatment. The safety indexes, such as routine tests of blood and urine, hepatic and renal function tests and electrocardiogram (ECG) were taken before and after the treatment. RESULTS: Index score of clinical memory scale in senile healthy people was significantly higher than that in MCI patients before treatment (P<0.01), and the content of AchE, IL-1alpha and IL-6 was obviously lower (P<0.01, P<0.05), the activity of SOD was higher (P<0.05). No significant difference was found in direction memory of clinical memory scale between the two treatment groups. Other index scores of clinical memory scale and traditional Chinese medicine syndrome in patients of Huannao Yicong capsule-treated group were significantly improved as compared with those of the aniracetam-treated group (P<0.05, P<0.01). The blood flow parameters of anterior cerebral artery, posterior cerebral artery and resistant index in patients of Huannao Yicong capsule-treated group were increased significantly (P<0.01, P<0.05). Huannao Yicong capsule could significantly increase the activity of serum SOD and decrease the content of AchE, IL-1alpha and IL-6 (P<0.01, P<0.05), better than aniracetam. Furthermore, Huannao Yicong capsule could significantly improve the blood lipid, such as the level of TG, LDL-C, HDL-C, ApoA-1 and ApoB-100 (P<0.01, P<0.05), and better than aniracetam (P<0.01, P<0.05). No significant changes were found after treatment in safety indexes, such as routine tests of blood and urine, hepatic and renal function tests and ECG. CONCLUSION: Huannao Yicong capsule has better therapeutic effect than aniracetam capsule in treating senile mild cognitive impairment.

Central venous catheter related Infection and risk factors after cardiovascular surgery / 中国综合临床

Objective To investigate the pathogen culturing of the catheter related infection(CRI),cathe-ter related bloodstram infection(CRB)and risk factors after central venous catheter(CVC)of cardiovascular surgery in order to provide the beneficial reference.Methods From Jan 2005 to Dec 2005,a total of 300 cases central ve-nous cathers were determined,and the cusp of the catheters was determined by bacteria cultivation,and blood bacte-ria cultivation.Results The infection happened in 35 of 300 patients with inserted central venous catheter.The cusps of CRI rate was 11.7%.CRB rate was 1.7%.54.3%pathogens were gram-positive cocci,34.3% were gram-negative bacilli,11.4% were fungi.The most common strain were Staphylococcus epidermis,Staphylococcus aureus,Klebsiella pneumoniae,Pseudomonas aeruginose,and Candiadia albicans.The infection rate increased obviously when the dwelling time>6 d.Conclusion CRI and CRB are the most severe complication of CVC,and it is important to cut down the death with the early diagnosis and applying antibiotics rationally.