Mechanism of n-butanol alcohol extract of Baitouweng Decoction in treatment of vulvovaginal candidiasis based on negative regulation of NLRP3 inflammasome via PKCδ/NLRC4/IL-1Ra axis / 中国中药杂志

This study aimed to explore the mechanism of n-butanol alcohol extract of Baitouweng Decoction(BAEB) in the treatment of vulvovaginal candidiasis(VVC) in mice based on the negative regulation of NLRP3 inflammasome via PKCδ/NLRC4/IL-1Ra axis. In the experiment, female C57BL/6 mice were divided randomly into the following six groups: a blank control group, a VVC model group, high-, medium-, and low-dose BAEB groups(80, 40, and 20 mg·kg~(-1)), and a fluconazole group(20 mg·kg~(-1)). The VVC model was induced in mice except for those in the blank control group by the estrogen dependence method. After modeling, no treatment was carried out in the blank control group. The mice in the high-, medium-, and low-dose BAEB groups were treated with BAEB at 80, 40, and 20 mg·kg~(-1), respectively, and those in the fluconazole group were treated with fluconazole at 20 mg·kg~(-1). The mice in the VVC model group received the same volume of normal saline. The general state and body weight of mice in each group were observed every day, and the morphological changes of Candida albicans in the vaginal lavage of mice were examined by Gram staining. The fungal load in the vaginal lavage of mice was detected by microdilution assay. After the mice were killed, the degree of neutrophil infiltration in the vaginal lavage was detected by Papanicolaou staining. The content of inflammatory cytokines interleukin(IL)-1β, IL-18, and lactate dehydrogenase(LDH) in the vaginal lavage was tested by enzyme-linked immunosorbent assay(ELISA), and vaginal histopathology was analyzed by hematoxylin-eosin(HE) staining. The expression and distribution of NLRP3, PKCδ, pNLRC4, and IL-1Ra in vaginal tissues were measured by immunohistochemistry(IHC), and the expression and distribution of pNLRC4 and IL-1Ra in vaginal tissues were detected by immunofluorescence(IF). The protein expression of NLRP3, PKCδ, pNLRC4, and IL-1Ra was detected by Western blot(WB), and the mRNA expression of NLRP3, PKCδ, pNLRC4, and IL-1Ra was detected by qRT-PCR. The results showed that compared with the blank control group, the VVC model group showed redness, edema, and white secretions in the vagina. Compared with the VVC model group, the BAEB groups showed improved general state of VVC mice. As revealed by Gram staining, Papanicolaou staining, microdilution assay, and HE staining, compared with the blank control group, the VVC model group showed a large number of hyphae, neutrophils infiltration, and increased fungal load in the vaginal lavage, destroyed vaginal mucosa, and infiltration of a large number of inflammatory cells. BAEB could reduce the transformation of C. albicans from yeast to hyphae. High-dose BAEB could significantly reduce neutrophil infiltration and fungal load. Low-and medium-dose BAEB could reduce the da-mage to the vaginal tissue, while high-dose BAEB could restore the damaged vaginal tissues to normal levels. ELISA results showed that the content of inflammatory cytokines IL-1β, IL-18, and LDH in the VVC model group significantly increased compared with that in the blank control group, and the content of IL-1β, IL-18 and LDH in the medium-and high-dose BAEB groups was significantly reduced compared with that in the VVC model group. WB and qRT-PCR results showed that compared with the blank control group, the VVC model group showed reduced protein and mRNA expression of PKCδ, pNLRC4, and IL-1Ra in vaginal tissues of mice and increased protein and mRNA expression of NLRP3. Compared with the VVC model group, the medium-and high-dose BAEB groups showed up-regulated protein and mRNA expression of PKCδ, pNLRC4, and IL-1Ra in vaginal tissues and inhibited protein and mRNA expression of NLRP3 in vaginal tissues. This study indicated that the therapeutic effect of BAEB on VVC mice was presumably related to the negative regulation of NLRP3 inflammasome by promoting PKCδ/NLRC4/IL-1Ra axis.

Influencing factors of postpartum depression/anxiety in Jinping Area, Yunnan Province / 中华围产医学杂志

Objective:To investigate the positive rate of postpartum depression/anxiety screening and its associated factors in Jinping area, Yunnan Province.Methods:This cross-sectional survey involved 761 women who delivered live, singleton infants at or after 28 gestational weeks from October 2019 to February 2021 in the People's Hospital of Jinping Miao, Yao, and Dai Autonomous County, Honghe Hani and Yi Autonomous Prefecture, Yunnan Province. A questionnaire survey on childbirth and upbringing, the Edinburgh Postnatal Depression Scale (defined as positive when ≥9 score), and the Self-rating Anxiety Scale (defined as positive when ≥50 score) were conducted at postpartum day 1 to 3. General obstetric information and medical history were also retrieved from medical records. The risk factors of maternal depression and anxiety were analyzed using Chi-square test and multivariate logistic regression. Results:All 761 parturients completed the questionnaire. The total positive rate was 7.49% (57/761) for depression screening and 8.02% (61/761) for anxiety screening. Univariate analysis showed that postpartum hemorrhage, intrapartum infection and puerperal morbidity, neonates being transferred to the pediatric ward, attendance of prenatal classes during pregnancy, whether the neonatal gender was in line with the maternal and family expectations were all associated with both postpartum depression and postpartum anxiety. In addition, an association was found between gravidity, parity, delivery mode and postpartum depression, as well as accompanied delivery, breastfeeding and postpartum anxiety (all P<0.05). Multivariate analysis showed that postpartum hemorrhage ( OR=1.934, 95% CI: 1.010-3.704), neonates being transferred to the pediatric ward ( OR=1.990, 95% CI: 1.037-3.816), and not attending prenatal classes during pregnancy ( OR=3.393, 95% CI: 1.166-9.872) were the risk factors for postpartum depression; neonates being transferred to the pediatric ward ( OR=1.972, 95% CI: 1.040-3.740) and non-breastfeeding ( OR=2.174, 95% CI: 1.077-4.389) were risk factors for postpartum anxiety (all P<0.05). Conclusions:Parturients in Jinping area of Yunnan Province were at a lower risk of postpartum depression/anxiety. Active attendance at prenatal classes and breastfeeding may help reduce the risk of postpartum depression/anxiety.

Treatment and prognosis of 826 infants with critical congenital heart disease: a single center retrospective study / 中华心血管病杂志

Objective: To analyze the current status of clinical treatment and factors influencing postoperative mortality in infants with critical congenital heart disease (CCHD) in China, optimize the perioperative management of CCHD, and provide a new scientific basis for clinical decision-making for the optimal management of these patients. Methods: This is a retrospective single-center study. Infants diagnosed with CCHD in Guangdong Provincial People's Hospital from January 2017 to December 2019 (aged 0-1 years at admission) were enrolled. General clinical information, inpatient treatment information, prognosis and complications were collected and analyzed. Multivariate logistic regression analysis was used to explore the independent risk factors of postoperative death in infants with CCHD. Results: A total of 826 infants with CCHD were included, including 556 males (67.3%) and the age at first admission was 51.0 (5.0,178.3) days. 264 (32.0%) cases were tetralogy of Fallot and 137 (16.6%) cases were total anomalous pulmonary venous return. 195 cases (23.6%) were diagnosed prenatally. 196 cases (23.7%) were treated with prostaglandin. The preoperative invasive ventilation time was 0 (0, 0) hour, and the postoperative invasive ventilation time was 95.0 (26.0, 151.8) hours. A total of 668 cases (80.9%) underwent surgical treatment. The age was 100.5 (20.0, 218.0) days during operation and the operation time was 190.0 (155.0, 240.0) hours. Sixty-two cases (7.5%) received medical treatment, and 96 cases (11.6%) gave up treatment. A total of 675 cases (81.7%) were discharged with improvement, 96 cases (11.6%) were discharged after giving up treatment, 55 cases (6.7%) died and 109 cases (13.2%) were readmitted within one year. Complications occurred in 565 (68.6%) cases, including pneumonia in 334 cases (40.4%) and cardiac arrhythmias in 182 cases (22.0%). Multifactorial analysis showed that delayed chest closure (OR=49.775, 95%CI 3.291-752.922, P=0.005), prolonged post-operative invasive ventilator ventilation (OR=1.003, 95%CI 1.000-1.005, P=0.038) and cardiac hypoplasia syndrome (OR=272.658, 95%CI 37.861-1 963.589, P<0.001) were the independent risk factors for mortality in CCHD infants post-operation. Conclusions: Tetralogy of Fallot and total anomalous pulmonary venous return account for the majority of infants with CCHD. The proportion of infants diagnosed prenatally was less than 1/4. The majority CCHD infants received surgical treatment. The main complications are pneumonia and arrhythmia. Delayed chest closure, prolonged postoperative invasive ventilator ventilation and low cardiac output syndrome are the independent risk factors for postoperative death in infants with CCHD.

Classification and distribution of fracture areas in fresh osteoporotic vertebral compression fractures based on CT multi-planar reconstruction and MRI / 中国组织工程研究

BACKGROUND; Some scholars have classified osteoporotic vertebral compression fractures based on X-ray and MRI findings. However, little is reported on the morphological types and distribution rules of fracture areas in osteoporotic vertebral compression fractures. OBJECTIVE; To investigate and summarize the morphological types and distribution of fracture areas in fresh osteoporotic vertebral compression fractures based on CT multi-planar reconstruction and MRI. METHODS; Clinical data from 352 patients with osteoporotic vertebral compression fractures, 73.07 years of age, including 69 males and 283 females admitted at the First Affiliated Hospital of Guangzhou University of Chinese Medicine from September 2011 to June 2017 were retrospectively reviewed. After admission, CT multi-planar reconstruction, MRI and bone mineral density measurements were conducted in each patient. Fresh osteoporotic vertebral compression fractures were confirmed in 477 vertebrae according to clinical manifestations and imaging findings. Fracture areas were defined as shade compact or bright line based on CT multi-planar reconstruction or bone marrow edema on the MRI. Morphological type and distribution of fracture areas were recorded by two experienced spinal surgeons and one senior radiologist independently. The study protocol was approved by the Ethic Committee of the First Affiliated Hospital of Guangzhou University of Chinese Medicine in China with an approval No. ZYYECKYJ[2017]057. RESULTS AND CONCLUSION: Fracture areas of 472 vertebrae were indicated distinctly on the MRI, whereas the fracture areas of 5 vertebrae were unclear. Meanwhile, fracture areas of 469 vertebrae were shown clearly on the CT multi-planar reconstruction, but the areas of 8 vertebrae were obscure on the CT. Fracture areas of 5 vertebrae were unclear in both CT and MRI. There was no significant difference between CT and MRI in the observation of fracture areas (P=0.402). Finally, fracture areas of 8 vertebrae could not be described accurately on CT, MRI or both. In the sagittal plane of CT and MRI, morphological types of fracture areas of 469 vertebrae were divided into impacted fracture area (n=311, 66.31%) and cleft fracture area (n=158, 33.69%). Of the 158 cleft fracture areas, 26 vertebrae contained gas, 28 vertebrae contained liquid, and 7 vertebrae included both gas and liquid. Of the 469 vertebrae, the location of fracture areas was divided into 5 types: Superior (n=238, 50.75%), inferior (n=80,17.06%), anterior (n=21, 4.48%), central (n=110, 23.45%) and mixed (n=20, 4.26%). These findings indicate that the morphological types and distribution of fracture areas in fresh osteoporotic vertebral compression fractures can be effectively distinguished by CT multi-planar reconstruction and MRI, which is important for early diagnosis and further treatment of fresh osteoporotic vertebral compression fractures.

Establish mouse osteoblast -osteoclast cell co-culture system in a Transwell chamber / 中国骨伤

<p><b>OBJECTIVE</b>To establish osteoblast-osteoclast cell co-culture system in a Transwell chamber, and detect cell viability of osteoblasts and osteoclasts in system.</p><p><b>METHODS</b>Osteoblast MC3T3-E1 and mouse monocytes RAW264.7 were cultivated in vitro. RANKL-induced mouse RAW264.7 monocytes differentiated into mature osteoclasts, osteoblast-osteoclast cell co-culture system was established in Transwell chamber. Cell activity of osteoblasts and osteoclasts were detected by CCK-8 experimenting, Alizarin Red staining, TRAP staining. The expression of OPG, ALP, RANKL, TGF-b1 gene and RANKL protein in osteoblast MC3T3-E1 were detected by PCR, Western-Blot methods. Also, the expression of RANK, NF-κB in gene and protein level in osteoclast were measured through the same method respectively.</p><p><b>RESULTS</b>The co-culture system of Mouse MC3T3-E1 cells and RAW264.7 cell were established in Transwell chamber. Co-culture system affected cell division activities of osteoblasts and osteoclasts. Differentiation of osteoblasts were increased, while differentiation of osteoclast division were slight decreased under microscope observation. OPG (0.65±0.08) and ALP (0.16±0.01) gene expression of co-culture system were less than single culture OPG(1.00±0.08) and ALP (1.01±0.16); TGF-b1(4.42±0.21) and RANKL(4.12±1.04) of osteoblasts in co-culture system were higher than TGF-b1(1.00±0.10) and RANKL(1.00±0.09) under single culture. However, gene expression of RANK(0.63±0.06) and NF-κB(0.64±0.08) in co-culture system were decreased than RANK(1.00±0.08) and NF-κB(1.00±0.09), in single culture, and had significant differences. Similarly, protein expression of OPG(0.43±0.05) and NF-κB(0.59±0.05) of co-culture system were less than OPG(0.84±0.06) and NF-κB(1.13±0.03) of single culture. While RANKL protein expression (0.54±0.03)of co-culture system was more than single culture RANKL(0.31±0.03), and had statistically differences, which was in agreement of the trend of gene expression change.</p><p><b>CONCLUSIONS</b>Co-culture system of mouse MC3T3-E1 cells and RAW264.7 cell was viable in Transwell chamber, and the activity of osteoblasts is higher than osteoclasts in co-culture system.</p>

Therapeutic Effect of Posterior Decompression, Internal Fixation and Interlaminar Fusion for Severe Osteoporotic Vertebral Fractures and Collapse Complicated with Spinal Canal Encroachment / 广州中医药大学学报

Objective To evaluate the clinical effect of posterior decompression, internal fixation and interlaminar fusion for the treatment of severe osteoporotic vertebral fracture and collapse complicated with spinal canal encroachment. Methods A retrospective study was carried out in 27 cases of severe osteoporotic vertebral fractures complicated with spinal canal encroachment. The patients were treated with posterior decompression, internal fixation and interlaminar fusion during the period from January 1, 2009 to December 31, 2014. All patients were given vertebral pedicle screw fixation after pedicle augmentation with bone cement. The pain scores of visual analogue scale(VAS), Oswestry Disability Index(ODI), Cobb angle , thoracolumbar Cobb angle and the recovery of neurological function(estimated by Frankel grading system) of the patients were compared beforeoperation, one week after operation and at the end of follow-up. The incidences of internal fixation failure, adjacent vertebral fracture and bone cement leakage also were recorded. Results The patients were followed up for an average of 27 months. The spinal canal occupation rate caused by fracture fragment of posterior vertebral wall was 27.41%~63.85%, with an average of(43.24 ± 10.61)%. Postoperative VAS pain scores, ODI, Cobb angle and thoracolumbar Cobb angle were statistically different from those before operation (P 0.05). In respect of Frankel grading of neurological function at the end of the follow-up, 6 cases were in grade D and 19 cases were in grade E, but the differences were insignificant compared with those before operation (P > 0.05). None of the patients had surgical site infection, screw looseness or breakage, or rod breakage during the follow-up period. There were 8 patients with asymptomatic bone cement leakage after operation. Vertebral compression fractures recurred in 5 patients, of which 2 had adjacent vertebral fractures and 3 had non -adjacent segment. Conclusion The therapy of posterior decompression, internal fixation and interlaminar fusion is effective for the treatment of severe osteoporotic vertebral fracture and collapse complicated with spinal canal encroachment by obviously relieving pain, improving the physiological function of the spine and stabilizing the spine.

Efficacy comparison between targeted and conventional percutaneous vertebroplasty of osteoporotic vertebral compression fractures / 中华创伤杂志

Objective To compare the clinical outcomes between conventional percutaneous vertebroplasty (PVP) and targeted PVP in the treatment of osteoporotic vertebral compression fractures (OVCFs).Methods A retrospective cohort study was designed to review 215 cases of single level OVCFs hospitalized between January 2014 and December 2015.According to the procedure techniques,the patients were assigned to targeted PVP group (89 cases) and conventional PVP group (126 cases) which was further divided into sufficient filled subgroup (110 cases) and insufficient filled subgroup (16 cases) on basis of cement distribution.Key techniques of targeted PVP included accurate needle insertion to fractured area and cement injection using a push rob with a side opening.Operating time,cement injection volume,rate and types of cement leakage,cement distribution in the fractured area and visual analogue score (VAS) of back pain were compared between the two groups.Results Operating time in targeted PVP group was longer than that in conventional PVP group (P ＜ 0.05).There were no significant differences in cement injection volume and rate and types of cement leakage between the two groups (P ＞ 0.05).None in targeted PVP group showed insufficient cement distribution in fractured area,while 16 cases (12.7％) in conventional PVP group (P ＜ 0.05).No significant differences in preoperative VAS of back pain existed among targeted PVP group,sufficient subgroup and insufficient subgroup (P ＞ 0.05).VAS of back pain was significantly decreased after PVP in three groups (P ＜ 0.05).Difference in postoperative VAS of back pain between targeted PVP group and sufficient filled subgroup was insignificant (P ＞0.05).However,postoperative VAS of back pain in insufficient filled subgroup was significantly increased compared with targeted PVP group and sufficient filled subgroup (P ＜ 0.05).Conclusion Targeted PVP provides sufficient cement to fill the fractured area and decreases incidence of unsatisfactory clinical outcome compared with traditional PVP,indicating a secure and effective new technique in the treatment of OVCFs.

Injured vertebra pedicle screww fixation versus short-segment pedicle instrumentation for thoracolumbar fracture:a meta-analysis / 中国组织工程研究

BACKGROUND: Posterior internal fixation is one of the most common methods for thoracolumbar fractures. There is a lack of systematic evaluation about the efficacy of injured vertebra pedicle screw fixation(IVPSF)versus short-segment pedicle instrumentation (SSPI) for thoracolumbar fracture. OBJECTIVE: To compare the clinical outcomes of IVPSF and SSPI for single thoracolumbar fracture through a METHODS: A computer-based on-line research of PubMed, Medline, Embase, Cochrane Library, CNKI, and WanFang databases was performed for the studies regarding IVPSF versus SSPI for thoracolumbar fracture from 1990 to 2016. meta-analysis. The randomized controlled trials and cohort studies were collected based on the strict criteria of inclusion and exclusion. A meta-analysis was conducted on Revman5.3 sofeware. RESULTS AND CONCLUSION: (1) Eleven articles were enrolled, including 5 English and 6 Chinese ones, involving 689 patients (328 cases for IVPSF and 361 cases for SSPI). (2) The meta-analysis indicated that the operation time, blood loss and mean hospital stay showed no significant differences between two groups. IVPSF showed more effective than SSPI in the kyphotic angle correction and anterior vertebral height recovery at postoperation and 1-5 years of follow-up. Moreover, the incidence of postoperative fixation failure in IVPSF was lower than that in SSPI. (3) These findings suggest that IVPSF that reduces the postoperative fixation failure rate for thoracolumbar fractures provides better kyphosis correction and restoration of anterior vertebral height at post-operation and 1-5 years of follow-up.

Research advancement of calcium phosphate and calcium sulfate scaffolds in bone tissue engineering / 中国组织工程研究

BACKGROUND: It is a hotspot that calcium phosphate and calcium sulphate as the main ingredients are combined with one or more other materials to improve or increase the performance of bone tissue engineering scaffolds. OBJECTIVE: To introduce the research advance of these two kinds of scaffolds in bone tissue engineering. METHODS: The articles related to the bone tissue engineering published during January 2000 to June 2015 were retrieved from CNKI and PubMed databases by computer. The key words were “bone tissue engineering, scaffold, calcium phosphate, calcium sulphate, vascularization” in Chinese and English, respectively. ESULTS AND CONCLUSION: Calcium phosphate and calcium sulfate are characterized as having good biocompatibility, biodegradability, osteoconductivity and complete bone substitutability. However, single use of calcium phosphate or calcium sulfate scaffold has certain disadvantages, both of which are difficult to ful y meet the requirements of the bone defect repair. Improvement can be acquired in the mechanical strength, injectability and biodegradability, as wel as drug-loading and pro-angiogenesis of the scaffold in combination with other materials. In the basal and clinical research, we should explore and develop ideal scaffolds in on the basis of therapeutic aim. However, most of the scaffold studies are stil at the extracorporeal and animal experiment stage, and the comparative studies on composite scaffolds and optimal proportion of those composite scaffolds stil need to be further investigated.

Risk factors for multiple level osteoporosis vertebral compression fractures / 中国骨伤

<p><b>OBJECTIVE</b>To identify risk factors associated with patients suffered multiple level osteoporosis vertebral compression fractures(OVCFs).</p><p><b>METHODS</b>From March 2011 to March 2015, 199 patients suffered osteoporotic were classified into multiple level OVCFs group and single level OVCF group. Multivariate logistic regression analysis were performed to identify risks factors associated with multiple level OVCFs.</p><p><b>RESULTS</b>All the patients underwent OVCF, including 71 multiple level OVCFs and 128 single level OVCF. There were no differences in the age, gender, BMI, hypertension and diabetes between two groups. While multiple level OVCFs were associated with spinal deformity index SDI[(2<=SDI<4, OR=2.587, 95% CI(1.148, 5.828);SDI>=-4, OR=7.775, 95% CI(3.272, 18.478)], BMD[(T<-4.5SD, OR=2.608, 95% CI(1.038, 6.551)].</p><p><b>CONCLUSIONS</b>SDI and BMD might be the risk factors for multiple level OVCFs.</p>

Analysis of clinical characteristics of 20 patients with pyogenic spondylitis / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the diagnostic value of clinical manifestation, laboratory examination and imaging changes for pyogenic spondylitis and to summarize the clinical characteristics of patients with pyogenic spondylitis.</p><p><b>METHODS</b>The clinical data, of 20 patients with pyogenic spondylitis were diagnosed by histopathological examination from March 2012 to March 2015, were retrospectively analyzed. There were 9 males and 11 females, aged from 43 to 72 years old with an average of 58.9 years. Included 3 cases of cervical vertebrae, 7 cases of thoracic vertebrae, 10 cases of lumbar vertebrae. Patients of blood analysis, erythrocyte sedimentation rate(ESR), C reactive protein(CRP), X rays, CT and MRI were performed before treatment. Visual analogue scale (VAS) was used to evaluate the pain of patients suffering from vertebral pain.</p><p><b>RESULTS</b>All the patients had suffered from vertebral pain before treatment. VAS was 9 points in 4 cases, 8 points in 6 cases, 7 points in 1 case, 3 points in 6 cases, and 2 points in 3 cases. Among them, 7 patients complicated with neurological symptoms, 11 with aggravating night pain, 10 with fever. WBC and Neutrophil count (NEU) of 5 cases were increased and other 15 cases were normal;CRP of 19 cases were increased and 1 case was normal;ESR of all 20 cases were increased. X rays showed the intervertebral space narrowing in all 20 cases, 13 cases complicated with destruction of vertebral body; CT showed the lesions of vertebral body in the 20 cases and complicated with destruction, sclerosis of sclerotin; MRI showed that the lesions of the vertebral body in the T1 image had uneven medium low signal, in the T2 image of the 16 cases had uneven high signal and 2 cases had uniform and high signal, 2 cases had main high signal compliated with mixed signal. Thirteen patients underwent surgical treatment and 7 patients received conservative treatment, and the patients left hospital while VAS had significantly improved after treatment.</p><p><b>CONCLUSIONS</b>Pyogenic spondylitis is easy to be misdiagnosed or missed in clinic. It can be combined with the clinical manifestations, laboratory examination and imaging characteristics in order to make a definite diagnosis for purulent spondylitis in early.</p>

Epidemiological and etiological characteristics of diarrheal disease among children under 5 years of age in Guangdong province, in 2012 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze the epidemiological and etiological characteristics of diarrheal disease among children under 5 years of age in Guangdong province, in 2012.</p><p><b>METHODS</b>64 hospitals in 21 cities were chosen as the diarrheal syndromic surveillance sites, of which 14 hospitals were selected to carry out etiological surveillance among children under 5 years of age, including isolation and culture of both Vibrio cholera and Shigella as well as nucleic acid detection of rotavirus and norovirus by PCR. Descriptive method was used to analyze data from syndromic and etiological surveillance programs on diarrheal, from 1932 parents of the children.</p><p><b>RESULTS</b>In 2012, the outpatient attendance rate on diarrheal among children under 5 years was 0.8%. The proportion of diarrheal in children under 5-year-olds was 63.5%, among the total number of diarrheal outpatients at the outpatient clinics under surveillance program. The morbidity of infectious diarrhea was 1454.5/10 million in children under 5 years of age. A total number of 1932 specimens were collected from children under 5 years of age, in the outpatient department. Among these specimens,Vibrio cholera appeared all negative but one was Shigella positive and proved to be Sh. sonnei. The positive rates of rotavirus and norovirus were 14.1% (273/1932)and 16.9% (326/1932). Both rotavirus and norovirus were found in 24 specimens, with a positive rate as 1.2% . 112 specimens were successfully gene sequenced for rotavirus, of which 33.9% as G1[P8] genotype, 25.9% as G9[P8], 12.5% as G2[P4] and 9.8% as G3[P8] respectively. 90 specimens were successfully gene-sequenced for norovirus, of which 76.7% as G II.4 genotype. Genetic subtypes of G II. 4/2006b, accounted for 50.0% and could be detected around the year except for June and December. New G II. 4/Sydney Strain_2012 was first detected in August and became the predominant in December. In addition, 5 specimens belonged to G I genotype with other 16 subtypes of G II.</p><p><b>CONCLUSION</b>Results from our study proved that children under 5 years of age belonged to high-risk group for diarrheal disease in Guangdong province. Rotavirus and norovirus were both diverse in terms of genome.</p>

Reduced circulating endothelial progenitor cells is a risk factor of coronary slow flow / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore if reduced number of circulating endothelial progenitor cells (EPCs) is a risk factor for patients with coronary slow flow (CSF).</p><p><b>METHODS</b>Thirty patients with CSF and 30 age and gender matched control subjects with normal coronary angiography were included in the study. Mononuclear cells were isolated from peripheral blood by Ficoll density gradient centrifugation and plated on fibronectin-coated culture dishes. EPCs were characterized as adherent cells double positive for DiI-AcLDL-uptake and lectin-binding by converted fluorescence microscope (×200).</p><p><b>RESULTS</b>Smoking, diabetes mellitus, hypertension and the levels of plasma lipoprotein profile were similar between the two groups (all P > 0.05). The number of EPCs was significantly lower in patients with CSF compared with control subjects (35.7 ± 5.9 vs.53.2 ± 5.9, P < 0.01). TIMI frame counts was correlated with circulating EPCs number (OR = 0.424, 95%CI 0.358 - 0.621, P < 0.01) and not associated with gender, age, smoking, diabetes mellitus, hypertension and the levels of plasma lipoprotein profile.</p><p><b>CONCLUSION</b>Decreased circulating EPCs is an independent risk factor for CSF.</p>

Etiology survey on virus of acute respiratory infection in Guangzhou from 2006 to 2009 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the pathogens of acute respiratory infection (ARI) in Guangzhou from 2006 to 2009.</p><p><b>METHODS</b>A total of 1554 cases of ARI patients in Second Affiliated Hospital of Guangzhou Medical College from September 2006 to September 2009, were recruited in the survey. The sample of throat and pharyngeal swab were collected from each patient.11 types of virus including influenza A (FluA), influenza B (FluB), adenovirus (ADV), human rhinovirus (HRV), respiratory syncytial virus (RSV), parainfluenza virus type 1, type 2, type 3 (HPIV1, HPIV2, HPIV3), human metapneumovirus (MPV) and human coronavirus (HCoV) type 229E, type OC43 were detected by Fluorescence Quota PCR method. The epidemic feature and clinical characteristic of each virus were then analyzed.</p><p><b>RESULTS</b>Virus were found in 1024 samples in total, accounting for 65.9% (1024/1554). RSV was the most common virus, which was found in 261 samples (16.8%); and followed by HRV as 13.9% (216/1554), FluA as 11.6% (181/1554), MPV as 6.5% (101/1554), FluB as 6.4% (99/1554), HPIV as 4.9% (76/1554), ADV as 3.5% (55/1554) and HCoV as 2.3% (35/1554). HPIV and HCoV shared a similar infection ratio among different age groups. The infection ratio of FluA and FluB was highest among 15-24 years old group, accounting for 16.5% (29/176) and 7.4% (13/176) respectively. MPV, RSV and HRV were the main pathogens caused infection among children under 4 years old, accounting for 9.7% (49/503), 21.7% (109/503) and 18.9% (95/503). The infection ratio of ADV was 6.0% (19/318), which was the most common pathogen among 5-14 years old patients. The incidence rate of HPIV and HRV showed no obvious seasonal features; while the prevalence of FluA, FluB, RSV, ADV, MPV and HCoV changed significantly in different seasons.22.2% (227/1024) ARI patients co-infected other respiratory virus.90.1% (163/181) FluA patients, 88.9% (88/99) FluB patients and 92.7% (51/55) ADV patients had high fever symptoms.</p><p><b>CONCLUSION</b>RSV was the main pathogen of ARI, and the new-found virus MPV was also another crucial pathogen. Some pathogens' incidence rate were related to the season and patient's age. Co-infections of other respiratory virus were also detected in parts of ARI patients.</p>

Molecular epidemiological characteristics of norovirus gastroenteritis outbreaks in Guangdong from 2005 to 2008 / 病毒学报

To study the molecular epidemiological characteristics of norovirus gastroenteritis outbreaks in Guangdong, we collected fecal and anal swabs specimens from 24 outbreaks of acute gastroenteritis from 2005 to 2008 to detect norovirus. Specimens were detected by RT-PCR and then sequenced. The descriptive data were also collected. According to our research, 19 of 24 outbreaks of gastroenteritis were positive for norovirus. The occurrence time was from October to next February mainly. The strains in 2005 belonged to G II-3 genotype and all outbreaks occurred in kindergarten and school. But from autumn of 2006, the outbreaks were all caused by G II-4/2006b variant and occurred in universities and community. The number of outbreaks in 2007 increased greatly and covered all over province. The nucleotide sequences of Guangdong strains in some sites showed high regional identity. Our results showed that with the shift of genotype from G II-3 to G II-4, occurrence of norovirus outbreaks increased greatly. The outbreaks of norovirus caused by G II-4/2006b variant spreaded widely and the involved population covered children and adult, indicating the strong invasiveness of this variant.

Investigation of human metapneumovirus in children with acute respiratory tract infections in Guangzhou areas / 中华预防医学杂志

<p><b>OBJECTIVE</b>To find out the status of human metapneumovirus (hMPV) infection in children under 14 years old with acute respiratory tract infections (ARI) in Guangzhou, analyze the epidemiology and clinical characteristics among the hMPV-infected children, and provide some basis for research of hMPV.</p><p><b>METHODS</b>All 521 throat and pharyngeal swabs were collected among the children with acute respiratory tract infections in outpatient departments and those admitted to the wards from September 2006 to August 2008. Then total nucleic acid was extracted from respiratory specimens. The 213 nucleosides of nucleoprotein gene were detected by RT-PCR and 16 strong positive samples were picked to compare with the sequence of hMPV in GenBank after the sequence of the amplification products were determined. Then applied statistical analysis to the data of the collected patients.</p><p><b>RESULTS</b>All 521 samples were detected by RT-PCR, and confirmed that N gene was positive in 39 samples with a detection rate of 7.49%, and the peak time was in October and April. The 16 amplification products were compared by using the analysis of gene sequence. The nucleocapsid protein (N) gene similarity to BJ1897 of Beijing was up to 99%, and to AY550156 of Thailand was up to 97%, genotype B was the most common genotype.</p><p><b>CONCLUSION</b>There existed hMPV infection in children acute respiratory system diseases in Guangzhou areas, in which the children under the age of 6 years were accounted for the main group, however there was no difference in gender. The main symptoms of the patients with hMPV infection were high fever and cough symptom of catarrh. Co-infections other than respiratory virus with hMPV were detected as 41.03% of positive samples.</p>

Analysis of the Utilization of Antidiabetic Drugs in 24 Hospitals of Nanjing District During the Years of 2002-2006 / 药物流行病学杂志

Objective:To survey and evaluate the situation of present clinic use of antidiabetic drugs,estimate their consuming trend and discuss the rational methods in applying antidiabetic drugs.Method:The drug purchasing data during the years of 2002 to 2006 in hospitals were compared,and statistically analyzed with Microsoft Excel.Result:Ac- counting approximately 52%-72% in total antidiabetie DDDS,sulfonylureas and bigunides were most commonly used.In- sulin and?-Glycosidase inhibitors also took more than 25%-35% share in total DDDs.Some other new drugs and tradi- tional Chinese medicine were less than 10% in total DDDs.The first line of antidiabetic drugs included mefformin,gliclas- ide,acarbose,glipizide and insulin.Conclusion:Clinical application of antidiabetic drugs was reasonable in Nanjing dis- trict.The cost of diabetes patient is the main factor which will influence the application of antidiabetic drugs normatively and continuously.

Pharmacokinetics and bioavailability of two kinds of gliclazide sustained release tablets following a single and multiple dose in healthy volunteers / 中国新药与临床杂志

AIM: To compare the pharmacokinetics and relative bioavailability of the domestic and imported sustained-release tablets of gliclazide in healthy volunteers. METHODS:The study was performed by an four-period crossover design with singledose and multiple-dose administration. The plasmadrug concentrations of twenty male healthy volunteers were determined by liquid chromatography with mass spectrum detector method (LC-MS). RESULTS:The pharmacokinetic parameters after a single oral dose of the domestic and imported gliclazide tablets were (7.2+s 1.5) h and (6.9 +1.4) h for tmax, (13.4 ±1.2) h and (13.7 +1.3) h for t1/2, (2.4 +0.8) mg ·L-1and (2.3 ±0.6) mg· L-1 forcmax, (48 ±14)mg · h · L-1 and (48 +14) mg· h · L-1 forAUC0-60,(51+15) mg· h· L-1 and (50±14) mg· h· L-1for AUC0-∞, (22.4 ± 1.9 ) h and (22.8 ± 1.9 ) h for MRT, respectively. The steady state pharmacokinetic parameters after multiple doses of the domestic and imported gliclazide tablets were (6. 1 ± 1.4) h and (6.5+1.4) h for tmax, (4.6±0.9) mg· L-1 and (4.7±1.1) mg· L-1 for cmax, (0.23 ±0.08) mg ·L-1and (0.26±0.08) mg· L-1 forcmin, (1.6±0.3) mg·L-1 and (1.6±0.3) mg · L-1 for mean value of steady plasma-drug concentration (cav),(94±19) mg· h · L-1 and (95 ±20) mg · h · L-1forAUCss, (282 ±33)% and (283 ±43)% for degree of fluctuation DF ), respectively. The relative bioavailability of the domestic gliclazide tablet to the imported gliclazide tablet following a single and multiple dose were ( 102 ± 9) % and (99 ± 10 ) %, respectively. Main pharmacokinetic parameters between the two formulations in both single and multiples dose studies showed no statistical difference ( P >0.05 ). CONCLUSION: The result of two one side t-test shows that the two formulations are bioequivalent.

Antihypertensives Used in Our Hospital from 2001 to 2004: Drug Use Evaluation / 中国药房

OBJECTIVE: To evaluate the status quo and the tendency of utilization of antihypertensives in our hospital. METHODS: The consumptions of antihypertensives from 2001 to 2004 were analyzed statistically with Microsoft Excel 2000. RESULTS: The use of antihypertensives assumed an increased tendency, of which, about 90% were included in the catalog of the Drugs of National Basic Hospitalization Insurance. Calcium antagonists, diuretics, ACEI and ?-receptor blocking agents were the basic clinical drugs. Usage of angiotensin;angiotensin Ⅱ receptor blocking agents increased to a large degree year by year. CONCLUSION: The utilization structure of antihypertensives in our hospital is basically reasonable. Developing compound antihypertensive that of excellent quality and reasonable price is of great significance in the management of hypertension and its complications.

Study rat nephrotoxicity of Longdan Xiegan Tang / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the nephrotoxocity of Longdan Xiegan Tang in rats, and to test its safety.</p><p><b>METHOD</b>Sprague-Dauley rats were given Longdan Xiegan Tang 4.5 mL x (100 mg)(-1) Bid for thirty days, and the control group was given NS. MTP, BUN, Cr, MDA, MTP/Ucr and SOD were measured on 1st, 2nd, 3rd, 4th week. The kidney tissues were viewed with light microscopy and electron microscope.</p><p><b>RESULT</b>MTP and MTP/Ucr were obviously higher than controls ( P < 0.01), and the other index had no difference (P > 0.05). No remarkable structural change could been seen with light microscopy, but with electron microscope we could find that the basal membranes were thickened and some of foot process were infused.</p><p><b>CONCLUSION</b>Longdan Xiegan Tang will result in injury of kidney function.</p>