Application value of acoustic radiation force impulse elastography in diagnosis of biliary atresia / 中华实用儿科临床杂志

Objective:To assess the value of acoustic radiation force impulse (ARFI) elastography in the diagnosis of children with biliary atresia.Methods:A prospective survey of infants with hepatitis syndrome and hyperbi-lirubinemia in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2017 to December 2018 was performed.The children with hepatitis syndrome were divided into the biliary atresia group( n=45) and non- biliary atresia group( n=30). Thirty children with hyperbilirubinemia were selected as the control group.Shear wave speed (SWS) of all infants was collected by ARFI ultrasound and compared among 3 groups.Receiver ope-rating characteristic curve(ROC curve) was used to analyze the optimal threshold value for SWS in the diagnosis of biliary atresia. Results:The mean SWS values in the biliary atresia group, non-biliary atresia group and the control group were (1.79±0.29) m/s, (1.26±0.12) m/s and (1.08±0.06) m/s, respectively.Compared with the control group, the mean SWS values in the biliary atresia group and non-biliary atresia group were significantly higher ( t=165.43, 15.75, all P<0.05). The mean SWS value in the non-biliary atresia group was significantly lower than that in the biliary atresia group ( t=90.27, P<0.05). With the non-biliary atresia group as reference, the area under the ROC curve of SWS for diagnosis of biliary atresia was 0.98(95% CI: 0.95-1.00), the optimal threshold was 1.45 m/s, and the sensitivity and specificity were 88.9% and 96.7%, respectively. Conclusions:Rapid non-invasive ARFI elastography is effective in the diagnosis of biliary atresia, and thus has important value for early diagnosis and treatment in clinical practice.

Early antiviral therapy of abidor combined with lopinavir/ritonavir and re-combinant interferonα-2b in patients with novel coronavirus pneumonia in Zhejiang: A multicenter and prospective study / 中华临床感染病杂志

Objective@#Comparing the benefit of Abidor, lopinavir/ritonavir and recombinant interferon α-2b triple combination antiviral therapy and lopinavir/ritonavir and interferon dual combination antiviral therapy to hospitalized novel coronavirus pneumonia 2019 in Zhejiang province.@*Methods@#A multi-center prospective study was carried out to compare the effect of triple combination antiviral therapy with dual combination antiviral therapy in 15 medical institutions of Zhejiang Province. All patients were treated with recombinant interferon α-2b (5 million U, 2 times/d) aerosol inhalation. 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir / ritonavir (2 tablets, 1 time/12 h) as the triple combination antiviral treatment group. 41 patients were treated with lopinavir / ritonavir (2 tablets, 1 time/12 h) as the dual combination antiviral treatment group. The patients who received triple combination antiviral therapy were divided into three groups: within 48 hours, 3-5 days and > 5 days after the symptom onset. To explore the therapeutic effects of triple combination antiviral drugs and dual combination antiviral drugs, as well as triple combination antiviral drugs with different antiviral initiate time. SPSS17.0 software was used to analyze the data.@*Results@#The time of virus nucleic acid turning negative was (12.2 ± 4.7) days in the triple combination antiviral drug group, which was shorter than that in the dual combination antiviral drug group [(15.0 ± 5.0) days] (t = 6.159, P < 0.01 ). The length of hospital stay [12 (9, 17) d] in the triple combination antiviral drug group was also shorter than that in the dual combination antiviral drug group [15 (10, 18) d] (H = 2.073, P < 0.05). Comparing the antiviral treatment which was started within 48 hours, 3-5 days and > 5 days after the symptom onset of triple combination antiviral drug group, the time from the symptom onset to the negative of viral shedding was 13 (10,16.8), 17 (13,22) and 21 (18-24) days respectively (Z = 32.983, P < 0.01), and the time from antiviral therapy to the negative of viral shedding was (11.8±3.9) , (13.5±5.1) and (11.2±4.3) d. The differences among the three groups were statistically significant (Z=32.983 and 6.722, P<0.01 or<0.05).@*Conclusions@#The triple combination antiviral therapy of Abidor, Lopinavir/Litonavir and recombinant interferon α-2b showed shorter viral shedding time and hospitalization time compared with the dual combination antiviral therapy. The earlier the time to initiate triple antiviral treatment, the shorter the time of virus shedding.

Analysis of Drug Use in a Patient with Brucellosis Combined with Liver Dysfunction by Clinical Pharmacists / 中国药房

OBJECTIVE：To provide reference for the selection of drug treatment plan in patients with Brucellosis combined with liver dysfunction. METHODS ：Clinical pharmacists analyzed drug treatment plan in a patient with Brucellosis combined with liver dysfunction in the First Affiliated Hospital of Medical College of Shihezi University. Referring to Brucella treatment guideline . Consensus statement by the American association of clini - HbA1c cal endocrinologists and American college of endocrinology on the comprehensive type 2 diabetes management al - and domestic and foreign clinical information ，the suggesti ons were put forward according to the change of liver dysfunction. RESULTS：The patient had chronic infection and moderate liver injury. The liver dysfunction in this patient was a common complication of Brucellosis. After consultation of doctors and pharmacists ，in consideration of the abnormal liver function ， intravenous drip of levofloxacin （0.5 g，qd）was given in the patient for anti-infection treatment. After the liver function was improved，levofloxacin was stopped ，and intravenous drip of rifampin （0.6 g，qd）and oral administration of doxycycline （100 mg，bid）were given for anti-infection treatment instead ；during the treatment period ，intravenous drip of reduced glutathione （1.8 g，qd）and diammonium glycyrrhizinate （150 mg，qd）were given for anti-inflammatory and liver protecting treatment. During the treatment，the clinical pharmacists closely monitored ADR of patients ，and carried out medication education for patients to improve the compliance. 10 d after medication ，although some of the liver function indexes of the patient did not return to normal ，but Brucellosis and liver dysfunction symptoms were improved. The patient could continue to take the same dose of rifampin and doxycycline after discharge. CONCLUSIONS ：When the patients with Brucellosis have abnormal liver function ，anti-infection treatment should be the main treatment target. The clinical pharmacists should refer to the relevant guidelines and combine with the clinical practice to help doctors adjust the treatment plan ，so as to ensure the safety and effectiveness of the patients ’medication.

Early antiviral therapy of abidol combined with lopinavir/ritonavir and recombinant interferon α-2b for patients with COVID-19 in Zhejiang: A multicenter prospective study / 中华临床感染病杂志

Objective:To compare the efficacy of the combination of abidol, lopinavir/ritonavir plus recombinant interferon α-2b (rIFNα-2b) and the combination of lopinavir/ritonavir plus rIFNα-2b for patients with COVID-19 in Zhejiang province.Methods:A multicenter prospective study was carried out to compare the efficacy of triple combination antiviral therapy and dual combination antiviral therapy in 15 medical institutions of Zhejiang province during January 22 to February 16, 2020. All patients were treated with rIFNα-2b (5 million U, 2 times/d) aerosol inhalation, in addition 196 patients were treated with abidol (200 mg, 3 times/d) + lopinavir/ritonavir (2 tablets, 1 time/12 h) (triple combination group) and 41 patients were treated with lopinavir/ritonavir (2 tablets, 1 time/12 h) (dual combination group). The patients who received triple combination antiviral therapy were further divided into three subgroups: <48 h, 3-5 d and >5 d according the time from the symptom onset to medication starting. The therapeutic efficacy was compared between triple combination group and dual combination group, and compared among 3 subgroups of patients receiving triple combination antiviral therapy. SPSS 17.0 software was used to analyze the data.Results:The virus nucleic acid-negative conversion time in respiratory tract specimens was (12.2±4.7) d in the triple combination group, which was shorter than that in the dual combination group [(15.0±5.0) d] ( t=6.159, P<0.01). The length of hospital stay in the triple combination group [12.0 (9.0, 17.0) d] was also shorter than that in the dual combination group [15.0 (10.0, 18.0) d] ( H=2.073, P<0.05). Compared with the antiviral treatment which was started within after the symptom onset of in the triple combination group, the time from the symptom onset to the viral negative conversion was 13.0 (10.0, 17.0), 17.0 (13.0, 22.0) and 21.0 (18.0, 24.0) d in subgroups of 48 h, 3-5 d and >5 d, respectively ( Z=32.983, P<0.01), while the time from antiviral therapy to viral negative conversion was (11.8±3.9), (13.5±5.1) and (11.2±4.3) d, respectively( Z=6.722, P<0.05). Conclusions:The triple combination antiviral therapy of abidol, lopinavir/litonavir and rIFNα-2b shows shorter viral shedding time and shorter hospitalization time, compared with the dual combination antiviral therapy; and the earlier starting triple combination antiviral therapy will result in better antiviral efficacy.

Investigation of a local dengue fever outbreak associated with serotype 1 virus in Fuzhou, 2017 / 中华实验和临床病毒学杂志

Objective@#To elucidate the epidemiological and etiological features of a local outbreak of dengue fever (DF) in Taijiang district in Fuzhou, Fujian province in 2017, and speculate possible viral source based on phylogenetic analysis.@*Methods@#The clinical and demographic data of cases were collected through field investigation and the outbreak was characterized epidemiologically by descriptive method. The patient′s serum were collected and the adult mosquitoes were captured by anti-mosquito double-net method for the laboratorial test and viral isolation. The viral isolates were typed by real-time fluorescent RT-PCR and their full length of viral envelope (E) genes were amplified by RT-PCR and sequenced. The E gene sequences obtained in this study, together with the reference sequences, were used for the phylogenetic analysis.@*Results@#A total of 13 cases of autochthonous DF were confirmed in the outbreak. All cases presented obvious clinical manifestations and clustered spatially and temporally. The Breteau Index (BI) of mosquito larva density was the highest in epidemic foci of Xingang street and was relatively low in surrounding areas. Four DENV-1 strains, three from patients and one from the captured adult Aedes albopictus, were isolated and identified by real-time RT-PCR. Full length E gene sequences of the four isolates were completely identical and phylogenetic analysis showed that the isolates were genetically closest to the strain (GenBank No. KT825033) from Vietnam in 2014, rather than the DENV-1 strains found in Fujian previously.@*Conclusions@#The DF outbreak occurred in Fuzhou in 2017 was caused by DENV-1 which was imported possibly from somewhere outside of Fujian province and subsequently led to local DF transmission in human via the mosquito Aedes albopictus.

Etiological characteristics of an imported Chikungunya fever epidemic in Fujian province in 2018 / 中华实验和临床病毒学杂志

Objective@#To study the etiological characteristics of an imported Chikungunya fever (CHIK) epidemic in Fujian province in 2018.@*Methods@#Serum samples collected at different days after the onset of the two CHIK cases were detected by real-time RT-PCR and ELISA. Structural protein E1 gene was amplified by RT-PCR and sequenced for nucleotide characteristics analysis and phylogenetic tree analysis.@*Results@#RNA of Chikungunya virus (CHIKV) was detected in the 4 serum samples collected on the first 5 days of the disease, and the earliest IgM antibodies were detected in specimens on the 5th day of the disease, however, IgG antibodies were only detected in specimen on 10th day. Compared with the S27-African prototype strain, 12 mutant points were found in the amino acids of E1 genes in this study. The E1 genes of the two CHIK cases were exactly the same, and they were closest to the evolutionary relationship with the strain isolated in the Philippines in 2014. Their genotype was Asian genotype.@*Conclusions@#This epidemic was confirmed to have been imported from the Philippines after the infection with the Asian genotype CHIKV, which suggests that Fujian province should strengthen the monitoring of persons entering from the CHIK epidemic area, so as to prevent imported cases from causing local outbreaks.

Guidance value of QT dispersion and JT dispersion for identification of coronary heart disease with blood stasis syndrome type／ / 心血管康复医学杂志

To explore the guidance value of QT dispersion (QTd) and JT dispersion (JTd) for identifica‐tion of coronary heart disease (CHD) with blood stasis syndrome type .Methods : A total of 246 CHD patients of our hospital were divided into blood stasis block group (n＝71) ,Tanbixinyang group (TBXY group ,n＝42) ,liver and renal Yin deficiency group (LRYD group ,n＝44) ,Qi and Yin deficiency group (QYD group ,n＝45) and cardiac and renal Yang deficiency group (CRYD group ,n＝35) according to four diagnostic methods of Traditional Chinese Medicine (TCM).The QTd ,corrected QTd (QTcd) ,JTd and corrected JTd (JTcd) were observed in all groups , and their predictive value for blood stasis block were analyzed .Results : Compared with TBXY ,LRYD ,QYD and CRYD group ,there were significant rise in levels of QTd [ (72. 21 ± 16.48) ms ,(50.89 ± 12.77) ms ,(49. 17 ± 7.91) ms ,(62. 54 ± 12.80) msvs.(82.30 ± 19.05) ms] ,QTcd [(73.82 ± 18. 72) ms ,(51.41 ± 12.81) ms ,(51. 12 ± 9.73) ms ,(62.48 ± 13.35) msvs .(87. 75 ± 20. 72) ms] ,JTd [ (74. 54 ± 16.83) ms ,(52.18 ± 12. 68) ms ,(51. 50 ± 10. 78) ms ,(64.75 ± 12. 30) msvs.(89.43 ± 24.40 ) ms] and JTcd [ (75.14 ± 21. 05 ) ms ,(54. 93 ± 11.41 ) ms , (52.90 ± 10. 03) ms ,(65.26 ± 12. 72) msvs.(91. 98 ± 24. 22) ms] in blood stasis block group , P＝0. 001 all.Area under curve (AUC) of QTd ,QTcd ,JTd ,JTcd predicting CHD with blood stasis block was 0. 832 ,0. 861 ,0.856 and 0.854 respectively ,and optimal cutoff point was 70.77ms ,69.83ms ,77. 80ms and 77.51ms respectively .Conclu‐sion : QTd and JTd levels on ECG in CHD patients with blood stasis block type are significantly higher than other syndrome types , so they possess certain guidance value for CHD syndrome typing .

Clinical effects of single femoral nerve block in combination with general anesthesia on geriatric patients receiving total knee arthroplasty

Objective: To evaluate the clinical effects of single femoral nerve block [sFNB] combined with general anesthesia on geriatric patients receiving unilateral total knee arthroplasty [UTKA]

Methods: Sixty geriatric UTKA patients who were treated in The First People's Hospital of Changzhou from January 2015 to August 2015 were randomly divided into an sFNB + laryngeal mask airway [FLA] group, an sFNB + tracheal intubation [FGA] group and a tracheal intubation [GA] group. Their clinical parameters and indices were recorded. They were scored by the Visual Analogue Scale [VAS]

Results: All patients completed this study. FLA and FGA groups used less propofol, remifentanil and fentanyl than GA group [P<0.01], with shorter recovery time and extubation time [P<0.05]. Compared to GA group, FLA and FGA groups had lower systolic blood pressures at T3, T4 and T5 [P<0.05], and lower heart rates at T5 [P<0.05]. FLA and FGA groups had fewer cases of adverse reactions after extubation [P<0.01]. FLA group was less prone to irritating cough after extubation and pharyngeal pain than FGA and GA groups [P<0.01]. The postoperative six hour and 24 hour VAS scores in resting state as well as the postoperative 24 hour and 48 hour scores in training state of FLA and FGA groups were lower than those of GA group [P<0.05]. FLA and FGA groups used significantly lower times and total doses of patient-controlled intravenous analgesia pump

Conclusion: sFNB combined with general anesthesia, especially that using laryngeal mask, were superior to general anesthesia alone, which reduced recovery and extubation times, and decreased intraoperative and postoperative drug uses, postoperative early VAS score and adverse reactions

Detection and epidemiology of mcr-1-positive Escherichia coli strains in Dongyang area of Zhejiang Province / 中华微生物学和免疫学杂志

Objective To investigate the prevalence of mcr-1 gene,a plasmid-mediated polymyxin resistance gene,in Escherichia coli(E.coli) strains isolated in Dongyang of Zhejiang Province and to under-stand the epidemiological characteristics of E.coli strains carrying mcr-1 gene in order to provide local clini-cians with a theoretical basis for prevention and control of the spread of mcr-1-bearing E.coli strains. Meth-ods A total of 315 E.coli strains were collected in the People′s Hospital of Dongyang, Zhejiang Province from January to December 2016. All strains were isolated from specimens of blood,urine,respiratory tract, etc. PCR was performed to detect the genes confering resistance to polymyxin (mcr-1 gene), β-lactamase and carbapenem. Minimal inhibitory concentrations (MIC) of antibiotics against mcr-1-positive strains were determined by micro-broth dilution method. Conjugation test was performed to confirm whether the mcr-1 gene was located on the transferable plasmid. Multilocus sequence typing (MLST) was used for molecular typing of mcr-1-positive strains. Results Five mcr-1-positive strains were identified from 315 E.coli strains with a positive rate of 1.6%. Two out of the five mcr-1-positive E.coli strains contained β-lactamase resist-ance genes,blaTEM-1and blaCTX-M-14. Both of them were resistant to the first, second and third generation of cephalosporins and one was also resistant to cefepime. All of the five mcr-1-positive E.coli strains were sen-sitive to ciprofloxacin and levofloxacin,but resistant to ticarcillin/clavulanic acid. No carbapenem resistance genes were detected. One transconjugant was successfully obtained by transconjugation assay. MLST analysis showed that a total of four sequence types were identified, including ST131 (two strains), ST43 (one strain),ST69 (one strain) and ST349(one strain). Conclusion Only 1.6% of all E.coli strains isolated in Dongyang area of Zhejiang Province carry mcr-1 gene,indicating that there is no epidemic of mcr-1 gene-positive E.coli infection. The coexistence of mcr-1 gene and β-lactamase resistance genes in E.coli strains isolated in Dongyang suggests that local clinicians should avoid antibiotic abuse to prevent the spread of drug-resistant E.coli.

Study on the possibility of hippocampus injury during whole brain radiotherapy for intracranial metastasis / 中国医师进修杂志

Objective To investigate the rate of hippocampus injury during whole brain radiotherapy for intracranial metastasis and explore the effect of whole brain radiotherapy in reducing the radiotherapy induced neurocognitive dysfunction of hippocampu and provide reference for the treatment of intracranial metastatic tumors. Methods The intracranial metastases in 123 patients from January 2015 to December 2016 were enrolled in this study. The MRI image data before and after radiotherapy were analyzed retrospectively.The anatomical position of tumor and the hippocampus in patients with intracranial metastasis was outlined.According to outlined position, the relationship between location of intracranial metastatic tumor and the hippocampus was analyzed, and the probability of the hippocampal damage by tumor radiotherapy was calculated in the treatment of intracranial metastatic brain. Neurocognitive dysfunction improvement by protective irradiation of hippocampus was compared between different radiotherapy methods. Results Four hundred and seventeen intracranial metastatic tumors were observed in 123 patients, among which the sites of 15 tumors(3.60%) were within the 5mm of hippocampus, the sites of 146 tumors(35.01%)were 5-10 mm from the hippocampus, and the sites of 256 tumors(61.39%) were beyond 10 mm of hippocampus. The distribution of 417 metastatic tumors in the brain was as followings: 137 tumors (32.85%) were in frontal lobe, 98 tumors(23.50%) were in temporal lobe, 59 tumors(14.15%)were in parietal lobe, 46 tumors(11.03%)were in occipital lobe, 41 tumors (9.83%) were in cerebellum and 36 tumors (8.63%) were in basal ganglia. Using helical tomotherapy, intracranial metastasis radiotherapy and volumetric modulated arc radiotherapy, the rate of patients with cognitive dysfunction induced by hippocampal injury was 1.96%(1/51), 10.26%(4/39)and 18.18% (6/33), and there was significant difference (χ2= 6.595, P = 0.000). Conclusions The hippocampus injury possibility is very small, when whole brain radiotherapy is used in the treatment of intracranial metastatic tumors. Avoiding the hippocampus in radiation therapy of intracranial metastasis has high feasibility, among which the helical tomotherapy can effectively reduce hippocampus injury and improve patients'cognitive function.

Changes of CK,CK-MB,cTnI and electrocardiogram before and after treatment in children with pneumonia / 国际检验医学杂志

Objective To investigate the changes of serum creatine kinase (CK),creatine kinase isoenzyme (CK-MB),cardiac troponin I(cTnI)and electrocardiogram (ECG) before and after the treatment of pneumo-nia in children.Methods From December 2014 to December 2016,95 children with pneumonia were selected as the study group,and 48 healthy subjects who underwent the healthy assessment from December 2014 to January 2016 were selected as the control group.All children with pneumonia were treated after admission.2 mL of venous blood were collected from each research subject after the admission and patients in study group after treatment,serum was seperated,and levels of CK,CK-MB,cTnI were measured and the ECG record was conducted.Results The serum levels of CK,CK-MB and cTnI in the study group were higher than those in the control group (P<0.05);the incidences of ST segment elevation or depression,atrial premature beat,ven-tricular premature beat,sinus tachycardia and sinus bradycardia in the study group were higher than those in the control group,and the differences were statistically significant (P<0.05);the serum levels of CK,CK-MB and cTnI in the study group were lower than those before treatment,and the difference was statistically signif-icant (P<0.05);the incidences of atrial premature beat,ventricular premature beat,sinus tachycardia and si-nus bradycardia in the study group after treatment were lower than those before treatment,and the difference was statistically significant (P<0.05);the incidence of ST segment elevation or depression after treatment in the study group was lower than that before treatment,and there was no significant difference (P>0.05).Con-clusion The serum levels of CK,CK-MB,cTnI and ECG were obviously abnormal in children with pneumoni-a.After treatment,serum CK,CK-MB and cTnI levels can be reduced and ECG abnormalities can be ameliora-ted.

Mutation analysis of a FGG gene causing hereditary abnormal fibrinogen / 中华医学遗传学杂志

OBJECTIVE@#To study the clinical phenotype and gene mutation analysis of a hereditary abnormal fibrinogenemia family and explore its molecular pathogenesis.@*METHODS@#The STA-R automatic hemagglutination analyzer to detect the proband and its family members (3 generations of 5 people) of prothrombin time(PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen activity (Fg: C), D-dimer (D-D), fibrinogen and fibrin degradation products (FDPs), plasminogen activity (PLG: A); The plasma levels of Fg: C and fibrinogen (Fg: Ag) were measured by Clauss method and immunoturbidimetry respectively. All exons and flanking sequences of FGA, FGB and FGG genes of fibrinogen were amplified by PCR, and the PCR products were purified and sequenced for gene analysis. The model was analyzed by Swiss software.@*RESULTS@#The PT and APTT of the proband, her mother and sister were slightly prolonged, TT was significantly extend, Fg: C decreased significantly, Fg: Ag, PLG: A, D-D and FDPs are within the normal range; Her brother and daughter of the results are normal. Genetic analysis showed that g.7476 G>A heterozygous missense mutation in exon 8 of FGG gene resulted in mutations in arginine at position 275 of fibrinogen gamma D domain to histidine (Arg275His). Her mother and sister have the same Arg275His heterozygous mutation, brother and daughter for the normal wild type.@*CONCLUSION@#The heterozygous missense mutation of FGG gene Arg275His in patients with hereditary dysfibrinogenemia is associated with a decrease in plasma fibrinogen activity.

Molecular diagnosis of yellow fever imported into Fujian province, 2016 / 中华实验和临床病毒学杂志

Objective@#To make laboratorial diagnosis of imported yellow fever (YF) cases in Fujian province with molecular method .@*Methods@#Serum and urine samples were collected from suspected cases at various time-points post illness onset. Real-time RT-PCR and nested RT-PCR were performed respectively for viral specific nucleotide detection and fragment amplification. Sequencing and restrictive fragment length polymorphism (RFLP) method were used to identify the wild virus infection.@*Results@#A total of five cases with wild yellow fever virus (YFV) infection were confirmed in this study. It revealed that the viral agent belonged to Angola-71 like YFV, and the duration of viral agent in urine was longer than that in serum.@*Conclusions@#Simultaneous detection of serum and urine samples would increase detection sensitivity, and further RFLP method contributed to rapid identification of wild YFV infection and exclusion of positive result due to recent vaccination.

Effects of interleukin-1β on intra-amniotic lipopolysaccharide-induced alveolar arrest in neonatal rats / 上海交通大学学报（医学版）

Objective·To investigate the effects of interleukin-1β (IL-1β) on neonatal rat alveolar arrest induced by intra-amniotic injection of lipopolysaccharide (LPS). Methods·A neonatal SD rat model of bronchopulmonary dysplasia (BPD) was constructed by intra-amniotic injection of LPS in pregnant rats. The pregnant rats (E19) were randomly assigned to Saline group, LPS group and LPS+anti-IL-1β group. The lungs of the neonatal rats were randomly collected 1, 3 and 7 days after birth. Pathological changes in the lungs were observed by hematoxylin-eosin (H-E) staining, and expression of IL-1β mRNA and protein was detected by real-time PCR and ELISA, respectively. Rat bone marrow derived primary macrophage was cultured in vitro, and given LPS intervention, then genes related with IL-1β were detected through whole transcriptome sequencing. Results·Compared with the Saline group, the alveolar counts and secondary septa counts significantly decreased, and mean liner intercept significantly increased in LPS group. Moreover, the expression of IL-1β mRNA and protein in lungs significantly increased in LPS group. The LPS-induced pathological changes of lung tissues in neonatal rats were improved by anti-IL-1β. LPS could up-regulate the expression of genes including Gbp5, Ccl3, Nod2, Ccr5, Mefv, Casp4 and Ifnar1, but down-regulate Lgals9 and Gstp1. Among these genes Gbp5, Ccl3, Nod2, Ccr5, Casp4, Ifnar1 and Lgals9 could positively regulate IL-1βproduction. Conclusion·LPS can induce alveolar arrest through up-regulating the expression of IL-1β in macrophages in neonatal rat BPD model. Whole transcriptome sequencing reveals that LPS can regulate the expression of IL-1β in macrophages through several paths.

Epidemiology and genetic characteristics of EV71 in Fujian Province,China / 中国人兽共患病学报

For investigating the epidemiology and genetic characteristics of enterovirus 71 (EV71) in Fujian from 2010 to 2015,we analyzed the surveillance data of EV71 and sequenced VP1 genes of 72 EV71 strains randomly picked from the past 6 years.The overall infection rate was gradually down and one incidence peak (from May to July) was observed each year.Major infectious population were focused on Xiamen,Fuzhou,Nanping and Quanzhou,the ages ranged from one to three years old.Scattered children were the most infected ones.The proportion of EV71 in the severe case was higher than in the HMFD(χ2 =732.064 5,P＜0.000 1).EV71 circulated from 2010 to 2015 in Fujian Province was belonged to subgenotype C4a in consistent with vaccine strain (H07).Compared with the VP1 of vaccine strains,the divergence of complete VP1 nucleotide sequence was gradually expanding as time distance increased,but the sequence of amino acid was not found obvious difference.Variations in 4 key immune epitopes of amino acid had not appeared a regular pattern in year and not consistent with the trend of proportion of EV71 in HMFD.As a result,we considered the epidemiology characteristics of EV71 in Fujian was obvious,72 strains still belonged to C4a subgenotype and had no outstanding antigenic drift or mutation.Extensive epidemiology surveillance and genetic characteristic are needed for the application of EV71 vaccine.

Molecular epidemiology of hand-foot-mouth disease associated pathogen Coxsackievirus A10 identified in Fujian province, 2011-2014 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the molecular epidemiology of hand-foot-mounth disease (HFMD) associated Coxsackievirus A10 (Cox A10) identified in Fujian province.</p><p><b>METHODS</b>A total of 1 525 specimens from non-EV71 non-Cox A16 HFMD patients were collected during 2011-2014. Isolated virus strains were identified and sub-typed. Full-length coding regions for the VP1 gene of the predominant serotype Cox A10 isolates were amplified and sequenced.</p><p><b>RESULTS</b>Among the 407 non-EV71 non-Cox A16 HFMD cases confirmed by virus isolation and molecular subtyping, 103 (25.3%) were caused by Cox A10, accounting for 11.0%, 6.0%, 18.4% and 9.2% among the HFMD-associated entero-viruses identified in 2011, 2012, 2013 and 2014, respectively, in Fujian province. Compared to the general features observed in the HFMD epidemics, no differences on the Cox A10-specificity rates were observed among factors as geographical origins, gender or age groups, but all with high rates of severity. Data from the nucleotide sequence analyses on VP1 genes showed low homology levels of 76.0%-77.1% among Cox A10 strains from Fujian province, in contrast to the prototype Cox A10 strain, but with high levels of homology in the amino acid sequences (91.9%-93.6%). RESULTS from the Phylogenetic analysis also indicated that Cox A10 isolates from Fujian province were distinct from the prototype strain or other isolates from other countries but was homologous to domestic strains, but the Fujian isolates clustered into multiple branches.</p><p><b>CONCLUSIONS</b>Cox A10 remained one of the predominant serotypes of HFMD in Fujian province. Cox A10 isolates identified in Fujian province were co-circulating and co-evolving with other domestic strains.</p>

Dynamic Observation and Value of Plasma Level of Thrombomodulin in Rats with Traumatic Hemorrhagic Shock / 现代检验医学杂志

Objective To explore the dynamic changes in the plasma levels of thrombomodulin(TM)with traumatic hemor-rhagic shock (THS).Methods The model of the THS with gradient decerease in the systolic blood pressure was eatablished in 1 7 rats without specific pathogen.The arterial blood during the different phase of shock,i.e.when the systolic pressures were three forth,one second,two fifth of the basis systolic blood pressure,one fifth of the basic systolic blood pressure and 10mmHg,was collected and TM levels in the plasma were determined by the double antibody sandwich method of enzyme-labeled immunosorbent assay (ELISA)and analyzed.Results There were significant differences in plasma levels of TM be-tween groups,with TM levels in T2~T3 period of time increased with the extension of time,and TM levels in T4~T5 peri-od of time decreased with the extension of time,and TM levels in T5~T6 period of time increased with the extension of time.Conclusion The animal model of THS was related to the systolic pressure during the shock,may be helpful to assess-ment changes in blood loss.The dynamic observation of the plasma levels of TM which is a good index of the damage to the vascular endothelial cells,may be helpful to assessment of the THS is related to the degree of damage to the vascular endo-thelial cells.

Effect of elemene on the expressions of TRAF6 and caspase-8 in H22 liver tumor tissues of mice / 中国医师杂志

Objective To investigate the effect of elemene on mRNA expressions of tumor necrosis factor (TNF) receptor associated factor 6 (TRAF6) and caspase-8 in tumor tissues of mice bearing hepatoma H22.Methods Forty BALB/c mice models bearing hepatoma H22 were established by subcutaneous inoculating tumor cells.Forty BALB/c mice were randomly divided into 4 groups:model group,low-and high-elemene dosage groups,and cisplatin group.The tumors after executing mice were weighted.The mRNA expressions of TRAF6 and caspase-8 in tumor tissues were detected by quantitative real-time reversetranscription polymerase chain reaction (RT-PCR).Results The dosage of elemene could inhibit tumor growth.The inhibition ratio of cancer in the low-and high-elemene dosage and cisplatin group was 24.2％,27.4％,and 28.2％,respectively.It reduced significantly tumor weights(P ＜0.01).Compared to the model group,the expression level of TRAF6 mRNA on tumors was decreased significantly,while the expression level of caspase-8 mRNA was increased significantly in the other groups(P ＜ 0.05).Conclusions The present results indicated that molecular mechanism of inhibition of liver cancer growth treated by elemene might be through down-regulating mRNA expressions of TRAF6 and caspase-8,promoting tumor cells apoptosis,and achieving the anti-tumor effect.

Detection of renal brush border membrane enzymes for evaluation of renal injury in neonatal scleredema

To evaluate renal brush border membrane enzymes in urine as an indicator for renal injury in neonatal scleredema[NS]. Sixty nine NS patients in our hospital were enrolled and divided into mild group and moderate/severe group. Patients were further randomly divided into therapy and control subgroups for 7 days ligustrazine administration. Urine samples were collected to detect renal brush border membrane enzymes [RBBME] by ELISA and beta[2]-microglobulin [beta[2]-MG] by radioimmunoassay [RIA]. The results were compared with those of 30 normal neonates. Data were statistically analyzed using SPSS13.0 software. Both RBBME and beta[2]-MG were found to be higher in urine in NS patients than normal controls [P < 0.01]. Level of RBBME increased with the severity of NS [P <0.05], while urinary beta[2]-MG did not [P >0.05]. After being treated with ligustrazine, a medicine for renal function recovery, both RBBME and beta[2]-MG were similarly significantly decreased comparing to untreated groups [P < 0.05]. 79.7% of NS patients showed abnormal RBBME while only 52.2% had an abnormal urinary beta[2]-MG [chi[2]=11.65, P < 0.01]. RBBME was more sensitive than beta[2]-MG in reflecting the renal injury in NS. Examination of RBBME effectively reflected the recovery of renal injury after treatment with ligustrazine

Limitations in the use of serum epidermal growth factor receptor mutations as prognostic markers for non-small-cell lung cancer

In this study, we surveyed patients with advanced non-small-cell lung cancer [NSCLC] who were undergoing tyrosine kinase inhibitor [TKI]-targeted therapy. Our aim was to determine whether epidermal growth factor receptor [EGFR] mutations in serum circulating tumor [ct]DNA are useful prognostic markers for NSCLC. Serum samples were collected from 300 patients with NSCLC that included adenocarcinoma [ADC, n = 155] and squamous cell carcinoma [SCC, n = 145]. DNA was extracted from the sera for the nested polymerase chain reaction [PCR] amplification of EGFR exons 18,19 and 21 mutations. Direct sequencing of the PCR products was carried out in an automated 3730 sequencer. The EGFR exons 18,19 and 21 were successfully detected in the serum samples of 300 NSCLC patients. No EGFR mutation was found in the blood samples regardless of the characteristics of gender, age, ADC and SCC status or smoking history. No mutations in EGFR exons 18,19 or 21 were identified in the serum ctDNA of these advanced-stage NSCLC patients undergoing TKI-targeted therapy. More studies are needed on the use of EGFR mutations in serum ctDNA as guidance for TKI-targeted therapy.