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Idiopathic pulmonary fibrosis （IPF） is a progressive interstitial lung disease with unknown etiology and poor prognosis. At present， there are few antifibrotic drugs， which have limited efficacy and cause diverse side effects in the treatment of IPF， failing to meet the clinical needs. Therefore， it is urgent to develop more safe and effective drugs to treat IPF. Traditional Chinese medicine （TCM） has garnered increasing attention in recent years in the treatment of IPF due to its unique advantages. Increasing studies have shown that Chinese medicines have remarkable therapeutic effects on IPF and broad application prospects. However， the unclear material basis and mechanism in treating IPF hinders the modernization， internationalization， and clinical application of Chinese medicines. Therefore， it is essential to decipher the mechanism of the active components in Chinese medicines in treating IPF， which has gradually become a hot spot in the research on IPF. Increasing research results have demonstrated that anti-inflammation， anti-oxidation， inhibition of epithelial-mesenchymal transition are involved in the treatment of IPF with these active components， whereas the systematic research and summary remain to be carried out. By reviewing the articles about the treatment of IPF with the active components in Chinese medicines in recent years， this paper summarizes the mechanism and experimental studies and puts forward the existing problems in the research on the mechanism， aiming to provide references for the further basic research on IPF and the development of targerted drugs.
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Objective:According to 2013 updated consensus guidelines of neck node levels, the distribution characteristics of cervical lymph nodes of nasopharyngeal carcinoma (NPC) were analyzed, aiming to provide preliminary reference for the clinical target volume (CTV) delineation of level Ⅴ in NPC.Methods:A total of 1110 patients pathologically diagnosed with NPC from 2012 to 2020 were retrospectively recruited for further analysis. All patients’ MRI and contrast-enhanced CT simulation scan imageswere retrospectively reviewed, metastatic lymph nodes were mapped using the 2013 International Consensus Guidelines. Then, the correlation between Ⅴa, Ⅴb and Ⅴc metastatic lymph nodes and other lymph nodes was analyzed. An NPC case diagnosed with T 1N 0M 0 was selected as the baseline standard for the normal anatomical structure and proportion of Ⅴc area. The metastatic lymph nodes in Vc were delineated on the CT simulation scan image of sample case, and the distribution characteristics of the metastatic lymph nodes inⅤc were analyzed. Results:Among the 1110 patients, 1004(90.5%) patients had lymph node metastases. The most common area of metastatic lymph node levels were level Ⅶa (74.7%) and level Ⅱb(70.7%), and the skip metastasis of lymph nodes was rare (1.0%). The multivariate analysis showed lymph node metastasis in level Va was correlated with levels Ⅱb, Ⅲ, Ⅳa, Ⅴb, and Ⅷ region ( P=0.010, 0.001, 0.001, 0.001, 0.037). Lymph node metastasis in level Ⅴb was correlated with levels Ⅲ, Ⅳa, Ⅴa and Ⅴc region ( P=0.006, 0.001, 0.001, 0.001). Lymph node metastasis in level Ⅴc was correlated with levels Ⅳb and Ⅴb region ( P=0.008, 0.001). There were 28 cases of lymph node metastasis in levelⅤc. A total of 38 metastatic lymph nodes were counted in level Vc. Among them, 33(86.8%) lymph nodes were located in the medial of the omohyoid muscle (Ⅴc-1 region), and 5(13.2%) were located in the lateral of the omohyoid muscle (Ⅴc-2 region). Conclusions:This study reflects the principle of individualized CTV delineation, which is based on the levels of nodal spread in NPC patients. When correlation is observed among different level V, V should be delineated as the moderate risk lymphatic drainage (CTV n2). It is recommended to individualized delineate level Vc when the CTV n2 covers Vc. The Ⅴc-2 region should be delineated as CTV n2 only when there is nodal spread in the ipsilateral Ⅴc-1 region.
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Objective:To explore the role of the fat mass and obesity-associated protein (FTO) in human renal tubular epithelial cells (HK-2) suffering ischemia-reperfusion injury (IRI).Methods:The in vitro IRI mo-del was established in HK-2 cells by induction with antimycin A, A23187 and 2-deoxy-D-glucose.The cells were divided into control group and ischemia-reperfusion group (I/R group). The mRNA and protein expressions of FTO, B-cell lymphoma / leukemia 2(Bcl-2)-associated X(Bax), Bcl-2 and cleaved cysteinyl aspartate specific proteinase(cleaved Caspase-3) in HK-2 cells before and after IRI were detected by real-time fluorescent quantitative PCR(qPCR) and Western blot, respectively.Cell apoptosis was measured using flow cytometry.The level ofe N 6-methy-ladenosine (m 6A) RNA was detected by colorimetry. Results:(1) The mRNA expressions of FTO (0.15±0.05 vs.1.00±0.23) and Bcl-2 (0.14±0.07 vs.1.02±0.25) in I/R group were significantly lower than those in control group; While those of Bax (3.10±0.35 vs.1.00±0.13) and cleaved Caspase-3 (4.21±0.56 vs.1.00±0.09) were significantly higher ( t=6.28, 5.84, -9.83, and -9.84, respectively, all P<0.01). (2) The protein expressions of FTO (0.69±0.14 vs.1.37±0.02) and Bcl-2 (0.50±0.12 vs.1.25±0.21) were significantly lower in I/R group than those of control group; While those of Bax (1.04±0.08 vs.0.57±0.06) and cleaved Caspase-3 (0.99±0.05 vs.0.36±0.07) were significantly higher ( t=8.10, 5.49, -8.22, and -12.09, respectively, all P<0.05). (3) Compared with the control group, the apoptosis rate of HK-2 cells in I/R group was significantly higher [(61.70±1.01)% vs.(0.16±0.10)%, t=63.80, P<0.01]. (4) Compared with the control group, the percentage of m 6A modification level in total RNA in I/R group was significantly higher [(3.13±0.21)% vs.(1.10±0.26)%, t=-10.61, P<0.01]. Conclusions:FTO-mediated RNA m 6A modification may affect renal IRI by regulating the apoptosis of HK-2 cells.
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Objective:To explore the efficacy and clinical significance of Eltrombopag combined with immunosuppression therapy(IST) in the treatment of severe aplastic anemia (SAA) in children.Methods:Clinical data of 63 children with initially diagnosed SAA in the Department of Hematology of Xinxiang Central Hospital from May 2017 to June 2019 were retrospectively analyzed.All of them were all donors without siblings and they were classified into observation group (31 cases) and control group (32 cases). Patients in the observation group received IST combined with Eltrombopag treatment, and those in the control group received IST treatment.The Chi- square test was used to compare the overall remission (OR) rate and complete remission (CR) rate at 3 months, 6 months and 12 months, and incidence of infection and significant bleeding between groups.The t-test was used to compare the application of gra-nulocyte colony stimulating factor, the mean red blood cell transfusion, and the mean platelet infusion volume between groups.Kaplan-Meier method was adopted to analyze the 2-year overall survival (OS) rate and failure-free survival (FFS) rate, followed by the Log- rank test. Results:The 3-month and 6-month OR rate of the observation group were 61.29%(19/31 cases) and 80.64% (25/31 cases), respectively, which was significantly higher than that of the control group [37.50%(12/32 cases) and 59.38%(19/32 cases), χ2=45.27, 43.81, respectively, all P<0.05]. The 3-month and 6-month CR rate of the observation group were 32.26%(10/31 cases) and 45.16%(14 /31 cases), respectively, which was significantly higher than that of the control group [15.62%(5/32 cases) and 28.13%(9/32 cases), χ2=47.02, 48.35, respectively, all P<0.05]. The 12-month OR rate and CR rate in the observation group were 83.87%(26/31 cases), and 64.52%(20/31 cases), respectively, which were 81.25%(26/32 cases), and 59.38%(19/32 cases), respectively in the control group, and no significant differences in them were detected between the two groups (all P>0.05). The total amount of granulocyte colony stimulating factors [(13.58±4.28) doses vs.(23.24±6.68) doses, t=2.591], and the mean infusion volume of red blood cells [(5.48±1.67) U vs.(10.58±3.67) U, t=2.040] and platelets (4.15±2.47) bags vs.(9.15±3.87) bags, t=2.744) used in observation group within 6 months of treatment were significantly lower than those of the control group (all P<0.05). The rate of infection (16.13% vs.43.75%, χ2=47.12) and significant bleeding (16.13% vs.37.50%, χ2=44.52) in the observation group were significantly lower than those of the control group (all P<0.05). The 2-year OS rate of the observation group and control group were 93.55% (29/31 cases), and 87.50% (28/32 cases), respectively.No significant difference in the OS rate was found between groups ( P=0.407 3), nor as the 2-year FFS rate(87.10% vs.78.13%, P=0.326 6). Conclusions:IST combined with Eltrombopag can significantly improve the early treatment response rate of SAA children without a sibling identical donor, which can reduce red blood cell and platelet transfusion, and the incidence of infection and bleeding.
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Clinical data of a case of Epstein-Barr virus-associated smooth muscle tumor with non-human immunodeficiency virus/transplantation admitted in the Department of Nephrology and Rheumatology, Hunan Children′s Hospital in May 2020 were retrospectively analyzed.The 6 years and 7 months old girl presented with bilateral hip pain for more than 1 year.Imaging examination revealed multiple nodular lesions in the central nervous system and lungs.Arthritis was the first manifestation in this case, and as a result, the patient was misdiagnosed as juvenile idiopathic arthritis.Finally, the patient was pathologically diagnosed as Epstein-Barr virus-associated smooth muscle tumor, which was a rare tumor associated with immunosuppression.
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Objective:To analyze the damage in hippocampal tissues of mice after whole-body irradiation with high- or low-dose ionizing radiation and to investigate the roles of microglia/macrophages polarization in the injury.Methods:C57BL/6 mice were randomly divided into three groups: sham irradiation group, low-dose group (0.05 Gy) and high-dose group (7 Gy). Low- and high-dose groups were respectively treated by whole-body irradiation with single dose of 60Co γ-rays. Hippocampal tissues of the mice were collected at 6 h, 1 d, 3 d and 7 d after irradiation. The morphology, structure and apoptosis of neurons were detected by HE staining, Nissl staining and Tunnel staining, respectively. RT-PCR and immunofluorescence assay were performed to detect the expression of M1 and M2 microglial markers at mRNA and protein levels in hippocampus tissues. The cognitive and emotional behaviors of mice were evaluated one month after the irradiation by Morris water maze, open field test, elevated plus maze and tail suspension test. Results:There were morphological and structural changes in the nerve cells in the hippocampus region of mice after irradiation, accompanied by apoptosis. Acute injuries occurred at 6 h after radiation, alleviated at 1 d and 3 d, and persisted at 7 d in a dose-dependent manner. The results of immunofluorescence staining and confocal imaging analysis showed that compared with the sham irradiation group, the high-dose group showed increased number of microglia, down-regulated expression of M1 microglial markers and up-regulated expression of M2 microglial markers in the hippocampus at 6 h and 1 d after radiation, while M2 microglial markers decreased at 3 d and 7 d after irradiation. PCR results showed that the expression of M1 and M2 microglial markers at mRNA level in the irradiation groups increased at 6 h after irradiation, but there was no statistical significance. The expression of related proinflammatory/anti-inflammatory factors was significantly up-regulated. The results of behavioral experiments showed that compared with the sham irradiation group, there was no statistical difference in cognitive or emotional behaviors at one month after irradiation.Conclusions:60Co γ-rays could damage mouse hippocampal tissues and result in the overexpression and different polarization patterns of microglia/macrophages in mice.
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Objective:To explore the clinical immune manifestations and high risk factors of children with neuropsychiatric systemic lupus erythematosus (NPSLE), so as to find the basis for early clinical differential diagnosis, prevention and treatment of NPSLE.Methods:Ninety-four children with systemic lupus erythematosus (SLE) admitted to Hunan Children′s Hospital from January 1, 2015 to April 30, 2022 were retrospectively selected. Among them, 19 children with NPSLE were in the NPSLE group, and 75 children without NPSLE were in the SLE group. The disease activity, immune system, lymphocyte subsets, inflammatory factors and autoantibodies were compared between the two groups.Results:Among 94 children with SLE, the incidence of NPSLE was 20.21%(19/94). The most common symptoms of 19 children with NPSLE were headache, epileptic seizure and cerebrovascular disease. The Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)-2000 score was (19.89±8.33)points. Most of them had a good prognosis through hormone intervention. Compared with the SLE group, NPSLE group had higher SLEDAI-2000 score, white blood cell count, urine protein, erythrocyte sedimentation rate (ESR), interferon (IFN)-α, positive rate of anti-Sm antibody and anticardiolipin antibody, lower platelet count, interleukin-2 (IL-2), C 3, C 4 level (all P<0.05), while there was no significant difference in positive rate of anti-dsDNA antibody and anti-SSA antibody between the two group (both P>0.05). Conclusions:Compared with SLE children, children with NPSLE are often complicated with many kinds of abnormal immune function, mainly abnormal humoral immune function and many kinds of positive antibody, with increased inflammatory factors.
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Pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) syndrome is a rare autoinflammatory bone disease, which caused by proline-serine-threonine phosphatase interacting protein 1 (PSTPIP1) gene mutations.Due to a lack of awareness of it among clinicians, PAPA syndrome is hard to diagnose and easy to be misdiagnosed or miss-diagnosed clinically.In this paper, twin brothers with recurrent fever and joints pain were reported.They were diagnosed with suppurative arthritis by many hospitals, but after receiving the joint cavity incision operation with negative pressure drainage for several times and antibiotics treatment, their conditions were not improved.Genetic tests showed that the twin brothers had a heterozygous mutation p. E250K (NM003978.3; c.748 G>A; p.Glu250Lys) on the PSTPIP1 gene.They were finally diagnosed with PAPA syndrome and improved with glucocorticoid therapy.
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Objective:To compare the diagnostic accuracy of lung ultrasonography and radiography in detection of acute traumatic intrathoracic injuries in children.Methods:A retrospective analysis was performed in 46 cases of children with chest trauma in Shenzhen Children′s Hospital from January 2017 to January 2021. The diagnostic efficiency of lung ultrasound and radiography in children with acute traumatic hemopneumothorax and lung contusion were compared. Computed tomography scan was used as gold standard.Results:The sensitivity and specificity of lung ultrasound were 0.79 and 0.98 for pneumothorax, 0.86 and 0.75 for hemothorax, 0.86 and 0.80 for pulmonary contusion, respectively. Area under the ROC curve of ultrasonography in detection of pneumothorax, hemothorax, and pulmonary contusion was 0.889 (95% CI=0.798-0.979, P<0.001), 0.804 (95% CI=0.707-0.901, P<0.001), and 0.831 (95% CI=0.623-1.000, P=0.013), respectively. Area under the ROC curve of radiography was 0.674 (95% CI=0.544-0.803, P=0.008) for detection of pneumothorax, 0.645 (95% CI=0.517-0.772, P=0.026) for hemothorax, and 0.547 (95% CI=0.289-0.805, P=0.724) for pulmonary contusion. Comparison of area under the ROC curve declared the significant superiority of ultrasonography in detection of pneumothorax, hemothorax and pulmonary contusion (all P<0.05). Conclusions:Lung ultrasound has higher sensitivity and accuracy than chest radiography in the initial evaluation of chest trauma. For children with acute chest trauma, lung ultrasound should be the first choice.
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In addition to the pyogenic arthritis, pyoderma gangrenosum and acne(PAPA) syndrome, autoinflammatory diseases caused by mutations in the proline-serine-threonine phosphatase interacting protein 1 (PSTPIP1) gene also include a group of clinical syndromes such as PSTPIP1-associated myeloid-related proteinemia inflammatory(PAMI) and pyoderma gangrenosum, acne, and hidradenitis suppurativa(PASH) syndrome.In this paper, the expanded spectrum and clinical characteristics of PSTPIP1 related autoinflammatory diseases were reviewed, so as to deepen clinicians′ understanding of this disease, facilitate early diagnosis, and finally improve the prognosis of patients.
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Workplace spirituality, as a powerful indicator of workplace outcomes, plays an important role in stabilizing nursing talents and improving nursing quality. This article aimed to summarize the overview, measurement tools, related factors and strategies of workplace spirituality from the field of healthcare, so as to promote nursing managers ′ understanding of workplace spirituality and provide a reference for improving the nursing environment.
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Objective:To investigate the status and their relationship of new nurses ′ transition shock, spiritual climate and nurses ′ intention to stay on the job, to explore the mediating effect of transition shock between spiritual climate and intention to stay among newly graduated nurses. Methods:A convenient sampling method was used from October to December in 2019 to investigate 231 new graduate nurses from four hospitals in Qingdao City with the general data questionnaire, the New Nurses ′ Transition Shock Scale, the Nurses ′ Intention to Stay on the Job Scale and the Spiritual Climate Scale. Results:The total score of new nurse retention intend was (20.65 ± 4.30) points, spiritual climate score was (63.20 ± 19.28), and transition shock score was (82.92 ± 22.33) points. Transition shock was negatively correlated with spiritual climate and intention to stay ( r values were -0.451, -0.548, P<0.01) ; spiritual climate was positively correlated with intention to stay ( r value was 0.450, P<0.01). Transition shock played a partial mediating role in spiritual climate and intention to stay (37%). Conclusions:Spiritual climate of the work environment can directly or indirectly affect the intention to stay through the transition shock among newly graduate nruses. Managers can take appropriate intervention measures to improve the spirit climate of the department, alleviate the impact of new nurses ′ transformation and stabilize nursing team.
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Objective:To investigate the diagnosis and treatment of cancer patients in the prefectural and municipal hospitals in Sichuan province during the outbreak of 2019 novel coronavirus disease (COVID-19) epidemic, and analyze the impact of the epidemic on the hospitalization and treatment of cancer patients, aiming to provide reference for the diagnosis and treatment of cancer patients by medical institutions in different provinces.Methods:The prefectural and municipal hospitals in Sichuan province were investigated in the form of questionnaire.Results:A survey was conducted in 37 prefecture-level large and medium-sized hospitals in Sichuan province, of which Grade 3A hospitals accounted for 78.4%. Among the investigated hospitals, the hospitals whose hospitalization index of oncology patients and radiotherapy index of radiotherapy patients were< 1 after the first-class response were 83.7% and 93.1%, respectively. Hospitals with normal or delayed chemotherapy within one-week consisted of 54.1%, and 89.7% of the hospitals received normal radiotherapy or delayed radiotherapy within one-week after the Spring Festival. After the second-class response, the proportion of hospitals with oncology patients and radiotherapy patients that increased after the first-class response was 78.4% and 79.3%, respectively.Conclusions:Under the guidance of the State Council, the Sichuan Provincial Party Committee and the Provincial Government, Health Commission of Sichuan Province, and the municipal health commissions at various levels and under the joint efforts of medical institutions and front-line medical staff from Department of Oncology, a majority of cancer patients admitted to prefectural and municipal hospitals in Sichuan province can receive active and effective treatment during the outbreak of COVID-19 epidemic.
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Objective:To analyze the application value of XpertMTB/RIF, culture of Mycobacterium tuberculosis (MTB), and detection of Mycobacterium tuberculosis DNA (TB-DNA) in the diagnosis of tuberculosis.Methods:From January 2018 to January 2020, 75 patients admitted to Wenzhou Central Hospital and diagnosed with tuberculosis in clinic were selected in the research.The results of clinical diagnosis were used as the gold standard.The sensitivity, specificity and accuracy of XpertMTB/RIF, TB cultureand TB-DNA in the detection of tuberculosis were analyzed.The resistance of MTB to rifampicin and the adverse reactions such as blood in sputum and fever of patients were evaluated.Results:The sensitivity, specificity and accuracy of XpertMTB/RIF in detecting tuberculosis were 95.24%, 72.71%and 85.33%, respectively.The sensitivity, specificityand accuracy of TB culture in detecting tuberculosis were 80.95%, 66.67% and 74.67%, respectively.The sensitivity, specificity and accuracy of TB-DNA detection in detecting tuberculosis were 78.57%, 69.70%and 74.67%, respectively.There were statistically significant differences in the sensitivity among XpertMTB/RIF, TBand TB-DNA in detecting tuberculosis (χ 2=4.086, 5.126, P=0.043, 0.024). The result of clinical diagnosis was used as the gold standard.In the positive samples obtained, the sensitivity and specificity of XpertMTB/RIF in detection of drug resistance were 72.73% and 93.55%, respectively.The sensitivity and specificity of TB were 54.55% and 74.19%, respectively, and the sensitivity and specificity of TB-DNA were 63.64% and 70.97%, respectively.The sensitivity and specificity of XpertMTB/RIF in detection of drug resistance were higher than those of TB culture and TB-DNA, and the difference in specificity was statistically significant (χ 2=4.292, 5.415, P=0.038, 0.020). In the fiberoptic bronchoscopy, alveolar lavage and brush biopsy, 75 patients did not have serious adverse reactions.After operation, there were 2 cases with blood in the sputum and 1 case with fever.The adverse reactions of above patients disappeared after 1-3 days. Conclusion:XpertMTB/RIF, TB culture and TB-DNA have good clinical application value in detecting MTB in specimens of patients of tuberculosis, but in terms of rapid detection of tuberculosis and resistance to rifampicin, XpertMTB/RIF detection is more accurate.
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Objective:To investigate the risk factors for prolonged acute post-streptococcal glomerulonephritis(APSGN) in children, and to provide evidence for the prevention and treatment of chronic kidney diseases in children.Methods:A retrospective analysis was performed on the patients who were diagnosed as APSGN and hospitalized in the Department of Nephrology and Rheumatology of Hunan Children′s Hospital from January 2005 to August 2017 with complete clinical data, and follow-up time of more than 12 months.The patients were divided into the non-prolonged group and the prolonged group according to whether the disease course of the children exceeded 1 year. Logistic regression analysis of the high-risk factors for the prolonged disease was conducted. Results:Among 271 children included in the study, 197 cases were males, 74 cases were females; with the median age of 9.91 (7.66, 11.33) years old; there were 154 cases in the non-prolonged group (course of disease < 1 year) and 117 patients in the prolonged group (course of disease ≥1 year). Logistic regression analysis showed that duration of proteinuria ≥8 weeks, acute kidney injury, a large amount of proteinuria, and female were the risk factors for the prolonged APSGN (all P<0.05). Giving 1 point to the acute kidney injury duration of proteinuria ≥8 weeks and female, and 2 points to a large amount of proteinuria, the receiver operating characteristic curve analysis showed that for patient whose risk score was 3 points or more, the sensitivity of APSGN to be belonged was 43.6%, specificity was 86.4%, and positive predictive value and negative predictive value were 70.8% and 66.8%. Conclusions:Patients with a large amount of proteinuria accompanied by acute kidney injury or proteinuria duration ≥8 weeks, or female patients with a large amount of proteinuria, or female patients with acute kidney injury and proteinuria duration ≥8 weeks, but without a large amount of proteinuria, have a higher risk of prolonged APSGN.
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Objective:To analyze the clinical characteristics of chronic granulomatous disease (CGD) with chronic active EB virus (EBV) infection (CAEBV).Methods:The clinical data of 1 CGD patient combined with CAEBV who underwent allogeneic hematopoietic stem cell transplantation (HSCT) in Beijing Friendship Hospital of Capital Medical University in March 2017 was retrospectively analyzed, and the relevant literature was also summarized.Results:After transplantation, the chimeric rate and gene test was 100% complete donor type. During the follow-up period, no recurrent severe infection occurred within 39 months, and EBV-DNA copy was 0; no acute or chronic graft-versus-host disease (GVHD) related manifestations occurred, and the quality of life was higher.Conclusions:Haploid allogeneic HSCT with myeloablative conditioning regimens is a relatively safe and effective treatment for CGD patients combined with CAEBV. For primary immunodeficiency disease, it suggests that the haploidentical donor carrying the monohybrid pathogenic gene can also be used as an effective stem cell source if the hematological and immunological function is normal.
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AIM: To compare the bioequivalence of two brands of fluconazole capsules (50 mg) made in Chengdu Brilliant Pharmaceutical Co., Ltd and Pfizer Pharmaceuticals Ltd. (held in France) in healthy volunteers under fasted and fed conditions. METHODS: The study was an open-label, randomized, two way-crossover study involving 52 healthy Chinese volunteers. A single oral test and reference fluconazole capsules (50 mg) were given to the volunteers under fasted and fed conditions. The plasma concentration of fluconazole was determined by LC-MS/MS method. The non-compartment model pharmacokinetic parameter calculation method was applied to calculate pharmacokinetic parameters and perform statistical analysis.RESULTS: The main pharmacokinetic parameters after oral administration of test and reference fluconazole capsules under fasted conditions were as follows, Cmax (1.32±0.21) μg/mL and (1.15±0.20) μg/mL; AUC0-t (52.84±7.91) μg•h•mL-1 and (51.49±8.15) μg•h•mL-1; AUC0-∞ (58.07±9.30) μg•h•mL-1 and (56.99±10.13) μg•h•mL-1, respectively. The main pharmacokinetic parameters after oral administration of test and reference fluconazole capsules under fed conditions were as follows, Cmax (1.04±0.14) μg/mL and (1.04±0.15) μg/mL; AUC0-t (50.64±7.08) μg•h•mL-1 and (49.91±9.13) μg•h•mL-1; AUC0-∞(56.79±9.26) μg•h•mL-1 and (56.06±11.58) μg•h•mL-1, respectively. The 90% confidential intervals of the geometric mean ratios of Cmax, AUC0-t, AUC0-∞ under fasted and fed conditions were all between 80% and 125%. CONCLUSION: The two brands of fluconazole capsules were bioequivalent under fasted and fed conditions.
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Objective To establish a set of operational status assessment indicators to meet the needs of informationized hospital management.Methods Assessment indicators were selected and weights were set respectively through literature review,field interview,and questionnaire survey.Six target dimensions were key performance indicators medical business,operational performance,cost control,medical insurance,balance and risk management,and development capability.Thus a set of operational status evaluation indicators was established in IT means,and based on the informationization level of a tertiary A general hospital in Zhejiang province.Results In the principle of public welfare,objectivity,effectiveness and prospectiveness,we analyzed and sorted out relevant data in the current hospital informationization,identifying six quantitative indicators,15 level-1 indicators,and 86 level-2 indicators.Conclusions It is feasible to build a set of assessment indicators for hospital operation and management in view of both technology and methodology.
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Objective Investigate the effect of neonatal hyperbilirubinemia on the detection of HBsAg by chemiluminescence and its elimination methods.Methods Case control study.The HBsAg in human serum was detected in 200 cases of hyperbilirubinemia neonates who were hospitalized in Beijing Children's Hospital,Capital Medical University from July 2015 to May 2016 and whose serum total bilirubin level exceeded 200 μmol/L.The positive serum was further detected by 16 200×g high-spoed centrifugation or blue light irradiation for 8 hours,and the results of re-assay of HBsAg were recorded.The retest positive serum wastested for HBV DNA load and checked the results of their mother's examination in HBV.136 adult serum samples with total bilirubin levels exceeding 200 μmol/L in the Peking University First Hospital,were taken as reference to compare the influence of hyperbilirubinemia between adults and newborns on the determination of HBsAg.Results The median level of serum total bilirubin in neonates was 259.0 μ mol/L (226.5,312.5);median level of indirect bilirubin 244.1 μmol / L(212.5,295.8).Median level of serum total bilirubin in adults 356.4 μmol/L(295.9,435.1);median level ofindirect bilirubin 137.1 μmol/L (107.8,172.7).The HBsAg test was negative in adults,11 cases (5.5％) were positive in newborns,their" HBV DNA load was less than＜100 IU/ml.Among them,9 have inoculated hepatitis B vaccine and 2 were unknown.10 of 11 mothers of infants were healthy and 1 was positive for HBsAg,HBeAb,HBcAb.2 of the 11 positive specimens turned negative of HBsAg after high-speed centrifugation.In addition to high speed centrifugation,4 cases turned negative after blue light irradiation.5 cases remained positive after high speed centrifugation and blue light irradiation.Conclusions Neonatal hyperbilirubinemia,which is different from that of adults,is mainly caused by indirectly bilirubin increased,which is one of the main reasons for false positive detection of HBsAg by chemiluminescence in neonates.High-speed centrifugation and blue light irradiation can eliminate the influence of serum indirect bilirubin on the detection of HBsAg to the greatest extent.
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Objective@#To establish comprehensive laboratory reference intervals for Chinese children.@*Methods@#This was a cross-sectional multicenter study. From June 2013 to December 2014, eligible healthy children aged from 6-month to 17-year were enrolled from 20 medical centers with informed consent. They were assessed by physical examination, questionnaire survey and abdominal ultrasound for eligibility. Fasting blood samples were collected and delivered to central laboratory. Measurements of 15 clinical laboratory parameters were performed, including estradiol (E2), testosterone(T), luteinizing hormone(LH), follicle-stimulating hormone(FSH), alanine transaminase(ALT), serum creatinine(Scr), cystatin C, immunoglobulin A(IgA), immunoglobulin G(IgG), immunoglobulin M(IgM), complement (C3, C4), alkaline phosphatase(ALP), uric acid(UA) and creatine kinase(CK). Reference intervals were established according to central 95% confidence intervals for reference population, stratified by age and sex.@*Results@#In total, 2 259 children were enrolled. Finally, 1 648 children were eligible for this study, including 830 boys and 818 girls, at a mean age of 7.4 years. Age- and sex- specific reference intervals have been established for the parameters. Reference intervals of sex hormones increased gradually with age. Concentrations of ALT, cystatin C, ALP and CK were higher in children under 2 years old. Serum levels of sex hormones, creatinine, immunoglobin, CK, ALP and urea increased rapidly in adolescence, with significant sex difference. In addition, reference intervals were variable depending on assay methods. Concentrations of ALT detected by reagents with pyridoxal 5'-phosphate(PLP) were higher than those detected by reagents without PLP. Compared with enzymatic method, Jaffe assay always got higher results of serum creatinine, especially in children younger than 9 years old.@*Conclusion@#This study established age- and sex- specific reference intervals, for 15 clinical laboratory parameters based on defined healthy children.