Diagnostic value of nucleic acid matrix-assisted laser desorption ionization-time of flight mass spectrometry in sputum smear-negative patients with nontuberculous Mycobacterial pulmonary disease / 中华临床感染病杂志

Objective:To investigate the diagnostic value of nucleic acid matrix-assisted laser desorption ionization-time of flight mass spectrometry（MALDI-TOF MS）in sputum smear-negative patients with nontuberculous Mycobacterial（NTM）pulmonary disease.Methods:Clinical data of 123 patients suspected of NTM pulmonary disease admitted in Public Health Clinical Center Affiliated to Shandong University between July 2022 and November 2023 were retrospectively analyzed. Bronchoalveolar lavage fluid（BALF）specimens were collected for MALDI-TOF MS assay and MGIT 960 culture. The diagnostic efficacy of MALDI-TOF MS for NTM pulmonary disease in patients with negative sputum smears for acid-fast bacilli was evaluated with receiver operating characteristic（ROC）curve. Statistical analysis was performed using SPSS 26.0 software and MedCalc statistical software.Results:Diagnosis of NTM pulmonary disease was finally confirmed in 66 out of the 123 suspected patients. It took 8 to 24 h for MALDI-TOF MS to identify NTM species and resistance. By MALDI-TOF MS，72 NTM strains were identified，with the Mycobacterium avium complex being the most prevalent（34 strains，47.22%），followed by the Mycobacterium abscessus complex（13 strains，18.06%）；resistance to macrolides was detected in 6 cases，while no resistance to aminoglycosides was found. It took 9 to 45 days for BALF MGIT 960 culture to identify NTM，and took 7 to 15 days for NTM typing and drug sensitivity testing. By BALF MGIT 960 culture，28 NTM strains were identified；and 1 case was found to be resistant to macrolides. Using confirmed diagnosis as the gold standard，MALDI-TOF MS demonstrated higher sensitivity，negative predictive value，and agreement rate compared to MGIT 960 culture（84.85% vs. 42.42%，81.13% vs. 56.32%，80.49% vs. 62.60%， χ2=25.667，8.998，9.664， P<0.05 or <0.01）. The area under ROC curve（AUC）for MALDI-TOF MS was significantly higher than that of MGIT 960 culture（0.801 vs. 0.642， Z=3.300， P=0.001）. Conclusion:Compared to MGIT 960 culture，MALDI-TOF MS exhibits superior diagnostic efficiency in detecting NTM pulmonary disease in patients with acid-fast bacilli smear-negative sputum，with advantage of rapidly identifying NTM species and resistance.

Significance of high-sensitivity polymerase chain reaction in detecting hepatitis B virus in chronic hepatitis B patients with a very low viral load / 临床肝胆病杂志

ObjectiveTo investigate the significance of high-sensitive polymerase chain reaction （PCR） in detecting hepatitis B virus （HBV） among the population with a very low viral load （HBV DNA 10‍ — ‍99 IU/mL）. MethodsThis study was conducted among the chronic hepatitis B （CHB） patients who were treated with nucleos（t）ide analogues for ≥48 weeks in The Fifth Affiliated Hospital of Guangzhou Medical University from September 2019 to February 2022 and had an HBV DNA load below the lower limit of ordinary-sensitivity detection （100 IU/mL）. Then high-sensitivity HBV DNA detection was performed for all patients， and according to these results， the patients were divided into very low viral load group （VLVL group with an HBV DNA load of 10‍ — ‍99 IU/mL） and complete virologic response group （CVR group with an HBV DNA load of <10 IU/mL or without HBV DNA detected）. The two groups were compared in terms of general characteristics， serum virological indicators， biochemical parameters， and noninvasive fibrosis markers； the value of related serum virological indicators in predicting the results of high-sensitivity HBV DNA above the lower limit of detection were assessed； the influencing factors for failure to achieve CVR were analyzed. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The receiver operating characteristic （ROC） curve was used to investigate the value of related serum virological indicators in predicting the results of high-sensitivity HBV DNA above the lower limit of detection， and a binary logistic regression analysis was used to investigate the influencing factors for failure to achieve CVR. ResultsA total of 106 CHB patients were enrolled， with 24 in the VLVL group and 82 in the CVR group. Compared with the CVR group， the VLVL group had a significantly younger age （P=0.004） and significantly higher quantitative hepatitis B surface antigen （qHBsAg） level （P=0.002）， HBeAg positive rate （P=0.002）， pgRNA positive rate （P=0.010）， and alanine aminotransferase level （P=0.017）. The qHBsAg level had an area under the ROC curve of 0.717 （P=0.002） in predicting the results of high-sensitivity HBV DNA above the lower limit of detection （>10 IU/mL）， with an optimal cut-off value of 1 214.5 IU/mL， a sensitivity of 95.5%， and a specificity of 53.9%. Positive HBeAg （odds ratio ［OR］=3.654， 95% confidence interval ［CI］： 1.162‍ —‍ ‍11.489， P=0.027） and qHBsAg （OR=2.985， 95%CI： 1.058‍ — ‍8.422， P=0.039） were independent influencing factors for failure to achieve CVR. ConclusionSome CHB patients have an HBV DNA load of <100 IU/mL by ordinary-sensitivity detection， but with the presence of VLVL determined by high-sensitivity PCR. The VLVL group had significantly higher level of inflammatory damage and positive rates of pgRNA and HBeAg. Positive HBeAg and high qHBsAg level are independent influencing factors for failure to achieve CVR. Clinicians should not ignore the presence of VLVL in CHB patients， and high-sensitivity HBV DNA detection should be performed in a timely manner.

Effect of electroacupuncture at different time points on postoperative urination function in patients with mixed hemorrhoids surgery / 中国针灸

OBJECTIVE@#To observe the effect of preoperative, intraoperative and postoperative electroacupuncture (EA) intervention on postoperative urination function in patients with mixed hemorrhoid surgery.@*METHODS@#A total of 240 patients with mixed hemorrhoid surgery under lumbar anesthesia were randomly divided into an EA preconditioning group (group A, 60 cases, 9 cases dropped off), an intraoperative EA group (group B, 60 cases, 4 cases dropped off), a postoperative EA group (group C, 60 cases, 6 cases dropped off), and a non-acupuncture group (group D, 60 cases, 3 cases dropped off). In the groups A, B and C, EA was exerted at Zhongliao (BL 33) and Huiyang (BL 35) , with disperse-dense wave, 4 Hz/20 Hz in frequency, and lasting 30 min, at 30 min before lumbar anesthesia, immediately after lumbar anesthesia and 6 h after surgery, respectively. No EA intervention was performed in the group D. The postoperative urination smoothness score in each group was observed 24 h after surgery. The first urination time, first urination volume, urine residual volume after first urination were recorded, and incidence of indwelling catheterization, postoperative visual analogue scale (VAS) score, number of remedial analgesia, and the incidence of postoperative nausea and vomiting were observed in each group.@*RESULTS@#In the groups A, B and C, the postoperative urination smoothness scores were superior to the group D (P<0.05), and the time of first urination was earlier than the group D (P<0.05). In the group C, the time of first urination was earlier than the group A and the group B (P<0.05), the first urination volume was higher than the group D (P<0.05), and the urine residual volume after first urination was lower than the group D (P<0.05). There was no significant difference in the incidence of indwelling catheterization and postoperative nausea and vomiting among the 4 groups (P>0.05). The VAS scores of the group A, B and C were lower than that in the group D (P<0.05), and the number of remedial analgesia cases was lower than that in the group D (P<0.05).@*CONCLUSION@#EA intervention could promote the recovery of urination function and relieve postoperative pain in patients with mixed hemorrhoids surgery. Early postoperative EA intervention is more conducive to the recovery of urination function.

Effect of Yinchenhao Decoction combined with exosomes derived from umbilical cord mesenchymal stem cells on acute liver failure and hepatocyte pyroptosis / 实用医学杂志

Objective To investigate the hepatoprotective effect and anti-hepatocyte pyroptosis effect of Yinchenhao decoction synergized with umbilical cord mesenchymal stem cells(UcMSCs)in vitro and vivo models of acute liver failure(ALF),as compared to single-drug treatment.Methods UcMSCs were extracted from umbilical cords and identified using electron microscopy and flow cytometry.Then the exosomes released from ucMSCs(UcMSCs-exo)were isolated through ultracentrifugation,and ucMSCs-exo were identified by nanoparticle tracking analysis(NTA),transmission electron microscopy,and Western blot for CD63 and CD9.Human hepatocyte cell line LO2 cells were stimulated by 100 ng/mL lipopolysaccharide(LPS)and 5 mmol/L adenosine triphosphate(ATP)to construct a vitro model of ALF.The cells were randomly divided into the following groups:a normal control group,a model group,a Yinchenhao decoction treatment group,a ucMSCs-exo treatment group,and a combination treatment group.The morphological changes of LO2 were observed under the electron microscope,the mortality of LO2 cells was detected by flow analysis,the expression of pyroptosis-related proteins Caspase-1 and Cleaved-Caspase-1 was detected by Western blot,and the expression of pyroptosis-related cytokines IL-1β and IL-18 was detected by ELISA.Then,fifty 6-8-week-old male C57BL/6 mice were randomly divided into the following groups:normal control group,model group,Yinchenhao decoction treatment group,ucMSCs-exo treatment group,and combined treat-ment group.Each group consisted of 10 mice.The ALF mouse model was constructed by intraperitoneal injection of 10 μg/kg LPS and 800 mg/kg D-galactosamine(D-GalN).After successful modeling,each group was given the appropriate drug interventions,and the ucMSCs-exo and combined treatment groups were injected with ucMSCs-exo interventions in the tail vein,and the drugs were administered continuously for 3 days.After 12 hours of intervention,serum specimens and liver tissues were collected from each group.The expression levels of ALT and AST were detected,and the liver tissues were stained with HE to observe the pathological changes.Results In the ALF cell model,hepatic cell death was inhibited in the Yinchenhao decoction treatment group,the ucMSCs-exo treatment group,and the combination group(P<0.05).The rate of hepatic cell death in the combination treatment group was significantly reduced(P<0.05).Initially,the study aimed to explore the effect on hepatic cell pyroptosis,and it was found that the combination treatment group could effectively suppress hepatocellular cell death more effectively compared to the single treatment groups.The combined treatment group significantly reduced the expression of the pyroptosis-related protein Cleaved-Caspase-1,as well as the cytokines IL-1β and IL-18(P<0.05).However,there was no statistically significant difference in the expression of Caspase-1(P>0.05).In the vivo model,the single Yinchenhao decoction treatment group,the ucMSCs-exo treatment group,and the combined treatment group were able to effectively reduce the serum ALT and AST levels compared to the model group(P<0.05).Additionally,these treatments were found to attenuate hepatocellular necrosis and the infiltration of inflammatory cells.Compared to the group treated with only Yinchenhao decoction or only ucMSCs-Exo,the group that received combined treat-ment showed a greater decrease in serum ALT and AST levels.Additionally,there was a reduction in the infiltration of inflammatory cells and the extent of cell death in the liver tissues(P<0.05).Conclusions The combination of Yinchenhao decoction and ucMSCs-exo demonstrated a significantly better hepatoprotective effect in the ALF vivo model compared to the individual treatments of Yinchenhao decoction or ucMSCs-exo alone.Furthermore,this combination treatment was able to effectively inhibit hepatocyte pyroptosis.

Genotypic characteristics of thalassemia and evaluation of the effectiveness of blood routine screening in Sanya City / 中华地方病学杂志

Objective:To analyze the mutation types and distribution characteristics of thalassemia gene among high-risk populations in Sanya City, and to evaluate the effectiveness of blood routine screening, in order to provide scientific basis for formulating measures for prevention and control of thalassemia in Sanya City.Methods:Retrospective analysis was used to collect detection results and clinical data from high-risk individuals who completed genetic screening for thalassemia at Sanya Materal and Child Health Hospital from January 2019 to August 2021. Mutation types and distribution characteristics of thalassemia gene were analyzed, and the missed detection rate and sensitivity of blood routine indicators [mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH)] were evaluated based on the results of genetic screening for thalassemia.Results:A total of 5 760 high-risk individuals were included in the screening results of thalassemia genes, and 3 868 samples of thalassemia gene mutations were detected, with a detection rate of 67.15%. Among them, there were 2 979 samples with α-thalassemia genetic mutations, with a detection rate of 51.72%; including 2 966 common genotype samples (99.56%), the main genotype was αα/-α 3.7 (20.14%, 600/2 979); 13 rare genotype samples (0.44%), 4 cases of αα/-- THAI, 3 cases of α CD40(AAG>AA-)α/αα, 2 cases of α PPα/αα, and 1 case of Fusion gene/αα, Fusion gene/α WSα, α WSα/α PPα, and α CD40(AAG>AA-)α/α WSα each. There were 340 samples with β-thalassemia gene mutations, with a detection rate of 5.90%; including 336 common genotype samples (98.82%). The β CD41/42/β N genotype was dominant (57.65%, 196/340); 4 rare genotype samples (1.18%), β CD5(-CT)/β N, β IVS-Ⅱ-2(-T)/β N, β IVS-Ⅱ-761(-T)/β N and β Initiation(ATG>AGG)/β N 1 case each. There were 549 samples of αβ-compound type thalassemia, with a detection rate of 9.53%. The α missing recombination β CD41/42 genotype was dominant (61.02%, 335/549). There were a total of 4 226 samples that could be traced back to MCV and MCH. Among them, 3 007 samples were found to have mutations in thalassemia genes through screening, 2 584 cases were found to have abnormalities in the combination of MCV and MCH indicators, and 423 samples were missed in blood routine screening, with a missed detection rate of 14.07% (423/3 007). The missed samples were mainly α static type, accounting for 89.13% (377/423) of the total missed samples. The screening sensitivity of MCV combined with MCH for α-, β- and αβ-compound type thalassemia was 82.65%, 98.07% and 98.15%, respectively. Conclusion:The types of genetic mutations in thalassemia in Sanya City are complex and diverse, and there are certain omissions in the blood routine screening of MCV combined with MCH.

The mediating effect of nurse professional identity between practice environment and safety behavior / 中华护理杂志

Objective To explore the mediating effect of nurse professional identity between the practice environment and safety behavior,in order to provide references and bases for managers to formulate scientific,reasonable and standardized interventions for nurse safety behavior.Methods A total of 1381 nurses from 5 tertiary general hospitals in Beijing were adopted for investigation from May to June 2022 by convenience sampling method.They were investigated with general information questionnaire,Nurse Safety Behavior Questionnaire,Nursing Practice Environment Assessment Scale and Nurse Professional Identity Assessment Scale.The structural equation model was used to analyze the mediating effect of nurse professional identity between practice environment and safety behavior.Results Finally,1303 nurses participated in the survey.The total scores of nurse safety behavior scale,nursing practice environment assessment scale and nurse professional identity scale were 59.0(56.0,60.0)points,3 441.0(3 066.0,3 586.0)points,131.0(115.0,150.0)points,which were all above the medium level.Nurse safety behavior was significantly positively correlated with nurse professional identity and the nurse practicing environment assessment(r=0.516,0.421,P<0.01),and was significantly positively correlated with the scores of all dimensions(P<0.01).The practice environment and professional identity can directly and positively affect the level of nurse safety behavior.The mediating test shows that nurse professional identity plays a partial mediating effect between the practice environment and safety behavior,and the mediating effect is 0.184,accounting for 46.11%of the total effect.Conclusion In this study,nurse professional identity is a mediator between the practice environment and safety behavior.Nursing managers should pay attention to the cultivation of nurses'professional identity and optimize the working environment of clinical nurses,so as to improve nurse safety behavior and ensure the safety of patients.

The regulatory mechanism of deubiquitin ligase USP9X in nasopharyngeal carcinoma cell proliferation through FOXM1-mediated glycolysis / 肿瘤

Objective:To explore whether the deubiquitinating enzyme deubiquitin ligase 9X(USP9X)affects the proliferation of nasopharyngeal carcinoma(NPC)cells via regulating forkhead box Ml(FOXM1)mediated glycolysis. Methods:Western blotting and real-time fluorescence quantitative PCR,respectively,were used to detect the protein and mRNA expression levels of USP9X in NPC tissue and normal nasal mucosa tissue.NPC cells(CNE2 and HNE2)were infected with lentivirus carrying specific shRNA targeting USP9X gene(shUSP9X)or full-length USP9X gene(Flag-USP9X)for USP9X overexpression.CCK-8 assay was used to evaluate the effect of USP9X silencing or overexpression on the proliferation of NPC cells.Cellular energy metabolism assay and extracellular acidification rate(ECAR)assay were performed to investigate the impact of USP9X alteration on the glycolysis of NPC cells.The interaction between USP9X and FOXM1 was analyzed using ubibrowser_v3/database,co-immunoprecipitation,and ZDOCK software,and the changes in FOXM1 protein ubiquitination levels upon USP9X silencing was examined.Real-time fluorescence quantitative PCR and Western blotting,respectively,were used to detect the effect of USP9X alteration on the expression of FOXM1 mRNA and protein in NPC cells.Finally,FOXM1 expression was restored in USP9X silencing CNE2 cells by expression of recombinant plasmid Flag-FOXM1 carrying full-length FOXM1 gene through lentiviral infection.CCK-8 assay was used to evaluate the effect of FOXM1 upregulation on the proliferation of CNE2 cells.Cellular energy metabolism assay and ECAR assay were used to investigate the effect of FOXM1 upregulation on the glycolysis of CNE2 cells. Results:Compared with normal nasal mucosa tissue,the expression levels of USP9X mRNA and protein were significantly increased in NPC tissues(P＜0.05).After USP9X downregulation,the proliferation and glycolysis of CNE2 cells was significantly inhibited as indicated by the results of CCK-8 assay,cellular energy metabolism assay and ECAR assay(P＜0.05).In contrast,the proliferation and glycolysis of HNE2 cells was significantly enhanced after USP9X upregulation(P＜0.05).The interaction between USP9X and FOXM1 was confirmed by ubibrowser_v3/database,co-immunoprecipitation,and ZDOCK software analysis.Silencing USP9X could significantly increase FOXM1 ubiquitination in CNE2 cells.Overexpressing FOXM1 in low-USP9X CNE2 cells restored the proliferation and glycolysis activity of NPC cells(P＜0.05). Conclusion:USP9X can enhance NPC cell glycolysis by inhibiting FOXM1 ubiquitination and subsequent degradation,thereby promoting NCP cell proliferation.USP9X may be a potential novel therapeutic target for the treatment of NPC.

Chemical constituents of Lindera aggregata and their bioactivities: a review / 中国中药杂志

The medicinal Lindera aggregata(Lindera, Lauraceae) boasts abundant resources, which is widely used in clinical settings. It has been found that the main chemical constituents of this medicinal species are sesquiterpenoids, alkaloids, sesquiterpenoid dimers, flavonoids, and phenolic acids. Some unreported novel structures, including lindenane-type sesquiterpene dimers and trimers, have been discovered from L. aggregata in recent years. The extracts and active components of L. aggregata have anti-tumor, anti-inflammatory, antalgic, liver-protecting, antioxidant, lipid-lowering, and glucose-lowering activities, and their mechanisms of action have been comprehensively investigated. This study summarizes the research on the chemical constituents and bioactivities of L. aggregata over the past decade, which is expected to serve as a reference for the future research and utilization of L. aggregata.

Surgical treatment and nursing care of patients with hypertensive cerebral hemorrhage at home and abroad / 中国基层医药

Hypertensive intracerebral hemorrhage is in the critical condition. Surgical treatment can promptly remove cranial hematoma, reduce the compression to the intracranial nerve, and improve the patient's neurological function and prognosis. At present, there are many operating modes, from the traditional large bone flap craniotomy to remove hematoma, to minimally invasive surgery. Each has its own advantages. This paper reviews various minimally invasive hematoma removal procedures and clinical nursing care based on traditional surgical treatment, analyzes the advantages and disadvantages of surgical treatment for patients with hypertensive cerebral hemorrhage, selects appropriate surgical methods and formulates reasonable surgical strategies.

Genetic analysis of a Chinese pedigree affected with Becker muscular dystrophy with myalgia as the main feature / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis of a Chinese pedigree affected with Becker muscular dystrophy (BMD) with myalgia as the main feature.@*METHODS@#Clinical data of the patients and results of auxiliary examinations were retrospectively analyzed. Multiplex ligation-dependent probe amplification and high-throughput sequencing were used to detect potential variants. Sanger sequencing was used to verify the results.@*RESULTS@#The clinical manifestations of the proband included myalgia and elevated serum creatine kinase, which is similar to another patient from the pedigree. Genetic testing revealed that the two patients both harbored hemizygous deletions of exons 10 to 29 of the DMD gene, for which the mother was a carrier. The same deletion was not found in his father. Based on the guidelines from American College of Medical Genetics and Genomics, the deletion was predicted to be pathogenic (PVS1+PM2+PP1).@*CONCLUSION@#Myalgia with elevated serum CK may be atypical clinical manifestations of BMD and may be associated with variants in the rod domain of the DMD gene. The deletion of exons 10 to 29 of the DMD gene probably underlay the BMD in this pedigree.

Distribution of CYP2C9∗3 and VKORC1-1639G>A gene polymorphism in Anhui Han population and their influence on the stable dose of warfarin / 中国临床药理学与治疗学

AIM: To study the distribution of CYP2C9∗3 and VKORC1-1639G>A gene polymorphism in Han population in Anhui province and their influence on the stable dose of warfarin. METHODS: The blood samples of 1 169 patients from 6 tertiary general hospitals in 5 areas of Anhui province from January 2020 to December 2021 were selected, the genotype of CYP2C9∗3 and VKORC1-1639G>A was detected by fluorescent staining in situ hybridization technique. RESULTS: The distribution of CYP2C9∗3 genotypes in 1 169 patients: the frequencies of AA, AC and CC genes were 90.16%, 9.24% and 0.60%, respectively; The distribution of VKORC1 genotype: the frequencies of AA, AG and GG genes were 84.26%, 14.71% and 1.03% respectively; There was no significant difference between the two genotypes in gender, age and regional distribution (P>0.05). The average daily warfarin dose of CYP2C9∗3 AA genotype in 755 patients with stable warfarin dose was (3.02±0.59) mg/d, which was significantly higher than patients with AC genotype and CC genotype; The average daily warfarin dose of patients with VKORC1-1639AA genotype was (2.72±0.40) mg/d, which was significantly lower than that of patients with AG genotype and GG genotype (P<0.05). And the difference was statistically significant (P<0.05); There are significant differences in gender, age and clinical diagnosis between patients with stable dose of warfarin and those without stable dose (P<0.05). CONCLUSION: CYP2C9 and VKORC1 genotypes are associated with the stable dose of warfarin. Clinical anticoagulation therapy guided by CYP2C9 and VKORC1 genotypes can provide guidance for individualized medication of warfarin.

KIF2C: a novel link between Wnt/β-catenin and mTORC1 signaling in the pathogenesis of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and is the fourth-leading cause of cancer-related deaths worldwide. HCC is refractory to many standard cancer treatments and the prognosis is often poor, highlighting a pressing need to identify biomarkers of aggressiveness and potential targets for future treatments. Kinesin family member 2C (KIF2C) is reported to be highly expressed in several human tumors. Nevertheless, the molecular mechanisms underlying the role of KIF2C in tumor development and progression have not been investigated. In this study, we found that KIF2C expression was significantly upregulated in HCC, and that KIF2C up-regulation was associated with a poor prognosis. Utilizing both gain and loss of function assays, we showed that KIF2C promoted HCC cell proliferation, migration, invasion, and metastasis both in vitro and in vivo. Mechanistically, we identified TBC1D7 as a binding partner of KIF2C, and this interaction disrupts the formation of the TSC complex, resulting in the enhancement of mammalian target of rapamycin complex1 (mTORC1) signal transduction. Additionally, we found that KIF2C is a direct target of the Wnt/β-catenin pathway, and acts as a key factor in mediating the crosstalk between Wnt/β-catenin and mTORC1 signaling. Thus, the results of our study establish a link between Wnt/β-catenin and mTORC1 signaling, which highlights the potential of KIF2C as a therapeutic target for the treatment of HCC.

Clinical value of anal swab positive in COVID-19 patients / 中华微生物学和免疫学杂志

Objective:To investigate the value of anal swabs positive for 2019-nCoV in patients with COVID-19 and the clinical features of the patients.Methods:Throat swabs, sputum and blood samples, and anal swabs were collected from 104 patients with COVID-19 at admission to test for 2019-nCoV nucleic acid. Clinical characteristics and hematological indexes were compared between viral nucleic acid-positive and -negative groups of different sample types. Fifteen patients whose anal swabs were positive for viral nucleic acid were selected to analyze the length of time before the nucleic acid turned negative in different specimens.Results:Compared with the patients having negative anal swab test results, those having positive test results showed decreased lymphocytes, increased lactate dehydrogenase (LDH) and high-sensitivity C-reactive protein (HsCRP), and higher incidence of severe COVID-19. The levels of HsCRP and IL-6 and the incidence of severe COVID-19 were significantly higher in patients with positive throat swab test results than in those with negative results. No significant difference in hematological indexes or the proportion of severe cases was detected between the patients with positive and negative sputum test results. Only 1.92% of the patients had positive blood test results, but all of them were severe patients. The positive rate of sputum test was the highest, which was 46.15%. Patients with positive results of both throat and anal swab test had significantly decreased lymphocytes, increased HsCRP and IL-6 levels, and higher incidence of critical COVID-19. It took longer time for patients to have negative anal swab and sputum test results. Moreover, it should be noticed that the viral nucleic acid in sputum might become positive again after it turned negative.Conclusions:Patients with positive anal swab test results had reduced lymphocytes, enhanced inflammatory response and higher incidence of severe COVID-19, suggesting that a positive anal swab test might be an indicator of severe COVID-19. Moreover, the time of 2019-nCoV nucleic acid turning negative in anal swabs was longer than that in throat swabs. The combined detection of throat swabs and anal swabs would help to predict the occurrence of severe COVID-19.

The study of relationship between acute myocardial injury and coagulation function in patients with COVID-19 / 医学研究生学报

ObjectiveTo study the relationship between acute myocardial injury（AMI） and coagulation function in patients with COVID-19.MethodsA retrospective study was carried out to record the general and laboratory data of 133 patients diagnosed with COVID-19 who were hospitalized in Wuhan TongJi Guanggu Hospital, Wuhan, Hubei Province from February 10 to February 29, 2020. The laboratory data includes blood routine, liver and renal function, myocardial infarction tests, coagulation function, inflammatory factors, hypersensitive C-reactive protein, procalcitonin etc. The patients were divided into two groups according to cardiac troponin I（TNI）34.2 ug/L. The differences of general conditions and laboratory data between the two groups were compared. Besides, the correlation between coagulation function and coagulation function, and the ROC curve of D-dimer in AMI were conducted .ResultsAmong the 133 patients, 9 (6.77%) had cTnI greater than 34.2 μg/L, and 124 (93.23%) had normal cTnI. There were significant differences between the two groups in age, COPD history, blood routine (neutrophil count, lymphocyte count, platelet count), myoglobin, liver function (direct bilirubin, indirect bilirubin), cytokines (IL-2 receptor, IL-6, IL-8, IL-10, TNF-α), coagulation function (PT, PTA, D-dimer). D-dimer level was positively correlated with TnI, CK-MB and myoglobin levels. The cut off value of D-dimer was 2.35 μg/ml in acute myocardial injury.ConclusionAcute myocardial injury in COVID-19 patients may be related to coagulation dysfunction. Therefore, monitoring of coagulation function dynamically, screening of thrombus and starting anticoagulant and antiplatelet therapy timely help to reduce acute myocardial injury.

The study of relationship between acute myocardial injury and coagulation function in patients with COVID-19 / 医学研究生学报

ObjectiveTo study the relationship between acute myocardial injury（AMI） and coagulation function in patients with COVID-19.MethodsA retrospective study was carried out to record the general and laboratory data of 133 patients diagnosed with COVID-19 who were hospitalized in Wuhan TongJi Guanggu Hospital, Wuhan, Hubei Province from February 10 to February 29, 2020. The laboratory data includes blood routine, liver and renal function, myocardial infarction tests, coagulation function, inflammatory factors, hypersensitive C-reactive protein, procalcitonin etc. The patients were divided into two groups according to cardiac troponin I（TNI）34.2 ug/L. The differences of general conditions and laboratory data between the two groups were compared. Besides, the correlation between coagulation function and coagulation function, and the ROC curve of D-dimer in AMI were conducted .ResultsAmong the 133 patients, 9 (6.77%) had cTnI greater than 34.2 μg/L, and 124 (93.23%) had normal cTnI. There were significant differences between the two groups in age, COPD history, blood routine (neutrophil count, lymphocyte count, platelet count), myoglobin, liver function (direct bilirubin, indirect bilirubin), cytokines (IL-2 receptor, IL-6, IL-8, IL-10, TNF-α), coagulation function (PT, PTA, D-dimer). D-dimer level was positively correlated with TnI, CK-MB and myoglobin levels. The cut off value of D-dimer was 2.35 μg/ml in acute myocardial injury.ConclusionAcute myocardial injury in COVID-19 patients may be related to coagulation dysfunction. Therefore, monitoring of coagulation function dynamically, screening of thrombus and starting anticoagulant and antiplatelet therapy timely help to reduce acute myocardial injury.

Effect of Gancao Xiexintang Combined with Vitamin B12 on T Lymphocyte Subset, Ulcer Area, Oral Flora in Children with Recurrent Oral Ulcer / 中国实验方剂学杂志

Objective:To investigate the clinical efficacy of Gancao Xiexintang combined with vitamin B12 on recurrent oral ulcer (ROU) in children. Method:Totally 116 children with ROU admitted in Jiangxi Provincial Children's Hospital from June 2016 to June 2018 were divided into observation group and control group on the basis of random number table,with 58 cases in each group. The control group was orally treated with vitamin B12, while the observation group was orally treated with Gancao Xiexintang in addition to the therapy of the control group. All of the children were treated for 14 days. Clinical efficacy, changes of T lymphocyte subset (CD3+, CD4+, CD8+, CD4+/CD8+), ulcer area, content of oral flora (veillonella, streptococcus) before and after treatment, and side effect were compared between the two groups. Result:The overall effective rate of the observation group was 96.6%(56/58), which was much higher than 84.5%(49/58) of the control group (P+, CD4+, CD4+/CD8+in peripheral blood, but lower CD8+compared with those before treatment (P+, CD4+, CD8+, CD4+/CD8+) indexes in observation group was improved more significantly (PPPPPConclusion:In treating ROU in children, the combination of Gancao Xiexintang and vitamin B12 can significantly correct imbalance of T lymphocyte subset, promote the recovery of oral ulcer, and positively regulate oral micro-ecological environment, with an exact curative effect and high patient tolerance.

Effect of Astragalus Polysaccharide on Growth and Tumor-related Apoptosis Protein of Human Breast Cancer MDA-MB-231 Transplanted Tumor in Nude Mice / 中国实验方剂学杂志

Objective: To observe the inhibitory effect of astragalus polysaccharides (APS) on growth of human breast cancer MDA-MB-231 xenograft tumor in nude mice and its effect on the apoptosis of tumor cells, in order to study the effect of APS on growth and induction of apoptosis of triple negative breast cancer MDA-MB-231 and its possible molecular mechanism. Method: Human breast cancer cell MDA-MB-231 was inoculated into the right axillary subcutaneous of BALB/c-nu female nude mice to establish the transplanted tumor model of breast cancer. Eighteen nude mice were randomly divided into 3 groups:model group (saline per day), low-dose APS group (200 mg·kg-1 APS per day), and high-dose APS group (400 mg·kg-1 APS per day), with 6 rats in each group. The drug was administered by gavage (200 μL) daily for 21 days. In the experiment, the length and diameter of breast cancer transplanted tumor were measured every two days, and the tumor volume was recorded and calculated. At the end of the experiment, the changes of tumor mass and tumor volume of the low and high-dose APS groups and the model group were observed and compared, and the tumor inhibition rate was calculated. The cell morphology in tumor tissue was observed by hematoxylin-eosin (HE) staining, and Terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) was used to verify the apoptosis of breast cancer tissues. The expressions of apoptosis-related proteins, such as B-cell lymphoma/leukemia-2 protein (Bcl-2), Bcl-2 associated X protein (Bax), Caspase in tumor tissues was detected by Western blot. Result: The tumor volume of breast cancer decreased in the low and high-dose APS groups, and the tumor inhibition rates were 37.9%and 57.57%, respectively, with statistically significant differences from the model group (PP0.01). HE of tumor tissue cells showed that APS led to obvious morphological changes, with apoptosis in the tissue cells. TUNEL staining showed that the apoptosis rate of tumor cells in APS intervention groups was higher than that in control group. Western blot showed that expression of Bcl-2 protein decreased(PPPPConclusion: APS can effectively inhibit the growth of MDA-MB-231 breast cancer xenografts in nude mice and induce apoptosis in human breast cancer MDA-MB-231 cells. The mechanism may be related to the effect of APS on expressions of apoptosis-related proteins Bcl-2, Bax, Caspase-9 and Caspase-7 in breast cancer cells.

Study on the Data Mining of Prescription Rules of Chinese Medicine Compound in Treating Liver Cirrhosis Based on the Theory of Toxin, Phlegm, Blood Stasis and Deficiency / 世界科学技术-中医药现代化

Objective: To explore the prescription rules in treating liver cirrhosis's based on poison phlegm blood stasis and deficiency. Method: Clinical data of patients, who had been diagnosed with liver cirrhosis, was gathered. The data had been extracted, transformed and loaded through data integration and remittance, then, the data was analyzed by data classification, association, clustering and other large data analysis methods. Results: The prescription rules based on poison phlegm blood stasis and deficiency showed that according to medication frequency, detoxification drugs commonly used ArtemisiacapillarisThunb, Coptis chinensis Franch, Forsythia suspensa, Hedyotis diffusa Willd, and Scutellaria baicalensis Georgi, eliminating phlegm drugs commonly used Semen Coicis, Citrus aurantium L, Pinellia ternate, Pericarpium Citri Reticulatae and Trichosanthes kirilowii Maxim, removeing blood stasis drugs commonly used Radix Salviae Miltiorrhiae, Radix Curcumae, Rhizoma Curcumae, Herba Lycopi and Pollen Typhae, reinforcing deficiency drugs commonly used Poria, Carapax Trionycis, Rhizoma Atractylodis Macrocephalae, Radix Astragali seu Hedysari and Radix Codonopsis (Radix Pseudostellariae) . The selection of herbal medicine for poison in traditional Chinese medicine (TCM) is not only cold in property, bitter in flavor, but also converges to liver, gallbladder, spleen and stomach channel.The selection of herbal medicine for phlegm in TCM is not only warm in property, pungent in flavor, but also converges to spleen and lung channel. The selection of herbal medicine for blood stasis in TCM is not only cold in property, bitter in flavor, but also converges to liver, heart and spleen channel. The selection of herbal medicine for deficiency in TCM is not only mild in property, sweet in flavor, but also converges to spleen, liver and kidney channel. Conclusion: The syndrome differentiation and treatment of liver cirrhosis in Liver Institute of Hubei Provincial Hospital of Traditional Chinese are mainly based on poison phlegm blood stasis and deficiency.

ARMS-PCR combined with capillary electrophoresis can be a sensitive and quantitative method for detection of MYD88-L265P mutation in lymphoma / 中国实验血液学杂志

OBJECTIVE@#To investigate the feasibility of sensitive and quantitative detection of MYD88 gene L265P mutation in lymphoma patients by using ARMS-PCR combined with capillary electrophoresis.@*METHODS@#ARMS-PCR amplified MYD88 gene was analyzed by capillary electrophoresis in ABI 3730 sequencer; Exon 5 of the same gene was sequenced bi-directionally as reported.@*RESULTS@#The sensitivity of detection L265P mutations by the ARMS-PCR combined with capillary electrophoresis and direct sequencing was 0.2% and 5%, respectively, according to the detection of the gradient-diluted plasmid standards. The detection rate of 184 patients was 13.59% and 8.28%, respectively (p<0.001). Moreover, the former method can successfully detect the mutation ratio(R=0.979), and the repeatabilities (CV=2.86%, 1.94%, 5.49%) are acceptable.@*CONCLUSION@#ARMS-PCR combined with capillary electrophoresis can quantitatively detect the MYD88 gene L265P mutation, and the detection sensitivity is significantly higher than sanger sequencing. As a supplement to the latter, it can effectively lead to the earlier diagnose and monitoring of minimal residual disease.

Fluorescence Carbon Dot-based Imprinted Polymer for Highly Selective Detection of Bovine Hemoglobin / 分析化学

A novel fluorescent imprinted polymer (CDs@ MIP) with selective recognition of hemoglobin was prepared by the sol-gel method using fluorescent carbon dots as the carrier material, 3-aminopropyltrieth-oxysilane as the functional monomer, tetraethoxysilane as the crosslinking agent and bovine hemoglobin as template molecule. The results of IR and scanning electron microscopy showed that the molecularly imprinted polymer was coated on the surface of fluorescent carbon dots. The CDs@ MIP showed selective recognition properties for bovine hemoglobin with an imprinting factor of 4. 60. Also the adsorption ability and specific recognition performance of CDs@ MIP were investigated, and it was found that the CDs@ MIP had high selectivity toward bovine hemoglobin, and the selection factors for ovalbumin, bovine serum albumin and human serum albumin were 4. 38, 4. 73 and 3. 66, respectively. Under the optimal conditions, the linear range of CDs@ MIP for bovine hemoglobin was 0. 1-10. 0 μmol/ L and the detection limit was 23. 0 nmol/ L. The CDs@ MIP was successfully used for the determination of bovine hemoglobin in bovine blood samples with recoveries of 99. 0％ -102. 5％ .