Genotyping Characteristics of Human Fecal Escherichia coli and Their Association with Multidrug Resistance in Miyun District, Beijing / 生物医学与环境科学（英文）

OBJECTIVE@#To explore the genotyping characteristics of human fecal Escherichia coli( E. coli) and the relationships between antibiotic resistance genes (ARGs) and multidrug resistance (MDR) of E. coli in Miyun District, Beijing, an area with high incidence of infectious diarrheal cases but no related data.@*METHODS@#Over a period of 3 years, 94 E. coli strains were isolated from fecal samples collected from Miyun District Hospital, a surveillance hospital of the National Pathogen Identification Network. The antibiotic susceptibility of the isolates was determined by the broth microdilution method. ARGs, multilocus sequence typing (MLST), and polymorphism trees were analyzed using whole-genome sequencing data (WGS).@*RESULTS@#This study revealed that 68.09% of the isolates had MDR, prevalent and distributed in different clades, with a relatively high rate and low pathogenicity. There was no difference in MDR between the diarrheal (49/70) and healthy groups (15/24).@*CONCLUSION@#We developed a random forest (RF) prediction model of TEM.1 + baeR + mphA + mphB + QnrS1 + AAC.3-IId to identify MDR status, highlighting its potential for early resistance identification. The causes of MDR are likely mobile units transmitting the ARGs. In the future, we will continue to strengthen the monitoring of ARGs and MDR, and increase the number of strains to further verify the accuracy of the MDR markers.

Clinical features and long-term prognosis of primary biliary cholangitis in patients with past hepatitis B virus infection / 中华肝脏病杂志

Objective: To investigate the clinical features and long-term prognosis of primary biliary cholangitis (PBC) in patients with past hepatitis B virus (HBV) infection. Methods: 353 cases with PBC who visited the Liver Disease Center of Beijing Friendship Hospital Affiliated to Capital Medical University between January 2000 and January 2018 were retrospectively analyzed and were divided into the past HBV infection group (156 cases) and the no HBV infection group (197 cases). The two groups' baseline clinical features were compared. Ursodeoxycholic acid response rate after one year, GLOBE score, UK-PBC score, and long-term liver transplantation-free survival rate were compared through outpatient and telephone follow-up. Results: PBC with past HBV infection had a significantly reduced female proportion compared to the no HBV infection group (91.9% vs. 79.5%, P = 0.001). However, there were no statistically significant differences in age, biochemical indices, immunological indicators, platelet count, cirrhosis proportion, and others. Ursodeoxycholic acid biochemical response rate was reduced in patients with past HBV infection at the end of one year of treatment, but the difference was not statistically significant (65.8% vs. 78.2%, P = 0.068). In addition, there were no statistically significant differences between the GLOBE score (0.57 vs. 0.59, P = 0.26) and UK-PBC 5-year (2.87% vs. 2.87%, P = 0.38), 10-year (9.29% vs. 8.2%, P = 0.39) and 15-year liver transplantation rates (16.6% vs. 14.73%, P = 0.39). Lastly, the overall 5-year liver transplantation-free survival rate had no statistically significant difference between the two groups of patients (86.4% vs. 87.5%, P = 0.796). Conclusion: Primary biliary cholangitis had no discernible effect in terms of age at onset, biochemical indices, immunological indicators, cirrhosis proportion, ursodeoxycholic acid response rate after one year, GLOBE score, UK-PBC score, or overall liver transplantation-free survival rate in patients with past hepatitis B virus infections.

Stratified therapeutic choices in elderly patients with diffuse large B-cell lymphoma / 国际肿瘤学杂志

The prognosis of elderly (>60 years) patients with diffuse large B-cell lymphoma (DLBCL) is significantly worse compared with young patients, and there is currently no standard treatment. Elderly patients with DLBCL are highly heterogeneous, a stratification before treatment can help achieve precise medicine and improve outcome of them. R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin and prednisolone) is still the recommended treatment for fit elderly DLBCL patients; and for unfit or very old patients, chemotherapy of reduced dose or palliative treatments should be considered. Choices for relapsed or refractory patients are limited, and novel compounds or therapies that are well tolerated may have a good application prospect.

Mandibular Osteomyelitis in Concurrence with Psoriasis: A Rare Case Report and Literature Review

Mandibular osteomyelitis in a patient with psoriasis is an uncommonly clinical manifestation while there is an increasing number of reports and studies on involvements of stomatology in psoriasis, especially the death of a patient via or not via Allogeneicbone marrow transplantation has never been reported.To review the management and possible mechanisms in pathogenesis and treatment of psoriasis, as well as the relative involvements between stomatology and psoriasis the typical case with pictures and files is reviewed and literature is collected.Wekeepthe knowledge that psoriasis is either a primary keratinocyte disorder or an immunocyte-mediated chronic skin inflammatorydisease while bone marrow is under suspected for immunopathogenesis. More association of stomatologic conditions with psoriasis is emerging. Conclusively, allogeneicBMT and new knowledge are worth to be stressed by both stomatological and dermatological doctors. Further insights of this kind of auto immunologic disease are under its developing.

Effectiveness and Safety of a Novel Approach for Management of Patients with Potential Difficult Mask Ventilation and Tracheal Intubation: A Multi-center Randomized Trial / 中华医学杂志(英文版)

<p><b>Background:</b>Patients with potential difficult mask ventilation (DV) and difficult intubation (DI) are often managed with awake intubation, which can be stressful for patients and anesthesiologists. This prospective randomized study evaluated a new approach, fast difficult airway evaluation (FDAE). We hypothesized that the FDAE approach would reduce the need for awake intubation.</p><p><b>Methods:</b>After obtaining informed consent, 302 patients with potential DV/DI undergoing elective surgeries were randomly assigned to the FDAE group (Group E) and the control group (Group C). In Group E, patients were gradually sedated, and adequacy of manual mask ventilation during spontaneous breathing was assessed at various sedation levels. Awake intubation was applied in those with inadequate mask ventilation. In Group C, DI was evaluated under local anesthesia. However, the care team could intubate under general anesthesia if the vocal cords were visible. The primary outcome was the rate of awake intubations in both groups and the induction efficiency assessed by the induction time. The secondary outcome was the incidence of serious complications.</p><p><b>Results</b>The rate of awake intubation was significantly lower in Group E than that in Group C (5.81% vs. 36.05%, χ = 42.3, P < 0.001). The induction time was much shorter in Group E than in Group C (11.85 ± 4.82 min vs. 18.71 ± 7.85 min, t = 5.39, P < 0.001). There was no significant difference in the incidence of intubation related complications between the two groups. Patients in Group E had a much lower incidence of recall (9.68% vs. 44.90%, χ = 47.68, P < 0.001) of the induction process and higher satisfaction levels than patients in Group C (t = 15.36, P < 0.001).</p><p><b>Conclusions</b>The FDAE significantly reduces the need for awake intubation and improves the efficiency of the intubation process without comprising safety in patients with potential difficult mask ventilation and DI.</p><p><b>Trial Registration:</b>No. ChiCTR-TRC-11001418; http://www.gctr.org/cn/proj/show.aspx?proj=1562.</p>

comparison of exposure of Glottis using the Airtraq or the Macintosh Laryngoscope in Potentially difficult airway management: A self-controlled clinical trial.

Objective: To compare glottis exposure of the same patients with potentially difficult tracheal intubation [PDTI] subjected to Airtraq laryngoscopy and Macintosh laryngoscopy under consciousness and topical anesthesia

Methods: A total of 147 PDTI patients with American Society of Anesthesiologists [ASA] I-III were subjected to Airtraq and Macintosh laryngoscopy performed by experienced anesthesiologists under consciousness and topical anesthesia

Results: All patients were successfully intubated. Among them, three patients were intubated with fiberoptic bronchoscopy, 13 with Macintosh laryngoscopy and 131 with Airtraq laryngoscopy. Of the patients with Cormack and Lehance [C and L] Grade-I glottic view, 88 were subjected to Airtraq laryngoscopy and five to Macintosh laryngoscopy; Of the patients with C and L Grade-II glottic view, 56 were subjected to Airtraq laryngoscopy and 21 to Macintosh bronchoscopy; Of the patients with C and L Grade-III glottic view, three were subjected to Airtraq laryngoscopy and 112 to Macintosh bronchoscopy; Of the patients with C and L Grade-IV glottic view, none was subjected to Airtraq laryngoscopy and 9 to Macintosh laryngoscopy

Value of T2WI scores in diagnosis and differential diagnosis of transition zone prostate cancer / 实用放射学杂志

Objective To evaluate the value of T2WI scores for diagnosis and differential diagnosis of transition zone prostate cancer(PCa).Methods T2WI of 43 cases of transition zone PCa and 91 cases of benign prostatic hyperplasia(BPH) were analyzed retrospectively.Transition zone T2WI signs were divided into the main signs and the secondary signs, which were given different scores and were evaluated separately by receiver operating characteristic (ROC) curve for their diagnostic value.Results In a total of 11 scores sections (-1-10), as the increase of scores, the sensitivity of transition zone PCa was decreased while the specificity and positive predictive value were both increased.According to the ROC curve, when the critical value of scores≥4.5, the sensitivity, specificity, negative predictive value, and the accuracy were 81%,73.3%,90.9%,70.4% respectively.When the scores ≥8.5,the specificity and positive predictive value were both 100%.When the scores ≥0.5 and ≥1.5,the negative predictive value were 100%.Conclusion T2WI scores can quantitatively analyze the transition zone PCa,which has an important value to improve the clinical diagnosis and guide treatment.

Identification of metabolites of pulsatilla saponin B7 in rats and in vitro by UHPLC-Q-TOF-MS / 中国药学杂志

OBJECTIVE: To identify the metabolites oi Pulsatilla oleanolic acid 3-α-L-rhamnopyranosyl (1→2) [β-D-glucopyr-anosyl-(1→4)]-α-L-pyran arabinoside (B7) in rat plasma, bile, urine, feces, and in vitro liver microsomes incubation system. METHODS: An ultra-high performance liquid chromatography combined with electrospray ionization quadrupole time of flight mass spectrometry (UHPLC-Q-TOF-MS) method was developed and successfully applied to the study on the metabolites of B7 in rat plasma, bile, urine, feces, and in vitro liver microsomes incubation system after oral administration. RESULTS: A total of 23 metabolites were identified, of which 12 metabolites were present in rat liver microsomes incubation system. CONCLUSION: Deglycosylation, demethylation glucuronidation, and hydroxylation are the major metabolic transformation forms of B7 in rats in vivo and in vitro.

Chemical constituents from stems of Glycosmis pentaphylla / 中草药

Objective: To study the chemical constituents in the stems of Glycosmis pentaphylla. Methods: The constituents were isolated and purified by silica gel and preparative HPLC, and their structures were elucidated by means of physicochemical properties and spectroscopic analyses. Results: Nine compounds were isolated from the n-butanol-soluble fraction of 95% ethanol extract from the stems of G. pentaphylla, and identified as methyl 2-hydroxybenzoate 2-O-β-D-apiofuranosyl-(1→2)-O-β-D-glucopyranoside (1), inosine (2), 4-methoxy-8-(O-β-D-glucopyranosyloxy)-2(1H)-quinolinone (3), threo-guaiacyl-glycerol-8-O-4'-sinapyl ether 7-O-β-D-glucopyranoside (4), vitexin (5), ethyl-O-β-D-glucopyranoside (6), 2-propyl-O-β-D-glucopyranoside (7), threo-guaiacyl glycerol (8), and erythro-guaiacyl glycerol (9). Conclusion: Compound 1 is a new phenolic glycoside named glycopentosine A, and compounds 2-4 and 6-9 are isolated from the plants of Glycosmis Correa for the first time.

Qualitative and quantitative analysis of fluoxetine hydrochloride by 19F NMR / 药学学报

The chemical shift of fluoxetine hydrochloride appears at delta 14.15 in 19F NMR analysis. The delta moved upfield slightly from 14.158 to 14.145 when the concentration of solution became diluted from 2.00 to 0.05 mmol x L(-1). Spiking test was suggested to confirm the existence of the compound for qualitative analysis. 19F NMR detection sensitivity test illustrated that a concentration of 17 mg in 1 L water could be detected while the sample was scanned 500 times with optimum parameters. In quantitative analysis, standard curve of concentration versus fluorine signal intensity was proposed to determine the amount of fluoxetine. Long capillary tube containing trifluoroacetic acid was used as internal standard for the integration measurements and straight line was obtained with good fitting. Direct additions of trifluoroethanol to fluoxetine solutions gave a poorer standard curve.

Impact of weight gain following smoking cessation on one-year outcome after drug-eluting stent implantation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Weight gain following smoking cessation increases cardiovascular risk, but its effects on prognosis after percutaneous coronary intervention (PCI) remain unclear. This study aimed to investigate the relationship between weight gain post smoking cessation and one-year clinical outcome in patients who underwent PCI with drug-eluting stent (DES).</p><p><b>METHODS</b>A total of 895 consecutive male smoking patients were divided into quitters (n = 437) and continuers (n = 458) according to their smoking status after PCI. Weight gain, major adverse cardiac events (MACE, including cardiac deaths, myocardial infarction and revascularization), and recurrent angina were recorded during follow-up for one year.</p><p><b>RESULTS</b>Average weight gain in quitters was more than that in continuers (1.5 kg vs. -0.03 kg, P < 0.001). Weight was unchanged or increased by more than 1.5 kg in 78.17% of continuers, while 50.57% of quitters had a weight gain of less than 1.5 kg. Compared with continuers, MACE in quitters was significantly reduced after PCI (6.12% vs. 4.81%, P = 0.049), especially recurrent angina (13.97% in continuers vs. 9.84% in quitters, P = 0.027). After adjusting for weight gain and other factors, smoking cessation was independently associated with a lower risk of MACE and recurrent angina (OR = 0.73, P = 0.035). However, weight gain > 1.5 kg (OR = 1.55, P = 0.026) could curtail the benefits from smoking cessation.</p><p><b>CONCLUSIONS</b>Weight gain may reduce the benefits of smoking cessation after PCI with DES implantation. Thus, although smoking cessation is recommended after PCI, weight control should also be highly encouraged for these patients.</p>

The clinical characteristics of primary biliary cirrhosis in China: a systematic review / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To summarize the clinical features, diagnosis and treatment of patients with primary biliary cirrhosis (PBC) in China.</p><p><b>METHODS</b>Systematic analysis of clinical characteristics by searching the Chinese literatures.</p><p><b>RESULTS</b>From 1955 to 2007, 2740 PBC patients were reported in 103 papers (duplicated reports were deleted). The detailed information of 985 patients from 16 papers were collected. Female : male was 6.82:1. The age range was 42 to 56.2-year-old. The time from onset to diagnosis was 12 to 98.4 months. The most common symptoms were fatigue (72.40%), jaundice (67.41%), anorexia (68.58%) and pruritus (45.60%). 20% patients were asymptomatic at onset. The most frequent physical signs were splenomegaly (57.53%), hepatomegaly (43.56%) and ascites (18.45%). Serum alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (GGT) levels were markedly elevated in most of these patients. The immunological marks of AMA and M2 were positive in 88.98% and 82.65% patients, respectively. The most common comorbidity were Sjögren syndrome (9.14%), rheumatoid arthritis (3.95%) and diabetes type II (2.54%). Of the 507 patients treated with ursodeoxycholic acid (UDCA), 345 patients got complete or partial clinical biochemical response. The common complications were gastrointestinal bleeding (41.67%) and liver failure (41.67%). Liver transplantation was the only effective way for the treatment of the end-stage liver disease.</p><p><b>CONCLUSION</b>The clinical feature of primary biliary cirrhosis in China was similar to the overseas literatures. Further research should focus on epidemic investigation, early diagnosis, long term follow up of asymptomatic patients, immunological mechanism and the efficacy of liver transplantation.</p>

Effect of angong niuhuang pill as an adjuvant treatment on moderate or severe neonatal hypoxic-ischemic Encephalopathy / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the clinical efficacy and safety of angong niuhuang pill (ANP) as an adjuvant treatment on moderate or severe neonatal hypoxic-ischemic encephalopathy (NHIE).</p><p><b>METHODS</b>Thirty-nine neonates with NHIE in the control group were treated with conventional treatment, and 58 in the treated group were administered orally ANP additionally, and relative indexes were observed.</p><p><b>RESULTS</b>The improvement of aspects such as recovery of consciousness, muscular tension, and primitive reflex and disappearance of convulsion, in the treated group was better than that in the control group (P < 0.01).</p><p><b>CONCLUSION</b>ANP as an adjuvant treatment has a definite effect on NHIE, it can promote the recovery of patients, decrease the occurrence of sequelae and with high safety, therefore, is a drug feasible for clinical application.</p>

Clinical Significance of Monitoring Indexes of Oxygen Exchange in Neonatal Respiratory Distress Syndrome / 实用儿科临床杂志

0.05).Conclusion Indexes of oxygen function may become criteria of early diagnosing NRDS,observing effect of treatment and guidance of ventilation weaning.