Promoting tanshinone synthesis of Salvia miltiorrhiza root by a seed endophytic fungus, Phoma herbarum D603 / 中国中药杂志

The interaction of endophytes and host plant is an effective mean to regulate the growth and secondary metabolism of medicinal plants. Here we want to elucidate the effects and mechanism of Phoma herbarum D603 on the root development and tanshinone synthesis in root of Salvia miltiorrhiza by endophyte-plant coculture system. The mycelium of P. herbarum D603 was colonized in the root tissue space, and formed a stable symbiotic relationship with host plant. The in vitro activities analysis showed that the concentration of IAA produced by D603 can reach(6.45±0.23) μg·mL~(-1), and this strain had some abilities of phosphorus solubilization and siderophore production activities. The coculture experiment showed that strain D603 can significantly promote the synthesis and accumulation of tanshinones in the root of S. miltiorrhiza, in which after 8 weeks of treatment with D603, the content of tanshinone Ⅱ_A in the roots reached up to(1.42±0.59) mg·g~(-1). By the qRT-PCR analysis results, we found that D603 could improve the expression levels of some key genes(DXR, DXS, GGPP, HMGR, CPS) of tanshinone biosynthesis pathway in host plant S. miltiorrhiza, but the promoting effect mainly occurred in the early stage of the interaction, and the enzyme activity level decreased in varying degrees of the later stage. In summary, seed-associated endophyte P. herbarum D603 can promote the growth and root development of S. miltiorrhiza by producing hormones, promoting nutrient absorption and siderophore production, and promote the synthesis and accumulation of tanshinones by regulating the expression level of key genes in the synthetic pathway in S. miltiorrhiza.

Effect of carbapenem exposure on isolation rate of multidrug-resistant organisms and prognosis of elderly patients with severe pneumonia / 中国感染控制杂志

Objective To evaluate the effect of carbapenem exposure on isolation rate of multidrug resistant organisms(MDROs) and prognosis of elderly patients with severe pneumonia.Methods Elderly patients with severe pneumonia and admitted to the intensive care unit in a hospital between February 2014 and February 2016 were investigated retrospectively.According to whether there was carbapenem exposure,patients were divided into group A(carbapenem exposure group) and group B(carbapenem non exposure group).Patients in group A were subdivided into two subgroups according to exposure time of carbapenems,group A1 received carbapenems for＞7 days,group A2 received carbapenems for ≤7 days.The isolation rates of MDROs,mechanical ventilation days,length of stay in ICU,and 28 day mortality among groups were compared and analyzed.Results A total of 86 patients were enrolled in the investigation,57 were males and 29 were females;the average age was (80.12 + 10.45) years (range:65-92 years).There were 40 cases in group A,46 in group B;24 cases in group A1,and 16 in group A2.The isolation rates of MDROs in group A and group B were 65.00％ and 36.96％ respectively,difference was sta tistically significant(P＜0.05);Comparison between two groups of patients revealed that mechanical ventilation days,length of stay in ICU,and 28 day mortality in group A were all higher than group B,difference was statistically significant(all P＜0.05);the isolation rates of MDROs in group A1 was higher than group A2 (75.00％ vs 43.75％,P＜0.05)；mechanical ventilation days of group A1 was higher than group A2 ([7.69 ± 2.22]d vs [6.34±-1.56]d,P＜0.05);28-day mortality and length of stay in ICU between group A1 and A2 were not significantly different(both P＞0.05).Conclusion Carbapenem exposure can increase the occurrence of MDRO infection,especially the non-fermentative bacterial colonization or infection,and prolong the mechanical ventilation days and length of stay in ICU,thus affect the prognosis of patients.

A randomized controlled trial of adjunctive Bunchang Naoxintong Capsule (步长脑心通胶囊) versus maintenance dose clopidogrel in patients with CYP2C19*2 polymorphism / 中国结合医学杂志

<p><b>OBJECTIVE</b>To determine the impact of adjunctive Buchang Naoxintong Capsule (, NXT) on dual antiplatelet therapy in patients with cytochrome P450 2C19*2 (CYP2C19*2) polymorphism undergoing percutaneous coronary intervention (PCI).</p><p><b>METHODS</b>Ninety patients with CYP2C19*2 polymorphism were enrolled, and their genotypes were confirmed by polymerase chain reaction (PCR). The patients were randomly assigned to receive either adjunctive NXT (triple group, 45 cases) or dual antiplatelet therapy (dual group, 45 cases) using a computer-generated randomization sequence and sealed envelopes. Platelet function was assessed at baseline and 7 days after treatment with conventional aggregometry. Subsequent major adverse cardiovascular events (MACE, including sudden cardiac arrest and acute coronary syndrome) were recorded during a 12-month follow-up.</p><p><b>RESULTS</b>Baseline platelet function measurements were similar in both groups. After 7 days, percent inhibitions of maximum platelet aggregation and late platelet aggregation were significantly greater in the triple versus dual group (42.3%±16.0% vs. 20.8%±15.2%, P<0.01, and 54.7%±18.3% vs. 21.5%±29.2%, P<0.01, respectively). During the 12-month follow-up, the rate of subsequent MACE (6/45) was significantly lower in the triple group compared with the dual group (14/45; P<0.05).</p><p><b>CONCLUSION</b>Adjunctive NXT to maintenance dose clopidogrel (75 g) could enhance the antiplatelet effect and decrease subsequent MACE in patients with the CYP2C19*2 polymorphism undergoing PCI.</p>

Case studies in nursing of mitochondrial diabetes

Mitochondrial diabetes [mtDM] which is caused by genetic defect of islet B cells is a new subtype of diabetes. It has many clinical manifestations compared with ordinary diabetes. We reviewed our nursing experiences on four cases with mtDM and focused on the nursing characteristics and management in order to explore specific care knowledge for mtDM