Clinical application of LASEREO endoscopic system in early gastric cancer / 中华内科杂志

Objective:To evaluate the clinical application of LASEREO endoscopic system in early gastric cancer (EGC).Methods:A total of 68 patients diagnosed with EGC were retrospectively analyzed between August 2017 to December 2020 in Fuding Hospital Affiliated to Fujian University of Traditional Chinese Medicine. There were 50 males and 18 females finally enrolled with a median age of 64 years. EGCs were analyzed from subjective and objective aspect, as well as from magnification and non-magnification status. Six endoscopists evaluated the visibility of the EGC (RSC) and calculated the color difference (ΔEC) between EGC and the surrounding mucosa in white light imaging (WLI), blue light imaging-bright (BLI-Bri) and linked color imaging (LCI) modes. In the case of magnification (×80), the visibility of the microstructures and microvessels (RSV) was analyzed and the color difference (ΔEV) between microvessels and non-vessels areas were calculated in WLI, BLI and LCI modes. The visibility was evaluated using visibility ranking scale(RS) and the color difference (ΔE) was calculated using L*a*b* color space.Results:In WLI, BLI-Bri, and LCI modes, the mean (±SD) RSC were 2.56±0.68, 2.63±0.59 and 3.17±0.50, and the mean(±SD) ΔEC were 15.71±5.58, 12.04±3.73, and 22.84±8.46, respectively, which in LCI were higher than those in WLI and BLI-Bri modes ( P<0.001).Regarding the data evaluated by senior endoscopists, the RSC was higher in BLI-Bri than that in WLI mode (2.98±0.58 vs. 2.79±0.73, P<0.001), but as to those evaluated by junior endoscopists, there were no significant differences between the WLI and BLI-Bri modes(2.29±0.72 vs. 2.23±0.72,P =0.218).In magnifying endoscopy with WLI, BLI, and LCI modes, the mean(±SD) RSV were 2.95±0.28, 3.46±0.40, and 3.38±0.33, and the mean (±SD) ΔEV were 21.68±7.52, 44.29±10.94, and 45.38±14.29, respectively.The RSV and ΔEV in LCI and BLI were higher than that in WLI mode ( P<0.001). Conclusions:LCI improves the visibility of EGC by increasing ΔEC, especially in junior endoscopists. Both BLI and LCI improve the visibility of microstructures and microvessels under magnification.

Surveillance results of foodborne diseases in Panjin City in 2014-2019 / 公共卫生与预防医学

Objective To understand the characteristics and epidemic trend of foodborne diseases in Panjin City. Methods The information of patients in the foodborne disease monitoring hospital and samples of suspected foodborne disease cases were collected, and statistical analysis was conducted according to the time, region, population, clinical symptoms, suspected food exposure, pathogenic microorganisms and other factors. Results From 2014 to 2019 , a total of 6 425 cases of foodborne diseases were reported in Panjin foodborne disease surveillance hospital. The third quarter was the season with high incidence of foodborne diseases (70.99%). A total of 2 590 cases were reported in Xinglongtai District (40.31%). There were 3 261 males (50.75%) and 3 164 females (49.25%). Most of the patients were 25-34 years old (21.04%). The most common occupations were housework and unemployment (28.37%). Aquatic animals and their products accounted for the largest proportion (69.04%) in food with suspected exposure. Suspicious feeding places were dominated by families (18.44%). The main pathogen was Vibrio parahaemolyticus (9.00%). Conclusion It is important to pay more attention to foodborne diseases, strengthen food safety publicity and education, improve the awareness of self-prevention, reduce the possibility of foodborne diseases, and ensure the health of the public. Meanwhile, it is necessary to improve the city's foodborne disease monitoring network, strengthen the capacity-building, promote the effective use of monitoring data, and provide guidance and suggestions for government departments to develop foodborne disease prevention and control measures.

Surveillance of clinical distribution and resistance characteristics of deep fungal isolates in children / 中华实用儿科临床杂志

Objective:To investigate the distribution of fungal species and their sensitivity to antifungal drugs in children with invasive fungal infections.Methods:All the fungal strains primarily isolated from the sterile parts of children in Beijing Children′s Hospital, Capital Medical University from January 2010 to December 2016 were analyzed.The sensitivity of strains to 5-Fluorocytosine, Fluconazole, Amphotericin B, Itraconazole and Voriconazole was tested using ATB-FUNGUS 3 yeast drug sensitivity test strip in accordance with the standards of Clinical and Laboratory Standards Institute M27-A2.Statistical analysis of data was performed using WHONET 5.6 software.Results:Among 236 fungi isolated from aseptic samples, 64.0% (151 strains) were from blood, 22.9%(54 strains) from cerebrospinal fluid, 3.8%(9 strains) from bone marrow, 3.8%(9 strains) from ascites, 3.4%(8 strains) from pleural effusion and 2.1%(5 strains) from tissues.The top 3 dominant species detected in the 236 strains of fungi were Candida spp.(175 strains, 74.2%), Cryptococcus neoformans (31 strains, 13.1%), and Saccharomyces spp.(9 strains, 3.8%). Among the Candida spp., the main isolates were Candida albicans (107 strains, 61.1%), Candida parapsilosis (33 isolates, 18.9%), and Candida tropicalis (13 isolates, 7.4%). Rare fungi of Penicillium marneffei, Exophiala spp.and Rhizopys spp.were also detected. Candida spp.was 100% sensitive to Amphotericin B. Cryptococcus neoformans was 100% sensitive to Fluconazole, Voliconazole and Amphotericin B. Conclusions:The most common strain isolated from pediatric patients with invasive fungal infections is Candida spp., especially Candida albicans. Cryptococcus neoformans causes central nervous system and systemic disseminated infections that can′t be ignored.Amphotericin B has higher antibacterial activity against Candida spp.and Cryptococcus neoformans.Separation of species of invasive fungal infections and monitoring of drug resistance in children should be strengthened to effectively control invasive fungal infections and facilitate rational use of antifungal drugs.

Listeria monocytogenes meningitis in 17 immunocompetent children / 中华实用儿科临床杂志

Objective To summarize the clinical characteristics and treatment of 17 children with Listeria monocytogenes(LM) meningitis (LMM).Methods Case histories (including clinical features,laboratory examination,treatment,prognosis) of 17 LMM children who were hospitalized at the Department of Infectious Disease of Beijing Children's Hospital from January 1,2013 to December 31,2017 were analyzed retrospectively.The age ranged from 7 months to 10 years,with an average of 3 years and 5 months.Among them,1 case ＜ 1 year old,1-3 years old was most common(10 cases,accounted for 59％),2 cases ＞3-＜6 years old,and 4 cases≥6 years old.Related literatures were summarized.Results All of 17 patients were diagnosed by a positive cerebrospinal fluid culture of LM.All patients had fever.Other symptoms included seizures,headache and vomiting were found during the course of disease;infectious symptoms were relatively mild.The symptoms presented 7 to 50 days before admission.None of the patients was known to have immune deficiencies or any other underlying diseases.Five cases underwent strain typing,all resulting from strain type l/2a.All patients used cephalosporin antibiotics before the diagnosis.After the diagnosis was confirmed,sensitive antibiotics were used according to the drug sensitivity test,including Penicillin,Meropenem,Vancomycin,Linezolid,and Sulfamethoxazole-trimethoprim (SMZ),etc.Out of the 17 patients,2 case had hydrocephalus,of which 1 cases had clinical symptoms,and underwent surgery for a ventriculoperitoneal shunt.All patients were followed up for 1 year,with good prognosis and no neurological sequela.Conclusions LMM is rare in children,especially in children with no immune deficiencies.LMM in children can present with hydrocephalus.Ampicillin remains the first choice of treatment,while meropenem,SMZ and Linezolid can be used as substitution drugs.

Antimicrobial resistance profile of clinical isolates in hospitals across China: report from the CHINET Surveillance Program, 2017 / 中国感染与化疗杂志

Objective To investigate the antimicrobial resistance profile of the clinical isolates collected from selected hospitals across China. Methods Twenty-nine general hospitals and five children's hospitals were involved in this program. Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems. Results were interpreted according to CLSI 2017 breakpoints. Results A total of 190 610 clinical isolates were collected from January to December 2017, of which gram negative organisms accounted for 70.8％ (134 951/190 610) and gram positive cocci 29.2％ (55 649/190 610). The prevalence of methicillin-resistant strains was 35.3％ in S. aureus (MRSA) and 80.3％ in coagulase negative Staphylococcus (MRCNS) on average. MR strains showed much higher resistance rates to most of the other antimicrobial agents than MS strains. However, 91.6％ of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 86.2％ of MRCNS strains were susceptible to rifampin. No staphylococcal strains were found resistant to vancomycin. E. faecalis strains showed much lower resistance rates to most of the drugs tested (except chloramphenicol) than E. faecium. Vancomycin-resistant Enterococcus (VRE) was identified in both E. faecalis and E. faecium. The identified VRE strains were mainly vanA, vanB or vanM type based on phenotype or genotype. The proportion of PSSP or PRSP strains in the non-meningitis S.pneumoniae strains isolated from children decreased but the proportion of PISP strains increased when compared to the data of 2016. Enterobacteriaceae strains were still highly susceptible to carbapenems. Overall, less than 10％ of these strains (excluding Klebsiella spp.) were resistant to carbapenems. The prevalence of imipenem-resistant K. pneumoniae increased from 3.0％ in 2005 to 20.9％ in 2017, and meropenem-resistant K. pneumoniae increased from 2.9％ in 2005 to 24.0％ in 2017, more than 8-fold increase. About 66.7％ and 69.3％ of Acinetobacter (A. baumannii accounts for 91.5％) strains were resistant to imipenem and meropenem, respectively. Compared with the data of year 2016, P. aeruginosa strains showed decreasing resistance rate to carbapenems. Conclusions Bacterial resistance is still on the rise. It is necessary to strengthen hospital infection control and stewardship of antimicrobial agents. The communication between laboratorians and clinicians should be further improved in addition to surveillance of bacterial resistance.

Distribution and antibiotic resistance profile of 350 strains of Haemophilus influenzae isolated from children / 中国感染与化疗杂志

Objective To analyze the distribution and antibiotic resistance profile of Haemophilus influenzae strains isolated from children for better antibiotic use.Methods The clinical and laboratory data concerning 350 strains ofH.influenzae were collected and analyzed retrospectively from 2014 to 2015 in our hospital,including pathogen source,production of beta lactamases and antimicrobial susceptibility.Antimicrobial susceptibility testing was carried out by using disk diffusion method.The results were interpreted according to the breakpoints of the Clinical and Laboratory Standards Association (CLSI) in 2014,and analyzed using WHONET 5.6 software.Results H.influenzae infection was more common in infants and young children.The prevalence of beta lactamase was 53.1％ in H.influenzae isolates.The H.influenzae isolates showed the highest resistance rate to trimethoprimsulfamethoxazole (76.9％),but relatively high susceptible rate to ciprofloxacin (99.1％),ceftizoxime (98.9％),chloramphenicol (95.4％),tetracycline (88.3％),amoxicillin-clavulanic acid (87.7％),cefuroxime (74.9％),azithromycin (65.4％),cefaclor (56.6％) and ampicillin (46.0％).All these H.influenzae strains were susceptible to ceftriaxone and meropenem.Conclusions Beta-lactamases are highly prevalent in the H.influenzae strains isolated from children,which is the main mechanism underlying ampicillin resistance in H.influenzae.Ampicillin is therefore not appropriate for first-line treatment ofH.influenzae infections.The H.influenzae strains are highly resistant to trimethoprim-sulfamethoxazole.In addition to beta-lactams,ciprofloxacin is the most active agent against H.influenzae strains,followed by chloramphenicol.

Distribution and antimicrobial resistance profile of the clinical bacterial strains isolated from Beijing Children's Hospital from 2009 to 2015 / 中国感染与化疗杂志

Objective To investigate the distribution and antimicrobial resistance profile of the common pathogens isolated during the period from 2009 to 2015.Methods All the bacterial strains isolated from pediatric inpatients in Beijing Children's Hospital during the period from 2009 to 2015 were analyzed. Antimicrobial susceptibility was determined by disk diffusion method and Phoenix 100 Automated Microbiology System. Results were analyzed according to the guidelines of CLSI (2014) using WHONET 5.6 software.Results The total strains were 26630. The most common gram-positive isolates were Streptococcus pneumoniae,Staphylococcusaureusand coagulase-negative Staphylococcus (CNS), while the most frequently isolated gram-negative microorganisms were Klebsiella spp.,Pseudomonas aeruginosa and Escherichia coli. The prevalence of S. pneumoniae was up to 25.7 % (4101/15973) in all respiratory tract specimens. About 50.2 % of the S. pneumoniae isolates were not susceptible to penicillin. The prevalence of methicillin-resistant strains was 20.6 % in S. aureus (MRSA) and 87.8 % in coagulase negative Staphylococcus (MRCNS) on average. The prevalence of MRSA increased from 11.1 % in 2009 to 29.8 % in 2015. No S. pneumoniae or staphylococcal strains were found resistant to vancomycin or linezolid. The Enterococcus strains were still highly susceptible to vancomycin and linezolid. Overall 0.3 % of the Enterococcus faecium isolates were resistant to vancomycin. The extended-spectrum beta-lactamases (ESBLs) producing strains accounted for 71.4 % -78.1 % of E. coli and 65.1 % - 76.9 % of K. pneumoniae isolates. The carbapenem-resistant E. coli and K. pneumoniae were reported for the first time in 2010, but in 2014, the strains resistant to carbapenems had increased to more than 7 % in E. coli, and higher than 20 % in K. pneumoniae. In 2015, up to 27.7 % and 25.7 % of P. aeruginosa isolates were resistant to imipenem and meropenem, respectively, and 59.9 % of the A. baumannii isolates were resistant to imipenem and meropenem. Beta-lactamase was positive in 46.3 % of the H. influenzae isolates. Conclusions MRSA and the carbapenem-resistant strains of E. coli,K. pneumoniae and A. baumannii are still on the rise in pediatric inpatients, which poses a serious threat to clinical practice and implies the importance of strengthening infection control.

Analysis of professor WU Lianzhong's experience of neck acupoints application / 中国针灸

Professor WU Lianzhong's experience of neck acupoints application is introduced. The characteristics,locations, acupuncture manipulations ,efficiency and main functions of neck acupoints including Tiandixue (Extra), Jingbixue (Extra), and cervical Jiaji (EX-B 2) are stated. According to the TCM thought of treatment based on syndrome differentiation,WU Lianzhong's special theory of neck acupoints application is explained so as to provide experience for improving acupuncture effects.

Clinical analysis of complete left bundle branch block after transcatheter closure of ventricular septal defect / 中华实用儿科临床杂志

Objective To evaluate the clinical features and prognosis of patients with complete left bundle branch block(CLBBB)following transcatheter device closure of ventricular septal defect(VSD)closure. Methods Clinical feathers of 11 patients with postoperative CLBBB in Department of Pediatric Cardiology,Guangdong General Hospital from January 2011 to December 2013 were collected and reviewed retrospectively. They were treated with dif-ferent protocol based on the appeared time of CLBBB occurrence and clinical symptoms. The patients were followed up, and the prognosis was recorded. Results The median age of 11 patients was 3. 9 years(3. 4 to 17. 5 years old). The median interval of intervention therapy to first attack of CLBBB was 2. 8 months(1 day to 25. 4 months). CLBBB oc-curred within 1 week to 1 month postoperatively in 4 patients,another 1 case suffered from CLBBB between 1 week to 1 month postoperatively,meanwhile 6 cases underwent CLBBB after 6 months postoperatively. The longest term of CLBBB attack postoperatively was 25. 4 months in 1 patient. The electrocardiograms on 5 patients returned to normal by only drug treatment. However,3 patients failed to recover with drug therapy,2 of them undertaken surgical procedure to re-move the occluder associated with VSD repair,1 patient recovered to normal and another converted to incomplete right bundle branch block. One of them refused to undertake surgical procedure and still bothered with persistent CLBBB. Another 3 cases did not receive special treatment due to the later attack of CLBBB(≥6 months)without clinical symp-toms. By the end of observation,the electrocardiogram(ECG)in 4 patients returned to normal,4 patients presented with persistent CLBBB. One patient's ECGs were presented with right bundle branch block. After ECG successfully returning to normal ECG by drug therapy,2 patients relapsed during follow - up,and 1 of them developed to an enlarging left ven-tricle and heart failure which led to death. Conclusions CLBBB may occur in short or long - term after VSD closure. ECG may become normal after early and appropriate treatment postoperatively. Systolic dyssynchrony and cardiac dys-function may be caused by persistent CLBBB. Therefore,patients with CLBBB after VSD closure should be treated ap-propriately without delay,and more frequent and longer follow - ups are required.

Prevalence and risk factors of arrhythmias after transcatheter closure of ventricular septal defect in children / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the prevalence and risk factors of arrhythmia after transcatheter closure of ventricular septal defect (VSD) in children.</p><p><b>METHODS</b>A total 1 069 children (583 males, mean age (7.7 ± 3.6) years) underwent transcatheter closure of VSD from January 2002 to December 2010 in our hospital were enrolled and retrospectively analyzed.VSD diameters were (4.0 ± 1.8)mm, 336 cases accompanied membranous aneurysm. Electrocardiogram were performed at 1, 3 days after the procedure.Once arrhythmias recorded, electrocardiogram was performed daily till discharge. All cases were followed up by ECG at 1, 3, 6, 12 months after the procedure in outpatient department and then in a year interval. The risk factors were identified by multivariable logistical analysis.</p><p><b>RESULTS</b>All VSDs were closed successfully and the diameters of occluder was (7.2 ± 2.1)mm. The median follow-up time was 2.2 (1.0-4.2) years. Mortality was zero during follow up.Incidence of early ( < 1 month) post-procedure arrhythmias was 24.6 % (263 cases), and severe arrhythmias were recorded in 50 cases (4.7%). There were 43 late ( ≥ 1 month) post-procedure arrhythmias (4.0%) including 4 (0.4%) complete atrioventricular block. Multivariable logistic analysis revealed that VSD treated with thin-waist-big-side occluder (OR = 2.426, 95%CI:1.835-3.208, P < 0.001) , male gender (OR = 1.267, 95%CI:1.055-1.523, P = 0.011) were the risk factors while higher body weight (OR = 0.838, 95%CI:0.737-0.951, P = 0.006) was protective factor for early onset arrhythmia. Placement of asymmetrical occluder (OR = 4.777, 95%CI:2.079-10.978, P < 0.001) , longer procedure time (OR = 1.011, 95%CI:1.002-1.020, P = 0.012) , occluder from foreign countries (OR = 2.621, 95%CI:1.143-6.014, P = 0.021) were the risks factors for early onset severe conduct block. Treatment with thin-waist-big-side occluder (OR = 2.654, 95%CI: 1.042-6.760, P = 0.041) was the risk factor while higher body weight (OR = 0.373, 95%CI:0.159-0.875, P = 0.023) was a protective factor for late onset conduct block.</p><p><b>CONCLUSIONS</b>Arrhythmia after transcatheter closure of VSD is common in children, and late onset severe conduct block is rare. The weight of patients should not too light and symmetrical occluder should be chosen if possible in the transcatheter closure VSD procedure to minimize the risk of late onset conduct block.</p>

An analyze of medium and long term follow-up of arrhythmias after transcatheter closure of ventricular ;septal defect in children / 临床儿科杂志

Objective To observe and analyze the medium and long term follow-up data of arrhythmias after transcatheter closure of children with ventricular septal defect (VSD). Methods Retrospectively analyzed the clinical data of 1071 children with VSD, who successfully underwent transcatheter device closure, at l, 3, 6, 12 months and ev-ery year post procedure from March 2002 to December 2010. Results Of all 1071 children, 272 cases (25.4%) were ob-served of having arrhythmias within 1 month after intervention, mainly including atrioventricular block (AVB), branch block, junctional tachycardia, atrial and ventricular tachycardia, frequent contractions, etc. Among them, 22 cases (2.1%) had above II degree AVB, complete left bundle branch block (CLBBB) and other causes of serious arrhythmias. After treatment, all cases got better and no permanent pacemaker was necessary. After 1 to 107 months (2.8±1.7 years) fol-low-up, 161 cases (18.2%) were observed of having persistent abnormal ECG mainly caused by AVB and branch block, including 10 cases (1.1%) with serious arrhythmias. In 4 cases with late-onset AVB, 3 cases had already appeared AVB in early postoperative, 1 case had recurrence CLBBB, left ventricle enlarge, and died of heart failure during follow up. Four cases were implanted permanent pacemaker. Conclusion During follow-up, serious arrhythmias after VSD closure, such as AVB or CLBBB, have high risk of recurring. Conduction block arrhythmias may reappear or worsen, while arrhythmias like tachycardia and premature heart rhythm mostly return to normal.

Effects of total saponins of tribulus on the differentiation of rat neural hippocampus stem cells / 第三军医大学学报

Objective To observe the effects of total saponins of tribulus of various consistency on the differentiation of neural hippocampus stem cells. Methods The hippocampus stem cells from newborn rat were obtained by serum-free medium and single-cell cloning technique. Hippocampus stem cells were induced by total saponins of tribulus of various consistency. Nestin, BrdU, neurofilament (NF-200), glial fibrillary acidic protein (GFAP) expression were detected using immunocytochemical stains. The numbers of NF and GFAP positive cells were counted. The percentages of positive cells were obtained. Results The dissociated cells from the organ of hippocampus developed into much of indiffrentiated otopheres of nestin positive cells. The hippocampus stem cell differentiated into neurons and astrocytes with the total saponins of tribulus. The percentage of NF positive neuron in the 20 mg/kg consistency of total saponins of tribulus groups was significantly higher than that in the control group and other consistency of total saponins of tribulus groups. Conclusion Total saponins of tribulus may enhance neural hippocampus stem cells differentiate into NF positive neuron.

The Effect of Astragalus Membranaceus and Angelica Sinensis on Grafted Cochlea Stem Cells Apoptosis in Hearing Impaired Rats / 听力学及言语疾病杂志

Objective To investigate the effects of astragalus membranaceus and angelica sinensis on grafted cochlea stem cells apoptosis in hearing imparied rats.Methods The hearing impaired rats were divided into 3 groups:cochlea stem cells group(45 rats),astragalus membranaceus and angelica sinensis group(45 rats),and the control group(35 rats).Cochlea stem cells only were grafted into the first group cochlea regions,mixture of stem cells and astragalus membranaceus and angelica sinensis were grafted into that of the second group.Saline was grafted into that of control rats.Observed was apoptosis at 1 day,3 days,5 days,10 days,15 days after the transplantation by CASPASE-3 and Bcl-2 immunofluorescence.Results After transplantationn 1 day,3 days,5 days,10 days,and 15 days of five time,for the cochlea stem cell group,the rates of apoptotic cells were 27.84%,49.37%,44.78%,39.37%,and 34.82%,respectively.The rates of astragalus membranaceus and angelica sinensis group were 18.35%,26.92%,23.18%,21.38%,and 18.19%,respectively.The percent of grafted cochlea stem cells apoptosis in astragalus membranaceus and angelica sinensis group was much lower than that in cochlea stem cells group and control group.The majority of apoptotic cells occurred within three to five days after transplantation.Conclusion The majority of apoptotic cells occur within three to five days after transplantation in the hearing impaired rats.The astragalus membranaceus and angelica sinensis could reduce the apoptotic rates of transplanted stem cells.