Prevalence of new defined extensive drug resistant tuberculosis in Xi'an / 中国热带医学

@#Abstract: Objective　To collect extensively drug-resistant tuberculosis (XDR-TB) Mycobacterium tuberculosis strains isolated from Xi'an City between 2019 and 2020, and analyze the drug resistance patterns of XDR-TB strains to second-line anti-tuberculosis drugs and the occurrence of new defined extensively drug-resistant tuberculosis in Xi'an, in order to provide evidence for guiding clinical drug use of multidrug-resistant tuberculosis (MDR-TB) patients. Methods A total of 3 088 strains of Mycobacterium tuberculosis that underwent phenotypic drug susceptibility testing at Xi'an Chest Hospital from January 2019 to December 2020 were retrospectively selected to analyze the resistance of anti-tuberculosis drug. Among the stored MDR-TB strains, 114 strains of preserved multidrug-resistant Mycobacterium tuberculosis were randomly selected for bedaquiline and linezolid susceptibility testing. Combined with the results of previous second-line drug susceptibility testing, the incidence of newly defined extensive drug resistance was analyzed. Results Among the 3 088 Mycobacterium tuberculosis strains analyzed, 411 strains (14.3%) showed resistance to isoniazid, 347 strains (11.2%) showed resistance to rifampicin, 142 strains (4.6%) showed resistance to ethambutol, 550 strains (17.8%) showed resistance to streptomycin, and 237 strains (7.6%) exhibited multidrug resistance. Of 237 MDR-TB strains, the resistance rates of ethambutol, moxifloxacin, rifampicin, sodium para-aminosalicylate, prothioconazole, capreomycin, amikacin, and clofazimine were 44.3%, 26.6%, 33.3%, 24.1%, 5.1%, 4.2%, 3.0%, and 2.5%, respectively. Among the randomly selected 114 MDR-TB strains, none showed resistance to bedaquiline, three showed resistance to linezolid, and one strain met the new definition for extensively drug-resistant tuberculosis. Conclusion In Xi'an City, high rates of resistance among MDR-TB strains are observed for ethambutol, quinolone and sodium para-aminosalicylate, and the drug susceptibility tests should be obtained as much as possible when using these drugs. The incidence of new definition extensively drug-resistant tuberculosis is low, and bedaquiline and linezolid remain effective drugs for the treatment of multidrug-resistant tuberculosis even without drug susceptibility testing results.

Regulation effect of endoplasmic reticulum stress and unfolded protein response activation on skeletal muscle fiber immune behavior / 解剖学报

Objective To investigate the regulatory effects of activated endoplasmic reticulum stress（ERS） and unfolded protein response（UPR） on the immune behavior of the stressed muscle fibers in inflammatory environments induced by interferon-γ（IFN-γ）. Methods The myogenic precursor cells（MPCs） of C57 BL/6 mice cultured in vitro were differentiated into multinucleated myogenic tubes by horse serum and then to set up: 1. Control group; 2. IFN-γ group; 3. Tunicamycin group; 4. Thapsigargin group; 5. IFN-γ and 4-phenylbutyrate（4-PBA） combined treatment group; 6. IFN-γ, TG and 4-PBA combined treatment group; 7. IFN-γ and 4μ8 c combined treatment group; 8. IFN-γ, TG and 4μ8 c combined treatment group; 9. IFN-γ and GSK2606414 combined treatment group; 10. IFN-γ, TG and GSK2606414 combined treatment group. The level of myokines gene was detected by Real-time PCR. The expression of UPR key molecules including eukaryotic intiatio factor 2α（eIF2α）, inositol requrring enzyme 1α（IRE1α） and activating transcription factor 6（ATF6） in muscle fibers was observed by immunofluorescence. Western blotting was used to detect immune molecules related to muscle cells, myokines and key molecules of UPR. Luminex analyzed the levels of pro-inflammatory myokines in muscle fibers. Results The expression of H-2 Kb, H2-Ea, Toll like receptor 3（TLR3）, p-eIF2α and p-IRE1α were up-regulated in IFN-γ induced inflammatory environment. The expression of H-2 Kb, H2-Ea, TLR3 and myokines in the group with UPR inhibitor 4-PBA was down-regulated compared with IFN-γ group, and the expression of these molecules in the group with IRE1α specific inhibitor 4μ8 c was down-regulated compared with the IFN-γ group. The addition of protein kinase R-like endoplasmic eticulum（PERK） specific inhibitor GSK2606414 showed no significant change. Conclusion In IFN-γ induced inflammatory environment, the UPR-IRE1α pathway activates and inhibits the synthesis of muscle fiber immune-related molecules, which further inhibits the muscle fiber mediated immune response and facilitates muscle regeneration.

The influence of COVID-19 prevention and control measures on the epidemic of influenza in Huzhou / 预防医学

Objective@#To evaluate the impact of coronavirus disease 2019 ( COVID-19 ) prevention and control measures in Huzhou on influenza epidemic strength and characteristics in 2020, so as to provide reference for formulating influenza prevention measures. @*Methods@#Using the influenza surveillance data of the national influenza sentinel surveillance system from January 2015 to July 2020, the seasonal characteristics of influenza epidemic were analyzed, the proportion of influenza-like illness cases ( ILI% ) and the positive rate of influenza virus in January to July of 2020 were compared with those of the same period in 2015-2019, in order to evaluate the impact of COVID-19 prevention and control measures. @*Results @#The ILI% and the positive rate of influenza virus in Huzhou were 3.90% and 15.32% during 2015-2019, while were 4.41% and 12.63% from January to July of 2020. The trends of ILI% during 2015-2019 fluctuated similar, but continued to drop since January 2020. The positive rate of influenza virus peaked from December to March in 2015-2019, also peaked from December 2019 to January 2020, but decreased to 0 in March. ILI% was positively correlated with the positive rate of influenza virus ( r=0.682, P<0.05). The growth rates of ILI% from January to July 2020 were 4.75%, -11.27%, 0.68%, 19.84% and 0.92%, compared with the same period of 2015-2019, respectively. The growth rates of ILI% in January 2020 were much higher ( >57.00% ) and from April to July were much lower ( <-33.00% ) . The growth rates of influenza virus positive rate from January to July 2020 were -47.96%, -36.53%, -3.44%, -35.92% and -39.37%, compared to the same period of 2015-2019, respectively. The growth rates of influenza virus positive rate in January 2020 were much higher ( >11.00% ) and from February to March were much lower ( <-61.00% ). @*Conclusion@#Since COVID-19 prevention and control measures were implemented in January 2020 in Huzhou, the ILI% and the positive rate of influenza virus in sentinel hospitals decreased significantly.

Relationship between lactic acid concentration and osteoclast differentiation of mouse monocytes / 中国组织工程研究

BACKGROUND: Preliminary study found that polylactic acid composite material could accelerate the bone construction rate, and the underlying mechanism still needs to be studied further. OBJECTIVE: To investigate the effect of lactic acid at different concentrations on osteoclast differentiation of mononuclear cells in mice. METHODS: Mouse RAW264.7 cells were cultured in DMEM with 0 (control group), 5, 10 and 20 mmol/L lactic acid, respectively, under the induction of 50 µg/L RANKL for 5 days. The effect of lactic acid concentration on the cell proliferation rate was analyzed by cell counting kit-8 assay. Tartrate resistant acid phosphatase positive polykaryotic cells were stained and counted with tartrate resistant acid phosphatase staining kit. mRNA expression levels of acid phosphatase 5, nuclear factor of activated T-cells 1 and RANK were detected by RT-PCR. Protein expression levels of cathepsin K and nuclear factor of activated T-cells 1 were detected by western blot assay. RESULTS AND CONCLUSION: (1) 5 mmol/L lactic acid produced the highest proliferation rate of raw264.7 cells, whereas the 20 mmol/L lactic acid produced lowest cell proliferation rate. Compared with the control group, the proliferation rate of raw264.7 cells by 10 mmol/L lactic acid was insignificant. (2) Tartrate resistant acid phosphatase staining showed the highest positive rate and mRNA expression levels of acid phosphatase 5, nuclear factor of activated T-cells 1 and RANK under the condition of 10 mmol/L lactic acid. (3) With the increase of lactic acid concentration, the expression level of cathepsin K increased, while the expression level of nuclear factor of activated T-cells 1 was on a decline. (4) Under the current experimental conditions, with the increase of lactic acid concentration, the ability of lactic acid to promote the osteoclast differentiation of mouse RAW264.7 cells is firstly increased and then decreased, and 10 mmol/L lactic acid was the optimal concentration to promote the osteoclast differentiation of mouse RAW264.7 cells. Lactic acid can affect the osteoclastic differentiation of mouse raw264.7 cells by nuclear factor of activated T-cells 1 in nuclear factor-KB signaling pathway.

Vein valve function following pharmacomechanical thrombectomy versus simple catheter-directed thrombolysis for lower extremity deep vein thrombosis: A case control study / 中国胸心血管外科临床杂志

@#Objective To compare vein valve function following pharmacomechanical thrombolysis (PMT) with simple catheter-directed thrombolysis (CDT) for deep vein thrombosis. Methods We retrospectively analyzed the clinical data of sixty patients who suffered acute lower extremity deep vein thrombsis in our hospital between October 2016 and March 2017. All patients underwent contralateral preprocedural duplex and bilateral postprocedure duplex to access patency and valve function. The patients were divided into three groups including a group A with catheter-directed thrombolysis (CDT) alone (36 patients with 20 males and 16 females at average age of 56 years), a group B with PMT alone (15 patients with 8 males and 7 females at average age of 55 years), and a group C with PMT combined CDT (9 patients with 4 males and 5 females at average age of 56 years). The valve function was compared among the Group A, Group B and Group C. Results There were 40.0% (24/60) patients with bilateral femoral vein valve reflux, 40.0% (24/60) patients with unilateral femoral vein valve reflux (all in the treated limbs), 20% (12/60) patients had no reflux in both limbs. Of the limbs treated with CDT alone, PMT alone and PMT combined CDT, the rate of valve reflux was 38.9% (14/36), 33.3% (5/15), and 55.6% (5/9) respectively (P=0.077). Conclusion In the patients suffering acute DVT, PMT or PMT combined CDT does not hamper valve function compared with CDT alone.

Application of the triage and acuity scale in the emergency department of stomatological hospital / 口腔疾病防治

Objective@#This study aims to explore the effect of practice on the triage and acuity scale in the emergency department of Stomatological Hospital. @*Methods @#150 emergency patients admitted to the emergency department from April 2016 to July 2016 were randomly selected as the control group before the implementation of graded district diagnosis and treatment, and 150 emergency patients admitted from August 2016 to November 2016 were selected as the observation group after the implementation of graded diagnosis and treatment. The control group was treated with the traditional nursing treatment mode, and the observation group adopted the triage and acuity scale mode. The efficiency of treatment for the patients and the degree of satisfaction of the patients in terms of the nursing work was compared between the two groups (waiting time, checkup time, start treatment time). @*Results@#A comparison of the patients in the observation group and control group showed that the waiting time (min)(25.63 ± 8.75 vs. 35.57 ± 10.60, t = -8.52, P < 0.001), the time of accepting examination (min)(24.80 ± 7.90 vs. 39.23 ± 12.42, t = -12.01, P < 0.001) and the starting time of treatment （min）(28.67 ± 9.37 vs. 40.47 ± 10.86, t = -10.08, P < 0.001) were significantly lower in the observation group than the control group (P < 0.05). The degree of satisfaction with the nursing work for the patients in the observation group (96.67%) was higher than that of the control group (85.33%), and this difference was statistically significant (χ2=17.647, P=0.001). @*Conclusion@#The application of a triage and acuity scale in the diagnosis and treatment of stomatological emergency patients according to the severity and urgency of disease can ensure the priority of treatment in critically ill patients, the safe and efficient performance of emergency work, and improvements to the efficiency and quality of emergency medical services.

Normal Range of Head-to-body Delivery Interval by Two-step Delivery / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The one-step method was routine practices in China, scientific evidence to support this intervention is scarce. The purpose of this study was to observe the natural process of head-to-body delivery interval by waiting for at least one contraction (two-step) after head delivered in normal birth.</p><p><b>METHODS</b>From March 1 to March 30 in 2015 at Haikou Maternal and Child Hospital in China, normal vaginal birth with normal baby condition were recorded by video. Videotapes were transferred to computer then replayed and observed.</p><p><b>RESULTS</b>Ninety-two cases were enrolled in this study. The average head-to-body delivery interval by two-step delivery was 71.04 ± 61.02 s, (mean + 2 standard deviation = 193.07 s, 95% confidence interval [15.65-229.15] s). Fifty-one patients (51/92, 55.43%) were <60 s, 41 patients (41/92, 44.57%) were over 60 s. Shoulders delivered at the first contraction were 96.74% (89/92), 3.26% (3/92) had delivered by the second contraction. Shoulders emerged from perineum were 71.73% (66/92), 15.21% (14/92) transversely, and 13.04% (12/92) emerged from under pubic arch. Babies cried before the shoulder were 31.52% (29/92), cried after birth 52.17% (48/92), and 16.30% (15/92) did not cry after birth. Baby activities included as making faces, sucking, and bubbled from mouth and noses, and the lighter blue color of skin with good perfusion.</p><p><b>CONCLUSIONS</b>The average time of head-to-body delivery interval was longer than 60 s by two-step delivery. Majority shoulders were delivered at the first contraction. Majority shoulders emerged from perineum rather from under pubic arch. The routine one-step method of shoulder delivery where the downward force applied is not necessary and is not the right direction. Baby's breath, making faces, sucking, bubble from noses and mouth, and the light blue color of the faces, all those signs during shoulder delivery indicated a normal live birth.</p>

The interactions among impact factors affecting 131I treatment efficacy of Graves′ disease / 中华核医学杂志

Objective To evaluate the possible interactions among different impact factors possibly affecting the treatment efficacy of 131I in Graves′ disease (GD). Methods Six hundred and thirty two GD patients that had been treated by 131I, with or without antithyroid drugs (ATD), were included in this study. The impact factors were pre-defined as age (x1), sex (x2), mass of thyroid (x3), course of disease (x4), initial symptom (x5), condition of disease (x6), ATD treatment duration (x7), effective half life time (x8), maximum 131I uptake rate (x9), total dose of 131I (x10), dose of 131I per gram of thyroid (x11), TRAb (x12), TSI (x13), TgAb (x14), and thyroid microsomal antibody(TMAb) level(x15). Interactions among different impact factors were studied by t-test, χ2 test and multi-variant logistic regression. Results Age, mass of thyroid, ATD treatment duration, maximum 131I uptake rate, dose of 131I per gram of thyroid tissue and TSI level were identified as independent impact factors affecting the 131I treatment efficacy on GD (χ2=6.908, t=-4.063, χ2=13.558, t=-2.553, t=4.528, χ2=9.716, all P0.05; F=2.928, 1.992, 2.629, 2.215, all P<0.05), which indicated that the treatment efficacy with co-existing multiple factors was not equal to simple summation of single factors. Conclusions The interactions among multiple factors can cause indi-rect effect on 131I treatment, which might guide the prescription of 131I dosage for GD treatment.

A comparative study of influential factors correlating with early and late hypothyroidism after (131)I therapy for Graves' disease / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>(131)I therapy is recognized as the simplest, safest, least expensive, and most effective treatment, and accepted by more and more patients. However its curative effect is influenced by many factors, therefore there are some difficulties for doctors to establish individual treatment strategy. The aims of this study were to determine the incidence of early and late hypothyroidism after (131)I treatment for Graves' disease (GD) and to compare their correlation, to observe and analyze the influential factors and to understand the predictabilities of them.</p><p><b>METHODS</b>Five hundred GD patients (144 males, 356 females; age (41.2 +/- 12.3) years) received (131)I treatment for the first time. The therapeutic procedure was carried out as the following: undergoing (131)I uptake test to obtain maximum of thyroid uptake value and effective half-life (EHL) time; estimating the thyroid's weight by ultrasonography; determination of thyroid hormones and correlative antibodies; pre-therapy physical examination; thyroid imaging; calculating (131)I therapeutic dosage; per os uptake of the determined (131)I dosage; follow-up appraisal of curative effect. The observing parameters included age, gender, thyroid weight, GD duration, condition of onset, state of disease, course of treatment, EHL time, maximum of thyroid uptake value, (131)I dosage and titer of correlative antibodies. We sorted out the data and used both univariate and multivariate analysis to evaluate them statistically.</p><p><b>RESULTS</b>The incidence rates of early and late hypothyroidism were 33.2% and 6.6% respectively after (131)I treatment and approximately 22.2% cases of late hypothyroidism developed from early hypothyroidism. The influential factors of early hypothyroidism included course of GD, the highest thyroid uptake ratio of (131)I, EHL time and thyroid microsome antibody (TMAb), etc. A multivariate analysis on late hypothyroidism showed that female patients, with recurrence after anti-thyroid drug treatment and higher thyroid weight, had lower possibility of late hypothyroidism after (131)I therapy.</p><p><b>CONCLUSIONS</b>The incidence of early hypothyroidism is higher than that of late hypothyroidism. The highest thyroid uptake ratio of (131)I, EHL and TMAb will increase the possibility of early hypothyroidism, while GD course is the protective factor. Higher (131)I dosage, longer EHL and higher TMAb titer will also increase the possibility of late hypothyroidism. The multi-perspective and multi-factor analysis has the benefit to establish individualized treatment strategy.</p>

Traditional Chinese medicine Drynaria fortunei J. Smith naringin promotes proliferation and differentiation of human periodontal ligament cells / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effects of Drynaria fortunei J. Smith naringin (DFSN) on proliferation and differentiation of human periodontal ligament cells (hPDLC).</p><p><b>METHODS</b>Cultured human periodontal ligament cells were treated with DFSN at different concentrations. Cell proliferation was determined by MTT method; cell differentiation was evaluated through the examination of alkaline phosphate (ALP) activities.</p><p><b>RESULTS</b>DFSN in a concentration ranged from 0.01 mu mol/L to 10 mu mol/L showed a promoting effect on proliferation of hPDLC (P< 0.05), and it also promoted ALP activities of hPDLC (P<0.05).</p><p><b>CONCLUSION</b>Drynaria fortunei J. Smith naringin can promotes the proliferation and differentiation of human periodontal ligament cells.</p>

Analysis of protamine content in patients with asthenozoospermia / 中华男科学杂志

<p><b>OBJECTIVE</b>To study the significance of the change of protamine content in the management of male infertility.</p><p><b>METHODS</b>Sperm nuclear proteins extracted from 199 infertile patients were analyzed by polyacrylamide gel-electrophoresis and scanning microdensitometry.</p><p><b>RESULTS</b>Forty-two (21%) cases of the total number had normal sperm nuclear proteins and 157 (79%) had aberrant ones, which mainly presented the interruption of HPRR and abnormality of P2 protamine. Thirty patients were selected at random from 157 abnormal cases for clinical treatment. After the treatment, the sperm nuclear proteins were extracted and analyzed and the results demonstrated that 11 cases (36.6%) improved markedly, 5 (16.6%) restored to normal and the other 16 (46.6%) remained unchanged.</p><p><b>CONCLUSION</b>There is a reduced level or selective absence or even complete selective absence of protamines in infertile patients. Protamines may act as a parameter for evaluating the treatment effect of infertile males and protamine content can be influenced by a certain or several factors.</p>

Expression of human phosphodiesterase 3A gene using baculovirus expression system in insect cell / 药学学报

<p><b>AIM</b>To investigate the expression of recombinant human phosphodiesterase 3A (HPDE3A) using baculovirus expression system in Tn cell line.</p><p><b>METHODS</b>The HPDE3A cDNA was recombined with baculovirus, and then the recombinant was transfected into Tn cell line. The expression of HPDE3A in Tn cell line was detected and identified by the RT-PCR, SDS-PAGE and Western blotting.</p><p><b>RESULTS</b>The recombinant HPDE3A protein was stably expressed in Tn cell line and detected by the distinct morphological changes of Tn cell, RT-PCR, SDS-PAGE and Western blotting using polyclonal antibody. The M(w) of the recombinant protein was about 120 kD.</p><p><b>CONCLUSION</b>Recombinant HPDE3A can be expressed in Tn cell line using the baculovirus expression system, and thus provided the basic material for studying its bioactivity and application in screening for HPDE3A inhibitor.</p>

Effect of hepatic artery embolization on the microwave coagulated area / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the effect of hepatic artery embolization on the microwave coagulated area, an in vivo animal experiment.</p><p><b>METHODS</b>Twenty-four suitable hepatic lobes of ten dogs were divided into two groups: microwave coagulation alone 12 lobes (control group) and hepatic artery occlusion with iodized oil and gelatin sponge particles followed by microwave coagulation 12 (experiment group). Microwave coagulation was delivered with an output of 50 W for 300 or 400 seconds with thermal needles introduced parallel to and 5 approximately 20 mm from the puncture needle. After sacrifice of the dogs, their hepatic lobes were sectioned along the puncture line. Then, the appearance and size of the coagulated area were recorded. The tissue specimens were fixed in formalin for light microscopic evaluation.</p><p><b>RESULTS</b>A decline in temperature gradient was detected from the center to the periphery of the affected tissue after the application of microwave coagulation, which was sharper in the control group than in the experimental group. Single polar microwave coagulation at 50 W for 300 seconds produced a necrotic volume of 25 approximately 33 mm in longitudinal diameter and 13 approximately 22 mm in transverse diameter in control group, 33 approximately 44 mm and 24 approximately 32 mm in the experimental group. The coagulation area was slightly bigger when the duration of coagulation was 400 seconds than 300 seconds, without significant difference.</p><p><b>CONCLUSION</b>Hepatic artery occlusion, inhibiting the heat loss caused by hepatic arterial blood flow, is able to significantly enlarge the necrotic volume of microwave coagulation.</p>

Expression of rat protamine gene in MEL cells / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the expression of rat protamine (RP) gene in MEL cells and the effect on cell growth.</p><p><b>METHODS</b>Eukaryotic expression plasmid pCR-3.1-RP was constructed and transfected into MEL cells. The changes of cell growth rate, mitotic index and colony-forming rate in semi-solid medium were investigated.</p><p><b>RESULTS</b>Transfected MEL cells showed lower growth rate, mitotic index and colony-forming rate. Volumes of cells were reduced and reduction of RNA transcription was observed.</p><p><b>CONCLUSION</b>These results suggest that expression of RP in MEL cell may inhibit the cell growth and proliferation.</p>