Pharmaceutical practice for one case of central nervous system infection caused by Mycobacterium malmoense combined with drug-induced liver injury / 中国药房

OBJECTIVE To introduce the drug diagnosis， treatment plan and pharmaceutical care of a case of central nervous system infection caused by Mycobacterium malmoense combined with drug-induced liver injury， and to provide a reference for clinical pharmacists to carry out pharmaceutical practice. METHODS Clinical pharmacists participated in the whole treatment of a case of central nervous system infection caused by M. malmoense combined with drug-induced liver injury. Considering the patient’s headache worsened and the skin appeared red spot again， clinical pharmacists suggested stopping isoniazid and adjusted the quadruple anti-infection regimen to Rifampicin capsules+Ethambutol hydrochloride tablets+Amikacin sulfate injection+ Clarithromycin tablets， and sending cerebrospinal fluid samples for the next-generation sequencing to identify the pathogen. After the pathogen was identified as M. malmoense， clinical pharmacists recommend continuing the above quadruple regimen. When the patient suffered from drug-induced liver injury， clinical pharmacists assisted physicians to adjust the medication plan， and suggested that Rifampicin capsules should be discontinued， Moxifloxacin hydrochloride tablets should be used for anti-infection treatment， Glutathione tablets should be used for liver protection treatment， and renal function and electrocardiogram monitoring should be performed. RESULTS & CONCLUSIONS The physicians adopted the advice of clinical pharmacists， and the patient was discharged after the condition improved. Clinical pharmacists review the patient’s medical and medication history， consult guidelines/consensus， research reports， and other literature materials， analyze the causes of adverse reactions based on the patient’s condition and the characteristics of drug action， adjust the medication plan of anti-infective drugs in a timely manner， and provide targeted treatment for adverse reactions. From a pharmaceutical perspective， they assist physicians in improving clinical treatment decisions and ensuring the efficacy and safety of clinical medication.

Jiedu Recipe, a compound Chinese herbal medicine, inhibits cancer stemness in hepatocellular carcinoma via Wnt/β-catenin pathway under hypoxia / 中西医结合学报

OBJECTIVE@#Jiedu Recipe (JR), a Chinese herbal remedy, has been shown to prolong overall survival time and decrease recurrence and metastasis rates in patients with hepatocellular carcinoma (HCC). This work investigated the mechanism of JR in HCC treatment.@*METHODS@#The chemical constituents of JR were detected using liquid chromatography-mass spectrometry. The potential anti-HCC mechanism of JR was screened using network pharmacology and messenger ribonucleic acid (mRNA) microarray chip assay, followed by experimental validation in human HCC cells (SMMC-7721 and Huh7) in vitro and a nude mouse subcutaneous transplantation model of HCC in vivo. HCC cell characteristics of proliferation, migration and invasion under hypoxic setting were investigated using thiazolyl blue tetrazolium bromide, wound healing and Transwell assays, respectively. Image-iT™ Hypoxia Reagent was added to reveal hypoxic conditions. Stem cell sphere formation assay was used to detect the stemness. Epithelial-mesenchymal transition (EMT) markers like E-cadherin, vimentin and α-smooth muscle actin, and pluripotent transcription factors including nanog homeobox, octamer-binding transcription factor 4, and sex-determining region Y box protein 2 were analyzed using Western blotting and real-time polymerase chain reaction. Western blot was performed to ascertain the anti-HCC effect of JR under hypoxia involving the Wnt/β-catenin pathway.@*RESULTS@#According to network pharmacology and mRNA microarray chip analysis, JR may potentially act on hypoxia and inhibit the Wnt/β-catenin pathway. In vitro and in vivo experiments showed that JR significantly decreased hypoxia, and suppressed HCC cell features of proliferation, migration and invasion; furthermore, the hypoxia-induced increases in EMT and stemness marker expression in HCC cells were inhibited by JR. Results based on the co-administration of JR and an agonist (LiCl) or inhibitor (IWR-1-endo) verified that JR suppressed HCC cancer stem-like properties under hypoxia by blocking the Wnt/β-catenin pathway.@*CONCLUSION@#JR exerts potent anti-HCC effects by inhibiting cancer stemness via abating the Wnt/β-catenin pathway under hypoxic conditions. Please cite this article as: Guo BJ, Ruan Y, Wang YJ, Xiao CL, Zhong ZP, Cheng BB, Du J, Li B, Gu W, Yin ZF. Jiedu Recipe, a compound Chinese herbal medicine, inhibits cancer stemness in hepatocellular carcinoma via Wnt/β-catenin pathway under hypoxia. J Integr Med. 2023; 21(5): 474-486.

Knowledge about, attitude and acceptance towards, and predictors of intention to receive the COVID-19 vaccine among cancer patients in Eastern China: A cross-sectional survey / 中西医结合学报

OBJECTIVE@#The coronavirus disease 2019 (COVID-19) pandemic has had a serious impact on health all over the world. Cancer patient, whose immunity is often compromised, faces a huge challenge. Currently, some COVID-19 vaccines are being developed and applied on general population; however, whether cancer patients should take COVID-19 vaccine remains unknown. Our study aimed to explore the knowledge, attitude, acceptance, and predictors of intention to receive the COVID-19 vaccine among cancer patients in Eastern China.@*METHODS@#A cross-sectional study was conducted in Eastern China from June 17th to September 3rd, 2021. Patients were selected using a convenience sampling method. A self-report questionnaire was developed to assess knowledge about the COVID-19 vaccine, attitude towards the vaccine and acceptance of the vaccine; following a review of similar studies previously published in the scientific literature, multivariate logistic regression analysis was used to determine the predictors associated with COVID-19 vaccine acceptance.@*RESULTS@#A total of 2158 cancer patients were enrolled in this study. The rate of vaccine hesitancy was 24.05% (519/2158); further, among the participants of vaccine acceptance, 767 had taken COVID-19 vaccine (35.54%), and 872 were willing to get vaccinated (40.01%). A total of 24 variables including demographic characteristics, clinical status of cancer, impact of COVID-19 pandemic on study participants, patients' knowledge about the COVID-19 vaccine, and attitude towards the vaccine, had significant differences between the "vaccine hesitancy" population and "vaccine acceptance" population. Multivariate logistic regression analysis indicated that parameters including alcohol consumption (odds ratio [OR] = 1.849; 95% confidence interval [CI]: 1.375-2.488; P-reference [P-Ref] < 0.001 vs non-drinkers), income impacted by COVID-19 pandemic (OR = 1.930, 2.037 and 2.688 for mild, moderate, and severe impact, respectively; all P-Ref < 0.01 vs no impact), knowledge of how the vaccine was developed (OR = 1.616; 95% CI: 1.126-2.318; P-Ref = 0.009 vs unknown), believing in the safety of the vaccine (OR = 1.502; 95% CI: 1.024-2.203; P-Ref = 0.038 vs denying the safety of vaccine), willingness to pay for the vaccine (OR = 3.042; 95% CI: 2.376-3.894; P-Ref < 0.001 vs unwilling), and willingness to recommend families and friends to get vaccinated (OR = 2.744; 95% CI: 1.759-4.280; P-Ref < 0.001 vs do not recommend) were contributors to vaccine acceptance. While such as being retired (OR = 0.586; 95% CI: 0.438-0.784; P-Ref < 0.001 vs unemployed), undergoing multiple therapies of cancer (OR = 0.408; 95% CI: 0.221-0.753; P-Ref = 0.004 vs no ongoing treatment), and worrying that the vaccine might deteriorate the prognosis of cancer (OR = 0.393; 95% CI: 0.307-0.504; P-Ref < 0.001 vs might not) were contributors to vaccine hesitancy.@*CONCLUSION@#This study provided preliminary estimates of the rates of vaccine acceptance and vaccine hesitancy among cancer patients in Eastern China. The intention to receive the COVID-19 vaccine was impacted by factors such as patient occupation, alcohol consumption, and some parts of knowledge about and attitude towards COVID-19 vaccine. It is recommended to develop individualized vaccination plans that meet the healthcare needs of cancer patients.

Core muscle functional strength training for reducing the risk of low back pain in military recruits: An open-label randomized controlled trial / 中西医结合学报

BACKGROUND@#Core muscle functional strength training (CMFST) has been reported to reduce injuries to the lower extremity. However, no study has confirmed whether CMFST can reduce the risk of low back pain (LBP).@*OBJECTIVE@#This study identified the effects of CMFST on the incidence of LBP in military recruits.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTION@#We performed a prospective, open-label, randomized, controlled study in a population of young healthy male naval recruits from a Chinese basic combat training program. Participants were randomly assigned to either the core group or the control group. In additional to normal basic combat training, recruits in the core group underwent a CMFST program for 12 weeks, while recruits in the control group received no extra training.@*MAIN OUTCOME MEASURES@#At the beginning of the study and at the 12th week, the number of participants with LBP was counted, and lumbar muscle endurance was measured. In addition, when participants complained of LBP, they were assessed using the visual analog scale (VAS) and Roland Morris Disability Questionnaire (RMDQ).@*RESULTS@#A total of 588 participants were included in the final analysis (295 in the core group and 293 in the control group). The incidence of LBP in the control group was about twice that of the core group over the 12-week study (20.8% vs 10.8%, odds ratio: 2.161-2.159, P < 0.001). The core group had better lumbar muscle endurance at 12 weeks than the control group ([200.80 ± 92.98] s vs [147.00 ± 84.51] s, P < 0.01). There was no significant difference in VAS score between groups, but the core group had a significantly lower RMDQ score at week 12 than the control group (3.33 ± 0.58 vs 5.47 ± 4.41, P < 0.05).@*CONCLUSION@#This study demonstrated that the CMFST effectively reduced the incidence of LBP, improved lumbar muscle endurance, and relieved the dysfunction of LBP during basic military training.

Effects of Non-selective β-blockers on Mortality of Patients with Cirrhosis and Ascites：A Meta-analysis / 中国药房

OBJECTIVE：To syste matically evaluate the effects of non-selective β-blockers（NSBB）on mortality of patients with cirrhosis and ascites ，and to provide evidence-based reference for clinical drug use. METHODS ：Retrieved from PubMed ，the Cochrane Library ，Embase，Web of Science ，CNKI and Wanfang database ，randomized controlled trials （RCTs）and cohort studies about the effects of NSBB on mortality of patients with cirrhosis and ascites were collected from the date of database establishment to Sept. 30th，2019. The patients in the trial group were treated with NSBB ，the patients in the control group were treated with blank control or isosorbidemononitrate ，variceal ligation or other measures to prevent variceal bleeding. After literature screening and data extraction ，the quality of RCTs and cohort studies were evaluated by using bias risk evaluation tool recommended by Cochrane system evaluator manual 5.1.0 and Newcastle-Ottawa scale . Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS ：Totally 18 studies were included ，involving 8 649 patients，4 RCTs and 14 cohort studies. Results of Meta-analysis showed that ，there was no significant difference in all-cause mortality between the patients using NSBB of trial group [RR ＝0.85，95％ CI（0.65，1.11），P＝0.22]，severe ascites [RR ＝0.58，95％ CI（0.15，2.22），P＝0.42] or refractory ascites [RR ＝0.85，95％CI（0.61，1.20），P＝0.36] and the control group. Subgroup analysis showed that ，there was no significant difference in all-cause mortality between the patients using NSBB of trial group and control group according to the research method （RCT vs. cohort study ）and the type of drug use （P＞0.05）. CONCLUSIONS ：The use of NSBB does not increase the incidence of all-cause mortality in cirrhosis patients with ascites ，or even in those with severe ascites or refractory ascites.

Effects of Arginine-supplemented Enteral Nutrition on the Prognosis and Immune Function of Trauma Patients ：a Meta-analysis / 中国药房

OBJECTIVE： To systematically review the effects of arginine-supplemented enteral nutrition on the prognosis and immune function of trauma patients. METHODS： Retrieved from PubMed， the Cochrane library， Embase， CNKI， Wanfang database， CBM and Chinese Clinical Trial Registry， randomized controlled trials （RCT） about arginine-supplemented enteral nutrition （trial group） versus standard enteral nutrition or other enteral nutrition without arginine （control group） for trauma patients were collected. After literature screening， data extraction and quality evaluation with bias risk evaluation tool of Cochrane System Evaluator Manual 5.1.0， Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS： Totally 13 RCTs were included， involving 777 patients. Results of Meta-analysis showed that fatality rate [RR＝1.67，95％CI（1.07，2.61），P＝0.03]， IgG [MD＝2.81， 95％CI（0.43， 5.18）， P＝0.02]， IgM [MD＝0.30， 95％CI（0.07， 0.54）， P＝0.01]， CD4+ [MD＝5.05， 95％CI（2.55，7.56）， P＜0.000 1] and CD4+/CD8+ [MD＝0.27，95％CI（0.11，0.44）， P＝0.001] in trial group were significantly higher than control group； the level of serum albumin [MD＝－0.47， 95％CI（－0.75，－0.19）， P＝0.000 9] in trial group was significantly lower than control group. There was no statistical significance in the incidence of infectious complications [RR＝0.77，95％CI（0.51，1.17），P＝0.22]， total hospitalization time [MD＝－2.35，95％CI（－10.72，6.02），P＝0.58]， IgA [MD＝0.38，95％CI（－0.06，0.82），P＝0.09]， CD8+ [MD＝－2.49，95％CI（－6.01，1.03），P＝0.17] or the incidence of ADR between 2 groups. CONCLUSIONS： Arginine-supplemented enteral nutrition can improve the immune function of trauma patients， but increase mortality. It is necessary to be cautious in clinical use.

Assessment methods of mental fatigue: An update / 第二军医大学学报

Mental fatigue, first known as brain fag, is one of the common clinical fatigue types. Due to the increase of the intensity and proportion of mental work, mental fatigue has an increasing prevalence among the people working in all fields especially, especially in the military field. In recent years, mental fatigue has become an important part of fatigue-relative research. How to prevent, control and alleviate mental fatigue is an important issue, which is based on evaluating or determining the degree of mental fatigue. Because mental fatigue has strong subjectivity and its mechanism is still unclear, there are many evaluation methods, but with no unified standard. This article reviews the evaluation methods of mental fatigue, including symptomatic, psychobehavioral, and physiological and biochemical assessment, and discusses the main contents and principles of various evaluation methods, so as to provide reference to mental fatigue research.

Relationship between low body weight and postoperative of gastric cancer / 中国现代普通外科进展

Objective:Analysis the effects of body mass index (BMI) on postoperative prognosis of gastric cancer.Methods:Review of gastric cancer patients with radical operation in 2000 January to 2010 June,and follow-up 650 patients with clinicopathological features,and study the prognosis by univariate and multivariate analysis.Comparatively analysis the clinicopathological features,overall survival time,1 year,3 years and 5 years survival rate between underweight (BMI＜18.5 kg/m2) and the nonunderweight (BMI ≥18.5 kg/m2).Results:body mass index(BMI),tumor size,Lauren classification,T stage,N stage,TNM stage,tumor site,were related with prognosis by Univariate analysis;in multivariate analysis,body mass index (BMI),tumor size,T stage,N stage,TNM stage,tumor site,are independent prognostic factors.The 1-year survival rate,3-year survival rate and 5-year survival rate were significantly poorer in the underweight than the nonunderweight group,but the clinicopathological features of two groups of patients between the underweight and the nonunderweight are no significant difference.Conclusions:Underweight not only might be a representation of the physical condition brought about by the extent of tumor progression,but also is an independent prognostic factor of survival in gastric cancer.

Preparation and Quality Evaluation of Carboprost Methyl-hydroxypropyl-β-cyclodextrin Clathrate Sublin-gual Tablets / 中国药房

OBJECTIVE:To prepare the Carboprost methyl-hydroxypropyl-β-cyclodextrin (HP-β-CD) clathrate sublingual tab-lets,and conduct quality evaluation. METHODS:Wet granulation method was used to prepare Carboprost methyl-HP-β-CD clath-rate sublingual tablets. Using the appearance,calving time,wetting time and main drug content as investigation indexes,mass ratio of mannitol-lactose,povidone volume fraction and amount of low-substituted hydroxypropylcellulose(L-HPC)as factors,orthogo-nal test was used to screen the formulation. The calving time,wetting time,main drug content,content uniformity,dissolution de-gree of sublingual tablets with optimal formulation were evaluated. RESULTS:The optimal formulation was as follow as 78.82 mg of carboprost methyl-HP-β-CD clathrate (containing carboprost methyl 1 mg),100 mg of mannitol-lactose (mass ratio of 9:1) mixed powder,appropriate amount of 2% povidone solution,30 mg of L-HPC,and 1 mg of magnesium stearate. The calving time of prepared 3 batches of sublingual tablets was(25.30±3.21)-(26.53±2.69)s;wetting time was(64.65±8.07)-(65.54±7.21)s;main drug content was (96.13 ± 0.43)%-(97.06 ± 0.82)%;content uniformity was 5.95-7.68;the cumulative dissolution degree within 10 min was more than 50%,and it can completely dissolute within 30 min. CONCLUSIONS:Carboprost methyl- HP-β-CD clathrate sublingual tablets,which are up to requirements,are prepared successfully.

Effect of essential oil from asarum on percutaneous delivery of sinapine and its mechanism / 中草药

Objective: To study the enhancing effect of essential oil from asarum (EOA) on percutaneous delivery of sinapine and its mechanism. Methods: Transepidermal water loss (TEWL) was determined with Vapo Meter to evaluate the decrease of skin barrier by asarum essential oil. In vitro permeation of sinapine through rat skin was performed in the presence or absence of EOA, and the permeated cumulative amount and retention of sinapine were compared. In vivo percutaneous test was further performed to estimate the improvement of EOA on percutaneous delivery of sinapine. Attenuated total reflection Fourier transform infrared spectroscopy (ATR-FTIR) and differential scanning calorimeter (DSC) were used to evaluate the changes of lipid and protein in stratum corneum. Results: TEWL value increased after the treatment of EOA, which indicated the decrease of skin barrier. The permeated cumulative amount and retention of sinapine in the presence of EOA were higher than those in the absence of EOA, and in vivo percutaneous test further confirmed this issue. After EOA treatment, the lipid and protein disorder could be observed from ATR-FTIR and DSC map, which indicated the increasing of skin permeability. Conclusion: EOA can enhance the percutaneous delivery of sinapine through improving the disorder of lipid and protein of stratum corneum.

A Relevant Research on Changes in Characteristics of N-glycan in Gastric Cancer and Its Relationship with TCM Syndromes / 中国中医药信息杂志

ObjectiveTo discuss the changes in characteristics of N-glycan in gastric cancer and its relationship with TCM syndromes.Methods The blood samples of 138 gastric cancer patients and 120 healthy volunteers were collected. The changes in N-glycan were detected by DNA sequencer-assisted and fluorophore-assisted carbohydrate electrophoresis (DSA-FACE), and differences of N-glycan among different TCM syndromes were compared.Results At least 9 N-glycan peaks could be identified in all samples. Compared with the healthy volunteers, Peak1, Peak5, Peak9 and Peak2 of gastric cancer patients obviously increased (P<0.05,P<0.01), whereas Peak3, Peak6 significantly decreased (P<0.01). Peak6 of gastric cancer in stage I was obviously higher than stages II, III, and IV (P<0.01), while Peak9 in stage I was obviously lower than the other three stages (P<0.01). Peak1 was significantly lower in disharmony between liver and stomach type than stagnation of phlegm-dampness type, interior retention of toxin stagnation type, deficiency of both Qi and blood type (P<0.05,P<0.01);lower in impairment of yin due to stomach heat type, deficiency-cold in spleen and stomach type than deficiency of both Qi and blood type (P<0.01);lower in stagnation of phlegm-dampness type, interior retention of toxin stagnation type than deficiency of both Qi and blood type (P<0.05). Peak6 was higher in disharmony between liver and stomach type than impairment of yin due to stomach heat type, stagnation of phlegm-dampness type, interior retention of toxin stagnation type than deficiency of both Qi and blood type (P<0.01). Peak9 was much higher in deficiency of both Qi and blood type than disharmony between liver and stomach type (P<0.01), impairment of yin due to stomach heat type and deficiency-cold in spleen and stomach type (P<0.05, P<0.01).Conclusion The expression of N-glycan was specifically changed in gastric cancer. These variations could promote the metastasis of gastric cancer and potentially have certain correlation with TCM syndromes.

Antimicrobial prophylaxis in the prevention of incisional infection after tension-free inguinal hernioplasty: a meta-analysia / 中华普通外科杂志

Objective We conducted a systematic review and meta-analysis of the published literature to evaluate the efficacy of prophylactic antibiotics in the prevention of incisional infection of inguinal tension-free hernioplasty.Methods Articles of randomized controlled trials about the efficacy of prophylactic antibiotics in the prevention of incisional infection in the inguinal tension-free hernioplasty published from January 1975 to October 2012 was retrieved and systematically reviewed.Results A total of 11 randomized controlled trials meeting the inclusion criteria were screened.Among the 4159 cases of patients,130 cases had wound infection,and the infection rate was 3.13％.In the prophylactic antibiotics group of 1845 cases,wound infection occurred in 45 cases; the infection rate was 1.94％.In the control group of 2314 cases,85 cases had incision infection; the infection rate was 3.67％.The preventive use of antimicrobial drugs reduced surgical site infection of inguinal tension-free hernioplasty (OR 0.55,95％ CI 0.38-0.80,P =0.002).Conclusions The use of prophylactic antibiotics can effectively reduce the incisional infection in the inguinal tension-free hernioplasty.

Relationship between recurrent spontaneous abortion and the level of interferon-γ and interleukin-4 in peripheral blood and gingival crevicular fluid of patients with chronic periodontitis / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between recurrent spontaneous abortion (RSA) and the level of interferon-γ (IFN-γ) and interleukin-4 (IL-4) in peripheral blood and gingival crevicular fluid of patients with chronic periodontitis.</p><p><b>METHODS</b>Fifty pregnant women with recurrent spontaneous abortion (gestational age: 5 - 28 weeks) and 40 pregnant women (gestational age: 39 - 41 weeks) were included and their periodontal status was examined. The level of IFN-γ and IL-4 in gingival crevicular fluid and peripheral blood was detected by enzyme-linked immunosorbent assay.</p><p><b>RESULTS</b>Nine RSA women and 5 in control group had periodontitis. The prevalence of periodontitis in RSA group was 18% (9/50) and 13% (5/40) in the control group (P < 0.05). The probing depth, attachment loss and bleeding index in RSA group were higher than those in the control group (P < 0.05). The level of IFN-γ was (52.98 ± 17.56) ng/L in gingival crevicular fluid of RSA group and (25.25 ± 7.93) ng/L in control group (P < 0.01). The level of IL-4 was (15.43 ± 1.77) ng/L in gingival crevicular fluid of RSA group and (19.62 ± 4.04) ng/L in control group (P < 0.01). The content of IFN-γ was (27.79 ± 3.59) ng/L in peripheral blood of RSA group and (18.39 ± 2.65) ng/L in control group (P < 0.05). The content of IL-4 was (15.88 ± 0.95) ng/L in peripheral blood of RSA group and (22.98 ± 4.30) ng/L in control group (P < 0.001). The content of cytokines in gingival crevicular fluid and peripheral blood in the same group was positively related (r > 0.8, P < 0.001).</p><p><b>CONCLUSIONS</b>Pregnant women of RSA have a higher chance of getting periodontitis. The change in the level of cytokines in periodontal tissue could result in excursion of maternal intrauterine immune environment to T-helper 1 (Th1). Periodontitis was related to RSA.</p>

The prevalence of parenteral nutrition-associated liver disease and its risk factors in elderly people after gastrointestinal operation / 中华老年医学杂志

Objective To explore the prevalence of parenteral nutrition-associated liver disease (PNALD) and its risk factors in elderly people after gastrointestinal operation. Methods Seventy-five patients received parenteral nutrition (PN) after gastrointestinal operation were retrospectively analyzed. Age, height, body mass index, suftering diseases, history of diseases, time of therapy, total calorie, nonprotein calorie, the kind and amount of fat emulsion and amino acid, the amount of glucose, non-protein energy to nitrogen ratio, ratio of glucose to lipid, liver function, renal function and blood routine were collected. Results The prevalence of PNALD was 25.3% (19/75). The total calorie, nonprotein calorie, the amount of protein, the amount of glucose and ratio of glucose to lipid were obviously higher in PNALD group than in non-PNALD group [(24.0±6.5) vs. (20.7±5.4)kcal·kg-1·d-1, (20.5±5.5)vs. (17.2±4.8)kcal·kg-1·d-1, (1.0±0.3)vs. (0.9±0.2)g ·kg-1·d-1, (2.9±0.9)vs.(2.3±0.9)g·kg-1·d-1, 1.5±0.7 vs. 1.1±0.5; all P<0.05], while the hemoglobin was lower in PNALD group [(97.4±15.1)vs. (110.1±19.1)g/L, P<0.05]. The kind of fat emulsion and amino acid, gender, history of diseases, suftering diseases, body mass index, serum albumin, leukocyte levels and renal function were comparable between the two groups (χ2=0.114,0.843,0.116,0.531,0.344,1.588,0.006,0.063 and 0.549, all P>0.05). Conclusions The prevalence of PNALD is 25.3% in 75 elderly patients after gastrointestinal operation. Total calorie, the amount of glucose and the ratio of glucose to lipid should be reduced in these patients for preventing PNALD.

Multidrug-resistant Clinical Enterobacter cloacae Isolates: Analysis of Their ESBLs Gene Types and Molecular Epidemiology / 中华医院感染学杂志

OBJECTIVE To understand the distribution and epidemiology of ESBLs in ceftazidime or cefotaxime-(resistant) clinical Enterobacter cloacae isolates.METHODS Twenty seven ceftazidime or cefotaxime-resistant(nonrepetitive) E.cloacae were collected from 27 patients hospitalized at the Huashan Hospital,Shanghai.PCR and(sequencing) were performed to understand the distribution of ESBLs in E.cloacae;rep-PCR was(performed) to(understand) the epidemiology of ESBLs in E.cloacae.RESULTS CTX-M-3 like(ESBLs) were the most prevalent in our study(48%);this was the first report of VEB-1-like ESBLs in the member of(Enterobacteriaceae) in China,and the first report of the ESBLs VEB-1-like and CTX-M-3-like in an isolate simultaneously;the majority of(ESBLs) producers exhibited the same rep-PCR pattern,but harbored different ESBLs gene.(CONCLUSIONS) In our study,ESBLs have become prevalent in clinical E.cloacae isolates,and become an important factor of E.cloacae isolates resistant to extended-spectrum beta(-lactams).

Evaluation of Vitapex paste in root canal therapy for infected permanent teeth / 实用口腔医学杂志

Objective:To evaluate the effect of Vitapex in root canal therapy (RCT) for infected permanent teeth.Methods:159 permanent teeth with chronic periapical periodontitis were treated by RCT, and the canals were filled with Vitapex (in 54 teeth),ZOE (in 52 teeth) and ZOE plus iodoform (in 53 teeth) respectively.The effects were evaluated by clinical and radiological observation.Results:The ratio (%) of apical tissue reaction in 3 days following RCT in the group of Vitapex,ZOE and ZOE plus iodoform was 14.8,59.6 and 50.9 (P0.05) respectively.Conclusion:Vitapex is effective in the treatment of infected root canals.