Analysis of Medication Errors in Patients with Hyperuricemia/Gout Based on National Monitoring Network for Clinical Safe Drug Use / 中国药房

OBJECTIVE：To investigate the occurrence of medication errors （ME）in patients with hyperuricemia/gout and its related factors ，in order to avoid and reduce the occurrence of related ADE and ensure the safety of drug use in patients. METHODS：The ME reports related to hyperuricemia/gout were collected from National Monitoring Network for Clinical Safe Drug Use during Sept. 22nd，2012 to Jul. 9th，2020，and then analyzed in terms of reporting provinces ，classification and drugs involved，error content ，initiator and error factors. RESULTS ：A total of 179 ME reports ，which met inclusion criteria ，were included from 47 hospitals in 11 provinces. The drugs involved mainly included benbromarone （36 cases，20.11％），allopurinol （31 cases，17.32％），calcium carbonate D 3（30 cases，16.76％），inverting sugar electrolyte （24 cases，13.41％）and sodium bicarbonate（22 cases，12.29％）. Grade B ME were the most frequently reported （124 cases，69.27％）；severe ME occurred in 3 cases（1.68％）. The main errors were contraindications ，accounting for 70 cases（37.43％，mainly involving calcium carbonate D 3 and inverting sugar electrolyte ）. The people who caused ME were mainly doctors ，involving 126 cases（70.39％，the main content of errors was contraindications ）. The main error factors for ME were personnel factors ，involving 120 cases（67.04％，mainly lacking of knowledge ），followed by environmental factors （33 cases，mainly equipment failure ）. CONCLUSIONS ：ME in patients with hyperuricemia/gout are mainly caused by uric acid-lowering drugs and non-uric acid-lowering drugs that cause changes in uric acid. The main error contents include contraindications ，which were mostly caused by non-uric acid-lowering drugs and doctors. The main error factors are lack of knowledge and equipment failure. It is suggested to strengthen personnel training or introduce clinical medication support decision-making system ，while pay attention to the correct use and maintenance of related equipment in the process of drug use.

Role of type Ⅵ secretion system in the pathogenicity and antibiotic resistance of Acinetobacter baumanii / 中华传染病杂志

Objective:To investigate the role of type Ⅵ secretion system (T6SS) in the pathogenicity and antibiotic resistance of Acinetobacter baumanii. Methods:From January 1 to December 31, 2016, a total of 45 Acinetobacter baumanii isolates were collected from patients with bloodstream infection in the First Affiliated Hospital of Wenzhou Medical University. The susceptibilities to commonly used antimicrobial agents were determined by VITEK 2 Compact automatic microbiology analyzer. Detection of T6SS characteristic gene hemolysin coregulated protein ( hcp) was achieved by polymerase chain reaction. Biofilm formations, serum resistances and competition tests of T6SS-positive/negative Acinetobacter baumanii were performed in vitro. The clinical data of patients with bloodstream infection were collected and analyzed. Chi-square test, t test and Kruskal-Wallis test were conducted for statistical analysis. Results:The positive rate of T6SS in 45 Acinetobacter baumanii isolates was 53.3% (24/45). The resistance rates of T6SS-positive Acinetobacter baumanii to ceftazidime, ciprofloxdcin, gentamicin, imipenem, levofloxacin, piperacillin/tazobactam, tobramycin and cefepime (95.8%, 95.8%, 66.7%, 95.8%, 79.2%, 95.8%, 79.2%, 91.7%)were all higher than that of T6SS-negative Acinetobacter baumanii (28.6%, 28.6%, 28.6%, 28.6%, 9.5%, 23.8%, 23.8%, 28.6%), and the differences were all statistically significant ( χ2=22.12, 22.12, 6.51, 22.12, 21.83, 24.72, 13.79, 18.97, respectively, all P<0.05). The biofilm formation ability, serum resistance and competitive ability of T6SS-positive Acinetobacter baumanii were stronger than those of T6SS-negative Acinetobacter baumanii, and the differences were all statistically significant ( t=4.99, Z=-2.61 and -2.27, respectively, all P<0.05). The positive rate of T6SS isolated from intensive care unit (ICU) ward (80.0%, 16/20) was significantly higher than that from non-ICU ward (32.0%, 8/25; χ2=10.29, P<0.05). But T6SS had no effect on the prognosis of patients ( χ2=1.74, P=0.188). Conclusions:T6SS of Acinetobacter baumanii is associated with high pathogenicity, and the high drug resistance rate makes treatment extremely difficult. Physicians need to pay much attention, especially to the patients from ICU wards.

Resistance mechanisms and molecular epidemiology of chlorhexidine acetate-resistant Klebsiella pneu-moniae clinical isolates / 中华微生物学和免疫学杂志

Objective To investigate the chlorhexidine acetate-resistance in Klebsiella pneumoniae ( K. pneumoniae) clinical isolates and to analyze the possible mechanisms and molecular epidemiology of re-sistant isolates. Methods A total of 332 K. pneumoniae clinical isolates were collected in the First Affilia-ted Hospital of Wenzhou Medical University in 2015. Standard agar dilution was used to screen chlorhexidine acetate-resistant isolates. The minimum inhibition concentrations ( MIC) of chlorhexidine acetate to resistant isolates with and without the presence of carbonyl cyanide m-chlorophenyl hydrazone ( CCCP) , which was an efflux pump inhibitor, were analyzed. Efflux pump genes of cepA, qacE and qacΔE1 that carried by and ex-pressed in those isolates were detected by polymerase chain reaction ( PCR) and quantitative real-time PCR ( RT-qPCR) , respectively. The biofilm formation ability was measured by crystal violet staining. The homol-ogy among the chlorhexidine acetate-resistant isolates was investigated with multilocus sequence typing ( MLST) and pulsed-field gel electrophoresis ( PFGE) . Results Twenty-five K. pneumoniae strains were re-sistant to chlorhexidine acetate. The MIC values of chlorhexidine acetate for them were reduced by at least four-fold in the presence of CCCP. Strains carrying the genes of cepA, qacE and qacΔE1 accounted for 100％, 40％ and 40％, respectively. The expression of the efflux pump genes in the chlorhexidine acetate-resistant isolates was higher than that in the susceptible isolates. The biofilm formation ability of the chlo-rhexidine acetate-resistant isolates was better than that of the susceptible isolates. Furthermore, negative, weak-positive and positive biofilm formation ability was observed in four ( 16％) , 20 ( 80％) and one (4％) strains, respectively. The results of MLST and PFGE showed that the 25 chlorhexidine acetate-resist-ant isolates belonged to 19 different sequence types ( ST) with diverse PFGE patterns. Conclusions This study suggested that active efflux was the main mechanism of chlorhexidine acetate resistance in K. pneumoni-ae. The 25 chlorhexidine acetate-resistant K. pneumoniae strains possessed different biofilm formation ability and shared low homology.

In vitro antibacterial activity of triclosan in combination with different antibacterial agents against triclosan-resistant multidrug-resistant Acinetobacter baumannii / 中华微生物学和免疫学杂志

Objective@#To investigate the in vitro antibacterial activity of triclosan combined with different antibacterial agents against triclosan-resistant multidrug-resistant Acinetobacter baumannii (A.baumannii).@*Methods@#A total of 626 A. baumannii strains were collected from the First Affiliated Hospital of Wenzhou Medical University from 2016 to 2017. The sensitivity of these A. baumannii strains to common antibiotics was detected by VITEK 2-compact automatical microbiological analyzer and the minimum inhibitory concentrations (MIC) of triclosan were detected by agar dilution method. Checkerboard method was used to detect the changes in MIC values of triclosan against 16 triclosan-resistant multidrug-resistant A. baumannii strains after it was used in combination with four external ointments, including gentamicin, erythromycin, chloramphenicol and kanamycin, and three common antibiotics of imipenem, meropenem and ciprofloxacin, respectively. Fractional inhibitory concentration index (FICI) was used to evaluate the joint bacteriostatic effects.@*Results@#Among the 626 A. baumannii strains, 17 were resistant to triclosan with a drug resistance rate of 2.7% (17/626). These triclosan-resistant strains had high MIC values for ciprofloxacin, imipenem, ceftazidime and other commonly used clinical antibiotic and most of them were multidrug-resistant. After triclosan was used in combination with seven different antibacterial drugs, the MIC values of all drugs decreased to various degrees compared with those when they were used alone. Triclosan in combination with gentamicin, chloramphenicol and ciprofloxacin showed synergistic effects on 62.5%, 56.25% and 62.5% of the 16 strains and additive effects on 37.5%, 43.75% and 37.5%, respectively. When it was used in combination with erythromycin, kanamycin, imipenem and meropenem, synergistic effects on 37.5%, 25%, 12.5% and 12.5%, additive effects on 37.5%, 56.25%, 62.5% and 62.5%, and indifferent effects on 25%, 18.75%, 25% and 25% of the strains were detected, respectively. No antagonistic effect was found between triclosan and any of the above antibiotics.@*Conclusions@#Triclosan combined with gentamicin, chloramphenicol and ciprofloxacin had better in vitro antibacterial effects against the triclosan-resistant multidrug-resistant A. baumannii strains in this study with synergistic and additive effects. Some indifferent effects were found between triclosan and kanamycin, erythromycin, imipenem and meropenem, but no antagonistic effects were detected.

In vitro antibacterial activity of triclosan in combination with different antibacterial agents against triclosan-resistant multidrug-resistant Acinetobacter baumannii / 中华微生物学和免疫学杂志

Objective To investigate the in vitro antibacterial activity of triclosan combined with different antibacterial agents against triclosan-resistant multidrug-resistant Acinetobacter baumannii ( A. bau-mannii) . Methods A total of 626 A. baumannii strains were collected from the First Affiliated Hospital of Wenzhou Medical University from 2016 to 2017. The sensitivity of these A. baumannii strains to common an-tibiotics was detected by VITEK 2-compact automatical microbiological analyzer and the minimum inhibitory concentrations ( MIC) of triclosan were detected by agar dilution method. Checkerboard method was used to detect the changes in MIC values of triclosan against 16 triclosan-resistant multidrug-resistant A. baumannii strains after it was used in combination with four external ointments, including gentamicin, erythromycin, chloramphenicol and kanamycin, and three common antibiotics of imipenem, meropenem and ciprofloxacin, respectively. Fractional inhibitory concentration index ( FICI) was used to evaluate the joint bacteriostatic effects. Results Among the 626 A. baumannii strains, 17 were resistant to triclosan with a drug resistance rate of 2. 7％ (17/626). These triclosan-resistant strains had high MIC values for ciprofloxacin, imipenem,ceftazidime and other commonly used clinical antibiotic and most of them were multidrug-resistant. After tri-closan was used in combination with seven different antibacterial drugs, the MIC values of all drugs de-creased to various degrees compared with those when they were used alone. Triclosan in combination with gentamicin, chloramphenicol and ciprofloxacin showed synergistic effects on 62. 5％, 56. 25％ and 62. 5％of the 16 strains and additive effects on 37. 5％, 43. 75％ and 37. 5％, respectively. When it was used in combination with erythromycin, kanamycin, imipenem and meropenem, synergistic effects on 37. 5％, 25％, 12. 5％ and 12. 5％, additive effects on 37. 5％, 56. 25％, 62. 5％ and 62. 5％, and indifferent effects on 25％, 18. 75％, 25％ and 25％ of the strains were detected, respectively. No antagonistic effect was found between triclosan and any of the above antibiotics. Conclusions Triclosan combined with genta-micin, chloramphenicol and ciprofloxacin had better in vitro antibacterial effects against the triclosan-resist-ant multidrug-resistant A. baumannii strains in this study with synergistic and additive effects. Some indiffer-ent effects were found between triclosan and kanamycin, erythromycin, imipenem and meropenem, but no antagonistic effects were detected.

Sex difference in brain structures of hippocampus and parahippocampus among patients with bipolar type I disorder / 中国神经精神疾病杂志

Objective This study aims to investigate the sex difference in the hippocampus and parahippocampus in patients with bipolar disorder. Methods We acquired T1－weighted structural MRI from 133 bipolar type I patients (60 males) and 144 normal controls (81 males). The General Linear Model was used to examine the relationship between sex and brain volumes of the hippocampus and parahippocampus, with age and intracranial volume as covariates. Results Patients showed significantly smaller volumes of the bilateral hippocampus and parahippocampus (P＜0.01). There were sex－by－diagnosis interactions in the left parahippocampus gyrus (F=6.534, P=0.044). Male patients had significant smaller volumes of the left parahippocampus gyrus compared to the male normal controls (P＜0.001) whereas the volumes were not significantly different between female patients and female normal controls (P＞0.05). Conclusion The results suggest sex difference in the left parahippocampus gyrus volume in patients with bipolar type I disorder, which deserves further investigation in the future bipolar imaging researches.

Biological functions of apoptosis stimulating protein of p53 2 and its role in liver diseases / 临床肝胆病杂志

Apoptosis stimulating protein of p53 2 (ASPP2) is a member of the apoptosis stimulating proteins of p53 and can specifically bind to the core region of p53 protein and enhance the ability of p53 to promote transcription of apoptotic genes. At present, it is believed that ASPP2 plays an important role in regulating cell apoptosis, autophagy, proliferation and affecting the progression of inflammation and tumors. This article summarizes the main biological functions of ASPP2 and the research advances in the role of ASPP2 in hepatocellular carcinoma, hepatitis C, and nonalcoholic fatty liver disease. Studies have shown that ASPP2 can regulate cell apoptosis and may be a potential therapeutic target for a variety of diseases.

Analysis of prevalence and related factors of osteoporosis in retired population based on Dongfeng-Tongji Cohort / 中华预防医学杂志

Objective@#To investigate the prevalence and related factors of osteoporosis among retired population in Dongfeng-Tongji cohort.@*Methods@#27 009 retired participants were recruited from Dongfeng Motor Corporation in Hubei Province in 2008 and followed up from April to October in 2013. newly retired participants also were recruited. Data were collected by using questionnaire, physical examination, serum hepatase detection and bone densitometry. Totally, 30 916 participants were included for data analysis after excluding participants with severe bone metabolic diseases, taking hormone drugs, incomplete follow-up data and who were under 45 years old. Age-standardized prevalence of osteoporosis was calculated according to data of the 2010 Sixth National Population Census. Multivariate logistic regression analysis was applied to explore the associated factors of osteoporosis.@*Results@#Prevalence of osteoporosis was 42.3% (13 083/30 916) and age standardized prevalence was 40.7%: 35.0% (4 854/13 878) and 34.8% for males; 48.3% (8 229/17 038) and 47.1% for females. Significantly associated factors with osteoporosis for both males and females included: older age (male: OR=1.67, 95%CI: 1.40-1.99; female:OR=3.34, 95%CI: 2.70-4.13), lower BMI (male: OR=1.70, 95%CI: 1.40-2.06; female: OR=1.27, 95%CI: 1.04-1.53), exercise (male: OR=0.69, 95%CI: 0.61-0.78; female: OR=0.87, 95%CI: 0.80-0.96), abnormal elevated serum alkaline phosphatase (ALP) (male: OR=1.12, 95%CI: 1.01-1.24; female: OR=1.15, 95%CI: 1.06-1.25), γ-glutamyltransferase (γ-GT) (male: OR=1.16, 95%CI: 1.02-1.30; female: OR=1.13, 95%CI: 1.03-1.24) and aspartate transaminase/alanine aminotransferase (AST/ALT) (male: OR=1.15, 95%CI: 1.05-1.25; female: OR=1.28, 95%CI: 1.19-1.38). Smoking (OR=1.27, 95%CI: 1.07-1.39) and drinking (OR=1.11, 95%CI: 1.08-1.16) were associated factors for males while menopausal (OR=1.67, 95%CI: 1.47-1.89) for females. There were positive dose-response correlation relationships of serum levels of ALP, γ-GT and AST/ALT with osteoporosis (all P values<0.05).@*Conclusion@#Osteoporosis was relatively common among retired population in Dongfeng-Tongji cohort. In addition to known factors such as older age, lower BMI and exercise, abnormal elevated serum ALP, γ-GT and AST/ALT were also associated with osteoporosis.

Association of alcohol use and incidence of type 2 diabetes mellitus in the middle-aged and elderly male population: a prospective cohort study / 中华预防医学杂志

Objective@#To investigate the association between alcohol use and incidence of type 2 diabetes mellitus (T2DM) in the middle-aged and elderly male population.@*Methods@#All participants were from Dongfeng-Tongji cohort, 27 009 retired employees from Dongfeng Motor Corporation in Hubei Province were enrolled in the Dongfeng-Tongji cohort baseline survey in 2008. In baseline study, information of alcohol use and other covariates were collected by semi-structured questionnaire and all participants completed physical examination including the test of fasting glucose and blood lipid levels. A total of 6 784 male participants from Dongfeng-Tongji cohort who were without diagnosis of diabetes, coronary heart disease, stroke, or cancer in baseline study were enrolled in this study. We completed the first follow-up in 2013 and the outcome of disease or death was retrieved based on health-care medical records according to the unique medical insurance ID. Cox proportional hazard regression model was used to estimate the association between alcohol use and incidence of type 2 diabetes mellitus (T2DM), by drinking features and patterns.@*Results@#Out of the 6 784 participants, 3 541 participant were defined as non-alcohol drinkers and there were 15 852.2 person-years of follow-up; among which 270 new cases of T2DM were diagnosed withthe crude incidence density of non-alcohol drinkers at 1 703.2/100 000 person-years. The other 3 243 subjects were classified as alcohol drinkers and there were 14 509.8 person-years of follow-up; and among which 258 new cases of T2DM were diagnosed, with the crude incidence density of T2DM at 1 778.1/100 000 person-years. Multivariate COX proportional hazard regression model indicated that there was no significantly increased risk of T2DM incidence between alcohol drinkers and non-alcohol drinkers(HR(95% CI): 1.09 (0.91- 1.30)). However, participants who averagely consumed >20 g/d or>7 times/week had a significantly increased risk of T2DM compared with non-alcohol drinkers, and the value of HR(95%CI) was 1.27 (1.02- 1.58) and 1.35 (1.00- 1.83), respectively. Among men who consumed alcoholic beverages more than 7 times/week, HR (95%CI) for T2DM incidence in the subjects who consumed 0.01 to 40 g and > 40 g once a time were 1.48 (1.05- 2.09) and 1.27 (0.80- 2.10), respectively.@*Conclusion@#Although we found no relationship between alcohol use and T2DM incidence overall, alcohol use more than 20 g/d or more than 7 times/week would increase the risk of T2DM.

Radial artery perforator flap for repair of soft tissue defect after palm postoperative scar contracture / 中国医师进修杂志

Objective To explore the clinical effect of the radial artery perforator flap on repairing soft tissue defect after palm postoperative scar contracture. Methods Eighteen patients with palm scar contracture were selected. The palm soft tissue defect was repaired by radial artery perforator flap after the operation of scar removal and soft tissue release. The areas of soft tissue ranged from 5 cm × 3 cm to 8 cm × 5 cm. The area of donor flap exceeds 20%of the wounds area, and wounds were repaired by free skin grafting. Six months after operation, the hand function was compared with that before operation. Results All the patients were followed up for 6-15 months (mean 10.8 months), all flaps survived with good shape, and flap donor site wounds were healed by skin grafting. The patients were evaluated 6 months after operation according to the Chinese Medical Hand Surgery Society of upper part of functional assessment criteria: excellent in 11 cases, good in 5 cases and general in 2 cases, but preoperative functional evaluation was excellent 0 case, good in 3 cases, general in 7 cases and poor in 8 cases. Compared with that before operation, the postoperative function was significantly improved. Conclusions It is a commendable approach of repairing soft tissue defect after postoperative palm scar contracture by radial artery perforator flap, because it can provide reliable blood supply, and significantly improve hand function with exactly clinical effect.

Effects of α-enolase silencing on drug resistance in drug resistant cell line K562/A02 / 中国药理学通报

Aim Drug resistance is one of the major hinders on cancer treatments. α-enolase ( eno1 ) was closely related to the generation and development of drug resistance. This article aims to study the effect of eno1 on cell growth and drug resistance in human chro-nic myeloid leukemia cell line K562/A02 . Methods We screened three eno1 stable silencing cells K562/A02-sheno1 and its control cells K562/A02-shcon. Cell count assay was performed to test cell growth, MTT assay was used to test cell proliferation, flow cytometry was used to test the intra-cellular Rho123 content, the expression of genes were tested by real-time PCR assay and western blot assay on mRNA level and protein level, respectively. Results eno1 was o-ver-expressed in K562/A02 cells and its expression was increased by ( 2. 85 ± 0. 56 ) times and ( 1. 43 ± 0. 05 ) times on mRNA level and protein level com-pared to K562 cells. However, there was no difference in cell growth rate between K562/A02 cells and K562 cells. K562/A02-sheno1 cells showed lower cell growth rate and higher drug sensitivity to anti-cancer drugs taxol and doxorubicin. Moreover the Rho123 content was increased in K562/A02-sheno1 cells. The expression of MDR1 decreased in both mRNA level and protein level in K562/A02-sheno1 cells. Conclusion eno1 silencing could suppress cell growth, reverse drug resistance and increase its drug sensitivity in K562/A02 cells, and the mechanism was associated with the MDR1 gene.

Detection of Treponema pallidum by immunohistochemistry in secondary syphilitic lesions / 中华皮肤科杂志

ObjectiveTo evaluate the diagnostic value of immunohistochemistry(IHC) for the identification and localization of Treponema pallidum(TP) in secondary syphilitic lesions.MethodsSkin tissue specimens were obtained from the lesions of 25 patients with secondary syphilis and 15 patients with dermatoses unrelated to TP infection,followed by fixation and embeding.IHC using a polyclonal antibody against TP and Warthin-Starry (W-S) silver stain were carried out respectively to detect TP in these specimens.Results TP was detected in 80.00％ (20/25) of the specimens by IHC,44.00％ by W-S silver stain (Fisher's Exact Test,P =0.046).Of the 20 IHC-based TP-positive specimens,all harbored TP in the epidermis,11 also in the dermis.The density of TP was associated with the types of skin lesions,and sequentially decreased from condyloma latum to papules,maculopapules and maculae(x2 =15.694,P =0.011 ).Spirochetes were not seen in any of the control lesional specimens.ConclusionsIHC is superior to traditional W-S silver stain for detecting spirochetes in secondary syphilitic lesions,and is of great value to the diagnosis of secondary syphilis.The accurate localization of TP by IHC may facilitate the study on the formation of syphilitic lesions.

PSF/SFPQ relocated on cell membrane in hematologic neoplasia, a potential MDR target of hematologic tumors / 白血病·淋巴瘤

Objective To identify multidrug resistance (MDR) associated cell surface antigen in hematologic neoplasia and to investigate the universality of membrane-relocated expression of this antigen in hematologic neoplasia.Methods The membrane antigen was isolated and precipitated by SDS-PAGE and co-immunoprecipitation (co-IP),then was identified by mass spectrum (MS).Specific siRNA was used to interfere with gene expression,laser confocal microsopy was used to validate the results involved in antigen information.FACS was performed to analyse relocated expression of the antigen in hematologic neoplasia.Results Co-IP and MS show that a nuclear factor PSF was the antigen of 5D12,a leukemia-MDR associated McAb,and this antigen could relocate on HL-60 cell membrane.A series of experiences further confirmed that PSF overexpressed on HL-60 cell membrane compared with HL-60/ADR.The binding percentages of 5D12 to many hematologic tumor cells were observed,HL-60 (78.56±0.76) ％,K562 (26.54±4.42) ％,Nomalwa (38.10±5.11) ％,U937 (64.03±7.96) ％,Jurkat (29.12±5.58) ％,Raji (74.92±3.41) ％,CEM (12.18±3.21) ％.Conclusion Nuclear protein,PSF relocalizes on cell surfaces in hematologic tumor cells and contributes to cell sensitivity.PSF is a potential target of MDR prediction in hematologic neoplasia.

The new method for transfection of macromolecules into cells using protein transductions domain / 白血病·淋巴瘤

Objective To construct a fusion protein to transfect some cell lines that were difficult to be transfected such as neoplastic cells, nerve cells, stem cells. Methods PCR was performed to amplified protein transductions domain(PTD),G4S and streptavidin (Strep).Enzymatic digestion and ligation were used to construct pAYZ-PTD-Strep plasmid. Fusion protein was induced to express by AP5 medium and was isolated by E-tag affinity chromatography. Fusion protein was identified by Western blot. eGFP was trasfected into U937 cells by pAYZ-PTD-Strep. FACS was performed to detect transfection percentage. Results Fusion protein PTD-G4S-Strep was expressed as soluble protein.The concentration of fusion protein was about 0.7 mg/L,and purity was over 90 ％. The protein could carry plasmid into a suspended cell line, U937 cells. The transfection-efficiency of protein was higher than monometer PTD.Conclusion The protein PAYZ-PTD-Strep could carry macromolecules into blood tumor cells,and its biological activity may be expected to develop into a highly efficient and reliable transfection method.

Effect of comprehensive rehabilitation on craniocerebral trauma / 中国康复理论与实践

@#ObjectiveTo study the effect of comprehensive rehabilitation on the patients with craniocerebral trauma. Methods85 cases with craniocerebral trauma were subjected to the rehabilitation training supplemented with hyperbaric oxygen and acupuncture and ultrasound therapy in addition to routine neurosurgical operation. Before and after treatment,Glasgow coma scale (GCS), Fugl-Meyer assessment (FMA) and Barthel index were assessed and compared. ResultsAfter comprehensive rehabilitation therapy, the degree of coma, limbs motion and activities of daily living were improved significantly (P<0.01).ConclusionComprehensive rehabilitation is effective on the patients with craniocerbral trauma.

Treatment of Condyloma Acuminatum with Imiquimod Cream:A Randomized,Double-blind,Place-bo-controlled,Multi-central Clinical Trial / 中华皮肤科杂志

Objective To observe the clinical efficacy and safety of5%imiquimod cream in the top-ical treatment of condyloma acuminatum(CA).Methods A randomized,double-blind,parallel placebo-controlled clinical study was conducted.The test drug was topically used in CA patients,three times a week for8weeks.Patients whose warts cleared completely were followed up for one month to determine recurrence rates.Results Two hundred fifty-eight patients with anogenital warts were enrolled into this trial.One hun-dred twenty-nine patients were randomly selected to receive5%imiquimod cream;129patients were ran-domly chosen to receive placebo cream.Results showed that the cure rates were12.30%,32.79%,50%,60.66%respectively in study group for2,4,6,8weeks and were4.88%,14.63%,19.51%,26.02%respec-tively in control group for2,4,6,8weeks(P

Clinical and laboratory features of preleukemia patients / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To explore prospective diagnostic criteria for preleukemia.</p><p><b>METHODS</b>A case control study was done comparing the discrepancies on clinical and laboratory features between patients with preleukemia and those with chronic aplastic anemia (CAA) or atypical paroxysmal nocturnal hemoglubinuria (a-PNH).</p><p><b>RESULTS</b>There were eight variables of significance: (1) lymphocytoid micromegakaryocytes in the bone marrow; (2) immature granulocytes in the peripheral blood; (3) > or = 2.0% myeloblasts in the bone marrow; (4) positive periodic acid schiff (PAS) stained nucleated erythrocytes; (5) myeloid differentiation index > or = 1.8; (6) typical colonal karyotypic abnormalities; (7) negative sister chromatid differentiation; (8) cluster/colony ratio of granulocyte-macrophage colony-forming units (CFU-GM) > 4.0. The following criteria were assigned: A: to meet variable one and at least two of the other seven variables and B: to meet at least four of the eight variables. All of the patients with preleukemia met either A or B and none of the patients with CAA or a-PNH did.</p><p><b>CONCLUSIONS</b>Preleukemia is different from CAA or a-PNH. It has its own clinical and laboratory features, which may be useful for its prospective diagnosis.</p>

Clinical analysis of 78 cases of paroxysmal nocturnal hemoglobinuria diagnosed in the past ten years / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To learn more about the clinical and laboratory features of patients with paroxysmal nocturnal hemoglobinuria (PNH) diagnosed in the past ten years.</p><p><b>METHODS</b>Clinical and laboratory data for 78 cases of PNH diagnosed from January 1990 to November 1999 in our hospital were analyzed retrospectively.</p><p><b>RESULTS</b>In comparison with PNH cases reported in the 1980s, the newly diagnosed PNH cases showed the following features: (1) older age of disease onset (from 27 to 34 years); more female cases (from 18.5% to 38.5%); more cases without hemoglobinuria (from 24.2% to 38.5%). (2) No positive family hereditary history. (3) Bone marrow dysplasia, abnormal karyotype and negative sister chromatid differentiation were found in 19.2%, 12.2% and 8.9% of the PNH patients, respectively. 12.3% of the patients had bone marrow hypoplasia, and most of them had no hemoglobinuria. Ham's tests were negative in about 34.2% of the cases. CD55 and CD59 on peripheral blood cells were deficient in 100.0% of the cases, suggesting that CD55 and CD59 tests can improve the diagnosis of PNH. (4) Adrenocortical hormone was effective in 83.8% of the patients, 54.2% of whom relapsed within one year. Eight refractory and relapsed patients were treated with low dose chemotherapy (MP therapy: Melphalan 2 - 6 mg x d(-1); Prednisone 0.5 mg x kg(-1) x d(-1)). Five (62.5%) of them showed positive responses. Bone marrow failure and other side effects were not serious in this group of patients.</p><p><b>CONCLUSIONS</b>PNH, an acquired blood disease seen more often among adult males, can be diagnosed more sensitively by hemocyte member CD55 and CD59 tests and treated more effectively with adrenocortical hormone or low dose chemotherapy.</p>

A long-term follow-up study of 50 patients with severe aplastic anemia who have survived more than 3 years after immunosuppressive therapy / 中华血液学杂志

<p><b>OBJECTIVE</b>To evaluate the long-term outcome of immunosuppressive therapy (IST) in patients with severe aplastic anemia (SAA).</p><p><b>METHODS</b>Hematopoietic recovery (peripheral blood cell counts, bone marrow aspirates, bone marrow biopsy, in vitro culture of hematopoietic progenitors), immunity of T lymphocyte, quality of life and side-effects of the therapy were assessed in 50 SAA patients who have survived more than 3 years after IST.</p><p><b>RESULTS</b>At 3 years, 4 years and 5 years follow-up, 81.5% (13 cases), 86.7% (13 cases) and 89.5% (17 cases) of the SAA patients reached and maintained normal peripheral blood cell counts, 93.4% (15 cases), 93.3% (14 cases) and 94.7% (18 cases) showed normal bone marrow pictures, and 37.5% (6 cases), 40.0% (6 cases) and 73.7% (14 cases) had normal yields of bone marrow cell culture, respectively. Overall, 86.0% (43 cases), 94.0% (47 cases) and 52.0% (26 cases) of the total SAA patients were normalized in peripheral blood counts, bone marrow picture and culture of hematopoietic progenitor yields, respectively. During the follow-up, 88.0% (44 cases) of the patients achieved 100 of Karnofsky scores; 26 of the 31 patients (83.9%) who received bone marrow biopsy showed normal histological pictures, and 29 of 37 patients (78.4%) tested had normal subsets of T lymphocytes. No clonal disease was found. The late side-effects of IST were mild. All of the parameters tested were normal in 24 patients.</p><p><b>CONCLUSION</b>After IST, the hematopoietic function of bone marrow, the immunity of the T lymphocyte and the life quality were normalized with few side-effects in patients with SAA. These patients would probably be cured.</p>

Treatment of Condyloma Acuminata with 5% Imiquimod Cream: A Randomized Double-Blind, Placebo-Controlled, Multi-Center Clinical Tria / 中华皮肤科杂志

Objective To observe the clinical efficacy and safety of 5% imiquimod cream in topical treatment of anogenital warts. Methods A randomized, double-blind, parallel placebo-controlled clinical study was conducted. Patients with anogenital warts were instructed to apply the test drug topically and then clean the drug with water 6 ~ 8 hours later, three times a week for 8 weeks. Patients whose warts cleared completely were followed up for one month to determine recurrence rates. Results Two hundred and thirty-one patients with anogenital warts were enrolled in this trial. One hundred and sixteen patients were randomly selected to receive 5% imiquimod cream; and the other receive placebo cream. For 2, 4, 6, 8 weeks, the cure rates were 8.41%, 30.84%, 49.53%, 61.68%, respectively in the study group, and 2.68%, 7.14%, 16.07%, 24.11%, respectively in the control group (P