The association of air pollutants with hospital outpatient visits for child and adolescence psychiatry in Shenzhen, China.

BACKGROUND: Although exposure to ambient air pollution has been associated with mental disorder, little is known about its potential effects on children and adolescents, especially in Chinese population. We aimed to reveal the relationship of air pollutants with hospital outpatient visits for child and adolescence psychiatry (HOVCAP) in Shenzhen. METHODS: A case-crossover study based on time-series data was applied, and a distributed lag non-linear model (DLNM) was used to evaluate the non-linear and delayed effects of 4 major air pollutants (NO2, PM2.5, SO2 and O3) on HOVCAP. Least absolute shrinkage and selection operator (LASSO) regression was used to control the multicollinearity between covariates and to filter variables. RESULT: A total of 94,660 cases aged 3-18 were collected from 2014 to 2019 in the Mental Health Center of Shenzhen. Results of pollutants at mode value (M0) showed that in the single lag effect result, when the average daily concentration of NO2 at 24 µg/m3, there was a significant effect on HOVCAP over lag 1, lag 4 and lag 5, respectively. The cumulative RR of NO2 M0 value to the outpatient visits were 1.438 (1.137-1.818) over lag 0-2, 1.454 (1.120-1.887) over lag 0-3, 1.466 (1.084-1.982) over lag 0-4, 1.680 (1.199-2.354) over lag 0-5, 1.993 (1.369-2.903) over lag 0-6, and 2.069 (1.372-3.119) over lag 0-7. However, PM2.5, SO2, O3 were not associated with HOVCAP over neither single lag effects nor cumulative effects. The RR values both shown an increase either when NO2 increases by 10 units or when the maximum concentration of NO2 is reached. CONCLUSION: Our study suggests that exposure to the normal air quality of NO2 in Shenzhen may associated with the risk of HOVCAP. However, PM2.5, SO2, O3 were not associated with HOVCAP.

Technology and principle of improving solubility of Dioscoreae Rhizoma formula granules based on powder modification / 中国中药杂志

The powder modification technology was used to improve the powder properties and microstructure of Dioscoreae Rhizoma extract powder, thereby solving the problem of poor solubility of Dioscoreae Rhizoma formula granules. The influence of modifier dosage and grinding time on the solubility of Dioscoreae Rhizoma extract powder was investigated with the solubility as the evaluation index, and the optimal modification process was selected. The particle size, fluidity, specific surface area, and other powder properties of Dioscoreae Rhizoma extract powder before and after modification were compared. At the same time, the changes in the microstructure before and after modification was observed by scanning electron microscope, and the modification principle was explored by combining with multi-light scatterer. The results showed that after adding lactose for powder modification, the solubility of Dioscoreae Rhizoma extract powder was significantly improved. The volume of insoluble substance in the liquid of modified Dioscoreae Rhizoma extract powder obtained by the optimal modification process was reduced from 3.8 mL to 0 mL, and the particles obtained by dry granulation of the modified powder could be completely dissolved within 2 min after being exposed to water, without affecting the content of its indicator components adenosine and allantoin. After modification, the particle size of Dioscoreae Rhizoma extract powder decreased significantly, d_(0.9) decreased from(77.55±4.57) μm to(37.91±0.42) μm, the specific surface area and porosity increased, and the hydrophilicity improved. The main mechanism of improving the solubility of Dioscoreae Rhizoma formula granules was the destruction of the "coating membrane" structure on the surface of starch granules and the dispersion of water-soluble excipients. This study introduced powder modification technology to solve the solubility problem of Dioscoreae Rhizoma formula granules, which provided data support for the improvement of product quality and technical references for the improvement of solubility of other similar varieties.

Cause Analysis and Solution Strategy of Poor Solubility of Dioscoreae Rhizoma Formula Granules / 中国实验方剂学杂志

Dioscoreae Rhizoma formula granules are made from decoction pieces by decocting， extracting， separating， concentrating， drying and granulating， which have the advantages of simple dispensing， convenient use and easy to take without decoction. However， because Dioscoreae Rhizoma is rich in starch and mucus components， its extract powder and formula granules are poorly soluble and difficult to dissolve or disperse completely within 5 min， and the insoluble material is difficult to dissolve completely even after 24 h in water， which affects the quality evaluation of the formula granules and medication psychology of patients. Therefore， by studying the dissolution process and mechanism of Dioscoreae Rhizoma extract and its formula granules， it was found that the special chemical composition of Dioscoreae Rhizoma， the denaturation of starch and its compounding with protein and other substances during the high temperature extraction process， and the contraction of coating membrane during the spray drying process were combined to form the special microstructure of coating membrane covering starch granules， and it is the root cause of poor solubility of Dioscoreae Rhizoma formula granules. Based on the research on the structure， property and function of the powder， this paper proposed a technical strategy to improve the solubility of Dioscoreae Rhizoma formula granules by powder modification process， and experimentally demonstrated that the modified Dioscoreae Rhizoma formula granules could completely dissolve within 2 min， which solved the technical problem and could provide reference for the improvement of solubility of other similar varieties， and promote the high-quality development of traditional Chinese medicine formula granule industry.

Modifying Anti-Compression Property and Water-Soluble Ability of Polyglycolic Acid via Melt Blending with Polyvinyl Alcohol.

Biodegradable polymeric materials have become the most attractive research interest in recent years and are gradually widely used in various fields in the case of environmental pollution. In this paper, binary blends, mainly including varying contents of polyglycolic acid (PGA) and poly(vinyl alcohol) (PVA), were prepared via a melt compounding strategy. The ethylene-methyl acrylate-glycidyl methacrylate (EMA-GMA) was employed as the compatibilizer to improve the compatibility between the PGA and PVA and the polyolefin elastomer (POE) was used as toughening agent. The anti-compression property and water-soluble ability of the blends were particularly studied to explore their potential application in an oil/gas exploitation field. Special attentions were paid to the evolution of the water-soluble ability of PGAX with the PVA concentration. Furthermore, isothermal shear measurement and thermogravimetric analysis were performed to evaluate the thermal stability of PGA and PGA blends (PGAX) during melt processing. The results showed that the incompatibility between PGA and PVA largely deteriorated the mechanical property, i.e., anti-compression strength, leading to fragile characteristics under a lower compressive load for the PGAX samples with varied contents of PVA. The presence of PVA and EMA-GMA greatly enhanced the viscoelasticity of the PGA melt, showing an increased storage modulus and viscosity at a low shear frequency; however, the thermal instability of PGAX was intensified owing to the greater ease of thermal degradation of PVA than that of PGA. Meanwhile, the water-soluble ability of PGAX was improved due to the high water dissolution of PVA, which played the role as a sacrificial material. The purpose of this work is to pursue an effective modification for PGA processing and application via melt blending.

Mycobacterium tuberculosis ESAT6 modulates host innate immunity by downregulating miR-222-3p target PTEN.

Tuberculosis (TB) remains a major cause of mortality and morbidity worldwide, and it is instant to discover novel anti-TB drugs due to the rapidly growing drug-resistance TB. Mycobacterium tuberculosis (Mtb) secreted effector ESAT6 plays a critical role in modulation miRNAs to regulate host defense mechanisms during Mtb infection, it can be a possible target for new tuberculosis drugs. The non-tuberculous mycobacteria Mycobacterium smegmatis (M. smegmatis) and Mtb have high gene homology but no pathogenicity. We used ESAT6 to interfere with macrophages or mice infected by M. smegmatis and determined that it enhanced the survival rate of bacteria and regulated miR-222-3p target PTEN. Expression of miR-222-3p reduced and PTEN enhanced with the progression of macrophages infected by M. smegmatis with ESAT6 co-incubation. MiR-222-3p overexpression diminished M. smegmatis survival and upregulated proinflammatory cytokines. VO-Ohpic trihydrate (PTEN inhibitor) reduced M. smegmatis survival and upregulated proinflammatory cytokines in vivo and in vitro, and VO-Ohpic trihydrate reversed the tissue damage of mouse organs caused by ESAT6. These results uncover an ESAT6 dependent role for miR-222-3p and its target PTEN in regulating host immune responses to bacterial infection and may provide a potential site for the development of anti-tuberculosis drugs that specifically antagonize the virulence of ESAT6.

Preparation of no-carrier-added 161Tb by lanthanide resin / 中华核医学与分子影像杂志

Objective:To produce 161Tb from enriched 160Gd 2O 3 isotope-enriched target material and realize domestic production of the novel medical isotope 161Tb. Methods:The 160Gd 2O 3 isotope-enriched target material was irradiated with neutrons by the China Mianyang Research Reactor (CMRR). The no-carrier-added 161Tb product was obtained after the processes of target broken, sample dissolution, separation and purification with lanthanide (LN) resin and solution replacement with diglycolamide (DGA) column. Various key indicators such as γ spectral purity, metal impurity content, specific activity, radiochemical purity, and radioactive concentration were used to conduct the quality inspection and the control of 161Tb products. Results:161TbCl 3 of 33.4 GBq was obtained in a single time with the radioactive concentration of 16.8 GBq/ml, nuclear purity more than 99.9%, and radiochemical purity of 99.2%. Metal impurity content was met the established standards, with the specific activity of 6.02×10 17 Bq/mol. The radiochemical purities of 161Tb labeling with 1, 4, 7, 10-tetraazacyclododecane-1, 4, 7, 10-tetraacetic acid- D-Phe1-Tyr3-Thr8-octreotide (DOTATATE) after 0 and 72 h were 100% and 95.8% respectively. Conclusion:The preparation of no-carrier-added 161Tb by using LN resin has the advantages of high separation performance and high sample loading, which has great significance in the field of medical isotope preparation and lays a good nuclide guarantee for the research and development of domestic 161Tb-labeled drugs.

Establishment of ultrasound-guided incomplete ablation model of ectopic implanted tumor of liver cancer in nude mice / 中华超声影像学杂志

Objective:To establish a good model of incomplete ablation of ectopic implanted tumor of liver, and explore the changes in the molecular landscape of residual cancer, cancer in nude mice.Methods:Eight immunodeficient BALB/c nude mice were used to establish an ectopic tumor model with the MHCC97-H hepatoma cell line, and they were randomly divided into experimental group and control group, with 4 mice in each group. The experimental group underwent simulated clinical incomplete ablation, and the control group only underwent false ablation. The differences between the models were evaluated by ultrasonic diagnostic equipment, thermal imaging cameras, HE staining and high-throughput whole transcriptome sequencing.Results:Liver cancer ectopic implantations in nude mices were all successful. The experimental group showed that the temperature of the tumor around the tip of the needle monitored by the thermal imaging camera was at 50-73.9 ℃. Compared with the control group, the HE staining of the experimental group mostly showed the coexistence of necrotic area-degeneration area-tumor cell area. The necrosis area was (23.75±13.77)%, and the degeneration area was 50%(30%). High-throughput whole transcriptome sequencing revealed that there were hundreds of overlapping stable molecular landscapes in the incomplete ablation simulation model both in vivo and in vitro.Conclusions:By establishing an ectopic implantion model of nude mice with incomplete ablation of residual liver cancer, it can provide a basis for studying the biological characteristics of incomplete ablation of residual cancer at the molecular level.

Isolating High Antimicrobial Ability Lignin From Bamboo Kraft Lignin by Organosolv Fractionation.

Lignin from different biomasses possess biological antioxidation and antimicrobial activities, which depend on the number of functional groups and the molecular weight of lignin. In this work, organosolv fractionation was carried out to prepare the lignin fraction with a suitable structure to tailor excellent biological activities. Gel permeation chromatography (GPC) analysis showed that decreased molecular weight lignin fractions were obtained by sequentially organosolv fractionation with anhydrous acetone, 50% acetone and 37.5% hexanes. Nuclear magnetic resonance (NMR) results indicated that the lignin fractions with lower molecular weight had fewer substructures and a higher phenolic hydroxyl content, which was positively correlated with their antioxidation ability. Both of the original lignin and fractionated lignins possessed the ability to inhibit the growth of Gram-negative bacteria (Escherichia coli and Salmonella) and Gram-positive bacteria (Streptococcus and Staphylococcus aureus) by destroying the cell wall of bacteria in vitro, in which the lignin fraction with the lowest molecular weight and highest phenolic hydroxyl content (L3) showed the best performance. Besides, the L3 lignin showed the ability to ameliorate Escherichia coli-induced diarrhea damages of mice to improve the formation of intestinal contents in vivo. These results imply that a lignin fraction with a tailored structure from bamboo lignin can be used as a novel antimicrobial agent in the biomedical field.

Routine blood test, C-reactive protein and blood culture for predicting necrotizing enterocolitis in preterm infants with late-onset sepsis / 中华围产医学杂志

Objective:To explore the value of blood routine indexes, C-reactive protein(CRP), and blood culture in predicting the occurrence of neonatal necrotizing enterocolitis (NEC) secondary to late-onset sepsis (LOS) in preterm infants.Methods:This study retrospectively enrolled 80 premature infants with LOS admitted to the First Hospital Affiliated to Army Medical University from January 1, 2015 to January 1, 2020. Based on whether complicated by NEC or not, all the subjects were assigned into the NEC group ( n=11) and non-NEC group ( n=69). Laboratory data for perinatal conditions, complete blood cell count, CRP, and blood culture in the early stage of LOS were recorded, and the decreased value of the hemoglobin concentration before and at early stage of LOS was calculated. Mann-Whitney U test, Chi-square test or Fisher exact probability method was used to compare the differences in perinatal conditions, blood routine, CRP and blood culture results between different groups. Binomial stepwise logistic regression analysis and the receiver operating characteristic (ROC) curve were used to evaluate the risk factors and their predictive value for NEC secondary to LOS, respectively. Results:(1) There was no significant difference in gestational age, birth weight or other perinatal factors between the NEC group and non-NEC group (all P>0.05). (2) Mean platelet volume (MPV), CRP, and the hemoglobin decreased value in NEC group were greater than those in non-NEC group [11.7 fl (10.9-12.6 fl) vs 10.7 fl (10.3-11.6 fl), Z=－2.773; 33.3 mg/L (21.3-92.9 mg/L) vs 13.5 mg/L (4.7-27.3 mg/L), Z=－2.662; 25.0 g/L (18.0 -36.0 g/L) vs 13.0 g/L (1.0-19.0 g/L), Z=－3.803; all P<0.01]. (3) Binomial stepwise logistic regression analysis suggested that higher MPV at early stage of LOS ( OR=3.213, 95% CI: 1.104-9.354, P=0.032) and the decreased hemoglobin ( OR=1.153, 95% CI: 1.057-1.257, P=0.001) were independent risk factors for NEC secondary to LOS in preterm infants. (4) The cut-off values of MPV combined with the decreased value of hemoglobin for predicting NEC in premature infants with LOS were 11.2 fl and 14.0 g/L, respectively, with a sensitivity of 1.00 and specificity of 0.71. Conclusions:MPV combined with the decreased value of hemoglobin may help to predict NEC in the early stage of LOS for preterm infants.

Preliminary Study on Commodity Grade Classification of Phyllanthi Fructus Based on Color Component Correlation / 中国实验方剂学杂志

Objective:To provide a scientific basis for the classification of Phyllanthi Fructus product grades. Method:A total of 30 batches of Phyllanthi Fructus currently available in the market were collected for quantification based on such appearance indexes as diameter， thickness， grain weight， and crust colour （<italic>L</italic>^*， <italic>a</italic>^*， and <italic>b</italic>^* values）. The contents of gallic acid， corilagin， chebulagic acid， and ellagic acid were measured by high performance liquid chromatography （HPLC）， followed by descriptive statistical analysis （DSA）， analysis of variance （ANOVA）， and principal component analysis （PCA） to determine the importance of each main index and explore the correlations between the appearance indexes and internal components. The classification standard of Phyllanthi Fructus product grades was formulated， and its scientificity was verified in hepatocelular carcinoma HepG2 cells. Result:The correlation analysis revealed that the crust colour <italic>L</italic>^*， <italic>a</italic>^*， and <italic>b</italic>^* values were significantly negatively correlated with corilagin， chebulagic acid， and ellagic acid （<italic>|r|</italic>>0.5， <italic>P</italic><0.01）， but irrelevant to gallic acid （<italic>|r|</italic><0.1）. Considering the variable coefficient of each index， PCA results， and the requirement of gallic acid as quality indicator for Phyllanthi Fructus in <italic>Chinese Pharmacopoeia</italic>， the crust colour <italic>L</italic>^*， <italic>a</italic>^*， and <italic>b</italic>^* values and gallic acid content were determined to be the classification indexes. The K-means cluster analysis confirmed that products with crust colour <italic>L</italic>^*<44， <italic>a</italic>^*<7， and <italic>b</italic>^*<10 and gallic acid content >1.6% could be classified into the first class， and those failing to meet the above requirements into the second class. The cell experiment demonstrated that the half-maximal inhibitory concentration （IC₅₀） of the first-class product against hepatocelular carcinoma HepG2 cells was lower than that of the second-class product. A colourimetric card was developed based on crust colour <italic>L</italic>^*， <italic>a</italic>^*， and <italic>b</italic>^* values to provide a visual tool for on-site evaluation of Phyllanthi Fructus products. Conclusion:This study has initially established the classification standard of Phyllanthi Fructus product grades， which contributes to guiding price negotiation of Phyllanthi Fructus products based on quality grade and thus ensuring high quality and high price.

Clinical characteristics and risk factors for mortality in cancer patients with COVID-19 / 医学前沿

Patients with cancer are at increased risk of severe infections. From a cohort including 3060 patients with confirmed COVID-19, 109 (3.4%) cancer patients were included in this study. Among them, 23 (21.1%) patients died in the hospital. Cancer patients, especially those with hematological malignancies (41.6%), urinary carcinoma (35.7%), malignancies of the digestive system (33.3%), gynecological malignancies (20%), and lung cancer (14.3%), had a much higher mortality than patients without cancer. A total of 19 (17.4%) cancer patients were infected in the hospital. The clinical characteristics of deceased cancer patients were compared with those of recovered cancer patients. Multivariate Cox regression analysis indicated that a Nutritional Risk Screening (NRS2002) score ⩾ 3 (adjusted hazard ratio (HR) 11.00; 95% confidence interval (CI) 4.60-26.32; P < 0.001), high-risk type (adjusted HR 18.81; 95% CI 4.21-83.93; P < 0.001), tumor stage IV (adjusted HR 4.26; 95% CI 2.34-7.75; P < 0.001), and recent adjuvant therapy (< 1 month) (adjusted HR 3.16; 95% CI 1.75-5.70; P < 0.01) were independent risk factors for in-hospital death after adjusting for age, comorbidities, D-dimer, and lymphocyte count. In conclusion, cancer patients showed a higher risk of COVID-19 infection with a poorer prognosis than patients without cancer. Cancer patients with high-risk tumor, NRS2002 score ⩾ 3, advanced tumor stage, and recent adjuvant therapy (< 1 month) may have high risk of mortality.

Antipyretic activity and potential mechanism of Indigo Naturalis on 2,4-dinitrophenol-induced fever rat model / 中国中药杂志

As an effective antipyretic medicine,Indigo Naturalis has a long history of application in the field of Chinese medicine.The content of organics,mainly indigo and indirubin,is about 10%. However,the active ingredients and mechanism of its antipyretic effect have not yet been fully elucidated. In view of this,they were investigated in this study with the rectal temperature change as an indicator and 2,4-dinitrophenol-induced fever rats as subjects. The content of PGE2 and c AMP in the hypothalamus and the serum levels of TNF-α,IL-1β and IL-6 were determined by ELISA. Moreover,the plasma samples of fever rats were analyzed by metabonomics in combination with UPLC-Q-TOF-MS for the exploration of potential biomarkers and the discussion on the antipyretic mechanism of Indigo Naturalis and its active ingredients. The results showed that the rising trend of rectal temperature in rats was suppressed 0. 5 h after the treatment with Indigo Naturalis,organic matter,indigo or indirubin as compared with the rats of model group( P < 0. 05),among which Indigo Naturalis and organic matter had better antipyretic effect. ELISA results showed that organic matter and indigo can inhibit the expression of PGE2 and c AMP( P<0. 01),while Indigo Naturalis and organic matter were effective in curbing the increase in TNF-α( P<0. 05). A total of 21 endogenous metabolites were identified from the plasma samples of the Indigo Naturalis,organic matter,indigo and indirubin groups,which were mainly involved in glycerophospholipid metabolism.

Preliminary adipose removal did not prevent diet-induced metabolic disorders in mice / 中华医学杂志(英文版)

BACKGROUND@#Obesity is a fundamental factor in metabolic disorders such as hyperlipidemia, insulin resistance, fatty liver, and atherosclerosis. However, effective preventive measures are still lacking. This study aimed to investigate different surgical protocols for removing partial adipose tissue before the onset of obesity and determine whether, and by which protocol, preliminary adipose removal could exert potent preventive effects against diet-induced metabolic disorders.@*METHODS@#Male low-density lipoprotein receptor (LDL-R) knockout (KO) mice were randomly divided into four groups and subjected to epididymal fat removal (Epi-FR) surgery, subcutaneous fat removal (suQ-FR) surgery, both subcutaneous and epididymal fat removal (Epi + suQ-FR) surgery, or sham-operation. After 1 week of recovery, all mice were given a high-fat diet (HFD) for 10 weeks to induce metabolic disorders.@*RESULTS@#In the Epi-FR group and the sham-operated group, the mean numbers of the residual subcutaneous fat were 28.59 mg/g and 18.56 mg/g, respectively. The expression of relative genes such as Pparg, Cebpa, Dgat2, Fabp4 and Cd36 in the residual subcutaneous fat increased 2.62, 3.90, 3.11, 2.06, 1.78 times in the Epi-FR group compared with that in the sham-operated group. Whereas in the other fat-removal groups, the residual fat depots had no significant change in either size or gene expression, as compared with those of the sham-operated group. Plasma lipid and glucose levels and insulin sensitivity, as detected by the glucose tolerance test, were not significantly alleviated in the three fat removal groups. Liver mass or lipid content was not attenuated in any of the three fat removal groups. The atherosclerosis burdens in the entire inner aorta and aortic root did not decrease in any of the three fat removal groups.@*CONCLUSIONS@#Our data suggest that removal of epididymal adipose or subcutaneous adipose alone or in combination before the onset of obesity did not protect against hyperlipidemia, insulin resistance, fatty liver, or atherosclerosis in LDL-R KO mice fed with a HFD. Hence, adipose removal possibly does not represent a potential approach in preventing obesity-related metabolic disorders in the obesity-susceptible population.

The value of serum programmed cell death molecule 5 protein expression in early prediction of gastric cancer and its clinical significance / 中国医师进修杂志

Objective:To investigate the value of serum programmed cell death molecule 5 (PDCD5) protein expression in early prediction of gastric cancer and its clinical significance.Methods:A total of 103 patients with gastric cancer who were treated in Yuechi County People′s Hospital in Sichuan Province from March 2014 to March 2016 and 80 healthy people who underwent physical examinations (control group) in the same period were selected as subjects. The serum level of PDCD5 protein were detected by enzyme-linked immunosorbent assay. The diagnostic performance of serum PDCD5 protein on gastric cancer was evaluated by receiver operating characteristic curve. The patients with gastric cancer were divided into low-level group (50 cases) and high-level group (53 cases) according to serum PDCD5 protein level. The relationship between serum PDCD5 protein level and clinical data in patients with gastric cancer was analyzed by χ2 test. Univariate and multivariate Cox regression models were used to analyze independent risk factors for survival and prognosis of gastric cancer. Kaplan-Meier method was used to map survival curves of gastric cancer patients with different levels of serum PDCD5 protein. Results:Serum PDCD5 protein level in gastric cancer group was significantly lower than that in control group: (0.82 ± 0.30) mg/L vs. (1.26 ± 0.39) mg/L, and there was statistical difference ( t=8.628, P<0.01). Serum PDCD5 protein level in patients with gastric cancer was related to tumor TNM stage and tumor invasion ( P<0.05), but not related to gender, age, body mass index (BMI), tumor size, lymph node metastasis, tumor type and tumor differentiation ( P<0.05). The area under curve (AUC) of serum PDCD5 protein in the diagnosis of gastric cancer was 0.810 (95% CI 0.747 to 0.873), with a sensitivity of 71.8%, and a specificity of 76.3% ( Z=9.641, P<0.01). Serum PDCD5 protein level was an independent risk factor for poor prognosis in patients with gastric cancer ( P<0.05). The 5-year survival rate in low-level group was significantly lower than that in high-level group: 32.0% vs. 62.3%, and there was statistical difference ( χ2=18.422, P<0.01). Conclusions:The serum PDCD5 protein level in patients with gastric cancer is significantly decreased. Low serum PDCD5 protein level is independent risk factors for poor prognosis of patients with gastric cancer.

Bacterial flora distribution and antimicrobial resistance of pyogenic liver abscess: a multicenter retrospective study (A report of 897 cases) / 中华消化外科杂志

Objective@#To investigate the bacterial flora distribution and antimicrobial resistance of patients with pyogenic liver abscess (PLA) in multi-centers of China.@*Methods@#The retrospective and descriptive study was conducted. The clinical data of 897 patients with PLA at 3 medical centers in China from October 2007 to April 2018 were collected, including 656 cases in the First Hospital of Harbin Medical University, 109 cases in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology and 132 cases in the Eastern Hepatobiliary Surgery Hospital of Naval Military Medical University. There were 582 males and 315 females, aged (59±11)years, with a range of 6-86 years. Observation indicators: (1) bacterial flora distribution; (2) bacterial resistance. Measurement data with normal distribution were represented as Mean±SD and measurement data with skewed distribution were represented as M (range). Count data were described as absolute numbers or percentages.@*Results@#(1) Bacterial flora distribution: among 897 patients, 733 cases of Klebsiella pneumoniae, 75 cases of Escherichia coli, 11 cases of Staphylococcus aureus, 10 cases of Streptococcus viridians, 9 cases of Klebsiella pneumoniae subsp. pneumoniae, 7 cases of β-emolytic streptococcus, 6 cases of Acinetobacter baumannii, 5 cases of Streptococcus intermadius, 5 cases of Enterococcus faecium, 3 cases of Alcaligenes xylosoxidans subsp. xylosoxidans, 2 cases of Proteus mirabilis, 2 cases of Streptococcus isthmus, 2 cases of Enterobacter cloacae subsp. cloacae, 1 case of Citrobacter koseri, 1 case of Proteus vulgaris, 1 case of Pasteurella pneumotropica, 1 case of Curobacter freudii, 1 case of Enterobacter amnigenus, 1 case of Stenotrophomonas maltophilia, 1 case of Acinetobacter lwoffii, 1 case of Streptococcus salivarius, 1 case of Streptococcus bacterium, 1 case of Enterococcus avium, 1 case of Enterococcus faecalis, 1 case of Klebsiella oxytoca, and 1 case of Staphylococcus epidermidis were cultured in the pus respectively. There were 12 cases of double bacterial infection, and 2 cases of multiple bacterial infections. (2) Bacterial resistance. ① Resistance of Klebsiella pneumoniae and Escherichia coli: the drug resistance rates of Klebsiella pneumoniae to ampicillin, piperacillin, cefazolin, cefuroxime, cefotaxime, ceftriaxone, ceftazidime, cefotetan, cefepime, cefoxitin, amoxicillin/carat Retinoic acid, ampicillin/sulbactam, piperacillin/tazobactam, cefoperazone/sulbactam, aztreonam, imipenem, meropenem, ertapenem, gentamicin, tobramycin, amikacin, tigaricycline, ciprofloxacin, levofloxacin, and trimethoprim sulfamethoxazole were 99.79%(474/475), 4.09%(7/171), 12.18%(82/673), 7.34%(49/668), 2.34%(4/171), 1.96%(11/562), 5.85%%(10/171), 0(0/562), 0.55%(4/733), 1.42%(9/635), 0(0/733), 2.46%(18/733), 0.55%(4/733), 0.27%(2/733), 1.36%(10/733), 0.14%(1/733), 0(0/733), 0.36%(2/562), 0.95%(7/733), 0.41%(3/733), 0(0/733), 0(0/562), 1.64%(12/733), 0.95%(7/733), and 4.50%(33/733), respectively. The drug resistance rates of Escherichia coli to above antibiotics were 78.67%(59/75), 40.91%(18/44), 65.33%(49/75), 56.00%(42/75), 38.64%(17/44), 41.94%(13/31), 20.00%(15/75), 3.23%(1/31), 25.33%(19/75), 5.77%(3/52), 18.67%(14/75), 32.00%(24/75), 8.00%(6/75), 16.00%(12/75), 37.33%(28/75), 1.33%(1/75), 0(0/75), 0(0/31), 40.00%(30/75), 14.67%(11/75), 1.33%(1/75), 0(0/31), 54.67%(41/75), 37.33%(28/75), and 52.00%(39/75), respectively. ② Drug resistance of other Gram-negative bacteria: the drug resistance rates of Klebsiella pneumoniae subsp. pneumoniae to ampicillin, cefazolin, cefuroxime, ceftriaxone, ceftazidime, cefotetan, cefepime, amoxicillin/carat Retinoic acid, ampicillin/sulbactam, piperacillin/tazobactam, cefoperazone/sulbactam, aztreonam, imipenem, meropenem, ertapenem, gentamicin, tobramycin, amikacin, ciprofloxacin, levofloxacin, and trimethoprim sulfamethoxazole were 8/8, 0/5, 0/5, 0/1, 0/9, 0/2, 0/9, 0/8, 0/9, 0/9, 0/6, 0/9, 0/9, 0/7, 0/1, 0/9, 0/8, 0/9, 0/9, 0/9, and 0/9. The drug resistance rates of Acinetobacter baumannii to ceftriaxone, ceftazidime, cefepime, ampicillin/sulbactam, piperacillin/tazobactam, cefoperazone/sulbactam, aztreonam, imipenem, meropenem, gentamicin, tobramycin, amikacin, tigaricycline, ciprofloxacin, levofloxacin, and trimethoprim sulfamethoxazole were 2/6, 4/6, 3/6, 0/6, 4/6, 1/6, 2/6, 4/6, 2/6, 4/6, 4/6, 3/6, 0/6, 4/6, 2/6, and 3/6, respectively. The drug resistance rates of Alcaligenes xylosoxidans subsp. xylosoxidans to ampicillin, cefazolin, cefuroxime, ceftazidime, cefepime, amoxicillin/carat Retinoic acid, piperacillin/tazobactam, aztreonam, imipenem, gentamicin, tobramycin, amikacin, ciprofloxacin, and levofloxacin were 3/3, 3/3, 3/3, 1/3, 1/3, 1/3, 0/3, 3/3, 2/3, 3/3, 3/3, 3/3, 3/3, and 1/3. ③ Drug resistance of other Gram-positive bacteria: the drug resistance rates of Staphylococcus aureus to penicillin, ampicillin, piperacillin, cefazolin, cefuroxime, cefotaxime, ceftazidime, cefepime, cefoxitin, amoxicillin/carat Retinoic acid, ampicillin/sulbactam, piperacillin/tazobactam, cefoperazone/sulbactam, aztreonam, imipenem, meropenem, gentamicin, tobramycin, amikacin, tetracycline, tigaricycline, ciprofloxacin, levofloxacin, moxifloxacin, trimethoprim sulfamethoxazole, linezolid, erythromycin, clindamycin, vancomycin, teicoplanin, and rifampin were 2/6, 6/8, 4/5, 4/5, 4/5, 4/5, 4/5, 4/5, 4/5, 4/5, 4/5, 4/5, 4/5, 3/5, 2/5, 2/5, 3/8, 3/5, 3/5, 0/8, 0/8, 3/8, 3/11, 0/5, 1/8, 0/8, 0/8, 2/6, 3/3, 1/3, and 0/3. The drug resistance rates of Streptococcus viridians to penicillin, ampicillin, ceftriaxone, cefoperazone/sulbactam, gentamicin, tetracycline, ciprofloxacin, levofloxacin, moxifloxacin, linezolid, erythromycin, clindamycin, vancomycin, teicoplanin, and rifampin were 3/10, 0/8, 0/7, 0/7, 2/8, 6/10, 0/8, 0/8, 0/7, 0/5, 4/10, 6/10, 0/5, 0/5, and 0/3. The drug resistance rates of β-emolytic streptococcus to antibacterial agents were 0. ④ Drug resistance of complex bacteria. For the 12 patients with double bacterial infection, in the Klebsiella pneumoniae combined with Gram-negative bacteria, the drug resistance rates of Klebsiella pneumoniae to cefotetan, cefoxitin, ampicillin/sulbactam, meropenem, ertapenem, tobramycin, tigecycline, and trimethoprim sulfamethoxazole were 0. The drug resistance rates of Acinetobacter baumannii to ertapenem, levofloxacin, and trimethoprim sulfamethoxazole were 0. The drug resistance rates of Escherichia coli to ceftazidime, cefoxitin, amoxicillin/clavulanic acid, piperacillin/tazobactam, imipenem, meropenem, ertapenem, tobramycin, amikacin, and tigecycline were 0. Citrobacter florida was sensitive to other antibiotics than levofloxacin and trimethoprim cotrimoxazole. In the Escherichia coli combined with Gram-positive bacteria, the drug resistance rates of Escherichia coli to cefotetan, cefepime, cefoxitin, cefoperazone/sulbactam, meropenem, tobramycin, and amikacin were 0. The drug resistance rates of Enterococcus faecalis to penicillin, ampicillin, levofloxacin, moxifloxacin, linezolid, vancomycin, and teicoplanin were 0. The drug resistance rates of Enterococcus casselifavus to ampicillin, tetracycline, levofloxacin, moxifloxacin, linezolid, and erythromycin were 0. The drug resistance rates of Staphylococcus hominis subspecies to levofloxacin, moxifloxacin, linezolid, vancomycin, teicoplanin, and rifampicin were 0. The drug resistance rates of Enterococcus faecium to tetracycline, linezolid, vancomycin, and teicoplanin were 0. In the multiple bacterial infections of Klebsiella pneumoniae + Escherichia coli + Staphylococcus aureus subspecies + Pseudomonas aeruginosa + Torulopsis glabrata, the drug resistance rates of Klebsiella pneumoniae to ceftriaxone, ceftazidime, cefotetan, cefepime, cefoxitin, ampicillin/sulbactam, piperacillin/tazobactam, cefoperazone/sulbactam, aztreonam, imipenem, tobramycin, amikacin, and levofloxacin were 0. The drug resistance rates of Escherichia coli to ceftazidime, cefotetan, cefepime, ampicillin/sulbactam, piperacillin/tazobactam, cefoperazone/sulbactam, aztreonam, imipenem, and amikacin were 0. The drug resistance rates of Staphylococcus aureus subspecies to ceftriaxone, ceftazidime, cefotetan, cefepime, ampicillin/sulbactam, piperacillin/tazobactam, cefoperazone/sulbactam, aztreonam, imipenem, tobramycin, amikacin, tigecycline, moxifloxacin, cotrimoxazole, teicoplanin, vancomycin, linezolid, and clindamycin were 0. The drug resistance rates of Pseudomonas aeruginosa to ceftazidime, cefepime, piperacillin/tazobactam, imipenem, gentamicin, tobramycin, amikacin, ciprofloxacin, and levofloxacin were 0. The drug resistance rates of Torulopsis glabrata to 5-fluorocytosine, fluconazole, itraconazole, and voriconazole were 0. In the multiple bacterial infections of Klebsiella pneumoniae + Escherichia coli + Acinetobacter baumannii, the drug resistance rates of Klebsiella pneumoniae to cefotetan, cefepime, piperacillin/tazobactam, imipenem, ertapenem, tobramycin, ciprofloxacin, and levofloxacin were 0. The drug resistance rates of Escherichia coli to amoxicillin/clavulanic acid, piperacillin/tazobactam, imipenem, meropenem were 0. The drug resistance ratets of Acinetobacter baumannii to trimethoprim sulfamethoxazole was 0.@*Conclusions@#Klebsiella pneumoniae is the main pathogen of PLA, followed by Escherichia coli. Klebsiella pneumoniae and Escherichia coli are sensitive to meropenem and tigecycline. Klebsiella pneumoniae subsp. pneumoniae and other Gram-negative bacteria are sensitive to ertapenem. Staphylococcus aureus are sensitive to Linezolid. Antibiotics are selected after drug sensitivity test for patients.

Bacterial flora distribution and antimicrobial resistance of pyogenic liver abscess: a multicenter retrospective study (A report of 897 cases) / 中华消化外科杂志

Objective To investigate the bacterial flora distribution and antimicrobial resistance of patients with pyogenic liver abscess (PLA) in multi-centers of China.Methods The retrospective and descriptive study was conducted.The clinical data of 897 patients with PLA at 3 medical centers in China from October 2007 to April 2018 were collected,including 656 cases in the First Hospital of Harbin Medical University,109 cases in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology and 132 cases in the Eastern Hepatobiliary Surgery Hospital of Naval Military Medical University.There were 582 males and 315 females,aged (59± 11) years,with a range of 6-86 years.Observation indicators:(1) bacterial flora distribution;(2) bacterial resistance.Measurement data with normal distribution were represented as Mean±SD and measurement data with skewed distribution were represented as M (range).Count data were described as absolute numbers or percentages.Results (1) Bacterial flora distribution:among 897 patients,733 cases of Klebsiella pneumoniae,75 cases of Escherichia coli,11 cases of Staphylococcus aureus,10 cases of Streptococcus viridians,9 cases of Klebsiella pneumoniae subsp.pneumoniae,7 cases of β-emolytic streptococcus,6 cases of Acinetobacter baumannii,5 cases of Streptococcus intermadius,5 cases of Enterococcus faecium,3 cases of Alcaligenes xylosoxidans subsp.xylosoxidans,2 cases of Proteus mirabilis,2 cases of Streptococcus isthmus,2 cases of Enterobacter cloacae subsp.cloacae,1 case of Citrobacter koseri,1 case of Proteus vulgaris,1 case of Pasteurella pneumotropica,1 case of Curobacter freudii,1 case of Enterobacter amnigenus,1 case of Stenotrophomonas maltophilia,1 case of Acinetobacter lwoffii,1 case of Streptococcus salivarius,1 case of Streptococcus bacterium,1 case of Enterococcus avium,1 case of Enterococcus faecalis,1 case of Klebsiella oxytoca,and 1 case of Staphylococcus epidermidis were cultured in the pus respectively.There were 12 cases of double bacterial infection,and 2 cases of multiple bacterial infections.(2) Bacterial resistance.① Resistance of Klebsiella pneumoniae and Escherichia coli:the drug resistance rates of Klebsiella pneumoniae to ampicillin,piperacillin,cefazolin,cefuroxime,cefotaxime,ceftriaxone,ceftazidime,cefotetan,cefepime,cefoxitin,amoxicillin/carat Retinoic acid,ampicillin/sulbactam,piperacillin/tazobactam,cefoperazone/sulbactam,aztreonam,imipenem,meropenem,ertapenem,gentamicin,tobramycin,amikacin,tigaricycline,ciprofloxacin,levofloxacin,and trimethoprim sulfamethoxazole were 99.79％ (474/475),4.09％ (7/171),12.18％ (82/673),7.34％(49/668),2.34％(4/171),1.96％(11/562),5.85％％(10/171),0(0/562),0.55％(4/733),1.42％(9/635),0(0/733),2.46％(18/733),0.55％(4/733),0.27％(2/733),1.36％(10/733),0.14％ (1/733),0 (0/733),0.36％ (2/562),0.95％ (7/733),0.41％ (3/733),0 (0/733),0 (0/562),1.64％ (12/733),0.95％ (7/733),and 4.50％ (33/733),respectively.The drug resistance rates of Escherichia coli to above antibiotics were 78.67％ (59/75),40.91％ (18/44),65.33％ (49/75),56.00％ (42/75),38.64％ (17/44),41.94％ (13/31),20.00％ (15/75),3.23％ (1/31),25.33％ (19/75),5.77％ (3/52),18.67％ (14/75),32.00％(24/75),8.00％(6/75),16.00％(12/75),37.33％(28/75),1.33％(1/75),0(0/75),0(0/31),40.00％(30/75),14.67％(11/75),1.33％(1/75),0(0/31),54.67％(41/75),37.33％ (28/75),and 52.00％ (39/75),respectively.② Drug resistance of other Gram-negative bacteria:the drug resistance rates of Klebsiella pneumoniae subsp.pneumoniae to ampicillin,cefazolin,cefuroxime,ceftriaxone,ceftazidime,cefotetan,cefepime,amoxicillin/carat Retinoic acid,ampicillin/sulbactam,piperacillin/tazobactam,cefoperazone/sulbactam,aztreonam,imipenem,meropenem,ertapenem,gentamicin,tobramycin,amikacin,ciprofloxacin,levofloxacin,and trimethoprim sulfamethoxazole were 8/8,0/5,0/5,0/1,0/9,0/2,0/9,0/8,0/9,0/9,0/6,0/9,0/9,0/7,0/1,0/9,0/8,0/9,0/9,0/9,and 0/9.The drug resistance rates of Acinetobacter baumannii to ceftriaxone,ceftazidime,cefepime,ampicillin/sulbactam,piperacillin/tazobactam,cefoperazone/sulbactam,aztreonam,imipenem,meropenem,gentamicin,tobramycin,amikacin,tigaricycline,ciprofloxacin,levofloxacin,and trimethoprim sulfamethoxazole were 2/6,4/6,3/6,0/6,4/6,1/6,2/6,4/6,2/6,4/6,4/6,3/6,0/6,4/6,2/6,and 3/6,respectively.The drug resistance rates of Alcaligenes xylosoxidans subsp.xylosoxidans to ampicillin,cefazolin,cefuroxime,ceftazidime,cefepime,amoxicillin/carat Retinoic acid,piperacillin/tazobactam,aztreonam,imipenem,gentamicin,tobramycin,amikacin,ciprofloxacin,and levofloxacin were 3/3,3/3,3/3,1/3,1/3,1/3,0/3,3/3,2/3,3/3,3/3,3/3,3/3,and 1/3.③ Drug resistance of other Gram-positive bacteria:the drug resistance rates of Staphylococcus aureus to penicillin,ampicillin,piperacillin,cefazolin,cefuroxime,cefotaxime,ceftazidime,cefepime,cefoxitin,amoxicillin/carat Retinoic acid,ampicillin/sulbactam,piperacillin/tazobactam,cefoperazone/sulbactam,aztreonam,imipenem,meropenem,gentamicin,tobramycin,amikacin,tetracycline,tigaricycline,ciprofloxacin,levofloxacin,moxifloxacin,trimethoprim sulfamethoxazole,linezolid,erythromycin,clindamycin,vancomycin,teicoplanin,and rifampin were 2/6,6/8,4/5,4/5,4/5,4/5,4/5,4/5,4/5,4/5,4/5,4/5,4/5,3/5,2/5,2/5,3/8,3/5,3/5,0/8,0/8,3/8,3/11,0/5,1/8,0/8,0/8,2/6,3/3,1/3,and 0/3.The drug resistance rates of Streptococcus viridians to penicillin,ampicillin,ceftriaxone,cefoperazone/sulbactam,gentamicin,tetracycline,ciprofloxaein,levofloxaein,moxifloxacin,linezolid,erythromycin,clindamycin,vancomycin,teicoplanin,and rifampin were 3/10,0/8,0/7,0/7,2/8,6/10,0/8,0/8,0/7,0/5,4/10,6/10,0/5,0/5,and 0/3.The drug resistance rates of β-emolytic streptococcus to antibacterial agents were 0.④ Drug resistance of complex bacteria.For the 12 patients with double bacterial infection,in the Klebsiella pneumoniae combined with Gramnegative bacteria,the drug resistance rates of Klebsiella pneumoniae to cefotetan,cefoxitin,ampicillin/sulbactam,meropenem,ertapenem,tobramycin,tigecycline,and trimethoprim sulfamethoxazole were 0.The drug resistance rates of Acinetobacter baumannii to ertapenem,levofloxacin,and trimethoprim sulfamethoxazole were 0.The drug resistance rates of Escherichia coli to ceftazidime,cefoxitin,amoxicillin/clavulanic acid,piperacillin/tazobactam,imipenem,meropenem,ertapenem,tobramycin,amikacin,and tigecycline were 0.Citrobacter florida was sensitive to other antibiotics than levofloxacin and trimethoprim cotrimoxazole.In the Escherichia coli combined with Gram-positive bacteria,the drug resistance rates of Escherichia coli to cefotetan,cefepime,cefoxitin,cefoperazone/sulbactam,meropenem,tobramycin,and amikacin were 0.The drug resistance rates of Enterococcus faecalis to penicillin,ampicillin,levofloxacin,moxifloxacin,linezolid,vancomycin,and teicoplanin were 0.The drug resistance rates of Enterococcus casselifavus to ampicillin,tetracycline,levofloxacin,moxifloxacin,linezolid,and erythromycin were 0.The drug resistance rates of Staphylococcus hominis subspecies to levofloxacin,moxifloxacin,linezolid,vancomycin,teicoplanin,and rifampicin were 0.The drug resistance rates of Enterococcus faecium to tetracycline,linezolid,vancomycin,and teicoplanin were 0.In the multiple bacterial infections of Klebsiella pneumoniae + Escherichia coli + Staphylococcus aureus subspecies + Pseudomonas aeruginosa + Torulopsis glabrata,the drug resistance rates of Klebsiella pneumoniae to ceftriaxone,ceftazidime,cefotetan,cefepime,cefoxitin,ampicillin/sulbactam,piperacillin/tazobactam,cefoperazone/sulbactam,aztreonam,imipenem,tobramycin,amikacin,and levofloxacin were 0.The drug resistance rates of Escherichia coli to ceftazidime,cefotetan,cefepime,ampicillin/sulbactam,piperacillin/tazobactam,cefoperazone/sulbactam,aztreonam,imipenem,and amikacin were 0.The drug resistance rates of Staphylococcus aureus subspecies to ceftriaxone,ceftazidime,cefotetan,cefepime,ampicillin/sulbactam,piperacillin/tazobactam,cefoperazone/ sulbactam,aztreonam,imipenem,tobramycin,amikacin,tigecycline,moxifloxacin,cotrimoxazole,teicoplanin,vancomycin,linezolid,and clindamycin were 0.The drug resistance rates of Pseudomonas aeruginosa to ceftazidime,cefepime,piperacillin/tazobactam,imipenem,gentamicin,tobramycin,amikacin,ciprofloxacin,and levofloxacin were 0.The drug resistance rates of Torulopsis glabrata to 5-fluorocytosine,fluconazole,itraconazole,and voriconazole were 0.In the multiple bacterial infections of Klebsiella pneumoniae + Escherichia coli + Acinetobacter baumannii,the drug resistance rates of Klebsiella pneumoniae to cefotetan,cefepime,piperacillin/tazobactam,imipenem,ertapenem,tobramycin,ciprofloxacin,and levofloxacin were 0.The drug resistance rates of Escherichia coli to amoxicillin/clavulanic acid,piperacillin/tazobactam,imipenem,meropenem were 0.The drug resistance ratets of Acinetobacter baumannii to trimethoprim sulfamethoxazole was 0.Conclusions Klebsiella pneumoniae is the main pathogen of PLA,followed by Escherichia coli.Klebsiella pneumoniae and Escherichia coli are sensitive to meropenem and tigecycline.Klebsiella pneumoniae subsp.pneumoniae and other Gram-negative bacteria are sensitive to ertapenem.Staphylococcus aureus are sensitive to Linezolid.Antibiotics are selected after drug sensitivity test for patients.

Microenvironment of hepatic oval cells activation and its relationship with hepatic fibrosis / 中华肝胆外科杂志

Liver fibrosis is a necessary stage for many kinds of chronic liver diseases to develop to cirrhosis,which is a serious threat to the health of Chinese people.It has been found that hepatic oval cells,a kind of hepatic stem cells with multiple differentiation potential located in hepatic periportal zone,play an important role in liver fibrosis.Several studies have shown that oval cells have dual capacities of promoting or anting fibrosis,and there is a close relationship between liver fibrosis and cell functions of oval cells.So,further study on the biological characteristics and microenvironmental regulation mechanism of oval cells will provide a new strategy for the treatment of liver fibrosis.Here we try to review the microenvironment for activating oval cells and its relationship with liver fibrosis.

Treatment of persistent allergic rhinitis via acupuncture at the sphenopalatine acupoint: a randomized controlled trial.

BACKGROUND: Allergic rhinitis is a common respiratory disease. Acupuncture is used to treat it in traditional Chinese medicine, and generally, the L120, ST2 and ST36 acupoints are selected in clinical practice. We report a new method of acupuncture at the sphenopalatine acupoint (SPA) for treatment of persistent allergic rhinitis (PAR). The effect of this treatment was investigated using two different needling depths. The efficacy of this treatment was associated with accurate stimulation of the sphenopalatine ganglion (SPG). METHODS/DESIGN: A total of 61 patients diagnosed with PAR were randomly allocated to either the acupuncture or the sham acupuncture group. The difference between the groups was the needle depth when acupuncture was administered, which was 50 mm and 20 mm. Alteration in total nasal symptom score (TNSS) was the primary outcome. Quality of life, medication dosages and adverse events were secondary outcomes, measured using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Confidence assessment was performed to evaluate data from the treatment and follow-up periods. RESULTS: Results were: (1) average TNSS in the treatment group was significantly lower than in the control group at week 4 (median and 25th and 75th percentiles were 5.00 (4.00, 7.00) and 8.00 (7.00, 10.00), respectively (P < 0.001)). However, scores in the two groups were not significantly different at week 12; (2) quality of life (RQLQ) was significantly improved at week 2 in the treatment group compared to the control group (scores of 35.47 ± 8.20 and 45.48 ± 8.84; P < 0.001); (3) during the follow-up period, the medication dosage in the treatment group was much lower than in the control group (3.64 ± 1.45 and 6.14 ± 2.34; P < 0.05); and (4) no adverse events were observed in either group during treatment. CONCLUSIONS: This pilot study revealed a profound effect of acupuncture at the SPA on prevention of PAR development. The TNSS in the treatment group (needle depth 50 mm), was significantly lower than in the control group (needle depth of only 20 mm). Our result demonstrates that performing acupuncture directly at the SPA to stimulate the SPG is an effective method to treat PAR. TRIAL REGISTRATION: Acupuncture Clinical Trial Registry, AMCTR-OOR-16000014 and Chinese Clinical Trial Register, ChiCTR-IOR-16009211 . Registered on 1 September 1 2016.

Study on the correlation between Th1T/Treg ratio and IDO in children with allergic asthma / 重庆医学

Objective To demonstrate that IDO may be involved in the development of allergic asthma in children by affecting Th1T/Treg differentiation and its related cytokines.Methods Thirty-three children over 5 years old who were diagnosed the first time with allergic asthma were selected from the pediatric outpatient department.Another 33 healthy children were selected as the controls.Pulmonary function test,skin prick test,eosinophil count were taken.Peripheral blood was collected to measure the number and percentage of Th17 and Treg cells and the levels of cytokines,including IL-10,IL-17,IL-6 and TGF-β.Venous blood and induced sputum were used to detect the concentration of tryptophan and kynureninein IDO metabolites.Results Compared with the control group,there was a significant Th17/Treg imbalance in the asthma group,IL-17,IL-6 levels were significantly increased,TGF-β,IL-10 levels were significantly reduced,IDO levels were significantly reduced,and its levels were negativly associated with Th17/Treg ratio.Conclusion In children with allergic asthma,IDO may stimulate the production of IL-10,inhibit the expression of IL-6,upregulate the level of Treg,and lead to the imbalance of Th17/Treg;Therefore,IDO may be a molecular "switch" that leads to the conversion of Th17 cells to Treg cells,which plays a potentially protective role in the pathogenesis of asthma.

Study on influence of OVA specific immunotherapy on IL-23/Th17 axis of a mouse asthma model and its mech-anism / 局解手术学杂志

Objective To establish a mouse model of immune treatment of asthma through subcutaneous injection with high dose of ovalbumin( OVA) in the abdomen and investigate the role of IL-23/Th17 axis response in its mechanism. Methods With a random number table method, 18 female BALB/c mice were divided into 3 groups( normal control group,asthma group and asthmatic immune tolerance model group) ,with 6 mice in each group. The mice in the asthmatic immune tolerance model group were sensitized with 10 μg OVA by intraperito-neal injection in the abdomen on day 0 and day 7. The mice in the model group induced immune tolerance with 1 mg OVA by subcutaneous injection in the abdomen every day for a week(day 21 to day 27). Both the model group and asthma control group were challenged with 1％OVA on day 35 to day 41. The mice in the normal control group were challenged with the equal amount of saline. On the 50th day,each group were sforzando challenged once with 10％ OVA. The airway reactivity was detected at 24 after the last challenge. The enhanced pause( Penh) was measured to evaluate the airway responsiveness with a lung functional instrument. Bronchoalveolar lavage fluid( BALF) was collected to count the total cells and eosinophils,and the cytological studies were conducted. The OVA-specific IgE in peripheral blood,and the IL-5,IFN-γIL-23,IL-10 in BALF were detected by enzyme-linked immunosorbent assay(ELISA). The lung tissue was obtained to perform histological analysis by HE staining. The percentagea of Treg and Th17 cells in spleen and lung tissue were calculated by the flow cytometry( FCM) . Then the expression of transcription factors was detected by q-PCR. Results For the asthmatic immune tolerance model group, the airway respon-siveness,the cell count of eosinophilic granulocytes in BALF,the levels of IL-23 and OVA-specific IgE in the serum were significantly lower than the asthma group and the difference is of statistical significance(P<0. 05),while the difference in the IFN-γlevel in BALF compared with the asthma group is of no statistical significance(P<0. 05). The transcription factor of lung tissue detected with q-PCR showed Foxp3 in the asthmatic immune tolerance model group was significantly higher than the asthma group,while RORγt was significantly lower than the asthma group(P>0. 05) and the differences were of statistical significance(P<0. 05). Conclusion Large dose of OVA specific immuno-therapy can alleviate the chronic inflammatory response of asthmatic mice, and the decrease of Th17 cells associated with the expression of IL-23 was decreased. The mechanism may be related to the correction of the lung Il-23 /Th17 axis.