[Advances in the pathogenesis of pre-hepatic failure].

Domestic scholars recognize that patients have a "pre-hepatic failure" before they progress to sub-acute and acute-on-chronic liver failure stage, which is also the golden window for effective clinical intervention, so early identification and intervention during this period can reduce the incidence and mortality of liver failure. The Guidelines for the Diagnosis and Treatment of Liver Failure (2018 Edition) issued by the Chinese Medical Association clearly defines the "pre-stage" of liver failure. And from the perspective of pathophysiological mechanism, the pre-hepatic failure corresponds to the stage of acute liver injury/acute decompensation, inflammation factor/ immunologic derangement. This article briefly introduces the research progress on substantive connotation and pathogenesis of pre-hepatic failure, and puts forward some problems to be explored in the future.

[Definition and diagnosis of acute-on-chronic liver failure: new knowledge and implication].

Acute-on-chronic liver failure (ACLF) is a common critical and severe syndrome in patients with chronic liver diseases in China and other countries in the Asia-Pacific region. In recent years, both the Eastern and Western experts have defined ACLF as a new type of liver disease manifesting as a high 28-day mortality rate (>30%) and extensive systematic inflammatory response. ACLF has become a hot topic in the field of liver diseases. This article reviews the research advances in the definition and etiological spectrum of ACLF and discusses the inspirations of such new knowledge for future research.

[Epidemiological characteristics on temporal-spatial distribution of varicella in Guangxi Zhuang Autonomous Region, 2014-2016].

Objective: To analyze the epidemiological characteristics of temporal-spatial distribution on varicella in Guangxi Zhuang Autonomous Region (Guangxi) during 2014 to 2016. Methods: Incidence data on varicella was collected from the National Notifiable Infectious Disease Reporting Information System (NNIDRIS) of the Center for Disease Control and Prevention (CDC) while geographic information data was from the national CDC. ArcGIS 10.2 software was used to analyze global and local spatial auto correlation on spatial clusters. SaTScan v9.1.1 was used to conduct temporal-spatial scan for exploring the areas of temporal-spatial clusters. Results: The overall incidence rates of varicella during 2014 to 2016 were 32.48/100 000, 43.56/100 000 and 61.56/100 000 respectively. Incidence of varicella showed a positive spatial auto correlation at the county level (the value of Moran's I was between 0.24 to 0.35, P<0.01), with consistent high morbidity. High-high cluster areas were seen and mainly concentrated in the north-western areas of Guangxi. Result from the temporal-spatial scan showed that temporal cluster of varicella occurred mainly between October and next January while the type Ⅰ cluster area was mainly distributed in all of the counties in Hechi city and most counties of Baise city, with most counties being covered in the north-western areas of Guangxi, during 2014-2016. When comparing to data from the last two years, two type Ⅱ cluster areas with larger scales were formed in the north-eastern area of Guanyang county and Haicheng county of southern area in Guangxi, in 2016. Conclusions: Incidence on Varicella seemed on the rise, and the distribution of cases showed clustered features, both on time and space. Strategies regarding control and prevention on Varicella should focus on high-high clustered areas, namely north-western areas of the province, including surrounding areas during the high onset season.

A common promoter variant of TBX21 is associated with allele specific binding to Yin-Yang 1 and reduced gene expression.

T-bet is a key regulator for the lineage commitment in CD4 T helper (Th) 1 cells by activating the hallmark production of interferon-γ, and its expression level is linked to autoimmune, infectious, and allergic diseases. A T to C base substitution has been identified at position -1993 in the TBX21 (encoding T-bet) promoter and has been associated with asthma and systemic lupus erythematosus. This study aimed to investigate the molecular mechanisms responsible for the influence of the T-1993C polymorphism on transcription and its functional effect by luciferase reporter, EMSAs, Chromatin immunoprecipitation assay, and flow cytometric analysis of intracellular T-bet, IFN-γ and IL-4 expression in activated CD4(+) T cells. The presence of a -1993T allele obviously increases promoter activity compared with that of a promoter with a -1993C allele. TBX21 promoter carrying -1993C allele possesses significantly stronger binding affinity to the Yin Yang 1 (YY1) transcription factor than that carrying -1993T allele. YY1 overexpression decreased TBX21 promoter function in a T cell line, demonstrating that this element functions as a repressor. The C to T base exchange relieves the repression mediated by YY1. The individuals carrying -1993C allele were determined to have significantly diminished expression of TBX21 and IFN-γ and increased IL-4 production in cells compared with the individuals carrying -1993T allele (P < 0.05). These findings demonstrate that the TBX21 T-1993C polymorphism represses TBX21 expression and Th1 cytokine production through control of YY1, which might result in the imbalance between Th1 and Th2 immune responses in autoimmune or allergic diseases.

[A new ecdysone hormone rhaponticum from Rhaponticum uniflorum (L.) DC].

OBJECTIVE: To study the chemical constituents of Rhaponticum uniflorum. METHOD: Solvent extraction, separation by silica gel column chromatography and identification by physico-chemical properties and spectral data. RESULT: A new ecdysone hormone, rhaponticum (1) was isolated from the root of R. uniflorum together with a known compound ecdysterone(2). CONCLUSION: The two compounds were obtained from the plant for the first time.

Turbulence under the microscope.

Our objective was to observe a new form of turbulence caused bybiological effects - biological micro-turbulence and explore itsprocess and controlling factors. The methods used were proteusmirabilis CGCs micro-cultured to render the occurrence of the specific movement on micro-organic suspension and its controllingfactors were determined by comparison with the control trials.The results showed that turbulence under the microscope was generally in a mass but partially regular. It was also confirmedthat the turbulence under the microscope exhibited hollow effect,temperature-dependent switching on of occurrence and self-controlof suspension quantity. It is clarified that this new form ofturbulence is a spontaneous and self-control process, which providesan experimental model with controllable conditions for studies ofturbulence and a new way for researches on the mechanism andphysiological functions of the flow of body liquid.

[Etiological features and abnormal cerebrospinal fluid findings in 101 patients with suspected intracranial infections].

101 patients (44 males, 57 females) with suspected intracranial infections were admitted to PUMC Hospital from 1988 to 1993. Their age ranged from 16 to 65 years (mean 29). Based on etiological categories, viral meningitis or encephalitis was diagnosed in 37.6% of the patients, purulent meningitis in 20.8%, tuberculous meningitis in 19.8%, cryptococcal meningitis in 5.9%, cerebral cysticercosis in 5.9%, infections of unknown etiology in 5.0%, and noninfectious diseases in 4.0%. During hospitalization, the mortality rate for cryptococcal, tuberculous and purulent meningitis was 33.3%, 20.0% and 14.3% respectively. This study also showed that cerebrospinal fluid examination was helpful for etiological analysis or differential diagnosis of intracranial infections.

[Prevention and antibiotic treatment of Pseudomonas aeruginosa septicemia].

Thirty-six cases of pseudomonas aeruginosa septicemia were found in 5 years from 1986 to 1990. The main risk factors predisposing septicemia included severe underlying diseases and local primary infection or impaired anatomic barrier. The use of broad-spectrum antibiotics, cytotoxic or immunosuppressive therapy, and leukopenia were also important risk factors. The percentages of in vitro resistant strains to 8 antipseudomonal antibiotics varied from 18% to 47%. The overall effective rate was 42% in 26 patients receiving appropriate antibiotic therapy. The mortality attributable to pseudomonas aeruginosa septicemia was 61%. The prevention and antibiotic treatment of pseudomonas aeruginosa septicemia are discussed.

[Bacterial sepsis and nosocomial infection: a study of 70 patients].

74 episodes of bacterial sepsis in 70 patients were analysed from July 1988 to June 1989. The incidence of sepsis is 0.7% of the whole admitted patients. Compared to a similar previous study from April 1982 to March 1983, the incidence of sepsis decreased (P less than 0.01), and the incidence of nosocomial sepsis remained unchanged, whereas its mortality decreased (P less than 0.05). The host defenses are important in predisposing to sepsis and determining prognosis. Antibiotic sensitivity test revealed that some bacterial strains were resistant to new beta-lactam antibiotics.

[Clinical analysis of 130 patients with fever of unknown origin].

Hospital records of 130 patients with fever of unknown origin (FUO) from 1985 to 1989 were studied. Etiologic diagnoses were made in 117 (90%) patients, 60 (46.1%) patients had infections, 22 (16.9%) neoplasms, 19 (14.6%) connective tissue diseases, and 16(12.3%) various diseases grouped under "miscellaneous", 10% of the FUO cases remained undiagnosed and the death rate was 13.8%. This clinical analysis showed that infection was the most frequent cause of FUO in this series.

[Mediterranean spotted fever. A case report and review of literature].

A patient was documented as having mediterranean spotted fever by indirect immunofluorescence antibody test and inoculation of the patient's blood into the yolk sac of embryonated hen egg. In general, the infection of rickettsia conorii is caused by bite of infected tick. The infection in this case, however, occurred in a laboratory, so the transmitting route might be infected aerosol via impaired mucous membrane.