Analysis of the component factors and connected factors of anhedonia in patients with first-episode schizophrenia / 四川精神卫生

ObjectiveTo explore the component factors of anhedonia in first-episode schizophrenia patients and the relationship with clinical symptoms， cognitive and social functioning. MethodsA total of 31 patients with first-episode schizophrenia who met the diagnostic criteria of the International Classification of Diseases， tenth edition （ICD-10） and another 33 healthy controls were enrolled. Then， the anhedonia level， mental symptoms， cognitive and social functioning were assessed using Temporal Experience of Pleasure Scale （TEPS）， Positive and Negative Syndrome Scale （PANSS）， Repeatable Battery for the Assessment of Neuropsychological Status （RBANS） and Personal and Social Performance Scale （PSP）. Thereafter， Pearson correlation was used to discuss the correlation of anhedonia level with clinical symptoms， cognitive and social functioning. ResultsThe consummatory anhedonia score in TEPS of first-episode schizophrenia patients was lower than that of healthy controls， with statistical difference ［（27.71±5.48） vs. （31.58±5.92）， t=2.705， P=0.009］. Correlation analysis showed that consummatory anhedonia had no correlation with PANSS， RBANS and PSP scores in first-episode schizophrenia patients（P>0.05）. ConclusionFirst-episode schizophrenia patients have consummatory anhedonia， and the consummatory anhedonia may be independent of clinical symptoms， cognitive and social functioning.

Bedside video electroencephalography monitoring for neonates in NICU—the nursing perspective / 中国新生儿科杂志

Objective To assess the safety and feasibility of video electroencephalographic (VEEG) monitoring in preterm infants and critically ill neonates in neonatal intensive care unit (NICU). Method From December 2017 to June 2018, high risk infants were prospectively enrolled and received VEEG monitoring in our NICU. Their basic information, adverse events and disturbances of any procedure during VEEG monitoring were collected by specially-trained nurses. Result A total of 245 times of VEEG were recorded. The average gestational age (GA) was (32.1 ± 3.6) weeks, the birth weight (BW) was (1879 ± 757) g, the corrected GA (cGA) at VEEG monitoring was (33.8±3.3) weeks, and the average weight at VEEG monitoring was (2008±716) g. The earliest cGA at VEEG monitoring was 25+5 weeks, and the lowest weight at VEEG monitoring was 520 g. The average monitoring duration was (4.9±2.4) h, ranging from 3 to 20 hours. During VEEG monitoring, 80 cases (32.7％) received noninvasive ventilation, 43 cases (17.6％) mechanical ventilation. The adverse events during electrodes placement were oxygen desaturation in 8(3.3％) cases. During VEEG monitoring, local skin erythema were found in 4 cases (1.6％), and electrodes displacement in 2(0.8％) cases. The disturbances of any clinical procedures were reported in 18(7.3％) cases. No severe adverse events such as displacement of endotracheal tube nor events requiring cardiopulmonary resuscitation occurred during VEEG monitoring. Conclusion It is feasible and safe for trained NICU nurses to place electrodes for high risk neonates.

Clinical analysis and follow-up of neonatal purulent meningitis caused by group B streptococcus / 中华儿科杂志

<p><b>OBJECTIVE</b>To study the clinical characteristics, antibiotics sensitivity and outcome of group B streptococcus (GBS) meningitis in neonates in order to provide the guide for early diagnosis and appropriate treatment.</p><p><b>METHOD</b>A retrospective review was performed and a total of 13 cases of neonatal purulent meningitis caused by GBS were identified in the Neonatal Intensive Care Unit of Yuying Children's Hospital of Wenzhou Medical University from January 1, 2005 to May 31, 2013. The clinical characteristics, antibiotics sensitivity test results and outcome were analyzed.</p><p><b>RESULT</b>Fever, poor feeding, seizure and lethargy were common clinical signs of neonatal purulent meningitis caused by GBS. Three cases of early onset GBS meningitis received prepartum antibiotics. All 13 cases had abnormal C-reactive protein (CRP) level, and 11 cases had increased CRP within hours after admission. Of the 13 patients, 7 were cured, 4 discharged with improvement, 2 patients died during hospitalization after being given up because of serious complication. The average length of stay for recovered patients was (47 ± 21)d. Acute complications mainly included hyponatremia (5 cases), intracranial hemorrhage (3 cases) , ventriculomegaly (3 cases) , subdural collection (2 cases) , hydrocephalus (2 cases), septic shock (2 cases), cerebral hernia (1 case), encephalomalacia (1 case). One preterm patient with early onset GBS meningitis died 1 month after hospital discharge. Among 7 survivors with 10-24 months follow-up, 3 were early onset GBS meningitis, 2 with normal results of neurologic examination, 1 with delayed motor development, 4 were late onset GBS meningitis, 1 with normal results of neurologic examination, 3 were neurologically impaired with manifestations including delayed motor development (2 cases) and seizures (1 case). All the GBS strains were sensitive to penicillin and linezolid (13/13, 10/10), the susceptibility to levofloxacin, ampicillin and vancomycin were 11/12, 9/10, 8/13 respectively.</p><p><b>CONCLUSION</b>The clinical manifestations of neonatal purulent meningitis caused by GBS are usually non-specific. It is associated with long hospitalization, neurological impairments and sequelae. Monitoring of serum CRP level is valuable for early diagnosis. Antepartum prophylaxis, early diagnosis and therapy are vital. Large dose penicillin is the priority choice to treat the neonatal purulent meningitis caused by GBS, linezolid should be used in intractable cases.</p>

Clinical analysis of nosocomial infection and risk factors of extremely premature infants / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the incidence of nosocomial infections of extremely premature infants and to explore the risk factors and strategies for infection control.</p><p><b>METHOD</b>There were 118 extremely premature infants who were confirmed to have nosocomial infection in neonatal intensive care unit of the authors' hospital from January 2008 to December 2012. Their data of the infection rate, risk factors and clinical characteristics were retrospectively analyzed.</p><p><b>RESULT</b>During the study, nosocomial infection occurred in 78 extremely premature infants 129 times. The nosocomial infection rate was 66.10%. The rate of ventilator-associated pneumonia (VAP) was 1.43% (35/2 452). The catheter related blood stream infection (CRBSI) rate was 0.35% (16/4 613). There were 74 (57.36%) cases of pneumonia, which was the most common nosocomial infection of extremely premature infants. There were 35 cases of VAP, which accounted for 47.30% of pneumonia. The next was sepsis, 48 cases. Seventy-four (74/90, 82.22%) strains of isolates were Gram-negative bacteria, which accounted for the highest proportion, followed by Gram-positive (12 strains), fungus (4 strains); Klebsiella pneumonia is the most common pathogens of nosocomial infection in extremely premature infants. The isolation rates of Klebsiella pneumonia with positive extended-spectrum beta-lactamases (ESBL) were 90.91% (20/22) , universally resistant to cephalosporins. Single-factor analysis showed that the body weight, mechanical ventilation, umbilical vein catheterization, central venous catheter, parenteral nutrition and hospitalization time were risk factors for nosocomial infections in extremely preterm infants. Logistic regression analysis showed that length of hospitalization (OR = 1.024, P = 0.043) and central venous catheterization (OR = 6.170, P = 0.041) were independent risk factors of nosocomial infection.</p><p><b>CONCLUSION</b>Extremely preterm infants were at higher risk of nosocomial infection. It is important to identify the high risk factors for nosocomial infections in extremely premature infants. To shorten time for mechanical ventilation, central venous catheterization and hospitalization days would be conducive to reducing the morbidity of nosocomial infection.</p>

Early diagnosis of sepsis with C-reactive protein, serum amyloid A and CD64 in very low birth weight infants / 中华围产医学杂志

Objective To investigate the value of C-reactive protein (CRP),serum amyloid A (SAA) and CD64 in early diagnosis of sepsis in very low birth weight infants (VLBWI).Methods Fifty-four VLBWI suspected to sepsis and 20 VLBWI without infection in neonatal intensive care unit of the Second Hospital of Wenzhou Medical College from May 2010 to May 2012 were enrolled in this study.CRP,SAA and CD64 of sepsis group were measured at 0 and 24 hour after suspected bacterial infection; and those of control group were measured at corresponding age.CRP and SAA were detected by enzyme-linked immunosorbent assay,and CD64 was detected by flow cytometry.The difference between groups was compared by Mann-Whitney U test.Receiver operating characteristic curve was used to predict the sensitivity and specificity of the three biomarkers on sepsis.Results Fifty-four VLBWI were suspected with sepsis,and 37 patients were finally diagnosed.The levels of the three biomarkers in sepsis group were higher than those of control group not only at 0 h [CRP:13.3 mg/L(4.6-67.2 mg/L) vs 4.4 mg/L(1.6-11.2 mg/L),Z=-2.308; SAA:95.7 mg/L(4.5-265.9 mg/L) vs 7.3 mg/L(2.5-16.9 mg/L),Z=-2.425; CD64:7306 fluorescent antibody molecules/cell (2667-10 853 fluorescent antibody molecules/cell) vs 2502 fluorescent antibody molecules/cell (1839-3017 fluorescent antibody molecules/cell),Z=-3.704],but also at 24 h[CRP:35.4 mg/L (7.7 106.5 mg/L) vs 3.2 mg/L (1.1-7.8 mg/L),Z-5.501; SAA:359.3 mg/L (3.8-503.2 mg/L) vs 6.6 mg/L (3.0-12.7 mg/L),Z =-2.818; CD64:8304 fluorescent antibody molecules/cell (2819-11 758 fluorescent antibody molecules/cell) vs 2563 fluorescent antibody molecules/cell (1760-3154 fluorescent antibody molecules/cell),Z =-7.670],P＜0.05 respectively.The best cutoff value of CD64 was 2934 fluorescent antibody molecules/cell,with the sensitivity of 81.1％ at 0 h and 91.9％ at 24 h; and the specificity of 90.0％ at 0 h and 80.0％ at 24 h.Although SAA had similar sensitivity (0 h:83.8％; 24 h:86.5％) as CD64,its specificity was relatively low(0 h:65.0％; 24 h:55.0％).Both the sensitivity (0 h:62.2％; 24 h:70.3％) and specificity (0 h:70.0％; 24 h:70.0％) of CRP were low.Combination of the three infection biomarkers could increase the sensitivity (0 h:91.9％; 24 h:97.2％) and specificity (0 h:95.0 ％ ; 24 h:90.0％).Conclusions Combination of CRP,SAA and CD64 might improve the diagnostic accuracy of sepsis in VLBWI.

Metabonomics in diabetes research / 中华内分泌代谢杂志

Diabetes mellitus is a typical metabolic disease.Its complications cause the main damage and lead to high mortality and disability eventually.The exact mechanism of diabetes is still unknown at present,and no radical cure of it is available.Therefore,the prevention of diabetes has become a priority.Metabolomics as a new technology can identify and measure the entire metabolic changes in the organism,and therefore has been widely applied to diabetes related studies with its enormous potential.

Comparison of five methods used for detection of Clostridium difficile infection / 中华检验医学杂志

Objective To evaluate five detection methods for the laboratory diagnosis of Clostridium difficile infection in the hospitals of USA, and explore a sensitive, specific, accuracy and rapid regimen for the early diagnosis of Clostridium difficile infection. Methods A total of 174 stool specimens submitted to the clinical microbiology laboratory for Clostridium difficile testing were separately tested by five methods including toxigenic culture (TGC), Premier Toxin A&B EIA( A/B-EIA), C. Diff Quick Chek Complete( DEIA), BD G eneOhm Cdiff assay(BD-PCR) and Laboratory-developed PCR(LD-PCR). The gold standard of TGC was used as a reference criterion, and the sensitivity, specificity, positive predictive value ( PPV )and negative predictive value (NPV) of A/B-EIA, D-EIA, BD-PCR and LD-PCR assays were determined. Results Among the 174 specimens studied, 24 were defined as true positives for Clostridium difficile infection by TGC assay, giving a positive rate of 13.8% (24/174). In comparison to the standard,the sensitivity, specificity, PPV and NPV were 62.5%, 99.3%, 93.8% and 94.3% for A/B-EIA;66.7%, 98.7%, 88.9% and 94.9% for D-EIA; 83.3%, 98.7%, 90.9% and 97.4% for BD-PCR;79.2%, 93.3%, 65.5% and 96.6% for LD-PCR. Among all tested specimens, 34 were positive by atleast one of five methods, and of which 15 were concordant by all five methods. The D-EIA results were divided into three groups depending on results of GDH and (or) toxins A/B: 18 were positive for both GDH and toxins A/B, 23 were positive for only GDH, and 133 were negative for both GDH and toxins A/B. Of 18 positive specimens by D-EIA assay, all were concordant with results of BD-PCR assay and 16 were agreement with results of TGC assay. Twenty-two of 24 positive specimens by TGC assay were included in 41 specimens that were positive for GDH. Among eight false negative specimens by D-EIA assay, four were differentiated as positive results by BD-PCR. According to the present study, the sensitivity, specificity,PPV and NPV of a two-step detection algorithm in combination with D-EIA and BD-PCR assays were 83.3%, 98.7%, 90.9% and 97.4%, respectively. Conclusions From the point of technological evaluation, BD-PCR is preferable. A two-step detection algorithm combining D-EIA with BD-PCR is proposed for the laboratory diagnosis of Clostridium difficile infection. This algorithm has demonstrated an excellent sensitivity and specificity, as well as decreased test turnaround time and test cost.

Effect of Tianwang Buxin decoction or Tianwang Buxin without Radix platycodi decoction on brain neurotransmitter of rats hyposomnia model / 中国中药杂志

<p><b>OBJECTIVE</b>To understand the action mechanism of Tianwang Buxin decoction that is the whole prescription included all drugs from Tianwang Buxin honeyed pill and Tianwang Buxin without radix platycodi decoction on the nerves-calming and hyposomnia-curing.</p><p><b>METHOD</b>The influence of Tianwang Buxin decoction and Tianwang Buxin without radix platycodi decoction on somnus utilizing the mice' s somnus in coordination with Pentobarbital sodium was observed. Investigation whether the compatibility of radix platycodi affect the concentration of brain neurotransmitter, 5-HT, NA and DA, correlated sleep-awareness by HPLC-ECD detection was carried out after rats' hyposomnia model were founded.</p><p><b>RESULT</b>The falling asleep rates of mice given subthreshold dose raised (P<0.05), remarkably because of Tianwang Buxin decoction. But there is significant difference with Tianwang Buxin lack of radix platycodi decoction despite the heightening tendency. All groups were discovered that the level of 5-HT and 5-HIAA, the monoamine transmitter, heighten obviously after the whole prescription and the prescription without radix platycodi were administered in nuclei raphae medullae oblongatae (P<0.05), but it is only the whole prescription group that emerged same phenomenon in the Ammon's horn and striatum area. Furthermore significant difference exist as comparing Tianwang Buxin whole prescription decoction with Tianwang Buxin without radix platycodi decoction. The level of another monoamine transmitter DA stepped up notably in the whole prescription and the prescription without radix platycodi groups following administration in corpora striata (P<0.05).</p><p><b>CONCLUSION</b>The mechanism of hypnosis action lie in enhancement of releasing 5-HT in encephalic regions for the Tianwang Buxin whole prescription decoction, but it's possible that radix platycodi may be the key point that adjusts the additional quantity.</p>

The expression of VEGF and PCNA in papillary thyroid carcinoma / 中国基层医药

Objective To investigate the expression of vascular endothial growth faetor(VEGF) proliferating cell nudear antigen(PCNA) and their biological significance was studied in papillary thyroid carcinoma and normal thyroid tissues. Methods Immuohistochemismy S-P technique was used to examine the expression of VEGF and PCNA in specimens of 58 papillary thyroid carcinoma and 19 normal thyroid tissues. Results The positive rates of VEGF and PCNA in papillary thyroid were higher than those in normal thyroid tissues( P＜0.01 ), and a positive correlation between these two expressions existed in papillary thyroid carcinoma. Conclusion VEGF and PCNA could be regarded as parameters to evaluate the biological behavior and they might be the indices for juvant diagnosis and evaluation of papillary thyroid cancer.

Progress in the study on insomnia animal model / 中国药理学通报

Hypnotic is the choice drug which etiologically and semeiologically treats insomnia. One of the key points for the hypnotic study is to design and choose satisfactory animal models, which links the preclinical foundation research to the clinical research. In this paper, according to the different models building theories——Traditional Chinese Medicine and modern medicine, the mechanisms, methods, advantages and disadvantages, applicable conditions of the insomnia animal models building were reviewed briefly.