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In the implementation of exemption from ethical review, medical institutions equate exemption from ethical review with no ethical review or simple review, misunderstand the scope of exemption from ethical review, confuse the concepts of de-identification and anonymization, and equate privacy with personal information. The implementation faced challenges such as the coordination of conditions for exempt review with other regulations, the lack of clear decision-making subjects for exempting from ethical review, the legality and compliance of using general informed consent for biological samples and information data, as well as non-traceability and the risk of being re-identified of anonymous information for exemption from ethical review. Measures such as improving relevant laws and regulations, perfecting the construction and management of information databases and biological sample libraries, strengthening the project management and process supervision of exemption from ethical review, and implementing scientific review can ensure the legal and compliant implementation of exemption from ethical review by medical and health institutions.
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Objective@#To investigate the expression and clinical significance of ribonucleotide reductase small subunit M2 (RRM2) in chronic hepatitis B virus (HBV) infection and related liver diseases.@*Methods@#A total of 428 patients with chronic HBV infection and liver disease were enrolled from Songyang County People’s Hospital from October 2017 to September 2019. There were 166 cases of chronic hepatitis B (CHB), 53 cases of HBV-related cirrhosis, 28 cases of non-HBV-related cirrhosis, 57 cases of HBV-related liver cancer, 33 cases of non-HBV-related liver cancer, and 91 cases of non-viral hepatitis. In addition, 36 healthy subjects were selected as the control group. Among 166 cases of CHB, there were 87 patients with high viral load group (HBV DNA ≥4.0 lg IU/mL) and 79 patients with low viral load group (HBV DNA <4.0 lg IU/mL); while in 87 high viral load patients, 56 had high alanine transaminase (ALT) (≥40 U/L) and 31 had normal ALT (<40 U/L). The expression level of serum RRM2 protein in patients was detected by enzyme-linked immunosorbent assay (ELISA), and the relationship of RRM2 expression with HBV DNA and liver function was analyzed. SPSS 23.0 and PRISM 8.0 statistical software were used to analyze data. Correlation analysis was performed using Spearman analysis.@*Results@#The serum ALT and RRM2 levels in patients with high viral load CHB were higher than those in low viral load group (Z=-6.68, t=6.80, P<0.01). Patients with HBV-related cirrhosis had higher serum RRM2 levels than those with non-HBV-related cirrhosis (t=9.16, P<0.01). The serum RRM2 level was higher in patients with HBV-related liver cancer than that in patients with non-HBV-related liver cancer (t=12.42, P<0.01). Among patients with high viral load CHB, there was no significant difference in serum RRM2 levels between patients with ALT ≥40 U/L group and patients with ALT <40 U/L group (t=0.51, P>0.05). The level of ALT in the non-viral hepatitis group was higher than that in the healthy control group (Z=-8.43, P<0.01), but there was no significant difference in serum RRM2 levels between the two groups (t=1.03, P>0.05). Correlation analysis showed that serum RRM2 level was positively correlated with HBV DNA load (r=0.51, P<0.01), but not correlated with liver function indicators such as ALT and aspartate aminotransferase (all P>0.05) in patients with chronic HBV infection and related liver diseases.@*Conclusions@#Serum RRM2 level is positively correlated with HBV DNA load and has no significant correlation with ALT. RRM2 might be used as a target for the development of new hepatitis B drugs.
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Objective To discuss the relationship between discipline ranking and personnel rationality,and explore the problems of personnel development among all the disciplines and put forward further countermeasures.Methods A 3A general hospital in Beijing was targeted,and departments in it were divided into,in descending order of hospital regulations,key disciplines,developing-key disciplines,characteristic disciplines and general disciplines.To analyze the rationality of personnel,four dimensions as educational background structure,professional title structure,age structure and academic proficiency of department leader were adopted.Results The hospital had 52 departments in total,which were divided into key disciplines (7),developing-key disciplines (10),characteristic disciplines (6) and general disciplines (29).With the decline of the discipline level,the problem of the talent team was gradually increasing.The major problem of personnel among all the disciplines was that the proportion of senior staff was too high,so did the key disciplines and developing key disciplines.Age structure irrationalized was another major problem for developing-key disciplines.As for characteristic disciplines,the problems in personnel were even diversified,which included not only the irrational age structure and senior professional proportion,but also the fact that director of one third of these departments showed low academic proficiency.In general disciplines,all above four types of problems exited.Conclusions The rationality of the talent team is closely related to the level of the discipline.Problems in personnel varied among different disciplines,and countermeasures should be provided targeted at existing problems.
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Objective To study the effect of licorice on the pharmacokinetics of lovastatin in hyperlipidemic rat model.Methods Eighteen rats were randomly divided into control group (n =6) and test group (n =12).Rats in the test group were administered high fat diet to construct hyperlipidemic rat model.The 12 hyperlipidemic rats were then randomly divided into two groups:lovastatin group (n =6) and lovastatin combined with hcorice group (n =6).The rats in both groups were administered lovastatin capsule (20 mg/kg,0.5% CMC-Na solution) after receiving licorice (for lovastatin combined with licorice group) or saline (for lovastatin group) for 7 days.Blood samples were collected at different time points before and after the administration of lovastatin capsule.The plasma concentrations of lovastatin and lovastatin acid (an active metabolite of lovastatin) were determined by LC-MS/MS method.Pharmacokinetics parameters were calculated using DAS 2.0 software,and the two groups were compared using SPSS 18.0 software.Results Long-term administration of licorice resulted in a significant increase in the plasma level of lovastatin acid in the hyperlipidemic rat,and the corresponding mean Cmax was approximately 80% higher than that of the lovastatin group (P < 0.05),while AUC0-t and AUC0-t increased by 115% and 109%,respectively (P =0.005 and P =0.027).Cmax and AUC of lovastatin also increased,but there was no statistical significance (P > 0.05).Conclusion Licorice can inhibit the metabolism of lovastatin in hyperhpidemic rats and increase its exposure in vivo.
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Under the background of"medical education synergy", there are still some problems such as the poor treatment of graduate students, mismatching of between the master's degree point and standard-ized training base for resident, weakening of tutor guidance, and the lack of corresponding resident training bases of some secondary disciplines. Starting from the actual work experience, through the expansion of the coverage of resident training funds, integration of the resident training base with master's degree point in medical institutions, the establishment of tutor groups, and strengthening the cultivation of students' innova-tion and research ability, our hospital has improved the shortcomings of the current training work in many directions to improve the postgraduate education system of master degree in clinical medicine.
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Objective To investigate the antibiotic resistance in clinical isolates in the Second Hospital of Hebei Medical University from 2015 to 2016.Methods A total of 16 292 strains of non-duplicate bacterial strains were collected.The isolates were subjected to identification and antimicrobial susceptibility testing on VITEK 2-Compact system.The data were processed and analyzed using WHONET 5.6 software.Results Specifically,7 961 and 8 331 strains of pathogens were collected in 2015,2016,respectively.Gram-negative bacteria accounted for 62.0% in 2015 and 66.9% in 2016,respectively.The top five pathogens isolated in these two years were still Klebsiella pneumoniae,Escherichia coli,Acinetobacter baumannii,Pseudomonas aeruginosa,and Staphylococcus aureus.The proportion of K.pneumoniae increased to the first place in 2016 which accounted for 16.1%.Coagulase negative Staphylococcus in blood samples decreased from 42.6% in 2015 to 30.0% in 2016.Vancomycin resistant strains were not found in Staphylococcus.In 2015 and 2016,the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was 56.2% and 51.3%,respectively.The prevalence of methicillinresistant coagulase negative Staphylococcus (MRCNS)was 79.3% and 63.1%,respectively.Enterococcus faecalis and Enterococcus faecium accounted for 25.2% and 73.2% respectively in the 911 strains of Enterococcus.In 2015 and 2016,3.1% and 2.9% of the E.faecium strains were resistant to vancomycin,respectively.In 2016,the prevalence of carbapenemresistant strains increased in K.pneumoniae,E.coli and E.cloacae.K.pneumoniae showed increasing resistance rate to all the antimicrobial agents tested except for gentamicin and amikacin.The percentage of the K.pneumoniae strains resistant to imipenem and meropenem increased from 19.3%,18.5% in 2015 to 24.2%,23.1%,respectively.A.baumannii isolates were still highly resistant to the commonly used antibiotics in these two years,but relatively susceptible to polymyxin B,tigecycline,cefoperazone-sulbactam and minocycline (<30% resistant).P.aeruginosa isolates showed lower resistance rate to amikacin (11.7%),cefoperazonesulbactam (15.5%),piperacillin-tazobactam (18.7%),ceftazidime (20.1%),cefepime (21.9%).P.aeruginosa presented a trend of declining resistance to all the antimicrobial agents tested from 2015 to 2016,except aztreonam,to which the resistant P.aeruginosa strains increased from 27.0% in 2015 to 34.7% in 2016.Conclusions The antimicrobial susceptibility profile of clinical bacterial isolates has been changing constantly.We need to adopt effective infection prevention and control measures in hospital and further standardize and control the use of antibacterial agents.
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Objective:To confirm the novel allele HLA-A*01∶130 and analyzed the nucleotide sequence of the abnormal reaction pattern.Methods: The HLA typing of sample DNA was performed by PCR-SBT.The ambiguous novel HLA allele was confirmed with single stranded SBT method,then DNA sequencing was performed to identify the difference between the novel allele and HLA-A?01:66 allele.Finally, it was modeled by Swiss-Model to three-dimensional structure of HLA Molecule.Results: The novel allele was not the same with all known HLA-A allele sequence.After analysis,there was one nucleotide differed from the A?01:66 at position 368 where A→G( codon 99 TAT→TGT) resulting in a coding change,99 Tyr was changed to Cys.The amino acid substitution at residue 99 the HLA polypeptide was located in a beta-sheet of antigenic peptide-binding region.Conclusion: The allele is a novel allele that has now been officially named as HLA-A*01∶130 by the World Health Organization( WHO) HLA Nomenclature Committee.
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90,180 and 360 mg·kg-1 on general central nervous system (CNS) of mice was investigated by general behavior observation, nembu-tal subthreshold hypnosis experiment, spontaneous activity test and rotary rod test. The changes in blood pressure, heart rate, electro-cardiogram, breathing flow and frequency in anaesthetic Bealge dogs were observed to evaluate the effects of the capsules respectively at the low, medium and high dosage of 16,32 and 64 mg·kg-1 on cardiovascular and respiratory systems. Results:The general behavior of mice was normal after the administration of Sansheng Jindan capsules. The capsules showed no synergetic hypnotic effect on nembu-tal, and had no influence on the spontaneous activity and body coordination ability of mice (P>0. 05). The blood pressure, ECG and respiratory index of anaesthetic Bealge dogs were also normal after the administration of the capsules (P>0. 05). Conclusion:There are no significant effects of Sansheng Jindan capsules at the experimental dosages on central nervous system of mice and respiratory and cardiovascular systems of Beagle dogs.
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Objective To investigate antimicrobial resistance and pathogen in hebei antibacterial resistance investigation net in 2012.Methods Antimicrobial susceptibility test was detected by Kirby-Bauer method or broth dilution test.Results were analyzed according to CLSI 2010 breakpoints.WHONET 5.5 software was used to analyze the data.Results A total of 10 504 clinical isolates were collected in 2012,of which gram negative bacilli and gram positive cocci accounted for 76.2%, 23.8%,respectively.The most common pathogen in gram-negative rod was E.coli,K.pneumoniae,P.aeruginosa, A.baumanii and E.cloacae respectively.The most common pathogen in gram-positive cocci was S.aureus,E.facium,E-.faecalis,S.pneumoniae and S.epidermidis.ESBL rate of E.coli and K.pneumoniae was 66.5 and 46.7%.The resistant rate of E.coli,K.pneumoniae,E.cloacae to imipenem was 0.1%,0.5%,8.9% and to meropenem was 0.1%,0.6%,4.2%, respectively.P.aeruginosa was resistant to imipenem and meropenem were 38.9% and 32.3%.A.baumanii was resistant to imipenem and meropenem were 5 6.5% and 5 9.7%.Methicillin-resistant strains accounted for an average of 5 7.5% in S.aureus and 87.3% in coagulase negative staphylococcus.Staphylococcus was still susceptible to minocycline and chloram-phenicol.No staphylococcal strains were found resistant to vancomycin,linezolid.But a few coagulase negative staphylococcal strains were resistant to teicoplanin.Conclusion Surveillance of antimicrobial agents played an important role in controlling hospital infection.
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Objective To investigate β-lactamase gene and class 1 integron gene from 60 clinical Acinetobacter baumannii isolates.Methods The minimal inhibitory concentrations (MICs) for 16 antibiotics widely used were determined using the standard broth microdilution method.The β-lactamase gene,class 1 integron gene and adeB gene were determined by PCR and then sequenced.Results Fifty-three strains of the 60 A.baumanii isolates were multi-drug resistant.OXA-23 gene was detected positive in six A.baumanii isolates,which were all resistant to more than five antimicrobial agents including carbapenem and showed high resistance to many antibiotics.Thirtyeight strains earring PER-1 gene showed higher resistance to cephalosporins than those without this gene (P<0.01).Class 1 integron gene was positive in 45 strains,which exhibited significantly higher multiple resistance than those without this gene (P<0.01).Twenty-five strains carrying both class 1 integron and PER-1 genes had a markedly higher multiple resistance (P<0.01),but not in resistant level,compared to the 7 strains without these two genes.Conclusion Class 1 integron and β-lactamase gene may be the causes of muhidrug-resistance of A.baumanii.The strains carrying OXA-23 gene always showed multiple and high resistance to several antibiotics,so effective measures must be taken to control the epidemic of these strains.
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Objectives To analyze the characteristics of antigenic genes of clinical Bordetella pertussis strains recently isolated by analyzing the sequence of pertussis toxin S1 subunit(ptxS1) , pertactin (Prn) , fimbriae 2 (Fim2) and fimbriae 3 (Fim3 ) genes of four clinical isolates. Methods The 4 clinical isolates were collected in 2002 in Shijiazhuang of Hebei province. Four strains were isolated from pertussis patient's nasopharyngeal aspirate. ptxS1, Prn, Fim2 and Fim3 genes of these strains were amplified and sequenced. The sequences of those genes were compared with those of the isolates in GenBank and the isoaltes used in the production of pertussis vaccine in China. Results The results of the gene sequencing showed the four clinical isolates belonged to ptxS1 A type, which were different from those in vaccine strains. In addition, three Prn and three Fim'3 variants were observed in the four clinical isolates. Sequence analysis showed that the nucleotide sequence and deduced amino acid sequence of those strains had more than 99% identity with those in vaccine strains. The phylogenetic trees of those genes also showed these strains had a higher level of similarity with other Bordetella pertussis strains. Conclusion The four clinical isolates are different from vaccine strains in four antigenic genes, which laid a foundation for further studies on pertussis epidemiology,quality control and development of pertussis vaccine in China.
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Objective To explore the efficacy of intratympanic dexamethasone injection in treating acute low-frequency hearing loss(ALHL).Methods Thirty-seven ALHL cases not responsive to intravenous dexamethasone and vasodilator medications were enrolled in the study and divided into two groups.In the treatment group,dexamethasone was injected intratympanically once per day to 18 cases for a seven-day history with unilateral ALHL and 1 case with bilateral ALHL.In the control group,18 cases with unilateral ALHL were given intravenous vasodilator medications for 7 days.All patients were followed up for 1~ 2 years.Results In the treatment group with unilateral ALHL,8 cases achieved complete recovery,7 cases achieved partial recovery and no change was observed in the other 3 cases.The efficiency was 83.3 %.2 cases showed recurrent low-frequency hearing loss during the follow-up period.One case with bilateral ALHL did not respond to the treatment and no recurrence was observed.No side effect was observed in the study.In the control group,3 cases completely recovered,5 cases partially recovered and 10 cases showed no improvement.The efficiency was 44.4%.5 cases recurred and one of them progressed to Meniere's disease.There was a statistically significant difference in efficiency of patients with unilateral ALHL between two groups(P<0.05).Conclusion Intratympanic dexamethasone application was an effective and safe treatment option for ALHL.
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OBJECTIVE To investigate the resistance of Staphylococcus aureus,includ MRSA and MSSA,to antimicrobial agents in intensive care unit(ICU),and to provide basis for clinical therapy.METHODS K-B disk diffusion method was used to determine the drug susceptibility of 171 strains of S.aureus,and meticillin-resistant S.aureus(MRSA) was detected by using the disk diffusion method according to NCCLS/CLSI.RESULTS In ICU,S.aureus was isolated mostly from the respiratory tract,urine tract and blood.MRSA made up 57.89%.For MRSA and MSSA,no resistance against vancomycin and norvancomycin was observed.The resistance rates of MRSA to other agents were as follows: chloramphenicol 20.45%,and minocycline 20.45%.While the resistance rates of MSSA to other agents were as follows:cefazolin 6.25%,and amikacin 6.25%,minocycline 9.38%.CONCLUSIONS MRSA shows the multidrug resistance.Pathogenic monitoring,keeping the patients apart,rational utilization of antibiotics,medical facility sterilization strictly and intensive hand hygiene are very important to prevent MRSA infection.
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BACKGROUND: It has been shown that Qiang Chang Heji (QCHJ) hadsome protective effects in rats with experimental brain injuries and couldimprove some hemorheological indices.OBJECTIVE: To observe effects of QCHJ on peripheral platelet in rats with experimental right brain insufficiency of blood supply.DESIGN: A randomized and controlled experiment.SETTING: Central Laboratory, General Hospital of Chengdu Military Area Command of Chinese PLA.MATERIALS: Totally 60 SD white rats (either sex, werghing from 150 g to 170 g) were used. They were divided randomly into 3 groups: sham-operation group (n=8), control group (n=18) and treatment group (n=34).QCHJ:Chinese herbal mixture, equal dosage of both Rhizoma seu Radix Notopterygii and Rhizoma Acori Graminei were decocted twice, each for 30minutes with mild fire after boiling. The two decoctions were mixed and concentrated to 1g raw herb per milliliter.METHODS: The experiment was carried out in Central Laboratory, General Hospital of Chengdu Military Area Command of Chinese PLA from July to September 2004. The right carotid artery (CA) of rats were separated,ligaturewas done in control and treatment groups ;but no ligature in sham operation group. Medication (po. by gastric perfusion) was given since the day of operation. In treatment group, 10 rats took QCHJ 10 g/kg per day for3 days; and others took 3.3, 6.7, 10 g/kg per day for 7 days respectively, (8 rats for each dose). In control group, equal volume physiological saline was given daily for 3 or 7 days. In sham operation group, equal volume physiological saline was given daily for 3 days. On the 3rd and 7th days after operation, platelet count (Plt), mean platelet volume (MPV), platelet distribution width (PDW) and platelet-large cell ratio (P-LCR) of platelet were determined with a Bakeman Blood Cell Auto-analyzer. t test was used to compare the difference.MAIN OUTCOME MEASURES:Effects of QCHJ on peripheral platelet in rats with brain insufficiency of blood in brain.RESULTS: ①Day 3 after operation: PLt were similar between control group and sham-operation group (P > 0.05); MPV, PDW and P-LCR were higher in control group than that in sham operation group (P < 0.01); in QCHJ treated group (10 g/kg per day), MPV, PDW, and P-LCR were significantly lower than that in control group (P < 0.01), and they were similar to that in sham operation group. ② Day 7 after operation: MPV, PDW, and P-LCR in control group were similar to that in sham operation group. In addition, P-LCR in control and QCHJ treatment group (3.3, 6.7, 10.0 g/kg per day) were lower than that in control group on the 3rd day of operation (P < 0.01).CONCLUSION: Experimental brain injury induced by block blood supply may result in peripheral platelet abnormities. QCHJ has been shown to improve some of the abnormities.
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<p><b>OBJECTIVE</b>To investigate the intraspecific difference of the triose phosphate isomerase (tim) gene from Giardia lamblia (G. lamblia).</p><p><b>METHODS</b>Total genomic DNA of G. lamblia was extracted and partial fragments of the triose phosphate isomerase (tim) gene were amplified by polymerase chain reaction (PCR). All nucleotide sequences were analyzed by using a phylogenetic analysis, which was constructed with parsimony and Neighbor-joining (N-J) methods.</p><p><b>RESULTS</b>A total of 124 variable sites (23% of all sequences detected) was defined, most of which were found at the silent sites of codons. Two similar phylogenetic trees were constructed, subdividing 16 Giardia isolates into two groups.</p><p><b>CONCLUSION</b>The genetic diversity of G. lamblia appeared to be little affected by factors of both host and geography, while natural-selection played an important role in DNA molecular evolution level of the tim gene. The tim gene may be considered a very useful genetic marker of the population genetic structure of G. lamblia.</p>
Subject(s)
Animals , Base Sequence , DNA, Protozoan , Chemistry , Genetics , Giardia lamblia , Genetics , Molecular Sequence Data , Phylogeny , Polymerase Chain Reaction , Sequence Alignment , Sequence Analysis, DNA , Sequence Homology, Nucleic Acid , Species Specificity , Triose-Phosphate Isomerase , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To confirm the genetic relation between Giardia lamblia (G. lamblia) isolates from different geographic regions of China and other countries.</p><p><b>METHODS</b>Genomic DNA were extracted from the trophozoites or cysts of Giardia lamblia. The triose phosphate isomerase (tim) gene was amplified using polymerase chain reaction (PCR) technique. PCR products were digested with endonuclease and sequenced. The data of sequencing were analyzed with the DNAstar software and compared with that of the isolates acquired from GenBank.</p><p><b>RESULTS</b>Of nine isolates of Giardia lamblia from China (C1, C2, CH2 and CH3), Cambodia (CAM), Australia (A1 and A2) and America (BP and CDC), respectively, 3 (A1, A2 and CAM) fit into Group 1 (WB), 2 (CH2 and CH3)) into Group 2, and 4 (C1, C2, BP and CDC) into Group 3 (GS). The results confirmed the genetic relatedness of G. lamblia isolates from all over the world.</p><p><b>CONCLUSION</b>Genotyping isolates of G. Lamblia provides important information for establishing the phylogenetic relationship or for the epidemiological evaluation of the spreading of this organism.</p>
Subject(s)
Animals , Amino Acid Sequence , Base Sequence , DNA, Protozoan , Chemistry , Genotype , Giardia lamblia , Classification , Genetics , Polymerase Chain Reaction , Restriction Mapping , Triose-Phosphate Isomerase , Chemistry , GeneticsABSTRACT
OBJECTIVE:To study the vitro antibacterial activity of domestic teicoplanin against224strains of enterococ-ci.METHODS:Determination of MIC of domestic teicoplanin against169strains of entercococcus faecalis and51strains of E.faecium was tested by agar dilution method,and its antibiotic effect was compared with that of the imported teicoplanin and other antibiotics.RESULTS:The MIC 50 of domestic teicoplanin against169strains of E.faecalis and51strains of E.faecium were0.125,0.25?g/ml respectively,MIC 90 were2,1?g/ml respectively;The MIC 50 of imported teicoplanin against E.faecalis and E.faecium were0.25,0.25?g/ml respectively,MIC 90 were1,0.5?g/ml respectively.CONCLUSION:Two kinds of te-icoplanin have strong antibacterial activity against224strains of enterococci;the sensitivity of224strains of enterococci to both kinds was100%.
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Objective To explore the change of the activities of peroxisome ?-oxidation in T2DM patients with the lipid disorders.Methods We analyzed the changes of the activities of peroxisome ?-oxidation and fatty acyl-CoA oxidase and its mRNA expression in 112 cases of T2DM patients.Results We found that there was compensatory increase in activity of peroxisome ?-oxidation of T2DM patients.As compared with control group,the activity of fatty acyl-CoA oxidase of T2DM group was increased by 5%(P