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Objective:To investigate the clinical characteristics of septic shock caused by an invasive pneumococcal disease (IPD) and analyze the factors that affect the prognosis of this disease.Methods:We retrospectively analyzed the clinical data of 42 children with an IPD-caused septic shock, who received treatment in The Second Hospital of Jiaxing from January 2015 to December 2020, and evaluated the clinical characteristics and prognosis of this disease.Results:The age of the included children averaged 1.3 (0.75, 4.15) years. The Pediatric Index of Mortality 2 was (23.38 ± 9.26) points. Infections were primarily in the blood and brain. Eighteen cases were sensitive to penicillin, 20 cases to cefepime, 22 cases to cefotaxime, and 20 cases to meropenem, vancomycin, and linezolid simultaneously. The mortality was 61.90% (26/42). The Pediatric Index of Mortality 2 [(37.17 ± 10.58) points vs. (0.92 ± 0.39) points, t = 17.45, P < 0.001], and the rate of children developing an intracranial hypertension crisis (69.23% vs. 25.03%) ( χ2 = 7.77, P = 0.05) were significantly higher in the death group than in the survival group. Compared with the survival group, the thoracic infection rate was significantly lower in the death group (7.69% vs. 50.00%, P < 0.05). Conclusion:Most children with an IPD-caused septic shock are young, and most infection sites are in the brain and blood. The IPD-caused septic shock is highly resistant to cephalosporins and penicillin and has high mortality because of an intracranial hypertension crisis. The IPD-caused septic shock should be screened and treated as early as possible.
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OBJECTIVE To explore the research sta tus，hotspots and frontier trends in the field of domestic evidence-based traditional Chinese medicine ，and to provide reference for the development of this field. METHODS Retrieved from CJFD ，VIP and Wanfang database ，CiteSpace software and bibliometrics method were used to statistically analyze the annual quantity of documents published ，authors，institutions，and keywords ，etc. RESULTS A total of 3 154 papers were included in this study ，and the annual number of papers presented an overall upward trend. The author with the highest number of papers was Liu Jianping ， who published 106 papers and was closely connected with other authors. China Academy of Chinese Medical Sciences ，Beijing University of Chinese Medicine and Tianjin University of Chinese Medicine were highly productive institutions ，with more than 100 articles published each and a relatively wide range of cooperation. Evidence-based medicine ，Traditional Chinese Medicine ， evaluation，evidence-based nursing ，review，medical education ，clinical research and other high-frequency keywords （frequency of more than 100 times each ）formed hot topics of research. CONCLUSIONS The research of evidence-based traditional Chinese medicine in China has been paid more and more attention ；“evidence-based medicine ”“traditional Chinese medicine ” “evidence-based nursing ”and“clinical research ”are the research hotspots.
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OBJE CTIVE To provide reference for the adjustment and optimization of the policies related to traditional Chinese medicine（TCM）injection in China. METHODS The policies related to TCM injections issued at the national level were collected from Jan. 1，1990 to May 31，2021. Based on the perspective of policy tool ，the content analysis and quantitative analysis were used to classify ，code and analyze the policy terms according to “policy serial number-chapter number-specific terms ”. RESULTS & CONCLUSIONS Totally 30 policy documents related to TCM injection were included ， with a total of 389 codes. Environment-based policy tools were the most widely used （79.95％），followed by supply-oriented policy tools ，accounting for 15.42％. Demand-based policy tools accounted for the least proportion （4.63％）. Among environment-based policy tools ，the regulatory and control policy tools （38.05％） received more attention，and the policy publicity （2.06％） received fewer applications. Among supply-oriented policy tools ，there were more applications of science and technology support （10.80％）， and fewer applications of capital investment （0.26％）. Among demand- based policy tools ，organizational coordination was the most widely used （3.34％），followed by experience demonstration （1.29％），which had not yet involved the relevant policies of international exchange. In order to promote the development of TCM injection ，it is necessary to appropriately reduce the application of environment-based policy tools ，increase the application of policies such as policy publicity ，and improve the external environment for TCM injection ；optimize the internal combination of supply-oriented policy tools ，increase the use of capital investment tools ，and effectively play the role of policy boosting；emphasize the application of demand-based policy XJY21013） tools to form an effective policy pulling force for the healthy development of TCM injection.
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Objective:To investigate the effects of obesity before pregnancy and excessive weight gain during pregnancy on the characteristics of offspring metabolism and the underlying mechanism.Methods:Pregnant women who delivered from April 2016 to December 2018 in Jiaxing Xiuzhou District Maternal and Child Health Hospital after providing written informed consent and their singleton newborns were considered for recruitment for this study. Finally, 2000 pregnant women and their newborns were included in this study. These pregnant women were divided into study control ( n = 1 576, normal body weight) and ( n = 424, overweight) groups according to their body mass before and during pregnancy. The levels of leptin, blood lipid, fasting blood glucose, fasting insulin, long form of leptin receptor (OB-Rb), suppressor of cytokine signaling 3 (SOCS3) gene expression, insulin resistance index, and insulin sensitivity index were compared between the control and study groups. Results:The body mass index before pregnancy and body mass during pregnancy in the study group were (30.91 ± 1.86) kg/m 2 and (21.25 ± 2.61) kg, respectively, which were significantly higher than those in the control group [(26.87 ± 1.05) kg/m 2, (14.57 ± 1.36) kg, t = 7.972, P = 0.013; t = 9.786, P = 0.001]. The levels of leptin, triglyceride, total cholesterol and low-density lipoprotein cholesterol in the study group were (1.23 ± 0.29) ng/mL, (0.65 ± 0.16) mmol/L, (1.40 ± 0.24) mmol/L, (0.76 ± 0.13) mmol/L, respectively, which were significantly higher than those in the control group [(0.63 ± 0.11) ng/mL, (0.38 ± 0.16) mmol/L, (1.13 ± 0.32) mmol/L, (0.56 ± 0.09) mmol/L, t = 7.701, P = 0.010; t = 7.329, P = 0.019; t = 5.734, P = 0.030; t = 9.387, P = 0.001]. The level of high-density lipoprotein cholesterol in the study group was significantly lower than that in the control group [(1.26 ± 0.17) mmol/L vs. (1.75 ± 0.26) mmol/L, t = 8.072, P = 0.008]. The expression of SOCS3 mRNA and OB-Rb mRNA in newborns from the study group was (1.44 ± 0.29) and (1.33 ± 0.39), respectively, which was significantly greater than that in the control group [(0.33 ± 0.19), (0.50 ± 0.21), t = 9.987, P < 0.001; t = 11.037, P < 0.001]. Fasting blood glucose and fasting insulin levels as well as insulin resistance index in the study group were (22.06 ± 3.94) mmol/L, (20.02 ± 4.61) mU/L, (19.79 ± 6.29) respectively, which were significantly higher than those in the control group [(11.73 ± 2.92) mmol/L, (13.31 ± 3.43) mU/L, (6.96 ± 2.52), t = 8.133, P = 0.001; t = 4.498, P = 0.027; t = 7.352, P = 0.002]. Insulin sensitivity index in the study group was significantly lower than that in the control group [(-6.07 ± 0.32) vs. (-4.98 ± 0.37), t = 8.244, P < 0.001]. Conclusion:Obesity before pregnancy and excessive weight gain during pregnancy will increase the expression of SOCS3 mRNA and further affect the expression of STAT3-SOCS3-leptin/insulin signaling pathway in offspring.
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Objective@#The aim of this study was to explore the clinicopathologic characteristics and prognostic factors of Paget′s disease.@*Methods@#137 patients with Paget′s disease of the breast who were diagnosed in Cancer Hospital Chinese Academy of Medical Sciences between January 2007 and May 2016 were identified and included in the study, including 134 females and 3 males.@*Results@#The average age at onset of the disease was 51.8 years(range, 27-78 years). Among the 137 patients, 7 cases were Paget′s disease without any other underlying malignancy, who were alive during the follow-up period. The other 130 patients were diagnosed with Paget′s disease and underlying ductal carcinoma in situ (DCIS) or (and) with an invasive carcinoma. The positive expression rates of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) were 29.2%(40/137), 38.0%(52/137)and 78.1%(107/137), respectively. The two-year and five-year overall survival were 99.0%, 96.0%, and disease-free survival of two-year and five-year were 97.6%, 92.8%, respectively for all 137 patients. On survival analysis, longer course of disease, HER-2 positivity, tumor stage(T1-T4), and axillary lymph node metastasis were significantly associated with overall survival.@*Conclusions@#Paget′s disease of the breast is a slowly progressive malignancy with good prognosis. A longer course of disease, HER-2 positivity, tumor stage, axillary lymph node metastasis and distant metastasis were significantly associated with poor prognosis.
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Objective: To develop a model for rapid and non-destructive determination of amoxilcillin sodium and sulbactam sodium for injection using the analysis of near infrared diffuse reflectance spectroscopy (NIR) and chemometrics.Methods: Totally 41 batches of commercial samples and 20 batches of laboratory samples were analyzed by NIR and the legal methods.The first derivative and vector normalization were selected as the preprocessing methods and 8 720-5 446 cm-1 was selected as the frequency range.Results: The quantitative model was constructed based on 16 batches of commercial samples and 15 batches of laboratory samples (0.75 g) and the content ranged from 4.45% to 61.82% for amoxilcillin and 15.75% to 30.25% for sulbactam.The root mean square errors of cross validation (RMSECV), determination coefficients (R 2) and root mean square errors of prediction (RMSEP) respectively was 0.858 , 0.998 1 and 0.936 for amoxilcillin, and respectively was 0.541 , 0.988 1 and 0.423 for sulbactam.The model was tested based on 5 batches of commercial samples and 5 batches of laboratory samples (0.75 g) and the results well met with those of the legal methods with difference ≤ 1.5 %.The model also applied in 10 batches of commercial samples (1.5 g) and 2 batches of samples from the other manufacturers.Conclusion: The non-destructive quantitative NIR methods are accurate with good reproducibility, and applicable for the rapid analysis of amoxilcillin sodium and sulbactam sodium for injection.
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Objective: To establish an HPLC method for the determination of mannityl nicotinate and its related substances. Methods:The HPLC method was performed on an Agilent Extend-C18 column (250 mm × 4. 6 mm, 5 μm) with the mobile phase of 0. 01 mol·L-1 ammonium acetate solution-methanol(40∶60). The detection wavelength was 264nm. The column temperature was 30℃. The flow rate was 1. 0 ml·min-1 and the injection volume was 10 μl. Results: The linear range of mannityl nicotinate was 53. 6-1 072. 8 μg·ml-1(r=1. 000 0), and the mean recovery was 98. 9%(RSD=0. 4%,n=9). Mannityl nixotinate and its related substances could be well separated. The limit of quantitation was 0. 06 μg·ml-1 and the limit of detection was 0. 02 μg·ml-1 . Con-clusion:The method is specific, accurate and rapid. It is suitable for the quality control of mannityl nicotinate.
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This is a work aimed to investigate the biodegradability, biocompatibility and mechanical property of the poly-lactide-co-glycolic acid (PLGA) knitted mesh preliminarily and to further explore its applications in tissue engineering and regenerative medicine. The biological property of PLGA mesh was investigated comprehensively with the degradation experiment in vitro, the acute cytotoxicity assay, the intradermal irritation test and the subcutaneous implantation test in vivo utilized. The degradation experiment in vitro demonstrated that the pH value of the removed solution fluctuated between 6.68 and 7.33. The elastic modulus of the PLGA mesh increased at first and then decreased afterwards. The acute toxicity test and the intradermal irritation test indicated that the PLGA mesh was with innocuity safety. The PLGA mesh accelerated degradation and was replaced gradually by the neotissue. The results of immunohistochemical staining demonstrated that the number of ED-1+ cells increased at first and then decreased afterwards. The PLGA mesh with excellent mechanical properties, good biocompatibility and favorable degradation ratio has the potential to be employed as a "skeleton" to reinforce the mechanical property of collagen-based dermal substitutes in tissue engineering.