Gelatin sponge-prothrombin-iohexol for blocking needle path of CT-guided percutaneous liver biopsy / 中国介入影像与治疗学

Objective To observe the safety and feasibility of gelatin sponge-prothrombin-iohexol for blocking needle path of CT-guided percutaneous liver biopsy.Methods Totally 101 patients who underwent CT-guided needle biopsy of liver due to unexplained liver diseases,cirrhosis or space-occupying lesions of liver with coagulation dysfunction were retrospectively analyzed.After biopsy,the puncture needle path was blocked with gelatin sponge-prothrombin-iohexol.The effect and complications of puncture,also patients'coagulation and liver function indicators before and after puncture were observed.Results Successful puncture and sampling were performed in all 101 cases,with both technical success rate and adequacy of histological specimens of 100%.Accurate pathological diagnose was acquired in all 101 cases.Complications including mild pain at the puncture site,penetration of the blocking agent into the liver capsule or subcutaneous tissue were observed in a total of 18 cases(18/101,17.82%),while no severe complication such as bleeding,pneumothorax or bile duct injury occurred.No significant difference of coagulation nor liver function indicators was found before and after CT-guided needle biopsy(all P＞0.05).Conclusion Gelatin sponge-prothrombin-iohexol were safe and reliable for blocking needle path of percutaneous liver biopsy,which could reduce complications such as bleeding.

Analysis of 3D slicer volume segmentation accuracy and perspect of application in forensic practice / 中国法医学杂志

Objective To explore the effectiveness of virtual autopsy-based postmortem computed tomography(PMCT)liver three dimensional slicer(3D slicer)artificial intelligence(AI)volume reconstruction to assist forensic practice.Methods Twenty cases of the deceased who underwent both virtual autopsy and traditional autopsy in our center were selected and subjected to liver volume segmentation by 3D slicer method,Tada's formula method and literature method,and the data obtained from the traditional autopsy were compared and analyzed to obtain the accuracy rate.Results The 3D slicer method yielded higher consistency(95%confidence interval),lower volumetric variability(standard deviation),and a smaller region(variance)of uncertainty than the Tada formula method and the methods mentioned in the literature.Conclusion 3D slicer AI reconstruction based on virtual autopsy can visualize virtual anatomy,help increase the diagnostic accuracy of traditional autopsy,assist in pathological diagnosis,and provide new directions and tools for the development of imaging histology of virtual autopsy.

Mutations in CERS3 Gene Underlies a Case of Autosomal Recessive Congenital Ichthyosis / 罕见病研究

Autosomal recessive congenital ichthyosis caused by CERS3 mutations is extremely rare in clinical practice. We recently identified a family of autosomal recessive congenital ichthyosis and performed multigene exome sequencing for hereditary skin diseases to identify causative genes. Mutation analysis revealed compound heterozygous mutations of c.746A>G(from the mother) and exon12 deletion(from the father)in CERS3 were detected in the proband, which were verified by Sanger sequencing and co-segregated with the ichthyosis phenotype in the proband and her parents. These mutations were both reported for the first time. For the treatment, the proband received an oral acitretin capsules of 20 mg once daily. After 3-month follow up, the patient's lesion improved significantly.

Identification of critical radioresistance genes in esophageal squamous cell carcinoma by whole exome sequencing / 国际肿瘤学杂志

Objective:To compare the genetic spectrums of esophageal squamous cell carcinoma (ESCC) patients with different prognosis after postoperative radiotherapy and to screen the genetic variants associated with radiotherapy resistance.Methods:A total of 32 ESCC patients who received radical surgery and postoperative adjuvant radiotherapy in Affiliated Hospital of Nantong University from January 2015 to December 2019 were selected as the study objects. According to whether there was any recurrence in the radiation field within 1 year, they were divided into a recurrence group (radiotherapy resistance group, n=16) and a stable group (radiotherapy sensitive group, n=16). Genomic DNA was extracted from patients and high-throughput sequencing was performed using whole exome sequencing (WES) technology. Biological information analysis software Trimmomatic, BWA and Picard were used to process the data and the alignment files were obtained by GATK comparison, then Vardict software was used to screen out various genetic variants from the sequencing data. The disease free survival (DFS) and overall survival (OS) were estimated by Kaplan-Meier method. Cox proportional hazard regression model was used to analyze the independent risk factors of DFS and OS of ESCC patients. Results:After quality control of the sample data, 26 patients were finally included in this study for follow-up analysis, 13 in each of the recurrence and stable groups. The median tumor mutation burden of non-silent tumors in the whole group was 0.95 mutations/Mb. The substitution types of mutant bases were mainly C>T conversion, followed by C>G transmutation. The genetic variants with the highest frequency were single nucleotide polymorphism (SNP) (75.1%), deletion mutation (13.7%) and insertion mutation (10.5%). The number of tumor-specific mutations in the recurrence group was slightly higher than that in the stable group (median mutation number was 36 and 34, respectively), and the top ten gene profiles of mutation frequency were significantly different between the two groups. In the recurrence group, 392 unique mutated genes were detected, and the top five were MUC19, NPIPA5, EPPK1, FLG and FOXG1. In the stable group, 192 unique mutation genes were detected, and the top five were TCHH, WNK1, AIM1L, COL6A5 and DPCR1. The median DFS and OS were 15.0 months (95% CI: 10.1 months-not reached) and 26.2 months (95% CI: 19.8 months-not reached) in the recurrence group respectively, and no recurrence or metastasis occurred in the stable group. Univariate analysis showed that GRIK2 ( χ2=6.81, P=0.009), MUC4 ( χ2=4.25, P=0.039), MUC5B ( χ2=4.03, P=0.045), PRRG1 ( χ2=5.15, P=0.023) gene mutations, 3p deletion ( χ2=4.16, P=0.041) and 14q deletion ( χ2=7.09, P=0.008) were correlated with DFS. FLG ( χ2=6.41, P=0.011), NPIPA5 ( χ2=4.57, P=0.033), PKD1L2 ( χ2=6.41, P=0.011), FOXG1 ( χ2=4.57, P=0.033) gene mutations, 3p deletion ( χ2=3.88, P=0.049), 14q deletion ( χ2=5.66, P=0.017) and 18p deletion ( χ2=3.85, P=0.050) were associated with OS. Multivariate analysis showed that 14q deletion ( HR=3.65, 95% CI: 1.18-11.32, P=0.025) was an independent risk factor for DFS of ESCC patients with postoperative adjuvant radiotherapy, and FLG ( HR=8.94, 95% CI: 1.52-52.74, P=0.016), NPIPA5 ( HR=6.36, 95% CI: 1.23-33.03, P=0.028) gene mutation and 14q deletion ( HR=3.82, 95% CI: 1.18-12.31, P=0.025) were independent risk factors for OS of ESCC patients with postoperative adjuvant radiotherapy. Conclusion:The WES results suggest that the types and rates of gene mutations of the ESCC patients with postoperative adjuvant radiotherapy in the recurrence and stable groups are basically the same, but the mutation spectrum of the two groups is significantly different. FLG, NPIPA5 gene mutations and 14q deletion can be used as molecular markers to predict the prognosis of ESCC patients treated with postoperative adjuvant radiotherapy.

Research on interventional embolization therapy for massive hemoptysis induced by pulmonary aspergillosis / 实用放射学杂志

Objective To investigate vascular characteristics and efficacy of interventional embolization in treatment of pulmonary aspergillosis induced massive hemoptysis.Methods A total of 103 patients with pulmonary aspergillosis were analyzed retrospectively,and there were 34 patients with massive hemoptysis.Gelatin sponges,microspheres and coils were chosen for treatment.The number of embolized blood vessels and the vascular characteristics were recorded,and follow-up efficacy and complications were evaluated.Results The mean follow-up time for all the patients was(11.0±2.2)months.A total of 139 vessels were embolized,and the mean number of embolized vessels was 4.0±1.1.The main blood supply arteries included bronchial artery,intercostal artery,internal thoracic artery,superior thoracic artery,lateral thoracic artery and thyroid neck trunk.The cumulative recurrence rates were 5.8％,14.7％and 20.5％at the 1 month,3 months,and 6 months follow-up after operation,respectively.The postoperative complications were mild and could be relieved after symptomatic support treatment.Conclusion Interventional embolization is effective,high safety,and has mild complications can be tolerated by patients in treating massive hemoptysis induced by pulmonary aspergillosis,which is worthy of further clinical application.

The non-communicating intracranial-extracranial Rosai-Dorfman disease: a case report / 中华神经科杂志

Rosai-Dorfman disease (RDD) is a benign self-limited disease characterized by lymphadenopathy and phagocytosis of lymphocytes by histiocytes. A case of intracranial-extracranial non communicating RDD was reported in this paper. The patient was admitted to Shiyan Taihe Hospital in May 2020 because of "the left top scalp tumor was found for 4 months, and the right lower limb was numb for more than half a month". The plain scan and enhanced scan of the patient′s head magnetic resonance imaging (MRI) showed that the disease focus of the left parietal bone was slightly uneven enhanced, its internal and external soft tissues were significantly enhanced, and the local internal and external soft tissues were significantly thickened irregularly, with the size of about 3.2 cm× 4.7 cm, and adjacent brain parenchyma was compressed. After resection of left top mass and intracranial mass, pathological results showed spindle cell proliferation with inflammatory reaction, and immunohistochemical staining results supported the diagnosis of RDD. The neurological function of the patient recovered to normal basically 7 months after operation, and no recurrence of the disease was found in the MRI examination of the head. The treatment effect was satisfactory.

Chinese expert consensus on diagnosis, treatment and prevention of venous thrombus embolism associated with chest trauma (2022 version) / 中华创伤杂志

Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.

A case of ADULT syndrome without finger/toe deformities caused by a TP63 mutation / 中华皮肤科杂志

Objective:To detect causative gene mutations in 1 patient with ADULT syndrome mainly presenting with ectodermal dysplasia.Methods:Clinical data were collected from a proband with ADULT syndrome, and genomic DNA was extracted from peripheral blood samples obtained from the proband and his parents. Exome sequencing was performed in the proband by using targeted panels for hereditary skin diseases to determine mutation sites, and then the candidate mutation sites were verified by Sanger sequencing in the family members.Results:The 22-year-old male patient presented with sparse and thin hair, scattered facial freckles, missing permanent teeth, cloudy corneas, palmoplantar erythema and keratosis, nail/toenail dystrophy, and nipple dysplasia. Genetic testing of the peripheral blood genomic DNA of the proband revealed a heterozygous mutation (c.1040G>T) in exon 8 of the TP63 gene, resulting in an amino acid change at position 347 (p.C347F) . The mutation was not detected in his father or mother with normal phenotypes, suggesting the cosegregation of the gene mutation with the disease phenotype in the family.Conclusion:The de novo heterozygous missense mutation in the TP63 gene may be the causative mutation in the proband, and combined with clinical manifestations, the proband was diagnosed with ADULT syndrome without finger/toe deformities.

Mutation analysis of the PNPLA1 gene in three families with congenital ichthyosiform erythroderma / 中华皮肤科杂志

Objective:To detect gene mutations in 3 Chinese families with congenital ichthyosiform erythroderma.Methods:Exome sequencing of peripheral blood DNA was performed for 3 probands clinically diagnosed with congenital ichthyosiform erythroderma by using a gene panel targeting hereditary skin diseases to identify mutation sites. Primers were designed according to the mutation sites for PCR amplification, and Sanger sequencing was performed to verify the mutations in probands and other family members in order to identify the cause of the disease.Results:The probands 1 and 2 presented with generalized skin dryness and scaling, and polygonal dark brown scales on the extensor aspect of the lower limbs; the proband 3 mainly presented with well-circumscribed erythema, papules and scales scattered on the trunk and extremities. All probands denied family history of similar diseases. Genetic testing showed that the proband 1 carried compound heterozygous mutations c.100G>A and c.377G>A in the PNPLA1 gene, which were inherited from her mother and father respectively; the proband 2 carried compound heterozygous mutations c.320T>A and c.434T>C in the PNPLA1 gene, which were inherited from her mother and father respectively; a homozygous mutation c.1300delG was identified in the PNPLA1 gene in the proband 3. The mutations co-segregated with the disease phenotypes in the two families with compound heterozygous mutations. Among the 5 identified mutations, the two missense mutations (c.377G>A and c.320T>A) were firstly reported.Conclusion:Biallelic mutations in the PNPLA1 gene are the causative mutations responsible for autosomal recessive congenital ichthyosis in the three probands, and the newly reported mutations expand the mutation spectrum in the disease.

Chanarin-Dorfman syndrome: the first case reported in China / 中华皮肤科杂志

Objective:To detect gene mutations and make a diagnosis in a family with ichthyosis accompanied by liver injury.Methods:Clinical data were collected from the proband, and genomic DNA was extracted from peripheral blood samples from the proband and his parents. Exome sequencing was performed in the proband by using a gene panel targeting hereditary skin diseases to identify mutation sites, and then the candidate mutation site was verified by PCR and Sanger sequencing in the family members. Results of peripheral blood smear examination and other auxiliary examinations were collected from the proband and his parents and analyzed.Results:The proband presented with generalized dry skin and tiny white scales on the lower limbs, accompanied by elevated transaminase levels, mild sensorineural hearing loss in both ears and fatty liver. Exome sequencing revealed a homozygous mutation c.933dupA in exon 6 of the ABHD5 gene encoding CGI-58 protein in the peripheral blood genomic DNA of the proband, resulting in a frameshift mutation p.R312Tfs*45 in the amino acid sequence. Heterozygous mutations at this site were identified in his father and mother. The mutation cosegregated with the disease phenotype in the family. The peripheral blood smear examination of the proband showed lipid vacuoles in neutrophils, which were called Jordan anomaly. Conclusion:The diagnosis of Chanarin-Dorfman syndrome was made in the proband based on the presentation of ichthyosis-like skin lesions and abnormal liver function, as well as the homozygous mutation in the ABHD5 gene and Jordan anomaly in peripheral blood smears.

A family of severe epidermolysis bullosa simplex caused by a de novo mutation in the KRT5 gene / 中华皮肤科杂志

Objective:To detect genetic mutations in a case of severe epidermolysis bullosa simplex.Methods:Clinical data and peripheral blood samples were collected from the patient and her parents, and genomic DNA was extracted. Whole exome sequencing was performed to identify causative gene mutations in the patient, and then Sanger sequencing to verify the mutations among the family members.Results:A heterozygous mutation c.1429G>A at position 1429 in exon 7 of the KRT5 gene was identified in the patient, which led to the substitution of glutamic acid by lysine at amino acid position 477 (p.Glu477Lys) of keratin 5 encoded by the KRT5 gene. The mutation was not detected in her unaffected parents.Conclusion:A causative mutation c.1429G>A (p.Glu477Lys) in the KRT5 gene was identified in the patient with severe epidermolysis bullosa simplex, which was a de novo mutation.

Gene mutation analysis in a family with Legius syndrome firstly reported in China / 中华皮肤科杂志

Objective:To identify the underlying gene mutation in a family with Legius syndrome mainly manifesting as multiple café-au-lait spots, and to confirm the diagnosis.Methods:Clinical data were collected from a proband with multiple café-au-lait spots as the main clinical manifestation, his parents and grandparents. Genomic DNA was extracted from peripheral blood samples of the above subjects. Whole-exome sequencing was performed to identify mutation sites in the proband, PCR and Sanger sequencing were performed to verify the candidate mutation among the family members, and to confirm the diagnosis.Results:The proband, a 12-year-old male patient, presented with more than 10 café-au-lait spots with a major diameter of > 5 mm on the trunk, and multiple freckles on the axilla and groin. Mutation analysis of the proband revealed a small heterozygous deletion mutation (c.1220_1238del) in exon 7 of the SPRED1 gene encoding Sprouty-related EVH1 domain-containing protein 1, causing a frameshift mutation in the amino acid sequence (p.L407fs*) . This mutation was detected in the affected mother of the proband, but not in his father or grandparents. The mutation in the proband was a novel mutation, and was inherited from his mother. The mutation was co-segregated with the disease in the family, and a diagnosis of Legius syndrome was made.Conclusion:Clinical symptoms of Legius syndrome are similar to those of early-stage neurofibromatosis type Ⅰ, and genetic testing is helpful for early diagnosis, prognosis prediction and follow-up scheduling.

Mutation analysis in a case of neurofibromatosis type 1 complicated by occipital arteriovenous malformation and scoliosis / 中华皮肤科杂志

A 15-year-old female patient presented with multiple café-au-lait spots all over the body for 15 years and scoliosis for more than 1 year. One year prior to the presentation, the patient underwent tumor resection due to occipital arteriovenous malformation. Skin examination showed multiple scattered café-au-lait spots of various sizes all over the body with the largest café-au-lait spot measuring about 3 cm × 4 cm, and freckles on the axillae and groins. Whole exome sequencing revealed a frameshift mutation due to a heterozygous one-base deletion (c.3328delT) in exon 26 of the NF1 gene in the patient, which was not identified in the patient′s parents and younger brother. The patient was diagnosed with neurofibromatosis type 1 complicated by occipital arteriovenous malformation and scoliosis.

Effectiveness and safety of Kang′ai injection combined with single agent chemotherapy in treatment of el-derly patients with advanced NSCLC / 实用医学杂志

Objective To observe the effectiveness and safety of Kang′ai injection combined with docetaxel or gemcitabine chemotherapy in treatment of elderly patients with advanced non-small cell lung cancer(NSCLC). Methods A multi-center,randomized and parallel control study was carried out in 150 elderly patients with ad-vanced NSCLC treated in 3 hospitals during the period from June 2013 to August 2014.The patients were randomly divided into platinum-based group(platinum-based doublet chemotherapy)and Kang′ai group(Kang′ai injection combined with single agent chemotherapy). The clinical efficacy,quality of life and adverse reactions were ob-served and compared between the two groups. Results There was no significant difference in the disease control rate between the two groups group(79.66% vs 81.82%)(χ2=0.101,P=0.751)while the effective rate of Kang′ai group was significantly higher than that of platinum-based group(30.51% vs 14.29%)(χ2=5.240,P=0.022). The effective rate of clinical symptom relief in Kang′ai group after treatment was significantly higher than that in platinum-based group(69.49% vs 48.05%)(χ2=6.278,P=0.012),and the increase rate of PS score in Kang′ai group after the treatment was also significantly higher than that in platinum-based group(18.64% vs 3.90%)(χ2=7.868,P=0.005).There was no significant difference in quality of life between two groups(P>0.05).The quali-ty of life score of Kang′ai group was significantly higher than that of platinum-based group at the second course of treatment(P<0.05).The incidence of adverse reactions in Kang′ai group was significantly lower than that in the platinum-based group(47.46% vs 71.42%)(χ2= 8.070,P < 0.05). Conclusion Kang′ai injection combined with single agent chemotherapy can effectively relieve clinical symptoms and reduce the tumor size in elderly patients with advanced NSCLC,with high safety.

Three column osteotomy procedures through previous spinal fusion site for the revision surgical treatment in severe spinal deformity patients / 中华骨科杂志

Objective To investigate the safety and efficacy of three column osteotomy (3-CO) procedures through previous spinal fusion site for the revision surgical treatment in severe spinal deformity patients.Methods From Oct.2010 to May 2014 in our hospital,a total of 12 severe spinal deformity patients underwent 3-CO for the revision surgical treatment.There were 7 males and 5 females with the average age of (21.8±3.8) years,ranging from 18 to 30 years.The mean time from the initial operation to the revision surgery was (10.2±4.8) years (ranging from 3 to 17 years).The reasons for revision were:curve progression in 7 patients,neurologic deficit in 2 cases,implant failure in 1 patient and pseudarthrosis in 2 patients.The coronal parameters including major Cobb angle and distance between C7 plumb line and center sacral vertical line (C7PL-CSVL),and the sagittal parameters including global kyphosis curve and sagittal vertical axis (SVA) were measured pre-operatively,post-operatively and at last followup,respectively.The operation time,intraoperative blood loss and complications were recorded.The paired t test was used to evaluate the difference among pre-revision,post-revision and last follow-up.Results The average operation time was (451.7±83.1) min (range,320-600 min) and the average blood loss was (4 016.7± 1 080.0) ml (range,2 700-6 000 ml).The average follow-up time after revision operation was (35.4±9.8) months (range,24-49 months).The coronal Cobb angles of pre-revision and post-revision were 83.8°±23.3°and 34.6°± 13.7°.The average correction rate was 60.1％ ±8.8％.At last follow-up,the average coronal Cobb angle was 34.9°±13.8°,there was no significant loss of correction.The pre-revision and post-revision values of global kyphosis were 99.1°±13.3°and 38.7°±7.8° with a mean correction rate of 60.8％ ±6.7％.At the last follow-up,the average global kyphosis was 39.3°±7.5°and no loss of correction was found.For the C7PL-CSVL and SVA,pre-revision (30.3± 17.1) mm and (40.1±31.1) mm were corrected to (14.3 ±7.6) mm and (19.1± 12.3) mm immediately after revision operation,respectively.At final follow-up,the average C7PL-CSVL and SVA were(14.1 ± 7.6) mm and (19.6± 12.1) mm,the correction was well maintained.Obviously,two patient's neurological status improved from Frankel C before revision surgery to Frankel E.Complications were encountered in five patients (41.7％),including SEP signal changed in 1 patient (8.3％),transient neurologic deficit after revision surgery in 1 patient (8.3％),cerebrospinal fluid leak in 1 patient (8.3％),and pleural effusion in 2 patients (16.7％).During the follow-up time,there was no patient experienced pseudarthrosis,implant failure,infection or significant loss of correction.Conclusion Based on results of this study,it was concluded that 3-CO procedures through previous spinal fusion sites could obtain satisfactory and safety results in severe spinal deformity revision surgery.However,it is a technique-demanding procedure with more blood loss,longer operative time and higher risk of perioperative complications.

Research on Policy Factors Affecting Private TCM Institutions Organized by Social Capital / 中国中医药信息杂志

In order to further promote the development of the TCM industry, promote and encourage social capital to organize TCM institutions, according to the national policy and system regulations on private TCM institutions, this article analyzed and studied policies factors affecting private Chinese medical institutions, concluded the advantaging policies for the development of private TCM institutions, teased out the unreasonable regulations to hinder and restrict the private TCM institutions, and finally proposed relevant suggestions and advice, with a purpose to promote the attention of government in the process of promoting private TCM institutions policy.

Determination of Bacterial Endotoxin in Fat Emulsion(10%)/Amino Acid (15)/Glucose (20%) Injection by Gel Method / 中国药房

OBJECTIVE:To adopt gel method for the determination of bacterial endotoxin in Fat emulsion(10%)/amino acid (15)/glucose (20%) injection. METHODS:According to the gel method in term ofbacterial endotoxin test methodin Chinese Pharmacopeia(2015 edition),the maximal valid dilution(MVD)of samples were determined through interference test and the vali-dated. The results were compared with chromogenic method. RESULTS:In gel method,the interference to agglutination reaction of TAL and bacterial endotoxin can be excluded when samples were diluted 24 times or less. In chromogenic method,the samples should be diluted 76 times or less. CONCLUSIONS:Gel method can be used for bacterial endotoxin test of Fat emulsion(10%)/amino acid(15)/glucose(20%)injection.

Optimization and Preliminary Methodology Study of in vitro Fresh Human Whole Blood Detection Method for Pyrogen-related Factor IL-1β / 中国药房

OBJECTIVE:To establish the detection method for pyrogen-related factor interleukin 1β(IL-1β)through optimiz-ing detection condition,and to conduct preliminary methodology study. METHODS:The in vitro fresh human whole blood detec-tion method was used. The bacterial endotoxin standard solution(5,2,0.8,0.32 EU/ml)were added into diluted blood;using di-luted RPMI 1640 as blank control,the content of IL-1β in blood sample was determined by ELISA after incubation. The relation-ship of the addition of different attenuants(RPMI 1640 culture,sterilized normal saline)and fetal bovine serum,final dilution vol-ume fraction(40%,20%,10%and 8.3%)and storage duration(2,5,6,8,26 h)with the contents of endotoxin IL-1βwere in-vestigated,and related coefficient and detection limits were calculated. Different dilution times of Qingkailing injection and Ginaton injection samples and interference solutions were added into diluted blood to detect their recovery. RESULTS:The results indicated that RPMI 1640 media and 40% diluted blood was more sensitive(detection limit was 0.128 EU/ml,r=0.993);while the addition of fetal bovine serum didn’t influence the results. The detection limits of blood sample storied at 4 ℃ for 26 h were 0.128 EU/ml (r>0.990). When Qingkailing injection and Ginaton injection were diluted 10,32 and more times,the detection method was not interfered and the recovery ranged 68%-118%. CONCLUSIONS:Established in vitro fresh human whole blood detection method can be used for the detection of pyrogen,and provides trial evidence for the pyrogen detection of TCM injection.

A case of skin infection caused by Mycobacterium szulgai / 中华皮肤科杂志

A 7?year?old girl presented with a plaque on the left side of the face for 4 years. Skin examination revealed a well?marginated circular firm plaque measuring 6 cm × 5 cm in size on the left side of the face with purulent crusts on the surface, which was nontender to palpation. Histopathologic study showed ulceration and necrosis in some areas in the epidermis, diffuse dermal infiltration of lymphocytes, histiocytes and epithelioid cells with the presence of many neutrophilic granulocytes in some regions. Both periodic acid?Schiff(PAS)staining and acid?fast staining were negative. After 25 days of tissue culture, scotochromogenic Mycobacterium colonies grew, and colony smears showed positive acid?fast staining. The sequences of 16S rRNA and hsp65 genes of the fungal isolate showed 100%and 99%homology with those of Mycobacterium szulgai, respectively. After the treatment with rifampicin, isoniazid and ethambutol, the patient′s condition was improved.

Rationality Evaluation of Drug Use in Children with Rotavirus Enteritis by Children Drug Utilization Index / 中国药师

Objective:To evaluate the rationality of drug use in the children with rotavirus enteritis by the children drug utilization index ( cDUI) . Methods:A retrospective analysis was used to investigate the cDUI, DDDs and rationality of cimetidine, saccharomy-ces boulardiiand and ganciclovir used in 78 children with rotavirus enteritis. Results and Conclusion: The value order of DDDs was saccharomyces boulardii>cimetidine >ganciclovir. Moreover, the dosage of cimetidine and saccharomyces boulardii was relatively high, while that of ganciclovir was basically rational.