Application of 8-ring traction-assisted endoscopic submucosal dissection for gastric lesions / 中华消化内镜杂志

To evaluate the effectiveness and safety of 8-ring assisted traction in endoscopic submucosal dissection (ESD), a total of 13 patients with 15 gastric lesions who underwent 8-ring traction-assisted ESD in Nanjing Drum Tower Hospital from July 2021 to January 2022 were included in the retrospective cohort study. All patients successfully completed the operation. The median procedure time was 56 min, and the dissected area per unit time was 0.20±0.02 cm 2/min. The en bloc resection rate, the complete resection rate and the curative resection rate were 93.3% (14/15), 80.0% (12/15) and 80.0% (12/15), respectively. There were no ESD-related complications, such as delayed bleeding or intraperative and postoperative perforation. No deaths occurred. As a novel internal traction technology, 8-ring traction method is simple to operate, providing a good field of vision during ESD to improve the dissection efficiency and reduce complications, which is worthy of further clinical research and promotion.

Efficacy and safety of endoscopic submucosal dissection for circular superficial esophageal cancer / 中华消化内镜杂志

Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for circular superficial esophageal cancer.Methods:A retrospective analysis was conducted on 74 consecutive cases of circular superficial esophageal squamous cell carcinoma treated with ESD at Nanjing Drum Tower Hospital from January 2015 to December 2019. The success rate of ESD, curative resection rate, incidence of complications, and additional treatment were mainly observed.Results:One case was transferred to surgery, and the remaining 73 cases successfully completed ESD treatment. The success rate of ESD was 98.6%. Postoperative pathology of ESD revealed that 39 cases achieved curative resection, with a curative resection rate of 53.4% (39/73). Intraoperative muscle layer injury occurred in 15 cases (20.5%), and intraoperative perforation occurred in 1 case (1.4%). Two cases (2.7%) experienced delayed bleeding, and one case (1.4%) experienced delayed perforation. Eleven cases were lost to follow-up, and the remaining 62 cases received follow-up for 36.4±19.0 months. Among the follow-up cases, 12 underwent additional surgery and 5 cases additional chemotherapy and radiotherapy. Among the 57 patients with follow-up data who did not underwent surgery, 49 developed esophageal stenosis after ESD, with an incidence rate of 86.0%.Conclusion:ESD for circular superficial esophageal cancer is generally safe, but it is prone to muscle layer injury during the operation, with a low curative resection rate, a high incidence of postoperative esophageal stenosis, and a high proportion of additional surgical procedures.

Comparative analysis of disease burden in Sichuan Province in 2010 and 2020 based on disability-adjusted life years / 上海预防医学

ObjectiveTo analyze the disease burden in Sichuan Province in 2010 and 2020， and to provide reference for disease prevention and control. MethodsMonitoring data on causes of death in Sichuan Province in 2010 and 2020 were collected. Disability-adjusted life years （DALY）， years of life lost （YLL） and years lived with disability （YLD） were calculated to assess the disease burden in Sichuan Province. ResultsIn 2020， DALY was 7.004 0 million years， among which YLL and YLD were 3.719 6 million and 3.284 4 million， respectively. Compared with 2010， the total DALY in 2020 increased by 8.27%， most of which came from the increase of YLL （16.66%）. In 2020， the standardized total DALY rate was 69.91‰， which decreased by 9.87% compared with 2010. Specifically， the rate decreased by 15.87% for females and 5.28% for males. In 2020， the burden of DALY disease in the elderly over 60 years old increased by 34.55% compared with 2010. The burden of infectious and maternal diseases decreased the most， and the standardized DALY rates of male and female in 2020 decreased by 47.03% and 55.50% compared with 2010， respectively. Injury was the next most important factor， which decreased by 32.97% in males and 26.92% in females. The standardized DALY rate of chronic diseases increased by 5.41% in males and decreased by 10.67% in females. In 2020， compared with 2010， the standardized DALY rate of males increased significantly in diabetes （82.02%）， nervous system and mental disorders （26.31%）， and cardiovascular and cerebrovascular diseases （19.86%）. Among women， significant increases were seen in diabetes mellitus （54.74%）， neurological and mental disorders （35.52%）， and musculoskeletal and connective tissue diseases （23.51%）. ConclusionThe overall disease burden in Sichuan Province shows a declining trend， mainly attributed to the decrease in infectious and maternal diseases and injuries. The disease burden among people over 60 years old has increased significantly， with the focus on chronic diseases such as diabetes， cardiovascular and cerebrovascular diseases， nervous system and mental disorders， and musculoskeletal and connective tissue diseases.

Molecular basis of broad neutralization against SARS-CoV-2 variants including Omicron by a human antibody

Omicron, a newly emerging SARS-CoV-2 variant, carried a large number of mutations in the spike protein leading to an unprecedented evasion from many neutralizing antibodies (nAbs). Here, we performed a head-to-head comparison of Omicron with other existing highly evasive variants in terms of their reduced sensitivities to antibodies, and found that Omicron variant is significantly more evasive than Beta and Mu variants. Of note, some key mutations occur in the conserved epitopes identified previously, especially in the binding sites of Class 4 nAbs, contributing to the increased Ab evasion. We also reported a broadly nAb (bnAb), VacW-209, which effectively neutralized all tested SARS-CoV-2 variants and even SARS-CoV. Finally, we determined six cryo-electron microscopy structures of VacW-209 complexed with the spike ectodomains of wild-type, Delta, Mu, C.1.2, Omicron, and SARS-CoV, and revealed the molecular basis of the broadly neutralizing activities of VacW-209 against SARS-CoV-2 variants. Overall, Omicron has once again raised the alarm over virus variation with significantly compromised neutralization. BnAbs targeting more conserved epitopes among variants will continue to play a key role in pandemic control and prevention. One sentence summaryStructural and functional analyses reveal that a human antibody named VacW-209 confers broad neutralization against SARS-CoV-2 variants including Omicron by recognizing a highly conserved epitope.

Short term effects of anti-reflux mucosectomy for proton pump inhibitor dependent gastroesophageal reflux disease / 中华消化内镜杂志

Clinical data of 26 patients with proton pump inhibitor dependent gastroesophageal reflux disease (GERD) who underwent anti-reflux mucosectomy (ARMS) in Nanjing Drum Tower Hospital from July 2017 to December 2020 were reviewed, and the GERD questionnaire (GERD-Q) score, the short-form reflux-qual (RQS) score, esophageal motility and 24 h esophageal pH parameters before and after ARMS were compared. With a median follow-up period of 18.4 months (6-27 months), 23 (88.5%) patients reported symptomatic improvement and 15 (57.7%) patients discontinued the use of proton pump inhibitors. After ARMS, the mean scores of GERD-Q (6.23 VS 13.19, P=0.004) and RQS (26.67 VS 10.98, P<0.001) were significantly improved, the mean DeMeester score (10.69 VS 53.15, P<0.001), the mean acid exposure time percentage (3.56% VS 9.92%, P<0.001) and the mean number of acid reflux episodes (36.9 VS 139.9, P=0.001) were lower, and the mean rest pressure at lower esophageal sphincter (LES) (25.19 mmHg VS 13.63 mmHg, P<0.001) and the mean distal contractile integral (1 819.15 mmHg·s·cm VS 1 007.67 mmHg·s·cm, P<0.001) were significantly increased compared with those before surgery. ARMS has significant short-term efficacy in the treatment of proton pump inhibitor dependent GERD, which can effectively improve reflux symptoms and life quality of patients, and strengthen the rest pressure of LES and peristalsis of the esophageal body.

Association of fetal cardiac structural abnormalities and chromosomal aneuploidies and copy number variations / 中华医学遗传学杂志

OBJECTIVE@#To investigate the association of fetal cardiac structural abnormalities with chromosomal aneuploidies and copy number variations (CNVs) in amniocytes.@*METHODS@#328 pregnant women were subjected to fetal ultrasonography and chromosomal microarray analysis (CMA). Based on the fetal heart structure, the subjects were divided into normal (n=273) and abnormal groups (n=55). The detection rates of chromosomal aneuploidies and CNVs were compared between the two groups. Spearman method was used to assess the association between the results and fetal cardiac structural abnormalities.@*RESULTS@#The detection rates for chromosomal aneuploidies and CNVs in the abnormal group were significantly higher than that in the normal group (P< 0.05), and the incidence of fetal cardiac structural abnormalities was strongly associated with chromosomal aneuploidies and CNVs (P< 0.05).@*CONCLUSION@#Fetal chromosomal aneuploidies and CNVs are strongly associated with cardiac structural abnormalities.

Effect of adenovirus-mediated recombinant Buthus martensii Karsch chloride toxin artifact on human glioma U251 cells / 肿瘤研究与临床

Objective:To investigate the inhibitory effect of adenovirus-mediated recombinant Buthus martensii Karsch chloride toxin artifact (Ad-rBmK CTa) on human glioma U251 cells and its related mechanisms.Methods:Groups of 3 titer gradients of 3.5×10 9, 7.0×10 9 and 3.5×10 10 pfu/ml Ad-rBmK CTa were set up and applied to U251 cells for 24, 48 and 72 h, and a blank control group (no cells and Ad-rBmK CTa were added) and a negative control group (only U251 cells were added) were set up at the same time. The virus infection status was observed by laser confocal fluorescence microscopy. The cell proliferation in each group was detected by methyl thiazolyl tetrazolium (MTT) assay. The cell cycle and apoptosis in each group were detected by flow cytometry. The expressions of apoptosis-related proteins bax, bcl-2 and caspase-3 were detected by Western blot. Results:The infection rate of Ad-rBmK CTa was over 90% after acting on U251 cells for 24 h. As the titer of Ad-rBmK CTa increased, the proliferation inhibition rate of U251 cells treated for the same hours gradually increased (all P <0.01); with the extension of time, the proliferation inhibition rate of U251 cells treated with the same titer of Ad-rBmK CTa also gradually increased (all P < 0.01). After 7.0×10 9 pfu/ml Ad-rBmK CTa acted on U251 cells for 48 h, the proportion of cells in G 0/G 1 phase was (40.7±0.8)%, and cells in S phase and G 2 phase accounted for (35.7±0.6)% and (23.6±1.4)%, and the difference was statistically significant ( F = 225.119, P < 0.01). When 7.0×10 9 pfu/ml Ad-rBmK CTa acted on U251 cells for 24, 48 and 72 h, the apoptosis rates were (7.4±1.4)%, (19.2±1.7)% and (22.3±1.7)% ( F = 49.470, P < 0.01). After 7.0×10 9 pfu/ml Ad-rBmK CTa acted on U251 cells for 48 h, compared with the negative control group, the expressions of bax and caspase-3 proteins increased, and the expressions of bcl-2 decreased. Conclusions:Ad-rBmK CTa may act on the DNA damage-induced G 1/S detection site to arrest the cell cycle in G 0/G 1 phase, thus inhibiting the proliferation of U251 cells in vitro. However, its induction of apoptosis in U251 cells is not obvious. The mechanism may be related to the direct or indirect inhibition of chloride ion channels.

Potent antiviral effect of protoporphyrin IX and verteporfin on SARS-CoV-2 infection

The SARS-CoV-2 infection is spreading rapidly worldwide. Efficacious antiviral therapeutics against SARS-CoV-2 is urgently needed. Here, we discovered that protoporphyrin IX (PpIX) and verteporfin, two FDA-approved drugs, completely inhibited the cytopathic effect produced by SARS-CoV-2 infection at 1.25 M and 0.31 M respectively, and their EC50 values of reduction of viral RNA were at nanomolar concentrations. The selectivity indices of PpIX and verteporfin were 952.74 and 368.93, respectively, suggesting broad margin of safety. Importantly, PpIX and verteporfin prevented SARS-CoV-2 infection in mice adenovirally transduced with human ACE2. The compounds, sharing a porphyrin ring structure, were shown to bind viral receptor ACE2 and interfere with the interaction between ACE2 and the receptor-binding domain of viral S protein. Our study suggests that PpIX and verteporfin are potent antiviral agents against SARS-CoV-2 infection and sheds new light on developing novel chemoprophylaxis and chemotherapy against SARS-CoV-2.

Clinical validation of eCura risk scoring system after endoscopic submucosal dissection for early gastric cancer / 中华消化内镜杂志

Objective:To verify the clinical applicability of " eCura system" , a scoring system for assessing the risk of lymph node metastasis after non-curative endoscopic submucosal dissection (ESD) for early gastric cancer (EGC).Methods:A retrospective analysis was performed on clinicopathological data of 155 patients with EGC, who underwent non-curative ESD confirmed by postoperative pathology in Drum Tower Hospital Affiliated to Medical School of Nanjing University from January 2012 to March 2018. According to the eCura scoring system, the 155 patients were divided to three groups: 100 cases in the low-risk group (0 to 1 point), 46 cases in the intermediate-risk group (2 to 4 points), and 9 cases in the high-risk group (5 to 7 points). Lymph node metastasis rates and prognosis of the three groups were observed and compared.Results:The follow-up time of the 155 patients was 25±15.0 months, of which median follow-up time was 25 months in the low-risk group, 23 months in the intermediate-risk group, and 34 months in the high-risk group. A total of 57 patients underwent additional surgery in the low-risk group, including 3 cases [5.26% (3/57)] of lymph node metastases; 29 patients underwent additional surgery in the intermediate-risk group, including 2 cases [6.90% (2/29)] of lymph node metastases; all 9 patients in the high-risk group underwent additional surgery and 4 cases had lymph node metastasis. Multivariate Logistic regression analysis showed that the risk of lymph node metastasis in the high-risk group was significantly higher than that in the low-risk group ( P=0.003, OR=14.499, 95% CI: 2.513-97.214), while the risk of lymph node metastasis in the intermediate-risk group was slightly higher than that in the low-risk group ( P=0.767, OR=1.326, 95% CI: 0.165-8.594). During follow-up, there was no metastasis or cancer-specific mortality in the low-risk group, and recurrence was found in 3 cases [6.98% (3/43)] of the 43 patients without additional surgery. Among the 17 patients in the intermediate-risk group, who did not undergo additional surgery, 1 case [5.88% (1/17)] had recurrence and 2 cases [11.76% (2/17)] had metastasis including 1 case [5.88% (1/17)] died of brain metastasis. There was no recurrence, metastasis or cancer-specific mortality in 29 patients in the intermediate-risk group, who underwent additional surgery during follow-up. And there was no recurrence, metastasis or cancer-specific mortality in the all 9 patients in the high-risk group received additional surgery after ESD during follow-up. Conclusion:The eCura scoring system could contribute to predict the lymph node metastasis risk in patients after non-curative ESD for EGC. The benefits of additional surgery are limited for low-risk patients, while for intermediate-risk and high-risk patients, additional surgery can effectively improve prognosis.

Nursing human resource management of infectious disease hospitals under COVID-19 threats / 中华医院管理杂志

With the outbreak of COVID-19, Beijing You′an Hospital has become one of the three infectious disease specialist hospitals designated to treat patients of such disease. Under the premise of comprehensively implementing various emergency treatment tasks and ensuring the normal operation of other wards, the Nursing Department has put in place emergency plans and deployed due manpower for rapid response, timely personnel deployment, and reasonable reserve echelon structure. These measures have been taken as required by the patients′ numbers, critical conditions, disease diagnosis, and the guidelines of treatment and protection. While ensuring the completion of treatment work, we managed to leverage nursing human resources in a scientific, standardized and maximized efficiency manner, to ensure the quality of nursing, and the physical and mental health of nursing staff.

Analysis of blocking antibody and lymphocyte subsets in elderly patients with recurrent spontaneous abortion / 中国综合临床

Objective:To explore the relationship between blocking antibody and lymphocyte subsets in elderly patients (age≥35 years old) with recurrent spontaneous abortion(RSA).Methods:A retrospective case-control study was conducted on the patients with recurrent spontaneous abortion who met the inclusion criteria from October 2014 to September 2019 in the Reproductive Center of Women Health Center of Shanxi.They were divided into two groups according to their ages: 66 cases in RSA group and 334 cases in normal pregnant age group.The blocking antibody and lymphocyte subsets were detected by flow cytometry.Results:The negative rate of blocking antibody in elderly recurrent spontaneous abortion patients was 77.27% (51/66), which was not significantly different from that in normal gestational recurrent spontaneous abortion patients (83.53%(279/334)) ( P=0.221), but significantly higher than that in normal women (23.46%(42/179)) ( P=0.001). The blocking antibody′s blocking efficiency results showed that the CD3′s blocking efficiency of elderly recurrent spontaneous abortion patients (0.10 (-0.50, 0.60)) was significantly lower than that of normal women (0.60 (0.00, 1.30)), the difference was statistically( P=0.001). The CD8 blocking efficiency of elderly recurrent spontaneous abortion patients (0.00 (-0.60, 0.63)) was significantly lower than that of normal women (0.30 (0.00, 0.70)), the difference was statistically( P=0.016). Lymphocyte subsets showed that the CD8 + T cell ratio in elderly recurrent spontaneous abortion patients (26.93±7.25) was significantly lower than that in normal gestational recurrent spontaneous abortion patients (29.22±7.29), the difference was statistically significant ( P=0.020). The CD4 + /CD8 + ratio in elderly recurrent spontaneous abortion patients (1.64±0.99) was significantly higher than that in normal gestational age recurrent spontaneous abortion patients (1.37±0.50), the difference was statistically significant ( P=0.030). The ratio of natural killer cells in elderly recurrent spontaneous abortion patients (16.13±7.10) was significantly higher than that in normal women (14.04±2.35), the difference was statistically significant ( P=0.022), and higher than that in normal gestational age recurrent spontaneous abortion women (15.57±7.02). Conclusion:There were differences in lymphocyte subsets between elderly RSA patients and normal pregnant women, and the increase of natural killer cell ratio may be an important factor in the occurrence of RSA, especially in elderly RSA patients.

Nursing human resource management of infectious disease hospitals under novel coronavirus pneumonia threats / 中华医院管理杂志

With the outbreak of novel coronavirus pneumonia, Beijing You'an Hospital has become one of the three infectious disease specialist hospitals designated to treat patients of such pneumonia. Under the premise of comprehensively implementing various emergency treatment tasks and ensuring the normal operation of other wards, the Nursing Department has put in place emergency plans and deployed due manpower for rapid response, timely personnel deployment, and reasonable reserve echelon structure. These measures have been taken as required by the patients’ numbers, critical conditions, disease diagnosis, and the guidelines of treatment and protection. While ensuring the completion of treatment work, we manage to leverage nursing human resources in a scientific, standardized and maximized efficiency manner, to ensure the quality of nursing, and the physical and mental health of nursing staff.

Comparative analysis of constitutes and metabolites for traditional Chinese medicine using IDA and SWATH data acquisition modes on LC-Q-TOF MS / 药物分析学报

Identification of components and metabolites of traditional Chinese medicines (TCMs) employing liquid chromatography-quadrupole time-of-flight mass spectrometry (LC-Q-TOF MS) techniques with information-dependent acquisition (IDA) approaches is increasingly frequent. A current drawback of IDA-MS is that the complexity of a sample might prevent important compounds from being triggered in IDA settings. Sequential window acquisition of all theoretical fragment-ion spectra (SWATH) is a data-independent acquisition (DIA) method where the instrument deterministically fragments all precursor ions within the predefined m/z range in a systematic and unbiased fashion. Herein, the superiority of SWATH on the detection of TCMs' components was firstly investigated by comparing the detection ef-ficiency of SWATH-MS and IDA-MS data acquisition modes, and sanguisorbin extract was used as a mode TCM. After optimizing the setting parameters of SWATH, rolling collision energy (CE) and variable Q1 isolation windows were found to be more efficient for sanguisorbin identification than the fixed CE and fixed Q1 isolation window. More importantly, the qualitative efficiency of SWATH-MS on sanguisorbins was found significantly higher than that of IDA-MS data acquisition. In IDA mode, 18 kinds of sangui-sorbins were detected in sanguisorbin extract. A total of 47 sanguisorbins were detected when SWATH-MS was used under rolling CE and flexible Q1 isolation window modes. Besides, 26 metabolites of sangui-sorbins were identified in rat plasma, and their metabolic pathways could be deduced as decarbonylation, oxidization, reduction, methylation, and glucuronidation according to their fragmental ions acquired in SWATH-MS mode. Thus, SWATH-MS data acquisition could provide more comprehensive information for the component and metabolite identification for TCMs than IDA-MS.

Study on the minimum inhibitory concentration of β-lactam and β-lactam resistance molecular mechanism of Haemophilus influenzae isolates from neonates / 中国小儿急救医学

Objective:To study the changes of β-lactam resistance of Haemophilus influenzae (Hi) strain isolated from neonatal lower respiratory tract and the molecular mechanism of β-lactam resistance.Methods:Nineteen Hi strains isolated from neonatal lower respiratory tract infection in the previous multicenter prospective epidemiological study were re-identified, and the P6, fucK and Cap genes were detected by PCR.The minimum inhibitory concentration(MIC) of ampicillin, amoxicillin clavulanic acid and cefuroxime were detected by microdilution method, and tem-1 gene, rob-1 gene and ftsI gene were sequenced and analyzed.Results:(1) Nineteen strains of Hi were confirmed to be capsule-free type by P6 gene, fucK gene and cap gene, which was non-typeable Haemophilus influenzae(NTHi). (2)Compared with 2003-2004, the MIC values of ampicillin, amoxicillin clavulanic acid and cefuroxime of NTHi isolated from the lower respiratory tract of the newborn from 2013-2014 were significantly higher( P<0.05). (3)The rates of β-lactamase producing strains during 2003-2004 and 2013-2014 were 33.33% (3/9) and 30.00% (3/10), respectively.There was no significant difference between them during 10 years ( P>0.05). The detection of the β-lactamase gene showed that the β-lactamase of the all six strains were of the tem-1 type, and the rob-1 type was not detected.(4)Only one gBLNAR strain ( n=9) was found during 2003~2004, and gBLNAR 1, gBLNAI 3, gBLPAR 3, gBLPACR 1 ( n=10)appeared during 2013~2014.(5)There were 11 amino acid substitution patterns in ftsI gene during 2013~2014, but only five amino acid substitution patterns in 2003~2004.The mutation rate of the S357N, S385T, N526K and T532S of ftsI gene significantly increased during the past ten years ( P<0.05). One strain of gBLNAR/gBLNACR resistant to ampicillin, amoxicillin clavulanic acid and cefuroxime isolated in 2014 showed D350N, S357N, M377I, S385T, L389F, A502T and N526K variation at the same time. Conclusion:Neonatal patients with lower respiratory tract NTHi infection may rapidly face the severe challenge of multiple drug resistance of β-lactam antibiotics.

Diagnostic value of flow cytometry in detecting human papillomavirus E6／E7 mRNA in cervical lesions / 中国综合临床

Objective To explore the diagnostic value of flow cytometry in detecting HPV E6／E7 mRNA of human papilloma virus (HPV) in the diagnosis of cervical lesions. Methods From January 2017 to September 2018,119 women with suspected cervical lesions in the department of gynecology and obstetrics of Shanxi Maternal and Child Health Hospital were selected. Flow cytometry was used to detect HPV E6 ／ E7 mRNA in cervical exfoliated cells of women,and the DNA of HPV was detected by the method of hybrid capture 2 (HC2). Results 31. 09%(37／119) HPV E6／E7 mRNA and 57. 14%(68 ／ 119) HPV DNA were positive in 119 cases. The positive rate of HPV E6／E7 mRNA in cervical intraepithelial neoplasia ( CIN)2+ group was 77. 78%(28／36),which was statistically significant compared with 20. 00%(4／20) in CIN1 group (χ2＝15. 246,P＜0. 01),and was statistically significant compared with 7. 94%(5／63) in nilm group (χ2＝50. 286,P＜0. 01) . In nilm group,HPV E6 ／ E7 mRNA positive rate was 7. 94%(5／63) and HPV DNA positive rate was 30. 16%(19 ／ 63),which was statistically significant (χ2＝10. 088,P＝0. 001) . In cin1 group,HPV E6／ E7 mRNA positive rate was 20. 00%(4 ／ 20) and HPV DNA positive rate was

Clinicopathologic characteristics and relevance of main and minor lesions of synchronous multiple early gastric cancer and gastric high grade intraepithelial neoplasia / 中华消化内镜杂志

Objective To investigate the clinicopathologic characteristics and relevance of main and minor lesions of synchronous multiple early gastric cancers ( SMEGC) and gastric high grade intraepithelial neoplasia ( GHGIN) . Methods Thirty-two patients with SMEGC or/and GHGIN who were diagnosed and treated with endoscopic submucosal dissection in Nanjing Drum Tower Hospital from July 2012 to September 2016 were enrolled in this study. Their clinicopathologic characteristics were summed up, and the correlation between main and minor lesions on the size, location, endoscopic classification, pathologic type, invasion depth and vascular invasion were analyzed. Results Among the 32 patients, with mean age of 66. 19±7. 46 years, 90. 62％(29/32) were male, 17 cases (53. 3％) had family history of gastric cancer, 25 (78. 13％) had smoking history, and 22 ( 68. 75％) were alcohol users. There were 30 cases ( 93. 75％) and 31 cases ( 96. 88％) with mucosal atrophy and intestinal metaplasia, respectively. The size of main and minor lesions showed a positive correlation (r=0. 4167, P=0. 018). The endoscopic classification of major and minor lesions had no statistical significant consistency ( P=0. 314 ) , but the pathologic type and invasion depth between major and minor lesions demonstrated a moderate significant positive correlation ( P<0. 05 ) . The comparison of location between the main and minor lesions did not show correlation. However, it showed a significant correlation between major lesion which on the upper 1/3 of stomach and minor lesion on the lower 1/3 of stomach ( r=0. 463,P=0. 003) . Further more, when the main lesion was at posterior gastric wall, the minor lesions on lesser curvature were increased, which showed a positive correlation( r=0. 417,P=0. 009) . Conclusion Old-age male with long-term smoking and alcohol history whose lesions combined with surrounding mucosa merger atrophy and intestinal metaplasia are considered as a high risk group in patients with SMEGC or/and GHGIN. Therefore, clinicians must keep high vigilant and make carefully observations on this group of patients during endoscopic examination, and consider the correlation between main and minor lesions to avoid misdiagnosis.

Prospective epidemiological study on the adults of lower respiratory tract infection with haemophilus influenzae in Chengdu area / 中华检验医学杂志

Objective To investigate the epidemic strains of biological type, drug resistance, and the basic clinical characteristics of haemophilus influenzae(Hi)isolated from hospitalized adults with lower respiratory tract infection in Chengdu area.Methods A prospective cross-sectional study was conducted to analyze the biological typing,capsular genes detected by PCR technique,and drug resistance tested by drug sensitive test of Hi epidemic strains isolated from the sputum of adults aged above 18 years who were hospitalized in two tertiary hospitals of west Sichuan in China.Results The positive rate of pathogenic bacteria in adults aged above 18 years who were hospitalized in the two hospitals was 46.71%(15 447/33 069)between November 2013 and October 2014.The positive rate of Hi isolated from the sputum of 100 adults with lower respiratory tract infection was 0.31%(101/33 069).The constituent ratio of Hi in lower respiratory tract infection pathogens was 0.65%(101/15 447).The Hi were all undifferentiated type detected by PCR,and the biological typing of Hi were typeⅠ(42.57%),Ⅳ(29.7%),Ⅱ(15.84%),Ⅲ(9.9%),Ⅶ(1.98%), and Ⅵ(0.9%).The diseases of Hi positive were acute phase of chronic obstructive pulmonary disease(59%), pneumonia(35%), and bronchitis(6%), in which community acquired infection was 55%.The rate of β-lactamase enzyme production was 38.61%.The frequencice of β-lactamase -nonproducing-ampicillin-resistant(BLNAR)strains was 2.97%,and of intermediary strains was 4.95%(5/101).The drug resistance rate of amoxicillin and clavulafiate was 2.97%.The drug resistance rate of cefuroxime was 12.87%, and intermediary rate was 12.87%.The drug resistance rate of cefaclor was 29.7%,and intermediary rate was 8.91%.The drug resistance rate of cefotaxime and ofloxacin was 6.93%and 1.99%.There were no obvious statistical differences between the drug resistance rates of the two hospitals.Conclusions The Hi epidemic strains isolated from the sputum of adults with lower respiratory tract infection were all undifferentiated type,and the common biological types were Ⅰ,Ⅳ,Ⅱ, andⅢ in west Sichuan in China.It should pay attention to the BLNAR strains and ofloxacin-resistant strains.

Multicenter prospective epidemiological studies and case-control study on Haemophilus influenza ;infection in hospitalized neonates / 中国小儿急救医学

Objective To explore the status of infection, biotype and resistant background of epi-demic strains of Haemophilus influenza ( Hi ) in neonates, and the clinical features of neonatal pneumonia caused by Hi. Methods The multicenter prospective epidemiological cross-sectional design was used; four hospitals in west Sichuan China were chosen as research field,sputum bacterial culture was done and biologi-cal typing,PCR identification and drug sensitivity test of Hi epidemic strains were carried out among 0 to 28 days hospitalized neonates with infectious pneumonia in four hospitals located in west Sichuan China. The ca-ses with discharge diagnosis of neonatal infectious pneumonia with Hi positive separation were assumed as case group,and the same number of cases with Hi negative separation were assumed as control group accord-ing to 1∶1 extraction at the same time. Results Totally 757 cases with admitting diagnosis of neonatal infec-tious pneumonia in four hospitals were investigated in west Sichuan from November 2014 to October 2015, and the rate of sputum culture was 95. 51%(723/757). The total pathogenic bacteria positive rate of sputum culture was 15. 63%(113/723),and Hi positive rate was 1. 94%(14/723),Hi accounting for 12. 39%(14/113) of the pathogenic bacteria in respiratory system. All the Hi strains(100%) were non-typeable Hae-mophilus influenzae( NTHi) indentified by PCR. The main biotypes of 14 Hi strains were typeⅠwith 57. 1%(8/14),type Ⅲ with 14. 3%(2/14) and type Ⅳ with 28. 6%(4/14). The total of 35. 7%(5/14) bacterial strains of β-lactamase distributed in four hospitals,7. 1%(1/14) bacterial strains of β-lactamase-nonproduc-ing-ampicillin-resistant,and 35. 7%(5/14) bacterial strains of β-lactamase-positive-ampicillin-resistant were found in four hospitals. The rate of resistance and mediation to cefuroxime were 14. 2%(2/14) respectively, the resistance rate to cefaclor was 35. 7%( 5/14 ) , and 21. 4%( 3/14 ) to ofloxacin. None of the 14 strains was resistant to amoxicillin clavulanic acid and cefotaxime. The 1∶1 matching analysis had been done for 10 cases with discharge diagnosis of neonatal pneumonia caused by Hi. There were no statistical differences in general conditions,main symptoms, lung signs, X-ray appearance, classification of leukocyte and C-reactive protein levels between case group and control group(P>0. 05). Conclusion All the Hi isolated from spu-tum were NTHi among 0 to 28 days inpatients with neonatal pneumonia and the main biotype were typeⅠ, type Ⅲand typeⅣin west Sichuan China. There were no significant differences in the clinical manifestations of neonatal pneumonia with NTHi infection and other infectious pneumonia.

Sodium dithionite-enhanced quality of radix scutellariae through modification of secondary metabolism.

INTRODUCTION: The quality of radix scutellariae is particularly associated with environmental stresses, but detailed mechanisms remained unclear. Plant under unfavorable situation generates redundant reactive oxygen species (ROS), and ROS can modify the secondary metabolism. The varied quality of radix scutellariae could be explained by ROS. MATERIALS AND METHODS: .004, 0.4, and 40 µmol/L of sodium dithionite (Na2S2O4), a material producing ROS, were applied to Scutellaria baicalensis to mimic unfavorable situation. The relationship between ROS, antioxidant enzymes activity, and secondary metabolite was investigated. RESULTS: ROS level fails to rise due to both the antioxidase and the secondary metabolites. The activities of both superoxide dismutase and catalase in the roots of S. baicalensis showed a moderately improvement, meanwhile the phenylalanine ammonia lyase was strongly expressed, and the biosynthesis of flavonoids was heavily elevated. Although the glycosides such as baicalin and wogonoside changed little, the aglycones with the highest effective, such as baicalein and wogonin, were increased by approximately 50%-100%. CONCLUSION: This is very valuable in insight into the stress physiology and provides a strong tool to enhance the quality of radix scutellariae.

Chromosomal alteration and fusion gene expression in children with acute lymphoblastic leukemia: a clinical study / 白血病·淋巴瘤

Objective To study the relationship between the cytogenetic and the prognosis in children with acute lymphoblastic leukemia (ALL).Methods RT-PCR was used to detect the common fusion gene,chromosome number and structure in 103 children with ALL.The effects of chromosome and fusion gene changes on treatment response and survival time were analyzed.Resuts Among 103 children with ALL,52 cases had normal gene number and no fusion gene,and 51 cases had fusion gene,including 22 cases with TEL-AML1 positive,10 cases with bcr-abl positive,11 cases with E2A-PBX1 positive,2 cases with MLL-AF4 positive,3 cases with HOX11 positive,1 case with SIL-TAL1,1 case with dupMLL and 1 case with TLS-ERG.The average survival time of bcr-abl group was shorter than that of non-fusion gene group,TEL-AML1 group and E2A/PBX1 group respectively,and there were significant differences [(16.5±3.8) months vs (34.6±1.7) months,(31.6±1.4) months,(34.5±3.3) months,all P ＜ 0.05],but there was no significant difference between bcr-abl group and other fusion gene group [(12.8±1.5) months,P ＞0.05].The average survival time of non-fusion gene group had no significant differences compared with TEL-AML1 group and E2A-PBX1 group(both P ＞ 0.05),but had significant differences with other fusion gene group (P ＜ 0.05).There were 18 patients with abnormal chromosome number and structure,including 4 cases with diploid,14 cases with super diploid.The patients with diploid had shorter survival time [(19.8±4.8) months vs (37.5 ±2.2) months,x2 =7.375,P =0.007] and were easier to relapse than ones with super diploid.The average survival time of patients with different white blood cell count and lactate dehydrogenase levels had significant differences (both P ＜ 0.05).Conclusion Detection of cytogenetics and chromosome fusion genes can be used to determine the prognosis and outcome of children with ALL,which has important guiding significance for the realization of individualized treatment.