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Clinical data and treatment of a patient with late-onset glutaric acidemia type Ⅱ who was admitted to the Department of Pediatric Intensive Care Unit (PICU) of Shenzhen Children′s Hospital were retrospectively analyzed.The patient is a female with the clinical manifestations of aggravated progressive proximal muscle weakness, accompanied by vomiting, abdominal pain and liver enlargement.A marked increase of transaminase, bilirubin and creatine kinase was detected, and hyperammonemia, hypoglycemia and metabolic acidosis were also observed in the patient.Blood amino acids and acylcarnitines spectra showed increased levels of various acylcarnitines.The muscle biopsy study suggested lipid storage myopathy (LSM), and the genetic test identified a homozygous mutation in the electron transfer flavoprotein dehydrogenase (ETFDH) gene.After treatment with Vitamin B 2, carnitine, coenzyme Q10 and plasma exchange, the motivate ability and biochemical parameters of the patient returned to normal.For patients with aggravated progressive proximal muscle weakness, hepatic dysfunction and increased serum creatine kinase levels, late-onset glutaric acidemia type Ⅱ should be considered.The key to early diagnosis and treatment of the disease is to improve the knowledge of it.
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The emergence of the novel human coronavirus, SARS-CoV-2, causes a global COVID-19 (coronavirus disease 2019) pandemic. Here, we have characterized and compared viral populations of SARS-CoV-2 among COVID-19 patients within and across households. Our work showed an active viral replication activity in the human respiratory tract and the co-existence of genetically distinct viruses within the same host. The inter-host comparison among viral populations further revealed a narrow transmission bottleneck between patients from the same households, suggesting a dominated role of stochastic dynamics in both inter-host and intra-host evolutions. Author summaryIn this study, we compared SARS-CoV-2 populations of 13 Chinese COVID-19 patients. Those viral populations contained a considerable proportion of viral sub-genomic messenger RNAs (sgmRNA), reflecting an active viral replication activity in the respiratory tract tissues. The comparison of 66 identified intra-host variants further showed a low viral genetic distance between intra-household patients and a narrow transmission bottleneck size. Despite the co-existence of genetically distinct viruses within the same host, most intra-host minor variants were not shared between transmission pairs, suggesting a dominated role of stochastic dynamics in both inter-host and intra-host evolutions. Furthermore, the narrow bottleneck and active viral activity in the respiratory tract show that the passage of a small number of virions can cause infection. Our data have therefore delivered a key genomic resource for the SARS-CoV-2 transmission research and enhanced our understanding of the evolutionary dynamics of SARS-CoV-2.
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Objective:To investigate the effects of of anti tumor necrosis factor-α (TNF-α) in adjuvant treatment of strangulated intestinal obstruction combined with ischemic intestinal necrosis.Methods:From February 2011 to August 2016 in Huadu District People′s Hospital Affiliated with Southern Medical University, 122 patients with strangulated intestinal obstruction combined with ischemic intestinal necrosis were selected and were equally divided into the experimental group and control group with 61 cases in each group according to the random draw envelope principle. Conventional surgical resection and anastomosis was used in control group, the postoperative anti TNF-α therapy was given for 2 weeks based on the treatment in control group.Results:All patients completed surgery and there were no serious complications during operation.The postoperative anal exhaust time and symptom remission time in experimental group were significantly lower than those in control group: (2.14 ± 0.41) d vs. (6.24 ± 1.28) d and (3.54 ± 0.77) d vs. (6.99 ± 0.91) d ( P<0.05). The incidence of postoperative 14 d complications such as anastomotic leakage, wound infection, anastomotic stenosis and pulmonary infection in the experimental group was 4.9%(3/61), and that of the control group was 18%(11/61), and the incidence of postoperative complications in the experimental group was significantly lower than that in the control group ( P<0.05). The postoperative 1d and 7 d serum TNF-α content in the experimental group was significantly lower than that in the control group ( P<0.05). The postoperative 14 d anal function in the experimental group was significantly better than that in the control group ( P<0.05). MRASP and MSP of postoperative 14 d in experimental group were all significantly higher than those in the control group: (80.24 ± 11.39) mmHg (1 mmHg=0.133 kPa) vs. (76.24 ± 12.11) mmHg, (231.98 ± 45.29) mmHg vs. (226.39 ± 41.87) mmHg ( P<0.05). Conclusions:The anti TNF-α in adjuvant treatment of strangulated intestinal obstruction combined with ischemic intestinal necrosis can promote the recovery of clinical symptoms and inhibit the release of TNF-α. It also can reduce the incidence of postoperative complications and improve gastrointestinal motility of patients.
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Objective:To explore the feature of impaired sustaind attention in the stable patients with bipolar disorder and their first degree relatives.Methods:Totally 76 patients with bipolar disorder meeting with, 83 first degree relatives of patients and 81 healthy controls, were employed and evaluated with continuous performance test (CPT).Results:In reaction time task (a simple performance), all of CPT parameters were higher in patients group than in the first degree relatives group and controlled group (Ps<0.01), while all of CPT parameters in the first degree relatives group were similar to those in healthy controls (Ps>0.05).In X task (a complex performance), the results of CPT in the first degree relatives group were between the patients and the normal controls, and the differences were statistically significant (Ps<0.05).Conclusion:The sustained attention function may have a certain hereditary apparent in stable patients with bipolar disorder.
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OBJECTIVE:To provide reference for the patent application of artificial cultivation and seed treatment technology of Paridis Rhizoma and natural resources protection. METHODS:Retrieved from State Intellectual Property Office patent database,“Paridis Rhizoma”and“Paris polyphylla”were used as search keywords from 1985 to March 31,2015;Paridis Rhizoma cultiva-tion and seed treatment technology patents as research object were analyzed in fields of the amount of patent application,regional construction and legal status,etc. RESULTS:Among 54 Paridis Rhizoma cultivation patent application,there were 19 applications from Yunnan,9 from Sichuan,8 from Hubei,5 from Anhui,4 from Hunan,3 from Guizhou,2 from Jiangxi,1 from Fujian, Shanxi,Jiangsu,Guangxi respectively;there were 18 licensed patents,and 13 licensed patents maintained more than 3 years, among which 1 patent right transferred;from aspect of patent without right,6 patent right were given up due to fail to pay annual fee,1 rejected and 5 withdrawn;from main types of patent proposer,enterprise submitted 24 patent application,universities 15, scientific research institutes 8 and other 7. 24 enterprise patents involved 21 enterprises,indicating that patent protection net didn’t form due to disperse proposers. CONCLUSIONS:Patent application is mainly from Yunnan. There still are some problems,such as small number of patent applications,poor quality of application writing,little patent transformation. It is suggested to plan artificial cultivation technology,enhance the quality of patent application,pay attention to patent operation and achievement transformation and other measures,in order to protect Paridis Rhizoma resource and industrial development.
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Paridis Rhizoma is a rare Chinese herbal medicine with variety of medicinal values. In recent years, the demand for Paridis Rhizoma has increased gradually. Artificial cultivation has met difficulties, while exploitation of wild resources was caught in a vicious circle and has overdrawn seriously. So it is of great significance to enhance the protection of Paridis Rhizoma, carry out basic research, in order to solve problems in seeding breeding, promote artificial cultivation to meet the market need and achieve sustainable development and supply. This article reviewed the status qua of seedling breeding of Paridis Rhizoma, including seed breeding, tuber breeding and tissue culture, with a purpose to standardize planting of resource conservation and utilization of Paridis Rhizoma.
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Objective To explore the features of sustained attention in the patients with social anxiety disorder and their first degree relatives.Methods 60 cases of normal controls,58 cases of patients with social anxiety disorder and 68 cases of their first degree relatives were performed with continuous performance test.Results In reaction time task(a simple performance),all of CPT parameters in patient group (number of cancel (5.2±6.9),number of omission(6.7± 13.6),reaction time(421.0± 112.0) ms,variance coefficient(47.3±38.1) %)were higher than those in the first degree relatives group(number of cancel (2.9± 3.3),number of omission (1.5±2.1),reaction time (342.0±47.0) ms,variance coefficient(28.9± 10.1) %) and controlled group (number of cancel (2.8 ± 2.9),number of omission (1.3 ± 0.7),reaction time (329.0 ± 53.0) ms,variance coefficient (27.8± 9.7) %),the differences were significant(P<0.01),while all of CPT parameters in the first degree relatives were similar to those in controlled group(P>0.05).In X task (a complex performance),the results of CPT in the first degree relatives were between the patients and the normal controls,and the differences were statistically significant(P<0.05).Conclusion The anxiety disorder patients showed no sustained attention impairment in simple performance while in a complex performance there were some defects of sustained attention functions in the patients with social anxiety disorder and their first degree relatives.
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Objective To establish an analytical method of chromatographic fingerprint of cortex moutan in Dianjiang County through HPLC;To provide reference for the quality control and general evaluation. Methods HPLC with Shim-pack VP-ODS C18 column (4.6 mm×250 mm, 5μm) was used;paeonol was taken as standard;the mobile phase was MeOH-H2O with liner gradient eluation;the delection mavelength was at 274 nm for paeonol and 230 nm for paeoniflorin;the flow rate was 1.0 mL/min. Fourteen batches of samples were analyzed to establish the fingerprint with paeonol and paeoniflorin as reference. Results The results of the 14 batches of samples and similarity evaluation showed that the similar degrees to the 10 batches among the 14 samples were between 0.968-0.998, which illustrated the good similar degrees among samples. Conclusion The established fingerprint with characteristics of stability, good reproducibility and simplicity, can be used for the quality evaluation and control of cortex moutan.
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Objective To explore the clinical characteristics of treatment?resistant depression ( TRD) and of its relevance with thyroid hormones. Methods 43 patients with TRD and 48 patients with non?TRD were as?sessed with 17?item Hamilton depression scale ( HAMD?17) and Hamilton anxiety scale ( HAMA) . The serum lev?el of thyroid?stimulating hormone ( TSH) ,total triodothgronine ( TT3) ,total thyroxine ( TT4) ,free triodothgronine ( FT3) and free thyroxine ( FT4) were determined by radioimmunoassay. χ2 test and t test were used for statistic a?nalysis. The quantitative relation of FT3 level with TRD was analyzed and the value of FT3 level in TRD diagnosis was evaluated by ROC curve.Results Compared with non?TRD patients,the TRD patients showed a younger dis?ease onset age ((16.98±2.25)years vs (23.50±3.38)years) and a longer disease course ((10.14±6.47)years vs (5.48±4.15)years) for total disease course;(60.35±23.64)months vs (5.00±3.40)months for current disease course),and had shorter education years ((8.53±1.72)years vs (11.04±2.07)years) and higher HAMD total scores (19.09±1.59 vs 15.69±2.38) and behavior retarding factor scores (8.72±0.98 vs 4.98±1.63). In addition, the FT3 level of TRD patients was lower than that of non?TRD patients ((3.92±0.15)pmol/L vs (4.16±0.20) pmol/L).All the above differences between two groups were statistically significant (P<0.05). The logistic regres?sion analysis showed that the risk of suffering TRD increased by 1. 006?fold when FT3 level reduced 0. 1 pmol/L (OR=2.006,95%CI=(1.501,2.681). The area under ROC curve was 0.821 (P<0.001) with its 95% confidence interval of (0.734,0.907). Conclusion Compared with non?TRD patients,TRD patients have a longer disease course,a younger disease onset age, a lower education level, higher HAMD total scores, more severe retardation symptoms,and a lower FT3 level. The serum FT3 level has a high reference value in diagnosis of TRD.
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Objective To study the quality difference of various processing methods about Angelica dahurica. Methods Samples were selected from different places, clean silt by washing and brushing, cut slices and cut blocks in equal division, dried and comminution, to determine total ash, ethanol thermal extract, imperatorin content and HPLC fingerprint similarity. Results The content of total ash was the lowest in “washed”and “washed & cut slice” sample, dilute ethanol thermal extract was the highest in“cut blocks”and“washed&cut blocks”sample, imperatorin content was the highest in“non-washed”and“non-washed & cut slice” sample. Conclusion Washed and cut process is not suitable in place of origin about Angelica dahurica.
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ObjectiveTo observe the clinical effect of laparoscopic intrafascial supracervical hysterectomy.Methods The complications during and after the operation of laparoscopic intrafascial supracervical hysterectomy of 46 patients were reviewed and summarized retrospectively. Results Laparoscopic intrafascial supracervical hysterectomy of 46 cases had been done well without significant complications,such as injury of intestine,bladder and ureter.Four cases had complications in short term,one was pelvic hematoma,one was pelvic infection,and two were hematocele in cervical canal.There were five cases had complications in long term.Residual cavity periodic hemorrhage in two cases,cervical gland cyst,pelvic parcel effusion and cervical polypoid hyperplasia each in one case.ConclusionsThere are less complications during the laparoscopic intrafascial supracervical hysterectomy,while much more after the surgery.Therefore,the surgical method needs to be improved.
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Objective To compare the effect of epidural anesthesia on vaginal total hysterectomy.Methods Eighty patients with vaginal total hysterectomy were selected and randomly divided into group Ⅰ(40 cases)and groupⅡ(40 cases).The patients of group Ⅰ were punctured with two-point method to the first tube of epidural in L1-2 and to the tail tube in L3-4 The patients of group Ⅱwere punctured with one-point method to the first tube of epidural in L2-3.Observed the level of anesthesia,induction period and anesthetic effect of all patients.Results The upper bound level of anesthesia was higher in group Ⅰthan that in group Ⅱ(P<0.05),the induction period Wag shorter in group Ⅰthan that in groupⅡ(P<0.05).The anesthetic effect Wag better in group Ⅰ(92.5%,37/40)than that in group Ⅱ(70.0%,28/40)(P<0.05).There were significant difference in maintain time,dose of boost and total between group Ⅰand groupⅡ(P<0.05).Conclusion Two-point method of epidural anesthesia is better for vaginal total hysterectomy,as it can provide rapidly and completely anesthetic effects.
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Objective To probe multislice spiral computed tomography(MSCT) features of superacute cerebral infarction.Methods 19 cases with superacute cerebral infarction were retrospectively analysed.MSCT scans were performed in all patients at 1~6 h after onset,and the lesions were proved by MSCT or MR at 3 h~5 d after onset.MSCT signs of superacute cerebral infarction were observed.Results 17 cases and 2 cases were diagnosed and suspectively diagnosed with superacute cerebral infarction by CT at first visit of patients.CT features of superacute cerebral infarction included hypodense of cerebral parenchyma in 19 cases,local cerebral swelling in 13 cases and hyperdense sign of cerebral artery in 3 cases.Conclusion MSCT plain scan has significant value in diagnosis of superacute cerebral infarction.
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Objective:To study the qualitative and quantitative methods of Shenbai concentrated pills. Methods:Danshen root and lightyellow sophora root in Shenbai concentrated pills were identified with the method of TLC. The contents of astragaloside Ⅳ and paeoniflorin were determined with the method of HPLC. Results: For TLC, the spots of the two herbal drugs were well separated and without interference. Quantitative analysis of HPLC showed that the average recovery of astragaloside 1V was 100.82% (RSD1.73%) with the RSD values of precision, repeatability and stability tests were 2.79%, 1.48% and 1.44%, respectively; and the average recovery of paeoniflorin was 99.83% (RSD2.34%) with the RSD values of precision, repeataibility and stability tests were 2.25%, 2.16% and 1.60%, respectively. Conclusions: The methods set up by this study are accurate and easy to perform with the merits of good resolution, specificity and reproducibility. It could effectively control the quality of Shenbai concentrated pills.
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Objective To set up the quality standard of Shenbai concentrated pills. Methods Radix Astragali, Radix Paeoniae Rubra and Rhizoma Imperatea in Shenbai concentrated pills were identified with the method of TLC. The concentration of salvianolic acid B was determined with the method of HPLC. Results For TLC, the chromatogram spots of Radix Astragali, Radix Paeoniae Rubra and Rhizoma Imperatea were well separated and without interference in their negative controls. Quantitative analysis of HPLC showed that the average recovery of salvianolic acid B was 99.74% (RSD=2.08%) with the RSD of precision, reproducibility and stability was 1.74%, 1.19% and 1.70%, respectively. Conclusions The methods set up by this study are easy, accurate and stable, and can be used as the quality control standard of Shenbai concentrated pills.
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@#ObjectiveTo observe the effect of muscle stimulating instrument on patients with cerebral palsy after microsurgical neurotomy of peripheral nerves.Methods77 patients with cerebral palsy after microsurgical neurotomy of peripheral nerves were divided into the treatment group (39 cases) and the control group (38 cases). Patients of two groups were treated with routine rehabilitation training, but muscle stimulating instruments treatment was added to patients of the treatment group. The muscle strength and motor ability of patients of two groups were followed up and compared.ResultsThe muscle strength and motor ability of the treatment group were better than that of control group during follow-up period(P<0.01).ConclusionMuscle stimulating instrument can accelerate the recovery of muscle strength and motor ability in patients with cerebral palsy after microsurgical neurotomy of peripheral nerves.