Study on the dynamic variation of the secondary metabolites in Viscum coloratum using targeted metabolomics / 中国天然药物

Viscum coloratum (Kom.) Nakai is a well-known medicinal plant. However, the optimal harvest time for V. coloratum is unknown. Few studies were performed to analyze compound variation during storage and to improve post-harvest quality control. Our study aimed to comprehensively evaluate the quality of V. coloratum in different growth stages, and determine the dynamic variation of metabolites. Ultra-performance liquid chromatography tandem mass spectrometry was used to quantify 29 compounds in V. coloratum harvested in six growth periods, and the associated biosynthetic pathways were explored. The accumulation of different types of compounds were analyzed based on their synthesis pathways. Grey relational analysis was used to evaluate the quality of V. coloratum across different months. The compound variation during storage was analyzed by a high-temperature high-humidity accelerated test. The results showed that the quality of V. coloratum was the hightest in March, followed by November, and became the lowest in July. During storage, compounds in downstream steps of the biosynthesis pathway were first degraded to produce the upstream compounds and some low-molecular-weight organic acids, leading to an increase followed by a decrease in the content of some compounds, and resulted in a large gap during the degradation time course among different compounds. Due to the rapid rate and large degree of degradation, five compounds were tentatively designated as "early warning components" for quality control. This report provides reference for better understanding the biosynthesis and degradation of metabolites in V. coloratum and lays a theoretical foundation for rational application of V. coloratum and better quality control of V. coloratum during storage.

Bibliometric analysis of status quo and hot spots of domestic and foreign pharmacovigilance research / 中国药房

OBJECTIVE To investigate th e status quo and hot spots of domestic and foreign pharmacovigilance research ，so as to provide reference for scientific evaluation of drug safety. METHODS Relevant literature were searched from Web of Science and CNKI during the inception to Mar. 31st，2021. Excel 2019 software and CiteSpace 5.7R2 software were used to visualize and analyze the co-occurrence ，clustering and burst of annual document volume ，researchers，countries/regions，institutions and keywords. RESULTS & CONCLUSIONS A total of 5 422 foreign literature and 966 domestic literature were included ，with an increasing trend year by year. The cooperation between foreign researchers was relatively close ，while the cooperation between domestic researchers was less. A close network of cooperation was set up ，mainly in Europe and the United States. China although the late start ，but since 2018，there was a relatively rapid development trend and has continued so far. In domestic literature ，the organizations with a large number of published literature were mainly national medicine regulatory authorities ，research institute ， colleges and universities ，the cooperation of them was relatively weak. ADR ，drug safety and relevant risk factors are the research hotspots of pharmacovigilance abroad ；the frontier mainly focuses on pharmacovigilance research for vaccines ，drugs and therapeutic methods. The current research hotspot in China is ADR ，and special attention is paid to the safety of traditional Chinese medicine. The establishment of pharmacovigilance system of “Drug Marketing Authorization Holders ”is the research frontier. In the process of drug safety evaluation ，attention should be paid not only to the monitoring and reporting of ADR ，but also to the evaluation and application of multi-link and multi-dimensional research evidence of pharmacovigilance ，so as to effectively promote safe and rational drug use.

Construction of evaluation system for clinical effectiveness of Drug Selection Guideline for Medical Institutions / 中国药房

OBJECTIVE To establish an evaluation syste m of clinical effec tiveness of Drug Selection Guideline for Medical Institutions，and to provide reference for drug selection in medical institution. METHODS Retrieved from relevant Chinese government websites ，PubMed，Embase，CBM and CNKI ，etc.，from the inception to Sept. 14th 2021，related contents of clinical effectiveness related to three secondary indicators ，such as “recommended level and strength of guideline ”“clinical pathway ”and “evidence and level of efficacy ”were extracted respectively ；evaluation system was construction for the clinical effectiveness. RESULTS A total of 5，4 and 17 policy documents or literatures were included according to “recommended level and strength of guideline”“clinical pathway ”and“evidence and level of efficacy ”，respectively.“The recommended level and strength of drug guideline”could reflect the clinical effectiveness of drugs ，and the evaluation content referred to the recommended level and strength of the selected drugs in the guidelines for corresponding indications. “Clinical pathway ”was the embodiment of drug effectiveness, and the evaluation content referred to the clinical path of whether the selected drugs were included in the corresponding indications. The evaluation contents of “evidence and level of efficacy ”were different between chemical medicine/ biological agent and Chinese patent medicine ；evidence and quality level of efficacy research for chemical medicine/biological agent referred to GRADE system ，while those for Chinese patent medicine referred to classic works or clinical experience inheritance. Therefore，the evaluation contents of this index system were the evidence and quality level of the efficacy research related to selected drugs. CONCLUSIONS The evaluation system of clinical effectiveness of drugs constructed from the perspective of drug selection in medical institutions can lay the foundation of evaluation system for the construction of Drug Selection Guideline for Medical Institutions ，and also provide reference for drug selection in medical institutions.

CHINA PH ARMACY Volume 33，Number 7，April 15，2022 Semimonthly Table of Contents Drug selection guideline for medical institutions / 中国药房

In order to promote the standardization of drug selection in medical institutions ，enhance the level of pharmaceutical affairs management of medical institutions and promote the safe ，effective，economical and appropriate use of drugs in the treatment of diseases ，the Drug Selection Guideline for Medical Institutions （hereinafter refer to as the Guideline ）is formulated. The development of the Guideline for medical institutions is following the latest definition of Institution of Medicine （IOM）， National Academy of Sciences and based on the methodology of WHO handbook for guideline development. During the construction of the Guideline ，the research points of the Guideline are constructed on the basis of Delphi method ；a drug selection and evaluation system with 10 primary indicators and 30 secondary indicators as the core is also designed. The evaluation indexes can be divided into research indexes and policy indexes according to their attributes and main sources of evidence. The GRADE method is used to evaluate the quality of the evidence system for research indexes ，while the policy indexes are graded according to the Legislation Law of the People ’s Republic of China . On this basis ，the evaluation methods of those indexes are constructed by using evidence-based medicine method ，the recommendation is formed through expert consensus method ，and finally a standard guideline for drug selection in medical institutions is formed.

Definition of Core Competitiveness of Drug Manufacturing Enterprises and Construction of Its Evaluation System / 中国药房

OBJECTIVE：To define the core competitiveness of drug manufacturing enterprises ，and build its evaluation system. METHODS ：With“core competitiveness ”and“pharmaceutical”as Chinese and English keywords ，the laws ，policies and interpretation documents published on relevant Chinese government websites （from the inception/establishment of the database to June 2020，the same below ）were retrieved. Related literatures were collected from PubMed ，Embase，CBM，Wanfang database ， CNKI，VIP databases. The evidence-based research method was adopted to define the core competitiveness and elements of drug manufacturing enterprises. Based on above elements and retrieval method ，guideline database （National Guideline Clearinghouse ， Guidelines International Network ，Trip database ，The National Institute for Health and Care Excellence ）and systematic review ， health technology assessment （HTA），health economics evaluation research databases （NHS Economic Evaluation Database ，the Cochrane Library ，HTA，etc.）were retrieved. The output indexes of the core competitiveness of drug manufacturing enterprises were extracted ；according to the principles of scientificity ，hierarchy，comparability and comprehensiveness ，the evaluation system of core competitiveness of drug manufacturing enterprises was constructed. RESULTS & CONCLUSIONS ：The definition of core competitiveness of drug manufacturers is proposed as the strategic needs of the enterprises ，actively undertaking major national science and technology projects ，introducing top scientific and technological talents at home and abroad ，having independent intellectual property rights ，enhancing the ability of scientific and technological support ，strengthening original innovation ， increasing R&D investment ， strengthening key technology breakthrough ， perfecting the innovation mechanism of enterprises-univerisities-researches integration with enterprises as the main body. The elements included original innovation ， 60362951。 R&D investment and scientific and technological talents. Atotal of 25 original innovation output indexes [including two aspects of innovation system （such as national science and technology innovation base ，national laboratory ），innovation achievements （such as National Natural Science Award ， National Technological Invention Award ）]，1 R&D input-output indicator （R&D amount ），7 scientific and technological talent output indicators of production enterprises （such as those selected in the “National Million Talent Project ”，“National Outstanding Scientific and Technological Talents ”award） were extracted. The evaluation system composed of original innovation ，R&D investment and scientific and technological talents is constructed ，which can provide objective evaluation for core competitiveness of pharmaceutical manufacturing enterprises.

Prognostic value of PD-L1 expression level in metastatic renal cell carcinoma / 中华泌尿外科杂志

Objective:To explore the prognostic value of PD-L1 expression level in patients with metastatic renal cell carcinoma (mRCC).Methods:The clinicopathological and survival data of patients with mRCC in our hospital from Jan 2014 to Apr 2016 were retrospectively analyzed including 46 males and 15 females. The median age of these patients was 56 years(range: 29-75 years), with 41 patients ≤60 years and 20 patients >60 years. The baseline data before the systemic therapy showed 36 patients(59.0%)had 1 metastatic organ and 25 patients (41.0%) had equal or more than 2 organs to be metastasized. Among them, 17 patients(27.9%)had lung metastasis and 54 patients(88.5%)had liver metastasis. Abnormal baseline LDH occurred in 4 patients and 52 patients had normal LDH. Favorite and intermediate risk patients categorized by MSKCC risk stratification accounted for 59.6%(34 patients)and 40.4%(23 patients), respectively. Six patients(9.8%)experienced distant metastasis at initial diagnosis, with 4 of them undergoing primary site resection, and the other 55 patients undergoing radical nephrectomy. PD-L1 expression was detected by the immunohistochemical staining method. PD-L1 staining rate ≥1% detected on the tumor cell membrane was defined as positive expression. The correlation between PD-L1 expression and clinicopathological characteristics were compared. Kaplan-Meier method and log-rank test were used to compare the differences about DFS and OS under different factors. Cox proportional hazards regression model is used for multivariable analysis of survival data.Results:The detailed pathological types of the 61 patients with renal cell carcinoma were classified as 53 clear cell carcinomas, 3 papillary carcinomas, 1 collecting duct carcinoma, 2 translocation renal cell carcinomas and 2 being unclassified. There were 4, 20, 19 and 9 patients categorized as WHO/ISUP nuclear grade 1, 2, 3 and 4, and 26, 12, 20 and 2 patients were categorized as T 1, T 2, T 3 and T 4 stage, respectively. Five patients had regional lymph node metastasis(N+), and the other 56 patients had no regional lymph node metastasis(N-). The numbers of patients categorized as stage Ⅰ, Ⅱ, Ⅲ and Ⅳ diseases according to TNM staging system were 20, 11, 21 and 8, respectively. The total PD-L1 positive rate was 24.6%(15/61). The corresponding PD-L1 expression rate of patients with WHO/ISUP nuclear grade 1-4 were 0(0 patient), 5.0%(1 patient), 31.6%(6 patients)and 44.4%(4 patients), respectively; With the increasing WHO/ISUP nuclear grade, the positive rate of PD-L1 gradually escalated with a linear correlation ( P=0.006). The PD-L1 expression of the normal and abnormal LDH group were 19.2%(10 patients)and 75.0%(3 patients), respectively, with significant difference( P=0.035). Univariate analysis of disease-free survival time(DFS)showed that the prognostic factors include PD-L1( P=0.045), age group( P=0.014), WHO/ISUP nuclear grade( P<0.001), T stage( P=0.015), N stage( P=0.026)and TNM stage( P=0.005). However multivariate analysis only suggested WHO/ISUP nuclear grade as the independent prognostic factors for DFS( HR=1.8, 95% CI 1.1-2.9, P=0.018). Either in univariate or multivariate analysis, PD-L1 was not a prognostic factor for overall survival (OS)of mRCC patients(univariate analysis: P=0.154; multivariate analysis: P=0.902). The independent prognostic factors of OS include WHO/ISUP nuclear grade( HR=3.0, 95% CI 1.1-8.0, P=0.033)and MSKCC risk stratification( HR=5.9, 95% CI 1.2-29.7, P=0.03). Conclusions:This study showed that the higher the WHO/ISUP nuclear grade of patients with mRCC, the higher the positive rate of PD-L1. PD-L1 expression was not the independent prognostic factor for DFS or OS of mRCC.

Value of galactose-deficient IgA1 in the early diagnosis of Henoch-Schönlein purpura nephritis in children / 中国当代儿科杂志

OBJECTIVE@#To explore the value of galactose-deficient IgA1 (Gd-IgA1) in the early diagnosis of Henoch-Schönlein purpura nephritis (HSPN) in children.@*METHODS@#A total of 67 hospitalized children who were definitely diagnosed with HSPN between January and April 2018 and 58 hospitalized children with Henoch-Schönlein purpura (HSP) were enrolled in the study. Twenty children undergoing routine physical examinations served as controls. The levels of serum and urine Gd-IgA1 were determined using ELISA. The receiver operating characteristic curve was used to analyze the value of serum Gd-IgA1 and urine Gd-IgA1/urine creatinine ratio in the diagnosis of HSPN.@*RESULTS@#The level of serum Gd-IgA1 and urine Gd-IgA1/urine creatinine ratio in children with HSP or HSPN were significantly higher than those in healthy control group (P<0.01), with a significantly greater increase observed in children with HSPN (P<0.01). Serum Gd-IgA1 ≥1 485.57 U/mL and/or urine Gd-IgA1/urine creatinine ratio ≥105.74 were of favorable value in the diagnosis of HSPN. During the six-month follow-up of the 49 children with HSP, the incidence of HSPN was 47% (23/49), which included a 100% incidence in children with serum Gd-IgA1 ≥1 485.57 U/mL and a 73% incidence in children with urine Gd-IgA1/urine creatinine ratio ≥105.74.@*CONCLUSIONS@#Serum and urine Gd-IgA1 is of favorable clinical value in the early diagnosis of HSPN.

Observations on the Therapeutic Effect of Kinetic Rectification Acupuncture on Acute Facial Neuritis / 上海针灸杂志

Objective To investigate the clinical efficacy of kinetic rectification acupuncture in treating acute facial neuritis. Method Sixty patients with acute facial neuritis were randomized to observation and control groups. The observation group received kinetic rectification acupuncture and the control group, conventional acupuncture alone. Acupuncture was given five times a week, five times as one course. The therapeutic effects were evaluated after three courses of treatment. Result The total efficacy rate was 93.3% in the observation group and 73.3% in the control group; there was a statistically significant difference between the two groups (P<0.05). The latencies and amplitudes of the frontal muscle, orbicularis oculi muscle and quadrate muscle of upper lip improved in the two groups after treatment and had statistically significant pre-/post-treatment differences (P < 0.01). There were statistically significant differences in the pre-/post-treatment difference values of the latencies and amplitudes of the frontal muscle and orbicularis oculi muscle (P<0.01) and no statistically significant difference in the pre-/post-treatment difference values of the latency and amplitude of the quadrate muscle of upper lip (P>0.05) between the two groups. Conclusion Kinetic rectification acupuncture has a marked therapeutic effect on acute facial neuritis. This study provides a particular therapeutic method for clinical practice.

Preliminary research on gene mutation in 10 children patients with esophageal atresia / 国际检验医学杂志

Objective To explore the genetic variation in children patients with esophageal atresia (EA ) to provide a prophase basis for further studying EA pathogenesis .Methods Ten children cases of EA were collected from the neonatal surgery department of our hospital .The high-throughput whole-exon sequencing was used to study the genetic variations ,and their clinical significance was analyzed by the bioinformatics methods .Results In the high quality sequencing data ,the effective clean reads accounted for 85 .36% ,in which 97% of the clean reads could participate in the comparison with the reference genes .The comparison analysis obtained 520541 single nucleotide polymorphism sites ,in which single nucleotide variation(SNV) occurred at 149622 sites ,including synonymous mutation ,nonsynonymous mutation ,stop codon gain ,stop codon loss ,frameshift insertion ,nonframeshift insertion ,unknown mutation ;meanwhile ,598 copy number variation genes were detected .The functional cluster analysis revealed that the mutant genes were closely related to cell biology .Conclusion The SNV occurrence may influence the expression and function of body various proteins and may play an important role in EA pathogenesis .

Comparison of therapeutic effects of prednisone combined with mycophenolate mofetil versus cyclosporin A in children with steroid-resistant nephrotic syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To compare the therapeutic effects of prednisone combined with mycophenolate mofetil (MMF) versus cyclosporin A (CsA) in children with steroid-resistant nephrotic syndrome (SRNS).</p><p><b>METHODS</b>The clinical data of 164 SRNS children who were treated with prednisone combined with MMF or CsA between January 2004 and December 2013 were collected, and the clinical effect of prednisone combined with MMF (MMF group, 112 children) or CsA (CsA group, 52 children) was analyzed retrospectively.</p><p><b>RESULTS</b>At 1 month after treatment, the CsA group had a significantly higher remission rate than the MMF group (67.3% vs 42.9%; P<0.05). At 3 months after treatment, the CsA group also had a significantly higher remission rate than the MMF group (78.8% vs 63.3%; P<0.05). The 24-hour urinary protein excretion in both groups changed significantly with time (P<0.05) and differed significantly between the two groups (P<0.05). There were no serious adverse events in the two groups.</p><p><b>CONCLUSIONS</b>Prednisone combined with MMF or CsA is effective and safe for the treatment of SRNS in children, and within 3 months of treatment, CsA has a better effect than MMF.</p>

Early warning value of laboratory indexes for death risk in children with critical hand foot and mouth disease / 国际检验医学杂志

Objective To quantitatively analyze the early warning value of laboratory indexes for death risk in children with criti ‐cal hand foot and mouth disease (HFMD) .Methods The univariate and multivariate Logistic regression analysis were conducted to explore the independent risk factors of death in critical HFMD children .Then the area under receiver operating characteristic curve (AUC) was applied to give the comprehensive assessment of the test model ,as well as the early warning capacity and the optimal cut‐off level of laboratory indexes in critical HFMD children .Results The AUC of the Logistic regression model (Y ) established based on white blood cell ,neutrophil ,myoglobin ,creatinine for early predicting the death risk in critical HFMD children patients was 0 .847 (95% CI :0 .783 - 0 .911) ,which indicating that its diagnostic value was superior to single index .Conclusion The diag‐nostic value of the Y model established based on four indexes of white blood cell count ,neutrophile granulocytes count ,myohemo‐globin and creatinine is superior to any single index ,which has the better early warning value for the death risk in children with crit‐ical HFMD .

Significance of trace deposition of immunoglobulin M in glomerular mesangium in children with minimal change nephrotic syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the significance of trace immunoglobulin M (IgM) deposits in glomerular mesangium in children with minimal change primary nephrotic syndrome (PNS).</p><p><b>METHODS</b>One hundred and six children who were clinically diagnosed with PNS and pathologically diagnosed with minimal change disease (MCD) and trace deposition of IgM in renal tissues were enrolled as subjects. Eighty-one PNS children with MCD but no deposition of immune complexes were used as the control group. The clinical characteristics and efficacies of glucocorticoids and immunosuppressants were retrospectively analyzed in the two groups. All patients were given full-dose prednisone by oral administration, and patients with glucocorticoid resistance or frequent relapses were additionally given immunosuppressants.</p><p><b>RESULTS</b>The incidence of glucocorticoid resistance in the IgM deposit group was significantly higher than that in the control group (27.2% vs 12.3%; P<0.05). The incidence of frequent relapses in the IgM deposit group was also significantly higher than that in the control group (48.1% vs 10.4%; P<0.05). The complete remission rate for glucocorticoid-resistant patients treated with prednisone combined with mycophenolate mofetil (MMF) was 68% and 62% respectively in the IgM deposit and control groups (P>0.05). The relapse frequency in patients with frequent relapses was significantly reduced in both groups after treatment with prednisone and MMF in combination (P<0.05).</p><p><b>CONCLUSIONS</b>Trace deposition of IgM in renal tissues may be an important factor for glucocorticoid resistance and frequent relapses in PNS children with MCD. Prednisone combined with MMF may be a better choice in the treatment of patients with glucocorticoid resistance or frequent relapses.</p>

Clinical characteristics of children with an initial onset of IgA nephropathy with nephrotic syndrome / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the clinical characteristics of children with an initial onset of IgA nephropathy with nephrotic syndrome and compare them with children with primary nephrotic syndrome, in order to provide a theoretical basis for the differential diagnosis of the two diseases.</p><p><b>METHODS</b>Fifty children diagnosed with an initial onset of IgA nephropathy with nephrotic syndrome were included in this study. Seventy-two children diagnosed with an initial onset of primary nephrotic syndrome served as the control group. The clinical and laboratory examination characteristics were compared between the two groups.</p><p><b>RESULTS</b>The IgA nephropathy group had significantly higher incidence rates of gross haematuria, microscopic haematuria, hypertension, acute kidney injury, low serum high-density lipoprotein cholesterol, anemia, low serum complement C4, steroid resistance, and nephritis-type nephrotic syndrome and a significantly lower incidence of elevated serum IgE compared with the control group (P<0.05). There were significant differences in serum creatinine, serum uric acid, serum total cholesterol, serum high-density lipoprotein cholesterol, serum IgE, serum complement C4, and hemoglobin levels between the IgA nephropathy and the control groups (P<0.05). The thresholds of serum IgE (<131.2 IU/mL) and high-density lipoprotein cholesterol (<1.35 mmol/L) were reference parameters in the differential diagnosis of IgA nephropathy with nephrotic syndrome and primary nephrotic syndrome.</p><p><b>CONCLUSIONS</b>Children with IgA nephropathy presenting nephrotic syndrome manifest mainly as nephritis type and steroid-resistant type in the clinical classification. Cinical manifestations accompanied by serum levels of high-density lipoprotein cholesterol and IgE are helpful for differential diagnosis of IgA nephropathy presenting nephrotic syndrome and primary nephrotic syndrome.</p>

Clinicle study on changes of neuroendocrine immunology sensitive indicators in children with hand-foot-and-mouth disease / 实用医学杂志

Objective To study the changes of Neuroendocrine immunology sensitive indicators in children with Hand-Foot-and-Mouth Disease (HFMD) and values of determining the patient′s conditions. Methods The children with HFMD were divided into three groups , the common group , severe group and risk group according to the clinical diagnosis and classification standards, meanwhile, the healthy children were enrolled as control group. Peripheral blood samples were collected from the case groups and control group , concentrations of cortisol (COR), β-endorphin (β-EP), interleukin-13 (IL-13), interferon-γ (IFN-γ), immunoglobulin (IgG, IgA, and IgM), and the relative contents of T cell subsets, B cells and NK cells were tested respectively. Results Compared with the control group, the levels of COR, β-EP, IL-13, IFN-γ and IgG, IgA, IgM all significantly increased in the three groups of HFMD. All the differences were statistically significant (P < 0.01), except the difference of IgG, and IgA between the ordinary type and the control group. Compared with the common group, the percentage of NK and B cells dramatically increased, meanwhile, compared the other two types with the control group , the percentage of T cell subsets and NK cells significantly decreased , but B cells significantly increased, and there were all significant difference (P < 0.01). Conclusions HFMD caused by EV71 infection is the result of the combined effect of changes in nervous system , immune system and endocrine system. It is extremely important to detect early the sensitive indicators in children with HFMD , such may help to find the risk cases and carry on early intervention for patients′ recovery.

Clinical and pathological features of children with acute kidney injurys in 7 years in China Hunan / 中华实用儿科临床杂志

Objective To analyze the clinical and pathological characteristics of children in different stages and to investigate the clinical significance based on clinical diagnosis and staging criteria of acute kidney injury(AKI).Methods Based on the clinical diagnosis and staging criteria of AKI,165 AKI children admitted to the Department of Nephrology of Hunan Children's Hospital,between Oct.2004 and Oct.2011 were divided into 3 groups:stage 1,stage 2 and stage 3.Clinical characteristics,age,etiology,pathology and prognosis were compared among 3 groups of children with AKI.Results (1) A total of 165 patients(109 males and 56 females) were included in this study,average age of (6.26 ± 4.43) years,including 69 patients in stage 1,19 patients in stage 2,and 77 patients in stage 3.(2) The 3 groups of patients had an average age of(9.09 ± 3.69) years,(4.34 ± 3.90) years,and (4.22 ± 3.78) years,respectively,which showed significant differences (P ＜ 0.01).(3)Three most frequent causes of AKI were drugs (24.8％),acute glomerulonephritis (AGN) (22.4％) and septicemia (15.2 ％),which showed significant differences (P ＜ 0.01).(4) Renal histopathological examination was performed on 140 AKI children,3 most main types of pathology were acute tubular interstitial nephritis 56 cases (40.0％),endocapillary proliferative glomerulonephritis 33 cases (23.6％) and mesangial proliferative glomerulonephritis 18 cases(12.9％).In the stage 1 patients,glomerular disease was predominant(84.4％).In the stage 2 patients,glomerular disease(38.5％) and tubulointerstitial lesions(38.5％) were the major pathological types.In the stage 3 patients,tubulointerstitial damage (73.0％) was the major pathological type (P ＜0.01).The patients in 3 different groups showed significant differences in the ratio of tubulointerstitial disease and glomerular disease(P ＜0.01).(5)The median recovery time of serum creatinine to the baseline was 9 days(3-41 days) for stage 1 patients,11 days(3-25 days) for stage 2 patients,and 16 days(3-∝ days) for stage 3 patients,which showed a significant difference (P ＜ 0.05).(6)Of the 165 A KI patients,124 cases had hematuria,126 cases had varying degrees of proteinuria.There were significant differences in the hematuria incidence and the duration among the 3 groups(P ＜ 0.01).There was no difference in the proteinuria incidence among the 3 groups (P ＞ 0.05),while the stage 1 patients showed significant differences from the other 2 groups (P ＜ 0.01).Conclusions The patients are mostly seen in stage 1 and stage 3.The stage 1 AKI children are largely school-age children and acute glomerulone phritis is the main etiology.The stage 3 AKI children are mainly infants and the etiology of AKI is mainly drugs and septicemia,the pathological type is mainly acute tubulointerstitial nephritis,and the renal functional recovery is slow.

Clinical characteristics of pancreatic gland damage in children with Henoch-Sch(o)nlein purpura / 中华实用儿科临床杂志

Objective To explore the clinical characteristics of pancreatic gland damage in children with Henoch-Sch(o)nlein purpura(HSP).Methods The serum and urine analysis of 95 examples were detected by the automatic biochemical analyzer,which were diagnosed as HSP from Aug.2009 to Jun.2010 in Department of Nephrology,Hunan Children's Hospital,and the clinical characteristics of them were analyzed.All children were treated with anti-infection and anti-allergic drugs.The pancreatic morphology of patients was observed by B ultrasonic,and the clinical features of skin,joints,digestive tract,and kidney damage were observed.And the relationship between damage of pancreas and damage of other systems was analyzed.Results There were 64 cases suffering from pancreatic gland damage in 95 HSP children:34 cases were male(53.1％),30 cases were female(46.9％),and there was no significant difference (x2 =0.56,P ＞ 0.05).The incidence of pancreatic gland damage of the patients with allergic purpura combined with abdominalgia was 82.8％ (53 cases),which was obviously higher than that in the patients without abdominalgia (11 cases,17.2％)(x2 =14.24,P ＜0.05).The incidence of pancreatic gland damage in mixed type of allergic purpura(61 cases,95.3％) was obviously higher than that in the patients which only possess the skin rash(3 cases,4.7％) (x2 =18.18,P ＜0.05).The pancreatic glands of the total 64 patients were detected by type B ultrasonic.None of them had been detected with pancreatic gland edema and deformation of structure.The mean hospital stay of the HSP patients with pancreatic gland damage was (10.80 ± 6.39) days (5-39 days),while mean hospital stay without pancreatic gland damage was (8.42 ± 3.51) days (4-13 days),and there was no significant difference between them (t =5.68,P ＞ 0.05).Conclusions HSP children usually were accompanied with pancreatic gland damage,and if they get abdominalgia and multi-system damage they are more likely to be accompanied with pancreatic gland damage,which should be paid attention to.

Construction and verification of lentivirus vector expressing mouse notch intracellular domain / 国际生物医学工程杂志

ObjectiveNotch signaling is highly conservative in evolution and plays an important role in cell's proliferation and differentiation.Construction of tentiviral vector containing Notch intracellular domain (NICD) would lay the foundation for the study of Notch signaling.MethodsTotal RNA was extracted from the myeloid tissue of C57BL/6 mice.cDNA was composed via reverse transcription.NICD sequence was obtained by PCR and recombined into lentiviral vector.Lentiviral vector with NICD was infected into target HEK293T cell.Real-time PCR and Western blot were used to examine NICD expression in HEK293T cell.ResultsNICD expression increased in HEK293T cells.ConclusionThe successful construction of lentiviral vector involving mice NICD expression provides the foundation for the future study.

Molecular epidemiology and antimicrobial susceptibility of Salmonella isolates recovered from children with diarrhea / 中华检验医学杂志

Objective To investigate molecular epidemiology and antimicrobial susceptibility of Salmonella spp. isolates recovered from the stool samples of children with diarrhea. Methods Seventy-two isolates of Salmonella spp. were collected from children with diarrhea. The serum type of Salmonella spp.was determined by serology agglutinating method. Antimicrobial susceptibility was determined by K-B disk diffusion method and MICs of cefotaxime and ceftazidime were measured by agar dilution method for Salmonella spp. isolates. PCR and DNA sequencing were used for detecting ESBL, ISEcpl and AmpC genes; The transfer of cefotaxime resistance was determined by conjugation experiments. PFGE was performed for determining the homogeneity of the S. typhimurium isolates. Results A total of 72 isolates of Salmonella spp. were collected, among which S. typhimurium accounted for 86 % (62/72) and was the main serum type. S. typhimurium isolates and S. thompson isolates were often resistant to most of clinically used antimicrobial agents. Resistance of S. thompson isolates to ampicillin was the highest (90%, 56/62),followed by tetracycline (81%, 50/62), trimethoprim/sulfamethoxazole (74%, 46/62) and chloramphenicol (66%, 41/62). Seventeen S. typhimurium isolates (27%, 17/62) and two S. thompson isolates were resistant to cefotaxime. Forty-nine S. typhimurium isolates and two S. thompson isolates were positive for blaTEB-1b and resistant to ampicillin. Thirteen ESBL-producing S. typhimurium isolates (21%, 13/62) were positive for blaCTX-M (eight for blaCTX-M-14, three for blaCTX-M-15, one for blaCTX-M-55, one for both blaCTX-M-14 and blaCTX-M-55). All isolates harboring blaCTX-M genes were positive for upstream insert sequence ISEcpl. blaDHA-1was detected in a cefoxitin-resistant S. thompson isolate. Two main clones (PFGE type A and D) accounting for 19% (12/62) and 50% (31/62) respectively were found among 62 S. typhimurium isolates. Seven CTXM-producing isolates belonged to PFGE type D. Conclusions The multi-resistance to antimicrobial agents and high prevalence of blaCTX-M genes are found among S. typhimurium and S. thompson clinical isolates. blaCTX-M-55 is first found in S. typhimurium isolates and blaDHA-1 is found in S. thompson isolates. Clonal spread is responsible for the dissemination of S. typhimurium isolates.

Clinical features of the nephrotic syndrome associated with ichthyosis vulgaris and analysis of related gene mutation / 中华儿科杂志

<p><b>OBJECTIVE</b>To study clinical features of 3 children who presented with nephrotic syndrome (NS) associated with ichthyosis vulgaris (IV), and to detect relationship between NS associated with IV in patients and FLG gene or NPHS2 gene.</p><p><b>METHOD</b>Clinical and kidney pathological data of the 3 patients were analyzed and progress of pathologic damage in the patient kidney was observed through repeated percutaneous renal biopsy. Using polymerase chain reaction-single strand conformation polymorphism and DNA sequencing, the diversity of the expression of NPHS2 gene in the 3 patients were analyzed, and FLG gene in the 3 patients and parts of their family members with IV was detected.</p><p><b>RESULT</b>(1) The age of the 3 patients (patient 1 was a girl and patients 2 and 3 were boys) suffering from NS was 3 years and 8 months, 2 years and 6 months, and 5 years and 3 months, respectively. The age of onset of IV was 1 year and 6 months, 10 months, and 2 years and 6 months, respectively. All the 3 patients were resistant to steroid therapy. Despite multi-immunosuppressive therapy, no clinical response was achieved. The patients were followed up for 1.5 to 4.0 years. The patients displayed continuous proteinuria, renal function was normal, but their heights were lower than other children at the same age. (2) The older brother of patient 1 died of uremia. The other patients' family members did not have kidney disease. (3) Renal histopathology showed that the patients 1 and 2 had mild mesangial proliferative glomerulonephritis (MsPGN) and the patient 3 had minimal change disease (MCD). One and a half years after the first renal biopsy, the patients 1 and 2 underwent repeated renal biopsy. Renal histopathology showed that the 2 patients' disease developed to medium MsPGN. (4) None of the 3 patients had NPHS2 gene mutation. All the three patients had R501X and 2282del4 which are the common gene mutation type of the FLG, and all the patients were heterozygote. With the detection of the FLG gene of the part of the patients of the three families, the second patient's grandfather had the R501X homozygote mutation and the others were the R501X heterozygote mutation and 2282del4 heterozygote mutation.</p><p><b>CONCLUSION</b>The 3 cases of NS associated with IV had no response to steroid and multi-immunosuppressive therapy, the renal damage observed by histopathology progressed fast. The children with NS associated with IV displayed R501X heterozygote mutation and 2282del4 heterozygote mutation of FLG gene, which suggested that the absence of response to steroid and multi-immunosuppressive therapy may be related to the FLG gene.</p>

Prognostic analysis of 336 patients with chronic severe hepatitis B / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the risk factors related to outcome of chronic severe hepatitis B.</p><p><b>METHODS</b>A total of 336 consecutive patients with chronic severe hepatitis B (CSHB) were analysed retrospectively. According to the outcome, objects were divided into survival group (n = 137) and death group(n = 199), then to observe the differences between them in respect to age, sex, family history, prothrombin activity (PTA), complications including ascites, infection, electrolyte disturbance, upper gastrointestinal bleeding, hepatic encephalopathy, hepatorenal syndrome and the corresponding quantity of complications in each individual, antivirus therapy, artificial liver support system (ALSS) therapy, and alprostadil therapy. Finally, risk factors related to prognosis were selected by stepwise Logistic regression analyse.</p><p><b>RESULTS</b>In univariate analyse, significant differences between the two groups were found related to age, PTA, complications and its quantity (P < 0.01 for all), and antivirus therapy (P < 0.05) rather than sex, family history and treatment of ALSS or alprostadil. Logistic regression revealed that risk factors comprised of PTA and quantity of complications, antivirus therapy was the only protective factor.</p><p><b>CONCLUSION</b>A numbers of factors including age, PTA, complications and its quantity, and antivirus therapy affect the prognosis of CSHB, among which, antivirus therapy can reduce the death rate.</p>