Chinese clinical practice guidelines for perioperative blood glucose management.

With the increased incidence of diabetes, the number of diabetic patients who require surgical treatment is also increasing. Unfortunately, practices in this area lack standardisation. The purpose of this multidisciplinary, evidence-based guidelines for perioperative blood glucose management is to provide a comprehensive set of recommendations for clinicians treating diabetes with different types of surgery. The intended audience comprises Chinese endocrinologists, surgeons, anaesthetists, clinical pharmacists, nurses and professionals involved in perioperative blood glucose management. The guidelines were formulated as follows. First, a multidisciplinary expert group was established to identify and formulate key research questions on topics of priority according to the Population, Intervention, Comparator and Outcomes (PICO) process. We conducted a meta-analysis of available studies using Review Manager version 5.3, as appropriate. We pooled crude estimates as odds ratios with 95% confidence intervals using a random-effects model, and used the Grading of Recommendations Assessment, Development, and Evaluation methods to assess the quality of the retrieved evidence. Finally, 32 recommendations were gathered that covered 11 fields-management and coordination, endocrinologists' consultation, diabetes diagnosis, surgery timing and anaesthesia method, blood glucose target values and monitoring frequency, hypoglycaemia treatment, oral administration of blood glucose lowering drugs, use of insulin, enteral and parenteral nutritional, postoperative treatment and medication and education and training. Twenty-five systematic reviews and meta-analyses were conducted for these guidelines to address the PICO questions. These guidelines are intended to improve perioperative blood glucose management and help doctors in specifying medical diagnosis and treatment, and will be implemented / disseminated extensively in China.

Probiotics' effects on gut microbiota in jaundiced neonates: a randomized controlled trial protocol.

Introduction: Recent evidence suggests that blue-light phototherapy impacts gut microbiota composition in jaundiced newborns, leading to disturbances closely related to the therapy's side effects. As a result, gut microbiota may serve as a potential intervention target to mitigate these side effects. In this study, we aim to examine the effects of AB-GG (Lactobacillus rhamnosus LGG), Bb-12 (Bifidobacterium animalis Bb-12) and M-16V (Bifidobacterium breve M-16V) and their combination on the intestinal microbiota, metabolomics and phototherapy-related side effects in neonates with jaundice. Methods and analysis: A total of 100 jaundiced newborns aged two weeks or younger will be included in this randomized, single-blind (the parents knew, but the neonatologists did not know), single-center controlled trial to receive either 109 colony-forming units of AB-GG, Bb-12, M-16V, a combination of the three probiotics with blue-light phototherapy, or blue-light phototherapy alone. The experimental group will be treated with oral probiotics once daily for 30 days, while the control group will receive only blue-light phototherapy. The follow-up duration will last 30 days. The primary outcomes include changes in gut microbiota, metabolomics, and the incidence of phototherapy side effects, assessed after each phototherapy session, as well as on days 10, 20, and 30. Ethics and dissemination: The study protocol has been approved by the Ethics Committee of our institution. The findings of this trial will be submitted to a peer-reviewed pediatric journal. Its abstracts will be submitted to relevant national and international conferences. Clinical Trial Registration: http://www.chictr.org.cn/index.aspx, identifer (ChiCTR2000036013).

Establishment of hierarchical management standard in patients with chronic obstructive pulmonary disease from the perspective of pharmacists based on Delphi method / 中国药房

OBJECTIVE To develop a standard of hierarchical management for patients with chronic obstructive pulmonary disease （COPD） from the perspective of pharmacists. METHODS The triangle hierarchical management model was used as the framework. Through literature research， the indicators of the hierarchical management standard for COPD patients were preliminarily compiled. A questionnaire was designed and administered to 18 experts， and Delphi method was conducted in two rounds to determine the contents of the standard. RESULTS The response rates for both rounds of expert consultation were 100%， with both authority coefficients of experts of 0.903 and Kendall coordination coefficiens of 0.279 and 0.189 for each indicator. The final established standard of hierarchical management for COPD patients included 25 stratified indicators and 17 pharmaceutical hierarchical management indicators. There were 9， 8 and 8 indicators in the high-risk， medium-risk， and stable layers， respectively， considering three aspects： disease， medication， and self-management level. The corresponding first-level， second- level， and third-level pharmaceutical management included 6， 6 and 5 indicators， respectively， including inhalation technical guidance， medication adherence guidance， treatment monitoring， and follow-up， etc. CONCLUSIONS The standard of hierarchical management for COPD patients established by Delphi method is scientific and reliable， which can provide a reference for pharmacists to carry out hierarchical management of COPD patients in China.

Pharmacoeconomics of ivabradine in the treatment of CHF in the context of “Quadruple Therapy” / 中国药房

OBJECTIVE To evaluate the cost-effectiveness of ivabradine in the treatment of chronic heart failure （CHF） in the context of “Quadruple Therapy” from the perspective of the health system. METHODS Based on real-world cohort data， the Markov model was constructed according to the natural progression of CHF， with a cycle time of 3 months， a study timeframe of 20 years， and a discount rate of 5%. Using quality-adjusted life year （QALY） and incremental cost-effectiveness ratios （ICER） as the output indexes， the cost-utility analysis was used to evaluate the cost-effectiveness of ivabradine in combination with the “Quadruple Therapy” regimen， compared with the “Quadruple Therapy” regimen for the treatment of CHF， and the robustness of the results of the base analysis was verified by univariate sensitivity analysis and probabilistic sensitivity analysis. RESULTS The results of the base analysis showed that the ICER of ivabradine combined with the “Quadruple Therapy” regimen was 165 065.54 yuan/QALY， compared with the “Quadruple Therapy” regimen， which was lower than the willingness-to-pay （WTP） threshold （257 094 yuan/QALY） based on 3 times of China’s gross domestic product （GDP） per capita in 2022. The results of the univariate sensitivity analysis showed that the discount rate had the greatest impact on the robustness of the model. The probabilistic sensitivity analysis showed that the probability that the ivabradine combined with the “Quadruple Therapy” regimen was cost-effective under the WTP threshold in this study was 59.50%. CONCLUSIONS When using 3 times China’s 2022 GDP per capita （257 094 yuan/ QALY） as the WTP threshold， the combination of ivabradine and the “Quadruple Therapy” regimen for treating CHF is cost- effective.

Effects of ivabradine on vascular endothelial function in patients with coronary artery disease：a meta-analysis / 中国药房

OBJECTIVE To evaluate the effects of ivabradine on vascular endothelial function in patients with coronary artery disease. METHODS PubMed， Embase， the Cochrane Library， Web of Science， CNKI， Wanfang Data， VIP and CBM databases were retrieved to collect randomized controlled trials （RCTs） about ivabradine （intervention group） versus placebo or β-blocker （control group） from the inception to Mar. 20th 2023. The meta-analysis was performed by using RevMan 5.4 software after literature screening， data extraction and quality evaluation. RESULTS A total of 12 RCTs were included， involving 1 206 patients. The results of meta-analysis showed that the levels of flow-mediated dilation （FMD） [MD＝1.71， 95%CI （0.96， 2.46）， P＜0.000 01] and nitric oxide （NO） [MD＝5.80， 95%CI （5.02， 6.59）， P＜0.000 01] in the intervention group were significantly higher than control group， while endothelin-1（ET-1） level was significantly lower than control group [MD＝－7.45， 95%CI （－8.42， －6.47）， P＜0.000 01]. There was no statistical significance in nitroglycerin-mediated dilation （NMD） level between 2 groups [MD＝0.13， 95%CI（－0.74， 1.00）， P＝0.77]. Subgroup analyses based on the different medications and intervention time in the control group showed better improvement in FMD level of patients receiving ivabradine， compared with placebo （P＜0.05）； compared with placebo and β-blocker， the level of NO in patients receiving ivabradine was improved significantly （P＜0.05）， while ET-1 level was decreased significantly （P＜0.05）. Regardless of the duration of the intervention， the levels of FMD， NO， and ET-1 in the intervention group were significantly improved compared to the control group （P＜0.01）， while the difference in NMD was not statistically significant （P＞0.05）. CONCLUSIONS Ivabradine can improve vascular endothelial function in patients with coronary artery disease.

Efficacy and Safety of Ivabradine in the Treatment of Chronic Heart Failure in the Context of the New Quadrilateral / 中国循环杂志

Objectives:To assess the effectiveness and safety of ivabradine for the treatment of chronic heart failure in the context of the new quadruple combination. Methods:Clinical data of 656 chronic heart failure patients hospitalized in Nanjing Drum Tower Hospital from March 2021 to June 2022 were retrospectively collected,and the patients were divided into control group(n=361)and observation group(n=295)according to ivabradine use,and both groups were treated with the new quadruple drug therapy.Propensity score matching was performed,268 patients in the observation group and 268 patients in the control group were successfully matched.The effectiveness(primary endpoint was the composite endpoint of cardiovascular death and rehospitalisation for worsening heart failure within 1 year of discharge;secondary endpoints were rehospitalisation for worsening heart failure,all-cause rehospitalisation,cardiovascular death,and all-cause death)and safety outcome measures(including bradycardia,atrial fibrillation,blurred vision,renal impairment,and hypertension)were compared between the two groups at 1 year after treatment. Results:After matching,there were no statistically significant differences at baseline characteristics between the two groups.Kaplan-Meier survival curve showed that the occurrence rates of primary endpoints(P=0.031),readmission for worsening heart failure(P=0.020),and all-cause readmission(P=0.036)were lower in the observation group than in the control group.Multivariate Cox proportional hazard regression analysis showed that the occurrence rates of primary endpoint events(P=0.045)and readmission for heart failure worsening(P=0.028)were lower in the observation group than in the control group. Conclusions:The ivabradine use on top of the new quadruple therapy regimen in patients with chronic heart failure is beneficial to improve one-year prognosis with favorable safety profile.

Genotyping identification and sequence analysis of ABO ambiguous blood group in 20 cases / 中国输血杂志

【Objective】 To study the genotypes of ABO ambiguous blood group samples(n=20) and identify their molecular biological characteristics. 【Methods】 The serological phenotype of the samples was analyzed by serological techniques. Seven exons of ABO gene were amplified by polymerase chain reaction (PCR) and the PCR products were directly sequenced; the genotypes and sequences of ABO subtypes were analyzed. 【Results】 The serological phenotypes of 20 samples presenting ABO ambiguous blood group were as follows: weak A antigen (n=5), weak A antigen combined with anti-A1 antibody (n=5), normal A antigen combined with anti-A1 antibody (n=2), weak B antigen (n=8). The genotypes of them were as follows: Ax02/O01 (n=3), Ael07/O01 (n=2), B313/O01 (n=2), A204/O02 (n=1), A220/O01 (n=1), Ael07/O02 (n=1), Ael02/O01 (n=1), Ael02/O02 (n=1), Ax03/O01 (n=1), Ax03/O02 (n=1), B313/O02 (n=1), B302/O01 (n=1), B302/O02 (n=1), Bw19/O02 (n=1), A102/B313 (n=1) and A101/Bw37 (n=1). 【Conclusion】 ABO genotyping technology can accurately identify the ambiguous blood group of samples, provide definite genetic information of blood group and ensure the safety of clinical transfusion.

Analysis of the characteristics of clinical pharmacists' teaching targets and discussion on the construction of "graded teaching model" / 中华医学教育探索杂志

At present, the teaching objects of clinical pharmacists have gradually changed from merely university students to complex and diverse groups including clinical pharmacist interns and others. However, the traditional teaching model cannot be tailored to different groups. In addition, it increases the burden of clinical pharmacists while not ensuring teaching quality. This study aims to classify teaching objects according to their characteristics, so as to provide individualized knowledge and service. Compared with the traditional way of teaching, this new method may make teaching more relevant and reduces the teaching load of teachers, which is of great significance to the training of clinical pharmacy personnel.

Clinical features of severe acute respiratory syndrome coronavirus-2 Omicron variant infection in mother-infant dyads during lactation / 中华围产医学杂志

Objective:To summarize the clinical features, viral load changes, and outcomes of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) Omicron variant infection in mother-infant dyads during lactation period.Methods:A total of 24 pairs of lactating mothers and infants under one year old who were infected with SARS-CoV-2 and hospitalized in Lingang Branch of Shanghai Sixth People's Hospital from April 8 to May 30, 2022, were selected as the lactation group in this retrospective study. Another 24 non-lactating mothers, with children of one to three years old, who matched with those mothers in the lactation group in clinical classification and admission date were selected as the control group. Vaccination status, clinical symptoms, daily cycle threshold (Ct) of open reading frame 1ab ( ORF1ab) gene and nucleocapsid protein ( N) gene, and the duration of positive nucleic acid test were compared between the groups and were analyzed using two independent samples t test, one-way analysis of variance, LSD test, and Chi-square test. Results:Among the 24 infants in the lactation group with an age of (6.5±2.1) months, 23 cases were mild type, one was common, and none had been vaccinated against SARS-CoV-2. The maternal age of the lactation and the control group did not differ statistically [(28.7±6.4) vs (28.2±5.2) years, t=0.30, P=0.768]. Mothers with mild type accounted for 88% (21/24) and those with common for 12% (3/24) in both groups of mothers. Three mothers received one dose of vaccine and two received two in the lactation group, while three received one dose and three received two in the control group [21%(5/24) vs 25%(6/24), χ 2=0.12, P=0.731]. The most common symptoms of lactating infants were fever (100%, 24/24) , followed by diarrhea (58%, 14/24) , cough (50%, 12/24), and wheeze (29%, 7/24), those of the lactating mothers were fever (75%, 18/24) , cough (75%, 18/24) , and sore throat (63%, 15/24) , while those of non-lactating mothers were cough (88%, 21/24) , sore throat (71%, 17/24), and fever (58%, 14/24). The duration of positive nucleic acid test was the shortest in the lactating infants [(9.2±2.1) d (5-14 d)], followed by mothers in the control group [(11.2±2.4) d (6-16 d)] and mothers in the lactation group [(14.0±4.2) d (8-26 d)] (LSD test, all P<0.05). Each day from day 2 to 9 after diagnosis, Ct values of nucleic acid of infants in the lactation group were all higher than those of mothers in both the lactation and control groups (LSD test, all P<0.05). On day 10, Ct value of nucleic acid infants was higher than that in mothers in the lactation group ( ORF1ab gene: 37.91±4.34 vs 32.79±5.47; N gene: 37.95±4.58 vs 32.66±5.77), which was lower than those in mothers in the control group ( ORF1ab gene: 32.79±5.47 vs 35.90±4.17; N gene: 32.66±5.77 vs 36.08±4.16) (LSD test, all P<0.05). On day 11, the nucleic acid Ct values of mothers in the lactation group were all lower than those in the control group ( ORF1ab gene: 35.03±3.74 vs 37.84±3.26, t=－2.78, P=0.008; N gene: 35.30±3.75 vs 38.11±2.90, t=－2.90, P=0.006). On day 12, Ct value of ORF1ab gene and N gene in mothers in the lactation group were similar to those in mothers in the control group (both P>0.05). Conclusions:The SARS-CoV-2 vaccination rate of mothers and infants were low during lactation. Lactating infants infected with SARS-CoV-2 Omicron variant have low virus load and may have a quick recovery, while for the lactating mothers, the virus load is high and the recovery is slow.

Doxycycline-moxifloxacin sequential therapy for Mycoplasma genitalium urethritis/cervicitis: a clinical observation / 中华皮肤科杂志

Objective:To investigate outcomes and safety of doxycycline-moxifloxacin sequential regimen in the treatment of Mycoplasma genitalium urethritis/cervicitis. Methods:From June 2019 to December 2020, patients with Mycoplasma genitalium urethritis/cervicitis confirmed by nucleic acid amplification testing were successively recruited at Department of Sexually Transmitted Diseases, Hospital of Dermatology, Chinese Academy of Medical Sciences, and received sequential therapy with oral doxycycline for 7 days followed by oral moxifloxacin for 7 days. Clinical and/or etiological assessment was conducted 2 to 3 weeks after the end of treatment. Fisher′s exact test was used to analyze factors influencing the treatment outcome. Results:Totally, 36 eligible subjects were enrolled, including 30 males and 6 females. Among them, 18 (50%) patients completed post-treatment etiological assessment, which showed that 12 achieved microbiological cure, and treatment failures occurred in 6; another 18 patients achieved clinical cure. The overall response rate to doxycycline-moxifloacin sequential therapy was 83.3% (30/36, 95% confidence interval[ CI]: 70.5%, 96.1%) . The treatment outcome showed no significant association with the patients′ age, gender, marital status, number of sexual partners in the past 1 month, history of sexually transmitted diseases, history of antibiotic use in the past 1 month, or co-infections (all P > 0.05) . Conclusion:The efficacy of doxycycline-moxifloacin sequential regimen is limited in the treatment of Mycoplasma genitalium infections in Nanjing area, and clinicians should be alerted to the possibility of treatment failure in clinical practice.

Participation of Clinical Pharmacists in the Management of Drug Therapy for Fetal Tachycardia Treated by Oral Administration of Digoxin through Mother / 中国药房

OBJECTIVE：To investigate the ro le of clinical pharmacists in the therapy of fetal tachycardia by oral administration of digoxin through mother. METHODS ：The clinical pharmacists participated in the whole process of drug therapy for a pregnant woman with fetal tachycardia. According to 31+6 weeks of gestation ，the fetal heart rate of 230 beats/min at admission，clinical pharmacists provided the suggestion for the doctor about the safety and blood concentration determination of digoxin in the treatment of fetal tachycardia by mother. The patient ’s blood potassium value was lower than the normal range ，and it was suggested that potassium should be supplemented before digoxin was used ，and the initial dose of digoxin was 0.5 mg per 12 h. On the 7th day in the hospital ，the dosage of digoxin should be adjusted to maintaining dose （0.25 mg per 12 h）；on the 11th day in the hospital ，the patient ’s blood sodium value was low ，and the clinical pharmacists gave diet guidance. At the same time ， the clinical pharmacists explained the adverse reactions of digoxin to the doctors ，nurses and patients ，and closely observed and educated the patients. RESULTS ：Doctors adopted the suggestions of the clinical pharmacists. The fetal heart rate decreased to 180 beats/min from hospital after 13 days of treatment. The maternal digoxin concentration remained stable. No adverse drug reactions occurred in the mother and infant. CONCLUSIONS ：Maternal and child safety should be taken into account in the medication of pregnant patients. The clinical pharmacists assisting doctors to formulate medication strategying ，and carrying out pharmaceutical care for patients ，can ensure the effectiveness and safety of medication for fetal tachycardia.

Clinical pharmacist participation in the treatment of a pregnancy complicated with Clostridium difficile infection / 药学实践杂志

Objective To explore the clinical pharmacist participation in the treatment of pregnancy complicated with Clostridium difficile infection. Methods From the perspective of medications, clinical pharmacists followed evidence-based medical practice, combined pharmaceutical theory with clinical evidence and provided individualized pharmacy care in drug selection, dose adjustment, medication regime and liver protection treatment. Results Clinical pharmacists integrated into the treatment team to ensure the effectiveness and safety of medication in the patient with pregnancy. Conclusion The individualized pharmacy care improved the effectiveness of drug treatment.

Epidemiological characteristics of human brucellosis in Jinan City of Shandong Province, 2010-2019 / 中华地方病学杂志

Objective:To analyze the epidemiological characteristics and trend of human brucellosis in Jinan City of Shandong Province from 2010 to 2019, so as to provide a scientific basis for improving prevention and control strategies and measures.Methods:The brucellosis surveillance data of Jinan City from 2010 to 2019 were obtained from the "Infectious Disease Surveillance System" in "China Information System of Disease Prevention and Control". Descriptive epidemiological methods were used to analyze the epidemiological situation and the three distributions (regional distribution, time distribution, population distribution) of cases.Results:A total of 1 882 cases of brucellosis were reported from 2010 to 2019, with an average incidence rate of 2.64/100 000. The incidence of brucellosis increased from 0.13/100 000 to 5.37/100 000, and reported incidence of brucellosis showed a increasing trend (χ 2trend=307.50, P<0.05). The epidemic areas were spread from 7 towns (streets) of 3 counties (districts) to 76 towns (streets) of 12 counties (districts). The cases were reported each month throughout the year with incidence peak period form April to July. The gender of the patients was mainly male, and the sex ratio of male to female was 2.66: 1.00 (1 368 ∶ 514). In terms of age distribution, 30-69 years old was peak age. Farmer was the predominant occupational group. Conclusions:In 2010 to 2019, the incidence of brucellosis in Jinan City has increased and the epidemic areas have expanded year by year. Corresponding measures for brucellosis prevention and control should be developed according to epidemiological characteristics in order to strengthen the capacity of epidemic prevention and control measures.

Lowering the incidence of complications of portal vein through vascular graft interposition during pediatric transplantation / 中华器官移植杂志

Objective:To explore the feasibility of using vascular graft interposition for lowering the complications of portal vein during pediatric liver transplantation.Methods:From June 1, 2013 to May 31, 2018, clinical data were collected for 297 children undergoing liver transplantation, including basic demographics, general preoperative status, preoperative tests, imaging findings, graft related profiles, surgical procedures and postoperative follow-ups, etc. Then the authors analyzed the effect of using interposition vessels upon lowering postoperative complications of portal vein reconstruction.Results:With a median age of 12 months, there were 153 boys (51.5%) and 144 girls (48.5%). The primary disease was mostly biliary atresia ( n=222, 74.7%). The median diameter of portal vein was 5 mm. There were 19 cases (6.4%) using vascular interposition. Among 20 cases of portal vein complications, there were portal vein stenosis ( n=17, 5.7%) and portal vein thrombosis ( n=3, 1.0%). After univariate analysis, binary Logistic regression analysis revealed that diameter of recipient's portal vein was an independent risk factor for the occurrence of portal vein complications after liver transplantation. Statistical analysis of children with portal vein diameter <4 mm ( n=90) was carried on and the results showed that there was no inter-group statistical difference ( χ2=3.061, P=0.080)on the occurrence of portal vein complications. Conclusions:Diameter of portal vein is an important factor affecting the strategic choice of portal vein reconstruction during pediatric liver transplantation and an independent risk factor for portal vein complications after liver transplantation. When the diameter of portal vein is ≤4 mm, using interposition vascular anastomosis shows no significant difference with other conventional modes.

Advance in research of beta coronavirus receptors on ocular surface / 中华实验眼科杂志

Novel coronavirus (2019-nCoV) caused an outbreak of corona virus disease 2019 (COVID-19) from December 2019 in China. 2019-nCoV which was identified is a kind of beta coronavirus belongs to one of four coronavirus genera. Except 2019-nCoV, two other beta coronavirus, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) are also quite harmful to human beings. 2019-nCoV uses the same cell entry receptor, angiotensin-converting enzyme 2 (ACE2), as SARS-CoV. And dipeptidyl peptidase 4 (DPP4) or CD26 is the cell receptor for MERS-CoV. The expression of ACE2 was found to have obvious positive expression in human corneal and conjunctival epithelium, and corneal endothelium. DPP4 activity was presented in normal animal conjunctival epithelium and fibroblasts of the subjacent connective tissue. It was also presented in the whole corneal epithelium and tear fluid of animal with severe injured corneas. The two receptors, ACE2 and DPP4, involve in many cellular signaling pathways and pathophysiological processes. Their expression in the cells of ocular surface may be an access route of corona virus in eye, which provides clues to elucidating the pathogenesis of corona virus in the eyeballs.

Advance in research of beta coronavirus receptors on ocular surface / 中华实验眼科杂志

2019-Novel coronavirus (2019-nCoV) caused an outbreak of corona virus disease 2019 (COVID-19) from December 2019 in China.2019-nCoV which was identified as a kind of beta coronavirus belongs to one of four coronavirus genera.Except 2019-nCoV, two other beta coronavirus, severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) are also quite harmful to human beings.2019-nCoV uses the same cell entry receptor, angiotensin-converting enzyme 2 (ACE2), as SARS-CoV.And dipeptidyl peptidase 4 (DPP4) or CD26 is the cell receptor for MERS-CoV.The expression of ACE2 was found to have obvious positive expression in human corneal and conjunctival epithelium, and corneal endothelium.DPP4 activity was presented in normal animal conjunctival epithelium and fibroblasts of the subjacent connective tissue.It was also presented in the whole corneal epithelium and tear fluid of animal with severe injured corneas.The two receptors, ACE2 and DPP4, are involved in many cellular signaling pathways and pathophysiological processes.Their expression in the cells of ocular surface may be an access route of corona virus in eye, which provides clues to elucidating the pathogenesis of corona virus in the eyeballs.

Mechanism and clinical application of probiotics in adjuvant treatment of neonatal jaundice / 国际儿科学杂志

Jaundice is a common clinical problem in neonatal period.Phototherapy is a common treatment for neonatal jaundice, but it also has side effects such as fever, diarrhea, rash and so on.In recent years, probiotics have been widely used in neonates with jaundice because they are beneficial to the health of the host, especially when they are treated with light and probiotics are added at the same time, which is more conducive to the elimination of jaundice.Studies have shown that abnormal bilirubin metabolism is closely related to microecology.This article reviews the mechanism and clinical application of probiotics in adjuvant treatment of neonatal jaundice.

Distribution and epidemiologic trends of HBV genotypes and subtypes in 14 countries neighboring china.

BACKGROUND: The number of cases of HBV infection reported by the WHO for each district and country is positively correlated with the number of HBV sequences in the database isolated from the corresponding district and country. OBJECTIVES: This study determined distribution characteristics of HBV genotypes and subtypes in 14 countries neighboring China. The progress made in genomic research involving HBV was also reviewed. MATERIALS AND METHODS: Nine hundred fifty-one complete genome sequences of HBV from 14 countries neighboring China were selected from NCBI. The sequence-related information was analyzed and recorded. One hundred seventy-two sequences of HBV genotype B were screened for alignment using DNA star and MEGA 5.1. RESULTS: Dominant HBV genotypes in the countries neighboring China were genotypes B, C and D and dominant subtypes were adw2 and adrq+. The association between genotype and serotype of HBV in these countries was shown to differ from previous research results. As shown by sequence alignment, the sequence divergence between five subgenotypes (B3, B5, B7, B8 and B9) was below 4%. The B subgenotypes shared six common specific amino acid sites in the S region. CONCLUSIONS: The B3, B5, B7, B8 and B9 subgenotypes can be clustered into quasi-sub-genotype B3 and the open reading frame of HBV has a start codon preference; however, whether a mutation in the start codon in the pre-S2 region has an impact on survival and replication of HBV remains to be determined.

Intravitreal injection of conbercept after operation in the treatment of proliferatived diabetic retinophathy complicated with vitreous hemorrhage / 中华眼底病杂志

Objective:To observe the efficacy and safety of intravitreal injection of conbercept in the treatment of proliferatived diabetic retinophathy (PDR) complicated with vitreous hemorrhage by minimally invasive vitreoretinal surgery.Methods:Prospective clinical study. A total of 50 patients with PDR complicated with vitreous hemorrhage clinically diagnosed in Tianjin Medical University Eye Hospital who needed vitrectomy were recruited in this study. According to the principle of informed consent, the patients were divided into two groups: postoperative injection group and the control group. Twenty-five eyes of 25 patients in each group were examined before operation. No significant proliferative changes in the posterior pole and traction retinal detachment were observed. There was significant difference of age between two groups ( t=-24.697, P=0.030), but no significant difference of sex ( χ2=0.330, P=0.564), duration of diabetes ( t=-1.144, P=0.258), logMAR BCVA ( t=-0.148, P=0.883), lens state ( χ2=0.397, P=0.529), panretinal laser photocoagulation ( χ2=1.333, P=0.248). The postoperative injection group was treated with intravitreous injection of 0.05 ml conbercept (10 mg/ml) immediately after 27G minimally invasive vitrectomy. The other treatment and follow-up were the same as those in the postoperative injection group except for conbercept injection. All patients underwent routine slit-lamp examination, indirect ophthalmoscope and B-ultrasound examination before operation. The main outcome measure included the time of operation, the incidence rate of iatrogenic retinal holes and silicone oil filling. The recurrence of vitreous hemorrhage, BCVA, intraocular pressure, central retinal thickness (CRT), postoperative complications and progression were recorded 1 week, 1 month, 3 months and 6 months after operation. Results:At 1 week and 1, 3, 6 months after operation, there was significant difference of logMAR BCVA between the two groups ( t=-4.980, -4.840, -4.892, -5.439; P<0.001). At 3 and 6 months after operation, the recurrence of vitreous hemorrhage in the postoperative injection group was lower than that in the control group, but there was no statistical difference between two groups ( χ2=3.030, 4.153; P=0.192, 0.103). At 1 week and 1, 3, 6 months after operation, the CRT in the postoperative injection group was lower than that in the control group, the difference was significant ( t=-2.622, -2.638, -3.613, -3.037; P=0.012, 0.010, 0.001, 0.004, 0.005). There was no complications such as choroid detachment, proliferative vitreoretinopathy, retinal detachment, iris redness and neovascular glaucoma in all the eyes after operation. Conclusions:Intravitreal injection of conbercept in the treatment of PDR after operation is safe and effective. It can reduce the recurrence of vitreous hemorrhage after vitrectomy, improve the BCVA.

Imaging dynamic observation of COVID-19 patients cured by imported coronavirus pneumonia / 中华放射学杂志

Objective@#To explore the imaging changes of lung lesions in patients with imported COVID-19 patients when reaching the discharge standard.@*Method@#The clinical and CT imaging data of 60 patients with imported COVID-19 cured and discharged from January to February 2020 in Anhui Province were retrospectively collected. The clinical characteristics of the patients and the characteristics of chest CT images at discharge were analyzed.@*Results@#Fever (57 cases) and cough (55 cases) were the main symptoms in 60 patients. At the initial diagnosis, 5 cases were mild, 53 were ordinary, and 2 were severe. In 5 light patients, 3 cases were negative in the whole course of CT examination, 2 cases were negative in the first time and abnormal in the second time. . The first CT imaging features of 55 patients (53 common type and 2 severe type)were mainly bilateral lung involvement (51 cases), multiple lesions (33 cases), more common under the pleura (40 cases), and ground glass opacities were the most common. (55 cases). The clinical features of chest CT in clinical outcomes are that the ground glass shadow in the lung gradually fades and was completely absorbed (19 cases); the scope of ground glass shadow in the lung expanded and progressed to crazy-paving, consolidation shadow, and the lesion gradually absorbs again followed by Fibrous cord shadows (27 cases); ground-glass opacities in the lungs quickly progressed to a consolidation and then slowly absorbed . Most of the lesions were accompanied by more residual fibrous cord shadows (4 cases). In 2 severe patients, the lesions in the lungs were larger ground glass, and a big amount of fibrous foci remained after slowly absorption.@*Conclusion@#Chest CT plays an important role in the diagnosis and treatment of imported COVID-19, and the degree of lung involvement seen on CT images is in good agreement with clinical outcome.