Acute pancreatitis is an inflammatory disease of the pancreas.The etiology and pathogenesis of acute pancreatitis have been intensively investigated for centuries worldwide.Many causes of acute pancreatitis have been ...Acute pancreatitis is an inflammatory disease of the pancreas.The etiology and pathogenesis of acute pancreatitis have been intensively investigated for centuries worldwide.Many causes of acute pancreatitis have been discovered,but the pathogenetic theories are controversial.The most common cause of acute pancreatitis is gallstone impacting the distal common bile-pancreatic duct.The majority ofinvestigators accept that the main factors for acute billiary pancreatitis are pancreatic hyperstimulation and bile-pancreatic duct obstruction which increase pancreatic duct pressure and active trypsin reflux.Acute pancreatitis occurs when intracellular protective mechanisms to prevent trypsinogen activation or reduce trypsin activity are overwhelmed.However,little is known about the other acute pancreatitis.We hypothesize that acute biliary pancreatitis and other causes of acute pancreatitis possess a common pathogenesis.Pancreatic hyperstimulation and pancreatic duct obstruction increase pancreatic duct pressure,active trypsin reflux,and subsequent unregulated activation of trypsin within pancreatic acinar cells.Enzyme activation within the pancreas leads to auto-digestion of the gland and local inflammation.Once the hypothesis is confirmed,traditional therapeutic strategies against acute pancreatitis may be improved.Decompression of pancreatic duct pressure should be advocated in the treatment of acute pancreatitits which may greatly improve its outcome.展开更多
Background The guidelines addressed the evidence-based indications for the management of children with acute infectious diarrhea in Chinese pediatric population. Data sources The experts group of evidence development ...Background The guidelines addressed the evidence-based indications for the management of children with acute infectious diarrhea in Chinese pediatric population. Data sources The experts group of evidence development put forward clinical problems, collects evidence, forms prelimi-nary recommendations, and then uses open-ended discussions to form recommendations. The literature review was done for developing this guideline in databases including PubMed, Cochrane, EMBASE, China Biomedical Database, and Chinese Journal Full-text Database up to June 2013. Search the topic 'acute diarrhea' or 'enteritis' and 'adolescent' or 'child' or'Pediatric patient' or 'Baby' or 'Infant'. Results For the treatment of mild, moderate dehydration, hypotonic oral rehydration solutions (ORS) are strongly recom-mended. Intravenous (IV) rehydration is recommended for severe dehydration, with a mixture of alkali-containing dextrose sodium solution. Nasogastric feeding tube rehydration is used for children with severe dehydration without IV infusion conditions with ORS solution. Regular feeding should resume as soon as possible after oral rehydration or IV rehydration. The lactose-free diet can shorten the diarrhea duration. Zinc supplements are recommended in children with acute infectious diarrhea. Saccharomyces boulardii and Lactobacillus Rhamnus are recommended to be used in acute watery diarrhea. Sac-charomyces boulardii is recommended in children with antibiotic-associated diarrhea as well. Montmorillonite and Racec-adotril (acetorphan) can improve the symptoms of diarrhea or shorten the course of acute watery diarrhea. Antibiotics are recommended with dysenteric-like diarrhea, suspected cholera with severe dehydration, immunodeficiency, and premature delivery children with chronic underlying disease;otherwise, antibiotics are not recommended. Conclusion The principles of the most controversial treatments with of acute infectious disease are reaching to a consensus in China.展开更多
The flow structure and the unsteady mechanism of the unsteady cavitating flow are reviewed in this paper. The flow patterns and structures in different cavitation regime, for the attached cavitation and the vortical c...The flow structure and the unsteady mechanism of the unsteady cavitating flow are reviewed in this paper. The flow patterns and structures in different cavitation regime, for the attached cavitation and the vortical cavitation, are shown with both the visualization and the quantitative information. The attached cavitating flow around the Clark-Y hydrofoil and the vortical cavitating flow around the Tulin hydrofoil are considered. In particular, the phenomena such as the large-scale vortex structure and the re-entrant flow associated with the cloud cavitation, and the cavitating vortex street's forming and crumbling are described. The evolution of the cavitation structure in the transient sheet/cloud cavity forming, along with the cavity collapse induced by the re-entrant flow and the shock wave propagation are discussed. The perspective future research of higher fidelity simulations, and the accurate identifications of the cavitating vortex structure is commented.展开更多
Background： The emergency department （ED） has a pivotal influence on the management of acute heart failure （AHF）, but dataconcerning current ED management are scarce. This Beijing AHF Registry Study investigated ...Background： The emergency department （ED） has a pivotal influence on the management of acute heart failure （AHF）, but dataconcerning current ED management are scarce. This Beijing AHF Registry Study investigated the characteristics. ED management, and short- and long-term clinical outcomes of AHF. Methods： This prospective, multicenter, observational study consecutively enrolled 3335 AHF patients who visited 14 EDs in Beijing from January 1, 2011, to September 23, 2012. Baseline data on characteristics and management were collected in the EDs. Follow-up data on death and readmissions were collected until November 31, 2013, with a response rate of 92.80%. The data were reported as median （interquartile range） for the continuous variables, or as number （percentage） for the categorical variables. Results： The median age of the enrolled patients was 71 （58 79） years, and 46.84% wvere women. In patients with AHH coronary heart disease （43.27%） was the most common etiology, andmyocardium ischemia （30.22%） was the main precipitant. Most of the patients in the ED received intravenous treatments, including diuretics （79.28%） and vasodilators （74.90%）. Fewer patients in the ED received neurohormonal antagonists, and 25.94%, 31.12%, and 33.73% of patients received angiotensin converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers, and spironolactone, respectively. The proportions of patients who were admitted, discharged, left against medical advice, and died were 55.53%, 33.58%, 7.08%, and 3.81%, respectively. All-cause mortalities at 30 days and 1 year were 15.30% and 32.27%, respectively. Conclusions： Substantial details on characteristics and ED management of AHF were investigated. The clinical outcomes of AHF patients were dismal. Thus, further investigations of ED-based therapeutic approaches for AHF are needed.展开更多
AIM: To perform a meta-analysis to quantitatively summarize the evidence for the association between the Notch signaling pathway and gastric cancer ( GC). METHODS: An electronic search of the MEDLINE, EMBASE and Chine...AIM: To perform a meta-analysis to quantitatively summarize the evidence for the association between the Notch signaling pathway and gastric cancer ( GC). METHODS: An electronic search of the MEDLINE, EMBASE and Chinese National Knowledge Infrastructure, which contain articles published from 1966 onwards, was conducted to select studies for this meta-analysis. RESULTS: Fifteen studies with a total of 1547 gastric cancer cases and 450 controls were included in this meta-analysis. Overall, the expression of Notch1, Notch2, Delta-like 4 and Hes1 was significantly higher in tumor tissues of GC compared to normal tissues. Specifically, stratified analyses showed that significantly increased expression of Notch1 was associated with non-cardia location, > 5 cm size, diffuse type, positive lymphovascular invasion and distal metastasis. Statistically significant higher expression of Notch3 was found in diffuse type GC. Jagged1 was also significantly over-expressed in diffuse type and poor differentiation type of GC. DLL4 was significantly over-expressed in advanced T stage, N stage and TNM stage in GC patients. However, the stratified analysis showed that there was no statistically significant difference in Hes1 expression between different subgroups. Sporadic reports showed that Notch1 and Jagged1 were independent poor prognostic predictors in GC. CONCLUSION: The Notch signaling pathway plays an important role in tumor progression of gastric cancer. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.展开更多
Background Staphylococcus aureus （S. aureus） remains as an important microbial pathogen resulting in community and nosocomial acquired infections with significant morbidity and mortality. Few reports for S. aureus i...Background Staphylococcus aureus （S. aureus） remains as an important microbial pathogen resulting in community and nosocomial acquired infections with significant morbidity and mortality. Few reports for S. aureus in lower respiratory tract infections （LRTIs） have been documented. The aim of this study was to explore the molecular epidemiology of S. aureus in LRTIs in China.Methods A multicenter study of the molecular epidemiology of S. aureus in LRTIs was conducted in 21 hospitals in Beijing, Shanghai and twelve other provinces from November 2007 to February 2009. All the collected S. aureus strains were classified as minimum inhibitory concentration （MIC）, mecA gene, virulence genes Panton-Valentine Leukocidin （PVL） and y-hemolysin （hlg）, staphylococcal cassette chromosome mec （SCCmec） type, agr type, and Multilocus Sequence Typinq （MLST）.Results Totally, nine methicillin-sensitive S. aureus （MSSA） and 29 methicillin-resistant S. aureus （MRSA） strains were isolated after culture from a total of 2829 sputums or bronchoalveolar lavages. The majority of MRSA strains （22/29） had a MIC value of 〉512 μg/ml for cefoxitin. The mecA gene acting as the conservative gene was carried by all MRSA strains. PVL genes were detected in only one S. aureus strain （2.63%, 1/38）. The hlg gene was detected in almost the all S. aureus （100% in MSSA and 96.56% in MRSA strains）. About 75.86% of MRSA strains carried SCCmec Ⅲ. Agr type 1 was predominant （78.95%） among the identified three agr types （agr types 1,2, and 3）. Totally, ten sequence type （ST） of S. aureus strains were detected. A new sequence type （ST1445） was found besides confirming ST239 as the major sequence type （60.53%）. A dendrogram generated from our own MLST database showed all the bootstrap values 〈50%. Conclusion Our preliminary epidemiology data show SCCmec Ⅲ, ST239 and agr type 1 of S. aureus as the predominant strains in LRTIs in Mainland of China.展开更多
Objectives:To develop a new Chinese medicine(CM)-based drug and to evaluate its safety and effect for suppressing acute respiratory distress syndrome(ARDS)in COVID-19 patients.Methods:A putative ARDS-suppressing drug ...Objectives:To develop a new Chinese medicine(CM)-based drug and to evaluate its safety and effect for suppressing acute respiratory distress syndrome(ARDS)in COVID-19 patients.Methods:A putative ARDS-suppressing drug Keguan-1 was first developed and then evaluated by a randomized,controlled two-arm trial.The two arms of the trial consist of a control therapy(alpha interferon inhalation,50(x g twice daily;and lopinavir/ritonavir,400 and 100 mg twice daily,respectively)and a testing therapy(control therapy plus Keguan-119.4 g twice daily)by random number table at 1:1 ratio with 24 cases each group.After 2-week treatment,adverse events,time to fever resolution,ARDS development,and lung injury on newly diagnosed COVID-19 patients were assessed.Results:An analysis of the data from the first 30 participants showed that the control arm and the testing arm did not exhibit any significant differences in terms of adverse events.Based on this result,the study was expanded to include a total of 48 participants(24 cases each arm).The results show that compared with the control arm,the testing arm exhibited a significant improvement in time to fever resolution(P=0.035),and a significant reduction in the development of ARDS(P=0.048).Conclusions:Keguan-1-based integrative therapy was safe and superior to the standard therapy in suppressing the development of ARDS in COVID-19 patients.(Trial registration No.NCT 04251871 at www.clinicaltrials.gov).展开更多
Lonicerae flos,a widely used traditional Chinese medicine(TCM),has been used for several thousand years in China.As a famous traditional Chinese herbal medicine,it was used as heat-clearing drug and alexipharmic agent...Lonicerae flos,a widely used traditional Chinese medicine(TCM),has been used for several thousand years in China.As a famous traditional Chinese herbal medicine,it was used as heat-clearing drug and alexipharmic agent and was widely cultivated in Hunan province.L.flos mainly contains biologically active compounds such as caffeic acid derivatives,essential oil,flavonoids,iridoid glycosides and terpenoids.A range of biological activities has been reported from plant extracts including anti-inflammatory,antitumor,antioxidant,antiallergy,immunomodulating and antibacterial activity.In this study,the author investigated ancient books of TCM and nowadays reports,summarized the chemical constituents,biological activity of L.flos to provide a comprehensive systematic review.展开更多
Liver fibrosis is the common pathological basis of all chronic liver diseases,and is the necessary stage for the progression of chronic liver disease to cirrhosis.As one of pathogenic factors,inflammation plays a pred...Liver fibrosis is the common pathological basis of all chronic liver diseases,and is the necessary stage for the progression of chronic liver disease to cirrhosis.As one of pathogenic factors,inflammation plays a predominant role in liver fibrosis via communication and interaction between inflammatory cells,cytokines,and the related signaling pathways.Damaged hepatocytes induce an increase in proinflammatory factors,thereby inducing the development of inflammation.In addition,it has been reported that inflammatory response related signaling pathway is the main signal transduction pathway for the development of liver fibrosis.The crosstalk regulatory network leads to hepatic stellate cell activation and proinflammatory cytokine production,which in turn initiate the fibrotic response.Compared with the past,the research on the pathogenesis of liver fibrosis has been greatly developed.However,the liver fibrosis mechanism is complex and many pathways involved need to be further studied.This review mainly focuses on the crosstalk regulatory network among inflammatory cells,cytokines,and the related signaling pathways in the pathogenesis of chronic inflammatory liver diseases.Moreover,we also summarize the recent studies on the mechanisms underlying liver fibrosis and clinical efforts on the targeted therapies against the fibrotic response.展开更多
AIM:To investigate the performance and diagnostic accuracy of interferon-gamma(IFN-γ) for tuberculous peritonitis(TBP) by meta-analysis.METHODS:A systematic search of English language studies was performed.We searche...AIM:To investigate the performance and diagnostic accuracy of interferon-gamma(IFN-γ) for tuberculous peritonitis(TBP) by meta-analysis.METHODS:A systematic search of English language studies was performed.We searched the following electronic databases:MEDLINE,EMBASE,Web of Science,BIOSIS,LILACS and the Cochrane Library.The Standards for Reporting Diagnostic Accuracy initiative and Quality Assessment for Studies of Diagnostic Accuracy tool were used to assess the methodological quality of the studies.Sensitivity,specificity,and other measures of the accuracy of IFN-γ concentration in the diagnosis of peritoneal effusion were pooled using random-effects models.Receiver operating characteristic(ROC) curves were applied to summarize overall test performance.Two reviewers independently judged study eligibility while screening the citations.RESULTS:Six studies met the inclusion criteria.The average inter-rater agreement between the two reviewers for items in the quality checklist was 0.92.Analysis of IFN-γ level for TBP diagnosis yielded a summary estimate:sensitivity,0.93(95%CI,0.87-0.97);specificity,0.99(95%CI,0.97-1.00);positive likelihood ratio(PLR),41.49(95%CI,18.80-91.55);negative likelihood ratio(NLR),0.11(95%CI,0.06-0.19);and diagnostic odds ratio(DOR),678.02(95%CI,209.91-2190.09).χ 2 values of the sensitivity,specificity,PLR,NLR and DOR were 5.66(P = 0.3407),6.37(P = 0.2715),1.38(P = 0.9265),5.46(P = 0.3621) and 1.42(P = 0.9220),respectively.The summary receiver ROC curve was positioned near the desirable upper left corner and the maximum joint sensitivity and specificity was 0.97.The area under the curve was 0.99.The evaluation of publication bias was not significant(P = 0.922).CONCLUSION:IFN-γ may be a sensitive and specific marker for the accurate diagnosis of TBP.The level of IFN-γ may contribute to the accurate differentiation of tuberculosis(TB) ascites from non-TB ascites.展开更多
Objective：To elucidate the mechanism of Chinese tuina in treating sciatic nerve crush injury,and to detect the levels of tissue plasminogen activator（t PA）and plasminogen activator inhibitor-1（PAI-1）,which is tho...Objective：To elucidate the mechanism of Chinese tuina in treating sciatic nerve crush injury,and to detect the levels of tissue plasminogen activator（t PA）and plasminogen activator inhibitor-1（PAI-1）,which is thought to play an important role in nerve regeneration.Methods：Thirty-two adult male Sprague-Dawley rats were subjected to sciatic nerve crush injury and 16 rats（sham-operated group）went through a sham operation.Control group was given no treatment while tuina group received tuina therapy since day 7 post-surgery.Tuina treatment was performed once a day and lasted for 20 days.The sciatic functional index was examined every 5days during the treatment session.The rats＇gastrocnemius muscles were evaluated for changes in mass and immunohistochemistry techniques were performed to detect the levels of tP A and PAI-1.Results：Tuina therapy improved the motor function of sciatic nerve injured rats（P〈0.05）,however,it did not increase muscle volume（P〈0.05）.Tuina downregulated the levels of t PA and PAI-1（P〈0.05）.Conclusions：The present study implies that tuina treatment could accelerate rehabilitation of peripheral nerve injury.展开更多
AIM: To evaluate the utility of carbohydrate antigen19-9(CA19-9) for differential diagnosis of pancreatic carcinoma and chronic pancreatitis.METHODS: We searched the literature for studies reporting the sensitivity, s...AIM: To evaluate the utility of carbohydrate antigen19-9(CA19-9) for differential diagnosis of pancreatic carcinoma and chronic pancreatitis.METHODS: We searched the literature for studies reporting the sensitivity, specificity, and other accuracy measures of serum CA19-9 levels for differentiating pancreatic carcinoma and chronic pancreatitis.Pooled analysis was performed using random-effects models, and receiver operating characteristic(ROC) curves were generated.Study quality was assessed using Standards for Reporting Diagnostic Accuracy and Quality Assessment for Studies of Diagnostic Accuracy tools.RESULTS: A total of 34 studies involving 3125 patients with pancreatic carcinoma and 2061 patients with chronic pancreatitis were included.Pooled analysis of the ability of CA19-9 level to differentiate pancreatic carcinoma and chronic pancreatitis showed the following effect estimates: sensitivity, 0.81(95%CI: 0.80-0.83); specificity, 0.81(95%CI: 0.79-0.82); positive likelihood ratio, 4.08(95%CI: 3.39-4.91); negative likelihood ratio, 0.24(95%CI: 0.21-0.28); and diagnostic odds ratio, 19.31(95%CI: 14.40-25.90).The area under the ROC curve was 0.88.No significant publication bias was detected.CONCLUSION: Elevated CA19-9 by itself is insufficient for differentiating pancreatic carcinoma and chronic pancreatitis, however, it increases suspicion of pancreatic carcinoma and may complement other clinical findings to improve diagnostic accuracy.展开更多
Rubus chingii Hu, a member of the rosaceae family, is extensively distributed in China and Japan. Its unripe fruits(Fupenzi in Chinese) have a long history of use as an herbal tonic in traditional Chinese medicine for...Rubus chingii Hu, a member of the rosaceae family, is extensively distributed in China and Japan. Its unripe fruits(Fupenzi in Chinese) have a long history of use as an herbal tonic in traditional Chinese medicine for treating various diseases commonly associated with kidney deficiency, and they are still in use today. Phytochemical investigations on the fruits and leaves of R. chingii indicate the presence of terpenoids, flavonoids, steroids, alkaloids, phenylpropanoids, phenolics, and organic acids. Extracts or active substances from this plant are reported to have various pharmacological properties, including antioxidant, anti-inflammatory, antitumor, antifungal, antithrombotic, antiosteoporotic, hypoglycemic, and central nervous system-regulating effects. This review provides up-to-date information on the botanical characterizations, traditional usages, chemical constituents, pharmacological activities, toxicity,and quality control of R. chingii. Possible directions for future research are also briefly proposed. This review aims to supply fundamental data for the further study of R. chingii and contribute to the development of its clinical use.展开更多
INTRODUCTIONThe increased expression of ICAM-1 on a widerange of cells and in the sera of patients withmalignancies, chronic liver diseases andinflammation diseases has been described since thelate 1980s[1-22]. Recent...INTRODUCTIONThe increased expression of ICAM-1 on a widerange of cells and in the sera of patients withmalignancies, chronic liver diseases andinflammation diseases has been described since thelate 1980s[1-22]. Recently rapid progress in studieson expression of ICAM-1 in patients withhepatocellular carcinoma ( HCC ) have beenachieved, including clinical and experimentalresearches[23-31].展开更多
Background Acinetobacter baumanii （A. baumanii ） remains an important microbial pathogen resulting in nosocomialacquired infections with significant morbidity and mortality. The mechanism by which nosocomial bacteri...Background Acinetobacter baumanii （A. baumanii ） remains an important microbial pathogen resulting in nosocomialacquired infections with significant morbidity and mortality. The mechanism by which nosocomial bacteria, like A. baumanii, attain multidrug resistance to antibiotics is of considerable interest. The aim in this study was to investigate the spread status of antibiotic resistance genes, such as multiple 13-1actamase genes and aminoglycoside-modifying enzyme genes, from A. baumanii strains isolated from patients with lower respiratory tract infections （LRTIs）. Methods Two thousand six hundred and ninety-eight sputum or the bronchoalveolar lavage samples from inpatients with LRTIs were collected in 21 hospitals in the mainland of China from November 2007 to February 2009. All samples were routinely inoculated. The isolated bacterial strains and their susceptibility were analyzed via VITEK-2 expert system. Several kinds of antibiotic resistant genes were further differentiated via polymerase chain reaction and sequencing methods. Results Totally, 39 A. baumanii strains were isolated from 2698 sputum or bronchoalveolar lavage samples. There was not only a high resistant rate of the isolated A. baumanfi strains to ampicillin and first- and second-generation cephalosporins （94.87%, 100% and 97.44%, respectively）, but also to the third-generation cephalosporins （ceftriaxone at 92.31%, ceftazidine at 51.28%） and imipenem （43.59%） as well. The lowest antibiotic resistance rate of 20.51% was found to amikacin. The OXA-23 gene was identified in 17 strains of A. baumanii, and the AmpC gene in 23 strains. The TEM-1 gene was carried in 15 strains. PER-1 and SHV-2 genes were detected in two different strains. Aminoglycoside-modifying enzyme gene aac-3-1a was found in 23 strains, and the aac-6＂lb gene in 19 strains, aac-3-1a and aac-6＂lb genes hibernated in three A. baumanfi strains that showed no drug-resistant phenotype. Conclusions A. baumanii can carry multiple drug-resistant genes at the sam展开更多
文摘Acute pancreatitis is an inflammatory disease of the pancreas.The etiology and pathogenesis of acute pancreatitis have been intensively investigated for centuries worldwide.Many causes of acute pancreatitis have been discovered,but the pathogenetic theories are controversial.The most common cause of acute pancreatitis is gallstone impacting the distal common bile-pancreatic duct.The majority ofinvestigators accept that the main factors for acute billiary pancreatitis are pancreatic hyperstimulation and bile-pancreatic duct obstruction which increase pancreatic duct pressure and active trypsin reflux.Acute pancreatitis occurs when intracellular protective mechanisms to prevent trypsinogen activation or reduce trypsin activity are overwhelmed.However,little is known about the other acute pancreatitis.We hypothesize that acute biliary pancreatitis and other causes of acute pancreatitis possess a common pathogenesis.Pancreatic hyperstimulation and pancreatic duct obstruction increase pancreatic duct pressure,active trypsin reflux,and subsequent unregulated activation of trypsin within pancreatic acinar cells.Enzyme activation within the pancreas leads to auto-digestion of the gland and local inflammation.Once the hypothesis is confirmed,traditional therapeutic strategies against acute pancreatitis may be improved.Decompression of pancreatic duct pressure should be advocated in the treatment of acute pancreatitits which may greatly improve its outcome.
文摘Background The guidelines addressed the evidence-based indications for the management of children with acute infectious diarrhea in Chinese pediatric population. Data sources The experts group of evidence development put forward clinical problems, collects evidence, forms prelimi-nary recommendations, and then uses open-ended discussions to form recommendations. The literature review was done for developing this guideline in databases including PubMed, Cochrane, EMBASE, China Biomedical Database, and Chinese Journal Full-text Database up to June 2013. Search the topic 'acute diarrhea' or 'enteritis' and 'adolescent' or 'child' or'Pediatric patient' or 'Baby' or 'Infant'. Results For the treatment of mild, moderate dehydration, hypotonic oral rehydration solutions (ORS) are strongly recom-mended. Intravenous (IV) rehydration is recommended for severe dehydration, with a mixture of alkali-containing dextrose sodium solution. Nasogastric feeding tube rehydration is used for children with severe dehydration without IV infusion conditions with ORS solution. Regular feeding should resume as soon as possible after oral rehydration or IV rehydration. The lactose-free diet can shorten the diarrhea duration. Zinc supplements are recommended in children with acute infectious diarrhea. Saccharomyces boulardii and Lactobacillus Rhamnus are recommended to be used in acute watery diarrhea. Sac-charomyces boulardii is recommended in children with antibiotic-associated diarrhea as well. Montmorillonite and Racec-adotril (acetorphan) can improve the symptoms of diarrhea or shorten the course of acute watery diarrhea. Antibiotics are recommended with dysenteric-like diarrhea, suspected cholera with severe dehydration, immunodeficiency, and premature delivery children with chronic underlying disease;otherwise, antibiotics are not recommended. Conclusion The principles of the most controversial treatments with of acute infectious disease are reaching to a consensus in China.
基金supported by the National Natural Science Foundation of China(Grant Nos.51839001,51679005 and 91752105)the Natural Science Foundation of Beijing(Grant No.3172029).
文摘The flow structure and the unsteady mechanism of the unsteady cavitating flow are reviewed in this paper. The flow patterns and structures in different cavitation regime, for the attached cavitation and the vortical cavitation, are shown with both the visualization and the quantitative information. The attached cavitating flow around the Clark-Y hydrofoil and the vortical cavitating flow around the Tulin hydrofoil are considered. In particular, the phenomena such as the large-scale vortex structure and the re-entrant flow associated with the cloud cavitation, and the cavitating vortex street's forming and crumbling are described. The evolution of the cavitation structure in the transient sheet/cloud cavity forming, along with the cavity collapse induced by the re-entrant flow and the shock wave propagation are discussed. The perspective future research of higher fidelity simulations, and the accurate identifications of the cavitating vortex structure is commented.
文摘Background： The emergency department （ED） has a pivotal influence on the management of acute heart failure （AHF）, but dataconcerning current ED management are scarce. This Beijing AHF Registry Study investigated the characteristics. ED management, and short- and long-term clinical outcomes of AHF. Methods： This prospective, multicenter, observational study consecutively enrolled 3335 AHF patients who visited 14 EDs in Beijing from January 1, 2011, to September 23, 2012. Baseline data on characteristics and management were collected in the EDs. Follow-up data on death and readmissions were collected until November 31, 2013, with a response rate of 92.80%. The data were reported as median （interquartile range） for the continuous variables, or as number （percentage） for the categorical variables. Results： The median age of the enrolled patients was 71 （58 79） years, and 46.84% wvere women. In patients with AHH coronary heart disease （43.27%） was the most common etiology, andmyocardium ischemia （30.22%） was the main precipitant. Most of the patients in the ED received intravenous treatments, including diuretics （79.28%） and vasodilators （74.90%）. Fewer patients in the ED received neurohormonal antagonists, and 25.94%, 31.12%, and 33.73% of patients received angiotensin converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers, and spironolactone, respectively. The proportions of patients who were admitted, discharged, left against medical advice, and died were 55.53%, 33.58%, 7.08%, and 3.81%, respectively. All-cause mortalities at 30 days and 1 year were 15.30% and 32.27%, respectively. Conclusions： Substantial details on characteristics and ED management of AHF were investigated. The clinical outcomes of AHF patients were dismal. Thus, further investigations of ED-based therapeutic approaches for AHF are needed.
基金Supported by National Natural Science Foundation of China,No.81071777Sichuan Province Science and Technology Support Program,No.2011SZ0293 and No.2011SZ0087
文摘AIM: To perform a meta-analysis to quantitatively summarize the evidence for the association between the Notch signaling pathway and gastric cancer ( GC). METHODS: An electronic search of the MEDLINE, EMBASE and Chinese National Knowledge Infrastructure, which contain articles published from 1966 onwards, was conducted to select studies for this meta-analysis. RESULTS: Fifteen studies with a total of 1547 gastric cancer cases and 450 controls were included in this meta-analysis. Overall, the expression of Notch1, Notch2, Delta-like 4 and Hes1 was significantly higher in tumor tissues of GC compared to normal tissues. Specifically, stratified analyses showed that significantly increased expression of Notch1 was associated with non-cardia location, > 5 cm size, diffuse type, positive lymphovascular invasion and distal metastasis. Statistically significant higher expression of Notch3 was found in diffuse type GC. Jagged1 was also significantly over-expressed in diffuse type and poor differentiation type of GC. DLL4 was significantly over-expressed in advanced T stage, N stage and TNM stage in GC patients. However, the stratified analysis showed that there was no statistically significant difference in Hes1 expression between different subgroups. Sporadic reports showed that Notch1 and Jagged1 were independent poor prognostic predictors in GC. CONCLUSION: The Notch signaling pathway plays an important role in tumor progression of gastric cancer. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.
文摘Background Staphylococcus aureus （S. aureus） remains as an important microbial pathogen resulting in community and nosocomial acquired infections with significant morbidity and mortality. Few reports for S. aureus in lower respiratory tract infections （LRTIs） have been documented. The aim of this study was to explore the molecular epidemiology of S. aureus in LRTIs in China.Methods A multicenter study of the molecular epidemiology of S. aureus in LRTIs was conducted in 21 hospitals in Beijing, Shanghai and twelve other provinces from November 2007 to February 2009. All the collected S. aureus strains were classified as minimum inhibitory concentration （MIC）, mecA gene, virulence genes Panton-Valentine Leukocidin （PVL） and y-hemolysin （hlg）, staphylococcal cassette chromosome mec （SCCmec） type, agr type, and Multilocus Sequence Typinq （MLST）.Results Totally, nine methicillin-sensitive S. aureus （MSSA） and 29 methicillin-resistant S. aureus （MRSA） strains were isolated after culture from a total of 2829 sputums or bronchoalveolar lavages. The majority of MRSA strains （22/29） had a MIC value of 〉512 μg/ml for cefoxitin. The mecA gene acting as the conservative gene was carried by all MRSA strains. PVL genes were detected in only one S. aureus strain （2.63%, 1/38）. The hlg gene was detected in almost the all S. aureus （100% in MSSA and 96.56% in MRSA strains）. About 75.86% of MRSA strains carried SCCmec Ⅲ. Agr type 1 was predominant （78.95%） among the identified three agr types （agr types 1,2, and 3）. Totally, ten sequence type （ST） of S. aureus strains were detected. A new sequence type （ST1445） was found besides confirming ST239 as the major sequence type （60.53%）. A dendrogram generated from our own MLST database showed all the bootstrap values 〈50%. Conclusion Our preliminary epidemiology data show SCCmec Ⅲ, ST239 and agr type 1 of S. aureus as the predominant strains in LRTIs in Mainland of China.
基金the National Administration of Traditional Chinese Medicine Project(No.2020ZYLCYJ05-1)the National Natural Science Foundation of China(Nos.81630100,81721002,81930110)+2 种基金China PLA Biosecurity Project(No.19SWAQ13)China PLA Emergency Project(BWS20J006)the Beijing Administration of Traditional Chinese Medicine Project(Nos.YJ2020-03,SYFY202011)。
文摘Objectives:To develop a new Chinese medicine(CM)-based drug and to evaluate its safety and effect for suppressing acute respiratory distress syndrome(ARDS)in COVID-19 patients.Methods:A putative ARDS-suppressing drug Keguan-1 was first developed and then evaluated by a randomized,controlled two-arm trial.The two arms of the trial consist of a control therapy(alpha interferon inhalation,50(x g twice daily;and lopinavir/ritonavir,400 and 100 mg twice daily,respectively)and a testing therapy(control therapy plus Keguan-119.4 g twice daily)by random number table at 1:1 ratio with 24 cases each group.After 2-week treatment,adverse events,time to fever resolution,ARDS development,and lung injury on newly diagnosed COVID-19 patients were assessed.Results:An analysis of the data from the first 30 participants showed that the control arm and the testing arm did not exhibit any significant differences in terms of adverse events.Based on this result,the study was expanded to include a total of 48 participants(24 cases each arm).The results show that compared with the control arm,the testing arm exhibited a significant improvement in time to fever resolution(P=0.035),and a significant reduction in the development of ARDS(P=0.048).Conclusions:Keguan-1-based integrative therapy was safe and superior to the standard therapy in suppressing the development of ARDS in COVID-19 patients.(Trial registration No.NCT 04251871 at www.clinicaltrials.gov).
基金funding support from the Key Laboratory For Quality Evaluation of Bulk Herbs of Hunan Province and national science foundation of China (No.81374062 and No.81673579)
文摘Lonicerae flos,a widely used traditional Chinese medicine(TCM),has been used for several thousand years in China.As a famous traditional Chinese herbal medicine,it was used as heat-clearing drug and alexipharmic agent and was widely cultivated in Hunan province.L.flos mainly contains biologically active compounds such as caffeic acid derivatives,essential oil,flavonoids,iridoid glycosides and terpenoids.A range of biological activities has been reported from plant extracts including anti-inflammatory,antitumor,antioxidant,antiallergy,immunomodulating and antibacterial activity.In this study,the author investigated ancient books of TCM and nowadays reports,summarized the chemical constituents,biological activity of L.flos to provide a comprehensive systematic review.
文摘Liver fibrosis is the common pathological basis of all chronic liver diseases,and is the necessary stage for the progression of chronic liver disease to cirrhosis.As one of pathogenic factors,inflammation plays a predominant role in liver fibrosis via communication and interaction between inflammatory cells,cytokines,and the related signaling pathways.Damaged hepatocytes induce an increase in proinflammatory factors,thereby inducing the development of inflammation.In addition,it has been reported that inflammatory response related signaling pathway is the main signal transduction pathway for the development of liver fibrosis.The crosstalk regulatory network leads to hepatic stellate cell activation and proinflammatory cytokine production,which in turn initiate the fibrotic response.Compared with the past,the research on the pathogenesis of liver fibrosis has been greatly developed.However,the liver fibrosis mechanism is complex and many pathways involved need to be further studied.This review mainly focuses on the crosstalk regulatory network among inflammatory cells,cytokines,and the related signaling pathways in the pathogenesis of chronic inflammatory liver diseases.Moreover,we also summarize the recent studies on the mechanisms underlying liver fibrosis and clinical efforts on the targeted therapies against the fibrotic response.
文摘AIM:To investigate the performance and diagnostic accuracy of interferon-gamma(IFN-γ) for tuberculous peritonitis(TBP) by meta-analysis.METHODS:A systematic search of English language studies was performed.We searched the following electronic databases:MEDLINE,EMBASE,Web of Science,BIOSIS,LILACS and the Cochrane Library.The Standards for Reporting Diagnostic Accuracy initiative and Quality Assessment for Studies of Diagnostic Accuracy tool were used to assess the methodological quality of the studies.Sensitivity,specificity,and other measures of the accuracy of IFN-γ concentration in the diagnosis of peritoneal effusion were pooled using random-effects models.Receiver operating characteristic(ROC) curves were applied to summarize overall test performance.Two reviewers independently judged study eligibility while screening the citations.RESULTS:Six studies met the inclusion criteria.The average inter-rater agreement between the two reviewers for items in the quality checklist was 0.92.Analysis of IFN-γ level for TBP diagnosis yielded a summary estimate:sensitivity,0.93(95%CI,0.87-0.97);specificity,0.99(95%CI,0.97-1.00);positive likelihood ratio(PLR),41.49(95%CI,18.80-91.55);negative likelihood ratio(NLR),0.11(95%CI,0.06-0.19);and diagnostic odds ratio(DOR),678.02(95%CI,209.91-2190.09).χ 2 values of the sensitivity,specificity,PLR,NLR and DOR were 5.66(P = 0.3407),6.37(P = 0.2715),1.38(P = 0.9265),5.46(P = 0.3621) and 1.42(P = 0.9220),respectively.The summary receiver ROC curve was positioned near the desirable upper left corner and the maximum joint sensitivity and specificity was 0.97.The area under the curve was 0.99.The evaluation of publication bias was not significant(P = 0.922).CONCLUSION:IFN-γ may be a sensitive and specific marker for the accurate diagnosis of TBP.The level of IFN-γ may contribute to the accurate differentiation of tuberculosis(TB) ascites from non-TB ascites.
基金Supported by the National Natural Science Foundation of China(No.81373759)Research Fund for the Doctoral Program of Higher Education(No.20130013110016)Natural Science Foundation of Beijing(No.7142097)
文摘Objective：To elucidate the mechanism of Chinese tuina in treating sciatic nerve crush injury,and to detect the levels of tissue plasminogen activator（t PA）and plasminogen activator inhibitor-1（PAI-1）,which is thought to play an important role in nerve regeneration.Methods：Thirty-two adult male Sprague-Dawley rats were subjected to sciatic nerve crush injury and 16 rats（sham-operated group）went through a sham operation.Control group was given no treatment while tuina group received tuina therapy since day 7 post-surgery.Tuina treatment was performed once a day and lasted for 20 days.The sciatic functional index was examined every 5days during the treatment session.The rats＇gastrocnemius muscles were evaluated for changes in mass and immunohistochemistry techniques were performed to detect the levels of tP A and PAI-1.Results：Tuina therapy improved the motor function of sciatic nerve injured rats（P〈0.05）,however,it did not increase muscle volume（P〈0.05）.Tuina downregulated the levels of t PA and PAI-1（P〈0.05）.Conclusions：The present study implies that tuina treatment could accelerate rehabilitation of peripheral nerve injury.
文摘AIM: To evaluate the utility of carbohydrate antigen19-9(CA19-9) for differential diagnosis of pancreatic carcinoma and chronic pancreatitis.METHODS: We searched the literature for studies reporting the sensitivity, specificity, and other accuracy measures of serum CA19-9 levels for differentiating pancreatic carcinoma and chronic pancreatitis.Pooled analysis was performed using random-effects models, and receiver operating characteristic(ROC) curves were generated.Study quality was assessed using Standards for Reporting Diagnostic Accuracy and Quality Assessment for Studies of Diagnostic Accuracy tools.RESULTS: A total of 34 studies involving 3125 patients with pancreatic carcinoma and 2061 patients with chronic pancreatitis were included.Pooled analysis of the ability of CA19-9 level to differentiate pancreatic carcinoma and chronic pancreatitis showed the following effect estimates: sensitivity, 0.81(95%CI: 0.80-0.83); specificity, 0.81(95%CI: 0.79-0.82); positive likelihood ratio, 4.08(95%CI: 3.39-4.91); negative likelihood ratio, 0.24(95%CI: 0.21-0.28); and diagnostic odds ratio, 19.31(95%CI: 14.40-25.90).The area under the ROC curve was 0.88.No significant publication bias was detected.CONCLUSION: Elevated CA19-9 by itself is insufficient for differentiating pancreatic carcinoma and chronic pancreatitis, however, it increases suspicion of pancreatic carcinoma and may complement other clinical findings to improve diagnostic accuracy.
基金the National Natural Science Foundation of China(No.81803794)the Program for Excellent Talents in Zhejiang Chinese Medical University(No.112123A12201/001/004/019)。
文摘Rubus chingii Hu, a member of the rosaceae family, is extensively distributed in China and Japan. Its unripe fruits(Fupenzi in Chinese) have a long history of use as an herbal tonic in traditional Chinese medicine for treating various diseases commonly associated with kidney deficiency, and they are still in use today. Phytochemical investigations on the fruits and leaves of R. chingii indicate the presence of terpenoids, flavonoids, steroids, alkaloids, phenylpropanoids, phenolics, and organic acids. Extracts or active substances from this plant are reported to have various pharmacological properties, including antioxidant, anti-inflammatory, antitumor, antifungal, antithrombotic, antiosteoporotic, hypoglycemic, and central nervous system-regulating effects. This review provides up-to-date information on the botanical characterizations, traditional usages, chemical constituents, pharmacological activities, toxicity,and quality control of R. chingii. Possible directions for future research are also briefly proposed. This review aims to supply fundamental data for the further study of R. chingii and contribute to the development of its clinical use.
基金Supported by the grant from the Guangxi ScienceTechnology Committee, No. 9811003
文摘INTRODUCTIONThe increased expression of ICAM-1 on a widerange of cells and in the sera of patients withmalignancies, chronic liver diseases andinflammation diseases has been described since thelate 1980s[1-22]. Recently rapid progress in studieson expression of ICAM-1 in patients withhepatocellular carcinoma ( HCC ) have beenachieved, including clinical and experimentalresearches[23-31].
文摘Background Acinetobacter baumanii （A. baumanii ） remains an important microbial pathogen resulting in nosocomialacquired infections with significant morbidity and mortality. The mechanism by which nosocomial bacteria, like A. baumanii, attain multidrug resistance to antibiotics is of considerable interest. The aim in this study was to investigate the spread status of antibiotic resistance genes, such as multiple 13-1actamase genes and aminoglycoside-modifying enzyme genes, from A. baumanii strains isolated from patients with lower respiratory tract infections （LRTIs）. Methods Two thousand six hundred and ninety-eight sputum or the bronchoalveolar lavage samples from inpatients with LRTIs were collected in 21 hospitals in the mainland of China from November 2007 to February 2009. All samples were routinely inoculated. The isolated bacterial strains and their susceptibility were analyzed via VITEK-2 expert system. Several kinds of antibiotic resistant genes were further differentiated via polymerase chain reaction and sequencing methods. Results Totally, 39 A. baumanii strains were isolated from 2698 sputum or bronchoalveolar lavage samples. There was not only a high resistant rate of the isolated A. baumanfi strains to ampicillin and first- and second-generation cephalosporins （94.87%, 100% and 97.44%, respectively）, but also to the third-generation cephalosporins （ceftriaxone at 92.31%, ceftazidine at 51.28%） and imipenem （43.59%） as well. The lowest antibiotic resistance rate of 20.51% was found to amikacin. The OXA-23 gene was identified in 17 strains of A. baumanii, and the AmpC gene in 23 strains. The TEM-1 gene was carried in 15 strains. PER-1 and SHV-2 genes were detected in two different strains. Aminoglycoside-modifying enzyme gene aac-3-1a was found in 23 strains, and the aac-6＂lb gene in 19 strains, aac-3-1a and aac-6＂lb genes hibernated in three A. baumanfi strains that showed no drug-resistant phenotype. Conclusions A. baumanii can carry multiple drug-resistant genes at the sam
