Clinical characteristics of family clustering pediatric and adult cases with severe acute respiratory syndrome coronavirus 2 Omicron variant infection / 中华传染病杂志

Objective:To investigate the clinical characteristics of family clustering pediatric and adult cases with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant infection in Shanghai City.Methods:A field investigation among the pediatric cases with Omicron variant infection and their household contacts from April 4 to April 30, 2022 in Children′s Hospital of Fudan University was conducted. The informations on case finding, clinical manifestations and SARS-CoV-2 vaccination status were collected. The epidemiological and clinical characteristics were compared between pediatric cases and adult cases. The independent sample t test or chi-square test was used for statistical analysis, and the relative risk ( RR) and 95% confidence interval (95% CI) were used to evaluate the protective effect of vaccination on the infection of Omicron variant. Results:There were 1 274 family members in 297 families including 370 children and 904 adults of whom 1 110(87.13%) were infected with Omicron variant, with 989(89.10%) symptomatic and 121(10.90%) asymptomatic. There were 355 children infected with Omicron variant, of whom 337(94.93%) were symptomatic, and the main manifestations were fever (96.74%(326/337)) and cough (40.36%(136/337)). Only one pediatric case with Rett syndrome developed critically severe pneumonia. A total of 194 pediatric cases had imaging examination, 64(32.99%) showed pulmonary inflammatory lesions. There were 755 adult cases infected with Omicron variant, of whom 652(86.26%) reported symptoms, and the main manifestations were fever (73.16%(477/652)) and cough (49.85%(325/652)). Among symptomatic cases, fever was more common in pediatric cases than in adult cases, while cough was more common in adult cases than in pediatric cases, and the differences were both statistically significant ( χ2=80.87 and 8.04, respectively, both P<0.01). The fever spike was higher in pediatric cases than in adult cases ((39.3±0.7) ℃ vs (38.6±0.6) ℃), and the difference was statistically significant ( t=9.85, P<0.001). The interval from the onset of symptoms to cycle threshold (Ct) value of the nucleic acid of Omicron variant≥35 was longer in pediatric cases than in adult cases ((13.0±3.1) d vs (10.9±3.6) d), and the difference had statistically significance ( t=2.97, P=0.004). Among 160 children aged 3 to 18 years, 54 (33.75%) received two-dose vaccination. Among the 904 adults, 388 (42.92%) received two-dose vaccination and 293 (32.41%) received a booster dose. In the adult cases, the risk of symptomatic infection was reduced by only 8% ( RR=0.92, 95% CI 0.86 to 0.98, P=0.014) following two-dose vaccination, and the risks of fever and cough following booster vaccination were reduced by 42%( RR=0.58, 95% CI 0.49 to 0.67, P=0.001) and 50% ( RR=0.50, 95% CI 0.34 to 0.78, P=0.001), respectively. Conclusions:Secondary attack rate and symptomatic rate of household infection are high in the context of the Omicron variant outbreak in Shanghai. Symptomatic infection is common in children and adults in household setting. Fever is the most common symptom and fever duration is short. Booster vaccination may provide certain protection against common symptoms caused by Omicron variant infection.

Immune activity enhancement of T lymphocyte by ultrasound microbubble mediated Itch gene silencing / 中华超声影像学杂志

Objective:To inhibit the Itch gene expression of T-lymphocytes and investigate the immune activity of T lymphocytes using ultrasound-targeted microbubble destruction (UTMD).Methods:T lymphocytes were separated by magnetic bead, and to establish an Itch gene targeted short hairpin RNA (shRNA) plasmid. There were three groups in this study: ①experimental group, Itch-shRNA plasmid-SonoVue microbubbles combined with ultrasound irradiation; ②control group, negative control shRNA plasmid-SonoVue microbubbles combined with ultrasound irradiation; ③blank group, untreated. Forty-eight hours after UTMD transfection, transfection efficiency was detected and analyzed by fluorescence microscopy and flow cytometry, the expression of Itch protein was measured with Western blotting.Seventy-two hours after UTMD transfection, the secretion of interleukin 2 (IL-2) and interferon γ (IFN-γ) in the cell supernatant were measured by enzyme-linked immunosorbent assay (ELISA). One-way ANOVA was used to compare the differences between groups, and LSD- t test was used to compare the differences between groups. Results:The UTMD mediated shRNA transfection rate was 52.3%, and the relative expression levels of Itch protein in the experimental group, control group and blank group were 0.301±0.080, 0.773±0.101 and 0.719±0.090, respectively, and the difference was statistically significant( F=24.441, P<0.01). The Itch gene expression can be effectively suppressed in the experimental group. Seventy-two hours after transfection, the concentrations of IL-2 in the experimental group, control group and blank group were (417.3±37.1)ng/L, (158.7±17.3)ng/L and (147.0±10.2)ng/L, respectively, and the difference was statistically significant( F=118.701, P<0.001) and the concentrations of IFN-γ were (168.3±12.1)ng/L, (74.3±3.7)ng/L and (74.6±7.1)ng/L, respectively, and the difference was statistically significant ( F=126.833, P<0.001). The expression levels of IL-2 and IFN-γ in the experimental group were significantly higher than those in the control group and the blank group. Conclusions:UTMD mediated shRNA transfection can significantly decrease the expression of Itch and promote immune activity of T lymphocyte.

Law of the meridian abnormality based on the effectiveness of electroacupuncture for severe functional constipation / 中国针灸

<p><b>OBJECTIVE</b>To observe the law of the meridian abnormal changes and the correlation with acupuncture efficacy based on the effectiveness study of electroacupuncture (EA) in treatment of severe functional constipation.</p><p><b>METHODS</b>Seventy patients of severe functional constipation were randomized into an EA group and a sham-EA group, 35 cases in each one. In the EA group, Tianshu (ST 25) and Fujie (SP 14) were punctured deeply and stimulated with EA (dense-disperse wave, 2Hz/15 Hz, 0. 1 to 1. 0 mA), and Shangjuxu (ST 37) was needled. In the sham-EA group, the sites lateral to Tianshu (ST 25) and Fujie (SP 14) were punctured shallowly and stimulated with electricity. The site lateral to Shangjuxu (ST 37) was punctured shallowly. The treatment was given continuously for 8 weeks in the two groups, 5 times weekly in the first 2 weeks and 3 times weekly in the rest 6 weeks. WANG Juyi's meridian examination method was applied to detect the abnormalities of the spleen, stomach and large intestine meridians before treatment, and in 2, 4, 6 and 8 weeks among 70 patients separately. The frequency of complete spontaneous bowel movement (CSBM) every two weeks, meridian abnormal value and the relativity with CSBM change rate were compared in the patients between two groups.</p><p><b>RESULTS</b>Regarding the increase of CSBM frequency, the effect started since the 2nd week in the EA group, with the treatment going on, CSBM frequency was increased apparently (all P<0. 05). In the sham-EA group, after 6 and 8-weeks of treatment, CSBM frequency was increased apparently as compared with that before treatment (all P<0. 05). The increase of CSBM frequency in the EA group was remarkably as compared with the sham-EA group at every time point (all P<0. 05). The abnormal value of the large intestine meridian in 2 weeks of treatment and the values of the stomach and spleen meridians and the relevant meridians in 4 weeks of treatment were all reduced apparently as compared with those in the baseline in the EA group (all P<0. 05). With the treatment time going on, the abnormal reflections on the large intestine and stomach meridians were reduced gradually (all P<0. 05), and the total change rate of abnormalities on the large intestine, stomach and spleen meridians presented the negative correlation with the total change rate of CSBM frequency (P<0. 01, P<0. 05).</p><p><b>CONCLUSION</b>In the EA group, the efficacy on CSBM frequency in severe functional constipation is advantageous and stable as compared with the sham-EA group. Acupuncture at the relevant acupoints of the spleen, stomach and large intestine meridians achieves the definite regulation to the meridian abnormalities. It is discovered that the abnormal changes in the spleen, stomach</p>

The related factor analysis and intervention of Miles postoperative skin damage around the stoma / 中国实用护理杂志

Objective To investigate the patients with postoperative skin damage around the stoma after Miles operation,take measures according to the influencing factors,and explore an effective way to reduce the incidence of skin damage around the stoma patients.Methods There were 62 cases of skin damage around the stoma in 110 cases of patients with permanent colostomy in out-patient follow-up.Each patient with skin damage occurring around the stoma were retrospectively analyzed the reasons,and the related factors that might affect Miles postoperative stoma skin damage were analyzed.Results The incidence rate of Miles postoperative skin damage around the stoma was 56.36％,through the multi-factor Logistic regression analysis,there were six related factors with the Miles postoperative skin damage around the stoma,patients' excrement stimulation,ostomy bag allergies,improper operation of the replacement of the ostomy bag,the potential skin disease,excessive scrub / rub the skin,unfamiliar with ostomy care knowledge were the influencing factors of patients with skin damage around the stoma.Conclusions Appropriate stoma care products and paste methods,detailed guiding of patients and their families about ostomy care knowledge and skills can significantly reduce the incidence rate of Miles postoperative skin damage around the stoma.

Effect on CYP1B1 expression of transplanted-A2780TS cells in nude mice paclitaxel resistance ovarian cancer by α-NF / 肿瘤研究与临床

Objective To study the effects of flavone compound α-NF on CYP1B1 gene in transplanted nude mice tumor with human paclitaxel resistance ovarian cancer cell. Methods Using 24 nude models of orthotopic transplantation of human ovarian cancer, they were divided randomly into four groups: control group, α-NF group, paclitaxel group and combined group. RT-PCR and Western blotting method were used to detect CYP1B1 mRNA and protein expression. Results There was no significant difference in CYP1B1 mRNA expression between α-NF group, combined group and control group(P >0.05). Compared with control group, CYP1B1 protein expression was distinctly lower in α-NF and combined group (P<0.01). Conclusion α-NF has no effect on CYPIB1 gene in mRNA level, whereas α-NF down-regnlate, CYP1B1 expression of transplanted A2780TS nude mice tumor in protein level, thus α-NF has the effect on reversing paclitaxel resistance of A2780TS cell.

Clinical study of 36 cases with severe pre-eclampsia complicated with ascites / 中国综合临床

Objective To analyse clinical characteristics and preventive methods of pregnancy-induced hypertensive severe pre-eclampsia with ascites.Methods 184 cases of patients with severe pre-eclampsia complicated with ascite were divided into two groups and the clinical characteristics were compared(severe pre-eclampsia complicated with ascite group,n=36;Severe pre-eclampsia group,n=148 cases).Results The average time of the termination of pregnancy was (34±4) weeks in severe pre-eclampsia complicated with ascites group,and (36±3) weeks in severe pre-eclampsia group (t=2.71,P＜0.01).There were 6 cases of intrauterine stillborn (16.67%),14 cases of neonatal mortality (38.89%);22 cases of premature labor (61.11%) in severe pre-eclampsia complicated with aacites group;There were 4 cases of intrauterine stillborn (2.7%);16 cases of neonatal mortality (10.81%);and 35 cases of premature labor (23.65%) in severe pre-eclampsia group (X~2=10.99,16.73,19.01,P＜0.001).There were differences in the total protein,albumin,white/ball ratio,lactic acid dehydregenase,serum creatinine,24-hour urinary protein between the two groups [total protein:(51.68±6.08) g/L vs (59.34±8.28)g/L,albumin:(24.32±4.06) g/L vs (32.16±5.63) g/L,white/ball ratio:(0.92±0.26) vs (1.16±0.26),lactic acid dehydrogenase:(495.87±312.56) U/L vs (323.81±185.00) U /L,serum creatinine:(131.62±95.34) μmol/L vs (91.52±86.83) μmol/L,24 h urinary protein(4.21±3.51)g/24 h vs (2.38±2.57)g/24h,t=6.17,8.77,5.50,4.79,2.72,3.98,P＜0.05 or ＜0.01].Conclusion Tbe condition of severe pre-eclampsia with ascites is extremely serious,so pregnancy should be timely terminated.The aacites can be dissipated after delivery.Early,systematic and regular prenatal care can prevent severe pre-eclampsia and complications in time.

Introduction to Quick and Surround Needling Method for Nodular Goiter / 针灸推拿医学（英文版）

Clinically guided by the holistic concept of traditional Chinese medicine and in combination with four diagnostic methods and pattern identification, quick and surround puncture is used for treating nodular goiter, fully displaying the practical application value of the special acupuncture therapy.

Use of Socratic method in clinical medical education / 中华医学教育探索杂志

There are many defects in traditional clinical medical education,Socratic method has been used in law and commerce education,and we find it has the feasibility and operation to use the method in clinical medical education.

Relationship between maternal hepatic function and fetal prognosis in intrahepatic cholestasis of pregnancy / 中国基层医药

Objective To investigate the relation between hepatic function of mothers and prognosis of fetuses in intrahepatic cholestasis of pregnancy(ICP).Methods 166 patients with ICP were retrospectively studied.Results The incidences of meconium passage and fetal distress were perfectly high in mothers of high serum transaminase and bilirubin.The birth weight and Apgar scores of neonate were related to the levels of bilirubin and we could predict the fetal prognosis by analysis of mother's serum bilirubin level.The serum total bile acid(TBA) levels and other hepatic indexes were not related to the incidences of meconium passage and fetal distress.Conclusions The fetal prognosis of mothers with high-level serum transaminase and bilirubin is bad,so they must be taken great aware of.The prognosis of fetuses can be bettered by cesarean section at proper time.

HPV Infection and its Correlation with MMP-9 and TIMP-1 Expression in Vulvar Squamous Cell Carcinoma / 中华皮肤科杂志

Objectives To investigate HPV infection and its correlati on with the expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibito r of metalloproteinase-1 (TIMP-1) in vulvar squamous cell carcinoma (VSCC). Meth ods HPV6/11 and 16/18 DNA were detected using in situ hybridization in 26 case s of VSCC, 21 cases of vulvar intraepithelial neoplasia (VIN) and 10 specimens o f normal skin. The expression of MMP-9 and TIMP-1 was measured by immunohistoche mical method in these three groups. Results The infection rates of HPV6/11 and 16/18 in VSCC and VIN were 69.23% (18/26) and 38.46% (10/26), 42.86% (9/21) and 28.57% (6/21) respectively, and no HPV6/11 or 16/18 DNA was discovered in norma l skin epidermis. The expression rates of MMP-9 and TIMP-1 in VSCC, VIN and norm al skin epidermis were 92.31%(24/26) and 76.92% (20/26), 90.45% (19/21) and 80.9 5% (17/21), and 80.00% (8/10) and 50.00% (5/10) respectively. MMP-9 expression in HPV positive lesions was higher than that in HPV negative lesions, but no sig nificant difference of TIMP-1 expression was observed in HPV positive and negati ve lesions. Conclusions HPV infection may play a role in the development of VS CC. The higher expression of MMP-9 comparing with that of TIMP-1 may be an early marker of tumor progression in VSCC, and HPV infection may facilitate the invas ion and metastasis of VSCC.

EXPRESSIONS OF ANGIOPOIETHIN 1 AND 2 IN THE ENDOMETRIUM OF WOMEN WITH ABNORMAL BLEEDING AFTER MEDICAL ABORTION / 解剖学报

Objective To investigate the expression and the roles of Angiopoietin 1(ang-1) and Angiopoietin 2(ang-2) in the endometrium of women with abnormal bleeding after medical abortion. Methods Analyzing endometrial pathological change of 1087 patients with abnormal bleeding after medical abortion in early pregnancy,and the endometrial specimens from 40 patients were randomly chosen for the study. The endometrial specimens from 20 women without abnormal bleeding after medical abortion were used as control group.Immunohistochemistry was used to detect the levels of Ang-1 and Ang-2 proteins in endometria. Results The percentage of patients with both the residul decidua and villus was 80.5%; positive immunoreactive signals of Ang-1 and Ang-2 were found in the endometrial glandular epithelium, stromal cells and the endothelial cells of vessels; the expression rate of Ang-1 and Ang-2 in the patients with abnormal bleeding were higher than that in the control group(P

Changes of portal hemodynamics in the development of experimental liver cirrhosis / 中国病理生理杂志

AIM: To understand the formation of portal hypertension through the change of portal hemodynamics on experiment cirrhosis. METHODS: Carbon tetrachloride was subcutaneously injected in the rat. The changes of the portal hemodynamics in the pathological process of liver tissue were observed. RESULTS: The liver underwent degeneration, necrosis of hepatocytes, and the normal architecture of the liver lobules was replaced by pseudolobule, which consist of regenerative hepatocytes and fibrous septa. The diameter, the blood flow velocity and the blood flow quantity of portal were significantly higher than that in former group (P0 05). CONCLUSION: The changes in hemodynamics of the portal are in accordance with the changes in pathology of liver in the formation of liver cirrhosis.