Clinical characteristics of plastic bronchitis and risk factors for recurrence in children / 中国当代儿科杂志

OBJECTIVES@#To study the clinical characteristics of plastic bronchitis (PB) in children and investigate the the risk factors for recurrence of PB.@*METHODS@#This was a retrospective analysis of medical data of children with PB who were hospitalized in Children's Hospital of Chongqing Medical University from January 2012 to July 2022. The children were divided into a single occurrence of PB group and a recurrent PB group and the risk factors for recurrence of PB were analyzed.@*RESULTS@#A total of 107 children with PB were included, including 61 males (57.0%) and 46 females (43.0%), with a median age of 5.0 years, and 78 cases (72.9%) were over 3 years old. All the children had cough, 96 children (89.7%) had fever, with high fever in 90 children. Seventy-three children (68.2%) had shortness of breath, and 64 children (59.8%) had respiratory failure. Sixty-six children (61.7%) had atelectasis and 52 children (48.6%) had pleural effusion. Forty-seven children (43.9%) had Mycoplasma pneumoniae infection, 28 children (26.2%) had adenovirus infection, and 17 children (15.9%) had influenza virus infection. Seventy-one children (66.4%) had a single occurrence of PB, and 36 cases (33.6%) had recurrent occurrence of PB (≥2 times). Multivariate logistic regression analysis showed that involvement of ≥2 lung lobes (OR=3.376) under bronchoscopy, continued need for invasive ventilation after initial removal of plastic casts (OR=3.275), and concomitant multi-organ dysfunction outside the lungs (OR=2.906) were independent risk factors for recurrent occurrence of PB (P<0.05).@*CONCLUSIONS@#Children with pneumonia accompanied by persistent high fever, shortness of breath, respiratory failure, atelectasis or pleural effusion should be highly suspected with PB. Involvement of ≥2 lung lobes under bronchoscopy, continued need for invasive ventilation after initial removal of plastic casts, and concomitant multi-organ dysfunction outside the lungs may be risk factors for recurrent occurrence of PB.

Clinical and bronchoscopy features of tracheobronchial tuberculosis in children / 中国当代儿科杂志

OBJECTIVES@#To study the clinical and bronchoscopic characteristics of tracheobronchial tuberculosis (TBTB) in children and to identify factors influencing residual airway obstruction or stenosis.@*METHODS@#The clinical data of children with TBTB were retrospectively collected. The children were divided into two groups based on the last bronchoscopic result within one year of follow-up: a group with residual airway obstruction or stenosis (n=34) and a group without residual airway obstruction or stenosis (n=58). A multivariate logistic regression analysis was used to identify the factors influencing residual airway obstruction or stenosis in children with TBTB. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of the factors influencing residual airway obstruction or stenosis in children with TBTB.@*RESULTS@#A total of 92 children with TBTB were included, and the main symptoms were cough (90%) and fever (68%). In children under 1 year old, the incidence rates of dyspnea and wheezing were significantly higher than in other age groups (P<0.008). Chest CT findings included mediastinal or hilar lymph node enlargement (90%) and tracheobronchial stenosis or obstruction (61%). The lymphatic fistula type was the main type of TBTB observed bronchoscopically (77%). All children received interventional treatment, and the effective rate was 84%. During one year of follow-up, 34 children had residual airway obstruction or stenosis. The TBTB diagnostic time and the initiation of interventional treatment were significantly delayed in the group with residual airway obstruction or stenosis compared with the group without residual airway obstruction or stenosis (P<0.05). The multivariate logistic regression analysis showed that the TBTB diagnostic time was closely related to residual airway obstruction or stenosis in children (P<0.05). ROC curve analysis showed that at the cut-off value of 92 days of TBTB diagnostic time, the area under the curve for predicting residual airway obstruction or stenosis in children with TBTB was 0.707, with a sensitivity of 58.8% and a specificity of 75.9%.@*CONCLUSIONS@#The clinical manifestations of TBTB are nonspecific, and symptoms are more severe in children under 1 year old. TBTB should be suspected in children with tuberculosis and chest imaging indicating airway involvement. Delayed diagnosis of TBTB is associated with the development of residual airway obstruction or stenosis.

Effect of anti-vascular endothelial growth factor therapy on intraocular inflammatory cytokine levels in the treatment of proliferative diabetic retinopathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To explore the effects of anti-vascular endothelial growth factor(VEGF)agents(Conbercept)before pars plana vitrectomy(PPV)on inflammatory cytokine levels of patients with proliferative diabetic retinopathy(PDR).METHODS: A total of 49 patients(49 eyes)who diagnosed with PDR at the First Affiliated Hospital with Nanjing Medical University from June 2017 to January 2018 were recruited and randomly divided into two groups. A total of 25 cases(25 eyes)who did not receive intravitreal injection before PPV were included in no-intravitreal injection of Conbercept(IVC)group, and 24 cases(24 eyes)who received IVC 5～7d before PPV were included in IVC group. The vitreous samples were collected from all the patients at the start of PPV. Levels of VEGF-A, monocyte chemotactic protein-1(MCP-1)and inflammatory cytokines in the vitreous humor were measured using Luminex technology.RESULTS: Compared with the no-IVC group, the level of VEGF-A decreased significantly(P&#x003C;0.001), the concentration of IL-6(P=0.004), IL-8(P=0.002), IL-18(P=0.04)and TNF-α(P=0.03)increased remarkably in the IVC group. The other inflammatory cytokines in the vitreous humor showed no significant difference between the IVC and no-IVC groups.CONCLUSION: IVC before PPV can effectively decrease the concentration of VEGF-A, but had limited influence on the level of inflammatory cytokines in the vitreous humor of patients with PDR.

Clinical characteristics and risk factors for bronchoscopic airway mucus hypersecretion in childhood pneumonia infected by different pathogens / 中华儿科杂志

Objective: To investigate the risk factors for airway mucus hypersecretion in childhood pneumonia infected by different pathogens. Method: A retrospective cohort included 968 children who were hospitalized for Mycoplasma pneumoniae pneumonia (MPP), respiratory syncytial virus (RSV) pneumonia, adenovirus pneumonia and underwent bronchoscopy in Respiratory Department of Children's Hospital of Chongqing Medical University from January 2019 to December 2021 was conducted. The children were divided into two groups distinguished by airway mucus secretion according to the airway mucus hypersecretion score which were scored according to the mucus secretion under the bronchoscope. The demographic characteristics, clinical characteristics, laboratory tests and disease severity of the two groups were compared. And the risk factors for the development of airway mucus hypersecretion in two groups were analyzed. Chi square test, Mann-Whithey U test and Fisher exact test were used to analyze the differences between the two groups, and multivariate Logistic regression was used to analyze the influencing factors. Result: There were 559 males and 409 females in the 968 children, with an age of 4.0 (1.4, 6.0) years. Among the 642 children with MPP, 185 cases were in the hypersecretion group and 457 cases were in the non-hypersecretion group. There were 41 cases in the hypersecretion group and 160 cases in the non-hypersecretion group of 201 children with RSV pneumonia. In the 125 children with adenovirus pneumonia, there were 39 cases in the hypersecretion group and 86 cases in the non-hypersecretion group. In these children, the age of children in the hypersecretion group was older than that in the non-hypersecretion group (6.0 (4.0, 7.0) vs. 5.0 (3.0, 7.0) years old, 1.5 (0.5, 3.6) vs. 0.8 (0.4, 1.6) years old, 2.0 (1.2, 4.5) vs. 1.3 (0.8, 2.0) years old, U=35 295.00, 2 492.00, 1 101.00, all P<0.05). Through multivariate Logistic regression analysis it found that increased risk of airway mucus hypersecretion was present in childhood MPP with increase in peripheral blood white blood cell count (OR=3.30, 95%CI 1.51-7.93, P=0.004) or increase in neutrophil ratio (OR=2.24, 95%CI 1.16-4.33, P=0.016) or decrease in lymphocyte count (OR=3.22, 95%CI 1.66-6.31, P<0.001) or decrease in serum albumin (OR=2.00, 95%CI 1.01-3.98, P=0.047). The risk of airway mucus hypersecretion was increased in children with RSV pneumonia combined with elevated peripheral blood eosinophils (OR=3.04, 95%CI 1.02-8.93, P=0.043). Meanwhile, airway mucus hypersecretion was associated with severe pneumonia (OR=2.46, 95%CI 1.03-6.15, P=0.047) in children with RSV pneumonia. Older age was associated with increased risk of airway mucus hypersecretion in children with adenovirus pneumonia (OR=1.02, 95%CI 1.00-1.04, P=0.026). In these children with occurrence of pulmonary rales, wheezes or sputum sounds (OR=3.65, 95%CI 1.22-12.64, P=0.028) had an increased risk of airway mucus hypersecretion. Neutrophils in bronchoalveolar lavage fluid (BALF) demonstrated higher ratio in hypersecretion group from children with MPP (0.65 (0.43, 0.81) vs. 0.59 (0.34, 0.76), U=24 507.00, P<0.01), while the proportion of macrophages in BALF was lower (0.10 (0.05, 0.20) vs. 0.12 (0.06, 0.24), U=33 043.00, P<0.05). Nucleated cell count and neutrophil ratio in BALF were higher in hypersecretion group of children with RSV pneumonia (1 210 (442, 2 100)×106 vs. 490 (210, 1 510)×106/L, 0.43 (0.26, 0.62) vs. 0.30 (0.13, 0.52), U=2 043.00, 2 064.00, all P<0.05). Conclusions: The increase in peripheral blood white blood cell count, neutrophil ratio and decrease in lymphocyte count, serum albumin in children with MPP is related to the development of airway mucus hypersecretion. In children with RSV pneumonia, the abnormal increase of eosinophils in peripheral blood has relationship with hypersecretion. The appearance of lung rale, wheezing, and sputum rale are associated with airway mucus hypersecretion in children with adenovirus pneumonia. In addition, local neutrophil infiltration in the respiratory tract is closely related to the occurrence of airway mucus hypersecretion caused by Mycoplasma pneumoniae and RSV infection.

Efficacy and safety analysis of the zanubrutinib-based bridging regimen in chimeric antigen receptor T-cell therapy for relapsed/refractory diffuse large B-cell lymphoma / 中华血液学杂志

Objective: To further elucidate the clinical efficacy and safety of a combination regimen based on the BTK inhibitor zebutanil bridging CD19 Chimeric antigen receptor T cells (CAR-T cells) in the treatment of relapsed/refractory diffuse large B-cell lymphoma (r/r DLBCL) . Methods: Twenty-one patients with high-risk r/r DLBCL were treated with a zanubrutinib-based regimen bridging CAR-T between June 2020 and June 2023 at the Department of Hematology, Tongji Hospital, Tongji University and the Second Affiliated Hospital of Zhejiang University, and the efficacy and safety were retrospectively analyzed. Results: All 21 patients were enrolled, and the median age was 57 years (range: 38-76). Fourteen patients (66.7%) had an eastern cooperative oncology group performance status score (ECOG score) of ≥2. Eighteen patients (85.7%) had an international prognostic index (IPI) score of ≥3. Three patients (14.3%) had an IPI score of 2 but had extranodal infiltration. Fourteen patients (66.7%) had double-expression of DLBCL and seven (33.3%) had TP53 mutations. With a median follow-up of 24.8 (95% CI 17.0-31.6) months, the objective response rate was 81.0%, and 11 patients (52.4%) achieved complete remission. The median progression-free survival (PFS) was 12.8 months, and the median overall survival (OS) was not reached. The 1-year PFS rate was 52.4% (95% CI 29.8% -74.3%), and the 1-year OS rate was 80.1% (95% CI 58.1% -94.6%). Moreover, 18 patients (85.7%) had grade 1-2 cytokine-release syndrome, and two patients (9.5%) had grade 1 immune effector cell-associated neurotoxicity syndrome. Conclusion: Zanubrutinib-based combination bridging regimen of CAR-T therapy for r/r DLBCL has high efficacy and demonstrated a good safety profile.

Screening Novel Drugresistant Mutations in Mycobacterium tuberculosis Strains by Using the Amplicon Sequencing Method / 中国生物化学与分子生物学报

Tuberculosis is one of the seriously public problems. The increasing drug-resistant tuberculosis is the key problem for controlling tuberculosis. Rapid and accurate diagnosis is important for further treatment. In this study‚ a next-generation sequencing method based on amplicon sequencing was constructed to screen the mutations in 17 drug-resistant genes of five first-line anti-tuberculosis drugs. A total of 65 mutations were identified in 26 clinic drug-resistant tuberculosis strains‚ including 33 hotspot mutations‚ 9 rare mutations‚ and 23 novel mutations. The pathogenesis‚ conservation‚ and partial structures caused by 18 novel missense mutations were predicted. The results showed that 14 novel mutations showed high conservation in nine species. All these 14 mutations could change the partial structure of protein. According to the detection and analysis results of this study‚ it is speculated that these newly discovered mutations may be potential drug-resistant mutations. It is a rapid‚ accurate and comprehensive method for the detection of drug-resistant mutations in first-line drug-resistant Mycobacterium tuberculosis‚ which could identify hotspot and rare mutations together with novel mutations. The detection method may be used for clinical diagnosis and basic research.

Epidemiological characteristics of respiratory syncytial virus in hospitalized children with acute lower respiratory tract infection in Chongqing, China, from 2013 to 2018: an analysis of 2 066 cases / 中国当代儿科杂志

OBJECTIVE@#To study the detection rate, epidemic pattern, and clinical features of respiratory syncytial virus (RSV) in hospitalized children with acute lower respiratory infection (ALRI).@*METHODS@#Nasopharyngeal aspirates were collected from children with ALRI, aged < 2 years, who were hospitalized in Children's Hospital of Chongqing Medical University from June 2013 to May 2018. Multiplex PCR was used to detect 16 common respiratory viruses. The epidemiological characteristics of RSV were analyzed.@*RESULTS@#A total of 2 066 hospitalized children with ALRI were enrolled. Among the children, 1 595 (77.20%) tested positive for virus and 826 (39.98%) tested positive for RSV [410(49.6%) positive for RSV-A, 414 (50.1%) positive for RSV-B, and 2 (0.2%) positive for both RSV-A and RSV-B]. RSV-B was the main subtype detected in 2013-2014 and 2016-2017, while RSV-A was the main subtype in 2014-2015 and 2017-2018, and these two subtypes were prevalent in 2015-2016. The highest detection rate of RSV was noted in winter. RSV + human rhinovirus was the most common combination of viruses and was detected in 123 children. These children were more likely to develop wheezing than those with single RSV detected (@*CONCLUSIONS@#In Chongqing in 2013-2018, RSV-A and RSV-B not only can predominate alternately, but also can co-circulate during a season. RSV is the major viral pathogen of hospitalized children with ALRI and can cause severe lower respiratory tract infection. There are no differences in clinical manifestations between children with RSV-A infection and those with RSV-B infection, but boys are more susceptible to RSV-A infection.

Clinical features and follow-up results of boys and girls with systemic lupus erythematosus: a comparative analysis / 中国当代儿科杂志

OBJECTIVE@#To compare the clinical features and follow-up results of systemic lupus erythematosus (SLE) between boys and girls.@*METHODS@#A retrospective analysis was performed for the clinical data of 79 children (18 boys and 61 girls), aged ≤14 years, who were diagnosed with SLE from 2008 to 2018. The boys and the girls were compared in terms of initial and major clinical symptoms, injury of organs/systems, related laboratory markers, and follow-up results.@*RESULTS@#As for the initial and non-initial symptoms, fever had the highest incidence rate in the boys, while facial erythema had the highest incidence rate in the girls. The boys tended to develop renal injury and hematological damage (P80%) of anti-nuclear antibody, dsDNA, complement C3, and erythrocyte sedimentation rate in both boys and girls (P>0.05). The boys had a significantly higher disease activity than the girls at the first visit and in year 9 of follow-up (P<0.05). A one-month to ten-year follow-up showed that among the boys, 3 were lost to follow-up, 1 died, 7 were well controlled but required oral administration of large doses of hormones or immunosuppression, 2 progressed to chronic renal failure, and 1 developed lupus encephalopathy. Among the girls, 3 were lost to follow-up; 5 died; 34 were well controlled, among whom 5 were maintained on oral prednisone acetate with a dose of <10 mg, 1 was withdrawn from the drug for 1 year, and 2 were withdrawn from the drug for 2 years; 4 developed lupus encephalopathy; 1 developed depression and anxiety and had suicidal tendency in the 7th year after disease onset; 2 experienced impaired vision, blurred vision, and chloropsia; 1 developed a vascular necrosis of both femoral heads in the 3rd year of hormone administration.@*CONCLUSIONS@#There are differences in clinical features, several laboratory markers, and prognosis between boys and girls with SLE. Boys tend to have a high severity at disease onset, develop renal injury and hematological damage, and have poor long-term prognosis, while girls tend to have joint involvement.

Effect of genipin on cardiomyocyte apoptosis and autophagy in rat after hypoxia / reoxygenation injury / 解剖学报

Objective To investigate the effect of genipin on cardiomyocyte apoptosis and autophagy in rat after hypoxia/ reoxygenation (H/ R) injury. Methods The method with hypoxia treatment of H9c2 cells for 12 hours and then reoxygenation treatment for 4 hours was used in the present study in order to establish H/ R model. The H9c2 cells were divided into control group (Con), genipin group (GE), model group (H/ R), model + genipin group (H/ R+ GE). Cell viability was detected by cell counting kit-8(CCK-8). Cell apoptosis was determined by flow cytometry. Transmission electron microscopy was used to observe autophagosomes. The expression of Bax, Bcl-2, P62, Beclin1, LC3-Ⅱ, protein kinase B(Akt), p-Akt, mammalian target of rapamycin(mTOR), p-mTOR proteins were assessed by Western blotting. Results Genipin pretreatment enhanced the cell viability, prevented cell apoptosis and autophagosome accumulation, and reduced the ratio of the cross-sectional areas of the autophagic structures to that of the cytoplasm after H/ R injury in H9c2 cells. Western blotting showed that genipin pretreatment decreased the expression of Bax, LC3-Ⅱ, Beclin1 proteins and increased the expression of Bcl-2, p62, p-Akt, p-mTOR proteins after H/ R injury. Conclusion Genipin can inhibit H/ R injury-induced apoptosis and autophagy, which may be through activating Akt/ mTOR signaling pathway.

Current status of antibiotic therapy for Staphylococcus aureus sepsis in children / 中国当代儿科杂志

OBJECTIVE@#To investigate the current status of empirical antibiotic therapy for children with Staphylococcus aureus sepsis and the effect of therapeutic paradigm on prognosis based on a retrospective analysis.@*METHODS@#A total of 78 children with Staphylococcus aureus sepsis who were admitted from January 2014 to August 2017 were enrolled. According to the preferred empirical antibiotics before the detection of Staphylococcus aureus by blood culture, these children were divided into a carbapenem group with 16 children, a β-lactam group with 37 children, a vancomycin group with 15 children and a vancomycin+β-lactam group with 10 children. A retrospective analysis was performed for related clinical data including general status, underlying diseases, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, history of use of immunosuppressant, drug resistance to methicillin and prognosis. A logistic regression analysis was used to investigate the effect of empirical antibiotic therapy on the clinical outcome and prognosis of children with Staphylococcus aureus sepsis.@*RESULTS@#There were no significant differences among these groups in general status, underlying diseases, history of use of immunosuppressant, APACHE II score, nosocomial infection and detection rate of methicillin-resistant Staphylococcus aureus (P>0.05). There were significant differences in the incidence rate of septic shock and in-hospital mortality among these four groups (P<0.05). The carbapenem group had the highest incidence rate of septic shock and in-hospital mortality (69% and 50% respectively). The multivariate logistic regression analysis showed that empirical antibiotic therapy with different antibiotics had different risks for septic shock and in-hospital death in children with Staphylococcus aureus sepsis (P<0.05), and that an APACHE II score of ≥15 was an independent risk factor for septic shock in these children (P<0.05). The carbapenem group had significantly higher risks of septic shock and in-hospital death than the vancomycin group (P<0.05).@*CONCLUSIONS@#Inappropriate empirical use of antibiotics may lead to a poor prognosis in children with Staphylococcus aureus sepsis. Empirical use of carbapenems is not recommended for children suspected of Staphylococcus aureus sepsis.

Polymorphisms of Ionotropic Glutamate Receptor-Related Genes and the Risk of Autism Spectrum Disorder in a Chinese Population

OBJECTIVE: To evaluate the association of GRIK2 and NLGN1 with autism spectrum disorder in a Chinese population. METHODS: We performed spatio-temporal expression analysis of GRIK2 and NLGN1 in the developing prefrontal cortex, and examined the expression of the genes in ASD cases and healthy controls using the GSE38322 data set. Following, we performed a case-control study in a Chinese population. RESULTS: The analysis using the publicly available expression data showed that GRIK2 and NLGN1 may have a role in the development of human brain and contribute to the risk of ASD. Later genetic analysis in the Chinese population showed that the GRIK2 rs6922753 for the T allele, TC genotype and dominant model played a significant protective role in ASD susceptibility (respectively: OR=0.840, p=0.023; OR=0.802, p=0.038; OR=0.791, p=0.020). The NLGN1 rs9855544 for the G allele and GG genotype played a significant protective role in ASD susceptibility (respectively: OR=0.844, p=0.019; OR=0.717, p=0.022). After adjusting p values, the statistical significance was lost (p>0.05). CONCLUSION: Our results suggested that GRIK2 rs6922753 and NLGN1 rs9855544 might not confer susceptibility to ASD in the Chinese population.

MRTF-A alleviates myocardial ischemia reperfusion injury via inhibiting TLR4/TRIF signaling pathways / 中华急诊医学杂志

Objective To observe the effect of myocardial transcription factor MRTF-A on myocardium inflammation and its mechanism.Methods Totally 30 rats were randomly divided into the sham,ischemia-reperfusion (myocardial ischemia 30 min and reperfusion 2 h),and MRTF-A groups(myocardial ischemia 30 min and reperfusion 2 h & Lentivirus infection MRTF-A) (n=10 each group).Serum myocardial enzyme activity was detected by biochemical analysis,myocardial infarct size detected by TTC,and degree of myocardial injury was measured by HE staining.The TLR4 and TRIF expression was analyzed by immunohistochemistry and qPCR.Results Compared with the sham group,the MRTF-A group significantly increased the activity of serum myocardial enzymes CK-MB and LDH (P＜0.05).The infarct area of myocardial tissue was gray-white,and the infarct area was (54.31±3.07)％ (P ＜ 0.05).Myocardial fibrosis was disorder,myocardial cell was swollen and burst,and inflammatory cell infiltration was obvious.Protein and mRNA expressions of TRL4 and TRIF were significantly up-regulated (P＜0.05).Compared with the ischemia-reperfusion group,the levels of CK-MB and LDH were significantly reduced after myocardial infection with MRTF-A (P＜0.05).The myocardial infarction area was significantly reduced to (16.74±4.26)％ (P＜ 0.05).The myocardial structure was nearly normal with mild edema.Protein and mRNA expression of TRL4 and TRIF decreased significantly (P＜0.05).Conclusions The overexpression of transcription factor MRTF-A in myocardial cells alleviates the myocardial ischemia reperfusion injury by inhibiting the TLR4/TRIF signaling pathway and reducing the serum myocardial enzyme activity and myocardial damage.

Therapeutic progress of respiratory viral infections in children / 中国实用儿科杂志

Respiratory infections,especially respiratory viral infections,are common diseases in children. Although most respiratory viral infection diseases are self-limiting,some children may be hospitalized or even life-threatened due to severe viral lower respiratory tract infection. With the progress of virology research,new and effective antiviral drugs have been developed. Thus,the study focuses on the therapeutic progress of respiratory viral infections so as to improve the treatment for common respiratory viral infections in children.

Expression of AQP2, AQP4 and AQP 8 in mouse intestine induced by unprocessed and processed Euphorbia lathyris

The present research was designed to study expression of AQP2, AQP4 and AQP8 in mouse intestines induced by unprocessed and processed Euphorbia lathyris. KM mice were given by different dose lavage of unprocessed and processed Euphorbia lathyris, Euphorbia factor L1, Euphorbia factor L2, Euphorbia factor L3. Samples of mouse intestine were collected for protein levels of AQP2, AQP 4 and AQP 8 which were assessed by immunohistochemical staining and mRNA expression of AQP2, AQP 4 and AQP 8 which were quantified by Real Time-PCR. Comparing to the normal control group, the protein levels of AQP2, AQP 4 and AQP 8 were significantly decreased [P<0.05]by Semen Euphorbiae group and Semen Euphorbiae Pulveratum group [unprocessed and processed Euphorbia lathyris] induced. Protein expression of AQP2, AQP 4 and AQP 8 in the Euphorbia factor L1, Euphorbia factor L2 and Euphorbia factor L3 group were not significantly lower than normal control group. There had no differences on the levels of AQP2 and AQP 8 mRNA expressions between the high-dose group of semen Euphorbiae group, semen Euphorbiae Pulveratum group and positive control group, while significantly lower than normal control group [P<0.05]. Expression of AQP4 mRNA in the Semen Euphorbiae group and Semen Euphorbiae Pulveratum group has not significantly decreased. But levels of AQP2, AQP 4 and AQP 8 mRNA in the Euphorbia factor L1 group had no significant differences in normal control group and positive control group. These findings suggest that semen Euphorbiae could regulate expression of AQP2, AQP 4 and AQP 8 protein and mRNA, which may be the possible one reason of semen Euphorbiae induces diarrhea. The semen Euphorbiae group has more significant effects on the levels of AQP2, AQP 4 and AQP 8 protein and mRNA than semen Euphorbiae Pulveratum group, which may be one of the mechanisms of processing attenuation

Development of Orthographic Awareness, Morphological Awareness and Rapid Automatized Naming of Elementary-level Students in China:A Longitudinal Analysis from Grades 1 to 4 / 华中科技大学学报（医学）（英德文版）

The longitudinal study sought to examine the dynamic development of cognitive skills for reading among elementary-level students in Mainland China.Two groups of students in first (n=164,mean age=6.65 years at first test) and second grade (n=202,mean age=7.73 years at first test) were followed on orthographic awareness,morphological awareness and rapid automatized naming (RAN) for two years.The children exhibited significant improvement in orthographic awareness,morphological awareness and RAN from grades 1 to 4.More importantly,to the orthographic and morphological awareness,while the children took a leap from grade 1 to 2 and grade 3 to 4,the progress developed at relatively slow rates from grade 2 to 3.In order to assure children's development of orthographic and morphological awareness,evidence-based orthographically and morphologically enhanced instruction is needed for Chinese children in the early elementary years,especially for those at the stage from grade 2 to 3.

Development of Orthographic Awareness, Morphological Awareness and Rapid Automatized Naming of Elementary-level Students in China:A Longitudinal Analysis from Grades 1 to 4 / 华中科技大学学报（医学）（英德文版）

The longitudinal study sought to examine the dynamic development of cognitive skills for reading among elementary-level students in Mainland China.Two groups of students in first (n=164,mean age=6.65 years at first test) and second grade (n=202,mean age=7.73 years at first test) were followed on orthographic awareness,morphological awareness and rapid automatized naming (RAN) for two years.The children exhibited significant improvement in orthographic awareness,morphological awareness and RAN from grades 1 to 4.More importantly,to the orthographic and morphological awareness,while the children took a leap from grade 1 to 2 and grade 3 to 4,the progress developed at relatively slow rates from grade 2 to 3.In order to assure children's development of orthographic and morphological awareness,evidence-based orthographically and morphologically enhanced instruction is needed for Chinese children in the early elementary years,especially for those at the stage from grade 2 to 3.

Chronic disease management in European countries — based on the case of Germany and the Netherlands / 中华医学教育探索杂志

In response to the increasing burden of chronic diseases, many countries have launched the reform of the health system. Based on the Diagnoses Treatment Combination (DTC) and Healthy Kinzig-tal Gesundes Kinzigtal (GK), this paper elaborates on the experience of chronic diseases management during different populations in Germany and the Netherlands. Based on the scientific decision-making and system integration, the DTC builds a multidisciplinary team to achieve individualized and continuous integrated disease management. The GK model focuses on health promotion, extensively integrated social resources, to achieve the goal of reducing the incidence of chronic diseases and controlling the cost. This provides a useful reference for the building of Healthy China: integrating resources from the supply side and the demand side, strengthening the integration of the health service system, promoting citizen engagement and improving individual health literacy, so as to achieve universal health.

A study of non-reduced SDS-PAGE purity method of conbercept / 药学学报

A non-reduced SDS-PAGE purity method for quantitation of conbercept fragments was established based on gel screening, comparison of gel imaging system, linearity range of main band, screening of destaining conditions. The results indicated that the bands could be separated effectively with good clearness and flatness on 4%-15% gradient concentration gel, the peaks of all bands could be separated from baseline using high-distinguishability gel imaging system, the signal intensity of a main band had shown a good linearity with ≤ 3 μg of loading amount, and that the destaining was set as a total of ≤ 3 h with exchanging 100 mL destaining buffer every 60 min. The established non-reduced SDS-PAGE method could demonstrate the purity of conbercept more objectively. After validation, the established non-reduced SDS-PAGE method was submitted to FDA in the form of supplementary materials, which laid a quality basis for the direct entry of conbercept to the clinical Ⅲ study in the United States.

Effects of 20 Hz sinusoidal or 20 Hz square wave stroboscopic illumination on the eyeball growth in guinea pigs / 中国实验动物学报

Objective To investigate the effect of prolonged stroboscopic illumination exposure on the growth of eyeball of guinea pig. Methods Thirty 2-week-old guinea pigs were randomized into three groups ( n=10 for each) . Two strobe-reared groups were raised with 20 Hz sinusoidal and 20 Hz square wave stroboscopic illumination, respectively. The control group received usual light illumination. The illumination intensity was 500 lux. All animals underwent refraction and biometric measurements prior to and after 2, 4, 6 and 8 weeks of treatment. Finally, flash electroretinograms were com-pared, and retinal microstructures were examined. Results There was a significant correlation between refractive errors and axial eye elongation, and myopia increasing was observed with eye elongation. After 8 weeks of treatment, the animals raised in 20 Hz sinusoidal and 20 Hz square wave stroboscopic illumination were (-0. 75 ± 0. 79)D and (-1. 50 ± 0. 91) D more myopic than the group raised in continuous illumination. The implicit time of the a-wave was delayed by 3. 8 and 7. 9 ms, respectively. No significant difference was found in retinal ultrastructures among the three groups. Conclusions Chronic exposure to 20 Hz sinusoidal or square wave stroboscopic illumination alters the emmetropization of the guinea pig eye to some extent.

Effects of 20 Hz sinusoidal or 20 Hz square wave stroboscopic illumination on the eyeball growth in guinea pigs / 中国实验动物学报

Objective To investigate the effect of prolonged stroboscopic illumination exposure on the growth of eyeball of guinea pig. Methods Thirty 2-week-old guinea pigs were randomized into three groups ( n=10 for each) . Two strobe-reared groups were raised with 20 Hz sinusoidal and 20 Hz square wave stroboscopic illumination, respectively. The control group received usual light illumination. The illumination intensity was 500 lux. All animals underwent refraction and biometric measurements prior to and after 2, 4, 6 and 8 weeks of treatment. Finally, flash electroretinograms were com-pared, and retinal microstructures were examined. Results There was a significant correlation between refractive errors and axial eye elongation, and myopia increasing was observed with eye elongation. After 8 weeks of treatment, the animals raised in 20 Hz sinusoidal and 20 Hz square wave stroboscopic illumination were (-0. 75 ± 0. 79)D and (-1. 50 ± 0. 91) D more myopic than the group raised in continuous illumination. The implicit time of the a-wave was delayed by 3. 8 and 7. 9 ms, respectively. No significant difference was found in retinal ultrastructures among the three groups. Conclusions Chronic exposure to 20 Hz sinusoidal or square wave stroboscopic illumination alters the emmetropization of the guinea pig eye to some extent.