Application value of tidal lung function combined with fractional exhaled nitric oxide in children with respiratory syncytial virus pneumonia / 中国医师进修杂志

Objective:To explore the application value of tidal lung function combined with fractional exhaled nitric oxide (FeNO) in children with respiratory syncytial virus (RSV) pneumonia.Methods:The clinical data of 65 children with RSV pneumonia in Shanghai Pudong New Area Gongli Hospital from April 2019 to October 2020 were retrospectively collected. According to the pneumonia severity index (PSI), they were divided into severe group (PSI score>130 points, 19 cases), mild to moderate group (PSI score ≤130 points, 46 cases), and 72 healthy children in the same period were selected as the normal control group. The levels of interleukin (IL)-8, IL-6, tumor necrosis factor-α(TNF-α), high-sensitivity C-reactive protein (hs-CRP) and tidal lung function parameters and FeNO were compared among the three groups and analyzed their correlation and evaluated the value in disease severity.Results:The level of FeNO in the severe group was higher than that in the mild to moderate group and the normal control group: (23.04 ± 5.49) ppb vs. (15.75 ± 8.24), (9.28 ± 3.51) ppb; the levels of tidal volume per kilogram of body mass (VT/kg), peak time ratio (TPEF/TE), peak volume ratio (VPEF/VE) in the severe group were lower than those in the mild to moderate group and the normal control group: (6.21 ± 1.89) ml/kg vs. (8.40 ± 1.27), ( 9.39 ± 3.04) ml/kg; (16.39 ± 6.61)% vs. (21.72 ± 5.39)%, (38.65 ± 7.20)%; (22.81 ± 6.39)% vs. (25.62 ± 5.30)%, (39.67 ± 4.04)% , there were statistical differences ( P<0.05). The correlation analysis results showed that the VT/kg, TPEF/TE, VPEF/VE were negatively correlated with IL-6 ( r = - 0.584, - 0.519, - 0.528; P<0.01), IL-8 ( r = - 0.521, - 0.542, - 0.567; P<0.01), TNF-α ( r = - 0.559, - 0.534, - 0.572; P<0.01) and hs-CRP ( r = - 0.528, - 0.567, - 0.533; P<0.01); the level of FeNO was positively correlated with IL-6, IL-8, TNF-α, hs-CRP ( r = 0.672, 0.639, 0.641, 0.672; P<0.01); the levels of VT/kg, TPEF/TE, VPEF/VE were negatively correlated with PSI scores in children with RSV pneumonia ( r = - 0.842, - 0.713, - 0.741; P<0.05); the level of FeNO was positively correlated with PSI scores in children with RSV pneumonia ( r = 0.809, P<0.05). The area under the curve of VT/kg, TPEF/TE, VPEF/VE combined with FeNO to assess the severity of RSV pneumonia in children with RSV pneumonia was 0.888, and the sensitivity and specificity were 73.68% and 91.30%, respectively. Conclusions:Tidal lung function parameters and FeNO are closely related to the severity of RSV pneumonia. The combined detection can be used as an objective basis for assessing the severity of RSV pneumonia.

Cancer screening and its association with core knowledge of cancer in community residents / 公共卫生与预防医学

Objective To understand the situation of cancer screening of community residents and its association with the knowledge of cancer core knowledge, and to provide reference for the formulation of secondary cancer prevention measures. Methods A cross-sectional survey was conducted among 2 037 residents aged 18-79 who lived in Bao 'an District, Shenzhen. Multivariate Logistic regression analysis was used to investigate the relationship between core knowledge and cancer screening behavior after adjusting for age, gender, education, marriage, occupation and smoking. Results The cancer screening rate of community residents was 28.10%, and the screening rate of middle-aged and elderly people aged 40-79 was 33.50 %.The proportion of “not very well understanding”, “partial understanding” and “basic understanding” of the core knowledge of cancer were 43.91%, 42.33% and 13.76%, respectively, which was higher than that of the non-participants. Multivariate analysis showed that the women, the higher the level of education of college/university or above and the higher the level of knowledge of cancer prevention core knowledge, the higher the probability of participating in cancer screening was OR (95%CI ) : 2.40 (1.86-3.12), 1.65 (1.29-2.10), 1.38 (1.18 - 1.62), respectively. Conclusion The proportion of cancer screening in community residents needs to be improved, and the degree of core knowledge of cancer is closely related to cancer screening behavior. It is suggested to increase the publicity and education of the core knowledge of cancer, and at the same time, carry out the health education of secondary cancer prevention for the key population such as men and people with low education level, so as to improve the proportion of “early detection, early diagnosis and early treatment” of cancer.

The willingness for dietary and behavioral changes in frontline epidemic prevention workers after experiencing the outbreak of COVID-19 in China: a cross-sectional study

BACKGROUND@#The 2019 novel coronavirus disease (COVID-19) has had a massive impact on public health, resulting in sudden dietary and behavioral habit changes. Frontline epidemic prevention workers play a pivotal role against COVID-19. They must face high-risk infection conditions, insufficient anti-epidemic material supplies, mental pressure, and so on. COVID-19 seriously affects their dietary and behavioral habits, and poor habits make them more susceptible to COVID-19. However, their baseline dietary and behavioral habits before COVID-19 and their willingness to change these habits after the outbreak of COVID-19 remain unclear for these workers in China. This study aimed to explore the baseline dietary and behavioral habits of frontline workers and their willingness to change these habits after the outbreak of the epidemic; in addition, susceptible subgroups were identified by stratified analyses as targets of protective measures to keep them from being infected with COVID-19.@*METHODS@#A cross-sectional study was conducted through an online questionnaire using a sample of 22,459 valid individuals living in China, including 9402 frontline epidemic prevention workers.@*RESULTS@#Before COVID-19, 23.9% of the frontline epidemic prevention workers reported a high-salt diet, 46.9% of them reported a high frequency of fried foods intake, and 50.9% of them smoked cigarettes. After the outbreak of COVID-19, 34.6% of them expressed a willingness to reduce salt intake, and 43.7% of them wanted to reduce the frequency of pickled vegetables intake. A total of 37.9% of them expressed a willingness to decrease or quit smoking, and 44.5% of them wanted to increase sleep duration. Significant differences in the baseline dietary and behavioral habits and the willingness to change their habits were observed between frontline epidemic prevention workers and other participants. Among the frontline epidemic prevention workers with poor dietary and behavioral habits before COVID-19, frontline epidemic prevention experience was a promoting factor for adopting worse dietary and behavioral habits, including those in the high-salt intake subgroup (OR, 2.824; 95% CI, 2.341-3.405) and the 11-20 cigarettes/day subgroup (OR, 2.067; 95% CI, 1.359-3.143).@*CONCLUSIONS@#The dietary and behavioral habits of frontline epidemic prevention workers were worse than that those of other participants before COVID-19. They had a greater willingness to adopt healthy dietary and behavioral habits after experiencing the outbreak of COVID-19. However, frontline epidemic prevention workers with poor dietary and behavioral habits before COVID-19 continued in engage in these poor habits. Dietary and behavioral intervention policies should be drafted to protect their health, especially frontline epidemic prevention workers with poor habits at baseline.

Clinical features of chronic cough with airway hyper-responsiveness in children / 中华实用儿科临床杂志

Objective To study the clinical features and spirometry of children with chronic cough and positive findings by bronchial provocation test.Methods Four hundred and fifty children with chronic cough from 3 hospitals of Shanghai Children's Medical Center Affiliated to Shanghai Jiao Tong Medical University School of Medicine,Gong Li Hospital of Pudong New Area,Pudong Hospital,were enrolled in this study from December 2012 to December 2014,and among them,373 cases completed the questionnaires,spirometry and bronchial provocation test.The differences in clinical features and spirometry between the bronchial provocation test positive group and negative group were compared.And the further evaluation of their clinical value was performed.Results Two hundred and thirty-six cases of children with bronchial provocation tests positive showed much higher rate of dry [72.03％ (170/236 cases)] and night cough[58.90％ (139/236 cases)] than those in the negative group[27.00％ (37/137 cases),22.63％ (31/137cases)],and the differences were significant (x2 =71.154,45.973,all P ＜0.01).Children in positive group also had higher morbidity of eczema[52.12％ (123/236 cases)],allergic conjunctivitis [24.15％ (57/236 cases)] and inhaled allergy history[40.25％ (95/236 cases)] than those in negative group[32.85％ (45/137 cases),10.95％ (15/137cases),18.98％ (26/137 cases)],and there existed significant differences (x2 =13.006,9.701,17.904,all P ＜0.01).And they also had higher asthma heredity [18.22％ (43/236 cases)] than that in negative group [9.49％(13/137 cases)],and the difference was significant (x2 =5.179,P =0.023);with worse small airway function [50.85％ (120/137 cases) vs 36.50％ (50/137 cases)] (x2 =7.197,P =0.007).For further study,the sensitivity and specificity for dry cough were both high(72.03％ and 72.99％).For specificity,family history was the most highest one (90.51％),and night cough and allergic conjunctivitis were also high.Conclusions Pulmonary function tests to reflect small airway function abnormalities,combined with a family history of asthma and chronic cough in children related to eczema,allergic conjunctivitis,and inhalation allergy history clinical features,can better predict airway hyperresponsiveness.

Positive bronchial provocation test and lower small airway function in the cough variant asthma / 临床儿科杂志

ObjectiveTo investigate bronchial provocation test (BPT) and small airway function in children with cough variant asthma (CVA).MethodsA total of 353 children with chronic cough whose mean age was (7.45±2.58) years from three hospitals of Pudong district were enrolled during May 2012 and February 2014. Conventional pulmonary function tests, BPT and questionnaire survey were performed and the difference in pulmonary function was analyzed between children with positive BPT and negative BPT.ResultsIn 353 children with chronic cough, there were 200 children (56.66%) diagnosed as CVA with posi-tive BPT. Compared with BPT negative group, the percentages of nighttime cough and severe dry cough in BPT positive group were signiifcantly higher while the percentages of morning/daytime cough and wet cough were signiifcantly lower (P<0.01). Fur-thermore, the rates of history of atopic dermatitis and rhinitis in BPT positive group were signiifcantly higher than those in BPT negative group (P<0.01). Forced expiratory lfow at 75% relfecting the small airway function was signiifcantly lower in BPT posi-tive group than that in BPT negative group (P=0.032).ConclusionsBronchial hyperresponsiveness and decreased small airway function are the important pathological features of CVA. BPT and spirometry have clinical signiifcances in the CVA diagnosis and the analysis of cause of chronic cough.

Genome-wide association study knowledge-driven pathway analysis of alcohol dependence implicates the calcium signaling pathway / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Alcohol dependence (AD) is a serious and common public health problem. The identification of genes that contribute to the AD variation will improve our understanding of the genetic mechanism underlying this complex disease. Previous genome-wide association studies (GWAS) and candidate gene genetic association studies identified individual genes as candidates for alcohol phenotypes, but efforts to generate an integrated view of accumulative genetic variants and pathways under alcohol drinking are lacking.</p><p><b>METHODS</b>We applied enrichment gene set analysis to existing genetic association results to identify pertinent pathways to AD in this study. A total of 1 438 SNPs (P < 1.0 × 10(-3)) associated to alcohol drinking related traits have been collected from 31 studies (10 candidate gene association studies, 19 GWAS of SNPs, and 2 GWAS of copy number variants).</p><p><b>RESULTS</b>Among all of the KEGG pathways, the calcium signaling pathway (hsa04020) showed the most significant enrichment of associations (21 genes) to alcohol consumption phenotypes (P = 5.4 × 10(-5)). Furthermore, the calcium signaling pathway is the only pathway that turned out to be significant after multiple test adjustments, achieving Bonferroni P value of 0.8 × 10(-3) and FDR value of 0.6 × 10(-2), respectively. Interestingly, the calcium signaling pathway was previously found to be essential to regulate brain function, and genes in this pathway link to a depressive effect of alcohol consumption on the body.</p><p><b>CONCLUSIONS</b>Our findings, together with previous biological evidence, suggest the importance of gene polymorphisms of calcium signaling pathway to AD susceptibility. Still, further investigations are warranted to uncover the role of this pathway in AD and related traits.</p>

Clinical significance of angiotension II in children with IgA nephropathy / 临床儿科杂志

objective To investigate the clinical signiifcance of the changes of angiotensionⅡ(AngⅡ) in children with IgA nephropathy (IgAN). Methods Thirty children diagnosed as primary IgA nephropathy by renal biopsy (IgAN group) and 30 healthy children (control group) were recruited from May 2008 to December 2012. The serum and urine AngⅡwere measured by ELISA and compared between IgAN group and control group. The AngⅡexpression in the renal tissue of IgAN group was detected by immuno-histochemical method, and was correlated with other clinical data.. Results Urine AngⅡwas signiifcantly higher in the primary IgAN group than that of control group (P<0.05);AngⅡexpression in the urine is positively correlated with proteinuria (r=0.37, P=0.046), and is associated with the severity of clinical presentation; AngⅡexpression in kidney tissue increased with the severity of the renal histopathologic grading (r=0.69, 0.79, P=0.000), while AngⅡin blood and proteinuria, AngⅡexpression in kidney tissue were not signiifcantly correlated with the number of crescents. Conclusions Urine AngⅡin children with IgAN is signiifcantly correlated with the severity of the pathologic stage and the level of proteinuria. Urine AngⅡdetection may be useful to assess the progress and prognosis of chronic kidney disease.

Study on Marzulene combined with Omeprazole for treating peptic ulcer disease and the safety of Marzulene in children / 中华实用儿科临床杂志

Objective To assess the effect of Marzulene as an adjuvant therapy for peptic ulcer disease in children and the safety of Marzulene.Methods From Dec.2011 to Feb.2013,138 cases of peptic ulcer disease in children from Chongqing,Guiyang,Guangzhou,Chengdu and Xinjiang were randomly divided into trial group (n =75) and control group (n =63).The treatment protocls of the trial group was Marzulene combined with Omeprazole,and the control group gave Omeprazole only,all the cases with Helicobacter pylori (Hp) infection were treated by antibiotics,then clinical manifestations,gastroscopy and laboratory examinations were followed up after 8 weeks.Results The remission rates of clinical manifestations in the trial group were abdominal pain 91.8％ (56/61 cases),vomiting 90.2％(37/41 cases),melena 92.9％ (26/28 cases),nausea 93.1％ (27/29 cases),hematemesis 89.5％ (17/19 cases),abdominal discomfort 100.0％ (19/19 cases),abdominal distension 100.0％ (11/11 cases),sour regurgitation 100.0％ (9/9 cases),ozostomia 90.0％ (9/10 cases),eructaion 88.9 ％ (8/9 cases),bloody stools 100.0％ (4/4 cases),poor appetite 50.0％ (1/2 case),and abdominal tenderness 89.3 ％ (50/56 cases) ;the remission rates of clinical manifestations in the control group were abdominal pain 90.4％ (47/52 cases),vomiting 89.7％ (26/29 cases),melena 96.4％(27/28 cases),nausea 87.5 ％ (21/24 cases),hematemesis 92.9 ％ (13/14 cases),abdominal discomfort 58.3 ％ (7/12 cases),abdominal distension 85.7％ (12/14 cases),sour regurgitation 100.0％ (13/13 cases),ozostomia 80.0％(8/10 cases),eructaion 100.0％ (8/8 cases),bloody stools 100.0％ (4/4 cases),poor appetite 33.3％ (1/3 case),and abdominal tenderness 90.0％ (45/50 cases).Abdominal discomfort,abdominal distension,ozostomia,eructaion and poor appetite had significant statistical disparity between control group and trial group (P ＜ 0.05).One hundred and thirty-one cases reviewed gastroscopy,in the control group their ulcer clearance rate was 65.1％ (41/63 cases) ;the remission rates of gastroscopic manifestations were edema 54.8％ (34/62 cases),hyperemia 51.7％ (31/60 cases),areola 76.0％ (19/25 cases),atrophy 0％ (0/1 case),and hemorrhage 85.7％ (12/14 cases),the Hp clearance rate in the control group was 67.9％ (19/28 cases).In the trial group the ulcer clearance rate was 66.2％ (45/68 cases),and the remission rates of gastroscopic manifestation were edema 63.0％ (46/73 cases),hyperemia 64.7 ％ (44/68 cases),areola 86.1％ (31/36 cases),atrophy 50.0％ (1/2 case),and hemorrhage 100.0％ (19/19 cases) ;the Hp clearance rate in the trial group was 72.7％ (24/33 cases),and the remission rates of atrophy and hemorrhage had significant disparity between the control group and the trial group.The clinical effective rates of the trial and the control groups were 98.7％ (74/75 cases) and 98.4％ (62/63 cases),and the gastoscopic detection rates were 98.5％ (67/68 cases) and 96.8％ (61/63 cases).There was no adverse reaction in the trial group due to using marzulene for 8 weeks and 4 weeks' follow-up after its withdrawal.Conclusions Marzulene is helpful for improving the clinical and gastroscopic manifestations of peptic ulcer disease in children,and is effective and safe as an adjuvant therapy in children.

Latest update on diagnosis and treatment of steroid-resistant nephrotic syndrome in children / 临床儿科杂志

Steroid-restant nephrotic syndrome (SRNS) is often continuously relapsed, and even develops into end-stage renal di-sease. It has been a great difficulty in the treatment of nephritic syndrome in children. In recent years, many researchers of children SRNS on diagnosis, pathology, treatment have been carried on domestically and in abroad. This paper reviews the latest update on the di-agnosis and treatment of SRNS in children.

Secular trends in trial of labor and associated neonatal mortality and morbidity in the United States, 1995 to 2002 / 中南大学学报(医学版)

OBJECTIVE@#A proportion of elective repeated cesarean sections where a trial of labor in a uterus with a previous scar was not attempted is on the increase. This study aimed to assess how reduced the use of trial of labor has impacted on neonatal outcomes in the United States.@*METHODS@#Pregnant women with one previous cesarean delivery and a singleton live birth of the index pregnancy were abstracted from the 1995 to 2002 birth registration data of the United States. Adjusted odds ratios for adverse neonatal outcomes of trial of labor were estimated by multiple logistic regression models, in overall study subjects and in the two periods with high and low rates of trial of labor.@*RESULTS@#A total of 1833407 eligible subjects were included in the analysis. Rate of trial of labor after one previous cesarean section dropped from 38.5% in 1995 to 15.0% in 2002. No significant change was observed in the patient population profile. Successful vaginal birth after cesarean delivery (VBAC) also declined from 76.6% in 1995 to 66.0% in 2002. A trial of labor after one previous cesarean section was correlated with increased risks of asphyxia-related neonatal death and neonatal morbidity. This risk was even more pronounced in low risk women and in the last study years with the lowest rate of trial of labor.@*CONCLUSION@#The reduced use of trial of labor after one cesarean delivery in recent years in the United States has actually resulted in increased risk of adverse neonatal outcomes associated with a trial of labor.

The biologic characteristics of human immunodeficieney virus-1 subtype B' R5 tropic strains in different disease stage / 中华传染病杂志

Objective To study biological characteristics of R5 tropic human immunodeficiency virus (HIV)-1 strains in different disease stage. Methods Primary clinical viruses were isolated from fresh peripheral blood mononuclear cells (PBMC) using co-culture methods; meanwhile, viral co receptor usage and infectivity were tested using flow cytometry on GHOST (3) cell lines,which expressed CD4 receptor and CC ehemokine receptor 5 (CCR5) or CXCR4 eoreceptor; to identified CCR5 tropic viruses(R5 tropic strains). Viral replication kinetics was detected in PBMCs. Plasma viral load was measured using an HIV-1 nucleotide fluorescence quantification assay kit. Results There were 22 individuals with HIV-1 subtype B' infection, in which 11 were CD4>0. 2 × 109/L and 11 were CD4≤0. 2 × 109/L. All isolated viruses used CCR5 coreceptor and therefore were HIV-1 R5 tropic strains. The infectivity of R5 tropic strains isolated from patients with CD4≤0.2 × 109/L was (7.392 7 ± 4. 584 2) % ; while the infectivity of R5 tropic strain from patients with CD4>0. 2 × 109/L was (2. 613 6 ± 1. 610 5)%. There were significant statistical difference(t= 3. 262, P<0.05). The possibility of viral replication became strong after the day 7 post-infection. There was a significant difference of viral replication between two groups in the day 7,10, 15 post-infection(t value was 3. 771, 2. 509 and 2. 260 respectively, P<0. 05). The possibility of viral replication was higher in CD4≤0.2 ×109/L group than that of CD4>0.2 × 109/L group. The logarithm of viral load was (5. 606 8 ± 0. 815 1 ) copies/mL in CD4≤0.2 × 109/L group and (4. 729 8 ± 0. 431 6) copies/mL in CD4> 0.2 × 109/L group. There was a significant difference between two groups(t = 3. 771 ; P<0.05). Conclusion Viral infection and replication are enhanced during progression of disease, even if viral coreceptor usage do not switch from CCR5 to CXCR4.

Effect analyses of automatic cleaning sterilizer and ultrasonic cleaners / 中国基层医药

Objective Exploration of best effect on washing medical instrument between automatic cleaning sterilizer and ultrasonic cleaners.Methods Suppose washing method A and method B.A:directly put medical instrument into automatic cleaning sterilizer,wash,sterilize and dry it step by step.B:place medical instrument into ultrasonic cleaners,wash with ultra sonic,shower with cool water,sterilize and dry with hot water.Results By comparison,after washing method A,there remains 0.33‰ residue on the medical instrument while after B there are 0.03‰ remains.It has an evident difference between result of the two methods(?~2=46.546,P=0.000).Especially on the cleaning result of saw-shaped medical instrument:A method has 0.52‰ residue while method B is 0.04‰,which is of great significance.But there exists no significant difference of washing result on non saw-shaped instrument(?~2=2.667,P=0.102).Conclusion Ultrasonic cleaners can reach the optimum washing effect on saw-shaped medical instrument,with a great decline on residue after cleaning.And automatic cleaning sterilizer can wash large quantity of non saw-shaped,saving labor and enhancing efficiency by automation cleaning process.Therefore,adpoting different equipment to wash different instrument can efficiently improve cleaning effect and ensure safe and qualified stelization.