Exploration on the blended learning reform in organ-systems based curriculum model of the endocrine system / 中华医学教育探索杂志

Since 2016, Binzhou Medical University began to carry out the blended learning reform in the organ-systems based curriculum (OSBC) of the experimental class of clinical medicine. Based on the traditional face-to-face teaching method, the blended learning mode of the integrated course of endocrine system under OSBC has been carried out by using the small private online course (SPOC) of MOOC platform of China universities. Many teaching methods have been adopted and formed, including case-based learning (CBL), problem-based learning (PBL), professional bilingual teaching, scientific research teaching and virtual simulation experiment teaching. The evaluation system for the combination of formative and summary assessment has been also adopted in the whole process to assess the students' academic achievement, and the teaching effect as well. The blended learning mode of the integrated course of the endocrine system under OSBC is still in the exploratory stage. There are some limitations, such as too high requirements for teachers' quality, long preparation time for teaching, and great difficulty in supervising online learning. However, the practice of teaching reform that has been carried out shows that it is effective, feasible, and worth popularizing.

Synthesis of selective PAK4 inhibitors for lung metastasis of lung cancer and melanoma cells

The p21 activated kinase 4 (PAK4) is serine/threonine protein kinase that is critical for cancer progression. Guided by X-ray crystallography and structure-based optimization, we report a novel subseries of C-3-substituted 6-ethynyl-1H-indole derivatives that display high potential and specificity towards group II PAKs. Among these inhibitors, compound 55 exhibited excellent inhibitory activity and kinase selectivity, displayed superior anti-migratory and anti-invasive properties against the lung cancer cell line A549 and the melanoma cell line B16. Compound 55 exhibited potent in vivo antitumor metastatic efficacy, with over 80% and 90% inhibition of lung metastasis in A549 or B16-BL6 lung metastasis models, respectively. Further mechanistic studies demonstrated that compound 55 mitigated TGF-β1-induced epithelial-mesenchymal transition (EMT).

Clinical Characteristics and Treatment of Blau Syndrome in Chinese Children-a National Multicenter Study / 罕见病研究

  Objective  To study the demographic and clinical characteristics, correlation of genotype and phenotype and treatment of Blau syndrome to facilitate early diagnosis and timely treatment of Blau syndrome.  Methods  Seventy-two patients with Blau syndrome from 11 centers from May 2006 to April 2022 were retrospectively analyzed, and their general information, clinical data, laboratory examination and treatment medication were collected.  Results  The distribution of patients with Blau syndrome was uniform in geographical north and south of China, and there was no obvious gender bias. The mean age of onset was (14.30±12.81) months, and the age of diagnosis was (55.18±36.22) months. 35% of patients with Blau syndrome happened before 1 year old, and all patients developed before 5 years old. 87.50% (63/72) had granulomatous arthritis, 65.28% (47/72) had rash, 36.11% (26/72) had ocular involvement, 27.78% (20/72) had fever, and 15.28% (11/72) had pulmonary involvement. Arthritic manifestations of Blau syndrome were most at risk, followed by rash, ocular involvement, and fever.The first 25 months of the disease, the risk of developing a rash was the greatest. The risk of developing arthritis was the greatest between 25 months and 84 months. The main mutations were p.R334Q and p.R334W, and patients with p.R334Q mutation had relatively high incidence of fever (35.71%[5/14] vs. 14.29%[1/7], P=0.43) and ocular involvement (42.86%[6/14]vs. 28.57%[2/7], P=0.51). There was a relatively high incidence of rash (85.71%[6/7] vs. 64.29%[9/14], P=0.59) in patients with the p.R334W mutation. Forty-five patients(62.50%)were treated with a combina-tion of glucocorticoid and methotrexate. Twenty-two patients were treated with tumor necrosis factor antagonist in addition to glucocorticoid and methotrexate.  Conclusions  The risk of different clinical manifestations of Blau syndrome from high to low was arthritis, followed by rash, ocular involvement and fever. The main treatment was glucocorticoid combined with methotrexate, to which biological agents could be added.

Study on the production efficiency of platelet components in 24 prefecture-level blood stations in China / 中国输血杂志

【Objective】 To learn the production efficient of platelet components among prefecture-level blood stations in China, to provide supporting data for those blood stations to optimize the production mode of platelet components and continuously improve production efficiency and supply capacity. 【Methods】 The data from 2017 to 2020 was obtained from 24 prefecture-level blood stations who were the members of the practice comparison network for blood institutes in China. The collection units of apheresis platelets, the number of dual-collections of apheresis platelets and plasma, the average apheresis units of one platelet apheresis procedure, the discarded rate of apheresis platelets, the amount of expired apheresis platelets and the amount of apheresis platelets issued were collected. For concentrated platelets, the prepared amount of platelet concentrates and the amount of expired platelet concentrates were collected; both the quantity of qualified and issued concentrated platelets were submitted for statistical analysis.The total output and efficiency of platelet components were calculated based on the collected data. 【Results】 The average annual growth rate of apheresis platelets collection in 24 prefecture-level blood stations was 12.23%, accounting for 99.80% of the total platelet output; the average collection unit of one platelets apheresis procedure was 1.75; from 2019 to 2020, only 5 blood stations performed dual-collection of platelet and plasma during one apheresis procedure; the discarded rate of apheresis platelets was 0.28%, of which 0.007% was due to expiration. A total of 1 621.2 therapeutic units of concentrated platelets were prepared, and 13.03% of them was discarded due to the expiration. The production efficiency of platelet components was 97.56%, of which the production efficiency of apheresis platelets was 97.61% and the production efficiency of concentrated platelets was 74.43%. 【Conclusion】 There are large regional differences in the supply capacity of platelet components in prefecture-level blood stations. Apheresis platelets are the main resource of platelet components product, and the collection capacity is increasing over the years with the characteristics of high production efficiency and low expiration scrapping rate. However, the preparation of concentrated platelets are still limited with relatively low production and high expiration discarded rate.

Practice of integrated theory and experiment teaching of systematic anatomy for international students / 中华医学教育探索杂志

Anatomy is an important medical course for international medical students. In order to improve the teaching quality and enhance the extent of students' learning, teachers integrated the theoretical and experimental courses of systemic anatomy, and introduced the "Digital Human" anatomical system to compensate the shortage of models, so as to realize the integrated theory and experiment teaching of systematic anatomy. Practice indicated that integrated teaching mode of theory and experiment was more consistent with the learning habits of foreign students, which improved their learning effect with significant advantages. But there were still some problems in this teaching mode and measures for solving these problems were proposed in this paper.

Evaluation the triage performance of p16/Ki-67 dual staining for HR-HPV positive women / 中华预防医学杂志

Objective@#This study aimed to evaluate the clinical performance of p16/Ki-67 dual staining for triage high risk HPV (HR-HPV) infected women.@*Method@#Target objects were women who infected HR-HPV and received colposcopy examination between April and December of 2016 at the Second Affiliated Hospital of Zhengzhou University. Gynecologists collected the cervical exfoliated cells from eligible women for p16/Ki-67 dual staining, LBC testing and HPV DNA testing. Histology diagnosis were used as gold standard. Sensitivities, specificities, positive predictive values (PPVs), negative predictive values (NPVs) of p16/Ki-67 dual staining, LBC testing and HPV16/18 testing for triage of HR-HPV positive population were calculated and compared.@*Results@#A total of 295 HR-HPV infected women were selected, and the mean age was (44.29±11.48) years old. Positive rates of p16/Ki-67 dual staining, HPV16/18 testing and LBC testing were 70.17% (207), 56.95% (168) and 85.76% (253), respectively. When CIN2+as the endpoint, among the three triage methods, sensitivity of p16/Ki-67 dual staining was 90.00% (95%CI: 85.06%-93.43%), higher than the value of HPV 16/18 testing, but lower than the value of LBC testing. Specificity, PPV and NPV of p16/Ki-67 dual staining were the highest [71.58% (95%CI: 61.81%-79.67%), 86.96% (95%CI:81.69%-90.88%) and 77.27% (95%CI: 67.49%-84.78%)]. When detection for CIN3+, sensitivity of p16/Ki-67 dual staining was 92.90% (95%CI: 87.74%-95.99%), lower than the value of LBC testing, but higher than the value of HPV16/18 testing. Specificity of p16/Ki-67 dual staining was 55.00% (95%CI: 46.74%-63.00%), lower than the value of HPV16/18 testing, but higher than the value of LBC testing. PPV of p16/Ki-67 dual staining was 69.57% (95%CI: 62.99%-75.43%), lower than the value of HPV 16/18 testing, but higher than the value of LBC testing. NPV of p16/Ki-67 dual staining was 87.50% (95%CI: 78.99%-92.87%), higher than value of HPV 16/18 testing, but lower than the value of LBC testing.@*Conclusion@#p16/Ki-67 dual staining has better clinical effects than HPV 16/18 testing and LBC testing for triage women with HR-HPV infection.

Diagnosis of Bainbridge-Ropers syndrome due to de novo ASXL3 variant by high throughput sequencing / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical and genetic features of a patient with mental retardation.@*METHODS@#G-Banding chromosomal karyotyping and high-throughput sequencing was carried out for the child. Suspected variant was validated in his family by Sanger sequencing and bioinformatic analysis.@*RESULTS@#The patient was found to carry a de novo heterozygous c.4090G>T (p.Gly1364X) variant of the ASXL3 gene, which was known to predispose to Bainbridge-Ropers syndrome.@*CONCLUSION@#The nonsense c.4090G>T (p.Gly1364X) variant probably accounts for the disease in this patient.

Patent analysis for coagulation factor Xa inhibitors / 中国药科大学学报

@#Anticoagulant drugs are widely used in the prevention and treatment of thromboembolic diseases. In recent years, coagulation factor Xa inhibitors have become a hot spot for the development of new anticoagulant drugs. However, the anticoagulant drugs currently used still have side-effects such as increased bleeding risk. This paper analyzes the patent applications of coagulation factor Xa inhibitors, and summarizes the development route of patent application of Bristol-Myers Squibb Company and Guangdong Dongyang Pharmaceutical Co. , Ltd. as representatives of key enterprises, in order to provide some useful references and recommendations for the development, patent protection countermeasure and intellectual property strategy of coagulation factor Xa for domestic pharmaceutical enterprises.

Practice of parenting and related factors on children aged 0-5 in the urban areas of China / 中华流行病学杂志

Objective@#To characterize the relations between the practice of parenting and associated factors on children (0-5 years old) in urban areas of China, in order to provide evidence for promoting the early development of children and to provide positive guidance and service programs on parenting.@*Methods@#A total of 4 515 parents from 15 cities (14 provinces) were surveyed with a self-administered questionnaire. Parenting and Family Adjustment Scales (PAFAS) was used, including parameters as: consistency and coercive parenting, positive encouragement, parent-child relationship and parental emotion adjustment, family relationship and parental teamwork aspects, etc. Both single factor analysis and multiple linear regression were used to examine the associations between parenting practice, individual, parental and family factors.@*Results@#The mean score of PAFAS was 21.00 (15.00-28.00), associated with factors as children’s age, only-child family, premature delivery, father’s education level, confidence on parenting, problems regarding the parental mood, annual family income, family structure and behavior on seeking professional help, etc. Results showed that there were big differences on the practice of parenting in China and influenced by variety of factors.@*Conclusions@#The general situation of parenting was well, in the urban areas of China. The practice of parenting was associated with a series of individual, parental and family factors. Programs on improving the parenting skills and promoting the early development of children, should be highlighted.

Analysis of application effect of water circulation blanket combined with warming flushing fluid in patients with percutaneous nephrolithotomy / 中国实用护理杂志

Objective@#To analyze the application effect of water circulation blanket combined with warming flushing fluid in patients with percutaneous nephrolithotomy.@*Methods@#A total of 86 patients with percutaneous nephrolithotomy who underwent surgery from January 2015 to August 2018 were enrolled in Gaochun People's Hospital of Nanjing. The prospective study was used and the patients were randomly divided into treatment group and control group for 43 patients in each group. The control group used conventional heat preservation measures and warming flushing fluid, and the treatment group used water circulation blanket combined with warming flushing fluid. The stress response, coagulation function, and adverse reactions were compared between the two groups.@*Results@#The body temperature, mean arterial pressure and heart rate of the treatment group 1 hour after surgery were (37.04±0.30) °C, (94.12±8.24) mmHg, (82.06±7.82) times/min, respectively, after the completion of the operation, the indexes were (36.97±0.40) °C, (95.36±8.15) mmHg, and (82.78±8.21) times/min. The control group 1 hour after surgery indexes was (36.74±0.36) °C, (90.12±8.21) mmHg, (85.78±8.32) times/min, after the completion of the operation, the indexes were (35.76±0.42) °C, (90.42±6.54) mmHg, and (90.32±7.43) times/min. The difference between the two groups was statistically significant (t=2.136-13.680, P<0.05 or 0.01). The serum fibrinogen, activated partial thrombin time and thrombin time in the treatment group were (3.10±0.52) g/L, (30.08±1.85) s, (17.02±1.60) s, respectively, and the control group was (3.85±0.60) g/L, (33.42±1.74) s, (19.56±1.75) s. The difference between the two groups was statistically significant (t=6.194, 8.624, 7.024, P<0.05 or 0.01).The incidence of adverse reactions such as hypothermia in the treatment group was 6.98% (3/43), which was significantly lower than that in the control group 27.91% (12/43). The difference was statistically significant (χ2=6.541, P<0.05).@*Conclusions@#The water circulation blanket combined with warming flushing fluid can help relieve the stress response of patients with percutaneous nephrolithotomy, maintain the body's coagulation function stable, and reduce adverse reactions such as intraoperative hypothermia.

Epidemiologic and clinical features of preschool children with brucellosis / 中华地方病学杂志

Objective@#To analyze the epidemiologic and clinical features of preschool children with brucellosis, and improve awareness of brucellosis and level of diagnosis.@*Methods@#In-patients treated for brucellosis in preschool children from December 2016 to November 2018 in Heilongjiang Agricultural Reclamation Bureau General Hospital were retrospectively analyzed for epidemiology, clinical feature, laboratory data, treatment and prognosis.@*Results@#There were 29 males and 16 females among the 45 preschool children brucellosis cases, with an average age of (3.7 ± 1.6) years old, ranged from 6 months to 6 years old. The patients of > 3-6 years old of age had the highest incidence (64.44%, 29/45). The patients were mainly rural residents (97.78%, 44/45). The onset time was mainly from March to June of the year (46.67%, 21/45). Clinical symptoms were mostly fever and joint pain, which accounted for 97.78% (44/45) and 57.78% (26/45), respectively. And lymph node enlargement and hepatosplenomegaly were also commonly seen, which accounted for 42.22% (19/45) and 35.56% (16/45). After treatment, the test results of patients with alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase isoenzyme (CK-MB), α-hydroxybutyrate dehydrogenase (HBDH) and lactate dehydrogenase (LDH) were compared with those of before the treatment, the differences were statistically significant (t=4.774, 2.970, 2.229, 5.664, 5.805, P < 0.05). Before the treatment, 36 patients (80.00%, 36/45) had positive blood culture, which turned negative after the treatment.@*Conclusions@#The epidemiologic and clinical features of preschool children with brucellosis are not typical. In the epidemic area of the disease and multiple seasons, for children with unexplained fever, the clinician should inquire about the epidemiological history and combine the clinical feature, consider the possibility of brucellosis, and strive for early diagnosis and treatment.

Analysis of application effect of water circulation blanket combined with warming flushing fluid in patients with percutaneous nephrolithotomy / 中国实用护理杂志

Objective To analyze the application effect of water circulation blanket combined with warming flushing fluid in patients with percutaneous nephrolithotomy. Methods A total of 86 patients with percutaneous nephrolithotomy who underwent surgery from January 2015 to August 2018 were enrolled in Gaochun People's Hospital of Nanjing. The prospective study was used and the patients were randomly divided into treatment group and control group for 43 patients in each group. The control group used conventional heat preservation measures and warming flushing fluid, and the treatment group used water circulation blanket combined with warming flushing fluid. The stress response, coagulation function, and adverse reactions were compared between the two groups. Results The body temperature, mean arterial pressure and heart rate of the treatment group 1 hour after surgery were (37.04±0.30)°C, (94.12± 8.24) mmHg, (82.06±7.82) times/min, respectively, after the completion of the operation, the indexes were (36.97±0.40)°C, (95.36±8.15) mmHg, and (82.78±8.21) times/min. The control group 1 hour after surgery indexes was (36.74±0.36) °C, (90.12±8.21) mmHg, (85.78±8.32) times/min, after the completion of the operation, the indexes were (35.76 ± 0.42) °C, (90.42 ± 6.54) mmHg, and (90.32 ± 7.43) times/min. The difference between the two groups was statistically significant (t=2.136-13.680, P<0.05 or 0.01). The serum fibrinogen, activated partial thrombin time and thrombin time in the treatment group were (3.10 ± 0.52) g/L, (30.08±1.85) s, (17.02±1.60) s, respectively, and the control group was (3.85±0.60) g/L, (33.42±1.74) s, (19.56± 1.75) s. The difference between the two groups was statistically significant (t=6.194, 8.624, 7.024, P<0.05 or 0.01).The incidence of adverse reactions such as hypothermia in the treatment group was 6.98% (3/43), which was significantly lower than that in the control group 27.91% (12/43). The difference was statistically significant (χ2=6.541, P<0.05). Conclusions The water circulation blanket combined with warming flushing fluid can help relieve the stress response of patients with percutaneous nephrolithotomy, maintain the body's coagulation function stable, and reduce adverse reactions such as intraoperative hypothermia.

Silencing ANO9 increases the radiosensitivity of pancreatic cancer cell AsPC-1 / 中华放射肿瘤学杂志

Objective To evaluate the effect of ANO9 on the radiosensitivity of pancreatic cancer cell AsPC-1,aiming to provide new targets for clinical radiotherapy of pancreatic cancer.Methods Western blot was performed to detect the expression of ANO9 in pancreatic cancer cell lines (BxPC-3,PANC-1,AsPC-1)and normal pancreatic cell line (HPNE).The AsPC-1 cell line with stable silencing ANO9 was constructed by using lentivirus and validated by Western blot.MTT assay was adopted to detect the cell viability of AsPC-1 with stable silencing ANO9 after irradiation.Colony formation assay was conducted to evaluate the effect of silencing ANO9 upon the radiosensitivity of AsPC-1 cells.Western blot was performed to assess the effect of ANO9 silencing on the expression of EGFR/ERK signaling protein.Results The expression levels of ANO9 were significantly up-regulated in three pancreatic cancer cell lines compared with that in the normal pancreatic cell line HPNE (t =7.426,5.543,11.850,all P＜0.05).After silencing ANO9,the expression level of ANO9 protein was significantly down-regulated than that in the control group (t =9.670,P＜0.05).The AsPC-1 cells with stable silencing ANO9 were successfully constructed.The sensitivity of AsPC-1 cells to irradiation was significantly increased after silencing ANO9,and the sensitivity enhancement ratio was 1.566.The expression levels of EGFR/ERK signaling proteins (EGFR and p-ERK 1/2) were significantly downregulated after silencing ANO9 (t =7.949,13.160,both P＜ 0.05).Conclusions Silencing ANO9 can significantly increase the sensitivity of AsPC-1 cells to radiotherapy,which is probably associated with the inhibition of EGFR/ERK signaling transduction.ANO9 might be a new therapeutic target for preventing the progression of pancreatic cancer.

Discovery of a series of dimethoxybenzene FGFR inhibitors with 5pyrrolo2,3-pyrazine scaffold: structure-activity relationship, crystal structural characterization and study

Genomic alterations are commonly found in the signaling pathways of fibroblast growth factor receptors (FGFRs). Although there is no selective FGFR inhibitors in market, several promising inhibitors have been investigated in clinical trials, and showed encouraging efficacies in patients. By designing a hybrid between the FGFR-selectivity-enhancing motif dimethoxybenzene group and our previously identified novel scaffold, we discovered a new series of potent FGFR inhibitors, with the best one showing sub-nanomolar enzymatic activity. After several round of optimization and with the solved crystal structure, detailed structure-activity relationship was elaborated. Together with metabolic stability tests and pharmacokinetic profiling, a representative compound () was selected and tested in xenograft mouse model, and the result demonstrated that inhibitor was effective against tumors with FGFR genetic alterations, exhibiting potential for further development.

Correlation of Gut Microbiome Between ASD Children and Mothers and Potential Biomarkers for Risk Assessment / 基因组蛋白质组与生物信息学报·英文版

Variation of maternal gut microbiota may increase the risk of autism spectrum disorders (ASDs) in offspring. Animal studies have indicated that maternal gut microbiota is related to neurodevelopmental abnormalities in mouse offspring, while it is unclear whether there is a correlation between gut microbiota of ASD children and their mothers. We examined the relationships between gut microbiome profiles of ASD children and those of their mothers, and evaluated the clinical discriminatory power of discovered bacterial biomarkers. Gut microbiome was profiled and evaluated by 16S ribosomal RNA gene sequencing in stool samples of 59 mother-child pairs of ASD children and 30 matched mother-child pairs of healthy children. Significant differences were observed in the gut microbiome composition between ASD and healthy children in our Chinese cohort. Several unique bacterial biomarkers, such as Alcaligenaceae and Acinetobacter, were identified. Mothers of ASD children had more Proteobacteria, Alphaproteobacteria, Moraxellaceae, and Acinetobacter than mothers of healthy children. There was a clear correlation between gut microbiome profiles of children and their mothers; however, children with ASD still had unique bacterial biomarkers, such as Alcaligenaceae, Enterobacteriaceae, and Clostridium. Candidate biomarkers discovered in this study had remarkable discriminatory power. The identified patterns of mother-child gut microbiome profiles may be important for assessing risks during the early stage and planning of personalized treatment and prevention of ASD via microbiota modulation.

Portal pressure gradient and serum albumin: A simple combined parameter associated with the appearance of ascites in decompensated cirrhosis treated with transjugular intrahepatic portosystemic shunt

BACKGROUND/AIMS: In recent years, greater assessment accuracy after transjugular intrahepatic portosystemic shunt (TIPS) to ascertain prognosis has become important in decompensated cirrhosis due to portal hypertension. The aim of this study was to assess the ratio of the portal pressure gradient (PPG) pre-TIPS (pre-PPG) to albumin (PPA), which influence ascites formation in cirrhotic patients in the 6-months after TIPS placement, and is a metric introduced in our study. METHODS: This was a retrospective cohort study of 58 patients with decompensated cirrhosis admitted to an academic hospital for the purpose of TIPS placement. We collected the following data: demographics, laboratory measures, and PPG during the TIPS procedure. Then we analyzed the association between the above data and ascites formation post-TIPS in cirrhosis patients. RESULTS: Twenty-two patients with ascites and 28 without ascites were evaluated. Univariate and binary logistic regression analysis were adjusted for the following variables: to determine prognosis; Child-Pugh scores, lymphocyte count, platelet count, hemoglobin level, albumin level and pre-PPG or PPA. The outcome showed that PPA was better than pre-PPG and albumin for predicting ascites according to area under receiver operating characteristic curves and a statistical model that also showed PPA’s influence 6-months post-TIPS. CONCLUSIONS: The combined measurement of pre-PPG and albumin, defined as PPA, may provide a better way to predict post-TIPS ascites in decompensated cirrhosis, which underlines the need for a large clinical trial in the future.

The correlation of the levels of interleukin-15 with late onset myasthenia gravis / 中华神经科杂志

Objective To investigate the relationship between the plasma level of interleukin 15 (IL-15) and the quantitative myasthenia gravis (QMG) score in late-onset myasthenia gravis (MG).Methods The blood samples of 86 patients (over 50 years old) who admitted to Henan Provincial People's Hospital between 2010 and 2016 were collected at two different stages:pre-treatment and six months post-treatment.The diagnosis was verified by characterizing clinical manifestation,neostigmine testing,electromyographic recording,thymic imaging and plasma anti-acetylcholine receptor (AchR).All the patients were divided further by modified Osserman classification and treated with cholinesterase inhibitor and glucocorticoid.The blood samples of 42 healthy controls were also collected from their physical examination at the end of 2016.Enzyme linked immunosorbent assay was used to evaluate the levels of IL-15 in plasma.Thymectomy was performed on patients with MG accompanied by thymoma.The possible correlation between the expression of IL-15 and the QMG scores,different types were analyzed.Results Before treatment,the levels of IL-15 in the plasma were much higher in the late onset MG patients (both ocular and generalized) than in the healthy controls ((5.75± 1.57) pg/ml vs (4.40±0.50) pg/ml,t=2.925,P＜0.01).And the late onset MG patients with thymoma showed higher level of IL-15 compared to the healthy controls ((7.39±0.84) pg/ml vs (4.40±0.50) pg/ml,t=3.925,P＜0.01).Further analysis showed that the IL-15 levels in all the MG patients with different pathological types of thymoma were higher than in the healthy controls.In the mild type of late-onset MG patients without thymoma,the IL-15 level was not increased ((4.49±0.74)pg/ml vs (4.40±0.50) pg/ml,t=1.752,P＞0.05) and in the severe type of late-onset MG patients without thymoma,the IL-15 level was mildly increased ((4.76±0.75) pg/ml vs (4.40±0.50) pg/ml,t=2.462,P＜0.05) compared to the healthy controls.Furthermore,the IL-15 level decreased dramatically upon the therapy in all the MG patients,especially in the late-onset MG patients with thymoma.Moreover,IL-15 was positively correlated with QMG scores before treatment (r=0.375,P＜0.01),especially in the late-onset MG patients with thymoma (r=0.823,P＜0.01),but not in the late-onset MG patients without thymoma (r=0.039,P＞0.05).IL-15 and QMG scores returned to normal six months after treatment.Conclusions IL-15 is increased in the plasma of late-onset MG patients,and is positively correlated with the QMG scores,especially in the late-onset MG patients with thymoma.In addition,IL-15 is decreased upon the therapy in the MG patients.

Epidemiologic and clinical features of preschool children with brucellosis / 中华地方病学杂志

Objective To analyze the epidemiologic and clinical features of preschool children with brucellosis, and improve awareness of brucellosis and level of diagnosis. Methods In - patients treated for brucellosis in preschool children from December 2016 to November 2018 in Heilongjiang Agricultural Reclamation Bureau General Hospital were retrospectively analyzed for epidemiology, clinical feature, laboratory data, treatment and prognosis. Results There were 29 males and 16 females among the 45 preschool children brucellosis cases, with an average age of (3.7 ± 1.6) years old, ranged from 6 months to 6 years old. The patients of > 3 - 6 years old of age had the highest incidence (64.44％, 29/45). The patients were mainly rural residents (97.78％, 44/45). The onset time was mainly from March to June of the year (46.67％, 21/45). Clinical symptoms were mostly fever and joint pain, which accounted for 97.78％ (44/45) and 57.78％ (26/45), respectively. And lymph node enlargement and hepatosplenomegaly were also commonly seen, which accounted for 42.22％ (19/45) and 35.56％ (16/45). After treatment, the test results of patients with alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase isoenzyme (CK-MB), α-hydroxybutyrate dehydrogenase (HBDH) and lactate dehydrogenase (LDH) were compared with those of before the treatment, the differences were statistically significant (t = 4.774, 2.970, 2.229, 5.664, 5.805, P < 0.05). Before the treatment, 36 patients (80.00％, 36/45) had positive blood culture, which turned negative after the treatment. Conclusions The epidemiologic and clinical features of preschool children with brucellosis are not typical. In the epidemic area of the disease and multiple seasons, for children with unexplained fever, the clinician should inquire about the epidemiological history and combine the clinical feature, consider the possibility of brucellosis, and strive for early diagnosis and treatment.

The clinical performance of high risk HPV DNA test among triage women with cytology showing atypical squamous cells of undetermined significance / 中华预防医学杂志

Objective@#To evaluate the performance of high risk human papillomavirus (HR-HPV) DNA test for triage ASC-US in Chinese population.@*Methods@#The study population was from Jiyuan city in Henan Province where a cervical cancer screening cohort (4 026 women) was set up from April to July in 2017. Women with ASC-US and complete recall information of colposcope were selected as the study objects. Self-designed questionnaire was used to survey the general information and medical history of cervical cancer, thencervical cytological speciments were collected for cytodiagnosis and HPV DNA test, followed by colposcopy, lesion biopsy and histology diagnose. The diagnosis of histology was used as the gold standard. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) as well as corresponding 95% confidential interval (CI) were calculated.@*Results@#The average age of the included 393 women with ASC-US were (50.81±9.22) years old. The positivity of high risk human papillomavirus (HR-HPV), HPV16 and HPV18 were 35.6%, 10.69% and 2.80%, respectively. The sensitivity, specificity, PPV and NPV for HR-HPV to detect CIN2+ were 84.38% (68.25%-93.14%), 68.70% (63.74%-73.26%), 19.29% (13.61%-26.61%) and 98.02% (95.46%-99.15%). When compared with HR-HPV, HPV16/18 had a lower sensitivity (59.38% (42.26%-74.48%)) and a higher specificity(91.14% (87.75%-93.65%)), the PPV and NPV were 59.38% (25.32%-50.98%) and 91.14% (93.61%-97.77%).@*Conclusion@#It was more effective for HR-HPV to triage ASC-US than HPV16/18. In order to improve the effect of HPV16/18, it should include more HR-HPV types which were more prevalent in Chinese population.

Rho-kinase Inhibitor Ameliorates Lipopolysaccharide-induced Kidney Injury by Inhibiting Toll-like Receptor 4 and Nuclear Factor-κB Signaling Pathway / 中国医科大学学报

Objective To explore whether Rho kinase inhibitor protects endotoxemia mice from kidney injury,and to investigate the mechanism underlying this effect. Methods Adult male C57BL/6 mice were randomly divided into three groups (n = 8 for each group): control,lipopolysaccharide (LPS),and LPS+ Y-27632 (Rho kinase inhibitor). For induction of acute kidney injury,mice were administered 30 mg/kg LPS intraperitoneally. Y-27632 (10 mg/kg body weight) was injected intraperitoneally 18 h and 1 h before injection of LPS,and an equal volume of sterile saline was administered at the corresponding time point in each group. The mice were killed 8 h after LPS administration. Blood samples and kidney tissues were taken and preserved for subsequent analysis. Results Pretreatment with Y-27632 significantly attenuated LPS-induced kidney injury;pretreatment with Y-27632 markedly reduced renal expression of inflammatory cytokines (TNF-α and IL-1β) in endotoxemia mouse,and also significantly inhibited LPS-induced caspase-3 expression in the kidney; and Y-27632 pretreatment dramatically reduced TLR4 protein expression and NF-κBp65 phosphorylation in kidney tissues of endotoxemia mouse. Conclusion Rho kinase inhibitor may inhibit TLR4 and NF-κB signaling pathway to reduce the inflammatory response in the kidneys of endotoxemia mice and alleviate acute renal injury induced by LPS.