Application of intelligent ward combined with DMAIC method in optimizing the process of patients receiving surgery / 中国实用护理杂志

Objective:To explore the application effect of the intelligent ward combined with DMAIC in improving the procedure and shortening the time of operation, so as to provide a reasonable basis for optimizing and improving the operation process.Methods:This was a prospective study. A total of 240 patients with gynecological surgery hospitalized in Shengjing Hospital of China Medical University from August to November 2021 were selected as the research object. From August to September 2021, the routine management mode of staff in the operating room and ward was adopted as the control group, with a total of 120 cases. From October to November 2021, the intelligent ward combined with DMAIC mode of staff in the operating room and ward was adopted as the observation group, with a total of 120 cases. The time of receiving operation notice, preoperative preparation time, preparation time of transfer personnel, waiting time after the arrival of transfer personnel and the total time of receiving operation were compared between the two groups.Results:The time of receiving operation notice was (1.42 ± 0.61) min in the observation group, which was less than that in the control group (3.53 ± 1.12) min, the difference was statistically significant ( t=18.14, P<0.05). The preoperative preparation time was (8.43 ± 1.80) min in the observation group,which was less than that in the control group (11.36 ± 2.01) min, the difference was statistically significant ( t=11.89, P<0.05). There was no significant difference in the preparation time of transfer personnel between the two groups ( P>0.05). The waiting time after the arrival of transfer personnel was 2.33(1.75, 2.93) min in the observation group, which was less than that in the control group 5.19(3.46, 8.42) min, the difference was statistically significant ( t=-10.06, P<0.05). The total time of receiving operation was (23.90 ± 4.94) min in the observation group, which was less than that in the control group (28.84 ± 4.75) min, the difference was statistically significant ( t=7.90, P<0.05). Conclusions:The intelligent ward combined with DMAIC improves the operation receiving process of the ward, shortens the total time for receiving the operation, and effectively improves the work quality and efficiency of the medical staff.

Lysosomal membrane protein Sidt2 knockout induces apoptosis of human hepatocytes in vitro independent of the autophagy-lysosomal pathway / 南方医科大学学报

OBJECTIVE@#To explore the regulatory mechanism of human hepatocyte apoptosis induced by lysosomal membrane protein Sidt2 knockout.@*METHODS@#The Sidt2 knockout (Sidt2-/-) cell model was constructed in human hepatocyte HL7702 cells using Crispr-Cas9 technology.The protein levels of Sidt2 and key autophagy proteins LC3-II/I and P62 in the cell model were detected using Western blotting, and the formation of autophagosomes was observed with MDC staining.EdU incorporation assay and flow cytometry were performed to observe the effect of Sidt2 knockout on cell proliferation and apoptosis.The effect of chloroquine at the saturating concentration on autophagic flux, proliferation and apoptosis of Sidt2 knockout cells were observed.@*RESULTS@#Sidt2-/- HL7702 cells were successfully constructed.Sidt2 knockout significantly inhibited the proliferation and increased apoptosis of the cells, causing also increased protein expressions of LC3-II/I and P62(P < 0.05) and increased number of autophagosomes.Autophagy of the cells reached a saturated state following treatment with 50 μmol/L chloroquine, and at this concentration, chloroquine significantly increased the expressions of LC3B and P62 in Sidt2-/- HL7702 cells.@*CONCLUSION@#Sidt2 gene knockout causes dysregulation of the autophagy pathway and induces apoptosis of HL7702 cells, and the latter effect is not mediated by inhibiting the autophagy-lysosomal pathway.

Progress in research on HIV cluster detection and response / 中华流行病学杂志

HIV cluster detection and response (CDR) is a critical strategy to end the HIV epidemic by offering information to identify prevention and care services gaps. The risk metrics for HIV clusters can be classified into three groups: growth-based metrics, characteristic-based metrics, and phylogeny-based metrics. When identifying HIV risk clusters, the public health response can reach people in the affected networks, including people with undiagnosed HIV, people with diagnosed HIV who might not be accessing HIV care or other services, and people without HIV who would benefit from prevention services. To provide references for HIV precise prevention in China, we summarized the risk metrics and the intervention measures for CDR.

Association between physical exercise and non-alcoholic fatty liver disease in people infected with hepatitis B virus / 中华流行病学杂志

Objective: To investigate the association between physical exercise and non-alcoholic fatty liver disease (NAFLD) in people infected with HBV. Methods: The information about the 3 813 participants infected with HBV, including the prevalence of NAFLD, prevalence of physical exercise and other covariates, were collected from the National Science and Technology Major Project of China during 2016-2020. The logistic regression model was used to evaluate the association between physical exercise and NAFLD in HBV infected patients, and subgroup analysis was performed to identify the effect modifiers. Results: A total of 2 259 HBV infected participants were included in the final analysis and 454 (20.10%) had NAFLD. After adjusting for covariates, we found that moderate physical exercise was a protective factor for NAFLD (OR=0.66, 95%CI: 0.46-0.94). Subgroup analysis suggested that the protective effect of moderate physical exercise on NAFLD might be stronger in women (OR=0.61, 95%CI: 0.36-1.01), those <45 years old (OR=0.24, 95%CI: 0.06-0.80), those who had low education level (OR=0.16, 95%CI: 0.04-0.49), those who had low annual income (OR=0.39, 95%CI: 0.16-0.89 for <30 000 yuan RMB; OR=0.64, 95%CI: 0.40-1.00 for 30 000-80 000 yuan RMB), those who had hypertension (OR=0.45, 95%CI: 0.21-0.88), those with BMI ≥24.0 kg/m2 (OR=0.66, 95%CI: 0.43-1.01), those who had more daily fruit or vegetable intake (OR=0.61, 95%CI: 0.38-0.97), those who had more daily meat intake (OR=0.49, 95%CI: 0.23-0.97), and those who had no smoking history (OR=0.66, 95%CI: 0.45-0.95) or passive smoking exposure (OR=0.61, 95%CI: 0.37-0.97). Conclusions: Among HBV infected patients, moderate physical exercise was negatively associated with the prevalence of NAFLD. Women, young people, those who had low education level, those who had low annual income, those with hypertension, those with high BMI, those who had more daily fruit or vegetable and meat intakes, and those who had no smoking history or passive smoking exposure might be more sensitive to the protective effect.

A novel mutation in PAX6 gene causing congenital iris coloboma with congenital cataract in a pedigree / 中华实验眼科杂志

Objective:To identify the pathogenic gene and inheritance pattern in a pedigree of congenital iris coloboma with congenital cataract.Methods:The method of pedigree investigation was adopted.A pedigree of congenital iris coloboma with congenital cataract was collected by Yunnan Disabled Rehabilitation Center and the 2nd Afliated Hospital of Kunming Medical University in February 2020.Ophthalmic examinations were carried out on the female proband, her parents, her children and her husband, and the clinical diagnosis was made.Genomic DNA was extracted from peripheral blood samples collected from the family members.The suspected pathogenic gene in the proband and her husband was screened by whole exome sequencing and was identified by bioinformatics analysis.The amino acid conservation was analyzed by UGENE software.The impact of the mutation on protein translation was predicted using MutationTaster software.The pathogenicity of the mutation was assessed according to the American College of Medical Genetics (ACMG) Standards and Guidelines.Pathogenic gene and mutations were verified by Sanger sequencing.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the 2nd Afliated Hospital of Kunming Medical University (No.PJ-2020-61).Written informed consent was obtained from each subject or custodian.Results:The proband showed large iris defects in both eyes with only a small amount of observable iris tissue in the periphery, lens cortical opacity and posterior capsule opacification, accompanied by nystagmus.A novel heterozygous frameshift variation c. 415dupA (p.R139fs) was located in exon 8 of PAX6 gene, and the variation was conservative across multiple species.The variation was in the highly conserved region of PAX6 gene and caused the dysfunction of PAX6 protein.The variation was graded as PVS1+ PM2+ PP1, a pathogenic variation, based on ACMG guidelines.The pedigree was consistent with co-segregation, indicating that the novel variation was pathogenic.The proband and her children were diagnosed, but her parents were phenotypically normal, in accordance with autosomal dominant inheritance. Conclusions:The novel frameshift variation c.415dupA (p.R139fs) on the exon 8 of PAX6 gene is responsible for congenital iris coloboma with congenital cataract in the pedigree.This is the first report of this novel variation in PAX6 gene.

Correlation between serum epidermal growth factor level change and cognitive impairment in patients with Parkinson's disease / 中国基层医药

Objective:To investigate the change in serum epidermal growth factor (EGF) level in patients with Parkinson's disease (PD) and correlate it with cognitive impairment.Methods:A total of 154 patients with early PD who received treatment in Hangzhou Third People's Hospital between July 2017 and June 2018 were included in this study. They were randomly divided into mild cognitive impairment (observation group) and no cognitive impairment (control group) according to the severity of cognitive impairment. Cognitive impairment was graded using Montreal cognitive assessment scale. Motor function was assessed using Unified Parkinson's Disease Rating Scale Part III formulated by International Parkinson and Movement Disorder Society. All these assessments were performed at enrollment and at the end of 2-year follow-up. Serum EGF level was measured by double antibody sandwich enzyme-linked immunosorbent assays. Patients without cognitive impairment were divided into four groups according to quartiles of serum EGF levels. The conversion rate of PD-MCI was calculated at 2 years of follow-up and compared between groups.Results:Among 154 patients, 68 (44.16%) patients developed PD-MCI, and 86 (55.84%) patients had no cognitive impairment. Montreal cognitive assessment scale score and serum EGF level in the observation group were (20.01 ± 3.15) points and (267.79 ± 63.18) ng/L, respectively, which were significantly lower than those in the control group [(28.21 ± 2.84) points, (491.53 ± 67.38) ng/L, t = 8.11, 9.03, both P < 0.001]. Unified Parkinson's Disease Rating Scale Part III score in the observation group was significantly higher than that in the control group [(23.47 ± 5.33) points vs. (18.69 ± 4.37) points, t = 5.18, P < 0.001]. Among the first quartile group, 14 (63.64%) patients converted to PD-MCI; while among the fourth quartile group, 2 (9.52%) patients converted to PD-MCI. The conversion rate of PD-MCI in the second, third and fourth quartile groups was significantly lower than that in the first quartile group (χ 2 = 9.73, 14.48, 33.47, all P < 0.05). Conclusion:Cognitive impairment in patients with PD is closely related to serum EGF level. Serum EGF level is a hematological index to predict cognitive impairment in patients with PD. This study is innovative and scientific.

Value of interleukin-6 combined with Model for End-Stage Liver Disease score in predicting the prognosis of hepatitis B virus-related acute-on-chronic liver failure / 临床肝胆病杂志

Objective To investigate the value of interleukin-6 (IL-6) combined with Model for End-stage Liver Disease (MELD) score in predicting the prognosis of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (HBV-ACLF). Methods A total of 86 patients with HBV-ACLF who were hospitalized in The First Affiliated Hospital of Soochow University from January 2015 to December 2018 were enrolled, and according to their survival status after follow-up for 90 days, they were divided into death group with 50 patients and survival group with 36 patients. ELISA was used to measure the serum level of IL-6, and a statistical analysis was performed for general information. The t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups. A Pearson correlation analysis was performed for IL-6 and other variables; a binary logistic regression analysis was used to investigate the independent risk factors for the prognosis of patients with HBV-ACLF; the receiver operating characteristic (ROC) curve was used to assess the value of IL-6 combined with MELD score in predicting the prognosis of HBV-ACLF. Results There were significant differences between the death group and the survival group in hematocrit ( t =2.413), platelet count ( t =6.584), total bilirubin (TBil) ( t =-8.070), prothrombin time (PT) ( U =77.500), international standardized ratio ( U =102.000), HBV DNA ( t =-2.767), IL-6 ( t =-16.543), and MELD score ( t =-8.192), and the death group had a significantly higher level of IL-6 than the survival group (27.13±12.18 pg/mL vs 9.72±5.56 pg/mL, P < 0.001). The Pearson correlation analysis showed that IL-6 was positively correlated with TBil and PT ( r =0.579 and 0.681, both P < 0.001). The binary logistic regression analysis showed that IL-6 (odds ratio[ OR ]=1.480, 95% confidence interval [ CI ]: 1.196~1.833, P =0.007) and MELD score ( OR =1.128, 95% CI : 1.033~1.231, P < 0.001) were independent risk factors for the death of HBV-ACLF patients within 90 days. IL-6 combined with MELD score had an area under the ROC curve (AUC) of 0.891 (95% CI : 0.778~0.999), with a higher AUC than IL-6 (AUC=0.838, 95% CI : 0.687~0.989) or MELD score (AUC=0.783, 95% CI : 0.634~0.933). IL-6 combined with MELD score had a significantly higher value than IL-6 alone in predicting the prognosis of patients with HBV-ACLF ( Z =-2.257, P =0.024). Conclusion IL-6 combined with MELD score can be used as a good model for predicting the short-term prognosis of patients with HBV-ACLF.

Safety pharmacological study of the compound of diphenhydramine hydrochloride and caffeine / 药学实践杂志

Objective To provide the reference resource for the safe clinical use of the compound of diphenhydramine hydrochloride and caffeine by observing its effects on the nervous system, cardiovascular system and respiratory system in experimental animals. Methods Single dose of the compound of diphenhydramine hydrochloride and caffeine was given to animals orally. The effects on climbing ability of mice and blood pressure, electrocardiogram, respiration rate and amplitude in beagle dogs were observed and recorded. Results With the dosage of the compound of diphenhydramine hydrochloride and caffeine (diphenhydramine hydrochloride / caffeine ratio is 1/2.4) at 51, 102, 204 mg/kg, there was no significant effect on the climbing ability in mice. With the dosages of 14.2, 28.3, 56.6 mg/kg for male Beagle dogs and 5.66, 14.2, 28.3 mg/kg for female Beagle dogs, no significant effects were observed in systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, ECG（P wave, R wave , T wave, QRS time, PR interval, QT interval）, respiratory rate and amplitude. Conclusion Under the experimental conditions, single oral dose of the compound of diphenhydramine hydrochloride and caffeine has no significant effect on the nervous system, cardiovascular system and respiratory system in experimental animals. Those results suggest that the compound of diphenhydramine hydrochloride and caffeine is a safe agent for clinical use.

Psychological Status and Influencing Factors of Staff at Centers for Disease Control and Prevention in Sichuan Province during the Outbreak of Coronavirus Disease 2019 / 中国医学科学院学报

Objective To assess the psychological status of staff at the centers for disease control and prevention(CDC) in Sichuan during the outbreak of coronavirus disease 2019(COVID-19) and explore the influencing factors. Methods The staff at Sichuan provincial,municipal,and county(district)-level CDC were selected by convenience sampling.Their basic information,work status,training status,work difficulties,and support from the work group were collected from the self-filled questionnaires online.The Generalized Anxiety Disorder Scale and the 9-question Patient Health Questionnaire were respectively employed to measure the anxiety and depression of the staff.The stepwise Logistic regression was carried out to analyze the influencing factors of anxiety and depression in CDC staff. Results Among the 653 staff,58.35% and 50.06% presented anxiety and depression,respectively.The regression results showed that age(OR=0.95,95%CI=0.92-0.97) and mental support from the work group(OR=0.61,95%CI=0.45-0.82) were the protective factors while physical fatigue(OR=1.82,95%CI=1.20-2.74),work pressure(OR=1.61,95%CI=1.21-2.12),and insufficient protective equipment(OR=1.92,95%CI=1.06-3.49) were the risk factors for depression of CDC staff.Age(OR=0.97,95%CI=0.94-0.99),length of sleep per day(OR=0.74,95%CI=0.56-0.96),and participation in technical training(OR=0.33,95%CI=0.12-0.95) were the protective factors while mental fatigue(OR=1.68,95%CI=1.18-2.41),work pressure(OR=2.94,95%CI=2.08-4.17),and unclear incentive system for overtime(OR=1.99,95%CI=1.23-3.23) were the risk factors for the anxiety of CDC staff. Conclusion The anxiety and depression status of CDC staff during the COVID-19 outbreak were worrying,which were mainly affected by age,sleep,supply of protective equipment,incentive system,fatigue,and work pressure.

Correlation between motor skills and focused with shifting attention in preschool children / 中国学校卫生

Objective@#To investigate correlations between motor skills with focused and shifting attention among preschool children, and to provide basis for the overall development of preschool children aged 4-6 years.@*Methods@#During March to June 2020, a total of 165 preschool children aged 4-6 years were selected and investigated with subscales of the Bruininks Oseretsky Test of Motor Proficiency 2nd Edition (BOT-2) for agility and limb bilateral coordination assessment, and subscales of the Movement Assessment Battery for Children test 2nd Edition (MABC-2) for throwing and catching skill assessment, as well as balance subscale for the assessment of limb movement coordination, hand eye coordination, agility, and balance. The Kansas Reflection Impulsivity Scale for Preschoolers for Pre schoolers (KRISP) and Dimensional Change Card Sort (DCCS) were used to assess focused and shifting attention levels. Correlation and linear regression analyses were performed for statistical analysis.@*Results@#Except for one handed throwing skills and shifting attention, there were statistically significant gender differences between boys and girls in total score of body movement coordination, total score of hand to eye coordination, hand to hand connection, total score of agility of movement, total score of movement balance, static support, walking on tiptoe, foot to foot jump and focused attention( t =-6.86, -2.00 ,-3.15,-3.75,-3.00,-2.95,-2.18,-2.11,-3.21, P ＜0.05), and girls were better than boys; children s total score of body movement coordination, total score of hand to eye coordination, hand to hand connection, agility of movement, walking on tiptoe and focused attention improves with age( r =0.47,0.41,0.47,0.51,0.16,0.31, P ＜0.05); After excluding the interference of gender and age, total score of body movement coordination was significantly correlated with preschool children s focused attention( β=0.31,95%CI =0.08-0.39, P ＜0.01).@*Conclusion@#Limb movement coordination and focused attention are significantly and positively correlated among preschool children aged 4-6 years. Therefore, preschool education and family activities should focus on designing and developing limb movement coordination related games and courses to enhance the focused attention of and form favorable attention quality in preschool children aged 4-6 years.

Investigation of doxorubicin inhibiting osteogenesis and promoting osteoclastogenesis in vitro and its mechanism / 中华内分泌代谢杂志

Objective:To investigate the effects of doxorubicin(DOX) on osteoblast differentiation of rat bone marrow mesenchymal stem cells(BMSCs) and osteoclast differentiation of bone marrow monocytes(BMMs) in vitro.Methods:Rat BMSCs were treated with various concentrations of DOX in osteogenic medium. The cell viability was detected by CCK-8 assay. Alizarin red staining and alkaline phosphatase(ALP) activity were used to detect the effect of DOX on osteogenic differentiation. Expressions of osteogenic differentiation-related genes were detected by real-time quantitative PCR, Western blot, and immunofluorescence. Similarly, BMMs were treated with various concentrations of DOX and its effects on cell viability and osteoclast differentiation were measured. Finally, the expressions of osteoclast-related genes were detected.Results:DOX treatment inhibited the ALP activity during BMSCs differentiation into osteoblasts and reduced the number of calcium nodules, along with decreased expressions of osteogenic-related genes(ALP, collagen-Ⅰ, and osteocalcin, P<0.05). DOX suppressed the expressions of Smad 1/5/9, bone morphogenetic protein 2(BMP-2), Osterix, and core binding factor α1(Runx2). BMP-2 supplement antagonized the effect of DOX on ALP activity. DOX promoted receptor activator of NF-κB ligand(RANKL) expression and inhibited osteoprotegerin expression. DOX promoted the osteoclast formation and expressions of osteoclast-related genes such as tartrate-resistant acid phosphatase, nuclear factor of activated T cells c1(NFATc1), and c-Fos in a direct and indirect manner. Conclusion:DOX inhibits BMSCs differentiation into osteoblasts through BMP-2/Smads signaling pathway while promotes RANKL-induced BMMs differentiation into osteoclasts in vitro.

Research progress in miRNAs mediated radiation-induced by stander effect / 中华放射医学与防护杂志

Radiation-induced bystander effect (RIBE) refers to that irradiated cells release signaling factors and induce responses in nonirradiated cells.In other words, it is the communication between irradiated and nonirradiated cells by intracellular signals. RIBE could influence the efficacy of tumor radiotherapy, but also has potential risk to the normal tissues outside of radiation field. Studies have found that ionizing radiation can induce the alteration of miRNA expression not only in the irradiated cells but also in adjacent nonirradiated tissues, and miRNAs may play an important role in the regulation of signaling pathways between irradiated and nonirradiated bystander cells. This article reviewed the roles of miRNAs in RIBE.

Qualitative and quantitative analysis of contrast-enhanced ultrasound images for assessing the correlation between the stability of newly formed vessels in the carotid plaque and the occurrence of ischemic stroke / 中国基层医药

Objective:To evaluate the stability of newly formed blood vessels in the carotid plaque using qualitative and quantitative analysis of contrast-enhanced ultrasound images and to investigate its correction with the occurrence of ischemic stroke.Methods:A total of 100 patients with carotid artery plaques diagnosed by routine ultrasound who received treatment between August 2017 and December 2019 in Haiyan People's Hospital, China were included in this study. They were divided into an ischemic stroke group ( n = 60) and a non-ischemic stroke group ( n = 40) according to the occurrence of stroke. Two groups of patients underwent contrast-enhanced ultrasound examination of the carotid artery. The correlation between the stability of the newly formed vessels in the carotid plaque and the occurrence of ischemic stroke was quantitatively analyzed. Results:Contrast-enhanced ultrasound results revealed low or medium intensity of echoes. The proportion of patients exhibiting grade 3-4 intensity of echoes in the ischemic stroke group was significantly higher than that in the non-ischemic stroke group ( P < 0.05). Time to peak in the ischemic stroke group was significantly shorter than that in the non-ischemic stroke group [(25.46 ± 3.25) seconds vs. (32.77 ± 4.28) seconds, t = 3.783, P = 0.000]. In the ischemic stroke group, peak intensity [(59.62 ± 10.18) dB vs. (47.53 ± 14.36) dB, t = 3.263, P = 0.000] and the area under the receiver operating characteristic curve [(2 365.37 ± 346.03) cm 2vs. (1 695.42 ± 525.44) cm 2, t = 4.981, P = 0.000] were significantly higher than those in the non-ischemic stroke group (both P < 0.05). Conclusion:Contrast-enhanced ultrasound visual scoring combined with quantitative ultrasonography technology can be used to assess the stability and possible development process of carotid plaques, which provide practical and reliable evidence for selecting a rational opportunity for clinical treatment of ischemic cerebrovascular disease and developing a reasonable treatment plan.

Studieson the characteristics of cerebral blood flow changes in MRI perfusion imaging in patients with cognition disorders in Parkinson disease and their correlation with serum epidermal growth factor / 中国医师进修杂志

Objective:To explore the characteristics of cerebral blood flow changes in MRI perfusion imaging in patients with Parkinson disease (PD) cognition disorders and its correlation with serum epidermal growth factor (EGF) level.Methods:One hundred and twenty PD patients diagnosed and treated from September 2017 to September 2020 in Hangzhou Third People′s Hospital were selected. According to the presence of mild cognitive impairment (MCI), they were divided into PD-MCI group (60 cases) and PD without cognition impairment (PD-NCI) group (60 cases). Another 60 cases of healthy physical examination during the same period were selected as the normal control group. MRI perfusion imaging was used to evaluate the cerebral vascular perfusion in each group, and the EGF level of each group was determined by enzyme-linked immunosorbent assay and compared.Results:The CBF and CBV in the PD-MCI group and PD-NCI group were lower than those in the normal control group, while the MTT was longer than that in the normal control group:(14.78 ± 2.49), (18.21 ± 2.84) ml/(100 g·min) vs. (18.21 ± 2.84) ml/(100g·min); (1.42 ± 0.29), (1.83 ± 0.31) ml/100 g vs. (2.87 ± 0.54) ml/100 g; (10.53 ± 2.18), (7.85 ± 1.39) s vs. (4.29 ± 1.05) s, and the differences were statistically significant ( P<0.05). The CBF and CBV in the PD-MCI group were lower than those in the PD-NCI group, while MTT was longer than that in the PD-NCI group, and the differences were statistically significant ( P<0.05). The level of serum EGF in the PD-MCI group and PD-NCI group were lower than those in the normal control group: (146.25 ± 30.12), (208.17 ± 21.25) ng/L vs. (242.38 ± 25.46) ng/L; the level of serum EGF in the PD-MCI group was lower than that in the PD-NCI group, and the differences were statistically significant ( P<0.05). CBF, CBV and EGF were linearly positively correlated with Montreal Cognitive Assessment Scale (MoCA) scores ( r1 = 0.810, r2 = 0.732, r3 = 0.825, P<0.05), while MTT was linearly negatively correlated with MoCA scores ( r4 = -0.756, P<0.05). Conclusions:PD-MCI patients have abnormal cerebral blood flow, and serum EGF level decrease. In PD-MCI patients, CBF, CBV and EGF are linearly positively correlated with MoCA scores, while MTT is linearly negatively correlated with MoCA scores.

Value of interleukin-32 combined with Model for End-Stage Liver Disease in predicting the prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure / 临床肝胆病杂志

ObjectiveTo investigate the value of interleukin-32 (IL-32) combined with Model for End-Stage Liver Disease (MELD) in predicting the prognosis of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (HBV-ACLF). MethodsA total of 92 patients with HBV-ACLF who were hospitalized in The First Affiliated Hospital of Soochow University from January 2015 to December 2018 were enrolled, and according to the follow-up results at 3 months after diagnosis, the patients were divided into survival group with 40 patients and death group with 52 patients. ELISA was used to measure the serum level of IL-32. Clinical data of the patients were collected, including age, sex, underlying diseases, major complications, white blood cell count (WBC), platelet count (PLT), hematocrit (HCT), total bilirubin (TBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (Alb), serum creatinine (SCr), prothrombin time (PT), international normalized ratio (INR), and HBV DNA. The t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test was used for comparison of categorical data between two groups; a Pearson correlation analysis was performed for IL-32 and other variables; a binary logistic regression analysis was performed to investigate the independent risk factors for the prognosis of patients with HBV-ACLF. The receiver operating characteristic(ROC) curve(AUC) was used to evaluate the value of IL-32 combined with MELD score in predicting the prognosis of patients with HBV-ACLF. The normal Z test was used for comparison of AUC. ResultsThere were significant differences between the two groups in HCT, PLT, TBil, SCr, PT, INR, HBV DNA, IL-32, and MELD score (all P＜0.05). IL-32 was positively correlated with TBil (r=0.952, P＜0.001) and MELD score (r=0850, P＜0.001). IL-32 (odds ratio ［OR］=1.137, 95% confidence interval ［CI］: 1040-1243, P=0.005) and MELD score (OR=1.055, 95% CI: 1.001-1.109, P=0.025) were independent risk factors for the death of HBV-ACLF patients. IL-32 combined with MELD score had the highest value in predicting the prognosis of patients with HBV-ACLF (AUC=0.992, 95% CI: 0.981-1000), with a significantly higher AUC than IL-32 (0.992 vs 0.984, Z=2.265, P＜0.05) and MELD score (0.992 vs 0877, Z=3182, P＜0.05). ConclusionBoth IL-32 and MELD score can predict the prognosis of patients with HBV-ACLF, and the combination of these two indicators has a better predictive value.

Salmon calcitonin combined with vitamin D3 in the treatment of hyperparathyroidism secondary to chronic renal insufficiency / 中国医师杂志

Objective:To explore the efficacy of salmon calcitonin combined with vitamin D3 in the treatment of chronic renal insufficiency and secondary hyperthyroidism and its effects on bone calcium metabolism.Methods:A total of 40 patients with chronic renal failure who underwent hemodialysis in our blood purification center from September 2017 to December 2017 were selected for the study and were divided into treatment group (20 cases) and control group (20 cases) according to the random number table method. Patients in control group were given conventional treatment + calcitriol orally, and patients in treatment group were given subcutaneous injection of salmon calcitonin on the basis of control group. The course of treatment in both groups was 12 weeks. The clinical efficacy and clinical symptoms improvement, serum calcium, serum phosphorus and parathyroid hormone (iPTH) as well as the adverse reactions were compared between the two groups. The Kidney Disease Targeted Areas (KDTA) and Visual Analogue Pain Score (VAS) were used to evaluate the patients' quality of life and bone pain.Results:The effective rate in treatment group was significantly higher than that in control group (95.00% vs 65.00%) ( P<0.05). The clinical symptoms of bone joint pain, muscle weakness and skin itching were significantly improved in the two groups, and the improvement was more significant in treatment group compared with that in control group ( P<0.05). The serum calcium levels in the two groups were significantly increased ( P<0.05), while the levels of serum phosphorus and iPTH were significantly decreased ( P<0.05); the serum calcium in treatment group was significantly higher than that in control group ( P<0.05), while the blood phosphorus and iPTH were significantly lower than those in control group ( P<0.05). The KDTA scores in the two groups were significantly increased ( P<0.05), while the VAS scores were significantly decreased ( P<0.05); the KDTA score in treatment group was significantly higher than that in control group ( P<0.05), while the VAS score was significantly lower than that in control group ( P<0.05). There was no significant difference in adverse reactions between the two groups ( P>0.05). Conclusions:The treatment effect of salmon calcitonin combined with vitamin D3 on chronic renal insufficiency secondary hyperthyroidism is obvious, and the clinical symptoms such as bone pain are improved obviously. It is believed that salmon calcitonin is related to the regulation of calcium, phosphorus and bone metabolism.

Value of mean platelet volume in evaluating the prognosis of hepatitis B virus-associated acute-on-chronic liver failure / 临床肝胆病杂志

ObjectiveTo investigate the association between mean platelet volume (MPV) and prognosis of hepatitis B virus-associated acute-on-chronic liver failure (HBV-ACLF) and the value of MPV in prognostic evaluation. MethodsA retrospective analysis was performed for the clinical data of 37 patients with hepatitis B cirrhosis, 44 patients with HBV-ACLF, and 27 patients with chronic hepatitis B, who were admitted to Department of Infectious Diseases, The First Affiliated Hospital of Soochow University, from January 2015 to December 2019, as well as 24 individuals who underwent physical examination during the same period of time. Related clinical data included sex, age, total bilirubin (TBil), creatinine (Cr), blood urea nitrogen (BUN), albumin (Alb), blood ammonia (NH3), routine blood test results, Model for End-Stage Liver Disease (MELD) score, and blood coagulation parameters. According to prognosis, the patients with HBV-ACLF patients were divided into improvement group with 19 patients and non-improvement group with 25 patients, and the patients were followed up for 3 months. The Kruskal-Wallis H test was used for comparison between multiple groups, and the Wilcoxon rank sum test was used for comparison within each group， the Mann-Whitney U test was used for comparison between two groups； a binary logistic regression analysis was used to investigate the independent influencing factors for prognosis, and the receiver operating characteristic (ROC) curve was used to predict the accuracy of variables. ResultsThere were significant differences in MPV, platelet count, prothrombin time (PT), international normalized ratio (INR), Alb, BUN, TBil, and MELD score between the liver cirrhosis group, the HBV-ACLF group, the chronic hepatitis group, and the healthy group (χ2=39.031， 75.837, 59.894, 56.033, 22.760, 83.353 and 70.299, all P＜0.001). Further comparison of MPV between two groups showed that the HBV-ACLF group had a significantly higher MPV than the healthy group and the chronic hepatitis group (Z=9.076 and 4.435, both corrected P＜0.001), and the liver cirrhosis group had a significantly higher MPV than the healthy group (Z=2.646, corrected P=0.049). For the patients with HBV-ACLF, there were significant differences in MPV, age, PT, INR, and MELD score between the improvement group and the non-improvement group (Z=-3.710， -2.726， -2.678， -2.322 and -2.610, all P＜0.05), and further binary logistic regression analysis showed that MPV (odds ratio ［OR］=1.175, 95% confidence interval ［CI］: 1.067-2.756, P=0.026) and MELD score (OR=1.643, 95% CI: 1.021-2.644, P=0.041) were independent influencing factors for the prognosis of HBV-ACLF. MPV alone, MELD score alone, and MPV combined with MELD score had an area under the ROC curve of 0.742, 0.731, and 0.791, respectively, in predicting the prognosis of HBV-ACLF, and MPV combined with MELD score had relatively high sensitivity (0.72) and specificity (0.895). ConclusionMPV is an independent influencing factor for the prognosis of HBV-ACLF and has a good value in predicting prognosis. MPV combined with MELD score has advantages over MPV or MELD score alone in predicting the prognosis of HBV-ACLF.

Analysis of HIV infection and its influencing factors among men who have sex with men in Wuxi City, 2016-2019 / 公共卫生与预防医学

Objective To analyze the situation of HIV infection and its influencing factors among men who have sex with men (MSM) in Wuxi city, 2016-2019, and to provide evidence for prevention and control of HIV infections in MSM. Methods Snowball sampling and online methods were used to recruit subjects, and a face-to-face questionnaire survey was conducted among MSM by professionally trained investigators. Blood samples were collected for HIV tests. Results A total of 1 451 MSM were recruited in this study. The awareness rate of AIDS related knowledge was 93.52%. The positive rate of HIV was 5.86%. The analysis of demographic characteristics showed that the differences between different age groups (χ2=18.81, P2=28.84, P2=12.63, P2=33.15, P0.05) for other factors. Conclusion It is necessary to strengthen health education and intervention measures among MSM.

The development of small-molecule inhibitors that target PRC2-related proteins / 药学学报

Abnormal expression of polycomb repressive complex 2 (PRC2) is related to the development of a variety of diseases. Inhibition of normal or overactive PRC2 can reduce cell survival and inhibit tumor growth in several cancers. Therefore, the identification and development of small molecule inhibitors has become an active field of current epigenetic-related anti-tumor strategies. A small molecule inhibitor targeting the S-adenosyl-L-methionine (SAM) binding site of enhancer of zeste homologue 2 (EZH2) has been approved by FDA. However, acquired drug resistance is of concern. Drugs targeting two different binding sites of embryonic ectoderm development (EED) are also being developed. The development of EZH2-EED proton pump inhibitor has attracted extensive attention due to its unique mechanism of action. In this paper, we review the research progress on various small molecule inhibitors that target PRC2-related proteins to provide a basis for further research and development of related drugs.

Estimating the basic reproduction number of COVID-19 in Wuhan, China / 中华流行病学杂志

Objective@#The number of confirmed and suspected cases of the COVID-19 in Hubei province is still increasing. However, the estimations of the basic reproduction number of COVID-19 varied greatly across studies. The objectives of this study are 1) to estimate the basic reproduction number (R0) of COVID-19 reflecting the infectiousness of the virus and 2) to assess the effectiveness of a range of controlling intervention.@*Method@#The reported number of daily confirmed cases from January 17 to February 8, 2020 in Hubei province were collected and used for model fit. Four methods, the exponential growth (EG), maximum likelihood estimation (ML), sequential Bayesian method (SB) and time dependent reproduction numbers (TD), were applied to estimate the R0.@*Result@#Among the four methods, the EG method fitted the data best. The estimated R0 was 3.49 (95% CI: 3.42-3.58) by using EG method. The R0 was estimated to be 2.95 (95%CI: 2.86-3.03) after taking control measures.@*Conclusion@#In the early stage of the epidemic, it is appropriate to estimate R0 using the EG method. Meanwhile, timely and effective control measures were warranted to further reduce the spread of COVID-19.