Anti-HMGCR immune-mediated necrotizing myopathy: A case report / 北京大学学报(医学版)

The patient was a 55-year-old man who was admitted to hospital with "progressive myalgia and weakness for 4 months, and exacerbated for 1 month". Four months ago, he presented with persistent shoulder girdle myalgia and elevated creatine kinase (CK) at routine physical examination, which fluctuated from 1 271 to 2 963 U/L after discontinuation of statin treatment. Progressive myalgia and weakness worsened seriously to breath-holding and profuse sweating 1 month ago. The patient was post-operative for renal cancer, had previous diabetes mellitus and coronary artery disease medical history, had a stent implanted by percutaneous coronary intervention and was on long-term medication with aspirin, atorvastatin and metoprolol. Neurological examination showed pressure pain in the scapularis and pelvic girdle muscles, and V- grade muscle strength in the proximal extremities. Strongly positive of anti-HMGCR antibody was detected. Muscle magnetic resonance imaging (MRI) T2-weighted image and short time inversion recovery sequences (STIR) showed high signals in the right vastus lateralis and semimembranosus muscles. There was a small amount of myofibrillar degeneration and necrosis, CD4 positive inflammatory cells around the vessels and among myofibrils, MHC-Ⅰ infiltration, and multifocal lamellar deposition of C5b9 in non-necrotic myofibrils of the right quadriceps muscle pathological manifestation. According to the clinical manifestation, imageological change, increased CK, blood specific anti-HMGCR antibody and biopsy pathological immune-mediated evidence, the diagnosis of anti-HMGCR immune-mediated necrotizing myopathy was unequivocal. Methylprednisolone was administrated as 48 mg daily orally, and was reduced to medication discontinuation gradually. The patient's complaint of myalgia and breathlessness completely disappeared after 2 weeks, the weakness relief with no residual clinical symptoms 2 months later. Follow-up to date, there was no myalgia or weakness with slightly increasing CK rechecked. The case was a classical anti-HMGCR-IMNM without swallowing difficulties, joint symptoms, rash, lung symptoms, gastrointestinal symptoms, heart failure and Raynaud's phenomenon. The other clinical characters of the disease included CK as mean levels >10 times of upper limit of normal, active myogenic damage in electromyography, predominant edema and steatosis of gluteus and external rotator groups in T2WI and/or STIR at advanced disease phase except axial muscles. The symptoms may occasionally improve with discontinuation of statins, but glucocorticoids are usually required, and other treatments include a variety of immunosuppressive therapies such as methotrexate, rituximab and intravenous gammaglobulin.

Transient elastography technology role assessment during the diagnosis and treatment of patients with chronic hepatitis B virus infection / 中华肝脏病杂志

Objective: To explore the role of transient elastography technology in the assessment of disease staging and treatment in patients with chronic hepatitis B virus (HBV) infection. Methods: Patients who were clinically diagnosed with chronic HBV infection at Beijing Tsinghua Changgung Hospital from January 2018 to December 2021 was collected. Liver stiffness measurement (LSM) examination was performed more than once by transient elastography. The count data were expressed as cases (%) and the χ (2) test was made. Fisher's exact test was used with theoretical frequency less than 5. The measurement data between two groups was compared by t-test. Multiple groups were compared with an analysis of variance. Results: 1 055 patients were included in this study, including 669 (63.4%) males and 386 (36.6%) females. 757 (71.8%) patients were untreated. Among the untreated patients, the LSM value in the immune clearance (10.2 ± 3.8) kPa (187 cases, 40.4%), and the reactivation stages (9.1 ± 3.4) kPa (114 cases, 24.6%) was significantly higher than that in the immune tolerance (8.7 ± 3.6) kPa (78 cases, 16.8%) and immune control stages (8.4 ± 3.5) KPa (84 cases, 18.1%), and the difference between the four groups was statistically significant (F = 5.31 and P = 0.03). With ALT (male: 30 U/L, female: 19 U/L) as defined the normal value, the LSM value in the immune tolerance and the immune control stages were (5.8 ± 0.9) kPa and (7.1 ± 2.5) kPa, respectively, which were significantly lower than those of patients in the immune tolerance and immune control stages, and the difference was statistically significant (P < 0.01). There were 294 (38.8%) patients with uncertain period, excluding patients with fatty liver. Patients with uncertain periods were divided into four gray zone (GZ) groups: immune tolerance stage: LSM (5.1 ± 1.3) kPa was significantly lower than GZ-A (6.5 ± 2.4) kPa, t = 2.06, P = 0.03, and the difference was statistically significant; immune control stage: LSM was (5.6 ± 1.5) kPa, which was also lower than GZ-C (6.8 ± 1.3) kPa, t = 3.08, P = 0.02, and the difference was statistically significant; immune clearance stage: LSM > 8.0 kPa. LSM values showed a year-by-year reduction in patients with expanded indications who started antiviral treatment and were followed up for three years. Conclusion: The LSM value is significantly lower after the decrease of the defined high-normal ALT value in patients with the immune tolerance and immune control stages of chronic HBV infection. The LSM values of GZ-A and GZ-C in the uncertain periods of chronic HBV infection are higher than those of patients in the immune tolerance and immune control stages.

Effective substances and mechanism of Yishen Guluo Mixture in treatment of chronic glomerulonephritis based on metabolomics and serum pharmacochemistry / 中国中药杂志

This study aimed to investigate the effective substances and mechanism of Yishen Guluo Mixture in the treatment of chronic glomerulonephritis(CGN) based on metabolomics and serum pharmacochemistry. The rat model of CGN was induced by cationic bovine serum albumin(C-BSA). After intragastric administration of Yishen Guluo Mixture, the biochemical indexes related to renal function(24-hour urinary protein, serum urea nitrogen, and creatinine) were determined, and the efficacy evaluations such as histopathological observation were carried out. The serum biomarkers of Yishen Guluo Mixture in the treatment of CGN were screened out by ultra-performance liquid chromatography-quadrupole time-of-flight/mass spectrometry(UPLC-Q-TOF-MS) combined with multivariate statistical analysis, and the metabolic pathways were analyzed. According to the mass spectrum ion fragment information and metabolic pathway, the components absorbed into the blood(prototypes and metabolites) from Yishen Guluo Mixture were identified and analyzed by using PeakView 1.2 and MetabolitePilot 2.0.4. By integrating metabolomics and serum pharmacochemistry data, a mathematical model of correlation analysis between serum biomarkers and components absorbed into blood was constructed to screen out the potential effective substances of Yishen Guluo Mixture in the treatment of CGN. Yishen Guluo mixture significantly decreased the levels of 24-hour urinary protein, serum urea nitrogen, and creatinine in rats with CGN, and improved the pathological damage of the kidney tissue. Twenty serum biomarkers of Yishen Guluo Mixture in the treatment of CGN, such as arachidonic acid and lysophosphatidylcholine, were screened out, involving arachidonic acid metabolism, glycerol phosphatide metabolism, and other pathways. Based on the serum pharmacochemistry, 8 prototype components and 20 metabolites in the serum-containing Yishen Guluo Mixture were identified. According to the metabolomics and correlation analysis of serum pharmacochemistry, 12 compounds such as genistein absorbed into the blood from Yishen Guluo Mixture were selected as the potential effective substances for the treatment of CGN. Based on metabolomics and serum pharmacochemistry, the effective substances and mechanism of Yishen Guluo Mixture in the treatment of CGN are analyzed and explained in this study, which provides a new idea for the development of innovative traditional Chinese medicine for the treatment of CGN.

Influence of SLC16A Family on Clinical Features and Biological Behaviours of Lung Adenocarcinoma and Squamous Cell Carcinoma / 肿瘤防治研究

Objective To explore the relation between SLC16A family and clinical characteristics, biological behavior of lung adenocarcinoma (LUAD) and lung squamous cell carcinoma (LUSC). Methods The expression of 14 members of the SLC16A family in LUAD tissues, LUSC tissues and normal tissues in TCGA database was analyzed by Wilcoxon signed rank sum test. Cox regression was used to evaluate the relation between the family and overall survival, progression-free survival of LUAD and LUSC patients. Logistic regression was used to evaluate the relation between the family and TNM, clinical stage of LUAD and LUSC patients. Principal component analysis was used to establish a Score-SLC16As that comprehensively reflected the family in LUAD and LUSC. ROC, Log rank analysis and univariate and multivariate Cox regression analyses were applied to evaluate the diagnostic effect and survival prediction function of Score-SLC16As on LUAD and LUSC respectively. GSEA was used to evaluate the biological significance of Score-SLC16As and CIBERSORT/Immune checkpoint clusters were used to assess the immune status of Score-SLC16As in LUAD and LUSC. Results In LUAD and LUSC, most members of SLC16A family were differentially expressed and significantly correlated with survival prognosis. Score-SLC16As can clearly diagnose LUAD and LUSC, significantly predict survival prognosis, and can be used as an independent risk factor. Score-SLC16As is a risk factor for LUAD but a protective factor for LUSC. Score-SLC16As is closely related to tumor proliferation pathways and immune escape. Conclusion The SLC16A family is closely related to the clinical features and malignant biological behaviors of LUAD and LUSC.

Research advances on undifferentiated connective tissue disease in pregnant women / 中华全科医师杂志

Undifferentiated connective tissue disease (UCTD) has clinical and laboratory characteristics of connective tissue disorders, but it can not meet the diagnostic criteria of any specific disease. Pregnancy complicated with UCTD is one of the most common rheumatic diseases in women of childbearing age. UCTD will increase the risk of adverse events of pregnancy, such as spontaneous abortion, preeclampsia, fetal growth restriction, small for gestational age,recurrent implantation failure and so on. Pregnancy may lead to recurrence, aggravation and even serious complications of UCTD; multidisciplinary monitoring and appropriate treatment can improve the pregnancy outcome.

Effective substance and mechanism of Ziziphi Spinosae Semen extract in treatment of insomnia based on serum metabolomics and network pharmacology / 中国中药杂志

This study aims to study the effective substance and mechanism of Ziziphi Spinosae Semen extract in the treatment of insomnia based on serum metabolomics and network pharmacology. The rat insomnia model induced by p-chlorophenylalanine(PCPA) was established. After oral administration of Ziziphi Spinosae Semen extract, the general morphological observation, pentobarbital sodium-induced sleep test, and histopathological evaluation were carried out. The potential biomarkers of the extract in the treatment of insomnia were screened by ultra-high performance liquid chromatography-mass spectrometry(UHPLC-MS) combined with multivariate analysis, and the related metabolic pathways were further analyzed. The "component-target-pathway" network was constructed by ultra-high performance liquid chromatography coupled with quadrupole-Exactive mass spectrometry(UHPLC-Q-Exactive-MS/MS) combined with network pharmacology to explore the effective substances and mechanism of Ziziphi Spinosae Semen in the treatment of insomnia. The results of pentobarbital sodium-induced sleep test and histopathological evaluation(hematoxylin and eosin staining) showed that Ziziphi Spinosae Semen extract had good theraputic effect on insomnia. A total of 21 endogenous biomarkers of Ziziphi Spinosae Semen extract in the treatment of insomnia were screened out by serum metabolomics, and the metabolic pathways of phenylalanine, tyrosine and tryptophan biosynthesis, phenylalanine metabolism, and nicotinate and nicotinamide metabolism were obtained. A total of 34 chemical constituents were identified by UHPLC-Q-Exactive-MS/MS, including 24 flavonoids, 2 triterpenoid saponins, 4 alkaloids, 2 triterpenoid acids, and 2 fatty acids. The network pharmacological analysis showed that Ziziphi Spinosae Semen mainly acted on target proteins such as dopamine D2 receptor(DRD2), 5-hydroxytryptamine receptor 1 A(HTR1 A), and alpha-2 A adrenergic receptor(ADRA2 A) in the treatment of insomnia. It was closely related to neuroactive ligand-receptor interaction, serotonergic synapse, and calcium signaling pathway. Magnoflorine, N-nornuciferine, caaverine, oleic acid, palmitic acid, coclaurine, betulinic acid, and ceanothic acid in Ziziphi Spinosae Semen may be potential effective compounds in the treatment of insomnia. This study revealed that Ziziphi Spinosae Semen extract treated insomnia through multiple metabolic pathways and the overall correction of metabolic disorder profile in a multi-component, multi-target, and multi-channel manner. Briefly, this study lays a foundation for further research on the mechanism of Ziziphi Spinosae Semen in treating insomnia and provides support for the development of innovative Chinese drugs for the treatment of insomnia.

Evaluation of taste changes of Scutellariae Radix before and after wine-frying based on electronic ongue technology and its application in identification of Scutellariae Radix pieces / 中国中药杂志

Scutellariae Radix(Huangqin) is a well-known traditional Chinese medicine(TCM) used for the treatment of clearing heat in clinical application. It is bitter-cold by using directly, but the bitter-cold property can be relieved after wine-frying. The study of taste changes before and after wine-frying of Scutellariae Radix is of great significance in identifying Scutellariae Radix and wine-processed Scutellariae Radix and clarifying the traditional theory of wine-processing. In this experiment, 10 batches of Scutellariae Radix and wine-processed Scutellariae Radix were prepared. The contents of 5 flavonoids were determined by high performance liquid chromatography(HPLC), and principal component analysis(PCA) was performed with 5 flavonoids as variables. As a result, the contents were different in different batches of Scutellariae Radix, but Scutellariae Radix and wine-processed Scutellariae Radix could not be distinguished. Five sensory attributes(sour, salty, fresh, sweet, and bitter) were evaluated by artificial tasting, and the response values of 7 sensors(AHS, AHS, PKS, CTS, NMS, CPS, ANS, SCS) representing the taste of pieces were detected by electronic tongue. The correlation between sensory evaluation and response values of the electronic tongue were analyzed, and the results showed that the sensory evaluation of sour, salty, fresh, sweet, bitter and AHS, CTS, NMS, ANS, SCS sensors had different degrees of correlation, indicating that the electronic tongue technology can be used as an alternative to artificial taste and can serve as a means for quantifying the taste, and it can be used to evaluate the taste of TCM pieces. The taste method was used to analyze the response values of the electronic tongue, and the results showed that the bitterness of wine-processed Scutellariae Radix decreased and the salty taste increased. PCA was used to analyze taste changes before and after wine-processed Scutellariae Radix, and the results showed that taste differences between 2 pieces were divided into 2 categories. PCA loading scattering plots showed that response of saltiness and bitterness were the major factors to affect overall taste in Scutellariae Radix and wine-processed Scutellariae Radix. Based on electronic tongue response values, the Fisher discriminant model for Scutellariae Radix and wine-processed Scutellariae Radix was established, which showed that it could effectively discriminate them with a recognition rate of 100%. The experimental results showed that the electronic tongue combined with multivariate statistical analysis can be used to evaluate taste of TCM, at the same time, it could provide a fast and simple method for identifying different processed products.

Recent progress of robots in stomatology / 华西口腔医学杂志

With the development of industrial robot technology, robotics has entered the medical field, and the research and development of new robots for many medical applications have become a significant research direction in global robotics. Robots are widely used in various aspects of dentistry, such as prosthodontics, orthodontics, implants, endodontics, and oral surgery. This article mainly introduces the application of robots in stomatology from the above five aspects.

Intelligence structure and clinical features of school-age children with attention deficit hyperactivity disorder and specific learning disorder / 中国当代儿科杂志

OBJECTIVE@#To study the intelligence structure and clinical features of children with attention deficit hyperactivity disorder (ADHD) and specific learning disorder (SLD).@*METHODS@#A retrospective analysis was performed on 88 school-age children with ADHD. According to the presence or absence of SLD, they were divided into two groups: simple ADHD group with 45 children and ADHD+SLD group with 43 children. Intelligence structure and clinical features were compared between the two groups.@*RESULTS@#Compared with the simple ADHD group, the ADHD+SLD group had significantly lower verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ), and full intelligence quotient (FIQ) (P<0.05), significantly lower scores of VIQ factors (including information, similarities, arithmetic, and recitation) (P<0.05), and significantly lower scores of PIQ factors (including picture completion, picture arrangement, block design, and object assembly) (P<0.05). The development of SLD was negatively correlated with FIQ, VIQ, and PIQ. It was also negatively correlated with the scores of intelligence structure factors (including information, similarities, arithmetic, recitation, picture completion, picture arrangement, block design, and object assembly) (P<0.05).@*CONCLUSIONS@#Children with ADHD and SLD have poorer FIQ, VIQ, and PIQ than those with ADHD alone, which mainly manifests as the weak abilities of most intelligence structure factors. It is necessary to pay attention to the management and intervention of SLD in school-age children with ADHD.

Comparison of maternal and neonatal outcomes between 5-minute immediate cesarean section and emergency cesarean section / 中华全科医师杂志

Objective:To compare the maternal and neonatal outcomes between 5-minute immediate cesarean section and emergency cesarean section.Methods:One hundred and seven puerperas who underwent 5-minutes cesarean section in Jinan University Affiliated Shenzhen Bao′an Maternal and Child Health Hospital during the period of January 2018 to December 2019(immediate cesarean section group), and 214 puerperas who underwent emergency cesarean section in the same period (emergency cesarean section group) were enrolled in the study. The top five indications of 5-minute immediate cesarean section were severe fetal distress ( n=26), complete placental abruption ( n=22), massive hemorrhage from placenta previa ( n=18), severe oligohydramnios ( n=10) and severe eclampsia ( n=9); while the top five indications of emergency cesarean section were mild and moderate fetal distress ( n=58), breech position ( n=17), mild and moderate eclampsia ( n=16), fetal head depression and stagnation ( n=16), oligohydramnios ( n=16). The hemorrhage 2 hours after parturition, cost of hospitalization, postpartum heart rate and blood pressure, Apgar score and death were compared between two groups. The influencing factors on NICU admission rate was analyzed with multivariate logistic regression analysis. Results:The volume of hemorrhage 2 hours after parturition and cost of hospitalization in the immediate cesarean section group were significantly higher than those in the emergency cesarean section group ( t=4.48, P<0.05; t=2.05, P=0.04). There was no significant difference in heart rate and blood pressure between the two groups ( t=0.23, P=0.82; t=-0.12, P=0.90; t=0.34, P=0.73). The 1 min Apgar score and 5 min Apgar score were lower in the immediate cesarean section group than those in the emergency cesarean section group ( t=-6.12, P<0.05; t=-3.61, P<0.05). The rate of NICU admission in the immediate cesarean section group was higher than that of the emergency cesarean section group (χ 2=11.95, P<0.05). The binary logistic regression analysis showed the influencing factors on neonatal admission to NICU were neonatal birth weight ( OR=1.31,95 %CI:1.06-1.62, P<0.05), gestational age ( OR=1.40, 95 %CI:1.11-2.40, P<0.05) and the way of cesarean section ( OR=2.32, 95 %CI:1.15-4.78, P<0.05). Conclusion:The puerparas undergoing 5-minutes immediate cesarean are prone to postpartum hemorrhage, and increased neonatal NICU admission. The management for acute and critically ill pregnant women needs to be further strengthened.

Effect of antitubercular treatment on the pregnancy outcomes and prognoses of patients with genital tuberculosis / 医学前沿

This retrospective study aims to demonstrate the effect of antitubercular treatment (ATT) on the pregnancy outcomes and prognoses of patients with genital tuberculosis (GTB) who had received laparoscopy and/or hysteroscopy. This study included 78 patients with infertility and who were diagnosed with GTB through laparoscopy and/or hysteroscopy over the period of November 2005 to October 2015. The recruited patients were divided into ATT and nonATT groups on the basis of ATT duration. The GTB recurrence rates, menstrual patterns, and pregnancy outcomes of the patients were determined at follow-up. Among the 78 patients, 46 received ATT and 32 did not receive ATT. The menstrual volumes of patients in the ATT group significantly decreased relative to those of patients in the nonATT group. GTB did not recur among all patients regardless of treatment. A total of 11 pregnancies (36.7%) in the ATT group and 19 pregnancies (63.3%) in the nonATT group were observed. Pregnancy rates significantly differed (P = 0.002) between the two groups. ATT may decrease the menstrual volume and pregnancy rates of patients who were diagnosed with GTB through laparoscopy and/or hysteroscopy. In addition, ATT did not improve the prognosis of patients with chronic GTB.

Predictors related to condom use behaviors based on the theory of planned behavior among female sex workers / 中华疾病控制杂志

Objective To identify predictors related to condom use in different tiered female sex workers (FSWs) in Hubei Province. Methods A cross-sectional study was conducted in Hubei Province in 2015 to investigate 816 eligible FSWs by using a multistage sampling method. All data were collected by using a structured questionnaire with scales on condom use, which was designed based on the theory of planned behavior (TPB). A structural equation model (SEM) was used to identify predictors of condom use in the different tiered FSWs. Results It showed that low-tier FSWs used less condom than higher-tier FSWs in commercial sexual behaviors of the last time and during the last month(P<0.001). The TPB scores were significantly different in different tiered FSWs. The scores of PBC in low-tier FSWs were lower than those in higher-tier FSWs (11.43±2.86 vs 12.06±2.87, respectively, P=0.002); But the scores of behavioral intentions were higher than those in higher-tier FSWs (5.47±1.11 vs 5.20±1.15, respectively, P=0.001). The PBC was the major factor related to condom use in low-tier FSWs (effect coefficient=0.55, P<0.001), while the behavioral intention was the major factor related to condom use in higher-tier FSWs (effect coefficient=0.33, P<0.001). Behavioral attitude was the major factor of intention to use condoms for both low-tier (effect coefficient=0.49, P<0.001) and higher-tier FSWs (effect coefficient=0.42, P<0.001). Conclusions Changing the attitude to condom use in FSWs is an important measure to promote the behavior intention. Condom promotion interventions should focus on the perceived behavioral control in low-tier FSWs, and promote the behavior intention in higher-tier FSWs.

Pathogens and clinical features of preterm infants with sepsis / 中国当代儿科杂志

OBJECTIVE@#To investigate the pathogen composition and clinical features of preterm infants with sepsis, and to provide a basis for early identification and treatment of sepsis in preterm infants.@*METHODS@#A retrospective analysis was performed for the clinical data of 371 preterm infants with sepsis who had a positive blood culture between January 2014 and May 2018. According to the time of onset, the preterm infants were divided into an early-onset group (an age of onset of <7 days) with 73 preterm infants and a late-onset group (an age of onset of ≥7 days) with 298 preterm infants. The two groups were compared in terms of pathogen composition and clinical features (initial symptoms, laboratory examination results at the time of onset, comorbidities, and prognosis).@*RESULTS@#There was a higher proportion of infants with Klebsiella pneumoniae infection in the late-onset group (P<0.05), while there was a higher proportion of infants with Escherichia coli, Streptococcus agalactiae or Listeria infection in the early-onset group (P<0.05). The early-onset group had a significantly higher proportion of infants with dyspnea than the late-onset group (P<0.05). Compared with the late-onset group, the early-onset group had significantly shorter time to negative conversion of blood culture, duration of antibiotic use before infection, and indwelling time of deep venous catheterization (P<0.05), and the late-onset group had a significantly higher incidence rate of neonatal necrotizing enterocolitis than the early-onset group (P<0.05). The early-onset group had a significantly higher rate of treatment withdrawal than the late-onset group (P<0.05).@*CONCLUSIONS@#Preterm infants with sepsis lack typical clinical manifestations and laboratory examination results at the time of onset. There are certain differences in pathogen composition and clinical features between preterm infants with early- and late-onset sepsis. Possible pathogens for sepsis should be considered based on age in days at the time of onset and related clinical features.

Causes of chronic cough in children in Chongqing, China: an analysis of 202 cases / 中国当代儿科杂志

OBJECTIVE@#To investigate the constitution of causes of chronic cough in children.@*METHODS@#The clinical data of 202 children with chronic cough who were hospitalized in the Affiliated Children's Hospital of Chongqing Medical University from May 2015 to November 2017 were retrospectively analyzed.@*RESULTS@#As for the causes of chronic cough in the 202 children, 81 (40.1%) had post-infection cough (PIC), 71 (35.1%) had cough variant asthma (CVA), 43 (21.3%) had upper airway cough syndrome (UACS), 3 (1.5%) had foreign body aspiration, 1 (0.5%) had gastroesophageal reflux cough, 2 (1.0%) had Tourette syndrome, and 1 (0.5%) had congenital respiratory disorders. Of the 202 children, 119 (58.9%) had chronic cough caused by a single factor and 83 (41.1%) had chronic cough caused by multiple factors. There was a significant difference in the constitution of causes of chronic cough among the children with different ages (<1 year, ≥1 year, ≥3 years and 6-14 years) or natures of cough (wet cough and dry cough) (P<0.01).@*CONCLUSIONS@#The top three causes of chronic cough in children are PIC, CVA and UACS. There are significant differences in the main causes of chronic cough between children with different ages and between those with different natures of cough.

Clinical significances of JAK2 mutation in patients with polycythemia vera / 中国肿瘤临床

Polycythemia vera (PV) is a myeloproliferative neoplasm (MPN) characterized by overproduction of red blood cells. The pathogenesis of PV is not completely understood. However, studies report that it may be associated with the gain-of-function somatic mutation of JAK2 and that the JAK2 mutation provides a molecular diagnostic standard for PV. JAK2 mutation and allele mutation bur-den are useful for predicting clinical features and courses. The discovery of JAK2 mutation has promoted the development of molecu-lar-targeted therapy, such as the JAK2 inhibitor, ruxolitinib, a drug with superior therapeutic effect and safety that is used in clinical practice. The JAK2 allele mutation burden is closely associated with leukocytosis and progression to myelofibrosis (MF). A high JAK2 al-lele mutation burden may be a risk factor for poor prognosis. This article briefly reviews the clinical significance of the JAK2 mutation in patients with PV.

Choroidal thickness changes in macular area and facular area of patients with diabetic retinopathy after panretinal photocoagulation / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To investigate the choroidal thickness changes in macular area and facular area of patients with diabetic retinopathy ( DR) after panretinal photocoagulation (PRP). METHODS: Totally 40 cases (78 eyes) of DR patients with PRP in our hospital from January 2015 to January 2017 were selected, and optical coherence tomography (OCT) was conducted for preoperative and postoperative choroidal thickness in macular area and facular area. RESULTS: At 1mo after PRP, the subfoveal choroidal thickness (SFCT), nasal choroidal thickness (NCT), the temporal choroidal thickness (TCT), superior choroidal thickness (SCT),inferior choroidal thickness(ICT) were sharply higher than those before operation, the difference was statistically significant(t=2.016,t=2 017, t=2.001, t=2.264, t=2.229;P<0.05). SFCT,NCT,TCT, SCT and ICT at postoperative 3mo sharply decreased when compared to those before operation, showing statistical significance (t=2.048, t=2.051, t=2.092, t=2 010, t=2.273; P<0.05). Postoperative baseline level average choroidal thickness in facular area of 227. 6士44 9μ m was evidently higher than that at postoperative 1mo (207.1士41.6μ m),the difference had statistical points (t=2.118, P<0.05). The mean thickness at postoperative 3mo (206. 5士41. 3μ m) was apparently lower than the baseline level mean choroidal thickness 227.6士44.9μ m, the difference showed statistical significance(t=2.188,P<0.05). CONCLUSION: The choroid thickness at macular region rises obviously for short term after PRP, while that in facula area reduces markedly, which shows choroidal blood flow redistribution after operation.

A review of the relationship between gut microbiome and necrotizing enterocolitis in preterm infants / 中国当代儿科杂志

Necrotizing enterocolitis (NEC) is a common severe gastrointestinal disease in preterm infants. The morbidity and mortality of NEC are negatively correlated with the gestational age and birth weight. In addition to causing a variety of gastrointestinal complications, NEC can also cause neurodevelopmental impairment. Recently, many studies have found that gut microbiome dysbiosis plays an important part in the pathogenesis of NEC. It is helpful to explore the relationship between gut microbiome and NEC for the early diagnosis and severity prediction of NEC. Researchers have paid much attention to the role of probiotics in reducing the morbidity and mortality of NEC in preterm infants. It's controversial as to whether probiotics is effective and safe in clinical application. This article will review the relationship between the development of gut microbiome and NEC in preterm infants, as well as the preventive effect of probiotics on NEC.

Effect of early application of recombinant human erythropoietin on white matter development in preterm infants / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of early application of recombinant human erythropoietin (rhEPO) on white matter development in preterm infants using fractional anisotropy (FA) of magnetic resonance diffusion tensor imaging (DTI).</p><p><b>METHODS</b>A total of 81 preterm infants with gestational age ≤32 weeks, birth weight <1 500 g, and hospitalization within 24 hours after birth were randomly divided into rhEPO group (42 infants) and control group (39 infants). The infants in the rhEPO group were administered rhEPO, while those in the control group were given the same volume of normal saline. The preterm infants of both groups took examinations of head magnetic resonance imaging, diffusion-weighted imaging, and DTI at the corrected gestational age of 35-37 weeks. FA was calculated for the regions of interest in both groups.</p><p><b>RESULTS</b>There was no significant difference in the incidence of intracranial hemorrhage, periventricular leukomalacia, focal cerebral white matter damage (CWMD), and extensive CWMD between rhEPO and control groups (P>0.05). Compared with the control group, the rhEPO group showed higher FA values at the posterior limb of the internal capsule, the splenium of the corpus callosum, frontal white matter, and occipital white matter (P<0.05). There was no significant difference in FA values at the parietal white matter, thalamus, lenticular nucleus, and caudate nucleus between the two groups (P>0.05).</p><p><b>CONCLUSIONS</b>Early application of rhEPO has a neuroprotective effect on white matter development in preterm infants.</p>

Determination of three pair of triterpenoid isomers in leaf of Ilex hainanensis by HPLC-ELSD / 中国中药杂志

The present study is to develop an HPLC-ELSD method for simultaneous determination of three pairs of triterpenoid isomers, Ilexsaponin A₁, Ilexhainanoside D, Ilexgenin A, 3β, 19α-dihydroxyolean-12-ene-24, 28-dioic acid (ilexhainanin E) ursolic acid and oleanic acid in the leaf of Ilex hainanensis, which could provide evidence to the quality control of this herb. The six constituents were measured on a Waters XBridge C₁₈ column (4.6 mm×250 mm, 5 μm), with a mobile phase consisting of methanol (A)- 0.5% formic acid in water (B) at a flow rate of 1.0 mL·min⁻¹ (0-18 min，70%-85% A，18-20 min，85%-95% A；20-35 min，95% A). The carrier gas was N₂, and the pressure was 2.8 L·min⁻¹. The drift tube in this experiment were set at 70 °C. The injection volume was 10 μL. The contents of the six triterpenoids in 6 samples were 3.7-8.5, 10.3 -22.1, 2.8-5.9, 7.8-14.1, 2.6-3.8 and 8.8-11.9 mg·g⁻¹, respectively. The established method is proved to be accurate and sensitive for the determination of triterpenoids in Ilicis Hainanensis Folium, and may be used for the quality improvement of this herb.

A review on the role of γ-aminobutyric acid signaling pathway in autism spectrum disorder / 中国当代儿科杂志

The etiology and pathogenesis of autism spectrum disorder (ASD) are not yet clear. Studies have shown that there are many neurotransmitter abnormalities in children with ASD, mainly involving in glutamate, γ-aminobutyric acid (GABA), dopamine, 5-HT and oxytocin. The imbalance of excitatory glutamatergic neurotransmitters and inhibitory GABAergic neurotransmitters is closely related to the pathogenesis of ASD. Both animal model studies and clinical studies on ASD suggest that GABA signaling pathway may play an important role in the pathogenesis of ASD. This article reviews the research on the association between GABA signaling pathway and the pathogenesis of ASD to further explore the pathogenesis of ASD and provide theoretical basis for the treatment of ASD.