Efficacy and safety of low-dose rituximab in treatment of pediatric nephrotic syndrome: a prospective randomized controlled trial / 中国当代儿科杂志

OBJECTIVES@#To study the efficacy and safety of repeated application of rituximab (RTX) at a low dose (200 mg/m2) versus the recommended dose (375 mg/m2) for remission maintenance in frequently relapsing nephrotic syndrome (FRNS) or steroid-dependent nephrotic syndrome (SDNS).@*METHODS@#A randomized controlled trial was conducted for 29 children with FRNS/SDNS who received systemic treatment in the Department of Nephrology, Anhui Provincial Children's Hospital, from September 2020 to December 2021. These children were divided into a recommended dose group (n=14) and a low dose group (n=15) using a random number table. The two groups were compared in terms of general characteristics, changes in CD19 expression after RTX treatment, number of relapses, glucocorticoid dose, adverse reactions of RTX, and hospital costs.@*RESULTS@#After RTX treatment, both the low dose group and the recommended dose group achieved B-lymphocyte depletion and had significant reductions in the number of relapses and glucocorticoid dose (P<0.05). The low dose group had a comparable clinical effect to the recommended dose group after RTX treatment (P>0.05), and the low dose group had a significant reduction in hospital costs for the second, third, and fourth times of hospitalization (P<0.05). There were no serious adverse reactions in either group during RTX treatment and late follow-up, and there was no significant difference in adverse reactions between the two groups (P>0.05).@*CONCLUSIONS@#Repeated RTX treatment at a low dose has comparable clinical efficacy and safety to that at the recommended dose and can significantly reduce the number of FRNS/SDNS relapses and the amount of glucocorticoids used, with little adverse effect throughout the treatment cycle. Therefore, it holds promise for clinical application.

Diagnosis and training by imaging technology in knee injuries in basketball / Diagnóstico e treinamento por tecnologia de imagem em traumatismos do joelho no basquetebol / Diagnóstico y entrenamiento mediante tecnología de imagen en lesiones de rodilla en baloncesto

ABSTRACT Introduction: The research and development of new methods of injury diagnosis and rehabilitation training in benefits to the health and training of athletes is a contemporary priority. Among modern techniques, diagnostic imaging technology stands out. Objective: Study the auxiliary effect of imaging technology in the diagnosis and rehabilitation training of functional knee joint injuries in basketball practice. Methods: 50 basketball players diagnosed and treated in the past four years for knee joint function injuries in a special hospital were selected, including 28 male and 22 female athletes, aged 17 to 25 years. PerkinElmer Spotlight-300 FTIR spectral imaging system was used to scan the articular cartilage sections, visible light and total absorption images of the samples were obtained by reflection mode imaging. Results: The peak infrared feature of the articular cartilage measured by the infrared spectrum imaging technology is very consistent with the FTIR spectrum. After rehabilitation training, the Y test score of female patients increased from 96.72 ± 6.05 to 105.40 ± 4.23, and the Y test score of male patients increased from 98.34 ± 5.33 to 105.51 ± 4.89, showing significant differences. Conclusion: Infrared spectrum imaging technology is an effective technique for identifying functional knee joint injury, and is of great use for diagnosis and training update in basketball players with knee trauma. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: A pesquisa e o desenvolvimento de novos métodos de diagnóstico de lesões e treinamento de reabilitação em benefícios para a saúde e o treinamento dos atletas é uma prioridade contemporânea. Entre as técnicas modernas, destaca-se o diagnóstico por tecnologia de imagem. Objetivo: Estudar o efeito auxiliar da tecnologia de imagem no diagnóstico e treinamento de reabilitação das lesões funcionais das articulações do joelho na prática do basquetebol. Métodos: Foram selecionados 50 jogadores de basquetebol diagnosticados e tratados nos últimos quatro anos por lesões da função articular do joelho em um hospital especial, incluindo 28 atletas masculinos e 22 atletas femininos, com idade entre 17 e 25 anos. O sistema de imagem espectral PerkinElmer Spotlight-300 FTIR foi usado para escanear as seções de cartilagem articular, a luz visível e as imagens de absorção total das amostras foram obtidas através da imagem em modo de reflexão. Resultados: O pico da característica infravermelha da cartilagem articular medida pela tecnologia de imagem de espectro infravermelho é muito consistente com o espectro FTIR. Após o treinamento de reabilitação, o escore do teste Y de pacientes do sexo feminino aumentou de 96,72 ± 6,05 para 105,40 ± 4,23, e o escore do teste Y de pacientes do sexo masculino aumentou de 98,34 ± 5,33 para 105,51 ± 4,89, mostrando diferenças significativas. Conclusão: A tecnologia de imagem de espectro infravermelho é uma técnica eficaz para identificar a lesão funcional da articulação do joelho, sendo de grande utilidade para o diagnóstico e atualização de treinamento em praticantes de basquetebol com traumatismos no joelho. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción: La investigación y el desarrollo de nuevos métodos de diagnóstico de lesiones y entrenamiento de rehabilitación en beneficios para la salud y el entrenamiento de los deportistas es una prioridad contemporánea. Entre las técnicas modernas destaca el diagnóstico por tecnología de imagen. Objetivo: Estudiar el efecto auxiliar de la tecnología de imagen en el diagnóstico y entrenamiento de rehabilitación de lesiones funcionales de la articulación de la rodilla en la práctica del baloncesto. Métodos: Se seleccionaron 50 jugadores de baloncesto diagnosticados y tratados en los últimos cuatro años por lesiones funcionales de la articulación de la rodilla en un hospital especial, incluidos 28 atletas de sexo masculino y 22 de sexo femenino, con edades comprendidas entre los 17 y los 25 años. Se utilizó el sistema de imágenes espectrales FTIR PerkinElmer Spotlight-300 para escanear las secciones de cartílago articular, y se obtuvieron imágenes de luz visible y de absorción total de las muestras mediante imágenes en modo de reflexión. Resultados: El pico infrarrojo del cartílago articular medido mediante la tecnología de imagen de espectro infrarrojo es muy coherente con el espectro FTIR. Tras el entrenamiento de rehabilitación, la puntuación de la prueba Y de las pacientes femeninas aumentó de 96,72 ± 6,05 a 105,40 ± 4,23, y la puntuación de la prueba Y de los pacientes masculinos aumentó de 98,34 ± 5,33 a 105,51 ± 4,89, mostrando diferencias significativas. Conclusión: La tecnología de imágenes del espectro infrarrojo es una técnica eficaz para identificar lesiones funcionales de la articulación de la rodilla, y es de gran utilidad para el diagnóstico y la actualización del entrenamiento en jugadores de baloncesto con traumatismo de rodilla. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

An investigation on serum antibody level of varicella-zoster virus in healthy population in Beijing / 中华预防医学杂志

Objective: To assess the level and trend of varicella-zoster virus (VZV) antibody among healthy population in Beijing in 2017, after the five-year implementation of the two doses varicella vaccination strategy in 2012, and to provide evidence for scientific evaluation of immunization strategy. Methods: A total of 2 144 subjects in ten age groups from 8 districts of Beijing city were recruited in this study using cross-sectional survey based on multi-stage cluster random sampling method. Serum samples were collected and VZV antibody was detected by ELISA. The influencing factors of antibody concentration and positive rate were analyzed and compared with the study in 2012. The antibody concentration and antibody positive rate were analyzed by nonparametric test and χ² test respectively. Results: The ratio of subjects with registered residence in Beijing city to other provinces was 1∶1. The ratio of male to female was 1∶1.08. The median concentration of VZV antibody was 341.4 (78.6, 1 497.8) mIU/ml, and the total antibody positive rate was 71.1% (1 524/2 144). There were significant differences in antibody positive rate (χ²=736.39, P<0.01) and antibody concentration (χ²=740.34, P<0.01) among different age groups. The antibody positive rate generally increased with age (χ²trend=7.32, Ptrend<0.01). Among 862 children under 14 years old, the antibody positive rate of two doses vaccination 72.8% (182/250) was significantly higher than that of one dose vaccination 51.9% (154/297) (χ²=25.14, P<0.01). There was significant difference between 1-4 years old group (χ²=11.71, P<0.01) and 10-14 years old group (χ²=5.95, P=0.02), but not in 5-9 years old group (χ²=3.00, P=0.07). Compared with the study in 2012, the antibody positive rate increased in 5-9 years old group (χ²=14.35, P<0.01) and decreased in 1-4 years old group (χ²=11.51, P=0.01) in 2017. Conclusion: The recommended varicella booster vaccination has significantly improved the VZV antibody level of children in Beijing city. In the future, it is necessary to explore a more optimized two doses varicella vaccination schedule for children in combination with epidemiological evidence.

A case control study:the treatment of cervical vertigo with micro needle knife / 中国骨伤

OBJECTIVE@#To observe the clinical efficacy of micro needle knife therapy on cervical vertigo.@*METHODS@#A total of 300 patients with cervical vertigo treated from January 1, 2017 to December 31, 2019 were randomly divided into micro needle knife group (96 cases, 4 cases falling off), traditional acupuncture group (96 cases, 4 cases falling off) and oral drug group(95 cases, 5 cases falling off). The micro needle knife group was treated with micro needle knife in the local upper cervical segment once every other day for 7 times; the traditional acupuncture group was treated with traditional acupuncture once a day for 2 weeks;the oral drug group was given Merislon (betahistine mesilate tablets) orally, 6 mg each time, 3 times a day for 2 weeks. The patients were followed up before treatment, at the end of treatment and 3 months after treatment. The dizziness handicap inventory(DHI) was observed and the curative effect was evaluated according to the DHI score.@*RESULTS@#At the end of the course of treatment and 3 months after the treatment, DHI scores of the three groups were significantly lower than those before treatment(P<0.01), and the DHI scores of micro needle knife group were lower than those of traditional acupuncture group and oral drug group at the same time point after treatment (P<0.01). There was no statistically significant difference in DHI scores between traditional acupuncture group and oral drug group at the same time after treatment(P< 0.05). The curative effect was evaluated according to DHI score:in micro needle knife group, 50 cases were cured, 28 cases were markedly effective, 14 cases were improved, the total effective rate was 95.83%; in traditional acupuncture group, 28 cases were cured, 26 cases were markedly effective, and 24 cases were improved, with the total effective rate of 81.25%;in oral drug group, 18 cases were cured, 20 cases were markedly effective, and 28 cases were improved, with the total effective rate of 69.47%. The total effective rate of micro needle knife group was significantly higher than that of other two groups (χ2=45.956, P=0.000). Among the cured patients in the three groups, the time required in the micro needle knife group was significantly less than that in the traditional acupuncture group and oral drug group(F=18.796, P=0.000).@*CONCLUSION@#Micro needle knife loosening atlantoaxial soft tissue has obvious curative effect on cervical vertigo which clinical cure rate, effective rate and treatment time required for cured patients are better than traditional acupuncture and oral drug.

Evaluation of factors for predicting risk of uveitis recurrence in Behcets disease patients

This study aimed to investigate the predictive factors for uveitis recurrence (UR) risk in Behcet's disease (BD) patients. BD patients (n=164) with a history of uveitis were recruited, and demographic data, clinical features, and laboratory tests were recorded. Uveitis was defined as anterior uveitis, intermediate uveitis, posterior uveitis, panuveitis referring to the "International Uveitis Study Group recommendations for the evaluation of intraocular inflammatory disease". In total, there were 70 UR patients and 94 non-UR patients. Compared to non-UR patients, UR patients appeared to be older and presented with increased uveitis occurrence rate and times within 3 months, oral ulcers occurrence rate, as well as higher concentrations of triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL), and serum amyloid A (SAA). Multivariate logistic model disclosed that uveitis occurrence times within 3 months, oral ulcers, TG, LDL, and SAA independently predicted higher risk of UR. Furthermore, receiver operating characteristic curve analysis showed that the combination of uveitis occurrence times within 3 months, oral ulcers, TG, LDL, and SAA exhibited a high predictive value for UR risk with an area under the curve of 0.983 (95%CI: 0.969−0.998). In conclusion, uveitis occurrence times within 3 months, oral ulcers, TG, LDL, and SAA might be potential predictive factors for UR risk in BD patients, which can help in prevention and management of the disease.

Efficacy and safety of metformin for Behcet's disease and its effect on Treg/Th17 balance: a single-blinded, before-after study / 南方医科大学学报

OBJECTIVE@#Behcet's disease (BD) is an autoimmune disorder that causes most commonly mouth and genital ulcerations and erythema nodules of the skin and currently has limited options of therapeutic medicines. Metformin is recently reported to suppress immune reaction, and we hypothesized that metformin could be an option for treatment of BD.@*METHODS@#Thirty patients with BD were enrolled in this perspective single-blinded, before-after study. We recorded the changes in the mucocutaneous activity index for BD (MAIBD), relapse frequency, C-reactive protein (CRP) level and erythrocyte sedimentation rate (ESR) after metformin treatment to assess the changes in the disease activity. We also analyzed the changes in the protein and mRNA expression levels of Foxp3, interleukin-35 (IL-35), transforming growth factor-β (TGF-β), Ror-γt, IL-17, and tumor necrosis factor- (TNF-) in these patients using ELISA and qRT-PCR.@*RESULTS@#Of the 30 patients enrolled, 26 completed the trial. After the treatment, favorable responses were achieved in 88.46% (23/26) of the patients, and partial remission was obtained in 11.54% (4/26) of them. During the treatment, 8 patients complained of gastrointestinal side effects, for which 4 chose to withdraw from the study in the first week. Our results showed that metformin treatment decreased MAIBD and relapse frequency in the patients, and significantly lowered the clinical inflammatory indexes including CRP and ESR. The results of ELISA and qRT-PCR revealed that metformin treatment obviously increased Foxp3 and TGF-β expressions at both the protein and mRNA levels and significantly decreased the levels of ROR-γt, IL-17 and TNF- as well as IL-35 level in these patients.@*CONCLUSIONS@#Metformin treatment relieves the clinical symptoms, reduces the inflammatory reaction indexes and regulates the Treg/Th17 axis in patients with BD, suggesting the potential of metformin as a candidate medicine for treatment of BD.

Mechanisms of Hirudo in promoting blood circulation and removing stasis based on network pharmacology / 中国中药杂志

The study aims to analyze the mechanisms of Hirudo in promoting blood circulation and removing blood stasis based on network pharmacology. A database of chemical components of Hirudo was established through literature retrieval. The targets were predicted by using the reverse pharmacophore matching method and screened according to the antithrombotic and anticoagulant drug targets approved by FDA in the DrugBank database. Then, the targets were analyzed by KEGG pathway analysis, the protein interactions were analyzed by using BioGrid database, and the active constituents-target-pathway network model of Hirudo was established to study the mechanisms of Hirudo in promoting blood circulation and removing blood stasis. This study collected 49 chemical components of Hirudo, including amino acid, polypeptide, fatty acid ester, alkaloid, glycosides, and steroid. Totally 376 targets were predicted, and 5 critical targets related to the effects of Hirudo in promoting blood circulation and removing blood stasis were screened, including fibrinogen gamma chain, plasminogen, prothrombin, Urokinase-type plasminogen activator and coagulation factor X. The potential regulatory pathways included complement and coagulation cascades, platelet activation, VEGF signaling pathway, focal adhesion. This study reflects the multi-component, multi-target and multi-pathway features of Hirudo, and provides a scientific basis for elucidating the mechanisms of action of Hirudo in promoting blood circulation and removing blood stasis, as well as a reference for the study of mechanisms of traditional Chinese medicine.

Biological assay in quality control of animal medicines / 中国中药杂志

Animal medicine is a unique part of traditional Chinese medicine. They have strong effects, but their effective compounds are not entirely known. The efficiency and safety of animal medicines can't be effectively controlled by current quality assurance system and evaluation method, which has deeply influenced the development of animal medicines. Biological assay does not focus on efficacy of single component, but directly reflects the pharmacodynamics and safety of animal medicines by biological effect. With the development of biotechnology, many new technologies have emerged, such as biochip and high content analysis. Based on the related targets, pathways and key biochemical factors, the field of biological assay has been expanded. With advantages of pharmacology andoverall controllability, as well as the characteristics of in line with the quality control of Chinese Medicine, biological assay will become one of the important development directionsfor quality standardization of animal medicines.

Chemical leukoderma induced by dimethyl sulfate

Abstract Chemical leukoderma occurs due to the toxic effect of a variety of chemical agents. Mechanisms include either destruction or inhibition of melanocytes. We report two male patients (36 and 51 years old) who presented with multiple hypopigmented macules and patches on the neck, wrist, and legs after exposure to dimethyl sulfate in a chemical industry. Physical examination revealed irregular depigmentation macules with sharp edges and clear hyperpigmentation around the lesions. History of repeated exposure to a chemical agent can help the clinical diagnosis of chemical leukoderma. This diagnosis is very important for prognosis and therapeutic management of the disease.

The epidemiological impact of varicella vaccination in kindergartens, primary and secondary schools in Beijing / 中华预防医学杂志

<p><b>OBJECTIVE</b>To study the epidemiological impact of varicella vaccine vaccination on kindergartens and school children in Beijing.</p><p><b>METHODS</b>According to "China Information System for Diseases Control and Prevention", the reported clinical diagnosis varicella cases were tracked in kindergartens, primary and secondary schools whose onset date were from 2008 to 2010. Epidemiological survey was conducted and epidemiological features were analyzed.</p><p><b>RESULTS</b>A total of 21 474 varicella cases were investigated: 55.3% (11 883 cases) had been vaccinated by varicella vaccine. Of cases with definite immunization history, interval between vaccination date and onset date were from 30 days to 1 year accounted for 3.4% (286/8510), 1 to 3 years accounted for 18.2% (1551/8510), 3 to 5 years accounted for 28.6% (2431/8510), 5 to 10 years accounted for 34.3% (2916/8510) (left-closed right-open interval); The peak age of onset was 4 years old in cases without immunization history, which was 6 years old in cases with immunization history; The proportion of cases with immunization history (≥ 30 days) had increased from 42.4% (2862/6754) in 2008 to 56.3% (4327/7679) in 2010. The cases with no fever had a higher proportion (54.9%, 6413/11 679) of immunization history (≥ 30 days) than cases with fever (47.7%, 4533/9500) (P < 0.01); The cases with rashes less than 50 had a higher proportion (57.4%, 8045/14 020) of immunization history (≥ 30 days) than cases with rashes more than 50 (40.2%, 2902/7216) (P < 0.01).</p><p><b>CONCLUSION</b>Varicella vaccine delays the peak age of onset, alleviates the symptoms. The current immunization strategy can not block varicella spread in kindergartens, primary and secondary schools.</p>

Analysis of adverse events following 2009 influenza A (H1N1) vaccinoprophylaxis in Beijing / 中华预防医学杂志

<p><b>OBJECTIVE</b>To evaluate the safety of 2009 influenza A (H1N1) vaccine based on mass immunization initiative in Beijing.</p><p><b>METHOD</b>There were 2 113 280 people were vaccinated during September to December 2009. The information of adverse events following immunization (AEFI) was collected through surveillance system, and descriptive methodology was used for data analysis.</p><p><b>RESULTS</b>A Total of 612 AEFI cases were reported, among which there were 321 vaccine reaction cases following immunization, 203 coincidental illness cases, 82 psychogenic reaction cases, and 6 pending cases. The rates of rare reactions and common reactions associated with vaccination were respectively 5.54/100 000 (117/2 113 280) and 9.65/100 000 (204/2 113 280). The rate of serious rare reaction was 0.19/100 000 (4/2 113 280). The rates of vaccine reactions in urban, suburb and county were 16.87/100 000 (36/213 519), 17.81/100 000 (187/1 049 817) and 11.53/100 000 (98/849 944), respectively. The rates of rare reaction and common reaction in different age groups were between 3.65/100 000 (6/164 604) to 8.99/100 000 (27/300 176), and between 0.61/100 000 (1/164 604) to 22.06/100 000 (85/385 275). The 117 rear vaccine reaction cases were mainly allergic reaction (107 cases), and the 204 common vaccine reaction cases were mainly fever (176 cases). There were 91.90% (295/321) vaccine reactions occurred within 24 hours of administration, and all cases had improved consequence.</p><p><b>CONCLUSION</b>The mostly symptoms of AEFI cases during the period of 2009 influenza A (H1N1) vaccinoprophylaxis were anaphylaxis and fever. The types of adverse reactions and the level of serious events are consistent with the anticipation. There were no rear or new events occurred.</p>

Safety and epidemiological effects of the first China-made mass A (H1N1) influenza vaccination / 中华流行病学杂志

Objective To evaluate the safety and epidemiological effects on the first mass vaccination program, using the China-made A (H1N1) influenza vaccine. Methods Descriptive epidemiology and cohort study design were used to assess the influenza A H1N1 vaccine on its safety and epidemiological effects. Results 95 244 subjects were immunized with A (H1N1) influenza vaccine. 193 adverse events were reported through AEFI Management System, with the Reported rates after immunization was carried out. Of 81 adverse reactions confirmed to be related to immunization,reported through the AEFI Management System. The epidemiological protection rate of A (H1N1)influenza vaccine showed a similar safety profile to seasonal flu vaccine. The vaccine demonstrated a good epidemiological effects against A (H1N1) influenza virus infection.

Research progress of H5N1 influenza viruses and the threat to human / 中南大学学报(医学版)

Human, birds and other mammals can be infected by avian influenza A (H5N1) virus. Bird infections spread among continents in the last 2 years. Human infections become endemic in certain areas, characterized with young patients and high mortality. An unprecedented epizootic avian influenza A (H5N1) virus that is highly pathogenic has crossed the species barrier in Asia to cause many human fatalities and poses an increasing pandemic threat. This summary describes the features of human infection with influenza A (H5N1) in epidemiology and etiology and reviews recommendations for prevention.