Construction of annexin A2 plasmid and its role in the proliferation and migration of bladder cancer pumc-91 cells / 西安交通大学学报(医学版)

【Objective】 Annexin A2 (annexin A2, Anxa2) has been reported to regulate bioactivity in various tumors cells. The purpose of this study was to investigate the correlation between the expression of Anxa2 protein and the proliferation and migration abilities of bladder cancer pumc-91 cells. 【Methods】 The ANXA2 sequence was amplified and inserted into the pcDNA3.1(+) vector in order to prepare the pcDNA3.1(+)-ANXA2 plasmid. PcDNA3.1 (+)-ANXA2 was transiently transfected into pumc-91 bladder cancer cells by lipofectamine 2000. Western blotting assay was performed to detect the expression of Anxa2 protein in the blank group, the control group transfected with pcDNA3.1(+), and the experimental group transfected with pcDNA3.1(+)-ANXA2 plasmid. The proliferation ability of pumc-91 cells was detected using Cell Counting Kit-8(CCK8), and the migration level of pumc-91 cells was detected by transwell assay. Differences in detection data among the groups were compared using one-way ANOVA or repeated measures ANOVA. 【Results】 The plasmid construction was successful and the sequencing was absolutely correct. Western blotting assay showed elevated Anxa2 protein expression level in the experimental group compared to the blank and control groups. CCK8 assay suggested that the number of proliferating pumc-91 cells was significantly higher in the experimental group than in the blank group (P<0.001) and the control group (P=0.001). Transwell assay also showed that the number of pumc-91 cells crossing the membrane was significantly higher in the experimental group than in the blank group (P=0.011) and the control group (P=0.027). 【Conclusion】 Our findings suggested that up-expression of Anxa2 may play a critical role in regulating proliferation and migration of bladder cancer pumc-91 cells.

Effects of different frequencies of pricking-bloodletting at auricular points plus auricular point sticking therapy on the serum levels of related factors in patients with acne vulgaris / 针灸推拿医学（英文版）

Objective: To observe the effects of different frequencies of pricking-bloodletting at auricular points plus auricular point sticking therapy on the levels of the serum immunoglobulin G (IgG), immunoglobulin M (IgM), testosterone (T), and insulin-like growth factor-1 (IGF-1) in patients with acne vulgaris (AV). Methods: Ninety patients with AV were randomly assigned to treatment group 1, treatment group 2, and treatment group 3 according to the random number remainder grouping method, with 30 cases in each group. All three groups received pricking-bloodletting at auricular points plus auricular point sticking therapy. Treatment group 1 was treated once a week, treatment group 2 was treated twice a week, and treatment group 3 was treated 3 times a week. Four-week treatment was taken as 1 treatment course, and 3 treatment courses were observed. On the day before the start of the study and on the day next to the end of each course, the global acne grading system (GAGS) score was recorded, and 3 mL of blood from the median cubital vein was collected to test the serum levels of IgG, IgM, T, and IGF-1. After 3 courses of treatment, the efficacy index was calculated according to the GAGS score, and the serum indicators in patients with effective treatment (efficacy index ≥20％) and complete sampling were analyzed. Results: A total of 60 patients were included in the final blood indicator analysis. After 3 courses of treatment, the intra-group comparisons showed that the serum IgG level increased significantly in patients in treatment group 1 (P<0.01); the serum T level decreased significantly in the female patients in treatment group 2 (P<0.05); the IGF-1 level significantly decreased in the patients in all three groups (P<0.05 or P<0.01). There were no significant differences in the serum levels of IgG, IgM, T, and IGF-1 among the three groups at each time point (P>0.05). Conclusion: Pricking-bloodletting at auricular points plus auricular point sticking therapy can affect the levels of serum IgG, T, and IGF-1 in AV patients. The level of the serum IGF-1 can be reduced by treatment once a week, twice a week, or 3 times a week. Treatment once a week can increase the patients' serum IgG level, and treatment twice a week can significantly decrease the serum T level in female patients. Reducing the serum IGF-1 level may be one of the action mechanisms of pricking-bloodletting at auricular points plus auricular point sticking therapy in treating AV.

HbA1c comparison and diagnostic efficacy analysis of multi center different glycosylated hemoglobin detection systems / 中华预防医学杂志

Objective: Compare and analyze the results of the domestic Lanyi AH600 glycated hemoglobin analyzer and other different detection systems to understand the comparability of the detection results of different detectors, and establish the best cut point of Lanyi AH600 determination of haemoglobin A1c (HbA1c) in the diagnosis of diabetes. Methods: Multi center cohort study was adopted. The clinical laboratory departments of 18 medical institutions independently collected test samples from their respective hospitals from March to April 2022, and independently completed comparative analysis of the evaluated instrument (Lanyi AH600) and the reference instrument HbA1c. The reference instruments include four different brands of glycosylated hemoglobin meters, including Arkray, Bio-Rad, DOSOH, and Huizhong. Scatter plot was used to calculate the correlation between the results of different detection systems, and the regression equation was calculated. The consistency analysis between the results of different detection systems was evaluated by Bland Altman method. Consistency judgment principles: (1) When the 95% limits of agreement (95% LoA) of the measurement difference was within 0.4% HbA1c and the measurement score was≥80 points, the comparison consistency was good; (2) When the measurement difference of 95% LoA exceeded 0.4% HbA1c, and the measurement score was≥80 points, the comparison consistency was relatively good; (3) The measurement score was less than 80 points, the comparison consistency was poor. The difference between the results of different detection systems was tested by paired sample T test or Wilcoxon paired sign rank sum test; The best cut-off point of diabetes was analyzed by receiver operating characteristic curve (ROC). Results: The correlation coefficient R2 of results between Lanyi AH600 and the reference instrument in 16 hospitals is≥0.99; The Bland Altman consistency analysis showed that the difference of 95% LoA in Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180) was -0.486%-0.325%, and the measurement score was 94.6 points (473/500); The difference of 95% LoA in the Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant II) was -0.727%-0.612%, and the measurement score was 89.8 points; The difference of 95% LoA in the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT) was -0.231%-0.461%, and the measurement score was 96.6 points; The difference of 95% LoA in the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT) was -0.469%-0.479%, and the measurement score was 91.9 points. The other 14 hospitals, Lanyi AH600, were compared with 4 reference instrument brands, the difference of 95% LoA was less than 0.4% HbA1c, and the scores were all greater than 95 points. The results of paired sample T test or Wilcoxon paired sign rank sum test showed that there was no statistically significant difference between Lanyi AH600 and the reference instrument Arkray HA8180 (Z=1.665,P=0.096), with no statistical difference. The mean difference between the measured values of the two instruments was 0.004%. The comparison data of Lanyi AH600 and the reference instrument of all other institutions had significant differences (all P<0.001), however, it was necessary to consider whether it was within the clinical acceptable range in combination with the results of the Bland-Altman consistency analysis. The ROC curve of HbA1c detected by Lanyi AH600 in 985 patients with diabetes and 3 423 patients with non-diabetes was analyzed, the area under curve (AUC) was 0.877, the standard error was 0.007, and the 95% confidence interval 95%CI was (0.864, 0.891), which was statistically significant (P<0.001). The maximum value of Youden index was 0.634, and the corresponding HbA1c cut point was 6.235%. The sensitivity and specificity of diabetes diagnosis were 76.2% and 87.2%, respectively. Conclusion: Among the hospitals and instruments currently included in this study, among these four hospitals included Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180), Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant Ⅱ), the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT), and the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT), the comparison between Lanyi AH600 and the reference instruments showed relatively good consistency, while the other 14 hospitals involved four different brands of reference instruments: Arkray, Bio-Rad, DOSOH, and Huizhong, Lanyi AH600 had good consistency with its comparison. The best cut point of the domestic Lanyi AH600 for detecting HbA1c in the diagnosis of diabetes is 6.235%.

Romidepsin (FK228) improves the survival of allogeneic skin grafts through downregulating the production of donor-specific antibody via suppressing the IRE1α-XBP1 pathway / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Antibody-mediated rejection (AMR) is one of the major causes of graft loss after transplantation. Recently, the regulation of B cell differentiation and the prevention of donor-specific antibody (DSA) production have gained increased attention in transplant research. Herein, we established a secondary allogeneic in vivo skin transplant model to study the effects of romidepsin (FK228) on DSA. The survival of grafted skins was monitored daily. The serum levels of DSA and the number of relevant immunocytes in the recipient spleens were evaluated by flow cytometry. Then, we isolated and purified B cells from B6 mouse spleens in vitro by magnetic bead sorting. The B cells were cultured with interleukin-4 (IL-4) and anti-clusters of differentiation 40 (CD40) antibody with or without FK228 treatment. The immunoglobulin G1 (IgG1) and IgM levels in the supernatant were evaluated by enzyme-linked immunosorbent assay (ELISA). Quantitative reverse transcription-polymerase chain reaction (RT-qPCR) and western blotting were conducted to determine the corresponding levels of messenger RNA (mRNA) and protein expression in cultured cells and the recipient spleens. The results showed that FK228 significantly improved the survival of allogeneic skin grafts. Moreover, FK228 inhibited DSA production in the serum along with the suppression of histone deacetylase 1 (HADC1) and HDAC2 and the upregulation of the acetylation of histones H2A and H3. It also inhibited the differentiation of B cells to plasma cells, decreased the transcription of positive regulatory domain-containing 1 (Prdm1) and X-box-binding protein 1 (Xbp1), and decreased the expression of phosphorylated inositol-requiring enzyme 1 α (p-IRE1α), XBP1, and B lymphocyte-induced maturation protein-1 (Blimp-1). In conclusion, FK228 could decrease the production of antibodies by B cells via inhibition of the IRE1α-XBP1 signaling pathway. Thus, FK228 is considered as a promising therapeutic agent for the clinical treatment of AMR.

Effect of Jiuwei Zhuhuang Powder on Cough Resolution in Children with Upper Respiratory Tract Infections: A Multicenter Randomized Controlled Trial / 中国结合医学杂志

OBJECTIVE@#To assess the effectiveness of Jiuwei Zhuhuang Powder (JWZH), a Tibetan patent medicine in treating upper respiratory tract infection (URTI) associated cough in children.@*METHODS@#The study was a multicenter, randomized, open-label, controlled trial. A total of 142 children aged 2 to 14 years old, with URTI-associated cough within 48 h of onset, were randomly assigned to two groups at a 1:1 ratio by computer-generated randomization sequence. Children were treated with JWZH (1 to 1.5 g, twice to thrice daily) in the treatment group or conventional treatment (Pediatric Paracetamol, Artificial Cow-bezoar and Chlorphenamine Maleate Granules, 0.25 to 1 g, thrice daily) in the control group for 5 days. The primary endpoints were the time to cough resolution and 4-day cough resolution rate. The secondary endpoints were the daily improvement in symptom scores and cough resolution rate during the study period.@*RESULTS@#A total of 138 children were included in the intention-to-treat analysis, with 71 cases in the treatment group and 67 cases in the control group. Compared with the conventional treatment, the children receiving JWZH had a shorter time to cough resolution [hazard ratio, 2.10; 95% confidence interval (CI), 1.29-3.40; P=0.003]. The median time to cough resolution for children receiving JWZH was shorter than that of the conventional treatment (2 days vs. 3 days; P<0.001). The 4-day cough resolution rate in the JWZH group was higher than that of the control group (94.4% vs. 74.6%; risk difference: 19.8%, 95% CI: 8.1%-31.5%; relative risk: 1.265, 95% CI: 1.088-1.470; P=0.001). There were no statistically significant differences in the improvement of other symptoms caused by URTI (P>0.05). Adverse events was reported in 5.6% (4/71) and 4.5% (3/67) in participants of JWZH and PPACCM groups (P>0.05), respectively, which were all mild and resolved without treatment.@*CONCLUSION@#JWZH seemed to be a safe and effective therapy for URTI-associated cough in children. (Trial registration No. ChiCTR2000039421).

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

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

Study on the mechanism of "guiding action" of borneol in Suxiaojiuxin pills / 药学学报

In order to research the mechanism of guiding action of borneol in Suxiaojiuxin pills, the model of in vitro intestinal absorption, in vivo drug metabolism of mice and cell in vitro absorption model of Caco-2 were established firstly. All animal experiments were in accordance with the regulations of the Animal Ethics Committee of Nankai University. The results showed that the cumulative absorption quantity and absorption permeability of ferulic acid and ligustilide in the intestinal juice of Suxiaojiuxin pills group were significantly increased comparing with fake Suxiaojiuxin pills group, which don't contain borneol. By using borneol, the content of ferulic acid and ligustilide in the blood and tissues, such as heart, were added. The transepithelial resistance value and the content of horseradish peroxidase (HRP) in Caco-2 were rapidly decreased and increased, respectively. Due to further explore mechanism of promoting intestinal absorption of borneol for drugs, in this study, photosensitive probes of borneol were synthesized to capture its targets, and dual luciferase reporter system was used to evaluate its activity of calcium. It was found that it could make calcium overload by regulating transient receptor potential cation channel, subfamily M, member 8 (TrpM8). Then, the results of mass spectrometry imaging showed that the accumulation of ferulic acid in the heart was significantly increased by borneol, and the relaxation rate of rat thoracic aorta was enhanced obviously. In summary, the borneol in Suxiaojiuxin pills can expand cell space and increase intestinal permeability by acting on TrpM8, thus promoting the intestinal absorption, tissue distribution and target organ enrichment of drugs.

Reproducibility study of Ovarian-Adnexal Reporting and Data System in describing adnexal masses / 中华超声影像学杂志

Objective:To investigate the intra- and inter-observer agreements of different experiencers using the Ovaria-adnexal Reporting and Data System (O-RADS) in the evaluation of adnexal masses.Methods:Totally 48 patients with adnexal masses (48 masses, mean size 9.5±4.7 cm, range 2.3-18.6 cm) found by ultrasound examination in the Third Affiliated Hospital of Sun Yat-sen University, from May 2019 to March 2020 were retrospectively analyzed. All the masses were confirmed by pathology or surgery. Four observers were divided into 2 senior doctors (Doctor 1 and Doctor 2) and 2 junior doctors (Doctor 3 and Doctor 4). Each observer independently evaluated adnexal masses twice using ultrasound O-RADS before and after systematic training, with an interval of 60 days. The intra-observer and inter-observer agreements were analyzed before and after training.Results:The inter-observer agreement between senior doctors were both excellent before and after systematic training (weight Kappa: 0.833 vs 0.802, percentage of agreement: 83.3% vs 81.3%). Whereas there was difference in the inter-observer agreement between non-experienced observers before and after training (weight Kappa: 0.399 vs 0.824, percentage of agreement: 50.0% vs 77.1%). After training, inter-observer agreement between junior doctors was significantly improved and comparable to senior (weight Kappa: 0.824 vs 0.802, percentage of agreement: 77.1% vs 81.3%). Before and after systematic training, the intra-observer agreements of the same doctor, the senior physicians were better than the junior (weight Kappa: 0.882 and 0.843 vs 0.440 and 0.605; percentage of agreement: 87.5% and 83.3% vs 58.3% and 54.2%).Conclusions:O-RADS risk classification system is a highly reproducible method in the subjective assessment of an adnexal mass among observers with varying levels of expertise. However, systematic training before clinical application is necessary and effective for non-experienced observers.

Follow-up and prognosis analysis of rheumatic disease complicated with pulmonary arterial hypertension in children / 中华实用儿科临床杂志

Objective:To explore the clinical features, follow-up characteristics and prognosis of rheumatic disease complicated with pulmonary arterial hypertension (PAH) in children, and to provide support for its clinical diagnosis and treatment.Methods:A retrospective analysis was conducted on the data of rheumatic 24 patients complicated with PAH hospitalized in the Department of Rheumatology and Immunology, Children′s Hospital Affiliated to the Capital Institute of Pediatrics, Department of Rheumatology and Immunology, Jiangxi Children′s Hospital, Department of Pediatrics Ⅰ, the First Affiliated Hospital of Zhengzhou University and Department of Pediatrics, the Affiliated Hospital of Inner Mongolia Medical University from January 2013 to June 2022.The rheumatic patients complicated with PAH were followed up by telephone on June 30, 2022, and their clinical symptoms, treatment, follow-up, and prognosis data were collected.According to different treatment methods, the patients were divided into different clinical subgroups. The change of PAH was analyzed. The t-test was used for comparison between groups. P<0.05 was statistically significant. Results:A total of 24 cases were enrolled, with 7 males and 17 females.The average onset age of PAH was (10.97±3.79) years old.The median duration of PAH was 6.00 (32.20) months.The average pulmonary artery pressure was (51.71±17.66) mmHg(1 mmHg=0.133 kPa). There were 9 cases of systemic lupus erythematosus, 5 cases of Takayasu′s arteritis, 3 cases of juvenile dermatomyositis, 3 cases of undifferentiated connective tissue disease, 2 cases of systemic juvenile idiopathic arthritis, 1 case of Behcet′s disease, and 1 case of Kawasaki disease.Among 24 cases, the common symptoms were fever (14 cases), fatigue (10 cases) and dyspnea (7 cases). Of the 24 cases, 10 cases were complicated with hydropericardium, 9 cases with valve regurgitation, and 5 cases with decreased systolic and/or diastolic function.Lung changes were observed in 17 cases.Eleven cases were tested for B-type natriuretic peptide (BNP), and the BNP levels were all elevated in them (11 cases), with a median BNP of 3 073 (10 645) ng/L.After the first occurrence of PAH, 12 cases were treated with Methylprednisolone therapy, 10 cases received Cyclophosphamide therapy, and 2 cases who were both systemic lupus erythematosus, underwent blood purification.In the treatment of PAH, 11 cases were treated with pulmonary artery pressure reduction, and 7 of the 11 cases took PAH-targeted drugs.The mean decrease of the average pulmonary artery pressure in children receiving the targeted therapy[(44.80±24.08) mmHg] was significant higher than that in children not receiving the targeted therapy [(16.15±17.25) mmHg] ( t=2.661, P=0.016). Twenty children were reexamined and/or followed up, and the average course of PAH at the telephone follow-up was (36.29±26.67) months.The pulmonary arterial hypertension in 6 cases completely recovered, with median recovery time of 8.00 (13.47) months, but 2 of them died after the complete recovery.The pulmonary arterial hypertension improved in 11 children, 1 of whom died and the remaining children were in stable condition.The pulmonary arterial hypertension worsened in 2 children, 1 of them improved previously but aggravated recently, and the other child did not monitor pulmonary artery pressure and died during telephone follow-up. Conclusions:Rheumatic diseases complicated with PAH are rare and most often diagnosed in severe rheumatic children.It can lead to death, and is commonly accompanied by notably elevated BNP levels.The patients who have early PAH detection, intensive treatment of the primary disease, symptomatic and targeted pulmonary artery pressure reduction show a better prognosis.

Clinical observation on different frequency of auricular bloodletting combined with auricular point sticking for acne vulgaris / 中国针灸

OBJECTIVE@#To observe the clinical efficacy of different treatment frequency of auricular bloodletting combined with auricular point sticking for acne vulgaris.@*METHODS@#A total of 90 patients with acne vulgaris were randomized into a treatment group 1 (30 cases, 2 cases dropped off), a treatment group 2 (30 cases, 4 cases dropped off) and a treatment group 3 (30 cases, 5 cases dropped off). Combination therapy of auricular bloodletting and auricular point sticking at Fei (CO14), Shenmen (TF4), Neifenmi (CO18) and Shenshangxian (TG2p) were given once a week, twice a week and 3 times a week in the treatment group 1, the treatment group 2 and the treatment group 3 respectively, 4 weeks were as one course and totally 3 courses were required in the 3 groups. Before treatment and after 1, 2, 3 courses of treatment, the scores of global acne grading system (GAGS), skin lesion and quality of life-acne (QoL-Acne) were observed, the clinical efficacy was evaluated after 3 courses of treatment and the recurrence rate was evaluated in follow-up of 1 month after treatment in the 3 groups.@*RESULTS@#Compared before treatment, the scores of GAGS and skin lesion were decreased at each time point in the 3 groups (P<0.05), the QoL-Acne scores were increased after 1 course of treatment in the treatment group 3 and after 2, 3 courses of treatment in the 3 groups (P<0.05). There were no statistical differences in scores of GAGS, skin lesion and QoL-Acne among the 3 groups (P>0.05). There were no statistical differences in effective rate and recurrence rate among the 3 groups (P>0.05).@*CONCLUSION@#Different frequency of auricular bloodletting combined with auricular point sticking have similar efficacy in treating acne vulgaris, all can improve the skin lesion and quality of life in patients with acne vulgaris, and have a cumulative effect and good long-term curative effect.

The relationship between liver function and arterial stiffness in physical examination population / 中华健康管理学杂志

Objective:To investigate the relationship between liver function and arterial stiffness in the physical examination population.Methods:A total of 9 111 people who received physical examination in the Health Management Center of Wuhan Tongji Hospital from January to December 2017 with an age of 18 and above and complete clinical data were included in this study. The subjects were divided into arterial stiffness group (3 252 cases) and the normal group (5 859 cases) according to the results of brachial-ankle artery pulse wave velocity (baPWV) examination. The liver function indicators were checked in all the subjects, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and glutamyl transpeptidase γ (GGT). According to interquartile range of the liver function indicators, the subjects were divided into 4 groups (group Q1- Q4). Multivariate logistic regression analysis and restricted cubic spline functions were used to explore the relationship between liver function and risk of arterial stiffness. Results:When the subjects were grouped by ALT, after adjusted for age and gender, the risk of arterial stiffness in the Q2 to Q4 groups was 1.260 (95% CI:1.093-1.452, P<0.05), 1.571 (95% CI:1.355-1.822, P<0.001) and 2.436 (95% CI:2.097-2.830, P<0.001) times of that in the Q1 group, respectively, P for trend<0.001. And after adjusted for age, gender, body mass index, low-density lipoprotein cholesterol (LDL-C), triglycerides, high-density lipoprotein cholesterol (HDL-C), the risk of arterial stiffness in the Q2 to Q4 groups was 1.158 (95% CI:1.003-1.338, P<0.05), 1.331 (95% CI:1.143-1.551, P<0.001) and 1.867 (95% CI:1.591-2.190, P<0.001) times of that in the Q1 group, respectively, P for trend <0.001. After adjusted for age, gender, body mass index, LDL-C, triglycerides, HDL-C, systolic blood pressure, diastolic blood pressure, heart rate, fasting blood glucose, blood uric acid, serum creatinine, with or without hypertension or diabetes, the risk of arterial stiffness in the Q2 to Q4 groups was 1.116 (95% CI:0.940-1.325, P=0.210), 1.241 (95% CI:1.036-1.488, P<0.05) and 1.598 (95% CI:1.322-1.932, P<0.001) times of that in the Q1 group, respectively, P for trend <0.001. Restricted cubic spline regression analysis showed a linear positive correlation between ALT and the risk of arterial stiffness. Similar results as ALT obtained with AST, ALP and GGT. Conclusions:The increase of liver function indicators is positively correlated with the risk of arterial stiffness.

Effect of DR4 Demethylation to the Proliferation and Apoptosis of Myeloid Leukemia K562 Cells / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of tumor necrosis factor death receptor (DR) 4 demethylation to the proliferation and apoptosis of myeloid leukemia K562 cells.@*METHODS@#The logarithmic phase of K562 cells were treated by desitabine (DCA) at 0, 0.8, 1.6 and 3.2 μmol/L, and the cells were divided into control group, DCA low dose group, DCA medium dose group and DCA high dose group respectively. The cells in control group were treated by tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) 0.5 μg/ml for 24 h, and the cells were divided into TRAIL group. The cells in DCA high dose group were treated by TRAIL 0.5 μg/ml for 24 h, and were divided into DCA high dose + TRAIL group. Methylation-specific polymerase chain reaction (MS-PCR) was used to measure the methylation status of the DR4 gene promoter in the control group and DCA low, medium and high dose groups. Real-time fluorescent quantitative polymerase chain reaction (qRT-PCR) and Western blot were used to determine the relative expression of DR4 mRNA and protein in the control group and DCA low, medium and high dose groups. Dime- thylthiazole (MTT) method was used to determine the inhibition rate of cell proliferation of the cells in control group, DCA high dose group, TRAIL group, DCA high dose + TRAIL group. Flow cytometry was used to determine the apoptotic rate of the cells in control group, DCA high dose group, TRAIL group, DCA high dose + TRAIL group.@*RESULTS@#The cells in the control group were methylation-positive, the brightness of the methylation bands of the cells in the DCA low, medium, and high dose groups was gradually decreased to disappear, and the DCA high dose group showed negative for methylation. The relative expression of DR4 mRNA and protein in the control group, DCA low, medium and high dose groups was increased sequentially (r=0.624, 0.704). The inhibition rate of cell proliferation of the cells in the control group, DCA high dose group, TRAIL group, DCA high dose + TRAIL group was increased sequentially (r=0.653, 0.754, 0.709, 0.725) at 24, 48 and 72 h.@*CONCLUSION@#DCA can reverse the methylation level of DR4 gene promoter in ML K562 cells and up-regulate the expression of DR4, which may enhance the proliferation inhibition and apoptosis promotion effects of TRAIL on K562 cells.

Clinical study on kidney allograft transplantation from marginal donors with high pathological Remuzzi score in preimplantation biopsy / 中华器官移植杂志

Objective:To explore the outcome of kidney transplantation from donation after cadaveric death(DCD)with high pathological Remuzzi score.Methods:From January, 2019 to December, 2019, 31 recipients of kidney allograft transplantation from marginal donors with Remuzzi score≥4 in preimplantation biopsy were retrospectively enrolled. They were divided into two groups of dual kidney transplantation(DKT, 14 cases)and single kidney transplantation(SKT, 17 cases). Median Remuzzi score of left kidney(5.05 in DKT group vs 4.92 in SKT group)or right kidney(5.26 vs. 4.58)was comparable. Dual donor kidneys were implanted into ipsilateral iliac fossa. Survival outcomes, kidney function, acute rejection episodes, incidence of delayed graft function(DGF)and proteinuria were recorded within Year 1 post-operation.Results:Proportion of male(92.9% vs. 52.9%, P<0.05)and recipient's body mass index(BMI, 23.93 vs. 21.09)were significant higher in DKT group than those in SKT group. One graft failure occurred in DKT group at Month 11 post-operation. The 1-year graft survival rate was 92.9% in DKT group and 1-year recipient survival rate both 100% in two groups. Mean 12-month serum creatinine[SCr, (164±37.7)μmol/L vs. (154.92±96.2)μmol/L]and estimated glomerular filtration rate[eGFR, (41.84±9.01) vs. (44.8±18.16)ml/(min·1.73m 2)]were comparable between two groups(both P>0.05). There was no occurrence of thrombosis resulting in graft loss. One-year incidence of acute rejection, rate of DGF(42.9% vs 41.2%)and proteinuria(57.1% vs. 41.2%)were comparable between two groups(both P>0.05). Conclusions:Through donor-recipient matching and dual kidney transplant allocation, short-term survival outcome of kidney allograft from marginal donors with high Remuzzi score≥4 is encouraging. However, long-term outcomes should be further examined.

Application of translabial ultrasound in female periurethral benign solid lesions / 中华超声影像学杂志

Objective:To investigate the value of translabial ultrasound (TLUS) in female periurethral benign solid lesions (PBSL).Methods:Twenty-one female patients (21 lesions) with PBSL identified pathologically within the process of cystoscope or surgery from June 2017 to December 2020 were enrolled. All of them underwent urethral examination (UE) and TLUS. The detection rates of the lesions of UE and TLUS were compared, and the ultrasonic diagnostic accuracy and ultrasonic manifestations were analyzed.Results:Sixteen of the 21 patients showed lower urinary tract symptoms (76.19%). Among the 21 lesions, the detection rates of UE and TLUS were 52.38% (11/21) and 85.71% (18/21), respectively, the difference was statistically significant ( P=0.019). The length of 18 lesions detected by TLUS was (1.79±1.04)cm, and 13 lesions (72.22%) were shorter than 3 cm. Among 18 cases, urethral caruncle (13 cases) was the most common benign periurethral mass, the main ultrasonic manifestations of urethral caruncle showed hyperecho lesions in the middle and distal urethra, and the blood flow was mostly in a branch-like distribution. At the same time, there were 5 cases of urethral myoma and other solid lesions, the main ultrasonic manifestations of urethral myoma showed clear boundary, low echo and peripheral short strip blood flow. Using pathological results as the gold standard, the accuracy of ultrasonic diagnosis was 88.89% (16/18). Conclusions:TLUS is able to improve the detection rate of periurethral benign solid lesions, and the diagnostic concordant rate is acceptable.TLUS can provide more diagnostic and therapeutic information.

Cerebral hemorrhage complicated with acute pulmonary embolism: a case report and literature review / 中国医师杂志

Objective:To discuss the risk factors, treatment process and prevention strategy of the cases of acute pulmonary embolism after cerebral hemorrhage, so as to improve the attention and level of the disease.Methods:The data of a patient with cerebral hemorrhage and acute pulmonary embolism treated in Lianyungang First People's Hospital were analyzed retrospectively, and the literature related to intracerebral hemorrhage complicated with acute pulmonary embolism was reviewed.Results:One week after intracerebral hemorrhage, the patient was diagnosed with acute pulmonary embolism and given anticoagulant treatment with low molecular weight heparin. The condition was alleviated without aggravating intracerebral hemorrhage. Lying in bed after intracerebral hemorrhage, limb braking, use of dehydration, diuresis, hemostasis and other drugs were the high-risk factors of pulmonary embolism.Venous thromboembolism can be prevented clinically by physical methods and drugs.Conclusions:Venous thromboembolism is easy to occur after intracerebral hemorrhage. Clinically, the incidence can be reduced by pneumatic therapy or anticoagulant drugs. In treatment, it is necessary to weigh the risk of death of pulmonary embolism and rebleeding. After comprehensive evaluation, we can formulate an individualized treatment plan. It may be safe and effective to use low molecular weight heparin to treat pulmonary embolism after the intracerebral hemorrhage hematoma is stable.

Clinical application and progress on adult donor dual kidney transplantation / 器官移植

Full application of marginal donor organs is a critical method to expand donor pool and alleviate organ shortage. After accurate donor evaluation, allocation and recipient selection, adult donor dual kidney transplantation (DKT) can not only achieve equivalent clinical efficacy to single kidney transplantation (SKT), but also effectively reduce the discard rate of marginal donor kidney. In this article, the clinical application and progress on adult donor DKT were reviewed from the perspectives of the development situation, allocation standard, recipient selection, surgical methods and complications as well as clinical efficacy of DKT, aiming to provide reference and guidance for subsequent development of marginal donor DKT.

Present situation and reform of symptomatology and clinical history taking teaching with introducing the clinical manifestation of disease / 中华医学教育探索杂志

Symptomatology and medical history taking are the focuses of diagnostics study. With the improvement of teaching and learning, students can basically master the standard process of clinical inquiry of chief complaints to family history efficiently. However, due to the lack of systematic learning of clinical diseases, it's difficult for most students to form a targeted, logical and speculative inquiry thinking pattern, so they are unlikely to write a medical history of present illness that reflects their thinking on disease inclusion and exclusion. In this study, we come up with the characteristics and defects of symptomatology teaching at present, and put forward a new idea of symptomatology teaching by introducing clinical manifestations of diseases and examples of inquiry.

Correlation between biochemical parameters and 99Tcm-MIBI SPECT/CT imaging in patients with hyperparathyropathy / 中国辐射卫生

Objective To explored the correlation between levels of serum calcium, phosphorus PTH and 99Tcm -MIBI in patients with hyperparathyropathy as well as to find cut off valve of serum calcium, phosphorus and PTH. Methods A total of 234 patients with hyperparathyroidism that confirmed by operation and pathology were collected from September 2017 to September 2019. Results The median PTH levels in PHPT group and SHPT group were 210.93 (122.60～529.20) pg/ml and 1842.50 (1342.50～2345.00) pg/ml, respectively. There was significant difference between the two groups (Z = − 10.83, P = 0.000). SHPT group was significantly higher than that in PHPT group. The median of Ca level of PHPT group and SHPT group was 2.86 (2.65～3.15) mmol/L and 2.43 (2.32～2.58) mmol/L, respectively. There was significant difference between the two groups (Z = −7.52, P = 0.000). The level of Ca in PHPT group was significantly higher than that in SHPT group. The median of P level in PHPT group and SHPT group was 0.80 (0.64～1.03) mmol/L and 2.26 (1.97～2.63) mmol/L respectively. There was significant difference between the two groups (Z = − 10.15, P = 0.000), and the PHPT group was significantly lower than the SHPT group. The age, gender, PTH and Ca and P value were taken as independent variables, and the results of MIBI imaging were used as dependent for logistic regression analysis. After screening, the influencing factor of PHPT group was PTH value (OR: 1.012, 95% CI: 1.002～1.023), and correlation analysis showed that r = 0.60 (P = 0.000). No related factors were found in SHPT group. ROC curves of 99Tcm-MIBI imaging results in PHPT group were drawn, corresponding to the areas under the maximum curve of 0.91, and the calculated cutoff value was 113.1 pg/mL. simple scatter plot of Ca value, P value and PTH value was drawn in PHPT group and SHPT group, and correlation analysis was performed. In PHPT group, Ca value and PTH value had moderate correlation (r = 0.64, P = 0.000), P value and PTH value had low correlation (r = − 0.28, P = 0.032); in SHPT group: Ca value and PTH value had low correlation (r = 0.17, P = 0.03), P value and PTH value had no correlation (P = 0.15). Conclusion The serum PTH level of PHPT was moderately correlated with MIBI imaging results. The higher the serum PTH level, the higher the positive rate of MIBI imaging, and the corresponding cutoff value of MIBI imaging was 113.1 pg/mL. There was a moderate correlation between serum Ca level and serum PTH level in PHPT, while in SHPT group low correlation between serum Ca level and serum PTH level.

Investigation on iodine content in drinking water of Shandong Province in 2017 / 中华地方病学杂志

Objective:To investigate the distribution of iodine in drinking water in Shandong Province, and to provide a basis for redefining different types of iodine in drinking water, adopting specific prevention measures and scientifically adjusting intervention strategies.Methods:In 2017, a survey on the distribution of water iodine in the whole province was carried out in townships (street offices, hereinafter referred to as townships). In addition, the administrative villages (neighborhood committees, hereinafter referred to as administrative villages) shall be taken as the units for the investigation of townships with a median water iodine of > 10 μg/L or more found in this or previous surveys. Arsenic-cerium catalytic spectrophotometry was used to detect water iodine.Results:A total of 1 844 townships were surveyed, with a median water iodine of 9.2 μg/L. Among them, there were 969 townships with water iodine of less than 10 μg/L, accounting for 52.55%. From 10 to 40 μg/L, 489 townships, accounting for 26.52%; There were 139 townships with > 40-100 μg/L, accounting for 7.54%; there were 247 townships of > 100 μg/L, accounting for 13.39%. A total of 37 073 administrative villages were surveyed in the townships with a median water iodine of > 10 μg/L, and 36 690 were collected with valid data. Among them, 5 531 villages with water iodine < 10 μg/L, accounting for 15.07%; there were 17 350 villages with 10-40 μg/L, accounting for 47.29%; there were 4 859 villages of > 40-100 μg/L, accounting for 13.24%; the number of villages > 100 μg/L was 8 950, accounting for 24.39%.Conclusions:In Shandong Province, most areas are iodine deficiency area (water iodine < 10 μg/L), waterborne high iodine areas (water iodine > 100 μg/L) and "optimal iodine" (water iodine 10-100 μg/L) regions exist, and there is the possibility of dynamic adjustment of water iodine. In the next step, the dynamic monitoring of iodine nutrition in water and population should be strengthened to provide data support for the adjustment of iodized salt supply strategy.

An analysis of iodine nutrition level of key population in waterbrone high iodine areas in Shandong Province in 2018 / 中华地方病学杂志

Objective:To investigate the iodine nutritional status of key population in waterbrone high iodine areas in Shandong Province and provide scientific basis for adjustment of control strategy.Methods:In 2018, the county (city, district, county for short) shall be the unit to carry out the monitoring work, and the administrative villages shall be the unit to determine the monitoring sites in the designated high-iodine areas. According to the results of the 2017 survey on drinking water iodine for residents of Shandong Province, each monitoring county sorted the administrative villages with a median water iodine above 100 μg/L according to the water iodine value and adopted a systematic sampling method. Each county took 5 administrative villages, and if there were less than 5 administrative villages, they were all extracted (if there were administrative villages with median water iodine above 300 μg/L, ensured at least one extraction). Among the monitoring sites, water iodine, children urinary iodine, salt iodine and thyroid volume, pregnant urinary iodine, and salt iodine were investigated. The "Arsenic Cerium Catalytic Spectrophotometry Method" (WS/T 107-2006) was used to detect the water iodine and urinary iodine contents; the B-ultrasound method was used to examine the thyroid volume of children; the semi-quantitative method was used to detect the salt iodine level of residents.Results:A total of 341 water samples were collected, the median water iodine was 131.15 μg/L, ranging from 7.10 to 1 054.00 μg/L. A total of 7 555 urine samples of children were tested and the median urinary iodine of children was 289.20 μg/L. The rate of goiter of children was 3.10% (234/7 555). A total of 1 996 urine samples of pregnant women were tested and the median urinary iodine of pregnant women was 179.90 μg/L. A total of 9 551 edible salt samples were collected from children and pregnant women, including 8 238 non-iodine salt samples and the consumption rate of non-iodine salt was 86.25% (8 238/9 551).Conclusions:The pregnant women are in a suitable state of iodine nutrition, the children's urinary iodine is at a higher than suitable level in waterbrone high iodine areas in Shandong Province. Therefore, it is still necessary to strengthen the efforts to improve water and reduce iodine, and strengthen the monitoring of iodine nutrition status of key populations.