Dynamic changes and clinical value of serum angiopoietin-2 and surfactant protein D in pediatric acute respiratory distress syndrome / 中国小儿急救医学

Objective:To study the relationship between the dynamic changes of angiopoietin-2 (Ang-2) and surfactant protein D (SP-D) in pediatric acute respiratory distress syndrome (pARDS) and the severity and prognosis of the disease.Methods:Using nested case-control study method, 80 children with pneumonia complicated with pARDS admitted to PICU at Fujian Maternal and Child Health Hospital from June 2018 to May 2021 were selected as pARDS group, and 19 healthy children with corresponding age were selected as control group.According to the oxygenation, the children in pARDS group were divided into three subgroups: mild group (23 cases), moderate group (32 cases) and severe group (25 cases). According to the prognosis at discharge, the children in pARDS group were divided into survival group (67 cases) and death group (13 cases). Ang-2 and SP-D were detected by enzyme-linked immunosorbent assay.The levels of Ang-2 and SP-D in children with pARDS of different severity on the first day were compared; The changes of Ang-2 and SP-D levels on the 1st, 3rd and 8th day of children in survival group and death group were compared, and the receiver operating characteristic (ROC) curve was plotted to compare the predictive value of Ang-2 and SP-D for pARDS prognosis.Results:(1) The levels of Ang-2 and SP-D on the first day in pARDS group were significantly higher than those in control group( P<0.001). (2) The levels of Ang-2 and SP-D on the first day in children with pARDS of different severity levels were significantly different ( P<0.001), and the levels of Ang-2 and SP-D increased gradually with the increase of disease severity.(3) The levels of Ang-2 and SP-D in death group were significantly higher than those in survival group on the 1st, 3rd and 8th day ( P<0.05). (4) Prognostic efficacy of Ang-2 and SP-D levels in pARDS group at different time points: when the areas under the ROC curve predicted by Ang-2 on the 1st, 3rd and 8th day for inpatient mortality in children with pARDS were 0.808, 0.981 and 0.989, respectively; the optimal cut-off values were 6 000 pg/mL, 6 971 pg/mL and 4 171 pg/mL, respectively; the sensitivity was 84.6%, 92.3% and 92.3%, respectively; and the specificity was 76.1%, 97.0% and 98.5%, respectively.The areas under the ROC curve predicted by SP-D on the 1st, 3rd and 8th day for inpatient mortality in children with pARDS were 0.689, 0.993 and 0.983, respectively; the optimal cut-off values were 13544 pg/mL, 16003 pg/mL and 12294 pg/mL, respectively; the sensitivity was 84.6%, 100.0% and 100.0%, respectively; and the specificity was 46.3%, 98.5% and 97.0%, respectively. Conclusion:Serum Ang-2 and SP-D levels in children with pARDS increase with the aggravation of the disease.The dynamic changes of Ang-2 and SP-D in children with pARDS with different prognosis are different during the course of disease, and monitoring serum Ang-2 and SP-D during the course of disease has a certain predictive value for clinical outcome.

Mechanisms mediating the inhibitory effects of quercetin against phthalates-induced testicular oxidative damage in rats / 南方医科大学学报

OBJECTIVE@#To explore the mechanism underlying the inhibitory effect of quercetin against testicular oxidative damage induced by a mixture of 3 commonly used phthalates (MPEs) in rats.@*METHODS@#Forty male Sprague-Dawley rats were randomly divided into control group, MPEs exposure group, and MPEs with low-, median- and high-dose quercetin treatment groups. For MPEs exposure, the rats were subjected to intragastric administration of MPEs at the daily dose of 900 mg/kg for 30 consecutive days; Quercetin treatments were administered in the same manner at the daily dose of 10, 30, and 90 mg/kg. After the treatments, serum levels of testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), and testicular malondialdeyhde (MDA), catalase (CAT) and superoxide dismutase (SOD) were detected, and testicular pathologies of the rats were observed with HE staining. The expressions of nuclear factor-E2-related factor 2 (Nrf2), Kelch-like ECH2 associated protein 1 (Keap1) and heme oxygenase 1 (HO-1) in the testis were detected using immunofluorescence assay and Western blotting.@*RESULTS@#Compared with the control group, the rats with MPEs exposure showed significant reductions of the anogenital distance, weight of the testis and epididymis, and the coefficients of the testis and epididymis with lowered serum testosterone, LH and FSH levels (P < 0.05). Testicular histological examination revealed atrophy of the seminiferous tubules, spermatogenic arrest, and hyperplasia of the Leydig cells in MPEs-exposed rats. MPEs exposure also caused significant increments of testicular Nrf2, MDA, SOD, CAT and HO-1 expressions and lowered testicular Keap1 expression (P < 0.05). Treatment with quercetin at the median and high doses significantly ameliorated the pathological changes induced by MPEs exposure (P < 0.05).@*CONCLUSION@#Quercetin treatment inhibits MPEs-induced oxidative testicular damage in rats possibly by direct scavenging of free radicals to lower testicular oxidative stress and restore the regulation of the Nrf2 signaling pathway.

Investigation on health status of workers exposed to glyphosate / 中华劳动卫生职业病杂志

Objective: To analyze the concentrations of glyphosate and its metabolites in occupational exposed workers and their possible effects on human health, so as to provide a reference for improving the safe use of glyphosate and toxicity research. Methods: From April to December 2020, 247 workers directly exposed to glyphosate in 5 enterprises were selected as the contact group, and 237 workers who were not exposed to glyphosate and other pesticides in the same enterprise were selected as the control group. Questionnaire survey and occupational health examination were conducted on objects, and the concentrations of glyphosate and its metabolites in the air of workplaces and biological samples were detected. The correlation between the concentrations and the difference of health examination between the two groups were analyzed. Results: The urine glyphosate concentration (0.022-47.668 mg/L), the rate of exceeding the standard (60.32%, 149/247) and the urine aminomethyl phosphonic acid concentration (<0.010-1.624 mg/L) in the contact group were higher than those in the control group [urine glyphosate concentration (<0.020-4.482 mg/L), the rate of exceeding the standard (2.53%, 6/237) and the urine aminomethyl phosphonic acid concentration (<0.010-0.524 mg/L) ], respectively (P<0.001). The exceeding standard rate of glyphosate concentration in the workplace was 33.67% (33/98). The concentration of glyphosate in the workplace was positively correlated with the concentrations of glyphosate and aminomethylphosphonic acid in urine (r(s)=0.804, 0.238, P<0.001), and the concentration of glyphosate in urine was positively correlated with the concentration of aminomethylphosphonic acid in urine (r(s)=0.549, P<0.001). The alanine aminotransferase (ALT), white cell ratio, creatinine, uric acid, the abnormal rates of ALT and total protein (TP) in the contact group were higher than those in the control group, and TP was lower than that in the control group, the differences were statistically different (P<0.05). The abnormal rates of overall liver function, overall renal function, blood routine test, urine routine test, electrocardiogram, liver B ultrasound and blood lipid in the contact group were significantly higher than those in the control group (P<0.05) . Conclusion: The concentration of glyphosate in the workplace is related to the concentrations of glyphosate and aminomethyl phosphonic acid in the urine of workers, and exposure to glyphosate may have some harmful effects on human health.

Influence of sleep fragmentation in infancy and toddler period on emotional and behavioral problem at the age of 6 years: a birth cohort study / 中华儿科杂志

Objective: To investigate the influence of sleep fragmentation in infancy and toddler period on emotional and behavioral problems at the age of 6 years. Methods: Using a prospective cohort design, 262 children were extracted from mother-child birth cohort recruited from May 2012 to July 2013 in Renji Hospital, School of Medicine, Shanghai Jiao Tong University. Children's sleep and physical activities were assessed using actigraphy at 6, 12, 18, 24, and 36 months of age, from which the sleep fragmentation index (FI) at each follow-up point was calculated. Children's emotional and behavioral problems at 6 years of age were assessed using the strengths and difficulties questionnaire. Group-based trajectory model was applied to determine sleep FI in infancy and toddler period trajectory groups with Bayesian information criteria being used to determine the best fitting model. Children's emotional and behavioral problems between groups were examined with independent t test and linear regression models, etc. Results: A total of 177 children, with 91 boys and 86 girls, were included in the final analysis and were divided into 2 groups: high FI group (n=30) and low FI group (n=147). Compared with children in the low FI group, those in the high FI group presents with higher total difficulties score and higher hyperactivity or inattention score ((11.0±4.9) vs. (8.9±4.1), (4.9±2.7) vs. (3.7±2.3) scores, t=2.17, 2.23, both P<0.05, respectively), with the differences remaining significant after adjusting for covariates (t=2.08, 2.09, both P<0.05 respectively). Conclusion: High sleep fragmentation in infancy and toddler period is associated with more emotional and behavioral problems, especially hyperactivity or inattention problems, at 6 years of age.

Visual quality observation of transepithelial photorefractive keratectomy and femtosecond small incision lenticule extraction for the correction of low myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To observe the changes in corneal aberrations and the characteristics of visual quality after transepithelial photorefractive keratectomy(T-PRK)and femtosecond small incision lenticule extraction(SMILE)in the correction of low myopia.METHODS: Prospective cohort study. A total of 32 cases(32 eyes)with low myopia who underwent T-PRK surgery and 45 cases(45 eyes)of SMILE surgery at Weifang Eye Hospital from April 2021 to April 2022 were selected. The uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), spherical equivalent(SE), corneal higher-order aberrations(HOAs)and objective visual quality were compared between the two groups.RESULTS:All patients completed the surgery successfully without complications such as infection. At 3mo postoperatively, the safety index was 1.13±0.16 and 1.16±0.17(P=0.48)and the efficacy index was 1.10±0.20 and 1.15±0.18(P=0.27)in the T-PRK and SMILE groups, respectively. The percentage of UCVA(LogMAR)≤0 in the T-PRK and SMILE groups was 94% and 98%, respectively. The percentage of the residual SE within ±0.5D was 88% and 87% in the two groups, respectively. The HOAs and spherical aberration in both groups were significantly increased(P≤0.01), and the increase was not statistically significant between the two groups(P=0.31, 0.89). There was no significant change in horizontal coma, horizontal trefoil and vertical trefoil in both groups(P&#x0026;#x003E;0.05). The vertical coma in SMILE group was significantly increased(P&#x0026;#x003C;0.001), while there was no significant change in T-PRK group(P&#x0026;#x003E;0.05), and the increase was significantly greater in SMILE group than in T-PRK group(P&#x0026;#x003C;0.001). There was no significant difference in objective scattering index(OSI), modulation transfer function cut off frequency(MTFcut off), Strehl ratio(SR), visual acuity(VA)100%, VA20% and VA9% between the two groups(P&#x0026;#x003E;0.05).CONCLUSION:Both T-PRK and SMILE showed good safety, efficacy, and visual quality in correcting low myopia, while SMILE induced more vertical coma than T-PRK.

Establishment and preliminary evaluation of a fluorescent recombinase-aided amplification/CRISPR-Cas12a system for rapid detection of Plasmodium falciparum / 中国血吸虫病防治杂志

Objective To establish a fluorescent assay for rapid detection of Plasmodium falciparum based on recombinaseaided amplification (RAA) and CRISPR-Cas12a system,and to preliminarily evaluate the diagnostic efficiency of this system.. Methods The 18S ribosomal RNA (rRNA) gene of P. falciparum was selected as the target sequence, and three pairs of RAA primers and CRISPR-derived RNA (crRNA) were designed and synthesized. The optimal combination of RAA primers and crRNA was screened and the reaction conditions of the system were optimized to create a fluorescent RAA/CRISPR-Cas12a system. The plasmid containing 18S rRNA gene of the P. falciparum strain 3D7 was generated, and diluted into concentrations of 1 000, 100, 10, 1 copy/μL for the fluorescent RAA/CRISPR-Cas12a assay, and its sensitivity was evaluated. The genomic DNA from P. vivax, P. malariae, P. ovum, hepatitis B virus, human immunodeficiency virus and Treponema pallidum was employed as templates for the fluorescent RAA/CRISPR-Cas12a assay, and its specificity was evaluated. Fifty malaria clinical samples were subjected to the fluorescent RAA/CRISPR-Cas12a assay and nested PCR assay, and the consistency between two assays was compared. In addition, P. falciparum strain 3D7 was cultured in vitro. Then, the culture was diluted into blood samples with parasite densities of 1 000, 500, 200, 50, 10 parasites/μL with healthy volunteers’ O-positive red blood cells for the RAA/CRISPR-Cas12a assay, and the detection efficiency was tested. Results The Pf-F3/Pf-R3/crRNA2 combination, 2.5 μL as the addition amount of B buffer, 40 min as the RAA reaction time, 37 °C as the reaction temperature of the CRISPR-Cas12a system were employed to establish the fluorescent RAA/CRISPR-Cas12a system. Such a system was effective to detect the plasmid containing 18S rRNA gene of the P. falciparum strain 3D7 at a concentration of 1 copy/μL, and presented fluorescent signals for detection of P. falciparum, but failed to detect P. ovum, P. malariae, P. vivax, T. pallidum, hepatitis B virus or human immunodeficiency virus. The fluorescent RAA/CRISPR-Cas12a system and nested PCR assay showed completely consistent results for detection of 50 malaria clinical samples (kappa = 1.0, P < 0.001). Following 6-day in vitro culture of the P. falciparum strain 3D7, 10 mL cultures were generated and the fluorescent RAA/CRISPR-Cas12a system showed the minimal detection limit of 50 parasites/μL. Conclusion The fluorescent RAA/CRISPR-Cas12a system is rapid, sensitive and specific for detection of P. falciparum, which shows promising value for rapid detection and risk monitoring of P. falciparum.

Efficacy and Safety of Pulse Magnetic Therapy System in Insomnia Disorder: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial

Objective@#This study’s objective is to assess the efficacy and safety of Pulsed Magnetic Therapy System (PMTS) in improving insomnia disorder. @*Methods@#Participants with insomnia disorder were randomly assigned to receive either PMTS or sham treatment for four weeks (n= 153; PMTS: 76, sham: 77). Primary outcomes are the Insomnia Severity Index (ISI) scores at week 0 (baseline), 1, 2, 3, 4 (treatment), and 5 (follow-up). Secondary outcomes are the Pittsburgh Sleep Quality Index at baseline and week 4, and weekly sleep diary-derived values for sleep latency, sleep efficiency, real sleep time, waking after sleep onset, and sleep duration. @*Results@#The ISI scores of the PMTS group and the sham group were 7.13±0.50, 11.07±0.51 at week 4, respectively. There was a significant group×time interaction for ISI (F3.214, 485.271=24.25, p<0.001, ηp 2=0.138). Only the PMTS group experienced continuous improvement throughout the study; in contrast, the sham group only experienced a modest improvement after the first week of therapy. At the end of the treatment and one week after it, the response of the PMTS group were 69.7% (95% confidence interval [CI]: 58.6%–79.0%), 75.0% (95% CI: 64.1%–83.4%), respectively, which were higher than the response of the sham group (p<0.001). For each of the secondary outcomes, similar group×time interactions were discovered. The effects of the treatment persisted for at least a week. @*Conclusion@#PMTS is safe and effective in improving insomnia disorders.

A case of BMP2 gene variation-caused short stature, facial dysmorphism and skeletal anomalies with or without cardiac anomaly syndrome / 中华围产医学杂志

This article reported the genetic analysis of a case diagnosed with fetal micrognathia and cleft palate by mid-trimester ultrasound in two consecutive pregnancies. In the first pregnancy, the pregnant woman delivered a full-term boy transvaginally, who died two weeks after birth and was diagnosed with Pierre Robin sequence (PRS). Chromosome karyotype and genomic copy number variation. In the second pregnancy, the woman underwent amniocentesis due to suspected PRS presenting by fetal cleft palate, micrognathism, and additional ultrasound anomalies. No abnormalities were detected in fetal karyotype or genomic copy number variation. Whole-exome sequencing, bioinformatics analysis, and Sanger sequencing suggested that both the fetus and the firstborn boy inherited a possible pathogenic variant of c.79delG p.E27Sfs*24 in the BMP2 gene from the mother. The pregnancy was terminated after the genetic consultation. Fetal phenotypes in the two fetuses were similar, indicating that short stature, facial dysmorphism, and skeletal anomalies with or without cardiac anomaly in the pedigree were caused by the heterozygous variant of c.79delG p.E27Sfs*24 in the BMP2 gene.

A hnRNPA2B1 agonist effectively inhibits HBV and SARS-CoV-2 omicron in vivo

The twenty-first century has already recorded more than ten major epidemics or pandemics of viral disease, including the devastating COVID-19. Novel effective antivirals with broad-spectrum coverage are urgently needed. Herein, we reported a novel broad-spectrum antiviral compound PAC5. Oral administration of PAC5 eliminated HBV cccDNA and reduced the large antigen load in distinct mouse models of HBV infection. Strikingly, oral administration of PAC5 in a hamster model of SARS-CoV-2 omicron (BA.1) infection significantly decreases viral loads and attenuates lung inflammation. Mechanistically, PAC5 binds to a pocket near Asp49 in the RNA recognition motif of hnRNPA2B1. PAC5-bound hnRNPA2B1 is extensively activated and translocated to the cytoplasm where it initiates the TBK1-IRF3 pathway, leading to the production of type I IFNs with antiviral activity. Our results indicate that PAC5 is a novel small-molecule agonist of hnRNPA2B1, which may have a role in dealing with emerging infectious diseases now and in the future.

Effects of deafness capsule combined with vinpocetine injection on hearing function, hemorheology and T lymphocyte subsets in patients with sudden deafness / 中国基层医药

Objective:To investigate the effects of deafness capsule combined with vinpocetine injection on hearing function, hemorheology and T lymphocyte subsets in patients with sudden deafness.Methods:Eighty patients with sudden deafness who received treatment in Wenzhou Central Hospital from April 2017 to October 2019 were included in this study. They were randomly assigned to undergo treatment either with vinpocetine injection (control group, n = 40) or with deafness capsule combined with vinpocetine injection (observation group, n = 40) for 1 month. Efficacy, hearing function, hemorheology, T lymphocyte subsets and adverse reactions were compared between the control and observation groups. Results:Total response rate in the observation group was significantly higher than that in the control group [90.00% (36/40) vs. 67.50% (27/40), χ2 = 6.050, P = 0.014). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). After 1 month of treatment, plasma viscosity, high-shear whole blood viscosity, low-shear whole blood viscosity in the observation group were (1.21 ± 0.29) mPa·s, (2.41 ± 0.31) mPa·s, (5.25 ± 1.29) mPa·s respectively, which were significantly lower than those in the control group [(1.65 ± 0.22) mPa·s, (4.94 ± 0.36) mPa·s, (8.64 ± 1.32) mPa·s, t = 7.64, 33.68, 11.61, all P < 0.001). The percentages of CD 8+, CD 4+, and CD 4+/CD 8+ T lymphocyte subsets in the observation group were (24.28 ± 2.16)%, (46.05 ± 6.52)% and (1.90 ± 0.28) respectively, and they were (27.41 ± 2.09)%, (40.54 ± 5.48)%, (1.48 ± 0.24) respectively in the control group ( t = 6.58, 4.09, 7.20, all P < 0.001). Pure tone threshold in the observation group was significantly lower than that in the control group [(38.07 ± 4.82) dB vs. (51.97 ± 5.96) dB, t = 11.46, P < 0.001). Conclusion:Deafness capsule combined with vinpocetine injection is highly effective on sudden deafness. The combined therapy can improve the hearing function, hemorheology, and the immunological function of T lymphocyte subsets in patients with sudden deafness.

Diagnostic value of blue light imaging-bright and linked color imaging for early esophageal cancer / 中华消化内镜杂志

Objective To investigate the diagnostic value of blue light imaging-bright (BLI-bright) and linked color imaging (LCI) for early esophageal cancer (EEC).Methods:Data of 63 consecutive patients with EEC who underwent gastroscopy under BLI-bright, LCI and white-light imaging (WLI) and endoscopic submucosal dissection (ESD) from May 2018 to August 2020 at Fuding Hospital Affiliated to Fujian University of Traditional Chinese Medicine were analyzed retrospectively in the cohort study. Subjective visibility analysis was performed by 6 endoscopists who were divided into 2 groups (expert group and trainee group) with 3 endoscopists in each group. The main observation index was the visibility score (ranking score, RS). The objective color difference (Δ E) between lesions of EEC and surrounding mucosa under 3 modes were analyzed by using the L *a *b * color space. Results:The overall RS of 6 endoscopists under WLI mode (2.57±0.81) was significantly lower than that under LCI (3.25±0.67) ( t=9.71, P<0.001) and BLI-bright (3.18±0.67) ( t=9.31, P<0.001). In the expert group, the RS of WLI (2.71±0.80) was significantly lower than that of LCI (3.33±0.66) ( t=7.16, P<0.001) and BLI-bright (3.42±0.62) ( t=8.09, P<0.001). In the trainee group, the RS of WLI (2.40±0.90) was also significantly lower than that of LCI (3.15±0.83) ( t=9.62, P<0.001) and BLI-bright (2.89±0.92) ( t=5.69, P<0.001), and the RS of LCI was higher than that of BLI-bright ( t=4.07, P<0.001). The Δ E between lesions of EEC and surrounding mucosa under WLI (11.52±3.40) was significantly lower than that under LCI (16.64±4.70) ( t=7.10, P<0.001) and BLI-bright (15.72±3.84) ( t=7.88, P<0.001). Conclusion:BLI-bright and LCI can effectively improve EEC visibility and color difference between EEC and surrounding mucosa. Furthermore, LCI is more conducive to the detection of EEC for the trainees.

Clinical application of LASEREO endoscopic system in early gastric cancer / 中华内科杂志

Objective:To evaluate the clinical application of LASEREO endoscopic system in early gastric cancer (EGC).Methods:A total of 68 patients diagnosed with EGC were retrospectively analyzed between August 2017 to December 2020 in Fuding Hospital Affiliated to Fujian University of Traditional Chinese Medicine. There were 50 males and 18 females finally enrolled with a median age of 64 years. EGCs were analyzed from subjective and objective aspect, as well as from magnification and non-magnification status. Six endoscopists evaluated the visibility of the EGC (RSC) and calculated the color difference (ΔEC) between EGC and the surrounding mucosa in white light imaging (WLI), blue light imaging-bright (BLI-Bri) and linked color imaging (LCI) modes. In the case of magnification (×80), the visibility of the microstructures and microvessels (RSV) was analyzed and the color difference (ΔEV) between microvessels and non-vessels areas were calculated in WLI, BLI and LCI modes. The visibility was evaluated using visibility ranking scale(RS) and the color difference (ΔE) was calculated using L*a*b* color space.Results:In WLI, BLI-Bri, and LCI modes, the mean (±SD) RSC were 2.56±0.68, 2.63±0.59 and 3.17±0.50, and the mean(±SD) ΔEC were 15.71±5.58, 12.04±3.73, and 22.84±8.46, respectively, which in LCI were higher than those in WLI and BLI-Bri modes ( P<0.001).Regarding the data evaluated by senior endoscopists, the RSC was higher in BLI-Bri than that in WLI mode (2.98±0.58 vs. 2.79±0.73, P<0.001), but as to those evaluated by junior endoscopists, there were no significant differences between the WLI and BLI-Bri modes(2.29±0.72 vs. 2.23±0.72,P =0.218).In magnifying endoscopy with WLI, BLI, and LCI modes, the mean(±SD) RSV were 2.95±0.28, 3.46±0.40, and 3.38±0.33, and the mean (±SD) ΔEV were 21.68±7.52, 44.29±10.94, and 45.38±14.29, respectively.The RSV and ΔEV in LCI and BLI were higher than that in WLI mode ( P<0.001). Conclusions:LCI improves the visibility of EGC by increasing ΔEC, especially in junior endoscopists. Both BLI and LCI improve the visibility of microstructures and microvessels under magnification.

Treatment of Diabetic Nephropathy from Collateral Diseases： A Review / 中国实验方剂学杂志

Diabetic nephropathy （DN） is classified into "collateral diseases" in traditional Chinese medicine （TCM）. This study reviewed， analyzed， and discussed the clinical and basic research on DN treatment from collateral diseases in recent years. The main TCM therapeutic principles of DN from collateral diseases are dominated by reinforcing the deficiency and dredging collaterals. Fundamental research showed that the relevant mechanism is related to the improvement of oxidative stress and endoplasmic reticulum stress， reduction of inflammatory responses， coping with microcirculation disorder and vascular endothelial damage， and alleviation of renal injury. The theory of collateral diseases can provide ideas for clinical and basic research on DN and also shows advantages in clinical application. However， the present clinical application of this therapeutic principle is mainly based on the combination of deficiency-reinforcing drugs and blood stasis-resolving drugs. In spite of some overlap， blood stasis syndrome and collateral diseases are not in the same category. Therefore， the current diagnosis and treatment of DN from collateral diseases fail to combine with the changes of collateral vessels， main pathogenic factors， and the changes of the secondary pathogenesis. The application of classic collateral drugs such as pungent drugs， rattan drugs， and insect drugs has not been paid enough attention in syndrome differentiation and treatment. In addition， there is a lack of correlation with clinical symptoms and laboratory indexes in the basic research on the treatment of DN by Chinese medicinal prescriptions. Accordingly， the present study advocates systematic research on DN under the guidance of collateral diseases theory， clarifying the essence of DN in collateral diseases and emphasizing the importance of collateral drugs and microscopic syndrome differentiation in screening target drugs for DN to explore the underlying mechanism of collateral drugs in the treatment of DN， so as to provide evidence for the clinical application of collateral diseases theory and Chinese medicinal prescriptions against collateral diseases in the treatment of DN.

Analysis of coping capacity and influencing factors of public health emergencies among college students in Shandong Province / 中国学校卫生

Objective@#To understand the current situation and influencing factors of coping capacity in public health emergencies among college students in Shandong Province, and to provide reference for public health emergencies responses.@*Methods@#Using stratified random sampling method, 7 719 students from 6 colleges and universities in Shandong Province were selected and investigated with self designed questionnaire from April to May 2020. Multiple linear regression was used to analyze the influencing factors of coping capacity in public health emergencies.@*Results@#The overall coping capacity of college students in Shandong Province to public health emergencies scored (46.22±8.47), with dimension from high to low being personal prevention before the event (15.65±2.75), post event cooperation and disposal (15.18±3.08), incident personal precaution (15.01±3.23). Multiple linear regression showed that gender, major, only child, parental education level, knowledge of public health emergencies, emergency drill exercises, and health education for public health emergencies were associated with coping capacity among college students in public health emergencies ( B =-1.53, -1.78, -2.08, 0.60, 0.81, 1.11, 1.38, 0.78, 1.65, 1.86, 9.14, 2.00, 2.62, P <0.05).@*Conclusion@#The overall coping capacity in public health emergencies among college students in Shandong is at a good level, but still needs to be improved through strengthening emergency education and family support.

Quality of life in 243 patients with primary palmar hyperhidrosis after endoscopic thoracic sympathicotomy / 中国胸心血管外科临床杂志

@#Objective    To evaluate the quality of life (QOL) in patients with primary palmar hyperhidrosis (PPH) after endoscopic thoracic sympathicotomy (ETS) and analyze the influencing factors. Methods    A total of 243 patients (118 males and 125 females, with an average age of 21.99±6.31 years) with PPH who were successfully treated with ETS (only T3 level thoracic sympathicotomy) in our hospital from January 2017 to January 2018 were enrolled, and the World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF) was used to assess the QOL scores before and after ETS. By establishing a linear regression model of gender, age, body mass index, compensatory hyperhidrosis (CH) and palm dryness, and the relationship between the changes of the QOL scores and various factors was studied. Results    The total QOL score after surgery was higher than that before surgery (63.01±4.58 vs. 48.11±1.95, P<0.05). Compared with the negative group of CH, the QOL score decreased by 4.662 in the postoperative CH patients. For every grade of CH severity increasing, the QOL score decreased by 3.449. Compared with the negative group, the QOL scores decreased by 1.804 and 2.400 respectively for every grade of CH severity increasing in the patients with postoperative chest and back CH. Conclusion    ETS can not only improve the symptoms of abnormal palmar hyperhidrosis, but also significantly improve the QOL. Severe chest and back CH is an important factor affecting the QOL of patients.

Expression and significance of serum soluble T cell immunoglobulin-domain and mucin-domain protein-3 and galectin-9 in patients with early acute pancreatitis / 中华消化杂志

Objective:To investigate the expression and significance of serum soluble T cell immunoglobulin-domain and mucin-domain protein-3 (sTIM-3) and galectin-9 (Gal-9) in patients with early acute pancreatitis (AP), so as to provide theoretical and clinical evidence for the early prediction and diagnosis of AP.Methods:From 15 September 2020 to 23 July 2021, a total of 94 AP patients with a time from onset to admission ≤48 h who were admitted to Changzhou No.2 People′s Hospital, Nanjing Medical University were selected, including 42 cases of mild acute pancreatitis (MAP), 35 cases of moderately severe acute pancreatitis (MSAP) and 17 cases of severe acute pancreatitis (SAP). The basic clinical features of AP patients were collected. Acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ), modified computed tomography severity index (MCTSI) and bedside index for severity in acute pancreatitis (BISAP) scores were evaluated in all AP patients. The levels of serum interleukin (IL)-6, IL-10, Gal-9 and sTIM-3 were detected with enzyme linked immunosorbent assay. Kruskal-Wallis test and Mann-Whitney U test were used for statistical analysis. Spearman rank correlation test and Pearson correlation analysis were used to analyze the correlation of sTIM-3, Gal-9 with inflammatory indicators and AP related scoring systems. Receiver operating characteristic curve (ROC) was performed for efficiency analysis of the combination of sTIM-3 and Gal-9 in predicting the severity of AP patients. Results:Serum sTIM-3, Gal-9 and IL-6 levels of SAP patients were higher than those of MAP patients (2 085.00 ng/L (1 628.00 ng/L, 2 673.00 ng/L) vs. 746.10 ng/L (514.50 ng/L, 1 303.00 ng/L); 466.60 ng/L (375.90 ng/L, 629.30 ng/L) vs. 108.10 ng/L (90.29 ng/L, 138.90 ng/L); (323.60±62.93) ng/L vs. (42.90±28.82) ng/L), while IL-10 level was lower than that of MAP patients ((760.30±200.40) ng/L vs. (1 206.00±566.30) ng/L), and the differences were statistically significant ( Z=45.00 and <0.01, t=23.62 and 3.15; all P<0.01). The APACHE Ⅱ and BISAP scores of SAP patients were higher than those of MAP and MSAP patients (12.00(6.00, 16.50) vs. 3.00(2.00, 5.00) and 6.00(3.00, 8.00); 3.00(3.00, 4.00) vs.1.00(1.00, 1.00) and 2.00(2.00, 3.00)), and the MCTSI score was higher than that of MAP patients (4.00(3.00, 6.00) vs. 2.00(0.00, 2.00)), and the differences were statistically significant ( Z=644.50, 704.00, 474.50, 492.50 and 664.00, all P<0.001). Serum sTIM-3 and Gal-9 were positively correlated with the pro-inflammatory factor IL-6 ( r=0.552 and 0.297, P<0.001 and =0.004). Serum sTIM-3 was negatively correlated with the anti-inflammatory factor IL-10 ( r=-0.397, P<0.001). There was no correlation between Gal-9 and the anti-inflammatory factor IL-10 ( P>0.05). Serum sTIM-3 and Gal-9 were positively correlated with APACHE Ⅱ, MCTSI and BISAP scores ( r=0.210, 0.271 and 0.363, P=0.042, =0.008 and <0.001; r=0.390, 0.448 and 0.440, all P<0.001). The areas under ROC curves (95% confidence interval) of serum sTIM-3 and Gal-9 detected alone and in combination was 0.805 (0.716 to 0.895), 0.814 (0.725 to 0.903) and 0.856 (0.773 to 0.939), respectively, and the sensitivity was 69.2%, 67.3%, 75.0%, respectively, and the specificity was 83.3%, 97.6%, 97.6%, respectively. Conclusions:The serum levels of sTIM-3 and Gal-9 increased in patients with early AP and are correlated with the severity of AP. The combined detection of sTIM-3 and Gal-9 has high sensitivity in predicting early AP, and the two indicators may be the reliable predictors of early AP.

The Relationship Between Night Shift Work and the Risk of Abnormal Thyroid-Stimulating Hormone: A Hospital-Based Nine-Year Follow-up Retrospective Cohort Study in Taiwan

Background@#Health-care providers typically undergo shift work and are subjected to increased stress. Night shift work may induce disturbed sleep cycles and circadian rhythm. The objective of this study was to explore if night shift workers (NSWs) show an increased risk of abnormal thyroid-stimulating hormone (TSH). @*Methods@#We conducted a retrospective cohort study of 574 employees without thyroid disease and abnormal TSH at baseline who underwent annual check-ups between 2007 and 2016 in a medical center. NSWs were defined as those with working time schedules other than daytime hours. We calculated the incidence rate and estimated the adjusted hazard ratio (HR) for incident abnormal TSH and subclinical hypothyroidism compared with non-NSWs using a Cox regression model. @*Results@#A total of 56 incident abnormal TSH cases and 39 subclinical hypothyroidism cases in NSWs were identified during 3000 person-years of follow-up. In models adjusted for age, sex, obesity, and working departments, we found no increased relative risk for incident abnormal TSH (HR: 0.72, 95% confidence interval: 0.33–1.60) or subclinical hypothyroidism (HR: 0.52, 95% confidence interval: 0.19–1.45) when comparing NSWs to non-NSWs; nor were incidence rates significantly different among exclusively medical employees after excluding administrative staff. @*Conclusion@#In this hospital-based nine-year follow-up retrospective cohort study, NSWs were not associated with increased relative risk of incident abnormal TSH and subclinical hypothyroidism, in contrast to previous cross-sectional studies.

The Relationship Between Night Shift Work and the Risk of Abnormal Thyroid-Stimulating Hormone: A Hospital-Based Nine-Year Follow-up Retrospective Cohort Study in Taiwan

Background@#Health-care providers typically undergo shift work and are subjected to increased stress. Night shift work may induce disturbed sleep cycles and circadian rhythm. The objective of this study was to explore if night shift workers (NSWs) show an increased risk of abnormal thyroid-stimulating hormone (TSH). @*Methods@#We conducted a retrospective cohort study of 574 employees without thyroid disease and abnormal TSH at baseline who underwent annual check-ups between 2007 and 2016 in a medical center. NSWs were defined as those with working time schedules other than daytime hours. We calculated the incidence rate and estimated the adjusted hazard ratio (HR) for incident abnormal TSH and subclinical hypothyroidism compared with non-NSWs using a Cox regression model. @*Results@#A total of 56 incident abnormal TSH cases and 39 subclinical hypothyroidism cases in NSWs were identified during 3000 person-years of follow-up. In models adjusted for age, sex, obesity, and working departments, we found no increased relative risk for incident abnormal TSH (HR: 0.72, 95% confidence interval: 0.33–1.60) or subclinical hypothyroidism (HR: 0.52, 95% confidence interval: 0.19–1.45) when comparing NSWs to non-NSWs; nor were incidence rates significantly different among exclusively medical employees after excluding administrative staff. @*Conclusion@#In this hospital-based nine-year follow-up retrospective cohort study, NSWs were not associated with increased relative risk of incident abnormal TSH and subclinical hypothyroidism, in contrast to previous cross-sectional studies.

Phospholipid peroxidation: a key factor in "susceptibility" to neurodegenerative diseases / 药学学报

The biochemical integrity of the brain is necessary to maintain normal function. Oxidative damage is one of the mortal important reasons leading to the destruction of this integrity. The nervous system is enriched in phospholipid and polyunsaturated fatty acids (PUFAs). Due to the nature of high oxygen-consumption and rich lipids, brain is particularly vulnerable to oxidative damages. Phospholipid peroxidation is one of the results of imbalance in oxidation-antioxidant system. Once the antioxidant system is insufficient to resist oxidative damage, membrane phospholipids will be prone to free radical attack. Phospholipid peroxidation leads to a variety of toxic oxidation products, including membrane damage, mitochondrial dysfunction, rapid accumulation of amyloid, etc. Multiple proteins and nucleic acids can be covalently modified by peroxidation products, resulting in the loss of the protein functions, which eventually triggers programmed cell death and general neuroinflammation in brain, and ends up with an increased susceptibility to neurodegenerative diseases. Based on the knowledge of mechanisms of phospholipid peroxidation, this review focuses on the characteristics of phospholipid peroxidation as a key factor in the development of neurodegenerative diseases, in order to provide theoretical basis for targeted intervention of phospholipid peroxidation as a potential strategy to prevent neurodegenerative diseases.

Drug-resistant gene polymorphisms in Plasmodium falciparum isolated from Bioko Island, Equatorial Guinea in 2018 and 2019 / 中国血吸虫病防治杂志

Objective To investigate the genetic polymorphisms of Plasmodium falciparum multidrug resistance protein 1 (PfMDR1), chloroquine resistance transporter (PfCRT) and Kelch 13 (PfK13) genes in Bioko Island, Equatorial Guinea, so as to provide insights into the development of the malaria control strategy in local areas. Methods A total of 85 peripheral blood samples were collected from patients with Plasmodium falciparum infections in Bioko Island, Equatorial Guinea in 2018 and 2019, and genomic DNA was extracted. The PfMDR1, PfCRT and PfK13 genes were amplified using a nested PCR assay. The amplification products were sequenced, and the gene sequences were aligned. Results There were no mutations associated with artemisinin resistance in PfK13 gene in Bioko Island, Equatorial Guinea, while drug-resistant mutations were detected in PfMDR1 and PfCRT genes, and the proportions of PfMDR1_N86Y, PfMDR1_Y184F and PfCRT_K76T mutations were 35.29% (30/85), 72.94% (62/85) and 24.71% (21/85), respectively. Conclusion There are mutations in PfMDR1, PfCRT and PfK13 genes in P. falciparum isolates from Bioko Island, Equatorial Guinea.