Clinical Comparison of the Efficacy of Systemic Thrombolysis,Catheter-Directed Thrombolysis,and AngioJet Percutaneous Mechanical Thrombectomy in Acute Lower Extremity Deep Venous Thrombosis / 中国医学科学院学报

Objective To compare the clinical effects of three treatment methods including systemic thrombolysis(ST),catheter-directed thrombolysis(CDT),and AngioJet percutaneous mechanical thrombectomy(PMT)in acute lower extremity deep venous thrombosis(LEDVT). Methods The data of 82 patients diagnosed with LEDVT in the Department of Vascular and Gland Surgery of the First Affiliated Hospital of Hebei North University from January 2017 to December 2020 were collected.The patients were assigned into a ST group(n=50),a CDT group(n=16),and a PMT group(n=16)according to different treatment methods.The efficacy and safety were compared among the three groups. Results Compared with that before treatment,the circumferential diameter difference of both lower limbs on days 1,2,and 3 of treatment in the ST,CDT,and PMT groups reduced(all P<0.001).The PMT group showed smaller circumferential diameter difference of lower limbs on days 1,2,and 3 of treatment than the ST group(all P<0.001)and smaller circumferential diameter difference of the lower patellar margin on day 1 of treatment than the CDT group(P<0.001).The PMT group showed higher diminution rate for swelling of the affected limb at the upper and lower edges of the patella than the ST group(P<0.001)and higher diminution rate for swelling at the upper edge of the patella than the CDT group(P=0.026).The incidence of complications after treatment showed no significant differences among the three groups(all P>0.05).The median of hospital stay in the PMT group was shorter than that in the ST and CDT groups(P=0.002,P=0.001).The PMT group had higher thrombus clearance rate than the ST group(P=0.002)and no significant difference in the thrombus clearance rate from the CDT group(P=0.361).The vascular recanalization rates in the PMT(all P<0.001)and CDT(P<0.001,P=0.002,P=0.009)groups 3,6,and 12 months after treatment were higher than those in ST group,and there were no significant differences between PMT and CDT groups(P=0.341,P=0.210,P=0.341). Conclusions ST,CDT,and PMT demonstrated significant efficacy in the treatment of LEDVT,and PMT was superior to ST and CDT in terms of circumferential diameter difference of the lower limbs,diminution rate for swelling of the affected limb,thrombus clearance rate,length of hospital stay,and long-term vascular recanalization.There was no obvious difference in safety among the three therapies.

Relationship between chronotype and mental health problems among middle school students in Taiyuan / 中国学校卫生

Objective@#To examine mental health problems among adolescents in Taiyuan City and its relationship to chronotype, so as to give a scientific basis for supporting mental health of middle school students.@*Methods@#From October to November 2021, a total of 2 621 pupils were enrolled from three junior high schools and two senior high schools in Taiyuan by using a multi stage stratified cluster random sampling method to investigate demographic characteristics, mental health status, and chronotype. Chi squared test, Spearman correlation analysis and Logistic regression were used to analyze the relationship between sleep patterns and mental health problems in middle school students.@*Results@#The proportion of morning, intermediate and evening types of middle school students sleep were 17.9%, 65.6%, and 16.4%, respectively. The overall detection rate of mental health problems was 13.8 %, which was statistically significant among middle school students in different grades, self perceived family economic status, the number of friends and sleep patterns ( χ 2=42.69, 29.15, 46.02, 93.99, P <0.05). After adjusting for grade, self perceived family economic status and the number of friends, Logistic regression analysis revealed that mental health problems were positively associated with evening type ( OR =2.84) and negatively associated with morning type ( OR =0.61)( P ＜0.05).@*Conclusion@#Chronotype is associated with mental health problems among middle school students, with a higher risk for evening type and a lower risk for morning type. Mental health of middle school students can be enhanced by changing their chronotype.

Relationship between depression, anxiety, stress and food addiction in primary and secondary school students / 中国学校卫生

Objective@#To explore the relationship between depression, anxiety, stress and food addiction among primary and secondary school students in Yixing City, so as to provide reference and suggestions for maintaining healthy eating behavior and psychological health intervention and promotion among primary and secondary school students in Yixing City.@*Methods@#From December 2022 to February 2023, a stratified cluster random sampling method was used to select 4 180 primary and secondary school students from four primary and secondary schools in Yixing City, Jiangsu Province. A questionnaire survey was conducted using the Depression Anxiety Stress Scale-21 (DASS-21) and related behavior questionnaires. The data was analyzed using χ 2 test, Wilcoxon, Kruskal Wallis H rank sum test, and binary Logistic regression.@*Results@#The prevalence of food addiction among primary and secondary school students in Yixing City was 0.98% (41 students), and there was no statistically significant difference in the comparison of food addiction, depression, anxiety, and stress scores among students of different genders and age groups ( Z/H = -1.34- 5.74, P >0.05). There was a positive correlation between food addiction and binge eating behavior, depression, anxiety, and stress symptoms ( r=0.14-0.23, P <0.01). The results of binary Logistic regression showed that anxiety ( OR=5.68, 95%CI =1.74- 18.55 ) and stress ( OR=5.41, 95%CI =2.20-13.32) were positively correlated with the occurrence of food addiction in primary and secondary school students ( P <0.01).@*Conclusions@#The risk of food addiction among primary and secondary school students with anxiety and stress symptoms is higher than that of the general population. Guidance and intervention on student mental health should cover the entire compulsory education and high school period, in order to improve the mental health level of students and reduce the occurrence of food addiction behavior.

Trichostatin C attenuates TNFα-induced inflammation in endothelial cells by up-regulating Krüppel-like factor 2 / 药学学报

Krüppel-like transcription factor 2 (KLF2) plays a key regulatory role in endothelial inflammation, thrombosis, angiogenesis and macrophage inflammation and polarization, and up-regulation of KLF2 expression has the potential to prevent and treatment atherosclerosis. In this study, trichostatin C (TSC) was obtained from the secondary metabolites of rice fermentation of Streptomyces sp. CPCC 203909 as a KLF2 up-regulator by using a high throughput screening model based on a KLF2 promoter luciferase reporter assay. TSC significantly inhibited the adhesion of tumor necrosis factor-α (TNFα) induced monocytes (THP-1) to human umbilical vein endothelial cells (HUVECs). Western blot results showed that TSC decreased TNFα induced the protein expression increase of vascular cell adhesion molecule-1 (VCAM-1), and thereby inhibited endothelial inflammation. The results of histone deacetylase (HDAC) overexpression and molecular docking experiments showed that TSC upregulated the expression of KLF2 by inhibiting subtypes of HDAC 4/5/7. In conclusion, this study suggests that TSC up-regulates the expression of KLF2 through inhibiting HDAC 4/5/7 and thus inhibits TNFα induced endothelial inflammation, and it has the potential to prevent and treat atherosclerosis.

Reliability and validity assessment of Daily Stressors Evaluation Questionnaire for Primary School Students / 中国学校卫生

Objective@#To develop the Daily Stressor Evaluation Questionnaire for Primary School Students and to evaluate the reliability and validity of the questionnaire.@*Methods@#In November 2020, a convenience sampling method was used to conduct semi structured interviews with 10 primary school students in Jiading District, Shanghai. Through literature review, semi structured interviews, and expert consultation, 59 question items were developed, and 138 elementary school students in 2 districts in Shanghai were selected for a pre survey in March 2021, and the formal questionnaire was formed after item screening and parallel analysis. Stratified cluster sampling was used to survey a total of 1 618 fourth and fifth grade students enrolled in five elementary schools in Jiading District, Shanghai from April to May, 2021, to further test the reliability of the questionnaire.@*Results@#The Daily Stressor Evaluation Questionnaire for Primary School Students contained 4 dimensions and 22 items in total. The internal consistency test showed that cronbach α coefficient of the questionnaire was 0.904 and Cronbach α coefficient of each dimension was between 0.689 to 0.803. The Guttman split half reliability was 0.885 and ranged from 0.582 to 0.732 for each dimension. The results of the validation factor analysis showed that the χ 2/df of the questionnaire was less than 4, the root mean square error of approximation was less than 0.08, and the Tueker Lewis index and comparative fit index were above 0.80. The critical value of using the ROC curve to evaluate the questionnaire was 31 points. At this point, the area under the curve was determined to be 0.783, while the sensitivity and specificity were found to be 71.43% and 73.39%, respectively. Additionally, the positive predictive value and negative predictive value were calculated to be 23.26% and 95.79%, respectively.@*Conclusion@#The Daily Stressor Evaluation Questionnaire for Primary School Students developed in this study has good reliability and validity and can be used as an assessment tool for evaluating stressors in primary school students.

Association between suicidal ideation and exposure to socialecological risk factors among middle school students in Taiyuan City / 中国学校卫生

Objective@#To understand the current situation of suicidal ideation among middle school students in Taiyuan City and its correlation with exposure to social ecological risk factors, so as to provide a reference basis for exploring the causes of suicidal ideation among middle and high school students and formulating effective preventive measures.@*Methods@#A questionnaire survey was conducted among 2 639 middle school students in urban and rural areas of Taiyuan City by multistage stratified random cluster sampling, including general demography characteristics, social ecological risk factors and suicidal ideation. SPSS 26.0 software was used for Chi squared test and binary Logistic regression analysis.@*Results@#The overall detection rate of suicidal ideation was 24.7 %. There were statistically significant differences in the detection rate of suicidal ideation among middle school students in different gender, grade, family residence, maternal education level, perceived family economic conditions, number of close friends, self-perceived academic burden ( χ 2=38.17, 13.44, 10.77, 8.15, 19.76, 18.95, 59.75, P <0.05). After adjusting the general demography characteristics, the binary Logistic regression showed that moderate and high risk in the individual, family and cultural dimension, and high risk in the school dimension of the social ecology were all positively correlated with suicidal ideation among middle school students ( OR=1.38, 2.28, 1.97, 3.28, 1.48, 2.15, 1.71, P <0.05).@*Conclusion@#The suicidal ideation among middle school students is related to individuals, families, and schools in the social ecological microsystem, as well as the cultural environment in the macro system. It is necessary to conduct intervention in suicidal ideation at the individual, family, and school levels, meanwhile, strengthening social and cultural construction to reduce the impact of adverse factors on the mental health among adolescents.

Research progress on role of apolipoprotein B mRNA-editing catalytic polypeptide 3B in occurrence and development of hematological tumors / 中国生物制品学杂志

@#The incidence of hematological tumors is increasing year by year. Childhood leukemia is a malignant tumor with the highest incidence in children. A variety of genetic mutations are closely related to the occurrence and development of hematological tumors. Apolipoprotein B mRNA-editing catalytic polypeptide 3B(APOBEC3B),a member of the cytosine deaminase family,can induce mutations in target DNA or RNA,which is one of the causes of tumor genome damage.APOBEC3B is highly expressed in many hematological tumors. This paper mainly reviewed the research progress on the role of APOBEC3B in hematological tumors,so as to provide potential targets for targeted therapy and accurate personalized therapy of hematological tumors.

Predictive value of dual-source stone energy spectrum CT for uric acid stones / 中华泌尿外科杂志

Objective:To investigate the predictive value of stone composition prediction method based on dual-source stone energy spectrum CT for uric acid stones.Methods:The clinical data of 204 patients with urinary stones, 159 males and 45 females, admitted to Shanghai Sixth People's Hospital from July 2020 to July 2022 were retrospectively analyzed. The average age was (50.7±14.3) years. There were 187 cases of upper urinary tract (kidney, ureter) stones and 17 cases of lower urinary tract (bladder, urethra) stones. All patients underwent preoperative dual-source stone energy spectroscopy CT, measuring CT values at 150 kV and 100 kV, respectively, and the calculated dual energy ratio (Ratio) was used to predict stone composition. Of the 204 cases in this group, 33 cases underwent percutaneous nephrolithotomy and 171 cases underwent ureteroscopic lithotripsy. Postoperative stone specimens were analyzed for stone composition by infrared spectroscopy. Subject work characteristic (ROC) curves were used to analyze the efficacy of preoperative dual-source stone energy spectrum CT to predict uric acid stones.Results:In 204 patients, preoperative CT predicted 28 cases of uric acid stones and 176 cases of non-uric acid stones, including 136 cases of calcium oxalate stones, 38 cases of hydroxyapatite, and 2 cases of cystine stones. Postoperative IR spectral analysis detected 26 cases of uric acid stones and 178 cases of non-uric acid stones, including 129 cases of calcium oxalate stones, 47 cases of hydroxyapatite, and 2 cases of cystine stones. Compared with the preoperative CT results, there were 2 false positives and no false negatives in the classification of uric acid stones. The ROC curve showed that the sensitivity of the CT value for predicting uric acid stones at 100 kV was 96.2%, the specificity was 99.5%, and the area under the ROC curve (AUC) was 0.995, with the best prediction value of 620 HU.The sensitivity of the CT value for predicting uric acid stones at 150 kV was 96.2%, specificity was 85.5%, AUC was 0.916, and the best predictive value was 597.5 HU. The sensitivity of using Ratio values for predicting uric acid stones was 100.0%, specificity was 97.9%, AUC was 0.996, and the best predictive value was 1.14. The CT values for uric acid stones at 100 kV and 150 kV were (558.58±77.07) HU and (521.12±83.54) HU, CT values for calcium oxalate stones were (1 335.26±301.82) HU and (878.21±200.21) HU, CT values for hydroxyapatite were (1 104.09±203.61) HU and (710.38±178.44) HU, respectively.The CT values of cystine stones were (684.5±67.18) HU and (573.5±67.10) HU, respectively, and the differences between uric acid stones and other components were statistically significant ( P<0.01). The Ratio values of uric acid stones, calcium oxalate stones, hydroxyapatite, and cystine stones were 1.08±0.06, 1.52±0.08, 1.62±0.40, and 1.19±0.02, respectively, and the differences were statistically significant ( P<0.01) when comparing uric acid stones with other components. Conclusion:The CT and Ratio values of dual-source stone energy spectrum CT can effectively distinguish uric acid stones from other types of stones, and the accuracy, sensitivity, and specificity of this method for predicting uric acid stones are high.

Distribution of gene mutation sites affecting artemisinin metabolism in the Kazak population in Xinjiang / 中国热带医学

@#Abstract: Objective　To detect the distribution of CYP2A6∗2, CYP2A6∗10, CYP2A6∗17, CYP2B6∗4, CYP2B6∗6, and CYP2B6∗18 loci affecting the metabolism of artemisinins in Kazak population in Xinjiang. To explore the pharmacogenetic background of the Kazak population in Xinjiang for artemisinin drugs and provide clinical decision support for the treatment and prevention of malaria based on artemisinin drugs. Methods　Six SNPs including CYP2A6∗2, CYP2A6∗10, CYP2A6∗17, CYP2B6∗4, CYP2B6∗6, and CYP2B6∗18 were selected for the sequencing experiment. 330 whole blood samples were collected from the Kazak population in Xinjiang. After extracting the whole blood DNA genome, multiplex PCR and high-throughput sequencing were used for genotyping. The allele frequencies were analyzed using the Hardy-Weinberg equilibrium. Results　In this study all SNPs follow the Hardy-Weinberg equilibrium (P>0.05), there was no significant difference in the distribution of SNPs between different genders (P>0.05). The number of successfully sequenced samples of CYP2A6∗2, CYP2A6∗10, CYP2A6∗17, CYP2B6∗4, CYP2B6∗6, and CYP2B6∗18 were 326, 319, 328, 318, 322 and 328 respectively. The frequencies of variant alleles of CYP2A6∗2, CYP2A6∗10, CYP2A6∗17, CYP2B6∗4, CYP2B6∗6, and CYP2B6∗18 in Kazak population are: 0.61%, 0%, 0%, 30.97%, 22.98%, 0%. Conclusions　Mutation alleles affecting the metabolism of artemisinins exist in the Kazak population in Xinjiang. When using artemisinins, the relationship between the drug effect and individual pharmacogenetic background should be further explored.

Pathogenic characteristics of bloodstream infections in patients with hematological diseases and the impact of stem cell transplantation on them / 中国热带医学

@#Abstract: Objective To investigate the epidemiological characteristics of pathogens causing bloodstream infection in hematology patients during treatment and to compare the effects of allogeneic hematopoietic stem cell transplantation (HSCT) on them, so as to provide evidence for the diagnosis and treatment of bloodstream infection. Methods A total of 292 cases with bloodstream infection in hematology wards of the PLA General Hospital were collected from 2017 to 2021, which were divided into HSCT group and N-HSCT group according to whether performed HSCT or not. The epidemiological characteristics and influence of pathogenic bacteria in blood stream infection were analyzed and compared between the two groups. Results A total of 362 strains of pathogenic bacteria were collected from 292 cases, including 106 strains in HSCT group (84 cases) and 256 strains in N-HSCT group (208 cases). Bloodstream infections were more common in acute myeloid leukemia (130/392, 44.52%), followed by non-Hodgkin's lymphoma (74/292, 25.34%). The rate of once bloodstream infection in HSCT group was higher than that in N-HSCT Group, but the rate of twice bloodstream infections in N-HSCT group was higher. Gram-negative Bacilli were the most common pathogens (56.08%), with Escherichia coli being absolutely dominant (109/362, 30.11%), followed by Klebsiella pneumoniae (39/362, 10.77%). Coagulase-negative staphylococci (CoNS) (107/362, 29.56%) were the most common Gram-positive cocci. The detection rate of fungi in HSCT group (10/106, 9.43%) was significantly higher than that in N-HSCT Group (3.52%). The drug resistance rate of the common pathogenic bacteria was at a high level, and there was a certain proportion of multi-drug resistant strains (except for Pseudomonas aeruginosa). The resistance rates of CoNS to penicillin, gentamicin, moxifloxacin, clindamycin and rifampicin in HSCT group were higher than those in N-HSCT Group. The resistance rate of Escherichia coli to piperacillin/tazobactam, cephalosporins and etapenem in HSCT group was significantly higher than that in N-HSCT group. Conclusions The pathogens of blood stream infection in hematology patients are complicated and various. It is difficult for clinical diagnosis and treatment to detect multiple infections and multiple pathogens. HSCT patients have a higher risk of fungal bloodstream infection and more multi-drug resistant strains detected. Therefore, the identification of bloodstream infection and multi-drug resistant strains associated with HSCT patients should prompt surveillance.

The risk surveillance of schistosomiasis in Yunnan, 2021 / 中国热带医学

@#Abstract: Objective　To evaluate the potential transmission risk of schistosomiasis in Yunnan Province, and to provide strategic basis for the prevention and control. Methods　Based on the prevalence of schistosomiasis, the social and environmental factors that may lead to the epidemic, 1-3 villages from 3 provincial-level and 15 county-level counties (cities and districts) were selected as the evaluated villages in 2021. The risk of schistosomiasis spread was analyzed comprehensively by consulting, reviewing and collecting routine surveillance data of schistosomiasis in the villages, combined with snail and wild feces survey. The risk level was evaluated for the positive snails, positive wild feces, resident infection, average density of live snails and snail frame occurrence rate. Results　Totally 7 snail counties schistosomiasis transmission was blocked of 18 epidemic counties and the rest were eliminated counties. A total of 152 447 snail frames were investigated and 3 043 frames with snails, 15 895 snails were captured and included 15 727 live snails in the 32 evaluated villages. The total area of snail was 58.87 hm2 and the area of reoccurrence was 34.19 hm2 with snail frame occurrence rate of 2.00% and average density of live snails 0.103 2/0.11 m2, and no positive snails were found by loop-mediated isothermal amplification (LAMP) assay. A total of 1 374 wild feces were collected in 27 evaluated villages of 14 epidemic counties, mainly from cattle, dogs, sheep, equine animals, pigs and so on, all of which were negative. According to the risk assessment of epidemic spread, Yongle Village and Yongsheng Village in Eryuan County, Zhiming Village in Chuxiong City were Ⅱ risk, and the rest were Ⅲ risk. Conclusions　Although the risk of transmission is low in Yunnan Province, the risk of transmission and spread still exists. It is necessary to strengthen the risk monitoring, control of snail and effective management of livestock to prevent the rebound of the epidemic.

Reliability and validity assessment of Daily Stressors Evaluation Scale for Urban Secondary School Students / 中国学校卫生

Objective@#To formulate an evaluation scale on daily stressors with good reliability and validity for urban secondary school students, and to provide a tool for psychological stress assessment.@*Methods@#Based on steps of instrument development, a pool of items regarding the daily stressors of junior/senior high school students was constructed by combining existing scales of adolescent life events or stressors, and a preliminary survey was conducted for items analysis and dimension evaluation among 393 middle and high school students in 2 districts of Shanghai. Then confirmatory factor analysis of the scale was conducted among 2 949 students collected by stratified cluster sampling from 11 districts in Shanghai.@*Results@#The final 28 item daily stressors evaluation scale for urban secondary school students, with an overall Cronbach s alpha coefficient of 0.94, consists of 8, 7, 7, and 6 items for the four dimensions of academic stress, physical and psychological stress, interpersonal stress and family stress, respectively. The Guttman s split half reliability was 0.88, and the test retest reliability was 0.68. Total scores of the 28 items reflect general psychological stress level of participants, with higher scores representing higher stress intensity. The confirmatory factor analysis showed that the root mean squared error of approximation ( RMSEA ) and the standardized root mean square residual ( SRMR ) were both less than 0.08, while all fit indexes were above 0.8.@*Conclusion@#The Daily Stressors Evaluation Scale for Urban Secondary School Students, with good reliability, validity and model goodness of fit, can be applicable for urban secondary school students.

Analysis of the characteristics and therapeutic effect of consonant errors in children with functional articulation disorders at different ages / 口腔疾病防治

Objective@#Analyzing the characteristics of consonant errors in children with functional dysarthria in different age groups and the effect of speech training provides a reference for clinical treatment. @*Methods @#This study followed medical ethics, and informed consent has been obtained from patients. Speech data from 388 patients with functional dysarthria were retrospectively studied. They were divided into two groups at the age of 6, namely, the preschool group (4-6 years old) of 226 patients and the school age group (6-13 years old, including 6 years old) of 162 patients. The characteristics of consonant pronunciation errors from four aspects were analyzed: average number of errors, pronunciation location, pronunciation method, and error type. One-on-one speech training was conducted, with a training frequency of once a week and once for 30 minutes. The training method was carried out in the order of phoneme training, syllable training, vocabulary training, sentence training, and short text and conversation training. The effects of speech training in the two groups were compared. @*Results@#Analysis by pronunciation location: both age groups had the highest frequency of errors in tongue tip posterior sounds; the school age group had the lowest error frequency for labiodental consonants, and the preschool group had the lowest error frequency for bilabial consonants. According to the analysis of pronunciation mode, both age groups had the highest error frequency of aspirated affricate and the lowest error frequency of nasal sound. Analysis by error type: both age groups are mainly characterized by substitution and omission. Compared with the preschool group, most consonants of patients in the school group tend to improve in terms of pronunciation location, pronunciation mode, and error types. Compared with the preschool group, the two types of errors-palatalization and lateralization-increased in frequency in the school group, but the trend of increased lateralization was not statistically significant. After 6.7 and 5.5 sessions of speech training, the pronunciation of the preschool group and the school-age group significantly improved; the cure rate of the school-age group was 84.9% (118/139), and that of the preschool group was 77.1% (91/118). There was no statistically significant difference in the cure rate between the two groups.@*Conclusion@# Functional dysarthria may improve with age, but it may not completely self-heal. Children of different age groups can achieve good treatment results through scientific and reasonable speech training.

Association between hyperuricemia and hypertension and the mediatory role of obesity: a large cohort study in China

SUMMARY OBJECTIVE: This study aimed to investigate the sex-specific association between hyperuricemia and the risk of hypertension and whether obesity mediates this association. METHODS: This study included 31,395 (47.0% women) adults without hypertension, cardiovascular disease, or cancer at baseline who completed at least one follow-up annual examination between 2009 and 2016. Cox regression models were performed to calculate hazard ratios and 95% confidence intervals. Mediation analysis was conducted to estimate the effect of body mass index on the association between hyperuricemia and hypertension. RESULTS: During a median 2.9-year follow-up, hyperuricemia was significantly associated with a higher risk of hypertension (HR 1.15, 95%CI 1.07-1.24 for all participants; HR 1.12, 95%CI 1.03-1.22 for men; and HR 1.23, 95%CI 1.02-1.48 for women) after adjustment for potential confounders. Additional adjustment for body mass index attenuated this association (HR 1.09, 95%CI 1.08-1.10 for all participants; HR 1.07; 95%CI 0.98-1.16 for men; HR 1.18; 95%CI 0.96-1.44 for women). Mediation analysis showed that BMI partially mediated the relationship between hyperuricemia and incident hypertension (indirect effect HR 1.09, 95%CI 1.08-1.10; direct effect: HR 1.08, 95%CI 1.02-1.15). The percentage of the mediation effect was 53.2% (95%CI 37.9-84.5). CONCLUSION: Hyperuricemia is associated with a risk of hypertension in both sexes, and BMI partially mediates hyperuricemia-related incident hypertension.

Effects of pre-injection of pressors on pressor response and bispectral index of patients receiving lower abdominal surgery under total intravenous anesthesia

Surgery in the lower abdomen can cause many adverse reactions in nervous system, metabolic and endocrine systems. Conventional intravenous anesthesia applied for lower abdominal surgery can cause the drop in blood pressure leading to hypoperfusion of vital organs. Hence, an ideal anesthesia state is required to make patients unconscious, unaware and have no postoperative memory during anesthesia. In this study, we investigated the effects of pre-injection of different pressors on the pressor response and bispectral index (BIS) of patients receiving lower abdominal surgery under total intravenous anesthesia. For this, 300 patients undergoing lower abdominal surgery under total intravenous anesthesia were divided into normal saline (Gr. A), ephedrine (Gr. B) and phenylephrine groups (Gr. C) (n=100). Hemodynamics indices were recorded before anesthesia induction (T0) and 1, 3, 5, 7 and 9 min after drug injection (T1-T5, respectively). We observed the following reactions and recorded. BIS values at T0-T5 as well as the time points when the values rose to 65, 75, 85 and 95 and those for respiratory recovery, consciousness recovery and extubation after stopping target-controlled infusion were recorded. Compared with Gr. A, Gr. B had significantly higher systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and cardiac output (CO) at T1-T5 (P <0.05), and Gr. C had higher SBP, DBP, MAP and lower HR (P <0.05). Adverse reactions viz., intraoperative hypotension, hypertension, postoperative bradycardia, tachycardia, nausea and vomiting were also observed. The incidence rates of hypotension and total adverse reactions in groups B and C were significantly lower than those of Gr. A (P <0.05). Group B had significantly higher BIS values at T1-T5 than those of Gr. A (P <0.05). The time when BIS values recovered to 65 and 75 in group B was significantly shorter than that of Gr. A (P <0.05). Pre-injection of ephedrine and phenylephrine to patients undergoing lower abdominal surgery under total intravenous anesthesia elevated the blood pressure and reduced the incidence rate of adverse reactions without affecting the recovery time.

Effects of keratinocyte-derived and fibroblast-derived exosomes on human epidermal melanocytes

Background: Exosomes have been demonstrated to carry proteins, membrane lipids, mRNAs and microRNAs which can be transferred to surrounding cells and regulate the functions of those recipient cells. Objectives: The objective of the study was to investigate the effects of exosomes released by keratinocytes and fibroblasts on the proliferation, tyrosinase activity and melanogenesis of melanocytes. Methods: Melanocytes, keratinocytes and fibroblasts obtained from human foreskin were cultured and exosomes secreted by keratinocytes and fibroblasts were harvested from the culture supernatants by ultracentrifugation. Each exosome fraction was divided into two parts; one part was subjected to high-throughput sequencing using an Illumina HiSeq sequencer to characterize the microRNA expression profiles, while the other part was labeled with the fluorescent dye PKH67 and was then co-cultivated with epidermal melanocytes. Results: High-throughput sequencing analysis showed 168 differentially expressed microRNA within exosomes derived from keratinocytes and from fibroblasts, 97 of those being up-regulated with the other 71 down-regulated. Gene ontology analysis showed that the target genes responsible for these differentially expressed microRNAs were mainly enriched in the protein-binding region of molecular functions. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis showed that target genes regulated by differentially expressed microRNA were mainly involved in mitogen-activated protein kinase (MAPK) signaling pathway, Ras signaling pathway, cAMP signaling pathway and Wnt signaling pathway. Keratinocyte-derived exosomes were taken up by melanocytes co-cultured with them and promoted the proliferation, tyrosinase activity and melanin synthesis of those melanocytes. However, fibroblast-derived exosomes had no similar effects on melanocytes. Conclusion: Keratinocyte-derived exosomes but not fibroblast-derived exosomes were taken up by melanocytes in co-culture and significantly stimulated their proliferation, tyrosinase activity and melanin synthesis. Those different effects may be mainly due to the differential expression of microRNAs in exosomes derived from the different types of cells. Limitations: Electron microscopy of the obtained exosomes and in-depth study of apparently differentially expressed microRNAs were not performed

Efficacy and safety of dexmedetomidine in maintaining hemodynamic stability in pediatric cardiac surgery: a systematic review and meta-analysis

Abstract Objectives: Dexmedetomidine (DEX) is a highly selective alpha-2 adrenergic receptor agonist, which is the main sedative in the intensive care unit. This study aims to investigate the effectiveness and adverse events of DEX in maintaining hemodynamic stability in pediatric cardiac surgery. Sources: Databases such as PubMed, Cochrane, Web of Science, WANFANG STATA and China National Knowledge Infrastructure were searched for articles about the application of DEX in maintaining hemodynamic stability during and after pediatric cardiac surgery up to 18th Feb. 2021. Only randomized controlled trials were included and random-effects model meta-analysis was applied to calculate the standardized mean deviation (SMD), odds ratio (OR) and 95% confidence interval (CI). Summary of the findings: Fifteen articles were included for this meta-analysis, and 9 articles for qualitative analysis. The results showed that preoperative prophylaxis and postoperative recovery of DEX in pediatric patients undergoing cardiac surgery were effective in maintaining systolic blood pressure (SBP), mean arterial pressure (MAP), diastolic blood pressure (DBP) and reducing heart rate (HR) (SBP: SMD = -0.35,95% CI: -0.72, 0.01; MAP: SMD = -0.83, 95% CI: -1.87,0.21; DBP: SMD = -0.79,95% CI: -1.66,0.08; HR: SMD = -1.71,95% CI: -2.29, -1.13). In addition, the frequency of Junctional Ectopic Tachycardia in the DEX treatment group was lower than that in the placebo group. Conclusions: The application of DEX for preoperative prophylaxis and postoperative recovery in pediatric cardiac surgery patients are effective in maintaining hemodynamic stability, and the clinical dose of DEX is not significantly related to the occurrence of pediatric adverse events which may be related to individual differences.

Clinical treatment outcomes and their changes in extremely preterm twins: a multicenter retrospective study in Guangdong Province, China / 中国当代儿科杂志

OBJECTIVES@#To investigate the clinical treatment outcomes and the changes of the outcomes over time in extremely preterm twins in Guangdong Province, China.@*METHODS@#A retrospective analysis was performed for 269 pairs of extremely preterm twins with a gestational age of <28 weeks who were admitted to the department of neonatology in 26 grade A tertiary hospitals in Guangdong Province from January 2008 to December 2017. According to the admission time, they were divided into two groups: 2008-2012 and 2013-2017. Besides, each pair of twins was divided into the heavier infant and the lighter infant subgroups according to birth weight. The perinatal data of mothers and hospitalization data of neonates were collected. The survival rate of twins and the incidence rate of complications were compared between the 2008-2012 and 2013-2017 groups.@*RESULTS@#Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of severe asphyxia and smaller head circumference at birth (P<0.05). The mortality rates of both of the twins, the heavier infant of the twins, and the lighter infant of the twins were lower in the 2013-2017 group compared with the 2008-2012 group (P<0.05). Compared with the 2008-2012 group, the 2013-2017 group (both the heavier infant and lighter infant subgroups) had lower incidence rates of pulmonary hemorrhage, patent ductus arteriosus (PDA), periventricular-intraventricular hemorrhage (P-IVH), and neonatal respiratory distress syndrome (NRDS) and a higher incidence rate of bronchopulmonary dysplasia (P<0.05).@*CONCLUSIONS@#There is a significant increase in the survival rate over time in extremely preterm twins with a gestational age of <28 weeks in the 26 grade A tertiary hospitals in Guangdong Province. The incidences of severe asphyxia, pulmonary hemorrhage, PDA, P-IVH, and NRDS decrease in both the heavier and lighter infants of the twins, but the incidence of bronchopulmonary dysplasia increases. With the improvement of diagnosis and treatment, the multidisciplinary collaboration between different fields of fetal medicine including prenatal diagnosis, obstetrics, and neonatology is needed in the future to jointly develop management strategies for twin pregnancy.

Protective effect of ginsenoside Rg_1 aganist diabetic retinopathy by inhibiting NLRP3 inflammasome in type 2 diabetic mice / 中国中药杂志

Ginsenoside Rg_1, one of the main active components of precious traditional Chinese medicine Ginseng Radix et Rhizoma, has the anti-oxidative stress, anti-inflammation, anti-aging, neuroprotection, and other pharmacological effects. Diabetic retinopathy(DR), the most common complication of diabetes, is also the main cause of impaired vision and blindness in the middle-aged and the elderly. The latest research shows that ginsenoside Rg_1 can protect patients against DR, but the protection and the mechanism are rarely studied. This study mainly explored the protective effect of ginsenoside Rg_1 against DR in type 2 diabetic mice and the mechanism. High fat diet(HFD) and streptozotocin(STZ) were used to induce type 2 diabetes in mice, and hematoxylin-eosin(HE) staining was employed to observe pathological changes in the retina of mice. The immunohistochemistry was applied to study the localization and expression of nucleotide-binding oligomerization domain-like receptors 3(NLRP3) and vascular endothelial growth factor(VEGF) in retina, and Western blot was used to detect the expression of nuclear factor-kappa B(NF-κB), p-NF-κB, NLRP3, caspase-1, interleukin-1β(IL-1β), transient receptor potential channel protein 6(TRPC6), nuclear factor of activated T-cell 2(NFAT2), and VEGF in retina. The results showed that ginsenoside Rg_1 significantly alleviated the pathological injury of retina in type 2 diabetic mice. Immunohistochemistry results demonstrated that ginsenoside Rg_1 significantly decreased the expression of NLRP3 and VEGF in retinal ganglion cells, middle plexiform layer, and outer plexiform layer in type 2 diabetic mice. According to the Western blot results, ginsenoside Rg_1 significantly lowered the expression of p-NF-κB, NLRP3, caspase-1, IL-1β, TRPC6, NFAT2, and VEGF in retina of type 2 diabetic mice. These findings suggest that ginsenoside Rg_1 can significantly alleviate DR in type 2 diabetic mice, which may be related to inhibition of NLRP3 inflammasome and VEGF. This study provides experimental evidence for the clinical application of ginsenoside Rg_1 in the treatment of DR.

Clinical characteristics and serum IgG, IgM antibody manifestations of patients infected with SARS-CoV-2 B.1.1.529 (Omicron) variant strain / 中国热带医学

@#Abstract: Objective　To analyze the clinical characteristics and changes of serum IgG, IgM antibodies in patients infected with the SARS-CoV-2 B.1.1.529 (Omicron) variant. Methods　The clinical data of 82 patients with SARS-CoV-2 B.1.1.529 variant was analyzed retrospectively. Based on the presence of pneumonia on chest CT, the patients were divided into pneumonia group and non-pneumonia group. Serum IgG, IgM antibodies were observed at 5 time points T1 (1~<4 d), T2 (4~<8 d), T3 (8~<15 d), T4 (15~<22 d) and T5 (22~<30 d) after admission. Results　Among the 82 patients infected with the SARS-CoV-2 B.1.1.529 variant strain, there were 62 cases of cough, 31 cases of fever, 33 cases of throat discomfort, 5 cases of muscle soreness and 3 cases of diarrhea. The serum IgG antibody levels at 5 time points were 50.22 (142.20) AU/mL, 326.50 (220.63) AU/mL, 368.23 (76.21) AU/mL, 368.65 (79) AU/mL, and 385.26 (113.10) AU/mL, respectively. The level of serum IgG antibody in the pneumonia group was lower than that of the non-pneumonia group at T1 and T4 time points, and the differences were statistically significant (P<0.05) , the positive rate of serum IgG antibody in the pneumonia group was lower than that of the non-pneumonia group at the T1 time point, and the difference was statistically significant (P<0.05) . The serum IgM antibody levels at 5 time points were 0.41 (0.81) AU/mL, 0.95 (1.62) AU/mL, 1.09 (2.42) AU/mL, 0.74 (3) AU/mL, and 0.81 (3.10) AU/mL respectively, and there was no significant difference between the two groups. Conclusion　The clinical symptoms of patients infected with the SARS-CoV-2 B.1.1.529 variant strain are mild. Serum IgG antibodies increased after infection, but there are some differences between the pneumonia group and the non-pneumonia group, whether serum IgG has a protective effect needs further research; the serum IgM antibodies do not increase highly after infection, there are some differences between individuals.