Research progress of tight junction protein Claudin of salivary glands / 口腔医学

@#Tight junction(TJ) is complex dynamic system involved in protein interactions in the paracellular secretory pathway, with both barrier and fence functions. Claudin family, the main section of tight junction strands, will be abnormal in expression pattern in the circumstances of radiation injuries, inflammation, Sj?gren's syndrome, diabetes and other pathological conditions in salivary glands. This change leads to abnormal structure and function of tight junctions, indirectly manifested as salivary gland dysfunction. In addition, the difference of Claudin expression in salivary gland tumors can also be used as an indicator of tumor type and prognosis. This review focuses on the progress of research on common Claudin in salivary glands, including the structure, function, expression patterns of related diseases and their applications. It is believed that the review may provide new ideas for clinical and basic research on Claudin protein-related diseases.

Research progress on deep learning algorithms to assist 3D tooth segmentation of digital dental models / 口腔疾病防治

@#Three-dimensional tooth segmentation is the segmentation of single-tooth models from a digital dental model. It is an important foundation for diagnosis, planning, treatment and customized appliance manufacturing in digital orthodontics. With the deep integration of artificial intelligence technology and big data from stomatology, the use of deep learning algorithms to assist 3D tooth segmentation has gradually become mainstream. This review summarizes the current situation of deep learning algorithms that assist 3D tooth segmentation from the aspects of dataset establishment, algorithm architecture, algorithm performance, innovation and advantages, deficiencies of current research and prospects. The results of the literature review showed that deep learning tooth segmentation methods could obtain an accuracy of more than 95% and had good robustness. However, the segmentation of complex dental models, operation time and richness of the training database still need to be improved. Research and development of the "consumption reduction and strong core" algorithm, establishment of an authoritative data sample base with multiple centers, and expansion of data application depth and breadth will lead to further development in this field.

Impact of Coronary Plaque on the Precision of Computational Fractional Flow Reserve Derived from CTA / 中山大学学报(医学科学版)

ObjectiveThe fractional flow reserve （FFR） computed from coronary computed tomographic （CT） angiograms makes it possible to noninvasively assess coronary artery disease， but the impact of plaque on FFR derived from computed tomography angiography （CTA） is still unknown. The study used invasive FFR as the reference standard to analyze the impact of plaque on coronary computed tomography angiography （CCTA）-based quantitative flow ratio （CT-QFR）. MethodsThe retrospective study included 108 patients with suspected coronary heart disease （CHD） who underwent both CCTA and FFR within 60 days. CCTA images were analyzed by the software. We obtained the CT-QFR of target vessels， perfomed the quantitative and qualitative analyses on target vascular plaques， including total plaque volume （TPV）， plaque burden， calcified plaque volume （CPV）， fibrous plaque volume （FPV）， lipid plaque volume （LPV）， and the presence or absence of high-risk plaque. ResultsAccording to the difference between CT-QFR and FFR at blood vessel level， 137 target vessels of 108 patients were divided into the overestimated group （difference＞0.03， n＝29）， reference group （-0.03≤difference≤0.03， n＝88） and underestimated group （difference＜-0.03， n＝20）. The underestimated group （14.81mm3） presented higher LPV than overestimated group （1.97mm3， P < 0.05）. There was a negative correlation between LPV and the difference （P＜0.05）. ConclusionsWhen CT-QFR is used to estimate hemodynamics of coronary artery stenosis， the presence of lipid plaque may underestimate the virtual FFR.

Effectiveness of comprehensive intervention on primary dental caries in 3-year-old children in Bengbu / 中国学校卫生

Objective@#To explore the effectiveness of the comprehensive intervention on prevention of deciduous primary caries in 3-year-old children, so as so provide reference for the prevention, health care and treatment of oral caries.@*Methods@#Three-year-old children selected by drawing lots from 10 public kindergartens in 5 districts of Bengbu were examined in 2021, and were randomly divided into intervention group ( n =300) and control group ( n =300). During the initial examination, caries loss (dmf) including dental caries, missing teeth, filling teeth were assessed in the two groups. At the initial examination, the intervention group received caries intervention while no intervention was administered in the non-intervention group until half a year later. Intervention measures included education, diet, self-cleaning and fluoride application intervention. The number of cases and the mean of caries loss in the two groups were compared by χ 2 test.@*Results@#Before the intervention, 43 children in the control group suffered from caries, with 88 dmf, including 44 dmf for boys and 44 dmf for girls. There were 45 children in the intervention group, with 101 dmf, including 49 dmf for boys and 52 dmf for girls. There was no significant difference in the number of dmf between the intervention group and the control group ( χ 2=0.91, P >0.05), and there was no significant difference in the prevalence rate (15.0%, 14.3%, χ 2=0.05, P >0.05). After the intervention, there were 26 new dental caries and 43 dmf in intervention group, including 25 dmf for boys and 18 dmf for girls. In the control group, there were 83 new dental caries and 168 dmf, including 72 dmf for boys and 96 dmf for girls. Compared with the control group, the new dmf in the intervention group was significantly different ( χ 2=75.38, P < 0.05). The number of new dental caries patients in the intervention group was significantly different from that in the control group ( χ 2=36.42, P <0.05).@*Conclusion@#Comprehensive interventions to prevent dental caries can significantly reduce the incidence of primary teeth caries in children. It is suggested to intervene dental caries as early as possible to reduce the incidence of dental caries and other oral diseases.

Research progress on early speech interventions for children with cleft lip and palate / 口腔疾病防治

@#Children born with cleft lip and palate (CLP) are at high risk of disorders involving early speech production, and these problems can persist into later childhood, leading to the emergence of compensatory articulation errors. These difficulties in early vocalization directly impact the subsequent development of children's speech and vocabulary. Studies have shown that providing naturalistic interventions, such as milieu teaching and focused stimulation, for children with CLP in the first three years of life have positive impacts on the speech development of children, such as the potential to increase phonemic inventories and the percentage of correct consonants. In addition to speech and language therapists who perform systematic speech therapy, parents can be trained and supervised to deliver early speech intervention. The percentage of correct consonants can be used to assess outcome measures of speech intervention when combined with other measures, such as consonant inventory and speech intelligibility. However, much recent research in the field has focused on older children. Therefore, it must be determined if intervening during the early phase of typical speech development leads to better results. Future research should use more robust methodological designs to determine whether early speech intervention exhibits a positive impact on the speech and future physical and mental development of children with CLP.

Effect of combined sedation using multiple drugs on inflammatory cytokines in patients with acute respiratory distress syndrome

Abstract he innate immune response plays an important role in the pathophysiology of acute respiratory distress syndrome (ARDS); however, no drug has been proven to be beneficial in the management of ARDS. Therefore, the aim of this study was to investigate the effects of using combined sedatives on systemic inflammatory responses in patients with ARDS. A total of 90 patients with ARDS and an intubation time of > 120 h were randomly divided into the propofol group (group P), midazolam group (group M), and combined sedation group (group U). Patients in groups P and M were sedated with propofol and midazolam, respectively, whereas patients in group U were sedated with a combination of propofol, midazolam, and dexmedetomidine. The dosage of sedatives and vasoactive drugs, duration of mechanical ventilation, and incidence of sedative adverse reactions were documented. The dosage of sedatives and vasoactive drugs, as well as the incidence of sedative adverse reactions in group U, was significantly lower than those in groups P and M. Similarly, the duration of mechanical ventilation in group U was significantly shorter than that in groups P and M. Hence, inducing sedation through a combination of multiple drugs can significantly reduce their adverse effects, improve their sedative effect, inhibit systemic inflammatory responses, and improve oxygenation in patients with ARDS

Clinical Value of Translocator Protein Gene in Evaluating the Efficacy of FLT3-ITD/DNMT3A R882 Double-Mutated Acute Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To observe the clinical significance of translocator proteins (TSPO) gene in the treatment of FLT3-ITD/DNMT3A R882 double-mutated acute myeloid leukemia (AML).@*METHODS@#Seventy-six patients with AML hospitalized in the Department of Hematology of the Affiliated People's Hospital of Ningbo University from June 2018 to June 2020 were selected, including 34 patients with FLT3-ITD mutation, 27 patients with DNMT3A R882 mutation, 15 patients with FLT3-ITD/DNMT3A R882 double mutation, as well as 19 patients with immune thrombocytopenia (ITP) hospitalized during the same period as control group. RNA was routinely extracted from 3 ml bone marrow retained during bone puncture, and TSPO gene expression was detected by transcriptome sequencing (using 2-deltadeltaCt calculation).@*RESULTS@#The expression of TSPO gene in FLT3-ITD group and DNMT3A R882 group at first diagnosis was 2.02±1.04 and 1.85±0.76, respectively, which were both higher than 1.00±0.06 in control group, but the differences were not statistically significant (P=0.671, P=0.821). The expression of TSPO gene in the FLT3-ITD/DNMT3A R882 group was 3.98±1.07, wich was significantly higher than that in the FLT3-ITD group and DNMT3A R882 group, the differences were statistically significant (P=0.032, P=0.021). The expression of TSPO gene in patients who achieved complete response after chemotherapy in the FLT3-ITD/DNMT3A R882 group was 1.19±0.87, which was significantly lower than that at first diagnosis, and the difference was statistically significant (P=0.011).@*CONCLUSION@#TSPO gene may be used as an indicator of efficacy in FLT3-ITD /DNMT3A R882 double-mutated AML.

The Changes of Peripheral Blood FⅫa-AT, TSP-1, LA Ratio in Patients with Systemic Lupus Erythematosus and the Clinical Value of Combined Diagnosis of Thrombotic Events / 中国实验血液学杂志

OBJECTIVE@#To explore the changes of Ⅻ antithrombin (FⅫa-AT), thrombospondin-1 (TSP-1), and lupus anticoagulant (LA) ratio in the peripheral blood factor of patients with systemic lupus erythematosus (SLE) and the clinical value of combined diagnosis of thrombotic events.@*METHODS@#A total of 133 SLE patients treated in Xingtai People's Hospital were selected and divided into simple SLE group (105 cases) and SLE complicated with thrombosis group (28 cases) according to whether thrombotic events occurred, and 102 cases of healthy people in the same period were selected as control. The clinical data of the 3 groups, the level of peripheral blood FⅫa-AT, TSP-1, and LA ratio were compared, the relationship between each peripheral blood index and SLE disease activity index (SLEDAI) score were analyzed. The influencing factors of thrombotic events in SLE patients were analyzed, and the value of each peripheral blood index in the diagnosis of SLE complicated with thrombotic events were evaluated.@*RESULTS@#The proportion of the patients with age ≥60 year, hypertension, and smoking history in SLE complicated with thrombosis group was higher than those in simple SLE group and control group (P＜0.05). The SLEDAI score, peripheral blood FⅫa-AT, TSP-1, LA ratio levels of the patients in SLE complicated with thrombosis group were significantly higher than those in simple SLE group and control group, and the simple SLE group was significantly higher than the control group (P＜0.05). FⅫa-AT, TSP-1, LA ratio in peripheral blood of SLE patients were positively correlated with SLEDAI score (r=0.663, 0.578 and 0.625). Age, blood pressure, smoking history, peripheral blood FⅫa-AT, TSP-1, LA ratio were the important influencing factors of thrombotic events in SLE patients (P＜0.05). The AUC diagnosed by the FⅫa-AT, TSP-1, and LA ratio in peripheral blood was 0.881, the 95% CI was 0.813-0.931, the sensitivity was 82.14%, and the specificity was 91.43%, which was superior to each index alone (P＜0.05).@*CONCLUSION@#Peripheral blood FⅫa-AT, TSP-1, LA ratio level changes in SLE patients are significantly related to disease activity, and the combined diagnosis of thrombotic events is more reliable.

Renal Amyloidosis Secondary to ANCA-Associated Vasculitis: A Case Report / 中国医学科学杂志(英文版)

Renal amyloidosis secondary to anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is extremely rare. Here, we reported a 77-year-old woman with ANCA-associated vasculitis. Renal biopsy with Masson trichrome staining showed pauci-immune crescentic glomerulonephritis, and electron microscopy showed amyloid deposition in the mesangial area. Immunofluorescence revealed kappa light chain and lambda light chain negative. Bone marrow biopsy revealed no clonal plasma cell. Finally, she was diagnosed as ANCA-associated vasculitis with secondary renal amyloid A amyloidosis.

Carbenoxolone enhances inhibitory effect of RSL3 against cisplatin-resistant testicular cancer cells by promoting ferroptosis / 南方医科大学学报

OBJECTIVE@#To investigate the inhibitory effect of RSL3 on the proliferation, invasion and migration of cisplatinresistant testicular cancer cells (I-10/DDP) and the effect of carbenoxolone on the activity of RSL3 against testicular cancer.@*METHODS@#MTT assay was used to evaluate the survival rate of I-10/DDP cells following treatment with RSL3 (1, 2, 4, 8, 16 or 32 μmol/L) alone or in combination with carbenoxolone (100 μmol/L) or after treatment with Fer-1 (2 μmol/L), RSL3 (4 μmol/L), RSL3+Fer-1, RSL3+carbenoxolone (100 μmol/L), or RSL3+Fer-1+carbenoxolone. Colony formation assay was used to assess the proliferation ability of the treated cells; wounding-healing assay and Transwell assay were used to assess the invasion and migration ability of the cells. The expression of GPX4 was detected using Western blotting, the levels of lipid ROS were detected using C11 BODIPY 581/591 fluorescent probe, and the levels of Fe2+ were determined with FerroOrange fluorescent probe.@*RESULTS@#RSL3 dose-dependently decreased the survival rate of I-10/DDP cells, and the combined treatment with 2, 4, or 8 μmol/L RSL3 with carbenoxolone, as compared with RSL3 treatment alone, resulted in significant reduction of the cell survival rate. The combination with carbenoxolone significantly enhanced the inhibitory effect of RSL3 on colony formation, wound healing rate (P=0.005), invasion and migration of the cells (P < 0.001). Fer-1 obviously attenuated the inhibitory effects of RSL3 alone and its combination with carbenoxolone on I-10/DDP cells (P < 0.01). RSL3 treatment significantly decreased GPX4 expression (P=0.001) and increased lipid ROS level (P=0.001) and Fe2+ level in the cells, and these effects were further enhanced by the combined treatment with carbenoxolone (P < 0.01).@*CONCLUSION@#Carbenoxolone enhances the inhibitory effect of RSL3 on the proliferation, invasion and migration of cisplatin-resistant testicular cancer cells by promoting RSL3-induced ferroptosis.

A comparative study of the morphology of suboccipital cavernous sinus using magnetic resonance imaging and cast specimens / Un estudio comparativo de la morfología del seno cavernoso suboccipital utilizando imágenes de resonancia magnética y muestras de yeso

SUMMARY: A comparative study of the morphology of suboccipital cavernous sinus (SCS) using MRI and cast specimens was performed. The present retrospective study analysed the craniocervical magnetic resonance venography (MRV) imaging data of 61 patients. Three-dimensional reconstruction was performed using Mimics 19.0. The SCS left-right diameter(d1), distance from the midline (d2), supero-inferior diameter(d3), anteroposterior diameter (d4), distance from posterior diameter to skin (d5), and diameter of the SCS at different parts (d6-d8) were measured. Comparison between MRV images and cast specimens, the SCS, marginal sinus, anterior condylar vein, and vertebral artery venous plexus were symmetrical and could be bilaterally displayed, whereas the presence of extra condylar vein and posterior condylar vein exhibited different types. The adjacency between the SCS and its communicating vessels and changes in its communicating vessels corresponded well with the MRV images and cast specimens. Many types of the presence of left and right lateral condylar and posterior condylar veins were found in the cast specimens, which could be divided into the bilateral presence of posterior condylar and lateral condylar veins, unilateral presence of posterior condylar veins, and unilateral presence of lateral condylar vein. A total of 61 cases analysed using MRV images revealed the bilateral presence of posterior condylar and lateral condylar veins (77.1 %), the unilateral presence of posterior condylar vein (18.0 %), and the unilateral presence of lateral condylar vein (9.8 %), of which the bilateral presence of posterior condylar and lateral condylar veins accounted for the largest proportion. MRV images and cast specimens of the SCS showed its normal morphological structure and adjacency, thus providing accurate and complete Three-dimensional imaging anatomical data of the SCS and its communicating vascular structures. This study enriches the Chinese SCS imaging anatomy data and may be valuable in clinical practice.

RESUMEN: Se realizó un estudio comparativo de la morfología del seno cavernoso suboccipital (SCS) mediante resonancia magnética y muestras de yeso. El presente estudio retrospectivo analizó los datos de imágenes de venografía por resonancia magnética (RNM) craneocervical de 61 pacientes. La reconstrucción tridimensional se realizó con Mimics 19.0. Se midió: el diámetro izquierdo-derecho del SCS (d1), la distancia desde la línea mediana (d2), el diámetro superoinferior (d3), el diámetro anteroposterior (d4), la distancia desde el diámetro posterior hasta la piel (d5) y el diámetro del SCS en diferentes partes (d6-d8). En la comparación entre las imágenes RNM y las muestras de yeso, el SCS, el seno marginal, la vena condilar anterior y el plexo venoso de la arteria vertebral eran simétricos y se observaron bilateralmente, mientras que la presencia de la vena extracondilar y la vena condilar posterior presentaba tipos diferentes. La proximidad del SCS y sus vasos comunicantes y los cambios en sus vasos comunicantes se correspondieron bien con las imágenes de RNM y los especímenes moldeados. Se encontraron muchos tipos de venas condilares laterales y condilares posteriores izquierda y derecha en las muestras de yeso, que podrían dividirse en presencia bilateral de venas condilares posteriores y condilares laterales, presencia unilateral de venas condilares posteriores y presencia unilateral de venas condilares laterales. Un total de 61 casos analizados mediante imágenes MRV revelaron la presencia bilateral de venas condilares posteriores y condilares laterales (77,1 %), la presencia unilateral de venas condilares posteriores (18,0 %) y la presencia unilateral de venas condilares laterales (9,8 %) de los cuales la presencia bilateral de las venas condilar posterior y condilar lateral representó la mayor proporción. Las imágenes de RNM y las muestras de yeso del SCS mostraron su estructura morfológica y adyacencia normales, lo que proporcionó datos anatómicos de imágenes tridimensionales precisos y completos del SCS y sus estructuras vasculares comunicantes. Este estudio enriquece los datos de anatomía de imágenes de SCS chino y puede ser valioso en la práctica clínica.

Role of complement system in the pathogenesis of uveitis / 国际眼科杂志(Guoji Yanke Zazhi)

Uveitis is a group of inflammation diseases involving the iris, ciliary body, choroid, vitreous body, retina and retinal vessels, which can lead to visual deterioration and even visual loss. The pathogenesis of uveitis is complex and diverse, including infection, autoimmunity, trauma, physical and chemical injury, immune genetic mechanism and so on. Recent studies have shown that the activation of complement system is one of the pathogenesis of uveitis. Various complement proteins, including CFH, CFB, CFI, MAC, CD59 and so on, regulate host tissue damage through a rigorous mechanism mediated by the complement system. And studies have found that those complement proteins are involved in the occurrence and development of uveitis at the gene level and biological function. In addition, complement components like C2, C3, C4 and C5 can affect the pathogenesis of uveitis in terms of copy number variation, gene polymorphism and the regulation of T-cell-mediated autoimmune response. Therefore, complement inhibition therapy and related gene therapy provide new ideas and targets for the treatment of uveitis.

Advances in classification and reconstruction of palatal fistula after cleft palate operation / 口腔疾病防治

@#Postoperative fistulae are one of the most significant complications of cleft palate repair. They usually has an adverse effect on patients’ oral hygiene, speech and even mental health. There has been a wide range of rates of fistula occurrence, from 0.8%-60%, with the classification and definition of fistulae differing from one author to the next. In this paper, the definition and classification of palatal fistulae and their reconstruction method are reviewed. At present, there is a lack of a consistent definition of palatal fistulae and a classification that can fully reflect the characteristics of palatal fistula. Adjacent flap is mainly used for repairing small fistulae with an adequate amount of surrounding tissue; anteriorly based dorsal tongue flaps are a safe and reliable method for large fistulae; free flap is beneficial for refractory and complicated palatal fistulae that are difficult to repair by the local and pedicle flap; and different synthetic materials are used in multilayer repair of fistulae; among them, composite polymer membrane is highly biocompatible, promoting cell attachment and proliferation in animal models, but its security in the human body needs further research.

Research progress on autologous fat transplantation in the treatment of velopharyngeal insufficiency / 口腔疾病防治

@#Autologous fat transplantation in the treatment of velopharyngeal insufficiency has the advantages of good histocompatibility, small local trauma, few complications, reversible operation and simple postoperative nursing, which can effectively increase the velopharyngeal closure area. If the clinical effect is poor, other surgical methods can be used at any time for replacement. Although there are many advantages in the treatment of velopharyngeal insufficiency with autologous fat transplantation, there are still some problems in the selection of indication, donor site, injection dose, recipient site, follow-up evaluation, complications and prevention and treatment. Current research shows that autologous fat transplantation is mainly used in patients with mild or moderate velopharyngeal insufficiency, but with the improvement of fat acquisition and treatment techniques, the indications for autologous fat transplantation continue to expand, and autologous fat transplantation combined with palatoplasty or pharyngoplasty has been proposed for the treatment of severe velopharyngeal insufficiency. However, there are complications, such as fat absorption and obstructive sleep apnea syndrome. In addition, the application of autologous fat transplantation in severe VPI patients and how to improve the long-term stability of autologous fat transplantation need further study.

Role formation of cyberbullying victims and effectiveness of coping strategy / 中国学校卫生

Abstract@#Victims of cyberbullying are the most affected role group in cyberbullying. Cyberbullying not only brings emotional and psychological distress to the victims, but also results in irrational externalizing behaviors among those victims. Victims of cyberbullying need profound psychological counseling and behavior intervention to resolve the long standing dilemma. How to deal with cyberbullying and how to avoid being victims of cyberbullying are of great importance. From the perspective of psychology, this paper analyzes and expounds the role formation of victims of cyberbullying and the effectiveness of coping strategies, so as to provide a theoretical basis for cyberbullying intervention.

Epidemiological characteristics of influenza clusters in Hangzhou / 预防医学

Objective@#To analyze the epidemiological characteristics of influenza clusters in Hangzhou from 2018 to 2019, so as to provide references for the prevention and control of influenza. @*Methods@#The data came from the epidemic investigation reports of influenza clusters in Hangzhou from the 27th week of 2018 and the 26th week of 2019. The time distribution, school types, population distribution and etiology of influenza were analyzed. Multivariate logistic regression model was employed to analyze the influencing factors for the attack rate of influenza clusters. @*Results@#During the surveillance season, a total of 231 school influenza clusters involving 4 233 cases were reported. The median of the attack rate was 21.74%. The peak of the clusters was in March 2019, with 89 events and 1 476 cases ( 34.87% ). The clusters occurred mainly in primary schools ( 188 events, 81.39% ) and were mainly caused by Victoria-like strains of influenza B virus ( 84 events, 36.36% ). The multivariate logistic regression analysis indicated that infection of teachers increased the risk of high attack rate ( OR=3.133, 95%CI: 1.180-8.320 ), and kindergartens had higher risk of high attack rate than primary schools ( OR=4.123, 95%CI: 1.579-10.763 ). @*Conclusions@#The influenza clusters in Hangzhou from 2018 to 2019 is mainly caused by Victoria-like strains of influenza B virus. Kindergartens and teachers are the key points for the prevention and control of influenza clusters.

Association between the Controlling Nutritional Status score and long-term outcome in patients with acute heart failure / 中华心血管病杂志

Objective: To evaluate the nutritional status by the Controlling Nutritional Status (CONUT) score and its association with the long-term prognosis in patients with acute heart failure (AHF). Methods: This prospective monocentric study consecutively enrolled patients admitted to our hospital for AHF from April 2012 to May 2016. Patients were divided into 3 groups based on the CONUT score at admission: normal (0-1), mild malnutrition (2-4) and moderate-severe malnutrition (5-12) groups. Baseline information was obtained and recorded within 24 hours after admission. All patients were followed up every 3 months by outpatient visit or telephone call until March 2019. The primary endpoint was all-cause mortality. The Kaplan-Meier survival curves and log-rank test were used to compare all-cause mortality between groups. Variables showing statistical significance in the univariate analysis were incorporated into multivariate Cox regression model to analyze the independent risk factors for all-cause mortality after discharge. Results: A total of 396 patients were enrolled in this study, including 114 patients with normal nutritional status, 200 patients with mild malnutrition and 82 patients with moderate-severe malnutrition. One hundred and fifty-eight patients died during a median follow-up of 34 (18, 46) months. The mortality was 32.4% (37/114), 39% (78/200) and 52.4% (43/82) in normal, mild malnutrition and moderate-severe malnutrition groups, respectively. The mortality was significantly higher in the moderate-severe malnutrition group than in normal nutrition group (P<0.05). However, there was no significant difference in mortality between normal and mild malnutrition group as well as between mild and moderate-severe malnutrition group (both P>0.05). Kaplan-Meier curves indicated that patients with high CONUT score group was at higher risk of all-cause mortality compared with those with low CONUT score (P=0.002). Cox proportional hazard analyses showed that the risk of all-cause mortality of moderate-severe malnutrition group was significantly higher than that of normal nutrition group (HR =1.648, 95%CI 1.021-2.660, P=0.041). Conclusions: The CONUT score of patients with AHF at admission is associated with the long-term prognosis. High CONUT score is an independent risk factor for all-cause mortality in AHF patients after discharge.

Effect and mechanism of phenotypic transformation of vascular smooth muscle cells regulated by TGF-β2 on the venous thrombus wall remodeling / 解放军医学杂志

Objective To investigate the role and mechanism of transforming growth factor-β2 (TGF-β2) on regulating the phenotype transformation of vascular smooth muscle cells (SMC) during the wall remodeling after venous thrombosis. Methods Human umbilical vein smooth muscle cells (HVSMCs) were treated with different concentration (0, 1, 10, 20 ng/ml) of TGF-β2 for 24 hours, or treated with 10 ng/ml TGF-β2 at different time points (0, 2, 6, 24 h). RT-PCR was performed to detect the mRNA expressions of phenotype markers (contractile type: α-SMA and Elastin; synthetic type: Col1A1 and Col1A2). SD rat models of inferior vena cava thrombosis (IVCT) were established. Rats were randomly divided into sham surgery group (n=5), thrombus group (n=9) and TGF-β2 experimental group (n=5). The successful establishment of rat model was confirmed by HE and Masson staining of vein wall tissues on 4 and 7 days after modelling. At the 14th day after modelling, IVCT rats were locally treated with hydrogel containing TGF-β2 10 ng per rat for 24 hours. RT-PCR was used to detect the expression of SMC phenotypic marker mRNA in the vein wall of each group. Results TGF-β2 up-regulated mRNA expressions of both contractile and synthetic markers in HVSMCs in a dose- and time-dependent manner (P<0.05). Notely, the mRNA expression of contractile markers was more up-regulated than that of synthetic markers. HE and Masson staining showed the acute thrombosis phase 4 days after modelling and the chronic organized thrombus and recanalization 7 days after modelling, confirming the successful establishment of IVCT models. At the 14th day after modelling, compared with the sham surgery group, the mRNA expression in SMC venous wall contractile markers of thrombus group was down-regulated obviously, and was up-regulated markedly in synthetic markers (P<0.05). When TGF-β2 was used to locally treat the thrombus, the expressions of contractile markers mRNA were more significantly up-regulated (P<0.05). Conclusions TGF-β2 may induce the expression of contractile and synthetic markers in HVSMCs, particularly up-regulating the contractile markers. In IVCT rats model, TGF-β2 can significantly up-regulate the mRNA expressions of SMC contraction markers, which is in favour of maintenance of SMC contractile phenotype in the thrombus vein wall.

Efficacy and safety of steroid combined with immunosuppressants in the treatment of primary IgA nephropathy in children: a Meta analysis / 中国当代儿科杂志

OBJECTIVE@#To systematically evaluate the efficacy and safety of steroid combined with immunosuppressants in the treatment of primary IgA nephropathy in children.@*METHODS@#English and Chinese electronic databases were searched to include the studies on the efficacy and safety of steroid combined with immunosuppressants versus steroid alone in the treatment of primary IgA nephropathy in children. Outcome measures included proteinuria remission rate, urinary protein quantification, incidence of adverse events, estimated glomerular filtration rate, and incidence of renal dysfunction. Review Manager 5.3 software was used for data analysis.@*RESULTS@#A total of 7 studies with 381 children were included. The children had moderate to severe proteinuria. The Meta analysis showed that compared with the steroid alone group, the steroid combined with immunosuppressants group achieved a significantly higher rate of proteinuria remission (RR=1.36, 95%CI: 1.19-1.55, P<0.001) and significantly lower urinary protein quantification (SMD=-0.82, 95%CI: -1.23 to -0.41, P<0.001). There was no significant difference in the incidence rate of adverse events between the two groups (RR=1.28, 95%CI: 0.92-1.77, P=0.14).@*CONCLUSIONS@#The current evidence shows that for children with primary IgA nephropathy who have moderate to severe proteinuria, steroid combined with immunosuppressants has a better effect than steroid alone and does not increase the incidence rate of adverse events.

Effects of severe fever with thrombocytopenia syndrome virus infection on the expression of TLR2 and inflammatory cytokines in mouse peritoneal macrophages / 医学研究生学报

Objective The secretion level of inflammatory factors is closely related to the severity of severe fever with thrombocytopenia syndrome (SFTS). This paper mainly discussed the effect of SFTSV infection on the expression of Toll-like receptor 2（TLR2） and inflammatory factors in macrophages in mice. Methods The expression of TLR2 andTNF-α, IFN-β, IL-6, IL-10 and other inflammatory factors were observed at 0, 6, 12, 24, 36, 48, 72 hours after SFTSV infected mice macrophages by qPCR, Western blot and ELISA. Results QPCR results showed that the mRNA levels of TNF-α at 0, 6, 12, 24, 36, 48, 72 h were 0.85±0.14, 15.23±2.45, 28.67±1.59, 94.52±7.05, 55.86±1.82, 23.55±6.15, 9.76±2.03, and the mRNA levels of IFN-β were 0.93±0.21, 1.55±0.33, 14.51±1.98, 55.16±3.64, 26.57±1.49, 9.22±0.51, 5.18±1.06. QPCR results showed that the mRNA levels of TNF-α and IFN-β produced by abdominal macrophages in the infected mice showed a trend of first increasing (the highest at the 24 hour) and then decreasing, and the difference of TNF-α and IFN-β mRNA levels at other time points was statistically significant compared with that at the 0 hour (P<0.05). However, IL-6 and IL-10 mRNA levels continued to increase, and the difference at other time points was statistically significant (P<0.05). ELISA results showed that the expression of four inflammatory factors showed a trend of gradual increase: TNF-α 0 and 72 h were (38.31±4.25, 140.41±23.45) pg/mL; IFN-β 0th and 72th were (17.56±0.66, 1084.93±111.42) pg/mL; IL-6 protein 0 and 72 h were (113.30±0.07, 2302.32±134.09) pg/mL; IL-10 protein 0 and 72 h were (515.00±21.21, 2590.40±226.19) pg/mL, respectively, with significant increases at the 24, 36, 48 and 72 hours compared with that at the 0 hour (P<0.05). The expression of TLR2 mRNA generated by mouse peritoneal macrophages showed a trend of first increasing and then decreasing, and increased to the highest level at 24 h, and the difference between each time point and 0 h was statistically significant (P<0.01). The expression of TLR2 gradually increased after infection with time extension. Conclusion SFTSV infection can up-regulate the expression of TLR2 in macrophages, thereby leading to the increased secretion of the cytokines.