Progress on the relationship between hyperoxia exposure and renal development in premature infants / 国际儿科学杂志

Oxygen therapy is a common therapeutic method to improve oxygenation of premature infants, but long-term exposure to high oxygen can cause damage to immature organs and abnormal development.In addition to bronchopulmonary dysplasia and retinopathy, high oxygen levels will increase the risk of chronic kidney disease and hypertension in adulthood.High oxygen exposure can lead to kidney damage and developmental abnormalities in premature infants, including reduced number and increased volume of glomeruli, renal cell apoptosis, and abnormal development of renal tubules.The mechanism may be related to abnormal signaling pathways related to renal development.This article reviews the relationship between hyperoxia and kidney development and the possible mechanism of kidney disease, in an attempt to provide theoretical reference for early clinical intervention.

Diagnostic value of nasal nitric oxide for children with primary ciliary dyskinesia / 中华儿科杂志

Objective: To evaluate the value of nasal nitric oxide (nNO) measurement as a diagnostic tool for Chinese patients with primary ciliary dyskinesia (PCD). Methods: This study is a retrospective study. The patients were recruited from those who were admitted to the respiratory Department of Respiratory Medicine, Children's Hospital of Fudan University from March 2018 to September 2022. Children with PCD were included as the PCD group, and children with situs inversus or ambiguus, cystic fibrosis (CF), bronchiectasis, chronic suppurative lung disease and asthma were included as the PCD symptom-similar group. Children who visited the Department of Child health Care and urology in the same hospital from December 2022 to January 2023 were selected as nNO normal control group. nNO was measured during plateau exhalation against resistance in three groups. Mann-Whitney U test was used to analyze the nNO data. The receiver operating characteristic of nNO value for the diagnosis of PCD was plotted and, the area under the curve and Youden index was calculated to find the best cut-off value. Results: nNO was measured in 40 patients with PCD group, 75 PCD symptom-similar group (including 23 cases of situs inversus or ambiguus, 8 cases of CF, 26 cases of bronchiectasis or chronic suppurative lung disease, 18 cases of asthma), and 55 nNO normal controls group. The age of the three groups was respectively 9.7 (6.7,13.4), 9.3 (7.0,13.0) and 9.9 (7.3,13.0) years old. nNO values were significantly lower in children with PCD than in PCD symptom-similar group and nNO normal controls (12 (9,19) vs. 182 (121,222), 209 (165,261) nl/min, U=143.00, 2.00, both P<0.001). In the PCD symptom-similar group, situs inversus or ambiguus, CF, bronchiectasis or chronic suppurative lung disease and asthma were significantly higher than children with PCD (185 (123,218), 97 (52, 132), 154 (31, 202), 266 (202,414) vs. 12 (9,19) nl/min,U=1.00, 9.00, 133.00, 0, all P<0.001). A cut-off value of 84 nl/min could provide the best sensitivity (0.98) and specificity (0.92) with an area under the curve of 0.97 (95%CI 0.95-1.00, P<0.001). Conclusions: nNO value can draw a distinction between patients with PCD and others. A cut-off value of 84 nl/min is recommended for children with PCD.

Efficacy and safety of dual drug regimen in patients with hantavirus hemorrhagic fever with renal syndrome and upper gastrointestinal bleeding / 中国医师杂志

Objective:To explore the efficacy and safety of dual drug regimen in the treatment of Hantavirus hemorrhagic fever with renal syndrome with upper gastrointestinal bleeding.Methods:Sixty patients with hantavirus hemorrhagic fever with renal syndrome and upper gastrointestinal bleeding admitted to the Eighth Medical Center of the 301 Hospital from January 2020 to January 2022 were selected as the research objects. They were randomly divided into the control group (30 cases) and the observation group (30 cases). They were treated with omeprazole and omeprazole combined with octreotide respectively for 72 hours. The clinical efficacy, hemostasis time, hospital stay, hemoglobin, serum glucagon levels, adverse reactions and rebleeding rate were compared between the two groups.Results:The total effective rate of clinical treatment in the observation group was 93.33%(28/30), significantly better than 76.67%(23/30) in the control group, with a statistically significant difference ( P<0.05). The hemostasis time and hospitalization time in the observation group were significantly shorter than those in the control group (all P<0.05). After treatment, the hemoglobin level in both groups was higher than that before treatment, and the serum glucagon level was lower than that before treatment, the difference was statistically significant (all P<0.05); After treatment, the hemoglobin level in the observation group was higher than that in the control group, and the serum glucagon level was lower than that in the control group (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (all P>0.05). The 48 hour rebleeding rate in the observation group was 3.33%(1/30), lower than the 26.67%(8/30) in the control group, with a statistically significant difference ( P<0.05). Conclusions:The dual drug regimen for Hantavirus hemorrhagic fever with renal syndrome with upper gastrointestinal bleeding can effectively control the bleeding symptoms, improve the hemostasis effect, lower the serum glucagon level, reduce the risk of rebleeding, and its safety is worthy of recognition.

Effects of early essential newborn care on breastfeeding and health outcomes of infants within 3 months of age / 中国新生儿科杂志

Objective:To study the effects of early essential newborn care (EENC) on breastfeeding and health outcomes of infants within 3 months of age.Methods:From September 2017 to September 2018, a prospective non-randomized controlled experimental study were carried out in 8 Women & Children's Hospital in Sichuan Province, including 1 municipal hospital and 3 county (district) hospitals as the intervention group and the other 1 municipal hospital and 3 county (district) hospitals as the control group. The intervention group received EENC and the control group received routine newborn care. Clinical data were collected after delivery and at the age of 1- and 3-month, including breastfeeding method, umbilical cord separation time, pneumonia, sepsis and diarrhea. Health outcome of the two groups were compared. The data were analyzed using SPSS 22.0.Results:There are 91.1% (278/305) of the newborns in the intervention group completed their first breastfeeding before their first mother-baby skin contact, compared with 33.3% (36/108) in the control group ( P<0.001). Exclusive breastfeeding rate before discharge in the intervention group was higher than the control group [(74.5% (228/306) vs. 55.0% (177/322), P<0.001]. The incidences of re-hospitalization and referred to other hospitals due to illness was lower in intervention group than the control group within 1 month of age [7.0% (19/272) vs. 13.3% (37/278), P=0.014]; Umbilical cord separation time in the intervention group was earlier than the control group [(8.3±2.9) d vs. (10.5±3.3) d, P<0.001]; No significant differences existed in the incidences of umbilical cord infection, pneumonia and diarrhea between the two groups ( P>0.05). The incidence of diarrhea in intervention group was higher than that the control group at 3 months of age ( P<0.05); No significant differences existed in the incidences of pneumonia and re-hospitalization and referred to other hospitals due to illness between the two groups ( P>0.05). There was no sepsis case in the two groups. Conclusions:EENC may improve exclusive breastfeeding rate before discharge, reduce the incidences of referral/hospitalization within 1 month and shorten the umbilical cord separation time without causing more infections.

Impact of indoxyl sulfate on left atrial strains in patients with maintenance hemodialysis: a three-dimensional speckle tracking study / 中华超声影像学杂志

Objective:To investigate the influence of indoxyl sulfate(IS), a typical protein-bound uremic toxin, on left atrial (LA) functional strains using three-dimensional speckle tracking echocardiography (3DSTE).Methods:From May 2019 to January 2020, 128 individuals were consecutively enrolled, including 37 healthy controls and 91 patients, who received maintenance hemodialysis (MHD) in the blood purification center of Zhongshan Hospital affiliated to Fudan University. Conventional echocardiographic parameters and 3DSTE datas of LA were obtained on interdialytic days.LA reservoir, conduit and contraction strains (LASr, LAScd and LASct) were calculated and compared. IS concentration in plasma was assessed by high-performance liquid chromatography tandem mass spectrometry in the MHD cohort.According to the IS concentration, the MHD group was divided into high and low IS (HI and LI) groups. The LA data were also compared between the two groups and linear regression analysis was used to identify independent impact factors of LA strains.Results:Compared to the control group, MHD group had markedly enlarged LA volumes( P<0.05). With regard to the LA phasic strains, both of LASr and LAScd were decreased( P<0.05), while LASct remained unchanged( P>0.05). Compared to the LI group, LASr, LAScd and LASct of the HI group were significantly decreased(all P<0.05). Correlation analysis showed IS concentration correlated well with LASr( rs=-0.674, P<0.001), LAScd( rs=0.454, P<0.001) and LASct( rs=0.376, P<0.001). After adjustment of age, systolic blood pressure, left ventricular mass index(LVMI), and pulmonary systolic pressure, IS concentration remained independently associated with LASr (β=-0.206, 95% CI=-0.353--0.059, P=0.007). Conclusions:In MHD patients, LA is enlarged, and its reservoir function and conduit function are impaired.LA strains derived from 3DSTE are independently related to the IS concentration in plasma, which can be used for the monitoring and evaluation of IS induced cardiac injury.

Application of artificial intelligence in surgery / 医学前沿

Artificial intelligence (AI) is gradually changing the practice of surgery with technological advancements in imaging, navigation, and robotic intervention. In this article, we review the recent successful and influential applications of AI in surgery from preoperative planning and intraoperative guidance to its integration into surgical robots. We conclude this review by summarizing the current state, emerging trends, and major challenges in the future development of AI in surgery.

Regulatory Effect of Yangxue Jiedu Decoction on Tight Junction of Keratinocytes in Psoriasis / 中国实验方剂学杂志

Objective::To observe the expressions of tight junction proteins (claduin-1, claudin-7 occludin)of psoriasis-like lesions in mice, and clarify the effect of Yangxue Jiedu decoction on the epidermal barrier of psoriasis, so as to provide scientific basis for the treatment of psoriasis with Yangxue Jiedu decoction. Method::C57BL/6J mice were randomly divided into control group, model group, methotrexate group and Yangxue Jiedu decoction.Methotrexate solution and water decoction of Yangxue Jiedu decoction were prepared, and the mice were given imiquimot to induce psoriasis-skin lesions after the hair was shaved.Daily photos were taken to record the forms of skin lesions and psoriasis area and severity index(PASI) scores.Water and oil test pens were used to detect skin moisture content. The pathological changes were observed by htoxylin eosin (HE) staining, and the epidermal thickness was measured.Ki67 was detected by immunofluorescence. Immunohistochemistry was used to detect the expressions of loricrin, CD3+ T lymphocyte infiltration and claduin-1, claudin-7, occludin.In addition, the expressions of claudin-7 and occludin in skin lesions were detected by Western blot.Meanwhile, interleukin-17(IL-17) (1 mg·L-1) was used to simulate the microenvironment of psoriasis skin lesions, and the intervention was conducted by making Yangxue component, Jiedu component and Yangxue Jiedu dry powder.The toxicity of the drug on Hacat cells was detected by cell counting kit-8(CCK-8)method.The effect of the drugs on the expressions of claudin-1, claudin-7, occludin in Hacat was detected by immunofluorescence assay. Result::Yangxue Jiedu decoction could significantly reduce the psoriasis skin lesions in mice, and reduce the PASI score and skin thickness (P<0.01). Compared with the model group, the skin moisture content in the lesion was increased (P<0.01). Abnormal expressions of ki67 and loricrin in epidermis and infiltration of CD3+ T cells were reduced (P<0.01). In addition, the expressions of claudin-1, claudin-7, occludin proteins (P<0.05), and the integrity of the tight junction structure were increased.In vitro studies, compared with the model group, the expressions of claudin-1, claudin-7, and occludin in the Yangxue Jiedu group and Yangxue group were increased (P<0.05). Compared with the model group, there was no statistically significant difference in protein expression in the Jiedu group. Conclusion::By regulating the expressions of tight junction proteins between keratinocytes, Yangxue Jiedu decoction can inhibit the abnormal proliferation and differentiation, and further restore the broken epidermal barrier.Yangxue Jiedu decoction plays a role in regulating tight junction mainly through Yangxue component.

Application of two risk assessment methods in ceramic manufacturing enterprises / 中华劳动卫生职业病杂志

Objective@#To explore the applicability of Singapore semi-quantitative assessment method and international committee on mining and metals occupational health risk assessment method in occupational health risk assessment of ceramic enterprises.@*Methods@#From March 2017 to May 2018, A ceramic enterprise was selected for the investigation and testing of occupational health, and the risk assessment of the occupational-disease-inductive factors in the workplace was conducted by the semi-quantitative assessment method of Singapore and the occupational health risk assessment method of the international committee on mining and metals.@*Results@#The occupational-disease-inductive factors in the production process of this ceramic enterprise mainly include silicon dust, noise, high temperature, carbon monoxide, carbon dioxide and so on. The two risk assessment methods were applied to assess the risk of occupational-disease-inductive factors in the workplace, and the results showed that the high risk level was 16.67%, the medium risk level was 63.33%, and the low risk level was 20.00%. The risk level of silicon dust is from low risk to high risk.@*Conclusion@#The semi-quantitative assessment method and the occupational health risk assessment method of the International Commission on Mining and Metals are simple to operate and practical, and are suitable for the assessment of occupational hazards in ceramic enterprises.

Changes of surgical interventions on necrotizing pancreatitis / 中华外科杂志

Objective@#To investigate the changes of surgical invitations on necrotizing pancreatitis in recent 14 years by reviewing single center data.@*Methods@#One thousand and eighty patients with necrotizing pancreatitis who received surgical invitation were involved in the study.All the patients were treated at Department of Pancreatic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2005 to December 2018. Six hundred and seventy-eight were males and 402 were females. The median (range) age of the study patients was 45 (20-76) years.The etiology of the disease was related to cholelithiasis in 335 cases(31.02%), hyperlipemia in 302 cases(27.96%), alcohol in 226 cases(20.93%), endoscopic retrograde cholangiopancreatography in 28 cases(2.59%), pregnancy in 50 cases(4.63%), idiopathic factors in 72 cases(6.67%) and other causes in 67 cases(6.20%). The patients were divided into two groups according to the time of admission. Group 1 included 1 475 patients that admitted from January 2005 to December 2010, and group 2 included 1 539 patients that admitted from January 2011 to December 2018. The surgical interventions, morbidity and mortality of the two group were compared, and χ2 test was used for the statistical test.@*Results@#Two hundred and sixty-six among the 1 080 cases were treated with drainage procedures because of the pseudocyst.One hundred and seventy-five drainage procedures were performed between January 2005 and December 2018, which account for 11.87%(175/1 475) of all patients of necrotizing pancreatitis; 91 drainage procedures were performed between January 2011 and December 2018, which account for 5.91%(91/1 539) of all patients of necrotizing pancreatitis. Eight hundred and fourteen cases received surgical intervention for infection of necrotizing tissues. Of these cases, 410 cases received percutaneous catheter drainage(PCD) of retroperitoneal fluid or residual infection. Debridement of necrotic tissues was performed on 756 cases. Of these cases, 32 cases received minimal invasive retroperitoneal debridement with/without denotes video assistant, 4 cases received transluminal endoscopic debridement, 21 cases received laparoscopic debridement, and 709 cases received open laparotic debridement.Three hundred and sixty-five cases were admitted to our institute during January 2005 to December 2010, and the other 391 cases were admitted to our institute from January 2011 to December 2018. Of the first period, all debridement were performed with open laparotic procedures. Of the second period, debridement were performed with open laparotic procedures and minimal invasive procedures. The average times of surgical invasion, morbidity of principal local complications and mortality of the two periods were 1.27 and 1.34,28.22%(103/365) and 29.92%(117/346), and 6.03%(23/365) and 6.91%(27/346), respectively.@*Conclusions@#Minimal invasive procedures can be considered for debridement in patients with necrotizing pancreatitis in some selected conditions.The involvements of minimal invasive procedures in treatment of necrotizing pancreatitis don′t decrease the morbidity of principal local complications and mortality in recent years. Rational surgical procedures and appropriate surgical timing are the keys to improve the efficacy of necrotizing pancreatitis.

Effects of Ligustrazine Structural Modification Product Liguzinediol on Hemodynamics of Chronic Heart Failure Model Rats Induced by Adriamycin / 中国药房

OBJECTIVE： To investigate the effects of ligustrazine structural modification product Liguzinediol on hemodynamics in chronic heart failure （CHF） model rats induced by adriamycin. METHODS： SD rats were given intraperitoneal injection of adriamycin （2 mg/kg） to induce CHF model. Model rats were randomly divided into normal saline group， positive control group （Deacetyl tricyanidin injection， 0.022 5 mg/kg） and Liguzinediol low-dose， medium-dose and high-dose groups （5， 10， 20        mg/kg）， with 8 rats in each group. Other 8 normal rats were selected as blank control group （normal saline）. Each group was given relevant medicine intravenously. The left ventricular systolic pressure （LVSP）， maximal rate of rise or drop of left ventricular     （±dp/dtmax）， systolic pressure （SP）， diastolic pressure （DP）， heart rate （HR） and other hemodynamic indexes were recorded by multichannel physiological recorder at 1， 5， 10， 20， 40， 60， 90， 120 min after medication. RESULTS： Compared with blank control group， LVSP， +dp/dtmax， │－dp/dtmax│， SP， HR and DP at 120 min after medication of normal saline group were decreased significantly （P＜0.05）. Compared with normal saline group， LVSP at 5-60 min after medication， +dp/dtmax at 40-90 min after medication， SP at 10-40 min after medication were increased significantly in Liguzinediol low-dose group （P＜0.05 or P＜0.01）. LVSP at 5-90 min after medication， SP at 10-60 min after medication， DP at 10-60 min （except for 20 min） after medication were increased significantly in Liguzinediol medium-dose group （P＜0.05 or P＜0.01）. LVSP at 1-120 min after medication， +dp/dtmax at 5-90 min after medication， │－dp/dtmax│， and SP at 5-60 min after medication， DP at 40-60 min after medication were increased significantly in Liguzinediol high-dose group （P＜0.05 or P＜0.01）. CONCLUSIONS： Single intravenous injection of Liguzinediol can significantly enhance ventricular systolic function of CHF model rats so as to control or relieve CHF.

Eradication of H.pylori is essential to reducing the incidence of gastric cancer / 中国实用内科杂志

Gastric cancer has become the world's fourth most common malignant tumor, and the second leading cause of cancer death worldwide. Helicobacter pylori(H.pylori) infection is a major risk factor of occurrence and development of gastric cancer. In the multistage pathogenesis of gastric cancer, H.pylori infection induces chronic active gastritis slowly, which develops into gastric cancer in the end through precancerous stage of atrophic gastritis, intestinal metaplasia and hyperplasia. Related researches prove that eradication of H.pylori, particularly in the early stage, can effectively prevent the occurrence of gastric cancer. In some cases, the eradication of H.pylori can prevent the development of gastric precancerous lesions and reverse them. This paper will elaborate on the role of H.pylori eradication in the prevention of gastric cancer.

Spatial analysis of the incidence of occupational diseases in Guangdong Province / 预防医学

Objective @#To explore the spatial distribution of occupational diseases in Guangdong Province and to provide evidence for the policy development of occupational disease prevention and control. @*Methods @#A database of occupational disease incidence from 2009 to 2016 in Guangdong Province was built. The distribution of occupational diseases in Guangdong Province was displayed based on the geographic information system（GIS）, then spatial autocorrelation analysis and trend-surface analysis were carried out to explore the clustering areas and spatial epidemic characteristics of occupational diseases in Guangdong Province.@* Results @#The number of cases with occupational diseases was 5 231 and was increasing year by year from 2009 to 2016 in Guangdong Province. The high-incidence areas were located in Guangzhou,Shenzhen,Foshan and Dongguan. Through global spatial autocorrelation analysis,it was found that there were spatial clustering of occupational diseases in Guangdong Province in each year（P<0.05）,and the cumulative incidence was also clustered（Moran's I=0.492,P<0.05）. The number of cases in Guangzhou,Shenzhen,Foshan and Dongguan had local spatial autocorrelation,and the local Moran's I values were 10.329,8.614,3.725 and 9.811,respectively（P<0.05）. The results of trend surface analysis showed that the overall incidence of occupational disease had a slight increase from west to east,and the Pearl River Delta region was a high-incidence area. @*Conclusion @#The incidence of occupational diseases in Guangdong Province had an obvious spatial clustering,the Pearl River Delta region was a high-incidence area.

Systematic review and Meta-analysis of efficacy and safety of Huachansu in treating cancer-related pain / 中国中药杂志

To evaluate the effectiveness and safety of Huachansu in the treatment of cancer-related pain,four Chinese databases( CNKI,VIP,Wan Fang,Sino Med) and three English databases( Cochrane Library,Medline,PubMed) were systematically and comprehensively retrieved since the establishment of each database to October 2018. Randomized controlled trials( RCTs) for the treatment of cancer-related pain with Huachansu were screened out according to pre-established inclusion criteria and exclusion criteria. Rev Man5. 3 software was used for Meta-analysis. A total of 241 articles were retrieved,and finally 10 studies were included. The total sample size was 1 293,including 648 in the experimental group and 645 in the control group. The overall quality of the included studies was generally low. The results of Meta-analysis showed that Huachansu combined with Western medicine acesodynes was superior to the single use of Western medicine acesodynes in the treatment of short-term pain relief,improvement of quality of life and reduction of constipation,nausea and vomiting,dizziness,drowsiness,anorexia and other adverse reactions. And it also has the advantage of a shorter onset time and longer duration time of analgesia,but cannot reduce the incidence of dysuria. Based on the findings,Huachansu had a certain effect in the treatment of cancer-related pain,and a significant positive effect on the improvement of quality of life and the reduction of adverse reactions. No serious adverse reactions occurred. However,due to the small number of studies included,the low quality of the included studies,published biases and other restrictions,the evidence in this study has a low quality,and the conclusion shall be adopted with caution. The effectiveness and safety of Huachansu in the treatment of cancer-related pain remained to be further confirmed in the future with a well-designed,rigorous,and standardized report,with a large sample size,multiple centers,and sufficient follow-up time for randomized controlled trials.

Preparation and biological identification of monoclonal and functional antibody against human specific polypeptide FXYD6 / 重庆医学

Objective To study and prepare the monoclonal antibody library against human FXYD6 functional region,to screen the hybridoma cell lines secreting the monoclonal antibodies against intracellular or extracellular region of human FXYD6,and to identify the biological function of monoclonal antibody against extracellular domain.Methods FXYD6 functional region recombinant protein which did not contain the transmembrane region was prokaryotically expressed,purified,and FXYD6 recombinant protein was used to immunize BALB/c mice.Then splenocytes after immunization were fused with myeloma cells SP2/0.After several rounds of screening and cloning,the hybridomas which secreted the antibodies against the extracellular domain or the intracellular domain of human FXYD6 were established.The antibody specificity and subtype were identified with indirect ELISA,western blot and immunohistochemistry.The monoclonal antibodies against the extracellular domain which recognized the native conformation were screened with flow cytometry.The antibody against extracellular region was prepared with the ascites revulsion method and purified.The affinity constants were measured with indirect ELISA.The function of extracellular monoclonal antibody was detected by HepG2 cell line with high expression of FXYD6.Results The hybridoma cell library which secreted the monoclonal antibody against extracellular domain or the intracellular domain of human FXYD6 was successfully obtained,and extracellular region monoclonal antibodies with the functional blocking were prepared.Conclusion The prepared anti-human FXYD6 extracellular monoclonal antibodies could inhibit HepG2 cell proliferation.

Immunometabolism and systemic lupus erythematosus / 北京大学学报(医学版)

Systemic lupus erythematosus (SLE) is a highly heterogeneous autoimmune disease, characterized by production of pathogenic autoantibodies and wide involvement of multiple systems. Damageofimmune tolerance and imbalance of immune homeostasis lead to the production of autoantibodies and the injuries of multiple organs and systems. In recent years, plenty of studies have identified that immunometabolism affects survival status of certain cells, also cell activation, differentiation and effector functions. Conversely, immune cells with different functions or differentiational status upregulate specific metabolic pathways to maintain their identities. In response to outer stimulations, naive immune cells differentiate into activated cells, accompanied with a series of immunometabolism changes. Therefore, abnormal immunometabolism can induce global imbalance of immune homeostasis, which further results in the initiation and development of autoimmune diseases, including SLE. Multiple abnormalities of immunometabolism have been found in patients with SLE or mouse models of lupus. Immune cells involved in the development of SLE, such as T cells, B cells, dendritic cells and macrophages present various metabolic abnormalities and pathological phenotypes. Among these cells, CD4+ T cells play predominant roles in the pathogenesis of SLE. Lots of studies demonstrated that CD4+ T cells and their subsets were in abnormal immunometabolic status,which further resulted in the development of SLE. In CD4+ T cells from patients with SLE or mouse models of lupus, both levels of glycolysis and oxidative phosphorylation are significantly higher compared with healthy controls. However,mitochondrial abnormalities, decreased ATP production and increased level of oxidative stress also have been found in these cells, which play important roles in the production of reactive oxygen intermediates and autoantibodies. Aggregated lipids rafts and increased synthesis of glycosphingolipid and cholesterol also have been observed in the CD4+ T cells from patients with SLE, leading to the abnormally elevated TCR signaling. Moreover, mechanistic target of rapamycin (mTOR) signaling is activated in the CD4+ T cells from both patients with SLE or mouse models of lupus and participate in the metabolic abnormalities of pathological CD4+ T cells. Progressive understanding of immunometabolism give us new insights of the pathogenesis of SLE and provide us with more therapeutic targets in the treatment of SLE.

GATA3-IL-13 pathway gene polymorphisms are associated with serum IL-13 and asthma / 中国免疫学杂志

Objective:Asthma is a chronic inflammatory respiratory disease .The data show that involvement of the GATA 3-IL-13 gene in asthma is biologically plausible .The objective of this study is investigated the association of GATA 3-IL13 gene polymorphisms and IL-13 levels with asthma;assess the correlations between GATA 3-IL-13 gene SNPs polymorphisms and serum levels of IL-13 in population of Xinjiang (China).Methods:A case group of 279 patients and 277 healthy controls were genotyped to perform using the MassARRAY SNP genotyping system.In 279 asthma patients and 277 controls,IL-13 levels were measured by ELISA.Data were analyzed using the statistical package for social science (SPSS) 22.0 (IBM,NY,USA) and Graph Pad Prism 6.0.Results:Patients were found that IL-13 levels were associated with asthma in asthmatic and the IL-13 ( rs2066960 AA ) , GATA3 ( rs3781093 CC) genotype was associated with a notably increased risk of asthma compared with the CC (rs2066960),TT (rs3781093) genotype (P<0.05).Similarly,IL-13(rs2066960) C-A alleles were significantly associated with risk of asthma (P<0.05).However,the rs3781093 C-T alleles had no obvious differences (P>0.05).In addition,the patients carrying the rs2066960 AA genotype presented with higher IL-13 levels compared to the CC group .Conclusion:This result suggests that the rs 2066960 C-A variant is associated with IL-33 levels in patients with asthma .

Evaluation of left ventricular strains in patients with maintenance hemodialysis using layer-specific two-dimensional speckle tracking imaging / 中华超声影像学杂志

Objective To evaluate the impact of maintenance hemodialysis(MHD) on left ventricular(LV) strains via layer-specific speckle-tracking imaging (LSTI).Methods Twenty-eight MHD patients and 28 matched controls were enrolled in the study.Conventional echocardiography and LSTI were performed on patients before and shortly after one hemodialysis session,as well as on controls.Results LV end-diastolic volume (LVEDV) were markedly reduced after one session of HD [(52.3±22.4)ml/m2 vs (55.0±15.3)ml/m2,P=0.033],but still larger than the control group (47.4±6.4) ml/m2.LV ejection fraction (LVEF) decreased in MHD patients after HD [(62.5±8.1)% vs (64.6±7.3)%,P=0.06],which was similar to those in the control group (66.0±4.2)% and in MHD patient before HD (P=0.391).The three layer circumferential and longitudinal strains decreased in the order of the control group,patients before HD and after HD [CS-endo:(-26.3±3.6)% vs (-22.2±4.7)% vs (-19.2±5.4)%;CS-mid:(-19.0±2.7)% vs (-15.3±3.5)% vs (-13.0±3.8)%;CS-epi:(-11.1±2.3)% vs (-8.0±2.6)% vs (-6.5±2.3)%;LS-endo:(-23.7±3.0)% vs (-18.6±3.6)% vs (-16.4±4.5)%;LS-mid:(-20.9±2.7)% vs (-16.3±3.1)% vs (-14.0±4.1)%;LS-epi:(-18.4±2.4)% vs (-14.1±2.8)% vs (-12.0±3.6)%;all P<0.01],while the synchrony index,standard deviation of times to peak longitudinal strain,increased in these three groups [(3.6±1.0)% vs (6.3±1.5)% vs (7.5±2.2)%,all P<0.01].Linear correlation analysis showed ultrafiltration volume was negatively related with the difference of longitudinal strains before and after HD (difference of LS-endo:r=-0.428,P=0.023;difference of LS-mid:r=-0.423,P=0.025;difference of LS-epi:r=-0.422,P=0.025).Conclusions One session of HD may have injurious effects on LV strains and systolic synchrony.The reduction of ultrafiltration volumes may be helpful to protect cardiomyocytes.

Assessment of right ventricular volume and systolic function after percutaneous pulmonary valve implantation by real-time three-dimensional echocardiography / 中华超声影像学杂志

Objective To investigate the alternation of right ventricular volume and systolic function in patients with severe pulmonary regurgitation under percutaneous pulmonary valve implantation(PPVI) by real-time three-dimensional echocardiography(RT-3DE).Methods Ten patients with severe pulmonary regurgitation were enrolled.The 2D echocardiography images and real-time 3D full volume images on apical four-chamber view on a Philips IE33 system were acquired before PPVI and at 3 days,1 month,3months and 6 months after PPVI.Right ventricular end diastolic volume (EDV),end systolic volume(ESV),stroke volume (SV),ejection fraction(EF),fractional area change(FAC),tricuspid annular plane systolic excursion (TAPSE),right ventricular longitudinal strain-free wall(RVLSf) and right ventricular longitudinal strainseptum(RVLSs) were analysed using off-line TomTec software,the differences among the five groups were compared,and correlation analysis was made between the CMR and RT-3DE measurements.Results The level of pulmonary regurgitation had decreased or disappeared after PPVI.Compared with the preoperation,EDV,ESV at 3 days,1 month,3months and 6 months after operation had decreased significantly.EF,FAC,TAPSE,RVLS had increased significantly(all P ＜0.05).There were close correlation in EDV,ESV,EF between RT-3DE and CMR(pre-operation r =0.811,0.817,0.807,post-operation r =0.735,0.834,0.800,all P ＜0.055).Conclusions RV volume notably decreases while RV systolic function remarkably improves.The RT-3DE is a helpful technology in the evaluation of right ventricular volume and systolic function in patients after PPVI.

Recommendations for acupuncture in clinical practice guidelines of the national guideline clearinghouse / 中国结合医学杂志

<p><b>OBJECTIVE</b>To organize the clinical practice guidelines (CPGs) related to acupuncture included in the National Guideline Clearinghouse (NGC) to systematically summarize the diseases and disorders most commonly treated with acupuncture, the strength of recommendations for acupuncture and the quality of evidence.</p><p><b>METHODS</b>The NGC database was systematically searched for guidelines that included acupuncture as an intervention. Two independent reviewers studied the summaries and the full texts of the guidelines and included guidelines based on the inclusion and exclusion criteria. Thirty-nine guidelines were collected with 80 recommendations. The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument was used to assess the quality of these guidelines.</p><p><b>RESULTS</b>Of the 80 recommendations on acupuncture, 49 recommendations were clearly for acupuncture, 25 recommendations were against acupuncture and 6 recommendations did not indicate any clear recommendations, 37 recommendations were for painful diseases/disorders, and 12 recommendations were for non-painful diseases/disorders. Locomotor system disorders were the most common in the painful diseases/disorders category. Out of all the recommendations for acupuncture, most recommendations (87.76%) were weak in strength, and most of the evidence (40.84%) was of low quality.</p><p><b>CONCLUSIONS</b>In the National Guideline Clearinghouse, the recommendations for acupuncture focus on painful diseases/disorders. The recommendations in the guidelines are not high in strength, and most of the evidence is moderate or low in quality.</p>

Correlation between hearing-related gene polymorphism and susceptibility of noise-induced hearing loss / 中国职业医学

OBJECTIVE: To examine the correlation between single nucleotide polymorphism( SNP) in 3' untranslated regions and hearing-related genes and their correlation with susceptibility in noise-induced hearing loss( NIHL) in Chinese Han population. METHODS: A total of 2 507 workers exposed to 72-120 d B( A) of normalized continuous A-weighted sound pressure level equivalent to a 40 h-working-week intensity of continuous noise in three large compressor manufacturing enterprises in Guangzhou were chosen as study subjects by judgment sampling method. A model was set up to define sensitive group( 238 sensitive workers) and resistant group( 238 resistant workers) by testing the workplace noise intensity and worker hearing pure tone threshold test. The genomic DNA from peripheral blood was collected from workers of these two groups. The genetic characteristic analysis was carried out by using the Taq Man probe with chemical fluorescence allelic identification test. RESULTS: The monaural threshold of weighted value( MTWV) of the left ear in sensitive group was higher than that of the right ear( P < 0. 01); the MTWV of left ear and right ear in sensitive group were respectively higher than that of the same ear in resistant group( P < 0. 01). A total of four candidate genes were screened: vesicle associated membrane protein 1( VAMP1),fibroblast growth factor 1( FGF1),potassium inwardly-rectifying channel,subfamily J,member 10( KCNJ10) and myosin IC( MYO1C). The results of SNP loci detection showed that more workers in sensitive group carried FGF1 rs17217562 AC and CC genotype than that of resistant group( P < 0. 05). More workers in sensitive group carried C allele of FGF1 rs17217562 than the resistant group( P < 0. 05). The logistic regression analysis showed that after correcting the confounding factors including age,noise exposure level,length of noise exposure,gender,smoking,drinking,whether or not using headset,organic solvents exposure,heavy metal exposure,high temperature exposure and hand-arm vibration exposure,the people carrying allele of FGF1 rs17217562 had an increased risk of NIHL susceptibility( P < 0. 05). The VAMP1,KCNJ10 and MYO1C gene had no susceptibility correlation with SNP and NIHL.CONCLUSION: Among Chinese Han population,SNP loci located on the FGF1 rs17217562 may be correlated with the susceptibility of NIHL.