Construction of a model for early identification of spotted fever and severe fever with thrombocytopenia syndrome / 预防医学

Objective@#To construct a model for clinical identification of spotted fever (SF) and severe fever with thrombocytopenia syndrome (SFTS), so as to provide insights into early identification of SF and SFTS.@*Methods@#The clinical data of laboratory-confirmed SF and SFTS patients in secondary and tertiary hospitals in Lu'an City, Anhui Province from May 2017 to May 2021 were retrieved from Chinese Disease Prevention and Control Information System. Factors affecting SF were identified using a logistic regression model, and the model for early identification of SF and SFTS was created. The model fitting effect was evaluated using Hosmer-Lemeshow test, and the value of the model for identification of SF and SFTS was evaluated using the area under the receiver operating characteristic curve (AUC).@*Results@#Data of 62 SF cases and 115 SFTS cases were included. Multivariable logistic regression analysis showed that rash (β=5.994), C-reactive protein (β=4.409), white blood cell (β=-3.176) and platelet (β=-3.234) were included in the model, which were scored 6, 4, -3 and -3, with a total score ranging from -5 to 10. Hosmer-Lemeshow test revealed a high model fitting effect (χ2=3.245, P=0.662). The AUC of the model was 0.992, and the sensitivity and specificity were 0.935 and 0.991 if the cutoff was 1.@*Conclusion@#A model for early identification of SF and SFTS that includes four variables of rash, C-reactive protein, white blood cell and platelet has been created, which has a high accuracy.

Risk factors for yersiniosis: a case-control study / 预防医学

Objective@#To investigate the risk factors for yersiniosis, so as to provide insights into prevention of yersiniosis.@*Methods@#The patients with yersiniosis admitted to the clinics in the surveillance site of Chengbei Township of Jin'an District and Chengnan Township of Yu'an District in Lu'an City from 2013 to 2021 were included as the case group, and the healthy family members matched to cases were selected as the family control group, while normal residents with a 1︰2 match in the same village, gender, and age difference within 5 years were included in the community control group. Participants' demographics, hand-washing and eating habits, living environment hygiene, poultry and livestock feeding were collected using questionnaire surveys, and factors affecting yersiniosis were identified using a multivariable conditional logistic regression model.@*Results@#There were 43 cases in the case group, with a median (interquartile range) age of 45 (34) years, 91 cases in the family control group, with a median (interquartile range) age of 36 (36) years and 86 cases in the community control group, with a median (interquartile range) age of 46 (34) years. Multivariable conditional logistic regression analysis showed that compared with the family control group, the habit of drinking unboiled water (OR=6.721, 95%CI: 1.765-25.588), and direct consumption of food stored in the refrigerator (OR=7.089, 95%CI: 1.873-26.829) were risk factors for yersiniosis in the case group; and compared with the community control group, not washing hands after contacting with poultry and livestock (OR=50.592, 95%CI: 2.758-927.997), habit of eating raw vegetables and fruits (OR=5.340, 95%CI: 1.022-27.887), direct consumption of food stored in the refrigerator (OR=19.973, 95%CI: 2.118-188.336), and unclean refrigerator (OR=12.692, 95%CI: 1.992-80.869) were risk factors for yersiniosis in the case group. Compared with the family and community control groups, not washing hands after contacting with poultry and livestock (OR=4.075, 95%CI: 1.427-11.637), habit of drinking unboiled water (OR=4.153, 95%CI: 1.331-12.957), habit of eating raw vegetables and fruits (OR=4.744, 95%CI: 1.609-13.993), and direct consumption of food stored in the refrigerator (OR=5.051, 95%CI: 1.773-14.395) were risk factors for yersiniosis in the control group.@*Conclusion@#Unhealthy habits such as eating raw vegetables and fruits, drinking unboiled water, direct consumption of food stored in the refrigerator, unclean refrigerator, and not washing hands after contacting poultry and livestock may increase the risk of yersiniosis.

Mechanism of 3-arylcoumarin derivatives inhibiting vascular calcification / 中国药科大学学报

@#To reveal the pharmacological mechanism of 3-arylcoumarin derivative 3-(4′-hydroxyphenyl)-6-hydroxycoumarin (SJ-6) against vascular calcification, advanced glycation end products (AGEs) were used to induce the calcification of human aortic vascular smooth muscle cells (HCASMCs), and calcification was identified by alizarin red staining and quantification.The effects of SJ-6 on alkaline phosphatase (ALP) activity, cell proliferation rate, calcium content, and total reactive oxygen species (ROS), superoxide dismutase (SOD), AGEs, and tetra methylethlene diamine proteinase factor-α (TNF-α), interleukin-6 (1L-6), interleukin-β (1L-β), runt-related transcription factor 2 mRNA (Runx2 mRNA), the receptor of advanced glycation endproducts (RAGE), nuclear factor kappa-B (NF-κB), napdh oxidase-1 (NoX-1), protein kinase C(PKC), protein kinase b(AKT), p38 mitogen-activated protein kinase (p38 MAPK), and smooth muscle actin-α (SMA-α) protein expression were determined.According to our results, SJ-6 significantly decreased AGEs content, ALP activity, intracellular calcium content, ROS content, Runx2 mRNA and inflammatory factors TNF-α, 1L-6 and 1L-β (P < 0.05) and increased SOD content (P < 0.01), with similar to those of the positive control drug aminoguanidine hydrochloride (AGH).Therefore, we investigated the pharmacological mechanism of compound SJ-6, which was found to significantly inhibit the expression of RAGE, NF-κB, NoX-1, PKC, Akt, p-p38 and other essential signaling proteins in the calcified cell model (P < 0.01) and increas the expression of smooth actin SMA-α (P < 0.01).SJ-6 inhibits vascular calcification by inhibiting oxidative stress and the expression of AGEs/RAGE, Akt/PKC and NF-κB signaling pathways, suggesting that it may be a novel drug for the treatment of vascular calcification.

The role of STAT3 in inflammatory bowel disease and colitis-associated cancer and research progress of the related drugs / 药学学报

Signal transducer and activator of transcription (STAT) 3 is a critical transcription factor for cell proliferation and survival. It is activated within cells by many cytokines to mediate immune and inflammatory responses to injury. Inflammatory bowel disease (IBD), represented by Crohn′s disease (CD) and ulcerative colitis (UC), is a chronic inflammatory disease of the intestinal tract. STAT3 has been shown to be abnormally activated in IBD colon tissues by many pro-inflammatory cytokines, leading to disruption of the intestinal mucosal barrier and excessive innate immune and Th17 responses. The persistent chronic inflammation eventually leads to intestinal fibrosis and stenosis. In addition to immune responses, STAT3 is also involved in intestinal fibrosis in IBD by promoting the transcription of fibrosis-related genes. Colitis-associated cancer (CAC) is a particularly aggressive subtype of colorectal cancer and is associated with chronic inflammation-induced IBD. STAT3 has also been associated with CAC initiation and development. STAT3 is overactivated in tumors, which leads to suppression of the anti-tumor activity of immune cells and promotion of cancer cell proliferation, tumor angiogenesis, invasion, and migration. In the present article, we summarize the role of STAT3 in IBD and CAC and the research progress of the related drugs developed for UC and CAC treatment.

Accuracy of photogrammetry and conventional impression techniques for complete-arch implant rehabilitation: an in vitro comparative study / 中华口腔医学杂志

Objective: To compare the accuracy of photogrammetry and conventional impression techniques for complete-arch implant rehabilitation. Methods: An edentulous maxillary stone cast containing 8 screw-retained implant abutment replicas was derived from a 74-year-old male patient who visited the Department of Dental Implant Center, Capital Medical University School of Stomatology in September 2019. The stone cast was copied through the open-tray splinted impression, and the copied cast was used as the master cast for this study. The abutment-level impressions of master cast were made by photogrammetry (PG) and the conventional impression technique (CNV) by one attending doctor. Group PG: after which scan bodies were connected to each implant replica, a photogrammetry system was used to obtain digital impressions of the master cast (n=10); Group CNV: conventional open-tray splinted impression technique was performed to fabricate conventional definitive casts (n=10). After connecting the scan bodies onto each implant replicas, the master cast and the 10 definitive casts from group CNV were digitized with a laboratory reference scanner. All data of group PG, group CNV and mater cast were saved as ".stl" files. For all test scans and reference scan, the three-dimensional information of scan bodies were converted to implant abutment replicas using a computer aided design software (Exocad). The data of the group PG and the group CNV were respectively registered with the reference data (trueness analysis) and pairwise within group (precision analysis) for accuracy evaluation in a three-dimensional analysis software (Geomagic Control X). Results: The trueness and precision of group PG [(17.33±0.34) and (2.50±0.79) μm ] were significantly statistically better than those of group CNV [(24.30±4.16) and (26.12±4.54) μm] respectively (t=-5.29 and -34.35, P<0.001). Conclusions: For complete-arch implant abutment-level impression, photogrammetry produces significantly better accuracy than conventional impression technique.

Comparison of the objective ocular torsion measured with GMPE module-based OCT and fundus color photography / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To compare the consistency and feasibility of objective ocular torsion measured with GMPE module-based optical coherence tomography(OCT)and fundus color photography(FCP).METHODS: Patients were enrolled in our strabismus clinic from December 2020 to March 2021, and the objective ocular torsion of the eyes was measured by both GMPE module-based OCT and FCP on the same day. FCP was used to measure the fovea-disc angle(FDA)manually by using the Adobe Photoshop software, while the GMPE module-based OCT software positioned automatically the macula and the center of the optic disc to measure the FDA.RESULTS: Fifty-five patients were included, the FDA measured by OCT was -6.6°±4.5° in the right eye and -8.8°±4.7° in the left eye, respectively; The FDA measured by FCP was -6.6°±4.7° in the right eye and -8.4°±4.1° in the left eye, respectively, with no statistically significant difference between the results of the two methods(Pright eye=0.90, Pleft eye=0.08). In patients with exotropia, the FDA measured by OCT was -5.8°±4.9° in the right eye and -9.1°±4.5° in the left eye, respectively, the FDA measured by FCP was -5.7°±5.0° in the right eye and -8.6°±4.3° in the left eye, respectively,(Pright eye=0.75, Pleft eye=0.15). Similarly, the patients with esotropia, the FDA measured by OCT was -9.0°±7.3° in the right eye and -11.3°±3.5° in the left eye, respectively, while the FDA measured by FCP was -10.0°±7.0° in the right and -10.1°±2.8° in the left eye(Pright eye=0.21, Pleft eye=0.10), respectively. There were no significant differences between the two methods in patients with esotropia or exotropia(P>0.05). The results of both Pearson test and Bland-Altman analysis were highly correlated(rright eye=0.93, rleft eye=0.94, P<0.01). CONCLUSION: GMPE module-based OCT can be used for objective ocular torsion measurement with high reliability and reproducibility, and is a promising clinical alternative to the fundus color photographic method.

A case of cicatricial female pattern hair loss / 中华皮肤科杂志

A case of cicatricial female pattern hair loss was reported. A 36-year-old female patient presented with gradually aggravated hair loss for more than 10 years. Skin examination showed diffuse hair thinning on the scalp, thin and soft hairs, and some pencil eraser-sized areas of focal atrichia. TrichoScan examination revealed markedly decreased hair density on the forehead, variability in hair diameter greater than 20%, and increased proportions of vellus hairs. Dermoscopic examination showed increased numbers of vellus hairs, plenty of focal atrichia areas measuring 3 - 5 mm in diameter, loss of some follicular ostia, and confluent white dots. Histopathological examination of vertical and transverse scalp sections showed predominantly distributed miniaturized hair follicles with lichenoid folliculitis around the infundibulum and isthmus, concentrically layered perifollicular fibrosis, a marked decrease in the number of hair follicles compared with healthy people of the same age, increased proportions of vellus hairs, a large number of miniaturized hair follicles and follicular streamers, and formation of follicular micro-scars. The patient was diagnosed with cicatricial female pattern hair loss. She received topical treatment with 5% minoxidil liniment once a day, and alternate treatment with topical tacrolimus ointment and clobetasol propionate ointment, as well as oral spironolactone at a dose of 20 mg twice a day and compound glycyrrhizin capsules at a dose of 50 mg thrice a day. After half a year of treatment, there was no marked aggravation of hair loss, and the follow-up continued.

Distributions of gut Akkermansia muciniphila and its non-linear associations with obesity / 中华内分泌代谢杂志

Objective:Investigating the distribution of intestinal Akkermansia muciniphila (AKK) and explore abundance-effect in obesity obesity to provide potential dose effect for obesity intervention.Methods:Clinical data of 6 986 subjects including body mass index, waist circumference, and common confounders such as gender, age, diastolic blood pressure, systolic blood pressure, fasting blood glucose, triglyceride, total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein-cholesterol, and uric acid were collected from Guangdong Gut Microbiome Project in 2008. 16S ribosomal RNA (16S rRNA) sequencing data were used to estimate the genus abundance of AKK as well as its operational taxonomic unites (OTUs). Central obesity and overall obesity were diagnosed according to the criteria of China Obesity Working Group in 2002. Multivariate logistic regression was used to analyze the OR (95% CI) of obesity with one-unite elevation of AKK. The dose effect of AKK on obesity was estimated by comparing the trend of ORs from the 1st to the 20th quantile. Results:A total of three AKK OTUs(AKK OTU1, AKK OTU2, AKK OTU3) were identified: AKK OTU1 and AKK OTU2 were distributed in more than 90% of the population, while AKK OTU3 was distributed at 21.7%; All the OTUs showed a"bimodal"distributional pattern and their correlations with common factors were variable. Disparities of the association with obesity were found between the OTUs and the AKK. AKK OTU1, AKK OTU2, and the genus level of AKK showed significant protective effects against obesity; The ORs (95% CI) were 0.95(0.93-0.98), 0.97(0.94-0.99), 0.93(0.91-0.96), respectively for central obesity; And ORs(95% CI) were 0.88(0.80-0.97), 0.98(0.93-1.02), 0.81(0.74-0.89), respectively for overall obesity. The results were similar after adjustment for common confounders. According to the calculation of dose-effect, the protect effects of AKK increased with accumulated abundance and the minimum effective dose on central obesity and overall obesity was 1.83% and 4.98%, respectively. Conclusion:AKK is a protective factor for obesity, but the dose-effect of AKK and the strain-differences should be considered in the future interventional study.

Protective Effect and Mechanism of Sanhuatang and Its Modifications on Cerebral Ischemia-reperfusion Injury in Rats / 中国实验方剂学杂志

ObjectiveTo observe the protective effect of Sanhuatang and its modifications on the brain tissue of rats exposed to cerebral ischemia-reperfusion injury （CIRI） and explore its action mechanism and compatibility characteristics. MethodOne hundred and forty SD male rats of clean grade were randomly divided into the control group， sham-operation group， and operation group. The Longa suture method was employed to establish the CIRI model. The successfully modeled CIRI rats were further divided into five groups， namely the model group， nimodipine group， Sanhuatang without Notopterygii Rhizoma et Radix group， Notopterygii Rhizoma et Radix group， and Sanhuatang group， and treated with the corresponding medicines by gavage for five days. The cerebral infarct size in each group was examined by 2，3，5-triphenyltetrazolium chloride （TTC） staining， and the pathological changes in the brain tissue were observed by hematoxylin-eosin （HE） staining and electron microscopy. The mRNA and protein expression levels of Claudin-5， Occludin， and zonula occludens-1 （ZO-1） in brain tissues were detected by real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） and Western blot， respectively. ResultCompared with the control group， the model group exhibited markedly increased infarct size， obvious changes in brain morphology and ultrastructure， and down-regulated mRNA and protein expression of Claudin-5， Occludin， and ZO-1 （P<0.01）. Compared with the model group， both nimodipine and Sanhuatang significantly decreased the infarct size （P<0.01） and relived the pathological changes. The infarct sizes in the Sanhuatang without Notopterygii Rhizoma et Radix group and Notopterygii Rhizoma et Radix group were reduced without exhibiting a statistically significant difference. The mRNA and protein expression levels of Claudin-5， Occludin， and ZO-1 in the nimodipine group， Sanhuatang group， and Notopterygii Rhizoma et Radix group were up-regulated significantly in comparison with those in the model group （P<0.01， P<0.01）. The mRNA and protein expression levels of Claudin-5 and ZO-1 were higher in the Notopterygii Rhizoma et Radix group than in the Sanhuatang without Notopterygii Rhizoma et Radix group （P<0.01， P<0.01）. ConclusionSanhuatang exerts the protective effect against CIRI in rats possibly by regulating the expression of Claudin-5， Occludin， and ZO-1 and improving the blood-brain barrier function. Notopterygii Rhizoma et Radix in Sanhuatang may play an important role in the protection of rats from CIRI.

Thoughts on Current Quality Standard of Atractylodis Rhizoma Based on Genuine Advantages of Traditional Chinese Medicine / 中国实验方剂学杂志

Atractylodis Rhizoma is a kind of commonly used clinical Chinese medicine （TCM）， which was first recorded in Shennong Bencaojing （《神农本草经》）. At that time， it was called "Zhu"， which is the general name of Atractylodis Rhizoma and Atractylodis Macrocephalae Rhizoma. After Song dynasty， Atractylodis Rhizoma and Atractylodis Macrocephalae Rhizoma were separated. Atractylodis Rhizoma can be divided into Atractylodes lancea and A. chinensis. In history， A. lancea as authentic， that its quality is better than A. chinensis. However， the quality of Atractylodis Rhizoma was evaluated by the index component atractylodin in the 2020 edition of Chinese Pharmacopoeia. The general results showed that the content of atractylodin in A. lancea was low， even failed to meet the specified standard， and its content in A. chinensis was significantly higher than that in A. lancea. The results were inconsistent with the records of ancient books and documents， and the quality theory of "genuine medicine is the best". It could not reflect the quality advantage of genuine Atractylodis Rhizoma， and may even affect the clinical application and development momentum of genuine medicine. In short， the quality standard of TCM should not only conform to the historical experience， but also have the connotation of modern science and technology， which can stand the test of practice. Based on this， the author intends to sort out relevant laws and regulations， sort out the literature related to the authenticity， composition and efficacy of Atractylodis Rhizoma， and analyze the rationality of the current standard of Atractylodis Rhizoma by integrating the relevant records of historical classics and modern research results， so as to provide a basis for the improvement of the quality standard of Atractylodis Rhizoma.

Effects of long-chain noncoding RNA Linc00673 overexpression on proliferation and apoptosis of gastric cancer cell line MGC-803 / 中国应用生理学杂志

Objective: To investigate the effects of long-chain noncoding RNA Linc00673 overexpression on proliferation and apoptosis of gastric cancer cells and its mechanisms. Methods: The recombinant lentivirus expressing plasmid pLVX-Linc00673 and the control empty plasmid pLVX-NC were packaged and amplified in 293T cells, and the recombinant lentivirus was transfected into gastric cancer cell line MGC-803 to establish a cell line stably overexpressing Linc00673. The expression of Linc00673 gene was detected by real-time fluorescence quantitative PCR. The growth and proliferation of cells were observed by MTT assay and clone formation assay. Cell cycle and apoptosis were detected by flow cytometry. The expressions of cell cycle related regulatory genes were detected by qPCR. The expressions of key molecules in the PI3K/Akt signaling pathway and tumor proliferation related proteins were detected by Western blot. Results: The expressions of Linc00673 in gastric cancer cell line MGC-803, BGC-823 and AGS were significantly higher than that in normal gastric mucosa cell line GES-1 (P＜0.05). MGC-803 cell line with stable overexpression of LINC00673 was established, and the expression level of LincC00673 was 200 times higher than that of the control empty carrier group. Overexpression of Linc00673 promoted proliferation of MGC-803 cells (P＜0.05) and clone formation (P＜0.05), inhibited cell apoptosis and affected the G1→S phase progression of cell cycle (P＜0.01). Overexpression of Linc00673 could affect the expressions of cell cycle regulatory gene CCNG2, P19 and CDK1 in MGC-803. Western blot showed that Linc00673 overexpression not only promoted the expressions of the key molecule pAkt in PI3K / Akt signaling pathway and its downstream target NF-κ B and Bcl-2 protein, but also up regulated the expressions of tumor related factors β-catenin and EZH2 proteins. Conclusion: Overexpression of Linc00673 may promote proliferation and inhibit apoptosis of MGC-803 cells through PI3K/Akt signaling pathway.

Weather and Birth Weight: Different Roles of Maternal and Neonatal GPR61 Promoter Methylation / 生物医学与环境科学（英文）

Objectives@#It is unclear whether G protein-coupled receptor 61 (GPR61) affecting body weight, plays a role in the association between birth weight and weather. This study aimed to assess the effects of prenatal weather and GPR61 on birth weight.@*Methods@#A total of 567 mother-newborn pairs were recruited in Houzhai Center Hospital during 2011-2012. We detected the maternal and neonatal GPR61 promoter methylation levels, and obtained meteorological and air pollution data.@*Results@#A positive association was observed between maternal and neonatal GPR61 methylation levels, and both of them were affected by precipitation, relative humidity (RH) and daily temperature range (DTR). Birth weight was associated negatively with RH and positively with DTR ( P < 0.05). A significant association was observed between birth weight and neonatal GPR61 methylation. We observed that maternal GPR61 methylation seemed to modify associations between weather and birth weight ( P interaction < 0.10), while neonatal GPR61 methylation mediated the effects of RH and DTR on birth weight ( P < 0.05).@*Conclusions@#Our findings revealed the significant associations among prenatal weather, GPR61 methylation and birth weight. Maternal GPR61 methylation may modify the susceptibility of birth weight to prenatal weather conditions, while neonatal GPR61 methylation may be a bridge of the effects of prenatal RH and DTR on birth weight.

WANG Ju-yi's meridian diagnosis method combined with Bobath rehabilitation training for post-stroke shoulder-hand syndrome typeⅠ / 中国针灸

OBJECTIVE@#To compare the clinical efficacy differences between WANG Ju-yi 's meridian diagnosis method combined with Bobath rehabilitation training and Bobath rehabilitation training alone for post-stroke shoulder-hand syndrome (SHS) typeⅠ.@*METHODS@#A total of 106 patients with post-stroke SHS typeⅠwere randomly divided into an observation group (53 cases, 2 cases dropped off ) and a control group (53 cases, 3 cases dropped off ). The patients in the both groups were treated with medications for basic diseases and conventional acupuncture at Waiguan (TE 5), Shousanli (LI 10) and Jianyu (LI 15) on the affected side. In addition, the patients in the control group were treated with Bobath rehabilitation training, 20 minutes each time; on the basis of the control group, the patients in the observation group were treated with WANG Ju-yi's meridian diagnosis method to adjust the abnormal parts in meridians of the hand taiyin and hand yangming on the affected side, 20 minutes each time. Both groups were treated once a day, 5 times a week for 8 weeks. The scores of visual analogue scale (VAS), upper-limb Fugl-Meyer assessment (FMA) and Barthel index (BI) were recorded before and after treatment as well as 6 weeks after treatment (follow-up), and the clinical efficacy of the two groups was evaluated after treatment.@*RESULTS@#Compared before treatment, the VAS scores were reduced and the scores of upper-limb FMA and BI were increased in the two groups after treatment and in the follow-up (P<0.05). The VAS score in the observation group was lower than that in the control group (P<0.05), and the scores of upper-limb FMA and BI in the observation group were higher than those of the control group (P<0.05). The total effective rate in the observation group was 82.4% (42/51), which was higher than 62.0% (31/50) in the control group (P<0.05).@*CONCLUSION@#WANG Ju-yi 's meridian diagnosis method combined with Bobath rehabilitation training could effectively treat post-stroke SHS typeⅠ, reduce pain symptoms and improve joint motor dysfunction, and improve the quality of life. Its curative effect is better than Bobath rehabilitation training alone.

Case report of acromesomelic dysplasia Maroteaux type caused by the NPR2 gene mutation / 中华实用儿科临床杂志

Clinical data of a child with acromesomelic dysplasia Maroteaux type (AMDM) treated in the Department of Pediatrics, Tianjin Medical University General Hospital at November 2018 was retrospectively analyzed.The female child aged 3 years and 3 months old with 83 cm height (-3.84 SD) had clinical manifestations of disproportionate short stature, disproportionate shortening of forearms and forelegs, and stubby fingers and toes.Gene sequencing identified compound heterozygous mutations, c.1640T>A(p.Val547Asp)/c.682G>A(p.Gly228Ser), in the NPR2 gene, which have not been reported in the Human Gene Mutation Database.Their protein function was predicted harmful.The child was diagnosed as AMDM.During the follow-up until 4 years and 8 months old, the child was 90 cm tall (-4.35 SD), with a growth velocity of 4.9 cm/year.She was treated with recombinant human growth hormone (rhGH) treatment for 9 months and regularly followed up.The child was now 98.2 cm height (-3.07 SD) and she had a growth velocity of 10.9 cm/year.This case report enriched the gene mutation spectrum of AMDM.Treatment with rhGH can effectively improve the height of the child, but the long-term effect needs further follow-up and observation.

Epidemiological characteristics of human brucellosis in Xianyang City, Shaanxi Province from 2011 to 2020 / 中华地方病学杂志

Objective:To analyze the epidemic characteristics of human brucellosis in Xianyang City, Shaanxi Province, to grasp the epidemic trend and provide scientific basis for further prevention and control of human brucellosis.Methods:Descriptive epidemiological methods were used to statistically analyze the incidence data and epidemic data of human brucellosis in Xianyang City, Shaanxi Province from 2011 to 2020 in the "Infectious Disease Surveillance System of China Disease Control and Prevention Information System".Results:A total of 864 human brucellosis cases had been reported in Xianyang City from 2011 to 2020, and there was no dead case. The annual incidence began to increase rapidly from 2014, the highest annual incidence in 2019 was 5.79/10 5. There were statistical differences between the incidence of different years (χ 2 = 900.40, P < 0.001). Human brucellosis cases in Xianyang City were mainly concentrated in dairy goat breeding counties, with a total of 571 cases reported, accounting for 66.09%. Cases were reported in all months of the year, and the peak incidence of human brucellosis was from April to August, accounting for 64.35% (556/864). The age of cases was mainly concentrated in the 40 - 69 years old group, accounting for 68.29% (590/864); the ratio of male to female was 2.40 ∶ 1.00 (610 ∶ 254). The occupation was mainly farmers, accounting for 83.45% (721/864). There had been an increase in the proportion of scattered children, students and preschool children. The total serological positive rate was 3.14% (283/9 009) in Xianyang City, and pathogenic culture showed variant strains. The median of interval between onset time and diagnosis time was 8 days. Conclusion:The prevalence of human brucellosis in Xianyang City, Shaanxi Province shows an overall upward trend, which needs to be paid more attention to and control efforts should be strengthened.

MLVA typing and epidemiological analysis of Brucella in Shaanxi Province, 2020 / 中华地方病学杂志

Objective:To analyze the incidence of brucellosis and the genotypes of Brucella isolates or nucleic acids in Shaanxi Province, to get the epidemiological and molecular genetic characteristics, and to provide scientific basis for precise prevention and control of human brucellosis. Methods:Log into the Chinese Disease Control and Prevention Information System, collect the incidence data of human brucellosis of Shaanxi Province in 2020, and analyze the epidemiological characteristics. Bacteriology and PCR methods were used to identify the isolates or nucleic acids, and multiple locus variable-number tandem repeat analysis (MLVA) was used for molecular typing. BioNumerics (Version 7.6) software was used to analyze the results of MLVA.Results:In 2020, 1 086 cases of human brucellosis were reported in Shaanxi Province, the incidence rate was 2.80/100 000, involving 86 counties (districts), the epidemic peak was from March to September (865 cases), male-to-female ratio was 2.68 ∶ 1.00 (791 ∶ 295), 79.74% (866 cases) in the age group of 30 to 69 years old, and 83.43% (906 cases) of the cases were farmers. Biotype identification of 36 isolates showed that 4 isolates were mutant Brucella melitensis, 3 isolates were Brucella melitensis 1 and 29 isolates were Brucella melitensis 3. The 36 isolates and 7 nucleic acids were identified as Brucella by BCSP31-PCR and Brucella melitensis by AMOS-PCR. MLVA-16 genotyping, panel1 showed two genotypes: type 42 (1-5-3-13-2-2-3-2) and type 63 (1-5-3-13-2-3-3-2), panel2A showed 4-41-8 and panel2B showed high variability. Thirty-six isolates and 7 nucleic acids were divided into 33 genotypes, of which 27 genotypes were single isolates and 6 genotypes were shared. Conclusions:The situation of human brucellosis prevention and control in Shaanxi Province is grim. MLVA-16 is a mature genotyping method, which determines the existence of multiple genotypes of Brucella isolates or nucleic acids in Shaanxi Province, which can provide scientific information for precise prevention and control of human brucellosis, outbreak analysis and epidemiological traceability.

Tumor necrosis factor-α inhibitor-induced psoriasis / 中华皮肤科杂志

Tumor necrosis factor-α (TNF-α) inhibitors have been widely used and proven to be effective in the treatment of various inflammatory disorders in recent years, but there is a noteworthy and paradoxical adverse drug reaction that cannot be ignored, that is, TNF-α inhibitor-induced psoriasis. Its pathological manifestations could be psoriasiform or spongiotic changes, and its pathogenesis may be related to the imbalance between TNF-α and type Ⅰinterferon, the involvement of interleukin-23/T helper 17 axis, or infection. This review elaborates the epidemiological, histopathological features and possible pathogenesis of TNF-α inhibitor-induced psoriasis, and provides a basis for recognition and treatment of TNF-α inhibitor-induced psoriasis.

Risk factors for one-year mortality in elderly patients with femoral intertrochanteric fracture following multidisciplinary treatment by intramedullary nailing / 中华创伤骨科杂志

Objective:To analyze the risk factors for postoperative one-year mortality in elderly patients with femoral intertrochanteric fracture following multidisciplinary treatment (MDT) by intramedullary nailing.Methods:The clinical data were retrospectively analyzed of the 158 elderly patients with femoral intertrochanteric fracture who had undergone MDT by proximal femoral intramedullary nailing between January 2018 and August 2020 at Department of Orthopedics, Trauma Center, Zhongda Hospital Affiliated to Southeast University. There were 41 males and 117 females with an average age of 82.5 years (from 65 to 95 years). By the modified Evans classification, there were 15 cases of type Ⅰ, 16 cases of type Ⅱ, 35 cases of type Ⅲ, 81 cases of type Ⅳ, and 11 cases of type Ⅴ. The one-year mortality was documented in the patients after surgery. To screen for risk factors, univariate analysis was conducted of gender, age, body mass index (BMI), modified Evans classification of fractures, time from injury to operation, American Society of Anesthesiologists (ASA) classification, Charlson comorbidity index (CCI) and comorbidities, as well as preoperative hemoglobin (Hb), serum albumin (ALB) and total lymphocyte count (TLC). The factors with P<0.05 were included in the multivariate logistic regression model analysis to determine the risk factors. Results:A total of 13 patients died within one year after surgery, yielding a mortality of 8.2% (13/158). Univariate analysis showed significant differences in age, body mass index, modified Evans classification of fractures, CCI and Hb between the surviving and dead patients ( P<0.05). Multivariate logistic regression analysis showed that age >85 years ( OR=0.122, 95% CI: 0.018 to 0.834, P=0.032), BMI>23.9 kg/m 2 ( OR=0.083, 95% CI: 0.013 to 0.510, P=0.007), CCI≥3 points ( OR=0.051, 95% CI: 0.090 to 0.275, P=0.001) and preoperative Hb<90 g/L ( OR=4.733, 95% CI: 1.036 to 21.624, P=0.045) were the independent risk factors for postoperative one-year mortality in the elderly patients with intertrochanteric fracture following MDT by proximal femoral intramedullary nailing. Conclusions:After MDT by proximal femoral intramedullary nailing of femoral intertrochanteric fractures, the geriatric patients with an age >85 years, BMI>23.9 kg/m 2, CCI≥3 points and Hb<90 g/L are likely to die. Therefore, special care should be taken for them.

Prevalence of overweight and obesity and its relationship with the risk factors of cardiovascular diseases among population for physical examination in Nanjing Drum Tower Hospital / 中华内分泌代谢杂志

Objective:To investigate the prevalences of overweight and obesity and its relationship with the risk factors of cardiovascular diseases among physical examination population in Nanjing Drum Tower Hospital.Methods:A retrospective analysis was performed on 384 061 adults aged 20 years and older. Age- and sex-standardized prevalences of overweight and obesity were calculated using Chinese census data in 2010. Multivariate logistic regression analysis was used to assess the associations of overweight and obesity with the risk factors of cardiovascular diseases.Results:The age-standardized prevalences of overweight and obesity were 42.8% and 13.2% in men and 23.9% and 6.6% in women. A gradually increasing trend was observed in the prevalences of overweight and obesity from 2008 to 2016, especially in subjects aged 20-39 years. Overweight and obesity were significantly associated with increased risks of dyslipidemia, diabetes mellitus, hypertension, and hyperuricemia. These associations were found to be the strongest among subjects aged 20-39 years, which became weaker along with the increasing of age. The OR(95% CI) of dyslipidemia, diabetes mellitus, hypertension, and hyperuricemia were 4.23(4.01-4.47), 3.70(2.97-4.60), 6.19(5.76-6.64), and 3.66(3.45-3.88) in obese men aged 20-39 years, while 5.29(4.63-6.04), 6.38(3.86-10.55), 9.36(7.86-11.13), and 6.65(5.70-7.74) in obese women aged 20-39 years, respectively. Conclusion:The increasing trend in the prevalence of overweight and obesity is a risk factor for cardiovascular diseases in Nanjing adults, especially in individuals aged 20-39 years.

The analysis of gait disorders in patients with idiopathic normal pressure hydrocephalus / 中华老年医学杂志

Objective:To investigate the features of gait disorders in patients with idiopathic normal pressure hydrocephalus(iNPH).Methods:Clinical data of 42 patients diagnosed with iNPH admitted to the neurological department of Aviation General Hospital from March 2017 to July 2020 were consecutively collected.The features of gait disturbance and activity of daily living were retrospectively studied.Results:Of the 42 patients, 29 cases(69%)were males, aged(73.0±8.3)years, and 13 cases were females, aged(73.0±8.3)years old.The mean course of disease was(3.5±3.0)years.There were 90.5% of patients(38/42)complained of gait disorders, and 61.9%(26/42)had fall histories.All patients had gait abnormalities.The time for 3m-Timed Up and Go(TUG)test were(27.8±17.0)seconds, and the proportion of patients with the time for 3m-TUG less than 10 seconds, 10~20 seconds and more than 20 seconds were 5.9%(2/34), 35.3%(12/34)and 58.8%(20/34), respectively.In the 10-meter walking test, 8 patients needed assistance.Of the 34 patients who could walk independently, 94.1%(32/34)had tandem walking disturbed and tendency toward falling, 76.5%(26/34)had turning disturbed, 44.1%(15/34)had wide based stride and small steps, 29.4%(10/34)had trunk balance disturbed, 23.5%(8/34)had reduced foot-floor clearance, and 8.8%(3/34)had start hesitation, 97.6%(41/42)had abnormal step counting and 90.5%(38/42)had abnormal time evaluation.The proportion of patients with activity of daily living(Barthel Index)scores of(mild dependence), moderate dependence and severe dependence were 71.4%(30/42), 28.6%(12/42)and 0%(0/42). Of the 30 patients with mild dependence, 56.7%(17/30)had fall histories.Conclusions:In our study, all patients have gait dysfunction, which causes some impact on activity of daily living and a higher risk of falls.Gait slowness, tandem walking disturbed, turning disturbed, tendency toward falling, wide based stride and small steps are the most involved gait characteristics.Early assessment of gait disorders is of great significance in early diagnosis and the prevention of falls and living ability decline.