Analysis of lung cancer screening through low-dose spiral computed tomography among petroleum company staffs in Sichuan-Chongqing Area in 2020 / 中华劳动卫生职业病杂志

Objective: To provide scientific evidence for early lung cancer screening, to analyze the incidence of pulmonary nodules among petroleum company staffs in Sichuan-Chongqing Area. Methods: In January 2021 , 6002 petroleum company staffs in Sichuan-Chongqing Area which scanned by low-dose spiral computed tomography (LDCT) of chest in medical examination center in 2020 were retrospectively collected as objects. Their imaging and clinical data were collected. χ(2) test was used to analyze the differences in the detection rates of lung nodules and suspected lung cancer nodules among workers in petroleum company staffs of different genders, ages and types of work. Results: Among the 6002 objects, 3853 (64.2%) were male and 2149 (35.8%) were female, with an average age of (47.25±12.13) years old. A total of 431 cases (7.2%) of pulmonary nodules and 57 cases (0.9%) of suspected lung cancer nodules were detected. 45 cases were followed up with surgical treatment, and 41 cases (91.1%) of lung cancer were diagnosed by postoperative pathology. There were significant differences in the detection rates of pulmonary nodules and suspected lung cancer nodules between different age groups (χ(2)=51.23, 18.81 , P<0.001). The detection rates of pulmonary nodules in the age groups 51-60 years old and ≥61 years old were higher than those in the age groups≤40 years old and 41-50 years old (P<0.05). The detection rate of suspected lung cancer nodules in the age group≥ 61 years old was higher than those in the age groups≤40 years old, 41-50 years old and 51-60 years old (P< 0.05) . And the detection rate of suspected lung cancer pulmonary nodules in oil workers was higher than that of ordinary workers (P<0.05) . Among female objects, the detection rate of pulmonary nodules in oil workers was higher than that in ordinary workers (χ(2)=8.09, P=0.004) . The detection rate of pulmonary nodules in oil workers aged ≥61 years old was higher than ordinary workers (χ(2)=37.94, P<0.001) . Among male objects, the detection rate of suspected lung cancer pulmonary nodules in oil workers was higher than that in ordinary workers (χ(2)=8.42, P=0.004) . The detection rates of suspected lung cancer pulmonary nodules in oil workers aged 51-60 years old and ≥61 years old groups were higher than those of ordinary workers (χ(2)=4.70, 8.74; P=0.030, 0.003) . Conclusion: LDCT is suitable for early lung cancer screening for petroleum company staffs. During the clinical screening process, LDCT should be used as a routine physical examination item for petroleum workers older than 51 years old.

Correlation between HIV infection, club drug use and anal canal human papillomavirus infection in men who have sex with men in Taizhou / 中华流行病学杂志

Objective: To explore the correlation between club drug use and anal canal human papillomavirus (HPV) infection in HIV-negative and HIV-positive men who have sex with men (MSM) in Taizhou. Methods: A cross-sectional survey was conducted in Taizhou. HIV-negative MSM were recruited by convenient sampling in voluntary counseling and testing clinics of Taizhou prefectural CDC from August 2016 to October 2017, and HIV-positive MSM were recruited through the routine follow-up and management by Taizhou prefectural CDC from August 2016 to June 2019. A face-to-face questionnaire interview was conducted to collect the information about the socio-demographic characteristics, sexual orientation, sexual behavior, club drug use and other information of the participants. Anal canal swabs were collected for HPV genotyping. The correlation between club drug use and the prevalence of HPV infection were evaluated with χ2 test and logistic regression analysis. Results: A total of 69 HIV-negative and 345 HIV-infected MSM were included. The prevalence of any type of anal canal HPV infection in HIV-negative MSM (27.5%, 19/69) was lower than that in HIV-positive MSM (66.4%, 229/345) (χ2=36.114,P<0.001). The prevalence of self-reported club drug use in HIV-negative MSM was higher (17.4%, 12/69) than that in HIV-positive MSM (7.0%, 24/345) (χ2=7.886, P=0.005). For HIV-negative MSM, the prevalence of club drug use was higher in MSM who had homosexual group sex (P=0.036); the prevalence of HPV infection was 50.0% (6/12) in club drug users and 22.8% (13/57) in non-club drug users (χ2=3.674, P=0.055). For HIV-positive MSM, the prevalence of HPV infection was 70.8% (17/24) in club drug users and 66.0% (212/321) in non-club drug users (χ2=0.230, P=0.632). Multivariable logistic regression model showed that HPV infection in MSM was positively correlated with HIV infection (OR=5.42, 95%CI: 2.92-10.06), and the association between HPV infection and club drug use (OR=1.66, 95%CI: 0.75-3.71) was not significant. Conclusions: HIV infection was positively correlated with anal canal HPV infection in MSM in Taizhou. Club drug use was positively correlated with high-risk sexual behaviors, while its association with HPV infection needs further study.

The effect of diabetes mellitus in the elderly on memory function in patients with mild cognitive impairment / 中华老年医学杂志

Objective:To investigate the effect of diabetes mellitus in the elderly on memory function in patients with mild cognitive impairment(MCI).Methods:Totally 449 community residents were selected for a 2-year follow-up survey.Montreal Cognitive Assessment(MoCA)and Mini-Mental State Examination(MMSE)were selected for overall cognitive function assessment.Fuld Object Memory(FOM)and Digital Span Test(DST)were used to evaluate delayed recall and instantaneous memory.Demographic data such as gender, age, education level, marital history, annual income, blood pressure, medical history etc.were collected.The glycosylated hemoglobin, fasting insulin, and carotid artery intima-media thickness were checked regularly.All subjects were grouped into non-diabetes mellitus normal cognitive group(NDM-NC group), non-diabetes mellitus mild cognitive impairment group(NDM-MCI group), diabetes mellitus normal cognitive group(DM-NC group)and diabetes mellitus mild cognitive impairment group(DM-MCI group).Results:In cross-sectional observation, the first, second, and last recall scores in the FOM showed a decreasing trend in the DM-MCI group, showed a word "U" -shaped fluctuation trend in the DM-NC group and the NDM-MCI group, and showed no significant change in the NDM-NC group.There were no significant differences in DST anterior-backward test scores between the DM-MCI group and NDM-MCI group(all P>0.05).Through longitudinal follow-up and two-by-two comparison with the other three groups, the average value of glycosylated hemoglobin in the DM-MCI group(6.78±0.60)% was the highest, and the differences were statistically significant( P<0.05).During follow-up, the average carotid intima-media thickness(CIMT)was higher in the DM-MCI group(1.03±0.20)mm than in NDM-NC group(0.89±0.20)mm( P<0.05), and the difference was statistically significant.Comparing with the other three longitudinal follow-up groups, the CIMT thickening speed in DM-MCI group was fastest. Conclusions:Elderly DM patient population have a higher prevalence of MCI, and their memory function fluctuates or declines significantly.Therefore, regular detection of memory function is conducive to delaying the progression of DM and MCI.

Risk factors of extrauterine growth retardation in very preterm infants with bronchopulmonary dysplasia / 中国新生儿科杂志

Objective:To study the nutritional status of very preterm infants (VPIs) with bronchopulmonary dysplasia (BPD) during hospitalization and the risk factors of extrauterine growth retardation (EUGR).Methods:From January 2017 to June 2020, clinical data of VPIs with BPD hospitalized in the department of neonatology of our hospital were retrospectively studied. The infants were assigned into EUGR group and non-EUGR group and their nutritional status and the risk factors of EUGR were compared.Results:A total of 225 VPIs were enrolled, including 143 cases of EUGR (63.6%) and 82 non-EUGR (36.4%). The EUGR group had significantly lower birth weight (BW) than non-EUGR group ( P<0.001). No significant difference existed in the gestational age (GA) between the two groups ( P=0.733). The incidences of EUGR in VPIs with mild, moderate and severe BPD were 41.9%, 70.8% and 90.7%, respectively and the differences were statistically significant ( P<0.001). Compared with non-EUGR group, EUGR group received less full-course antenatal corticosteroids (47.6% vs. 63.4%, P=0.022). EUGR group had longer duration of parenteral nutrition, fasting time and achieving full enteral nutrition ( P<0.05). EUGR group also showed slower increment of enteral feed volumes, slower growth velocity and higher incidence of feeding intolerance ( P<0.05). Multivariate logistic regression analysis showed that moderate/severe BPD, BW <1 000 g and feeding intolerance were independent risk factors for EUGR in VPIs. The use of pulmonary surfactant at birth was a predictive factor for EUGR in VPIs with BPD. Growth velocity >13 g/(kg·d) and full-course of antenatal corticosteroids were protective factors of EUGR for BPD infants. Conclusions:It is necessary to improve the use of full-course antenatal corticosteroids to reduce the application of pulmonary surfactant at birth in VPIs. Better enteral nutrition and improved growth velocity will help reducing the incidence of EUGR in VPIs with BPD.

Clinical Application of Toxin Pathogen Causing Disease in Common Nervous System Diseases： A Review / 中国实验方剂学杂志

The diverse nervous system diseases （NSDs） are common complex refractory systemic diseases in clinical settings， which are manifested as trigeminal neuralgia， facial paralysis， neuromyelitis optica， multiple sclerosis， stroke， vascular dementia， encephalitis B， Parkinson's disease， epilepsy， Alzheimer's disease， amyotrophic lateral sclerosis， and diabetic peripheral neuropathy. Amid the accelerating population aging， the morbidity and prevalence of NSDs have been on the rise， posing a threat to quality of life of patients and bringing a heavy burden to society and individuals. This is also a challenge to the clinical prevention and treatment of the diseases. At the moment， NSDs are mainly treated with western medicine which is effective. However， in the long-term use and progression of the diseases， there are some potential risks such as adverse drug reactions， easy recurrence after withdrawal， drug dependence， and drug resistance. From the holistic view， traditional Chinese medicine （TCM） excels in treating diseases based on syndrome differentiation. According to the etiology， location， and pathogenesis of diseases in TCM， the overall therapy is applied， shows obvious advantages in alleviating disease symptoms， delaying disease progression， and improving the quality of life. TCM has a long history and categorizes NSDs into encephalopathy. According to clinical practice and theories， toxin is an important pathogen of NSDs in TCM. To be specific， the external toxins are insect and beast toxins， food toxin， toxin of six excesses， and epidemic toxin， and the internal toxins are phlegm toxin， dampness toxin， stasis toxin， fire toxin， and turbid toxin. Accumulation of all pathogens will lead to diseases with multiple syndromes. In the case of sudden attack of toxin， the disease is characterized by rapid onset. In the instance of fierce toxin， disease progresses rapidly. If the toxin is dependent， the disease symptoms are diverse. If the toxin is stubborn and frequently occurs， disease recurrence is common. In the case that toxin damages the collaterals， the healthy Qi is impaired. Controlling physiological function of the body， nervous system corresponds to the house of brain in TCM， which is the extraordinary organ， the house of intelligence， and the seat of mental activities that governs the whole body. In the case of toxin damaging the brain collaterals， cerebrospinal injury and orifice obstruction will occur， followed by disharmony of Qi and blood， Yin-yang imbalance， vital activity injury， disorder of primordial spirit， and dysfunction. The treatment principle should be detoxification and eliminating pathogen， and different diseases should be treated with the same method. At the moment， many doctors and scholars have focused on the prevention and treatment of NSDs based on the toxin pathogen. This paper summarizes the research on the clinical application of toxin pathogen causing disease in NSDs， including the peripheral nerve disease， demyelinating disease of the central nervous system， cerebrovascular disease， infectious disease of central nervous system， movement disorders， epilepsy， nervous system degenerative disease and nervous system complications of internal medicine disease， which is expected to provide some ideas and methods for the prevention and treatment of NSDs with TCM.

Neurocognitive impairment and characteristics of neurocognitive performance among people with HIV on antiretroviral treatment / 中华流行病学杂志

Objective: Using two measuring tools to examine the prevalence and correlates of neurocognitive impairment (NCI) as well as characteristics of neurocognitive performance among people with HIV (PWH) on antiretroviral treatment (ART). Methods: A total of 2 250 treated PWH from the Comparative HIV and Aging Research in Taizhou (CHART) were recruited in Taizhou, Zhejiang province. The Chinese version of the Mini-mental State Examination (MMSE) and the International HIV Dementia Scale (IHDS) were used to evaluate their neurocognitive performance. Cluster analysis was conducted on the seven cognitive domains in the scale. Results: Among 2 250 treated PWH, 48.0% (1 080/2 250) were aged 45 to 89, 79.2% (1 782/2 250) were male, and 37.8% (852/2 250) had primary school education or below. The prevalence of neurocognitive impairment judged by MMSE and IHDS among HIV-infected people was 14.3% (321/2 250) and 31.8% (716/2 250), respectively. Aged 60 to 89 (aOR=2.63, 95%CI:1.52-4.56), depressive symptoms (aOR=5.58, 95%CI:4.20-7.40) and treatment with EFV (aOR=2.86, 95%CI:1.89-4.34) were main risk factors of NCI diagnosed by MMSE. Male (aOR=0.71, 95%CI:0.51-1.00), overweight (aOR=0.63, 95%CI:0.44-0.89), and high education level (aOR=0.11, 95%CI:0.05-0.25) were protective factors of NCI diagnosed by MMSE. Aged 60 to 89 (aOR=3.10, 95%CI:2.09-4.59), depressive symptoms (aOR=1.78, 95%CI:1.44-2.20) and treatment with EFV (aOR=1.79, 95%CI:1.41-2.29) were risk factors of NCI diagnosed by IHDS. Male (aOR=0.75, 95%CI:0.58-0.97), underweight (aOR=0.67, 95%CI:0.47-0.96), baseline CD4+ T lymphocyte (CD4) counts ≥350 cells/μl (aOR=0.69, 95%CI:0.53-0.91) and high education level (aOR=0.23, 95%CI:0.14-0.39) were protective factors of NCI diagnosed by IHDS. The neurocognitive performance of HIV-infected people can be divided into four main types. Among four types, age, gender, education level, alcohol drinking, depressive symptoms, waist-to-hip ratio, hypertension, diabetes, baseline CD4 counts and treatment with EFV were different statistically (all P<0.05). Conclusions: There are four main types of neurocognitive performance in treated PWH. The prevalence of NCI is high among this population, underscoring the need for tailored prevention and intervention.

Transmission characteristics and risk factors of household COVID-19 clusters caused by 2019-nCoV Omicron variant in Tianjin / 中华流行病学杂志

Objective: To understand the transmission characteristics and risk factors of household COVID-19 clusters caused by 2019-nCoV Omicron variant in Tianjin and provide evidence for COVID-19 prevention and control. Methods: Field epidemiological method was used to investigate the epidemiological characteristics of COVID-19 cases, and descriptive analysis was used to describe the epidemiological information. Results: A total of 430 cases were reported in this epidemic in Tianjin, in which 409 cases were included in this study. Among these cases, 70.90% (290/409) occurred in families. The family secondary attack rate was 33.64% The family secondary attack rate in age group 12-17 years (13.79%) was significantly lower than that in age group 18-49 years (36.48%), the OR was 0.378 (95%CI: 0.170-0.840). The logistic regression analysis showed that compared with centralized quarantine, the OR of the index cases found in closed-off/controlled areas and in home quarantine were 2.951 (95%CI:1.322-6.586) and 2.287 (95%CI:1.164-4.495), respectively, compared with the cases without sore throat, the OR of the index cases with sore throat was 3.003 (95%CI: 1.576-5.720), and compared with cases in families without completed COVID-19 vaccinations in all members, the OR of the cases in families with completed COVID-19 vaccinations in all members was 0.268 (95%CI: 0.132-0.552). Conclusions: The risk of household transmission of infection with Omicron variant was high. Detecting the index case in closed-off/controlled areas or in home quarantine and sore throat in index cases were the risk factors of the household transmission, completed COVID-19 vaccination was the protective factor.

Evaluation of Dominant Diseases of Traditional Chinese Medicine： A Case Study of Ischemic Stroke / 中国实验方剂学杂志

The present study explored the effective approaches to realize the leading role of traditional Chinese medicine （TCM） in preventing diseases， the synergistic role in treating serious diseases， the core role in the rehabilitation of diseases and summarized the experience to provide feasible plans for the evaluation of other dominant diseases of TCM. To evaluate the effectiveness， safety， and economy of TCM in the treatment of ischemic stroke， encephalopathy project team of the China Center for Evidence-based Traditional Chinese Medicine（CCEBTCM） established an evaluation group to determine the work plan and complete the evaluation work. The concepts of the evaluation involved high-quality evidence， expert opinion survey， expert interview， and drug catalog. Under the guidance of clinical experts and methodologists， the evaluation work was completed in accordance with four steps， i.e.， plan making， data collection and data extraction， evidence synthesis and evaluation， and report writing with the rapid review method. Through the review of TCM and western medicine experts， the advantage of TCM in the treatment of ischemic stroke was positioned in the convalescence period with the predominant effects of improving the neurological function defect and improving the daily living ability. In the convalescence period of stroke， TCM treatment could improve post-stroke motor dysfunction， post-stroke cognitive impairment， consciousness disorder， swallowing disorder， aphasia， constipation， urinary function， diplopia， etc.， and the advantages of acupuncture， Chinese medicine， and traditional exercise were more prominent. In terms of safety， TCM treatment of ischemic stroke showed lower incidence of adverse reactions， fewer adverse events， and a milder degree of related symptoms. In terms of economic performance， the combined treatment of TCM and western medicine played a synergistic role and made the treatment cost more reasonable. Compared with conventional intervention， the integrated TCM and western medicine rehabilitation program showed more economic and social benefits.

Incidence of extrauterine growth retardation and its risk factors in very preterm infants during hospitalization: a multicenter prospective study / 中国当代儿科杂志

OBJECTIVES@#To investigate the incidence of extrauterine growth retardation (EUGR) and its risk factors in very preterm infants (VPIs) during hospitalization in China.@*METHODS@#A prospective multicenter study was performed on the medical data of 2 514 VPIs who were hospitalized in the department of neonatology in 28 hospitals from 7 areas of China between September 2019 and December 2020. According to the presence or absence of EUGR based on the evaluation of body weight at the corrected gestational age of 36 weeks or at discharge, the VPIs were classified to two groups: EUGR group (n=1 189) and non-EUGR (n=1 325). The clinical features were compared between the two groups, and the incidence of EUGR and risk factors for EUGR were examined.@*RESULTS@#The incidence of EUGR was 47.30% (1 189/2 514) evaluated by weight. The multivariate logistic regression analysis showed that higher weight growth velocity after regaining birth weight and higher cumulative calorie intake during the first week of hospitalization were protective factors against EUGR (P<0.05), while small-for-gestational-age birth, prolonged time to the initiation of total enteral feeding, prolonged cumulative fasting time, lower breast milk intake before starting human milk fortifiers, prolonged time to the initiation of full fortified feeding, and moderate-to-severe bronchopulmonary dysplasia were risk factors for EUGR (P<0.05).@*CONCLUSIONS@#It is crucial to reduce the incidence of EUGR by achieving total enteral feeding as early as possible, strengthening breastfeeding, increasing calorie intake in the first week after birth, improving the velocity of weight gain, and preventing moderate-severe bronchopulmonary dysplasia in VPIs.

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

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

Outcomes in randomized controlled trials of acupuncture for vascular cognitive impairment during recent five years / 中国针灸

The existing problems in the outcomes of randomized controlled trials (RCTs) of acupuncture for vascular cognitive impairment (VCI) during recent five years are analyzed and suggestions are proposed. The RCTs of acupuncture for VCI were selected in PubMed, EMbase, Cochrane Library, Clinical Trials, CNKI database, Wanfang database, VIP database, SinoMed database and Chinese Clinical Trial Registry (ChiCTR) from January 1, 2015 to September 14, 2020. The outcomes were extracted and analyzed. As a result, 21 RCTs were included and the outcomes used were divided into 9 categories: clinical symptom/sign indexes, quality of life indexes, neuroimaging indexes, neuroelectrophysiology indexes, blood biochemical indexes, hemorheology indexes, TCM syndrome score indexes, clinical efficacy indexes, and safety indexes. Among them, the top three of the most used outcomes were clinical symptoms/signs indexes (21, 100.0%), clinical efficacy indexes (14, 66.7%) and quality of life indexes (12, 57.1%). In the RCTs of acupuncture for VCI, attention should be paid to distinguish the primary outcomes and secondary outcomes, adopt objective and standardized efficacy evaluation, and give consideration to report the outcomes of safety, health economic and TCM characteristic indexes.

Overview of systematic reviews of acupuncture for vascular cognitive impairment / 中国针灸

OBJECTIVE@#To overview the methodological quality, report quality and evidence quality of the systematic review (SR) of acupuncture for vascular cognitive impairment ( VCI ).@*METHODS@#The SRs regarding acupuncture for VCI were searched in PubMed, Cochrane Library, EMbase, CNKI, SinoMed, Wanfang and VIP databases. The retrieval period was from the establishment of the database to September 24, 2020. The report quality, methodological quality and evidence quality of the included SRs were evaluated by PRISMA statement, the AMSTAR 2 tool and the GRADE system.@*RESULTS@#A total of 22 SRs were included, including 102 outcome indexes. The methodological quality was generally low, with low scores on items 2, 5, 7, 10, 14, 15 and 16. The report quality was good, with scores ranging from 19 points to 24.5 points. The problems of report quality were mainly reflected in the aspects of structural abstract, program and registration, other analysis and funding sources. The level of outcome indexes of SRs was mostly low or very low, and the main leading factor was limitation, followed by inconsistency and inaccuracy.@*CONCLUSION@#Acupuncture for VCI is supported by low quality evidence of evidence-based medicine, but the methodological quality and evidence body quality of relevant SRs are poor, and the standardization is needed to be improved.

Study on quality standard for rice-fired Glehnia littoralis / 中国药房

OBJECTIVE To establish a quality standard for rice-fired Glehnia littoralis . METHODS Appearance observation ， powder microscopic identification and thin-layer chromatography （TLC）identification were performed for the samples of rice-fired G. littoralis decoction piece. According to the relevant methods stated in 2020 edition of Chinese Pharmacopoeia （part Ⅳ），the contents of moisture ，total ash ，acid-insoluble ash ，water-soluble extract and acid-soluble extract were determined. The contents of psoralen，zanthoxylin，bergapten，imperatorin and isoimperatorin were determined by high performance liquid chromatography （HPLC）. RESULTS The rice-fired G. littoralis decoction pieces were round-like small segments ，slightly rough ，yellow（peeled） or dark yellowish brown （with peel ），special gas and slightly sweet taste. The powder was yellowish white. Under the microscope ， secretions and secretory cells ，ducts，gelatinized starch granules ，ray cells ，parenchyma cells ，etc. could be seen. TLC showed the spots developed clearly. In the chromatogram of the test sample ，there was the same blue fluorescent spot at the corresponding position of the chromatogram of isoimperatorin control sample. The moisture ，total ash ，acid-insoluble ash ，water-soluble extract and ethanol-soluble extract from 9 batches of samples were 5.82％-6.27％，3.19％-3.59％，0.21％-0.27％，24.91％-30.30％ and 20.66％ -25.83％ ，respectively. The linear range of psoralen ，zanthotoxin，bergapten，imperatorin and isoimperatorin were 0.240-2.400，0.320-3.200，0.224-2.240，0.292-2.920，0.208-2.080 µg/mL（all r＞0.999 0）. Limits of quantitation were 0.032 0， 0.030 0，0325 0，0.032 0，0.045 0 µg，respectively. Limits of detection were 0.100 8，0.089 6，0.071 5，0.090 0，0.132 0 µg， respectively. RSDs of prescision ，stability（24 h）and reprodu- cibility tests were less than 3％. Average recoveries were 100.56％ （RSD＝1.36％ ，n＝6），100.73％（RSD＝2.25％ ，n＝6）， 100.36％（RSD＝0.98％，n＝6），98.24％（RSD＝0.40％，n＝6） E-mail：853063968@qq.com and 99.40％（RSD＝0.35％，n＝6），respectively. The contents of above five components were 5.85-13.31，8.63-33.38，6.23- E-mail：shixiaofeng2005@sina.com 15.25，6.12-12.98，5.52-10.77 µg/g，respectively. The total contents were 34.20-83.47 µg/g. CONCLUSIONS It is preliminarily proposed that the moisture ，total ash and acid-insoluble ash should not exceed 7.30％，4.10％，0.30％. The water-soluble extract and ethanol-soluble extract are no less than 21.00％ and 18.00％，respectively. The total content of coumarin should not be less than 52.03 µg/g（with peel ）and 26.34 μg/g（peeled）. Established quality standard can be used for the quality control of rice-fired G. littoralis .

Analysis of clinical features and ADNP variant in a child with Helsmoortel-Van der Aa syndrome / 中华医学遗传学杂志

OBJECTIVE@#To analyze the clinical characteristics and genetic etiology of a child with Helsmoortel-Van der Aa syndrome (HVDAS).@*METHODS@#Genetic testing was carried out for the child and his parents, and the clinical phenotypes and genetic variants of reported cases were summarized through literature review.@*RESULTS@#The child has featured peculiar facies, accompanied by autism spectrum disorder, intellectual disability and motor retardation, and curving of the second toes, which was unreported previously. Genetic testing revealed that the child has harbored a heterozygous c.2157C>G (p.Tyr719*) variant of the ADNP gene, which was not found in either parent. Based on the guidelines of the American College of Medical Genetics and Genomics, this variant was rated as pathogenic. Among 80 HVDAS cases described in the literature, most had various degrees of behavioral abnormalities, intellectual disability, language retardation and motor retardation, with common features involving the nervous system, gastrointestinal system and eye. Variants of the ADNP gene mainly included frameshift variants and nonsense variants, with the hotspot variants including p.Tyr719*, p.Asn832lysfs*81 and p.Arg730*.@*CONCLUSION@#The clinical phenotype of the child is closely correlated with the heterozygous variant of the ADNP gene, which expanded the phenotypic spectrum of HVDAS. As HVDAS may involve multiple systems and have high phenotypic heterogeneity, genetic testing technology can facilitate accurately diagnose.

A Single-cell Transcriptome Atlas of Cashmere Goat Hair Follicle Morphogenesis / 基因组蛋白质组与生物信息学报·英文版

Cashmere, also known as soft gold, is produced from the secondary hair follicles (SHFs) of cashmere goats. The number of SHFs determines the yield and quality of cashmere; therefore, it is of interest to investigate the transcriptional profiles present during cashmere goat hair follicle development. However, mechanisms underlying this development process remain largely unexplored, and studies regarding hair follicle development mostly use a murine research model. In this study, to provide a comprehensive understanding of cellular heterogeneity and cell fate decisions, single-cell RNA sequencing was performed on 19,705 single cells of the dorsal skin from cashmere goat fetuses at induction (embryonic day 60; E60), organogenesis (E90), and cytodifferentiation (E120) stages. For the first time, unsupervised clustering analysis identified 16 cell clusters, and their corresponding cell types were also characterized. Based on lineage inference, a detailed molecular landscape was revealed along the dermal and epidermal cell lineage developmental pathways. Notably, our current data also confirmed the heterogeneity of dermal papillae from different hair follicle types, which was further validated by immunofluorescence analysis. The current study identifies different biomarkers during cashmere goat hair follicle development and has implications for cashmere goat breeding in the future.

Metabolic engineering of Escherichia coli for production of hydroxytyrosol / 生物工程学报

Hydroxytyrosol is an important fine chemical and is widely used in food and medicine as a natural antioxidant. Production of hydroxytyrosol through synthetic biology is of important significance. Here we cloned and functionally characterized a hydroxylase encoding gene HpaBC from Escherichia coli BL21, and both subunits of this enzyme can be successfully expressed to convert the tyrosol into hydroxytyrosol. A HpaBC gene integration expression cassette under the tac promoter was constructed, and integrated into the genome of a tyrosol hyper-producing E. coli YMG5A*R using CRISPR-Cas9 technology. Meanwhile, the pathway for production of acetic acid was deleted, resulting in a recombinant strain YMGRD1H1. Shake flask fermentation showed that strain YMGRD1H1 can directly use glucose to produce hydroxytyrosol, reaching a titer of 1.81 g/L, and nearly no by-products were detected. A titer of 2.95 g/L was achieved in a fed-batch fermentation conducted in a 5 L fermenter, which is the highest titer for the de novo synthesis of hydroxytyrosol from glucose reported to date. Production of hydroxytyrosol by engineered E. coli lays a foundation for further construction of hydroxytyrosol cell factories with industrial application potential, adding another example for microbial manufacturing of aromatic compounds.

Treatment and genetic analysis of a child with Kabuki syndrome type 2 and secondary pulmonary infection due to a de novo variant of KDM6A gene / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis of a child with recurrent infection, multiple malformation and dysmorphism.@*METHODS@#The child and his parents were subjected to trio whole exome sequencing.@*RESULTS@#The child had a complaint of fever and cough, with long and thin eye fissures and long eyelashes. Genetic testing revealed that the child has carried a non-triplet deletion of the KDM6A gene, which was unreported previously. The variant resulted in frameshift and premature termination of the translation. His parents were both of the wild type for the locus. After antibiotic and immunoglobulin treatment, the severe secondary pneumonia caused by immunodeficiency has improved.@*CONCLUSION@#With combined laboratory test, imaging examination and genetic testing, the child was ultimately diagnosed with Kabuki syndrome type 2. The characteristics of immunodeficiency of Kabuki syndrome may render conventional antibiotic treatment ineffective, which deserves clinical attention.

Situation analysis of outcome indicators of randomized controlled trials of traditional Chinese medicine in treatment of hypertensive intracerebral hemorrhage in recent three years / 中国中药杂志

The study aims to analyze the outcome indicators of randomized controlled trial(RCT) of traditional Chinese medicine(TCM) in the treatment of hypertensive intracerebral hemorrhage(HICH) in recent three years, and thus provide suggestions for the future studies in this field. Four English databases, four Chinese databases and two online registration websites of clinical trials were searched. The RCTs published between January 2018 and September 2020 were screened. The risk of bias was assessed and outcome measures were classified. A total of 151 839 articles were retrieved, of which 44 RCTs were included for analysis after screening. The outcome measures of the included RCTs were classified into 7 categories, among which the symptoms/signs category showed the highest reporting rate. National Institute of Health stroke scale(72.73%) was the most frequently reported outcome indicator, while the vo-lume of intracerebral hemorrhage determined by computerized tomography(36.36%) was the most frequently reported lab test outcome. Most studies collect the outcomes at the end of treatment, while 9 studies reported long-term outcomes 3 months or more after onset. Compared with those of international clinical trials, the application of some of the outcomes was reasonable, focusing on patients' symptoms, quality of life and objective outcomes. However, there were still several problems: unclear primary and secondary outcome measures, insufficient attention to long-term prognosis, insufficient attention to social function, few TCM outcomes, lack of measurement blindness and the use of unreasonable composite outcomes. It is recommended that researchers should rationally design the outcome indicators of clinical trials and develop the core outcome set.

Effect of acupuncture on pain-emotion related brain regions in patients with cervical spondylosis of cervical type: a fMRI study / 中国针灸

OBJECTIVE@#To observe the changes of functional connectivity of brain pain-emotion regulation region in patients with cervical spondylosis of cervical type by functional magnetic resonance imaging (fMRI).@*METHODS@#Thirty-two subjects were selected. Of them, 16 patients with cervical spondylosis of cervical type were divided into an observation group and 16 healthy subjects into a control group. The patients in the observation group were treated with acupuncture at Tianzhu (BL 10), Jingbailao (EX-HN 15), Jianzhongshu (SI 15) and @*RESULTS@#In the observation group, the VAS score was (1.94±1.12) after the treatment, which was lower than (5.62±1.20) before treatment (@*CONCLUSION@#Pain involves the formation and expression of "pain-emotion-cognition". Acupuncture can systematically regulate the brain functional connections between cognitive regions such as dorsal prefrontal lobe and anterior cingulate gyrus and emotional regions such as insula and VTA in patients with cervical spondylosis of cervical type, suggesting that acupuncture has a multi-dimensional and comprehensive regulation effect on pain.

Survival analysis of HIV-infected patients on antiretroviral therapy during 2006-2019 in Taizhou City / 上海预防医学

Objective:To examine the survival status and explore factors related to death among human immunodeficiency virus （HIV） infected patients receiving antiretroviral therapy （ART） in Taizhou City during 2006‒2019. Methods:A retrospective cohort study was conducted to analyze the data on HIV-infected patients receiving ART in Taizhou during 2006‒2019. Kaplan-Meier （K-M） method was used to calculate the cumulative survival rate and cumulative treatment success rate. Cox regression model was used to determine survival status and factors associated with ART. Results:A total of 2 904 HIV-infected patients was included. The cumulative survival rate after 1， 3， 5， and 8 years of ART were 96.9%， 94.9%， 93.1% and 92.1%， respectively， and the cumulative treatment response rate were 91.3%， 85.3%， 81.8% and 73.8%， respectively. Compared with aged 18-30 years old， baseline CD4+T cell >350 count/μL， normal hemoglobin level， effective ART， no clinical symptom at baseline， and homosexual transmission， we found that aged 51-60 years old（HR=4.94，95%CI：1.66-14.69）， aged over 60 years old（HR=9.14，95%CI：3.14-26.63）， anemia at baseline（HR=2.24，95%CI：1.55-3.23）， baseline CD4+T cell <200 count/μL（HR=4.35，95%CI：2.14-8.86）， ART failure （HR=3.90，95%CI：2.73-5.58）， heterosexual transmission（HR=1.92，95%CI：1.15-3.20）， and signs of symptom at baseline（HR=1.68，95%CI：1.16-2.41） were risk factors of HIV-related death. Conclusion:The effect of ART in Taizhou City is confirmed with a high cumulative survival rate and treatment success. We should pay additional attention to senior HIV-infected patients with anemia at baseline and intensively monitor the effect of ART. Interventions such as “treat after discover” are supposed to be implemented more widely to further reduce HIV-related mortality.