Perinatal management and genetic testing and for a puerperant affected with ATP7B gene variation in Wilson disease / 中国综合临床

Objective:To explore the perinatal management of patients with WD during pregnancy, and to determine its genetic etiology and the possibility of fetal morbidity using the genetic detection of amniotic fluid and umbilical cord blood.Method:In terms of fine management during the perinatal period, a case of K-F ring was found in the Ophthalmology Department of Beijing Friendship Hospital, Capital Medical University in March 2019 due to eye astringency and eye swelling, and the hepatology department further diagnosed WD for one artificial abortion. After the second pregnancy in October 2020, multidisciplinary consultation and standardized treatment during pregnancy including gynecology and obstetrics, liver disease center, anesthesiology department, gastroenterology department and nutrition department were carried out. The genomes of patients' venous blood, amniotic fluid and umbilical cord blood were extracted and analyzed for ATP7B gene variation by Sanger sequencing.Result:Through multi-disciplinary collaborative management, the patient gave birth successfully in the case of pregnancy complicated with liver cirrhosis, portal hypertension, splenomegaly with hyperfunction, thrombocytopenia, anemia, esophageal and gastric varices and other complications. The phenotype of the newborn was normal, and the Apgar score was 10-10-10. Sequencing results showed that the patient had ATP7B p.Arg778Leu and p.Val890Met, which were missense heterozygous variants reported in the mutation database, and ACMG was classified as pathogenic variants. The results of amniotic fluid and umbilical cord blood showed that the fetus had only p.Arg778Leu single heterozygous variation, and it was predicted that there would be no clinical phenotype of WD.Conclusion:Perinatal multidisciplinary collaborative management has important protective significance for the successful pregnancy of patients with WD. Genetic screening of amniotic fluid and umbilical cord blood is conducive to early detection of fetal WD.

Analysis of changes in mortality of children and adolescents aged 5 to 19 years in China from 2004 to 2018 and policy effects / 中华预防医学杂志

Objective: To analyze the trend of child and adolescent mortality rate in China from 2004 to 2018 and explore the possible policy effects. Methods: This study used the mortality data of child and adolescent aged 5 to 19 years from 2004 to 2018 based on the National Disease Surveillance System. Age-standardized mortality rate was calculated by using the population from the sixth national census. Joinpoint regression was used to analyze the trend of child and adolescent mortality with different features from 2004 to 2018. Results: From 2004 to 2018, the overall mortality rate of children and adolescents in China dropped from 40.02 per 100 000 to 22.00 per 100 000, and the average annual percentage change (AAPC) was -4.28 (95%CI:-5.35,-3.20,P<0.001). The mortality rate dropped rapidly from 2004 to 2006, and the annual percentage change (APC) was -9.20 (95%CI:-15.63,-2.28,P=0.017). The decline rate slowed down between 2006 and 2013, and the APC was -1.56 (95%CI:-2.78,-0.33,P=0.020). The downward trend accelerated from 2013 to 2018, and the APC was -5.99 (95%CI:-7.52,-4.43,P<0.001). The trend of child mortality rate in rural area, females, eastern provinces of China, children aged 10 to 14 years, children aged 15 to 19 years, and injury mortality rate were basically consistent with the overall trend. The child mortality rate in urban area, central provinces of China and the mortality rate of infectious diseases, maternal and infant, and nutritional deficiencies diseases showed a uniform downward trend from 2004 to 2018, with AAPC values about -3.59 (95%CI:-4.38,-2.78,P<0.001), -2.89 (95%CI:-3.24,-2.54,P<0.001) and -6.66 (95%CI:-7.64,-5.68,P<0.001), respectively. Conclusion: The mortality rate of children and adolescents aged 5 to 19 years in China continues to decline from 2004 to 2018, and the decline rate becomes faster after 2011.

Methods for evaluating overweight and obesity among children and adolescents and application in SPSS and SAS / 中华预防医学杂志

Overweight/obesity has become one of the major public health problems among children and adolescents all over the world. The current screening standards for overweight and obesity in children and adolescents are not unified. It is easy to make mistakes and inefficient to evaluate item by item or develop self-written packages. Taking the"Screening standards for overweight and obesity in Chinese school-age children and adolescents"as an example, this study introduced four methods and procedures for evaluating overweight and obesity among children and adolescents from the world and China and described their application methods in combination with specific cases. At the same time, the SPSS and SAS packages were compiled and the specific application steps were explained, so that users could correctly and quickly screen overweight and obesity among children and adolescents, and conduct horizontal comparisons of similar studies across different regions.

Status of the poor vision among primary and secondary school students in a division of Xinjiang Production and Construction Corps and analysis of the influencing factors / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To understand the status of poor vision and analyze the main influencing factors among primary and secondary school students in a division of the Xinjiang Production and Construction Corps, and provide a scientific basis for prevention and control of poor vision.METHODS: A total of 12 primary and secondary schools in a divisional urban district and regiment field of the Xinjiang Production and Construction Corps were chosen using stratified cluster random sampling from August to October 2020. A total of 2 982 primary and secondary school students were selected for visual inspections and questionnaires. Logistic regression analysis was used to explore the influencing factors of poor vision.RESULTS: The rate of poor vision was 65.66% among 2 982 primary and secondary school students in the division of the Xinjiang Production and Construction Corps, with the majority severe poor vision. Furthermore, the rates of poor vision were higher in girls(70.17%)than that in boys(61.47%)(χ2=4.993, P<0.001)and the urban area(70.03%)were higher than the rural area(58.96%)(χ2=38.680, P<0.001)and the Han nationality students(66.83%)were higher than Uyghur students(52.82%)(χ2=19.772, P<0.001). The risk of poor vision increased with age(χ2trend =300.144, P<0.001), and by the age group ≥18 years old, the rate of poor vision reached 80.47%. The results of the multivariate analysis showed that the women, the age≥13 years old, writing and reading duration every day ≥2h, cram school on weekends and presence of myopia in parents increases the risk of poor vision, increase the outdoor exercise time, sleep time ≥8h, and do eye exercises every day can reduce the occurrence of poor vision.CONCLUSION: Poor vision rate of primary and secondary school students in the division of the Xinjiang Production and Construction Corps is higher than that of many regions in the country. Girls with the age(≥13 years old)whose parents are myopic should receive special attention. Increasing outdoor exercise time, doing eye exercises every day, and keeping your eyes more than one foot away from books when reading and writing is effective in preventing poor vision.

UPLC fingerprint and indicator components of Boenninghausenia albiflora var. albiflora / 中国中药杂志

The fingerprint of Boenninghausenia albiflora var. albiflora was established by ultra performance liquid chromatography(UPLC), and the content of 12 active components including chlorogenic acid was determined. Multivariate statistical analysis was used to explore the indicator components of B. albiflora var. albiflora and a comprehensive evaluation system was created for the quality of B. albiflora var. albiflora. In this study, 33 batches of B. albiflora var. albiflora with different sources were collected and studied, and the UPLC fingerprint of B. albiflora var. albiflora was developed. There were 37 common peaks, of which 12 components were identified, and the content of these 12 components was measured. In combination of the common peaks and the content of chemical components, multivariate statistical analysis was performed, and the results showed that 6 components [daphnoretin, isoimperatorin, astragalin, imperatorin, neochlorogenic acid, and isoquercitrin(weight coefficient>0.1)] were selected as chemical markers for the quality of B. albiflora var. albiflora. Technique for order of preference by similarity to ideal solution(TOPSIS) analysis and chemometrics revealed that the quality of S32, S28 and S29 were superior, while that of S12, S7 and S16 were inferior. The quality evaluation method of B. albiflora var. albiflora constructed in this study was accurate and reliable, with simpleness and easiness to operate. It is suggested that the 6 above-mentioned active components could be used as indicator components for quality control of B. albiflora var. al-biflora. The samples were harvested during the flowering and fruiting period, which is from the beginning of July to the end of August.

Injury mortality among Chinese aged 5 to 24 years from 1990 to 2019 / 北京大学学报(医学版)

OBJECTIVE@#To analyze the mortality of injuries among children and adolescents aged 5 to 24 in China from 1990 to 2019, and to provide the theoretical basis for the formulation of policies related to injury prevention.@*METHODS@#The mortality data of children and adolescents aged 5 to 24 years in China between 1990 and 2019 were obtained from Global Burden of Disease (GBD) 2019, and the change in mortality between 1990 and 2019 was described. Age-period-cohort analysis was utilized to determine the age effect, period effect and cohort effect for road injuries, drowning and self-harm.@*RESULTS@#Injury mortality of Chinese children and adolescents aged 5 to 24 years decreased from 46.22 [95% uncertainty interval (UI): 40.88-52.12] per 100 000 to 20.36 (95%UI: 17.58-23.38) per 100 000 between 1990 and 2019. Sub-group analysis revealed a pattern that was basically consistent with the overall trend. From 1990 to 2019, drowning declined from the first leading cause of injury death among children and adolescents aged 5 to 24 years in China to the second while road injuries became the one which caused the most death among them, and self-harm was the third leading cause of injury death. The top three causes of injury death in each subgroup were basically the same as the overall, but the order was different in each subgroup. Age-period-cohort analysis showed that the death risk of road injuries, drowning, and self-harm all decreased with period and cohort. Aside from that, the death risk of road injuries showed a U-shape trend, which decreased at first but increased soon afterwards, with the increase of age, while the death risk of drowning decreased with age and the death risk of self-harm increased with age.@*CONCLUSION@#In China, the injuries mortality among children and adolescents aged 5 to 24 years has decreased over the last three decades. However, specific cause-related injury deaths, manifested differently in different sub-groups. Targeted policies and intervention should be proposed to reduce the mortality of children and adolescents in accordance with the characteristics of injuries death in different genders and age groups.

Ganoderma lucidum polysaccharides promote T lymphocyte infiltration into tumor by regulating expression of ICAM-1 in endothelial cells / 中国中药杂志

Polysaccharide is among the main active components of Ganoderma lucidum for tumor prevention and treatment. Howe-ver, it remains unclear whether it has synergy with tumor immunotherapy. This study evaluated the effect of G. lucidum polysaccharides(GLP) on the infiltration of T lymphocytes into tumor and the underlying mechanism, in order to provide a reference for its application in tumor immunotherapy. GLP were prepared by water extraction and alcohol precipitation combined with Sevag method and then given(intraperitoneal injection) to the mice bearing B16-F10 cells at 25, 50 and 100 mg kg~(-1), respectively, to evaluate the effect on tumor growth. The infiltration of CD3~+ and CD8~+ T cells and the expression of intercellular cell adhesion molecule-1(ICAM-1) in tumor were detected by immunohistochemistry. EA.hy926 cells were treated with 50, 100 and 200 μg·mL~(-1) GLP, and the expression of ICAM-1 was determined by Western blot. The adhesion of EA.hy926 cells treated with GLP was measured with fluorescence-labeled Jurkat cells. To analyze the mechanism based on NF-κB pathway, this study determined the protein levels of nuclear factor kappa-B(NF-κB) p65, alpha inhibitor of NF-κB(IκBα), p-NF-κB p65 and p-IκBα by Western blot. The results showed that GLP can significantly inhibit the tumor growth in mice bearing B16-F10 cells, promote the infiltration of CD3~+ and CD8~+ T cells in tumor, and increase the expression of ICAM-1 in tumor. Meanwhile, GLP could also enhance the expression of ICAM-1 in EA.hy926 cells, thus strengthen the adhesion to Jurkat cells, induce phosphorylation and protein degradation of IκBα, and raise the expression and phosphorylation level of NF-κB p65. These results suggested that GLP could promote the expression of ICAM-1 through NF-κB pathway and further enhance the infiltration of T lymphocytes into tumor, thereby inhibiting tumor growth. This study lays a foundation for the further application of GLP in tumor immunotherapy.

Analysis of risk factors for arrhythmia in patients after heart valve replacement / 中国胸心血管外科临床杂志

@#Objective    To explore and analyze the risk factors for arrhythmia in patients after heart valve replacement. Methods    A retrospective analysis of 213 patients undergoing cardiac valve replacement surgery under cardiopulmonary bypass in our hospital from August 2017 to August 2019 was performed, including 97 males and 116 females, with an average age of 53.4±10.5 year and cardiac function classification (NYHA) grade of Ⅱ-Ⅳ. According to the occurrence of postoperative arrhythmia, the patients were divided into a non-postoperative arrhythmia group and a postoperative arrhythmia group. The clinical data of the two groups were compared, and the influencing factors for arrhythmia after heart valve replacement were analyzed by logistic regression analysis. Results    There were 96 (45%) patients with new arrhythmia after heart valve replacement surgery, and the most common type of arrhythmia was atrial fibrillation (45 patients, 18.44%). Preoperative arrhythmia rate, atrial fibrillation operation rate, postoperative minimum blood potassium value, blood magnesium value in the postoperative arrhythmia group were significantly lower than those in the non-postoperative arrhythmia group (P<0.05); hypoxemia incidence, hyperglycemia incidence, acidosis incidence, fever incidence probability were significantly higher than those in the non-postoperative arrhythmia group (P<0.05). The independent risk factors for postoperative arrhythmia were the lowest postoperative serum potassium value (OR=0.305, 95%CI 0.114-0.817), serum magnesium value (OR=0.021, 95%CI 0.002-0.218), and hypoxemia (OR=2.490, 95%CI 1.045-5.930). Conclusion    Taking precautions before surgery, improving hypoxemia after surgery, maintaining electrolyte balance and acid-base balance, monitoring blood sugar, detecting arrhythmia as soon as possible and dealing with it in time can shorten the ICU stay time, reduce the occurrence of complications, and improve the prognosis of patients.

Factors reducing inappropriate attendances to emergency departments before and during the COVID-19 pandemic: A multicentre study

INTRODUCTION@#Inappropriate attendances (IAs) to emergency departments (ED) create an unnecessary strain on healthcare systems. With decreased ED attendance during the COVID-19 pandemic, this study postulates that there are less IAs compared to before the pandemic and identifies factors associated with IAs.@*METHODS@#We performed a retrospective review of 29,267 patient presentations to a healthcare cluster in Singapore from 7 April 2020 to 1 June 2020, and 36,370 patients within a corresponding period in 2019. This time frame coincided with local COVID-19 lockdown measures. IAs were defined as patient presentations with no investigations required, with patients eventually discharged from the ED. IAs in the 2020 period during the pandemic were compared with 2019. Multivariable logistic regression was performed to identify factors associated with IAs.@*RESULTS@#There was a decrease in daily IAs in 2020 compared to 2019 (9.91±3.06 versus 24.96±5.92, P<0.001). IAs were more likely with self-referrals (adjusted odds ratio [aOR] 1.58, 95% confidence interval [CI] 1.50-1.66) and walk-ins (aOR 4.96, 95% CI 4.59-5.36), and those diagnosed with non-specific headache (aOR 2.08, 95% CI 1.85-2.34), or non-specific low back pain (aOR 1.28, 95% CI 1.15-1.42). IAs were less likely in 2020 compared to 2019 (aOR 0.67, 95% CI 0.65-0.71) and older patients (aOR 0.79 each 10 years, 95% CI 0.78-0.80).@*CONCLUSION@#ED IAs decreased during COVID-19. The pandemic has provided a unique opportunity to examine factors associated with IAs.

Progress of researches on serine protease inhibitors for zoonotic cestode family Taeniidae / 中国血吸虫病防治杂志

Serine protease inhibitor, a protein superfamily that inhibits the serine protease activity, protects hosts from parasitic infections. This review describes the spatial structure and classification of serine protease inhibitor, mechanisms underlying the interplay between serine protease inhibitor and host immune responses and current advances in serine protease inhibitor of zoonotic cestode family Taeniidae, so as to provide insights into the diagnosis of zoonotic tapeworm infections, discovery of therapeutic targets and screening of vaccine candidates.

Advance and prospective of long non-coding RNA in diabetic kidney disease / 中华内分泌代谢杂志

In recent years, the incidence of diabetic kidney disease(DKD) has been increasing gradually, and it has become the leading cause of end-stage renal disease. However, current therapies show limited efficacy in preventing the progression of DKD. Against the backdrop of chip and high-throughput sequencing, long non-coding RNAs are revealed to an important role in the pathogenesis of DKD. This article summarizes the research progress of long non-coding RNA in DKD, and look forward to the more extensive application of long non-coding RNA in the future.

A case report of individualized treatment of high risk and volume metastatic prostate cancer / 中华泌尿外科杂志

A 69-year old man presented with high-risk metastatic prostate cancer. After 7 months of androgen deprivation therapy (ADT), he progressed to metastatic castration resistant prostate cancer. We suggested him comprehensive therapy, including Abiraterone, chemo-therapy, radio-therapy, platinum chemo-therapy and Enzalutamide, which proved effective with his long term survival.

Analysis of prevalence and risk factors of overweight and obesity among children and adolescents in Jiangxi Province / 中国学校卫生

Objective@#To investigate prevalence and influencing factors of overweight and obesity among children and adolescents in Jiangxi Province, and to provide the basis for strategies for prevention and treatment of overweight and obesity.@*Methods@#Using stratified random cluster sampling ,a total of 77 780 primary and middle school students in 11 districts of Jiangxi Province were investigated with physical examination and questionnaire during March to November in 2019.@*Results@#The detection rates of overweight and obesity of children and adolescents in Jiangxi province were 20.5% and 8.4%, respectively. Which decreased with the increase of the learning stage（ χ 2=178.65, 389.86）,with significantly higher in boys and urban areas （ χ 2=1 061.06, 504.21;56.17, 34.14）（ P ＜0.01）.In different economic areas, the detection rates of overweight and obesity in moderate economic area( 23.3 %, 9.7%) were the highest, followed by high economic area (21.1%, 8.7%) and low economic area(18.2%, 7.2%), and the differences were statistically significant（ χ 2=266.29, 143.90， P ＜0.01）.The results of multivariate Logistic regression analysis showed that in terms of social demography, overweight and obesity of children and adolescents in Jiangxi Province were associated with economic area, residence, learning stage and gender; in terms of dietary behavior, overweight of children and adolescents in Jiangxi Province was associated with consumption frequency of sugary drinks, sweets, fresh fruits and vegetables, and the influencing factors of obesity were consumption frequency of sweets and fresh fruits( P <0.05).@*Conclusion@#The situation of overweight and obesity of children and adolescents in Jiangxi Province is sorrisome, and comprehensive prevention and control should be carried out with the joint efforts of society, school and family.

Origanum vulgare L. leaf extract alleviates finasteride-induced oxidative stress in mouse liver and kidney

Objective: To investigate the hepatorenoprotective effects of Origanum vulgare L. against finasteride-induced oxidative injury in the liver and kidney of mice. Methods: Liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI/MS) analysis was utilized to yield a fingerprint of Origanum vulgare polyphenolic constituents. Thirty BALB/c mice received 0.5 mL/day distilled water, finasteride (25 mg/kg/day for 10 d), and 100, 200, or 400 mg/kg/day finasteride + Origanum vulgare extract with 6 mice per group for five weeks. On day 36, liver and kidney function as well as pro- and anti-inflammatory (IFN-γ, IL-12, IL-6, TNF-α, IL-1β, and IL-10) cytokines were measured. The total antioxidant status, nitric oxide (NO), and malondialdehyde levels as well as the activities of NO synthase and catalase were also evaluated. Histopathological study was conducted to assess the effect of Origanum vulgare extract on finasteride-induced renal and hepatic toxicities. Results: Twenty-five major polyphenolic compounds were identified in the Origanum vulgare extract by LC-ESI/MS. Origanum vulgare extract, especially at 200 and 400 mg/kg/day doses, significantly improved liver and kidney biochemical indices, decreased inflammatory cytokines, increased total antioxidant status and NO synthase and catalase activities, as well as decreased plasma NO and malondialdehyde levels in a dose-dependent manner as compared to the finasteride group. Histopathological results further confirmed the protective effect of Origanum vulgare extract. Conclusions: Origanum vulgare extract ameliorates finasteride-induced hepatic and renal biochemical and histopathological alterations, and restores antioxidant/oxidant balance.

Origanum vulgare L. leaf extract alleviates finasteride-induced oxidative stress in mouse liver and kidney

Objective: To investigate the hepatorenoprotective effects of Origanum vulgare L. against finasteride-induced oxidative injury in the liver and kidney of mice. Methods: Liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI/MS) analysis was utilized to yield a fingerprint of Origanum vulgare polyphenolic constituents. Thirty BALB/c mice received 0.5 mL/day distilled water, finasteride (25 mg/kg/day for 10 d), and 100, 200, or 400 mg/kg/day finasteride + Origanum vulgare extract with 6 mice per group for five weeks. On day 36, liver and kidney function as well as pro-and antiinflammatory (IFN-γ, IL-12, IL-6, TNF-α, IL-1β, and IL-10) cytokines were measured. The total antioxidant status, nitric oxide (NO), and malondialdehyde levels as well as the activities of NO synthase and catalase were also evaluated. Histopathological study was conducted to assess the effect of Origanum vulgare extract on finasteride-induced renal and hepatic toxicities. Results: Twenty-five major polyphenolic compounds were identified in the Origanum vulgare extract by LC-ESI/MS. Origanum vulgare extract, especially at 200 and 400 mg/kg/day doses, significantly improved liver and kidney biochemical indices, decreased inflammatory cytokines, increased total antioxidant status and NO synthase and catalase activities, as well as decreased plasma NO and malondialdehyde levels in a dose-dependent manner as compared to the finasteride group. Histopathological results further confirmed the protective effect of Origanum vulgare extract. Conclusions: Origanum vulgare extract ameliorates finasteride-induced hepatic and renal biochemical and histopathological alterations, and restores antioxidant/oxidant balance.

Lengths of the fixed loop and the adjustable loop in the coarse bone tunnel were compared to influence the widening of the femoral bone tunnel and the function of the knee joint / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the effects of two different femoral cortical suspension devices (fixation loop and adjustable loop) on tunnel widening and knee function in patients following anterior cruciate ligament reconstruction for 12 months.@*METHODS@#A total of 60 patients who had undergone anterior cruciate ligament reconstruction were included in this study. According to the length of the loop(n)[n= total length of loop-(total length of femoral tunnel-total length of coarse tunnel)] in the rough bone tunnel, the patients were divided into A (adjustable loop was 0 mm in the coarse bone tunnel), B (fixation loop was greater than 0 mm and less than or equal to 10 mm in the coarse bone tunnel) and C (fixation loop was greater than 10 mm in the coarse bone tunnel) groups, of which 11 cases were in group A, 27 cases in group B and 22 cases in group C. In the three-dimensional reconstruction of the knee joint with multi-slice spiral CT, the widening of the bone tunnel in the three groups was compared. At the same time, IKDC, Lysholm and Tegner scores of the patients in the three groups were compared.@*RESULTS@#There were differences in the widening degree of the femoral canal among groups A, B and C, and the median difference of the widening degree of the femoral tunnel 12 months and immediately after the surgery was A < B < C. The difference of femoral canal widening in group A was significantly different from that in groups B and C (P < 0.05).According to the linear regression the relationship between the difference of the width of the femoral canal and the change of the length (n) of the loop in the coarse canal, it was found that there was a linear relationship between the value of n and the difference of the width of the bone canal. With the increase of the value of n, the difference of the width of the bone canal gradually became larger. The median difference of the width of the middle and superior tunnel was negative, while the median difference of the width of the middle and inferior tunnel was positive. During the follow-up, we found that there were no statistical differences in IKDC, Lysholm and Tegner scores among the three groups one year after surgery (P > 0.05).@*CONCLUSION@#Twelve months after surgery, compared with group B (fixed loop group) and group C (fixed loop group), group A (adjustable loop group) had less bone tunnel widening.In groups A, B and C, as the length of the loop in coarse bone tunnel gradually increased, the width of bone tunnel became more significant. At the end of 12 months follow-up after anterior cruciate ligament reconstruction, the medial and inferior femoral tunnel was significantly wider than immediately after surgery, and the medial and superior femoral tunnel had gradually begun to undergo tendon-bone healing. There was no significant difference in knee function scores among groups A, B, and C in the follow-up 12 months after surgery.

Evaluating continence recovery time after robot-assisted radical prostatectomy / 北京大学学报(医学版)

OBJECTIVE@#To evaluate urinary continence recovery time and risk factors of urinary continence recovery after robot-assisted laparoscopic radical prostatectomy (RARP).@*METHODS@#From January 2019 to January 2021, a consecutive series of patients with localized prostate cancer (cT1-T3, cN0, cM0) were prospectively collected. RARP with total anatomical reconstruction was performed in all the cases by an experienced surgeon. Lymph node dissection was performed if the patient was in high-risk group according to the D'Amico risk classification. The primary endpoint was urinary continence recovery time after catheter removal. Postoperative and pathological variables were analyzed. Continence was rigo-rously analyzed 48 hours, 1 week, 4 weeks, 12 weeks, and 24 weeks after catheter removal. Continence was evaluated by recording diaper pads used per day, and all the patients were instructed to perform the 24-hour pad weight test until full recovery of urinary continence. The patient was defined as continent if no more than one safety pad were needed per day, or no more than 20-gram urine leakage on the 24-hour pad weight test. Time from catheter removal to full recovery of urinary continence was recorded, and risk factors influencing continence recovery time evaluated.@*RESULTS@#In total, 166 patients were analyzed. The mean age of the enrolled patients was 66.2 years, and the median prostate specific antigen (PSA) was 8.51 μg/L. A total of 59 patients (35.5%) had bilateral lymphatic dissection, and 28 (16.9%) underwent neurovascular bundle (NVB) preservation surgery. Postoperative pathology results showed that stage pT1 in 1 case (0.6%), stage pT2 in 77 cases (46.4%), stage pT3 in 86 cases (51.8%), and positive margins in 28 patients (16.9%). Among patients who underwent lymph node dissection, lymph node metastasis was found in 7 cases (11.9%). Median continence recovery time was one week. The number of the continent patients at the end of 48 hours, 1 week, 4 weeks, 12 weeks, and 24 weeks were 65 (39.2%), 32 (19.3%), 34 (20.5%), 24 (14.5%), and 9 (5.4%). Two patients remained incontinent 24 weeks after catheter removal. The continence rates after catheter removal at the end of 48 hours, 1 week, 4 weeks, 12 weeks, and 24 weeks were 39.2%, 58.4%, 78.9%, 93.4%, and 98.8%, respectively. Univariate COX analysis revealed that diabetes appeared to influence continence recovery time (OR=1.589, 95%CI: 1.025-2.462, P=0.038). At the end of 48 hours, 4 weeks, 12 weeks, and 24 weeks after catheter removal, the mean OABSS score of the continent group was significantly lower than that of the incontinent group.@*CONCLUSION@#RARP showed promising results in the recovery of urinary continence. Diabetes was a risk factor influencing continence recovery time. Bladder overactive symptoms play an important role in the recovery of continence after RARP.

Clinical efficacy of docetaxel combined with carboplatin in patients with metastatic castration-resistant prostate cancer / 北京大学学报(医学版)

OBJECTIVE@#To observe the early efficacy and toxicity of docetaxel combined with carboplatin in patients with metastatic castration-resistant prostate cancer (mCRPC).@*METHODS@#From May 2017 to July 2019, fifteen patients with mCRPC treated in Peking University First Hospital were collected. The median age was 70 years (43-77 years), and the pathological types were all adenocarcinoma, which was confirmed as distant metastasis by imaging examination. They were given the chemotherapy of docetaxel combined with carboplatin. The specific method was as follows: each cycle was 28 days. Androgen deprivation therapy was administered routinely throughout the treatment period. Blood routine, liver and kidney function, blood clotting function and prostate-specific antigen (PSA) tests were performed before each cycle. Docetaxel was administered intravenously on the first day of each cycle at a dose of 75 mg/m2, and carboplatin was administered intravenously on the second day at the dose calculated by Calvert formula. The main outcome measures including PSA decline range, pain remission rate and occurrence of adverse reactions were observed and analyzed.@*RESULTS@#Among the 15 patients, 12 had completed at least 4 cycles of chemotherapy and had short-term efficacy evaluation. PSA decline range > 50% was observed in 8 patients (66.7%). Among the 9 patients with bone pain, remarkable pain relief was observed in 4 patients (44.4%). Among the 4 patients with measurable metastatic lesions, 2 achieved partial response, 1 was evaluated as stable disease, and 1 was evaluated as progressive disease. The main adverse reactions of chemotherapy included bone marrow suppression, gastrointestinal reactions, fatigue and neurological disorders, and most of them were within the tolerable range.@*CONCLUSION@#This report is a case series study of docetaxel combined with carboplatin in the treatment of mCRPC reported in China and the conclusions are representative. The chemotherapy of docetaxel combined with carboplatin has positive short-term efficacy and high safety in patients with mCRPC, which is worthy of further promotion and exploration in clinical practice.

Epidemiological characteristics of infectious diseases of group A, B and C among Chinese students' population / 北京大学学报(医学版)

OBJECTIVE@#To analyze the secular trend, ranking change, age- and regional- characteristics of leading infectious diseases among Chinese students population aged 6 to 22 years from 2008 to 2017.@*METHODS@#Data were drawn from the national surveillance from 2008 to 2017, and the participants were students aged from 6 to 22 years who were diagnosed with notifiable infectious diseases. A total of 40 infectious diseases were classified into three groups based on national notifiable infectious diseases classification of A, B and C. The morbidity and mortality rates from infectious diseases were calculated using the numbers of students published by the ministry of education as the denominator. The age- and province-specific infectious diseases with the highest incidence were selected as the leading infectious diseases for analysis.@*RESULTS@#From 2008 to 2017, the incidence rate, the number of cases and the number of deaths of infectious diseases among the boys aged 6-22 years in China were higher than that of the girls, and the overall trend was downward during the study period. The incidence rates in the boys and girls decreased from 2008 to 2015 with decrease of 43.4% and 40.1%, respectively. However, by 2017, the increase rate rebounded with the increases of 47.1% and 53.8%. The rebound trend was mainly caused by the increase of group C of infectious diseases. During the past decade, the top leading three diseases of groups A and B of infectious diseases were viral hepatitis, tuberculosis and dysentery in 2018, respectively, which changed to tuberculosis, scarlet fever and viral hepatitis in 2017. The top leading three infectious diseases in terms of mortality were rabies, tuberculosis, and human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) in 2008, which were transformed into HIV/AIDS, rabies, and tuberculosis in 2017. There was no significantly obvious change in the incidence and mortality order of group C of infectious diseases during the decade. In the analysis of age groups and regions, the leading infectious diseases in groups A and B transferred from viral hepatitis to scarlet fever and tuberculosis, while in group C, mumps and infectious diarrhoea almost always dominated the leading infectious diseases. But in recent years, influenza and hand-foot-and-mouth disease increased significantly in the eastern region.@*CONCLUSION@#During the past decade, China has got remarkable achievements in the prevention and control of children infectious disease. However, the change patterns and characteristics of notifiable infectious diseases among children and adolescents show the urgent need for prevention and control of respiratory tract infectious diseases, HIV/AIDS and other sexually transmitted diseases as well as new emerging infectious diseases in China in the future. This study provides important basis for policy making of Chinese national school-based infectious disease prevention and control mechanism.

Key data elements for clinical management and outcomes of patients with coronary artery disease: definitions from Coronary Artery Disease and Creative Antithrombotic Clinical Research Collaboration (CardiaCare) / 中华心血管病杂志

Objective: To develop a set of data elements and standardized definitions of Coronary Artery Disease and Creative Antithrombotic Clinical Research Collaboration (CardiaCare), aiming to facilitate the exchange of disparate data sources, enhance the abilities to support multicenter researches, and subsequently ensure the databases use under standardized process and criteria. Methods: The Cardiacare writing committee members reviewed data elements and definitions from published guidelines, clinical trials, databases, and standardized documents, then determined the data elements and standardized definitions, which should be included in CardiaCare. The writing committee also considered the specific domestic clinical management strategies during the establishment of Cardiacare. The resulting documents provide a series of key data elements and standardized definitions used in the management of coronary artery disease patients. Key data elements from CardiaCare could be sorted by clinical management flowsheet and outcome from hospitalization to long-term follow-up. Results: The Cardiacare standardized set comprised 864 data elements from admission to post-hospital follow-up visit. There were 8 tables in the documents, including demographic and admission information (23 elements), medical history and risk factors (102 elements), clinical presentations and diagnosis (22 elements), diagnostic and laboratory tests (111 elements), interventional diagnosis and treatment (118 elements), pharmacological therapy (213 elements), clinical outcomes (161 elements), and special subpopulations (114 elements: 87 elements for transcatheter valve replacement and 27 elements with cardiac rehabilitation). Conclusions: The Cardiacare standardized data elements set could provide support for real-world clinical research in consecutive data collection and databases mining. A wider applicability in various settings of CardiaCare needs to be explored further.