Analysis of clinical histopathological composition of 699 cases with orbital tumors and tumor-like lesions / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the clinical and histopathological composition of orbital tumors and tumor-like lesions.METHODS: Retrospective case-series study. The clinical histopathological data of 699 cases(707 eyes)with orbital tumor and tumor-like lesions who treated in the orbital disease and ophthalmic plastic department of Tianjin Eye Hospital between January 2010 and December 2020 were collected. All the pathology diagnosis results were divided into three categories which were benign tumor, borderline tumor and malignant tumor according to the eighth edition of the American Joint Committee on Cancer staging system and the 2018 World Health Organization Classification of tumors of the eye. All cases were divided into four groups according to age, including 0～17 years old, 18～39 years old, 40～59 years old, 60 years and above. The histological composition of each group was analyzed.RESULTS: Among the 699 cases(707 eyes), 311 patients(316 eyes)were male and 388 patients(391 eyes)were female. The patient's age at diagnosis ranged from 1 to 84 years(mean 39.9±2.2)years. The right orbit was involved in 307 patients, the left orbit in 384 patients, and 8 patients in bilateral orbit. There were 598 patients(604 eyes, 85.6%)with benign tumor and tumor-like lesions, 7 patients(7 eyes, 1.0%)with borderline tumor, and 94 patients(96 eyes, 13.4%)with malignant tumors. The top 5 benign tumor and tumor-like lesions were cavernous hemangioma(110 cases, 15.7%), dermoid cysts(96 cases, 13.7%), pleomorphic adenomas(54 cases, 7.7%), inflammatory pseudotumors(38 cases, 5.4%), and schwannomas(29 cases, 4.1%)respectively. The top 5 borderline and malignant tumors were non-Hodgkin lymphomas(42 cases, 41.6%), solitary fibrous tumors(12 cases, 11.9%), adenoid cystic carcinomas(11 cases, 10.9%), metastatic tumor(9 cases, 8.9%), and rhabdomyosarcoma(8 cases, 7.9%), respectively. Among the common orbital benign tumors and tumor-like lesions, cavernous hemangioma and pleomorphic adenoma showed a female predominance. Among the common borderline and malignant tumors, non-Hodgkin lymphoma and mesenchymal chondrosarcoma showed a male predominance. The most common benign and malignant tumors were dermoid cysts, rhabdomyosarcomas respectively in group under 18 years old. And dermoid cysts and solitary fibrous tumors were the most common benign and malignant tumors respectively in patients between 18 and 39 years old. Cavernous hemangioma and non-Hodgkin lymphomas were the most common benign and malignant tumors respectively in patients between 40 and 59 years old. While cavernous hemangioma and non-Hodgkin lymphomas were the most common benign and malignant tumors respectively in cases over 60 years old.CONCLUSION: Most orbital tumors and tumor-like lesions are benign. The most common benign orbital tumor is cavernous hemangioma, followed by dermoid cyst. Non-Hodgkin lymphoma is the most common malignant orbital tumor.

Association between the Neutrophil-to-lymphocyte Ratio and New-onset Subclinical Macrovascular and Microvascular Diseases in the Chinese Population / 生物医学与环境科学（英文）

OBJECTIVE@#The association between neutrophil-to-lymphocyte ratio (NLR) with subclinical macrovascular and microvascular diseases has been less investigated. We sought to examine the association between NLR and new-onset subclinical macrovascular and microvascular abnormalities in the Chinese population.@*METHODS@#From a community cohort, we included 6,430 adults aged ≥ 40 years without subclinical macrovascular and microvascular diseases at baseline. We measured subclinical macrovascular and microvascular abnormalities separately using the ankle-brachial index (ABI), brachial-ankle pulse wave velocity (baPWV), and albuminuria.@*RESULTS@#During a mean follow-up of 4.3 years, 110 participants developed incident abnormal ABI, 746 participants developed incident elevated baPWV, and 503 participants developed incident albuminuria. Poisson regression analysis indicated that NLR was significantly associated with an increased risk of new-onset abnormal ABI, elevated baPWV, and albuminuria. Compared to overweight/obese participants, we found a much stronger association between NLR and subclinical vascular abnormalities in participants with normal weight. Furthermore, we found an interaction between the NLR and body mass index (BMI) on the risk of new-onset abnormal ABI ( P for interaction: 0.01).@*CONCLUSION@#NLR was associated with subclinical macrovascular and microvascular diseases in the Chinese population. Furthermore, in participants with normal weight, the association between NLR and subclinical vascular abnormalities was much stronger.

Changes in psychological status of initial-diagnosed breast cancer patients before and after surgical treatment / 国际外科学杂志

Objective:To study the effect of surgical treatment on the psychological status of initial-diagnosed breast cancer patients.Methods:Using a prospective study method, 73 initial-diagnosed breast cancer patients who received surgical treatment in Beijing Bo′ai Hospital from March 2015 to June 2017 were selected. The self-rating anxiety scale (SAS), the self-rating depression scale (SDS) and the symptom checklist-90 (SCL-90) were used to evaluate the psychological health status before and after surgery by face-to-face conversation. The measurement data were described as mean±standard deviation( ± s), and the scores of SAS, SDS and SCL-90 before and after surgery were analyzed by paired t-test. Chi-square test was used to compare count data before and after surgery. Results:After surgical treatment, the anxiety and depression scores were 38.03±8.53 and 42.17±10.93, which were significantly lower than that in the pre-operation (46.47±11.47 and 51.01±14.22), the differences were statistically significant ( P<0.001). The scores of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, anxiety, depression, hostility, phobia, paranoid and psychotic disorder of initial-diagnosed breast cancer patients in SCL-90 were 4.52±4.71, 6.15±5.49, 3.51±3.26, 4.52±4.44, 7.12±6.23, 1.55±2.03, 3.18±3.36, 0.99±1.36 and 2.85±3.59 after surgical treatment, which were significantly lower than that in the pre-operation (6.88±6.36, 10.08±6.77, 5.99±5.57, 10.03±8.00, 12.59±9.78, 4.12±5.25, 4.92±4.46, 2.59±3.60) and (5.84±5.43), the differences were statistically significant ( P=0.002 in somatization, others P<0.001). Conclusion:Surgical treatment can improve the psychological status of initial-diagnosed breast cancer patients, which has important significance for the psychological rehabilitation of patients who were initial-diagnosed breast cancer.

Correlates of Sedentary Behavior among Bhutanese Adults: Findings from the 2014 Bhutan STEPS Survey Data / 가정의학회지

Background@#Sedentary behavior is associated with several adverse health outcomes. Data on factors that influence sedentary behavior are lacking in Bhutan. This study examined factors associated with increased sedentary behavior in Bhutan, with a focus on exploring sex differences. @*Methods@#Data of 2,796 adults from the nationally representative 2014 Bhutan STEP-wise surveillance (STEPS) survey were analyzed. Factors associated with sedentary behavior were identified using backward elimination multiple logistic regression analysis, disaggregated by sex. The analysis accounted for the complex survey design used in the primary survey. @*Results@#The overall prevalence of sedentary behavior was 8.2%, with a higher proportion among women than men (10.3% vs. 4.9%). In the full sample, female sex, being single, high education and income, urban residence, inadequate physical activity, and high blood sugar were associated with increased odds of sedentary behavior. Among females, those who had high education and income, were single, physically less active, and urban residents were more likely to be sedentary. Self-employment was related to reduced odds of sedentary behavior among women and in the overall sample population. In males, being single, higher education level, and urban residence were associated with sedentariness. @*Conclusion@#The findings suggest that interventions targeting females, especially those who are physically less active and from higher socioeconomic groups, urban residents, and those with hyperglycemia can potentially help reduce sedentary behavior and avert the associated detrimental impacts.

Association of Visit-to-Visit Variabilities in Metabolic Factors with Chronic Kidney Disease in Chinese Adults Living in Shanghai / 生物医学与环境科学（英文）

Objective@#This study aimed to examine the association of visit-to-visit variabilities in metabolic factors with chronic kidney disease (CKD) in Shanghai community residents.@*Methods@#We used data from a cohort study of community residents who participated in three examinations in 2008, 2009, and 2013, respectively. Fasting plasma glucose (FPG) level, blood pressure (BP), and lipid levels were determined in 2,109 participants at all three visits, and CKD was evaluated between the second and the third visits. Visit-to-visit variabilities in metabolic factors were described by coefficients of variation (CV) at three visits. A variability score was calculated by adding the numbers of metabolic factors with a high variability defined as the highest quartile of CV. CKD was defined as the estimated glomerular filtration rate < 60 mL/min per 1.73 m @*Results@#A total of 200 (9.5%) participants had CKD at the third visit. Compared with the lowest quartile of CV, the highest quartile was associated with a 70% increased risk of CKD for FPG [odds ratio, @*Conclusion@#The visit-to-visit variabilities in metabolic factors were significantly associated with the risks of CKD in Shanghai community residents.

Regional anesthesia and cancer recurrence in patients with late-stage cancer: a systematic review and meta-analysis / 中华医学杂志(英文版)

BACKGROUND@#Whether regional anesthesia may help to prevent disease recurrence in cancer patients is still controversial. The stage of cancer at the time of diagnosis is a key factor that defines prognosis and is one of the most important sources of heterogeneity for the treatment effect. We sought to update existing systematic reviews and clarify the effect of regional anesthesia on cancer recurrence in late-stage cancer patients.@*METHODS@#Medline, Embase, and Cochrane Library were searched from inception to September 2020 to identify randomized controlled trials (RCTs) and cohort studies that assessed the effect of regional anesthesia on cancer recurrence and overall survival (OS) compared with general anesthesia. Late-stage cancer patients were primarily assessed according to the American Joint Committee on Cancer Cancer Staging Manual (eighth edition), and the combined hazard ratio (HR) from random-effects models was used to evaluate the effect of regional anesthesia.@*RESULTS@#A total of three RCTs and 34 cohort studies (including 64,691 patients) were identified through the literature search for inclusion in the analysis. The risk of bias was low in the RCTs and was moderate in the observational studies. The pooled HR for recurrence-free survival (RFS) or OS did not favor regional anesthesia when data from RCTs in patients with late-stage cancer were combined (RFS, HR = 1.12, 95% confidence interval [CI]: 0.58-2.18, P = 0.729, I2 = 76%; OS, HR = 0.86, 95% CI: 0.63-1.18, P = 0.345, I2 = 48%). Findings from observational studies showed that regional anesthesia may help to prevent disease recurrence (HR = 0.87, 95% CI: 0.78-0.96, P = 0.008, I2 = 71%) and improve OS (HR = 0.88, 95% CI: 0.79-0.98, P = 0.022, I2 = 79%).@*CONCLUSIONS@#RCTs reveal that OS and RFS were similar between regional and general anesthesia in late-stage cancers. The selection of anesthetic methods should still be based on clinical evaluation, and changes to current practice need more support from large, well-powered, and well-designed studies.

Renoprotective Effect of Sanjiao Qushi Prescription Against Cationic Bovine Serum Albumin Induced Membranous Nephropathy Mice Model and Its Influence on Nrf2/HO-1 Signaling Pathway / 中国实验方剂学杂志

Objective:To investigate the renoprotective effects that Sanjiao Qushi prescription ameliorates cationic bovine serum albumin （C-BSA） induced membranous nephropathy（MN） in mice model and its influence on nuclear factor erythroid-2-related factor-2（Nrf2）/heme oxygenase-1（HO-1） signaling pathway. Method:Sixty female BALB/c mice were randomly divided into the normal group（<italic>n</italic>=10） and the model group（<italic>n</italic>=50）. The mice in the model group received C-BSA injection via tail vein （6.5 mg·kg^-1）. The mice that were successfully modeled were randomized into the model group， the low dose Sanjiao Qushi prescription group（3.71 g·kg^-1）， the high dose Sanjiao Qushi prescription group（7.42 g·kg^-1） and benazepril hydrochloride group（1.3 mg·kg^-1）. And they were administered with the corresponding medicine by gavage once a day for four consecutive weeks. 24 hour-urine protein quantitation were performed before C-BSA injection and after C-BSA injection as well as the medicine gavage. When the treatment was finished， all of the mice were sacrificed and the biochemical indicators such as serum creatinine（SCr）， blood urea nitrogen（BUN）， triglyceride（TG）， total cholesterol（TC）， total protein（TP） and albumin（Alb） were measured. And the renal pathological morphology changes were observed by light microscope with hematoxylineosin（HE）， Masson and periodic acid-silver metheramine（PASM） staining. The deposition of immunoglobulin G（IgG） in the glomerulus was detected by fluorescence microscope. The expression of reactive oxygen species （ROS） of kidney was detected by fluorescence immunoassay. The protein expression levels of Nrf2 in cell nucleus and cytoplasm and the downstream protein factors HO-1 and NADH quinone acceptor oxidoreductase 1（NQO1） were detected by Western blot. Result:Compare to normal group， the levels of 24 hour-urine protein quantitation， TG and TC significantly increased in model group（<italic>P</italic><0.01）， while TP and Alb levels significantly decreased（<italic>P</italic><0.01）. The model group exhibited enlarged volume of glomerular， significantly thickened glomerular basement membrane（GBM）， fuchsinophilic protein deposition and spike formation through light microscope. Immunofluorescence staining for the model group exhibited granular deposition of IgG along the capillary wall. The expression of ROS in kidney significantly increased（<italic>P</italic><0.01）. The protein expression levels of Nrf2 in cell nucleus significantly increased（<italic>P</italic><0.01）， while Nrf2 in cytoplasm significantly decreased（<italic>P</italic><0.01）.The protein expression levels of HO-1 and NQO1 significantly increased（<italic>P</italic><0.01）. Compared to model group， the levels of 24 hour-urine protein quantitation， TG and TC significantly decreased in each treated group（<italic>P</italic><0.01）， TP and Alb levels significantly increased（<italic>P</italic><0.05，<italic>P</italic><0.01）. The pathological damages alleviated obviously. The expression of ROS in kidney significantly decreased（<italic>P</italic><0.01）. The protein expression levels of Nrf2 in cell nucleus significantly decreased（<italic>P</italic><0.01）， while Nrf2 in cytoplasm significantly increased（<italic>P</italic><0.05，<italic>P</italic><0.01）. The protein expression levels of HO-1 and NQO1 significantly increased（<italic>P</italic><0.01）. Conclusion:Sanjiao Qushi prescription worked on MN mice possibly by regulating related proteins in the Nrf2/HO-1 signaling pathway and relieving oxidative stress， thus decreasing 24 hour-urine protein and blood lipid， increasing serum protein， and alleviating the pathological damages to protect renal function and delay progress of the disease.

Correlates of Sedentary Behavior among Bhutanese Adults: Findings from the 2014 Bhutan STEPS Survey Data / 가정의학회지

Background@#Sedentary behavior is associated with several adverse health outcomes. Data on factors that influence sedentary behavior are lacking in Bhutan. This study examined factors associated with increased sedentary behavior in Bhutan, with a focus on exploring sex differences. @*Methods@#Data of 2,796 adults from the nationally representative 2014 Bhutan STEP-wise surveillance (STEPS) survey were analyzed. Factors associated with sedentary behavior were identified using backward elimination multiple logistic regression analysis, disaggregated by sex. The analysis accounted for the complex survey design used in the primary survey. @*Results@#The overall prevalence of sedentary behavior was 8.2%, with a higher proportion among women than men (10.3% vs. 4.9%). In the full sample, female sex, being single, high education and income, urban residence, inadequate physical activity, and high blood sugar were associated with increased odds of sedentary behavior. Among females, those who had high education and income, were single, physically less active, and urban residents were more likely to be sedentary. Self-employment was related to reduced odds of sedentary behavior among women and in the overall sample population. In males, being single, higher education level, and urban residence were associated with sedentariness. @*Conclusion@#The findings suggest that interventions targeting females, especially those who are physically less active and from higher socioeconomic groups, urban residents, and those with hyperglycemia can potentially help reduce sedentary behavior and avert the associated detrimental impacts.

Prognostic neurodevelopmental outcome accuracy of amplitude-integrated electroencephalogram in premature infant: a Meta-analysis / 中国小儿急救医学

Objective:To evaluate the prognostic value of amplitude-integrated electroencephalogram(aEEG) on predicting long-term neurodevelopmental outcome of preterm infants.Methods:Literatures were searched in PubMed, the Cochrane library, Web of science, Wanfang database, CNKI and CBM database from inception to August, 2020.The studies which investigated the prognostic value of aEEG on neurodevelopmental outcome of preterm infants were included.Articles screening, data extraction and quality assessment were accomplished by two investigators independently, and statistical analyses were performed by Meta-disc1.4.Results:Six studies were included with 557 cases.The Meta-analysis revealed that the pooled sensitivity was 0.81 (95% CI 0.75-0.87), specificity was 0.68 (95% CI 0.63-0.73), positive likelihood ratio was 2.32(95% CI 1.52-3.52), negative likelihood ratio was 0.27(95% CI 0.19-0.37)and the area under the curve of summary receiver operating characteristic curve was 0.79(95% CI 0.75-0.82). Burst-suppression, continuous low voltage and flat trace were regard as a index of poor neurodevelopmental prognosis. Conclusion:aEEG is a valuable tool for predicting the outcome of long-term neurodevelopment in preterm infants.

New progress in treatment of hypophosphatasia / 中华实用儿科临床杂志

Hypophosphatasia (HPP) is caused by loss-of-function mutation(s) of the gene that encodes the tissue-nonspecific isoenzyme of alkaline phosphatase (TNSALP). Its manifestations are variable, including impaired skeletal mineralization, altered calcium and phosphate metabolism, recurrent fractures, pain, impaired mobility, premature tooth loss, developmental delay, and seizures.There are different attempts for HPP.Asfotase alfa (Strensiq?), is a bone-targeted recombinant TNSALP which has shown significant improvements in morbidity and mortality in patients with perinatal and infantile hypophosphatasia, and it can improve growth, mobility function and quality of life.This enzyme replacement therapy has generally been well-tolerated, with most adverse reactions being mild-to-moderate in nature.This article reviews recent advances in the treatment of the disease.

Pharmaceutical care for a patient with cancer pain after surgery for metastatic breast cancer / 药学实践杂志

Objective By participating in the process of drug treatment and pharmaceutical monitoring for a patient with cancer pain, clinical pharmacists participated in formulating drug treatment plans and proposed rational medication recommendations. At the same time, patients were given health education to reduce or avoid adverse drug reactions. Methods Pharmacists participate in the process of pharmacy monitoring of patients by participating in the review of prescriptions, discovering problems, intervening in time for improper prescriptions, communicating with doctors, changing medication plans, and providing health education to patients. Results Physicians accepted the suggestions of pharmacists and modified the medication regimen. The patient's condition improved. Conclusion The pharmacist participated in the intervention of an improperly prescribed medication for a patient with metastatic breast cancer postoperative cancer pain, and gave the patient a full range of pharmaceutical care, which reflects the importance of the pharmacist in pharmaceutical care.

Metabonomics study of Shouhui Tongbian Capsules in slow transit constipation based on UPLC-ESI-QE-Orbitrap-MS / 中国中药杂志

The effect of Shouhui Tongbian Capsules(SHTB) on the endogenous metabolites of colon tissue in mice with slow transit constipation was analyzed by metabolomics methods to explore its mechanism in the treatment of constipation. ICR mice were randomly divided into normal group, model group and SHTB group according to the body weight. The mice were given diphenoxylate to establish the slow transit constipation model. Mouse carbon ink pushing rate, first defecation time and the number of defecation particles in 12 h were observed. The mouse colon tissue was separated and the mucous cells were detected by Periodic acid Schiff and Alcian blue(AB-PAS) staining. Ultra-high-performance liquid chromatography electrospray ionization orbitrap tandem mass spectrometry(UPLC-ESI-Orbitrap-MS/MS) technology was used to characterize the differences in tissue metabolism to screen out the potential different metabolites and possible metabolic pathways in colon tissue. The results indicated that SHTB could significantly shorten the first defecation time and the number of defecations, and increase the number of intestinal peristalsis and mucous cells in the colonic mucosa compared to the model mice. Metabolomics results showed that, compared with the normal group, a total of 17 potential biomarkers, including L-kynurenine, N6,N6,N6-trimethyl-L-lysine, L-formylkynurenine, N6-acetyl-L-lysine, L-phenylalanine, phenylacetaldehyde, xanthoxin, thymidine, glycyl-L-leucine, cystathionine,(R)-1-aminopropan-2-ol, deoxycytidine, gamma-glutamyl-gamma-aminobutyraldehyde, D-galactose, L-arginine, L-proline and pyruvate, were found and identified in colon tissue. Treated with SHTB, these metabolic differences tended to return to normal levels. Therefore, it could be made a conclusion that the therapeutic effect of SHTB on chronic transit constipation may be related to regulating phenylalanine metabolism, phenylalanine, tyrosine and tryptophan biosynthesis, arginine and proline metabolism, cysteine and methionine metabolism, tyrosine metabolism, arginine biosynthesis, pyruvate metabolism, glycolysis, pyrimidine metabolism, tricarboxylic acid cycle and galactose metabolism.

Molecular chaperones facilitate soluble expression of recombinant non-toxic mutant CRM197 of diphtheria toxin in Escherichia coli / 生物工程学报

Diphtheria toxin is an ADP-ribosyltransferase toxic to human cells. Mutation of the active site in its catalytic domain eliminates the toxicity, but retains its immunogenicity. A non-toxic mutant of diphtheria toxin known as CRM197 protein has become an ideal carrier protein for conjugate vaccines. CRM197 can further improve its immunogenicity by cross-linking with other antigens, so it has good potential to find broad applications. Unfortunately, inclusion bodies are easily formed during the expression of recombinant CRM197 protein in Escherichia coli, which greatly reduces its yield. In order to address this problem, pG-KJE8 vector carrying molecular chaperones and plasmid pET28a-CRM197, were co-expressed in Escherichia coli. The results showed that the recombinant CRM197 protein was successfully expressed and appeared largely in inclusion bodies. The molecular chaperones DnaK, DnaJ, GrpE, GroES and GroEL5 expressed can facilitate correct and rapid folding of CRM197. Furthermore, it can also improve the recovery rate of soluble CRM197 protein. The soluble expression of CRM197 was maximized upon addition of 1.0 mmol/L IPTG, 0.5 mg L-arabinose, 5.0 ng/mL tetracycline and induction at 20oC for 16 h. The soluble CRM197 protein shows good immunoreactivity, demonstrating the molecular chaperones expressed from pG-KJE8 facilitated the soluble expression of CRM197 protein in E. coli.

Malnutrition in Relation with Dietary, Geographical, and Socioeconomic Factors among Older Chinese / 生物医学与环境科学（英文）

Objective@#Nutrition is closely related to the health of the elderly population. This study aimed to provide a comprehensive picture of the nutrition status of elderly Chinese and its related dietary, geographical, and socioeconomic factors.@*Methods@#A total of 13,987 ≥ 60-year-old persons from the 2010-2013 Chinese National Nutrition and Health Survey were included to evaluate various aspects of malnutrition, including underweight, overweight or obesity, and micronutrient inadequacy.@*Results@#Overall, the prevalence of obesity, overweight, and underweight was 12.4%, 34.8%, and 5.7%, respectively, with disparities both geographically and socioeconomically. The prevalence of underweight was higher among the older old (≥ 75 years), rural residents and those with low income, with low education status, and residing in undeveloped West areas. More than 75% of the elderly do not meet the Dietary Reference Intakes for vitamins A, B @*Conclusions@#Obesity epidemic, inadequacy of micronutrient intake, and high prevalence of underweight and anemia in susceptible older people are the major nutrition challenges for the rapidly aging population in China.

Inverted U-Shaped Associations between Glycemic Indices and Serum Uric Acid Levels in the General Chinese Population: Findings from the China Cardiometabolic Disease and Cancer Cohort (4C) Study / 生物医学与环境科学（英文）

Objective@#The relationship between serum uric acid (SUA) levels and glycemic indices, including plasma glucose (FPG), 2-hour postload glucose (2h-PG), and glycated hemoglobin (HbA1c), remains inconclusive. We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.@*Methods@#The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study. A total of 105,922 community-dwelling adults aged ≥ 40 years underwent the oral glucose tolerance test and uric acid assessment. The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.@*Results@#A total of 30,941 men and 62,361 women were eligible for the current analysis. Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels, but with different inflection points in men and women. The thresholds for FPG, 2h-PG, and HbA1c for men and women were 6.5/8.0 mmol/L, 11.0/14.0 mmol/L, and 6.1/6.5, respectively (SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).@*Conclusion@#An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes, while the inflection points were reached earlier in men than in women.

Effect of CYP2C19 polymorphism and different P2Y 12 inhibitors on the long-term prognosis of patients with acute coronary syndromes / 国际生物医学工程杂志

Objective:To explore the relationship between the selection of different P2Y 12 inhibitors and the long-term prognosis of acute coronary syndrome (ACS) patients with and without CYP2C19 defect gene. Method:289 consecutive ACS patients who underwent percutaneous coronary intervention (PCI) at Tianjin Third Central Hospital from March 2016 to October 2016 were selected for CYP2C19 gene polymorphism detection. According to the detection results, the patients were divided into group A (with CYP2C19 loss-of-function gene, 199 cases) and group B (without CYP2C19 loss-of-function gene, 90 cases). After PCI, different P2Y 12 inhibitors were selected. The patients were followed up for 3 years, and 23 cases were lost to follow-up. Finally, 182 cases were enrolled in group A and 84 cases were enrolled in group B. According to whether there were major adverse cardiovascular events (MACE) within 3 years, the patients in groups A and B were divided into MACE subgroups (58 cases, 32 cases) and non-MACE subgroups (124 cases, 52 cases). The single factor analysis of the two subgroups in groups A and B was carried out based on the patient's clinical data, coronary artery disease and intervention status, and postoperative drug treatment plan. Risk factors with statistical significance ( P<0.05) were selected, and multivariate logistic regression analysis was performed on groups A and B to compare the effects of different P2Y 12 inhibitors on the prognosis of the two groups. Results:The differences in platelet volume, fasting blood glucose, HbA1c, left ventricular end-diastolic diameter, proportion of single-branch lesions, proportion of intervention for left main lesions, and dual antiplatelet therapy were statistically significant between the two subgroups in group A (all P<0.05). The differences in low-density lipoprotein (LDL), left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter, proportion of two-branch lesions, proportion of three-branch lesions, and proportion of using tirofeben were statistically significant between the two subgroups in group B (all P<0.05). In the group A, the choice of different P2Y 12 inhibitors was the independent risk factor for the long-term prognosis. Compared with patients treated with Ticagrelor, the probability of long-term MACE was 11.971 times larger ( OR=12.971, 95% CI: 5.028~33.464, P<0.001) among patients treated with Clopidogrel 75 mg/day, and 5.029 times larger ( OR=6.029, 95%CI: 2.278~15.958) among patients treated with Clopidogrel 100 mg/day. No significant correlation was witnessed between different P2Y 12 inhibitors and long-term prognosis in group B. In the group B, different P2Y 12 inhibitors have no significant correlation with their long-term prognosis of patients( P>0.05). Conclusions:For ACS patients with CYP2C19 loss-of-function gene, the choice of P2Y 12 inhibitors is associated with their long-term MACE events after PCI. Ticagrelor therapy brings the lowest risk of long-term MACE. For those without CYP2C19 loss-of-function gene, the correlation between the choice of different P2Y 12 inhibitors and their prognosis is not significant.

Peripheral Artery Disease and Risk of Fibrosis Deterioration in Nonalcoholic Fatty Liver Disease: A Prospective Investigation / 生物医学与环境科学（英文）

Objective@#Liver fibrosis is an important predictor of mortality in nonalcoholic fatty liver disease (NAFLD). Peripheral artery disease (PAD) and liver fibrosis share many common metabolic dysfunctions. We aimed to explore the association between PAD and risk of fibrosis deterioration in NAFLD patients.@*Methods@#The study recruited 1,610 NAFLD patients aged ≥ 40 years from a well-defined community at baseline in 2010 and followed up between August 2014 and May 2015. Fibrosis deterioration was defined as the NAFLD fibrosis score (NFS) status increased to a higher category at the follow-up visit. PAD was defined as an ankle-brachial index of 1.40.@*Results@#During an average of 4.3 years' follow-up, 618 patients progressed to a higher NFS category. PAD was associated with 92% increased risk of fibrosis deterioration [multivariable-adjusted odds ratio ( ): 1.92, 95% confidence interval ( ): 1.24, 2.98]. When stratified by baseline NFS status, the for progression from low to intermediate or high NFS was 1.74 (95% : 1.02, 3.00), and progression from intermediate to high NFS was 2.24 (95% : 1.05, 4.80). There was a significant interaction between PAD and insulin resistance (IR) on fibrosis deterioration ( for interaction = 0.03). As compared with non-PAD and non-IR, the coexistence of PAD and IR was associated with a 3.85-fold (95% : 2.06, 7.18) increased risk of fibrosis deterioration.@*Conclusion@#PAD is associated with an increased risk of fibrosis deterioration in NAFLD patients, especially in those with IR. The coexistence of PAD and IR may impose an interactive effect on the risk of fibrosis deterioration.

Expression of anaplastic lymphoma kinase clone 1A4 in pediatric medulloblastoma and its significance / 中华病理学杂志

Objective@#To investigate the immunohistochemical staining of anaplastic lymphoma kinase (ALK; clone 1A4) in pediatric medulloblastoma (MB).@*Methods@#Molecular subtyping was performed based on the NanoString and sequencing techniques for 44 pediatric MB cases at Children′s Hospital, Zhejiang University School of Medicine from 2014 to 2017. ALK expression was detected with EnVision immunhistochemistry using ALK clone 1A4 on whole section. Statistical analyses were performed to evaluate the correlation of protein expression with molecular subgroups.@*Results@#The age ranged from 0.5 to 13.0 years with an average age of 5.8 years. There were 28 males and 16 females, and 31 classic, 5 desmoplastic nodular, 3 extensive nodular and 5 large cell/anaplastic MBs. Except three cases was unable classified, 41 MBs were classified into the four molecular groups: 5 in WNT group, 12 in SHH group, 9 in Group 3 and 15 in Group 4. Thirteen of 44 MB cases were positive staining for ALK, and the positive rate was 29.5%. Six cases were strong reaction, and 7 cases were weak. The expression of ALK at the protein level was associated with the WNT group (P<0.01). The characteristic perinuclear dot-like staining was only showed in WNT group.@*Conclusions@#The ALK immunhistochemistry using antibody clone 1A4 is a useful marker for the molecular subgroup detection of MB. The strong staining and perinuclear dot-like staining indicate as WNT group.

Effect of electroacupuncture on expressions of Lyn and Syk in mast cells of subcutaneous loose connective tissue in rats with urticarial / 中国针灸

OBJECTIVE@#To observe the effect of electroacupuncture (EA) preconditioning on the expressions of tyrosine kinase Lyn and spleen tyrosine kinase (Syk) in mast cells of subcutaneous loose connective tissue in the rats with urticaria and explore the potential biological mechanism of EA in the intervention of urticaria.@*METHODS@#A total of 32 SD rats were randomized into a blank group, a model group, an EA group and a positive medication group, 8 rats in each one. Except of the blank group, the passive cutaneous anaphylaxis (PCA) was adopted to prepare the model of urticaria in the rats of the rest three groups. In the EA group, EA was applied to bilateral "Quchi" (LI 11), "Xuehai" (SP 10) and "Zusanli" (ST 36), with disperse-dense wave, 2 Hz/15 Hz in frequency and 1 mA in current intensity, once daily, for 20 min each time, consecutively for 7 days. In the positive medication group, loratadine (1 mg•kg•d) was for intragastric administration, once daily, consecutively for 7 days. The samples were collected for index detection 30 min after PCA antigen challenge in the rats of each group. Spectrophotometer was adopted to determine the effusion quantity of Evans blue in the allergized site of skin. HE staining was used to observe the morphological changes in the allergized site of skin. Toluidine blue staining was provided to observe mast cell degranulation in subcutaneous loose connective tissue in the allergized site of skin. Immunohistochemistry was applied to determine the protein expressions of Lyn and Syk during degranulation of mast cells.@*RESULTS@#In the rats of the odel group, the eipdermis of allergized site was thickening, cells were disorganized in hierarchy and inflammatory cells were infiltrated largely in the dermis. In the positive medication group and the EA group, the epidermis was getting thin, cell arrangement was clear and the inflammatory cell infiltration was obviously alleviated as compared with the model group. Compared with the blank group, the OD value of skin dye effusion quantity, the degranulation rate of mast cells and the positive expressions of Lyn and Syk were all increased in the model group (<0.01). Compared with the model group, the OD value of skin dye effusion quantity, the degranulation rate of mast cells and the positive expressions of Lyn and Syk were all reduced in the EA group and the positive medication group (<0.01). Compared with the positive medication group, the degranulation rate of mast cells was increased significantly in the EA group (<0.01).@*CONCLUSION@#Electroacupuncture at "Quchi" (LI 11), "Xuehai" (SP 10) and "Zusanli" (ST 36) reduces vascular permeability and gives play to the role of anti-allergy by the way of regulating and controlling the degranulation of mast cells in the rats with urticaria and the effect mechanism of electroacupuncture may be related to the inhibition of protein expressions of Lyn and Syk in mast cells.

Survey of the acceptance status of HPV self-sampling screening in female population for cervical cancer / 中华妇产科杂志

Objective To investigate the acceptance of HPV self-sampling mode in cervical cancer screening population and explore its feasibility. Methods From March 5 to 15, 2018, researchers investigated women who participated in cervical cancer screening organized by Beijing Shunyi Women＇s and Children＇s Hospital in the form of questionnaires. Questionnaires were conducted on their acceptance status and the factors that affect the self-sampling experience. The specific contents of the questionnaires were as follows: (1) the experience of using self-sampling included operability, comfortable, sample time-consuming, bleeding or not after sampling; (2) psychological changes after self-sampling, including the willingness to accept self-sampling again, the worrying problems during self-sampling process. According to whether or not have operating video guidance, the self-sampling experience and psychological changes after self-sampling were compared. Results (1) There were 1 375 women participated in the questionnaire survey, and 86.55% (1 190/1 375) of them thought the self-sampling was convenient, 78.40% (1 078/1 375) thought it was not uncomfortable, 88.58% (1 218/1 375) thought the sampling time was fast (less than 5 minutes), 94.04% (1 293/1 375) self-sampling without bleeding; and 83.27% (1 145/1 375) were willing to self-sampling for cervical cancer screening again, 85.82% (1 180/1 375) were afraid of inaccurate sampling. (2) Among the 1 375 women, 1 202 were in the video guidance group and 173 were in the non-guidance group. The self-sampling experience of women in video guidance group was better than those of non-guidance group in operability, comfortable, sampling time-consuming and bleeding after sampling. The proportion of women who willing to self-sampling again was higher than that of non-guidance group (86.69% vs 59.54%, respectively). The proportion of women who worried operating incorrectly was lower than that of non-guidance group (11.23% vs 32.37%, respectively). The differences were significant (all P<0.05). Conclusions Self-sampling for HPV testing in cervical cancer screening is easy to operate and has little discomfort complaint. It is feasible in cervical cancer screening. Operational video guidance during the screening process could effectively improve the women＇s experience and willingness to self-sampling again in the future.