Establishment and analysis of an early prognosis model of patients with acute kidney injury in intensive care unit / 中华危重病急救医学

Objective:To establish a predictive model for the progression of acute kidney injury (AKI) to stage 3 AKI (renal failure) in the intensive care unit (ICU), so as to assist physicians to make early and timely decisions on whether to intervene in advance.Methods:A retrospective analysis was conducted. Thirty-eight patients with AKI admitted to the intensive care medicine of the Third People's Hospital of Henan Province from January 2018 to May 2023 were enrolled. Patient data including acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) upon admission, serum creatinine (SCr), blood urea nitrogen (BUN), daily urine output during hospitalization, and the timing of continuous renal replacement therapy (CRRT) intervention were recorded. Based on clinically collected pathological data, standardized creatinine value ratio mean polynomial fitting models were established as the first criterion for judging the progression to stage 3 AKI after data cleansing, screening, and normalization. Additionally, standardized creatinine value ratio index fitting models were established as the second criterion for predicting progression to stage 3 AKI.Results:A total of 38 AKI patients were included, including 25 males and 13 females. The average age was (58.45±12.94) years old. The APACHEⅡ score was 24.13±4.17 at admission. The intervention node was (4.42±0.95) days. Using a dual regression model approach, statistical modeling was performed with a relatively small sample size of statistical data samples, yielding a scatter index non-linear regression model for standardized creatinine value ratio data relative to day " n", with y = 1.246?2 x1.164?9 and an R2 of 0.860?1, indicating reasonable statistical fitting. Additionally, a quadratic non-linear regression model was obtained for the mean standardized creatinine value ratio relative to day " n", with y = -0.260?6 x2+3.010?7 x-1.612 and an R2 of 0.998?9, indicating an excellent statistical fit. For example, using a baseline SCr value of 66 μmol/L for a healthy individual, the dual regression model predicted that the patient would progress to stage 3 AKI within 3-5 days. This prediction was consistent when applied to other early intervention renal injury patients. Conclusion:The established model effectively predicts the time interval of the progression of AKI to stage 3 AKI (renal failure), which assist intensive care physicians to intervene AKI as early as possible to prevent disease progression.

Processing Magnoliae Officinalis Cortex with ginger juice: process optimization based on AHP-CRITIC weighting method and composition changes after processing / 中国中药杂志

The weight coefficients of appearance traits, extract yield of standard decoction, and total content of honokiol and magnolol were determined by analytic hierarchy process(AHP), criteria importance though intercrieria correlation(CRITIC), and AHP-CRITIC weighting method, and the comprehensive scores were calculated. The effects of ginger juice dosage, moistening time, proces-sing temperature, and processing time on the quality of Magnoliae Officinalis Cortex(MOC) were investigated, and Box-Behnken design was employed to optimize the process parameters. To reveal the processing mechanism, MOC, ginger juice-processed Magnoliae Officinalis Cortex(GMOC), and water-processed Magnoliae Officinalis Cortex(WMOC) were compared. The results showed that the weight coefficients of the appearance traits, extract yield of standard decoction, and total content of honokiol and magnolol determined by AHP-CRITIC weighting method were 0.134, 0.287, and 0.579, respectively. The optimal processing parameters of GMOC were ginger juice dosage of 8%, moistening time of 120 min, and processing at 100 ℃ for 7 min. The content of syringoside and magnolflorine in MOC decreased after processing, and the content of honokiol and magnolol followed the trend of GMOC>MOC>WMOC, which suggested that the change in clinical efficacy of MOC after processing was associated with the changes of chemical composition. The optimized processing technology is stable and feasible and provides references for the modern production and processing of MOC.

Application of a closed-loop tracking system in the quality monitoring program for intravenous infusions / 中华护理杂志

Objective To monitor the quality of intravenous infusions in a constructed closed-loop tracking system,and to discuss its application effect.Methods The information program is reinvested in a team for the closed-loop tracking system of the intravenous infusion.There are modules of processing medical orders,pharmacy preparations,execution procedures with the doctor's orders,as well as the computing module.The system was put into clinical trial operation in November 2021 and officially applied in January 2022.Specifically,the number of infusion-related adverse events/red-light alert is recorded and compared before(January to December 2021)and after(January to December 2022)the application of the system.Random sampling method has been performed in a ward to investigate the amount of abnormal infusion for the comparison.Results It is shown that it occurred 3 times for the infusion-related adverse events before the operation of the system,and a time after that.In the neurological inpatients,we observe the amount of red-light alert as 5,120.25±775.82 before the system operation,and 1,518.25±74.77 after that.It is shown to decline by 70.35％on average with statistical significance on the total difference(P＜0.001).Monthly amount of infusion in the ward is 5,184 with 155 times of overfast(2.99％)for 775 minutes in total,and with 207 times of slow(3.99％)for 1,035 minutes in total.The average handling time per contact is 5 minutes.Conclusion The closed-loop tracking system for intravenous infusion quality monitoring can track and record the whole process of intravenous infusions.It is expected to provide accurate and objective data for closed-loop quality inspection on clinical nursing practice,which is conducive to nursing managers for any potential problems during infusion processing timely,to promote standardized nursing operations,and to further improve the safety of inpatients with intravenous infusion and medication.

Curative effects of Shugan Hewei Zhitong Recipe on chronic gastritis complicated by Helicobacter pylori infection / 中国基层医药

Objective:To investigate the curative effects of Shugan Hewei Zhitong Recipe on chronic gastritis complicated by Helicobacter pylori infection. Methods:Eighty-seven patients with chronic gastritis complicated by Helicobacter pylori infection who received treatment in the Huguosi Hospital of Traditional Chinese Medicine, Beijing University of Chinese Medicine, China from July 2018 to June 2020 were included in this study. They were randomly assigned to undergo treatment with either conventional Western medicine ( n = 43, control group) or Shugan Hewei Zhitong Recipe based on conventional Western medicine ( n = 44, observation group) for 2 weeks. Before and after treatment, traditional Chinese medicine syndrome scores were compared between the two groups. Curative effects of Shugan Hewei Zhitong Recipe on chronic gastritis complicated by Helicobacter pylori infection were evaluated. Results:Total response rate in the observation group was significantly higher than that in the control group [91% (40/44) vs. 72% (31/43), χ2 = 5.13, P = 0.024]. In each group, the traditional Chinese medicine symptom score post-treatment was significantly lower than the traditional Chinese medicine symptom score pre-treatment (both P < 0.001). After treatment, the traditional Chinese medicine score of the observation group was significantly lower than that of the control group ( P < 0.05). There were no adverse reactions in each group. Conclusion:Shugan Hewei Zhitong Recipe is safe and effective on chronic gastritis complicated by Helicobacter pylori infection, which is worthy of clinical promotion.

Clinical analysis of cryptococcosis neoformans infection in patients with connective tissue disease / 中华风湿病学杂志

Objective:To improve the level of clinical diagnosis and treatment by analyzing the clinical features and relevant factors of cryptococcosis neoformans in patients with connective tissue disease(CTD).Methods:Twelve patients with CTD and cryptococcosis neoformans infection in Peking University People's Hospital from January 2010 to April 2021 were retrospectively enrolled. Clinical and laboratory data, treatment and outcome were collected and analyzed. Independent sample t-test or Rank-sum test was used. Results:The age of the patients ranged from 18 to 85 years old(mean 51 years old), all of whom were female. None of them were exposed to pigeons and their feces. Of the 12 patients, 3 patients suffered from rheumatoid arthritis, 7 patients had systemic lupus erythematosus, 1 patient was diagnosed with primary Sj?gren 's syndrome, and 1 patient was diagnosed as undifferentiated connective tissue disease. Four cases were cryptococcal meningitis, 8 were pulmonary cryptococcosis. None of the 12 patients had immunodeficiency virus infection. All 12 patients were given glucocorticoid alone or combined with immunosuppressive or biological agents. All were detected with positive cryptococcus neoformans antigen in serum; 6 got lumbar puncture, 2 cases were positive for ink stain, cerebrospinal fluid (CSF) culture were positive in 2, in whom 3 had high intracranial pressure, in which the highest one was more than 600 mmH 2O (1 mmH 2O=0.009 8 kPa); 7 cases underwent lung biopsy. Among these patients, all were positive for cryptococcosis neoformans in lung tissue pathological examination; 6 had the number of peripheral lymphocytes less than 1.0×10 9/L, and 2 were detected for the number of CD4 + T cell, which was significantly decreased. As for the initial anti-fungal drug therapy, all cases were treated with fluconazole intravenously; 2 were treated with combined amphotericin, 1 was treated with combined fluorocytosine, 1 was treated with amphotericin and fluorocytosine. Then oral flu-conazole was prescribed as sequential therapy. The whole treatmentcourse ranged from 4 to 21 months. Eleven patients were cured, and 1 was relieved. Conclusion:Patients with connective tissue disease complicated with cryptococcus neoformans infection have atypical clinical symptoms. Treatment with immunosuppressive drugs and glucocorticoids are related causes. Patients with decreased peripheral blood lymphocytes, especially CD4 + T cell, are more susceptible to infection. Early diagnosis and timely treatment are the key to improve the prognosis and cure of the disease.

Effects of LEF1 and CTNNB1 on cycle arrest, apoptosis and radiation resistance of esophageal carcinoma cells / 中华放射肿瘤学杂志

Objective:To investigate the relationship between the expression level of lymphocyte enhancer-binding factor 1(LEF1) and CTNNB1 and the cycle arrest, apoptosis and radiation resistance of esophageal cancer cells and unravel the related mechanisms.Methods:Recombinantplasmids and empty plasmids expressing LEF1 and CTNNB1were constructed and transfected into esophageal cancer cells. RT-PCR assay was used to detect the transfection efficiency of the plasmids. Clone formation assay, CCK8 assay, cell cycle test by flow cytometry, apoptosis test by flow cytometry and Western blot were performed to detect the differences in theradioresistance, proliferation, cell cycle and apoptosis of esophageal cancer cells before and after transfection.Results:The survival rate of clonal colony cells in the pGEX-LEF1+ pCMV6-CTNNB1 group was significantly better than those in other groups ( P<0.05). The proliferation of clonal colony cellsat 72 h, 96 h and 120 h in the pGEX-LEF1+ pCMV6-CTNNB1 group was significantly better than those in the pGEX+ pCMV6, pGEX-LEF1+ pCMV6 and pCMV6-CTNNB1+ pGEX groups (all P<0.05). The percentage of G 2 phase arrest cells in the pGEX-LEF1+ pCMV6-CTNNB1 group was significantly higher than those in the other groups (all P<0.05). The apoptosis rate of esophageal cancer cells in the pGEX-LEF1+ pCMV6-CTNNB1 group was significantly lower compared with those in the pGEX+ pCMV6, pGEX-LEF1+ pCMV6 and pCMV6-CTNNB1+ pGEX groups (all P<0.05). The expression levels of Bax and Caspase 3 proteins in the pGEX-LEF1+ pCMV6-CTNNB1 group were significantly lower than those in the pGEX+ pCMV6, pGEX-LEF1+ pCMV6 and pCMV6-CTNNB1+ pGEX groups (all P<0.05). The expression level of Bcl-2 protein in the pGEX-LEF1+ pCMV6-CTNNB1 group was significantly higher compared with those in the other groups (all P<0.05). Conclusion:LEF1 and CTNNB1 can regulate the proliferation and G 2 phase arrest of esophageal cancer cells after radiation intervention by mediating the Wnt signaling pathway, and improve the radiation resistance of esophageal cancer cells by inhibiting cell apoptosis.

Etiological analysis of the immunosuppressed children with severe pneumonia by metagenomics next generation sequencing / 中国小儿急救医学

Objective:To explore the application of metagenomics next generation sequencing(mNGS)in the immunosuppressed children with severe pneumonia and to understand the distribution of pathogens in order to provide reference for early prevention and treatment.Methods:We performed a retrospective analysis of the immunosuppressed children with severe pneumonia who had mNGS reports admitted to PICU according with the enrollment condition from July 2019 to July 2020.The records included general clinical data, traditional detection method report and mNGS results.We evaluated the consistency of the mNGS with the clinical microbiology reports and clinical judgment.Results:Twenty-three patients were enrolled, 15 were male and 8 were female, aging from 28 days to 10 years old, with an average age of(3.67±3.20)years old.Seven cases were cured, 2 were improved, and 14 died.A total of 23 samples were obtained, including 21 blood specimens and 2 bronchoal-veolar lavage fluid specimens.Among the 23 cases, 5 were single infected and 15 were mixed infected.Fungi were detected in 15 cases(65.22%), including 12 cases of Pneumocystis jirovecii, 2 cases of Aspergillus fumigatus and 2 cases of Candida albicans.Virus were detected in 14 cases(60.87%), including cytomegalovirus(CMV) in 10 cases(8 cases with pneumocystis infection), Herpes virus in 3 cases and fine ring virus in 2 cases(1 case with herpes virus infection). Bacteria were detected in 10 cases, including 3 cases of Acinetobacter, 1 case of Klebsiella pneumoniae, 1 case of Stenotrophomonas maltophilia, 1 case of Pinocytogenes, 4 cases of Staphylococcus and 1 case of Bacillus licheniformis.There were Mycoplasma in 3 cases with mixed infection.The positive rate and coincidence rate of mNGS were significantly higher than that of the traditional test group( P<0.05). A total of 19 cases were treated with hormone or immunosuppressive agents, and 17 cases were treated for 1 to 6 months when severe pneumonia occurred. Conclusion:Most immunosuppressed children with severe pneumonia are mixed infection.The common pathogens are Pneumocystis jirovecii and CMV.The use of mNGS can significantly improve the pathogen detection rate, effectively guiding the treatment.

Correlation between classic Wnt signaling pathway and radioresistance of esophageal cancer cells / 中华放射肿瘤学杂志

Objective:To clarify the role of classic Wnt signaling pathway in the radioresistance of esophageal cancer cells (ECC), and investigate the underlying mechanism, aiming to identify critical molecular targets for clinically enhancing the radiosensitivity of esophageal cancer.Methods:The radiosensitivity of four types of ECCs (EC9706, ECA109, KYSE70 and KYSE150) were assessed by colony formation assay. Western blot and RT-PCR were used to detect the activation of classical Wnt signaling pathway after irradiation. Classic Wnt signaling pathway activator (AZD2858) and inhibitor (XAV-939) were utilized to comprehensively evaluate the effect of classic Wnt signaling pathway on the radiosensitivity of ECCs. Cellular immunofluorescence staining was performed to detect the production and repair of DNA double-strand breaks (DSB), as well as the foci formation of DSB repair proteins after irradiation.Results:The results of colony formation assay showed that the radiosensitivity of four types of ECCs from high to low was EC9706, ECA109, KYSE70 and KYSE150. In KYSE150, a radioresistant cell type, the level of nuclear β-catenin and the transcription of c-Myc gene were significantly increased after irradiation (both P<0.05). However, in EC9706, a radiosensitive cell type, the level of nuclear β-catenin and c-Myc gene transcription were not affected by irradiation (both P>0.05). Moreover, EC9706 cells showed enhanced radioresistance in the presence of AZD2858( P<0.05), whereas XAV-939 treatment decreased the radioresistance in KYSE150 cells ( P<0.05). AZD2858 accelerated the DSB repair in EC9706 cells ( P<0.05), whereas XAV-939 delayed the DSB repair in KYSE150 cells ( P<0.05). Furthermore, the results of immunofluorescence staining showed that XAV-939 reduced the DSB repair capacity by inhibiting homologous recombination repair-related proteins (BRCA1 and RAD51) rather than non-homologous end junction repair-related proteins (Ku80 and XRCC4). Conclusions:The classic Wnt signaling pathway participates in the regulation of radiosensitivity in ECCs by regulating the homologous recombination repair of DSB after irradiation. Inhibition of the classic Wnt signaling pathway can counteract the radioresistance of ECCs and enhance the killing effect of irradiation on ECCs.

Acute Hepatitis Due to Agomelatine Use in Elderly Women with Depression: Case Series

Although agomelatine may be associated with an increased risk of hepatotoxicity, the incidence rate of acute hepatitis seemed divergent between clinical trials and daily practice. Whether aging or gender is a risk factor in developing hepatotoxicity due to agomelatine is not clear. We present 3 older female cases with acute hepatitis occurring due to highly probable idiosyncratic drug-induced liver injury caused by agomelatine. From these cases, regular surveillance on liver function in the older women taking antidepressants would be of benefits.

Clinical analysis of severe pneumocystis pneumonia in 7 children with non-human immunodeficiency virus infection / 中国小儿急救医学

Objective:To better understand the clinical characteristics of children with pneumocystis pneumonia(PCP).Methods:Seven cases of non-human immunodeficiency virus infected children with PCP admitted to pediatric intensive care unit(PICU) at Xi′an Children′s Hospital from January 1, 2019 to December 31, 2019 were enrolled.Clinical findings, laboratory examination results, diagnosis, treatment, and outcome data were retrospectively reviewed.Results:There were seven children enrolled in this study including six boys and one girl.The average age was(6.09±3.80)years.Six patients received a long-term steroid or immunosuppressive therapy, and the average duration of medication was(80±30)days.One patient was eventually diagnosed with immunodeficiency disease despite no history of steroid and immunosuppressive therapy.Fever, cough and progressive dyspnea were the main manifestations.The pulmonary signs were not obvious, however, the chest radiographs showed serious ground glass changes.Laboratory examination showed that white blood cell counts were normal, lymphocyte counts were decreased to varying degrees, while C-reactive protein, calcitonin and lipopolysaccharide increased slightly or normal.Lactate dehydrogenase significantly increased and PaO 2/FiO 2 decreased, respectively.All children combined with different degrees of heart, liver and digestive tract damage.Pneumocystis jirovecii infection was diagnosed by metagenomics next-generation sequencing(mNGS), of which one case was detected by bronchoalveolar lavage fluid, and the remaining six cases were detected by peripheral blood.After entering PICU, mechanical ventilation, intravenous injection of human immunoglobulin, and continuous renal replacement therapy were performed.None of the children used TMP-SMZ for prophylaxis outside the hospital.Among them, one case was diagnosed with PCP before entering PICU and was given TMP-SMZ for 20 days, while the remaining six patients started to receive TMP-SMZ after entering PICU.Finally, one patient was cured, three died and another three cases died after giving up treatment.The average hospitalization days were(11.28±8.78)days, and the average hospitalization costs were (78, 000±24, 000) RMB. Conclusion:Children with non-human immunodeficiency virus infected PCP usually have underlying diseases or immunodeficiency diseases.Due to non-specific manifestations, rapid progression and high mortality, clinicians should pay more attention to it.It is necessary to dynamically observe the respiratory symptoms, perform mNGS as soon as possible, and give TMP-SMZ treatment in time.TMP-SMZ prophylaxis can be given to patients who are highly suspected of PCP but unable to perform pathogenic examinations.

Application of Correspondence Analysis in the Analysis of Accidental Death of Chinese Residents / 法医学杂志

Objective To study the preference relation between residence, sex, age and causes of accidental death of Chinese residents. Methods In this study, 72 residence-sex-age groups and 8 causes of accidental death were qualitatively and quantitatively analyzed by correspondence analysis using the official statistical yearbook issued from 2014 to 2018, and the preference values were calculated. Results Among the 576 pairs of correspondences between the residence-sex-age groups and causes of accidental death, 352 pairs （61.11%） showed a preference relation （preference value>0）. In terms of residence and sex, accidental death preference among Chinese residents was higher in rural areas than in urban areas, and males were higher than females. In terms of the causes of accidental death, the overall risk of accidental mechanical asphyxia and motor vehicle accidents was the highest among all age groups of Chinese residents. In terms of age, with the increase of age, the preference value of accidental death of Chinese residents showed a trend of first increasing and then decreasing. The comparative analysis results of the preference values of various causes of accidental death in different age groups showed that motor vehicle traffic accidents, accidental poisoning, death by crush and electric shock were more likely to occur in the working age group between 20 and 59 years old, accidental fall and fire were more likely to occur in the elderly group over 80 years old, and drowning and accidental mechanical asphyxia were more likely to occur in the minor group between 1 and 19 years old. Conclusion There are different preference relations between residence-sex-age groups and causes of accidental death in China. Therefore, effective control strategies and measures should be formulated for Chinese residents with preference for accidental death.

Therapeutic effect and mechanism of hydrogel-encapsulated human umbilical cord mesenchymal stem cells on traumatic brain injury in rats / 解剖学报

Objective To investigate the therapeutic effect of hydrogel-encapsulated human umbilical cord mesenchymal stem cells (hUC-MSCs) on traumatic brain injury in rats and its related mechanism. Methods SD rat models of traumatic brain injury were constructed, which were divided into control group, chitosan group, stem cell group and combined treatment group. Results During the treatment, there was no significant difference in mNSS score between the control group and the chitosan group (P>0.05). On the 15th, 22nd, 29th and 36th day, the mNSS score of the combined treatment group decreased most significantly than that of the control group, followed by the stem cell group (P0.05), and the expression of related proteins in the stem cell group and the combined treatment group increased significantly. The expression level of the related protein in the combined treatment group was the highest, followed by stem cell group, the lowest in the control group and chitosan group (P<0.05). Conclusion Compared with stem cell transplantation alone, hydrogel-encapsulated hUC-MSCs transplantation can improve the motor and learning and memory abilities of rats with traumatic brain injury more effectively.

Clinical trial on the modified Baihe-Gujin Decoction combined with routine chemotherapy for the elderly patients with primary treated pulmonary tuberculosis and lung-kidney yin deficiency / 国际中医中药杂志

Objective:To evaluate the clinical efficacy of modified Baihe-Gujin Decoction combined with routine chemotherapy for the elderly patients with primary treated pulmonary tuberculosis and lung-kidney yin deficiency. Methods:A total of 94 patients who met the inclusion criteria in our hospital from January 2016 to January 2018 were selected and divided into 2 groups according to the random number table method, with 47 patients in each group. The control group was treated with the routine chemotherapy regimen of 2HRZE/4HR (H: isoniazid, R: rifampicin, Z: pyrazinamide, E: ethambutanol), the observation group was treated with Baihe-Gujin Decoction on the basis of the routine chemotherapy. Both groups were treated continuously for 6 months. The sputum negative rate was observed 2, 5 and 6 months after treatment, The closure of cavity shadows was observed by chest CT. The content of IL-6 and IFN-γ-inducible protein-10 were detected by double antibody sandwich ELISA. T cell subsets was detected by flow cytometry. And the clinical efficacy was evaluated. Results:The total effective rate was 87.2% (41/47) in the observation group and 61.7% (29/47) in the control group, and the difference between the two groups was statistically significant ( χ2=8.050, P=0.004). After treatment, the TCM syndrome score of the observation group was significantly lower than that of the control group ( t=5.698, P<0.01). At the end of 6 months after treatment, the sputum negative rate in the observation group was significantly higher than that of the control group ( t=5.317, P=0.021), the effective rate of cavity shadow closure (95.7% with 45/47 vs. 83.0% with 39/47) in the observation group was significantly higher than that of the control group ( χ2=4.029, P=0.044). After treatment, the levels of CD3 +, CD4 + and CD4 +/CD8 + in the observation group were all significantly higher than those in the control group ( t values were 2.107, 3.571 and 2.351, respectively, all Ps<0.05), and the levels of CD8 + in the observation group were all significantly lower than those in the control group ( t=2.711, P=0.005). The levels of IL-6 and IFN-γ-induced protein-10 in the observation group were significantly lower than those in the control group ( t values were 2.517 and 2.890, respectively, all Ps<0.05). Conclusions:The modified Baihe-Gujin Decoction combined with routine chemotherapy can improve the immunity of the elderly patients with primary treated pulmonary tuberculosis with lung-kidney yin deficiency, and improve the clinical efficacy.

Application of glycan microarrays in cancer research / 生物工程学报

Glycosylation is one of the common post-translational modifications of proteins to regulate the ability of tumor invasion, metastasis and tumor heterogeneity by interacting with glycan-binding proteins such as lectins and antibodies. Glycan microarray can be constructed by chemical synthesis, chemical-enzyme synthesis or natural glycan releasing. Glycan microarray is an essential analytical tool to discover the interaction between glycan and its binding proteins. Here we summarize the standard techniques to construct glycan microarray for the application in cancer vaccine, monoclonal antibody and diagnostic markers.

Comparison of clinical and immunological features between clinically amyopathic dermatomyositis and typical dermatomyositis / 北京大学学报(医学版)

OBJECTIVE@#To study the differences between clinically amyopathic dermatomyositis (CADM) and typical dermatomyositis (DM) on clinical and immunological features.@*METHODS@#By collecting clinical data of 106 CADM patients and 158 DM patients from January 2010 to June 2019 in the department of Rheumatology and Immunology, Peking University People's Hospital, the clinical characteristics and immunological features in the two groups were compared, and the distribution characters and the clinical meanings of myositis autoantibodies were discussed in the two groups respectively. Myositis autoantibodies were measured by immunoblotting according to the manufacturers' instructions.@*RESULTS@#In the aspects of clinical manifestations, CADM presented more with onset of interstial lung diseases (ILD) compared with DM (20.7% vs. 7.6%, P=0.002), and CADM-ILD was more likely to be acute ILD (58.3% vs. 26%, P < 0.001), and there were no differences between CADM and DM in cutaneous manifestations, accompanied with connective tissue disease (CTD) and malignancy. In CADM, the positive rate of rheumatoid factors and antinuclear antibodies was lower in DM. The most common myositis specific autoantibodies (MSAs) in CADM were anti-MDA5 (36%), anti-PL-7 (11.2%) and anti-TIF-1γ (10.1%). The most common MSAs in DM were anti-Jo-1 (19.2%), anti-TIF-1γ (11.5%) and anti-MDA5 (11.5%). Anti-MDA5 was correlated with acute ILD and skin ulceration both in CADM and DM; in CADM, skin ulceration was not associated with the titer of anti-MDA5; while in DM, skin ulceration was associated with high titer of anti-MDA5. In DM, anti-TIF-1γ was correlated with heliotrope eruption, V/shawl neck sign, perionychia erythma and malignancy, and higher rate of malignancy was seen in all titers of the anti-TIF-1γ positive patients. In CADM, anti-TIF1-γ showed no correlation with clinical manifestations. The most common myositis associated autoantibody was anti-Ro-52 both in CADM and DM. In CADM, anti-Ro-52 was associated with Raynaud's phenomenon and chronic ILD, while in DM, anti-Ro-52 was associated with mechanic's hands, noninfectious fever and accompanied CTD.@*CONCLUSION@#Compared with DM, ILD is more likely to be acute in CADM. It is different between CADM and DM about the distribution of myositis autoantibodies and the clinical significance of the same myositis antibody, and the clinical significance of some myositis antibodies is related to titers.

Forensic Significance of Skin Injury and Fracture Caused by Child Abuse / 法医学杂志

In recent years, cases of child abuse that result in injuries and death have occurred from time to time in China, and there may be more undetected child abuse cases. However, many pediatricians and forensic doctors lack professional knowledge and formal training in detecting child abuse, which leads to the missed diagnosis, misdiagnosis and misidentification of many cases of child abuse. This paper reviews a large number of relevant domestic and foreign literatures, combined with practical work experience and China's national conditions, preliminarily summarizes the main points of clinical diagnosis and forensic identification of child abuse cases, in order to provide some help for early detection, accurate identification of child abuse cases and timely and effective treatment and protection for abused children.

Long-term efficacy of prostatic arterial embolization for benign prostatic hyperplasia / 中国介入影像与治疗学

Objective: To evaluate the long-term clinical efficacy of prostatic arterial embolization (PAE) for treatment of benign prostatic hyperplasia (BPH). Methods: A total of 38 patients with BPH underwent PTA were followed up for more than 36 months. Relative indicators, including International Prostate Symptom Score (IPSS), quality of life (QOL) score, maximum flow rate (Qmax), residual urine (RU), prostate-specific antigen (PSA) and International Index of Erectile Function (IIEF) were compared pre- and postoperation during follow-up. Transrectal CDFI was used to observe pre- and postoperative changes of maximal velocity (Vmax) during systole, minimum velocity (Vmin) during diastole and resistance index (RI) of the prostatic arteries. MRI was used to measure the pre- and postoperative changes of the prostate volume (PV). Results: The technical success rate of PAE for treatment of BPH was 100% (38/38), and the clinical success rate was 84.21% (32/38). The overall differences of IPSS, QOL score, Qmax, RU, PSA, PV, Vmax, Vmin and RI before and after PAE were all statistically significant (all P0.05). During the follow-up period, PV of 3 patients increased by 3.44% at the 48th month, while the symptoms of urinary tract obstruction were aggravated in 4 patients, with RU, times of nocturia and the blood flow signal of prostate increased, and the second PAE treatment was performed. Conclusion: Long-term efficacy of PAE for treatment of BPH is stable and reliable.

The epigallocatechin gallate derivative Y reverses drug resistance mediated by the ABCB1 transporter both and

Previously, we reported that Y, a new epigallocatechin gallate derivative, is efficacious in reversing doxorubicin (DOX)--mediated resistance in hepatocellular carcinoma BEL-7404/DOX cells. In this study, we evaluated the efficacy of Y in reversing drug resistance both and by determining its effect on the adenosine triphosphate-binding cassette protein B1 transporter (ABCB1 or P-glycoprotein, P-gp). Our results showed that Y significantly sensitized cells overexpressing the ABCB1 transporter to anticancer drugs that are ABCB1 substrates. Y significantly stimulated the adenosine triphosphatase activity of ABCB1. Furthermore, Y exhibited a higher docking score as compared with epigallocatechin gallate inside the transmembrane domain of ABCB1. In addition, in the nude mouse tumor xenograft model, Y (110 mg/kg, intragastric administration), in combination with doxorubicin (2 mg/kg, intraperitoneal injection), significantly inhibited the growth of BEL-7404/DOX cell xenograft tumors, compared to equivalent epigallocatechin gallate. In conclusion, Y significantly reversed ABCB1-mediated multidrug resistance and its mechanisms of action may result from its competitive inhibition of the ABCB1 drug efflux function.

Forensic Identification of Child Sexual Abuse / 法医学杂志

This paper reviews relevant literatures at home and abroad. The cases of child sexual abuse are systematically discussed from the aspects of epidemiology and forensic examination, in order to develop and improve the inspection and appraisal thinking and ability of domestic forensic workers in such cases. The paper also briefly introduces the current situation and existing problems of dealing with child sexual abuse cases for case-handling units at base level in China, in order to provide help to the formulation, improvement and development of relevant standards and norms for child protection in China.

Effect of Different Doses of Radiation on Intestinal Injury in NOD/SCID Mice / 中国医学科学院学报

Objective To study the effect of different doses of radiation on intestinal injury,with an attempt to find the optimal radiation dose for establishing intestinal injury models in NOD/SCID mice. Methods Forty healthy male SPF-grade NOD/SCID mice were divided randomly into four groups:blank control group and 4-,5-,6-Gy irradiatio groups,with 10 mice in each group. The irradiation rate was 1 Gy/min. The general conditions,body weight,intestinal bacterial translocation,and histopathologic changes were observed and compared. Results The survival rate was 60%,50%,and 30% in the 4-,5-,and 6-Gy groups 15 days after irradiation,and the intestinal bacterial translocation rate was 20%,50%,and 70%,respectively. The body weights in 5-Gy group (P=0.015) and 6-Gy group (P=0.011) were significantly higher than that in blank control group. The length of small intestinal villi decreased in the 4-Gy group. In the 5-Gy group,the structure of intestinal mucosa villi became wide,flat,and inverted,along with the shedding of epithelial cells,the atrophy of glands,and the damage of recess structures. In the 6-Gy group,the structure of intestinal mucosal villi was damaged,the villi were ruptured and smashed,and the recess structures were missing;meanwhile,there was a large amount of inflammatory cell infiltration between tissues,along with visible spotty bleeding and necrosis. The length of small intestine villi in the blank control group and 4-,5-,and 6-Gy groups were (361.77±22.77),(291.68±32.45),(248.03±51.09),and (195.90±26.39) μm,respectively. In particular,it was significantly shorter in 4-Gy group (P=0.005),5-Gy group (P<0.001),and 6-Gy (P<0.001) than in the blank control group,was significantly shorter in the 5-Gy group (P=0.041) and 6-Gy group (P=0.001) than in the 4-Gy group,and significantly shorter in 6-Gy group than in the 5-Gy group (P=0.020). Conclusion 5-Gy irradiation in mice models can decrease body weight,cause the damage of intestinal mucosa and the shedding of inflammatory cells,with stable survival rate and bacterial translocation rate.