Nucleophosmin acetylation and construction and expression of its modified sites mutants in breast cancer / 解剖学报

Objective To determine the acetylation level of nucleophosmin(NPM)in female breast cancer and to discuss its function through mutation of modified lysine sites.To construct positive and negative NPM mutants on its acetylated lysine sites and to express them in breast cancer cells.Methods Acetylation level and acetylated lysine sites of NPM in three breast cancer tissues and para-carcinoma tissues were detected by acetylome technology;NPM mutants were constructed by site-directed mutagenesis PCR,specific PCR products were digested by DpnI and transformed into Escherichia coli(E.coli)to obtain specific plasmids for mutants;The accuracy of mutants were verified by double restriction enzyme digestion and sequencing;The mutants were expressed in BT-549 cells by transient transfection and verified by RT-PCR method.Protein expression and acetylation level of NPM were validated by Western blotting;Function of NPM acetylation was analyzed by proteomic detection and bioinformatic analysis.Results The 27th and 32nd lysine of NPM were highly acetylated in breast cancer tissues,which were 2.76 and 2.22 times higher than those in adjacent normal tissues,respectively;The NPM mutants showed the same molecular weight as that of wild type NPM and contained expected mutation sites;Corresponding NPM mRNA levels of BT-549 cells transfected with NPM mutants were significantly increased.With the increase of wild type NPM expression level,NPM acetylation level increased,while decreased after 27th lysine underwent negative mutation.NPM acetylation can significantly change the expression levels of 101 proteins in BT-549 cells,which are enriched in regulation of cellular macromolecule biosynthesis,DNA-template transcription,RNA biosynthesis and RNA metabolism process.Conclusion NPM is highly acetylated in breast cancer and can play a key role in cellular macromolecule biosynthesis,DNA-templated transcription,RNA biosynthesis and RNA metabolism process.

Status quo of Chinese educational research in community bases for general practice standardized residency training: a bibliometric study / 中华全科医师杂志

Objective:To investigate the status quo of educational and teaching research in community bases for general practice standardized residency training in China.Methods:The studies related to education research in community bases for general practice standardized residency training were searched from Chinese Journal Full Text Database (CNKI), Wanfang Database and China Science and Technology Journal Database (VIP) from inception to November 30, 2023. The keywords of "standardized training of general practitioner residents" or "general practice standardized training" or "general practitioner standardized training" or "general practice training" and "community-based teaching " or "community training" "community base" or "community teaching" were used for search, and affiliations of authors should contain"community health service center". The literature was read and summarized using Endnote and Excel software.Results:A total of 171 articles were retrieved that met the criteria, and 130 articles were finally selected for analysis according to the quality review criteria of the literature. The authors of articles were distributed in 78 institutions of 17 provinces or regions, with 9 provinces or regions having a total of 123 articles (94.6%) with 2 published articles or more, of which the highest number was found in Beijing and Shanghai. Seventeen institutions published 2 or more articles with a total of 69 articles (53.1%), including 67 articles (51.5%) were co-authored by 2 units. The ranking top ten institutions in terms of the number of articles published were 5 community health service centers in Beijing, 4 in Shanghai (co-authored with Shanghai Zhongshan Hospital). There were 46 articles (35.4%) published in core journals and 55 articles (42.3%) with fund-supported projects. The studies presented teaching methods, teaching and training contents, teaching evaluation and effects, teacher training, teaching base construction and information technology application.Conclusion:The educational and teaching research in community bases for general practice standardized training in China has gradually received attention, the researches were mainly carried out by community medical institutions, but the overall quality of research needs to be further improved.

Orthokeratology compliance, digital device use, and myopia control among children with myopia during COVID-19 home confinement in Taiwan

Purpose: The coronavirus disease 2019 (COVID?19) pandemic profoundly impacts lifestyle habits and myopia control in children worldwide. This study investigated the changes in eyecare habits, orthokeratology compliance, axial length, and time interval of follow?up visits during home confinement in the COVID?19 pandemic in Taiwan. Methods: This investigation was part of a prospective study undertaken to evaluate the effectiveness of a mobile application. A semi?structured telephone interview was conducted with parents retrospectively to document eyecare habits and myopia control during the COVID?19 home confinement. Results: Thirty?three children with myopia participated in the follow?up of orthokeratology lenses for 2 years. The children’s time viewing digital devices such as tablets and televisions significantly increased during the COVID?19 pandemic (P < 0.05). An analysis using McNemar’s test found that the proportional growth of axial length <0.2 mm in 2021 was significantly higher than that in 2020 (77.42% vs. 58.06%, P < 0.05). In the multivariate logistic regression analysis, onset <10 years of age (P = 0.001) and parents with high myopia (P < 0.001) were independent risk factors for the growth of axial length ?0.2 mm in 2021. Conclusion: The suspension of face?to?face classes and after?school tutorials benefited myopic axial elongation in children during COVID?19 home confinement. The use of digital devices and staying indoors may not be the exclusive reasons for myopia progression. Educating parents about the influence of extra learning classes after school on myopia progression would be prudent.

A qualitative study on high risk behaviors of HIV/AIDS among young adult males in Shandong Province / 中国学校卫生

Objective@#To identify high risk behaviors and infection related factors among young adult males diagnosed with HIV/AIDS in Shandong Province, to provide evidence for targeted AIDS prevention and control strategies.@*Methods@#By using convient sampling method, an face to face in depth interview on HIV related behaviors was conducted among young adult males newly diagnosed with HIV/AIDS in Shandong Province in July 2021.@*Results@#A total of 31 young adult males diagnosed with HIV/AIDS were interviewed. All were male and infected through homosexuality behavior. Average age was (20.6±1.8) years. Totally 90.3% (28/31) were enrolled in tertiary education at the time of diagnosis. The findings revealed that 93.5% (29/31) of participants got infection due to unprotected homosexual behavior with the temporary partner whose HIV infection status was unknown, and 86.2% (25/29) got in touch with these temporary partner by social software. The awareness rate of knowledge about AIDS among all the participants was 100%, however, 83.9% (26/31) reported occasion condom usage while having homosexual behavior, and 16.1% (5/31) never did. Totally 74.2% (23/31) of the young adult males diagnosed with HIV/AIDS had a history of HIV testing before diagnosis.@*Conclusion@#The primary high risk behavior of HIV infection in young adult students are unawareness of HIV infection status for temporary sexual partner and the separation of knowing and doing. A targeted strategy should be developed to control the spread of HIV in young adult students.

Dietary supplement intakes among adults living in Kota Kinabalu during the COVID-19 pandemic: A crosssectional study

@#Introduction: During the coronavirus 2019 (COVID-19) pandemic, the public may seek a non-pharmacological approach, such as dietary supplements, to prevent or manage COVID-19. Therefore, this study aimed to evaluate the use of dietary supplements during the COVID-19 pandemic among adults in Kota Kinabalu. Methods: This cross-sectional study recruited 213 adults living in Kota Kinabalu through convenient sampling from October 2021 to March 2022. A validated questionnaire was used to evaluate their perception on the use of dietary supplements, and the types of dietary supplements consumed before and during the COVID-19 pandemic. Results: One-hundred sixty-one (75.6%) adults reported that they were told to consume dietary supplements during the COVID-19 pandemic, primarily from close family members (64.0%) and social media (58.4%). One-hundred and thirty-two (62%) adults were consuming dietary supplements and 46 (34.8%) of them only started taking them during the COVID-19 pandemic. The reasons for taking dietary supplements during the COVID-19 pandemic included enhancing the immune system (83.6%) and for prevention of COVID-19 infection (64.4%). The most common dietary supplements consumed during the COVID-19 pandemic were vitamin C (90.2%), followed by multi-vitamin and mineral (32.6%), and fish oil (25.8%). After adjusting for age, sex, education level, and income level, KadazanDusun adults were most likely to consume dietary supplements (adjusted odds ratio = 2.369, 95% CI: 1.070 - 5.248, p=0.034). Conclusion: There was an increase in the number of adults consuming dietary supplements during the COVID-19 pandemic, which was likely driven by information sharing via family members and social media.

Reflection and Practice on the Implementation of "Exemption from Ethical Review" in Medical Institutions / 中国医学伦理学

From the perspective of medical institutions, this paper sorted out the contents of Article 32 of the Measures for Ethical Review of Life Sciences and Medical Research Involving Human regarding "exemption from ethical review". At the same time, combined with domestic and foreign regulations, this paper deeply considered and analyzed the applicable premise and special circumstances of the provisions from the implementation level, and then put forward suggestions from the perspective of practical operation of medical institutions, with a view to providing some practical guidance and reference for ethical practitioners of medical institutions.

Diagnostic value of nasal nitric oxide for children with primary ciliary dyskinesia / 中华儿科杂志

Objective: To evaluate the value of nasal nitric oxide (nNO) measurement as a diagnostic tool for Chinese patients with primary ciliary dyskinesia (PCD). Methods: This study is a retrospective study. The patients were recruited from those who were admitted to the respiratory Department of Respiratory Medicine, Children's Hospital of Fudan University from March 2018 to September 2022. Children with PCD were included as the PCD group, and children with situs inversus or ambiguus, cystic fibrosis (CF), bronchiectasis, chronic suppurative lung disease and asthma were included as the PCD symptom-similar group. Children who visited the Department of Child health Care and urology in the same hospital from December 2022 to January 2023 were selected as nNO normal control group. nNO was measured during plateau exhalation against resistance in three groups. Mann-Whitney U test was used to analyze the nNO data. The receiver operating characteristic of nNO value for the diagnosis of PCD was plotted and, the area under the curve and Youden index was calculated to find the best cut-off value. Results: nNO was measured in 40 patients with PCD group, 75 PCD symptom-similar group (including 23 cases of situs inversus or ambiguus, 8 cases of CF, 26 cases of bronchiectasis or chronic suppurative lung disease, 18 cases of asthma), and 55 nNO normal controls group. The age of the three groups was respectively 9.7 (6.7,13.4), 9.3 (7.0,13.0) and 9.9 (7.3,13.0) years old. nNO values were significantly lower in children with PCD than in PCD symptom-similar group and nNO normal controls (12 (9,19) vs. 182 (121,222), 209 (165,261) nl/min, U=143.00, 2.00, both P<0.001). In the PCD symptom-similar group, situs inversus or ambiguus, CF, bronchiectasis or chronic suppurative lung disease and asthma were significantly higher than children with PCD (185 (123,218), 97 (52, 132), 154 (31, 202), 266 (202,414) vs. 12 (9,19) nl/min,U=1.00, 9.00, 133.00, 0, all P<0.001). A cut-off value of 84 nl/min could provide the best sensitivity (0.98) and specificity (0.92) with an area under the curve of 0.97 (95%CI 0.95-1.00, P<0.001). Conclusions: nNO value can draw a distinction between patients with PCD and others. A cut-off value of 84 nl/min is recommended for children with PCD.

Peripherally inserted central venous catheter-related thrombosis in a neonate / 中国当代儿科杂志

The female infant in this case study was admitted to the hospital 4 hours after birth due to preterm birth and respiratory distress. On the third day after birth, peripherally inserted central venous catheter (PICC) catheterization was performed. On day 42, thrombus was found at the entrance of the right atrium from the inferior vena cava during a cardiac ultrasound, and it was considered to be related to PICC placement. Low-molecular-weight heparin and urokinase were given. After two weeks of treatment, ultrasonic monitoring showed thrombus shrinkage. No bleeding or pulmonary embolism occurred during the treatment. The patient discharged after improvement. This article mainly introduces a multidisciplinary team approach to diagnosis and treatment of PICC-related thrombosis in neonates.

Advancing Cardio-Oncology in Asia

Cardio-oncology is an emerging multi-disciplinary field, which aims to reduce morbidity and mortality of cancer patients by preventing and managing cancer treatment-related cardiovascular toxicities. With the exponential growth in cancer and cardiovascular diseases in Asia, there is an emerging need for cardio-oncology awareness among physicians and country-specific cardio-oncology initiatives. In this state-of-the-art review, we sought to describe the burden of cancer and cardiovascular disease in Asia, a region with rich cultural and socio-economic diversity. From describing the uniqueness and challenges (such as socio-economic disparity, ethnical and racial diversity, and limited training opportunities) in establishing cardio-oncology in Asia, and outlining ways to overcome any barriers, this article aims to help advance the field of cardio-oncology in Asia.

Research progress in HIV non-occupational post-exposure prophylaxis among men who have sex with men in China / 中国热带医学

@#Abstract: In recent years, the HIV prevention intervention strategy has had a positive effect on reducing the HIV infection prevalence in China. HIV non-occupational post-exposure prophylaxis (nPEP) has become an effective measure to prevent HIV for men who have sex with men (MSM) exposed to possible risks. From the perspective of the "knowledge, attitude, and practice" theory, domestic and overseas scholars used outpatient data and questionnaires to investigate the awareness, attitude, usage, medication, follow-up, and drug prescription of HIV nPEP among MSM in China. This article reviewed the above-mentioned and found that the overall awareness rate of HIV nPEP among MSM in China is high with a positive attitude, but the actual utilization rate is very low. On a regional level, their follow-up after the medication is not ideal despite good medication. Drug prescription varies between different regions domestically. The prescription rate of tenofovir + emtricitabine + raltegravir is the highest, followed by the prescription rate of tenofovir + emtricitabine + dolutegravir, and tenofovir + lamivudine + dolutegravir. In the future, researchers should expand the number of study objects and the scope of the research sites in China, analyze the "knowledge, attitude, and practice" of HIV nPEP, medication follow-up, and medication prescription among MSM, and increase the research on HIV nPEP service areas to provide the reference for further formulating and refining the comprehensive HIV prevention intervention strategy among MSM in China.

Exploration of the thinking and methods in treatment of cancer pain with acupuncture and moxibustion on the base of the fascia theory / 中国针灸

There is a commonality between jingjin (muscle region of meridian) and the fascial network for coordinating the balance in the body. The occurrence and the progression of tumor may disrupt the overall coordination between the fascial network and jingjin directly or indirectly, thereby, the impairment of this coordination may result in cancer pain. Rooted on the theory of overall balance of the fascial network, and combined with understanding of pain in jingjin theory, professor HUANG Jin-chang emphasizes the importance of "relaxing the knot" in treatment of cancer pain. It is recommended to select the fascia reaction point as the target point, in accordance with the principle of balance adjustment and apply various acupuncture and moxibustion therapies, such as Fu's subcutaneous needling, small-needle scalpel therapy, fire needling, and moxibustion.

Analysis of the diagnostic value of ultrasound elastography combined with EZH2 and BRCA1 proteins in triple-negative breast cancer / 中华内分泌外科杂志

Objective:To investigate the diagnostic value of ultrasound elastography combined with enhancer of Zeste homolog 2 (EZH2) and breast cancer susceptibility gene 1 (BRCA1) proteins in triple-negative breast cancer.Methods:A total of 116 breast cancer patients selected for treatment in our hospital from 2019 to 2021 were analyzed, and ER and PR were analyzed according to the expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2). Patients who were all HER2 negative were classified as TNBC group, with a total of 21 cases, and patients who were positive for ER, PR, and HER2 were classified as non-TNBC, a total of 95 cases. All enrolled patients underwent ultrasonic elastography examination. The positive expression of EZH2 and BRCA1 was detected by immunohistochemistry. Chi-square test was used to analyze the diagnostic value of ultrasound elastography combined with EZH2 and BRCA1 proteins in TNBC.Results:In the TNBC group, the proportion of smooth edges (35.09) and lobulation of lesions (9.52) was higher than that in the non-TNBC group (12.63, 5.26), while the proportion of burrs (28.57) and fuzziness (23.81) was lower than that in the non-TNBC group (50.53, 31.58). The proportion of calcifications (52.38) in the TNBC group was lower than that in the non-TNBC group (85.26). The non-attenuation ratio of rear echo (80.95) was higher than that of non-TNBC group (52.63). The proportion of blood flow grade enrichment (57.14) was lower than that in the non-TNBC group (63.16) (all P<0.05). The positive expression rate of EZH2 in the TNBC group (85.71) was higher than that of non-TNBC (63.16) ( P<0.001), and the positive expression rate of BRCA1 in the TNBC group (19.05) was lower than that of non-TNBC (55.79) ( P<0.05). The posterior echo non-attenuation ratio (88.89) and rich blood supply ratio (88.89) of EZH2 positive patients in the TNBC group were higher than those with negative (33.33, 0) (all P<0.05), and the rear echo non-attenuation ratio (25.00) and rich blood supply ratio (25.00) of BRCA1 positive in the TNBC group were lower than those with negative (52.94, 88.24) (all P<0.05) ; According to the pathological results, the sensitivity, specificity and accuracy of posterior echo for the diagnosis of TNBC were 25.37%, 91.84% and 53.44%, respectively. The sensitivity, specificity and accuracy of EZH2 were 23.08%, 92.11% and 45.69%, respectively. The sensitivity, specificity and accuracy of BRCA1 were 28.81%, 92.98% and 60.34%, respectively. The combined sensitivity, specificity and accuracy of the three were 53.13%, 95.24% and 83.62%, respectively. The sensitivity, specificity and accuracy of blood flow fraction for the diagnosis of TNBC were 25.81%, 90.74% and 56.03%, respectively. The sensitivity, specificity and accuracy of blood flow fraction, EZH2 and BRCA1 were 59.26%, 94.38% and 86.21%, respectively. Conclusion:The joint classification of the posterior echoes and blood flow in ultrasonic elastography combined with EZH2 and BRCA1 has important significance in the diagnosis of TNBC.

Clinical and electrophysiological study of lower limb split signs in amyotrophic lateral sclerosis / 中华神经科杂志

Objective:To investigate the association between split foot and electrophysiology in patients with amyotrophic lateral sclerosis (ALS).Methods:The clinically definite or clinically probable ALS patients hospitalized in the Department of Neurology, the First Medical Center of Chinese People′s Liberation Army General Hospital from April 2021 to December 2022 were prospectively collected. From April 2021 to December 2022, patients who visited the Chinese People′s Liberation Army General Hospital for other reasons without abnormal electrophysiological examination were collected as the control group. The incidence of split leg [the limb whose modified Medical Research Council Muscle Strength Scale (mMRC) score of ankle dorsiflexors was lower than that of ankle plantarflexors] in ALS patients was calculated, and the incidence of split foot (the limb whose mMRC score of hallux dorsiflexors was lower than that of hallux plantarflexors) in ALS patients was calculated. The amplitude of compound muscle action potential (CMAP) of common peroneal nerve and tibial nerve was detected to observe the involvement of motor neurons innervating ankle dorsiflexors and ankle plantarflexors. The characteristics of split leg and split foot in ALS patients were analyzed from the perspective of muscle strength, and the characteristics of split foot in ALS patients were analyzed from the perspective of electrophysiology. Receiver operating characteristic (ROC) curve was used to analyze the sensitivity and specificity of peroneal nerve/tibial nerve CMAP amplitude ratio in distinguishing ALS patients from controls.Results:A total of 101 ALS patients with lower limb involvement and 110 controls with normal lower limb muscle strength were collected. Among the 101 ALS patients with lower limb involvement, strength of ankle plantarflexors was greater than that of ankle dorsiflexors in 35.64% (36/101) patients, strength of ankle dorsiflexors was greater than that of ankle plantarflexors in 5.94% (6/101) patients, and strength of ankle plantarflexors and ankle dorsiflexors was equal in 58.42% (59/101) patients. Strength of hallux dorsiflexors was lower than that of hallux plantarflexors in 53.47% (54/101) patients, strength of hallux dorsiflexors was greater than that of hallux plantarflexors in 1.98% (2/101) patients, and the strength of hallux dorsiflexors and hallux plantarflexors was equal in 44.55% (45/101) patients. The incidence of split leg was negatively correlated with age ( OR=0.25, 95% CI 0.16-0.40, P<0.05), course of disease ( OR=0.52, 95% CI 0.38-0.80 P<0.05) and ALS functional revised scores ( OR=0.29, 95% CI 0.12-0.67, P<0.05). The incidence of split foot was negatively correlated with the onset time of lower limb symptoms ( OR=0.96, 95% CI 0.93-0.99, P<0.05). Compared with the control group, the differences of the decrease of CMAP amplitude in the common peroneal nerve and tibial nerve [the common peroneal nerve (6.45±2.56) mV vs (3.63±1.83) mV, tibial nerve (12.87±4.72) mV vs (9.18±6.22) mV] were statistically significant ( t=-4.65, t=-3.44, both P<0.001) and the differences of the peroneal nerve/tibial nerve CMAP amplitude ratio (0.54±0.24 vs 0.36±0.18) decrease was statistically significant ( t=-4.31, P<0.001) in patients with split foot. ROC curve analysis showed that the area under the ROC curve of CMAP amplitude ratio of common peroneal nerve/tibial nerve in ALS patients with split foot was 0.70, indicating that the accuracy of CMAP amplitude of common peroneal nerve/tibial nerve in distinguishing ALS patients from controls was low. Conclusions:In ALS patients with lower limb involvement, strength of ankle dorsiflexors is weaker than that of ankle plantarflexors, and strength of hallux dorsiflexors is weaker than that of hallux plantarflexors. At the diagnostic level, the CMAP amplitude ratio of common peroneal nerve/tibial nerve in ALS patients with split foot has a lower accuracy in the diagnosis of ALS.

Analysis on the secondary attack rates of SARS-CoV-2 Omicron variant and the associated factors / 中华预防医学杂志

Objective: To evaluate the secondary attack rates of the SARS-CoV-2 Omicron variant and the associated factors. Methods: A total of 328 primary cases and 40 146 close contacts of the SARS-CoV-2 Omicron variant routinely detected in local areas of Jiangsu Province from February to April 2022 were selected in this study, and those with positive nucleic acid test results during 7 days of centralized isolation medical observation were defined as secondary cases. The demographic information and clinical characteristics were collected, and the secondary attack rate (SAR) and the associated factors were analyzed by using a multivariate logistic regression model. Results: A total of 1 285 secondary cases of close contacts were reported from 328 primary cases, with a SAR of 3.2% (95%CI: 3.0%-3.4%). Among the 328 primary cases, males accounted for 61.9% (203 cases), with the median age (Q1, Q3) of 38.5 (27, 51) years old. Among the 1 285 secondary cases, males accounted for 59.1% (759 cases), with the median age (Q1, Q3) of 34 (17, 52) years old. The multivariate logistic regression model showed that the higher SAR was observed in the primary male cases (OR=1.632, 95%CI: 1.418-1.877), younger than 20 years old (OR=1.766, 95%CI: 1.506-2.072),≥60 years old (OR=1.869, 95%CI: 1.476-2.365), infected with the BA.2 strain branch (OR=2.906, 95%CI: 2.388-3.537), the confirmed common cases (OR=2.572, 95%CI: 2.036-3.249), and confirmed mild cases (OR=1.717, 95%CI: 1.486-1.985). Meanwhile, the higher SAR was observed in the close contacts younger than 20 years old (OR=2.604, 95%CI: 2.250-3.015),≥60 years old (OR=1.287, 95%CI: 1.052-1.573) and exposure for co-residence (OR=27.854, 95%CI: 23.470-33.057). Conclusion: The sex and age of the primary case of the Omicron variant, the branch of the infected strain, case severity of the primary case, as well as the age and contact mode of close contacts are the associated factors of SAR.

Analysis on the secondary attack rates of SARS-CoV-2 Omicron variant and the associated factors / 中华预防医学杂志

Objective: To evaluate the secondary attack rates of the SARS-CoV-2 Omicron variant and the associated factors. Methods: A total of 328 primary cases and 40 146 close contacts of the SARS-CoV-2 Omicron variant routinely detected in local areas of Jiangsu Province from February to April 2022 were selected in this study, and those with positive nucleic acid test results during 7 days of centralized isolation medical observation were defined as secondary cases. The demographic information and clinical characteristics were collected, and the secondary attack rate (SAR) and the associated factors were analyzed by using a multivariate logistic regression model. Results: A total of 1 285 secondary cases of close contacts were reported from 328 primary cases, with a SAR of 3.2% (95%CI: 3.0%-3.4%). Among the 328 primary cases, males accounted for 61.9% (203 cases), with the median age (Q1, Q3) of 38.5 (27, 51) years old. Among the 1 285 secondary cases, males accounted for 59.1% (759 cases), with the median age (Q1, Q3) of 34 (17, 52) years old. The multivariate logistic regression model showed that the higher SAR was observed in the primary male cases (OR=1.632, 95%CI: 1.418-1.877), younger than 20 years old (OR=1.766, 95%CI: 1.506-2.072),≥60 years old (OR=1.869, 95%CI: 1.476-2.365), infected with the BA.2 strain branch (OR=2.906, 95%CI: 2.388-3.537), the confirmed common cases (OR=2.572, 95%CI: 2.036-3.249), and confirmed mild cases (OR=1.717, 95%CI: 1.486-1.985). Meanwhile, the higher SAR was observed in the close contacts younger than 20 years old (OR=2.604, 95%CI: 2.250-3.015),≥60 years old (OR=1.287, 95%CI: 1.052-1.573) and exposure for co-residence (OR=27.854, 95%CI: 23.470-33.057). Conclusion: The sex and age of the primary case of the Omicron variant, the branch of the infected strain, case severity of the primary case, as well as the age and contact mode of close contacts are the associated factors of SAR.

Congenital pulmonary alveolar proteinosis in a neonate / 中国当代儿科杂志

The male patient was referred to the hospital at 44 days old due to dyspnea after birth and inability to wean off oxygen. His brother died three days after birth due to respiratory failure. The main symptoms observed were respiratory failure, dyspnea, and hypoxemia. A chest CT scan revealed characteristic reduced opacity in both lungs with a "crazy-paving" appearance. The bronchoalveolar lavage fluid (BALF) showed periodic acid-Schiff positive proteinaceous deposits. Genetic testing indicated a compound heterozygous mutation in the ABCA3 gene. The diagnosis for the infant was congenital pulmonary alveolar proteinosis (PAP). Congenital PAP is a significant cause of challenging-to-treat respiratory failure in full-term infants. Therefore, congenital PAP should be considered in infants experiencing persistently difficult-to-treat dyspnea shortly after birth. Early utilization of chest CT scans, BALF pathological examination, and genetic testing may aid in early diagnosis.

Comparison of distribution of eight components from Liangxue Tuizi Mixture between normal and Henoch-Schonlein purpura rats / 中国中药杂志

This study used UPLC-TQ-MS technology to replicate a Henoch-Schonlein purpura(HSP) model in rats by administering warm drugs by gavage and injecting ovalbumin with Freund's complete adjuvant emulsion. The distribution differences and characteristics of eight major components(ferulic acid, caffeic acid, neochlorogenic acid, cryptochlorogenic acid, benzoyl oxypaeoniflorin, tracheloside, loganin, and paeoniflorin) in rat liver, lung, heart, spleen, and kidney tissues were determined after oral administration of the Liangxue Tuizi Mixture at a dose of 42 g·kg~(-1) in both normal physiological and HSP states at 0.5, 1, 2, 6, and 12 hours. The results showed that the distribution patterns of the eight components of Liangxue Tuizi Mixture in the tissues of normal and HSP model rats were different. The main component, paeoniflorin, in Moutan Cortex and Paeoniae Radix Alba had higher content in all tissues. The eight components were predominantly distributed in the liver, lung, and kidney tissues, followed by spleen and heart tissues.

Therapeutic effects of transnasal low-flow oxygen therapy after noninvasive mechanical ventilation on acute exacerbation of chronic obstructive pulmonary disease complicated by type II respiratory failure / 中国基层医药

Objective:To investigate the clinical efficacy of transnasal low-flow oxygen therapy after noninvasive mechanical ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by type II respiratory failure.Methods:This study is a retrospective study. A total of 200 patients with AECOPD complicated by type II respiratory failure who received treatment in The First People's Hospital of Huzhou from January 2021 to March 2023 were selected as the research subjects through the health management platform of The First People's Hospital of Huzhou. These patients were divided into a control group and an observation group ( n = 100 per group) according to the treatment methods. The control group received noninvasive mechanical ventilation but without transnasal low-flow oxygen therapy. The observation group received noninvasive mechanical ventilation and transnasal low-flow oxygen therapy. The anti-inflammatory factors (interleukin 10 and transforming growth factor-beta) and pro-inflammatory factors (tumor necrosis factor-alpha and interleukin 6) were measured by enzyme-linked immunosorbent assay in both groups. Oxygen pressure and carbon dioxide pressure were compared between the two groups before and after treatment. The relief and disappearance time of symptoms such as fever, difficulty in breathing, palpitations, and difficulty in coughing were compared between the two groups. Statistical analysis was performed using IBM SPSS 26.0 software. Results:After treatment, the interleukin-10 level in the control group was (21.45 ± 7.02) ng/L, which was significantly lower than (26.77 ± 9.40) ng/L in the observation group ( t = 4.54, P < 0.001). The interleukin-6 level in the control group was (25.56 ± 8.58) ng/L, which was significantly higher than (18.98 ± 5.78) ng/L in the observation group ( t = 6.37, P < 0.001). Oxygen pressure in the control group was (71.41 ± 5.91) mmHg (1 mmHg = 0.133 kPa), which was significantly lower than (93.69 ± 4.45) mmHg in the observation group ( t = 30.09, P = 0.004). Carbon dioxide pressure in the control group was (43.85 ± 2.99) mmHg, which was significantly higher than (37.87 ± 4.48) mmHg in the observation group ( t = 11.10, P < 0.001). The time to fever relief in the control group was (6.59 ± 1.51) days, which was significantly longer than (6.13 ± 1.19) days in the observation group ( t = 2.39, P = 0.008). The time to dyspnea relief in the control group was (5.61 ± 2.17) days, which was significantly longer than (4.47 ± 1.73) days in the observation group ( t = 4.10, P = 0.021). Conclusion:Noninvasive mechanical ventilation combined with transnasal low-flow oxygen therapy exhibits good therapeutic effects on inflammation control, symptom relief, and pulmonary function recovery in patients with AECOPD combined with type II respiratory failure.

Influence of small-group experiential learning of integrated traditional Chinese and Western medicine on the oral health knowledge, beliefs, and behaviors of elderly patients with diabetes

SUMMARY OBJECTIVE: This study aimed at the oral health problems of elderly patients with diabetes. A training course of integrated traditional Chinese and Western medicine was constructed, helping patients improve their oral health quality of life. METHODS: A randomized controlled prospective experimental study was conducted. A total of 190 elderly patients were divided randomly into an observation group and a control group with 95 cases in each. The control group received regular health education, while the observation group was based on the control group to implement the integrated experiential learning of traditional Chinese and Western medicine in small groups. The oral health knowledge, attitude, behavior, and blood glucose control status along with the oral health quality of life of the two groups were compared before the intervention and at 3-month postintervention. RESULTS: Three months after the intervention, the fasting blood glucose control and the 2-h postprandial blood glucose/glycosylated hemoglobin levels in the observation group were significantly better than in the control group, and the difference was statistically significant (p<0.05). The oral health quality of life in the observation group was significantly better than in the control group, and the difference was statistically significant (p<0.05). CONCLUSION: The small-group experiential learning model of integrated Chinese and Western medicine can promote the transformation of knowledge-beliefs-behaviors in elderly patients with diabetes, which is conducive to controlling blood sugar levels and improving the quality of oral health.

Residential elevation and its effects on hypertension incidence among older adults living at low altitudes: a prospective cohort study

BACKGROUND@#Research on the relationship between residential altitude and hypertension incidence has been inconclusive. Evidence at low altitudes (i.e., <1,500 m) is scarce, let alone in older adults, a population segment with the highest hypertension prevalence. Thus, the objective of this study is to determine whether hypertension risk may be affected by altitude in older adults living at low altitudes.@*METHODS@#This prospective cohort study collected data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). We selected 6,548 older adults (≥65 years) without hypertension at baseline (2008) and assessed events by the follow-up surveys done in 2011, 2014, and 2018 waves. The mean altitude of 613 residential units (county or district) in which the participants resided was extracted from the Digital Elevation Model (DEM) of the National Aeronautics and Space Administration (NASA) and was accurate to within 30 m. The Cox regression model with penalized splines examined the linear or nonlinear link between altitude and hypertension. A random-effects Cox regression model was used to explore the linear association between altitude and hypertension.@*RESULTS@#The overall rate of incident hypertension was 8.6 per 100-person years. The median altitude was 130.0 m (interquartile range [IQR] = 315.5 m). We observed that the exposure-response association between altitude and hypertension incidence was not linear. The shape of the exposure-response curve showed that three change points existed. Hypertension risk increased from the lowest to the first change point (247.1 m) and slightly fluctuated until the last change point (633.9 m). The risk decreased above the last change point. According to the categories stratified by the change points, altitude was only significantly associated with hypertension risk (hazard ratio [HR] = 1.003; 95% confidence interval [CI] = 1.002-1.005) under the first change point (247.1 m) after adjusting for related covariates.@*CONCLUSION@#Our study found that the association between altitude and hypertension risk might not be linear. We hope the further study can be conducted to confirm the generality of our findings.