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.

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.

The expression and clinical significance of promyelocytic leukemia zinc finger in human peripheral blood with asthma / 中华急诊医学杂志

Objective:To investigate the expression of promyelocytic leukemia zinc finger (PLZF) in human peripheral blood with asthma and its clinical significance.Methods:Forty patients with stable asthma from May 2021 to October 2021 in the Department of Respiratory Medicine of the Shanghai Fifth People's Hospital were enrolled, and forty healthy controls were recruited in the study. The levels of cytokines in serum were measured by enzyme-linked immunosorbent assay (ELISA). Quantitative real-time PCR (qPCR) was used to detect the expression of PLZF mRNA in plasma. The level and distribution of PLZF+ cells in PBMCs were detected by flow cytometry after isolating peripheral blood mononuclear cells (PBMCs). Independent sample t test, Mann-Whitney U test, χ 2 test, ROC curve and Logistic regression were used to analyze the results with SPSS 26.0 and Graphpad Prism 7.0. A P<0.05 was considered statistically significant. Results:The levels of cytokines IFN-γ, IL-2, IL-4, TNF-α and IL-17 in human peripheral blood from the asthma group were obviously higher than those in the control group ( P<0.05), whereas there was no significant difference in the level of cytokine IL-10 between the two groups. The level of PLZF mRNA in PBMCs from the asthma group was significantly up-regulated compared to that in the control group [(3.40%±2.52%) vs. (1.23%±0.78%), P<0.05]. CD8+PLZF+ and Vβ11+PLZF+T cells in the asthma group were significantly outnumbered than those in the control group ( P<0.05). Logistic regression and ROC curve analysis showed that PLZF expression in PBMC was a risk factor for the development of asthma ( OR =3.67, AUC=0.87, P<0.05). Conclusions:The high expression of PLZF in peripheral blood may play an important role in the development of asthma, which needs to be further confirmed by large sample studies.

Correlation of intraocular pressure changes and the surgical parameters after SMILE for high myopia / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the correlation of changes in non-contact intraocular pressure(IOPNCT)and the surgical parameters after femtosecond laser small incision lenticule extraction(SMILE)for high myopia.MOTHODS:A retrospective analysis, the clinical data of 98 patients(196 eyes)with high myopia were operated SMILE in the optometric center of Gansu Provincial Hospital from January 2018 to July 2019 were analyzed. The change of IOPNCT before and after operation was observed, and recorded the optical zone(OZ), lenticule thickness(LT), cap thickness(CT)and residual stromal thickness(RST)and the correlation with the change value of IOPNCT(△IOPNCT, △IOPNCT=IOPpreoperative-IOP postoperative at 6mo).RESULTS:After operation at 1d, 1wk, 1,3 and 6mo, the group of patients with IOPNCT(10.84±2.14,11.00±2.19,10.65±2.43,10.45±2.04,10.61±1.39mmHg)and the preoperative(16.79±1.65mmHg)comparison have a difference(P<0.001).The optical zone and lenticule thickness were positively correlated with △IOPNCT respectively(r=0.1537, 0.8161, all P<0.05). The cap thickness and residual stromal thickness were negatively correlated with △IOPNCT respectively(r=-0.8362, -0.3351, all P<0.0001). Introduce the above related factors into a multiple linear regression analysis model. The regression coefficients of variables are statistical significane. The regression equation was Y=16.189+0.227X1+0.032X2-0.083X3-0.007X4(Y=△IOPNCT, X1=OZ, X2=LT, X3=CT, X4=RST). The equation was statistically significant(F=195.704, P<0.001), and the regression model coefficient of determination R2=0.901.CONCLUSION:The intraocular pressure changes after SMILE with high myopic were correlated with optical zone, lenticule thickness, cap thickness and residual stromal thickness. The regression equation would provide reference to evaluation the real intraocular pressure after SMILE in clinic.

Impact and related mechanisms of glucose fluctuations on aortic fibrosis in type 1 diabetic rats / 中华心血管病杂志

Objective: To investigate the impact and related mechanisms of glucose fluctuations on aortic fibrosis in rats with type 1 diabetes mellitus. Methods: After injection of streptozotocin (STZ), male Sprague Dawley (SD) (8-12 weeks) rats (n=24) were randomly divided into three groups in accordance with the random number table: controlled STZ-induced diabetes (C-STZ) group (n=8); uncontrolled STZ-induced diabetes (U-STZ) group (n=8); STZ-induced diabetes with glucose fluctuations (STZ-GF) group (n=8). After three weeks, rats were sacrificed and aorta was obtained, aortic fibrosis was detected by Masson trichrome staining. The expression of collagen type 1 (collagen Ⅰ) was tested by immunofluorescence. The expression of runt-related transcription factor 2 (Runx2) was tested by immunohistochemistry. The mRNA levels of collagen Ⅰ and Runx2 were detected by quantitative real-time PCR (qRT-PCR). The protein expressions of collagen Ⅰ, Runx2 and nuclear factor (NF)-κB were determined by Western blot. Primary rat aortic smooth muscle cells (VSMCs) were cultured in three conditions: normal glucose (NG), high glucose (HG) and glucose fluctuations (GF). Cells in GF group were incubated for 72 hours with glucose alternating between 5.5 and 25 mmol/L every 12 hours. TPCA-1, the inhibitor of NF-κB, the expression of collagenⅠin different groups of cells was tested by immunofluorescence. The protein expressions of collagen Ⅰ, Runx2 and NF-κB were also determined by Western blot. Results: (1) The quantitative ratios of the area of fibrosis in the C-STZ group, U-STZ group, STZ-GF group were (8.42±0.10)%, (21.30±0.74)% and (44.39±1.09)% (P<0.05), respectively. The means of integral optical density (IOD) of collagenⅠ in the three groups were 11.92±0.88, 50.04±3.56 and 77.52±2.69, respectively (P<0.05). The mRNA levels of collagenⅠ in the three groups were 1.00±0.10, 2.02±0.28 and 2.83±0.33, respectively (P<0.05). The protein expressions of collagenⅠ in the three groups were 1.05±0.03, 2.06±0.32 and 4.93±0.25, respectively (P<0.05). (2) The average IOD of Runx2 in the three groups were 150.00±7.35, 204.84±2.32 and 391.48±7.13, respectively (P<0.05). The mRNA levels of Runx2 in the three groups were 1.02±0.02, 1.27±0.04 and 2.18±0.12, respectively (P<0.05). The protein expressions of Runx2 in the three groups were 1.03±0.01, 2.34±0.36 and 4.52±0.75, respectively (P<0.05). (3) The protein expressions of NF-κB in the three groups were 1.02±0.01, 1.96±0.13 and 2.64±0.21, respectively (P<0.05). (4) In vitro, application of inhibitor of NF-κB reversed glucose fluctuations-induced upregulation of protein levels of Col Ⅰ and Runx2 (P<0.05). Conclusion: Glucose fluctuations could aggravate aortic fibrosis through activating Runx2 via NF-κB signaling pathways.

Identification, molecular structure and expression characteristics of Torso like gene in Anopheles dirus / 中国血吸虫病防治杂志

ObjectiveTo characterize Torso-like (tsl) gene and investigate its expression characteristics in Anopheles dirus, so as to provide a theoretical basis for subsequent functional studies of the tsl gene. MethodsAccording to the coding sequences of Drosophila melanogaster and An. gambiae tsl genes, the complete genome of An. dirus was retrieved and the An. dirus tsl gene was characterized. Specific primers were designed and the target gene was amplified using PCR and reverse-transcription PCR assays. The physicochemical properties, signal peptide, transmembrane structure, secondary structure and tertiary structure of the encoded protein TSL were analyzed using bioinformatics tools, and a phylogenetic analysis was performed. In addition, the specific expression of the tls gene was detected in various tissues of An. dirus using a quantitative real-time PCR assay. Results The An. dirus tsl gene was 16 751 bp in length with a CDS region of 1 134 bp, encoding 377 amino acids, and the encoded TSL protein was a stably hydrophilic protein. The TSL protein was predicted to be a secretory protein that was located in extra-membrane regions containing signal peptides. The secondary structure of the TSL protein contained α-helix (51.72%), extended strand (12.20%), β-bridge (4.78%) and random coil (31.30%) in the secondary structure, and a 3D homology model was generated using 5cj9.1.A as a template. Phylogenetic analysis revealed a close genetic relationship in the TSL protein between An. dirus and An. farauti. In addition, quantitative real-time PCR assay detected the tsl gene expression in the head, chest, abdomen and foot of An. dirus, with the highest expression in the head and low expression in the foot. Conclusions The tsl gene is characterized in An. dirus at a genomic level, and the prediction of the TSL protein structure and the elucidation of the tissue-specific tsl gene expression in An. dirus provide a basis for the further studies on the gene functions.

Medium-chain acyl-CoA dehydrogenase deficiency: neonatal screening and follow-uP / 中国当代儿科杂志

OBJECTIVE@#To investigate the epidemiological characteristics, phenotype, genotype, and prognosis of medium-chain acyl-CoA dehydrogenase deficiency (MCADD) in the Chinese population.@*METHODS@#A retrospective analysis was performed for the clinical data of the neonates who underwent screening with high-performance liquid chromatography-tandem mass spectrometry from January 2009 to June 2018 and were diagnosed with MCADD by gene detection.@*RESULTS@#A total of 2 674 835 neonates underwent neonatal screening, among whom 12 were diagnosed with MCADD. Gene detection was performed for 10 neonates with MCADD and found 13 mutation types at 16 mutation sites of the ACADM gene, among which there were 7 reported mutations (p.T150Rfs*4, p.M1V, p.R206C, p.R294T, p.G310R, p.M328V, and p.G362E), 5 novel mutations (p.N194D, p.A324P, p.N366S, c.118+3A>G, and c.387+1del G), and 1 exon 11 deletion; p.T150Rfs*4 was the most common mutation (4/16). The detection rate of mutation sites in the ACADM gene was 80%. No phenotype-genotype correlation was observed. Dietary guidance and symptomatic treatment were given after confirmed diagnosis. No acute metabolic imbalance was observed within 4-82 months of follow-up. All neonates had good prognosis except one who had brain dysplasia.@*CONCLUSIONS@#MCADD is relatively rare in southern China, and p.T150Rfs*4 is a common mutation in the Chinese population. Cases with positive screening results should be evaluated by octanoylcarnitine C8 value and gene detection.

13,14-EpDPE dilates coronary arterioles in rats by activating BK channels / 医学研究生学报

Objective The mechanisms of docosahexaenoic acid (DHA) protecting the cardiovascular system have not yet been clarified. This study was to investigate the vasorelaxative effect of 13,14-epoxy docosapentaenoic acid (13,14-EpDPE) on coronary arterioles in normal rats and its action mechanisms.Methods We isolated coronary artery smooth muscle cells (CASMCs) from normal rats by enzyme digestion, examined the open probabilities of the large conductance calcium-activated potassium (BK) channels in inside-out single channel configuration in the presence of different concentrations (0, 1, 10 and 100 pmol/L) of 13,14-EpDPE, and recorded the BK currents with the patch clamp in whole cell configuration. Then we assessed the coronary arterial relaxation by measuring dilatory responses to 13,14-EpDPE in pre-contracted tissues with or without pre-treatment with iberiotoxin.Results In the presence of 0, 1, 10 and 100 pmol/L of 13,14-EpDPE, the open probabilities of the BK channels were 0.25±0.03, 0.34±0.03, 0.44±0.06 and 0.85±0.16 (n=6), respectively, significantly increased at 100 pmol/L as compared with 0, 1 and 10 pmol/L (P<0.05). The BK channels were activated by 13,14-EpDP in a concentration-dependent manner and its half-effect concentration was (15.94±1.21) pmol/L. The current density was increased from (58.27±16.35) to (95.94±23.00) pA/pF (P=0.002) after 10 pmol/L 13,14-EpDP perfusion when the stimulation voltage was 100 mV. 13,14-EpDPE dilated the isolated coronary arterioles in a dose-dependent manner, and its effects were abolished after pre-treatment with iberiotoxin (100 nM).Conclusion 13,14-EpDPE can dilate coronary arterioles by activating BK channels in CASMCs, which might be one of the mechanisms underlying its protective effect on the cardiovascular system.

Progressesin endothelial progenitor cells derived extracellular vesicles / 医学研究生学报

Endothelial progenitor cells (EPCs) play an important role in angiogenesis and tissue repair, which have been used to treat various kinds of diseases associated with poor perfusion or organ dysfunction. In recent years, researches had shown that extracellular vesicles(EVs) are the important paracrine components of cells. They carry the protein, mRNA, miRNA and other bioactive substances from the original cells to the target cells, yielding a similar effect to stem cell transplantation. The effects of extracellular vesicles derived from endothelial progenitor cells (EPCs-EVs) have been explored in cardiovascular diseases, diabetes mellitus, and renal injury et al. This review covers the biological characteristics of EVs, the application and mechanism of EPCs-EVs in these studies.

Prevalence and related factors investigations of myopia among multi-ethnic adolescents in Linxia Prefecture / 国际眼科杂志(Guoji Yanke Zazhi)

· AIM:To investigate the prevalence of juvenile myopia and factors affecting its occurrence in Linxia Prefecture.· METHODS:Totally 8 683 juvenile students who were 6-18 years old were extracted as respondent with stratified cluster sampling method.The eyesight,diopter and axial length were detected,and the gender,age,ethnicity,eye behavior were collected by self-made questionnaire.· RESULTS:The prevalence of myopia was 42.80％.The myopic rates of all ethnic groups were as follows:Tibetan Nationality:59.05％,Han Nationality:46.71％,Dongxiang Nationality:46.36％,Tu Nationality:45.24％,Sala Nationality:41.30％,Baoan nationality:40.61％,Hui Nationality:31.97％.Myopia rate between each ethnic groups had statistical difference (x2 =44.08,P=0.007).Multivariate analyses revealed that outdoor activities during the break was the protect factor for myopia;age,using electronic products on weekends and holidays,using the same lighting in room while studying were risk factors for myopia.· CONCLUSION:The prevalence of myopia increase with age in Linxia.The prevalence in different ethnic groups is different.Education department and family should make joint efforts to increase the outdoor time,improve the environment for teenagers to reduce the occurrence and development of myopia.

Prevalence and related factors of dry eye in primary school pupils in Lanzhou / 国际眼科杂志(Guoji Yanke Zazhi)

· AIM:To investigate the prevalence and related factors of dry eye in primary school pupils in Lanzhou,Gansu Province.· METHODS:From October to November 2016,1347 pupils in two primary schools in Lanzhou,Gansu Province,were randomly selected as subjects.Every pupil was carried on the questionnaire of dry eye and eye inspection to confirm the diagnosis of dry eye.Besides,the prevalence and influencing factors of dry eye in pupils were analyzed by chi-square test,Mann-Whitney U test and logistic regression model.· RESULTS:A total of 1 268 pupils took part in this study and the inclusion ratio was 94.14％;271 individuals were diagnosed as dry eye,and the prevalence rate was 21.37％.Statistical analysis showed that the risk factors of dry eye were male,senior pupils,often using eye drops,poor reading habits,wearing contact lenses,video terminals last for a long time,learning pressure.· CONCLUSION:Dry eye has become one of the main diseases that plagued pupil's life and learning.It should cause wide attention.Considering the above factors,rational use of eye and improve lifestyle will help to reduce the damage to eye of pupils.

Research and practice of health impact assessments abroad / 中华健康管理学杂志

Health Impact Assessment (HIA) is an important tool for promoting health in all policies.HIA helps decision-makers foresee how different factors can affect health,and to make choices between alternatives and improvements to prevent disease/injury,as well as to actively promote health.The Healthy China 2030 Planning Outline proposed the establishment of overall health impact assessment systems to systematically assess the potential health effects of various economic and social development programs and policies and important engineering projects on a population.This paper introduces international research on the definition,origin,development,function,contents,and implementation of HIA,as well as two typical practical examples,namely the HIA in Urban Design and Planning of Manukau,NZ,and the HIA of the Healthy Families Act of 2009,USA.Finally,the authors put forward suggestions for exploring and establishing the Chinese HIA system.Specifically,to strengthen the guidance of HIA to the direction of law and regulation,to promote the publicity and awareness of the HIA concept,and carry out research on HIA evaluation methodology and technical tools.

Risk assessment on occupational hazards in automobile maintenance industry / 预防医学

Objective To investigate the occupational hazards in automobile maintenance industry in Hangzhou and to provide field-research based evidence for prevention and control. Methods We visited 12 workshops of automobile maintenance to investigate the actors of occupational hazards, examine the protective facilities, and evaluate the occupation-related risk using MES method. Results The factors of occupation-related hazards at polishing posts met the criteria. At the painting posts in the painting room, the factors of chemical hazards satisfied the criteria, however, the levels of xylene and butyl acetate exceeded the standard lines in some enterprises when the ventilation system was close. The noise was higher than the limit at a few posts of sheet metal. The ventilation in spray paint room and the dust collector in dry mill room work well. The risks of occupational hazards at grinding, painting, and sheet metal posts were slightly harmful. Conclusion The occupational hazard factors in automobile repair enterprises were much more complicated. The noise hazard of the sheet metal posts was relatively prominent.

A study on the lymphocytes genetic damage of occupational population exposed to methyl tert-butyl ether / 预防医学

Objective To investigate the genetic toxicity of methyl tert-butyl ether (MTBE) to lymphocytes and to provide reference for establishing the occupational population exposure limit of MTBE. Methods The human B lymphocytes in the logarithmic growth phase were respectively exposed to MTBE at concentrations of 0, 1.25, 2.5, 5, 10 and 12.5 μmol/L. The percentage of tail DNA and Olive tail moment of human B lymphocytes were evaluated after 24 h exposure by using comet assay. Apoptosis was tested by Annexin V-FITC/PI double-staining flow cytometry. The contents of MDA and 8-OHdG, as well as GSH-Px activity were measured by ELISA kit. Sixty workers from a petrochemical factory in Zhejiang were selected as the occupational exposure population, and 55 non-occupational exposure workers were selected as the control population. And 5 mL heparin anticoagulant peripheral blood was collected, and the number of micronucleus of peripheral blood lymphocytes was measured by micronucleus test, and the percentages of tail DNA as well as Olive tail moment of peripheral blood lymphocytes were measured by comet assay. The contents of MDA and 8-OhdG and GSH-Px activity in peripheral blood plasma were measured by ELISA kit. Results After 24 h exposure, the percentage of tail DNA and Olive tail moment in human B lymphocytes at concentrations of 10-12.5 μmol/L were significantly higher than those in the control group (P<0.05), and the percentage of early apoptosis cells was significantly increased at concentrations of 10-12.5 μmol/L (P <0.01) . The results of population-based study indicated no statistically significant difference in micronucleus positive rate, and the contents of MDA and 8-OhdG, and GSH-Px activity between the exposure group and the control group, but the Olive tail moment was significantly higher in the exposure group compared with the control group (P=0.000) . Conclusion The results of vitro study showed that exposure to 10-12.5 μmol/L MTBE could cause genetic toxicity to human B lymphocytes. Olive tail moment of peripheral blood lymphocytes of occupational exposure workers was significantly higher than that of non-occupational exposure group.

Diagnostic Value of Nasopharyngeal Aspirates in Children with Lower Respiratory Tract Infections / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The accuracy of nasopharyngeal aspirate (NPA) specimens in detecting lower respiratory pathogens remains controversial. The objective of this study was to evaluate the diagnostic accuracy of aspirates (NPAs) specimen in lower respiratory tract infections (LRTIs) in children.</p><p><b>METHODS</b>The prospective study was designed to collect the data of paired NPAs and bronchoalveolar lavage fluids from children with acute LRTIs from January 2013 to December 2015. All specimens were subjected to pathogen detection: bacterial detection by culture, Mycoplasma pneumoniae (Mp) detection by polymerase chain reaction assay and virus (influenza A and B viruses, parainfluenza virus [PIV] Types 1 and 3, respiratory syncytial virus, and adenovirus) detection by immunofluorescence assay. The diagnostic accuracy analysis of NPAs was stratified by age ≤3 years (n = 194) and >3 years (n = 294).</p><p><b>RESULTS</b>We collected paired specimens from 488 children. The positive rate of pathogen was 61.6%. For Streptococcus pneumoniae, NPA culture had the specificity of 89.9% and negative predictive value of 100% in age ≤3 years, the specificity of 97.2% and negative predictive value of 98.9% in age >3 years. For Mp, the positive predictive values of NPA was 77.4% in children ≤3 years, and 89.1% in children >3 years. For PIV III, NPA specimen had the specificity of 99.8% and negative predictive value of 96.5% in children ≤3 years. For adenovirus, NPA had the specificity of 97.8% and negative predictive value of 98.4% in age ≤3 years, the specificity of 98.9% and negative predictive value of 99.3% in age >3 years.</p><p><b>CONCLUSIONS</b>NPAs are less invasive diagnostic respiratory specimens, a negative NPA result is helpful in "rule out" lower airway infection; however, a positive result does not reliably "rule in" the presence of pathogens.</p>

Clinical Observation of Homemade Medicated and Dietary Compound Granules in Treating Sub-health Insomnia with Deficient Cultivation of Heart-spirit / 广州中医药大学学报

Objective To observe the clinical effects of the homemade medicated and dietary compound granules in treating sub-health insomnia with deficient cultivation of heart-spirit. Methods Sixty qualified patients were randomly divided into treatment group and control group, 30 cases in each group. The treatment group was given homemade medicated and dietary compound granules(mainly composed of Semen Ziziphi Spinosae, Radix Codonopsis, Sclerotiium Poriae Circum Radicem Pini, Radix Polygalae, Flos Rosae Rugosae, Plumula Nelumbinis, Fructus Ziziphi Jugubae, and Arillus Longan). The control group was given Oryzanol powder. The course of treatment lasted for half a month. Before and after treatment, the scores of Pittsburgh Sleep Quality Index(PSQI) and the traditional Chinese medicine(TCM)symptom rating scale were observed, and the clinical efficacy of the two groups were also evaluated. Results After treatment for half a month and after suspension of medicine for half a month , (1) the total effective rate of the treatment group was higher than that of the control group (P 0.05). The total PSQI scores , sleep quality scores , falling asleep time scores, and daytime function disorder scores of the treatment group were lower than those of the control group (P<0.01);(3) the total scores of TCM symptoms as well as the scores of dreaminess and susceptibility to awakening, palpitation and amnesia, lassitude and weakness, poor appetite, pale complexion, vertigo and dizziness, abdominal distension and loose stools were declined in the treatment group (P < 0.05 or P < 0.01 compared with those before treatment). Conclusion Medicated and dietary compound granules are effective on improving sleep quality, shortening time to fall asleep, improving sleep disorder, increasing the efficiency of daytime function, improving patients’ mental state entirely, and maintaining the short-term curative effect.

Etiology and diagnosis of intellectual disability / 中国当代儿科杂志

Intellectual disability, occurring in 1%-3% of the general population, is a common disease of the nervous system in children. Since diverse genetic and environmental factors contribute to its pathogenesis, the etiological diagnosis of intellectual disability is challenging with respect to the selection of diagnostic tests. It is important to determine the etiology of intellectual disability for the assessment of prognosis, treatment and the family plan. This paper summarizes the research progress in etiology and diagnosis for intellectual disability and introduces the recommended clinical genetics diagnostic approach from the American Academy of Pediatrics.

Effect of Dietary Resistant Starch on Prevention and Treatment of Obesity-related Diseases and Its Possible Mechanisms / 生物医学与环境科学（英文）

Overweight or obesity has become a serious public health problem in the world, scientists are concentrating their efforts on exploring novel ways to treat obesity. Nowadays, the availabilities of bariatric surgery and pharmacotherapy have enhanced obesity treatment, but it should has support from diet, physical exercise and lifestyle modification, especially the functional food. Resistant starch, an indigestible starch, has been studied for years for its beneficial effects on regulating blood glucose level and lipid metabolism. The aim of this review is to summarize the effect of resistant starch on weight loss and the possible mechanisms. According to numerous previous studies it could be concluded that resistant starch can reduce fat accumulation, enhance insulin sensitivity, regulate blood glucose level and lipid metabolism. Recent investigations have focused on the possible associations between resistant starch and incretins as well as gut microbiota. Resistant starch seems to be a promising dietary fiber for the prevention or treatment of obesity and its related diseases.

Epidemiology of viral infection causing acute exacerbations of chronic obstructive pulmonary disease in the elderly patients during 2010-2012 in Minhang district of Shanghai / 中华急诊医学杂志

Objective To investigate the epidemiology of viral infection in elderly patients to contract acute exacerbations of chronic obstructive pulmonary disease (AECOPD)in Minhang district of Shanghai from 2010 to 2012,and to study the relationships between viral infection and clinical features.Methods The elderly patients (age >70 year old)with AECOPD admitted from September 2010 to November 2012 were enrolled for study.The patients who couldn't complete lung function test were excluded.The pharyngeal swabs (PS)were taken from each patient within the first 24 h after admission.Nine respiratory viruses and their subtypes from pharyngeal swabs were detected by the nested multiplex polymerase chain reaction (PCR)method,including influenza virus A (FluA),2009 influenza A (H1N1 )virus (09FluH1 ), influenza virus B (FluB),respiratory syncytial virus A (RSVA)and B (RSVB),human coronavirus-229E (hCOV-229E),human coronavirus-NL63 (hCOV-NL63 ),human coronavirus-OC43 (hCOV-OC43 ), human coronavirus-HKU1 (hCOV-HKU1),human parainfluenza virus 1-4 (hPIV1-4),human adenovirus (hAdV),human boca virus (hBoV),human metapneumo-virus (hMPV)and human rhinovirus (hRV). According to the PCR results,all patients were divided into positive viral infection group and negative viral infection group.The relationships between viral infection and clinical features were analyzed.Results Sixty patients were eligible for study.Of them,14 patients were found to be positive for virus infection including a triple infected patient (FluB,hRV and hROV)and 46 patients were negative for virus infection.The viral pathogens detected in the positive viral group were:9 cases of hRV (15.00%),2 cases of hPIV (3.33%),2 cases of hCOV (3.33%),2 cases of FluB (3.33%)and 1 cases of RSV (1.67%).The mortality in the positive viral group was higher than that in the negative viral group.However,the other clinical characteristics between the two groups had no significant differences. Conclusions Human rhinovirus was the most common viral pathogen in elderly patients with AECOPD.Viral infection might be associated with the prognosis.However,the patients with viral infection are lack of specific clinical characteristics,therefore,the prompt diagnosis before careful study would be difficult.

Observation on efficacy of Huaiqihuang Granule in treatment of nephrotic syndrome in children / 中草药

Objective: To investigate the efficacy of Huaiqihuang Granule in children with primary nephrotic syndrome. Methods: There were 112 cases (78 male and 34 female, at the age of 1.3-13.5 years old) in the ward of Renal Department of Internal Medicine in Affiliated Children's Hospital, School of Medicine, Zhejiang University during July 1st, 2009 to June 30th, 2010, who were initially treated and sensitive to glucocorticoid. They were enrolled in the study randomly and were divided into two groups under the similar condition: group A (54 cases in treatment group with Huaiqihuang Granule) and group B (58 cases in control group with hormone instead of Huaiqihuang Granules). We observed the duration of proteinuria turned into negative, the frequency of recurrence, the frequency of respiratory tract infection, and the changing of cytokines after the treatments. On the admission and six months after the onset of disease, the IL-2, -4, -6, and -10, TNF, and IFN-γ of some patient children were determined. Results: The duration of proteinuia being negative was 5-22 d (average 12.6 d) in the group A and 5-24 d (average 14.1 d) in the group B. After one year's follow-up, nine cases suffered recurrence in group A (16.67%), while 20 cases in group B (34.48%). There was statistically significant difference with P < 0.05. Among 38 cases who were suffered respiratory tract infection frequently in group A, the times of infection were significantly reduced in 32 cases, the reduction rate was 84.21%, while it was 47.50% in group B (P < 0.01). All the recurrence patients were associated with infection. The level of IL-2 was low during disease, after recovery, it increased faster in group A than in group B (P < 0.05). IFN-γ was elevated at the onset in both groups, after recovery it dropped down to normal in group A, and decreased under the normal level in group B. The TNF, IL-6, and -10 showed no significant deference between the two groups. Conclusion: Huaiqihuang Granule can reduce the relapse rate of nephrotic syndrome in children according to its influence to cellular immune function.