Advances in diagnosis and treatment of IgG4-related hepatobiliary and pancreatic diseases / 临床肝胆病杂志

IgG4-related hepatobiliary and pancreatic diseases are a part of the IgG4-related disease multiorgan fibroinflammatory disorder, including IgG4-related autoimmune pancreatitis, IgG4-related sclerosing cholangitis, and IgG4-related hepatic involvement. The main pathological features include IgG4 + plasma cell/lymphocyte infiltration, storiform fibrosis, obliterative phlebitis, and eosinophil infiltration. The diagnosis of this disease is often based on the comprehensive diagnostic criteria for IgG4-related diseases and organ-specific diagnostic criteria. However, it is difficult to differentiate IgG4-related hepatobiliary and pancreatic diseases from neoplastic diseases, and novel diagnostic biomarkers are expected to improve the sensitivity and specificity of diagnosis. To date, glucocorticoids remain the first-line drug for this disease, and biological agents, especially anti-CD20 monoclonal antibody, may be an alternative therapy for patients with corticosteroid contraindication/intolerance or recurrent/refractory disease.

Comparative study on the mechanical properties of lower limb arterial stents under various deformation modes / 生物医学工程学杂志

Lower extremity movement is a complex and large range of limb movement. Arterial stents implanted in lower extremity are prone to complex mechanical deformation, so the stent is required to have high comprehensive mechanical properties. In order to evaluate the mechanical property of different stents, in this paper, finite element method was used to simulate and compare the mechanical properties of six nitinol stents (Absolute Pro, Complete SE, Lifestent, Protégé EverFlex, Pulsar-35 and New) under different deformation modes, such as radial compression, axial compression/tension, bending and torsion, and the radial support performance of the stents was verified by experiments. The results showed that the comprehensive performance of New stent was better than other stents. Among which the radial support performance was higher than Absolute Pro and Pulsar-35 stent, the axial support performance was better than Complete SE, Lifestent and Protégé EverFlex stent, the flexibility was superior to Protégé Everflex stent, and the torsion performance was better than Complete SE, Lifestent and Protégé Everflex stent. The TTR2 type radial support force tester was used to test the radial support performance of 6 types, and the finite element analysis results were verified. The mechanical properties of the stent are closely related to the structural size. The result provides a reference for choosing a suitable stent according to the needs of the diseased location in clinical applications.

Impacts of comprehensive reforms of clinic-pharmacy separation and medicine-consumables expenditure linkage in Beijing on medical expenditure / 中华医院管理杂志

Objective:To evaluate the effect of the comprehensive reforms of clinic-pharmacy separation and medical-consumables expenditure linkage in Beijing.Methods:Monitoring data of the comprehensive reforms were collected from 363 public medical institutions in Beijing between January 2016 and December 2019, while descriptive analysis and interrupted times series analysis using segmented regression models were adopted to analyze the influence of the two reforms on medical expense and its structure. We also studied the impact mechanism of service utilization and service price factors on medical expense control.Results:During the period from 2016 to 2019, the medical expenditure of public medical institutions in Beijing increased steadily at an annual growth rate of 4.4%-7.2%. The proportion of drug expense decreased from 44.6% in 2016 to 34.6% in 2019, while the proportion of medical service expense rose from 15.6% in 2016 to 24.3% in 2019, the proportion of examination and laboratory test expenses respectively showed a significant decline in April 2017 and June 2019. These two months witnessed respectively the launch of the two comprehensive reforms. Service utilization played an important role in controlling outpatient and emergency expenses, and service price was the key factor for controlling inpatient expenditure.Conclusions:The implementation of the two reforms in Beijing has effectively curbed the unreasonable growth of medical expenditure, and the expense structure has been constantly optimized and labor value of medical staff gradually improved.

Application of biomechanical modeling and simulation in the development of non-invasive technologies and devices for cardiovascular testing / 生物医学工程学杂志

The prevalence of cardiovascular disease in our country is increasing, and it has been a big problem affecting the social and economic development. It has been demonstrated that early intervention of cardiovascular risk factors can effectively reduce cardiovascular disease-caused mortality. Therefore, extensive implementation of cardiovascular testing and risk factor screening in the general population is the key to the prevention and treatment of cardiovascular disease. However, the categories of devices available for quick cardiovascular testing are limited, and in particular, many existing devices suffer from various technical problems, such as complex operation, unclear working principle, or large inter-individual variability in measurement accuracy, which lead to an overall low popularity and reliability of cardiovascular testing. In this study, we introduce the non-invasive measurement mechanisms and relevant technical progresses for several typical cardiovascular indices (e.g., peripheral/central arterial blood pressure, and arterial stiffness), with emphasis on describing the applications of biomechanical modeling and simulation in mechanism verification, analysis of influential factors, and technical improvement/innovation.

Analysis of current situation of pediatric medical resources allocation in Beijing from 2013 to 2017 / 中华医院管理杂志

Objective@#To find out the present pediatrician allocation and the burden of diagnosis and treatment in Beijing, so as to provide evidence for effective allocation of pediatricians.@*Methods@#Data and indicators were selected from Beijing Health Comprehensive Statistical Information Platform, including Manpower Basic Information Survey of Beijing Health Institutions, Annual Report of Medical Institutions, Beijing Statistical Data on Health Work(Compendium), as well as Beijing Health and Family Planning Statistical Yearbook. The study dynamically analyzed the number of pediatricians, that of pediatricians per 1 000 children, that of outpatients and emergency patients per pediatrician and the number of discharges per pediatrician from 2013 to 2017. Descriptive analysis was carried out on the data.@*Results@#In 2017, the proportion of pediatricians accounted for 2.78% of the total number of doctors in the city, the number of pediatric emergencies accounted for 6.47% of the total outpatients and emergencies in the city, and the number of hospitalizations accounted for 5.70% of the total discharge in the city.From 2013 to 2017, the number of outpatients and emergency patients per pediatrician increased by 40.58%, and the number of discharged patients increased by 36.70%. The proportion of hospitalization at tertiary hospitals increased from 80.2% to 85.1%, and that in primary institutions decreased from 6.3% to 1.7%.@*Conclusions@#The study found such setbacks in the allocation of pediatric medical resources in Beijing, as insufficient pediatricians, unreasonable allocation and excessive burden on pediatricians. We should strengthen the planning and construction of pediatric human resources, improve the training mode of pediatricians, improve the salary level of pediatricians, and ease the burden on pediatricians, so as to provide high-quality medical services for children.

Analysis of current situation of pediatric medical resources allocation in Beijing from 2013 to 2017 / 中华医院管理杂志

Objective To find out the present pediatrician allocation and the burden of diagnosis and treatment in Beijing,so as to provide evidence for effective allocation of pediatricians.Methods Data and indicators were selected from Beijing Health Comprehensive Statistical Information Platform,including Manpower Basic Information Survey of Beijing Health Institutions,Annual Report of Medical Institutions,Beijing Statistical Data on Health Work (Compendium),as well as Beijing Health and Family Planning Statistical Yearbook.The study dynamically analyzed the number of pediatricians,that of pediatricians per 1 000 children,that of outpatients and emergency patients per pediatrician and the number of discharges per pediatrician from 2013 to 2017.Descriptive analysis was carried out on the data.Results In 2017,the proportion of pediatricians accounted for 2.78％ of the total number of doctors in the city,the number of pediatric emergencies accounted for 6.47％ of the total outpatients and emergencies in the city,and the number of hospitalizations accounted for 5.70％ of the total discharge in the city.From 2013 to 2017,the number of outpatients and emergency patients per pediatrician increased by 40.58％,and the number of discharged patients increased by 36.70％.The proportion of hospitalization at tertiary hospitals increased from 80.2％ to 85.1％,and that in primary institutions decreased from 6.3％ to 1.7％.Conclusions The study found such setbacks in the allocation of pediatric medical resources in Beijing,as insufficient pediatricians,unreasonable allocation and excessive burden on pediatricians.We should strengthen the planning and construction of pediatric human resources,improve the training mode of pediatricians,improve the salary level of pediatricians,and ease the burden on pediatricians,so as to provide high-quality medical services for children.

Clinical and genetic characteristics of dopamine-responsive dystonia in 3 children / 临床儿科杂志

Objective To explore the clinical and genetic characteristics, treatment. and prognosis of dopamine responsive dystonia (DRD) in children. Method The clinical data of DRD in 3 children admitted to neurology clinic from January 2014 to August 2017 were retrospectively analyzed. Results Two male children, 20-month-old and 2-year-old respectively, and one 4-year-old female child suffered from hypotonia after birth or one year after birth. Genetic testing found that case 1 had heterozygous mutations in tyrosine hydroxylase (TH) gene, C. G943A (p. G315S) from his mother (PMID 20056467) and C. G739A (p. G247S) from his father (PMID 18554280, 24753243) . Case 2 had a heterozygous mutation, c.454-2A＞G, in GCH-1 gene, which was identified to be from his father (PMID 10732814) . Case 3 had two mutations in TH1 gene, c.580+2T>C from her mother (novel mutation) and c.698G>A (p.R233H) from her father (PMID 9703425) . The mother of case 1 was pregnant again. Prenatal examination revealed that the fetus only carried c.G943A (p.G315S) from the mother. Three patients were treated with a small dose of madopar after diagnosis, and gradually increased to obtain the best effect. After 6-month follow-up, cases 1 and 2 recovered to normal, and case 3 showed significant improvement in dystonia, but left foot deformity. Conclusion DRD can start in infants and young children with atypical early symptoms. Genetic testing can make a definite diagnosis. The family that has proband should undergo prenatal examination.

Performance of the Autism Spectrum Rating Scale and Social Responsiveness Scale in Identifying Autism Spectrum Disorder Among Cases of Intellectual Disability / 神经科学通报·英文版

The Autism Spectrum Rating Scale (ASRS) and the Social Responsiveness Scale (SRS) have been widely used for screening autism spectrum disorder (ASD) in the general population during epidemiological studies, but studies of individuals with intellectual disability (ID) are quite limited. Therefore, we recruited the parents/caregivers of 204 ASD cases, 71 ID cases aged 6-18 years from special education schools, and 402 typically developing (TD) children in the same age span from a community-based population to complete the ASRS and SRS. The results showed that the ID group scored significantly lower on total and subscale scores than the ASD group on both scales (P < 0.05) but higher than TD children (P < 0.05). Receiver operating characteristic analyses demonstrated a similar fair performance in discriminating ASD from ID with the ASRS (area under the curve (AUC) = 0.709, sensitivity = 77.0%, specificity = 52.1%, positive predictive value (PPV) = 82.2%) and the SRS (AUC = 0.742, sensitivity = 59.8%, specificity = 77.5%, PPV = 88.4%). The results showed that individuals with ID had clear autistic traits and discriminating ASD from ID cases was quite challenging, while assessment tools such as ASRS and SRS, help to some degree.

Effector molecules of mouse CD4 T cell converted double negative T cell / 国际外科学杂志

Objective To investigate the function characteristics of CD4 T cell converted double negative T cell and provide a basis for further insight into the characteristics of mouse converted double negative T cell.Methods The gene expression profile was analyzed by transcriptome sequencing and protein mass spectrometry.The expression of cell active marker CD44,CD69 and OX40 was investigated by flow cytometry and the cytotoxicity of mouse double negative T cell was verified by CFSE staining.Results Mouse CD4 T cell converted double negative T cell expressed cell phenotype that differed from other mature CI4 T cells.Mouse converted double negative T cell expressed high level of active marker of CD44,CD69 and OX40.Cytotoxicity of PrfO DN T was significantly reduced.Conclusions Mouse CD4 T cell converted double negative T cell has distinguishing cell phenotypes,that are not identical to other mature CD4 T cells.Mouse double negative T cell overexpresses cell activation marker and cytotoxic cytokines.The immune suppressive function of mouse double negative T cell is mainly dependent on perforin pathway.

Knockout gata4 gene and establish ment of a zebrafish model of congenital heart disease by TALEN / 中国比较医学杂志

Objective To establish a gata4 gene knockout zebrafish model of congenital heart disease, and construct transcription activator-like effector nuclease ( TALEN) vectors targeting gata4 gene.Method We construct TALEN vectors targeting zabrafish gata4 gene using unit assembly method and the in vitro-transcribed TALEN mRNAs were microinjected into one-cell stage zebrafish embryos.The efficiency of TALEN was identified by injected embryos, and mutations of zebrafish were screened and confirmed the different types through PCR and enzyme digestion.Results We successfully constructed correct targeting vectors by enzyme digestion and sequencing, and the gene knockout efficiency was 35.18%.We screened the mutant zebrafish and confirmed different types of gata4 gene mutations.Conclusions A gata4 knockout zebrafish model is successfully established, it can provide a good animal model for further research of congenital heart diseases.

Clinical Research on Simvastatin Combined with Tanshinone in the Treatment of Acute Cerebral Infarction / 中国药师

Objective:To analyze the effect of simvastatin combined with tanshinone in the treatment of patients with acute cere-bral infarction. Methods:The patients with acute cerebral infarction were randomly divided into the treatment group (n=50) and the control group (n=50). The control group was given tanshinone treatment, the treatment group was given simvastatin treatment addi-tionally, and the treatment course was 14 d. The NIHSS ( nerve function defect degree) , ADL ( daily life activity) and the treatment effect before and after the treatment were comprehensively evaluated and compared between the two groups. Results: Compared with those before the treatment, the NIHSS and ADL scores were significantly improved in the two groups after the treatment, and the differ-ences were statistically significant (P<0. 05), and the improvement in the treatment group was significantly better than that in the control group with statistical significance (P<0. 05). The total effective rate of the observation group was 98%, which was higher than that (70%) in the control group (P<0. 05). Conclusion: Simvastatin combined with tanshinone in the treatment of acute cerebral infarction shows obvious therapeutic effect, which can obviously improve neurologic deficits and daily life activity, and is worthy of fur-ther clinical application.

Research of zebrafish quality standardization / 中国实验动物学报

At present, zebrafish has played an increasingly important role in models for human development and diseases and several areas of life sciences.As a newly laboratory animal resource, standardization research has become the technical bottleneck to be solved and an inevitable trend.In this review, we summarized the research history and character-istics of zebrafish and the status of quality standardization.We also discussed the main problem facing by the standardiza-tion research of zebrafish as a newly laboratory animal.We hope that the data can provide useful reference for the develop-ment of zebrafish quality standardization research.

Relationship between insulin resistance and carotid atherosclerosis in elderly patients with type 2 diabetes / 中华老年医学杂志

Objective To study the relationship between insulin resistance and carotid atherosclerosis in elderly patients with type 2 diabetes.Methods A total of 63 elderly patients with type 2 diabetes were divided into 2 groups:group A (HbA1c≤7％,n=30),group B (HbA1c＞7％,n=33); and 30 healthy people were as controls.Fasting blood sugar(FBS),fasting insulin (FINS),glycated hemoglobin (HbA1c) and carotid intima-media thickness (IMT) were measured,atherosclerotic plaques were counted,and insulin resistance was calculated by homeostatic model assessment (HOMA-IR).Results The IMT,number of atherosclerotic plaques and incidence of carotid atherosclerosis were all higher in the two diabetic groups than in controls (P＜0.05).The levels of FINS,HbA1c and HOMA-IR were all higher in group A and group B than in controls (P＜0.05 and P＜0.01),which had a significant difference between group A and group B [(9.7± 2.1)mU/L vs.(13.6±2.0) mU/L; (6.5±0.4)％ vs.(8.2±0.6)％; (3.5±0.4) vs.(6.1±0.5); all P＜0.05].Pearson correlation analysis showed that IMT was positively correlated with FBS and HOMA-IR in group A and group B (r=0.62 and r=0.46,respectively,P＜0.05).Conclusions There is a positive correlation between insulin resistance and carotid atherosclerosis in elderly patients with type 2 diabetes.

The application of a high resolution melting-based genotyping method in studing the association between FTO rs9930506 polymorphism and metabolic syndrome in Beijing population / 中华内科杂志

Objective To set up a new method,which is sensitive,low cost,rapid and suitable for clinical application for FTO gene rs9930506 variant genotyping basing on high resolution melting (HRM) platform,and to preliminarily put into practice in susceptibility analysis for metabolic syndrome (MS) in Beijing.Methods Unlabelled probe with C3-spacer block specific for rs9930506 variant has been designed according to the Refseq from GenBank.With LC-Green plus dye pre-mixed,we scanned the signal for the genotype analysis after PCR amplification and HRM reaction.Restriction fragment length polymorphism (RFLP) and PCR-sequencing methods were designed as 2 control genotyping methods for the evaluation of accuracy and convenience.Afterwards,the HRM-based method was put into practice in metabolic syndrome patients (n =500) and control groups (n =500) for rs9930506 genotyping,and primarily study the association between rs9930506 and MS.Results All the 3 methods could genotype rs9930506 appropriately,although the 2 control methods seemed to be a little time-inefficient.The call rate of HRM-method was 100％ and sampling accuracy reached 99.3％ according to sequencing results.In the MS group,AA,AG and GG genotypes were found in 290,185 and 25 cases,respectively.And in the control group,those were found in 344,138 and 18 cases.No genotype distribution difference was detected between control group and HapMap-CHB data (P =0.520 ).The genotype distributions were all in Hardy-Weinberg equilibrium in each group.AA genotype of rs9930506 seemed to reduce the risk for MS( OR =0.626,95％CI =0.483-0.812).Conclusions The AA genotype of rs9930506 variant in FTO might be a protective factor for MS in Beijing population.The susceptibility related genotyping in clinical samples could be more rapid,precise and inexpensive with the development of HRM in genotyping.

Comparative study on the low-dosage methyltestosterone or andriol treatments of senile osteoporosis in men / 中华老年医学杂志

ObjectiveTo evaluate the therapeutic efficacy of low-dosage methyltestosterone or andriol in men with senile osteoporosis. MethodsA total of 134 male patients with senile osteoporosis and the decreased serum level of free testosterone were divided into three groups. 45 patients were treated with low-dosage methyhestosterone(100 mg, once a day, sublingual) and 46 patients were treated with low-dosage andriol (40 mg, once a day, orally), while 43 patients were treated with placebo. The duration of treatment in each group was 1 year. The bone density, blood and urine biochemical indexes related to bone metaholites,the quality of life indexes, ultrasonography for prostate,serum prostate specific antigen,blood routine, urine routine, hepatic and renal function were detected before and after the treatment. ResultsBoth low-dosage methyltestosterone and low-dosage andriol could prevent the decrease of bone mineral density and improve patients' general health, role-emotional function and vitality (all P＜0.05). The difference values of femoral neck bone mineral density before and after treatment with low-dosage andriol and low-dosage methyltestosterone were (0.14+0.18)g/cm2 and (0.12±0.09)g/cm2 , respectively(P＜0.05). Low-dosage andriol hadstronger effects in increasing the level of estradiol (32.5±14.2 )ng/L than low-dosage methyltestosterone(19.3±9.2)ng/L(P＜0.05) and showed more notable effects in improving the physical functioning and role-physical function than low-dosage methyhestosterone. The use of the two androgenic hormones at low dosage showed safety. ConclusionsBoth low-dosage methyltestosterone and low-dosage andriol can be used to treat senile osteoporosis in men and to improve life quality. Both of them are effective and safe therapeutic choices.