Current status of diagnosis and treatment of chronic lymphocytic leukemia in China: A national multicenter survey research / 中华血液学杂志

Objective: To understand the current status of diagnosis and treatment of chronic lymphocytic leukemia (CLL) /small lymphocytic lymphoma (SLL) among hematologists, oncologists, and lymphoma physicians from hospitals of different levels in China. Methods: This multicenter questionnaire survey was conducted from March 2021 to July 2021 and included 1,000 eligible physicians. A combination of face-to-face interviews and online questionnaire surveys was used. A standardized questionnaire regarding the composition of patients treated for CLL/SLL, disease diagnosis and prognosis evaluation, concomitant diseases, organ function evaluation, treatment selection, and Bruton tyrosine kinase (BTK) inhibitor was used. Results: ①The interviewed physicians stated that the proportion of male patients treated for CLL/SLL is higher than that of females, and the age is mainly concentrated in 61-70 years old. ②Most of the interviewed physicians conducted tests, such as bone marrow biopsies and immunohistochemistry, for patient diagnosis, in addition to the blood test. ③Only 13.7% of the interviewed physicians fully grasped the initial treatment indications recommended by the existing guidelines. ④In terms of cognition of high-risk prognostic factors, physicians' knowledge of unmutated immunoglobulin heavy-chain variable and 11q- is far inferior to that of TP53 mutation and complex karyotype, which are two high-risk prognostic factors, and only 17.1% of the interviewed physicians fully mastered CLL International Prognostic Index scoring system. ⑤Among the first-line treatment strategy, BTK inhibitors are used for different types of patients, and physicians have formed a certain understanding that BTK inhibitors should be preferentially used in patients with high-risk factors and elderly patients, but the actual use of BTK inhibitors in different types of patients is not high (31.6%-46.0%). ⑥BTK inhibitors at a reduced dose in actual clinical treatment were used by 69.0% of the physicians, and 66.8% of the physicians had interrupted the BTK inhibitor for >12 days in actual clinical treatment. The use of BTK inhibitors is reduced or interrupted mainly because of adverse reactions, such as atrial fibrillation, severe bone marrow suppression, hemorrhage, and pulmonary infection, as well as patients' payment capacity and effective disease progression control. ⑦Some differences were found in the perceptions and behaviors of hematologists and oncologists regarding the prognostic assessment of CLL/SLL, the choice of treatment options, the clinical use of BTK inhibitors, etc. Conclusion: At present, a gap remains between the diagnosis and treatment of CLL/SLL among Chinese physicians compared with the recommendations in the guidelines regarding the diagnostic criteria, treatment indications, prognosis assessment, accompanying disease assessment, treatment strategy selection, and rational BTK inhibitor use, especially the proportion of dose reduction or BTK inhibitor discontinuation due to high adverse events.

Expression of LRG-1 in mice with hypertensive renal damage and its significance / 中南大学学报(医学版)

OBJECTIVES@#Long-term elevated blood pressure may lead to kidney damage, yet the pathogenesis of hypertensive kidney damage is still unclear. This study aims to explore the role and significance of leucine-rich alpha-2-glycoprotein-1 (LRG-1) in hypertensive renal damage through detecting the levels of LRG-1 in the serum and kidney of mice with hypertensive renal damage and its relationship with related indexes.@*METHODS@#C57BL/6 mice were used in this study and randomly divided into a control group, an angiotensin II (Ang II) group, and an Ang II+irbesartan group. The control group was gavaged with physiological saline. The Ang II group was pumped subcutaneously at a rate of 1.5 mg/(kg·d) for 28 days to establish the hypertensive renal damage model in mice, and then gavaged with equivalent physiological saline. The Ang II+irbesartan group used the same method to establish the hypertensive renal damage model, and then was gavaged with irbesartan. Immunohistochemistry and Western blotting were used to detect the expression of LRG-1 and fibrosis-related indicators (collagen I and fibronectin) in renal tissues. ELISA was used to evaluate the level of serum LRG-1 and inflammatory cytokines in mice. The urinary protein-creatinine ratio and renal function were determined, and correlation analysis was conducted.@*RESULTS@#Compared with the control group, the levels of serum LRG-1, the expression of LRG-1 protein, collagen I, and fibronectin in kidney in the Ang II group were increased (all P<0.01). After treating with irbesartan, renal damage of hypertensive mice was alleviated, while the levels of LRG-1 in serum and kidney were decreased, and the expression of collagen I and fibronectin was down-regulated (all P<0.01). Correlation analysis showed that the level of serum LRG-1 was positively correlated with urinary protein-creatinine ratio, blood urea nitrogen, and blood creatinine level in hypertensive kidney damage mice. Serum level of LRG-1 was also positively correlated with serum inflammatory factors including TNF-α, IL-1β, and IL-6.@*CONCLUSIONS@#Hypertensive renal damage mice display elevated expression of LRG-1 in serum and kidney, and irbesartan can reduce the expression of LRG-1 while alleviating renal damage. The level of serum LRG-1 is positively correlated with the degree of hypertensive renal damage, suggesting that it may participate in the occurrence and development of hypertensive renal damage.

Cardiac Structural and Functional Features in Patients With Type 2 Diabetes Mellitus and Heart Failure With Preserved Ejection Fraction:A Study Based on Propensity Score Matching / 中国医学科学院学报

Objective To investigate the cardiac structural and functional characteristics in the patients with heart failure with preserved ejection fraction (HFpEF) and type 2 diabetes mellitus (T2DM),and predict the factors influencing the characteristics. Methods A total of 783 HFpEF patients diagnosed in the Department of Geriatric Cardiology,the First Hospital of Lanzhou University from April 2009 to December 2020 were enrolled in this study.Echocardiography and tissue Doppler technique were employed to evaluate cardiac structure and function.According to the occurrence of T2DM,the patients were assigned into a HFpEF+T2DM group (n=332) and a HFpEF group (n=451).Propensity score matching (PSM)(in a 1∶1 ratio) was adopted to minimize confounding effect.According to urinary albumin excretion rate (UAER),the HFpEF+T2DM group was further divided into three subgroups with UAER<20 μg/min,of 20-200 μg/min,and>200 μg/min,respectively.The comorbidities,symptoms and signs,and cardiac structure and function were compared among the groups to clarify the features of diabetes related HFpEF.Multivariate linear regression was conducted to probe the relationship of systolic blood pressure,blood glucose,glycosylated hemoglobin,and UARE with cardiac structural and functional impairment. Results The HFpEF+T2DM group had higher prevalence of hypertension (P=0.001) and coronary heart disease (P=0.036),younger age (P=0.020),and larger body mass index (P=0.005) than the HFpEF group,with the median diabetic course of 10 (3,17) years.After PSM,the prevalence of hypertension and coronary heart disease,body mass index,and age had no significant differences between the two groups(all P>0.05).In addition,the HFpEF+T2DM group had higher interventricular septal thickness (P=0.015),left ventricular posterior wall thickness (P=0.040),and left ventricular mass (P=0.012) and lower early diastole velocity of mitral annular septum (P=0.030) and lateral wall (P=0.011) than the HFpEF group.Compared with the HFpEF group,the HFpEF+T2DM group showed increased ratio of early diastolic mitral filling velocity to early diastolic mitral annular velocity (E/e') (P=0.036).Glycosylated hemoglobin was correlated with left ventricular mass (P=0.011),and the natural logarithm of UAER with interventricular septal thickness (P=0.004),left ventricular posterior wall thickness (P=0.006),left ventricular mass (P<0.001),and E/e' ratio (P=0.049). Conclusion The patients with both T2DM and HFpEF have thicker left ventricular wall,larger left ventricular mass,more advanced left ventricular remodeling,severer impaired left ventricular diastolic function,and higher left ventricular filling pressure than the HFpEF patients without T2DM.Elevated blood glucose and diabetic microvascular diseases might play a role in the development of the detrimental structural and functional changes of the heart.

Single-cell RNA sequencing reveals the transcriptomic landscape of kidneys in patients with ischemic acute kidney injury / 中华医学杂志(英文版)

BACKGROUND@#Ischemic acute kidney injury (AKI) is a common syndrome associated with considerable mortality and healthcare costs. Up to now, the underlying pathogenesis of ischemic AKI remains incompletely understood, and specific strategies for early diagnosis and treatment of ischemic AKI are still lacking. Here, this study aimed to define the transcriptomic landscape of AKI patients through single-cell RNA sequencing (scRNA-seq) analysis in kidneys.@*METHODS@#In this study, scRNA-seq technology was applied to kidneys from two ischemic AKI patients, and three human public scRNA-seq datasets were collected as controls. Differentially expressed genes (DEGs) and cell clusters of kidneys were determined. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis, as well as the ligand-receptor interaction between cells, were performed. We also validated several DEGs expression in kidneys from human ischemic AKI and ischemia/reperfusion (I/R) injury induced AKI mice through immunohistochemistry staining.@*RESULTS@#15 distinct cell clusters were determined in kidney from subjects of ischemic AKI and control. The injured proximal tubules (PT) displayed a proapoptotic and proinflammatory phenotype. PT cells of ischemic AKI had up-regulation of novel pro-apoptotic genes including USP47 , RASSF4 , EBAG9 , IER3 , SASH1 , SEPTIN7 , and NUB1 , which have not been reported in ischemic AKI previously. Several hub genes were validated in kidneys from human AKI and renal I/R injury mice, respectively. Furthermore, PT highly expressed DEGs enriched in endoplasmic reticulum stress, autophagy, and retinoic acid-inducible gene I (RIG-I) signaling. DEGs overexpressed in other tubular cells were primarily enriched in nucleotide-binding and oligomerization domain (NOD)-like receptor signaling, estrogen signaling, interleukin (IL)-12 signaling, and IL-17 signaling. Overexpressed genes in kidney-resident immune cells including macrophages, natural killer T (NKT) cells, monocytes, and dendritic cells were associated with leukocyte activation, chemotaxis, cell adhesion, and complement activation. In addition, the ligand-receptor interactions analysis revealed prominent communications between macrophages and monocytes with other cells in the process of ischemic AKI.@*CONCLUSION@#Together, this study reveals distinct cell-specific transcriptomic atlas of kidney in ischemic AKI patients, altered signaling pathways, and potential cell-cell crosstalk in the development of AKI. These data reveal new insights into the pathogenesis and potential therapeutic strategies in ischemic AKI.

Comparison of the predictive value of anthropometric indicators for the risk of benign prostatic hyperplasia in southern China / 亚洲男科学杂志(英文版)

This study aimed to compare the predictive value of six selected anthropometric indicators for benign prostatic hyperplasia (BPH). Males over 50 years of age who underwent health examinations at the Health Management Center of the Second Xiangya Hospital, Central South University (Changsha, China) from June to December 2020 were enrolled in this study. The characteristic data were collected, including basic anthropometric indices, lipid parameters, six anthropometric indicators, prostate-specific antigen, and total prostate volume. The odds ratios (ORs) with 95% confidence intervals (95% CIs) for all anthropometric parameters and BPH were calculated using binary logistic regression. To assess the diagnostic capability of each indicator for BPH and identify the appropriate cutoff values, receiver operating characteristic (ROC) curves and the related areas under the curves (AUCs) were utilized. All six indicators had diagnostic value for BPH (all P ≤ 0.001). The visceral adiposity index (VAI; AUC: 0.797, 95% CI: 0.759-0.834) had the highest AUC and therefore the highest diagnostic value. This was followed by the cardiometabolic index (CMI; AUC: 0.792, 95% CI: 0.753-0.831), lipid accumulation product (LAP; AUC: 0.766, 95% CI: 0.723-0.809), waist-to-hip ratio (WHR; AUC: 0.660, 95% CI: 0.609-0.712), waist-to-height ratio (WHtR; AUC: 0.639, 95% CI: 0.587-0.691), and body mass index (BMI; AUC: 0.592, 95% CI: 0.540-0.643). The sensitivity of CMI was the highest (92.1%), and WHtR had the highest specificity of 94.1%. CMI consistently showed the highest OR in the binary logistic regression analysis. BMI, WHtR, WHR, VAI, CMI, and LAP all influence the occurrence of BPH in middle-aged and older men (all P ≤ 0.001), and CMI is the best predictor of BPH.

Progress in the Treatment of Adult Langerhans Cell Histiocytosis --Review / 中国实验血液学杂志

Langerhans cell histiocytosis (LCH) is a rare proliferative disease dominated by the proliferation of Langerhans cells, which is inflammatory myeloid neoplasms. Its clinical manifestations are variable, occurring at any age and at any site, and it is rarer in adults than in children. The gold standard for diagnosis is histopathological biopsy. Due to the rarity of adult LCH and the heterogeneity of this disease, treatment of adult LCH should be developed according to the extent of the disease and risk stratification. With the discovery of MAPK, PI3K and c-KIT signaling pathway activation, especially BRAF V600E and MAP2K1 mutations, targeted therapy has become a hot spot for therapeutic research. Meanwhile, the discovery of high expression of M2-polarized macrophages and Foxp3+ regulatory T cells (Treg) in LCH has provided an important basis for the immunotherapy. In this article, we will focus on reviewing the latest research progress in the treatment of adult LCH in recent years, and provide a reference for clinical research on the treatment of adult LCH patients.

Design and Experimental Research of Portable Extracorporeal Circulation Pipeline Performance Testing System / 中国医疗器械杂志

Aiming at the current situation of performance testing of hemodialysis extracorporeal circulation tubing, which has slow efficiency, inaccurate measurement, and inconvenient testing, a portable detection system for testing the performance of hemodialysis extracorporeal circulation tubing is designed. The system mainly includes a hardware system and a software system. The hardware system uses STM32F407 single-chip microcomputer as the core to design the driving control of the roller pump; the software system uses the C++ real-time operating system, and the flow detection data is transmitted to the upper computer through RS485 communication and displayed. Experimental showed that the system detects the accuracy and the stability of the flow rate. It has the characteristics of stability and high precision. The relative error of the experimental measurement is within the range of ±10%. The weight of the whole machine is 2 kg, which improves the efficiency by 50% compared with the traditional detection method.

Tube-in-tube airway management in a patient with Montgomery T-tube in situ -a case report- / 대한마취과학회지

Background@# Montgomery T-tube (MTT) is a useful airway device but is seldom used. Owing to its specific shape and structure, it is challenging for anesthesiologists to manage airway in patients with MTT in situ who require general anesthesia and continuous positive-pressure ventilation (CPPV). Case: A 48-year-old 74-kg man with an MTT in situ was scheduled for local pancreatic resection under general anesthesia. We transorally inserted a cuffed endotracheal tube into the intratracheal limb of the MTT to achieve CPPV and to deliver the inhalation anesthetic. The endotracheal tube was removed successfully after the patient fully recovered from anesthesia. No tracheal injury or hemorrhage occurred after intubation or extubation, and the location of the MTT remained unchanged. @*Conclusions@# Transoral insertion of a cuffed endotracheal tube into the intratracheal limb of the MTT could therefore be considered as a safe and feasible approach for airway management.

Tube-in-tube airway management in a patient with Montgomery T-tube in situ -a case report- / 대한마취과학회지

Background@# Montgomery T-tube (MTT) is a useful airway device but is seldom used. Owing to its specific shape and structure, it is challenging for anesthesiologists to manage airway in patients with MTT in situ who require general anesthesia and continuous positive-pressure ventilation (CPPV). Case: A 48-year-old 74-kg man with an MTT in situ was scheduled for local pancreatic resection under general anesthesia. We transorally inserted a cuffed endotracheal tube into the intratracheal limb of the MTT to achieve CPPV and to deliver the inhalation anesthetic. The endotracheal tube was removed successfully after the patient fully recovered from anesthesia. No tracheal injury or hemorrhage occurred after intubation or extubation, and the location of the MTT remained unchanged. @*Conclusions@# Transoral insertion of a cuffed endotracheal tube into the intratracheal limb of the MTT could therefore be considered as a safe and feasible approach for airway management.

Assessment of growth pattern of preterm infants up to a corrected age of 24 months / 中国当代儿科杂志

OBJECTIVES@#To assess the growth of preterm infants up to a corrected age of 24 months, and to understand the growth trend and pattern of preterm infants.@*METHODS@#A preterm infant follow-up database was established based on the Internet Plus follow-up system. A total of 3 188 preterm infants who were born from April 2018 to April 2021 were enrolled. Their length, weight, and head circumference were recorded at birth and at the corrected ages of 1, 3, 6, 12, 18, and 24 months. The preterm infants were grouped by perinatal factors. The growth curves of these infants were plotted and compared with the International Fetal and Newborn Growth Consortium for the 21st Century (INTERGROWTH-21st) standard and World Health Organization (WHO) standard.@*RESULTS@#The weight, length, and head circumference curves of each group of preterm infants grouped by various perinatal factors all rose rapidly within the corrected age of 6 months, but the growth rate slowed down after the corrected age of 6 months. Based on the actual age for the groups of preterm infants with different gestational ages (<28 weeks, 28-31@*CONCLUSIONS@#The physical growth rate of preterm infants is faster within the corrected age of 6 months, and the growth rate slows down after the corrected age of 6 months. Preterm infants with a smaller gestational age need longer time to catch up in weight and head circumference. More attention should be paid to the physical growth of extremely preterm infants, extremely low birth weight infants, and small-for-gestational-age infants.

Self-assembling dendrimers for biomedical applications / 中国药科大学学报

@#Dendrimers, a special class of synthetic polymers known for their well-defined ramified structures and unique multivalent cooperativity, hold great promise for various biomedical applications. However, preparation of defect-free dendrimers of high-generation on a large scale remains challenging because of the tedious and time-consuming synthesis as well as difficult purification. To overcome these limitations, an alternative strategy based on self-assembling approach has been developed to construct supramolecular dendrimers using small amphiphilic dendrimer-building units. By virtue of the amphiphilic nature, these small dendrimer-building units self-assemble and form large non-covalent supramolecular dendritic structures that mimic high-generation covalent dendrimers. Here, we present a brief overview of the supramolecular dendrimers developed in our group for the delivery of nucleic acid therapeutics, anticancer drug and imaging agents.

Design of Gas Detection System Based on STM32 Infusion Set / 中国医疗器械杂志

Aiming at the low efficiency and low quality detection level of the manual infusion set, a gas detection system for infusion set based on STM32 single-chip microcomputer was designed. The detection system includes hardware system design and software system design. The hardware system is based on the STM32F103 single-chip microcomputer. It mainly designs the gas pressure sensor acquisition circuit and the multi-way solenoid valve control circuit. The software system uses a C ++ real-time operating system to ensure system monitoring's real-time performance and validity. Test data is transmitted to the upper computer and displayed via USB serial communication. The experiment proves that the infusion set gas detection system can perform gas detection on the infusion set. The system has the characteristics of stability and high accuracy. The relative error of the experimental measurement is within ±5%, and the detection efficiency is better than manual detection.

Application of the Children Neuropsychological and Behavioral Scale-Revision 2016 in young children with autism spectrum disorder / 中国当代儿科杂志

OBJECTIVE@#To compare the assessment results of the Children Neuropsychological and Behavioral Scale-Revision 2016 (CNBS-R2016) between young children with autism spectrum disorder (ASD) and global developmental delay (GDD, without ASD) and to explore whether CNBS-R2016 could be helpful to early identification of ASD.@*METHODS@#A total of 260 ASD and 371 GDD children aged 18-30 months were enrolled to finish the assessment of CNBS-R2016. The development quotients (DQs) of the five domains of CNBS-R2016 including gross motor, fine motor, adaptability, language and social behavior were compared between the two groups. The receiver operating characteristic (ROC) curve was used to evaluate the value of the autism-predicted domain in identifying ASD and GDD.@*RESULTS@#The DQs of all the five domains in the ASD group were lower than those in the GDD group (P<0.05). The language DQ and total DQ of the ASD group had a negative correlation with the score of the autism-predicted domain (r=-0.566, -0.552 respectively, P<0.01). When the cut-off value of the autism-predicted domain was 10.5, the largest area under the ROC curve was 0.835, and the sensitivity and specificity for the diagnosis of ASD were 0.750 and 0.798 respectively.@*CONCLUSIONS@#The development of ASD children aged 18-30 months is worse than that of GDD children. CNBS-R2016 may be helpful to distinguish ASD from children with developmental delay.

Clinical Features of Patients with Blastic Plasmacytoid Dendritic Cell Neoplasm / 中国实验血液学杂志

OBJECTIVE@#To analyze the clinical characteristics, pathological features, treatment response and prognosis of patients with blastic plasmacytoid dendritic cell neoplasm (BPDCN), so as to provide reference for reducing clinical misdiagnosis and treatment regimens.@*METHODS@#The clinical, pathological features, treatment regimens and treatment response of 9 patients with BPDCN diagnosed and treated from January 1, 2013 to June 30,2019 in Xiangya Second Hospital of Central South University were analyzed respectively.@*RESULTS@#The most common site of involvement in 9 patients with BPDCN was skin; the pathological features were involvement of dermis, and the highest positive immunohistochemical indexes rate were CD4, CD43, LCA, CD123, and VIM (all 100%), followed by CD56 and CD68, TDT, CD5, PAX-5, CD3, CD8, CD20; MPO and EBER of 9 patients were negative. However, Ki-67 of the 9 patients showed a medican of 77. 5% (40%-90%), which suggests that CD4, CD43, LCA, CD123, and VIM were the most sensitive antigens for diagnosing BPDCN. Of the 9 patients, 2 cases were lost to follow-up, 2 cases were untreated, and 5 cases were treated, in which 2 cases received treatment of regiment for acute lymphoblastic leukemia and 3 cases received treatment of regimen for lymphoma. The PR of clinical symptoms in the first cycle in 5 patients were 100%, and 1 patient has survived for 6 years since the disease was diagnosed.@*CONCLUSION@#BPDCN is a rare and highly invasive lymphoid hematopoietic malignancy. The most common initial symptom of the patients is skin lesions. The most sensitive pathological indicators are CD4, CD43, LCA, VIM, and the BPDCN patients received treatment of regimens for lymphoid tumor show a better response rate.

Determination of six polyphenols in different parts of Queshe tea extracted by different processes by HPLC / 中草药

Objective: To establish HPLC method for the determination of 6'-O-caffeoylarbutin (1), arbutin (2), robustaside A (3), p-hydroxybenzoic acid (4), caffeic acid (5) and caffeic acid methyl ester (6) of Queshe tea. Methods: Using the SunFire® C18 (250 mm×4.6 mm, 5 μm) chromatographic column, mobile phase of acetonitrile-0.1% phosphoric acid aqueous solution, the flow rate at 1.0 mL/min, and column temperature at 30 ℃ to optimum the extraction method of Queshe tea and investigate the linearity, stability and repeatability of the method. Results: With distilled water as the extraction solvent, the highest extraction rate can be obtained by ultrasonic extraction for 20 min. Under the above chromatographic conditions, 6'-O-caffeoylarbutin (1), arbutin (2), robustaside A (3), p-hydroxybenzoic acid (4), caffeic acid (5) and caffeic acid methyl ester (6) have good separation effect, and the experiment has good linearity, stability and repeatability. Conclusion: The method is simple, sensitive and accurate, and can be used for the detection of the above six main chemical components.

Application and effect evaluation of "3-PR" participatory health education model in the improvement of health literacy of secondary health school / 中国学校卫生

Objective@#To compare the effect of two different methods of "3-PR" participatory health education and traditional distribution of publicity materials on health literacy improvement of medical students, to provide a reference for making more effective measure to improve health literacy.@*Methods@#173 Second-grade students in nursing major were selected in a secondary vocational school in Datong City. Two different intervention methods were used to intervene for 8 weeks. The experimental group (92 students) received "3-PR" participatory health education; the traditional health education intervention in the control group(81 students). The "National Residents’ Health Literacy Monitoring Questionnaire 2015" was used to conduct a questionnaire survey on the experimental group and the control group before and after the intervention, and to compare the effects before and after the intervention.@*Results@#The average score of health literacy was (36.04±9.43) points and (36.01±10.17) points before and after intervention in the control group; (35.78±8.91) points and (49.53±13.53) points before and after intervention in the experimental group; No statistical difference between experimental and control group was found before intervention(t=0.18, P=0.86); There was no significant difference in health literacy score before and after intervention for the control group(t=0.03, P=0.98); Health literacy significantly increased in the experimental group after intervention(t=-11.36, P=0.00). Adequate health literacy accounted for 3.70% and 4.94% before and after intervention in the control group and 4.35% and 45.65% in the experimental group before and after intervention. No significant difference was found in adequate health literacy proportion between the two groups before intervention(χ2=0.00, P=1.00). However, the difference showed statistically significant after intervention(χ2=36.58, P=0.00). The change of health literacy score in the control group and the experimental group was (-0.02±7.52) and (12.75±10.77), respectively, accounting for 1.24% decrement and 41.30% increment. The difference between the two groups was statistically significant (t=-8.93, P=0.00). The dimension-and type-specific score of health literacy showed similar pattern.@*Conclusion@#The "3-PR" participatory health education model is more effective than the traditional health education method in improving health literacy, and it could be carried out by multi-disciplinary students.

3D speckle tracking imaging in evaluating severity of coronary artery disease / 中国医学影像技术

Objective: To explore the value of 3D speckle tracking imaging (3D-STI) in evaluating the degree of coronary artery disease in patients with coronary artery disease. Methods Totally 103 patients with suspected coronary artery disease were enrolled. According to the coronary angiography results and Gensini score, the patients were divided into lesion group (n=79) and normal group (Gensini score=0, n=24). Patients in lesion group were then divided into mild subgroup (Gensini score 50, n=13). 3D global longitudinal strain (3D-GLS), 3D global circumferential strain (3D-GCS), 3D global area strain (3D-GAS) and 3D radial strain (3D-GRS) were obtained using 3D-STI and compared between the two groups and among the three subgroups. ROC curve was drawn, and the efficacy of 3D-STI parameters were evaluated for the normal or mild coronary lesions (Gensini score <25) and moderate to severe lesions (Gensini score ≥25). Results: 3D-GLS, 3D-GCS, 3D-GAS and 3D-GRS in the lesion group were lower than those in the normal group (all P<0.05). There were significant differences in the overall strain parameters among the mild, moderate and severe subgroups in the lesion group (all P<0.05). ROC curve results showed that AUC decreased from 3D-GLS (0.929), 3D-GCS (0.873), 3D-GRS (0.853) to 3D-GAS (0.819). Conclusion: 3D-STI has certain value in evaluating the severity of coronary artery disease in patients with coronary artery disease.

A follow-up study of abnormal mutation in neonatal deafness gene screening / 中华耳鼻咽喉头颈外科杂志

Objective@#To screen, diagnose and follow up the abnormal mutation in the gene screening of neonatal deafness.@*Methods@#A total of 24161 newborns born in Zhuhai Maternal and Child Health Hospital from February 1, 2015 to January 31, 2008 were screened for hearing and deafness genes, and audiological screening, diagnosis and 1-3 years follow-up were carried out for the newborns with positive gene screening.@*Results@#There were 991 cases of deafness gene mutation (533 males and 458 females), and the rate of abnormal mutation was 4.10%(991/24 161). Among them, 921 cases were single heterozygous mutation, 130 cases were failed in primary hearing screening, 11 cases were failed in secondary hearing screening, 8 cases were abnormal in audiological diagnosis finally. In these 8 cases, 3 were diagnosed as otitis media and passed audiological follow-up after cure, 2 cases of single ear sensorineural injury caused by high-risk factors, passed after close audiological follow-up, and the other 3 cases were closely audiological follow-up while none of them were successfully sequenced. All of them were moderate to severe sensorineural deafness, 1 case was heterozygous mutation at 3 loci of GJB2(c.235delC,c.408C>A,c.134G>A), 1 case was heterozygous mutation at 2 loci of GJB2(c.235delC, c.109G>A), and 1 case was single heterozygous mutation of GJB2(c.235delC). The remaining 913 cases who passed the primary screening, secondary screening or hearing diagnosis were followed up for 1 to 3 years. Three cases of multiple heterozygous mutation were found in gene screening(2 cases were SLC26A4 2168A>G, IVS7-2A>G, 1 case was GJB2 c.176_191del 16bp, c.299_300del AT), all of them passed both primary and secondary hearing screening. In these 3 cases, the final audiological diagnosis was moderate sensorineural deafness in both ears, with no improvement in the follow-up of 1-3 years. There were 9 monogenic homozygous mutations, 7 failed in primary hearing screening, 3 failed in secondary hearing screening and also failed in audiological diagnosis and 1-3 years′ audiological follow-up, all of whom were GJB2 c.235 del C homozygous mutations, and one of whom had a definite family history of deafness. The remaining 6 cases of homozygous mutation diagnosed by primary screening, secondary screening or hearing diagnosis were GJB2 c109G>A homozygous mutation, and passed the 1-3 years′ hearing follow-up. 58 children with mtDNA mutations, including 2 with 12S rRNA 1494C>T homozygous mutation, 47 with 1555A>G homozygous mutation, and 9 with 1555A>G heterozygous mutation, all passed the primary or secondary hearing screening, and were instructed to ban ototoxic drugs for the whole life, and passed the 1-3 years′ hearing follow-up.@*Conclusions@#The audiological follow-up of children with monogenic heterozygous mutations in deafness gene screening is generally normal. In case of abnormality, the influencing factors such as otitis media should be excluded at first. In case of unexplained moderate to severe sensorineural deafness, the whole-gene sequencing should be performed to find possible pathogenic factors. The children with homozygous mutation or compound heterozygous mutation in gene screening, most of whom show different degrees of hearing loss, should be followed up for a long time, and provide parents with scientific and reasonable genetic counseling according to the mutation genes and loci,. The hearing of drug-induced deafness gene carriers is normal after birth. Parents should be advised to strengthen prevention and follow-up is generally enough.

Changes in serum IL-22 level in patients with hypertensive renal damage and its clinical significance / 中南大学学报(医学版)

To observe the changes in serum interleukin-22 (IL-22) level and its correlation with other clinical indexes in patients with essential hypertension and hypertensive renal damage, and to investigate its effects and clinical significance.
 Methods: A total of 97 essential hypertension (EH) patients and 40 healthy control were enrolled in this study. The EH patients were divided into a simple hypertension (SH) group (n=45) and a hypertensive renal damage (HRD) group (n=52) according to 24 h urinary protein (24 h-UPRO) level. Basic clinical data were collected; serum IL-22 level was detected by enzyme-linked immunosorbent assay (ELISA); the proportion of Th22 cells in peripheral blood was evaluated by flow cytometry (FCM); and serum high sensitivity C-reactive protein (hs-CRP) concentration was measured by immune turbidimetry. Correlation analysis was applied between serum IL-22 level and other indexes.
 Results: Serum IL-22 level and Th22 cell proportion in patients with hypertension were significantly higher than those in the healthy controls (all P<0.01). Compared with the SH group, serum IL-22 level and Th22 cell proportion were significantly elevated in the HRD group (P<0.01, P<0.05, respectively). Bivariate linear correlation analysis revealed that serum IL-22 level was positively correlated with systolic blood pressure (SBP), diastolic blood pressure (DBP), and hsCRP (r=0.367, P<0.01; r=0.402, P<0.01; r=0.329, P<0.05); there was also a positive correlation between serum IL-22 concentration and Th22 cell proportion (r=0.478, P<0.01) in the SH group. Serum IL-22 level was positively correlated with 24 h-UPRO level (r=0.318, P<0.05) in the HRD group.
 Conclusion: Serum IL-22 level and peripheral blood Th22 cells are significantly increased in the HRD group compared with the SH group. Serum IL-22 level is closely correlated with extent of hypertensive renal damage, indicating that serum IL-22 level may involve in the pathogenesis of hypertensive renal damage.

Study on risk factors of catheter-related venous thrombosis and prevention effect of low-molecular-weight heparin in patients with hematological malignancies / 肿瘤研究与临床

Objective@#To investigate the incidence and risk factors of catheter-related venous thrombosis (PICC-DVT) after peripherally inserted central catheter (PICC) in patients with hematologic malignancies, and to analyze the safety of anti-coagulation therapy with low-molecular-weight heparin.@*Methods@#From August 2016 to June 2018, 43 patients with hematologic malignancies received PICC in Baoan District People's Hospital of Shenzhen City were enrolled. The patients were divided into low-molecular-weight heparin anticoagulation group (22 cases) and blank control group (21 cases) according to the random number table method. The blood routine, coagulation quadruple, D-dimer, protein C activity, protein S activity, and antithrombin Ⅲ activity before and after catheterization were compared between the two groups.@*Results@#Of the 43 patients, 5 cases (11.62%) occurred PICC-DVT within 1 month after PICC, including 2 cases (9.09%) in the low-molecular-weight heparin anticoagulation group, and 3 cases (14.29%) in the blank control group, the difference between the two groups was not statistically significant (P = 0.664). No pulmonary embolism occurred in all patients with PICC-DVT. One case in the blank control group developed PICC-DVT and catheter-associated staphylococcus aureus infection, the patient was extubated after anti-infection and thrombolytic therapy, the other patients with PICC-DVT were not extubated, and the thrombus was dissolved after anticoagulant therapy. There were no significant differences in the white blood cell count, platelet count, prothrombin time, activated partial thromboplastin time, D-dimer, protein C activity, protein S activity, and antithrombin Ⅲ activity between the low-molecular-weight heparin anticoagulation group and blank control group (all P > 0.05). The anticoagulant index (protein C, protein S or antithrombin Ⅲ activity) was decreased in 5 patients with PICC-DVT, and in 38 non-thrombotic patients, the anticoagulant index was reduced in 16 patients (42.11%), the difference was statistically significant (P = 0.021).@*Conclusions@#The incidence of protein C, protein S or antithrombin Ⅲ activity reduction in hematological malignancies patients with PICC-DVT is higher than that in non-thrombotic patients. Low-molecular-weight heparin anticoagulant therapy can not reduce the occurrence of PICC-DVT within 1 month after PICC in patients with hematological malignancies, but the treatment is safe and has no relevant bleeding event.