Non-targeted screening of emerging contaminants in drinking water based on high-resolution mass spectrometry / 上海预防医学

ObjectiveTo establish a non-targeted screening method for emerging contaminants in drinking water based on high-resolution mass spectrometry and apply it to actual water samples. MethodsA total of 9 drinking water samples collected from 3 reservoirs in Shanghai were purified and concentrated by HLB solid phase extraction column， then separated and analyzed by liquid chromatography high-resolution mass spectrometer and gas chromatography high⁃resolution mass spectrometer. The acquired data were analyzed by Thermo Tracefinder， Excel and other software combined with mzCloud and NIST databases. The methodology was verified with representative compound standards. Pesticide and perfluorinated compounds were taken as examples to analyze their pollution status. ResultsA non-targeted analysis strategy based on liquid chromatography and gas chromatography tandem high-resolution mass spectrometry was established. The pollution level of 20 kinds of pesticides and 4 kinds of perfluorinated compounds identified in 9 drinking water samples were higher in the Huangpu River than in the Yangtze River estuary. ConclusionThe established non-targeted screening method by high-resolution mass spectrometry can detect potential emerging contaminants in drinking water without relying on the standards， which provides a powerful technical means for water quality monitoring and risk assessment.

Determination of 9 halogenated alkanes in toothpaste by GC⁃MS / 上海预防医学

ObjectiveTo establish a GC-MS method for the detection of 9 halogenated alkanes in toothpastes. MethodsVarious brands of toothpastes on the market were collected as the samples. Methanol was used as the extraction solution. After shaking， vortex and centrifugation， the supernatant was filtered by 0.45 μm microporous filter membrane. The content of 9 halogenated alkanes including chloromethane， dichloromethane， chloroform， 1，1，1-trichloroethane， carbon tetrachloride， 1，2-dichloroethane， 1，1，2-trichloroethane， 1，2-dibromoethane， 1，2，3-trichloropropane in the filtrate were determined by GC-MS. ResultsThe 9 halogenated alkanes showed a good linear relationship in the concentration range of 0.03‒1.00 μg·mL-1. The correlation coefficient was ≥0.998 7 with the detection limits of 0.015‒0.056 mg·kg-1. The spiked recoveries were 83.2%‒108.9% with the RSD of 2.0%‒9.8%. In the actual sample analysis， 1，1，2-trichloroethane and 1，2，3-trichloropropane were respectively detected in 6 toothpaste samples from 5 brands. ConclusionThe method is simple， sensitive， accurate， and has good spiked recoveries. It can be used for the determination of halogenated alkanes in toothpastes.

Analysis of Salmonella contamination and pathogenic characteristics in raw poultry meats in Jiading District， Shanghai in 2021 / 上海预防医学

ObjectiveTo investigate the contamination status， serotype distribution and drug resistance of Salmonella in retail poultry in Jiading District， Shanghai. MethodsFour types of poultry （chicken， duck， goose and pigeon） have been sampled from commercial markets. Salmonella contamination has been isolated and identified using serotype analysis. Furthermore， resistance of isolated Salmonella strains towards 16 commonly used antibiotics has been determined. ResultsA total of 60 Salmonella strains were isolated from 80 poultry samples. The detection rates of Salmonella in pigeon， goose， duck and chicken were 86.67%， 81.82%， 72.73% and 59.38%， respectively. Contamination status has been categorized by storage conditions. Lowest detection rate （65.63%） has been noted in poultry samples under refrigeration storage. The majority serotypes of Salmonella have been revealed as Salmonella typhimurium， Salmonella enteritidis and Salmonella corvallis. Relatively higher drug resistance was discovered with tetracycline， nalidixic acid， ampicillin and chloramphenicol， with drug resistance rate of 60.00%， 58.33%， 50.00% and 48.33%， respectively. Low drug resistance was revealed with cefotaxime. In addition， these Salmonella strains were completely sensitive to imipenem. Significant difference in drug resistance was identified across the types of poultry or Salmonella serotypes. The 11.67% of Salmonella strains were non-resistant to any tested drugs. Multi-drug resistant strains accounted for 46.67% of isolated strains， which were resistant to 13 different antibiotics. Ampicillin-tetracycline or chloramphenirol-cefazolin drug resistance pattern suggested that the Salmonella strain was multi-drug resistant. ConclusionSalmonella contamination remains high in retail poultry in Jiading District， Shanghai. Drug resistance to antibiotics is increasing. Therefore， monitoring and control of Salmonella should be strengthened.

Analysis of Campylobacter spp. contamination and drug resistance in poultry sold in Jiading District， Shanghai from 2019 to 2021 / 上海预防医学

ObjectiveTo investigate the contamination status and drug resistance of Campylobacter spp. in poultry sold in Jiading District， Shanghai. MethodsFour types of poultry meats （chickens， ducks， geese and pigeons） were sampled from commercial markets， and potential Campylobacter spp. contamination was isolated and identified. Furthermore， resistance of isolated Campylobacter spp. to 15 commonly used antibiotics was tested. ResultsTotally 29 Campylobacter jejuni strains and 34 Campylobacter. coli were isolated from 236 commercial poultry samples. The most severe contamination of Campylobacter spp. was found in chicken samples， with a detection rate of 34.04%， while the lowest detection rate of Campylobacter spp. was found in duck （19.67%）. Contamination status was categorized with different storage conditions. The lowest detection rate of 6.67% was noted under frozen condition， while highest detection rate of 41.27% was noted under cold storage. Campylobacter jejuni was completely resistant to cefazolin， ciprofloxacin， nalidixic acid and tetracycline， and Campylobacter coli was completely resistant to cefazolin， cefoxitin and nalidixic acid； Campylobacter spp. showed the lowest resistance to imipenem. Multi-drug resistant strains accounted for 100.00% of the isolated strains. 96.83% of the strains were resistant to more than 5 drugs， with the highest number reaching 14 kinds of antibiotics. ConclusionThere is a significant difference in the contamination status and drug resistance of Campylobacter spp. isolated from four types of poultry meats sold in Jiading District， Shanghai， and the drug resistance is serious. It is strongly recommended that the use of antibiotics should be strictly controlled. Freezing can effectively reduce Campylobacter spp. pollution.

Enterotoxin gene profiles of Staphylococcus aureus isolated from environment and patients in a hospital in Shanghai from 2018 to 2021 / 上海预防医学

ObjectiveTo investigate the prevalence of Staphylococcus aureus in a hospital in Jiading District， Shanghai， and to determine the enterotoxin gene profiles of Staphylococcus aureus isolated from patients and environment. MethodsSpecimens were collected from environment and patients from a hospital for Staphylococcus aureus isolation and identification. Furthermore， enterotoxin genes （SEA‒SEE） of Staphylococcus aureus were detected. ResultsA total of 54 Staphylococcus aureus strains were isolated from 780 hospital environmental specimens from 2018 to 2021， with a prevalence of 6.92%. In the armrests in the wards， patient’s pillows/quilts， and bedside cupboards， the prevalence was determined to be 20.00%， 20.00% and 16.67%， respectively. In contrast， in the computer’s mouse and keyboard and work clothes of physicians and nurses， the prevalence was 17.42% and 16.67%， respectively. Meanwhile， from 2018 to 2021， a total of 75 strains were collected from patients， of which 36.00%， 14.67% and 14.67% were from the departments of intensive care medicine （ICU）， neurosurgery and orthopedics， respectively. The prevalence of Staphylococcus aureus enterotoxin genes were 48.15% and 61.33% in the environment and patients， respectively. Furthermore， the prevalence of SEA， SEB， SEC， SED， and SEE genes were 14.67%， 41.33%， 9.33%， 1.33%， 1.33% in patients， respectively ， whereas 20.37%， 25.93%， 1.85 %， 1.85% and 0% in environmental specimens， respectively. In the environmental specimens isolated from comprehensive ICU， the prevalence of enterotoxin genes was 77.27%. In the patient's specimens， Staphylococcus aureus was mostly isolated in sputum. Additionally， the prevalence of enterotoxin genes was high in the patients of departments of respiratory medicine， ICU， and orthopedics. ConclusionPrevalence of Staphylococcus aureus remains moderate in the hospital environment. Enterotoxin genes of Staphylococcus aureus are common， with seb gene as the most common gene， followed by SEA gene. It warrants strengthening the disinfection and control of Staphylococcus aureus in the hospital， especially in the ICU.

Construction and application of rational drug use database for children in our hospital / 中国药房

OBJECTIVE To establish a database of rational drug use for children in our hospital， and to provide reference for ensuring the safety of drug use in children. METHODS The construction and filling of the knowledge base of rational drug use for children were performed by establishing the basic structure of the knowledge base， formulating reference standards for the quality level of pediatric medication evidence， and refining evidence-based evidence of pediatric medication. The rule base of rational drug use for children was designed and built from four aspects： preliminary determination rules for patient information， basic drug information rules， prescription suitability review rules， result labeling and post-processing rules. The database was embedded into prescription review system of our hospital and was applied online to test its effectiveness. RESULTS A set of database containing 672 commonly used pediatric medicines and more than 15 000 rules for rational drug use for children was initially constructed. The average interception rate of unreasonable medical orders for hospitalized children after database application（from December 2021 to May 2022）was 2.03%， and was higher than 0.80% before database application（from June 2021 to November 2021）（χ 2＝5 784.389， P＜0.001）； after post-sampling and prescription review， the average qualified rate of medication orders in discharged medical records for children after the application of the database was 99.10%， and was higher than 94.58% before the application of the database （χ 2＝301.237， P＜0.001）. CONCLUSIONS Self-constructed evidence-based rational drug use database for children is close to the actual clinical needs of pediatrics in medical institutions， which can effectively reduce clinical irrational drug use behaviors in pediatrics， improve the pass rate of prescriptions， and ensure the safety of children’s drug use.

Exposure level of neonicotinoid pesticides and their metabolites in pregnant women in the suburb of Shanghai / 中华预防医学杂志

In 2021, a total of 151 pregnant women were selected from the suburb of Shanghai. A questionnaire survey was conducted to obtain data about maternal age, gestational week, total annual household income, education level and passive smoking among pregnant women and one spot urine was collected. The concentrations of eight neonicotinoid pesticides and four metabolites in urine were measured by ultra-high performance liquid chromatography-tandem quadrupole time-of-flight mass spectrometry. The differences in detection frequencies and concentrations of neonicotinoid pesticides and their metabolites among pregnant women with different characteristics were compared, and the influencing factors of the detection of neonicotinoid pesticides in urine were analyzed. The results showed that at least one neonicotinoid pesticide was detected in 93.4% (141 samples) of urine samples. The detection frequencies of N-desmethyl-acetamiprid, clothianidin, thiamethoxam, and N-desmethyl-clothianidin were high, about 78.1% (118 samples), 75.5% (114 samples), 68.9% (104 samples), and 44.4% (67 samples), respectively. The median concentration of the sum of all neonicotinoid pesticides was 2.66 μg/g. N-desmethyl-acetamiprid had the highest detection concentration with a median concentration of 1.04 μg/g. A lower urinary detection frequency of imidacloprid and its metabolites was seen in pregnant women aged 30-44 years [OR (95%CI): 0.23 (0.07-0.77)]. A higher detection frequency of clothianidin and its metabolites was seen in pregnant women with per capita annual household income≥100 000 yuan [OR (95%CI): 6.15 (1.56-24.28)]. There was widespread exposure to neonicotinoid pesticides and their metabolites in pregnant women from the suburb of Shanghai, which might pose potential health risks to pregnant women, and maternal age and household income were potential influencing factors of the exposure to neonicotinoid pesticides.

Analysis of salmonella drug resistance in poultry sold in Jiading District from 2019 to 2020 / 上海预防医学

ObjectiveTo investigate the contamination situation， serotype distribution and drug resistance of salmonella in poultry sold in Jiading District， Shanghai. MethodsBetween 2019 and 2020， four types of poultry meat （chicken， duck， goose and pigeon） were sampled from markets， and potential salmonella contamination was isolated and identified via serotyping. Furthermore， resistance detection of isolated salmonella to 13 commonly-used antibiotics was conducted. ResultsA total of 32 salmonella strains were isolated from 156 commercial poultry samples. No salmonella was identified in pigeon samples， while the most severe contamination was detected in goose samples， with a detection rate of 28.00%. Contamination situation was categorized with different storage conditions. The lowest detection rate of 12.90% was noted under cold storage， while the highest rate of 26.67% was detected under frozen condition. The major serotypes of salmonella were Salmonella typhimurium， Salmonella enteritidis and Salmonella Argonne. Relatively higher drug resistance was detected with nalidixic acid and tetracycline， with drug resistance rate of 59.38% and 40.63%， respectively. Low drug resistance was detected with cephalosporins， and no drug resistance was detected with imipenem. Significant difference in drug resistance was noted in the serotype of Salmonella isolated from meat of chicken， duck and goose. Three major salmonella strains had different drug resistance. 21.88% （7/32） of salmonella strains were non-resistant to any tested drugs. Multi-drug resistant strains accounted for 31.25% （10/32） of the isolated strains. At most， salmonella was resistant to 11 kinds of different antibiotics. ConclusionThere is a significant difference in the contamination situation and drug resistance of Salmonella isolated from four types of poultry meat sold in Jiading District， Shanghai. It is strongly recommended that different supervision strategies and management upon classification be implemented.

Effect of exposure to typical phthalate esters on estrogen homeostasis during pregnancy / 上海预防医学

ObjectiveTo study the relationship between the exposure to two kinds of phthalate esters （PAEs） ［Di-N-butyl phthalate，（DBP） and Di-（2-ethylhexyl）phthalate （DEHP）］ and estrogen homeostasis in pregnant women. MethodsIn 2021， we classified the Jiading District of Shanghai into five geographical areas， east， west， south， north and central. A total of 151 pregnant women from each area were selected for questionnaire survey， with random urine samples during first， second， and third trimesters collected. A DBP metabolite ［Mono-N-butyl phthalate （MBP）］ and two DEHP metabolites ［Mono（2-ethylhexyl） phthalate （MEHP）， Mono（2-ethyl5-oxohexyl） phthalate， （MEOHP）］ and three estrogens ［estrone （E1）， 17β -estradiol （E2）， and estriol （E3）］ in urine were determined by ultra-performance liquid chromatography tandem quadrupole time-of-flight mass spectrometry. After a natural logarithmic transformation of PAEs metabolite levels and estrogen concentration， multivariable linear regression was used to control potential confounders and determine the relationship between PAEs metabolite levels and estrogen concentration. ResultsThe detection rates of three PAEs metabolites in urine of pregnant women were more than 98%. The median corrected concentrations of MBP， MEHP and MEOHP were 5.18， 0.59 and 4.23 mg·kg-1， respectively. During the whole pregnancy， MEOHP was positively correlated with E1 （β=0.450， 95%CI： 0.057‒0.844）， and MBP was positively correlated with E3 （β=0.250， 95%CI： 0.034‒0.465）. Stratified by trimesters， MBP was positively correlated with E3 in the first trimester （β=0.428， 95%CI： 0.103‒0.752）. MEOHP was positively correlated with E1 in the second trimester （β=0.734， 95%CI： 0.130‒0.752）， and had a possitive trend with E1 in the third trimester （β=0.744， 95%CI： -0.140‒1.629）. In addition， MEHP had a negative correlation with E1 in the second trimester （β=-0.498， 95%CI： -1.063‒0.066）. MEOHP had a positive correlation trend with E2 （β=0.628， 95%CI： -0.101‒1.356） in the third trimester. ConclusionPAEs exposure may interfere with estrogen homeostasis during pregnancy and differs by trimesters. Given the cross-sectional nature of this study， it warrants further study to validate the findings.

Application of three-dimensional visualization technique in laparoscopic D3 radical resection of right colon cancer / 南方医科大学学报

OBJECTIVE@#To explore the clinical value of three-dimensional (3D) visualization technique in laparoscopic D3 radical resection of right colon cancer.@*METHODS@#We retrospectively analyzed the clinical data of 73 patients with right colon cancer undergoing laparoscopic D3 radical operation in our hospital between May, 2019 and March, 2021. Among these patients, 41 underwent enhanced CT examination with 3D visualization reconstruction to guide the actual operation, and 32 underwent enhanced CT examination only before the operation (control group). In 3D visualization group, we examined the coincidence rate between the 3D visualization model and the findings in surgical exploration of the anatomy and variations of the main blood vessels, supplying vessels of the tumor, and the tumor location, and the coincidence rate between the actual surgical plan for D3 radical resection of right colon cancer and the plan formulated based on the 3D model. The operative time, estimated blood loss, unexpected injury of blood vessels, number of harvested lymph nodes, mean time of the first flatus, complications, postoperative hospital stay and postoperative drainage volume were compared between the two groups.@*RESULTS@#The operative time was significantly shorter in 3D visualization group than in the control group (P < 0.05). The volume of blood loss, proportion of unexpected injury of blood vessel, the number of harvested lymph nodes, time of the first flatus, proportion of complications, postoperative hospital stay and postoperative drainage volume did not differ significantly between the two groups (P > 0.05). In the 3D visualization group, the 3D visualization model clearly displayed the shape and direction of the colon, the location of the tumor, the anatomy and variation of the main blood vessels and the blood vessels supplying the cancer, and showed a coincidence rate of 100% with the findings by surgical exploration. The surgical plan for D3 radical resection of right colon cancer was formulated based on the 3D model also showed a coincidence rate of 100% with the actual surgical plan.@*CONCLUSION@#The 3D visualization reconstruction technique allows clear visualization the supplying arteries of the tumor and their variations to improve the efficiency, safety and accuracy of laparoscopic D3 radical resection of right colon cancer.

Anti-asthmatic effect of agarwood alcohol extract in mice and its mechanism / 中国中药杂志

As recorded, agarwood has the function of improving qi reception and relieving asthma, but the underlying mechanism is unclear and rarely reported. Therefore, this study explored the anti-asthmatic effect of the alcohol extract of agarwood produced by the whole-tree agarwood-inducing technique(Agar-Wit) in the asthma mouse model induced by intraperitoneal injection of ovalbumin(OVA) + Al(OH)_3 combined with intranasal administration of OVA and the mechanism, and compared the anti-asthmatic effects of agarwood induced with different methods. Firstly, the anti-inflammatory and anti-asthmatic effects of Agar-Wit agarwood in mice were evaluated based on the asthma frequency, lung tissue injury, and peripheral inflammatory white blood cell(WBC) count and eosinophil count. Then, the levels of interleukin-1β(IL-1β), IL-17, and IL-10 in serum of mice were detected by enzyme-linked immunoassay(ELISA) and the expression of inflammation-and apoptosis-related genes in tissues was measured by reverse transcription polyme-rase chain reaction(RT-PCR) so as to preliminarily explore the anti-asthmatic mechanism. RESULTS:: showed that the alcohol extract of Agar-Wit agarwood significantly reduced asthma frequency, relieved pathological injury, improved peripheral WBC count and eosinophil count, decreased the levels of inflammatory cytokines IL-1β and IL-17, elevated the level of anti-inflammatory cytokine IL-10, and down-regulated the mRNA expression of IL-1 R, tumor necrosis factor receptor R(TNFR), nuclear transcription factor-kappa B(NF-κB), Bax, and caspase 3, but had no significant influence on the expression of high-mobility group box 1(HMGB1) protein, caspase 8, and Bcl-2. The effect of Agar-Wit agarwood alcohol extract was better than that of wild agarwood alcohol extract and alcohol extract of agarwood induced with the burning-chisel-drilling method at the same dose. In conclusion, Agar-Wit agarwood can significantly alleviate inflammation and asthma, which is related to its anti-inflammation and anti-apoptosis activity.

The prevalence of gout and related factors in community population / 中华内分泌代谢杂志

Objective:To explore the prevalence of gout and related factors in community population, thereby provide evidence for comprehensive prevention and control of gout in community.Methods:A stratified multi-stage cluster sampling was used to survey the permanent residents of 20 to 75 years old in the 3 selected streets (towns), univariate analysis was performed using logistic regression by SPSS statistical software.Results:The prevalences of hyperuricemia and gout were 9.82% and 5.75% respectively(male 18.88% and 7.94%, female 3.79% and 4.29%)in Jiading Shanghai. The positive rate of family history was 17.13%, and the relationship between family history and gout was significant( OR=3.140, 95% CI 2.365-4.169, P<0.01). Age( OR=1.034, 95% CI 1.021-1.047), body mass index ( OR=1.102, 95% CI 1.074-1.131), waist-hip ratio ( OR=4.876, 95% CI 1.153-20.622), sleep quality ( OR=1.310, 95% CI 1.159-1.480), other animal meat ( OR=1.117, 95% CI 1.007-1.240), fresh water fish ( OR=1.138, 95% CI 1.005-1.288), and processed meat ( OR=1.145, 95% CI 1.033-1.270) were closely related to gout ( P<0.05 or P<0.01). Sex, alcohol drinking, marine fish, and soybean milk/soymilk were related to gout ( P<0.05 or P<0.01), but showed a protective effect ( OR<1.000). Conclusion:Reducing uric acid production through less consumption of purine-rich food such as animal meat as well as processed meat and weight control would be helpful in preventing gout.

Association of diet and physical activity with myopia among middle school students in Jiading District, Shanghai / 上海预防医学

Objective To explore the association between daily diet and physical activity with myopia in middle school students in Shanghai, so as to provide evidence for the prevention of myopia. Methods A stratified cluster random sampling of 795 students from two middle schools and one high school in Jiading District of Shanghai was selected. Data was extracted from 2017 adolescent health related behaviors surveillance in Shanghai. Results The reported rate of myopia among middle and high school students was determined to be 57.2%. The proportion of middle school students reporting no drinking soda, no eating desserts and no eating fried foods during the past week were 45.2%, 16.4% and 31.1%, respectively. The proportion of reporting eating fresh fruit, eating vegetables, drinking a cup of milk or yogurt among middle school students every day were 45.8%, 73.2% and 40.7%, respectively. The proportion of physical activity over 60 minutes and moderate intensity exercise over 30 minutes every day were 25.6% and 15.4%, respectively. The proportion of no drinking soda, no eating fried foods, eating fresh fruit every day, eating vegetables every day, and physical activity over 60 minutes during the past week in the non-myopia group were significantly higher than those in the myopia group(P < 0.01). Middle school students eating fresh fruit every day and physical activity over 60 minutes every day were determined to be protective factors for myopia(P < 0.01). Conclusion The proportions of Middle and high school students in Shanghai reporting healthy diet and physical activity are relatively low. Healthy diet and sufficient physical activity may be protective against myopia.

Abnormally expressed lncRNAs in the prognosis and clinicopathology of oesophageal cancer: a systematic review and meta-analysis

The relationship between the long noncoding RNA (lncRNA) expression and oesophageal cancer prognosis has been widely studied, but less consensus has been reached. We conducted this study to evaluate the relationship between the expression of lncRNAs and the prognosis and clinical pathology of oesophageal cancer. We conducted a systematic search of PubMed, EMBASE and Cochrane Library until 25 January 2019. Studies that evaluated the associations of a specific lncRNA with survival and/or clinicopathology of oesophageal cancer were included. Pooled hazard ratios (HRs), odds ratios (ORs), and corresponding 95% confidence intervals (CIs) were calculated using fixed or random-effect models. Sensitivity analysis was used to verify the stability of results. Publication bias was detected using Begg tests and adjusted utilizing the trim-and-fill method if a bias existed. A total of 51 studies comprising 6510 patients and regarding 41 lncRNAs were included in the present systematic review and meta-analysis. The results showed that dysregulation of lncRNAs was associated with overall survival, disease-free survival, and progression-free survival. The expression of lncRNAs was related to some certain clinicopathological parameters of oesophageal cancer, including tumour size, T classification, lymph node metastasis, tumour node metastasis (TNM) stage and differentiation. Among these findings, lncRNA AK001796, CASC9, HOTAIR, MALAT1 and UCA1 were identified and were expected to be ideal biomarkers for the prognosis and clinicopathology of oesophageal cancer. Although significant publication bias was observed in some studies, the results were not changed after adjustment using the trim-and-fill method. Abnormal lncRNA-expression profiles could serve as a promising indicator for prognostic evaluation of patients with oesophageal cancer. The combination of these lncRNAs will contribute to clinical decision-making in the future.

Botulinum toxin type A injections in the facial plastic surgery incision: a meta-analysis / 中华医学美学美容杂志

Objective:To systematically evaluate the influence of botulinum toxin type A (BTXA) injections in the facial plastic surgery incision.Methods:A systematic literature search for studies which were published on PubMed, EMbase, Cochrane Central, CNKI and VIP, was performed from January 1998 to Octomber 2019. " Facial wound" , " Keloid" , " Scar" , " Cicatrix hypertrophy" , " Botulinum toxin" , " Boutulin" , " Botox" were set as the key words. We included trails related to the influence of botulinum toxin type A (BTXA) injections in the facial plastic surgery incision. The data were extracted and Rev Man 5.3 was used for meta-analysis.Results:Participants included seven randomized controlled trial of 450 patients. The Vancouver scar scale score of BTXA group was higher than those in the control group ( Z=23.92, P<0.01). The visual analogue scale score of BTXA group was higher than that of the control group ( Z=8.60, P<0.01). The scar width of BTXA group was less than that in the control group ( Z=10.84, P<0.01). Patients＇ satisfactory rate of BTXA group was higher than that of the control group ( Z=2.83, P<0.01). Conclusions:The injection treatment of BTXA for facial hyperplastic scar has certain curative effect, without obvious side effects, but the authenticity and stability of therapeutic effect have to be verified by more high quality research.

Keloidal cutaneous fibrohistiocytic tumor: a clinical analysis / 中华医学美学美容杂志

Objective:To investigate the clinical and pathological features and immunophenotyping of keloidal cutaneous fibrous histiocytoma (FH) and dermatofibrosarcoma protuberans (DFSP) to provide evidence for clinical diagnosis and treatment.Methods:The clinical data were colleceted from March 2015 to March 2019 and retrospectively analyzed, including 12 cases of FH, 5 males and 7 females, aged 14-76 years, with average age (37.67±17.71) years and 9 cases of DFSP, 5 males and 4 females, aged 19-64 years, with average age (42.56±13.82) years. The clinical manifestations, histopathological features and immunophenotyping of FH and DFSP were compared.Results:The clinical manifestations of all cases were keloid-like lesions. All patients underwent surgical treatment. 12 cases of FH were diagnosed in the postoperation routine pathological examination and immunohistochemical staining, CD68 was positive in 10 cases, 9 cases of SMA were positive and all of S-100 were negative. 9 cases of DFSP were diagnosed and 2 cases were fibrosarcomatous DFSP among them. For the 7 cases of DFSP, CD34 were all positive, 5 cases of CD68 were negative, 6 cases of SMA were negative. For 2 cases of fibrosarcomatous DFSP, CD34, CD68 and SMA were all negative. During the follow-up period from 6 months to 4 years, there was no recurrence of FH cases, and 3 cases of DFSP recurred, 2 cases were fibrosarcomatous DFSP among them, and 1 case of fibrosarcomatous DFSP presented distant metastasis.Conclusions:The clinical manifestations and pathological features of some FH and DFSP are similar to keloids in a certain extent, and there is a little difficulty for clinical differential diagnosis. Early diagnosis and standardized treatment are crucial for prognosis.

Early treatment of suspension moxibustion for Bell's palsy in acute stage / 中国针灸

OBJECTIVE@#To observe the efficacy of early treatment of suspension moxibustion for Bell's palsy and its influence on the prognosis, and to explore whether the early treatment of suspension moxibustion has non-inferiority effect to hormone treatment and whether suspension moxibustion combined with hormone treatment has the synergistic effect.@*METHODS@#A total of 132 patients with acute-stage Bell's palsy were divided into a hormone group (94 cases) and a moxibustion group (38 cases) by non-random method, and the hormone group was further randomly divided into a hormone with moxibustion group (48 cases) and a hormone without moxibustion group (46 cases). The acupuncture and oral administration of mecobalamin capsule were used as basic treatment. Acupuncture was applied at Yangbai (GB 14), Sibai (ST 2), Quanliao (SI 18), Dicang (ST 4), Jiache (ST 6), Yifeng (TE 17), etc., with the needles retained for 30 min, once a day, 5 consecutive days per week; there was an interval of 2 days between two weeks, and a total of 4-week treatment was given. The oral administration of mecobalamin capsule was given 0.5 mg each time, 3 times a day for 4 weeks. The patients in the moxibustion group, on the basis of basic treatment, were treated with the suspension moxibustion at Yangbai (GB 14), Sibai (ST 2), Dicang (ST 4), Jiache (ST 6), Wangu (GB 12), Yifeng (TE 17) of affected side, 5 min per acupoint, once a day, 5 consecutive days per week; there was an interval of 2 days between two weeks, and a total of 4-week treatment was given. The patients in the hormone without moxibustion group, on the basis of basic treatment, were treated with prednisone acetate tablets. The patients in the hormone with moxibustion group, on the basis of basic treatment, were treated with suspension moxibustion and prednisone acetate tablets. All the treatment was given for 4 weeks. The House-Brcackmann facial nerve grading (H-B) global score and facial disability index (FDI) scale were used to evaluate the curative effect in the three groups before treatment, 2 weeks and 4 weeks into treatment and 4 weeks after treatment; the efficacy was compared among the three groups.@*RESULTS@#Compared before treatment, the H-B grading and FDI scores were significantly improved 2 weeks and 4 weeks into treatment and 4 weeks after treatment (0.05); the H-B grading and FDI scores in the hormone with moxibustion group were superior to those in the moxibustion group and the hormone without moxibustion group 4 weeks into treatment and 4 weeks after treatment (0.05). At the end of follow-up, the cured rate in the hormone with moxibustion group was 81.3% (39/48), which was superior to 68.4% (26/38) in the moxibustion group and 60.9% (28/46) in the hormone without moxibustion group (0.05).@*CONCLUSION@#The three treatment methods are all safe and effective for acute-stage Bell's palsy. The suspension moxibustion combined with hormone therapy are superior to suspension moxibustion or hormone therapy alone. Early treatment of suspension moxibustion is safe and effective for Bell's palsy, and has obvious synergistic effect with hormone. For the patients who cannot use hormone, suspension moxibustion could replace hormone, which is non-inferior to hormone.

Identification of a de novo MAP2K1 gene variant in an affected patient with Cardio-facio-cutaneous syndrome / 中华医学遗传学杂志

OBJECTIVE@#To explore the genotype-phenotype correlation of Cardio-facio-cutaneous syndrome (CFCS) caused by MAP2K1 gene variants.@*METHODS@#Genomic DNA was extracted from peripheral blood sample from a child patient and his parents. Whole exome sequencing (WES) was carried out for the patient. Suspected variant was verified by Sanger sequencing.@*RESULTS@#The patient was a 1-year-8-month old Chinese male who manifested short stature, psychomotor retardation, relative macrocephaly, distinctive facial features, and congenital heart disease. WES test revealed a heterozygous missense c.389A>G (p.Tyr130Cys) variant in the MAP2K1 gene. Sanger sequencing has confirmed the variant as de novo. According to ACMG/AMP guidelines, the variant was classified as pathogenic.@*CONCLUSION@#Compared with previously reported CFCS cases due to MAP2K1 variants. The patient showed obvious behavioral problems, good appetite and tricuspid regurgitation, which may to be novel features for CFCS.

Predictive value of obesity measurement index for H-type hypertension / 中国医师杂志

Objective By investigating the obesity of the adult population in Hunan,we explored the relationship between body mass index (BMI) [including waist circumference (WC),waist-to-hip ratio (WHR),waist-to-body ratio (WHtR) and H-type hypertension] in predicting H-type hypertension.Methods A multi-stage random sampling method was used to conduct a questionnaire survey,physical examination and laboratory testing on 4 012 adults ＞ 30 years old in 6 districts of Hunan Province.The receiver operator characteristic (ROC) curve was used to evaluate the predictive effects of BMI,WC,WHR and WHtR on H-type hypertension.Results ROC curve analysis indicated that the area under curve (AUC) of the evaluation of H-type hypertension of WC,WHtR,WHR and BMI in men were:0.637,0.640,0.601,0.639,of which the largest were combination of WC + BMI and WHtR + BMI,both being 0.647.In women,the AUC of individual indexes WC,WHtR,WHR and BMI for evaluating H-type hypertension were 0.660,0.670,0.660 and 0.604 respectively.The combination of WHtR and WHR had the largest AUC,which was 0.675.The WC for evaluating H-type hypertension in youth people had the largest AUC (0.732);the WC + BMI,WHR + BMI for evaluating H-type hypertension in middle-aged people had the largest AUC,all being 0.687;the WC predicted the largest AUC of H-type hypertension in elderly people (0.590).Conclusions WC,WHtR,WHR and BMI are important predictors of H-type hypertension.The optimal indicators for different genders and ages are different,and the combined indicators are better than the individual indicators.

Comparison of Decitabine Rigimen and Traditional Chemotherapy Regimen in Treatment of Patients with Intermediate or High-Risk Myelodysplastic Syndrome / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To compare the clinical efficacy and relevant adverse reactions of homebred decitabine regimen and traditional chemotherapy regimen in treatment of patients with intermediate or high-risk myelodysplastic syndrome (MDS).</p><p><b>METHODS</b>Forty-eight patients suffered from newly diagnosed intermediate or high-risk MDS from December 2011 to December 2016 were analyzed retrospectively. Among them 29 patients were treated by traditional chemotherapy regimen, and 19 patients were treated by decitabine regimen [15 mg/(m·d), ivgtt, d1-5]. The clinical efficacy and relevant adverse reactions in two groups were compared.</p><p><b>RESULTS</b>The overall response rate (ORR) of decitabine group was 78.9% (15/19), after 2 cycles of treatment, among them 5 achieved complete remission(CR), 5 achieved partial remission(PR), and 5 achieved hematologic improvement (HI); the ORR of traditional chemotherapy group was 65.9% (16/29), including 6 CR, 5 PR, 8 HI, the ORR and remission rate (PR+CR) in decitabine treatment group were not statistically significantly different from the that in traditional chemotherapy group (x=0.458,P>0.05; x=0.499, P>0.05). After 4 cycles of treatment, the ORR in decitabine group was 84.2% (16/19), including 5 CR, 9 PR and 2 HI. The ORR in traditional chemotherapy group was 68.9% (20/29), including 6 CR, 5 PR and 9 HI. The ORR of decitabine group was not statistically significantly different from the that in traditional chemotherapy (x=0.726,P>0.05), but the remission rate was statistically significantly different(x=4.534,P<0.05). The overall survival and progression-free survival in the decitabine group were different statistically significantly different from the traditional chemotherapy (P<0.05; P<0.01). The incidences of III-IV grades adverse reactions of hemoglobin, platelet and neutrophile in the patients treated with decitabine and traditional chemotherapy group were 52.6% and 79.3% (P>0.05), 57.9% and 86.2%(P>0.05), 84.2% and 96.6%(P>0.05), respectively. The infection rates were 26.3% and 79.3%(P<0.05), respectively.</p><p><b>CONCLUSION</b>The homebred decitabine can effectively treat intermediate-or high-risk MDS, also can be well tolerated. So, it is worth to be clinically popularized.</p>