Pharmacogenetic testing improves treatment responses in patients with PLA2R-related membranous nephropathy / 南方医科大学学报

OBJECTIVE@#To evaluate the value of pharmacogenetic testing for improving the efficacy and safety of treatment with cyclosporine, tacrolimus, and cyclophosphamide (CTX) for PLA2R-related membranous nephropathy and for determing individualized and precise treatment plans for the patients.@*METHODS@#A total of 63 patients with PLA2R-related membranous nephropathy hospitalized in the Department of Nephrology at our hospital from January, 2019 to October, 2021 were enrolled in this study. Thirty-three of the patients underwent pharmacogenetic testing before taking the immunosuppressive drugs selected based on the results of genetic screening for sensitive targets, and the other 30 patients were empirically given immunosuppressive drugs according to the guidelines (control group). The clinical efficacy and adverse effects of the immunosuppressive drugs were analyzed for all the patients. The two groups of patients were compared for demographic and biochemical parameters including 24-h urine protein, serum albumin, renal function, and serum anti-phospholipase A2 receptor antibody both before and at 3 months after the beginning of the treatment.@*RESULTS@#Among the 33 patients undergoing pharmacogenetic testing, 51.5% showed a GG genotype for cyclosporine, and 61.6% had an AG genotype for tacrolimus; for CTX, 51.5% of the patients showed a homozygous deletion and 63.6% had an AA genotype. After treatment for 3 months, serum anti-phospholipase A2 receptor antibody, 24-h urine protein, and serum albumin levels were significantly improved in pharmacogenetic testing group as compared with the control group (P < 0.05).@*CONCLUSION@#Individualized and precise administration of immunosuppressive drugs based on pharmacogenetic testing better controls proteinuria and serum antiphospholipase A2 receptor antibodies and increases serum albumin level in patients with PLA2R-related membranous nephropathy.

Preliminary study on calculating size-specific dose estimate values based on age in children′s head / 中华放射医学与防护杂志

Objective:To investigate the feasibility of size-specific dose estimate of head based on pediatric patients′ age.Methods:A retrospective study was conducted on plain head CT scans of 210 patients in Tianjin Children′s Hospital from January to March in 2022. The volume CT dose index (CTDI vol) values, age and sex of the patients were recorded. The anteroposterior diameter (AP) and lateral diameter(LAT), aera and CT value in the middle slice of the scan region were measured on the workspace. According to the AAPM reports 220 and 293, the water equivalent diameter ( DW) of head, size-specific conversion factors ( fmeasuredH16), and size-specific dose estimate (SSDE measured) were calculated. The effective diameter ( Deff; WHO) was calculated for male and female individuals using the ralationship between the standard head circumference and age of children provided by World Health Organization (WHO). The effective diameter ( Deff; WHO) was converted into a water equivalent diameter ( DW; WHO), using a correlation established from the Deff and DWwhich were measured in 210 image sets of male and female patients. Then the corresponding fWHOH16 and SSDE WHO of head can be calculated. The correlation between DW and DW; WHO, fmeasuredH16 and fWHOH16, the correlation and consistency between SSDE measured and SSDE WHO, and the conversion relationship between age and fWHOH16 were analyzed for male and female patients. Results:A significant correlation were found between the measured DW and DW; WHO(female: r=0.917, P<0.01; male: r=0.873, P<0.01), fmeasuredH16 and fWHOH16(female: r=0.916, P<0.01; male: r=0.883, P<0.01), SSDE measured and SSDE WHO( r=0.991, P<0.01; male: r=0.992, P<0.01). The Bland-Altman test indicated that there was good coherence between SSDE measured and SSDE WHO. Maximal mean root-mean-square errors of SSDE measured and SSDE WHO were 5.61% in female and 5.25% in male. The conversion relationship between fWHOH16 and patient age in different genders was obtained by curve fitting. Conclusion:The SSDE of head in pediatric patients can be estimated simply and accurately by directly using the patient′s age.

Meta analysis of effectiveness of high intensity interval training on cognitive executive function of adolescents / 中国学校卫生

Objective@#To summarize the effective of high intensity interval training on cognitive executive function among adolescents through Meta analysis,and to provide reference for medical rehabilitation and physical education practice.@*Methods@#Literature search was conducted for Chinese and English keywords "High Intensity Interval Training", "Cognition", "Cognition Function"，"Executive Function" and "Executive Controls" regarding the effect of high intensity interval training on cognitive executive function among adolescents published prior to September 20, 2020 in PubMed, Cochrane library, Web of science, Embase, the China National Knowledge Infrastructure (CNKI), the Wanfang database and the VIP database. Stata 14 software and Revman 5.3 software were used for Meta analysis, fixed effect or random effect model was used to combine the results based on the heterogeneity.@*Results@#The response time of Stroop test immediately after acute high intensity interval training significantly decreased ( SMD=0.70，95%CI =0.28-1.11， z=3.29，P <0.01); there was no significant change in response time of Stroop test 30 min after training ( SMD=0.23，95%CI=-0.14-0.60，z=1.23，P >0.05); the correct rate of Stroop test immediately after acute high intensity interval training increased significantly ( SMD=0.26，95%CI=0.03-0.50，z=2.21，P <0.05); there was no significant change in correct rate of Stroop test 30 min after training ( SMD=-1.38，95%CI=-4.28-1.52，z=0.93，P >0.05). After long term high intensity interval training, the response time of Stroop and TMT test were significantly shortened ( SMD=0.38, 95%CI=0.07-0.70, z=2.41, P < 0.05 ).@*Conclusion@#Acute and long term high intensity interval training can effectively improve cognitive executive function among adolescents, but the long term effect of acute training is unclear.

High-frequency repetitive transcranial magnetic stimulation can relieve mild amnestic cognitive impairment / 中华物理医学与康复杂志

Objective:To investigate the therapeutic mechanism of high-frequency repetitive transcranial magnetic stimulation (rTMS) in treating mild amnestic cognitive impairment (aMCI).Methods:Twenty-five patients with aMCI were randomly divided into an observation group of 13 and a control group of 12. The observation group was given 10-Hz rTMS over the left dorsolateral prefrontal cortex at 80% of the motor threshold-400 pulses a day, 5 times a week for 4 consecutive weeks. The control group received sham stimulation on the same schedule. Before and after the experiment, both groups were evaluated using the Montreal cognitive assessment (MoCA) and received fMRI scans.Results:After the intervention, the average MoCA score of the observation group had improved significantly more compared with that of the control group and compared with before the intervention. According to the fMRI results, regional homogeneity in the right middle frontal gyrus of the observation group had increased significantly, while that of the control group both there and in the left precuneus had decreased significantly.Conclusions:High-frequency rTMS can effectively improve the cognitive function of patients with aMCI and synchronize neuron activity in cognition-related brain regions.

Analysis of the status and influencing factors of delivery food consumption in Wuhan college students / 中国学校卫生

Objective@#To explore the current situation of college students’ delivery food consumption and the related factors, and to provide reference for healthy eating behaviors among college students.@*Methods@#A random cluster sampling was used to select 2 597 student sample of various majors and grades of Wuhan University of Science and Technology. The self-made questionnaire was used to investigate the frequency and causes of college students ordering delivery food, as well as the status of nutrition knowledge, attitude and behavior. The Zung Depression Self-rating Scale (SDS) was adopted to measure the mental health status of the students, and height and weight were measured by a unified height and weight scale. Finally, the influencing factors mentioned above and consumption frequency of delivery food was analyzed.@*Results@#Among the college students,60.0% reported the habit of ordering delivery food; As for the frequency of delivery food consumption, boys were singnificantly higher than girls(OR=1.38), students of first(OR=0.48) and third grade(OR=0.61) were lower than that of fourth grade,the medicine major’s frequency was lower than the science and engineering major’s(OR=0.57), and the art major’s was higher than the science and engineering’s(OR=1.94); The frequency of students who had received relevant health education was lower than the unreceived students’(OR=0.70); Students who had better performance in the nutrition learning attitude, and those who had healthier eatting habits (OR=0.62, 0.49); Students who saving reckoned delivery food as convenient, time and tasty (OR=4.77, 4.82, 2.85); Howver, students’ BMI, the score of depression scale, nutritional knowledge score, knowledge and practical attitude,diet structure score, food packaging, price and nutritional factors showed no significant effect on the frequency of delivery food consumption (P>0.05).@*Conclusion@#It is common for college students to order delivery food. gender, grade, major, nutrition and health education background, nutritional attitude, eating habits and convenient, time-saving, tasty nature of fast food are the factors influencing the frequency of delivery food consumption.

Depression evaluation in before and after first time hemodialysis in patients with uremia and related factors analysis / 重庆医学

Objective To investigate the depression status and its influencing factors in the patients with uremia before and after the first time hemodialysis.Methods A total of 177 patients with uremia conducted the questionnaire investigation by using the Hamilton Depression Scale and self-made general information questionnaire.Meanwhile,the laboratory indexes were detected and analyzed.Results At one week before dialysis,35% of the patients had different degrees of depression symptoms,11.9% of the patients had depressive symptoms at 1 week after dialysis;the depression scores before and after dialysis were(14.96 ± 8.37) points and(6.52 ± 3.81)points respectively,the difference was statistically significant(t=16.267,P<0.01).The depression score had statistical difference between the patients with complications and patients without complications(t= -2.528,P=0.013);while the depression scores had no statistical difference among the patients with different sexes,ages,cultural levels,types of original dis-eases,whether smoking and drinking(P<0.01).The Spearman correlation analysis showed that the levels of GLU,Cr and BUN were positively correlated with the depression score,while the levels of TC and Alb were negatively correlated with the depression score,the difference was statistically significant(P< 0.01).Conclusion The evaluation of depression status in hemodialysis pa-tients should be emphasized.

Resistance Mechanisms of Clinical Isolated Carbapenem-Resistant Klebsiella Pneumoniae / 现代检验医学杂志

Objective To explore the molecular mechanisms of carbapenem-resistant Klebsiella pneumoniae.Methods Carba NP confirmatory test were used to detect carbapenemases.Carbapenemase genes,ESBL genes and plasmid-mediated AmpC genes were amplified by polymerase chain reaction (PCR).The genetic correlation analysis was carried out by using multiple sequence type (MLST).Results 42 out of the 50 carbapenem-resistant Klebsiella pneumoniae strains were KPC-2-positive strains,1 strain was positive for NDM-1,the other 7 strains were not detected for any carbapenemase genes.The percentages of KPC-2-positive Klebsiella pneumoniae with the bla CTX-M,bla SHV,bla TEM,bla DHA were 21.5 ％,42.9 ％,69.1％ and 4.8％ respectively.The results of MLST showed that 37 out of 42 KPC-2 positive strains were ST11.Conclusion The production of KPC-2 is the main mechanism of Klebsiella pneumoniae resistance to carbapenem and there is an outbreak of ST11 KPC-2 Klebsiella pneumoniae in this hospital.

Investigation of Iodine Nutritional Status and Thyroid Function in Pregnant Women During Different Periods / 现代检验医学杂志

Objective To study the iodine nutritional status and the thyroid function of pregnant women during different periods,and provide scientific basis for iodine supplementation.Methods Totally 728 pregnant women who visited the obstetric outpatient of Nanjing Drum Tower Hospital for routine prenatal care from December 2014 to August 2016 were recruited in this study,and at the same time 182 non-pregnant women were recruited as control group.The thyroid stimulating hormone (TSH) and free thyroxine (FT4) were measured by Roche 601.The urinary iodine level was measured by SR-I-100 kit.Results The median urinary iodine of 728 pregnant women was 168.24 g/L,and the median urinary iodine of those women in the T1,T2 and T3 period were 186.31,162.65 and 148.76 g/L,respectively.The TSH at T1 period was lower than T2 and T3 period (t=3.429,3.135,P＜0.05).The FT4 at T1 period was higher than T2 and T3 period (t=5.251,5.965,P＜ 0.05).The prevalence rate of thyroid disease in normal urinary iodine group was lower than that in low urinary iodine group and high urinary iodine group (x2 =4.139,4.131,P＜0.05).Conclusion There was no iodine deficiency among those pregnant women groups,but only 34.75 ％ individuals reached the appropriate iodine nutritional level,and the ratio of iodine insufficient increased with the extension of pregnancy.The whole prevalence rate of thyroid disease in abnormal urinary iodine pregnant women was obviously higher than that in normal.It is necessary to improve the pregnant women's knowledge of iodine nutrition,moreover it is suggested that urinary iodine monitoring and thyroid function should be conducted in pregnant women.

Serological Interleukin-35 Level in Patients with Breast Cancer and Its Clinical Significance / 现代检验医学杂志

Objective To investigate the level of serological interleukin 35 (IL-35) in breast cancer patients and its clinical significance.Methods From Jan 2015 to July 2016,serum of 55 patients with breast cancer were collected from a tertiary hospital of Nanjing.Their pathological stages were also analyzed,including 12 cases of stage Ⅰ,15 cases of stage Ⅱ,12 cases of stage Ⅲ,and 15 cases of stage Ⅳ.Meanwhile,serum from 54 healthy individuals also selected.The level of serological IL-35 was determined by ELISA,and the IL-35 level,pathological stage and tumor metastasis were analyzed by correlation a nalysis.Results The serum IL-35 in patients with breast cancer was significantly elevated than health individuals.With the increase in pathological stage,IL-35 level in breast cancer patients with stage Ⅲ and Ⅳ was significantly higher compared to patients with stage Ⅰ breast cancer (P＜0.05).Further,patients with breast cancer metastasis had increased level of IL-35,compared to breast cancer patients without tumor metastasis (P＜ 0.05).Finally,Spearman correlation analysis indicated that the serum level of IL-35 in patients with breast cancer was positlvely correlated with the pathological stages (r=0.390,P=0.004) and tumor metastasis (r=0.361,P=0.008) of the patients,respectively.Conclusion High level of IL-35 was detected in serum from breast cancer patients,and its expression was highly correlated with pathological stage and tumor metastasis.Detection of IL-35 could be applied as a valuable potential biomarker for the diagnosis of breast cancer.

Effect of Acupoint Magnetic Therapy on Mild Cognitive Impairment / 中国康复理论与实践

Objective To observe the effects of mind-regulating brain-developing acupoint magnetic therapy in patients with mild cogni-tive impairment (MCI). Methods From May to October, 2015, 60 patients with MCI were randomly divided into control group (n=30) and observation group (n=30). The control group received magnetic therapy on Yangming meridians, and the observation group received magnet-ic therapy on mind-regulating brain-developing acupoints, for two months. They were assessed with Montreal Cognitive Assessment (Mo-CA), digit-span and digit symbol of Wechsler Adult Intelligence Scale (WAIS). Results After treatment, the scores of MoCA, digit-span and digit symbol of WAIS significantly increased in the observation group (t>4.858, P2.188, P5.527, P2.324, P2.262, P0.05). Conclusion Magnetic therapy on acupoints related with cognition could improve the cognitive function in patients with MCI.

Value of Urinaryα1-Acid Glycoprotein in Early Diagnosis of Diabetic Nephropathy / 现代检验医学杂志

Objective To investigate the clinical value of urinaryα1-acid glycoprotein (AAG)in the early diagnosis of diabetic nephropathy(DN).Methods 266 cases of diabetic patients in Drum Tower Hospital Affiliated to Medical School of Nanjing University from May 2013 to October 2014 were recruited,and patients were divided into four groups based on the urine al-bumin/creatinine (ACR)levels,as follows:non-diabetic nephropathy group (Non-DN)152 cases,low urinary albumin/cre-atinine group (LUA)49 cases,high urinary albumin/creatinine group (HUA)32 cases,and very high urinary albumin/cre-atinine group (VHUA)33 cases.63 cases of healthy subjects (NC group)and 66 cases of fracture patients (stress group) were recruited as control group.The urinary AAG and other biochemical indicators were measured for all subjects.Results The level of urinary AAG in DN group was significantly higher than that in stress group,Non-DN group and NC group (t=7.951,7.985,8.021,P <0.05),and gradually increased from LUA,HUA to VHUA group (P <0.05).The urinary AAG level was positively correlated with UA,Cr,CRP and ACR (r=0.169,0.286,0.373,0.606,P <0.01).Stepwise logistic re-gression analysis showed that the urinary AAG was the independent risk factor of DN (P <0.05).Conclusion The level of urinary AAG has good application value in the early diagnosis and monitoring progression of DN.