Analysis of the current status and related factors of first aid knowledge among middle-aged and elderly residents in a community in Shanghai / 上海预防医学

ObjectiveTo investigate the current status of first aid knowledge among middle-aged and elderly residents aged 50 and above in a community in Shanghai， in order to provide reference for improving the self-rescue and mutual aid capabilities of middle-aged and elderly residents. MethodsA multi-stage stratified random sampling method was used to conduct a survey on 335 residents aged 50 and above in a community in Shanghai using a self-made survey questionnaire. The current situation and related factors of emergency knowledge level of residents aged 50 and above in the community were comprehensively analyzed. ResultsFirst aid knowledge level of 335 residents aged 50 and above was low， and the rate of high cognitive level was only 24.18%. Univariate analysis showed that male residents had a higher awareness rate than female residents （P=0.044）， while residents aged 70 and above and 60‒ had lower awareness rates than residents aged 50‒ （P<0.05）. Residents with chronic diseases had a higher awareness rate than those who did not （P=0.031）. Residents with family members suffering from chronic diseases had a higher awareness rate than those without （P<0.001）. Experience of first aid training affected residents’ awareness of first aid （P=0.003）. ConclusionThe level of first aid knowledge among middle-aged and elderly residents aged 50 and above in the community is low. Age， the presence of chronic diseases in family members， and emergency training are independent and relevant factors that affect the awareness of first aid knowledge among middle-aged and elderly residents. The government and relevant institutions should explore the establishment of a standardized emergency response training system， implement classification and grading for middle-aged and elderly groups with different characteristics， and provide targeted emergency training to strengthen their self-rescue and mutual aid capabilities and improve the success rate of pre-hospital emergency care.

Effects of Vitamin D Supplementation on Children with Autism Spectrum Disorder: A Systematic Review and Meta-analysis

The effect of vitamin D supplementation on individuals with autism spectrum disorder (ASD) is inconclusive. We aimed to conduct a meta-analysis of the available randomized controlled trials (RCTs) to explore whether vitamin D supplementation can improve core symptoms and coexisting conditions in children with ASD. Data were obtained by searching the PubMed, Embase, Web of Science, CINAHL and Cochrane Library databases up to February 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Using a random-effects model, mean differences with 95% confidence intervals (CIs) were calculated through a meta-analysis. There were eight RCTs with 266 children with ASD in the present review, among which six RCTs were included in the meta-analysis.Children who received vitamin D supplementation showed a significant improvement in stereotypical behavior scores (pooled mean difference (MD): −1.39; 95% CI: −2.7, −0.07; p = 0.04) with low heterogeneity (I2 = 34%), and there was a trend toward decreased total scores on the Social Responsiveness Scale (SRS) and Childhood Autism Rating Scale (CARS, p = 0.05); however, there were no other significant differences in the core symptoms of ASD and coexisting conditions between groups as measured by the Aberrant Behavior Checklist (ABC). Vitamin D supplementation appears to improve stereotypical behaviors but does not improve other core symptoms and coexisting conditions. Further randomized controlled trials with large sample sizes and individualized doses are needed.

Comparison of clinical features of Takayasu′s arteritis in children at different ages / 中华实用儿科临床杂志

Objective:To improve the understanding of Takayasu′s arteritis (TA) and its diagnosis and treatment by analyzing and summarizing the clinical characteristics of TA in children at different ages.Methods:Clinical and follow-up data of 41 children with TA admitted in Children′s Hospital, Capital Institute of Pediatrics between January 2010 and May 2020 were retrospectively analyzed.Based on the cut-off age of 3 years, children with TA were divided into older group and younger group.Clinical characteristics, involvement of the coronary artery, blood pressure control and growth restriction between 2 groups were analyzed.Counting data were expressed as percentage and case, and compared by the Chi- square test. Results:Among the 17 children with TA in younger group, there were 8 males and 9 females.There were 6 males and 18 females in older group.The general type was most common in younger group, with 10 cases (58.8%). In older group, thoracic and abdominal aortic type was the most common, with 13 cases (54.2%). The most common clinical manifestation in younger group was fever, with 13 cases (76.5%). In older group, 19 patients (79.2%) had hypertension.Lower hemoglobin (Hb) was detected in younger group.Leukocyte count, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) increased in all patients (100.0%). In older group, leukocyte count increased in 6 cases (25.0%), ESR increased in 13 cases (54.2%), and CRP increased in 11 cases (45.8%). The coronary artery and its branches (anterior descending branch and circumvolute branch) were the mostly affected in younger group, with 16 cases (94.1%). The subclavian artery was the most commonly involved in older group (15 cases, 62.5%). All TA children in younger group were in the active stage.Among them, 8 cases were treated with biological agents alone, 3 cases were treated with glucocorticoid alone, 5 cases were treated with the combination of glucocorticoid and biological agents, and 1 case was treated with glucocorticoid first, and then transferred to biological agents due to the poor effect.In older group, there were 18 active-stage patients (75.0%), and 2 refused treatment.Sixteen active patients and 6 inactive patients were treated with glucocorticoid, involving 19 cases treated with glucocorticoid combined with Cyclophosphamide, and 3 cases treated with glucocorticoid combined with biologics.There were 16 cases of coronary artery involvement in younger group and only 1 case in older group ( P<0.01). In younger group, 9 patients had growth restriction, while none was detected in older group ( P<0.01). The blood pressure of younger group was all controlled, which was not satisfactorily controlled in 16 cases of older age ( P<0.01). The incidence of general type and active stage in younger group was higher than that of older group without significant difference ( P>0.05). Conclusions:The clinical characteristics of TA vary at different ages.TA progresses more rapidly in younger children, which are more prone to the involvement of extensive vessels, the coronary arteries and other vessels, and the effects of drugs on growth and development should be well concerned.Older TA patients can be alleviated into the inactive phase by themselves, which is mainly characterized as the involvement of large vessels and hypertension sequelae.

Single-cell transcriptomic atlas of individuals receiving inactivated COVID-19 vaccines reveals distinct immunological responses between vaccine and natural SARS-CoV-2 infection

To control the ongoing COVID-19 pandemic, CoronaVac (Sinovac), an inactivated vaccine, has been granted emergency use authorization by many countries. However, the underlying mechanisms of the inactivated COVID-19 vaccine-induced immune response remain unclear, and little is known about its features compared to SARS-CoV-2 infection. Here, we implemented single-cell RNA sequencing (scRNA-seq) to profile longitudinally collected PBMCs (peripheral blood mononuclear cells) in six individuals immunized with CoronaVac and compared these to the profiles of COVID-19 infected patients from a Single Cell Consortium. Both inactivated vaccines and SARS-CoV-2 infection drove changes in immune cell type proportions, caused B cell activation and differentiation, and induced the expression of genes associated with antibody production in the plasma. The inactivated vaccine and SARS-COV-2 infection also caused alterations in peripheral immune activity such as interferon response, inflammatory cytokine expression, innate immune cell apoptosis and migration, effector T cell exhaustion and cytotoxicity, however, the magnitude of change was greater in COVID-19 patients, especially those with severe disease, than in immunized individuals. Further analyses revealed a distinct peripheral immune cell phenotype associated with CoronaVac immunization (HLA class II upregulation and IL21R upregulation in naive B cells) versus SARS-CoV-2 infection (HLA class II downregulation and IL21R downregulation in naive B cells severe disease). There were also differences in the expression of important genes associated with proinflammatory cytokines and thrombosis. In conclusion, this study provides a single-cell atlas of the systemic immune response to CoronaVac immunization and reveals distinct immune responses between inactivated vaccines and SARS-CoV-2 infection.

Proteomic and metabolomic signatures associated with the immune response in healthy individuals immunized with an inactivated SARS-CoV-2 vaccine

SummeryCoronaVac (Sinovac), an inactivated vaccine for SARS-CoV-2, has been widely used for immunization. However, analysis of the underlying molecular mechanisms driving CoronaVac-induced immunity is still limited. Here, we applied a systems biology approach to understand the mechanisms behind the adaptive immune response to CoronaVac in a cohort of 50 volunteers immunized with 2 doses of CoronaVac. Vaccination with CoronaVac led to an integrated immune response that included several effector arms of the adaptive immune system including specific IgM/IgG, humoral response and other immune response, as well as the innate immune system as shown by complement activation. Metabolites associated with immunity were also identified implicating the role of metabolites in the humoral response, complement activation and other immune response. Networks associated with the TCA cycle and amino acids metabolic pathways, such as phenylalanine metabolism, phenylalanine, tyrosine and tryptophan biosynthesis, and glycine, serine and threonine metabolism were tightly coupled with immunity. Critically, we constructed a multifactorial response network (MRN) to analyze the underlying interactions and compared the signatures affected by CoronaVac immunization and SARS-CoV-2 infection to further identify immune signatures and related metabolic pathways altered by CoronaVac immunization. These results suggest that protective immunity against SARS-CoV-2 can be achieved via multiple mechanisms and highlights the utility of a systems biology approach in defining molecular correlates of protection to vaccination.

Fingerprint Establishment and Content Determination of 3 Components in Fritillaria thunbergii Formula Granules / 中国药房

OBJECTIVE：To establish the fingerprint of Fritillariae thunbergii formula granules and determine the contents of 3 components. METHODS ：HPLC method was used. Using peiminine as reference ，HPLC fingerprints of 13 batches of F. thunbergii formula granules were drawn with Similarity Evaluation System of TCM Chromatogram Fingerprint （2012 edition）. Similarity evaluation and common peak identification were conducted. The contents of peimisine ，peimine and peiminine in F. thunbergii formula granules were determined by the same HPLC method. The quality difference of samples were compared among different manufacturers. RESULTS ：There were 5 common peaks in 13 batches of F. thunbergii formula granules ，and the similarity was 0.669-0.971. Three common peaks of peimisine ，peimine and peiminine were identified. The linear ranges of peimisine ，peimine and peiminine were 30.00-180.00 μg/mL（r＝0.999 9），79.58-477.50 μg/mL（r＝0.999 6）and 97.33-584.00 μg/mL（r＝0.999 4）， respectively. RSDs of precision ，stability（24 h）and reproducibility tests were all lower than 3％. The average recoveries were 95.82％（RSD＝1.17％，n＝6），99.00％（RSD＝1.96％，n＝6）and 95.39％（RSD＝2.00％，n＝6），respectively. In the 13 batches of samples ，the content of peimisine ，peimine and peiminine were 0.17-1.02 mg/g，0.52-2.26 mg/g，and 0.70-3.50 mg/g， respectively. Their average total content was 3.62 mg/g. The average total content of manufacturer C and A was higher （5.02 mg/g and 4.61 mg/g），followed by manufacturer E and B （3.48 mg/g and 3.02 mg/g）；the lowest was manufacturer D（only 1.87 mg/g）. CONCLUSIONS：Established fingerpri nt and content determination method is simple ，feasible and reproducible ，which can be used for the quality evaluation of F. thunbergii formula granules. There are some differences in content among different manufacturers.

Simultaneous Determination of 4 Components in Huanshao Capsules by HPLC / 中国药房

OBJECTIVE：To estab lish a me thod for simultaneous determination of morroniside ，loganin，echinacoside and acteoside in Huanshao capsules. METHODS ：HPLC method was adopted. The determination was performed on Zhongpuhong RD-C18 column with mobile phase consisted of acetonitrile- 0.1％ formic acid solution （gradient elution ）at the flow rate of 1.0 mL/min. The detection wavelength was set at 240 nm （morroniside，loganin） and 330 nm （echinacoside，acteoside）. The column temperature was set at 35 ℃，and sample size was 10 μL. RESULTS：The linear range were 5.29-105.80 μg/mL for morroniside， 4.49-89.88 mg/L for loganin ，16.26-325.25 mg/L for echinacoside and 16.31-326.25 mg/L for acteoside ，r values were 0.999 9. RSDs of precision ，stability （24 h），reproducibility and durability tests were all lower than 2.0％ . The recoveries were 94.34％ -96.23％（RSD＝0.81％ ，n＝6），97.04％ -98.89％（RSD＝0.73％ ，n＝6），96.23％ -98.08％（RSD＝0.82％ ，n＝6）， 95.40％-98.47％（RSD＝1.23％，n＝6），respectively. The contents of above 4 components in 11 batches of Huanshao Capsules were 0.190-0.704，0.439-0.857，2.723-4.475 and 0.589-1.035 mg/g，respectively. CONCLUSIONS ：Established method is specific ， precise and can be used for content determination of 4 components in Huanshao capsules.

The role of serum cytokine level in the evaluation of the efficacy of tocilizumab for the treatment of systemic-onset juvenile idiopathic arthritis / 中华检验医学杂志

Objective@#To evaluate the value of serum cytokine level in the efficacy of tocilizumab for the treatment of systemic-onset juvenile idiopathic arthritis.@*Methods@#30 cases with SoJIA hospitalized in Capital Institute of Paediatrics from June 2016 to October 2018 were treated with Interleukin-6 receptor antagonist(tocilizumab) injection. Among them, 20 were males(67%) and 10 were females(33%). The age at diagnosis was between 0.84 to 13years. Whiteblood cell, C-reactive protein, erythrocyte sedimentation rate, serum interleukin(IL-6, IL-2R, IL-8, IL-10, IL-1β) and tumor necrosis factor-alpha levels were observed before treatment, after the 2nd week, after the 6th week and after the 22nd week.Mann-Whitney nonparametric test and Chi-square test were used to analyze the data of cytokines pre and after-treatment.@*Results@#All of the 30 cases had fever before medication. The fever disappeared in 28 cases after using tocilizumab. One case stopped using tocilizumab because of allergic reaction and one case stopped because of poor efficacy. Among 28 cases with normal body temperature after medication, the arthritis and rash manifestations were significantly improved. WBC, AESR and CRP were all lower than those before medication. Within these 28 cases, the serum IL-6 level was168.50(67.40-589.25) pg/mL pre-treatment, 107.50(28.03-281.50) pg/mL after the 2nd week. There was no statistical difference between them(Z=-1.754, P>0.05). The serum IL-6 level was 64.05 (19.90-130.75) pg/mL after the 6th week and 24.80 (3.45-95.40) pg/mL after the 22nd week. Compared with pre-treatment, they were all lower than pre-treatment levels(Z=-2.942,-3.334,P<0.01,<0.01).Serum IL-2R level was 740.50(510.00-1 161.00)U/mL after the 2nd week, 796.50 (534.00-1 008.00) U/mL after the 6th week and 688.00 (527.00-889.50) U/mL after the 22nd week. Compared with pre-treatment [1 322.50(812.00-1 659.00)U/mL], they were all lower than pre-treatment levels (Z=-2.818,-3.130,-3.466, P<0.01, <0.01, <0.01). Serum TNF-alpha level was 23.70 (20.30-41.23) pg/ml after the 2nd week, 26.75(16.83-47.03) pg/ml after the 6th week,18.60(13.10-34.90) pg/ml after the 22nd week. Compared with pre-treatment [26.50(20.55-37.43) pg/ml], there were no statistical difference between after and pre-treatment(Z=0,-0.560,-1.954,P>0.05,>0.05,>0.05). Serum IL-8 level was 200.85(95.43-364.00)pg/ml after the 2nd week, 194.50(50.75-433.00)pg/ml after the 6th week, 161.50 (38.98-308.00)pg/ml after the 22nd week. Compared with pre-treatment [96.20(59.75-371.75) pg/ml], there were no statistical difference between after and pre-treatment(Z=-0.86,-0.131,-0.186,P>0.05,>0.05,>0.05). There was no statistical difference between after the 2nd week and pre-treatment in the IL-10 level(χ2=2.33, P>0.05). The IL-10 level after 6th week and after 22nd week were all lower than pre-treatment levels(χ2=4.08, 4.08, P<0.05, <0.05). There were no statistical difference between after and pre-treatment(χ2=0.084, 2.504,3.818,P>0.05,>0.05,>0.05)in IL-1β level.@*Conclusion@#After treatment with tocilizumab, the levels of serum IL-6 and IL-2R are helpful to assess the activity of SoJIA and the efficacy of therapy.

Analysis of clinical features of 14 infants with Takayasu arteritis / 中华实用儿科临床杂志

Objective@#To improve the understanding and diagnosis and treatment level of infant with Takayasu arteritis (TA) by analyzing the clinical features of 14 pediatric patients and reviewing related articles.@*Methods@#The clinical and follow-up data of infants with TA who were admitted to the Children′s Hospital Affiliated to Capital Institute of Pediatrics between July 2016 and May 2019 were retrospectively analyzed.By reviewing related articles, the clinical features of this disease were summarized.@*Results@#The age of 14 patients (including 6 males and 8 females) were between 1 month and 23 days and 28 months.The most common clinical manifestations were fever in 10 cases (71.4%), hypertension in 9 cases (64.3%), weak or no pulse in 5 cases (35.7%). According to the clinical type of lesion vessels, 11 cases (78.5%) were generalized type, 3 cases (21.4%) were brachiocephalic artery type, and there was no thoracic abdominal aorta or single pulmonary artery type in this group.Among 14 infants with TA, 12 cases had common carotid artery, carotid artery, subclavian artery, coronary artery and its branches (anterior descending branch, circumflex branch) involved (85.7%); 11 cases had renal artery involved (78.6%); 9 cases had radial artery involved (64.2%); 8 cases had abdominal aorta involved (57.1%); 6 cases had descending aorta involved (42.9%); 6 cases had thoracic aorta involved (42.9%); 6 cases had superior mesenteric artery involved (42.9%); 5 cases had femoral artery involved (35.7%); 5 cases had pulmonary artery involved (35.7%); and 4 cases had brachial artery involved (28.6%). In those 14 patients, 11 cases were misdiagnosed, and 3 cases had unclear diagnosis, with misdiagnosis duration of 18 days to 2 months.In misdiagnosed cases, 8 cases were misdiagnosed as atypical Kawasaki disease.Among those 14 cases, the ranges of most lesions were gradually decreased, and the slightly involved vessels even completely returned to normal state after treatment in 7 cases.The vascular imaging showed no significant exacerbation or improvement in 4 cases.Nine cases developed hypertension, the blood pressure of whom could be controlled within normal range with hypotensive drugs which could not be interrupted.Physical examination found weak or no pulse in 5 cases who were not improved.Among 14 patients, 7 cases showed normal development, while the height and body mass of another 7 cases were the 25th percentile below those of normal children of the same age.All 14 patients were followed up for 2-22 months and received regular treatment without recurrence.@*Conclusions@#TA patients aged less than 3 years tend to have more blood vessels involved, be in serious condition and have higher rate of misdiagnosis.The disease can be controlled quickly after treatment, but vascular diseases may be developed easily.Some patients have a poor prognosis.

The role of serum cytokine level in the evaluation of the efficacy of tocilizumab for the treatment of systemic-onset juvenile idiopathic arthritis / 中华检验医学杂志

Objective:To evaluate the value of serum cytokine level in the efficacy of tocilizumab for the treatment of systemic-onset juvenile idiopathic arthritis.Methods:30 cases with SoJIA hospitalized in Capital Institute of Paediatrics from June 2016 to October 2018 were treated with Interleukin-6 receptor antagonist(tocilizumab) injection. Among them, 20 were males(67%) and 10 were females(33%). The age at diagnosis was between 0.84 to 13years. Whiteblood cell, C-reactive protein, erythrocyte sedimentation rate, serum interleukin(IL-6, IL-2R, IL-8, IL-10, IL-1β) and tumor necrosis factor-alpha levels were observed before treatment, after the 2nd week, after the 6th week and after the 22nd week.Mann-Whitney nonparametric test and Chi-square test were used to analyze the data of cytokines pre and after-treatment.Results:All of the 30 cases had fever before medication. The fever disappeared in 28 cases after using tocilizumab. One case stopped using tocilizumab because of allergic reaction and one case stopped because of poor efficacy. Among 28 cases with normal body temperature after medication, the arthritis and rash manifestations were significantly improved. WBC, AESR and CRP were all lower than those before medication. Within these 28 cases, the serum IL-6 level was168.50(67.40-589.25) pg/mL pre-treatment, 107.50(28.03-281.50) pg/mL after the 2nd week. There was no statistical difference between them( Z=-1.754, P>0.05). The serum IL-6 level was 64.05 (19.90-130.75) pg/mL after the 6th week and 24.80 (3.45-95.40) pg/mL after the 22nd week. Compared with pre-treatment, they were all lower than pre-treatment levels( Z=-2.942,-3.334, P<0.01,<0.01).Serum IL-2R level was 740.50(510.00-1 161.00)U/mL after the 2nd week, 796.50 (534.00-1 008.00) U/mL after the 6th week and 688.00 (527.00-889.50) U/mL after the 22nd week. Compared with pre-treatment [1 322.50(812.00-1 659.00)U/mL], they were all lower than pre-treatment levels ( Z=-2.818,-3.130,-3.466, P<0.01, <0.01, <0.01). Serum TNF-alpha level was 23.70 (20.30-41.23) pg/ml after the 2nd week, 26.75(16.83-47.03) pg/ml after the 6th week,18.60(13.10-34.90) pg/ml after the 22nd week. Compared with pre-treatment [26.50(20.55-37.43) pg/ml], there were no statistical difference between after and pre-treatment( Z=0,-0.560,-1.954, P>0.05,>0.05,>0.05). Serum IL-8 level was 200.85(95.43-364.00)pg/ml after the 2nd week, 194.50(50.75-433.00)pg/ml after the 6th week, 161.50 (38.98-308.00)pg/ml after the 22nd week. Compared with pre-treatment [96.20(59.75-371.75) pg/ml], there were no statistical difference between after and pre-treatment( Z=-0.86,-0.131,-0.186, P>0.05,>0.05,>0.05). There was no statistical difference between after the 2nd week and pre-treatment in the IL-10 level(χ 2=2.33, P>0.05). The IL-10 level after 6th week and after 22nd week were all lower than pre-treatment levels(χ 2=4.08, 4.08, P<0.05, <0.05). There were no statistical difference between after and pre-treatment(χ 2=0.084, 2.504,3.818, P>0.05,>0.05,>0.05)in IL-1β level. Conclusion:After treatment with tocilizumab, the levels of serum IL-6 and IL-2R are helpful to assess the activity of SoJIA and the efficacy of therapy.

Analysis of clinical features of 14 infants with Takayasu arteritis / 中华实用儿科临床杂志

Objective To improve the understanding and diagnosis and treatment level of infant with Takayasu arteritis (TA) by analyzing the clinical features of 14 pediatric patients and reviewing related articles.Methods The clinical and follow-up data of infants with TA who were admitted to the Children's Hospital Affiliated to Capital Institute of Pediatrics between July 2016 and May 2019 were retrospectively analyzed.By reviewing related articles,the clinical features of this disease were summarized.Results The age of 14 patients (including 6 males and 8 females) were between 1 month and 23 days and 28 months.The most common clinical manifestations were fever in 10 cases (71.4％),hypertension in 9 cases (64.3％),weak or no pulse in 5 cases (35.7％).According to the clinical type of lesion vessels,11 cases (78.5％) were generalized type,3 cases (21.4％) were brachiocephalic artery type,and there was no thoracic abdominal aorta or single pulmonary artery type in this group.Among 14 infants with TA,12 cases had common carotid artery,carotid artery,subclavian artery,coronary artery and its branches (anterior descending branch,circumflex branch) involved (85.7％);11 cases had renal artery involved (78.6％);9 cases had radial artery involved (64.2％);8 cases had abdominal aorta involved (57.1％);6 cases had descending aorta involved (42.9％);6 cases had thoracic aorta involved (42.9％);6 cases had superior mesenteric artery involved (42.9％);5 cases had femoral artery involved (35.7％);5 cases had pulmonary artery involved (35.7％);and 4 cases had brachial artery involved (28.6％).In those 14 patients,11 cases were misdiagnosed,and 3 cases had unclear diagnosis,with misdiagnosis duration of 18 days to 2 months.In misdiagnosed cases,8 cases were misdiagnosed as atypical Kawasaki disease.Among those 14 cases,the ranges of most lesions were gradually decreased,and the slightly involved vessels even completely returned to normal state after treatment in 7 cases.The vascular imaging showed no significant exacerbation or imnprovement in 4 cases.Nine cases developed hypertension,the blood pressure of whom could be controlled within normal range with hypotensive drugs which could not be interrupted.Physical examination found weak or no pulse in 5 cases who were not improved.Among 14 patients,7 cases showed normal development,while the height and body mass of another 7 cases were the 25th percentile below those of normal children of the same age.All 14 patients were followed up for 2-22 months and received regular treatment without recurrence.Conclusions TA patients aged less than 3 years tend to have more blood vessels involved,be in serious condition and have higher rate of misdiagnosis.The disease can be controlled quickly after treatment,but vascular diseases may be developed easily.Some patients have a poor prognosis.

Early typing diagnostic and predictive value of AKA, APF and ACPA in juvenile idiopathic arthritis / 中华检验医学杂志

Objective To investigate the early typing diagnostic and predictive value of anti-keratin antibodies(AKA), anti-perinuclear factor(APF) and anti-citrullinated protein antibodies(ACPA) in patients of juvenile idiopathic arthritis (JIA). Methods A retrospective study was conducted to collect 144 cases of JIA who were hospitalized in Capital Institute of Pediatrics from December 2013 to June 2016 and followed up for at least one year.Among them,66 were males (46％) and 78 were females (54％).The age at diagnosis was between 1 year 5 months to 15 years 9 months.144 patients were tested for AKA,ACPA,APF and TNFα upon admission. Chi-square test or Fisher exact test were used to compare the positive rates of three antibodies among different subtypes. Mann-Whitney nonparametric test and Chi-square test or Fisher exact test were used to analyze the data of prognosis between antibody-positive group and antibody-negative group in the course of disease. Results In 144 patients, 49(34％) were classified as systemic arthritis, 28 (19.4％) as polyarthritis, 61(42.3％) as oligoarthritis, and 6(4.2％) as enthesitis-associated arthritis. 52 cases (36.1％) were positive for one antibody or more antibodies of AKA/APF/ACPA at the early stage,14(9.7％) were AKA positive, 44(30.6％) were ACPA positive and 12(8.3％) were APF positive. The positive rates of ACPA/AKA/APF antibodies were significantly different among different subtypes(χ2=33.863,26.860,14.395;P<0.01,<0.01,<0.05).The rates in polyarthritis were higher than those in systemic arthritis and oligoarthritis;In 95 children with non-systemic form,the level of TNFαin antibody-positive group(43 cases)was higher than that in antibody-negative group(52 cases)at the early stage(Z=4.785, P<0.01);144 patients were followed up for at least one year,the rates of patients who accepted biologic therapies were significantly different between antibody-positive group and antibody-negative group (50％ vs 25％). So do the rates of patients with joint deformities(17.3％vs 2.2％)and with important joints involvement (hip and axis joints)(59.6％vs 14.1％)(χ2=9.249, 10.875, 32.392; P<0.01, <0.01, <0.01). Further more, the number of joints involved in the antibody-positive group (7.07 ± 3.85) was significantly more than that in the antibody-negative group (2.31 ± 1.64)(F=63.822,P<0.01). Conclusions AKA,APF and ACPA are important in the early typing diagnosis of JIA,and may be closely related to the prognosis of patients with JIA.

Early typing diagnostic and predictive value of AKA, APF and ACPA in juvenile idiopathic arthritis / 中华检验医学杂志

Objective@#To investigate the early typing diagnostic and predictive value of anti-keratin antibodies(AKA), anti-perinuclear factor(APF) and anti-citrullinated protein antibodies(ACPA) in patients of juvenile idiopathic arthritis (JIA).@*Methods@#A retrospective study was conducted to collect 144 cases of JIA who were hospitalized in Capital Institute of Pediatrics from December 2013 to June 2016 and followed up for at least one year.Among them,66 were males (46%) and 78 were females (54%).The age at diagnosis was between 1 year 5 months to 15 years 9 months.144 patients were tested for AKA,ACPA,APF and TNFα upon admission. Chi-square test or Fisher exact test were used to compare the positive rates of three antibodies among different subtypes. Mann-Whitney nonparametric test and Chi-square test or Fisher exact test were used to analyze the data of prognosis between antibody-positive group and antibody-negative group in the course of disease.@*Results@#In 144 patients, 49(34%) were classified as systemic arthritis, 28 (19.4%) as polyarthritis, 61(42.3%) as oligoarthritis, and 6(4.2%) as enthesitis-associated arthritis. 52 cases (36.1%) were positive for one antibody or more antibodies of AKA/APF/ACPA at the early stage, 14(9.7%) were AKA positive, 44(30.6%) were ACPA positive and 12(8.3%) were APF positive. The positive rates of ACPA/AKA/APF antibodies were significantly different among different subtypes(χ2=33.863,26.860,14.395; P<0.01,<0.01,<0.05).The rates in polyarthritis were higher than those in systemic arthritis and oligoarthritis; In 95 children with non-systemic form, the level of TNFα in antibody-positive group (43 cases) was higher than that in antibody-negative group (52 cases) at the early stage(Z=4.785, P<0.01);144 patients were followed up for at least one year,the rates of patients who accepted biologic therapies were significantly different between antibody-positive group and antibody-negative group (50% vs 25%). So do the rates of patients with joint deformities (17.3% vs 2.2%) and with important joints involvement (hip and axis joints) (59.6% vs 14.1%) (χ2=9.249,10.875,32.392; P<0.01,<0.01,<0.01). Further more, the number of joints involved in the antibody-positive group (7.07±3.85) was significantly more than that in the antibody-negative group (2.31±1.64) (F=63.822, P<0.01).@*Conclusions@#AKA,APF and ACPA are important in the early typing diagnosis of JIA,and may be closely related to the prognosis of patients with JIA.

The function of DKK2 in breast cancer and its molecular mechanism / 中华内分泌外科杂志

Objective To study the expression and the function of DKK2 and to explore its potential mechanisms in breast cancer.Methods The expression of DKK2 was detected by RT-PCR in normal breast tissues and breast cancer cells.we have transfected DKK2 into breast cancer cell lines MDA-MB-231 and MCF-7.The cells before transfection were used as control group and marked with Vector.The cells after transfection were used as experimental group and marked with DKK2.Furthermore by qRT-PCR and Western-blot,the expression of DKK2,Notch signaling pathway and related factors were analyzed.We also detected the function of DKK2 by cloning assay,Transwell assay and proliferation assay.Results No expression of DKK2 was found in breast cancer cell lines MDA-MB-231 or MCF-7,with relatively high expression in normal breast tissue.The number of apoptotic cells was 2.57±1.18 before transfectionin in cell line MDA-MB-231,and 49.53±8.27 after transfection.The difference was statistically significant between the two groups (P＜0.005).The relative colony formation rate of MDA-MB-231 cells and MCF7 cells after transfection accounted for 20.44％ and 15.21％,respectively.The difference was statistically significant by t test.The number of apoptosis cells in MB231/DKK2 group was 49.53± 8.27 and that in MB231 / Vector group was 2.57±1.18.The difference was statistically significant (P＜0.005).The number of migrated cells in MB231/DKK2 group was 112.0±8.1 and that in MB231/Vector group was 178.0±12.0.The difference was statistically significant (P＜0.005).The mRNA expression of Notch 1 in group MB231/Vector was recorded as 1.The mRNA expression of JAG1 in MB231/DKK2 group was 0.2891.The difference was also statistically significant (P＜0.005).Conclusions Restored expression of DKK2 in silenced breast cells suppresses breast cancer cell proliferation and migration through repressing Notch signaling.DKK2-Notch signaling pathway may be its potential molecular mechanism to function in breast cancer.DKK2 may be one of the target genes for early diagnosis and treatment of breast cancer.

Tocilizumab for refractory systemic juvenile idiopathic arthritis / 中华儿科杂志

Objective@#To evaluate the efficacy and side effects of tocilizumab for the treatment of systemic juvenile idiopathic arthritis.@*Method@#In this prospective self case-control study, the children diagnosed with refractory systemic juvenile idiopathic arthritis admitted to Department of Rheumatism and Immunology of Children's Hospital Affiliated to Capital Institute of Pediatrics from December 2013 to June 2016 were enrolled and information before and after treatment of tocilizumab was analyzed. The tocilizumab was introvenously guttae in a dose of 8-12 mg/kg every 2 weeks. Complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were tested before and after the application of tocilizumab. Detailed clinical manifestations were recorded. All results were analyzed by χ2 test and t test.@*Result@#Forty patients with a median age of (6.6±3.7) years were enrolled, including 15 males and 25 females. All of the patients presented with fever and 38 patients got normal temperature 24-48 hours after treatment with tocilizumab. Symptoms disappeared in 13 and improved in 4 patients after treatment among the 17 patients who presented with arthritis. Within the 10 patients who manifested with rashes, 9 patients' rashes disappeared without relapse accompanied by the normalization of temperature after the treatment of tocilizumab. One patient got normal temperature but intermittently emerged rashes after symptoms of arthritis improved. In the 40 patients, 38 well tolerated tocilizumab while 2 showed rashes and chill which disappeared shortly after antianaphylaxis treatment. No severe treatment-related infection was found in any patients. According to the study, the white blood cell counts(×109/L), CRP(mg/L) and ESR(mm/1h) tested 2 weeks after the treatment with tocilizumab were significantly lower than that before treatment(12.1±1.2 vs. 16.5±1.8, 47±8 vs. 67±9, 21±5 vs. 57±6, t=2.75, 3.98, 5.22, P=0.009, 0, 0, respectively). No significant changes were found in concentration of IL-6 and TNF-α (65(207) vs. 45(137) ng/L, and 14(6) vs. 17(19)ng/L, Z=-1.247 and-1.285, P=0.212 and 0.199 respectively).@*Conclusion@#Tocilizumab is a treatment with good efficacy and safety for refractory systemic juvenile idiopathic arthritis. Adverse effects would be found in some patients.

High Throughput Screening of 86 Kinds of Glucocorticoids in Cosmetics Using QuEChERS and Isotope Dilution-Liquid Chromatography Copuled to High Resolution Time-of-Flight Mass Spectrometry / 分析化学

A high throughput screening method based on QuEChERS purification and stable isotope dilution-liquid chromatography coupled to high resolution time-of-flight mass spectrometry was developed for the simultaneous rapid determination of 86 kinds of glucocorticoids (GCs) in cosmetics.The analytes were extracted by acetonitrile, and then the extracts were purified using an improved QuEChERS method.The chromatographic separation was performed on a novel multiple chromatographic retention mechanisms column of Poroshell 120 PFP (100 mm × 2.1 mm, 2.7 μm) with gradient elution using 0.2% (V/V) acetic acid and acetonitrile as mobile phase.The accurate mass database of parent ions and mass spectra library of fragment ions of 86 GCs were established under positive ionization mode with electrospray ionization source.Based on the method described above, the qualitative identifications of the 86 GCs were accomplished without the contrast of standard substances.The results demonstrated that the linear range of this method was from 2 μg/L to 200 μg/L with good correlation coefficients of R2>0.99.The average recoveries of the 86 GCs ranged from 66.2% to 112.8%, and the relative standard deviation (RSDs) was 4.6%-13.9% at three different spiked levels.The limit of detection (LOD) and quantification (LOQ) were 0.006-0.015 mg/kg and 0.02-0.05 mg/kg, respectively.The method is simple, efficient, reliable and accurate, and is suitable for high throughput screening of 86 GCs added illegally in cosmetics.

Study of Stainless Steel Solid Phase Microextraction Fiber for Selective Absorption of Impurities in Gutter Oil / 分析化学

A special solid phase micro extraction ( SPME ) fibre was successfully attained by coating with a special adsorptive material on a porous stainless steel support. And the porous stainless steel support was prepared by electrochemical corrosion for the first time. The optimized erosion condition in this research was as follows: the current intensity of 30 mA, the stainless steel was etched in 2 mol/L hydrochloride solution for 1 min, then sonicated for 3 min; these procedures repeated 5 times. Meanwhile, the treated fiber coated 35 times in the sorbent solution with concentration of 5% ( m/V) in dichloromethane. The SPME fibre was applied to the analysis of gutter oil samples, and the performance of the SPME fibre for the headspace solid phase micro extraction of the exogenous impurities in gutter oil was specific, durable, stable and low-cost. The four detected trace level characteristic impurities in certain gutter oil were given as follows:42 . 7 mg/kg for acetic acid, 21. 6 mg/kg 3-butenenitrile, 71. 8 mg/kg carbon disulfide and 2. 8 mg/kg allylisothiocyanate.

Application of bundle strategies in the management of multidrug-resistant organisms / 中国感染控制杂志

Objective To explore the application of bundle strategies in the management of multidrug-resistant or-ganisms(MDROs).Methods From July 1 ,2013,bundle intervention measures were applied in the management of MDROs from inpatients in a tertiary first-class hospital,the implementation of isolation measures for MDRO-infec-ted/colonized patients were monitored,April-June 2013 was pre-intervention group,July-September 2013 was the first stage of intervention,October-December 2013 was the second stage of intervention,the qualified rate of each measure and incidence of MDRO infection per 1 000 patient-days before and after intervention were compared. Results From April to December 2013,a total of 3 430 non-repetitive isolates were detected.The qualified rate of doctors’ order “contact isolation ”before intervention and in the second stage of intervention were 78.14% and 95.95% respective-ly;the qualified rate of hanging bed-side isolation signs,providing bed-side quick-drying hand disinfectant,and patients wearing blue wristbands before intervention were 52.70%,66.89%,and 87.16% respectively,and in the second interven-tion stage were all 100.00%.The qualified rate of disinfection of medical supplies and environment,as well as patients’ bed assignments before intervention were 23.65% and 15.54% respectively,in the second stage were 79.79% and 77.66% respectively.Health care workers’awareness rate of hand hygiene knowledge,hand hygiene compliance rate,and hand hygiene correct rate before intervention were 69.70%,45.76%,and 76.35% respectively;in the second stage were 90.23%,87.50%,and 94.58% respectively;the qualified rate of implementation of each isolation measure before inter-vention and in different stages after intervention were all significantly different(all P <0.01).The incidence of MDRO in-fection per 1 000 patient-days before intervention,in the first and second intervention stages were 3.24‰,2.63‰,and 2.20‰ respectively.Conclusion After the monitoring and intervention in MDROs with bundle management strategies,the qualified rate of each measure improved,incidence of MDRO infection per 1 000 patient-days decreased.

High Throughput Screening of Drug Multi Residues in Fish by Quadrupole-Time-of-Flight Mass Spectrometry / 分析化学

A high-throughput method for screening drug multi residues was developed by quadrupole-time-of-flight( Q-TOF) mass spectrometry together with QuEChERS sample preparation technique. It has been used for the determination of 57 drugs, such as tetracyclines ( TCs ) , sulfonamides ( SAs ) , quinolones ( QNs ) , triphenylmethanes (TPMs), estrogens (ETs), androgens (AGs) and glucocorticoids (GCs) in fish. The optimized pretreatment conditions were examined. The target compounds were extracted with acetonitrile under the condition of Na2 EDTA-Mcllvaine buffer, and the usage of clean-up reagents was 25 mg anhydrous magnesium sulfate, 12. 5 mg octadecylsilane and 6. 25 mg N-Propylethylenediamine sorbent for extracted solvent of each milliliter. The positive results acquired by this high-throughput method were confirmed by liquid chromatography-tandem mass spectrometry ( LC-MS/MS) . The detection limit for these 59 drugs was in the range of 0. 5-5. 3 μg/kg. The method is time-saving, convenient, effective and wide coverage. Its sensitivity can meet the requirement of the detection of drug residues in aquatic products.

Rapid Screening of Carbamates Pesticide Residues in Vegetables by Electrospray Ionization Mass Spectrometry Based on Principle of Enzyme Inhibition / 分析化学

Arapidscreeningmethodforthedeterminationofcarbamatepesticides(CBPs)residuesin vegetables by measuring acetylcholinesterase ( AChE ) inhibition rate using electrospray ionization mass spectrometry ( ESI-MS ) has been established. After pretreatment by QuEChERS method, sample solution reacts with AChE using acetylthiocholine as substrate. AChE inhibition rate was calculated by determination of the conversion of substrate to product ( thiocholine) using ESI-MS. The temperature, time and concentration conditions of enzymatic reactions have been optimized. The relationship between the concentration of 10 kinds of common CBPs and AChE inhibition rate was researched. Matrix effects of real vegetables were studied. The limit of detection ( LOD) , which was measured by 3 times of enzyme inhibition rate of pesticide-free vegetable samples, was 0. 01-0. 05 mg/kg. The results showed that the method was better than the current national standard method of china for rapid screening of pesticide residues and fully meet the requirements of maximum residue limits( MRL) for pesticides in food of national food safety standard. False positive results were avoided effectively due to its good ability of resistance matrix interference. The reliability was proved by analyzing vegetables with liquid chromatography-tandem mass spectrometry. The method is simple, rapid, sensitive, reliable, and can be used for the rapid, high-throughput screening of CBPs in vegetables.