Chest CT Imaging Features of Indeterminate Pulmonary Nodules and Outcomes in Patients with High-grade Soft Tissue Sarcoma: A Single-center Retrospective Study / 肿瘤防治研究

Objective To explore the imaging features, clinical outcome, and prognosis of indeterminate pulmonary nodules (IPN) in patients with high-grade soft tissue sarcoma. Methods A retrospective study of 82 patients with high-grade soft tissue sarcoma who have IPNs. The clinical characteristics, imaging features of IPN, and survival of patients were analyzed with statistical software. Results The IPN size of 82 patients was 6.453±0.864 mm. IPN diameter, shape, density, and nodule discovery interval may be CT imaging features related to malignancy tendency. Age (HR=1.047, 95%CI: 1.007-1.088) and interval between each nodule discovery (HR=3.194, 95%CI: 1.052-9.694) are independent factors that affect the survival of patients with malignant IPN. Conclusion The imaging features of chest CT may provide important guidance for determining the nature and survival prognosis of benign and malignant nodules.

GPR34 Knockdown Relieves Cognitive Deficits and Suppresses Neuroinflammation in Alzheimer's Disease via the ERK/NF-κB Signal.

Alzheimer's disease (AD) is a serious neurodegenerative disease characterized by amyloid-ß (Aß) aggregation and neuroinflammation. G-protein-coupled receptor 34 (Gpr34) was found highly expressed in the hippocampus of APP/PS1 mice. However, its role in AD remains unclear. Herein, the role of Gpr34 as well as its molecular mechanism was explored. Data in GSE85162 were analyzed and the differently expressed genes in the hippocampus tissues of APP/PS1 mouse model of AD were subjected to GO, KEGG and GSEA enrichment analyses. APP/PS1 mice were used as an animal model of AD and the cognitive impairment was evaluated by a water maze test. The level of Gpr34 in hippocampus and BV-2 cells as well as the activation of ERK/NF-κB signal was determined by quantitative real-time PCR, western blot or immunofluorescence. Our results showed that, in BV-2 cells exposed to Aß1-42, Gpr34 knockdown decreased the levels of TNF-α, IL-1ß, IL-6 and iNOS and suppressed the activation of ERK/NF-κB signal. Moreover, the Gpr34-overexpression-induced activation of ERK/NF-κB signal and up-regulated levels of TNF-α, IL-1ß, IL-6 and iNOS were abolished by FR180204, an ERK inhibitor. On the other hand, the in vivo study showed that Gpr34 knockdown ameliorated the cognitive impairment in APP/PS1 mice, decreased the levels of TNF-α, IL-1ß and IL-6, the activation of microglia and ERK/NF-κB signal. In conclusion, Gpr34 knockdown relieved cognitive deficits in APP/PS1 mice and suppressed neuroinflammation and microglial activation, maybe via the ERK/NF-κB signal. It is indicated that the high level of Grp34 in hippocampus may contribute to the pathogenesis of AD.

Trehalose attenuates abdominal aortic aneurysm formation by inducing autophagy in smooth muscle cells.

BACKGROUND: Trehalose is a naturally occurring disaccharide, which has been identified as an autophagy inducer and exhibits protective effect in cardiovascular diseases such as myocardial infraction and atherosclerosis. However, the functional role of trehalose in abdominal aortic aneurysm (AAA) remains undefined. METHODS: To study the effect of trehalose in AAA, trehalose (1 g/kg per day) were given for 14 continuous days in a mouse model of elastase-induced abdominal aortic aneurysm. On day 14, ultrasound was performed to measure aortic diameter before the abdominal aortas were harvested and processed for further analysis. Verhoeff-Van Gieson staining and TUNEL staining were performed on paraffin sections to evaluate vascular histology and apoptosis, immunofluorescence staining and Western-blot were performed to evaluate expression of autophagy markers. RESULTS: Echocardiography and in situ pictures demonstrated that trehalose attenuated infrarenal aorta dilation. Verhoeff-Van Gieson staining showed elastin degradation was improved in trehalose-treated group. Compared with vehicle-treated mice, trehalose treatment restored smooth muscle cell contractile phenotype with increased α-SMA, Calponin and Myh11 expression. Furthermore, trehalose also attenuated cell apoptosis and leukocytes infiltration. Importantly, trehalose induced autophagy with decrease SQSTM1/p62 accumulation, increased lamp2 expression and LC3B conversion. CONCLUSION: Trehalose attenuated AAA progression with decreased inflammation and restored SMC contractile phenotype by inducing autophagy. These results demonstrated the therapeutic potential of trehalose in AAA.

Clinical outcome and prognosis of indeterminate pulmonary nodules in patients with osteosarcoma / 中华骨科杂志

Objective:To explore the incidence, clinical characteristics, imaging features, clinical outcome and prognosis of indeterminate pulmonary nodules (IPN) in patients with osteosarcoma.Methods:A total of 69 patients of osteosarcoma with IPN in lung treated in the Bone tumor Center of Eastern Theater General Hospital from January 2011 to January 2021 were collected retrospectively, there were 47 males and 22 females, with a median age of 19 years old (range 7-60 years old). The clinical characteristics including disease-free interval, the chemotherapy response, with recurrence/non-pulmonary, IPN presence before / during / after chemotherapy and imaging features of IPN including number of IPN, location of IPN, density of IPN, boundary clarity of IPN and outcome. The patients were divided into the metastasis pulmonary nodules group and the benign nodules group according to the final outcome of IPN. Further, χ 2 test was performed for comparison of the clinical and imaging characteristics between the two groups. The survival of patients was counted and the correlation between single factor and survival was compared by Kaplan-Meier test, and multivariate survival analyses were performed using Cox proportional hazards regression models. Results:Sixty-nine cases occurred IPN in 211 patients with osteosarcoma, with an incidence of 32.7%. Of the 69 patients, 45 patients (65.2%) with IPN were diagnosed as metastases, and 24 patients (34.8%) with IPN were diagnosed as benign nodules. Follow-up length ranged from 1 to 124 months, with the median follow up time 43 months. To the end of follow-up, 41 patients (59.4%) remained alive and 28 patients (40.6%) had died. The median survival time was 41.0 (20.0, 65.0) months and the median survival time after diagnosis of IPN was 25.0 (10.0, 43.0) months. There were significant differences in lung nodule density ( P<0.001), boundary ( P=0.002), history of recurrence/extra-pulmonary metastasis ( P=0.023) and chemotherapeutic effect ( P<0.001) between the metastasis pulmonary nodules group and the benign nodules group. Multivariate survival analysis showed that chemotherapeutic effect was an independent factor affecting the overall survival of patients [ HR=0.048, 95% CI (0.01, 0.26)]. Boundary definition [ HR=0.12, 95% CI (0.02, 0.93)] and chemotherapeutic effect [ HR=0.06, 95% CI (0.01, 0.29)] were independent factors influencing survival after diagnosis of IPN. Conclusion:Osteosarcoma patients with IPN have a poor prognosis. The poor effect of chemotherapy is an independent risk factor for the overall survival time of those patients and the survival time after diagnosis of IPN. The boundary definition of IPN is an independent risk factor for the survival time after diagnosis of IPN.

Nutritional Status of Children Aged 3 to 7 Years in Zhag′yab， Tibet / 中山大学学报(医学科学版)

ObjectiveTo understand the physical development level of 3-7 years old children in Zhag′yab， and to provide reference for local health decision-making. MethodsA cross-sectional study was conducted between June 2021 and July 2021， with a sample of 1 247 Tibetan children aged 3-7 years from kindergartens in 13 districts of Zhag′yab. Their height and weight were measured and the hemoglobin was detected by a unified method. Standard statistical method was adopted （Z-score method）. Z-scores of length /height-for-age （HAZ）， Z-scores of weight-for-age （WAZ）， Z-scores of body mass index （BMI）-for-age （BAZ） and Z-scores of weight-for-height （WHZ） were calculated by WHO Anthro v3.2.2 and WHO Anthro Plus. The nutritional status of children was evaluated according to WHO diagnostic criteria for malnutrition and anemia. ResultsThe average WAZ and HAZ of children aged 3 to 7 in Zhag′yab were lower than the WHO standards，except for the WAZ of 4-year old， the differences were statistically significant （P<0.05）. The overall detection rate of malnutrition was 25.7%， stunting， underweight， wasting， overweight， obesity and anemia were 11.6%， 11.8%， 10.8%， 3.3%， 1.8% and 29.3%， respectively. The detection rates of all indicators in boys were higher than those in girls， and the differences were not statistically significant （P>0.05）. The overweight rate and obesity rate of rural children were lower than those of urban children， and the other detection rates were higher than those of urban children. The differences of underweight rate， obesity rate and anemia rate were statistically significant between urban and rural children （P<0.05）. Among the detection rates of all indicators in different age groups， there were statistically significant differences in the overweight rate and the anemia rate （P<0.05）. The overweight rate of children aged 4 and the anemia rate of children aged 5 were the highest. ConclusionsThe physical development of children aged 3 to 7 in Zhag′yab is poor， and the prevalence of malnutrition and anemia is high. Underweight and anemia are more serious in rural children， and the overweight and obesity problem of urban children is emerging. More attention should be paid to promote their nutritional status. The prevention and intervention of children’s malnutrition should be strengthened in Zhag′yab.

Applicatoin of chitosan-based hydrogel in oral tissue engineering / 中南大学学报(医学版)

Pulpitis, periodontitis, jaw bone defect, and temporomandibular joint damage are common oral and maxillofacial diseases in clinic, but traditional treatments are unable to restore the structure and function of the injured tissues. Due to their good biocompatibility, biodegradability, antioxidant effect, anti-inflammatory activity, and broad-spectrum antimicrobial property, chitosan-based hydrogels have shown broad applicable prospects in the field of oral tissue engineering. Quaternization, carboxymethylation, and sulfonation are common chemical modification strategies to improve the physicochemical properties and biological functions of chitosan-based hydrogels, while the construction of hydrogel composite systems via carrying porous microspheres or nanoparticles can achieve local sequential delivery of diverse drugs or bioactive factors, laying a solid foundation for the well-organized regeneration of defective tissues. Chemical cross-linking is commonly employed to fabricate irreversible permanent chitosan gels, and physical cross-linking enables the formation of reversible gel networks. Representing suitable scaffold biomaterials, several chitosan-based hydrogels transplanted with stem cells, growth factors or exosomes have been used in an attempt to regenerate oral soft and hard tissues. Currently, remarkable advances have been made in promoting the regeneration of pulp-dentin complex, cementum-periodontium-alveolar bone complex, jaw bone, and cartilage. However, the clinical translation of chitosan-based hydrogels still encounters multiple challenges. In future, more in vivo clinical exploration under the conditions of oral complex microenvironments should be performed, and the combined application of chitosan-based hydrogels and a variety of bioactive factors, biomaterials, and state-of-the-art biotechnologies can be pursued in order to realize multifaceted complete regeneration of oral tissue.

Pathogenesis and staging treatment for non-specific low back pain based on the meridian sinew theory / 中国针灸

Based on the physiological and pathological characteristics of meridian sinew theory, the staging treatment of non-specific low back pain (NLBP) is explored to provide the reference of clinical practice. The twelve meridian sinews of the human body communicate with the bones and joints of the whole body, which governs the movement, body protection and defense, and meridian regulation. Physiologically, the meridian sinew maintains the functions of the lumbar region. In pathology, the meridian sinew may encounter stasis and pain, contraction and spasm or "transverse collateral" formation. According to the pathological staging of meridian sinew disorders, the progress of NLBP is divided into 3 phases and the corresponding treatments are provided. Mild stimulation and rapid analgesia is suggested to promote tissue repair at the early phase; muscle spasm is relieved to adjust muscular status at the middle phase; and the "cord-like" muscle foci is removed at the later phase of the disease.

Epidemiological characteristics of influenza among the elderlyin Heilongjiang Province / 预防医学

Objective @#To investigate the epidemiological characteristics of influenza among the elderly in Heilongjiang Province from 2017 to 2021 (April 2017 to March 2022), so as to provide insights into influenza control among the elderly.@*Methods @#The data pertaining to surveillance of patients with influenza-like illness (ILI) at ages of 60 years and older in Heilongjiang Province from 2017 to 2021 were retrieved from Chinese Influenza Surveillance Information Management, and the temporal distribution of ILI cases and the results of influenza virus tests were descriptively analyzed. @*Results @#Totally 26 908 ILI cases at ages of 60 years and older were reported in Heilongjiang Province from 2017 to 2021, with an ILI prevalence rate of 0.17%. The prevalence of ILI appeared a tendency towards a rise in Heilongjiang Province from 2017 to 2021 (χ2trend=268.554, P<0.001), and the epidemic peaked in the 3rd to 7th weeks of 2019 and 2020. The overall positive rate of influenza virus was 6.80%, and the positive rate of influenza virus showed a tendency towards a decline from 2017 to 2021 (χ2trend=425.268, P<0.001). Influenza A (H1N1) pdm09 (46.82%) and A (H3N2) (22.79%), as well as influenza B virus lineages B/Victoria (12.11%) and B/Yamagata (18.28%) were predominant types, which changes among the study period. The detection of influenza virus-positive samples peaked from December to March of the next year, and a high positive rate of influenza virus was detected in Hegang (12.35%), Heihe (11.47%) and Daqing cities (11.07%). There was no significant correlation between the prevalence of ILI and the positive rate of influenza virus in Heilongjiang Province from 2017 to 2021 (rs=-0.800, P=0.104).@*Conclusions@# The prevalence of ILI appeared a tendency towards a rise among the elderly at ages of 60 years and older in Heilongjiang Province from 2017 to 2021, and the epidemic peaked in winter and spring. Influenza A (H1N1) pdm09, A (H3N2), B/Victoria, B/Yamagata were alternately prevalent and there was no obvious correlation between ILI prevalence and the positive rate of influenza virus.

Dynamic AIE crosslinks in liquid crystal networks: visualizing for actuation-guiding, re-bonding for actuation-altering.

Covalent adaptable liquid crystal networks (CALCNs) are highly potential actuating materials due to their actuation properties and shape reprogrammability. Given the importance of network crosslinking state in a CALCN actuator, we sought an all-in-one strategy to probe and visualize its dynamic network while ensuring actuation and reprogramming. Here, tetraphenylethylene derivatives were incorporated into liquid crystal networks via the Diels-Alder (DA) reaction, acting simultaneously as reversible crosslinkers and aggregation-induced emission (AIE) fluorescent probes. The thermally tunable fluorescence of the resulting network can correlate to and thus visualize the actuator's crosslinking status, actuation capability and temperature in real-time and in situ, yielding an intriguing actuation limit-alerting function. Furthermore, we verified unprecedented reprogrammability of the AIE-type CALCNs through both associative and dissociative exchange mechanisms of DA chemistry.

Electrically driven liquid crystal network actuators.

Soft actuators based on liquid crystal networks (LCNs) have aroused great scientific interest for use as stimuli-controlled shape-changing and moving components for robotic devices due to their fast, large, programmable and solvent-free actuation responses. Recently, various LCN actuators have been implemented in soft robotics using stimulus sources such as heat, light, humidity and chemical reactions. Among them, electrically driven LCN actuators allow easy modulation and programming of the input electrical signals (amplitude, phase, and frequency) as well as stimulation throughout the volume, rendering them promising actuators for practical applications. Herein, the progress of electrically driven LCN actuators regarding their construction, actuation mechanisms, actuation performance, actuation programmability and the design strategies for intelligent systems is elucidated. We also discuss new robotic functions and advanced actuation control. Finally, an outlook is provided, highlighting the research challenges faced with this type of actuator.

Endoscopic treatment and prognosis of primary sclerosing cholangitis / 中华消化内镜杂志

Objective:To investigate the outcome and prognostic factors associated with endoscopic retrograde cholangiopancreatography (ERCP) in patients with primary sclerosing cholangitis (PSC).Methods:PSC patients admitted to Xijing Hospital from May 2009 to May 2020 were included. Data of demographics, clinical symptoms, laboratory and imaging tests, and ERCP consultations were collected to explore the population characteristics and clinical efficacy of ERCP treatment, and to follow up disease progression, transplant-free survival, and overall survival .Results:A total of 74 patients with PSC were included in this study, with a median age of 53 years, 54.1% (40/74) male. Patients combined with bile duct dominant stenosis, inflammatory bowel disease (IBD), and another autoimmune liver disease were 32.4% (24/74), 18.9% (14/74), and 17.6% (13/74), respectively, and those undergoing ERCP were 36.5% (27/74). Logistic regression analysis showed that high total bilirubin ( OR=12.33, 95% CI: 1.24-122.63, P=0.032) and bile duct dominant stenosis ( OR=24.67, 95% CI: 3.40-178.88, P=0.002) were independent high-risk factors for ERCP consultation. The operation and clinical success rates of ERCP were both 96.3% (26/27). As of the last follow-up, the proportions of patients progressing to cirrhosis, bile duct cancer, liver transplantation and death were 9.5% (7/74), 4.1% (3/74), 5.4% (4/74) and 18.9% (14/74), respectively. The five-year survival rate of the follow-up patients ( n=54) was 83.3%. The differences in transplant-free survival ( P=0.933) and overall survival ( P=0.608) between ERCP patients and non-ERCP patients were not statistically significant. Transplant-free survival of those who were companied with pruritus ( HR=5.30, 95% CI: 1.50-18.90, P=0.010) was shorter. Conclusion:PSC patients have higher proportion of IBD and less autoimmune liver disease. Higher proportion of patients with higher total bilirubin or bile duct dominant stenosis receive ERCP. While the short-term efficacy of ERCP is satisfactory, the long-term prognosis is still suboptimal. Patients with pruritus have a shorter transplant-free survival.

Analysis of bile bacterial diversity in patients with recurrent common bile duct stones / 中华消化内镜杂志

Objective:To compare the bile bacterial diversity in patients with different types of common bile duct stones (CBDS).Methods:A total of 45 patients with CBDS diagnosed by abdominal ultrasound, abdominal CT and (or) magnetic resonance cholangiopancreatography (MRCP) and treated by endoscopic retrograde cholangiopancreatography (ERCP) in the First Affiliated Hospital of Air Force Medical University from August 2017 to January 2018 were divided into the non-stone (NS) group, the primary cholesterol stone (PCS) group, the primary pigment stone (PPS) group, and the recurrent stone (RS) group. 16S rRNA sequencing was used to analyze the microbile community structure and diversity in bile which was collected before contrast medium injection.Results:Thirty-three patients were in the non-RS group (8 in the NS group, 8 in the PCS group, and 17 in the PPS group) and 12 were in the RS group. The proportion of patients with intra-diverticular papilla [41.67% (5/12) VS 3.03% (1/33), χ2=8.27, P=0.004], loose stones [91.67% (11/12) VS 36.36% (12/33), χ2=10.77, P=0.001] and pigmental stones [100.00% (12/12) VS 51.52% (17/33), χ2=7.04, P=0.008] were significantly higher in the RS group than those in the non-RS group. There was no significant difference in other baseline data ( P>0.05). At the phylum and genus level, the bacterial abundance was similar in the RS and PPS group. Alpha and Beta diversity analysis showed that the microbial diversity was similar between the RS and PPS group, both of which were lower than those in the NS and PCS group ( P<0.05). MetaStat analysis revealed that Helicobacter pylori was the dominant bacteria in the RS group, and Proteobacteria and Escherichia coli were the dominant bacteria in both RS and PPS groups. Conclusion:Bacterial abundance of bile in the RS group is similar to that of the PPS group, but the diversity of biliary bacteria flora in the RS group and PPS group are significantly lower than those in the PCS group and NS group. Helicobacter pylori is the dominant biliary bacteria in the RS group.

Risk factors for moderate to severe pancreatitis after endoscopic retrograde cholangiopancreatography / 中华消化内镜杂志

Objective:To investigate the risk factors for moderate to severe pancreatitis (PEP) after endoscopic retrograde cholangiopancreatography (ERCP) .Methods:Data of 6 731 patients diagnosed as having biliary and pancreatic diseases with initial papilla who underwent endoscopic retrograde cholangiopancreatography (ERCP) from June 2010 to June 2020 in the First Affiliated Hospital of Air Force Medical University were retrospectively analyzed. Parameters related to intubation and postoperative complications were prospectively collected. The main end point was moderate to severe PEP. Logistic regression analysis was used to explore the risk factors for moderate to severe PEP.Results:The incidence of overall PEP and moderate to severe PEP in 6 731 ERCP patients with initial papilla were 5.3% ( n=359) and 1.0% ( n=68) respectively. Univariate analysis showed that female, indications of ERCP, cannulation method, cannulation time, cannulation attempts, times of inadvertent pancreatic duct cannulation and cannulation with or without trainee involvement were all associated with moderate to severe PEP ( P<0.10). Multivariate analysis showed that female ( OR=2.32, 95% CI:1.28-4.21, P=0.006), non-common bile duct stones indication ( OR=2.04, 95% CI:1.16-3.59, P=0.014), cannulation time ≥5 min ( OR=2.23, 95% CI: 1.20-4.13, P=0.011), inadvertent pancreatic duct cannulation time ≥1 ( OR=1.88, 95% CI: 1.03-3.44, P=0.040) and non-trainee involvement cannulation ( OR=1.81, 95% CI: 1.02-3.22, P=0.043) were independent risk factors for moderate to severe PEP. Conclusion:The independent risk factors for moderate to severe PEP include female, non-common bile duct stones indication, non-trainee involvement cannulation and difficult cannulation. Great importance should be attached to these factors above during the whole perioperative period of ERCP.

Evaluation of the applicability of the Zhang′s diagnostic criteria for atopic dermatitis in adolescents and adults from southern Jiangsu / 中华皮肤科杂志

Objective:To evaluate the applicability of the Zhang′s diagnostic criteria for atopic dermatitis (AD) in adolescents and adults from southern Jiangsu.Methods:A total of 1 769 patients were collected, who were newly diagnosed with eczema or AD in departments of dermatology of 7 hospitals in southern Jiangsu from May 2019 to May 2021. A standardized survey interview was conducted with patients by dermatologists using a self-designed questionnaire, which included patient′s personal information, relevant medical history, clinical characteristics, laboratory tests, etc. Using Hanifin-Rajka criteria as the gold standard, the sensitivity and specificity of the Williams criteria, Zhang′s criteria and Japanese Dermatological Association (JDA) criteria were evaluated, separately.Results:Among the 1 769 patients, there were 759 (42.9%) males and 1 010 (57.1%) females, aged 32.2 ± 8.2 years (range, 12 - 79 years) . Pruritus was the most common clinical feature among the AD patients (883/913, 96.7%) . When using the Hanifin-Rajka criteria as the gold standard, 913 (51.6%) subjects were diagnosed with AD; the sensitivity of Zhang′s criteria reached 92.6% (845/913) , and its specificity was 73.2% (627/856) ; the sensitivity of Williams′ criteria was 87.8% (802/913) , and its specificity was 81.3% (696/856) ; the sensitivity of JDA criteria reached 96.9% (885/913) , and its specificity was 68.9% (590/856) . The consistency in the diagnosis of AD was moderate between the Zhang′s criteria and Williams criteria (Kappa = 0.61, P = 0.009) , was relatively high between the Zhang′s criteria and JDA criteria (Kappa = 0.85, P = 0.001) , and was moderate between the Williams criteria and JDA criteria (Kappa = 0.51, P = 0.013) . Conclusions:Compared with the Hanifin-Rajka criteria, the Zhang′s criteria exhibit good sensitivity and specificity for the diagnosis of AD among adolescents and adults in southern Jiangsu. However, pruritus remains important for the diagnosis of AD.

External quality assessment results of in vitro analysis of nuclear medicine from 2004 to 2018 in Shanghai / 中华核医学与分子影像杂志

Objective:To analyze the results of external quality assessment (EQA) of Shanghai Nuclear Medicine Quality Control Center, in order to further strengthen the quality control and management of in vitro testing laboratories. Methods:The EQA results of 41 units evaluated by Shanghai Nuclear Medicine Quality Control Center from 2004 to 2018 were summarized and retrospectively analyzed. The overall qualified rate of all items (total triiodothyronine, TT 3; total thyroxine, TT 4; free triiodothyronine, FT 3; free thyroxine, FT 4; thyroid stimulating hormone, TSH; alpha fetoprotein, AFP; carcinoembryonic antigen, CEA; total prostate specific antigen, TPSA) and the qualified rate of singe item over the years were calculated respectively. Results:From 2004 to 2018, the overall qualified rates of all items of the laboratories were 84.0%(356/424), 90.1%(381/423), 94.8%(399/421), 94.8%(291/307), 96.6%(308/319), 97.2%(280/288), 96.6%(224/232), 97.8%(225/230), 98.7%(224/227), 100.0%(221/221), 99.5%(218/219), 98.6%(215/218), 99.5%(217/218), 99.5%(189/190), 100.0%(90/90), respectively; and the qualified rate of singe item showed an upward trend, but there were still some laboratories′ EAQ results did not reach " qualified" , and there may be potential risk factors affecting the test results during the test process.Conclusions:The qualified rates of in vitro testing laboratories evaluated by Shanghai Nuclear Medicine Quality Control Center show an upward trend from 2004 to 2018. Analyzing the EQA results can help to find the potential risks in the laboratory and improve the detection ability.

Association between metabolically healthy obesity and incident risk of stroke in adult aged over 40 from rural Henan province / 中华预防医学杂志

Objective: To investigate the association between metabolically healthy obesity and the incident risk of stroke in people aged ≥40 years from rural areas of Henan Province. Methods: During 2007 to 2008, 20 194 residents aged ≥18 years were selected for baseline examination by random cluster sampling and 17 265 participants were followed up during 2013 to 2014. According to the aim of current study, a total of 11 864 eligible subjects were included in this post-hoc analysis. Depending on body mass index and metabolic status, subjects were divided into four groups: metabolically healthy normal weight, metabolically healthy obesity, metabolically abnormal normal weight and metabolically abnormal obesity. Multivariate logistic regression model was used to analyze the relationship between metabolically healthy obesity and the risk of stroke. Results: The median (Q1, Q3) age of study participants was 54(46, 61) years, and 4 526 participants were men. During the mean follow-up of 6 years, the cumulative incidence of stroke was 7.16%. The incidence of stroke in metabolically healthy normal weight, metabolically healthy obesity, metabolically abnormal normal weight, and metabolically abnormal obesity were 3.73%, 4.61%, 8.99% and 9.38%, respectively (χ²=117.458, P<0.001). After adjusting possible confounding factors, compared with metabolically healthy normal weight, the risk of stroke was significantly increased in the metabolically healthy obesity group, metabolically abnormal normal weight group and metabolically abnormal obesity group with the odds ratio (OR) and 95% confidence interval (CI) of 1.52(1.10-2.12), 2.11(1.61-2.77) and 2.78(2.18-3.55), respectively. Stratified analysis showed that the risk of stroke was significantly higher in metabolically healthy obesity people aged 40-59 years compared with metabolically healthy normal weight group (OR=2.12, 95%CI: 1.36-3.30). Conclusion: Metabolically healthy obesity, metabolically abnormal normal weight and metabolically abnormal obesity are positively associated with the risk of stroke.

Retrospective analysis of 67 cases of neurosyphilis with abnormal mental behaviors as the initial symptom / 中华皮肤科杂志

Objective:To analyze clinical characteristics of neurosyphilis patients with abnormal mental behaviors as the initial symptom, and to provide a reference for clinical classification of, as well as outcome prediction and efficacy monitoring in neurosyphilis.Methods:Clinical data were collected from 67 HIV-negative neurosyphilis patients with abnormal mental behaviors as the initial symptom in the Second Affiliated Hospital of Soochow University from November 2012 to November 2019, and retrospectively analyzed. Statistical analysis was carried out by using t test. Results:Among the 67 patients, 52 (77.6%) were males, and 15 (22.4%) were females; there were 63 (94.0%) middle-aged and elderly patients and 4 (6.0%) adolescent patients; 38 (56.7%) patients were diagnosed with progressive general paresis, 21 (31.3%) with meningovascular neurosyphilis, 1 (1.5%) with meningeal neurosyphilis, 3 (4.5%) with tabes dorsalis, and 4 (6.0%) with mixed-type neurosyphilis. As laboratory examination showed, 67 patients all presented with positive serum rapid plasma reagin (RPR) test, serum Treponema pallidum particle agglutination (TPPA) test, and cerebrospinal fluid TPPA test, 55 (82.1%) had positive cerebrospinal fluid RPR test, 47 (70.1%) had elevated cerebrospinal fluid protein levels of > 0.45 g/L, 50 (74.6%) had increased white blood cell counts of > 8 ×10 6/L in cerebrospinal fluids, and 28 (41.8%) had elevated IgG levels in cerebrospinal fluids. Magnetic resonance imaging of the brain revealed multiple ischemic foci in 21 (31.3%) cases, multiple leukodystrophy in 17 (25.4%) , cerebral atrophy in 15 (22.4%) , infarction in 8 (11.9%) , and encephalitis-like changes in 2 (3.0%) . Of the 67 patients, 48 were treated with penicillin in aqueous solutions, 15 with ceftriaxone, and 4 with doxycycline. Six months later, the follow-up showed that 46 (68.7%) patients responded to the treatment, and the early course of disease was significantly shorter in the highly responsive group than in the poorly responsive group ( P < 0.05) . Conclusion:The middle-aged and elderly males were predominant in the neurosyphilis patients with abnormal mental behaviors as the initial symptom, magnetic resonance imaging is helpful for clinical classification and prognosis prediction of neurosyphilis, and early and standardized antisyphilitic treatment can markedly improve the prognosis of patients.

Interleukin-17A-mediated psoriasis and cardiovascular comorbidities / 中华皮肤科杂志

The interleukin (IL) -23/IL-17 axis is the main pathway in the pathogenesis of plaque-type psoriasis vulgaris, and IL-17A plays a key role in the relevant immune pathways. IL-17A mediates overlapping inflammatory pathways in atherosclerosis and psoriasis, promotes inflammation, coagulation and thrombosis, and plays an important role in the occurrence and development of cardiovascular comorbidities in patients with psoriasis. Inhibiting the inflammatory effect of IL-17A can reduce the incidence and mortality of cardiovascular comorbidities in patients with severe psoriasis. This review summarizes recent research progress in IL-17A-mediated systemic inflammation and cardiovascular comorbidities in patients with psoriasis, and provides a reference for prevention and reduction of cardiovascular comorbidities in patients with psoriasis in clinical practice.

Stability of iodine content in potassium iodate iodized salt in Jilin Province / 中华地方病学杂志

Objective:To study the stability and influencing factors of potassium iodate iodized salt that can be sold in Jilin Province.Methods:In November 2020, 10 large supermarkets were randomly selected in Jilin Province, and two kinds of potassium iodate iodized salts were randomly selected in each supermarket, with five copies of each kind, a total of 100 samples of iodized salt, and the iodine content was determined by spectrophotometry (iodide-starch blue light method). Iodized salt samples were classified according to different salt species (mine salt, sea salt and lake salt) and different production processes (refined salt and non-refined salt). The salt was stored at room temperature, and the iodine content in the salt was measured at 0, 10 and 20 days after opening the packaging. The iodine content attenuation rates of different salt species and different production processes were compared.Results:The mine salt, sea salt and lake salt in iodized salt samples were 45, 45 and 10 portions, respectively. The iodine contents of the 0th day of storage [(19.89 ± 1.38), (20.62 ± 1.91), (19.78 ± 1.01) mg/kg] were compared, and the difference was not statistically significant ( F = 2.57, P = 0.093). On the 10th day, the iodine content of mine salt was lower than that of sea salt and lake salt, and the differences were statistically significant ( P < 0.05); on the 20th day, the iodine content of mine salt was lower than that of sea salt, and the difference was statistically significant ( P < 0.05). There was a significant difference in the iodine content of mine salt stored at 0, 10 and 20 days ( F = 90.62, P < 0.001). The iodine content of sea salt and lake salt on the 20th day was significantly lower than that on the 0th and 10th day, and the differences were statistically significant ( P < 0.05). The iodine content attenuation rates of mine salt, sea salt and lake salt on the 0 - 10 days was compared with that on the 10 - 20 days, and the differences were statistically significant ( Z = 2.24, 2.94, 2.80, P < 0.05). There was a significant difference in the iodine content attenuation rates of mine salt, sea salt and lake salt during the 0 - 10 days of storage ( Z = 24.05, P < 0.001), there was no statistically significant difference in the iodine content attenuation rates on 10 - 20 days ( Z = 5.86, P = 0.053). There was no significant difference in iodine content attenuation rates between refined salt and non-refined salt on 0 - 10, 10 - 20 days ( Z = 1.16, 0.28, P > 0.05). There was no statistical significant difference in the iodine content attenuation rates of refined salt and non-refined salt on the 0 - 10 days compared with those of 10 - 20 days ( Z = 0.76, 1.90, P > 0.05). Conclusions:Iodine loss occurs at 20 days after opening the packaging of iodized salt in Jilin Province. The attenuation of iodine content is less affected by salt species and production processes. It is recommended to eat iodized salt within 20 days after opening the packaging.

Physiologically based pharmacokinetic modeling of the inhibitory effect of dapagliflozin on intestinal and renal SGLT / 药学学报

This study establishes and optimizes the physiologically based pharmacokinetics (PBPK) model for dapagliflozin, predicts the drug distribution into relevant tissues, and calculates the inhibitory effect on the sodium-glucose cotransporters (SGLTs) in the intestine and renal proximal tubule. Based on literature data, a PBPK model for oral administration in healthy adults was established and the predicted blood concentration-time curve characteristics, the main pharmacokinetic parameters (PK), and drug excretion in urine were compared with the published data. To verify and optimize the model and verify the accuracy of the tissue distribution and concentration predictions, a pharmacodynamics model (PD) was established. Urine glucose excretion (UGE) was simulated at the corresponding times. The characteristics of the drug-time curve predicted by the model are similar to those of the measured curve, and the ratio of the main PK parameters to the measured values is within a two-fold range; the accuracy of the established PBPK model is good. The maximal inhibition obtained with 10 mg of dapagliflozin on the duodenum and jejunum segment sodium-glucose co-transporter 1 (SGLT1s) was 1.6%-4.7%, and the inhibition rate of the sodium-glucose co-transporter 2 (SGLT2s) in the proximal tubule of the kidney was as high as 99.9%. At a dose of 10 mg, dapagliflozin delayed intestinal glucose absorption while occupying most of the sites (99.9%) of the renal sodium-glucose cotransporter 2 and inhibiting its glucose reabsorption. This physiological-pharmacokinetic model for dapagliflozin in healthy adults can provide meaningful guidance for exploring pharmacological mechanisms and potential toxicity of gliflozin by simulating drug distribution in different tissues.