Association between combined exposure of heavy metals and biomarkers of early renal damage in occupational population / 中国职业医学

Objective: To investigate the effect of combined exposure to four heavy metals (lead, cadmium, arsenic, mercury) on early kidney injury in occupational population. Methods: A total of 384 workers exposed to combined heavy metals in a non-ferrous metal smelting plant in Guangdong Province were selected as the research subjects using judgment sampling method. The levels of blood lead, urinary cadmium and urinary arsenic were detacted by inductively coupled plasma mass spectrometry, while urinary mercury levels were measured using cold atomic absorption spectroscopy (acidic tin chloride reduction method). The levels of biomarkers such as urinary β2-microglobulin (β2-MG), kidney injury molecule-1 (Kim-1) and neutrophil gelatinase-associated lipocalin (NGAL) were detected by enzyme-linked immunosorbent assay. Spearman correlation analysis, linear regression, weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) models were used to analyze the association between the exposure to the four heavy metals and early kidney injury biomarkers. Results: The median of blood lead, urinary cadmium, urinary arsenic and urinary mercury were 0.47 μmol/L and 4.450, 27.790 and 0.520 μg/gCr, respectively. The median of urinary β2-MG, Kim-1 and NGAL were 62.960, 1.130 and 18.150 μg/gCr, respectively. Spearman correlation analysis showed that urinary levels of β2-MG, Kim-1, and NGAL were weakly correlated with blood lead and urinary mercury levels (all P<0.01), but not correlated with urinary cadmium and urinary arsenic (all P>0.05). The results of multiple linear regression analysis showed that urinary mercury was positively correlated with urinary β2-MG, Kim-1 and NGAL (all P<0.01), urinary arsenic was positively correlated with urinary β2-MG level (P<0.01), and blood lead was negatively correlated with urinary β2-MG and Kim-1 (all P<0.05). The WQS regression analysis showed that the combined effect of the four heavy metals was positively correlated with urinary β2-MG, Kim-1 and NGAL (all P<0.01), with mercury having the highest impact and lead the lowest. BKMR model analysis showed the increasing trend in urinary β2-MG, Kim-1 and NGAL with the increasing levels of the combined exposure to the four heavy metals. Urinary β2-MG, Kim-1 and NGAL decreased when urinary mercury level increased from the 25th percentile to the 75th percentile and the other metals were correspondingly fixed at a certain level. When the blood exposure levels of other metals remained at the corresponding median levels, urinary β2-MG, Kim-1 and NGAL levels were positively correlated with urinary arsenic level, but no significant linear dose-response relationship was observed with the other three heavy metals. Conclusion: sLead, arsenic, and mercury are independently associated with early kidney injury biomarkers in occupational population from non-ferrous metal smelting. The four heavy metals had positive combined effects on urinary β2-MG, Kim-1 and NGAL, with mercury having the greatest impact.

Association between exposure to lead, cadmium, and arsenic and blood pressure in workers from a smelter / 环境与职业医学

Background Occupational exposure to lead, cadmium, or arsenic is a potential risk factor for blood pressure elevation. Current studies mainly focus on the relationship between a single metal and blood pressure. However, mixed metal exposure often exists in the actual working environment, and the interactive effects of polymetallic interactions on blood pressure and the dose-effect relationship remain unclear yet. Objective To explore the influence proportion of occupational exposure to lead, cadmium, or arsenic on blood pressure and their interactive effects. Methods From January to December 2021, workers from a smelter in southern China were selected. Demographic characteristics, height, weight, and blood pressure of workers were collected through questionnaire and physical examination. At the same time, their urine samples were collected and the levels of urinary lead, urinary cadmium, and urinary arsenic were detected by inductively coupled plasma mass spectrometry, and corrected by urinary creatinine (Cr). Linear regression and logistic regression were used to analyze the relationship between urinary lead, cadmium, and arsenic and blood pressure. Weighted quantile sum (WQS) regression was applied to evaluate the dose-effect relationship between urinary lead, cadmium, and arsenic exposures and blood pressure and the effect weight of each metal on blood pressure. Generalized linear regression and additive/multiplicative scaling were used to identify interactive effects of the three metals on blood pressure. Results A total of 1075 workers were included in this study, with a mean age of (44.68±5.11) years and mean working seniority of (24.66±5.23) years. There were 891 males (88.9%) and 184 were females (17.1%); 24.7% workers were drinkers and 45.7% workers were smokers; 302 workers (28.1%) reported hypertension and 37 of them were taking antihypertensive drugs. The P50 (P25, P75) levels of urinary lead, urinary cadmium, and urinary arsenic were 6.11 (3.71, 11.08), 3.88 (2.68, 5.44), and 26.04 (19.99, 35.11) μg·g−1, respectively. After adjusting for gender, age, working seniority, body mass index, smoking, drinking, and the usage of antihypertensive drugs, systolic and diastolic blood pressure increased by 0.772 and 0.418 mmHg respectively for 10% increase in lead, cadmium, and arsenic mixed exposure. Urinary cadmium, among the three single exposures, had the greatest effect on systolic and diastolic blood pressure, weight (w)=0.523 and 0.551 respectively. The interaction of urinary lead and urinary cadmium was positively correlated with the occurrence of hypertension, multiplicative interaction OR (ORint)=1.88 (95%CI: 1.09, 3.63), attributable proportion due to interaction (AP)=1.19 (95%CI: 0.40, 8.18). Conclusion This study shows that mixed exposure to lead, cadmium, and arsenic has a positive relationship with blood pressure, in which cadmium plays a major role. Co-exposure to lead and cadmium has a positive interactive effect on hypertension development and systolic blood pressure elevation.

Treatment of Allergic Rhinitis with Traditional Chinese Medicine： A Review / 中国实验方剂学杂志

This article reviews the clinical studies about the treatment of allergic rhinitis （AR） with traditional Chinese medicine （TCM） in recent years. AR is a common and frequently occurring disease in the department of otolaryngology. The common manifestations of AR include nasal congestion， sneezing， runny nose， and nasal itching. AR， belonging to the category of rhinitis， is a dominant disease in the TCM treatment of otorhinolaryngologic diseases and head and neck diseases. The ancient literature has laid a solid theoretical basis on the etiology and pathogenesis of AR. According to the ancient literature， the theoretical basis， and their own experience， modern doctors classified the causes of AR into the disorders in Zang-fu organs and six meridians. Most of the explanations focus on the disorders in Zang-fu organs， especially the lung， spleen， and kidney. The clinical studies in this field mainly involve TCM treatment alone， integrated TCM and Western medicine treatment， and TCM external treatment. These therapies have good efficacy in the clinical treatment of AR. Among them， TCM treatment alone has significant advantages in alleviating the symptoms and nasal signs， declining the scores of related scales， and reducing the eosinophil count （EOS） of nasal secretions， with definite long-term efficacy. Integrated TCM and Western medicine treatment can complement with each other. The TCM external treatment methods include acupuncture， moxibustion， acupoint catgut embedding， acupoint application， and nasal irrigation with TCM， which are safe， simple， acceptable by patients and have good therapeutic effect. Finally， the clinical research status of TCM treatment of AR was summarized， and suggestions were put forward from three aspects： standardizing the clinical research protocol of TCM， encouraging pure TCM research， and exploring the mechanism of TCM treatment on the basis of frontier research achievements. This review aims to provide higher-level evidence for subsequent clinical research and promote the research on dominant AR diseases.

Signal mining of valproic acid-induced adverse drug events based on FAERS / 中国药房

OBJECTIVE To provide reference for clinically safe and rational drug use through mining and analyzing adverse drug event （AE） signals induced by valproic acid （VPA）. METHODS Reporting Odds Ratio （ROR） and Bayesian Confidence Propagation Neural Network （BCPNN） methods of Measures of Disproportionality were performed to mine and analyze the data of VPA-related AE reports in the US FDA Adverse Event Reporting System （FAERS） database from the first quarter of 2013 to the fourth quarter of 2022. RESULTS A total of 1 253 （ROR） and 1 109 （BCPNN） valid signals of preferred terms （PT） were obtained after data processing by the two analysis methods， involving 27 system organs （SOC）， mainly focusing on nervous system disorders， psychiatric disorders， general disorders and administration site conditions. Signals that did not appear in the instruction were associated with 2 SOCs： ear and labyrinth disorders， infections and infestations. CONCLUSIONS As a first-line broad-spectrum anti-epileptic drug， attention should also be paid to eye toxicity and infection risk in the clinical application in addition to paying attention to common adverse events in the instruction.

Association between appendicular skeletal muscle mass and ankle-brachial index in patients with type 2 diabetes / 中华健康管理学杂志

Objective:To assess the relationship between appendicular skeletal muscle mass (ASM) and ankle brachial index (ABI) among patients with type 2 diabetes.Methods:In this cross-sectional study, from July 2018 to March 2019, a total of 278 patients with type 2 diabetes treated in Zhongda Hospital were enrolled in this study, and there were 158 males and 120 females. General information and clinical biochemical parameters and ABI in the patients were collected. The appendicular muscle mass was quantitatively measured with body composition analyzer to achieve ASM. And the appendicular skeletal muscle mass index (ASMI), skeletal muscle index (SMI), and appendicular skeletal muscle mass/body mass index (ASM/BMI) were calculated respectively. Correlation analysis and multiple linear regression analyses with different adjustment models were conducted to analyze the correlation between ABI and above-mentioned indexes.Results:The Pearson correlation analysis showed that ABI had significant positive correlation with ASM, ASMI and ASM/BMI ( r=0.14, 0.13, 0.13, all P<0.05), but a marginal relation with SMI ( r=0.116, P=0.053). Multiple linear regression analysis suggested that ASMI ( β=0.053, 95% CI: 0.006-0.101, P=0.027) and AMI/ABI ( β=0.347, 95% CI: 0.040-0.654, P=0.027) were significantly related to ABI. Conclusion:ASM is positively associated with ABI in patients with type 2 diabetes.

Effects of ruminative thinking on 1-year outcomes in patients with first-episode depression: the mediating role of family functioning / 中华行为医学与脑科学杂志

Objective:To investigate whether rumination and family functioning can predict the level of depression after 1 year of follow-up in patients with first-episode depression, and whether family functioning plays a mediating role between rumination and depression level.Methods:Sixty-five patients with first-episode depression who met the enrollment requirements were included, and all subjects were assessed the 17-item Hamilton depression scale(HAMD-17), rumination response scale(RRS) and family assessment device(FAD). All subjects were followed up for 1 year, and the predictive effects of rumination and family functioning at baseline on the level of depression after 1 year of follow-up were investigated by hierarchical linear regression analysis and mediation analysis.Results:At the baseline stage, rumination, role, affective involvement (AI) and general functioning (GF) were significantly positively associated with depression level after 1 year of follow-up in patients with first-episode depression ( r=0.49, P<0.01; r=0.30, P=0.02; r=0.43, P<0.01; r=0.50, P<0.01; respectively). Rumination, AI and GF at the baseline stage predicted depression level after 1 year of follow-up ( β=0.315, t=2.954, P=0.005; β=0.261, t=2.550, P=0.013; β=0.323, t=2.952, P=0.005). Mediation analysis showed that AI and GF partially mediated the relationship between rumination at baseline and depression level at 1 year follow-up (point estimate value for AI=0.040, 95% CI=0.012-0.090); point estimate value for GF=0.066, 95% CI=0.017-0.143). Conclusions:Rumination and family functioning at baseline in first-episode depressed patients can predict the depression level at 1 year follow-up.Family functioning partly mediates the relationship between the baseline rumination and the depression level at 1 year follow-up.

Isolation and identification of human placental microvascular endothelial cells / 中国医师进修杂志

Objective:To isolate and identify the phenotype and biological characteristics of human placental microvascular endothelial cells(HPMEC).Methods:The HPMEC were isolated from term placenta and cultured in ECM medium. The morphology of the cells was observed under microscope. The functions of HPMEC were detected by uptake of Dil-Ac-LDL, tube formation and cell proliferation. Western Blot was used to detect the expression of endothelial nitric oxide synthase (eNOS), PROKR1 and PROKR2.Results:The HPMEC isolated from the placenta could expressed eNOS, PROKR1 and PROKR2, and were capable of the functions of Dil-Ac-LDL uptaking, tube formation, cell proliferation.Conclusions:HPMEC can be isolated from the placenta, proliferate effectively in vitro and maintain the characteristics of endothelial cells.

Fanconi anemia gene-associated germline predisposition in aplastic anemia and hematologic malignancies / 医学前沿

Whether Fanconi anemia (FA) heterozygotes are predisposed to bone marrow failure and hematologic neoplasm is a crucial but unsettled issue in cancer prevention and family consulting. We retrospectively analyzed rare possibly significant variations (PSVs) in the five most obligated FA genes, BRCA2, FANCA, FANCC, FANCD2, and FANCG, in 788 patients with aplastic anemia (AA) and hematologic malignancy. Sixty-eight variants were identified in 66 patients (8.38%). FANCA was the most frequently mutated gene (n = 29), followed by BRCA2 (n = 20). Compared with that of the ExAC East Asian dataset, the overall frequency of rare PSVs was higher in our cohort (P = 0.016). BRCA2 PSVs showed higher frequency in acute lymphocytic leukemia (P = 0.038), and FANCA PSVs were significantly enriched in AA and AML subgroups (P = 0.020; P = 0.008). FA-PSV-positive MDS/AML patients had a higher tumor mutation burden, higher rate of cytogenetic abnormalities, less epigenetic regulation, and fewer spliceosome gene mutations than those of FA-PSV-negative MDS/AML patients (P = 0.024, P = 0.029, P = 0.024, and P = 0.013). The overall PSV enrichment in our cohort suggests that heterozygous mutations of FA genes contribute to hematopoietic failure and leukemogenesis.

Analysis of intestinal flora in Mongolian female students under anxiety in a medical university / 中国学校卫生

Objective@#To investigate the change in intestinal flora in Mongolian students with anxiety,so as to provide basis for exploring the relationship between flora and secretion expression in vivo.@*Methods@#The Self rating Anxiety Scale(SAS)was used to assess anxiety in medical college students; then a semi structured interview was administered. Fecal samples that met the inclusion criteria were collected and divided into anxiety (SAS score≥50) and control groups (no anxiety, SAS score<50) according to the standard score of SAS. Samples provided by Mongolian female students were selected from each group. The total bacterial DNA was extracted from the fecal samples for PCR amplification and NovaSeq 2x250bp high throughput sequencing was performed for the V3- V4 region of 16S rDNA gene to obtain the biological information of the intestinal flora. The intergroup OTU, structural diversity, significant difference, and LEfSe analyses were performed with information mining of the literature think tanks.@*Results@#Anxiety existed in 23.86% of the Mongolian students,and 16.96% of the Han people. A Chi square test showed no significant difference in detection of anxiety between Mongolian and Han college students ( P =0.07). Analysis of the alpha diversity index showed that the Shannon index, Simpson index, Chao1 index, and Observed species did not differed significantly between the two groups( t =8.0， 9.0 ，6.0，6.5). The difference in abundance of some bacteria was significant at the Class, Order, Family, and Genus levels between the two groups( t =-2.26-2.57，-5.08-3.58，-2.65-2.09， P <0.05).@*Conclusion@#The alpha diversity index showed that there was no significant difference in the abundance and diversity of intestinal flora between the two groups. While there were significant differences at different classification levels, the results suggest that the structure of intestinal flora can change in students with anxiety.

Coexisting anti-N-methyl-D-aspartate receptor and anti-glutamic decarboxylase antibody- associated encephalitis after herpes simplex virus encephalitis: a case report / 中华神经科杂志

Herpes simplex virus encephalitis (HSE) is a common form of viral encephalitis, often with a single-phase course. A case of HSE with abnormal mental behavior as the main manifestation, admitted in Peking University Shenzhen Hospital in Octorber 2020, which improved after sufficient antiviral treatment was reported. After 2 months, abnormal mental behavior with memory deterioration recurred. It was considered as anti-N-methyl-D-aspartate receptor antibody combined with anti-glutamic decarboxylase antibody double-positive encephalitis, and improved after rituximab treatment. At present, there is no clinical report of such double antibody positive autoimmune encephalitis secondary to HSE. The purpose of this case report is to raise clinician awareness of post-HSE autoimmune encephalitis.

One case of misdiagnosis of 22q11.2 deletion syndrome with ovarian mixed germ cell tumor / 中华内分泌代谢杂志

Idiopathic hypoparathyroidism is a rare endocrine disease. It is often manifested as neuropsychiatric symptoms, especially epileptic seizures. Thus, it is easy to be misdiagnosed as primary epilepsy. The following case report details the diagnosis of a 17-year-old girl who had been misdiagnosed as primary epilepsy for a long time. She was found hypoparathyroidism during the hospitalization for the operation of ovarian mixed germ cell tumor. After whole exome sequencing, she was ultimately diagnosed as 22q11.2 deletion syndrome. This case suggested that clinicians should be aware of the possibility of hypoparathyroidism in adolescent epilepsy, especially hereditary hypoparathyroidism. At the same time, the possible high risk of tumors should also be considered in hereditary hypoparathyroidism.

Correlation analysis of eye and neurological manifestations in 56 children with infantile gangliosideosis in China / 中华眼底病杂志

Objective:To observe and analyze the clinical characteristics and correlation between the eye and nervous system in children with infantile gangliosideosis.Methods:From November 2018 to January 2021, 3 children with infantile ganglion lipidosis diagnosed by genetic examination in the Department of Ophthalmology and Neurology, Beijing Children's Hospital of Capital Medical University, and through China National Knowledge Infrastructure and Wanfang database and The National Library of Medicine of the United States (PubMed) were searched, and 53 cases of Chinese infantile gangliosideosis diagnosed by gene, enzyme activity or pathological examination were selected and a total of 56 cases were included in the study. The searching time was from the establishment of the database to February 2021, and the search keywords are"gangliosideosis", "cherry-spot" macula and "Chinese". The demographic characteristics of 56 cases of children and other system manifestations were analyzed such as eyes, nervous system, skin, bones. According to the presence or absence of cherry-spot (CS) on the fundus examination, the children were divided into a fundus CS group (group A) and a fundus without CS group (group B), with 20 and 27 cases, respectively. The age of onset, gender, different types and neurological manifestations of the two groups of children were compared and analyzed. The non-parametric rank sum test was used for age comparison between groups; the χ2 test or Fisher's exact test were used for the comparison of gender, disease type and incidence between groups. Results:Among the 56 children, 27 were males and 29 were females; the median age of onset was 7.0 months. There were 33 and 23 cases of GM1 and GM2, respectively. Among 44 children with visual function examination records, 41 cases (93.2%, 41/44) were unable to follow the visual object. Of 47 children who underwent ocular fundus examination, 20 cases (42.6%, 20/47) had CS on the fundus. The main manifestations of the nervous system are neuromotor development regression or retardation (100%, 56/56), convulsions (58.1%, 25/43), and "startle" phenomena (89.7%, 26/29). Among 42 patients with brain magnetic resonance imaging examination records, 39 cases (92.9%) were abnormal. The incidence of "startle" and seizures in group A was higher than that in group B, and the difference was statistically significant ( χ2=5.815, 6.182, P=0.021, 0.013). Conclusios:Chinese infantile gangliosideosis is more common in GM1 type. Ocular visual impairment is the visual object as the main manifestation, the incidence of fundus CS is 42.6%, and the symptoms of neurological damage in children with CS are more severe.

Electroacupuncture applied at the Sanyinjiao point can relieve stress incontinence by up-regulating the expression of spinal NMDA and α 2 adrenergic receptors / 中华物理医学与康复杂志

Objective:To explore the effect of electroacupuncture on the expression of N-methyl-D-aspartic acid (NMDA) in the spine and the activity of α 2 adrenergic receptors in rats with stress urinary incontinence (SUI). Methods:In all, 48 adult female rats were randomly divided into a sham operation group, a model group and an acupuncture group. The sham operation group received sham vaginal distention. Both the model and acupuncture groups had SUI induced using endovaginal balloon dilatation. The former group then had no further intervention, while the latter was given acupuncture on the sanyinjiao point for one week. Urodynamic testing and leak point pressure (LPP) determination were then conducted with all three groups, as well as urethral sphincter electromyography. The expression of NMDA in the L 6-S 1 spinal segments using the polymerase chain reaction and α 2 adrenergic receptor activity was analyzed using western blotting. Results:No significant differences in the urodynamic variables were observed among the three groups. However, compared with the sham operation group, a significant decrease in the average LPP and the frequency and amplitude of the external urethral sphincter electromyography was observed in the model group. Moreover, compared with the model group, the acupuncture group showed significantly increased average LPP and higher electromyographic frequency and amplitude. The average mRNA and protein expression of NMDA in the spine were also significantly higher in the acupuncture group, as was the average α 2 receptor activity. Conclusions:Vaginal distention is an effective method of establishing urinary incontinence in rats. Electroacupuncture can not only improve the ability to store urine, it also increases urination, which may be related to the up-regulation of the expression of NMDA and α 2 adrenergic receptors.

A de novo mutation leading to Marfan syndrome in a case / 中华医学遗传学杂志

OBJECTIVE@#To explore the genetic basis for a child featuring unexplained rapid growth and heart malformation.@*METHODS@#Whole exome sequencing (WES)was carried out for the patient. Suspected variant was verified by Sanger sequencing and subjected to bioinformatic analysis.@*RESULTS@#The child was found to harbor a novel de novo c.5846_5848delATA (p. N1949del) variant in exon 48 of the FBN1 gene, which was predicted to be pathogenic by Mutation Taster. The patient was ultimately diagnosed with Marfan syndrome.@*CONCLUSION@#Above finding has enriched the spectrum of genetic variants associated with Marfan syndrome. WES has provided a powerful tool for the diagnosis of rare diseases.

Significance of changes of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in neoadjuvant therapy for rectal cancer / 肿瘤研究与临床

Objective:To investigate the significance of changes of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in neoadjuvant therapy for rectal cancer.Methods:The data of 86 patients with rectal cancer who received neoadjuvant therapy from November 2013 to January 2015 in Shanxi Provincial Cancer Hospital were retrospectively analyzed, and the correlations of NLR and PLR changes with the patients' clinicopathological characteristics and therapeutic effects were also analyzed.Results:There were 43 cases of increased NLR and 43 cases of increased PLR after treatment. NLR and PLR changes before and after neoadjuvant therapy in patients with rectal cancer were not associated with age, gender, TNM stage, lymph node metastasis, number of cancer nodules, and tumor diameter (all P > 0.05). The increasing proportion of NLR and PLR after treatment in patients with the distance from the tumor to anus < 6 cm was higher than that in those with the distance≥6 cm [60.00% (30/50) vs. 36. 11% (13/36), χ2 = 4.778, P = 0.029; 64.00% (32/50) vs. 30.56% (11/36), χ2 = 9.364, P = 0.002]. The increasing proportion of NLR and PLR after treatment in patients with the body mass index (BMI) ≥28 kg/m 2 was higher than that in those with BMI < 28 kg/m 2 [81.82% (9/11) vs. 45.33% (34/75), χ2 = 5.108, P = 0.024; 90.91% (10/11) vs. 44.00% (33/75), χ2 = 8.444, P = 0.004]. The remission rate of patients in NLR reduction group after treatment was higher than that in NLR increase group [72.09% (31/43) vs. 51.16% (31/43), χ2 = 3.983, P = 0.046]. PLR changes were not associated with the therapeutic effects of neoadjuvant therapy before and after treatment ( P > 0.05). Conclusion:NLR changes are associated with therapeutic efficacy before and after neoadjuvant therapy for patients with rectal cancer.

Hemodynamic changes and the significance of near-infrared spectroscopy monitoring in neonatal hypoxic-ischemic encephalopathy during mild hypothermia treatment / 中华围产医学杂志

To improve the therapeutic effect of mild hypothermia, avoid the adverse impact of mild hypothermia on cerebral blood flow, and improve the prognosis of hypoxic-ischemic encephalopathy, it is necessary to further explore the mechanism of cerebral hemodynamic disorder in hypoxic-ischemic encephalopathy under mild hypothermia treatment, the influence of systemic hemodynamic changes on cerebral blood flow, and the use of near-infrared spectroscopy to monitor cerebral blood flow and adjust the dosage of vasoactive drugs for avoiding large fluctuation of cerebral blood flow during mild hypothermia treatment and rewarming.

Role of microRNA in hepatitis B virus infection-related diseases / 临床肝胆病杂志

MicroRNA (miRNA) plays an important role in viral diseases by regulating post-transcriptional gene expression. MiRNA can affect the replication and gene expression of hepatitis B virus (HBV) in host cells, while HBV can regulate the expression of host miRNA to provide a favorable environment for its own survival and replication. This miRNA-mediated relationship between HBV and host is an important basis for the pathogenesis of HBV infection-related diseases. This article reviews the research advances in the role of miRNA in HBV infection-related chronic hepatitis B, liver cirrhosis, and hepatocellular carcinoma.

The effect of Toll-like receptor 2 gene on cognitive function in obese mice and its mechanism / 中华内分泌代谢杂志

Objective:To investigate the effect and mechanism of Toll-like receptor 2 (TLR2) on cognitive function in obese mice.Methods:Male C57BL/6J and TLR2 knockout mice were divided into control group, obesity group, TLR2 knockout group, and TLR2 knockout obesity group according to standard diet or high-fat diet. After 16 weeks, water maze experiments were performed to test the learning and memory ability of mice in each group. The body weight and blood lipid biochemical indexes of the mice in each group were measured. Immunohistochemical analys was used to detect amyloid-β (Aβ) protein expression in the hippocampus. Western blotting was used to detect the expression of nuclear factor-κB (NF-κB) p65, phosphorylated (p-) NF-κB p65, low density lipoprotein receptor-related protein 1 (LRP1), and Aβ protein.Results:Compared with the standard control group, the expressions of TLR2, NF-κB p65, p-NF-κB p65, and Aβ protein in obesity group were significantly increased, LRP1 protein expression level was reduced, and the learning and memory ability of mice was significantly reduced. Compared with the obese group, the expression levels of NF-κB p65, p-NF-κB p65, and Aβ protein in the TLR2 gene knockout obesity group decreased, while the expression level of LRP1 protein increased. The memory and learning ability of these mice was significantly improved.Conclusion:TLR2 deficiency may improve the cognitive function of obese mice by inhibiting the TLR2/NF-κB pathway. The mechanism may be related to the up-regulation of LRP1 protein expression.

Scoping review of active surveillance systems for vaccine safety world-wide / 中华预防医学杂志

Objective@#To identify post-marketing active surveillance systems for vaccine safety around the world and understand their features and mechanisms, in order to provide guidance for vaccine administration activities in China.@*Methods@#Following the steps of scoping review, literature about active surveillance system for vaccine safety and published by 30 June 2018 were identified by searching electronic databases, including PubMed, Scopus, and Cochrane Library. Grey literature were also sought by exploring relevant websites. Identified literature were screened according to eligibility criteria, and informative data from included literature were then charted. Framework Synthesis and Thematic Analysis were performed to integrate the charted data.@*Results@#97 pieces of literature were included for review, and 11 active surveillance systems for vaccine safety were identified, mostly located in developed countries. These systems were constructed by 3 types of organizations: administration departments, academic or research institutions, and health care providers. Their data sources included immunization registries, electronic medical records, claims data, case reports of adverse events following immunization electronic questionnaires, and epidemiologic study data. According to their operation procedures, these systems were grouped into 4 modes of active surveillance: Data Linkage, Investigator Network, Automatic Follow-up System, Studies Consortium.@*Conclusion@#Practice of active surveillance for vaccine safety greatly varies across countries, with different conditions and advantages. It is suggested that developing countries should choose suitable mode of active surveillance considering their local situations.

Clinical characteristics and treatment of infantile lactose intolerance and evaluation of the diagnostic value of fecal pH / 中华实用儿科临床杂志

Objective@#To investigate the clinical characteristics, diagnostic approach, and treatment of infantile lactose intolerance, and to evaluate the diagnostic value of fecal pH.@*Methods@#The feces and clinical data of all infants(less than 1 year old) diagnosed with simple diarrhea but without signs of infection were collected, who were treated at 4 Grade Ⅲ-Class-A hospitals within the period of June 2012 to June 2015 in Beijing were collected.Lactose intolerance was diagnosed based on urine galactose level, lactose tolerance test, and fecal pH.The clinical characteristics, therapeutic effects and detection methods of lactose tolerance group and intolerance group were analyzed.Then the diagnostic value of fecal pH was evaluated.@*Results@#A total of 217 infants were enrolled in the study, consisting of 113 boys and 104 girls.Their age ranged from 3 to 330 days, 174 infants (80.2%) were less than 6 months old.Among them, 156 infants were diagnosed with lactose intolerance (71.9%), their median age 90.0 days (3-330 days), while the median age of the lactose tolerant group was 51.5 days (3-300 days). The incidence of lactose intolerance in infants less than 6 months old was 70.6%, and 76.7% in those older than 6 months.Clinical characteristics showed that more infants in the lactose intolerant group were breastfed compared with the lactose tolerant group [73/156 cases(46.8%) vs.16/61 cases(26.2%), χ2=7.666, P<0.05], the occurrence of loose foamy feces was higher in the lactose intolerant group [67/156 cases(42.9%) vs.15/61 cases (24.6%), χ2=6.287, P<0.05], the median duration of diarrhea in the lactose intolerant group was 30 days (1-210 days), and that in the lactose tolerant group was 30 days (1-300 days). The incidence of diarrhea more frequent than 10 times per day in the lactose intolerant group was 9.0% (14/156 cases), while that in the lactose tolerant group was 6.6% (4/61 cases). The rate of infection in the lactose intolerant group was similar to that in the lactose tolerant group [32/165 cases((20.5%) vs.17/61 cases(27.9%)]. The median time of recovery by feeding lactose-free formula milk was 2 days (1-60 days), recovery by feeding lactase lasted a median of 4 days (2-25 days), while recovery by using pro-biotics and dioctahedral smectite lasted a median of 2 days (1-5 days). The characteristics of fecal pH showed that mean pH value of fecal and the incidence of fecal pH<5.5 had no statistical significance between the lactose intolerant and tolerant group, between infants ≤6 months and infants>6 months, between the breastfeeding group and formula-feeding group, or between those with infection and those without infection (all P>0.05).@*Conclusions@#Infants with lactose intolerance often manifest foamy feces and tend to be breastfed.Lactose-free treatment efficacy was better than that with lactase.Clinical symptoms when combined with urine galactose level and lactose tolerance test can help diagnosis.However, the decrease of fecal pH proves to be unhelpful in aiding diagnosis.