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Esophageal cancer is a common malignant tumor of the digestive tract. At present， the pathogenesis of esophageal cancer has not been fully clarified. Although surgery， radiotherapy， chemotherapy， targeted therapy， and immunotherapy have achieved good clinical results in the treatment of esophageal cancer， there are still many complications and severe adverse reactions. As an important part of traditional Chinese medicine （TCM）， in recent years， many basic experiments and clinical studies have proved that Chinese medicine has a good effect in treating esophageal cancer. At the same time， the multi-component and multi-target characteristics of Chinese medicine and unclear pathogenesis of esophageal cancer determine that there are some problems such as unclear mechanisms of Chinese medicine in preventing and treating esophageal cancer. It is necessary to start with modern medicine and reveal the mechanism of Chinese medicine in preventing and treating diseases from the aspects of molecular biology and network pharmacology. It is believed in TCM that the occurrence of esophageal cancer is mostly attributed to stagnation of liver Qi， phlegm stasis and Qi stagnation， fluid consumption and heat accumulation， the decline of healthy Qi， and the cementation of cancer toxicity. According to the literature review， Chinese medicinal compounds mainly include tonic formulae （such as Liu Junzitang）， drying and moistening formulas （such as Qigesan）， and heat-clearing formulas （such as Fufang Kushen injection）. Chinese medicinal monomers mainly include drugs potent in attacking poison and killing insects， clearing heat， activating blood and resolving stasis， and regulating Qi， which is consistent with the etiology and pathogenesis of esophageal cancer in TCM. It is also found that Chinese medicine can promote cell apoptosis and autophagy， block cell cycle， and reverse cell resistance by regulating phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt）， neurogenic locus notch homolog protein （Notch）， Wnt/β-catenin， mitogen-activated protein kinase （MAPK）， nuclear factor-κB （NF-κB）， Janus kinase 2/signal transducer and activator of transcription 3 （JAK2/STAT3）， and other related signaling pathways， but there is no systematic summary. This study systematically summarized the relevant signaling pathways of Chinese medicine in regulating esophageal cancer， which is helpful to clarify the relevant mechanisms of Chinese medicine in the process of esophageal cancer occurrence， development， invasion， and metastasis， so as to provide new targets and new perspectives for the treatment of esophageal cancer and promote the modernization of TCM.
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Objective:To analyze the frequency and characteristics of polymyositis (PM) in idiopathic inflammatory myopathy (IIM), and to investigate whether PM is over-diagnosed.Methods:Patients diagnosed as IIM according to the Bohan & Peter criteria of IIM hospitalized in the Department of Rheumatology of China-Japan Friendship Hospital from 2008 to 2019 were involved in the study. Definite PM (dPM) was defined as typical clinical and pathological features including elevated creatine kinase (CK) level, muscle weakness and muscle biopsy findings with endomysial CD8 + T cell infiltration and expression of MHC-1 on sarcolemma. Meanwhile, dermatomyositis (DM), anti-synthase syndrome(ASS), immune-mediated necrotic myopathy(IMNM), sporadic inclusion body myositis(sIBM) and other myopathies were excluded according to the new classification criteria of IIM subtypes respectively. Statistical analysis was performed using SPSS software 24.0. The Kruskal-Wallis test and χ2 test were used to compare the clinical characteristics between the dPM group and other IIM subtypes. Results:A total of 1 259 patients with IIM including 1 015 (80.6%) DM and 244(19.4%) PM were enrolled in this study. According to the strict definition of PM criteria, only 0.5% of patients (6/1 259) in IIM could be diagnosed as dPM. Most PM patients were IMNM and ASS according to the new IIM subtypes criteria, of which 48.0% (117/244) were IMNM and 32.0% (78/244) were ASS. 66.7%(4/6) of dPM patients were women. One complicated with RA, and one was dPM overlaped with systemic sclerosis. All of them had muscle weakness, mild elevation of CK level [611(391,1 451) U/L], and were myositis-specific autoantibodies negative. Except one dPM patients who did not receive immunoregulatory therapy due to chronic obstructive pulmonary disease, the others were administrated with low or medium dose prednisone combined with or without immunosuppressive agents. After a median follow-up of (38±26) months, the muscle strength of dPM patients were improved.Conclusion:dPM is a very rare clinical subtype of IIM. PM is an over-diagnosed entity in clinical practice. Patients with dPM have mild symptoms and good outcome.
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Objective:To analyze and interpret the literature on intestinal preparation during colonoscopy in the elderly in China, and explore the research hotspots and development frontiers in this field, so as to provide theoretical reference for relevant institutions and researchers.Methods:Bibliometrics CiteSpace Ⅴ software was used to search CNKI, Wanfang Database, VIP, Chinese biomedical journal database, Chinese biomedical literature database from January 1, 2000 to April 30, 2022, and then statistical analysis was made on the number of published papers, distribution of institutions and regions, authors, journals, funding, and the maps of high-frequency keywords, clustering, and cooperation of authors, institutions and burst words were drawn.Results:A total of 281 literatures were included, and the characteristics of intestinal preparation, the effect of intestinal preparation for colonoscopy and nursing intervention of intestinal preparation for colonoscopy in the elderly were extracted as the research focus.Conclusions:The visualization analysis showed the research hotspots and trend of intestinal preparation during colonoscopy in the elderly. Intestinal preparation and comprehensive nursing intervention are still the focus of future research, and the cooperation among researchers and quality of published literature should be improved based on the research hotspots in the future.
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Objective:To explore the effect of emergency rescue ability training of operating room nurses based on video tracking method, and provide reference for improving emergency ability of operating room nurses.Methods:This study was a quasi-experimental study. In March 2021, 85 nurses working in the Department of Anesthesiology and Surgery of the Provincial Hospital Affiliated to Shandong First Medical University were selected by cluster sampling method. We implemented a training program of rescue emergency ability based on video tracking and adopted the inspection list of rescue emergency ability assessment and doctors′ satisfaction questionnaire of operating room nurses to evaluate the scores of each item in the nurses' rescue emergency ability list and doctors' satisfaction of rescue cooperation of operating room nurses.Results:The scores of the dimensions of recognition of fatal arrhythmias, fatal arrhythmia, several situations that can directly call help, writing of emergency state nursing records and handover of medical records, use of defibrillator, correct use and maintenance of negative pressure attraction, use and management of rescue vehicle and situation disposal in the inspection list of rescue ability after training were 9.80 ± 1.61, 26.06 ± 2.20, 17.34 ± 1.29, 13.00 ± 1.57, 7.35 ± 0.74, 10.24 ± 1.14, 33.89 ± 2.73, which were higher than before training 9.24 ± 1.18, 24.92 ± 2.15, 15.69 ± 1.92, 12.21 ± 1.66, 6.55 ± 0.92, 8.94 ± 1.32, 32.94 ± 2.20. The differences were statistically significant ( t values were -6.83 to -2.51, all P<0.05); after the training, in the questionnaire of doctors' satisfaction with nurses, surgical materials and instruments preparation, first aid skill operating level, attention to surgical progress, active and correct delivery, orderly and busy, coordination and communication ability, professional knowledge, evaluation ability and foresight, ability to deal with emergencies, clear division of labor and good cooperation, and responsibility scores were 4.22 ± 0.58, 4.52 ± 0.54, 4.53 ± 0.47, 4.43 ± 0.58, 4.44 ± 0.44, 4.37 ± 0. 59, 4.45 ± 0.51, 4.51 ± 0.53, 4.51 ± 0.57, 4.17 ± 0.63, which were higher than the pre-training 4.05 ± 0.58, 4.38 ± 0.56, 4.26 ± 0.76, 4.04 ± 0.67, 4.25 ± 0.62, 4.19 ± 0.74, 4.25 ± 0.74, 4.34 ± 0.67, 4.21 ± 0.84 and 3.56 ± 0.58. All differences were statistically significant ( t values were -8.22 to -2.10, all P<0.05). Conclusions:The training method based on video tracking method improved the emergency rescue ability of operating room nurses and the doctor's satisfaction with rescue cooperation, and provided a reference for the training of operating room nurses.
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Objective:To analyze the medication law of Traditional Chinese Medicine (TCM) patent compounds for Alzheimer disease (AD) by using data mining method.Methods:The TCM compounds for the treatment of AD in the patent database were screened, and the frequency, clustering and association analysis were carried out with the help of TCM inheritance calculation platform, SPSS Statistics 21.0 and SPSS Modeler 18.0 software. The medication law was analyzed.Results:A total of 220 patent compounds were included, involving 361 kinds of Chinese materia medica; the top 10 high-frequency drugs were Acori Tatarinowii Rhizoma, Polygalae Radix, Ginseng Radix et Rhizoma, Chuanxiong Rhizoma, Astragali Radix, Lycii Fructus, Poria, Rehmanniae Radix PraeparataAngelicae Sinensis Radix, Salviae Miltiorrhizae Radix et Rhizoma; the most frequently used drugs were drugs for tonifying deficiency and promoting blood circulation to remove blood stasis; most of their properties belonged to warm, mild and cold; the tastes were mainly sweet, bitter and pungent; the meridians belonged to the five internal organs. 16 items of association data (4 combinations of two items and 12 combinations of three items) were obtained by association rule analysis, and the strongest correlation group was " Acori Tatarinowii Rhizoma- Polygalae Radix" and " Acori Tatarinowii Rhizoma- Chuanxiong Rhizoma- Polygalae Radix". Cluster analysis showed four prescription combinations and three pairs of drug compatibility, including the addition and subtraction structure of Kaixin Powder, Zuogui Pill, Bazhen decoction and so on. Conclusion:The core treatment principle of TCM patent compound treatment of AD is regulating and tonifying the five internal organs to treat its root, resolving phlegm and removing blood stasis to treat the symptoms, which accords with the theoretical basis of TCM in the treatment of AD, and can provide reference for clinical practice and new drug research and development.
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ObjectiveTo investigate the changes of differential metabolites in the serum of mice at different stages of bleomycin sulfate（BLM）-induced pulmonary fibrosis modeling and administration， and the mechanism of Wenfei Huaxian granules（WHG）against idiopathic pulmonary fibrosis. MethodMice were randomly divided into control group， control group of 14 days， model group， model group of 14 days， low-dose WHG group and high-dose WHG group. BLM（0.04 U per mouse）was injected into the trachea of mice in the model group， model group of 14 days， low-dose WHG group and high-dose WHG group， and sterile normal saline was injected into the trachea of mice in the control group and control group of 14 days. Mice of low-dose WHG group and high-dose WHG group were given different doses of WHG by gavage every day after injection of BLM， and mice of control group， control group of 14 days， model group and model group of 14 days were given sterile water by gavage every day. The peripheral blood of mice in the control group of 14 days and model group of 14 days were taken to prepare serum after injection of BLM for 14 days， and the peripheral blood and other materials of mice in the other groups were taken after continuous administration for 28 days. The bronchoalveolar lavage fluid（BALF）was collected for leucocyte differential count， the pathological examination and hydroxyproline（HYP）content determination of lung tissues of mice were performed， and the small molecule metabolites in serum samples of mice in each group were determined by ultra-high performance liquid chromatography-mass spectrometry（UHPLC-MS）. Principal component analysis（PCA）and orthogonal partial least squares-discriminant analysis（OPLS-DA）were conducted to screen differential metabolites and their biological functions were analyzed. ResultCompared with the control group， a large number of continuous fibrotic foci appeared in the lung tissue of mice in the model group， the alveolitis score， fibrosis degree score and HYP content increased significantly（P<0.01）， and the total number of leukocytes， macrophages and lymphocytes in BALF increased significantly（P<0.05）. A total of 33 differential metabolites were screened between the control group of 14 days and model group of 14 days， mainly lipid metabolites， which were mainly involved in oxidative damage and inflammatory process. A total of 34 differential metabolites， mainly amino acid metabolites， were screened between the control group and model group， mainly involving nucleic acid damage and inflammatory process. Compared with the model group， the HYP content， fibrosis score and alveolitis score in the lung tissue of mice from high-dose WHG group decreased significantly（P<0.05， P<0.01）， and the total number of lymphocytes in BALF decreased significantly（P<0.05）. Compared with the model group， 27， 40 differential metabolites were identified in the serum of mice from the low-dose WHG group and high-dose WHG group separately. There were totally 9 common differential metabolites between the model group and low-dose WHG group/high-dose WHG group， which mainly involved in the metabolic pathways of inflammation related lipids metabolism， arginine and tryptophan metabolism， and the change trends in low-dose WHG group and high-dose WHG group were significantly back-regulated compared with the model group. ConclusionWHG can alleviate BLM-induced pulmonary fibrosis， collagen deposition and inflammatory reaction in mice， and its anti-fibrotic effect may be related to the adjusting of inflammatory factors， nitric oxide and oxidative stress related metabolic pathways.
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Galactinol synthase (GolS) genes play important roles in plant response to abiotic stress. In this research, the plant expression vector of soybean GmGolS2-2 gene was constructed and transformed into tobacco to study the drought tolerance of transgenic tobacco. A GmGolS2-2 gene with 975 bp coding sequence was cloned from soybean leaves by reverse transcription-polymerase chain reaction (RT-PCR). GmGolS2-2 was linked to the plant expression vector pRI101 by restriction enzyme sites Nde Ⅰ and EcoR Ⅰ, and transformed into tobacco by leaf disc method. Genomic DNA PCR and real-time PCR showed that three GmGolS2-2 transgenic tobacco plants were obtained. The growth status of GmGolS2-2 transgenic tobacco under drought stress was better than that of wild-type tobacco. After drought stress treatment, the electrolyte leakage and malondialdehyde content of transgenic tobacco were lower than those of wild-type tobacco, but the proline content and soluble sugar content were higher than those of wild-type tobacco. The results of real-time PCR showed that the heterologous expression of GmGolS2-2 increased the expression of stress-related genes NtERD10C and NtAQP1 in transgenic tobacco. The above results indicated that GmGolS2-2 improved drought resistance of transgenic tobacco.
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Drought Resistance , Tobacco/genetics , Soybeans/genetics , Plant Proteins/metabolism , Plants, Genetically Modified/genetics , Stress, Physiological/genetics , Droughts , Gene Expression Regulation, PlantABSTRACT
Stenotrophomonas species are non-fermentative Gram-negative bacteria that are widely distributed in environment and are highly resistant to numerous antibiotics. Thus, Stenotrophomonas serves as a reservoir of genes encoding antimicrobial resistance (AMR). The detection rate of Stenotrophomonas is rapidly increasing alongside their strengthening intrinsic ability to tolerate a variety of clinical antibiotics. This review illustrated the current genomics advances of antibiotic resistant Stenotrophomonas, highlighting the importance of precise identification and sequence editing. In addition, AMR diversity and transferability have been assessed by the developed bioinformatics tools. However, the working models of AMR in Stenotrophomonas are cryptic and urgently required to be determined. Comparative genomics is envisioned to facilitate the prevention and control of AMR, as well as to gain insights into bacterial adaptability and drug development.
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Stenotrophomonas/genetics , Drug Resistance, Bacterial/genetics , Anti-Bacterial Agents/pharmacology , Gram-Negative Bacteria , Genomics , Microbial Sensitivity TestsABSTRACT
This article reported a survived case of amniotic band syndrome (ABS) following fetal reduction by radiofrequency ablation. The woman conceived monochorionic diamniotic twin pregnancy spontaneously. Prenatal ultrasound at 24 weeks of gestation indicated twin-twin transfusion syndrome (stage Ⅲ), and radiofrequency ablation for fetal reduction was successfully performed after formal consent. At 28 +6 weeks, ultrasound reexamination revealed significant edema in the left foot of the fetus, with banding around the ankle, as well as the strangulation mark and narrowing rings. Fetal ABS (ⅡB stage) was diagnosed after multidisciplinary consultation. An immediate emergency cesarean section was performed and a live male baby was born. A thin amniotic band could be seen wrapping around the left ankle of the newborn for several rounds, with obvious strangulation marks about 1 cm deep into the skin, and significant edema on the dorsum and sole of the foot, and the submalleolus area. The amniotic band was released at once, and the edema faded gradually after surgery. After a follow-up of 28 days, the lower limbs of the newborn became normal.
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Clinical decision support system based on medical artificial intelligence(AI)is a key link in medical artificial intelligence transformation of Alzheimer's disease.This paper reviews the status of medical AI used for diagnosis and treatment of Alzheimer's disease, proposed the deficiencies existing in the current application process, in order to provide new ideas for the development of a more professional clinical decision support system for Alzheimer's disease that is suitable for China's national conditions.
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Objective:To study the effect of local infiltration of ropivacaine in gallbladder triangle on agitation and postoperative pain in patients undergoing laparoscopic cholecystectomy (LC).Methods:108 patients with LC who met the requirements of this study treated in Yunnan Cancer Hospital from March 2018 to March 2021 were randomly divided into two groups, 54 cases in each group. Both groups received routine LC under general anesthesia. The observation group received ropivacaine for local infiltration in the gallbladder triangle, and the control group received the same amount of normal saline for local infiltration in the gallbladder triangle. The anesthesia indexes, agitation during awakening and postoperative pain were compared between the two groups.Results:There was no significant difference in extubation, anesthesia and recovery time between the observation group and the control group (all P>0.05); The scores of static and dynamic visual analogue scale (VAS) in the two groups reached the highest value at 6 h after operation, and then decreased gradually, with significant differences between the two groups ( F=15.28, 4.26, 11.06, 3.21, all P<0.05). The dynamic and static VAS scores of the observation group were lower than those of the control group at the time of awakening, 6 h, 12 h and 24 h after operation, with statistically significant difference (all P<0.05). Compared with the control group, the Riker sedation agitation score (SAS) and the incidence of agitation in the observation group were significantly lower (all P<0.05), and the effective times of analgesic pump pressing 24 hours after operation were significantly less ( P<0.05); There was no significant difference in SpO 2 level between the observation group and the control group ( P>0.05); The levels of heart rate (HR) and mean arterial pressure (MAP) in the two groups were significantly higher than those before anesthesia, and the rising degree in the observation group was significantly lower than that in the control group (all P<0.05); The levels of norepinephrine (NE), C-reactive protein (CRP) and cortisol in the two groups were significantly higher than those before anesthesia, and the rising degree in the observation group was significantly lower than that in the control group (all P<0.05). Conclusions:Local infiltration of gallbladder triangle with ropivacaine during LC can reduce the degree of postoperative pain, the use of PCIA pump and the occurrence of agitation during awakening, so as to maintain hemodynamic stability.
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BACKGROUND@#Although previous studies have shown that meteorological factors such as temperature are related to the incidence of bacillary dysentery (BD), researches about the non-linear and interaction effect among meteorological variables remain limited. The objective of this study was to analyze the effects of temperature and other meteorological variables on BD in Beijing-Tianjin-Hebei region, which is a high-risk area for BD distribution.@*METHODS@#Our study was based on the daily-scale data of BD cases and meteorological variables from 2014 to 2019, using generalized additive model (GAM) to explore the relationship between meteorological variables and BD cases and distributed lag non-linear model (DLNM) to analyze the lag and cumulative effects. The interaction effects and stratified analysis were developed by the GAM.@*RESULTS@#A total of 147,001 cases were reported from 2014 to 2019. The relationship between temperature and BD was approximately liner above 0 °C, but the turning point of total temperature effect was 10 °C. Results of DLNM indicated that the effect of high temperature was significant on lag 5d and lag 6d, and the lag effect showed that each 5 °C rise caused a 3% [Relative risk (RR) = 1.03, 95% Confidence interval (CI): 1.02-1.05] increase in BD cases. The cumulative BD cases delayed by 7 days increased by 31% for each 5 °C rise in temperature above 10 °C (RR = 1.31, 95% CI: 1.30-1.33). The interaction effects and stratified analysis manifested that the incidence of BD was highest in hot and humid climates.@*CONCLUSIONS@#This study suggests that temperature can significantly affect the incidence of BD, and its effect can be enhanced by humidity and precipitation, which means that the hot and humid environment positively increases the incidence of BD.
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Humans , Beijing/epidemiology , China/epidemiology , Dysentery, Bacillary/epidemiology , Humidity , TemperatureABSTRACT
Objective:To explore the driving mechanism contributing to doctors′ turnover intention in public hospitals based on the grounded theory.Methods:" Willingness or intention for doctors to quit public hospitals" was used as the theme word, and the literature was retrieved from CNKI published from January 1, 2017 to January 1, 2022. Based on the grounded theory, NVivo 11.0 software was used for a qualitative analysis of the literature. The three-level coding method of open coding, axial coding and selective coding was used to identify the main categories affecting the willingness of doctors to quit public hospitals. On this basis, the driving mechanism model was integrated. In-depth interviews with hospital managers were used to test the theoretical saturation.Results:When 31 papers were coded, four level-1 influencing factors of the formation of doctors′ turnover intention in public hospitals were summarized: career selection deviation, practice reality, perceived experience and external opportunity. Among them, perceived experience was the direct driving factor; career selection deviation was the initial driving factor, and the practice reality was the key driving factor, both of them affected the perceived experience; external opportunity was the possible driving factor.Conclusions:In order to prevent doctors from willing to leave, the following measures are expected: the hospital management should improve both its recruitment evaluation indexes and recruitment effectiveness; pay attention to doctors′ psychological capital management and cultivate positive perception; promote the reform of performance pay, emphasize fairness and value; pay attention to employee relationship management and build a supportive hospital culture.
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Objective:To evaluate the construction effect of famous doctor studio and the correlation among the acceptance indexes by analyzing the achievements of famous doctor studio in the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine.Methods:R software was used to count the relevant data of national famous medical studios approved from 2010 to 2018, and the advantages were analyzed by radar chart; Spearman correlation coefficient was calculated, and R software was used to draw the correlation heat map between the evaluation indexes; papers published by studio members during the construction period were retrieved, which were transformed into refworks format, imported into CiteSpace software to draw a visual knowledge map.Results:A total number of 506 articles were included in this study, involving 25 evaluation indexes and 22 national famous doctors' studios. The statistical analysis results showed that there was a significant positive correlation between the number of academic experience papers of famous and senior TCM experts published in core journals (V3) and the number of diagnosis and treatment schemes of dominant diseases (V1), and there was a significant negative correlation between 8 groups of indexes; Tinnitus, insomnia, premature ovarian failure, acupuncture and acupuncture therapy are research hotspots.Conclusions:When evaluating the construction effect of famous doctor studio, various indicators should be considered comprehensively, appropriately control of the number of members is helpful to improve the quality of talent training, and pay attention should be paid to experience exchange and thought collision during the training process.
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Objective:To compare clinical characteristics of sporotrichosis between children and adults in a third-grade class-A hospital in Jilin province during 2010—2019.Methods:Clinical data were collected from 3 124 patients with sporotrichosis in Department of Dermatology, The First Hospital of Jilin University from January 1, 2010 to December 31, 2019, and retrospectively analyzed. There were 911 children aged < 18 years and 2 213 adults aged ≥ 18 years. All the patients were confirmedly diagnosed with sporotrichosis by fungal culture of skin lesions. Chi-square test was used to compare clinical characteristics of sporotrichosis between children and adults.Results:Among the 911 children, the male-to-female ratio was 1.4 ∶1; 720 (79.0%) developed sporotrichosis in cold seasons (January-March and October-December) , 790 (86.7%) were diagnosed with fixed cutaneous sporotrichosis, and 835 (91.7%) presented with skin lesions on the face. Among the 2 213 adult patients, the male-to-female ratio was 1∶2.5; 1 450 (65.5%) developed sporotrichosis in cold seasons, 1 523 (68.8%) were diagnosed with fixed cutaneous sporotrichosis; skin lesions mostly occurred on the extremities (1 090 cases, 49.3%) and face (975 cases, 44.1%) . The proportion of patients developing sporotrichosis in cold seasons was significantly higher in children than in adults ( χ2 = 55.55, P < 0.001) , and the proportion of fixed cutaneous sporotrichosis was also significantly higher in children than in adults ( χ2 = 107.55, P < 0.001) . In addition, the distribution of skin lesions significantly differed between the children and adults ( χ2 = 599.91, P < 0.001) . Conclusion:The epidemiological characteristics and clinical manifestations of sporotrichosis markedly differed between children and adults.
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Objective:To evaluate the clinical value of prenatal molecular diagnostic technology in preventing hereditary diseases through analysis of prenatal diagnostic characteristics in 22 monogenic skeletal disorders pedigrees.Methods:This study retrospectively analyzed prenatal molecular diagnostic results of 22 pedigrees with monogenic skeletal disorders who were admitted to Department of Osteoporosis and Bone Diseases in our hospital from January 2014 to July 2021.Results:Among 22 pedigrees, there were 10 pedigrees with X-linked hypophosphatemic rickets due to PHEX gene mutations, in which 8 fetuses were found to carry pathogenic variants; 6 pedigrees with osteopetrosis, including 3 cases of CLCN7 gene mutation, 2 TCIRG1 gene mutation, and 1 CTSK gene mutation, were detected to have 2 affected fetuses and 1 carrier. There were 4 cases of osteogenesis imperfecta, including 2 cases of COL1A1 gene mutation, 1 case of COL1A2 gene mutation, and 1 case of SERPINF1 gene mutation, in which 1 affected fetus and 1 carrier were found; only one case of osteoarthritis with mild chondrodysplasia caused by COL2A1 gene mutation was found to harbor pathogenic variant in fetus; 1 case of hypophosphatasia due to ALPL gene mutation was not detected to carry pathogenic variant in fetus. By the time of follow-up, all 12 affected fetuses were terminated, and the remaining 10 fetuses except for one case still in pregnancy were born in good condition.Conclusion:Prenatal molecular diagnosis may confirm whether the fetus carries pathogenic variants at the first and second trimesters. For monogenic skeletal disorders that comply with Mendel′s law of separation, prenatal diagnosis can be determined by calculating the probability of recurrence of offspring. In addition, for families with de novo mutations in the offspring, it is necessary to pay attention to whether there are mosaic mutations in the parents.
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Objective:To learn about the iodine nutrition level of school-age children aged 8 - 10 in Shaanxi Province.Methods:From 2017 to 2020, in counties (cities, districts) under the jurisdiction of Shaanxi Province, one township (street) was selected from five directions: East, West, South, North and Middle, one primary school was selected from each township (street), and 42 non-boarding school-age children aged 8 - 10 (age balanced, half male and half female) were selected from each primary school. Random urine samples of children were collected once, and urinary iodine was detected by arsenic-cerium catalytic spectrophotometry.Results:A total of 91 766 children's urine samples were tested from 2017 to 2020, and the median urinary iodine was 221.7 μg/L. Urinary iodine < 100 μg/L accounted for 10.4% (9 554/91 766), 100 - < 200 μg/L accounted for 32.3% (29 602/91 766), 200 - < 300 μg/L accounted for 30.6% (28 065/91 766), and ≥300 μg/L accounted for 26.7% (24 545/91 766). The median of children's urinary iodine in each year was 228.5, 218.0, 211.7, and 230.1 μg/L, respectively, the difference between years was statistically significant ( H = 278.66, P < 0.001). Conclusion:From 2017 to 2020, the iodine nutrition of school-age children aged 8 - 10 in Shaanxi Province is generally in an ultra-suitable state.
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Objective:To learn about the iodine nutrition status of children aged 8 - 10 and pregnant women in Chongqing.Methods:From March to November 2018, according to the requirements of the "Technical Plan for Iodine Deficiency Disorders Monitoring in Chongqing in 2018", in all 39 counties (districts) of the city, each county (district) was divided into 5 sampling areas according to the orientation of east, west, south, north and middle. One township/street was selected from each area, one primary school was selected from each township/street, and 40 non-boarding students aged 8 - 10 (age balanced, half male and half female) were selected from each primary school. At the same time, 20 pregnant women (balanced in early, middle and late pregnancy) were selected from each township/street. Household edible salt and random urine samples from children and pregnant women were collected to detect the contents of salt iodine and urinary iodine. Children from 13 counties (districts) were selected for thyroid examination, and the goiter rate of children was calculated.Results:Totally 7 973 and 3 927 household edible salt samples from children and pregnant women were tested, respectively. The median salt iodine was 26.20 mg/kg, the coverage rates of iodized salt were 99.07% (7 899/7 973) and 99.57% (3 910/3 927), the consumption rates of qualified iodized salt were 93.72% (7 472/7 973) and 95.03% (3 732/3 927), respectively. Totally 7 973 and 3 927 urine samples from children and pregnant women were tested, respectively. The medians urinary iodine were 228.60 and 186.30 μg/L, respectively. Among the 39 monitored counties (districts), there were no county (district) with iodine deficiency in children, and 4 counties (districts) had iodine deficiency in pregnant women. A total of 2 656 children were examined, and the goiter rate was 1.73% (46/2 656).Conclusions:In 2018, children aged 8 - 10 in Chongqing are generally at the appropriate level of iodine, and the goiter rate conforms to the national standard (< 5%). Pregnant women are generally at the appropriate level of iodine, however, pregnant women in some counties (districts) are at risk of iodine deficiency.
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Objective To investigate the protective effect of adult human liver-derived stem cell exosomes (HLSC-exo) intravenously injected at different time points against acute liver injury induced by concanavalin A (ConA) in mice. Methods HLSC-exo was extracted by differential centrifugation. Western blot was used to measure the expression of the marker proteins CD9 and CD63, and nanoparticle tracking analysis was used to investigate particle size distribution. A total of 56 male C57BL/6 mice were randomly divided into blank control group, ConA model group, and HLSC-exo treatment group. The ConA model group and the HLSC-exo treatment group were further divided into 3-, 6-, and 12-hour subgroups according to the interval between phosphate buffer or HLSC-exo injection and ConA injection. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), tumor necrosis factor-α (TNF-α), and interleukin-10 (IL-10) were measured, and the gross morphology and histopathology of the liver were compared between groups. A one-way analysis of variance was used for comparison of continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups. Results HLSC-exo was a membranous vesicle with a diameter of 90-110 nm, with a clear saucer-like structure under an electron microscope and marked expression of its specific marker proteins CD9 and CD63. In the blank control group, the levels of ALT and AST were 31.81±6.74 U/L and 69.75±8.30 U/L, respectively. Compared with the blank control group, the 3-, 6-, and 12-hour ConA model groups had significant increases in the levels of ALT and AST (all P < 0.001); compared with the 3-and 6-hour ConA model groups, the 3-and 6-hour HLSC-exo treatment groups had significant reductions in the levels of ALT and AST (225.58±115.59 U/L vs 1989.32±347.67 U/L, 1174.71±203.30 U/L vs 2208.33±349.96 U/L, 303.53±126.68 U/L vs 2534.27±644.72 U/L, 1340.70±262.56 U/L vs 2437.13±288.13 U/L, all P < 0.001); compared with the 6-hour HLSC-exo treatment group, the 3-hour HLSC-exo treatment group had significantly greater reductions ( P < 0.001). In the blank group, the levels of IL-10 and TNF-α were 313.51±10.97 pg/ml and 476.05±7.31 pg/ml, respectively. Compared with the blank control group, the 3-, 6-, and 12-hour ConA model groups had a significant reduction in the level of IL-10 (all P < 0.001); compared with the 3-and 6-hour ConA model groups, the 3-and 6-hour HLSC-exo treatment groups had a significant increase in the level of IL-10(331.61±10.46 pg/ml vs 266.20±8.15 pg/ml, 288.13±10.74 pg/ml vs 264.41±9.12 pg/ml, both P < 0.001); compared with the 6-hour HLSC-exo treatment group, the 3-hour HLSC-exo treatment group had a significantly greater increase ( P < 0.001). Compared with the blank control group, the 3-, 6-, and 12-hour ConA model groups had a significant increase in the level of TNF-α (all P < 0.001); compared with the 3-and 6-hour ConA model groups, the 3-and 6-hour HLSC-exo treatment groups had a significant reduction in the level of TNF-α (478.26±12.99 pg/ml vs 551.31±17.70 pg/ml, 515.58±7.18 pg/ml vs 556.21±11.15 pg/ml, both P < 0.001); compared with the 6-hour HLSC-exo treatment group, the 3-hour HLSC-exo treatment group had a significantly greater reduction ( P < 0.001). Compared with the 3-and 6-hour ConA model groups in terms of the gross morphology and histopathology of the liver, the 3-and 6-hour HLSC-exo treatment groups had a significant reduction in the degree of hepatocyte necrosis, and the 3-hour HLSC-exo treatment group had a basically complete lobular structure, with sporadic spotty necrosis; the 12-hour HLSC-exo treatment group had no significant improvement in hepatocyte necrosis compared with the 12-hour ConA model group. Conclusion Intravenous injection of adult HLSC-exo can alleviate acute liver injury induced by ConA in mice, and injection at 3 hours in advance has the most significant protective effect. Regulation of cytokines is one of the important mechanisms for HLSC-exo to alleviate liver injury.
ABSTRACT
Although portal hypertensive enteropathy (PHE) is similar to portal hypertensive gastroenteropathy, it has various endoscopic manifestations with a lack of specificity, and there are still no unified diagnostic criteria. It is easily ignored by clinicians due to great individual differences and the absence of symptoms for quite a long period of time. Based on the patients' conditions and local expert experience, the treatment methods include symptomatic supportive treatment, pharmacotherapy, endoscopic therapy, radioactive intervention therapy, and surgical interventions. Although there have been reports on the endoscopic manifestations and treatment of PHE in recent years, the diagnosis, treatment, and prognosis of this disease should be taken seriously by clinicians.