Selection of statistical methods for estimating the association between exposure factors and rare outcomes based on cohort studies / 中华流行病学杂志

Odds ratio (OR) and relative risk (RR) are the most commonly used statistical indicators for the estimation of the association between exposure and outcome. In the cohort study with rare outcomes, the estimated OR approximately equals RR, but RR seems more interpretable. The study aims to explore the difference between OR and RR estimated by different multivariate analyses to provide reference for the selection of more appropriate multivariate regression methods and reporting indicators for estimating the association between exposure and rare outcome in cohort studies. This case study used the data from China birth cohort study. Modes of conception and congenital disabilities were regarded as exposure and outcome, respectively. Maternal age, family history of congenital disabilities with clear evidence were included as covariates. Logistic regression, log-binomial regression, and Poisson regression were used to estimate the OR and RR, respectively. Then, OR, RR, and their 95%CI estimated by three regression models were compared. The OR estimated by logistic regression was approximately equal to the RR estimated by log-binomial regression or Poisson regression. However, the RR estimated by log-binomial regression or Poisson regression was closer to 1.00, with a narrower 95%CI. Log-binomial regression or Poisson regression might have non convergence or over dispersion problems. It is recommended to report the RR obtained by log-binomial regression or Poisson regression in the cohort study with rare outcomes if applicable.

Development and application syndromic surveillance and early warning system in border area in Yunnan Province / 中华流行病学杂志

Objective: To establish a dynamic syndromic surveillance system in the border areas of Yunnan Province based on information technology, evaluate its effectiveness and timeliness in the response to common communicable disease epidemics and improve the communicable disease prevention and control in border areas. Methods: Three border counties were selected for full coverage as study areas, and dynamic surveillance for 14 symptoms and 6 syndromes were conducted in medical institutions, the daily collection of information about students' school absence in primary schools and febrile illness in inbound people at border ports were conducted in these counties from January 2016 to February 2018 to establish an early warning system based on mobile phone and computer platform for a field experimental study. Results: With syndromes of rash, influenza-like illness and the numbers of primary school absence, the most common communicable disease events, such as hand foot and mouth disease, influenza and chickenpox, can be identified 1-5 days in advance by using EARS-3C and Kulldorff time-space scanning models with high sensitivity and specificity. The system is easy to use with strong security and feasibility. All the information and the warning alerts are released in the form of interactive charts and visual maps, which can facilitate the timely response. Conclusions: This system is highly effective and easy to operate in the detection of possible outbreaks of common communicable diseases in border areas in real time, so the timely and effective intervention can be conducted to reduce the risk of local and cross-border communicable disease outbreaks. It has practical application value.

Epidemiological characteristics of overseas imported dengue fever and malaria cases in Yunnan Province from 2015 to 2021 / 预防医学

Objective@#To investigate the epidemiological characteristics of overseas imported dengue fever and malaria cases in Yunnan Province from 2015 to 2021, so as to provide insights into the prevention and control of overseas imported arthropod-borne infectious diseases.@*Methods@#The data pertaining to imported dengue fever and malaria cases in Yunnan Province from 2015 to 2021 were collected from the Chinese Disease Prevention and Control Information System, and the temporal distribution, regional distribution, population distribution, sources, diagnosis and treatment of imported dengue fever and malaria cases were descriptively analyzed.@*Results@#Totally 4 332 overseas imported dengue fever cases and 2 011 overseas imported malaria cases were reported in Yunnan Province form 2015 to 2021, which accounted for 30.09% of all reported dengue fever cases and 98.53% of all reported malaria cases. The number of overseas imported dengue fever and malaria cases peaked from August to November (83.13% of all imported dengue fever cases) and from April to July (59.08% of all imported malaria cases), and the cases were predominantly reported in Dehong Prefecture (50.99% and 58.88%), with farmers as the predominant occupation (40.21% and 67.93%). The dengue fever and malaria cases were mainly imported from Southeast Asia (99.04% and 88.21%), and the proportions of definitive diagnosis of dengue fever and malaria were 88.33% and 97.80% at township hospitals, respectively.@*Conclusions@#The number of overseas imported dengue fever and malaria cases peaked from August to November and from April to July in Yunnan Province from 2015 to 2021, and the cases were predominantly reported in Dehong Prefecture and imported from Southeast Asia, with farmers as the predominant occupation.

Experimental study of cardioprotective effects of Cinnamomi Ramulus and Cinnamomi Cortex formula granules on myocardial ischemia/reperfusion injury in rats based on efficacy of "warming and coordinating heart Yang" / 中国中药杂志

This study aimed to parallelly investigate the cardioprotective activity of Cinnamomi Ramulus formula granules(CRFG) and Cinnamomi Cortex formula granules(CCFG) against acute myocardial ischemia/reperfusion injury(MI/RI) and the underlying mechanism based on the efficacy of "warming and coordinating the heart Yang". Ninety male SD rats were randomly divided into a sham group, a model group, CRFG low and high-dose(0.5 and 1.0 g·kg~(-1)) groups, and CCFG low and high-dose(0.5 and 1.0 g·kg~(-1)) groups, with 15 rats in each group. The sham group and the model group were given equal volumes of normal saline by gavage. Before modeling, the drug was given by gavage once a day for 7 consecutive days. One hour after the last administration, the MI/RI rat model was established by ligating the left anterior descending artery(LAD) for 30 min ischemia followed by 2 h reperfusion except the sham group. The sham group underwent the same procedures without LAD ligation. Heart function, cardiac infarct size, cardiac patho-logy, cardiomyocyte apoptosis, cardiac injury enzymes, and inflammatory cytokines were determined to assess the protective effects of CRFG and CCFG against MI/RI. The gene expression levels of nucleotide-binding oligomerization domain-like receptor family pyrin domain protein 3(NLRP3) inflammasome, apoptosis-associated speck-like protein containing a CARD(ASC), cysteinyl aspartate specific proteinase-1(caspase-1), Gasdermin-D(GSDMD), interleukin-1β(IL-1β), and interleukin-18(IL-18) were determined by real-time quantitative polymerase chain reaction(RT-PCR). The protein expression levels of NLRP3, caspase-1, GSDMD, and N-GSDMD were determined by Western blot. The results showed that both CRFG and CCFG pretreatments significantly improved cardiac function, decreased the cardiac infarct size, inhibited cardiomyocyte apoptosis, and reduced the content of lactic dehydrogenase(LDH), creatine kinase MB isoenzyme(CK-MB), aspartate transaminase(AST), and cardiac troponin Ⅰ(cTnⅠ). In addition, CRFG and CCFG pretreatments significantly decreased the levels of IL-1β, IL-6, and tumor necrosis factor-α(TNF-α) in serum. RT-PCR results showed that CRFG and CCFG pretreatment down-regulated the mRNA expression levels of NLRP3, caspase-1, ASC, and downstream pyroptosis-related effector substances including GSDMD, IL-18, and IL-1β in cardiac tissues. Western blot revealed that CRFG and CCFG pretreatments significantly decreased the protein expression levels of NLRP3, caspase-1, GSDMD, and N-GSDMD in cardiac tissues. In conclusion, CRFG and CCFG pretreatments have obvious cardioprotective effects on MI/RI in rats, and the under-lying mechanism may be related to the inhibition of NLRP3/caspase-1/GSDMD signaling pathway to reduce the cardiac inflammatory response.

Epidemiological characteristics of varicella in schools of Yunnan Province in 2018 - 2020 / 公共卫生与预防医学

Objective To analyze the epidemiological characteristics of school varicella and varicella public health emergency event (PHEE) in Yunnan Province, and to provide a scientific basis for the prevention and control of varicella in schools. Methods The descriptive epidemiological method was used to analyze the reported PHEE of varicella in students and varicella in schools in Yunnan Province from 2018 to 2020. Results From 2018 to 2020, a total of 69,391 cases of varicella were reported in students in Yunnan Province, accounting for 71.48% (69 391 / 97 080) of the total cases in the province, and the annual average reported incidence rate was 255.56/100 000 (69 391/27.1522 million). The time distribution of the incidence showed double peaks, which were from May to July (26.48%) and October to January of the following year (53.88%). The incidence rates of different schools from high to low were 301.74/100 000 for primary schools (34 816/11.538 3 million), 250.43/100 000 for kindergarten (11 526/4.6024 million), 202.74/100 000 for middle school (16 779/8.276 1 million), and 119.07/100 000 for others (3 257/2.735 4 million). The age distribution was mainly concentrated in 5-9 years old, accounting for 39.81% (27 625/69 391). Varicella PHEE accounted for 25.64% (180/702）of the province's PHEE in the same period, school varicella PHEE accounted for 100% of varicella PHEE, and the attack rate was 3.38% (6 566/194 260). The sources of reported varicella PHEE were hospitals 45.40% (58/123), epidemic analysis 36.78% (44/123), schools 13.22% (15/123), and others 4.60% (6/123). Conclusion The incidence of varicella in schools in Yunnan Province is high, which is harmful to students. PHEE reported in rural schools are relatively lagging behind. On the basis of doing two doses of varicella vaccination, emergency prevention should be focused on epidemic seasons, lower grade schools and rural schools. The source of infection shall be controlled and managed in time to prevent the outbreak of the epidemic. It is recommended that varicella should be included in the management of Class C infectious diseases.

Variability in reference for serum metabolomics profiles among healthy Han people in different regions of China / 中华内分泌代谢杂志

Objective:To establish the reference for serum metabolomics profiles among healthy Han adults in China, and explore the variation on metabolomics profiles by geographic regions, sex, and age.Methods:Cross-sectional data and serum samples were obtained from the China National Health Survey. A total of 1 039 male and 1 032 female healthy adults(≥30 years) were included in this study. Serum metabolomics analyses were conducted with ultra-performance liquid chromatography-mass spectrometry(UPLC-MS). Orthogonal partial least squares discriminant analysis(OPLS-DA) was performed to compare the differences of metabolomics among different region, sex, and age.Results:Significant differences on metabolomics profiles were identified among region, sex, and age. A total of 114 region-related metabolites were spotted, including 53 metabolites that involved in human metabolic pathways, mainly peptides(20 metabolites) and glycerophospholipid metabolism-related(14 metabolites). Fifty-nine metabolites were pinned down to be sex-related, among which cotinine was significant in all 7 provinces. Age-related metabolites were only found in Shaanxi and Hainan, with 22 metabolites were recognized.Conclusion:Serum metabolomics varies by geographic regions, sex, and age. When metabolomics is applied for diagnosis or biomarker screening in various studies, it shall take into consideration of setting tailored references.

Epidemiological characteristics of brucellosis in Yunnan Province from 2008 to 2018 and prediction of grey GM (1, 1) model / 中华地方病学杂志

Objective:To discover the epidemic characteristics of brucellosis in Yunnan Province, and establish a grey GM (1, 1) model to predict brucellosis in Yunnan Province.Methods:The epidemic data of incidence rate of brucellosis and population data in Yunnan Province from 2008 to 2018 were collected from China Disease Prevention and Control Information System and Yunnan Provincial Bureau of Statistics. Epidemiological characteristics (including time, area and population distributions) were analyzed, and grey GM (1, 1) model was used to predict the incidence of brucellosis in Yunnan Province in 2019 and 2020.Results:A total of 1 216 brucellosis cases were reported in Yunnan Province from 2008 to 2018, with an average annual incidence rate of 0.237 4/100 000, showing an increasing trend year by year (χ 2trend = 843.34, P<0.01). Case reports were mainly from March to September, accounted for 69.41% (844/1 216) of the total number of cases. The top five regions with case reports were Honghe (289 cases), Qujing (264 cases), Kunming (258 cases), Dali (160 cases), and Yuxi (134 cases), accounting for 90.87% (1 105/1 216). The occupation was mainly farmers, accounting for 79.03% (961/1 216). A grey GM (1, 1) model was established to predict the incidence of brucellosis in Yunnan Province in 2019 and 2020, which was 0.487 6/100 000 and 0.481 7/100 000, respectively. Conclusion:The incidence of brucellosis in Yunnan Province has increased compared with that of the past, and targeted prevention and control should be carried out in key areas and key populations, and the prediction results should be prospectively evaluated to gradually improve the establishment of brucellosis prediction model in Yunnan Province.

Cosinor-rhythmometry for 24-h urinary sodium, potassium, creatinine excretion in the Chinese adult population / 中华医学杂志(英文版)

BACKGROUND@#The low accuracy of equations predicting 24-h urinary sodium excretion using a single spot urine sample contributed to the misclassification of individual sodium intake levels. The application of single spot urine sample is limited by a lack of representativity of urinary sodium excretion, possibly due to the circadian rhythm in urinary excretion. This study aimed to explore the circadian rhythm, characteristics, and parameters in a healthy young adult Chinese population as a theoretical foundation for developing new approaches.@*METHODS@#Eighty-five participants (mean age 32.4 years) completed the 24-h urine collection by successively collecting each of the single-voided specimens within 24 h. The concentrations of the urinary sodium, potassium, and creatinine for each voided specimen were measured. Cosinor analysis was applied to explore the circadian rhythm of the urinary sodium, potassium, and creatinine excretion. The excretion per hour was computed for analyzing the change over time with repeated-measures analysis of variance and a cubic spline model.@*RESULTS@#The metabolism of urinary sodium, potassium, and creatinine showed different patterns of circadian rhythm, although the urinary sodium excretion showed non-significant parameters in the cosinor model. A significant circadian rhythm of urinary creatinine excretion was observed, while the circadian rhythm of sodium was less significant than that of potassium. The circadian rhythm of urinary sodium and creatinine excretion showed synchronization to some extent, which had a nocturnal peak and fell to the lowest around noon to afternoon. In contrast, the peak of potassium was observed in the morning and dropped to the lowest point in the evening. The hourly urinary excretion followed a similar circadian rhythm.@*CONCLUSION@#It is necessary to consider the circadian rhythm of urinary sodium, potassium, and creatinine excretion in adults while exploring the estimation model for 24-h urinary sodium excretion using spot urine.

Training doctors for people health: teaching preventive medicine for clinical medicine students in Fudan medical college / 上海预防医学

Preventive medicine is a required course for students majoring in clinical medicine, which is essential for them to understand public health. Teaching teams of Fudan University have focused on the curriculum reform of preventive medicine and kept innovating with the aim of improving the competence of future doctors. Flipped classroom approach was adopted to promote interaction between teachers and students. In addition, a variety of practice sectors were integrated into teaching process, such as diet calculation through graph cards, health risk appraisal practice, hospital visiting. In addition, a 4-weeks community-based practice further strengthened students' understandings of public health in the real world. Much attention was on cultivate scientific spirit, humanity and the capability to serve the people. A multi-dimension, whole-process evaluation is applied and the results shows that the students' comprehensive ability and literacy are significantly improved.

Design, synthesis and biological evaluation of pyrazolo3,4-

Fibroblast growth factor receptors (FGFRs) have emerged as promising targets for anticancer therapy. In this study, we synthesized and evaluated the biological activity of 66 pyrazolo[3,4-

Age-dependent changes of total and differential white blood cell counts in children / 中华医学杂志(英文版)

BACKGROUND@#Total and differential white blood cell counts are important for the diagnostic evaluation of suspected diseases. To facilitate the interpretation of total and differential white blood cell counts in pediatric patients, the present study investigated age-dependent changes in total and differential white blood cell counts in healthy reference children.@*METHODS@#Data were obtained from the Pediatric Reference Intervals in China study (PRINCE), which aims to establish and verify pediatric reference intervals for Chinese children based on a nationwide multicenter cross-sectional study from January 2017 to December 2018. Quantile curves were calculated using the generalized additive models for location, shape, and scale method. The 2.5th, 50th, and 97.5th quantile curves were calculated for both total and differential white blood counts. Percents of stacked area charts were used to demonstrate the proportions of differential white blood cells. All statistical analyses were performed using R software.@*RESULTS@#Both 50th and 97.5th quantiles of total white blood cell count and monocyte count were highest at birth, then rapidly decreased in the first 6 months of life; relatively slow reduction continued until 2 years of age. The lymphocyte count was low during infancy and increased to its highest level at 6 months of age; it then exhibited moderate and continuous reduction until approximately 9 years of age. The pattern of neutrophil count changed with age in a manner opposite to that of lymphocyte count. Besides, there were two inter-sections of lymphocyte count and neutrophil count during infancy and at approximately 5 years of age, based on locally weighted regression (LOESS) analysis. There were no apparent age-related changes in eosinophil or basophil counts.@*CONCLUSION@#These data regarding age-related changes in total and differential white blood cell counts can be used to assess the health of pediatric patients and guide clinical decisions.

Analysis on epidemiological and spatio－temporal characteristics of hand，foot and mouth disease in Yunnan Province from 2014 to 2018 / 中华疾病控制杂志

@#Objective To analyze the epidemic situation and characteristics of spatial autocorrelation and spatiotemporal regular of hand，foot and mouth disease( HFMD) in Yunnan Province during the period from 2014 to 2018，thus to provide theoretical basis for HFMD prevention and control． Methods Descriptive epidemiologic method was used to analyze the epidemic situation of HFMD，spatial autocorrela- tion was used to analyze the spatial cluster aggregation，and discrete Possion model in spatio－temporal in scan was used to detect HFMD＇s spatio－temporal clustering condition． Ｒesults The incidence of HFMD in Yunnan Province had been risen rapidly during the past 5 years． Cases mainly occurred among the group of male，0－4 years old group and scattered children． The predominant pathogen had changed，Other enterovir- us gradually replaced enterovirus 71( EV71) to be the predominant． HFMD cases and pathogen showed sig- nificant spatial clustering aggregation，HFMD cases hot spots mainly concentrated in the central and south－ central part of Yunnan Province． The amount of EV71 cases hot spots increased gradually，and the hot spot areas augmented and extended to the central and south－central part of Yunnan Province． There was obvious spatial－temporal aggregation of HFMD，annual scan results detected 3 first－level cluster areas and 1 second －level cluster area． Clustering time was mainly concentrated in April to October of each year． Conclusions Distribution characteristics of HFMD among people in Yunnan Province did not change significantly during the period from 2014 to 2018，while the proportion of pathogenic spectrum changed significantly． The key areas of HFMD control and prevention were still in the central and central－south part of Yunnan Province，while the aggregation and break of HFMD in these areas from April to October should be concerned．

Expression and relevance of serum IgE,IgE receptors and autoantibodies in patients with chronic urticaria / 中华检验医学杂志

Objective:To detect serum levels of immunoglobulin E (IgE), soluble version of the IgE-binding alpha-chain of Fcepsilon-RI (sFcεRIα), immunoglobulin G (IgG) anti-IgE, IgG anti-FcεRI in patients with chronic urticaria(CU), and to evaluate their relevanceMethods:Forty-three newly diagnosed patient with CU were enrolled. Thirty-seven patients with dermatitis or eczema and 51 healthy subjects were selected as the disease control (DC) and normal control (NC) group, respectively.Serum IgE was detected by immunoturbidimetry; serum anti-IgE, anti-FcεR Ⅰ and sFcεR Ⅰ α were determined byenzyme-linked immunosorbent assay (ELISA) methods. Statistical analysis was carried out by non-parametric test for comparisons of the above variables between groups, and by Spearman correlation analysis for assessment of relationships between the variables as well as between the variables and disease severity, and by receiver operating characteristic curve to analyze the diagnostic value of the variables.Results:Serum IgE, anti-IgE and anti-FcεRI in CU were significantly higher than that of NC.Their medians are 65.70 IU/ml vs 17.10 IU/ml,χ 2=28.541, P=0.001;0.61 vs 0.39,χ 2=27.408, P=0.001;0.64 vs 0.51, χ 2=29.102, P<0.001.Serumanti-FcεRI in CU was significantly lower than that in NC(0.64 vs 0.83,χ 2=25.869, P=0.007).The medians of serum sFcεRIα in CU, DC and NC groups were 5.74,5.38,4.50 ng/ml, respectively. The difference was not statistically significant,χ 2=3.463, P=0.177.There was a positive correlation between IgE and sFcεR Ⅰ α, anti-IgE and anti-FcεRI( r=0.455, P<0.001; r=0.611, P<0.001).No significant correlation was showed between the four variables and the course of disease or the severity of symptoms, P>0.05. The diagnostic performances of IgE, anti-FcεRI for CU were similar (AUC=0.72),which were better than that of sFcεRIα (AUC=0.61).The highest diagnostic efficacy (AUC=0.83) can be achieved by four joint tests.Anti-FcεRI is of value in differential diagnosis of CU and DC, AUC=0.7, P=0.002. Conclusion:The levels of serum IgE, anti-IgE, anti-FcεRI were significantly increased in CU patients, and these mast cell activation-related molecules have the potential to be diagnostic markers for CU.

Analysis of epidemic characteristics of hand-foot-mouth disease Virus using circular distribution method / 公共卫生与预防医学

Objective To understand the epidemic characteristics of different virus types of hand, foot and mouth disease (HFMD) in Zhaotong City, and provide guidance and recommendations for the prevention and control of HFMD, and to analyze seasonal characteristics of different virus types of HFMD in Zhaotong City. Methods The epidemiological characteristics of different virus types of HFMD in Zhaotong City from 2014 to 2017 were analyzed using the concentration and circular distribution methods. Results The main pathogens detected were EV71, Cox A16 and other enteroviruses, which were 216, 182, and 294, respectively, accounting for 57.45%, 73.44%, and 67.11%. M was 0.86, indicating that EV71 had strong seasonality. The Rayleigh test showed statistically significant differences (Z = 99.53, P <0.001). ā = 157 °, the peak day of onset was May 10, similar to untyped (May 16), the peak period was April 21-June 1, and the epidemic period was April 1-June 21. Conclusion According to the incubation period of hand-foot-mouth disease and the period of time during which the vaccine develops protective effects, vaccination of hand-foot-mouth disease vaccine at the peak period has a good guiding significance for the timeliness and pertinence of vaccination.

Epidemiological characteristics of imported acute infectious diseases in the border areas of Yunnan province, 2008-2017 / 中华流行病学杂志

Objective@#To understand the epidemiological characteristics of imported acute infectious diseases between 2008 and 2017 in the border areas of Yunnan province.@*Methods@#All the cases occurred between January 2008 and December 2017 and related information was from the Chinese CDC infectious disease report information management system, according to definition of imported cases diagnosed by clinicians. Epidemiological characteristics of the imported cases of related information were gathered.@*Results@#A total of 13 157 imported acute infectious diseases were reported from the border areas of Yunnan province, which accounted for 6.03% (13 157/218 284) of the total number of acute infectious diseases in the same areas from 2008 to 2017. Malaria, dengue fever and hand-foot-mouth disease were accounted for 56.05% (7 374/13 157), 21.82% (2 871/13 157) and 4.62% (608/13 157), of all the case, respectively. The number of imported malaria cases decreased annually. However, dengue fever showed a sharp increase. Peaks of the epidemics appeared as: May for malaria and October for dengue fever. Male patients were accounting for the majority (73.22%, 9 634/13 157), so as the patients with Chinese nationality (54.91%, 7 225/13 157). The age distribution appeared as: 67.12% (8 829/13 157) for the 15-44 year olds and 19.26% (2 535/13 157) were children below 14 years of age. Proportions of occupation appeared as: farmers (45.23%, 5 596/13 157), migrant workers (21.30%, 2 802/13 157) and children living at home (11.12%, 1 463/13 157). Most of the imported cases were coming from Myanmar and appearing in the following three counties: Ruili city, Tengchong city, and Yingjiang of Yunnan province. Cities/counties that with number of imported cases more than 10% of the local reported cases, would include Ruili city, Tengchong city, Zhenkang county and Mangshi of Yunnan province.@*Conclusions@#Imported acute infectious disease was a serious public health problem in Yunnan province, 2008-2017. The main imported acute infectious diseases were malaria, dengue fever and hand-foot-mouth disease. The majority imported cases were accounting for Chinese, male, young adults and farmers. It is also important for immigration workers to carry out surveillance, prevention and control programs on infectious diseases when working in neighboring countries.

An indirect ELISA method for quantitative detection of anti-IgE autoantibodies / 中华检验医学杂志

Objective@#The accurate measurement of anti-IgE levels in patients′ serum helps for make diagnosis of chronic urticaria (CU). An indirect ELISA method for quantitative detection of IgG anti-IgE, were established.@*Methods@#The serum samples and the clinical data of 75 first-diagnosed CU patients and 120 healthy controls were collected at Shanghai General Hospital during the year of 2018. In the indirect ELISA system to measure the IgG (anti-human IgE), the antigen, Human IgE Myeloma, was coated on the plate; Omalizumab (a humanized anti-human IgE antibody) was the standard, and horse radish peroxidase (HRP)-labeled anti-human IgG was the tracer. The optimum concentrations of serum and HRP-labeled anti-human IgG were determined by chessboard titration, and method evaluation was conducted. The comparison of serum anti-IgE levels in CU patients and healthy people were analyzed by Mann-Whitney U test and chi-square test. Receiver operating characteristic (ROC) curves were applied to establish the diagnostic performance of serum anti-IgE for CU.@*Results@#The coating concentration of IgE was 5.0×10-4 mg/ml; serum dilution was 1∶300; enzyme-labeled antibody dilution was 1∶100 000. Standard curve was in good linearity with R2=0.996. The intra-and inter-assay coefficient of variation were 3.9%-7.5% and 6.0%-8.2%, and the recovery rate of low and high concentration samples were 95.9% and 108.4%, respectively. When hemoglobin≤1.3 g/L, triglyceride≤4.6 mmol/L, bilirubin≤171 μmol/L, no interference were observed. The limit of blank, limit of detection, and limit of quantitation were 5.8×10-4, 1.8×10-3, and 2.0×10-3 mg/ml. The linearity range was from 2.0×10-3 to 354.4 mg/ml. No Hook effect was found until anti-IgE reached 354.4 mg/ml. The anti-IgE remained stable after serum storage at 4 ℃ overnight or treated with 6 repeated freeze-thaw cycles. The anti-IgE levels in CU patients [19.0(1.9, 58.6)mg/ml] were significantly higher than those in healthy controls [0.7(0.002, 11.1)mg/ml] with P<0.001. When cut-off value was set as 15.3 mg/ml, in this method, the positive rate of CU patients (54.7%) was significantly higher than these of healthy controls (18.3%) (P<0.001, AUC=0.736).@*Conclusions@#The indirect ELISA method for serum anti-IgE measurement was successfully established. Anti-IgE autoantibodies in serum would be used in the diagnosis of CU.

Internal control development at public hospitals in Ya'an city: problems and countermeasures / 中华医院管理杂志

Internal control of public hospital can prevent and control risk exposure of public hospitals in their economic activities,in order to reasonably guarantee their legal compliance,safety and effective use of assets,as well as their authenticity and integrity of financial information.It can also effectively fend off fraud,corruption,and improve the quality of public health services and service efficiency.The authors analyzed the present situation and existing problems of internal control efforts at public hospitals in Ya'an city,and put forward countermeasures and suggestions as well.

Expression of Nod-like receptor protein 3 inflammasome in peripheral blood mononuclear cells of children with Kawasaki disease in the acute stage / 中国当代儿科杂志

OBJECTIVE@#To study the association of Nod-like receptor protein 3 (NLRP3) inflammasome with inflammatory response in the acute stage and coronary artery lesion (CAL) in children with Kawasaki disease (KD).@*METHODS@#A total of 42 children with KD who were hospitalized from January to October 2017 were enrolled as the KD group, among whom 9 had CAL (CAL group) and 33 had no CAL (NCAL group). Fifteen age- and gender-matched children with pneumonia and pyrexia were enrolled as the pneumonia-pyrexia group. Fifteen healthy children were enrolled as the healthy control group. Real-time PCR was used to measure the mRNA expression of NLRP3 inflammasome (NLRP3, ASC and caspase-1) in peripheral blood mononuclear cells. The Spearman rank correlation test was used to investigate the correlation of NLRP3 mRNA expression with serum levels of C-reactive protein, erythrocyte sedimentation rate, interleukin-6, interleukin-1β, procalcitonin, albumin and prealbumin.@*RESULTS@#The KD group had significantly higher mRNA expression of NLRP3, ASC and caspase-1 in the acute stage than the pneumonia-pyrexia and healthy control groups (P<0.05). The CAL group had significantly higher mRNA expression of NLRP3 than the NCAL group (P<0.05). NLRP3 mRNA expression was correlated with C-reactive protein, interleukin-6, interleukin-1β, and prealbumin levels in children with KD in the acute stage (r=0.449, 0.376, 0.427, and -0.416 respectively; P<0.05).@*CONCLUSIONS@#NLRP3 inflammasome may participate in inflammatory response in the acute stage and the development of CAL in children with KD.

Comparative analysis on chemical constituents in Bupleurum chinense,B. marginatum,B. marginatum var. stenophyllum and B. smithii var. parvifolium / 中国中药杂志

UPLC-Q-TOF-MS was used to analyze the chemical differences in Bupleurum. chinense,B. marginatum,B. marginatum var. stenophyllum and B. smithii var. parvifolium. Chromatographic separation was carried out on an Acquity HSS T3 C_(18) column( 2. 1 mm ×100 mm,1. 8 μm,Waters) with the mobile phase composed of 0. 1% formic acid in water-acetonitrile in the gradient elution. A hybrid quadrupole time-of-flight tandem mass spectrometry( Q-TOF-MS~E) was used for mass spectrometric analysis. Finally,25 peaks were identified based on their exact mass data and fragmentation characteristics. B.chinense,B.marginatum,B. marginatum var. stenophyllum and B. smithii var. parvifolium were obviously clustered into 3 types through processing by principal component analysis( PCA). There was almost no difference between B. chinense and B. marginatum. However,the compounds existed in B. chinense were different from those in B. marginatum var. stenophyllum,and B. smithii var. parvifolium.

An indirect ELISA method for quantitative detection of anti-IgE autoantibodies / 中华检验医学杂志

Objective The accurate measurement of anti-IgE levels in patients' serum helps for make diagnosis of chronic urticaria (CU). An indirect ELISA method for quantitative detection of IgG anti-IgE, were established. Methods The serum samples and the clinical data of 75 first-diagnosed CU patients and 120 healthy controls were collected at Shanghai General Hospital during the year of 2018. In the indirect ELISA system to measure the IgG (anti-human IgE), the antigen, Human IgE Myeloma, was coated on the plate;Omalizumab (a humanized anti-human IgE antibody) was the standard, and horse radish peroxidase (HRP)-labeled anti-human IgG was the tracer. The optimum concentrations of serum and HRP-labeled anti-human IgG were determined by chessboard titration, and method evaluation was conducted. The comparison of serum anti-IgE levels in CU patients and healthy people were analyzed by Mann-Whitney U test and chi-square test. Receiver operating characteristic (ROC) curves were applied to establish the diagnostic performance of serum anti-IgE for CU. Results The coating concentration of IgEwas 5.0 × 10-4 mg/ml; serum dilution was 1:300; enzyme-labeled antibody dilution was 1:100000. Standard curve was in good linearity with R2=0.996. The intra-and inter-assay coefficient of variation were 3.9％-7.5％ and 6.0％-8.2％, and the recovery rate of low and high concentration samples were 95.9％ and 108.4％, respectively. When hemoglobin≤1.3 g/L, triglyceride≤4.6 mmol/L, bilirubin≤171μmol/L, no interference were observed. The limit of blank, limit of detection, and limit of quantitation were 5.8 × 10-4, 1.8 × 10-3, and 2.0 × 10-3 mg/ml. The linearity range was from 2.0 × 10-3 to 354.4 mg/ml. No Hook effect was found until anti-IgE reached 354.4 mg/ml. The anti-IgE remained stable after serum storage at 4℃overnight or treated with 6 repeated freeze-thaw cycles. The anti-IgE levels in CU patients [19.0(1.9, 58.6)mg/ml] were significantly higher than those in healthy controls [0.7(0.002, 11.1)mg/ml] with P<0.001. When cut-off value was set as 15.3 mg/ml, in this method, the positive rate of CU patients (54.7％) was significantly higher than these of healthy controls (18.3％) (P<0.001, AUC=0.736). Conclusions The indirect ELISA method for serum anti-IgE measurement was successfully established. Anti-IgE autoantibodies in serum would be used in the diagnosis of CU.