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Objective To optimize the formulation and preparation of diphenhydramine hydrochloride and caffeine orally disintegrating tablet. Methods Melt granulation technology of steric acid and API was used to mask the unpleasant tasting of diphenhydramine hydrochloride. The tablets were prepared by direct pressing the dry powder with CCMC-Na as disintegrating agent. The formulation was optimized by orthogonal experiments to achieve the shortest disintegration time and the best taste correction. Results The optimized formula of orally disintegrating tablet was as follows： diphenhydramine hydrochloride 25 mg, caffeine 60 mg, stearic acid 25 mg, aspatan 40 mg, blueberry essence 7 mg, mannitol 45 mg, MCC 210 mg, CCMC-NA 25 mg, SDS 8 mg and magnesium stearate 5 mg. Conclusion This preparation method for orally disintegrating tablet of diphenhydramine hydrochloride and caffeine is practical and easy for quality control.
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ObjectiveTo analyze the content and psychological measurement indicators of the commonly used motor function assessment tools for children and adolescents, based on the theory and method of International Classification of Function, Disability and Health-Children and Youth Version (ICF-CY). MethodsBased on the ICF-CY classification framework and coding system, four commonly used functional evaluation tools for children and adolescents were selected, and their motor function measurement methods and psychological measurement indicators were analyzed by applying ICF coding rules and matching principles. ResultsFinally, nine English articles and two Chinese articles were included, from four countries including South Korea, Spain, China and Brazil. They were mainly published in the journals of clinical medicine, neuroscience, public health, rehabilitation science and other fields from 2011 to 2021. The age of the subjects was 0 to 16 years old involving 987 subjects; the health condition included spastic cerebral palsy, neurodevelopmental disorder, etc. Among the eleven articles included, six articles used Gross Motor Function Measure (GMFM-88), two articles used Fine Motor Function Measure Scale (FMFM), two articles used Peabody Developmental Motor Scales Second Edition (PDMS-2), and two articles used Pediatric Evaluation of Disability Inventory-Functional Skills Scale (PEDI-FSS), and three articles used Pediatric Evaluation of Disability Inventory (PEDI). The measurement methods were objective evaluation, subjective evaluation, and subjective observation, etc. The number of measurements was two to six. The measurement indicators of motor function mainly involved two levels. The first was the physical activity level, including gross movement, fine movement and motor control ability. The second was the functional level of activities, mainly including activities of daily living and functional independence. ConclusionBased on ICF-CY, the evaluation of children's motor function and activity and participation was mainly divided into two levels. At the body function level, the main evaluation indicators included b730, b760, b770, etc. At the level of activities and participation, the main evaluation indicators were d410, d440, d445, etc. GMFM-88 focuses on the evaluation of children's body movement and activity functions, such as sitting, standing, lying, walking and running, mainly involving b760, d410, d455, etc. FMFM focused on autonomous movement, motor motivation and motor coordination, and was mainly used to assess the functional status of upper limbs of children with cerebral palsy aged 0 to 3 years, mainly involving b760, d155, d440, etc. PDMS-2 payed more attention to evaluating the overall motor development level and motor function status of children and adolescents, mainly involving b750, b760, d415, etc. PEDI-FSS move partition focused on children's actual motor function performance in activities of daily living, and evaluated the application and practicability of children's motor function in activities of daily living, mainly involving b760, d410, d450, etc. In terms of measurement methods, the measurement of motor function mainly included objective evaluation and subjective evaluation; the measurement of activity function mainly included objective evaluation and subjective observation. These assessment tools have established norms varies with different age groups according to the movement development. Evaluators need accept professional training before using the above assessment tools to improve the reliability, validity and adaptability of the assessment.
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Juvenile zebrafish were used to screen the active components of Lycii Fructus for improving osteoporosis. The screening results were further verified by zebrafish adult osteoporosis model and the action mechanism was explored. Prednisolone was used as the inducer to build osteoporosis models of juvenile and adult zebrafish, and 9 groups of samples of different extracts and chemical parts of Lycii Fructus were given. Alizarin red staining was applied for observing the scale matrix mineralization and bone resorption. The activities of osteoblasts and osteoclasts were detected using alkaline phosphatase (ALP) and tartrate resistant acid phosphatase (TRAP/TRACP) staining. The expressions of bone metabolism-related genes alp, osteoprotectin (opn), osteoblast specific transcription factor (sp7), cathepsin K (ctsk), tracp, and Runt family transcription factor 2b (runx2b) in each group were determined using quantitative polymerase chain reaction. The results showed that all components of Lycii Fructus improved the formation area of the first vertebrae, the staining light density value, and the number of vertebrae joints in juvenile zebrafish and the Lycium barbarum polysaccharide (LBP) treatment group exerted the best effect. In addition, LBP prevented the formation of bone resorption lacunae in zebrafish scales, increased ALP activity, decreased TRAP activity, up-regulated the alp, sp7, and opn genes, and lowered the expressions of ctsk and tracp genes. In conclusion, LBP regulated the activity of osteoblasts and osteoclasts, reduced bone resorption, promoted bone formation and enhanced bone density, which might be the main anti-osteoporosis active fraction of Lycii Fructus. This study provided modern scientific evidence for the scientific connotation of the traditional effect of "strengthening bones and muscles" of Lycii Fructus, provided the reference for the evaluation of the anti-osteoporosis activity of traditional Chinese medicine based on zebrafish adult model, and provided beneficial enlightenment for the bone health needs of the aging society population.
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AIM: To observe the effect of soluble glycoprotein 130(sgp130)on expression of p-STAT3 and vascular endothelial growth factor(VEGF)-A in retina of mice with diabetes mellitus(DM), and explore the possibility of sgp130 in interfering with inflammatory damage of diabetic retinopathy(DR).METHODS: A total of 45 mice were randomly divided into normal group, DM group and sgp130 group. DM models were made in DM group and sgp130 group with streptozotocin. No special intervention was given to normal group and DM group, but sgp130 group was given intravitreal injection of 1.5mg/mL sgp130 2μL at the 1 and 5wk. After 10wk, all the mice were sacrificed to assess the protein expression of interleukin 6(IL-6), p-STAT3 and VEGF-A in the retina.RESULTS: The expressions of IL-6, p-STAT3 and VEGF-A in retina of DM group were higher than those of normal group at 10wk(all P<0.01). The expression of p-STAT3 and VEGF-A in sgp130 group were lower than those in DM group(all P<0.01).CONCLUSION: The sgp130 can selectively antagonize the trans signal transduction pathway of IL-6, down-regulate the expression of downstream inflammatory factors VEGF-A, and it may be used in the intervention of retinal inflammatory damage related with IL-6 in DM.
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ObjectiveThis study aimed to analyze the difference in setup error before and after correction of systematic error. To determine the most appropriate image-guided strategy during HT treatment， we use different scanning ranges and image-guidance frequencies in patients with nasopharyngeal carcinoma （NPC） treated with helical tomotherapy （HT）. MethodsFifteen patients with NPC who received HT treatment in Sun Yat-sen University Cancer Center from October 2019 to February 2020 were selected. Megavoltage computed tomography （MVCT） scanning was performed before each treatment. After five times of radiotherapy， system-error correction was performed to adjust the setup center. The setup errors before and after the correction of systematic errors， as well as the setup errors of different scanning ranges and different scanning frequencies， were collected for analysis and comparison. ResultsWhen comparing the setup errors before and after the correction of systematic error， the differences in setup errors in the left–right （LR）， superior–inferior （SI）， and anterior–posterior （AP） directions were statistically significant （P<0.05）.The different scanning ranges of "nasopharynx + neck" and "nasopharynx" were compared， and a statistically significant difference was found in yaw rotational errors （P<0.05）. In the comparison of daily and weekly scan frequency after system-error correction， a significant difference was found in AP direction （P<0.05）. ConclusionDuring radiotherapy for NPC， the systematic error can be corrected according to the first five setup errors， and then small-scale scanning was selected for image-guided radiotherapy every day.
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Objective:To investigate the expression of coronavirus disease 2019 (COVID-19) transmission-related receptors angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) in human conjunctival tissue and its clinical significance.Methods:Fifty human conjunctival tissue specimens from 50 patients including 10 normal conjunctival tissues, 15 conjunctival papilloma tissues, 15 conjunctival nevus tissues and 10 conjunctival cyst tissues were collected from June 2019 to June 2020 at Xi'an People's Hospital.Ten corneal tissue samples from 10 patients with eyes removed due to trauma were collected as control.The distribution of ACE2 and TMPRSS2 in different corneal tissues was detected by the immunohistochemistry.The expression of ACE2 and TMPRSS2 was scored and compared.Reuse of the human samples and the research protocol was approved by an Ethics Committee of Xi'an People's Hospital (No.20190022). Written informed consent was obtained from each patient.Results:ACE2 and TMPRSS2 were both expressed in normal conjunctival epithelium, epithelial cells in conjunctiva papilloma and conjunctival nevus, and cells in conjunctiva cyst wall.ACE2 was mainly distributed in the superficial and intermediate cells of conjunctival epithelium, but not in the basal cells and goblet cells.TMPRSS2 was found in different layers of cells.The positive expression rates of ACE2 and TMPRSS2 in conjunctiva were both 100%.There was no significant difference in the expression intensity of ACE2 and TMPRSS2 among normal conjunctival tissue, conjunctival papilloma, conjunctival nevus and conjunctival cyst (all at P>0.05). Weakly expressed in corneal tissues, ACE2 and TMPRSS2 were more moderately and strongly expressed in conjunctival tissues.There were significant differences in the number of differently graded ACE2 and TMPRSS2 expression between normal conjunctival tissues, conjunctival papilloma, conjunctival nevus, conjunctival cyst and corneal tissues (ACE2: Z=-3.473, -4.183, -3.970, -3.873, all at P<0.01; TMPRSS2: Z=-4.119, -4.472, -4.443, -4.147, all at P<0.001). Conclusions:COVID-19 transmission-related receptors ACE2 and TMPRSS2 are expressed in human conjunctival tissue, which provides organological evidence for ocular surface transmission of COVID-19.
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Objective:To evaluate the curative effect of Moshen Decoction combined with routine western medicine on idiopathic membranous nephropathy (IMN) of spleen-kidney qi deficiency syndrome and explore its influences on renal function, C1q, PLA2R and E-cadherin levels.Methods:A total of 62 patients with IMN meeting inclusion criteria in the hospital were enrolled between January 2018 and January 2021. According to simple random grouping method, they were divided into control group (hormones combined with cyclophosphamide) and observation group (Moshen Decoction on basis of control group), 31 in each group. Both groups were treated continuously for 6 months. Before and after treatment, TCM syndromes were scored. The levels of blood urea nitrogen (BUN), serum creatinine (SCr), cystatin C (Cys-C), anti-phospholipase A2 receptor (PLA2R) and E-cadherin (EC) were detected by ELISA. The level of serum complement C1q was detected by immunoturbidimetry. The 24 h urine was collected for quantitative determination by full-automatic biochemical analyzer. The adverse events during treatment were observed and recorded. And clinical curative effect was evaluated.Results:The differences in total response rate between observation group and control group were statistically significant [93.55% (29/31) vs. 74.19% (23/31); χ2=4.29, P=0.038]. After treatment, scores of TCM syndromes (edema of lower limbs, fatigue and poor appetite, lusterless complexion) in observation group were significantly lower than those in the control group ( t=10.07, 10.80, 4.34, 4.57, P<0.001). After treatment, levels of serum Cys-C [(0.51±0.05) mg/L vs. (0.55±0.06) mg/L, t=2.85], 24 h urine protein quantification [(0.95±0.19) g vs. (1.38±0.23) g, t=13.32] in observation group were lower than those in the control group ( P<0.01), and levels of serum PLA2R [(17.53±1.84) Ru/ml vs. (19.62±2.05) Ru/ml, t=4.22], EC [(2.74±0.26) μg/L vs. (3.05±0.37) μg/L, t=3.82] and complement C1q [(152.34±15.62) mg/L vs. (169.33±16.77) mg/L, t=4.13] in observation group were significantly lower than those in the control group ( P<0.01). During treatment, there was no significant difference in incidence of adverse events between observation group and control group [12.90% (4/31) vs. 16.13% (5/31); χ2=0.13, P=0.781]. Conclusion:Moshen Decoction combined with routine western medicine can improve renal function and clinical curative effect in patients with IMN of spleen-kidney qi deficiency syndrome. Its mechanism of action may be related to reducing urine protein, complement C1q, PLA2R and EC.
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@#<b>Objective</b> To investigate the differences in output results between difference analysis software, and to provide a reference for the improvement of quality control and the standard revision of SPECT equipment. <b>Methods</b> The image analysis software for quality control held by 14 radiological health technical service institutions was selected as the research subjects using the cluster sampling method. The results of the comparison were analyzed and evaluated according to the Z-score method with certified reference values. <b>Results</b> In the comparison items of “intrinsic uniformity” and “intrinsic spatial linearity”, the number of software with suspicious, deviated and incorrect results accounted for a relatively high proportion, while the results of other comparison items were satisfactory. <b>Conclusion</b> The applicability of SPECT image analysis software lacks effective supervision measures. Relevant departments should introduce feasible measures to standardize the software production and update process, accelerate the construction of radiological health information reporting platform, and promote the healthy development of the radiation health testing industry.
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Objective@#To discuss the feasibility of applying home-made auto quality assurance (AQA) phantom in Cyberknife AQA test.@*Methods@#The same treatment plan for AQA test was designed in the Cyberknife treatment planning system. The AQA tests were performed under the same conditions using the home-made AQA phantom and the AQA phantom in the fourth-generation (G4) Cyberknife mode and the fifth-generation (VSI) Cyberknife mode, respectively, and each measurement was repeated five times to analyze and compare the differences in test results between the two phantoms.@*Results@#The total deviations of the home-made AQA phantom and the AQA phantom in the AQA test under the G4 Cy- berknife mode were (0.28 ± 0.12) mm and (0.28 ± 0.15) mm, respectively (P > 0.05); the test results under the VSI Cy- berknife mode were (0.46 ± 0.19) mm and (0.50 ± 0.07) mm, respectively (P > 0.05); the total deviations of all test results were smaller than 1.0 mm, which met the requirements of WS 667—2019 Specification for Testing of Quality Control in Ro- botic Arm Radiotherapy Device.@*Conclusion@#The test results of the home-made AQA phantom and the AQA phantom are consistent in the AQA test, and the home-made AQA phantom can be used for Cyberknife quality control.
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Objective To examine the effects of ankle brace on biomechanics of the lower extremity during landing, so as to provide a theoretic support to choose ankle brace for people with different sports levels. Methods The key words (ankle brace OR ankle braces OR ankle bracing OR ankle support) AND (landing OR land OR jump OR hopped OR hopping) AND (biomechanics OR kinematics OR kinetics OR electromyography OR neuromuscular) in Chinese and English were searched from different electronic databases (CNKI, Web of Science, EBSCO, PubMed and other databases), for a period of Jan. 2000 to Dec. 2020. Cochrane was used to evaluate the quality of eligible studies. For meta analysis, subgroup analysis was used to assess the impact of ankle braces on ankle biomechanics.Results Thirteen studies with a total of 222 participants were included for mata analysis in this study. The semi-rigid ankle brace reduced the peak of ankle inversion by 25.8% compared with the elastic ankle brace (SMD=-0.562, P<0.001). Moreover, the elastic ankle brace reduced ankle plant flexion during landing among athletes (SMD=-3.42, P=-0.021). As for collagiate students, both elastic ankle and semi-rigid ankle decreased the ankle inversion (elastic ankle brace: 35.4%, SMD=-1.000, P=-0.013; semi-rigid ankle brace: 31.11%, SMD=-0.881, P<0.001) and ankle plant flexion (elastic ankle brace:23.30%, SMD=-1.381, P<0.001;semi-rigid ankle brace: 36.33%, SMD=-1.605, P<0.001).Conclusions Both ankle braces can prevent ankle sprain for athletes (basketball, volleyball, running) who experience training more than 5 years. The elastic ankle brace can limit the inversion and plantar flexion, while the semi-rigid ankle brace can merely decrease the ankle inversion. Therefore, athletes are more suitable for the elastic ankle brace. As for collegiate students without training history, both ankle brace can decrease the ankle inversion and plantar flexion. The elastic ankle brace has greater restriction on inversion, while the semi-rigid ankle brace has more restriction on plantar flexion. Therefore, the elastic ankle brace should be utilized if collegiate students have calcaneofibular ligament injury, while the semi-rigid ankle brace is more suitable for collegiate students who have a history of anterior talofibular ligament injury.
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Objective:To observe the imaging features of optical coherence tomography (OCT) in peripheral retinal abnormalities of high myopia (HM).Methods:A retrospective series of case studies were conducted. From March 2019 to March 2021, 38 cases (50 eyes) in high myopia with peripheral retinal abnormalities who were confirmed to Henan Eye Hospital were enrolled in the study. There were 21 eyes in 17 males and 29 eyes in 21 females, age was 39.58±15.29 years, diopter was (-9.10±2.44) D. All patients underwent wide-angle fundus photography and OCT examination. According to wide-angle fundus photography and OCT, HM with peripheral retinal abnormalities were classified into white-without-pressure, black-without-pressure, lattice degeneration, peripheral pigmented degeneration, retinoschisis and retinal holes. OCT imaging features of peripheral abnormalities in high myopia was observed.Results:In 50 eyes, 65 peripheral retinal abnormalities were observed by OCT. In 6 white-without-pressure, intense hyperreflectivity was shown at the level of the ellipsoid zone that abruptly transitions to relative hyporeflectivity at the dark border of the lesion. In 16 black-without-pressure, reflectivity of the ellipsoid zone decreased. In 10 sites of lattice degeneration, cystoid degeneration, local thinning, retinal tear at the posterior edge and boundary of the lesion was shown, whcih may be accompanied by local vitreous condensation and traction. In 4 peripheral pigmented degeneration, retinal interlayer hyperreflectivity was shown. In 12 retinoschisis, neuroepith-elial separation was connected by vertical bridge or columnar light bands, of which 3 were accompanied with localized retinal detachment and 2 with splitting-related retinal vascular abnormalities. In 17 retinal holes, full layer of neuroepithelium lost, that 12 zones were accompanied with retinal detachment with vitreous adhesion or traction.Conclusion:OCT manifestations of peripheral retinal abnormalities in HM varies.
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Objective:To evaluate the kinetic metrics changes of FDG in key organs after chemo-immunotherapy in patients with locally advanced non-small cell lung cancer (NSCLC) identified by total-body PET/CT dynamic imaging, and explore its potential biological significance.Methods:From August 2020 to March 2021, 16 patients (13 males, 3 females; age: 43-67 years) with locally advanced NSCLC who underwent total-body 18F-FDG PET/CT dynamic imaging in Sun Yat-sen University Cancer Center were retrospectively analyzed. ROIs of key organs were drawn at baseline and after chemo-immunotherapy to obtain the time-activity curves (TACs). The kinetic metrics, including K1, k2, k3 and metabolic rate of FDG (MR FDG), were fitted by the two-tissue compartment model. Paired t test or Wilcoxon signed rank test was used to compare the differences of FDG kinetic parameters in each organ before and after treatment. Results:Compared with baseline, SUV max of colon (3.23±1.29 vs 4.81±2.73), MR FDG ((2.77±1.96) vs 3.56(1.07, 9.89) μmol·100 g -1·min -1) of lungs, SUV max (2.16±0.27 vs 2.33±0.41), k3 ((0.008±0.002) vs (0.012±0.004) min -1) and MR FDG ((2.65±0.81) vs (3.76±1.59) μmol·100 g -1·min -1) of spleen, and SUV max (2.59±0.45 vs 4.49±2.73), k2 ((0.76±0.37) vs (1.27±0.66) min -1), k3 ((0.032±0.007) vs (0.066±0.029) min -1) and MR FDG ((5.14±1.44) vs (8.39±2.67) μmol·100 g -1·min -1) of bone marrow were increased after chemo-immunotherapy with significant differences ( t values: from -5.40 to 3.47, z=-2.02, all P<0.05). There were no significant differences of SUV max, k values and MR FDG in other organs ( t values: from -2.00 to 2.35, z values: from -1.45 to -0.05, all P>0.05). Conclusions:After chemo-immunotherapy, the activation of immune system may be manifested as the increase of FDG kinetic rate constants in spleen and bone marrow. The lung and colon may be target organs for immune-related adverse effects.
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Objective:To investigate the predictive role of dynamic changes of plasma biomarkers in patients with viral and mycoplasma community-acquired pneumonia (CAP).Methods:From January 2020 to June 2020, 141 patients with viral and mycoplasma CAP in People's Hospital of Ningxia Hui Autonomous Region were enrolled. Pneumonia severity index (PSI) scores [grade Ⅰ-Ⅱ(PSI score ≤ 70), grade Ⅲ (PSI score 71-90) and grade Ⅳ-Ⅴ(PSI score ≥ 91)], serum amyloid A (SAA), hypersensitive C-reactive protein (hs-CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) on the 1 day after admission were compared between the different pathogens (viral and mycoplasma) or different disease severity. The change in level of SAA, hs-CRP on the third day (Δ 3 d = 1 d-3 d) were compared among different disease outcome groups (patients were divided into improved group, stable group and exacerbation group based on PSI scores or lung CT images on the third day). The change in the level of SAA, hs-CRP on the seventh day (Δ 7 d = 1 d-7 d) were compared among different disease prognosis groups (patients were divided into survival group and death group based on 28-day survival data). The receiver operating characteristic curve (ROC) were drawn to evaluate the value of SAA in the evaluation of disease and prediction prognosis. Results:The level of SAA in mycoplasma group (43 cases) was significantly higher than that in virus group (98 cases) on the 1 day after admission. There were no significant differences in other plasma biomarkers between the two groups. The more severe the illness, the higher the SAA level on the 1 day after admission. The trends of other plasma biomarkers in the two groups were consistent with SAA. The levels of SAA in the patients with exacerbation of the virus group and mycoplasma group (12 cases, 9 cases) were significantly higher than those of the improved group (57 cases, 26 cases) and the stable group (29 cases, 8 cases). SAA increased gradually in the exacerbation group, decreased gradually in the improved group, and slightly increased in the stable group. ΔSAA 3 d were differences among three groups. The change trend of hs-CPR was consistent with SAA. The level of SAA in the death group was higher than that in the survival group on the seventh day. SAA increased in the death group and decreased in survival group with time from hospital admission. There were differences according to ΔSAA 7 d between death group and survival group. The change trend of hs-CPR was consistent with SAA. ROC curve showed that the value of SAA was better than hs-CRP in assessing the severity of patients on admission day, and the area under ROC curve (AUC) was respectively 0.777 [95% confidence interval (95% CI) was 0.669-0.886], 0.729 (95% CI was 0.628-0.830). The value of ΔSAA 3 d was better than SAA on the third day predicting disease trends, and AUC was respectively 0.979 (95% CI was 0.921-1.000), 0.850 (95% CI was 0.660-1.000). hs-CRP on the third day and Δhs-CRP 3 d had no predictive value. Both SAA on the seventh day and ΔSAA 7 d have predictive value for prognosis. AUC was respectively 0.954 (95% CI was 0.898-0.993) and 0.890 (95% CI was 0.689-1.000). SAA on the seventh day and ΔSAA 7 d were better than hs-CRP on the seventh day. Δhs-CRP 7 d have no predictive value. Conclusions:SAA is a sensitive and valuable indicator for CAP patients with viruses and mycoplasma. Dynamic monitoring of SAA can evaluate the patient's progression, prognosis, and assist diagnosis and treatment.
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In the past 10 years, remarkable progress has been made in prevention and control of endemic diseases in China through implementation of the National Plan for Prevention and Control of Endemic Diseases during the "12th Five Year Plan" and the "13th Five Year Plan" and the Three-year Action Plan for Tackling Key Problems in Prevention and Control of Endemic Diseases. Based on analysis of the monitoring data of endemic diseases in China for 10 consecutive years, this paper summarized the progress made in prevention and control of endemic diseases in China, discussed the main problems faced at present, and put forward key tasks of prevention and control of the diseases in the future.
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Objective@#To explore the prevalence of depressive symptoms among middle school students in Nanjing and the relationship between screen time, sleep duration and depressive symptoms, and to provide a scientific reference for depression prevention in adolescents.@*Methods@#Using stratified cluster random sampling method, a total of 2 010 students from 5 middle schools in urban areas and 3 middle schools in suburban counties were selected. Screen time and sleep duration were evaluated through questionnaires, and depressive symptom was assessed by the Center for Epidemiological Studies Depression Scale (CES-D).@*Results@#The prevalence of depressive symptoms (CES-D≥16) was 27.71%(557). Logistic regression analysis showed that students with screen time >2 h/d( OR=1.90, 95%CI =1.53-2.37), sleep duration <7 h/d ( OR=2.54, 95%CI =1.88-3.42) were statistically associated with depressive symptoms. stratified analysis showed that, sleep duration of <7 h/d was associated with increased odds of depressive symptoms, the magnitude among students with screen time >2 h/d( OR=2.46, 95%CI =1.64-3.71) was higher than those with screen time ≤2 h/d( OR=2.35, 95%CI =1.51-3.65).@*Conclusion@#High prevalence of depressive symptoms was observed among middle school students in Nanjing. Prolonged screen time and insufficient sleep duration are associated with increased odds of depressive symptoms. Attention should be paid to the mental health of adolescents with the combined exposure of screen based activities and lack of sleep.
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Objective: To investigate the predictive value of D-dimer for deep venous thrombosis (DVT) of lower extremity in adult burn patients. Methods: A retrospective case series study was conducted. The clinical data of 3 861 adult burn patients who met the inclusion criteria and were admitted to the Department of Burns of Zhengzhou First People's Hospital from January 1, 2015 to December 31, 2019 were collected. The patients were divided into DVT group (n=77) and non-DVT group (n=3 784) according to whether DVT of lower extremity occurred during hospitalization or not. Data of patients in the two groups were collected and compared, including the gender, age, total burn area, D-dimer level, with lower limb burn and inhalation injury or not on admission, with sepsis/septic shock, femoral vein indwelling central venous catheter (CVC), history of surgery, and infusion of concentrated red blood cells or not during hospitalization. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, and chi-square test. The indicators with statistically significant differences between the two groups were analyzed with multivariate logistic regression analysis to screen the independent risk factors for DVT of lower extremity in 3 861 adult burn patients. The receiver operating characteristic (ROC) curve of the independent risk factors predicting DVT of lower extremity in 3 861 adult burn patients were drawn, and the area under the curve (AUC), the optimal threshold value, and the sensitivity and specificity under the optimal threshold value were calculated. The quality of the AUC was compared by Delong test, and the sensitivity and specificity under the optimal threshold value were compared using chi-square test. Results: There were no statistically significant differences in gender, occurrence of sepsis/septic shock or history of surgery during hospitalization between patients in the two groups (P>0.05), while there were statistically significant differences in age, total burn area, D-dimer level, lower limb burn and inhalation injury on admission, and femoral vein indwelling CVC and infusion of concentrated red blood cells during hospitalization between patients in the two groups (t=-8.17, with Z values of -5.04 and -10.83, respectively, χ2 values of 21.83, 5.37, 7.75, and 4.52, respectively, P<0.05 or P<0.01). Multivariate logistic regression analysis showed that age, total burn area, and D-dimer level were the independent risk factors for DVT of lower extremity in 3 861 adult burn patients (with odds ratios of 1.05, 1.02, and 1.14, respectively, 95% confidence intervals of 1.04-1.06, 1.00-1.03, and 1.10-1.20, respectively, P<0.05 or P<0.01). The AUCs of ROC of age, total burn area, and D-dimer level for predicting DVT of lower extremity in 3 861 adult burn patients were 0.74, 0.67, and 0.86, respectively (with 95% confidence intervals of 0.68-0.80, 0.60-0.74, and 0.83-0.89, respectively, P values<0.01), the optimal threshold values were 50.5 years old, 10.5% total body surface area, and 1.845 mg/L, respectively, the sensitivity under the optimal threshold values were 71.4%, 70.1%, and 87.0%, respectively, and the specificity under the optimal threshold values were 66.8%, 67.2%, and 72.9%, respectively. The AUC quality and sensitivity and specificity under the optimal threshold value of D-dimer level were significantly better than those of age (z=3.29, with χ2 values of 284.91 and 34.25, respectively, P<0.01) and total burn area (z=4.98, with χ2 values of 326.79 and 29.88, respectively, P<0.01), while the AUC quality and sensitivity and specificity under the optimal threshold values were similar between age and total burn area (P>0.05). Conclusions: D-dimer level is an independent risk factor for DVT of lower extremity in adult burn patients, its AUC quality and sensitivity and specificity under the optimal threshold value are better than those of age and total burn area, and it has good predictive value for DVT of lower extremity in adult burn patients.
Subject(s)
Adult , Humans , Middle Aged , Burns/complications , Fibrin Fibrinogen Degradation Products/analysis , Lower Extremity/blood supply , Lung Injury/etiology , Prognosis , Retrospective Studies , Shock, Septic/etiology , Venous Thrombosis/etiologyABSTRACT
Objective: To analyze the clinical characteristics and prognostic value of liver function in a large samples of patients with anti-glycoprotein 210 (gp210 antibody) positive primary biliary cholangitis (PBC). Methods: A retrospective study was performed on 931 PBC cases in Beijing You'an Hospital affiliated to Capital Medical University from 2010 to 2019. According to the detection of gp210 antibody, 318 cases were divided into gp210 antibody positive group (positive group) and 613 cases were divided into gp210 antibody negative group (negative group). The differences in demographic, medical history, clinical indicators, B-ultrasound and pathological indicators as well as the histopathological basis were compared between the two groups. SPSS 16.0 software was used for statistical analysis. Measurement data were analyzed by t-test or rank sum test, and enumeration data by χ2 test. Multivariate analysis was used for logistic test, and and survival analysis was used for prognosis. Results: The positive and the negative groups were compared. The ratio of male to female was significantly higher in positive than negative group (1:5.35 vs. 1:9.73, P＜0.05), and the difference was statistically significant. The proportion of hormone use in history of past diagnosed and treated was higher in positive than negative group (12.9% vs. 3.47%, P＜0.05), and the difference was statistically significant. The detection of biochemical indexes such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), alkaline phosphatase (ALP), glutamyl transpeptidase (GGT) were higher in positive than the negative group (51.1 U/L vs. 41.1 U/L, 62.6 U/L vs. 49.6 U/L, 24.1 μmol/L vs. 17.9 μmol/L, 228.3 U/L vs. 169.6 U/L, 203.9 U/L vs. 147.6 U/L), (P＜0.05), and the differences were statistically significant. Antinuclear antibody (ANA)-positive rate, high titer ratio and immunoglobulin G (IgG) levels were higher in positive than negative group (95.2% vs. 81.6%, 69.7% vs. 48.8%, 17.2 g/L vs. 16.2 g/L), (P＜0.05), and the differences were statistically significant. The incidence of liver failure was higher in positive than negative group (P＜0.05). CK7 and inflammation score were higher in positive group than negative group in liver histopathological observations (0.83±0.53 vs. 0.28±0.47; 1.06±0.39 vs. 0.54±0.65), (P＜0.05), and the differences were statistically significant. Conclusion: The illness condition of patients with gp210 antibody positive PBC is more severe than patients with gp210 antibody negative PBC, and the incidence of liver failure is significantly increased. Cholangiocytes may be the histopathological basis of the clinical characteristics of gp210 antibody positive PBC patients.
Subject(s)
Female , Humans , Male , Aspartate Aminotransferases , Autoantibodies , Liver Cirrhosis, Biliary/diagnosis , Liver Failure , Retrospective StudiesABSTRACT
Objective: The aim of this study was to summarize the clinical and imaging characteristics of post-primary tuberculosis in children, so as to improve the early identification and diagnosis of post-primary tuberculosis. Methods: This was a retrospective study which enrolled children who were admitted to the Department No.2 of Respiratory Medicine, Beijing Children's Hospital Affiliated to Capital Medical University between January 2015 to December 2020 and with a diagnosis of post-primary tuberculosis. Results: A total of 30 patients were enrolled, including 10 males and 20 females. The age on admission were 13.0 (12.0, 13.3) years. Their common symptoms were cough and fever, there were 26 cases (87%) with cough and 23 cases (77%) with fever, but only 4 cases (13%) had other toxic symptoms (night sweat, weakness or weight loss) of tuberculosis other than fever. Blood examination showed that the white blood cell count was (10±3)×109/L, accompanied by elevated proportion of neutrophils (0.69±0.11) and increased level of C-reactive protein (31 (15,81) mg/L). The common radiographic findings of CT were nodular or mass shadow with cavitation (19 cases (63%)), consolidation (13 cases (43%)), bronchogenic spread (12 cases (40%)), hilar or mediastinal lymphadenopathy (5 cases (17%)) in this cohort. The affected locations included the right upper lobe (21 cases (70%)), the left lower lobe (17 cases (57%)) and the right lower lobe (15 cases (50%)). Acid-fast bacillus smears and mycobacterial cultures were attempted for all cases, resulting in 33% (10/30) with smear positivity and 50% (15/30) with culture positivity. Conclusions: Post-primary tuberculosis in children has no specific clinical manifestations. Imaging of chest CT is mainly manifested as nodular shadow with cavitation, consolidation or bronchogenic spread. Accurate identification of post-primary tuberculosis is crucial for preventing the spread and early treatment of tuberculosis.
Subject(s)
Child , Female , Humans , Male , Cough/etiology , Lung , Lung Diseases , Retrospective Studies , Tuberculosis/diagnosisABSTRACT
Objective: To assess the incidence of dengue fever and E gene evolution of dengue virus in Guangzhou in 2020 and understand the local epidemiological characteristics of dengue fever and spreading of dengue virus. Methods: The information of dengue fever cases in Guangzhou in 2020 was collected from Notifiable Infectious Disease System of Chinese Center for Disease Control and Prevention Information System. Serum samples from the cases were detected by real-time PCR. The E gene was sequenced and analyzed. Maximum likelihood phylogenetic trees were constructed using software MEGA 5.05. The statistical analysis was conducted using software SPSS 20.0. Results: A total of 33 dengue fever cases were reported in Guangzhou in 2020, including 31 (93.94%) imported cases and 2 (6.06%) local cases. Compared with the data during 2016 to 2019, the number of cases, overall incidence and local incidence all decreased with statistically significant differences (all P<0.05). The imported cases from Southeast Asia constituted 90.32% (28/31) of imported cases. The E gene sequences and the phylogenetic trees of imported and local cases demonstrated close relationship with the virus sequences from Southeast Asian, and they were less homologous with the sequences of dengue virus isolated in Guangzhou in previous years. Conclusions: The incidence of dengue in Guangzhou in 2020 was significantly affected by the imported cases, especially those from Southeast Asian countries. The study result demonstrated that dengue fever was not endemic in Guangzhou and it was caused by imported ones.
Subject(s)
Humans , China/epidemiology , Dengue/epidemiology , Dengue Virus/genetics , Disease Outbreaks , Evolution, Molecular , Genotype , PhylogenyABSTRACT
Objective To investigate the role of clinical pharmacists in identifying adverse drug reactions (ADR), to draw clinical attention to the possibility of drug-induced lung injury caused by rhG-CSF, and distinguish them from infectious diseases. Methods A case of rhG-CSF induced acute lung injury was analyzed. After analyzing the relationship between rhG-CSF and acute eosinophilic pneumonia, exploring the possible mechanism, in combination with the patient's condition, the clinical pharmacist put forward the suggestion for the treatment of the disease. Results After receiving rhG-CSF, the patient's eosinophils increased, the pneumonia was aggravated, and the effect of anti-infection treatment was poor. Eosinophils pneumonia associated with rhG-CSF was considered. The patient's pulmonary symptoms improved after treatment with glucocorticoid in combination with withdrawal of antibiotics and antiviral drugs, and eosinophil returned to normal. Conclusion rhG- can cause rare eosinophilic pneumonia. The clinical pharmacist's participation in clinical treatment can help to identify drug-induced diseases, reorient the direction of treatment and ensure the success of clinical therapy.