Proteomics study of Mycoplasma pneumoniae pneumonia reveals the Fc fragment of the IgG-binding protein as a serum biomarker and implicates potential therapeutic targets / 医学前沿

Macrolide and corticosteroid resistance has been reported in patients with Mycoplasma pneumoniae (MP) pneumonia (MPP). MP clearance is difficult to achieve through antibiotic treatment in sensitive patients with severe MPP (SMPP). SMPP in children might progress to airway remodeling and even bronchiolitis/bronchitis obliterans. Therefore, identifying serum biomarkers that indicate MPP progression and exploring new targeted drugs for SMPP treatment require urgency. In this study, serum samples were collected from patients with general MPP (GMPP) and SMPP to conduct proteomics profiling. The Fc fragment of the IgG-binding protein (FCGBP) was identified as the most promising indicator of SMPP. Biological enrichment analysis indicated uncontrolled inflammation in SMPP. ELISA results proved that the FCGBP level in patients with SMPP was substantially higher than that in patients with GMPP. Furthermore, the FCGBP levels showed a decreasing trend in patients with GMPP but the opposite trend in patients with SMPP during disease progression. Connectivity map analyses identified 25 possible targeted drugs for SMPP treatment. Among them, a mechanistic target of rapamycin kinase (mTOR) inhibitor, which is a macrolide compound and a cell proliferation inhibitor, was the most promising candidate for targeting SMPP. To our knowledge, this study was the first proteomics-based characterization of patients with SMPP and GMPP.

Transvaginal ultrasound and contrast-enhanced ultrasound combined with clinical factors to assess the treatment options of cesarean scar pregnancy / 中华超声影像学杂志

Objective:To investigate the significance of clinical factors combined with transvaginal ultrasound and contrast-enhanced ultrasound(CEUS) in guiding the choice of treatment plan for cesarean scar pregnancy(CSP).Methods:The clinical and transvaginal ultrasound and CEUS data of 120 patients with CSP from January 2016 to June 2021 in the First People′s Hospital of Foshan were retrospectively analyzed, and they were divided into ultrasound-guided curettage/ hysteroscopic group (Group A, 91 cases) and laparoscopic group (Group B, 29 cases) according to treatment option, and the differences in clinical and ultrasound factors between the two groups were compared, and to determine the relevant clinical and ultrasound indicators for the choice of treatment option.Results:There were statistical differences between the 2 groups in comparison of whether the gestational sac/mass protruded toward the plasma membrane, gestational sac/mass diameter, the main blood supply site of the gestational sac/mass, the site of the chorion/early placenta and scar thickness (all P<0.05). Logistic regression analysis indicated that CEUS showing major blood supply site of the gestational sac/mass ( OR=6.029, P=0.003) and uterine scar thickness ( OR=12.998, P=0.002) were independent risk factors for minimally invasive surgery for CSP. Conclusions:Ultrasound combined with clinical factors have a certain value in the selection of treatment options for CPS, and the thickness of the uterine scar and the main blood supply site of the gestational sac/mass showed in CEUS may be key factors affecting the minimally invasive surgical treatment of CSP.

Evaluation on measurement uncertainty of correction factors of fluconazole impurities determined by HPLC standard curve method / 中国药科大学学报

@#In this paper, the uncertainties of correction factors of fluconazole impurities determined by HPLC standard curve method were evaluated, and the main common factors affecting the accuracy of standard curve method were found, so as to improve the accuracy of the method.In this study, the corresponding fitting lines of fluconazole and its impurities A, B, C, D, F and I were established respectively, and the ratio of the slope of fitting lines of each impurity and its corresponding principal component was calculated as the correction factor of the impurity.Then on the basis of GUM method, the uncertainty of each impurity correction factor determined by standard curve method was evaluated according to the established uncertainty evaluation scheme of correction factor determination process.The correction factor and uncertainty of fluconazole impurities A, B, C, D, F and I were 1.068 ± 0.046, 0.102 ± 0.005, 0.0582 ± 0.0031, 1.382 ± 0.121, 0.802 ± 0.067 and 1.383 ± 0.119, respectively, and the coverage factor k was 2.Finally, the contribution rate of each uncertainty component was calculated.In the relative combined standard uncertainties urel(f) of fluconazole impurities A, B, C, D, F and I correction factors, the sum of contribution rate of slope uncertainty urel(K) of the linear equation of principal component and its impurity is more than 85%; in the slope uncertainties urel(K) of linear equation, the contribution rates of uncertainties of solution concentration in 8 of 12 data groups are more than 80%, and the contribution rates of uncertainties introduced by reference substance content in solution concentration are about 80%.It can be seen that the preparation of linear solution concentration is the most influential factor in the determination of impurity correction factor by standard curve method, followed by the linear fitting process.In the preparation process of linear solution concentration, the purity of reference substance is the most influential factor, followed by weighing and pipetting times.The conclusion can help the experimenters to better formulate experimental plans and ensure the accuracy of the results when doing similar work.

Discovery of a potent FKBP38 agonist that ameliorates HFD-induced hyperlipidemia

The mammalian target of rapamycin (mTOR)-sterol regulatory element-binding proteins (SREBPs) signaling promotes lipogenesis. However, mTOR inhibitors also displayed a significant side effect of hyperlipidemia. Thus, it is essential to develop mTOR-specific inhibitors to inhibit lipogenesis. Here, we screened the endogenous inhibitors of mTOR, and identified that FKBP38 as a vital regulator of lipid metabolism. FKBP38 decreased the lipid content

miRNA-296-5p functions as a potential tumor suppressor in human osteosarcoma by targeting SND1 / 中华医学杂志(英文版)

BACKGROUND@#The pathogenesis of osteosarcoma (OS) is still unclear, and it is still necessary to find new targets and drugs for anti-OS. This study aimed to investigate the role and mechanism of the anti-OS effects of miR-296-5p.@*METHODS@#We measured the expression of miR-296-5p in human OS cell lines and tissues. The effect of miR-296-5p and its target gene staphylococcal nuclease and tudor domain containing 1 on proliferation, migration, and invasion of human OS lines was examined. The Student's t test was used for statistical analysis.@*RESULTS@#We found that microRNA (miR)-296-5p was significantly downregulated in OS cell lines and tissues (control vs. OS, 1.802 ± 0.313 vs. 0.618 ± 0.235, t = 6.402, P < 0.01). Overexpression of miR-296-5p suppressed proliferation, migration, and invasion of OA cells. SND1 was identified as a target of miR-296-5p by bioinformatic analysis and dual-luciferase reporter assay. Overexpression of SND1 abrogated the effects induced by miR-296-5p upregulation (miRNA-296-5p vs. miRNA-296-5p + SND1, 0.294 ± 0.159 vs. 2.300 ± 0.277, t = 12.68, P = 0.003).@*CONCLUSION@#Our study indicates that miR-296-5p may function as a tumor suppressor by targeting SND1 in OS.

Establishment of national reference standard of tazobactam impurity A / 中国药科大学学报

@#To improve the standard of quality control of tazobactam and its preparations in China, national reference standard of tazobactam impurity A was developed. After tazobactam impurity A was synthesized, its structure was validated by infrared (IR), mass spectrometry (MS) and nuclear magnetic resonance (NMR), and its content uniformity and short-term stability were measured and investigated. Then, water content and residue on ignition of impurity A were determined, and its purity was determined using high performance liquid chromatography (HPLC) with 10 mmol/L ammonium acetate solution-acetonitrile (98∶2) as the mobile phase. Mass balance method was used to determine the content of the first batch of tazobactam impurity A national standard substance. Meanwhile, nuclear magnetic quantitative method was used to calculate the content, which was mutually verified with the mass balance method. The developed reference material of tazobactam impurity A is consistent with the maximum degradation impurity in tazobactam system applicability solution and the reference material of tazobactam related substance A contained in USP41. Within the 95% confidence range, the ratio of inter- and intra-bottle variance of impurity A after separation was 0.61 (< F0.05(11,12)), proving that the uniformity was satisfying. The contents of organic impurity, water content and inorganic impurity in impurity A were 0.90%, 1.24% and 0.25%, respectively. The content of impurity A was determined to be 97.6% by mass balance method, which was basically consistent with the result of nuclear magnetic quantitative method (97.1%). Under the condition of 25 °C, the area normalized purity of impurity A was 99.1% at 0, 3, 5 and 10 days, proving that the sample was stable at room temperature for 10 days. Finally the first batch of national standard substance of tazobactam impurity A was established successfully.

Analysis of drug - resistant gene polymorphisms in Plasmodium falciparum imported from Equatorial Guinea to Shandong Province in 2015 and 2016 / 中国血吸虫病防治杂志

ObjectiveTo investigate the drug-resistant gene polymorphisms in Plasmodium falciparum imported from Equatorial Guinea to Shandong Province. MethodsFrom 2015 to 2016, blood samples were collected from imported P. falciparum malaria patients returning from Equatorial Guinea to Shandong Province, and genome DNA of the malaria parasite was extracted. The drug-resistant Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, and K13 genes of P. falciparum were amplified using a PCR assay, followed by DNA sequencing, and the sequences were aligned. Results The target fragments of all 5 drug-resistant genes of P. falciparum were successfully amplified and sequenced. There were 72.8%, 18.6%, and 8.6% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfcrt gene, respectively, and all mutant haplotypes were CVIET (the underline indicates the mutation site). There were 20.0%, 61.4% and 18.6% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfmdr1 gene, respectively, and the mutant haplotypes mainly included YF and NF (the underlines indicate the mutation sites). There were 1.4%, 98.6%, and 0 of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfdhfr gene, respectively, and AIRNI was the predominant mutant haplotype (the underline indicates the mutation site). There were 1.4%, 94.3%, and 4.3% of P. falciparum parasites carrying the wild-, mutant-, and mixed-type Pfdhps gene, respectively, and SGKAA was the predominant mutant haplotype (the underline indicates the mutation site). The complete drug-resistant IRNGE genotype consisted of 8.6% of the Pfdhfr and Pfdhps genes, and the K13 gene A578S mutation occurred in 1.4% of the parasite samples. Conclusions There are mutations in the Pfcrt, Pfmdr1, Pfdhfr, Pfdhps, and K13 genes of P. falciparum imported from Equatorial Guinea to Shandong Province, with a low frequency in the Pfcrt gene mutation and a high frequency in the Pfmdr1, Pfdhfr, and Pfdhps gene mutations, and the K13 gene A578S mutation is detected in the parasite samples.

Study on Optimization of Formulation and Technology of Citronellol Submicroemulsion / 中国药房

OBJECTIVE：To optimize the p reparation technology of citronellol submicroemulsion. METHODS ：The content of citronellol in Citronellol submicroemulsion was determined by HPLC. Citronellol submicroemulsion by high-speed shearing dispersion-high pressure homogenization method ，with centrifugation stability constant （ke） and particle size were used as evaluation indexes. Its formulation and preparation technology were optimized and validated. Drug-loading amount and encapsulation rate of the preparation were detected. RESULTS ：The linear range of citronellol were 4-64 μg/mL（R 2＝0.999 9）. RSDs of precision ，stability（24 h）and reproducibility tests were all lower than 3％. The recoveries were 97.64％-101.97％（RSD＝ 2.28％，n＝3），97.71％-99.50％（RSD＝1.29％，n＝3），96.87％-101.48％（RSD＝2.86％，n＝3）. The optimal formulation included that total weight of soybean oil and medium chain triglycerides （1 ∶ 1，g/g）was 3.75 g，1.2％ soybean phospholipid was 0.6 g， cholesterol was 0.06 g，citronellol was 1.25 g，0.6 ％ sodium oleate was 0.3 g，15-hydroxystearic acid polyethylene glycol ester was 0.75 g，poloxamer 188 was 0.75 g，water added to 50 mL. After prepared by optimal technology at 4 ℃ which contained shearing speed of 13 000 r/min，lasting for 5 min， primary emulsion was adjusted to pH 7 with dilute hydro- chloric acid ，and homogenized with 600 Bar high pressure for 1434412440@qq.com 5 min. The parameters of Citronellol submicroemulsion accor- ding to optimal formulation and technology contained mean particle size of （91.05±0.26）nm，PDI of （0.20±0.01）， Zeta-potential of （－30.86±0.39）mV，average content of 649511230@qq.com citronellol（100.21±0.01）％，the drug-loading amount was （2.481 7 ± 0.000 7） mg/mL，the encapsulation rate was （99.27 ± 0.03）％ . CONCLUSIONS ：The optimal formulation and technology is stable and feasible.

Study on the Fingerprint of Crude/vinegar-processed Corydalis yanhusuo Decoction Pieces and Their Dispen- sing Granules and Content Determination of Five Alkaloids / 中国药房

OBJECTIVE：To establish the fingerprint of crude/vinegar-processed Corydalis yanhusuo decoction pieces and their dispensing granules，and to determine the contents of five alkaloids （protopine，tetrahydropalmatine，corydaline，berberine hydrochloride，palmatine hydrochloride ）. METHODS ：HPLC method was adopted. The determination was performed on Agilent TC-C18 column with mobile phase consisted of 0.1％ phosphoric acid solution-methanol （gradient elution ）at the flow rate of 1.0 mL/min. The detection wavelength was set at 280 nm，and the column temperature was 30 ℃. The sample size was 10 μL. Using palmatine hydrochloride as reference ， Similarity Evaluation System of TCM Chromatographic Fingerprint （2012 edition） was used to establish the fingerprint of 11 059） batches of C. yanhusuo decoction pieces ，7 batches of crude . yanhusuo dispensing granules ， 12 batches of vinegar- processed C. yanhusuo decoction pieces and 11 batches of vinegar-processed C. yanhusuo dispensing granules. The same HPLC method was adopted to determine the contents of protopine， tetrahydropalmatine， corydaline， berberine hydrochloride and palmatine hydrochloride in 41 batches of crude/ vinegar-processed C. yanhusuo decoction pieces and their dispensing granules. RESULTS ：There were 12 and 20 common peaks for crude C. yanhusuo decoction pieces and its dispensing granules ，and 14 and 16 common peaks for vinegar-processed C. yanhusuo decoction pieces and its dispensing granules. The similarity of each batch of same type were 0.529-0.981，0.342-0.985， 0.711-0.999，0.437-0.998，respectively. The linear range of protopine ，tetrahydropalmatine，corydaline，berberine hydrochloride and palmatine hydrochloride were 1.9-38.0，2.0-40.0，2.2-44.0，2.6-52.0，2.3-46.0 μg/mL（R2＞0.999 0）. The recoveries were 100.12％-100.98％（RSD＝1.05％-1.90％，n＝9）. RSDs of precision ，reproducibility，stability（24 h）and durability tests were all lower than 2.0％. The average contents of five alkaloids in different batches of crude/vinegar-processed C. yanhusuo decoction pieces and its dispensing granules were 0.24-0.46，0.37-0.82，0.24-0.58，0.07-0.75，0.24-0.76 mg/g. RSDs were 12.27％-147.48％. CONCLUSIONS：The fingerprint of crude/vinegar-processed C. yanhusuo decoction pieces and its dispensing granules is established successfully. The similarities of fingerprint are different before and after processing with vinegar ，and the contents of five alkaloids in C. yanhusuo decoction pieces and its dispensing granules are greatly different.

Advances in the diagnosis and treatment of congenital myasthenic syndrome / 中国当代儿科杂志

Congenital myasthenic syndrome (CMS) is a group of clinical and genetic heterogeneous diseases caused by impaired neuromuscular transmission due to genetic defects. At present, it has been reported that more than 30 genes can cause CMS. All CMS subtypes have the clinical features of fatigue and muscle weakness, but age of onset, symptoms, and treatment response vary with the molecular mechanisms underlying genetic defects. Pharmacotherapy and symptomatic/supportive treatment are the main methods for the treatment of CMS, and antisense oligonucleotide technology has been proven to be beneficial for CHRNA 1-related CMS in animals. Since CMS is a group of increasingly recognized clinical and genetic heterogeneous diseases, an understanding of the latest knowledge and research advances in its clinical features, genetic research, and treatment helps to give early diagnosis and treatment as well as gain a deeper understanding of the pathogenesis of CMS, so as to make new breakthroughs in the treatment of CMS.

Glycyrrhizic Acid Protect IEC-6 Cells from Apoptosis Via HuR Mediated Posttranscription of p21 / 中国实验方剂学杂志

Objective:To investigate the protective effect of glycyrrhizic acid (GA) from tumor necrosis factor-α+actinomycetes ketone （TNF-α+CHX） induced apoptosis in rat small intestine crypt epithelial cell line (IEC-6) via AU rich element mRNA binding protein HuR mediated posttranscription of p21 and the potential mechanism. Method:The cultured IEC-6 cells were observed. The experiment was divided into blank group, GA (60 μmol·L-1) group, TNF-α+CHX group and GA+TNF-α+CHX group. Cytoplasmic and nuclear HuR were measured by Western blot. The interaction of HuR and p21 mRNA was detected by biotin pull down and RNA IP. Luciferase activity was measured after transfection with construct with p21 3'-UTR cloned into downstream of luciferase reporter. Cell apoptosis was detected by real-time dynamic cell analyzer, p21 and cysteine proteinas-3 precursor protein（proCaspase-3） association was analysised by CO-IP. Result:After GA treatment for 48 h, cytoplasmic HuR protein expression increased（P<0.05）,the binding between HuR and p21 mRNA expression up regulated(P<0.05), luciferase activity increased(P<0.01), and p21 mRNA and protein expression also increased(P<0.05), while these results were abolished by HuR silencing with siRNA. GA enhanced p21 and procaspase3 interaction(P<0.05), and attenuated TNF-α+CHX induced apoptosis in IEC-6 cells. Conclusion:GA protected IEC-6 cells from TNF-α/CHX induced apoptosis via HuR mediated p21 posttranscription, which due to GA enhanced HuR binding to endogenous and recombinant p21 mRNA and increased p21 interaction with proCaspase3.

Diagnosis and classification of high-functional autism spectrum disorder and attention deficit hyperactivity disorder by combining empathy and executive function / 中华行为医学与脑科学杂志

Objective:To explore the significance of empathy and executive function indexes in the diagnosis and classification of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD).Methods:According to DSM-Ⅴ diagnostic criteria, 33 children with ASD, 30 children with ADHD and 39 typical development (TD) children and adolescents were enrolled as the research subjects.The empathy and executive function characteristics were compared and analyzed in the subjects.Based on empathy and executive function indicators, the three groups of subjects were diagnosed and classified by machine learning method.Results:The total score of Griffith empathy measure parent ratings(GEM-PR)(ASD: (0.67±0.64), ADHD: (1.00±0.79), TD: (0.98±0.73)) and each factor score ( F=3.595-10.363, all P<0.05) and the total score of behavior rating inventory of executive function(BRIEF)(ASD: (62.79±7.45), ADHD: (59.47±8.77), TD: (49.08±7.91)) and each factor score of the three groups were different ( F=6.557-33.205, all P<0.01). Among them, the scores of empathy and executive function in ASD and ADHD groups were generally higher than those in TD children (all P<0.05). When combined with BRIEF scale and GEM scale, the classification accuracy of the three groups reached 62.75%. Conclusion:Both ASD and ADHD children have damages in empathy and executive function.Combining empathy and executive function indexes are more helpful for diagnosis and classification than single index.

Application of an HPLC correction factor method in pharmaceutical analysis / 药学学报

With the in-depth study of related substances and the development of consistency evaluation of generic drugs, relative correction factors are gaining increasing attention. By analyzing the domestic and foreign literature on correction factors in recent years, this paper describes the correction factor component, the current measurement method and its application. The rules and key points of use of an impurity correction factor and its determination and application are described, and some problems in its determination and application are discussed, providing a reference and basis for the standardization of research on impurity correction factors in the future.

Value of the detection of BRAFV600E gene mutation and protein expression in auxiliary cytological diagnosis of papillary thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective@#To evaluate the utility of the BRAFV600E mutation detection in different cytoloy categories and to determine if the VE1 antibody can serve as a screening tool for the detection of BRAFV600E mutation in thyroid fine needle aspiration (FNA) specimens.@*Methods@#A total of 273 FNA residual specimens were collected. BRAFV600E testing was performed on these liquid-based specimens. And also 78 specimens with enough residual cells were stained with VE1 antibody. Comparisons of molecular and immunocytochemistry results with clinicopathological outcomes were performed. SPSS 17.0 software was used to analyze the data.@*Results@#There were 70 indeterminated diagnoses in 273 cases with FNAs. Fifty-eight cases were proven to be papillary thyroid carcinoma (PTC) by histology, including 9 cases of atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS), 3 cases of follicular neoplasm/suspicious for follicular neoplasm (FN/SFN), and 46 cases of suspicious for malignancy (SM). BRAFV600E analysis detected PTC in 3 of 9 cases with AUS/FLUS, and in 31 (67.4%) of 46 cases with SM. The sensitivity of immunostaining with VE1 antibody was 62.8%(27/43) and the specificity was 91.4% (32/35). VE1 expression showed moderately concordance with the molecular mutation (κ=0.524, P<0.001).@*Conclusions@#Additional BRAFV600E detecting can improve the diagnostic efficacy for PTC in AUS/FLUS and SM. VE1 expression may be an alternative method for BRAFV600E detecting when molecular detecting is unavailable.

Effect of caregiver factors on the efficacy of Play-based Communication and Behavior Intervention in children with autism spectrum disorder / 中华实用儿科临床杂志

Objective@#Children with autism spectrum disorder(ASD) who participated in the " Play-based Communication and Behavior Intervention(PCBI)" were studied in order to evaluate the impact of caregiver factors on the efficacy of the PCBI very early intervention model systematically.@*Methods@#Seventy-six children with ASD aged 8-30 months were recruited in this study at Brain Hospital Affiliated to Nanjing Medical University form December 2017 to June 2018, and they were trained for PCBI very early intervention.The Autism Treatment Evaluation Checklist (ATEC) and the Gesell Developmental Schedules were used to evaluate the efficacy of the PCBI very early intervention.Parenting Stress Index Short Form, General Self-Efficacy Scale and the self-developed Caregiver Training Course Evaluation Scale and the Homework Completion Level Scale were used to assess the level of parental stress, self-efficacy, curriculum satisfaction and acceptance.A pair of sample t-test was used to analyze the ASD symptoms, developmental level and caregiver factors of ASD children before and after intervention.Multivariate regression analysis was used to analyze the caregiver factors and the effects of PCBI very early intervention.@*Results@#(1) At the end of 12 weeks of PCBI very early intervention, the score of the ATEC (17.36±15.98) was lower than that before intervention (78.43±22.84), and the difference was statistically significant(P<0.05); the adaptive developmental quotient(5.90±15.45), the fine action developmental quotient(5.13±19.89), the language developmental quotient (12.43±20.60) and the personal social developmental quotient(4.79±16.02) scores of the Gesell Developmental Schedules were higher than those before intervention (73.08±20.54, 77.33±23.63, 52.24±19.12, 71.79±20.81), and the differences were statistically significant (all P<0.05). (2) At the end of PCBI very early intervention, there was a significant decrease in the scores of Parenting Stress Index Short Form, and the differences were statistically significant (4.84±14.69 vs.94.05±29.67, P<0.05). (3) Acceptance of the intervention model, and mastery of the skills in the caregiver factors had a positive predictive effect on the effect of PCBI very early intervention (t=3.068, 10.468, all P<0.05).@*Conclusions@#PCBI very early intervention can effectively reduce the parenting pressure of the caregivers, and in the PCBI very early intervention, the better the mastery of skills and the completion of homework, the better the efficacy of intervention.

Assessment of the feasibility of transperineal ultrasound combined with clinical factors in predicting female stress urinary incontinence factors / 中华超声影像学杂志

Objective To investigate the feasibility and accuracy of transperineal real‐time three‐dimensional ultrasound combined with clinical factors in predicting the risk of female stress urinary incontinence( SUI ) . Methods T hree hundred and forty‐eight female patients with SUI diagnosed were selected as the case group ,and 102 healthy people in the same period were selected as the control group . All subjects underwent transperineal real‐time three‐dimensional ultrasound . T he ultrasonic parameters of resting state ,contraction and Valsalva were measured ,and the clinical parameters such as age ,height , weight ,history of pregnancy and childbirth were collected . According to the time sequence ,all the subjcets were divided into derivation cohort and verification cohort inproportion to 2∶1 ,single factor screening and logistic multiple regression analysis were carried out on 24 factors ,and the risk model was established . T he cut‐off value of the disease probability P was determined by the ROC curve of the subjects ,and then the accuracy of the cut‐off value in predicting SUI was verified in the verification group . Results Single factor analysis showed that 13 parameters were associated with SUI( all P ＜0 .05) . Logit P＝2 .014+1 .870× Z1 was established by multivariate logistic regression analysis . T he cut‐off value of the disease probability P determined by ROC curve was 0 .823 . T he predictive sensitivity of the model was 68 .1% ( 95% CI : 59 .6% －76 .6% ) ,specificity was 91 .2% ( 95% CI :86 .0% －96 .4% ) ,positive predictive value was 64 .3%( 95% CI : 55 .6% － 73 .0% ) and negative predictive value was 92 .5% ( 95% CI : 86 .2% － 98 .8% ) . Conclusions It is feasible to predict the risk of female stress urinary incontinence by transperineal real‐time three‐dimensional ultrasound combined with clinical factors . Although ,some limitations with the prediction model ,it has accuracy in predicting SUI with obvious symptoms .

Effects of sodium acetate Ringer solution on electrolytes, blood glucose and lactate levels in pediatric neurosurgery / 中国中西医结合急救杂志

Objective To observe the effect of sodium acetate Ringer solution on serum levels of electrolytes, blood glucose (Glu) and lactic acid (Lac) in peri-operational stage of children undergoing neurosurgery. Methods Forty cases of children prepared to undergo neurosurgery admitted into Hunan Children's Hospital from December 2018 to April 2019 were enrolled, and according to the criteria of American Society of Anesthesiologists (ASA), they were classified into Ⅰ-Ⅱ grade. They were divided into a sodium acetate Ringer solution group and a sodium lactate Ringer solution group by random number table method, 20 cases in each group. Sodium acetate Ringer solution group was given the sodium acetate Ringer solution; sodium lactate Ringer solution group was given the sodium lactate Ringer solution, and both groups used intravenous infusion of their own respective solution at a rate of 10 mL·kg-1·h-1. Arterial blood gas detections were measured after anesthesia induction (T1), 1 hour after administration (T2), 2 hours after administration (T3) and at the end of surgery (T4); the changes in serum levels of electrolyte concentrations, blood Glu and Lac were observed in the patients of two groups. Results With the prolonged operation time, the levels of Glu and Lac in the two groups showed an increasing trend, compared with the levels at T1 and T2 , the levels were increased at T3 and T4 [the sodium lactate ringer solution group: Glu (mmol/L) were 5.85±1.02, 6.95±1.21 vs. 5.28±0.72, 5.20±0.62, and Lac (mmol/L) were 1.53±0.74, 1.91±1.41 vs. 1.23±0.71, 1.38±0.69; sodium acetate ringer solution group: Glu (mmol/L) was 5.44±0.86, 5.85±1.12 vs. 5.05±0.85, 5.14±0.74, Lac (mmol/L) were 1.58±1.31, 1.61±1.23 vs. 1.14±0.65, 1.28±0.95, all P < 0.05], the Lac and Glu levels at T4 in sodium acetate Ringer solution group were significantly lower than those in sodium lactate Ringer solution group (both P < 0.05). There were no statistically significant differences in pH value, Na+, K+ and residual base (BE) levels between the two groups at different time points (all P > 0.05). Conclusion Sodium acetate Ringer solution used in pediatric neurosurgery for more than 2 hours can reduce the blood lactic acid level without rising blood glucoselevel. Therefore, it is more suitable for infusion during pediatric neurosurgery.

Effect of caregiver factors on the efficacy of Play-based Communication and Behavior Intervention in children with autism spectrum disorder / 中华实用儿科临床杂志

Objective Children with autism spectrum disorder(ASD) who participated in the " Play-based Communication and Behavior Intervention(PCBI) " were studied in order to evaluate the impact of caregiver factors on the efficacy of the PCBI very early intervention model systematically.Methods Seventy-six children with ASD aged 8-30 months were recruited in this study at Brain Hospital Affiliated to Nanjing Medical University form December 2017 to June 2018,and they were trained for PCBI very early intervention.The Autism Treatment Evaluation Checklist (ATEC) and the Gesell Developmental Schedules were used to evaluate the efficacy of the PCBI very early intervention.Parenting Stress Index Short Form,General Self-Efficacy Scale and the self-developed Caregiver Training Course Evaluation Scale and the Homework Completion Level Scale were used to assess the level of parental stress,self-efficacy,curriculum satisfaction and acceptance.A pair of sample t-test was used to analyze the ASD symptoms,developmental level and caregiver factors of ASD children before and after intervention.Multivariate regression analysis was used to analyze the caregiver factors and the effects of PCBI very early intervention.Results (1) At the end of 12 weeks of PCBI very early intervention,the score of the ATEC (17.36 ± 15.98) was lower than that before intervention (78.43± 22.84),and the difference was statistically significant (P ＜ 0.05);the adaptive developmental quotient (5.90 ± 15.45),the fine action developmental quotient (5.13 ± 19.89),the language developmental quotient (12.43 ± 20.60) and the personal social developmental quotient (4.79 ± 16.02) scores of the Gesell Developmental Schedules were higher than those before intervention (73.08 ± 20.54,77.33 ± 23.63,52.24 ± 19.12,71.79 ± 20.81),and the differences were statistically significant (all P ＜ 0.05).(2) At the end of PCBI very early intervention,there was a significant decrease in the scores of Parenting Stress Index Short Form,and the differences were statistically significant (4.84 ± 14.69 vs.94.05 ± 29.67,P ＜ 0.05).(3) Acceptance of the intervention model,and mastery of the skills in the caregiver factors had a positive predictive effect on the effect of PCBI very early intervention (t =3.068,10.468,all P ＜ 0.05).Conclusions PCBI very early intervention can effectively reduce the parenting pressure of the caregivers,and in the PCBI very early intervention,the better the mastery of skills and the completion of homework,the better the efficacy of intervention.

Severe pneumonia associated with sepsis-induced myopathy: one case report and literature review / 中国感染控制杂志

Clinical data of one patient with sepsis-induced myopathy (SIM) who was successfully treated were reviewed retrospectively, analysis was conducted combined with the relevant literatures. Patient was a middle-aged woman without underlying disease, she was admitted to hospital because of fever, cough, chest tightness and shortness of breath, during the treatment period, type II respiratory failure occurred repeatedly, and it was difficult in withdrawing respirator, patient was finally diagnosed with SIM. After anti-infective treatment and rehabilitation training, she was successfully withdrawn respirator, muscle strength was recovered. This case suggests that SIM can be completely cured through early identification, neuromuscular nutrition therapy, graded rehabilitation training and lung rehabilitation therapy.

Effect of play-based communication and behavior intervention on toddlers with autism spectrum disorder / 中华实用儿科临床杂志

Objective To compare and analyze the short-term effect of play-based communication and behavior intervention (PCBI) and applied behavioral analysis (ABA) on the treatment of toddlers with autism spectrum disorder (ASD).Methods Seventy-four ASD toddlers aged from 19 to 30 months were recruited in Nanjing Brain Hospital Affiliated to Nanjing Medical University from November 2017 to May 2018.The toddlers who participated in this study were randomly assigned into PCBI group and ABA group,then they were intervened weekly by PCBI or ABA for a total of 12 weeks.Portage Early Development Checklist and autism treatment evaluation checklist (ATEC) were used to estimate the toddlers' developmental level and the treatment efficacy respectively.The t-test was used to reveal whether there was significant difference between the 2 groups before and after intervention.Results (1) Compared with the ABA group,there was a significant increase in cognitive scores (△PCBI =9.03 scores,△ABA =4.27 scores,t =3.997) and a significant decrease in social behavior scores (△PCBI =8.87 scores,△ABA =16.91 scores,t =-4.022) of the Portage Early Development Checklist after 12 weeks of intervention in the PCBI group,and there were statistically significant differences(all P ＜ 0.001);while the total score and the scores of language,movement,and self-care subscale of Portage Early Development Checklist were also increased after PCBI intervention but without significant differences (all P ＞ 0.05).(2)Compared with the ABA group,after 12 weeks of PC BI intervention,the scores of social contact,perception,behavior of ATEC were decreased,but the difference was not significant (P ＞ 0.05);the total score of ATEC scale(△PCBI total =14.89 scores,△ABA total =22.22 scores,t =2.209)and the scores of language subscale(△PCBI language =2.89 scores,△ ABA language =6.43 scores,t =2.515) were decreased significantly,and there were statistically significant differences (all P ＜ 0.05).Conclusions After 12 weeks of the very early intervention of PCBI,the ASD toddlers all improved in clinical symptoms and developmental level.Compared with ABA intervention,PCBI very early intervention with parental guidance was comparable in short term efficacy,and PCBI was not taking up as much medical rehabilitation resources as ABA.