Hospitalization costs of pediatric community-acquired pneumonia in Shanghai / 中华儿科杂志

Objective: To investigate the epidemiology and hospitalization costs of pediatric community-acquired pneumonia (CAP) in Shanghai. Methods: A retrospective case summary was conducted on 63 614 hospitalized children with CAP in 59 public hospitals in Shanghai from January 2018 to December 2020. These children's medical records, including their basic information, diagnosis, procedures, and costs, were extracted. According to the medical institutions they were admitted, the patients were divided into the children's hospital group, the tertiary general hospital group and the secondary hospital group; according to the age, they were divided into <1 year old group, 1-<3 years old group, 3-<6 years old group, 6-<12 years old group and 12-18 years old group; according to the CAP severity, they were divided into severe pneumonia group and non-severe pneumonia group; according to whether an operation was conducted, the patients were divided into the operation group and the non-operation group. The epidemiological characteristics and hospitalization costs were compared among the groups. The χ2 test or Wilcoxon rank sum test was used for the comparisons between two groups as appropriate, and the Kruskal-Wallis H test was conducted for comparisons among multiple groups. Results: A total of 63 614 hospitalized children with CAP were enrolled, including 34 243 males and 29 371 females. Their visiting age was 4 (2, 6) years. The length of stay was 6 (5, 8) days. There were 17 974 cases(28.3%) in the secondary hospital group, 35 331 cases (55.5%) in the tertiary general hospital group and 10 309 cases (16.2%) in the children's hospital group. Compared with the hospitalizations cases in 2018 (27 943), the cases in 2019 (29 009) increased by 3.8% (1 066/27 943), while sharply declined by 76.2% (21 281/27 943) in 2020 (6 662). There were significant differences in the proportion of patients from other provinces and severe pneumonia cases, and the hospitalization costs among the children's hospital, secondary hospital and tertiary general hospital (7 146 cases(69.3%) vs. 2 202 cases (12.3%) vs. 9 598 cases (27.2%), 6 929 cases (67.2%) vs. 2 270 cases (12.6%) vs. 9 397 cases (26.6%), 8 304 (6 261, 11 219) vs. 1 882 (1 304, 2 796) vs. 3 195 (2 364, 4 352) CNY, χ2=10 462.50, 9 702.26, 28 037.23, all P<0.001). The annual total hospitalization costs of pediatric CAP from 2018 to 2020 were 110 million CNY, 130 million CNY and 40 million CNY, respectively. And the cost for each hospitalization increased year by year, which was 2 940 (1 939, 4 438), 3 215 (2 126, 5 011) and 3 673 (2 274, 6 975) CNY, respectively. There were also significant differences in the hospitalization expenses in the different age groups of <1 year old, 1-<3 years old, 3-<6 years old, 6-<12 years old and 12-18 years old (5 941 (2 787, 9 247) vs. 2 793 (1 803, 4 336) vs. 3 013 (2 070, 4 329) vs. 3 473 (2 400, 5 097) vs. 4 290 (2 837, 7 314) CNY, χ2=3 462.39, P<0.001). The hospitalization cost of severe pneumonia was significantly higher than that of non-severe cases (5 076 (3 250, 8 364) vs. 2 685 (1 780, 3 843) CNY, Z=109.77, P<0.001). The cost of patients who received operation was significantly higher than that of whom did not (10 040 (4 583, 14 308) vs. 3 083 (2 025, 4 747) CNY, Z=44.46, P<0.001). Conclusions: The number of children hospitalized with CAP in Shanghai decreased significantly in 2020 was significantly lower than that in 2018 and 2019.The proportion of patients from other provinces and with severe pneumonia are mainly admitted in children's hospitals. Hospitalization costs are higher in children's hospitals, and also for children younger than 1 year old, severe cases and patients undergoing operations.

Research progress on the effect mechanism of polysaccharides against pancreatic cancer / 中国药房

Polysaccharide is a recognized immunomodulator that has been shown to have inhibitory effects on a variety of cancer cells and has the potential to be developed as an anti-cancer drug. Pancreatic cancer， one of the cancers with the highest mortality rate， is treated with long-term chemotherapeutic drugs and is prone to a variety of side effects such as immune deficiency， fatigue， and neurological lesions. The polysaccharide anti-pancreatic cancer research landscape both domestically and internationally is summarized in this publication. By regulating nuclear factor-κB， Hippo-Yes-associated protein， integrin and other signaling pathways， polysaccharide components play an anti-pancreatic cancer role by multi-target ways， such as inducing apoptosis and autophagy， inhibiting proliferation， migration and invasion of cancer cells， and regulating the cancer cell cycle.

Short-term efficacy and perioperative safety of catheter-based intervention for pulmonary vein stenosis caused by fibrosing mediastinitis / 中华心血管病杂志

Objective: To evaluate the short-term efficacy and perioperative safety of catheter-based intervention in patients with pulmonary vein stenosis caused by fibrosing mediastinitis (FM). Methods: It was a case series study. Consecutive patients with pulmonary vein stenosis caused by FM, who underwent percutaneous pulmonary vein angioplasty in Gansu Provincial Hospital from January 2018 to June 2020, were retrospective enrolled. The baseline characteristics, comorbidities, exercise capacity and hemodynamic data before and after treatment were compared, and the procedural related complications were evaluated. Results: A total of 30 patients ((64.3±7.1) years, 15 males) were included. Sixty-three pulmonary vein stenosis were treated by 32 percutaneous pulmonary vein angioplasty procedures. Forty-four stents were implanted in 41 pulmonary veins after balloon angioplasty, and the diameter of implanted stents was (8.3±1.2)mm. Balloon angioplasty was performed on 22 pulmonary vein stenosis, the mean balloon diameter was (4.2±2.1)mm. The pulmonary vein diameter increased from (2.6±1.3) to (6.6±2.6) mm (P<0.001) and the pressure gradient across the pulmonary vein stenotic segment reduced from 19 (12, 29) to 2 (0, 4) mmHg (1 mmHg=0.133 kPa) (P<0.001) immediately post procedure. The pulmonary vein flow grade was significantly improved compared with baseline (P<0.001). The most common operation related complications were lung injury (44.0% (11/25)) and hemoptysis (18.8% (6/32)), which did not need special treatment. During the 2.0 (1.3, 3.2) months follow-up, the WHO functional class was significantly improved (P<0.05), the 6-minute walking distance increased from (254.8±114.5) m to (342.8±72.4)m (P<0.05), the mean pulmonary arterial pressure decreased from (40.9±8.3) mmHg to (35.4±7.7) mmHg (P<0.01), 17 out of 19 patients with refractory pleural effusion experienced total remission during the follow-up period (P<0.001). CT pulmonary venography was repeated in 17 patients. The incidence of in-stent restenosis of pulmonary vein was 24.0% (6/25). Conclusions: Percutaneous pulmonary vein angioplasty is effective for the treatment of pulmonary vein stenosis caused by fibrosing mediastinitis. However, it's not so safe, procedural related complication should be paid attention to and the rate of in-stent restenosis is relative high during the short-term follow-up.

Effect of effective parts of Dracocephalum moldavica on the necroptosis of HBMECs after OGD/R injury / 药学学报

We investigated the ability of Dracocephalum moldavica (EPDM) flavonoids to protect human brain microvascular endothelial cells (HBMECs) from necroptosis induced by ischemia-reperfusion injury. To mimic the process of cerebral ischemia-reperfusion injury, a necroptosis model was established by treatment with the pan-cysteine aspartic acid protease (caspase) inhibitor Z-VAD-FMK combined with oxygen-glucose deprivation/re-oxygenation (OGD/R) injury using HBMECs. Cell proliferation and cytotoxicity (cell counting kit-8, CCK-8) was used to measure cell viability. A Hoechst33342/PI fluorescent double-staining method was exploited to determine the rate of cell necroptosis. A commercial kit was used to detect lactate dehydrogenase in the cell culture supernate. DCFH-DA probes, calcein AM and JC-1 probes were used to measure changes in ROS production, mitochondrial membrane permeability transformation pore (MPTP) opening and mitochondrial membrane potential (MMP), respectively. Enzyme-linked immunosorbent assay (ELISA) kits were chosen to detect the release of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6). Western blotting was used to detect necroptosis-related proteins. The results show that relative to control group, Z-VAD-FMK combined with OGD/R injury reduced cell viability, increased the necroptosis rate and the levels of LDH and ROS in HBMECs. The MPTP of the model group cells opened and the MMP reduced. TNF-α, IL-1β, and IL-6 levels were significantly elevated. Furthermore, the expression of receptor-interacting protein kinase 3 (RIP3) and mitochondrial phosphoglycerate mutase 5 (PGAM5) was significantly increased, accompanied by an increase of phosphorylated mixed-lineage kinase domain-like protein (p-MLKL)/MLKL. EPDM partially reversed the changes of the above-mentioned factors in HBMECs induced by Z-VAD-FMK plus OGD/R injury. These results indicate that EPDM may protect HBMECs from cerebral ischemia-reperfusion injury by inhibiting the RIP3/MLKL/PGAM5 pathway and MPTP opening to maintain mitochondrial function, thereby providing a scientific basis for the use of EPDM in the treatment of cerebral ischemia-related diseases.

Study of the protective effect of total flavonoids of Dracocephalum moldavica L.On doxorubicin induced injury in HUVECs based on VEGF-B/AMPKa pathway / 中国药理学通报

Aim To investigate the protective effect of TFDM on doxorubicin-induced endothelial cell injury and its mechanism.Methods Cell viability was detected by CCK-8 assay.Cell morphology was observed by microscope.The changes of LDH, SOD and mitochondrial membrane potential were detected by kit method.Cell migration was detected by Transwell assay; Endothelial dysfunction and VEGF-B/AMPKa pathway related protein expression were detected by Western blot.Results Compared with model group, TFDM significantly increased cell viability, improved the morphologic changes of HUVEC induced by DOX, decreased LDH leakage, increased SOD activity, increased mitochondrial membrane potential, promoted endothelial cell migration, and inhibited endothelial cell injury.The results of Western blot showed that com pared with control group TFDM increased the expression levels of non-receptor tyrosine kinase ( Src) and focal adhesion kinase (FAK) .increased the phosphorylation level of eNOS, and decreased the expression level of ET-1 protein, thereby inhibiting endothelial dysfunction.The protein expression levels of VEGF-B, NRP1 , VEGFR1 and the ratio of p-AMPKa/AMPKa significantly increased in the administration group.Conclusion TFDM may inhibit doxorubicin-induced endothelial cell injury by activating VEGF-B/AMPKa pathway.

Metabolism characteristics and pharmacological insights of flavonoids based on the intestinal bacteria / 药学学报

The gut microbiota takes part in many in vivo important physiological activities of host, such as the substance metabolism and energy exchange, etc. The interaction between the host and the intestinal microorganisms has attracted scholars' attention. Flavonoids are a group of polyphenol compounds widely found in natural plants, with the bioactive effect of regulation of glucose and lipid metabolism, anti-inflammation. However, their low bioavailability cause difficulty to clarify the effective substances and the mechanism of flavonoids. Apart from the metabolic effects of liver on flavonoids, recent studies have shown that the gut microbiota can interact with flavonoids. On the one hand, flavonoids can be metabolized by gut microbiota and subsequent metabolites can produce pharmacological activities different from the parent components. On the other hand, flavonoids and their metabolites can in turn regulate the composition and physiological activities of the intestinal flora, which seems to provide a new insight for the research on the effective substances of flavonoids. In this review, we introduced the metabolic characteristics of flavonoids under the actions of intestinal bacteria, and the regulation effects of flavonoids on gut microbiota was also summarized. Meanwhile, the therapeutic effect of flavonoids under the action of intestinal bacteria was discussed.

Research progress of famesyltransferase and its inhibitors in cancer therapy / 中国药理学通报

Famesyltransferase, a membrane-associated protein, catalyzes the addition of the 15-carbon fragment of famesyl diphosphate to the cysteine SH group of the CAAX motif containing protein substrates to regulate the function of target proteins through famesylation. As one of the most important target proteins of FTase, oncogenic forms of Ras mutants have been reportedly involved in more than 30% human cancers, and are known to play critical roles in cancer development and progression. Despite decades of research, Ras inhibitors are so elusive that no therapeutic agents directly targeting Ras mutants have been clinically approved, the primary reason for which is the lack of druggable pockets on the surface of Ras. Therefore, FTase, the main regulator of Ras protein, has gradually become a research hotspot, and many FTase inhibitors have been developed, synthesized and used for the treatment of malignant tumors. In the present review, we briefly describe the regulation of Ras functions by FTase and the role of FTase in cancers, and mainly explore the research progress of FTase inhibitors as a promising strategy for cancer therapy.

Role of Kelch-like ECH-associated Protein-1-Nuclear Factor Erythroid 2-related Factor-2/Antioxidant Responsive Element Signal Pathway for Multiple Sclerosis (review) / 中国康复理论与实践

Multiple sclerosis (MS) is a chronic inflammatory disease, mainly due to the activation of the T cells, which makes oxidative stress reaction in brain and leads to demyelination finally. Kelch-like ECH-associated protein-1 (Keap1)-nuclear factor erythroid 2-related factor-2 (Nrf2)/antioxidant responsive element (ARE) signal pathway is one of the most important endogenous antioxidant pathways, which promotes the expression of detoxification enzymes and antioxidant protein to eliminate oxygen free radicals and balance intracellular redox system. Activation of the Keap1-Nrf2/ARE may delay the progression of MS by drugs or rehabilitation.

An analysis on incidence of HIV-1 epidemics among men who have sex with men in Sichuan Province during 2011-2015 / 中华预防医学杂志

The assay was used in HIV/AIDS surveillance sentinel sites to identify recent HIV-1 infection, to estimate HIV-1 incidence and understand the epidemic trends among men who have sex with men during 2011-2015. During 2011-2015, the HIV-1 incidence of men who have sex with men was 5.16%(95%CI: 4.65%-5.66%) in Sichuan Province. According to<Pilot study on classification criteria of AIDS epidemic in China>, a total of 9 cities had been divided into two type of regions: the first type(the proportion of live HIV/AIDS accounts for more than 0.1% of the permanent population, and the number of live HIV/AIDS has reached 500 cases and above) and the second type(the proportion of live HIV/AIDS accounts for 0.03% to 0.100% of the permanent population, and the number of live HIV/AIDS has reached 100-500 cases). During 2011-2015, the HIV-1 incidence of the second type was 4.24% (95%CI: 3.72%-4.76%). The HIV-1 incidence of men who have sex with men was at a high level. The spread of HIV-1 to the second region was possible.

Survival analysis of people living with HIV/AIDS in Sichuan province, 1991-2017 / 中华流行病学杂志

Objective@#To analyze the survival time of people living with HIV/AIDS and related influencing factors in Sichuan province during 1991-2017.@*Methods@#A retrospective cohort study was conducted to analyze the data of 143 988 HIV/AIDS cases. The data were collected from Chinese HIV/AIDS Comprehensive Information Management System. Life table method was used to calculate the survival proportion of the cases, and Cox proportion hazard regression model was used to identify the factors related with survival time.@*Results@#Among 143 988 HIV/AIDS cases a total of 30 420 cases died of AIDS related diseases (21.1%) and the average survival time was 11.51 years (95%CI: 11.39-11.64). Multivariate Cox regression analysis showed that the influencing factors for the survival of HIV/AIDS cases were gender (male vs. female, HR=1.35, 95%CI: 1.32-1.40), education level (primary school or below vs. junior middle school: HR=1.15, 95%CI: 1.12-1.18), ethnic group (Han vs. other ethnic groups, HR=1.46, 95%CI: 1.41-1.52), occupation (farmer vs. other occupations: HR=1.26, 95%CI: 1.22-1.29), age (≥55 years old vs. 15-24 years old: HR=3.18, 95%CI: 3.02- 3.36), disease phase (AIDS vs. HIV infection: HR=1.44, 95%CI: 1.39-1.48), antiretroviral therapy (ART) (receiving ART vs. receiving no ART: HR=0.20, 95%CI: 0.19-0.20), and CD4+T cell counts at diagnosis (>500 cells/μl vs.<200 cells/μl: HR=0.42, 95%CI: 0.40-0.45).@*Conclusions@#The average survival time of HIV/AIDS cases was 11.51 years in Sichuan during 1991- 2017. The risk factors for the survival of the cases were male, education level of primary school or below, Han ethnic group, farmer, old age at diagnosis, disease phase, The protective factors for the survival of HIV/AIDS cases were receiving ART and higher CD4+ T cell counts at diagnosis.

Biomarkers enhance the long-term predictive ability of the KAMIR risk score in Chinese patients with ST-elevation myocardial infarction / 中华医学杂志(英文版)

BACKGROUND@#The Global Registry of Acute Coronary Events (GRACE) score is recommended by current ST-elevation myocardial infarction (STEMI) guidelines. But it has inherent defects. The present study aimed to investigate the more compatible risk stratification for Chinese patients with STEMI and to determine whether the addition of biomarkers to the Korea Acute Myocardial Infarction Registry (KAMIR) score could enhance its predictive value for long-term outcomes.@*METHODS@#A total of 1093 consecutive STEMI patients were included and followed up 48.2 months. Homocysteine, hypersensitive C-reactive protein (hs-CRP), and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were detected. The KAMIR score and the GRACE score were calculated. The performance between the KAMIR and the GRACE was compared. The predictive power of the KAMIR alone and combined with biomarkers were assessed by the receiver-operating characteristic (ROC) curve.@*RESULTS@#The KAMIR demonstrated a better risk stratification and predictive ability than the GRACE (death: AUC = 0.802 vs. 0.721, P < 0.001; major adverse cardiovascular events (MACE): AUC = 0.683 vs. 0.656, P < 0.001). It showed that the biomarkers could independently predict death [homocysteine: HR = 1.019 (1.015-1.024), P < 0.001; hs-CRP: HR = 1.052 (1.000-1.104), P = 0.018; NT-pro BNP: HR = 1.142 (1.004-1.280), P = 0.021] and MACE [homocysteine: HR = 1.019 (1.015-1.024), P < 0.001; hs-CRP: HR = 1.012 (1.003-1.021), P = 0.020; NT-pro BNP: HR = 1.136 (1.104-1.168), P = 0.006]. When they were used in combination with the KAMIR, the area under the ROC curve (AUC) significantly increased for death [homocysteine: AUC = 0.802 vs. 0.890, Z = 5.982, P < 0.001; hs-CRP: AUC = 0.802 vs. 0.873, Z = 3.721, P < 0.001; NT-pro BNP: AUC = 0.802 vs. 0.871, Z = 2.187, P = 0.047; homocysteine, hs-CRP and NT-pro BNP: AUC = 0.802 vs. 0.940, Z = 6.177, P < 0.001] and MACE [homocysteine: AUC = 0.683 vs. 0.771, Z = 6.818, P < 0.001; hs-CRP: AUC = 0.683 vs. 0.712, Z = 2.022, P = 0.031; NT-pro BNP: AUC = 0.683 vs. 0.720, Z = 2.974, P = 0.003; homocysteine, hs-CRP and NT-pro BNP: AUC = 0.683 vs. 0.789, Z = 6.900, P < 0.001].@*CONCLUSION@#The KAMIR is better than the GRACE in risk stratification and prognosis prediction in Chinese STEMI patients. A combination of above-mentioned biomarkers can develop a more predominant prediction for long-term outcomes.

The influence of self-efficacy on parenting stress among parents of children with malignant solid tumors / 中国实用护理杂志

Objective@#To explore the effect of self-efficacy on parenting stress among parents of children with malignant solid tumors.@*Methods@#Totally 100 parents of children with malignant solid tumors were investigated and analyzed by using the general questionnaire, parenting stress Index-Short Form(PSI-SF) and General Self-Efficacy Scale (GSES).@*Results@#The score of general self-efficacy for parents was 1.93±0.54, and the total score of parenting stress was 111.84±13.36. The general self-efficacy and parenting stress scores of parents with malignant solid tumors were significantly negatively correlated with the scores of parental misery, parent-child relationship and difficult children (r=-0.72, -0.65, -0.62 -0.55, all P<0.01). Hierarchical logistic regression analysis indicates that the parenting stress was influenced by self-efficacy, the gender of parents, education level and whether or not on position.@*Conclusions@#Self-efficacy is one of the most critical influencing factors on parenting stress of parents.A new approach to improve the self-efficacy is to be achieved to reduce the parenting stress level among parents of children with solid tumors.

The influence of self-efficacy on parenting stress among parents of children with malignant solid tumors / 中国实用护理杂志

Objective To explore the effect of self-efficacy on parenting stress among parents of children with malignant solid tumors. Methods Totally 100 parents of children with malignant solid tumors were investigated and analyzed by using the general questionnaire, parenting stress Index-Short Form(PSI-SF) and General Self-Efficacy Scale (GSES). Results The score of general self-efficacy for parents was 1.93±0.54, and the total score of parenting stress was 111.84±13.36. The general self-efficacy and parenting stress scores of parents with malignant solid tumors were significantly negatively correlated with the scores of parental misery, parent-child relationship and difficult children(r=-0.72,-0.65,-0.62-0.55, all P<0.01). Hierarchical logistic regression analysis indicates that the parenting stress was influenced by self-efficacy, the gender of parents, education level and whether or not on position. Conclusions Self-efficacy is one of the most critical influencing factors on parenting stress of parents.A new approach to improve the self-efficacy is to be achieved to reduce the parenting stress level among parents of children with solid tumors.

Activation of M3-mAChR attenuates hypoxia injury induced by CoCl2in rat myocardial cell line H9c2 / 基础医学与临床

Objective To investigate the cytoprotection and mechanism of carbachol(CCH)to stimulate M3mus-carinic acetylcholine receptor(M3-mAChR) against hypoxia injury induced by cobaltous chloride hexahydrate (CoCl2) in rat cardiomyocyte line H9c2. Methods Select the normal rat cardiomyocyte line H9c2 as the control group, rat cardiomyocyte line H9c2 was managed with CoCl2to develop hypoxia injury model, M3-mAChR spe-cific agonist CCH and antagonist 4-diphenyl-acetoxy-N-methyl-piperidine methiodide(4-DAMP) were used for in-tervention. The cell viability was tested by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT); The apoptosis in cardiomyocyte was detected by flow cytomery(FCM); The expression of M3-mAChR,caspase-3, HIF-1α and HO-1 proteins was measured by Western blot assay. Results In hypoxia group,the ap-optosis rate was significantly increased while cell proliferation decreased, the expression of HIF-1α, caspase-3 and HO-1 proteins were up-regulated obviously;After treatment with CCH,the apoptosis and cell proliferation of cardiomyocytes were significantly decreased, while the proliferation of cells increased, and the expression of M3-mAChR, HIF-1α and HO-1 proteins increased, the expression of caspase-3 protein was significantly decreased. Moreover, when applying 4-DAMP as intervention, these effects mediated by CCH was abolished.Conclusions CCH stimulates M3-mAChR against hypoxia injury induced by CoCl2in rat cardiomyocyte strain H9c2, and the mechanism may be related to down-regulation of caspase-3 expression and up-regulation of HIF-1α and HO-1 protein expression.

Incidence rates of HIV-1 epidemics among 4 high risk groups in Sichuan province during 2011-2015 / 中华流行病学杂志

Objective Data from the HIV/AIDS surveillance sentinel sites was used to identify the recent HIV-1 infections and to estimate the HIV-1 incidence and epidemic trends among intravenous drug users (IDU),MSM,female sex workers and men attending the sexually transmitted disease clinics in Sichuan province.Methods Specimens collected from IDUs,MSM,female sex workers and men attending the sexually transmitted disease clinics sentinel sites were confirmed as HIV-I positive and tested with BED-CEIA.Annual HIV-1 prevalence and incidence rates were calculated and the incidence was adjusted by McNermar method.Results A total number of 194 223 serum specimens were collected and HIV antibody tested,with 5 297 HIV-1 positive.4 640 of the positives underwent BED-CEIA,with 749 identified as recent infections.During 2011-2015,HIV-1 incidence rates of the four types of population appeared as 5.16％ (95％CI:4.65-5.66),0.22％ (95％CI:0.16-0.28),0.57％(95％CI:0.45-0.69),7.53％ (95％CI:6.06-9.01) and 0.44％ (95％CI:0.36-0.53) respectively.Significant differences were seen in the HIV-1 incidence rates.Conclusions The HIV-1 incidence rates of IDUs from other sentinel sites in Sichuan province,female sex workers and men attending the sexually transmitted disease clinics appeared low,showing that the AIDS prevention and control activities worked effectively.However,the HIV-1 incidence of MSM was still at high level and even rising,suggesting that HIV-1 transmission between MSM and IDUs was possible.

Incidence rates of HIV-1 epidemics among 4 high risk groups in Sichuan province during 2011-2015 / 中华流行病学杂志

Objective Data from the HIV/AIDS surveillance sentinel sites was used to identify the recent HIV-1 infections and to estimate the HIV-1 incidence and epidemic trends among intravenous drug users (IDU),MSM,female sex workers and men attending the sexually transmitted disease clinics in Sichuan province.Methods Specimens collected from IDUs,MSM,female sex workers and men attending the sexually transmitted disease clinics sentinel sites were confirmed as HIV-I positive and tested with BED-CEIA.Annual HIV-1 prevalence and incidence rates were calculated and the incidence was adjusted by McNermar method.Results A total number of 194 223 serum specimens were collected and HIV antibody tested,with 5 297 HIV-1 positive.4 640 of the positives underwent BED-CEIA,with 749 identified as recent infections.During 2011-2015,HIV-1 incidence rates of the four types of population appeared as 5.16％ (95％CI:4.65-5.66),0.22％ (95％CI:0.16-0.28),0.57％(95％CI:0.45-0.69),7.53％ (95％CI:6.06-9.01) and 0.44％ (95％CI:0.36-0.53) respectively.Significant differences were seen in the HIV-1 incidence rates.Conclusions The HIV-1 incidence rates of IDUs from other sentinel sites in Sichuan province,female sex workers and men attending the sexually transmitted disease clinics appeared low,showing that the AIDS prevention and control activities worked effectively.However,the HIV-1 incidence of MSM was still at high level and even rising,suggesting that HIV-1 transmission between MSM and IDUs was possible.

Application of total hysterectomy in treatment of cervical intraepithelial neoplasia / 第二军医大学学报

Objective To investigate the clinical value of total hysterectomy in the treatment of cervical intraepithelial neoplasia. Methods We retrospectively analyzed the clinicaldata of 283 patients undergoing total hysterectomy for cervical intraepithelial neoplasia in Changhii Hospital of Second Military Medical University from Jan. 2009 to Dec. 2016. Among the patients, 206 cases received loop electrosurgical excision procedure CLEEP) before total hysterectomy (pre-operative LEEP group), 28 only received total hysterectomy directly after colposcopy biopsy (hysterectomy group) and 49 received LEEP during total hysterectomy (intra-operative LEEP group). The changes of pathological grade and the lesion residual rates of the patients before and after operation were compared. The effect of clinicopathological features (age, pregnancy times, partus times, abortion times, menopausal years, pathology, human papilloma virus (HPV) infection, tumor family history and so on) on postoperative residual lesion were analyzed by univariate and multivariate analysis. Results The cure rate, lesionresidual rate, pathological downgrade rate and pathological upgrade rate in the pre-operative LEEP group was 35. 92%(74/206), 64. 08%(132/206), 63. 11% (130/ 206) and 3. 88% (8/206), respectively, and two cases with canceration were found. In the hysterectomy group, the consistent rate of pathological diagnosis before and after operation, pathological downgrade rate and pathological upgrade rate were 57. 14%(16/28), 35. 71 %(10/28) and 7 14%(2/28), respectively, and one case with invasive carcinoma was found after operation. The lesion residual rate, pathological downgrading rate and pathologicil upgrading rate in the intra- operative LEEP group were 40. 82% (20/49), 65. 31% (32/49) and 8. 16% (4/49), respectively, and two cases with invasive carcinoma were found after operation. Univariate analysis showed that age and menopausal years were the factors influencing lesion remaining after LEEP (P<0. 05). Multivariate analysis showed that patients with longer menopausal years had lower risk of lesion remaining (P = 0. 02). The pregnancy times, partus times, abortion times, lesion involving glands, positive margins, HPV infection and family history of cancer had no significant effects on postoperative lesion remaining. Conclusion Total hysterectomy plays an important role in preventing the recurrence of cervical precancerous lesion and reducing the incidence of invasive carcinoma. It is suitable for people with few screening opportunities, poor follow-up conditions and no fertility requirements. Patients with high grade intraepithelial lesion who are not menopausalor have short menopausal years need to be followed up more closely and can receive total hysterectomy if necessary.

Clinical characteristics and gene analysis in three children with Gitelman syndrome / 临床儿科杂志

Objectives To explore the clinical and gene mutation characteristics of Gitelman syndrome in children. Method The clinical data of 3 children with Gitelman syndrome were retrospectively analyzed. Results All three cases were male and their age were 3, 8 and 10 years . The clinical manifestations were hypokalemia, hypomagnesemia, alkalosis, hyperreninemia,and hyperaldosteronemia.Gene detection revealed a complex heterozygous mutation in the SLC12A3 gene.A total of 5 mutation sites were found in the SLC12A3 gene,c.179C>T(Thr60Met),c.248 G>A(Arg83Gln),c.2129 C>A(Ser710X), c.2660+1G>A, c.1456G>A (Asp486Asn). After the diagnosis was confirmed, they were treated with potassium supplement, magnesium supplement, and spironolactone and the conditions were improved in all cases. Conclusions In children with hypokalemia, be aware of Gitelman syndrome, and gene detection is helpful for the diagnosis.

Effect of ulinastatin on oxidative stress injury to myocardial ceils in diabetic rats in vitro / 中华麻醉学杂志

Objective To evaluate the effect of ulinastatin on oxidative stress injury to myocardial cells in diabetic rats in vitro.Methods The H9c2 cells were cultured in DMEM culture medium and the cells at the logarithmic growth phase were seeded in 96-well plates (density 1 × 104 cells/ml,200 μl/well) or in 6-well plates (density 1× 105 cells/m1,2 ml/well).The cells were randomly divided into 4 groups (n=18 each) using a random number table:normal control group (group C),high-glucose group (group HG),high-glucose + oxidative stress group (group HG+OS),ulinastatin +high-glucose+oxidative stress group (group U+HG+OS).The cells were cultured in high-glucose DMEM culture medium (25.0 mmol/L) for 48 h in group HG.After the cells were cultured in high-glucose DMEM culture medium for 24 h,H2O2 with the final concentration of 500 μmol/L was added to the high-glucose culture medium,and the cells were continuously cultured for 24 h in HG+OS and U+HG+OS groups.In group U+HG+OS,ulinastatin 400 U/ml was added to the high-glucose culture medium.The cells were collected for determination of cell viability,H9c2 apoptosis,activity of superoxide dismutase (SOD) and contents of malonadehyde (MDA).Apoptosis rate was calculated.The cell culture supernatant was collected for detection of lactate dehydrogenase (LDH) activity.Results Compared with group C,the cell viability and SOD activity were significantly decreased,and the apoptosis rate,MDA content and LDH activity were increased in the other groups.Compared with HG group,the cell viability and SOD activity were significantly decreased,and the apoptosis rate,MDA content and LDH activity were increased in HG+OS and U+HG+OS groups.Compared with group HG+OS,the cell viability and SOD activity were significantly increased,and the apoptosis rate,MDA content and LDH activity were decreased in group U + HG+ OS.Conclusion Ulinastatin can mitigate oxidative stress injury to myocardial cells in diabetic rats,and inhibited cell apoptosis is involved in the mechanism.

Drug-resistance characteristics of CRF01_AE and CRF07_BC subtypes of HIV-1 strains in Sichuan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the drug resistance of HIV patients to the HIV-1 CRF01_AE and CRF07_BC strains in Sichuan province during 2010 to 2013.</p><p><b>METHODS</b>1.5 ml of plasma were collected from AIDS patients who had been receiving anti-retroviral treatment for over 6 months but still had a HIV-1 virus load of over 1 000 copies/ml from January 1, 2010 to December 31, 2013 in Sichuan province. Genetic analysis of the HIV-1 pol gene was performed using self-established method, and patients with a positive drug-resistant HIV-1 pol gene mutation were included. HIV-1 poly gene was successfully sequenced for a total of 1 213 patients. Drug resistance of different HIV-1 strains was compared with χ2 test or Fisher exact test.</p><p><b>RESULTS</b>558 cases (46.0%) of the 1 213 successfully sequenced patients were infected by HIV-1-strains with drug-resistant mutations, including 327 cases (58.6%) infected by CRF01_AE strain, 126 (22.6%) by CRF07_BC strain, 46 (8.2%) by CRF08_BC strain, 33 (5.9%) by B strain, 4 (0.7%) by C strain, 1 (0.2%) by CRF02_AG strain, and 21 (3.8%) by unidentified strains. Drug-resistant mutation analysis revealed that L33, F116, L74, Q151, and T69 resistance mutations occurred only in the CRF01_AE strain, while A71, K43, and Q58 resistance mutations occurred only in the CRF07_BC strain; in nuclear nucleoside reverse transcriptase inhibitors (NRTIs) and non nucleoside reverse transcriptase inhibitors (NNRTIs), CRF01_AE subtype strains showed highly resistant rate were higher than CRF07_BC, CRF08_BC and B subtype strains, with the differences were statistically significant (P<0.05).</p><p><b>CONCLUSION</b>The drug-resistant HIV-1 strains in Sichuan mainly included the CRF01_AE and CRF07_BC strains, which had different resistance mutations.</p>