Inflammatory and Immunomodulatory Effects of Tripterygium wilfordii Multiglycoside in Mouse Models of Psoriasis Keratinocytes / 中国结合医学杂志

OBJECTIVE@#To determine the role of Tripterygium wilfordii multiglycoside (TGW) in the treatment of psoriatic dermatitis from a cellular immunological perspective.@*METHODS@#Mouse models of psoriatic dermatitis were established by imiquimod (IMQ). Twelve male BALB/c mice were assigned to IMQ or IMQ+TGW groups according to a random number table. Histopathological changes in vivo were assessed by hematoxylin and eosin staining. Ratios of immune cells and cytokines in mice, as well as PAM212 cell proliferation in vitro were assessed by flow cytometry. Pro-inflammatory cytokine expression was determined using reverse transcription quantitative polymerase chain reaction.@*RESULTS@#TGW significantly ameliorated the severity of IMQ-induced psoriasis-like mouse skin lesions and restrained the activation of CD45+ cells, neutrophils and T lymphocytes (all P<0.01). Moreover, TGW significantly attenuated keratinocytes (KCs) proliferation and downregulated the mRNA levels of inflammatory cytokines including interleukin (IL)-17A, IL-23, tumor necrosis factor α, and chemokine (C-X-C motif) ligand 1 (P<0.01 or P<0.05). Furthermore, it reduced the number of γ δ T17 cells in skin lesion of mice and draining lymph nodes (P<0.01).@*CONCLUSIONS@#TGW improved psoriasis-like inflammation by inhibiting KCs proliferation, as well as the associated immune cells and cytokine expression. It inhibited IL-17 secretion from γ δ T cells, which improved the immune-inflammatory microenvironment of psoriasis.

Clinical and genetic analysis of a child with early-onset severe obesity / 中华医学遗传学杂志

OBJECTIVE@#To explore the clinical phenotype and genetic etiology of a child with early-onset severe obesity.@*METHODS@#A child who presented at the Department of Endocrinology, Hangzhou Children's Hospital on August 5, 2020 was selected as the study subject. Clinical data of the child were reviewed. Genomic DNA was extracted from peripheral blood samples of the child and her parents. Whole exome sequencing (WES) was carried out on the child. Candidate variants were verified by Sanger sequencing and bioinformatic analysis.@*RESULTS@#This child was a 2-year-and-9-month girl featuring severe obesity with hyperpigmentation on the neck and armpit skin. WES revealed that she has harbored compound heterozygous variants of the MC4R gene, namely c.831T>A (p.Cys277*) and c.184A>G (p.Asn62Asp). Sanger sequencing confirmed that they were respectively inherited from her father and mother. The c.831T>A (p.Cys277*) has been recorded by the ClinVar database. Its carrier frequency among normal East Asians was 0.000 4 according to the 1000 Genomes, ExAC, and gnomAD databases. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), it was rated as pathogenic. The c.184A>G (p.Asn62Asp) has not been recorded in the ClinVar, 1000 Genomes, ExAC and gnomAD databases. Prediction using IFT and PolyPhen-2 online software suggested it to be deleterious. Based on the guidelines from the ACMG, it was determined as likely pathogenic.@*CONCLUSION@#The c.831T>A (p.Cys277*) and c.184A>G (p.Asn62Asp) compound heterozygous variants of the MC4R gene probably underlay the early-onset severe obesity in this child. Above finding has further expanded the spectrum of MC4R gene variants and provided a reference for the diagnosis and genetic counseling for this family.

Progress in the role of adiponectin in the pathogenesis of diabetic retinopathy / 中华眼底病杂志

Diabetic retinopathy (DR) is one of common and specific microvascular complications caused by diabetic mellitus, and remains a serious and common ocular complication leading preventable blindness. At present, the specific pathogenesis of DR is not completely clear, and many factors are involved in its occurrence and development. Adiponectin (APN) is an endogenous cytokine secreted by adipocytes. It is expressed in all layers of retina, especially in the outer layer (rods and cones). It is involved in regulating fatty acid oxidation and glucose metabolism by binding with specific receptors. In recent years, a lot of studies have found that APN can be involved in regulating blood glucose, inhibiting neovascularization, reducing inflammation, dilating blood vessels and improving vascular endothelial function. At present, the specific mechanism of APN in the occurrence and development of DR Remains to be determined. Further research on the level changes and the specific mechanism of action of APN in DR may help to identify the characteristic metabolic changes of DR, thus providing new biomarkers for the diagnosis of DR, while helping to promote the innovation of the treatment of DR.

Diterpenoids of Tripterygium wilfordii decrease inflammatory response of macrophage by inhibiting multiple signaling pathways / 中国药理学通报

Aim To study the anti-inflammatory activ¬ity of diterpenes from Tripterygium wilfordii on lipopo- lysaccharide ( LPS)-induced macrophage and its mech¬anism. Methods MTT assay was used to detect the cytotoxicity of compounds. The Griess method was used to detect the NO on LPS-induced RAW264. 7 cells. ELISA was applied to determine the contents of inter- leukin 6 (IL-6) , tumor necrosis factor a ( TNF-a ) , interleukin lp (IL-lfj) and interleukin 18 (IL-18) in cell culture supernatant. Western blot was used to de¬tect IkBcx, .INK, ERK, p38, STAT3 and their phos-phorylation in LPS-induced RAW264.7, as well as the effect on COX-2, iNOS, NLRP3, caspase-1 , cleaved- caspase-1. Flow cytometry was employed to detect the effects of compounds on the phagocytosis of RAW 264. 7 cells. Results Hypoglicin II (1) and ent-pimara-8 (14) , 15-diene-19-ol (6) , two diterpenoid compounds from Tripterygium wilfordii could effectively inhibit the expression of inflammatory mediators ( COX-2 and iN- OS) and inflammatory cytokines (IL-6, IL-lp, IL- 18) in LPS-induced RAW264. 7 cells. Further re¬search found that the phosphorylation of IkBcx , JNK, ERK, P38, STAT3 and NLRP3 was all inhibited; however, there was no significant effect on the expres¬sion of IkBcx, JNK, ERK, P38 and STAT3. At the same time, they also inhibited the phagocytosis of mac-rophages. Conclusions The anti-inflammatory mecha¬nism of Tripterygium wilfordii diterpenoids 1 and 6 might be through inhibiting the production of NLRP3 inflammatory bodies, inflammatory mediators (COX-2 and iNOS) and inflammatory cytokines (IL-6, IL-lp and IL-18) , which is closely related to inhibiting the activation of MAPK, NF-kB and STAT3 pathway.

The method of determination for butyronitrile and isobutyronitrile in the air of workplace by dissolved desorption-gas chromatography / 中华劳动卫生职业病杂志

Objective: To establish a method for the determination of butyronitrile and isobutyronitrile in the air of workplace by gas chromatography. Methods: In March 2020, butyronitrile and isobutyronitrile in the air of workplace was collected by silica gel, eluted with methanol, separated and determined by gas chromatogram with flame ionization detector, the characteristics of determination of nitrile and isobutyronitrile by gas chromatography were analyzed. Results: The limit of detection for butyronitrile and isobutyronitrile was 0.33 μg/ml. The linear range of butyronitrile determined by this method was 1.60-1600.00 μg/ml, y=2.295x-3.480, and the coefficient correlation was 0.99998, and the minimum detection concentration was 0.22 mg/m(3) (collected sample volume was 1.50 L) . The within-run precisions were 2.43%-4.12%, the between-run precisions were 1.72%-3.70%, and the desorption rates were 93.26%-98.41%. The linear range of isobutyronitrile determined by this method was 1.52-1520.00 μg/ml, y=2.208x-0.102, and the coefficient correlation was 0.99998, and the minimum detection concentration was 0.22 mg/m(3) (collected sample volume was 1.50 L) . The within-run precisions were 2.52%-3.22%, the between-run precisions were 1.20%-3.82%, and the desorption rates were 96.85%-102.50%. The sealed samples could be stored at least 10 days at room temperature without significant loss. Conclusion: The method has the advantages of good precision, high sensitivity and simple operation. It is suitable for the simultaneous determination of butyronitrile and isobutyronitrile in the air of workplace.

Consensus of experts on the oral health management and medical risk prevention for the patients with chronic airway diseases (2022 edition) / 中华口腔医学杂志

Today, there is greater awareness on the association between oral diseases and respiration diseases after the outbreak of COVID-19. However, confusion regarding the oral health management and medical risk prevention for patients with chronic airway diseases has been remained among dental clinicians. Therefore, the dental experts of the Fifth General Dentistry Special Committee, Chinese Stomatological Association, combined with the experts of respiratory and critical care medicine, undertook the formation of consensus on the oral health management of patients with chronic airway diseases in order to help dental clinicians to evaluate medical risks and make better treatment decision in clinical practice. In the present consensus report, the relationship of oral diseases and chronic airway diseases, the oral health management and the treatment recommendations of patients with chronic airway diseases are provided.

The Influence of Diabetes, Hypertension, and Hyperlipidemia on the Onset of Age-Related Macular Degeneration in North China: The Kailuan Eye Study / 生物医学与环境科学（英文）

Objective@#To analyze the prevalence of dry and wet age-related macular degeneration (AMD) in patients with diabetes, hypertension and hyperlipidemia, and to analyze the risk factors for AMD.@*Methods@#A population-based cross-sectional epidemiologic study was conducted involving 14,440 individuals. We assessed the prevalence of dry and wet AMD in diabetic and non-diabetic subjects and analyzed the risk factors for AMD.@*Results@#The prevalence of wet AMD in diabetic and non-diabetic patients was 0.3% and 0.5%, respectively, and the prevalence of dry AMD was 17% and 16.4%, respectively. The prevalence of wet AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 0.5%, 0.3%, 0.2%, and 0.7%, respectively. The prevalence of dry AMD in healthy, hypertensive, hyperlipidemic, and hypertensive/hyperlipidemic populations was 16.6%, 16.2%, 15.2%, and 17.2%, respectively. Age, sex, body mass index, and use of hypoglycemic drugs or lowering blood pressure drugs were corrected in the risk factor analysis of AMD. Diabetes, diabetes/hypertension, diabetes/hyperlipidemia, and diabetes/hypertension/hyperlipidemia were analyzed. None of the factors analyzed in the current study increased the risk for the onset of AMD.@*Conclusion@#There was no significant difference in the prevalence of wet and dry AMD among diabetic and non-diabetic subjects. Similarly, there was no significant difference in the prevalence of wet and dry AMD among subjects with hypertension and hyperlipidemia. Diabetes co-existing with hypertension and hyperlipidemia were not shown to be risk factors for the onset of dry AMD.

Risk factors and prognostic value of heart-type fatty acid binding protein in patients with heart failure / 中华检验医学杂志

Objective:To investigate the prognostic value and related factors of heart-type fatty acid binding protein (H-FABP) in patients with heart failure.Methods:A total of 877 consecutive patients who were admitted to heart failure care unit of Fuwai hospital and diagnosed as heart failure from July 2015 to July 2017 were enrolled in this study. Baseline serum H-FABP concentration was measured by fluorescence lateral flow immunoassay. According to serum H-FABP levels, patients were divided into three groups: low H-FABP group (H-FABP≤4.04 ng/ml, n=292), middle H-FABP group (H-FABP 4.04-7.02 ng/ml, n=292) and high H-FABP group (H-FABP≥7.02 ng/ml, n=293). The general clinical characteristics were collected and compared among the three groups. According to whether heart failure was caused by coronary artery disease or not, patients with heart failure were divided into ischemic heart failure and non-ischemic heart failure. Multivariate linear regression analysis was performed to explore the independent risk factors of H-FABP. The primary endpoint events were the composite of all-cause death or heart transplantation. Multivariate Cox regression analyses, receiver operating characteristic (ROC) curves, risk prediction tests with multivariate Cox regression model and Kaplan-Meier analyses were conducted to investigate the relationship between H-FABP and the prognosis of heart failure. Results:Multivariate linear regression analysis showed that age, coronary artery disease, alanine aminotransferase, uric acid and N-terminal pro-B type natriuretic peptide (NT-proBNP) were positively associated with H-FABP (β=0.012, 0.238, 0.001, 0.345 and 0.063 respectively,all P<0.05), while female, hemoglobin, albumin, sodium, and estimated glomerular filtration rate (eGFR) were negatively associated with H-FABP (β=-0.184, -0.006, -0.016, -0.034 and -0.006 respectively, all P<0.05). One hundred and nineteen patients (13.6%) lost to follow-up, and 246 patients (32.5%) suffered from all-cause death or heart transplantation during the median follow-up duration of 931 (412-1 185) days. Multivariate Cox regression analysis showed that baseline H-FABP (log 2H-FABP) level was the independent predictor of all-cause death or heart transplantation in patients with heart failure ( HR=1.39, P<0.001). ROC curves showed that baseline H-FABP was a predictor of all-cause death or heart transplantation in patients with heart failure within 3 months, 1 year and 2 years (areas under the curves were 0.69, 0.69 and 0.71 respectively), and the best cut-off values were 5.85 ng/ml, 6.54 ng/ml and 6.54 ng/ml respectively. Risk prediction test with multivariate Cox regression model showed that baseline H-FABP could provide additional prognostic value in predicting all-cause death or heart transplantation for patients with heart failure on top of basic model and baseline NT-proBNP ( P<0.001). Taking 6.54 ng/ml and trisected levels of H-FABP as cut-off values respectively, Kaplan-Meier analyses showed that the survival rates were significantly different among the two or three groups ( P<0.001). Subgroup analyses showed that baseline H-FABP (log 2H-FABP) level was an independent predictor of all-cause death or heart transplantation in patients with ischemic heart failure ( HR=1.74, P<0.001), as well as in patients with non-ischemic heart failure ( HR=1.28, P=0.027). Conclusions:Age, sex, coronary artery disease, hemoglobin, albumin, alanine aminotransferase, sodium, eGFR, uric acid and NT-proBNP are associated with H-FABP level. Baseline H-FABP level is an independent predictor of all-cause death or heart transplantation in patients with heart failure. On top of basic model and baseline NT-proBNP, baseline H-FABP could provide additional prognostic value in predicting adverse events for patients with heart failure.

Investigation on epidemic and drug resistance characteristics of diarrhea related pathogens in Panzhihua City / 公共卫生与预防医学

Objective To understand the distribution and drug-resistance characteristics of diarrhea related etiology in Panzhihua City, and to provide the basis for epidemiological investigation and clinical diagnosis and treatment. Methods The fecal samples of 779 patients with diarrhea in Panzhihua city from October 2019 to October 2020 were collected. The pathogenic bacteria of diarrhea were isolated and drug sensitivity test was conducted. The epidemiological data of the occurrence of diarrhea, such as age and season, were analyzed and summarized. Results Atotal of 175 strains of pathogenic bacteria were isolated from the fecal samples of 779 diarrhea cases, with the isolation rate of 22.46% (175/779), including 65 strains of Salmonella, 39 strains of Vibrio, 51 strains of diarrheagenic Escherichia coli, 13 strains of Campylobacter and 7 strains of Shigella. 121 diarrhea virus positive samples were detected, and the positive detection rate was 15.53% (121/779). There were 55 cases of GII norovirus, 15 cases of GI, 45 cases of rotavirus, 2 cases of zaravirus and 4 cases of adenovirus. A total of 296 positive samples of pathogenic bacteria and viruses from diarrhea were collected, including 175 males (59.12%) and 121 females (40.88%), with a male to female ratio of 1.45:1. The age range was 2-65 years old, and the average age was (37.14±6.18) years old. The positive rate in the 0-14 year group was the highest (P2 =7.915)..The detection of diarrhea pathogenic bacteria showed obvious seasonality, and the positive rate was the highest in the third quarter (July to September) (P<0.05). The positive rate of diarrhea associated virus was the highest in the first quarter (January-March) and the fourth quarter (October-December) (P<0.05). The drug resistance test results showed that The drug resistance rates of diarrheogenic Escherichia coli and Salmonella to piperacillin/tazobactam, ceftazidime, imipenem and cefotaxime were relatively low (<30.00%). Conclusions The main pathogens causing diarrhea in Panzhihua City are Klebsiella, Salmonella, proteus, etc., and the multiple drug resistance is serious. The distribution of pathogens has obvious seasonal and age differences, so pathogen monitoring should be strengthened and effective measures should be taken to prevent and control the occurrence of drug resistance.

Relationship between serum heme oxygenase1,lipoxin A4 levels and type 2 diabetic nephropathy / 中国综合临床

Objective:To investigate the correlation between serum levels of heme oxygenase-1 (HO-1) and lipoxin A4 (LXA4) and diabetic nephropathy, and to analyze the value of HO-1 and LXA4 in the diagnosis of diabetic nephropathy.Methods:A prospective cohort study was conducted in 185 patients with type 2 diabetes admitted to the Department of Endocrinology, Yan'an Hospital Affiliated to Kunming Medical University from January 2016 to January 2020. There were 96 cases with diabetic nephropathy (nephropathy group) and 89 cases without diabetic nephropathy (non nephropathy group). According to the stage of chronic kidney disease,the nephrotic group was divided into three subgroups: stage 1-2 group (31 cases), stage 3-4 group (40 cases) and stage 5 group (25 cases). Another 82 healthy volunteers were selected as the control group.Serum HO-1, LXA4, oxidative stress,inflammatory factors, glucose metabolism and renal function were detected. Pearson analysis of HO-1, LXA4 and oxidative stress, inflammatory factors, glucose metabolism and renal function index correlation, binary logistic regression analysis of diabetic nephropathy factors.Results:The serum HO-1 ((0.60 ± 0.20) μg/L) and LXA4 levels ((435.12 ± 22.42) ng/L) in nephrotic group were lower than those in non nephrotic ((0.72 ± 0.23) μg/L, (498.21 ± 29.48) ng/L)( t=29.351, 24.135, all P<0.05). The serum HO-1 and LXA4 levels in the 5 stage group were lower than those in the 3-4 stage and 1-2 stage group (all P<0.05). The serum HO-1 and LXA4 levels in the 3-4 stage group were lower than those in the 1-2 stage group (all P<0.05). Pearson correlation analysis showed that HO-1 was positively correlated with total antioxidant capacity (T-AOC), superoxide dismutase (SOD) and estimated glomerular filtration rate (EGFR) ( r=0.516, 0.602, 0.617; all P<0.05), and was positively correlated with malondialdehyde (MDA) and homeostasis model insulin resistance (homeostasis model insulin resistance) Model assessment insulin resistance (HOMA-IR), urinary albumin creatinine ratio (UACR) LXA4 was negatively correlated with T-AOC, SOD and EGFR ( r=-0.559, 0.597, 0.637; all P<0.05), and positively correlated with MDA, IL-6, TGF-β1, HOMA-IR and UACR There was a negative correlation ( r=-0.498, -0.623, -0.725; all P<0.05). Binary logistic regression analysis showed that malondialdehyde ( OR=1.587, 95% CI 1.402-1.603, P=0.016), TGF-β1 ( OR=1.679, 95% CI 1.642-1.739, P=0.012), HOMA-IR ( OR=1.699、95% CI 1.534-1.739, P=0.009) were risk factors of diabetic nephropathy (all P<0.05). HO-1 ( OR=0.506, 95% CI 0.423-0.653, P<0.001) and LXA4 ( OR=0.492, 95% CI 0.409-0.535, P<0.001) were protective factors for DN ( P<0.001). After adjusting for MDA, TGF-β1 and HOMA-IR, HO-1 ( OR=0.485, 95% CI:0.402-0.564, P<0.001) and LXA4 ( OR=0.416, 95% CI:0.386-0.475, P<0.001) were still associated with DN. ROC analysis showed that the area under curve (AUC) of HO-1 and LXA4 were 0.820 (95% CI:0.760-0.880, P<0.001) and 0.763 (95% CI:0.691-0.836, P<0.001), respectively. The sensitivity and specificity were 71.88%, 80.90%, 75.00% and 84.27%, respectively. Conclusion:The decrease of serum LXA4 and HO-1 levels is closely related to diabetic nephropathy, which can be used as a biological indicator for the diagnosis of diabetic nephropathy.

Analysis of the predictive value of serum betatrophin and fibrin-3 during early pregnancy for gestational diabetes mellitus / 中国医师进修杂志

Objective:To explore the predictive value of serum betatrophin and ficolin-3 during early pregnancy for gestational diabetes mellitus (GDM).Methods:Using a prospective research method, from June 2018 to June 2019, 7 to 13 weeks pregnant women were selected in Yan′an Hospital of Kunming City, and their fasting peripheral venous blood samples were reserved. At 24 to 28 weeks of pregnancy, oral glucose tolerance test (OGGT) was performed. Sixty-five cases were diagnosed as GDM (GDM group), and 60 pregnant women with normal OGGT result and matched age and gestational weeks were selected as normal group. In addition, 60 non-pregnant healthy women with matched age were selected as control group. The serum levels of betatrophin and ficolin-3 were measured in GDM group, normal control group (during 7 to 13 weeks of gestation) and control group were measured by enzyme linked immunosorbent assay method. Pearson test was used to analyze the correlation between serum betatrophin, ficolin-3 and glycolipid metabolism indexes during 24 to 28 weeks of gestation. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum betatrophin and ficolin-3 during early pregnancy for GDM.Results:The serum betatrophin and ficolin-3 in GDM group were significantly higher than those in normal group and control group: (35.69 ± 6.15) ng/L vs. (23.90 ± 7.68) and (19.68 ± 6.33) ng/L, (31.75 ± 10.30) μg/L vs. (22.88 ± 12.71) and (18.47 ± 9.54) μg/L, the betatrophin and ficolin-3 in normal group were significantly higher than those in control group, and there were statistical differences ( P<0.05). The correlation analysis result showed that serum betatrophin was positive correlation with total cholesterol (TC), glycosylated hemoglobin (HbA 1c) and homeostatic model assessment insulin resistance index (HOMA-IR) ( r = 0.585, 0.440 and 0.735; P<0.01); the serum ficolin-3 was positively correlated with HbA1c ( r = 0.673, P<0.01), and negatively correlated with high-density lipoprotein cholesterol (HDL-C) ( r = - 0.520, P<0.01). ROC curve analysis result showed that the areas under curve of betatrophin and ficolin-3 for predicting GDM were 0.829 and 0.795, 95% CI 0.753 to 0.905 and 0.718 to 0.872, and the optimum critical values were 27.69 ng/L and 29.72 μg/L, with a sensitivity of 89.36% and 84.58%, a specificity of 72.14% and 79.64% and Yorden index of 0.62 and 0.59. The areas under curve of betatrophin combined with ficolin-3 for predicting GDM was 0.923, 95% CI 0.868 to 0.978, with a sensitivity of 91.25%, a specificity of 87.24% and Yorden index of 0.86. Conclusions:GDM pregnant women have abnormal expression of serum betatrophin and ficolin-3 during early pregnancy, and the indexes are related to glycolipid metabolism. Serum betatrophin and ficolin-3 during early pregnancy have certain predictive value for GDM.

Effects of Virus Inactivation Treatment of Plasma Specimen on Plasma Concentration Determination of Vorico- nazole，Linezolid，Vancomycin and Teicoplanin / 中国药房

OBJECTIVE：To study the effects of virus in activation treatment of plasma specimen on plasma concentration determination of voriconzole ，linezolid，vancomycin and teicoplanin. METHODS ：The remaining plasma of 36 inpatients in our hospital after routine blood concentration examination of voriconazole ，linezolid，vancomycin and teicoplanin were collected as specimen（9 drug-contained plasma specimens for each drug ），and merged into three different concentration levels （low，medium， high）of mixed samples according the results of routine blood test. Then the mixed samples with different concentration levels were divided into inactivated group and non-inactivated group ，with 3 samples in each group. The inactivated plasma samples were heated at 56 ℃ for 30 min in metal bath with constant temperature. Non-inactivated group were not treated. After pretreating plasma sample of 2 groups，2-dimensional liquid chromatography was used to detect plasma concentration of the four drugs ；the difference of detection result between inactivated group and non-inactivated group were analyzed. RESULTS ：Plasma samples containing voriconazole，linezolid，vancomycin and teicoplanin were still stable after heating at 56 ℃ for 30 min in metal bath with constant temperature. Compared with non-inactivated group ，relative error of plasma concentration detection result of above 4 drugs were all lower than 15％ in low ，medium，high concentration mixed samples of inactivated group. CONCLUSIONS ：Plasma samples can be inactivated by heating at 56 ℃ for 30 min in metal bath with constant temperature ，when the plasma concentration of voriconazole，linezolid，vancomycin and teicoplanin are determined by 2-dimensional liquid chromatography.

Clinical characteristics of hypertrophic cardiomyopathy and restricted cardiomyopathy patients complicating with intracardiac thrombosis / 中华心血管病杂志

Objective: To investigate the clinical characteristics of patients with hypertrophic cardiomyopathy (HCM) and restrictive cardiomyopathy (RCM) complicating with intracardiac thrombosis. Methods: This is a retrospective observational study. Consecutive patients diagnosed with HCM or RCM and complicated with intracardiac thrombosis (including left and right atrium or ventricular thrombosis), who were admitted to the Heart Failure Care Unit of Fuwai Hospital, Chinese Academy of Medical Sciences, from September 2008 to September 2018, were enrolled in this study. Patients with myocardial infarction were excluded. The general clinical data of the enrolled patients, including demographic data, major complications, laboratory indicators, echocardiographic indicators, drug application and distribution of intracardiac thrombosis, were collected from electronic medical record system and analyzed. Results: A total of 98 patients were enrolled in this study, including 52 patients (53.1%) with HCM and 46 patients (46.9%) with RCM. The most common comorbidity was atrial fibrillation/flutter: 40 patients (76.9%) in HCM group and 36 patients (78.3%) in RCM group. Majority of patients received oral anticoagulants treatment: 43 patients (82.7%) in HCM group and 35 patients (76.1%) in RCM group. Intracardiac thrombosis was mainly located in the left atrium in both HCM group (39 cases (75.0%)) and RCM group (32 cases (69.6%)). Thrombosis was found in ≥ 2 chambers in 7 patients (7.1%). Rate of left atrial thrombosis was the highest (81.6% (62/76)) in HCM and RCM patients complicating with atrial fibrillation/flutter. Intra-aneurysmal thrombosis occurred in 4 out of 5 patients complicated with apical left ventricular aneurysm. The rate of left ventricular thrombosis in patients with left ventricular ejection fraction≥50% was 7.4% (4/54), which was significantly lower than that in patients with left ventricular ejection fraction<50% (34.5%(10/29)) (P<0.01). Conclusion: There are certain distribution characteristics of HCM and RCM patients with intracardiac thrombosis, and the left atrium is the most common site of thrombosis, more attention should be paid in HCM and RCM patients on the diagnosis and treatment of intracardiac thrombosis.

Determination of 15 kinds of vapor state organic acids in workplace air by dissolved desorption-gas chromatography / 中国职业医学

OBJECTIVE: To establish a method for simultaneous determination of 15 kinds of vapor state organic acids in workplace air by solvent desorption-gas chromatography.METHODS: A total 15 kinds of vapor state organic acids such as acetic acid, propanoic acid, butyric acid and pentanoic acid in the air of workplace were collected by silica gel, eluted with acetone, separated by DB-FFAP capillary chromatograph column, and detected by gas chromatography with flame ionization detection. RESULTS: There was a good linear relationship in the selected range of 15 kinds of organic acids. The coefficient correlation was 0.999 97-0.999 98. The limit of detection of this method was 0.04-0.29 mg/L, and the minimum detection concentration was 0.03-0.19 mg/m~(3 )(collected sample volume was 1.50 L). The average desorption efficiency was 92.9%-98.5%. The within-run and between-run relative standard deviation was 0.3%-1.6% and 1.5%-3.0%, respectively. The samples could be kept for at least 15 days at room temperature. CONCLUSION: The method is simple for operation, with high sensitivity, and good precision, which is suitable for simultaneous determination of 15 kinds of vapor state organic acids in the air of workplace and sites of emergency accident.

Establishment of an accurate C57BL6/J mouse model of acute radiation-induced enteritis based on small animal radiation research platform / 中华放射肿瘤学杂志

Objective:To establish an accurate C57BL6/J mouse model of acute radiation-induced enteritis based on small animal radiation research platform (SARRP).Methods:Forty-eight female mice were randomly divided into the following four groups: blank control group, 6 Gy irradiation group, 9 Gy irradiation group and 12 Gy irradiation group. Based on the SARRP, the mice in the irradiation groups were exposed to a single fraction dose of 6 Gy, 9 Gy and 12 Gy at a dose rate of 4Gy/min, respectively. The general condition, body weight and pathological changes of the small intestine of mice were observed.Results:After CT scanning, the target area and normal tissues were delineated. According to the dose distribution of the target area and the protection of spinal cord, the AP-PA field irradiation scheme at the isocentric level was adopted. The average irradiation time in the 6, 9 and 12 Gy groups was 163, 252 and 328 seconds, respectively. The survival rates of mice in the 6, 9 and 12 Gy groups were 100%, 100% and 50% 15 days after irradiation.The body weight of mice in the 6 Gy ( P=0.035), 9 Gy ( P=0.002) and 12 Gy groups ( P<0.001) was decreased significantly on the 5 th day after irradiation, and gradually increased on the 10 th day. With the increase of irradiation dose, the villus and gland injury was aggravated. Compared with the blank control group, the villus length in the 9 and 12 Gy groups was significantly shorter (both P<0.001), and the intestinal wall thickness in the irradiation groups was significantly thinner (all P<0.001). Conclusion:SARRP can provide accurate target location, planned screening and accurate dose delivery in the establishment of C57BL6/J mouse model of acute radiation-induced enteritis. The C57BL6/J mouse model of acute radiation-induced enteritis can be successfully established by a single fraction total-abdominal irradiation of 6-9 Gy.

Analysis of online public sentiment characteristics and response of public hospitals since the outbreak of COVID-19 / 中华医院管理杂志

Objective:To analyze the current situation and characteristics of online public sentiments faced by public hospitals since the outbreak of COVID-19, and provide suggestions for coping strategies for such hospitals.Methods:The data of " trending topic" or " Trending hash tag" of " Wuhan Union Hospital" and " anti-epidemic" were captured on three mainstream new media platforms, namely Sina Microblog, Tik Tok and Headline Today with the help of data analysis tools of Sina and online data statistical software from December 2019 to February 2020. Content analysis method was used to analyze the occurrence frequency, time distribution and development trend of public sentiment on Internet.Results:Under the epidemic of COVID-19, public hospitals faced an exponential growth of online public sentiment. The cumulative total number of searches was 72 119 802 tens of thousands of that before the epidemic. The transmission showed fragmentation of content, instantaneous speed and higher attention to negative information, which brought great challenges for public hospitals.Conclusions:The high participation of online discussion of COVID-19 is unprecedented. Thus public hospitals should attach importance to the work related to online public sentiment, and establish corresponding coping mechanism for response.

Analysis of maternal deaths with cardiovascular diseases in Shanghai obstetric heart disease intensive care unit within twenty-six years / 中华妇产科杂志

Objective@#To analyze risk factors, cardiovascular complications, time of death, gestational age of delivery and offspring outcomes in the maternal deaths with cardiovascular diseases (CVD).@*Methods@#Totally 4 112 cases of pregnant women with CVD in Shanghai obstetric heart disease intensive care unit within 26 years (from January 1993 to December 2018) were collected, and 20 maternal deaths within these cases were analyzed retrospectively.@*Results@#(1) Among the 20 deaths, structural heart diseases accounted for 90% (18/20), pregnancy induced heart diseases was 10% (2/20) while there was no dysfunctional heart disease. The mortality of pregnant women with CVD was 0.486% (20/4 112). (2) The following risk factors were common in these women, getting pregnant without counselling (95%, 19/20) , New York Heart Association classⅢ or Ⅳcardiac function (70%, 14/20), complicated with pulmonary hypertension (75%, 15/20) and prior heart events (60%, 12/20). And 85% (17/20) deaths occurred in puerperium, 15% (3/20) occurred before labor,while no death occurred during labor. And 65% (13/20) deaths died due to heart failure, 20% (4/20) deaths were due to pulmonary hypertension crisis, 5% (1/20) died on sudden cardiac arrest, rupture of aortic dissection and sudden death, respectively.@*Conclusions@#Women with CVD should get pregnant after strict evaluation. Pulmonary hypertension is one of the most severe contraindications to pregnancy, especially in patients with moderate to severe pulmonary hypertension. The puerperium period is a critical period that threatens the safety of these patients. Since heart failure is the most common cause of death, it is necessary to prevent and treat heart failure and to monitor heart function dynamically, especially in those with structural abnormal heart diseases. Moreover, it is also of importance to standardize antenatal care and to identify the severity of heart diseases in time.

Preparation of Lappaconitine-Loaded Microemulsion with Olive Oil and Research on Its Properties / 中国药学杂志

OBJECTIVE: To prepare lappaconitine(LA)-loaded microemulsion with olive oil and study its morphology, particle size, drug loading capacity, drug release behavior and rheological characteristics. METHODS: Pseudo-ternary phase diagram method was used to screen and prepare LA-loaded microemulsion with olive oil. LA release properties in vitro were investigated by dynamic dialysis method. The rheological properties of LA-loaded microemulsion with olive oil were studied using MCR 301 rheometer. RESULTS: The optimal formulation of LA-loaded microemulsion with olive oil was as follows:olive oil was the oil phase, castor oil polyoxyethylene ether-40/span-80(4:1) was the surfactant, glycerin was the cosurfactant, and Km=3. The morphology of the microemulsion particles was round or oval, and the average particle size was(91±0.55) nm. The drug-loading rate of LA in the microemulsion was 1.85%.Drug release experiments in vitro showed that the microemulsion had a sustained release effect on LA, and the drug release behavior was more suitable to be described by Higuchi equation. Rheological experiments showed that the fluid of LA-loaded microemulsion with olive oil belong to pseudoplastic fluid of non-Newtonian fluid exhibiting thixotropic and shear-thinning fluid behavior as well as certain viscoelasticity. CONCLUSION: The LA-loaded microemulsion witholive oil are successfully prepared, and the microemulsion has ideal sustained release behavior and good rheological properties. The study provides a foundation for the developmenton preparation of LA-loaded microemulsion with olive oil.

Analysis of maternal deaths with cardiovascular diseases in Shanghai obstetric heart disease intensive care unit within twenty-six years / 中华妇产科杂志

Objective To analyze risk factors, cardiovascular complications, time of death, gestational age of delivery and offspring outcomes in the maternal deaths with cardiovascular diseases (CVD). Methods Totally 4 112 cases of pregnant women with CVD in Shanghai obstetric heart disease intensive care unit within 26 years (from January 1993 to December 2018) were collected, and 20 maternal deaths within these cases were analyzed retrospectively. Results (1) Among the 20 deaths, structural heart diseases accounted for 90% (18/20), pregnancy induced heart diseases was 10% (2/20) while there was no dysfunctional heart disease. The mortality of pregnant women with CVD was 0.486% (20/4 112). (2) The following risk factors were common in these women, getting pregnant without counselling (95%, 19/20), New York Heart Association classⅢorⅣcardiac function (70%, 14/20), complicated with pulmonary hypertension (75%, 15/20 ) and prior heart events (60%, 12/20). And 85% (17/20) deaths occurred in puerperium, 15% (3/20) occurred before labor , while no death occurred during labor. And 65% (13/20) deaths died due to heart failure, 20% (4/20) deaths were due to pulmonary hypertension crisis, 5% (1/20) died on sudden cardiac arrest, rupture of aortic dissection and sudden death, respectively. Conclusions Women with CVD should get pregnant after strict evaluation. Pulmonary hypertension is one of the most severe contraindications to pregnancy, especially in patients with moderate to severe pulmonary hypertension. The puerperium period is a critical period that threatens the safety of these patients. Since heart failure is the most common cause of death, it is necessary to prevent and treat heart failure and to monitor heart function dynamically, especially in those with structural abnormal heart diseases. Moreover, it is also of importance to standardize antenatal care and to identify the severity of heart diseases in time.

Nearinfrared light transillumination for detection of incipient proximal caries in primary molars / 北京大学学报(医学版)

OBJECTIVE@#To evaluate the practical value of nearinfrared light transillumination (NILT, DIAGNOcam) on detection of incipient proximal caries in primary molars.@*METHODS@#In this study, 4-9-year-old children with suspicious proximal lesions in primary molars were recruited. The target teeth were examined with clinical examination, bitewing radiograph and DIAGNOcam. And the caries indexes were rated as 0 (no caries), 1 (caries reaching outer 1/2 enamel), 2 (caries reaching inner 1/2 enamel), and 3 (dentine caries). Those primary molars with at least one of the adjacent molars according with the criteria of invasive treatment, i.e. the teeth were diagnosed as caries reaching inner 1/2 enamel or dentine with at least two detection methods, were included. The target teeth with caries index ≥2 accepted the invasive treatment. And the caries status of the adjacent teeth was observed under direct vision and those teeth of caries index ≥2 would also accept the invasive treatment. The relationship of lesions to enamel-dentine junction (EDJ) were recorded and used as reference standard to compare the sensitivity, specificity and accuracy of those three methods in detecting the incipient proximal caries in primary molars.@*RESULTS@#In this study, 36 children with 104 suspicious proximal lesions in primary molars were recruited, of which 5 were diagnosed as no caries, 20 were diagnosed as superficial enamel caries, and 79 accepted invasive treatment, of which 22 were diagnosed as EDJ caries, and 57 as dentine caries. The sensitivity of clinical examination, bitewing radiograph, and DIAGNOcam were 68.69%, 81.82%, 78.79%, respectively. The specificity were 100.00%, 100.00%, 80.00%, and the accuracy were 75.96%, 85.65%, 78.85%, respectively. As for superficial enamel caries, the sensitivity of clinical examination was lowest, only 10%, while DIAGNOcam was 60%, higher than 40% of bitewing radiograph. As for EDJ caries, the sensitivity of bitewing radiograph was highest as 86.36%, followed by DIAGNOcam 72.73% and clinical examination 68.18%. As for dentine caries, the sensitivity of the three detection methods were higher than 85%, of which bitewing radiograph was the highest as 94.74%.@*CONCLUSION@#The accuracy of DIAGNOcam in detecting incipient proximal caries in primary molars was comparable to that of bitewing radiograph. It was safe, and convenient with no exposure to radiation, which was applicable to be used in pediatric dentistry.