Efficacy of ursodeoxycholic acid in the prevention and treatment of COVID-19 in patients with chronic hepatitis B / 临床肝胆病杂志

ObjectiveTo investigate the potential effect of ursodeoxycholic acid （UDCA） in the prevention and treatment of COVID-19 in patients with chronic hepatitis B. MethodsClinical data were collected from 324 patients with chronic hepatitis B who were treated in Beijing Ditan Hospital， Capital Medical University， from January to December 2022， and according to whether UDCA was administered， they were divided into UDCA group and control group. The propensity score matching （PSM） method was used to balance the confounding factors such as age， sex， and chronic complications， and the two groups were compared in terms of SARS-CoV-2 infection rate， symptoms， and recovery time after COVID-19. The two groups were also compared in terms of related laboratory markers （white blood cell count ［WBC］， hemoglobin ［Hb］， platelet count ［PLT］， alanine aminotransferase ［ALT］， aspartate aminotransferase ［AST］， albumin ［Alb］， alkaline phosphatase ［ALP］， total bilirubin ［TBil］， triglyceride ［TG］， and total cholesterol ［TC］）， vaccination， and the incidence rate of liver disease symptoms after COVID-19. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of data with skewed distribution between the two groups； the chi-square test and the continuously corrected chi-square test were used for comparison of categorical data between two groups. The binary Logistic regression model was used for univariate and multivariate analyses to investigate the influencing factors for COVID-19 after matching. ResultsThere were 87 patients in the UDCA group and 237 patients in the control group， and after PSM， there were 78 patients in the UDCA group and 137 patients in the control group， with good balance between the two groups. There was a significant difference in SARS-CoV-2 infection rate between the UDCA group and the control group ［82.1% （64/78） vs 95.6% （131/137）， χ2=10.847， P=0.001］. After COVID-19， compared with the control group， the UDCA group had a significantly lower proportion of the patients with chill （10.9% vs 38.9%， χ2=16.124， P<0.001） and cough （56.3% vs 74.8%， χ2=6.889， P=0.009）. There was a significant difference between the UDCA group and the control group in the proportion of the patients with a recovery time of ≤7 days after COVID-19 （79.7% vs 61.1%， χ2=6.760， P=0.009）. Both univariate and multivariate logistic regression analyses showed that UDCA was an independent influencing factor for COVID-19 （odds ratio=0.21 and 0.17， both P<0.05）. ConclusionUDCA is an protective factor against COVID-19 in patients with chronic hepatitis B and can alleviate related symptoms to some extent and shorten the recovery time， and therefore， it has an important value in the prevention and treatment of COVID-19.

Patients with type 2 diabetes mellitus and psoriasis re-infected with measles: one case report and literature analysis / 中国基层医药

Objective:To analyze the rash characteristics and diagnosis and treatment process of measles infection in patients with diabetes mellitus and psoriasis, to reduce the clinical diagnosis and treatment delay of such patients.Methods:The clinical data of a patient with diabetes combined with psoriasis and measles infection who was diagnosed and treated in The First Hospital of Yulin in April 2015 were analyzed.Results:The patient was admitted to hospital due to polydipsia and polyuria for 3 years and fever for 3 days. Hypoglycemic and anti-inflammatory treatment after admission was not good. On the third day after hospitalization, rash on the trunk and the extremities was seen. The patient had a history of measles infection. Based on clinical practice, Measles morbillivirus infection was not excluded, and Measles morbillivirus infection was confirmed by pathogen inspection. Measles reinfection was considered to be caused by variation of Measles morbillivirus. The atypical rash formed because of the patient's need for long-term treatment with Acitretin capsule and capotriol for psoriasis. After adjusting the antibiotic treatment, hypoglycemia and antiviral therapy were given, the body temperature was normal and the rash gradually subsided.Conclusion:For patients with type 2 diabetes mellitus and psoriasis, if they have a fever, they should be considered comprehensively to guard against re-infection caused by measles virus mutation. Timely etiological diagnosis is performed to avoid missed diagnosis and delayed treatment.

miR-23b-3p regulates the differentiation of goat intramuscular preadipocytes by targeting the PDE4B gene / 生物工程学报

This study aimed to explore the effect of miR-23b-3p on the differentiation of goat intramuscular preadipocytes, and to confirm whether miR-23b-3p plays its roles via targeting the PDE4B gene. Based on the pre-transcriptome sequencing data obtained previously, the miR-23b-3p, which was differentially expressed in goat intramuscular adipocytes before and after differentiation, was used as an entry point. real-time quantitative-polymerase chain reaction (qPCR) was used to detect the expression pattern of miR-23b-3p during the differentiation of goat intramuscular preadipocytes. The effects of miR-23b-3p on adipose differentiation and adipose differentiation marker genes were determined at the morphological and molecular levels. The downstream target genes of miR-23b-3p were determined using bioinformatics prediction as well as dual luciferase reporter assay to clarify the targeting relationship between miR-23b-3p and the predicted target genes. The results indicated that overexpression of miR-23b-3p reduced lipid droplet accumulation in goat intramuscular adipocytes, significantly down-regulated the expression levels of adipogenic marker genes AP2, C/EBPα, FASN, and LPL (P < 0.01). In addition, the expressions of C/EBPβ, DGAT2, GLUT4 and PPARγ were significantly downregulated (P < 0.05). After interfering with the expression of miR-23b-3p, lipid droplet accumulation was increased in goat intramuscular adipocytes. The expression levels of ACC, ATGL, AP2, DGAT2, GLUT4, FASN and SREBP1 were extremely significantly up-regulated (P < 0.01), and the expression levels of C/EBPβ, LPL and PPARγ were significantly up-regulated (P < 0.05). It was predicted that PDE4B might be a target gene of miR-23b-3p. The mRNA expression level of PDE4B was significantly decreased after overexpression of miR-23b-3p (P < 0.01), and the interference with miR-23b-3p significantly increased the mRNA level of PDE4B (P < 0.05). The dual luciferase reporter assay indicated that miR-23b-3p had a targeting relationship with PDE4B gene. MiR-23b-3p regulates the differentiation of goat intramuscular preadipocytes by targeting the PDE4B gene.

Research progress on the relationship between pediatric epilepsy and vitamin D / 中国临床药理学与治疗学

Epilepsy is a long-term, chronic, recurrent, multi-factorial, multi-symptomatic nervous system disease, and was caused by abnormal discharge of brain neurons. Etiology can cause irreversible brain dysfunction and even death. There are about 6.5 million children with epilepsy in China, with incidence rate twice that of adult, presenting serious threaten to children's growth and development. Vitamin D has been well-known for crucial importance to development of nervous, skeletal, and immune system. Studies have found that pediatric epilepsy as well as other neurological diseases were closely related with vitamin D deficiency. First, a large number of studies have shown that vitamin D in children with epilepsy is affected by epilepsy itself; second, the use of anti-seizure medicines can alter metabolism of vitamin D by inducing cytochrome oxidases; third, the inducement was concerned to varieties, combination and duration of anti-seizure medicines; fourth, it was expected that supplement of vitamin D during antiepileptic treatment would guarantee an improvement of treating given that anti-seizure medicines may lead to deficiency of vitamin D. Large numbers of researches have reported on the correlation ship between pediatric epilepsy and vitamin D. However, there is still a lack of systematic review. This article aims to retrospect the research progress of relationship between pediatric epilepsy and vitamin D, and provide valuable feedbacks on further treatment of pediatric epilepsy.

Gene cloning and sequence analysis of the RPL29 gene and its effect on lipogenesis in goat intramuscular adipocytes / 生物工程学报

The aim of this study was to clone the goat RPL29 gene and analyze its effect on lipogenesis in intramuscular adipocytes. Using Jianzhou big-eared goats as the object, the goat RPL29 gene was cloned by reverse transcription-polymerase chain reaction (RT-PCR), the gene structure and expressed protein sequence were analyzed by bioinformatics, and the mRNA expression levels of RPL29 in various tissues and different differentiation stages of intramuscular adipocytes of goats were detected by quantitative real-time PCR (qRT-PCR). The RPL29 overexpression vector pEGFP-N1-RPL29 constructed by gene recombination was used to transfect into goat intramuscular preadipocytes and induce differentiation. Subsequently, the effect of overexpression of RPL29 on fat droplet accumulation was revealed morphologically by oil red O and Bodipy staining, and changes in the expression levels of genes related to lipid metabolism were detected by qRT-PCR. The results showed that the length of the goat RPL29 was 507 bp, including a coding sequence (CDS) region of 471 bp which encodes 156 amino acid residues. It is a positively charged and stable hydrophilic protein mainly distributed in the nucleus of cells. Tissue expression profiling showed that the expression level of this gene was much higher in subcutaneous adipose tissue and inter-abdominal adipose tissue of goats than in other tissues (P < 0.05). The temporal expression profile showed that the gene was expressed at the highest level at 84 h of differentiation in goat intramuscular adipocytes, which was highly significantly higher than that in the undifferentiated period (P < 0.01). Overexpression of RPL29 promoted lipid accumulation in intramuscular adipocytes, and the optical density values of oil red O staining were significantly increased (P < 0.05). In addition, overexpression of RPL29 was followed by a highly significant increase in ATGL and ACC gene expression (P < 0.01) and a significant increase in FASN gene expression (P < 0.05). In conclusion, the goat RPL29 may promote intra-muscular adipocyte deposition in goats by up-regulating FASN, ACC and ATGL.

Cloning and expression profile of ZFP36L1 gene in goat / 生物工程学报

The purpose of this study was to clone and characterize the ZFP36L1 (zinc finger protein 36-like 1) gene, clarify its expression characteristics, and elucidate its expression patterns in different tissues of goats. Samples of 15 tissues from Jianzhou big-eared goats, including heart, liver, spleen, lung and kidney were collected. Goat ZFP36L1 gene was amplified by reverse transcription-polymerase chain reaction (RT-PCR), then the gene and protein sequence were analyzed by online tools. Quantitative real-time polymerase chain reaction (qPCR) was used to detect the expression level of ZFP36L1 in intramuscular preadipocytes in different tissues and adipocytes of goat at different differentiation stages. The results showed that the length of ZFR36L1 gene was 1 224 bp, and the coding sequence (CDS) region was 1 017 bp, encoding 338 amino acids, which was a non-secretory unstable protein mainly located in nucleus and cytoplasm. Tissue expression profile showed that ZFP36L1 gene was expressed in all selected tissues. In visceral tissues, the small intestine showed the highest expression level (P < 0.01). In muscle tissue, the highest expression level was presented in longissimus dorsi muscle (P < 0.01), whereas the expression level in subcutaneous adipose tissue was significantly higher than that in other tissues (P < 0.01). The results of induced differentiation showed that the expression of this gene was up-regulated during adipogenic differentiation of intramuscular precursor adipocytes (P < 0.01). These data may help to clarify the biological function of the ZFP36L1 gene in goat.

Cloning, identification and functional analysis of the goat transcription factor c-fos / 生物工程学报

C-fos is a transcription factor that plays an important role in cell proliferation, differentiation and tumor formation. The aim of this study was to clone the goat c-fos gene, clarify its biological characteristics, and further reveal its regulatory role in the differentiation of goat subcutaneous adipocytes. We cloned the c-fos gene from subcutaneous adipose tissue of Jianzhou big-eared goats by reverse transcription-polymerase chain reaction (RT-PCR) and analyzed its biological characteristics. Using real-time quantitative PCR (qPCR), we detected the expression of c-fos gene in the heart, liver, spleen, lung, kidney, subcutaneous fat, longissimus dorsi and subcutaneous adipocytes of goat upon induced differentiation for 0 h to 120 h. The goat overexpression vector pEGFP-c-fos was constructed and transfected into the subcutaneous preadipocytes for induced differentiation. The morphological changes of lipid droplet accumulation were observed by oil red O staining and bodipy staining. Furthermore, qPCR was used to test the relative mRNA level of the c-fos overexpression on adipogenic differentiation marker genes. The results showed that the cloned goat c-fos gene was 1 477 bp in length, in which the coding sequence was 1 143 bp, encoding a protein of 380 amino acids. Protein structure analysis showed that goat FOS protein has a basic leucine zipper structure, and subcellular localization prediction suggested that it was mainly distributed in the nucleus. The relative expression level of c-fos was higher in the subcutaneous adipose tissue of goats (P < 0.05), and the expression level of c-fos was significantly increased upon induced differentiation of subcutaneous preadipocyte for 48 h (P < 0.01). Overexpression of c-fos significantly inhibited the lipid droplets formation in goat subcutaneous adipocytes, significantly decreased the relative expression levels of the AP2 and C/EBPβ lipogenic marker genes (P < 0.01). Moreover, AP2 and C/EBPβ promoter are predicted to have multiple binding sites. In conclusion, the results indicated that c-fos gene was a negative regulatory factor of subcutaneous adipocyte differentiation in goats, and it might regulate the expression of AP2 and C/EBPβ gene expression.

Evaluation of health warning labels for commercial locations vending sugar-sweetened beverages / 环境与职业医学

Background Long-term excessive consuming sugar-sweetened beverages have a negative impact on health. In order to decrease the consumption of sugar-sweetened beverages and create a healthy food environment, the Health Commission of Shenzhen Municipality pioneered to enforce health warning labels presented in commercial locations vending sugar-sweetened beverages based on relevant provisions of the Health Regulations of Shenzhen Special Economic Zone，but its effect has not yet been evaluated. Objective To evaluate the impact of presenting health warning labels in commercial locations vending sugar-sweetened beverages in Shenzhen. Methods A multi-stage stratified sampling method was used to randomly select one street in each of the 10 districts (excluding the Shenzhen Shantou Special Cooperation Zone) of Shenzhen followed by a convenience sampling to select sampling sites to conduct an undercover investigation on the presentation of health warning labels for sugar-sweetened beverages in six different types of venues (n=232) such as shopping malls, ordinary supermarkets/convenience stores, self-service vending machines, catering service places, medical institutions, and venues serving minors' education and activities. At the same time, 238 site managers, 1002 adult consumers, and 7396 child and adolescent consumers were interviewed. Results Among 213 commercial locations vending sugar-sweetened beverages, the rate of health warning label installation was 26.3%, with the highest installation rate in shopping malls (55.0%). Among site managers, 47.8% were aware that commercial locations were required to install health warning labels, and 50.0% were aware of the standards for setting up health warning labels. The higher the awareness of relevant regulations, the higher the rate of installation of health warning labels. More than half of site managers (55.3%) believed that after installing health warning labels, the sales of sugar-sweetened beverages and sugar-sweetened beverages in large-volume packages had decreased compared to the same period in previous years. Most of the interviewed consumers indicated that if they saw the health warning labels for sugar-sweetened beverages, they would buy less, give up purchasing, or choose low-sugar or sugar-free beverages, and also discourage their family members or friends from drinking such beverages. Compared with participants without awareness of the health warning labels, both adult and child and adolescent consumers with awareness of the health warning labels believed that the installation is beneficial to their good eating habits and reported a higher proportion of discouraging family members or friends from drinking such beverages, with a lower frequency of consuming sugar-sweetened beverages. Conclusion Health warning labels for sugar-sweetened beverages have a significant effect on promoting behavior changes, and both site managers and citizens have a high level of support for them. However, in view of the low voluntary compliance rate of commercial locations and the installation rate of health warning labels, the publicity and enforcement of the Health Regulations of Shenzhen Special Economic Zone should be enhanced.

Trastuzumab Combined with Irinotecan in Patients with HER2-Positive Metastatic Colorectal Cancer: A Phase II Single-Arm Study and Exploratory Biomarker Analysis / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#The human epidermal growth factor receptor 2 (HER2) is an established therapeutic target for various kinds of solid tumors. HER2 amplification occurs in approximately 1% to 6% of colorectal cancer. In this study, we aimed to assess the efficacy and safety of trastuzumab in combination with chemotherapy in HER2-positive metastatic colorectal cancer (mCRC). @*Materials and Methods@#An open-label, phase II trial (Clinicaltrials.gov: NCT03185988) was designed to evaluate the antitumor activity of trastuzumab and chemotherapy in HER2-positive digestive cancers excluding gastric cancer in 2017. Patients from this trial with HER2-positive, KRAS/BRAF wild-type, unresectable mCRC were analyzed in this manuscript. Eligible patients were treated with trastuzumab (8 mg/kg loading dose and then 6 mg/kg every 3 weeks) and irinotecan (120 mg/m2 days 1 and 8 every 3 weeks). The primary endpoint was the objective response rate. @*Results@#Twenty-one HER2-positive mCRC patients were enrolled in this study. Seven patients (33.3%) achieved an objective res-ponse, and 11 patients (52.4%) had stable disease as their best response. The median progression-free survival (PFS) was 4.3 months (95% confidence interval, 2.7 to 5.9). Four of the 21 patients (19.0%) had grade 3 adverse events, including leukopenia, neutropenia, urinary tract infection, and diarrhea. No treatment-related death was reported. Exploratory analyses revealed that high tumor tissue HER2 copy number was associated with better therapeutic response and PFS. Alterations in the mitogen-activated protein kinase pathway, HER2 gene, phosphoinositide 3-kinase/AKT pathway, and cell cycle control genes were potential drivers of trastuzumab resistance in mCRC. @*Conclusion@#Trastuzumab combined with chemotherapy is a potentially effective and well-tolerated therapeutic regimen in mCRC with a high HER2 copy number.

circZNF124 regulates the proliferation, migration and invasion of colorectal cancer SW620 cells by targeting miR-4262 / 中国临床药理学与治疗学

AIM: To explore the effect and mechanism of circZNF124 on the proliferation, migration and invasion of colorectal cancer SW620 cells. METHODS: The expression levels of circZNF124 and miR-4262 in colorectal cancer tissues were measured by qRT-PCR method. Human colorectal cancer cells SW620 were cultured in vitro, and were randomly grouped into si-NC group, si-circZNF124 group, miR-NC group, miR-4262 group, si-circZNF124 j anti-miR-NC group, si-circZNF124 j antimiR-4262 groups. CCK-8 method, plate clone formation test, scratch test and Transwell test respectively were used to detect cell proliferation, clone formation, migration and invasion of SW620 cells. The dual luciferase reporter experiment analyzed the targeted binding of circZNF124 to miR-4262. Western blot was used to detect the expression of E-cadherin and N-cadherin protein. RESULTS: The expression of circZNF124 in colorectal cancer tissue was increased by about 3.75 times compared with that in the adjacent tissue (P i 0.05), and the expression of miR-4262 was decreased by about 0.73 times compared with the adjacent tissue (P i 0.05). Compared with the si-NC group, the cell viability, scratch healing rate and the protein level of N-cadherin in the si-circZNF124 group were decreased (P i 0.05), the number of cell clone formation and the number of invasive cells were decreased (P i 0.05), while the protein level of E-cadherin was increased (P i 0.05). circZNF124 could negatively regulate the expression of miR-4262. Compared with the miR-NC group, the cell viability, scratch healing rate and the protein level of N-cadherin in the miR-4262 group were reduced (P i 0.05), the number of cell clones and the number of invasive cells were reduced (P i 0.05), while the protein level of E-cadherin was increased (P i 0.05). Inhibition of miR-4262 expression reversed the effect of interfering circZNF124 expression on the proliferation, migration and invasion of SW620 cells.CONCLUSION: Interference with the expression of circZNF124 can attenuate the proliferation, migration and invasion of colorectal cancer cells by targeting miR-4262.

Spine curvature and the cardiopulmonary exercise endurance of adolescents with idiopathic scoliosis / 中华物理医学与康复杂志

Objective:To quantify any correlation between the severity of spinal curvature of an adolescent with idiopathic scoliosis and their cardiopulmonary exercise endurance.Methods:The cardiopulmonary exercise test (CPET) results and the full-length spinal X-rays in a standing position of 64 adolescents with idiopathic scoliosis were reviewed retrospectively. Independent t-tests were used to compare the two datasets obtained from those with left or right thoracic scoliosis. The correlation between the Cobb angle and cardiopulmonary exercise endurance was analyzed using Pearson correlation coefficients, multiple factor linear regression and two-stage linear regression.Results:After adjusting for gender, age, height and weight, the multiple linear regression analysis showed that the Cobb angle was significantly negatively correlated with maximum tidal volume (β=-0.013) and significantly positively correlated with the rate of respiration (β=0.421). The relationship between the Cobb angle and cardiopulmonary exercise endurance was non-linear. With a Cobb angle > 34°, a 1° increase reduces cardiopulmonary exercise endurance by a factor of 1.4 on average. At smaller Cobb angles the corresponding increase is about 0.87 times.Conclusions:The Cobb angle is a negative predictor of ventilation during exercise among adolescents with idiopathic scoliosis. The more severe a patient′s spinal curvature, the lower the cardiopulmonary exercise endurance is likely to be.

Analysis of risk factors of death after cardiopulmonary bypass in children with congenital heart disease less than 5 kg / 中国综合临床

Objective:To investigate the risk factors for surgical death in children with congenital heart disease (CHD) less than 5 kg undergoing cardiopulmonary bypass.Methods:The clinical data of 225 children with CHD who underwent open cardiopulmonary bypass in the First Affiliated Hospital of Air Force Military Medical University from February 2017 to February 2020 were collected for a retrospective case-control study. The independent sample T test was used for inter-group comparison of measurement data, Chi square test or chi squre correction test was used for the comparision between count data. Mann-Whitney rank-sum test was used for rank distribution data and multiple Logistic regression analysis was performed for factors affecting surgical death of children with CHD.Results:Among the 225 cases, 204 (90.67%, 204/225) survived surgery and 21 (9.33%, 21/225) died. Univariate analysis showed that age (2.48±0.68) months and body weight (2.28±0.56) kg in the death group were significantly lower than that in the survival group (4.92±0.65) months ( t=16.33, P<0.001) and body weight (4.26±0.52) kg ( t=16.38, P<0.001), while the proportion of female (66.67% (14/21)), malnutrition (none: 14.28% (3/21); Mild: 42.86% (9/21). Severity: 42.86%(9/21)), palliative surgery proportion (28.57%(6/21)), emergency surgery proportion (71.43%(15/21)), congenital heart surgery risk assessment (RACHS-1) grading ratio (<grade 3: 23.81%(5/21), ≥grade 3: 76.19% (16/21)), CPB time (135.24±11.19) min, aorta blocking time (78.24±8.20) min, operation time (178.43±13.82) min, heart malformation complex ratio (complex: 47.62% (10/21), simple: 52.38% (11/21)), ICU treatment days (4.76±0.77) d, postoperative mechanical ventilation time (121.33±12.66) h were significantly higher than the female survival group (41.67% (85/204), χ2=4.83, P=0.028), malnutrition rate (none: 38.24%(78/204); Mild: 42.15% (86/204)); Severe: 19.61% (40/204) ( z=2.72, P=0.007), palliative surgery proportion 8.82% (18/204), proportion of radicalsurgery91.18% (186/204) ( χ2=5.86, P=0.016), RACHS-1 grading ratio (<grade 3:77.45% (158/204); ≥grade 3: 22.55% (46/204), χ2=27.44, P<0.001), CPB time (106.87±11.12) min ( t=11.12, P<0.001), aorta occlusion time (58.68±9.26) min ( t=9.32, P<0.001), operation time (167.24±13.75) min ( t=3.55, P<0.001), heart malformation complex ratio (complex: 78.92%(161/204), simple: 21.08%(43/204) ( χ2=10.23, P<0.001)), ICU treatment time (3.67±0.87) d ( t=5.52, P<0.001), postoperative mechanical ventilation time (109.74±13.75) h ( t=3.70, P<0.001). Logistic regression analysis showed that operation time ( OR=1.064, 95% CI: 1.019-1.110, P=0.004), postoperative mechanical ventilation time ( OR=1.083, 95% CI: 1.031~1.138, P=0.002), ICU treatment time ( OR=5.317, 95% CI: 2.410-11.730, P<0.001) and malnutrition ( OR=2.974, 95% CI: 1.291-6.850, P=0.010) were independent risk factors for surgical death after cardiopulmonary bypass in children with CHD less than 5 kg. Conclusions:The mortality rate of CHD patients with low body weight less than 5 kg was relatively high. The increase of operation time, ICU treatment time, degree of malnutrition and postoperative mechanical ventilation time will increase the probability of death. Targeted measures should be taken to reduce the surgical mortality of children.

Analysis of surveillance results of brucellosis in Lushan County, Pingdingshan City, Henan Province from 2011 to 2019 / 中华地方病学杂志

Objective:The surveillance results of brucellosis in Lushan County, Pingdingshan City, Henan Province are analyzed to provide basis for formulating prevention and control strategies.Methods:Retrospective analysis method was used to collect the surveillance data from Lushan County Center for Disease Control and Prevention and Animal Husbandry Department from 2011 to 2019. Descriptive statistical analysis was made on the serological, pathogenic of brucellosis.Results:From 2011 to 2019, 15 943 high-risk people were investigated, and 10 834 were serologically tested, with a positive detection rate of 23.11% (2 504/10 834). Among them, the positive detection rate of brucellosis serum increased rapidly in 2013 and decreased after 2016. The positive detection rate was 25.87% (1 593/6 157) in men and 19.48% (911/4 677) in women. The age of positive detection was mainly 40-< 70 years old, accounting for 70.45% (1 764/2 504). The positive detection rate of farmers in all occupations was the highest, which was 25.97% (2 242/8 634). There were significant differences in the positive detection rates among different gender, age and occupation (χ 2=61.163, 27.855, 257.412, P < 0.01). A total of 578 blood samples from patients with acute brucellosis were isolated and cultured, 215 strains of Brucella were detected, and the positive detection rate was 37.20%. Conclusions:The high-risk group of human brucellosis in Lushan County, Pingdingshan City is middle-aged and elderly male farmers engaged in aquaculture. It is suggested that the joint prevention and control measures should be strengthened, the health education of high-risk groups should be strengthened, and comprehensive prevention and control measures should be taken to control the occurrence and prevalence of brucellosis.

Risk assessment of unintention injury among preschool children in Shunyi District of Beijing / 中国学校卫生

Objective@#To understand the current situation and associated factors of unintentional injury among preschool children in Shunyi District, and to provide reference for the development of unintentional injury intervention measures.@*Methods@#Three kindergartens in Shunyi district were selected through stratified cluster sampling method, and all the parents were surveyed online by self-designed questionnaire.@*Results@#The proportion of low, medium and high risk assessment of unintentional injury in preschool children were 59.5%, 37.5% and 3.0%, respectively. Risk of unintentional injury increased significantly with age and grade(χ 2=12.35, 12.70, P<0.05). The risk of unintentional injury in inter-generational care (3.7%) was higher than that in parental care(2.4%). The higher the education level of the primary caretaker and family income, the higher level of unintentional injury risk(χ 2=11.23, 14.10, P<0.05).There were significant differences in the risk for burning, poisoning, other accidental injury, prevention of accidental injury and total score of unintentional injury among children of different ages and classes(F=8.26，5.61，4.95，6.15，7.86；9.88，8.39，4.25，6.27，7.55，P<0.05). There was statistical significance in burning risk between boys and girls(t=-4.27, P<0.05). There was statistical significance in unintentional injury prevention between children of different residence(t=9.11, P<0.05). There were significant differences in behavior supervision among risk among children of different ages and grades(P<0.05). Multiple linear regression analysis showed that education level of primary caregivers (college:B=-2.66, 95%CI=-4.69--0.63; bachelor degree or higher:B=-3.80, 95%CI=-5.90--1.70), annual family income (B=-2.82, 95%CI=-4.80--0.84) were associated with unintentional injury risk of preschool children(P<0.05).@*Conclusion@#Health education of unintentional injury prevention among preschool children should focus on the primary caretaker with low education and low family income, which is crucial for prevention of children s injury.

Research progress of relationship between peritoneal microenvironment and peritoneal metastasis of gastric cancer / 中华消化外科杂志

Peritoneal metastasis is one of the most frequent metastatic patterns of advanced gastric cancer, but the mechanism underlying remains unclear. The 'seed and soil’ theory is now well recognized for peritoneal metastasis of gastric cancer at present. The combination of various cells, extracellular matrix, and ascites components within the abdominal cavity provide a suitable microenvironment for the plantation, infiltra-tion, growth and metastasis of gastric cancer cells. Fully under-standing of peritoneal microenvironment will help to diagnose the peritoneal metastasis of gastric cancer and tumor recurrence, and provide theoretical basis for the development of drugs targeting peritoneal microenvironment. The authors review the main cell formation, ascites and immune microenvironment involved in the formation of the peritoneal microenvironment based on relevant literatures at home and abroad, and investigate the relationship between peritoneal microenvironment and peritoneal metastasis of gastric cancer.

Infrequent gene mutations of KRAS, NRAS and BRAF in colorectal cancer and their clinical significance: a report of 1 513 cases / 中华消化外科杂志

Objective:To investigate the infrequent gene mutations of KRAS, NRAS and BRAF in colorectal cancer and their clinical significance.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 1 513 patients with colorectal cancer who were admitted to the Peking University Cancer Hospital from December 2013 to November 2018 were collected. There were 921 males and 592 females, aged from 15 to 97 years, with an average age of 59 years. The genomic DNA of tumor tissue was extracted, and the mutation status of KRAS (exon 2, 3), NRAS (exon 2, 3) and BRAF (exon 15) was detected by the Sanger sequencing. Observation indicators: (1) mutation status of KRAS, NRAS and BRAF; (2) relationship of different mutation status of KRAS, NRAS and BRAF with clinicopathological characteristics; (3) infrequent mutation status of single gene and its clinicopathological characteristics; (4) simultaneous mutations of two genes and their clinicopathological characteristics. Count data were expressed by absolute numbers or percentages, and comparison between groups was analyzed by the chi-square test.Results:(1) Mutation status of KRAS, NRAS and BRAF: the mutation rates of KRAS, NRAS and BRAF were 37.806%(572/1 513), 3.173%(48/1 513) and 5.486%(83/1 513) of the 1 513 patients with colorectal cancer, respectively. The mutation rates of exon 2 and exon 3 in KRAS were 35.889%(543/1 513) and 1.917%(29/1 513), respectively. The mutation rates of exon 2 and exon 3 in NRAS were 1.322%(20/1 513) and 1.851%(28/1 513), respectively. The mutation rate of exon 15 in BRAF was 5.486%(83/1 513). The mutation of KRAS mainly occurred in codon 12, 13 of exon 2 and codon 61 of exon 3, with a mutation rate of 27.759%(420/1 513), 7.733%(117/1 513), and 1.586%(24/1 513), respectively. Infrequent mutation in codon 14, 59, 60 of KRAS were found in 7 patients with colorectal cancer [0.463%(7/1 513)], including V14I mutation in 2 cases [0.132%(2/1 513)], A59T mutation in 2 cases [0.132%(2/1 513)], A59E mutation in 2 cases [0.132%(2/1 513)] and G60D mutation in 1 case [0.066%(1/1 513)]. The mutation of NRAS mainly occurred in codon 12, 13 of exon 2 and codon 61 of exon 3, including Q61K with a mutation rate of 0.925%(14/1 513), followed by G12D with a mutation rate of 0.727%(11/1 513). The mutation rates of Q61R, Q61H, Q61L, G13R, G12C, G12V, G12S, G13D, and G13C were relatively low. The mutation of BRAF mainly occurred in codon 600 of exon 15 as V600E mutation, with a mutation rate of 4.957%(75/1 513). Infrequent mutation in BRAF were found in 8 patients with colorectal cancer, with a mutation rate of 0.529%(8/1 513), including D594G mutation in 5 cases [0.330%(5/1 513)], D594H mutation in 1 case [0.066%(1/1 513)], S607T mutation in 1 case [0.066%(1/1 513)], and 599-600 codon insertion AGA in 1 case [0.066%(1/1 513)]. Of the 1 513 patients, 4 [0.264%(4/1 513)] had simultaneous mutations at codon 12 and 13 of KRAS, including 2 [0.132%(2/1 513)] with simultaneous mutations at G12V and G13D, 1 [0.066%(1/1 513)] with simultaneous mutations at G12D and G13A, and 1 [0.066%(1/1 513)] with simultaneous mutations at G12V and G13F. In addition, 1 patient [0.066%(1/1 513)] had simultaneous mutations at G13D of KRAS and G12S of NRAS, and 1 patient [0.066%(1/1 513)] had simultaneous mutations at G12C of KRAS and Q61H of NRAS. (2) Relationship of different mutation status of KRAS, NRAS and BRAF with clinicopathological characteristics: patients with different tumor location and tumor differentiation degree had significantly different KRAS mutation status ( χ2=25.317, 4.166, P<0.05); patients with different gender, tumor location, tumor differentiation degree, and lymph node metastasis had significantly different BRAF mutation status ( χ2= 11.290, 22.317, 38.035, 12.611, P<0.05). The proportion of Q61K mutation and Q61R mutation of NRAS in the patients with age of < 65 and ≥ 65 years was 12/18, 2/10 and 1/18, 5/10, respectively, showing significant differences between the two groups ( χ2=5.600, 7.542, P<0.05). (3) Infrequent mutation status of single gene and its clinicopathological characteristics: 15 of the 1 513 patients had single gene mutation. Of the 7 patients with infrequent mutations in codon 14, 59 and 60 of KRAS, 6 were males and 1 was female; 6 were < 65 years old and 1 was ≥ 65 years old; 3 had tumors located in the left colon, 3 in the right colon and 1 in the rectum; 6 had highly or moderately differentiated adenocarcinoma and 1 had poorly differentiated adenocarcinoma; 6 were in stage Ⅳ and 1 was in stage Ⅱ of TNM staging; 6 had distant metastasis and 1 had no distant metastasis; 3 had lymph node metastasis and 4 had no lymph node metastasis; there was no postoperative recurrence. Of the 8 patients with infrequent gene mutation of BRAF, 4 were males and 4 were females; 4 were < 65 years old and 4 were ≥ 65 years old; 5 had tumors located in the left colon, 1 in the right colon and 2 in the rectum; 7 had moderately differentiated adenocarcinoma and 1 had poorly differentiated adenocarcinoma; 5 were in stage Ⅳ, 2 in stage Ⅲ, and 1 in stage Ⅱ of TNM staging; 6 had distant metastasis and 2 had no distant metastasis; 3 had lymph node metastasis and 5 had no lymph node metastasis; 1 had postoperative recurrence. (4) Simultaneous mutations of two genes and their clinicopathological characteristics: 6 of the 1 513 patients had simultaneous mutations of two genes. Of 6 patients with simultaneous mutations of two genes, 5 were males and 1 was female; 2 were < 65 years old and 4 were ≥ 65 years old; 1 had tumor located in the left colon, 4 in the right colon and 1 in the rectum; 5 had highly or moderately differentiated adenocarcinoma and 1 had poorly differentiated adenocarcinoma; 5 were in stage Ⅳ and 1 was in stage Ⅱ of TNM staging; 4 had distant metastasis and 2 had no distant metastasis; 3 had lymph node metastasis and 3 had no lymph node metastasis; 1 had postoperative recurrence. Conclusions:The infrequent mutations of KRAS and BRAF in colorectal cancer often occur in the rare codon region and mainly are point mutations. Different mutations of KRAS, NRAS and BRAF are related to clinicopathological features, which provide an important basis for treatment of colorectal cancer.

Effects of oropharyngeal administration of colostrum on feeding intolerance in preterm infants / 中国实用护理杂志

Objective:To evaluate the effects of oropharyngeal administration of colostrum on feeding intolerance in preterm infants.Methods:A total of 87 preterm infants from December 2016 to December 2017 in the Second Affiliated Hospital of Wenzhou Medical University were distributed to the study group(41 cases) and the control group(46 cases) by random digits table method. The study group got oropharyngeal administration of 0.4 ml of own mother’s colostrum three times a day for 5 days. The control group got sterile water. The research data included early gastric residual volumes(the first to fourteenth day), gastric residual times and feeding status.Results:The gastric residual volumes on the eighth day, the eleventh day, the twelfth day were 8.5(0, 18.25), 0(0, 13.50), 2.5(0, 5.00) ml in the control group and 0(0,9.00), 0(0,1.00), 0(0,2.50) ml in the study group, the differences were statistically significant ( t values were -2.001, -1.987, -2.061, all P<0.05). The gastric residual times on the eighth day, the eleventh day were 1.5(0, 4.0), 0(0, 2.0) times in the control group, and 0(0, 1.0), 0(0, 0.5) times in the study group, the differences were statistically significant ( t values were -1.984, -2.267, all P<0.05).The vomiting times on the tenth day, the twelfth day were 0(0, 1.0), 0(0, 1.0) times in the control group and 0(0, 0.0), 0(0, 0.0) times in the study group, the differences were statistically significant ( t values were -3.149, -2.098, P<0.01 or 0.05). The time reaching full enteral feeding was (17.45±10.44) d in the study group, and (21.62±5.52) d in the control group, the difference was statistically significant ( t value was -2.022, P<0.05). Conclusions:Oropharyngeal administration of colostrum can better the condition of feeding intolerance.

Validation and comparison of risk prediction models in patients with cardiogenic shock complicating acute myocardial infarction / 中华急诊医学杂志

Objective:To externally validated the intra-aortic balloon pump (IABP) shockⅡ score and CardShock score for predicting in-hospital mortality in patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS) and compared them with the Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ) score.Methods:According to the inclusion and exclusion criteria, patients admitted to the cardiac care center (CCU) of our center from December 2010 to May 2019 were enrolled in this study. Patients’ baseline characteristics, in-hospital interventions, and outcomes were collected. The APACHEⅡ score was calculated during hospitalization by clinicians and collected by researchers. Two researchers independently calculated the IABP-ShockⅡ score and CardShock score; any disagreement was discussed with the third researcher. The performance of risk scores was evaluated by discrimination and calibration. The discriminative ability of risk scores was evaluated using the area under the receiver operating characteristic curve (AUC) and compared by the Delong method. The calibration of these risk scores was examined by the Hosmer-Lemeshow goodness-of-fit test. The calibration plot was also built.Results:A total of 150 patients enrolled in our study, and the in-hospital mortality was 60%. According to the IABP-ShockⅡ score, patients scored as low risk (0-2), moderate risk (3-4), and high risk (5-9) had in-hospital mortality of 29%, 68%, and 80%, respectively. According to the CardShock score, patients scored as low risk (0-3), moderate risk (4-5), and high risk (6-9)had in-hospital mortality of 21%, 57%, and 82%, respectively. According to the APACHEⅡ score, patients scored<20, 20-30, and >30 had in-hospital mortality of 19%, 69%, and 93%, respectively. For predicting the in-hospital mortality, the APACHEⅡ score demonstrated excellent discrimination (AUC=0.90, 95% CI: 0.84-0.95). The IABP-ShockⅡ score and CardShock score showed good discrimination (AUC=0.76, 95% CI: 0.68-0.83 and AUC=0.79, 95% CI: 0.72-0.85). The discriminative ability did not significantly differ between the IABP-ShockⅡ score and the CardShock score (0.76 vs 0.79, P>0.05), but both of which were significantly lower than the APACHEⅡ score (0.76 vs 0.90, P<0.05, and 0.79 vs 0.90, P<0.05). At the same time, it was not significantly different between the IABP-ShockⅡ score and the CardShock score (0.76 vs 0.79, P>0.05). All of these three scores were adequately calibrated according to the Hosmer-Lemeshow goodness-of-fit test ( P>0.05).The calibration plot showed accurate calibration of these three scores. Conclusions:Although less accurate than the APACHEⅡ score, the IABP-ShockⅡ score and CardShock score can show accurate prediction for in-hospital mortality of AMI-CS patients.

Rapid on-site evaluation in CT-guided percutaneous biopsy of peripheral pulmonary nodules / 中国介入影像与治疗学

Objective: To observe the value of rapid on-site evaluation (ROSE) in CT-guided percutaneous lung biopsy of peripheral pulmonary nodules (≤2 cm). Methods: A total of 108 patients with pulmonary nodules who underwent CT-guided percutaneous lung biopsy were retrospectively analyzed. According to the presence or absence of ROSE, they were divided into ROSE group (n=58) and conventional group (n=50). The adequacy of sampling, diagnostic accuracy, complications, secondary biopsy rate and statistical consistency were compared between ROSE and histopathology. Results: The adequacy and diagnostic accuracy in ROSE group were higher than those in conventional group (93.10% [54/58] vs 78.00% [39/50], 89.66% [52/58] vs 74.00% [37/50], both P0.05). The consistency of ROSE and histopathology for benign and malignant lesions was 91.30% (21/23) and 93.33% (28/30), respectively. Conclusion: ROSE can guide puncture sampling without prolonging operation time and increasing complications, so as to ensure the adequacy of sampling, improve diagnostic accuracy and reduce the rate of secondary puncture during biopsy of pulmonary nodules, which has good consistency with histopathology and can make immediate diagnosis.

Analysis of Risk Factors of SkinAdverse Reactions by Intravenous Injection of Iodine ContrastAgent / 中国药房

OBJECTIVE：To investiga te main risk factors for adverse drug reactions （ADR）of skin by intravenous injection of iodine contrast agent. METHODS ：From Jan. 2009 to Apr. 2020，the patients suffering from skin ADR after enhanced CT with iodine contrast agent were collected from our hospital. The basic information ，laboratory test results before using iodine contrast agent and ADR related information were collected through hospital information system （HIS）. The use of iodine contrast agent ，main manifestations of skin ADR and drug combination were analyzed statistically. Taking the sex ，age，body mass index （BMI），the dosage of iodine contrast agent ，length of stay ，laboratory examination ，tumor history ，basic disease ，allergy history ，drinking history as independent variables ，the incidence of skin ADR related to iodine contrast agent was analyzed by single factor analysis ，and the variables with statistically significant were selected for multivariate Logistic stepwise regression analysis. RESULTS ：There were 157 cases of skin ADR ，involving 79 males（50.3％）and 78 females（49.7％）. The age ranged from 19 to 86 years old ，being（52.68± 18.73）years old in average. BMI was 14.6-40.7 kg/m2，being（22.5±3.7） kg/m2. 67 cases（42.68％）were treated with iprodione ，34 cases（21.66％）with iodixanol ，31 cases（19.74％）with iohexol and 25 cases（15.92％）with iopamidol ；the dose of iodine contrast agent were 50-100 mL，being（73.06±13.29）mL in average. There was no significant difference among different dosage of 4 kinds of iodine contrast agents （P≤0.05）. Among 4 kinds of iodine contrast agents ，the incidence of skin ADR induced by iopromide was the highest（0.197％）. The skin ADR related to iodine contrast agent was mainly acute （89.2％），the severity was mild （75.2％），and urticaria（38.9％）was the most common. After symptomatic treatment ，135 cases were cured ，13 cases were improved and 9 cases were not improved. Among the patients with iodine contrast agent related skin ADR ，the incidence of ADR induced by combined use of anti infective drugs was the highest （33.1％）；however，the combined use of anti-tumor drugs was the main cause of severe skin ADR. The length of stay ｛11～20 d[OR＝1.21，95％CI（1.07，1.20），P＝0.042]、21～30 d[OR＝1.39，95％CI（1.12，1.52），P＝0.035]、31～40 d[OR＝1.15，95％CI（1.03，1.37），P＝0.008]、＞40 d[OR＝1.33，95％CI（1.28，1.53），P＝0.003]｝，respitatory and circulatory system tumor history[OR ＝1.51，95％CI（1.35，1.61），P＝0.037]，injection allergy history[OR ＝1.50，95％CI（1.37，1.59），P＝0.005] can significantly increase the incidence of iodine contrast agent related skin ADR. CONCLUSIONS ：The main manifestation of skin ADR related to iodine contrast agent was urticaria. The main risk factors of skin ADR related to iodine contrast agent were length of stay （＞ 10 d），respiratory and circulatory system tumor history and injection allergy history.