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Objective To investigate the pollution of antibiotic resistance genes (ARGs) in the Lhasa River and provide a scientific basis for the safety of drinking water for the regional population and the prevention and control of water environment pollution. Methods A total of five water samples were collected in the Lhasa River in July 2022. Using quantitative real-time polymerase chain reaction (qPCR) assay, 19 types of ARGs, including eight “last-resort” ARGs (LARGs) were detected and analyzed. Statistical analysis was conducted using the SPSS 22.0 software, and Student's t-test was used to compare data between two groups. Results All the 19 ARGs were detected with high frequencies, with the aminoglycoside resistance gene aadA having the highest concentration, followed by the sulfonamide resistance gene sul1 and the macrolide resistance gene ermB. Among the eight LARGs, the carbapenem resistance gene blaOXA-48 had the highest concentration. The absolute and relative concentrations of LARGs were lower than those of common ARGs. There was a statistically significant difference in the absolute concentrations between them, but no significant difference was observed in the relative concentrations. Conclusion Both “conventional” ARGs and LAGRs have been detected in the Lhasa River. Although they are at a relatively low level compared to other domestic waters, in view of the serious adverse effects that ARGs, especially LARGs, may cause, the pollution of ARGs in the Lhasa River should be taken seriously.
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Objective:To analyze the influencing factors of thyroid volume in children aged 8 - 10 in Yunnan Province, and provide scientific basis for improving iodine deficiency disorders monitoring.Methods:From March to July 2020, in 129 counties (cities, districts) under the jurisdiction of Yunnan Province, each county (city, district) was divided into 5 sampling areas based on east, west, south, north, and middle. One township was selected from each area, and 40 non-boarding children aged 8 - 10 from one primary school were selected from each township (age balanced, half male and half female) as survey subjects. One random urine sample and household edible salt samples were collected for urine iodine and salt iodine testing, and physical examination and thyroid volume measurement were conducted for children. The influencing factors of thyroid volume were analyzed using Pearson correlation.Results:A total of 24 934 urine samples were collected from children, with a median urine iodine of 233.2 μg/L. A total of 24 933 household edible salt samples were collected from children, the median salt iodine was 24.17 mg/kg, and the qualified rate of iodized salt was 96.63% (24 003/24 839); A total of 24 937 children were examined of their thyroid gland, with a median thyroid volume of 2.62 ml and a goiter rate of 1.12% (280/24 937). Among them, there were 12 410 boys and 12 527 girls, with thyroid volumes of 2.61 and 2.64 ml, respectively. The thyroid volume of boys was positively correlated with age, height, weight, body mass index, body surface area, and salt iodine ( r = 0.15, 0.21, 0.26, 0.18, 0.25, 0.03, P < 0.001). The thyroid volume of girls was positively correlated with age, height, weight, body mass index, and body surface area ( r = 0.17, 0.26, 0.28, 0.17, 0.27, P < 0.001). Conclusion:Children aged 8 - 10 in Yunnan Province are at an iodine excess level; the age, weight, height, body mass index, and body surface area are influencing factors of thyroid volume.
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It remains unclear whether heart transplantation is still feasible on patients who develop neurological complications before surgery and underwent successful neurological treatment.This article reported the diagnosis and treatment process of a heart failure patient complicating with acute ischemic stroke,who underwent successful heart transplantation after thrombectomy for acute ischemic stroke,aiming to provide clinical evidence and decision-making plan on diagnosis and treatment options for this group of patients with severe neurological complications.
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Objective:To understand the contents of edible salt iodine and urinary iodine of children and pregnant women in Yunnan Province, and to evaluate the iodine nutrition status, so as to provide a basis for scientific prevention and treatment of iodine deficiency disorders (IDD).Methods:From November to December 2020, one county (city) was selected from each prefecture (city), two townships (towns and streets) were selected from each county (city) and two villages (neighborhood committees) were selected from each township (town and street) from each of the 16 prefectures (cities) in Yunnan Province as the investigation sites. A total of 20 non-boarding children (male and female balanced) aged 8 - 10 years old were selected from each primary school in each village (neighborhood committee) to collect salt and urine samples. A total of 80 children were investigated in each county (city). A total of 20 pregnant women were selected from each township (town and street) to collect salt and urine samples. A total of 40 pregnant women were investigated in each county (city). All salt samples and urine samples were tested for iodine contents.Results:A total of 2 009 salt samples and 2 041 urine samples (1 375 for children, 666 for pregnant women) were collected from children aged 8 - 10 years old and pregnant women in 16 counties (cities) of Yunnan Province. Among them, the median salt iodine was 26.0 mg/kg, the coverage rate of iodized salt was 100.0% (2 009/2 009), the qualified rate of iodized salt was 98.7% (1 982/2 009), and the consumption rate of qualified iodized salt was 98.7% (1 982/2 009). The difference of salt iodine content in key populations in different counties (cities) was statistically significant ( H = 258.98, P < 0.01). The median urinary iodine of children aged 8 - 10 years old was 188.5 μg/L. There was statistically significant difference in urinary iodine content among children of different ages ( H = 29.45, P < 0.01), but there was no statistically significant difference in urinary iodine content among children of different genders ( H = 1.43, P > 0.05). In addition, the median urinary iodine of pregnant women was 141.9 μg/L, 52.1% (347/666) was < 150 μg/L. There was statistically significant difference in urinary iodine content of pregnant women in different counties (cities, H = 88.32, P < 0.01). Conclusions:The qualified rate of iodized salt, the coverage rate of iodized salt and the consumption rate of qualified iodized salt in key populations of Yunnan Province are more than 90%, and the iodized salt supply is good. Iodine nutrition of children aged 8 - 10 years old is at an appropriate level (100 - 199 μg/L); iodine nutrition of pregnant women is in an state of iodine deficiency ( < 150 μg/L). It is suggested to strengthen IDD monitoring and health education among key populations, improve residents' awareness of disease prevention, and make scientific iodine supplementation.
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Objective:To explore the diagnosis and treatment of transplanted renal artery stenosis(TRAS)in children.Methods:From January 2016 to August 2021, clinical data of 7 TRAS patients were collected.A definite diagnosis was confirmed by Doppler ultrasound and computed tomography angiography.Results:Patient age was significantly higher than donor age(11.9±3.7 vs 1.0±0.5 years, P<0.001); 5 patients had a widened diameter at stenotic grafted renal artery after intervention(1.98±0.47 vs 4.64±1.19 mm, P=0.002). A reduction in peak systolic flow velocity in stenotic segment of artery(463.3±90.6 vs 183.6±58.9 cm/s, P<0.001)and lower systolic blood pressure(137.2±15.5 vs 129.7±12.3 mmHg, P=0.029)were observed.Resistance index rose(0.38±0.22 vs 0.60±0.03, P=0.063). Significant difference of estimated glomerular filtration rate was observed at Week 4 post-operation as compared with pre-intervention.Two patients developed complications after intervention, including perirenal hematoma and stent-attached thrombus.Two patients were treated conservatively with a gradual increase in blood pressure and three antihypertensive drugs prescribed. Conclusions:Doppler ultrasound should be performed regularly after renal transplantation for detecting TRAS at an early stage in children.Interventional treatment is ideal for severe TRAS to improve perfusion and renal function.Clinicians should pay more attention to complications.
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Objective:To observe and analyze the intervention effect of logotherapy on anxiety and depression in patients with chronic glomerulonephritis (CGN).Methods:Selected 102 CGN patients from March 2019 to May 2020 in Beijing Tiantan Hospital Affiliated to Capital Medical University as the research objects, the general information of the patients was collected, and the patients were randomly divided into the observation group and the control group with 51 cases in each group. The control group was given routine nursing intervention for CGN patients, and the observation group was given logotherapy therapy intervention based on the intervention of the control group. The differences in the scores of the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) between the two groups before and after 3 months of intervention.Results:There were no significant differences in SAS and SDS scores before and after intervention in the control group ( P>0.05). The SAS and SDS scores in the observation group after 3 months of intervention were (40.67 ± 4.17), (48.74 ± 5.01) points, which were significantly lower than (51.34 ± 5.04), (55.19 ± 5.49) points in the control group ( t=8.37, 3.32, both P<0.01). Conclusions:The positive psychological intervention of patients with logotherapy can effectively improve the anxiety and depression of patients with CGN.
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Objective:To explore the influence of short-time pasteurization (62.5±0.5℃ for 5 s) on the main bioactive components and immune cells in human breast milk.Methods:Fresh breast milk was collected from 53 women whose premature infants were admitted to the neonatal intensive care unit of the Children's Hospital of Fudan University from May 2020 to October 2020. Each sample (20 ml) was divided into unsterilized, Holder pasteurized (62.5 ℃ for 30 min), or short-time pasteurized groups. The concentration of secretory immunoglobulin A (sIgA), lactoferrin (LTF), lysozyme (LZM), and insulin-like growth factor binding protein-3 (IGFBP-3) in breastmilk whey were detected by enzyme-linked immunosorbent assay and the number of viable immune cells (leukocytes, monocytes, T cells, and B cells) in breastmilk by flow cytometry.Results:(1) A total of 87 breast milk samples were collected. The levels of sIgA, LTF, and LZM were the highest in the unsterilized group, followed by the short-time and Holder pasteurized group [0.42 mg/ml (0.33-0.65 mg/ml) vs 0.40 mg/ml (0.28-0.62 mg/ml) and 0.25 mg/ml (0.17-0.37 mg/ml); (3.57±1.06) vs (3.53±1.11) and (0.85±0.58) mg/ml; 128.60 μg/ml (77.18-203.00 μg/ml) vs 121.70 μg/ml (68.66-188.20 μg/ml) and 83.40 μg/ml (47.40-151.40 μg/ml); all P<0.05]. There was no significant difference in the level of IGFBP-3 among the groups. The median retention rates of sIgA, LTF, and LZM in the Holder pasteurized group were all lower than those in the short-time pasteurized group [55.87% (46.01%-71.41%) vs 96.93% (83.03%-115.90%); 21.72% (12.54%-29.42%) vs 97.88% (88.98%-104.30%); 69.26% (49.42%-89.08%) vs 93.80% (74.85%-110.20%); all P<0.05]. No significant difference in the level of preserved IGFBP-3 was observed between the three groups ( P>0.05). (2) The number of viable leukocytes, monocytes, T cells, and B cells in the Holder pasteurized group were lower than those in the unsterilized group [leukocytes: 185.50 (87.00-356.50) vs 1 271.00 (540.50-2 283.00); monocytes: 12.00 (6.00-16.75) vs 266.00 (137.30-518.80); T cells: 1.00 (0.00-2.00) vs 47.50 (28.50-116.00); B cells: 1.00 (0.00-1.75) vs 21.00(10.00-41.50); all P<0.05]. The percentage of viable leukocyte to the total leukocyte and the viable monocytes, T cells, and B cells to the viable leukocytes were lower in the Holder pasteurized group than those in the unsterilized group [24.80%(16.00%-36.80%) vs 74.20%(63.55%-86.45%); 5.91%(4.09%-8.77%) vs 21.90%(17.40%-29.30%); 0.31%(0.00%-1.31%) vs 4.00%(2.69%-6.43%); 0.30%(0.00%-0.86%) vs 1.27%(0.57%-2.85%); all P<0.05]. A similar trend was observed between short-time pasteurization and unsterilized groups (all P<0.05). (3) The percentages of viable monocytes, T cells, and B cells in their subsets were lower in both Holder and short-time pasteurized groups than those in the unsterilized group [2.94%(1.33%-7.14%) vs 9.72%(5.77%-16.00%) and 52.60%(31.35%-68.75%); 0.00%(0.00%-1.61%) vs 0.49%(0.00%-2.53%) and 28.10%(10.55%-57.00%); 0.00%(0.00%-0.83%) vs 0.24%(0.00%-2.47%) and 13.80%(3.27%-41.00%); all P<0.05].The number and percentage of viable leukocytes in total leukocytes and viable monocytes in total monocytes [leukocytes: 279.50(116.80-548.50), 32.20%(20.70%-45.75%); monocytes: 32.00(21.00- 83.75),15.60%(11.10%-19.15%)] were higher than those in the pasteurized group (all P>0.05). The short-time pasteurized group was noted only for a higher percentage of the viable monocytes to viable leukocytes than the Holder pasteurized group (all P<0.05). Conclusions:Compared with the Holder pasteurization, sIgA, LTF, LZM level, and monocyte activity in breast milk can be better preserved by short-time pasteurization.
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Objective:To investigate the development and maturation process of intestinal organoids in neonatal mice so as to provide a new model for research on perinatal/neonatal intestinal epithelial development and related diseases.Methods:Intestinal tissue of 3-day-old C57BL/6 mice were collected and cultured for mouse intestinal organoids (MIOs) under standard conditions down to the fifth generation. The morphological changes of MIOs were observed and recorded using inverted phase contrast microscope. Real-time fluorescent quantitative polymerase chain reaction and immunofluorescence technique were used to detect the expression and location of markers of intestinal stem cells and differentiated cells of intestinal epithelium among different generations of MIOs (Selected marker genes: Lgr5 for intestinal stem cells, Tpm2 and Gja1 for fetal intestinal progenitor cells, Villin for intestinal epithelial cells, Lyz1 for Paneth cells, Muc2 for goblet cells, Chga for endocrine cells; Selected marker proteins: villin for intestinal epithelial cells, mucin 2 for goblet cells, chromaffin A for endocrine cells, lysozyme for Paneth cells). One-way analysis of variance and Bonferroni test were adopted for statistical analysis. Results:Two types of MIOs were observed, immature spheroid and mature organoids with crypt-villus structure. Spheroid was the main form in the primary culture. From primary to the second generation, the proportion of spheroids decreased from (96.61±1.36)% to (8.93±1.50)%, and so did the size ( F=12.88, P<0.001). During the second to the fifth generation, mature organoid, as the main form, increased from (91.07±1.50)% to (95.56±2.14)%. The expression of intestinal stem cell marker Lgr5 in the second generation decreased to 0.40±0.06 times of the primary one ( F=76.75, P<0.001) and then increased after this period. The expression of fetal intestinal progenitor markers Tpm2 decreased significantly during the passage (primary generation: 1.00±0.11, the fifth generation: 0.003±0.001, F=148.00, P<0.001); And the expression of Gja1 decreased from primary generation (1.00±0.14) to the second generation (0.06±0.04) ( F=197.10, P<0.001), but kept stable from the second to fifth genetation ( F=2.20, P=0.13). The expressions of gene markers of differentiated cells in intestinal epithelium, including enterocytes, goblet cells, endocrine cells, and Paneth cells, increased after the second generation (the second generation: Villin: 0.46±0.11; Muc2: 0.68±0.29; Chga: 2.53±0.16; Lyz1: 0.98±0.21; the fifth generation: Villin: 1.02±0.05; Muc2: 8.79±0.61; Chga: 4.32±0.45; Lyz1:3.81±0.36; all P<0.05). Immunofluorescence showed that villin, the intestinal epithelial cell marker protein, was distributed along the villus-side of MIOs in primary and the fifth generation culture. Mucin 2 from goblet cell and chromaffin A from endocrine cell expressed at a very low level in the primary generation, while higher in the fifth generation. In the primary culture, lysozyme from Paneth cell was evenly distributed in organoid cells, and high fluorescent dot-shaped expression was observed in the fifth generation. Conclusions:The development and maturation of immature intestinal epithelium can be simulated by continuous culture of neonatal MIOs. MIOs between the primary and second generation could be used as a research model for development of perinatal intestinal epithelium, and the second to the fifth generation as a model for neonatal intestinal diseases studies.
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Objective@#To explore the fear of evaluation in college student with social anxiety, in order to reveal the existence of implicit fear of evaluation and its relationships with explicit fear of evaluation.@*Methods@#A total of 490 college students, selected from Fuzhou University by using convenience cluster sampling method, were surveyed with Interaction Anxiousness Scale (IAS). Finally, 65 valid subjects have completed the Implicit Association Test.@*Results@#Social anxiety students explicit fear of evaluation was significantly higher than those of non social anxiety college students, including positive and negative ( t =7.03, 5.66 , P <0.01). There were significant differences between self positive evaluation of college students social anxiety (1 019.26±124.44 ms) and self neutral evaluation (909.78±175.20 ms)( t =5.67, P <0.05). In two groups of college students, there were significant differences between self negative evaluation[(1 142.54±157.06, 1 120.88± 216.33 )ms] and self neutral evaluation[(921.53±161.28, 783.72±140.74)ms]( t =9.17, 12.33, P <0.01). Implicit fear of evaluation were found to exist among students with social anxiety and without social anxiety. There was a low correlation between explicit and implicit fear of evaluation between social anxiety students and non social anxiety students( P >0.05); There was no significant gender difference between implicit and explicit fear of evaluation( P > 0.05 ).@*Conclusion@#Social anxiety college students have explicit and implicit fear of evaluation, with separate and independent effects.
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Recent studies have revealed that human milk harbors stem cells at various stages of differentiation,including pluripotent stem cells,hematopoietic stem cells and mesenchymal stem cells.The stem cellular components of human milk with high interindividual variability are affected by gestational age and lactation stages.The maternal stem cells which pass to the infant through human milk could help boost offspring growth and development.Human milk stem cell with multi-directional differentiation potential may be a new source of stem cell replacement therapy in the future.We hereby review the latest progress in human milk stem cells from these aspects.
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Objective To explore the value of transseptal puncture for left-sided accessory pathway in radio-frequency catheter ablation in children with paroxysmal supraventricular tachycardia(PSVT). Methods Thirty-three patients with PSVT who had underwent radiofrequency catheter ablation in the First Affiliated Hospital,Sun Yat-Sen University from January 2012 to December 2017 were retrospectively analyzed. All the cases were treated by transaortic approach(transaortic group)or transseptal approach(transseptal group). The immediate success rates,total fluoroscopy time and radiation exposure between 2 groups were compared,and the perioperative complications and recurrence rates were observed between 2 groups. Results Thirty-three cases of children were enrolled,22 cases were male and 11 cases were female. Nineteen cases were treated by transaortic approach(transaortic group),while 18 cases were treated by transseptal approach(transseptal group),including 4 recurrent cases in the transaortic group who were switched to transseptal approach because of previous treatment failure. The age was(10. 16 ± 3. 06)years and(10. 67 ± 2. 20) years,and the weight was(37. 68 ± 14. 28)kg and(37. 33 ± 8. 64)kg,respectively. There were no significant diffe-rences in age and weight statistics between 2 groups(all P>0. 05). The total fluoroscopy time was(20. 16 ± 11. 41) minutes and(12. 56 ± 5. 23)minutes,and the median dose of radiation exposure was 67. 0 mGy and 33. 5 mGy,re-spectively. The postoperative recurrence rate was 21%(4/19 cases)and 0(0/18 cases),respectively. There were sig-nificant differences in total fluoroscopy time,radiation exposure and recurrence rate statistics between 2 groups( t =2. 627,Z= -2. 31,χ2 =4. 249,all P<0. 05). No complications were found in both 2 groups. Conclusions It is safe and feasible by transseptal puncture for left-sided accessory pathway in radiofrequency catheter ablation in children with PSVT. Radiofrequency catheter ablation by transseptal approach could significantly reduce the postoperative recu-rrence rate,and should be the first choice for left-side accessory pathway in children.
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Objective To study the urinary iodine and serum thyroid stimulating hormone (TSH) and thyroglobulin (Tg) levels in adult women (pregnant women, lactating women, childbearing age women) in Dali City, Yunnan Province, and to explore the feasibility of TSH and Tg as indicators for iodine nutrition evaluation in pregnant women. Methods From July to December 2014, from the five districts of east, west, south, north and middle district of Dali City, Yunnan Province, one township ( town ) was selected , and 20 pregnant women in the early, middle and late stages, respectively, 20 lactating women, 20 childbearing age women were selected from each township ( town ) , collected urine and blood samples , and urinary iodine , serum TSH and Tg levels were detected. Results The medians urinary iodine (MUI) in different populations were 136.85μg/L for pregnant women (n = 356 ) , 102 . 63 μg/L for lactating women ( n = 111 ) , 166 . 21 μg/L for childbearing age women ( n = 98 ) . The medians TSH in pregnant women (n = 368), lactating women (n = 112) and childbearing age women (n = 96) were 1.995, 2.345 and 2.565 mU/L, respectively, the difference between the different populations was statistically significant(χ2=16.128, P<0.05). The medians Tg of pregnant women, lactating women and childbearing age women were 10.49, 9.28 and 9.66μg/L, respectively, the difference between the three groups was not statistically significant (χ2 = 2.083, P > 0.05). A total of 120, 126, and 122 cases of pregnant women in the early, middle, and late stages were investigated. The medians TSH of early, middle and late pregnancy were 1.850, 2.030 and 2.235 mU/L, respectively, the difference between the different stages of pregnancy was statistically significant (χ2 = 6.970, P <0.05). The medians Tg of early, middle and late stages were 10.56, 10.78 and 10.08 μg/L, respectively, the difference between the different stages of pregnancy was not statistically significant (χ2= 1.058, P > 0.05). Conclusions Tg levels are stable in the different stages of pregnancy women and it can be considered as an indicator of iodine nutrition evaluation in pregnant women.
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Objective To investigate the changes in neutrophil immunophenotypes in neonates with late-onset sepsis and their clinical significance.Methods A total of 42 neonates with late-onset sepsis were enrolled prospectively as sepsis group from Children's Hospital of Fudan University from January 2015 to October 2016,which included 26 preterm infants and 16 term infants.Another 33 neonates without infectious diseases consisting of 20 preterm infants and 13 term infants were selected as control group.According to the severity of sepsis,neonates in the sepsis group were further divided into severe (n=11)and mild sepsis (n=31) subgroups.Expression of CD16 and CD62L on neutrophils was measured by flow cytometry to determine the distribution of neutrophil subsets in neonatal peripheral blood.Differences in the distribution of neutrophil subsets between the two groups and two subgroups were compared using Wilcoxon rank-sum test.Multivariate logistic regression analysis was used to investigate the relationship between neutrophil subsets and the severity of neonatal sepsis.Receiver operating characteristic (ROC) curves were used to assess the diagnostic value of neutrophil subsets for the severity of sepsis.Results Four neutrophil subsets were identified in neonatal peripheral blood,including early-stage neutrophils (CD16-/CD62L-),immature neutrophils (CD16-/CD62L+),mature neutrophils (CD16+/CD62L+) and activated neutrophils (CD16+/CD62L-).Activated [preterm:61.1% (20.2%-79.4%),term:47.6% (15.2%-70.1%)] and mature neutrophils [preterm:35.7% (19.9%-75.8%),term:52.0% (25.6%-82.8%)] were the dominant subsets in the control group.In preterm infants,the proportion of early-stage [3.5% (1.7%-9.4%) vs 1.9% (0.6%-4.0%),Z=-2.501,P=0.012] and immature neutrophils [6.3% (0.7%-45.5%) vs 0.4% (0.3%-0.7%),Z=-3.878,P<0.001] were higher,but that of activated neutrophils [8.3% (2.3%-49.2%) vs 61.1% (20.2%-79.4%),Z=2.991,P=0.002] were lower in the sepsis group than those in the control group;same differences were found in the absolute counts of each neutrophil subsets.Among term infants,more immature neutrophils were found in the sepsis group than those in the control group [49 (18-200) vs 13 (5-36)/μl,Z=-2.193,P=0.028].The proportion and the absolute counts of early-stage and immature neutrophils in the severe sepsis subgroup were all higher than those in the mild cases [early-stage neutrophils:5.8% (3.4%-17.8%) vs 3.0% (1.4%-7.3%),304 (137-1478) vs 158 (53-321)/μl;immature neutrophils:23.0% (6.3%-47.0%) vs 0.9% (0.5%-6.8%),1003 (487-2818) vs 85 (18-275)/μl;all P<0.05].Multivariate logistic regression analysis showed that the proportion of early-stage neutrophils was associated with the severity of sepsis (OR=1.2,95%CI:1.0-1.4,P=0.012).In addition,the diagnostic value of the proportion of early-stage neutrophils for severe sepsis was the highest when the cut-off value was 3.3%,with the area under the ROC curve was 0.7 (95%CI:0.6-0.9),sensitivity of 81.8% (95%CI:48.2%-97.7%) and specificity of 62.3% (95%CI:42.2%-78.2%).Conclusions There are four neutrophil subsets in the peripheral blood of neonates and autoactivation of neutrophils may exist.With the onset of sepsis,neutrophil subsets react differently between preterm and term infants.The proportion of early-stage neutrophils may be correlated with the severity of neonatal sepsis,which may have a predictive value for severe sepsis.
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Objective After implementation of new standard iodized salt,to comprehensively assess the iodine nutrition levels of different populations in Dali City of Yunnan Province.Methods From 2012 to 2015,in Dali City,there were 5 districts divided into east,west,south,north and middle,each district selected 1 township (town),and each township (town) selected 4 administrative villages,15 households for edible salt in each administrative village were sampled,and the salt iodine content was measured by "General Test Method in Salt Industry Determination of Iodine" (GB/T 13025.7-2012).In 2014,in the five districts of east,west,south,north and middle of Dali City,one township (town) was selected,and 20 pregnant women in the early,middle and late stages,respectively,20 lactating women,20 ordinary healthy adults and 20 children aged 0 to 4 were selected from each township (town);one primary school in each township (town) was selected in each district,and 40 students aged 8-10 years old were selected from each primary school as the survey objects.The urine samples of the survey objects were collected,and the urinary iodine content was measured by "Method for Determination of Iodine in Urine by As3+-Ce4+ Catalytic Spectrophotometry" (WS/T 107-2006).In 2015,in each administrative village of Dali,a water source with the largest number of drinking people was investigated,and water iodine was detected by the "Method of Water Iodine Detection Suitable for Iodine Deficiency and High Iodine Areas".Through questionnaires,the sources of iodine supplementation for pregnant and lactating women were investigated.Results The qualified iodized salt consumption rate of residents was higher than 90% per year from 2012 to 2015,and median of salt iodine decreased from 29.38 mg/kg (2012) to 24.96 mg/kg (2015).The medians of urinary iodine in different populations were 136.85 μg/L for pregnant women (n =356),102.63 μg/L for lactating women (n =111),164.03 μg/L for adults (n =163),209.61 μg/L for 8-10 years old children (n =200),157.27 μg/L for children aged 0-< 2 years old (n =57),and 134.08 μg/L for 2-4 years old children (n =50).The median of iodine content of drinking water (n =142) in Dali was 0.62 μg/L,the range of iodine content was 0.00-9.92 μg/L.The average intake frequencies of iodine-rich seaweed for pregment women and lacting women were 0.99,1.07 time/month,respectively,only 1.99% (9/453) of the population supplemented iodine through multivitamin and minerals tablets.Conclusions After reduction of salt iodine content,the iodine nutrition of populations in Dali City (a low water iodine region) is generally at an appropriate level.Maintaining a higher level of qualified iodized salt consumption rate,strengthening the monitoring of different populations and promotion of healthy behaviors are key steps in prevention and control of the disease in the future.
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Objective To provide a reference for the individualized medication of tacrolimus in children after living related liver transplantation,according to the effect of CYP3A5 genotyping on the concentration/dose ratio of tacrolimus in children with living related liver transplantation.Methods Peripheral blood samples were collected from children with living related liver transplantation in the transplant center.The CYP3A5 genotype was determined by polymerase chain reaction (PCR)pyrosequencing.Related indicators such as tacrolimus dose and concentration in children with living related liver transplantation were collected within 3 months after operation.According to the donor/receptor genotype,the donor/receptor expression group,the donor/receptor single expression group,and the donor/receptor non-expression group were set up.Tacrolimus concentration/dose (C0/D) ratio was statistically analyzed at 5th day,7th day,14th day,28th day,2nd month and 3rd month after administration.Results Among the 76 patients,there were 21 patients (27.63%) in CYP3A5 donor/receptor non-expression group,27 patients (35.53%) in donor/receptor single expression group,and 28 patients (36.84%) in the donor/receptor expression group.The time to the target concentration range (C0>8 ng/mL) in CYP3A5 donor/receptor expression group was longer than in donor/receptor single expression group and donor/receptor non-expression group.Except for the individual time points,there were significant differences between CYP3A5 donor/receptor expression group and donor/receptor non expression group,or between donor/receptor non-expression group and donor/receptor single expression group,or between donor/receptor expression group and donor/receptor single expression group at rest time points (P<0.05 for all).Conclusion In the CYP3A5 donor/receptor gene expression group,the higher dose was needed to reach the target concentration range than the gene single expression group and the donor/receptor non-expression group.Except for individual time points,there were significant differences in C0/D at rest different time points.Regardless of whether the donor or recipient contained the CYP3A5* 1 allele,C0/D was lower than the non-expressed type of the gene.Considering the polymorphism of the donor/receptor CYP3A5 gene,it was worthful for children with living related liver transplantation to allow the drug concentration to reach the therapeutic window as soon as possible and reduce organ rejection and adverse reactions.
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Objective To assess medication literacy status of outpatients and analyze the effect of medication literacy on medication adherence. Methods Outpatients were investigated with Medication Literacy Assessment scale and Medication Adherence Scale in Tianjin Chest Hospital, Tianjin Huanhu Hospital and the Second Hospital of Tianjin Medical University in August 2017. Results The average score of Medication literacy scale of 200 outpatients was 7.60 ± 2.98. There were significant differences among the scores of Medication Literacy Assessment scale of different ages(F=9.444, P<0.05) and education levels(F=26.682, P<0.05). Logistic regression analysis showed that medication literacy had an impact on medication adherence in outpatients (P<0.05). The medication compliance of outpatients with high medication literacy was 2.336 times as high as who with medium medication literacy and 18.529 times as high as who with low medication literacy, and the medication compliance of outpatients with medium medication literacy was 7.925 times as high as who with low medication literacy. Conclusion The medication literacy of outpatients was at the middle level, and most of the outpatients were poor in adherence. The higher the medication literacy level was, the better the medication adherence was; the lower medication literacy level was, the poorer medication adherence was. The medical staff could improve the medication adherence by improving the medication literacy to ensure the health of outpatients.
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Objective To investigate the value of pulmonary function tests during the early periods in the diagnosis and treatment of children with refractory mycoplasmapneumoniae pneumonia.Methods The clinical data of 67 children with refractory mycoplasma pneumoniae pneumonia (RMPP) and non-refractory mycoplasma pneumoniae pneumonia(non-RMPP) were retrospectively analyzed in the Department of Pediatrics,Shenyang Hospital of China Medical University.Thirty RMPP and 37 non-RMPP were detected by lung function test in the acute and recovery phase.Results The pulmonary function index (FVC、FEV1、PEF、MEF75、MEF50、MEF25 、MMEF75/25)of acute phase more decreased than recovery phase in PMPP group,and the same as nonRMPP group(P < 0.05).In the acute phase,pulmonary function index (FVC、FEV1、PEF、MEF75、MEF50、MEF25 、MMEF75/25) of RMPP group decreased more than non-RMPP group (P < 0.05).In the recovery phase,pulmonary function index (FVC 、FEV1 、PEF、MEF75 、MEFS0、MEF25 、MMEF75/25) of RMPP group decreased more than non-RMPP group (P < 0.05).The pulmonary function index (FVC、FEV1、PEF、MEF75、MEF50 、MEF25 、MMEF75/25)of recovery phase of RMPP and non-RMPP group decreased more than control group (P < 0.05).Conclusion Early and dynamic detection of the pulmonary function index in MPP is beneficial to identify the RMPP earlier,and necessary to give intervention treatment,in order to prevent the occurrence of complications.
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Objective To investigate the characteristics and risk factors for cognitive decline in elderly patients with cerebral infarction.Methods A cross-sectional study was performed to investigate the population of Jiang'an Town,Rugao,Jiangsu Province from November 13,2014 to December 21,2014.The samples from the Rugao longitudinal study of aging included 1 788 individuals from 31 villages aged from 70 to 84 years.They were all Han nationality,including 830 males and 958 females.History of cerebral infarction was identified according to the neurological diagnosis confirmed by the secondary hospital and above or brain CT.The modified Kyohko Hasegawa dementia scale was used to evaluate the cognitive function.Five dimensions (orientation,memory,near memory,computing power,and common sense) of this population were assessed.The total score >21.5 was non-cognitive impairment and ≤21.5 was cognitive impairment.Multivariate logistic regression was used to analyze the risk factors for cognitive decline in elderly patients with cerebral infarction.Results (1) In the 1 788 subjects,133 had cerebral infarction (7.4%),and 1 655 did not have cerebral infarction.The proportion of hypertension in patients with cerebral infarction was higher than that without cerebral infarction (63.9% [n=85] vs.41.7% [n=690]).The high-density lipoprotein cholesterol level was lower than that of the non-cerebral infarction group (1.40±0.29 mmol/L vs.1.47±0.33 mmol/L).There was statistically significant difference (all P<0.05).(2) The patients with cerebral infarction were partially impaired in orientation and computational power,and the overall cognitive function score was 20±7,which was significantly lower than patients with non-cerebral infarction (21±6).The difference between the two groups was statistically significant (P<0.05).(3) In 133 patients with cerebral infarction,76 had cognitive impairment,the incidence was 57.1%,and 59 of them were women.The average value of serum creatinine in patients with cognitive impairment was 59±15 μmol/L,which was significantly lower than those with non-cognitive impairment (66±14 μmol/L).There was significant difference (P<0.05).(4) Multivariate logistic regression analysis showed that the education level below primary school (OR,2.86,95%CI 2.19-3.72) and female (OR,1.85,95%CI 1.50-2.28) were the independent risk factors for cognitive decline in elderly patients with cerebral infarction.High serum creatinine concentration (OR,0.96,95%CI 0.95-0.97) was a protective factor for it.Conclusion The cognitive function of the elderly was decreased after cerebral infarction,especially in the aspect of orientation and calculation.The education level below primary school and women were the independent risk factors for cognitive impairment,and high serum creatinine concentration had a certain protective effect.
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Objective To investigate the relationship between CYP3A5 gene polymorphism and tacrolimus concentration/dose ratio in children living donor liver transplantation and the correlation with clinical efficacy,for the relatives living donor liver transplantation in children tacrolimus individualized medication providing reference indicators.Methods Peripheral blood samples were collected from children with relatives living donor liver transplantation in the center of liver transplantation,the genotype of CYP3A5 was determined by polymerase chain reaction (PCR)/pyrophosphate sequencing,The dosage of tacrolimus and blood concentration,liver and kidney function and other related indicators were measured within 3 months after operation According to genotypes,the children can be divided into gene expression group (CYP3A5 *1/*1 and CYP3A5 *1/*3) and non-expression group (CYP3A5*3/*3).The drug concentration (C0),tacrolimus dose / body weight (D/W) ratio,drug concentration/dose (C0/D) ratio of each genotype at 1 day,3 d,5 d,7 d,14 d,28 d,2 months and 3 months after administration and the genotype at the time point on liver and kidney function was carried out statistics.Results Among the 80 cases,36 cases (45.0%) were CYP3A5*3/*3,37 cases (46.2%) were CYP3A5*1/*3,7 cases (8.8%) were CYP3A5*1/*1.CYP3A5 gene expression group reached a therapeutic concentration range (C0 > 8 μg/L) than the gene non-expression group takes longer time.There was no significant difference in CYP3A5 gene expression group between the non-expression group on the initial dose (P> 0.05);CYP3A5 gene expression group than the non-expression group,tacrolimus C0 within 1 month after operation were statistically significant.CYP3A5 gene expression group than the non-expression group,tacrolimus D/ W in addition to the first day after surgery,other time points were statistically significant (P<0.05).CYP3A5 gene expression group than the non-expression group,C0/D at the above time points were statistically significant (P<0.05);There were no significant differences in liver and kidney function between the two genotypes (P > 0.05),but there was significant difference in the alkaline phosphatase.Conclusion CYP3A5 gene expression in children than non-expression group of children need higher doses to reach the therapeutic drug concentration;CYP3A5 gene polymorphism had significant effects on early tacrolimus C0,D/W and C0/D values;CYP3A5 gene polymorphism is instructive for the administration of tacrolimus in children with living donor liver transplantation,CYP3A5 gene type tests should be regular,improve efficacy and reduce the incidence of adverse reactions.
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Objective To analyze the clinical characteristics of urinary tract infection after kidney transplantation and to analyze the distribution of pathogenic virulence factors.Methods From January 2014 to June 2016,a total of 255 cases were subjected to DCD renal transplantation in our center,and 45 cases of urinary tract infection occurred after operation.Among them,urinary tract E.coli infection occurred in 32 cases.The virulence factors gene aer,hly,irp2 and iucD in the 32 strains of E.coli isolated from urine were tested using PCR and multiple PCR.Results Thirty-two cases (71.1%) of urinary tract infection after renal transplantation was caused by E.coli,and divided into 9 cases of nosocomial infection group,and 23 cases of community-acquired group.The positive rate for aer,hly,irp2 and iucD in Nosocomial infection group was 66.7%,33.3%,88.9% and 77.8%,and that in community-acquired group was 30.4%,8.70%,39.1% and 34.7%,respectively.There were statistically significant differences among four kinds of virulence factors between two groups (P<0.05).The positive rate of virulence factors was significantly higher in nosocomial infection group than in community-acquired groups.The total resistance rate was 84.38%,and there was significarit difference in multi-drug resistance rate between two groups (P<0.01).Conclusion E.coli is the main pathogenic bacteria of urinary tract infection after renal transplantation,especially nosocomial infections.The detection rate of virulence factor is high,and the multiple drug resistance is outstanding,so the attention should be paid clinically.