Impact of therapeutic plasma exchange intervention timing and liver injury periodization on the prognosis of patients with exertional heat stroke / 中国输血杂志

【Objective】 To explore the prognostic impact and clinical application value of therapeutic plasma exchange(TPE) intervention timing and liver injury periodization in patients with exertional heat stroke(EHS). 【Methods】 Data of 127 EHS patients from the First Medical Center of the General Hospital of the People′s Liberation Army from January 2011 to December 2023 were collected, then divided into the death group and the survival group based on therapeutic outcomes and into 5 stages according to the dynamic changes of ALT, AST, TBIL and DBIL. According to propensity score matching analysis, 11 patients in the survival group and 12 patients in the death group were included in the statistical analysis, and 20 of them were treated with TPE. The changes in indicators and clinical outcomes before and after TPE were observed, in order to evaluate the impact of intervention timing on prognosis. 【Results】 Among the 23 patients, 14 had no liver injury or could progress to the repair phase, resulting in 3 deaths(with the mortality rate of 21.43%), while 9 patients failed to progress to the repair phase, resulting in 9 deaths(with the mortality rate of 100%), with significant differences(P<0.05). The mortality rate of the first TPE intervention before the third stage of liver injury was 23.08%(3/13), while that of intervention after reaching or exceeding the third stage was 85.71%(6/7), and the difference was statistically significant(P<0.05). 【Conclusion】 TPE should be executed actively in EHS patients combined with liver injury before the third phase to lock its pathological and physiological processes, thereby improving prognosis and reducing mortality.

Application of Pentacam TNP in calculating the intraocular lens power after corneal refractive surgery / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To assess the accuracy of predicting intraocular lens(IOL)power after myopic refractive surgery using the Pentacam system's true net power(TNP)in the 3 mm zone combined with the SRK/T formula [i.e. TNP 3 mm(SRK/T)].METHODS: Retrospective study. This study enrolled 35 cases(50 eyes)of patients undergoing cataract surgery after laser assisted in situ keratomileusis(LASIK)or photorefractive keratectomy(PRK)from July 2019 to December 2021. Preoperatively, IOL power of 50 eyes, 34 eyes and 41 eyes was calculated by TNP 3 mm(SRK/T), Barrett True-K and Olsen 2 formulas, respectively, with at least 2 formulas used to calculate IOL power for each patient. The actual diopter was recorded 3 mo postoperatively. Prediction errors(PE)of IOL power were compared among the three calculation methods, and the proportion of eyes with PE within ±0.5 D and ±1.0 D was analyzed.RESULTS: The PE at 3 mo postoperatively for TNP 3 mm(SRK/T), Barrett True-K, and Olsen 2 was -0.02±0.63, -0.54±0.80, and 0.25±0.80 D, respectively(P&#x003C;0.001). The proportions of PE within ±0.5 D were 66%(33/50), 44%(15/34)and 37%(15/41), respectively(P&#x003C;0.05); the proportions of PE within ±1.0 D were 88%(44/50), 71%(24/34)and 80%(33/41), respectively(P&#x003E;0.05).CONCLUSION: The Pentacam TNP 3 mm(SRK/T)method is simple to operate and provides accurate calculation of IOL power after corneal refractive surgery.

A case report of anti-NMDAR encephalitis complicated with acute peripheral nerve damage / 中国综合临床

N-methyl-D-aspartate receptor (NMDAR) encephalitis in combination with acute peripheral nerve damage is rare. A young female patient with anti-NMDAR encephalitis was admitted to Qianfoshan Hospital in Shandong Province on October 23, 2022. The main manifestations were abnormal mental behavior, consciousness disorders, and flaccid paralysis. Electromyography indicated axonal damage to the upper and lower extremities. Patient was in critical condition and admitted to the ICU with tracheal intubation for central hypoventilation. A combination of critical polyneuropathy was considered. The prognosis was good after hormone shock, immunosuppressive therapy, surgical therapy, anti-infection, respiratory support and symptomatic support. The diagnosis of anti-NMDAR encephalitis with acute peripheral nerve damage is difficult. Immune factors need to be considered and paraneoplastic syndrome should be differentially diagnosed.

Epidemiological features of pathogens of acute respiratory tract infection in children in Guangzhou area from 2018 to 2021 / 中华传染病杂志

Objective:To investigate the epidemiology of pathogens of acute respiratory tract infection (ARTI) in children in Guangzhou area.Methods:A total of 13 610 hospitalized children with ARTI in Guangzhou Women and Children′s Medical Center from January 2018 to December 2021 were enrolled. Throat swab specimens were collected, and fluorescent quantitative polymerase chain reaction (PCR) was performed to detect 11 respiratory pathogens, including respiratory syncytial virus (RSV), adenovirus (ADV), parainfluenza virus (PIV), human rhinovirus (HRV), human bocavirus (HBoV), human metapneumovirus (HMPV), enterovirus (EV), influenza A virus (IFA), influenza B virus (IFB), Mycoplasma pneumoniae (MP) and Chlamydia pneumoniae (CP). Grouping according to age (< one year group, one to < three years group, three to < six years group, six to 14 years group) and season. Chi-square test was used for statistical analysis. Results:At least one pathogen was detected in 6 331 cases among 13 610 patients, and the overall positive rate was 46.52%. The detection rates from high to low were as follows: RSV (13.75%(1 872/13 610)), ADV (4.82%(656/13 610)), PIV (4.82%(656/13 610)), MP (4.54%(618/13 610)), HRV (3.39%(462/13 610)), HBoV (2.64%(359/13 610)), HMPV (2.59%(352/13 610)), EV (1.76%(239/13 610)), IFA (1.29%(176/13 610)), IFB (0.90%(122/13 610)) and CP (0.30%(41/13 610)). The positive rate of viral detection showed significant differences among different age groups ( χ2=49.91, P<0.001), and the highest positive rate was in the age group of one to <three years (50.83%(2 196/4 320)). The positive rate of viral detection showed a significant difference in terms of seasonal distribution ( χ2=13.90, P=0.003), with a peak prevalence in summer (48.76%(1 498/3 072)). Conclusions:RSV, ADV, PIV, MP and HRV are important pathogens causing ARTI in children in Guangzhou area. The distribution of pathogens in children with ARTI is associated with age and season.

Prediction of EGFR mutant subtypes in patients with non-small cell lung cancer by pre-treatment CT radiomics and machine learning / 中华放射医学与防护杂志

Objective:To evaluate the feasibility and clinical value of pre-treatment non-enhanced chest CT radiomics features and machine learning algorithm to predict the mutation status and subtype (19Del/21L858R) of epidermal growth factor receptor (EGFR) for patients with non-small cell lung cancer (NSCLC).Methods:This retrospective study enrolled 280 NSCLC patients from first and second affiliated hospital of University of South China who were confirmed by biopsy pathology, gene examination, and have pre-treatment non-enhanced CT scans. There are 136 patients were confirmed EGFR mutation. Primary lung gross tumor volume was contoured by two experienced radiologists and oncologists, and 851 radiomics features were subsequently extracted. Then, spearman correlation analysis and RELIEFF algorithm were used to screen predictive features. The two hospitals were training and validation cohort, respectively. Clinical-radiomics model was constructed using selected radiomics and clinical features, and compared with models built by radiomics features or clinical features respectively. In this study, machine learning models were established using support vector machine (SVM) and a sequential modeling procedure to predict the mutation status and subtype of EGFR. The area under receiver operating curve (AUC-ROC) was employed to evaluate the performances of established models.Results:After feature selection, 21 radiomics features were found to be efffective in predicting EGFR mutation status and subtype and were used to establish radiomics models. Three types models were established, including clinical model, radiomics model, and clinical-radiomics model. The clinical-radiomics model showed the best predictive efficacy, AUCs of predicting EGFR mutation status for training dataset and validation dataset were 0.956 (95% CI: 0.952-1.000) and 0.961 (95% CI: 0.924-0.998), respectively. The AUCs of predicting 19Del/L858R mutation subtype for training dataset and validation dataset were 0.926 (95% CI: 0.893-0.959), 0.938 (95% CI: 0.876-1.000), respectively. Conclusions:The constructed sequential models based on integration of CT radiomics, clinical features and machine learning can accurately predict the mutation status and subtype of EGFR.

Analysis on the development and influencing factors of frailty in elderly patients on maintenance hemodialysis / 中华老年医学杂志

Objective:To investigate the development and influencing factors of frailty in elderly patients on maintenance hemodialysis.Methods:A cross-sectional survey involved 146 elderly patients on maintenance hemodialysis at the blood purification department of the First Affiliated Hospital of Xi'an Jiaotong University.A self-designed demographic questionnaire was used to collect general information of patients, the Simple Physical Performance Scale(SPPB)was used to assess physical function, the 5-item SARC-F was used as a tool for rapid screening of sarcopenia, and the Hospital Anxiety and Depression Scale(HADS)was used for screening of anxiety and depression.The FRAIL scale was used for frailty assessment and participants were divided into a no frailty group, a pre-frailty group and a frailty group according to different frailty scores.Relevant influencing factors of frailty were analyzed.Results:Among 146 hemodialysis patients, 33(22.6%)were in the non-frailty group, 86(58.9%)in the pre-frailty group, and 27(18.5%)in the frailty group.Univariate analysis showed that there were statistically significant differences in sex( χ2=6.220, P=0.045), age( F=5.197, P=0.007), body type( χ2=31.927, P<0.001), SARC-F score( χ2=24.283, P<0.001)and SPPB score( χ2=26.773, P<0.001)between different groups.There were 3 patients(9.4%)at high risk for sarcopenia in the no frailty group, 13 patients(40.6%)at high risk for sarcopenia in the pre-frailty group, and 16 patients(50%)at high risk for sarcopenia in the frailty group, and differences in the occurrence of sarcopenia between the different subgroups of frailty were statistically significant( χ2=27.496, P<0.001). Multifactorial Logistic regression analysis showed that age, ( OR=1.04, 95% CI: 0.99-1.08, P=0.049), sex( OR=0.39, 95% CI: 0.17-0.87, P=0.021), body size( OR=0.07, 95% CI: 0.01-0.50, P=0.008), SARC-F( OR=0.14, 95% CI: 0.05-0.38, P<0.001)were independent influencing factors of frailty in elderly maintenance hemodialysis patients( P<0.05). Conclusions:The incidence of frailty is high in elderly patients on maintenance hemodialysis, and the development of frailty is affected by age, body mass index and sarcopenia.

Chimeric antigen receptor T-associated cytokines release syndrome managed by therapeutic plasma exchange and tumor necrosis factor inhibitors: a case report / 中国输血杂志

【Objective】 To learn more about the role of therapeutic plasma exchange in the management of cytokines release syndrome(CRS) after chimeric antigen receptor T(CAR-T) infusion by reviewing and analyzing the diagnosis and treatment of one case. 【Methods】 The diagnosis and treatment of lymphoma patients with CAR-T infusion related CRS were described, and case analysis was carried out by searching PubMed, Elsevier, Wiley, CNKI, and other databases for relevant guidelines, clinical trials, and case reports. 【Results】 The patient was diagnosed with follicular cell lymphoma. Progressive disease(PD) was assessed after multiple courses of treatment, and anti-CD19/20 CAR-T cell therapy was administered.The patient developed a high fever and chills, secondary dyspnea and hypotension at night on the day of infusion, and the inflammatory factors such as C-reactive protein(CRP) and interleukin-6(IL-6) increased sharply, suggesting the occurrence of cytokines release syndrome(CRS). After the patient was given symptomatic antipyretic, broad-spectrum anti-infection, tumor necrosis factor(TNF) antibody and three occasions of plasma exchange, the clinical manifestations of CRS gradually relieved. Three months after discharge, the patient was in complete response(CR). 【Conclusion】 CAR-T-associated CRS is a serious cellular immunotherapy-related toxicity that can result in multiple organ failure or even death in patients. Therapeutic plasma exchange may be a potential treatment for some patients with severe CRS.

Efficacy and safety of lenvatinib in patients with unresectable hepatocellular carcinoma previously treated with tyrosine kinase inhibitor / 临床肝胆病杂志

Objective To investigate the efficacy and safety of lenvatinib in patients with unresectable hepatocellular carcinoma (HCC) previously treated with tyrosine kinase inhibitor (TKI). Methods A retrospective analysis was performed for the clinical data of 76 patients with unresectable HCC who were treated with lenvatinib in Beijing Ditan Hospital, Capital Medical University, from January 2019 to January 2020, and according to the treatment method, they were divided into TKI previously untreated group with 49 patients and TKI treatment-experienced group with 27 patients. The patients were observed till one year after enrollment, adjustment of treatment regimen, tumor progression, or death. The two groups were compared in terms of progression-free survival (PFS) time, objective response rate (ORR), disease control rate (DCR), and incidence rate of adverse events. The t -test or the Wilcoxon rank-sum test was used for comparison of continuous data between two groups, and the chi-square test or the Wilcoxon rank-sum test was used for comparison of categorical data between two groups; the Kaplan-Meier method was used for survival analysis, and the log-rank test was used for comparison between groups. Results There were no significant differences between the TKI previously untreated group and the TKI treatment-experienced group in median PFS time (115 days vs 72 days, P =0.148), ORR (36.7% vs 18.5%, P =0.098), DCR (65.3% vs 55.6%, P =0.402), and incidence rates of grade ≥3 adverse events (24.5% vs 18.5%, P =0.550). Conclusion Patients with unresectable HCC previously treated with TKI can benefit from lenvatinib and have good safety, with similar results to those treated with TKI for the first time.

Evaluation on vascular access-interventional therapy of hemodialysis under ultrasound in day surgery mode / 中华肾脏病杂志

Objective:To investigate the clinical effect on ultrasound-guided vascular access-interventional therapy of hemodialysis in day surgery mode.Methods:Hemodialysis patients with vascular access dysfunction who underwent ultrasound-guided interventional therapy in the First Affiliated Hospital of Xi'an Jiaotong University from September 1, 2018 to October 31, 2020 were retrospectively analyzed. Demographic and clinical data were collected by electronic medical record system and telephone follow-up. Kaplan-Meier method was used to analyze the patency rate of vascular access.Results:A total of 421 cases of ultrasound-guided vascular access intervention were performed in 269 patients. The technical success rates of stenosis, chronic occlusion and acute occlusion lesion were 98.8%, 90.6% and 86.4%, respectively, and 406 cases (96.4%) of 246 patients were clinically successful. The postoperative brachial artery blood flow was 821(627, 1 029) ml/min, which was significantly higher than 309(202, 453) ml/min before the operation ( Z=-13.547, P<0.001). No serious complications occurred during and after the operation. At 6, 12, 18 and 24 months after operation, the primary patency rate was 74%, 59%, 48% and 45%, respectively, the assisted primary patency rate was 94%, 91%, 88% and 82%, and the secondary patency rate was 96%, 93%, 91% and 86%. Compared with the conventional inpatient surgery mode, the total cost of the day surgery mode was significantly reduced [12 067(10 051, 13 198) yuan vs 14 986(12 411, 20 643) yuan, Z=-13.185, P<0.001], and the hospital stay was significantly shortened [5.1(3.5, 6.9) h vs 73.4(31.6, 146.6) h, Z=-13.348, P<0.001]. Conclusion:It is safe and effective to perform interventional therapy for vascular access malfunction under ultrasound in day surgery mode, which can save cost and time of hospitalization, and can be carried out in hospitals with relevant conditions.

Clinical observasion of Pingchuan Decoction combined with routine western medicine therapy for the children with acute attack of bronchial asthma / 国际中医中药杂志

Objective:To explore the clinical effect of Pingchuan Decoction combined with routine western medicine therapy in the treatment of acute attack of bronchial asthma in children. Methods:From January 2017 to June 2019, 118 children with acute attack of bronchial asthma were selected from the Seventh People’s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, and they were randomly divided into control group (59 cases) and observation group (59 cases) according to the random number table. The control group was treated with routine western medicine therapy, and the observation group was treated with Pingchuan Decoction on the base of control group, and both groups were treated for 14 days. The main symptom scores before and after treatment were evaluated. The percentage of forced vital capacity expressed as percent predicted (FVC% pred) and the forced expiratory volume in 1 second expressed as percent predicted (FEV1% pred) were measured by pulmonary function meter. The levels of CD3 +, CD4 + and CD4 +/CD8 + in peripheral blood were detected by flow cytometry. The adverse reactions during the treatment were recorded and the clinical efficacy was evaluated. Results:The total clinical effective rate was 93.2% (55/59) in the observation group and 71.2% (42/59) in the control group, where the difference between the two groups was statistically significant ( χ2=9.790, P=0.002). After treatment, the scores of cough, wheezing and wheezing rale in the observation group were significantly lower than those in the control group ( t=27.695, 17.573, 32.827, P<0.001). After treatment, FVC% pred [(80.21 ± 4.06)% vs. (71.71 ± 3.95)%, t=11.526], FEV1% pred [(78.84±3.92)% vs. (72.26 ± 3.59)%, t=9.508] in the observation group were significantly higher than those in the control group ( P<0.01). The levels of CD3 + [(74.05 ± 5.13)% vs. (67.44 ± 4.98)%, t=7.101], CD4 + [(48.43 ± 4.31)% vs. (42.20 ± 4.06)%, t=8.082] and the ratio of CD4 +/CD8 + (1.67 ± 0.29 vs. 1.34 ± 0.25, t=6.620) in the observation group were significantly higher than those in the control group ( P<0.01). During the treatment, the incidence of adverse reactions was 10.2% (6/59) in the observation group and 6.8% (4/59) in the control group, and there was no significant difference between the two groups ( χ2=0.437, P=0.509). Conclusion:The Pingchuan Decoction combined with routine western medicine therapy can reduce the clinical symptoms of children with acute attack of bronchial asthma, improve lung function, improve organism immunity and clinical effect with safety.

Inflow-based vascular-space-occupancy MRI for evaluation of arteriolar muscular blood volume in dermatomyositis patients / 中华放射学杂志

Objective:To investigate the reproducibility of inflow-based vascular-space-occupancy (iVASO)-MRI in quantifying skeletal muscle perfusion and its potential clinical value in patients with dermatomyositis (DM).Methods:Totally 15 consecutive patients with DM and 15 healthy volunteers were enrolled in this prospective study from December 2018 to April 2019 at Nanfang Hospital, Southern Medical University. All subjects underwent T 1WI, short-tau inversion recovery (STIR) T 2WI, and iVASO-MRI of thigh on a 3.0 T MR scanner. According to findings on T 1WI and STIR T 2WI, the muscles were divided into normal, unaffected, edematous and atrophic or fat-infiltrated groups. Maximum arteriolar muscular blood volume (MBVa_max) and mean MBVa (MBVa_mean) of these 4 groups of muscles were obtained by 2 radiologists independently. In order to evaluate the reproducibility of iVASO, the repeated scan was performed 3 days later in 17 subjects (12 healthy volunteers and 5 DM patients), and the MBVa values were measured to calculate the intraclass correlation coefficients (ICC). The MBVa_max and MBVa_mean among the 4 groups were compared by using Kruskal-Wallis H test and the differences of each 2 groups was compare by using Mann-Whitney U test. Results:The ICC between the 2 observers was 0.95 and 0.96 for MBVa_max and MBVa_mean, respectively. The ICC between repeated tests was 0.87 and 0.89 for MBVa_max and MBVa_mean, respectively.There was significant difference among normal muscles, unaffected muscles, edematous muscles and atrophic or fat-infiltrated muscles ( P<0.001). Post hoc comparisons of MBVa_max and MBVa_mean showed that compared to normal muscles, unaffected muscles, edematous muscles and atrophic or fat-infiltrated muscles had a significant decrease of MBVa ( P<0.05). Unaffected muscles and edematous muscles showed no significant difference in terms of MBVa_max and MBVa_mean (both P=0.99), which were significantly higher than those of atrophic or fat-infiltrated muscles ( P<0.05). Conclusions:iVASO-MRIcan reliably quantify the MBVa of thigh muscular arteriolar, and it is potentially valuable in the diagnosis of DM.

Efficacy and safety of Changsulin ? compared with Lantus ? in type 2 diabetes: a phase Ⅲ multicenter, randomized, open-label, parallel, controlled clinical trial / 中华内科杂志

Objective:To compare the efficacy and safety of Changsulin ? with Lantus ? in treating patients with type 2 diabetes mellitus (T2DM). Methods:This was a phase Ⅲ, multicenter, randomized, open-label, parallel-group, active-controlled clinical trial. A total of 578 participants with T2DM inadequately controlled on oral hypoglycemic agents were randomized 3∶1 to Changsulin ? or Lantus ? treatment for 24 weeks. The efficacy measures included changes in glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2h postprandial plasma glucose (2hPG), 8-point self-monitoring of blood glucose (SMBG) profiles from baseline, and proportions of subjects achieving targets of HbA1c and FPG. The safety outcomes included rates of hypoglycemia, adverse events (AEs) and anti-insulin glargine antibody. Results:After 24 weeks of treatment, mean HbAlc decreased 1.16% and 1.25%, FPG decreased 3.05 mmol/L and 2.90 mmol/L, 2hPG decreased 2.49 mmol/L and 2.38 mmol/L in Changsulin ? and in Lantus ?, respectively. No significant differences could be viewed in above parameters between the two groups (all P>0.05). There were also no significant differences between Changsulin ? and Lantus ? in 8-point SMBG profiles from baseline and proportions of subjects achieving the targets of HbA1c and FPG (all P>0.05). The rates of total hypoglycemia (38.00% and 39.01% for Changsulin ? and Lantus ?, respectively) and nocturnal hypoglycemia (17.25% and 16.31% for Changsulin ? and Lantus ?, respectively) were similar between the two groups (all P>0.05). Most of the hypoglycemia events were asymptomatic, and no severe hypoglycemia were found in both groups. No differences were observed in rates of AEs (61.77% vs.52.48%) and anti-insulin glargine antibody (after 24 weeks of treatment, 6.91% vs.3.65%) between the two groups (all P>0.05). Conclusions:Changsulin ? shows similar efficacy and safety profiles compared with Lantus ? and Changsulin ? treatment was well tolerated in patients with T2DM.

Advances in targeted therapy and immunotherapy for hepatocelluar carcinoma / 临床肝胆病杂志

There are still high incidence and mortality rates of hepatocellular carcinoma at present, and systemic treatment plays an important role in the treatment of advanced hepatocellular carcinoma. This article describes the application of molecular-targeted drugs and immune checkpoint inhibitors in hepatocellular carcinoma and points out that dual-targeted therapy, dual immunotherapy, and targeted therapy combined with immunotherapy are the current research hotspots in the treatment of hepatocellular carcinoma.

Epidemiology, clinical and imaging features of pediatric patients with COVID-19: analysis of 14 cases / 中华全科医师杂志

Epidemiologic, clinical and imaging data were collected from 14 children with confirmed coronavirus disease 2019 (COVID-19) admitted in Beijing Ditan Hospital from January 27, 2020 to February 12, 2020. There were 6 boys and 8 girls with a median age of 3.5 years (6 months-9.4 years). Four patients had a history of travel to Wuhan City or Hubei Province and 2 patients had contacted with people from Wuhan; 13 patients were familial cluster of infection. The incubation period was 4 to 16 days. The clinical manifestations were fever in 8 cases, cough in 5 cases, diarrhea in 1 case; and 2 cases were asymptomatic. Four patients had abnormal peripheral blood routine, including 1 had lymphocytosis, 3 had lymphocytopenia; 3 patients had a slightly elevated CRP, and 3 patients had hepatic dysfunction. Thirteen patients underwent chest CT; and 1 case showed bilateral lung glass exudation, 1 case showed multiple patchy high density shadows of bilateral lung. One patient underwent chest X-ray examination, which was showed no abnormal findings. The pediatric patients with COVID-19 in this series generally have a traceable epidemiological history. The clinical manifestations are fever, cough and diarrhea. Peripheral white blood cell counts were most normal. Chest CT reveals less severe changes than those in adults, most child patients show no manifestation of pneumonia.

Effect of combined therapy of radiosurgery and temozolomide on U87-epidermal growth factor receptor and variant Ⅲ cells and their xenograft / 中华神经医学杂志

Objective To explore the effect of radiosurgery in combination of temozolomide therapy in vitro and in vivo on invasion and endocrine function of human glioma cell line U87-epidermal growth factor receptor and variant Ⅲ (EGFRvⅢ) and their xenografl.Methods (1) Human glioma U87-EGFRvⅢ cells were routinely cultured;CCK-8 was used to detect the effect of temozolomide at different concentrations on proliferation of U87-EGFRvⅢ cells,and the semi-inhibitory concentration (IC50) oftemozolomide was calculated;the U87-EGFRvⅢ cells were divided into control group,6 Gy radiotherapy group and 12 Gy radiotherapy group,and the expressions of invasion-related proteins and gene repair proteins in the three groups were detected by Western blotting after 0,6 and 12 Gy edge-dose irradiation,respectively;the U87-EGFRvⅢ cells were divided into control group,6 Gy radiotherapy group and 6 Gy radiation combined with temozolomide treatment group (5 mmol/L temozolomide was added after 6 Gy irradiation),and 24 h after each treatment,Western blotting was used to detect the expressions of invasion related proteins and gene repair related proteins in the three groups.(2) Nude mouse transplantation intracranial glioma models were established with cell suspension of the control group,6 Gy radiotherapy group and 6 Gy radiation combined with temozolomide treatment group;7,14,21 d after transplantation,biolumineseence imaging (BLI) was employed to detect luciferase expression in nude micein vivo and measurement of transplanted tumors was performed;survival curve and body mass curve were drew in nude mice;immunohistochemical staining was used to detect the expressions of EGFRvⅢ,epidermal growth factor receptor (EGFR),matrix metalloproteinase (MMP)-9,vascular endothelial growth factor (VEGF) and Ki67 in intracranial transplanted gliomas.Results (1) The IC50 oftemozolomide on U87-EGFRvⅢ cells was 5 mmol/L;as compared with those in the control group,the expressions of EGFRvⅢ,EGFR,MMP-2,MMP-9,VEGF,MGMT,AKT-1,β-catenin and Ku70 significantly increased in the cells of the 6 Gy radiotherapy group,while the expressions of EGFRvⅢ,EGFR,MMP-2,MMP-9,VEGF,MGMT,AKT-1,β-catenin and Ku70 significantly decreased in the cells of the 12 Gy radiotherapy group as compared with those in the 6 Gy radiotherapy group (P＜0.05);as compared with those in the 6 Gy radiotherapy group,the expressions of EGFRvⅢ,EGFR,MMP-2,MMP-9,VEGF,MGMT,AKT-1,β-catenin and Ku70 in cells of the 6 Gy radiotherapy combined with temozolomide group were statistically decreased (P＜0.05).(2) As compared with mice in the control group and 6 Gy radiotherapy group,mice in the 6 Gy radiotherapy combined with temozolomide group had significantly lower cell tumorigenicity,significantly higher survival rate and body mass 21 d after transplantation,and significantly smaller volume of xenograft tumors (P＜0.05);the expressions of EGFRvⅢ,EGFR,MMP-9,VEGF and Ki67 in tumor tissues of nude mice in the 6 Gy radiotherapy group were significantly decreased as compared with those in the control group;as compared with those in the 6 Gy radiotherapy group,the expressions of EGFRvⅢ,EGFR,MMP-9,VEGF and Ki67 in tumor tissues of mice in the 6 Gy radiotherapy group were significantly decreased (P＜0.05).Conclusion The combined treatment of radiosurgery and temozolomide can more obviously inhibit the invasiveness of U87-EGFRvⅢ cells and it exerts a stronger inhibitory effect on tumorigenicity of U87-EGFRvⅢ cells in brain of nude rats.

A prospective cohort study on the relationship between maternal prenatal depressive symptoms and children's behavioral problems at 2 years old / 中华流行病学杂志

Objective: To explore the associations between maternal and prenatal depressive symptoms and children's behavioral problems at 2 years old. Methods: In the present study, a total of 491 mother-child pairs were selected from the Shanghai-Minhang Birth Cohort Study (S-MBCS) which was conducted in Maternal and Child Health Hospital of Minhang District in Shanghai between April and December, 2012. Data from the Center for Epidemiologic Studies on Depression was gathered to assess the maternal depressive symptoms in the second and third trimester of pregnancy, as well as at 6 months and 12 months postpartum. Neurodevelopment at 2 years was assessed, using the Child Behavior Checklist. We used generalized linear models with a log-link function and a Binomial distribution to estimate the risk ratios (RRs) and 95%CIs, on children's behavioral problems at 2 years of age. Sensitivity analyses were performed among participants without postpartum depressive symptoms. Results: After adjustment on factors as maternal age, gestation week, average monthly income per person, parental education and children's gender etc., maternal depression in second trimester of pregnancy was found associated with higher risk of both developing emotional (RR=2.61, 95%CI: 1.36-4.99) and internalizing problems (RR=1.94, 95%CI: 1.22-3.08). However, maternal depression in third trimester was found to be associated with higher risks of developing emotional (RR=6.46, 95%CI: 3.09-13.53), withdrawn (RR=2.42, 95%CI: 1.16-5.02), aggressive (RR=2.93, 95%CI: 1.45-5.94), internalizing (RR=1.79, 95%CI: 1.01-3.16) or externalizing problems (RR=2.56, 95%CI:1.49-4.42). In sensitivity analysis, antenatal maternal depression was found positively associated with children's emotional, internalizing and externalizing problems and the differences all statistically significant. Conclusions: Maternal depression during pregnancy might increase the risks of children's behavioral problems. In order to decrease the incidence of children's behavioral problems and promoting both maternal and child health status, monitoring program regarding maternal mental health care should be strengthened.

Initiatory Application of Three-dimensional Asymmetry on Anterior-cruciate-ligament Rupture Gait Analysis / 中国康复理论与实践

@#Objective Gait analysis plays an important role in the description of the site and degree of injury in the lower limbs, and symmetry is an important indicator of gait characteristics. The aim of this study is to quantitatively describe gait information and its asymmetry in three-dimensional space, dig deeper into gait information and improve the analysis of abnormal gait characteristics.Methods The information about the change of coronal-sagittal plane angle in different parts was obtained based on the inertial gait sensor, and the gait space vector was inverted to build the movement curve and form a motion symmetry detection method based on three-dimensional space angle vector distance. The characteristics of normal subjects (control group) and the anterior cruciate ligament (ACL) rupture patients (patients group) were analyzed from July, 2017 to January, 2018, and its effectiveness was verified.Results There was a better discrimination effect in the calf, thigh and knee asymmetry, etc., between the control group and the patient group (P<0.05). The characteristics of the calf space motion vector were highest among the control group and the patient group, and the discrimination was relatively stable, and not various with gender, age, height or body mass index.Conclusion The time-coronal-sagittal vector diagrams of left and right limbs were obtained by inertial sensor and the average of the square of the Euclidean distances in space at the selected gait cycle time points was calculated in three-dimensional space, which could be used as a gait asymmetry analysis method.

A prospective cohort study on the relationship between maternal prenatal depressive symptoms and children's behavioral problems at 2 years old / 中华流行病学杂志

Objective To explore the associations between maternal and prenatal depressive symptoms and children's behavioral problems at 2 years old.Methods In the present study,a total of 491 mother-child pairs were selected from the Shanghai-Minhang Birth Cohort Study (S-MBCS) which was conducted in Maternal and Child Health Hospital of Minhang District in Shanghai between April and December,2012.Data from the Center for Epidemiologic Studies on Depression was gathered to assess the maternal depressive symptoms in the second and third trimester of pregnancy,as well as at 6 months and 12 months postpartum.Neurodevelopment at 2 years was assessed,using the Child Behavior Checklist.We used generalized linear models with a log-link function and a Binomial distribution to estimate the risk ratios (RRs) and 95％CIs,on children's behavioral problems at 2 years of age.Sensitivity analyses were performed among participants without postpartum depressive symptoms.Results After adjustment on factors as maternal age,gestation week,average monthly income per person,parental education and children's gender etc.,maternal depression in second trimester of pregnancy was found associated with higher risk of both developing emotional (RR =2.61,95％ CI:1.36-4.99) and internalizing problems (RR=1.94,95％ CI:1.22-3.08).However,maternal depression in third trimester was found to be associated with higher risks of developing emotional (RR=6.46,95％CI:3.09-13.53),withdrawn (RR=2.42,95％CI:1.16-5.02),aggressive (RR=2.93,95 ％CI:1.45-5.94),internalizing (RR =1.79,95 ％CI:1.01-3.16) or externalizing problems (RR =2.56,95％ CI:1.49-4.42).In sensitivity analysis,antenatal maternal depression was found positively associated with children's emotional,internalizing and externalizing problems and the differences all statistically significant.Conclusions Maternal depression during pregnancy might increase the risks of children's behavioral problems.In order to decrease the incidence of children's behavioral problems and promoting both maternal and child health status,monitoring program regarding maternal mental health care should be strengthened.

Effect of major air pollutants on the risk of ischemic stroke onset and its mechanism of action / 国际脑血管病杂志

The mortality and disability of ischemic stroke are high.A number of epidemiological studies have confirrned that air pollutants can increase the prevalence or admission rate of ischemic stroke.Air pollutants mainly include sulfur dioxide,nitrogen dioxide,fime particles,carbon monoxide,and ozone.This article reviews the main sources of various major air pollutants,the effect of major air pollutants on the risk of ischemic stroke onset,and the possible mechanisms.

Association between cytotoxic T lymphocyte associated antigen-4 gene polymorphism and ankylosing spondylitis susceptibility: a meta-analysis / 中华风湿病学杂志

Objective To explore the association between cytotoxic T lymphocyte associated antigen-4 (CTLA-4) gene polymorphism and susceptibility to ankylosing spondylitis (AS). Methods The case-control studies from Chinese Biomedical Database, Chinese National Knowledge Infrastructure, Wanfang, Weipu, PubMed, Cochrane Library, OvidSP, Wiley Online Library, Elsevier Science Direct, Springer Link databases for the association of CTLA-4 gene polymorphism with AS. The association strength was assessed with chi-squared test by Stata 12.0 software. Results Seven references of CTLA-4 gene +49A/G (rs231775) polymorphism were enrolled which included 1119 AS patients and 995 controls (healthy subjects or non-AS patients), which showed that there were no statistical difference between AS and control groups under recessive, dominant, co-dominant, additive and allele gene models. Five references of CTLA-4 gene-318C/T (rs5742909) polymorphism were enrolled which included 635 AS patients and 512 controls, which showed that there were no statistical difference between AS and control groups under recessive and additive gene models; however, there were statistical difference between AS and control groups under dominant model [ OR=1.651, 95%CI (1.052, 2.590), P=0.029], co-dominant model [OR=0.621, 95%CI (0.403, 0.957), P=0.031] and allele model [OR=1.587, 95%CI (1.068, 2.357), P=0.022]. Conclusion The meta analysis reveal that CTLA-4 gene rs231775 single nucleotide polymorphism is not associated with the susceptibility to AS; rs5742909 SNP is associated with the susceptibility to AS, which suggests that C→T mutation increases the risk of AS.