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Obesity is a well-known high-risk factor for many kinds of neoplasms. Adipokines secreted by adipose tissue play an important role in the process of obesity promoting tumorigenesis and development, and different adipokines play a role in promoting or suppressing cancer via different signaling pathways. Currently, lifestyle modification to control weight and targeted therapy of adipokines and their receptors are major research directions of cancer treatment, but most of the studies are still in the stage of basic and pre-clinical research. Therefore, the molecular mechanisms of adipokines in promoting or suppressing cancer should be further explored, and the dual inhibitors as well as combined therapy are the key research strategies for adipokines in cancer treatment in the future.
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IL-22 is a member of IL-10 cytokine family. In recent years, increasing evidence has shown that IL-22 is closely related to the immunity in female reproductive tract, and its role in disease development is two-sided. It can not only maintain the balance of microbiota, enhance the resistance to pathogens and reduce the tissue damage caused by infection, but also promote the development and progression of malignant diseases via various signaling pathways. More studies on the biological characteristics and functions of IL-22 are needed for clarifying the pathogenic mechanism and providing new insight into the diagnosis and treatment of female reproductive tract diseases.
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Ovarian Leydig cell tumor(LCT), also known as ovarian testicular stromal cell tumor, is a rare sex cord stromal tumor, accounting for about 0.1% of all ovarian tumors. LCT is often accompanied by clinical manifestations of elevated androgen, and the imaging manifestations sometimes lack specificity. The diagnosis requires histopathological examination. Surgery is the primary treatment method, and postoperative prognosis is generally favorable. This paper retrospectively analyzes the diagnosis and treatment of a patient with LCT in our hospital combining relevant literature, explore the clinical characteristics, diagnosis, and treatment progress of LCT, aiming to improve disease management.
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China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.
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Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection (LRTI) and hospitalizations in infants under 1 year of age, seriously jeopardizing infants′ health.Most hospitalizations (up to 80%) due to RSV-LRTI occur in otherwise healthy infants born at term.At present, no effective treatment and preventative measure against RSV is available domestically.Passive immunization with fully human long-acting monoclonal antibody Nirsevimab offers immediate protection for all infants experiencing their first RSV season with one shot, thus ushering in a new era of prevention of RSV infection among infants.
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Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.
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Hypoxemia is a common complication of pneumonia, asthma, and bronchopulmonary dysplasia in children.Rapid identification of hypoxemia is of great significance for the disposal and management of critical children.Pulse oximetry is recognized by the World Health Organization as the best way to monitor hypoxemia in children, and it can monitor pulse oxygen saturation noninvasively and continuously.Based on the related literature at home and abroad, combined with the clinical needs of pediatrics, the " Expert consensus on clinical application of pulse oximetry in children" is formulated to improve the understanding of pediatricians and nurses on the application in pediatric clinical practice, principle, operation techniques, and limitations of pulse oximetry.
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Asthma is the most common chronic respiratory disease in children and requires long-term medical management.Adolescence has unique physical and psychological characteristics, which challenge the management of asthma in adolescents.A personalized transition strategy can achieve a successful asthma transition from childhood into adulthood and improve long-term outcomes of asthma.In this paper, the characteristics of adolescence, burden of adolescent asthma, challenges to adolescent asthma, adolescent asthma management system, and successful transition of adolescent asthma were reviewed.
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Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.
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Immunoprophylaxis refers to the strategy to enhance specific immunity of the body through artificial methods, which can be divided into active immunization(mainly vaccination) and passive immunization (including maternal vaccination). Vaccination is the most cost-effective measure to prevent and control the novel coronavirus disease 2019 (COVID-19). Recently, the United States, Costa Rica and Australia have authorized use of the COVID-19 vaccine for children down to 6 months of age.In real-world evaluation, maternal vaccination was associated with a substantial reduction in incidence of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection, the risk of COVID-19 related hospitalization and critical illness among infants younger than 6 months of age.Coupled with these advances in young children, it is possible to achieve the whole population coverage of SARS-CoV-2 immune prevention.
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Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.
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Currently, testing for immunoglobulin E (IgE) sensitization is the cornerstone for the diagnosis and management of allergic diseases, including environmental control measures, medications, and/or allergen immunotherapy.In 2020, the World Allergy Organization (WAO) published a position paper on IgE allergy diagnostics and other relevant tests in allergy, both in vivo and in vitro.This paper aim to interpret both the skin prick test (SPT) and the intradermal test (IDT) in vivo diagnosis.The indications, technical methods, measurement and interpretation of result, as well as the advantages and disadvantages of these two diagnostic skin tests.In addition, and supplementary explanations are made on individual issues for a better understanding.
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The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 has rapidly spread globally. Cancer patients are at a higher risk of being infected with the coronavirus and are more likely to develop severe complications, as compared to the general population. The increasing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Concerted efforts should be put into managing gynecological malignancies in an orderly manner by strictly implementing the measures that are specifically developed for controlling the spread of COVID-19. We have drafted Recommendations on Management of Gynecological Malignancies during the COVID-19 Pandemic based on our experience on controlling COVID-19 pandemic in China. We recommend that patients with gynecological malignancies should be managed in hierarchical and individualized manners in combination with local conditions related to COVID-19. Medical care decision should be balanced between controlling COVID-19 pandemic spread and timely diagnosis and treatment for gynecologic oncology patients.
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The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 has rapidly spread globally. Cancer patients are at a higher risk of being infected with the coronavirus and are more likely to develop severe complications, as compared to the general population. The increasing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Concerted efforts should be put into managing gynecological malignancies in an orderly manner by strictly implementing the measures that are specifically developed for controlling the spread of COVID-19. We have drafted Recommendations on Management of Gynecological Malignancies during the COVID-19 Pandemic based on our experience on controlling COVID-19 pandemic in China. We recommend that patients with gynecological malignancies should be managed in hierarchical and individualized manners in combination with local conditions related to COVID-19. Medical care decision should be balanced between controlling COVID-19 pandemic spread and timely diagnosis and treatment for gynecologic oncology patients.
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The mucosal immune system is the first line of defense against pathogens such as bacteria and viruses invading the bodies. The female reproductive tract mucosal immune system not only resists the invasion of pathogens through innate and adaptive immunity, but also contribute to successfully fertilization and pregnancy, thus maintaining the health of women′s reproductive system. The innate immunity of female genital tract involves the mechanical barrier of the mucosal epithelium, microbial barrier of commensal bacteria, immunological barrier of immune cells and their receptors, and adaptive immunity including B cell-mediated humoral immunity and T cell-mediated cellular immunity. Female genital mucosal immunity is not only involved in local inflammation, but may also have anti-tumor effects. Moreover, the female genital tract mucosal immune is also regulated by sex hormone to maintain a homeostasis of local microenvironment. Herein, this paper summarized recent progress in female genital mucosal immunity.
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Lactic acid is the main substance produced by Lactobacillus and plays an important role in maintaining a healthy vaginal microecology. Recent studies indicates that both L- and D-chiral isomers of lactic acid can be protonated and destroy the cell membranes of pathogens, thereby inhibiting bacterial vagi-nosis- and aerobic vaginitis-related pathogens. Lactic acid also can inhibit the pathogens of sexually transmit-ted diseases such as Chlamydia trachomatis and human immunodeficiency virus. Moreover, lactic acid acts as an immunomodulator to inhibit the inflammatory responses caused by pathogenic microorganisms and as an epigenetic regulator regulating gene expression in vaginal epithelial cells. In this paper, we reviewed the pro-gress in lactic acid-mediated maintenance of a healthy vaginal microbiology in recent years for providing ref-erence for further research.
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Objective@#To investigate the expressions of migration and invasion inhibitory protein (MIIP) and p21-activated kinase 1 (PAK1) in endometrial carcinoma (EC) and their correlation with clinicopathological features.@*Methods@#The protein levels of MIIP and PAK1 in 135 paraffin-embedded EC tissues, 55 atypical hyperplasia of endometrium (AHE) and 88 normal endometrium (NE) tissues were quantified by immunohistochemistry, the clincial significance and the relationship of these two proteins were also analyzed.@*Results@#The positive rates of MIIP expression in NE, AHE and EC tissues were 52.3%(46/88), 41.8% (23/55) and 34.8% (47/135), respectively. The expression of MIIP in EC was significantly lower than that of MIIP in NE (P<0.05). The positive rates of PAK1 expression in NE, AHE and EC tissues were 45.5% (40/88), 50.9% (28/55) and 62.2% (84/135), respectively. The expression of PAK1 in EC tissues was significantly higher than that of PAK1 in NE tissues (P<0.05). The expression of MIIP in EC tissues was significantly associated with myometrial invasion, International Federation of Gynaecology and Obstetrics (FIGO) stage and lymph node metastasis (P<0.05). The expression of PAK1 in EC tissues was significantly related with differentiation, myometrial invasion, FIGO stage and lymph node metastasis (P<0.05). The expressions of MIIP and PAK1 in EC tissues were marginally related with the overall survival of patients (P=0.092, P=0.052). The expression of MIIP in EC was negatively correlated with PAK1 (r=-0.329, P<0.001).@*Conclusions@#The down-regulation of MIIP and up-regualtion of PAK1 paticipate in the initiation and development of EC, which are correlated with the poor prognosis of EC. The protein expression of MIIP is inversely related with PAK1 in EC.
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Objective To analyze the value of vaginal microecological detection in evaluating therapeutic effect of simple vulvovaginal candidiasis(VVC), and explore microecological factors which can affect the cure rate of simple VVC.Methods 75 patients with simple VVC in Tianjin Medical University General Hospital from January 2016 to June 2017 were enrolled.Vaginal secretion was collected and applied for vaginal microecological detection.The patients were treated with clotrimazole based monotherapy later. The relationship between vaginal microecological characters and therapeutic effects was analyzed.Results PH values,leukocyte counts,flora density,flora diversity,small bacilli and cocci counts had no influence on therapeutic effects(P>0.05).The cure rate of patients with lactobacillary gradesⅠ-Ⅱa was higher than that with lactobacillary gradesⅡb-Ⅲ(83.33% vs 53.33%,P=0.033), while lower with lactobacilli≤22.8/hpf than that with lactobacilli >22.8/hpf(59.26% vs 87.50%,P=0.007), which indicate that lactobacilli counts was the main factor that affects therapeutic effects.Conclusions Vaginal microecological detection plays an important role in predicting the therapeutic effect of simple VVC.For the patients with lower lactobacillus counts,the follow-up after treatment should be strengthened.(Chin J Lab Med,2018, 41:292-295)
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Objective To study the vaginal microecology of the patients in the outpatient department of Obstetrics and gynecology in China.Methods A multicenter cross-sectional study was conducted in gynecologic clinic of 9 collaborative hospitals in China.200 consecutive patients were collected in each hospital and their vaginal microecology combined with related factors were analyzed.Results A total of 2 093 specimens were collected in this study.The detection rate of Trichomonas was 5.5%(115/2 093). The detection rate of Candida mycelia was 15.9%(333/2 093), with germinal spores was 4.1%(86/2093).The detection rate of bacterial vaginosis was 18.8%(394/2 093).The distribution results of vaginal flora in patients showed that the normal flora accounted for only 27.3%(571/2 093).The normal flora with the insufficiency of H2O2 accounted for 23%(480/2 093).The bacteria inhibiting flora accounted for 3.8%(79/2 093).The abnormal microflora(non BV type)accounted for 14.9%(312/2 093).The abnormal microflora(BV intermediate type)accounted for 13.4%(280/2 093).The abnormal microflora(BV type)accounted for 17.6%(369/2 093).The average pH of vaginal discharge was 4.58 ±0.495.There was no significant difference of the incidence of trichomonas and bacterial vaginosis between north and south of the Yangtze river, while the detection rate of fungal hyphae and the fungal spores is significantly higher in the south than that in the north.The analysis results of factors affecting the microecology showed that age and contraception methods were two important factors.The patients′age from bacteria inhibition group was 49.64 +16.68 which was significantly higher than that of the other microecology groups.The proportion of abnormal microflora of patients from the oral contraceptive group was 40%(20/50).The proportion of abnormal microflora of patients from IUD group was 36.6%(63/172).Compared with these two contraception methods, the proportion of abnormal microflora of patients from condoms usage group was 27.8%(91/327)which was significantly lower.The incidence of abnormal leucorrhea in the normal group was 37.7%, which was significantly lower than that of other abnormal groups.Conclusion This study showed the vaginal microecology status of the Chinese outpatient ′s clinic and found that the vagina microecology was related to age, region and contraceptive methods.The typical manifestation of microecological abnormality is the increase of leucorrhea.(Chin J Lab Med,2018, 41:287-291)
ABSTRACT
The evaluation of vaginal microecology has certain advantages in the accurate and rapid diagnosis of single vaginitis and mixed vaginal infections,which can reduce the rates of missed diagnosis and misdiagnosis.Moreover, this evaluation can guide the application of vaginalmicroeclogial modulators after treatment for vaginitis.At present, the currentevaluation of vaginal microecology is mainly based on morphology mainly, and supplemented by functional testing.However, functional testing needs regulation and quality control,and further clinical research is needed for the diagnosis of vaginal infections based on microbial metabolites alone.(Chin J Lab Med,2018,41:256-258)
