Correlation of gut microbiota with leukopenia after chemotherapy in patients with colorectal cancer.

BACKGROUND: The most common toxic side effect after chemotherapy, one of the main treatments for colorectal cancer (CRC), is myelosuppression. OBJECTIVE: To analyze the correlation between gut microbiota and leukopenia after chemotherapy in CRC patients. METHODS: Stool samples were collected from 56 healthy individuals and 55 CRC patients. According to the leukocytes levels in peripheral blood, the CRC patients were divided into hypoleukocytes group (n = 13) and normal leukocytes group (n = 42). Shannon index, Simpson index, Ace index, Chao index and Coverage index were used to analyze the diversity of gut microbiota. LDA and Student's t-test(St test) were used for analysis of differences. Six machine learning algorithms, including logistic regression (LR) algorithm, random forest (RF) algorithm, neural network (NN) algorithm, support vector machine (SVM) algorithm, catboost algorithm and gradient boosting tree algorithm, were used to construct the prediction model of gut microbiota with leukopenia after chemotherapy for CRC. RESULTS: Compared with healthy group, the microbiota alpha diversity of CRC patients was significantly decreased (p < 0.05). After analyzing the gut microbiota differences of the two groups, 15 differential bacteria, such as Bacteroides, Faecalibacterium and Streptococcus, were screened. RF prediction model had the highest accuracy, and the gut microbiota with the highest predictive value were Peptostreptococcus, Faecalibacterium, and norank_f__Ruminococcaceae, respectively. Compared with normal leukocytes group, the microbiota alpha diversity of hypoleukocytes group was significantly decreased (p < 0.05). The proportion of Escherichia-Shigella was significantly decreased in the hypoleukocytes group. After analyzing the gut microbiota differences of the two groups, 9 differential bacteria, such as Escherichia-Shigella, Fusicatenibacter and Cetobacterium, were screened. RF prediction model had the highest accuracy, and the gut microbiota with the highest predictive value were Fusicatenibacte, Cetobacterium, and Paraeggerthella. CONCLUSION: Gut microbiota is related to leukopenia after chemotherapy. The gut microbiota may provide a novel method for predicting myelosuppression after chemotherapy in CRC patients.

Comparison of bacterial diversity in Bactrocera cucurbitae (Coquillett) ovaries and eggs based on 16S rRNA sequencing.

Next-generation sequencing allows for fine-scale studies of microbial communities. Herein, 16S ribosomal RNA high-throughput sequencing was used to identify, classify, and predict the functions of the bacterial communities in the eggs and ovaries of Bactrocera cucurbitae (Coquillett) (Diptera: Tephritidae), which is a pest that infests a variety of cucurbit fruits at different developmental stages. Taxonomic analyses indicate that bacteria associated with B. cucurbitae represent 19 phyla, which were spread across different developmental stages. Specifically, the egg microbiota had a higher alpha diversity than those of microbiota in the primary and mature ovaries. Significant differences were not observed between the primary and mature ovaries in terms of their microbiota's alpha diversities. Pseudomonadota, Deinococcota, Bacteroidota, Bacillota, and Actinomycetota were the dominant phyla in all three developmental stages of B. cucurbitae, and Pseudomonadaceae and Enterobacteriaceae were the most abundant families. Owing to the unique physiological environment of the ovaries, the diversity of their bacterial community was significantly lower than that in the eggs. This study provides new insights into the structure and abundance of the microbiota in B. cucurbitae at different developmental stages and contributes to forming management strategies for this pest.

Study on the application of sound thinking combined with Sandwich teaching method in oncology nursing teaching / 中华医学教育探索杂志

Objective:To explore the application of sound thinking combined with Sandwich teaching in oncology nursing practice teaching.Methods:A total of 68 nursing students who were interns in the Department of Oncology, The First Affiliated Hospital of Air Force Medical University from 2020 to 2021 were included in the study, and they were divided into a control group ( n=34) and an observation group ( n=34). The control group took routine teaching for interns, while the observation group took sound thinking combined with Sandwich teaching. The examination results, critical thinking abilities, and the evaluation of nursing teaching effectiveness of the two groups of nursing interns were evaluated. SPSS 22.0 was used for Chi-square test and t-test. Results:The examination scores of nursing students in the observation group were higher than those in the control group ( t=3.44, 2.87, 3.45, P<0.05). Compared with those before training, the scores of critical thinking ability of nursing interns in both groups increased after the training, and the observation group was better than the control group ( t=0.180, 3.64, 0.61, 2.92, 0.31, 2.74, 0.45, 2.65, 0.25, 3.58, 1.16, 2.85, 0.36, 3.20, 0.33, 2.38, P<0.05). The scores of autonomous learning ability, communication and collaboration ability, independent thinking ability, clinical reasoning ability, and problem-analyzing and -solving ability in the observation group were higher than those in the control group ( t=2.82, 3.46, 2.68, 3.29, 2.44, P<0.05). Conclusion:Combining sound thinking with Sandwich teaching in nursing clinical practice teaching in department of oncology can improve the examination scores of nursing students, improve their critical thinking abilities, and enable them to give a high evaluation of nursing teaching effectiveness.

Advances in Chemical Constituents and Pharmacological Action of Tinosporae Radix / 中国实验方剂学杂志

Tinosporae Radix， as a traditional Chinese medicinal herb， is the dried root tuber of Tinospora sagittata or T. capillipes. It was first recorded in the Compendium of Materia Medica Supplement in the Qing Dynasty and included in the previous edition of the Chinese Pharmacopoeia. Tinosporae Radix is excavated in autumn and winter and used after removing fibrous roots， washing， and drying. It is indicated for sore throat， carbuncle boils poison， waist and abdominal pain， and various heat syndromes and is commonly used to treat chronic inflammation. Its efficacy is significantly known as “broad-spectrum antibiotics in Zhuang medicine”. Tinosporae Radix is a traditional Chinese medicinal herb often taken by Zhuang and Yao nationalities in Guangxi province and has a wide range of application and development values and research significance. Modern studies have shown that Tinosporae Radix contains diterpenoids， alkaloids， sterols， anthraquinones， glycosides， fatty acids， volatile oils， and other compounds， which have many pharmacological activities such as anti-inflammatory and analgesic， antibacterial and antibacterial， antioxidant， anti-diabetic， and anti-tumor and anti-cancer effects， and it has achieved good efficacy in inhibiting inflammation and treating sore throat and other diseases. In recent years， there have been many research reports on the status， chemical constituents， pharmacological action， clinical application， and quality evaluation of Tinosporae Radix resources， but there is no systematic review and introduction at present. By consulting the literature and combining it with modern research， this paper systematically summarizes and collates Tinosporae Radix resources to provide guidance for the comprehensive development and utilization of Tinosporae Radix resources and subsequent in-depth study.

Prognosis of fetal umbilical cord cyst with structural abnormalities indicated by prenatal ultrasound: analysis of 109 cases / 中华围产医学杂志

Objective:To explore the prognosis of umbilical cord cysts in fetuses with structural abnormalities diagnosed by prenatal ultrasonography.Methods:This retrospective study involved 109 cases of umbilical cord cysts diagnosed by ultrasound at Beijing Obstetrics and Gynecology Hospital from January 2016 to December 2020. According to the ultrasound findings, these cases were divided into the isolated umbilical cord cyst, umbilical cord cyst with soft ultrasound markers, and umbilical cord cyst with fetal malformation groups. Chi-square was performed for statistical analysis to compare the prognosis. Results:(1) Among 109 cases of umbilical cord cysts, 55 cases (50.5%) were isolated, 20 (18.3%) were complicated by soft ultrasound markers, and 34 (31.2%) cases were complicated by fetal malformation. After excluding two cases of multiple cysts at different locations, the incidence of umbilical cord cysts at the placental end, free segment, and fetal terminal with other ultrasound abnormalities in the remaining 107 cases increased sequentially [27.5% (14/51), 10/17, and 76.9% (30/39), χ2=22.20, P<0.001]. The incidence of umbilical cord cysts with other ultrasound abnormalities at the fetal end was higher than at the placental end ( χ2=21.65, P<0.001). (2) A total of 60 fetal malformations were detected, dominated by fetal ventricular septal defect, omphalocele, giant bladder, fetal edema, and nuchal cystic hygroma, et al., mainly involving the cardiovascular system, urogenital system, anterior abdominal wall, and skeletal system. (3) Eighty-nine cases were followed up to the end of the pregnancy, and 21 (23.6%) of them had adverse outcomes. The prognoses of isolated umbilical cord cyst cases were all good. Two pregnancies (2/18) were terminated in the umbilical cord cyst with ultrasound soft markers group. In the group of umbilical cord cyst with fetal malformation, 19 pregnancies (19/26, 73.1%) had adverse outcomes, including pregnancy termination, intrauterine fetal demise, and perinatal death. Conclusions:The prognosis of isolated umbilical cord cysts is generally good. The umbilical cord cyst complicated by soft ultrasound marker and fetal malformation can have adverse outcomes, while conditions might be worse in those with fetal malformation. When an umbilical cord cyst is revealed, a systematical examination is recommended to identify whether it is combined with other ultrasound abnormalities.

How adverse and benevolent childhood experiences influence depression and suicidal ideation in Chinese undergraduates: a latent class analysis

BACKGROUND@#There has been minimal research on the role of benevolent childhood experiences (BCEs) and how such events may offer protection from the insidious effects of adverse childhood experiences (ACEs) or later in life.@*OBJECTIVES@#This research aims to learn how BCEs and ACEs interact to affect adolescents' psychological distress.@*METHODS@#Cross-sectional survey was conducted in three cities (Xuzhou, Nanjing, and Wuhan) in China from March 2021 to May 2021. Latent class analysis (LCA) was used to classify the patterns of ACEs and BCEs. We adopted hierarchical multivariable regression to examine the influences of ACEs and BCEs on depression and suicidal ideation.@*RESULTS@#To explore the relationship between childhood experience and suicidal ideation and depression, LCA revealed three patterns of ACEs: (1) emotional abuse (10.57%); (2) high ACEs (0.55%); and (3) low ACEs classes (88.88%). Adolescents with emotional abuse (depression: OR = 3.82, 95%CI = 2.80-5.22, P < 0.001; suicidal ideation: OR = 5.766, 95%CI = 3.97-8.38, P < 0.001) and high ACEs class (suicidal ideation: OR = 5.93, 95%CI = 1.19-29.66, P < 0.05) had an increased risk of psychological distress (reference: low ACEs). LCA revealed four patterns of BCEs: (1) relationship support (14.54%); (2) low BCEs (4.85%); (3) high BCEs (55.34%); and (4) high quality of life classes (25.28%). Adolescents with a high quality of life (depression: OR = 0.09, 95%CI = 0.05-0.16, P < 0.001; suicidal ideation: OR = 0.22, 95%CI = 0.12-0.40, P < 0.001) and high BCEs (depression: OR = 0.05, 95%CI = 0.03-0.09, P < 0.001; suicidal ideation: OR = 0.15, 95%CI = 0.09-0.26, P < 0.001) protected the mental health of adolescents (reference: low BCEs).@*CONCLUSIONS@#High ACEs and emotional abuse classes were significantly associated with poorer mental health symptoms, including suicidal ideation and depression. In contrast, high BCEs and high quality of life classes were associated with better mental health. These findings point out that it is more necessary to identify and support victims of ACEs, and it is urgent to increase BCEs in early childhood.

A preliminary investigation on internal exposure dose of artificial radionuclides in nuclear medicine staff / 上海预防医学

ObjectiveTo tentatively understand the status of radioactive contamination in nuclear medicine personnel. MethodsA total of 34 radiation staff engaged in nuclear medicine diagnosis and treatment were selected from two hospitals in Shanghai as the survey subjects.Among the 34 medical staff， 8 were nuclear medicine doctors， 14 were nuclear medicine technicians and 12 were nuclear medicine nurses. After surface contamination monitoring was first carried out to confirm that they had no surface radioactivity contamination， whole body scanning was performed with a whole body counter to determine whether they were internally contaminated with artificial radionuclides. ResultsThe α surface contamination was not detected in the nuclear medical staff. The β surface contamination of the nuclear medicine doctors， technicians and nurses was （13.8±0.8）， （14.1±0.8） and （14.0±0.7） times per second， respectively. There were 2， 2， and 4 nuclear medicine doctors who were contaminated with 18F， 99mTc and 131I， 3， 5， and 2 nuclear medicine technicians who were contaminated with 18F， 99mTc and 131I， and 6， 8， and 5 nuclear medicine nurses who were contaminated with 18F， 99mTc and 131I， respectively. The 18F activity of nuclear medicine technicians was 1 997‒9 401 Bq， and the 99mTc activity of nuclear medicine technicians and nurses was 3 699‒18 692 and 652‒388 22 Bq， respectively. One nuclear medicine nurse had a 99mTc activity of 35 389 Bq. According to the preliminary estimation of 131I internal irradiation dose， the maximum committed effective dose of nuclear medicine doctors， technicians and nurses could reach 0.370， 0.018 and 0.584 mSv， respectively. ConclusionThe nuclear medicine staff are exposed to radioactive contamination， and it is important to monitor and evaluate their internal radiation doses.

Non-coding RNA-mediated TGF-β1/Smads Signaling Pathway and Liver Fibrosis， and Intervention by Active Components of Chinese Medicinal： A Review / 中国实验方剂学杂志

Liver fibrosis is a wound healing response that occurs in the setting of chronic liver injury and is caused by imbalance in the synthesis and degradation of extracellular matrix （ECM）. If left untreated， it can progress to liver cirrhosis and hepatocellular carcinoma. The activation of hepatic stellate cell （HSC） is now well established as a central driver of liver fibrosis. The activated HSC will transform into myofibroblasts that produce ECM protein. Transforming growth factor-β1 （TGF-β1） can induce the activation of hepatic stellate cell （HSC）， and TGF-β1/Smads signaling pathway is one of the important pathways to promote liver fibrosis. Non-coding RNA （ncRNA） does not encode proteins during the transcription but plays an important regulatory role in the post-transcriptional process of genes. Accumulating evidence shows that the occurrence of liver fibrosis is closely related to the abnormal expression of ncRNA which participates in the activation of HSC by regulating TGF-β1 signal transduction and then affects the process of liver fibrosis. MiRNA-mediated TGF-β1/Smads signaling pathway can not only promote liver fibrosis but also play a role in anti-fibrosis. Long non-coding RNA （lncRNA） not only promotes the development of liver fibrosis by binding to target genes but also enhances TGF-β1 signal transduction by acting as competitive endogenous RNA. circular RNA （circRNA） acts as a ''sponge'' to regulate TGF-β1/Smads pathway， thereby inhibiting HSC activation and exerting the anti-liver fibrosis effect. Chinese medicinal plays an essential part in the prevention and treatment of liver fibrosis， and the active components can inhibit TGF-β1/Smads pathway by regulating the expression of miRNA， thus alleviating liver fibrosis. This article reviews the role and mechanism of miRNA-， lncRNA- and circRNA-mediated TGF-β1/Smads signaling pathway in liver fibrosis and summarizes the anti-liver fibrosis effect of active components of Chinese medicinals by regulating miRNA-mediated TGF-β1/Smads signaling pathway， which can serve as a reference for clinical treatment of liver fibrosis and the development of new drugs.

Optimization of water extraction process of Maxing kechuan granules / 中国药房

OBJECTIVE To optimize the water extraction process of Maxing kechuan granules. METHODS With the contents of ephedrine hydrochloride， bergenin， prim-O-glucosylcimifugin， 5-O-methylvisamin， naringin and hesperidin and the rate of extraction as the evaluation indexes， the weight was determined by the analytic hierarchy process（APH）-entropy weight method， and the comprehensive score was calculated as the response value. Based on the single-factor test， the Box-Behnken response surface method was used to investigate the factors， and the best water extraction process of Maxing kechuan granules was optimized； process validation was also carried out. RESULTS The best water extraction process of Maxing kechuan granules optimized was as follows： soaking for 40 minutes， adding 8 times water， and extracting for 180 minutes. After three validation tests， the comprehensive score was 94.82 （RSD＝0.96%， n＝3）， which had a small difference from the predicted value of 94.64. CONCLUSIONS The water extraction process of Maxing kechuan granules is stable and reliable， which can provide a reference for the development of the preparation.

Whole-exome sequencing identified a homozygous novel RAG1 mutation in a child with omenn syndrome

Introduction and objectives Omenn syndrome (OS) is a very rare type of severe combined immunodeficiencies manifested with erythroderma, eosinophilia, hepatosplenomegaly, lymph-adenopathy, and elevated level of serum IgE. OS is inherited with an autosomal recessive mode of inheritance. Germline mutations in the human RAG1 gene cause OS. Materials and methods In this study, we investigated a 2-month-old boy with cough, mild anaemia, pneumonia, immunodeficiency, repeated infection, feeding difficulties, hepatomegaly, growth retardation, and heart failure. Parents of the proband were phenotypically normal. Results Karyotype analysis and chromosomal microarray analysis found no chromosomal structural abnormalities (46, XY) and no pathogenic copy number variations (CNVs) in the proband. Whole-exome sequencing identified a novel homozygous single nucleotide deletion (c.2662delC) in exon 2 of the RAG1 gene in the proband. Sanger sequencing confirmed that both the proband parents were carrying this variant in a heterozygous state. This variant was not identified in two elder sisters and one elder brother of the proband and in the 100 ethnically matched normal healthy individuals. This novel homozygous deletion (c.2662delC) leads to the frameshift, which finally results in the formation of the truncated protein (p.Leu888Phefs*3) V(D)J recombination-activating protein 1 with 890 amino acids compared with the wildtype V(D)J recombination-activating protein 1 of 1043 amino acids. Hence, it is a loss-of-function variant. Conclusion Our present study expands the mutational spectrum of the RAG1 gene associated with OS. We also strongly suggested the importance of whole-exome sequencing for the genetic screening of patients with OS (AU)

Disulfide stabilization reveals conserved dynamic features between SARS-CoV-1 and SARS-CoV-2 spikes.

SARS-CoV-2 spike protein (S) is structurally dynamic and has been observed by cryo-EM to adopt a variety of prefusion conformations that can be categorized as locked, closed and open. The locked conformations feature tightly packed trimers with structural elements incompatible with RBD in "up" position. For SARS-CoV-2 S, it has been shown that the locked conformations are transient under neutral pH. Probably due to their transience, locked conformations remain largely uncharacterized for SARS-CoV-1 S. Intriguingly, locked conformations were the only conformations captured for S proteins of bat and pangolin origin SARS-related coronaviruses. In this study, we introduced x1, x2, and x3 disulfides into SARS-CoV-1 S. Some of these disulfides have been shown to preserve rare locked conformations when introduced to SARS-CoV-2 S. Introduction of these disulfides allowed us to image a variety of locked and other rare conformations for SARS-CoV-1 S by cryo-EM. We identified bound cofactors and structural features that are associated with SARS-CoV-1 S locked conformations. We compare newly determined structures to other available spike structures of Sarbecoviruses to identify conserved features and discuss their possible functions.

Research on the Visual Imagery of Posters Based on the Culture Code Theory of Design.

According to the Culture Code Theory of Design, posters can be divided into strategy aspect, meaning aspect, and technical aspect. This study explored the impact of visual imagery on poster communication and effect focus on the meaning and technical aspects which directly related to the audiences. The visual imagery preference of ten public poster samples is collected from 40 participants by online questionnaire with the semantic differential method. The results show that the audience's visual imagery at the technical aspect is mainly related to the richness of colors, graphics, and texts. When receiving the information from the meaning aspect of the poster correctly, the visual imagery will be influenced by the type of theme. Most importantly, the same or similar visual imagery at the technical and meaning aspect encourages audiences to explore the deep information of posters. Poster works that keep visual imagery coherent and smooth at the two aspects can achieve a better effect.

Analysis of the initial ethical review of Investigator-Initiated Trails research and discussion of standardized management / 中华医学科研管理杂志

Objective:By analyzing the data of Investigator-Initiated Trials (IITs) in a grade A tertiary hospital and common problems in the initial ethical review, this study puts forward corresponding countermeasures, providing a reference for standardizing the ethical management of clinical scientific research projects in medical institutions.Methods:A causal analysis was conducted based on the statistics of the number of IITs undergoing ethical review in a grade A tertiary hospital from January 2012 to August 2021, and the analysis of the problems in the ethical formal review of 271 clinical research involving human beings.Results:At present, there are some problems in scientific research ethics, such as weak review execution, inadequate supervision, and weak ethical awareness of researchers.7 targeted measures were put forward.Conclusions:Establishing a hospital subject protection system, strengthening the construction of a scientific research ethics supervision system, refining ethical norms and standards, and promoting the institutionalization of scientific research ethics training are of great importance for standardizing investigator-initiated clinical research, improving research quality, avoiding scientific research ethical risks, and effectively guiding the ethical management of clinical research in hospitals.

Analysis of clinical characteristics of patients with different vaccines and underlying diseases infected with novel coronavirus Omicron variant / 中华危重病急救医学

Objective:To analyze the clinical characteristics of patients inoculated with different vaccines and underlying diseases, infected with the novel coronavirus Omicron variant.Methods:The data of 430 patients infected with the novel coronavirus Omicron variant who were admitted to Tianjin First Center Hospital from January 21, 2022 to March 7, 2022 were collected. A total of 108 patients with Omicron variant infection with underlying diseases were selected and enrolled. The gender, age, body mass index (BMI), history of underlying diseases, vaccination status (vaccination times, vaccination type), clinical symptoms, laboratory test indicators, imaging data, hospitalization time, nucleic acid negative conversion time, re-positivity and antibody titer from the two groups of the patients were collected and analyzed.Results:In the 108 patients, 93 cases received inactivated vaccine and 15 cases received adenovirus vaccine. There was no statistically significant difference between the two groups in terms of gender, age, BMI, disease types, whether completed the fully vaccinated, whether had prime boost and underlying diseases. Both groups had fever, dry cough, sore throat, runny nose and other clinical symptoms, but there were no statistical difference between the two groups. There were no statistically significant differences in laboratory blood routine tests, biochemical indexes, C-reactive protein (CRP) level and the results of chest computed tomography (CT) imaging between the two groups. There were no statistically significant differences in hospitalization days, nucleic acid negative conversion time, whether admission to intensive care unit (ICU), turn re-positive on nucleic acid tests and immunoglobulin M (IgM) antibody titer expression between the two groups, but immunoglobulin G (IgG) antibody titer in adenovirus group was higher than that in inactivated group (g/L: 229.67±26.13 vs. 194.33±61.56, P = 0.020). There were also no significant differences in laboratory examinations, hospitalization days, nucleic acid negative conversion time, turn re-positive on nucleic acid tests and Novel coronavirus antibody titers expression of the patients with booster shots between the inactivated vaccine group and the adenovirus vaccine group. Conclusions:The protection of inactivated virus vaccine is equivalent to adenovirus vaccine in patients with underlying disease Omicron variant infection, and the titer of IgG antibody in patients with adenovirus vaccine is higher than that in patients with inactivated virus vaccine after one week of recovery.

A retrospective study on the risk factors and time distribution of renal recurrence in lupus nephritis patients with long-term follow-up / 中华肾脏病杂志

Objective:To explore the risk factors and time distribution of renal relapse in patients with lupus nephritis (LN).Methods:Clinical, pathological characteristics and long-term outcomes of LN patients who were diagnosed and followed in Jinling Hospital from January 2004 to December 2008 were retrospectively analyzed. The patients were divided into relapse group and non-relapse group. The differences of clinical pathological characteristics between the two groups were compared. The multivariate Cox proportion risk model was used to analyze the risk factors affecting renal relapse in LN. The risk factors and time distribution of renal relapse were analyzed with annual relapse risk-time curve.Results:A total of 814 patients with LN were included in the study, with 419 cases (51.5%) of complete remission and 395 cases (48.5%) of partial remission. The age was (30.24±10.90) years old, and there were 112 males (13.8%). There were 367 patients suffering renal relapse. The time of first renal relapse was (3.21±2.70) years. The results of multivariate Cox regression showed that age ( HR=0.976, 95% CI 0.966-0.986, P<0.001), renal pathological activity index (AI) score ( HR=1.039, 95% CI 1.013-1.065, P=0.003), remission status after induction treatment ( HR=0.671, 95% CI 0.504-0.894, P=0.006), 24 h urinary protein quantitation ( HR=1.297, 95% CI 1.115-1.508, P=0.001), anti-double strand DNA antibody (A-dsDNA, HR=1.450, 95% CI 1.139-1.846, P=0.003) and complement C3 ( HR=0.223, 95% CI 0.128-0.389, P<0.001) were correlated with increasing risk of renal relapse in LN. The annual relapse risk profile was unimodal, with a peak period of the second year after maintenance treatment. Similar patterns of relapse were presented in subgroup analysis. Conclusions:Age, renal pathological AI score, remission status after induction therapy, 24 h urine protein, A-dsDNA and blood complement C3 are the influencing factors for relapse of LN patients. The peak period of renal relapse in patients with LN is in the second year of maintenance therapy.

Predictive value of ultrasound signs of the involvement of the cervix in the adverse pregnancy outcomes of placenta accreta spectrum / 中华超声影像学杂志

Objective:To explore the the predictive value of ultrasound signs of the involvement of the cervix in the clinical grade diagnosis of placenta accreta spectrum(PAS) with placenta previa and adverse pregnancy outcomes.Methods:A retrospective analysis was performed on PAS patients with placenta previa diagnosed during delivery or by cesarean section in Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University from January 2018 to March 2021. According to the signs of cervical involvement on prenatal ultrasound, the patients were divided into cervical involvement group and cervical non-involvement group. Logistic analysis was performed on clinical data between the two groups. The clinical data, hysterectomy rate, intraoperative blood loss and clinical diagnosis were compared between the two groups.Results:There were 1 455 patients with PAS diagnosed by clinical diagnosis or placental pathology, of which 170 were with placenta previa, 24 with incomplete clinical data or non-standard ultrasound images, and the remaining 146 patients were included. In the cervical involvement group, all of 6 cases had placenta percreta. Of the 140 cases in the unaffected cervical group, 89 cases (63.6%) had placental accreta, 48 cases (34.3%) had placental increta, and 3 cases (2.1%) had placenta percreta. There were no significant differences of the age and uterine operation history between the two groups. There was significant difference in the number of cesarean sections between the two groups ( P<0.05). There were significant differences in intraoperative blood loss, hysterectomy rate and placenta accreta grade diagnosis between the two groups(χ 2/ Z=4.203, 11.165, 95.248, all P<0.05). Conclusions:The ultrasonographic signs of cervical involvement have a good predictive value for the pregnancy outcome of PAS.

Meta analysis and systematic review of influencing factors on unplanned shutdown of continuous blood purification / 中国小儿急救医学

Objective:To systematically evaluate the influencing factors on unplanned shutdown of continuous blood purification, and to provide reference basis for the prevention of unplanned shutdown.Methods:The literatures related to the influencing factors of unplanned shutdown of continuous blood purification in CNKI, Wanfang Database, Chinese Biomedical Literature Database, Chinese Science and Technology Periodical Full-text Database, PubMed and Web of Science were searched.The retrieval time of Chinese database was from the establishment of the database to March 2021.English databases were searched from March 2016 to March 2021.Literature selection, quality evaluation and data extraction were independently conducted by two researchers, and Meta-analysis was performed by Stata 14.0 software.Results:A total of 11 studies were included, including 3 031 cases of continuous blood purification treatment and 1 412 cases of unplanned discontinuation.The combined OR value and 95% CI of all influencing factors were as follows: treatment mode 2.22 (1.06-4.62), blood flow velocity 0.91 (0.776-1.09), agitation 4.54 (2.33-8.86), ventilator 2.67 (1.63-4.38), transfusing blood products and fat milk 1.07 (0.34-3.36), one-time catheter success 0.26 (0.05-1.42), catheterization site (femoral vein vs.jugular vein) 2.24 (0.83-6.02). Conclusion:Unplanned deplaning is influenced by many factors.Treatment mode, agitation and ventilator use are the risk factors for unplanned deplaning.There is no correlation between blood flow velocity, transfusing blood products and fat milk, one-time catheterization success, catheterization site and unplanned deplaning.

Mechanism of adrenocorticotropic hormone in the treatment of nephrotic syndrome / 中华实用儿科临床杂志

In recent years, it has been demonstrated in some studies that adrenocorticotropic hormone (ACTH) is effective in the treatment of certain steroid-resistant nephrotic syndrome, including membranous nephropathy, focal segmental glomerular sclerosis, minimal change nephropathy and so forth.ACTH can effectively relieve proteinuria and protect renal function, suggesting that there may be other mechanisms in addition to the adrenocorticotropic effect.This article mainly introduces the biological characteristics of ACTH, in combination with the clinical and basic studies on the treatment of nephrotic syndrome by ACTH, and clarifies several possible mechanisms, in an attempt to provide basis for clinical application.

Epidemiological characteristics of measles in Jinshan District of Shanghai in 2002‒2019 / 上海预防医学

Objective To determine the epidemiological characteristics of measles in Jinshan District of Shanghai in 2002‒2019. Methods This study was a secondary data analysis using measles surveillance system and epidemiological case reports in Jinshan District from January 2002 through December 2019. Temporal characteristics of the disease onset was determined by a concentration method. ArcGis 10.4 and SaTScan 9.6 software were used for spatiotemporal clustering scanning analysis. Results From 2002 through 2019， a total of 289 cases of measles were reported in Jinshan District， Shanghai， with an average annual incidence of 2.24 per 105. The annual incidence fluctuated from 0 to 11.27 per 105. The highest incidence was recorded in 2005 （11.27 per 105）， followed by a decline； however， there was a rebound in 2008 （5.26 per 105） and 2015 （3.30 per 105）. The concentration M was determined to be 0.62， showing a clear seasonality concentrated in February to May. The spatiotemporal scan found that spatial and temporal clusters were more likely to occur in the areas with higher population density such as Zhujing Town and Shihua Community and between 2002 and 2009. The majority of measles cases were infants and children under the age of 1 and adults aged 20‒39 years. Approximately 66.78% of measles cases reported unknown vaccination history. In addition， in children aged 8 month to 4 years， the vaccination rate of measles-containing vaccines in the domestic migrants was much lower than the local residents （χ2=4.44， P=0.035）. Conclusion The incidence of measles in Jinshan District presents a downward trend. The population affected has a "two-way displacement"， which is concentrated in the more populated areas. It is necessary to strengthen measles surveillance and implement supplementary immunization programs with measles-containing vaccines for at-risk populations.

Determination of fluoxetine ，norfluoxetine and sertraline concentration in human placental perfusate and their placental permeability by UFLC-MS/MS / 中国药房

OBJECTIVE To establish t he method for determining the concentrations of fluoxetine ，norfluoxetine and sertraline in human placental perfusate method and their placental permeability. METHODS Using glyburide as internal standard ，the samples were pretreated by protein precipitation method and detected by ultra-fast liquid chromatograph-mass spectrometer/mass spectrometer （UFLC-MS/MS）. The determination was performed on Synergi TM Hydro-RP 80A LC column with mobile phase consisted of water （containing 0.1％ formic acid ）-acetonitrile（containing 0.1％ formic acid ）at the flow rate of 0.70 mL/min，with a gradient elution. The column temperature was set at 40 ℃，and sample size was 5 μL. Detection was performed with electrospray ionization source in multipl e reaction monitoring mode . The ion pairs for quantitative analysis we re m/z 309.9→148.1（fluoxetine），m/z 296.0→134.4 （-167）， （norfluoxetine），m/z 306.1→159.0 （sertraline），m/z 493.9→ No.2018FE001（-207），（internal standard ）. The perfusion model of singal placenta under bidrectional cardiopulmonary bypass was established. Fluoxetine （160 ng/mL），norfluoxetine（160 ng/mL）， sertraline（100 ng/mL）and antipyrine （positive control ，ng/mL）were added into the maternal perfusate. The concen- 65324888 trations of fluoxe tine， norfluoxetine and sertrali ne were measured by above UFLC-MS/MS at 0，10，20，30，45，60，90，120，150 and 180 min of circulation ，and the placental permeability was calculated. RESULTS The linear range of fluoxetine ，norfluoxetine and sertraline were 5.00-500 ng/mL（all r＞ 0.990），and the lower limits of quantification were all 5.00 ng/mL. The RSDs of intra-day and inter-day were all less than 14.0％， and relative error ranged －9.6％ to 14.7％. The relative error of stability test was －4.0％ to 11.0％；the residual effect ，extraction method and matrix effect did not affect the quantitative analysis of the substance to be tested. Totally 31 perfusion model of human placenta under cardiopulmonary bypass were successfully established ，including 15 fluoxetine and norfluoxetine perfusion ，10 sertraline perfusion and 6 antipyrine perfusion. After 3 hours of perfusion ，the average placental permeability of fluoxetine ， norfluoxetine and sertraline were （8.74 ± 1.67）％ ，（10.70 ± 4.81）％ ，（5.90 ± 1.25）％ ，respectively. CONCLUSIONS The established UPLC-MS/MS is simple ，sensitive and accurate. It can be used for determination of fluoxetine ，norfluoxetine and sertraline in human placental perfusate. Fluoxetine ，norfluoxetine and sertraline can pass through the placenta ，but sertraline has a lower placental permeability.