[Characterization of otorhinolaryngologic manifestations in children with mucopolysaccharide storage disease typeⅠand type Ⅱ]

Objective:To analyze the characteristics of otorhinolaryngological clinical manifestations in children with Mucopolysaccharide（MPS） type Ⅰ and type II in order to improve the knowledge of otorhinolaryngologists about this disease. Methods:Clinical data related to 55 children with MPS type Ⅰ and type II were retrospectively analyzed to investigate the clinical manifestations of MPS in ENT. Results:All 40 patients（72.72%） with MPS had at least one ENT symptom during the course of the disease, with 95% of them having an ENT symptom prior to the diagnosis of MPS; upper airway obstruction was the most common ENT symptom（34, 85.00%）, followed by recurrent upper respiratory tract infections（23, 57.50%）, and lastly, hearing loss（11, 27.50%）; all 26 patients had undergone at least one surgical procedure, of which 15（57.69%） had undergone ENT surgery, and all of these patients underwent ENT surgery before diagnosis. The most common ENT surgery was adenoidectomy. Conclusion:Early clinical manifestations of MPS patients are atypical, but the early and prevalent appearance of otolaryngologic symptoms and increased awareness of the disease among otolaryngologists has a positive impact on the prognosis of MPS.

Integration of network pharmacology and proteomics to elucidate the mechanism and targets of traditional Chinese medicine Biyuan Tongqiao granule against allergic rhinitis in an ovalbumin-induced mice model

ETHNOPHARMACOLOGICAL RELEVANCE

Biyuan Tongqiao granule (BYTQ) is a traditional Chinese medicine that has been used in China to clinically treat patients with allergic rhinitis (AR), yet its underlying mechanism and targets remains unclear.

AIM OF THE STUDY

The study aimed to investigate the potential mechanism of BYTQ against AR using the ovalbumin (OVA) -induced AR mice model. Integrating network pharmacology and proteomics to investigate possible targets of BYTQ for AR.

MATERIALS AND METHODS

The compounds in BYTQ were analyzed using UHPLC-ESI-QE-Orbitrap-MS. The OVA/Al(OH)3 were used to induce the AR mice model. The nasal symptoms, histopathology, immune subsets, inflammatory factors, and differentially expressed proteins were examined. Proteomics analysis elucidated the potential mechanisms of BYTQ to improve AR, which was further validated by Western blot (WB) assay. The compounds and potential targets of BYTQ were systematically elucidated by integrating network pharmacology and proteomics analysis to explore the mechanism. The binding affinity between key potential targets and corresponding compounds was then validated using molecular docking. Molecular docking results were verified by a western blotting and cellular thermal shift assay (CETSA).

RESULTS

A total of 58 compounds were identified from BYTQ. BYTQ significantly suppressed AR symptoms by inhibiting the release of OVA-specific immunoglobulin E (IgE) and histamine, improving the pathological injury of nasal mucosal tissue, and regulating the proportions of lymphocytes to maintain immune balance. Proteomics analysis showed that the cell adhesion factors and focal adhesion pathway might be potential mechanism of BYTQ against AR. The levels of E-selectin, vascular endothelial cell adhesion molecule-1 (VCAM-1), and intercellular adhesion molecule-1 (ICAM-1) proteins in the nasal mucosal tissue were significantly downregulated in the BYTQ-H group compared to the AR group. Integrating network pharmacology and proteomics analysis identified that SRC, PIK3R1, HSP90AA1, GRB2, AKT1, MAPK3, MAPK1, TP53, PIK3CA, and STAT3 may be potential protein targets for BYTQ to treat AR. Molecular docking analysis indicated that the active compounds of BYTQ could bind tightly to these key targets. In addition, BYTQ could inhibit OVA-induced phosphorylation levels of PI3K, AKT1, STAT3 and ERK1/2. The CETSA data suggested that BYTQ could improve the heat stability of PI3K, AKT1, STAT3 and ERK1/2.

CONCLUSIONS

BYTQ suppresses E-selectin and VCAM-1 and ICAM1 expression by regulating PI3K/AKT and STAT3/MAPK signaling pathways, thus alleviating inflammation in AR mice. BYTQ is the aggressive treatment for AR.

[Clinical study of the Cobb+1 to Cobb fusion strategy for Lenke 5C adolescent idiopathic scoliosis patients with the lower lumbar apex]

Objective: To investigate the indications and surgical outcome of Cobb+1 to Cobb fusion strategy in Lenke 5C adolescent idiopathic scoliosis (AIS) patients with the lower lumbar apex. Methods: The clinical data of Lenke 5C AIS patients treated in Nanjing Drum Tower Hospital from August 2015 to December 2018 were retrospectively analyzed. The patients were followed-up for at least 2 years after surgery and treated with selective Cobb+1 to Cobb fusion strategy. The patients were divided into the normal lumbar apex group (apex location of the main curve was between T12 and L1) and the lower lumbar apex group (apex location of the main curve was below the disc of L1/L2). The occurrence of proximal decompensation in the two groups was compared. In addition, according to whether the patients had proximal decompensation at the last follow-up, the patients in the lower lumbar apex group were further divided into proximal decompensation group and non-decompensation group. The radiographic parameters and Scoliosis Research Society-22 (SRS-22) scores of the two groups were compared. Results: A total of 52 patients (19 cases in the normal lumbar apex group and 33 cases in the lower lumbar apex group), aged (15.3±1.6) years, were followed up for 2-5 (3.2±1.2) years. Six patients (6/19) in the normal lumbar apex group and 5 cases (15.2%) in the lower lumbar apex group showed proximal decompensation during follow-up, and the incidence was significantly higher in the normal lumbar apex group (P=0.034). Within the lower lumbar apex group, the patients with proximal decompensation (n=5) showed similar Risser grade, baseline thoracic Cobb angle, and main Cobb angle as those without proximal decompensation(n=28), and the differences were all not statistically significant (all P>0.05). However, the baseline thoracic/lumbar apical vertebra translation (AVT) ratio was significantly larger in patients with proximal decompensation (0.6±0.2 vs 0.4±0.2, P=0.042), but the postoperative upper instrumented vertebra (UIV) tilt angle was similar (4.5°±2.3° vs 6.2°±3.4°, P=0.312). Conclusion: Cobb+1 to Cobb fusion strategy, selecting UIV at 1 level above upper end vertebra (UEV), could be performed in Lenke 5C patients with the lower lumbar apex location. In addition, UIV could be selected at UEV+1 in patients with small baseline thoracic curve.

[The clinical application value of brain 18F-FDG PET/CT in the diagnostics of Parkinsonian syndromes]

Objective: To analyze the PET/CT imaging features of fluoride 18F-fluorodeoxyglucose (18F-FDG) in patients with various types of Parkinson's syndrome (PS), and to establish a "diagnostic tree" model of 18F-FDG PET/CT for PS. Methods: Data of patients with Parkinson's disease (PD), patients with multiple system atrophy cerebellar type (MSA-C), and patients with multiple system atrophy Parkinson's type (MSA-P)admitted to the Neurology Department of Huashan Hospital affiliated to Fudan University from January 2019 to December 2021. 18F-FDG PET/CT examination was conducted in all patients. Clinical and follow-up data was collected to determine clinical diagnosis. The specific patterns of brain glucose metabolism in patients with various types of Parkinsonism were observed and their utility in the differential diagnosis of the disease was analyzed. 18F-FDG PET/CT imaging"diagnostic tree"model was established and its value in the differential diagnosis of Parkinsonism was verified. Results: A total of 320 patients, 187 males and 133 females, aged (62±9) years, were enrolled in our study, including 80 PD, 90 PSP, 114 MSA-C and 36 MSA-P patients. The differential diagnostic features of cerebral glucose metabolism of Parkinsonism were as follows: the metabolism of putamen increased in PD patients, the metabolism of caudate nucleus, thalamus, midbrain, and frontal lobe decreased in PSP patients, the metabolism of cerebellum decreased in MSA-C patients, and the metabolism of putamen and cerebellum decreased in MSA-P patients. The sensitivity and specificity of the"diagnostic tree"model are 88.75% and 91.25% for PD diagnosis, 54.44% and 96.96% for PSP diagnosis, 87.72% and 86.41% for MSA-C diagnosis, and 55.56% and 91.55% for MSA-P diagnosis, respectively. It could correctly classify 75%(240/320) of patients. Conclusions: Characteristic metabolism patterns of brain in 18F-FDG PET/CT imaging is significant for the differential diagnosis of PD, PSP, MSA-C and MSA-P. The"diagnostic tree"model is valuable for clinical diagnosis.

Effect of PD-L1 Expression for the PD-1/L1 Inhibitors on Non-small Cell Lung Cancer: A Meta-analysis Based on Randomised Controlled Trials

AIMS

As PD-L1 expression has been proposed as one of the cancer biomarkers for non-small cell lung cancer (NSCLC), the predictive value of tumour proportional score (TPS) in the effect of immunotherapy [programmed death protein-1/ligand 1 (PD-1/L1) inhibitors] for NSCLC is worth exploring further. Here, we aimed to summarise the outcomes of current NSCLC randomised controlled trials (RCTs) and explore the predictive value of TPS in clinical immunotherapy, including immune checkpoint inhibitors (ICIs) with or without chemotherapy.

MATERIALS AND METHODS

RCTs published by PubMed, Medline, Embase and Scopus before February 2023 comparing immunotherapy (PD-1/L1 with or without other therapy) versus a control group in advanced or metastatic NSCLC were included to assess the prognosis according to the patients' TPS with 1% and 50% as the thresholds. The primary endpoints were overall survival and progression-free survival.

RESULTS

In total, 28 RCTs containing 17 266 participants with advanced or metastatic NSCLC were included in this meta-analysis. Statistical results showed that compared with TPS <1%, ≥1% or within 1-49%, patients with TPS ≥50% benefited more significantly from the immunotherapy. A subgroup analysis showed that when TPS was <1%, ≥1% or within 1-49%, ICIs + chemotherapy had better efficacy than ICIs alone; PD-1 (such as pembrolizumab) inhibitors had better efficacy than PD-L1 inhibitors (such as atezolizumab).

CONCLUSION

The efficacy of immunotherapy (PD-1/L1 inhibitors) for advanced or metastatic NSCLC is influenced by TPS.

Clinical characteristics of abruptly increased paediatric patients with Omicron BF.7 or BA.5.2 in Beijing

BACKGROUND

The coronavirus disease 2019 outbreak has hit Beijing since mid-Nov, 2022, with soaring growth of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children. Therefore, it is vital to determine the clinical manifestations of epidemic SARS-CoV-2 strains in paediatric patients.

METHODS

In this study, nucleic acid tests (NATs) for SARS-CoV-2 were performed in paediatric outpatients with symptoms of acute respiratory tract infection during 18 Nov-6 Dec, 2022. Half of the outpatients positive for SARS-CoV-2 were randomly selected to screen for other respiratory pathogens, whereas those with low cycle threshold values in SARS-CoV-2 NATs were amplified and sequenced to determine the SARS-CoV-2 variants. Finally, children positive for SARS-CoV-2 with clinical information in detail were enrolled in a follow-up study to identify potential factors significantly associated with long recovery.

RESULTS

Among 9625 paediatric outpatients tested for nucleic acid of SARS-CoV-2, 733 (7.62%, 733/9625) were identified as SARS-CoV-2 NAT positive, with only three (0.82%, 3/366) co-infected with other pathogens among 366 randomly selected patients, and 71 (62.83%) determined as Omicron subvariant BF.7 and 42 (37.22%) as BA.5.2 among 113 successfully sequenced. Among the 681 patients with complete clinical information, fever was the most common symptom (96.8%). In a follow-up study of 592 patients, 46.96% became asymptomatic on the third day and 65.71% on the fifth day. Only 1.7% of infected children experienced febrile seizures. Combined with abnormal C-reactive protein, a higher percentage of antibiotics administration was observed. More co-living members and longer duration of first symptoms served as independent risk factors for long-term recovery, especially in children vaccinated for SARS-CoV-2.

CONCLUSIONS

BF.7 and BA.5.2 were the dominate Omicron subvariants and caused milder infections during the SARS-CoV-2 outbreak in Beijing. The number of co-living members and duration of first symptoms were independent risk factors for long-term recovery.

Clinical effect of wumei bolus on ulcerative colitis: A meta-analysis

Wumei Bolus is a traditional Chinese medicine prescription, first appeared in Shennong Bencao Jing. Modern pharmacology believes that Wumei Bolus has antibacterial, antitussive, sedative, antiviral and anti-tumor effects, and plays a therapeutic role by acting on multi-target/multi-pathway. Moreover, it has great advantages in digestive system diseases, such as repairing the damaged gastrointestinal mucosa and improving the inflammatory environment.

Aim of the study

This review aimed to evaluate the efficacy and safety of prescriptions based on the Wumei Bolus treating ulcerative colitis (UC).

Materials and methods

In this meta-analysis, we searched CNKI, Wanfang Database, VIP, Pubmed, Web of Science (WOS) with language restrictions of Chinese and English for articles published from the establishment of the database to Dec 2022. This meta-analysis controlled randomized controlled trials (RCTs) assessing the efficacy and safety of Wumei Bolus against ulcerative colitis and using RevMan 5.4 and Stata 15.0to analyze information from the compliant studies.

Results

The search incorporated 3145 results (1617 cases assigned into Wumei Bolus group and 1528 cases assigned into control group), from which 37 studies fulfilled our inclusion criteria and were included. The outcomes of this meta-analysis showed that compared to the control group, the Experiment group was significantly more effective (RR = 1.24，95%CI [1.20，1.28])and lower adverse reactions (RR = 0.32, 95%CI [0.20, 0.53]). According to the subgroup analysis, The results showed that the RR = 1.23 and 95%CI [1.16, 1.30] in the group treated with Wumei Bolus alone and the group treated with Western medicine with RR = 1.25 and 95%CI [1.20, 1.30], indicating that the efficacy of Wumei Bolus in the treatment of UC was better and the difference was statistically significant (P < 0.00001). The results showed that compared with the control group, the experimental group had more advantages in reducing inflammatory factors whether TNF-α or IL-8 (TNF-α:SMD = -4.44, 95%CI [-5.75, -3.14]; IL-8: SMD = -3.02, 95%CI [-4.06, -1.97]) and improving TCM symptoms and reduced TCM syndrome points (SMD = -3.82, 95%CI [-4.30, -3.34]). There was significant association of the basic treatment of Wumei Bolus improving clinical efficacy, reducing serum pro-inflammatory factors, improving symptoms, and reducing adverse reactions in UC patients. These results were statistically significant (P < 0.00001).

Conclusions

The prescriptions based on the Wumei Bolus is greatly related to reducing serum pro-inflammatory factors, improving symptoms, improving clinical efficacy and reducing adverse reactions in the treatment of UC compared to conventional western medicine and improve the total clinical effective rate.

miR-146a-5p regulates autophagy and NLRP3 inflammasome activation in epithelial barrier damage in the in vitro cell model of ulcerative colitis through the RNF8/Notch1/mTORC1 pathway

Ulcerative colitis (UC) is a chronic inflammatory disease affecting the colon that can be influenced by microRNAs (miRNAs). This study aims to investigate the impact of miR-146a-5p on lipopolysaccharide (LPS)-induced Caco-2/HT-29 cell autophagy and NLRP3 inflammasome activation and the underlying mechanism, with the aim of identifying potential therapeutic targets. We used LPS to establish Caco-2/HT-29 cell models and measured cell viability by CCK-8. The levels of miR-146a-5p, RNF8, markers of NLRP3 inflammasome activation and autophagy, proteins involved in the Notch1/mTORC1 pathway, and inflammatory factors were assessed by RT-qPCR, Western blot, and ELISA. Intestinal epithelial barrier function was evaluated by measuring transepithelial electrical resistance. Autophagic flux was measured using tandem fluorescent-labeled LC3. miR-146a-5p was highly-expressed in LPS-induced Caco-2/HT-29 cells, and autophagy flux was blocked at the autolysosomal stage after LPS induction. Inhibition of miR-146a-5p suppressed NLRP3 inflammasome activation, reduced intestinal epithelial barrier damage, and facilitated autophagy inhibition in LPS-induced Caco-2/HT-29 cells. The autophagy inhibitor NH4Cl partially nullified the inhibitory effects of miR-146a-5p inhibition on NLRP3 inflammation activation. miR-146a-5p targeted RNF8, and silencing RNF8 partly abrogated the action of miR-146a-5p inhibition on promoting autophagy and inhibiting NLRP3 inflammasome activation. miR-146a-5p inhibition suppressed the Notch1/mTORC1 pathway activation by upregulating RNF8. Inhibition of the Notch1/mTORC1 pathway partially nullified the function of silencing RNF8 on inhibiting autophagy and bolstering NLRP3 inflammasome activation. In conclusion, miR-146a-5p inhibition may be a potential therapeutic approach for UC, as it facilitates autophagy of LPS-stimulated Caco-2/HT-29 cells, inhibits NLRP3 inflammasome activation, and reduces intestinal epithelial barrier damage by upregulating RNF8 and suppressing the Notch1/mTORC1 pathway.

Development and Validation of a Cardiovascular Disease Risk Prediction Model for Patients with Non-Dialysis-Dependent Chronic Kidney Diseases Based on the Nomogram

INTRODUCTION

Most chronic kidney disease (CKD) patients experience cardiovascular issues before commencing renal replacement therapy. An accuracy prediction model is helpful for physicians to assess cardiovascular prognoses in each individual and to provide insights on how to outline individualized lines of therapy.

METHOD

This study enrolled 1,138 participants with non-dialysis-dependent chronic kidney disease (NDD-CKD). Following a proportion of 7:3, patients were randomly assigned to training and validation cohorts. The relevant predictors of cardiovascular events were screened using the least absolute shrinkage and selection operator (Lasso) regression. The area under the receiver operating characteristic curve (AUC) and the calibration curve with 1,000 bootstrap resamples were used to assess the nomogram's performance. Tests on the discrimination of the prediction model used Kaplan-Meier (KM) curve.

RESULTS

After screening all the predictors by lasso regression, the five remaining ones (albumin, estimated glomerular filtration rate, etiology of CKD, cardiovascular disease history, and age) were used to construct the prediction model. The AUCs of 1 year, 2 years, and 3 years were 0.81 (95% CI = 0.75-0.87), 0.80 (95% CI = 0.75-0.86), and 0.80 (95% CI = 0.73-0.86), respectively. The calibration curve and the KM curve showed good prediction features, and the external validation also had a good prediction performance (AUCs of 1, 2, and 3 years were 0.77, 0.84, and 0.82, respectively).

CONCLUSION

We successfully developed a novel nomogram that has decent prediction performance and can be used for assessing the probability of cardiovascular events in patients with NDD-CKD, displaying valuable potential for clinical application.

Promotive role of IRF7 in ferroptosis of colonic epithelial cells in ulcerative colitis by the miR-375-3p/SLC11A2 axis

Ferroptosis is implicated in the progression of ulcerative colitis (UC), and interferon regulatory factor 7 (IRF7) contributes to cell death. This study probed the mechanism of IRF7 in ferroptosis of colonic epithelial cells (ECs) in mice with dextran sodium sulfate (DSS)-induced UC. The UC mouse model and the in vitro ferroptosis model were respectively established by DSS feeding and the treatment of FIN56 (a ferroptosis inducer). Results of quantitative real-time polymerase chain reaction and western blotting revealed the upregulation of IRF7 and solute carrier family 11 member 2 (SLC11A2/NRAMP2/DMT1) and the downregulation of microRNA (miR)-375-3p in DSS-treated mice and FIN56-treated ECs. Silencing of IRF7 improved the symptoms of UC in DSS-induced mice and decreased the levels of tumor necrosis factor α, interleukin 6, monocyte chemoattractant protein 1, and interleukin 1β, reactive oxygen species, iron ions, lipid peroxidation, and increased glutathione and glutathione peroxidase 4. Chromatin immunoprecipitation and dual-luciferase assays showed that binding of IRF7 to the miR-375-3p promoter inhibited miR-375-3p expression, and miR-375-3p suppressed SLC11A2 transcription. The rescue experiments revealed that knockdown of miR-375-3p neutralized the role of silencing IRF7 in alleviating ferroptosis of colonic ECs. Overall, IRF7 upregulated SLC11A2 transcription by inhibiting miR-375-3p expression, thereby prompting ferroptosis of colonic ECs and UC progression in DSS-treated mice.

Pattern of anatomic disorder and surgical management of anorectal prolapse in anorectal malformation

AIM

Due to the paucity of data and controversy regarding the etiology and surgical approach for managing anorectal prolapse (ARP) after anorectoplasty, we sought to investigate the underlying anatomic disorder and the surgical outcome in managing this challenging complication.

METHODS

We performed a retrospective study on 83 patients with ARP related to anorectal malformations (ARM). Logistic regression analyses were performed to detect the risk factors for the ARP severity. Surgical procedures were stratified according to identified anatomical abnormalities and surgical outcomes were analyzed.

RESULTS

50 patients (62.7%) had high-type ARM. The original anorectoplasty had a higher rate of ARP in laparoscopic-assisted anorectoplasty (n = 49, 59.0%) versus posterior sagittal anorectoplasty (n = 11, 13.3%). ARP was associated with rectal fat hyperplasia (67.5%), dilated muscular tunnel (79.5%), longitudinal muscle (LM) discontinuity (16.9%), rectal dilation (22.9%), mislocated anus (7.2%), and excessive mobile mesorectum (3.6%). Based on the ARP severity, the patients were divided into a severe group (Group 1, n = 38) and a moderate group (Group 2, n = 45). Binary logistic regression analysis showed that hyperplasia rectal fat (OR 4.55, 95% CI 1.16-17.84), rectal dilation (OR 4.21, 95% CI 1.05-16.94), and high-type ARM (OR 2.90, 95% CI 1.14-7.39) were independent risk factors for the development of severe ARP. Complications after stratified surgical repair included wound infection in six patients (7.2%), anal stenosis in one patient (1.2%), and ARP recurrence in two patients (2.4%). Twenty-six patients without colostomy before prolapse repair were followed up for 2 to 12 years. All the patients maintained voluntary bowel movements. Following ARP repair, there was an overall higher rate of no soiling or grade 1 soiling (88.5 vs. 65.4%), but 3 of 12 patients with grade 2 constipation were upgraded to grade 3.

CONCLUSION

Our study shows that ARM-related anorectal prolapse is associated with excessive rectum, hyperplasia of rectal fat, mobile mesorectum, loose muscular tunnel, LM discontinuity, and anal mislocation. Surgical repair with techniques stratified according to the patients' underlying risk factors is effective to prevent recurrence and improve the soiling continence.

[Health hazards and hearing loss risk assessment of workers exposed to noise in an automobile manufacturing enterprise]

Objective: To investigate the current situation of occupational exposure to noise among noise workers in an automobile manufacturing enterprise in Tianjin, understand the impact of noise on workers＇ nervous system and hearing, and assess the risk of hearing loss among noise workers. Methods: In May 2021, 3516 workers in an automobile manufacturing enterprise were investigated by using a self-made questionnaire＂Noise Workers Questionnaire＂ and cluster sampling method. The occupational noise hygiene survey and occupational hazards detection were carried out in their workplaces. They were divided into noise exposure group and non-noise exposure group according to whether they were exposed to noise or not. The general characteristics, hearing and nervous system symptoms of the two groups of workers were compared, and the risk of hearing loss was assessed. Results: There were 758 workers in the noise exposure group, aged (26±5) years old, with a working age of 3.0 (2.0, 6.0) years exposed to noise. 2758 workers in the non-noise exposure group, aged (25±6) years old, with a working age of 2.0 (1.0, 4.0) years. There were statistically significant differences in the distribution of workers＇education level, working age and memory loss between the two groups (χ(2)=37.98, 38.70, 5.20, P<0.05). The workers in the noise exposure group showed a decreasing trend of insomnia, dreaminess, sweating and fatigue with the increase of working age (χ(2trend)=6.16, 7.99, P<0.05). The risk classification of binaural high-frequency hearing loss for workers in all noise positions until the age of 50 and 60 was negligible, the risk of occupational noise deafness was low for workers in stamping and welding noise positions until the age of 60. Conclusion: The occupational noise exposed to automobile manufacturing workers may cause certain harm to their nervous and auditory systems. Noise protection measures should be taken to reduce the risk of hearing loss and occupational noise deafness.

A Clinical Practice Guideline for the Emergency Management of Anaphylaxis (2020)

Background: For anaphylaxis, a life-threatening allergic reaction, the incidence rate was presented to have increased from the beginning of the 21st century. Underdiagnosis and undertreatment of anaphylaxis are public health concerns. Objective: This guideline aimed to provide high-quality and evidence-based recommendations for the emergency management of anaphylaxis. Method: The panel of health professionals from fifteen medical areas selected twenty-five clinical questions and formulated the recommendations with the supervision of four methodologists. We collected evidence by conducting systematic literature retrieval and using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Results: This guideline made twenty-five recommendations that covered the diagnosis, preparation, emergency treatment, and post-emergency management of anaphylaxis. We recommended the use of a set of adapted diagnostic criteria from the American National Institute of Allergy and Infectious Diseases and the Food Allergy and Anaphylaxis Network (NIAID/FAAN), and developed a severity grading system that classified anaphylaxis into four grades. We recommended epinephrine as the first-line treatment, with specific doses and routes of administration for different severity of anaphylaxis or different conditions. Proper dosage is critical in the administration of epinephrine, and the monitor is important in the IV administration. Though there was only very low or low-quality evidence supported the use of glucocorticoids and H1 antagonists, we still weakly recommended them as second-line medications. We could not make a well-directed recommendation regarding premedication for preventing anaphylaxis since it is difficult to weigh the concerns and potential effects. Conclusion: For the emergency management of anaphylaxis we conclude that: • NIAID/FAAN diagnostic criteria and the four-tier grading system should be used for the diagnosis • Prompt and proper administration of epinephrine is critical.

PLAG1 Promotes High Glucose-Induced Angiogenesis and Migration of Retinal Endothelial Cells by Regulating the Wnt/β-Catenin Signalling Pathway

Proliferation and migration of retinal endothelial cells (RECs) contribute to the development of diabetic retinopathy. PLAG1 (pleomorphic adenoma gene 1) functions as a zinc-finger transcription factor to participate in the development of lipoblastomas or pleomorphic adenomas of the salivary glands through regulation of cell proliferation and migration. The role of PLAG1 in diabetic retinopathy was investigated in this study. Firstly, RECs were induced under high glucose conditions, which caused reduction in viability and induction of apoptosis in the RECs. Indeed, PLAG1 was elevated in high glucosetreated RECs. Functional assays showed that silence of PLAG1 increased viability and suppressed apoptosis in high glucose-induced RECs, accompanied with up-regulation of Bcl-2 and down-regulation of Bax and cleaved caspase-3. Moreover, migration of RECs was promoted by high glucose conditions, while repressed by knockdown of PLAG1. High glucose also triggered angiogenesis of RECs through up-regulation of vascular endothelial growth factor (VEGF). However, interference of PLAG1 reduced VEGF expression to retard the angiogenesis. Silence of PLAG1 also attenuated high glucose-induced up-regulation of Wnt3a, β-catenin and c-Myc in RECs. Moreover, silence of PLAG1 ameliorated histopathological changes in the retina of STZ-induced diabetic rats through down-regulation of β-catenin. In conclusion, knockdown of PLAG1 suppressed high glucose-induced angiogenesis and migration of RECs, and attenuated diabetic retinopathy by inactivation of Wnt/ β-catenin signalling.

[Epidemiological characteristics of imported COVID-19 cases in Tianjin]

Objective: To understand the epidemiological characteristics of imported COVID-19 cases in Tianjin, and provide references for risk assessment and control of imported COVID-19 cases. Methods: The information of imported COVID-19 cases were obtained from National Notifiable Disease Report System of China CDC. The data of imported COVID-19 cases reported from Tianjin airport and epidemiological surveys by CDCs at all levels from March 15, 2020 to August 31, 2021 were collected and analyzed by using software Excel 2010, SPSS 25.0 and R. Results: From March 15, 2020 to August 31, 2021, a total of 606 imported cases of COVID-19 were reported in Tianjin, in which 552 cases were finally included in the analysis. The male to female ratio of the cases was 1.8∶1, the age of the cases ranged from 3 to 77 years, and the cases were mainly reported in age group 20-39 years (59.8%). The areas where the imported case sojourned within 14 days included Europe (242 cases, 43.8%), Africa (139 cases, 25.2%), Americas (85 cases, 15.4%) and Asia (86 cases, 15.6%). The proportion of confirmed cases in autumn and winter was relatively high. During the study period, the proportion of infected persons found in custom entry quarantine decreased, and the proportion of persons with personal health declaration and under medical isolation observation increased. The interval between entry and diagnosis of infected persons tended to increase. Conclusion: The proportion of imported COVID-19 cases detected on the first day of entry at Tianjin airport decreased, and the interval to detect the infected persons trended to increase, to which close attention must be paid.

Current status of Chinese herbal medicine to treat allergic rhinitis in children: from the perspective of Western medicine-a narrative review

Allergic rhinitis (AR) has a high prevalence and significantly affects quality of life in children. According to traditional Chinese medicine theory, AR in children can be classified as BiQiu, and the etiology lies in the lung, spleen and kidney. The internal cause is primarily related to congenital deficiencies of vital qi; dysfunction of the lungs, which will lead to inhibited nose orifices; and deficiency of the spleen and kidney, which will lead to lung qi deficiency. The external cause is cold, inadequate diet and other factors. The theoretical systems of Chinese and Western medicine represent different understandings of the life science of the human body from the different perspectives of Eastern and Western culture. Therefore, ways for these approaches to communicate with and promote one another to achieve a true combination approach is the focus of our attention. In this review, we specifically discuss the mechanisms of action of herbal monomers and compounds of Chinese herbal medicines in the treatment of AR and present some results and shortcomings of Chinese herbal medicines in combination with Western medicines in the treatment of AR. We also propose future research directions and trends to enhance combined treatment with Chinese and Western medicines.

[Clinical study of selection of the upper instrumented vertebra at one level caudal to upper end vertebra in patients with Lenke 5C adolescent idiopathic scoliosis]

Objective: To investigate whether the upper instrumented vertebra (UIV) can be selected at one level caudal to upper end vertebra (UEV) in Lenke type 5C adolescent idiopathic scoliosis (AIS) patients. Methods: Total of 28 Lenke 5C AIS patients who underwent selective posterior fusion in Drum Tower Hospital of Nanjing University Medical School from September 2013 to September 2015 were included. There were 4 males and 24 females, with an age of (15.0±2.0) years, the Risser sign was graded 2-5. The following imaging parameters were measured on standing full spine X-ray before, immediately after the surgery and at the last follow-up: thoracolumbar/lumbar (TL/L) Cobb angle, coronal balance, UIV translation, lower instrumented vertebra (LIV) translation, UIV tilt, LIV tilt, and thoracic apical vertebral translation (T-AVT), lumbar apical vertebral translation (L-AVT). The patients were divided into two groups: decompensation group (n=6) and non-decompensation group (n=22). Radiographic parameters and Scoliosis Research Society (SRS)-22 scores were compared between the two groups. Results: Six cases (21.4%) had proximal decompensation at the last follow-up. There were no significant differences in Risser grade(3.8±1.0 vs 3.6±1.6), baseline thoracic Cobb angle(25.8°±2.2° vs 26.3°±6.4°) and TL/L Cobb angle(43.7°±3.4° vs 45.2°±6.5°) between the two groups (all P>0.05). However, the baseline lumbar/thoracic apical vertebra translation (L-T AVT ratio) was significantly higher in patients with proximal decompensation (6.3±1.3 vs 4.0±2.0, P=0.048). Conclusion: Selecting UIV at one level caudal to UEV, would not increase the incidence of proximal decompensation in Lenke 5C AIS patients with Risser higher than grade 2, the smaller baseline L-T AVT ratio, and with thoracic compensatory curve over 15°, and can obtain satisfactory clinical results.

A pre-registered short-term forecasting study of COVID-19 in Germany and Poland during the second wave

Disease modelling has had considerable policy impact during the ongoing COVID-19 pandemic, and it is increasingly acknowledged that combining multiple models can improve the reliability of outputs. Here we report insights from ten weeks of collaborative short-term forecasting of COVID-19 in Germany and Poland (12 October-19 December 2020). The study period covers the onset of the second wave in both countries, with tightening non-pharmaceutical interventions (NPIs) and subsequently a decay (Poland) or plateau and renewed increase (Germany) in reported cases. Thirteen independent teams provided probabilistic real-time forecasts of COVID-19 cases and deaths. These were reported for lead times of one to four weeks, with evaluation focused on one- and two-week horizons, which are less affected by changing NPIs. Heterogeneity between forecasts was considerable both in terms of point predictions and forecast spread. Ensemble forecasts showed good relative performance, in particular in terms of coverage, but did not clearly dominate single-model predictions. The study was preregistered and will be followed up in future phases of the pandemic.

[The distribution and variance of neonatal pulse oxygen saturation at different altitudes]

Objective: To analyze the distribution and variance of neonatal pulse oxygen saturation (SpO₂) at different altitudes in China, and provide a new evidence for the screening of NCHD at high altitudes. Methods: Based on the database of National Screening Project of NCHD, the distribution of SpO₂ values was described in 26 766 newborns at altitudes of 0-100 m, 600-700 m, 900-1 100 m, 1 400-1 600 m, 1 900-2 100 m, and 2 200-2 500 m. One-way analysis of variance was used to analyze the differences among SpO₂ values in newborns at different altitudes. Results: The average SpO₂ values of right hand in newborns at altitudes of 0-100 m, 600-700 m, 900-1 100 m, 1 400-1 600 m, 1 900-2 100 m and 2 200-2 500 m were 97.7%±1.4%, 97.1%±1.1%, 96.1%±1.3%, 96.0%±1.7%, 95.9%±1.7% and 95.5%±2.4%, respectively. And corresponding average SpO₂ values of either foot were 97.7%±1.4%, 96.9%±1.1%, 96.3%±1.4%, 96.0%±1.7%, 95.6%±1.8% and 95.2%±2.7%, respectively. There were statistically significant differences in the average SpO₂ values of newborns at different altitudes (right hand: F=1 248.35, P<0.001; either foot: F=1 280.45, P<0.001). The SpO₂ of newborns tended to be lower with the increase of altitudes (P-trend<0.001). Conclusion: SpO₂ values in newborns were negatively associated with the altitudes, which indicated that the cut-off value of screening for NCHD at sea level might not be applicable to newborns at higher altitudes. Thus, it is worthwhile to conducted studies on the normal values of SpO₂ and the cut-off value of screening for NCHD in newborns at high altitudes.

[Molecular identification of Tricula spp. and the parasitized trematode cercariae in schistosomiasis-endemic areas of Yunnan Province]

OBJECTIVE

To characterize a species of the genus Tricula and parasitized trematodes in schistosomiasis-endemic areas of Yunnan Province using a molecular analysis, so as to understand their taxonomic positions.

METHODS

Tricula spp. and Oncomelania snails were collected from Xiangyun County, Yunnan Province, and cercaria parasitizing snails were observed using crushing followed by microscopy. Cercaria parasitizing Tricula snails at various morphologies were sampled using a shedding method. Genomic DNA was extracted from snail soft tissues and cercariae, and the 16S rRNA, COI, 28S rDNA genes in snails and the ND1 and 28S rDNA genes in cercariae were amplified using a PCR assay and sequenced. The species of Tricula snails and their parasitized trematodes was characterized using sequence alignment and phylogenetic analysis.

RESULTS

Among 382 Tricula snails detected, there were three types of trematode cercariae found, including the non-forked (20.94%, 80/382), double-forked (3.40%, 13/382) and swallow shapes (7.07%, 27/382). Sequence and phylogenetic analyses showed that the 16S rRNA, COI and 28S rDNA gene sequences of this species of Tricula had high homology to those in Delavaya dianchiensis, and were clustered in a branch. Sequencing analysis of the ND1 and 28S rDNA genes revealed that the non-forked cercariae belonged to the family Pleu- rogenidae, the swallow-shaped cercariae belonged to the family Opecoelidae, and the double-forked cercariae belonged to another species of the genus Schistosoma that was different from S. sinensium and S. ovuncatum.

CONCLUSIONS

The species and taxonomy of Triculla spp. and their parasitized trematodes are preliminarily determined in schistosomiasis-endemic areas of Yunnan Province; however, further studies are required to investigate the more definite taxonomy and pathogenicity.

Atacama sub-millimeter telescope experiment polarimeter (APol) I: design and lab-test result: publisher's note

This publisher's note corrects errors in the author affiliations, abstract and the Funding sections in Appl. Opt.59, 2593 (2020).APOPAI0003-693510.1364/AO.378008.

Whole genome sequence analysis and in vitro probiotic characteristics of a Lactobacillus strain Lactobacillus paracasei ZFM54

AIM

The aim was to identify a Lactobacillus strain with potential probiotic characteristics by whole-genome sequence analysis and in vitro experimental studies.

METHODS AND RESULTS

The whole-genome sequencing was carried out using PacBio RSII sequencing method and Illumina's paired-end sequencing technology. Gene prediction and annotation were achieved using GlimmerVersion 3.02 and NCBI prokaryotic Genome Annotation Pipeline. Identification was done by biochemical tests and 16S rRNA sequence analysis. mega 6 software was used to build phylogenetic tree. Antagonism against pathogen was determined by agar well diffusion method. Resistance and stability to bile, simulated gastric acid, different salt concentration and thermostability were investigated. Hydrophobicity assay, aggregation assay and anti-oxidation assay were performed to check further probiotic traits. Finally antibiotic susceptibility and acute oral toxicity of the strain in mice were investigated to check its safety status. The strain showed >99% similarity to Lactobacillus paracasei which was further confirmed by biochemical tests. It significantly inhibited pathogens in agar well diffusion assay. It showed tolerance to simulated gastric acid (pH 3), 0·3% bile salt and 10% NaCl. Significant hydrophobic, aggregation and anti-oxidizing activities were observed. No resistance to antibiotics tested was observed and no adverse effects during acute oral toxicity in mice were detected.

CONCLUSIONS

Lactobacillus paracasei ZFM 54, a new and safe Lactobacillus strain was identified with numerous probiotic-associated genes and characteristics confirmed by experimental studies.

SIGNIFICANCE AND IMPACT OF THE STUDY

A new probiotic strain has been identified which is highly stable, safe and suitable to be used in health and food industries.

Atacama sub-millimeter telescope experiment polarimeter (APol) I: design and lab-test result

In this paper, the Atacama Submillimeter Telescope Experiment (ASTE) is presented. A 10-m aperture telescope hosts a camera equipped with a transition edge sensor (TES). We developed a fore-optics module-"APol," to convert the 271 pixels of the TES working at 350 GHz into a sensitive imaging polarimeter without sacrificing the image quality and the ${7.5}^\prime$7.5^' field of view. Here, we describe the detailed optical design of APol and present the results of the preliminary test in a laboratory.

[Analysis of the social support and related factors of the elderly in the elderly activity centers in Macao, Hong Kong and Guangzhou]

Research participants were recruited at 16 elderly activity centers among three cities in Macao, Hong Kong and Guangzhou. A total of 324 people were surveyed, with women ≥ 55 years old and men ≥ 60 years old; There were 90, 100 and 134 in Macao, Hong Kong and Guangzhou respectively. The median (P(25), P(75)) score of the social support rating scale (SSRS) for the elderly was 30 (25, 38) for Macao, 24 (20, 29) for Hong Kong and 30 (26, 37) for Guangzhou respectively. The elderly in Macao and Guangzhou had a higher proportion of the SSRS in the middle and high groups (85.20%, 84.50%) when compared to the elderly in Hong Kong (62.10%) (P<0.05). The city, marital status, and personal well-being index are related to SSRS scores.

[Effects of p-Phenylene diamine on liver and kidney functions of occupational exposed workers]

Objective: To study the effect of p-phenylenediamine (PPD) on liver and kidney function in occupational exposed workers. Methods: Workers in a hair dye production enterprise which used p-phenylenediamine as a raw material for production were selected as the main research population. Then we conducted a questionnaire survey on the basic conditions of workers and conducted occupational health checkups on general health status, liver and kidney function. Occupational health examination assessment results were tested in Taizhou Cancer Hospital. All data was built using EpiData 3.1 software, and statistical analysis was performed using software SPSS 20.0. Results: The liver function indicators including direct bilirubin, prealbumin, total protein, and white protein, globulin, aspartate aminotransferase, glutamyl transpeptidase, and total bilirubin in the workers exposed to high concentration of PPD were at high normal values, and these indicators were significantly different from low PPD concentration group (P<0.05) . The serum creatinine and serum uric acid in the renal function index were significantly higher in workers exposed to PPD than in workers exposed to low concentrations and in the control group (P<0.05) . Conclusion: Occupational exposed to PPD may have a hazard to the workers' liver and kidney function. Long-term occupational exposure to PPD may lead to increased cumulative exposure of workers, which may cause potential chronic liver and kidney damage in occupationally exposed populations.

[Analysis of relationship between personal wellbeing index and related factors in the elderly aged 55 or above, who visit the day care centers in Macao, Hong Kong and Guangzhou]

Objective: To investigate the personal wellbeing index (PWI) among elderly aged 55 and above from the elderly day care centers in Macao, Hong Kong and Guangzhou, and associated factors. Methods: We used convenient sampling to select participants from 16 elderly day care centers in Macao, Hong Kong and Guangzhou. Inclusion criteria were: females aged 55 or above, males 60 or above, the participants who were conscious and clearly understood the questionnaire. Informed consent form was signed by the participants. A total of 324 elderly participated in the study: 90 from Macao, 100 from Hong Kong, and 134 from Guangzhou. Close-end questionnaire was used to collect demographic information and PWI inventory (Cantonese version) was used to assess the PWI scores. Comparison in the PWI scores difference was conducted. Multiple regression method was used to analyze factors associated with PWI. Results: The PWI was 7.3±1.9 (Macao: 7.7±1.9, Hong Kong: 7.2±1.7, Guangzhou: 7.0±1.9) (F=3.32, P=0.037). The multiple regression analysis showed that comparing to those who did exercised 3 times or less, or single/devoiced/separated, or had no education, the elderly who did exercised 4 times or more per week or married/widowed, or received education in primary school or above had higher PWI scores. The beta values (95%CI) were 0.82 (95% CI: 0.31-1.34), 1.03 (95% CI: 0.12-1.94), 0.51 (95% CI: 0.04-0.99) respectively. Conclusion: The elderly participants aged 55 or above who went to elderly day care centers in three cities had higher PWI score generally. Marital status, participate in sufficient physical activity and advanced education level were significant related to PWI.

[Review on the relationship between major air pollutants and related indicators of type 2 diabetes mellitus]

The situation of air pollution has become increasingly serious and its relationship with diabetes becomes a new research concern, in China. After going through a large number of epidemiological studies published in recent years, this paper reviews the relationship between major air pollutants and both blood glucose and blood lipid, related to type 2 diabetes. It also summarizes the relationships among the main pollutants of the atmosphere so as to propose the research directions in this field. Hopefully, this paper can provide reference for forming policies on air pollution, prevention and treatment of type 2 diabetes in the country.

New process for producing butane-2,3-dione by oxidative dehydrogenation of 3-hydroxybutanone

Reaction of 3-hydroxybutanone in air has been studied with and without a catalyst under atmospheric pressure and at temperatures between 523 and 673 K.

[Effects of ethylbenzene on cell injury and mitochondrial membrane potential of CPCs]

Objective: To investigate the effects of ethylbenzene on growth morphology、proliferation ability and mitochondrial membrane potential (MMP) of cochlear progenitor cells (CPCs) , and to lay a foundation for the mechanism of hearing loss induced by ethylbenzene. Methods: We can use the fluorescence microscopy to identify the original CPCs isolated from the newborn rats, and followed by the addition of different concentrations of ethylbenzene (0, 15, 30, 45 μmol/L) for 24 hours. The morphological changes of cell injury were observed by inverted optical microscope. The proliferation ability of cells was detected by MTT colorimetry, and the change of MMP was detected by fluorescent probe JC-1. Results: The results of CPCs identification showed the expression of Myosin VIIa and Epsin positive; The results observed by inverted optical microscope showed all groups of CPCs morphological changes compared with the control group; MTT results showed that the decreased significantly proliferation ability of CPCs groups compared with the control group and a dose effect relationship with statistically significant difference (P<0.05) ; JC-1 test results showed the decreased significantly mitochondrial membrane potential in the treated group compared with the control group, and there was a statistically significant difference (P<0.05) . Conclusion: Ethylbenzene may cause damage to CPCs, inhibition of cell proliferation and decrease of MMP in rats.

[Construction of cochlear progenitor cells with recombinant short-hairpin RNA lentiviral vector inhibiting the expression of the β-catenin gene]

Objective: To construct a recombinant short-hairpin RNA (shRNA) lentiviral vector targeting the β-catenin gene in cochlear precursor cells (CPCs) in mice, and to investigate its inhibitory effect. Methods: PCR was used for the multiplication of the β-catenin gene, and shRNA oligo was designed based on the β-catenin gene to construct an interference vector. Gateway Technology was used to construct shRNA lentiviral vector which carried the β-catenin gene, and then 293FT cells were transfected with the constructed lentiviral vector and helper plasmids pLV/helper-SL3, pLV/helper-SL4, and pLV/helper-SL5. The virus supernatant was collected to obtain viral particles, and then mouse CPCs were transiently infected with the recombinant lentivirus with four different concentrations (0, 5, 10, and 20 μl) . The shRNA control group was established. Quantitative real-time PCR and Western blot were used to investigate the inhibitory effect of shRNA β-catenin lentiviral vector on β-catenin. Results: The recombinant shRNA β-catenin lentiviral vector was successfully constructed, and the virus titers of shβ-catenin and shβ-catenin-control were 5.05×10(7) and 4.34×10(7), respectively. The results of in vitro experiments showed that in CPCs transfected with four different concentrations of recombinant lentivirus, the content of β-catenin protein gradually decreased with the increase in concentration, and there was a significant difference between groups (P<0.05) ; the CPCs transfected with shβ-catenin had significantly lower mRNA expression of β-catenin than those in the shβ-catenin-control group (P<0.05) . Conclusion: The constructed lentiviral vector targeting the β-catenin gene has a high infection efficiency, and the successful construction of lentiviral vectors provides a technical support for analyzing the role of β-catenin in the differentiation of CPCs into auditory hair cells.

[Clinical features of post-splenectomy pulmonary hypertension and effects of its target therapy]

Objective: To analyze the clinical features of post-splenectomy pulmonary hypertension and effects of its target therapy, and improve the diagnosis and treatment of the disease. Methods: Clinical data of 18 patients with post-splenectomy pulmonary hypertension admitted to Fuwai Hospital from October 2006 to March 2017 were systematically reviewed and analyzed. Results: Among the 18 patients with a mean age of (41±11) years old, 11 were women and 7 were men. The interval between splenectomy and the diagnosis of pulmonary hypertension was (11±6) years. Shortness of breath (14/18) and chest distress (12/18) were the most common clinical manifestations. Nine patients were in World Health Organization functional class (WHO-FC) Ⅲ-Ⅳ, and two patients were combined with pulmonary embolism. According to the cause of splenectomy, the pulmonary hypertension patients were divided into hepatocirrhosis portal hypertension group (10/18) and non-hepatocirrhosis portal hypertension group (8/18). In hepatocirrhosis portal hypertension group, patients were combined with chronic liver abnormalities presentation, and no pulmonary embolism was found in these patients. Cardiac output and cardiac index were significantly higher (P=0.007 and 0.011, respectively) and pulmonary vascular resistance was significantly lower (P=0.013) in hepatocirrhosis portal hypertension group as compared with non-hepatocirrhosis portal hypertension group. There was no difference in WHO-FC and mean pulmonary arterial pressure between two groups (P=0.448 and 0.379, respectively). After 3 months of target treatment in 8 patients, WHO-FC of 3 patients improved, systolic pulmonary artery measured by ultrasonic cardiogram was significantly decreased[(84±10) vs (71±12) mmHg(1 mmHg=0.133 kPa), P=0.005]and right ventricular end diastolic diameter/left ventricular end diastolic diameter was significantly reduced[(0.78±0.17) vs (0.62±0.16), P=0.010]compared to the baseline. The level of NT-proBNP also tended to be decreased, although not to a significant extent. Conclusions: Post splenectomy pulmonary hypertension has various clinical features. Post splenectomy pulmonary hypertension resulted from hepatocirrhosis portal hypertension has better hemodynamics. Target treatment is effective for the patients with post splenectomy pulmonary hypertension.

Successful Treatment of Cytogenetically Normal Acute Myeloid Leukemia With Ten-Eleven Translocation 2-Isocitrate Dehydrogenase 2 and Additional Sex Comb-like 1-Nucleophosmin Co-mutations by HLA Haploidentical Stem Cell Transplantation: A Case Report and Literature Review

The presence of recurrent gene mutations is increasingly important in acute myeloid leukemia (AML) and sheds new insights into the understanding of leukemogenesis, prognostic evaluation, and clinical therapeutic efficacy. Until now, ten-eleven translocation 2 (TET2) and isocitrate dehydrogenase 2 (IDH2) mutations were reported to be mutually exclusive in AML patients. Similarly, nucleophosmin (NPM1) and additional sex comb-like 1 (ASXL1) mutations were rarely coexisted in AML. A 47-year-old man diagnosed with high-risk AML presented simultaneous mutations of TET2-IDH2 and NPM1-ASXL1 revealed by next-generation sequencing. After successful treatment with chemotherapy followed by HLA haploidentical transplantation, he achieved a clinical complete remission without evidence of overt graft-versus-host disease. This case highlights that HLA haploidentical transplantation might be a safe and feasible therapy for AML patients who are characterized by TET2-IDH2 and NPM1-ASXL1 co-mutations.

Three-vessel-trachea view in the diagnosis of fetal cardiac great vessel malformation

Fetal cardiac great vessel malformation is attracting increasing attention in the prenatal ultrasonic diagnosis of fetal congenital heart disease. To investigate the clinical diagnostic values of three-vessel-trachea view (3VT view) in the ultrasonic diagnosis of this malformation, the present study analyzed the echocardiographic examination results of 77 fetuses with great vessel malformation, retrospectively analyzed the echocardiographic characteristics in the three-vessel-trachea view, and followed up the enrolled cases. The results suggest that great vessel malformation had characteristic manifestations, such as abnormal arrangement order, inner diameter, blood flow direction and branch. Color Doppler flow imaging found V, O, C, U, Ioo and oVo structures. There were 20 cases of blood vessel position abnormality, 38 cases of abnormal blood vessel diameter, and 19 cases of abnormal number of blood vessels. The detection rate of abnormal blood vessel diameter was 95%, which was the highest; the detection rate of abnormal blood vessel position was 97.4%, and that of abnormal number of blood vessels was 84.2%. It is concluded that the 3VT view can indicate fetal cardiac great vessel malformation. The 3VT view is beneficial to timely prenatal diagnosis, relief of body pain and improvement of quality of birth.

Molecular conformations of DNA targets captured by model nanoarrays

An open question in single molecule nanoarrays is how the chemical and morphological heterogeneities of the solid support affect the properties of biomacromolecules. We generated arrays that allowed individually-resolvable DNA molecules to interact with tailored surface heterogeneities and revealed how molecular conformations are impacted by surface interactions.

[Association between parental exposure to environmental risk factors and the risk of childhood acute lymphoblastic leukemia]

Objective: To investigate the association between parental environmental risk factors exposure and the risk for childhood acute lymphoblastic leukemia (ALL). Methods: A total of 179 ALL children cases were selected in Tianjin Blood Disease Hospital and 136 healthy children matched by age, gender and living place were selected in 2015 for a case control study. The data were analyzed with univariate and multivariate non conditional logistic regression models. Results: The results of multivariate logistic regression analysis indicated that sex, history of abortion, exposure in a smoking environment during pregnancy, catching a cold, taking antipyretic analgesics, maternal exposure to air purifying agent, father' s occupational exposure to petroleum products and home decoration during pregnancy were associated with the risk of childhood ALL (P<0.05) and the results of multivariate logistic regression analysis indicated that sex, history of abortion, catching a cold, father's occupational exposure to petroleum products and home decoration during pregnancy were associated with the risk of childhood ALL (P<0.05). Conclusion: The five factors including sex, history of abortion, catching a cold, father' s occupational exposure to petroleum products and home decoration during pregnancy were risk factors for childhood ALL.

Bioinformatics tools for analysing viral genomic data

The field of viral genomics and bioinformatics is experiencing a strong resurgence due to high-throughput sequencing (HTS) technology, which enables the rapid and cost-effective sequencing and subsequent assembly of large numbers of viral genomes. In addition, the unprecedented power of HTS technologies has enabled the analysis of intra-host viral diversity and quasispecies dynamics in relation to important biological questions on viral transmission, vaccine resistance and host jumping. HTS also enables the rapid identification of both known and potentially new viruses from field and clinical samples, thus adding new tools to the fields of viral discovery and metagenomics. Bioinformatics has been central to the rise of HTS applications because new algorithms and software tools are continually needed to process and analyse the large, complex datasets generated in this rapidly evolving area. In this paper, the authors give a brief overview of the main bioinformatics tools available for viral genomic research, with a particular emphasis on HTS technologies and their main applications. They summarise the major steps in various HTS analyses, starting with quality control of raw reads and encompassing activities ranging from consensus and de novo genome assembly to variant calling and metagenomics, as well as RNA sequencing.

Anthropometric Reference Data for Children and Adults: United States, 2011-2014

Anthropometry or human body measurements provide important indicators of nutritional status in children and adults (1). In children, measurements reflect general health status, dietary adequacy, and growth and development over time. In adults, body measurements are used to evaluate health and dietary status, disease risk, and body composition. This report presents anthropometric reference data for 2011-2014 for U.S. children and adults.

[Clinical features of Takayasu arteritis patients with pulmonary hypertension due to pulmonary artery involvement]

OBJECTIVE

To summarize the clinical features of Takayasu arteritis (TA) patients with pulmonary hypertension due to pulmonary artery involvement.

METHODS

Ninety-four TA patients with pulmonary artery involvement treated in Fuwai Hospital from Jun 1988 to Jun 2014 were retrospectively summarized. Patients were divided into two groups according to whether aorta and its main branches affected (APTA, n=48) or not (PTA, n=46). Clinical features and angiographic data were further analyzed.

RESULTS

Of all the patients, male to female rate was 1∶3.3, age ranged from 8 to 60 years with median age of 33.5 years when symptom onset. Main symptoms included dyspnea on exertion. Heart murmur and mid-systolic murmur in pulmonic area were commonly found by physical examination. All patients had pulmonary hypertension by echocardiographic examination. Angiographic data showed that multi-lobular and multi-segmental pulmonary branches were predominantly affected, followed by sub-segmental and peripheral branches. Both sides of pulmonary artery involvement were more common than one side involvement, while the right pulmonary arteries were more often affected than the left. Most of the clinical symptoms and signs between APTA group and PTA group were comparable. However, erythrocyte sedimentation rate and N-terminal pro-natriuretic peptide were significant higher in APTA group than that in PTA group when admission [14.0(5.0, 28.0) vs 8.5(3.0, 19.3) mm/1 h and (1 936±1 769) vs (1 627±1 153) ng/L, both P<0.05].

CONCLUSIONS

Dyspnea on exertion may be the main manifestation of TA with pulmonary artery involvement. All patients present with pulmonary hypertension and moderate to severe heart failure when symptom onset.

Mining drug-disease relationships as a complement to medical genetics-based drug repositioning: Where a recommendation system meets genome-wide association studies

A novel recommendation-based drug repositioning strategy is presented to simultaneously determine novel drug indications and side effects in one integrated framework. This strategy provides a complementary method to medical genetics-based drug repositioning, which reduces the occurrence of false positives in medical genetics-based drug repositioning, resulting in a ranked list of new candidate indications and/or side effects with different confidence levels. Several new drug indications and side effects are reported with high prediction confidences.