The patient was a boy aged 1 year and 9 months who presented with 46,XY disorder of sex development (DSD), with severe undermasculinization of the external genitalia. Laboratory tests and ultrasound examinations showed normal functions of Leydig cells and Sertoli cells in the testes. Genetic testing revealed a novel pathogenic heterozygous variant, c.1186dupA (p.T396Nfs*17), in the PPP1R12A gene. Thirteen cases of PPP1R12A gene variants have been reported previously. These variants may cause isolated involvement of the genitourinary or neurological systems, or affect other systems/organs including the digestive tract, eyes, heart, etc. Patients with DSD typically present with a 46,XY karyotype and variable degrees of undermasculinization involving the external genitalia, gonads, and reproductive tract. This article reports a child with 46,XY DSD accompanied by growth retardation caused by a heterozygous variant in the PPP1R12A gene, which expands the clinical disease spectrum associated with PPP1R12A gene variants.
Humans ; Male ; Infant ; Disorder of Sex Development, 46,XY/etiology* ; Protein Phosphatase 1/genetics*

Objective To investigate the clinical characteristics and prognosis of pneumococcal meningitis(PM),and drug sensitivity of Streptococcus pneumoniae(SP)isolates in Chinese children.Methods A retrospective analysis was conducted on clinical information,laboratory data,and microbiological data of 160 hospitalized children under 15 years old with PM from January 2019 to December 2020 in 33 tertiary hospitals across the country.Results Among the 160 children with PM,there were 103 males and 57 females.The age ranged from 15 days to 15 years,with 109 cases(68.1% )aged 3 months to under 3 years.SP strains were isolated from 95 cases(59.4% )in cerebrospinal fluid cultures and from 57 cases(35.6% )in blood cultures.The positive rates of SP detection by cerebrospinal fluid metagenomic next-generation sequencing and cerebrospinal fluid SP antigen testing were 40% (35/87)and 27% (21/78),respectively.Fifty-five cases(34.4% )had one or more risk factors for purulent meningitis,113 cases(70.6% )had one or more extra-cranial infectious foci,and 18 cases(11.3% )had underlying diseases.The most common clinical symptoms were fever(147 cases,91.9% ),followed by lethargy(98 cases,61.3% )and vomiting(61 cases,38.1% ).Sixty-nine cases(43.1% )experienced intracranial complications during hospitalization,with subdural effusion and/or empyema being the most common complication[43 cases(26.9% )],followed by hydrocephalus in 24 cases(15.0% ),brain abscess in 23 cases(14.4% ),and cerebral hemorrhage in 8 cases(5.0% ).Subdural effusion and/or empyema and hydrocephalus mainly occurred in children under 1 year old,with rates of 91% (39/43)and 83% (20/24),respectively.SP strains exhibited complete sensitivity to vancomycin(100% ,75/75),linezolid(100% ,56/56),and meropenem(100% ,6/6).High sensitivity rates were also observed for levofloxacin(81% ,22/27),moxifloxacin(82% ,14/17),rifampicin(96% ,25/26),and chloramphenicol(91% ,21/23).However,low sensitivity rates were found for penicillin(16% ,11/68)and clindamycin(6% ,1/17),and SP strains were completely resistant to erythromycin(100% ,31/31).The rates of discharge with cure and improvement were 22.5% (36/160)and 66.2% (106/160),respectively,while 18 cases(11.3% )had adverse outcomes.Conclusions Pediatric PM is more common in children aged 3 months to under 3 years.Intracranial complications are more frequently observed in children under 1 year old.Fever is the most common clinical manifestation of PM,and subdural effusion/emphysema and hydrocephalus are the most frequent complications.Non-culture detection methods for cerebrospinal fluid can improve pathogen detection rates.Adverse outcomes can be noted in more than 10% of PM cases.SP strains are high sensitivity to vancomycin,linezolid,meropenem,levofloxacin,moxifloxacin,rifampicin,and chloramphenicol.[Chinese Journal of Contemporary Pediatrics,2024,26(2):131-138]

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To investigate the changing trend of mortality rate and death cause spectrum among household-registered residents aged 60 and above in Beijing from 2007 to 2020.Methods:The mortality data was collected from the Beijing Death Information Registration and Management System. We calculated the mortality rates and constituent ratios by gender, age groups, and death causes and estimated the changing trend of mortality rate and average annual percent change (AAPC) by Joinpoint 4.3.1.Results:The crude mortality rate decreased from 27.62‰ in 2007 to 23.55‰ in 2020 (AAPC=-1.18%, P<0.001), and the standard rate also decreased from 25.39‰ in 2007 to 19.85‰ in 2020 (AAPC=-1.68%, P<0.001) among registered residents aged 60 and above in Beijing. The top 5 causes of death were heart diseases, malignant tumors, cerebrovascular diseases, respiratory diseases, and endocrine and nutritional metabolic diseases, accounting for 87.1% of the total deaths. The mortality rates of heart diseases (AAPC=-1.08%, P=0.024), cerebrovascular diseases (AAPC=-3.79%, P<0.001), malignant tumors (AAPC=-0.31%, P=0.006) and respiratory diseases (AAPC=-5.56%, P=0.007) showed a decreasing trend. The rate of injury and poisoning showed an increasing trend (AAPC=1.54%, P=0.001), while no statistically significant change was found in endocrine and nutritional metabolic diseases mortality rates (AAPC=-1.46%, P=0.054). Conclusions:The mortality rate of registered residents aged 60 years and over in Beijing showed a downward trend from 2007 to 2020. Heart diseases, cerebrovascular diseases, malignant tumors, and respiratory diseases should be treated as the key diseases for prevention and control, and targeted measures should be taken to improve the health level of the elderly population.

To fully respect the true meaning and self-determination of human genetic resources providers,the Regulation on the Administration of Human Genetic Resources gives the providers the right to withdraw unconditionally at any time,that is,the right to withdraw consent."Withdraw unconditionally at any time"means that the providers have the right to withdraw their consent at any stage without any adverse consequences.To ensure that the right to withdraw the consent of human genetic resources providers can be realized under the rule of law,adequate information should be provided to ensure the provider's right to know,institutional management systems and withdrawal mechanisms should be established,and ethical reviews should be strengthened,which will ultimately produce legal effects,such as providers'termination of participation,the destruction or deletion of genetic resources and no further use.

Objective To observe the effects of electroacupuncture on intestinal flora and serum inflammatory factors in rabbit model with rheumatoid arthritis(RA);To explore the mechanism of its therapeutic effect on RA.Methods RA model rabbits were established by ovalbumin induction combined with Freund's complete adjuvant,and the rabbits after successful modeling were randomly divided into model group,probiotic group and electroacupuncture group,with 6 rabbits in each group.Another 6 rabbits were set as the normal group.The electroacupuncture group received electroacupuncture at the bilateral"Zusanli"and"Dubi"for 30 minutes,the probiotic group was given probiotic capsules solution(14.5 mg/kg)by gavage,once a day,for two consecutive weeks.The knee joint circumference and pain threshold of rabbits were measured,histopathological morphological changes of colonic tissue and synovial tissue ws observed by HE staining,16S rDNA sequencing was used to analyze structural changes of intestinal flora,the contents of TNF-α,IL-1β and IL-6 in serum were detected by ELISA.Results Compared with the normal group,the circumference of knee joint of rabbits in the model group increased significantly,the pain threshold was significantly decreased(P<0.01);the colonic mucosal damage was serious,the goblet cells were missing,a large number of inflammatory cells were infiltrate;the joint capsule synovial surface was rough,the synovial cell layer was hyperplasia and thickening,the synovial tissue inflammatory cell infiltration was obvious;the number and evenness of gut microbiota species decreased,while the relative abundance of Proteobacteria,Firmicutes,and Bacteroidetes decreased(P<0.05,P<0.01),the relative abundance of Desulfobacteria increased(P<0.01),while the relative abundance of Campylobacter,Lawsonella,and Pseudomonas increased(P<0.01),while the relative abundance of Heshanomonas and Herbaspirillum decreased(P<0.01);the contents of serum TNF-α,IL-1β and IL-6 increased(P<0.01).Compared with the model group,the knee joint circumference of the probiotic group and the electroacupuncture group decreased,the pain threshold increased(P<0.01,P<0.05);the degree of intestinal mucosal damage was reduced,the goblet cells were basically arranged neatly,the inflammatory cell infiltration was reduced;synovial cells proliferation and thickening decreased,with a small amount of inflammatory cell infiltration;the number and evenness of gut microbiota species increased,while the relative abundance of Proteobacteria,Firmicutes,and Bacteroidetes increased(P<0.05,P<0.01),the relative abundance of Desulfobacteria decreased(P<0.01),while the relative abundance of Campylobacter,Lawsonella and Pseudomonas decreased(P<0.01),the relative abundance of Heshanomonas and Herbaspirillum increased(P<0.05,P<0.01);the contents of serum TNF-α,IL-1β and IL-6 significantly decreased(P<0.01).Conclusion Electroacupuncture can significantly improve the symptoms of RA rabbits and reduce the inflammatory reaction in synovial tissue of joint,and the mechanism may be related to the regulation of intestinal flora structure.

The chemical constituents from the stems and leaves of Mycetia hainanensis were isolated by silica gel, ODS gel, and Sephadex LH-20 gel column chromatography and preparative HPLC. The chemical structures of all the isolated compounds were identified on the basis of their physicochemical properties, spectroscopic data, as well as the comparison of their physicochemical and spectroscopic data with the reported data in literature. Twelve compounds were isolated from the 85% ethanol extract of the stems and leaves of M. hainanensis, and they were identified as mycehainanic acid(1), 11-methoxyviburtinal(2), isovaltrate acetoxyhydrin(3), jatamanvaltrate K(4), jatamanin C(5), sarmentol F(6), 4,5-dihydroblumenol A(7), petasitolone(8), xylaguaianol D(9), aristolan-9-en-1-one(10), 3α-hydroxycostic acid(11), and ilicic acid(12). Among them, compound 1 was a new nor-sesquiterpene, and compounds 2-12 were isolated from Mycetia for the first time. In addition, the MTS method was employed to assess the anti-rheumatoid arthritis activities of compounds 1-12 based on their anti-proliferative effects on synoviocytes in vitro. The results showed that compounds 1 and 6-12 exhibited notable anti-rheumatoid arthritis activities, showcasing inhibitory effects on the proliferation of MH7A synovial fibroblast cells with the IC_(50) ranging from(5.27±0.07) to(172.68±0.32)μmol·L~(-1), which were comparable to that of the positive control methotrexate \[IC_(50) of(132.39±0.21)μmol·L~(-1)\].
Plant Leaves/chemistry* ; Plant Stems/chemistry* ; Arthritis, Rheumatoid/physiopathology* ; Humans ; Drugs, Chinese Herbal/isolation & purification* ; Animals ; Cell Line ; Molecular Structure

Abstract Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.

Objective To study the effect and possible mechanism of thioridazine on the biological behavior of liver cancer Huh-7 cells.Methods Hepatocellular carcinoma Huh-7 cells were randomly divided into a control group and low,medium,and high concentration groups of thiazidine.The miR-3174 mimics and its negative control,miR-3174 inhibitor and its negative control were transfectel to Huh-7 cells,and the miR-3174 mimics and its negative control were treated with thiolidazine.Effect of thioridazine on the proliferation of Huh-7 cells was assessed by CCK-8 method and plate cloning experiment;effect of thioridazine on the migration and invasion of Huh-7 cells was calculated using scratch healing test and Transwell experiment;effect of thioridazine on the expression of miR-3174 in Huh-7 cells was detected by RT-qPCR;E-cadherin and N-cadherin proteins expression was analyzed using Western blotting.The effects of interference with miR-3174 or miR-3174 up-regulation combined with thioridazine on the biological behavior of Huh-7 cells were detected by the above methods.Results After thiolidazine treatment and interference with miR-3174 expression,miR-3174 expression in Huh-7 cells was decreased,proliferation,migration and invasion ability,N-cadherin protein expression were decreased,and E-cadherin protein expression was increased(P＜0.05).Up-regulating the expression of miR-3174 attenuated the effect of thiolidazine treatment on the malignant biological behavior of Huh-7 cells.Conclusion Thioridazine inhibits the proliferation,migration and invasion of liver cancer Huh-7 cells by down-regulating miR-3174 expression.

Objective To investigate the clinical efficacy and application value of traditional Chinese medicine Shugan Jiangzhi decoction combined with L-ornithine-L-aspartate(LOLA)in the treatment of fatty liver after viral hepatitis.Methods Patients with fatty liver after viral hepatitis who were diagnosed and treated in Hebei Chest Hospital from October 2018 to October 2020 were enrolled and randomly divided into control group and test group.The control group was treated with LOLA,and the test group was treated with Shugan Jiangzhi decoction on the basis of the treatment of the control group,and the changes of liver function,blood lipids and immune function before and after treatment in the two groups were observed and compared.Results A total of 144 patients were included in the study,including 72 patients in the control group and 72 cases in the test group.After treatment,the total effective rate of the test group was 93.06% ,which was higher than that of the control group(79.17% )(P<0.05).After treatment,the serum levels of ALT,AST,TBIL,DBIL,GGT,TC,LDL-C and TG in the two groups were significantly decreased(P<0.05),and the test group was lower than that in the control group(P<0.05).The ratio of HDL-C value to CD4+ T lymphocytes in the two groups was higher than that before treatment(P<0.05),and the test group was higher than that in the control group(P<0.05),but there was no significant change in the proportion of CD8+T lymphocytes(P>0.05).The ultrasound grade of fatty liver in the test group was better than that in the control group(P<0.05).Conclusion Shugan Jiangzhi decoction combined with LOLA can improve the immune function and the liver function,balance the blood lipid level,and continuously improve the prognosis of patients with fatty liver after viral hepatitis.