Objective To observe the therapeutic effect of anti-inflammatory combined with cedilanid and diuretic therapy for treatment of patients with senile pneumonia and lung cancer accompanied by pleural effusion and to investigate the changes of concentrations in plasma levels of B-type natriuretic peptide(BNP)and C-reactive protein(CRP),procalcitonin(PCT)before and after treatment. Methods From July 2012 to January 2013, a prospective study was carried out to investigate 57 emergently hospitalized patients with pleural effusion,and according to the etiology,they were divided into two groups:a senile pneumonia group(30 cases)and a lung cancer group(27 cases). The same therapeutic measures were taken in the two groups,such as anti-infection,enhancement of cardiac function,diuresis,and limitation of the amount of liquid intake. Respectively,all the patients took the CT scan of the chest before treatment and on the 7th day after treatment,and at the same time,plasma concentrations of BNP,CRP and PCT were detected. Results ①According to the gradation of the New York Heart Association (NYHA),before treatment most of the cardiac function of patients in pneumonia group was at the Ⅲ grade,while that in the lung cancer group was at theⅠgrade,and the incidence of congestive heart failure(CHF)in pneumonia group was significantly higher than that in lung cancer group(86.7% vs. 14.8%,P<0.01). Before treatment,the plasma BNP level in pneumonia group was obviously higher than that in lung cancer group(ng/L:582.67±126.53 vs. 146.27±43.77,P<0.01);compared with that before treatment,BNP was significantly decreased in the pneumonia group(ng/L:225.59±131.33,P<0.05)after treatment,but no such obvious change in the lung cancer group(ng/L:149.34±51.05)was seen. The therapeutic effect of pleural effusion in the pneumonia group was markedly better than that in lung cancer group〔cure:70.0%(21 cases)vs. 0(0),P<0.01〕. ②Before treatment,the plasma levels of CRP and PCT in pneumonia group were remarkably lower than those in lung cancer group(both P<0.05);after treatment,CRP and PCT levels were decreased or decreased to close to the normal physiological range in patients of the two groups,but the comparisons between the two groups there were no statistically significant differences〔CRP(mg/L):20.21±16.32 vs. 22.76±18.53,PCT(ng/L):0.46±0.13 vs. 0.55±0.17,both P>0.05〕. Anti-inflammatory effect in pneumonia group was much superior to that in lung cancer group〔basically cured:86.7%(26 cases)vs. 0(0),P<0.05〕. In pneumonia group,the decrease of the above two indexes after treatment was consistent with the pneumonia shadow dissipation,while in the lung cancer group,no such consistency was found,apparently,the latter phenomenon was associated with the tumor invasive occupation. Conclusion To detect the concentration changes of plasma BNP, CRP and PCT has important clinical significance in screening the cardiac insufficiency and evaluating the curative effect of anti-inflammatory combined with cedilanid and diuretic therapy in patients of lung diseases complicated by pleural effusion.

Objective To explore and compare the clinical efficacy of levetiracetam tablets and compound sodium valproate sustained release tablets in the treatment of children and adolescents with epilepsy.Methods From April 2017 to April 2018,80 children and adolescents with epilepsy treated in Chaonan Minsheng Hospital of Shantou were selected as study objects,and they were randomly divided into two groups by drawing lots,with 40 cases in each group.The observation group was given levetiracetam tablets,and the control group was treated with valproate.The improvement of EEG after therapy,the total effective rate,and the incidence of adverse reactions were observed and evaluated.Results The EEG improvement rates after treatment for 6 months in the observation group and control group were 41.17％,45.71％,respectively,the difference was not statistically significant(x2 =0.508,P ＞0.05).The EEG improvement rates after treatment for 9 months in the observation group and control group were 70.58％,74.28％,respectively,the difference was not statistically significant (x2 =0.225,P ＞ 0.05).The total effective rate in the observation group was 92.50％,which was 95.00％ in the control group,the difference was not statistically significant between the two groups (x2 =0.354,P ＞ 0.05).However,the incidence rate of adverse reactions of the observation group(22.50％) was significantly lower than that of the control group(45.00％)(x2 =6.864,P ＜ 0.05).Conclusion Both levetiracetam tablets and compound sodium valproate sustained release tablets have appreciable efficacy and safety in the treatment of epilepsy in children and adolescents,but levetiracetam therapy has less adverse reactions,which deserves further promotion in monotherapy of epilepsy in children and adolescents.

OBJECTIVETo study the economic burden caused by occupational chronic n-hexane poisoning.

METHODSInformation about the cost of treatment, compensation, board, wage, diagnosis, escorts, transportation and the days off work were collected in a 34 cases of occupational chronic n-hexane poisoning accident to estimate the economic burden.

RESULTSThere were 4 mild, 19 moderate, 11 severe in the 34 cases and the total cost was 6 084 809 yuan. The hospitalization days was respectively (204.0 ± 3.7) d, (226.6 ± 78.3) d and (417.6 ± 94.1) d, averaging (285.8 ± 96.3) d. The treatment cost was respectively 62 525.8, 69 409.7 and 128 155.6 yuan. The compensation was respectively 20 000.0, 20 052.6 and 30 290.9 yuan. The wage was respectively 23 460.0, 26 062.6 and 47 644.0 yuan. The board was respectively 17 566.5, 19 499.8 and 36 230.1 yuan. The days of work was respectively (176.8 ± 3.2) d, (196.4 ± 67.9) d and (361.4 ± 81.6) d, averaging (247.7 ± 83.5). The lost productivity was respectively 1 809 724.8, 2 010 350.4 and 3 699 290.4 yuan.

CONCLUSIONThe economic burden of occupational chronic n-hexane poisoning was so heavy that prevention measures should be strengthened.

Adolescent ; Chronic Disease ; economics ; Cost of Illness ; Female ; Health Care Costs ; Hexanes ; poisoning ; Humans ; Male ; Occupational Exposure ; economics ; Young Adult

OBJECTIVE: To explore the genetic etiology for a newborn with corneal opacity. METHODS: The neonate and her parents were subjected to routine G-banding chromosomal karyotyping analysis. Copy number variation (CNV) was analyzed with low-coverage whole-genome sequencing (WGS) and single nucleotide polymorphism microarray (SNP array). RESULTS: No karyotypic abnormality was found in the newborn and her parents. Low-coverage WGS has identified a de novo 5.5 Mb microdeletion at chromosome 8q21.11-q21.13 in the neonate, which encompassed the ZFHX4 and PEX2 genes. The result was confirmed by SNP array-based CNV analysis. CONCLUSION The newborn was diagnosed with chromosome 8q21.11 deletion syndrome. ZFHX4 may be one of the key genes underlying this syndrome.
Chromosome Banding ; Chromosomes, Human, Pair 8/genetics* ; DNA Copy Number Variations ; Female ; Genetic Testing ; Homeodomain Proteins/genetics* ; Humans ; Infant, Newborn ; Karyotyping ; Monosomy/genetics* ; Peroxisomal Biogenesis Factor 2/genetics* ; Polymorphism, Single Nucleotide ; Transcription Factors/genetics*

Objective:To systematically evaluate the role of air pollutants in the development and exacerbation of autoimmune rheumatic diseases.Methods:We followed PRISMA guidelines and searched EMBASE, Scopus, PubMed, and Cochrane Library databases using keywords and MeSH terms from inception to July 2019. Observational studies reporting the relationship between autoimmune rheumatic diseases and exposure to certain air pollutants were included. Screening of literature according to established inclusion and exclusion criteria. No meta-analysis but the qualitative analysis was conducted due to the high methodological heterogeneity.Results:A total of 24 studies were included. Rheumatoid arthritis (RA) ( n=6), anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) ( n=1), ankylosing spondylitis (AS) ( n=1), systemic lupus erythematosus (SLE) ( n=3), childhood-onset systemic lupus erythematosus (cSLE) ( n=3), juvenile idiopathic arthritis (JIA) ( n=2), Kawasaki disease (KD) ( n=4), systemic autoimmune rheumatic diseases (SARD) ( n=4). The results of the study suggested that short-term elevation in particulate matter (PM)2.5 concentration was possibly associated with an increased risk of SLE and cSLE flare-ups, disease activity of AS, JIA and SARDs exacerbation. Studies demonstrated an increased risk of RA with cumulative exposure to carbon monoxide (CO), nitrogen dioxide (NO 2), ozone (O 3), and sulfur dioxide (SO 2). Only one study demonstrated an increased risk of KD admission with elevated O 3 levels. No association was found between AAV and ambient air pollution. Conclusion:Air pollution is likely to be involved in the development and exacerbation of certain autoimmune diseases. At the same time, the mechanism of autoimmune diseases of ambient air pollutants should be actively studied, so as to promote the early prevention of cardiovascular diseases.

OBJECTIVETo assess the value of G-banded karyotyping in combination with multiplex ligation-dependent probe amplification (MLPA) as a tool for the detection of chromosomal abnormalities in fetuses with congenital heart defects.

METHODSThe combined method was used to analyze 104 fetuses with heart malformations identified by ultrasonography. Abnormal findings were confirmed with chromosomal microarray analysis (CMA).

RESULTSNineteen (18%) fetuses were found to harbor chromosomal aberrations by G-banded karyotyping and MLPA. For 93 cases, CMA has detected abnormalities in 14 cases including 10 pathogenic copy number variations (CNVs) and 4 CNVs of uncertain significance (VOUS). MLPA was able to detect all of the pathogenic CNVs and 1 VOUS CNV.

CONCLUSIONCombined use of G-banded karyotyping and MLPA is a rapid, low-cost and effective method to detect chromosomal abnormalities in fetuses with various heart malformations.

Chromosome Aberrations ; Chromosome Banding ; Chromosome Disorders ; diagnosis ; genetics ; DNA Copy Number Variations ; Female ; Fetal Diseases ; diagnosis ; genetics ; Genetic Testing ; methods ; Heart Defects, Congenital ; diagnosis ; genetics ; Humans ; Karyotyping ; methods ; Multiplex Polymerase Chain Reaction ; methods ; Pregnancy ; Prenatal Diagnosis ; methods ; Reproducibility of Results ; Sensitivity and Specificity

OBJECTIVETo investigate the effects of rs10916581, a common single nucleotide polymorphism (SNP) located in the promoter region of pre-miR-320b-2, on coronary heart disease (CHD) risk and circulating microRNA-320b (miR-320b) level. To explore potential factors influencing circulating miR-320b level.

METHODSRs10916581 was genotyped in a case-control study with 1 507 CHD cases and 1 379 age- and sex-frequency-matched controls. The cases were consecutively recruited from 3 hospitals (Tongji Hospital, Union Hospital, and Wugang Hospital) in Wuhan city (Hubei, China) between May 2004 and October 2009 and all the controls resided in Wuhan communities. A subgroup of 174 CHD cases and 181 non-diabetes controls without acute infection were randomly selected and their circulating miR-320b levels were detected using quantitative reverse transcriptase polymerase chain reaction assays. The association of rs10916581 with CHD susceptibility was analyzed with multivariable logistic regression model. Generalized linear regression model was used to explore the associations of rs10916581 and some other factors with circulating miR-320b level.

RESULTSIn single-factor logistic regression analysis, no association was found between rs10916581 and CHD risk. After adjustment for age, sex, BMI, smoking status, hypertension, diabetes, total triglyceride, total cholesterol/high density lipoprotein (TC/HDL-C), the result did not materially alter(compared with CC genotype, the OR (95%CI) of CHR in the subjects carried CT, TT, CT+TT genotypes were 0.94 (0.76-1.15), 0.99 (0.74-1.33) and 0.95 (0.78-1.16) ). No significant interactions were observed between the conventional risk factors of CHD (age, gender, smoking status, BMI, hypertension, diabetes, CHD family history) and rs10916581 on CHD risk (P > 0.05). Rs10916581 showed no significant association with circulating miR-320b level in cases, controls or total population (β(95%CI) was -0.028 (-0.495-0.440), 0.250 (-0.226-0.727) and 0.134 (-0.218-0.486) respectively, P > 0.05). However, circulating miR-320b level was negatively associated with BMI (β (95%CI) was -0.140 (-0.261--0.020), P = 0.022) while positively associated with TC/HDL(β (95%CI) was 0.620 (0.261-0.979), P = 0.001) in cases, and in total population, its circulating level tended to be lower in diabetes or hypertension patients (β(95%CI) was -1.025 (-1.696--0.354) and -0.594 (-1.138--0.049) respectively, P = 0.003, 0.033 respectively) and was positively associated with TC/HDL-C (β(95%CI) was 0.108 (0.027-0.190), P = 0.009).

CONCLUSIONThe common SNP (rs10916581) in the promoter region of pre-miR-320b-2 might have little contribution to the CHD predisposition in Chinese Han population, and it might not affect circulating miR-320b level. Conventional CHD risk factors (BMI, TC/HDL-C, hypertension and diabetes) might have effects on its circulating level.

Aged ; Case-Control Studies ; China ; ethnology ; Coronary Disease ; genetics ; Diabetes Mellitus ; Genotype ; Humans ; Hypertension ; Logistic Models ; MicroRNAs ; adverse effects ; blood ; genetics ; Polymorphism, Single Nucleotide ; genetics ; Promoter Regions, Genetic ; Risk Factors ; Triglycerides

Objective To investigate the characteristics of distribution and expression profiles of plasma miRNA in childhood acute lymphocytic leukemia (cALL) patients;the association between cALL incidence risk and plasma miRNA levels;the feasibility of plasma miRNA serving as cALL diagnostic biomarker.Methods A total of 111 pairs of newly diagnosed cALL patients and patients with fractures were collected from Shenzhen Children's Hospital,China,between January 2015 and November 2016.Age and sex of the cases and controls were 1 ∶ 1 matched and LNATM miRNA microarray was performed using 4 pairs of cALL and controls selected from the sample population.The expression level of miRNA was validated by real time quantitative PCR.Conditional logistic regression analysis was applied to evaluate the association between miRNA expression levels and the incidence risk of cALL.The receiver operating characteristic curve (ROC) and reclassification analysis were conducted to assess the feasibility of miRNAs serving as biomarkers for cALL.Results A total of 204 differentially expressed miRNA were screened out and let-7f-5p,miR-5100,miR-25-3p and miR-3654 were selected for validation identified according to the inclusion criteria.The expression levels of let-7f-5p,miR-5100 and miR-25-3p in the cALL patients were significantly lower than those of the controls (P＜0.01).After adjusting for confounding factors,3 miRNAs remained significantly associated with the risk of cALL (OR and 95％CI were 0.84 (0.76-0.92),0.81 (0.73-0.90)and 0.81 (0.74-0.89),respectively.Results from both the ROC analysis and reclassification analysis showed that introduction of one or more miRNA to traditional risk factors improved the area under the curve (P＜0.05) and provided additional values to diagnosis (P＜0.01).Conclusion The expression levels of let-7f-5p,miR-5100 and miR-25-3p were significantly associated with the incidence rate of cALL,and these miRNAs might serve as promising biomarkers for cALL.

Objective:To investigate the effects of early-life (intrauterine and breastfeeding period) exposure to angiotensin Ⅱ type 1 receptor autoantibody (AT 1-AA) on lipid metabolism in offspring rats. Methods:Thirty-two AT 1-AA negative healthy nonpregnant specific pathogen free female Sprague Dawley rats weighing 150-170 g were randomly divided into two groups. Those in the immune group ( n=16) were subcutaneously injected with the mixture of an equal volume of Freund's adjuvant and the second extracellular loop of human-derived angiotensin Ⅱ receptor type 1 (AT1R-ECⅡ) repeatedly to establish the AT 1-AA-positive rat model by active immunization and those in the control group ( n=16) with normal saline solution. Before each immunization, blood samples were collected from the tail of rats to detect serum AT 1-AA levels of those rats in both groups, and the AT 1-AA-positive rat model was successfully established when the serum AT 1-AA was positive and its level reached a plateau. After eight weeks of immunization, the female rats in the two groups were mated with healthy AT 1-AA-negative male rats to conceive. Serum samples were collected from the maternal and offspring rats at the gestation of 18 days (G18), postnatal 21 days (P21), and from the normally fed offspring rats from the time of weaning to 12 weeks old (W12). Active immunization was not performed on the offspring throughout the experiment. The serum AT 1-AA levels of maternal and offspring rats were determined by enzyme-linked immunosorbent assay, and serum AT1-AA was positive when the ratio of AT1-AA level of the immune group over the control group ≥2.1. The blood lipid levels of maternal and offspring rats were measured by an automatic biochemical analyzer. Serum AT 1-AA levels, total cholesterol (TC), high-density lipoprotein-cholesterol [instead of high-density lipoprotein (HDL)], low-density lipoprotein-cholesterol, and free fatty acid levels of the offspring and maternal rats were determined for correlation analysis. Two independent sample t-test, linear regression analysis, and analysis of variance were adopted for statistical analysis. Results:(1) The serum levels of AT 1-AA in maternal rats at G18 and P21 in the immune group were significantly higher than those in the control group (G18: 1.170±0.190 vs 0.114±0.016, t=14.64; P21: 0.988±0.283 vs 0.084±0.006, t=9.57; both P<0.001). (2) The serum levels of AT 1-AA in the offspring at G18 and P21 in the immune group were significantly higher than those in the control group (offspring at G18: 0.948±0.220 vs 0.105±0.010, t=10.10; male offspring at P21: 0.758±0.273 vs 0.080±0.002, t=7.46; female offspring at P21: 0.774±0.274 vs 0.084±0.005, t=7.55; all P<0.001), which showed a positive correlation with those in maternal rats at the same period (offspring at G18: R=0.78; male offspring at P21: R=0.82; female offspring at P21: R=0.82; all P<0.05). However, there was no significant difference in the serum AT 1-AA level in offspring at W12 between the immune and control group ( P>0.05). (3) The serum levels of TC at G18 and P21, and HDL at P21 in maternal rats in the immune group were all higher than those in the control group [TC at G18: (2.36±0.32) vs (1.95±0.24) mmol/L, t=2.70; P21: (2.82±0.50) vs (2.18±0.26) mmol/L, t=3.41; HDL at P21: (1.94±0.33) vs (1.57±0.23) mmol/L, t=2.80; all P<0.05]. (4) Compared with the offspring in the control group, there was no significant change in lipid metabolism at G18 and W12 in the offspring in the immune group (both P>0.05). The serum levels of TC and HDL in male and female offspring at P21 in the immune group were higher than their counterparts in the control[TC in male offspring: (2.38±0.52) vs (1.83±0.30) mmol/L, t=2.73; HDL in male offspring: (1.44±0.32) vs (1.07±0.18) mmol/L, t=2.98; TC in female offspring: (2.50±0.72) vs (1.70±0.26) mmol/L, t=3.16; HDL in female offspring: (1.41±0.33) vs (1.00±0.14) mmol/L, t=3.41; all P<0.05]. (5) The serum levels of TC and HDL in male and female offspring at P21 in the immune group showed no correlation with those in maternal rats at P21 (all R<0.5, all P>0.05). The serum levels of HDL in male and female offspring at P21 in the immune group had a positive correlation with their own serum TC levels (male offspring: R=0.98; female offspring: R=0.97; both P<0.001) and also with their own serum AT 1-AA levels (male offspring: R=0.74, P=0.023; female offspring: R=0.91, P=0.001). The serum levels of TC in male and female offspring at P21 in the immune group had a positive correlation with their serum AT 1-AA levels (male offspring: R=0.72, P=0.030; female offspring: R=0.90, P=0.001). Conclusion:The early-life exposure to AT 1-AA may cause abnormal expression of TC and HDL in offspring rats.