1.Development and Application of Detection Methods for Capture and Transcription Elongation Rate of Bacterial Nascent RNA
Yuan-Yuan LI ; Yu-Ting WANG ; Zi-Chun WU ; Hao-Xuan LI ; Ming-Yue FEI ; Dong-Chang SUN ; O. Claudio GUALERZI ; Attilio FABBRETTI ; Anna Maria GIULIODORI ; Hong-Xia MA ; Cheng-Guang HE
Progress in Biochemistry and Biophysics 2024;51(9):2249-2260
ObjectiveDetection and quantification of RNA synthesis in cells is a widely used technique for monitoring cell viability, health, and metabolic rate.After exposure to environmental stimuli, both the internal reference gene and target gene would be degraded. As a result, it is imperative to consider the accurate capture of nascent RNA and the detection of transcriptional levels of RNA following environmental stimulation. This study aims to create a Click Chemistry method that utilizes its property to capture nascent RNA from total RNA that was stimulated by the environment. MethodsThe new RNA was labeled with 5-ethyluridine (5-EU) instead of uracil, and the azido-biotin medium ligand was connected to the magnetic sphere using a combination of “Click Chemistry” and magnetic bead screening. Then the new RNA was captured and the transcription rate of 16S rRNA was detected by fluorescence molecular beacon (M.B.) and quantitative reverse transcription PCR (qRT-PCR). ResultsThe bacterial nascent RNA captured by “Click Chemistry” screening can be used as a reverse transcription template to form cDNA. Combined with the fluorescent molecular beacon M.B.1, the synthesis rate of rRNA at 37℃ is 1.2 times higher than that at 15℃. The 16S rRNA gene and cspI gene can be detected by fluorescent quantitative PCR,it was found that the measured relative gene expression changes were significantly enhanced at 25℃ and 16℃ when analyzed with nascent RNA rather than total RNA, enabling accurate detection of RNA transcription rates. ConclusionCompared to other article reported experimental methods that utilize screening magnetic columns, the technical scheme employed in this study is more suitable for bacteria, and the operation steps are simple and easy to implement, making it an effective RNA capture method for researchers.
2.Preparation modification strategies for clinical treatment drugs of Parkinson's disease
Meng-jiao HE ; Yi-fang XIAO ; Xiang-an-ni KONG ; Zhi-hao LIU ; Xiao-guang WANG ; Hao FENG ; Jia-sheng TU ; Qian CHEN ; Chun-meng SUN
Acta Pharmaceutica Sinica 2024;59(3):574-580
Parkinson's disease (PD) is a chronic neurodegenerative disease. At present, levodopa and other drugs are mainly used for dopamine supplementation therapy. However, the absorption of levodopa in the gastrointestinal tract is unstable and its half-life is short, and long-term use of levodopa will lead to the end-of-dose deterioration, dyskinesia, the "ON-OFF" phenomenon and other symptoms. Therefore, new preparations need to be developed to improve drug efficacy, reduce side effects or improve compliance of patients. Based on the above clinical needs, this review briefly introduced the preparation modification strategies for the treatment of PD through case analysis, in order to provide references for the research and development of related preparations.
3.Overexpression of Hsp70 Promoted the Expression of Glycolysis-related Genes in C2C12 Cells
Lei QIN ; Ke XU ; Chun-Guang ZHANG ; Han CHU ; Shi-Fan DENG ; Jian-Bin ZHANG ; Hua YANG ; Liang HONG ; Gui-Feng ZHANG ; Chao SUN ; Lei PU
Chinese Journal of Biochemistry and Molecular Biology 2024;40(10):1417-1425
The aim of this study was to investigate the impact of overexpressing 70-kD heat shock pro-teins(Hsp70)on glycolysis in C2C12 cells during myogenesis and adipogenesis.Using C2C12 cells as the research material,adenovirus was used to overexpress the Hsp70 gene,and changes in the expression of glycolytic genes were detected using fluorescence quantitative PCR and Western blotting techniques.The study indicated that during C2C12 cell myogenic differentiation,the expression trend of the Hsp70 gene was consistent with that of Gsk3β,Pkm,Prkag3,Pfkm,and Hk-2 genes,suggesting a relationship between Hsp70 and the glycolytic pathway during myogenic differentiation.Overexpression of Hsp70 in the later stages of myogenic differentiation significantly upregulated the expression of Gsk3β,Pkm,Prk-ag3,and Pfkm genes(P<0.05),with no significant impact on Hk-2 gene expression(P>0.05).Dur-ing C2C12 cell adipogenic induction,the expression trend of the Hsp70 gene was similar to that of Gsk3β,Pkm,Prkag3,Pfkm,and Hk-2 genes,indicating a relationship between Hsp70 and the glycolytic path-way during adipogenic induction.Following Hsp70 overexpression,in the later stages of adipogenic in-duction,the number of lipid droplets was significantly higher compared to the control group,with a sig-nificant upregulation of Gsk3β,Pkm,Prkag3,and Pfkm gene expression(P<0.05),while Hk-2 gene expression was not significantly affected(P>0.05).In conclusion,Hsp70 in C2C12 cells in myogenic and adipogenic states promoted the breakdown of glycogen into 6-phospho-glucose,thereby enhancing the glycolytic pathway,providing insights into the functional role of the Hsp70 gene in glycolysis in C2C12 cells.
4.The risk surveillance of schistosomiasis in Yunnan, 2021
SHEN Mei-fen ; DU Chun-hong ; SONG Jing ; WANG Li-fang ; SUN Jia-yu ; CHEN Chun-qiong ; FENG Xi-guang ; ZHANG Zhong-ya ; JIANG Hua ; ZHOU Ji-hua ; DONG Yi
China Tropical Medicine 2023;23(2):157-
Abstract: Objective To evaluate the potential transmission risk of schistosomiasis in Yunnan Province, and to provide strategic basis for the prevention and control. Methods Based on the prevalence of schistosomiasis, the social and environmental factors that may lead to the epidemic, 1-3 villages from 3 provincial-level and 15 county-level counties (cities and districts) were selected as the evaluated villages in 2021. The risk of schistosomiasis spread was analyzed comprehensively by consulting, reviewing and collecting routine surveillance data of schistosomiasis in the villages, combined with snail and wild feces survey. The risk level was evaluated for the positive snails, positive wild feces, resident infection, average density of live snails and snail frame occurrence rate. Results Totally 7 snail counties schistosomiasis transmission was blocked of 18 epidemic counties and the rest were eliminated counties. A total of 152 447 snail frames were investigated and 3 043 frames with snails, 15 895 snails were captured and included 15 727 live snails in the 32 evaluated villages. The total area of snail was 58.87 hm2 and the area of reoccurrence was 34.19 hm2 with snail frame occurrence rate of 2.00% and average density of live snails 0.103 2/0.11 m2, and no positive snails were found by loop-mediated isothermal amplification (LAMP) assay. A total of 1 374 wild feces were collected in 27 evaluated villages of 14 epidemic counties, mainly from cattle, dogs, sheep, equine animals, pigs and so on, all of which were negative. According to the risk assessment of epidemic spread, Yongle Village and Yongsheng Village in Eryuan County, Zhiming Village in Chuxiong City were Ⅱ risk, and the rest were Ⅲ risk. Conclusions Although the risk of transmission is low in Yunnan Province, the risk of transmission and spread still exists. It is necessary to strengthen the risk monitoring, control of snail and effective management of livestock to prevent the rebound of the epidemic.
5.Incidence and prognosis of olfactory and gustatory dysfunctions related to infection of SARS-CoV-2 Omicron strain: a national multi-center survey of 35 566 population.
Meng Fan LIU ; Rui Xia MA ; Xian Bao CAO ; Hua ZHANG ; Shui Hong ZHOU ; Wei Hong JIANG ; Yan JIANG ; Jing Wu SUN ; Qin Tai YANG ; Xue Zhong LI ; Ya Nan SUN ; Li SHI ; Min WANG ; Xi Cheng SONG ; Fu Quan CHEN ; Xiao Shu ZHANG ; Hong Quan WEI ; Shao Qing YU ; Dong Dong ZHU ; Luo BA ; Zhi Wei CAO ; Xu Ping XIAO ; Xin WEI ; Zhi Hong LIN ; Feng Hong CHEN ; Chun Guang SHAN ; Guang Ke WANG ; Jing YE ; Shen Hong QU ; Chang Qing ZHAO ; Zhen Lin WANG ; Hua Bin LI ; Feng LIU ; Xiao Bo CUI ; Sheng Nan YE ; Zheng LIU ; Yu XU ; Xiao CAI ; Wei HANG ; Ru Xin ZHANG ; Yu Lin ZHAO ; Guo Dong YU ; Guang Gang SHI ; Mei Ping LU ; Yang SHEN ; Yu Tong ZHAO ; Jia Hong PEI ; Shao Bing XIE ; Long Gang YU ; Ye Hai LIU ; Shao wei GU ; Yu Cheng YANG ; Lei CHENG ; Jian Feng LIU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(6):579-588
Objective: This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Methods: Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. Results: A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, P<0.001) and young people(χ2=120.210, P<0.001) were more likely to develop these dysfunctions. Gender(OR=1.564, 95%CI: 1.487-1.645), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), oral health status (OR=0.881, 95%CI: 0.839-0.926), smoking history (OR=1.152, 95%CI=1.080-1.229), and drinking history (OR=0.854, 95%CI: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, P=0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.
Female
;
Humans
;
Adolescent
;
SARS-CoV-2
;
Smell
;
COVID-19/complications*
;
Cross-Sectional Studies
;
COVID-19 Vaccines
;
Incidence
;
Olfaction Disorders/etiology*
;
Taste Disorders/etiology*
;
Prognosis
6.Drug-coated balloons for the treatment of ostial left anterior descending or ostial left circumflex artery lesions: a patient-level propensity score-matched analysis.
Liang PAN ; Wen-Jie LU ; Zhan-Ying HAN ; San-Cong PAN ; Xi WANG ; Ying-Guang SHAN ; Meng PENG ; Xiao-Fei QIN ; Guo-Ju SUN ; Pei-Sheng ZHANG ; Jian-Zeng DONG ; Chun-Guang QIU
Journal of Geriatric Cardiology 2023;20(10):716-727
BACKGROUND:
Controversy exists as to the optimal treatment approach for ostial left anterior descending (LAD) or ostial left circumflex artery (LCx) lesions. Drug-coated balloons (DCB) may overcome some of the limitations of drug-eluting stents (DES). Therefore, we investigated the security and feasibility of the DCB policy in patients with ostial LAD or ostial LCx lesions, and compared it with the conventional DES-only strategy.
METHODS:
We retrospectively enrolled patients with de novo ostial lesions in the LAD or LCx who underwent interventional treatment. They were categorized into two groups based on their treatment approach: the DCB group and the DES group. The treatment strategies in the DCB group involved the use of either DCB-only or hybrid strategies, whereas the DES group utilized crossover or precise stenting techniques. Two-year target lesion revascularization was the primary endpoint, while the rates of major adverse cardiovascular events, cardiac death, target vessel myocardial infarction, and vessel thrombosis were the secondary endpoints. Using propensity score matching, we assembled a cohort with comparable baseline characteristics. To ensure result analysis reliability, we conducted sensitivity analyses, including interaction, and stratified analyses.
RESULTS:
Among the 397 eligible patients, 6.25% of patients who were planned to undergo DCB underwent DES. A total of 108 patients in each group had comparable propensity scores and were included in the analysis. Two-year target lesion revascularization occurred in 5 patients (4.90%) and 16 patients (16.33%) in the DCB group and the DES group, respectively (odds ratio = 0.264, 95% CI: 0.093-0.752, P = 0.008). Compared with the DES group, the DCB group demonstrated a lower major adverse cardiovascular events rate (7.84% vs. 19.39%, P = 0.017). However, differences with regard to cardiac death, non-periprocedural target vessel myocardial infarction, and definite or probable vessel thrombosis between the groups were non-significant.
CONCLUSIONS
The utilization of the DCB approach signifies an innovative and discretionary strategy for managing isolated ostial lesions in the LAD or LCx. Nevertheless, a future randomized trial investigating the feasibility and safety of DCB compared to the DES-only strategy specifically for de novo ostial lesions in the LAD or LCx is highly warranted.
7.Efficacy of Chinese Herbal Medicines on Pregnancy Outcomes in Patients with Endometriosis in Long-Term Management: A Multicenter Retrospective Cohort Study.
Xin-Chun YANG ; Yong LIU ; Wei-Wei SUN ; Guang SHI ; Ying WU ; Cai XU ; Qing-Wei MENG ; Zeng-Ping HAO ; Qian HAN ; Rui-Hua ZHAO
Chinese journal of integrative medicine 2023;29(11):971-979
OBJECTIVE:
To analyze the factors related to pregnancy of endometriosis and whether Chinese herbal medicines (CHMs) can improve pregnancy outcomes in patients with endometriosis in long-term management.
METHODS:
This multicenter cohort study retrospectively analyzed the clinical data of endometriosis patients with fertility needs from January 2019 to November 2019. A total of 252 patients with endometriosis from 5 level-III Grade A hospitals in Beijing were included in this study. Univariate and multivariate logistic regression analysis were performed for the relevant factors. The propensity score matching (PSM) function of SPSS software was used to match the CHMs group with the non-CHMs group. The pregnancy rate and live birth rate were analyzed.
RESULTS:
The results of univariate analysis showed that age, disease course, presence of infertility, presence of adenomyosis, time after surgery or use of gonadotropin-releasing hormone agonist (GnRH-a), use of CHMs and follow-up time were influencing factors of pregnancy in endometriosis patients (P<0.05). The results of multivariate analysis showed that age, presence of adenomyosis, time after surgery or use of GnRH-a, use of CHMs and follow-up time were independent factors affecting pregnancy in endometriosis patients, among which, age ⩾35 years old, presence of adenomyosis and follow-up time >6 months were independent risk factors (OR=0.445, 0.348, 0.140, respectively, P<0.05), time after surgery or use of GnRH-a ⩽6 months and use of CHMs were independent protective factors (OR=3.839, 3.842, respectively, P<0.05). After PSM, 99 pairs of two groups were matched successfully. The pregnancy rate of the CHMs group was higher than that of the non-CHMs group [55.56% (55/99) vs. 36.36% (36/99), P<0.05]. The live birth rate of the CHMs group was higher than that of the non-CHMs group [49.49% (49/99) vs. 35.35% (35/99), P<0.05].
CONCLUSION
CHMs can effectively improve clinical pregnancy rate and live birth rate of patients with endometriosis in the chronic disease management.
Pregnancy
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Female
;
Humans
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Adult
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Pregnancy Outcome
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Endometriosis/surgery*
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Retrospective Studies
;
Cohort Studies
;
Adenomyosis
;
Gonadotropin-Releasing Hormone
;
Plant Extracts
;
Fertilization in Vitro
8.Expression and Detection Value of 6 Chlamydia Trachomatis Protein Antibodies in Tubal Factor Infertility
Ming-na LIU ; Man-li QI ; Xiao-hong CHEN ; Jin-feng TAN ; Dan ZHANG ; Yu-yan LIU ; Jian-de HAN ; Chun-guang MA
Journal of Sun Yat-sen University(Medical Sciences) 2023;44(1):150-158
ObjectiveTo further study the pathogenic role of different types of Chlamydia trachomatis (CT) proteins in tubal factor infertility, evaluate the clinical detection value of Chlamydia trachomatis protein antibody in predicting tubal factor infertility. MethodsA total of 58 cases of tubal factor infertility (TFI), 41 cases of fertile controls (FC) and 18 cases of infertile controls (IFC) were included. For serum detection, first, CT-IgG ELISA kit was used to detect the expression of CT-IgG in serum of three groups of people; then, 6 kinds of Chlamydia trachomatis proteins were expressed and purified in the early stage to establish the antibody test for these proteins, and ELISA detection method was used to detect the expression of their antibodies in the serum of TFI group, FC group and IFC group, respectively; and finally, the antibody OD value of the 6 kinds of Chlamydia trachomatis proteins in the three groups of subjects were statistically described, and CT-IgG was used as the reference standard to draw the receiver operating characteristic curve (ROC curve) of each CT antibody. The Youden Index determines the cutoff value for each antibody. Taking TFI as the reference class, two disordered multiple classification logistic regression models were established with the FC and IFC groups, respectively; and the reference class was used to explore the value of various antibodies and age in predicting TFI, FC and IFC of Chlamydia trachomatis. The back-off method was used to screen the variables. ResultsThe OD value of CT376 antibody in the TFI group was higher than that in the FC group (0.86 vs. 0.60, P=0.026). The CT376 antibody OD value in the TFI group was higher than that in the IFC group (0.86 vs. 0.64, P=0.026). The CT443 antibody OD value in the IFC group was higher than that in the TFI group (0.59 vs. 0.34, P=0.036) and higher than that in the FC group (0.59 vs. 0.30, P=0.02). The multiple classification logistic regression analysis established between TFI and FC showed that CT-IgG [P<0.001, OR=0.084, 95%CI (0.025, 0.284)], CT376 antibody [P=0.068, OR=0.359, 95%CI (0.120, 1.078)]. CT-IgG is an independent risk factor for tubal infertility, and CT376 antibody cannot be an independent risk factor for tubal infertility. The multiple classification logistic regression analysis established between TFI and IFC showed that among infertile patients, CT-IgG [P<0.05, OR=0.194, 95%CI (0.046, 0.817)], CT376 antibody [P<0.05, OR=0.176, 95%CI (0.038, 0.818)] and CT381 antibody [P<0.05, OR=0.112, 95%CI ( 0.016, 0.796)] were independent risk factors for tubal infertility. ConclusionThe expression of CT376 antibody in tubal infertility patients is higher than that in fertile and infertile controls, suggesting that CT-induced tubal factor infertility may be related to CT376. CT-IgG, and CT376 antibodies are meaningful in predicting CT-induced tubal factor infertility.
9.Effect of Polysaccharides from Root, Stem, Leaf and Fruit of Schisandra chinensis on Exercise Endurance in D-galactose-induced Aging Mice
Jia-hui FANG ; Jia-wei LIU ; Yu-xin JIANG ; Shu JING ; Chun-mei WANG ; Jing-hui SUN ; Cheng-yi ZHANG ; Jian-guang CHEN ; He LI
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(11):102-109
ObjectiveTo observe the effect of polysaccharides from root, stem, leaf and fruit of Schisandra chinensis on exercise endurance in the aging mice induced by D-galactose. MethodMale ICR mice were randomly assigned into six groups: blank control group, model group, root polysaccharide group, stem polysaccharide group, leaf polysaccharide group and fruit polysaccharide group. The mice were administrated with distilled water or root, stem, leaf and fruit polysaccharide (total sugar content of 35 mg·kg-1) by gavage. Thirty minutes after the administration, the blank control group was subcutaneously injected with normal saline, and the other groups with D-galactose (300 mg·kg-1), once daily for 6 weeks. The anti-fatigue effects were evaluated by rotarod test, forelimb grip strength test, and weight-loaded swimming test. The fatigue and oxidation indicators such as blood urea nitrogen (BUN), serum lactic acid (LD), lactic dehydrogenase (LDH), creatine kinase (CK), superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and reactive oxygen species (ROS) were measured by chemical colorimetry. The protein levels of pro-apoptotic protein B cell lymphoma-2 (Bcl-2)-associated X protein (Bax), anti-apoptotic Bcl-2 and cleaved cysteinyl aspartate-specific protease-3 (cleaved Caspase-3) in mouse skeletal muscle were detected by Western blot. ResultIn the rotarod test, the time on rod was shorter in the model group than in the blank control group (P<0.01) and the root, stem and fruit polysaccharide groups (P<0.01). In the forelimb grip strength test, the forelimb grip strength in the model group was lower than that in the blank control group (P<0.01) and the root, stem, leaf and fruit polysaccharide groups (P<0.01). In the weight-loaded swimming test, the weight-loaded swimming time in the model group was shorter than that in the blank control group (P<0.01) and the root, stem, leaf and fruit polysaccharide groups (P<0.01). Compared with those in the blank control group, the BUN, LD, LDH and CK levels significantly increased in the model group (P<0.05, P<0.01). The increases in BUN and LDH levels were decreased by the root, stem and fruit polysaccharides (P<0.05, P<0.01) and those in LD and CK by the root, stem, leaf and fruit polysaccharides (P<0.05, P<0.01). Compared with the blank control group, the model group showed decreased SOD and GSH-Px activities (P<0.01) and increased MDA and ROS content (P<0.01). Compared with the model group, the root, stem, and fruit polysaccharide increased the SOD activity (P<0.05, P<0.01) and decreased ROS content (P<0.01). The root and stem polysaccharides decreased the MDA content (P<0.01) and increased the GSH-Px activity (P<0.05, P<0.01). Compared with the blank control group, the model group showed up-regulated protein levels of Bax and cleaved Caspase-3 and down-regulated protein level of Bcl-2 (P<0.01). Compared with the model group, the root, and stem polysaccharides down-regulated the protein levels of cleaved Caspase-3 (P<0.05) and up-regulated protein level of Bcl-2 (P<0.01). ConclusionThe polysaccharides from the root, stem, leaf, and fruit of S. chinensis have anti-fatigue effect in D-galactose-induced aging mice. The polysaccharides may exert such effect by improving the antioxidant capacity and inhibiting the apoptosis of skeletal muscle cells.
10.A 10-year retrospective analysis of spectrums and treatment options of orthostatic intolerance and sitting intolerance in children.
Ya Xi CUI ; Jun Bao DU ; Qing You ZHANG ; Ying LIAO ; Ping LIU ; Yu Li WANG ; Jian Guang QI ; Hui YAN ; Wen Rui XU ; Xue Qin LIU ; Yan SUN ; Chu Fan SUN ; Chun Yu ZHANG ; Yong Hong CHEN ; Hong Fang JIN
Journal of Peking University(Health Sciences) 2022;54(5):954-960
OBJECTIVE:
To analyze the disease spectrums underlying orthostatic intolerance (OI) and sitting intolerance (SI) in Chinese children, and to understand the clinical empirical treatment options.
METHODS:
The medical records including history, physical examination, laboratory examination, and imagological examination of children were retrospectively studied in Peking University First Hospital from 2012 to 2021. All the children who met the diagnostic criteria of OI and SI were enrolled in the study. The disease spectrums underlying OI and SI and treatment options during the last 10 years were analyzed.
RESULTS:
A total of 2 110 cases of OI and SI patients were collected in the last 10 years, including 943 males (44.69%) and 1 167 females (55.31%) aged 4-18 years, with an average of (11.34±2.84) years. The overall case number was in an increasing trend over the year. In the OI spectrum, postural tachycardia syndrome (POTS) accounted for 826 cases (39.15%), followed by vasovagal syncope (VVS) (634 cases, 30.05%). The highest proportion of SI spectrum was sitting tachycardia (STS) (8 cases, 0.38%), followed by sitting hypertension (SHT) (2 cases, 0.09%). The most common comorbidity of OI and SI was POTS coexisting with STS (36 cases, 1.71%). The highest proportion of treatment options was autonomic nerve function exercise (757 cases, 35.88%), followed by oral rehydration salts (ORS) (687 cases, 32.56%), metoprolol (307 cases, 14.55%), midodrine (142 cases, 6.73%), ORS plus metoprolol (138 cases, 6.54%), and ORS plus midodrine (79 cases, 3.74%). The patients with POTS coexisting with VVS were more likely to receive pharmacological intervention than the patients with POTS and the patients with VVS (41.95% vs. 30.51% vs. 28.08%, χ2= 20.319, P < 0.01), but there was no significant difference in the proportion of treatment options between the patients with POTS and the patients with VVS.
CONCLUSION
POTS and VVS in children are the main underlying diseases of OI, while SI is a new disease discovered recently. The number of children with OI and SI showed an increasing trend. The main treatment methods are autonomic nerve function exercise and ORS. Children with VVS coexisting with POTS were more likely to take pharmacological treatments than those with VVS or POTS only.
Child
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Electrolytes
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Female
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Humans
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Male
;
Metoprolol
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Midodrine
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Orthostatic Intolerance/therapy*
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Postural Orthostatic Tachycardia Syndrome/diagnosis*
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Retrospective Studies
;
Salts
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Sitting Position
;
Syncope, Vasovagal/diagnosis*
;
Tilt-Table Test

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