Objective To estimate the correlations between chronic idiopathic urticaria (CIU) development and interrelated autoantibodies,including anti-high affinity immunoglobulin E receptor (anti-FcεRI) antibody,anti-immunoglobulin E (anti-IgE) antibody,anti-Helicobacter pylori (HP) antibody and antithyroglobulin antibody (TGAb).Methods This study included 100 patients with CIU,100 patients with acute urticaria (AU) and 100 healthy controls.Autologous serum skin test (ASST) was performed and allergens were detected by fluorescence-based enzyme linked immunosorbent assay (ELISA) in each subject.Serum levels of total IgE,anti-FcεRI antibody,anti-IgE antibody,anti-HP antibody and TGAb were measured.Chi-square test,analysis of variance,and Wilcoxon rank sum test were conducted for statistical analysis.Results The positivity rate of ASST was 53％,12％ and 0 respectively in patients with CIU,patients with AU and healthy controls,respectively.Food or inhalant allergens were detected in 86％ of the patients with AU,but not detected in any of the patients with CIU or healthy controls.Patients with CIU showed significantly higher levels of anti-FcεRI antibody and anti-IgE antibody compared with patients with AU and healthy controls (all P ＜ 0.05).The serum IgE level in healthy controls was statistically lower than that in patients with AU (T =226.00,P ＜ 0.05),but higher than that in patients with CIU (T =190.00,P ＜ 0.05).ASST-positive patients with CIU had a higher level of serum anti-FcεRI antibody (T =101.73,P ＜ 0.05),but a similar level of serum anti-IgE antibody compared with ASST-negative patients with CIU (T =312.04,P ＞ 0.05).No significant differences were observed in the positivity rate of anti-HP antibody (29％,19％ and 23％,P ＞ 0.05) or TGAb (18％,15％ and 11％,P ＞ 0.05) between the patients with CIU,patients with AU and healthy controls.Both anti-HP antibody-positive patients and TGAb-positive patients with CIU showed a significantly higher positivity rate of anti-FcεRI antibody (all P ＜ 0.01),but a similar positivity rate of anti-IgE antibody compared with the patients with AU and healthy controls (all P ＞ 0.05).Conclusions Anti-FcεRI antibody and anti-IgE antibody are present in patients with CIU,and may play a certain role in the pathogenesis of CIU.

Objective To investigate the relationship between anti-Helicobacter pylori (Hp) antibodies and development of chronic urticaria (CU).Methods Fifty CU patients with positive 13C-urea breath test and anti-Hp antibodies,as well as 50 healthy human controls were recruited in this study.Serum samples were collected from all the subjects.The samples from the patients were subjected to tests for anti-high affinity IgE receptor (anti-FcεRI) and-IgE antibodies.Human mast cells (HMCs) were classified into several parts to be incubated with the sera of patients with CU,the sera of healthy controls with anti-IgE and-FcεRI antibodies respectively for 20 minutes.Those incubated with the sera of healthy controls without these antibodies served as the control.Subsequently,the levels of histamine released by HMCs were measured by enzyme-linked immunosorbent assay (ELISA).Results The sera of CU patients showed a stronger ability to activate HMCs to release histamine than those of healthy controls ((3.13 ± 0.93) μg/L vs (2.92 ± 0.75) μg/L,t =2.39,P ＜ 0.05).Anti-FcεRI antibodies were detected in 4 patients,and antiIgE antibodies in 3 patients.A significant increase was observed in the levels of histamine released by HMCs incubated with anti-FcεRI antibody-positive and anti-IgE antibody-positive patient-derived sera (t =4.82,6.34,respectively,both P ＜ 0.01),but not in those incubated with patient-derived sera only positive for anti-Hp antibodies (t =1.74,P ＞ 0.05) compared with those incubated with healthy control-derived sera.In comparison with the antibody-free healthy control-derived sera,those with anti-Hp IgG antibodies showed no significant effect on the release of histamines by HMCs (t =1.95,P ＞ 0.05),whereas those with anti-FcεRI antibodies and anti-IgE antibodies exhibited an obvious promoting effect (t =3.72,3.02,respectively,both P ＜ 0.01).Conclusions The anti-Hp antibodies appears to have no role in the pathogenesis of CU,but the presence of anti-FcεRI and anti-IgE antibodies may contribute to the initiation of CU in patients with Hp infection.

Objective To investigate the prevalence and influencing factors of job burnout among medical staff in secondary and lower-level public hospitals in a suburban area of Shanghai City. Methods A total of 1 959 in-service medical staff from 15 grade Ⅱ and lower-level public hospitals were selected as the research subjects using cluster sampling method. The Maslach Burnout Inventory-Human Service Survey was used to investigate their job burnout situation. Results The median and the 25th and 75th percentiles of job burnout scores for the research subjects were 2.7 (2.1, 3.1) points, and the detection rate of job burnout was 56.6% (1 109/1 959). The detection rate of mild, moderate, and severe job burnout was 26.7%, 18.5%, and 11.4%, respectively. The results of multiple linear regression analysis showed that medical staff aged 20-<31、31-<41、41-<51 had a higher risk of job burnout than those the age of ≥51 (P<0.01), unmarried medical staff had a higher risk of job burnout than married medical staff (P<0.05), intermediate professional title medical staff had a higher risk of job burnout than senior professional title medical staff (P<0.05), medical staff in grade Ⅱ hospitals had a higher risk of job burnout than those in gradeⅠ hospitals (P<0.01), and medical and nursing staff had a higher risk of job burnout than pharmaceutical and technical staff (P<0.01), after excluding confounding factors such as gender, professional title, educational level, and management position. Conclusion Job burnout is prominent among medical staff in grade Ⅱ and lower-level public hospitals in suburban Shanghai City. Age, marital status, professional title, hospital level, and job type are the independent influencing factors of their job burnout.

Decoction is one of the most commonly used dosage forms of traditional Chinese medicine. The stability of chemical constituents in decoction is closely related to the clinical efficacy and safety. There were few reports about the influence of metal ions in the stability of chemical constituents in traditional Chinese medicine. However, there is no evidence that metal ions in decoction water need to be controlled. In this study, 2,3,5,4'-tetrahydroxy stilbene-2-O-β-D-glucoside (THSG), one of the main constituents in Polygoni Multiflori Radix was studied. Ordinary tap water, deionized water, and water containing different metal ions were used to investigate and compare the influence on THSG. The results showed that after storage in a dark place at the room temperature for 10 days, the degradation of THSG was 7% in deionized water, while undetectable in tap water. The content of THSG could be decreased by different kinds of metal ions, and the effect was concentration-dependent. Moreover, Fe3+ and Fe2+ showed the greatest influence at the same concentration; and our study has shown that THSG decreased more than 98% in Fe and Fe2+ solutions at 500 ppm concentration. In the same time we found out p-hydroxybenzaldehyde (molecular weight: 122.036 7) and 2,3,5-trihydroxybenzaldehyde-2-O-glycoside (molecular weight: 316.079 4) were the main degradation products of THSG in tap water and water containing Cu2+, Ca2+, Zn2+, Mg2+ and Al3+. The product of THSG dimer with a water molecule was found in water containing Fe3+ and Fe2+. The above results showed that the metal ions in water could significantly influence the stability of THSG in water, indicating that the clinical efficacy and safety of decoction would be affected if the metal ions in water were not under control. It's suggested that deionized water should be used in the preparation of decoction containing Polygoni Multiflori Radix in the clinic to avoid degradation of THSG. Meanwhile, decoction prepared by tap water should be taken by patients in a short time. Our investigation provides important information and reference about the influence of metal ions on the stability of decoctions in other traditional Chinese medicine that have unstable groups such as hydroxyls and unsaturated bonds, etc.

OBJECTIVETo assess the relationship between myocardial regional perfusion using second harmonic myocardial contrast echocardiography (MCE) by venous injection of Levovist and coronary artery stenosis detected by coronary angiography to determine whe ther MCE can be used to detect coronary artery disease (CAD) and its sensitivity and specificity for detecting CAD.

METHODSThirty-six patients who underwent coronary artery angiography and MCE formed the study groups. Ten myocardial segments (5 each in the apical two- and four-chamber views) from the images were scored for detecting myocardial perfusion as follows: 1, normal perfusion; 2, decreased perfusion; and 3, perfusion defect. The arteries were classified as normal or diseased. The diseased arteries were classified into three groups according to the perfusion scores.

RESULTSThere were significant differences in coronary diameter stenosis among the different perfusion score groups (P < 0.001). There were 10 total occluded arteries, and the myocardial perfusion scores were different because of different collateral circulation. In the normal perfusion group (Group A), the coronary diameter stenosis was 65% +/- 12%, and the myocardial perfusion score index was 1 +/- 0.00. In the decreased perfusion group (Group B), the average coronary diameter stenosis was 82% +/- 8%, and the myocardial perfusion score was 1.93 +/- 0.16. The diameter stenosis was less than 85% in 63% of the coronary arteries (including diameter stenosis < or = 75% in 12% of the vessels). The diameter stenosis was 85%-90% in 22% of the coronary arteries and > 90% in 15% of the arteries. In the perfusion defect group (Group C), the average diameter stenosis was 90% +/- 6%, and the myocardial perfusion score index was 2.89 +/- 0.24. The diameter stenosis was > or = 85% in 94% of the coronary arteries, and the diameter stenosis was < 85% and > 75% only in 6% of the coronary arteries. The overall sensitivity and specificity of MCE in identifying angiographic coronary diameter stenosis was 67% and 100%, respectively. The false negative rate was 32.6% for the 108 coronary arteries. Further subdivided analysis showed the sensitivities in Groups A, B and C were 0, 100%, and 100%, respectively. The sensitivity increased with increased lumen diameter stenosis of coronary arteries.

CONCLUSIONSThere is a close relationship between coronary artery stenosis and MCE perfusion scores. MCE with venous injection of new generation contrast can define the presence of CAD and lesion graded classifications. Some disagreements between perfusion score and coronary diameter of stenosis may indicate other factors such as different collateral circulation, which should be further investigated. As artery stenosis increases, the sensitivity of MCE is increased.

Adult ; Aged ; Coronary Circulation ; Coronary Disease ; diagnostic imaging ; Echocardiography ; Female ; Humans ; Male ; Middle Aged ; Sensitivity and Specificity

Objective To analyze the relationship between angiotensin type Ⅱ 1 receptor autoantibodies (AT1-AA),blood uric acid and urea nitrogen with hypertensive disorder complicating pregnancy (HDCP). Methods A total of 125 patients with HDCP diagnosed in the obstetrics department of Tianjin Municipal Bao-di District People's Hospital from August 2021 to February 2023 were randomly selected as the HDCP group, and 55 healthy pregnant women admitted to this hospital during the same period were selected as the control group.The HDCP group was divided into the gestational hypertension subgroup (n=77) and preeclampsia group (n=48) according to the degree of disease progression.The levels of serum uric acid,blood urea nitro-gen and AT1-AA were detected and compared between the HDCP group and control group and between the gestational hypertension subgroup and preeclampsia subgroup.Results There were no statistically significant differences in the age,gestational time,D-dimer,serum calcium and serum creatinine between the control group and the HDCP group (P>0.05).The levels of peripheral blood AT1-AA,serum uric acid and blood u-rea nitrogen in the HDCP group were higher than those in the control group,and the differences were statisti-cally significant (P<0.05).The levels of peripheral blood AT1-AA,serum uric acid and blood urea nitrogen in the preeclampsia subgroup were significantly higher than those in the gestational hypertension subgroup, and the differences were statistically significant (P<0.05).The Spearman rank correlation coefficient analysis showed that the levels of peripheral blood AT1-AA (r=0.301),serum uric acid (r=0.380) and blood urea nitrogen (r=0.257) levels were positively correlated with the severity degree of HDCP (P<0.01).The area under the curve (AUC) of AT1-AA,serum uric acid and blood urea nitrogen detection alone and combined de-tection in the diagnosis of HDCP were 0.680,0.714,0.647 and 0.725,and the corresponding Youden coeffi-cients were 0.368,0.380,0.306 and 0.439,indicating that the value of combined testing was higher than that of single item detection in the diagnosis of HDCP.Conclusion AT1-AA,serum uric acid and blood urea nitro-gen are correlated with the occurrence and development of HDCP,and the 3-item combined detection has high-er value.

Objective:To investigate the clinical significance of suction blister transplantation in improving the efficacy of ReCell technique in the treatment of vitiligo.Methods:Patients were divided into three groups, namely, vitiligo patients without history of suction blister therapy, patients with ineffective suction blister therapy and patients with effective suction blister therapy. There were 30 patients in each group. All patients were treated with standard procedure of ReCell technique. The color recovery effect of leukoplakia was observed 3 and 6 months after operation, and the incidence of complications was also observed.Results:The effective rate of color recovery 3 and 6 months after operation were as follow: in patients without history of suction blister group, the effective rate of three months was 53.3%, and that of six months was 63.3%; in patients with ineffective suction blister group, the effective rate was 43.3% in three months and 50.0% in six months, and in patients with effective suction blister group, the effective rate was 76.7% in three months and 90.0% in six months. No obvious complications were observed in the three groups.Conclusions:For the treatment of stable vitiligo with ReCell technique, suction blister method is a simple and effective method for screening patients.

Objective To explore the ART willingness and influencing factors of male HIV/AIDS patients in a special prison area in Shanghai. Methods The information was collected from face-to-face questionnaire survey of HIV/AIDS patients conducted from July 1, 2019, to December 31, 2019. Data was analyzed by univariate and multivariate analysis. The influence of social demographic characteristics, basic situation of detention, AIDS epidemiology, knowledge of AIDS ART, and family awareness on the willingness of anti-virus treatment was investigated. Results A total of 121 HIV / AIDS patients were investigated in this study. The results of multivariate analysis showed that HIV / AIDS patients who were less likely to receive ART included patients with multiple custody, patients with ART knowledge score less than 8, patients whose family members were unaware of their HIV infection, patients thought that they met the treatment standard but had no symptoms and did not need to take medicine, and patients thought that they could discontinue taking medicine at will. Conclusion A variety of factors have an impact on ART willingness of HIV/AIDS patients in custody. It is suggested that HIV / AIDS patients should be provided with more targeted ART knowledge training and social care and family support as far as possible.

Objective : To analyze the association between multiple loci of genes and the risk of early⁃onset pre⁃ eclampsia (EOPE) with pregnancy induced hypertension. Methods : Among 382 EOPE patients who had lived in Yanbian area for more than 10 years , 192 patients were randomly selected as case group. At the same time , 192 cases of natural delivery in the hospital were randomly selected as the control group. PCR⁃RFLP method was used to determine the specific genotype and allele distribution information , and non⁃conditional Logistic method was used to obtain odds ratio (OR) and 95% confidence interval (CI) to confirm the risk of various genotypes. Results : There were two alleles of T and C at the GRB2 rs8082005 locus , TC , TT , and CC genotypes. There were two alleles of T and C at the RXRA rs3849222 locus , TC , TT , and CC genotypes. Through unconditional logistic regression analysis , in the GRB2 rs8082005 locus , compared with the TT genotype , the CC genotype was more susceptible to EOPE ( OR = 3. 155 , 95% CI = 1. 513 - 6. 579 , P = 0. 002) . In the explicit model , compared to patients with TT+ TC genotype , patients with CC genotype increased the risk of EOPE ( OR = 3. 000 , 95% CI = 1. 495 - 6. 022 , P = 0. 002) . In the RXRA rs3849222 locus , compared with the CC genotype , the TT genotype was more susceptible to EOPE ( OR = 2. 031 , 95% CI = 1. 077 - 3. 820 , P = 0. 028) . In the invisible model , compared to patients with CC + CT genotype , patients with TT genotype had an increased risk of EOPE ( OR = 2. 549 , 95% CI = 1. 421 - 4. 573 , P = 0. 002) . Conclusion There is a significant correlation between single nucleotide polymorphism (SNP) at the GRB2 rs8082005 and RXRA rs3849222 loci and the risk of EOPE in pregnant women with gestational hypertension in Yanbian area.

Background Lead and manganese are heavy metal pollutants widely existing in the environment, which can accumulate in the human body through the food chain, exert neurotoxicity, and cause neurodegenerative disorders. Especially in early childhood, the developing blood-brain barrier and nervous system are highly susceptible to environmental chemical pollutants. Most of the previous studies focused on the toxic effects of single heavy metal such as lead or manganese, while the studies on combined toxic effect are still scarce, and involved mechanisms are still unclear. c-Jun N-terminal kinase (JNK) is involved in neuronal development and regeneration, and some studies have found that JNK is involved in lead or manganese induced neurotoxicity. Its role in the toxicity of combined lead and manganese is unknown. Objective To understand the neurodevelopmental toxicity mechanism and to observe changes of JNK expression in zebrafish induced by combined lead and manganese exposure at environmentlly low concentrations. Methods Zebrafish embryos within 2 h post fertilization (hpf) were divided into four groups: control group, lead exposure group (0.1 mg·L⁻¹ lead acetate), manganese exposure group (0.3 mg·L⁻¹ manganous chloride), and lead-manganese combined exposure group (0.1 mg·L⁻¹ lead acetate +0.3 mg·L⁻¹ manganous chloride) and exposed to lead or/and manganese at designed levels for 7 d. Spontaneous movements and motor locomotion were observed, and mortality rate were calculated. The changes of JNK mRNA expression in zebrafish were evaluated. Results The experimental results showed that no significant effect of lead or/and manganese on spontaneous movements and mortality rate was found in zebrafish compared with the control group (P＞0.05). The results of locomotion analysis showed that compared with the control group, the activity counts and activity distance of zebrafish in the manganese exposure group were slightly increased (P＜0.01); the activity counts and activity distance of zebrafish in the lead exposure group were reduced by 50% and those in the lead-manganese exposure group were reduced by 80% (P＜0.01). Compared with the lead exposure group, the activity counts and activity distance of zebrafish in the lead-manganese combined exposure group decreased significantly by 60% (P＜0.05). The real-time quantitative PCR results showed that the JNK mRNA expression level was significantly increased in the lead-manganese combined exposure group compared with the control group(P＜0.01). Conclusion Lead exposure combined with manganese exposure at environmentlly low concentration can induce neurodevelopmental toxicity to zebrafish. JNK may be involved in neurodevelopmental toxicity induced by the combined exposure to lead and manganese.