Objective To provide basis for the diagnosis,treatment,prevention and control of pertussis by analyzing serological test findings and clinical features of inpatients.Methods Serological test findings (including outpatients and inpatients) of suspected cases and medical records diagnosed as pertussis (severe group and non-severe group) were analyzed in Shandong Provincial Hospital Affiliated to Shandong University from January 1,2012 to December 31,2014.This retrospective study was conducted to explore the epidemiological characteristics,clinical manifestations,image manifestations of pertussis in recent years.Results The incidence of pertussis was obviously higher in 2014 than the previous 2 years,nearly 10 times than that of 2013;summer and autumn were high-occurrence seasons;pertussis was found predominately in children under 6 years old,as 68％-80％,and the majority of them were 3 months-1 year old and 4-6 years old,and there was a notable increase in children more than 6 years old in 2014;the clinical manifestations tended to be atypical,primarily spasmodic cough (79.01％,64/81 cases),cyanosis (60.49 ％,49/81 cases),vomiting after cough (35.80％,30/81 cases),conjunctiva haemorrhage (22.22 ％,18/81 cases) apnea or heart rate decrease(9.88％,8/81 cases),and whooping cough (7.41％,6/81 cases).There were significant differences(all P ＜ 0.05) in age (t =2.940),paroxysmal cyanosis (x2 =4.505),elevated white blood cell count (x2 =4.410),and lymphocyte percentage increase(x2 =7.830) between severe group and non-severe group.There was no statistical difference in sex(x2 =0.847),season (x2 =0.178),spasmodic cough (x2 =0.097),whooping cough (x2 =0.002),conjunctiva hemorrhage (x2 =0.395),apnea (x2 =0.395) and fever (x2 =0.301) between the 2 groups (all P ＞ 0.05).Mixed infection with mycoplasma was most common.Imaging manifestations of pertussis were not specific,and they might manifest uneven density,patchy inflammatory infiltrates and atelectasis.Conclusions The morbidity of pertussis is rising and atypical cases is increasing in these years,and severe cases are seen most frequently in small infants,it is necessary to perfect the laboratory test methods and immunization strategy.

OBJECTIVETo investigate the characteristics,diagnosis and therapy of post-biopsy renal artery pseudoaneurysm in children and to study the clinical value of arterial embolization for traumatic renal hemorrhage when conservative treatment failed.

METHODData were compiled from medical records of a child in whom renal artery pseudoaneurysm occurred after biopsy in the Provincial Hospital Affiliated to Shandong University , and the related literature was reviewed to analyze the diagnosis and treatment of such pseudoaneurysm.

RESULTA 13-year-old boy had gross hematuria, aggravated dysuria and decreased hemoglobin 10 days after percutaneous renal biopsy. Hb decreased from 110 g/L on the first day after admission to 92 g/L on the 4th day, 83 g/L on the 7th day and the minimum to 74 g/L at the 8th day after admission. Ultrasound showed solid echogenic mass in the right renal pelvis as well as the bladder. Color Doppler ultrasound shows the red and blue rotation of blood flow in the polar capsule under the right kidney. Contrast-enhanced CT in the arterial phase showed a 0.5 cm sized renal mass with a strongly enhanced dot in the lower pole of the right kidney, suggesting a renal artery pseudoaneurysm. Haemostatic, supplement of red blood cells and blood volume and other integrative treatment of hematuria were applied for seven days, but his gross hematuria continued to be worsened. He was diagnosed as pseudoaneurysm by digital subtraction angiography (DSA) on the 19th day after renal biopsy. Superselective renal artery embolization using micro-coils and gelatin sponge particles was performed, and the blood clots were cleaned under cystoscope. Macro-haematuria and dysuria disappeared after the interventional treatment. Retrieval of reports on post-biopsy renal artery pseudoaneurysm in children by using "pseudoaneurysm, child" as the search term showed report of one case from the Chinese CNKI database and 3 cases from the PubMed database. The underlying disease was Henoch-Schonlein purpura nephritis in 3 cases and Sneedon syndrome in 1 case; clinical manifestation of gross haematuria was present in 4 cases, lumbago or pain at the site of the puncture in 2 cases, dysuria in 1 case, and fever in 2 cases.

CONCLUSIONThe post-biopsy renal artery pseudoaneurysm in children is often manifested as gross hematuria, lumbago, pain at the site of the puncture, fever and dysuria, DSA can be used for definite diagnosis and the interventional treatment is effective.

Adolescent ; Aneurysm, False ; therapy ; Angiography, Digital Subtraction ; Biopsy ; Embolization, Therapeutic ; Hematuria ; Hemorrhage ; Humans ; Kidney ; blood supply ; pathology ; Kidney Diseases ; diagnosis ; Male ; Nephritis ; Renal Artery ; pathology

Objective To investigate the value of combined serum levels of neutrophil gelatinase-associated lipocalin(NGAL)and growth differentiation factor 15(GDF-15)in diagnosis of renal injury in elderly patients with H-type hypertension.Methods A total of 177 patients with H-type hypertension admitted to Department of Neurology and Department of General Medicine of the Affiliated Hospital of Chengde Medical College from April 2021 to June 2022 were enrolled,and based on their estimated glomerular filtration rate(eGFR),they were divided into the renal im-pairment group(81 cases)and normal renal function group(96 cases).General data and laboratory indicators were collected in the two groups.ROC curve analysis was used to evaluate the diagnos-tic value of combined NGAL and GDF-15 levels for renal injury in the elderly patients with H-type hypertension,and Pearson correlation analysis was performed to analyze the correlation between serum NGAL and GDF-15 levels and renal injury in the patients.Results SBP level was significantly higher in the renal impairment group than the normal renal function group[148.53±14.62 mm Hg(1 mm Hg=0.133 kPa)vs 138.75±13.36 mm Hg,P＜0.01],but no such difference was observed in DBP level between the two groups(P＞0.05).The levels of creatinine(Cr),urea nitrogen(BUN),β2-microglobulin(β2-MG),cystatin C(Cys C),urinary microalbumin(MA),NGAL and GDF-15 levels were obviously higher in the renal impairment group than the group with normal renal function(P＜0.01).ROC curve analysis showed that the combined detection of NGAL and GDF-15 levels was significantly higher than that of the two indicators alone(P＜0.01).Pearson correlation analysis indicated that serum NGAL and GDF-15 levels were positively correlated with Cr,BUN,β2-MG,Cys C and MA levels(P＜0.01).Conclusion Serum NGAL and GDF-15 levels are elevated in elderly H-type hypertension patients.Combined detection of the two indicators has higher value in the diagnosis of renal injury in elderly H-type hypertension patients.

OBJECTIVETo investigate the quantitative and qualitative changes of TCRVα24(+)Vβ11(+) natural killer T (NKT) cells from bone marrow (BM) of aplastic anemia (AA) after in vitro stimulation of α-galactosylceramide (α-Galcer).

METHODSNKT cells in the bone marrow mononuclear cells (BMMNCs) from either AA patients or healthy controls were enumerated with flow cytometry. BMMNCs were cultured in RPMI1640 medium supplemented with either α-Galcer and rhIL-2 or α-Galcer, rhIL-2 and rhG-CSF. The proliferative capacity of NKT cells was determined by NKT cell numbers before and after in vitro culture. Expression of intracellular IFNγ and IL-4 in activated NKT cells was analyzed with flow cytometry.

RESULTSIn AA group, the percentage of NKT cells in BMMNCs was (0.19 ± 0.09)%. Addition of rhG-CSF into the α-Galcer/rhIL-2 culture medium resulted in significantly reduced expansion of NKT cells (67.45 ± 29.42-fold vs 79.91 ± 40.56 fold, P < 0.05). Meanwhile, addition of rhG-CSF reduced IFNγ positive NKT cells \[(37.45 ± 7.89)% vs (62.31 ± 14.67)%, P < 0.01\] and increased IL-4 positive NKT cells \[(55.11 ± 12.13)% vs (27.03 ± 9.88)%, P < 0.01\]. In healthy control group, the percentage of NKT cells in BMMNCs was (0.25 ± 0.12)%. Addition of rhG-CSF into the α-Galcer/rhIL-2 culture medium also significantly reduced expansion of NKT cells (97.91 ± 53.22-fold vs 119.58 ± 60.49-fold, P < 0.05), reduced IFNγ positive NKT cells \[(28.65 ± 10.63)% vs (50.87 ± 12.66)%, P < 0.01\], and increased IL-4 positive NKT cells \[(66.53 ± 14.96)% vs (31.11 ± 10.07)%, P < 0.01\].

CONCLUSIONCompared to those from healthy controls, BMMNCs from AA patiants have a reduced fraction of NKT cells, which possesses a decreased potential to expand in vitro in response to α-Galcer stimulation, and produce more IFNγ(+) NKT1 cells. rhG-CSF, in combination with α-Galcer, confers polarization of NKT cells towards IL-4(+) NKT2 subpopulation.

Anemia, Aplastic ; metabolism ; Bone Marrow ; metabolism ; Humans ; Interleukin-4 ; metabolism ; Killer Cells, Natural ; cytology ; Natural Killer T-Cells

Objective:To explore the cognition of community health care workers and the elderly on frailty, and attitudes towards frailty management.Methods:The semi-structured interview was conducted with 14 community health care workers and 17 community elderly in 3 communities in Beijing with the method of phenomenological research. We interviewed respondents' cognition on frailty management and attitudes towards frailty management. Colaizzi 7-step method was used for data analysis.Results:Three themes of cognition on elderly frailty were extracted including that the elderly in the community had different cognition and understandings of elderly frailty; community health care workers had a comprehensive understanding of the concept of elderly frailty, but not much contact with this concept; there were several misunderstandings about the cognition of elderly frailty. Four themes of attitudes towards frailty management were extracted including that the elderly want scientific frailty management; the elderly in the early stage of frailty did not agree with frailty management; community health care workers affirmed the importance of frail management; there were many obstacles to the frailty management in Beijing communities.Conclusions:It is necessary to strengthen education and publicity for the elderly frailty, speed up the formulation of evidence-based frailty management plans, guide community practice, and improve the quality of life of the elderly.

Objective To investigate the association of red cell distribution width (RDW) with all-cause and cardiovascular disease (CVD)-related mortality in patients undergoing continuous ambulatory peritoneal dialysis (CAPD).Methods A retrospective analysis was performed on 207 patients who initiated CAPD for more than 3 months between July 2005 and March 2016 in the First Hospital Affiliated to Zhengzhou University.Baseline data on demographic,clinical and biochemical variables as well as comorbidities were obtained;medications and clinic outcomes were recorded.According to receiver operator characteristic curve (ROC) analysis,patients were divided into high RDW (RDW ＞ 15.1％) and low RDW (RDW≤ 15.1％) groups.The data of two groups were compared and Spearman's correlation analysis was used to explore the association of RDW with clinical and biochemical parameters.Survival curves were calculated using Kaplan-Meier method.Cox regression model was employed to analyze risk factors of all-cause and CVD-related mortality.Results In this study,207 CAPD patients were enrolled.The overall median survival time was 80 months.And the median survival time of high RDW group (68 patients) and low RDW group (139 patients) were 59 months and 96 months,respectively.There were statistical differences in diastole pressure,hemoglobin,hematocrit,serum albumin,intact parathyroid hormone (iPTH),eGFR,cholesterol,lipoprotein a,4-hour dialysate-to-plasma ratio for creatinine (4hD/Pcr),total Ccr (P ＜ 0.05,respectively);the two groups also varied in the proportion of chronic obstructive pulmonary disease,cardiovascular disease and hyperlipidemia,as well as in the use of iron supplements,angiotensin-converting enzyme (ACE) inhibitors or angiotensin Ⅱ receptor blockers (ARB),and beta-receptor blockers (P＜0.05,respectively).Cardiovascular event was a leading cause of mortality.Kaplan-Meier survival curves showed that the high RDW group had higher all-cause and CVD-related mortality compared with the low RDW group (P ＜ 0.01).The 1-year,3-year,and 5-year patient survivals of the high RDW and low RDW group were 87.97％ vs 97.01％,58.02％ vs 81.53％,and 41.62％ vs 67.96％,respectively,demonstrating significant differences (P=0.001).Multivariate Cox regression analysis showed that high RDW was independent risk factor for all-cause mortality (HR=1.212,95％CI:1.007-1.458,P=0.042) and CVD-related mortality (HR=1.697,95％ CI:1.030-2.795,P=0.038).Conclusion RDW is associated with mortality risks in CAPD patients and can be stratified as a valuable indicator for the risk of death.

Objective To investigate whether the JAK2/STAT3 signaling pathway is involved in the epithelial-mesenchymal transition (EMT) of peritoneal mesothelial cells in uremic peritoneal dialysis (PD) rats.Methods A total of 48 male Sprague-Dawley (SD) rats were randomly separated into six groups:normal control group (NC group,n=8),sham group (n=8),uremic group (n=8),PD group (n=8),S3I-201 control group (n=8) and S3I-201 group (n=8).Uremic model generated by 5/6 nephrectomy surgery in rats was established.The rats of PD group,S3I-201 control group and S3I-201 group received daily infusion of 4.25％ glucose-based peritoneal dialysate fluid (3 ml/100 g) from PD catheters for 28 days.Rats of S3I-201 group were injected with STAT3 inhibitor S3I-201 (2.5 mg/kg) solution from the catheters every other day;the same dose of the solvent of S3I-201 was simultaneously given to S3I-201 control group rats.After PD for 28 days,peritoneal function,pathologic changes,and microvessel density (MVD) were evaluated.Creatinine,urea nitrogen and interleukin-6 (IL-6) concentration in blood and dialysate,and protein and mRNA levels of phospho-JAK2 (p-JAK2),phospho-STAT3 (p-STAT3),E-cadherin,alpha-smooth muscle actin (α-SMA) and vascular endothelial growth factor (VEGF) in peritoneum were determined.Results Uremia and peritoneal dialysate could aggravate the peritoneal function and elevate peritoneal thickness and MVD.They could also increased the concentration of IL-6 in blood and dialysate and the expression levels of α-SMA,VEGF,p-JAK2 and p-STAT3 in peritoneum,while lowering E-cadherin expression in peritoneum.These manifestations were even more remarkable in PD group compared to those in uremic group.There was no statistical difference between the S3I-201 control group and the PD group as regards all the index (all P ＞ 0.05).Compared with the S3I-201 control group,the rats treated with S3I-201 showed better peritoneal function.S3I-201 could reduce peritoneal thickness (P＜0.05),MVD (P＜0.05),the concentration of IL-6 in blood and dialysate,the mRNA and protein expression of α-SMA,VEGF,p-JAK2 and p-STAT3 (all P ＜ 0.05),while enhance the mRNA and protein expression of E-cadherin (all P ＜ 0.05).Conclusions After STAT3 is inhibited,the peritoneal thickness,MVD and IL-6 concentration in PD rats are decreased,and EMT is also inhibited,while peritoneal function is improved.The JAK2/STAT3 signaling pathway may thus be involved in the process of EMT of peritoneum in uremic peritoneal dialysis rats by regulating the expression of IL-6.

Nonalcoholic fatty liver disease （NAFLD） is one of the most common complications of type 2 diabetes mellitus （T2DM）. Cell death caused by iron-lipid disorder is a new mode of regulating programmed cell death， which is characterized by lipid peroxidation induced by the accumulation of lipid reactive oxygen species and excessive accumulation of iron ions induced by iron metabolism disorders. Among them， iron homeostasis disorder and metabolic pathway disorder are the main causes of iron-lipid disorder， which play an important role in a variety of pathological processes related to cell death. Because the liver is an important organ for iron storage and lipid metabolism， iron-lipid disorder is an ideal target for liver disease， and inhibition of iron-lipid disorder may become a new strategy for the treatment of NAFLD. However， the pathogenic relationship and mechanism between NAFLD and iron-lipid disorder have not been fully elucidated. Based on the complex molecular regulation mechanism of iron-lipid disorder， by expounding the role of iron-lipid disorder in NAFLD and its related mechanism， this paper summarizes the research status of traditional Chinese medicine on the target treatment of NAFLD in recent years， so as to provide a new perspective and point out a new direction for the treatment of NAFLD in the future.

Objective? To understand and analyze the research status of traditional Chinese medicine nursing for diabetes mellitus, and to provide reference for its clinical application and research direction. Methods? China Journal Full Text Database (CNKI), VIP database and WanFang Database were searched to get the relevant articles on diabetes Traditional Chinese medicine nursing published from the establishment date to December 2018. Data mining and keyword clustering analysis were used to analyze the literature features and research hotspots. Results? Finally, 1 963 articles related to traditional Chinese medicine nursing of diabetes mellitus were included, and 2 389 keywords and 27 high frequency keywords were obtained. Bibliometric analysis showed that the amount of relevant research fluctuated and increased year by year. Cluster analysis result revealed that the research of traditional Chinese medicine nursing of diabetes mainly focused on the nursing of elderly patients in community, the nursing of diabetic complications, the application of traditional Chinese medicine nursing technology and the evaluation of traditional Chinese medicine nursing program. Conclusions? Diabetes traditional Chinese medicine nursing has made some progress in the traditional field, but the expansion and innovation of the research still need to be strengthened. In the later stage, we should attach importance to the exploration of talent training mode, encourage the development of basic theory and interdisciplinary exchanges and cooperation, adhere to the combination of inheritance and innovation, and improve the scientific nature of diabetes traditional Chinese medicine nursing.

Objective:To explore the research hotspots and trends of traditional Chinese medicine (TCM) nursing for stroke.Methods:Literatures on TCM nursing for stroke were retrieved in Chinese National Knowledge Infrastructure (CNKI) , WanFang Data, VIP, China Biological Medicine (CBM) from building database to September 2018. The data management tools included BICOMB 2.0, SPSS 22.0 and UCINET 6.0. The research hotspots and trends of TCM nursing for stroke were analyzed with the methods of co-word analysis, clustering analysis and social network analysis.Results:A total of 7 253 literatures were included involving 17 236 keywords and 30 high-frequency keywords. Clustering analysis showed that research hotspots of TCM nursing for stroke focused on the application of auricular buried beans in symptomatic nursing for stroke, negative emotion management of stroke, body function treatment after stroke and its research on model and TCM rehabilitation appropriate technology of stroke sequela. Social network analysis showed that scope and quantity of research hotspots of TCM nursing for stroke expanded year by year, exploration field was excavated and deepened constantly and inheritance emerged gradually.Conclusions:Co-word, clustering and social network analysis objectively reflects the research hotspots and trends of TCM nursing for stroke which could provide the information support for researchers and clinical workers and provide a reference for research selected topic as well as clinical practice.