Objective To explore the clinical value of red blood cell volume distribution width coefficient of variation(RDW-CV),serum interleukin-11(IL-11)and interleukin-31(IL-31)in the diagnosis of interstitial lung disease(ILD).Methods Prospectively selected 46 ILD patients admitted to the Department of Respiratory and Critical Care Medicine,the Affiliated Hospital of Chengde Medical University from November 2022 to October 2023 were set as ILD group,40 patients with community-acquired pneumonia(CAP)as CAP group,and 35 healthy examiners as control group.The ILD group was further divided into idiopathic interstitial pneumonia(IIP)subgroup(n=30)and connective tissue disease-related ILD(CTD-ILD)subgroup(n=16)based on clinical diagnosis.General and clinical data of each group were recorded,and RDW-CV and serum IL-11 and IL-31 levels were detected in each group.The ILD group was tested for alveolar arterial oxygen pressure difference(AaDO2)and arterial blood oxygen pressure(PaO2),and calculated the oxygenation index(OI).The correlation between the levels of RDW-CV,IL-11 and IL-31 and the severity of ILD were analyzed to explore the value of the above indicators in the clinical diagnosis of ILD and the differential diagnosis of different types of ILD.Results Compared with control group,there was no statistically significant difference in general information such as age,gender,smoking history,and complications between the ILD and CAP groups(P>0.05);RDW-CV,absolute values of neutrophil count(NEUT),and serum IL-11 and IL-31 levels in ILD group were significantly increased(P<0.05).Compared with CAP group,the levels of RDW-CV and serum IL-11,IL-31 in ILD group were increased,while the level of serum C-reactive protein(CRP)was decreased,with statistically significant differences(P<0.05).Correlation analysis results showed that RDW-CV and serum IL-31 in ILD patients were negatively correlated with OI(P<0.05),and positively correlated with AaDO2(P<0.05).The area under the ROC curves(AUC)of RDW-CV and serum IL-11,IL-31 single and combined applications for diagnosing ILD were 0.770,0.666,0.646,and 0.854,respectively(P<0.05).The AUC of serum IL-11 for differential diagnosis of CTD-ILD and IIP was 0.727(95%CI 0.580-0.874),with sensitivity of 62.5%and specificity of 73.3%(P<0.05).Conclusions RDW-CV and serum IL-31 have certain value in assessing the severity of ILD.RDW-CV and serum IL-11 and IL-31 have certain value in the diagnosis of ILD.Serum IL-11 has certain value in the differential diagnosis between CTD-ILD and IIP.

Sleep-wake disorder is one of the most common nonmotor symptoms of Parkinson's disease (PD). Melatonin has the potential to improve sleep-wake disorder, but its mechanism of action is still unclear. Our data showed that melatonin only improved the motor and sleep-wake behavior of a zebrafish PD model when melatonin receptor 1 was present. Thus, we explored the underlying mechanisms by applying a rotenone model. After the PD zebrafish model was induced by 10 nmol/L rotenone, the motor and sleep-wake behavior were assessed. In situ hybridization and real-time quantitative PCR were used to detect the expression of melatonin receptors and lipid-metabolism-related genes. In the PD model, we found abnormal lipid metabolism, which was reversed by melatonin. This may be one of the main pathways for improving PD sleep-wake disorder.
Animals ; Zebrafish ; Melatonin/pharmacology* ; Lipid Metabolism/drug effects* ; Disease Models, Animal ; Rotenone/pharmacology* ; Sleep Wake Disorders/metabolism* ; Parkinson Disease/metabolism* ; Motor Activity/drug effects* ; Sleep/drug effects*

OBJECTIVE: To investigate the clinical features and outcome of neonatal acute respiratory distress syndrome (ARDS) in southwest Hubei, China. METHODS: According to the Montreux definition of neonatal ARDS, a retrospective clinical epidemiological investigation was performed on the medical data of neonates with ARDS who were admitted to Department of Neonatology/Pediatrics in 17 level 2 or level 3 hospitals in southwest Hubei from January to December, 2017. RESULTS: A total of 7 150 neonates were admitted to the 17 hospitals in southwest Hubei during 2017 and 66 (0.92%) were diagnosed with ARDS. Among the 66 neonates with ARDS, 23 (35%) had mild ARDS, 28 (42%) had moderate ARDS, and 15 (23%) had severe ARDS. The main primary diseases for neonatal ARDS were perinatal asphyxia in 23 neonates (35%), pneumonia in 18 neonates (27%), sepsis in 12 neonates (18%), and meconium aspiration syndrome in 10 neonates (15%). Among the 66 neonates with ARDS, 10 neonates (15%) were born to the mothers with an age of ≥35 years, 30 neonates (45%) suffered from intrauterine distress, 32 neonates (49%) had a 1-minute Apgar score of 0 to 7 points, 24 neonates (36%) had abnormal fetal heart monitoring results, and 21 neonates (32%) experienced meconium staining of amniotic fluid. Intraventricular hemorrhage was the most common comorbidity (12 neonates), followed by neonatal shock (9 neonates) and patent ductus arteriosus (8 neonates). All 66 neonates with ARDS were treated with mechanical ventilation in addition to the treatment for primary diseases. Among the 66 neonates with ARDS, 10 died, with a mortality rate of 15% (10/66), and 56 neonates were improved or cured, with a survival rate of 85% (56/66). CONCLUSIONS Neonatal ARDS in southwest Hubei is mostly mild or moderate. Perinatal asphyxia and infection may be the main causes of neonatal ARDS in this area. Intraventricular hemorrhage is the most common comorbidity. Neonates with ARDS tend to have a high survival rate after multimodality treatment.
China ; Female ; Humans ; Infant, Newborn ; Meconium Aspiration Syndrome ; Pregnancy ; Respiratory Distress Syndrome, Newborn ; Retrospective Studies

OBJECTIVE: To study the clinical features of the diseases associated with aminoacyl-tRNA synthetases (ARS) deficiency. METHODS: A retrospective analysis was performed of the clinical and gene mutation data of 10 children who were diagnosed with ARS gene mutations, based on next-generation sequencing from January 2016 to October 2019. RESULTS: The age of onset ranged from 0 to 9 years among the 10 children. Convulsion was the most common initial symptom (7 children). Clinical manifestations included ataxia and normal or mildly retarded intellectual development (with or without epilepsy; n=4) and onset of epilepsy in childhood with developmental regression later (n=2). Some children experienced disease onset in the neonatal period and had severe epileptic encephalopathy, with myoclonus, generalized tonic-clonic seizure, and convulsive seizure (n=4); 3 had severe delayed development, 2 had feeding difficulty, and 1 had hearing impairment. Mutations were found in five genes: 3 had novel mutations in the AARS2 gene (c.331G>C, c.2682+5G>A, c.2164C>T, and c.761G>A), 2 had known mutations in the DARS2 gene (c.228-16C>A and c.536G>A), 1 had novel mutations in the CARS2 gene (c.1036C>T and c.323T>G), 1 had novel mutations in the RARS2 gene (c.1210A>G and c.622C>T), and 3 had novel mutations in the AARS gene (c.1901T>A, c.229C>T, c.244C>T, c.961G>C, c.2248C>T, and Chr16:70298860-70316687del). CONCLUSIONS A high heterogeneity is observed in the clinical phenotypes of the diseases associated with the ARS deficiency. A total of 14 novel mutations in 5 genes are reported in this study, which enriches the clinical phenotypes and genotypes of the diseases associated with ARS deficiency.
Amino Acyl-tRNA Synthetases ; genetics ; Child ; Epilepsy ; Humans ; Mutation ; Phenotype ; Retrospective Studies

Objective To evaluate the diagnostic value of gray-scale ultrasound combined with contrast-enhanced ultrasound (CEUS) in thyroid imaging and reporting system ( TI-RADS) 3-5 nodules of American College of Radiology ( ACR) . Methods The 208 patients( 216 nodules) who underwent thyroid contrast-enhanced ultrasound examination from April 2014 to December 2016 were retrospectively analyzed . The ACR TI-RADS classification and contrast-enhanced mode of thyroid ultrasound were evaluated . The benign and malignant thyroid lesions were constructed through the analysis of contrast-enhanced mode of thyroid benign and malignant lesions in the past literature and the preliminary study of our group . Prediction model of gray scale combined with contrast-enhanced ultrasound for lesions were established . Besides ,the sensitivity ,specificity and accuracy of gray scale ultrasound combined with contrast-enhanced ultrasound prediction model for differential diagnosis of benign and malignant thyroid lesions were calculated based on the results of puncture biopsy or surgical pathology as the gold standard . Results Compared with pathological results , the positive predictive value , negative predictive value , accuracy , sensitivity and specificity of gray scale combined with contrast-enhanced ultrasound in evaluating thyroid nodules were 90 .8％ ,93 .3％ ,91 .2％ ,98 .8％ and 62 .2％ ,respectively . Conclusions Gray-scale ultrasound combined with contrast-enhanced ultrasound can provide clinical value in differential diagnosis of benign and malignant TI-RADS 3-5 thyroid nodules .

Objective To evaluate the significance of liver biopsy and B ultrasonograpgy in the diagnosis of fatty liver. Methods The results of 62 patients with liver steatosis diagnosed by liver puncture biopsy but not by B-ultrasonograpgy were contrastively analyzed and combined with liver function, blood lipids, blood glucose, and body mass index. Results The 62 cases which were not diagnosed as fatty liver by B-ultrasonograpgy were proved to be 5％-33％liver steatosis after liver puncture biopsy. Among the 62 cases, 23 cases were indicated by the B-ultrasonograpgy that the liver parenchyma echo did not see abnormalities, 18 cases showed the liver parenchyma echo slightly was enlarged, 17 cases showed the liver parenchyma echo density was a bit enhanced and 4 cases were diffuse liver damage,which respectively were 37.01％、29.03％、27.42％and 6.45％. Pathologically it indicated that 45 cases were 5％≤liver steatosis≤19％. Among the 45 cases, 18 cases were indicated by the B-ultrasonograpgy that the liver parenchyma echo was not seen abnormalities, 8 cases showed the liver parenchyma echo slightly was enlarged, 17 cases showed the liver parenchyma echo density was a bit enhanced, and 2 cases were diffuse liver damage, and the change of ultrasound was mainly showed by the liver parenchyma echo not seen abnormalities and the enhanced liver parenchyma echo density. Pathologically it indicated that 17 cases were 20％≤liver steatosis≤33％, 6 cases were indicated by the B-ultrasonograpgy that the liver parenchyma echo did not see abnormalities, 5 cases showed the liver parenchyma echo slightly was enlarged, 5 cases showed the liver parenchyma echo density was a bit enhanced, and 1 case was diffuse liver damage, and the change of ultrasound was mainly showed by the liver parenchyma echo not seen abnormalities, the slightly enlarged liver parenchyma echo and the enhanced liver parenchyma echo density. By analyzing the influence to the ultrasound changes by patients' liver function, body mass index, blood fat and blood sugar, and with logistic regression analysis through a disorderly classification, it was found that the larger value of the glutamine transferase, alkaline phosphatase, body mass index, triglyceride and low density lipoprotein cholesterol, the higher possibility of diffuse liver damage, and the higher level of fatty degeneration, the higher possibility of diffuse liver damage. Conclusion In the diagnosis of fatty liver, when the fatty degeneration is below 1/3, B-ultrasonic examination can't show characteristic changes of fatty liver. It should be closely observed or take liver puncture biopsy to make a definite diagnosis of fatty liver.

To improve the water solubility of daidzein, solid inclusion complexes of daidzein with two amino-modified β-cyclodextrins (ACDs), i.e., mono-6-amino-6-deoxy-β-cyclodextrin (NCD) and mono-6-ethylenediamino-6-deoxy-β-cyclodextrin (ENCD), were prepared by the saturated solution method in water under the preparation conditions as follows: the ratio of daidzein/ACD was 3∶1 and the stirring time was 72 h (83% and 67% yields, respectively).The formation of two inclusion complexes was confirmed by x-ray diffractometry (XRD) and themogravimetric (TG) analysis.The inclusion stoichiometry of the inclusion complexes was 1∶1 from the Job plot and their complexation stability constants (KS) were 899.2 and 203.8 L/mol from fluorescence titration, respectively.After formation of inclusion complexes with NCD and ENCD, the water solubility of daidzein was dramatically raised from 8.31 μg/mL to 15.2 and 13.2 mg/mL at 25℃, increasing by 1800-fold and 1500-fold.

Objective To explore the therapeutic effect of group medical visits on high-risk elder people suffering senile osteoporosis.Methods A total of 86 high-risk elder people aged over 65, suffering senile osteoporosis and with the OSTA index below-4 were randomly selected, and were separated into an intervention group and a control group, with 43 patients belonging to each group.The dual-energy X-ray absorptiometry(DXA) was used to measure the left femoral neck bone mineral density (LFN BMD), and relevant biochemical indexes thereof and biochemical indicators of bone metabolism thereof were measured at the same time.The osteoporotic knowledge test(OKT) and the osteoporotic self-efficiency scheme(OSES) were used to make relevant evaluations.Group interventions included the following four items: health edutaion and individual technical guidance, state of illness monitoring, group activities and prescription of medicines.At one year after the intervention, the above-mentioned items were to be evaluated again for the two groups.Results After the intervention, the blood calcium(Ca2+), phosphorus(P3+) and LFN BMD of the two groups had no statistical difference(P>0.05);the OKT and OSES scores as well as the level of 25(OH)VitD3 of the intervention group were all higher than those of the control group as well as those of the intervention group before the intervention(P<0.05).After intervention, the PTH, PINP and β-CTX levels of the intervention group were lower than those of the control group as well as those of the intervention group before the intervention(P<0.05).Conclusion The group medical visit is an effective community-based management intervention mode suitable for high-risk patients suffering osteoporosis.

Objective To observe the clinical efficacy and safety of the tiotropium bromide powder inhalation combined with theophylline sustained-release tablets in the treatment of chronic obstructive pulmonary disease(COPD) in stable phase.Methods Forty patients of COPD in stable phase were randomly divided into control group and treatment group with 20 cases per group.Control group was given theophylline sustained-release tablets 0.2 g,bid,oral.Treatment group was given tiotropium bromide powder inhalation 18 μg,qd,Inhalation therapy.The clinical efficacy,mean blood oxygen saturation at nigh (MSaO2),lowest blood oxygen saturation (LSaO2),the ratio on the blood oxygen saturation ＜ 90％ of the total amount of sleep time (T90) and adverse drug reactions were compared between two groups.Results After treatment,the total effective rates in the treatment and control groups were 95.00％ (19 cases/20 cases)and 65.00％ (13 cases/20 cases) with statistically significant difference (P ＜ 0.05).After treatment,the main indexes in the treatment and control groups were compared:MSaO2 were (93.72 ± 3.44) ％ and (86.42 ± 4.11) ％,LSaO2 were (92.53 ±5.64)％ and(86.94 ±6.23)％,T90 were(28.14 ±6.31)％ and(31.22 ±7.81)％,the differences were statistically significant(all P ＜0.05).The adverse drug reactions in treatment group were based on dry mouth,which in control group were based on mild stomach discomfort.The incidences of adverse drug reaction in the treatment and control groups were 10.00％ and 5.00％ without significant difference(P ＞ 0.05).Conclusion Tiotropium bromide powder inhalation combined with theophylline sustained-release tablet has a definitive clinical efficacy and safety in the treatment of COPD in stable phase,which can improve the respiratory function.