OBJECTIVE To explore the effects and potential mechanism of Huangqi jianzhong decoction on intestinal inflammation in the rats of irritable bowel syndrome with diarrhea （IBS-D） based on the mitogen-activated protein kinase （MAPK）/ nuclear factor-κB （NF-κB） signaling pathway. METHODS Male SD rats were selected. Ten rats were randomly chosen as the control group， and the remaining rats （50 rats） were used to prepare the IBS-D model by acetic acid enema+restraint stress. The rats with successful modeling were randomly divided into the IBS-D group， the traditional Chinese medicine （TCM） group （Huangqi jianzhong decoction 15 g/kg）， the positive control drug group （Rifaximin tablets 150 mg/kg）， the activator group （anisomycin 125 μg/kg， the activator of p38 MAPK）， and the TCM+activator group （Huangqi jianzhong decoction 15 g/kg+ anisomycin 125 μg/kg）， with 10 rats in each group. Rats in each group were given a gavage or tail vein injection of the corresponding medicine liquid or the same volume of normal saline， once a day for two consecutive weeks. After the last administration， feces within 24 hours were collected for the calculation of fecal water content and fecal trait score， and the minimum volume threshold was detected. The levels of tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， and IL-6 in serum were detected； the pathological changes of colonic tissue were observed； the expressions of tight junction protein ZO-1， occludin mRNAs and proteins related to the MAPK/NF- κB signaling pathway in colonic tissue were determined. RESULTS Compared with the control group， obvious edema and inflammatory cell infiltration could be observed in the colonic tissue of rats in the IBS-D group. The fecal water content and trait score， serum levels of inflammatory factors， as well as the protein phosphorylation levels of p38 MAPK and NF-κB p65 in the colonic tissue were significantly increased， while the minimum volume threshold and the mRNA expressions of ZO-1 and occludin were significantly decreased or down-regulated （P＜0.05）. Compared with the IBS-D group， the pathological changes of colonic tissue in the TCM group and positive control drug group were alleviated， and the above indicators improved significantly （P＜0.05）， while the above indicators in the activator group deteriorated further （P＜0.05）. Compared with the TCM group， the above indicators in the TCM+activator group were significantly reversed （P＜0.05）. CONCLUSIONS Huangqi jianzhong decoction can alleviate colonic inflammation in IBS-D rats， relieve visceral hypersensitivity， and has a certain protective effect on their intestinal barrier function. The above-mentioned effects may be related to the inhibition of the MAPK/NF- κB signaling pathway.

Objective To formulate the quantitative grip strength training program for application in the postoperative patients with autogenous arteriovenous internal fistula,and to evaluate its effect on the mat-uration and initial use of autogenous arteriovenous internal fistula.Methods A total of 98 patients with ce-phalic venous radial arterial anastomosis internal fistula formation surgery in Shenzhen Hospital of Southern Medical University from September 2021 to November 2022 were selected as the study subjects by the conven-ience sampling method.According to the follow-up time,they were divided into the observation group (n=41) and control group (n=42).The observation group adopted the quantitative grip strength training for function-al exercise of the limb on the side of internal fistula,while the control group adopted the conventional grip training for functional exercise of the limb on the side of internal fistula.In postoperative 8 weeks,the matura-tion rate of internal fistula,natural blood flow amount of internal fistula,internal diameter of cephalic vein,pre-pump pressure used in the initial stage of internal fistula and the incidence rate of internal fistula complica-tions were evaluated in the two groups.Results Compared with the control group,the maturation rate of in-ternal fistula in the observation group was higher (97.6％ vs. 83.3％).The inner diameter of cephalic vein and natural blood flow amount of internal fistula in the observation group were larger than those in the control group[(5.24±0.66)mm vs. (4.63±0.59)mm;(1215.38±562.99)mL/min vs. (955.75±341.94)mL/min],the pre-pump pressure used at the initial stage of internal fistula in the observation group was lower than that in the control group[(119.20±19.83)mmHg vs. (135.74±17.07)mmHg],and the differences were statistically significant (P<0.05).Conclusion The quantitative grip strength training could increase the postoperative maturity rate of patients's internal fistula,and is beneficial to the use in the initial stage of internal fistula.

Objective    To summarize the results of surgical treatment for 79 patients with coarctation of the aorta (CoA) combined with complex anomalies (CA) in recent years. Methods    The data from 79 patients with CoA combined with CA admitted to Guangzhou Women and Children's Medical Center between January 19, 2010 and September 7, 2017 were collected and analyzed. There were 52 males and 27 females. The median age was 71 days, and the median weight was 4.3 kg. There were 26 patients combined with tracheostenosis and 7 patients with preoperative tracheal intubation. Extended end-to-side anastomosis was used to correct the CoA, and the associated cardiac abnormalities were treated simultaneously by an incision through median sternotomy. All operations were performed by the same group of surgeons. Results    The median deep hypothermic circulatory arrest was 18 (13-28) minutes, the median aorta cross-clamp time was 62 (15-199) minutes, the median cardiopulmonary bypass time was 145 (71-674) minutes, the median ventilation time was 72 (9-960) hours, the median length of ICU stay was 144 (12-1 944) hours, and the median length of hospital stay was 24 (2-93) days. Early death occurred in 9 patients and late death occurred in 5 patients. Reoperation occurred in 28 patients and recoarctation developed in 10 patients. After operation, transcoarctation gradient was reduced, and the transcutaneous oxygen saturation, C-reactive protein (CRP), lactate and creatinine were increased. Compared to the survival group, both preoperative and postoperative transcutaneous oxygen saturation were worse and the postoperative levels of plasma brain natriuretic peptide (BNP) and CRP were higher in the death group. Conclusion    Correcting the CoA and the associated CA simultaneously with extended end-to-side anastomosis by an incision through median sternotomy is effective and safe, and the outcomes of immediate and medial-term are satisfactory. Improving oxygenation and limiting elevation of BNP and CRP levels may reduce the death rate.

Objective:To understand the characters of norovirus infection in children with acute diarrhea in Beijing from 2014 to 2019.Methods:Fecal specimens were collected from children with acute diarrhea visiting the hospital affiliated to the Capital Institute of Pediatrics from April 2014 to December 2019 for norovirus screening by reverse transcription-polymerase chain reaction (RT-PCR). Then RdRp gene and VP1 gene of norovirus (NoV) were amplified and sequenced from positive specimens and then genotyped by Norovirus Genotyping Tool 2.0.Results:Fecal specimens were collected from 2 577 cases with acute diarrhea and tested for NoV RNA in this study, of which 484 cases (18.78%, 484/2 577) were positive for NoV. NoV infection can occur all year round, with obvious seasonal distribution, the epidemic peak is in autumn and winter. There was no gender difference in the detection of NoV ( χ2=1.77, P=0.183). 399 specimens genotyped by VP1 gene with 98.25% (392/399) being GII and GII.4 Sydney as the mainly genotype (52.13%, 208/399), followed by GII.3 (19.8%, 79/399) and GII.2 (18.5%, 74/399). Then 267 specimens also were genotyped by RdRp region, which revealed that the main genotype was GII.P31 (57.3 %, 153/267), followed by GII.P12 (15.36%, 41/267) and GII.P16 (14.98 %, 40/267). Dual-typing revealed that various combination strains, GII.4 Sydney[P31] (53.18%, 142/267) as the major combination, followed by GII.3[P12] and GII.2[P16] (15.36%, 41/267 and 10.49%, 28/267). While GII.3[P12] showed a downward trend, GII.4 Sydney[P16] increased gradually. Conclusions:Norovirus is an important pathogen of acute diarrhea in children in Beijing, from 2014 to 2019, with various prevalent genotypes.

Objective:To explore the clinical characteristics, therapeutic effect and prognosis of movement disorders in anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.Methods:The prospectively collected data of hospitalized 163 patients with anti-NMDAR encephalitis admitted to Xuanwu Hospital, Capital Medical University from June 2012 to October 2019 were analyzed. According to the presence of movement disorders, the patients were divided into movement disorders group (75 cases, 46.0%) and non-movement disorders group (88 cases, 54.0%). Patients were followed up for six months and 12 months after immunotherapy. The clinical manifestations, auxiliary examinations, treatment and prognosis of the two groups were compared.Results:Among 163 patients with anti-NMDAR encephalitis, 91 patients (55.8%) were male and 72 patients (44.2%) were female, with an age of 26(19, 34) years. In the 75 patients of the movement disorders group, 50 patients (66.7%) presented with orofacial dyskinesia, 45 patients (60%) with limb stereotypies, 28 patients (37.3%) with choreoathetosis, nine patients (12.0%) with ballism, seven patients (9.3%) with bradykinesia, five patients (6.7%) with tremor, and 13 patients (17.3%) with status dystonicus. Compared with the non-movement disorders group, the movement disorders group had a higher proportion of ovarian teratoma (14.7% vs 3.4%), modified Rankin Scale score of 3-5 before immunotherapy (76.0% vs 33.0%), abnormal electroencephalogram (89.3% vs 77.3%), increased lumbar puncture pressure (53.3% vs 34.1%), cerebrospinal fluid (CSF) pleocytosis (73.3% vs 51.1%), strong positive NMDAR antibody of CSF (44.0% vs 25.0%), admitting to intensive care unit (60.0% vs 9.1%), treated with intravenous immunoglobulin (80.0% vs 40.9%), plasma exchange (36.0% vs 3.4%), and immunosuppressive therapy (37.2% vs 17.0%); had shorter days from the onset to the beginning of immunotherapy [20(10, 33) d vs 35(15, 77) d]; had longer days from the beginning of immunotherapy to the improvement [34(20, 60) d vs 20(15, 35) d]; and there were significant differences of above items between the two groups ( P<0.05). There was no significant difference in the prognosis and relaps between the two groups at six and 12 months after immunotherapy. Conclusions:Nearly a half of patients with anti-NMDAR encephalitis had movement disorders with multiple phenotypes. The severity of movement disorders was related to the severity of the disease. After active immunotherapy and symptomatic treatment, movement disorders improved with the improvement of primary disease in majority of patients.

The TEA domain (TEAD) family proteins (TEAD1‒4) are essential transcription factors that control cell differentiation and organ size in the Hippo pathway. Although the sequences and structures of TEAD family proteins are highly conserved, each TEAD isoform has unique physiological and pathological functions. Therefore, the development and discovery of subtype selective inhibitors for TEAD protein will provide important chemical probes for the TEAD-related function studies in development and diseases. Here, we identified a novel TEAD1/3 covalent inhibitor (DC-TEADin1072) with biochemical IC

Objective:To investigate the prevalence and genetic characteristics of human adenovirus (HAdV) in healthy children and diarrheal children in Beijing.Methods:A total of 1 834 fecal samples were collected from diarrheal children younger than 6 years old in outpatients from January, 2015 to December, 2017 and from healthy children with the same age group from May, 2016 to February, 2017. The hexon and fiber genes of HAdV were detected for genotyping and the sequences analysis, respectively.Results:The detection rate of HAdVs in healthy children (1.5%, 8/536) was significantly lower than that in children with diarrhea (7.4%, 96/1 298) ( χ2=23.62, P<0.001). HAdV-41 was the dominant type detected both in the healthy children and diarrheal outpatients. There was no gender difference in HAdV-positive children with diarrhea. Except for newborns with no positive case, there was no difference in the detection rate of HAdV among the other age groups. There was no obvious seasonality of HAdV prevalence. Phylogenetic analysis showed that HAdV-41 strains circulating in Beijing belonged to three evolutionary branches, and strains with 15-amino acid truncated in the shaft of fiber were found. Conclusions:HAdV was one of the important pathogens causing diarrhea in children in Beijing from 2015 to 2017, with HAdV-41 as the predominant type.

Objective:To investigate the molecular epidemiology of norovirus associated with pediatric acute gastroenteritis in Beijing under the Working Mechanism for Joint Prevention and Control of the Epidemic in 2020.Methods:This was a retrospective, repeated cross-sectional study. Fecal or vomit samples (1 213 cases) were collected from children visited the Capital Institute of Pediatrics Affiliated Children′s Hospital for acute gastroenteritis from January 1 to December 31, 2020. First, real-time reverse PCR (RT-PCR) was used to screen the samples for norovirus, and then RdRp gene and capsid gene VP1 of norovirus-positive samples were amplified by conventional RT-PCR for genotyping based on the nucleotide sequence. The χ 2 test was used to compare the positive rates and genotypes of norovirus among different specimen types, genders of children, and different age groups. Results:Among the 1 213 samples were collected, 215 samples were positive for norovirus, with a positivity rate of 17.7% for the whole year. The peak of norovirus infection observed mainly in the cold seasons, as the positive rates were 28.6% (18/63), 26.2% (16/61), 22.8% (77/338) and 17.1% (89/520) in January, October, November and December, respectively. The positive rate of norovirus in fecal sample was significantly higher than that in vomit sample (χ 2 = 9.692, P<0.01). There was no significant difference between genders (χ 2=0.041, P>0.05), but significant difference was found between age groups with the highest rate in the 6-48 months group (χ2=103.112, P<0.01). Three genogroups (GⅠ, GⅡ and GⅨ) of the circulating virus were detected by G-gene typing, and GⅡgenogroup was predominant, accounting for 98.5% (196/199). Among the GⅡ positive samples, genotype GⅡ.4 Sydney (55.1%, 108/196) was the most common, followed by GⅡ.2 (29.6%, 58/196), while the GⅡ.3 norovirus (10.2%, 20/196) which was common in previous years was not as much as before. Based on the P-type, GⅡ.P16 was predominant (61.5%, 96/156), followed by GII.P31 (19.9%, 31/156). The dual genotyping revealed that GⅡ.4 Sydney [P16] (36.4%, 56/154) and GⅡ.2 [P16] (24.7%, 38/154) were predominant. Conclusion:The prevalence of norovirus in children in 2020 in Beijing is not much different from those of the previous years, but the genotypes composition has changed significantly, and there are multiple genotypes circulating simultaneously.

Objective:To describe the long-term outcomes of intensive care unit (ICU) survivors of mechanical ventilation, and investigate the views of survivors on ICU rehabilitation clinics.Methods:A single-center cross-sectional descriptive study was designed. ICU survivors of mechanical ventilation admitted to the First Affiliated Hospital of Guangzhou Medical University from January to December 2016 were enrolled. Data were collected from August 2017 to March 2018. The general information questionnaire, Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and ICU rehabilitation clinics questionnaire were used to evaluate ICU survivors social-demographic factors, social and economic outcomes, clinical data, quality of life and the views on ICU rehabilitation clinics.Results:A total of 248 ICU survivors of mechanical ventilation were included in the study, 130 (52.4%) of them were followed up successfully. The mean time from ICU discharge to follow-up day was (19.64±3.20) months. The average age of the survivors was (60.09±15.42) years old, and 55.4% of them were over 60 years old. Among 130 ICU survivors, severe pneumonia was the dominant ICU admission diagnosis (23.1%), followed by surgical operations (cardiac surgery 16.9%, other surgical operations 20.8%), lung transplantation (13.1%), and acute exacerbation of chronic obstructive pulmonary disease (AECOPD, 12.3%), etc. The first APACHEⅡ score after ICU admission was 16.88±7.37, the mechanical ventilation time was (12.52±12.34) days, and the length of ICU stay was (16.71±15.11) days. In terms of social and economic outcomes, the proportion of having full-time or part-time jobs decreased from 32.3% (42/130) before ICU admission to 25.4% (33/130) by the date of follow-up, while the unemployed rate increased from 6.9% (9/130) to 18.5% (24/130). Only 45.1% (23/51) of the ICU survivors returned to the post before ICU admission. 36.2% (47/130) of the ICU survivors reported that they needed care from others, and 86.9% (113/130) reported that their treatment experiences in ICU had an impact on their lives. In terms of quality of life, physiological function dimension, which was 34.62±33.15, scored the lowest and suffered the most. The physical pain dimension and mental health dimension suffered the least, and the scores were 90.19±16.98 and 75.28±15.15, respectively. Furthermore, physical component summary (PCS) score was 61.12±17.09, and mental component summary (MCS) score was 65.97±21.85. In terms of the views of ICU rehabilitation clinics, 68.5% (89/130) of the subjects believed that the establishment of ICU rehabilitation clinics was very helpful or helpful.Conclusions:The long-term outcomes of ICU survivors of mechanical ventilation are not optimistic. Their quality of life is lower than that of general people. It is necessary to set up ICU rehabilitation clinics.

Objective: To investigate the relationship between human bocavirus 2 (HBoV2) infection and acute diarrhea in children younger than 5 years of age in a case-control study. Methods: This was a prospective case-control study. During May 2016 to December 2016, fecal specimens were collected from children ≤5 years of age with acute diarrhea who visited the Affiliated Children's Hospital of Capital Institute of Pediatrics (case group), or from children ≤5 years of age without diarrhea from Longtan Community Medical Service Center, Beijing (control group). The case group (n=240) and the control group (n=240) were divided into 8 age subgroups: ≤1 month old, >1-3 months old, >3-6 months old, >6-12 months old,>1-2 years old,>2-3 years old,>3-4 years old and >4-5 years old, and there were 30 cases in each age subgroup. The specimens were tested for 7 types of diarrhea-associated viruses, especially for HBoV2 by real-time PCR method. The HBoV2 viral load was predicted according to the cycle threshold (Ct). Finally, t-test was used to compare the differences between groups. Results: In the case group (n=240), the positive rate of norovirus was 16.7% (40 cases); rotavirus, 10.8% (26 cases); HBoV2, 7.5% (18 cases); adenovirus, 7.1% (17 cases); astrovirus, 6.3% (15 cases); parachovirus, 3.8% (9 cases); and Aich virus, 0.4% (1 case). The positive rates of HBoV2 in case group (7.5%, 18 cases) and control group (5.0%, 12 cases) showed no significant difference (χ²=1.280, P=0.258), as well as in different age groups (all P>0.05) . However, the mean viral load of the HBoV2 in the case group (1×10⁹copies/L with cycle threshold (Ct) 25.8) was higher than that of control group (1×10⁵copies/L with Ct 33.8), showing a significant difference (t=0.597, P=0.000). Conclusions Norovirus and rotavirus are still the important viral pathogens in children with acute diarrhea. A higher load of HBoV2 may indicate a higher risk of acute diarrhea in children ≤5 years of age in Beijing.