Objective To investigate the relationship and potential pathways between metal(loid)exposure and the risk of polycystic ovary syndrome(PCOS)in women of childbearing age. Methods This case-control study included 200 patients with PCOS(cases)and 896 non-PCOS controls with the age of 25-37 years.The concentrations of 29 metal(loid)s in the follicular fluid(FF)and clinical indicators in the serum were measured in all participants.Logistic regression analysis and mediation analysis were conducted to evaluate the associations between metal(loid)exposure and PCOS risk and investigate the possible roles of clinical indicators,respectively. Results Logistic regression analysis revealed an association between high copper levels in FF and increased PCOS risk(highest vs.lowest quartile:adjusted odds ratio=2.94,95%confidence interval:1.83-4.72).A high luteinizing hormone/follicle-stimulating hormone ratio and elevated levels of testosterone and anti-Müllerian hormone(AMH)were strongly associated with increased PCOS risk induced by high copper exposure.The mediation analysis indicated a mediating effect of AMH in the association between copper exposure and PCOS risk. Conclusion Copper may affect PCOS risk through the hypothalamic-pituitary-ovarian axis,mediated by AMH.Copper exposure and internal AMH levels are important indicators for early warning of PCOS development.

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

OBJECTIVE: To investigate the role of multiple serological methods in the identification of complex antibodies. METHODS: The blood group antigens were detected by saline and microcolumn agglutination methods. The saline method was used to screen and identify IgM-type antibodies in the patient's serum, while the polybrene, anti-globulin, microcolumn agglutination, enzymic and absorption-elution methods were used to screen and identify IgG-type antibodies. RESULTS: The patient was B/CCDee/Jk(a-b+)/Fy(a-b+) blood type. The serum reacted with panel cells, and the reaction presented anti-E pattern in the saline medium. It was fully positive in the microcolumn agglutination card, except 2 negative ones after using papain to treat the panel cells. Referring to the pattern table, it was concluded that there existed anti-c, anti-E, and anti-Jk^a antibodies, and one antibody corresponding to an antigen that was easily destroyed by papain. The red blood cells with specific phenotype were selected for absorption-elution to identify IgG-type anti-c, anti-E, anti-Jk^a and anti-Fy^a antibodies. CONCLUSION It is confirmed that IgM-type anti-E, and IgG-type anti-c, anti-E, anti-Jk^a and anti-Fy^a antibodies exist in the patient's serum by multiple serological methods.
Humans ; Papain ; Blood Group Antigens ; Erythrocytes ; Immunoglobulin G ; Immunoglobulin M

Objective: To analyze the clinical characteristics of children with Burkitt lymphoma (BL) and to summarize the mid-term efficacy of China Net Childhood Lymphoma-mature B-cell lymphoma 2017 (CNCL-B-NHL-2017) regimen. Methods: Clinical features of 436 BL patients who were ≤18 years old and treated with the CNCL-B-NHL-2017 regimen from May 2017 to April 2021 were analyzed retrospectively. Clinical characteristics of patients at disease onset were analyzed and the therapeutic effects of patients with different clinical stages and risk groups were compared. Survival analysis was performed by Kaplan-Meier method, and Cox regression was used to identify the prognostic factors. Results: Among 436 patients, there were 368 (84.4%) males and 68 (15.6%) females, the age of disease onset was 6.0 (4.0, 9.0) years old. According to the St. Jude staging system, there were 4 patients (0.9%) with stage Ⅰ, 30 patients (6.9%) with stage Ⅱ, 217 patients (49.8%) with stage Ⅲ, and 185 patients (42.4%) with stage Ⅳ. All patients were stratified into following risk groups: group A (n=1, 0.2%), group B1 (n=46, 10.6%), group B2 (n=19, 4.4%), group C1 (n=285, 65.4%), group C2 (n=85, 19.5%). Sixty-three patients (14.4%) were treated with chemotherapy only and 373 patients (85.6%) were treated with chemotherapy combined with rituximab. Twenty-one patients (4.8%) suffered from progressive disease, 3 patients (0.7%) relapsed, and 13 patients (3.0%) died of treatment-related complications. The follow-up time of all patients was 24.0 (13.0, 35.0) months, the 2-year event free survival (EFS) rate of all patients was (90.9±1.4) %. The 2-year EFS rates of group A, B1, B2, C1 and C2 were 100.0%, 100.0%, (94.7±5.1) %, (90.7±1.7) % and (85.9±4.0) %, respectively. The 2-year EFS rates was higher in group A, B1, and B2 than those in group C1 (χ²=4.16, P=0.041) and group C2 (χ²=7.21, P=0.007). The 2-year EFS rates of the patients treated with chemotherapy alone and those treated with chemotherapy combined with rituximab were (79.3±5.1)% and (92.9±1.4)% (χ²=14.23, P<0.001) respectively. Multivariate analysis showed that stage Ⅳ (including leukemia stage), serum lactate dehydrogenase (LDH)>4-fold normal value, and with residual tumor in the mid-term evaluation were risk factors for poor prognosis (HR=1.38,1.23,8.52,95%CI 1.05-1.82,1.05-1.43,3.96-18.30). Conclusions: The CNCL-B-NHL-2017 regimen show significant effect in the treatment of pediatric BL. The combination of rituximab improve the efficacy further.
Adolescent ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Burkitt Lymphoma/drug therapy* ; Child ; Disease-Free Survival ; Female ; Humans ; Lactate Dehydrogenases ; Lymphoma, B-Cell/drug therapy* ; Male ; Prognosis ; Retrospective Studies ; Rituximab/therapeutic use* ; Treatment Outcome

Objective: To analyze the change trend of underground dust concentration, the incidence and survival status of pneumoconiosis patients, and provide reference for improving the working environment of dust-exposed workers and the prevention and treatment of pneumoconiosis patients in the future. Methods: In February 2020, a retrospective investigation was conducted on the dust data of underground mining operations in a steel enterprise in Jiangsu Province from 1991 to 2019, and the case data of patients diagnosed with pneumoconiosis from 1956 to 2019 were collected. The time trends of the number of pneumoconiosis patients and dust concentration, the stage of pneumoconiosis and survival status of patients were analyzed. Results: From 1956 to 2019, a total of 241 patients with pneumoconiosis were diagnosed in the steel enterprise. From 1991 to 2019, the annual average dust concentration in the mine showed a downward trend as a whole. Compared with the transportation platform (14.28%, 1447/10132) , the average dust concentration exceeding rate of the mining platform (43.68%, 8415/19263) was significantly higher (χ(2)=2674.84, P<0.01) . The average age of pneumoconiosis patients was (73.54±10.42) years old, and the average working age of dust exposure was (21.41±8.68) years, of which 85 cases (35.27%) survived and 156 cases (64.73%) died. The main type of pneumoconiosis was silicosis (90.46%, 218/241) , and the main stage of pneumoconiosis was the stage I (96.68%, 233/241) ; The higher the stage of pneumoconiosis, the younger the diagnosis age (P<0.01) . The average survival time of patients was (27.264±1.982) years, and the median survival time was 28 years. The cumulative survival rates of patients with pneumoconiosis in different diagnosis time periods were significantly different (χ(2)=35.57, P<0.01) . Conclusion: The improved dust-proof measures have a significant effect on reducing the concentration of underground dust. We need to focus on the dust control of underground mining platforms and the treatment of patients with stage Ⅲ pneumoconiosis.
Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Child ; Adolescent ; Young Adult ; Adult ; Incidence ; Coal Mining ; Steel ; Retrospective Studies ; Pneumoconiosis/diagnosis* ; Dust ; Occupational Exposure/adverse effects*

OBJECTIVE：To investigate the clini cal features of thrombocytopenia induced by antidepressants ，and to provide reference for the rational use of clinical drugs. METHODS ：Retrieved from CNKI ，Wanfang database ，VIP，PubMed and Web of Science，during Jan. 1st in 1985 to Aug. 31st in 2020，case reports about antidepressants-induced thrombocytopenia was collected and analyzed descriptively in terms of demographic characteristics ，medication，clinical manifestations ，treatment and outcome. RESULTS：A total of 17 literatures were retrieved ，and 19 patients were included ，involving 10 male and 9 female，aged from 5 to 95 years old ，with an average of （48±24）years old. Nine kinds of drugs were involved ，including 4 cases of escitalopram ，3 cases of citalopram ，3 cases of fluoxetine ，3 cases of mirtazapine ，2 cases of amitriptyline ，1 case of sertraline ，1 case of paroxetine，1 case of mianserin and 1 case of imipramine. There were 9 cases of single drug and 10 cases of drug combination. All 19 patients suffered from thrombocytopenia at 3 d-10 years after medication ，14 of them had hemorrhage tendency. Main clinical manifestations included mucocutaneous hemorrhage ，gingival bleeding ，black stool ，hematochezia，vaginal bleeding ，ocular hemorrhage，alveolar hemorrhage. No bleeding was found in 5 cases. After drug withdrawal/changing drugs and other symptomatic treatment， platelet count of 19 patients recovered to normal ， and bleeding symptoms disappeared. CONCLUSIONS ： Thrombocytopenia caused by antidepressants has no obvious clinical features and is not easy to be found ，but it may lead to severe； bleeding symptoms if it is not found in time. The changes of platelet count should be closely monitored in clinical application of such drugs to ensure the safety of drug use.

AIM: To study the clinical efficacy, complications and visual related quality of life(VRQoL)of Ozurdex in the treatment of macular edema secondary to retinal vein occlusion(RVO-ME).

METHODS: Totally 30 patients with ME, which had developed secondary to either CRVO(13 eyes)or BRVO(17 eyes), were monitored for 6mo after treatment with Ozurdex in the Department of Ophthalmology of our Hospital. We measured the best corrected visual acuity(BCVA), intraocular pressure(IOP), central macular thickness(CMT)at different time after treatment(1wk, 1mo, 2mo, 3mo, 4mo, 5mo, and 6mo after treatment), and we also measured the Chinese version vision related quality of life questionnaire-25(CVRQoL-25)at 3mo after treatment and compared them separately with the ones measured before treatment to evaluate the efficacy, adverse reactions and the visual related quality of life.

RESULTS: Generalized estimation equation results showed that BCVA, CMT and IOP all had differences at different time points(P<0.001). A BCVA increase was achieved and CMT decreased in all patients at any time point after the onset of treatment(P<0.001). The changes of BCVA and CMT were the largest in the 2mo compared to the baseline(P<0.001). The score of CVRQol-25 at 3mo after treatment was significantly higher than that before treatment and then the central retinal thickness decreased and a BCVA increased compared to the baseline level(P<0.01). The score of CVRQoL-25 at 3mo was negatively correlated both with the LogMAR BCVA evaluated before treatment and at 3mo after treatment(rs= -0.717, -0.746, all P<0.001); Meanwhile, the score of CVRQoL-25 was also negatively correlated with CMT at 3mo after treatment(rs= -0.862, P=0.001). In 19 eyes(63%)of the patients with RVO-ME,a relapse was observed after a follow-up time of 1-3mo and the average recurrence time was(2.8±0.5)mo. In follow-up of 6mo, about(2.3±0.4)intravitreal Ozurdex injections per eye was observed. The increase in IOP was observed at 1wk, 1, 2, 3mo after pretherapy(P<0.05). The mean IOP values reached a peak at 2mo after injection, which rose(7.85±0.32)mmHg above the baseline level(P<0.05)and decreased to normal at 4mo after treatment. 10% of patients had an elevation in IOP above 25mmHg, which could be medically controlled and 4 eyes(13%)of patients had cataract formation, two of which needed to surgery.

CONCLUSION: Ozurdex proved to be efficacious with increase in visual acuity and reduction of central retinal thickness and improve the visual function-related quality of life of RVO-ME patients. After single injection of Ozurdex, visual acuity benefited for 2-3mo. 63% of the patients relapsed at about 3mo after treatment. Adverse reactions associated to the use of Ozurdex include the formation of cataracts and an increase in IOP.

Based on the concept of network pharmacology, the main nephroprotective components in Erzhi Pill reported in previous studies, were used to predict the targets through the PharmMapper method. Molecular docking was applied to screen for potential targets and biological information annotation databases (DAVID) was used to analyze the molecular function and biological process of the action targets. The Cytoscape software was used to construct the “ingredient-target-pathway” network of Erzhi Pill for renal injury treatment. TTD and GAD database were then applied to screen for the targets of renal disease for building “ingredient-core target” network. We found that 17 major active ingredients of Erzhi Pill regulated 32 targets (including ESR1, ESR2, GCK, MMP3) and affected 6 pathways, such as PI3K-Akt signaling pathway, estrogen signaling pathway and purine metabolism. This study reflected the nature of traditional Chinese medicine as multi-ingredients, multi-targets and multi-pathways, providing new clues for basic science research on the nephroprotective pharmacological mechanism of Erzhi Pill.

Objective: To establish a microwave scattering parameter acquisition system to detect cerebral hemorrhage and cerebral ischemia animal models, and to study the non-contact rapid identification methods for the two stroke types. Methods: Rabbits were selected for modeling. Eight rabbits in the cerebral hemorrhage group were injected with autologous blood. Six rabbits in the cerebral ischemia group were treated with bilateral common carotid artery clamping and femoral artery bleeding. The measurement excitation source has a scanning frequency range of 300 kHz to 3 GHz and an intermediate frequency bandwidth of 30 kHz. The signal of the S21 phase was acquired. The collected microwave scattering signals were subjected to mean filtering, principal component analysis dimension reduction, and mean clustering and nearest neighbor analysis to realize the identification of stroke types. Results: The microwave scattering measurement method can reflect the changes of cerebral hemorrhage and cerebral ischemia. The phase of S21 decreases with the increase of blood loss and increases with the increase of ischemic duration. The results of the differential experiment showed that all 14 models were correctly identified. Conclusions The stroke identification system based on microwave scattering measurement can effectively distinguish rabbit cerebral hemorrhage model and ischemic model. This technology is low cost, portable non-invasive, simple operation and fast, which make it be a promising method for identifying pre-hospital stroke types.

Objective To observe the clinical efficacy and safety of doxorubicin injection in the treatment of post-herpetic neuralgia.Methods One hundred and four patients with post-herpetic neuralgia were randomly divided into control and treatment groups with 52 cases per group.Control group was given pulse radiofrequency therapy with 3 min per time,twice a week.Treatment group was given doxorubicin 10 mg per time,once two weeks,intervertebral foramen injection.Two groups were treated for 4 weeks.The clinical efficacy,visual analogue scale (VAS) scores,the levels of serum interleukin-6 (IL-6) and IL-10,and adverse drug reactions were compared between two groups.Results After treatment,the total effective rates of treatment and control groups were 86.54％ (45 cases/52 cases) and 69.23％ (36 cases/52 cases) with significant difference (P ＜ 0.05).After treatment,the main indexes in treatment and control groups were compared:IL-6 were (174.83±23.72) and (321.65 ±45.82) pg · mL-1,IL-10 were (183.46 ±28.11) and (164.67 ±21.31) μg · mL-1,VAS were (2.32 ±0.65) and (3.51 ±0.84) score,the differences were statistically significant (all P ＜ 0.05).The adverse drug reactions in treatment group were skin numbness in block area and palpitation,and no adverse drug reactions occurred in control group.The incidences of adverse drug reactions in treatment and control groups were 5.77％ and 0 without significant difference (P ＞ 0.05).Conclusion Doxorubicin injection has a definitive clinical efficacy in the treatment of post-herpetic neuralgia,which can significantly balance the inflammatory factors,improve the pain,without increasing the incidence of adverse drug reactions.