Objective To investigate the correlations between HLAⅡgene polymorphism and the development of Mycoplasma pneumoniae pneumonia ( MPP ) in children and to identify the susceptibility genes and protective genes for MPP for further elucidating the pathogenesis of MPP and providing the guid-ance for researches on gene therapy for MPP. Methods Genotypes of HLAⅡgene ( HLA-DQA1 and HLA-DRB1) in 60 children with MPP and 30 healthy children were detected by using sequence specific primer polymerase chain reaction ( SSP-PCR) . The haplotype frequencies, linkage disequilibrium and correlations with MPP were analyzed by using Arlequin software and Chi-square test. Results The frequencies of HLA-DQA1*0201/*0301 in children with MPP (35. 83%/30. 00%) were higher than those in healthy children (16. 67%/8. 33%) (χ2=12. 139, P<0. 05, OR=5. 059;χ2=15. 142, P<0. 05, OR=7. 500). However, the frequency of HLA-DQA1*0401 in children with MPP decreased to 12. 50% as compared with 40. 00%in healthy children (χ2=24. 638, P<0. 05, OR=0. 083). The frequencies of HLA-DRB1*07/*15 in children with MPP increased to 38. 33%/30. 00% as compared with 20. 00%/16. 67% in healthy children (χ2=11. 735, P<0. 05, OR=4. 929; χ2=5. 692, P<0. 05, OR=3. 000). But the frequency of HLA-DRB1*11 dropped to 15. 00% as compared with 43. 33% in healthy children (χ2=19. 448, P<0. 05, OR=0. 087). Conclusion HLA-DQA1*0201, HLA-DQA1*0301, HLA-DRB1*07 and HLA-DRB1*15 might be the susceptibility genes for MPP in children, while HLA-DQA1*0401 and HLA-DRB1*11 were probably associated with the resistance to MPP. No extensive linkage disequilibrium was found between HLA-DQA1 and HLA-DRB1.

Objective To survey the dietary iodine intake among residents in the coastal province of Fujian after universal salt iodization. Methods Using multi-stage stratified random sampling method, four different geographic areas of coastal cities, inland cities, coastal rural and inland rural areas were selected; 3 counties (cities, districts) were selected from each area; 30 families were selected from each of those counties (cities, districts). Total dietary study method was applied to investigate the basic information, all food and water intake during the investigation, the spice variety, quantity and cooking methods, and recipes. All foods consumed were divided into 13 classes:grains and their products, beans(including nuts) and their products, potato and its products, meat and its products, eggs and their products, aquatic products, milk and dairy products, vegetables, fruits and their products, sugar and sugar products, beverage and water, alcohol and seaweeds. Food samples were collected and iodine contents of different types of food were measured, and daily food consumption of the reference man(adult male) in the four areas was calculated. Then the male adult dietary iodine intake in the four areas and Fujian Province was estimated. Results A total of 69 families(accounting for 19.2% of the 359 families surveyed) ate seaweed foods during the three days survey period. The average salt intakes per reference man were 4.5, 5.8, 7.5, 12.3 g, respectively, in coastal cities, inland cities, coastal rural and inland rural. The adult male dietary iodine intake in Fujian Province was 343.8μg/d, and the values were 234.4, 347.1, 328.4, 465.3μg/d, respectively, in coastal cities, coastal rural, inland cities and inland rural. If people did not eat seaweed foods, the results would be 239.7, 137.5, 253.6, 200.3, 367.4μg/d. The main sources of dietary iodine intake were vegetables (33.2%), seaweeds(30.3%), meat(13.4%) and aquatic products(13.0%). If people did not eat seaweed foods, the results would be vegetables(47.6%), meat(19.1%) and aquatic products(18.7%), and iodine contribution rate of the 3 types of food was 85.4%. Conclusions Under the conditions of eating iodized salt, male adult dietary iodine intake is appropriate in different areas of Fujian Province. There is no such problem as iodine excessive. Iodized salt is the main source of dietary iodine. Residents in coastal city, if not eating seaweed foods, will be at risk of iodine deficiency, even if they eat iodized salt.

Objective To evaluate the semi-quantitative parameters of dynamic contrast enhanced MRI (DCE MRI) with double echo in the diagnosis of breast tumors.Methods Thirty eight patients suspected of breast tumour underwent DCE MRI with double echo examination by using 3.0 T whole-body MR scanner with a sixteen-channel phased-array breast coil.Semi-quantitation of both pharmacokinetic and perfusion parameters were performed including peak enhancement ratio (PER),time from contrast agent arrive to peak enhancement (Tmax),and maximum signal intensity loss (MSIL).The mean PER,Tmax and MSIL of the breast cancer,fibroma and other benign lesions were calculated.One-way ANOVA and receiver operating characteristic curve (ROC) analysis were used to compare the differences between malignant and benign lesions.Results The mean PER,Tmax and MSIL of the lesions were as follows:0.61 ± 0.09,(164.9 ± 20.5) s,and 0.31 ± 0.03 for breast cancers (n =20) ; 0.46 ± 0.07,(183.2 ± 13.7) s,and 0.17± 0.03 for fibromas (n =10) ; 0.23 ± 0.06,(139.4 ± 23.6) s,and 0.24 ± 0.07 other benign lesions (n =8),respectively.There were significant differences among 3 groups in all semi-quantitative parameters (F =4.319,4.154,4.752,respectively.P ＜ 0.05).The areas under the ROC curve of PER,Tmax and MSIL for the diagnosis of malignant lesions were 0.513,0.794 and 0.769,respectively.The sensitivity of PER,Tmax,and MSIL were 60.0％,80.0％ and 62.5％ and the specificity were,62.5％,75.0％ and 90.0％,respectively,with the maximum Youden'index as cut off value.When combining the 3 semi-quantitative parameters,the sensitivity,specificity and accuracy for differential diagnosis of breast tumors were 95.0％ (19/20),83.3％ (15/18),and 89.4％ (34/38),respectively.Conclusion The semi-quantitation of pharmacokinetic parameters (PER,Tmax) and perfusion data (MSIL) can be simultaneously estimated in a dynamic contrast enhanced MRI with double echo in breast lesions.The Accuracy for differential diagnosis of breast tumors can be improved when judge by combination of PER,Tmax and MSIL.

Objective To assess the risk of vaccination in children with genetic epilepsy combined with febrile seizures plus (GEFS+).Methods Sixty-seven children with GEFS+,admitted to our hospital from May 2016 to May 2019,were enrolled in our study;using targeted second-generation sequencing technology,these patients were divided into positive SCN1A gene mutation group (SCN1A+group,n=l 1) and negative SCN1A gene mutation group (SCN1A-group,n=51) after kicking out 5 patients with other gene mutations.The frequencies of convulsion and changes of body temperature after vaccination were analyzed retrospectively in the two groups from birth to age of 7 years.The levels of interleukin (IL)-2,IL-6,IL-10 and tumor necrosis factor (TNF)-α in peripheral blood were measured by flow cytometry in both groups after seizures.Results Children from SCN1A+ group were vaccinated for 34 times,with incidence of post-vaccine convulsion reaching 47％ (16/34);children from SCN1A-group were vaccinated for 186 times,with incidence of post-vaccine convulsions reaching 6.45％ (12/186);incidence of post-vaccine convulsion was statistically significant between the two groups (P＜0.05).The mean body temperature in children from the SCN1A+ group ([38.06±0.57] ℃C) during convulsion was significantly lower than that in SCN1A-group ([39.49±0.49] ℃,P＜0.05).Expressions of IL-6 and IL-10 in peripheral blood after convulsion in children from SCN1A+ group (96.80±25.05 and 74.90±18.28) were significantly higher than those in SCN1A-group (72.97±4.81 and 43.99±10.63,P＜0.05).Conclusion GEFS+ children in the SCN1A+ group are more prone to convulsion after vaccination than those in the SCN1A-group;cytokines may be involved in the development of convulsion.

To conduct the association between vitamin B12 and mental health in children and adolescents. Five databases were searched for observational studies in any language reporting on mental health and vitamin B12 levels or intake in children and adolescents from inception to March 18, 2022. Two authors independently extracted data and assessed study quality. Qualitative and quantitative analysis of data were performed. The review was registered in the PROSPERO database (CRD42022345476). Fifty six studies containing 37,932 participants were identified in the review. Vitamin B12 levels were lower in participants with autism spectrum disorders (ASD) (standardized mean difference [SMD], −1.61;95% confidence interval [95% CI], −2.44 to −0.79; p ＜ 0.001), attention deficit hyperactivity disorders (SMD, −0.39; 95% CI, −0.78 to −0.00; p = 0.049) compared with control group. Vitamin B12 intake were lower in participants with ASDs (SMD, −0.86; 95% CI, −1.48 to −0.24; p = 0.006) compared with control group, but showed no difference between depression group (SMD, −0.06; 95% CI, −0.15 to 0.03; p = 0.17) and the control group. Higher vitamin B12 intake were associated with lower risk of depression (odds ratio [OR], 0.79; 95% CI, 0.63−0.98; p = 0.034) and behavioral problems (OR, 0.83; 95% CI, 0.69−0.99; p = 0.04). The vast majority of included studies supported potential positive influence of vitamin B12 on mental health, and vitamin B12 deficiency may be a reversible cause for some mental health disorders in children and adolescents.

OBJECTIVE: To explore the association between the blood oxygenation T₂* values of resectable esophageal squamous cell carcinomas (ESCCs) and tumor stages. MATERIALS AND METHODS: This study included 48 ESCC patients and 20 healthy participants who had undergone esophageal T₂*-weighted imaging to obtain T₂* values of the tumors and normal esophagi. ESCC patients underwent surgical resections less than one week after imaging. Statistical analyses were performed to identify the association between T₂* values of ESCCs and tumor stages. RESULTS: One-way ANOVA and Student-Newman-Keuls tests revealed that the T₂* value could differentiate stage T1 ESCCs (17.7 ± 3.3 ms) from stage T2 and T3 tumors (24.6 ± 2.7 ms and 27.8 ± 5.6 ms, respectively; all p(s) < 0.001). Receiver operating curve (ROC) analysis showed the suitable cutoff T₂* value of 21.3 ms for either differentiation. The former statistical tests demonstrated that the T₂* value could not differentiate between stages T2 and T3 (24.6 ± 2.7 ms vs. 27.8 ± 5.6 ms, respectively, p > 0.05) or between N stages (N1 vs. N2 vs. N3: 24.7 ± 6.9 ms vs. 25.4 ± 4.5 ms vs. 26.8 ± 3.9 ms, respectively; all p(s) > 0.05). The former tests illustrated that the T₂* value could differentiate anatomic stages I and II (18.8 ± 4.8 ms and 26.9 ± 5.9 ms, respectively) or stages I and III (27.3 ± 3.6 ms). ROC analysis depicted the same cutoff T₂* value of 21.3 ms for either differentiation. In addition, the Student's t test revealed that the T₂* value could determine grouped T stages (T0 vs. T1–3: 17.0 ± 2.9 ms vs. 25.2 ± 6.2 ms; T0–1 vs. T2–3: 17.3 ± 3.0 ms vs. 27.1 ± 5.3 ms; and T0–2 vs. T3: 18.8 ± 4.2 ms vs. 27.8 ± 5.6 ms, all p(s) < 0.001). ROC analysis indicated that the T₂* value could detect ESCCs (cutoff, 20 ms), and discriminate between stages T0–1 and T2–3 (cutoff, 21.3 ms) and between T0–2 and T3 (cutoff, 20.4 ms). CONCLUSION: The T₂* value can be an additional quantitative indicator for detecting ESCC except for stage T1 cancer, and can preoperatively discriminate between some T stages and between anatomic stages of this tumor.
Carcinoma, Squamous Cell* ; Epithelial Cells* ; Esophagus ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging* ; Oxygen* ; ROC Curve

ObjectiveTo investigate the influencing factors for chronic pancreatitis （CP） complicated by pancreatogenic portal hypertension （PPH）， and to establish a predictive model. MethodsA retrospective analysis was performed for the clinical data of 99 patients with CP complicated by PPH who were hospitalized in The First Affiliated Hospital of Kunming Medical University， Chuxiong Yi Autonomous Prefecture People’s Hospital， Wenshan People’s Hospital， and Puer People’s Hospital from January 2017 to December 2022， and these patients were enrolled as PPH group. The incidence density sampling method was used to select 198 CP patients from databases as control group. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. The Least Absolute Shrinkage and Selection Operator （LASSO） regression model was used to identify the potential predictive factors for CP complicated by PPH， and the predictive factors obtained were included in the multivariate Logistic regression analysis to obtain independent risk factors， which were used to establish a nomogram prediction model. The receiver operating characteristic （ROC） curve， the calibration curve， and the Hosmer-Lemeshow goodness-of-fit test were used to perform internal validation of the model， and the clinical decision curve was used to assess the clinical practicability of the model. ResultsThere were significant differences between the two groups in sex， history of recurrent acute pancreatitis attacks， acute exacerbation of CP， bile duct stones， peripancreatic fluid accumulation， pseudocysts， pulmonary infection， elevated C-reactive protein （CRP）， elevated procalcitonin， fibrinogen （FIB）， neutrophil-lymphocyte ratio （NLR）， gamma-glutamyl transpeptidase， total bilirubin， direct bilirubin， low-density lipoprotein （LDL）， serum amylase， D-dimer， and serum albumin （all P<0.05）. The predictive variables obtained by the LASSO regression analysis included sex， recurrent acute pancreatitis attacks， bile duct stones， peripancreatic fluid accumulation， pulmonary infection， pseudocysts， CRP， NLR， FIB， and LDL. The multivariate Logistic regression analysis showed that sex （odds ratio ［OR］=2.716， P<0.05）， recurrent acute pancreatitis attacks （OR=2.138， P<0.05）， peripancreatic fluid accumulation （OR=2.297， P<0.05）， pseudocysts （OR=2.805， P<0.05）， and FIB （OR=1.313， P<0.05） were independent risk factors for CP complicated by PPH. The above factors were fitted into the model， and the Bootstrap internal validation showed that the nomogram model had an area under the ROC curve of 0.787 （95% confidence interval： 0.730 — 0.844）， and the calibration curve was close to the reference curve. The Hosmer-Lemeshow goodness-of-fit test showed that the model had a good degree of fitting （χ²=7.469， P=0.487）. The clinical decision curve analysis showed that the prediction model had good clinical practicability. ConclusionMale sex， recurrent acute pancreatitis attacks， peripancreatic fluid accumulation， pseudocysts， and FIB are independent risk factors for CP complicated by PPH， and the nomogram model established has good discriminatory ability， calibration， and clinical practicability.

OBJECTIVE: To survey the residents for their understanding of Coronavirus Disease 2019 (COVID-19)-related knowledge, attitude and practices (KAP) in two hard hit provinces of China to facilitate the governmental decisions on strategies against the disease. METHODS: We invited the participants from Hubei and Henan Provinces of China for an internetbased survey starting from 12:00 on February 21, 2020 to 12:00 on February 23. The survey included the general conditions, KAP of COVID-19, psychological status and living conditions of the residents. RESULTS: The effective response rate of the questionnaire was 98.9%. The mean (P25, P75) age of the participants was 19 (16, 40) years, and 54.3% of them were students. Social media were the most important source of information concerning the pandemic of the respondents. The respondents had a high awareness of person-to-person transmission of the virus through the respiratory tract or droplets but showed a relatively low level of awareness of the population susceptible to COVID-19 and its specific symptoms. The results of multivariate analysis showed that women, undergraduate students (including college students) and higher degree holders had better knowledge of COVID-19 ( < 0.05); the proportion of respondents who expressed to have different levels of psychological stressed such as worry, anxiety and panic reached 77.2%; 16.7% of the responders considered psychological interventions necessary for their psychological conditions; 63.6% of the respondents confessed a bias against the people returning from Hubei and Henan provinces, while 22.4% worried that they might be biased because of their residence in Hubei and Henan. The rate of personal protective equipment shortage was as high as 69.4%; the rates of the responders who would "covering the mouth and nose when coughing or sneezing", "properly use masks in accordance with regulations", "maintain proper hand hygiene ", "avoid gatherings with relatives and friends" and "refrain from going to public places" were 92.4%, 95.9%, 93.5%, 88.8% and 93.1%, respectively. Women and groups with good knowledge of the disease reported better protective behaviors against the diseases ( < 0.05). CONCLUSIONS The residents in Hubei and Henan Provinces have generally good KAP related to COVID-19, and the online platforms plays a positive role to in circulating epidemic-related information. It is essential to further increase the supply of the protective materials and pay more attention to the mental health of the residents during the pandemic, and psychological counseling and psychological protection should be provided if necessary.
Attitude ; Betacoronavirus ; Coronavirus Infections ; Female ; Humans ; Pandemics ; Pneumonia, Viral

Entinostat plus exemestane in hormone receptor-positive (HR+) advanced breast cancer (ABC) previously showed encouraging outcomes. This multicenter phase 3 trial evaluated the efficacy and safety of entinostat plus exemestane in Chinese patients with HR + ABC that relapsed/progressed after ≥1 endocrine therapy. Patients were randomized (2:1) to oral exemestane 25 mg/day plus entinostat (n = 235) or placebo (n = 119) 5 mg/week in 28-day cycles. The primary endpoint was the independent radiographic committee (IRC)-assessed progression-free survival (PFS). The median age was 52 (range, 28-75) years and 222 (62.7%) patients were postmenopausal. CDK4/6 inhibitors and fulvestrant were previously used in 23 (6.5%) and 92 (26.0%) patients, respectively. The baseline characteristics were comparable between the entinostat and placebo groups. The median PFS was 6.32 (95% CI, 5.30-9.11) and 3.72 (95% CI, 1.91-5.49) months in the entinostat and placebo groups (HR, 0.76; 95% CI, 0.58-0.98; P = 0.046), respectively. Grade ≥3 adverse events (AEs) occurred in 154 (65.5%) patients in the entinostat group versus 23 (19.3%) in the placebo group, and the most common grade ≥3 treatment-related AEs were neutropenia [103 (43.8%)], thrombocytopenia [20 (8.5%)], and leucopenia [15 (6.4%)]. Entinostat plus exemestane significantly improved PFS compared with exemestane, with generally manageable toxicities in HR + ABC (ClinicalTrials.gov #NCT03538171).