OBJECTIVE:To observe the efficacy and safety of azithromycin sequential therapy in the treatment of mycoplasma pneumonia in children. METHODS:67 children with mycoplasma pneumonia were randomly divided into control group(34 cases) and observation group (33 cases). All children received conventional treatment,such as fever,cough,supplemented by nutrition support;based on it,control group received 10 mg/kg Azithromycin for injection,adding into 5% Glucose injection by intrave-nous drip in 200 ml,once a day;observation group received azithromycin(the same dosage with control group)after intravenous drip 5 d,switched to 10 mg/(kg·d)Azithromycin dry suspension,orally,then stopped 4 d after continuous 3 d. The treatment course was 7-10 d. Clinical efficacy,disappearance time of fever,cough and lung rales,and lung indexes before and after treat-ment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:There were no significant differences in the to-tal effective rate,disappearance time of fever,cough and lung rales in 2 groups(P>0.05). After treatment,the lung function in-dexes were significantly higher than before,the differences were statistically significant(P<0.01),but there was no significant dif-ference between 2 groups (P>0.05). The incidence of adverse reactions in observation group was significantly lower than control group,the difference was statistically significant (P<0.05). CONCLUSIONS:Based on conventional treatment,azithromycin se-quential therapy shows similar efficacy to without sequential therapy in the treatment of mycoplasma pneumonia in children,but with better safety.

Objective To study the Bailing capsule combined losartan for UMA and lipid metabolism in patients with early diabetic nephropathy impact analysis.Methods 118 patients with early diabetic nephropathy from October 2015 to May 2016 in our hospital, according to the random lottery was divided into observation group and control group, control group using losartan treatment, observation group on the basis of the combination of Bailing capsule for treatment.Two groups of patients were treated after 3 months, observing two groups of patients with UMA and lipid metabolism related situation, and analyzes the effect of the treatment.Results The UMA ( 125.00 ±44.00 ) mg/24 h and UAER ( 54.64 ±17.31 )μg/min were significantly lower in the observation group than in the control group UMA (216.00 ±46.00) mg/24 h, UAER (67.42 ±21.86) μg/min, 2 group difference was statistically significant (P<0.05).The total cholesterol (TC) of the observation group was (6.15 ±0.75) mmol/L, triglyceride (TG) was (2.34 ±0.48) mmol/L, low density lipoprotein (LDL-C) was (3.55 ±0.73) mmol/L.The levels of TC (6.74 ±0.78) mmol /L, TG (3.01 ± 0.41) mmol/L and LDL-C (4.06 ±0.64) mmol/L, respectively.The levels of TC, TG and LDL-C in the observation group were significantly lower than those in the control group, and high-density lipoprotein (HDL-C) (1.39 ±0.26)mmol/L was significantly higher than that in the control group (1.26 ±0.42) mmol/L, the difference was statistically significant (P<0.05); Two groups of patients after treatment, the observation group total effective rate was 89.7%, significantly higher than that of control group total effective rate 75.0%, two groups are significant difference (P<0.05). Conclusion Bailing capsule combined losartan treatment of early diabetic nephropathy , can effectively reduce the levels of UMA, improve blood lipid in patients with blood sugar levels, which has significant therapeutic effect.

Objective To investigate the tendency of diapause symptoms in breast cancer patients during their chemotherapy. Method Sixty-four breast cancer patients with chemotherapy participated in the study by using Pittsburgh sleep quality index (PSQI), the cancer fatigue scale (CFS), the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) to assess their sleep, fatigue, anxiety and depression at every first day from the second course to sixth one of chemotherapy. Results The diapause symptoms including fatigue, sleep disorders, anxiety and depression varied with the therapeutic course progressing. The conditions in sleep quality, fatigue and depression were the poorest at the diapause of the fourth course and the condition of anxiety was the poorest at the diapause of the third course. Conclusion The medical staff should attach importance to the patients'physical and mental problems brought by the process of chemotherapy, strengthen the regulation of psychosomatic symptoms during chemotherapic diapause, and give reasonable control and intervention before the symptoms deteriorating.

[ABSTRACT]AIM:Toestablishatransgenicheterozygousmousemodelofprecancerouslesionsofcolorectal cancer with p110δmutation in the C57BL/6J background for serving the studies on colorectal cancer research mediated by p110δ.METHODS:The transgenic heterozygous mice were generated by crossing in p110δD910A/D910A mouse and ApcMin/+mouse, and the genotype was detected by PCR .Compared with ApcMin/+mice, transgenic heterozygous mice ( ApcMin/+;p110δD910A/D910A)were counted, and the number and size of intestine polyps were analyzed after methylene blue staining . The intestinal tissue structure was assessed by HE staining .RESULTS:The transgenic heterozygous mouse model of pre-cancerous lesions of colorectal cancer with p 110δmutation was established .The number and size of polyps in the transgenic heterozygous mice were declined .CONCLUSION: A transgenic heterozygous mouse model of precancerous lesions of colorectal cancer with p 110δmutation was successfully established .The initial phenotype of intestinal tumors in transgenic mice was observed .This model will greatly contribute to the related research of colorectal cancer in mice .

Purpose: Numerous barriers hinder individuals with mental illness from seeking medical assistance in rural regions, yet a comprehensive understanding of these challenges remains elusive. This metasynthesis aims to understand the barriers and facilitators in medical help-seeking among rural individuals with mental illness. Methods: We systematically searched seven databases [PubMed, CINAHL, Medline (OVID), PsycINFO (OVID), Cochrane, Embase, and ProQuest] in May 2023 and included the studies if they reported the barriers or/and facilitators to seek healthcare in rural patients with mental illness. We conducted hand search and citation search on Google Scholar for literature supplements. Thematic analysis was employed. Results: The study included 27 articles reporting on the barriers and facilitators to seeking medical help in this population from 2007 to 2023. We ultimately identified themes at three levels: navigating the terrain of vulnerability and empowerment (the individual with mental illness), navigating the terrain of external environment (the external environment) and connectivity within the healthcare ecosystem for mental health (the health service system). Conclusions We must design more effective strategies to improve mental healthcare access for rural patients, considering cultural nuances and health service utilization patterns. This requires a multi-level approach, tailored to the unique needs of diverse populations.

Objective To explore the effect of low-dose ionizing radiation on the platelets and leukocytes of the radiation workers.Methods We collected data from a total number of 2 055 radiation related workers and with their cumulative doses.Data on platelets and leukocytes was gathered from physical examination of the staff members,from 2013 to 2015 in Chengdu.T test,variance analysis,x2 test,linear correlation,covariance analysis and multivariate logistic regression analysis were used to analyze the data.Results Results from the covariance analysis showed that with the increase of cumulative doses,the quantity of platelet and leukocyte appeared a decreasing trend.Multivariate logistic regression analysis showed that,with the increase of BMI levels and the medium cumulative dose and above (＞4.333 mSv),the risk of thrombocytopenia became more obvious (trend test as P＜ 0.05).In the group with high-dose exposure radiation (＞15.639 mSv) and combined factor as smoking,the risk of developing thrombocytopenia would increase (OR=2.33,95％ CI:1.23-4.44).Staff with cumulative dose of less than 4.332 mSv and exercised more than 1 time per week,the risk of developing low leukocyte would decrease (OR=0.26,95％CI:0.09-0.70).Conclusions Along with the increase of cumulative doses on exposure to radiation related workers.The quantity of platelet and leukocyte showed a decreasing trend among them.When this high-dose exposure radiation combined with overweight/obesity or cigarette smoking,the risk of developing thrombocytopenia was high.However,physical exercise might have served as protective factor on leukopenia.

Objectives: To explore the association between the polymorphism of persistent obesity and genetic variations in the LEP (human leptin gene, LEP) and LEPR (leptin receptor gene, LEPR) genes and different molecular subtypes of breast cancer. Methods: All 703 female patients of breast cancer diagnosed by histopathology in the Sichuan Cancer Hospital or the West China Hospital, excluding patients with metastatic breast cancer or mental disease, were selected as cases from April 2014 to May 2015. At the same time, 805 healthy women received physical examination in medical examination center of Sichuan People Hospital or Shuangliu maternal and child health care hospital, excluding those with therioma, breast disease, and mental disease, were enrolled in control group. A uniform questionnaire was used to collect general information including demographic characteristic, reproductive history height, weight, and so on. And the obesity status in recent 10 years was judged. Time of Flight Mass Spectrometer was used to determine the genotypes of LEP rs7799039, LEPR rs1137100 and LEPR rs1137101, while the multinomial logistic regression analysis was conducted to estimate the effect of risk factors related to breast cancer in different molecular subtypes; and then, the association between polymorphism of persistent obesity, the LEP, LEPR genes and breast cancer of different molecular subtypes was analyzed by binary logistic regression models. Results: The average age of controls was (48.98±8.83) years old, while the age of cases of TNBC, Luminal A, Luminal B, and HER-2+ were (51.43±11.33), (49.94±10.10), (49.73±9.38), (50.50±9.04) years old, respectively. The frequency of genotype LEP rs7799039, LEPR rs1137100 and LEPR rs1137101 in control group was separately 74.8%(1 157/1 546), 83.6%(1 339/1 602) and 88.4%(1 416/1 602); while 77.6% (1 074/1 384), 82.4% (1 155/1 402) and 87.9% (1 232/1 402) respectively in case group. Compared with non-persistent obesity subjects, the persistent obesity ones showed an increased risk in TNBC (OR=3.58, 95%CI: 1.90-6.72), Luminal A (OR=2.65, 95%CI: 1.35-5.21) and Luminal B (OR=1.90, 95%CI: 1.26-2.89) breast cancer. LEP rs7799039-AA was relevant with the upward risk of Luminal B independently (OR=1.30, 95%CI: 1.00-1.69). Besides, persistent obesity was found to have a combined effect on Luminal B (β=3.34, 95% CI: 1.00-11.12) with LEPR rs1137101-GG. Conclusion Persistent obesity could increase the potential risk of TNBC, Luminal A and Luminal B breast cancer. Women who were suffered from persistent obesity with a genotype of LEPR rs1137101-GG were more susceptible to Luminal B breast cancer.

A 43-year-old female patient was admitted with recurrent thrombosis for more than 2 years and thrombocytopenia for more than 1 year. Both arterial and venous thromboses developed especially at rare sites even during anticoagulation therapy such as cerebral venous sinus thrombosis. Antinuclear antibody, anti-ENA antibody and antiphospholipid antibody were all negative. Platelet count elevated to normal after high dose glucocorticoid and intravenous immunoglobulin (IVIG). Immune thrombocytopenia was suspected. When 4 grade thrombocytopenia recurred, intravenous heparin, rituximab 600 mg, IVIG and eltrombopag were administrated. After 3 weeks, thrombocytopenia did not improve, and new thrombosis developed instead. Screening of thrombophilia related genes revealed PROS1 gene heterozygous mutation and MTHFR TT genotype. Low amount of serum IgG κ monoclonal protein was detected. Heparin-induced thrombocytopenia was differentiated and excluded. Finally, serum negative antiphospholipid syndrome was considered the most likely diagnosis. Dexamethasone 20 mg/day × 4 days combined with sirolimus 2 mg/day was prescribed. The patient was discharged with low molecular weight heparin. At one month, her headache was greatly relieved. The platelet count raised to 20-30×10 9/L, and no new thrombosis or bleeding was reported.

Objective:To understand the clinical characteristics of pregnant women infected with dengue virus (DENV) in Ruili City, Yunnan Province, so as to provide basis for formulating effective diagnosis and treatment protocol of dengue fever in pregnant women.Methods:A total of 18 pregnant women infected with DENV hospitalized in Ruili People's Hospital in 2017 and 2018 were selected as observation group, and 18 non-pregnant women infected with DENV were selected as control group according to the age range of the observation group, and epidemiological and clinical data of patients in the two groups were retrospectively collected. Epidemiological characteristics, clinical symptoms and laboratory biochemical indexes of the two groups were compared and analyzed.Results:There were no significant differences ( t = - 0.032, 0.495, P > 0.05) in age [(27.9 ± 5.3) vs (27.9 ± 5.1) years old] and hospitalization stay [(6.8 ± 1.6) vs (6.6 ± 2.0) d] between the observation group and control group. One pregnant woman in observation group had early pregnancy abortion. Patients of both groups had fever in 18 cases (100.0%), headache, muscle aches, and chills in 14 cases (77.8%), anorexia in 15 cases (83.3%), and nausea and vomiting in 5 cases (27.8%); fatigue in 14 cases (77.8%) and 16 cases (88.9%), respectively; there was 1 case of rash in observation group (5.6%), and no rash in control group. There were no significant differences in the above mentioned clinical symptoms distribution between the two groups ( P > 0.05). On the first day of admission, the reduction proportions in red blood cells [61.1% (11/18) vs 5.6% (1/18)], hemoglobin [50.0% (9/18) vs 16.7% (3/18)], and hematocrit [61.1% (11/18) vs 16.7% (3/18)] in observation group were significantly higher than those in control group ( P < 0.05); on the fifth day of admission, the reduction proportions in hemoglobin [33.3% (6/18) vs 5.6% (1/18)] and hematocrit [33.3% (6/18) vs 5.6% (1/18)] in observation group were significantly higher than those in control group ( P < 0.05). Conclusions:The red blood cells, hemoglobin and hematocrit of pregnant women infected with DENV are significantly reduced, and there is a risk of miscarriage in early pregnancy. It is suggested that relevant departments should strengthen the training of medical staff to diagnose and treat pregnant women infected with DENV early.

BACKGROUND:Existing studies have confirmed that exosomes can effectively promote pulp regeneration.However,the biological functions and properties of exosomes from preconditioned sources can be significantly changed,which have different effects on cell proliferation,migration and odontogenic differentiation. OBJECTIVE:To discuss the application status of exosomes and their preconditioning methods in the field of pulp regeneration,and summarize the preconditioning methods that affect the function of exosomes,and explore the effect of exosomes and their preconditioning on pulp regeneration. METHODS:The relevant articles were searched in WanFang,CNKI,PubMed,and Web of Science databases from 2006 to 2022.The Chinese and English search terms were"exosomes,pulp regeneration;preconditioning method".A total of 78 articles were included for analysis. RESULTS AND CONCLUSION:(1)Exosomes have the advantages of good biocompatibility,low immunogenicity and no cytotoxicity,and can induce the regeneration of pulp tissue by promoting stem cell tooth formation,neurogenesis and vascularization.(2)Exosomes derived from preconditioning can enhance the ability of tissue repair and regeneration and have a significant impact on the quality of regenerated dental pulp.(3)Currently,the preconditioning methods used in the field of dental pulp regeneration include inflammatory stimulation,hypoxia induction,conditioned medium and three-dimensional culture,and secreted exosomes can effectively improve the quality of regenerated dental pulp.Nevertheless,the specific effect and mechanism of different preconditioning methods on pulp regeneration need to be explored.