Objective To analyze the risk factors for CAL secondary to Kawasaki disease children.Methods The clinical data of 60 patients with Kawasaki disease were retrospectively analyzed.Results There were 27 CAL secondary to Kawasaki disease in 60 Kawasaki disease patients.9 patients were age ≤ 1 year.16 CAL secondary to Kawasaki disease were male.11 CAL secondary to Kawasaki disease were female.6 CAL secondary to Kawasaki disease were WBC＞20 × 109/L、21 CAL secondary to Kawasaki disease were WBC ≤20 × 109/L;17 CAL secondary to Kawasaki disease were PLT＞300 x 109/L、10 CAL secondary to Kawasaki disease were PLT≤300 x 109/L;9 CAL secondary to Kawasaki disease were ESR＞100mm/1h、15 CAL secondary to Kawasaki disease were ESR ≤ 100mm/1 h;5 CAL secondary to Kawasaki disease were fever duration＞10d using IVIG、22 CAL secondary to Kawasaki disease were fever duration ≤ 10d using IVIG.There were no significant differences(P＞0.05),9 CAL secondary to Kawasaki disease were CRP＞100mg/L、18 CAL secondary to Kawasaki disease were CRP≤ 100mg/L,showed significant difference(P＜0.01).Conclusion Kawasaki disease patients had CAL secondary to Kawasaki disease has no difference between male and female.The high risk factors for CAL secondary to Kawasaki disease are age ≤ 1 year,CRP＞100mg/L.

Objective To investigate the similarities and differences of incomplete Kawasaki disease and typical Kawasaki disease,in order to provide basis for early diagnosis and treatment.Methods The clinical and laboratory data of 60 children with Kawasaki disease were retrospectively analyzed.Results The incidence rate of symptoms in clinical diagnostic criteria was lower in incomplete Kawasaki disease than that in typical Kawasaki disease(x2 =16.46,10.10,11.71,34.43,all P ＜ 0.01).No statistical differences of leukocytes,platelet,erythrocyte sedim-entation rate and C-reactive protein were found in the incomplete Kawasaki disease and typical Kawasaki disease(x2 =0.04,0.12,0.04,0.26,all P ＞ 0.05).The incidence rate of coronary artery lesions had significant difference between incomplete Kawasaki disease and typical Kawasaki disease (x2 =31.43,P ＜ 0.01).Conclusion The early diagnosis of Kawasaki disease could be confirmed by representative clinical characteristics,laboratory examination and ultrasound cardiogram.

Serum cortisol levels during oral glucose tolerance test (OGTY) were measured in subjects of type 2 diabetic pedigrees. The results showed that cortisol levels during OGTF were higher in type 2 diabetic patients than those in non-diabetic first-degree relatives and normal controls. Fasting cortisol level was positively correlated with fasting plasma glucose level in type 2 diabetic pedigree members. These results suggest that the dysregulation of hypothalamic-pituitary-adrenal axis may coexist in type 2 diabetic patients.

Objective To investigate the change of serum non-esterified fatty acid (NEFA) level in nondiabetic first-degree relatives of type 2 diabetics, and to explore the related factors in the change.MethodsSerum lipid profile, plasma glucose and insulin levels were measured in 186 type 2 diabetic patients, 565 nondiabetic first-degree relatives of type 2 diabetics and 149 normal controls. Results (1) The fasting NEFA level in first-degree relatives was significantly lower than that of type 2 diabetic patients [(0.53±0.28 vs 0.63±0.31) mmol/L,P＜0.01]and HOMA-IR was significantly higher than that of normal controls (0.98±0.51 vs 0.89±0.47,P＜0.01). (2) The fasting NEFA level in the first-degree relatives with higher body mass index (BMI), plasma glucose or area under curve of glucose concentration (AUCglu) was higher than that in those with lower BMI, plasma glucose , blood pressure or AUCglu (all P＜0.05). (3) NEFA showed significantly positive correlations with BMI, systolic blood pressure, diastolic blood pressure (DBP), AUCglu in the first-degree relatives by correlative analysis (r=0.12, r=0.148, r=0.21 and r=0.281 respectively, all P＜0.05). Stepwise linear regression analysis showed that DBP, AUCglu and age were the independent risk factors of NEFA (all P＜0.01). Conclusion Insulin resistance exists in nondiabetic first-degree relatives of type 2 diabetics, which seems to be related to elevated NEFA levels.

Objective To explore the variation and influential factors of high sensitive C-reactive protein (hs-CRP) level in type 2 diabetic family members. Methods A total of 427 type 2 diabetic patients, 377 non-diabetic first-degree relatives of type 2 diabetics and 135 normal control subjects without diabetic family history were recruited. Serum hs-CRP, clinical and biochemical parameters were measured. The relations among indicators were analyzed. Results Compared with normal control subjects, serum hs-CRP levels in type 2 diabetics and first-degree relatives were significantly increased (both P＜0.05), and the increment was even marked in type 2 diabetics than that in first-degree relatives (P＜0.01). The serum hs-CRP levels in type 2 diabetics and first-degree relatives were positively associated with body mass index, waist-hip ratio, abdominal circumference, postgrandial 2 h plasma glucose, fasting and postgrandial 2 h serum insulin, HOMA-IR, triglyceride, creatinine and negatively correlated with high density lipoprotein-cholesterol. In first-degree relatives, serum hs-CRP level was positively associated with systolic blood pressure and HOMA-β. Conclusion As in type 2 diabetic patients, there exists inflammatory reaction in the non-diabetic first-degree relatives of type 2 diabetics, which may play an important role in the pathogenesis of type 2 diabetes mellitus.

Objective To study the association of transcription factor 7-like 2(TCF7L2)polymorphisms with tvpe 2 diabetes mellitus in Chinese Han population. Methods Two polymorphisms (rs7903146 and rs12255372)of TCF7L2 gene were genotyped in 446 patients with type 2 diabetes mellitus(T2DM group)and 303 normal subiects (NC group) by PCR-restriction fragment length polymorphism(PCR-RFLP).Waist circumference.body mass index,plasma glucose,serum insulin,lipid profiles,high-sensitivity C-reactive protein and non-esterified fatty acid were measured.Homeostasis model assessment of insulin resistance(HOMA-IR)and β-cell function(HOMA-β)were calculated.Results (1) In T2DM group,T allele frequency and CT,TY geno tvpe frequeneies of rs7903146 were significantly higher than those in NC group(0.093,0.150,0.018 vs 0.043, 0.079,0.003,respectively,a11 P

Objective: To investigate the quality and influencing factors of direct drinking water in schools in Nanjing City, so as to provide basis for management of school drinking water. Methods: From April to July 2023, direct drinking water equipment from 146 primary and secondary schools were selected from Nanjing City using a stratified random sampling method and tested for colony forming units (CFU) and permanganate index. Mann-Whitney U test was used to compare the differences between groups, and multiple linear regression was used to analyze the influencing factors. Results: The CFU and permanganate levels of school direct drinking water in Nanjing City were 1.00(0.00,15.50)CFU/mL and 0.47(0.26, 0.75)mg/L, respectively. The CFU level increased when the filter replacement time exceeded 3 months and when the water source was piped, while the permanganate index increased when the filter replacement time exceeded 3 months and using activated carbon technology ( Z =-2.21, -3.92, -2.31, -8.45 , P <0.05). The results of multiple linear regression analysis showed that the replacement time of filter element exceeding 3 months was positively correlated with the CFU level, and the process type involving activated carbon, a laid pipe network and a filter replacement time exceeding 3 months were positively correlated with the permanganate index( β =167.08, 0.32, 0.35, 0.11, P ＜0.05). Conclusions There are certain problems with the water quality of primary and secondary school direct drinking water in Nanjing City. Schools should promptly replace the filter and maintain the drinking water equipment to ensure the hygiene and safety of campus water quality.

Objective To investigate the effect and mechanism of emodin on focal cerebral ischemia in rats based on myeloid differentiation factor 88(MyD88)/extracellular signal-regulated kinase(ERK)pathway and nuclear factor-κB(NF-κB)nuclear translocation.Methods SD rats were randomly divided into sham operation group,model group and emodin group,with six rats in each group.The rat model of transient middle cerebral artery occlusion(tMCAO)was established by middle cerebral artery embolization.Rats in the emodin group were given 40 mg·kg-1 emodin by gavage for three times at 72,48 and 24 hours before modeling.At 24 hours after modeling,the neurological function of rats was scored.TTC staining was used to detect the area of cerebral infarction.HE staining was used to observe the morphological changes of brain tissue.The mRNA expression levels of MyD88 and tumor necrosis factor-α(TNF-α)in brain tissue were detected by RT-qPCR.The expression levels of MyD88,ERK,p-ERK and TNF-α in brain tissue were detected by Western Blot.The protein expression of NF-κB in brain tissue was detected by immunofluorescence.Results Compared with the sham operation group,the neurological function score of the model group was significantly increased(P＜0.01),and the cerebral infarction area was significantly increased(P＜0.01).In the cortical area of the ischemic penumbra,cell necrosis,abnormal cell morphology,nuclear fragmentation and atrophy,and the number of cells decreased significantly;the mRNA expression levels of MyD88 and TNF-α in brain tissue were significantly increased(P＜0.01,P＜0.001),the protein levels of MyD88,p-ERK/ERK and TNF-α were significantly increased(P＜0.05,P＜0.01,P＜0.001),and the proportion of NF-κB into nuclear cells was significantly increased(P＜0.001).Compared with the model group,the neurological function score of rats in the emodin group was significantly decreased(P＜0.05),and the area of cerebral infarction was significantly reduced(P＜0.05).The number and morphology of neurons in the ischemic penumbra cortex were restored to a certain extent.The mRNA expression levels of MyD88 and TNF-α in brain tissue were significantly decreased(P＜0.05,P＜0.01),the protein levels of MyD88,p-ERK/ERK and TNF-α were significantly decreased(P＜0.05),and the proportion of NF-κB into nuclear cells was significantly decreased(P＜0.001).Conclusion Emodin has a preventive and protective effect on rats with focal cerebral ischemia,which may be related to its inhibition of MyD88 activation,ERK phosphorylation and NF-κB nuclear translocation,and then down-regulation of inflammatory cascades and secretion of pro-inflammatory factors such as TNF-α,thereby exerting anti-inflammatory effects.

Objective To summarize the electrophysiological indexes and scales used for evaluation of post-stroke spasticity, for integration of clinical management of spasms. Methods Literatures on identification and evaluation of post-stroke spasticity from databases of Web of Science, PubMed, CNKI, and Wanfang Data up to May 15, 2021 were retrieved and the indicators related to post-stroke spasticity were extracted for a scoping review. Results The scales of modified Asworth Scale, Comprehensive Spasticity Scale and modified Tardieu Scale; the electrophysiological indexes of F wave, H reflex, motor evoked potentials, visual-startle reaction time and vestibular evoked myogenic potentials were used to identify and evaluate post-stroke spasticity. Conclusion More clinical researches are needed to explore earlier identification and evaluation of post-stroke spasticity more objectively and accurately.

Background N-nitrosodimethylamine (NDMA), a new disinfection by-product in drinking water, has attracted extensive attention due to its high detection rate and concentration. Objective To investigate the concentration of NDMA in drinking water in Nanjing situated in the lower Yangtze River Basin of China, and to evaluate associated human health risk. Methods In dry period (January–March) and wet period (July–September) of 2021, raw water, finished water, and tap water from 16 centralized water treatment plants in Nanjing were collected to detect the concentration of NDMA in water samples by solid phase extraction and gas chromatography-triple quadrupole mass spectrometry with programmable temperature vaporizer-based large volume injection. The concentrations of NDMA in water samples of different water types, water periods, and disinfection methods were analyzed, and the daily exposure levels and carcinogenic risk values of NDMA in drinking water of different exposure routes and different exposed populations were calculated. Monte Carlo simulation was implemented with Crystal Ball 11 software to establish a health risk assessment model and conduct sensitivity analysis. Results A total of 61 drinking water samples were collected in Nanjing, and NDMA was positive in all the water samples, with concentrations ranging from 1.36 to 25.65 ng·L⁻¹ and an overall average concentration of (8.00±4.06) ng·L⁻¹. There were no statistically significant differences in the average concentrations of NDMA among raw water, finished water, and tap water samples (F=2.875, P=0.064), between wet season and dry season (t=−0.855, P=0.397), or among different disinfection methods by liquid chlorine, sodium hypochlorite, and chlorine dioxide (F=0.977, P=0.385). The results of health risk assessment showed that the average carcinogenic risk of NDMA and its P₉₅ were 5.95×10⁻⁶ and 1.12×10⁻⁵ respectively for oral intake of drinking water, and the values for dermal contact were both lower than 1.00×10⁻⁶. The mean carcinogenic risks of exposure to drinking water NDMA in children, adolescents, and adults were 1.84×10⁻⁶, 8.27×10⁻⁷, and 3.28×10⁻⁶, respectively. The results of sensitivity analysis showed that the contributions of daily drinking water volume and NDMA concentration in drinking water to the calculated health risk were high, and the contribution of body weight was negative. Conclusion There is a potential carcinogenic risk of NDMA in the drinking water of Nanjing section of the lower Yangtze River Basin，but it is within the acceptable range.