In recent years,chronic fatigue syndrome (CFS)has attracted much attention in medicine field. Complex pathogenesis of CFS has still remained unclear, and it is related to psychological factors, viral infection, fatigue toxins, immune disorders, genetic and other factors. Currently treatment is not effective, and drug use is not satisfied.

Objective To explore the relationship between interleukin(IL)-13 RS20541 gene polymorphism and susceptibility of enterovirus 71 (EV71) infection in children's hand-foot-mouth disease.Methods Blood samples were collected from 123 children with EV71 infection from the Central Hospital of Xiangtan (experimental group),and they were divided into mild EV71 infection group (n =62) and severe EV71 infection group (n =61) according to their severity.And 52 healthy children without EV71 infection were selected as the controls,with age and sex matched.Two mL blood samples stored in the-80 ℃ freezer,were collected from all subjects,and DNA was extracted by Beijing ubiolab genetic technology company limited.The SNaPshot was used to determine genotype for G/A polymorphism at RS20541 position of IL-13 gene.SPSS 18.0 software was used to analyze the data.Results IL-13 RS20541 loci had 3 genotypes:AA,GA,GG;the frequency of AA,GA,GG in the experimental group was 4.07％,44.71％,51.22％,which was significantly lower than that in the healthy control group (the frequency of AA,GA,GG were 11.54％,32.69％,55.77％),there was no statistically significant difference in genotypes (x2 =4.676,P ＞ 0.05);there was no statistically significant difference in allele frequency (the frequency of A,G in experimental group was 26.42 ％,73.58 ％,and that of the healthy control group was 27.88 ％,72.12 ％;x2 =0.080,P ＞ 0.05).EV71 infection caused by mild group,severe group and healthy controls genotype frequencies between the 3 groups [(AA + GA) were 53.22％,44.26％,44.23％;GG were 46.78％,55.74％,55.77％;x2 =1.294,P ＞ 0.05] and allele frequency (A were 30.65％,22.13％,27.88％;G were 69.35％,77.87％,72.12％;x2 =2.349,P ＞ 0.05) among the mild group,severe group and healthy control group had no statistical significance.Conclusion There is no correlation between the IL-13RS20541 gene polymorphism and EV 71 infection in children with the hand-foot-mouth disease.

Objective To explore the relationship between the interleukin-6 (IL-6) RS1800796 gene polymorphism and susceptibility of Enterovirus 71 (EV71) infection.Methods One hundred and twenty-three children with EV71 infection were selected as infection experimental group from March 2012 to December 2014 in the Central Hospital of Xiangtan,and they were divided into mild EV71 infection group (62 cases) and severe EV71 infection group (61 cases).And 52 age-and gender-matched healthy children were selected as the healthy control group.Two mL blood samples were collected from all subjects,and DNA was extracted by Beijing Optimal Boland Gene Technology LTD.The SNaPshot was used to determine the genotype for G/C polymorphism at RS1800796 position of IL-6 gene.Results The genotype frequency of IL-6 RS1800796 GG in the infection experimental group [73.2％ (90/123 cases)]was significantly higher than that in the healthy control group[48.1％ (25/52 cases)],and the difference was statistically significant (x2 =10o 215,P =0.002,OR =2.945,95 ％ CI:1.500-5.782).No significant difference was found in the distribution of genotype frequency of the IL-6 RS1800796 GG between the mild EV71 infection group and the severe EV71 infection group[71.0％ (44/62 cases)vs.75.4％ (46/61 cases),x2 =0.309,P =0.685].The G allele in IL-6 RS1800796 G/C was more frequent in the infection group (85.0％)than that in the control group (70.2％),and the difference was statistically significant (x2 =10.183,P =0.002,OR =2.399,95％ CI:1.389-4.143).No significant difference was found in allele frequency of the IL-6 RS1800796 G between the mild EV71 infection group and the severe EV71 infection group (83.1％ vs.86.9％,x2 =0.703,P =0.477).Conclusion The G allele of IL-6 RS1800796 confers susceptibility to infection of EV71.But G allele carrier will not increase the risk of severity after infection.

BACKGROUNDFUS2 gene locating at 3p21.3 is considered a promising candidate tumor suppressor gene. The aim of this study is to examine the difference in FUS2-767A/T polymorphism site between lung cancer patients and normal controls in Chinese population.

METHODSThe genotype FUS2-767A/T was detected in 146 lung cancer patients and 113 normal controls by PCR-SSCP method. The relationship between lung cancer risk and difference in genotypes of FUS2 gene was analysed.

RESULTSFUS2-767A/T was significantly related to histological type (P=0.044), age of the patients with lung cancer (P=0.011) and vessel cancer embolus (P=0.031) in lung cancer group. There was no significant difference in distribution of FUS2 genotypes between lung cancer patients and normal controls (P=0.945).

CONCLUSIONSThe results suggest that the FUS2-767A/T polymorphism may be a susceptibility factor for lung cancer among Chinese population.

Objective:To investigate the prognosis of severe hyperbilirubinemia in full-term infants who met the exchange transfusion criteria and were treated by blood exchange transfusion and phototherapy.Methods:A total of 168 full-term infants with severe hyperbilirubinemia who met the criteria for exchange transfusion and were hospitalized in the Neonatology Department of seven tertiary hospitals in Hebei Province from June 2017 to December 2018 were retrospectively included. According to the treatment protocol, they were divided into two groups: exchange transfusion group (38 cases) and phototherapy group (130 cases). Two independent sample t-test and Chi-square test were used to compare the clinical manifestations and follow-up results between the two groups. Multivariate logistic regression was used to analyze the risk factors for poor prognosis. Results:Neonatal severe hyperbilirubinemia in the exchange transfusion and phototherapy group were both mainly caused by hemolytic disease [42.1%(16/38) and 29.2%(38/130)], sepsis [28.9%(11/38) and 11.5%(15/130)] and early-onset breastfeeding jaundice [15.8%(6/38) and 11.5%(15/130)]. Total serum bilirubin level on admission in the exchange transfusion group was significantly higher than that in the phototherapy group [(531.7±141.3) vs (440.0±67.4) μmol/L, t=3.870, P<0.001]. Moreover, the percentage of patients with mild, moderate and severe acute bilirubin encephalopathy in the exchange transfusion group were higher than those in the phototherapy group [15.8%(6/38) vs 3.8%(5/130), 7.9%(3/38) vs 0.8%(1/130), 13.2%(5/38) vs 0.0%(0/130); χ2=29.119, P<0.001]. Among the 168 patients, 135 were followed up to 18-36 months of age and 12 showed poor prognosis (developmental retardation or hearing impairment) with four in the exchange transfusion group (12.9%, 4/31) and eight in the phototherapy group (7.7%, 8/104). Multivariate logistic regression analysis showed that for full-term infants with severe hyperbilirubinemia who met the exchange transfusion criteria, phototherapy alone without blood exchange transfusion as well as severe ABE were risk factors for poor prognosis ( OR=14.407, 95% CI: 1.101-88.528, P=0.042; OR=16.561, 95% CI: 4.042-67.850, P<0.001). Conclusions:Full-term infants who have severe hyperbilirubinemia and meet the exchange transfusion criteria should be actively treated with blood exchange transfusion, especially for those with severe ABE, so as to improve the prognosis.

Background: The association between Graves’ disease (GD) and co-existing thyroid cancer is still controversial and most of the previously reported data have been based on surgically treated GD patients. This study investigated the clinicopathological findings and prognosis of concomitant thyroid cancer in GD patients in the era of widespread application of ultrasonography. Methods: Data of GD patients who underwent thyroidectomy for thyroid cancer between 2010 and 2019 in three tertiary hospitals in South Korea (Asan Medical Center, Chonnam National University Hwasun Hospital, and Pusan National University Hospital) were collected and analyzed retrospectively. In the subgroup analysis, aggressiveness and clinical outcomes of thyroid cancer were compared nodular GD and non-nodular GD groups according to the presence or absence of the thyroid nodules other than thyroid cancer (index nodules). Results: Of the 15,159 GD patients treated at the hospitals during the study period, 262 (1.7%) underwent thyroidectomy for coexisting thyroid cancer. Eleven patients (4.2%) were diagnosed with occult thyroid cancer and 182 patients (69.5%) had microcarcinomas. No differences in thyroid cancer aggressiveness, ultrasonographic findings, or prognosis were observed between the nodular GD and non-nodular GD groups except the cancer subtype. In the multivariate analysis, only lymph node (LN) metastasis was an independent prognostic factor for recurrent/persistent disease of thyroid cancer arising in GD (P=0.020). Conclusion The prevalence of concomitant thyroid cancer in GD patients was considerably lower than in previous reports. The clinical outcomes of thyroid cancer in GD patients were also excellent but, more cautious follow-up is necessary for patients with LN metastasis in the same way as for thyroid cancer in non-GD patients.

Background: Hürthle cell carcinoma (HCC), a type of thyroid carcinoma, is rare in South Korea, and few studies have investigated its prognosis. Methods: This long-term multicenter retrospective cohort study evaluated the clinicopathological features and clinical outcomes in patients with HCC who underwent thyroid surgery between 1996 and 2009. Results: The mean age of the 97 patients included in the study was 50.3 years, and 26.8% were male. The mean size of the primary tumor was 3.2±1.8 cm, and three (3.1%) patients had distant metastasis at initial diagnosis. Ultrasonographic findings were available for 73 patients; the number of nodules with low-, intermediate-, and high suspicion was 28 (38.4%), 27 (37.0%), and 18 (24.7%), respectively, based on the Korean-Thyroid Imaging Reporting and Data System. Preoperatively, follicular neoplasm (FN) or suspicion for FN accounted for 65.2% of the cases according to the Bethesda category, and 13% had malignancy or suspicious for malignancy. During a median follow-up of 8.5 years, eight (8.2%) patients had persistent/recurrent disease, and none died of HCC. Older age, gross extrathyroidal extension (ETE), and widely invasive types of tumors were significantly associated with distant metastasis (all P<0.01). Gross ETE (hazard ratio [HR], 27.7; 95% confidence interval [CI], 2.2 to 346.4; P=0.01) and widely invasive classification (HR, 6.5; 95% CI, 1.1 to 39.4; P=0.04) were independent risk factors for poor disease-free survival (DFS). Conclusion The long-term prognosis of HCC is relatively favorable in South Korea from this study, although this is not a nation-wide data, and gross ETE and widely invasive cancer are significant prognostic factors for DFS. The diagnosis of HCC by ultrasonography and cytopathology remains challenging.

Background: The study aimed to compare the prognostic value of the 4th edition of World Health Organization classification (WHO-2017) with the previous WHO classification (WHO-2004) for follicular thyroid carcinoma (FTC). Methods: This multicenter retrospective cohort study included 318 patients with FTC from five tertiary centers who underwent thyroid surgery between 1996 and 2009. We evaluated the prognosis of patients with minimally invasive (MI), encapsulated angioinvasive (EA), and widely invasive (WI) FTC according to WHO-2017. Further, we evaluated the proportion of variation explained (PVE) and Harrell’s C-index to compare the predictability of disease-free survival (DFS) and disease-specific survival (DSS). Results: In total, 227, 58, and 33 patients had MI-, EA-, and WI-FTC, respectively. During a median follow-up of 10.6 years, 46 (14.5%) patients had disease recurrence and 20 (6.3%) patients died from FTC. The 10-year DFS rates of patients with MI-, EA-, and WI-FTC were 91.1%, 78.2%, and 54.9%, respectively (P<0.001, PVE=7.1%, C-index=0.649). The corresponding 10-year DSS rates were 95.9%, 93.5%, and 73.5%, respectively (P<0.001, PVE=2.6%, C-index=0.624). The PVE and C-index values were higher using WHO-2017 than using WHO-2004 for the prediction of DFS, but not for DSS. In multivariate analysis, older age (P=0.02), gross extrathyroidal extension (ETE) (P=0.003), and distant metastasis (P<0.001) were independent risk factors for DSS. Conclusion WHO-2017 improves the predictability of DFS, but not DSS, in patients with FTC. Distant metastasis, gross ETE and older age (≥55 years) were independent risk factors for DSS.

Background: Inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR), serve as valuable prognostic indicators in various cancers. This multicenter, retrospective cohort study assessed the treatment outcomes of lenvatinib in 71 patients with radioactive iodine (RAI)-refractory thyroid cancer, considering the baseline inflammatory biomarkers. Methods: This study retrospectively included patients from five tertiary hospitals in Korea whose complete blood counts were available before lenvatinib treatment. Progression-free survival (PFS) and overall survival (OS) were evaluated based on the median value of inflammatory biomarkers. Results: No significant differences in baseline characteristics were observed among patients grouped according to the inflammatory biomarkers, except for older patients with a higher-than-median NLR (≥2) compared to their counterparts with a lower NLR (P= 0.01). Patients with a higher-than-median NLR had significantly shorter PFS (P=0.02) and OS (P=0.017) than those with a lower NLR. In multivariate analysis, a higher-than-median NLR was significantly associated with poor OS (hazard ratio, 3.0; 95% confidence interval, 1.24 to 7.29; P=0.015). However, neither the LMR nor the PLR was associated with PFS. A higher-than-median LMR (≥3.9) was significantly associated with prolonged OS compared to a lower LMR (P=0.036). In contrast, a higher-than-median PLR (≥142.1) was associated with shorter OS compared to a lower PLR (P=0.039). Conclusion Baseline inflammatory biomarkers can serve as predictive indicators of PFS and OS in patients with RAI-refractory thyroid cancer treated with lenvatinib.

OBJECTIVE: To explore the differences of Chinese people's age and gender in orthostatic hypertension (OHT) by a single-center experience study.
 METHODS: A total of 2 994 patients with unexplained syncope and dizziness, who were outpatients or had been hospitalized in Second Xiangya Hospital, Central South University from January 2000 to August 2012, were chosen and subjected to the head-up tilt table test (HUTT). Their ages ranged from 2.00 to 78.00 years old, with an average at 19.07±14.78 years old. There were 1 406 and 1 588 cases for male and female, respectively. A total of 745 patients were OHT, who were divided into a adult group (≥18 years old, 247/904 cases) and a children group (<18 years old, 498/2 090 cases). The difference of the occurrence rate, classification, and 3 min quantity of blood pressure were analyzed.
 RESULTS: 1) The incidence of OHT in HUTT was 24.88% (745/2 994 cases). There was no statistical difference between the males and the females(25.75% vs 24.12%, χ2=1.058, P>0.05), but it was higher in the adult group compared with that in the children group (27.05% vs 23.83%, χ2=4.125, P=0.042). There were 52 cases (6.98%) of high systolic and high diastolic blood pressure (sOHT merge dOHT), 16 cases (2.15%) of simple high systolic blood pressure OHT (sOHT), and 677 cases (90.87%) of simple high diastolic blood pressure OHT (dOHT) in the 745 patients with OHT. The incidence of dOHT and sOHT merge sOHT in the adults group were significantly higher than those in the children group (1.11% vs 0.29%, χ2=7.965, P<0.01; 2.88% vs 1.24%, χ2=9.849, P<0.01, respectively); there was no statistical difference in simple dOHT between males and females (23.56% vs 22.20%, χ2=0.668, P>0.05); there was also no statistical difference in sOHT plus dOHT and dOHT between males and females (sOHT merge dOHT: 1.71% vs 1.76%, χ2=0.014, P>0.05; dOHT: 23.68% vs 21.66%, χ2=1.742, P>0.05; 1.71% vs 1.76%, χ2=0.014, P>0.05, respectively); but the dOHT was significantly higher in the males than that in the females in the children group (24.53% vs 19.74%, χ2=6.933, P>0.05). 2) There was no difference in the increment of systolic blood pressure in sOHT plus dOHT [(25.62±4.96) mmHg vs (23.54±5.83) mmHg, t=1.385, P>0.05] and the increment of diastolic blood pressure in dOHT [(13.46±3.49) mmHg vs (13.23±3.22) mmHg, t=0.840, P>0.05] between the adults group and the children group. There was no difference in the increment of systolic blood pressure in sOHT [(25.44±4.96) mmHg vs (23.68±5.35) mmHg, t=1.411, P>0.05] and the increment of diastolic blood pressure in dOHT [(14.09±4.28) mmHg vs (13.05±3.82) mmHg, t=1.887, P>0.05] between the adults group and the children group.
 CONCLUSION The incidence of OHT is higher in the adults group than that in the children group. There is no difference in systolic and diastolic blood pressure increment within 3 minutes during HUTT between the adults and children.
Adolescent ; Adult ; Aged ; Blood Pressure ; Child ; Child, Preschool ; Female ; Humans ; Hypertension ; Male ; Middle Aged ; Syncope ; Tilt-Table Test ; Young Adult