School is a densely populated place, which can easily lead to tuberculosis clusters, then affect the physical and mental health of students and the normal teaching order of school. Tuberculosis latent infection (LTBI) screening for new students and close contacts of tuberculosis patients has become important parts of school tuberculosis prevention and control strategies. Previous studies have shown that the LTBI rate of Chinese in-school students is about 5.74% to 11.67%, and there are differences in gender, studying phase and urban-rural distributions. Preventive treatment is an effective measure to prevent LTBI from developing into active tuberculosis, but the proportion of LTBI preventive treatment for students in most areas is low. The difficulties in implementing preventive treatment may be attributed to concerns about adverse reactions to medication and sense of shame towards illness among students, and lack of awareness about preventive treatment among medical staff. This review searches the research literature published from 2016 to 2023, and summarizes the prevalence of LTBI in Chinese students and progress on preventive treatment, so as to provide insights into prevention and control of tuberculosis among students.

Objective To observe the clinical efficacy of needling the three trembling points plus rehabilitation and taking levodopaand benserazide hydrochlo-ride.Method Ninety-three patients with early Parkinson's disease were randomized into group A of 32 cases, group B of 30 cases, and group C of 31 cases. Group A was intervened by needling the three trembling points plus rehabilitation and taking levodopaand benserazide hydrochlo-ride, group B by rehabilitation and taking levodopaand benserazide hydrochlo-ride, while group C by taking levodopaand benserazide hydrochlo-ride. UPDRSⅢ scores and Berg balance scale (BBS) scores were observed.Result After intervention, UPDRSⅢ scores and BBS scores were significantly changed in all groups (P<0.05). UPDRSⅢ scores of group A were markedly different form that of group B and C (P<0.05). BBS scores of group A and B were markedly different form that of group C (P<0.05).Conclusion Needling the three trembling points plus rehabilitation and taking levodopaand benserazide hydrochlo-ride can improve motor function and equilibrium function in the early Parkinson's disease patients.

Bone marrow-derived mesenchymal stem cells (BMSCs) for repairing damaged heart tissue are a new kind of important treatment options because of their potential to differentiate into cardiomyocytes. We in this experiment investigated the effect of different electrical stimulation time on the expression of myocardial specificity gene and protein in rat bone marrow mesenchymal stem cells (rBMSCs) in vitro. The rBMSCs of second or third generation were randomly divided into three groups, i.e, electrical stimulation (ES) group, 5-Azacytidine (5-Aza) group and the control group. The rBMSCs in the ES groups with complete medium were exposed to 2 V, 2 Hz, 5 ms electrical stimulation for 0. 5 h, 2 h, 4 h, and 6 h respectively every day for 10 days. Those in the 5-Aza group were induced by 5-Aza (10 μmol/L) for 24 h, and then cultured with complete medium for 10 days. Those in the control group were only cultured with complete medium, without any treatment, for 10 days. The rBMSCs' morphological feature in each group was observed with inverted phase microscope. The mRNA expression of myocyte-specific enhancer factor 2C (MEF-2C) and connexin 43 (Cx43) were examined with Real-Time quantitative PCR and the protein expression of MEF-2C, Cx43 were detected with Western Blot method. The results showed that the mRNA expression level of the MEF-2C, Cx43 and the protein expression level of MEF-2C, Cx43 were significantly higher in the ES group and 5-Aza group than those in the relative control group (P < 0.05). It suggests that electrical stimulation could play a part of role in the induction of the rBMSCs to differentiate into the cariomyocyte-like cells in vitro and the effectiveness of the electrical stimulation with 2 h/d had the best in our experiment. But the mechanism how electrical stimulation promotes the differentiation of rBMSC into cardiomyocyte is still unclear.
Animals ; Biomarkers ; metabolism ; Cell Differentiation ; Cells, Cultured ; Connexin 43 ; metabolism ; Electric Stimulation ; MEF2 Transcription Factors ; metabolism ; Mesenchymal Stromal Cells ; cytology ; metabolism ; Myocytes, Cardiac ; cytology ; RNA, Messenger ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective To investigate the death of chondrocytes in rats which feed with T-2 toxin under selenium (Se) deficient conditions.Methods Thirty two healthy male SD rats were divided into two groups by weight which were normal diet group and Se deficiency diet group,16 rats in each group.Rats in normal diet group were fed with Se 101.5 μg/kg diet,and rats in Se deficiency diet group were fed with Se 1.1 μg/kg diet for 30 d.Normal diet group was divided into control group and T-2 toxin group,and Se deliciency diet group was randomly divided into Se-deficiency group and Se-deficiency plus T-2 toxin group,8 rats in each group.After that,rats in T-2 toxin and Se-deficiency plus T-2 toxin groups were administrated intragastrically with T-2 toxin (100 μg/kg) everyday for 30 d.Rats were put to death,the left knee was taken and stained with hematoxylin-eosin and SafraninFast green,pathological changes of rat's knee joint cartilage were observed under light microscopy,expression levels of active caspase-3 and receptor interacting protein 3 (RIP3) in rat's articular cartilage cells were determined via the immunohistochemical method.The apoptosis was also detected by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling assay (TUNEL).Results Red ghost outlines of chondrocyte and multiple chondral cell clusters surrounded the non-cell areas in deep zone of articular cartilage of knee joint stained with hematoxylineosin were seen in Se-deficiency plus T-2 toxin group under light microscope.In the superficial zone of cartilage,the positive percent of TUNEL and active caspase-3 in Se-deficiency plus T-2 toxin group was higher than those of control group,Se-deficiency group and T-2 toxin group [(7.47-± 0.34)％ vs (4.68 ± 0.54)％,(2.67-± 0.64)％,(2.56 ±0.54)％;(4.75 ± 0.67)％ vs (1.24 ± 0.25)％,(0.00 ± 0.00)％,(0.00 ± 0.00)％,P ＜ 0.05].In the middle zone of cartilage,the positive percent of TUNEL,active caspase-3 and RIP3 in Se-deficiency plus T-2 toxin group was significantly higher than those of control group,T-2 toxin group and Se-deficiency group [(72.06 ± 6.15)％ vs (16.10 ± 3.00)％,(19.57 ± 3.49)％,(19.33 ± 5.19)％;(51.13 ± 4.18)％ vs (10.97-± 3.01)％,(15.36 ± 4.37)％,(15.23 ± 3.13)％;(25.91 ± 13.39)％ vs (1.59 ± 1.14)％,(4.32 ± 2.91)％,(7.50 ± 5.00)％,P ＜ 0.05].The positive percents of TUNEL,active caspase-3 and RIP3 were not significantly different in the deep zone (P ＞ 0.05).Conclusion The death of the middle zone in the rat cartilage induced by T-2 toxin under selenium deficient conditions isapoptosis and necroptosis.

Objective To analyze the causes of hypoglycemia coma in emergency diabetes patients and its corresponding nursing strategies.Methods The reasons of hypoglycemia coma was retrospectively analyzed in our hospital and the risk factors of hypoglycemic coma were analyzed by multivariate logistic regression,and the corresponding nursing strategies were summarized.Results Of the 767 critically ill patients,100 (13.04％) had hypoglycemia,among whom 27 patients (3.52％) had severe hypoglycemia.Multivariate logistic regression analysis showed that patients with type 2 diabetes history,hypoglycemic drugs therapy,hypoproteinemia,renal insufficiency,hemodialysis,malnutrition were risk factors for hypoglycemic coma.While normal hemoglobin was a protective factor for hypoglycemic coma.Conclusion Hypoglycemia is the result of multiple factors in emergency patients.Reasonable nursing measures can effectively prevent the occurrence of hypoglycemic coma in emergency patients.

Objective To analyze the causes of hypoglycemia coma in emergency diabetes patients and its corresponding nursing strategies.Methods The reasons of hypoglycemia coma was retrospectively analyzed in our hospital and the risk factors of hypoglycemic coma were analyzed by multivariate logistic regression,and the corresponding nursing strategies were summarized.Results Of the 767 critically ill patients,100 (13.04％) had hypoglycemia,among whom 27 patients (3.52％) had severe hypoglycemia.Multivariate logistic regression analysis showed that patients with type 2 diabetes history,hypoglycemic drugs therapy,hypoproteinemia,renal insufficiency,hemodialysis,malnutrition were risk factors for hypoglycemic coma.While normal hemoglobin was a protective factor for hypoglycemic coma.Conclusion Hypoglycemia is the result of multiple factors in emergency patients.Reasonable nursing measures can effectively prevent the occurrence of hypoglycemic coma in emergency patients.

Objective:To explore the influencing factors of drug application deviation in elderly diabetes mellitus patients during hospital-family transition period.Methods:A total of 278 elderly diabetes mellitus patients in Henan Provincial People's Hospital from March 2019 to March 2021 were selected as the study subjects.All patients were followed up by telephone 1 week after discharge.The drug deviation evaluation tool(MDT)was used to evaluate the drug application deviation in patients during the hospital-family transition period.They were divided into drug application deviation group and non-drug application deviation group.Sociodemographic and disease-related data and medication management data were compared between the two groups.Logistic regression analysis was used to analyze the influencing factors of drug application deviation in elderly patients with diabetes mellitus during hospital-family transition period.Results:Of the 278 elderly patients with diabetes, 162(58.27%)had at least one drug application deviation during hospital-family transition period.The family care index was lower in drug application deviation group than non-drug application deviation group( Z=6.578, P<0.001).As compared with non-drug application deviation group, drug application deviation group had the higher number of drugs at discharge, and had lower scores of Morisky Medication Adherence Scale with Eight-Item(MMAS-8), had lower scores of Summary of Diabetes Self Care Activities(SDSCA)and had lower scores of Self-efficacy for Appropriate Medication Use Scale(SEAMS), with statistically significant differences( Z=10.971, 6.077, t=5.947, 14.105, all P<0.001).Binary Logistic regression analysis and forest map showed that the more number of discharge medication was a risk factor for drug application deviation during hospital-family transition period in elderly patients with diabetes mellitus( OR=4.128, P<0.001); family care index, MMAS-8 score, SDSCA score and SEAMS score were its protective factors( OR=0.343, 0.523, 0.922, 0.568, all P<0.05). Conclusions:The incidence of drug application deviation during hospital-family transition period is higher in elderly patients with diabetes mellitus.The possible protective factors are high scores of family care index, MMAS-8, SDSCA and SEAMS, and the risk factor is large number of drugs ordered by discharged doctors.Therefore, targeted intervention measures can be implemented to reduce the occurrence of drug application deviation during hospital-family transition period.

Objective:To explore the clinical features and managements of novel coronavirus (2019-nCoV) infection after kidney transplantation.Methods:The authors reviewed medical history, laboratory values, imaging studies, treatment options and clinical outcomes of two confirmed hospitalized cases of COVID-19 after kidney transplant in February 2020. Both cases were middle-aged males and confirmed as COVID-19 at 11 or 12 months after transplantation. They both presented initially with moderate-to-low fever, cough and fatigue. Chest computed tomography (CT) hinted at multiple peripheral patchy ground glass opacities or patchy exudation and in bilateral multiple lobular and subsegmental with obscure boundary. Both had varying degrees of renal function and cardiac insufficiency.Results:In case 1, the dose of immunosuppressants was tapered while a higher dose of glucocorticoids was prescribed during treatment. In case 2, the dose of immunosuppressants was not tapered and continuous renal replacement therapy (CRRT) performed thrice in the early disease course due to renal insufficiency and hyperkalemia. Both cases received oxygen inhalation, lopinavir/ritonavir, oral abidor and interferonα-2b antiviral therapy, antibiotics treatment. Both cases were cured.Conclusions:The clinical manifestations and diagnosis of COVID-19 patients after kidney transplantation are not significantly different from those of other people. However, early renal function and heart function abnormalities occur. How to adjust the immunosuppressant in the treatment course of severe COVID-19 after renal transplantation should be further explored.

Objective:To study the clinical characteristics of growth development and metabolic disorders in obese children and adolescents with insulin resistance (IR).Methods:Normal weight or obese children and adolescents who hospitalized at the Department of Children′s Health Care of Children′s Hospital Affiliated to Nanjing Medical University from September 2015 to April 2018 were recruited.Children′s height, body weight and waist circumference were measured, and waist-to-height ratio (WHtR) and body mass index (BMI) were calculated.Puberty process was determined by Tanner stage.Blood glucose, blood lipid and insulin were measured in fasting state, and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated based on fasting blood glucose and insulin levels.IR was considered when HOMA-IR was over 2.69.Non-alcoholic fatty liver (NAFLD) was diagnosed by abdominal ultrasound.Results:(1) A total of 691 subjects were included, including 183 cases with the age of (9.73±2.38) years in the normal weight group/normal group, and 508 cases with the age of (10.24±2.05) years old in the obese group.The rate of IR was higher in obese group than that in normal group (55.71% vs. 10.38%), and the difference was statistically significant ( P<0.001). (2)HOMA-IR was positively correlated with age ( r=0.256, P<0.001), BMI ( r=0.426, P<0.001), waist circumference ( r=0.454, P<0.001), and WHtR ( r=0.321, P<0.001). After the adjustment for age, sex, and puberty stage, HOMA-IR was also positively correlated with BMI ( r=0.418, P<0.001), waist circumference ( r=0.419, P<0.001) and WHtR ( r=0.375, P<0.001). (3) During puberty, HOMA-IR in both of obese group and normal group was increased, and HOMA-IR in obese group was more particularly serious compared to normal group[TannerⅠ: 2.60(1.49, 3.94) vs.1.28(0.80, 1.90); Tanner Ⅱ: 3.07(1.75, 5.17) vs.1.80(1.16, 2.96); Tanner Ⅲ: 4.33(2.80, 6.57) vs.2.47(1.41, 3.68); Tanner Ⅳ-Ⅴ: 3.49(1.04, 5.78) vs.1.91(0.54, 2.60)], and the differences were all statistically significant(all P<0.05). (4)Compared with the obese objects without IR, obese children and adolescents with IR had higher systolic blood pressure[112(104, 124) mmHg vs.109(98, 121) mmHg, 1 mmHg=0.133 kPa], triglyceride level [1.27(0.95, 1.81) mmol/L vs.1.09(0.79, 1.61) mmol/L], fas-ting blood glucose level [4.80(4.46, 5.01) mmol/L vs.4.48(4.16, 4.76) mmol/L] and fasting insulin level [21.27(16.21, 28.56) mmol/L vs.7.62(4.43, 10.83) mmol/L], and the differences were all statistically significant(all P<0.05). IR was a risk factor for NAFLD in obese children( OR=1.536, 95% CI: 1.049-2.247, P<0.05). Conclusions:Serious and abdominal obesity in children and adolescents is a major risk factor for the development of IR.HOMA-IR of obese children and adolescents is particularly serious during puberty.The obese children with IR are more likely to have metabolic disorders in blood glucose, serum lipid and blood pressure, and have the risk of NAFLD development.

OBJECTIVE：To learn from the experie nce of post-marketing risk management of biopharmaceuticals in the United States，and to provide reference for post-marketing risk management of biopharmaceuticals in China. METHODS ：By studying guidance documents and website information issued by FDA ，the risk management of biopharmaceuticals after marketing in the United States was analyzed. Taking infliximab as an example ，the specific implementation situation was introduced ，the management characteristics were summarized ，and the enlightenment and relevant suggestions were put forward for the risk management of biopharmaceuticals after marketing in China. RESULTS & CONCLUSIONS ：The post-marketing risk management of biopharmaceuticals in the United States mainly includes two aspects as “risk evaluation and mitigation strategy （REMS）”and “post-marketing study and clinical trials system ”. The latter included post-marketing requirement （PMR） and post-marketing commitment（PMC）. Taking infliximab as an example ，since it was approved by FDA in August 1998，its manufacturer submitted REMS to FDA in 2009 and obtained approval ，and proposed post-marketing studies and clinical trials for five times. It can be seen that FDA has issued specific guidelines for post-marketing risk management of biopharmaceuticals to encourage multi-role participation in risk management ， realize effective communication with patients ， and continuously supervise the risk of biopharmaceuticals，so as to reduce the risk of the use of biopharmaceuticals. For biopharmaceuticals ，China has not yet formulated systematic and specific implementation rules and guidelines ，and there is still lack in post-marketing risk management. It is suggested that China can learn from the measures and system of post-marketing risk management of biopharmaceuticals in the United States ，involve stakeholders in post-marketing management ，enhance patients ’awareness of drug use risks through effective communication，and further improve the post-marketing research management system to guarantee patients ’safety of drug use.