Female ; Gastroscopy ; Humans ; Infant ; Intestinal Obstruction ; diagnosis ; therapy ; Treatment Outcome

Objective To analyze the podiatric conditions of athletes with intellectual disabilities.Methods From May eleventh to 17th, 2015,779 athletes who participated in the sixth National Special Olympics were enrolled partly.Their lower limbs and feet were evaluated with Fit Feet Healthy Athletes Screening Form.Results Common podiatric conditions found in Special Olympics athletes included flat feet (52.2% in left side and 51.7% in right side), over pronation (56.1% in left side and 56.9% in right side), callus (44.7%), wrong nail cut (46.6%),ingrown nail(21.1%),and cross over toes(6.8%),etc.Conclusion Special Olympics athletes have podiatric structural,functional, nail and skin problems,which may relate to intellectual disabilities.

Objective To explore whether Th17 cells play a role in the neuroinflammatory process of Parkinson's disease (PD).Methods C57BL/6 mice were injected intraperitoneally with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) to induce PD models.Saline-injected and naive mice were used as controls.In substantia nigra compact (SNc) part,double-immunofluorescence staining was used to observe glucose transporter (Glut 1+) and CD4+ T cells or retinoic acid-related orphan nuclear receptor γt (ROR γt) and intedeukin (IL)-17.Real-time PCR was employed to examine the mRNA expressions ofIL-17 and IL-22 in the SNc.Results PD models were successfully induced in the mice; CD4+ T cells invaded into the brain parenchyma of PD mice models.Besides,the mount of CD4+ T cells on the seventh day of MPTP injection was more than that of the second day of MPTP injection.The expressions ofROR γt and IL-17 increased in the SNc of the PD mice; a co-localization ofROR γt and IL-17 in SNc indicated that invasive CD4+ T cells contained Thl7 cells.There was evident up-regulation in the expressions ofIL-17 and IL-22 mRNAs in PD mice as compared with the saline-injected or intact mice,which was much more evident in the late phase of disease (the seventh day of MPTP) than in the early stage (the second day of MPTP injection).Conclusion Neuroinflammation induced by infiltration of Th17 cells participates in the process of PD.

OBJECTIVETo explore the specific efficacy of different moxibustion techniques in treatment of common diseases and clinical indications, and compare the specificity in clinical indications and efficacy among different moxibustion techniques so as to guide clinical practice better.

METHODSThe modern computerization and data mining technology were adopted to set up moxibustion literature database. The relevant literature of moxibustion techniques in recent 60 years were collected, screened, examined, extracted and analyzed statistically so as to explore the advantages of different moxibustion techniques in clinical treatment.

RESULTS(1) Of 2,516 literature, moxa stick, moxe cone and moxa device were used in the highest frequency in internal medicine department, for 730 times, 278 times and 102 times respectively. The warm needling technique was used in the highest frequency, for 70 times in the surgical department. (2) In the dermatology department, the curative rate with moxa cone was the highest, 75%. In the ear-nose-throat department, the warm needing technique and moxa device achieved the highest curative rate, 49% for both of them. In the internal medicine department and surgical department, the curative rate of warm needling technique was 53% and 58% respectively. In the gynecology department, the curative rate of moxa device was the highest, 59%. In the pediatrics department, the curative rate of moxa cone was the highest, 80%. (3) The numbers of priority disorders, frequency ≥20 times: 24 kinds of disease for moxa stick, five kinds of disease for moxa cone, 2 kinds of disease for warm needling technqiue and one disorder for moxa device. Facial paralysis, diarrhea, lumbar and leg pain and elbow and knee swelling pain were of the highest priority, treated with these 4 moxibustion techniques, with a certain of literature research values. (4) The warm needling technique achieved the better efficacy on elbow and knee swelling pain, lumbar and leg pain and diarrhea compared with the other three techniques and the curative rate was higher. The moxa device tecnique achieved the higher curative rate for facial paralysis compared with the other three techniques.

CONCLUSIONThrough the comparison of application frequency, curative rate, clinical application frequency in disorders and the efficacy of priority disorders in the treatment with different moxibustion techniques, it is found that moxa stick, moxa cone and moxa device are simple in manipulation, safe and effective. Hence, they can be extensively used in the treatment of common disorders in every department in clinic. The warm needling technique acts on the body by the co-work of needling and warming stimulation of mugwort. It achieves the particular effect on the disorders with complicated etiologies compared with the other three techniques. It can be chosen in priority for the disorders caused by blockage in meridian and collateral and stagnation of qi and blood.

OBJECTIVETo discuss the specificity of diseases treated by moxibustion and fire needling in clinical practice, so as to provide references for clinical treatment.

METHODSWith data mining of modern computer technique, journal and literature databases regarding moxibustion and fire needling were established, respectively. Literature regarding moxibustion and fire needling for the past 60 years has been collected, screened, included, reviewed and abstracted. The utility rate of moxibustion and fire needling in each department was calculated, frequency of diseases in clinical practice was summarized, and diseases which had differences in clinical practice in each department were screened; also the advantages of disease categories and clinical practice between two kinds of therapies in each department were compared.

RESULTS(1) The utility rate of moxibustion was highest in department of internal medicine and surgery, which were 43.6% and 28.1%, respectively; the utility rate of fire needling was highest in surgery and dermatological department, which were 53.7% and 23.8%, respectively. (2) According to the comparison and analysis on diseases treated by two therapies in clinic, among 26 kinds of gynecology diseases that were treated by moxibustion, 20 kinds were not involved with fire needling; among 22 kinds of pediatrics diseases that were treated by moxibustion, 20 kinds were not involved with fire needling. It was certain that the difference of the two therapies in clinical application was more significant in gynecology and pediatrics than that in the rest four departments. (3) Among the diseases which had differences in clinical practice in each department, the ones involved with moxibustion alone were insomnia, distention and fullness, consumptive fatigue in the department of internal medicine, blood-vessel Bi, stiff neck and hernia in surgery department, urticarial, skin Bi and skin cancer in dermatological department, malposition, infertility and amenorrhea in gynecology department, diarrhea, indigestion and stomachache in pediatrics department, blepharoptosis, blurred vision and dryness syndrome in ENT department; the ones involved with fire needling alone were numbness, coldness syndrome and acute renal colic in the department of internal medicine, lipoma, soft tissue injury and papilloma in surgery department, bromhidrosis, freckle and erysipelas in dermatological department, uterine fibroid in gynecology department, umbilical polyp in pediatrics department, auricle pseudocyst, starred nebula and phlegmatic mass in ENT department.

CONCLUSIONMoxibustion is frequently applied in department of internal medicine and surgery, while fire needling is frequently used in surgery and dermatological department; the application of moxibustion is broader than that of fire needling in gynecology and pediatrics department. Among the diseases which have differences in clinical practice in each department, moxibustion is commonly seen for clinical symptoms featured with deficiency syndrome, while fire needling is commonly applied for the diseases that have obvious local symptoms.

Objective To investigate the effects of spleen-yin nourishing formula,ZiBu PiYin Recipe (ZBPYR),on endoplasmic reticulum stress (ERS)in the hypothalamus of spleen yin deficiency diabetic rats.Methods Rats were randomly divided into five groups:control (cont)group,Diabetes Mellitus (DM)group,spleen yin deficiency (pi)group,piDMgroup,and ZBPYR group.The expressions of p-PERK,p-eIF2α,eIF2αand GRP78,which were endoplasmic reticulum stress markers in the hypothala-mus of rats,were measured using western blotting methods.Results The protein expressions of p-PERK,p-eIF2αand GRP78 in the hypothalamus of DM group and piDM group were elevated,as com-pared with cont group (P <0.05).Their levles were decreased in the ZBPYR group,compared with DM group and piDMgroup (P <0.05).In addition,no significant difference in eIF2αexpression was detec-ted among different groups.Compared with the cont group,GRP78 mRNA expression in hypothalamus increased in the DMgroup,pi group and piDMgroup (P <0.05).The expression of GRP78 mRNA was lower in ZBPYR group than in the DMand piDMgroups (P <0.05).Conclusion Endoplasmic reticu-lum stress seems to be present in the hypothalamus in the DM and piDM groups.Formulas that enrich and tonify the spleen yin have the effects of alleviating endoplasmic reticulum stress.

Objective: Patients with acute coronary syndrome due to multivessel disease (MVD) were at the highest risk of adverse cardiovascular events. Neutrophil to lymphocyte ratio (NLR) was proposed as a marker of cardiovascular risk. Present study evaluated the independent predictive value of NLR for acute myocardial infarction (AMI) patients with MVD. Methods: AMI patients with MVD (n=1 433) underwent percutaneous coronary intervention (PCI) between January 2013 and December 2013 were followed up for 2 years. Patients were divided into 2 sub-groups based on an optimal cut off value of NLR to predict 2-year all-cause mortality. The primary endpoint was all-cause death. The secondary endpoint was long-term major adverse cardiovascular and cerebrovascular events (MACCE). Results: By receiver operating characteristics curve analysis, the optimal cut-off value of admission NLR to predict 2-year all-cause mortality was 3.39 (area under the curve 0.765, sensitivity 71%, specificity 73%). The high NLR group(n=396) had higher prevalence of prior myocardial infarction, prior PCI and intra-aortic balloon pump use (IABP)(P<0.01). Compared to the low NLR group (n=1 037), patients in the high NLR group were older, had higher level of neutrophil count and high-sensitivity C-reactive protein (hs-CRP) (P<0.001), but lower level of lymphocyte count, estimated glomerular filtration rate (eGFR) and ejection fraction (P<0.001). During the follow-up period, rate of long-term all-cause death was significantly higher in the high NLR group than in the low NLR group (5.1% (20/396) vs. 0.8% (8/1 037), P<0.001). Cardiac death (4.0% (16/396) vs. 0.7% (7/1 037), P<0.001) and MACCE (21.7% (86/396) vs. 12.6% (131/1 037), P<0.001) were also significantly higher in the high NLR group than in the low NLR group. Multivariate Cox analysis showed that NLR ≥ 3.39 was determined as an independent predictor of 2-year all-cause mortality (HR=3.23, 95%CI 1.38-7.54, P=0.007) and MACCE (HR=1.58, 95%CI 1.19-2.10, P=0.002) in this patient cohort after adjusting for other risk factors. Correlation analysis showed that the NLR was positively correlated with hs-CRP levels (r=0.241, P<0.001). Conclusion Our study demonstrates that admission NLR ≥ 3.39 is an independent predictor of long term all cause death and MACCE in AMI patients with MVD post PCI.

The pathogenesis of the nephrotic syndrome is complex and the pathological types are diverse, so the minor symptoms in its early phases are difficult to detect. Renal biopsy is the gold indicator for the diagnosis of renal pathology and progression, but poor patient compliance shows, and the optimal treatment time is often delayed. Therefore, the discovery of biomarkers for early diagnosis and disease progression monitoring is of great clinical significance. In this study, doxorubicin-injured podocyte models were used to simulate human kidney disease at different stages of progression. LC-MS-based metabolomic technology combined with statistical methods was used to screen and identify the potential biomarkers associated with early injury or progression of podocytes. The results of cell viability, apoptosis tests and podocyte structural protein analysis showed that the model was successfully constructed, and the degree of podocyte injury was significantly different between the two modeling methods. According to VIP > 1 and P < 0.05 based on the orthogonal partial least squares discriminant analysis (OPLS-DA) model, nine differential metabolites reflecting early podocyte injury and twelve differential metabolites reflecting the injury progression were screened, respectively. ROC analysis was adopted to focus on the potential biomarkers that can reflecting the early podocyte injury including L-tryptophan, guanosine triphosphate (GTP), 5′-thymidylic acid (dTMP) and thymidine, and the biomarkers reflecting the injury progression of podocytes composed of L-phenylalanine, L-tyrosine acid, uridine 5′-diphosphate (UDP) and guanosine 5′-diphosphate (GDP) AUC > 0.85. It indicated that these eight metabolites may have high sensitivity and diagnostic ability. This study provides a reference for the research on biomarkers of progressive diseases.

Objective:To investigate the incidence and influencing factors of allergic reactions to cephalosporins.Methods:A cross-sectional study of 29 medical institutions in Zhejiang Province was conducted from April 2021 to June 2021.The incidence of allergic reactions to cephalosporins was investigated,and the influencing factors of cephalosporin-induced allergic reactions were analyzed by Poisson regression.Results:A total of 56 155 patients were included in this study.The total incidence of allergic reactions to cephalosporin was 1.67‰,the highest incidence of anaphylaxis occurred for ceftizoxime(4.27‰),followed by ceftriaxone(3.49‰)and cefotaxime(2.40‰).There was no significant difference in the incidence of allergic reactions between patients with negative skin tests and those without skin tests(1.75％o vs.1.63‰,RR=1.07,95％CI:0.70-1.63,P＞0.05).Poisson regression showed that body mass index(BMI)＜18.5 kg/m2(RR=2.43,95％CI:1.23-4.82,P＜0.05)and history of β-lactam antibiotics allergy(RR=33.88,95％CI:1.47-781.12,P＜0.05)increased cephalosporin-induced anaphylaxis.Compared with cefuroxime,the risk of allergic reactions was increased for ceftriaxone(RR=3.08,95％CI:1.70-5.59,P＜0.01),ceftazidime(RR=1.89,95％CI:1.03-3.47,P＜0.05),and ceftizoxime(RR=3.74,95％CI:1.64-8.50,P＜0.01).Conclusions:Lower BMI and history of β-lactam antibiotics allergy increase the risk of cephalosporin allergic reactions.The routine skin test may not reduce the occurrence of allergic reactions to cephalosporins. This study has been registered at Chinese Clinical Trial Registry(ChiCTR2200064314).

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.