Objective To screen immune molecules expressed on peripheral blood mononuclear cells (PBMCs) which arc related to the aggravation of chronc hepatitis B (CHB). Methods Real-time polymerase chain reaction (PCR) was employed to detect the relative expression of 39 immune molecules at mRNA level and then compare the differences between groups (control group, mild CHB group, moderate CHB group and severe CHB group). The investigated immune molecules included leukocyte differentiation antigens, chemokine receptors, apoptosis-related ligands and receptors,adhesion molecules and Toll like receptors. Scheffe model was used to compare the differences among all groups and Spearman rank correlation was used for correlation analysis. Results Among the 39 immune molecules, the expressions of tumor necrosis factor related apoptosis inducing ligand (TRAIL), TRAIL receptor (TRAIL-R) 2, CD64, CD30, CD27, CD28, L-selectin (CD62L),intercellular adhesion molecule-1 (ICAM-1), chemokine (C-X-C motif) receptor (CXCR) 2 were significantly increased in severe CHB group compared with those in control group ( 1.96, 2.13, 1.33,1.16, 1.57, 2.14, 2.03, 2. 10 and 2.09, respectively; all P＜0.05). The expressions of TRAIL,TRAIL-R2, CD64, CD30, CD27 were highly correlated with the expression of interferon gamma (IFN-γ) (r=0. 816, 0. 572, 0. 462, 0. 697 and 0. 793, respectively; all P＜0.01). The expressions of TRAIL-R2, CD64, CD30, CD62L, ICAM-1 were highly correlated with the expression of tumor necrosis factor alpha (TNF-α) (r=0. 494, 0. 588, 0. 568, 0. 968 and 0. 976, respectively; all P＜0.01). Conclusion The abnormal expression of TRAIL,TRAIL R2,CD64,CD30,CD27,CD28,CD62L,ICAM-1 and CXCR2 may play an important role in the pathogenesis and aggravatoin of hepatitis B.

OBJECTIVE:To evaluate therapeutic efficacy and safety of valaciclovir versus acyclovir in the treatment of herpes zoster,and to provide evidence-based reference in clinic.METHODS:Retrieved from PubMed,Medline,CJFD,VIP and Wanfang Database,randomized controlled trials (RCTs) about valaciclovir (trial group) versus acyclovir (control group) in the treatment of herpes zoster were included.The data was analyzed statistically by using Rev Man 5.3 software after data extraction and quality evaluation by Cochrane systematic reviewer manual 5.1.0.RESULTS:A total of 12 RCTs were included,involving 1 059 patients.The result of Meta-analysis showed that:total response rate [OR =4.64,95 ％ CI (2.99,7.20),P＜ 0.001] and cure rate [OR =2.93,95％CI(2.13,4.03),P＜0.001] of trial group were significantly higher than those of control group;the incidence of postherpetic neuralgia in trial group [OR=0.39,95％CI(0.22,0.69),P=0.001] was significantly lower than control group,with statistical significance.There was no statistical significance in the incidence of ADR between 2 groups [OR=0.79,95％CI(0.49,1.29),P=0.35].CONCLUSIONS:Therapeutic efficacy of valaciclovir is better than that of acyclovir in the treatment of herpes zoster,can significantly reduce the incidence of postherpetic neuralgia.Both have similar safety.

Objective:To establish a mortality risk prediction model of severe bacterial infection in children and compare it with the pediatric early warning score (PEWS), pediatric critical illness score (PCIS) and pediatric risk of mortality score Ⅲ (PRISM Ⅲ).Methods:A total of 178 critically ill children were selected from the PICU of the Children's Hospital of Nanjing Medical University from May 2017 to June 2022. After obtaining the informed consent of the parents/guardians, basic information such as sex, age, height and weight, as well as indicators such as heart rate, systolic blood pressure and respiratory rate were collected from all children. A standard questionnaire was used to score the child 24 h after admission to the PICU. The children were divided into the survival and death groups according to their survival status at 28 d after admission. A mortality risk prediction model was constructed and nomogram was drawn. The value of the mortality risk prediction model, PEWS, PCIS and PRISM in predicting the risk of death was assessed and compared using the receiver operating characteristic (ROC) curve and the area under the ROC curve (AUC).Results:Among the 178 critically ill children, 11 cases were excluded due to severe data deficiencies and hospitalization not exceeding 24 h. A total of 167 children were included in the analysis, including 134 in the survival group and 33 in the death group. A mortality risk prediction model for children with severe bacterial infection was constructed using pupillary changes, state of consciousness, skin color, mechanical ventilation, total cholesterol and prothrombin time. ROC curve analysis showed that the AUCs of mortality risk prediction model was 0.888 ( P<0.05). The AUCs of PEWS, PCIS and PRISM Ⅲ in predicting death in children with severe bacterial infection were 0.769 ( P< 0.05), 0.575 ( P< 0.05) and 0.759 ( P< 0.05), respectively. Hosmer-Lemeshow goodness-of-fit test showed the best agreement between risk of death and PEWS predicted morbidity and mortality and actual morbidity and mortality (χ 2 = 5.180, P = 0.738; χ 2 = 4.939, P = 0.764), and the PCIS and PRISM Ⅲ predicted mortality rates fitted reasonably well with actual mortality rates (χ 2= 9.110, P= 0333; χ 2 = 8.943, P= 0.347). Conclusions:The mortality risk prediction model for predicting the death risk has better prognostic value than PEWS, PCIS and PRISM Ⅲ for children with severe bacterial infection.

OBJECTIVE: To carry out genetic testing for a patient with 45,X/46,XY mosaicism and autism spectrum disorder (ASD). METHODS: Peripheral blood samples of the patient and his parents were collected for the extraction of genomic DNA. Trio-based whole exome sequencing and Sanger sequencing were carried out thereafter. RESULTS: The proband and his father were found to harbor a heterozygous c.4781G>A (p.Arg1594Gln) variant of the CACNA1I gene. In addition, the proband was also found to harbor a de novo c.268C>T (p.Arg90Trp) missense variant of the MTRR gene. Based on guidelines of the American College of Medical Genetics and Genomics (ACMG), the c.4781G>A (p.Arg1594Gln) variant of the CACNA1I gene was predicted to be pathogenic (PVS1, PM1, PM2, PP3), while the c.268C>T (p.Arg90Trp) variant of the MTRR gene was predicted to be of uncertain significance. CONCLUSION Variants of the CACNA1I and MTRR genes, together with the chromosomal mosaicism, may have predisposed to the susceptibility to the ASD in this patient.
Autism Spectrum Disorder/genetics* ; Genomics ; Heterozygote ; Humans ; Mosaicism ; Whole Exome Sequencing

【Objective】 To study the protective effect of glycine solution on frozen red blood cell thawing process. 【Methods】 A total of 20 bags of 1 U of leukocytes reduced suspended red blood cells within 6 days were selected for the study. After mixing, each 2 bags of suspended red blood cells were divided into 2 bags and into two groups with 10 bags of 1 U in each group, and were frozen for storage. One group was deglycerolized with sodium chloride solution (control group), and one group was deglycerolized with glycine solution (experimental group). The hemoglobin, free hemoglobin, residual glycerol, total glycerol in red blood cells, adenosine triphosphate (ATP) and 2,3-diphosphoglycerate (2,3-DPG) were detected in the two groups. 【Results】 Compared with the free hemoglobin content (0.90±0.05)g/L and residual glycerol content (1.17± 0.08)g/L in the control group, the final product red blood cell supernatant free hemoglobin content (0.77±0.15)g/L and residual glycerol content (0.79±0.33)g/L in the experimental group were decreased, and the difference was statistically significant (P<0.05). Compared with the ATP content (4.03±0.38)µmol/gHb and 2,3-DPG content (485.65±78.08)µg/L in the control group, the ATP content (4.41±0.35)µmol/gHb and 2,3-DPG content (656.28±116.68)µ g/L in the experimental group were significantly increased, with statistical significance (P<0.05). 【Conclusion】 Using glycine solution instead of sodium chloride solution to prepare frozen thawed deglycerolized erythrocytes achieved the effect of protecting erythrocytes, reduced the hemolysis rate of erythrocytes and glycerin residue, and increased the recovery rate of erythrocytes.

BackgroundComorbid attention-deficit/hyperactivity disorder （ADHD） and emotional dysregulation may represent a distinct subtype of ADHD， which is characterized by an increased risk of anxiety or depressive disorder and a poor clinical prognosis， so research is urgently required to explore its unique executive functioning profile and clinical characteristics. However， there is limited research comparing the clinical symptoms and executive function in children with ADHD in terms of the presence or absence of emotional dysregulation. ObjectiveTo explore the executive function and clinical characteristics of ADHD children with emotional dysregulation. MethodsFrom June 2020 to December 2023， 118 children aged 7 to 12 with ADHD attending the Mental Health Center of West China Hospital， Sichuan University and fulfilling the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） diagnostic criteria were enrolled. Children were classified into emotional dysregulation group （n=68） and non-emotional dysregulation group （n=50） based on the standard T-scores of Achenbach's Child Behavior Checklist （CBCL）- anxious/depressed， aggressive behavior and attention problems subscales. All children were then subjected to complete the Chinese version of Swanson Nolan and Pelham，Version IV Scale-parent form （SNAP-IV）， Chinese Wechsler Intelligence Scale for Children （C-WISC）， Weiss Functional Impairment Scale-Parent form （WFIRS-P） and 4 tests of the Cambridge Neuropsychological Test Automated Battery （CANTAB）： ①Stockings of Cambridge （SOC） testing spatial planning. ②Intradimensional-extradimensional Set Shifting（IED） testing cognitive/attentional flexibility， adjusting the total errors across the task. ③Spatial Working Memory （SWM） testing spatial working memory. ④Rapid Visual Information Processing （RVP） testing sustained attention. ResultsThe SNAP-IV Inattention， Hyperactivity/Impulsivity and Oppositional Defiant Disorder domain scores and total score were all higher in emotional dysregulation group compared with non-emotional dysregulation group （t=3.206， 5.088， 6.316， 6.553， P<0.01）. The WFIRS-P family， school learning， life skills， self-concept， social activities and risky activities domain scores and total score were all higher in emotional dysregulation group compared with non-emotional dysregulation group （t=6.074， 4.406， 4.143， 3.984， 6.575， 6.662， 8.254， P<0.01）. In CANTAB， emotional dysregulation group made more total adjusted errors across the IED task compared with non-emotional dysregulation group （t=2.168， P<0.05）. ConclusionChildren with ADHD who exhibit emotional dysregulation have been observed to experience more severe core symptoms， impaired social functioning and poorer performance on tests assessing executive function， particularly in the area of cognitive flexibility. ［Funded by 1·3·5 Project for Disciplines of Excellence-Clinical Research Incubation Project， West China Hospital， Sichuan University （number， 2018HXFH045）]