OBJECTIVE To study the effect of different doses of aspirin on clinical efficacy in acute stage of Kawasaki’s disease, and to explore the optimal dose of aspirin. METHODS A total of 150 patients suffered from Kawasaki’s disease were randomly selected by hospital information system from March to May 2022 for retrospective analysis. According to different doses of aspirin, they were divided into three groups: high dose group(>50 mg·kg−1·d−1), medium dose group(30−50 mg·kg−1·d−1) and low dose group(<30 mg·kg−1·d−1). The antipyretic time, the incidence of non-response to intravenous human immunoglobulin, the improvement of laboratory indexes and prevalence of adverse drug reaction were compared among the three groups. RESULTS There was no significant difference in body temperature recovery among the three groups under different doses of aspirin. There was no significant difference in patients with non-response to intravenous human immunoglobulin among the three groups. Before treatment, there were no significant differences in white blood cell(WBC) count, blood platelet(PLT) count and C-reactive protein(CRP) concentration among the three groups. After treatment, the count of WBC, PLT and CRP in the three groups was significantly improved compared with that before treatment, and the difference was statistically significant(P<0.05). However, there was no significant difference in the above indexes among the three groups after treatment. There was a higher incidence of adverse reactions in children treated with medium or high dose aspirin. CONCLUSION Different doses of aspirin combined with intravenous human immunoglobulin have good therapeutic effect on Kawasaki’s disease, but considering the safety and economy of aspirin, low dose administration is recommended.

Objective: To understand the current status of diagnosis and treatment of chronic lymphocytic leukemia (CLL) /small lymphocytic lymphoma (SLL) among hematologists, oncologists, and lymphoma physicians from hospitals of different levels in China. Methods: This multicenter questionnaire survey was conducted from March 2021 to July 2021 and included 1,000 eligible physicians. A combination of face-to-face interviews and online questionnaire surveys was used. A standardized questionnaire regarding the composition of patients treated for CLL/SLL, disease diagnosis and prognosis evaluation, concomitant diseases, organ function evaluation, treatment selection, and Bruton tyrosine kinase (BTK) inhibitor was used. Results: ①The interviewed physicians stated that the proportion of male patients treated for CLL/SLL is higher than that of females, and the age is mainly concentrated in 61-70 years old. ②Most of the interviewed physicians conducted tests, such as bone marrow biopsies and immunohistochemistry, for patient diagnosis, in addition to the blood test. ③Only 13.7% of the interviewed physicians fully grasped the initial treatment indications recommended by the existing guidelines. ④In terms of cognition of high-risk prognostic factors, physicians' knowledge of unmutated immunoglobulin heavy-chain variable and 11q- is far inferior to that of TP53 mutation and complex karyotype, which are two high-risk prognostic factors, and only 17.1% of the interviewed physicians fully mastered CLL International Prognostic Index scoring system. ⑤Among the first-line treatment strategy, BTK inhibitors are used for different types of patients, and physicians have formed a certain understanding that BTK inhibitors should be preferentially used in patients with high-risk factors and elderly patients, but the actual use of BTK inhibitors in different types of patients is not high (31.6%-46.0%). ⑥BTK inhibitors at a reduced dose in actual clinical treatment were used by 69.0% of the physicians, and 66.8% of the physicians had interrupted the BTK inhibitor for >12 days in actual clinical treatment. The use of BTK inhibitors is reduced or interrupted mainly because of adverse reactions, such as atrial fibrillation, severe bone marrow suppression, hemorrhage, and pulmonary infection, as well as patients' payment capacity and effective disease progression control. ⑦Some differences were found in the perceptions and behaviors of hematologists and oncologists regarding the prognostic assessment of CLL/SLL, the choice of treatment options, the clinical use of BTK inhibitors, etc. Conclusion: At present, a gap remains between the diagnosis and treatment of CLL/SLL among Chinese physicians compared with the recommendations in the guidelines regarding the diagnostic criteria, treatment indications, prognosis assessment, accompanying disease assessment, treatment strategy selection, and rational BTK inhibitor use, especially the proportion of dose reduction or BTK inhibitor discontinuation due to high adverse events.
Female ; Humans ; Male ; Aged ; Middle Aged ; Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy* ; Prognosis ; Lymphoma, B-Cell ; Immunohistochemistry ; Immunoglobulin Heavy Chains/therapeutic use*

OBJECTIVE: To assess the practical and health economical values of non-invasive prenatal test (NIPT) in Changsha Municipal Public Welfare Program. METHODS: A retrospective analysis was carried out on 149 165 women undergoing NIPT test from April 9, 2018 to December 31, 2019. For pregnant women with high risks, invasive prenatal diagnosis and follow-up of pregnancy outcome were conducted. The cost-benefit of NIPT for Down syndrome was analyzed. RESULTS: NIPT was carried out for 149 165 pregnant women and succeeded in 148 749 cases (99.72%), for which outcome were available in 148 538 (99.86%). 90% of pregnant women from the region accepted the screening with NIPT. 415 (0.27%) were diagnosed as high risk. Among these, 381 (91.81%) accepted amniocentesis, which led to the diagnosis of 212 cases of trisomy 21 (PPV=85.14%), 41 cases with trisomy 18 (PPV=48.81%) and 10 cases with trisomy 13 (PPV=20.83%). The sensitivity and specificity of NIPT for trisomy 21, trisomy 18 and trisomy 13 were (97.70%, 99.98%), (97.62%, 9.97%) and (100%, 99.97%), respectively. In addition, 213 and 30 cases were diagnosed with sex chromosomal aneuploidies (PPV=46.2%) and other autosomal anomalies (PPV=16.57%), respectively. For Down syndrome screening, the cost and benefit of the project was 120.79 million yuan and 1,056.95 million yuan, respectively. The cost-benefit ratio was 1: 8.75, and safety index was 0.0035. CONCLUSION NIPT is a highly accurate screening test for trisomy 21, which was followed by trisomy 18 and sex chromosomal aneuploidies, while it was less accurate for other autosomal aneuploidies. The application of NIPT screening has a high health economical value.
Aneuploidy ; Cost-Benefit Analysis ; Female ; Humans ; Noninvasive Prenatal Testing ; Pregnancy ; Retrospective Studies ; Trisomy 18 Syndrome/genetics*

Objective:To analysis the application value of rigid ureteroscope combined with holmium laser in diagnosis and treatment of complicated hepatolithiasis guided by three-dimensional visualization technology.Methods:50 patients with complex hepatolithiasis treated in Hunan People′s Hospital from October 2016 to March 2019 were selected as the study subjects. They were divided into observation group and control group by simple random method. 20 cases underwent rigid ureteroscope combined with holmium laser under the guidance of three-dimensional visualization technology were taken as observation group, 30 cases underwent rigid ureteroscope combined with holmium laser by traditional imaging diagnosis were taken as control group. The differences between the two groups in operation time, intraoperative bleeding volume, stone residual rate, postoperative hospital stay and postoperative complications were statistically analyzed.Results:The residual rate of calculi in observation group was 10% (2/20), while it was 40% (12/30) in control group; the amount of bleeding during operation in the observation group was (170.9±18.0)ml, and it was (371.6±37.0)ml in the control group; the operation time of observation group was (179.0±14.3)minutes, and it was (340.2±24.3)minutes in the control group; the postoperative hospital stay of observation group was (8.3±1.5)days, and it was (10.1±1.8)days in the control group; postoperative biliary hemorrhage occurred in 1 cases of the observation group, biliary tract leakage occurred in 2 cases, postoperative biliary hemorrhage occurred in 3 cases of the control group, biliary tract leakage occurred in 4 cases.Conclusions:Rigid ureteroscope combined with holmium laser guided by three-dimensional visualization technology can further improve the clinical efficacy in the diagnosis and treatment of complex hepatolithiasis. which is worthy of clinical application.

Objective: “Food addiction” may be one of the drivers of the obesity epidemic. Bariatric surgery-induced weight loss can significantly alleviate food addiction in overweight or obese people. Appetite regulation is part of the feedback control system for energy balance. The purpose of this study was to investigate the effects of mobile application-based dietary intervention on weight-loss and food addiction in overweight and obese adults. Methods: A total of 101 overweight or obese people aged over 18 years, who were admitted to the obese multidisciplinary clinic of Ningbo First Hospital from August 2015 to January 2018 were enrolled. All subjects received health education and dietary guidance, and submitted their diet log through the weight management application of their smartphone. Over 12 weeks, a dietitian guided and corrected the subjects who did not meet the diet standards. Interviews, physical examinations, laboratory tests, and the Yale Food Addiction Scale Questionnaire survey were administered before and after the intervention (12 weeks) comparing subjects’ weight, food addiction symptom count, and the proportion of food addiction before and after intervention. Statistical analysis of body composition measurements, blood biochemical parameters, and symptom count scores was performed using paired data t-test, McNemar chi-square test, and Fisher’s exact test. Results: A total of 101 overweight and obese subjects were enrolled, including 31 males and 70 females, with an average age of (30.4±7.3) years, mean body mass index of (32.76±4.46) kg/m², and average body weight of (89.95±17.12) kg. The proportion of food addiction was 26.73%. After 12 weeks of dietary intervention with the mobile application, the number of people with food addiction decreased from 27 to 14, the proportion of food addiction decreased by 12.87%, the proportion of symptom counts ≥3 decreased from 41.58% to 19.80%.（χ²=5.17， 11.26, all P <0.01), and the symptom count decreased from 2.25 ±1.61 to 1.50±1.31 (t=3.64, P<0.001). Simultaneously, body weight, BMI, and waist circumference decreased by (6.54±1.03) kg, (2.35±0.36) kg/m², and (6.50±0.86) cm (t=6.36, 5.62 and 3.78, all P<0.001), respectively, compared with those before the intervention. Metabolic indicators such as fasting glucose, insulin resistance index, and LDL-C cholesterol also significantly improved, with a decrease of (0.38±0.10) mmol/L, 1.83±0.46, (0.22±0.75) mmol/L (t=3.67, 3.59, 2.97, all P<0.01). Conclusion The smartphone application-based dietary intervention can effectively improve blood glucose and lipid levels in overweight and obese people, reduce visceral fat accumulation and reduce insulin resistance, and improve the food addiction status of overweight and obese people.

Objective: To explore the feasibility of applying Omaha system theory to patients with coronary heart disease (CHD) through comparative analysis of nursing description. Methods: Using content extraction analysis method, the nursing records, nursing plans and nursing measures of discharged patients with CHD were retrieved from the medical records, and then the conceptual consistency of the extracted records and the problem classification system and intervention measures in the Omaha system were evaluated by cross mapping method. Results: A total of 2 609 nursing problems and intervention measures were extracted from the medical records of 68 patients with CHD. Among them, 1 844 (70.68%) records were labeled as "perfect fit", 608 records (23.30%) as "partial fit", and 157 (6.02%) recordsas "not fit at all". The total fit rate was 93.98% (perfect fit and partial fit). The most frequently reported problems were in physiological domain, followed by health-related behaviors domain, psychosocial domain and environmental domain. The nursing interventions extracted accounted for 26.67% (1 968 sentences) of directions and l00.00% (4 kinds) of categories in the intervention scheme of Omaha system. Conclusions The conceptual congruence between the medical records of patients with CHD and the Omaha System is quite high. It can help to improve nursing problems of patients of CHD in health-related behavioral domain, psychosocial domain and environmental domain, and can be applied to such patients after appropriate adjustment, so as to help clinical nursing staff to provide specialized and all-round guidance for patients with CHD.

A new isobenzofuranone derivative was isolated from Chaenomeles sinensis by using various chromatographic techniques,including silica gel,Sephadex LH-20,MCI-gel resin and RP-HPLC. This compound was determined as 2,2-dimethyl-5-( 2-oxopropyl)-2 H-furo[3,4-h]chromen-7( 9 H)-one( 1) by NMR,MS,IR and UV spectra,and was also evaluated for its antibacterial activity. The results showed that it showed prominent antibacterial activity with MIC90 value of( 53. 7±4. 5) mg·L-1 for methicillin resistant Staphylococcus aureus( MRSA) strain. This value is close to that of levofloxacin [with MIC90 value( 50. 2± 4. 2) mg·L-1].
Anti-Bacterial Agents ; isolation & purification ; pharmacology ; Benzofurans ; isolation & purification ; pharmacology ; Chromatography, High Pressure Liquid ; Methicillin-Resistant Staphylococcus aureus ; drug effects ; Microbial Sensitivity Tests ; Phytochemicals ; isolation & purification ; pharmacology ; Rosaceae ; chemistry

Objective To investigate the difference between mammary gland tissues and breast cancer tissues.Methods Monoclonal antibodies against Mam-A immunized epitopes were screened for immunohistochemical staining of normal breast tissues and breast cancer tissues.The average optical density was used as an index to identify the quantitative data by computer-aided technology to screen epitope-specific antibodies with significant difference in staining characteristics between two types of tissues.Furthermore the feasibility and effectiveness of breast cancer diagnosis were evaluated.Results Four anti-Mam-A epitope-specific monoclonal antibodies,mAb1152,mAb11617,mAb995 and mAb656,were obtained.Immunohistochemical staining showed that the average density of mAb1152,mAb11617 and mAb995 was significantly different between the two types of tissues.The difference was significant between normal breast tissues and breast cancer tissues under the same conditions.The results showed that mAb11617 was better than mAb1152 and mAb995.At the best working point,mAb11617 was the best,the specificity was 90％ and the sensitivity was 59.62％.Further analysis showed that the sensitivity of mAb11617 combined with mAb995 in the diagnosis of in situ breast cancer was 81.48％ and the specificity was 90％,which was of great diagnostic significance.Conclusion There is significant difference between breast tissues and breast cancer tissues in Mam-A protein immunological activity or expression.This difference,which can be recognized by the specific antibody staining and computer aided technology,is of important diagnostic value.

Objective:To investigate the effects of bone morphogenetic protein 2(BMP-2)expression in the related periodontal tissue on bone remodeling under different distracting force during rapid tooth movement by resistance reduction and distraction. Methods:1 2 Beagle dogs were randomly divided into 4 groups as follows:5 d distraction,1 5 d distraction,1 5 d distraction and 1 0 d retaining and 1 5 d distraction and 90 d retaining.4 4 were distalized.6 teeth in each group were randomly assigned to re-sistance and distracting method,resistance and conventional method and conventional method,and there were 2 teeth in each group.Moving teeth models were prepared regularly.BMP-2 expression was examined by immunohistochemistry.Results:The BMP-2 positive expression of the 3 groups of different distraction schedule showed similar distribution area,and it reached peak at the end of 1 5-day distration,but the group of resistance and distracting method showed the maximum peak(P <0.05)and maximum tooth movement(P <0.01 ).In different stages of distraction,the positive expression in the group of resistance reduc-tion and conventional method was higher than in the group of conventional method but lower than the group of resistance reduction and extraction method(P <0.05).There was no significant difference in BMP-2 positive expression among 3 groups when retai-ning was 90 d(P >0.05).Conclusion:Resistance reduction with sustained strong distracting force can significantly increased the positive expression of BMP-2 and effectively accelerate new bone formation in periodontal tissue.