Objective:To investigate the nutritional risk and the incidence of malnutrition in children with recurrent abdominal Henoch Schonlein purpura(HSP), and observe the changes in the incidence of malnutrition after nutritional intervention.Methods:We retrospectively analyzed 90 children diagnosed with recurrent HSP in our hospital from 2017 to 2019.The cases were divided into two groups according to whether nutritional intervention was performed.The cases from January 2017 to May 2018 were chosen as the control group( n=42), and the cases from June 2018 to December 2019 were chosen as the experimental group( n=48). Based on the treatment of the primary disease, the high nutritional risk cases in experimental group were treated with extensively hydrolysed infant formula for nutritional intervention.The children were evaluated for nutritional risk with the STRONGkids nutrition tool.According to the score results, they were divided into high nutritional risk group and medium nutritional risk group.The Z score was used to evaluate malnutrition, and the degree of malnutrition was compared at admission and discharge. Results:Eighty-one children (90.0%) with recurrent abdominal allergic purpura had a high nutritional risk, 9 cases (10.0%)had a medium nutritional risk.There was no significant difference in the incidence of moderate and severe malnutrition between experimental group and control group at admission[39.6% (19/48) vs.40.5% (17/42), P>0.05]. The incidence of moderate and severe malnutrition in control group was higher than that in experimental group at discharge[66.7% (28/42) vs.22.9% (11/48), P<0.05]. Conclusion:In children with recurrent abdominal HSP, due to severe gastrointestinal symptoms and a high incidence of high nutritional risk, nutritional intervention with extensively hydrolysed infant formula can avoid the occurrence or aggravation of iatrogenic malnutrition during hospitalization.

Objective To observe protective and repairing effect of Aorui Gel on esophageal mucosa injury in reflux esophagitis rats. Methods Rat models of reflux esophagitis were established by partial pylori ligation plus cardiomyotomy. Model control group,low-,middle-and high-dose Aorui Gel groups,positive control group,excipient control group and sham operation group were set up. Rats were treated with the corresponding drugs 7 days after operation. After treatment for 14 days,the rats'general state,and macroscopic features and pathological features of esophageal mucosa were compared. Results Macroscopic features and pathological features of esophageal mucosa in Aorui Gel groups differed from those in the model control group,inflammation of esophageal mucosa in Aorui Gel groups was alleviated,and pathological features were relieved and arrived to the normal state. Conclusion Aorui Gel can alleviate esophageal mucosa injury in reflux esophagitis rats,indicating that Aorui Gel has protective and repairing effect on esophageal mucosa injury.

Objective:To explore bromodomain and extra-terminal (BET) inhibition in the regulation of vascular endothelial cells activation and early atherosclerosis formation and its potential molecular mechanisms.Methods:1.Human umbilical vein endothelial cells (HUVEC) and mouse heart endothelial cells (MHEC) were isolated,and tumor necrosis factor α (TNFα) was used to activate in flammatory genes transcription in the presence or absence of JQ1,a specific BET inhibitor.The groups are as follows:(1)Normal control group;(2) TNFα(25 ng/mL)group;(3) TNFα+JQ 1 group.The gene mRNA and protein expression of inflammatory cytokines were measured by both real-time PCR and flow cytometry (FCM).2.LDL receptor-deficient (LDLR-/-) mice were randomly divided into 2 groups:JQ1 group (n=8,JQlintraperitoneal,50 mg/kg,daily) and control group (n=8,DMSO,daily).After 8 weeks feeding with high cholesterol diet,vascular cell adhesion molecule-1 (VCAM-1) expression in aortic arch was measured by immunohistochemistry.The activity of nuclear factor kappa B (NF-κB) signaling was monitored by 5XκB luciferase reporter assay in HEK293.Results:TNFα dramatically induced the mRNA and protein expression of inflammatory genes and JQ 1 significantly downregulated the induction of them (E-selectin,P-selectin,VCAM-1,IL-8)(P＜0.01).Immunohistochemistry detection indicated that JQ1 significantly downregulated the expression of VCAM-1 in aortic arch induced by 8 weeks high cholesterol diet feeding comparing to control group.In addition,BET bromodomain inhibition downregulated TNFα upregulated NF-κB transcriptional activity (P＜0.01).Conclusions:Our study demonstrated that BET bromodomain was involved in NF-κB mediated inflammatory genes expression;inhibition of BET bromodomain suppressed vascular endothelial activation in vitro,and attenuated early atherogenesis in vivo.

Objective: To investigate the public opinion on pharmaceutical service and explore the implementation of pharmaceutical service fee and the prospect of online pharmaceutical service in our country.Methods: Questionnaires which related to pharmaceutical service fee and online pharmaceutical service were distributed to patients and their relatives or friends, and then recycled.The data including the recycling of questionnaires, information of respondents and answers to the questions were statistically analyzed.Results: Totally 63.8% respondents considered pharmaceutical service fee was reasonable and the fee should be borne by the government finance and health care insurance.Totally 85.5% respondents thought launching online pharmaceutical service was necessary, which included online retails of medicine, consultation, medication guidance, decoction of Chinese traditional medicines, medicine delivery and so on, especially pharmacy consultation.Conclusion: Outpatients have high demands of pharmaceutical service and most of them accept online pharmaceutical service with different understandings.Pharmaceutical service fee is an inevitable trend in the development of pharmaceutical industry.More publicity and guidance should be given to improve people's acceptance of pharmaceutical service and relevant cost.Relevant departments should take full advantages of Internet and provide diversified pharmaceutical service.

Objective:To analyze the changes of cerebral perfusion level and its relationship with cognitive impairment in patients with first anterior circulation acute ischemic post-stroke cognitive impairment.Methods:From March 2018 to March 2020, 70 patients with acute ischemic stroke in the first anterior circulation who were treated in the Department of Neurology of Kailuan General Hospital affiliated to North China University of Technology and met the inclusion and exclusion criteria were retrospectively analyzed.The mini-mental state examination was used to divide 36 cases of post-stroke cognitive impairment group and 34 cases of post-stroke cognitive impairment group.All the selected patients were examined by computed tomography(CT) and diffusion-weighted MR imaging(MRI-DWI) to determine the diagnosis and distribution of lesions; detection of cerebral artery stenosis by MRA; apply 3D pseudo-continuous arterial spin labeling(3D-pCASL) perfusion imaging, set the post label delay 1.5 s and 2.5 s to detect cerebral perfusion level.Results:(1)There was no statistical significance between the two groups in the comparison of basic clinical data.(all P>0.05). (2) The proportion of patients with middle cerebral artery, anterior cerebral artery and internal carotid artery ≥1 or ≥2 moderate and severe stenosis / occlusion on the focal side in the post-stroke cognitive impairment group (91.67%(33/36), 33.33%(12/36)) was higher than that in the post-stroke non-cognitive impairment group (23.53%(8/34), 8.82%(3/34)); the proportion of patients with moderate and severe stenosis / occlusion of MCA and ICA on the focal side in the post-stroke cognitive impairment group (69.44%(25/36), 44.44%(16/36)) was higher than that in the post-stroke cognitive impairment group (14.71%(5/34), 11.76%(4/34)), and the difference was statistically significant(χ 2 values were 33.455, 6.239, 21.394, 9.150, all P<0.05). (3) The proportion of patients with ≥ 2 cerebral infarction lesions in the post-stroke cognitive impairment group (61.1%(22/36))was higher than that in the post-stroke cognitive impairment group (38.03%(27/71))than that in the non-stroke group (20.6%(7/34), 19.05%(8/42)), and the difference was statistically significant(χ 2=11.833, 4.447, all P<0.05). PLD 2.5 s, the CBF value of frontal lobe infarction in post-stroke cognitive impairment group((31.516±8.333) mL/(100 g·min)) was lower than that in post-stroke non-cognitive impairment group((45.442±8.281) mL/(100 g·min)), the difference was statistically significant( t=3.835, P<0.05). Correlation analysis showed that the CBF value of PLD 2.5 s frontal infarction lesion was positively correlated with MMSE score( r=0.738, P<0.05). (4) The proportion of patients with ≥ 1 or ≥ 2 hypoperfusion areas (frontal lobe, temporal lobe, parietal lobe) on the focal side of PLD 1.5 s and 2.5 s after stroke (88.89%(32/36), 88.89%(32/36), 77.78%(28/36), 66.67%(24/36)) were higher than those without cognitive impairment after stroke (67.65%(23/34), 8.82%(3/34), 29.41%(10/34), 0), the difference was statistically significant(χ 2 values were 4.686, 44.837, 16.483, 34.493, all P<0.05). At PLD 1.5 s, CBF values of frontal lobe and parietal lobe in cerebral hypoperfusion area ((20.260±5.266) mL/(100 g·min), (17.664±3.947) mL/(100 g·min)) in patients with cognitive impairment after stroke were lower than those in patients without cognitive impairment ((33.442±10.563) mL/(100 g·min), (28.071±6.913) mL/(100 g·min)), the difference was statistically significant( t values were 3.392, 6.225, all P<0.05), at PLD 2.5 s, the CBF value after compensatory perfusion of frontal lobe, parietal lobe and temporal lobe in the post-stroke cognitive impairment group ((37.732±8.355) mL/(100 g·min), (32.942±6.459) mL/(100 g·min), (39.282±7.443) mL/(100 g·min)) was lower than that in the non cognitive impairment Group ((57.189±9.965) mL/(100 g·min), (52.415±7.017) mL/(100 g·min), (49.258±8.912) mL/(100 g·min)), the difference was statistically significant( t values were 5.443, 10.227, 2.950, all P<0.05). Correlation analysis found that the CBF value of the frontal lobe and parietal lobe of the PLD 1.5 s lesion area and the CBF value of the PLD 2.5 s hypoperfusion brain area after the perfusion of the frontal lobe, parietal lobe, and temporal lobe were positively correlated with the MMSE score( r values were 0.693, 0.675, 0.823, 0.799, 0.545, all P<0.05). Conclusion:Patients with first anterior circulation acute ischemic post-stroke cognitive impairment often have extensive hypoperfusion in the peripheral cerebral region, the occurrence of cognitive impairment after the first anterior circulation acute ischemic post-stroke cognitive impairment is related to the decrease of the perfusion level of the infarct lesion and the brain area around the lesion.

OBJECTIVE:To provide reference for the better development of intemet pharmaceutical service of hospital pharmacists.METHODS:The questionnaire investigation was carried out on the cognition of pharmacists to intemet pharmaceutical service in 9 third grade class A hospitals.The survey data were analyzed statistically.RESULTS:A total of 600 questionnaires were distributed and 527 questionnaires were collected with recovery rate of 87.8％.Among them,there were 499 valid questionnaires with effective rate of 94.7％.The most selected internet pharmaceutical service contents were medication consultation (94.4％) and medication education (91.6％).93.0％ considered that intemet pharmaceutical service were worthy or very worthy of promotion.The most concerned issues about intemet pharmaceutical service were technical problems (58.5％) and legal liability (55.9％).57.1％ of the surveyed pharmacists considered that they were totally or possibly capable of performing interact pharmaceutical care;37.9％ didn' t get in touch with intemet pharmaceutical care and were not clear about it.The most important qualifications of pharmacists who provided intemet pharmaceutical service were rank of pharmacist's title (67.9％) and working experience (67.7％).It was considered that the most effective measures to ensure the quality of intemet pharmaceutical care were regular pharmaceutical service training (74.3％) and proportionally sampling the quality of pharmaceutical service consultation (67.5％).CONCLUSIONS:Internet pharmaceutical service may become a new direction of the development of pharmaceutical service under new medical reform.The development of intemet pharmaceutical service requires perfect laws and regulations,and pharmacist team with high professional level.

Objective:To observe the effect of parecoxib on neutrophil-to-lymphocyte ratio (NLR)after the modified radical mastectomy,and to explore its potential mechanisms for inhibition ofperioperative inflammation.Methods:A total of 40 breast cancer patients undergone the modified radical mastectomy were randomly divided into a parecoxib group (n=20) and a control group (n=20).The parecoxib group received intravenous parecoxib (40 mg,5 mL) during general anesthesia induction,post-operative day 1 and day 2;the control group received intravenous normal saline (5 mL) at the corresponding time points.Their peripheral bloods were collected for routine test in the morning of the surgery day (T1),and Day 1 (T2),Day 3 (T3) and Day7 (T4) after the surgery, and NLRwas calculated.Results:Compared with T1,NLR in the control group at T2 and T3 was significantly increased (P＜0.05),but not at T4 (P＞0.05);NLR in the parecoxib group was sharply increased at T2 (P＜0.01),and returned to preoperative levels at T3 and T4 (P＞0.05).NLR in the parecoxib group was significantly lower than that in the control group at T2 (P＜0.05),but there were no significant difference between the two groups at other time points (P＞0.05).Conclusion:Parecoxib can restrain the inflammatory responses and improve immune function of the breast cancer patients by suppressing the elevation of NLR after the modified radical mastectomy,which is expected to improve the prognosis of the breast cancer patients.

The Assistive Devices Program was funded and supported sufficiently, and improved the qulity of life of the disabled persons significantly (scores of SF-36). Most disabled users were satisfied with the Program. Some problems, such as inefficient way of working,undefined screening standards, lack of integrity of the assessment content, limited categories of assistive devices and home modifications,unavailable follow-up services, needed to be improved.

OBJECTIVE: To explore the genetic basis for a fetus suspected for congenital nephrotic syndrome of Finland (CNF). METHODS: Genomic DNA was extracted from peripheral and umbilical cord blood samples derived from both parents and the fetus. Potential variants were detected by using next-generation sequencing. Suspected variants were confirmed by Sanger sequencing. RESULTS: The fetus was found to carry compound heterozygous variants c.1440+1G>A and c.925G>T of the NPHS1 gene, which were respectively inherited from its mother and father. CONCLUSION Identification of the compound heterozygous NPHS1 variants has enabled diagnosis of CNF in the fetus and genetic counseling for the affected family.
Female ; Fetus ; Finland ; Heterozygote ; Humans ; Membrane Proteins ; genetics ; Nephrotic Syndrome ; congenital ; diagnosis ; Pregnancy ; Prenatal Diagnosis

Objective:To investigate the clinical manifestations, diagnosis, and treatment methods of Lophomonas blattarum infection combined with paragonimiasis in children, and improve pediatricians' understanding of the disease. Methods:The clinical data of two children with Lophomonas blattarum infection combined with paragonimiasis who received treatment in the Department of Pediatrics of The First People's Hospital of Yunnan Province were retrospectively analyzed. Children's clinical manifestation and diagnosis and treatment were analyzed. Relative literature was reviewed. Results:Case 1 had the onset of gastrointestinal symptoms. Case 2 had the onset of headache and liver dysfunction. Routine blood tests showed elevated eosinophils two cases and sputum examination results revealed the presence of live eggs of Lophomonas blattarum and paragonimiasis in two cases. Fecal roundworm eggs were also detected in case 1. Follow-up results showed that both cases were cured after treatment with metronidazole injection and praziquantel tablets. Conclusion:Lophomonas blattarum infection is a relatively rare opportunistic infection. Paragonimiasis is a natural parasitic disease that affects both humans and animals. Mixed infection of the two pathogens is rare. We hope that the findings from this paper will broaden clinical physicians' thoughts and guide clinical practice.