Objective:To analyze the clinical characteristics of adult abdominal migraine (AM), and improve the understanding and the accuracy of diagnosis of this disease.Methods:A case of adult AM diagnosed in the First Affiliated Hospital of Zhengzhou University in October 2019 was reported, and patients diagnosed with AM in the medical literature from January 2004 to May 2020 were searched and summarized.Results:A total of 634 articles were retrieved, among which 14 articles reported 17 adult AM patients,totally 18 adult AM patients (11 females),including the case diagnosed in the First Affiliated Hospital of Zhengzhou University. Only two cases were diagnosed within one year after the onset, and the other cases were diagnosed several years later, of which the longest diagnostic delay was 37 years. The location and nature of abdominal pain were diverse. The median frequency of episodes was 2.5 times per month. Sixteen patients had a duration of 2-72 hours per attack, and the longest one lasted for four days. Fourteen patients had nausea, 13 had vomiting, and seven had headache. Fifteen patients had a personal or family history of migraine. Sixteen patients′ episodes were separated by weeks to months. Because nonsteroidal anti-inflammatory drugs were not beneficial to adults with AM, abortive triptan therapy was recommended and anesthetics were considered when necessary. All patients responded to prophylactic migraine therapies.Conclusions:Adult AM is a rare disease. Patients with unexplained, recurrent and moderate to severe abdominal pain, combined with headache, a personal or family history of migraine, are highly suspected of having AM. Early diagnosis and prophylactic migraine therapies could contribute to good prognosis.

The purpose of this paper is to clarify the structure-activity relationship of anti-tumor activity of diosgenin derivatives in vitro. Study has found that diosgenin can inhibit the reproduction of tumor cells by inducing apoptosis and the main target spot of this effect is Bcl-2. Based on the characteristics of pharmacophoric points' of the three-dimensional pharmacophore for Bcl-2 inhibitors, we have docked lots of diosgenin derivatives with Bcl-2, then synthesized 31 compounds of them, finally assessed the anti-tumor activity of the diosgenin derivatives in vitro against A375, A549, HepG-2 and K562. Preliminary studies of SAR have indicated that the aliphatic esters, and aromatic esters of diosgenin without F ring have no anti-tumor activity in vitro. The triazole bromides of diosgenin all achieve fairly good anti-tumor activity in vitro, and those with larger hydrophobic group have the better activity. The stronger is the hydrogen bonding interaction and dipole-dipole interaction of the heterocyclic of diosgenin and diosgenin without F ring and the acid ester of diosgenin without F ring, the better is the activity of derivatives.

Objective:To investigate the current status of pertussis laboratory diagnosis and confirmed pertussis cases reporting in Shaanxi Province, and evaluate the quality of case reports.Methods:The information of confirmed pertussis cases reported in Shaanxi Province from January to July 2022 was collected through the China Disease Control and Prevention Information System. The laboratory diagnostic methods and pertussis vaccine immunization history of confirmed cases were investigated, and the descriptive epidemiological method was used for statistical description.Results:Of the 164 confirmed cases of pertussis reported from January to July 2022, two were not tested in the laboratory and 162 were tested in the laboratory. The proportions of different detection methods were 1.85% (3/162) of isolation and culture, 31.48% (51/162) of serum antibody IgG, 14.20% (23/162) of serum antibody IgM, 49.38% (80/162) of serum antibody PCR and 3.09% (5/162) of serum antibody IgM+ PCR. Among the 79 serological positive cases, 12 cases (15.19%)had no history of pertussis immunization, and 15 cases (18.99%), 11 cases (13.92%) and 41 cases (51.90%) had the time interval from vaccination to detection of <1 year, 1-3 years and >3 years, respectively. Based on the analysis of laboratory testing methods and vaccination history, 38 cases were misdiagnosed/misreported among 164 cases, with a misdiagnosis or misreported rate of 23.17%. There were 17, 12 and 9 cases of misdiagnosis/misreport in 0-2 years old group, 3-6 years old group and≥7 years old group, and the misdiagnosis or misreported rates were 27.42%(17/62), 26.67%(12/45) and 15.79%(9/57), respectively.Conclusions:The selection of pertussis laboratory testing methods in some medical institutions in Shaanxi Province is incorrect, which leads to a certain proportion of misdiagnosis or misreport, and it is necessary to further strengthen the training and standardization.