Objective To investigate the laparoscopie resection of the adrenal tumor effects and clinical experience. Methods Among the 24 cases of Laparoscopic adrenalectomy tumors, there were 8 cases of adrenal adenoma, 7 cases of pheochromoeytoma and 9 eases primary aldosteronism. Results One ease was transit to open operation, the other 23 were successful,each surgerical time was 40～130 min with an average of 98 rain. Hemorrhage was 50～300 mL, 140 ml average, no blood transfusion. It was 1～2 d after sur- gery to remove drainage tubes, and could take some activities and have fresh flow in the second day. The pa- tients didn't appear complications and discharged after 5～7 d. Follow-up of 6～24 months, there was no recurrence and long-term complications. Conclusion Laparoscopic adrenalectomy has the advantages of minor trauma surgery, less bleeding, good demonstrating, convenient operation, fewer complications and quick recovery.

Objective:To investigate prevalence and related factors of overweight and obesity in children aged 6-12 years in Yiwu of Zhejiang Province.Methods:The stratified sampling method was used to perform physical examination and questionnaire survey among 500 children aged 6-12 years from five schools in Yiwu (166 from city-level schools, 168 from district-level schools, and 166 from village-level schools). The number of children at each year of 6-12 years was 54 (10.8%), 66 (13.2%), 70 (14.0%), 69 (13.8%), 83 (16.6%), 79 (15.8%) and 79 (15.9%). The factors that affect the prevalence of overweight and obesity were analyzed.Results:Among 500 school-age children, the detection rates of overweight and obesity were 12.8% (64/500) and 11.6% (58/500), respectively. There were significant differences in the detection rates of overweight and obesity between male and female children (16.1%/9.0%, 15.4%/7.3%), among children whose fathers received different levels of education (primary school and below/junior high school/senior high school and above) (25.0%/13.1%/9.2%, 22.9%/11.2%/9.2%), among children whose mothers received different levels of education (primary school and below/junior high school/senior high school and above) (23.5%/12.9%/10.1%, 19.6%/13.3%/7.7%), among children living in cities versus villages (18.6%/8.8%, 16.7%/8.1%), among children performing exercise for different lengths of time (< 0.5 hours/0.5-1.0 hours/> 1.0-2.0 hours/> 2.0 hours) (21.2%/14.9%/13.1%/3.6%, 19.2%/13.1%/11.9%/3.6%), among children with different sleep time (< 8 hours/8-10 hours/>10 hours) (16.8%/14.2%/6.3%, 15.9%/12.7%/5.6%), among children taking dessert at different frequencies (< 3 days per week/3-5 days per week/> 5 days per week) (5.6%/10.3%/23.4%, 4.9%/9.4%/21.4%), among children taking sugary or carbonated drinks at different frequencies (< 3 days per week/3-5 days per week/> 5 days per week) (6.5%/11.2%/17.1%, 6.5%/9.4%/16.1%), and among children who took extra meals before bed (< 3 days per week /3-5 days per week /> 5 days per week) (15.8%/9.4%/20.3%, 14.3%/8.5%/19.0%) (overweight: χ2 = 5.61, 8.41, 6.74, 10.48, 17.45, 6.74, 22.43; obesity: χ2 = 7.88, 6.28, 6.58, 8.63, 14.76, 6.74, 20.69, all P < 0.05). Multivariate logistic regression analysis showed that boys, unbalanced diet and extra meals before bed are independent risk factors for overweight and obesity in school-age children (all P < 0.05). Sleep time, exercise time and mother's education were protective factors of overweight and obesity (all P < 0.05). Conclusion:The incidences of overweight and obesity among school-age children aged 6-12 years in Yiwu of Zhejiang province are high, and sex, mother's education level, diet, exercise and sleep are the main influential factors of overweight and obesity.

Objective To investigate the relationship between vWF levels and ADAMTS13 levels of DVT (venous thrombosis) in patients with cervical cancer,and then to evaluate the predictive value of vWF levels and ADAMTS13 levels of cervical cancer patients with DVT. Methods A total of sixty-six patients diagnosed as cervical cancer and treated from June 2015 to June 2016 in Weinan Maternal and Child Health Hospital were enrolled,and their baseline data,pathological type,tumor classification,TNM staging,vWF, ADAMTS13 levels and Autar score were recorded. All patients were followed up for 1 year and the patients with adverse outcomes were defined as poor prognosis group during the follow-up period while the patients whose disease progression free were defined as good prognosis group. Univariate analysis showed that the incidence of venous thrombosis in patients with cervical cancer was affected; Cox proportional hazard model further assessed the impact of all statistically significant factors on the occurrence of venous thrombosis in patients; t test showed the distribution of influential factors between the two groups; ROC curve was used to analyze the sensitivity and specificity of vWF and ADAMTS13 levels in predicting the occurrence of venous thrombosis in cervical cancer patients. Results At the end of the follow-up,among the 66 patients,Six were not followed and 40 had good prognosis without venous thrombosis,which was a good prognosis group; Twenty had poor prognosis,i. e. venous thrombosis,which was a poor prognosis group,including 5 deaths. The poor prognosis rate was 30. 30%. Univariate Cox proportional hazard model results showed that vWF (P＝0. 023, (95%CI: 1. 743－1. 215)) and ADAMTS13 (P＝0. 037,(95%CI: 1. 158－1. 566)) had a significant effect on the patients with venous thrombosis. The levels of vWF (( 0. 535 ± 0. 075) μg/L) and ADAMTS13 ((69. 453±10. 284)%) in good prognosis group were significantly lower than those in poor prognosis group ((0. 592 ± 0. 082 ) μg/L, ( 79. 245 ± 11. 477 )%), and the differences between the two groups were statistically significant (t＝2. 690,3. 345,P＜0. 05). Under ROC curve,the AUC of vWF level was 0. 841,the sensitivity and specificity were 55% and 97. 5% respectively,and that of ADAMTS13 level was 0. 906,the sensitivity and specificity were 85% and 80%,respectively. Conclusion The levels of vWF and ADAMTS13 have a good predictive effect on the occurrence of venous thrombosis in patients with cervical cancer. It is expected to be used as a routine evaluation index to predict the occurrence of venous thrombosis in patients with cervical cancer after treatment.

BACKGROUND: Vaccination has been shown effective in controlling the global coronavirus disease 2019 (COVID-19) pandemic and reducing severe cases. This study was to assess the flare and change in disease activity after COVID-19 vaccination in patients with stable rheumatoid arthritis (RA). METHODS: A prospective cohort of RA patients in remission or with low disease activity was divided into a vaccination group and a non-vaccination group based on their COVID-19 vaccination status. Each of them was examined every 3 to 6 months. In the vaccination group, disease activity was compared before and after vaccination. The rates of flare defined as disease activity scores based on 28-joint count (DAS28) >3.2 with ΔDAS28 ≥0.6 were compared between vaccination and non-vaccination groups. RESULTS: A total of 202 eligible RA patients were enrolled. Of these, 98 patients received no vaccine shot (non-vaccination group), and 104 patients received two doses of vaccine (vaccination group). The median time interval from pre-vaccination visit to the first immunization and from the second dose of vaccine to post-vaccination visit was 67 days and 83 days, respectively. The disease activity scores at pre-vaccination and post-vaccination visits in the vaccination group patients were similar. At enrollment, gender, RA disease course, seropositivity, and disease activity were comparable across the two groups. Flare was observed in five (4.8%) of the vaccination group patients and nine (9.2%) of the non-vaccination group patients at post-vaccination assessment ( P  = 0.221). In terms of safety, 29 (27.9%) patients experienced adverse events (AEs) after vaccination. No serious AEs occurred. CONCLUSIONS COVID-19 vaccinations had no significant effect on disease activity or risk of flare in RA patients in remission or with low disease activity. Patients with stable RA should be encouraged to receive the COVID-19 vaccination.
Humans ; Arthritis, Rheumatoid ; Cohort Studies ; COVID-19/prevention & control* ; COVID-19 Vaccines/adverse effects* ; East Asian People ; Prospective Studies ; Vaccination/adverse effects*

Objective To explore the therapeutic mechanism of Modified Lugen Formula(Phragmitis Rhizoma,Cicadae Periostracum,Batryticatus Bombyx,Lonicerae Japonicae Flos,Glycyrrhiza,Menthae Haplocalycis Herba,Notopterygii Rhizoma et Radix,Puerariae Lobatae Radix,Bupleuri Radix)in treating influenza from the virus-host interaction interface.Methods The phytocompounds were first collected from the HERB database,and then potential active compounds were screened out by Lipinski's rules of five.The targets of active compounds were further predicted through the SwissTargetPrediction platform.Differentially expressed genes(DEGs)were determined from the human H1N1 influenza dataset GSE90732 available in the Gene Expression Omnibus database(GEO).H1N1-Homo sapiens-related protein-protein interactions(PPIs)were gathered from the Pathogen-Host Interaction Search Tool(PHISTO).The above mentioned bioinformatic datasets were integrated.Then a PPI network and a Formula-virus-host interaction network were constructed using Cytoscape.Functional enrichment analyses were performed by using R software.Finally,molecular docking was carried out to evaluate the binding activities between the key compounds and targets.Results A total of 1 252 active compounds,1 415 targets,951 influenza-related DEGs,and 10 142 H1N1-Homo sapiens-related PPIs were obtained.There were 72 intersection targets between the Modified Lugen Formula and influenza.Functional enrichment analyses showed that these targets are closely related to host defense and programmed cell death.The network topological analysis showed that active compounds in the Modified Lugen Formula,such as oleanolic acid,γ-undecalactone,and longispinogenin,regulate viral proteins M2,NA,NS1,and HA and/or the host factors HSP90AA1,NRAS,and ITGB1,thus exert therapeutic effect.Molecular docking results confirmed that these compounds had a good binding ability with the targets.Conclusion Multiple active ingredients in Modified Lugen Formula directly target influenza virus proteins and/or host factors,thereby play an anti-influenza role in multiple dimensions,including inhibiting virus replication,regulating host defense and cell death.This study provides a theoretical basis for further experimental analysis of the action mechanism of the Modified Lugen Formula in treating influenza.