Objective To explore the effects of indoor environmental factors on the respiratory symptoms in children aged 4-17 years. Methods A cross-sectional survey of indoor environmental factors related respiratory symptoms in 6 551 children and teenagers aged 4-17 years was conducted throughout urban area of Shanghai in 2007. The information was obtained on certain aspects of the family socioeconomic status (SES) and other confounding factors,and the associations between indoor environmental factors and respiratory symptoms were analyzed. Results After controlling confounders,parent smoking,the house or the classroom nearby roads (

Objective To investigate the clinical value of procalcitonin (PCT) levels in bacteria identification in intensive care unit (ICU) patients with bloodstream infection.Methods There were 540 cases of patients with bloodstream infection in our ICU between December 2007 and December 2013.The PCT levels and bacteria were identified.The application effectiveness of PCT levels in the bacteria identification was studied.Results The G+ bacteria infection rate was 49.63％ (268/540),G-bacteria infection rate was 38.52％ (208/540),and the fungal infection rate was 11.85％ (64/540).The patients of G-bacteria had significant difference with G + bacteria and fungal infection (P ＜ 0.05).The PCT average and positive rate of G-bacteria were significantly higher than G + bacteria and fungi group (P ＜ 0.05),respectively.G+ bacteria and fungi infection did not have significant difference (P ＞ 0.05).When PCT ＞ 2.04 ng/ml,the sensitivity and specificity that applying serum PCT level to identify the between G-and G+ bacteria were 82.18％ and 76.09％,respectively.When PCT ＞3.16 ng/ml,the sensitivity and specificity that applying serum PCT level to identify the between G-and fungus bacteria were 59.42％ and 65.73％,respectively.Conclusions The identification between G-bacteria and G + bacteria,fungi with applying PCT level in bloodstream infections had high accuracy.When the PCT levels was greater than 2.04 ng/ml,the occurrence of G-bacteria was greater risk of infection.The accuracy of PCT level identifying the G + bacteria and fungi was poor.

ObjectiveTo determine the genotypes of human papillomavirus(HPV) and to estimate their correlations with recurrence of perianal and anal condyloma acuminatum(CA) among men who have sex with men(MSM) in Shanghai.MethodsTissue specimens were obtained from the lesions of perianal or anal CA in 57 MSM.Flow-through hybridization and gene chip were used to determine the genotypes of HPV in these specimens.Follow-up was carried out to observe the recurrence of CA in these patients after CO2 laser treatment.ResultsOf the 57 specimens,56(98.2％) were positive for HPV,and a total of 11 HPV subtypes were identified.The predominant genotypes were HPV 11 (42 cases,75％ ) and HPV 6 (30 cases,53.6％),sequentially followed by HPV 16 (8 cases,14.3％),HPV 18 (4 cases,7.1％),HPV 33 (2 cases,3.6％),HPV 59(2 cases,3.6％),HPV cp8304 (2 cases,3.6％),HPV 31 (1 case,1.8％) and HPV 35 (1 case,1.8％).Of the HPV-positive specimens,64.3％(36/56) harbored low risk HPV types(11 and/or 6),and 35.7 ％ (20/56) harbored high risk HPV types.Among the 20 specimens positive for high risk HPV,17(85％) harbored both low risk- and high risk-HPV genotypes.During the 6-month follow-up after CO2 laser treatment,recurrence was observed in 95％ of patients with high risk HPV and 66.7％ of patients with low risk HPV (P ＜ 0.05).ConclusionsAmong MSM with perianal and anal CA in Shanghai,the predominant genotypes of HPV are low risk types 11 and 6; high risk HPV infection is usually complicated by low risk HPV infection; the recurrence of CA is higher in patients with high risk HPV than in those with low risk HPV.

Objective To investigate the mechanism underlying the WNK4 kinasemediated inhibitory effect on BK channel. Methods Cos-7 cells were cotransfected with BK in combination with either CD4 (control group) or wild type WNK4 (WNK4-WT).Immunostaining and confocal microscopy,chemiluminescence,Western blotting analysis were then employed to determine the BK localization in cells,BK surface expression and total protein level,respectively.To further investigate whether the reduction of BK protein expression is due to an increase in degradation through a lysosomal pathway,BK protein level was determined after treated with bafilomycin A1(Baf A1),a proton pump inhibitor affecting lysosomal degradation. Results Immunostaining and confocal microscopic study showed that BK was localized both in plasma membrane and cytosol in the control group.After cells transfected with WNK4-WT,BK expression was markedly reduced.Chemiluminescent assay found that BK surface expression level was 299.9±18.6 in the control group,whereas it was significantly reduced (148.4±13.7,P＜0.01) in the WNK4-WT group.Western blotting analysis showed that total BK protein level was markedly reduced in the presence of WNK4-WT compared to the control group.WNK4-WT was shown to significantly reduce the BK total protein level (42.3％±15.2％) compared to the control group (100％) (P＜0.01).When the cells was treated with Bafilomycin A1 (Baf A1,0.5 μmol/L),WNK4-mediated reduction in BK protein was reversed (82.2％±12.1％,P＜0.05). Conclusions WNK4 inhibits total and surface protein expression of BK in Cos-7 cells whick is likely due to an increase in BK degradation through a lysosomal pathway.

To investigate the prediction of serum amyloid beta protein level on hemorrhage transformation in acute cerebral infarction and its related factors. Methods A total of 114 patients with acute cerebral infarction were selected from March 2021 to October 2021，and divided into HT group （41 cases） and control group （73 cases） according to whether the hemorrhage was transformed. The general basic information and serum amyloid beta protein level after admission were recorded，and the risk factors of hemorrhage transformation after cerebral infarction were analyzed. Results There were no significant differences in age，gender，history of atrial fibrillation，Hyc and LDL between the two groups （P> 0.05）.There were statistically significant differences in serum Aβ level，history of hypertension，history of diabetes，uric acid level and NHISS score（≥10 points） between the two groups （P< 0.05）. Binary Logistic regression analysis showed that history of hypertension，serum uric acid level，NHISS score （≥10 points） and serum Aβ level were nonrisk factors for hemorrhage transformation of thrombolysis acute cerebral infarction. The difference of Aβ level between asymptomatic group and symptomatic group in HT group was statistically significant（P<0.05）. ROC curve analysis showed that the area under the curve of serum Aβ for predicting the risk of hemorrhage transformation after acute cerebral infarction was 0.909，the optimal cutoff value was 166.84ng/ml，the sensitivity was 87.8%，and the specificity was 79.5%. The results of appeal analysis suggest that serum Aβ level can also predict the severity of hemorrhage after transformation. Conclusion History of hypertension，high NHISS score after admission，elevated uric acid level and serum Aβ level in patients with acute cerebral infarction are the influencing factors of hemorrhage transformation.

Objective:To explore the effect of attentional bias training on the attentional bias, psychological craving and relapse rate of alcohol dependent patients during rehabilitation.Methods:A randomized controlled trial was used to select 90 alcohol-dependent patients and randomly divide them into an intervention group and a control group. The alcohol cue pictures and neutral pictures were imported into E-Prime software at a ratio of 1∶1.The patients in the two groups were trained for eight times with attentional bias and without attentional bias by point delection paradigm. After each training, the software automatically records the response time and correct rate of the cue pictures and neutral pictures, and before intervention(T0), after 4 interventions(T4), and after 8 interventions(T8), the alcohol craving score was assessed by visual analogue scale and the relapse situation was followed up 1 month after the intervention. SPSS 24.0 software was used for statistical analysis.Repeat measure ANOVA, χ2 test and t-test were used to compare the response time, accuracy and psychological craving of the two groups. Results:Repeated measurement analysis of variance showed that there were interaction between group and time in cue-map response time, line chart accuracy and psychological craving score of the two groups ( F=5.218, 6.939, 147.14, all P<0.01). Simple effect analysis showed that there was no significant difference in cue pictures response time, cue pictures accuracy and psychological craving score between the intervention group and the control group at T0(all P>0.05), but there was significant difference at T4 and T8 (all P<0.05), and there was significant difference in neutral pictures reaction only at T8 ( P<0.05). The comparison between two groups showed that the intervention group showed a downward trend in cue pictures response, T4 and T8 were lower than T0, with statistical difference (both P<0.001), while there was no difference in the control group. In the intervention group, the correct rate of cue pictures increased, T4 and T8 were higher than T0, and there were statistical differences (both P<0.001), while there was no difference in the control group( P>0.05). The psychological craving scores of both the intervention group and the control group showed a downward trend, T4 and T8 were lower than T0, there were statistical differences (both P<0.001), but the difference between T4 and T8 in the control group remained unchanged. One month after the end of the intervention, the difference in the rate of relapse between the intervention group and the control group was marginal (11.10%, 26.70%, P=0.059). The total number of days of abstinence in the intervention group was longer than that in the control group ((28.33±4.99)d, (26.47±6.66)d, P=0.010). Conclusion:Attentional bias training can improve the mental craving and attentional bias of alcohol-dependent patients during the rehabilitation period, and the relapse rate decreased one month after the intervention.

Objective:To explore the effect of positive psychology theory on recovering patients with alcohol dependence.Methods:According to the order of admission, 60 patients with alcohol dependence in convalescence were divided into intervention group and control group, 30 cases each. The control group received only routine treatment for alcohol dependence. In addition to conventional treatment, the intervention group also underwent positive psychological treatment for 5 weeks to evaluate the changes in social support, negative automatic thinking, psychological craving, attention bias and other aspects at pre-baseline, week 1, week 3, and week 5 of treatment.Results:The positive psychology therapy had a good effect on the social support of alcohol-dependent patients. Except for the difference in the degree of support utilization in the intervention group ( P>0.05), the difference in other indicators was statistically significant ( F values were 1.653 - 6.571, P <0.01), while the difference in the subjective support score in the control group was statistically significant ( F value was 5.445, P<0.01). The time factors of repeated measurement anova showed that the total score of social support, objective support, subjective support, utilization of support, total score of automatic thinking and visual desire score were significantly different with the increase of treatment times ( F values were 3.324 - 17.153, P<0.01 or 0.05). The interaction between the total score of social support, subjective support, visual desire and intervention measures was significant ( F values were 9.331 - 17.578, P<0.01). The intergroup factors showed that the intervention measures had positive effects on the total score of social support, objective support, total score of automatic thinking and visual desire between the two groups, with statistically significant differences ( F values were 3.865-12.061, P<0.01 or 0.05). There was no statistically significant difference between the intervention group and the control group in response time of cue words, negative word response time and neutral word response time before intervention ( P> 0.05), and the response time of cue words in the intervention group was lower than that in the control group after intervention ( t value was -3.148, P<0.01). Before intervention in the intervention group and control group in the cue word correctly, negative word correctly, neutral accuracy differences of no statistical significance ( P > 0.05), after intervention intervention group negative word accuracy was higher than the control group, the difference was statistically significant ( t value was 2.298, P<0.05), and after the intervention intervention group neutral accuracy is higher than the control group, difference was statistically significant ( t value was 2.010, P<0.05). Conclusions:Positive psychological therapy can enhance the social support of alcohol-dependent patients, reduce the automatic thinking of patients, reduce the craving, and change the attention bias of alcohol-dependent patients, providing a basis for clinical research.

OBJECTIVETo study hepatitis B virus (HBV) genotype and subtype distribution and its clinical significance in HBV-infected patients.

METHODSWe used type/subtype-specific primers and PCR to detect HBV genotype and subtype of 445 HBV-infected patients from Beijing, Changchun, Hanchuan Shenzhen, Qingyuan and Nanjing, including 7 acute hepatitis (AH), 36 asymptomatic HBV carriers (ASC), 352 chronic hepatitis (CH), 28 liver cirrhosis (LC), and 22 hepatocellular carcinoma (HCC) cases. Genotyping results were confirmed by PCR product sequencing.

RESULTSAmong 445 HBV-infected patients, the proportions of genotype B, C, and B/C were 32.6% (145/445), 53.7% (239/445), and 13.7% (61/445), respectively. In genotype C, 13 (5.4%) were subtype C1, 135 (56.5%) were subtype C2, and the remaining 91 (38.1%) were neither C1 nor C2. In genotype B, 100 (69.0%) were subtype Ba, 25 (17.2%) subtype Bj, and the other 20 (13.8%) were neither Ba nor Bj. In genotype B/C, 15 (24.6%) were Ba/C2, 8 (13.1%) Bj/C2, 6 (9.8%) Ba/C1, 3 (4.9%) Bj/C1, 11 (18.0%) Ba/neither C1 nor C2, 7 (11.5%) Bj/neither C1 nor C2, and 6 (9.8%) neither Ba nor Bj/neither C1 nor C2, 2 (3.3%) neither Ba nor Bj/C1, 3 (4.9%) neither Ba nor Bj/C2. The HBV genotype and subtype distribution we found exhibited significant differences in the various clinical types of HBV infection tested, and showed that genotype C was predominant among patients with liver cirrhosis (78.6%) and hepatocellular carcinoma (86.4%) while genotype B was predominant in asymptomatic carriers (72.2%). In addition, genotype and subtype distribution showed no significant differences between male and female patients, but genotype and subtype distribution showed significant differences in patients positive or negative with HBeAg.

CONCLUSIONSubtypes Ba and C2 are predominant in patients with hepatitis B from these 6 cities, and genotype C may be associated with the development of liver cirrhosis and hepatocellular carcinoma.

Genotype ; Hepatitis B virus ; genetics ; Hepatitis B, Chronic ; virology ; Humans ; Liver Cirrhosis ; virology ; Liver Neoplasms ; virology ; Polymerase Chain Reaction

Objective To investigate the correlation between red cell volume distribution width (RDW) and the mortality rate of acute respiratory distress syndrome (ARDS) patients after renal transplantation. Methods Clinical data of 106 ARDS patients undergoing renal transplantation were retrospectively analyzed. According to RDW, all patients were assigned into the normal (≤15.0%, n=68) and increasing RDW groups (>15.0%, n=38). Baseline data and the incidence of adverse events were statistically compared between two groups. Kaplan-Meier survival curve was adopted to compare the 50 d-mortality rate between two groups. Cox's proportional hazards regression model was utilized to identify the risk factors of the mortality of ARDS patients. Results Among 106 patients, the 50 d-mortality rate was calculated as 43.4% (46/106). The sequential organ failure assessment (SOFA) score, serum creatinine, hemoglobin and platelet count significantly differed between two groups (all P<0.05). In the increasing RDW group, the 50 d-mortality rate and the incidence of infectious shock were significantly higher than those in the normal RDW group (both P<0.05). Kaplan-Meier survival curve demonstrated that the 50 d-mortality rate significantly differed between two groups (P<0.01). Cox's proportional hazards regression model univariate analysis revealed that hemoglobin level<100 g/L, serum creatinine>133 μmol/L, platelet count<100×109/L, severe ARDS and RDW>15.0% were the potential risk factors of the 50 d-mortality rate in ARDS patients (all P<0.05). Multivariate analysis demonstrated that severe ARDS [odd ratio (OR)=12.77, 95%confidence interval (CI) 11.63-15.39, P<0.001] and RDW>15.0% (OR=2.01, 95%CI 1.02-3.94, P<0.043) were the independent risk factors of the 50 d-mortality rate in ARDS patients. Conclusions RDW elevation is correlated with the severity of disease and 50 d-mortality rate in ARDS patients following renal transplantation. RDW can serve as a clinical parameter to predict the prognosis of ARDS patients after renal transplantation.

Objective To understand the clinical nutritional status and malnutrition risk factors of Parkinson's disease (PD) patients and construct their risk scoring system.Methods A total of 221 patients with PD admitted to our hospital from January 2015 to January 2019 were enrolled. The nutritional status of the patients was assessed by Mini Nutrition Assessment (MNA), and according to the MNA scores, these patients were divided into well-nourished groups (n=176) and malnourished group (including patients having malnutrition and malnutrition risk,n=45). Single factor analysis and Logistic regression analysis were used to analyze the risk factors; their scoring systems were constructed and Hosmer-Lemeshow goodness of fit test was used. Accuracy and discrimination of evaluation scoring systems were evaluated by area under receiver operating characteristic (ROC) curve.Results A total of 45 patients (20.36％) had malnutrition or risk of malnutrition. Multivariate regression analysis suggested that the course of disease≥9 years, motor symptoms (unified PD rating scale Ⅲ scores≥54), Hoehn-Yahr (H-Y) staging≥4, daily levodopa equivalent dose≥600 mg, scores of non-motor symptom scale (NMSS) scores≥101, and quality of life (39-item PD questionnaire scores≥81) were independent risk factors for malnutrition in PD patients (P<0.05). The constructed risk scoring system scored from 0 to 30, and Hosmer-Lemeshow goodness of fit test were:χ2=6.259,P=0.618; the area under ROC curve was0.830 (95％CI: 0.801-0.860); when the predicted score was 14, Yoden index was the largest (0.517), and the sensitivity and specificity were 75.70％ and 76.00％, respectively.Conclusion sPD patients have a high risk of malnutrition or malnutrition. The risk scoring system based on risk factors has high predictive ability and discriminating ability, and can be used as an important tool for malnutrition risk assessment in PD patients.