Objective:To analyze the influencing factors of thyroid volume in children aged 8 - 10 in Yunnan Province, and provide scientific basis for improving iodine deficiency disorders monitoring.Methods:From March to July 2020, in 129 counties (cities, districts) under the jurisdiction of Yunnan Province, each county (city, district) was divided into 5 sampling areas based on east, west, south, north, and middle. One township was selected from each area, and 40 non-boarding children aged 8 - 10 from one primary school were selected from each township (age balanced, half male and half female) as survey subjects. One random urine sample and household edible salt samples were collected for urine iodine and salt iodine testing, and physical examination and thyroid volume measurement were conducted for children. The influencing factors of thyroid volume were analyzed using Pearson correlation.Results:A total of 24 934 urine samples were collected from children, with a median urine iodine of 233.2 μg/L. A total of 24 933 household edible salt samples were collected from children, the median salt iodine was 24.17 mg/kg, and the qualified rate of iodized salt was 96.63% (24 003/24 839); A total of 24 937 children were examined of their thyroid gland, with a median thyroid volume of 2.62 ml and a goiter rate of 1.12% (280/24 937). Among them, there were 12 410 boys and 12 527 girls, with thyroid volumes of 2.61 and 2.64 ml, respectively. The thyroid volume of boys was positively correlated with age, height, weight, body mass index, body surface area, and salt iodine ( r = 0.15, 0.21, 0.26, 0.18, 0.25, 0.03, P < 0.001). The thyroid volume of girls was positively correlated with age, height, weight, body mass index, and body surface area ( r = 0.17, 0.26, 0.28, 0.17, 0.27, P < 0.001). Conclusion:Children aged 8 - 10 in Yunnan Province are at an iodine excess level; the age, weight, height, body mass index, and body surface area are influencing factors of thyroid volume.

Kidney is one of the key target organs involved in autoinflammatory diseases (AIDs). The clinical manifestations of renal impairment associated with AIDs are diverse, including hematuria, proteinuria, nephrotic syndrome, hypertension, renal artery stenosis, renal insufficiency, and others. The pathogenesis is mostly renal amyloidosis and/or renal vasculitis/vasculopathy caused by inflammasome activation. Whether or not the kidney is involved and its degree is closely related to the prognosis of AIDs patients. This article introduces the pathogenesis of AIDs-related renal impairmen and highlights the clinical characteristics of renal damage in some AIDs, aiming to enhance clinicians′ understanding of AIDs-related renal damage, and to implement early diagnosis and treatment to improve patients′ quality of life and prognosis.

Objective:To understand the epidemiological and etiological characteristics of hand-foot-mouth disease (HFMD) in the Nanshan District of Shenzhen City from 2019 to 2022 and to provide a scientific basis for HFMD prevention in the area.Methods:Epidemiological data on HFMD in Shenzhen Nanshan District from 2019 to 2022 in the China Information System for Disease Control and Prevention were analyzed using descriptive research methods.Real-time reverse transcription polymerase chain reaction (RT-PCR) was used to analyze the etiology characteristics of clinical specimens from HFMD patients. The VP1 gene of the dominant pathogen coxsackievirus A6 (CV-A6) was amplified and sequenced. SepMan Pro of DNASTAR software was used for sequence assembly and MegAlign was used for nucleotide homology analysis.Results:A total of 13 195 HFMD cases were reported in Shenzhen Nanshan District from 2019 to 2022, with an average annual incidence rate of 186.18/100, 000. Summer and autumn are the main onset seasons and children under 7 years old were the main population, accounting for 93.1%. The male-to-female ratio is 1.44∶1. A total of 451 clinical HFMD specimens were detected in the laboratory, including 403 positive (87.36%) and 48 negative (10.64%). The main pathogens were CV-A6 (63.03%), coxsackievirus A16 (CV-A16) (27.79%), coxsackievirus A4 (CV-A4) (4.71%), coxsackievirus A10 (CV-A10) (1.99%), Echovirus 11 (Echo-11) (0.25%), and uncertain type accounted for 2.23%, with no detection for enterovirus71 (EV71) type. The nucleotide homology of the 13 CV-A6 strains ranged from 94.0%?99.6%, and the nucleotide homology with the prototype strain Gdula ranged 84.1%?85.8%. The results of phylogenetic tree showed that all 13 CV-A6 strains in Nanshan District were of the D3a genotype.Conclusions:FHFMD in Nanshan District of Shenzhen City in 2019-2022 shows obvious differences in population and time distribution. Therefore, it is necessary to strengthen publicity and education on HFMD prevention and control in the summer and fall seasons and among key populations. CV-A6 and CV-A16 are the dominant strains of HFMD in Nanshan District, Shenzhen in recent years, so the monitoring of the dominant strains should be improved.

Objective:To determine the content of the released nickel ion through the 7 extraction media to extract the Ni-Ti wires and to plot the curve of the released nickel ion so as to identify a leaching medium that can be substituted for blood for in vitro Ni release evaluation. Methods:The release of Ni through microwave digestion/inductively coupled plasma mass spectrometry (ICP-MS) in the goat serum was determined. Because of the high content of Ni release, it could be determined by diluting the extraction medium, and other extraction media could be determined directly. Ni release standard curves were plotted by the release amount and different time point variables. Though the different extraction media Ni release curves confirm the specificity of extraction media instead of blood.Results:By analyzing the Ni release curves of seven leaching media, it was found that none of these seven extraction media was suitable for the evaluation of Ni release in in vitro leaching media. Considering the safety of the leaching medium and the simplicity of preparation, hydrochloric acid solution was chosen as the leaching medium, but the concentration needed to be diluted accordingly. Finally, a hydrochloric acid solution was created as an alternative to blood for the in vitro study of Ni release from Ni-Ti alloy cardiovascular products, with a volume fraction of 0.005%. Conclusions:The in vitro leaching medium that can replace blood was found to be hydrochloric acid for the time being, but its concentration was too high, resulting in too much Ni release as well, which deviated from the actual situation. Therefore, the hydrochloric acid solution was diluted step by step, and the Ni release curve was examined until it was close to the clinical release level, and the actual concentration was determined, thus laying a solid foundation for the subsequent evaluation of the safety and risk.

Objective:To explore the clinical characteristics and outcomes of SARS-CoV-2 infection in kidney transplant recipients(KTRs)and examine the risk factors for severe/critical infection.Methods:A retrospective analysis was conducted for 208 adult KTRs diagnosed with SARS-CoV-2 infection between December 15, 2022, and March 15, 2023.They were assigned into two groups of mild/ordinary(n=168)and severe/critical(n=40)according to the severity of SARS-CoV-2 infection.Two groups were compared with regards to general profiles, status of baseline vaccination against COVID-19, transplant history, immunosuppressive regimens, comorbidities and treatment outcomes.For continuous variables, t or Mann-Whitney U test was utilized for comparing the inter-group differences.For categorical variables, chi-square or Fisher's exact test was employed.Bonferroni correction was applied for multiple comparisons when p value was ≤0.05.Logistic regression analysis of univariates and multivariates was conducted for identifying the risk factors for severe/critical infections.Results:The rates of hospitalization, severe illness, ICU admission, mechanical ventilation and mortality among 208 KTRs with COVID-19 were 27.4%(57/208), 19.2%(40/208), 3.4%(7/208), 5.3%(11/208)and 1.9%(4/208)respectively.Among 57 COVID-19 infected individuals, 43.9%(25/57)experienced bone marrow suppression with an incidence of anemia 36.8%(21/57)and thrombocytopenia 22.8%(13/57). The lowest counts of whole blood lymphocyte, CD4 + T lymphocyte and CD8 + T lymphocyte were 390.0(245.0, 615.0), 138.0(78.0, 293.5)and 180.0(94.7, 575.2)cells/μL respectively.The incidence of bacterial, cytomegaloviral, Pneumocystis jirovecii and other fungal infections after COVID-19 infection was 17.8%(37/208), 3.8%(8/208), 2.9%(6/208)and 2.9%(6/208)respectively.The severe/critical group had a higher incidence of other pathogen infections as compared to mild/ordinary group, including bacterial infections[62.5%(25/40)vs 7.1%(12/168), 95% CI: 47.5%~63.3%, P<0.001], cytomegaloviral infections[15.0%(6/40)vs 1.2%(2/168), 95% CI: 8.1%~19.5%, P=0.001], P.jirovecii infections[15%(6/40)vs 0(0/168), 95% CI: 9.4%~20.6%, P<0.001]and other fungal infections of Candida, Cryptococcus, Malassezia and Aspergillus fumigatus[15.0%(6/40)vs 0(0/168), 95% CI: 9.4%~20.6%, P<0.001]. The incidence of acute kidney injury(AKI)after COVID-19 infection was 13.5%(28/208)and severe/critical group had a higher incidence of AKI than mild/ordinary group[52.5%(21/40)vs 4.2%(7/168), 95% CI: 40.3% to 56.3%, P<0.001]. Univariate analysis showed that age( P=0.003), male gender( P=0.002), smoking history( P=0.012), coronary heart disease( P=0.011), diabetes mellitus( P=0.002), chronic renal insufficiency( P=0.001)and pulmonary disease history( P=0.001)were significantly different between severe/critical and mild/ordinary groups.Multivariate regression analysis revealed that comorbid chronic kidney disease( OR=3.34, 95% CI: 1.46-7.64, P=0.004)and a history of lung disease( OR=3.42, 95% CI: 1.49-7.87, P=0.004)were independent risk factors for severe/critical illness.Baseline vaccination rate against COVID-19 was 17.8%(37/208). Completion of baseline vaccination was associated with a lower risk of severe/critical COVID-19 infection( OR=0.28, 95% CI: 0.08-0.98, P=0.047). Conclusions:KTRs with severe/critical COVID-19 infections are more prone to multiple pathogen co-infections and the incidence of kidney function impairment after infection has remained relatively high.Histories of pulmonary and chronic kidney diseases are independent risk factors for severe/critical infections.Completion of baseline vaccination provides protection against severe/critical infections.

Takayasu arteritis is a a rare, chronic large-vessel vasculitis that predominantly affects aorta, its major branches and the pulmonary arteries; it is the most common, granulomatous inflammation of large arteries in children.It induces a variety of nonspecific inflammatory symptoms and ischemic symptoms due to stenotic lesions.Recent advances in imaging modalities including magnetic resonance angiography, computed tomography(CT), sonography, and fluorodeoxy glucose positron emission tomography/CT(FDG-PET/CT)allow accurate diagnosis of Takayasu arteritis and shorter duration between onset of the disease and diagnosis.Medical treatment for Takayasu arteritis is also changing.In addition to the traditional glucocorticoids and immunosuppressants, many new biological agents such as TNF-α antagonists and tocilizumab are being applied to patients with Takayasu arteritis refractory to conventional treatment with favorable results.This review critically discusses recent advances in medical management of Takayasu arteritis, with a special focus on the rationale and evidence to support the use of biologic agents in this disease.

Objective:To study the effect of different doses of 60Co γ-ray ionizing radiation on mitochondrial function in mouse hematopoietic stem and progenitor cells (HSPCs). Methods:C57BL/6 mice were divided into control group, 1 Gy irradiation group and 4.5 Gy irradiation group. The mitochondrial functions were detected at 12 h and 24 h after irradiation, including ROS level, membrane potential, mitochondrial structure, and mitochondrial stress. Bone marrow c-Kit + cells received a single 15 Gy irradiation in vitro, after 24 h, mitochondrial function was detected. Results:It was found that mice leukocytes ( t=12.41, 18.31, 16.48, 14.16, 19.08, 20.25, P<0.05), red blood cells ( t=4.81, 6.62, P<0.05) and platelets ( t=4.33, 6.68, P<0.05) were significantly reduced. The numbers of bone marrow colony formation unit ( t=16.27, 55.66, 17.06, 43.75, P<0.05), and HSPCs ( t=5.16, 11.55, P<0.05) were decreased dose-dependently post-irradiation. Under 1 Gy irradiation, the mitochondrial function and mitochondrial basal metabolic index of HSPCs ( t= 7.36, 3.68, 4.58, 3.15, 3.15, P<0.05) were enhanced at 24 h post-irradiation. Under 4.5 Gy irradiation, mitochondrial number, mitochondrial membrane potential ( t=12.29, 10.46, P<0.05), maximal respiration and spare respiratory capacity were decreased ( t=7.81, 5.78, 6.70, 5.83, P<0.05), ROS level was increased ( t=4.63, 4.12, P<0.05). The basal respiration and oxidative phosphorylated ATP production were reduced at 12 h after irradiation ( t=8.48, 3.80, P<0.05); and the proton leakage was increased ( t=6.57, P<0.05) and coupling efficiency was reduced ( t=11.43, P<0.05) at 24 h after irradiation. In cultured c-Kit + cells, the level of ROS ( t=11.30, P<0.05) and the maximum respiration and spare respiratory capacity were increased ( t=4.25, 3.44, P<0.05) while the mitochondrial membrane potential was decreased ( t=34.92, P<0.05) significantly. Conclusions:A method for systematically assessing mitochondrial function in HSPCs was established, and the effect of ionizing radiation on mitochondrial function of HSPCs was clarified, laying a foundation for further revealing the mechanism of ionizing radiation-induced mitochondrial damage in HSPCs.

Objective:To study the respiratory morbidity and the risk factors of respiratory complications in late-preterm infants.Methods:The data of 959 late-preterm infants in 21 hospitals in Beijing from October 2015 to April 2016 were collected.These infants were divided into the respiratory morbidity group (237 cases) and the control group (722 cases) according to whether they had short-term respiratory morbidity after birth.Clinical data of the two groups were compared.Results:Among the 959 late-preterm babies, 530 were male and 429 were female.Two hundred and thirty-seven cases (24.7%) developed short-term respiratory morbidity after birth.Infectious pneumonia developed in the most cases (81 cases, 8.4%), followed by transient tachypnea (65 cases, 6.8%), amniotic fluid aspiration (51 cases, 5.3%), and respiratory distress syndrome (24 cases, 2.5%) successively.All the infants recovered and discharged.There were no differences between gender and maternal age between 2 groups (all P>0.05). Compared with the control group, more late-preterm infants were delivered by cesarean section (73.4% vs.59.7%, χ2=14.43, P<0.001) and the 1-minute Apgar score was lower [(9.41±1.66) scores vs.(9.83±0.53) scores, t=5.40, P<0.001] in the respiratory morbidity group.The differences were statistically significant.There were more cases with maternal complications in the respiratory morbidity group that in the control group (66.7% vs.58.6%, χ2=4.877, P=0.027), but no difference in various complications between 2 groups was observed ( P>0.05). In the respiratory morbidity group, the most frequent complications were maternal hypertension and preeclampsia (27.8% vs.22.6%, χ2=2.728, P=0.099). There were no differences between 2 groups in gestational age, birth weight and birth length (all P>0.05). There were more infants small for gestational age and large for gestational age in the respiratory morbidity group than in the control group (18.8% vs.14.1%, 6.3% vs.2.4%, χ2=8.960, P=0.011). The duration of hospitalization of the respiratory morbidity group was significantly longer than that of the control group [(9.00±4.42) d vs.(6.82±4.19) d, t=6.676, P<0.001] since the infants with respiratory morbidity needed to be hospita-lized. Conclusions:Respiratory diseases occur in about 1/4 of late-preterm infants.Infants who are delivered by cesarean section and whose mothers are complicated with the maternal hypertension and preeclampsia should be monitored closely.Respiratory support should be provided for infants not appropriate for gestational age who are more likely to suffer from respiratory diseases, so that they can successfully pass through the transition period.

Objectives:To investigate the effect of polyester filament fiber surgical drape in neurosurgery.Methods:A total of 181 neurosurgical surgeries were selected from April to July 2019 in a first-class general hospital. They were randomly divided into 2 groups, cotton group (92 cases) were covered with cotton drape, polyester filament fiber group (89 cases) were covered with polyester filament fiber. The anti-permeation performance, incidence of intraoperative hypothermia, and incidence of postoperative surgical site infection (SSI) between the two groups were compared.Results:At the end of the operation, the wetting rate of the cotton draped was 58.7% (54/92) and that in polyester filament fiber was 15.7% (14/89), with statistically significant differences ( χ2 value was 35.605, P<0.05);The incidence of intraoperative hypothermia was 22.8% (21/92) in the cotton group and 11.2% (10/89) in the polyester filament fiber group, with statistically significant differences ( χ2 value was 4.281, P<0.05). The incidence of SSI in the cotton group was 16.3% (15/92) , while that in the polyester filament fiber group was 6.7% (6/89) , with statistically significant differences ( χ2 value was 4.034, P<0.05). Conclusions:In neurosurgical operations with a long operation time and a large amount of irrigation fluid during the operation, using the polyester filament fiber drape can prevent the irrigation fluid from wetting the surgical drape, protect the surgical incision better, reduce the incidence of SSI and intraoperative hypothermia to some extent.

Objective:To accurately grasp the current status of water iodine distribution in environmental of Yunnan Province, and provide a basis for scientific iodine supplementation.Methods:In 2017, according to the "National Drinking Water Iodine Content Survey Program", a survey of water iodine content was conducted in townships. In 2018, a search survey was carried out for administrative villages with water samples of iodine content > 40 μg/L in drinking water found in previous surveys. In centralized water supply villages, 2 samples of end water were collected. In decentralized or partially decentralized water supply villages, each village was divided into 5 parts: east, south, west, north and center. In villages with more than 50 water sources, 10% of the water sources were selected from each part; villages with less than 50 water sources, one water source was selected from each part; villages with less than 5 water sources, all the water sources were selected to determine the water iodine content. At the same time, the mode of water supply and demographic data were investigated.Results:At the township level water iodine survey, a total of 24 589 water samples were collected from 1 389 townships in 129 counties of 16 prefectures (cities). The median water iodine content of township was 1.3 μg/L, ranging 0.0 - 9.3 μg/L. The population covered by the survey accounted for 53.94% (25 013 804/46 371 207) of the total population of the province. According to the survey results of high iodine villages, 93 administrative villages in 68 townships of 37 counties in 12 prefectures (cities) were surveyed, covering 40 940 households and 208 880 people. A total of 761 samples of drinking water were tested, and the median water iodine content of administrative villages was 1.3 μg/L (ranging 0.0 - 196.8 μg/L). There were 2 administrative villages with iodine higher than 100 μg/L, which were Xiaobona Administrative Village (145.8 μg/L) in Liuchang Township, Xiangyun County, and Dasongshu Administrative Village (196.8 μg/L) in Yangchang Township, Xuanwei City.Conclusions:The iodine content of water in Yunnan Province is generally low, which belongs to the area of environmental iodine deficiency. For the high iodine villages, further investigation should be carried out to clarify the prevention and control measures.