Objective:To analyze trends in urticaria incidence among children aged 0 - 14 years in China from 1990 to 2021, to explore its changing patterns in different age, period, and cohort groups, and to investigate the impact of age and air pollutants on the incidence trends.Methods:Data were obtained from the Global Burden of Disease Database (GBD2021) , including the number of urticaria cases, crude incidence rates, and age-standardized incidence rates among children aged 0 - 14 years of different genders in China from 1990 to 2021. The Joinpoint regression model was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to assess temporal trends in incidence rates. An age-period-cohort model was applied to assess the effects of age, period, and cohort on urticaria incidence. Data on the annual emissions of 4 air pollutants (SO 2, CO, PM 2.5, and PM 10) in China from 1990 to 2021 were obtained from the Emissions Database for Global Atmospheric Research (EDGAR) , and a multivariable meta-regression model was used to explore the relationship between air pollutants and urticaria incidence. Results:From 1990 to 2021, the age-standardized incidence rate of urticaria among children aged 0 - 14 years in China demonstrated a slight overall downward trend (AAPC = -0.03%, P < 0.01) . The incidence rate was generally higher in female children than in male children, and the decline in incidence rates was greater in female children than in male children (female AAPC = -0.02%, male AAPC = -0.01%, both P < 0.01) . The age-period-cohort model indicated that the risk of urticaria decreased with advancing age: with the age group of 0 - 4 years as the reference ( RR = 1.000) , the risk of urticaria significantly decreased in the age group of 5 - 9 years ( RR = 0.790, 95% CI: 0.789 - 0.791) and further declined in the age group of 10 - 14 years ( RR = 0.711, 95% CI: 0.710 - 0.711) ; the period effect analysis showed that the risk of urticaria gradually decreased after the baseline period of 1992 - 1996 ( RR = 1.000) , and dropped to 0.995 (95% CI: 0.994 - 0.997) in the period of 2017 - 2021; in the cohort effect analysis of the overall population aged 0 - 14 years, with the 1988 - 1992 birth cohort as the base cohort, an earlier birth cohort 1978 - 1982 exhibited the highest risk of urticaria ( RR = 1.006, 95% CI: 1.004 - 1.009) , while the 2013 - 2017 cohort showed the lowest risk ( RR = 0.996, 95% CI: 0.994 - 0.997) . The multivariable meta-regression analysis indicated a significant association between PM 2.5 exposure and urticaria incidence ( β = 0.319, 95% CI: 0.022 - 0.616, P = 0.033) , although this association was not statistically significant in different age groups. Conclusions:From 1990 to 2021, children aged 0 - 4 years in China were the highest-risk group for urticaria; the decline in the incidence rate of urticaria was more pronounced in female children than in male children, and earlier birth cohorts exhibited higher risks of urticaria. Exposure to PM 2.5 appeared to be associated with the incidence of urticaria.

Objective:To analyze trends in urticaria incidence among children aged 0 - 14 years in China from 1990 to 2021, to explore its changing patterns in different age, period, and cohort groups, and to investigate the impact of age and air pollutants on the incidence trends.Methods:Data were obtained from the Global Burden of Disease Database (GBD2021) , including the number of urticaria cases, crude incidence rates, and age-standardized incidence rates among children aged 0 - 14 years of different genders in China from 1990 to 2021. The Joinpoint regression model was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to assess temporal trends in incidence rates. An age-period-cohort model was applied to assess the effects of age, period, and cohort on urticaria incidence. Data on the annual emissions of 4 air pollutants (SO 2, CO, PM 2.5, and PM 10) in China from 1990 to 2021 were obtained from the Emissions Database for Global Atmospheric Research (EDGAR) , and a multivariable meta-regression model was used to explore the relationship between air pollutants and urticaria incidence. Results:From 1990 to 2021, the age-standardized incidence rate of urticaria among children aged 0 - 14 years in China demonstrated a slight overall downward trend (AAPC = -0.03%, P < 0.01) . The incidence rate was generally higher in female children than in male children, and the decline in incidence rates was greater in female children than in male children (female AAPC = -0.02%, male AAPC = -0.01%, both P < 0.01) . The age-period-cohort model indicated that the risk of urticaria decreased with advancing age: with the age group of 0 - 4 years as the reference ( RR = 1.000) , the risk of urticaria significantly decreased in the age group of 5 - 9 years ( RR = 0.790, 95% CI: 0.789 - 0.791) and further declined in the age group of 10 - 14 years ( RR = 0.711, 95% CI: 0.710 - 0.711) ; the period effect analysis showed that the risk of urticaria gradually decreased after the baseline period of 1992 - 1996 ( RR = 1.000) , and dropped to 0.995 (95% CI: 0.994 - 0.997) in the period of 2017 - 2021; in the cohort effect analysis of the overall population aged 0 - 14 years, with the 1988 - 1992 birth cohort as the base cohort, an earlier birth cohort 1978 - 1982 exhibited the highest risk of urticaria ( RR = 1.006, 95% CI: 1.004 - 1.009) , while the 2013 - 2017 cohort showed the lowest risk ( RR = 0.996, 95% CI: 0.994 - 0.997) . The multivariable meta-regression analysis indicated a significant association between PM 2.5 exposure and urticaria incidence ( β = 0.319, 95% CI: 0.022 - 0.616, P = 0.033) , although this association was not statistically significant in different age groups. Conclusions:From 1990 to 2021, children aged 0 - 4 years in China were the highest-risk group for urticaria; the decline in the incidence rate of urticaria was more pronounced in female children than in male children, and earlier birth cohorts exhibited higher risks of urticaria. Exposure to PM 2.5 appeared to be associated with the incidence of urticaria.

Threatened abortion is a common disease of obstetrics and gynecology and one of the diseases responding specifically to traditional Chinese medicine （TCM）. The China Association of Chinese Medicine organized experts in TCM obstetrics and gynecology， Western medicine obstetrics and gynecology， and pharmacology to deeply discuss the advantages of TCM and integrated Chinese and Western medicine treatment as well as the medication plans for threatened abortion. After discussion， the experts concluded that chromosome， endocrine， and immune abnormalities were the key factors for the occurrence of threatened abortion， and the Qi and blood disorders in thoroughfare and conception vessels were the core pathogenesis. In the treatment of threatened abortion， TCM has advantages in preventing miscarriages， alleviating clinical symptoms and TCM syndromes， relieving anxiety， regulating reproductive endocrine and immune abnormalities， personalized and diversified treatment， enhancing efficiency and reducing toxicity， and preventing the disease before occurrence. The difficulty in diagnosis and treatment of threatened abortion with traditional Chinese and Western medicine lies in identifying the predictors of abortion caused by maternal factors and the treatment of thrombophilia. Recurrent abortion is the breakthrough point of treatment with integrated traditional Chinese and Western medicine. It is urgent to carry out high-quality evidence-based medicine research in the future to improve the modern diagnosis and treatment of threatened abortion with TCM.

Objective To compare the effects of different statistical protocols on the results of external quality assessment(EQA)of se-men,and select appropriate statistical protocols for the promotion of EQA of semen.Methods Taking sperm concentration as an ex-ample,the semen EQA data of 20 laboratories in Hunan Province in 2022 were selected,and the advantages and disadvantages of the traditional statistical scheme(TSS),robust statistical scheme(RSS)and traditional statistical scheme after eliminating the"outliers"(TSEOS)combined with robust statistical technology were analyzed and compared.Results The"outliers"could not be excluded from the sperm concentration data of the four groups in the TSS,which led to the difference between TSS and RSS or TSEOS.The num-ber of qualified laboratories for TSS and RSS were 19 vs 16,19 vs 16,19 vs 19,and 19 vs 19,respectively.Conclusion The results of RSS are similar to those of TSEOS.Compared with TSS,RSS do not need to remove outlier data steps,and are more suitable for se-men EQA data analysis with small data volume.

Objective To investigate the efficacy of entecavir (ETV) versus tenofovir disoproxil fumarate (TDF) and the treatment measures for poor response in previously untreated chronic hepatitis B (CHB) patients with high viral load. Methods A total of 165 CHB patients who received antiviral therapy and met the inclusion criteria in Department of Infectious Diseases, The First Affiliated Hospital of Guangxi Medical University, from June 2016 to July 2021 were enrolled. The patients enrolled had a baseline HBV DNA level of > 6lg copies/ml and were previously untreated CHB patients who had used ETV or TDF for 48 weeks, and quantitative real-time PCR was used to measure HBV DNA. Virologic response rate was calculated after 48 weeks of treatment; a logistic regression analysis was used to investigate the influencing factors for the response of HBV DNA < 500 copies/mL and HBV DNA < 100 copies /mL at 48 weeks; a stratified analysis was performed to compare the virologic response rate of HBV DNA < 500 copies /ml and HBV DNA < 100 copies/ml after 48 weeks between the patients with different ages, sexes, baseline HBV DNA levels, baseline alanine aminotransferase (ALT) levels, types of first-line medication, and HBeAg statuses. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups, the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups, and the binary logistic regression model was used for multivariate analysis. Results After 48 weeks of treatment, 85.5% (141/165) of the patients achieved an HBV DNA load of < 500 copies/mL, and 66.1% (109/165) of the patients achieved an HBV DNA load of < 100 copies /mL, with no significant difference in treatment outcome between the ETV group and the TDF group. The multivariate logistic regression analysis showed that sex( OR =2.793, 95% CI : 1.197-6.517), baseline HBV DNA( OR =0.369, 95% CI : 0.142-0.959), baseline ALT( OR =4.556, 95% CI : 1.770-11.732), and baseline HBeAg( OR =0.120, 95% CI : 0.033-0.429) were influencing factors for complete virologic response(all P < 0.05). For the patients with normal ALT (≤40 U/L) at baseline, 75.6% (34/45) achieved an HBV DNA load of < 500 copies/mL after 48 weeks of treatment, and 53.3% (24/45) achieved an HBV DNA load of < 100 copies/mL, with no significant difference in treatment outcome between the ETV group and the TDF group. For the patients with abnormal ALT (> 40 U/L) at baseline, 89.2% (107/120) achieved an HBV DNA load of < 500 copies/mL after 48 weeks of treatment, and the proportion of such patients in the TDF group was significantly higher than that in the ETV group (96.1% vs 84.1%, χ 2 =4.386, P =0.036); 70.8% (85/120) achieved an HBV DNA load of < 100 copies/mL, the proportion of such patients was no significant difference between the TDF group and the ETV group (78.4% vs 65.2%). The response of HBV DNA < 100 copies/ml of the normal baseline ALT group and the abnormal baseline ALT group, there were no significant differences between the patients aged≤30 years and aged > 30 years (77.8% vs 47.2%, 85.2% vs 66.7%). For the patients who did not achieve complete virologic response (HBV DNA ≥100 copies/mL) after 48 weeks of treatment, 87.9% (29/33) achieved complete virologic response after the original treatment regimen was prolonged for 48 weeks, and 100% (9/9) of the patients achieved complete virologic response after switching to or adding the first-line nucleos(t)ide analogues (NUCs) without cross-resistance sites with the original regimen for another 48 weeks. Conclusion The patients aged > 30 years should receive antiviral therapy as early as possible, regardless of viral load and ALT level, especially those with a family history of liver cirrhosis or hepatocellular carcinoma; the patients aged ≤30 years who have a normal ALT level and a high viral load should consider initiating antiviral therapy after providing informed consent. For the patients with poor response after 48 weeks of treatment, first-line NUCs without cross-resistance sites with the original regimen should be switched to or added in time.

Objective:To investigate the relationship between psoriasis severity and clinical features in psoriatic arthritis (PsA).Methods:Patients were recruited from the Chinese REgistry of Psoriatic ARthritis (CREPAR) between December 2018 and June 2021, and data were collected including the baseline demographic characteristics, various clinical manifestations (including arthritis, nail disease, comorbidities), laboratory tests[including erythrocyte sedimentation rate(ESR), C-reactive protein (CRP)], health assessment questionnaire (HAQ). Body surface area (BSA) and psoriasis area and severity index (PASI) were selected for the tools of assessment of cutaneous psoriasis. Patients were divided to two groups, including the severe psoriasis group (BSA>10%) and the non-severe psoriasis group (BSA≤10%). Disease assessment included ankylosing spondylitis disease activity score (ASDAS), disease activity score 28 (DAS28) and disease activity in psoriatic arthritis (DAPSA).Results:1 074 eligible patients with PsA were recruited, and 106 (9.9%) had severe psoriasis. Compared with non-severe psoriasis group, the severe psoriasis group had more peripheral joint involvement (including patients with ever or current peripheral arthritis, 94.3% vs. 85.6%), more polyarticular joint involvement (including patients with current peripheral arthritis, 74.0% vs. 58.2%), more axial joint involvement (51.4% vs. 39.9%), more nail disease (72.6% vs. 61.4%), more frequency of smoking (20.2% vs. 18.7%), and higher proportion of hypertension (23.4% vs. 14.4%). In addition, the severe psoriasis group had higher level of ESR [33(10, 70) mm/1h vs. 20(9, 38) mm/1h] and CRP [18.6(5.0, 60.8) mg/L vs. 7.0(2.4, 18.1) mg/L], higher values of DAS28-ESR (4.5±1.7 vs. 3.7±1.5), DAS28-CRP (4.2±1.5 vs. 3.4±1.4), ASDAS-ESR (3.5±1.4 vs. 2.6±1.2), and ASDAS-CRP(3.4±1.6 vs. 2.5±1.2), higher scores of HAQ [0.6(0.1, 1.0) vs. 0.3(0.0, 0.8)].Conclusion:Patients with PsA with severe psoriasis bore a heavier disease burden. Therefore, clinicians were supposed to pay more attention to them. In addition to skin lesions, they should also focus on examination of other clinical manifestations, such as joints and nails.

Adult ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use* ; COVID-19/drug therapy* ; Humans ; Pyridones/therapeutic use* ; Treatment Outcome

Objective:To compare the detection rate of genital Chlamydia trachomatis (CT) DNA between urine and urethral/cervical swab samples. Methods:From December 2018 to December 2019, a total of 1 475 outpatients were collected from sexually transmitted disease clinics in 7 medical institutions, such as Department of Venereology, Guangzhou Institute of Dermatology, including 1 118 males and 357 females. One urethral/cervical swab sample and one urine sample were collected successively from each patient. Real-time fluorescence-based PCR was performed to detect CT DNA in urine and urethral/cervical swab samples, and paired chi-square test was used to compare the positive rate of CT DNA between the 2 kinds of samples. Random- or fixed-effect meta-analysis was conducted for the test of heterogeneity and merging of positive rates of CT DNA in the urine and urethral/cervical swabs among 7 medical institutions.Results:The positive rate of CT DNA in the urine samples was significantly higher than that in the swab samples from 4 medical institutions (all P < 0.05) , while there was no significant difference in the positive rate of CT DNA between the 2 kinds of samples from 3 medical institutions (all P > 0.05) . The heterogeneity ( I2) estimates of the CT-DNA positive rate in urine and swab samples among different medical institutions were 78.6% (95% CI: 55.9% - 89.6%) and 73.7% (95% CI: 43.7% - 87.7%) , respectively; meta-analysis showed that the total merged positive rate of CT DNA in the urine samples was 10.8% (95% CI: 7.2% - 15.9%) , which was significantly higher than that in the swab samples (7.8%, 95% CI: 4.9% - 12.1%; χ2 = 39.2, P < 0.05) . Compared with the swab sample-based CT-DNA detection method, the sensitivity, specificity, positive predictive value, negative predictive value and consistency rate of the urine sample-based CT-DNA detection method were 97.0% (128/132) , 96.3% (1 293/1 343) , 71.9% (128/178) , 99.7% (1 293/1 297) , and 96.3% (1 421/1 475) , respectively. The positive rate of CT DNA in the urine samples from 1 118 male patients was 11.0% (95% CI: 7.2% - 16.5%) , which was significantly higher than that in the swab samples (7.6%, 95% CI: 4.9% - 11.8%; χ2 = 34.3, P < 0.05) . There was no significant difference in the positive rate of CT DNA between the urine (11.9%, 95% CI: 7.7% - 17.9%) and cervical swab samples from 357 female patients (10.4%, 95% CI: 7.6% - 14.0%; χ2 = 3.2, P > 0.05) . Conclusions:The positive rate of CT DNA in urine samples is higher than or similar to that in urethral/cervical swab samples. The urine sample-based CT-DNA detection method has characteristics of convenience, non-invasiveness, painlessness and low cost, and is worthy of clinical promotion.

Objective:To analyze the risk factors of postinflammatory hyperpigmentation (PIH) after laser in the treatment of acquired bilateral nevus of Ota-like macules (ABNOM).Methods:A retrospective study was conducted to follow up 120 patients with acquired bilateral nevus of Ota-like macules in the Department of Laser and Physiotherapy, Guangzhou Institute of Dermatology between January 2011 and December 2018, which accepted 1064-nm Q-switched neodymium: yttrium-aluminum-garnet laser treatment. The difference was analyzed between different age, sex, clinical classification, Fitzpatrick skin classification, ABNOM with melasma and postinflammatory pigmentation after laser treatment. Logistic regression was used to analyze the risk factors of postinflammatory hyperpigmentation after 1064-nm Q-switched neodymium: yttrium-aluminum-garnet laser treatment of acquired bilateral nevus of Ota-like macules.Results:Fifty-three ABNOM patients (44.17%) developed PIH after laser treatment. Univariate analysis showed that age, clinical classification, Fitzpatrick skin classification and the patients with both ABNOM and melasma all affected the occurrence of PIH after laser in the treatment of ABNOM, and the difference was statistically significant ( P<0.01). Logistic regression showed that older age, more severe clinical classification and the presence of ABNOM with melasma were the risk factors of PIH after treatment of ABNOM. Conclusions:ABNOM patients should be treated as early as possible. The risk of inducing PIH is great after laser treatment in patients with more severe clinical classification and patients with both ABNOM and melasma.