Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

Background::Hepatitis B poses a heavy burden for children in China, however, the national studies on the distributional characteristics and health care costs of children with severe hepatitis B is still lacking. This study aimed to analyze the disease characteristics, health economic effects, and medical cost for children with severe hepatitis B in China.Methods::Based on patient information in the Hospital Quality Monitoring System, cases with severe hepatitis B were divided into four groups according to age, and the etiology and symptoms of each group were quantified. The cost of hospitalization was calculated for cases with different disease processes, and severity of disease. The spatial aggregation of cases and the relationship with health economic factors were analyzed by Moran’s I analysis. Results::The total number of children discharged with hepatitis B from January 2016 to April 2022 was 1603, with an average age of 10.5 years. Liver failure cases accounted for 43.48% (697/1603) of total cases and cirrhosis cases accounted for 11.23% (180/1603). According to the grouping of disease progression, there were 1292 cases without associated complications, and the median hospitalization cost was $818.12. According to the spatial analysis, the aggregation of cases was statistically significant at the prefectural and provincial levels in 2019, 2020, and 2021 (all P <0.05). The number of severe cases was negatively correlated with gross domestic product (Moran’s I <0) and percentage of urban population (Moran’s I <0), and positively correlated with the number of pediatric beds per million population (Moran’s I >0). Conclusion::The number of severe hepatitis B cases is low in areas with high gross domestic product levels and high urban population ratios, and health care costs have been declining over the years.

Objective To analyze the relationship between dietary and lifestyle inflammatory scores and metabolic syndrome, diabetes mellitus, cardiovascular disease, non-alcoholic fatty liver disease, tumor and other common metabolic diseases, and to explore the impact of dietary and lifestyle inflammatory potential on metabolic diseases, so as to provide new ideas for the diagnosis, treatment and prevention of metabolic diseases. Methods Databases such as CNKI, Wanfang , and PubMed were searched, and literatures related to the dietary and lifestyle inflammatory scores (DLIS) and metabolic diseases were reviewed . Results Seven articles showed that dietary and lifestyle inflammation scores had a positive correlation with metabolic diseases, and two articles showed that only lifestyle inflammatory scores had a positive correlation with metabolic diseases. Conclusion Dietary and lifestyle inflammatory scores may be positively correlated with metabolic diseases, but some results are still controversial. Further studies are needed to prove the correlation between DLIS and metabolic diseases.

Objective:To compare the clinical efficacy and safety of continuous dosing or alternate-day dosing of apatinib combined with SOX regimen as first-line treatment for patients with advanced gastric cancer.Methods:A total of 52 patients with human epidermal growth factor receptor 2 (HER2) negative and inoperable locally advanced or advanced gastric cancer who were pathologically diagnosed from January 2018 to January 2021 in the Second Affiliated Hospital of Shandong First Medical University were collected. The patients were divided into continuous dosing group and alternate-day dosing group by random number table method. The continuous dosing group received apatinib (250 mg, once a day) combined with SOX regimen (S-1+oxaliplatin); the alternate-day dosing group received apatinib (250 mg, once every other day) combined with SOX regimen. Twenty-one days were a cycle, and the efficacy was evaluated after 2 cycles. After 4-6 cycles, patients with stable disease received apatinib and S-1 for maintenance therapy. The therapeutic effects and adverse reactions of the two groups were compared.Results:The curative effect could be evaluated in 51 patients, including 26 in the continuous dosing group and 25 in the alternate-day dosing group. The disease control rates in the continuous dosing group and the alternate-day dosing group were 84.6% (22/26) and 76.0% (19/25) ( χ2 = 0.60, P = 0.499), and the median progression-free survival time was 7.50 months (95% CI 6.17-8.83 months) and 8.30 months (95% CI 6.99-9.61 months) ( χ2 = 0.71, P = 0.401), and the median overall survival time was 15.50 months (95% CI 11.30-19.69 months) and 15.60 months (95% CI 13.63-17.57 months) ( χ2 = 1.82, P = 0.177). The main adverse reactions in the two groups were leukopenia, thrombocytopenia, hypertension, nausea, vomiting, fatigue, hand-foot syndrome, proteinuria, liver and kidney damage. The incidence rates of ≥grade 3 adverse reactions in the continuous dosing group and the alternate-day dosing group were 42.3% (11/26) and 12.0% (3/25), and the difference was statistically significant ( χ2 = 4.46, P = 0.035). Conclusions:The efficacy of continuous dosing or alternate-day dosing of apatinib combined with SOX regimen as first-line treatment for advanced gastric cancer is similar, but the incidence of ≥grade 3 adverse reactions in alternate-day dosing group is lower, which improves the compliance and tolerance of patients.

Objective:To investigate the relationship between serum C3 and progression of renal function in IgA nephropathy.Methods:A single-center retrospective cohort study was conducted in patients with IgA nephropathy confirmed by renal biopsy who were admitted to the Second People's Hospital of Shenzhen from January 2011 to June 2020 and the patients were followed up until January 2021. Patients with secondary IgA nephropathy, baseline estimated glomerular filtration rate (eGFR)<30 ml·min -1·(1.73 m 2) -1, lack of baseline serum C3 or creatinine, and follow-up time<6 months were excluded. The clinical data, laboratory examination and renal pathology were collected. The threshold effect analysis was used to obtain the cut-off point, and inflection point and 95% confidence interval were obtained using bootstrapping resampling technique. According to the cut-off point, the patients were divided into serum C3<0.97 g/L group and C3≥0.97 g/L group. The baseline data between the two groups were compared. Cox regression model was used to analyze the correlation between serum C3 level and renal function progression. Results:A total of 414 patients were enrolled in this study, with 145 males (35.0%), and age of (35.15±9.18) years old. The baseline eGFR was 77.80(46.67, 106.10) ml·min -1·(1.73 m 2) -1, and the serum C3 was (1.04 ± 0.19) g/L. There were 153 patients with serum C3<0.97 g/L and 261 patients with serum C3≥0.97 g/L. Compared to patients with serum C3≥0.97 g/L, those patients with serum C3<0.97 g/L were younger and had higher proportion of females, higher levels of hemoglobin and eGFR, and lower levels of mean arterial pressure, total cholesterol, triglyceride, serum uric acid, serum creatinine, 24 h urinary protein, IgA and C4 (all P<0.05). The relationship between serum C3 and progression of renal function was found to be U-shaped by smooth curve fitting. After adjustment for confounding factors such as age, sex, mean arterial pressure, serum uric acid, 24 h urinary protein, and renal pathology (MESTC), the results of the threshold effect and multivariate Cox regression showed, for patients with C3<0.97 g/L, the risk of renal function progression decreased by 40% for every 0.1 g/L increase of C3 ( HR=0.60, 95% CI 0.39-0.94, P=0.024), but for patients with C3≥0.97 g/L, every 0.1 g/L increase in serum C3 increased the risk of renal function progression by 27%( HR=1.27, 95% CI 1.03-1.57, P=0.027). The inflection point was 0.97(95% CI 0.92-1.01) g/L. Conclusions:Serum C3 is nonlinear correlated with the progression of renal function in patients with IgA nephropathy. Serum C3 level maintaining at 0.92-1.01 g/L is associated with better renal prognosis.

Objective:To explore the relationship between segmental glomerulosclerosis and the change of renal function in IgA nephropathy (IgAN).Methods:It was a single-center retrospective cohort study. The patients with biopsy-proven primary IgAN who were hospitalized in Shenzhen Second People's Hospital from January 1, 2011 to December 31, 2018 were included. Participants with a secondary cause of IgAN, without baseline serum creatinine or renal pathology data for Oxford classification, baseline estimated glomerulofiltration rate (eGFR)<30 ml·min -1·(1.73 m 2) -1, follow-up time<6 months, or less than three times measurements of followed-up serum creatinine were excluded. The clinical data, laboratory tests and renal pathology data and so on were collected. Patients were divided into absence of segmental glomerulosclerosis (S0) group and segmental glomerulosclerosis (S1) group according to the Oxford classification. The generalized additive mixed model was used to analyze the associations of segmental glomerulosclerosis and longitudinal renal function decline (Renal function was evaluated by using the eGFR). Results:There were 280 patients included in this study, with 199 patients in S0 group, and 81 patients in S1 group. Compared with S0 group, patients in S1 group exhibited higher levels of triglyceride, serum uric acid as well as 24-hour urinary protein, and a lower level of eGFR, and had higher proportions of tubular atrophy and interstitial fibrosis (T) (all P<0.05). After adjusting for age, gender, mean arterial pressure, 24-hour urinary protein, mesangial hypercellularity (M), endocapillary hypercellularity (E), T and crescent (C) in the generalized additive mixed model, the effect value of S1 (the difference of baseline eGFR between S1 group and S0 group) was -14.09 ml·min -1·(1.73 m 2) -1. For every additional year, the eGFR of S0 group decreased 1.29 ml·min -1·(1.73 m 2) -1 (95% CI 0.47-2.12, P=0.002) in average, and eGFR decline in S1 group had 2.85 ml·min -1·(1.73 m 2) -1 more than that in S0 group [95% CI 1.05-4.64, P=0.002]. Conclusion:Segmental glomerulosclerosis is independently associated with the longitudinal decrease in renal function in patients with IgAN, which suggests therapies targeted for improving the early damages of segmental glomerulosclerosis may be essential to delay the renal function decline progression.

Objective To study the curative effect and the prognostic factors of endoscopic traumatic optic neuropathy (TON). Methods The clinical data of 53 patients with TON from 2010 to 2015 years was retrospectively analyzed. Divided the patients into the surgery group and the non-surgery group, according to whether or not accept the treatment of endoscopic optic decompression. And evaluating the potential prognostic factors in chi-square test, group t-test and multiple regression analysis. Results In 53 patients (55 eyes ), 31 eyes have no visual acuity before treated: 8 eyes’ visual acuity was improved in 16 eyes (8/16) that accepted operation; 3 eyes’ visual acuity was improved in 15 eyes (3/15) that with non-operation;24 eyes have visual acuity before treated:11 eyes’ visual acuity was improved in 14 eyes (11/14) that accepted operation;3 eyes’ visual acuity was improved in 10 eyes (3/10) that with non-operation;19 eyes’ visual acuity was improved in 30 eyes (19/30) that accepted operation, the total effective rate was 63.3%, and there was no complications happened in the patients who accepted operation. The age, eye-side, sex, visual acuity, optic canal fracture , orbit fracture , all these factors have no correlation to the prognosis (P>0.05), but the interval time between injury and operation (less than 3 days) and the way of the treatment are benefit to improve vision (P<0.05). Conclusions The endoscopic optic decompression is an effective treatment in TON, and it’s better to improve vision in 3-day after TON.

Objective: To summarize our experience in the diagnosis of internal carotid artery trauma in patients with traumatic optic neuropathy, and to make recommendations for the treatment. Methods: The clinic data of 6 cases who had traumatic optic neuropathy with internal carotid artery trauma and who were admited in Department of Otorhinolaryngology, the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University from Jan. 2013 to Dec. 2015 were analyzed retrospectively. Results: All 6 cases were monocular blindness. Four cases did not undergo nasal endoscopic optic nerve decompression because of the diagnoses of internal carotid artery trauma. One case was diagnosed after nasal endoscopic optic nerve decompression because of fatal bleeding during the operation. One case was diagnosed because of late-onset recurrent epistaxis. Among the 6 cases with internal carotid artery trauma, 3 cases were successfully treated with endovascular interventional treatment (stent embolization was used in one case, Coil embolization was used in two cases), and 3 patients refused treatment. Conclusions The patients with traumatic optic neuropathy have the possibility of severe carotid artery trauma. Endoscopic optic nerve decompression is not suitable for these cases. It should pay more attention to patients with traumatic optic neuropathy. For suspected cases, vascular-enhanced computed tomography screening and digital subtraction angiography should be recommended and patients should be treated by endovascular intervention in a timely manner.

OBJECTIVE To investigate the effect of subcutaneousimmunotherapy(SCIT) on levels of the serum human beta defensin-2 in children with allergic rhinitis. METHODS 30 cases of children with allergic rhinitis who were treated by SIT were selected as the treatment group, 20 cases of healthy children as the control group. Serum HBD-2 concentration of the control group was tested. Serum HBD-2 concentration of the treatment group was tested at three different time points: before SCIT, half a year after SCIT and one year after SCIT. And total nasal symptom scores(TNSS) and medication scores were recorded at each time point. RESULTS The serum HBD-2 concentration of the control group, that of the treatment group before SIT, half a year after SIT and one year after SIT were 4.62[4.08; 4.87], 3.74[3.37; 4.61], 4.62[4.13; 5.54], 4.79[4.45;6.19]ng/ml. The HBD-2 concentration gradually increased after SCIT. The TNSS of the treatment group before SCIT, half a year after SCIT and one year after SCIT were 7.43±2.15, 4.17±2.16, 4.20±1.92, The medication scores of the treatment group before SCIT, half a year after SCIT and one year after SCIT were 1.25[0.75; 1.38], 0.25[0; 0.75, 0.25[0; 0.75].There was no correlation (all P>0.05) between the serum HBD-2 concentration and TNSS or medication scores of the treatment group. CONCLUSION The serum levels of HBD-2 in patients with allergic rhinitis were lower than those in normal persons. The specific immunotherapy raised the serum HBD-2 levels of allergic rhinitis patients.

Objective To explore the effect of 1a,25(OH)2 D3 on circadian clock gene expressions in cardiac myocytes.Methods Cultured cardiac myocytes isolated from 7 -day -old Sprague -Dawley(SD)rats were identified by immunofluorescence.The medium including 1a,25 (OH)2 D3 (final concentrations were 0 nmol/L,1 nmol/L, 10 nmol/L,50 nmol/L and 100 nmol/L)were added to primary myocardial cells to culture for 2 h and then total RNA was extracted.Real -time polymerase chain reaction (RT -PCR)was applied to analyze myocardial cells circadian clock gene (Bmal1,Per2,Rev -erba)transcript levels to determine optimum concentration of 1a,25(OH)2 D3 .Then, the primary myocardial cells cultured for 72 h were divided into 3 groups:the control group was of serum -free culture medium;serum shock group was of DMEMcontaining 50%volume fraction of horse serum cultured 2 h;1a,25(OH)2 D3 treatment group receiving 1a,25 (OH)2 D3 at optimal concentration cultured 2 h.The cells were collected at 7 time points (0 h,4 h,8 h,12 h,16 h,20 h,24 h)and then total RNA was extracted.RT -PCR was applied to analyze circa-dian clock gene (Bmal1,Per2,Rev -erba)transcript levels in the myocardial cells.Results In the presence of 50 nmol/L 1 a,25(OH)2 D3 ,the Bmal1 mRNA expression showed the highest level,but the Per2 and Rev -erba mRNA expression levels were minimum.Compared with the control group,both 1a,25 (OH)2 D3 treatment group and serum shock group caused day -cycle rhythmic oscillation in circadian clock genes(Bmal1,Per2,Rev -erba)in the cardiac myocytes.And the expressions pattern of Bmal1 and Per2 genes were in the opposite phase.While Bmal1 gene expres-sion appeared at peak at 12 h,Per2 gene expression appeared in a trough.Expression of Rev -erba gene trend began to rise at 8 h,and the highest expression level appeared at 12 -16 h.Conclusions 1a,25(OH)2 D3 can affect Bmal1, Per2 and Rev -erba mRNA expressions of circadian clock genes in the cardiac myocytes.