1.A questionnaire survey and analysis on the current situation of forensic ethics practice and educational needs
Wenjie LUO ; Tiantian PAN ; Shiyue LI ; Mengjun ZHAN ; Lirong QIU ; Yuchi ZHOU ; Xin CHEN ; Fei FAN ; Zhenhua DENG
Chinese Medical Ethics 2025;38(3):378-384
ObjectiveTo explore the current situation of forensic ethics practice and education by designing a questionnaire on forensic ethics, with a view to exploring the path of forensic ethics education construction. MethodsA total of 667 valid questionnaires were collected using the online survey method, basically covering various regions across the country and all sub-specialties of forensic medicine. Descriptive analysis was used to analyze the relevant data. ResultsMost practitioners had relevant ethical reflections in the process of forensic practice. 69.12% of the respondents indicated that they had studied the relevant rules, but approximately half stated that there were no corresponding ethical norms or standard operating manuals. The specific behaviors violating ethics in different units were diverse. 23.04% of the respondents reported that they had encountered unethical behaviors, but only 4.9% of them reported such violations. In terms of forensic ethics education, 87.75% of the respondents believed that there were issues with the current model of forensic ethics education. Meanwhile, the respondents showed a high degree of recognition for receiving forensic ethics education, with 84.15% of respondents expressing willingness to participate in relevant courses. More than half of respondents were willing to participate in forensic ethics education during undergraduate studies, new employee training, and regular post-employment training. ConclusionCurrently, there is a problem of ethical neglect in forensic work in China. Combining ethics courses with professional courses at the practitioner training stage and providing regular training at the practice stage are effective measures to popularize forensic ethics knowledge, enhance ethical awareness, and improve the quality of practice.
2.Research progress on drug preparations of rectal administration for ulcerative colitis
Jun WAN ; Lisha ZHOU ; Tiantian LUO ; Xinyue ZHANG ; Shiyao CHEN ; Xia ZHOU
China Pharmacy 2025;36(7):887-890
Ulcerative colitis (UC), which is characterized by a complex and multifactorial etiology, remains one of the challenging disorders in the international field of digestive system diseases. In recent years, rectal administration preparations have made rapid progress in UC therapeutic applications. This study systematically reviews the dosage forms, mechanisms of action, and clinical applications of rectally-administered preparations for the treatment of UC. It is found that suppositories are the most commonly used dosage forms for rectal administration. The newer suppositories have the advantages of high bioavailability and good stability. Enemas can retain the drug in the intestine as much as possible to achieve the effects of diluting intestinal toxins, cleansing the bowel, and reducing inflammation. Gels can achieve a drug-sustained-release effect and effectively improve intestinal mucosal damage. The mechanism of action of this type of preparation is mainly to inhibit inflammatory cell infiltration, regulate intestinal microbial homeostasis, and increase the expression of tight-junction proteins, so as to play anti-inflammatory, regulate the intestinal bacterial flora, repair the intestinal mucosa, and other efficacies. The diversity of rectal administration forms provides a wide range of choices for the clinical treatment of UC, such as Mesalazine suppositories, Lianshao enemas, and temperature- sensitive gels loaded with drugs for UC.
3.Protective Effect of Tongluo Baoshen Prescription-containing Serum on Lipopolysaccharide-induced Podocyte Injury of Rats
Yongfang LIU ; Tiantian YIN ; Huiyang LIU ; Rui HUANG ; Zhiying FENG ; Li ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(10):139-148
ObjectiveTo observe the effects of Tongluo Baoshen prescription (TLBS)-containing serum on the rat podocyte injury induced by lipopolysaccharide (LPS) and explore the potential mechanisms. MethodsSD rats were used to prepare the blank serum, losartan potassium-containing serum, and low-, medium-, and high-dose TLBS-containing sera. Rat podocytes were cultured in vitro, and the effects of drug-containing sera on podocyte viability were detected by the cell counting kit-8 (CKK-8) method. The optimal intervention volume fraction of drug-containing sera and the optimal concentration of LPS for inducing the podocyte injury were determined. Rat podocytes were grouped as follows: normal control (NC, 10% blank serum), model control (MC, 20.00 mg·L-1 LPS+10% black serum), losartan potassium (LP, 20.00 mg·L-1 LPS+10% losartan potassium-containing serum), low-dose TLBS (TLBS-L, 20.00 mg·L-1 LPS+10% low-dose TLBS-containing serum), medium-dose TLBS (TLBS-M, 20.00 mg·L-1 LPS+10% medium-dose TLBS-containing serum), and high-dose TLBS (TLBS-H, 20.00 mg·L-1 LPS+10% high-dose TLBS-containing serum), and the interventions lasted for 48 h. The ultrastructure of podocytes was observed under a transmission electron microscope. The podocyte apoptosis was detected by the terminal deoxynucleoitidyl transferase mediated nick-end labeling (TUNEL) kit. Immunofluorescence was used to detect the expression of gasdermin D N-terminal fragment (GSDMD-NT) in podocytes. The mRNA and protein levels of G protein-coupled receptor family C group 5 member B (GPRC5B), nuclear factor-κB (NF-κB) p50, NF-κB p52, NF-κB p65, Rel B, c-Rel, NOD-like receptor protein 3 (NLRP3), cysteinyl aspartate-specific protease-1 (Caspase-1), GSDMD-NT, interleukin (IL)-1β, IL-18, nephrin, integrin α3, and integrin β1 in podocytes were determined by real-time quaritiative polymerase chain reaction (Real-time PCR) and Western blot, respectively. ResultsCompared with the NC group, the MC group showed reduced podocyte protrusions and organelles, segmental missing of cell membranes, increased and swollen mitochondria, irregular nuclear membranes, light chromatin, increased TUNEL fluorescence-positive nuclei (P<0.01), obviously enhanced fluorescence intensity of GSDMD-NT, up-regulated mRNA and protein levels of GPRC5B, NF-κB p50, NF-κB p52, NF-κB p65, Rel B, c-Rel, NLRP3, caspase-1, GSDMD-NT, IL-1β, and IL-18 (P<0.01), and down-regulated mRNA and protein levels of nephrin, integrin α3, and integrin β1 (P<0.01) in podocytes. Compared with the MC group, the LP, TLBS-M, and TLBS-H groups showed improved ultrastructure of podocytes with increased protrusions, intact cell membranes, reduced organelles, and alleviated mitochondrial swelling, decreased TUNEL fluorescence-positive nuclei (P<0.01), weakened fluorescence intensity of GSDMD-NT, down-regulated mRNA and protein levels of GPRC5B, NF-κB p50, NF-κB p52, NF-κB p65, Rel B, c-Rel, NLRP3, caspase-1, GSDMD-NT, IL-1β, and IL-18 (P<0.01), and up-regulated mRNA and protein levels of nephrin, integrin α3, and integrin β1 (P<0.05, P<0.01). Moreover, the changes above were the most obvious in the TLBS-H group. ConclusionThe TLBS-containing serum can regulate the GPRC5B/NF-κB/NLRP3 pathway to inhibit pyroptosis, thereby ameliorating the podocyte injury induced by LPS.
4.Impact of Toxoplasma gondii type I rhoptry protein 16 on programmed cell death ligand 1 expression and its binding to programmed cell death 1 in lung adenocarcinoma cells
Guangqi LI ; Yuning ZHOU ; Shaohan MA ; Mei TIAN ; Tiantian DANG ; Zhijun ZHAO
Chinese Journal of Schistosomiasis Control 2025;37(1):44-54
Objective To investigate the impact of Toxoplasma gondii type I, II and III rhoptry protein 16 (ROP16) on programmed cell death ligand 1 (PD-L1) expression in lung adenocarcinoma cells, and to examine the effects of T. gondii type I ROP16 protein on the relative PD-L1 expression, the relative PD-L1 distribution on the cell membrane surface, and the binding of programmed cell death 1 (PD-1) to PD-L1 in lung adenocarcinoma cells. Methods Lentiviral vectors overexpressing T. gondii type I, II and III ROP16 proteins were generated, and transfected into the human lung adenocarcinoma A549 cell line. A549 cells were used as a blank control group, and A549 cells transfected with an empty lentiviral expression vector were used as a negative control group, while A549 cells transfected with lentiviral vectors overexpressing T. gondii type I, II and III ROP16 proteins served as experimental groups. Stably transfected cells were selected with puromycin and verified using Western blotting, quantitative real-time PCR (RT-qPCR), and immunofluorescence assays. The PD-L1 expression was quantified at translational and transcriptional levels using Western blotting and RT-qPCR assays in A549 cells in the five groups, and the relative PD-L1 distribution was detected on the A549 cell membrane surface using flow cytometry. In addition, the effect of T. gondii type I ROP16 protein on the PD-1/PD-L1 binding was measured in A549 cells using enzyme-linked immunosorbent assay (ELISA). Results The relative ROP16 protein expression was 0, 0, 1.546 ± 0.091, 1.822 ± 0.047 and 2.334 ± 0.089 in the blank control group, negative control group, and the T. gondii type I, II and III ROP16 protein overexpression groups (F = 1 339.00,P < 0.001), and the relative ROP16 mRNA expression was 2.153 ± 0.949, 2.436 ± 1.614, 14.343 ± 0.020, 12.577 ± 0.285 and 15.090 ± 0.420 in the blank control group, negative control group and the T. gondii type I, II and III ROP16 protein overexpression groups, respectively (F = 483.50,P < 0.001). The ROP16 expression was higher in the T. gondii type I, II and III ROP16 protein overexpression groups than in the blank control group at both translational and transcriptional levels (allP values < 0.001). Immunofluorescence assay revealed that T. gondii type I, II and III ROP16 proteins were predominantly localized in A549 cell nuclei. Western blotting showed that the relative PD-L1 protein expression was 0.685 ± 0.109, 0.589 ± 0.114, 1.007 ± 0.117, 0.572 ± 0.151, and 0.426 ± 0.116 in the blank control group, negative control group, and the T. gondii type I, II and III ROP16 protein overexpression groups (F = 9.46,P < 0.05), and RT-qPCR assay quantified that the relative PD-L1 mRNA expression was 1.012 ± 0.190, 1.281 ± 0.465, 1.950 ± 0.175, 0.889 ± 0.251, and 0.230 ± 0.192 in the blank control group, negative control group, and the T. gondii type I, II and III ROP16 protein overexpression groups (F = 14.18,P < 0.05). The PD-L1 expression was higher in the T. gondii type IROP16 protein overexpression group than in the blank control group at both translational and transcriptional levels (both P values < 0.05). Flow cytometry detected that the relative distributions of PD-L1 protein were (10.83 ± 0.60)%, (11.23 ± 0.20)%, and (14.61 ± 0.50)% on the A549 cell membrane surface (F = 28.31, P < 0.05), and the relative distribution of PD-L1 protein was higher in the T. gondii type IROP16 protein overexpression group than in the blank control group and negative control group (both P values < 0.001). ELISA measured significant differences in the absorbance (A) value among the T. gondii type IROP16 protein overexpression group, the blank control group and the negative control group if the concentrations of the recombinant PD-1 protein were 0.04 (F = 10.45, P < 0.05), 0.08 μg/mL (F = 11.68, P < 0.05) and 0.12 μg/mL (F = 52.68, P < 0.05), and the A value was higher in the T. gondii type IROP16 protein overexpression group than in the blank control group and the negative control group (both P values < 0.05), indicating that T. gondii type IROP16 protein promoted the PD-L1/PD-1 binding in A549 cells in a concentration-dose manner. Conclusions T. gondii type IROP16 protein overexpression may up-regulate PD-L1 expression in A549 cells at both transcriptional and translational levels and the relative PD-L1 distribution on the A549 cell membrane surface, and affect the PD-1/PD-L1 binding in a concentration-dependent manner.
5.Knowledge and behaviors about hepatitis B prevention and control among carriers of hepatitis B surface antigen
LI Siwen ; ZHOU Tiantian ; ZHANG Chao ; ZHANG Dan ; HU Weijun
Journal of Preventive Medicine 2025;37(3):253-256,261
Objective:
To investigate the knowledge and behaviors related to hepatitis B prevention and control among carriers of hepatitis B surface antigen (HBsAg), so as to provide the basis for conducting health education and interventions for HBsAg carriers.
Methods:
Based on the seroepidemiological survey of hepatitis B among individuals aged 1 to 69 years in Shaanxi Province, HBsAg carriers were selected as the study subjects. Basic information, knowledge and behaviors about hepatitis B prevention and control were collected through questionnaire surveys. The awareness of hepatitis B prevention and control knowledge and related behaviors among HBsAg carriers were analyzed.
Results:
A total of 107 HBsAg carriers were enrolled, including 52 males (48.60%) and 55 females (51.40%), and had a median age of 47.04 (interquartile range, 19.78) years. The awareness of hepatitis B prevention and control knowledge ranged from 56.07% to 87.85% among HBsAg carriers, with the highest awareness for "hepatitis B vaccination can effectively prevent hepatitis B "(87.85%), and the lowest awareness for "sharing meals with HBsAg carriers or hepatitis B patients will not lead to infection" (56.07%) and "hepatitis B can be treated with antiviral drugs" (61.68%). The proportions of those who did not seek medical consultation, undergo regular check-ups, or receive treatment were relatively high, at 65.42%, 72.90% and 77.57%, respectively.
Conclusions
The awareness of hepatitis B transmission routes and treatment-related knowledge among HBsAg carriers is relatively low, and their medical-seeking behaviors are relatively passive. There is a need to enhance the dissemination of hepatitis B prevention and control knowledge, improve medical-seeking behaviors, and reduce the risk of hepatitis B virus transmission.
6.Establishment and validation of liver micronucleus assay in rats using 4%neutral formaldehyde-fixed tissues
Tiantian ZHAO ; Weiwei HE ; Changhui ZHOU ; Zehao ZHAO ; Zixuan YANG ; Yan CHANG
Chinese Journal of Pharmacology and Toxicology 2024;38(6):436-444
OBJECTIVE To establish and validate a rat liver micronucleus test(LMNT)method based on fixation of liver tissue with 4%neutral formaldehyde(HCHO fixation)for preparation of hepa-tocytes(HEPs).METHODS ①The LMNT based on neutral HCHO fixation(HCHO fixation-LMNT)was established using the liver micronucleus positive compound N-nitrosodiethylamine(DEN).SD rats were divided into female and male groups,and each group was randomly subdivided into the vehicle control group and DEN 12.5 mg·kg-1 group,with five rats in each.The rats were ig administered with normal saline and DEN once a day for 14 consecutive days,after which liver tissues were collected.Some of the tissue was digested with collagenase to prepare HEP suspension,and the remaining tissue was used to prepare HEP suspension with HCHO fixation.After staining with SYBR Gold,the number of micronucleated hepatocytes(MN-HEP)and the number of HEPs in the mitotic phase were counted under a microscope.The micronucleus rate of HEP(MN-HEP rate)and the mitotic index were calculated,and an MN-HEP rate>0.07%was considered positive.②Male SD rats were divided into the quinoline(30,60,120 mg·kg-1)group,N-nitrosoopyrrolidine(NPYR,25,50,100 mg·kg-1)group,vehicle control group(deionized water for NPYR,and corn oil for quinoline),and positive control DEN(12.5 mg·kg-1)group,with 5-6 rats per group,and were ig administrated for 15 consecutive days.Body mass was recorded daily,and at the end of the experiment,the liver was removed to record the total liver weight,and calculate the liver coefficient.Liver function-related serum biochemical indicators including glutamic-pyruvic transaminase(GPT),glutamic-oxaloacetic transaminase(GOT)activities,and levels of total bili-rubin(T-BIL)were measured and direct bilirubin(D-BIL)using an automatic biochemical analyzer.The MN-HEP rate was determined using the collagenase digestion and HCHO fixation methods,and the peripheral blood MN assay and hepatocellular carcinoma comet assay were conducted to evaluate the genotoxicity of quinoline and NPYR.RESULTS ① Compared with the corresponding vehicle control groups(0.069%and 0.030%),the MN-HEP rate of male rats treated with DEN by formalin-LMNT was 1.10%,and the MN-HEP rate of female ones was 0.82%,both significantly increased(P<0.05).Com-pared with corresponding vehicle control groups(0.060%and 0.030%),the MN-HEP rate of male rats treated with DEN by collagenase digestion-LMNT was 1.45%,and that of female rats was 0.46%,both significantly increased(P<0.05),which were considered positive.The MN-HEP rate of male rats was significantly higher than that of females with both methods(P<0.05).There was no significant differ-ence in mitotic indexes between the DEN groups by collagenase digestion-LMNT and HCHO fixation-LMNT in male and female rats compared to corresponding vehicle control groups.② Compared to the vehicle control group,the body mass of rats in the NPYR 50 and 100 mg·kg-1 groups was significantly reduced 7 to 14 days into the ig administration(P<0.01),and the DEN group showed a significant reduction at days 8 to 14(P<0.01).The body mass of rats in the quinoline 120 mg·kg-1 group was signifi-cantly reduced 4 to 14 days into the ig administration(P<0.01),and the DEN group showed a signifi-cant reduction at days 10 to 14(P<0.05).Compared to the vehicle control group,both the liver weight and liver coefficient were significantly reduced in the NPYR 100 mg·kg-1 group(P<0.01)and the DEN group(P<0.05).The liver weight(P<0.01)and liver coefficient(P<0.05)were significantly increased in the quinoline 60 and 120 mg·kg-1 groups.Compared to the vehicle control group,the serum T-BIL level was significantly increased in the DEN group(P<0.01),and the activities of GPT and GOT,as well as the levels of D-BIL and T-BIL,were significantly increased in the NPYR 100 mg·kg-1 group(P<0.01).There were no significant changes in the NPYR 25,50 mg·kg-1 groups or any of the dose groups of quinoline.The MN-HEP rate by HCHO fixation-LMNT for NPYR was slightly higher than that by collage-nase digestion-LMNT,both considered positive.Compared with corresponding control group,the MN-HEP rate by formalin-LMNT for NPYR and the MN-HEP rate by collagenase digestion for NPYR were both significantly increased(P<0.05).The MN-HEP rate by HCHO fixation-LMNT for quinoline was comparable to that by collagenase digestion-LMNT,both considered positive.Compared with corresponding vehicle control group,the MN-HEP rate by HCHO fixation-LMNT for quinoline and the MN-HEP rate by collagenase digestion-LMNT for quinoline were both significantly increased(P<0.05).The correlation between the MN-HEP rates based on HCHO fixation and collagenase digestion for NPYR and quinoline was good(R2=0.8614 and 0.9279,respectively).In the NPYR groups,the periph-eral blood micronucleus assay were negative,while the comet assay results were positive.In the quino-line group,both the peripheral blood micronucleus assay and the comet assay results were negative.CON-CLUSION The HCHO fixation-LMNT has been established and validated,and the sensitivity of the LMNT method based on HCHO fixation-LMNT for detection of hepatocarcinogens is higher than that of collagenase digestion-LMNT.
7.Correlation between plasma neurofilament light chain and subtypes of Parkinson disease
Xiaojing LIANG ; Hongyan YI ; Tiantian LI ; Fugui XU ; Lijun WANG ; Zhou OU ; Qiang TONG
Chinese Journal of Behavioral Medicine and Brain Science 2024;33(9):783-789
Objective:To investigate the correlation between plasma total α-synuclein (α-syn), phosphorylated α-synuclein (p-α-syn), neurofilament light chain(NfL) and subtypes of Parkinson disease(PD).Methods:A total of 62 PD patients admitted to the Department of Neurology, the Affiliated Huai 'an No. 1 People 's Hospital of Nanjing Medical University from September 2021 to January 2023 were selected and scored on the Hoehn-Yahr stage(H-Y), unified Parkinson's disease rating scale Ⅲ(UPDRS-Ⅲ), levodopa equivalent daily dosage(LEDD), mini-mental state examination(MMSE), Parkinson disease quality of life questionnaire(PDQ-39) and activities of daily living(ADL). During the same period, 25 healthy individuals matched in age and sex were enrolled as the control group (HC). Clinical characteristics and blood samples were collected. The plasma levels of α-syn, p-α-syn and NfL were detected by enzyme-linked immunosorbent assay(ELISA). PD patients were divided into tremor dominant type (TD, n=27) and akinetic-rigid dominant type (AR, n=35) based on UPDRS-Ⅲ scores. Multifactorial Logistic regression analysis was performed by SPSS 25.0 software to determine the influencing factors of subtypes of Parkinson disease. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off point of plasma NfL between the AR type and the TD type. Results:Plasma α-syn, p-α-syn, NfL levels in the PD group were significantly higher than those of the HC group ( Z=-2.537, -6.580, -7.101, all P<0.05). There were statistically significant differences between the AR type and the TD type in disease duration, H-Y stage, UPDRS-Ⅲ scores, LEDD and MMSE scores ( Z=-2.503, -3.021, -2.025, -2.086, -2.409, all P<0.05). While no significant difference was found in plasma α-syn and p-α-syn levels between the AR type and TD type ( Z=-0.341, -0.085, both P>0.05), the plasma NfL levels were notably higher in the AR type(92.79(16.84, 117.53) pg/mL) compared to the TD type (12.10(6.99, 100.17) pg/mL)( Z=-2.236, P<0.05). Plasma NfL levels were correlated with rigidity scores ( r=0.438, P<0.001), UPDRS-Ⅲ scores ( r=0.337, P<0.05) and motor subtypes ( r=0.286, P<0.05) in PD patients. Multivariate Logistic regression analysis showed that NfL was risk factor for AR( B=0.002, OR=1.002, 95% CI=1.001-1.003, P=0.017). The ROC curve analysis indicated that plasma NfL levels could predict different subtypes of PD with an AUC=0.667, optimal cutoff =26.527. Conclusion:There is a correlation between elevated plasma NfL levels and the occurrence of AR type of PD, suggesting that nerve injury is probably involved in the occurrence and progression of various motor subtypes of PD.
8.Nursing expert consensus on subcutaneous injection for allergen-specific immunotherapy
Allergy and Clinical Immunology Committee of Chinese Research Hospital Association ; Allergy Care Group,Chinese Society of Allergology,Chinese Medical Association ; Allergy Prevention and Control Committee of Chinese Preventive Medicine Association ; Qing WANG ; Jun LIU ; Fan ZHI ; Wenjin WAN ; Fengying TIAN ; Xiaopeng HUO ; Wenhua ZHOU ; Yongshi YANG ; Tiantian WANG ; Jinlü SUN
Chinese Journal of Nursing 2024;59(9):1080-1084
Objective To develop an expert consensus on subcutaneous injection for allergen-specific immunotherapy.Methods Relevant domestic and intemational literature was reviewed,and nursing experts who had experiences in subcutaneous injection of allergen-specific immunotherapy were interviewed to form the initial draft of the consensus.A total of 85 experts from 42 hospitals nationwide were invited to participate in discussions.2 rounds of expert consultations,adjustments,revisions,and improvements were made to the initial draft,and an online meeting was held to form the final version of the consensus.The content approved by more than 75%of the expert group is adopted,or it will be discussed or deleted.Results The expert consensus includes operational standards for subcutaneous injection of allergen-specific immunotherapy,identification and management of adverse reactions,and health education.Conclusion The consensus demonstrates strong scientific rigor and practicality,providing guidance for nursing practices in the field of clinical allergology.
9.Analysis of the etiology and factors associated with the severity of chronic spontaneous urticaria in children
Tiantian ZHOU ; Xuege WU ; Huan YANG ; Xiao FANG ; Jinqiu JIANG ; Jingsi CHEN ; Xiaoyan LUO ; Hua WANG
Chinese Journal of Dermatology 2024;57(4):324-330
Objective:To analyze the etiology of chronic spontaneous urticaria (CSU) in children and associated factors affecting the disease severity.Methods:A single-center cross-sectional study was conducted. Children aged ≤ 17 years with CSU were prospectively enrolled at the Department of Dermatology, Children′s Hospital of Chongqing Medical University from November 2021 to November 2022. Clinical data were collected, serum total IgE and allergen-specific IgE (sIgE) were detected, and basophil activation test (BAT) and autologous serum skin test (ASST) were performed. According to the ASST and BAT results, the children were divided into the chronic autoimmune urticaria (CAU) group (positive for both ASST and BAT), non-CAU group (negative for both ASST and BAT), and partial CAU group (positive for either ASST or BAT). Differences in the etiology and clinical characteristics were analyzed between the CAU group and the non-CAU group. Based on the weekly urticaria activity score (UAS7), the children with CSU were divided into the mild group (UAS7 < 16 points) and moderate to severe group (UAS7 ≥ 16 points). Factors associated with the severity of CSU in children were analyzed using logistic regression. Non-normally distributed quantitative data were expressed as M ( Q1, Q3), and the non-parametric rank sum test (Kruskal-Wallis test) was used to compare quantitative data among multiple groups. Results:This study enrolled a total of 93 children with CSU, including 50 males (53.8%) and 43 females (46.2%), with the age being 5.9 (2.9, 9.2) years, and the disease duration being 4 (2, 8) months; 32 patients (34.4%) were complicated by angioedema, 28 (30.1%) had a family history of chronic urticaria, 49 (52.7%) had a family history of atopic diseases, 14 (15.1%) had a family history of autoimmune diseases, and 26 (28.0%) had at least one atopic comorbidity. Etiologic analysis showed that 32 cases (32/69, 46.4%) were positive for ASST and 28 (28/70, 40.0%) were positive for BAT. Both ASST and BAT were performed in 57 cases, and they were divided into the CAU group (18 cases), non-CAU group (24 cases), and partial CAU group (15 cases) according to the test results. There were no significant differences in the age, disease duration, gender ratio, proportion of patients with atopic comorbidity, or proportion of patients having a family history of atopic diseases among the 3 groups (all P > 0.05), while the proportion of patients with moderate to severe CSU (UAS7 ≥ 16 points) was higher in the CAU group (16/18) than in the non-CAU group (11/24, P < 0.05). Triggering factors were identified in 19 cases (20.4%), including 18 (19.3%) cases of food allergy and 1 case (1.0%) of antibiotic allergy. The serum total IgE level was elevated in 22 cases (22/89, 24.7%), and 40 (40/81, 49.4%) showed elevated levels of at least 1 sIgE. The UAS7 of the children with CSU was 16 (15, 21) points, and there were 31 (33.3%) children with mild CSU and 62 (66.7%) with moderate to severe CSU. Univariate logistic regression analysis showed that BAT positivity was associated with disease severity ( OR = 7.566, 95% CI: 2.238 - 25.572, P < 0.05). After adjustment for age and gender, multivariate logistic regression analysis showed that BAT positivity was associated with moderate to severe CSU ( OR = 6.725, 95% CI: 1.361 - 33.227, P < 0.05) . Conclusions:Autoimmunity may be the main cause of CSU in children, followed by allergic factors. ASST could be used as a primary screening test for the diagnosis of CAU in children, and BAT may help identify CAU and predict disease severity.
10.Analysis of confirmed cases of pertussis reported in Shaanxi Province
Ruize WANG ; Xiao ZHENG ; Weixuan LI ; Tiantian ZHOU ; Yake LYU ; Weijun HU
Chinese Journal of Microbiology and Immunology 2024;44(6):485-488
Objective:To investigate the current status of pertussis laboratory diagnosis and confirmed pertussis cases reporting in Shaanxi Province, and evaluate the quality of case reports.Methods:The information of confirmed pertussis cases reported in Shaanxi Province from January to July 2022 was collected through the China Disease Control and Prevention Information System. The laboratory diagnostic methods and pertussis vaccine immunization history of confirmed cases were investigated, and the descriptive epidemiological method was used for statistical description.Results:Of the 164 confirmed cases of pertussis reported from January to July 2022, two were not tested in the laboratory and 162 were tested in the laboratory. The proportions of different detection methods were 1.85% (3/162) of isolation and culture, 31.48% (51/162) of serum antibody IgG, 14.20% (23/162) of serum antibody IgM, 49.38% (80/162) of serum antibody PCR and 3.09% (5/162) of serum antibody IgM+ PCR. Among the 79 serological positive cases, 12 cases (15.19%)had no history of pertussis immunization, and 15 cases (18.99%), 11 cases (13.92%) and 41 cases (51.90%) had the time interval from vaccination to detection of <1 year, 1-3 years and >3 years, respectively. Based on the analysis of laboratory testing methods and vaccination history, 38 cases were misdiagnosed/misreported among 164 cases, with a misdiagnosis or misreported rate of 23.17%. There were 17, 12 and 9 cases of misdiagnosis/misreport in 0-2 years old group, 3-6 years old group and≥7 years old group, and the misdiagnosis or misreported rates were 27.42%(17/62), 26.67%(12/45) and 15.79%(9/57), respectively.Conclusions:The selection of pertussis laboratory testing methods in some medical institutions in Shaanxi Province is incorrect, which leads to a certain proportion of misdiagnosis or misreport, and it is necessary to further strengthen the training and standardization.

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