Objective: To investigate the causal relationship between antioxidant nutrients and pregnancy complications, so as to provide the reference for the prevention and treatment of pregnancy complications. Methods: Data of seven antioxidant nutrients including vitamin A, vitamin C, vitamin E, selenium, zinc, copper and iron were collected from genome-wide association study (GWAS) Catalog database, and data of four pregnancy complications including gestational diabetes mellitus, pre-eclampsia, spontaneous abortion and preterm birth were collected from the Finland database. Single nucleotide polymorphism (SNP) data were collected, and 27 SNPS strongly correlated with seven antioxidant nutrients were selected as instrumental variables. Mendelian randomization (MR) analyses were performed using the inverse-variance weighted (IVW) method with seven antioxidant nutrients as exposures factors and four pregnancy complications as outcome variables. The heterogeneity was assessed using the Cochran's Q test, the horizontal pleiotropy was assessed using the MR-PRESSO test and MR-Egger regression, and the robustness of the results was verified with the leave-one-out. Results: Cochran's Q test showed heterogeneity of MR results between vitamin C and gestational diabetes mellitus, preeclampsia and preterm birth, between vitamin E and iron and gestational diabetes (all P<0.05), and a random effect model was employed. There was no heterogeneity in other results (all P>0.05), and a fixed effect model was employed. MR analysis results showed that there was no causal association between seven antioxidant nutrients and the risk of four pregnancy complications (all P>0.05). MR-PRESSO test and the MR-Egger regression identified no horizontal pleiotropy of instrumental variables (both P>0.05). Conclusion This study did not find genetically predicted associations of antioxidant nutrients with pregnancy complications.

Objective:To compare the histopathological features and treatment efficacy of different methods for metachronous early gastric cancer (MEGC) in the remnant stomach.Methods:A total of 66 patients [38 endoscopic submucosal dissection (ESD) and 28 gastrectomy] with MEGC in the remnant stomach from January 2014 to December 2020 in Drum Tower Hospital were divided into the ESD group and the gastrectomy group. The baseline characteristics, histopathological features, treatment efficacy, and cost differences of the two groups were analyzed.Results:The MEGC in the remnant stomach mostly occurred in elderly male patients, with the mean age of 69.7±8.5 years. The mean interval of the occurrence of MEGC in the remnant stomach was 6 years. As for the tumor location, the gastric body (31.6%) was the main location in the ESD group and gastric cardia (53.6%) in the gastrectomy group with significant difference ( χ2=11.07, P=0.026). The mean operation time, hospital stay, postoperative fasting time, and total treatment cost were 80.0 min, 6.0 d, 1.5 d, ￥19 436 in the ESD group and 215.0 min, 19.0 d, 6.5 d, and ￥68 665 in the gastrectomy group, respectively, with significant differences between the two groups ( P<0.05). The overall survival rate during follow-up was 76.3% in the ESD group and 71.4% in the gastrectomy group with no significant difference between the two groups ( χ2=0.736, P=0.778). In terms of postoperative complications, the incidences of bleeding and infection were 7.9% and 5.3% in the ESD group, and those of obstruction and infection were both 14.3% in the gastrectomy group. There was significant difference in the incidences of postoperative obstruction between the two groups ( P<0.05). Conclusion:ESD is safe and effective for MEGC in the remnant stomach and is better than gastrectomy in terms of the treatment cost and operation time, but the long-term efficacy still needs to be validated by large-scale prospective studies.

MADS-box gene family is a significant transcription factor family that plays a crucial role in regulating plant growth, development, signal transduction, and other processes. In order to study the characteristics of MADS-box gene family in Docynia delavayi (Franch.) Schneid. and its expression during different stages of seed germination, this study used seedlings at different stages of germination as materials and screened MADS-box transcription factors from the transcriptome database of D. delavayi using bioinformatics methods based on transcriptome sequencing. The physical and chemical properties, protein conservative motifs, phylogenetic evolution, and expression patterns of the MADS-box transcription factors were analyzed. Quantitative real-time PCR (qRT-PCR) was used to verify the expression of MADS-box gene family members during different stages of seed germination in D. delavayi. The results showed that 81 genes of MADS-box gene family were identified from the transcriptome data of D. delavayi, with the molecular weight distribution ranged of 6 211.34-173 512.77 Da and the theoretical isoelectric point ranged from 5.21 to 10.97. Phylogenetic analysis showed that the 81 genes could be divided into 15 subgroups, among which DdMADS27, DdMADS42, DdMADS45, DdMADS46, DdMADS53, DdMADS61, DdMADS76, DdMADS77 and DdMADS79 might be involved in the regulation of ovule development in D. delavayi. The combination of the transcriptome data and the qRT-PCR analysis results of D. delavayi seeds indicated that DdMADS25 and DdMADS42 might be involved in the regulation of seed development, and that DdMADS37 and DdMADS38 might have negative regulation effects on seed dormancy. Previous studies have reported that the MIKC^* subgroup is mainly involved in regulating flower organ development. For the first time, we found that the transcription factors of the MIKC^* subgroup exhibited a high expression level at the early stage of seed germination, so we speculated that the MIKC^* subgroup played a regulatory role in the process of seed germination. To verify the accuracy of this speculation, we selected DdMADS60 and DdMADS75 from the MIKC^* subgroup for qRT-PCR experiments, and the experimental results were consistent with the expression trend of transcriptome sequencing. This study provides a reference for further research on the biological function of D. delavayi MADS-box gene family from the perspective of molecular evolution.
MADS Domain Proteins/metabolism* ; Phylogeny ; Gene Expression Regulation, Plant ; Genes, Plant ; Transcription Factors/genetics* ; Plant Proteins/metabolism* ; Gene Expression Profiling

Objective:To investigate the effects of long non-coding RNA Wilms tumor 1 associated protein pseudogene 1(WTAPP1)on the proliferation,invasion,migration and Wnt/β-catenin signaling pathway of nephroblastoma cells. Methods:Real-time fluorescence quantitative PCR was used to detect the relative expression level of WTAPP1 in 48 cases of nephroblastoma tumor tissues and their matched adjacent tissues,human nephroblastoma cells(SK-NEP-1)and normal renal epithelial cells(PCS-400-01 0,PCS-400-011 and PCS-400-01 2).The clinicopathological characteristics and prognosis of nephroblastoma patients with high or low WTAPP1 expression of were analyzed and compared.SK-NEP-1 cells were infected with lentivirus carrying the full-length WTAPP]gene(WTAPP1 overexpression)or shRNA targeting WTAPP1(shWTAPP1).Then,colony formation assay and CCK-8 assay were used to assess the proliferation of SK-NEP-1 cells,wound healing assay and Transwell assay were used to evaluate the migration and invasion activity of SK-NEP-1 cells respectively,and Western blotting was used to examine the relative expression levels of Wnt3a,β-catenin,C-myc and Survivin proteins. Results:The relative expression level of WTAPP1 in cancer tissues was higher than that in adjacent tissues(P＜0.05).The relative expression level of WTAPP1 in SK-NEP-1 cells was higher than that in normal renal epithelial cells(PCS-400-01 0,PCS-400-01 1 and PCS-400-01 2;P＜0.05).WTAPP1 expression was associated with the clinical stages of nephroblastoma(P＜0.05)but not with the age,gender,tumor diameter or lymph node metastasis of nephroblastoma patients(all P＞0.05).The 5-year survival rate of WTAPP1-high patients was significantly lower than that of WTAPP1-low patients(P＜0.05).The proliferation,migration and invasion activities of SK-NEP-1 cells were significantly increased after WTAPP1 overexpression(all P＜0.05)while decreased after WTAPP1 silencing(all P＜0.05).The relative expression levels of Wnt3a,β-catenin,C-myc and Survivin proteins were significantly upregulated after WTAPP1 overexpression(all P＜0.05)while decreased after WTAPP1 silencing(all P＜0.05). Conclusion:WTAPP1 is correlated with the clinical stages and prognosis of nephroblastoma patients and may promote the proliferation,invasion and migration of tumor cells by activating Wnt/β-catenin signaling pathway.

Objective:To analyze the status of the dyadic coping in spouses of young and middle-age cervical cancer patients undergoing synchronous radiotherapy and chemotherapy, and to explore the influencing factors in bi-directional of patients and their spouses.Methods:With the convenience sampling method, a total of 150 cervical cancer patients undergoing synchronous radiotherapy and chemotherapy who were hospitalized in the Radiotherapy Department of Tianjin Medical University Cancer Institute and Hospital from March 2021 to February 2022 and their spouses were selected. A cross-sectional study was conducted by the Dyadic Coping Inventory, the Lock-Wallace Marital Adjustment Test, the General Self-Efficacy Scale, the Hospital Anxiety and Depression Scale, etc. Besides, multiple linear regression was used to identify predictors of the dyadic coping in spouses of cervical cancer patients undergoing synchronous radiotherapy and chemotherapy.Results:The total score of dyadic coping, marital quality, general self-efficacy, anxiety and depression in spouses of cervical cancer patients undergoing synchronous radiotherapy and chemotherapy were (121.69 ± 19.67), (97.23 ± 25.05), (25.13 ± 5.19), (9.98 ± 3.46), (8.19 ± 4.06) points. The scores of anxiety and depression of cervical cancer patients undergoing synchronous radiotherapy and chemotherapy were (10.57 ± 3.60), (9.10 ± 4.12) points. Multiple linear regression analysis showed that factors of the patients′ anxiety and depression, spouse′s perception of marital quality, spouse′s general self-efficacy, changes in family relationship, family income, and period of radiotherapy were the main influencing factors ( P<0.01), which accounted for 55.7% of total variation. Conclusions:The level of dyadic coping in spouses of cervical cancer patients undergoing synchronous radiotherapy and chemotherapy was medium, the marriage quality remains to be further improved,and its influence factors involved in the bi-directional of patient and spouse, including patients′ anxiety and depression, the changes of the family relationship, period of radiotherapy, spouses perception of marital quality and self-efficacy and family income. Clinical medical staff can improve the level of dyadic coping in spouses of cervical cancer patients undergoing synchronous radiotherapy and chemotherapy by improving their cognition of disease, reducing the incongruence of dyadic illness appraisals, and taking multiple measures to reduce the economic burden felt of the spouses.

Objective:To investigate the correlation between the waiting time for radiotherapy after induction chemotherapy and the prognosis of locally intermediate and advanced nasopharyngeal carcinoma, as well as its optimal time.Methods:Retrospective analysis of 101 patients with locally intermediate and advanced nasopharyngeal carcinoma admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from 2017 to 2020 was performed. All patients received at least 2 courses of induction chemotherapy followed by radical radiotherapy. The waiting time for radiotherapy was defined as the time from the end of induction chemotherapy to the start of the first radiotherapy. The relationship between waiting time for radiotherapy and other factors (age, gender and stage, etc.) with progression-free survival (PFS), local recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) was analyzed through Cox model. The median waiting time for radiotherapy with 3 weeks was used as the boundary, and all patients were divided into ≤3 weeks and>3 weeks groups. The PFS, LRFS and DMFS between two groups were compared using Kaplan-Meier survival analysis. P<0.05 was considered as statistical significance. Results:Cox-regression analysis showed that the waiting time was correlated with PFS, LRFS, and DMFS (all P<0.05). Kaplan-Meier survival analysis suggested that the PFS, LRFS and DMFS in the ≤3 weeks group were significantly better than those in the >3 weeks group (all P<0.05). Under the premises of the T 3 stage, N 2 stage and the increased EB virus DNA replication levels before treatment, the PFS, LRFS and DMFS in the ≤3 weeks group were significantly better than those in the >3 weeks group (all P<0.05). Conclusions:The waiting time for radiotherapy is one of the factors affecting clinical prognosis of locally intermediate and advanced nasopharyngeal carcinoma. The earlier the time, the better the prognosis. Radiotherapy should be delivered within 3 weeks.

Cow′s milk protein allergy (CMPA) is one of the most common presentations of food allergy seen in early childhood.It is an abnormal immune response caused by cow′s milk protein.CMPA can be clinically subdivided into either immediate-onset IgE mediated or delayed onset non-IgE mediated, or both.At present, concerns regarding the early and timely diagnosis of CMPA have been high-lighted over the years and there are many expert consensus on CMPA in China, but these consensus did not distinguish IgE mediated or non-IgE mediated CMPA.In view of the obvious clinical differences between the two type of CMPA and non-IgE mediated CMPA is more common in infancy, experts focus on pediatric gastroenterology, allergy/immunology, dermatology, nutrition and child healthcare convened by the Allergy Prevention and Control Professional Committee of Chinese Preventive Medicine Association present this guideline to help practitioners in primary care settings to early recognize and make suitable management of non-IgE mediated CMPA in China.The guideline incorporates the cutting-edge international guidance and the actual situation of Chinese children describing in detail the types, clinical features, diagnosis and nutritional intervention of non-IgE mediated CMPA.There are 42 recommendations in 7 categories in total referring to the common questions related to non-IgE mediated CMPA.

Objective:To compare the efficacy of combination therapy on cyclic vomiting syndrome(CVS)in children, and improve the efficacy of CVS treatment in the future.Methods:This study retrospectively analyzed patients′ medical records of CVS, which were admitted to Digestive Department of Beijing Children′s Hospital from 2012 to 2019.The treatment regimen was A(Cyproheptadine+ Doxepin+ Valproate), B(Propranolol+ Cyproheptadine), or C(Propranolol+ Amitriptyline). Meanwhile, the patients should take drugs more than three months.The clinical data of 42 cases were analyzed retrospectively, and the treatment effect after discharge was followed up by telephone until October, 2020.Results:Among the 42 cases, 17 were male and 25 were female, whose mean age of onset was (4.65±3.23) years, and the age of diagnosis was (6.79±3.58) years.The main accompanied symptoms were abdominal pain and upper gastrointestinal bleeding.Forty-two patients were moderate/severe CVS.The regimens A, B and C were observed in 7, 11, and 24 patients, respectively.The age at improvement was(8.17±4.12)years.The course of treatment was(1.37±0.96)years.The age at follow-up was(10.32±4.03)years.During the 1-year follow-up, 35 cases were effective, and the efficiency was 83.3%.Among them, 23 cases had no paroxysmal vomiting and 7 cases had no effect.There was no significant difference in therapy effects among group A, B and C. Between the effective group and non-effective group, there were statistical differences in the personal history of hiatus hernia( P=0.024), the weight at follow-up ( P=0.042), and the course of medication( P=0.020). Conclusion:The combination regimen has a higher effective rate in the treatment of CVS.There was no significant difference among the three regimens in the treatment of CVS.For children with refractory CVS, who can not be treated with combination therapy, individualized therapy should be further developed.

Objective:To explore the effects of on-site management model based on 5M1E in high-risk patients with chest pain coming to hospital by themselves.Methods:Totally 263 high-risk patients with chest pain who went to Beijing Luhe Hospital, Capital Medical University by themselves from July 2017 to October 2018 were selected. Patients who received routine management from July 2017 to February 2018 ( n=128) were included into the routine management group, while patients who received on-site management based on 5M1E from March to October 2018 ( n=135) were included into the on-site management group. The arrival time at the emergency department gate (D) -first ECG time, D-blood collection time, blood collection time-chest pain biomarker result time, D-time of leaving emergency department for patients entering the catheterization room, D-balloon expansion time (D2B) for patients undergoing interventional therapy, and the treatment time of emergency patients with chest patients of the two groups of patients were recorded and compared. Results:The difference in D-first ECG time, D-blood collection time, blood collection time-chest pain biomarker result time, and D-time of leaving emergency department between the two groups of patients was statistically significant ( P<0.05) , whereas there was no statistically significant difference in D2B between the two groups ( P>0.05) . Conclusions:The on-site management model based on 5M1E can effectively shorten the time for consultation and treatment of high-risk patients with chest pain who come to the hospital by themselves, which is worth promoting in clinical practice.

Objective:To investigate the clinical features of pediatric ulcerative colitis (UC) and analyze the risk factors of disease relapse.Methods:The clinical data of 79 children with UC diagnosed in Beijing Children′s Hospital, Capital Medical University from January 2016 to February 2021 were retrospectively analyzed. They were divided into early relapse group and non-early relapse group according to the clinical relapse within 12 months after diagnosis. T-test, rank sum test, χ 2 test or Fisher′s exact test were used to compare the variables between the 2 groups, including the clinical features, laboratory examination results and treatments. The Logistic regression was used to analyze the risk factors of early relapse. The cumulative relapse rate during follow-up was calculated by Kaplan-Meier method. Results:Among the 79 UC children, 46 were males and 33 were females, and the age of onset was 10.6 (6.4, 12.7) years. The children were mainly characterized by extensive disease (E3) and pancolitis (E4) (51/79, 65%), moderate to severe activity (48/79, 61%) and moderate to severe inflammation of colonic mucosa (71/79, 90%). Thirty-eight (48%) patients had atypical phenotype and 17 (22%) had extraintestinal manifestations. The follow-up period was 43.9 (22.8, 61.3) months, and of the 41 patients rechecked with colonoscopy, 7 (17%) had disease progression. According to Kaplan-Meier analysis, the cumulative relapse rate of the 79 cases at 3 months, 6 months, 1 year and 2 years after diagnosis were 27% (21/79), 47% (37/79), 57% (45/79) and 73% (53/73), respectively. There were 45 children (57%) in early relapse group and 34 (43%) in non-early relapse group. In early relapse group, hemoglobin and mucosal healing rate were both significantly lower (105 (87, 122) vs. 120 (104, 131) g/L, 28% (7/25) vs. 7/9, Z=-2.38, χ2=4.87, both P<0.05). The rate of steroid-dependent, E3 and step-up therapy during the induction period were all significantly higher than those in non-early relapse group (11/19 vs. 1/12, 24% (11/45) vs. 6% (2/34), 29% (13/45) vs. 6% (2/34), χ2=5.67, 4.85, 6.66, all P<0.05). Multivariate Logistic regression analysis showed that extraintestinal manifestations ( OR=4.33, 95% CI 1.05-17.83), E3 ( OR=8.27, 95% CI 1.47-46.46) and step-up therapy during the induction period ( OR=5.58, 95% CI 1.01-30.77) were independent risk factors for early relapse. Conclusions:Pediatric UC is usually extensive and severe, with atypical phenotype, a high rate of relapse and a risk of disease progression. Extraintestinal manifestations, E3 and step-up therapy during the induction period are independent risk factors for early relapse.