Objective:To explore the diagnostic value of the toxicant and drug detection in clinical poisoning diseases and analyze the clinical characteristics of patients with positive poison test.Methods:This study was a multicenter retrospective cohort study. Sampling and clinical information data were collected between October 1, 2020 and September 30, 2022 from 41 tertiary hospitals in and around Jiangsu province. The clinical characteristics of patients with positive toxicology tests were analyzed, and the correlation between the drug sampling situation and the test results was analyzed..Results:A total of 895 patients with clinical diagnosis or suspected poisoning were enrolled in this study. Among them, 652 patients had positive results, accounting for 72.85%. Among all positive patients, 506 patients were exposed to a single poison and 147 patients were exposed to multiple poisons. The top three poisons were pesticide herbicides (202 cases, 30.98%), sedative and psychotropic drugs (151 cases, 23.16%), and pesticide insecticides (97 cases, 14.88%). Among 541 patients with clear exposure history, the positive rate was 78.19%, and among 354 patients with unclear exposure history, the positive rate was 64.69%. The top three poisons (drugs) of patients with unclear exposure history were sedative and psychotropic (82, 12.58%), herbicide (26, 3.99%), and rodenticide (22, 3.37%). Patients who admitted to hospital for unexplained consciousness disorder, abnormal blood coagulation function and multiple organ dysfunction were more likely to obtain positive poison test results.Conclusions:There is uncertainty in the exposure history of poisoning diseases, so it is necessary to improve the detection of toxic substances as soon as possible. Toxicant testing should be considered when patients have impaired consciousness, abnormal coagulation function and multiple organ dysfunction.

Objective: To explore the related factors of subependymal hemorrhage (SEH) and cerebral hemodynamic changes. Methods: From October 2012 to October 2017, 200 cases of children with subependymal hemorrhage diagnosed by ultrasound in our department of pediatrics were selected as the observation group , and a total of 150 children who were admitted to the Department of Pediatrics in the same period due to craniocerebral diseases and other serious diseases were selected as control group. The independent risk factors of the children in the observation group were analyzed, and the difference of the maximum systolic blood flow velocity (SV), the diastolic maximum flow velocity (DV), the systolic and diastolic velocity ratio (S/D), the resistance index (RI), and the pulsatile index (PI) were compared between the two groups. Results: Neonatal asphyxia, preterm birth, acidosis, neonatal respiratory distress syndrome (NRDS), patent ductus arteriosus and coagulation dysfunction were independent risk factors for subependymal hemorrhage. The bleeding side SV and DV of the observation group were higher than those of the control group, with statistically significant difference (P<0.001). In the observation group, the bleeding side SV and DV were higher than those of the healthy side, with statistically significant difference (P<0.001). There was no significant difference in bleeding side SV, DV, S/D, RI and PI in 110 cases of single side ependymal hemorrhage (P>0.05). Conclusions Children with ependymal hemorrhage can observe the hemodynamic indexes of anterior cerebral artery (ACA) dynamically by craniocerebral ultrasound, and judge the therapeutic effect by evaluating the systolic and diastolic blood flow velocity, so as to prevent the further aggravation of subependymal hemorrhage

Objective To analyze the clinical characteristics of community-acquired influenza virus pneumonia in hospitalized children and improve the clinicians' understanding level of this disease.Methods Data of 70 cases with community-acquired influenza virus pneumonia admitted to the Respiratory Department and Infectious Disease,Beijing Children's Hospital,Capital Medical University,from November 2009 to April 2018 were collected and the clinical characteristics were analyzed.Results Of the 70 cases,61 cases(89.7％) were discharged after improvement.The median age was 3.5 years old,and 50 cases(71.4％) were 0 to 5 years old.There were 29 cases with severe influenza pneumonia,41 cases with mild influenza pneumonia,3 cases died,and 19 cases (27.1％) had underlying diseases.Sixty-four cases (91.4％) were hospitalized in winter and spring.The first symptoms were mainly fever in 64 cases (91.4％) and cough in 65 cases (92.9％),and temperatures were mostly from 39.1 ℃ to 41.0 ℃.Lung auscultation was dominated by moist rales (30 cases,58.8％) and wheezing (8 cases,15.7％).There were many complications of influenza virus pneumonia,including 19 cases with myocardial injury,11 cases with liver function injury,4 cases with toxic encephalopathy,3 cases with electrolyte disturbance,2 cases with multiple organ failure,2 cases with hemophagocytic syndrome,and 1 case with septic shock.Chest radiographic results reveal bilateral inflammation in 40 children (57.1％),prodominatly in lower lobe lesions (39 cases).The common changes were patchy shadow,interstitial parenchymal lesion,ground glass shadow,and pleural effusion.Forty-seven children (67.1％) were infected by influenza A,and 23 children(32.9％) were co-infected.The percentage of severe cases with underlying diseases (68.4％) was significantly higher than that in children without chronic diseases (31.4％),the difference was statistically significant (x2 =7.830,P =0.005).The increase rate of C reaction protein (CRP) in severe cases (54.3％) was significantly higher than that in mild cases (28.6％),the difference was statistically significant (x2 =4.769,P =0.029).Conclusions Community-acquired influenza virus pneumonia in children mainly occurs in winter and spring.It is more common seen in children under 5 years of age.The main clinical manifestations of community-acquired influenza virus pneumonia are high fever and cough,extrapulmonary complications are more common.Most children have moist rales and showed bilateral inflammation and lower lobe lesions in chest radiography.Children with underlying diseases are more likely to develop severe influenza virus pneumonia.Elevated CRP is associated with severe influenza virus pneumonia.Most patients have a good prognosis,but there are still cases of death.

In the original publication the grant number is incorrectly published. The correct grant number should be read as "17140901600". The corrected contents are provided in this correction article. This work was partially supported by grants from the National Natural Science Foundation of China (Nos. 81670470 and 81600149), a grant from the Shanghai Municipal Commission for Science and Technology (17140901600, 18411953500 and 15JC1400201) and a grant from National Key Research and Development Program (2016YFC0905100).

Objective This study aimed to analyze the knowledge, attitude, behavior, and practice of pneumococcal vaccination in type 2 diabetes mellitus patients. Methods From January to March 2018, 3000 patients with type 2 diabetes mellitus were randomly selected from patients with type 2 diabetes registered and managed in community health service centers to participate in a questionnaire survey, using multi-stage cluster random sampling. The questionnaire included basic information, pneumococcal vaccine awareness, and pneumococcal vaccination status and inoculation intention, 2896 valid questionnaires were collected. The chi-squared test and multivariate logistic regression analysis were used to analyze the knowledge, attitude, behavior, and practice and influencing factors of pneumococcal vaccination. Results Of all the patients, 1267 (43.75％) patients with type 2 diabetes were willing to receive pneumococcal vaccination, and 23 (0.79％) patients with type 2 diabetes were vaccinated against pneumococcal, 1295(44.72％) patients with type 2 diabetes believed that patients with chronic diseases were susceptible to pneumococcal. Eight hundred seventy-seven (30.38％) patients believed that pneumococcal vaccination for chronic disease patients could reduce the risk of outpatient, hospitalization and death. Seven hundred ninety-nine (27.59％) patients believed that diabetic patients were the primary recipients of the pneumococcal vaccine. Multivariate logistic regression analysis showed that retired patients; those who thought that patients with chronic diseases were susceptible to pneumonia; those who thought that pneumococcal vaccination could reduce the risk of needing outpatient care, hospitalization, and death;and those who thought that diabetes was the priority of pneumococcal vaccination were more willing to receive pneumococcal vaccination (OR=1.442, 0.764, 1.494, 1.713, P all<0.05). Conclusion Patients with type 2 diabetes in Shenzhen have lower pneumococcal vaccine awareness, inoculation intention, and vaccination rates. Health education on the prevention of diabetes complications and pneumococcal vaccination should be promoted.

Objective To detect the serum level of 3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid (CMPF),a significant metabolite offish oil,in subjects with normal glucose tolerance (NGT) in local communities,and to investigate the association of CMPF with fatty acid metabolism.Methods A total of 272 NGT participants from screening for diabetes in Shanghai in 2013 were enrolled.Anthropometric measurements,biochemical evaluation,and questionnaire interview were performed for all the participants.The participants were divided into normal weight group [body mass index (BMI) ≤23.9 kg/m2,n =143] and overweight/obesity group (BMI ≥ 24 kg/m2,n =129).The serum CMPF concentrations were determined using an enzyme-linked immunosorbent assay.Results Serum CMPF level in overweight/obesity group was lower than that in normal weight group [96.50 (46.11,169.56) μmol/L vs 153.20 (83.16,282.97) μmol/L,P＜0.05].The serum CMPF level was negatively correlated with BMI (r =-0.256,P＜0.01),triglycerides (r =-0.175,P =0.004),and free fatty acid (r =-0.126,P =0.041) according to bivariate correlation analyses.A multivariate stepwise linear regression analysis showed that the serum CMPF level was independently associated with BMI,triglycerides,free fatty acid,and HbA1C.A logistic regression analysis showed that the CMPF was a protective factor against obesity (OR =0.324,95％ CI 0.158,0.664).Conclusion Serum CMPF level is reduced in overweight/obese subjects.CMPF is beneficial to lipid metabolism.

Adenosine ; genetics ; Adenosine Deaminase ; genetics ; metabolism ; Animals ; CRISPR-Associated Protein 9 ; genetics ; metabolism ; CRISPR-Cas Systems ; genetics ; Embryo, Mammalian ; metabolism ; Gene Editing ; Genetic Variation ; genetics ; Mice ; Mice, Inbred C57BL ; Rats ; Rats, Sprague-Dawley

Objective: To evaluate the cost-effectiveness of intervention and management of the patients with dyslipidemia in some districts in Shenzhen and provide health economic basis for prevention and control of dyslipidemia. Methods: We conducted a comprehensive community intervention among patients for dyslipidemia management, enrolling 204 cases of dyslipidemia in the intervention group and 200 cases in the control group through multi-stage cluster random sampling. We collected baseline and intervention data, such as the cost of institutional intervention (labor costs, office expenses, material expenses, loss of low-value consumables, service costs, and depreciation of fixed assets), patient costs (direct and indirect medical costs), effect indicators (lipid control rate, lipid improvement rate, and lipid exacerbation rate) to analyze cost-effectiveness. Results: After 12 months of the comprehensive community intervention, the total cost for the intervention group was 1 321.62 yuan per capita; the cost per patient was 973.33 yuan; and per capita institutional cost was 348.29 yuan. Total cholesterol, triglyceide, and high-density lipoprotein cholesterol of intervention group decreased by 0.43 mmol/L, 0.16 mmol/L, and 0.42 mmol/L, respectively, after the intervention, and there was a significant difference before and after the intervention (P<0.05). After intervention, the intervention group lipid control rate was 17.6%, the lipid improvement rate was 48.0%, and the lipid exacerbation rate was 7.4%, whereas those of the control group were 10.5%, 22.5%, and 16.0%, respectively. The lipid control rate and improvement rate in the intervention group were higher than those in the control group, and the lipid exacerbation rate was lower than that of the control group. The difference between the two groups was statistically significant (χ²=43.774, P<0.001). Patients in the control group had a unit cost of 81.17 yuan for 1% of blood lipid control rate and 37.88 yuan for one unit of blood lipid improvement rate. The corresponding per capita cost of the intervention group was 74.87 yuan and 27.51 yuan, respectively. The intervention group's cost-effect ratio was lower than that of the control group and had good cost-effectiveness. Conclusions The comprehensive community intervention and management of patients with dyslipidemia was effective in terms of health economics and it is worth the long-term implementation and promotion in the community health service center.

Objective To investigate the role and significance of neuropilin-2(NRP2)for regulating the angiogenesis of pancreatic neuroendocrine tumors(PNETs).Methods The NRP2 expression in pancreatic neuroendocrine tumer BON-1 cell line was intevened.The BON-1 cells cultural supernatants in the control group and interference group were used to treat human umbilical vein endothelial cells(HUVEC).CCK-8 was used to detect the cell proliferation,Transwell was used to detected the cell migration and the tubule formation test was used detect the pro-angiogenesis.Results The CCK-8 detection showed that there was no statistically significant difference in the supernatant treated HUVEC proliferations between the interference group and control group medium(P>0.05):the absorbancy in the control group was 0.35±0.04,while which in the interference group was 0.32±0.04.The Transwell test showed that the invasion ability of HUVEC treated with cultural supernatants in the interference group was weakened compared with the control group,the control group was(203±13)/hole,while the interference group was(100±10)/hole(P＜0.01);the tubule formation test showed that HUVEC tubular formation treated by cultural supernatant in the interference group was decreased,the control group was 40±5,while the interference group was 24±3(P＜0.01).Conclusion Interfering NRP2 expression of BON-1 cells can inhibit the vessel formation ability of co-cultured HUVEC,suggesting that NRP2 may have the pro-angiogenesis effect of PNETs,and may be a potential new target for the treatment of PNETs.

Objective To analyze the significance of levels and combined detection of plasma homocysteine(Hcy),high-sensitivity C reactive protein(hs-CRP) and lipoprotein-associated phospholipase A2(Lp-PLA2) in patients with ischemic cerebral stroke(ICS).Methods A total of 140 patients with ICS were selected into ICS group,and 100 healthy individuals were recruited in the control group.The plasma levels of Hcy,hs-CRP,Lp-PLA2 were examined,then the positive rates of them were statistically analyzed.Analyzed the value of the levels and joint detection of Hcy,hs-CRP and Lp-PLA2.Results The plasma levels and the positive rates of Hcy,hs-CRP and Lp-PLA2 in ICS group were statistically higher than those in the control group(P<0.05).The area under the receiver-operating characteristic curve of combined detection of Hcy,hs-CRP and Lp-PLA2 in diagnosis of ICS was 0.949,the sensitivity was 0.850,and the specificity was 0.807,which were higher than Hcy,hs-CRP and Lp-PLA2 alone.Conclusion The plasma levels of Hcy,hs-CRP and Lp-PLA2 increase in ICS patients,and the combined detection of the three indicators might improve the early diagnostic value of ICS.