Objective:To investigate the value of diameter of pulmonary nodules,radiological indicators,serum tumor markers(CEA,CYFRA21-1,and SCC),and methylation of HOXA7 and SOX17 in circulating tumor DNA(ctDNA)in the early diagnosis of lung can-cer.Methods:A total of 60 patients with malignant pulmonary nodules and 60 patients with benign pulmonary nodules who were admit-ted to our hospital from September 2021 to December 2022 were enrolled as lung cancer group and benign nodule group,respectively,and 80 healthy individuals who underwent physical examination in our hospital during the same period of time were enrolled as control group.The three groups were compared in terms of the diameter of nodules,spiculation sign,levels of serum tumor markers,and meth-ylation rates of HOXA7 and SOX17 in plasma ctDNA,and a multivariate regression analysis was performed to identify the independent risk factors for carcinogenesis and establish a predictive model.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic performance of the model.Results:Compared with the benign nodule group and the control group,the lung cancer group had significantly higher diameter of pulmonary nodules,proportion of patients with spiculation sign,CEA,ProGRP,CYFRA21-1,and methylation rates of serum HOXA7,and SOX17,and the lung can-cer group had a significantly higher level of SCC than the control group(all P<0.05).The diameter of pulmonary nodules,spiculation sign,and methylation rates of HOXA7 and SOX17 in serum ctDNA were independent risk factors for malignant pulmonary nodules(P<0.05),and a predictive model was established as Y=ex/(1+ex),where x=-7.233+(0.108×nodule diameter)+(3.860×spiculation sign)+(0.021×HOXA7 methylation rate)+(0.043×SOX17 methylation rate).The predictive model had an area under the ROC curve(AUC)of 0.981,with a significantly larger AUC than each indicator alone and the Mayo and LCBP models(P<0.05).Conclusion:The diameter of pulmonary nodules,spiculation sign,and methylation rates of HOXA7 and SOX17 in ctDNA have a relatively high value in the early diagnosis of lung cancer,and the predictive model based on these indicators can significantly improve diagnostic performance.

Objectives:The aim of this study was to investigate the value of assessing Selvester QRS score in evaluating myocardial fibrosis in hypertrophic cardiomyopathy(HCM)patients.Methods:A total of consecutive 149 patients with HCM,who were admitted in Fuwai Hospital from October 2008 to September 2013,were enrolled in this study.Qualitative and quantitative analyses of myocardial fibrosis were conducted based on late gadolinium enhancement(LGE)derived from enhanced cardiac magnetic resonance imaging(CMR).According to the qualitative analysis of myocardial fibrosis by CMR-LGE,the patients were divided into the LGE-negative group(n=46)and the LGE-positive group(n=103).Standard 12-lead electrocardiogram examination was performed and the Selvester QRS score was calculated.Multivariate binary Logistic regression analysis was used to analyze the predictive factors of positive LGE,and the correlation analysis between the Selvester QRS score and the LGE score was also performed.Results:Compared with the LGE-negative group,the proportion of patients with a family history of HCM(12.8%vs.28.2%),the proportion of patients with a positive Selvester QRS score(65.2%vs.83.5%)and the Selvester QRS score([1.65±1.81]points vs.[5.71±3.80]points)were higher,the maximum thickness of the left ventricular wall([20.5±3.2]mm vs.[24.5±5.0]mm)and the percentage of left ventricular myocardial scar area([5.0±5.5]%vs.[17.1±11.4]%)were larger in the LGE-positive group(all P<0.05).Multivariate binary logistic regression analysis showed that the Selvester QRS score(OR=1.429,95%CI:1.128-1.802,P=0.003)and the maximum left ventricular wall thickness(OR=1.257,95%CI:1.029-1.537,P=0.025)were independent predictors of positive LGE.Pearson correlation analysis showed that in all HCM patients,the Selvester QRS score was positively correlated with the LGE score(r=0.682,P<0.001),and the percentage of left ventricular myocardial scar area was positively correlated with the percentage of enhanced area to the total mass of left ventricular myocardium(LGE%)(r=0.682,P<0.001);In the LGE positive group,the Selvester QRS score was positively correlated with the LGE score(r=0.569,P<0.001).Receiver operating characteristic(ROC)curve analysis showed that the optimal cut-off values of Selvester QRS score and maximum left ventricular wall thickness for predicting positive LGE were≥3.5 points and≥21 mm,respectively.Conclusions:In HCM patients,the Selvester QRS score is significantly associated with myocardial fibrosis,and the total score≥3.5 serves as a good predictive cutoffvalue for identifying the presence of LGE.

Objectives:The aim of this study was to investigate the value of assessing Selvester QRS score in evaluating myocardial fibrosis in hypertrophic cardiomyopathy(HCM)patients.Methods:A total of consecutive 149 patients with HCM,who were admitted in Fuwai Hospital from October 2008 to September 2013,were enrolled in this study.Qualitative and quantitative analyses of myocardial fibrosis were conducted based on late gadolinium enhancement(LGE)derived from enhanced cardiac magnetic resonance imaging(CMR).According to the qualitative analysis of myocardial fibrosis by CMR-LGE,the patients were divided into the LGE-negative group(n=46)and the LGE-positive group(n=103).Standard 12-lead electrocardiogram examination was performed and the Selvester QRS score was calculated.Multivariate binary Logistic regression analysis was used to analyze the predictive factors of positive LGE,and the correlation analysis between the Selvester QRS score and the LGE score was also performed.Results:Compared with the LGE-negative group,the proportion of patients with a family history of HCM(12.8%vs.28.2%),the proportion of patients with a positive Selvester QRS score(65.2%vs.83.5%)and the Selvester QRS score([1.65±1.81]points vs.[5.71±3.80]points)were higher,the maximum thickness of the left ventricular wall([20.5±3.2]mm vs.[24.5±5.0]mm)and the percentage of left ventricular myocardial scar area([5.0±5.5]%vs.[17.1±11.4]%)were larger in the LGE-positive group(all P<0.05).Multivariate binary logistic regression analysis showed that the Selvester QRS score(OR=1.429,95%CI:1.128-1.802,P=0.003)and the maximum left ventricular wall thickness(OR=1.257,95%CI:1.029-1.537,P=0.025)were independent predictors of positive LGE.Pearson correlation analysis showed that in all HCM patients,the Selvester QRS score was positively correlated with the LGE score(r=0.682,P<0.001),and the percentage of left ventricular myocardial scar area was positively correlated with the percentage of enhanced area to the total mass of left ventricular myocardium(LGE%)(r=0.682,P<0.001);In the LGE positive group,the Selvester QRS score was positively correlated with the LGE score(r=0.569,P<0.001).Receiver operating characteristic(ROC)curve analysis showed that the optimal cut-off values of Selvester QRS score and maximum left ventricular wall thickness for predicting positive LGE were≥3.5 points and≥21 mm,respectively.Conclusions:In HCM patients,the Selvester QRS score is significantly associated with myocardial fibrosis,and the total score≥3.5 serves as a good predictive cutoffvalue for identifying the presence of LGE.

Objective:To explore the role of using methacholine challenge test（MCT）to detect airway responsiveness in standardized drug treatment management of asthma in children and adolescents.Methods:A total of 64 children diagnosed with moderate to severe persistent asthma from August 2010 to May 2021 at the Pediatric Asthma Clinic of the Second Hospital of Tianjin Medical University，who received standardized pharmacotherapy for 2 years，were selected and divided into a discontinued group（31 cases）and a continued group（33 cases）.The clinical value of lung function indicators，fractional exhaled nitric oxide（FeNO）values，and MCT results for evaluating and predicting the treatment effect of asthma in children and adolescents before and after treatment were analyzed.Results:The percentage of the expected value of forced expiratory volume in one second（FEV 1）before treatment discontinued group was higher than that in the continued group，and the difference was statistically significant（ F=7.283， P=0.009）.After standardized treatment for 6 months，1 year，and 2 years，the percentage of the expected value of FEV 1 in the discontinued group（ F=3.045， P=0.036）and continued group（ F=17.485， P<0.001）was significantly higher than that before treatment.There was no statistically significant difference in FeNO between the two groups before treatment（ F=0.298， P=0.587）.By treated for 6 months（ F=6.568， P=0.013），1 year（ F=4.317， P=0.042），and 2 years（ F=8.737， P=0.004），the FeNO levels of continued group were significantly higher than those of the discontinued group，with statistical significance.After treatment for 2 years，the PD 20 of the discontinued group was（1.702 ± 0.906）mg，while the PD 20 of the continued group was（1.184 ± 0.924）mg.The result was a significant difference between the two groups（ t=2.263， P=0.027）. Conclusion:Airway hyperresponsiveness of asthma patients persists，and the time for asthma to achieve clinical symptom control and inflammation improvement is earlier than that when airway responsiveness reaches the ideal level.In the long-term treatment and management of asthma，the clinical value of airway responsiveness assessment is relatively important.

Objective:To explore the possible pathogenic mechanism of the central nervous system by studying the neurodegenerative diseases caused by tick-borne encephalitis virus (TBEV) infection in mice.Methods:The mice were intracranially inoculated with TBEV, 8 days later the mice were sacrificed, the brain tissues of all mice were collected and observed after HE staining to verify if the model was successfully established; the expressions of neuronal nuclei (NeuN), glial fibrillary acidic protein (GFAP), proliferating cell nuclear antigen (PCNA) and reduced upon activation, normal T cell expressed and secreted (RANTES) in mouse brain tissue were detected by immunohistochemical method, the number of positive cells was counted and the gray value was analyzed to calculate the score.Immunofluorescence combined with laser scanning confocal microscopy were used to observe the distribution of NeuN and GFAP positive cells and the expression of RANTES and PCNA.Results:The number of NeuN-positive cells in the brain tissue of mice infected with TBEV decreased, while the GFAP-positive cells increased. Furthermore, astrocytes proliferated faster than neurons, and RANTES was mainly produced by astrocytes.Conclusions:TBEV infection could cause neurotoxic reactions in brain tissue, leading to nerve cells death and activating astrocytes which produces many RANTES.

Coronavirus disease 2019 (COVID-19) can increase the risk of thrombosis and arterial embolism events in patients. The more serious the condition, the higher the risk. Therefore, many academic groups at home and abroad have successively issued guidelines on the prevention and treatment of thrombosis in patients with COVID-19. Among them, American Society of Hematology 2021 guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19 (ASH guidelines) and its updates are newer and have more detailed recommendations on the application of anticoagulant drugs to prevent venous thromboembolism in acutely and critically ill patients with COVID-19. This review aims to provide reference for clinic through general viewing the ASH guidelines as well as other relevant guidelines at home and abroad.

Coronavirus disease 2019 (COVID-19) can increase the risk of thrombosis and arterial embolism events in patients. The more serious the condition, the higher the risk. Therefore, many academic groups at home and abroad have successively issued guidelines on the prevention and treatment of thrombosis in patients with COVID-19. Among them, American Society of Hematology 2021 guidelines on the use of anticoagulation for thromboprophylaxis in patients with COVID-19 (ASH guidelines) and its updates are newer and have more detailed recommendations on the application of anticoagulant drugs to prevent venous thromboembolism in acutely and critically ill patients with COVID-19. This review aims to provide reference for clinic through general viewing the ASH guidelines as well as other relevant guidelines at home and abroad.

BACKGROUND: Decreased heart rate variability (HRV) is a predictor of autonomic system dysfunction, and is considered as a potential mechanism of increased risk of cardiovascular disease (CVD) induced by exposure to particulate matter less than 2.5 μm in diameter (PM METHODS: An updated systematic review and meta-analysis of panel studies till November 1, 2019 was conducted to evaluate the acute effect of exposure to ambient PM RESULTS: A total of 33 panel studies were included in our meta-analysis, with 16 studies conducted in North America, 12 studies in Asia, and 5 studies in Europe. The pooled results showed a 10 μg/m CONCLUSION Short-term exposure to PM
Adult ; Aged ; Aged, 80 and over ; Air Pollutants/analysis* ; Air Pollution/analysis* ; Female ; Heart Rate/drug effects* ; Humans ; Male ; Middle Aged ; Particulate Matter/analysis* ; Young Adult

In order to clarify regions of production and to discriminate processing methods, quantitative and qualitative analyses for saccharides and terpenes in 35 batches of Alismatis Rhizoma were performed. Methodologies included HPLC-PDA, HPLC-VWD and UHPLC-MS , combined with principal component analysis (PCA) and partial least squares regression techniques (PLSR). The inhibitory effects of triterpenes and Alismatis Rhizoma extracts on lipase activity were evaluated . PLSR analysis revealed significant positive correlations ( = 0.5795) between the contents of triterpenes , , , and and the inhibitory effects of Alismatis Rhizoma. The present study establishes an effective method for simultaneous determination of multiple components, and identifies key bioactive triterpenes. These results can be used for systematic and novel analytical strategies for the quality control of Alismatis Rhizoma production.

Objective: The study assessed the clinical characteristics and response to acute intravenous antiarrhythmic drug therapy of supraventricular tachycardia (SVT) in children. Methods: This was a multicenter prospective descriptive study including 257 children from First Hospital of Tsinghua University, Peking University First Hospital, Children's Hospital Affiliated to Capital Institute of Pediatrics and Beijing Anzhen Hospital who received intravenous antiarrhythmic drug therapy for SVT from July 2014 to February 2017. The clinical and tachycardia features, response to intravenous antiarrhythmic drug therapy of these children were characterized. Statistical analyses were performed using t test, Mann-Whitney U test, χ² test and H test. Results: The onset of SVT occurred at any age with a distribution with positive skewness, 57.6% (n=148) children<1 year, 17.5% (n=45) children1~<3 years, 10.5% (n=27) children 3~<6 years and 14.4% (n=37) children ≥ 6 years of age. The percentages of SVT types were 49.4% (n=127) for atrioventricular reentry tachycardia (AVRT), 4.3% (n=11) for atrioventricular nodal reentry tachycardia (AVNRT), 26.8% (n=69) for unclassified paroxysmal SVT and 19.5% (n=50) for atrial tachycardia (AT), respectively. Tachycardia-induced cardionyopathy (TIC) secondary to SVT developed in 30 of 225 (13.3%). Left ventricular ejection fraction (LVEF) of the 27 children attacked by TIC returned to normal after successful control of SVT (41.1%±6.3% vs. 60.3%±9.2%, t=-10.397, P=0.000). Complete termination of SVT by antiarrhythmic drugs was achieved in 164 of 257 (63.8%), partial termination rate was 18.7% (48 of 257) and failure to terminate rate was 17.5% (45 of 257). Propafenone (complete cardioversion in 98 (73.1%) of 134) and amiodarone (complete cardioversion in 23 (76.7%) of 30) showed better efficacy for SVT termination than adenosine (complete cardioversion in 26 (44.1%) 59) (χ²=20.524, P=0.000). Paroxysmal SVT had a higher termination rate on pharmacological therapy than AT (67.1% vs. 50.0%, χ²=6.337, P=0.042). Patients of different age groups had significantly different response to antiarrhythmic therapy (χ²=13.904, P=0.031). Children<1 year of age showed the least response to antiarrhythmic drug therapy with complete termination in 51 (55.4%) of 92. Adverse effects occurred in 9 patients (3.5%): Four patients had severe hypotensive shock using propafenone (n=3) and adenosine (n=1), and 3 patients had sinus arrest using adenosine. Conclusion Most (57.6%) children with SVT have their first clinical episode within 1 year of age, and AVRT is the most common type. TIC occurs in 13.3% of children with SVT. Intravenous antiarrhythmic drug therapy has a 63.8% complete termination rate for children with SVT and incidence of adverse effects is 3.5%. Propafenone and amiodarone are more effective for SVT termination in children than adenosine. Serious adverse effects may occur when using propafenone.