Objective To investigate the distribution of traditional Chinese medicine(TCM)syndrome types in patients with primary Sj?gren's syndrome(PSS),and to explore the correlation between TCM syndrome types and laboratory findings of immunological parameters and inflammatory cytokines.Methods A retrospective study was conducted on 326 patients with PSS who attended the Department of Rheumatology of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,from January 2018 to December 2022.Analysis was carried out for the distribution of TCM syndrome types,namely yin deficiency and blood dryness syndrome,deficiency of qi and yin syndrome,internal retention of damp-heat syndrome,and stagnant heat in the collateral syndrome,in PSS patients.The gender,age of onset,and duration of disease of PSS patients with different TCM syndrome types were compared.And then an exploration was performed in the correlation between TCM syndrome types and laboratory findings of Sj?gren's syndrome antigen A antibody(anti-SSA),Sj?gren's syndrome antigen B antibody(anti-SSB),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),immunoglobulin G(IgG),immunoglobulin A(IgA),interleukin 6(IL-6),complement 3(C3)and complement 4(C4).Results(1)The analysis of the distribution of TCM syndrome types showed that among the 326 patients,106 cases(32.5%)were differentiated as internal retention of damp-heat syndrome,which accounted for the most,and then came yin deficiency and blood dryness syndrome(84 cases,25.8%),stagnant heat in the collateral syndrome(78 cases,23.9%),and deficiency of qi and yin syndrome(58 cases,17.8%)in descending order.(2)There was no statistically significant difference in the gender among the PSS patients with different TCM syndrome types(P>0.05),but the differences of age of onset and the duration of disease among the PSS patients with different TCM syndrome types were statistically significant(P<0.05).The distribution of duration of disease and age of onset in the PSS patients with yin deficiency and blood dryness syndrome,deficiency of qi and yin syndrome,and stagnant heat in the collateral syndrome,internal retention of damp-heat syndrome was in descending order.(3)The analysis of the correlation between TCM syndrome types and laboratory findings showed that yin deficiency and blood dryness syndrome was positively correlated with anti-SSB,IgA,IgG,and C4;deficiency of qi and yin syndrome was positively correlated with anti-SSB,IgG,and C4;internal retention of damp-heat syndrome was positively correlated with CRP,ESR,IL-6,anti-SSA,and IgA;stagnant heat in the collateral syndrome was positively correlated with CRP,ESR,IL-6,and anti-SSA.The differences were all statistically significant(P<0.05 or P<0.01).Conclusion The patients with PSS are usually differentiated as internal retention of damp-heat syndrome,patients with yin deficiency and blood dryness syndrome and deficiency of qi and yin syndrome usually have longer duration of disease and older age of onset,and the patients with internal retention of damp-heat syndrome and stagnant heat in the collateral syndrome usually have shorter duration of disease and younger age of onset.The laboratory findings such as immunological parameters and inflammatory cytokine are correlated with TCM syndrome types of PSS patients to some extent,which will supply guidance for the clinical differentiation of TCM syndromes of PSS.

A quantitative analytical method was established for 275 kinds of metabolites in plasma based on ultra-high performance liquid chromatography-triple quadrupole mass spectrometry/multiple reaction monitoring-selected ion monitoring(UHPLC-QQQ-MS/MRM-SIM)technique.Based on UHPLC-high resolution(HRMS)/full MS-parallel reaction monitoring(PRM)technique,165 kinds of lipid metabolites in plasma were qualitatively identified and quantitatively detected to address the analytical challenges of lipid isomers.This quantitative metabolomics approach was successfully applied to a rat myocardial infarction study,identifying and quantifying 372 kinds of metabolites in total.Comparative analysis with the sham-operated group revealed significant alterations in 59 kinds of plasma metabolites in myocardial infarction rats.Key metabolic pathways,which included amino acid metabolism(alanine,aspartate,and glutamate metabolism;glycine,serine,and threonine metabolism,etc.),one-carbon unit metabolism,and tricarboxylic acid cycle,were significantly disrupted.

Objective To investigate the trends of major thyroid function indices in Chinese adolescent females at different ages and the differences from adult reference intervals.Methods A total of 791 female students from 4 junior high schools were enrolled in the study by selecting one junior high school in each of the following locations:Minhang District of Shanghai,Haimen City of Jiangsu Province,Yuhuan City of Zhejiang Province,and Deqing County of Zhejiang Province from Oct to Nov 2017 and from Jan to Mar 2019.The subjects were subjected to physical examination as well as thyroid hormone levels;and the Pubertal Developmental Events Self-Assessment Scale(PDS)was used to evaluate the staging of pubertal development.Follow-ups were conducted after 2 years,with the same survey content.Thyroid function levels were assessed in 5 age groups between 11 to 15 years old,95%CI were calculated,and mixed linear models were used to analyze the effects of age and pubertal developmental stage on hormone levels.Results The reference intervals for thyroid stimulating hormone(TSH),free triiodothyronine(FT3)and free thyroxine(FT4)in adolescent females differed significantly from those of adults,with misclassification rates ranging from 2.98%to 5.17%.Statistically significant differences were found for age,pubertal development staging,and the interaction of age and pubertal staging after correcting for BMI,waist circumference(all P<0.05).TSH levels were more affected by age before the completion of pubertal development,the level of the 12-year-old group was higher than that of the 11-year-old group(P=0.001 2)and the 13-year-old group(P<0.000 1);FT3 levels showed greater variability with age during late pubertal stage,with levels significantly higher at 13 years of age than at 11 and 12 years of age(P<0.0001),and gradually decreasing after 13 years of age(P<0.000 1).In contrast,FT4 levels were generally less affected by age between 11 and 15 years of age,with levels slightly higher at 13-15 years of age than at 11-12 years of age(P<0.000 1).Conclusion The levels of TSH,FT3,and FT4,as indicators of thyroid function in adolescent females,differ significantly from those of adults,and are differently affected by age and the stages of pubertal development;further refinement of the reference intervals for age-and pubertal-development-specific thyroid indicators is necessary.

Objective To investigate the clinical characteristics of primary Sj?gren's syndrome (pSS) complicating atherosclerosis(AS).Methods The clinical data of the patients with PSS in the rheumatology department of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine of Shanghai Univer-sity of Traditional Chinese Medicine from January 2019 to January 2022 were retrospectively analyzed.The pa-tients were divided into the complication group (n=108) and non-complicating group (n=106) according to whether or not complicating AS.The differences in the general data,laboratory indicators and carotid intima-media thickness (IMT) were compared between the two groups.The risk factors were analyzed.Results Compared with the non-complicating group,the age in the complicating group was bigger[66.00(61.25,69.00)years old vs. 59.00(50.75,65.25)years old],the disease course was longer[128.00(108.25,141.75)months vs. 94.00 (74.75,112.25)months],the levels of ESR,monocyte count,interleukin-6 (IL-6),interleukin-2 receptor (IL-2R),total cholesterol and low density lipoprotein-cholesterol were higher[27.00(14.10,48.00)mm/h vs. 22.00(12.00,36.50)mm/h;0.40(0.30,0.50)×109/L vs. 0.30(0.30,0.50)×109/L;3.56(2.17,5.95)pg/mL vs. 2.62(1.00,5.15)pg/mL;519.00(403.00,662.00)U/mL vs. 441.00(348.00,592.00)U/mL;(4.86±1.17)mmol/L vs. (4.55±1.10)mmol/L;(3.07±0.80)mmol/L vs. (2.82±0.78)mmol/L],IMT was larger[left side:0.80(0.80,0.90)mm vs. 0.80(0.78,0.80)mm;right side:0.80(0.80,0.90)mm vs. 0.80 (0.80,0.80)mm],and the differences were statistically significant (P<0.05).The multivariate logistic re-gression analysis results showed that the long disease course (OR=1.080) and ERS level increase (OR=1.021) were the independent risk factors of AS occurrence in pSS (P<0.05).Conclusion There are differ-ences in the serologic indicators between the pSS patients with complicating AS and the pSS patients without complicating AS,and the disease course and ESR level have the influence on it.

Objective:To explore the value of REG3α,sST2 and TNFR1 in peripheral blood for risk stratification and prognostic evaluation of acute graft-versus-host disease(aGVHD)after allogeneic hematopoietic stem cell transplantation(allo-HSCT)in children.Methods:From January 2020 to March 2022,70 children with aGVHD after allo-HSCT in the First Affiliated Hospital of Zhengzhou University were selected as the research objects,of which 50 cases were mild aGVHD(grade Ⅰ-Ⅱ)and 20 cases were severe aGVHD(grade Ⅲ-Ⅳ).30 healthy children who underwent physical examinations in our hospital during the same period were selected as the control group.Luminex platform was used to detect the protein expression levels of REG3α,sST2 and TNFR1 during aGVHD occurrence,and the differences between the three groups were analyzed by one-way ANOVA.According to the outcome of aGVHD treatment within 28 days,the patients were divided into a good prognosis group of 58 cases and a poor prognosis group of 12 cases.The ROC curve was used to analyze the value of REG3α,sST2 and TNFR1 in predicting the prognosis of children with aGVHD.Results:The peripheral blood levels of REG3α,sST2 and TNFR1 in the mild aGVHD and severe aGVHD groups were significantly higher than those in the control group(P＜0.05),and those in the severe aGVHD group were significantly higher than those in the mild aGVHD group(P＜0.05).Compared with the good prognosis group,the peripheral blood levels of REG3α,sST2 and TNFR1 in the poor prognosis group were significantly higher(t=9.27,3.33,2.97;P＜0.01).ROC curve analysis showed that the area under the curve(AUC),sensitivity and specificity of the combined detection of REG3α,sST2 and TNFR1 in predicting the prognosis of children with aGVHD were higher than those of the above indicators detected alone or in pairs.Conclusion:The expression levels of REG3α,sST2 and TNFR1 were related to the severity of aGVHD.The combination of REG3α,sST2 and TNFR1 has a high clinical value in predicting the prognosis of children with aGVHD,which is expected to provide a reliable reference for clinical evaluation of the prognosis of children with aGVHD.

Objective: To study the incidence of bloodstream infections, pathogen distribution, and antibiotic resistance profile in patients with hematological malignancies. Methods: From January 2018 to December 2021, we retrospectively analyzed the clinical characteristics, pathogen distribution, and antibiotic resistance profiles of patients with malignant hematological diseases and bloodstream infections in the Department of Hematology, Nanfang Hospital, Southern Medical University. Results: A total of 582 incidences of bloodstream infections occurred in 22,717 inpatients. From 2018 to 2021, the incidence rates of bloodstream infections were 2.79%, 2.99%, 2.79%, and 2.02%, respectively. Five hundred ninety-nine types of bacteria were recovered from blood cultures, with 487 (81.3%) gram-negative bacteria, such as Klebsiella pneumonia, Escherichia coli, and Pseudomonas aeruginosa. Eighty-one (13.5%) were gram-positive bacteria, primarily Staphylococcus aureus, Staphylococcus epidermidis, and Enterococcus faecium, whereas the remaining 31 (5.2%) were fungi. Enterobacteriaceae resistance to carbapenems, piperacillin/tazobactam, cefoperazone sodium/sulbactam, and tigecycline were 11.0%, 15.3%, 15.4%, and 3.3%, with a descending trend year on year. Non-fermenters tolerated piperacillin/tazobactam, cefoperazone sodium/sulbactam, and quinolones at 29.6%, 13.3%, and 21.7%, respectively. However, only two gram-positive bacteria isolates were shown to be resistant to glycopeptide antibiotics. Conclusions: Bloodstream pathogens in hematological malignancies were broadly dispersed, most of which were gram-negative bacteria. Antibiotic resistance rates vary greatly between species. Our research serves as a valuable resource for the selection of empirical antibiotics.
Humans ; Bacteremia/epidemiology* ; Cefoperazone ; Sulbactam ; Retrospective Studies ; Drug Resistance, Bacterial ; Microbial Sensitivity Tests ; Hematologic Neoplasms ; Sepsis ; Anti-Bacterial Agents/pharmacology* ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Piperacillin, Tazobactam Drug Combination ; Escherichia coli

AIM: To investigate the differences in visual recovery, corneal astigmatism, and rotation stability of Toric intraocular lens(TIOL)implantation in cataract patients with different axial lengths.METHODS: Retrospective analysis. A total of 132 patients(132 eyes)with age-related cataract and corneal astigmatism who underwent phacoemulsification cataract extraction combined with TIOL implantation in our hospital's ophthalmology department from February 2021 to September 2022 were selected. They were divided into two groups based on the axial length: the group with axial length ≤24mm(79 cases, 79 eyes)and the group with axial length >24mm(53 cases, 53 eyes). Compare the best corrected distance visual acuity(BCDVA), corneal astigmatism, and TIOL rotation between the two groups of patients at 3mo after surgery.RESULT: After 3mo of surgery, both groups of patients had improved BCDVA and significantly decreased corneal astigmatism compared to those before surgery(P<0.001). However, there was no difference in BCDVA and corneal astigmatism between the two groups(P>0.05), and there was no significant difference in TIOL rotation between the two groups [(5.24±3.72)° vs.(6.36±4.21)°, P=0.110].CONCLUSION: There is no significant difference in visual recovery, corneal astigmatism, and TIOL rotational stability after TIOL implantation in cataract patients with different axial lengths.

Objective: To analyze and compare therapy responses, outcomes, and incidence of severe hematologic adverse events of flumatinib and imatinib in patients newly diagnosed with chronic phase chronic myeloid leukemia (CML) . Methods: Data of patients with chronic phase CML diagnosed between January 2006 and November 2022 from 76 centers, aged ≥18 years, and received initial flumatinib or imatinib therapy within 6 months after diagnosis in China were retrospectively interrogated. Propensity score matching (PSM) analysis was performed to reduce the bias of the initial TKI selection, and the therapy responses and outcomes of patients receiving initial flumatinib or imatinib therapy were compared. Results: A total of 4 833 adult patients with CML receiving initial imatinib (n=4 380) or flumatinib (n=453) therapy were included in the study. In the imatinib cohort, the median follow-up time was 54 [interquartile range (IQR), 31-85] months, and the 7-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.2%, 88.4%, 78.3%, and 63.0%, respectively. The 7-year FFS, PFS, and OS rates were 71.8%, 93.0%, and 96.9%, respectively. With the median follow-up of 18 (IQR, 13-25) months in the flumatinib cohort, the 2-year cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) were 95.4%, 86.5%, 58.4%, and 46.6%, respectively. The 2-year FFS, PFS, and OS rates were 80.1%, 95.0%, and 99.5%, respectively. The PSM analysis indicated that patients receiving initial flumatinib therapy had significantly higher cumulative incidences of CCyR, MMR, MR(4), and MR(4.5) and higher probabilities of FFS than those receiving the initial imatinib therapy (all P<0.001), whereas the PFS (P=0.230) and OS (P=0.268) were comparable between the two cohorts. The incidence of severe hematologic adverse events (grade≥Ⅲ) was comparable in the two cohorts. Conclusion: Patients receiving initial flumatinib therapy had higher cumulative incidences of therapy responses and higher probability of FFS than those receiving initial imatinib therapy, whereas the incidence of severe hematologic adverse events was comparable between the two cohorts.
Adult ; Humans ; Adolescent ; Imatinib Mesylate/adverse effects* ; Incidence ; Antineoplastic Agents/adverse effects* ; Retrospective Studies ; Pyrimidines/adverse effects* ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy* ; Treatment Outcome ; Benzamides/adverse effects* ; Leukemia, Myeloid, Chronic-Phase/drug therapy* ; Aminopyridines/therapeutic use* ; Protein Kinase Inhibitors/therapeutic use*

ObjectiveTo further study the pathogenic role of different types of Chlamydia trachomatis （CT） proteins in tubal factor infertility， evaluate the clinical detection value of Chlamydia trachomatis protein antibody in predicting tubal factor infertility. MethodsA total of 58 cases of tubal factor infertility （TFI）， 41 cases of fertile controls （FC） and 18 cases of infertile controls （IFC） were included. For serum detection， first， CT-IgG ELISA kit was used to detect the expression of CT-IgG in serum of three groups of people； then， 6 kinds of Chlamydia trachomatis proteins were expressed and purified in the early stage to establish the antibody test for these proteins， and ELISA detection method was used to detect the expression of their antibodies in the serum of TFI group， FC group and IFC group， respectively； and finally， the antibody OD value of the 6 kinds of Chlamydia trachomatis proteins in the three groups of subjects were statistically described， and CT-IgG was used as the reference standard to draw the receiver operating characteristic curve （ROC curve） of each CT antibody. The Youden Index determines the cutoff value for each antibody. Taking TFI as the reference class， two disordered multiple classification logistic regression models were established with the FC and IFC groups， respectively； and the reference class was used to explore the value of various antibodies and age in predicting TFI， FC and IFC of Chlamydia trachomatis. The back-off method was used to screen the variables. ResultsThe OD value of CT376 antibody in the TFI group was higher than that in the FC group （0.86 vs. 0.60， P=0.026）. The CT376 antibody OD value in the TFI group was higher than that in the IFC group （0.86 vs. 0.64， P=0.026）. The CT443 antibody OD value in the IFC group was higher than that in the TFI group （0.59 vs. 0.34， P=0.036） and higher than that in the FC group （0.59 vs. 0.30， P=0.02）. The multiple classification logistic regression analysis established between TFI and FC showed that CT-IgG ［P<0.001， OR=0.084， 95%CI （0.025， 0.284）］， CT376 antibody ［P=0.068， OR=0.359， 95%CI （0.120， 1.078）］. CT-IgG is an independent risk factor for tubal infertility， and CT376 antibody cannot be an independent risk factor for tubal infertility. The multiple classification logistic regression analysis established between TFI and IFC showed that among infertile patients， CT-IgG ［P<0.05， OR=0.194， 95%CI （0.046， 0.817）］， CT376 antibody ［P<0.05， OR=0.176， 95%CI （0.038， 0.818）］ and CT381 antibody ［P<0.05， OR=0.112， 95%CI （ 0.016， 0.796）］ were independent risk factors for tubal infertility. ConclusionThe expression of CT376 antibody in tubal infertility patients is higher than that in fertile and infertile controls， suggesting that CT-induced tubal factor infertility may be related to CT376. CT-IgG， and CT376 antibodies are meaningful in predicting CT-induced tubal factor infertility.

Abstract：Objective To predict the structure and function of sterol O⁃acyltransferase 1（SOAT1）related to hepatocellular carcinoma（HCC）by using bioinformatics tools，in order to understand its mechanism as the marker and therapeutic target of S⁃Ⅲ subtype. Methods The structure，function and protein interaction of SOAT1 were predicted and analyzed by using databases or softwares such as NCBI，STRING，Protscale，SignalP，TMHMM，PSORT，SOPMA，SWISS ⁃ MODEL， NetNGlyc，NetOGlyc，Netphos and ProtParam. Results The protein encoded by SOAT1 was a hydrophobic protein with good stability，which was a nonclassical pathway protein with 8 transmembrane regions，mainly distributed among the cell membrane. SOAT1 was expressed in many tissues，while most of them in the adrenal gland，which showed multiple phosphorylation sites and was mainly involved in the synthesis and catabolism of cholesterol. Conclusion Bioinformatics analysis of structure and function of SOAT1 showed that SOAT1 lipid synthesis and catabolism pathways played an important role，and lipid expression was closely related to the development of cancer，indicating that the treatment of HCC may be achieved by regulating the expression of SOAT1 gene.