OBJECTIVE To investigate the expression of transforming growth factor-beta 1(TGF-β1)and bone morphogenetic protein-2(BMP-2)in patients with chronic rhinosinusitis with nasal polyps(CRSwNP).METHODS A cohort of 44 CRSwNP patients and 32 control subjects was included in the study.The expression levels of TGF-β1 and BMP-2 proteins in the peripheral blood and nasal polyp tissues of CRSwNP patients were measured.The correlations with Lund-Mackay scores and global osteitis scoring scale(GOSS)scores were analyzed.RESULTS Compared to the control group,the peripheral blood level of TGF-β1 protein in CRSwNP patients was significantly reduced(t=2.650,P=0.009),while the expression difference of BMP-2 was not statistically significant.In the nasal polyp tissues,both TGF-β1(t=13.180,P<0.001)and BMP-2(t=8.699,P<0.001)protein expressions were decreased.TGF-β1 was most abundantly expressed in the glandular epithelium of the polyps,whereas BMP-2 showed higher expression in the mucosal epithelium.CONCLUSION The expression of TGF-β1 is downregulated in CRSwNP patients;an increase in BMP-2 may assist in the identification of refractory CRSwNP cases.

Objective:To investigate the serum antibody level in children with pertussis in Hangzhou city, and to evaluate the incidence of pertussis in children and the immunization effect of vaccine.Methods:A retrospective study was conducted.The pertussis toxin IgG antibody levels in 1 486 children aged 0-14 who received physical exa-mination in Hangzhou Children′s Hospital from January to December 2018 of were collected and analyzed.Serum antibody level ≥30 IU/mL was considered seropositive.The children enrolled were divided into the 0-3-year-old, 4-6-year-old, 7-9-year-old and 10-14-year-old groups; then the children under 3 years old were subdivided into groups of 0-<3 months, 3-<6 months, 6-<9 months, 9-<12 months, 12-<18 months, and 18-≤ 36 months; finally, the children were grouped according to their vaccination times, the pertussis toxin IgG antibody level and the infection rate of pertussis were compared among different groups by Mann- Whitney U, Kruskal- Wallis and χ2 tests. Results:The overall positive rate of the pertussis toxin IgG antibody was 23.62% (351/1 486), and the median antibody concentration was 6.60 IU/mL.Among children aged 0-14, the 0-3-year-old children had the highest positive rate of the pertussis toxin IgG antibody and the highest median antibody concentration, which were 24.58% (29/118) and 6.95 IU/mL, respectively.There was no significant difference in the antibody positive rate and the median antibody concentration among different age groups (all P>0.05). Among different subgroups of children aged 0-3, the pertussis toxin IgG antibody positive rate and the median antibody concentration were statistically significant (all P<0.05). It was predicted that the pertussis infection rate in children over 3 years old in Hangzhou was about 45.99%.The patients receiving more than 3 doses of vaccination accounted for 87.48% (1 300/1 486), and their antibody positive rate was 25.46% (331/1 300). After excluding unvaccinated children, the comparison results suggested that there was statistical significance in the antibody positive rate and median antibody concentration among different vaccination groups ( χ2=24.467, 67.438, all P<0.001). Conclusions:The serum pertussis toxin IgG antibody positive rate in children aged 0-14 in Hangzhou is low, but their predicted pertussis infection rate is higher.Children aged 0-14 are easy to become a main source of infection.Therefore, it is necessary to pay attention to and strengthen the vaccination plan and research, enhance the monitoring of the infection source, and prevent the " recurrence of pertussis" .

Objective:To explore the significance of empathy and executive function indexes in the diagnosis and classification of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD).Methods:According to DSM-Ⅴ diagnostic criteria, 33 children with ASD, 30 children with ADHD and 39 typical development (TD) children and adolescents were enrolled as the research subjects.The empathy and executive function characteristics were compared and analyzed in the subjects.Based on empathy and executive function indicators, the three groups of subjects were diagnosed and classified by machine learning method.Results:The total score of Griffith empathy measure parent ratings(GEM-PR)(ASD: (0.67±0.64), ADHD: (1.00±0.79), TD: (0.98±0.73)) and each factor score ( F=3.595-10.363, all P<0.05) and the total score of behavior rating inventory of executive function(BRIEF)(ASD: (62.79±7.45), ADHD: (59.47±8.77), TD: (49.08±7.91)) and each factor score of the three groups were different ( F=6.557-33.205, all P<0.01). Among them, the scores of empathy and executive function in ASD and ADHD groups were generally higher than those in TD children (all P<0.05). When combined with BRIEF scale and GEM scale, the classification accuracy of the three groups reached 62.75%. Conclusion:Both ASD and ADHD children have damages in empathy and executive function.Combining empathy and executive function indexes are more helpful for diagnosis and classification than single index.

Objective:To explore the influencing factors of self-management of diabetics in community so as to provide a scientific basis for personalized self-management of diabetics.Methods:From March 2016 to August 2017, this study selected 980 diabetics from 6 communities in Chaoyang District of Beijing by convenience sampling. All of patients were investigated with the self-management, nursing instruction need and medication adherence questionnaire and the medication adherence scale to understand the self-management, such as blood glucose management, exercise, medication adherence and nursing instruction need. Simple correlation and multiple regression were used to analyze the influencing factors of self-management, nursing instruction need and medication adherence.Results:Among those diabetics in community, the score of self-management was (1.76±0.25) . The score of nursing instruction need was (1.73±0.29) with medication instruction need dimension for the highest and diabetic knowledge instruction need dimension for the lowest. The score of medication adherence was (3.48±0.64) with unauthorized drug withdrawal dimension for the highest and times of taking medicine dimension for the lowest. Simple correlation showed that there were statistical differences in the scores of self-management among patients with different on-the-job situations and education levels ( P<0.05) , and in the score of nursing instruction need among patients with different education levels ( P<0.05) , and in the scores of medication adherence among patients with different ages, on-the-job situations and diagnosed ages ( P<0.05) . Multiple regression analysis showed that the influencing factor of self-management and nursing instruction need was the education level ( P<0.05) , and the influencing factor of self-management was the on-the-job situation ( P<0.05) , and the influencing factor of medication adherence was the age ( P<0.05) . Conclusions:Among diabetics in community, the self-management is influenced by the education level and on-the-job situation; nursing instruction need is influenced by the education level; the medication adherence is influenced by the age. We should increase the self-management of patients with the low level of education and on-the-job, provide nursing instruction for patients with the high level of education, promote the medication adherence of diabetics with low ages so as to improve the self-management and quality of life of patients.

Objectives: To analyze the cardiac T2* value, liver iron concentration (LIC) , and related laboratory parameters in myelodysplastic syndrome (MDS) with iron overload and evaluate the changes of organ functions after iron chelation therapy. To explore the value of magnetic resonance imaging (MRI) T2* in making early diagnosis and assessing organs iron overload. Methods: Retrospective investigation was used to observe the cardiac T2* value, LIC, iron metabolism parameters and related laboratory parameters of 85 MDS patients from Nov 2014 to Jan 2018. Among them, 7 MDS patients with Low/Int-1 have received iron chelation therapy for 6 months during two MRI examinations. The above parameters were collected before and after iron chelation therapy for comparison. Results: Correlations were found between heart T2* value and age (rs=-0.290, P=0.007) and left ventricular ejection fraction (LVEF) (rs=0.265, P=0.009) . There was a significant negative correlation between heart T2* value and blood transfusion units (rs=-0.701, P<0.001) . There was a significant positive correlation between LIC and serum ferritin (SF) (rs=0.577, P<0.001) . There was also a correlation between LIC and ALT (rs=0.268, P=0.014) and blood transfusion units (rs=0.244, P=0.034) . There was no correlation between heart T2* and pro-BNP, SF (all P>0.05) , and no correlation between LIC and age (P>0.05) . The increase of heart T2* between the normal and abnormal groups was statistically significant (P=0.005) , but the iron overload ratio of the heart T2*<20 ms was not significant between the two groups. There was statistical significance in the proportion of severe liver iron overload (LIC>15 mg/g DW) (P=0.045) . After iron chelation therapy, the values of SF, transferrin saturation, ALT, AST, pro-BNP and LIC of 7 patients were decreased compared with values before iron chelation therapy, and the peripheral blood cell level was increased. However, the changes of LVEF and T2* values after iron chelation were not obvious. Conclusion MRI T2* may be a predictor of iron overload in patients with MDS in early stage, and may be more valuable compare with LVEF, SF and other laboratory indicators. The safety and repeatability of MRI cardiac T2* examination are recognized, and it can be used as an ideal detection for patients with iron overload.

Objective To investigate the influencing factors of self-care status of patients with hypertension in communities, so as to provide scientific evidences for personal self-care management of hypertension patients. Methods From March 2016 to August 2017, 1 010 hypertensive patients from 6 communities in Chaoyang District of Beijing were surveyed using general data questionnaire, Self-care Status and Nursing Guidance Needs Questionnaire and Medication Compliance Scale, to analyze the influencing factors of self-care status. Results In the 1 010 cases of hypertension patients in community, the score of self-care status was (1.70±0.22), the score of the demand of nursing education was (1.69±0.33), and the score of medication compliance was (3.54±0.58). The differences in the score of self-care status of patients with different education level and different years of hypertension diagnosis were statistically significant (P＜0.05). There were significant differences in the scores of nursing guidance needs among patients of different ages and educational backgrounds (P＜0.05). There were significant differences in the scores of medication compliance among patients of different ages, occupations and years of hypertension diagnosis (P＜0.05). Multivariate linear regression analysis showed that age, education level, years of hypertension diagnosis and occupation were the influencing factors of self-care status of patients. Conclusions Self-care status of hypertensive patients are affected by age, education level, years of diagnosis and occupations. The personal health education and guidance should be given based on patients' different social background, so as to enhance the level of self-care status and improve the patients' life quality.

Adult ; Aged ; Aged, 80 and over ; Agranulocytosis ; chemically induced ; Azacitidine ; adverse effects ; analogs & derivatives ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Myelodysplastic Syndromes ; drug therapy ; Neutrophils ; drug effects ; Young Adult

Objective:To analyse the biological function of anti-IL-6Rβ(gp130) monoclonal antibody and its regulatory effect on IL-6 signaling.Methods:Biological characteristics of anti-IL-6Rβ(gp130) mAb were assessed by Western blot analysis, capture ELISA and peptide ELISA .The phosphorylation of STAT 3 was tested by Western blot analysis in IL-6-stimulated U266/RA-FLS/RA-PBMC with or without anti-IL-6Rβ(gp130) mAb treatment.Results:3 strains of mouse anti-human gp130 mAb were with high affini-ty and different binding epitopes , the kaff of 10A1 was 2.62E-10.In U266, RA-PBMC and RA-SFMC, IL-6 signaling highly activated STAT3 which could be inhibited by anti-gp130 mAb.Conclusion: Anti-IL-6Rβ( gp130 ) mAb might have different binding epitopes and could affect IL-6 stimulated phosphorylation of STAT3, which provides a preliminary experiment for analyse the correlation of IL-6 signaling and RA .

Objective To study the effect of decitabine treating elderly patient with myelodysplastic syndrome-ring sideroblastic refractory anemia (MDS-RAS) and review the literatures. Methods Decitabine treated a patient with MDS-RAS four courses, at the dose of 25 mg everyday for 5 days per course. Observed the change of symptoms, peripheral blood cell counts, myelogram, T cell polarization, cellular immunity,chromosome. Determined the curative effect combined with efficiency standard of WHO 2008. Results The clinical symptoms got better after two courses. Peripheral blood cell counts began to get better after one course. The number of leukocyte, hemoglobin and platelet got nearly normal after four courses. After two courses, T cell polarization state got normal, the number of iron ring promyelocyticin bone marrow declined from 16 % to 0 and chromosome changed from complex karyotype to normal. Conclusion Decitabine is an effective drug to the old patient with MDS-RAS. But it needs to increase the number of cases and follow up long-term to observe the effective rate and long-term efficacy.

OBJECTIVE: To explore the mechanism of enalapril for renal interstitial fibrosis by observing the effect of enalapril on the expression of transforming growth factor-beta1(TGF-beta1), p-Smad2/3 and Smad7 in renal tissuess of unilateral urethral obstruction (UUO) rat model. METHODS: Thirty female Sprague-Dawley(SD) rats were randomly subdivided into a sham-operated group, a model group and an enalapril treated group. UUO model was induced by ligating the left ureter of rats. All rats were sacrificed 14 days after UUO. Pathological changes of the renal tissue were observed by HE and Masson staining, the protein expressions of Collagen I (ColI), TGF-beta1, p-Smad2/3 and Smad7 were detected by immunohistochemical staining,and the mRNA expressions of TGF-beta1 and Smad7 were detected by RT-PCR. RESULTS: The renal interstitial damage index, the relative Collagen area and the expression of ColI in the model group significantly increased(P<0.01). Enalapril reduced these indexes. The protein and mRNA expressions of TGF-beta1 and the protein expressions of p-Smad2/3 were low in the sham-operated group, but were strongly positive in the model group, and enalapril could decrease the expressions of TGF-beta1 and p-Smad2/3(P<0.01). The protein and mRNA expressions of Smad7 in the model group were less than that in the sham-operated group(P<0.01),and enalapril could improve the expressions of Smad7(P<0.01). CONCLUSION Enalapril could inhibit the renal interstitial fibrosis by affecting TGF-beta1, p-Smad2/3 and Smad7 of TGF-beta/smads pathway in the renal tissues of UUO rats.
Angiotensin-Converting Enzyme Inhibitors ; pharmacology ; Animals ; Enalapril ; pharmacology ; Female ; Fibrosis ; prevention & control ; Kidney ; metabolism ; pathology ; RNA, Messenger ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Smad2 Protein ; genetics ; metabolism ; Smad3 Protein ; genetics ; metabolism ; Smad7 Protein ; genetics ; metabolism ; Transforming Growth Factor beta1 ; genetics ; metabolism ; Urethral Obstruction ; complications