Objective To investigate the serum interleukin-17A(IL-17A)and chemokine CXC motif ligand 13(CXCL13)levels in children with cough variant asthma and their clinical significance.Methods A total of 108 children with cough variant asthma admitted to Meihe Maternity Hospital from November 2021 to Febru-ary 2023 were selected as the study group,and 86 healthy children who underwent physical examinations dur-ing the same period were selected as the control group.The levels of serum IL-17A and CXCL13 in the two groups were detected by enzyme-linked immunosorbent assay.Multivariate Logistic regression was used to an-alyze the factors influencing the occurrence of cough variant asthma.Receiver operating characteristic(ROC)curve was plotted to analyze the diagnostic value of serum IL-17A and CXCL13 expressions for cough variant asthma.Results The levels of serum IL-17A and CXCL13 in the study group were both higher than those in the control group(P＜0.05).The levels of serum IL-17A and CXCL13 in children with cough variant asthma were negatively correlated with forced vital capacity(FVC),forced expiratory volume in one second(FEV1),maximal expiratory flow rate(PEF),and FEV1/FVC and basal respiratory conductivity(Grs cont),while positively correlated with initial resistance value(Rrs cont).Multivariate Logistic regression analysis indicated that FVC,FEV1,PEF,FEV1/FVC,and Grs cont were protective factors influencing the occurrence of cough variant asthma(P＜0.05).However,Rrs cont,IL-17A and CXCL13 were risk factors affecting the occurrence of cough variant asthma(P＜0.05).The area under the curve(AUC)of serum IL-17A and CXCL13 levels for diagnosing cough variant asthma were 0.920 and 0.867,respectively.The AUC of the combined diagnosis of the two was 0.937,which was significantly greater than that of the diagnosis of CXCL1 alone(Z=2.194,P=0.028).Conclusion The levels of serum IL-17A and CXCL13 in children with cough variant asthma are upreg-ulated,and both are related to the lung function and airway responsiveness of children with cough variant asthma.The combined detection of serum IL-17A and CXCL13 levels has a high diagnostic value for cough variant asthma.

OBJECTIVE: To explore the clinical characteristics and genetic variant in a premature infant with Netherton syndrome (NS). METHODS: A neonate with NS caused by variants of SPINK5 gene diagnosed at the Children's Hospital Affiliated to Zhejiang University School of Medicine in March 2020 was selected as the study subject. Clinical data and family history were collected. Peripheral blood samples (2 mL each) were obtained from the child and her parents for whole-exome sequencing (WES). Candidate variants were subjected to pathogenicity classification and deleteriousness evaluation. This study has been approved by the Medical Ethics Committee of the Hospital (Ethics No. 2024-IRB-0251-P-01). RESULTS: The infant was born prematurely at 35⁺³ weeks due to "premature rupture of membranes for 4 hours" and exhibited generalized skin peeling, with meconium-stained amniotic fluid resembling bean curd residue. The condition improved with supportive treatments such as anti-infection and moisturizing therapy, though periodic hair loss had persisted. No similar case was reported by family history. WES has revealed a heterozygous c.1130delG (p.G377Efs*127) variant in exon 14 of the SPINK5 gene, which was inherited from her mother, and deletion of exons 1 ~ 33 of the SPINK5 gene, which was inherited from her father. CONCLUSION This case of NS presented with intrauterine onset in a preterm infant, which has not been previously reported. The identification of c.1130delG (p.G377Efs*127) variant has expanded the mutation spectrum of the SPINK5 gene.
Humans ; Serine Peptidase Inhibitor Kazal-Type 5/genetics* ; Netherton Syndrome/genetics* ; Female ; Infant, Newborn ; Infant, Premature ; Mutation ; Exome Sequencing ; Male

Objective:To investigate the hospitalization utilization of pneumoconiosis patients and its influencing factors in a northwestern city, and to provide theoretical basis for formulating service policies for pneumoconiosis patients.Methods:From March to October 2021. Existing living pneumoconiosis patients in kashgar were selected as the research objects. The "Survey Questionnaire on Medical Behaviors and Influencing Factors of Pneumoconiosis Patients" developed by the National Institute of Occupational Health and Poison Control of China Centers for Disease Control and Prevention was used to collect pneumoconiosis patients infomations from March to October 2021. This study investigated the demographic characteristics of pneumoconiosis patients, the types and stages of pneumoconiosis, as well as hospitalization in the past year, reasons for hospitalization, treatment measures, reasons for discharge. Additionally, it examined factors influencing medical behaviors, including medical insurance reimbursement, work-related injury insurance, and compensation situations.Logistics regression was used to analyze the influencing factors of hospitalization utilization.Results:The average age of the pneumoconiosis patients was elder with the age of 64.8. 86.7% (156/178) of them were retired, 75.8% (135/178) of them relied primarily on pensions for their income. The main types of pneumoconiosis were silicosis and coal workers' pneumoconiosis with the proportion of 57.3% (102/178) and 24.2% (43/178). 67.4% of them were stage I. The hospitalization rate in the year prior to the survey was 37.1%. The factors that promoted hospitalization were pension as the main source of income, pneumoconiosis in stage II, silicosis as the pneumoconiosis type, suffering joint pain, with two OR more other lung diseases (tuberculosis, cor pulmonale, COPD, pulmonary infection, bulla or pneumothorax, lung cancer, or mesothelioma) ( P<0.05) . Conclusion:The hospitalization rate of pneumoconiosis patients in the previous year was low. It is mainly influenced by the patient's economic income, the duration of pneumoconiosis, and the presence of comorbidities.

OBJECTIVE To explore the therapeutic effect of hearing aids on chronic subjective tinnitus with moderate to severe sensorineural hearing loss.METHODS Ninety-five patients were enrolled in this prospective study.Pure tone audiometry,acoustic immittance and tinnitus were performed before hearing aids were worn.The tinnitus handicap inventory(THI),hospital anxiety and depression scale(HADS)and visual analogue scale(VAS)were completed before and after 3 and 6 months after wearing the device.SPSS 22 was used for statistical analysis.RESULTS After 3 months and 6 months of hearing aid wearing,THI,HADS and VAS scores of the patients were significantly decreased,and there were significant differences before and after wearing the hearing aid(P<0.05).The THI score of patients in the catastrophic group decreased the most,reaching 44.5 points.Age,gender,duration of tinnitus,the side of tinnitus and the degree of hearing loss have no effect on the treatment effect of hearing aids.CONCLUSION Hearing aids can not only improve the hearing of patients,but also reduce tinnitus,relieve anxiety and depression.

Objective:To explore the clinical characteristics and genetic variant in a premature infant with Netherton syndrome (NS).Methods:A neonate with NS caused by variants of SPINK5 gene diagnosed at the Children′s Hospital Affiliated to Zhejiang University School of Medicine in March 2020 was selected as the study subject. Clinical data and family history were collected. Peripheral blood samples (2 mL each) were obtained from the child and her parents for whole-exome sequencing (WES). Candidate variants were subjected to pathogenicity classification and deleteriousness evaluation. This study has been approved by the Medical Ethics Committee of the Hospital (Ethics No. 2024-IRB-0251-P-01). Results:The infant was born prematurely at 35 + 3 weeks due to "premature rupture of membranes for 4 hours" and exhibited generalized skin peeling, with meconium-stained amniotic fluid resembling bean curd residue. The condition improved with supportive treatments such as anti-infection and moisturizing therapy, though periodic hair loss had persisted. No similar case was reported by family history. WES has revealed a heterozygous c. 1130delG (p.G377Efs*127) variant in exon 14 of the SPINK5 gene, which was inherited from her mother, and deletion of exons 1 ~ 33 of the SPINK5 gene, which was inherited from her father. Conclusion:This case of NS presented with intrauterine onset in a preterm infant, which has not been previously reported. The identification of c. 1130delG (p.G377Efs*127) variant has expanded the mutation spectrum of the SPINK5 gene.

Objective:To analyze the clinical characteristics and related factors of cognition disorders in elderly hypertensive patients.Methods:It was a cross-sectional study. A total of 612 hypertensive patients with the age of (69.06±6.58) years (median 68.00 years) admitted in the Department of Cardiology, General Hospital of Chinese People′s Liberation Army from October 2022 to April 2024 were enrolled. The demographic and clinical data were collected, the cognition status was assessed with Mini-Mental State Examination (MMSE) at admission. The related factors of cognition disorders were analyzed with univariate and multivariate logistic regression.Results:The results showed that female hypertensive patients and those with older age, lower education, higher fasting blood glucose (FBG) and diabetes mellitus, higher low-density lipoprotein cholesterol (LDL-C) level, higher systolic blood pressure (SBP) and more cardiovascular comorbidities were likely to have cognition disorders (all P<0.05). Multivariate logistic regression analysis showed that smoking history, elevated SBP, elevated heart rate, elevated FBG, and elevated LDL-C were independent risk factors for cognition disorders in elderly hypertensive patients,while higher education level was an independent protective factor (all P<0.05). Conclusion:Smoking, increased SBP, increased heart rate, increased FBG, increased LDL-C and lower education level are independently associated with cognition disorders in elderly hypertensive patients.

The aim of this updated guideline is to provide comprehensive recommendations for the management of gout in patients with common comorbidities, such as chronic kidney disease(CKD), cardiovascular disease(CVD), diabetes, osteoarthritis(OA), and gastrointestinal disorders. This guideline was developed by a multidisciplinary expert panel consisting of specialists in endocrinology, rheumatology, nephrology, cardiology, gastroenterology, and methodology. The development process adhered to standard methodologies, including PICO(population, intervention, comparator, and outcomes) question deconstruction, systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation(GRADE) for evidence and recommendation evaluation, Delphi voting, and expert consensus. The guideline presents 26 evidence-based recommendations addressing 7 clinical questions for patients with hyperuricemia and gout in the context of comorbidities. Key recommendations include the maintenance of strict serum urate targets, particularly for patients with CKD stage≥3, chronic gouty arthritis, and OA, in order to prevent disease progression. In patients with CVD or diabetes, intra-articular triamcinolone is preferred over systemic glucocorticoids. Prioritized anti-inflammatory treatments for patients with CKD, gastrointestinal diseases and OA are recommended. The guideline also introduces emerging therapies, such as interleukin-1 inhibitors and selective urate transport inhibitors, as potential treatment options for refractory cases. The update offers a comprehensive, patient-centered approach to managing gout, particularly in individuals with associated comorbidities. Multidisciplinary collaboration and emerging new treatments and evidence ensure the optimization of the recommendations.

Objective:To analyze the multidrug resistance and genomic characteristics of Monophasic variant of Salmonella enterica serovar Typhimurium (monophasic Salmonella enterica serovar Typhimurium) isolates from clinical patients and food sources in Henan province. Method:A total of 91 monophasic S.Typhimurium strains isolated from clinical and food sources in Henan from 2021 to 2023 were analyzed for antimicrobial sensitivity and underwent whole genome sequencing. Multilocus sequence typing(MLST), multidrug resistance genes and plasmid types were identified using the sequencing data. Phylogenetic tree based on core genome multilocus sequence typing (cgMLST) and single nucleotide polymorphism (SNP) sites was constructed to analyze the genetic evolutionary relationship by comparing with international popular strains in public databases. The Chi-square test was used to compare drug resistance rates. Results:No significant difference was observed in the drug resistance rates between the clinical strains and food strains in Henan [82.19%(60/73) and 11/18, χ2=2.614, P=0.106]. The overall multidrug resistance (MDR) rate was 78.02%(71/91). Most strains were resistant to ampicillin, tetracycline chloramphenicol, β-lactam and sulfonamides. Resistance genes carried by the isolates varied, as well as the drug-resistant phenotypes. MLST showed that 91 strains of S.Typhimurium belonged to ST34 and carried aminoglycoside acetyltransferase gene aac(6′)-Iaa and mobile genetic elements such as plasmids IncQ1 and IncHI2/IncHI2A. The results of cgMLST typing phylogenetic trees showed that food and clinical isolates from the same region in Henan were identified as the same cgST type and clustered in the same branch, which indicated the risk for cross-infection between animal and human. The phylogenetic tree of monophasic S.Typhimurium constructed based on SNP sites showed that the majority of monophasic S.Typhimurium strains in Henan were close to the strains from other provinces in China, other strains were close to the strains from Europe and Southeast Asia, suggesting the possibility of cross regional transmission of the strains. Pork was identified as the main food source. Conclusion:The prevalent ST type of monophasic S.Typhimurium isolated from Henan was ST34, which carried multiple antibiotic resistance genes and widespread drug resistance phenotypes. Most of the monophasic S.Typhimurium isolates in Henan showed a specific phylogenetic lineage with the foreign epidemic strains, indicating the possibility of dissemination of strains between humans and food.

Objective:To construct a quality assessment tool for teaching plans designed for clinical scenario-based simulation, test its reliability and validity, and provide an effective tool for accurately and objectively evaluating the simulation instructors' capabilities in clinical scenario-based simulation teaching designs and the quality of teaching plans.Methods:Through literature review and two rounds of expert consultation using the Delphi method, an initial draft of the assessment tool was formed. Subsequently, an empirical study was conducted with 85 clinical scenario-based simulation teaching plans collected nationwide to test the reliability and validity of the assessment tool.Results:The quality assessment tool for teaching plans designed for clinical scenario-based simulation consists of 5 primary items and 17 secondary items. The Cronbach's α coefficient of the scale was 0.872. The inter-rater reliability, measured by the intraclass correlation coefficient, was 0.838. The scale level content validity index was 0.949. The results of confirmatory factor analysis showed χ2/d f of 2.385, a root mean square error of approximation of 0.090, and a comparative fit index of 0.861, indicating an acceptable model fit. Conclusions:The quality assessment tool for teaching plans designed for clinical scenario-based simulation demonstrates high reliability and validity and can be used as a tool for evaluating the simulation instructors' capabilities in clinical scenario-based simulation teaching designs and the quality of teaching plans.

In recent years, the bacteriophage Φ29 (Phi29) DNA polymerase has garnered increasing attention due to its high-fidelity amplification capacity at constant temperatures. To advance the industrial application of this type of isothermal polymerases, this study mined and characterized new enzymes from the microbial metagenome based on the known Phi29 DNA polymerase sequence. The results revealed that a new enzyme, Php29 DNA polymerase, was identified in the microbial metagenome with plants as the hosts. This enzyme exhibited higher strand displacement activity, with a 59.5% similarity to bacteriophage Φ29. Experimental validation demonstrated that the enzyme had 3'→5' exonuclease activity, and its amplification products can serve as substrates for further catalytic reactions. The discovery and validation of Php29 DNA polymerase gives insights into the future industrial application of isothermal polymerases.
DNA-Directed DNA Polymerase/metabolism* ; Bacillus Phages/genetics* ; Metagenome