Objective To analyze the distribution characteristics of the single nucleotide polymorphism (SNP) site rs76206423 in the promoter region of the interleukin-2 receptor (IL-2R) β gene among Han males in a high radiation background area (HBRA) in Yangjiang City. Methods A total of 48 male participants from Tangkou Town, Yangxi County, Yangjiang City (HBRA group), and 51 male participants from Hengpo Town, Enping City (control group) were selected as the research subjects using the random number table method. Peripheral venous blood samples of participants from both groups were collected, and genomic DNA was extracted. The genotyping and allele frequency distribution of the rs76206423 (A/G) site in the IL-2R β promoter region was detected among the participants in both groups using the SNP detection method. The difference of allele frequencies between population in HBRA group and five area of East Asia, South Asia, Africa, Europe, and the Americas published in the Human Genome Project database from National Center for Biotechnology Information were analyzed. Results The allele frequencies of rs76206423 of population in both groups conformed to Hardy-Weinberg equilibrium (P>0.05). In the HBRA group, the AA genotype was predominant (64.6%), while the AG genotype was the most common in the control group (51.0%), with a significant difference (P<0.05). Population in both groups showed a predominance of the variant allele A (78.1% and 72.5%, respectively), with no significant difference (P>0.05). The frequency of the G allele of rs76206423 in the population in HBRA group was higher than those in South Asian, African, European, and American populations (all P<0.01), but showed no significant difference compared with East Asian populations (P>0.05). Conclusion In the Han male population from the HBRA in Yangjiang City, the rs76206423 site in the IL-2R β gene promoter region is predominantly composed of the wild-type A allele and AA genotype, indicating genetic stability and a relatively high degree of variation at this locus.

Objective To explore the clinical efficacy of high hip center technique total hip arthroplasty(THA)for CroweⅡ and Ⅲ developmental dysplasia of hip(DDH)and severe hip osteoarthritis(HOA).Methods From January 2018 to Jan-uary 2020,74 patients with Crowe type Ⅱ and Ⅲ DDH and severe HOA were admitted,and 37 cases of anatomical hip center reconstruction were taken as control group,including 7 males and 30 females,aged from 42 to 65 years old with an average of(58.40±4.98)years old,body mass index(BMI)ranged from 18 to 29 kg·m-2 with an average of(23.02±2.21)kg·m-2.Thirty-seven routine high hip center technical reconstruction were performed as study group,including 5 males and 32 females,aged from 41 to 65 years old with an average of(57.31±5.42)years old,BMI ranged from 18 to 29 kg·m-2 with an average of(23.14±2.07)kg·m-2.The patients presented with hip pain,limited function and range of motion,and gait instability before surgery.All patients underwent THA,the control group underwent intraoperative anatomical hip center reconstruction,and the study group underwent intraoperative high hip joint reconstruction.The perioperative indicators of the two groups were com-pared.The hip joint function,balance function and gait of the patients were evaluated before surgery,3 months,6 months,and 12 months after surgery.The length difference of both lower limbs,horizontal distance of rotation center,vertical distance of ro-tation center and femoral eccentricity were measured before operation and 1 year after operation.The incidence of complica-tions in the two groups during the operation and postoperative follow-up was counted.Results The operation time of the study group was shorter than that of the control group,and the intraoperative blood loss was less than that of the control group(P＜0.05).After 12-months follow-up,1 was lost to followvup in study group and 2 were lost to follow-up in control group.The Har-ris scores and Berg balance scale(BBS),pace,stride frequency and single step length in the study group were higher than those in the control group at 3 months and 6 months after operation(P＜0.05);there was no statistically significant difference between the two groups in the indexes 12 months after operation(P＞0.05).The vertical distance of the center of rotation of the study group was greater than that of the control group 12 months after operation(P＜0.05),and there was no significant difference in the length difference of the lower limbs,the horizontal distance of the center of rotation,and the femoral eccentricity between two groups(P＞0.05).There were no complications in either group.Conclusion The long-term effects of TH A in patients with DDH and severe HO A were similar between the two central hip reconstruction methods,and the safety was good,and the high hip central reconstruction technique could shorten the operation time and reduce the amount of intraoperative blood loss.At the same time,it has certain advantages in early recovery of hip joint function,balance function and walking function of patients.

Objective To analyze the efficacy of two-hole and four-hole laparoscopic surgery in patients with sigmoid carcinoma,and to explore the influencing factors leading to complications.Methods The clinical data of 130 patients with sigmoid carcinoma who underwent laparoscopic surgery in our hospital from October 2020 to December 2022 were analyzed.The patients were divided into groups according to the surgical perforation methods.Sixty-eight patients in two-hole group were treated with two-hole laparoscopic surgery and 62 patients in four-hole group were treated with four-hole laparoscopic surgery.The perioperative indexes,visual analogue scale(VAS)scores and postoperative complications of patients in the two groups were observed and compared,and the influencing factors of complications were analyzed.Results The total incision length,first time to get out of bed,first postoperative exhaust time,postoperative hospital stay and VAS score at each time point after surgery of patients in two-hole group were significantly shorter/lower than those in four-hole group(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Univariate analysis showed that there were statistically significant differences in the age,preoperative albumin,operation time,intraoperative blood loss,first time to get out of bed,first postoperative exhaust time,postoperative hospital stay,VAS scores at the 3rd day and 5th days after surgery of patients in the occurrence group and the non-occurrence group(P<0.05).Further Logistic regression analysis showed that operation time and preoperative albumin<35 g/L were the main influencing factors for the occurrence of complications(P<0.05).Conclusion Compared with four-hole laparoscopic surgery,two-hole laparoscopic surgery for patients with sigmoid carcinoma has shorter time of perioperative recovery,less postoperative pain,and no difference was found in postoperative complications between the two methods.Operation time and preoperative albumin level<35 g/L were the main influencing factors for the occurence of complications.

To evaluate the effectiveness and safety of implantable D-shant atrial shunt device in patients with severe pulmonary arterial hypertension(PAH)and right heart failure.A 53-year-old female patient diagnosed with severe idiopathic PAH and right heart failure,her WHO FC grade was Ⅳ.The right heart catheter and implantation of D-shant atrial shunt device were performed under local anesthesia on November 30,2021.A 6 mm×4 cm peripheral artery balloon was selected to dilate the atrial septum and a D-shant atrial shunt device with a fixed 4 mm diameter orifice was implanted into the heart.The clinical symptoms and hemodynamics of the patient was improved after the intervention.Implantation of atrial shunt device as a palliative therapy to established a right to left shunt is another strategy for treating patients with severe PAH in late period,which has good effectiveness and safety.It could be the last replacement therapy to improve symptoms and prolonged lives to drug resistant and severe PAH patients.

AIM To study the chemical constituents from the n-butanol fraction of Siegesbeckiae glabrescens Makino.METHODS The n-butanol fraction from S.glabrescens was isolated and purified by silica gel,ODS and preparative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.RESULTS Seventeen compounds were isolated and identified as orientalin B(1),ent-2-oxo-15,16,19-trihydroxypimar-8(14)-ene(2),ent-12α,16-epoxy-2β,15α,19-trihydroxypimar-8-ene(3),ent-12α,16-epoxy-2β,15α,19-trihydroxy-pimar-8(14)-ene(4),kirenol(5),benzyl-O-β-D-glucopyranoside(6),hexyl-β-glucopyranoside(7),(Z)-3-hexenyl-β-D-glucopyranoside(8),phenylethyl-O-β-D-glucopyranoside(9),(6R,9S)-3-oxo-α-ionol-β-D-glucopyranoside(10),2-methoxy-4-(2-propenyl)phenyl-β-D-glucoside(11),4-allyl-2,6-dimethoxyphenyl glucoside(12),2-hydroxy-methylphenyl-1-O-β-D-glucopyranoside(13),icarside B2(14),everlastoside D(15),(2S,4R,5S,7S,9S,10R,13S,15R)-2,7,15,16,19-pentahydroxypimar-8(14)-ene(16),and benzyl-β-D-apiofuranosyl-(1″→6′)-β-D-glucopy-ranoside(17).Compound 9 showed weak ABTS radical scavenging capability,and compound 15 had strong DPPH and ABTS radicals scavenging activities.CONCLUSION Compounds 7-9,14-15 are isolated from genus Siegesbeckia for the first time.Compounds 2-4,7-17 are first isolated from this plant.Compound 9 and 15 exhibit antioxidant activities.

Objective:To investigate the effect of quality improvement (QI) project on delayed cord clamping (DCC) implementation in very preterm infants.Methods:This study retrospectively collected the clinical data and assessed the QI indices of very preterm infants born in the Women and Children's Hospital of Chongqing Medical University and transferred to the Neonatology Department from January 2017 to January 2021. The indices for QI assessment included three types: (1) process indices: the implementation rate and timing of DCC; (2) outcome indices: hemoglobin level and hematocrit, etc; (3) balancing indices: the proportion of neonates requiring endotracheal intubation in the delivery room and chest compressions, Apgar score body temperature, and blood pH value on admission, etc. There were four phases for the implementation of QI, the pre-QI period (January to December of 2017), the QI period (January to December of 2018), the post-QI period (January to December of 2019), and the sustained-QI period (January 2020 to January 2021). The QI project was performed since August 2018. Control charts or statistical tests were used for statistical analysis.Results:(1) Process indices: After the implementation of the QI project, the practice of DCC increased from 0 to 82.2%, and the timing of umbilical cord clamping was from 0 s to a delay of 47.1 s. (2) Outcome indices: The levels of hemoglobin in the QI period, the post-QI period, and the sustained-QI period were significantly higher than those in the pre-QI period [(202.22±28.84), (210.10±33.52), (210.52±32.27) g/L vs. (187.94±35.29) g/L; F=8.61, P<0.001]. The hematocrit values in the post-QI period and the sustained-QI period were significantly higher than those in the pre-QI period [(58.99±8.71) %, (60.18±8.06)% vs. (55.41±9.17)%; χ2=5.13, P=0.002]. The other indices showed no statistical differences in different phases. (3) Balancing indices: The proportions of neonates receiving endotracheal intubation in the delivery room in the post-QI period and the sustained-QI period were significantly lower than those in the pre-QI period [16.0% (19/119), 13.2% (25/191) vs. 42.3% (30/71); χ2=29.08, P<0.001]. The body temperature on admission increased gradually through the four periods [pre-QI period: 35.3 ℃ (34.5-36.1 ℃); QI period: 36.0 ℃ (34.0-37.7 ℃); post-QI period: 36.0 ℃ (35.6-37.4 ℃); sustained-QI period: 37.0 ℃ (35.9-38.1 ℃); H=277.88, P<0.001]. The blood pH value on admission in the sustained-QI period [7.32 (6.85-7.50)] was significantly higher than those in the other three periods [7.26 (7.07-7.46), 7.26 (7.04-7.43), and 7.25 (6.91-7.49); H=34.46, P<0.001]. Conclusion:The interventions in this QI project significantly increase the practice of DCC and enable a longer DCC in very preterm infants.

Objective:In chronic hepatitis B (CHB) patients with previous 96-week treatment with tenofovir amibufenamide (TMF) or tenofovir disoproxil fumarate (TDF), we investigated the efficacy of sequential TMF treatment from 96 to 144 weeks.Methods:Enrolled subjects who were previously assigned (2:1) to receive either 25 mg TMF or 300 mg TDF with matching placebo for 96 weeks received extended or switched TMF treatment for 48 weeks. Efficacy was evaluated based on virological, serological, biological parameters, and fibrosis staging. Statistical analysis was performed using the McNemar test, t-test, or Log-Rank test according to the data. Results:593 subjects from the initial TMF group and 287 subjects from the TDF group were included at week 144, with the proportions of HBV DNA<20 IU/ml at week 144 being 86.2% and 83.3%, respectively, and 78.1% and 73.8% in patients with baseline HBV DNA levels ≥8 log10 IU/ml. Resistance to tenofovir was not detected in both groups. For HBeAg loss and seroconversion rates, both groups showed a further increase from week 96 to 144 and the 3-year cumulative rates of HBeAg loss were about 35% in each group. However, HBsAg levels were less affected during 96 to 144 weeks. For patients switched from TDF to TMF, a substantial further increase in the alanine aminotransferase (ALT) normalization rate was observed (11.4%), along with improved FIB-4 scores.Conclusion:After 144 weeks of TMF treatment, CHB patients achieved high rates of virological, serological, and biochemical responses, as well as improved liver fibrosis outcomes. Also, switching to TMF resulted in significant benefits in ALT normalization rates (NCT03903796).

Objective:In chronic hepatitis B (CHB) patients with previous 96-week treatment with tenofovir amibufenamide (TMF) or tenofovir disoproxil fumarate (TDF), we investigated the safety profile of sequential TMF treatment from 96 to 144 weeks.Methods:Enrolled subjects that previously assigned (2:1) to receive either 25 mg TMF or 300 mg TDF with matching placebo for 96 weeks received extending or switching TMF treatment for 48 weeks. Safety profiles of kidney, bone, metabolism, body weight, and others were evaluated.Results:666 subjects from the initial TMF group and 336 subjects from TDF group with at least one dose of assigned treatment were included at week 144. The overall safety profile was favorable in each group and generally similar between extended or switched TMF treatments from week 96 to 144. In subjects switching from TDF to TMF, the non-indexed estimated glomerular filtration rate (by non-indexed CKD-EPI formula) and creatinine clearance (by Cockcroft-Gault formula) were both increased, which were (2.31±8.33) ml/min and (4.24±13.94) ml/min, respectively. These changes were also higher than those in subjects with extending TMF treatment [(0.91±8.06) ml/min and (1.30±13.94) ml/min]. Meanwhile, switching to TMF also led to an increase of the bone mineral density (BMD) by 0.75% in hip and 1.41% in spine. On the other side, a slight change in TC/HDL ratio by 0.16 (IQR: 0.00, 0.43) and an increase in body mass index (BMI) by (0.54±0.98) kg/m 2 were oberved with patients switched to TMF, which were significantly higher than that in TMF group. Conclusion:CHB patients receiving 144 weeks of TMF treatment showed favorable safety profile. After switching to TMF, the bone and renal safety was significantly improved in TDF group, though experienceing change in metabolic parameters and weight gain (NCT03903796).

Objective To explore the risk factors associated with cow's milk protein allergy(CMPA)in infants.Methods This study was a multicenter prospective nested case-control study conducted in seven medical centers in Beijing,China.Infants aged 0-12 months were included,with 200 cases of CMPA infants and 799 control infants without CMPA.Univariate and multivariate logistic regression analyses were used to investigate the risk factors for the occurrence of CMPA.Results Univariate logistic regression analysis showed that preterm birth,low birth weight,birth from the first pregnancy,firstborn,spring birth,summer birth,mixed/artificial feeding,and parental history of allergic diseases were associated with an increased risk of CMPA in infants(P＜0.05).Multivariate logistic regression analysis revealed that firstborn(OR=1.89,95％CI:1.14-3.13),spring birth(OR=3.42,95％CI:1.70-6.58),summer birth(OR=2.29,95％CI:1.22-4.27),mixed/artificial feeding(OR=1.57,95％CI:1.10-2.26),parental history of allergies(OR=2.13,95％CI:1.51-3.02),and both parents having allergies(OR=3.15,95％CI:1.78-5.56)were risk factors for CMPA in infants(P＜0.05).Conclusions Firstborn,spring birth,summer birth,mixed/artificial feeding,and a family history of allergies are associated with an increased risk of CMPA in infants.[Chinese Journal of Contemporary Pediatrics,2024,26(3):230-235]

Objective To investigate the risk factors for bronchopulmonary dysplasia(BPD)in twin preterm infants with a gestational age of<34 weeks,and to provide a basis for early identification of BPD in twin preterm infants in clinical practice.Methods A retrospective analysis was performed for the twin preterm infants with a gestational age of<34 weeks who were admitted to 22 hospitals nationwide from January 2018 to December 2020.According to their conditions,they were divided into group A(both twins had BPD),group B(only one twin had BPD),and group C(neither twin had BPD).The risk factors for BPD in twin preterm infants were analyzed.Further analysis was conducted on group B to investigate the postnatal risk factors for BPD within twins.Results A total of 904 pairs of twins with a gestational age of<34 weeks were included in this study.The multivariate logistic regression analysis showed that compared with group C,birth weight discordance of>25%between the twins was an independent risk factor for BPD in one of the twins(OR=3.370,95%CI:1.500-7.568,P<0.05),and high gestational age at birth was a protective factor against BPD(P<0.05).The conditional logistic regression analysis of group B showed that small-for-gestational-age(SGA)birth was an independent risk factor for BPD in individual twins(OR=5.017,95%CI:1.040-24.190,P<0.05).Conclusions The development of BPD in twin preterm infants is associated with gestational age,birth weight discordance between the twins,and SGA birth.