Objective To explore imaging findings of 10 cases of misdiagnosed IgG4-associated pancreatitis.Methods Ten cases of IgG4-associated pancreatitis misdiagnosed by preoperative CT and/or MRI were retrospectively collected,and intrapancreatic and extra pancreatic manifestations were observed.Results Among 10 cases,diffuse lesions resulted"sausage like"appearance of pancreas were observed in 2 cases,focal lesions were found in 7 cases,including 3 cases in neck,3 cases in head and 1 case in tail of pancreas,while multifocal lesions involved the head,neck and tail of pancreas in 1 case.The lesions mostly presented as slightly low densities and occasional calcifications on non-enhanced CT,slightly low signals on MR T1WI,equal or high signals on T2WI as well as slightly high signals on diffusion weighted imaging,and progressively enhanced after administration of contrast agents.Peripheral halo sign was found in 3 cases,and mild dilatation of main pancreatic duct was observed in 7 cases.Extrapancreatic manifestations mainly included dilatation of bile ducts both inside and outside the liver and involvement of other organs.Conclusion Imaging findings of misdiagnosis IgG4-associated pancreatitis present as focal or diffuse lesions of pancreas with peripheral halo sign and extrapancreatic involvements,which progressively enhanced after administration of contrast agents.

Objective To investigate the expression and clinical significance of serum cystatin SA(Cystatin SA)and long non-coding RNA(lncRNA)promoter of CDKN1A antisense DNA damage activated RNA(PANDAR)in patients with type 2 dia-betic kidney disease(T2DN).Method A total of 142 patients with type 2 diabetes mellitus(T2DM)admitted to Shanghai Jiao Tong University School of Medicine Suzhou Jiulong Hospital from February 2021 to October 2023 were selected.According to whether they had nephropathy,they were divided into T2DN group(n=82)and non-T2DN group(n=60).60 healthy people who underwent physical examination during the same period were used as the control group.Serum Cystatin SA levels were detected by enzyme-linked immunosorbent assay(ELISA).Serum lncRNA PANDAR level was detected by real-time fluorescence quanti-tative PCR.Pearson correlation analysis was used to analyze the correlation between serum Cystatin SA,lncRNA PANDAR and clinical parameters in T2DN patients.Logistic regression analysis was used to analyze the influencing factors of T2 DN.The re-ceiver operating characteristic(ROC)curve was used to analyze the value of serum Cystatin SA and lncRNA PANDAR in the evaluation of T2DN.Results Serum Cystatin SA(236.28±44.63 ng/L)and serum lncRNA PANDAR(3.21±0.34)in the T2DM group were higher than those in the control group(91.25±22.33 ng/L,1.06±0.23),and the differences were statistically significant(t=23.127,42.379,all P<0.001).Serum Cystatin SA(275.08±46.83 ng/L)and lncRNA PANDAR(3.64±0.38)in T2DN group were higher than those in non-T2DN group(183.25±40.88 ng/L,2.62±0.30),and the differences were statistically significant(t=12.169,17.226,all P<0.001).Serum Cystatin SA and lncRNA PANDAR in T2DN patients were positively correlat-ed with diabetes duration,serum creatinine(sCr),blood urea nitrogen(BUN)and UACR(r=0.562～0.750,all P<0.001),and neg-atively correlated with eGFR(r=-0.656,-0.634,all P<0.001).Serum Cystatin SA,lncRNA PANDAR,duration of diabetes,UACR,sCr were risk factors for T2DN,eGFR was a protective factor(Wald χ2=4.257～12.360,all P<0.001).The area under the curve(AUC)of serum Cystatin SA combined with lncRNA PANDAR in predicting T2DN was 0.920(0.899～0.960),which was greater than that of single index[0.847(0.791～0.887),0.851(0.803～0.896)],and the differences were statistically significant(Z=4.522,4.319,all P<0.05).Conclusion Serum Cystatin SA and lncRNA PANDAR are elevated in patients with T2DN,which are related to renal function indexes and are risk factors affecting the occurrence of T2DN.The combination of the two can effec-tively evaluate the occurrence of T2DN.

Objective To investigate the expression and clinical significance of serum cystatin SA(Cystatin SA)and long non-coding RNA(lncRNA)promoter of CDKN1A antisense DNA damage activated RNA(PANDAR)in patients with type 2 dia-betic kidney disease(T2DN).Method A total of 142 patients with type 2 diabetes mellitus(T2DM)admitted to Shanghai Jiao Tong University School of Medicine Suzhou Jiulong Hospital from February 2021 to October 2023 were selected.According to whether they had nephropathy,they were divided into T2DN group(n=82)and non-T2DN group(n=60).60 healthy people who underwent physical examination during the same period were used as the control group.Serum Cystatin SA levels were detected by enzyme-linked immunosorbent assay(ELISA).Serum lncRNA PANDAR level was detected by real-time fluorescence quanti-tative PCR.Pearson correlation analysis was used to analyze the correlation between serum Cystatin SA,lncRNA PANDAR and clinical parameters in T2DN patients.Logistic regression analysis was used to analyze the influencing factors of T2 DN.The re-ceiver operating characteristic(ROC)curve was used to analyze the value of serum Cystatin SA and lncRNA PANDAR in the evaluation of T2DN.Results Serum Cystatin SA(236.28±44.63 ng/L)and serum lncRNA PANDAR(3.21±0.34)in the T2DM group were higher than those in the control group(91.25±22.33 ng/L,1.06±0.23),and the differences were statistically significant(t=23.127,42.379,all P<0.001).Serum Cystatin SA(275.08±46.83 ng/L)and lncRNA PANDAR(3.64±0.38)in T2DN group were higher than those in non-T2DN group(183.25±40.88 ng/L,2.62±0.30),and the differences were statistically significant(t=12.169,17.226,all P<0.001).Serum Cystatin SA and lncRNA PANDAR in T2DN patients were positively correlat-ed with diabetes duration,serum creatinine(sCr),blood urea nitrogen(BUN)and UACR(r=0.562～0.750,all P<0.001),and neg-atively correlated with eGFR(r=-0.656,-0.634,all P<0.001).Serum Cystatin SA,lncRNA PANDAR,duration of diabetes,UACR,sCr were risk factors for T2DN,eGFR was a protective factor(Wald χ2=4.257～12.360,all P<0.001).The area under the curve(AUC)of serum Cystatin SA combined with lncRNA PANDAR in predicting T2DN was 0.920(0.899～0.960),which was greater than that of single index[0.847(0.791～0.887),0.851(0.803～0.896)],and the differences were statistically significant(Z=4.522,4.319,all P<0.05).Conclusion Serum Cystatin SA and lncRNA PANDAR are elevated in patients with T2DN,which are related to renal function indexes and are risk factors affecting the occurrence of T2DN.The combination of the two can effec-tively evaluate the occurrence of T2DN.

Objective To explore imaging findings of 10 cases of misdiagnosed IgG4-associated pancreatitis.Methods Ten cases of IgG4-associated pancreatitis misdiagnosed by preoperative CT and/or MRI were retrospectively collected,and intrapancreatic and extra pancreatic manifestations were observed.Results Among 10 cases,diffuse lesions resulted"sausage like"appearance of pancreas were observed in 2 cases,focal lesions were found in 7 cases,including 3 cases in neck,3 cases in head and 1 case in tail of pancreas,while multifocal lesions involved the head,neck and tail of pancreas in 1 case.The lesions mostly presented as slightly low densities and occasional calcifications on non-enhanced CT,slightly low signals on MR T1WI,equal or high signals on T2WI as well as slightly high signals on diffusion weighted imaging,and progressively enhanced after administration of contrast agents.Peripheral halo sign was found in 3 cases,and mild dilatation of main pancreatic duct was observed in 7 cases.Extrapancreatic manifestations mainly included dilatation of bile ducts both inside and outside the liver and involvement of other organs.Conclusion Imaging findings of misdiagnosis IgG4-associated pancreatitis present as focal or diffuse lesions of pancreas with peripheral halo sign and extrapancreatic involvements,which progressively enhanced after administration of contrast agents.

Objective:To explore the occurrence and clinical characteristics of thyroid dysfunction caused by camrelizumab.Methods:The subjects were selected from all malignant tumor patients who were treated with camrelizumab during hospitalization in Heping Hospital Affiliated to Changzhi Medical College from June 2020 to September 2021. The electronic medical records of patients who met the inclusion criteria were collected, and the general conditions, camrelizumab application, combined medication, and the thyroid function test results before and after the application of camrelizumab were collected. The causality between drugs and injuries in patients who developed thyroid dysfunction was assessed using Naranjo′s causality assessment scale. The clinical characteristics of thyroid dysfunction were analyzed based on the medical records that had evaluation results of "certainly" or "probably".Results:A total of 71 patients were included in the analysis, and 22 patients (31.0%) developed camrelizumab-related thyroid dysfunction (causality assessment results were all "probably"). When thyroid dysfunction was found for the first time, hypothyroidism and hyperthyroidism were diagnosed in 11 patients, respectively, and 3 patients with hyperthyroidism developed into hypothyroidism later. The incidences of hypothyroidism and hyperthyroidism were 19.7% and 11.3% respectively. Among the 22 patients, 15 were male and 7 were female, aged 47-78 years; 10 patients were with lung cancer, 4 with gastric cancer, 3 with esophageal cancer, 2 with liver cancer, 2 with breast cancer, and 1 with peritoneal omental mesothelioma; 3 patients were treated with camrelizumab monotherapy, and 19 were treated with camrelizumab combined with chemotherapy and/or targeted drug therapy. Thyroid dysfunction all occurred in the first to sixth cycles of camrelizumab treatment, of which 15 (68.2%) in the first to third cycles. Of the 11 patients with initial diagnose of hypothyroidism, 6 had no obvious symptoms, 5 had fatigue (1 was complicated with apathy), and 4 were subclinical hypothyroidism; the severity was grade 1 in 4 cases and grade 2 in 7 cases. None of the 11 patients with initial diagnose of hyperthyroidism had significant symptoms, and 5 of them had subclinical hyperthyroid. All of the 11 cases were grade 1 in severity, 3 developed into hypothyroidism after 3, 6, and 7 cycles of camrelizumab treatment, which was grade 2 in severity. None of the 22 patients discontinued camrelizumab. No intervention was given to the patients with grade 1 hypothyroidism and hyperthyroidism, of which 3 patients with hyperthyroidism returned to normal on their own and the remaining showed no obvious changes in their thyroid function. Ten patients with grade 2 hypothyroidism received thyroid hormone replacement therapy; thyroid function was normal in 2 patients, improved in 5 patients, and without obvious changes in 3 patients.Conclusions:Thyroid dysfunction is a very common adverse reaction of camrelizumab, which can present as both hypothyroidism and hyperthyroidism, and initial hyperthyroidism can evolve to hypothyroidism. Thyroid dysfunction was mostly grade 1-2 in severity and the drug does not need to be discontinued generally. Patients with grade 2 hypothyroidism should be given thyroid hormone replacement therapy.

Objective:To explore the occurrence and clinical characteristics of thyroid dysfunction caused by camrelizumab.Methods:The subjects were selected from all malignant tumor patients who were treated with camrelizumab during hospitalization in Heping Hospital Affiliated to Changzhi Medical College from June 2020 to September 2021. The electronic medical records of patients who met the inclusion criteria were collected, and the general conditions, camrelizumab application, combined medication, and the thyroid function test results before and after the application of camrelizumab were collected. The causality between drugs and injuries in patients who developed thyroid dysfunction was assessed using Naranjo′s causality assessment scale. The clinical characteristics of thyroid dysfunction were analyzed based on the medical records that had evaluation results of "certainly" or "probably".Results:A total of 71 patients were included in the analysis, and 22 patients (31.0%) developed camrelizumab-related thyroid dysfunction (causality assessment results were all "probably"). When thyroid dysfunction was found for the first time, hypothyroidism and hyperthyroidism were diagnosed in 11 patients, respectively, and 3 patients with hyperthyroidism developed into hypothyroidism later. The incidences of hypothyroidism and hyperthyroidism were 19.7% and 11.3% respectively. Among the 22 patients, 15 were male and 7 were female, aged 47-78 years; 10 patients were with lung cancer, 4 with gastric cancer, 3 with esophageal cancer, 2 with liver cancer, 2 with breast cancer, and 1 with peritoneal omental mesothelioma; 3 patients were treated with camrelizumab monotherapy, and 19 were treated with camrelizumab combined with chemotherapy and/or targeted drug therapy. Thyroid dysfunction all occurred in the first to sixth cycles of camrelizumab treatment, of which 15 (68.2%) in the first to third cycles. Of the 11 patients with initial diagnose of hypothyroidism, 6 had no obvious symptoms, 5 had fatigue (1 was complicated with apathy), and 4 were subclinical hypothyroidism; the severity was grade 1 in 4 cases and grade 2 in 7 cases. None of the 11 patients with initial diagnose of hyperthyroidism had significant symptoms, and 5 of them had subclinical hyperthyroid. All of the 11 cases were grade 1 in severity, 3 developed into hypothyroidism after 3, 6, and 7 cycles of camrelizumab treatment, which was grade 2 in severity. None of the 22 patients discontinued camrelizumab. No intervention was given to the patients with grade 1 hypothyroidism and hyperthyroidism, of which 3 patients with hyperthyroidism returned to normal on their own and the remaining showed no obvious changes in their thyroid function. Ten patients with grade 2 hypothyroidism received thyroid hormone replacement therapy; thyroid function was normal in 2 patients, improved in 5 patients, and without obvious changes in 3 patients.Conclusions:Thyroid dysfunction is a very common adverse reaction of camrelizumab, which can present as both hypothyroidism and hyperthyroidism, and initial hyperthyroidism can evolve to hypothyroidism. Thyroid dysfunction was mostly grade 1-2 in severity and the drug does not need to be discontinued generally. Patients with grade 2 hypothyroidism should be given thyroid hormone replacement therapy.

Since its establishment 30 years ago, the discipline of metabolic engineering has developed rapidly based on its deep integration with molecular biology, systems biology and synthetic biology successively, which has greatly contributed to advancing and upgrading biotechnology industry. This review firstly analyzes the current status of academic research and China's competence in the area of metabolic engineering according to the data of papers published in SCI-indexed journals in the past 30 years. Subsequently, the article summarizes the development of systems biology methods and enabling technologies of synthetic biology and their applications in metabolic engineering in the past 10 years. Finally, the major challenges and future perspectives for the development of metabolic engineering are briefly discussed.
Biotechnology ; Industry ; Metabolic Engineering ; Synthetic Biology ; Systems Biology

Objective:To analyze the characteristics and prognosis of hearing loss in children with bacterial meningitis.Methods:This was a single-center retrospective cohort study. Patients diagnosed with bacterial meningitis who were hospitalized in Beijing Children′s Hospital between 2010 and 2016 and older than 28 days and younger than 18 years at symptom onset were included in this study ( n=573). All clinical information including hearing assessment results during hospitalization were reviewed. All patients with hearing loss were followed up to repeat their hearing test and assess their hearing condition with parents′ evaluation of aural and (or) oral performance of children (PEACH). Patients were grouped according to their hearing assessment results, and Logistic regression analysis was used to analyze the risk factors for hearing loss in patients with bacterial meningitis. Results:Five hundred and seventy-three patients were enrolled in this study, including 347 males and 226 females. The onset age ranged from 29 days to 15.8 years. Two hundred and forty-six patients had identified causative pathogens, among whom 92 cases (37.4%) were pneumococcal meningitis cases. Hearing loss was found in 160 cases (27.9%) during hospitalization, involving 240 ears. Permanent hearing loss was found in 20 cases (16.9%), involving 32 ears. In the patients with permanent hearing loss, 87.5% (28/32) of ears were identified as severe or profound hearing loss during hospitalization. Logistic regression analysis showed that dystonia, the protein concentration level in cerebrospinal fluid>1 g/L, glucose concentration level lower than 1 mmol/L and subdural effusion were independent risk factors for hearing loss ( OR=2.426 (1.450-4.059), 1.865 (1.186-2.932), 1.544 (1.002-2.381) and 1.904 (1.291-2.809)). Conclusions:Hearing loss is a common sequela of bacterial meningitis in children. Most patients have transient hearing loss, but patients with severe or profound hearing impairment have a higher risk of developing permanent hearing loss.

OBJECTIVE: To establish a clinically applicable model of rapid identification of adverse drug reaction program (RiADP) for risk management and decision-making of clinical drug use. METHODS: Based on the theory of disproportion analysis, frequency method and Bayes method, a clinically applicable RiADP model in R language background was established, and the parameters of the model were interpreted by MedDRA coding. Based on the actual monitoring data of FDA, the model was validated by the assessing hepatotoxicity of lopinavir/ritonavir (LPV/r). RESULTS: The established RiADP model included four parameters: standard value of adverse drug reaction signal information, empirical Bayesian geometric mean value, ratio of reporting ratio and number of adverse drug reaction cases. Through the application of R language parameter package "phViD", the model parameters could be output quickly. After being encoded by MedDRA, it was converted into clinical terms to form a clinical interpretation report of adverse drug reactions. In addition, the evaluation results of LPV/r hepatotoxicity by the model were matched with the results reported in latest literature, which also proved the reliability of the model results. CONCLUSIONS In this study, a rapid identification method of adverse reactions based on post marketing drug monitoring data was established in R language environment, which is capable of sending rapid warning of adverse reactions of target drugs in public health emergencies, and providing intuitive evidence for risk management and decision-making of clinical drugs.
Databases, Pharmaceutical ; Decision Making, Computer-Assisted ; Drug Monitoring ; Drug-Related Side Effects and Adverse Reactions ; HIV Protease Inhibitors ; adverse effects ; pharmacology ; Humans ; Liver ; drug effects ; Lopinavir ; adverse effects ; toxicity ; Models, Statistical ; Reproducibility of Results ; Software ; standards

Objective To investigate the calcification characteristics and biological activity of hepatic alveolar echinococcosis(HAE). Methods Retrospective analysis of 60 patients in the First Affiliated Hospital of Xinjiang Medical University from June 2016 to April 2017 with hydatid positive or surgical pathology confirmed HAE.All patients underwent abdominal CT scan and double-phase enhanced PET-CT examination were confirmed with single lesion.The CT and PET-CT features were analysed,and the maximum standard uptake value (SUVmax) of the focal lesion on the PET-CT was measured. According to the calcification,HAE patients were divided into A,B,C type.Kruskal-Wallis H test was used to compare the difference of SUVmax between lesions of different HAE types. Results Sixty patients with hepatic alveolar echinococcosis were evenly divided into A,B and C by different calcifications.The median SUVmax of A,B and C were 3.41(2.17 to 3.75),7.45(6.77 to 9.01)and 6.67(6.28 to 9.01),respectively.The median SUVmax within three types was statistically significant (χ2=4.429, P<0.05). Conclusion The biological activity of different HAE calcifications is different.