Neonatal sepsis is a global health problem that seriously affects the body health and life safety of newborns. It has a higher incidence in preterm infants,especially for early-onset sepsis (EOS) within 72 hours of birth. The diagnosis of neonatal EOS requires a series of examinations,and early and accurate diagnosis can improve clinical outcomes and reduce antibiotic overuse in a timely manner. At present,the commonly used biomarkers and traditional blood culture methods for EOS diagnosis have certain shortcomings,so it is urgent to find new molecular diagnostic methods. This article summarizes and compares the early and novel diagnostic methods of neonatal EOS,in order to provide a reference for clinical practice.

Neonatal sepsis is a global health problem that seriously affects the body health and life safety of newborns. It has a higher incidence in preterm infants,especially for early-onset sepsis (EOS) within 72 hours of birth. The diagnosis of neonatal EOS requires a series of examinations,and early and accurate diagnosis can improve clinical outcomes and reduce antibiotic overuse in a timely manner. At present,the commonly used biomarkers and traditional blood culture methods for EOS diagnosis have certain shortcomings,so it is urgent to find new molecular diagnostic methods. This article summarizes and compares the early and novel diagnostic methods of neonatal EOS,in order to provide a reference for clinical practice.

Objective Based on the measurement of the ambient dose equivalent rate of points around the novel self-shielding Zap-X radiotherapy system, its self-shielding effect was evaluated and analyzed, and suggestions were proposed for the revision and improvement of related standards in China. Methods The ambient dose equivalent rates were measured at 15 points around the Zap-X system under 6 system operating conditions. The radiation shielding effect of the Zap-X system was evaluated according to the domestic and international radiation protection standards of radiotherapy equipment. Results Measurement of ambient dose equivalent rate and dose evaluation showed that the shielding effect of the Zap-X system met the requirements of international standards, but the dose rates at some points failed to satisfy the reference control levels in the domestic standards. Conclusion Without the shielded treatment room, the self-shielding effect of the Zap-X radiotherapy system is insufficient to meet the requirements of domestic standards for radiation safety and protection. The system should be operated in the treatment room to meet domestic standards.

Abstract Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

Objective: To analyze the global epidemiology of renal cell carcinoma (RCC) in 2020. Methods: The incidence and mortality data of RCC in the cooperative database GLOBOCAN 2020 of International Agency for Research on Cancer of WHO and the human development index (HDI) published by the United Nations Development Programme in 2020 were collated. The crude incidence rate (CIR), age-standardized incidence rate (ASIR), crude mortality rate (CMR), age-standardized mortality rate (ASMR) and mortality/incidence ratio (M/I) of RCC were calculated. Kruskale-Wallis test was used to analyze the differences in ASIR or ASMR among HDI countries. Results: In 2020, the global ASIR of RCC was 4.6/100 000, of which 6.1/100 000 for males and 3.2/100 000 for females and ASIR was higher in very high and high HDI countries than that in medium and low HDI countries. With the rapid increase of age after the age of 20, the growth rate of ASIR in males was faster than that in females, and slowed down at the age of 70 to 75. The truncation incidence rate of 35-64 years old was 7.5/100 000 and the cumulative incidence risk of 0-74 years old was 0.52%. The global ASMR of RCC was 1.8/100 000, 2.5/100 000 for males and 1.2/100 000 for females. The ASMR of males in very high and high HDI countries (2.4/100 000-3.7/100 000) was about twice that of males (1.1/100 000-1.4/100 000) in medium and low HDI countries, while the ASMR of female (0.6/100 000-1.5/100 000) did not show significant difference. ASMR continued to increase rapidly with age after the age of 40, and the growth rate of males was faster than that of females. The truncation mortality rate of 35-64 years old was 2.1/100 000, and the cumulative mortality risk of 0-74 years old was 0.20%. M/I decreases with the increase of HDI, with M/I as 0.58 in China, which was higher than the global average of 0.39 and the United States' 0.17. Conclusion: The ASIR and ASMR of RCC presented significant regional and gender disparities globally, and the heaviest burden was in very high HDI countries.
Male ; Humans ; Female ; Adult ; Middle Aged ; Infant, Newborn ; Infant ; Child, Preschool ; Child ; Adolescent ; Young Adult ; Aged ; Carcinoma, Renal Cell/epidemiology* ; Incidence ; Databases, Factual ; China ; Kidney Neoplasms/epidemiology* ; Global Health

ObjectiveTo investigate the analgesic effect and its mechanism of （-）-gallocatechin gallate （EGCG） on high-frequency stimulation （HFS）-induced chronic primary pain in female mice. MethodsThe model of chronic primary pain in female mice were established by HFS of sciatic nerve in left hind limb at 10 V （100 Hz， 0.5 ms， 4 trains of 1-s duration at 10-s intervals）. The mice were randomly divided into sham operation group， vehicle （saline） + HFS group， different concentrations of EGCG + HFS groups （4~5 mice in each group）. 10 μL EGCG （10， 20， 50， 200 μmol/L） or vehicle was injected intrathecally 1 h before surgery. The therapeutic effect of EGCG was evaluated by paw withdrawal threshold （PWT） and analgesic efficiency. Immunofluorescence of lumbar spinal cord was used to evaluate the possible mechanisms. ResultsCompared with vehicle HFS group， intrathecal administration of EGCG alleviated HFS-induced mechanical allodynia in a dose-dependent manner， and the maximum analgesic efficiency was 84.95%. EGCG also blocked the increases in c-Fos （a marker for neuronal excitability） positive neurons and the expressions of calcitonin gene-related peptide （CGRP⁺） terminals， Iba1 （a marker for microglia） and GFAP （a marker for astrocytes） in the ipsilateral spinal dorsal horn. ConclusionIntrathecal injection of EGCG exerts an analgesic effect against HFS-induced chronic primary pain， mediated by inhibiting the increases in presynaptic CGRP⁺ terminals， postsynaptic neuronal excitability and glial activation in the spinal dorsal horn.

Objective: To analyze the course of disease and epidemiological parameters of COVID-19 and provide evidence for making prevention and control strategies. Methods: To display the distribution of course of disease of the infectors who had close contacts with COVID-19 cases from January 1 to March 15, 2020 in Guangdong Provincial, the models of Lognormal, Weibull and gamma distribution were applied. A descriptive analysis was conducted on the basic characteristics and epidemiological parameters of course of disease. Results: In total, 515 of 11 580 close contacts were infected, with an attack rate about 4.4%, including 449 confirmed cases and 66 asymptomatic cases. Lognormal distribution was fitting best for latent period, incubation period, pre-symptomatic infection period of confirmed cases and infection period of asymptomatic cases; Gamma distribution was fitting best for infectious period and clinical symptom period of confirmed cases; Weibull distribution was fitting best for latent period of asymptomatic cases. The latent period, incubation period, pre-symptomatic infection period, infectious period and clinical symptoms period of confirmed cases were 4.50 (95%CI:3.86-5.13) days, 5.12 (95%CI:4.63-5.62) days, 0.87 (95%CI:0.67-1.07) days, 11.89 (95%CI:9.81-13.98) days and 22.00 (95%CI:21.24-22.77) days, respectively. The latent period and infectious period of asymptomatic cases were 8.88 (95%CI:6.89-10.86) days and 6.18 (95%CI:1.89-10.47) days, respectively. Conclusion: The estimated course of COVID-19 and related epidemiological parameters are similar to the existing data.
COVID-19 ; Cohort Studies ; Contact Tracing ; Humans ; Incidence ; Prospective Studies

Objective:To explore the effect of Bushen Huatan prescription on serum lipopolysaccharide （LPS） and Toll-like receptor 4 （TLR4）/ myeloid cell differentiation protein 88 （MyD88）/nuclear transcription factor-κB （NF-κB） signaling pathway in rats with ovariectomy-induced osteoporosis. Method:Sixty SPF 6-month-old female rats were randomly divided into sham operation group， model group， estradiol valerate group and Bushen Huatan prescription low， medium and high dose groups.One week after modeling by bilateral ovariectomy， 8 rats in each group were selected to receive intragastric administration.The estradiol valerate group was given 0.184 mg·kg^-1 by gavage， and Bushen Huatan prescription low， middle and high dose groups were given 4.7， 9.4 and 18.8 g·kg^-1 by gavage， sham operation group and model group were given 0.9% saline 4 mL by gavage respectively.After 12 weeks of intervention， the rats were sacrificed for detection.Serum LPS was detected by enzyme linked immunosorbent assay （ELISA）， while protein expressions of TLR4， MyD88 and phosphorylated （p）-NF-κB p65 in bone tissue were detected by Western blot， and the mRNA expressions of TLR4， MyD88， NF-κB p65， IL-1β， and IL-6 in bone tissue were detected by quantitative real-time polymerase chain reaction（PCR）. Result:Compared with sham operation group， the serum LPS level as well as protein expression of TLR4， MyD88， p-NF-κB p65 and mRNA expression of TLR4， MyD88， NF-κB p65， IL-1β， and IL-6 significantly increased in model group（P<0.05）.Compared with the model group， serum LPS level， protein expression of TLR4， MyD88， and p-NF-κB p65， mRNA levels of TLR4， MyD88， and NF-κB p65 in bone tissues as well as downstream inflammatory factors IL-1β， IL-6 mRNA expression decreased to different degrees in estradiol valerate group and Bushen Huatan prescription high dose group（P<0.05）. Conclusion:Bushen Huatan prescription can reduce serum LPS content， regulate mRNA and protein expression of TLR4， MyD88， NF-κB p65 and p-NF-κB p65 in TLR4/MyD88/NF-κB pathway， and down-regulate mRNA levels of IL-1β and IL-6 in bone tissues to improve bone microstructure and inhibit the development of postmenopausal osteoporosis （PMOP）.

ObjectiveTo investigate whether L-theanine exerts anti-pruritic effect on mice with imiquimod （IMQ）-induced psoriasis and its related mechanisms. MethodsWe established the psoriasis model by applying the IMQ ointment topically on mice back skin and oral （10 mg/kg∙d） or topical pretreatment （50， 125， 250 mmol/L， twice one day） of L-theanine was used as the treatment. Spontaneous behavior， such as scratching， was used to detect the therapeutic effect. Immunofluorescence （IF）， Western Blot （WB） and primary dorsal root ganglion （DRG） neuronal culture were used to investigate the mechanisms. ResultsOral administration of L-theanine had no apparent effect on IMQ-induced pruritus， but topical delivery in the lesional skin significantly improved the spontaneous behavior such as licking or biting and flinching in a dose-dependent manner. IF and WB results showed that L-theanine not only inhibited the overexpression of TNF-α in model mouse skin， but also prevented the abnormal growth of β3-tubulin⁺ nerve fibers and the upregulation of transient receptor potential vanilloid 1 （TRPV1）， an itch-related molecule. Moreover， the results from the experiments with primary cultured DRG neurons further confirmed that L-theanine directly reduced IMQ-induced abnormal outgrowth of CGRP⁺， β3-tubulin⁺ neurites in a concentration dependent manner. ConclusionsTopical application of L-theanine can relieve pruritus or discomfort in IMQ-induced psoriasis mouse model by inhibiting abnormal growth of skin nerve fiber endings. Therefore， L-theanine could be a potential treatment for chronic itch in psoriasis.