Objective:To analyze the correlation between peripheral blood eosinophil (EOS) level and clinical characteristics of patients with pneumoconiosis complicated with chronic obstructive pulmonary disease (COPD) .Methods:From January 2007 to November 2020, newly diagnosed patients with pneumoconiosis complicated with COPD in Beijing Chaoyang Hospital, were retrospectively analyzed. These patients were stratified into EOS<100 cells/μl group and EOS≥100 cells/μl group, taking 100 cells/μl as the cut-off value. Demographic characteristics, clinical symptoms, lung function and laboratory indexes were compared between the two groups.Results:The median EOS count of patients with pneumoconiosis complicated with COPD was 100 (40, 180) cells/μl. 50.2% (160/319) had blood eosinophil counts ≥100 cells/μl, and 11.0% (35/319) had blood eosinophil counts ≥300 cells/μl. In comparison with EOS<100 cells/μl group, EOS≥100 cells/μl group were older ( P=0.035), had higher body mass index ( P=0.008), and had lower forced respiratory volume in the first second ( P=0.017), had higher the ratio of residual volume to total lung volume ( P=0.010), and had lower diffusing capacity of the lung for carbon monoxide ( P=0.008). Arterial partial pressure of oxygen was significantly reduced in EOS≥100 cells/μl group ( P=0.039). The peripheral blood EOS count was negatively correlated with forced vital capacity, forced breathing volume in the first second, carbon monoxide diffusion, peak expiratory flow, and maximum mid expiratory flow as a percentage of expected values ( rs=-0.22, -0.18, -0.19, -0.19, -0.19, P=0.000, 0.001, 0.003, 0.008, 0.002), and positively correlated with the ratio of residual air volume to total lung volume ( rs=0.17, P=0.002) . Conclusion:There was a correlation between blood EOS count and pulmonary function parameters, can proide reference for the diagnosis and treatment of chnoric obstuctive pulmmory disease in clinical practice.

Objective:To analyze the treatment effect and drug resistance mutation of HIV-1 infected patients who changed to the second-line antiretroviral treatment regimen after they had developed drug-resistance with first-line antiretroviral treatment regimen in some areas of Sichuan Province.Methods:Using the cohort study method, the patients who had developed drug resistance with the first-line regimen were followed up for two years from 1 January 2019 to 31 December 2021.The changes of CD4 +T lymphocytes (CD4) counts and viral load (VL) at the endline and the detection of drug-resistant mutation sites were analyzed using the chi-square test. Multivariate logistic regression model was used to analyze the influencing factors of antiretroviral treatment effect in patients who had good compliance after switching to the second-line regimen. Results:A total of 737 patients were recruited. Among the cases with continuous good compliance, those who timely changed to the second-line regimen had higher proportion of maintaining continuous CD4 >200 cells/μl and sustained virus inhibition ( P<0.05). Among the patients with different levels of drug resistance at baseline, there was no significant difference in continuous CD4 >200 cells/μl and sustained VL <200 copies/ml ( P>0.05). After changing to the second-line regimen, the drug-resistant mutation sites of some protease inhibitors showed an upward trend, while those of the non-nucleoside reverse transcriptase inhibitors showed a downward trend ( P<0.05). Multivariate logistic regression analysis showed that, among patients who had good compliance and who had switched to the second-line regimen, mother-to-child-transmitted patients had 3.01 times higher risk than heterosexual sexually transmitted infection (95% CI:1.29-7.00), failure to change the second-line protocol in time brought 2.55 times higher risk than that of timely changing to the second-line regimen (95% CI:1.41-4.62) and patients who infected with CRF85_BC subtype had 3.32 times higher risk than those infected with CRF01_AE subtype (95% CI:1.49-7.42). Conclusions:Difference in the drug resistance levels with the first-line regimen does not affect patients' antiretroviral treatment effect after changing to the second-line regimen in Sichuan Province. Changing to the second-line regimen in time and maintaining good compliance are beneficial to higher immune levels and lower VLs in drug-resistant patients. Among patients who changed to the second-line regimen, mother-to-child transmission, failure to change the second-line program in time, and infection with CRF85_BC virus are risk factors endangering antiretroviral treatment success after changing to the second-line regimen.

Objective:To analyze the correlation between peripheral blood eosinophil (EOS) level and clinical characteristics of patients with pneumoconiosis complicated with chronic obstructive pulmonary disease (COPD) .Methods:From January 2007 to November 2020, newly diagnosed patients with pneumoconiosis complicated with COPD in Beijing Chaoyang Hospital, were retrospectively analyzed. These patients were stratified into EOS<100 cells/μl group and EOS≥100 cells/μl group, taking 100 cells/μl as the cut-off value. Demographic characteristics, clinical symptoms, lung function and laboratory indexes were compared between the two groups.Results:The median EOS count of patients with pneumoconiosis complicated with COPD was 100 (40, 180) cells/μl. 50.2% (160/319) had blood eosinophil counts ≥100 cells/μl, and 11.0% (35/319) had blood eosinophil counts ≥300 cells/μl. In comparison with EOS<100 cells/μl group, EOS≥100 cells/μl group were older ( P=0.035), had higher body mass index ( P=0.008), and had lower forced respiratory volume in the first second ( P=0.017), had higher the ratio of residual volume to total lung volume ( P=0.010), and had lower diffusing capacity of the lung for carbon monoxide ( P=0.008). Arterial partial pressure of oxygen was significantly reduced in EOS≥100 cells/μl group ( P=0.039). The peripheral blood EOS count was negatively correlated with forced vital capacity, forced breathing volume in the first second, carbon monoxide diffusion, peak expiratory flow, and maximum mid expiratory flow as a percentage of expected values ( rs=-0.22, -0.18, -0.19, -0.19, -0.19, P=0.000, 0.001, 0.003, 0.008, 0.002), and positively correlated with the ratio of residual air volume to total lung volume ( rs=0.17, P=0.002) . Conclusion:There was a correlation between blood EOS count and pulmonary function parameters, can proide reference for the diagnosis and treatment of chnoric obstuctive pulmmory disease in clinical practice.

Objective:To evaluate the performance of biomarkers in aneuploidy screening in the first trimester-pregnancy associated plasma protein A(PAPP-A) combined with Fetal Medicine Foundation (FMF)'s competing risk model in screening preeclampsia among our population.Methods:This study was based on a prospective cohort of singleton pregnant women who underwent aneuploidy screening in the first trimester in Nanjing Drum Tower Hospital from January 2017 to September 2020. Mean arterial pressure (MAP), uterine artery pulsatility index (UtA-PI), and PAPP-A were converted into multiples of median (MoM) using the algorithm disclosed on the website of the FMF (fetalmedicine.org). The predictive outcomes of maternal factors alone or in combination with MAP, UtA-PI, and PAPP-A (alone or in combination) were calculated. Chi-square test, Fisher's exact test or rank sum test were used for comparison among groups and Bonferroni method for pairwise comparisons. Receiver operating characteristic (ROC) curve was used to evaluate the screening efficiency and to calculate the sensitivities of predicting preeclampsia, term and preterm preeclampsia at false-positive rates of 5% and 10%. The predictive performance of this model was further compared to the screening strategy that was recommended in Diagnosis and treatment of hypertension and pre-eclampsia in pregnancy: a clinical practice guideline in China (2020). Results:Among the 5 144 singleton pregnancy women who were recruited in the cohort, 4 919 cases were included and analyzed in this study. A total of 223 cases were diagnosed as preeclampsia (4.5%), including 55 preterm (1.1%) and 168 term preeclampsia (3.4%). The median of MoM values of MAP, UtA-PI, and PAPP-A in the non-preeclampsia group were around 1.0±0.1. Statistical significance was observed in the difference of MAP, UtA-PI, and PAPP-A Mom between women with preterm preeclampsia and those without preeclampsia [1.061 (0.999-1.150) vs 0.985 (0.935-4.043), 1.115 (0.873-1.432) vs 1.039 (0.864-1.236), 0.820 (0.493-1.066) vs 1.078 (0.756-1.508)], which was also seen in the difference of MAP and PAPP-A Mom between women with term preeclampsia and those without preeclampsia [1.065 (1.002-1.133) vs 0.985 (0.935-4.043), 1.007 (0.624-1.393) vs 1.078 (0.756-1.508)] (all P<0.025). The combination screening with maternal factors+MAP+UtA-PI+PAPP-A was noted for the best efficiency. In predicting preeclampsia preterm and term preeclampsia at the false-positive rate of 10%, the sensitivity of the model was 53.0%, 76.4% and 44.6% respectively. Using the screening method recommended in Diagnosis and treatment of hypertension and pre-eclampsia in pregnancy: a clinical practice guideline in China(2020), the proportion of people at high risk of preeclampsia was 5.9% (290/4 919), and the sensitivity for predicting preterm preeclampsia was 25.5% (14/55), which was significantly lower than the combination screening with maternal factors+MAP+UtA-PI+PAPP-A [65.5% (36/55)] when using the same proportion of high-risk population. Conclusion:The preeclampsia screening model based on aneuploidy screening biomarkers in the first trimester--PAPP-A in combination with materral factors, MAP, UtA-PI, can effectively screen preterm preeclampsia in the local population without increasing the laboratory costs.

Background Certain metabolites are closely related to the occurrence and development of pulmonary fibrosis, and the related mechanism has not been fully elucidated. It is necessary to explore the trends of various metabolites and causes of pulmonary fibrosis. Objective To discuss the trends of publication and research hotspots of pulmonary fibrosis-related metabolites by bibliometrics. Methods With "pulmonary fibrosis" and "metabolites" in both Chinese and English as primary keywords, literature search was conducted through public online databases: PubMed, Web of Science, SinoMed, and CNKI. NoteExpress 3.0 and Excel 2019 were used to store and organize the collected literature. Analyses included publication year, number of papers, institution, country/region, and journal title. VOSviewer 1.6.10 was used for visual analysis. Keyword co-occurrence was analyzed by setting the minimum threshold for the occurrence of keywords to 5 times. Results The research on pulmonary fibrosis and associated metabolites in foreign language was earlier than that in Chinese language. Since the 1990s, the number of literature showed an increasing trend in both foreign and Chinese language literature. A total of 1 062 articles were published in foreign languages, of which 864 articles contained the authors’ address information. The authors in the United States published 340 articles, followed by China with 196 articles, and then Japan, Germany, and Italy. There were 728 relevant pieces of literature published in Chinese, 709 of which included the authors’ institution information and 350 institutions were involved. North China University of Science and Technology, Shanxi Medical University, Peking University, Zhengzhou University, China Medical University，and Soochow University were the top 6 by number of publication. A total of 255 Chinese journals published 728 Chinese articles, and among them 242 articles (33.24%) were published by 12 journals having published more than ten articles per journal. A total of 1062 articles were published in 609 foreign language journals, and among them 179 articles (16.85%) were published by 8 journals with more than 15 articles published by each journal. The results of keywords co-occurrence analysis suggested that pulmonary fibrosis in association with glucose metabolism, lipid metabolism, amino acid metabolism, nucleotide metabolism, and biological oxidation were the common themes studied at home and abroad. Conclusion The number of publications on pulmonary fibrosis and metabolites has been on the rise in recent years, and the research hotspots include glucose metabolism, lipid metabolism, amino acid metabolism, nucleotide metabolism, and biological oxidation.

Exploding head syndrome (EHS) is a sleep disorder that is easily missed diagnosed and misdiagnosed in Neurology. Its long-term existence can seriously affect the quality of life of patients; therefore, early and accurate identification of EHS and early intervention are very important. This article summarizes the recent advance in EHS in recent years from the aspects of etiology, pathogenesis, epidemiology, clinical manifestations, diagnosis, treatment and prognosis as follows, in order to deepen the understanding of clinical colleagues.

Exploding head syndrome (EHS) is a sleep disorder that is easily missed diagnosed and misdiagnosed in Neurology. Its long-term existence can seriously affect the quality of life of patients; therefore, early and accurate identification of EHS and early intervention are very important. This article summarizes the recent advance in EHS in recent years from the aspects of etiology, pathogenesis, epidemiology, clinical manifestations, diagnosis, treatment and prognosis as follows, in order to deepen the understanding of clinical colleagues.

Objective:To evaluate the clinical effect and pregnancy outcome of infertile patients with moderate and severe intrauterine adhesions by comprehensive treatment.Methods:Totally 148 infertile patients with moderate to severe intrauterine adhesions who were hospitalized in the Department of Reproductive Medicine of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from May 1, 2017 to May 1, 2018 were retrospectively analyzed. They were divided into two groups based on American Fertility Association (AFS) scoring: the moderate group (79 patients) with an AFS score of 5-8 and the severe group (69 patients) with an AFS score of 9-12. All patients received comprehensive treatment for intrauterine adhesions, including intrauterine adhesion decompression and postoperative adjuvant therapy, such as estrogen, physical barrier and biogels. Through case investigation, telephone and outpatient follow-up, the postoperative review of uterine cavity, menstruation and pregnancy outcomes were collected, and the follow-up time was 24-36 months after surgery.Results:1) Postoperative recovery of uterine cavity: 80.41% (119 cases of 148) patients with intrauterine adhesions had improved uterine cavity environment, and 65 of 79 moderate patients had significantly improved uterine cavity environment, the improvement rate was 82.28% (65/79). The uterine environment was significantly improved in 54 cases of 69 severe patients, the improvement rate was 78.26% (54/69). 2) Changes of postoperative intrauterine AFS score: postoperative AFS score of patients with moderate intrauterine adhesions decreased (4.10±0.21) points, and the difference was statistically significant ( P<0.001). AFS score of patients with severe intrauterine adhesions decreased (7.12±0.30) points after operation, and the difference was statistically significant ( P<0.001). 3) Improvement of menstruation after surgery: in the first 3 months after surgery, 72 patients with moderate intrauterine adhesions (91.14%) had improved menstruation. A total of 57 patients (82.61%) with severe intrauterine adhesions had improved menstruation. Three months after surgery, 52 patients (65.82%) with moderate intrauterine adhesions had better menses than before; a total of 41 patients (59.42%) with severe intrauterine adhesions had improved menstruation. 4) Pregnancy outcome: among 79 patients with moderate intrauterine adhesions, 44 cases were pregnant, of which 37 cases delivered live births (19 cases of natural pregnancy, 18 cases of assisted reproductive pregnancy), with a live birth rate of 84.09%. There were 33 pregnancies and 20 live births (15 natural pregnancies and 5 assisted pregnancies) in the patients with severe intrauterine adhesions, with a live birth rate of 60.61%. Conclusion:The comprehensive treatment of intrauterine adhesions can obviously improve the uterine environment of moderate and severe intrauterine adhesions, reduce AFS score, improve menstruation, increase pregnancy rate and improve pregnancy outcome.

Objective:To evaluate the clinical effect and pregnancy outcome of infertile patients with moderate and severe intrauterine adhesions by comprehensive treatment.Methods:Totally 148 infertile patients with moderate to severe intrauterine adhesions who were hospitalized in the Department of Reproductive Medicine of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from May 1, 2017 to May 1, 2018 were retrospectively analyzed. They were divided into two groups based on American Fertility Association (AFS) scoring: the moderate group (79 patients) with an AFS score of 5-8 and the severe group (69 patients) with an AFS score of 9-12. All patients received comprehensive treatment for intrauterine adhesions, including intrauterine adhesion decompression and postoperative adjuvant therapy, such as estrogen, physical barrier and biogels. Through case investigation, telephone and outpatient follow-up, the postoperative review of uterine cavity, menstruation and pregnancy outcomes were collected, and the follow-up time was 24-36 months after surgery.Results:1) Postoperative recovery of uterine cavity: 80.41% (119 cases of 148) patients with intrauterine adhesions had improved uterine cavity environment, and 65 of 79 moderate patients had significantly improved uterine cavity environment, the improvement rate was 82.28% (65/79). The uterine environment was significantly improved in 54 cases of 69 severe patients, the improvement rate was 78.26% (54/69). 2) Changes of postoperative intrauterine AFS score: postoperative AFS score of patients with moderate intrauterine adhesions decreased (4.10±0.21) points, and the difference was statistically significant ( P<0.001). AFS score of patients with severe intrauterine adhesions decreased (7.12±0.30) points after operation, and the difference was statistically significant ( P<0.001). 3) Improvement of menstruation after surgery: in the first 3 months after surgery, 72 patients with moderate intrauterine adhesions (91.14%) had improved menstruation. A total of 57 patients (82.61%) with severe intrauterine adhesions had improved menstruation. Three months after surgery, 52 patients (65.82%) with moderate intrauterine adhesions had better menses than before; a total of 41 patients (59.42%) with severe intrauterine adhesions had improved menstruation. 4) Pregnancy outcome: among 79 patients with moderate intrauterine adhesions, 44 cases were pregnant, of which 37 cases delivered live births (19 cases of natural pregnancy, 18 cases of assisted reproductive pregnancy), with a live birth rate of 84.09%. There were 33 pregnancies and 20 live births (15 natural pregnancies and 5 assisted pregnancies) in the patients with severe intrauterine adhesions, with a live birth rate of 60.61%. Conclusion:The comprehensive treatment of intrauterine adhesions can obviously improve the uterine environment of moderate and severe intrauterine adhesions, reduce AFS score, improve menstruation, increase pregnancy rate and improve pregnancy outcome.

Objective:To screen the potential characteristic gene spectrums and signal pathways of osteoarthritis based on gene chips.Methods:We analyzed 2 microarrays of human joint synovial tissue (GSE82107 and GSE55235) derived from the Gene Expression Omnibus (GEO) database and included for this study 20 osteoarthritis (OA) samples and 17 healthy control samples. The differentially expressed genes (DEGs) between OA and HC were screened by GEO2R tool. Analyses of Gene Ontology function and Kyoto Encyclopedia of Genes and Genomes pathway enrichment were performed using the Database for Annotation, Visualization and Integrated Discovery to identify the pathways and functional annotations of DEGs (https://david.ncifcrf.gov/). Protein-protein interaction of these DEGs was analyzed based on the Search Tool for the Retrieval of Interacting Genes database and visualized by Cytoscape software (http://www.string-db.org/).Results:191 up-regulated DEGs and 49 down-regulated DEGs were screened out from the 2 microarray databases. Enrichment of DEGs was mainly found in regulation of such biological functions as "inflammation" , "bone cell differentiation" and "positive apoptotic cell regulation" , HTLV-I infection, silk crack on the original amp-activated protein kinase (MAPK) signaling pathway, swine flu, tumor necrosis factor (TNF) signaling pathway, the nf-kappa B signaling pathway, PI3 kinase/Akt pathway, toll-like receptor pathway, legionella, salmonella and other 14 signaling pathways. In 2 modes of MNC and Degree, the top 10 core genes were screened, of which interleukin-6 (IL6), JUN, chemokine 8 (CXCL8), early reaction growth factor (EGR1) and cyclin (CCND1) were identified as valuable biomarkers of OA.Conclusions:Based on GEO chips, 10 characteristic gene profiles such as IL6, JUN, CXCL8, EGR1, CCND and 14 signal pathways such as tumor necrosis factor (TNF) signal pathway, NF-κB signal pathway, PI3 kinase/Akt pathway and Toll-like receptor pathway were screened, which may provide new clues for understanding of the pathogenesis of osteoarthritis.