Objective To investigate the-75 G/A single-nucleotide polymorphism in the promoter region of apolipoprotein A1 gene(apoA1)and its association with gestational diabetes mellitus(GDM)in pregnant women and to provide references for the exploration in the molecular genetic basis of GDM.Methods A total of 626 GDM patients and 1022 normal pregnant women,ie,the controls,were included in the study.The genotyping of apoA1-75 G/A polymorphism was performed by polymerase chain reaction and restriction fragment length polymorphism(PCR-RFLP)analysis.Total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and glucose(Glu)were measured by enzymatic methods.Plasma insulin(INS)was measured by chemiluminescence immunoassay.The protein levels of apoA1 and apoB were measured by the turbidimetric immunoassay.Results Allele frequencies of G and A were 0.718 and 0.282 in the GDM group and 0.713 and 0.287 in the control group,respectively.Distribution of the genotype frequencies was found to be in Hardy-Weinberg equilibrium in both the GDM and control groups.There was no significant difference in the frequencies of alleles G and A and the genotypes of apoA1-75 G/A polymorphism between the GDM and the control group(P>0.05).In the GDM group,the carriers with the genotype AA were associated with significantly higher levels of TC,HDL-C,and apoA1 than those with genotypes GG and GA did(all P<0.05).After the GDM patients were divided into obese and non-obese subgroups,the genotype-related apoA1 variation was observed only in obese patients,while the genotype-related TC and HDL-C variations were evident in non-obese patients(P<0.05).In the control group,carriers of genotypes AA and GA had higher systolic blood pressure(SBP)and HDL-C than the carriers of genotype GG did(all P<0.05).Carriers of genotypes AA had significantly lower Glu levels than carriers of genotypes GG and GA did(P<0.05).The control subjects were further divided into subgroups according to their body mass index(BMI).Analysis of the subgroups showed that AA carriers were associated with higher SBP levels in the obese control women only,while lower Glu levels were evident in both obese and non-obese control women.Conclusion These results suggest that-75 G/A polymorphism in the apoA1 gene is not associated with GDM.However,the genetic variation is closed associated with the plasma apoA1,HDL-C,and TC levels in GDM patients and plasma HDL-C,Glu,and SBP levels in the control subjects.The apoA1 variant-associated lipids and SBP variation is BMI dependent in both groups.

China has classified the Corona Virus Disease 2019(COVID-19) as a statutory category B infectious disease and managed it according to Category B since January 8, 2023.In view that Omicron variant is currently the main epidemic strain in China, in order to guide the treatment of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infection in children with the times, refer to the Diagnosis and Treatment Protocol for Novel Coronavirus Infection (Trial 10 th Edition), Expert Consensus on Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fourth Edition) and the Diagnosis and Treatment Strategy for Pediatric Related Viral Infections.The Expert Consensus on the Diagnosis, Treatment and Prevention of Novel Coronavirus Infection in Children (Fifth Edition) has been formulated and updated accordingly on related etiology, epidemiology, pathogenic mechanism, clinical manifestations, auxiliary examination, diagnosis and treatment, and added key points for the treatment of COVID-19 related encephalopathy, fulminating myocarditis and other serious complications for clinical reference.

Objective:To comprehensively analyze the current research status, hotspots, and development trends in the field of fatigue in maintenance hemodialysis patients both domestically and internationally in order to provide reference for future research directions.Methods:Relevant literature on the fatigue status of maintenance hemodialysis patients from the establishment of the database to the publication before December 30, 2022 was retrieved through CNKI, VIP database, Wanfang database, and Web of ScienceTM core collection database, and visualized using CiteSpace 6.1.R3 for analysis.Results:A total of 152 Chinese articles and 110 English articles were included. Analysis showed that foreign publications were first published in 1996, while domestic publications were first published in 2011, and the number of publications has shown a significant upward trend since 2017. The research focus at home and abroad mainly focuses on the influencing factors and intervention measures of fatigue in dialysis patients. Foreign researchers have paid more attention to the correlation between "depression" emotions and the positive intervention of aerobic exercise. In addition, China is actively exploring traditional Chinese medicine therapy aromatherapy to alleviate patient fatigue.Conclusions:In the future, clinical workers should pay attention to fatigue assessment in maintenance hemodialysis patients and explore the influencing factors of fatigue through large-scale longitudinal studies, in order to better provide intervention targets for the treatment of fatigue; Simultaneously conduct high-quality prospective intervention studies to maximize the improvement of fatigue status in such patients and form standardized guidelines for promotion and application.

Monkeypox is a zoonotic disease.Previous studies have shown that children are vulnerable to monkeypox and are also at high risk for severe disease or complications.In order to improve pediatricians′ understanding of monkeypox and achieve early detection, early diagnosis, early treatment and early disposal, the committee composed of more than 40 experts in the related fields of infectious diseases, pediatrics, infection control and public health formulate this expert consensus, on the basis of the latest clinical management and infection prevention and control for monkeypox released by the World Health Organization (WHO), the guidelines for diagnosis and treatment of monkeypox (version 2022) issued by National Health Commission of the People′s Republic of China and other relevant documents.During the development of this consensus, multidisciplinary experts have repeatedly demonstrated the etiology, epidemiology, transmission, clinical manifestations, laboratory examinations, diagnosis and differential diagnosis, treatment, discharge criteria, prevention, case management process and key points of prevention and control about monkeypox.

Since December 2019, severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) infections have raged globally for more than 2 years.China has always adopted scientific and effective prevention and control measures to achieved some success.However, with the continuous variation of SARS-CoV-2 cases and imported cases from abroad, the prevention and control work has become more difficult and complex.With the variation of the mutant strain, the number of cases in children changed, and some new special symptoms and complications were found, which proposed a new topic for the prevention and treatment of SARS-CoV-2 infection in children in China.Based on the third edition, the present consensus according to the characteristics of the new strain, expounded the etiology, pathology, pathogenesis, and according to the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of effective prevention and treatment of SARS-CoV-2 infection in children in China.

Objective:To investigate the predictive value of systemic inflammation response index (SIRI) before treatment for pathological complete response (pCR) in patients with breast cancer undergoing neoadjuvant chemotherapy.Methods:The clinicopathological data of 119 patients with primary breast cancer undergoing neoadjuvant chemotherapy and subsequent breast-conserving or modified radical surgery from Cangzhou Central Hospital of Hebei Province between January 2010 to March 2020 were retrospectively analyzed, and patients were divided into pCR group ( n=19) and non-pCR group ( n=100) based on postoperative pathology. The SIRI before treatment between the two groups was compared. The patients were divided into SIRI≤0.25 ( n=10) , 0.26-0.50 ( n=42) , 0.51-0.75 ( n=29) , 0.76-1.00 ( n=19) , and >1.00 ( n=19) groups according the SIRI before treatment, and the pCR ratios of the five groups were compared. Spearman correlation analysis was applied to evaluate the relationship between SIRI before treatment and pCR, logistic regression analysis was used to identify the influencing factors of pCR for neoadjuvant chemotherapy in breast cancer patients, and receiver operating characteristic (ROC) curve was used to evaluate the predictive value of SIRI before treatment for pCR of neoadjuvant chemotherapy in breast cancer patients. Results:Tumor size ( Z=2.26, P=0.024) , axillary lymph node metastasis ( χ2=5.73, P=0.017) , human epidermal growth factor receptor-2 (HER-2) ( χ2=8.77, P=0.003) , Ki-67 ( Z=2.68, P=0.007) , cytological nuclear grade ( χ2=5.08, P=0.024) , neutrophil count before treatment ( Z=2.44, P=0.015) , monocyte/lymphocyte ratio before treatment ( Z=3.04, P=0.002) , and SIRI before treatment ( Z=3.29, P=0.001) had statistical differences between the pCR and non-pCR groups. The pCR ratios were 50% (5/10) in the SIRI ≤0.25 group, 21% (9/42) in the 0.26-0.50 group, 10% (3/29) in the 0.51-0.75 group, 11% (2/19) in the 0.76-1.00 group, and 0 (0/19) in the >1.00 group, with a statistic difference ( χ2=14.28, P=0.006) . SIRI before treatment was negatively related with pCR ( r=-0.30, P=0.001) . Univariate logistic regression analysis showed that tumor size ( OR=0.50, 95% CI: 0.28-0.89, P=0.019) , axillary lymph node metastasis ( OR=5.43, 95% CI: 1.19-24.83, P=0.029) , HER-2 ( OR=7.54, 95% CI: 1.65-34.36, P=0.009) , Ki-67 ( OR=1.03, 95% CI: 1.01-1.05, P=0.008) , cytological nuclear grade ( OR=0.20, 95% CI: 0.04-0.92, P=0.038) , neutrophil count before treatment ( OR=0.54, 95% CI: 0.32-0.92, P=0.023) , monocyte/lymphocyte ratio before treatment ( OR=0.00, 95% CI: 0.00-0.01, P=0.007) , and SIRI before treatment ( OR=0.03, 95% CI: 0.00-0.37, P=0.007) were influencing factors for pCR of neoadjuvant chemotherapy in breast cancer patients. Multivariate logistic regression analysis confirmed that tumor size ( OR=0.31, 95% CI: 0.14-0.72, P=0.007) , axillary lymph node metastasis ( OR=10.97, 95% CI: 1.35-89.61, P=0.025) , HER-2 ( OR=6.47, 95% CI: 1.18-35.65, P=0.032) , Ki-67 ( OR=1.04, 95% CI: 1.00-1.07, P=0.029) , cytological nuclear grade ( OR=7.87, 95% CI: 1.01-61.35, P=0.049) , and SIRI before treatment ( OR=0.03, 95% CI: 0.00-0.58, P=0.020) were independent influencing factors for pCR of neoadjuvant chemotherapy in breast cancer patients. The ROC curve showed that the area under the curve of SIRI before treatment for predicting pCR was 0.74 (95% CI: 0.65-0.82) , sensitivity was 68.0%, and specificity was 75.3%. The area under the curve of monocyte/lymphocyte ratio before treatment for predicting pCR was 0.72 (95% CI: 0.63-0.80) , sensitivity was 48.0%, and specificity was 84.2%. The area under the curve of neutrophil count before treatment for predicting pCR was 0.68 (95% CI: 0.59-0.76) , sensitivity was 61.0%, and specificity was 83.7%. Conclusion:SIRI before treatment may serve as a marker for predicting pCR in patients with breast cancer undergoing neoadjuvant chemotherapy, patients with low SIRI are more likely to obtain pCR.

2019 novel coronavirus(2019-nCoV) outbreak is one of the public health emergency of international concern.Since the 2019-nCoV outbreak, China has been adopting strict prevention and control measures, and has achieved remarkable results in the initial stage of prevention and control.However, some imported cases and sporadic regional cases have been found, and even short-term regional epidemics have occurred, indicating that the preventing and control against the epidemic remains grim.With the change of the incidence proportion and the number of cases in children under 18 years old, some new special symptoms and complications have appeared in children patients.In addition, with the occurrence of virus mutation, it has not only attracted attention from all parties, but also proposed a new topic for the prevention and treatment of 2019-nCoV infection in children of China.Based on the second edition, the present consensus further summarizes the clinical characteristics and experience of children′s cases, and puts forward recommendations on the diagnostic criteria, laboratory examination, treatment, prevention and control of children′s cases for providing reference for further guidance of treatment of 2019-nCoV infection in children.

Chongqing Medical University and University of Dundee have explored the "4+ 1" integration training mode combining undergraduate and postgraduate for biomedical engineering major in 2018, including mode of education, curriculum linkage and credit recognition, contract signing and publicity, process assessment and management, and degree awarding. After repeated communication and argument, Chongqing Medical University and University of Dundee signed the contract of the "4+ 1" integration training mode in 2019. One junior student participated in the "Summer Camp of University of Dundee" in the same year, and one senior student participated in this integration training mode program in 2020. According to the feedback of the first batch of students, the "4+ 1" integration training mode can guide students from different angles, which is conducive to broadening students' international vision and injecting strong power into the cultivation of biomedical engineering talents.

Under the background of "Three Whole Education", the College of Biomedical Engineering of Chongqing Medical University builds the rule of undergraduate tutors, promotes the effective connection among the entrance -in school -graduation education, integrates the innovative education and teaching throughout into the undergraduate period, and implements "4+1" education models of theory teaching - ability training - competetion incubation - atmosphere building to create innovative classroom transcripts, finally realizing the all-around education of innovative undergraduate talents. Through the innovation and practices, we will continue to refine educational effects.

Objective:To evaluate the efficacy of auricular acupoint pressure therapy combined with intranasal dexmedetomidine for transthoracic echocardiography in pediatric patients.Methods:A total of 117 pediatric patients with congenital heart disease, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, aged 3-36 months, weighing 5-20 kg, scheduled for elective transthoracic echocardiography under outpatient sedation, were selected.Transthoracic echocardiography was performed under sedation using intranasally administered dexmedetomidine or using auricular acupoint pressure therapy combined with intranasal dexmedetomidine.The interval between the two sedation methods was at least 1 week.Intranasal dexmedetomidine: Dexmedetomidine 3 μg/kg was administered to both nostrils via a nebulizer, with 1/2 dose in each nostril.Intranasal dexmedetomidine combined with auricular acupoint pressure: auricular acupressure with Wang Bu Liu Xing (semen vaccariae) seeds was used at the auricular acupoints.After each acupoint was rubbed for about 1 min, dexmedetomidine 3 μg/kg was administered to both nostrils via a nebulizer, with 1/2 dose in each nostril.After the examination, auricular acupoint pressure therapy was continued at home, and pressing-rubbing at the acupoints was manipulated for 3 times daily, one of which was performed at 30 min before going to bed, for 3 consecutive days.When the University of Michigan Sedation Scale score≥2 and body movement score ≥2 within 30 min after giving dexmedetomidine, sedation was considered to be successful.The onset time of sedation, examination time, waiting time, recovery time and the success of sedation were recorded.The incidence of adverse reactions such as bradycardia, hypotension, hypertension, hypoxemia, nausea and vomiting, respiratory depression, restlessness, hyperactivity, action imbalances and allergic reaction were recorded within 24 h after administration of dexmedetomidine.Time to recovery and improvement of sleep quality at night were recorded.Results:Compared with intranasal dexmedetomidine, the successful rate of sedation and incidence of improvement of sleep quality at night were significantly increased ( P<0.05), and no significant change was found in adverse reactions using intranasal dexmedetomidine combined with auricular acupoint pressure ( P>0.05). Conclusion:Intranasal dexmedetomidine combined with auricular acupoint pressure therapy can increase the successful rate of sedation and improve the sleep quality at night in pediatric patients undergoing transthoracic echocardiography when compared to intranasal dexmedetomidine.