Objective The Nuangong Waifu formula （NGWFF） is a traditional Chinese medicine prescription that has been used in gynecology of traditional Chinese medicine in our hospital for many years. It has a certain effect on preventing postoperative intrauterine re-adhesion. To further retrospectively analyze the clinical efficacy of NGWFF. Methods A total of 200 patients who were diagnosed with intrauterine adhesions and underwent intrauterine adhesion separation from January 2018 to December 2020 were retrospectively included. They were divided into control group and observation group according to different drug use for postoperative prevention of re-adhesion, with 100 cases in each group. All patients were given oral estrogen and progesterone （ethinyl estradiol tablets 0.037 5 mg, q12 h, or estradiol valerate tablets 3 mg, q12 h, a total of 21 days, 7 days after estrogen therapy plus dydrogesterone 20 mg, qd or progesterone capsules 200 mg, qd） to promote endometrial growth. In the control group, 100 patients only used estrogen and progesterone after operation. In the observation group, 100 patients were treated with NGWFF at Guanyuan acupoint （four fingers under the navel）, once a day. Both groups were evaluated for the degree of intrauterine adhesions under hysteroscopy and the effective rate after 3-5 menstrual cycles of drug treatment. Results Compared with using estrogen and progesterone alone, combination use of NGWFF significantly decreased in the scores of intrauterine adhesions under hysteroscopy （2.41±1.19 vs 3.31±1.18, P=0.00）, and the effective rate was also significantly higher than that in the control group （ 86 % vs 47 %, P<0.000）. Conclusion The combination use of NGWFF was more effective than using estrogen and progesterone alone in preventing re-adhesion after intrauterine adhesions， which provided a scientific basis for the clinical application of NGWFF.

Objective To investigate the results of ambulatory electrocardiographic(ECG)monitoring in a community-based homebound elderly population and to explore the applicability of wearable long-range ambulatory ECG monitor for them.Methods Elderly volunteers were recruited in Shuangbei Community,Shapingba District,Chongqing,from November 2021 to June 2023.A single-lead wearable ambulatory ECG recorder was applied to them to obtain ECG for 7 consecutive days.The adverse reactions,acceptability,monitoring duration,and arrhythmia detection rate during the wearing were described and recorded.Serious arrhythmic events included frequent atrial premature,atrial flutter,atrial fibrillation(AF),frequent ventricular premature,and RR intervals ≥5 s.Results There were 416 individuals enrolled,with a mean age of 71.2±6.6 years,and a male percentage of 36.1％(150 men).Finally,384(92.3％)participants completed the wearing of the ECG monitor for 7 d,with an average time of 159.2±29.4 h.There were 179 participants(48.5％)reporting no discomfort during wearing,and 175 ones(47.4％)feeling itchy at the wearing site.The monitoring results showed that the common arrhythmias were atrial premature contractions(97.1％),premature ventricular contractions(93.3％),atrial tachycardia(84.6％),bradycardia(46.6％),frequent atrial premature contractions(15.1％),ventricular tachycardia(13.2％),and long RR interval(11.8％).Among them,29.1％of the participants experienced serious arrhythmic events,and the detection rate of certain serious arrhythmic events was comparatively higher in the individuals≥70 years of age and those with history of previous cardiac disease.Conclusion The detection rate of common arrhythmias is quite high in the community-based homebound elderly population.A 7-day long-range ambulatory ECG monitoring may be appropriate.

Objective To analyze and construct systolic blood pressure(SBP)fluctuation trajectory in a community population with hypertension and to analyze the factors influencing different trajectories.Methods This is a community-based retrospective cohort study.A latent class trajectory model was used to identify and construct longitudinal trajectories of blood pressure change.Multinomial logistic regression analysis was performed to identify the associated factors of blood pressure trajectories by adjusting for different confounders.Potential confounding factors were identified using a directed acyclic graph based on a priori knowledge.Results A total of 793 patients with hypertension were enrolled in the analysis.They were divided into 3 groups by LCTM-fitted systolic blood pressure trajectories,namely stable low-level group(n=561,70.74％),declining group(n=170,21.44％)and rising group(n=62,7.82％).Significant differences were observed among the 3 trajectories groups in terms of age,frequency of exercise,ways of follow-up,salt intake,compliance behavior,and referral(P＜0.05).Compared to the stable low-level group and adjusting for corresponding confounding factors,the male patients and the patients with"outpatient follow-up"were more likely to be classified into"declining group",with OR and 95％CI of 1.436(1.016～2.030)and 1.702(1.202～2.410),respectively.The participants aged ≥ 65 years,who did not exercise or occasionally exercised,and had moderate and severe salt intake,were more likely to be classified into the"rising group"(OR=1.949,2.284,2.433,4.540,95％CI:1.145～3.317,1.305～3.998,1.272～4.654,1.291～15.963).Conclusion SBP trajectories in community-dwelling hypertensive population can be divided into stable low-level,declining and rising groups.Gender,age,salt intake,exercise frequency,and follow-up methods may be influencing factors for SBP blood pressure trajectory.

Objective:To investigate the efficacy of low-dose uric acid oxidase in treating children with aggressive mature B-cell non-Hodgkin lymphoma accompanied by hyperuricemia.Methods:Clinical data of children with primary aggressive mature B-cell non-Hodgkin lymphoma and hyperuricemia, who were treated in Beijing Children′s Hospital, Capital Medical University from January 2016 to June 2021 were retrospectively analyzed.The serum uric acid concentration was monitored in all pediatric patients from the day before chemotherapy to the seventh day of chemotherapy.Low-dose uric acid oxidase [0.05-0.10 mg/(kg·dose)] was intravenously injected into the patients when the serum uric acid level exceeded the upper limit of the normal range.The therapeutic effect and clinical medication experience of uric acid oxidase were summarized.The change of serum uric acid levels with time before and after the application of different doses of uric acid oxidase was analyzed by a repeated measures ANOVA. Results:A total of 106 children with primary aggressive mature B-cell non-Hodgkin lymphoma and hyperuricemia were enrolled in this study.There were 88 males and 18 females, with a median age of 6.5 (3.5, 10.0) years.The pathological subtypes comprised Burkitt′s lymphoma in 95 cases (89.6%), high-grade B-cell lymphoma in 7 cases (6.6%), and diffuse large B-cell lymphoma in 4 cases (3.8%). Additionally, 39 cases (36.8%) were in clinical stage Ⅲ and 67 cases (63.2%) were in stage Ⅳ.All cases had high tumor burden, including renal involvement in 52 cases (49.1%), tumor lysis syndrome in 42 cases (39.6%), and acute kidney injury in 27 cases (25.5%). Totally, one dose of uric acid oxidase was intravenously injected into 41 children (38.7%), 41 children (38.7%) were given 2 dosages, 20 children (18.9%) were given 3 dosages, and 4 children (3.8%) received 4 dosages.Moreover, 9 cases (8.5%) were supplemented with continuous renal replacement therapy.Serum uric acid concentrations before chemotherapy and 12 hours after injecting the first dose of uric acid oxidase were (741.4±312.9) μmol/L and (210.8±148.6) μmol/L, respectively.The difference was statistically significant ( t=5.288, P<0.001). The change of serum uric acid levels over time before and after the application of different doses of uric acid oxidase in children was compared, and no significant difference was found ( F=0.225, P=0.879). No delay in chemotherapy or death arising from tumor lysis syndrome and acute kidney injury occurred within 28 days after chemotherapy. Conclusions:Low-dose and on-demand application of uric acid oxidase can rapidly and effectively reduce serum uric acid levels in children with aggressive mature B-cell non-Hodgkin lymphoma in the early stage of chemotherapy.

Spinal fusion is a standard operation for treating moderate and severe intervertebral disc diseases. In recent years, the proportion of three-dimensional printing interbody fusion cage in spinal fusion surgery has gradually increased. In this paper, the research progress of molding technology and materials used in three-dimensional printing interbody fusion cage at present is summarized. Then, according to structure layout, three-dimensional printing interbody fusion cages are classified into five types: solid-porous-solid (SPS) type, solid-porous-frame (SPF) type, frame-porous-frame (FPF) type, whole porous cage (WPC) type and others. The optimization process of three-dimensional printing interbody fusion cage and the advantages and disadvantages of each type are analyzed and summarized in depth. The clinical application of various types of 3D printed interbody fusion cage was introduced and summarized later. Lastly, combined with the latest research progress and achievements, the future research direction of three-dimensional printing interbody fusion cage in molding technology, application materials and coating materials is prospected in order to provide some reference for scholars engaged in interbody fusion cage research and application.
Humans ; Intervertebral Disc Degeneration ; Intervertebral Disc Displacement ; Porosity ; Printing, Three-Dimensional ; Spinal Fusion

Objective:To explore the effect of long-term exposure to ambient particulate matter (PM 10) on the prevalence of diabetes and fasting plasma glucose (FPG). Methods:The subjects of the study were from the baseline population of "Jinchang Cohort", and 24 285 subjects were finally included after excluding incomplete home address information and diabetic diagnosis information. The demographic characteristics, lifestyle and health status of the survey subjects were collected through questionnaire, physical examination and laboratory tests. ArcGIS software was used to match the nearest environmental monitoring stations for each subject according to residential address. Two-year average concentrations of PM 10 were calculated to estimate exposure level. The logistic regression and the multiple linear regression were conducted to assess the effects of ambient PM 10 on the prevalence of diabetes and FPG. The restricted cubic spline was used to quantify the dose-response relationship. Stratified analysis and effect modification analysis were also performed. Results:The age of 24 285 participants was (49.32±8.60) years, and the BMI was (24.22±6.09) kg/m 2. There were 13 950 (57.44%) males and 2 066 (8.51%) diabetic patients. After adjusting for confounders, for every 10 μg/m 3 increase in the average PM 10 concentration in the first two years of the survey, the prevalence of diabetes increased [ OR (95% CI) =1.05 (1.01-1.09)]and the FPG level elevated [β (95% CI) = 0.061 (0.047-0.076) mmol/L]. The results of the restricted cubic spline analysis showed a nonlinear relationship between PM 10 concentration and FPG level ( P<0.001). Further subgroup analysis showed that female [ OR (95% CI) =1.10 (1.03-1.18)], people over 50 years old [ OR (95% CI) =1.06 (1.02-1.11) ], subjects with family history of diabetes [ OR (95% CI) = 1.13 (1.04-1.23) ], and with hypertension [ OR (95% CI) = 1.07 (1.02-1.12) ] had a stronger association between the prevalence of diabetes and PM 10 exposure (all P interaction values were<0.05). The effects of PM 10 on FPG were more significant in people older than 50 years[β (95% CI) = 0.080 (0.050-0.109) mmol/L], with family history of diabetes [β (95% CI) = 0.087 (0.036-0.137) mmol/L], and hypertension [β (95% CI) = 0.077 (0.046-0.108) mmol/L] (all P interaction values were<0.05). Conclusions:Long-term exposure to ambient PM 10 increases the diabetes prevalence and FPG. People older than 50 years old, with family history of diabetes and hypertension could be more sensitive to the effects of PM 10 exposure.

Objective:To explore the effect of long-term exposure to ambient particulate matter (PM 10) on the prevalence of diabetes and fasting plasma glucose (FPG). Methods:The subjects of the study were from the baseline population of "Jinchang Cohort", and 24 285 subjects were finally included after excluding incomplete home address information and diabetic diagnosis information. The demographic characteristics, lifestyle and health status of the survey subjects were collected through questionnaire, physical examination and laboratory tests. ArcGIS software was used to match the nearest environmental monitoring stations for each subject according to residential address. Two-year average concentrations of PM 10 were calculated to estimate exposure level. The logistic regression and the multiple linear regression were conducted to assess the effects of ambient PM 10 on the prevalence of diabetes and FPG. The restricted cubic spline was used to quantify the dose-response relationship. Stratified analysis and effect modification analysis were also performed. Results:The age of 24 285 participants was (49.32±8.60) years, and the BMI was (24.22±6.09) kg/m 2. There were 13 950 (57.44%) males and 2 066 (8.51%) diabetic patients. After adjusting for confounders, for every 10 μg/m 3 increase in the average PM 10 concentration in the first two years of the survey, the prevalence of diabetes increased [ OR (95% CI) =1.05 (1.01-1.09)]and the FPG level elevated [β (95% CI) = 0.061 (0.047-0.076) mmol/L]. The results of the restricted cubic spline analysis showed a nonlinear relationship between PM 10 concentration and FPG level ( P<0.001). Further subgroup analysis showed that female [ OR (95% CI) =1.10 (1.03-1.18)], people over 50 years old [ OR (95% CI) =1.06 (1.02-1.11) ], subjects with family history of diabetes [ OR (95% CI) = 1.13 (1.04-1.23) ], and with hypertension [ OR (95% CI) = 1.07 (1.02-1.12) ] had a stronger association between the prevalence of diabetes and PM 10 exposure (all P interaction values were<0.05). The effects of PM 10 on FPG were more significant in people older than 50 years[β (95% CI) = 0.080 (0.050-0.109) mmol/L], with family history of diabetes [β (95% CI) = 0.087 (0.036-0.137) mmol/L], and hypertension [β (95% CI) = 0.077 (0.046-0.108) mmol/L] (all P interaction values were<0.05). Conclusions:Long-term exposure to ambient PM 10 increases the diabetes prevalence and FPG. People older than 50 years old, with family history of diabetes and hypertension could be more sensitive to the effects of PM 10 exposure.

Novel Coronavirus Pneumonia (NCP) is a class B infectious disease, which is prevented and controlled according to class A infectious diseases. Recently, children′s NCP cases have gradually increased, and children′s fever outpatient department has become the first strategic pass to stop the epidemic. Strengthening the management of the fever diagnosis process is very important for early detection of suspected children, early isolation, early treatment and prevention of cross-infection. This article proposes prevention and control strategies for fever diagnosis, optimizes processes, prevents cross-infection, health protection and disinfection of medical staff, based on the relevant diagnosis, treatment, prevention and control programs of the National Health and Health Commission and on the diagnosis and treatment experience of experts in various provinces and cities. The present guidance summarizes current strategies on pre-diagnosis; triage, diagnosis, treatment, and prevention of 2019-nCoV infection in common fever, suspected and confirmed children, which provide practical suggestions on strengthening the management processes of children′s fever in outpatient department during the novel coronavirus pneumonia epidemic period.

Objective: To identify a novel human leukocyte antigen (HLA) B allele in a Chinese Han individual and construct its three-dimensional structure. Methods: The initial HLA genotyping was performed by PCR-sequence-based typing (PCR-SBT). The ambiguous allele was confirmed with single-strand DNA sequencing. The DNA sequence was analyzed to identify the difference between the novel allele and its closest matching allele. Finally, the three-dimensional molecular structure of the novel allele was constructed using a Swiss-Model. Results: One allele of the subject at the HLA-B locus was B*44: 03: 01, whilst the other was a novel allele which differed from the closest matching allele B*51: 01: 01: 01 by nucleotide (nt) 329 A>C in exon 2, resulting in an amino acid change at codon 86 (p.Asn86Thr). Conclusion A novel HLA-B allele has been identified and officially named as HLA-B*51: 159 by the WHO Nomenclature Committee for Factors of the HLA System. The three-dimensional structure of B*51: 159 was simulated.

Objective: To explore the clinical features, the serotype distribution and drug resistance of the isolates in patient with invasive pneumococcal disease (IPD). Methods: By retrieving the laboratory information system in 18 children′s hospitals from 2012 to 2017, the children with IPD were enrolled. Streptococcus pneumoniae (Spn) must be isolated from the sterile sites (blood, cerebrospinal fluid, hydrothorax and joint effusion etc.). The clinical characteristics, serotype, drug resistance, treatment and prognosis were reviewed and analyzed. According to the telephone follow up results, the patients were divided into death group and recovered group. The index as an independent risk factor of mortality was demonstrated by multivariate logistic regression analysis. Results: There were 1 138 children with IPD, including 684 male and 454 female. The proportion of male to female was 1.5∶1. The age ranged from one day to 16 years. The median age was 1 year 3 month. The majority was under 5 years of age (89.3%, n= 1 016), especially under 2 years of age (61.9%, n=704). In all cases, 88.2% (n=1 004) were community acquired infection. The infections included meningitis (n=446, 39.2%), pneumonia with bacteremia (n=339, 29.8%), and bacteremia without focus (n=232, 20.4%). Underlying diseases were found in 242 cases (21.3%). Co-infections were determined in 62 cases (5.4%) with mycoplasma, 27 cases (2.4%) with adenovirus and 34 cases with influenza virus (3.0%). The penicillin insensitivity (PNSP) rates in meningitis and non-meningitis isolates were 69.5% (276/397) and 35.9% (221/615), respectively. There were 81 strains serotyped, in which 93.8% (76/81) were covered by 13-valent protein-polysaccharide conjugate vaccine (PCV13). In the 965 patients who were followed up by phone call, 156 cases (16.2%) were confirmed dead. The independent risk factors for the death were under 2 years of age (OR=2.143, 95%CI 1.284-3.577, P=0.004), meningitis (OR=3.066, 95%CI 1.852-5.074, P<0.01), underlying disease (OR=4.801, 95%CI 2.953-7.804, P<0.01), septic shock(OR=3.542, 95%CI 1.829-6.859, P<0.01), disseminated intravascular coagulation (DIC) (OR=4.150, 95%CI 1.468-11.733, P=0.007), multiple organ failure (OR=12.693, 95%CI 6.623-24.325, P<0.01) and complications of central nervous system (OR=1.975, 95%CI 1.144-3.410, P=0.015). Conclusions Most children with IPD were under 5 years of age, having underlying diseases and acquired the infection in community. The independent risk factors for death were under two years old, meningitis, underlying diseases and multiple organ failure. The problem of drug resistance was severe. The universal immunization of PCV13 would be effective to prevent IPD in Chinese children.