Juvenile idiopathic arthritis (JIA) is the most common condition of chronic rheumatic disease in children. JIA is an autoimmune or autoinflammatory disease, with unclear mechanism and limited treatment efficacy. Recent studies have found a number of alterations in gut microbiota and its metabolites in children with JIA, which are related to the development and progression of JIA. This review focuses on the influence of the gut microbiota and its metabolites on immune function and the intestinal mucosal barrier and discuss the key role of the gut-joint axis in the pathogenesis of JIA and emerging treatment methods based on gut microbiota and its metabolites. This review could help elucidate the pathogenesis of JIA and identify the potential therapeutic targets for the prevention and treatment of JIA.
Humans ; Arthritis, Juvenile/physiopathology* ; Gastrointestinal Microbiome/physiology* ; Child ; Intestinal Mucosa

With the growing emphasis on maternal and child oral health, the significance of managing oral health across preconception, pregnancy, and infancy stages has become increasingly apparent. Oral health challenges extend beyond affecting maternal well-being, exerting profound influences on fetal and neonatal oral development as well as immune system maturation. This expert consensus paper, developed using a modified Delphi method, reviews current research and provides recommendations on maternal and child oral health management. It underscores the critical role of comprehensive oral assessments prior to conception, diligent oral health management throughout pregnancy, and meticulous oral hygiene practices during infancy. Effective strategies should be seamlessly integrated across the life course, encompassing preconception oral assessments, systematic dental care during pregnancy, and routine infant oral hygiene. Collaborative efforts among pediatric dentists, maternal and child health workers, and obstetricians are crucial to improving outcomes and fostering clinical research, contributing to evidence-based health management strategies.
Humans ; Pregnancy ; Female ; Infant ; Consensus ; Mouth Diseases/therapy* ; Pregnancy Complications/therapy* ; Oral Health ; Infant, Newborn ; Delphi Technique ; Oral Hygiene

Objective: To understand the prevalence and pattern of abnormal uterine bleeding (AUB) among female medical college students in Shanghai，to provide a basis for menstrual health intervention for female college students. Methods: A total of 912 female medical students from a university in Shanghai were selected through cluster sampling. An anonymous questionnaire survey on menstrual history and related factors was conducted in March 2021. Results: The prevalence of AUB among female medical college students was 39.9%, with cycle disordered and non cycle disordered AUB of 24.7% and 15.2%, respectively. Among female college students with AUB, 21.7% had two or three abnormal menstrual symptoms. Multivariate Logistic analysis showed that sleep quality was associated with both types of AUB, and female undergraduates with poorer and poor sleep quality were at increased risk of both cyclic disordered AUB ( OR =2.05) and non cyclic disordered AUB ( OR =2.00). Low BMI ( OR =1.66) and weight gain and loss ( OR =1.76) were associated with cycle disordered AUB. Frequent insomnia ( OR =2.45) was associated with non cyclic disordered AUB( P <0.05). Conclusion Abnormal uterine bleeding (AUB) is common in female college students, female medical college students with AUB have multiple concurrent abnormal bleeding patterns. Factors associated with AUB varied according to the type of AUB, with sleep quality correlates with both types of AUB.

ObjectiveTo develop a self-assessment questionnaire for menstrual abnormalities and test its reliability and validity. To provide an assessment tool for self-identification of abnormal menstruation in young women and to investigate the health seeking situation of abnormal menstruation in the population. MethodsFifteen physicians with clinical experience were invited to participate in the Delphi expert consultations. Medical indications for menstrual abnormalities were constructed and questionnaires were formed based on domestic and international literature， expert meetings and 2 rounds of Delphi expert consultations. A whole-group sampling was used to select 923 female college students from a medical school in Shanghai for the survey， and 306 of them were retested. The internal consistency， retest correlation， researcher-investigator evaluation correlation， and structural and response validity of the questionnaire were examined. ResultsThe questionnaire formed 6 dimensions with 17 indications. The positive coefficients for the two rounds of consulting experts were >90%. The mean authority coefficient was 0.857. The Kendall W coordination coefficient was 0.465 and 0.455， respectively （P<0.001）. The questionnaire Cronbach's alpha coefficient was 0.622. The retest correlation coefficient was 0.459. The correlation coefficient between the researcher's score and the respondents' self-assessment was 0.562. The five common factors extracted by factor analysis were consistent with the structure of the questionnaire， and the cumulative contribution of variance was 54.4%. Total questionnaire scores were moderately to highly correlated with each dimension score （0.409 to 0.699）. There was low correlation between the dimensions （-0.002 to 0.203）. Girls who had sought medical care had higher scores on the total questionnaire， category A， category B， cycle dimension， menstrual dimension， and dysmenorrhea/PMS dimension than girls who had not sought medical care （P<0.01）， and the difference between the two groups in menstrual volume dimension scores was not statistically significant. ConclusionThe self-assessment questionnaire for menstrual abnormalities developed in this study has acceptable reliability， good structure validity and response validity. It can provide a self-examination tool and medical consultation guidance for young women with abnormal menstruation.

Objective:To investigate the long-term death of patients with ischemic stroke and its influencing factors.Methods:Based on the data of patients with ischemic stroke in the multi-center oral fibrinogen-lowering drug secondary prevention database, the follow-up patient information and the cause of death were registered through the epidemiological investigation method, and then compared with the baseline data of patients in the original database.Results:A total of 278 patients completed the follow-up, and 166 were in lumbrokinase group and 112 were in control group. There were 124 deaths (44.6%) within 10 years, of which 92 (74.2%) were vascular deaths. In the lumbrokinase group, 74 patients (44.6%) died of all causes and 55 (33.1%) died of vascular diseases; in the control group, 50 (44.6%) died of all causes and 37 (33.0%) died of vascular diseases. Cox proportional risk model analysis showed that lumbrokinase treatment had no significant effect on the 10-year survival rate of patients with ischemic stroke. The analysis of death influencing factors showed that the baseline international normalized ratio (INR) was significantly associated with the 10-year non-vascular death risk of patients (hazard ratio [ HR] 1.98, 95% confidence interval [ CI] 1.21-3.25; P=0.006). The greater the decrease of tissue plasminogen activator (tPA) within half a year, the lower the 10-year all-cause mortality risk ( HR 0.94, 95% CI 0.90-0.99; P=0.011); the greater the decrease in INR within one year , the lower the 10-year vascular death risk ( HR 0.41, 95% CI 0.17-0.96; P=0.040); the greater the decrease of D-dimer within one year , the higher the risk of the 10-year vascular death ( HR 1.37, 95% CI 1.02-1.83; P=0.034). The greater the decrease of INR in patients with ischemic stroke within one year, the higher the 10-year non-vascular death risk ( HR 2.15, 95% CI 1.29-3.59; P=0.004). Conclusions:The 10-year mortality rate of patients with ischemic stroke is higher, and about 3/4 are vascular deaths. The fibrinogen-lowering treatment in the acute stage has no significant effect on the 10-year all-cause mortality of patients with ischemic stroke. The greater the decrease of tPA in half a year, the lower the all-cause mortality; the greater the decrease of D-dimer level at baseline and within 1 year, the higher the 10-year vascular death; the greater the decrease of INR at baseline and within 1 year, the higher the 10-year non-vascular death risk.

Objectives To investigate whether a longer time period of gadolinium ethoxybenzyl diethylenetriaminepen-taacetic acid (Gd-EOB-DTPA)-enhanced T1 mapping scanning, as well as dynamic contrast-enhanced (DCE) and multiple hepatobiliary phase magnetic resonance imaging (MRI) have the potential to provide information about liver function in rats with liver fibrosis. Methods Forty rats were divided into the carbon tetrachloride-induced hepatic injury groups [carbon tetrachloride for four (

Objective:To investigate the clinicopathological characteristics and 18F-fluorodeoxyglucose (FDG) PET/CT imaging features of bronchopulmonary neuroendocrine tumors(BP-NETs) with different pathological subtypes. Methods:From January 2013 to May 2018, 280 patients (196 males, 84 females, median age 58 years) with BP-NETs proved by pathology in Henan Provincial People′s Hospital were retrospectively analyzed. Age, gender, smoking history, the location and size of tumor, Ki-67 positive index, thyroid transcription factor-1 (TTF-1), synaptophysin (Syn), chromogranin-A (CgA), CD56, maximum standardized uptake value (SUV max), lymph node metastasis and distant metastasis were compared among 4 pathological subtypes of BP-NETs, including typical carcinoid (TC), atypical carcinoid (AC), small cell lung carcinoma (SCLC) and large cell neuroendocrine carcinoma (LCNEC). One-way analysis of variance, χ2 test, Fisher exact test and Kruskal-Wallis rank sum test were used for data analysis. Results:There were significant differences in age, smoking history, tumor size and location, Ki-67 positive index, CgA, CD56, TTF-1, SUV max and TNM stage among TC( n=59), AC( n=21), SCLC( n=184) and LCNEC ( n=16) groups ( F values: 2.067, 3.358, H values: 17.749-22.351, all P<0.05). SCLC had the largest tumor size (5.5(3.0, 6.8) cm) and the highest proportion of central type (85.3%, 157/184), and were more prone to lymph node metastasis. LCNEC had the oldest age ((66±16) years), the largest proportion of smoking history (14/16) and peripheral type (12/16). CD56 in SCLC (95.7%, 176/184) and LCNEC(15/16) mostly showed positive expression, while the positive expression rates of CgA and TTF-1 were higher in TC and AC (96.6%(57/59), 93.2%(55/59) and 95.2%(20/21), 90.5%(19/21), respectively). The Ki-67 positive index and SUV max of the four subtypes were significantly different, with the highest in SCLC group and the lowest in TC group. Conclusion:Different pathological subtypes of BP-NETs manifest different clinicopathological features and imaging presentation on 18F-FDG PET/CT, which are useful for understanding their characteristics.

Objective:To prepare 68Ga-2-(4, 7-bis(carboxymethyl)-1, 4, 7-triazonan-1-yl)pentanedioic acid (NODAGA)-YHWYGYTPQNVI (GE11) and evaluate its feasibility of PET imaging for pancreatic cancer. Methods:GE11 peptide was conjugated with NODAGA and then labeled with 68Ga. The labeling yield, radiochemical purity, hydrophilicity, stability and specificity in vitro were determined. Human pancreatic cancer BxPC3 nude mice models ( n=9) were established. MicroPET imaging was then obtained after 30 and 90 min, and mice were sacrificed at 90 min to acquire the radioactivity distribution of main organs and tumors. Pair t test was used to analyze the data. Results:The labeling yield was (73.5±5.4)% and radiochemical purity was more than 98%. After incubation 120 min in mouse serum at 37 ℃, radiochemical purity was more than 92%. The uptake was specific in BxPC3 cell lines. MicroPET images showed that 68Ga-NODAGA-GE11 could accumulate quickly in tumor. Value of tumor uptake was significantly higher than that of normal pancreas at 90 min ((1.38±0.25) vs (0.49±0.07) %ID/g; t=12.67, P<0.05), and the radio-uptake of blood, muscle and bone was lower than that of tumor. Conclusions:68Ga-NODAGA-GE11 is easy to be prepared with high radiochemical purity and good stability, and can specifically target BxPC3 xenograft tumor. However, due to the high uptake in the kidneys and liver, the value of 68Ga-NODAGA-GE11 in PET imaging for pancreatic tumor needs further study.

Objective:To study the correlation between changes of cerebral striatal dopamine D 2 receptors non-displaceable binding potential (BP ND), functional connectivity (FC) and clinical symptoms in patients with first-episode major depressive disorder (MDD), by 11C-Raclopride PET/CT and resting state fMRI (rs-fMRI). Methods:Thirty-eight first-episode depression patients (MDD group) and forty healthy volunteers (control group) matched with age, gender and years of education were selected. All subjects were scored with Hamilton depression scale (24 versions) before enrollment.All the subjects underwent cerebral 11C-Raclopride PET/CT and rs-fMRI in resting state. MIAKAT and DPARSF were used to analyze BP ND of cerebral striatal dopamine D 2 receptors and FC of striatum and the whole brain in subjects, respectively. Changes of striatal dopamine D 2 receptors BP ND and striatum and the whole brain FC of MDD were analyzed, and correlations among BP ND, FC and Hamilton depression rating scale were calculated by Rest 1.8 and SPSS 20.0. Results:Compared with the control group, BP ND of bilateral caudate nucleus and putamen dopamine D 2 receptors in the MDD group were decreased(left caudate nucleus: 1.16±0.37 vs 1.48±0.39, right caudate nucleus: 1.21±0.31 vs 1.62±0.48, left putamen: 1.73±0.47 vs 2.21±0.66, right putamen: 1.79±0.46 vs 2.17±0.65, t=3.66, -4.42, -3.68, -2.91, all P<0.001). Besides, FC of left caudate nucleus and left medial prefrontal lobes(4.38±1.31, 2.35±0.48), left caudate nucleus and left middle frontal gyrus(3.36±1.11, 1.64±0.56), left caudate nucleus and left superior frontal gyrus(3.14±0.78, 1.64±0.53), left putamen and left medial prefrontal lobes(4.10±1.42, 2.42±0.64, t=6.82, P<0.05), right caudate nucleus and right medial prefrontal lobes (4.32±1.30, 2.33±0.63, t=8.51, P<0.05), right putamen and right medial prefrontal lobes(3.77±1.25, 2.31±0.63, t=6.49, P<0.05)in the MDD group were increased.FC of left putamen and left anterior cingulate(1.60±0.55, 2.68±0.84, t=-6.76, P<0.05), right caudate nucleus and right amygdala (1.67±0.57, 3.46±0.64, t=-8.27, P<0.05) in the MDD group were decreased. Furthermore, there were significant negative correlations between D 2 receptors BP ND of bilateral striatum and FC of the same lateral striatum and medial prefrontal lobes ( r=-0.66, -0.50, -0.67, -0.47, all P<0.05). In MDD group, FC in left caudate nucleus and left medial prefrontal lobe were positively correlated with total score of Hamilton depression scale and anxiety somatization( r=0.55, 0.68, P<0.001). FC in left putamen and left medial prefrontal cortex were positively correlated with cognitive impairment and retardation ( r=0.37, 0.40, P=0.021, 0.001). FC of right caudate nucleus and right medial prefrontal lobe were positively correlated with Hamilton depression scale total score and anxiety somatization ( r=0.52, 0.67, all P<0.001). FC in right putamen and right medial prefrontal cortex was positively correlated with cognitive impairment ( r=0.50, P=0.002). Conclusion:The abnormal BP ND of cerebral striatal dopamine D 2 receptor of patients with first-episode depression is related to the abnormal activity of dopamine reward circuit related neurons in patients with MDD, which was related to clinical symptoms of depression. It may be involved in the pathogenesis of depression.

Objective To explore the changes of dopamine D2 receptor in dopamine pathway in in-somnia patients and discuss its clinical significance. Methods From January 2016 to December 2016, 15 patients with insomnia (1 male, 14 females, age:(44.3±8.6) years) and 15 gender-/age-matched-healthy volunteers (control group;3 males, 12 females, age:(40.5±9.0) years) were included to undergo resting brain 11C-Raclopride PET/CT imaging. The D2 receptor binding potential (BPND) of the dopamine pathway was calculated by molecular imaging and kinetic analysis toolbox ( MIAKAT) software. The BP ND , Hamilton depression scale ( HAMD) , transient and graphics memory scale results were compared with two-sample t test and Mann-Whitney u test between the two groups. Pearson correlation analysis was used to evaluate the correlation between BPND(nucleus accumbens, caudate nucleus, putamen) and Pittsburgh sleep quality in-dex ( PSQI) , HAMD, course of disease, transient memory and graphical memory scale scores in the patient group. Results The BP ND in bilateral putamen, nucleus accumbens and left caudate nucleus of patients was lower than that of controls( left putamen:z=-2.717, right putamen:z=-2.883, both P<0.01;left nu-cleus accumbens:t=-2.269, right nucleus accumbens:t=-2.410, both P<0.05;left caudate nucleus:t=-2.632,P<0. 05), but the BPND level of right caudate nucleus was not significantly different(z=-0.850, P>0.05) . The scores of HAMD in the patient group were higher than those in control group ( t=10. 273, P<0. 01), while the scores of instantaneous memory (t=-4.888, P<0.01) and graphical memory scale (t=-2.624, P<0.05) were lower. There were significant negative correlations between the BP ND of bilateral nucleus ac-cumbens, caudate nucleus and putamen and the course of insomnia in the patient group ( r range:-0.761 to-0.682, all P<0.01) . Conclusion Patients with insomnia have abnormal neurotransmitter system of dopa-mine D2 and it may play a role in the pathogenesis of insomnia.