Objective To evaluate the intravascular volume at different levels of edema and disease course by the fractional excretion of filtered sodium(FeNa)of children with primary nephrotic syndrome(PNS).Methods A total of 172 children with newly diagnosed PNS who were hospitalized in the Affiliated Hospital of Xuzhou Medical University from September 2022 to September 2024 were selected and divided into non-e-dema group(n=51),mild edema group(n=43),moderate edema group(n=46)and severe edema group(n=32)according to the degree of edema at the time of admission.A total of 40 healthy children who underwent physical examination during the same period were selected as the healthy control group.Serum creatinine,ser-um sodium were detected before and after treatment.Urine samples were collected to detect urine creatinine,urine sodium,FeNa was calculated and compared according to the results,and the degree of edema was recor-ded.24 h urine samples were collected on the same day to detect 24 h urine protein quantification and 24 h u-rine volume.Results On day 1 to 2 of the course of the disease,about 12%of the PNS children had FeNa<0.2%,indicating insufficient intravascular volume,which was mainly concentrated in the severe edema group.The moderate,severe edema group had a significantly lower FeNa level than the non-edema group,mild edema group,and healthy control group(P<0.01).The moderate edema group had a significant increase in FeNa on days 6 to 7 of the course of the disease,and the severe edema group had a significant increase in Fena on days 11 to 12 of the course of the disease(P<0.01).Conclusion Intravascular volume of PNS children with mod-erate to severe edema is often reduced,and intravascular volume may be insufficient in severe edema.PNS chil-dren with moderate to severe edema have increased intravascular volume with the extension of the course of disease and the improvement of the condition.

ObjectiveTo analyze the monitoring data of schistosomiasis from 2004 to 2021 in Suzhou New District， Jiangsu Province， and to provide evidence for improving schistosomiasis elimination strategies. MethodsFollowing the Opinions on Prevention and Control of Schistosomiasis， Parasitic Diseases and Endemic Diseases in Suzhou and the Technical Plan for Prevention and Control of Schistosomiasis， Parasitic Diseases and Endemic Diseases in Suzhou， the monitoring of schistosomiasis in the population and snail habitats from 2004 to 2021 was conducted. The Mann-Kendall method and Joinpoint regression method were employed to analyze the trend of epidemic indicators （such as seropositive rate， prevalence of snail frames， etc.）. Time series analysis （exponential smoothing model） was conducted to predict snail occurrence. ResultsFrom 2004 to 2021， a total of 73 680 people were serologically tested for schistosomiasis， with a positive rate of 0.084%. The seropositivity rate showed statistically significant differences between different years （χ²=70.73， P<0.05）， but there was no significant trend over time. In addition， 3 053 fecal tests were conducted and no positive result was found. The snail habitats covered an area of 70.11 hm² and showed a decreasing trend （Z=-1.97， P<0.05）. A total of 30 093 frames were surveyed， of which 19.038% contained snails. The difference in the prevalence of snail frames between different years was statistically significant （χ²=7 203.09， P<0.05）， with a decreasing trend in the prevalence of snail frames （Z=-2.05， P<0.05）. A total of 26 296 live snails were seized and density of live snails was 0.874 snails per frame， showing a decreasing trend in the density of live snails （Z=-2.35， P<0.05）. A total of 12 391 snails were dissected and no infected snail was found. The areas treated with molluscicides remained stable at 264.60 hm². An area of 27.77 hm² achieved the goal of snail eradication through environmental modification， with a decreasing trend （Z=-2.44， P<0.05）. It is estimated that the prevalence of snail frames and snail density will remain relatively stable from 2022 to 2026， but the snail habitat area will fluctuate significantly， showing an increasing trend. ConclusionNo indigenous cases of schistosomiasis and no infected snails are reported， indicating the successful consolidation of schistosomiasis prevention and control measures. However， the snail habitat area fluctuates greatly with an increasing trend， suggesting the need for long-term Oncomelania snail monitoring in local areas.

Objective:To summarize the clinical characteristics and therapeutic efficacy of central nervous system (CNS) aspergillosis.Methods:The clinical manifestations, laboratory examination, neuroimaging features, treatment and prognosis of 37 cases of CNS aspergillosis diagnosed and treated in the First Medical Center of People′s Liberation Army General Hospital from January 2000 to January 2021 were retrospectively analyzed. According to the correlation between intracranial lesions and paranasal sinus lesions, they were divided into two groups: rhino-cerebral aspergillosis (RA, n=21) group and cerebral aspergillosis (CA, n=16) group. Results:Only 16.2% (6/37) of CNS aspergillosis patients had a clear background of immunosuppression, but 35.1% (13/37) were complicated with diabetes. The most common clinical manifestations were headache (73.0%, 27/37), cranial nerve involvement (59.5%, 22/37) and fever (37.8%, 14/37). Cerebrospinal fluid characteristics included increased pressure (53.8%, 14/26), increased white blood cell count (46.7%, 14/30), decreased glucose (30.0%, 9/30), increased protein (70.0%, 21/30), and high positive results of the metagenomic next-generation sequencing (mNGS) of pathogenic microorganism (7/10). Cranial magnetic resonance imaging showed that commonly involved sites were sinus, orbital apex, posterior orbit, cavernous sinus (43.2%, 16/37) and cerebral lobes (27.0%, 10/37). Treatment options included antifungal drugs alone (64.9%, 24/37), combination of drugs and surgery (27.0%, 10/37) and surgery alone (8.1%, 3/37). Compared with the CA group, RA group had fewer males [47.6% (10/21) vs 14/16, χ2=6.34, P=0.012] and older age [(54.2±19.4) years vs (38.4±18.4) years, t=2.50, P=0.017], and was more prone to headache [85.7% (18/21) vs 9/16, χ2=4.00, P=0.046) and cranial nerve involvement [81.0% (17/21) vs 5/16, χ 2=9.31, P=0.006]. The misdiagnosis rate of these patients in the early stage was 73.0% (27/37). A total of 29 patients (85.3%, 29/34) were treated with voriconazole successively, and the course of treatment was 3.0 (0.5, 10.4) months. Compared with salvage therapy, the mortality of primary therapy was lower (4/17 vs 9/12, χ2=7.54, P=0.006). All patients were followed up to December 2021, and 17 patients died, with a mortality rate of 45.9% (17/37). Conclusions:CNS aspergillosis may have no definite immunosuppressive background. Some of CNS aspergillosis patients are complicated with diabetes, and the clinical manifestations of the disease lack specificity, with high misdiagnosis rate in the early stage, no inflammatory changes in cerebrospinal fluid, and high positive rate of mNGS for pathogenic microorganism. Early and long-term application of voriconazole can significantly reduce the mortality rate.

Objective:To investigate whether the synonymous variation of the ATP-binding cassette transporter A3 (ABCA3) gene may increase the risk of respiratory distress syndrome (RDS) in Mongolian and Han newborns in Inner Mongolia.Methods:From January 2018 to June 2019, the children of Mongolian and Han nationality who were hospitalized in the Department of Neonatal Pediatrics, affiliated Hospital of Inner Mongolia Medical University and the control group were sequenced by ABCA3 exon gene to analyze whether there was synonymous mutation in ABCA3 gene.Results:A total of 101 children with RDS were enrolled, including 37 children with Mongolian and 64 with Han children. There were 113 patients in the control group, including 45 Mongolian children and 68 Han children. Children with Mongolian and Han nationality RDS and control group can detect multiple synonymous mutation sites, such as: F353F, P585P, A227A, V150V, L982L, A928A, S1372S, P1653P, E1618E, and A1027A, etc, among them, four synonymous variants of p.A227A, p.F353F, p.P585P and p.S1372S are common synonymous mutants. In both Mongolian and Han nationality, the frequency of ABCA3 gene synonymous mutation in RDS group was significantly higher than that in control group (Mongolian: χ2=9.402, P=0.002; Han: χ2=9.348, P=0.002 ). The mutation rates of F353F and P585P in Mongolian and Han children with RDS were higher than those in the control group, and the difference was statistically significant(Mongolian F353F: χ2=5.270, P=0.022; Han F353F: χ2=5.532, P=0.019.Mongolian P585P: χ2=4.711, P=0.030; Han P585P: χ2=4.480, P=0.034). Conclusions:The synonymous variation of ABCA3 gene may increase the risk of RDS in Mongolian and Han newborns in Inner Mongolia, and F353F and P585P may be one of the susceptible genes of RDS in Mongolian and Han newborns in Inner Mongolia.

Objective:To understand the incidence of HIV infections and associated factors among men who have sex with men (MSM) in Jiangsu province.Methods:Based on national AIDS sentinel surveillance in 2019, MSM from 13 cities in Jiangsu were recruited for questionnaire interview and laboratory testing during April to July, 2019. Seropositive samples were tested with Limiting-antigen avidity enzyme immunoassay to detect recent HIV infections. The incidence of HIV infection in MSM were calculated according to the formula and parameters from China CDC. Multivariable logistic regression analysis was used to identify factors associated with recent infection of HIV.Results:A total of 4 469 MSM were subjects and the incidence of HIV infection were 4.5% (95% CI: 3.4%-5.5%).Multivariate logistic regression analysis results showed that compared with these aged ≥40 years, recruitment ways from MSM venues, awareness of AIDS knowledge, non-unprotected anal sex in the past 6 months and non-syphilis infection, those who aged 18-24 years (a OR=2.083,95% CI:1.087-3.990), recruitment ways from VCT clinics (a OR=2.125,95% CI:1.175-3.843), unawareness of AIDS knowledge (a OR=2.456,95% CI:1.109-5.437), unprotected anal sex in the past 6 months (a OR=3.553,95% CI:2.143-5.889) and syphilis infection (a OR=2.414,95% CI:1.033-5.462) were higher risk of HIV infection. Conclusion:The new infection rates of HIV were high in MSM in Jiangsu province. Health education, condom use and HIV/syphilis screening promotions should therefore be top priority in the prevention and control of HIV infection in MSM.

Objective:To explore the effect of PSD-95 inhibitor ZL006 in neonatal rats with hypoxic-ischemic brain damage(HIBD) and its potential mechanism.Methods:The seven-day-old healthy Wistar rats( n=80) were randomly divided into control group( n=20), sham operation group( n=20) and operation group (HIBD model group, n=40). The operation group was randomly divided into ZL006, treatment group (intraperitoneal injection of ZL006, 10 mg/kg, n=20) and non-treatment group ( n=20). The neonatal rats of each group were randomly selected on the 1st and 7th day after operation, and the degree of cerebral infarction was observed by triphenyl tetrazolium chloride staining.The protein expression level of brain tissue in the injured area was examed by Western blot, and the effects of ZL006 on oxidative stress and antioxidant enzymes in rats with HIBD were evaluated by ELISA. Results:(1) On the first day after operation, the brain injury was the most serious in the non-treatment group, and the cerebral infarction decreased in the ZL006 treatment group.On the 7th day after operation, a little infarction could be seen in the operation group, but there was no significant difference among other three groups.(2)On the first day after operation, the expression of PSD-95 protein in the operation group was significantly higher than that in the control group and sham operation group( P<0.01). There was significant difference in the expression of PSD-95 protein between the ZL006 treatment group and the non-treatment group ( P<0.05). On the 7th day after operation, there was no significant difference in the expression of PSD-95 protein among three groups.(3)On the first day after operation, the expression of 4-hydroxynonenal in the operation group was significantly higher than that in the control group and sham operation group( P<0.01), and that in the non-treatment group was higher than that in the ZL006 treatment group ( P<0.05). On the 7th day after operation, there was no significant difference in the expression of 4-hydroxynonenal among three groups.(4) On the first day after operation, the expression of superoxide dismutase in the operation group was significantly lower than that in the control group and sham operation group( P<0.01), and that in the non-treatment group was lower than that in the ZL006 treatment group ( P<0.05). There was no significant difference in the expression level of superoxide dismutase among three groups on the 7th day after operation. Conclusion:It is suggested that PSD-95 may be involved in the early pathogenesis of HIBD, and ZL006 may have neuroprotective effect on HIBD in newborn rats.

Objective To study the relationship between pulmonary surfactant protein B (SP-B) intron 4 gene polymorphism and bronchopulmonary dysplasia (BPD) in premature infants.Method From January 2016 to January 2019,premature infants diagnosed with BPD in our hospital were selected as the BPD group,and non-BPD premature infants of the same ethnic group were selected as the control group.The genotype and allele distribution of SP-B intron 4 were analyzed using polymerase chain reaction (PCR)method.Result A total of 74 infants with BPD were included,including 30 Mongolian infants and 44 Han infants.A total of 134 cases were in the control group,including 56 Mongolian infants and 78 Han infants.Wild type and variant type (including insertion and deletion) could be detected in SP-B intron 4 gene in both Mongolian and Han infants.The frequencies of wild and variant genotypes and alleles in Mongolian BPD infants were similar with the control group [36.7％ (11/30) vs.19.6％ (11/56),21.7％ (13/60) vs.12.5％ (14/112)] (P ＞ 0.05).The frequencies of wild and variant genotypes and alleles in Han infants with BPD were significantly different from the control group [31.8 ％ (14/44) vs.12.8 ％ (10/78),20.5 ％(18/88)vs.7.1％(11/156)] (P＜0.05).Conclusion The variation of intron 4 gene in SP-B may be related with the genetic susceptibility of Han infants with BPD in Inner Mongolia.

Firstly, three 3-arylcoumarins 4a- 4c were synthesized from p-aminophenylacetic acid and salicylaldehyde by Perkin condensation reaction and hydrochloric acid acidification; subsequent-amidation reaction of 4a- 4c with substituted benzoyl chlorides 6a- 6h furnished; ten 3-(4′-benzoyl amino-phenyl)coumarins 7a- 7j. The structures of all target compounds were fully characterised by NMR and ESI-MS. Those target compounds were screened for-glucosidase inhibitory and advanced glycation end products(AGEs)formation inhibitory activity. The results showed that compound 7f had good inhibitory activity against α-glucosidase(IC50=10. 84±0. 36 μmol/L); compound 7g possessed much more potent inhibitory activity against AGEs formation(IC50=5. 01±0. 55 μmol/L)than the positive control aminoguanidine hydrochloride(IC50=290. 31±7. 32 μmol/L). These results provided a theoretical basis for further research on antidiabetic drugs.

Objective To compare the perioperative characteristics and long term outcomes between extracorporeal membrane oxygenation (ECMO)-conventional cardiopulmonary switch (experimental group,26 cases) and off-pump high-risk coronary artery bypass grafting (OPCABG group,24cases).Methods Perioperative characteristics and survival rate were retrospectively analyzed between experimental group and OPCABG group.Long term survival rates without major cardiovascular adverse events (MACE) were comparatively analyzed via Kaplan-Meier curves.Results The average Euroscore value were 11.7 ± 2.4 and 10.9 ± 2.0,respectively(P =0.208).The experimental group had a higher complete revascularization rate (96.2％ vs.66.7％,P =0.009),a shorter length of postoperative ECMO support [(33.1±23.6)h vs.(80.8±18.5)h],an intensive care unit stay[(4.8±1.1)d vs.(10.2±9.0)d]and a hospital stay [(17.7±6.3)d vs.(28.2±17.5)d] (all P＜0.05) as compared with OPCABG group.Preoperative New York Heart Association (NYHA) grading of cardiac function (r =0.511,P =0.008) and intraoperative ultrafiltration volume (r =-0.442,P =0.024) were significantly correlated with postoperative ECMO continuation in the experimental group.The follow-up period was (45.4 ± 15.2) months.The experimental group had a higher survival rate without MACE than had the OPCABG group (Log-rank test:x2=4.828,P=0.028).Conclusions The ECMO-conventional cardiopulmonary switch mode might facilitate a higher complete revascularization,a lower incidence of postoperative morbidities and improve the longterm survival rate without MACE for patients with high risks.

BACKGROUND:The self-expanding Smart nitinol stent system is a popular treatment for carotid artery stenosis, because it is easy to manipulate and deploy, and endothelialization is rapid. OBJECTIVE:To assess the efficacy of Smart nitinol stent system for the treatment of severe atherosclerotic carotid stenosis. METHODS:We conducted a retrospective, single-center, non-randomized, paral el control ed trial. A cohort of 103 patients with severe atherosclerotic carotid stenosis was included in the analysis after obtaining written informed consent from participants or their guardians. Treatment was undertaken according to each patient’s wishes after weighing the options:a Smart nitinol stent system (Cordis Corporation, Miami, FL, USA) was used in 40 patients, while 63 were managed conservatively with antiplatelet drugs. The primary outcome is the degree of disability of dependence 2 years after treatment, assessed by the modified Rankin Scale. The secondary outcomes are mRS scores 90 days and 1 year after treatment, recurrence of cerebrovascular events, and severity of neurologic deficit measured using the National Institutes of Health Stroke Scale 1 and 2 years after treatment. The study protocol was approved by the Ethics Committee of Beijing Jishuitan Hospital, China (approval number:201605-01) and conducted in accordance with the guidelines of the Declaration of Helsinki, formulated by the World Medical Association. This trial was registered at ClinicalTrial.gov (NCT02800174). DISCUSSION:Previous studies of the Smart nitinol stent system for the treatment of carotid stenosis are mostly self-control ed case series or smal cohort studies with short fol ow-up periods. Consequently, the long-term influence of Smart nitinol stent deployment on the risk of cerebrovascular events and long-term outcomes are not known. This trial il uminates the therapeutic benefits of the Smart nitinol stent system in a 2-year fol ow-up study involving a large cohort of patients with severe atherosclerotic carotid stenosis.