Background High-sensitivity C-reactive protein (hs-CRP) is a sensitive biomarker for cardiovascular disease (CVD) and can independently predict the risk of cardiovascular events. Although the association between per- and polyfluoroalkyl substances (PFAS) exposure and CVD risk has been widely reported, studies on the association between hs-CRP and PFAS remain limited. Objective To investigate the association between PFAS and hs-CRP levels, to provide a scientific basis for early identification and prevention of environment-related cardiovascular events. Methods This study utilized data from the National Health and Nutrition Examination Survey (NHANES) database (2015–2018). Based on predefined inclusion and exclusion criteria, a total of 3219 participants were included for subsequent analysis. Five PFAS with detection rates exceeding 90% were selected as exposure factors and log-transformed (lnPFAS) for subsequent analysis, including perfluorohexane sulfonic acid (PFHxS), perfluorononanoic acid (PFNA), perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), and perfluorodecanoic acid (PFDA). After selecting potential confounders through a change-in-estimate approach, logistic regression was employed to examine the effects of individual PFAS on serum hs-CRP level. Additionally, quantile g-computation and Bayesian kernel machine regression (BKMR) were applied to assess the combined effects of PFAS mixtures on hs-CRP. Results The study included 3219 participants with a mean age of (50.4±17.6) years, of whom 1554 (48.28%) were male. The median concentrations of the five PFAS compounds were: 1.20 ng·mL⁻¹ (PFHxS), 0.50 ng·mL⁻¹ (PFNA), 1.50 ng·mL⁻¹ (PFOA), 5.20 ng·mL⁻¹ (PFOS), and 0.20 ng·mL⁻¹ (PFDA). The Wilcoxon rank-sum tests revealed statistically significant differences between the elevated serum hs-CRP (≥2 mg·L⁻¹) and normal (<2 mg·L⁻¹) groups for all five PFAS compounds (PFHxS: P=0.005; PFNA: P=0.009; PFOA: P<0.001; PFOS: P<0.001; PFDA: P<0.001). After adjusting for potential confounders, the analysis of individual PFAS exposure demonstrated significant negative associations between serum hs-CRP levels and both ln-PFOS (OR: 0.87; 95%CI: 0.79, 0.96; P=0.0036) and lnPFDA (OR: 0.78; 95%CI: 0.71, 0.86; P < 0.001). The joint effect analysis using quantile g-computation revealed an overall inverse association between PFAS mixtures and hs-CRP, with lnPFDA emerging as a primary contributor; an similar association was observed in males, but not significant in females. Further evaluation through BKMR showed that when PFAS mixture concentrations reached or exceeded P₇₀, their combined effect on hs-CRP became significantly lower than when all PFAS concentrations were at P₅₀, establishing a clear negative dose-response relationship. Conclusion The mixed exposure to PFAS showed a significant negative joint effect on serum hs-CRP levels, with PFDA being the key component contributing to this combined effect. Future prospective cohort studies are warranted to further validate these findings and elucidate the underlying mechanisms involved.

Objective:Discipline construction is the key and effective method for the high-quality development of hospitals. This study summarized the practical and valuable experience of discipline construction with the support of the ″Sanming Project of Medicine″ in Shenzhen, to provide a worthy reference for similar projects and hospital specialty development.Methods:Taking the introduction of the hematology-oncology team of the Canadian Children′s Hospital as an example, we analyzed the background, the process, and the effectiveness of discipline construction of hematology and oncology of Shenzhen Children′s Hospital under the support of the ″Sanming Project of Medicine″, and explored the common rules for rapid specialty development.Results:Through the implementation of two levels supporting policies from cities and hospitals and quantifiable and verifiable annual progressive program, the adoption of the international advanced medical management mode and concepts, and the transformation and application of cutting-edge clinical technologies, we successfully built the largest pediatric hematologic oncology diagnosis and treatment center in South China and the largest pediatric hematopoietic stem cell transplant center in China. By executing a multi-level talent developing program, the number of specialists with MD and PhD degrees increased by 6.5 times, and 23 doctors and nurses were trained abroad, leading to the development of provincial key clinical specialties and municipal key scientific research platforms.Conclusions:This project concluded the beneficial experience of introducing high-level overseas medical teams to boost discipline construction, including internationally advanced medical concepts and management modes, tiered talent cultivation schemes, the construction of clinical and basic research platforms, etc., providing references for the rapid improvement of discipline construction in terms of health care for other hospitals in Shenzhen and similar cities.

Objective To investigate therapeutic effect of the low dose clomiphene treatment of idiopathic oligoasthenospermia and effect on sperm epididymal protein level 4.Methods183 cases of idiopathic oligoasthenospermia were divided into three groups, vitamin group of 61 patients were given vitamin E,clomiphene group(61 cases)treated with low dose clomiphene, combined group of 61 patients were given low dose clomiphene and vitamin E, lasted for 12 weeks.Semen volume, sperm density, sperm motility, sperm survival rate and sperm reactive oxygen species (ROS), malondialdehyde (MDA), superoxide dismutase (SOD), human epididymis protein 4 (HE4), follicle stimulating hormone, luteinizing hormone, testosterone concentration were observed before and after treatment.After treatment, the patients were followed up for 1 year, the observation of the natural pregnancy rate after treatment.ResultsSperm density, sperm survival rate and sperm and a A+B grade sperm in the clomiphene group were significantly higher comparedwith the vitamin group (P< 0.05), sperm density, sperm survival rate and sperm and a A+B grade sperm in the combined group were significantly increasedcompared with clomiphene group and vitamin group (P< 0.05),levels of HE4 after treatment was significantly lower compared with before treatment (P< 0.05), And the difference between the three groups were statistically significant (P< 0.05).Follicle stimulating hormone, luteinizing hormone, testosterone in clomiphene group and combined group after treatment, were significantly increased compared with before treatment (P< 0.05), and the combined group had no statistically difference compared with clomiphene group.The pregnancy rate in 1 year of vitamin group, clomiphene group and combined group were 24.59%, 42.62% and 62.29% (P< 0.05).ConclusionClomiphene treatment of idiopathic asthenospermia is better than vitamin E, the combination of the two has a synergistic effect.

OBJECTIVE:To investigate the effects of Yiqi huayu granules on gastrointestinal motility of gastrointestinal motili-ty disorder model mice and blood rheology of acute blood stasis model rats,and to provide experimental evidence for clinical use of it. METHODS:50 ICR mice were randomly divided into normal group,model group,mosapride group(positive control chemi-cal drug,0.003 g/kg),Muxiang shunqi pills group(positive control TCM,0.36 g/kg)and Yiqi huayu granules group(2.4 g/kg), with 10 mice in each group. Treatment groups were given relevant medicine solution intragastrically,once a day,for a week;nor-mal group and model group were given normal saline intragastrically. Those groups fasted for 24 h after last medication,and then were given above medicine intragastrically;1 h later,they were given atropine sulfate intragastrically to induce gastrointestinal mo-tility disorder model except for normal control group. The stomach residue rate and intestinal propulsive rate of mice were mea-sured. 60 SD rats were randomly divided into normal group,model group,Compound danshen tablet group(positive control,1.0 g/kg)and Yiqi huayu granules high-dose,medium-dose and low-dose groups(2.4,1.2,0.6 g/kg),with 10 rats in each group. Nor-mal group and model group were given normal saline intragastrically,and treatment groups were given relevant medicine,once a day,for a week. 1 h after last medication,those groups were given adrenaline intraperitoneally+aqua astricta. to induce acute blood stasis model except for normal group. The whole blood viscosity(high-shearing,middle-shearing,low-shearing),plasma viscosity, 1,3,5 min platelet aggregation rate ,hematocrit and maximal platelet aggregation rate were all detected in rats. RESULTS:Com-pared with normal group,stomach residue rate of mice in model group was increased significantly(P<0.01),while intestinal pro-pulsive rate was decreased significantly(P<0.01). The whole blood viscosity(high-shearing,middle-shearing,low-shearing),plas-ma viscosity,hematocrit,1,3,5 min platelet aggregation rate and maximal platelet aggregation rate of rats were all increased sig-nificantly in model group (P<0.01). Compared with model group,above indexes of mice/rats were all improved significantly in treatment groups(P<0.05 or P<0.01). CONCLUSIONS:Yiqi huayu granules can significantly promote the function of gastrointes-tinal peristalsis and anticoagulation.

Objective To discuss the difference of handwriting characteristics of schizophrenia,neurosis and healthy people according to the gender,the age and the level of educated.Methods The handwriting data were obtained under the standard condition of handwriting,then the 24 Chinese characters handwriting image information were transformed into digital data using the quantitative characteristics of Chinese characters handwriting recognition system (CCQAS4.0),finally the data of 99 patients with schizophrenia and 131 patients with neurosis were analyzed.Results Many significant differences had been found in schizophrenia,neurosis and norm group (P ＜0.05,P＜0.01),such as footer space((198.33±26.50) mm,(180.31±39.31)mm,(192.39±35.08) mm),average line spacing ((4.02 ± 1.68) mm,(5.34 ± 2.20) mm,(4.76 ± 2.00) mm) etc ; and there were also some important differences between the schizophrenia patient and the neurosis patient from different gender,age and education level in the 24 handwriting characteristics (P＜0.05,P＜0.01).Conclusions (1) Significant handwriting characteristic differences have surely been found among the schizophrenia/neurosis patient and normal people.(2) Gender,age and education level have impact on the characteristic in the schizophrenia patient and the neurosis patient.

OBJECTIVEWiskott-Aldrich syndrome (WAS) is a rare X-linked primary immunodeficiency characterized by microthrombocytopenia, eczema, recurrent infections, and an increased incidence of autoimmunity and malignancies. The patients always have a severe clinical phenotype that can result in death if not diagnosed and treated early in life. The treatment of choice with the best outcome is hematopoietic stem cell transplantation, preferably from a matched related donor. But uncertain treatment effect and high treatment cost limit its clinical application. It is the best strategy that avoiding birth of a fetus with defect through prenatal diagnosis at present. This study aimed to analyze the mutation of WASP gene in 4 Chinese families with WAS and to provide prenatal diagnosis for the high-risk fetus.

METHODThe probands of the four WAS families were all males, one of whom was deceased but had a family history and clinical datas integrated. All the patients were detected with blood routine tests, immunological tests and bone marrow examination. PCR and bilateral direct sequencing of PCR product was carried out in the regions of exon and exon-intron boundaries of WASP gene for 3 probands, 4 mothers and 100 unrelated healthy individuals as control. Prenatal diagnosis was provided for the two fetuses at the first trimester by mutation analysis.

RESULTFour WASP gene mutations were detected: c.91A > G (p.E31K), c.665C > T (p.R211X), c.397G > A (p.E133K), c.952-953delCC (p. P317fsX18), among which c.952-953delCC (p. P317fsX18) was first reported. Mothers in Family 2, 3 and 4 were carriers of WASP gene mutation, but family 1 was considered as a de-novo mutation. None of the 100 unaffected subjects had the above mutants. Prenatal diagnosis indicated that the fetus in family 2 was male and carried the same mutation as the proband, so the fetus was presumably to be a patient. The parents decided to receive an induced abortion. Following the termination of the pregnancy, the result of gene analysis of the aborted tissues was consistent with prenatal diagnosis. The fetus in family 3 was normal male confirmed by normal test results six months after birth.

CONCLUSIONThe 4 mutations of the WASP gene probably were causative to the families of WAS, among which c.952-953delCC was reported for the first time. Prenatal diagnosis by DNA sequencing is the effective method to avoid birth of WAS patient.

Asian Continental Ancestry Group ; genetics ; Base Sequence ; DNA Mutational Analysis ; Exons ; genetics ; Female ; Fetal Diseases ; diagnosis ; Heterozygote ; Humans ; Male ; Mutation ; genetics ; Polymerase Chain Reaction ; Pregnancy ; Prenatal Diagnosis ; Sequence Analysis, DNA ; Wiskott-Aldrich Syndrome ; diagnosis ; genetics ; Wiskott-Aldrich Syndrome Protein ; genetics ; X-Linked Combined Immunodeficiency Diseases

Retrospective analysis was performed for 68 sacroiliac joint pain patients treated at our hospital from June 2007 to March 2012.And 27 patients received sacroiliac joint ozone injection,and others anti-inflammatory and analgesic solution.Both methods can significantly relieve sacroiliac joint pain (P ＜ 0.05).However there was no inter-group difference (P ＞ 0.05).No difference existed in efficacy [(0.51 ±0.03) vs.(0.34 ±0.06) cm],treatment frequency (1.98 ±0.94) vs.(1.82 ±0.88) or hospitalization duration [(14.6 ± 7.0) vs.(14.9 ± 6.4) days] between two groups (P ＞ 0.05).Thus sacroiliac joint ozone injection can significantly relieve sacroiliac joint pain and its effect is similar to anti-inflammatory analgesic injection.

Objective: To investigate the effect of moxibustion on telomerase activity and genes expression in tissues of senescent rats. Methods: Subacute aging rats model were established by injection with D-gal solution. Points Shenshu (BL 23) were treated with moxibustion in treatment group, contrasting with a model group and a normal group. Enzyme-Linked Immunosorbent Assays(ELISA) was used for the level oftelomerase activity in liver tissues, and In Situ Hybridization(ISH) was used for the condition of expression of telomerase genes in liver tissues. Results: The level of telomerase activity in the aging model group was obviously lower than that in normal control group (P＜0.01), the level in moxibustion group was obviously higher than that in model group(P＜0.05). In comparison with normal rats, the positive-expressed areas and photodensity of telomerase genes in aging model group were all significantly lower (P＜0.01,P＜0.01), and the positive-expressed areas in moxibustion group was significantly higher than that in model group (P＜0.01). Conclusions: Moxibustion could regulate telomerase activity of senile rats, hence delaying aging.

BACKGROUND: Treatment of ulcerative colitis (UC) with herbs-partition moxibustion is of good intervenient effect, whether the effect is related to neutrophil apoptosis in the pathogenic process of UC?OBJECTIVE: To investigate the changes of neutrophil appptosis rate of rats with UC and the regulative effect of medicinal cake moxibustion. DESIGN: A randomized controlled trial based on SD rats.SETTING: Shanghai Research Institute of Acupuncture and Meridian.MATERIALS: The experiment was completed from August 2002 to June 2003. A total of 30 healthy male SD rats of clean grade, weighing (140±20) g,provided by Experimental Animal Center of Shanghai University of Traditional Chinese Medicine, were at random divided into 2 groups: model building group (n=20) and normal control group (n=10).METHODS: Rat UC models were set up with immunological method. After the models were successively set up, four model rats and two normal rats were randomly selected for pathological observation of distal colon tissue. The rest models were divided as model group and herbs-partition moxibustion group with 8 rats for each, and the rest 8 normal rats were taken as control group. The rats of herbs-partition moxibustion group were given herbs-partition moxibustion at tian shu (ST-25) of both sides and qi hai (CV-6) points; the herbs cones was made from Radix Aeoniti Praeparata,Cortex Cinnamoni, and so on. About 90 mg moxa cone was put on the herbs cones for moxibustion, once a day, for 10 times. After treatment, all rats of the three group were executed, then the peripheral monocytes were isolated for cell culture. A 1:50 diluted supernatants of each group were taken, and the same volume of RPMI-1640 culture fluid was used as blank control group. They were respectively incubated together with neutrophils of peripheral blood of normal rats. The neutrophil apoptosis rates were measured by using flow cytometry.MAIN OUTCOME MEASURES: Comparison of neutrophil apoptosis rates of rats in each group.RESULTS: Totally 20 rats in model group and 10 in normal control group were accepted. Then 4 rats in model group and 2 in normal group were sacrificed and observed with tissue pathology, and 16 and 8 rats entered the final analysis in model and normal control groups respectivelly. ① The neutrophil apoptosis rate of UC rats was significantly lower that that of rats in blank control group [(16.34±2.80) ％, (52.33±9.94) ％, q= -35.99, P＜ 0.01]; but there was no significant diffenence between normal control group [(48.79±11.33) ％] and blank control group, (P＞0.05). ② After treatment the neutrophil apoptosis rate of herbs-partition moxibustion group [(36.03±8.31) ％] was significantly higher than that of UC model group (q=19.69, P ＜ 0.01), but it was still lower than that of normal control group (q= -16.30, P ＜ 0.05).CONCLUSION: One of the main mechanism for herbs-partition moxibustion to treat UC might be regulating and/or reducing the inhibited state of neutrophil apoptosis in UC.

Objective:To investigate the syndromes distribution in patients with dysfunctional uterine bleeding(DUB) related to kidney deficiency, and to provide the basis for standardizing the DUB syndrome differentiation of kidney deficiency. Methods: DUB Patients with kidney deficiency were chosen and accepted epidemical survey through the questionnaire, then the frequency and constituent ratio of each syndrome were calculated. Results: In 612 cases of DUB patients with kidney deficiency, there were 102 patients with simple syndromes covered 16.67%, and 510 patients with compound syndromes covered 83.33%. In patients with simple syndromes, the common syndromes were kidney-yin deficiency(45,44.12%) and kidney-qi deficiency(45,41.18%). And the syndromes of kidney-qi deficiency and kidney-yin deficiency were often respctively complicated with liver stagnation(68,11.09%; 113,18.43%), blood defi ciency(57,9.30%; 99,16.15%) and blood stasis(57,9.30%; 99,16.15%), the syndrome of kidney-yang deficiency usually complicated with spleen-qi deficiency(75,12.23%). The syndrome of kidney-qi deficiency(186,57.23%) was commonly-seen in the patients with ovular DUB, while the syndromes of kidney-qi(146,50.69%) and kidney-yin deficiency(111,38.54%) were frequently-seen in the patients with anovular DUB. Conclusion: In clinic, the compound syndromes were commonly seen in patients with DUB due to kidney deficiency, the complicated syndromes of kidney deficiency were liver stagnation, spleen-qi deficiency, blood deficiency and blood stasis..