Objective:To evaluate the diagnostic efficacy and practicality of the Jaundice color card (JCard) as a screening tool for neonatal jaundice.Methods:Following the standards for reporting of diagnostic accuracy studies (STARD) statement, a multicenter prospective study was conducted in 9 hospitals in China from October 2019 to September 2021. A total of 845 newborns who were admitted to the hospital or outpatient department for liver function testing due to their own diseases. The inclusion criteria were a gestational age of ≥35 weeks, a birth weight of ≥2 000 g, and an age of ≤28 days. The neonate′s parents used the JCard to measure jaundice at the neonate′s cheek. Within 2 hours of the JCard measurement, transcutaneous bilirubin (TcB) was measured with a JH20-1B device and total serum bilirubin (TSB) was detected. The Pearson′s correlation analysis, Bland-Altman plots and the receiver operating characteristic (ROC) curve were used for statistic analysis.Results:Out of the 854 newborns, 445 were male and 409 were female; 46 were born at 35-36 weeks of gestational age and 808 were born at ≥37 weeks of gestational age. Additionally, 432 cases were aged 0-3 days, 236 cases were aged 4-7 days, and 186 cases were aged 8-28 days. The TSB level was (227.4±89.6) μmol/L, with a range of 23.7-717.0 μmol/L. The JCard level was (221.4±77.0) μmol/L and the TcB level was (252.5±76.0) μmol/L. Both the JCard and TcB values showed good correlation ( r=0.77 and 0.80, respectively) and agreements (96.0% (820/854) and 95.2% (813/854) of samples fell within the 95% limits of agreement, respectively) with TSB. The JCard value of 12 had a sensitivity of 0.93 and specificity of 0.75 for identifying a TSB ≥205.2?μmol/L, and a sensitivity of 1.00 and specificity of 0.35 for identifying a TSB ≥342.0?μmol/L. The TcB value of 205.2?μmol/L had a sensitivity of 0.97 and specificity of 0.60 for identifying TSB levels of 205.2 μmol/L, and a sensitivity of 1.00 and specificity of 0.26 for identifying TSB levels of 342.0 μmol/L. The areas under the ROC curve (AUC) of JCard for identifying TSB levels of 153.9, 205.2, 256.5, and 342.0 μmol/L were 0.96, 0.92, 0.83, and 0.83, respectively. The AUC of TcB were 0.94, 0.91, 0.86, and 0.87, respectively. There were both no significant differences between the AUC of JCard and TcB in identifying TSB levels of 153.9 and 205.2 μmol/L (both P>0.05). However, the AUC of JCard were both lower than those of TcB in identifying TSB levels of 256.5 and 342.0 μmol/L (both P<0.05). Conclusions:JCard can be used to classify different levels of bilirubin, but its diagnostic efficacy decreases with increasing bilirubin levels. When TSB level are ≤205.2 μmol/L, its diagnostic efficacy is equivalent to that of the JH20-1B. To prevent the misdiagnosis of severe jaundice, it is recommended that parents use a low JCard score, such as 12, to identify severe hyperbilirubinemia (TSB ≥342.0 μmol/L).

Chronic hepatitis B (CHB) virus infection is an important threat to global health despite the administration of vaccines and the use of antiviral treatments. In recent years, as the prevalence of obesity and metabolic syndrome has increased, non-alcoholic fatty liver disease (NAFLD) in patients with CHB has become more common. Both diseases can lead to liver fibrosis and even hepatocellular carcinoma, but the risk of dual etiology, outcome, and CHB combined with NAFLD is not fully elucidated. In this review, we assess the overlapping prevalence of NAFLD and CHB, summarize recent studies of clinical and basic research related to potential interactions, and evaluate the progressive changes of treatments for CHB patients with NAFLD. This review increases the understanding of the relationship and mechanisms of interaction between steatosis and hepatitis B virus infection, and it provides new strategies for the future clinical management and treatment of CHB combined with NAFLD.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

OBJECTIVE: To investigate the role of NOV/CCN3 in regulating the proliferation of mesenchymal stem cells (MSCs) and its regulatory mechanism and assess the value of CCN3 as a proliferative factor in bone tissue engineering. METHODS: Mouse embryonic fibroblasts (MEFs) were used as the MSC model, in which CCN3 expression was up-regulated and downregulated by transfection with the recombinant adenovirus vectors Ad-CCN3 and Ad-siCCN3, respectively. Flow cytometry was used to analyze the changes in cell cycle and apoptosis of the transfected cells. Western blotting was used to detect the expression levels of the proliferation indicators (PCNA, cyclin E, and cyclin B1) and the apoptosis indicators (Bax and Bcl-2) to assess the effect of modulation of CCN3 expression on MEF proliferation and apoptosis. CCN3 protein secretion by the cells was detected using ELISA. RT-qPCR and Western blotting were employed to analyze the changes in the expressions of Notch1, ligand DLL1, the downstream key proteins or genes (Hey1, P300, H3K9) and MAPK pathway-related proteins ERK1+2 and p-ERK1+2. RESULTS: Flow cytometry showed that compared with the control cells, MEFs transfected with Ad-CCN3 exhibited significantly increased cell proliferation index ( CONCLUSIONS CCN3 over-expression promotes the proliferation and inhibits apoptosis of MEFs possibly by inhibiting the classical Notch signaling pathway and activating the MAPK pathway
Animals ; Apoptosis ; Cell Cycle ; Cell Proliferation ; Fibroblasts ; Mice ; Nephroblastoma Overexpressed Protein

Human secreted phospholipase A2 GIIE (hGIIE) is involved in inflammation and lipid metabolism due to its ability of hydrolyzing phospholipids. To reveal the mechanism of substrate head-group selectivity, we analyzed the effect of mutation of hGIIE on its activity and selectivity. hGIIE structural analysis showed that E54 might be related to its substrate head-group selectivity. According to the sequence alignment, E54 was mutated to alanine, phenylalanine, and lysine. Mutated genes were cloned and expressed in Pichia pastoris X33, and the enzymes with mutations were purified with 90% purity by ion exchange and molecular size exclusion chromatography. The enzymatic activities were determined by isothermal microthermal titration method. The Km of mutant E54K towards 1,2-dihexyl phosphate glycerol decreased by 0.39-fold compared with that of wild type hGIIE (WT), and the Km of E54F towards 1,2-dihexanoyl-sn-glycero-3-phosphocholine increased by 1.93-fold than that of WT. The affinity of mutant proteins with phospholipid substrate was significantly changed, indicating that E54 plays an important role in the substrate head-group selectivity of hGIIE.
Humans ; Kinetics ; Mutation ; Phospholipases A2, Secretory ; Phospholipids ; Saccharomycetales ; Substrate Specificity

This study attempts to develop a reference substance for the live bacteria count of Streptococcicosis live vaccines in order to evaluate the validity of live bacterial count in inspection and testing. We prepared a batch of live Streptococcus suis reference substance for live bacterial count, tested their physical property, purity, vacuum degree, remaining moisture, and determined their homogeneity, thermal stability and transportation stability. Moreover, we organized collaborative calibration to assign count values to the reference substance and determine the shelf life of the reference substance in 12 months. The results showed that the physical property, the purity, the remaining moisture and the vacuum degree of the reference substance were all in compliance with the requirements of the Chinese Veterinary Pharmacopoeia. The homogeneity test showed that the coefficient of variation of the count of the reference substance was less than 10%, indicating a good homogeneity. Transportation stability test showed that the reference substance remained active after 72 h transportation in summer and winter with the package of styrofoam boxes and ice packs. Thermal stability test showed that the reference substance could be stored for up to 3 months at -20 °C, or up to 21 days at 4 °C. According to the collaborative calibration, the reference vaccine was assigned a count value range of (8.5-12.1)×107 CFU/ampoule. The shelf life test showed that the reference substance was stable for 12 months when stored at -70 °C. The reference substance could provide a reference for the live bacterial count of Streptococcicosis live vaccines. Moreover, it could also be used as a reference to evaluate the quality of corresponding agar media.
Bacterial Load ; Reference Standards ; Vaccines, Attenuated

Objective:To evaluate the prognostic effects of gradient boosting machine (GBM) model on the short-term effects of percutaneous endoscopic lumbar discectomy (PELD) in the treatment of lumbar disc herniation.Methods:Clinical data and outcomes of 475 patients who underwent PELD surgery for single-segment lumbar disc herniation from October 2016 to March 2018 were retrospectively collected. The lumbar JOA score was used as a reference for the evaluation of curative effects. The improvement rate ≥50% was considered as good curative effects, while <50% was considered as poor curative effects. GBM model and multivariate Logistic regression model were utilized to screen out the influencing factors of the short-term clinical effects of PELD. Prognostic models were established, receiver operating characteristic (ROC) curves were drawn and compared. Sensitivity, specificity and Youden index were compared to evaluate the predictive performance of GBM model.Results:A total of 395 patients were followed up effectively for 24 months. There were 347 patients (87.8%) with good curative effects. However, forty-eight patients (12.2%) had poor curative effects. There were statistically differences in the lumbar JOA score improvement rates between the groups in regards to age, location and type of herniated disc, degeneration level of intervertebral disc and facet joint in surgical segment, sagittal diameter of the protrusion and whether or not there was calcification, onset time to the surgery time period and degeneration level of intervertebral disc in adjacent segment ( P<0.05). The results of multivariate analysis showed that patients with age ≥60 [ OR=9.15, 95% CI(4.04, 20.73), P<0.001] and with larger sagittal diameter of the protrusion [ OR=1.37, 95% CI(1.18, 1.58), P<0.001] were more likely to have a poor prognosis. Patients with unilateral disc herniation had a better prognosis than the extreme lateral type [ OR=0.17, 95% CI(0.06, 0.55), P=0.003]. The prognoses of patients with grade Ⅲ intervertebral disc degeneration in surgical segment were worse than those with grade Ⅱ [ OR=0.17, 95% CI(0.04, 0.70), P=0.014]. The prognoses of patients with grade Ⅲ intervertebral disc degeneration in adjacent segment were worse than those with grade Ⅱ [ OR=0.29, 95% CI(0.10, 0.81), P=0.018]. The AUC predicted by GBM model was 0.92 [95% CI(0.77, 0.96)] with 93.46% sensitivity, 83.33% specificity and 0.77 Youden index. The above parameters were higher than those by the Logistic regression model. The predictive effects of the two models were both statistically significant ( P<0.001). The AUC values of the two models were also statistically significant ( Z=0.11, P<0.001). Conclusion:GBM model is better than multivariate logistic regression analysis model in predicting the short-term clinical effects of PELD in treating lumbar disc herniation.

Objective To investigate the changes of blood test indexes in patients with severe acute respiratory syndrome (SARS) after 10 years of rehabilitation, and to evaluate the effects of SARS on blood system. Methods Twenty-five cases of SARS confirmed in our hospital (SARS group) and 25 healthy personnel (control group) were included in this study. Values of blood routine test, liver and kidney function, blood lipids, blood glucose, thyroid function, tumor marker and T cell subset index were compared between two groups. Results The serum level of calcium was higher in SARS group than that of control group (mmol/L:2.32 ± 0.08 vs. 2.29 ± 0.08,t=2.072,P<0.05). The level of thyroxine was also higher in SARS group than that of control group (nmol/L: 119.95 ± 29.09 vs. 96.39 ± 14.26, t=3.681,P<0.05), but the results were in the normal range, there was no clinical significance. The level of neuron specific enolase (NSE) was higher in SARS group than that of control group (μg/L, 10.368 ± 3.684 vs. 3.282 ± 1.828, t=9.012, P<0.05), in which only 2 cases were slightly higher than the normal range, but did not exceed more than 1 times of the normal value. The imaging was only part of the old change, and there was no clinical significance. There were no significant differences in other results between two groups. Conclusion Virus of SARS cause no long-term effects on blood system, liver and kidney function, thyroid function and immunity in patients with SARS, and do not increase the probability of cancer.

UNLABELLEDObjective To explore the effects of sperm DNA integrity rate, acrosome integrity rate and acrosome reaction rate on the outcomes of rescue intracytoplasmic sperm injection (ICSI).

METHODSThis retrospective analysis was conducted among 97 infertile couples receiving rescue ICSI due to failure of in vitro fertilization procedures in our Reproductive Medicine Center. Of these 97 women, 41 had clinical pregnancy and 56 did not, and the effects of sperm DNA integrity rate (estimated by DNA fragmentation index, DFI), acrosome integrity rate and acrosome reaction rate on rescue ICSI outcomes were analyzed.

RESULTSNo significant difference was found in paternal age, testosterone value, testicular volume, FSH, female patient' age or the number of eggs retrieved between the two groups (P>0.05), but the infertility years was significantly shorter in the pregnancy group than in the non-pregnancy group (P<0.05). The fertilization rate and cleavage rate were similar between the two groups (P>0.05), but the good embryo rate was significantly higher in the pregnancy group (P<0.05). The sperm DNA integrity or acrosome reaction rate did not differ significantly between the two groups (P>0.05), but the acrosome integrity rate was significantly higher in the pregnancy group (P<0.05). The sperm DNA integrity rate, acrosome integrity or acrosome reaction rate were not correlated with the fertilization rate, cleavage rate or good embryo rate (P>0.05). The pregnancy rate, twin and single fetus rates were 42.3%, 10.3% and 32.0% in this cohort after recue ICSI, respectively.

CONCLUSIONRescue ICSI is an effective treatment after failed in vitro fertilization procedure, and sperm acrosome integrity rate is associated with the outcome of rescue ICSI.

Acrosome ; pathology ; Acrosome Reaction ; DNA Fragmentation ; Female ; Fertilization ; Fertilization in Vitro ; Humans ; Infertility ; Male ; Pregnancy ; Pregnancy Rate ; Retrospective Studies ; Sperm Injections, Intracytoplasmic

Objective: To explore the high dose atorvastatin reducing contrast induced nephropathy (CIN) rate in patiens with emergent percutaneous coronary intervention (PCI) via improveing heat shock protein-90 (HSP90) expression with its possible mechanism. Methods: A total of 158 STEMI patients with emergent PCI in our hospital were studied. The patients were randomly divided into 2 groups: High dose atorvastatin group, the patients received pre-operative atorvastatin 40 mg,n=80 and Control group, the patients received pre-operative placebo,n=78. The serum creatinin (Scr), creatinine clearance rate (Ccr), blood urea nitrogen (BUN), superoxide dismutase (SOD), malondialdehyde (MDA), nitrogen monoxide (NO), HSP90 mRNA expression and protein concentration and urine α1-microglobulin were examined in all patients and the incidence rates of CIN were compared between 2 groups. Results: Compared with Control group, High dose atorvastatin group had drcreased Scr (68.92 ± 8.80) μmol/L vs (77.25 ± 13.36) μmol/L, MDA (3.88 ± 0.53) nmol/L vs (4.08 ± 0.52) nmol/L and urine α1-micrglobulin (1.38 ± 0.36) mg/dl vs (1.89 ± 1.13 ) mg/dl; increased Ccr (89.71 ± 9.85) ml/min vs (77.28 ± 13.78) ml/ min, SOD (129.52 ± 30.63) U/ml vs (117.66 ± 27.98) U/ml, NO (66.23 ± 29.26) μmol?gprot vs (55.12±27.43) μmol?gprot, allP<0.05. Compared with Control group, High dose atorvastatin group presented higher post-operative HSP90 mRNA expression (0.466 ± 0.158) vs (0.224 ± 0.278 ) and protein concentration (1259.83 ± 121.17) pg/ml vs (1195.0 ± 127.65) pg/ml, allP<0.05. The incidence rate of CIN was lower in High dose atorvastatin group (2.5%) than Control group (10.3%),P<0.05. Conclusion: A high dose atorvastatin administration before emergent PCI may decrease CIN occurrence rate. Atorvastatin may promote HSP90 expression, increase NO produciton, then improve the vascular endothelial function and anti-oxidative ability to protect the renal function in STEMI patients.