The disease spectrum of ABCB4 gene mutation involves various diseases such as progressive familial intrahepatic cholestasis type 3 （PFIC3）， gallstone disease， intrahepatic cholestasis of pregnancy， portal hypertension， liver cirrhosis， and even primary hepatic and biliary malignancies. A young male patient was admitted to Department of Hepatobiliary Medicine， Eastern Hepatobiliary Surgery Hospital， and was initially diagnosed with liver cirrhosis and gallstones， and he was planned to receive laparoscopic cholecystectomy. Preoperative examination showed abnormal liver function， liver cirrhosis， splenomegaly， and mild esophageal varices， and next-generation sequencing was performed to make a confirmed diagnosis of ABCB4 gene mutation-associated liver cirrhosis with gallstones. The liver function of the patient gradually returned to normal after cholagogic treatment with ursodeoxycholic acid capsules.

China prospective multicenter birth cohort (Prospective Omics Health Atlas birth cohort, POHA birth cohort) study was officially launched in 2022. This study, in collaboration with 12 participating units, aims to establish a high-quality, multidimensional cohort comprising 20 000 naturally conceived families and assisted reproductive families. The study involves long-term follow-up of parents and offspring, with corresponding biological samples collected at key time points. Through multi-omics testing and analysis, the study aims to conduct multi-omics big data research across the entire maternal and infant life cycle. The goal is to identify new biomarkers for maternal and infant diseases and provide scientific evidence for risk prediction related to maternal diseases and neonatal health.

To analyze the methodological and reporting quality of systematic reviews of prediction models published in Chinese journals, with the aim of providing reference for enhancing the overall quality of Chinese systematic reviews of prediction models.

Background Zinc is a trace element essential for normal fetal heart development, and excess zinc can be toxic. The relationship between maternal and fetal zinc levels and the development of congenital heart disease (CHD) in the offspring is unclear. Objective To study the effects of maternal and neonatal zinc exposure levels on the risk of developing CHD in the offspring. Methods The data and biological samples of the study subjects were derived from the birth cohort established by Gansu Provincial Maternity and Child Care Hospital in Lanzhou from 2010 to 2012. Questionnaire surveys were conducted at baseline in the first trimester and at follow-up visits in the second trimester, the third trimester, and 42 d after delivery. Maternal venous blood during the third trimester and neonatal umbilical venous blood at delivery were collected, and information on their birth outcomes was extracted from medical records. Ninety-seven children with CHD diagnosed by echocardiography at birth and confirmed at the follow-up after 42 d were selected as the case group, and 194 healthy full-term infants were selected as the control group, 1∶2 matched for maternal age and geographical location from the database. The zinc concentrations in whole blood of pregnant mothers and umbilical cord blood of fetuses in both groups were measured by inductively coupled plasma mass spectrometry. According to the quartiles P₂₅ and P₇₅ of zinc levels in the whole blood of pregnant mothers and neonatal cord blood in the control group, zinc exposure was divided into three groups: low, medium, and high. After adjusting for maternal vaginal bleeding in early pregnancy, pre-pregnancy folic acid and vitamin supplementation, birth weight, and umbilical cerclage confounders, a multiple conditional logistic regression model was applied to analyze the associations between maternal whole blood and fetal umbilical cord blood zinc levels and the risk of CHD in the offspring, and a further subgroup analysis was performed by disease classification. Results The medians (P₂₅, P₇₅) of maternal whole blood zinc levels in the case group and the control group were 5.034 (3.456, 6.644) and 4.693 (3.411, 5.646) mg·L⁻¹, respectively, with significant differences between the two groups (P=0.029). The medians (P_25, P₇₅) of neonatal cord blood zinc level was 2.153 (1.479, 2.405) mg·L⁻¹ in the case group and 1.636 (1.304, 1.979) mg·L⁻¹ in the control group, with significant differences between the two groups (P<0.001). The zinc levels of maternal whole blood and neonatal cord blood in the simple CHD group were significantly higher than those in the control group (P<0.05). The multiple conditional logistic regression model showed that compared with the maternal medium zinc exposure level group (3.41-5.65 mg·L⁻¹), the risk of offspring CHD was 2.225 times of the high exposure level group (>5.65 mg·L⁻¹) (OR=2.225, 95%CI: 1.017-4.868). Compared with the neonatal medium zinc exposure level group (1.30-1.98 mg·L⁻¹), the neonatal high exposure level group (>1.98 mg·L⁻¹) also had an increased risk of CHD (OR=4.132, 95%CI: 1.801-9.480). The subgroup analysis results showed that compared with corresponding medium exposure level groups, the risk of simple CHD in the offspring of the maternal high zinc exposure level group was increased (OR=4.081, 95%CI: 1.427-11.669), and the risks of simple CHD (OR=7.122, 95%CI: 2.126-23.854) and complex CHD (OR=5.165, 95%CI: 1.859-14.346) of neonates of the neonatal high zinc exposure level group were increased. Conclusion Under the exposure levels of the study population, high concentrations of zinc exposure in pregnant mothers and neonates may be associated with the incidence of CHD.

Objective:To investigate the effects of type 2 diabetes mellitus (T2DM) on the clinicopathological characteristics and prognosis of patients with hepatocellular carcinoma (HCC) after curative hepatectomy.Methods:From November 2009 to June 2011, the clinicopathological and survival data of HCC patients who underwent radical resection at Eastern Hepatobiliary Surgery Hospital of Naval Medical University were retrospectively analyzed. The patients were divided into T2DM group and non-T2DM group. Clinicopathological characteristics and prognosis of two groups were compared. Chi square test or Fisher exact test were used for statistical analysis. Kaplan-Meier test was used for univariate survival analysis, and Cox proportional hazard regression model was used for multivariate survival analysis.Results:A total of 1 691 patients with HCC were enrolled in this study. Among them, 142 patients (8.4%) were complicated with T2DM. The proportion of patients with onset age≥65 years old, the proportion of men, the proportion of patients with hypertension and γ-glutamyltranspeptidase >61 U/L in the T2DM group were higher than those in non-T2DM group (24.6%, 35/142 vs. 10.4%, 161/1 549; 92.3%, 131/142 vs. 85.7%, 1 327/1 549; 43.7%, 62/142 vs. 12.3%, 191/1 549; 58.5%, 83/142 vs. 49.4%, 765/1 549), while the proportion of patients with chronic hepatitis virus infection and α-fetoprotein >20 μg/L in the T2DM group were both lower than those in non-T2DM group (76.1%, 108/142 vs. 92.0%, 1 425/1 549; 47.2%, 67/142 vs. 59.9%, 928/1 549), and the differences were all statistically significant ( χ2=25.79, 4.75, 100.36, 4.28, 39.01 and 8.66, all P<0.05). The results of univariate survival analysis showed that there was no significant difference in the postoperative overall survival (OS) rate between T2DM group and non-T2DM group ( χ2=3.02, P=0.082). The results of further subgroup analysis showed that among HCC patients with TNM stage Ⅰ, there was statistically significant difference in the OS rate between T2DM group and non-T2DM group ( χ2=4.53, P=0.033). The OS rates at 1 year, 3 years and 5 years after curative resection of HCC patients in T2DM group were lower than those of patients in non-T2DM group (96.0%, 48/50 vs. 97.6%, 558/572; 78.0%, 39/50 vs. 88.6%, 507/572; 68.0%, 34/50 vs. 79.5%, 455/572). The results of multivariate Cox regression survival analysis demonstrated that T2DM was an independent risk factor for postoperative survival in patients with TNM stage Ⅰ HCC (odds ratio=1.663, 95% confidence interval 1.045 to 2.648, P=0.032). Conclusions:The effect of T2DM on prognosis of patients after radical resection of HCC is associated with TNM stage, and its effect may be limited on the early stage of HCC.

OBJECTIVE：To investigate the effects and mechanism of puerarin （Pue） on hypoxia-induced pyroptosis of pulmonary artery smooth muscle cells （PASMCs）. METHODS ：PASMCs of rats as research objects were randomly divided into normoxia group ，hypoxia group and hypoxia+Pue group （0.2 mmol/L）. Except for normoxia group ，other groups were cultured with 5％ CO2 and 3％ O2 at 37 ℃ for 24 hours to establish hypoxia model. Western blot assay was used to detect the expression of pyroptosis related proteins [NOD-like receptor protein- 3 （NLPR3），caspase-1，interleukin-1 β （IL-1 β），apoptosis-associated speck-like protein （ASC）]. Lactate dehydrogenase （LDH）release assay was used to detect the release of LDH in cells ；Hoechst 33342/PI double staining test was adopted to detect the proportion of pyroptosis positive cells. PASMCs was randomly divided into normoxia group+control plasmid group ，hypoxia+control plasmid group ，hypoxia+over-expression plasmid group and hypoxia+ over-expression plasmid+Pue group. Except for the normoxia+control plasmid group ，the other groups were established hypoxia model by the same method. After transfection of control plasmid or NLRP 3 over-expression plasmid ，Western blot ，LDH release test and Hoechst 33342/PI double staining test were used to investigate whether Pue could inhibit hypoxia-induced PASMCs pyroptosis by interfering with the activity of NLRP 3 inflammasomes. RESULTS ：Compared with normoxia group ，the expression of pyroptosis related proteins ，the release of LDH and the proportion of pyroptosis positive cells were increased significantly in hypoxia group （P＜0.05 or P＜0.01）. Pue had the effect of reversing the above indexes （P＜0.05 or P＜0.01）. When the NLRP 3 inflammasome was over-expressed ，the expression of pyroptosis related proteins ，the release of LDH and the proportion of Δ 基金项目：黑龙江省自然科学基金资助项目（No.ZD201416） pyroptosis positive cells were increased significantly （P＜0.05 ＊教授，博士生导师 ，博士。研究方向 ：心血管药理学 。电话： or P＜0.01）. Pue could inhibit the above phenomenon through 0451-58853046。E-mail：zhangxd85@163.com regulating NLRP 3 inflammasome （P＜0.05 or P＜0.01）. 中国药房 2021年第32卷第11期 China Pharmacy 2021Vol. 32 No. 11 ·1337· CONCLUSIONS：Pue can significantly inhibit the hypoxia-induced pyroptosis of PASMCs by down-regulating the expression of pyroptosis related proteins ，reducing the release of LDH and proportion of pyroptosis positive cells. The mechanism is related to the activity inhibition of NLRP 3 inflammasome.

Dental resin materials have been widely used in the treatment of dental defects. However, the polymerization shrinkage of the resin materials tends to cause microleakage and accumulation of bacterial plaque, which leads to secondary dental caries. Endowing dental resin with antibacterial properties is an important way to solve this problem. Adding antibacterial agents to dental resin is the main method to give it antibacterial properties. Antimicrobial agents are mainly divided into three types: release type, non-release type and mixed type. In terms of antibacterial effects, the selection and addition of antibacterial agents will affect the antibacterial and mechanical properties of dental resin materials; and the long-term antibacterial effect of antimicrobial agents in the oral cavity remains to be verified; as antimicrobial agents or other environmental factors can lead to drug resistance and even dormant persistent bacteria. In recent years, researchers have been committed to improving the antibacterial effect by modifying antibacterial agents. The sustained release of antimicrobial agents via carriers is also the main research direction. This paper reviews the research progress on the antibacterial properties of dental resin materials.

Objective:To investigate the clinical characteristics of neonatal congenital tongue base cyst.Methods:This retrospective study involved 35 neonates with congenital tongue base cyst diagnosed in the neonatal intensive care unit (NICU) of Xi'an Children's Hospital from June 2013 to December 2019. General information, clinical manifestations, supplementary results, treatment and prognosis of these babies were described.Results:(1) The median age at the onset of the disease was 12.5 (0~28) d and the median age at admission was 15 (0~28) d for these babies. The main clinical manifestations were laryngeal stridor (28/35, 80.0%), inspiratory dyspnea and crying, especially when feeding (26/35, 74.3%) and choking and spitting with feeding (23/35, 65.7%). (2) Among the 35 cases, 15 (42.9%) required emergency endotracheal intubation due to significant dyspnea when were admitted to the NICU and five out of them were considered for having tongue base mass under laryngoscopy, while the other 10 cases underwent bedside electronic laryngoscopy after endotracheal intubation, in which space-occupying lesions were found. Tongue base cyst was considered in seven cases with laryngeal stridor complicated by protracted pneumonia using fiberoptic bronchoscopy. The other 13 cases were examined by electronic laryngoscope and considered as tongue base cyst. Thirty-five cases underwent cervical ultrasound and only five of them were considered as tongue base tumor. Thirty-two cases underwent cervical CT scan and only two of them were normal. Three cases were found to have tongue base cyst by cranial MRI. (3) Thirty-four cases were treated by radiofrequency ablation assisted with self-retaining microlaryngoscope and general anesthesia, while the other one firstly received puncture and drainage under direct laryngoscope due to the difficult intubation because of the huge tongue base cyst and then underwent surgery when stable. Only one case (2.9%) relapsed after surgical treatment during regular follow-up.Conclusions:Neonatal congenital tongue base cyst has an early onset and atypical clinical manifestations. Electronic laryngoscopy/fiberoptic bronchoscopy combined with neck CT or MRI examination should be performed promptly in patients with laryngeal stridor and inspiratory dyspnea to facilitate the accurate diagnosis and timely surgery is required for.

Objective:To analyze the clinical characteristics, risk factors for critical illness and death of severe adenovirus pneumonia in children, so as to provide clinical evidences for early diagnosis and reliable treatment.Methods:A total of 75 pediatric cases with severe adenovirus pneumonia admitted to Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January to October 2019 were studied. The clinical features, laboratory and imaging data, therapeutic approaches, efficacy of the treatments and prognosis were investigated retrospectively. Patients were divided into severe group and critical group. Chi square test and Mann-Whitney U rank sum test were used to analyze the data of the two groups. The risk factors for critical illness and death were analyzed by univariate and multivariate Logistic regression. Results:Among the 75 children, there were 52 males and 23 females, aged from 3 months to 8 years, including 30 of severe cases and 45 of critical case. The positive rate of adenovirus antigen in nasopharyngeal swab was 21% (15/72), and the positive rate of serum adenovirus IgM antibody was only 13% (10/75). However, the positive rate of adenovirus nucleic acid in nasopharyngeal swab was 75% (21/28). What is more, the positive rates of metagenomics next generation sequencing (mNGS) in plasma and bronchoalveolar lavage fluid were 92% (33/36) and 96% (54/56), respectively, of which 95% (63/66) were confirmed as adenovirus type 7. Relatively high dose of ribavirin and integrated therapeutic approaches (respiratory support, glucocorticoids, immunoglobulin and organ supportive therapies) were used. The recovery rate was 77% (58/75), the improvement rate was 8% (6/75) and the mortality rate was 15% (11/75). The proportion of children with the duration of fever longer than 3 days after ribavirin treatment in the critical group was significantly higher than that in the severe group(51% (18/35) vs. 8% (2/26), χ 2=12.949, P<0.05). The risk factors for critical illness were younger than 4 years, longer duration of fever before and after admission to PICU, oxygenation index<300 mmHg (1 mm Hg=0.133 kPa), ferritin>1 000 μg/L, lactate dehydrogenase (LDH)>1 500 U/L, 5 lung lobes involvement, pleural effusion and (or) air leakage (all P<0.05). Among them, 5 lung lobes involvement was the independent risk factor for critical illness (adjusted OR=49.641, 95% CI 4.186-588.618, P=0.002). Risk factors for death included longer duration of fever after being admitted to PICU, oxygenation index<100 mmHg, ferritin>2 000 μg/L, interleukin (IL)-6>100 ng/L, LDH>1 500 U/L, pleural effusion and (or) air leakage (all P<0.05). Among them, IL-6>100 ng/L was the independent risk factor for the mortalities of critically ill children (adjusted OR=16.094, 95% CI2.059-25.787, P=0.008). Conclusions:The mortality rate of severe pediatric adenovirus pneumonia caused by adenovirus type 7 is high. High positive rates of adenovirus nucleic acid in nasopharyngeal swabs and mNGS in plasma or bronchoalveolar lavage fluid contribute to early diagnosis, and mNGS can also be used for serotyping. Younger children under 4 years of age, persistent fever, extensive pulmonary lesions and significantly increased inflammatory cytokines such as IL-6 are warning indicators for critical illness and poor prognosis. Relatively high dose of ribavirin combined with integrated therapeutic approaches are beneficial for prognosis.

OBJECTIVE：To optim ize the water extraction-ethanol precipitation technology of polysaccharide from Litchi chinensis seed，and to evaluate its hypoglycemic activity in vitro . METHODS ：The content of polysaccharides was determined by phenol-sulfuric acid colorimetry ，and the extraction rate of polysaccharides was calculated. Single factor test and response surface methodology were used to optimize the water extraction technology with the ratio of material to liquid ，extraction times and extraction time as factors ，and the extraction rate of polysaccharide as index. Single factor test was used to screen the concentration volume fraction of water extract and ethanol precipitation Using acarbose as contro l，4-nitrophenol-α-D-glucopyranoside method was used to investigate in vitro inhibitory activity of polysaccharide from L. chinensis seed to α-glucosidase. RESULTS ：The optimal technology was the ratio of material to liquid 1∶19 （g/mL），decocting for 3 times，1 h for each time ，concentrating the water extract to 40％ of original volume ，and adding ethanol to 80％ volume fraction. After deproteinization by Sevage method ，the crude polysaccharide of L. chinensis seed was obtained. The results of 3 times of validation tests showed that ，extraction rates of polysaccharide were 7.61％，7.89％，7.99％，average extraction rate was 7.83％（RSD＝2.52％，n＝3）. The contents of polysaccharide were 55.57％，55.83％ and 56.66％，average content was 56.02％（RSD＝1.81％，n＝3）. The inhibitory activity of the polysaccharide from L. chinensis seed to α-glucosidase were increased as concentration ；its IC 50 was 0.056 mg/mL，which was lower than positive control acarbose （0.196 mg/mL）. CONCLUSIONS：The optimal water extraction-ethanol precipitation technology of polysaccharide from L. chinensis seed is stable and feasible. The polysaccharide from L. chinensis seed show significant in vitro inhibitory effect on α-glucosidase，which is better than that of acarbose.