Objective: To understand the current situation regarding pediatric off-label use of drugs recommendations in Chinese clinical practice guidelines and to make recommendations for standardized reporting format regarding off-label use of drugs for children. Methods: This cross-sectional study was carried out by systematically searching the databases for Chinese guideline consensus articles published in journals between 2018 and 2020 and extracting recommendations regarding off-label use of drugs from those articles. The essential characteristics of the included guidelines, the ranking of off-label drug types, the order of drug information, the type of off-label drug use, and the percentage of citation studies on which the recommendations were based were analyzed. Results: Among 108 studies that included Chinese off-label guidelines and consensus, 364 recommendations on pediatric off-label use of drugs were included. The Chinese Medical Association published the most, 48 out of the 108 studies (44.4%), and of those 14 studies (13.0%) were on infectious and parasitic diseases. Of the 364 recommendations on off-label use of drugs, the most commonly addressed drugs were 16 recommendations (4.4%) for cyclosporine A, 11 recommendations (3.0%) for methotrexate , and 11 recommendations (3.0%) for fentanyl. The most commonly addressed drug categories were as follows: 68 recommendations (18.6%) were immune system drugs, 66 recommendations (18.1%) were anti-infectives, and 56 recommendations (15.4%) were oncology drugs. The most commonly addressed drug information accounts were as follows: 364 recommendations (100.0%) were indications, 204 recommendations (56.0%) were dosages, and 198 recommendations (54.4%) were the route of administration. Based on the instructions approved by the Chinese Food and Drug Administration, the main forms of the off-label drug were as follows: 175 recommendations (48.1%) were unapproved indications, 127 recommendations (34.9%) were unapproved populations, and 72 recommendations (19.8%) were unapproved ages. Only 129 recommendations (35.4%) were cited, mainly including clinical guidelines (48 studies, 23.4%), reviews (22 studies, 10.7%), and pediatric randomized controlled trials (22 studies, 10.7%). Conclusions: Off-label use of drugs is commonly recommended in pediatric guidelines and consensus documents written by Chinese authors. However, the reporting of the recommendations varies widely, and the quality of the supporting evidence is poor.
Child ; China ; Consensus ; Cross-Sectional Studies ; Humans ; Off-Label Use ; Pharmaceutical Preparations

OBJECTIVE: To explore the influencing factors of low back pain and the relationship of the influence of bad working posture, weight load and frequency of load and the dose-response relationship among the occupational workers of key industries in China. METHODS: A total of 57 501 employees from 15 key industries in China were selected as research subjects using stratified cluster sampling method. The occurrence of low back pain in the past one year, as well as occupational factors such as job type, labor organization and work posture were investigated by using the Chinese version Musculoskeletal Disorders Questionnaire. RESULTS: The prevalence of low back pain in the occupational population of key industries in China was 16.4%(9 448/57 501). Multivariate Logistic regression analysis showed that the risk of low back pain in females was higher than that in males(P<0.01). Married, obese, occasional and frequent smokers, and a history of lower back disease were associated with increased risk of low back pain(all P<0.05). The risk of low back pain was associated with older age, higher education level, and lower frequency of physical exercise(all P<0.01). The risk of low back pain was higher with longer working time, greater back curvature, and the high frequency of long standing and sitting position work, uncomfortable working posture, repeated operation per minute, and lifting>5 kg weight(all P<0.01). CONCLUSION: The influencing factors of low back pain in the occupational population of key industries in China include bad working posture, high frequency load, weight load and other individual factors. There is a dose-response relationship with low back posture load and frequency of load.

Sirtuins belongs to the class III family of histone deacetylases (HDAC), which is a mammalian homolog of the yeast silencing information regulator Sir2. Silent information regulator factor 2-related enzyme 1 (SIRT1) is the most well studied family member of Sirtuins. Distributed mainly in the nucleus and cytoplasm, SIRT1 is involved in various intracellular biological processes, including DNA damage repair, gene transcription, energy metabolism, stress and apoptosis through its NAD

Objective:To investigate the clinical effect of arthroscope treating traumatic omarthralgia with Bankart injury.Methods: 69 patients with traumatic omarthralgia with Bankart injury were divided into observation group (38 cases) and control group (31cases). And patients of observation group received the treatment of arthroscopic while those of control group received routine treatment. And then the shoulder joint score and visual analogue scale (VAS) of the two groups at post-treatment 1 week and post-treatment 1 month were compared, respectively.Results: At post-treatment 1 week, series of shoulder joint scores, included of pain, functional activity, activity degree of shoulder joint, muscle force and total score, of observation group were significantly higher than those of control group, respectively (t=5.27,t=6.02,t=6.81,t=3.37,t=8.22,P<0.05). While at post-treatment 1 month, all of above shoulder joint scores between the two groups were no significantly (t=1.02,t=1.73,t=2.85,t=2.46,t=4.01,P>0.05), respectively. And for all of these scores, post-treatment 1 month were higher than that of post-treatment 1 week. Besides, for both of the two groups, the VASs of post-treatment were lower than that of pre-treatment, and the VAS of observation group was significantly lower than that of control group(t=6.88,P<0.05).Conclusions: In the process of arthroscopic treating traumatic omarthralgia with Bankart injury, the recovery of shoulder joint function and the alleviating of painful of patients achieve better effect, and post-operative recovery is faster. Therefore, the therapy method is worthy in the popularization and application of clinical practice.

Objective To evaluate enteral nutrition treatment on nutritional status of patients with esophageal cancer during radiotherapy in Chinese population. Methods We searched domestic and foreign relevant databases (PubMed, Medline, Cochrane Library, Wanfang Data, Chinese Journal Database, VMIS) by key words (esophageal cancer, chemoradiotherapy, enteral nutrition) , meeting the conditions of the clinical randomized controlled trials, and evaluated the quality of each document. We used meta-analysis method to analysis the published literatures about clinical randomized controlled trials, which were enteral nutrition treatment on nutritional status of patients with esophageal cancer during radiotherapy in Chinese population.RevMan5.1 statistical analysis software were used. Results Seven separate clinical randomized controlled trials including 503 cases were included into the meta-analysis. The following five indexes of nutritional status in enteral nutrition treatment (ENT) group were superior to routine treatment (RT) group (P<0.05): body weight, Body Mass Index (BMI), hemoglobin, serum albumin, serum prealbumin. The MD Values and 95％CI (confidence interval) were 5.54 (3.61-7.46), 2.20 (2.02-2.39), 12.46 (5.86-19.05), 4.04 (2.48-5.61), 49.53 (20.93-78.13) .The funnel plot showed no significant publication bias in each indexes. Conclusion Enteral nutrition treatment can improve the nutritional status of patients with esophageal cancer during radiotherapy compare only with routine treatment.

BACKGROUND: Psoriasis is an autoimmune disease that is caused by a shift in the Th1/Th2 balance toward Th1-dominant immunity. It has been established as an effective treatment to counteract psoriasis by subcutaneous injection of recombinant interleukin (IL)-4, and IL-4 gene therapy by topical transdermal penetration has shown its antipsoriatic effect in mice. Retinoic acid (RA) and dimethylsulfoxide can increase the efficiency of gene transfection in the topical transdermal delivery system. OBJECTIVE: We investigated whether RA could improve anti-psoriasis efficiency using IL-4 expression plasmid pORF-mIL-4 (pIL-4) via transdermal delivery system in K14-vascular endothelial growth (K14-VEGF) factor transgenic mice. METHODS: After pretreatment with RA, plasmid pIL-4 in 10% dimethylsulfoxide was applied to the ear skin by topical transdermal penetration. Hematoxylin- eosin staining and immunohistochemistry were performed with ear samples to evaluate anti-psoriasis efficiency in mice. RESULTS: The psoriasis pathological features were relieved and psoriasis-associated factors were significantly reduced. CONCLUSION: Our results reveal that topical application of pIL-4 in dimethylsulfoxide by transdermal delivery with RA pretreatment can improve psoriasis significantly.
Animals ; Autoimmune Diseases ; Dimethyl Sulfoxide ; Ear ; Eosine Yellowish-(YS) ; Genetic Therapy ; Immunohistochemistry ; Injections, Subcutaneous ; Interleukin-4* ; Interleukins ; Mice ; Mice, Transgenic ; Plasmids ; Psoriasis* ; Skin ; Transfection ; Tretinoin*

OBJECTIVETo study the expression of ecotropic viral integration site (EVI1) gene in childhood acute myeloid leukemia (AML) and the clinical features of EVI1-positive children with AML.

METHODSThe clinical data of EVI1-positive children with AML were collected and analyzed. RT-PCR and real-time quantitative PCR were used for qualitative and quantitative analysis of expression of EVI1. Flow cytometry (FCM) was used for determining the immunophenotypes of bone marrow cells. Multiparameter FCM was used for monitoring minimal residual disease. The karyotypes were determined.

RESULTSOf 241 children with AML, 33 (13.7%) were positive for EVI1 expression. There were no significant differences in age at first visit as well as the white blood cell count, hemoglobin level, and platelet count in peripheral blood between EVI1-positive and EVI1-negative children with AML (P>0.05), but EVI1-positive children had a significantly increased proportion of females compared with EVI1-negative children (P<0.05). The change in EVI1 expression was not synchronous with clinical remission and the change of MRD: some children had clinical remission or negative conversion of MRD before negative conversion of EVI1, while some had negative conversion of EVI1 before clinical remission or while MRD showed positive. EVI1 gene was usually co-expressed with other fusion genes. CD33 (100%), CD38 (88%), and HLADR (76%) were highly expressed in EVI1-positive children with AML. Abnormal chromosome structure or number was found in 15 patients. Compared with EVI1-negative children, EVI1-positive children had significantly lower complete remission rates after the first course of treatment (P<0.05).

CONCLUSIONSEVI1-positive children with AML have a poor short-term prognosis. In the development of AML, the activation of EVI1 gene is not isolated, but the result of interactions with other genes or chromosome abnormalities, and the mechanism of activation and its function need further study.

Adolescent ; Child ; Child, Preschool ; Chromosome Aberrations ; DNA-Binding Proteins ; genetics ; Female ; Flow Cytometry ; Gene Expression Regulation, Neoplastic ; Humans ; Immunophenotyping ; Infant ; Leukemia, Myeloid, Acute ; genetics ; immunology ; MDS1 and EVI1 Complex Locus Protein ; Male ; Neoplasm, Residual ; Prognosis ; Proto-Oncogenes ; genetics ; Transcription Factors ; genetics

In order to obtain the lead compound for treatment of rheumatoid arthritis (RA), in this study, therapeutic efficacy of three bispecific antibodies (BsAB-1, BsAB-2 and BsAB-3) against both hIL-1beta and hIL-17 were compared on CIA model mice. First, by ELISA method we compared the binding capacity of the three bispecific antibodies to the two antigens. The results showed that all three antibodies could simultaneously bind both antigens, among these antibodies, BsAB-1 was superior over BsAB-2 and BsAB-3. CIA model was established with chicken type II collagen (CII) and developed RA-like symptoms such as ankle swelling, skin tight, hind foot skin hyperemia. The CIA mice were treated with three antibodies once every two days for total of 29 days. Compared with the CIA model mice, the RA-like symptoms of the antibody treated-mice significantly relieved, while the BsAB-1 treated-mice were almost recovered. CII antibody level in the serum and cytokines (IL-2, IL-1beta, IL-17A and TNF-alpha) expression in the spleen were examined. Compared with the CIA model mice, all three antibodies could significantly reduce CII antibody and cytokine expression levels. BsAB-1 antibody was more potent than BsAB-2 and BsAB-3. In summary, BsAB-1 is superior over BsAB-2 and BsAB-3 in amelioration of RA symptoms and regulation of CII antibody production and pro-inflammatory cytokine expression, therefore, BsAB-1 can be chosen as a lead compound for further development of drug candidate for treatment of RA.
Animals ; Antibodies ; metabolism ; Antibodies, Bispecific ; immunology ; therapeutic use ; Antigen-Antibody Reactions ; Arthritis, Experimental ; chemically induced ; metabolism ; therapy ; Arthritis, Rheumatoid ; chemically induced ; metabolism ; therapy ; Collagen Type II ; immunology ; Interleukin-17 ; metabolism ; Interleukin-1beta ; metabolism ; Interleukin-2 ; metabolism ; Male ; Mice ; Spleen ; metabolism ; Tumor Necrosis Factor-alpha ; metabolism

Objective To know the status of the unhealthy behavior of adolescent in Kaihua County.Methods Multi -stage cluster sampling survey was carried out and 741 middle school students in 17 classes from 10 schools were selected. The survey was conducted by using a self-reported questionnaire.Results Middle school students who felt good health status accounted for 46.96%,while students who had the suicide ideation accounted for 15.38% and who had suicide behavior accounted for 2.29%.34.55% students had smoking behavior.Students who had never eaten breakfast were accounted to 9.45%,and who had never drink milk were accounted to 46.15%.50.88% and 60.32% students had the behavior of washing hands before eating and after using the toilet respectively.Students who had the behavior of brushing teeth were accounted to 88.08%.Students who had never participated physical activity that was longer than 60 minutes were accounted to 5.24%,and playing games and chatting were the two major internet activities.The awareness rate of AIDS knowledge was 59.32%.The rates of behavior of school violence and stolen was 8.91% and 18.08% respectively. Sex behavior was 3.37%.Conclusion There are smoking,playing online games,campus violence,poor hygiene and other bad behavior in some middle school students.

OBJECTIVETo explore the effect of Chlamydia pneumoniae (C.pn) infection on human laryngeal carcinoma cell line HEp-2 cell adhesion and migration, to further clarify the role and mechanism of C.pn infection in tumor metastasis.

METHODSHEp-2 cells were infected with C.pn after the culture and propagation of C.pn. The cytopathic effect was observed by microscopy. Morphological characteristics of C.pn inclusions in HEp-2 cells were examined by fluorescence microscopy and acridine orange staining. The ultrastructural changes of C.pn inclusions in the HEp-2 cells were examined by transmission electron microscopy (TEM). Cell adhesion assay was performed to investigate the effect of C.pn infection on the adhesion of HEp-2 cells to collagen I. Wound-healing assay and transwell assay were performed to explore the effect of C.pn infection on HEp-2 cell migration.

RESULTSAt 72 h post-infection, C.pn infected-HEp-2 cells were swollen and partially desquamated. Numerous vacuoles (inclusions) were observed and C.pn inclusions occupied almost the whole cytoplasm of the HEp-2 cells. Grape-like C.pn inclusions were observed in the HEp-2 cells stained with acridine orange under a fluorescence microscope at 72 h after infection. Under TEM, there were more mature pear-shaped elementary bodies, but less larger and round reticulate bodies in the HEp-2 cells infected with C.pn for 72 h. In the cell adhesion assay, the A value in C.pn infection group was 0.669 ± 0.011, significantly higher than that in the control group (0.558 ± 0.005) at 2 h after infection (P < 0.001). The cell adhesion ratio in the C.pn infection group was 119.89%. The migration distance of C.pn infected-HEp-2 cells in the wound-healing assay was significantly longer than that of control cells at 24 h after infection (P < 0.05). HEp-2 cells infected with C.pn for 12 h migrated more than the control cells in the transwell assay (23.40 ± 2.41 vs 10.40 ± 1.67) (P < 0.001).

CONCLUSIONSC.pn infection can significantly promote HEp-2 cell adhesion to collagen I and migration of HEp-2 cells, indicating that C.pn infection may play an important role in promoting the metastasis of laryngeal cancer.

Carcinoma, Squamous Cell ; microbiology ; pathology ; Cell Adhesion ; Cell Line, Tumor ; Cell Movement ; Chlamydophila Infections ; microbiology ; physiopathology ; Chlamydophila pneumoniae ; Humans ; Laryngeal Neoplasms ; microbiology ; pathology