Background::Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods::A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson’s correlation, multiple linear regression, and analyses of covariance.Results::All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. Conclusions::The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.

Objective To investigate the incidence rate,clinical characteristics,and prognosis of neonatal stroke in Shenzhen,China.Methods Led by Shenzhen Children's Hospital,the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022.The incidence,clinical characteristics,treatment,and prognosis of neonatal stroke in Shenzhen were analyzed.Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137,1/6 060,and 1/7 704,respectively.Ischemic stroke accounted for 75％(27/36);boys accounted for 64％(23/36).Among the 36 neonates,31(86％)had disease onset within 3 days after birth,and 19(53％)had convulsion as the initial presentation.Cerebral MRI showed that 22 neonates(61％)had left cerebral infarction and 13(36％)had basal ganglia infarction.Magnetic resonance angiography was performed for 12 neonates,among whom 9(75％)had involvement of the middle cerebral artery.Electroencephalography was performed for 29 neonates,with sharp waves in 21 neonates(72％)and seizures in 10 neonates(34％).Symptomatic/supportive treatment varied across different hospitals.Neonatal Behavioral Neurological Assessment was performed for 12 neonates(33％,12/36),with a mean score of(32±4)points.The prognosis of 27 neonates was followed up to around 12 months of age,with 44％(12/27)of the neonates having a good prognosis.Conclusions Ischemic stroke is the main type of neonatal stroke,often with convulsions as the initial presentation,involvement of the middle cerebral artery,sharp waves on electroencephalography,and a relatively low neurodevelopment score.Symptomatic/supportive treatment is the main treatment method,and some neonates tend to have a poor prognosis.

The genomic characteristics and cellular tropism of a Mangshi virus(MSV)isolated in China were investigated,thereby establishing a robust foundation for further research on the evolution and pathogenicity of MSV.The genome sequence of MSV strain V301/YNJH/2019 was obtained by next-generation sequencing,followed by phylogenetic tree construction and rearrangement assessment using software IQtree,RPD4,and Simplot.Viral proliferation was assessed in C6/36(Aedes albop-ictus),Vero(African green monkey kidney),and BHK(baby hamster kidney)cells.An initial epidemiological investigation of MSV in local cattle and goats was conducted using the serum neutralization test.The genome of MSV strain V301/YNJ H/2019 was 20623 bp in length,encompassing 12 segments of double-stranded RNA(Seg-1 to Seg-12).Sequence analysis confirmed genomic rearrangement of the Seg-1 and Seg-11 sequences,ex-hibiting high similarity to MSV isolated from lake sediment in China in 2022,while Seg-2 to Seg-10 and Seg-12 were most closely related to a MSV strain isolated from mosquitoes in China in 2013.The virus efficiently proliferated and induced sig-nificant cytopathic effects(CPE)in both C6/36 and BHK cells,but limited replication and no observable CPE in Vero cells.No detectable neutralizing antibodies against MSV were detected in 20 goat serum samples collected in Mangshi,while 2 of 20 bo-vine serum samples were positive with neutralizing antibody titers of 1:128 and 1:54.Whole genome sequencing revealed re-assortment events of the V301/YNJH/2019 strain,which is capable of infecting C6/36,BHK,and Vero cells.MSV infection was confirmed in cattle in Mangshi.

BACKGROUND: Data on the immunogenicity and safety of heterologous immunization schedules are inconsistent. This study aimed to evaluate the immunogenicity and safety of homologous and heterologous immunization schedules. METHODS: Multiple databases with relevant studies were searched with an end date of October 31, 2021, and a website including a series of Coronavirus disease 2019 studies was examined for studies before March 31, 2022. Randomized controlled trials (RCTs) that compared different heterologous and homologous regimens among adults that reported immunogenicity and safety outcomes were reviewed. Primary outcomes included neutralizing antibodies against the original strain and serious adverse events (SAEs). A network meta-analysis (NMA) was conducted using a random-effects model. RESULTS: In all, 11 RCTs were included in the systematic review, and nine were ultimately included in the NMA. Among participants who received two doses of CoronaVac, another dose of mRNA or a non-replicating viral vector vaccine resulted in a significantly higher level of neutralizing antibody than a third CoronaVac 600 sino unit (SU); a dose of BNT162b2 induced the highest geometric mean ratio (GMR) of 15.24, 95% confidence interval [CI]: 9.53-24.39. Following one dose of BNT162b2 vaccination, a dose of mRNA-1273 generated a significantly higher level of neutralizing antibody than BNT162b2 alone (GMR = 1.32; 95% CI: 1.06-1.64), NVX-CoV2373 (GMR = 1.60; 95% CI: 1.16-2.21), or ChAdOx1 (GMR = 1.80; 95% CI: 1.25-2.59). Following one dose of ChAdOx1, a dose of mRNA-1273 was also more effective for improving antibody levels than ChAdOx1 (GMR = 11.09; 95% CI: 8.36-14.71) or NVX-CoV2373 (GMR = 2.87; 95% CI: 1.08-3.91). No significant difference in the risk for SAEs was found in any comparisons. CONCLUSIONS: Relative to vaccination with two doses of CoronaVac, a dose of BNT162b2 as a booster substantially enhances immunogenicity reactions and has a relatively acceptable risk for SAEs relative to other vaccines. For primary vaccination, schedules including mRNA vaccines induce a greater immune response. However, the comparatively higher risk for local and systemic adverse events introduced by mRNA vaccines should be noted. REGISTRATION PROSPERO; https://www.crd.york.ac.uk/PROSPERO/ ; No. CRD42021278149.
Adult ; Humans ; BNT162 Vaccine ; 2019-nCoV Vaccine mRNA-1273 ; Network Meta-Analysis ; Immunization Schedule ; COVID-19/prevention & control* ; COVID-19 Vaccines/adverse effects* ; Viral Vaccines ; mRNA Vaccines ; Antibodies, Neutralizing ; Antibodies, Viral

Objective Exploring the occurrence and clinical characteristics of adverse drug reactions caused by the treatment of malignant hematological diseases in children with pegaspargase,in order to provide reference for safe drug use in clinical practice.Methods Summarize and organize 24 cases of adverse reactions related to pegaspargase reported in the pediatric hematology ward of our hospital from January 2016 to June 2023 for analysis and re evaluation.The basic information,severity of adverse drug reaction(ADR),dosage,route of administration,clinical manifestations,occurrence time and outcome of ADR were analyzed statistically.Results Among the 24 ADR reports,there were 15 males(62.50％)and 9 females(37.50％).The age ranged from 2 to 15 years,with an average age of(7.79±4.68)years.There were 16 children under 10 years old(66.67％).The primary disease is acute lymphocytic leukemia(87.50％).The administration mode of 24 patients was intramuscular injection,and the dosage was 1200-3 750 U.A total of 30 AD Rs occurred in 24 patients,10 of which were serious ADRs.The most common organ involved in ADR was gastrointestinal system damage(8 cases,27.59％),followed by systemic(6 cases,20.69％)and skin and Subcutaneous tissue(5 cases,17.24％).The shortest occurrence time of ADR is 5 minutes after medication,and the longest is 56 days after medication.Conclusion Clinical attention should be paid to the occurrence characteristics of asparaginase ADR.After medication,patients need to be monitored for safety over a long period of time,closely monitoring their clinical symptoms and related test indicators,especially in young children,to reduce the damage caused by ADR to patients.

Objective:To establish the biology reference interval (RI) of peripheral blood procalcitonin (PCT) for children between 3 days and 6 years old in China.Methods:Totally 3 353 reference individuals with apparent health or no specific diseases were recruited in 18 hospitals throughout the country during October 2020 to May 2021. Reference individuals were divided into four groups: 3-28 days, 29 days - 1 year, 1-3 years and 4-6 years. Vein blood or capillary blood were collected by percutaneous puncture from every reference individual. The PCT level in serum and the capillary whole blood were assayed by Roche Cobas e601 and Norman NRM411-S7 immunoanalyzer. Outliers were deleted and 95th percentiles of every group were provided as RIs. Man-Whitney U test or Kruskal-Wallis test were used performed to assess the difference among different gender, age or method groups. Results:The difference of PCT distribution between male and female is not statistically significant, but the difference between serum and capillary whole blood is statistically significant. The differences between age groups are significant too. For Roche e601, serum PCT RI of 3-28 days group is <0.23 μg/L, 29 days - 6 years are <0.11 μg/L. For NRM411, Serum PCT RI of 3-28 days group is <0.21 μg/L, 29 days - 1 year: <0.09 μg/L, 1 - 6 years: <0.10 μg/L. For whole blood PCT, RI of 3-28 days group is <0.26 μg/L, 29 days - 6 years is <0.15 μg/L.Conclusions:Serum and capillary whole blood PCT have different RIs, however, capillary whole blood PCT testing is valuable in pediatric application. Children in 3-28 days show higher PCT levels than other age group. To establish the RIs and understand the differences among different groups are essential for the interpretation and clinical application of peripheral blood PCT testing results.

By referring to the relevant ancient herbal literature， medical records and prescription books， the textual research of Violae Herba has been conducted to verify the name， origin， producing area， quality evaluation and processing method changes. The results showed that the name of Zihua Diding originated from its flower color and plant morphological characteristics. The primitive plant of Violae Herba is Viola genus of Violaceae， V. yedoensis， as stipulated in the 2020 edition of Chinese Pharmacopoeia， has been the mainstream in past dynasties of China. Violae Herba is mainly wild， and it is widely distributed throughout the country. Since modern times， the quality of Violae Herba is better with integrity， green color and yellow root. There are few records on the harvesting and processing methods of Violae Herba in ancient times， most of which are directly used after drying. It is suggested that the collection and processing methods of Violae Herba in the famous classical formulas can be implemented in accordance with the provisions of the 2020 edition of Chinese Pharmacopoeia.

Objective:To evaluate the value of MAGiC STIR sequence inassessing bone marrow edema (BME) of the sacroiliac joint (SIJ) in ankylosing spondylitis (AS) patients.Methods:Twenty two AS patients from the Affiliated Fifth Hospital of Sun Yat-sen University from September 2019 to January 2020 underwent MR scanning, consisting of T 2WI fat-suppressed (FS) sequence and MAGiC sequence. Each SIJ was divided into four quadrants for analysis on oblique coronal MR image. Two radiologists [middle-higher seniority levels (radiologist 1 and radiologist 2) reviewed image sets of two sequences [T 2WI FS and MAGiC short T 1 inversion recovery (STIR) sequence] independently at separate times, using Hermann-Braun scoring system for degree of BME and summing numbers of quadrants based on BME findings. Disagreements were resolved to reach an agreement for final results.Assessments were repeated two weeks later by radiologist 2. Intra-class correlation coefficients (ICC) were calculated to assess the inter-and intra-observer agreement for the degree of BME and numbers of positive BME quadrants in the MAGiC STIR sequence, respectively. The differences between the two sequences for the degree of BME and numbers of positive BME quadrants were analyzed with Wilcoxon signed-rank test and Chi-square test, respectively. Taking the results of T 2WI FS sequence as a reference standard, the ROC curve was drawn, sensitivity, specificity, positive predictive value and negative predictive value in the detection of BME were calculated for the MAGiC STIR sequence. Results:Nineteen AS patients including 38 sacroiliac joints were enrolled in our study, being divided into 152 quadrants. Inter-and intra-observer agreement for the degree of BME and inter-observer agreement for numbers of positive BME quadrants in the MAGiC STIR sequence were all good (ICC=0.936, 95%CI 0.912-0.953, P<0.001; ICC=0.910, 95%CI 0.878-0.934, P<0.001; ICC=0.876, 95%CI 0.833-0.909, P<0.001). The difference between the two sequences for the degree of BME in quadrants was statistically significant ( Z=-3.132, P=0.002). But there was no statistically significant difference between sequences for numbers of quadrants in detecting BME (χ2=0.244, P=0.622). Area under the ROC curve of MAGiC STIR sequence in diagnosis of BME was 0.920 ( P<0.001). Sensitivity, specificity, positive predictive value and negative predictive value for the MAGiC STIR sequence in the detection of BME were 82.0%, 95.1%, 89.1% and 91.5%, respectively. Conclusion:MAGiC STIR sequence can be used to evaluate bone marrow edema of SIJ in AS patients with high sensitivity and specificity.

Objective: To explore the effects and correlation of gross motor intervention on social skills of autistic children. To provide new ideas for rehabilitation intervention of autistic children s social ability. Methods: Recruiting 23 autistic children through WeChat in Nanchang, randomly divided into experimental groups (n=13) and control group (n=10). The experimental group underwent 6 weeks of large muscle exercise intervention, in the control group, Test of Gross Motor Development 3 (TGMD3), Social Responsiveness Scale(SRS) and the Autism Social Skills Scale (ASSS) examined changes in social skills, and analyze the relationship between sports and social ability. Results: TGMD-3 score in the intervention group before intervention was (34.31±9.79) and increased significantly after intervention (59.77±13.92)(t=-15.28, P<0.01). There was no statistical significance before and after experiment in the control group (P>0.05). The scores of SRS and ASSS in the experimental group were (96.77±15.79, 97.31±29.22) before the intervention, and (82.92±15.86, 117.62±24.93) after the intervention, and the differences were statistically significant(t=4.55, -5.61, P<0.01). The difference between the SRS and ASSS scores of the control group before and after experiment was not statistically significant(P>0.05). Both the TGMD-3 score and the object manipulation score were related to the SRS total score (r=-0.49, -0.45) and ASSS total score(r=0.54, 0.51)(P<0.05). Conclusion Gross motor intervention can improve the motor and social skills of children with autism, and there is a positive correlation between motor ability and social skills in children with autism.

ObjectiveTo analyze the clinical outcomes of Gardner stage I and stage Ⅱ fresh blastocysts transfer on day 5 in patients without transferable cleavage-stage embryos， so as to explore the best transfer strategy. MethodsA retrospective analysis was done on patients without transferable cleavage-stage embryos who underwent single blastocyst transfer in our IVF center from January 2014 to December 2019. Of the total of 178 cycles of fresh blastocyst transfer， 97 involved stage I and 81 stage Ⅱ. Control Group 1 included 754 cycles of fresh grade 2 cleavage-stage embryo transfer on day 3 and Control Group 2 included 144 transfer of day-6 vitrified blastocysts. Like study groups， two control groups were also single blastocyst or single embryo transfer cycles. The clinical outcomes including live birth rate， clinical pregnancy rate， early miscarriage rate and ongoing pregnancy rate， and neonatal conditions such as gestational week at delivery， neonatal weight and length were analyzed among the groups. ResultsThe live birth rate （7.22% vs. 18.83%/7.22% vs. 15.97%）， clinical pregnancy rate （11.34% vs. 25.33%/11.34% vs. 24.31%） and ongoing pregnancy rate （7.22% vs. 19.89%/7.22% vs. 15.97%） were significantly decreased in fresh stage I blastocyst transfer group than those in Control Group 1 （P < 0.01） and Control Group 2 （P < 0.05）. There was no significant difference in early miscarriage rate and neonatal conditions between fresh stage I blastocyst transfer group and Control Group 1 or between fresh stage I blastocyst transfer group and Control Group 2 （all P > 0.05）. There was no significant difference in clinical outcomes and neonatal conditions between fresh stage Ⅱ blastocyst transfer group and Control Group 1 or between fresh stage Ⅱ blastocyst transfer group and Control Group 2 （all P > 0.05）. ConclusionIn patients without transferable cleavage-stage embryos， all embryos are better to be cultured to blastocyte-stage. Higher clinical pregnancy rate and live birth rate could be achieved if stage I blastocysts on D5 is transferred in a subsequent thawed-cycles after extended culture and stage Ⅱ blastocysts on D5 is transferred in fresh cycles.