Objective: To evaluate the prognostic value of left ventricular ejection fraction (LVEF) reserve assessed by gated SPECT myocardial perfusion imaging (SPECT G-MPI) for major adverse cardiovascular event (MACE) in patients with coronary artery disease. Methods: This is a retrospective cohort study. From January 2017 to December 2019, patients with coronary artery disease and confirmed myocardial ischemia by stress and rest SPECT G-MPI, and underwent coronary angiography within 3 months were enrolled. The sum stress score (SSS) and sum resting score (SRS) were analyzed by the standard 17-segment model, and the sum difference score (SDS, SDS=SSS-SRS) was calculated. The LVEF at stress and rest were analyzed by 4DM software. The LVEF reserve (ΔLVEF) was calculated (ΔLVEF=stress LVEF-rest LVEF). The primary endpoint was MACE, which was obtained by reviewing the medical record system or by telephone follow-up once every twelve months. Patients were divided into MACE-free and MACE groups. Spearman correlation analysis was used to analyze the correlation between ΔLVEF and all MPI parameters. Cox regression analysis was used to analyze the independent factors of MACE, and the optimal SDS cutoff value for predicting MACE was determined by receiver operating characteristic curve (ROC). Kaplan-Meier survival curves were plotted to compare the difference in the incidence of MACE between different SDS groups and different ΔLVEF groups. Results: A total of 164 patients with coronary artery disease [120 male; age (58.6±10.7) years] were included. The average follow-up time was (26.5±10.4) months, and a total of 30 MACE were recorded during follow-up. Multivariate Cox regression analysis showed that SDS (HR=1.069, 95%CI: 1.005-1.137, P=0.035) and ΔLVEF (HR=0.935, 95%CI: 0.878-0.995, P=0.034) were independent predictors of MACE. According to ROC curve analysis, the optimal cut-off to predict MACE was a SDS of 5.5 with an area under the curve of 0.63 (P=0.022). Survival analysis showed that the incidence of MACE was significantly higher in the SDS≥5.5 group than in the SDS<5.5 group (27.6% vs. 13.2%, P=0.019), but the incidence of MACE was significantly lower in the ΔLVEF≥0 group than in theΔLVEF<0 group (11.0% vs. 25.6%, P=0.022). Conclusions: LVEF reserve (ΔLVEF) assessed by SPECT G-MPI serves as an independent protective factor for MACE, while SDS is an independent risk predictor in patients with coronary artery disease. SPECT G-MPI is valuable for risk stratification by assessing myocardial ischemia and LVEF.
Humans ; Male ; Middle Aged ; Aged ; Coronary Artery Disease/diagnostic imaging* ; Stroke Volume ; Myocardial Perfusion Imaging ; Retrospective Studies ; Ventricular Function, Left ; Myocardial Ischemia

Since the end of 2019,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has swept the world,bringing great harm to human society and significantly increasing the health burden.Due to stron-ger infectivity,faster transmission,and higher reinfection rate of the Omicron variant,it has now replaced the Delta variant as the main epidemic strain for both imported and local outbreaks in China.Chinese Diagnosis and treatment protocol for SARS-CoV-2 infection(10th trial version)emphasizes"strengthening the protection of key popula-tions,"which includes the increasing number of immunocompromised population.These people have a high inci-dence of severe diseases and a high fatality rate after infected with SARS-CoV-2,and belong to the high-risk popula-tions of severe or critical diseases.Moreover,due to underlying diseases,these people take immunosuppressants and other related drugs chronically.The interactions between anti-SARS-CoV-2 infection treatment drugs and origi-nal drugs are complicated,thus bring significant challenges to the treatment after the SARS-CoV-2 infection.Cur-rently,there is a lack of guidelines or consensus on the diagnosis and treatment of SARS-CoV-2 infection among im-munocompromised population.Therefore,the Guangzhou Institute of Respiratory Health and National Center for Respiratory Medicine organized experts from multiple disciplines(respiratory and critical care medicine,organ transplantation,rheumatology and immunology,hematology,infection,critical care medicine,etc.)in China.Af-ter multiple rounds of discussions,13 items of recommendations are made as the reference for peers based on evi-dence-based medical evidence,so as to provide a theoretical and practical reference for the diagnosis and treatment strategies of this population.

Objective: To analyze the clinical characteristics of children with Burkitt lymphoma (BL) and to summarize the mid-term efficacy of China Net Childhood Lymphoma-mature B-cell lymphoma 2017 (CNCL-B-NHL-2017) regimen. Methods: Clinical features of 436 BL patients who were ≤18 years old and treated with the CNCL-B-NHL-2017 regimen from May 2017 to April 2021 were analyzed retrospectively. Clinical characteristics of patients at disease onset were analyzed and the therapeutic effects of patients with different clinical stages and risk groups were compared. Survival analysis was performed by Kaplan-Meier method, and Cox regression was used to identify the prognostic factors. Results: Among 436 patients, there were 368 (84.4%) males and 68 (15.6%) females, the age of disease onset was 6.0 (4.0, 9.0) years old. According to the St. Jude staging system, there were 4 patients (0.9%) with stage Ⅰ, 30 patients (6.9%) with stage Ⅱ, 217 patients (49.8%) with stage Ⅲ, and 185 patients (42.4%) with stage Ⅳ. All patients were stratified into following risk groups: group A (n=1, 0.2%), group B1 (n=46, 10.6%), group B2 (n=19, 4.4%), group C1 (n=285, 65.4%), group C2 (n=85, 19.5%). Sixty-three patients (14.4%) were treated with chemotherapy only and 373 patients (85.6%) were treated with chemotherapy combined with rituximab. Twenty-one patients (4.8%) suffered from progressive disease, 3 patients (0.7%) relapsed, and 13 patients (3.0%) died of treatment-related complications. The follow-up time of all patients was 24.0 (13.0, 35.0) months, the 2-year event free survival (EFS) rate of all patients was (90.9±1.4) %. The 2-year EFS rates of group A, B1, B2, C1 and C2 were 100.0%, 100.0%, (94.7±5.1) %, (90.7±1.7) % and (85.9±4.0) %, respectively. The 2-year EFS rates was higher in group A, B1, and B2 than those in group C1 (χ²=4.16, P=0.041) and group C2 (χ²=7.21, P=0.007). The 2-year EFS rates of the patients treated with chemotherapy alone and those treated with chemotherapy combined with rituximab were (79.3±5.1)% and (92.9±1.4)% (χ²=14.23, P<0.001) respectively. Multivariate analysis showed that stage Ⅳ (including leukemia stage), serum lactate dehydrogenase (LDH)>4-fold normal value, and with residual tumor in the mid-term evaluation were risk factors for poor prognosis (HR=1.38,1.23,8.52,95%CI 1.05-1.82,1.05-1.43,3.96-18.30). Conclusions: The CNCL-B-NHL-2017 regimen show significant effect in the treatment of pediatric BL. The combination of rituximab improve the efficacy further.
Adolescent ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Burkitt Lymphoma/drug therapy* ; Child ; Disease-Free Survival ; Female ; Humans ; Lactate Dehydrogenases ; Lymphoma, B-Cell/drug therapy* ; Male ; Prognosis ; Retrospective Studies ; Rituximab/therapeutic use* ; Treatment Outcome

Objective To investigate the distribution and density of Culex mosquito populations and the resistance of Culex pipiens pallens to insecticides in Jiangsu Province in 2018 and 2019. Methods During the period from June to October in 2018 and 2019, six counties (districts, cities) were sampled in southern, northern and central Jiangsu Province as surveillance sites. The density of Culex mosquitoes was measured overnight using the light trapping technique. In addition, Culex pipiens pallens mosquitoes were collected from Hai’an of Nantong City and Yandu District of Yancheng City, central Jiangsu Province, and the sensitivity of female first filial generations to dichlorodiphenyltrichloroethane (DDT), malation, proposur, beta cypermethrin and deltamethrin was tested using the standard WHO insecticide susceptibility test assay. Results A total of 104 423 Culex mosquitoes were captured in six surveillance sites of Jiangsu Province in 2018 and 2019, and Culex quinquefasciatus (49.11%), Culex pipiens pallens (28.38%), and Culex tritaeniorhynchus (21.04%) were predominant species. The density of Culex mosquitoes started to increase since early June, peaked in July and tended to be low in late October. Culex pipiens pallens mosquitoes captured from Hai’an was susceptible to malation, while those from Yandu District were moderately resistant to malation. Culex pipiens pallens mosquitoes from both Yandu and Hai’an were moderately resistant to proposur, and were resistant to DDT, beta cypermethrin and deltamethrin. Conclusions Culex quinquefasciatus, Culex pipiens pallens and Culex tritaeniorhynchus are predominant Culex species in Jiangsu Province. Culex pipiens pallens is resistant to DT, beta cypermethrin and deltamethrin in central Jiangsu Province.

【Objective】 To explore the clinical value of urinary aldosterone concentration(UAC) in primary aldosteronism(PA) screening and to evaluate the consistency of the two methods, liquid chromatography tandem mass spectrometry(LC-MS/MS) and chemiluminescence immunosorbent assay(CLIA), for determining UAC. 【Methods】 Among the 133 patients with suspected PA enrolled from October 2018 to August 2019, 55 were diagnosed with PA(30 with aldosteroneproducing adenoma and 25 with bilateral idiopathic hyperplasia) and 78 with essential hypertension(EH). Parallel determination of UAC was done with LC-MS/MS and CLIA assays on all subjects, then we compared the two methods and evaluated their correlation and consistency. Reciever operating characteristic(ROC) analysis was applied to assess the diagnostic accuracies, area under the curve(AUC) and cutoff values of UAC, plasma aldosterone concentration(PAC), random aldosterone to renin ratio(ARR) and urine aldosterone to renin ratio(UARR). Furthermore, ROC analysis of high urine sodium subgroup(urine sodium≥130 mmol/24h) was performed to evaluate the impact of sodium intake on PA screening. 【Results】 ①UACCLIA and UACLC-MS/MS were positively correlated(r=0.69, P < 0.001). Bland-Altman analysis showed poor consistency between CLIA and LC-MS/MS. ②The diagnostic efficiency of UAC and PAC in PA screening was equivalent (P > 0.05), while ARR was more efficient than UAC and PAC(P < 0.0001). AUC of UACCLIA, UACLC-MS/MS, PAC and ARR was 0.739, 0.659, 0.723, 0.943, respectively. The cutoff values for them were 5.1 μg/24 h, 11.6 μg/24 h, 27.6 ng/dL and 23.2 ng·dL^-1(/ μg·L^-1·h^-1), respectively. ③Both UARRCLIA and UARRLC-MS/MS performed as well as ARR in PA screening. AUC of UARRCLIA was 0.924 at the cutoff value of 1.75 μg·24h^-1(/ μg·L^-1·h^-1). While AUC of UARRLC-MS/MS was 0.906 at the cutoff value of 4.63 μg·24h^-1(/ μg·L^-1·h^-1). AUC of UACLC-MS/MS in high urine sodium subgroup was 0.708 at the cutoff of 14.9 μg/ 24 h. ④The diagnostic efficiency of UAC made no difference after sodium intake increased to 130 mmol/24 h or higher. 【Conclusion】 UAC alone is of little clinical value compared to ARR in PA screening and can serve as a supplementary indicator currently. But UARR, a combintion of UAC and plasma renin activity(PRA), is as valuable as ARR for screening PA. The optimal cutoff values of UACLC-MS/MS and UACCLIA are 11.6 μg/24 h, 5.1 μg/24 h, respectively. The optimal cutoff values of UARRLC-MS/MS and UARRCLIA are 4.63 μg·24 h^-1/(μg·L^-1·h^-1) and 1.75 μg·24 h^-1/(μg·L^-1·h^-1), respectively. Besides, significant bias of UAC observed in CLIA and LC-MS/MS results indicates that appropriate definition of cutoff value and reference range for each method are mandatory.

OBJECTIVE: To explore the molecular-level mechanism on the hematopoiesis effect of Angelicae sinensis Radix (ASR) with systems-based interactome analysis. METHODS: This systems-based interactome analysis was designed to enforce the workflow of "ASR (herb)→compound→target protein→internal protein actions→ending regulated protein for hematopoiesis". This workflow was deployed with restrictions on regulated proteins expresses in bone marrow and anemia disease and futher validated with experiments. RESULTS: The hematopoiesis mechanism of ASR might be accomplished through regulating pathways of cell proliferation towards hemopoiesis with cross-talking agents of spleen tyrosine kinase (SYK), Janus kinase 2 (JAK2), and interleukin-2-inducible T-cell kinase (ITK). The hematopoietic function of ASR was also validated by colony-forming assay performed on mice bone marrow cells. As a result, SYK, JAK2 and ITK were activated. CONCLUSION This study provides a new approach to systematically study and predict the therapeutic mechanism for ASR based on interactome analysis towards biological process with experimental validations.

OBJECTIVETo investigate genetic and antibiotic resistance characteristics of Campylobacter jejuni (C. jejuni) isolated from Shenzhen.

METHODSMultilocs sequence typing and agar dilution methods were used to define the genotype and antibiotic resistance of C. jejuni, respectively.

RESULTSIn total, 126 C. jejuni strains were isolated. The prevalence of C. jejuni was 5.3% in diarrheal patients. The prevalence in poultry meat (36.5%) was higher than that in cattle meat (1.1%). However, the prevalence in poultry cloacal swabs (27.0%) was lower than that in cattle stool (57.3%). Sixty-two sequence types were obtained, among which 27 of the STs and 10 alleles were previously unreported. The most frequently observed clonal complexes were ST 21 (11.9%), ST-22 (10.3%), and ST-403 (7.1%). ST-21, ST-45, ST-354, ST-403, and ST-443 complexes overlapped between isolates from patients and cattle, whereas ST-45 and ST-574 complexes overlapped between isolates from patients and poultry. All C. jejuni were resistant to at least one antibiotic. The highest resistance rate was toward ciprofloxacin (89.7%), followed by tetracycline (74.6%), and nalidixic acid (69.0%).

CONCLUSIONThis is the first report of the genotypes and antibiotic resistance of C. jejuni in Shenzhen. Overlapping clonal complexes were found between isolates from patients and cattle, and between patients and poultry.

BACKGROUND: The type of brackets is closely related to the efficiency of orthodontic treatment. A self-ligating bracket is characterized by low friction, simple operation, mild pain and discomfort, and it has been an issue of concern in orthodontics. In recent years, studies on the therapeutic efficiency of self-ligating brackets versus conventional brackets for orthodontic correction have been reported, but there is no conclusion. OBJECTIVE: To systematically compare the conventional and self-ligating brackets concerning treatment efficiency. METHODS: A computer-based search of PubMed, EMBASE, MEDLINE, WanFang, VIP and CNKI was performed for randomized controlled trials concerning self-ligating brackets versus conventional brackets for orthodontic correction. The keywords were "orthodontic brackets/ self-ligating, random" in English and "appliance/self-ligating/ conventional/orthodontic correction efficiency" in Chinese. The retrieve time was set from inception to December 2017. Stata12.0 software was used for meta-analysis following literature screening, data extraction and risk assessment of bias. RESULTS AND CONCLUSION: A total of 9 randomized controlled trials involving 603 patients were included. The results of meta-analysis on the efficiency of the two groups showed that there was no significant difference in overall treatment time, number of visits, time of alignment and time of space closure (P ＞ 0.05). Only the time of chairside operation showed significant difference between the two groups (P ＜ 0.05). These findings indicate that compared with the conventional bracket, the self-ligating bracket has no obvious advantage in the therapeutic efficiency.

Objective To explore the expression characteristics of cytochrome P450(CYP)candidate genes(CYP6M3, CYP6Y1,CYP6P5,CYP4H14,CYP4G17,CYP12F16)in Anopheles sinensis.Methods The samples were collected from dif-ferent developmental stages(eggs,larvae,pupae and adult mosquitoes(females and males)),and different tissues(salivary glands,malpighian tubes,midguts,ovaries,and fat bodies)of An.sinensis and the female adult mosquitoes exposed by differ-ent insecticide doses(0,1.25,3.75,6.25,12.5μg/bottle)and time points(0,5,15,30,60 minutes),then the total RNA was extracted. Quantitative reverse transcription PCR(qPCR)assay was used to analyze the relative expressions of six CYP genes in An.sinensis at different developmental stages,tissues and different insecticide exposure doses and time.Results The expressions of CYP6M3 and CYP6Y1 in the male adult mosquitoes were the highest,the expression of CYP6M3 gene in the males was 35.1 times higher than that in the females,the expression of CYP6Y1 in the males was 61.4 times higher than that in the females;the expression level of CYP4H14 in the larvae was the lowest,the expression of CYP4H14 in the females was 22.5 times higher than that in the fourth instar larvae.The expressions of candidate CYP genes in different tissues of An.sinensis were significantly different,the expression of CYP6M3 in the malpighian tubule was 38.9 times higher than that in the ovary,the ex-pression of CYP6Y1 in the fatbody was 9.1 times higher than that in the ovary,the expression of CYP4G17 was 4.6 times higher than that in the ovary,and the expression of CYP12F16 was 4.4 times higher thanthat in the ovary.The exposure to different in-secticide doses and time showed some induction effects in the expressions of candidate CYP genes,which affected the expres-sions of candidate CYP genes in An.sinensis.Conclusion The expression of candidate CYP genes varies significantly in differ-ent developmental stages and various tissues of An.sinensis,and exposure to deltamethrin at various doses and time points af-fects CYP genes expression in An.sinensis.

Objective To investigate the influence of combination of external prostaglandin and narrow band ultraviolet B (NB-UVB) on skin melanin and tyrosinase level in models with vitiligo.Methods Guinea pigs models with vitiligo were produced by 3％ hydroquinone cream.And then all the animal models were randomly divided into six groups according to the weight:normal group,model group,control group,medication alone group,light alone group and combination group.Normal group and model group were not treated.Control group was used the same amount of vaseline,2 times per day;the 0.25 mg · mL-1 dipropionazone tincture skin smear in medication alone group,2 times per day,stay on 2 months;the NB-UVB irradiation treatment instrument was exposed to 1 J · cm-1 at about 20 cm from the skin of the white spot,and the wavelength was 310 ～315 nm in light alone group,and once every other day,stay on 2 months;combination group,topical prostaglandina combination NB-UVB irradiation,frequency,method and time same to medication alone group and light alone group.After administration,the observation of vitiligo guinea pig skin tissue morphology and melanin distribution in the light microscope.Results The percentage of melanin hair follicles in model group,control group,medication alone group,light alone group and combination group were (37.50 ± 20.43) ％,(53.33 ± 14.38) ％,(55.00 ± 16.12) ％,(46.67 ± 19.66)％,(71.67 ± 7.53)％,respectively.The combined group is compared to the model group,the difference is significant in statistics (P ＜ 0.05).But comparison between control group,medication alone group,light alone group and model group,the difference were not significant in statistics (all P ＞ 0.05).Conclusion Combination of external prostaglandins and NB-UVB have some effect on vitiligo treatment.