Objective:To investigate the incidence and influencing factors of allergic reactions to cephalosporins.Methods:A cross-sectional study of 29 medical institutions in Zhejiang Province was conducted from April 2021 to June 2021.The incidence of allergic reactions to cephalosporins was investigated,and the influencing factors of cephalosporin-induced allergic reactions were analyzed by Poisson regression.Results:A total of 56 155 patients were included in this study.The total incidence of allergic reactions to cephalosporin was 1.67‰,the highest incidence of anaphylaxis occurred for ceftizoxime(4.27‰),followed by ceftriaxone(3.49‰)and cefotaxime(2.40‰).There was no significant difference in the incidence of allergic reactions between patients with negative skin tests and those without skin tests(1.75％o vs.1.63‰,RR=1.07,95％CI:0.70-1.63,P＞0.05).Poisson regression showed that body mass index(BMI)＜18.5 kg/m2(RR=2.43,95％CI:1.23-4.82,P＜0.05)and history of β-lactam antibiotics allergy(RR=33.88,95％CI:1.47-781.12,P＜0.05)increased cephalosporin-induced anaphylaxis.Compared with cefuroxime,the risk of allergic reactions was increased for ceftriaxone(RR=3.08,95％CI:1.70-5.59,P＜0.01),ceftazidime(RR=1.89,95％CI:1.03-3.47,P＜0.05),and ceftizoxime(RR=3.74,95％CI:1.64-8.50,P＜0.01).Conclusions:Lower BMI and history of β-lactam antibiotics allergy increase the risk of cephalosporin allergic reactions.The routine skin test may not reduce the occurrence of allergic reactions to cephalosporins. This study has been registered at Chinese Clinical Trial Registry(ChiCTR2200064314).

Congenital abnormalities of the kidney and urinary tract (CAKUT) are common congenital malformations identified by prenatal ultrasound. This review summarizes the fetal renal development, the mechanism of CAKUT, and the influence of the fetal environment on CAKUT. CAKUT can manifest as different degrees of renal disease, from transient hydronephrosis to severe bilateral renal dysplasia, a major risk factor for chronic and end-stage renal disease in childhood. Genetic factors and abnormal fetal environment can both contribute to CAKUT. Ultrasound screening is conducive to detect CAKUT but may miss some defects. Monogenic mutations identified in CAKUT can help us gain more insight into the molecular mechanisms of renal development.

Objective:To explore the effect of mobile health (mHealth) management system on dietary behavior of patients with coronary heart disease (CHD) .Methods:Using the convenient sampling method, CHD patients who were hospitalized in Department of Cardiology of Beijing Anzhen Hospital and Beijing Chaoyang Hospital of Capital Medical University were selected as the research objects from June 2019 to January 2020. The research objects were randomly divided into the intervention group and the control group using SAS software. Finally, 68 cases in the intervention group and 66 cases in the control group completed the study. The intervention group received mhealth management, while the control group received routine management, and they were followed up to 1 month after discharge. The proportion of patients with the low-salt and low-oil diet, the intake of salt, oil, staple food, vegetables, fruits, fish, shrimp, poultry and eggs, BMI and blood pressure were compared between the two groups.Results:At 1 month follow-up, the intervention group was better than the control group in terms of low salt and low oil diet, salt intake, oil intake and vegetable intake compliance, and the differences were statistically significant ( P<0.05) . At 1 month follow-up, there were no statistically significant differences in BMI and blood pressure between two groups ( P>0.05) . Conclusions:The mobile health system can effectively increase the proportion of patients with a low-salt and low-oil diet, and improve the intake compliance of salt, edible oil and vegetables in patients with CHD. In future studies, the intervention time should be extended to further explore the long-term intervention effect of mobile health and give full play to the role of mobile health in continuous behavior management of patients with CHD after discharge.

Objective: To explore the correlation between sleep and laryngopharyngeal reflux disease by epidemiological approaches. Methods: From May 1, 2017 to April 30, 2018, data of age, gender, height, weight, smoking, alcohol consumption, constipation and high fat diet in patients in Otorhinolaryngology specialist clinic, the Eighth Medical Center, General Hospital of the Chinese PLA were retrospectively analyzed. Reflux Symptom Index (RSI), Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS)were filled. According to RSI scores, patients were divided into case group and control group. The differences of the above indicators between the two groups were compared by Stata 12.0 software, and the risk factors of LPRD were analyzed by multivariate Logistic regression. Results: A total of 908 patients were enrolled, including 166 in the case group and 742 in the control group. There was no significant difference in BMI, smoking, drinking, constipation and high fat diet between the two groups (all P>0.05). The PSQI, anxiety and depression score of the case group were higher than those of the control group. The anxiety and depression scores of the patients with sleep disorders in the case group were significantly higher than those of the normal sleepers (all P<0.05). RSI of the patients with sleep disorders was higher than that of the patients with normal sleep(9.5[4.0,16.0]vs. 5.0[1.0,10.0], Z=-6.07, P<0.001). Multivariate analysis showed that sleep disorder was the risk factors of LPRD (OR=2.59, 95%CI 1.75-3.84). Conclusions Sleep disorder is related to the occurrence of LPRD. The association between LPRD and sleep disturbances is bidirectional. Sleep disorder may also be related to the anxiety and depression in LPRD patients. Handling sleep disorder timely may benefit LPRD patients.

Objective To investigate the clinical value of radiomics nomogram,which is established by 18F-fluorodeoxyglucose (FDG) PET/CT radiomics signature combined with clinical-pathologic risk factors,in predicting the prognosis of patients with postoperative gastric carcinoma.Methods 18F-FDG PET/CT data of 207 patients (143 males,64 females,age range:20-85 years) with postoperative gastric carcinoma from January 2008 to August 2015 was reviewed retrospectively.Patients were divided into training group (n=104) and validation group (n =103),and the clinicopathologic information and disease-free survival (DFS) data were acquired.Significant textural features were selected from PET/CT images,and radiomics score (RS) for individual patient was calculated based on the radiomics signatures.The relationship between RS and DFS was analyzed.Cox regression analysis was performed to determine the risk factors ofDFS.The radiomics nomo-gram,obtained from combination of RS with clinicopathologic risk factors,was established and further evaluated in predictive value for recurrence or metastasis of postoperative gastric carcinoma,and the concordance index (C-index) was calculated.Results Cox regression analysis demonstrated that RS,tumor location,depth of invasion,lymph node metastasis,and distant metastasis were the significant risk factors for DFS (hazard ratios:2.148-2.828,all P＜0.05).The radiomics nomogram combined with RS and 4 clinicopathologic risk factors had a better prediction for the estimated DFS,comparing to RS alone.C-index of radiomics nomogram and RS were 0.830 and 0.700 in training group,and 0.776 and 0.681 in validation group,respectively.Conclusion Radiomics nomogram which is established by radiomics signatures and clinicopathologic risk factors may be better for predicting DFS of patients with postoperative gastric carcinoma.

Objective To summarize the key points of nursing care in reservation of catheters in 11 cases of nasopharyngeal carcinoma patients who received concurrent chemo-radiotherapy with symptomatic thrombosis after ultrasound-guided implantation of double-lumen PICCs(PowerPICC).Methods From January,2014 to December,2015,totally 11 cases with symptomatic venous thromboembolism were identified among 109 cases of nasopharyngeal carcinoma patients receiving concurrent radiotherapy and chemotherapy,and observation and nursing care were provided at the early stage of thrombosis and during thrombosis.Results All double-lumen PICCs were reserved,and no recurrence or aggravation of thrombosis was recorded to the end of the treatment.The duration of carrying PICCs was 67～89(77.45±6.65) days.Conclusion With careful treatment and nursing,PICC catheter-related complications can be reduced and the duration of carrying catheters can be prolonged,which leads to accomplishment of the treatment plan for patients.

Objective To assess the technical feasibility and effectiveness of X-ray-guided implantation of inverted Y-type metal airway stent under local anesthesia by using a modified technique of exchanging guide wire in order to shorten operation time.Methods The clinical data of a total of 16 patients,who received inverted Y-type metal airway stent implantation under local anesthesia,were retrospectively analyzed.Routine gradual guide wire exchange method with a harder one was used in 6 patients (routine group),while in 10 patients (modification group) a modified technique of exchanging guide wire,i.e.inserting two hard wires at one time,was employed.Technical success rate and operation time were used as the main observation indexes.Results Under local anesthesia,the implantation of inverted Y-type metal airway stent was successfully accomplished in all 16 patients.The mean operation time of the routine group and the modification group was 15.6 minutes and 11.1 minutes respectively,the difference between the two groups was statistically significant (P＜0.05).Conclusion For the performance of implantation of inverted Ytype metal airway stent under local anesthesia to treat malignant carina stenosis,the use of modified technique of guide wire insertion,i.e.inserting two hard wires at one time,can effectively shorten the operation time.

Objective To retrospectively analyze the clinical classification ,laboratory and imageological examinations of Wil‐son′s disease for strengthening the cognition on this disease and increasing the diagnosis rate .Methods The clinical data of the pa‐tients with WD in our hospital from January 2011 to September 2014 ,were collected and performed the statistical analysis .Results Among different ages ,nationalities and genders of WD patients ,first onset age ,clinical classification and laboratory examination had some difference ,the average age of first onset in male WD patients was earlier than that in female WD patients ,the low density shadow change of nervous type WD existed in MRI .Conclusion Heredity is not a unique factor affecting WD ,gender ,age and na‐tionality may be one of factors affecting the first onset age and clinical symptoms in the WD patients .

Objective To investigate the effect of expression level and methylation level of miR-200b on proliferation, invasion and apoptosis of gastric cancer cell line MGC-803 in vitro. Methods Normal human gastric epithelium cell line GES-1, and gastric cancer cell line MGC-803 cells were cultured and harvested to extract total RNA. Then miR-200b ex?pression level was examined via q-PCR;Methylation in promoter of miR-200b was revealed by Bisulphite PCR. MGC-803 cells were treated with different concentrations of 5′-Aza-CdR to test its effect on miR-200b expression and methylation of its promotor. The effect of its treatment at 10μmol/L for 72 h on invasion,proliferation and apoptosis of both cell lines were detected by Transwell assay, Flow cytometry and apoptosis assay respectively. The gene related to EMT (epithelial-mesen?chymal transition ) such as E-cadherin,N-cadherin,ZEB1,Slug were checked by Western blot. Results The expression of miR-200b in GES-1 is higher than that in MGC-803(P=0.022). The methylation level in promoter region of miR-200b in GES-1 is lower than that in MGC-803(P=0.034). After treated with 5′-Aza-CdR, the expression of miR-200b in MGC-803 cell was up-regulated in a timely dependent manner. On the contrary, the methylation in promoter of mirR-200b were down-regulated when 5′-Aza-CdR were added at 10μmol/L(P=0.043). What’s more, 5′-Aza-CdR administration increas?es cell apoptosis especially in aged cells and delays cell cycle at G0/G1 which in turn decrease ratio of cells in S phages. 5′-Aza-CdR treatment also decreased invasiveness and induced expression of E-cadherin, as well as down regulated the ex?pressions of N-cadhrin, ZEB1, Slug and MMP9 in MGC-803 cells. Conclusion Expression of miR-200b could be affected by methylation of promoter of miR-200b and in turn regulate proliferation and invasion of gastric cells in vitro.