H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Objective:To investigate the prognostic value of 18F-FDG PET/CT in patients with locally recurrent nasopharyngeal carcinoma (NPC) receiving chemoradiotherapy, and relationships between different metabolic parameters and peripheral blood inflammation markers. Methods:From January 2013 to June 2016, the data of 56 patients (40 males, 16 females, age 27-81 years) with locally recurrent NPC receiving chemoradiotherapy in the First People′s Hospital of Foshan were retrospectively analyzed. The SUV max, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were determined by 18F-FDG PET/CT and peripheral blood inflammation markers within 1 week before treatment were measured. Spearman rank correlation analysis was used to estimate the correlations between metabolic parameters and inflammation markers. According to the ROC curve, the best cut-off values of the SUV max, MTV and TLG were obtained and used to group patients. The Kaplan-Meier method and Cox regression were used to conduct univariate analysis and multivariate analysis of 3-year locoregional failure-free survival (LRFFS) and 3-year overall survival (OS) in patients with locally recurrent NPC. The prognostic value of metabolic parameters in patients with early and advanced recurrent T(rT) stages were compared. Results:MTV was positively correlated with neutrophils, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and high-sensitivity C-reactive protein (hs-CRP) before treatment in patients with locally recurrent NPC ( rs values: 0.30, 0.30, 0.28, 0.27, all P<0.05); TLG was positively correlated with neutrophils, monocytes, NLR and PLR ( rs values: 0.30, 0.28, 0.32, 0.30, all P<0.05). But there were no correlations between SUV max and peripheral blood inflammation markers ( rs values: from -0.18 to 0.24, all P>0.05). SUV max was an factor affecting 3-year LRFFS of patients undergoing radiotherapy and chemotherapy (hazard ratio ( HR)=3.815(95% CI: 1.278-11.388), P=0.016), while rT stage and MTV were prognostic factors for 3-year OS ( HR values: 4.492(95% CI: 1.474-13.688), 7.238(95% CI: 1.653-31.688), P values: 0.008, 0.009). For patients with advanced rT (rT3-4), the 3-year OS of the MTV≥6.84 cm 3 group was significantly lower than that of MTV<6.84 cm 3 group ( χ2=6.99, P=0.008). Conclusions:SUV max of tumor and MTV before treatment have important prognostic values in patients with locally recurrent NPC receiving chemoradiotherapy, but their predictive effects on prognosis are not the same. The varying effects of local inflammation on metabolic parameters may be one of the important reasons lead to that difference.

OBJECTIVE: To establish a new emergency dynamic score (EDS) method based on modified early warning score (MEWS) combined with clinical symptoms, rapidly available examination results and bedside examination data in the emergency department, and to observe its applicability and feasibility in the clinical application of emergency department. METHODS: A total of 500 patients admitted to the department of emergency of Xing'an County People's Hospital from July 2021 to April 2022 were selected as research objects. After admission, EDS and MEWS scores were performed first, and then acute physiology and chronic health evaluation II (APACHE II) was performed retrospectively, and the prognosis of patients was followed up. The difference of short-term mortality in patients with different score segments of EDS, MEWS and APACHE II were compared. Receiver operator characteristic curve (ROC curve) was drawn to evaluate the prognostic value of various scoring methods in critically ill patients. RESULTS: The mortality of patients in different score groups of each scoring method increased with the increase of the score value [The mortality of 0-1, 2-3, 4-5, 6-7 and ≥ 8 of MEWS were 1.9% (3/159), 2.9% (6/208), 12.4% (11/89), 29.0% (9/31) and 61.5% (8/13), respectively. The mortality of EDS stage 1 weighted MEWS score 0-3, 4-6, 7-9, 10-12 and ≥ 13 were 0 (0/49), 3.2% (8/247), 6.6% (10/152), 31.9% (15/47) and 80.0% (4/5), respectively. The mortality of EDS stage 2 clinical symptom score 0-4, 5-9, 10-14, 15-19, ≥ 20 were 0 (0/13), 0.4% (1/235), 3.6% (6/165), 26.2% (17/65), 59.1% (13/22), respectively. The mortality of EDS stage 3 rapid test data score 0-6, 7-12, 13-18, 19-24 and ≥ 25 were 0 (0/16), 0.6% (1/159), 4.6% (6/131), 13.7% (7/51) and 65.0% (13/20), respectively. The mortality of patients with APACHE II score 0-6, 7-12, 13-18, 19-24 and ≥ 25 were 1.9% (1/53), 0.4% (1/277), 4.6% (5/108), 34.2% (13/38) and 70.8% (17/24), respectively, all P < 0.01]. When the MEWS score was more than 4, the specificity was 87.0%, the sensitivity was 67.6%, and the maximum Youden index was 0.546, which was the best cut-off point. When the weighted MEWS score of EDS in the first stage was greater than 7, the specificity of predicting the prognosis of patients was 76.2%, the sensitivity was 70.3%, and the maximum Youden index was 0.465, which was the best cut-off point. When clinical symptom score of EDS in the second stage was more than 14, the specificity and sensitivity of predicting the prognosis of patients were 87.7% and 81.1%, respectively, and the maximum Youden index was 0.688, which was the best cut-off point. When the third stage rapid test of EDS reached 15 points, the specificity of predicting the prognosis of patients was 70.9%, and the sensitivity was 96.3%, and the maximum Youden index was 0.672, which was the best cut-off point. When APACHE II score was higher than 16, the specificity was 87.9%, the sensitivity was 86.5%, and the maximum Youden index was 0.743, which was the best cut-off point. ROC curve analysis showed that: EDS score in the stage 1, 2 and 3, MEWS score and APACHE II score can predict the short-term mortality risk of critically ill patients. The area under the ROC curve (AUC) and 95% confidence interval (95%CI) were 0.815 (0.726-0.905), 0.913 (0.867-0.959), 0.911 (0.860-0.962), 0.844 (0.755-0.933) and 0.910 (0.833-0.987), all P < 0.01. In terms of the differential ability to predict the risk of death in the short-term, the AUC in the second and third stages of EDS were highly close to APACHE II score (0.913, 0.911 vs. 0.910), and significantly higher than MEWS score (0.913, 0.911 vs. 0.844, both P < 0.05). CONCLUSIONS EDS method can dynamically evaluate emergency patients in stages, and has the characteristics of fast, simple, easy to obtain test and inspection data, which can facilitate emergency doctors to evaluate emergency patients objectively and quickly. It has strong ability to predict the prognosis of emergency patients, and is worth popularizing in emergency departments of primary hospitals.
Humans ; Research Design ; Critical Illness ; Retrospective Studies ; Hospitals ; Emergency Service, Hospital

Objective:To understand the genome analysis and molecular typing of foodborne Yersinia enterocolitica ( Y.e) strains in Liaocheng City of Shandong Province from 2020 to 2021. Methods:The Y.e strains were isolated from raw meat and meat products. Then we made the strain identification, drug sensitivity test, virulence gene test, pulsed-field gel electrophoresis (PFGE), and whole genome sequencing (WGS). The genome sequencing data were assembled with the microbial genome annotation package. We performed the multilocus sequence typing (MLST) and core genome multilocus sequence typing (cgMLST) and used WGS-based single nucleotide polymorphism typing (wg-SNPs) method to carry out genetic evolution analysis with 14 domestic and Y.e genomes obtained from the NCBI. Results:A total of 21 strains of Y.e were detected from 165 samples, with a detection rate of 12.73%. The 20 strains of Y.e were sequenced successfully. The 20 strains of Y.e carries a variety of drug resistance genes and virulence genes, showing multiple drug resistance. The virulence gene PCR test showed that 21 strains of Y.e having two virulence genes. Cluster analysis of PFGE, MLST, and cgMLST showed that the genomics of 21 strains was highly diverse. The genetic evolution analysis of wg-SNPs showed that 20 Y.e strains could be divided into two main evolutionary branches. Conclusions:Y.e strains isolated from raw meat in Liaocheng City carry a variety of drug resistance genes and virulence genes, and the molecular typing is highly diverse, which may cause infection risk. The molecular biological monitoring of Y.e in raw meat should be strengthened, and genome sequencing and molecular typing detection be carried out to provide the theoretical basis for foodborne illness caused by Y.e.

OBJECTIVE: To explore the clinical features and genetic basis for a Chinese pedigree diagnosed with congenital glycosylation disease (CGD). METHODS: Clinical manifestations of two brothers were analyzed. Whole exome sequencing was carried out for the sib pair. Suspected variants were verified by Sanger sequencing. RESULTS: Both the proband and her younger brother were found to carry compound heterozygous variants of the PMM2 gene, which included a known pathogenic mutation of c.395T>C (p.I132T) and a previously unreported c.448-1(delAG) in the 5' end of exon 6 of the gene. CONCLUSION The compound heterozygous variants of the PMM2 gene probably underlay the CGD in the sib pair.
Asians/genetics* ; China ; Female ; Glycosylation ; Humans ; Male ; Mutation ; Pedigree ; Whole Exome Sequencing

Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.

Background Occupational stress and depressive symptoms of disease prevention and control personnel are serious. Objective To investigate the relationship between occupational stress, psychological capital, and depressive symptoms of disease prevention and control personnel, and analyze the potential mediating effect of psychological capital on the relationship between occupational stress and depressive symptoms. Methods From July to September 2020, a cluster random sampling method was used to select 2201 employees from 21 centers for disease control and prevention as study subjects covering all levels of administrative divisions in Jiangsu Province. A total of 2036 valid questionnaires were collected with a recovery rate of 92.5%. The Core Occupational Stress Scale, Patient Health Questionnaire, and Psychological Capital Questionnaire were used to investigate their occupational stress, depressive symptoms, and psychological capital. Stratified regression analysis was used to explore the effects of occupational stress and psychological capital on depressive symptoms. A mediating effect model was used to analyze and verify the potential mediating effect of psychological capital on the relationship between occupational stress and depressive symptoms. Results The total scores in M (P₂₅, P₇₅) of occupational stress, depressive symptoms, and psychological capital in the target population were 42.0 (37.0, 48.0), 8.0 (4.0, 9.0), and 4.6 (4.0, 5.0) respectively. The positive rate of occupational stress was 31.0% (631/2036), and the positive rate of depressive symptoms was 22.0% (448/2036). The dimensional scores of organization and reward, and demand and effort of occupational stress were positively correlated with the total score of depressive symptoms [Spearman correlation coefficients (r_s) were 0.371 and 0.269, P<0.05]. The dimensional scores of social support and autonomy of occupational stress and the score of psychological capital were negatively correlated with the total score of depressive symptoms (r_s=−0.373, −0.112, −0.494, P<0.05). The organization and reward, and demand and effort had positive effects on depressive symptoms (b=0.188, 0.177, P<0.05), while social support and autonomy had negative effects on depressive symptoms (b=−0.290, −0.078, P<0.05), and associated with a 22.5% increase of explanatory variance. Psychological capital had a negative effect on depressive symptoms (b=−0.368, P<0.05), and associated with an 11.0% increase of explanatory variance. Psychological capital had mediating effects on the associations of social support, organization and reward, and autonomy with depressive symptoms, and the mediating effect values were −0.210 (95%CI: −0.253-−0.171), 0.096 (95%CI: 0.071-0.122), and −0.164 (95%CI: −0.229-−0.103), respectively. The corresponding mediating effect percentages were 40.23%, 26.97%, and 45.56%, respectively. Conclusion Occupational stress of disease prevention and control personnel can directly affect depressive symptoms, but also indirectly through psychological capital. Psychological capital plays a partial mediating role in the associations of social support, organization and reward, and autonomy of occupational stress with depressive symptoms. The occurrence of depressive symptoms can be reduced by decreasing occupational stress and increasing psychological capital.

The nucleocapsid (N) protein of SARS-CoV-2 has been reported to have a high ability of liquid-liquid phase separation, which enables its incorporation into stress granules (SGs) of host cells. However, whether SG invasion by N protein occurs in the scenario of SARS-CoV-2 infection is unknow, neither do we know its consequence. Here, we used SARS-CoV-2 to infect mammalian cells and observed the incorporation of N protein into SGs, which resulted in markedly impaired self-disassembly but stimulated cell cellular clearance of SGs. NMR experiments further showed that N protein binds to the SG-related amyloid proteins via non-specific transient interactions, which not only expedites the phase transition of these proteins to aberrant amyloid aggregation in vitro, but also promotes the aggregation of FUS with ALS-associated P525L mutation in cells. In addition, we found that ACE2 is not necessary for the infection of SARS-CoV-2 to mammalian cells. Our work indicates that SARS-CoV-2 infection can impair the disassembly of host SGs and promote the aggregation of SG-related amyloid proteins, which may lead to an increased risk of neurodegeneration.
Amyloidogenic Proteins/metabolism* ; Amyotrophic Lateral Sclerosis/genetics* ; Animals ; COVID-19 ; Cytoplasmic Granules/metabolism* ; Mammals ; SARS-CoV-2 ; Stress Granules

Objective:To investigate regional homogeneity(ReHo)and whole brain functional connectivity(FC)in patients with mild cognitive impairment(MCI), and to explore the mechanisms of MCI in the resting state.Methods:Resting-state functional magnetic resonance imaging(RS-fMRI)was performed on 24 patients with MCI and 30 age, gender and nationality-matched normal controls.Abnormal brain areas in the MCI group were screened and analyzed by using the DPARSFA2.3 and SPM8 software programs.Whole brain FC analysis was performed with the posterior cingulate cortex(PCC)/precuneus as the seed points.Results:Compared with the control group, MCI subjects displayed higher ReHo values in the frontal-middle-Left, precentral-Left, postcentral-Left, rolandic-opercular-Left, and frontal-inferior-opercular-Left and lower ReHo values in the temporal-superior-right, temporal-middle-right, postcentral-right, and temporal -pole -superior -right(Voxel level, Alphasim correction, P<0.05). Whole brain FC analysis showed greater functional connectivity of PCC/precuneus with fusiform-right, thalamus-right, lingual-right and parahippocampal-right in subjects with MCI, and less functional connectivity of the PCC/precuneus with temporal-middle-Left, angular-Left, temporal-superior-Left and occipital-middle-Left in subjects with MCI(Voxel level, Alphasim correction, P<0.05). Conclusions:Abnormalities of the default mode network may be associated with the onset of MCI, and abnormalities in posterior cingulate/precuneus connectivity may be helpful in finding imaging evidence with high sensitivity to MCI.