Anti-signal recognition particle(SRP)necrotizing myopathy is a type of immune-mediated necrotizing myopathy(IMNM).It is a rare disease in clinical practice and has the features of insidious onset and rapid progression,with the main manifestations of symmetrical proximal limb weakness and a significant increase in creatine kinase.This ar-ticle reports a patient with positive serum anti-SRP antibody and anti-GT1a antibody accompanied by peripheral neuropa-thy and analyze related clinical data and diagnosis and treatment processes,in order to improve the understanding of this disease among clinicians.

Objective To investigate the clinical efficacy and safety of intelligent pressure controlled retrograde renal surgery(IRIRS)for the treatment of 2-3cm kidney stones.Methods Totally 110 patients with renal stones with a diameter of 2-3cm admitted to Ganzhou People's Hospital from January 2019 to December 2021 were randomly divided into IRIRS group and control group(microchannel percutaneous nephrolithotomy with vacuum aspiration),with 55 cases in each group.The surgical time,rate of stone clearance,hemoglobin decrease,scores for postoperative pain,hospital stay and incidence of complications were systematically compared between the two groups.Results The surgical time and stone clearance rates at four weeks post-operation did not exhibit any statistically significant differences between the IRIRS group and the control group(P>0.05).The hospitalization time,hemoglobin decrease,and scores for postoperative pain in the IRIRS group were notably lower compared to the control group,with these differences being statistically significant(P<0.05).The difference in total postoperative complication rates between the IRIRS and control groups was not statistically significant(P>0.05).Conclusion IRIRS is an effective and safe method for treating renal stones with a diameter of 2-3 cm,meriting broader clinical adoption and application.

Entinostat plus exemestane in hormone receptor-positive (HR+) advanced breast cancer (ABC) previously showed encouraging outcomes. This multicenter phase 3 trial evaluated the efficacy and safety of entinostat plus exemestane in Chinese patients with HR + ABC that relapsed/progressed after ≥1 endocrine therapy. Patients were randomized (2:1) to oral exemestane 25 mg/day plus entinostat (n = 235) or placebo (n = 119) 5 mg/week in 28-day cycles. The primary endpoint was the independent radiographic committee (IRC)-assessed progression-free survival (PFS). The median age was 52 (range, 28-75) years and 222 (62.7%) patients were postmenopausal. CDK4/6 inhibitors and fulvestrant were previously used in 23 (6.5%) and 92 (26.0%) patients, respectively. The baseline characteristics were comparable between the entinostat and placebo groups. The median PFS was 6.32 (95% CI, 5.30-9.11) and 3.72 (95% CI, 1.91-5.49) months in the entinostat and placebo groups (HR, 0.76; 95% CI, 0.58-0.98; P = 0.046), respectively. Grade ≥3 adverse events (AEs) occurred in 154 (65.5%) patients in the entinostat group versus 23 (19.3%) in the placebo group, and the most common grade ≥3 treatment-related AEs were neutropenia [103 (43.8%)], thrombocytopenia [20 (8.5%)], and leucopenia [15 (6.4%)]. Entinostat plus exemestane significantly improved PFS compared with exemestane, with generally manageable toxicities in HR + ABC (ClinicalTrials.gov #NCT03538171).

This study aimed to obtain the first national estimate of the prevalence of autism spectrum disorder (ASD) in Chinese children. We targeted the population of 6 to 12-year-old children for this prevalence study by multistage convenient cluster sampling. The Modified Chinese Autism Spectrum Rating Scale was used for the screening process. Of the target population of 142,086 children, 88.5% (n = 125,806) participated in the study. A total of 363 children were confirmed as having ASD. The observed ASD prevalence rate was 0.29% (95% CI: 0.26%-0.32%) for the overall population. After adjustment for response rates, the estimated number of ASD cases was 867 in the target population sample, thereby achieving an estimated prevalence of 0.70% (95% CI: 0.64%-0.74%). The prevalence was significantly higher in boys than in girls (0.95%; 95% CI: 0.87%-1.02% versus 0.30%; 95% CI: 0.26%-0.34%; P < 0.001). Of the 363 confirmed ASD cases, 43.3% were newly diagnosed, and most of those (90.4%) were attending regular schools, and 68.8% of the children with ASD had at least one neuropsychiatric comorbidity. Our findings provide reliable data on the estimated ASD prevalence and comorbidities in Chinese children.

Breast cancer is the most common cancer for Chinese women. Early screening is the best way to improve the rates of early diagnosis and early treatment of breast cancer. The peak ages of breast cancer in Chinese women are obviously different from those in the European and American countries. It is imperative to develop a guideline for breast cancer screening that is suitable for Chinese women. Based on the analysis and summary of breast cancer screening data in China, and the latest guidelines and consensus on breast cancer screening in Europe, the United States and East Asia, China Anti-Cancer Association and National Clinical Research Center for Cancer (Tianjin Medical University Cancer Institute and Hospital) has developed a population-based guideline for breast cancer screening in Chinese women. This guideline has provided detailed recommendations on the screening starting age, screening modalities, and screening interval in Chinese women with average risk and high risk of breast cancer, respectively. This article aims to interpret the above guideline, providing references for professionals in breast cancer screening.

Objective The role of this essay is to explore the relationship of BIM deletion polymorphism and paclitaxel intrinsic resistance in breast cancer. Methods Human breast cancer cell lines were screened by techniques of PCR and gene sequencing to detect BIM deletion polymorphism.MTS was used to detect the cytotoxic effects of paclitaxel in different cell lines. Meanwhile,levels of BIM mRNA and protein were detected by rtPCR and Western Blot. Results Comparing with the wild type cell line(MCF7),T47D was a deletion cell line with BIM deletion polymorphism and resistant to paclitaxel(T47D vs.MCF-7,IC50>30le vs.IC50=0.16 vs.02 μmol/L). Moreover,the ratio of BIM EXON3 to EXON4 was significantly increased and the level of functional BIM protein was down-regulated in T47D compared with MCF7(P < 0.05). Conclusion BIM deletion polymorphism might initiate intrinsic resistance to paclitaxel therapy in breast cancer.

Objective To investigate the incidence of enteric pathogens causing acute gastroenteritis (AGE) among children to measure the incidence of coinfections,and to compare the clinical characteristics of those infected with one versus multiple agents.Methods A retrospective study was conducted from January 2014 to December 2014.All patients between 1 month and 14 years of age admitted to the Pediatric department with a diagnosis of AGE were eligible for enrollment.Two stool samples for each patient were tested for gastrointestinal pathogens.We summarized the clinical severity of episodes,describing the duration of diarrhea,duration and frequency of vomiting,fever.All patients underwent medical evaluation with estimation of dehydration.Results One or more etiological agents were detected in 3595 out of 4728 patients(76.0％),while we did not detect any etiological agent in 1133 (24.0％).Rotavirus was detected in 1889 (40.0％),adenovirus in 412 (8.7 ％),norovirus in 309 (6.5 ％),verotoxigenic Escherichia coli (VTEC) in 274 (5.8 ％),Salmonella spp.in 276(5.8％),Klebsiella pneumoniae in 123 (2.6％),Shigella spp.in 78 (1.6％),Staphylococcus aureus in 70 (1.5％),C.perfringens in 126(2.7％).In 1370 children out of 4728(29.0％),we found evidence of coinfection.with rotavirus and norovirus was the most common 150 (3.2％),rotavirus and C.perfringens was also common 127(2.7％).Children with coinfection had a more severe clinical presentation.The difference has statistical significance.Conclusion Rotavirus is still the most common pathogen in children with acute diarrhea,followed by NV,adenovirus,Salmonella spp.and VTEC.Rotavirus with norovirus infection was the most common.VTEC combined with three kinds of virus infection had the highest incidence.Children with multiple viral infections were more severe than those of single virus infection in the duration of vomiting and dehydration.There was no significant difference in the duration of fever and diarrhea and the frequency of diarrhea.Children infected by viruses and bacteria had a more severe clinical presentation such as fever,vomiting and diarrhea lasting for a long time,more serious diarrhea and dehydration than those with single bacteria and single virus infection.The difference has no significant difference in degree and duration of diarrhea.

Objective To assess the clinical value and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for duodenal lesions.Methods The data of 12 patients with duodenal space-occupying lesions underwent EMR or ESD from January 2010 to December 2015 in Chinese PLA General Hospital were retrospectively analysed.Results All patients received operation, including 9 male and 3 female with mean age of 50.0 years(33.0-62.0 years).There were 8 lesions in duodenal bulb and 4 in descending part.The mean diameter of the lesions was 1.2 cm (0.5-3.0 cm).Three lesions were originated from mucosa, of which 2 were high-grade intraepithelial neoplasia and 1 was villous/tubular adenoma.Nine lesions were located in submucosa, including 3 cases of neuroendocrine neoplasm, 1 case of stromal tumor, 1 liomyoma case, 1 lipoma case, 1 case of Brunner glands adenoma, 1 case of ectopic pancreas, and 1 inflammatory lesion.One patient had perforation with rate of 8.3%(1/12) and was recovered after conserved treatment.The bleeding was very little during operation.No infection or stenosis happened.The mean hospitalized time was 6.0 days (1.0-12.0 days) after operation.No recurrence was found during 23.8 months(3.0-73.0 months) of follow-up.Conclusion EMR and ESD are effective and safe for treatment of duodenal space-occupying lesions.

OBJECTIVETo explore the etiology and clinical characteristics of hypoxic hepatitis (HH) in children.

METHODClinical data of 7 patients with HH in Shenzhen Children's Hospital from January 2011 to March 2014 were retrospectively reviewed.

RESULTSeven cases diagnosed as HH, age from 4 months to 11 years, were admitted to pediatric intensive care unit (PICU), and accounted for 0.32% of patients in PICU during the same period. The primary causes of HH were respiratory failure and cardiac shock caused by severe hand-foot-and-mouth disease, fulminant myocarditis, infant muggy syndrome . Serologic tests for hepatitis B virus, hepatitis C virus, as well as serum antibody and DNA for Epstein-Barr virus and cytomegalovirus were all negative. There was an increase of alanine aminotransferase (ALT) (≥20 time supper limit of normal (ULN), the highest ALT was more than 130 times ULN in all the patients, which was decreased to 2 times ULN from peak within 10 days. There was a significant relationship between ALT and aspartate aminotransferase(AST)in 3 cases(r=1.000, 1.000, and 0.833, respectively, P<0.05), ALT and lactate dehydrogenase (LDH)in 2 cases(r=1.000 and 0.886, respectively, P<0.05), ALT and blood urea nitrogen(BUN)in 1 case(r=1.000, P<0.05), and ALT and creatine kinase(CK)in 1 case(r=0.964, P<0.05). The ALT, AST and LDH returned to normal soon after the primary diseases were controlled.

CONCLUSIONSevere heart failure, hypoxemia, shock, etc. are the leading primary diseases causing HH. The sharp increase in ALT, AST and LDH is the typical laboratory manifestion in HH after the onset, which may decline to normal shortly after the treatment, sometimes complicated with reversible change in BUN or CK.

Alanine Transaminase ; Animals ; Aspartate Aminotransferases ; Child ; Child, Preschool ; Creatine Kinase ; Heart Failure ; Hepatitis ; Herpesvirus 4, Human ; Humans ; Hypoxia ; Infant ; L-Lactate Dehydrogenase ; Respiratory Insufficiency ; Retrospective Studies

Objective To explore the efficacy and adverse reactions of diminishing scheme of cefaclor sustained re-lease tablets in the treatment of recurrent urinary tract infection(RUTI).Methods 60 RUTI patients in a hospital were divided into treatment group(n=30)and control group (n=30),patients in treatment group were treated with diminishing scheme of cefaclor sustained release tablets,patients in control group were treated with diminishing scheme of levofloxacin tablets,clinical therapeutic efficacy and adverse reactions of two groups were observed. Results The curative rate in treatment group was higher than control group ([80.00%,n =24]vs [53.33%,n =16])(χ2 =4.80,P =0.028).The incidence of RUTI in treatment group was lower than control group ([6.67%,n=2]vs [26.67%,n=8])(χ2 =4.32,P =0.038).Incidence of adverse reactions in treatment group was lower than control group (16.67% vs 50.00%)(χ2 =7.50,P =0.006).Conclusion The diminishing scheme of cefaclor sus-tained release tablets in the treatment of RUTI has good curative efficacy,low recurrence rate,fewer adverse reac-tions,and can be used for the treatment of recurrence of RUTI.