Objective This study aimed to evaluate the associations of serum folate and/or vitamin B12 concentrations with obesity among Chinese children and adolescents. Methods A cross-sectional study was conducted including 3,079 Chinese children and adolescents,aged 6 to 17 years,from Jiangsu,China.Anthropometric indices,such as,children's body mass index(BMI),BMI z-scores,waist circumference,and waist-to-height ratio were utilized.Multivariable linear regression and generalized additive models were used to investigate the associations of serum folate and vitamin B12 levels with anthropometric indices and odds of obesity. Results We observed that serum vitamin B12 concentrations were inversely associated with all anthropometric indices and the odds of general obesity[odds ratio(OR)= 0.68;95%confidence interval(CI)= 0.59,0.78]and abdominal obesity(OR = 0.68;95%CI = 0.60,0.77).When compared to participants with both serum vitamin levels in the two middle quartiles,those with both serum folate and vitamin B12 levels in the highest quartile were less prone to general(OR = 0.31,95%CI = 0.19,0.50)or abdominal obesity(OR = 0.46,95%CI = 0.31,0.67).Conversely,participants with vitamin B12 levels in the lowest quartile alongside folate levels in the highest quartile had higher odds of abdominal obesity(OR = 2.06,95%CI = 1.09,3.91). Conclusion Higher serum vitamin B12 concentrations,but not serum folate concentrations,were associated with lower odds of childhood obesity.Children and adolescents with high levels of vitamin B12 and folate were less likely to be obese.

The twenty-first century has already recorded more than ten major epidemics or pandemics of viral disease, including the devastating COVID-19. Novel effective antivirals with broad-spectrum coverage are urgently needed. Herein, we reported a novel broad-spectrum antiviral compound PAC5. Oral administration of PAC5 eliminated HBV cccDNA and reduced the large antigen load in distinct mouse models of HBV infection. Strikingly, oral administration of PAC5 in a hamster model of SARS-CoV-2 omicron (BA.1) infection significantly decreases viral loads and attenuates lung inflammation. Mechanistically, PAC5 binds to a pocket near Asp49 in the RNA recognition motif of hnRNPA2B1. PAC5-bound hnRNPA2B1 is extensively activated and translocated to the cytoplasm where it initiates the TBK1-IRF3 pathway, leading to the production of type I IFNs with antiviral activity. Our results indicate that PAC5 is a novel small-molecule agonist of hnRNPA2B1, which may have a role in dealing with emerging infectious diseases now and in the future.
Animals ; Mice ; Antiviral Agents/pharmacology* ; COVID-19 ; Hepatitis B virus ; Interferon Type I/metabolism* ; SARS-CoV-2/drug effects* ; Heterogeneous-Nuclear Ribonucleoprotein Group A-B/antagonists & inhibitors*

Repairing glans dehiscence after failed hypospadias repair is challenging for pediatric surgeons. Here, we introduced and evaluated a newly modified Mathieu technique, Mathieu combined tunnel (MCT), which involves multiple custom-designed flaps for the shortage of flap source material after repeated operations; we also constructed a tunnel to avoid the glans incision that may carry new risks of dehiscence. This retrospective study included 26 patients who were consecutively admitted to the First Affiliated Hospital of Sun Yat-Sen University (Guangzhou, China) for glans dehiscence repair after failed hypospadias repair from October 2014 to October 2020; sixteen patients underwent surgery using the MCT (MCT group) and ten patients underwent surgery using the tubularized incised plate (TIP) technique (TIP group). The operative time, blood loss, postoperative complications, normal urethral meatus rate, success rate, and Hypospadias Objective Penile Evaluation (HOPE) score were compared between the two groups. The MCT group achieved an overall satisfactory penile appearance and voiding function, with a higher rate of normal urethral meatus (15/16, 93.8%) and a lower rate of glans dehiscence (1/16, 6.2%), compared with the TIP group (70.0% and 30.0%, respectively). However, these differences were not statistically significant, possibly because of the limited number of patients (all P > 0.05). Mean postoperative HOPE scores were similar in the MCT group (mean ± standard deviation: 8.83 ± 0. 89) and TIP group (8.94 ± 0.57) (P > 0.05). No significant differences were found between the two groups in terms of blood loss and success rate, nor in the rates of various complications (e.g., fistula, urethral stricture, and glans dehiscence). In conclusion, the MCT technique appears to be feasible and reliable for repairing glans dehiscence after failed hypospadias repair.
Child ; Female ; Humans ; Hypospadias/surgery* ; Infant ; Male ; Retrospective Studies ; Treatment Outcome ; Urethra/surgery* ; Urologic Surgical Procedures, Male/methods*

OBJECTIVE: To investigate the effect and feasibility of closed reduction and internal fixation with PFNA in the treatment of intertrochanteric fracture of femur in the supine position without traction bed. METHODS: From June 2014 to March 2018, 45 patients with intertrochanteric fracture of femur who were treated and followed up were analyzed retrospectively. There were 21 males and 24 females, with an average age of 67.4 years (43 to 92 years);18 cases on the left side and 27 on the right side. According to Evans Jensen classification, there were 7 patients of type Ⅱ, 17 patients of type Ⅲ, 16 patients of type Ⅳ and 5 patients of type Ⅴ. The time from injury to operationwas 2 to 6 days. The operation time, blood loss and fracture healing, closing time, postoperative complications and Harris score of hip joint were recorded. RESULTS: The operation time of 45 patients was 35 to 80 min, with an average of 52.6 min;the intraoperative bleeding volume was 40 to 110 ml, with an average of 68.7 ml;the hospitalization time was 6 to 11 days, with an average of 8.4 days;the follow up time was 12 to 18 months, with an average of 14.7 months;the internal fixation of 2 patients failed, and 43 patients achieved bony healing;the deep vein thrombosis of the lower extremity in the perioperative period was 1 case, and the inferior vena cava filter was inserted;the internal fixation of 2 patients was cut out, and the hip was renovated. The incidence of complications was 8.9%(4 / 45). At the final follow up, Harris score of hip joint was 56 to 95 (81.30±8.40), including excellent 15 cases, good 26 cases, fair 2 cases and poor 2 cases. CONCLUSION It is safe and feasible to treat intertrochanteric fracture of femur with closed reduction and anti rotation intramedullary nailing under the bed without traction in a supine position. It has the advantages of small trauma and low complications, and the clinical effect is satisfactory. It is worth popularizing and using in basic hospitals.
Adult ; Aged ; Aged, 80 and over ; Bone Nails ; Female ; Fracture Fixation, Intramedullary ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Supine Position ; Treatment Outcome

Objective To determine the utility of single energy CT value and spectrum energy curve in identifying different cause of diffuse spleen enlargement.Methods 43 patients confirmed by either surgical pathology,aspiration biopsy or clinical comprehensive diagnosis and follow-up were assessed,including lymphoma with spleen infiltration(lymphoma group,n=18) and cirrhotic splenomegaly(liver cirrhosis group,n=25).All patients underwent upper abdomen CT scans in GSI mode and the GSI data were transferred to the Workstation AW 4.6 to acquire single energy CT value(40-140 keV,10 keV's interval) and spectrum energy curve of the spleen on the venous phase.All single energy CT values and the slope of curves were comparatively analyzed through independent-samples t test.The diagnostic efficiency were evaluated by ROC analysis.Results Under 40-140 keV energy range,single energy CT values were significantly lower in the lymphoma group than in the liver cirrhosis group(all P＜0.05).The spectrum energy curve were both types of decreasing.Under 40-90 keV,100-140 keV energy range,the slop of curves in the lymphoma group(2.42 ± 0.70,0.27± 0.08) were also significantly lower than in the liver cirrhosis group (3.11 ± 0.62,0.34± 0.07),respectively(all P ＜0.05).When the slope of curve under 40-90 keV energy range was selected as a diagnostic indicator,the area under the curve(AUC) would reach 0.77.If threshold value of 1.39 was taken,the sensitivity and specificity would be equal to 86 ％ and 64 ％,respectively.Conclusion Single energy CT value and spectrum energy curve are helpful for differentiation of lymphoma with spleen infiltration from cirrhotic splenomegaly.

Objective:To know the work status of clinical pharmacy in medical institutions of Guizhou province. Methods:Ques-tionnaires were used to analyze the situation of clinical pharmacy in 108 medical institutions of Guizhou province. Results: A total of 246 questionnaires were taken back, and among the 231 valid questionnaires were received including gradeⅡor above hospitals. The main contents of clinical pharmacy work carried out in medical institutions included 7 aspects: pharmacists ’ participation in ward rounds, which accounted for 47. 11%; pharmacists’ participation in case consultation, which accounted for 16. 65%; pharmacists’ participation in teaching practice, which accounted for 38. 84%; pharmacists’ participation in prescription evaluation and analysis, which accounted for 72. 73%;pharmacists’ participation in antimicrobial drug monitoring and drug use evaluation, which accounted for 62. 37%;pharmacists’ participation in drug counsultation and education, which accounted for 58. 68%;pharmacists’ participation in adverse drug reaction monitoring and supervision, which accounted for 77. 32%. Conclusion:The development of clinical pharmacy in Guizhou province still lags behind, and the number of clinical pharmacists is insufficient, which can’ t meet the growing demand for personalized medicine. In particular, the development of clinical pharmacy is restricted by the limited pharmaceutical service. The cog-nition degree of pharmacist group in Guizhou province has been improved. However, the number and the service quality of clinical pharmacists need to be improved further.

BACKGROUNDThe conventional approaches to diabetes screening are potentially limited by poor compliance and laboratory demand. This study aimed to evaluate the performance of fasting plasma glucose (FPG) and postprandial urine glucose (PUG) in screening for diabetes in Chinese high-risk population.

METHODSNine hundred and nine subjects with high-risk factors of diabetes underwent oral glucose tolerance test after an overnight fast. FPG, hemoglobin A1c, 2-h plasma glucose (2 h-PG), and 2 h-PUG were evaluated. Diabetes and prediabetes were defined by the American Diabetes Association criteria. The area under the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic accuracy of 2 h-PUG, and the optimal cut-off determined to provide the largest Youden index. Spearman correlation was used for relationship analysis.

RESULTSAmong 909 subjects, 33.4% (304/909) of subjects had prediabetes, and 17.2% (156/909) had diabetes. The 2 h-PUG was positively related to FPG and 2 h-PG (r = 0.428 and 0.551, respectively, both P < 0.001). For estimation of 2 h-PG ≥ 7.8 mmol/L and 2 h-PG ≥ 11.1 mmol/L using 2 h-PUG, the area under the ROC curve were 0.772 (95% confidence interval [CI ]: 0.738-0.806) and 0.885 (95% CI: 0.850-0.921), respectively. The corresponding optimal cut-offs for 2 h-PUG were 5.6 mmol/L and 7.5 mmol/L, respectively. Compared with FPG alone, FPG combined with 2 h-PUG had a higher sensitivity for detecting glucose abnormalities (84.1% vs. 73.7%, P < 0.001) and diabetes (82.7% vs. 48.1%, P < 0.001).

CONCLUSIONFPG combined with 2 h-PUG substantially improves the sensitivity in detecting prediabetes and diabetes relative to FPG alone, and may represent an efficient layperson-oriented diabetes screening method.

Aged ; Asian Continental Ancestry Group ; Blood Glucose ; metabolism ; Diabetes Mellitus ; blood ; diagnosis ; urine ; Fasting ; blood ; Female ; Glucose Tolerance Test ; Humans ; Male ; Mass Screening ; methods ; Middle Aged ; Postprandial Period ; physiology

To evaluate the efficacy and safety of compound Decumbent Corydalis Rhizome (DCR) in treating patients with knee osteoarthritis (OA). Totally 79 patients with knee osteoarthritis were selected from out-patient and inpatient departments of West China Hospital and randomly divided into the test group and the control group. The test group (n = 41) was given Compound DCR with the dosage of 1.8 g · d(-1), while the control group (n = 38) was administered with diclofenac sodium with the dosage of 75 mg · d(-1). After 12 weeks of treatment, the total efficacy rates based on patients/physicians evaluation for experimental and control groups were 68.29%, 63.41% and 71.05%, 63.16%, respectively, without significant difference between the two groups. Both of the two groups showed significant improvements in the main efficacy indexes (pain on walking 20 m) and minor indexes (tenderness on palpation, Western Ontario and McMaster Universities OA index (WOMAC) and Short-Form Health Survey (SF-36 ), but without significant difference in efficacy between them. The incidence of related adverse events was 24.39% in the test group and 47.37% in the control group, respectively, with significant differences between the two groups (P < 0.05). In the controlled study, compound DCR is as efficient as diclofenac sodium but more tolerable, with a good clinical application prospect.
Adult ; Aged ; Corydalis ; chemistry ; Diclofenac ; administration & dosage ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Male ; Middle Aged ; Osteoarthritis, Knee ; drug therapy ; Rhizome ; chemistry ; Treatment Outcome

OBJECTIVETo compare the advantages and disadvantages of the Foley catheter draining method versus the urethral stent plus gastric tube draining method for urine drainage following urethroplasty for hypospadias.

METHODSWe retrospectively analyzed the clinical data of 361 cases of hypospadias treated by urethroplasty. After operation, 91 of the cases received urine drainage with the Foley catheter (group A) and 270 with a urethral stent plus a gastric tube (group B). We compared the incidence rates of bladder irritation, fistula, urethral stricture, and urethral diverticulum between the two groups of patients.

RESULTSNo statistically significant differences were found between groups A and B in the incidences of bladder irritation (9.89% vs 10.70%, P > 0.05) and urethral diverticulum (1.09% vs 2.22%, P > 0.05). The incidence rate of fistula was markedly higher in group A than in B (20.80% vs 13.30%, P < 0.05), and so was that of urethral stricture (10.90% vs 5.55%, P < 0.05).

CONCLUSIONThe urethral stent plus gastric tube draining method is more effective than the Foley catheter draining method for urine drainage following urethroplasty.

Aged ; Child ; Diverticulum ; etiology ; Drainage ; methods ; Humans ; Hypospadias ; surgery ; Incidence ; Male ; Retrospective Studies ; Stents ; Urethra ; surgery ; Urethral Stricture ; etiology ; Urinary Catheterization ; instrumentation ; methods

Objective To observe the change of the serum ABCG2 level of patients with non‐small cell lung cancer(NSCLC)be‐fore and after chemotherapy ,and explore its clinical significance .Methods Venous blood specimens of 15 healthy adults and 50 pa‐tients with NSCLC were collected before and chemotherapy ,the serum ABCG2 level of these specimens were detected by ELISA . the relation between the ABCG2 level and the chemosensitivity was investigated .Results The serum ABCG2 level of patients with NSCLC before chemotherapy was significantly higher than that in healthy adults(P<0 .05);the serum ABCG2 level was not related with TNM stage in NSCLC(P<0 .05);The serum ABCG2 level of patients with NSCLC after chemotherapy was significantly high‐er than that of before(P<0 .05);in chemosensitive patients ,the different of serum ABCG2 level was not significantly before and af‐ter chemotherapy(P>0 .05);among chemoresistant patients ,the serum ABCG2 level of patients with NSCLC after chemotherapy was significantly higher than that of before(P<0 .05);the serum ABCG2 level was higher in patients with pleural effusion than the patients without pleural effusion ,but the different was not significantly(P>0 .05) .Conclusion The serum ABCG2 level of patients with NSCLC is higher than that of healthy adults ;serum ABCG2 level may become a useful indicator in predicting the effect of NSCLC chemotherapy .