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25 September 2021, Volume 48 Issue 05
    

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  • CAI Jia-li, WANG Xia, YIN An-wen, SHEN Ye-jiao, XIAO Qing-qing, SHEN Ling-hong, HE Ben
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    Objective To investigate the role of Atorvastatin (ATO) in mice with metabolic disorders and cardiac remodeling induced by high fat diet (HFD) and N-nitro-L-arginine methyl ester (L-NAME). Methods HFD+L-NAME was used to construct the mice cardiac remodeling model induced by metabolic syndrome.C57BL/6 mice were randomly divided into the control group (Chow), the model group (HFD+L-NAME +Vehicle), the 10 mg·kg-1·d-1 ATO group (HFD+L-NAME+ATO10) and the mg·kg-1·d-1 ATO group (HFD+L-NAME+ATO20).The changes of fasting blood glucose, glucose tolerance test, blood lipid levels, body weight and blood pressure in mice were monitored.After 12 weeks of modeling, cardiac function of the mice was evaluated by Echo. HE staining was used to observe the changes of heart morphology and ventricular wall thickness, and Masson staining was used to observe the changes of cardiac fibrosis.The changes of myocardial size were observed by WGA immunofluorescence, and the protein expressions of Collagen Ⅰ and α-SMA were detected by Western blot. Results Compared with the model group, Atorvastatin reduced the HFD+L-NAME induced fasting glucose increase (P=0.006, F=5.56), maintained blood glucose and lipid homeostasis, and inhibited the increase of body weight (P<0.001, F=11.75) and blood pressure in mice.Echo results showed that Atorvastatin improved HFD+L-NAME induced the mice cardiac output reduction (P<0.001, F=23.56).The results of WGA and protein immunoblotting showed that Atorvastatin inhibited HFD+L-NAME induced cardiac wall thickness increased (P<0.001, F=11.75), myocardinal fibrosis increased (P=0.002, F=10.95), myocardial hypertrophy (P<0.001, F=40.08), Collagen Ⅰ (P=0.014, F=4.49) and α-SMA (P=0.004, F=6.28) protein expression increased in mice. Conclusion Atorvastatin improves the abnormal glucose and lipid metabolism, obesity and hypertension induced by HFD+L-NAME, and inhibits the cardiac remodeling induced by HFD+L-NAME in mice.
  • CHEN Ying-wei, XU Ji-xiang, WANG Yi, YAN Hui-hui, GAO Jun-ling
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    Objective To understand public preference and immunization willingness for COVID-19 vaccine in China, and analyze influence factors, provide references for sufficient vaccination coverage. Methods An online D-efficient discrete choice experiment was conducted from Jan 5, 2021 to Jan 12, 2021, in 1 241 people (with 1066 valid feedbacks), using choice sets with 5 vaccine attributes:protection rate, adverse effect, protection duration, convenience of vaccination, and out-of-pocket cost.Conditional Logit and panel mixed Logit models were used to analyze the effect of vaccine attributes on preferences, while random-effects Logit model was used to analyze the effect of vaccine attributes on vaccination willingness. Results The COVID-19 vaccine with high protection rate(βefficacy 95%=1.76, P<0.001), low adverse effects(βlow risk=1.93, P<0.001), long protection duration (β5 years=0.59, P<0.001), convenient vaccination process(βconvenient=0.53, P<0.001), and less cost(βcost=0.14, P<0.001) was preferred by the public. Conclusion Public preference and vaccination willingness for COVID-19 vaccine influenced by all 5 vaccine attributes (protection rate, adverse effect, protection duration, convenience of vaccination, and out-of-pocket cost).The efficacy and safety of the vaccine had the most significant impact.
  • LI Xue-jie, ZHOU Nian-wei, SUN Min-min, LI Wei, WANG Yong-shi, XIE Hui-lin, SHU Xian-hong
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    Objective To investigate the gene variation and phenotype characteristics of filamin C (FLNC) in Han patients with cardiomyopathy, and further improve the variant spectrum of FLNC. Methods A total of 150 patients with hypertrophic cardiomyopathy (HCM) and 50 patients with dilated cardiomyopathy (DCM) were enrolled in this study.The whole exome sequencing of DNA from patient's peripheral blood was performed.The sequencing results were analyzed and screened.FLNC mutations were then confirmed by Sanger sequencing performed on probands and their available relatives.Clinical information of the probands and their relatives was collected. Results In all probands, 6 FLNC variants were detected, which were all new variants that had not been published.One case was familial DCM, and the rest were sporadic cases.All of them were missense variants in HCM patients and truncated variants in DCM patients. Conclusion Various types of FLNC variants participate in different cardiomyopathy through different mechanisms. This study preliminarily summarized the correlation of different variation and phenotypes, and expanded the variant spectrum of FLNC in Chinese Han patients with cardiomyopathy.
  • CHEN Rui-fang, YUE Hui-ran, LI Wen-zhi, LU Xin, LI Jun
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    Objectives To evaluate the expression and prognostic value of myeloid zinc finger 1 (MZF1) in ovarian cancer. Methods We first analyzed the differential expression of MZF1 among fallopian tube epitheliums, low malignant potential ovarian tumors (borderline ovarian tumor), and ovarian cancers using Gene Expression Ominus (GEO) database (GSE10971 and GSE12172 datasets).Then, we assessed the relationship between MZF1 expression and overall survival (OS) of ovarian cancer patients using GEO database and The Cancer Genome Altas (TCGA) database.Finally, gene set enrichment analysis (GSEA) was performed to identify the potential MZF1-associated signaling pathways in ovarian cancer patients. Results (1) MZF1 expression was decreased in ovarian cancers compared with that in fallopian tubes and low malignant potential ovarian tumors;(2) In optimally debulked ovarian cancer patients, increased expression of MZF1 was associated with improved progression free survival and overall survival;(3) GSEA indicated that the genes involved in inflammatory response, epithelial-to-mesenchymal transition, angiogenesis, and adipogenesis were strongly enriched in ovarian cancer tissues with relatively low expression of MZF1. Conclusion MZF1 expression was decreased in ovarian cancer tissues, and increased MZF1 expression was associated with a better clinical outcome. MZF1 may play a tumor-suppressive role in ovarian cancer.
  • MAO Li-juan, CAO Jia-ying, WANG Wen-ping, HAN Hong, CHEN Kai-ling, MAO Feng, DONG Yi
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    Objective To investigate the enhancement features of dynamic three-dimensional contrast-enhanced ultrasound (3D-CEUS) in focal liver lesions (FLLs). Methods According to the inclusion and exclusion criteria, 210 patients with 210 FLLss confirmed by pathological examination or clinical follow-up were enrolled in our study.Both conventional two-dimensional contrast-enhanced ultrasound (2D-CEUS) and dynamic 3D-CEUS were performed in the same lesion and the images acquired were assessed.The differences of the feeding vessels, enhancement pattern and intratumoral vessels of the same lesion on the two modes were compared statistically. Results Dynamic 3D-CEUS was similar to 2D-CEUS (P=0.887) with respect to enhancement patterns.Compared with 2D-CEUS, dynamic 3D-CEUS provided more detailed information about the number, continuity and morphology of the feeding vessels (P<0.001).Dynamic 3D-CEUS was also superior to 2D-CEUS in the display of intratumoral vessels (P<0.001). Conclusion Dynamic 3D-CEUS is an useful tool for displaying the enhancement patterns in arterial phase of FLLss.Compared with 2D-CEUS, dynamic 3D-CEUS provides additional information of vascular characteristics in the diagnosis of FLLss.
  • JIANG Yi-zhou, ZHANG Wei-bo, WANG Ying-ying, ZHU Li-na, ZHUANG Wen-xu, CAI Jun, WANG Na
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    Objective To evaluate the impact of COVID-19 epidemic on anxiety status of active psychological counselors in Shanghai, China. Methods We collected the demographic information of participants, cognition and attention to COVID-19, attitude towards the disappearance of COVID-19 and answers to the State-Trait Anxiety Inventory (STAI) on the Shanghai online psychological counseling platform from Feb 4th, 2020 to Mar 11st, 2020.Multiple Logistic regression was used to analyze the associations between COVID-19 epidemic and State-anxiety and Trait-anxiety. Results Of 704 participants with an average age of 33.24 years (ranging from 18 to 73 years), the mean State-scores and Trait-scores were 44.49±6.31 and 46.19±5.22, respectively.In multivariate Logistic regression analysis, after gender stratification and adjustment of related variables, we found that for males, engaging in relevant prevention and control work was associated with a lower risk for medium or high State-anxiety (OR=0.28, 95%CI:0.09-0.89), and holding a intensively positive attitude was associated with a lower risk for medium or high Trait-anxiety (OR=0.25, 95%CI:0.07-0.87);while for females, those with medical background had a lower risk for State-anxiety (OR=0.17, 95%CI:0.03-0.92), and those paying moderate attention to epidemic had a lower risk for Trait-anxiety (OR=0.22, 95%CI:0.07-0.69). Conclusion COVID-19 epidemic had different effects on the anxiety status of psychological counselors with different characteristics.Psychological counselors who have poor cognition of the epidemic, excessive attention to the epidemic, low hope for the disappearance of the epidemic, and non-disease prevention and control profession are more susceptible to greater anxiety, which are the key objects of protection in the event of public health emergencies.
  • ZHANG Xing-can, ZHAO Wan, ZHENG Huang, BI Chen-chen, SU Hua-lin, YANG Ying
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    Objective To investigate the prevalence of rush popper use and its related factors among men who have sex with men (MSM) in Shanghai, and to provide theoretical basis for making and implementing intervention measures for MSM. Methods From 2019 to 2020, a cross-sectional survey was conducted.A face-to-face anonymous survey was conducted among MSM to collect demographic information (such as age, nationality, educational level, marital status, etc.), the use of rush popper in the last six months, and the characteristics of sexual behavior.HIV and syphilis serological tests were carried out. χ2 test or Fisher exact probability method was used to compare the differences of rush popper use among different characteristics and sexual behaviors.Multivariate Logistic regression was used to analyze the influencing factors of rush popper usage. Results A total of 479 of MSM were investigated, 45.3% (217/479) of them had used rush popper in the past 6 months.The prevalence rates of HIV or syphilis among the MSM were 13.4% (64/479) and 6.1% (29/479), respectively.Multivariate Logistic regression showed that factors related to rush popper use include:monthly income level of 6 000-9 999 yuan (aOR=2.379, 95%CI:1.056-5.356);registered residence in other provinces (aOR=1.968, 95%CI:1.267-3.050);had used Internet or dating software to find male sexual partners(aOR=2.583, 95%CI:1.067-6.254);had anal intercourse (aOR=3.426, 95%CI:1.486-7.895);receptive role in anal intercourse (aOR=1.879, 95%CI:1.092-3.232);had sex with 7 or more people in the past 6 months (aOR=3.161, 95%CI:1.532-6.519);never used condom when having sex with their spouse (aOR=2.747, 95%CI:1.101-6.856);sometimes used condom when having sex with their spouse (aOR=2.846 (95%CI:1.171-6.917);HIV positive (aOR=2.310, 95%CI:1.247-4.279). Conclusion Use of rush popper was high among MSM in Shanghai.A strong correlation between MSM rush popper use and high-risk sexual behaviors of HIV positive was observed.Measures should be taken to reduce the abuse of rush popper in MSM is of great significance for the prevention and control of AIDS.
  • FANG Liang, WANG Wen-ping, CHEN Yue, HUANG Bei-jian, MAO Feng, DONG Yi, ZHU Zheng
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    Objective To explore the diagnostic value of real-time contrast-enhanced ultrasound(CEUS) for small hepatic hemangionmas. Methods An analysis was conducted of 81 surgically and pathologically confirmed small hepatic hemangiomas in 73 patients from Jun 2015 to Jul 2019.All the hemangiomas were examined by both conventional ultrasound (CU) and real-time contrast-enhanced ultrasound, and the two modalities were compared for diagnostic accuracy. Results After injection of contrast agent, enhancement was observed in all hemangiomas in the arterial phase, with 60 showing peripheral nodular enhancement and 21 peripheral ring enhancement. Whole-tumor enhancement in the portal phase or delayed phase occurred in 64(79.0%) lesions, and partial tumor enhancement in 17(21.0%) lesions.During portal phase and delayed phase, 56 lesions were hyperechoic, 20 isoechoic, and 5 hypoechoic.The accuracy rate was 77.8% (63/81) for conventional ultrasound and 96.3% (78/81) for contrast-enhanced ultrasound, the difference was statistically significant (P<0.05). Conclusion Real-time contrast-enhanced ultrasound is able to show the dynamic enhancement patterns of small hepatic hemangionmas with high sensitivity, and its use enhances the diagnostic accuracy.
  • LI Man-shi, HUANG Wei-feng, LU Yi-han
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    Objective To determine the metagenomic next-generation sequencing (mNGS) for infectious diseases, and to compare the consistency of taxonomic profiling between two databases. Methods Different clinical specimens from patients with infectious diseases were collected and sequenced using mNGS. The NCBI NR database and MetaPhlAn2 were employed for taxonomic profiling, in which the consistency between the two databases was evaluated. Results From Jun 2019 to Oct 2020, in four hospitals of Shanghai, metagenomic sequencing data of 174 specimens collected from patients with suspected infectious diseases were analyzed. The detection proportion based on the NCBI database was 67.2% and on MetaPhlAn2 was 93.1%.The taxonomic profile among different types of specimens varied.The detection proportion in blood and cerebrospinal fluid specimens was relatively low, compared to other types of specimens.Based on the preliminary annotation and classified by the type of microorganism (bacteria, virus, fungi, or undetected), the consistency between the two databases was only 36.8% (κ=0.177 9, Z=5.2781, P<0.000 1).After adjusting the interpretation criteria on both databases, the consistency was improved to be 73.0% (κ=0.571 2, Z=11.7362, P<0.000 1).Among them, the highest consistency of 74.0% of microbial species was observed in cerebrospinal fluid specimens (κ=0.512 0, Z=5.139 2, P<0.000 1). Conclusion Both databases could identify and profile the major pathogens existed in all specimens.For those collected from aseptic sites, MetaPhlAn2 has good consistency with traditional NCBI in taxonomic profiling, which could be used as a supplement.
  • LIU Jie, FAN Bing, ZHAO Xin, YAO Kang, WU Hong-yi, GE Jun-bo
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    Objective To evaluate the relationship between platelet activity as measured by thrombelastography (TEG) and interventional procedure and periprocedural myocardial injury (PMI) in patients undergoing selective percutaneous coronary intervention (PCI). Methods The data was collected from 378 patients of coronary heart disease (CHD) who received coronary arteriography (CAG) and stent implantation in Department of Cardiology, Zhongshan Hospital from Jan to Oct, 2017.After 12 hours of dual anti-platelet drug load, platelet reaction of the patients was measured by TEG.The number and length of stents in PCI were counted.Thrombin-induced maximum amplitude of clot strength (MAThrombin) reflected the intrinsic platelet activity, AA% and ADP% reflected the platelet inhibition rate of aspirin and clopidogrel, respectively. Results A total of 98 patients (25.9%) occurred PMI. Compared with the non-PMI group, the ADP% in PMI group was poor (48.5%±24.0% vs. 54.7%±25.9%, P=0.038).However, there was no significant difference between the two groups in the inhibitory rate of MAThrombin and AA%.Multi-factor Logistic regression revealed that age (OR=1.041, 95%CI:1.013-1.071, P=0.004), number of stents ≥ 3 (OR=3.009, 95%CI:1.590-5.694, P=0.001), length of stents ≥ 40 mm (OR=2.687, 95%CI:1.436-5.030, P=0.002) and ADP% (OR=0.990, 95%CI:0.980-0.999, P=0.040) are independent predictors of PMI occurrence. Conclusion PMI is a result mediated by multiple factors in patients undergoing selective coronary stenting. In addition to age, the number and length of stents implanted, the clopidogrel resistance were also independent risk factors for the occurrence of PMI.
  • Medical Experience Communications
  • ZHANG Ya-wen, ZHANG Qiong-yue, TAO Jun-jun, MIAO Qing, ZENG Fang-fang, ZHOU Li-nuo, YANG Ye-hong
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    Objective To identify related factors for hypoglycemic episodes in patients with type 2 diabetes mellitus (T2DM) through continuous glucose monitoring (CGM). Methods The included 147 patients with T2DM were those who had undergone CGM for 5 days in our ward of Department of Endocrinology and Metabolism, Huashan Hospital from Dec 2018 to Oct 2019.The general information, laboratory parameters and CGM parameters of the patients were collected. According to whether there was an episode of hypoglycemia during the monitoring period, the patients were divided into non-hypoglycemia group and hypoglycemic group.A single hypoglycemia episode was defined as a sensor monitoring blood glucose of less than 3.9 mmol/L and lasting for more than 15 minutes.CGM parameters included the mean blood glucose (MBG), standard deviation (SD), coefficient of variation (CV), the differences between maximum and minimum blood glucose (BG) levels (ΔBG), mean amplitude of glycemic excursions (MAGE) and the percentage of time in range (%TIR) of BG at <3.9 mmol/L, 3.9-7.8 mmol/L, >7.8 mmol/L, 3.9-10.0 mmol/L, and >10.0 mmol/L. Results Logistic regression analysis showed that lower estimated glomerular filtration rate (eGFR) levels, increased use of insulin and its analogs and lower MBG levels were associated with hypoglycemic episodes. Spearman correlation analysis showed that the MBG level and the%TIR of BG>7.8 mmol/L and BG>10.0 mmol/L were negatively associated while glycemic variability (GV) levels (SD, CV, ΔBG, MAGE) and% TIR of BG at 3.9-7.8 mmol/L were positively associated with hypoglycemic episodes.Pearson correlation analysis showed that the duration of hypoglycemic episodes was positively correlated with the use of sulfonylureas and CV levels. Conclusion Lower eGFR levels, increased treatment with insulin and its analogs and lower MBG levels were related factors for hypoglycemic episodes in patients with T2DM.
  • RU De-wen, YAN Yu-feng, SHEN Xiao, LIU Meng, WANG Er-song
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    Objective To investigate the changes of plasma endothelial cell specific molecule-1 (ESM-1) level at early stage after injury in patients with traumatic brain injury (TBI) and its relationships with the severity and prognosis of TBI. Methods A total of 94 TBI patients, admitted to the Department of Neurosurgery, Jinshan Hospital of Fudan University from Jun 2017 to Dec 2019, were recruited and their clinical data were collected.Then, all of the patients were divided into mild TBI group (n=36), moderate TBI group (n=32) and severe TBI group (n=26) according to admission Glasgow Coma Score (GCS).According to the Glasgow Outcome Score (GOS), all TBI patients were divided into good prognosis group (GOS 4-5) and poor prognosis group (GOS 1-3).Forty-eight patients with intracranial pressure(ICP) probe were divided into controlled ICP group (ICP ≤ 15 mmHg), elevated ICP group (15 mmHg
  • Method and Technique
  • SONG Xi-xi, WANG Jian, CAI Hui, YANG Cheng-yu, MO Yu-qing, ZHU Meng-chan, ZHU Gui-ping, YE Ling, JIN Mei-ling
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    Objective To quantify the degree of pulmonary cystic damage in CT and compare its correlation with pulmonary function tests (PFTs) and serum levels of vascular endothelial growth factor (VEGF-D), and to study the potential of quantitative CT to assess the degree of lung damage and decide treatment in lymphangioleiomyomatosis (LAM). Methods Pulmonary cystic areas in CT images were identified by the artificial intelligence software.The volumetric percentage of cystic regions of the total lung volume was calculated to get a cyst score.The association between the 36 times of CT scan and PFTs were analyzed in 21 patients.The correlation of serum VEGF-D levels of 17 patients and their 24 times of CT scan were studied.A ROC curve was calculated to select the threshold at which the cyst scores could predict the lung impairment best. Results Cyst scores correlated significantly with percentage of predicted forced of expiratory volume in one second (FEV1%pred) (r=-0.72, P<0.001) and percentage of predicted diffusion capacity (DLCO/VA%pred) (r=-0.821, P<0.000 1), while its correlation with serum VEGF-D levels (r=-0.143, P=0.506) was not obvious. The Youden index is max (0.667) with a 94.44% sensitivity and a 72.22% specificity when cyst score is 15.80%. Conclusion Pulmonary cyst scores on CT is strongly correlated with FEV1%pred and DLCO/VA%pred. However, the association with serum levels of VEGF-D is not obvious. Cyst score>15.80% might indicate an abnormal lung function and patients are recommended a sirolimus treatment.
  • Reviews
  • LI Xiao-chen, CHEN Yu, WANG Yan-qing, MAO-YING Qi-liang
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    Inflammatory pain is one of the most common types of chronic pain.G-protein-coupled receptor kinase 2 (GRK2) can regulate the rapid desensitization of G-protein-coupled receptors (GPCRs) and subsequently protect cells against overstimulation.In recent years, accumulating evidence suggests that GRK2 plays a crucial role in the regulation of inflammatory pain.There are several studies which have indicated that GRK2 plays a key role in modulating the transition from acute to chronic inflammatory pain.The level of GRK2 in dorsal root ganglia is reduced in the model of inflammatory pain induced by Freund's complete adjuvant (FCA) or carrageenan, and overexpression of GRK2 can relieve chronic inflammatory pain.The GRK2 in different neural cells is involved in different models of inflammatory pain:reduced GRK2 levels in primary sensory neurons causes the activation of exchange protein 1 directly activated by cAMP 1(Epac1) and other signaling pathways, involved in the regulation of inflammatory pain induced by prostaglandin E2 (PGE2), epinephrine (EPI), CFA and carrageenan;and reduced GRK2 levels in microglia result in microglia activation, which leads to neuroinflammation and is involved in interleukin-1β- and carrageenan-induced inflammatory pain.This review summarizes the recent evidence for a major contribution of GRK2 in neurons, microglia and astrocytes in inflammatory pain, which will help to further study the mechanisms of inflammatory pain and development of new drugs.
  • LI Yin, CHEN Yi-wei, CHEN Fang-hua, ZHANG Shu, LU Chun-lai
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    Glycosylation is an important protein post-translational modification. Both programmed cell death-1 (PD-1) and programmed cell death ligand-1 (PD-L1) are heavily glycosylated and their glycosylation significantly affects the efficacy of immunotherapy.There are four N-glycosylated sites of PD-1, including N49, N58, N74 and N116. Fucosyl transferase 8 (FUT8) can catalyze the core fucosylation of PD-1.Monoclonal antibodies targeting at the N58 site of PD-1 can effectively block the PD-1/PD-L1 interaction. In addition, blocking N74 glycosylation site of PD-1 of chimeric antigen receptor T-cell (CAR-T) can enhance its killing effect.PD-L1 also has four glycosylation sites, namely, N35, N192, N200 and N219.Inhibition or promotion of the glycosylation of PD-L1 can result in certain biological effects.In this review, we summarized the impact of glycosylation on the expression and function of PD-1/PD-L1, aiming to provide novel insights based on glycosylation for improving the efficacy of tumor immunotherapy.
  • ZHANG Yang, WANG Yi-mei, JIANG Wu-hua, ZHAO Shuan, DING Xiao-qiang
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    Acute kidney injury (AKI) is a common clinical critical complication with high incidence and mortality. Early diagnosis and treatment of AKI is an effective way to reduce mortality and treatment costs. At present, the biomarker for diagnosis of AKI is the product of the concentration of tissue inhibitors of metalloproteinase 2 (TIMP2) and insulin-like growth factor binding protein 7 (IGFBP7) in urine.However, the biological functions of TIMP2 and IGFBP7, especially in the kidney, remain unclear compared with other biomarkers of AKI.Therefore, we reviewed the protein characteristics and biological functions of the two families, as well as the role of the two proteins in kidney development and AKI progression, which can provide a theoretical reference for clinicians to understand TIMP2 and IGFBP7 in addition to their role as AKI biomarkers and a new perspective for more accurate and efficient use of TIMP2 and IGFBP7 in diagnosis and treatment of AKI.
  • ZHU Gui-ping, YE Ling, JIN Mei-ling
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    The difficulty in the treatment of steriod resistant asthma has always been the priority of asthma research. It has been found that abnormal glucocorticoid receptor (GR) and decreased histone deacetylase 2 (HDAC2) activity play important roles in the pathogenesis of steroid resistant asthma. In addition, Th cell immune imbalance, infection, obesity, non-coding RNA and autophagy also play critical parts in steriod resistant asthma, becoming research focus in asthma recently. In this paper, the research progress of the pathogenesis of steriod resistant asthma above is reviewed in order to improve the understanding of steriod resistant asthma and provide directions for future treatment.
  • SI Jing-yi, PIAO Si-rong, WU Hao
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    Neuropsychiatric systemic lupus erythematosus (NPSLE) is a series of severe complications of systemic lupus erythematosus (SLE).It affects the nervous system and leads to neurological and psychiatric symptoms.At present, the pathogenesis of NPSLE is still unclear, which may be related to a variety of immune responses.Microglia (MG) are immune cells in the central nervous system (CNS).This review summarized the relevant evidence of MG participation in NPSLE, and reviewed the studies on MG involvement in the occurrence and development of NPSLE through phagocytosis and neurotoxicity.It is expected to provide new ideas and clues for further study of the pathogenesis and the effective treatment of NPSLE.
  • LUO Yu-fan, YANG Xiao-li, SUN Wen-bo, ZHONG Ping, HAN Xiang, WU Dan-hong
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    Cerebral small vessel disease (CSVD), the most common cerebrovascular disease in the elderly, is strongly associated with retinal vascular changes.The development of artificial intelligence (AI) has enhanced retinal fundus image processing and further advanced the CSVD retinal vascular changes research.This review performed an overview on the AI-assisted research on CSVD retinal vascular changes, through a systematic review of AI's recognition of typical retinopathy, retinal vascular diameter and geometric changes, and AI's recognition of characteristic changes in octa.We further discussed the future direction of the research on the retinal vascular changes of CSVD assisted by AI.
  • Short Reports
  • FANG Hong-ji, HAN Ming-hui, WANG Yuan-ping, YANG Dong-jian, WANG He-xing, JIANG Qing-wu
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    To investigate the incidence of dyspepsia in school-age children in Changning District of Shanghai and to study the effect of dietary patterns on it, a total of 304 healthy children aged 7-11 years were selected from 5 primary schools in Changning District in Sep 2019.The basic information, living habits, food consumption and the incidence of dyspeptic symptoms were investigated by questionnaire. Factor analysis was used to extract dietary patterns, and Logistic regression was used to analyze the relationship between dietary patterns and dyspeptic symptoms of school-age children.The number of people with abdominal pain, diarrhea, constipation and bad breath within half a year accounted for 42.4% (123/290), 48.3% (140/290), 39.1% (115/294) and 50.7% (148/292), respectively.Increasing age, boys, overweight or obese mothers, smoking and low water intake may be risk factors for dyspeptic symptoms, and a high degree of parental education may be a protective factor for dyspeptic symptoms.Children in the high group of seafood dietary pattern had an increased incidence of diarrhea (OR=1.87, 95%CI:1.10-3.20) and constipation within half a year (OR=1.80, 95%CI:1.06-3.06).Children in the high group of dairy dietary pattern had a lower incidence of abdominal pain (OR=0.54, 95%CI:0.32-0.91) and diarrhea (OR=0.51, 95%CI:0.30-0.87) within half a year. Children in the high group of traditional diet pattern had a lower incidence of diarrhea within half a year (OR=0.51, 95%CI:0.30-0.87).Children in the high-calorie dietary group had an increased incidence of abdominal pain (OR=1.78, 95%CI:1.06-2.99) and bad breath (OR=1.86, 95%CI:1.11-3.12) within half a year. School-age children in Changning District of Shanghai have a higher incidence of dyspeptic symptoms, and dietary patterns may affect the occurrence of dyspeptic symptoms in school-age children.
  • JIN Yu-feng, YIN Zhi-wen, SHI Wei-lin, TANG Shu-jie, ZHANG Li-yan
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    To summarize the nursing effect of multidisciplinary integration care mode in Cushing's disease undergoing transsphenoidal surgery.The clinical data, complications and perioperative management of 70 patients who admitted during Dec 2018 to Nov 2019 in the neuroendocrine tumor treatment center of Huashan Hospital Affiliated to Fudan University were retrospectively analyzed. Among them, there were 13 males and 57 females, 8 cases with adrenal hyperplasia or adenoma, and 42 cases with adrenocorticotropic hormone elevation.The clinical manifestations were centripetal obesity, purple striae of the skin, acne and other physical changes, hypertension, hyperglycemia and hypercholesterolemia, et al. Women also had irregular menstruation.There were 61 cases of postoperative endocrine dysfunction, 56 cases of nasal wound discharge, 41 cases of diabetes insipidus, 33 cases of headache and 1 case of mental panic attack, no nursing related complications.Comprehensive evaluation, adequate preoperative preparation, prevention and treatment of complications and early complications are the key points of perioperative nursing management.Nurses in a multidisciplinary integration team should consider evidence-based nursing with individual needs of patients, and provide a full-course, focused disease care.
  • Case Report
  • WANG Min-hui, HUANG Wei, SHEN Jie
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    Topiramate is often used clinically in the treatment of epilepsy and migraine.Decrease of neutrophils is a very rare adverse reaction of topiramate, and no case has been reported in Chinese people or in healthy people.We presented a case with decrease of neutrophils induced by topiramate in a Chinese adult male healthy participant in a bioequivalence (BE) study of topiramate tablets, and discussed the treatment and outcome of this case.It reminds us to pay attention to hematopoietic system related adverse reactions associated with topiramate and the safety of healthy volunteers in clinical trials.It may provide some referential ideas for the early diagnosis and treatment of idiosyncratic drug-induced neutropenia (IDIN).