Search

Spiroorthocarbonates (SOCs) exhibit good shrinkage resistance with ring-opening polymerization initiated by a cationic photoinitiator, with potential application in reducing the volume shrinkage by C=C double bond polymerization on three-dimensional (3D) printing. However, SOCs as an additive dealing with volume shrinkage in 3D printing are rarely reported. Moreover, little progress has been made in the kinetics study on its ring-opening polymerization. In this study, we presented an effective strategy to reduce 3D printing volume shrinkage based on SOCs chemistry and systematically studied the ring-opening photopolymerization kinetics. 3,9-diethyl-3,9-bis(allyloxymethyl)-1,5,7,11-tetraoxastetraoxaspiro undecane (DB-TOSU), one kind of SOCs, was adopted as an expanding monomer. Initiated by cationic photoinitiator with sensitizer under 405 nm LED light, the maximum conversion of DB-TOSU is up to 84%. As a volume-control agent for 3D printing, volume shrinkage reduction is 71.2% when adding DB-TOSU into 3D printing resin based on SOCs chemistry. Moreover, the toughness of resin was enhanced. In the 3D printing application test, DB-TOSU displayed a good application prospect owing to its good compatibility with the printing resin and printing accuracy after volume expansion.

Suanzaoren decoction (SZRD) in Traditional Chinese Medicine is a common prescription for chronic insomnia. This study systematically and accurately evaluated the safety and efficacy of SZRD in the treatment of chronic insomnia, thus providing a reference for its clinical application.From the establishment of the corresponding database until May 2022, we systematically queried EMbase, PubMed, Cochrane Library, Web of Science, CNKI, VIP, and Wanfang Database. Randomized control trials (RCTs) were included in this study, and the results that qualified for inclusion were screened and cross-checked by two researchers. After the relevant data were extracted, a meta-analysis was performed using RevMan 5.3 software.A total of 1,311 patients with chronic insomnia from 12 RCTs were enrolled in the meta-analysis, showing that the use of SZRD alone or in combination was superior to the control group in improving the clinical effective rate (RR=1.22, 95%CI [1.16, 1.29], p0.00001), reducing the recurrence rate (RR=0.47, 95%CI [0.28, 0.80], p=0.005), and lowering the Pittsburgh Sleep Quality Index (PSQI) scores (MDSZRD+WM=-3.35,95%CI [-5.22, -1.47], p0.00001); (MDSZRD=-1.94, 95%CI [-3.80, -0.07], p = 0.04). SZRD also could reduce the adverse effects rate (RR=0.30, 95% CI [0.22, 0.40], p0.00001).It was therefore concluded that SZRD alone or in combination with Western medicine can increase the clinical effective rate, reduce the recurrence rate, improve the quality of life of chronic insomnia patients, and decrease the incidence of adverse effects. However, studies included in this analysis varied in quality, and more large-sample, high-quality, multi-center RCTs are still needed to verify the above conclusions.

患儿8月龄起病以脾脏、淋巴结和腮腺肿大为突出表现，伴反复发热、窦肺感染、贫血和血小板减少，外周血多克隆性B细胞增殖。基因检出半胱天冬酶募集结构域11基因第5外显子新发杂合变异（c.368CT，p.G123D），父母为野生型，诊断NF-κB相关B细胞增殖和T细胞失能性疾病。经10年利妥昔单抗治疗，淋巴增殖控制良好。.

Interstitial lung disease (ILD) is a frequent complication of patients with connective tissue disease (CTD) and significantly affects morbidity and mortality. Disease course may vary from stable or mildly progressive to more severe, with rapid loss of lung function. At present, there are great challenges and poor prognosis in the diagnosis and treatment of CTD-ILD. Based on the evidence and guidelines from China and other countries, experts from the Chinese Rheumatology Association developed standardization of diagnosis and treatment of CTD-ILD. The aim is to strengthen the early identification of, standardize the diagnosis and treatment of CTD-ILD, and delay the progress of the disease.间质性肺疾病（ILD）是结缔组织病（CTD）的常见并发症，显著影响患者预后。CTD相关ILD临床可表现为相对稳定、隐匿进展或急剧加重，患者肺功能逐渐恶化，最终导致死亡。CTD相关ILD的诊治目前面临巨大挑战，中华医学会风湿病学分会在借鉴国内外诊治指南和经验的基础上，制定了本规范，旨在加强临床医生对CTD相关ILD的早期识别，规范CTD相关ILD的诊断与治疗，延缓疾病进展，改善患者预后。.

NN

OBJECTIVE: To analyze the distribution characteristics of hereditary peripheral neuropathy (HPN) pathogenic genes in Chinese Han population, and to explore the potential pathogenesis and treatment prospects of HPN and related diseases. METHODS: Six hundred and fifty-six index patients with HPN were enrolled in Peking University Third Hospital and China-Japan Friendship Hospital from January 2007 to May 2022. The PMP22 duplication and deletion mutations were screened and validated by multiplex ligation probe amplification technique. The next-generation sequencing gene panel or whole exome sequencing was used, and the suspected genes were validated by Sanger sequencing. RESULTS: Charcot-Marie-Tooth (CMT) accounted for 74.3% (495/666) of the patients with HPN, of whom 69.1% (342/495) were genetically confirmed. The most common genes of CMT were PMP22 duplication, MFN2 and GJB1 mutations, which accounted for 71.3% (244/342) of the patients with genetically confirmed CMT. Hereditary motor neuropathy (HMN) accounted for 16.1% (107/666) of HPN, and 43% (46/107) of HPN was genetically confirmed. The most common genes of HMN were HSPB1, aminoacyl tRNA synthetases and SORD mutations, which accounted for 56.5% (26/46) of the patients with genetically confirmed HMN. Most genes associated with HMN could cause different phenotypes. HMN and CMT shared many genes (e.g. HSPB1, GARS, IGHMBP2). Some genes associated with dHMN-plus shared genes associated with amyotrophic lateral sclerosis (KIF5A, FIG4, DCTN1, SETX, VRK1), hereditary spastic paraplegia (KIF5A, ZFYVE26, BSCL2) and spinal muscular atrophy (MORC2, IGHMBP, DNAJB2), suggesting that HMN was a continuum rather than a distinct entity. Hereditary sensor and autosomal neuropathy (HSAN) accounted for a small proportion of 2.6% (17/666) in HPN. The most common pathogenic gene was SPTLC1 mutation. TTR was the main gene causing hereditary amyloid peripheral neuropathy. The most common types of gene mutations were p.A117S and p.V50M. The symptoms were characterized by late-onset and prominent autonomic nerve involvement. CONCLUSION: CMT and HMN are the most common diseases of HPN. There is a large overlap between HMN and motor-CMT2 pathogenic genes, and some HMN pathogenic genes overlap with amyotrophic lateral sclerosis, hereditary spastic hemiplegia and spinal muscular atrophy, suggesting that there may be a potential common pathogenic pathway between different diseases.

Influenza is an infectious respiratory disease caused by the influenza viruses. Older people, infants and people with underlying medical conditions could have a higher risk of severe influenza symptoms and complications. The co-infection of Coronavirus Diseases 2019 (COVID-19) with influenza viruses could lead to the complication of prevention, diagnosis, control, treatment, and recovery of COVID-19. Influenza vaccine and COVID-19 vaccine overlapped in target populations, vaccination time, and inoculation units. Although there was insufficient evidence on the immunogenicity and safety of co-administration of influenza vaccine and COVID-19 vaccine, World Health Organization and some countries recommended co-administration of inactivated influenza vaccine and COVID-19 vaccine. This review summarized domestic and international vaccination policies and research progress, and put forward corresponding suggestions in order to provide scientific support for the formulation of vaccination strategy on seasonal influenza vaccine and COVID-19 vaccine.流感是一种由流感病毒引起的传染性呼吸道疾病。老年人、婴幼儿和患有基础疾病人群，出现严重临床症状和并发症的风险更高。新型冠状病毒与流感病毒的共同感染和流行可导致新型冠状病毒肺炎的预防、诊断、控制、治疗和康复复杂化。季节性流感疫苗和新型冠状病毒肺炎疫苗在目标人群、接种时间、接种单位都有重叠，虽然目前流感疫苗与新型冠状病毒肺炎疫苗同时接种免疫原性和安全性的相关研究证据不足，但世界卫生组织和一些国家已建议流感灭活疫苗和新型冠状病毒肺炎疫苗同时接种。本文汇总了国内外两种疫苗同时接种的政策和研究进展，同时提出了相应的思考和建议，以期为季节性流感疫苗和新型冠状病毒肺炎疫苗接种策略的制订提供科学支撑。.

关于“胎盘植入相关疾病”的命名，国内还有不同的看法和做法，但，国际上已经广泛使用规范化的命名——“胎盘植入性疾病”。随着产前的检查技术的发展进步，国内对“胎盘植入性疾病”的识别诊断水平也在进步，有必要进行规范化的命名，以更规范地开展临床工作，并能顺畅地进行国际学术交流。除了规范化命名，也要规范“分级”，无论是临床分级还是病理分级。.

Cockscomb seeds-derived carbon dots (CSCDs) were fabricated by hydrothermal method with common cockscomb seeds. The prepared CSCDs exhibit selectively antibacterial properties towards Gram-positive bacterias, such as Staphylococcus aureus (S. aureus) and Staphylococcus epidermidis (S. epidermidis). Then, the CSCDs were separated to three groups with lipophilic, amphipathic and hydrophilic ones by simple gradient extraction. Interestingly, the three groups of CSCDs exhibited different antibacterial activities, and the amphipathic CSCDs(ACSCDs) showed best bacterial inhibition. This phenomenon might stem from the surface properties of the amphipathic CSCDs, which have both hydrophilic region and hydrophilic region on the surface. The structure might help the samples to penetrate the bacterial membrane more easily, and finally cause apoptosis. This work not only supplied a novel antibacterial carbon dots, but also further revealed that surface chemistry might be an important factor which could affect the bactericidal performance of carbon dots.

The smoking cessation rate of 1 314 people at high risk of lung cancer in the area of lung cancer screening and early diagnosis and early treatment in Sichuan Province increased from 22.37% at baseline to 41.78% after screening (χ²=227.97,1 314名四川省肺癌筛查及早诊早治项目地区肺癌高危人群的戒烟率从基线时的22.37%增至筛查后的41.78%（χ²=227.97，

心房颤动（房颤）的节律控制是指通过应用抗心律失常药物、直流电转复、导管或外科消融恢复窦性心律并进行长期维持。如今节律控制已成为房颤治疗的主流策略，抗心律失常药物回归核心地位，导管消融迅速崛起，使用好抗心律失常药物和导管消融将是临床实践中至关重要的问题。.

2019新型冠状病毒感染流行，孕产妇作为一类特殊的易感人群，围产期的任何时段都可能受到感染。感染后往往病情进展较快较重，严重威胁母儿健康。因此，如何加强覆盖妊娠期、分娩期和产褥期的围产期保健全程防控，以减少不良母儿结局、保障母儿安全就显得十分重要。本文就围产期的全程防控提出了有针对性的建议，以供参考。.

OBJECTIVE: To investigate the incidence and clinicopathologic features of cervical lymph node metastasis in salivary gland adenoid cystic carcinoma (AdCC). METHODS: Retrospective analysis was made in 798 AdCC patients who underwent tumor resection during January, 2001 to January, 2019 in Peking University School and Hospital of Stomatology, especially the clincopathologic characteristics of 82 cases with lymph node metastasis. RESULTS: In the study, 82 of the 798 patients were identified with cervical lymph node metastasis, which was confirmed by histopathological examination. The palate, the region of sublingual gland and mouth floor, and the parotid were the frequently involved primary sites for AdCCs. The general incidence rate of lymph node metastasis was approximately 10%. The submandibular gland, the region of sublingual gland and mouth floor, and the mobile tongue were the most frequent sites of lymph node metastasis with the incidence rates of 20.8%, 16.1%, and 15.1%, respectively; while lymph node metastasis was uncommon in the tumors which were the origin from the palate and parotid, with incidence rates of 6.1% and 3.4%, respectively. Most AdCC cases (70.7%) showed the classic “tunnel-style” metastatic pattern of occurrence, and the level Ⅰ and Ⅱ regions were the most frequently involved areas. The 5-year and 10-year overall survival rates of the patients with lymph node metastasis were 77.4% and 20.6% respectively, while the 5-year and 10-year overall survival rates of the patients with no lymph node metastasis were 83.5% and 57.6%, respectively. The univariate analysis demonstrated that statistically significant differences in the overall survival for the presence of lymph node metastasis (P

OBJECTIVE: To investigate the diagnostic value of tremor analysis in early stages of Parkinson’s syndrome, when the clinical symptoms of tremor onset are not unilaterally often able for a definite diagnosis to be made. METHODS: We included 70 patients with unilateral tremor, under 45 years old and disease duration within 3 years enrolled in Peking University Third Hospital from January, 2014 to December 2015. We recorded clinical features, unified Parkinson’s disease rating scale (UPDRS)-Ⅲ, non-motor symptom (NMS) scores. Tremor analysis and transcranial sonography were performed for all the patients. Based on the results of tremor analysis, we arbitrarily divided the patients into 3 groups: (1) The patients with classical Parkinson’s syndrome manifestations on one side (25 cases); (2) The patients with classical Parkinson’s syndrome manifestations on both sides (15 cases); (3) The patients with no classical Parkinson’s syndrome manifestations (30 cases). The patients were monitored every 6 months to 3 years, until the final diagnosis was made. RESULTS: There was no significant difference in age, gender distribution, Hamilton depression scale (HAMD) scores and H-Y scores among the three groups (P>0.05). The average UPDRS-Ⅲ motor scores of the three groups were significantly different (P=0.001), with 18.23, 18.79 and 14.67, respectively. The average scores of NMS were significantly different, with 15.81, 17.07 and 9.90, respectively (P

Pancreatic cancer (PC) is one of the most common malignant tumors of the digestive system with a high degree of malignancy. Currently, there have been many studies on exosomal microRNAs (miRNAs) discovery in pancreatic cancer. This systematic review aimed to give an overview about known exosomal miRNAs and discuss their diagnostic performance, as well as prognostic value in PC.PubMed and Web of Science were used for systematic literature research for this review. This literature research was mainly to identify studies that performed plasmatic and serological testing for exosomal miRNAs in pancreatic cancer patients and controls. Two independent reviewers separately extracted data on study characteristics and results.In total, nine prior studies were included in this review. Of which, eleven different single exosomal miRNAs and three exosomal miRNA panels were reported.When single exosomal miRNA was used as a diagnostic tool, the specificity is generally high, but the sensitivity is commonly low. When multiple of exosomal miRNAs were used simultaneously, higher sensitivities can be obtained at relatively reasonable specificity levels with certain miRNA combinations. Developing a combination of miRNA markers may be a promising approach for early detection of pancreatic cancer.

心房颤动（房颤）已成为严重危害人民群众健康的重大公共卫生问题。以非维生素K拮抗剂口服抗凝药、房颤综合管理、导管消融为主的疾病防治理念和技术的进步，正在推动房颤治疗模式发生革命性的变化。房颤防治已取得了里程碑式的进步，展望未来，房颤防治任重道远，房颤防治仍有巨大的发展空间。.

This study investigated the effect of human parathyroid hormone replacement therapy on specific disease-related outcomes in patients with hypoparathyroidism. Medline, Cochrane, EMBASE, and Google Scholar databases were searched until January 13, 2015 for randomized trials using the following search terms: hypoparathyroidism, parathyroid hormone/PTH, and hormone replacement therapy. Five randomized controlled trials (n=245) that investigated effect of either PTH (1-34) (3 trials) or PTH (1-84) (2 trials) on serum calcium, phosphate, 1, 25-dihydroxyvitamin D, 25-dihydroxyvitamin D levels, and urine level of calcium were included in the meta-analysis. Both PTH (1-34) and PTH (1-84) therapies were not associated with change in serum calcium level compared with calcitriol/placebo. The level of 24-h urine calcium excretion had a significant decrease in PTH (1-34)-treated group compared placebo/calcitriol (control) group (p≤0.012). PTH (1-34) did not change serum phosphate (p=0.053). PTH (1-84) did not change level of 24-h urine calcium excretion compared with control (p≥0.214) but it did decrease the levels of serum phosphorous (p=0.000). Both PTH-replacement therapies were not associated with change in serum 1,25-dihydroxyvitamin D level compared with control (p≥0.606), but were associated with a significant decrease in serum 25-dihydroxyvitamin D levels (p≤0.04). In conclusion, although the number of randomized trial is limited, our meta-analysis suggests that PTH (1-34) replacement therapy may maintain the serum calcium levels in the normal range by reducing the levels of urine calcium excretion, and both replacement therapies may maintain 1,25-dihydroxyvitamin D serum levels by reducing serum level of 25-dihydroxyvitamin D.

To characterize the ultraphytoplankton community structure and understand its succession and its relationship with environmental factors, High Performance Liquid Chromatography (HPLC-CHEMTAX) was used to analyze the photosynthetic pigment concentration and the algae composition. Algal phyla composition and their abundance were determined based on the presence of pigments, and environmental parameters were synchronously tested in the Three Gorges Reservoir in China. High-performance liquid chromatography (HPLC) analysis showed that there were eight characteristic photosynthetic pigments in the Three Gorges reservoir area: alloxanthin, chlorophyll b, chlorophyll a, fucoxanthin, lutein, neoxanthin, violaxanthin, and zeaxanthin. Among them, fucoxanthin, allophycocyanin, zeaxanthin, and chlorophyll b were the most important photosynthetic pigments in the Three Gorges reservoir area. There were significant differences in the time scale of the eight photosynthetic pigments (P 0.05). The calculation of the matrix factorization program chemical taxonomy (CHEMTAX) showed that the ultraphytoplankton community was composed of 7 phyla: Euglenophytes, Chrysophytes, Cyanophytes, Cryptophytes, Chlorophytes, Diatoms, and Dinoflagellates. Redundancy analysis (RDA) revealed that the key environmental factors that affected the structure of the ultraphytoplankton community were light intensity, total phosphorus, and water temperature. The results provided a basis and data support for the biodiversity of phytoplankton in the Three Gorges Reservoir and its relationship with environmental factors and environmental monitoring.

To prepare ion exchange doxorubicin-loaded poly (acrylic acid) microspheres (DPMs) and evaluate the properties of these chemoembolic agents.Poly (acrylic acid) microspheres (PMs) without drug were prepared by inverse suspension polymerization method and then doxorubicin was loaded by ion exchange mechanism to prepare DPMs. Optical microscope was used to investigate the morphology and particle size distribution of PMs and DPMs; fluorescence microscope and confocal microscope were used to observe the distribution of doxorubicin after drug loading. Elasticities of both the microspheres were evaluated by texture analyzer. High performance liquid chromatography (HPLC) method was established to determine the drug loading behavior of PMs and releasing behavior of DPMs. The in vivo embolic property was evaluated by embolizing the hepatic artery of a rabbit with 0.1 mL of DPMs.PMs and DPMs were both spherical in shape, smooth in surface and dispersed well. Doxorubicin was mainly in the outer area inside of DPMs and distributed evenly. The average particle size of PMs and DPMs were (283±136) μm and (248±149) μm, respectively. PMs and DPMs both had good compression ability with the Young's modulus of (62.63±1.65) kPa and (93.94±1.10) kPa separately. PMs reached the drug loading balance at 12 h, and the entrapment efficiency was greater than 99%. Drug loading of PMs in doxorubicin solution at the concentration of 5.0 g/L and 12.5 g/L was (19.78±0.27) g/L and (49.45±0.37) g/L, respectively. Doxorubicin released slowly from DPMs in PBS and the accumulative release percentages of DPMs with corresponding drug loading were 6.82%±0.02% and 2.83%±0.10% after 24 h, respectively. Arterial angiograms showed that the hepatic artery of the rabbit was successfully embolized with DPMs.DPMs with good performance of loading doxorubicin could be a potential embolic agent for transcatheter arterial chemoembolization.

The effects of external strain on the electronic structure and carrier mobility of graphitic blue phosphorus are investigated theoretically. Symmetry breaking induced by the in-plane strain not only modulates the band structure, but also changes the carrier population at the valence band maximum and conduction band minimum so that the transport current density can be regulated. Compressed deformation in the direction normal to the plane transforms the blue phosphorus into an in-plane structure and the superfluous electrons reduce the band gap giving rise to a semiconductor–metal transition. Our theoretical assessment reveals that strain engineering is a useful method to design electronic devices.