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Objective To understand the epidemiological status of hypertension and related influencing factors in the areas of very high altitude in Tibet, and provide a basis for the prevention and control of hypertension in high altitude areas. Methods Using the whole-group random sampling method, questionnaires and physical examinations were conducted to collect basic personal information, height, weight, and blood pressure from adult Tibetan residents living in Jiaqiong Township, Bange County, Naked City, Tibet Autonomous Region. SPSS 26. 0 software was used for descriptive analysis, univariate analysis and Logistic regression analysis. Results The prevalence of hypertension among native adult Tibetan residents in Jiaqiong Town, Bange County, Naked City was 25. 4%, with 30. 5% in males and 21. 3% in females. The results of the multifactorial logistic regression analysis showed that the age group was middle-aged group (45 -59 years old) (OR = 3. 570, 95% CI = 2. 036-6.260, P <0. 001), elderly group (≤60 years old) (OR =6.213, 95% CI = 2. 744-14.067, P < 0. 001), obesity (OR = 3. 292,95% CI = 1. 721-6. 298, P < 0. 001), waist-to-height-ratio 0. 5 (OR =2. 733, 95% CI = 1. 278-5. 844, P < 0. 05 ) were the independent risk factors for hypertension. Female gender (OR = 0. 402,95 % CI =0. 237-0. 682, P = 0. 001) were protective factors for hypertension. Conclusion The prevalence of hypertension in native Tibetans living in the very high altitude areas of Tibet is at an average level, and people with advanced age, obesity, and waist-to-height ratio ≤0. 5 are at high risk of hypertension. [ABSTRACT FROM AUTHOR]

A gas chromatography-mass spectrometry (GC-MS) method for the determination of four key aroma compounds, 3 -methylbutanal, 3 -methylbutanol, 3 -methylthio -propionic aldehyde and phenylethanol in quick - brewed fish sauce was established. Headspace solid phase microextraction (HS-SPME) and mass spectrometry (GC-MS) were used to identify four key aroma compounds in fish sauce. The influence of extraction temperature, extraction time and selection of internal standard on the analysis results were examined. The results showed that the optimized SPME conditions were as follows: the internal standard substance was 2-methyl-3-heptanone, extraction temperature 45 extraction time 40 minutes. The four key aroma compounds had a good linear relationship, and the correlation coefficient R2 was higher than 0.98. In addition, the standard recovery experiment showed that the recovery rate of the samples was 75.47%-134.41%, and the relative standard deviation was less than 10%, which met the requirements of trace quantification. The gas chromatography-mass spectrometry method used for the quantitative detection of the key aroma compounds in fish sauce was simple, fast with high precision, meeting the needs of detection of the four key aroma compounds in fish sauce, and contributing to the establishment of aroma quality evaluation system. [ABSTRACT FROM AUTHOR]

This paper presented a numerical model of FRP - strengthened reinforced concrete (RC) slabs under fire and conducted the coupled thermo - mechanical analysis. Based on the information about the temperature - dependent mechanical properties of concrete, reinforcing steel and FRP materials, this study developed a nonlinear finite element (FE) code to investigate the fire performance of FRP strengthened RC slabs. The FE code was verified through comparisons with existing fire tests. Based on the code, the effects of intumescent coating thickness, fire load ratio, longitudinal steel reinforcement, amount of FRP strengthening, section al height and concrete cover on the mid - span deflection of FRP - strengthened RC slabs under fire were considered. The parametric studies show that intumescent coating thickness, fire load ratio and amount of FRP strengthening have significant effects on fire performance of strengthened slabs; sectional height and concrete cover only have moderate influences; and mid - span deflection versus longitudinal steel reinforcement is not obvious. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence and influencing factors of isolated diastolic hypertension (IDH) in the Tibetan population in Tibet and to provide some evidence for the prevention and control of hypertension and other related diseases in high-altitude areas., Methods: A multistage stratified whole-group random sampling method was used to enroll participants from Ngari Prefecture, Nagqu City, Shannan City, and Lhasa City, Tibet. A total of 3918 native Tibetans with complete data were enrolled in the survey between June 2020 and August 2023. The participants were aged from 18 to 80. The demographic data, life habits, and chronic disease prevalence of the participants were collected. Fasting venous blood samples were collected to perform the routine blood tests and blood biochemistry tests. The prevalence of IDH in subgroups with different characteristics was analyzed and the influencing factors were analyzed by multivariate logistic regression, accordingly. The predictive value of influencing factors on the prevalence of IDH was analyzed by the receiver operating characteristic (ROC) curve and the findings were compared with those of the previous prediction models for IDH., Results: The prevalence of hypertension in the participants was 33.7% ( n =1321), among which, 395 had IDH, accounting for 29.9% of the hypertensive patients. The results of multivariate regression showed that age, heart rate, body mass index, waist circumference, hemoglobin, and low-density lipoprotein cholesterol were associated with risks of developing IDH ( P <0.05). The area under the ROC curve ( AUC ) was 0.71, which indicated improved accuracy for predicting the risks for IDH in comparison with previous predictive models for IDH. Among the influencing factors, BMI showed the best predictive value for IDH risks., Conclusion: The prevalence of IDH is high among Tibetans in Tibet, suggesting the necessity for rational allocation of health resources in accordance. Compared with the previous IDH prediction models, the model proposed in this study is more suited for the Tibetan population. Targeted interventions should be carried out for the high-risk populations, such as young and middle-aged adults and populations suffering from overweight/obesity, central obesity, high-altitude polycythemia, and dyslipidemia, so as to effectively control the occurrence and development of IDH., Competing Interests: 利益冲突　所有作者均声明不存在利益冲突, (© 2024《四川大学学报（医学版）》编辑部 版权所有Copyright ©2024 Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objective: To explore the relationship between hearing loss and cognitive function in the elderly population through propensity score matching method., Methods: We analyzed the data of 7605 participants aged 60 and above who were included in the 2018 China Health and Retirement Longitudinal Study (CHARLS). The non-substitutable 1∶1 nearest neighbor matching method without caliper value was used for propensity score matching and G-computation was used to estimate the average treatment effect (ATE) of hearing loss on all dimensions of cognitive function., Results: Before matching, there were 3626 (47.68%) women, with 1409 (18.53%) of whom suffering from hearing loss and 3031 (39.86%) of whom suffering from cognitive impairment. After matching, 1409 subjects were included in the hearing loss group and 1409, in the normal hearing group, with both groups sharing similar distribution of basic demographic characteristics. The results for the average treatment effect of the population indicated that the cognitive function scores of the hearing loss group were lower than those of the normal hearing group, with the overall cognitive function being 0.593 points lower (95% confidence intervel [ CI ]: －0.916-－0.257, P <0.001), orientation being 0.183 points lower (95% CI : －0.302-－0.055, P =0.004), immediate memory being 0.150 points lower (95% CI : －0.218-－0.085, P <0.001), and language skills being 0.178 points lower (95% CI : －0.303-－0.058, P =0.006). The prevalence of cognitive impairment of the hearing loss group was 4.2% higher than that of the normal hearing group (95% CI : 0.007-0.077, P =0.020)., Conclusion: Hearing loss adversely affects the orientation, memory, and language skills of the elderly population and forms a potential risk factor for cognitive impairment in the elderly population., Competing Interests: 利益冲突　所有作者均声明不存在利益冲突, (© 2024《四川大学学报（医学版）》编辑部 版权所有Copyright ©2024 Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objective: To analyze the prevalence of hyperuricemia (HUA) among the Tibetan population in Nagqu City, Tibet and to uncover the relevant influencing factors., Methods: From July 2020 to August 2021, 763 Tibetan natives from Bangor County (specifically Xinji Township and Jiaqiong Township) and Seni District (specificially Sexiong Township), Nagqu City were investigated by multi-stage cluster random sampling method and the prevalence of HUA was studied by retrospective analysis. Chi-square test and multiple logistic regression were used to analyze the influencing factors of HUA prevalence., Results: The overall prevalence of HUA among the Tibetan population in the three townships of Nagqu City was 19.66% (150/763). In particular, the prevalence in men was 35.00%, while that in women was 8.58%, showing significant difference ( P <0.05). According to the results of univariate analysis, there were significant differences in the distribution of sex, abnormal liver function, abnormal hemoglobin, hyperlipidemia, high level of low-density lipoprotein, hypertriglyceridemia, hypercholesterolemia, abnormal creatinine, hyperhomocysteinemia, obesity, and hypertension between HUA and non-HUA patients ( P <0.05). Multiple logistic regression showed that female sex (odds ratio [ OR ]=0.195, 95% confidence interval [ CI ]: 0.120-0.315) was a protective factor for HUA, while abnormal liver function ( OR =2.812, 95% CI : 1.685-4.692), abnormal creatinine ( OR =7.374, 95% CI : 1.446-37.620), high level of low-density lipoprotein ( OR =2.357, 95% CI : 1.011-5.492), and hyperlipidemia ( OR =3.056, 95% CI : 1.886-4.951) were independent risk factors., Conclusion: The prevalence of HUA is relatively high in Nagqu city and the prevalence of HUA is much higher in men than that in women. Male sex, abnormal liver function, abnormal creatinine, elevated low-density lipoprotein, and hyperlipidemia may be the risk factors for HUA in the local Tibetan population., Competing Interests: 利益冲突　所有作者均声明不存在利益冲突, (© 2024《四川大学学报（医学版）》编辑部 版权所有Copyright ©2024 Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objective: To examine the differences and commonalities of factors influencing the utilization of health services among urban and rural residents in Tibet and to identify vulnerable populations in the utilization of health services, thereby providing references for the formulation of local health policies and the allocation of health resources., Methods: Using the Tibetan area data from the Sixth National Health Service Survey, we conducted statistical analysis of the health service utilization status of 8 297 residents of agro-pastoral areas and 2 179 residents of urban areas with χ 2 test and logistic regression model., Results: The two-week outpatient visit rates of residents in agro-pastoral areas and that of the urban residents were 65.3% and 57.1%, respectively, and the one-year hospitalization rates were 8.3% and 8.9%, respectively. The influencing factors of two-week outpatient visits for rural and pastoral residents included urban and rural health insurance coverage, Three Guarantees in One coverage, distance to medical facilities, chronic disease status, physical examination, family doctor contract status, employment status, and health status self-assessment. The influencing factors of two-week outpatient visit for urban residents included chronic disease status, urban and rural medical insurance coverage, health status self-assessment, health records, and physical examination. The factors influencing hospitalization for agro-pastoral residents were sex, age, marital status, urban and rural medical insurance coverage, Three Guarantees in One coverage, critical illness insurance, health self-assessment, mobility, health records, physical examination, and chronic disease status. The factors influencing the hospitalization of urban residents were sex, marital status, health status self-assessment, health records, urban employee medical insurance coverage, and chronic disease status. The factors influencing the hospitalization of urban residents were sex, marital status, health status self-assessment, health records, urban employee medical insurance coverage, and chronic disease status., Conclusion: The urban and rural residents in Tibet have relatively poor health and their awareness of seeking early medical help after they fall ill is relatively weak. The health institutions concerned should dedicate more attention to the vulnerable populations who have difficulty accessing health services, focus on the commonly shared influencing factors of health service utilization among urban and rural residents, take into account the differences, rationally allocate health resources, and improve the effective utilization rate of health services among residents in Tibet., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objective: To explore the possible interaction between overweight/obesity and dyslipidemia and to provide some evidence for the interaction of the risk of hypertension with overweight/obesity and dyslipidemia., Methods: By using multi-stage stratified cluster random sampling method, the subjects of the study were randomly selected from Naqu city, Shannan city, and Ali prefecture, Tibet. A total of 4047 Tibetans with complete data were included. Investigators obtained relevant information on the subjects through questionnaire surveys, measured their height, body mass index, and blood pressure, and collected fasting venous blood samples. The multivariate logistic regression model was used to analyze the independent effects of overweight/obesity and dyslipidemia and hypertension. Stratified analysis and an additive interaction model were used to evaluate the effect of two-factor interaction on the risk of hypertension., Results: The overall prevalence of hypertension, overweight/obesity, and dyslipidemia among Tibetans living in Tibet was 29.3%, 46.2%, and 40.9%, respectively. Overweight/obesity (odds ratio [ OR ]=2.151) and dyslipidemia ( OR =1.240) were risk factors of hypertension. Evaluation results of the effect of additive interaction showed significant additive interaction of overweight/obesity and dyslipidemia on hypertension ( P =0.028), with the synergy index ( SI ) being 1.318., Conclusion: Overweight/obesity and dyslipidemia are risk factors for having hypertension and there is an additive interaction between dyslipidemia and overweight/obesity., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Gan-Yu-Hua-Huo syndrome(Live qi stagnation transforming into fire pattern) is one of the core contents of the theory of emotional diseases in traditional Chinese medicine(TCM). It is the key link of the pathogenesis change of emotion-related diseases and widely exists in the pathological process of various related diseases. However, due to the lack of animal models in line with the characteristics of TCM syndromes, the research on biomedical basis of Gan-Yu-Hua-Huo syndrome and study of Chinese medicines for soothing liver and purging fire have been restricted seriously. This study found that the pathological process of facial fire-heat symptoms of Gan-Yu-Hua-Huo syndrome was similar to the facial symptoms due to the emotional stress-induced latent herpes simplex virus-1(HSV-1) reactivation. Therefore, this study proposed that the emotional stress-induced latent HSV-1 activation be used to establish the animal model of Gan-Yu-Hua-Huo syndrome. In this study, the state-of-art literature in the field of Gan-Yu-Hua-Huo syndrome was summarized, and the experimental animal model of Gan-Yu-Hua-Huo syndrome was established from the perspective of emotional stress-induced latent HSV-1 reactivation to reveal the active substances, potential targets and pathways related to the pathological mechanism of the syndrome. This study was expected to provide reference and basis for the pharmacodynamic characterization of commonly used Chinese medicine for Gan-Yu-Hua-Huo syndrome in clinical practice.

Objectives: To investigate the distribution of body mass index (BMI) and risk factors for obesity in children with Diamond-Blackfan Anemia (DBA)., Methods: The children with DBA who attended National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, from January 2003 to December 2020 were enrolled as subjects. The related clinical data and treatment regimens were recorded. The height and weight data measured within 1 week before or after follow-up time points were collected to calculate BMI. The risk factors for obesity were determined by multivariate regression analysis in children with DBA., Results: A total of 129 children with DBA were enrolled, among whom there were 80 boys (62.0%) and 49 girls (38.0%), with a median age of 49 months (range 3-189 months). The prevalence rate of obesity was 14.7% (19/129). The multivariate logistic regression analysis showed that the absence of ribosomal protein gene mutation was closely associated with obesity in children with DBA (adjusted OR =3.63, 95% CI : 1.16-11.38, adjusted P =0.027). In children with glucocorticoid-dependent DBA, obesity was not associated with age of initiation of glucocorticoid therapy, duration of glucocorticoid therapy, and maintenance dose of glucocorticoids ( P >0.05)., Conclusions: There is a high prevalence rate of obesity in children with DBA, and the absence of ribosomal protein gene mutation is closely associated with obesity in children with DBA.

Bryophytes have been used in many fields, such as landscaping and soil and water conservation. How-ever, few studies focused on moss regeneration and its influencing factors, which retards the application study. Three common desiccation-tolerant mosses ( Barbula unguiculata , Didymodon vinealis , and Didymodon tectorum ) in the Loess Plateau region were collected across four seasons. We measured vigor index of new shoots, representing vegetative regeneration capacity, and physiological indices, which included the contents of chlorophyll, soluble sugar, soluble protein and malondialdehyde (MDA), to determine seasonal differences in regeneration capacity and physiological characteristics of the three mosses, as well as their relationships. The results showed that, 1) vegetative regeneration of mosses showed significantly seasonal differences. The vigor index of the three mosses in summer were the lowest, averagely decreased by 56.1%, 48.4%, and 10.1% compared with that in autumn, winter, and spring, respectively. The vigor index of the three mosses in the same season showed interannual variation. 2) There were considerable differences in the regeneration capacity of mosses across species. D. tectorum and B. unguiculata had the highest and lowest vigor indices, respectively. In terms of regeneration capacity, B. unguiculata had the largest seasonal and interannual variations. 3) The physiological characteristics of mosses had seaonal variations. The mosses collected in the summer had the highest MDA content but the lowest contents of soluble sugar and soluble protein. 4) Seasonal variations in desiccation-tolerant moss regeneration were mostly due to soluble sugar. Our results showed seasonal variations of vegetative propagation capacity, and highlighted the role of soluble sugar as a critical factor influencing vegetative propagation of mosses. These findings could provide scientific support for moss protection and artificial cultivation.

Objective: To study the status quo of the readmission of senile dementia patients in Chengdu, and to analyze the primary diagnosis, the economic burden and the influencing factors of readmission., Methods: Dementia inpatients aged 60 and above in Chengdu were the subjects of this study. The subjects were diagnosed with dementia between 2013 and 2017. Their heath insurance coverage was either the basic medical insurance for urban employees in Chengdu or the basic medical insurance for urban and rural residents of Chengdu. The rank sum test and the chi-square test were conducted to analyze the differences in readmission rate and the economic burden of hospitalization among subjects with different characteristics. Logistic regression was done to analyze the factors affecting readmission., Results: The total number of dementia inpatients over the 5-year period was 27881 patients (78820 admissions). The 30-day readmission rate was 25.14% (7011/27881) and the 5-year readmission rate was 45.79% (12767/27881). The primary diagnoses of 12767 readmitted patients mainly included dementia (28.57%), circulatory system diseases (24.26%), and respiratory system diseases (23.71%). The economic burden of hospitalization was higher for readmitted patients than that of patients who were not readmitted ( Z =33.777, P <0.001). The occurrence of readmission was correlated to the following factors, advanced age (compared to that of the 60-65 yr. group, the 70-75 yr. group: odds ratio [ OR ]=1.123, 95% confidence interval [ CI ]: 1.019-1.237, and the 75-80 yr. group: OR =1.123, 95% CI : 1.108-1.218), participation in the basic medical insurance for urban employees ( OR =1.674, 95% CI : 1.578-1.775), types of dementia (compared to unspecified dementia, Alzheimer's dementia group: OR =1.256, 95% CI : 1.163-1.357, Parkinson's disease dementia group: OR =1.774, 95% CI : 1.658-1.898, and mixed-type dementia group: OR =1.750, 95% CI : 1.457-2.103), disease condition (compared with patients with only dementia, those who have other diseases: OR =0.536，95% CI ：0.493-0.583), length of hospital stay ( OR =1.593, 95% CI : 1.552-1.635), and staying at a lower level hospital (compared to that of tertiary hospitals, secondary hospitals: OR =1.319, 95% CI : 1.248-1.395, primary hospitals: OR =1.744, 95% CI : 1.608-1.891, and other hospitals: OR =1.465, 95% CI : 1.311-1.537)., Conclusion: Senile dementia patients have a high 30-day readmission rate, and the readmission entails heavy economic burdens on the patients. For the populations covered by medical insurance, the following features are correlated to the occurrence of readmission: advanced age, coverage by the basic medical insurance for urban employees, Alzheimer's dementia, Parkinson's disease dementia, mixed-type dementia, dementia patients without other comorbidities, extended length of stay, and hospitalization at a lower level hospital. However, further research is needed for better understanding of the specific mechanisms so that readmission of senile dementia patients can be reduced and the economic burden of the disease can be minimized., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Sciences).)

Objectives: To study the association between paroxysmal nocturnal hemoglobinuria (PNH) clone and immunosuppressive therapy (IST) in children with severe aplastic anemia (SAA)., Methods: A retrospective analysis was performed on the medical data of 151 children with SAA who were admitted and received IST from January 2012 to May 2020. According to the status of PNH clone, these children were divided into a negative PNH clone group ( n =135) and a positive PNH clone group ( n =16). Propensity score matching was used to balance the confounding factors, and the impact of PNH clone on the therapeutic effect of IST was analyzed., Results: The children with positive PNH clone accounted for 10.6% (16/151), and the median granulocyte clone size was 1.8%. The children with positive PNH clone had an older age and a higher reticulocyte count at diagnosis ( P <0.05). After propensity score matching, there were no significant differences in baseline features between the negative PNH clone and positive PNH clone groups ( P >0.05). The positive PNH clone group had a significantly lower overall response rate than the negative PNH clone group at 6, 12, and 24 months after IST ( P <0.05). The evolution of PNH clone was heterogeneous after IST, and the children with PNH clone showed an increase in the 3-year cumulative incidence rate of aplastic anemia-PNH syndrome ( P <0.05)., Conclusions: SAA children with positive PNH clone at diagnosis tend to have poor response to IST and are more likely to develop aplastic anemia-PNH syndrome.

Objective: To study the clinical features and genetic mutations of children with Shwachman-Diamond syndrome (SDS) and malignant myeloid transformation., Methods: Next-generation sequencing was used to analyze the gene mutations in 11 SDS children with malignant myeloid transformation, and their clinical features and genetic mutations were analyzed., Results: Of the 11 children with SDS, 9 (82%) presented with refractory cytopenia of childhood (RCC), 1 (9%) had myelodysplastic syndrome with excess blasts (MDS-EB), and 1 (9%) had acute myeloid leukemia with myelodysplasia-related changes (AML-MRC). The median age of onset of malignant myeloid transformation was 48 months (ranged 7 months to 14 years). Of the 11 children, 45% had abnormalities in the hematological system alone. Mutations of the SBDS gene were detected in all 11 children, among whom 5 (45%) had c.258+2T>C homozygous mutation and 3 (27%) had c.184A>T+c.258+2T>C compound heterozygous mutation. The new mutations of the SBDS gene, c.634&#95;635insAACATACCTGT+c.637&#95;638delGA and c.8T>C, were rated as "pathogenic" and "possibly pathogenic" respectively. The 3-year predicted overall survival rates of children transformed to RCC and MDS-EB/AML-MRC were 100% and 0% respectively (P=0.001)., Conclusions: SDS children may have hematological system symptoms as the only manifestation, which needs to be taken seriously in clinical practice. The type of malignant transformation is associated with prognosis.

Objective: To study the clinical features and gene mutation spectrum of children with sideroblastic anemia (SA) and the clinical value of targeted next-generation sequencing in the molecular diagnosis of children with SA., Methods: Clinical data were collected from 36 children with SA. Targeted next-generation sequencing was used to detect mutations in SA-related pathogenic genes and genes associated with heme synthesis and mitochondrial iron metabolism. The association between genotype and clinical phenotype was analyzed., Results: Of the 36 patients, 32 had congenital sideroblastic anemia (CSA) and 4 had myelodysplastic syndrome with ring sideroblasts (MDS-RS). Mutations in CSA-related genes were detected in 19 children (19/36, 53%), among whom 9 (47%) had ALAS2 mutation, 4 (21%) had SLC25A38 mutation, and 6 (32%) had mitochondrial fragment deletion. No pathogenic gene mutation was detected in 4 children with MDS-RS. Among the 19 mutations, 89% (17/19) were known mutations and 11% (2/19) were novel mutations. The novel mutation of the ALAS2 gene c.1153A>T(p.I385F) was rated as "possibly pathogenic" and the novel mutation of the SLC25A38 gene c.175C>T(p.Q59X) was rated as "pathogenic"., Conclusions: ALAS2 and SLC25A38 gene mutations are commonly seen in children with CSA, but mitochondrial gene fragment deletion also accounts for a relatively high proportion. For children with hypoplastic anemia occurring in infancy, mitochondrial disease should be considered.

An online SPE-HPLC method for simultaneous determination of cordycepin (3'-deoxyadenosine) and 2'-deoxyadenosine in Cordyceps genus (C. sinensis,C. militaris,Hirsutella sinensis and C. sobolifera) was developed. The samples were enriched on a ZORBAX SB-AQ (4.6 mm×12.5 mm,5 μm) column with isocratic elution by 9% methanol solution. The separation of analytes was performed on a ZORBAX SB-AQ (4.6 mm×150 mm,5 μm) column with gradient elution by 0.1% formic acid solution and methanol (91∶9). The flow rate was 1.0 mL•min⁻¹. Column temperature was 40 ℃ and detection wavelength was 260 nm. This method has been applied for analysis of different Cordyceps genus. The 2'-deoxyadenosine was detected in C. sinensis,Hirsutella sinensis and C. sobolifera. The cordycepin was detected in C. militaris. In summary,the cordycepin chromatographic peak from C. sinensis in some past reports may be the 2'-deoxyadenosine chromatographic peak or the mixture peak of 2'-deoxyadenosine and cordycepin in which 2'-deoxyadenosine content was higher than cordycepin. The developed method is suitable for analysis of cordycepin and 2'-deoxyadenosine in Cordyceps genus., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Chinese Pharmaceutical Association.)

Objective: To evaluate the clinical characteristics and risk factors of clonal evolution after immunosuppressive therapy (IST) in children with severe/very severe aplastic anemia (SAA/VSAA)., Methods: The clinical data of 231 children with newly-diagnosed SAA/VSAA who received IST were retrospectively studied. The incidence and risk factors of clonal evolution after IST were analyzed., Results: The 5-year overall survival rate of the 231 patients was 82.7%. Except for 18 cases of early deaths, 213 patients were evaluated for IST efficacy. Among the 231 patients, cytogenetic abnormalities for at least two chromosome metaphase were detectable in 14 (7.4%) patients, and PNH clones were detectable in either peripheral red blood cells or neutrophils for 95 patients. Among the 213 patients evaluated for IST efficacy, 15 patients experienced clonal evolution after IST. Five patients had PNH and trisomy 8 which were defined as favorable progressions, and ten patients experienced monosomy 7 and MDS/AML as unfavorable progressions. The 5-year accumulative incidence of favorable and unfavorable progression were (2.2±2.2)% and (4.8±3.3)%, respectively. Until the last follow-up, 100% (5/5) of patients with favorable progressions and 50% (5/10) of patients with unfavorable progressions survived. WBC>3.5×10 9 /L, CD3 + T cell percentage>80%, dosage of antithymocyte globulin >3.0 mg/(kg·d) and no response to IST were related to unfavorable progressions by univariate analysis. Cox multivariate analysis revealed that an increased CD3 + T cell percentage (>80%) and no response to IST were independent risk factors for unfavorable progressions., Conclusions: The children with SAA/VSAA who have an increased CD3 + T cell percentage at diagnosis or have no response to IST are in high risks of unfavorable progressions.

The study is aimed to develop a method in evaluation of the bioactive consistency of cardiotonic pill (CP). HepG2 cell line was employed as a biological detector. After treated with CP for 24 h, gene chip and qRT-PCR were used to select m RNAs that can represent the bioactivity of CP. Then similarity between different batches of CP were calculated based on expression levels of marker genes to evaluate the bioactive consistency of CP. Marker genes were selected according to the criteria as follows: 1 fold change < 0.67 or > 1.5; 2 potential relevance to curative effects; 3 extensive involvement in the cellular functions and clustering analysis categories; 4 dose-dependent effect. A total of 10 genes were selected as bioactive markers of CP. Angular cosine was calculated to evaluate the similarity between two samples. The method was validated using intra-day precision and inter-day precision. Using angular cosine similarity, the intra-day and inter-day precision were 0.4% and 0.6%, respectively. The similarities of 6 batches of CDPs ranged from 0.992 to 0.999, and 1 batch of Compound Danshen Tablet was 0.534. The established method is specific and accurate, and provides comprehensive and objective evaluation of bioactive quality of CDPs. It can also benefit the bioactive consistency evaluation of other compounds in traditional Chinese medicines.

Objective: To investigate the association between clinical outcome and gene mutations in children with Fanconi anemia (FA)., Methods: A retrospective analysis was performed for the clinical data of six children with the same severity of FA and receiving the same treatment. At first, single cell gel electrophoresis and chromosome breakage induced by mitomycin C were performed for diagnosis. Then the gene detection kit for congenital bone marrow failure diseases or complementation test was used for genotyping of FA. Finally the association between the clinical outcome at 3, 6, 9, or 12 months after treatment and gene mutation was analyzed., Results: Of all the six FA children, five had FANCA type disease, and one had FANCM type disease; four children carried two or more FA gene mutations. Among the children with the same severity of FA, those with more FA mutations had a younger age of onset and poorer response to medication, and tended to progress to a severe type., Conclusions: Children carrying more than two FA mutations have a poor clinical outcome, and hematopoietic stem cell transplantation should be performed as soon as possible.

Objective: To ovaluate the prognostic value of prednisone response in treatment regimes of children with acute lymphoblastic leukemia., Methods: A total of 598 newly diagnosed ALL patients were enrolled and received prednisone pre-treatment. Based on the peripheral lymphoblast count on day 8, these patients were divided into 2 groups: prednisone good response (PGR) and prednisone poor response (PPR). PPR patients were classified into high risk group immediately and then received intensed chemotherapy. The all enrolled patients were followed up and the clinical features and treatment outcomes of the two groups were analyzed., Results: Compared with PGR group, PPR group had different characteristics. They were older in age and had higher initial white blood cell count (P<0.05). T-cell ALL (T-ALL) and Philadelphia chromosome positive ALL (Ph+ ALL) were frequent in PPR group (P<0.05). Event-free survival (EFS) rate of PPR group was significantly lower than that of PGR group (P<0.05). 2 year event-free survival(EFS) rate of PGR group was (88.3±1.5)%, while the 2-year EFS rate of PPR group was (58.4±5.3)%. 5 year EFS rates of PGR and PPR were (80.8±2.1)% and (53.4±6.0)%, respectively. The EFS rate of PPR group was falling rapidly within 2 years. PPR group had higher relapse rate, and most relapses occurred within 18 months (P<0.05). PPR group had more high incidence of minimal residual disease (MRD) both on day 33 and on week 12 (P<0.05). No significant difference of EFS and relapse time was found between PPR and high risk PGR patients (P>0.05). In multi-variate regression analysis, the PPR, the presence of BCR-ABL1 and MLL were significantly unfavorable factors (P<0.05)., Conclusion: Prednisone response has been confirmed to be still great prognostic value and PPR children patients have poor outcomes generally. It is likely that the response to prednisone does not make much sense to high risk ALL patients.

Objective: To observe the efficacy of polyethylene glycol conjugated asparaginase (peg-asp) for induction treatment of children with newly diagnosed acute lymphoblastic leukemia (ALL)., Method: A total of 268 newly diagnosed children with ALL enrolled in CCLG-2008 from January, 2010 to August, 2012 were analyzed. Patients received either native Escherichia coli asparaginase or pegaspargase along with multiagent chemotherapy during remission induction treatment. Status of bone marrow aspiration was assessed on day 15, day 33 (M1, M2, M3)., Result: Of the 268 patients stratified, 37.3% (n = 100) were SR, 32.1% (n = 86) were IR, and 31.6% (n = 82) were HR; 159 patients received native Escherichia coli asparaginase and 109 patients received pegaspargase. Characteristics of two groups in age, sex, blood count at diagnosis, immunophenotype and response to prednisolone had no significant difference (P > 0.05). Bone marrow status on day 15 in pegaspargase group was M1 in 70 (64.2%) cases, M2 in 23 (21.1%) and M3 in 16 (14.7%), while in native Escherichia coli asparaginase group, M1 in 112 (70.4%) cases, M2 in 21 (13.2%) and M3 in 26 (16.4%), respectively (χ(2) = 2.938, P = 0.230). Bone marrow status on day 33 was M1 in 105 (96.3%), M2 in 3 (2.8%) and M3 in 1 (0.9%) in pegaspargase group, while it was M1 in 154 (96.9%) cases, M2 in 5 (3.1%) and M3 in native Escherichia coli asparaginase group, respectively (χ(2) = 1.494, P = 0.474)., Conclusion: Domestic pegaspargase of our country can achieve the similar efficacy in induction treatment for ALL patients as compared with native Escherichia coli asparaginase. The drug could be considered as not only the choice for allergic patients but also a first-line alternative for new patients.

This study was aimed to retrospectively analyse the prognosis of childhood myelodysplastic syndromes (MDS-RCC ) from China and Japan. Two hematologists and one pathologist from China and Japan constituted a diagnosis group. According to the criteria of 2008 WHO, 33 children with MDS-RCC from 50 chinese children diagnosed as acquired bone marrow failure syndrome from 2009 to 2011, and 74 Japanese children with MDS-RCC in a prospective registration group conducted by the Japanese Society of Pediatric Hematology were enrolled in this study. The outcome of total 107 childhood MDS-RCC treated with different treatment strategies was analyzed retrospectively. The results indicated that: (1) the 3 and 5-year overall survival rates (OS) for all patients were 93.8% and 79.7% respectively. (2) All 107 patients with MDS-RCC were further subclassified into 2 groups: transfusion dependent group and transfusion independent group. The 3 and 5-year overall survival rates (OS) for transfusion dependent group were 89.9% and for transfusion independent group were 70.6% respectively, the 5-year overall survival rate (OS) for transfusion independent group was 100.0%. (3) Treatment strategy: patients from transfusion dependent group were treated with immunosuppression therapy (IST), in which CsA combined with or without ATG and patients were treated with HSCT. The 5-year overall survival rate (OS) was 100% for IST group. The 3 and 5-year overall survival rates (OS) for HSCT patients were 82.9% and 30.6%, respectively. All the patients from transfusion independent group were alive till the last follow up. (4) Compared with patients from our hospital and Japan, the 5-year overall survival rate (OS) for patients in our hospital was 100.0%, the 3-and 5-year overall survival rates (OS) for patients in Japan were 93.7% and 75.0%, respectively. It is concluded that children with MDS-RCC are seldom progressive. The observation and wait strategy is applicable for patients with MDS-RCC who have no transfusion dependent. IST therapy is recommended to those who have transfusion-dependent.

Objective: To study the clinical and laboratory characteristics of cases with warts, hypogammaglobulinemia, infections and myelokathexis (WHIM) syndrome., Method: An 11-year-old boy was diagnosed as WHIM syndrome and CXCR4 gene mutation analysis was performed., Result: Since 3 years of age, the patient had recurrent fever and persistent cough. Since 6 years of age, he had warts on his fingers, the warts increased gradually. His complete blood count showed: white blood cell (WBC) 0.65×10(9)/L, neutrophil 0.15×10(9)/L, hemoglobin 116 g/L, platelet 200×10(9)/L, reticulocyte 0.62%. Results of serum biochemical tests: total protein (TP) 72.2 g/L (reference value 60 - 80 g/L), albumin 20.4 g/L (reference value 20 - 35 g/L), gammaglobulin 20.4 g/L (reference value 20 - 35 g/L). IgG 5.56 g/L (reference value 7.51 - 15.6 g/L), IgA 0.48 g/L (reference value 0.82 - 4.53 g/L), IgM 0.29 g/L (reference value 0.46 - 3.04 g/L). Peripheral blood lymphocyte subsets: CD3(+)T lymphocyte 43.6% (reference value 64.01% - 75.95%), CD19(+)B lymphocyte 1.00% (reference value 9.02% - 14.1%). Bone marrow smears showed that many of the neutrophils had a reactive appearance, with cytoplasmic vacuolation. Most neutrophils had hypersegmentation with four or five nuclear lobules. In some cells, the filaments connecting the nuclear lobes were long. CXCR4 mutation was detected., Conclusion: WHIM syndrome is a rare immunodeficiency disorder with an autosomal-dominant pattern of inheritance. The disease is less progressive, and may accompany the patients' whole life.

Methamphetamine (MA) is a representative drug of amphetamine-type stimulants for central nervous system and has become one of the most dangerous drugs in the world recently. The present article reviews the pharmacological effects, distribution, metabolism, intoxication mechanism, the effects of MA on cardiovascular and central nervous systems of MA, and the current situation of forensic investigation on MA.

Objective: To investigate the clinical effect of improved laparoscopic Vechitti procedure for constructing a functioning vagina., Methods: By using the method of raising vestibular mucosa, 18 patients with congenital absence of vagina and uterus underwent surgery in our hospital. No cave was made between bladder and rectum. The procedure involved puncturing the vulvar vestibulum pit with an epidural paracentetic needle or specially-made needle into abdominal cavity through rectovesical interspace, two drag-lines was introduced through anterior abdominal wall, using the line to tie a clothes button of 2.0-2.5 cm diameter to the vulva, rasing the lines day by day, the vestibule go upward along with the button, then the vagina was formed., Results: After the procedures, the artificial vagina of all 18 patients could hold a speculum and the mucosa appeared soft and smooth with normal lubrication. The vulvar tissues appeared uninjured and normal in all cases. The married patients were satisfactory to the intercourse. One case of vagino-rectal fistula was observed in a patient after she rode a bicycle with the vaginal mould., Conclusion: The improved laparoscopic Vechitti procedure for constructing a functioning vagina has less trauma than conventional operation and is easy to operate. Therefore, the new improved procedure is a preferred way in constructing vagina for treating those patients.