最新刊期
      卷 45 ， 期 3 ， 2024

        Topic on overactive bladder in children

      • HE Ping,CHAO Min
        Vol. 45, Issue 3, Pages: 331-336(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240419.002
        摘要：Nerve growth factor （NGF） has been widely studied because it plays an important role in the survival， growth and differentiation of nerve cells. It is distributed throughout the body and plays different pathophysiological roles according to the combined receptors. TrkA is its high affinity receptor， and many studies have shown that NGF plays different roles according to its downstream signal transduction pathways after combining with it. After combining with NGF， it also has a cross-effect on other signal transduction pathways that occur in the body. This paper reviews the signal transduction pathways combined with NGF and TrkA from different disease symptoms， so as to explore the role of NGF/TrkA signal pathways in children with overactive bladder.  
        关键词：nerve growth factor;pediatric overactive bladder;TrkA receptor;p75 receptor;signal transduction pathway   
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        发布时间：2024-06-05
      • HE Ping,ZHANG Ye,ZHANG Yin,SUN Qihang,YOU Long,CHAO Min
        Vol. 45, Issue 3, Pages: 337-343(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240424.003
        摘要：ObjectiveTo explore the efficacy of Solifenacin in the treatment of children with idiopathic overactive bladder （OAB）.MethodsThe study included 67 children with idiopathic OAB treated in the urology clinic of our hospital from March 2022 to March 2023. After at least 2-week-long behavioral therapy showed no significant therapeutic effect， 52 of the cases in the trial group were given oral Solifenacin 5 mg once daily and the other 15 cases in the control group continued the behavioral therapy. The cases in trial group were subdivided into OAB-dry group （27 cases without urinary incontinence） and OAB-wet group （25 cases with urinary incontinence）. The 3-day micturition diary， OAB Symptom Scores （OABSS） and the adverse reactions were recorded and analyzed before， at Weeks 2， 4， 8 and 12 after the treatment.ResultsOf all the 67 cases who completed a 3-month follow-up， 44 were cured including 41 in the trial group and 3 in the control group， 4 presented with adverse reactions. After the 3-month follow-up， the OABSS declined markedly in trial group than in control group （Z=4.524， P<0.001）； the cure rates in trial group and control group are 78.8% and 20% respectively， with significant difference （χ2=15.367， P<0.001）. At each follow-up，we found increased mean voided volume （F=9.707， P<0.001）， reduced mean voiding frequency during daytime （F=3.837， P=0.009） and decreased voiding urgency （χ2=482.835， P<0.001）. After the 3-month follow-up， the cure rates in OAB-dry group and OAB-wet group are 81.5% and 76% respectively， with no significant difference （χ2=0.234， P=0.629）.ConclusionsIn children with idiopathic OAB， oral Solifenacin 5 mg once daily could significantly increase mean voided volume， reduce mean voiding frequency during daytime， relieve symptoms of urinary urgency and lead to fewer adverse reactions， but is not significantly effective for the treatment of urinary incontinence in OAB-wet children .  
        关键词：overactive bladder （OAB）;urinary incontinence;urinary urgency;children;Solifenacin   
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        发布时间：2024-06-05

        Review

      • DAI Yuting,SHI Jingming
        Vol. 45, Issue 3, Pages: 344-353(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240419.006
        摘要：Alzheimer's disease （AD） is the most common form of senile dementia， and its pathogenesis is still unclear. While β-amyloid （Aβ） is considered an important cause of AD， the pathological mechanism of Aβ inducing AD is subject to various controversies. Recent studies have shown that the myeloid cell trigger receptor （TREM2） plays an important role in the pathological process of AD， and it can not only serve as an important receptor for the internalization of Aβ but also become a biological diagnostic biomarker and therapeutic target. Hence， elucidating the structure and function of TREM2 will provide important ideas for the prevention and treatment of AD. This article will provide a systematic review of the structure of TREM2， its impact on microglial cell function， its pathological role in AD， and the current status of targeted TREM2 therapy for AD. These summaries will provide valuable references for basic research on AD.  
        关键词：Alzheimer's disease;TREM2;microglia;β-amyloid;cell receptors   
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        发布时间：2024-06-05
      • QU Bingheng,TONG Xiaopeng
        Vol. 45, Issue 3, Pages: 354-360(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240419.003
        摘要：Diabetic kidney disease （DKD） is a chronic kidney disease caused by diabetes， influenced by genetic and environmental factors and their interaction. It is the primary cause of chronic kidney disease and end-stage renal disease. Recent studies have found， as a natural isoquinoline alkaloid， berberine （BBR） has hypoglycemic， hypolipidemic， antioxidant， anti-inflammatory and anti-fibrotic properties， thus protects against kidney injury in DKD. The mechanisms of action of BBR may involve improving glucolipid metabolism， reducing oxidative stress， alleviating inflammatory responses， mitigating renal fibrosis， regulating DNA methylation， promoting mitochondrial function and modulating the gut microbiota to enhance gut metabolism and clearance. This article systematically reviews the current status of research on the mechanisms of BBR in the treatment of DKD and provides reference for future clinical application of BBR in the treatment of DKD.  
        关键词：berberine （BBR）;diabetic kidney disease （DKD）;improved renal function;mechanisms of action;systematic review   
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      • YU Yu,YAO Yandan
        Vol. 45, Issue 3, Pages: 361-369(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240520.001
        摘要：With the improvement in quality of life and the development of medical science and technology， people's requirements for postoperative beauty are correspondingly improved. On the premise of ensuring safety and feasibility， the advantages of endoscopic small incisions are used to treat breast diseases. With the vigorous promotion of scholars all over the world， endoscopic treatment of breast cancer has changed from concept to reality. This article will briefly describe the development history of endoscopic treatment of breast cancer， introduce the indications obtained by experts from all over the world through practice， as well as the surgical methods of endoscopic treatment of breast cancer that have evolved based on traditional breast cancer surgery， and discuss the controversy and prospect of endoscopic treatment of breast cancer.  
        关键词：endoscope;breast cancer;surgery;minimally invasive;research development   
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        发布时间：2024-06-05
      • YU Ting,LIU Haijun
        Vol. 45, Issue 3, Pages: 370-376(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240515.002
        摘要：O-linked N-acetylglucosamine glycosylation （O-GlcNAcylation） is a protein post- translational protein formed by O-linked acetylglucosamine and serine/threonine residues on intracellular proteins. O-GlcNAc glycosylation modification is ubiquitous in the brain and is closely related to transcription， translation and protein homeostasis. O-GlcNAc glycosylation modification is involved in the occurrence and development of various neurological degenerative diseases， but its regulatory mechanism remains unclear. This paper reviews the relationship between O-GlcNAc glycosylation modification and neurological degenerative diseases.  
        关键词：O-GlcNAc glycosylation;neurodegeneration;OGT;OGA;glycosylation modification   
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      • YE Qing,SU Zhongzhen
        Vol. 45, Issue 3, Pages: 377-382(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240425.003
        摘要：First-phase ejection fraction （EF1） is the volume change rate of left ventricle （LV） from end-diastole to the time of peak aortic velocity. This article reviewed the research progress of EF1 in detecting early left ventricular systolic dysfunction （LVSD） of patients with aortic stenosis （AS）， stable coronary artery disease （SCAD）， Coronavirus Disease 2019 （COVID-19） and so on， analyzed the advantages and limitations of EF1 in clinical application， and envisioned the future development of EF1 as a novel predictor of early LVSD in clinical use.  
        关键词：first-phase ejection fraction （EF1）;ejection fraction;echocardiography;left ventricular systolic dysfunction （LVSD）;speckle tracking technique   
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        发布时间：2024-06-05

        Preclinic Research

      • YAN Yan,XU Zhaofeng,HUANG Yanran
        Vol. 45, Issue 3, Pages: 383-392(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240419.004
        摘要：ObjectiveThe heightened expression of local immunoglobulins is a significant pathological characteristic of chronic rhinosinusitis with nasal polyps （CRSwNP）， particularly in the Asian population. This study is centered on exploring the association between MZB1 and the localized aggregation of immunoglobulins in Asian individuals with CRSwNP.MethodsNasal polyp tissues obtained from 40 CRSwNP patients and inferior turbinates from 6 healthy controls underwent examination for both mRNA and protein levels. The assessments were conducted using polymerase chain reaction， luminex， and immunohistochemical staining. Statistical analyses， including one-way Anova （ANOVA）， independent samples t-test， and Pearson's correlation analysis， were employed for comprehensive data evaluation.ResultsThe mRNA expression levels of MZB1（P < 0.01） and HSP90B1 （P < 0.01） were significantly higher in type 2 CRSwNP patients compared with those in healthy controls. Immunohistochemical staining revealed a significant increase in MZB1 protein expression in type 2 CRSwNP. MZB1 demonstrated correlation with the expression of immunoglobulin E in nasal polyp tissues （P < 0.01， r = 0.52）. Additionally，MZB1correlated with the expression ofIL-5（P < 0.05， r = 0.4） and IL-13 （P < 0.05， r = 0.44） in nasal polyp tissues. Furthermore，MZB1showed correlation with the number of eosinophils in nasal polyp tissues （P < 0.05， r = 0.72）.ConclusionThe expression of MZB1 is notably elevated in Asian CRSwNP， particularly in type 2 CRSwNP， when compared with controls.MZB1expression correlates significantly with high IgE expression and disease severity in nasal polyp tissues.  
        关键词：chronic rhinosinusitis;chronic rhinosinusitis with nasal polyps;immunoglobulin;MZB1;IgE   
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      • YUAN Xun,BAN Li,TIAN Songlin,ZHU Qiulian,ZHANG Guiping,QIN Yuan,PAN Li,HOU Ning
        Vol. 45, Issue 3, Pages: 393-411(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240515.003
        摘要：ObjectiveTo explore how hyperthyroidism induces ventricular remodeling via activating β-catenin/FoxO1 in rat cardiomyocytes.MethodsHyperthyroidism-induced ventricular remodeling rat models were established by intraperitoneal injection of levothyroxine （T4） at 0.1 mg/kg for 30 days. β-catenin inhibitor MSAB （14 mg/kg） was administrated for 30 days. We used western blot to detect the expression of myocardial hypertrophy marker ANP， β-catenin and FoxO1； immunofluorescence to examine the expression and intracellular distribution of β-catenin and FoxO1. Hyperthyroidism-induced cardiomyocyte hypertrophy rat models were established by treatment of triiodothyronine （T3） into cultured primary neonatal rat cardiomyocytes for 24 hours. β-catenin siRNA （30 nmol/L） was used to down-regulate β-catenin expression in cardiomyocytes. Western blot and immunofluorescence were used to analyze the effects of β-catenin inhibition on the hyperthyroidism-induced cardiomyocyte hypertrophy.ResultsFollowing Wnt/β-catenin activation， β-catenin was found increased nuclear expression， to bind to the nuclear transcriptional factors and regulate the gene expression. β-catenin nuclear expression was significantly increased in the hyperthyroidism-induced ventricular remodeling rats， but no change was found in the expression of typical transcriptional factor TCF7l2. Our results revealed that inhibiting β-catenin by MSAB attenuated the hyperthyroidism-induced rat ventricular remodeling. Further analysis indicated that β-catenin/FoxO1 expression was significantly increased in hyperthyroidism-induced myocardial hypertrophy which could be attenuated by suppressing β-catenin/FoxO1 in cardiomyocytes.Conclusionsβ-catenin/FoxO1 is activated in hyperthyroidism-induced myocardial hypertrophy and β-catenin/FoxO1 inhibition attenuates hyperthyroidism-induced cardiomyocyte hypertrophy.  
        关键词：hyperthyroidism;myocardial hypertrophy;β-catenin;FoxO1;cardiomyocyte hypertrophy;MSAB;thyroid hormone   
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        发布时间：2024-06-05

        Clinical Research

      • LI Ximeng,LI Wenjuan,ZHANG Ke,LIU Chaoran,ZHU Yunfei,ZHAN Yingying,LIANG Mingzhu,HONG Guobin
        Vol. 45, Issue 3, Pages: 412-419(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240515.004
        摘要：ObjectiveTo analyze the value of grey-scale reversed T1-weighted （rT1） MRI in the detection of structural lesions of the sacroiliac joint （SIJ） in patients with axial spondyloarthritis （ax-SpA）.MethodsFifty-two ax-SpA patients who underwent both MRI and CT in our hospital within a week from February 2020 to December 2022 were retrospectively included. Both sacral and iliac side of each SIJ on oblique coronal images were divided into anterior， middle and posterior portion. Two radiologists reviewed independently three groups of MRI including T1-weighted imaging （T1WI）， rT1 and T1WI + rT1 images to evaluate the structural lesions like erosions， sclerosis and joint space changes in each of the 6 regions of the SIJ. One of the radiologist did the evaluation again one month later. CT images were scored for lesions by a third radiologist and served as the reference standard. Intra-class correlation coefficients （ICC） were calculated to test the inter- and intra-reader agreement for the assessment of SIJ lesions. A Friedman test was performed to compare the lesion results of MRI and CT image findings. We examined the diagnostic performance ［accuracy， sensitivity （SE） and specificity］ of different groups of MRI in the detection of lesions by using diagnostic test. A McNemar test was used to compare the differences of three groups of MRI findings.ResultsCT showed erosions in 71 joints， sclerosis in 65 and joint space changes in 53. Good inter-and intra-reader agreements were found in three groups of MRI images for the assessment of lesions， with the best agreement in T1WI + rT1. There were no difference between T1WI + rT1 and CT for the assessment of all lesions， nor between rT1 and CT for the assessment of erosions and joint space changes （P>0.05）. T1WI + rT1 yielded better accuracy and SE than T1WI in detection of all lesions （Accuracy erosions： 90.3% vs 76. 9%； SE erosions： 91.6% vs 76.1%； Accuracy sclerosis： 89.4% vs 80.8%； SE sclerosis： 84.6% vs 73.9%； Accuracy joint space changes： 86.5% vs 73.1%； SE joint space changes： 84.9% vs 60.4%； P<0.05）. rT1 yielded better accuracy and SE than T1WI in detection of erosions and joint space changes （Accuracy erosions： 87.5% vs 76.9%； SE erosions： 88.7% vs 76.1%； Accuracy joint space changes： 85.6% vs 73.1%； SE joint space changes： 83.0% vs 60.4%； P<0.05）.ConclusionsIn the detection of SIJ structural lesions in ax-SpA， rT1 improves the diagnostic performance and T1WI + rT1 is more superior to others.  
        关键词：axial spondyloarthritis （ax-SpA）;sacroiliac joint （SIJ）;structural lesions;MRI;grey-scale reversed   
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      • WU Caojun,FU Shishun,JIANG Guihua,MA Xiaofen,TIAN Junzhang
        Vol. 45, Issue 3, Pages: 420-428(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240424.001
        摘要：ObjectiveChildhood trauma （CT） is considered one of the major risk factors for developing major depressive disorder （MDD） in adulthood. However， the neural basis of MDD patients with CT （CT-MDD） remains poorly understood. Therefore， the objective of our study is to explore the resting-state global brain functional connectivity （FC） in CT-MDD.MethodsA total of 34 CT-MDD and 34 healthy controls performed resting-state fMRI. Whole-brain voxel-level degree centrality （DC） analysis was performed， and the brain regions with significant differences between the two groups were selected as region of interest （ROI） for further estimating the global brain FC. Subsequently， correlation analysis was performed between DC values， FC values in abnormal brain areas and clinical characteristics.ResultsThe CT-MDD group showed increased DC value of the right middle frontal gyrus （MFG） compared with the healthy controls. Seed-based FC revealed that the CT-MDD group showed increased connections between the left precuneus and the right MFG or the right medial prefrontal cortex， relative to healthy controls （threshold at P<0.05）. Additionally， the DC value of the right MFG was correlated with the severity of CT.ConclusionOur results show the increased FC between the left precuneus and the ROI （right MFG） as well as the right medial prefrontal cortex， which are two important brain regions within the default mode network （DMN）， and might suggest increased synchronism between the cognitive executive networks and DMN in CT-MDD. These findings may provide insights into the pathophysiological mechanisms underlying CT-MDD.  
        关键词：Childhood trauma;Major depressive disorder;Degree centrality;Functional connectivity;default mode network   
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      • LIN Suiwen,YAO Minrong,WU Fangyan,ZHAO Yong,LIN Jinmei,LIU Bin
        Vol. 45, Issue 3, Pages: 429-437(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240523.001
        摘要：ObjectiveTo establish the reference intervals of thyroid hormones in pregnant women from Sanming city and compare them with those from other areas in China.MethodsThe study recruited 605 pregnant women and 229 non-pregnant healthy women who visited Sanming First Hospital between March 29 and June 28， 2023. Blood samples were sequentially collected from the participants to determine the serum levels of thyroid stimulating hormone （TSH）， free triiodothyronine （FT3） and free thyroxine （FT4）. The reference intervals of thyroid hormones were established by using a percentile range of P2.5 to P97.5 and their changes in different periods of pregnancy were analyzed and compared with those from other areas in China.ResultsThere were significant differences in levels of TSH， FT4 and FT3 at different periods of pregnancy （all P <0.05）. Compared with non-pregnant women， women in first trimester had significantly decreased levels of TSH and FT4， but similar level of FT3. Since the second trimester， TSH level displayed rising tendency， while FT3 and FT4 levels showed gradual decrease. The reference intervals of thyroid hormones in the first， second and third trimester of pregnancy in Sanming city were TSH （0.068， 2.943） μU/mL， FT3 （4.302， 6.888） pmol/L， FT4 （8.240， 14.719） pmol/L； TSH （0.419， 3.274） μU/mL， FT3 （4.074， 6.629） pmol/L， FT4 （6.726， 11.980） pmol/L； TSH （0.422， 3.570） μU/mL， FT3 （3.741， 5.850） pmol/L， FT4 （6.103， 10.347） pmol/L， respectively. Significant differences were found in the reference intervals of thyroid hormones during pregnancy among different areas in China.ConclusionsThe levels of TSH， FT3， FT4 during pregnancy are different from those during non-pregnancy， and also significantly differ in different periods of pregnancy. Reference intervals of thyroid hormones in pregnant women are affected by various factors such as geographic location， ethnicity and laboratory test method， etc. Therefore， establishing the population-specific reference intervals of thyroid hormones will benefit for the diagnosis and treatment of thyroid disease in pregnant women from Sanming city.  
        关键词：pregnancy;thyroid hormones;reference intervals;thyroid disease;pregnancy outcome;every province and city;analysis   
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        发布时间：2024-06-05
      • YUAN Xin,XU Yuanyuan,ZHU Zhengping,ZHANG Min,WU Sushu,WANG Jingwen,WANG Shaokang
        Vol. 45, Issue 3, Pages: 438-445(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240425.001
        摘要：ObjectiveTo investigate the depression status and its influencing factors in HIV/AIDS patients receiving antiviral therapy.MethodsFrom July 2022 to September 2022， successive sampling method was used to recruit HIV/AIDS patients receiving antiviral therapy from antiviral treatment institutions in Nanjing， and they were instructed to fill out anonymous questionnaires. The questionnaire collected the basic information of patients， and depression， HIV stigma score and social support level were investigated by Patient Health Questionnaire-9 （PHQ-9）， Berger HIV stigma scale （BHSS） and Multidimensional Scale of Perceived Social Support （MSPSS）. Multivariate Logistic regression was used to analyze the influencing factors of depression.ResultsA total of 1879 valid questionnaires were collected in this study， and the detection rate of depression was 50.1%. The results of multivariate logistic analysis showed that compared with patients with middle school or below， the risk of depression was lower for those with postgraduate or above ［OR=0.534， 95%CI （0.341， 0.835）， P=0.006］. Compared with antiviral therapy duration<1 year， antiviral therapy duration for 1 to 5 years ［OR=0.729， 95%CI （0.536， 0.991）］， >5 to 10 years ［OR=0.516， 95%CI （0.379， 0.702）］， >10 years ［OR=0.603， 95%CI （0.375， 0.969）］ was associated with a lower risk of depression. High level of social support was a protective factor for depression in HIV/AIDS patients compared with middle and low level of social support ［OR=0.430， 95% CI（0.349， 0.530）， P < 0.001］. There was a higher risk of depression with side effects than without side effects ［OR=2.260， 95%CI （1.833， 2.786）， P < 0.001］. The higher the score on the HIV stigma scale， the higher the possibility of depression was.ConclusionThe detection rate of depression of patients receiving antiviral therapy in Nanjing is high. After starting antiviral therapy， we should strengthen the monitoring of side effects and psychological status of patients， carry out psychological intervention， alleviate psychological problems， and improve the quality of life of patients receiving antiviral therapy.  
        关键词：antiviral therapy;HIV/AIDS patients;depression;influencing factor;Logistic regression   
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      • WU Zhen,SHUI Xing,WU Zhen,CHEN Zefeng,CHEN Lin
        Vol. 45, Issue 3, Pages: 446-456(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.2024.0314
        摘要：ObjectiveTo investigate the effect of remnant cholesterol （RC）/high-density lipoprotein cholesterol （HDL-C） ratio on coronary computed tomography-derived fractional flow reserve （FFRct） in coronary heart disease （CHD） patients with critical lesions.MethodsA retrospective study was done on patients who were admitted to our department and underwent coronary computed tomography angiography （CCTA） from January 1， 2022 to December 31， 2022. All the 304 culprit vessels from the 219 patients with moderate coronary artery stenosis （50%~70%） were divided into FFRct ischemia group （FFRct≤0.8， N=108） and FFRct non-ischemia group （FFRct>0.8， N=111）. Multivariate logistic regression analysis was used to explore the influencing factors of FFRct≤0.8 in CHD patients with critical lesions. Receiver operating characteristic （ROC） curve was drawn to evaluate the predictive value of RC/HDL-C for FFRct≤0.8. Pearson correlation analysis was used to assess whether there was a correlation between RC/HDL-C and FFRct.ResultsThere were significantly more diabetic patients in FFRct ischemia group （P<0.001）. RC/HDL-C ratio， levels of RC， non-HDL-C， APOB， HbA1c and FPG in FFRct ischemic group were significantly increased （P<0.05）. Pearson correlation analysis showed that the RC/HDL-C ratio， levels of RC， Non-HDL-C， TC， TG， LDL-C， HDL-C， LP（a）， HbA1c， and FPG were all significantly negatively correlated with FFRct values （P<0.05）. Univariate logistic regression analysis showed that diabetes mellitus， RC/HDL-C ratio， levels of RC， non-HDL-C， TG， LP（a）， HbA1c and FPG were significantly correlated with FFRct≤0.8 （P<0.05）. Multivariate logistic regression analysis showed that RC/HDL-C ratio was a predictor of FFRct≤0.80 （OR=4.682， 95%CI 1.197~18.316， P<0.05）.ConclusionsRC/HDL-C ratio is independently correlated with FFRct≤0.8 in CHD patients with moderate stenosis and it is a potential indicator for evaluating coronary functional ischemia.  
        关键词：critical lesions of coronary heart disease;computed tomography-derived fractional flow reserve （FFRct）;RC/HDL-C ratio;remnant cholesterol （RC）;lipid metabolism   
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      • FANG Guangdong,JIA Beibei,CHEN Changchun,JIANG Shanyu
        Vol. 45, Issue 3, Pages: 457-465(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240419.001
        摘要：ObjectiveTo investigate the clinical features and high risk of very preterm infants with late-onset bacterial sepsis，so as to propose feasible prevention and treatment suggestions．MethodsTotally 94 very preterm infants with late-onset bacterial sepsis from the Neonatology Department of Women’s Hospital of Jiangnan University were recruited from February， 2012 to January， 2024. Their clinical data， including the perinatal situation， clinical symptoms， pathogens， risk factors and treatment， were collected and analyzed.ResultsThe incidence rate of very preterm infants with late-onset bacterial sepsis were 8.40 for 100 live birth babies. The major pathogens of the infections among these very premature infants included gram-positive bacteria （71.1%）. Logistic regression analysis showed that long term（≥7 d）use of antibiotics， invasive mechanical ventilation， indwelling central venous catheter（≥7 d）， and vaginal delivery were high risk factors of very preterm infants with late-onset bacterial sepsis， the relative risk （OR） values were 2.787， 4.243， 3.033 and 2.174， respectively.ConclusionThe gram-positive bacteria are the main pathogens of late-onset bacterial sepsis in very preterm infants. Long term（≥7 d）use of antibiotics， invasive mechanical ventilation， indwelling central venous catheter（≥7 d）and vaginal delivery are high risk factors of very preterm infants with late-onset bacterial sepsis. The incidence of late-onset bacterial sepsis in very preterm infants can be reduced by strengthening perinatal management， shortening the time of antibiotic application and reducing invasive operations.  
        关键词：very preterm infants;late-onset sepsis;bacterial infection;risk factor;prevention strategy   
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      • LI Dandan,HUANG Guodong,MA Wei,LIU Yiling
        Vol. 45, Issue 3, Pages: 466-474(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240515.001
        摘要：ObjectiveTo assess the impact of intraoperative plasma infusion dose and coagulation test value INR on the clinical prognosis of patients undergoing cardiac surgery， providing a basis for guiding rational blood use during cardiac surgery.MethodsThe clinical data of 305 surgical patients who received fresh frozen plasma transfusion during cardiac surgery were collected in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2014 to December 2022. The patients were divided into low-dose group （plasma infusion dose <15 mL/kg， n = 214） and high-dose group （plasma infusion dose ≥15 mL/kg， n = 91） based on the intraoperative plasma dose. Univariate analysis， correlation analysis and logistic multivariate regression analysis were used to analyze the relationship between plasma infusion dose， changes in INR before and after plasma transfusion， and the clinical prognosis of patients undergoing cardiac surgery.ResultsThe median plasma infusion dose for all patients was 11.11 （8.17-19.05） mL/kg， while the median plasma infusion dose in the high-dose group and the low-dose group was 17.78 （15.69-20.91） mL/kg and 9.52 （7.77-11.43） mL/kg， respectively， with a statistically significant difference （P <0.001）. The median INR decrease in the high-dose and low-dose groups was 0.98 （0.60-1.26） and 0.50 （0.35-0.76）， respectively， with a statistically significant difference （P<0.001）. Logistic multivariate regression analysis revealed that abnormally elevated preoperative INR values increased the risk of postoperative red blood cell transfusion within 24 hours in cardiac surgery patients （P<0.001）， with an OR 95%CI of 6.757（3.068， 14.822）. Additionally， it also increased the risk of postoperative in-hospital mortality （P< 0.001）， with an OR 95%CI of 5.441 （2.193， 13.499）. INR decrease reduced the risk of postoperative red blood cell transfusion within 24 hours in cardiac surgery patients （P=0.001）， with an OR 95%CI of 0.244（0.107， 0.558）. Correlation analysis showed positive correlation between plasma infusion dose and postoperative ICU days （rs=0.569， P<0.001） and hospital days （rs=0.302， P<0.001） in cardiac surgery patients.ConclusionAmong patients undergoing cardiac surgery who receive intraoperative plasma transfusion， high plasma infusion dose and abnormally elevated preoperative INR values are associated with poorer clinical outcomes， while patients who show a greater degree of INR correction after plasma transfusion exhibit better clinical results.  
        关键词：plasma dose;cardiac surgery;INR;red blood cells;clinical prognosis   
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      • XIA Kunjian,WANG Lin,SUN Zhenhua
        Vol. 45, Issue 3, Pages: 475-483(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240424.002
        摘要：ObjectiveTo investigate whether severe myelosuppression after chemotherapy is associated with prognosis in patients with breast cancer.MethodsTriple negative breast cancer （TNBC） patients who received chemotherapy at the Second Affiliated Hospital of Nanchang University from May 2， 2013 to May 2， 2018 were divided into a control group （no/mild myelosuppression） and a case group （severe myelosuppression）. In this study， 251 patients with TNBC met the inclusion and exclusion criteria， including 125 patients in the control group （20 patients with grade 0 myelosuppression， 43 patients with grade I myelosuppression， 62 patients with grade Ⅱ myelosuppression）， 126 patients in the case group （114 patients with grade Ⅲ myelosuppression， 12 patients with grade Ⅳ myelosuppression）. The general clinicopathological data of the patients in the two groups， including age， pathological type of tumor， tumor T stage， tumor N stage， tumor Nottingham grade， intravascular cancer thrombus， were analyzed using the χ2 test. The disease-free survival （DFS） and overall survival （OS） of the two groups were analyzed using the Kaplan-Meier method. A Cox proportional hazards regression model with multiple factors was used to analyze the impact of post-chemotherapy severe myelosuppression on disease-free survival （DFS） and overall survival （OS） in patients with TNBC.ResultsThe differences in general clinicopathologic data between the two groups of patients were not statistically significant （all P＞0.05）. The 5-year disease-free survival （DFS） rate was significantly lower in the control group compared with the case group （75.2% vs. 85.7%， P=0.027）. However， there was no statistically significant difference in the 5-year overall survival （OS） rate between the two groups （88.8% vs. 95.2%， P=0.057）. The analysis of the multifactorial Cox proportional hazards regression model revealed that post-chemotherapy severe myelosuppression was an independent protective factor for disease-free survival （DFS） （HR=0.332， 95% CI： 0.173-0.638， P=0.001） and overall survival （OS） （HR=0.193， 95% CI： 0.062-0.602， P=0.005） in TNBC patients.ConclusionOur results show that TNBC patients with severe myelosuppression after chemotherapy have longer disease-free survival （DFS） than those with no/mild myelosuppression， and overall survival （OS） also tend to be prolonged compared with those with no/mild myelosuppression， and severe myelosuppression after chemotherapy can be used as an independent predictor of a good prognosis in breast cancer.  
        关键词：triple negative breast cancer;adjuvant chemotherapy;myelosuppression;disease-free survival;overall survival   
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      • CHEN Shuoshuo,YANG Zhengfei,LI Zixuan,YE Guitong,YANG Xiao,WANG Mengyi
        Vol. 45, Issue 3, Pages: 484-492(2024) DOI: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20240419.005
        摘要：ObjectiveTo assess the repeatability （intra-operator variability） and reproducibility （inter-operator variability） of a new partial coherence interferometry （PCI）-based ocular biometer， Myopia Master， and its agreement with IOL Master 500 for measuring axial length （AL） and corneal curvature （K） in children aged 8-12 years.MethodsThe same operator measured school children with the Myopia Master and the IOL Master 500 in random order to assess agreement. Additionally， some of these children received measurements from another operator using the Myopia Master to assess repeatability and reproducibility. AL， flat keratometry （Kf）， steep keratometry （Ks）， mean keratometry （Km）， J0 and J45 were analyzed. The repeatability and reproducibility were assessed by the within-subject standard deviation （Sw）， test-retest repeatability （TRT）， coefficient of variation （CoV） and intra-class correlation coefficient （ICC）. The agreement between the Myopia Master and the IOL Master 500 was assessed by Bland-Altman plots and 95% limits of agreement （LoA）.ResultsBoth repeatability and reproducibility of the Myopia Master were high for AL measurements （Sw=0.02 mm， ICC=0.999； Sw=0.04 mm， ICC=0.998）， but moderate for K measurements （Sw range， 0.04 to 0.12 D， ICC range， 0.861 to 0.991； Sw range， 0.06 to 0.20 D， ICC range， 0.835 to 0.992）. There were significant mean differences between the Myopia Master and the IOL Master 500 in measurements of AL （-0.01±0.04） mm， Kf （-0.09 ± 0.15） D， Ks （-0.47±0.40） D， and Km （-0.28±0.23） D， J0 （0.18±0.20） D and J45 （-0.01±0.12） D.ConclusionsThe Myopia Master provided high repeatability and reproducibility for AL measurements in schoolchildren with myopia， but the Myopia Master and the IOL Master 500 cannot be used interchangeably in measuring AL and K.  
        关键词：partial coherence interferometry the （PCI）;axial length（AL）;corneal curvature （K）;repeatability;reproducibility;agreement   
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