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2023 Vol. 53, No. 3 Published: 2023-03-25   173 Influence of FCGR3A gene variations on the risk of Crohn’s disease and the clinical response to infliximab in Chinese patients SHAO Xiaoxiao, HU Dingyuan, CAO Shuguang, WU Hao, XU Yuan, HU Yue, JIANG Yi. DOI: 10.3969/j.issn.2095-9400.2023.03.001 Objective: To investigate the influence of FCGR3A (rs396991, rs4656317) gene variations on the risk of Crohn’s disease (CD) and the clinical response to infliximab (IFX). Methods: After the collection of 225 CD patients and 476 age- and gender-matched controls from the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University during January 2012 to January 2021, the genotypes of rs396991 and rs4656317 were determined by Matrix Assisted Laser Desorption Spectrometry for time-of-flight Mass Spectrometry technique. Linkage disequilibrium (LD) and haplotype were analyzed in all study subjects.Of 225 CD patients, who had initial active stage [Crohn’s disease activity index (CDAI)≥150 points] were given intravenous IFX (5 mg/kg) at week 0, 2, and 6 to induce remission, followed by the same dose of IFX every 8 weeks. These patients were divided into response group and non-response group based on CDAI and simplified endoscopic score for Crohn’s disease (SES-CD) at 14th week. A retrospective analysis was performed for the influence of FCGR3A gene variations on the clinical response of IFX in this cohort of CD patients. Results: The variant allele (C) of rs396991 was shown to be more prevalent in CD patients than in the controls (39.33% vs. 31.83%, P=0.006). Both the variant allele (C) and variant genotype (GC+CC) of rs4656317 were more frequent in CD patients than in the controls (45.33% vs. 36.55%, P=0.002; 71.11% vs. 61.76%, P=0.016). The stratified analysis indicated that the variant genotype (AC+CC) of rs396991 and variant genotype (GC+CC) of rs4656317 were decreased in the patients with type L2 CD or type L3 CD in contrast to those with type L1 CD (55.00% vs. 72.31%, P=0.016; 66.25% vs. 83.08%, P=0.012). The polymorphic loci of rs396991 and rs4656317 were in close linkage disequilibrium with each other in FCGR3A gene (D’=0.94, r2=0.72). The analysis for LD showed that the frequency of haplotype (AG) was lower in CD patients than in the controls (53.78% vs. 62.18%, P=0.003).In contrast, the frequency of haplotype (CC) was higher in CD patients than in the controls (38.67% vs. 30.56%,P=0.003). After the treatment of IFX for 14 weeks, 98 CD patients with initial active stage were divided into response group (82 cases) and non-response group (16 cases). The variant allele (C) of rs396991 was shown to be less prevalent in response group than in non-response group (23.17% vs. 43.75%, P=0.016). At the 14th week, 16 patients of non-response group were analyzed according to the effective concentration of IFX and the concentration of IFX anti-antibody. The result suggested that the proportion of rs396991 allele C in IFX anti-antibody highconcentration group (≥70 ng/mL) was higher than that in IFX anti-antibody low-concentration group (<70 ng/mL) (71.43% vs. 22.22%, P=0.011). Conclusion: Both the variations of rs396991 and rs4656317 in FCGR3A gene may increase the risk of CD, especially the risk of terminal ileal involvement. In addition, the variation of rs396991 might contribute to the production of IFX anti-antibody, thereby reducing the clinical response of CD patients to IFX treatment. 2023 Vol. 53 (3): 173-181 [Abstract] ( 304 ) HTML (1 KB)  PDF (1359 KB)  ( 635 ) 182 Effect of Apigenin on angiogenesis and neurogenesis in the cerebral ischemic penumbra of middle cerebral artery occlusion rat via VEGF signaling pathway LIU Chan, HU Quan, XIE Qingfeng, ZHU Anqi, CHEN Xiang. DOI: 10.3969/j.issn.2095-9400.2023.03.002 Objective: To investigate the effects of Apigenin (APG)-induced angiogenesis and neurogenesis in the cerebral ischemic penumbra of middle cerebral artery occlusion (MCAO) rats and whether these changes involve the vascular endothelial growth factor (VEGF) signaling pathway. Methods: A total of 144 adult male Sprague Dawley rats were randomly divided into sham operation group (groups S7 and S14, respectively), a model group (groups M7 and M14, respectively), an APG treatment model group (groups AM7 and AM14,respectively), and an APG+VEGF-R inhibitor treatment model group (groups AIM7 and AIM14, respectively).A MCAO animal model was established; neurobehavioral performance and infarct volumes were assessed using the modified neurological severity score (mNSS) and 2, 3, 5‑triphenyl tetrazolium chloride staining; VEGF expression levels, and changes in angiogenesis and new neurons in the cerebral ischemic penumbra were evaluated using Western blot analysis, immunohistochemistry, and immunofluorescence. Results: Compared with the S group, the neurologic impairment symptoms and white infarcts were observed in the M group, AM group and AIM group; the neurological scores and infarct volume in the AM group were significantly decreased compared with those in the M group at the same time-point (P<0.05). The VEGF expression in the AM group was increased compared with that in the M group at the same time-point (P<0.01), and microvessel density was increased in the AM7 group compared with that in the M7 group (P<0.05). The number of bromodeoxyuridine (BrdU)/nestin and BrdU/NeuN double-labeled positive cells in the AM group were significantly increased compared with those in the M group at the same time-point (P<0.01). VEGF-R inhibitors reversed the improvement effect of APG. Conclusion: APG ameliorates focal cerebral ischemia/reperfusion-induced neurological deficit by promoting angiogenesis and neurogenesis through upregulation of the VEGF signaling pathway. 2023 Vol. 53 (3): 182-188 [Abstract] ( 285 ) HTML (1 KB)  PDF (2674 KB)  ( 493 ) 189 Anti-gastric cancer activity of 4’-O-methylbroussochalcone B in vitro TANG Yaling, YI Baozhu, LI Wulan, WU Jianzhang, ZHANG Huajie DOI: 10.3969/j.issn.2095-9400.2023.03.003 Objective: To investigate the anti-gastric cancer activity of 4’-O-methylbroussochalcone B in vitro. Methods: After the gastric cancer cell line AGS was treated with 4’-O-methylbroussochalcone B, the cell growth was detected by MTT and colony assay, cell migration by wounding healing assay, cell cycle and apoptosis by the flow cytometry, the expression of DYRK1A protein by Western blot. Results: The IC50 of 4’-Omethylbroussochalcone B on AGS was (7.7±1.3) μmol/L, which could inhibit colony formation and migration,induce cycle arrest and apoptosis, and down-regulate the expression of DYRK1A in a concentration-dependent manner (P<0.05). Conclusion: 4’-O-methylbroussochalcone B has significant anti-gastric cancer activity by inhibiting DYRK1A in vitro. 2023 Vol. 53 (3): 189-194 [Abstract] ( 307 ) HTML (1 KB)  PDF (2108 KB)  ( 739 ) 195 Development trajectory and influencing factors of cancer recurrence fear in spouses of patients with postoperative adjuvant chemotherapy after breast cancer ZHANG Yanfang, YU Yuanyuan, HU Manman,LUO Qun, WANG Li, ZHAO Long, YANG Xiumu DOI: 10.3969/j.issn.2095-9400.2023.03.004 Objective: To analyze the development trajectory of cancer recurrence fear and its influencing factors in the spouses of patients with adjuvant chemotherapy after breast cancer surgery. Methods: Convenient sampling method was used to select spouses of patients with adjuvant chemotherapy after breast cancer surgery as the investigation subjects, who were admitted to the Department of Oncology, the First Affiliated Hospital of Bengbu Medical College and the Second Affiliated Hospital of Bengbu Medical College from May 2021 to December 2022. Spouses were surveyed by fear of disease progression reduced scale, resilience scale and perceived social support scale before surgery, 7 days, 3 months, 5 months, 7 months after surgery. The growth mixed model was used to identify spouse cancer recurrence fear trajectory of potential categories, and multiclassification Logistic regression analysis was made on the influencing factors of potential categories. Results: A total of 192 spouses of breast cancer patients were included, and the trajectory of cancer recurrence was identified into three categories, namely, late remission (32.8%), slow decline (50.5%), and persistent fear (16.7%). Multiclassification Logistic regression analysis showed that residence, education level, combined chronic diseases,shared caregivers, psychological resilience and social support were the influencing factors of the trajectory of cancer recurrence (P<0.05). Conclusion: The fear of cancer recurrence in spouses of breast cancer patients is heterogeneous from preoperative to 7 months postoperative. Medical staff should pay more attention to the evaluation and intervention of the fear of cancer recurrence in spouses with more chronic diseases and lower level of social support. 2023 Vol. 53 (3): 195-202 [Abstract] ( 333 ) HTML (1 KB)  PDF (1381 KB)  ( 668 ) 203 Short-term clinical effect of artificial joint replacement in the treatment of the elderly after failure of femoral trochanteric internal fixation CAI Leyi, XIANG Guangheng, CHEN Hua, GUO Xiaoshan, CHEN Long. DOI: 10.3969/j.issn.2095-9400.2023.03.005 Objective: To investigate the short-term clinical effect of artificial joint replacement after failure of internal fixation of femoral trochanteric fracture in elderly osteoporosis patients. Methods: The patients with internal fixation failure of femoral trochanteric fracture who were treated at the Second Affiliated Hospital of Wenzhou Medical University between January 2010 and January 2020 with complete follow-up data were selected and treated with artificial joint replacement. Relevant clinical indicators and complications of patients were recorded, and Harris score and VAS score of hip joint of patients before and after operation were compared.Results: A total of 20 patients were included, including 14 males and 6 females, with an age range from 65 to 85 years (mean age, 74.7±5.8 years old). All patients successfully underwent the operation, with a mean operation time of (113.5±16.3)min, and the bleeding volume was (687.5±304.3)mL. Two patients suffered pulmonary infection and 1 patient had heart failure after surgery but improved with relevant medical treatment. One patient developed superficial infection, and the wound healed after oral antibiotics and dressing change. In the followup,there was one case of periprosthetic fracture, and the rest had no complications such as prosthesis loosening,prosthesis sinking, prosthesis instability, deep joint infection, joint dislocation, etc. Harris score of the hip joint of the patients in this group was 39.4±6.8 before operation, and 85.7±4.3 in the last follow-up. The preoperative VAS score was 7.2±1.0, and the final follow-up VAS score was 1.6±0.5. The preoperative SF-36 score was 43.6±7.9,and the final follow-up score was 84.5±4.1. All the three scores were significantly improved (P<0.05). Conclusion:Artificial joint replacement is an effective treatment for elderly patients with osteoporotic femoral intertrochanteric fracture who experience failure of internal fixation after surgery, with a significant short-term clinical effect that can effectively reduce hip joint pain and restore hip joint function. 2023 Vol. 53 (3): 203-208,214 [Abstract] ( 279 ) HTML (1 KB)  PDF (1601 KB)  ( 912 ) 209 The predictive value of nomogram model in the occurrence of plastic bronchitis in patients with Mycoplasma pneumoniae infection LIU Jiahui, MA Li, LI Fang. DOI: 10.3969/j.issn.2095-9400.2023.03.006 Objective: To explore the predictive value of nomogram model in the occurrence of plastic bronchitis (PB) in children with Mycoplasma pneumoniae pneumonia (MPP). Methods: A retrospective analysis was performed on 246 children with MPP who were admitted to the pediatrics department of Lanzhou Xigu District People’s Hospital from June 2018 to June 2022. Children were divided into PB group (n=66) and non-PB group (n=180) according to whether PB occurred or not. The variables were screened by univariate analysis and multivariate logistic regression analysis, and a nomogram prediction model for the occurrence of PB in children with MPP was constructed. Then, the consistency of the prediction model by calibration curve, the accuracy of the prediction model by receiver operating characteristic (ROC) curve, and the clinical value of the prediction model was evaluated by decision curve analysis (DCA). Results: The values of fever duration, peak body temperature, neutrophil percentage, interleukin-6, lactate dehydrogenase, D-dimer, C-reactive protein and the proportions of children with hypoxemia, glucocorticoids, atelectasis and pleural effusion were significantly higher than those in the non-PB group (P<0.05), while the platelet count was significantly lower than that in the non-PB group (P<0.05). Multivariate logistic regression results showed that fever duration, peak body temperature, atelectasis, pleural effusion, neutrophil percentage, platelet count, interleukin-6 and lactate dehydrogenase were the influencing factors of PB in children with MPP. The calibration curve results showed that the incidence of PB predicted by the nomogram model had a good agreement with the actual incidence. The ROC curve results showed that the AUC of the nomogram model was 0.925 (95%CI=0.886 -0.965, P<0.05). The DCA curve results showed that the nomogram model had a higher rate of clinical net benefit. Conclusion: In this study, a nomogram prediction model for the occurrence of PB in children with MPP was constructed by using fever duration, peak body temperature, atelectasis, pleural effusion, neutrophil percentage, platelet count, interleukin-6 and lactate dehydrogenase, which has good consistency and accuracy, clinical application value. 2023 Vol. 53 (3): 209-214 [Abstract] ( 343 ) HTML (1 KB)  PDF (1396 KB)  ( 576 ) 215 The precision of novel color LED corneal analyzer Cassini in measuring corneal curvature and intraocularlens power calculation HU Xiuli, LU Weicong, YU Xinxin DOI: 10.3969/j.issn.2095-9400.2023.03.007 Objective: To evaluate the repeatability and agreement of novel corneal analyzer Cassini in measuring corneal curvature and corneal astigmatism with IOLMaster analyzer with an analysis of the prediction of Cassini in intraocular lens power calculation. Methods: This prospective comparative study included 77 eyes of 77 patients. One experienced operator measured corneal parameters using Cassini and IOLMaster three times, including the flattest keratometry (Kf), the steepest keratometry (Ks), astigmatism (Ast), total corneal power (TCP), total corneal astigmatism (TCA) and vector analysis of astigmatism (J0, J45). The within-subject standard deviation (Sw), test-retest repeatability (TRT), and intraclass correlation coefficient (ICC) were used to assess repeatability. The agreement between Cassini and IOLMaster was achieved by Bland-Altman plots and 95% limits of agreement (LoA). The mean absolute error (MAE) of different devices and subjective refraction was calculated after a 3-month follow-up period to analyze the precision of intraocular lens (IOL) power calculation. Results:  The TRT of Kf, Ks and TCP measured by Cassini were less than 0.55 D, and the ICC values were more than0.995. The TRT and ICC were 0.47 D and 0.973 for astigmatism, respectively. The TRT and ICC of TCA were 0.75 D and 0.953, respectively. All the TRT values were less than 0.48 D and ICC values were more than 0.893 for J0, J45, J0-TCA and J45-TCA. The MAE values of Cassini and IOLMaster were both lower than 0.43 D with four different IOL calculation formulas. The percentages of eyes within ±0.25 D, ±0.50 D, ±0.75 D and ±1.00 D of prediction error were all greater than 28%, 62%, 85% and 94% with different IOL calculation formulas. Conclusion: The novel corneal analyzer Cassini in measuring corneal curvature and corneal astigmatism had fantastic repeatability except TCA. The corneal curvature parameters revealed good agreement in Ks and Kf with IOLMaster and could be used interchangeably. In prediction error, the Cassini had similar precision with IOLMaster that makes it suitable for application inIOLcalculation 2023 Vol. 53 (3): 215-220 [Abstract] ( 282 ) HTML (1 KB)  PDF (1410 KB)  ( 469 ) 221 The value of dual energy CT-based nomogram in predicting extraglandular invasion of papillary thyroid carcinoma XIA Shuiwei, LIN Guihan, CHEN Weiyue, CHEN Chunmiao, YING Haifeng, JI Jiansong. DOI: 10.3969/j.issn.2095-9400.2023.03.008 Objective: To investigate the value of nomograms based on dual-energy CT in predicting extraglandular invasion (ETE) of papillary thyroid carcinoma (PTC) before surgery. Methods: A total of 252 patients with PTC confirmed by surgery and pathology in the Fifth Affiliated Hospital of Wenzhou Medical University from March 2017 to December 2021 were retrospectively collected, and were divided into ETE group (n=150) and non-ETE group (n=102) according to the results of pathological diagnosis. All patients were randomly divided into training group (n=176) and validation group (n=76) using a ratio of 7:3. All patients underwent preoperative dual-energy CT neck enhanced scan, and the standardized iodine concentration (NIC), slope of the spectral curve (λHU), and effective atomic number (Zeff) of the lesion in the arterial and venous phases were measured and calculated; conventional CT features including lesion location, longest diameter, presence or absence of calcification, and presence or absence of breakthrough capsule were analyzed. Independent risk factors for ETE were screened by univariate analysis and multivariate logistic regression analysis, and a joint model was constructed and a nomogram was drawn. Model performance and clinical value were assessed using area under receiver operating characteristic (ROC) curve (AUC), calibration curve, and decision curve analysis (DCA). Results: In the training set, there’s significant difference between the two groups (all P<0.05) in the tumor location and whether or not the capsule had broken through the capsule. The NIC, λHU and Zeff in the arterial phase and the Zeff in the venous phase of PTC in the ETE group were significantly higher than those in the non-ETE group (all P<0.05). Multivariate logistic regression analysis showed that ventral location of the lesion, breakthrough of the capsule under CT, NIC in the arterial phase, Zeff in the arterial phase, and Zeff in the venous phase were independent risk factors for predicting ETE in PTC. The AUCs of the constructed nomogram prediction model in the training and validation sets were 0.902 (0.859-0.946) and 0.892 (0.810-0.964), respectively. The calibration curve showed a good agreement between the actual value of the sample and the predicted probability of the model, and the DCA indicated that the clinical application value of the model was high. Conclusion: The nomogram based on dual-energy CT can provide a certain guiding value for non-invasive preoperative prediction of ETE in patients with PTC. 2023 Vol. 53 (3): 221-226 [Abstract] ( 368 ) HTML (1 KB)  PDF (1701 KB)  ( 840 ) 227 Significance of peripheral blood platelet/lymphocyte ratio and its changes in clinical features and prognosis of patients with early cervical cancer ZHANG Fan, DU Junqiang, WANG Chaoqun, HU Yan DOI: 10.3969/j.issn.2095-9400.2023.03.009 Objective: To explore the effects of platelet/lymphocyte ratio (PLR) level and its change preand post-operation on patients with early cervical cancer, and to analyze the relationship between PLR and clinical features and prognosis. Methods: Clinical, pathological and prognostic data of 203 patients with stage I-IIA cervical cancer admitted to Affiliated Dongyang Hospital of Wenzhou Medical University from January 2012 to December 2017 were retrospectively collected. PLR was calculated by dividing the value of peripheral blood platelets by the absolute value of lymphocytes. The patients were divided as PLR high-level group and low-level group, before and after operation respectivel, based on the median value of PLR. The differences of clinicopathological characteristics and prognosis between groups were compared. Results: The preoperative PLR level was negatively correlated with age (P=0.010) and menopausal status (P<0.001), while postoperative PLR level was positively correlated with lymph node metastasis (P=0.012). The increase of PLR level after operation was positively correlated with the menopause status of patients (P=0.011). Survival analysis showed that there was no significant difference in the overall survival rate and progression free survival rate between groups with high and low levels of PLR before and after surgery, and between groups with increased and decreased levels of PLR after surgery (P>0.05), suggesting that it was not related to the prognosis of cervical cancer. Cox regression analysis showed that clinical staging was an independent influence factor for 5-year DFS in patients with early cervical cancer. Conclusion: PLR level and changes pre- and post- operation are closely related to some clinicopathological features in early cervical cancer patients, but not associated with the prognosis of patients. 2023 Vol. 53 (3): 227-232 [Abstract] ( 337 ) HTML (1 KB)  PDF (1445 KB)  ( 530 ) 233 The application of metagenomic next-generation sequencing to the diagnosis of causative pathogens of lung LIANG Chunchan, LE Yisha, LI Haiyan, XU DOI: 10.3969/j.issn.2095-9400.2023.03.010 Objective: To explore the application value of mNGS in the diagnosis of causative pathogens of lung abscesses. Methods: The clinical data and mNGS results of 4 children with lung abscess treated at the respiratory department of our hospital from August 2019 to August 2021 were retrospectively analyzed, and the relevant literature was reviewed. Results: All 4 cases were male, with onset age ranging from 2 month to 11 years presented with symptoms such as cough and fever, with the mean fever duration being 10.5 (range 6-17 d) d; P4 also had dyspnea and chest pain. All 4 cases of lung abscess were diagnosed using chest CT, and P4 had two pulmonary abscesses. The mNGS analysis identified Streptococcus pneumoniae, Staphylococcus aureus ,prevotella respectively in P1-3 (BALF), and Acinetobacter Johnson and Staphylococcus hominis in P4 (blood).Only P1 (BALF) had bacterial cultures positive for Streptococcus pneumoniae, and the other three patients were negative. All patients improved after intravenous antibiotic therapy with the mean duration being 11.75 (ranging9-14 d) d. They received oral antibiotic therapy (sequential) after discharge. They were followed-up 8-12 weeks, and their chest imaging was normal. Seven articles on the diagnosis of adult lung abscess pathogens by mNGS were retrieved. However, Literature search identified no related literature in pediatric cases or study. Conclusion: With its unique technical advantages, high sensitivity and the ability to detect anaerobic bacteria and rare pathogens, mNGS can provide new means for the diagnosis of causative pathogens of pediatric lung abscesses,which will guide the treatment of clinical antibacterial drugs. 2023 Vol. 53 (3): 233-239 [Abstract] ( 265 ) HTML (1 KB)  PDF (1661 KB)  ( 529 ) 233 Analysis of clinical features of Trophery whipplei pneumonia in children LI Changchang, PAN Xiaoyu, DOI: 10.3969/j.issn.2095-9400.2023.03.011 Objective: To investigate the clinical features, diagnosis and treatment of Trophery whipplei (TW) pneumonia in children and to improve the understanding of the disease. Methods: The clinical data of 3 children with TW pneumonia admitted to the Department of Pediatric Respiratory of the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University from August 2020 to January 2022 were analyzed retrospectively. The keywords “Trophery whipplei” and “lung infection” or “pneumonia” were used in China Knowledge Network and Wanfang database, and the keywords “Trophery whipplei” and “pneumonia” were used as keywords to search the relevant literature in PubMed database since the establishment of the database until July 2022. The clinical features, ancillary examinations, treatment and prognosis of TW pneumonia were summarized. Results: Of the three children in this paper, two were male and one was female, with a mean age of (7.3±2.3)years. TW was detected by macrogenomic second generation sequencing (BALF mNGS) of alveolar lavage fluid in all cases, and Haemophilus influenzae was detected in case 3 combined. All 3 cases were treated with ceftriaxone injection anti-infection, combined or renewed with TMP-SMZ, and the prognosis was good in the remaining 2 cases except case 2, which had a poor prognosis. Three Chinese literature articles and 15 English literature articles were searched for eligible cases, totaling 23 cases. Together with the 3 cases in our group, a total of 26 cases, the clinical features of the disease were non-specific, mainly presenting as cough (14 cases), dyspnea/shortness of breath (12 cases), and chest pain (6 cases). Conclusion: Whipple’s feeder pneumonia is mostly a chronic lung infection with atypical clinical features and imaging manifestations, which is very easy to be misdiagnosed clinically. Early BALF mNGS can help to clarify the pathogen and assist in the diagnosis, and  reasonable anti-infective treatment can rapidly relieve the symptoms, but it is easy to recur, and the prognosis is mostly good. 2023 Vol. 53 (3): 233-239 [Abstract] ( 497 ) HTML (1 KB)  PDF (1567 KB)  ( 917 ) 245 Risk factors related to sleep disorder in maintenance hemodialysis patients PAN Lulu, SHAO Guojian, DOI: 10.3969/j.issn.2095-9400.2023.03.012 Objective: To explore the related risk factors for sleep disorder in maintenance hemodialysis (MHD) patients so as to provide theoretical basis for clinical prevention and treatment. Methods: A total of 200 MHD patients who visited the hemodialysis center of Wenzhou Central Hospital from January 2022 to August 2022 were selected. MHD patients were divided into non-sleep disorder group and sleep disorder group according to the Pittsburgh sleep quality index (PSQI) scale. With general data of the two groups obtained, their blood samples were collected before hemodialysis in the month of investigation. The two groups were compared in the differences of each clinical index and their correlation with the occurrence of sleep disorder. Results: The incidence of sleep disorder in 200 MHD patients was 66.5% (133/200). There were significant differences between the two groups (P<0.05) in age, proportion of constipation, proportion of diabetes, proportion of skin pruritus,hemoglobin, blood phosphorus, iPTH, hs-CRP, BMI, Kt/V and 25(OH)D3 levels. Further multivariate Logistic regression analysis showed that age, hs-CRP, hemoglobin, Kt/V, 25(OH)D3, combined constipation and combined skin pruritus were associated with sleep disorder in MHD patients (P<0.05). Conclusion: Older age, high level of hs-CRP, low level of hemoglobin, low level of Kt/V, low level of 25(OH)D3, constipation and skin pruritus were independent risk factors for sleep disorder in MHD patients. 2023 Vol. 53 (3): 245-249 [Abstract] ( 282 ) HTML (1 KB)  PDF (1288 KB)  ( 493 ) 256 Progress of lung ultrasound in the diagnosis and treatment of pneumonia in children CAI Shujing，ZHANG Lele, ZHENG Yangming, ZHANG Hailin DOI: 10.3969/j.issn.2095-9400.2023.03.015 Lung ultrasound has advantages of real-time imaging, no radiation risk, relatively low costs, no need for a sedative, high sensitivity and specificity, bedside availability, easy to learn, suitable for dynamic follow-up, therefore it has gradually become one of the important tools and achieved increasingly wide application in the clinical diagnosis of lung diseases. In recent years, more and more literatures have been found on the application of lung ultrasound in the diagnosis and evaluation of pneumonia in children, but agreement has not yet reached on some issues. The author summarizes the methods and common signs of lung ultrasound, and its value in the diagnosis, etiological differentiation and severity judgment of infective pneumonia in children. This article reviews the progress of the application of lung ultrasound in the diagnosis, etiological differentiation, severity judgment and prognosis follow-up of pneumonia in children, so as to improve clinicians' understanding of this technique for further application and development. 2023 Vol. 53 (3): 256-258 [Abstract] ( 342 ) HTML (1 KB)  PDF (1304 KB)  ( 611 )

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