Objective:To explore the new mechanism of liver fibrosis through D-galactosamine/lipopolysaccharide (D-GalN/LPS)-induced necroptosis as an entry point to inhibit lethal injury.Methods:The carbon tetrachloride (CCl4)-induced mouse model of liver fibrosis was established. At 6 weeks of fibrosis, the mice were challenged with a lethal dose of D-GalN/LPS, and the normal mice treated with the same treatment were used as the control. The experiment was divided into four groups: control group (Control), acute injury group (D-GalN/LPS), liver fibrosis group (Fib), and liver fibrosis + acute challenge group (Fib + D-GalN/LPS). Quantitative PCR and immunofluorescence were used to analyze the expression of necroptosis key signal molecules RIPK1, RIPK3, MLKL and/or P-MLKL in each group. Normal mice were treated with inhibitors targeting key signaling molecules of necroptosis, and then given an acute challenge. The inhibitory effect of D-GalN/LPS-induced-necroptosis on acute liver injury was evaluated according to the changes in transaminase levels and liver histology. Liver fibrosis spontaneous ablation model was established, and then acute challenge was given. Necroptosis key signal molecules expression was analyzed in liver tissue of mice in each group and compared by immunohistochemistry. The differences between groups were compared with t-test or analysis of variance.Results:Quantitative PCR and immunofluorescence assays result showed that D-GalN/LPS-induced significant upregulation of RIPK1, RIPK3, MLKL and/or P-MLKL. Necroptosis key signal molecules inhibition had significantly reduced D-GalN/LPS-induced liver injury, as manifested by markedly reduced serum ALT and AST levels with improvement in liver histology. Necroptosis signaling molecules expression was significantly inhibited in fibrotic livers even under acute challenge conditions. Additionally, liver fibrosis with gradual attenuation of fibrotic ablation had inhibited D-GalN/LPS-induced necroptosis.Conclusion:Liver fibrosis may protect mice from acute lethal challenge injury by inhibiting D-GalN/LPS-induced necroptosis.

目的 观察老年反杓型血压节律者中,日间血压控制是否达标的影响因素、用药选择以及对心脏重构的影响.方法 连续入选2016年1月至2019年1月在我院老年内科住院的年龄≥65岁的高血压患者,通过24小时动态血压监测(24 h ABPM)筛选出反杓型血压节律患者共300例,根据日间手测血压结果是否达标分为达标组148例和未达标组152例.比较2组患者的特征及药物使用的差异,通过超声心动图方法比较血压控制是否达标对心脏结构和功能的影响.结果 2组日间手测血压比较,未达标组收缩压更高,而舒张压差异无统计学意义;ABPM结果显示,2组间除舒张压外,不同时段的平均收缩压和平均脉压之间差异均有统计学意义(均P<0.05).2组患者中,年龄、性别、冠心病、外周血管疾病、肾功能不全共患病率、血脂水平之间差异均无统计学意义(均P>0.05);糖尿病共患病率、体重指数(BMI)、氮末端脑钠肽(NT-pro-BNP)水平在血压未达标组中明显高于达标组,差异均有统计学意义(均P<0.05).药物治疗方面,绝大多数患者(272例,90.67％)为联合用药,钙离子拮抗剂、血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂(ACEI/ARB)以及α受体拮抗剂的应用比例差异均无统计学意义,而噻嗪类利尿剂和β受体阻滞剂的应用,在日间血压达标组较未达标组明显增多.应用超声心动图评估心脏结构功能,2组患者的左心室射血分数(LVEF)之间差异无统计学意义;室间隔厚度、左心室重量指数(left ventricular mass index,LVMI)、左心房内径、E/e'值在血压未达标组均高于达标组(均P<0.05).结论 在老年反杓型节律高血压患者中,噻嗪类利尿剂及β受体阻滞剂的应用更有利于血压降至目标值.血压控制未达标患者的NT-pro-BNP水平升高,且室间隔厚度、LVMI、左心房内径和E/e'值均明显升高,显示即使同为反杓型血压节律患者中,血压控制未达目标值对心脏重构的影响更加显著.

Objective:To provide a clinical evidence-based medicine by comparing the efficacy of all-inside versus inside-out suture techniques in arthroscopic meniscal injury repair surgery.Methods:Five English and Chinese databases were searched for controlled studies about arthroscopic meniscus all-inside versus inside-out suture, including PubMed, Web of Science, Excerpt Medica Database(EMBASE), China Knowledge Network Infrastructure, and Wanfang. The search was conducted from the establishment of the database to May 2020, and the results were limited to English and Chinese literature. According to the defined criteria, patients who first underwent arthroscopic meniscus suture and had no underlying disease or other joint disease were screened for inclusion. After data extraction, five indicators were pooled including excellent healed rate, complications, operative time, Lyshlom score, and Tegner score. The quality of the literature was evaluated using the Cochrane System Evaluation Manual and the Newcastle-Ottawa scale (NOS). The analysis of dichotomous and continuous variables was performed by RevMan 5.3 software.Results:Ten studies with a total of 631 patients (340 in the all-inside suture group and 291 in the inside-out suture group) were included. There was no statistically significant difference in rate of meniscal excellent healed. The result of all-inside suture was similar to inside-out suture [the randomized control trial (RCT) group: the risk ratio (RR)=1.02, 95% confidence interval (CI) (0.79, 1.31), P=0.88; non-RCT group: RR=1.00, 95% CI (0.92, 1.09), P=0.99]. The all-inside suture technique did not reduce the postoperative complication rate, and there was no statistically significant difference between the all-inside suture method and the inside-out suture method [RCT group: RR=0.65, 95% CI (0.22, 1.92), P=0.43; non-RCT group: RR=0.50, 95% CI (0.25, 1.97), P=0.05]. The mean operative time of patients in the all-inside suture group was shorter than the Inside-out suture group, with a statistically significant difference of 16 min in RCT group and 46 min in non-RCT group [RCT group: mean difference (MD)=-16.31, 95% CI (-30.56, -2.07), P=0.02; non-RCT group: MD=-46.60, 95% CI (-60.79, -32.41), P<0.001]. The effect of all-inside and inside-out suture on the knee function of patients was similar, and there were no statistically significant difference in both group for postoperative Lyshlom score [RCT group: MD=6.24, 95% CI (-11.39, 23.86), P=0.49; non-RCT group: MD=1.15, 95% CI (-0.40, 2.69), P=0.15] and Tegner score [MD=0.00 95% CI (-0.20, 0.21), P=0.97].Conclusions:Compared with the inside-out suture technique, the arthroscopic all-inside suture has no advantage in terms of meniscal excellent healed rate, complication rate or knee function. However, all-inside suture can shorten the mean operation time. The clinician should be thoughtful in choosing the all-inside suture as the procedure is more costly and the outcomes are comparable to inside-out suture.

医疗设备是公共卫生体系的重要组成部分,是影响医院发展、医疗成本和诊疗费用的关键因素.以国家相关政策及指导文件为切入点,概述公共卫生防控救治体系建设下,医疗机构设备配置模式、合理配置常规设备和专科设备、配置管理流程和原则、科学决策方法以及配置国产设备的重要性,并提出在配置医疗设备时,将环境、人及设备作为整体要素进行分析,推动科学合理地配置医疗设备,促使医疗资源高效利用和发展.

甲基丙二酸血症(MMA)是由甲基丙二酰辅酶A变位酶缺陷或者辅酶钴胺素代谢发生障碍而导致有机酸代谢障碍的一类遗传代谢病,多为常染色体隐性遗传.患儿临床症状与体征各异.目前MMA的确诊及分型通过有机酸及酰基肉碱分析、酶活性评估、基因突变检测等方法 完成.MMA目前无根治办法.维生素B12有效型患儿,可采用饮食管理、口服维生素B12等传统治疗方法 ,预后尚可;维生素B12无效型患儿,需尽早进行肝移植,术后适当控制蛋白饮食并补充左卡尼汀.基因疗法为治愈MMA的新方向.

目的 观察吉西他滨注射剂联合顺铂注射剂治疗非小细胞肺癌(NSCLC)患者的临床疗效及安全性.方法 将100例NSCLC患者随机分为对照组和试验组,每组50例.对照组给予37.5 mg·m-2多西他赛,第1,8天,静脉滴注+75 mg·m-2顺铂,第1～3天,静脉滴注;试验组给予900 mg·m-2吉西他滨,第1,8天,静脉滴注+75 mg·m-2顺铂,第1～3天,静脉滴注.2组患者均治疗6个周期,每个周期21 d.比较2组患者的临床疗效,转化生长因子-β1(TGF-β1)、基质金属蛋白酶-2(MMP-2)和癌胚抗原(CEA)水平,以及药物不良反应的发生情况.结果 治疗后,试验组和对照组的总有效率分别为58.00％(29例/50例)和38.00％(19例/50例),差异有统计学意义(P＜0.05).治疗后,试验组和对照组的TGF-β1分别为(32.02±3.42)和(35.98±4.11)μg·L-1,MMP-2分别为(74.51±12.21)和(88.98±14.36) μg·L-1,CEA分别为(21.41±5.17)和(25.86±6.31)ng·mL-1,差异均有统计学意义(均P ＜0.05).试验组和对照组的恶心呕吐发生率分别为24.00％和30.00％,肝肾功能损害发生率分别为8.00％和12.00％,白细胞下降发生率分别为12.00％和14.00％,腹泻发生率分别为20.00％和28.00％,差异均无统计学意义(均P＞0.05).结论 吉西他滨注射剂联合顺铂注射剂治疗NSCLC的临床疗效确切,其能显著地降低肿瘤细胞因子的表达水平,且不增加药物不良反应的发生率.

背景 与核酸检测相比,传统快速流行性感冒(流感)病毒抗原检测方法灵敏度偏低,因此需要探索新的流感快速检测方法.目的 探讨免疫荧光法流感病毒抗原检测在流感筛查中的临床应用价值.方法 分别于2017年7—12月、2019年1—2月选取北京大学第三医院感染疾病科发热门诊收治的患者472例,采集其鼻咽拭子.采用免疫荧光法流感病毒抗原检测试剂盒读取仪器(简称Sofia)和传统快速流感抗原检测方法(免疫渗滤法和胶体金法)、流感病毒核酸检测实时荧光定量聚合酶链反应(RT-PCR)进行病原学检测.结果 472例患者采用RT-PCR方法共检出甲型/乙型流感292例(61.9％),其中甲型流感195例(41.3％),乙型流感94例(19.9％),另有3例同时检出甲型流感和乙型流感.472例患者采用免疫荧光法共检出甲型/乙型流感262例(55.5％),其中甲型流感169例(35.8％),乙型流感93例(19.7％).以RT-PCR方法为金标准,免疫荧光法、免疫渗滤法、胶体金法检测甲型/乙型流感的灵敏度依次为89.0％、82.9％、84.6％,特异度依次为98.9％、97.2％、93.3％;免疫荧光法、免疫渗滤法、胶体金法检测甲型流感的灵敏度依次为85.4％、79.3％、79.3％,特异度依次为100.0％、99.3％、97.1％;免疫荧光法、免疫渗滤法、胶体金法检测乙型流感的灵敏度依次为93.8％、87.6％、89.7％,特异度依次为99.5％、99.2％、97.3％.以RT-PCR方法为金标准,免疫荧光法对甲型H1流感、甲型H3流感、乙型流感的检出阳性符合率分别为91.8％(56/61)、84.7％(111/131)、94.8％(91/96).16～20岁、21～40岁、41～60岁、>60岁患者中,免疫荧光法对甲型/乙型流感检测的灵敏度依次为95.6％、90.2％、87.2％、78.4％,特异度依次为100.0％、98.2％、100.0％、100.0％.结论 与传统快速流感病毒抗原检测方法比较,免疫荧光法在甲型/乙型流感的检测中表现出更高的灵敏度,在流感筛查中有一定应用前景.

Objective To explore the clinical application value of fluorescent immunoassay kit for influenza virus antigen detection by comparing the method to the direct fluorescent antibody staining and the reverse transcriptase polymerase chain reaction (RT-PCR) of influenza virus nucleic acids.Methods From July to December 2017,350 patients in the fever clinic were examined by the fluorescent immunoassay kit for influenza virus antigen detection (Sofia FIA),direct fluorescent antibody staining (DFA)and RT-PCR of influenza virus nucleic acids.Results A total of 186 cases of influenza A/B viruses were detected by Sofia FIA,with an overall positive detection rate of 53.1％,and the detection rates of influenza A and B viruses were 35.4％ and 17.7％,respectively.Compared to RT-PCR,the results of sensitivity,specificity,positive predictive value,negative predictive value,consistency rate and kappa value of Sofia FIA were 89.4％,100.0％,100.0％,86.6％,93.7％ and 0.873 in the combined detection of influenza A/B viruses;87.9％,100.0％,100.0％,92.5％,95.1％ and 0.897 in the detection of influenza A virus;and were 92.5％,100.0％,100.0％,98.3％,98.6％ and 0.952 in the detection of influenza B virus,respectively.Compared to RT-PCR,the results of sensitivity,specificity,positive predictive value,negative predictive value,consistency rate and kappa value of DFA were 83.2％,100.0％,100.0％,80.2％,90.0％ and 0.800 in the combined detection of influenza A/B viruses;82.3％,100.0％,100.0％,89.3％,92.9％ and 0.847 in the detection of influenza A virus;and were 85.1％,100.0％,100.0％,96.6％,97.1％ and 0.902 in the detection of influenza B virus,respectively.Conclusions Sofia FIA and DFA had high sensitivity and specificity,and were in consistency with RT-PCR.The methods showed have certain clinical significance in the screening of influenza.

Glioma is the most common malignant tumor of the central nervous system with high morbidity and mortality. Circular RNAs (circRNAs) are abundant non-coding RNAs, which contribute to tumor progression by competing with other endogenous RNAs such as microRNA (miRNA). MiRNA are a class of small non-coding RNAs, which interrupt the translation of target mRNAs. CircPCMTD1 (hsa-circ-0001801) is a newly discovered circRNA that was found to be significantly upregulated in glioma. However, its function is unclear. In this study, circPCMTD1 upregulation promoted the cell viability, migration and invasion dramatically, while the inhibition of circPCMTD1 led to a significant reduction of tumor growth in vivo. MiRNAs microarray analyses on circPCMTD1 silencing models in U251 and U118MG cells were performed, and the results suggested that circPCMTD1 knockdown could upregulate the expression of miR-224-5p and downregulate the expression of mTOR, one of miR-224-5p targets, in both cell lines. According to the prediction from circular RNA interactome and Targetscan, there was a complementary sequence in circPCMTD1 for miR-224-5p. Dual-luciferase reporter assay demonstrated that circPCMTD1 were targets of miR-224-5p. RIP assay was also performed to further confirm their directly interaction. Overexpression of miR-224-5p inhibited the viability and proliferation, migration, and invasion of U251 and U118MG glioma cells. In conclusion, circPCMTD1 could contribute to the promotion of glioma progression, and it may serve as the sponge of miR-224-5p to exert its function.

目的:帕拉米韦是新型的抗病毒药物,本研究拟评价帕拉米韦治疗流行性感冒的临床安全性.方法:以北京大学第三医院感染疾病科发热门诊就诊的流行性感冒患者89例为研究对象,所有患者均给予帕拉米韦氯化钠注射液3 mg·mL-1治疗,单次静脉滴注,评价其发热、呼吸道和全身症状的缓解情况和药物的安全性.结果:患者平均年龄(28.31±8.30)岁.诊断为甲型流感84例,乙型流感5例.治疗后7d随访,发热均缓解,缓解时间(24.92±14.44)h.主要不良事件包括消化道症状5例(5.62％),神经系统症状3例(3.37％).心电图由治疗前的窦性心律变为治疗后的窦性心动过缓9例(10.11％),窦性心律不齐6例(6.74％),2例治疗后QTc间期延长.治疗前正常,治疗后2例丙氨酸氨基转移酶异常,15例(16.85％)甘油三酯升高,6例(6.74％)网织红细胞异常.无严重不良事件.结论:帕拉米韦治疗流行性感冒的安全性相对较高.

目的 评价预防性抗病毒治疗对乙型病毒性肝炎表面抗原(HBsAg)阳性非霍奇金淋巴瘤(NHL)患者免疫化疗后乙型病毒性肝炎病毒(HBV)再激活的影响及相关因素.方法 回顾性分析2010年至2018年北京大学第三医院血液科收治的1003例NHL患者,其中71例HBsAg阳性NHL患者同时接受预防性抗病毒治疗及免疫化疗.根据是否HBV再激活分为未激活组61例和激活组10例.比较2组患者的临床特点、预防性抗病毒方案及免疫化疗对HBV再激活的影响.结果 免疫化疗后,未激活组与激活组的平均谷丙转氨酶分别为(20.31 +12.77)和(262.80±100.08)U·L-1,谷草转氨酶分别为(25.77±18.74)和(100.20:95.67)U·L-1,总胆红素分别为(13.63±8.46)和(41.12±35.41)μmol·L-1,差异均有统计学意义(均P＜0.05).激活组化疗前及化疗后HBV-DNA分别为(2.82±1.59)和(4.14±1.57)1g U·mL-1,差异有统计学意义(P＜0.05).不同病理分型及临床分期NHL患者HBV再激活差异均无统计学意义(均P ＞0.05).拉米夫定(LAM)单药预防及恩替卡韦(ETV)单药预防后HBV再激活发生率分别为33.3％和8.7％,差异有统计学意义(P＜0.05).未应用利妥昔单抗及应用利妥昔单抗患者HBV再激活发生率分别为28.6％和10.3％,差异无统计学意义(P＞0.05).6例患者因HBV再激活中断化疗或利妥昔单抗治疗,其中HBV再激活肝炎3例,肝衰竭死亡1例.结论 HBSAg阳性NHL患者接受免疫化疗时需预防性抗病毒治疗,不同病理分型及临床分期NHL患者HBV再激活无显著差异;ETV较LAM能更有效地降低HBV再激活发生率,但仍有中度风险.

普拉德-威利综合征(PWS),又称为小胖威利综合征, 是15号染色体印迹基因区异常导致的多系统异常综合征. 本病新生儿期肌张力低下,喂养困难,2～4岁后食欲亢进,渐出现身材肥胖,矮小,性腺发育落后,智力低下[1]. PWS在生长发育的不同阶段临床表现不同, 且大多数医生缺乏PWS诊治经验,极易被误诊、漏诊,错过最佳治疗年龄. 本研究回顾性分析5例PWS患儿临床资料,以期提高对PWS诊断及治疗的认识.

BACKGROUND Acute liver injury in the setting of hepatic fibrosis is an intriguing and still unsettled issue. We previously have demonstrated the protective effects conferred by M2-like macrophages in the fibrotic liver. In the present work, we further decipher the cellular mechanisms governing this hepatoprotection. MATERIAL AND METHODS Macrophages were isolated from control mice (M0 macrophages), then polarized into M1 or M2 phenotype using IFN-γ or IL-4, respectively. Conditioned media (CM) from M0, M1, and M2 macrophages were harvested and applied to M1 macrophages. Cell apoptosis was evaluated by immunostaining and real-time PCR. Similarly, human monocyte-derived macrophages were isolated and polarized, then M0, M1, and M2 CM were applied to HL-7702 or HepG2 cells followed by apoptosis induction. Cell apoptosis was assessed by flow cytometry. RESULTS For the mouse conditioned medium experiment, stronger expression of cleaved caspase 3 and higher Bax/Bcl-2 mRNA ratio were found in M1 macrophages pretreated with M2 CM compared to those in M1 macrophages pretreated with M0 or M1 CM. Similarly, exposure of HL-7702 and HepG2 cells to either M0 or M1 CM had no significant effect on cell apoptosis. Nevertheless, the frequency of hepatocyte apoptosis was substantially reduced in HL-7702 (from 32.23±2.99 to 15.37±0.69 for Annexin V+/PI+ staining, p<0.01) and HepG2 cells (from 36.1±7.26 to 15.2±1.2 for Annexin V+/PI+ staining, p<0.01) with M2 CM pretreatment. CONCLUSIONS M2-like macrophages exert their hepatoprotective effect by promoting M1-like macrophage apoptosis but protecting against hepatocyte apoptosis.

天气转凉,孩子容易患流行性腮腺炎(以下简称流腮),很多人以为这是一种儿科疾病,其实成人也会患流行性腮腺炎.让我们一起来了解一下这个古老的传染病吧. 流腮,也就是俗称的“痄腮”,是由腮腺炎病毒引起的的急性呼吸道传染病,以腮腺肿痛为主要特征,少部分患者出现脑膜炎、胰腺炎、睾丸炎等并发症.早在公元前460年,古希腊著名医学家希波克拉底就记载了在一个小岛上暴发的流腮的情况.后来流腮在全世界都发生多次大流行.现在经过多年的预防接种,发病率已明显下降.

Objective To discuss the clinical manifestations and treatment of sildenafil-induced liver injury.Methods A case report of intrahepatic cholestasis induced by sildenafil in 1 male patients as well as related case reports in literatures were analyzed.Results and conclusion The few cases reported to date suggest that sildenafil-associated liver damage is rare but it still needs to be carefully watched out.The pattern of liver injury can be manifested as elevated transaminase or severe cholestasis.Regular monitoring liver function should be performed when using sildenafil.

[目的]探讨妊娠期糖尿病(GDM)孕妇产后糖尿病发生的高危因子.[方法]选择2015年1月至2015年12月在北京大学深圳医院规律产检并分娩的单胎妊娠期糖尿病孕妇342例,所有孕妇在孕24～28周均直接行75 g葡萄糖耐量试验(OGTT).根据空腹、1 h和2 h血糖值,将仅有一项血糖指标异常的记为GDMⅠ(219例),二项异常的为GDMⅡ(81例)和全部异常的为GDMⅢ(42例).以同期在本院规律产检,血糖值正常并分娩的968例孕妇设为对照组.所有研究对象均排除家族糖尿病史、产科并发症和其他内科并发症等高危因素.所有受试对象于分娩后一年,再次行OGTT试验,分析比较各组孕妇妊娠期各时间点血糖及糖化血红蛋白(HbA1c)等高危因子与产后糖尿病发生的相关性分析.[结果]复查结果显示,342名GDM孕妇中有27名产后发生2型糖尿病,发病率高于对照组,差异有统计学意义(P<0.05),其中GDMⅢ组中发病率为45.23％,发病率高于其他GDM组(P<0.05);在发生2型糖尿病的GDM孕妇中,与自身妊娠前和同期未发生2型糖尿病的GDM孕妇相比,2 h血糖和HbA1c值明显增加,且差异具有统计学意义(P<0.05).Logistic回归分析结果显示,GDMⅢ组别、2 h血糖和HbA1c值,这三种高危因子均是GDM孕妇发生2型糖尿病的危险因素(P<0.05).[结论]OGTT血糖全部异常的GDM孕妇产后发生2型糖尿病的发病率明显增加.临床上应对这类孕妇的血糖进行动态的监控,及时发现并纠正2 h血糖和HbA1c值的异常.

Potassium voltage-gated channel interacting protein 3 (KChIP3), also termed downstream regulatory element antagonist modulator (DREAM) and calsenilin, is a multifunctional protein belonging to the neuronal calcium sensor (NCS) family. Recent studies revealed the expression of KChIP3 in dorsal root ganglion (DRG) neurons, suggesting the potential role of KChIP3 in peripheral sensory processing. Herein, we show that KChIP3 colocalizes with transient receptor potential ion channel V1 (TRPV1), a critical molecule involved in peripheral sensitization during inflammatory pain. Furthermore, the N-terminal 31-50 fragment of KChIP3 is capable of binding both the intracellular N and C termini of TRPV1, which substantially decreases the surface localization of TRPV1 and the subsequent Ca2+ influx through the channel. Importantly, intrathecal administration of the transmembrane peptide transactivator of transcription (TAT)-31-50 remarkably reduces Ca2+ influx via TRPV1 in DRG neurons and alleviates thermal hyperalgesia and gait alterations in a complete Freund's adjuvant-induced inflammatory pain model in male rats. Moreover, intraplantar injection of TAT-31-50 attenuated the capsaicin-evoked spontaneous pain behavior and thermal hyperalgesia, which further strengthened the regulatory role of TAT-31-50 on TRPV1 channel. In addition, TAT-31-50 could also alleviate inflammatory thermal hyperalgesia in kcnip3−/− rats generated in our study, suggesting that the analgesic effect mediated by TAT-31-50 is independent of endogenous KChIP3. Our study reveals a novel peripheral mechanism for the analgesic function of KChIP3 and provides a potential analgesic agent, TAT-31-50, for the treatment of inflammatory pain. SIGNIFICANCE STATEMENT Inflammatory pain arising from inflamed or injured tissues significantly compromises the quality of life in patients. This study aims to elucidate the role of peripheral potassium channel interacting protein 3 (KChIP3) in inflammatory pain. Direct interaction of the KChIP3 N-terminal 31-50 fragment with transient receptor potential ion channel V1 (TRPV1) was demonstrated. The KChIP3–TRPV1 interaction reduces the surface localization of TRPV1 and thus alleviates heat hyperalgesia and gait alterations induced by peripheral inflammation. Furthermore, the transmembrane transactivator of transcription (TAT)-31-50 peptide showed analgesic effects on inflammatory hyperalgesia independently of endogenous KChIP3. This work reveals a novel mechanism of peripheral KChIP3 in inflammatory hyperalgesia that is distinct from its classical role as a transcriptional repressor in pain modulation.

Objective To study the antiviral regimen among outpatients with chronic hepatitis B in general hospital.Methods Outpatients diagnosed with chronic hepatitis B between January 2014 and January 2016 were included.All of them needed antiviral therapy.Retrospective study was done to their antiviral agents with cross-section analysis.Results A total of 83.9％ outpatients with chronic hepatitis B were accepting antiviral therapy and most of them used nucleos(t)ide analogs.There were 78.0％ of them chosed single or combined nucleos (t) ide analogs,16.4％ chosed interferon α plus nucleos(t) ide analogs,5.6％ chosed single interferon α.The most frequently used nucleos(t) ide analogs were Entecavir and then adefovir dipivoxil.Conclusion Nucleos (t)ide analogs were frequently used in outpatients with chronic hepatitis B and Entecavir ranked first place.Interferon α should be enhanced.

Objective: To identify the clinical features of mononucleosis caused by co-infection of Epstein-Barr virus (EBV) and cytomegalovirus (CMV) in adult patients. Methods: A total of 103 inpatients with mononucleosis in Peking University Third Hospital from May 2013 to May 2016 were collected as the study subjects.The patients were divided into three groups according to the responsible pathogens: 33 patients infected with EBV and CMV, 53 infected with EBV alone and 17 infected with CMV alone.Furthermore, a case-control study was employed to retrospectively compare the clinical characteristics and prognosis with χ(2,) t or rank tests. Results: The incidences of sore throat, pharynx congestion, tonsil enlargement, tonsil membrane, lymphadenectasis in co-infected patients were statistically lower than those in EBV-infected patients(χ(2)=19.202-25.492, all P<0.05), and were equivalent to those in CMV-infected patients(χ(2)=0.078-4.381, all P>0.05). The levels of alkaline phosphatase, glutamyl transferase, lactic dehydrogenase, white blood cell count and atypical lymphocyte in co-infected patients were statistically lower than those in EBV-infected patients(t/U=3.471-104.629, all P<0.05), and were similar to those in CMV-infected patients(t/U=0.447-24.330, all P>0.05). The levels of alanine aminotransferase and total bilirubin in co-infected patients were equivalent to those in the other two groups(U=1.695, 6.371, both P>0.05). The duration of fever in co-infected patients[(18±9) d] was between EBV alone [(15±7) d] and CMV alone [(21±7) d]infected patients. Conclusions: Co-infection of EBV and CMV is not uncommon.The clinic manifestation of co-infection is more like CMV infection. Liver injury and duration of fever shows no aggravation.

Objective To investigate the influence of iron deficiency anemia(IDA)on glycated hemoglobin A1c(HbA1c)determination and the application of capillary electrophoresis in the determination of hemoglobin A2 (HbA2)for the diagnosis of IDA. Methods A total of 79 patients with IDA were enrolled,and 79 subjects with normal blood routine test results and ferritin were enrolled as control group. Fasting blood glucose,glycated serum protein,ferritin,HbA1c and HbA2 were determined. Using 2 plans,the influence of IDA on HbA1c determination was evaluated.(1)The influence of IDA on the results of HbA1c determination was evaluated.(2)HbA2 was determined by capillary electrophoresis,and the differences of hemoglobin(Hb),mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),ferritin,HbA1c and HbA2 before and after treatment were compared. The HbA2 results in control and IDA groups by capillary electrophoresis were analyzed. The cut-off values of HbA2 by capillary electrophoresis for IDA were assessed by receiver operating characteristic(ROC)curve. Results Fasting blood glucose and glycated serum protein showed no statistical significance between control and IDA groups(P>0.05). Ferritin and HbA1c showed statistical significance between control and IDA groups(P<0.05). In IDA group,Hb, MCV,MCH,ferritin,HbA1c and HbA2 had statistical significance between before and after treatment(P<0.01). When the cut-off value of HbA2 by capillary electrophoresis for IDA screen was 2.25%,the sensitivity was 93.4%,and the specificity was 92.1%. Conclusions IDA has certain effect on HbA1c determination. Capillary electrophoresis can determine HbA1c and HbA2 simultaneously,which can be used into IDA screen.