简介：AbstractImportance:The clinical characteristics of infectious mononucleosis (IM) in Chinese children have not been evaluated in multicenter studies, and the effectiveness of antiviral treatment are controversial.Objective:To investigate the clinical characteristics of Chinese children with IM and current status of antiviral therapy for affected patients.Methods:Hospitalized patients with IM were enrolled between 2018 and 2020 in five children's hospitals in China. The clinical characteristics were compared among four age groups: <3 years, 3-<6 years, 6-<10 years, and ≥10 years. The clinical characteristics of IM and effectiveness of antiviral therapy were compared among patients receiving acyclovir (ACV), ganciclovir (GCV), and no antiviral therapy (i.e., non-antiviral group).Results:In total, 499 patients were analyzed; most patients were 3-<6 years of age. The most common symptoms and signs included fever (100%), lymphadenopathy (98.6%), pharyngitis (86.4%), eyelid edema (76.8%), and snoring (72.9%). There were significant differences in rash, hepatomegaly, and liver dysfunction among the four age groups. Patients aged < 3 years had a lower incidence of liver dysfunction and a higher incidence of rash. Among the 499 patients, 50.1% were treated with GCV, 26.3% were treated with ACV, and 23.6% received no antiviral therapy. Compared with the non-antiviral group, patients in the ACV and GCV groups had longer durations of fever (P < 0.001). There were no significant differences in the incidences of complications among the three treatment groups.Interpretation:The incidence of IM in Chinese children peaked at 3-<6 years of age. Clinical features of IM varied according to age. Patients receiving antiviral therapy exhibited more serious clinical manifestations than did patients without antiviral therapy. The effectiveness of antiviral therapy for IM requires further analysis.

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简介：AbstractBackground:COVID-19 can lead to increased psychological symptoms such as post-traumatic stress disorder (PTSD), depression, and anxiety among patients with COVID-19. Based on the previous mindfulness-based interventions proved to be effective, this protocol reports a design of a randomized controlled trial aiming to explore the efficacy and possible mechanism of a mindful living with challenge (MLWC) intervention developed for COVID-19 survivors in alleviating their psychological problems caused by both the disease and the pandemic.Methods:In April 2021, more than 1600 eligible participants from Hubei Province of China will be assigned 1:1 to an online MLWC intervention group or a waitlist control group. All participants will be asked to complete online questionnaires at baseline, post-program, and 3-month follow-up. The differences of mental health status (e.g. PTSD) and physical symptoms including fatigue and sleeplessness between the COVID-19 survivors who receiving the online MLWC intervention and the control group will be assessed. In addition, the possible mediators and moderators of the link between the MLWC intervention and target outcomes will be evaluated by related verified scales, such as the Five Facets Mindfulness Questionnaire. Data will be analyzed based on an intention-to-treat approach, and SPSS software will be used to perform statistical analysis.Discussion:The efficacy and potential mechanism of MLWC intervention in improving the quality of life and psychological status of COVID-19 survivors in China are expected to be reported. Findings from this study will shed light on a novel and feasible model in improving the psychological well-being of people during such public health emergencies.Trial registrationChinese Clinical Trial Registry (ChiCTR), ChiCTR2000037524; Registered on August 29, 2020, http://www.chictr.org.cn/showproj.aspx?proj=60034.

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简介：AbstractObjective:This study conducted inverse probability of treatment weighting (IPTW) survival analysis to examine survival in pancreatic adenocarcinoma patients.Methods:In this population-based study, data from the Surveillance, Epidemiology, and End Results program of the United States were analyzed to identify patients diagnosed with adenocarcinoma of the pancreas 2004 to 2014. Differences in survival rates were examined among patients who underwent pancreatectomy alone, radiotherapy alone, and those who had pancreatectomy plus adjuvant radiotherapy. Kaplan-Meier estimates and Cox proportional hazards models with the IPTW were performed to determine the effect of different treatments on overall and cancer-specific survival. This study was approved by the Ethics Review Board of Weifang Medical University.Results:A total of 8191 patients were included, with 3409 taking pancreatectomy only, 2865 taking radiotherapy only, and 1917 taking pancreatectomy plus adjuvant radiotherapy. Patients who received surgery plus adjuvant radiotherapy had statistically a higher survival rate than those who received the other 2 treatments. Survival analysis with the IPTW for the 3 different groups showed that the difference in median overall survival time among these patient groups was significant.Conclusion:Using IPTW survival analysis, the present study shows that surgery with adjuvant radiotherapy is significantly associated with improved overall and cancer-specific survival among patients with pancreatic adenocarcinoma.

简介：AbstractObjective:This study aimed to evaluate the incidence and associated clinical risk factors for preeclampsia (PE) and its subtypes in a large multicentre retrospective study of Beijing, China.Methods:This study was conducted as a secondary analysis from the Gestational diabetes mellitus Prevalence Survey (GPS), a multicentre retrospective cohort study, which included 15 hospitals in Beijing, China. This analysis included 15,003 pregnant women who delivered in Beijing from June 20th to November 30th, 2013. The incidence of PE was calculated. Risk factors for PE, including maternal age, pre-gestational body mass index (BMI), parity, chronic hypertension, pre-existing diabetes, and gestational diabetes mellitus, were assessed. PE was defined as early- or late-onset PE based on clinical manifestations during the week of delivery, and mild or severe PE based on the severity of the disease. Logistic regression analysis was used to quantify the association with the risk factors, and data were displayed as odds risks (OR) and 95% confidence interval (CI).Results:The overall incidence of PE was 2.65% (397/15,003). The prevalence of early-onset and late-onset PE was 0.36% (54/15,003) and 2.29% (343/15,003), respectively. The prevalence of mild and severe PE was 0.91% (137/15,003) and 1.73% (260/15,003), respectively. Risk factors including high BMI considered overweight (adjusted odds risk (aOR): 1.48; 95% CI: 1.06-2.05; P= 0.02) and obesity (aOR: 2.15; 95% CI: 1.50-3.08; P < 0.001), nulliparity (aOR: 1.73; 95% CI: 1.32-2.25; P < 0.001), multiple gestation (aOR: 4.58; 95% CI: 2.86-7.32; P < 0.001), and chronic hypertension (aOR: 34.95; 95% CI: 26.60-45.93; P < 0.001), were associated with increased risk for PE. Only chronic hypertension (aOR: 13.75; 95% CI: 4.78-39.58; P < 0.001) was a significant risk factors for early-onset PE, whereas high BMI considered both overweight (aOR: 1.54; 95% CI: 1.09-2.18; P= 0.01) and obesity (aOR: 2.23; 95% CI: 1.53-3.27; P < 0.001), nulliparity (aOR: 2.00; 95% CI: 1.49-2.68; P < 0.001), multiple gestation (aOR: 4.11; 95% CI: 2.40-7.05; P < 0.001), and chronic hypertension (aOR: 35.57; 95% CI: 26.66-47.47; P < 0.001) were more relevant risk factors for late-onset PE. Risk factors including obesity (aOR: 2.20; 95% CI: 1.28-3.76; P < 0.01 and aOR: 1.80; 95% CI: 1.16-2.80; P= 0.01), nulliparity (aOR: 2.28; 95% CI: 1.44-3.60; P < 0.001 and aOR: 1.48; 95% CI: 1.09-2.02; P= 0.01), multiple gestation (aOR: 5.50; 95% CI: 2.87-10.67; P < 0.001 and aOR: 3.51; 95% CI: 1.93-6.41; P < 0.001), and chronic hypertension (aOR: 33.98; 95% CI: 22.20-52.01; P < 0.001 and aOR: 35.03; 95% CI: 25.40-48.31; P < 0.001) were associated with mild and severe PE. Moreover, we found that women with an increasing number of these risk factors had a higher risk of developing PE than pregnant women without any identified risk factors.Conclusion:The incidence of PE in this study is consistent with previous reported studies. Our findings indicate chronic hypertension and multiple gestation are the most important risk factors for PE in Chinese pregnant women. The risk for developing PE is associated with both the type and abundance of risk factors. These factors are valuable when monitoring patients at risk for PE, as this can help ensure an earlier diagnosis and prediction in women who are more likely to develop PE.

简介：AbstractPneumoconiosis refers to a spectrum of pulmonary diseases caused by inhalation of mineral dust, usually as the result of certain occupations. The main pathological features include chronic pulmonary inflammation and progressive pulmonary fibrosis, which can eventually lead to death caused by respiratory and/or heart failure. Pneumoconiosis is widespread globally, seriously threatening global public health. Its high incidence and mortality lie in improper occupational protection, and in the lack of early diagnostic methods and effective treatments. This article reviews the epidemiology, safeguard procedures, diagnosis, and treatment of pneumoconiosis, and summarizes recent research advances and future research prospects.

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简介：AbstractVenous thromboembolism (VTE) is a leading cause of maternal morbidity and mortality though with low rates. Compared to non-pregnant women of comparable age, women during pregnancy have five- to ten-fold increased risk of VTE, additional risk factors for VTE during pregnancy include a personal history of thrombosis, the presence of a thrombophilia, cesarean delivery, obesity, hypertension, preeclampsia, autoimmune disease, heart disease, sickle cell disease and multiple gestation. Thus, early clinical evaluation, preferably in peri-conceptional period, is crucial for VTE risk detection and, thus, for prophylaxis decision making. VTE thromboprophylaxis brought significant advantages in pregnancy outcomes and maternal deaths. Common pharmacological and mechanical forms of thromboprophylaxis includes heparin compounds, anti-embolic stockings and intermittent pneumatic compression devices. Low-molecular-weight heparin as first line strategy. Current guidelines or expert opinions on VTE treatment or prophylaxis during pregnancy diverge significantly. High quality research in this area is still needed, and China needs to develop its own VTE guidelines. Importantly, absolute risks and potential benefits of VTE thromboprophylaxis should be evaluated to make the best decisions on VTE screening, prevention, and treatment.

简介：AbstractBackground:Regulated upon activation, normal T-cell expressed, and secreted (RANTES) is a chemokine actively involved in the initiation and progression of atherosclerosis (AS), which is the major cause of ischemic cerebrovascular disease (ICVD). This study aimed to determine the associations between circulating RANTES level and overall AS conditions of cardiac and cerebral vessel beds in patients with ICVD.Methods:Patients with ICVD admitted to the department of neurology of Xuanwu Hospital from April 1, 2019 to June 30, 2019 were prospectively enrolled in the study. Plasma RANTES level was measured by enzyme-linked immunosorbent assay to represent the circulating RANTES level. The integrated AS burden of the cervicocephalic and coronary arteries was examined using computed tomography angiography and reflected by "cardio-cerebral AS burden (CCAB)" as a continuous variable. Then, the relationship of plasma RANTES level and CCAB in patients with ICVD was analyzed by correlation analyses and general linear models.Results:A total of 40 patients with ICVD were included in the study. There was a significant positive correlation between CCAB and plasma RANTES level in ICVD (r = 0.786, P < 0.001), independent of age, sex, acute or chronic phase of ICVD, and mono or dual antiplatelet therapy (adjusted B for ln RANTES, 12.063; 95% confidence interval, 7.572-16.533). The association of plasma RANTES level with AS conditions (burden, severity, and extent) in single cardiac or cerebral vessel bed was similar to that with CCAB, but the correlation coefficient for CCAB was higher (increment ranged from 0.126 to 0.397).Conclusions:Plasma RANTES level was an independent indicator for the integrated AS burden of the cervicocephalic and coronary arteries in ICVD. Comprehensive evaluation of AS conditions using the novel continuous index CCAB might be important in revealing the systematic relationship between circulating RANTES and AS in patients with ICVD.