Multi-centric Study on Clinical Epidemiology Is the Key Link in Treating Hypertension with Integrative Chinese and Western Medicine

General survey ofhypertension has beencarried out in our coun—try for three times.Thelast time was in 1999,with the result showingthat in our country theincidence of hyperten-sion among people over15 years old was11.26％.The incidencehas been raised by 25％

Liver cirrhosis in a child associated with Castleman's disease: A case report

BACKGROUND Castleman's disease(CD)is a lymphoproliferative disorder.TAFRO syndrome is classified as a variant of CD based on its key clinical manifestations of thrombocytopenia,anasarca(generalized edema and pleural effusion),fever(pyrexia),reticulin fibrosis in the bone marrow and the proliferation of megakaryocytes,and organomegaly(such as hepatosplenomegaly and multiple lymphadenopathies);TAFRO syndrome is mainly reported in Japanese patients.To our knowledge,this is the first pediatric case report detailing a CD-associated disorder progressing to cirrhosis.CASE SUMMARY A 10-year old male patient presented with fever and anemia.Six months before hospitalization,he had remarkable abdominal distention.Subsequently,he visited a clinic for a fever that lasted 5 d.The physical findings were marked hepatosplenomegaly and cervical lymphadenopathy.A blood test revealed leukocytosis,microcytic anemia,aspartate aminotransferase-dominant transaminase elevation,high levels of C-reactive protein,polyclonal hypergammaglobulinemia,and high levels of interleukin-6 and vascular endothelial growth factor.Abdominal contrast computed tomography and magnetic resonance imaging suggested cirrhosis,which was confirmed by liver histology.Histological findings in the enlarged hepatic lymph nodes revealed both hyperplasia and atrophy of lymphoid follicles with some vascular hyperplasia and moderate plasmacytosis between the lymphoid follicles,which is compatible with lymph node histology in TAFRO syndrome.Prednisolone was not effective in reducing the patient’s symptoms;therefore,the patient was prescribed tocilizumab.To date,the patient remains free of fever and continues to receive tocilizumab.CONCLUSION We described the clinicopathological features of TAFRO syndrome to highlight the clinical presentation of this rare disease in a pediatric case.

Effects and interaction of temperature and relative humidity on the trend of influenza prevalence:A multi-central study based on 30 provinces in China's Mainland from 2013 to 2018

Background:Evidence is inefficient about how meteorological factors influence the trends of influenza transmission in different regions of China.Methods:We estimated the time-varying reproduction number(Rt)of influenza and explored the impact of temperature and relative humidity on Rt using generalized additive quasi-Poisson regression models combined with the distribution lag non-linear model(DLNM).The effect of temperature and humidity interaction on Rt of influenza was explored.The multiple random-meta analysis was used to evaluate region-specific association.The excess risk(ER)index was defined to investigate the correlation between Rt and each meteorological factor with the modification of seasonal and regional characteristics.Results:Low temperature and low relative humidity contributed to influenza epidemics on the national level,while shapes of merged cumulative effect plots were different across regions.Compared to that of median temperature,the merged RR(95%CI)of low tem-perature in northern and southern regions were 1.40(1.24,1.45)and 1.20(1.14,1.27),respectively,while those of high temperature were 1.10(1.03,1.17)and 1.00(0.95,1.04),respectively.There were negative interactions between temperature and relative humidity on national(SI=0.59,95%CI:0.57e0.61),southern(SI=0.49,95%CI:0.17e0.80),and northern regions(SI=0.59,95%CI:0.56,0.62).In general,with the increase of the change of the two meteorological factors,the ER of Rt also gradually increased.Conclusions:Temperature and relative humidity have an effect on the influenza epidemics in China,and there is an interaction between the two meteorological factors,but the effect of each factor is heterogeneous among regions.Meteorological factors may be considered to predict the trend of influenza epidemic.