Objective To investigate the expressions of heat shock protein(HSP)90α and HSP90β in peripheral blood mononuclear cells (PBMC) in myasthenia gravis (MG) children before and after glucocorticoid (GC) treatment,and normal control groups.Methods Fresh bloods were collected from 20 cases of children with MG before and after treatment and 19 healthy children.PBMCs were isolated,followed by measurement of the expression levels of HSP90α and β by immunocytochemistry,and HSP90α and β mRNAs by reverse transcription and polymerase chain reaction (RT-PCR).Results The positive cell ratio of HSP90α andβ of MG children before and after of GC treatment was significantly higher than control groups (P ＜ 0.05),and their mRNA expression levels was higher than control groups (P ＜ 0.05).HSP90β in MG children after GC treatment was mainly expressed in the nucleus(P ＜ 0.05).Conclusions HSP90α and β in PBMC of MG children before and after GC treatment were significantly higher than those of normal control groups.HSP90β in MG Children after GC treatment was significantly increased.The present results suggest HSP90β promote GC receptor binding and enhance GC transportation,which promotes and strengthens the physiological and pharmacological effects of GC to improve the clinical symptom of MG children.

Objective To apply sandplay therapy in cerebral palsy children's parents for the psychological problems. Methods 40 parents of cerebral palsy children were randomly divided into experimental group (n=20) and control group (n=20). The experimental group accepted sandplay therapy once a week for 10 weeks, and the control group without any intervention. All the parents were assessed with Symptoms Check-List 90 (SCL-90), Self-Esteem Scale (SES), compliance questionnaire, Quality of Life Questionnaire-Core 30 (QLQ-C30) before and after the experiment. Results The scores of all the factors of SCL-90 were lower in the experimental group than in the control group (P<0.05), with the higher scores of compliance and self-esteem (P<0.05), and the high quality of life in physical function, role in work and social function (P<0.05) in the experimental group. Conclusion Sandplay therapy can be used to solve the psychological problems of cerebral palsy children's parents, and improve their compliance, self-esteem and quality of life.

【Objective】 To study the yielding rate and distribution of unexpected antibodies in blood transfusion children with thalassemia in Yunnan province, and to explore the blood transfusion strategies. 【Methods】 From January 2016 to December 2021, 298 children with thalassemia, who received blood transfusion treatment in Kunming, Xishuangbanna, Wenshan, Dehong, Yuxi and Baoshan hospitals across Yunnan Province, were selected. The unexpected antibodies of blood plasma were screened by microcolumn gel card. The samples with positive antibodies were identified for alloantibody specificity. 【Results】 Unexpected antibodies were yielded in 67 out of 298(22.48%) transfused children with thalassemia. The positive rates of unexpected antibodies in boys and girls were 16.55%(24/145) and 28.10%(43/153), respectively. The positive rates of unexpected antibodies in Han, Dai, Zhuang, Yi, Bulang, Jinuo and Miao people were 14.06%(18/128), 30.80%(32/104), 35.71%(10/28), 36.36%(8/22), 50.00%(4/8), 60.00%(3/5)and 66.67%(2/3), respectively, with statistically significant differences between each other. The positive rate of unexpected antibodies in ethnic minorities was higher than that in Han. The positive rates of unexpected antibodies in children who received the first transfusion at birth-one year old, 1~3 years old, 3~6 years old and above 6 years old were 12.50%(3/24), 10.14%(7/69), 24.54%(40/163)and 40.48%(17/42), respectively. The positive rates of unexpected antibodies in children with first transfusion after 3 years old were significantly higher than those before 3 years old. The positive rates of unexpected antibodies in children with one transfusion, 1~3, 3~10, 10~20 and more than 20 transfusions were 4.76%(1/21), 12.07%(7/58), 23.71%(23/97), 28.16%(29/103)and 36.84%(7/19), respectively, with statistically significant differences between each other. The number of blood transfusions was positively correlated with the unexpected antibody yielding. The yielding rate of unexpected antibodies in children with α thalassemia, βthalassemia, δ+ βthalassemia and untyped thalassemia was 7.50%(3/40), 17.62%(34/193), 53.70%(29/54)and 9.09%(1/11), respectively(P<0.05). The yielding rate of unexpected antibodies in transfused children with δ+ βthalassemia was the highest. And 57 unexpected antibodies of Rh blood group system were yielded, 6 anti-M antibodies, 2 anti-N antibodies and 2 undetermined. 【Conclusion】 The positive rate of unexpected antibodies in transfused children with thalassemia in Yunnan province is high. Routine antibody screening should be carried out for transfusion children with thalassemia, and blood units, compatible with ABO, Rh and MNS typing results, should be selected to ensure the safety and effectiveness of clinical blood use.

【Objective】 To compare the clinical efficacy between a direct aspiration first-pass technique (ADAPT) and stent-retriever thrombectomy (SRT) in the treatment for acute ischemic stroke (AIS) caused by intracranial atherosclerotic stenosis related large vessel occlusion (ICAS-LVO). 【Methods】 We retrospectively included patients with AIS caused by ICAS-LVO who received endovascular treatment in The First Affiliated Hospital of Xi’an Jiaotong University or The Second Affiliated Hospital of Shaanxi University of Chinese Medicine between January 2020 and January 2023. They were divided into ADAPT group and SRT group according to the first-selected device for thrombectomy. We compared the baseline data, test and examination results, operation process, clinical prognosis and follow-up data of the two groups. 【Results】 A total of 117 patients were recruited, including 48 patients in the ADAPT group and 69 patients in the SRT group. There was no significant difference in the baseline data between the two groups. The success rate of both the first-time thrombectomy (P=0.014) and the first-selected device of thrombectomy (P<0.001) was significantly higher in the SRT group than in the ADAPT group. Meanwhile, the incidence of iatrogenic dissection (P<0.001) and vasospasm (P=0.003) was significantly lower in the SRT group than in the ADAPT group. The proportion of patients for whom the device of thrombectomy was changed for remedial treatment in the ADAPT group was significantly higher than that in the SRT group (P<0.001). However, the two groups did not differ significantly in the rate of successful vascular recanalization, incidence of symptomatic/asymptomatic intracranial hemorrhage or the rate of 90-day favorable prognosis. 【Conclusion】 For patients with AIS caused by ICAS-LVO of MCA, SRT has a higher rate of immediate successful vascular recanalization with a lower rate of secondary vascular injury compared with ADAPT, but the two techniques have similar efficacy on the 90-day prognosis.