Objective To find out more extrema simultaneously including global optimum and multiple local optima existed in multi-modal functions. Methods Germinal center is the generator and selector of high-affinity B cells, a multicellular group's artificial immune algorithm was proposed based on the germinal center reaction mechanism of natural immune systems. Main steps of the algorithm were given, including hyper-mutation, selection, memory, similarity suppression and recruitment of B cells and the convergence of it was proved. Results The algorithm has been tested to optimize various multi-modal functions, and the simulation results show that the artificial immune algorithm proposed here can find multiple extremum of these functions with lower computational cost. Conclusion The algorithm is valid and can converge on the satisfactory solution set D with probability 1 and approach to global solution and many local optimal solutions existed.

Objective To investigate the underlying causes, clinical characteristics, treatment and prognosis of non-traumatic pneumomediastinum (PM) in children. Methods A retrospective analysis of the clinical data of 64 children diagnosed with non-traumatic PM in Yuying Children’s Hospital Affiliated to Medical University from Jan 2003 to Dec 2013 was performed. Nineteen children with SPM and the other 45 with clear causes of non-traumatic PM were divided into two groups for comparison. According to age, 64 cases were divided into 0-6y group and 6-18y group for further comparison. Results A total of 64 patients with non-traumatic PM were collected. Nineteen of them aged 14.90±2.00 y had SPM with unknown etiology, and 84.2%were male. The other group of 45 patients aged 4.26±4.45y, and 55.6%of this group were male. The common causes were pneumonia or other lower respiratory tract infection, asthma and foreign body inspiration. The patients with SPM were always with chest pain. While the patients with clear causes of non-traumatic PM were more complained of dyspnea, coughing, subcutaneous emphysema. The treatment of patients with SPM was bed rest, oxygen uptaking, antitussive, anti-infection and other conservative therapy. All the patients with clear causes of non-traumatic PM had favorable prognosis with the treatment of actively curing primary disease and timely mediastinal air drainage, subcutaneous air drainage and thoracic close drainage. In 35 cases younger than 6 years old, the most common causes were pneumonia or other lower respiratory tract infection, none had SPM. In 29 cases older than 6 years, 19 of them had SPM. Conclusions Etiologies of pneumomediastinum varied with age in children,which should be vigilantly examined, especially for those younger than 6 years old. The key of the treatment to non-traumatic PM with clear etiologies was to treat its primary disease.

Objective To explore the attention bias characteristics and impacts of attention training on negative attention bias of undergraduates with sub-clinical depression.Methods The undergraduates whose BDI scores being at the top of 5％ were recruited as participations and assigned to early attention training group and late attention training group using random number table.The dot probe paradigm was used to compare the difference of depressive symptoms and ingredients of attention bias made by different processing phases of attention training.Results (1)The BDI score after the training(87.91± 12.47) was significantly lower than that the former test (97.23±17.72) (F~,32)=4.78,P＜0.05),and the attention bias score in late attention training group (-5.97±2.92) was lower than that in the early attention training group(2.77±2.75) (P＜0.05).The interaction of the stimulus materials presenting time and the measuring time was significant(F(2,64) =4.76,P＜0.05).Simple effect analysis showed that when the time of stimulus material presenting was 1 000 ms,the score of negative attention bias after the test (-4.89 ± 23.66) was significantly lower than pre-test (7.73±26.14) (F(1,33) =5.11,P＜ 0.05).In the pre-test,the negative attention bias scores of the stimulus materials presenting time for 100 ms and 1 000 ms (8.62 ± 27.60,7.73 ± 26.14) were significantly higher than that for 500 ms (-12.80±29.09)(P＜0.05).(2)When the negative disengaged score as a dependent variable,the repetitive measure analysis of variance showed that the interaction effect of the stimulus materials' presenting time and training group type was significant (F(1,32) =4.41,P＜0.05).Simple effect analysis results indicated the negative disengaged score of the late attention training group at post-test (-5.84±7.79) was significantly lower than that at pre-test (24.16±7.35) (P＜0.05).Conclusion The attention training during the late stage of the attention process can efficiently intervene the negative attention bias of undergraduates with sub-clinical depression.

Objective To investigate the predictive value of combined analysis on single nucleotide polymorphisms (SNPs) of X-ray cross-complementing1 ( XRCC1 ) gene 194 and 399 codon,xeroderma pigmentosum group D (XPD) gene 312 codon and glutathione S-transferase P1 (GSTP1) gene 105 codon in platinum based chemotherapy.Methods Direct sequencing was performed to detect XRCC1,XPD and GSTP1 genotypes in peripheral blood from 50 cancer patients receiving platinum-based chemotherapy.Genetic polymorphisms of these genes related to sensitivity of platinum were reviewed.Results Favorable genotypes were Arg/Trp and Trp/Trp in XRCC1 194 codon,Arg/Arg in XRCC1 399 codon,Asn/Asn in XPD 312 codon and Val/Val in GSTP1 105 codon.The response rate to chemotherapy was 57.1％,75.0％,60.9％,85.7％ and 87.5％,respectively.The response rate for patients possessing ≥2 favorable genotypes and those possessing 1 or 0 favorable genotype was 78.9％,36.4％ and 0,respectively.Patients possessing ≥2 favorable genotypes demonstrated higher sensitivity to platinum based chemotherapy,compared with those possessing 1 or 0 favorable genotype ( x2 =25.79,P ＜ 0.01 ).Conclusions Combination analysis of genomic polymorphisms of XRCC1,XPD and GSTP1 may be useful in predicting sensitivity of platinum based chemotherapy.

Objective To explore the occurence,clinical characteristics and treatment of Mycoplasma pneumonia complicated with embolism in children.Methods Twenty-three cases with Mycoplasma pneumonia complicated with embolization were retrospectively analyzed from January 1990 to December 2012.Results The ages of cases were from 4 years old to 13 years old,and fifteen cases were male,eight cases were female.Nineteen cases with single-shot embolism included four cases of lower limb venous thrombosis,one case of internal carotid artery thrombosis,nine cases of cerebral infarction,two cases of cardiac infarction,two cases of splenic infarction,one case of pulmonary infarction; and the other four cases were multiple embolism,two cases combined pulmonary embolism and lower limb deep vein thrombosis,one case combined cardiac embolism and pulmonary embolism,one case combined internal carotid artery and the brain embolism.In addition,eight cases had temporary anti-cardiolipin antibody IgM,two cases combined protein C decrease,one case merge protein S decrease,and one case was lack of AT-Ⅲ.At last,two children died,the rest all recovered well after thrombolysis and anticoagulation therapy.Conclusion Mycoplasma pneumoniae has hypercoagulative state and potentialized to thrombosis,especially for children with high risk factors of thrombosis.Early diagnosis and anticoagulation and thrombolysis treatment actively is the key to better prognosis.

Objective To determine the prediction and clinical characteristics of intravenous immunoglobulin (IVIG) treated Kawasaki disease (KD) failure in initial dose.Methods Retrospective analysis was performed with the clinical data of 1 11 children with KD.The paticnts were divided into sensitive group and unresponsive group according to initial effect of IVIG.The clinical manifestations,laboratory examination and radiological features of the children were compared.Logistic regression analysis was performed in significant different indicators to determine independent correlation factors.In order to seek the reference indexes which indicate unresponsive to IVIG,a receiver operating characteristic (ROC) curve was made,of which the diagnostic cut-off was nine independent correlation factors while grouping was made according to patients' different responses to IVIG.Results (1)There were 90 cases (81.1％)in effective group and 21 cases (18.9％) in unresponsive group.(2) Compared with the sensitive group,hyperpyrexia cases[66.7％ (14/ 21 cases) vs 34.4％ (31/90 cases),x2 =7.334,P =0.007] and the chances of coronary artery lesions [47.6％ (10/ 21 cases) vs 23.3％ (21/90 cases),x2 =4.989,P =0.026] were significantly higher in the unresponsive group.(3)Compared with the children administered twice with gamma globulin,the children of single-dose treatment significantly reduced the unresponsive probability [12.5 ％ (9/72 cases) vs 30.8 ％ (12/39 cases),x2 =5.504,P =0.019],and there was no difference in the chances of coronary artery lesions[23.6％ (17/72 cases) vs 30.8％ (12/39 cases),x2 =0.672,P =0.412].(4)Comparing the sensitive group and the unresponsive group,the percentage of neutrophils count [(0.72 ± 0.06) vs (0.76 ± 0.04),t =-2.84,P =0.005],platelet counts [(352.38 ± 42.18) × 109/L vs (373.14 ±36.93) × 109/L,t =-2.076,P =0.040] and C-reactive protein (CRP) [(74.38 ± 12.92) mg/L vs (92.05 ± 11.17) mg/L,t =-5.780,P =0.000] were significantly higher in the unresponsive group,but the level of serum albumin[(34.09 ±3.19) g/L vs (31.61 ±2.03) g/L,t =4.442,P =0.000] was lower.(5) Multivariate Logistic regression analysis indicated that the percentage increase of neutrophils count (P =0.018),CRP (P =0.000) increase and serum albumin(P =0.040) decrease were independent risk factors for unresponsive treatment with gamma globulin.(6)After the area under the ROC curve was calculated,the percentage of neutrophils count,CRP and serum albumin could be effective predictors to IVIG treatment failure in initial dose,and the critical values were 0.72,78.5 mg/L and 33.11 g/L,respectively.Conclusions Treatment with IVIG for the first time may be ineffective in some situations such as the percentage of neutrophils count ≥0.72,CRP ≥78.5 mg/L or serum albumin≤33.11 g/L.

AIM: To study the effect of signal transducer and activator of transcription 6 (STAT6) on airway inflammation of rats with asthma. METHODS: Male Sprague-Dawley rats were randomly divided into control group and asthma group. The lung tissue was sampled from the left lung. Bronchoalveolar lavage fluid (BALF) was collected from the right lung. The concentrations of IL-4 in serum and BALF were measured by sandwich ELISA. STAT6 protein and STAT6 mRNA were observed in the epithelial cells of bronchus by the technique of immunohistochemistry and in situ hybridization. RESULTS: (1) The concentrations of IL-4 in BALF and serum of asthma group were significantly higher than those in control group (P

Objective:To explore the value of stress hyperglycemia ratio (SHR) in predicting the prognosis of patients with acute heart failure (AHF).Methods:AHF patients admitted to the Emergency Department of Shanghai Jiao Tong University Affiliated Sixth People's Hospital from December 2016 to January 2019 were retrospectively included. Clinical data were recorded and SHR was calculated. According to the survival of the patients within 1 year, they were divided into the death group ( n=89) and the survival group ( n=218). Logistic regression analysis was used to analyze the risk factors of mortality. Kaplan-Meier analysis was used to evaluate the correlation between SHR and the prognosis of AHF patients. Results:A total of 307 patients aged 83 ( range 74-87) years old who met the inclusion criteria were included in this study, including 153 males and 104 females. The age, SHR and N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in the death group were higher than those in the survival group [84 (78, 88) vs 82 (72, 86), 1.11 (0.91, 1.51) vs 1.02 (0.86, 1.27), 5 351 (2 098, 14 039)μg/L vs 4 243 (2 294, 7 565)μg/L ]. The left ventricular ejection fraction (LVEF) in the death group was significantly lower than that of the survival group [53 (45, 57) % vs 58 (44, 64) %, P< 0.05]. Logistic regression analysis showed that SHR was an independent risk factor for death in AHF patients ( OR=2.397, 95% CI: 1.285-4.471, P< 0.05). Median SHR was used to draw the survival curve. Patients with high SHR had a lower cumulative survival rate, and the difference was statistically significant ( P<0.05). Conclusion:SHR can identify critically ill patients and is an independent risk factor for death in AHF patients.

Objective To explore the clinical manifestations,imaging findings,pathological classification and treatment of congenital cystic adenomatoid malformation (CCAM)of the lung.Methods The clinical features,imaging findings,pathology information,diagnosis,treatment method and its prognosis of children with CCAMconfirmed by ope-ration and pathology were retrospectively analyzed in Yuying Children′s Hospital Affiliated to Wenzhou Medical Univer-sity from August 2006 to August 201 4.Results Eleven patients were boys and 4 patients were girls.One case had a-symptomatic clinical features,1 2 cases had pulmonary infection,1 case had recurrent chest pain,and 1 case had de-pressed deformity in sternum inferior segment.Chest CT scanning indicated that 9 cases had multiple gas cysts at unila-teral side of lung,among which 1 case was of funnel chest and pulmonary sequestration,1 case of huge cyst containing air and fluid at inferior lobe of left lung,and 4 cases of high density lung shadow;CT examination indicated that 1 case had recurrent chest pain and eventration of diaphragm of the right side combined with pulmonary sequestration.All ca-ses were treated by surgical resection,of whom 1 case was given cystectomy and sequestrectomy,diaphragmatic plication respectively,1 case complicated with funnel chest disease underwent lesion pulmonary lobectomy,sequestrectomy and minimally invasive corrective surgery in pectus excavatum (Nuss surgery),and the remaining 1 2 cases received lesion pulmonary lobectomy.All of 1 5 cases recovered well without complications.Pathological classification type of CCAMin-cluded 1 1 cases of type Ⅰ,3 cases of type Ⅱ and 1 case of type Ⅲ,among which 2 cases had pulmonary sequestration. Conclusions CCAMis a rare disease which can be discovered along with pulmonary infection.Multiple gas cysts are the most common imaging findings and the preoperative diagnosis of CCAM is mostly based on chest CT examination. Type Ⅰ and type Ⅱ are the most common pathological classification.The surgical resection should be given early surgi-cal resection and the prognosis is usually good.

Tamarindus indica Linn. tamarinds,belonging to the family Caesalpiniaceae,is a kind of large subtropical ever?green tree. Every part of tamarind has rich nutritional value and broad usage in traditional medicine since ancient times. Recent studies suggest extraction of leaves,flesh,seeds,and velamina of T. indica Linn. have numerous biological activities such as anti-microbial, anti-inflammatory,detoxification,analgesic,antidiabetic and anti-hyperlipidemiactions. A great interest has been seen in various sec?ondary metabolites isolated and identified from chemical components of T. indica Linn. In this review article,we summarize recent achievement in chemical components and biological activities of T. indica Linn.,aiming to provide a useful reference for further study and exploitation of T. indica Linn..