Objective To understand the risk factors for poor prognosis of severe adenovirus pneumonia (SAP)in children,and provide guidance for clinical diagnosis and prognosis.Methods Clinical data of 91 hospitalized children who diagnosed with SAP in Chongqing Children’s Hospital of Chongqing Medical University between January 2012 and January 2014 were analyzed retrospectively.Results Of 91 SAP children,23 (25.27%)had poor prognosis. Univariate analysis showed that risk factors for poor prognosis of SAP were age of onset,congenital heart disease and other serious underlying diseases,mechanical ventilation therapy,acute respiratory distress syndrome (ARDS), atelectasis and other serious radiological changes,and emergence of two and more extra-pulmonary complications (all P <0.05).Multivariate regression analysis showed that congenital heart disease and other serious underlying diseases,and emergence of two and more extra-pulmonary complications were independent risk factors for poor prognosis of SAP (all P <0.05).Conclusion Congenital heart disease and other serious underlying diseases,emer-gence of two and more extra-pulmonary complications are independent risk factors for poor prognosis of SAP,active intervention should be conducted during the process of clinical diagnosis and treatment,so as to improve the prognosis.

As a nuclear transcription repressor,the functions of TGIF are complicated,not only represses target genes expression directly,but also takes part in the regulation of multiple important cellular signaling pathways,which are associated with the differentiation of cells and tissues,inflammation,metabolism and tumors.In past few years,more and more studies on the role of TGIF in tumors suggest TGIF may be a new therapy target in the diagnosis and treatment of tumours.This article mainly reviews the research progress of TGIF in some signaling pathways like TGF-β,MAPK,PI3K/AKT,and tumours like hepatocellular carcinoma,lung carcinoma and urinary tract urothelial carcinoma.

Pancreatic tuberculosis (PTB) is a rare,chronic,specific and infectious disease which is generally secondary to tuberculosis at the common sites of pancreas,and it has a high misdiagnosis rate due to the hidden onset and nonspecific symptoms of PTB.A patient with PTB was admitted to the First Affiliated Hospital of Zhengzhou University in June 2014.Before operation,the space-occupying lesions of the head of pancreas were detected by preoperative imaging examination,and the patient was regarded as with pancreatic cancer.Intraoperative exploration showed cystic duct involvement,and the granulomatous inflammation was detected by rapid pathological examination using frozen section technique,after that the patient received granuloma resection+cholecystectomy according to suspected PTB.The diagnosis of PTB was confirmed by postoperative pathological examination,and the patient received liver-protective and anti-tuberculosis treatments after discharge.

Glucose-sensitive materials have attracted much interest due to their potential application in diabetes treatment in recent years.Phenylboronic acid-based glucose-responsive polymers,which possess continuous glucose sensitivity and good stability,have been most widely used in self-regulated insulin delivery.This review covers the recent advances in PBA-functionalized nanogels (microgels),micelles,vesicles and nanoparticles.Synthesis and application of these nanomaterials are discussed.With the development of PBA-regulated polymers,these nanomaterials will migrate from laboratory to clinical use in the near future.

Endoscopy ; Foreign Bodies ; surgery ; Humans ; Maxillary Sinus ; surgery ; Orbit ; surgery

Objective To explore the effect of calreticulin (CRT) on cell proliferation and invasion of human hepatocellular carcinoma cell line SMMC-7721 and HepG2.Methods SMMC-7721 and HepG2 cells were transfected with small interfering RNA (siRNA).The transfection rate was detected by immunoflurescence and western blot.The cell proliferation,invasion and apoptosis of SMMC-7721 and HepG2 cells were determined by using cell counting kit-8 (CCK-8) assays,transwell assays and flow cytometry,respectively.The p-Akt and Akt levels were detected by western blot.Results The growth inhibition rate in the siRNA experimental group of SMMC-7721 and HepG2 cells for 24,36 and 48 h were (41.0 ±2.2) ％,(46.5 ±1.6)％,(59.7 ±2.2)％ and (36.8 ±2.7)％,(47.3 ± 1.8)％,(61.5 ±3.2)％,respectively.The apoptosis rate after down-regulating the expression of CRT in SMMC-7721 and HepG2 cells for 36h were (45.2 ± 9.1) ％ and (48.9 ± 8.0) ％,respectively.Compared with the blank group and the negative control group,the growth inhibition rate in the siRNA experimental group was lower (P ＜0.05),but the apoptosis rate was significantly higher (P ＜ 0.05).Transwell experiments confirmed that the numbers of invaded SMMC-7721 and HepG2 cells in the blank group and the negative control group and siRNA experimental group were (96.8±7.3),(95.6±5.4),(34.0±4.2) and (124.0 ±9.9),(121.6 ±7.0),(70.4±9.5),respectively,indicating that cell invasion in the siRNA experimental group was significantly suppressed (P ＜ 0.05).The expression of p-Akt was decreased (P ＜ 0.05) after down-regulating the expression of CRT for 36h.Conclusion CRT gene silencing by siRNA can inhibit the SMMC-7721 and HepG2 cell proliferation and invasion,but increase the cell apoptosis by regulating PI3K/Akt signal pathway.

Objective: To provide longitudinal evidence for interventions in suicidal behavior among college students, this study explored the mechanisms underlying the relationship between cyberbully. Methods: Based on the general strain theory, 558 college students from Beijing and Xi an were followed up 2 times(T1 and T2) by using the Cyberbullying Questionnaire, Beck Scale for Suicide Ideation and Center for Epidemiological Survey Depression Scale(CES-D). Results: T1 cyberbully could positively predict depression and suicidal ideation among college students at T2( β =0.06, 0.15, P <0.01), and depression at T1 could positively predict suicidal ideation among college students at T2( β =0.29, P <0.01). The mediation effect revealed that depression at T1 could mediate the relationship between cyberbully and suicidal ideation. Compared to boys, girls were likely to be affected by cyberbully and resulted in depression and suicidal ideation. Conclusion Findings contribute to the prespective causal relation between cyberbullying and suicidal ideation among college students and provide the longitudinal evidence for intervention of suicidal ideation.

Objective To analyze current situation and development tendency of medical teaching case library construction and to provide information for medical teaching reform. Methods Bibliometrics was used to retrieve and analyze literatures on the subject of medical teaching case library construction from China National Knowledge Infrastructure, CBMdisc, VIP and Wanfang Data from construction to June 20th,2017. Results Totally 116 articles published in 71 journals were included.A gradual growth was found in the number of publication and funded articles. The average citation count was 2.05. A majority of articles were produced in Beijing, Guangdong and Shanghai. Medical teaching case library covered 9 majors and 42 courses and applied in class teaching (50.00%, 58/116), clinical practice (37.07%, 43/116), refresher training (2.59%, 3/116), assessment and evaluation (0.86%, 1/116). Satisfaction investigate,examination score analysis and expert review were commonly used to evaluate the quality of case library. Conclusions Researches in China on medical teaching case library construction were increasing in recent years.Case library were applied in various aspects of medical teaching,however, there still remained some problems.Articles on the subject of case library were not highly-cited.There was no core author group yet. The subject on medical case library still needed deep and further exploration. There′s suggestion that we should attach importance to medical case library construction and related study to push medical education reform.

OBJECTIVETo establish the theories and methods to determine apparent solubility paraneters of multiple components for the Chinese materia medica (CMM) with HPLC fingerprint.

METHODThe mathematical functional expresses to determine the apparent solubility parameters for multiple constituents were established according to total quantum geometrical average retention time (TQGART) for HPLC fingerprint that characterized the entirety tendencies for all-over chromatographic peaks, validated by the aloe-emodin's solubility parameters which had been determined. The HPLC for the aloe-emodin's solubility parameters were carried out with an Alltech Apollo C18 as column, Acetone: Water as mobile phase, gradient elution,flow rate as 1.0 mL x min(-1), the detection wave-length as 430 nm and the temperature as 30 degrees C.

RESULTThe mathematical functional model between the TQGART of HPLC chromatographic fingerprint and the total quantum apparent solubility parameters was established and used to determine the aloe-emodin's mixture solubility parameter as 36.12 J(1/2) x cm(-3/2), nearly equal to 35.57, 36.07 J(1/2) x cm(-3/2) calculated by ration of peak area ratios and molecular fraction, respectively.

CONCLUSIONThe TQGART of HPLC fingerprint can be used to determine simultaneously the apparent or single intrinsic solubility parameters for total quantum or intrinsic solubility parameters for single in multiple constitute systems, by which theoretical and technologic platform to study the compatibility rule and dosage form reform of the single CMM will be established.

Objective:To explore the application value of sevoflurane inhalation anesthesia in mitral valve replacement.Methods:A total of 94 patients who underwent mitral valve replacement in our hospital (October 2016-October 2018) were randomly divided into the control group ( n=47) and the observation group ( n=47). The control group received target-controlled infusion of propofol, and the observation group inhaled sevoflurane.The postoperative conditions [intensive care unit (ICU) stay time, extubation time of tracheal tube, spontaneous cardiac rebound], hemodynamic indexes [mean arterial pressure (MAP), heart rate (HR)], serum creatine phosphokinase isoenzyme (CK-MB), cardiac troponin I (cTnI), malondialdehyde (MDA) and superoxide dismutase (SOD) in the two groups were analyzed. The patients were followed up for one month. The incidence of major adverse cardiovascular events (MACE) was calculated. Results:⑴ Postoperative situation: the time of stay in ICU and extubation of tracheal tube in the observation group was shorter than that in the control group, and the rate of spontaneous cardiac rebound (93.62%) was higher than that in the control group (72.34%) ( P<0.05); ⑵ Hemodynamic index level: there was no statistically significant difference in MAP and HR levels between two groups before operation, before cardiopulmonary bypass, after cardiopulmonary bypass, and after operation ( P>0.05); ⑶ CK-MB and cTnI: the levels of serum CK-MB and cTnI in the two groups were higher at 2, 6, 24, and 48 h after aortic cross-clamp release than before anesthesia induction, but the indicators of the observation group were lower than those in the control group; ⑷ MDA and SOD: the serum SOD level in the two groups at 2, 6, 24, and 48 h after aortic cross-clamp release were lower than before anesthesia induction, and the MDA level in the two groups at 2, 6, 24, and 48 h after aortic cross-clamp release were higher than before anesthesia induction. The level of SOD in the observation group was higher than that in the control group, and the level of MDA was lower than that in the control group ( P<0.05); ⑸ MACE: the incidence of MACE in the observation group (12.77%) was lower than that of the control group (29.79%) ( P<0.05). Conclusions:During mitral valve replacement, sevoflurane inhalation anesthesia can maintain hemodynamic stability. The duration of ICU stay and tracheal tube extubation time is shorter, and the fluctuation of serum CK-MB, cTnI, MDA and SOD is small, and it can reduce the risk of MACE.