Objective:To analyze the predictive value of four scoring systems,Pediatric Clinical Illness Score (PCIS),Pediatric Logistic Organ Dysfunction Score 2 (PELOD-2),Pediatric Risk of Mortality Ⅲ (PRISM Ⅲ),and Pediatric Sequential Organ Failure Assessment (pSOFA),in the severity and prognosis in pediatric sepsis.Methods:The medical records of 159 children with sepsis who admitted to PICU at the First Hospital of Jilin University between August 2015 and December 2020 were retrospectively analyzed.The PCIS,PELOD-2,PRISM Ⅲ and pSOFA scores were calculated according to the worst value of each index within 24 h of admission.The children were divided into survival group and death group based on clinical outcomes during hospitalization.The children were stratified according to the severity of sepsis into sepsis (no organ dysfunction) group ( n=18) and severe sepsis group ( n=141).The receiver operator characteristic (ROC) curve was used to evaluate the value of PCIS,PELOD-2,PRISM Ⅲ and pSOFA scores in predicting the severity and prognosis in pediatric sepsis. Results:There were 97 (61.01%) cases in the survival group and 62(38.99%) cases in the death group.There were 141(88.68%) children with severe sepsis.The areas under curve (AUCs) of PCIS,PELOD-2,PRISM Ⅲ and pSOFA scores for predicting severe sepsis in children with sepsis were 0.869,0.875,0.672 and 0.933,respectively (all P <0.05).The AUCs of PCIS,PELOD-2,PRISM Ⅲ and pSOFA scores for predicting the death of children with sepsis in PICU were 0.687,0.697,0.716 and 0.656,respectively (all P<0.05). Conclusion:Among the four scoring systems,the pSOFA scoring system had the highest predictive power for the severity of sepsis.The PRISM Ⅲ score had higher value in assessing the risk of death in all patients with sepsis.

Objective To analyze the effect of night-shift work, anxiety and their interaction on work-related musculoskeletal disorders (WMSDs) among electronics manufacturing employees. Methods A total of 2 676 employees from 58 electronic manufacturing enterprises in the Pearl River Delta region of Guangdong Province were selected as the research subjects using the judgment sampling method. The Basic Situation Survey Scale, Generalized Anxiety Disorder 7-item Scale and Questionnaire of Musculoskeletal Disorders were used to assess night-shift work, anxiety and the prevalence of WMSDs in employees. The multivariate logistic regression model was used to analyze the effects of night-shift work, anxiety and their combined effects on the risk of WMSDs. Results The proportion of night-shift work was 30.3%, and the detection rates of anxiety and WMSDs were 26.8% and 41.3%, respectively. The results of multivariate logistic regression analysis showed that night-shift work and anxiety were independent risk factors of WMSDs in the research subjects, after excluding the influence of confounding factors such as age, marital status, enterprise size and length of service [odds ratio (OR) and 95% confidence interval (CI) were 1.307 (1.092-1.564) and 3.282 (2.739-3.934), respectively, both P<0.01]. Compared with those without night-shift work or anxiety, the risk of WMSDs was higher in individuals with only night-shift work, only anxiety, or both night-shift work and anxiety [OR and 95%CI were 1.347 (1.091-1.663), 3.395 (2.727-4.227) and 4.117 (3.072-5.519), respectively, all P<0.01]. Conclusion Both night-shift work and anxiety can increase the risk of WMSDs among electronic manufacturing employees, and these two factors exhibit a synergistic effect in increasing the risk of WMSDs.

Objective To establish diagnostic criteria for dampness syndrome through scientific and normative research methods.Methods The basis for syndrome differentiation of dampness syndrome was comprehensively integrated through literature research and structured tools,and in-depth investigation was carried out on the connotation and extension of dampness syndrome,judgment basis and criteria construction through questionnaire surveys and consensus conference method.Results Thirty-six items for syndrome differentiation of dampness syndrome were obtained through literature research.Through the questionnaire surveys,some experts suggested that the diagnosis mode of dampness syndrome should be in line with the clinical practice requirements.Accordingly,we were deep in thought about the key issue of"how to establish accurate diagnostic criteria".After in-depth investigation,we found that the dampness syndrome had specific and sensitive indicators.And 11 specific and 19 sensitive indicators were determined.Furthermore,according to the experts'suggestions,the specific indicators were classified into three categories based on dampness characteristics.Meanwhile,we investigated the diagnosis attributes of Chinese medicine syndromes and summarized them into four corresponding modes.Based on this,specificity mode and similarity/consistency mode should be adopted for diagnostic criteria for dampness syndrome.In addition,the judgment form in accord with the diagnostic attributes of dampness syndrome was determined.Conclusion This diagnostic criteria can provide a basis for the clinical diagnosis of dampness syndrome.Besides,this study explored the diagnostic attributes of Chinese medicine syndromes,which could provide reference for the development of other Chinese medicine syndrome criteria.

Objective:To investigate the status quo and influencing factors of support perception of spouses of breast cancer patients, and to provide reference for clinical intervention.Methods:A cross-sectional study was conducted to facilitate the selection of 180 breast cancer patients who were treated at the Sun Yat-sen University Cancer Center from January 2022 to June 2023. The general information questionnaire, the Perceived Support Scale for Spouses of Breast Cancer Patients, the Hospital Anxiety and Depression Scale, the Locke-Wallace Marriage Adjustment Scale, and the Brief Illness Perception Questionnaire were used to investigate them. Multiple linear regression was used to analyze the influencing factors of perceived support level of spouses of breast cancer patients.Results:A total of 180 patients were admitted ultimately, all of them were females, aged (49.88 ± 8.95) years old. The total score of Perceived Support Scale for Spouses of Breast Cancer Patients was (62.38 ± 6.54) points. The average scores of each dimension from high to low were emotional support (2.70 ± 0.48) points, information support (2.65 ± 0.52) points and actual support (2.51 ± 0.62) points. There were significant differences in the scores of spouse support perception among breast cancer patients with different educational levels, surgical methods and self-care ability ( F=4.08, 17.63, t=2.41, all P<0.05). Pearson correlation analysis showed that the total score of Perceived Support Scale for Spouses of Breast Cancer Patients was negatively correlated with anxiety score, depression score and disease perception score ( r=-0.388, -0.410, -0.350, all P<0.01), and positively correlated with marital adjustment score ( r=0.692, P<0.01). The results of multiple linear regression showed that education level, surgical method, anxiety, depression, disease perception and marital adjustment were the influencing factors of spouse support perception level of breast cancer patients ( t values were 3.04-4.44, all P<0.05 ), which could explain 54.6 % of the total variation. Conclusions:The level of support perception of spouses of breast cancer patients needs to be improved. Education level, surgical method, anxiety, depression, disease perception and marital adjustment are the influencing factors of patients ′ perception of spouse support level.

Objective This study aimed to explore the potential categories and characteristics of the fear of falling in the initial ambulation day among patients who underwent major abdominal surgery,analyze the factors influencing different potential categories,and propose implications for the care of such patients.Methods A total of 213 patients who u nderwent elective major abdominal surgery in the Department of Gastrointestinal Gland Surgery and Hepatobiliary Surgery in the First Affiliated Hospital of Guangxi Medical University from April to August 2023 were selected as the study subjects.The general data questionnaire and the Revised Version of the Fall Fear Scale and Patient Fall Risk Perception Scale were used to investigate the patients on the day they first got out of bed after surgery.The potential profile of the fall fear characteristics of the study subjects was analyzed,and the relevant influencing factors among different categories were explored by univariate analysis,variance analysis,and logistic regression analysis.Results A total of 202 patients who underwent major abdominal surgery were included in this study.The total score of the fear of falling when getting out of bed for the first time was(35.28±8.85).The fear of falling showed 3 potential categories:low-level fear(22.28％),medium-level fear(47.52％),and high-level fear(30.20％).A significant difference was found in the first time of getting out of bed among different types of fear(H=19.292,P＜0.001).Results of multi-factor logistic regression analysis showed that patients with high levels of personal activity factors in fall perception and those who underwent pancreatic surgery were likely to develop medium-level fear(P=0.037).Patients with high levels of perceived environmental factors,high levels of perceived personal activity factors,and low self-efficacy were likely to develop high-level fear(P＜0.05).Conclusion The fear of falling on the initial ambulation day in patients who underwent major abdominal surgery was distributed in categories,and the proportion of patients with medium and high fear levels was high.Patients'fall risk perception,self-efficacy,and surgical site are important factors influencing fear of falling.Therefore,postoperative nursing staff should focus on developing targeted health education and activity programs to reduce the level of fall fear.

Objective To develop the symptom terminology standard of dampness syndrome,and to provide reference for researches related to the dampness syndrome.Methods According to the workflow of The Principle and Method of Examining and Approving the Terminology in Science and Technology,we conducted the research as the following process:collecting symptoms,denominating symptoms and defining symptoms.First,we merged symptoms according to their intension and extension,and made symptoms independency based on their dampness characteristics and diagnostic value.We also included negative symptoms if they had diagnostic value on dampness syndrome.And then we denominated symptoms following the principle of monosemy and scientificity.Previous researches on symptom terminology usually gave symptom term nominal definitions,while in this study we gave the symptom terms operational definitions,including intension and application operationalization.Besides,based on symptom characteristics we developed symptomatic grading and quantification criteria.At last,the above-mentioned were optimized and confirmed based on the expert opinions.Results In this study,we denominated and defined forty-two symptoms,and also developed symptomatic grading and quantification criteria for them.Conclusion We developed symptom terminology standard for dampness syndrome.This study especially valued symptom independence and symptom terms operational definitions,which could give dampness syndrome diagnosis and evaluation real practice significance,and serve well for scientific researches and clinical practice.

Objective:To investigate the expression at protein level and diagnostic value of histone acetyltransferase MYST2 in pancreatic cancer.Methods:From December 1st, 2017 to June 30th, 2020, at Peking Union Medical College Hospital, a total of 54 cases of pancreatic cancer tissues and corresponding paracancerous pancreatic tissues (>5 cm from the surgical margin) resected and confirmed by pathology were collected. ASPC1 and BXPC3 pancreatic cancer cell lines were knocked down (ASPC1 and BXPC3 knockdown group), CFPAC1 and SW1990 pancreatic cancer cell lines were overexpressed (CFPAC1 and SW1990 overexpression group), the untreated ASPC1, BXPC3, CFPAC1 and SW1990 were set as blank vector control group. The expression at protein level of MYST2 was detected by Western blotting in patients with different degrees of pathological differentiation, human normal pancreatic duct epithelial cell line HPDE, human pancreatic cancer cell lines ASPC1, BXPC3, CFPAC1 and SW1990, knockdown group, overexpression group and blank vector control group. The cell proliferation, migration, invasion and colony formation ability of the knockdown group, overexpression group and blank vector control group were determined by real-time cellular analysis, Transwell migration and invasion test, and plate colony formation assay. MYST2 immunohistochemical scoring was performed on pancreatic cancer tissues and para cancer tissues. Receiver operating characteristic curve was drawn to analyze the value of different MYST2 protein expression levels in the diagnosis of pancreatic cancer. Independent sample t test and variance analysis were used for statistical analysis. Results:Among the pathological slides of 54 cases of pancreatic cancer, 13 cases were highly differentiated, 24 cases were moderately differentiated, 15 cases were poorly differentiated and 2 cases were undifferentiated, the MYST2 expression at protein level in pancreatic cancer cells was 3.12±1.67, 2.87±1.59, 2.12±1.03 and 1.08±0.34, respectively, and the difference was statistically significant ( F=1.241, P<0.05). The MYST2 expression levels of ASPC1, BXPC3, CFPAC1 and SW1990 were all higher than that of normal pancreatic ductal epithelial cell lines HPDE (1.41±0.47, 1.40±0.93, 1.13±0.62 and 1.71±0.46 vs. 0.82±0.25), and the differences were statistically significant( t=1.625, 1.577, 1.319 and 1.832, all P<0.05). The MYST2 expression level of BXPC3 knockdown group was lower than that of BXPC3 blank vector control group (0.39±0.12 vs. 0.75±0.34); that of ASPC1 knockdown group was lower than that of ASPC1 blank vector control group (0.43±0.22 vs. 0.82±0.48); that of CFPAC1 overexpression group was higher than that of CFPAC1 blank vector control group (1.38±0.45 vs. 0.82±0.37); that of SW1990 overexpression group was higher than that of SW1990 blank vector control group (1.34±0.65 vs. 0.51±0.22), and the differences were statistically significant ( t=1.414, 1.378, 1.319 and 1.934, all P<0.05). The cell proliferation of ASPC1 knockdown group was slower than that of ASPC1 blank vector control group, and the proliferation peak at 80 h was lower than that of blank vector control group (1.02±0.77 vs. 4.31±2.45); the cell proliferation of BXPC3 knockdown group was slower than that of BXPC3 blank vector control group, and the proliferation peak at 80 h was lower than that of blank vector control group (0.91±0.24 vs. 2.84±0.53); the proliferation of pancreatic cancer cells in SW1990 overexpression group was faster than that of SW1990 blank vector control group, and the proliferation peak at 80 h was higher than that of blank vector control group (3.10±0.67 vs. 1.04±0.17); the proliferation of pancreatic cancer cells in CFPAC1 overexpression group was faster than that that of CFPAC1 blank vector control group, and the proliferation peak at 80 h was higher than that of blank vector control group (5.45±1.13 vs. 1.01±0.29), and the differences were statistically significant ( t=1.427, 1.316, 1.292 and 1.501, all P<0.05). In the test of migration ability, the number of cells passed through the Transwell chamber of ASPC1 knockdown group was less than that of ASPC1 blank vector control group (34.08±17.62 vs. 118.76±5.31); that of BXPC3 knockdown group was less than that of BXPC3 blank vector control group (18.62±9.64 vs. 57.90±12.67); that of SW1990 overexpression group was more than that of SW1990 blank vector control group (134.84±24.65 vs. 37.82±6.73); that of CFPAC1 overexpression group was more than that of CFPAC1 blank vector control group (65.79±27.46 vs. 11.68±5.13), and the differences were statistically significant ( t=1.475, 1.322, 1.437 and 1.219, all P<0.05). In the test of invasion ability, the number of cells passed through the Transwell chamber of ASPC1 knockdown group was less than that of ASPC1 blank vector control group (9.79±5.75 vs. 45.76±12.71); that of BXPC3 knockdown group was less than that of BXPC3 blank vector control group (23.46±11.13 vs. 84.92±17.65); that of SW1990 overexpression group was more than that of SW1990 blank vector control group (156.42±34.50 vs. 42.13±22.17); that of CFPAC1 overexpression group was more than that of CFPAC1 blank vector control group (112.64±47.82 vs. 39.09±17.23), and the differences were statistically significant ( t=1.324, 1.635, 1.423 and 1.119, all P<0.05). The number of colony formation of the ASPC1 knockdown group was less than that of ASPC1 blank vector control group (13.15±6.42 vs. 86.79±35.17); that of BXPC3 knockdown group was less than that of BXPC3 blank vector control group (14.93±9.30 vs. 52.93±15.76); that of SW1990 overexpression group was more than that of SW1990 blank vector control group (129.10±57.31 vs. 62.42±37.43); that of CFPAC1 overexpression group was more than that of CFPAC1 blank vector control group (157.98±66.45 vs. 74.35±34.69), and the differences were statistically significant ( t=1.148, 1.290, 1.274 and 1.462, all P<0.05). The MYST2 score of pancreatic cancer tissues was higher than that of adjacent paracancerous pancreatic tissues (3.04±2.23 vs. 1.32 ± 0.70), and the difference was statistically significant ( t=3.479, P<0.05). When the total immunohistochemistry score of MYST2 was 3 point, the area under the curve was the largest (0.888, 95% confidence interval 0.827 to 0.948), and the Youden index was 0.56. Conclusion:MYST2 is associated with the proliferation, invasion and migration of pancreatic cancer cells, and promotes the development of pancreatic cancer.

Grey matter (GM) alterations may contribute to cognitive decline in individuals with white matter hyperintensities (WMH) but no consensus has yet emerged. Here, we investigated cortical thickness and grey matter volume in 23 WMH patients with mild cognitive impairment (WMH-MCI), 43 WMH patients without cognitive impairment, and 55 healthy controls. Both WMH groups showed GM atrophy in the bilateral thalamus, fronto-insular cortices, and several parietal-temporal regions, and the WMH-MCI group showed more extensive and severe GM atrophy. The GM atrophy in the thalamus and fronto-insular cortices was associated with cognitive decline in the WMH-MCI patients and may mediate the relationship between WMH and cognition in WMH patients. Furthermore, the main results were well replicated in an independent dataset from the Alzheimer's Disease Neuroimaging Initiative database and in other control analyses. These comprehensive results provide robust evidence of specific GM alterations underlying WMH and subsequent cognitive impairment.

Objective Proteus syndrome is a rare disease. The aim of the present study was to analyze the clinical characteristics and gene mutations of Proteus syndrome with a case report and relevant literature review. Methods Clinical data of the patient with Proteus syndrome were collected in detail and biochemical measurements and radiological examinations were conducted. Tissues from phalanges with lesions were obtained to extract DNA, and Sanger sequencing of AKT1 gene was carried on. The pathogenic mutation was further tested in peripheral blood samples of the patient, his parents and 250 healthy volunteers. Orthopaedic surgery was performed on the affected limbs of the patient. Results The patient was presented with progressive overgrowth of the right extremity, scoliosis, cerebral connective tissue nevus and lower extremity venous. A heterozygous mutation of AKT1 gene (c. 49G>A) was identified in DNA extracted from the affected bone tissue of the patient, but not be found in genomic DNA of peripheral blood samples from the patient, his parents and 250 healthy volunteers. Movement function of the affected limb improved significantly after the operations. Conclusions The prominent features of Proteus syndrome are overgrowth of one extremity and cerebral connective tissue nevus. A mosaic somatic mutation of AKT1 gene is one of the pathogenic mutations for Proteus syndrome, and orthopedic surgery may be a good way to improve symptoms of the disease.

Recent studies have discovered a selective autophagy-lipophagy, which can selectively identify and degrade lipids and plays an important role in regulating cellular lipid metabolism and maintaining intracellular lipid homeostasis. The process of lipophagy can be directly or indirectly regulated by genes, enzymes, transcriptional regulators and other factors. This review examines the role of lipophagy in reducing liver lipid content, regulating pancreatic lipid metabolism, and regulating adipose tissue differentiation, and summarizes the findings of the molecules (Rab GTPase, enzymes, ion channels, transcription factors, small molecular substances) involved in the regulation of lipophagy, which points to new directions for the treatment of diseases caused by lipid accumulation.
Adipose Tissue ; Autophagy ; Homeostasis ; Lipid Metabolism ; Liver