Human breast milk contains a good balance of nutrients.In recent years,researchers have found that it contains not only abundant nutrients,but also different active components,and MicroRNAs (miRNA) are included.MiRNA are endogenous non-coding RNA,consisting of 21 to 25 nucleotides in length.They play an important role in regulating a variety of biological processes.In the miRNA confirmed in human breast milk,let-7、miRNA-30b and miRNA-378 are highly expressed and researches have already demonstrated that these miRNA are participating in the regulation of adipocytes differentiation,lipid accumulation and sugar and lipid metabolism.

Objective To explore the expression levels of immune-related microRNA-146b (miR-146b),microRNA-155 (miR-155) and microRNA-30b(miR-30b) in human breast milk and its relationship with maternal and infant's health.Methods One hundred and thirty-four mothers and their infants from obstetrical department were recruited in the study after delivery.The subjects were divided into 2 groups,breast feeding group(n =86) and formula-feeding group(n =48),and were followed up 3 months after delivery.Breast milk samples were collected at 2-5 days after delivery(colostrum) and 3 months after delivery(mature milk).The expression levels of microRNAs in milk samples were detected by real-time PCR.The relationship between levels of microRNAs and maternal and infant-related factors was analyzed.Results 1.MiR-146b,miR-155 and miR-30b expressions were abundant both in human colostrums (5.950 ± 0.823,3.899 ± 0.920,4.057 ± 0.604) and mature milk (4.840 ± 0.805,2.128 ± 0.969,4.929 ± 0.566).The levels of miR-146b and miR-155 were higher in colostrum than that of mature milk (t =7.716,10.215,all P ＜ 0.01),while the level of miR-30b was higher in mature milk than that of colostrums(t =-8.626,P ＜ 0.0l).2.Additionally,the level of miR-30b was negatively correlated with maternal pre-pregnancy body mass index (r =-0.298,P ＜ 0.01).3.The levels of miR-146b and miR-30b were higher in mothers giving birth by vaginal delivery than those who underwent cesarean section(t =2.356,3.108,all P ＜0.05).4.The levels of miR-146b and miR-155 were higher in colostrum-fed girls than boys (t =-2.204,-2.985,all P ＜ 0.05).5.The level of miR-146b in mature milk was negatively correlated with 3-month-old infant' s Z score of body weight (r =-0.425,P ＜ 0.05) and body length (r =-0.569,P ＜ 0.01).6.During follow-up,the incidence of baby eczema in breast feeding group (8.82％,3/34 cases) was lower than that in formula milk feeding group(29.17％,14/48 cases) (x2 =5.012,P =0.025).Conclusions The levels of immunocompetent microRNAs in human milk are influenced by the lactation period,maternal prepregnancy body mass index,mode of delivery and infant sex.The immune-related microRNAs in human milk could be involved in the regulation of infant's immunity and growth.

Objective To investigate the expression of Ki-67,Survivin,Livin in dysplasia,colon carcinogenesis and para-carcinoma tissues,and to discuss the variation of cell proliferous capability in colon carcinogenesis and antiapoptosis factors.Methods 219 specimens were composed of mild,moderate and severe atypical hyperplasia,well,moderately,poorly differentiated adenocarcinoma,para-carcinoma tissues of 36,34,18,35,27,35 and 34 cases.Detected the expression of Ki-67,Survivin and Livin with tissue microarray and immunohistochemical methods.All data were statistically analyzed by SPSS 17.0.Results In mild,moderate and severe atypical hyperplasia,well,moderately,poorly differentiated adenocarcinoma and para-carcinoma tissues the expression of Ki-67 were (21.56 ± 19.20)％,(37.44 ± 17.41)％,(36.17 ± 17.41)％,(55.29 ± 16.13)％,(44.89 ± 29.67)％,(45.11 ± 29.24)％,(43.94 ± 28.84)％,Survivin were 13.8 ％,44.1％,77.8 ％,85.7 ％,85.1％,91.4 ％,91.1％,and Livin were 2.7 ％,38.2 ％,55.6 ％,100.0 ％,77.8 ％,80.8 ％,79.4 ％.The differences of Ki-67,Survivin and Livin expression in each group were statistically significant (F =6.796,X2 =81.754,X2 =95.200,all P ＜ 0.05).Ki-67 was significantly correlated with expression of Livin (r =0.360,P ＜ 0.05) and no correlated with expression of Survivin (r =0.044,P ＞ 0.05).Conclusion Colonic epithelium from mild atypical hyperplasia to proliferation of well-differentiated adenocarcinoma cells formed a peak,and gradually down to poorly differentiated adenocarcinoma formed a platform.When the colon epithelial cells to become cancerous,the capability of cell proliferation will significantly enhance,apoptosis inhibition will reach the peak and the tumor cell will happen the changes of malignant biological behavior.Tumor microenvironment may promote the cell proliferation in para-carcinoma tissues and the development of colon cancer.Livin may inhibit apoptosis and promot the progression in synergistic mechanism importing with Survivin,which play a role in the development of colonic adenocarcinoma.

Objective: The purpose of this study was to analyze the impact of surgery of primary sites on stage IVB cervical cancer patients from a population-based database, the Surveillance, Epidemiology and End Results (SEER). Methods: Propensity score matching was performed to minimize heterogeneity in patient between with-surgery group and without-surgery group. Clinicopathological characteristics were compared using the χ2 or Fisher's exact test. Survival analysis included the Kaplan-Meier method, log-rank test, and Cox proportional hazards model. Results: Between 2010-2015, a total of 1,139 International Federation of Gynecology and Obstetrics (FIGO) stage IVB cervical cancer patients receiving chemoradiotherapy (CRT) were included in this retrospective study. Within post-matching cohort, the median duration of overall survival (OS) in stage IVB cervical cancer patients receiving CRT was 22 months. The overall 5-year survival rate was 25.7%. The increasing American Joint Committee on Cancer T stage (T1 vs. T2, p=0.033, hazard ratio [HR]=1.79, 95% confidence interval [CI]=1.05–3.05; T1 vs. T3, p=0.003, HR=2.20, 95% CI=1.31–3.67; T1 vs. T4, p=0.037, HR=2.75, 95% CI=1.06–7.12) and visceral metastasis (with vs. without, p=0.038, HR=1.60, 95% CI=1.03–2.49) was reported as independent risk factors of OS. Surgery of primary sites combined with CRT tended to prolong the survival of stage IVB cervical cancer patients (p<0.001, HR=0.36, 95% CI=0.21–0.61) compared with CRT, especially for patients without visceral metastasis (p=0.005, HR=0.31, 95% CI=0.14–0.70). Conclusions In conclusion, patients with stage IVB cervical cancer may achieve their best outcomes through CRT combined with surgery of primary sites. However, it deserves large scale prospective clinical trials to confirm.

Objective To evaluate the effect of nimodipine combined with 7.5％ hypertonic saline (HS) on postoperative cognitive function in aged rats.Methods Ninety-six healthy male Wistar rats,aged 18 months,weighing 450-500 g,were assigned into 4 groups (n=24 each) using a random number table:splenectomy group (group S),nimodipine group (group N),group HS and nimodipine plus HS group (group N+HS).Nimodipine 1 mg/kg was intraperitoneally injected in group N.In group HS,7.5％ HS 4 ml/kg was injected via the caudal vein.The equal volume of normal saline was injected intraperitoneally or via the caudal vein in group S.Splenectomy was performed under sevoflurane anesthesia at 30 min after the end of administration.On 1 day before operation and 3 and 7 days after operation,Morris water maze test was performed,and blood sainples from the caudal vein were simultaneously collected for determination of the concentrations of serum S100β protein and neuron-specific enolase (NSE) by enzyme-linked immunosorbent assay.Results Compared with group S,the frequency of crossing the original platform was significantly increased,the escape latency was shortened,and the concentrations of serum S100β protein and NSE were decreased at each time point after operation in N,HS and N+HS groups (P＜0.05).Compared with group N or group HS,the frequency of crossing the original platform was significantly increased,the escape latency was shortened,and the concentrations of serum S100β protein and NSE were decreased at each time point after operation in group N+HS (P＜0.05).Conclusion Nimodipine combined with 7.5％ HS exerts better efficacy than either alone in improving postoperative cognitive function in aged rats.

Chemoradiotherapy ; Cohort Studies ; Epidemiology ; Gynecology ; Humans ; Joints ; Methods ; Neoplasm Metastasis ; Obstetrics ; Population Characteristics ; Propensity Score ; Proportional Hazards Models ; Prospective Studies ; Retrospective Studies ; Risk Factors ; Survival Rate ; Uterine Cervical Neoplasms

OBJECTIVE: To investigate the prevalence and related factors of emotional problems of newly identified patients with HIV/AIDS in Changsha, Hunan Province, and to provide scientific evidence for the mental health intervention in this special population. METHODS: A total of 370 patients with HIV/AIDS who were newly identified by the Center for Disease Prevention and Control in Changsha City from March 1, 2013 to February 28, 2014 were investigated. Self-designed questionnaire, Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), HIV/AIDS Stress Scale and Social Support Rating Scale (SSRS) were performed to assess the prevalence of depression, the anxiety symptoms, the HIV related stress and the status of social support. RESULTS: The prevalence of depression and anxiety were 40.3% (PHQ-9 ≥ 10 points) and 30.5% (GAD-7 ≥ 10 points), respectively. Severe depressive symptoms (PHQ-9≥20 points) and severe anxiety (GAD-7 ≥ 15 points) accounted for 8.1% and 14.3%, respectively. Hierarchical regression analysis showed that the status of employment (b=-3.407, P<0.001; b=-2.799, P=0.001), the sexual orientation (b=1.903, P=0.008; b=1.314, P=0.034), the resident status (b=-1.995, P=0.012; b=-2.167, P=0.002), the emergence of HIV-related symptoms(b=4.578, P<0.001; b=3.652, P<0.001) and the HIV related stress (b=0.081, P<0.001; b=0.090, P<0.001) were the predictors for both depressive and anxious emotional problems whereas the social support (b=-0.046, P=0.044) was the predictor for depressive emotional problems. Both anxiety (ΔR2=54.7%, P<0.001) and depression (ΔR2=55.8%, P<0.001) were strong predictors for patients with HIV/AIDS. CONCLUSION Depression and anxiety are prevalent among the newly identified patients with HIV/ AIDS. Psychosocial support and basic mental health services should be integrated into the current HIV/AIDS care system.
Acquired Immunodeficiency Syndrome ; psychology ; Anxiety ; epidemiology ; Depression ; epidemiology ; HIV Infections ; psychology ; Humans ; Mental Health ; Prevalence ; Regression Analysis ; Social Support ; Surveys and Questionnaires

Objective: To investigate the effects of remifentanil combined with propofol on hemodynamics, inflammatory stress response and immune function in patients with acute abdomen complicated with septic shock. Methods: From June 2017 to August 2018, 112 patients with acute abdomen complicated with septic shock who admitted to the First Affiliated Hospital of Xiamen University were enrolled in the study.They were randomly divided into observation group and control group according to the digital table, with 56 cases in each group.The control group was anesthetized with sevoflurane combined with propofol.The observation group was anesthetized with remifentanil combined with propofol.The hemodynamic parameters of the patients entering the operating room(T0₎, 0.5h(T₁), 1h(T₂) and awake(T₃) after anesthesia were recorded.The intraoperative norepinephrine dosage was recorded.The inflammatory response, stress response and immune function indicators at T₀, T₂ and T₃ were recorded. Results: Compared with T₀, T₁ and T₂, the MAP of the two groups was higher at T₃, and the differences were statistically significant(t_{control group}=4.834, 4.484, 5.378, t_{observation group}=6.420, 7.006, 6.152, all P<0.05). Compared with T₀, the HR of the two groups was higher at T₃, and the differences were statistically significant(t_{control group}=5.943, t_{observation group}=7.722, all P<0.05). Compared with T₁ and T₂, CO of the two groups was higher at T₃, and the differences were statistically significant(t_{control group}=4.276, 2.262, t_{observation group}=6.318, 5.132, all P<0.05). There were no statistically significant differences in MAP, HR and CO between the two groups at T₀, T₁, T₂ and T₃(all P>0.05). The doses of norepinephrine in the observation group and the control group were (1 587.7±287.5)μg and (1 937.9±397.6)μg, respectively, and the difference was statistically significant(t=5.341, P<0.05). The serum levels of C reactive protein(CRP), tumor necrosis factor alpha(TNF-α) and interleukin 6(IL-6) increased with time in the two groups, and the differences were statistically significant(t_{control group}=17.06, 36.13, 19.07, 3.822, 9.466, 2.874, 14.18, 26.87, 16.21, t_{observation group}=11.72, 20.79, 11.01, 2.810, 6.559, 3.716, 10.52, 24.56, 17.64, all P<0.05). At T₂ and T₃, the serum levels of CRP, TNF-α and IL-6 in the observation group[T₂: CRP (89.63±17.65)mg/L, TNF-α (51.16±10.16)ng/L, IL-6 (34.26±6.25)ng/L, T₃: CRP (136.15±26.25)mg/L, TNF-α (58.64±11.12)ng/L, IL-6 (67.56±12.67)ng/L]were lower than those in the control group[T₂: CRP (112.15±22.34)mg/L, TNF-α (59.56±11.58)ng/L, IL-6 (42.65±8.37)ng/L, T₃: CRP (175.16±34.75)mg/L, TNF-α (65.79±11.35)ng/L, IL-6 (79.02±14.56)ng/L], the differences were statistically significant(t=5.919, 6.703, 4.080, 3.367, 6.010, 4.443, all P<0.05). Compared with T0, serum levels of epinephrine(E), cortisol(Cor) increased in two groups at T₂ and T₃, and the differences were statistically significant(t_{control group}=10.03, 8.096, 8.679, 7.029, t_{observation group}=6.473, 4.728, 6.330, 4.727, all P<0.05). Compared with T₂, serum levels of E and Cor in two groups at T₃ were decreased, and the differences were statistically significant(t_{control group}=2.400, 2.638, t_{observation group}=2.260, 2.162, all P<0.05). At T₂ and T₃, the serum levels of E, Cor in the observation group[T₂: E (286.36±41.02)ng/L, Cor (262.52±29.89)μg/L, T₃: E (270.35±33.59)ng/L, Cor (253.23±30.28)μg/L]were lower than those in the control group[T₂: E (312.56±38.75)ng/L, Cor (287.56±38.76)μg/L, T₃: E (295.79±35.12)ng/L, Cor (270.25±30.15)μg/L], the differences were statistically significant (t=3.457, 3.917, 3.828, 2.981, all P<0.05). At T₀, T₂ and T₃, there were no statistically significant differences in CD₃⁺, CD₄⁺, CD₈⁺ and CD₄⁺/CD₈⁺ between the two groups(all P>0.05). Conclusion Remifentanil combined with propofol anesthesia can make hemodynamics more stable in patients with acute abdomen complicated with septic shock, and can alleviate inflammation and stress response.

Objective To observe the value of 3D Res2Net deep learning model for predicting volume doubling time(VDT)of solid pulmonary nodule.Methods Chest CT data of 734 patients with solid pulmonary nodules were retrospectively analyzed.The patients were divided into progressive group(n=218)and non-progressive group(n=516)according to whether lung nodule volume increased by ≥25％during follow-up or not,also assigned into training set(n=515)and validation set(n=219)at a ratio of 7∶3.Then a clinical model was constructed based on clinical factors being significantly different between groups,CT features model was constructed based on features of nodules on 2D CT images using convolutional neural network,and 3D Res2Net model was constructed based on Res2Net network using 3D CT images as input.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated.Taken actual VDT as gold standard,the efficacy of the above models for predicting solid pulmonary nodule'VDT≤400 days were evaluated.Results No significant difference of predicting efficacy for solid pulmonary nodule'VDT≤400 days was found among clinical model,CT feature model and 3D Res2Net model,the AUC of which was 0.689,0.698 and 0.734 in training set,0.692,0.714 and 0.721 in validation set,respectively.3D Res2Net model needed 5-7 s to predict VDT of solid pulmonary nodules,with an average time of(5.92±1.08)s.Conclusion 3D Res2Net model could be used to predict VDT of solid pulmonary nodules,which might obviously reduce manual interpreting time.

Objective:To explore the clinical characteristics and prognoses of severe autoimmune glial fibrillary acidic protein astrocytopathy (GFAP-A).Methods:A retrospective analysis was performed. The clinical data of 12 patients with severe GFAP-A admitted to Department of Neurology, Guangdong 999 Brain Hospital from January 2018 to June 2023 were collected, including demography, clinical manifestations, MRI features, laboratory examination results (such as antibodies), treatments and prognoses.Results:Among the 12 patients, 9 were male and 3 were female, with an average onset age of (46.58±17.53) years. Primary symptoms included headache, limb weakness, limb numbness, mental disorder, epileptic seizure, and urinary and defecation disorder; 9 patients had fever before onset. With aggravated severe GFAP-A, 12 patients had impaired consciousness, 12 had respiratory failure, 6 had unstable blood pressure and heart rate, and 2 had status epilepticus. Cranial MRI indicated abnormal lesions in all 12 patients, including 10 with brainstem involvement (7 had involved medulla oblongata); 10 showed soft meningeal enhancement. In 8 patients received MRI of the whole spinal cord, 7 had abnormal spinal cord lesions; point-like enhancement of the whole spinal meninges was observed in 6 of the 7 patients. All 12 patients had positive cerebrospinal fluid GFAP-IgG, and 3 patients also had positive serum GFAP-IgG. All patients accepted glucocorticoids and immunoglobulin immunotherapy, and 1 patient was supplemented with mycophenolate mofetil; 8 patients had good prognosis, and 4 patients died. Pulmonary infection, hyponatremia, hypoproteinemia, and deep vein thrombosis were the common complications.Conclusion:Patients with severe GFAP-A mainly manifest as meningoencephalitis and meningoencephalomyelitis, and are likely involved medulla oblongata, enjoying rapid clinical progression; even with early immunotherapy, high mortality rate is still noted.