AIM:To investigate the autophagy induced by sepsis and acute kidney injury , and the regulation of phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway in this process.METHODS: The rats were subjected to cecal ligation and puncture ( CLP) or sham operation .Histopathologic changes of the renal tissues were examined by HE staining .Blood urea nitrogen ( BUN) and serum creatinine ( SCr) were measured by chemical colorime-try.The protein expression of microtubule-associated protein light chain 3 I/II (LC3 I/II), beclin-1 and p-Akt at different time points after CLP was detected by Western blotting .In vitro, human proximal tubular epithelial cell line HK-2 were treated with LPS to induce autophagy .The protein expression of LC 3 I/II and p-Akt in the HK-2 cells after LPS treatment at different time points and different concentrations was detected by Western blotting .These molecules in HK-2 cells and apoptosis of HK-2 cells treated with LPS plus PI3K inhibitor or Akt inhibitor were also detected .RESULTS: Compared with sham group , the severe changes of renal histopathological injuries in CLP groups were observed , the levels of BUN and SCr in CLP groups were significantly increased .LC3 I/II, beclin-1 and phosphorylation of Akt gradually increased after CLP.After treatment with LPS, the expression of p-Akt (308) in the HK-2 cells gradually increased in a dose-and time-dependent fashion.The expression of beclin-1 and p-Akt (472) reached a peak at 8 h or 10 mg/L LPS treatment.Treat-ment with PI3K or Akt inhibitor down-regulated the expression of LC3 and promoted the apoptosis of HK-2 cells.CON-CLUSION:Autophagy in the kidney is induced by sepsis and acute kidney injury .PI3/Akt signaling pathway may be in-volved in this process .

Objective To compare test results of antinuclear antibodies (ANA ) using different brands kit and methodology . Methods 180 cases who accepted serum ANA detection in hospital from April to December 2012 were choosen ,in which 145 cases of positive serum and 35 cases of healthy control .The 180 cases were tested for ANAs by YHLO ANA-17S ,EUROIMMUN ANA profile 3 and ANA IIFA kits at the same time ,and all parameters about ANA decetion were compared such as sensitivity ,specifici-ty ,positive predictive value ,negative predictive value and the coincidence rate between the two kinds of kits .Results The sensitivi-ty of YHLO ANA-17S ,EUROIMMUN ANA profile 3 and EUROIMMUN ANA IIFA was 94 .8% ,90 .4% ,95 .6% ;specificity was 88 .9% ,91 .1% ,93 .3% ;positive predictive value was 96 .2% ,96 .8% ,97 .7% ;negative predictive value was 85 .1% ,75 .9% , 87 .5% ;the coincidence rate between the EUROIMMUN ANA profile 3 and EUROIMMUN ANA IIFA was 84 .0% (P>0 .05) ,be-tween the YHLO ANA-17S and EUROIMMUN ANA IIFA was 80 .0% (P>0 .05) ,between theYHLO ANA-17S and EUROIM-MUN ANA profile 3 was 93 .0% (P> 0 .05) .Conclusion Three kits for detecting ANAs have good sensitivity and specificity , which can be used for autoimmune disease detection .Laboratory tests result should be combined with clinical symptoms according to the diagnostic criteria to make the final diagnosis .

Objective To explore the correlation between human cytomegalovirus(HCMV) infection with infantile hepatitis syn‐drome(IHS) and hepatic function damage .Methods The real‐time fluorescent quantitative polymerase chain reaction(PCR) was a‐dopted to test the urine HCMV DNA in 236 infants with IHS and 236 healthy infants ,respectively .The hepatic functions in 254 in‐fants with HCMV infection were analyzed retrospectively .Results Among these 236 cases of IHS ,the positive rates of HCMV DNA in urine sample was 62 .7% (148/236) .The positive rates of HCMV DNA and HCMV IgM in the IHS group were significant‐ly higher than those in the control group with statistical difference(P< 0 .01) .The liver function indexes in 254 infants with HCMV infection showed that the serum concentrations of total bilirubin (TBIL ) ,gamma glutamyl transpeptidase (GGT ) ,total bile acid (TBA) ,aspartate aminotransferase(AST ) and alanine aminotransferase(ALT ) were higher than the normal reference ranges ,and the differences were statistically significant(P < 0 .01) .Conclusion The detection rate of HCMV infection is high among the in‐fants with IHS in Guangxi area and HCMV is an important pathogen of IHS .HCMV may lead to hepatic function damage .

Objective To investigate the expression and clinical significance of CD28 and CD160 in patients with chronic HIV infection.Methods 50 patients with HIV from January 2016 to January 2017 were selected as the observation group, and 50 healthy volunteers were recruited as control group.Observe and record general information of all participants, the expression of CD28, CD160 in CD4+and CD8+T cells, initial T cells (TN), the expression of CD160 in central memory T cells (TCM), effector memory T cells (TEM), end effector memory T cells (TEMRA), mean fluorescence intensity (MFI), viral load of two kinds of the cells, analyze the correlation between the expression level of CD28 and CD160 and CD4+T cell count and viral load.Results With the increase of CD160 expression of CD4+T cells, CD4+T cells showed a downward trend, there is a negative correlation between them (r=-0.561, P＜0.05), CD8+T cell number is on the rise, there is a positive correlation between them (r=0.619, P＜0.05), and HIV-RNA copy number increased with the increase of CD160 expression on CD4+T cells and CD8+T cells, both positive (r=0.684, P＜0.05, r=0.459, P＜0.05);with the increase of CD28 cells on the expression of CD4+T, CD4+, CD8+T cells showed a rising trend, there is a positive correlation between them (r=0.621, P＜0.05, r=0.527, P＜0.05, HIV-RNA) and the copy number decreased with the increase of the expression of CD28 and CD4+T on CD8+T cells, there is a negative correlation between them (r=-0.634, P＜0.05, r=-0.582, P＜0.05).There was no significant difference in the positive rate of expression in TEMRA subgroup and MFI of CD160 in CD8+T cell in two groups (P＞0.05).The positive rate and MFI of CD8+T cell CD160 in TN, TCM and TEM subgroups in observation group were significantly higher than those in control group (Tcm), with statistical significance.Conclusion The expression of CD28 in patients with chronic HIV infection is decreased, and the expression of CD160 is increased, which may be related to the decrease of HIV CD4+T and CD8+T cells, in which CD160 mainly affects the memory CD8+T.

Objective To explore the effect of a phased rehabilitation training programme to relieve shoulder dys-function in patients after neck dissection and to provide effective solutions for postoperative shoulder joint function recov-ery of patients.Methods This study has been reviewed and approved by the Ethics Committee,and informed consent has been obtained from patients.A phased rehabilitaiton training programme for the shoulder after neck dessection was developed through literature review and discussion,and 70 eligible patients from Hospital of Stomatology,Sun Yat-sen University from December 2020 to April 2021 were selected and randomly divided into the test group and control group(35 patients in each group).The control group underwent motor rehabilitation training from 6 weeks postoperative to 1 year after surgery,such as shoulder mobility and coordination training and small range of motion training of the neck,while the test group took part in a rehabilitation training program that included familiarization maneuver training,protective rehabilitation,exercise rehabilitation,and resistance training in the following four stages:preoperative,postop-erative general anesthesia and awake until the removal of stitches,the removal of stitches until 6 weeks after surgery,and 6 weeks after surgery until 1 year after surgery.The frequency of training in both groups was at least 3 days per week,and the length of each training session was 10-15 min.The intensity of exercise was 2-3 points on the Borg Conscious Ex-ercise Intensity Scale(i.e.,mild-to-moderate tachypnea or fatigue).The neck dissection injury index(NDII)was used to evaluate the quality of life related to shoulder joint function at four time points:preoperative,postoperative 3 months,postoperative 6 months,and postoperative 12 months.The higher the score,the better the quality of life.Results 28 cases in the test group and 32 cases in the control group completed a one-year follow-up.At 3 and 6 months postopera-tive,the NDII of the test group was significantly higher than that of the control group[3 months postoperative:test group(93.48±9.36)vs.control group(80.00±11.34)(P＜0.001),6 months postoperative:test group(98.21±4.76)vs.control group(90.70±9.12)(P＜0.001)];12 months after surgery,the NDII of the test group(97.23±4.88)was still higher than that of the control group(96.33±4.49),but the difference was not statistically significant(P=0.458).The difference in NDII scores among subjects at 3,6,and 12 months after surgery was statistically significant in each group(P＜0.001).Conclusion The application of the phased rehabilitation training method in neck dissection patients has a feasibility and could improve the quality of life of patients'shoulder joint function within 6 months after surgery.

BackgroundMental illness during pregnancy has become a major public health problem in China over the recent years， and depression is the most common psychological symptom during pregnancy. Current research efforts are directed towards the therapy on prenatal depression， whereas the construction of prediction model for prenatal depression risk has been little studied. ObjectiveTo construct a simple model for predicting the risk of prenatal depression， thus providing a valuable reference for the prevention of maternal depression during pregnancy. MethodsA total of 803 pregnant women attending three hospitals in Nanchong city were consecutively recruited from May 2021 to February 2022. A self-administered questionnaire was developed for the assessment of social demographic variables， obstetrical and general medical indexes and psychological status of all participants， and Self-rating Depression Scale （SDS） was utilized to screen for the presence of maternal depression. Subjects were randomly assigned into modelling group （n=635） and validation group （n=168） at the ratio of 8∶2 under simple random sampling with replacement. The candidate risk factors of maternal depression during pregnancy were screened using binary Logistic regression analysis， and the predictive model was constructed. Then the performance of the predictive model was validated using receiver operating characteristics （ROC） curve. Results① Lack of companionship （β=-0.692， OR=0.501， 95% CI： 0.289~0.868）， low mood during the last menstrual period （β=-1.510， OR=0.221， 95% CI： 0.074~0.656）， emotional stress during the last menstrual period （β=-1.082， OR=0.339， 95% CI： 0.135~0.853）， unsatisfactory relationship between mother-in-law and daughter-in-law （β=-1.228， OR=0.293， 95% CI： 0.141~0.609）， and indifferent generally relationship between mother-in-law and daughter-in-law （β=-0.831， OR=0.436， 95% CI： 0.260~0.730） were risk factors for prenatal depression in pregnant women （P<0.05 or 0.01）. ② Model for predicting the prenatal depression risk yielded an area under curve （AUC） of 0.698 （95% CI： 0.646~0.749）， the maximum Youden index was 0.357 in modelling group with the sensitivity and specificity was 0.606 and 0.751， and an AUC of 0.672 （95% CI： 0.576~0.767） and maximum Youden index of 0.263 in validation group with the sensitivity and specificity of 0.556 and 0.707. ConclusionThe simple model constructed in this study has good discriminant validity in predicting of the risk of prenatal depression. ［Funded by Nanchong Social Science Research Project of the 14th Five-Year Plan （number， NC21B165）］