Sepsis is the most common cause of death in infants and children in the world.Common infection sites leading to sepsis include respiratory tract,bloodstream,urinary tract,alimentary tract,central nervous system,and endocardia.Infection site is hypothesized to have the significant susceptibility.There is little epidemiological or national research data on the site of sepsis in China.In this article,we discussed the susceptibility of infection site in sepsis by literature review.Identifying infection site early would help guide clinical decision making in diagnosis, treatment and prognosis.

Objective To investigate the effects and mechanism of retinoie acid on B16 marina mel-anoma cells and human melanocytes in vitro. Methods B16F10 murine melanoma cells and human mela-noeytes were cultured in culture medium which contains different concentration of components, including retinoic acid. Using reverse transcription-polymerase chain reaction (RT-PCR) mRNA expression of the tyrosinase was detected. Tyrosinase activity, melanin content and cell proliferation rate were also deter-mined. Results Retinoieacid exhibited an inhibitory effect on the expression of tyrosinase mRNA. As the concentration of retinoic acid was 100 μmol/L, treating for 72 h, the expression of tyrosinase mRNA de-creased 30.13 %, retinoic acid exhibited an inhibitory effect on tyrosinase activity and melanin production at high concentration (>500 μmol/L), and it could promote the cell proliferation. Retinoic acid and hy-droqninone could be cooperative at high concentration (1 000 μmol/L), and enhanced the down regulation of tyrosinase activity and melanin content. Retinoic acid could also mitigate the inhibitory effect of hydro-quinone on cell proliferation, so as to protect the cells from injury. Hydroquinone had no effect on tyrosi-nase gene expression at mRNA level. Conclusion Retinoic acid inhibits the synthesis of melanin by the genetic regulation at mRNA level.

Objective:To explore the potential categories of post-traumatic stress disorder (PTSD) in patients undergoing replantation of severed fingers, and analyze their influencing factors.Methods:From January 2022 to December 2023, convenience sampling was used to select 335 patients who underwent replantation of severed fingers at the Hand and Foot Surgery of Taizhou Hospital of Zhejiang Province as research subjects. The survey was conducted using the General Information Questionnaire, PTSD Checklist-Civilian Version, Event Related Rumination Inventory, Chinese version of the Perceived Social Support Scale, and the Eysenck Personality Questionnaire-Revised, Short Scale for Chinese. Potential profile analysis was used to explore the potential categories of PTSD in patients undergoing replantation of severed fingers, and ordered Logistic regression was used to analyze the influencing factors of PTSD categories.Results:A total of 335 questionnaires were distributed, and 328 valid questionnaires were collected, with a valid response rate of 97.91%. Potential profile analysis showed that PTSD of 328 patients undergoing severed finger replantation were divided into three latent categories, including low PTSD-high avoidance type ( n=67, accounting for 20.43%), moderate PTSD-high alertness type ( n=178, accounting for 54.27%), and high PTSD-high alertness type ( n=83, accounting for 25.30%). There were statistically significant differences in the number of severed fingers, incidence of postoperative vascular crisis, rumination, perceived social support, and personality trait scores among patients with different types of severed finger replantation ( P<0.05). Taking low PTSD-high avoidance type as a reference, ordered Logistic regression analysis showed that invasive rumination, purposive rumination, and personality types (introversion, neuroticism, psychoticism) were potential influencing factors for the moderate PTSD-high alertness type ( P<0.05). The number of severed fingers, postoperative vascular crisis, invasive rumination, purposive rumination, perceived social support, and personality type (introversion, neuroticism, psychoticism) were potential influencing factors of high PTSD-high alertness type ( P<0.05) . Conclusions:There is significant population heterogeneity in PTSD among patients undergoing severed finger replantation, which can be divided into "low PTSD-high avoidance type", "moderate PTSD-high alertness type", and "high PTSD-high alertness type". Nursing staff should conduct targeted interventions in the early stage based on factors such as the number of severed fingers, whether vascular crisis occurs after operation, level of rumination, personality type, to prevent and improve the occurrence of PTSD.

Objective Stereotactic body radiotherapy(SBRT)and radiofrequency ablation(RFA)are primary treatments for hepatocellular carcinoma(HCC)at present.However,the effect of these treatments in clinical trails are rather controversial.The purpose of this paper is to conduct a meta-analysis on the clinical effect and related complications of SBRT and RFA for HCC.Methods A computerized retrieval of academic papers concerning the treatment effect of SBRT and RFA for HCC from the databases of PubMed,Embase,Cochrane Library,Scopus,Web of Science,CBM,CNKI,Wanfang database,VIP was conducted.The retrieval time period was from the establishment of the database to June 2022.Stata14.0 software was used to make meta-analysis.Results A total of 14 retrospective studies including 6 806 patients were included in this analysis.The results of combined hazard ratio(HR)based on overall survival(OS)showed that the OS rate of SBRT was lower than that of RFA(HR=1.25,95％CI=1.10-1.43,12=0％,P=0.000 9),while the results of combined HR of local control(LC)rate indicated that SBRT had a better therapeutic effect(HR=0.61,95％CI=0.47-0.78,I2=0％,P=0.000 1).Subgroup analysis revealed that the combined HR of LC rate favored the performance of SBRT for patients with tumor diameter larger than 2 cm(HR=2.64,95％CI=1.56-4.48,I=0％,P=0.000 3).No statistically significant difference in the incidence of late serious adverse reactions existed between SBRTgroup and RFA group(OR=1.01,95％CI=0.59-1.73,I2=30％,P=0.97).Conclusion SBRT is superior to RFA in controlling local HCC lesions,especially in patients whose tumor diameter is larger than 2 cm,although it does not show certain advantages in the survival benefit.(J Intervent Radiol,2023,32:1233-1241)

Objective: To evaluate the incremental vaccine effectiveness (VE) of two dose of the mumps containing vaccine (MuCV) in chidren, so as to provide a basis for optimizing mumps immunization strategies. Methods: A 1∶2 frequency matched case-control study was conducted by using reported mumps cases in childcare centers or schools from Lu an, Hefei, Ma anshan and Huainan cities of Anhui Province from September 1, 2023 to June 30, 2024, as a case group(383 cases). And healthy children in the same classroom were selected as a control group(766 cases). The MuCV immunization histories of participants were collected to estimate the incremental VE of the second dose of MuCV against mumps. Group comparisons were performed using the Chi square test or t-test. For matched case-control pairs, the Cox regression model was employed to calculate the odds ratio (OR) with 95% confidence interval (CI) for two dose MuCV vaccination and to estimate the incremental vaccine effectiveness (VE). Results: There were no statistically significant differences between the case and control groups regarding gender, age, dosage of MuCV vaccination and the time interval since the last dose vaccination( χ 2/t=0.05, 0.20, 0.94, -0.02, P >0.05). The proportions of the case and control groups vaccinated with two doses of MuCV were 26.63% and 29.37%, respectively, and the overall incremental VE of the second dose of MuCV was 40.73% (95% CI=3.03%-63.77%, P <0.05). Subgroup analyses revealed that the incremental VE for children with a period of ≥1 year between the two doses of MuCV was 54.13% (95% CI=1.90%-78.56%, P <0.05), while for children with a period of <1 year, it was 30.63% (95% CI=-28.59%-62.58%, P >0.05). The incremental VE of the second dose of MuCV was 30.36% (95% CI=-25.95%-61.50%, P >0.05) in kindergarten children and 66.73% (95% CI=14.92%-86.99%, P <0.05) in elementary and secondary school students. The incremental VE was 28.78% (95% CI=-27.46%-60.21%, P >0.05) within five years of the last dose of MuCV vaccination and 66.07% (95% CI=-41.56%-91.87%, P >0.05) for vaccinations administered beyond five years. Conclusions The second dose of MuCV may offer additional protection for children; however, extending the interval between two dose of MuCV (<1 year) has shown limited incremental protective effects. Therefore, it is crucial to consider optimizing current immunization strategies for mumps.