Objective To explore the significance of NK cell activity,interleukin-2 receptors (sCD25) and glycosylated ferritin in the early diagnostic of acquired hemophagocytic lymphohistiocytosis (HLH).Methods 57 patients suspected of HLH from June 2005 to May 2008 and 25 healthy subjects were enrolled in the study.The patients suspected of HLH were divided into three groups i.e.(1) a group with diagnosis confirmed at first visit;(2) a group with diagnosis confirmed at subsequent visit and (3) a group with diagnosis unconfirmed according to HLH-2004 diagnostic criteria.Healthy subjects were enrolled as control.NK cell activity was determined with a released LDH assay.The percentage of glycosylated ferritin was determined with phytohemagglutinin adsorption assay,sCD25 was examined with ELISA double antibody sandwich assay.We compared the coincidence of each diagnostic index before and after diagnosis.Results The median percentage of NK cell activity was significantly lower in the first group ( 18.3±5.6) % and the second ( 16.7±6.7)% than that in the third group (33.4±6.8)% or in the controls (36.6±5.0)%.The median percentage of glycosylated ferritin was also significantly lower in the first group ( 15,4 ± 2.0)% and the second group (16.9 ± 3.4)% than that in the third group (40.4 ± 3.0)% or in the controls (45.2±2.2)%.Meanwhile,the median level of sCD25 was significantly higher in the first group (12 916±4328) ng/L and the second group (12 117 ± 5465) ng/L than that in the third group (4728±1482) ng/L or in the controls (3841 ± 993) ng/L.Furthermore,NK cell activity,sCD25 and glycosylated ferritin were abnormal in all the patients in the early stage of HLH.Conclusion NK cell activity,sCD25 and glycosylated ferritin may be helpful markers for the early diagnosis of HLH.

Objective:To explore the impact of completion rates of 3-hour and 6-hour sepsis bundle therapy on prognosis of patients with septic shock in Prefecture-level grade A hospitals, and analyze the risk factors for prognosis.Methods:A retrospective analysis was conducted to patients with septic shock in the intensive care unit (ICU) of Liaocheng People's Hospital, Shandong Province from January 1, 2020 to December 31, 2021. The data of gender, age, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ), sequential organ failure assessment (SOFA), sites of infection, pathogenic microorganisms, completion rates of 3-hour and 6-hour sepsis bundle therapy, 28-day prognosis were collected. Logistic regression analysis was used to identify risk factors for patients' mortality at 28-day.Results:① Among 159 patients with septic shock, 93 survived and 66 died with 28-day. There were no significant differences in gender and age between the survival group and death group. Compared with the survival group, APACHE Ⅱ score and SOFA score were significantly higher in the death group [APACHE Ⅱ score: 26.85±5.04 vs. 20.67±4.29, SOFA score: 12.86±3.02 vs. 9.37±2.51, both P < 0.05]. ② Sites of infection in the 159 patients: 47 cases were abdominal infection (29.6%), 36 case were bloodstream infection (22.6%), 31 cases were pulmonary infection (19.5%), 16 cases were soft tissue infection (10.1%), 13 cases were urinary tract infection (8.2%), 12 cases were biliary tract infection (7.5%), and 4 cases were other sites infection (2.5%). Pathogens were found in 128 cases and the positive rate was 80.5%, including 90 cases of Gram-negative (G -) bacilli (56.6%), 27 cases of Gram-positive (G +) cocci (17.0%) and 11 cases of fungi (6.9%). The top three pathogenic bacteria were Escherichia coli (49 cases, 30.8%), Klebsiella pneumoniae (21 cases, 13.2%) and Staphylococcus aureus (15 cases, 9.4%). The differences were not statistically significant. ③ Among the 159 patients, 101 cases completed 3-hour sepsis bundle therapy (63.5%), including 67 cases (72.0%) in survival group and 34 cases (51.5%) in death group; 106 cases completed 6-hour sepsis bundle therapy (66.7%), including 70 cases (75.3%) in survival group and 36 cases (54.5%) in death group. The differences between the two groups were statistically significant (all P < 0.05). ④ The factors (APACHE Ⅱ score, SOFA score and completion rate of 3-hour and 6-hour sepsis bundle therapy) affecting the prognosis in the univariate analysis were included in the binary Logistic regression analysis, and the results showed that the APACHE Ⅱ score, SOFA score, completion rate of 3-hour sepsis bundle therapy were independent risk factors affecting mortality within 28-day [odds ratio ( OR) was 1.216, 1.303, 0.402, all P < 0.05]. Conclusions:The higher APACHE Ⅱ score and SOFA score in septic shock, the worse the prognosis. Improving the completion rates of 3-hour and 6-hour bundle therapy especially the completion rate of 3-hour bundle therapy can reduce the mortality of patients and improve the prognosis.

Objective To study the impact of earthquake disasters on the mental health of military medical personnel during emergency rescue. Methods Three hundred military medical personnel who participated in the emergency rescue of earthquake disasters in five military hospitals in Shaanxi Province were selected as the study subjects, and their mental health levels were analyzed using the Mental Symptom Checklist 90 (SCL-90). Results In this survey, a total of 300 SCL-90 questionnaires were issued, 300 were recovered, and the effective recovery rate was 100%. Only 30.67%(92/300) of people participated in emergency disaster rescue during investigation, 31.33% (94/300) had psychological problemsafter arriving in the earthquake-stricken area after one week, such as somatization, obsessive-compulsive disorder, anxiety, and horror. SCL-90 scores were 0.45±0.03, 1.13±0.13, 0.79 ±0.08, 1.07±0.09, 1.01±0.14. The psychological stress response rates of the emergency response of military medical staff of different characteristics were different. Among them, the stress response rates of military personnel with different degrees (specialty, bachelor or above) and whether they have participated in rescue work were 74.07% (40/54), 21.95% (54/246), 15.22% (14/92), 38.46% (80/208).The difference was statistically significant (χ2=55.913,16.018, P<0.01). Conclusions The medical staff of the army participating in the earthquake disaster rescue has psychological pressure due to many injuries, environmental risks, lack of supplies, etc. The medical unit should provide adequate training in theory and practice to its personnel and focus on the mental health of rescue workers, give timely psychological counseling to ensure the successful completion of the rescue.

Objective To analyze the effect of dexmedetomidine(Dex)on biological behavior of A549 cells through expression of miR-1307.Methods Human lung cancer A549 cells were randomly divided into four groups after being cultured for 24 hours:Lung cancer A549 cell group,Dex 20μg/ml group,Dex 40μg/ml group and Dex 80μg/ml group;Each group has 6 parallel samples per hole.After each group of cell culture,we detected the cell proliferation by CCK-8 method,cell apoptosis by flow cytometry,mir-1307 expression by qRT-PCR,cell invasion and cell migration(Transwell)respectively Results Dex inhibits the viability of lung cancer A549 cells in a concentration-and time-dependent manner.Dex can promote the apoptosis of lung cancer A549 cells,and the apoptosis rate can be increased to 22.23%when the concentration of Dex reaches 80μg/ml,the apoptosis rate can rise to 22.23%.Dex inhibits the migration and invasion of lung cancer A549 cells in a concentration-dependent manner.In addition,the relative expression of miR-1307 in A549 cells after Dex treatment decreased significantly comparing to the control group,and the decline was more noteworthy with the increase of Dex concentration.Conclusion Dex can effectively inhibit the proliferation,invasion,metastasis,and apoptosis of humen A549 cells in a dose-dependent manner,and its efficacy may be related to its regulation of miR-1307 expression.

Objective To explore the iodine nutritional status of people after adjusting iodine content in iodized salt in Anhui Province. Methods In 2014, 30 counties (cities, districts) were selected in Anhui Province according to the probability ratio sampling method (PPS), and one school was selected in each county (city, district), and 50 children aged 8 - 10 years were selected in each school. Urine and household salt samples were collected, urine and salt iodine levels were tested, and thyroid was examined using B-ultrasound. In the township where the school was located, 20 pregnant women's urine samples and household salt samples were collected for urine and salt iodine detection. The salt iodine level was measured by direct titration, Chuan salt and other fortified salt iodine levels were determined by arbitration method (GB/T 13025.7-2012). Urinary iodine was determined by arsenic-cerium catalytic spectrophotometry (WS/T 107-2006). Results A total of 1575 children's household salt samples were collected, the median salt iodine was 23.77 mg/kg, the qualified iodized salt consumption rate was 93.65％(1475/1575); 600 household salt samples were collected from pregnant women, the salt iodine median was 23.50 mg/kg, the consumption rate of qualified iodine salt was 96.33％( 578/600 ) . A total of 1575 urine samples were collected from children, the median urinary iodine was 242.20 μg/L; six hundred urine samples were collected from pregnant women, and the median urinary iodine was 158.15μg/L, 43.33％(13/30) of the counties (cities, districts) pregnant wowen median urinary iodine < 150 μg/L. A total of 1575 thyroid glands were examined in children aged 8 to 10 years, and the thyroid enlargement rate was 3.75％ (59/1575). Conclusion The iodine nutrition of children aged 8 - 10 years in Anhui Province is higher than the appropriate level, but the iodine is not in the excessive state, and the iodine nutrition of pregnant women in some counties (cities, districts) is insufficient.

Objective:To understand the knowledge and behavior changes of pregnant women on iodine deficiency disorders (IDD) prevention and treatment in iodine deficiency areas in Anhui Province before and after the implementation of the intervention measures, and to provide a scientific basis for pregnant women's iodine nutrition improvement.Methods:From March to December 2018, from Lujiang County, an iodine deficiency area in Anhui Province, Lucheng and Nihe towns were selected as the survey sites. Relying on the township health centers, pregnant women in early pregnancy (≤12 weeks) were selected as the survey subjects, and long-term follow-up was conducted. The edible salt samples of pregnant women in early pregnancy were collected and salt iodine content was detected by direct titration method. The urine samples of pregnant women in the morning in early, middle (13 - 28 weeks) and late pregnancies (≥29 weeks) were collected, urinary iodine content was determined by arsenic-cerium catalytic spectrophotometry. Baseline questionnaire survey was conducted for pregnant women in early pregnancy, mainly including basic information, IDD prevention and treatment knowledge (pregnant women prone to iodine deficiency, the harm of iodine deficiency in pregnant women, suitable iodine supplement methods for pregnant women and foods with high iodine content), and the consumption frequency of iodine-rich foods. After the baseline survey, the knowledge publicity on IDD prevention and treatment was carried out in townships, and iodine-rich foods such as kelp and laver were recommended to supplement iodine. The intervention activities lasted for 6 months, and retrospective questionnaire survey was conducted on pregnant women in late pregnancy.Results:A total of 128 edible salt samples were collected from the families of pregnant women in early pregnancy, and the median salt iodine was 21.5 mg/kg. The iodized salt coverage rate was 99.2% (127/128), the qualified rate of iodized salt was 98.4% (125/127), and the consumption rate of qualified iodized salt was 97.7% (125/128). A total of 129, 95 and 70 urine samples were collected from pregnant women in early, middle and late pregnancies, the medians urinary iodine were 179.0, 185.5 and 189.7 μg/L, respectively, all of which were at the appropriate iodine level. The total awareness rates of IDD prevention and treatment before and after intervention were 22.4% (28/125) and 64.6% (82/127), respectively, and the difference was statistically significant (χ 2 = 45.538, P < 0.01). Compared with the awareness rates before the intervention, the awareness rates of the harm of iodine deficiency in pregnant women, suitable iodine supplement methods for pregnant women and foods with high iodine content were all higher after the intervention ( P < 0.01). There were statistically significant differences in the frequency of eating kelp, laver and other iodine-rich foods among pregnant women in early, middle and late pregnancies (χ 2 = 163.170, 102.373, P < 0.01). Before the intervention, 57 (45.2%) pregnant women had not eaten kelp, which decreased to 1 (0.8%) pregnant woman after the intervention. Before the intervention, 72 (57.1%) pregnant women had not eaten laver and other iodine-rich foods, which decreased to 7 (5.5%) pregnant women after the intervention. Conclusions:After the intervention, the awareness rate of IDD prevention and treatment knowledge and the frequency and proportion of iodine-rich foods consumption among pregnant women in iodine deficiency areas in Anhui Province have increased significantly. It is recommended to carry out publicity and education on IDD prevention and treatment knowledge in early pregnancy.

Objective:To elucidate the effect of bepridil, an Na +/Ca 2+ exchanger (NCX) inhibitor, on the proliferation, migration and apoptosis of melanoma cells, and to explore their potential underlying mechanisms. Methods:Six paraffin-embedded tissue specimens were collected from 3 patients histopathologically diagnosed with melanocytic nevi and 3 patients histopathologically diagnosed with melanoma in the Hospital for Skin Diseases, Chinese Academy of Medical Sciences from January to December 2023. NCX1 expression in tissues was determined by immunohistochemical staining, and Western blot analysis was performed to verify the expression of NCX1 in primary melanocytes and melanoma cell lines A375, A875, SKMEL-28, M14, MV3, and SK-MEL-5. Cell counting kit 8 (CCK8) assay was conducted to evaluate the effect of bepridil at different concentrations on the viability of melanoma cells, and the proliferation curve was drawn to calculate the half inhibitory concentration (IC50) of bepridil. Some melanoma cells were then treated with bepridil at IC50 (bepridil groups), and cells treated with dimethyl sulfoxide-containing media served as control groups. Intracellular Ca 2+ levels were assessed in A375 and SK-MEL-28 cells using the Fluo-4 calcium assay kit, the migration and apoptosis of A375, SK-MEL-28, and A2058 cells were estimated by Transwell assay and flow cytometry respectively. The effects of bepridil treatment on gene expression and pathways in A375 cells were evaluated by transcriptome sequencing, Gene Ontology (GO) enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. The content of reactive oxygen species (ROS) in melanoma cells after the bepridil treatment was detected by flow cytometry, and the expression of endoplasmic reticulum stress- and mitochondrial apoptotic pathway-related molecules was determined by Western blot analysis. Comparisons between two groups were performed by t test. Results:Immunohistochemical assay showed that the expression of NCX1 was significantly higher in the melanoma tissues (0.320 ± 0.020) than in the melanocytic nevus tissues (0.235 ± 0.008, t = 4.04, P = 0.016) ; Western blot analysis showed that the NCX1 protein bands were darker in color in the melanoma cell lines than in the primary melanocytes. CCK8 assay showed a gradual decrease in melanoma cell viability with increasing concentrations of bepridil. In the A375 and SK-MEL-28 cells, the fluorescence intensity of calcium was higher in the bepridil groups after the treatment with bepridil at IC50 (25 μmol/L) (64.82 ± 2.98, 75.84 ± 2.07, respectively) than in the corresponding control groups (37.10 ± 2.33, 66.54 ± 1.47, respectively, both P < 0.05) ; in the A375, SK-MEL-28, and A2058 cells, the migration ability was lower in the bepridil groups (103.00 ± 9.07, 67.33 ± 7.22, 61.33 ± 1.76, respectively) than in the corresponding control groups (400.00 ± 25.17, 276.70 ± 14.63, 116.00 ± 10.69, respectively, all P < 0.05), while their apoptosis rates were higher in the bepridil groups (5.72% ± 0.06%, 13.58% ± 0.86%, 25.76% ± 1.95%, respectively) than in the corresponding control groups (3.99% ± 0.50%, 6.47% ± 0.88%, 8.01% ± 0.36%, respectively, all P < 0.05). Transcriptome sequencing revealed 119 up-regulated genes and 164 down-regulated genes in bepridil-treated A375 cells compared with control cells, and the differentially expressed genes were mainly associated with metabolic pathways, endoplasmic reticulum stress, and tumor-related pathways. The ROS levels were higher in bepridil-treated A375, SK-MEL-28, and A2058 cells (1 907 ± 33, 7 607 ± 535, 3 380 ± 300, respectively) than in the corresponding control groups (1 646 ± 16, 4 386 ± 163, 2 110 ± 66, respectively, all P < 0.05). Western blot analysis showed that the expression of C/EBP homologous protein and activating transcription factor 4 was higher in bepridil-treated A375 and SK-MEL-28 cells than in the corresponding control groups, but was lower in the A375 and SK-MEL-28 cells treated with bepridil and BAPTA (a calcium chelator) than in the corresponding cells treated with bepridil alone. Conclusion:The NCX inhibitor bepridil could increase intracellular Ca 2+ levels, suppress the proliferation and migration, and promote the apoptosis of melanoma cells, which may be closely related to biological processes such as endoplasmic reticulum stress.

Objective:To establish an automatic colorimetric method for determination of iodine in drinking water by enzyme-labeled instrument (hereinafter referred to as this method).Methods:The water iodine was measured in the range of 0 - 10 μg/L and 0 - 100 μg/L, experiments were carried out on linear relationship, detection limit, precision and accuracy of this method. And the results were compared with the National Reference Laboratory for Iodine Deficiency Disorders recommended arsenic cerium catalytic spectrophotometry method.Results:In the range of 0 - 10 μg/L and 0 - 100 μg/L, all│ r│ > 0.999 0, the detection limits were 0.6 and 1.1 μg/L (samples were 200 and 100 μl), respectively; the relative standard deviation ( RSD) of water samples of low, medium and high iodine mass concentrations were < 3%, the recovery rates ranged from 92.5% to 108.3% and 93.2% to 108.9%, with a total average recovery of 100.0% and 100.3%, respectively. This method and arsenic cerium catalytic spectrophotometry method were used to detect 40 water samples in the range of 0 - 10 μg/L and 0 - 100 μg/L, there was no significant difference in water iodine content between the two methods ( t = 0.99, P > 0.05). Conclusion:This method has good linear curve relationship for determination of water iodine content, good precision and high accuracy, and it is suitable for wide application.

Objective To evaluate the risk of bias and reporting quality in randomized controlled trials(RCTs)of the Chinese medicine injection for acute cerebral infarction in the last five years.Methods RCTs literature on Chinese medicine injection in the treatment of acute cerebral infarction was systematically searched in CNKI,Wanfang Data,VIP,China Biology Medicine Database(CBM),PubMed,Embase and Cochrane Library from April 20,2018 to April 20,2023.The risk of bias and reporting quality of included RCTs were evaluated using the Cochrane Risk of Bias Tool(ROB 1.0)and CONSORT-CHM Formulas 2017,respectively.Results A total of 4 301 articles were retrieved,and 408 RCTs were included according to inclusion and exclusion criteria.The ROB evaluation results showed that the the majority of studies were rated as having an unclear risk of bias due to the lack of reporting on allocation concealment,blind method,trial registration information,and funding sources.The evaluation results of CONSORT-CHM Formulas 2017 showed that the number of reported papers of 17 items was greater than or equal to 50%,and the number of reported papers of 25 items was less than 10%,and most of the RCTs did not show the characteristics of TCM syndrome differentiation and treatment.Conclusion The quality of Chinese medicine injection in the treatment of acute cerebral infarction RCTs is generally low.It is recommended that researchers refer to the methodology design of RCTs and international reporting standards,improve the trial design,standardize the trial report,and highlight the characteristics of TCM syndrome differentiation and treatment.