The mechanisms of immunosuppression of TWH were studied. The results indicated that TWH was able to reduce the antibody forming cells of splenocytes in mice and to suppress directly the proliferation of B cells to lipopolysaceharide ( LPS ) and to decrease the production of IL-2. Furthermore, TWH was able to produce immu-nosuppressive effect by activiting Ts cells.

Objective:To study the optimal pain control goal for preventing delirium in critical patients.Methods:A prospective cohort study were conducted. The patients admitted to general departments and transferred to the intensive care unit (ICU) due to critical illness in the First People's Hospital of Changde from January 2017 to November 2019 were enrolled. The General data of the patients were collected within 48 hours after admission. All patients admitted to the ICU were evaluated for pain level using the critical care pain observation tool (CPOT) every 8 hours by nurses, and confusion assessment method of ICU (CAM-ICU) was used to screen delirium patient every 8 hours by the leader of nursing team without knowing the pain level of the patients, until the subjects were transferred out of ICU. The receiver operating characteristic (ROC) curve was drawn, the area under ROC curve (AUC) and the optimal threshold were analyzed with delirium as the reference standard; according to the optimal threshold, multivariate Logistic regression analysis was used to evaluate the correlation between CPOT score and delirium.Results:During the study period, 575 patients were admitted to the participating departments and passed the preliminary screening according to the inclusion and exclusion criteria. During the study period, 34 patients were excluded due to incomplete data. Finally, a total of 541 patients were enrolled in the analysis, including 149 patients in delirium group and 392 patients in non-delirium group. There was no significant difference in gender, age, source of patients, education level, smoking history, drinking history, family mental history, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score or other general information between the two groups. There were 10.1% (15/149) of patients in the delirium group used opioids, which was significantly higher than 4.3% (17/392) in the non-delirium group, and the difference was statistically significant ( P < 0.05). The CPOT score in the delirium group was significantly higher than that in the non-delirium group (4.24±1.78 vs. 2.75±1.95, P < 0.01). The patients were subdivided into young group (< 40 years old), middle-aged group (40-65 years old) and old group (> 65 years old) according to age. The analysis results were consistent with the overall analysis results. ROC curve analysis showed that the AUC of CPOT score predicting delirium was 0.719; when the best threshold value of CPOT score was 2.5, the sensitivity was 91.3%, the specificity was 49.0%, the positive predictive value was 40.5% and the negative predictive value was 93.7%. Multivariate Logistic regression analysis showed that the risk of delirium in ICU patients with CPOT score ≥ 3 was 10.043 times higher than that in patients with CPOT score < 3 [odds ratio ( OR) = 10.043, 95% confidence interval (95% CI) was 5.498-18.345, P < 0.001]. When the gender, age, APACHEⅡ score, smoking history, drinking history, opioids usage were adjusted, the risk of delirium in patients with CPOT score ≥ 3 was 10.719 times higher than that in patients with CPOT score < 3 ( OR = 10.719, 95% CI was 5.689-20.196, P < 0.001). Conclusion:The best pain control goal for preventing the occurrence of delirium in ICU patients is a CPOT score of 3 or less.

Objective To evaluate the value of ultrasonic Graf methods in screening developmental dysplasia of the hip (DDH)in infants .Methods 1 580 cases of 0-6 monthes old infants without severe limb anomalies were examined .Bilateral hip joints were examined mcluded analyzed according to Graf method .Results A total of 1 580 cases included 3 160 hip joints were analyzed ,827 were male (52 .34% ) and 753 were female (52 .34% ) among them .104 cases (6 .58% ) were diagnosed with abnormalities of the hip joints .Among the 104 cases ,88 cases (5 .57% ) were type Ⅱa hip joints ,9 cases (0 .57% ) were type Ⅱ b ,5 cases (0 .32% ) were type Ⅱc ,1 case (0 .06% ) and 1 case (0 .06% ) were type Ⅲ and type Ⅳ respectively .In each month of age abnormalities of the hip joints were diagnosed as followed :79 cases(9 .69% ) were one month old ,13 cases (3 .98% ) were two month old ,2 cases (2 .15% ) were three month old ,6 cases (2 .26% ) were four month old ,1 cases (2 .44% ) was five month old and 3 cases (7 .69% ) were six month old .Conclusion Ultrasonic Graf method can provide the basic data for incidence of developmental dysplasia of hip in infants in local region and may be helpful to offer the related standards for early screening the abnormalities of the hip joints .

Objective To study the radiosensitivity enhancement effects of recombinant adenovirus mediated retinoblastoma 94 gene on the growth of esophageal carcinoma cells EC109.Methods EC109cells was transfected with recombinant Rb94 gene adenovirus and irradiated by 137Cs γ-rays.The cohorts were divided into groups as blank control,Ad-LacZ,Ad-Rb94,radiation and Ad-Rb94 combined with radiation.Cell inhibition ratio,cell cycle and expression of retinoblastoma protein of EC109 cells were analyzed.Results The growth of EC109 cells transfected with Ad-Rb94,radiation and Ad-Rb94 combined with radiation group was all inhibited.The group of Ad-Rb94 combined with radiation resulted in greater inhibition of cells growth compared with Ad-Rb94 group and radiation group ( F =23.31,P ＜0.05 ).Cells of G2 phases of EC109 cancinoma cells for Ad-Rb94 combined with radiation group were the highest,which was 50％.The combination of Ad-Rb94 and radiation group resulted in the greatest expression of retinoblastoma protein,which reached 71％,significantly higher than Ad-Rb94 infection and radiation groups ( x2 =8.31,6.73,P ＜ 0.05 ).Conclusions Retinoblastoma 94 gene combined with ionizing radiation can enhance the radiation sensitivity of EC109 cells.

Objective To investigate the clinical and pathological characteristics,diagnosis,differential diagnosis,treatment and prognosis of giant neurofibroma of penis in the child.Methods The clinical data including general data,imaging data,treatment methods,pathological characteristics of a case with giant neurofibroma of penis in a child were analyzed retrospectively and the relevant literature was reviewed.Results Gross appearance of the penile shaft neurofibroma was about 9 cm × 11 cm × 15 cm,with local ulceration.Computerized tomography scan revealed a giant mass in the penile shaft,about 9.0 cm × 10.0 cm × 13.4 cm.Partial excision of the penis was performed.Postoperative appearance of the residual penile shaft was about 2 cm long.The HE staining showed spindle cells with the red dye cytoplasm,spindle or elliptic nuclei and arranged in wavy partly.Positive immunostaining was presented with S-100 protein and Vimentin.The pathologic examination revealed a neurofibroma.There was no evidence of recurrence and the penis of the boy had normal sensation and erection by follow-up in 2 years.Conclusions Neurofibroma of penis in the child is extremely rare and the differential diagnosis of soft-tissue tumors of penis should be considered.The operative method should be individualized,the treatment goal is the complete resection;however,this goal must be weighed against detriment to functioning and the cosmetics of the involved organ.

Objective To study the combined effect of interleukin-21 gene transfer and ionizing radiation on the growth of cervical carcinoma HeLa cells.Methods Previously constructed Ad-IL-21 gene was amplified by infecting 293A cells and the titer was measured by TCID50 method. HeLa cells were transfected with Ad-1L-21 and then irradiated with 6 Gy 137Cs γ-rays.The cells were divided into 5 groups,including blank control,Ad-LaeZ group,Ad-IL-21 group,radiation group and Ad-IL-21 combined with radiation group (combination group).The cell growth,cell cycle,apoptosis,and the expressions of IL-21 gene and protein in HeLa cells were detected.Results Ad-IL-21 was successfully amplified and the titer of Ad-11.-21 was 9 × 1010 pfu/ml.Compared with Ad-IL-21 group and radiation group,the cell growth of combination group was significantly inhibited at 96 h after transfection ( F =85.26,72.98,P ＜ 0.05 ).The cells in combination group were arrested in G1 phase and decreased at S phase( F =36.69,34.83,P ＜ 0.05),while the cellular apoptosis increased markedly ( F =28.23,25.57,P ＜ O.05 ). The gene expression of 1L-21 in the combination group was 1.54- and 2.43-fold of Ad-IL-21 group and blank control group,respectively (F=22.31,36.65, P ＜ 0.05 ), while the protein expression of IL-21 in the combination group was 1.62-fold and 2.31-fold of Ad-IL-21 group and blank control group,respectively ( F =27.36,35.86,P ＜ 0.05 ).Conclusions Ad-IL-21 gene transfection combined with radiation has synergic effect on the inhibition of cervical carcinoma cell growth.

Objective: To investigate the incidence of malnutrition in children and adolescents aged between 8 and 16 years in Zhongshan, Guangdong Province and to explore the impact of lower body mass index in early childhood on malnutrition in children and adolescents. Methods: A retrospective cohort of 2 188 students with complete data on weight and height from grade one in primary school to grade one in high school in Zhongshan were included in this analysis. Normal weight individuals with BMI lower than the 50th percentiles (P50) were defined as lower BMI, according to "Report on the Physical Fitness and Health Surveillance of Chinese School Students" in 2005. Screening Standard for Malnutrition of School-age Children and Adolescents in 2014 (WS/T 456—2014) was used to define malnutrition. Prevalence and incidence of malnutrition was calculated, and chi-square test was used to compare the difference of the incidence of malnutrition between children with BMI Results: The prevalence of malnutrition was 15.08% for children in grade one of primary school, which reached highest of 16.32% in grade two of primary school and decreased to 7.27% in grade one in high school. The annual incidence of malnutrition among students with normal weight decreased from 8.37% in grade two in primary school to 1.22% in grade one in high school. Boys with lower BMI in grade one in primary school had the incidence of malnutrition with 12.47% in grade two in primary school, while those with BMI ≥P50 had the incidence of 0.63%. Girls with lower BMI had higher incidence of malnutrition than those with BMI ≥P50. Conclusion Incident malnutrition between grade one in primary school and grade one in high school is more likely to occur in early childhood. Lower BMI in early childhood significantly increases the risk of malnutrition in children and adolescents. Malnutrition prevention should be implemented from early childhood, especially for those with lower BMI.

Objective:To explore the clinical value of serum tumor markers ,which are carcino-embryonic antigen (CEA) ,car-bohydrate antigen 19-9 (CA19-9) ,carbohydrate antigen 72-4 (CA72-4) and cytokeratin 19 fragments (CYFRA21-1) ,in early diagnosis and treatment of laryngeal carcinoma .Methods :From January 2012 to June 2013 ,60 patients with laryngeal carcino-ma (case group) were selected ,and 60 corresponding participants in physical examination were also enrolled as healthy controls in this study .The serum contents of CEA ,CA19-9 ,CA72-4 and CYFRA21-1 were measured before and after operation in the two groups .The differences of sensitivity and specificity in detection of laryngeal carcinoma were compared between individual and combined detection of targeted indicators .Results:The serum levels of CEA ,CA19-9 ,CA72-4 and CYFRA21-1 were significantly higher in the study group than those in the control group (P<0 .01) .The serum levels of CEA ,CA19-9 ,CA72-4 and CYFRA21-1 of the study group were significantly higher in pre-operation than those in post-operation ,and the differ-ences were statistically significant (P<0 .01) ,among which CA19-9 showed the highest sensitivity (60 .00% ) ,while CA19-9 and CA72-4 showed the highest specificity (both were 100% ) .ROC curve analysis showed that the area under curve (AUC) of CA19-9 was 0 .987 ,which is significantly higher than those of CEA ,CA72-4 and CYFRA21-1 .The sensitivity of combined de-tection was significantly higher than individual test ,and the differences were statistically significant (P<0 .05) .Conclusions :Detection of serum CEA ,CA19-9 ,CA72-4 and CYFRA21-1 levels can be applied to early diagnosis of laryngeal carcinoma . Combined detection can significantly improve the sensitivity in diagnosis meanwhile maintain the superior specificity .

Objective:To investigate the clinicopathological features of hepatic vascular tumors in children. Methods The clinical characteristics, histology and immunohistochemical staining results were summarized and analyzed in 22 cases of hepatic vascular tumors in children at Guangzhou Women and Children′s Medical Center from September 2007 to November 2020. Results:The 22 patients aged from 1.0 month to 2.5 years (mean age 9 months). There were 10 males and 12 females. Five cases were found in premature and had low birth weight infants; three cases were discovered in the antenatal period; one patient also had cutanous hemangioma; six patients had associated anemia; Kasabach-Merritt phenomenon was not seen in any patient. CT examination showed 17 tumors were solitary and five were multifocal lesions. Macroscopically, the tumors size ranged from was 0.6 cm to 11.0 cm; the cut surface was solid, gray red and brown in color, and in six cases there were hemorrhage and necrosis in the central area. Microscopically,15 cases of solitary congenital hepatic hemangiomas showed characteristic necrosis in the central area, with loose fibrous tissues at periphery. Proliferation of capillaries, residual bile ducts between the vascular lumens, and dilated thrombosed vascular channels were seen, and contained extramedullary hematopoietic foci and calcification. Five cases of multiple hepatic infantile hemangiomas showed capillaries of different sizes composing of plump endothelium and pericytes and were arranged in lobular or diffuse patterns. Two cases of cavernous hemangioma (venous malformation) consisted of dilated thin-walled blood vessels with branch-like pattern lined with flat endothelial cells. Immunohistochemically, all 22 case expressed vascular endothelial markers CD31 and CD34, but D2-40 was negative. Glut1 was positive in five cases of multiple hepatic infantile hemangiomas, and the other cases were negative.Conclusion:Hepatic vascular tumors in children are rare, and their classification is different from that of adults. It is of great significance to make clear pathologic diagnosis.

Objective:To explore clinical value of nucleic acid detection for hepatitis B virus (HBV) screening in hospitalized patients.Methods:This cross-sectional study collected and analyzed plasma samples from patients admitted to 10 domestic medical institutions from July 2021 to December 2021. Serological immunoassay and nucleic acid screening were used to simultaneously detect hepatitis B markers such as hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), hepatitis B e Antigen (HBeAg), hepatitis B e antibody (HBeAb), hepatitis B core antibody (HBcAb),and HBV DNA. Statistical analysis was performed on the serology, nucleic acid test results and clinical information of the patients.Results:Of the 8 655 collected samples, HBsAg was positive in 216 (2.50%) samples,HBV DNA was positive in 238 (2.75%) samples ( P>0.05); 210 (2.43%) samples were positive for both HBsAg and HBV DNA, 28 (0.32%) were HBsAg negative and HBV DNA positive, 6 cases (0.07%) were HBsAg positive and HBV DNA negative. Conclusion:These results indicate that the HBV DNA testing is equally effective as hepatitis B virus serological detection for hepatitis B virus screening in hospitalized patients.