Objective:To construct a prediction model of inadvertent perioperative hypothermia in patients under general anesthesia , and to apply to clinic to verify its performance.Methods:The data of 19 068 surgical patients in a Grade Ⅲ Class A hospital in Zhejiang Province from January 2016 to September 2020 were included. The model was constructed by using artificial intelligence technology based on deep learning, and the prediction effect of the model was tested by using the area under the subject operating characteristic curve and decision curve. Totally 2 157 surgical patients were included from October 2020 to March 2021 to test the prediction accuracy of the model.Results:The incidence of hypothermia was 13.89% (2 649/19 068) in the modeling group and 14.18% (306/2 157) in the validation group. The area under the subject operating characteristic curve of the prediction model was 0.724 (95% CI: 0.707-0.741), the sensitivity was 0.516, the specificity was 0.823, the cut-off value was 0.175, and the accuracy of practical application was 79.54%. Conclusions:This model can stably predict the incidence of perioperative inadvertent hypothermia in patients under general anesthesia, and provide reference for clinical prevention of inadvertent perioperative hypothermia.

Objective To investigate the effects of lobaplatin on proliferation and invasion of cervical cancer CaSki cells.Methods Human cervical cancer CaSki cells were randomly divided into blank control group,2,6 and 12 μg/ml lobaplatin groups by random number table method.The proliferations of the cells were detected by methyl thiazolyl tetrazolium (MTT).The morphological changes of the cells were observed by inverted microscope.The invasive abilities of the cells were detected by Transwell invasion test.The protein expressions of extracellular signal-regulated kinase (ERK) and phospho-extracellular signal-regulated kinase (p-ERK) were detected by Western blotting.Results The absorbance (A) values of blank group,2,6,12 μg/ml lobaplatin groups cultured for 24 h were 0.513 ± 0.023,0.428 ± 0.014,0.380 ± 0.012 and 0.300 ± 0.013 respectively,those of the cells cultured for 48 h were 0.831 ± 0.024,0.558 ± 0.019,0.415 ± 0.015 and 0.088 ±0.009 respectively,and those of the cells cultured for 72 h were 1.153 ±0.022,0.572 ± 0.023,0.201 ± 0.017 and 0.052 ± 0.014 respectively.The differences were statistically significant (F =12.922,P ＜ 0.001;F =10.192,P ＜ 0.001;F =11.192,P ＜ 0.001),and the differences between each two groups were statistically significant (all P ＜ 0.05).Under inverted microscope,the cells of the platinum groups were shrunken and round,the volume and quantity were reduced,the morphology was irregular,the gap was increased,and the changes were more obvious with the increase of the concentration and the culture time.The numbers of penetrating cells of the blank group,2,6,12 μg/ml lobaplatin groups were 87.27 ±9.38,71.02 ± 8.92,53.20 ± 10.02 and 21.02 ± 7.37 respectively.The difference was statistically significant (F =87.291,P ＜ 0.001),and the differences between each two groups were statistically significant (all P ＜ 0.05).The A values of ERK protein in the blank group,2,6,12 μ~ml lobaplatin groups (0.955 ± 0.021、0.953 ± 0.023、0.950 ± 0.020、0.951 ±0.022)showed no significant difference (F =2.033,P =0.783),but the A values of p-ERK protein in the four groups were 0.941 ±0.015,0.831 ±0.020,0.620 ±0.019 and 0.493 ±0.017 respectively,which showed significant difference (F =11.921,P ＜0.001),and the differences between each two groups were statistically significant (all P ＜ 0.05).Conclusion Lobaplatin can inhibit the proliferation and invasion of cervical cancer CaSki cells,which may be related to the inhibition of the expression of p-ERK protein.

[摘 要] 目的：探讨β-1,6 N-乙酰氨基葡萄糖转移酶2（GCNT2）基因在胃癌（GC）组织中的表达及其在GC发生、发展和诊断及预后中的作用。方法：利用TIMER、GEPIA2、Oncomine和UALCAN等数据库数据，以及2018年1月至2019年12月滨州医学院附属医院手术切除的25例GC患者的癌和配对癌旁组织标本，分析GCNT2基因在GC组织中的表达及其在GC诊断和预后中的价值，利用LinkedOmics、GSEA和ssGSEA分析GCNT2所涉及的主要信号通路及其与免疫浸润之间的相关性。将pc-GCNT2及其阴性对照质粒转染进胃癌SGC-7901和BGC-823细胞，用克隆形成实验和Transwell实验检测GCNT2对GC细胞增殖和侵袭的影响，WB法检测细胞中GCNT2、STAT3和PD-L1蛋白的表达水平。结果：GCNT2 mRNA在GC组织中的表达水平显著低于癌旁组织（P<0.05或P<0.01），其表达水平与患者预后显著相关（P<0.05），其对GC诊断有较高的价值。GCNT2在GC组织中的甲基化状态显著高于癌旁组织，GCNT2基因参与的生物过程主要是参与细胞形态发生的成分、细胞间黏附、多细胞生物信号和突触传递等。单基因GSEA分析发现，GCNT2在GC中主要抑制IL-6/JAK/STAT3、IL-2/STAT5信号通路和炎症反应、α/γ干扰素响应与NF-κB表达等。GCNT2的表达与GC组织的免疫浸润具有显著相关性。过表达GCNT2可显著抑制GC细胞的增殖和侵袭能力（均P<0.01），降低细胞中STAT3和PD-L1的表达水平（均P<0.01）。结论：GCNT2基因在GC组织中低表达，与GC的诊断及预后显著相关，其主要通过抑制IL-6/JAK/STAT3和免疫相关致癌信号通路而在GC的发生、发展中发挥重要的作用。

Objective:To analyze the epidemiological features of respiratory syncytial virus (RSV) infection in Beijing, and monitor the sequence variations in RSV glycoprotein (G) gene and clinical features of infected children.Methods:Respiratory tract specimens were collected from children with acute respiratory infection in the Children′s Hospital Affiliated to Capital Institute of Pediatrics from January 1, 2023 to December 31, 2023. RSV-positive specimens screened by multiple nucleic acid testing were subjected to PCR to amplify the full-length RSV G gene. A phylogenetic tree was constructed after gene sequencing to analyze RSV subtypes and trace G gene variants. Clinical data were retrieved from the medical record system to analyze the clinical features of children with RSV infection in Beijing.Results:A total of 5 489 respiratory specimens were collected from 3 046 male patients and 2 443 female patients. The average age of the patients was 4.36 years. A total of 589 RSV-positive specimens (10.7%, 589/5 489) were detected with 349 from male patients and 240 from female patients. The average age of children with RSV infection was (2.51±2.78) years and the median age was 0.48 years. RSV had been circulating among children in Beijing since March 2023 with two epidemic peaks in May (24.6%, 122/496) and December (18.2%, 126/693). The predominant subtype of RSV in the first half of 2023 was subtype A, but it was replaced by subtype B from November 2023. Phylogenetic analysis revealed a novel G gene of RSV subtype B (RSV-B-BA9-954bp) with a length of 954 bp, which belonged to a new cluster in the phylogenetic tree. The percentage of patients admitted to the Intensive Care Unit (ICU) was higher in children with new variant of RSV subtype B infection than in those with common RSV subtype B infection [44.1% (15/34) vs 25.2% (31/123), χ 2=4.600, P=0.032], while the counts of white blood cells and the levels of C-reactive protein were lower in the children with new variant infection ( P<0.05). Conclusions:RSV has been prevalent among children in Beijing since March 2023 with two epidemic peaks. The predominant A subtype is gradually replaced by to B subtype. A new variant of RSV B G gene (RSV-B-BA9-954bp) is detected among the children.

Objective:To analyze the differentially expressed genes of human respiratory syncytial virus (RSV) subtype A genotype ON1, a predominant genotype in Beijing, after infecting A549 cells using transcriptomic sequencing, and provide potential targets for RSV prevention and treatment.Methods:A local strain (61397-ON1) identified by whole-genome sequencing as ON1 genotype of RSV subtype A was selected to infect A549 cells. Total mRNA was extracted, and the differentially expressed genes in infected and uninfected A549 cells were screened by transcriptomic sequencing. GO analysis and KEGG pathway analysis were performed. Besides, six genes with differential expression ratio greater than two times were randomly selected for qRT-PCR verification.Results:There were 1 632 differentially expressed genes between infected and uninfected A549 cells, of which 807 genes were up-regulated and 825 genes were down-regulated. The differentially expressed genes were mainly involved in immune response-related biological processes such as cytokine response and positive regulation of MAPK cascades, and were enriched in MAPK signaling pathway, NOD-like receptor signaling pathway, p53 signaling pathway, TNF signaling pathway, IL-17 signaling pathway and NF-κB signaling pathway. The results of qRT-PCR for six differentially expressed genes were consistent with the trend of transcriptome data.Conclusions:The differentially expressed genes of RSV A subtype ON1 genotype after infecting A549 cells are mainly involved in cytokine response and immune-related signaling pathways. This study provides basic data for further study of the molecular mechanism of RSV infection and the development of prevention and treatment strategies.

Objective    To analyze factors affecting the recovery of postoperative left ventricular function in patients with valvular disease combined with heart failure with reduced ejection fraction [HFrEF, left ventricular ejection fraction (LVEF)<40%]. Methods    The clinical data of 98 patients with valvular disease combined with HFrEF who underwent surgeries in our hospital from January 2011 to June 2018 were retrospectively analyzed, including 75 males and 23 females aged 9-78 (55.3±11.9) years. Results    A total of 15 patients were dead after the operation, including 4 deaths within 3 months and 11 mid-long-term deaths after the operation. Ninety-one patients were followed up for more than 6 months (10 months to 8.6 years). The postoperative cardiac function (NYHA) of 91 patients was classⅠ-Ⅱ, the LVEF of 18 (19.8%) patients increased more than 10%, that of 47 (51.6%) patients maintained at the preoperative level, and that of 26 (28.6%) patients decreased. Postoperative LVEF was more prone to recover in HFrEF patients with sinus rhythm before operation (P=0.038), valvular disease mainly in aortic valve (P=0.026), obvious reduction of left ventricular end diastolic diameter in early postoperative period (P=0.017), and higher systolic pulmonary artery pressure (SPAP) before operation (P=0.018). The risk factors for postoperative LVEF deterioration included large left atrium before operation (P=0.014), smaller left ventricle end systolic diameter before operation (P=0.003), and fast heart rate after operation (P=0.019). Conclusion    Mitral valve prolapse patients with obviously increased left ventricular diameter should receive operation as soon as possible. HFrEF patients with aortic valve disease should receive operation positively. The operation efficacy is satisfactory in the HFrEF patients with high SPAP.