OBJECTIVE: To investigate the effects of compound preparation of Cordyceps sinensis and Tripterygium hypoglaucum (CSTHC) on survival time of grafted pigskin after allogeneic transplantation and its mechanism. METHODS: The pigskin was treated with CSTHC solution before allogeneic transplantation, and CSTHC ointment was applied for external use on the grafted pigskin after skin transplantation. Cyclosporine A (CsA) and normal saline were served as control. The survival time, the appearance and the histomorphological changes of the grafted pigskin were observed. The histomorphological changes of testicles in pigs were also examined. The CD4 and CD8 expressions in the grafted pigskins were measured by immunohistochemical method. The white blood cell count in peripheral blood and the liver and renal functions were also examined. RESULTS: The survival time of the grafted pigskin in the CSTHC-treated group was (28.50+/-3.26)d, which was much longer as compared with (10.60+/-1.52)d in the untreated group (P<0.01). The survival time of the grafted pigskin in the CsA-treated group was (28.33+/-3.50)d, and there was no remarkable difference in the survival time of the grafted pigskin between the CsA-treated group and the CSTHC-treated group. The expressions of CD4 and CD8 were lower in the CSTHC-treated group than those in the untreated group on the 7th and 14th day after skin graft (P<0.05), while there was no significant difference in the indices between the CSTHC-treated group and the CsA-treated group. The WBC count was higher in the untreated group than that in the CSTHC-treated group or CsA-treated group on the 7th day after skin graft (P<0.05). CONCLUSION: CSTHC can prolong the survival time of allogeneic grafted pigskin. Its mechanism of inhibiting the immunological rejection may relate to decreasing the expressions of CD4(+) and CD8(+) in the grafted pigskin and reducing the local inflammatory reaction.

Epigenetics refers to the heritable changes of gene expression without altering DNA sequence.Epigentic mechanism involves DNA methylation, microRNA, histone modification and so on.Tetralogy of Fallot(TOF)is a common congenital heart disease characterized by ventricular septal defect, pulmonary stenosis, aortic straddling and right ventricular hypertrophy.Many experimental investigations indicate that epigentics plays an important role in the development of the heart.It will be an important research field in the future showing important clinical significance to study the etiology of tetralogy of Fallot.

Epigenetic modification genes are defined as genes whose products modify the epigenome directly through DNA methylation, histone modification or chromatin remodeling.More and more studies have shown that mutations in epigenetic modification genes are an important etiology of rare diseases with abnormal cardiac development.And these diseases usually affect multiple organs including heart due to the change of epigenetic components.Moreover, children′s lives and health are often threatened by a lack of effective drugs and complex cardiovascular malformations.This article reviews advances in molecule genetics of Tatton-Brown-Rahman syndrome, Kabuki syndrome, Rubinstein-Taybi syndrome, CHARGE syndrome and Sifrim-Hitz-Weiss syndrome, and mainly elaborates the mechanism of cardiovascular malformations caused by mutations in corresponding epigenetic modification genes, providing more comprehensive reference for clinical diagnosis and management.

Congenital heart disease（CHD）is a common congenital anomaly that is the leading cause of death among children under the age of five years with birth defects in both developed and developing countries. With the increasing prevalence of CHD，the importance of early diagnosis and intervention of CHD is well accepted. Prenatal ultrasonography is routinely applied for the screening of CHD but many factors influence its diagnostic accuracy. Biomarker testing is a simple and rapid method that can be used as an adjunct to prenatal screening for CHD. This review aims to provide new ideas for the early diagnosis of children with CHD by exploring the pathogenesis of biomarkers in CHD. In recent years，many studies have been devoted to the exploration of biomarkers related to CHD，and the studies on biomarkers in CHD are summarized from three aspects：epigenetics，proteomics and environmental factors.

OBJECTIVE Aim to evaluate the mental level in 4-6 years old children with obstructive sleep apnea hypopnea syndrome(OSAHS). METHODS Children who were diagnosed as OSAHS with a whole night PSG monitor in the sleep center between January 2015 and August 2016, and 30 healthy children were included in the study. Intelligent levels were evaluated at the enrollment day. The following intelligent levels evaluation questionnaires were used: Wechsler Intelligence Scale for children and infants. Intelligent levels were compared between the patient and healthy control groups. RESULTS The 60 children, including 30 children with OSAHS(patient group) and 30 healthy children(control group) were enrolled. Comparison of the patient versus the control groups revealed that total intelligence quotient(FIQ) was 96.59±12.60 vs 102.53±8.44; language capability(VIQ) was 94.00±13.24 vs 101.03±9.41; comprehension test was 5.96±2.5 vs 7.57±2.14; visual analysis was 8.85±2.32 vs 10.3±1.93. All the 4 values in the patient group were significantly lower than those in the control group(all P ＜0.05). The accumulated time of SO2＜90％ correlated with PIQ negatively and significantly. CONCLUSION The intelligent level of children with OSAHS was in the normal range, but lower than that of healthy group. Snoring affects the IQ level of 4-6 years old children, and the influence on PIQ is closely related to the accumulated time of SO2＜90％ in total sleep time.

Objective To study the effects of ultrasound-guided quadratus lumborum block(QLB)on intraoperative hemodynamics and opioid dosage in emergency patients with ectopic pregnancy.Methods A total of 70 patients with ectopic pregnancy undergoing laparoscopic surgery in Langfang People's Hospital from January 2021 to February 2024 were selected as subjects.According to the different anesthesia methods,the patients were divided into the control group and the study group,with 35 cases in each group.The control group was given general anesthesia,while the study group additionally added ultrasound-guided QLB.The intraoperative sedation effect,hemodynamics,postoperative pain,incidence of adverse reactions and opioid use at different times(admission,entry,intubation,skin incision,extubation,and discharge)were observed in the two groups.Results There were no statistically significant differences in the onset time of sedation,the rate of salvage sedation,the incidence of intraoperative body movements,the modified observer's assessment of alert/sedation(MOAA/S)at each time,and the hemodynamics at the time of admission,entry and intubation between the two groups.The mean arterial pressure(MAP),systolic blood pressure(SBP)and heart rate(HR)in the study group were significantly lower than those in the control group during skin incision,extubation and discharge[skin incision:MAP(mmHg,1 mmHg≈0.133 kPa)was 85.24±4.59 vs.96.95±4.68,SBP(mmHg)was 92.24±4.85 vs.99.49±5.13,HR(times/min)was 85.33±2.96 vs.94.51±2.92;extubation:MAP(mmHg)was 94.84±5.02 vs.102.05±5.13,SBP(mmHg)was 96.48±4.72 vs.105.03±5.07,HR(times/min)was 95.51±4.95 vs.102.49±5.87;discharge:MAP(mmHg)was 86.14±4.99 vs.93.71±5.25,SBP(mmHg)was 96.48±4.69 vs.104.37±5.02,HR(times/min)was 84.05±4.57 vs.90.51±4.86,all P<0.05]and pulse oxygen saturation(SpO2)was higher than those in the control group(skin incision:0.988 5±0.012 2 vs.0.965 4±0.012 3,extubation:0.974 7±0.012 4 vs.0.963 2±0.012 1,discharge:0.981 1±0.012 4 vs.0.970 3±0.012 3,all P<0.05).The resting numeric rating scale(NRS)scores and active NRS scores in the study group were lower than those in the control group at 3,6,12,and 24 hours after surgery,the random time was prolonged,the resting NRS and active NRS in the two groups gradually increased,reaching a peak at 24 hours after surgery,and the resting NRS and active NRS in the study group were significantly lower than those in the control group(resting NRS:3.86±0.82 vs.4.53±1.04,active NRS:4.26±1.05 vs.4.85±1.13,all P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group[11.43%(4/35)vs.34.29%(12/35),P<0.05].The dosage of Sufentanil in 24 hours and 48 hours,the number of analgesic pump in 48 hours and the number of relief analgesia cases in the study group were lower than those in the control group[the dosage of Sufentanil in 24 hours(μg):23.28±4.02 vs.36.14±4.57,the dosage of Sufentanil in 48 hours(μg):41.61±4.82 vs.59.33±6.25,the number of analgesic pump in 48 hours(times):2.94±1.22 vs.6.15±1.71,the proportion of relief analgesia:8.57%(3/35)vs.28.57%(10/35),all P<0.05].Conclusion Ultrasound-guided QLB can reduce hemodynamic fluctuations,relieve postoperative pain,reduce adverse reactions and opioid use in emergency patients with ectopic pregnancy,demonstrating a positive impact.

Objective To observe the effect of quadratus lumborum block(QLB)anesthesia on intraoperative blood gas indexes and postoperative recovery in female uremic patients with peritoneal dialysis catheterization.Methods A total of 70 female uremic patients with peritoneal dialysis catheterization admitted to Langfang People's Hospital from January 2021 to December 2023 were selected as the research objects.According to the random number table method,they were divided into the control group and the study group,with 35 cases in each group.The control group was given conventional local infiltration anesthesia,whereas the study group was given QLB anesthesia.The changes of mean arterial pressure(MAP),heart rate(HR),blood gas indexes[pulse oxygen saturation(SpO2),arterial partial pressure of carbon dioxide(PaCO2)]and numeric rating scale(NRS)score,at different points pain factors[5-hydroxytryptamine(5-HT),substance P(SP),norepinephrine(NE)]before operation and 24 hours after operation,postoperative recovery(time to get out of bed for the first time,exhaust time,length of hospital stay)and adverse reactions were observed in the two groups.Results There was no significant difference in MAP,HR,blood gas index and NRS score between the two groups at the admission.The MAP,HR,PaCO2 in the study group were significantly lower than those in the control group during skin incision,rectus abdominis separation,catheterization,suture,and leaving the room,and SpO2 was significantly higher than that in the control group,and NRS score in the study group were significantly lower than those in the control group during skin incision,rectus abdominis separation,catheterization,suture(all P<0.05).There was no significant difference in the levels of 5-HT,SP and NE between the two groups before operation,but the levels of 5-HT,SP and NE at 24 hours after operation were significantly higher than those before operation,but the levels of 5-HT,SP and NE in the study group were lower than those in the control group.The first ambulation time,exhaust time and hospitalization time in the study group were significantly shorter than those in the control group(all P<0.05).The incidence of nausea and vomiting,constipation,pruritus,dizziness and other adverse reactions in the study group was significantly lower than that in the control group(all P<0.05).Conclusion QLB can reduce the fluctuation of intraoperative blood gas indexes in female uremic patients with peritoneal dialysis catheter,relieve postoperative pain,reduce the level of pain factors and reduce the occurrence of adverse reactions,and has a good effect on promoting postoperative recovery of patients.

Objective:To study the epidemic status about genotype of the astrovirus, and to provide the epidemic data and control epidemic of infectious disease.Methods:Screening for astrovirus positive nucleic acids was performed using an astrovirus real-time fluorescent PCR kit. RT-PCR amplification was performed with astrovirus-specific primers Mn289/270. The positive products were recovered and purified and directly sequenced. Sequence analysis and phylogenetic analysis of astrovirus sequences were performed using Clustal and MEGA3.0 biological software.Results:From 2016 to 2018, we collected 496 fecal specimens from children with diarrhea from different regions, of them 136 cases had viral diarrhea, and in 17 of them astrovirus (3.4%) was detected, there were more males than females. All the 17 cases were under 5 years of age, and 12 cases (70.58%) were younger than 1 year old. In regional distribution, samples from Xining accounted for 64.70% (11/17), Huangzhong county for 29.41% (5/17), Huangnan Prefecture for 5.88%(1/17). The positive cases were mainly found in April to June, and there was another peak from October to December, which was consistent with the time distribution of rotavirus in past years. Seven strains were HAstV-1, one strain was HAstV-2, and the homology among four strains of HAstV-1 was 99.0%-100%. The homology with the other two strains of the same type was 88.4-95.7%.Conclusions:The dominant genotype of Astrovirus was HAstV-1 in infants with diarrhea in Qinghai, meanwhile there was also HAstV-2.

Objective:This study aimed to analyze the genomic characteristics of Varicella-Zoster Virus (VZV) strains circulating in Jilin province from 2010 to 2023.Methods:Vesicle fluid from 78 sporadic cases with VZV infection were collected in Jilin province from 2010 to 2023, after detecting by Real-time PCR, 26 specimens (CT<25) were detected by PCR. Open reading frame 22(ORF22), ORF38 and ORF62 were amplified and analyzed. Genotyping was confirmed by SNPs ORF22 (37902, 38019, 38055, 38081 and 38177) and ORF38 (69424). Vaccine strains were indentified from wild-type strains according to ORF38 (69349) and ORF62 (106262, 107252, and 108111). Sequences were analyzed by homologous comparison and phylogenetic analysis.Results:The comparison with Dumas sequence revealed that SNPs (37902, 38055, 38081 and 38177) in ORF22 and ORF38 (69424) have mutations similar to the pOka strain, which belong to clade 2. Compared to the Dumas and Baike strains, all 26 samples were wild-type strains. JL2016-4 strain changes from threonine to asparaginyl at position 38059, JL2021-4 strain changes from arginine to proline at position 37933, from aspartic acid to tyrosine at position 37935, and from aspartic acid at base 38031 to tyrosine. JL2023-1 strain changes from arginine to leucine at position 37933.Conclusions:VZV has been prevalent for 14 years in Jilin province. The main epidemic strains belong to the clade 2. We should strengthen the monitoring of VZV outbreaks and raise the coverage rate of VZV vaccination.