Objective:To identify enolase,47 kD allergen,from Litopenaeus vannamei by Mass spectrometry. Methods: The proteins were extracted from Litopenaeus vannamei tissue with acetone precipitation method. The protein components were analyzed by SDS-PAGE and Western blot. By using Matrix-Assisted Laser Desorption/Ionization time of flight mass spectrometry ( MALDI-TOF/TOF-MS) ,the 47 kD allergen from Litopenaeus vannamei was identified as enolase. Results:By SDS-PAGE,we proved that the native protein components from Litopenaeus vannamei were completely. According to the Western blot result more than 14 components could react with the positive serum. MALDI-TOF/TOF analysis results showed that the suspected proteins were enolase. A sensitization frequency was 55%. Conclusion:Enolase was identified as a new allergen of Litopenaeus vannamei.

Objective To investigate the status of social adjustment in undergraduate nursing students, and to explore the influence of interpersonal relations and social support on social adjustment. Methods A total of 485 undergraduate nursing students in the School of Nursing of University of South China were investigated by using the Comprehensive Diagnostic Scale for Interpersonal Relations, Social Support Rating Scale and Chinese College Students' Adaptability Scale with stratified cluster sampling method. Results The total scores of social adjustment of undergraduate nursing students were (195.37 ± 26.63) points. The total scores of interpersonal relations were (9.18 ± 5.81) points. The total scores of social support were (36.72 ± 5.39) points. Social support and social adjustment were positively correlated (r=0.274, P<0.01), but interpersonal relations and social adjustment were negatively correlated (r=-0.490, P<0.01). The main influencing factors of social adjustment in a descending order included interpersonal dating(β=-0.390, P=0.000), interpersonal conversation(β=-0.146, P =0.024) and subjective support(β=0.133, P =0.005). Conclusions The scores of the social adjustment, social support and interpersonal relations of undergraduate nursing students are all in the middle level. The main influencing factors of social adjustment include interpersonal dating, interpersonal conversation and subjective support, particulally interpersonal dating. Educators can improve their social adjustment through improving interpersonal dating, interpersonal conversation and subjective support .

Transcranial Doppler (TCD) is a method for measuring cerebral artery blood flow velocity, which has the advantages of low cost, non-invasive, high temporal resolution. Dynamic cerebral autoregulation (dCA) is to study the instantaneous change of cerebral blood flow (CBF) at the moment of arterial blood pressure or intracranial pressure change, that is, the ability to recover CBF in the face of sudden change of perfusion pressure. After the onset of acute ischemic stroke (AIS), effective dCA can maintain the stability of cerebral hemodynamics and avoid excessive or insufficient perfusion at the injured site. Therefore, it is of great significance to evaluate dCA in patients with AIS. However, at present, there is no recognized optimal evaluation method for dCA. This article mainly summarizes the advantages of TCD in evaluating dCA compared with other methods and the application of TCD combined with transfer function analysis (TFA) in evaluating dCA in AIS.

Objective:To investigate the effect of Zuojin Pill on the expression of hypoxia inducible factor-1α (HIF-1α) and apoptosis of thyroid cells in rats with autoimmune thyroiditis (AIT). Methods:Ninetysix rats were divided into control group, model group, standarlized protocol and low, medium and high dose Zuojin Pill groups. Except the control group, the rats in other groups were produced as AIT model. After successful modeling, rats in low-, medium-, and high-dose groups were intragastrically administered with 0.63, 1.26, and 2.52 g/kg Zuojin Pill respectively, standarlized protocol was given 6.25 mg/kg Tripterygium wilfordii polyglycoside, and the control group and model group were given the same amount of normal saline. The levels of tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) were detected by enzyme-linked immunosorbent assay (ELISA); the activity of SOD and the content of MDA in thyroid tissue were detected by kit; the pathological changes of thyroid tissue were observed by HE staining; the apoptosis of thyroid cells was detected by TUNEL; the expression of HIF-1α, B-cell lymphoma-2 (Bcl-2), Bcl-2-related X protein (Bax) and Cleaved caspase-3 in thyroid tissues was detected by Western blot. Results:Compared with the model group, the content of TNF-α, TPOAb and TGAb in serum of rats in the low, medium and high dose Zuojin Pill groups significantly decreased, the content of IL-10 in serum significantly increased ( P<0.05). The SOD activity significantly increased, and the MDA content significantly decreased in the low, medium and high dose Zuojin Pill groups ( P<0.05). The apoptosis rate significantly decreased in the low, medium and high dose Zuojin Pill groups ( P<0.05). The expression of HIF-1α (0.48 ± 0.05, 0.63 ± 0.06, 0.86 ± 0.06 vs. 0.33 ± 0.03), Bcl-2 (0.48 ± 0.04, 0.59 ± 0.05, 0.68 ± 0.04 vs. 0.37 ± 0.04) significantly increased, the expression of Bax (0.67 ± 0.05, 0.53 ± 0.05, 0.40 ± 0.05 vs. 0.80 ± 0.06), Cleaved caspase-3 (0.64 ± 0.06, 0.51 ± 0.03, 0.36 ± 0.03 vs. 0.77 ± 0.05) significantly decreased in the low, medium and high dose Zuojin Pill groups ( P<0.05). Conclusion:Zuojin Pill could enhance the expression of HIF-1α, regulate the secretion of inflammatory factors, reduce the level of oxidative stress and thyroid autoantibody, and inhibit the apoptosis of thyroid cells.

OBJECTIVE: To investigate specific immunologic therapy (SIT) intervention in patients with nasal polyps accompanied with perennial rhinitis after functional endoscopic sinus surgery (FESS). METHOD: To divide patients with nasal polyps into two groups randomly: group I: FESS + SIT after operation; group II: FESS only. To compare the symptom and physical sign of the 2 groups before the operation and 1 and 2 years after the operation, with SNOT-20 and Lund-Kennedy and Lund-Mackay Standard. RESULT: Both of the 2 groups' final scores of the total 20 items and the most important 5 items of SNOT-20 and Lund-Kennedy and Lund-Mackay were greatly improved, however there is an obvious difference between them: the therapeutic effect of groups I is better than group II. CONCLUSION SIT can reduce the recurrence of nasal polyps after operation, and improve the state after treatment.
Adolescent ; Adult ; Aged ; Endoscopy ; Female ; Humans ; Immunotherapy ; methods ; Male ; Middle Aged ; Nasal Polyps ; diagnosis ; surgery ; therapy ; Postoperative Period ; Prognosis ; Recurrence ; Treatment Outcome ; Young Adult

Objective: To investigate the prevalence of hyperactivity behavior in children aged 3-6 in Yunnan Province, to explore its relationship with neuropsychological development, so as to provide clues for early prevention and intervention of attention deficit hyperactivity disorder (ADHD) in children. Methods: A total of 1 321 children aged 3 to 6 from 10 kindergartens in 5 prefectures (cities) of Yunnan Province were selected by stratified random sampling method from October 2022 to May 2023. Teacher Rating Scale (TRS) was used to investigate childrens hyperactive behavior and coexistent behavior. A qualified evaluator applied the Developmental Scale for Children Aged 0-6 Years to assess the development of 5 ability areas of gross motor movement，fine movement，adaptive ability，language and social behavior. Statistical analysis was performed using Wilcoxon rank sum test and χ2 test. Binary Logistic regression was applied to analyze the score of their hyperactivity behavior and its relationship with other behavior problems and neuropsychological development. Results: The detection rate of hyperactivity behavior was 8.6% in children aged 3 to 6 years, 12.8% in boys and 4.1% in girls (χ2=31.53, P<0.01). The detection rate of hyperactivity in 3yearold children was 13.9%, which was higher than that in 4yearold (9.2%) and 5yearold children (7.0%) (χ2=8.73, P<0.05). The detection rate of inattentionpassivity of rural children (14.6%) was higher than that of urban children (5.9%) (χ2=22.23, P<0.01). Binary Logistic regression analysis showed that the higher the level of adaptive development, the lower the risk of hyperactivity (OR=0.58, 95%CI=0.39-0.86), the higher the risk of hyperactivity (OR=0.57, 95%CI=0.35-0.91), the higher the risk of conduct problems (OR=0.57, 95%CI=0.37-0.87), inattentionpassivity (OR=0.49, 95%CI=0.33-0.74) were also at lower risk (P<0.05). Children with higher levels of fine motor development had a lower risk of inattentionpassivity (OR=0.59, 95%CI=0.37-0.93, P<0.05). Conclusions Hyperactivity in boys and inattentionpassivity in rural children requires more attention. It is necessary to strengthen childrens early adaptive ability and fine motor training to prevent hyperactive behavior and inattention.

Objective:Based on the current medical environment, to learn about cognition status of doctor-patient relationship among medical students and analyze causes of the tension between doctors and patients.Methods:Using the self-designed questionnaire "Clinical Medical Students' Cognition Survey on Occupational Status and Doctor-Patient Relationship", a cross-sectional survey was conducted on 527 medical students from 5-year and 7-year clinical program in Batch 2014 in a medical university in Heilongjiang Province. The survey mainly analyzed the causes of the tension between doctors and patients from the level of medical staff, patients and their families, hospitals and society. SPSS 22.0 was used for descriptive statistics and chi-square test.Results:The results showed that 93.7% of the medical students believed that the current doctor-patient relationship was not harmonious. There were cognitive differences among medical students in different gender ( P=0.029), first contact clinical grade ( P=0.003) and professional identity ( P<0.001). Conclusion:Medical students have a poor evaluation towards the current doctor-patient relationship. In order to construct harmonious doctor-patient relationship in the future, we can try to take measures such as carrying out relevant courses of doctor-patient communication, improving the medical students' communication skills and enhancing their professional identity.

Objective:We observed and compared the differences in immune reconstruction between single-infusion anti-B-cell maturation antigen (BCMA) , chimeric antigen receptor T cells (CAR-T) , and combined infusion of anti-CD19 CAR-T cells in the treatment of recurrent/refractory multiple myeloma (RRMM) .Methods:Sixty-one patients with RRMM who underwent CAR-T cell therapy in our hospital from June 2017 to December 2020 were selected. Among them, 26 patients received anti-BCMA target, and 35 patients received anti-BCMA combined with anti-CD19 target. Using flow cytometry, we determined T cell subsets (CD3 +, CD4 +, CD8 +, CD4 +/CD8 +) , B cells (CD19 +) , and NK cells (CD16 + CD56 +) at different time points before and after CAR-T treatment, and detected immunoglobulin IgG, IgA and IgM levels by immunoturbidimetry. We compared the reconstruction rules of lymphocyte subsets and immunoglobulins in the two groups. Results:CD8 + T lymphocytes recovered most rapidly after the infusion of CAR-T cells, returning to pre-infusion levels at 3 months and 1 month after infusion, respectively[BCMA: 695 (357, 1264) /μl vs 424 (280, 646) /μl; BCMA+CD19: 546 (279, 1672) /μl vs 314 (214, 466) /μl]. NK cells returned to normal levels at 3 months after infusion in both groups[BCMA: 171 (120, 244) /μl, BCMA+CD19: 153 (101, 218) /μl (Normal reference range 150-1100/μl) ]; however, the NK cells were not maintained at stable levels in the BCMA CAR-T cells group. The recovery of CD4 + T lymphocytes in both groups was slow and remained persistently low within 12 months after infusion, and no recovery was observed in most patients. The reversal of the ratio of CD4 +/CD8 + lasted for more than a year. The levels of CD19 + B cells in both groups returned to baseline 3 months after infusion[BCMA: 62 (10, 72) /μl vs 57 (24, 78) /μl; BCMA+CD19: 40 (4, 94) /μl vs 29 (14, 46) /μl]. IgG returned to the pre-infusion level 12 months after infusion in the group with anti-BCMA cells alone, but not in the group with combined infusion of CD19 CAR T cells[7.82 (6.03, 9.64) g/L vs 6.92 (4.62, 12.76) g/L]. IgA returned to pre-infusion levels at 9 and 12 months after infusion, respectively[BCMA: 0.46 (0.07, 0.51) g/L vs 0.22 (0.12, 4.01) g/L; BCMA+CD19: 0.46 (0.22, 0.98) g/L vs 0.27 (0.10, 0.53) g/L]. IgM in both groups returned to pre-infusion levels 6 months after infusion[BCMA: 0.43 (0.06, 0.60) g/L vs 0.20 (0.13, 0.37) g/L; BCMA+CD19: 0.53 (0.10, 0.80) g/L vs 0.16 (0.11, 0.28) g/L]. There was no significant difference in the indexes of lymphocyte subpopulation reconstruction and immunoglobulin recovery between the two groups at each time point. Conclusion:This study showed that in patients with RRMM treated with CAR-T cells, the appropriate target antigen can be selected without considering the difference of immune reconstruction between anti-BCMA CAR-T and combined anti-CD19 CAR-T therapy.

Objective　To investigate the feature of the shunt volume of right-to-left shunt (RLS) in cryptogenic ischemic stroke (CIS) and migraine with aura (MA) and to analyze the different pathogenesis of CIS and MA with RLS.Methods　Forty-eight CIS patients and 42 MA patients from two case groups and 33 healthy volunteers from normal control group(NCG),using contrast enhanced transcranial doppler (cTCD) for diagnosing RLS and shunt volume grades,the positive rate of the three groups were analyzed.Results　In the case groups，the positive rate of RLS was MA 57.1% (24/42) and CIS 60.4%(29/48),of which large shunt accounted for MA 16.7% (7/42) and CIS 29.2%(14/48).In the NCG,the positive rate of RLS was 30.3% (10/33),of which large shunt accounted for 9.1% (3/33).Comparison of the three groups of the total positive rate，the total positive rate of two case groups were higher than NCG (MA vs NCG,P=0.02),(CIS vs NCG,P=0.008).Large shunt rate in CIS group was significantly higher than NCG (P=0.029).Conclusion　CIS and MA are significantly related to RLS.The large shunt rate of RLS in CIS patients was significantly higher than that in NCG.

OBJECTIVE To systematically evaluate the therapeutic effect of acupuncture on geriatric insomnia.METHODS Randomized controlled trials(RCTs)on acupuncture in the treatment of senile insomnia were searched in CNKI,VIP,Wanfang,China Biomedical Database,PubMed,Web of science,Embase and Cochrane Library databases from inception dates to June 24,2024.Litera-ture was screened and data were extracted based on the inclusion and exclusion criteria.The literature quality was evaluated according to the risk of bias table recommended by the Cochrane Collaboration Handbook 5.1.0,and the outcome indicators were graded using the GRADE system for the quality of evidence.RevMan5.4 software was used to evaluate the quality of the included literature,and Sta-ta18.0 software was used to conduct Meta-analysis on the included literature.RESULTS A total of 18 studies involving 1399 pa-tients were included.Meta-analysis showed that:compared with the simple western medicine treatment,acupuncture in the treatment of senile insomnia patients could improve the clinical effective rate[RR=1.18,95%CI(1.13,1.24),P<0.001],reduce the total PSQI score[MD=-1.10,95%CI(-1.25,-0.96),P<0.001],daytime dysfunction[MD=-1.38,95%CI(-1.59,-1.16),P<0.001],sleep latency[MD=-0.66,95%CI(-0.86,-0.47),P<0.001],sleep duration[MD=-0.45,95%CI(-0.64,-0.25),P<0.001],sleep efficiency[MD=-0.69,95%CI(-0.89,-0.49),P<0.001],sleep disorder[MD=-1.24,95%CI(-1.47,-1.01),P<0.001],sleep quality[MD=-0.84,95%CI(-1.05,-0.64),P<0.001].GRADE classification showed that the clinical efficacy was advanced evidence;the adverse reactions were intermediate evidence;the total score of PSQI,daytime dysfunction,sleep latency,sleep efficien-cy,sleep quality and sleep disorder were low evidence;sleep time was extremely low evidence.CONCLUSION Acupuncture inter-vention in senile insomnia patients is superior to the control group in clinical efficiency and various PSQI scores.Acupuncture interven-tion is worthy of further promotion and use in clinical practice as the complementary and alternative therapy for the conventional western medication treatment of senile insomnia.However,the evidence levels of some outcome indicators are relatively low,and more high-quality RCTs with large sample sizes are still needed to increase the strength of evidence.