Objective To study the pathogenesis of avascular necrosis of femoral head(ANFH) in young adults.Methods The data of DSA of femoral head(113 femoral heads) with ANFH proved by clinic or radiology and treated by interventional radiology and 45 normal peoples(46 femoral head) were comparatively analysed.Results The variation of artery of femoral head in interventional treating group was appeared in 28 cases(35.9%),51 arteries involved,including 17 internal iliac arteries variation(33.3%),29 medial femoral circumflex arteries variation(56.9%),4 lateral femoral circumflex arteries variation(7.8%),1 lateral and medial femoral circumflex arteries common bole variation(2.0%).The variation of artery of femoral head in control group was appeared in 5 cases,5 arteries involved.There was significant difference between the two groups(P

Objective To explore the correlation and role of E2F3 gene,miR-17-5p and miR-20a in the cell lines of transitional cell carcinoma of bladder. Methods The plasmids of pcDNA3.1-HA-E2F3 and pAAV-siRNA-E2F3 were used to overexpress and knockdown E2F3.The mimics of miR-17-5p,miR-20a and their anti-miRNA oligonucleotides were used to overexpress and screen miR-17-5p and miR-20a.The expression levels of E2F3 gene,miR-17-5p and miR-20a were detected by quantitative real-time PCR,and E2F3 protein were detected by Western blot. Results When E2F3 was overexpressed,the 2- △△Ct of miR-17-5p and miR-20a were 2.26 ± 0.30 and 4.04 ± 0.51,it was statistically significant to compared with control (P ＜ 0.05) ; when E2F3 was knockdown,the 2 △△Ct of miR-17-5p and miR-20a were 0.49 ± 0.02and 0.65 ± 0.04 (P ＜ 0.05) ; when miR-17-5p and miR-20a were overexpressed simultaneously,the level of E2F3 mRNA was significantly decreased,the average E2F3 protein gray scale was 55.31 ± 7.89,the control was 103.67 ± 13.61 (P ＜ 0.05 ) ; when miR-17-5p and miR-20a were knockdown simultaneously,the E2F3 mRNA was significantly increased,the E2F3 protein gray scale was 295.68 ± 19.25,the control was 103.67 ± 13.61 ( P ＜ 0.05 ). Conclusions miR-17-5p and miR-20a could be up-regulated by E2F3 gene,and the E2F3 gene could be down-regulated by miR-17-5p and miR-20a.The regulatory feedback loop of E2F3 gene,miR-17-5p and miR-20a exists in transitional cell carcinoma of bladder. The loop maybe plays a key role in the development of bladder cancer.

Objectiv e:To investigate the effect of different culture conditions on the differentiation of Treg and Th17 to lay a foundation for exploring the methods to reverse the immune tolerance induced by tumor microenvironment.Methods:The IL-6 gene was cloned and stablely transferred into the tumor cell line expressing TGF-β.The conditioned mediums ( CM) were prepared by collecting the culture supernatants of tumor cell lines with or without IL-6 expression and used in the in vitro culture of peripheral blood mononuclear cells ( PBMC ) .The changes of Treg and Th17 in PBMC treated with different CM were detected with flow cytometry ( FCM) .Results:The expression of TGF-βin BEL-7402 was higher than that in HepG2.Thus the BEL-7402 was selected for preparation of cell line stablely transfected with IL -6 gene.ELISA detection confirmed the effective expression of IL -6 by the identified cell lines.It was showed that the Treg increased in PBMC treated with culture supernatants of tumor cells .However,the presence of IL-6 reversed the increase of Treg and promoted the differentiation of Th 17.Conclusion: The culture supernatants of tumor cells increases the proportion of Treg.However,the presence of IL-6 in this CM can reverse the increase of Treg and raise the proportion of Th 17.

Objective : To investigate the willingness to receive HIV testing in primary health service institutions (PHSIs) among young students in Wuhan City, so as to provide the evidence for improving the detection of HIV testing among young students. Methods: Fifteen PHSIs were sampled using a stratified random sampling method in 14 districts of Wuhan City, and school students at ages of 15 to 24 years were sampled from each district using a convenience sampling method. Participants' demographics, awareness of AIDS-related knowledge, HIV testing and willingness to receive HIV testing were collected using questionnaires, and factors affecting the willingness to receive HIV testing in PHSIs were identified among school students using a multivariable logistic regression model. Results : A total of 301 questionnaires were allocated, and 299 valid questionnaires were recovered, with an effective recovery rate of 99.34%. The respondents included 143 men (47.83%) and 156 women (52.17%), and had a mean age of (19.36±2.40) years; there were 223 respondents with an educational level of diploma and above (74.58%). The awareness of AIDS-related knowledge was 71.57% among the respondents, and 144 respondents had received AIDS-related health education in PHSIs (48.16%). There were 34 respondents that had received HIV testing (11.37%) and 203 respondents that were willing to receive HIV testing in PHSIs (67.89%). The respondents that were unwilling to receive HIV testing in PHSIs were mainly attributed to considering to be unlikely to get HIV infections (82.29%). Multivariable logistic regression analysis showed that school students who knew AIDS-related knowledge (OR=2.797, 95%CI: 1.583-4.941), knew free HIV counseling and testing services in PHSIs (OR=2.070, 95%CI: 1.123-3.814), and had received AIDS-related health education in PHSIs (OR=2.814, 95%CI: 1.573-5.032) were more willing to receive HIV testing in PHSIs. Conclusions There were 67.89% of school students that were willing to receive HIV testing in PHSIs in Wuhan City, and the willingness to receive HIV testing was correlated with the awareness of risk of HIV infections, and awareness and experience of AIDS control services in PHSIs.

Objective To analyze the mechanism of interaction between cardiac and renal failure and observe the protective effects of Zhenwu decoction on cardio-renal syndrome rats. Methods The rats were divided into five groups: Sham group, MI (myocardial infarction) group, MI merger STNx group, MI intervention group, MI merger STNx intervention group. The first three groups were fed with saline (NS) for two weeks after surgery. The latter two groups of rats were fed with an equal volume of Zhenwu decoction. The cardiac function of rats in each group were evaluated , including the mass of heart , left ventricle and left kidney weights as a ratio of body weight, fractional shortening and left ventricular ejection fraction. And serum levels of indoxyl sulfate and serum creatinine were also achieved. Results MI merger STNx could further aggravate the heart function, kidney function and left ventricular remodeling in rats. Zhenwu decoction could obviously improve the heart function, kidney function and left ventricular remodeling in rats. Conclusions Based on the MI models, STNx can worsen heart function and kidney function. Zhenwu decoction can significantly improve heart function and kidney function.

Objective To study the sleep improvement function of DHA-PC.Methods The mice were randomly divid-ed into control, vehicle, DHA+Lecithin (60+200 mg/kg) and DHA-PC(50,100,200 mg/kg) groups.Ten mice were enrolled in each group .The mice of control were administered with normal food , the vehicle group was orally given normal saline at the dosage of 0.2 ml/10 g, while both DHA-PC and DHA+Lecithin were orally given corresponding drugs at the dosage of 0.2 ml/10 g.All the groups were treated for 30 days except control group .The direct sleep-inducing test, the test of lengthening sleep time induced by pentobarbital sodium , the test of pentobarbital sodium subthreshold-hypnosis and the test of barbital sodium sleep latency were conducted to observe the inductive effect of DHA -PC.Results Neither the effect on mice body mass nor directly-induced sleep was observed .DHA-PC (50,100, and 200 mg/kg) could prolong sleep time to (56.2 ±13.7),(57.9 ±25.4) and(64.1 ±18.4) min, respectively,compared to vehicle(32.9 ±10.8)min (P<0.05).DHA+Lecithin could not prolong sleep time (38.6 ±11.7)min compared to (32.9 ±10.8)min of vehicle.There was significant difference compared with DHA-PC at the dosage of 200 mg/kg (64.1 ±18.4)min (P<0.05).DHA-PC (200 mg/kg) enhanced pentobarbital sodium subthreshold-hypnosis (70%) compared to vehicle (10%) (P<0.05),so did DHA+Lecithin (60%) compared to vehicle (10%) (P<0.05).Both DHA-PC (200 mg/kg)[(22.9 ±4.1)min ] and DHA+Lecithin [(19.5 ±2.7) min ]could shorten sleep latency compared to vehicle (31.3 ±6.9) min(P<0.01), and the sleep latency of DHA +Lecithin (19.5 ±2.7) min was shorter than that of DHA-PC(50,100 mg/kg).Conclusion DHA-PC has some effect some sleep improvement in mice .

Objective: To understand the molecular evolution characteristics of the nucleoprotein (N) genes and epidemiological feature of 118 rabies virus (RABV) strains isolated in Yunnan province, China from 2006 to 2015. Methods: The brain tissue samples from mad dogs, suspicious sick dogs, sick cow, and human brain tissue, saliva and CSF samples from rabies patients were collected in Yunnan province to detect the viral antigen by direct immunofluorescence assay (DFA). The viral RNA from positive samples was extracted. Coding region of N gene was amplified by RT-PCR and sequenced. The phylogenetic tree was constructed by Neighbor-Joining method of MEGA5.0 software. Results: The sequences of N genes of 91 RABV strains in Yunnan from 2012 to 2015 were obtained. With the sequences of N genes of 27 RABV strains in Yunnan from 2006 to 2011 and 29 RABV strains from Southeast Asian Countries, the phylogenetic analysis was performed. RABV strains in Yunnan were divided into clades YN-A (105 strains), YN-B (6 strains), YN-C (7 strains), which belonged to clades China-I, China-VI, China-II respectively. Clade YN-A was epidemic every year from 2006 to 2015, of them, 14 strains from 2006 to 2011 and 91 strains from 2012 to 2015 were distributed in 13 prefectures (cities) of Yunnan. Clades YN-B and YN-C were epidemic only from 2006 to 2010 and from 2008 to 2011 respectively. The regional distribution of clades YN-B and YN-C was limited. The strains of YN-A and YN-C were closely related to the strains of clades China-I and China-II from neighboring Sichuan, Guizhou, Guangxi and Hunan provinces. The strains of YN-B were closely related to the strains from Myanmar, Laos, Vietnam and Cambodia. Conclusions Three RABV clades with multiple transmission sources were identified in Yunnan. Clade YN-A was widely distributed in rabies endemic area in Yunnan from 2006 to 2015, and it has strong ability to spread as principal clade in Yunnan. Since 2012, clades YN-B and YN-C were not found again in Yunnan.

Objective:To explore the pathogenic genes, clinical characteristics and treatment follow-up of children with congenital long QT syndrome (LQTS).Methods:Clinical data of 20 cases diagnosed with congenital LQTS and underwent gene testing from April 15, 2011 to April 15, 2021 in Department of Pediatric Cardiology, Shandong Provincial Hospital Affiliated to Shandong University were retrospectively collected and analyzed using independent sample t-test and Fisher′ s exact probability method. Results:LQTS-related gene mutations were detected in all the 20 cases, and pathogenic or suspected pathogenic mutations were identified in 18 cases (90.0%). Five LQTS mutation genes were discovered, including KCNQ1, KCNH2, SCN5A, CACNA1C and AKAP9.Eighteen cases (90.0%) had positive symptoms, and 13 cases (65.0%) had definite inducements.The inducement of symptoms in children with LQTS type 1(LQT1) was related to exercise, the causes of syncope in LQT1 and Jervell-Lange-Nielsen syndrome type 1 (JLNS1) with complex heterozygous mutations were exercise or emotional agitation; the causes of syncope in LQTS type 2 (LQT2) were unrelated to exercise; severe exercise in LQTS type 3 (LQT3) resulted in symptoms; and seizure in LQTS type 8 (LQT8) was non-induced.The corrected QT(QTc) interval of 20 cases was (553.1±66.6) ms, with a range of 460-707 ms, among which 17 cases showed QTc≥480 ms.The electrocardiogram(ECG) manifestations of children with various types of LQTS were different.There was no significant difference in QTc between different genders, or between children with syncope and those without syncope (all P>0.05). The follow-up time was (3.4±2.3) years, ranging from 0 to 8.3 years.Seventeen children received treatment[beta blockers and implantable cardiovertor-defibrillator(ICD)] and 3 cases did not.By the end of the follow-up, 1 child died, 19 cases survived, and 2 cases of the surviving children lost consciousness. Conclusions:There is a high consistency between genetic diagnosis and clinical diagnosis of congenital LQTS.The positive rate of gene detection is 90.0%.The clinical manifestations and ECG characteristics vary with genotypes.Beta blockers are protective.ICD therapy can prevent sudden cardiac death when oral medication does not respond.

In recent years, foreign countries are gradually implementing broad consent to improve the utilization of medical data and biological samples, but broad consent may face ethical issues such as imperfect notification and affecting the rights of subjects. There are already relevant regulations and practices on broad consent in foreign countries. The concept of broad consent is not clearly defined in China′s laws. At present, the treatment of biological samples can be roughly divided into four categories in practice, and there is potential application space for broad consent. The specific scope of broad consent should be clarified, distinguished from donation behavior, and the implementation of broad consent should be explored on the basis of protecting the rights of subjects.

Objective:To study the application effect of modified butterfly needle fixation method for implantable venous access port in breast cancer patients, in order to povide reference for the clinical applicaiton.Methods:A total of 300 patients with breast cancer from Janurary to December 2019 in Sun Yat-Sen University Cancer Center were divided into two groups by random digits table method: experimental group and control group, 150 cases in each group. The experimental group was treated with modified implantable intravenous port butterfly needle fixation method, while the control group was treated with conventional fixation method. The Visual Analogue Scale of pain during needle extraction, the incidence of needle stick injury and the time of needle extraction were measured between the two groups.Results:The Visual Analogue Scale of pain, the time of needle pulling were (4.01±0.89) points, (2.71±0.52) min in the control group, and (1.84±0.84) points, (1.86±0.39) min in the experimental group, the differences were statistically significant ( t values were -21.70, -16.02, P<0.01). The incidence of needle stick injury was 4.00% (6/150) in the control group and no needlestick injury event occurred in the experimental group, the difference was statistically significant (Fisher exact probability, P<0.05). Conclusions:The modified method of dressing fixation can effectively reduce the pain during needle pulling, reduce the incidence of needle stick injury, and effectively shorten the time of needle pulling.