Objective:To study the characteristics of mathematical cognitive function in children with sleep-disordered breathing(SDB) by event-related potential (ERP).Methods:From October 2020 to October 2022, totally 22 cases of SDB children and 22 cases of normal children aged 8-11 were selected.All subjects performed mathematic tasks including calculating and deciding.The EEG changes and behavioral data of children with SDB and normal children were recorded.The latency and amplitude of N1, P2, N2, P3 in leads Fz were measured and compared by Matlab. SPSS 23.0 software was used for statistical analysis, and t test or Mann Whitney U test were used for two independent sample data. Results:(1)Behavior test: the interaction effect between group and type, the group main effect, and the type main effect in accuracy between SDB group and normal group were not significant ( F=0.470, 3.590, 0.003, all P>0.05). The group main effect and interaction effect between group and type in reaction time between SDB group and normal group were not significant ( F=0.465, 1.991, both P>0.05), while the type main effect was significant ( F=18.010, P<0.05). (2)ERP test: the N2, P3 latencies for addition in children with SDB were longer than those in normal group(N2: (371.38±34.23)ms vs (348.12±26.34)ms; P3: (610.72±64.78)ms vs (529.05±30.25)ms)( t=2.526, 5.358, both P<0.05). There was no significant difference between SDB group and normal group in ERP latency and amplitude for subtraction(both P>0.05). The N2, P3 latencies for multiplication in children with SDB were longer than those in normal group(N2: (439.20±24.28)ms vs (351.14±25.26)ms; P3: (531.71±35.42)ms vs (415.23±19.01)ms)( t=11.792, 13.590, both P<0.05). The P3 amplitudes in children with SDB was higher than that in normal group(P3: (3.16±4.78)μV vs (0.38±3.27)μV)( t=2.248, P<0.05). The P3 latency for correct judgment in children with SDB was longer than that in normal group(P3: (420.38±34.79)ms vs (398.54±33.71)ms)( t=2.115, P<0.05). The P3 latency for wrong judgment in children with SDB was longer than that in normal group(P3: (475.25±51.11)ms vs (414.88±27.53)ms)( t=4.878, P<0.05). Conclusion:The latency of N2 and P3 in ERP of SDB children is prolonged, and P3 latency is more sensitive than N2, indicating that SDB children have impairment of mathematical cognitive function.The latency changes of N2 and P3 occurs earlier than the behavioral changes (reaction time and accuracy), which can be used as one of the electrophysiological indicators for early assessment of mathematical cognitive impairment in SDB children.

Vaccination is the most cost-effective measure to prevent infectious diseases in both children and adults. At present, the global burden of infectious diseases in adults is still heavy. With the continuous development and improvement of vaccines, vaccination has shown great potential to prevent infectious diseases, further reduce the morbidity and mortality of infectious diseases in adults and improve people's life quality. This article summarizes the current status of adult immunization, immunization strategies of representative countries, different adult vaccination strategies, and the advantages and challenges of adult immunization to provide reference for further exploring adult immunization strategies and improving adult vaccination recommendations. More attention should be paid to the immunization strategies for different adult populations, and effective measures should be taken to improve the vaccination coverage for the better protection of people's life and health.

Influenza is a contagious respiratory disease caused by influenza viruses, and the burden of severe disease is commonly seen in high risk populations. Influenza vaccination is an effective way to prevent influenza and its complications, especially for high risk populations. Although some countries have included influenza vaccine in their national immunization programs, influenza vaccination rates remain low globally in high risk populations. The influenza vaccine in China is still a non-immunization program vaccine that is voluntarily vaccinated at its own expense, and the influenza vaccine immunization strategy is different across the country. There is still a gap between the vaccination rate of the influenza vaccine and that of developed countries. It is an urgent problem to further optimize the whole population immunization strategy of influenza vaccine in China, strengthen the publicity of the whole population immunization strategy of influenza vaccine, and reduce the disease burden of influenza in China.

Objective To investigate the role of human umbilical cord mesenchymal stem cell-derived extracellular vesicle (hUC-MSC-EV) in the regeneration of fibrotic liver. Methods C57BL/6 mice were randomly divided into the 70% normal liver resection group (Oil+PHx group), 70% liver fibrosis resection group (CCl₄+PHx group) and 70% liver fibrosis resection+mesenchymal stem cell-derived extracellular vesicle (MSC-EV) treatment group (CCl₄+PHx+MSC-EV group), with 8 mice in each group. LX-2 cell lines were assigned into the phosphate buffer solution (PBS) group, transforming growth factor (TGF)-β group and TGF-β+MSC-EV group. The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) in mice after partial liver resection were detected in each group. The expression levels of liver fibrosis and proliferation-related parameters were analyzed in each group. The messenger RNA (mRNA) expression levels of epidermal growth factor (EGF), fibroblast growth factor (FGF), vascular endothelial growth factor (VEGF) and hepatocyte growth factor (HGF) in LX-2 cells were detected in each group, and their effects on HGF expression in mouse liver were observed. Results Compared with the Oil+PHx group, the serum levels of AST, ALT and LDH were up-regulated, and the degree of fibrosis was more severe, the positive area of Sirius red and α-smooth muscle actin (α-SMA) staining was larger, and the expression level of α-SMA protein was up-regulated in the CCl₄+PHx group. Compared with the CCl₄+PHx group, the serum levels of AST, ALT and LDH were decreased, the degree of fibrosis was slighter, the positive area of Sirius red and α-SMA staining was decreased, and the expression level of α-SMA protein was down-regulated in the CCl₄+PHx+MSC-EV group, and the differences were statistically significant (all P < 0.05). Compared with the Oil+PHx group, the protein expression levels of Ki67 and proliferating cell nuclear antigen (PCNA) were lower in the CCl₄+PHx group. Compared with the CCl₄+PHx group, the protein expression levels of Ki67 and PCNA were increased in the CCl₄+PHx+MSC-EV group, and the differences were statistically significant (all P < 0.05). Compared with the PBS group, the expression level of CollagenⅠ mRNA in LX-2 cells was increased, the expression level of α-SMA protein was up-regulated and the expression level of HGF protein was decreased in the TGF-β group. Compared with the TGF-β group, the expression level of CollagenⅠ mRNA in LX-2 cells was decreased, the expression levels of HGF mRNA and protein were increased, and the expression level of α-SMA protein was decreased in the TGF-β+MSC-EV group, the differences were statistically significant (all P < 0.05). The expression level of HGF protein in the CCl₄+PHx group was lower than that in the Oil+PHx group, whereas the difference was not statistically significant (P > 0.05). The expression level of HGF protein in the CCl₄+PHx+MSC-EV group was higher than that in the CCl₄+PHx group, and the difference was statistically significant (P < 0.05). Conclusions The regenerative capacity of fibrotic liver is weaker than that of normal liver. hUC-MSC-EV may alleviate liver fibrosis and improve liver regeneration by promoting HGF secretion from actived hepatic stellate cells and effectively enhancing the regenerative capacity of fibrotic liver.

Objective:To investigate the application effect of situational simulation combined with the Debriefing-GAS method in the teaching of prenatal genetic counseling.Methods:A total of 30 medical students of the five- and eight-year programs in the classes of 2017 and 2018 who received genetic counseling training in The First Affiliated Hospital of Sun Yat-sen University from May 2021 to May 2022 were selected as research subjects, and situational simulation combined with the debriefing-GAS method was used for the teaching of prenatal genetic counseling. Assessment was performed by the teacher to evaluate the change in genetic counseling abilities during the teaching process, and a questionnaire survey was conducted to investigate the degree of satisfaction with teaching among the students. SPSS 26.0 software was used for data analysis; normally distributed continuous data were expressed as mean±standard deviation, non-normally distributed continuous data were expressed as M d(P 25,P75), and categorical data were expressed as frequency and rate; the paired samples t-test was used for comparison of assessment scores before and after teaching. Results:After teaching, there were significant increases in the assessment scores of genetic counseling [(74.5±18.6) points vs. (87.2±14.5) points, t=4.10, P<0.001] and comprehensive abilities such as clinical ability [(35.4±9.6) points vs. (41.1±6.9) points, t=3.72, P=0.001], doctor-patient communication [(17.5±4.6) points vs. (20.8±3.8) points, t=4.34, P<0.001], professional literacy [(11.0±2.5) points vs. (12.5±2.3) points, t=2.89, P=0.007], teamwork [(3.5±1.0) points vs. (4.2±0.8) points, t=3.67, P=0.001], and organizational effectiveness [(7.1±2.0) points vs. (8.3±1.7) points, t=2.94, P=0.006]. The questionnaire survey showed that the degree of satisfaction among students was rated above satisfaction for the reasonability of the implementation process and links of genetic counseling teaching [3.0 (3.0, 4.0) points], teaching quality [3.5 (3.0, 4.0) points], whether the teaching model could effectively increase the interest and initiative in learning [4.0 (3.0, 4.0) points], the improvement in theoretical knowledge [4.0 (3.0, 4.0) points], communication skills in genetic counseling [3.0 (3.0, 4.0) points], and the understanding of related techniques and application prospect [3.0 (3.0, 4.0) points]. However, two students (6.7%) thought that this teaching model could not efficiently reach teaching objectives, since the teaching process was slightly complicated. Conclusions:Situational simulation combined with the debriefing-GAS method has achieved a good effect in the teaching of prenatal genetic counseling and can help undergraduates to master the theoretical knowledge of prenatal genetic counseling and improve their comprehensive clinical abilities, with a relatively high degree of satisfaction, and therefore, it holds promise for clinical application.

Objective:To explore the vigilant attention function and behavioral changes in sleep disordered breathing(SDB) children.Methods:Thirty SDB children (SDB group) and 30 normal children (control group) were selected from June 2022 to August 2023. All participants underwent continuous performance test(CPT-AX) (Go/Nogo) and behavioral test. The latency and amplitude of contingent negative variation(CNV) components under cue/uncue conditions in leads F3, Fz and F4 were measured. The t-test and Mann-Whitney U test were used to conduct statistical analysis by SPSS 25.0 software. Results:(1) There were no statistically significant differences in the number of correct responses, reaction time and number of false alarms between the SDB group and the control group (all P>0.05).(2) The latencies of cue-CNV in the SDB group(F3: 618.00(582.50, 644.50)ms, Fz: 603.00(579.50, 634.00)ms, F4: (606.87±25.07)ms) were longer than those in the control group(F3: (508.47±25.82)ms, Fz: 502.00(470.00, 520.50)ms, F4: 514.00(487.00, 536.50)ms) in leads F3, Fz and F4. The latency of cue-CNV of lead F4 in the SDB group was higher than that in the control group, and the difference was statistically significant ( P<0.05). The latencies of uncue-CNV in lead F3 and Fz in the SDB group were higher than those in the control group, and the differences were statistically significant (both P<0.05). Conclusion:SDB children have shown activation in the right brain area during attentional tasks, and the prolonged CNV latency may be a sensitive neuroelectrophysiological marker for early clinical assessment of vigilant attention dysfunction.

Objective:To explore the cognitive function characteristics of children with primary snoring (PS) and obstructive sleep apnea-hypopnea syndrome (OSAHS) using event-related potentials.Methods:From October 2020 to October 2022, 20 children with OSAHS, 20 children with PS, and 22 normal children were recruited for continuous performance task (CPT) and behavioral assessments. ERP and behavioral data were meticulously recorded, with measurements of N1, P2, N2, and P3 wave amplitudes and latencies at F3, Fz, and F4 electrode sites. Statistical analyses were conducted using one-way ANOVA and Kruskal-Wallis test via SPSS 25.0 software.Results:(1) Behavioural test: There was no statistically significant difference in terms of correct responses, response times, and false alarms among the three groups (all P>0.05). (2) F3 Lead: There were statistically significant differences in Go-P2 amplitude, Nogo-P2 amplitude, Nogo-P2 latency, Go-P3 amplitude, and Nogo-P3 latency among the three groups (all P<0.05). Specifically, the OSAHS group exhibited higher Go-P2 amplitude((15.03±5.12) μV vs (10.97±5.50)μV), Nogo-P2 amplitude((14.80±5.84) μV vs (9.67±4.79)μV), and Go-P3 amplitude((11.58±6.02) μV vs (7.49±4.89) μV) compared to the normal group. Additionally, the OSAHS and PS groups exhibited longer Nogo-P2 latency compared to the normal group((223.10±20.61) ms vs (208.00±23.09) ms, (230.60±13.61) ms vs (208.00±23.09) ms), as well as prolonged Nogo-P3 latency((459.20±34.26) ms vs (460.40±24.52) ms and (429.91±31.49) ms) (all P<0.05). Fz Lead: There were statistically significant differences in Go-N1, Go-P2, Nogo-P2, Go-P3, Nogo-N2 wave amplitudes, and Nogo-P3 latency among the three groups (all P<0.05). Compared to the normal group, the OSAHS group exhibited increased Go-P3 amplitude((9.07±5.68) μV vs (5.10±3.51) μV) and decreased Nogo-N2 amplitude((-8.80±5.97) μV vs (-12.84±4.86) μV). Moreover, both the OSAHS and PS groups had prolonged Nogo-P3 latency compared to the normal group((481.60±45.16) ms vs (435.13±28.17) ms and 484.00(443.50, 525.00) ms vs (435.13±28.17) ms) (both P<0.05). F4 Lead: There were statistically significant differences in Go-P2 and Nogo-P2 wave amplitudes among the three groups (all P<0.05). Compared to the normal group, the OSAHS group demonstrated increased Go-P2 amplitude((13.72±5.64) μV vs (9.70±4.59) μV) and Nogo-P2 amplitude((13.90±5.35) μV vs (9.64±3.74) μV) (both P<0.05). Conclusions:Both children with OSAHS and PS exhibit attentional cognitive impairments. However, children with OSAHS demonstrate more pronounced deficits in conflict monitoring, response inhibition, and executive functioning. The prolonged latency of the P3 wave serves as a sensitive electrophysiological marker for the early detection of neurocognitive impairment in children with sleep disordered breathing.

Natural products, as a gift of nature to humanity, have long been used as drugs or pharmacological actives to help people cure various diseases. Yet we still know comparatively little about their ability to be materials. In recent years, some small molecule natural products isolated from traditional Chinese medicines have been found to have new features, namely, self-assembly to form gels (., natural product gels, NPG). However, the application development of these natural products is seriously lacking, which greatly weakens their practical value and delays the maturity of the field. Here, a series of self-assembled triterpenoid natural products are used as materials (gel scaffolds) to construct drug delivery systems. Surprisingly, these NPG not only exhibit the excellent self-healing, controlled gelation, good safety and sustained release, but also achieve synergistic treatment of tumors through bioactive natural products. Compared with non-bioactive gel scaffolds, NPG scaffolds show great advantages in tumor therapy, including optimal tumor inhibition, preferable health, better body recovery, stronger immune function, less toxic side effects and longer survival. The successful construction of NPG scaffolds not only takes full advantage of the self-assembled natural products, but also takes an important step in the development of new applications for natural products.

Immunotherapy combined with effective therapeutics such as chemotherapy and photodynamic therapy have been shown to be a successful strategy to activate anti-tumor immune responses for improved anticancer treatment. However, developing multifunctional biodegradable, biocompatible, low-toxic but highly efficient, and clinically available transformed nano-immunostimulants remains a challenge and is in great demand. Herein, we report and design of a novel carrier-free photo-chemotherapeutic nano-prodrug COS-BA/Ce6 NPs by combining three multifunctional components-a self-assembled natural small molecule betulinic acid (BA), a water-soluble chitosan oligosaccharide (COS), and a low toxic photosensitizer chlorin e6 (Ce6)-to augment the antitumor efficacy of the immune adjuvant anti-PD-L1-mediated cancer immunotherapy. We show that the designed nanodrugs harbored a smart and distinctive "dormancy" characteristic in chemotherapeutic effect with desired lower cytotoxicity, and multiple favorable therapeutic features including improved ¹O₂ generation induced by the reduced energy gap of Ce6, pH-responsiveness, good biodegradability, and biocompatibility, ensuring a highly efficient, synergistic photochemotherapy. Moreover, when combined with anti-PD-L1 therapy, both nano-coassembly based chemotherapy and chemotherapy/photodynamic therapy (PDT) could effectively activate antitumor immunity when treating primary or distant tumors, opening up potentially attractive possibilities for clinical immunotherapy.

Abstract During the yellow fever epidemic in Angola in 2016, cases of yellow fever were reported in China for the first time. The 11 cases, all Chinese nationals returning from Angola, were identified in March and April 2016, one to two weeks after the peak of the Angolan epidemic. One patient died; the other 10 cases recovered after treatment. This paper reviews the epidemiological characteristics of the 11 yellow fever cases imported into China. It examines case detection and disease control and surveillance, and presents recommendations for further action to prevent additional importation of yellow fever into China.