AIM: To study the effect of wild-type p53 gene on the differentiation, apoptosis and expression of scavenger receptor CD36 in U937 cells. METHODS: Recombinant adenovirus vector with wild-type p53 gene was constructed and used to transfect U937 cells. With the expression of wild-type p53 gene following adenoviral infection, transfected U937 cells were largely promoted to differentiate into macrophages. RESUITS: Trypanblue-staining test demonstrated that the percentage of positive cells increased from (14.2±5.5)% to (64.6±9.2)% and nitroblue tetrazolium (NBT) reduction test reached similar results (6.3±1.8)% vs (49.7±12.6)%. Furthermore, CD36 mRNA was up-regulated as confirmed by RT-PCR. The increased expression level of CD 36 was also detected by flow cytometry analysis. CONCLUSION: These results suggest that wild-type p53 gene can affect U937 cells differentiation and apoptosis, up-regulate expression of scavenger receptor CD36. It may have a potential significance on atherogenesis.

Objective To identify the pathogen that caused an outbreak of viral encephalitis in Henan area in 2011.Phylogenic analysis was carried out on Coxsackie-virus B5 (CVB5) which was isolated during this outbreak.Methods Five throat swab,21 stool and 14 cerebrospinal fluid (CSF) specimens were collected from 29 inpatients during this outbreak.Viral isolation and real time RT-PCR were then performed for all specimens.Viral nucleic acid of enterovirus 71 (EV71),coxsackievirus A 16 (CA16) and pan-enterovirus (PE)were detected by real time RT-PCR.Phylogenetic tree based on entire VP1 sequences was constructed among CVB5 isolates from 2 stool and 3 CSF specimens of 5 inpatients and others published data retrieved from GenBank.Results The real time RT-PCR results showed that the PE nucleic acid positive rates of throat swab,stool and CSF specimens were 60.0％ (3/5),61.9％ (13/21) and 85.7％ (12/14) respectively.All of these specimens were negative for EV71 and CA16.The isolation rates of throat swab,stool and CSF specimens were 20.0％ (1/5),25.0％ (5/21) and 29.0％ (4/14),respectively.BLAST with both VP1 and 5′-UTR sequences and molecular typing indicated that CVB5 was the main pathogen.Analysis among the 5 positve isolates based on the complete VP1 sequences showed 97.9％-99.5％ homology.Data from homologous comparisons indicated that these isolates had the highest nucleotide acid identity with the Changchun CVB5 CC10/10/Changchun strain (97.1％-98.1％) which caused hand,foot,and mouth disease (HFMD) outbreak in Changchun in 2010,and lower identity (89.0％-89.6％ and 91.8％-92.5％) with the COXB5/Henan/2010 and 03001N strain isolated from Pingdingshan,Henan in 2010 and 2012,respectively.Phylogenetic tree in VP1 region showed that isolates of this outbreak belonged to genotype D,the same clade with Changchun strain.Conclusion CVB5 was the major etiological agent correlated with this outbreak.The shift of predominant genotype might serve as one of the causes that associated with this outbreaks.

Objective: To investigate human enterovirus (HEV) infection and clinical characteristics of viral encephalitis patients in Pingdingshan, Henan Province. Methods: Cerebrospinal fluid specimens and epidemiological information were collected from 274 viral encephalitis patients in the departments of pediatrics and neurology in hospitals in Pingdingshan, Henan Province, from April 2011 to August 2012. Patients with bacterial infections were excluded from the study. Demographic information was collected by questionnaires and clinical information was mainly obtained from hospital examinations. Viral RNA was extracted using magnetic bead extraction. Real-time RT-PCR was then performed for HEV, CV-A16, and EV-A71 testing. SPSS statistical software was statistical analyses. Significant differences were determined using the chi-squared test (P<0.05). Results: Among 274 cases of viral encephalitis, 180 cases (65.7%) were male and 94 cases were female (34.3%). The median age was 2.17 years. Approximately 61.3% (168) of patients were younger than 3 years of age. A total of 107 (39.1%), 2 (0.7%), and 42 (15.3%) cases were positive for HEV, CV-A16, and EV-A71, respectively. Eleven patients were younger than 6 months of age and one patient was co-infected with HEV and EV-A71. In the<3, 3-5, 6-15, and>15 years old age groups, HEV infections comprised 31.5% (53/168), 52.9% (18/34), 53.0% (35/66), and 16.7% (1/6) (χ²=13.10, P=0.003), respectively. The EV-A71 infection rates were 17.9% (30/168), 23.5% (8/34), 6.1% (4/66), and 0 (χ²=8.04, P=0.045), respectively. The other enterovirus (OEV) infection rates were 12.5% (21/168), 29.4% (10/34), 48.5% (32/66), and 16.7% (1/6) (χ²=35.19, P<0.001), respectively. The rate of vomiting in OEV and EV-A71 infected patients was 73% (44/60) and 26% (11/42), respectively, while the frequency of skin rash in OEV and EV-A71 infected patients was 32% (19/60) and 79% (33/42), respectively. Approximately 95% (99/104) of patients infected with HEV had a fever, and the breathing rhythm change rate was 19% (20/104), which was lower than that of patients without HEV infection (36.8% (60/163)) (χ²=9.35, P=0.002). Conclusion In Pingdingshan, HEV was a major causative agent of viral encephalitis and the rate of OEV infection was high, especially in children aged 3-15 years old. Fever was a common clinical symptom of patients infected with HEV. Patients infected with OEV primarily exhibited vomiting symptoms and EV-A71 infected patients showed skin rash.

Objective To explore the role of serum Irisin,Nesfatin-1 and chitinase like protein 40(YKL-40)levels detection in evaluating the condition of patients with multiple sclerosis(MS).Methods A total of 160 MS patients who visited the First Hospital of Handan City from August 2017 to November 2023 were selected as the study subjects.According to clinical classification,they were separated into a remission group(n=115)and a progression group(n=45),and according to the severity of condition,they were separated into a mild group(n=109)and a severe group(n=51).ELISA method was applied to detect the levels of Irisin,Nesfatin-1 and YKL-40 in serum.Pearson was applied to analyze the correlation between serum Irisin,Nesfatin-1,YKL-40 levels and expanded disability status scale(EDSS)score in MS patients.Multivariate Logistic regression was applied to analyze the influencing factors of Ms Necerity.ROC curve was applied to analyze the evaluation value of serum Irisin,Nesfatin-1 and YKL-40 levels for the progression of MS patients.Results In the advanced stage group,the serum levels of Irisin(8.25±2.17 ng/ml)and Nesfatin-1(5.94±1.76 ng/ml)in MS patients were lower than those in the remission stage group(14.94±3.58 ng/ml,9.92±2.15 ng/ml),while the YKL-40(42.98±10.89 ng/ml)level was higher than that in the remission stage group(22.78±7.95 ng/ml),and the differences were statistically significant(t=11.709,11.048,12.956,all P<0.05).In the severe group,the serum levels of Irisin(8.86±2.21 ng/ml)and Nesfatin-1(6.32±1.91 ng/ml)in MS patients were lower than those in the mild group(15.02±4.42 ng/ml,9.96±2.30 ng/ml),while the disease course(5.84±1.65 years)and YKL-40(37.28±10.15 ng/ml)levels were higher than those in the mild group(3.65±1.45 years,24.34±7.62 ng/ml),and the differences were statistically significant(t=8.514,9.407,9.823,8.971,all P<0.05).Serum Irisin and Nesfatin-1 levels in MS patients were negatively correlated with EDSS scores(r=-0.504,-0.517,all P<0.05),while YKL-40 levels were positively correlated with EDSS scores(r=0.509,P<0.05).Irisin(OR=0.724,95%CI:0.589～0.889)and Nesfatin-1(OR=0.813,95%CI:0.669～0.945)were protective factors for disease progression in MS patients,while YKL-40(OR=2.964,95%CI:1.795～4.894)was a risk factor for disease progression in MS patients(all P<0.05).The AUCs of serum Irisin,Nesfatin-1 and YKL-40 levels in evaluating the progression of MS patients were 0.844,0.849 and 0.823,respectively,which were lower than the AUC(0.957)of their combination(Z=3.158,3.096,3.324,all P<0.05).Conclusion Serum Irisin,Nesfatin-1 and YKL-40 detection levels can effectively evaluate the progression of MS patient condition.

Objective To understand the compliance of highly active anti-retroviral therapy (HAART) and influencing factors in people living with HIV/AIDS (PLWHA) in Nanjing. Methods PLWHA receiving HAART in No. 2 Hospital of Nanjing during May-June 2014 were recruited in this study. Self-administrated questionnaire was used to collect the data about HAART compliance and socio-demographic characteristics of PLWHA surveyed. Descriptive and multivariate statistical analysis were conducted to examine the effects of the factors on self-reported HAART adherence. Results A total of 276 PLWHA were surveyed,According to the evaluation criterion of Center for Adherence Support Evaluation (CASE),252 cases showed good compliance (91.3%). logistic regression analysis revealed that smoking,progress of the disease and side effects,reminding of taking drug and age were correlated with self-reported HAART adherence. Conclusion It is suggested to strengthen the education about antiviral therapy compliance in PLWHA with mild infection and those who are smokers and young,suffer from side effects,have no reminding methods for taking drug.

BackgroundChronic superficial gastritis （CSG） is a common clinical disease in children. The emotional behavior of CSG children is susceptible due to them suffering from such disease at young age. ObjectiveTo explore the impact of coping strategies on emotional behavior and the effect of family function in children with CSG， and to provide references for clinical intervention in CSG children with emotional behavior problems. MethodsA total of 177 children with CSG admitted to Anhui Children's Hospital from June 2019 to January 2023 were selected as the research subjects. Investigation on family function， emotional and behavioral problems and coping strategies of children was conducted by employing the Family APGAR index （APGAR）， the Strengths and Difficulties Questionnaire （SDQ） and Coping Strategies Questionnaire （CSQ）. The structural equation model was used to test the mediating effect of family function between coping strategies and emotional behaviors. ResultsThe APGAR score was negatively correlated with both SDQ score and negative coping strategies score （r=-0.507， -0.551， P<0.01）， but was positively correlated with positive coping strategy score （r=0.579， P<0.01）. The positive coping strategy score was negatively correlated with SDQ score （r=-0.539， P<0.01）， while the negative coping strategy score was positively correlated with SDQ score （r=0.543， P<0.01）. The result showed that family function played a partial mediating role between positive coping strategies and emotional behavior ［indirect effect was -0.133 （95% CI： -0.256~-0.079， P<0.01）， accounting for 29.40% of the total effect］. The same mediating effect happened between negative coping strategies and emotional behavior ［indirect effect was 0.093 （95% CI： 0.198~0.045， P<0.01）， accounting for 28.50% of the total effect］. ConclusionCoping strategies of CSG children can affect emotional behavior directly and indirectly with family function playing a partial intermediary effect.

Objective:To explore changes of acid-base metabolism in the brain tissue of patients with chronic ischemic cerebrovascular disease (CICVD) using MRI amide proton transfer-weighted (APTw) imaging.Methods:This was a cross-sectional study. From January 2021 to July 2022, thirty-nine patients with CICVD at West China Hospital, Sichuan University were retrospectively included. All patients received CT perfusion (CTP) and APTw imaging. NeuBrainCARE brain perfusion software was used to analyze the impaired perfusion sites and measure the mean transit time (MTT) and time to peak (TTP). Standard spatial matching between CTP and APTw images was performed to measure the APTw values of the same sites. For comparison with normal tissue, APTw values were measured for normal-appearing white matter (NAWM) in the ipsilateral cerebral hemisphere, the contralateral cerebral hemisphere, and the ipsilateral cerebellar hemisphere in areas of impaired perfusion. ANOVA was used to compare the APTw values of impaired perfusion brain tissue, ipsilateral cerebral NAWM, contralateral cerebral NAWM, and ipsilateral cerebellar NAWM. The Bonferroni method was used to correct for multiple comparisons. Pearson correlation coefficient was used to analyze the correlation between APTw values and MTT and TTP in the cerebral tissue with impaired perfusion.Results:In 39 patients with CICVD, both the mean and minimum APTw values of cerebral tissue with impaired perfusion were significantly lower than those in the NAWM of the ipsilateral cerebral hemisphere, the contralateral cerebral hemisphere, and the ipsilateral cerebellar hemisphere ( P<0.001). In the NAWM of the cerebellar hemispheres with unimpaired perfusion, both the mean and minimum APTw values were significantly higher than those in the ipsilateral cerebral hemispheres and the contralateral cerebral hemisphere ( P<0.001). Correlation analysis showed that MTT was significantly negatively correlated with both the mean APTw and the minimum APTw ( r values were -0.90 and -0.82, P<0.001). TTP was significantly negatively correlated with both the mean APTw and the minimum APTw ( r values were -0.86 and -0.78, P<0.001). Conclusion:APTw value can reflect acidosis in cerebral tissue with impaired perfusion in patients with CICVD.

OBJECTIVETo understand the compliance of highly active anti-retroviral therapy (HAART) and influencing factors in people living with HIV/AIDS (PLWHA) in Nanjing.

METHODSPLWHA receiving HAART in No. 2 Hospital of Nanjing during May-June 2014 were recruited in this study. Self-administrated questionnaire was used to collect the data about HAART compliance and socio-demographic characteristics of PLWHA surveyed. Descriptive and multivariate statistical analysis were conducted to examine the effects of the factors on self-reported HAART adherence.

RESULTSA total of 276 PLWHA were surveyed, According to the evaluation criterion of Center for Adherence Support Evaluation (CASE), 252 cases showed good compliance (91.3%). logistic regression analysis revealed that smoking, progress of the disease and side effects, reminding of taking drug and age were correlated with self-reported HAART adherence.

CONCLUSIONIt is suggested to strengthen the education about antiviral therapy compliance in PLWHA with mild infection and those who are smokers and young, suffer from side effects, have no reminding methods for taking drug.

Acquired Immunodeficiency Syndrome ; drug therapy ; Age Factors ; Antiretroviral Therapy, Highly Active ; Antiviral Agents ; adverse effects ; therapeutic use ; China ; Disease Progression ; HIV Infections ; drug therapy ; Humans ; Medication Adherence ; statistics & numerical data ; Reminder Systems ; Smoking ; Surveys and Questionnaires

The complexity of oral ulcerations poses considerable diagnostic and therapeutic challenges to oral specialists. The expert consensus was conducted to summarize the diagnostic work-up for difficult and complicated oral ulcers, based on factors such as detailed clinical medical history inquiry, histopathological examination, and ulceration-related systemic diseases screening. Not only it can provide a standardized procedure of oral ulceration, but also it can improve the diagnostic efficiency, in order to avoid misdiagnosis and missed diagnosis.
Consensus ; Humans ; Oral Ulcer/therapy*