Objective To evaluate the detection of membrane neutrophilic alkaline phosphatase ( mNAP) by flow cytometry in diagnosis of bloodstream infection .Methods A total of 298 patients with suspected bloodstream infections admitted in the First People ’ s Hospital of Lianyungang during June 2013 and October 2014 were enrolled;80 healthy subjects in physical examination center were also enrolled as the control group.Bloodstream infection was diagnosed by blood culture and mNAP was detected by flow cytometry.Serum levels of procalcitonin (PCT) and C-reactive protein (CRP) were detected by electro-chemiluminescence (ECL) and immune scatter turbidimetry , respectively.The value of mNAP, PCT and CRP in diagnosing bloodstream infection was determined by receiver operating characteristic ( ROC) curve. Results Among 298 patients, 109 were confirmed with bloodstream infections , including 43 patients with Gram-positive bacterial infections and 66 with Gram-negative bacterial infections .The median levels of CRP , PCT and mNAP in bloodstream infection group were 138.71 mg/L, 7.04 ng/mL and 13 929 AB/c, which were significantly higher than those in healthy control group (1.50 mg/L, 0.12 ng/mL, 1 831 AB/c;U=5.00, 48.50 and 65.01, P<0.01).The expression of mNAP in Gram-positive bacterial infection group was 9 598 ( 6 064-11 643 ) AB/c, which was significantly lower than that in Gram-negative bacterial infection group [16 512 (11 654-22 001) AB/c] (U=250.00, P<0.01).ROC curve analysis showed that, the areas under the curve (AUCs) of mNAP, PCT and CRP in diagnosing bloodstream infection were 0.987, 0.962 and 0.901.When 4 578AB/c, 0.90 ng/mL and 13.50mg/L were taken as optimal cut-off values, the sensitivities of mNAP, PCT and CRP in diagnosis of bloodstream infection were 95.8%, 93.0%and 90.3%; the specificities were 97.8%, 95.6% and 85.5%, respectively.Conclusion Among mNAP, PCT and CRP, mNAP is of the highest value in diagnosing bloodstream infection , and may be used as a biomarker for clinical diagnosis of bloodstream infection .

Objective: To explore the clinical effect of artificial dermis on partial nail bed defects. Methods: From May 2013 to September 2016, 16 cases of 21 fingers with partial nail bed defect and bone exposure received primary repair with artificial dermis after debridement. Then the outer dressing was changed 3 days after the operation, and the dressing was changed once every 3 to 5 days. The pink dermis like tissue was placed on the wound surface 2 to 3 weeks after the operation. The wound surface was naturally epithelialized. Results: All the fingers were survived after artificial dermis repair, and the fingertip surface of nail bed defect was epithelialized naturally and healed well. Postoperative follow-up was 5 to 16 months, with an average of 8.2 months. The growth of fingernails was smooth with symmetrical appearance, natural toughness, good adhesion between the nail body and the nail bed, and no pain or hyperesthesia at the tip. Results of curative effect evaluation showed excellent in 18 fingers, good in 3 fingers. Results of patient′s satisfaction with postoperative finger appearance showed very satisfactory in 13 cases and satisfactory in 3 cases. Conclusions The method of repairing partial defect of nail bed using artificial dermis is simple with minimal damage and a good clinical effect.

Objective:To evaluate the accuracy and stability of Eye-Monitor, a smart wearable device, in quantifying environmental risks related to myopia.Methods:A diagnostic test study was conducted.Forty-two subjects aged 18-25 years old were recruited from Shandong University of Traditional Chinese Medicine in December 2021.Forty-two Eye-Monitors were selected from 80 devices using the simple random sampling method.Static and dynamic tests were carried out to compare environmental risks related to myopia.The static tests included measurements under different working distances, different head tilt angles when sitting, and different light intensities.The dynamic tests included measurements under different near-work time, different outdoor activity time, different time watching computers, and different phone viewing time.Eye-Monitor with the largest sum of absolute values of total relative error was selected, Spearman rank correlation analysis was used to analyze the correlation between the set values and Eye-Monitor measurements, and the accuracy of the objectively measured values was evaluated by Bland-Altman consistency analysis.The stability of the objectively measured values from Eye-Monitor was evaluated by the coefficient of variation.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine (No.HEC-KS-2021005KY). Written informed consent was obtained from each subject.Results:There were significant correlations between the measured values and setting values in the working distance, head tilt angle when sitting, indoor light intensity, total near-work time, average continuous near-work time, outdoor activity time, time watching computers, and time viewing phones ( rs=0.999, 0.998, 0.999, 0.998, 0.976, 0.959, 0.992, 0.997; all at P<0.001), with the 95% limits of agreement (LoA) of-1.23-2.32 cm, -1.49-4.24°, -13.90-26.90 lx, -6.46-0.11 minutes, -4.50-1.20 minutes, -4.01-1.34 minutes, -2.54-1.94 minutes and-2.15-0.45 minutes, respectively.More than 95% of dots were within the clinically acceptable LoA.The coefficients of variation of the measured values ranged from 1.23%-2.99%, 2.39%-8.25%, 0.87%-8.03%, 1.49%-12.52%, 6.63%-13.59%, 0.00%-14.15%, 1.20%-8.33 and 1.49%-12.51%, respectively, showing good stability.Eye-Monitor had good accuracy in measuring outdoor light intensity (95% LoA: -336.50-130.00 lx). Conclusions:The smart wearable device Eye-Monitor can be used to objectively monitor working distance, head tilt angle when sitting, indoor light intensity, total near-work time, average continuous near-work time, outdoor activity time, time watching computers, and time watching phones, which are with good accuracy and stability.

Objective: To investigate the distribution of pupil diameter and its association with myopia in school age children, providing ideas into the mechanisms of the role of pupil diameter in the onset and development of myopia. Methods: Adopting a combination of stratified cluster random sampling and convenience sampling method, 3 839 children from six schools in Shandong Province were included in September 2021. Pupil diameters distribution was analyzed by age, sex, and myopic status. Pearson correlation analysis was used to assess the relationship between pupil diameter and cycloplegic spherical equivalent (SE), as well as axial length (AL) and other variables. Propensity score matching (PSM) was applied to match myopic and non myopic children at a 1∶1 ratio based on age and sex. A generalized linear model (GLM) was constructed with pupil diameter as the dependent variable to identify independent factors influencing pupil size and its association with myopia. Results: The mean pupil diameter of school age children was (5.77±0.80)mm. Pupil diameter exhibited a significant increasing trend with age ( F =49.34， P trend ＜ 0.01). Myopic children had a significantly larger mean pupil diameter [(6.10±0.73)mm] compared to non myopic children [(5.62±0.79)mm] with a statistically significant difference( t=18.10, P <0.01). Multivariable GLM analysis, adjusted for age, amplitude of accommodation, and uncorrected visual acuity, revealed a negative correlation between pupil diameter and cycloplegic SE (before PSM: β =-0.089, after PSM: β =-0.063, both P ＜0.01). Conclusions Myopic school age children exhibite larger pupil diameters than their non myopic counterparts. Pupil diameter may serve as a potential indicator for monitoring myopia development in school age children.

Objective: To investigate the effect of curcumin on the apoptosis and autophagy of human gastric cancer cells with different degree of differentiation. Methods: Gastric cancer cell lines BGC-823 and MKN-28 were treated with curcumin at different concentrations. The effect of curcumin on cell proliferation was measured by MTT assay. Apoptosis was assessed by flow cytometry. Autophagy status was analyzed by acridine orange staining. The expression levels of apoptotic and autophagy-related proteins were detected by Western blot. Results: The cell viability of BGC-823 and MKN-28 was inhibited by curcumin in a time- and dose-dependent manner. At 48 h after treatment, the IC₅₀ value of BGC-823 (15.18 μmol/L) was close to that of MKN-28 (15.84 μmol/L), and the difference was not statistically significant (P=0.513). Meanwhile, flow cytometry showed that curcumin induced the apoptosis of gastric cancer cells in a dose-dependent manner. Western blot results showed that the expression of pro-apoptotic proteins bax, active-caspase-3 and active-caspase-9 was significantly increased in BGC-823 and MKN-28 cells, whereas that of the anti-apoptotic protein bcl-2 was strikingly reduced. In addition, the formation of acidic vesicular organelles in cytoplasm, conversion of LC3-Ⅰ to LC3-Ⅱ and increased levels of autophagy-related proteins Beclin1, Atg7 and Atg5-Atg12 were observed in curcumin-treated cells. Moreover, activation of PI3K/Akt/mTOR signaling pathway was also significantly suppressed after curcumin treatment. Blocking autophagy by adding the autophagy inhibitor 3-methyladenine (3-MA) significantly promoted the apoptotic cell death induced by curcumin. Conclusions Curcumin induces apoptosis and protective autophagy in human gastric cancer cells in vitro. Curcumin combined with autophagy inhibitor may provide a more effective strategy for its clinical application.