AIM: To investigate the CPU86017 and its enantiomers inhibit abnormal gene expression of calcineurin and NFκB in rat cardiomyopathy induced by L-thyroxin and compare the effect of CPU86017 (racemate) with its 4 enantiomers: (7S, 13R), (7S, 13S), (7R,13S), and (7R,13R)-CPU86017 in this model. METHODS: The animals were randomly divided into 7 groups. The rat hypertrophied model was produced by treatment with L-thyroxin 0.2 mg·kg-1·d-1, sc for 10 d and treated with CPU86017 or its enantiomers 4 mg·kg-1·d-1, sc from d 6 to d 10. The changes in left ventricular (LV) weight index, redox system, and the NO and iNOS activity in the myocardium were investigated. The expression of mRNA of calcineurin、NF-κB in the left ventricle was measured. RESULTS: There were significant cardiac hypertrophy and oxidative stress in rats treated by L-thyroxin. The expression of calcineurin, NFκB mRNA were upregulated (P<0.05, compared with that of control). After treatment with CPU86017 (racemate and enantiomers), LV remodeling and the redox system were improved. CPU86017 and (7S,13R)-CPU86017 showed a better improvement on LV remodeling and the redox than the other isomers and restored the normal expression of calcineurin, NF-κB (P<0.05, P<0.01), respectively. CONCLUSION: It suggested that an up-regulation of calcineurin and NFκB possibly related to the altered intracellular calcium handling system plays a role in the progression of L-thyroxin induced cardiomyopathy and CPU-86017 and its 7S,13R-CPU86017 enantiomer effectively inhibit the abnormal expression of calcineurin and NFκB genes, the NOS enzyme and oxidant stress in the cardiomyopathy.

Objective:To analyze the clinical characteristics and SLC25A13 gene mutation in children with neonatal intrahepatic cholestasis caused by citrin deficiency(NICCD).Methods:The data of 18 children diagnosed with NICCD in Xi′an Children′s Hospital from January 2014 to December 2018 were collected.The clinical manifestations, biochemical characteristics, SLC25A13 gene mutation and prognosis were analyzed.Results:All the 18 cases of NICCD were from North China and the age of initial diagnosis averaged(63.4±19.5)days.The clinical manifestations included jaundice(100%), light yellow or white stool(38.9%), growth retardation(27.8%)and so on.All patients had cholestasis.Of 18 cases, the levels of glutamyltranspeptidase, total bile acid and alpha fetoprotein were all increased, and serum albumin was decreased.Elevated aspartate aminotransferase(94.4%), elevated glutamic pyruvic transaminase(72.2%), prolonged prothrombin time(88.9%), hyperlactemia(83.3%), hypoglycemia(77.8%), anemia(66.7%)and other biochemical abnormalities were observed.Citrulline and other serum amino acids of all cases were elevated in blood samples by tandem mass spectrometry.The increase of 4-hydroxyphenyllactate and 4-hydroxyphenylpyruvate was found in 70%(7/10)urine samples by gas chromatography.Age was negatively correlated with total bile acid( r=-0.469, P=0.049), and positively correlated with blood ammonia, threonine, methionine, ornithine and tyrosine( r=0.472, 0.690, 0.698, 0.678 and 0.769, respectively, P<0.05). A total of 16 SLC25A13 gene mutations were detected, of them c. 851_854del(33.3%)and c. 1638_1660dup(19.4%)were the most common.c.1841+ 3_1841+ 4del, c.980_981del(p.E327Vfs*45)and c. 602A>T(p.E201V)were novel mutations.Among the 17 children who were followed up, 1 case died and 16 cases had normal biochemical parameters within 1 year. Conclusion:The characteristic biochemical changes are helpful for early recognition of NICCD.The prognosis of NICCD is good if the treatment is appropriate and timely.c.851_854del and c. 1638_1660dup are high-frequency mutations of SLC25A13 gene in north China.

BACKGROUND:Silver nanoparticles (AgNPs) show strong antibacterial effect and are not easy to have drug resistance. But the antibacterial mechanisms of AgNPs have not been wel developed.
OBJECTIVE:To explain the antibacterial mechanisms of AgNPs.
METHODS:We investigated the influence of Ti, TiO2 and TiO2 containing AgNPs onEscherichia coliand Staphylococcus aureus by bacterial inhibition ring test. Escherichia coli was cultured in LB liquid medium with 0, 5, 10 mg/L AgNPs. We measured the absorbance value of bacterial culture. DNA gel electrophoresis was used to study the effect of AgNPs onEscherichia coliDNA. Then we researched the character of apoptosis on Escherichia coli by Annexin V and PI staining, using flow cytometry.
RESULTS AND CONCLUSION:The inhibiting effect of Ti and TiO2 onEscherichia coliandStaphylococcus aureus was not obvious. But the inhibition rings of TiO2 containing AgNPs to bacteria appeared. The absorbance value of Escherichia coliculture was reduced whenEscherichia coliwas co-cultured with AgNPs. And this decrease tendency was in direct proportion with AgNPs concentration. AgNPs reduced the amount of DNA of Escherichia coli and this tendency was directly proportional with AgNPs concentration. TheEscherichia coli apoptosis rate induced by AgNPs was increased and this tendency was positively correlated to the AgNPs concentration. These results indicate that AgNPs can induce bacterial apoptosis to influence the growth of bacteria.

Objective To explore the influencing factors of fear of progression among postoperative elderly patients with prostatic cancer. Methods From December 2016 to December 2017, we selected 404 elderly prostatic cancer patients with surgical treatment of Urinary Surgery in Tangshan People's Hospital as subjects by purposive sampling. All of the patients were investigated with the Fear of Progression Questionnaire-Short Form (FoPQ-SF), Readiness for Hospital Discharge (RHD), the Chinese Version of the M. D. Anderson Symptom Inventory and Family Adaptability and Cohesion Scale Ⅱ (FACES Ⅱ). Binary Logistic regression was used to analyze the influencing factors of fear of progression among postoperative elderly patients with prostatic cancer. Results The total of 404 elderly prostatic cancer patients were divided into two groups according to FoPQ-SF, 202 patients with the score of FoPQ-SF less than or equal to 34 in control group and 202 patients with the score of FoPQ-SF more than 34 in case group. There were statistical differences in ages, family support, clinical stages, scores of Gleason, symptom distress and readiness for hospital discharge of patients between two groups (χ2=10.164, 24.762, 21.083, 21.052, 21.915, 25.783;P＜ 0.05). Logistic regression analysis showed that the influencing factors of fear of progression among postoperative elderly patients with prostatic cancer included ages, family support, readiness for hospital discharge, symptom distress and scores of Gleason (P＜ 0.05). Conclusions Fear of progression among postoperative elderly patients with prostatic cancer is affected by many factors. Improving patients' readiness for hospital discharge will help to lower the fear of progression of patients.

The pelvis is one of the most likely affected areas of the human body in case of side impact, especially while people suffer from motor vehicle crashes. With the investigation of pelvis injury on side impact, the injury biomechanical behavior of pelvis can be found, and the data can help design the vehicle security devices to keep the safety of the occupants. In this study, a finite element (FE) model of an isolated human pelvis was used to study the pelvic dynamic response under different side impact conditions. Fracture threshold was established by applying lateral loads of 1000, 2000, 3000, 4000 and 5000 N, respectively, to the articular surface of the right acetabulum. It was observed that the smaller the lateral loads were, the smaller the von Mises stress and the displacement in the direction of impact were. It was also found that the failure threshold load was near 3000 N, based on the fact that the peak stress would not exceed the average compressive strength of the cortical bone. It could well be concluded that with better design of car-door and hip-pad so that the side impact force was brought down to 3000 N or lower, the pelvis would not be injured.
Accidents, Traffic ; Biomechanical Phenomena ; Computer Simulation ; Finite Element Analysis ; Fractures, Bone ; physiopathology ; prevention & control ; Humans ; Pelvis ; injuries ; Stress, Mechanical

Objective: To survey the prevalence and distribution of sleep disorders in patients with Parkinson disease (PD) and to analyze the influencing factors. Methods: The prevalence and distribution of sleep disorders were surveyed with Parkinson Disease Sleep Scale (PDSS) among 206 PD patients. The association of sleep disorders with age, course of disease, cognitive function, motor function, depression, and the equivalent dose of levodopa (LED) was analyzed. Results: The overall PDSS score in 206 patients was (116.9±21.4). The three most frequent items of sleep disorders were the overall sleep quality(181/206, 87.9%), difficulty in maintaining sleep(160/206, 77.7%)and nocturnal enuresis(151/206, 73.3%); the three least frequent items were early awaking(87/206, 42.2%), urinary incontinence(56/206, 27.2%)and hallucination(44/206, 21.4%). The three items with the lowest average scores were nocturnal enuresis(6.9±3.1), difficulty in maintaining of sleep(7.1±2.7)and overall sleep quality(7.1±2.0); three items with the highest average scores were audiovisual illusion(9.3±1.8), incontinence caused by motion disability(9.0±2.1) and early awaking with upper and lower limb pain(8.7±2.1). PD patients were divided into group 1 [Hoehn-Yahr(H&Y) stage 1.0-1.5], group 2 (H&Y stage 2.0-2.5) and group 3 (H&Y stage 3.0-4.0). One-way analysis of variance or non-parametric test showed that there were significant differences in the course of disease(F=21.91, P=0.00), total score and the subscale scores of Unified Parkinson Disease Rating Scale(UPDRS, UPDRS Ⅰ-Ⅳ) (F=90.67, χ²=12.86, F=31.20, F=60.17, χ²=24.01, all P<0.01), the Hamilton Rating Scale for Depression(HAMD) scores (χ²=11.06, P=0.00), LED (F=14.93, P=0.00) and Minimum Mental State Examination(MMSE) scores (χ²=9.81, P=0.01) among three groups. There was no significant difference in age and PDSS scores among three groups. The results showed that there were significant differences in terms of restless state and nocturnal dysphoria (F=5.12, P=0.01; F=3.27, P=0.04) between group 1 and group 3. The linear regression analysis showed that the HAMD and the LED scores had the greatest influence on PDSS score (R²=0.142, 0.196). Conclusion PD patients have a variety of sleep symptoms. The treatment of large doses of dopamine and depression contribute to the occurrence of PD sleep disorders.

Objective:To investigate the epidemiological and clinical characteristics of visceral leishmaniasis (VL) in children, and to analyze the distinguishing features of VL associated hemophagocytic lymphohistiocytosis (HLH), so that to provide reference for the diagnosis and treatment of VL.Methods:Forty-one children with VL admitted to Xi′an Children′s Hospital from July 2012 to June 2021 were enrolled. The clinical data were retrospectively analyzed, including epidemiology, clinical manifestations, laboratory data, diagnostic methods, treatment regimens and outcomes. The patients were divided into VL group and VL+ HLH group according to whether combined with HLH or not, and the clinical characteristics and laboratory findings of the two groups were compared. Two independent samples t test, Mann-Whitney U test and chi-square test were used for statistical analysis. Results:Forty-one children with VL were from different provinces, including Shaanxi Province (70.73%(29/41)), Gansu Province (14.63%(6/41)), Shanxi Province (12.20%(5/41)) and Ningxia Hui Autonomous Region (2.44%(1/41)), and 87.80%(36/41) of them lived in rural areas. The peak age was >1.0 to 3.0 years old (63.41%(26/41)). They were sporadic throughout the year. The main clinical manifestations included fever (97.56%(40/41)), splenomegaly (95.12%(39/41)), lymphadenopathy (82.93%(34/41)) and hepatomegaly (60.98%(25/41)). The numbers of cases that Leishman-Donovan bodies were detected in the first, second and third bone marrow smears were 36, four and one, respectively. Anemia, thrombocytopenia and leukopenia detected by blood routine test were 100.00%(41/41), 78.05%(32/41) and 58.54%(24/41), respectively. There were statistically significant differences in the platelet count, lactate dehydrogenase, alanine aminotransferase, triglycerides, fibrinogen and ferritin between VL group (28 cases) and VL+ HLH group (13 cases) ( t=-2.56, t=2.64, Z=-2.66, t=7.15, t=-5.76 and t=3.86, respectively, all P<0.050). The proportions of hepatomegaly and hemophagocytes found in the bone marrow smears in VL group were both lower than those in VL+ HLH group, and the differences were both statistically significant ( χ2=4.47 and 10.93, respectively, both P<0.050). Twelve cases with VL+ HLH were treated with antimony (for six days) and intravenous immunoglobulin, and the others were treated with antimony only. The cure rates of the patients treated with antimony for one and two courses were 92.68%(38/41) and 4.88%(2/41), respectively. The dose of antimony was increased one third and treatment course was prolonged to eight days in one cured case. After (41.36±31.49) months of follow-up, three cases recurred after five to eight months of cure and all of them were cured after one more course of treatment with antimony. Conclusions:Children with VL are mainly distributed in rural areas. The common clinical manifestations are fever and involvement of reticuloendothelial system, which are not specific. The positive rate of Leishman-Donovan bodies found in bone marrow smears is high, and a few negative cases need repeated bone marrow aspiration. Standardized treatment with antimony for VL in children is effective, and combination therapy with immunoglobulin can be considered if patients with VL associated HLH. Very few cases may recur and antimony is still effective.

Objective To detect the changes of 25-hydroxy vitamin D (25-OH-D) and blood calcium concentrations in the serum of prostate cancer (Pca) patients with bone metastases,and to analyze the correlation between bone calcium metabolism and bone metastasis of prostate cancer.Methods The 35 untreated prostate cancer patients without bone metastases,30 patients with bone metastasis of prostate cancer,and 30 healthy controls were selected,and fluorescent immune chromatography was used to determine the content of 25-OH-D,the Azo arsenic method was used to detect the blood calcium level,and ROC curve was used to analyze the value of two indexes in diagnosing prostate cancer bone metastases.Results The blood calcium content in bone metastasis of prostate cancer group was significantly higher than the other groups (P ＜ 0.05),and the prostate cancer group had a higher blood calcium content than healthy controls (P ＜ 0.05).For 25-OH-D content,bone metastases of prostate cancer group was significantly lower than the other groups (P ＜0.05).25-OH-D level showed a negative correlation with blood calcium in each group (r =0.628,P ＜ 0.05).The ROC curve showed levels of blood calcium and 25-OH-D in the diagnosis of bone metastases of prostate cancer were 0.763 and 0.712.Conclusion The high blood calcium and low vitamin D levels may be an effective predictor for bone metastases of prostate cancer.

Objective: To evaluate the characteristics and related factors of physical activities both inside and outside the kindergarten among preschool children, so as to provide a reference for promoting targeted physical activities among different types of children in the future. Methods: From April 2016 to December 2022, 706 preschool children aged 3 to 6 years from the Shanghai parent child cohort followed up. Accelerometers were used to measure their physical activities during kindergarten hours, and a parent questionnaire was employed to assess their physical activities and screen time outside the kindergarten. Restrictive cubic spline analysis was used to examine the relationship between moderate to vigorous physical activities (MVPA) inside and outside the kindergarten. Cluster analysis was performed to identify physical activity patterns among children, and multinomial Logistic regression analysis was conducted to explore the influencing factors of these physical activity patterns. Results: On weekdays, preschooler accumulated an average of (40.83±15.71) minutes of MVPA inside the kindergarten and 30(15, 53) minutes outside daily. Restricted cubic spline analysis revealed an inverted U shaped relationship between MVPA inside and outside the kindergarten. Cluster analysis identified four groups: low daily MVPA but active inside (196, 27.8%), moderate daily MVPA but high screen time outside (97, 13.7%), adequate daily MVPA and relatively active outside (96, 13.6%), and low daily MVPA and relatively inactive both inside and outside (317, 44.9%). Compared to the reference group of adequate daily MVPA and relatively active outside, children with screen time exceeding 60 minutes at 2 years old were more likely to belong to the group with adequate daily MVPA but more screen time outside ( OR =3.84, 95% CI =1.16-12.74, P <0.05). Boys had a lower likelihood of being in the group with low daily MVPA and relatively inactive both inside and outside ( OR =0.33, 95% CI =0.16-0.70, P <0.05). Children from neighborhoods with insufficient sport facilities were more likely to be in the low daily MVPA and relatively inactive group ( OR =2.20, 95% CI = 1.05 -4.63, P <0.05). Conclusions Behavior patterns of physical activity and screen time for both inside and outside the kindergarten vary greatly among different children. Screen time at the age of 2 and the sports facilities around the commuinty are key factors influencing the physical activity pattern. It is recommended to implement personalized intervention plans in collaboration with schools and families for different types of children.

Objective: To investigate the distribution of various types of screen time and examine the association of screen time with psychological and behavioral development problems in children aged 3-6 years, so as to provide scientific basis for children s screen use and mental health promotion. Methods: A total of 3 875 mother child dyads who completed the follow up in Shanghai Maternal-Child Pairs Cohort were included. The daily usage time of children s tablet, mobile phone, TV, projectors, and other types of screens were obtained in questionnaire survey. Children s psychological and behavioral development problems were evaluated by Age-Stage Questionnaire, Third Edition (ASQ-3) and Strengths and Difficulties Questionnaire (Parent version) (SDQ). The Chi-square test, Mann Whitney U and Kruskal Wallis rank sum test were used to compare the detection rate of psychological and behavioral development problems and screen time in children with different characteristics. Multivariate binary Logistic regression was used to analyze the association of screen time with psychological and behavioral development problems. Results: There were 49.91% of children having screen time more than 1 h/d. Children s TV, tablet and mobile phone screen time were 0.39(0.25, 0.96 ), 0.25(0,0.61) and 0.18(0,0.25) h/d. The detection rates of suspected developmental delay in fine motor, problem solving and personal-social domains and pro social behavior deficiency and externalizing behaviors in boys (8.54%, 6.77%, 5.46%, 30.07 %, 27.39%) were higher than that in girls (4.64%, 4.85%, 2.48%, 22.10%, 22.36%) ( χ 2=23.76, 6.49, 22.37, 31.81, 13.06, P <0.05). There were statistically significant differences in the detection rates of suspected developmental delay in communication, fine motor and problem solving, as well as internalizing behavior and externalizing behavior of children with different parents educational levels ( χ 2=14.37, 15.18, 21.10, 11.66, 9.27; 16.34, 26.75, 32.89, 16.97, 6.37, P <0.05). There were significant differences in the detection rates of suspected developmental delay in problem solving, prosocial behavior deficiency, internalizing behavior and externalizing behavior of children whose mothers had anxiety/depression symptoms during pregnancy ( χ 2= 5.61 , 9.05, 21.90, 7.17; 8.75, 6.06, 12.76 , 5.55, P <0.05). The average total screen time of boys was longer than that of girls (1.07, 1.00 h/d, Z=-2.08, P =0.04). Compared with children with other educational levels of their parents, the total screen time, mobile phone and TV screen time of children whose parents had college education or above were short (father: H =42.01, 44.49 , 21.24, mother: H =42.31, 39.21 , 26.47, P <0.01). Among all types of screen time, mobile phone screen time had the most impact on psychological and behavioral development. More mobile phone screen time increased the risk of suspected developmental delay and abnormal emotional behavior ( P < 0.05). Screen time of tablet, mobile phone and TV were positively correlated with externalizing behavior ( OR=1.36, 1.57, 1.27 , P <0.05). Conclusions Screen time is related to children s psychological and behavioral development problems and mobile phones affect the most. Parents should limit their children s screen time to avoid excessive screen time affecting their psychological and behavioral development.