Objective To explore the risk factors associated with surgery and postoperative recurrence in patients with Crohn's disease (CD).Methods A total of 183 patients diagnosed as CD from January 2008 to December 2013 were enrolled.Forty-six patients after surgery were assigned to surgery group,and 137 non-surgical CD patients were assigned to control group.All the patients were followed up until the endpoint of the study or death,and the follow-up period was at least 12 months.Typing was according to the Montreal classification.The risk factors associated with surgery and postoperative recurrence were analyzed by Logistic regression.Results The surgery rate of CD patients was 25.1 ％ (46/183),the postoperative clinical recurrence rate of surgery group was 39.1％ (18/46),and the recurrence time was 20 months (7～42 months).Before surgery,the rate of definite diagnosis of CD was only 13.0％ (6/46).Stricture (odd ratio (OR)=5.836,95％ confidence interval (CI) 2.199 to 15.487,P＜0.01) and penetration (OR=25.706,95％oo CI 7.091 to 93.190,P＜0.01) were independent risk factors for the surgery.Furthermore,perianal disease(OR=23.550,95％CI 1.311 to 422.912,P=0.032) and lack of prophylaxes treatment after surgery (OR=58.701,95％CI 1.803 to 1 991.000,P=0.022) were independent risk factors for postoperative clinical recurrence.Conclusions Stricture and penetration are risk factors for surgery.Perianal disease and lack of prophylaxes treatment after surgery are risk factors for postoperative clinical recurrence.

Objective: To compare the effect of scalp acupuncture and scalp acupuncture plus acupuncture exercise therapy (AET) on walking ability in children with spastic cerebral palsy (CP). Methods: A total of 60 spastic CP children with gross motor function classification system (GMFCS) grades Ⅰ-Ⅲ were divided into a control group and an observation group by the random number table method, with 30 cases in each group. Both groups were treated with the same conventional rehabilitation and scalp acupuncture therapy for CP. The control group received conventional rehabilitation first and then scalp acupuncture. The observation group received AET, which was to receive the conventional rehabilitation and scalp acupuncture simultaneously. Before and after treatment, the clinical efficacy was evaluated by the modified Ashworth scale (MAS) score, scores of dimensions D and E of the gross motor function measure (GMFM) scale, walking speed, and walking distance. Results: During treatment, there were 2 dropouts in the observation group. After 3 courses of treatment, the MAS scores in both the control group and observation group decreased compared with the same group before treatment (P<0.05), and the scores of dimensions D and E of the GMFM, walking speed, and walking distance were increased (P<0.05); the between-group comparison showed that the MAS score in the observation group was lower than that in the control group (P<0.05), and the scores of dimensions D and E of the GMFM, walking speed, and walking distance in the observation group were higher or longer than those in the control group (P<0.05). Conclusion: W ith the same treatments, scalp acupuncture combined with AET is superior to the conventional scalp acupuncture method in reducing lower-limb muscle tone, improving standing balance ability, and walking stability in children with spastic CP.

Objective To analyze the expression and role of ubiquitin specific peptidase 18 (USP18) in gastric cancer cells,and to investigate the relationship between the development of gastric cancer and USP18.Methods The levels of USP18 protein and mRNA expression in immortalized gastric mucosa epithelial GSE cell lines and gastric cancer cell lines (AGS,MKN45,MKN25,BGC823,BGC803,SGC7901) were detected by using reverse transcription-polymerase chain reaction (RT-PCR) and Western blot,respectively.The role of USP18 in the invasion and proliferation of gastric cancer cells was analyzed by using CCK8 and Transwell assays.Results The mRNA level of USP18 was lower in GSE cell lines than that in gastric cancer cells (F =794.052,P ＜ 0.000 1).In six gastric cancer cell lines,mRNA level of USP18 was relatively high in BGC823 (17.62±0.55) and BGC803 (13.52±0.50) cell lines,and low in MKN28 (1.40±0.17) and MKN45 cell lines (4.23±0.26).As for the protein level,the expression of USP18 was lowest in GSE cell line.In six gastric cancer cell lines,the expression of USP18 was the highest in more aggressive SGC7901 and BGC803 cell lines and the lowest in AGS and MKN45 cells.Compared with the control group,interference of USP18 decreased the invasion and proliferation abilities of SGC7901 and BGC803 cell lines (P ＜ 0.01).Conclusion USP18 is highly expressed in more invasive gastric cancer cells,and the downregulation of USP18 can suppress the invasion and proliferation of gastric cancer cells.

Syndrome of resistance to thyroid hormone(RTH)is a rare hereditary thyroid disease with various clinical manifestations and laboratory findings. RTH could be misdiagnosed and mistreated, resulting in aggravation of the disease. We reviewed the medical records of a patient with RTH over the past six years. In addition, we provided a summary of latest progress for RTH to help the clinicians to improve the understanding of the disease.

Objective:To investigate the value of dual-layer detector spectral CT in preoperative evaluation of immunohistochemical expression levels in breast cancer patients.Methods:The clinical, pathological and imaging data of breast cancer patients who received preoperative spectral CT chest scan in Affiliated Hospital of Southwest Medical University from October 2020 to January 2021 were retrospectively analyzed. A total of 70 patients were divided into positive or negative estrogen receptor (ER) group, positive or negative progesterone receptor (PR) group, positive or negative human epithelial growth factor receptor 2 (HER2) group, and positive or negative Ki-67 group according to the immunohistochemistry. Philips workstation and Special Diagnostic Suite software were used for processing and analysis. The CT value and iodine concentration value (IC) of the lesion and the effective atomic number (Z eff) of the lesion in the arterial and venous phases were measured, and the standardized CT value (NCT), standardized iodine concentration value (NIC), slope (K) of the keV-CT value curve in the arterial and venous phases as well as the CT difference and the IC difference in the arteriovenous phase were calculated. Independent sample t test was used to compare the differences in spectral parameters between patients with positive and negative immunohistochemical parameters, and ROC curve was used to analyze the efficacy of spectral parameters in the differential diagnosis of positive and negative different immunohistochemical parameters. Results:Z eff, NIC, K value, CT value, IC value of arterial and venous phase and NCT value of venous phase in negative ER group were higher than those in positive ER group, the difference was statistically significant ( P<0.05). Z eff, NIC, K value, IC, CT difference in arteriovenous phase and IC difference in arteriovenous phase in positive HER2 group were higher than those in negative HER2 patients, the difference was statistically significant (P<0.05). The arterial K value in positive Ki-67 group was higher than that in negative Ki-67 group, the difference was statistically significant ( P<0.05). Taking arterial phase K value of 1.22 as the diagnostic threshold, it had the highest diagnostic efficiency in differential diagnosis of ER positivity versus negativity (area under curve of 0.791, sensitivity of 84.00%, specificity of 65.00%). Taking the arteriovenous phase IC difference of 0.47 mg/ml as the diagnostic threshold, it had the highest performance in differential diagnosis of HER2 positivity versus negativity (area under curve of 0.736, sensitivity of 76.32%, specificity of 65.62%). Conclusion:Dual-layer detector spectral CT has certain diagnostic value for the immunohistochemical expression of breast cancer patients, which can provide reference for clinical diagnosis and treatment.

Objective:To study the relationship of macrophage migration inhibitory factor(MIF)/activator protein-1(AP-1)/matrix metalloproteinase-9(MMP-9)expression with inflammatory response and coronary artery lesion(CAL)in Kawasaki disease(KD).Methods:Forty-six children with KD were enrolled as the KD group, and divided into CAL group( n=17)and non-coronary artery lesion(NCAL)group( n=29). Fifteen age-and gender-matched children with lower respiratory infections and twenty children for selective operation were chosen as the control groups.Fluorescence quantitative PCR and Western blot were used to detect c-Jun/c-Fos mRNA and protein expression respectively.Serum levels of MIF/phospho-c-Jun/MMP-9 were measured by ELISA. Results:The c-Jun/c-Fos mRNA and protein expression as well as phospho-c-Jun level increased significantly in acute phase of KD as compared with those in control groups(comparison between groups: c-Jun mRNA: F=654.318, P<0.001; c-Fos mRNA: F=580.998, P<0.001; phospho-c-Jun: F=74.756, P<0.001; all P<0.05), and they were even higher in the CAL group(c-Jun mRNA: t=6.820, P<0.001; c-Fos mRNA: t=8.047, P<0.001; phospho-c-Jun: t=2.361, P=0.029; all P<0.05), then decreased in subacute phase.Serum protein levels of MIF and MMP-9 in acute phase of KD were higher than those of control groups(comparison between groups: MIF: F=104.008, P<0.001; MMP-9: F=182.798, P<0.001), and much higher in CAL group than those in NCAL group(MIF: t=2.163, P=0.043; MMP-9: t=2.104, P=0.048). There were positive correlations among serum MIF, phospho-c-Jun and MMP-9 in acute phase of KD(MIF and phospho-c-Jun: r=0.552, P<0.001; phospho-c-Jun and MMP-9: r=0.731, P<0.001; MIF and MMP-9: r=0.421, P=0.004). Conclusion:MIF/AP-1/MMP-9 signaling pathway may participate in the pathological progress of KD vasculitis and CAL.AP-1 expression and activation level in acute phase may be helpful to assess the inflammatory status and to predict CAL.

Objective:To explore the application of positive psychological intervention methods in young stroke patients and verify the effect on post-traumatic growth and subjective well-being of patients.Methods:Using the convenient sampling method, a total of 114 young stroke patients who were hospitalized in Department of Neurology in a ClassⅢ Grade A hospital from October 2018 to February 2020 were selected as the research objects. According to the random number table method, they were divided into the control group (57 cases) and the experimental group (57 cases) . The control group implemented routine psychological nursing, while the experimental group implemented active psychological intervention on the basis of the control group. Posttraumatic Growth Inventory (PTGI) and General Well-Being Schedule (GWB) were used to evaluate patients the two groups.Results:After intervention, the total score of PTGI, the total score of GWB and scores of all dimensions of the experimental group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Positive psychological intervention can improve post-traumatic growth and subjective well-being of young stroke patients.

Objective:To investigate the present situation of unintended pregnancy within two years postpartum and its influencing factors in China.Methods:Participants who delivered a live birth at 60 hospitals in 15 provinces in the eastern, central and western regions of China during July 2015 to June 2016 were interviewed by using structured questionnaire. Information on occurrence of unintended pregnancy within 2 years after delivery, postpartum contraceptive use, sexual resumption, breastfeeding, and women′s socio-demographic characteristics, and so on, were collected. Life-table analysis, cluster log-rank tests and a 2-level Cox regression model were used for data analysis.Results:A total of 18 045 postpartum women were investigated. The cumulative 1- and 2-year unintended pregnancy rates after delivery were 5.3% (95% CI: 4.5%－6.1%) and 13.1% (95% CI: 11.3%－14.8%), respectively. Cox regression model analysis showed that the risk of unintended pregnancy within 2 years postpartum were increased in younger women, ethnic minorities, women with abortion history, and those who had a vaginal delivery with short lactation time and late postpartum contraceptive initiation (all P<0.01). The risk of postpartum unintended pregnancy was not associated with geographic regions and hospitals where women gave a birth (all P>0.05). Conclusions:In China, the risk of unintended pregnancy within 2 years after delivery is relatively high. Service institutions and service providers should improve the quality of postpartum family planning services, promote the use of high effect contraceptive methods, and educate women to use a method at the time of their sexual resumption or even before.

Objective:To study the influencing factors of influenza-associated severe acute respiratory illness (SARI) in children younger than 5 years of old in Suzhou, and to provide evidence to support the improvement of prevention and control strategies for influenza in children.Methods:We conducted a prospective influenza surveillance for hospitalized SARI and outpatient influenza-like illness (ILI) at Children′s Hospital of Soochow University from April 2011 to March 2017. We compared the clinical and other characteristics of influenza-positive patients with SARI to those with ILI to find the differences and to identify influencing factors of influenza-associated SARI, using χ2 test and unconditional logistic regression. Results:We found 786 cases of influenza-associated ILI and 413 cases of influenza-associated SARI during the study period. Cough, runny nose, shortness of breath, asthma or wheezing were more common in influenza-associated SARI than in influenza-associated ILI ( P<0.01). Univariate and multivariate logistic regression showed that the influencing factors which significantly associated with increased risk of influenza-associated SARI were as follows: younger age (<6 months OR=3.6, 6-23 months a OR=2.5), respiratory infection history within 3 months (a OR=4.5), chronic lung disease history ( OR=3.4), fever above 39.0 ℃ (39.0-39.9 ℃ a OR=2.4, ≥40.0 ℃ a OR=6.0), and the presence of A/H1N1 (a OR=2.3), A/H3N2 (a OR=1.9). Conclusion:Children younger than 2 years old, with a history of chronic lung disease, a history of respiratory infection within 3 months, or with a fever peak above 39.0 ℃ should seek medical advice as soon as possible or receive annual influenza vaccination to reduce the incidence of influenza-associated serious outcomes.

We analyzed the influenza surveillance data of Children′s Hospital of Suzhou University from 2016 to 2018 and estimated the hospitalization burden of children under 5 years old due to influenza infection in Suzhou. The results showed that the influenza virus positive rate of 1 451 severe acute respiratory infection (SARI) cases in Children′s Hospital of Suzhou University was 13.6% (95%CI :11.8%?15.3%;197 cases), among which the influenza pandemic intensity in 2017?2018 was relatively high, and A/H1N1 was the main pandemic virus. It was estimated that the hospitalization rate of influenza?related SARI in children under 5 years old in Suzhou was 6.9‰ (95%CI : 6.6‰?7.2‰), among which the hospitalization rate of children aged<6 months was higher, up to 11.4‰(95%CI: 9.9‰?12.8‰).