BACKGROUND:Neuroblastoma is the most common solid tumor in infants and children. Targeting cancer stem cel therapy can be expected to cure cancer radicaly, but because of smal number, anti-apoptotic and anti-chemotherapy capacity, cancer stem cels are not sensitive to the radiotherapy and chemotherapy.
OBJECTIVE:To explore the expression of stem cel marker CD133 in neuroblastoma and its clinical significance.
METHODS:Fifty-eight children with neuroblastoma admitted at Department of Pediatric Surgery, the First Affiliated Hospital of Xinjiang Medical University, China from June 2004 to February 2014 were enroled, including 46 cases of neuroblastoma and 12 cases of ganglion neuroblastoma. Then, the expression level of CD133 was analyzed by immunohistochemistry method, and the relationship between pathological types, International Neuroblastoma Staging System stage, survival time after surgery and the expression level of CD133 was explored.
RESULTS AND CONCLUSION:There were 22 cases (48%) of neuroblastoma positive for CD133, and 4 cases (33%) of ganglion neuroblastoma positive for CD133. CD133 mainly expressed in the tumor cel cytoplasm. The expression rates of CD133 in different clinical stages were significantly different (P=0.011), which were 21% for stages 1 and 2, 64% for stages 3 and 4, 36% for stage 4S. And the positive rates of CD133 between patients with good prognosis and patients with poor prognosis were significantly different (P=0.031), which were 29% and 57%, respectively. The life cycle of CD133-negative patients was significantly longer than that of CD133-positive infants (P < 0.05). There were tightly connections between CD133 and the occurrence, development, and prognosis of neuroblastoma, and thus, CD133 is of great significance to assess the survival time after surgery and improve of the diagnosis and treatment of neuroblastoma.

Objective To investigate the predictive value of plasma gelsolin in the prognosis of patients with ST-sgement elevation myocardial infarction ( STEMI ) and undergone primary percutaneous coronary intervention ( PCI ) .Methods The study included 206 patients with STEMI and undergone primary PCI, 148 patients with stable angina pectoris and received elective PCI and 80 healthy volunteer as the health population (NP) control.Blood samples were taken at admission on day 1, 3, 5, 7 and 9 to determine the plasma gelsolin level .Patients′baseline clinical characteristics , blood biochemistry tests results , details of operation and their cardiovascular risk factors were recorded .Major adverse cardiovascular events (MACE) within one year were recorded.Results (1) Compared to the stable angina group and the NP group, the level of plasma gelsolin of STEMI patients were obviously decreased at various time points ( all P<0.05 ) .There were no statistical differences between the stable angina group and the NP group .( 2 ) Patients with STEMI were catagorized into MACE group (n=78) and non-MACE group (n=128) according their follow up record in 1 year.The level of plasma gelsolin in patients with MACE were lower than the non-MACE group ( P <0.05 ) with the minimum value detected on day 7.Among patients complicated with MACE (n=78), they were further devided into the deceased group (n=18) and the survival group (n=60).Plasma gelsolin levels were lower in the deceased group with satistical differences found on day 5, 7 and 9.(3) Single factor Logistic regression analysis showed that the level of plasma gelsolin on day 7 was independent risk factor of MACE within one year ( P =0.014 ) .( 4 ) Setting the cutoff value of plasma gelsolin on day 7 as 21.7 mg/L,the sensitivity and speciticity for the MACE in STEMI patients treated with primary PCI within one year were 82.1%and 81.4%respectively , with the area under the receiver operator characteristic curve ( ROC ) was 0.854 ( 95% confidence interval 0.732 -0.961 , P <0.01 ) . Conclusions Plasma gelsolin levels are correlated with the severity of STEMI lesions and plasma gelsolin can be used as predicting factor of prognosis .

Objective To investigate the risk factors of Hirschsprung's associated enterocolitis (HAEC) to provide a basis for the diagnosis and treatment of Hirschsprung's disease (HSCR),and offer the guidance for reducing the postoperative complications occurrence and postoperative rehabilitation. Methods The case data of the children patients with HSCR treated by initial surgery in the pediatric surgery department of this hospital from January 2015 to January 2023 were analyzed retrospectively.The risk factors of HAEC occurrence were analyzed.Results Among 110 children patients with HSCR,34 cases developed HAEC with a incidence rate of 30.91％.There were statistical differences in different ages,preoperative enter-itis occurrence,low body weight,length of spastic segment of lesion and diet control (P<0.05).The multiva-riate logistic regression analysis results showed that the age ≥6 years old (OR=2.407,95％CI:1.040-5.568),preoperative bowel washing time<2 weeks (OR=2.464,95％CI:1.082-5.612),preoperative enter-itis occurrence (OR=2.943,95％CI:1.193-7.260),low body weight (OR=2.588,95％CI:1.113-6.014),and the length of spastic segment of lesion ≥30 cm (OR=2.801,95％CI:1.224-6.412) were the risk fac-tors of HAEC occurrence (P<0.05),while dietary control (OR=0.358,95％CI:0.153-0.837) was the pro-tective factor for HAEC (P<0.05).Conclusion Prevention after operation in the children patients with HSCR should be carried out according to the risk factors of HAEC occurrence.

Objective To investigate the effects of menaquinone-4(MK4)on the activation and function of CD8+T cells.Methods An in vitro culture system for primary mouse CD8+T cells was established by isolating these cells from the spleen using CD8a T cell isolation kit.The isolated CD8+T cells were then incubated and activated in a 96-well plate coated with anti-CD3/CD28 antibodies.The impact of MK4 on the activation and cytokine secretion of CD8+T cells was explored by quantifying the expression levels of CD8+T cell activation receptors and cytokines using flow cytometry.Additionally,the concentrations of these cytokines in the culture supernatant were measured by enzyme-linked immunosorbent assay(ELISA).The influence of MK4 on the anti-tumor function of CD8+T cells was evaluated by co-culturing colorectal cancer MC38 cells of mice with CD8+T cells at different ratios,and the effect of MK4 was assessed by detecting tumor cell apoptosis.Results High-purity primary CD8+T cells of mice(97.5％)were isolated using the magnetic bead,which could be activated by pre-coated CD3/CD28 antibodies and showed proliferation.Compared with the control group,the MK4-treated group exhibited increased expressions of CD25,CD69 and CD44 on CD8+T cells,as well as higher production and secretion levels of interleukin-2(IL-2),interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α)and granzyme B.In addition,CD8+T cells in the MK4-treated group induced a higher percentage of tumor cell apoptosis(36.7％)compared with the control group(29.1％).Conclusion MK4 can enhance the activation of CD8+T cells and promote anti-tumor functions.

Objective To evaluate the effectiveness and associated factors of prevention of motherto-child human immunodeficiency virus (HIV) transmission in Hubei Province,and to provide a reference for prevention of mother-to-child transmission of HIV.Methods In this prospective cohort study,HIV-positive pregnant women who were in some counties and cities of Hubei Province from January 2004 to December 2016 were enrolled.Prevention of mother-to-child transmission of HIV was conducted for these HIV-positive pregnant women and their infants,and their clinical data were collected.Descriptive analysis and x2 test were used to analyze the general characteristics of HIV-positive pregnant women and their infants.Logistic regression analysis was adopted to explore the associated factors of mother-to-child HIV transmission.Results In total,536 HIV-positive pregnant women (628 pregnancies) were found,among which,334 pregnant women and 345 infants were enrolled in this study.Twenty-four infants were HIV-positive,which was 6.96％ in all infants (95％CI:4.27％-9.64％).The rates of mother-to-child HIV transmission without prevention,formula feeding only,infant medication plus formula feeding,mother and infant medication plus formula feeding were 35.71％ (95％CI:21.61％-51.93％),8.82％ (95％CI:2.08％-15.57％),7.41％ (95％CI:0.92％-24.22％),and0.48％ (95％CI:0.01％-2.64％),respectively.No antiretroviral medications during delivery (OR =14.484,95 ％CI:1.740-120.577,P=0.013),breastfeeding (OR=6.542,95％CI:2.416-17.713,P=0.000),and CD4-T lymphocyte count＜200 cells/μL during delivery (OR=3.060,95％CI:1.076-8.703,P=0.036) were independent risk factors of mother-to-child HIV transmission.Conclusions The rate of mother-to-child HIV transmission without prevention is high in Hubei Province,which can be significantly reduced by comprehensive interventions (mother and infant medication plus formula feeding).Thus,we should diagnose HIV-positive pregnant women as early as possible,and should give pregnant woman antiretroviral therapy plus infant medication and formula feeding to further reduce the rate of mother-to-child HIV transmission.

Objective To investigate the effect and mechanism of miR-20a-5p on human nephroblastoma cell line WiT49 transplanted tumor in nude mice.Methods The gene expression chip was downloaded from GEO database,and the differential gene miR-20a-5p was obtained by GEO2R.The NF-κB gene was positively correlated with the expression of miR-20a-5p through cBioPortal database.The target gene of miR-20a-5p was predicted to be NFKBIB of the NF-κB transcription factor suppressor protein family by targetscan database,and was verified by dual luciferase assay.Nephroblastoma cell line WiT49 was cultured in vitro and transfected into WiT49 cells with lentiviral vectors constructed with miR-20a-5p mimics and its suppressor gene.Twelve nude mice were randomly divided into three groups:WiT49 model group,WIT49-miR-20a-5p overexpression group and WIT49-miR-20a-5p knockdown group.The tumor mass and volume of each group were detected by tumor formation experiment in nude mice.real time fluorescent quantitative polymerase chain reaction(qRT-PCR)was used to detect the expression of miR-20a-5p,NFKBIB and NF-κB in each group;CCK-8 cell proliferation assay was used to verify the proliferation of tumor cells in each group.Results miR-20a-5p is highly expressed in nephroblastoma and is positively correlated with the expression of NF-κB.miR-20a-5p and NFKBIB have mutual binding sites and binding effects.In the tumor formation experiment of nude mice,the tumor volume and mass of WIT49-miR-20a-5P overexpression group were significantly increased compared with WiT49 model group,and the difference was statistically significant(P<0.05).In the qRT-PCR test,the expressions of miR-20a-5p and NF-κB in the WIT49-miR-20a-5p overexpression group were higher than those in the WiT49 model group,and NFKBIB expression in the WIT49-miR-20a-5p overexpression group was lower than that in the WiT49 model group,with statistical significance(P<0.05).CCK-8 cell proliferation assay showed that the absorbance of WIT49-miR-20a-5p overexpression group at 24 and 48 hours was higher than that of WiT49 model group,and the absorbance of WIT49-miR-20a-5p knockdown group at 24,48 and 72 hours was lower than that of WiT49 model group,and the difference was statistically significant(P<0.05).Conclusion miR-20a-5p may promote the growth of human nephroblastoma cell WiT49 transplanted tumor in nude mice by regulating NFKBIB activation of NF-κB pathway.

In recent years, society has gradually shifted from a "fearful" approach of unscientific plan design, unbalanced resource protection and inadequate management experience leading to the spread of public panic and negative emotions to a "comfortable" approach of proactive prevention, precise control, information symmetry, scientific response and systematic treatment in the face of public health emergencies. College students are increasingly becoming the "key minority" to participate in crisis management. This is mainly due to their values in line with social ideals, their mobility in line with disciplinary practice and volunteerism, their knowledge accumulation in multi-disciplinary cross-fertilization, and their good cognitive thinking literacy, high information media literacy and perfect social support system. Therefore, this group has a strong comprehensive advantage in public health emergencies. Based on this background, combined with on-site investigation and interview feedback, this paper considered that this group can play an active role in normal prevention and early warning beforehand, information transmission and communication at the moment the event occur, corrective cognitive implementation and disposal in the event, and scientific research innovation and popularization afterwards, so as to better play an increasingly important leading demonstration effect in public health emergencies. At the same time, it can also encourage universities to take the initiative in the process of talent training to teach people according to the concept of "change according to the matter, advance according to the time and new according to the situation", and lead college students of different majors to maximize the pioneering effect of role models in public health emergencies.

Objective To explore the clinical application value of MRI fat quantification parameter[verte-bral bone marrow fat fraction(FF)]combined with 25-hydroxyvitamin D[25(OH)D]in predicting fracture risk in patients with osteoporosis.Methods A total of 90 patients with osteoporosis who were admitted to the hospital from January 2023 to April 2024 were selected as the subjects.Among them,50 patients with osteoporotic vertebral com-pression fractures were included in the fracture group,and 40 patients without fractures were included in the control group.All patients underwent the iterative decomposition of water and fat with echo asymmetry and least-squares estimation(IDEAL-IQ)method of MRI to measure the FF of each vertebra among L1-5 and the average FF of L1-5.Serum 25(OH)D level was detected by electrochemiluminescence method.FF and serum 25(OH)D levels of the two groups were compared.The correlation of FF,25(OH)D and bone mineral density(BMD)was analyzed.Multi-variate logistic regression analysis was conducted to screen the risk factors for fracture in patients with osteoporosis.Receiver operating characteristic(ROC)curves were used to evaluate the predictive value of FF,25(OH)D,and their combination for fracture in patients with osteoporosis.Results Patients in the fracture group were older than those in the control group.BMD and serum 25(OH)D level were lower than those of the control group(P<0.05).The FF of L2 and average FF of L1-5 in the fracture group were higher than those in the control group(P<0.05).Correlation analysis results showed that the FF of L2 and the average FF of L1-5 were negatively correlated with BMD(P<0.05),while serum 25(OH)D level was positively correlated with BMD(P<0.05).Multivariate logistic regression analysis showed that age and FF of L2 were independent risk factors for fracture in patients with osteoporo-sis,while BMD and 25(OH)D were protective factors(P<0.05).ROC curves indicated that the AUC values of FF of L2 and 25(OH)D for predicting fracture were 0.714(95%CI:0.606～0.822)and 0.774(95%CI:0.672～0.876).The AUC of joint prediction was 0.923(95%CI:0.867～0.978),which was significantly larger than that of separate prediction(P<0.05).Conclusions FF of L2 and serum 25(OH)D are related to fracture in patients with osteopo-rosis.Age and BMD are factors influencing the occurrence of fracture in patients with osteoporosis.FF of L2 and 25(OH)D have certain predictive value for fracture risk in patients with osteoporosis,and combined detection of the two can improve predictive efficiency.

Pulmonary blast injury has become the main type of trauma in modern warfare, characterized by externally mild injuries but internally severe injuries, rapid disease progression, and a high rate of early death. The injury is complicated in clinical practice, often with multiple and compound injuries. Currently, there is a lack of effective protective materials, accurate injury detection instrument and portable monitoring and transportation equipment, standardized clinical treatment guidelines in various medical centers, and evidence-based guidelines at home and abroad, resulting in a high mortality in clinlcal practice. Therefore, the Trauma Branch of Chinese Medical Association and the Editorial Committee of Chinese Journal of Trauma organized military and civilian experts in related fields such as thoracic surgery and traumatic surgery to jointly develop the Clinical treatment guideline for pulmonary blast injury ( version 2023) by combining evidence for effectiveness and clinical first-line treatment experience. This guideline provided 16 recommended opinions surrounding definition, characteristics, pre-hospital diagnosis and treatment, and in-hospital treatment of pulmonary blast injury, hoping to provide a basis for the clinical treatment in hospitals at different levels.