Objective To investigate the diagnostic value of plasma cardiac troponin Ⅰ (cTnI) and brain natriuretic peptide (BNP) for heart failure complicated with pneumonia in children.Methods 30 children of heart failure complicated with pneumonia (heart failure group),30 children with pneumonia in acute phase (pneumonia group) and 30 healthy children (control group) were selected.The levels of plasma cTnI and BNP in the heart failure group were detected in acute phase(6-24h) and recovery phase(5-7d),and the results were compared with pneumonia group and control group.Results The levels of plasma cTnI and BNP in the heart failure group were significantly higher than those in the pneumonia group and control group(F =5.303,4.632,all P ＜ 0.05).The levels of plasma cTnI and BNP were not significantly different between the pneumonia group and control group(P ＞ 0.05).The levels of plasma cTnI and BNP in recovery phase of the heart failure group were significantly lower than those in acute phase of the heart failure group (t =4.291,5.393,all P ＜ 0.05),but there were no siganificant differences compared with the pneumonia group and control group(P ＞ 0.05).Conclusion The plasma cTnI and BNP maybe a reliable index in the diagnosis of heart failure complicated with pneumonia in children.

Background: and Purpose This study aimed to determine the clinical features, diagnosis, and treatment of patients with persistent geotropic (pG) and persistent apogeotropic (pAG) direction-changing positional nystagmus (DCPN). Methods: This retrospective study included 30 patients with pG-DCPN and 44 patients with pAG-DCPN. All patients underwent neurological and neurotological examinations, including an evaluation of gaze-evoked nystagmus, eye-movement tests, and assessments of limb ataxia and balance, as well as magnetic resonance imaging to exclude central causes. The characteristics of positional nystagmus were detected using the supine roll test (SRT) and bow-andlean test (BLT). The null point (NP) at which the nystagmus disappeared was determined. All patients were treated with the barbecue maneuver, and treatment efficacy was evaluated immediately, 1 week, and 1 month after treatment. Results: The history of diseases associated with atherosclerosis, peripheral vestibular disorders, otological disease, and migraine differed significantly between patients with pG-DCPN and pAG-DCPN. The affected sides of persistent horizontal DCPN can be determined using the SRT and the BLT, while determining the second NP and vestibular function as well as performing an audiological evaluation can be used to assist in identifying the affected side. The efficacy rates immediately and 1 week after treatment with the barbecue maneuver were higher in patients with pAG-DCPN than in patients with pG-DCPN. Conclusions pAG-DCPN was more compatible with the characteristics of cupulolithiasis, and pG-DCPN was more likely to be associated with a light cupula rather than canalolithiasis. pAG-DCPN was more likely to be accompanied by a disease associated with atherosclerosis, while pG-DCPN was often accompanied by autoimmune-related diseases and a history of migraine. The associations between pAG-DCPN, pG-DCPN, and the above-mentioned diseases need to be clarified further. The canalith-repositioning maneuver was effective in patients with pAG-DCPN and ineffective in patients with pG-DCPN, but most cases of pGDCPN are self-limiting.

Background: and Purpose This study aimed to determine the clinical features, diagnosis, and treatment of patients with persistent geotropic (pG) and persistent apogeotropic (pAG) direction-changing positional nystagmus (DCPN). Methods: This retrospective study included 30 patients with pG-DCPN and 44 patients with pAG-DCPN. All patients underwent neurological and neurotological examinations, including an evaluation of gaze-evoked nystagmus, eye-movement tests, and assessments of limb ataxia and balance, as well as magnetic resonance imaging to exclude central causes. The characteristics of positional nystagmus were detected using the supine roll test (SRT) and bow-andlean test (BLT). The null point (NP) at which the nystagmus disappeared was determined. All patients were treated with the barbecue maneuver, and treatment efficacy was evaluated immediately, 1 week, and 1 month after treatment. Results: The history of diseases associated with atherosclerosis, peripheral vestibular disorders, otological disease, and migraine differed significantly between patients with pG-DCPN and pAG-DCPN. The affected sides of persistent horizontal DCPN can be determined using the SRT and the BLT, while determining the second NP and vestibular function as well as performing an audiological evaluation can be used to assist in identifying the affected side. The efficacy rates immediately and 1 week after treatment with the barbecue maneuver were higher in patients with pAG-DCPN than in patients with pG-DCPN. Conclusions pAG-DCPN was more compatible with the characteristics of cupulolithiasis, and pG-DCPN was more likely to be associated with a light cupula rather than canalolithiasis. pAG-DCPN was more likely to be accompanied by a disease associated with atherosclerosis, while pG-DCPN was often accompanied by autoimmune-related diseases and a history of migraine. The associations between pAG-DCPN, pG-DCPN, and the above-mentioned diseases need to be clarified further. The canalith-repositioning maneuver was effective in patients with pAG-DCPN and ineffective in patients with pG-DCPN, but most cases of pGDCPN are self-limiting.

Objective:To investigate the current status of professional identity among the clinical medical postgraduates and its correlation with mentoring function and professional competency, so as to provide reference for optimizing the training mode of clinical medicine postgraduates.Methods:A questionnaire survey was conducted among 217 academic and professional full-time postgraduates from Batch 2016 to 2018 majoring in clinical medicine in Peking University Health Science Center in 2019. The contents included four aspects: basic information, preliminary questionnaire of professional identity, mentoring function scale and professional competency. SPSS 26.0 was used for t test, one-way ANOVA, Kruskal-Wallis H test, and Pearson correlation analysis to analyze the status of professional identity and its correlation with professional competency and mentoring function. Results:Both professional and academic clinical medicine postgraduates had high scores of the overall level and four factors, and there was no statistical significance in the scores between the two groups ( P >0.05). There were significant differences in the overall level, behavior and appropriateness of professional identity among different grades of professional postgraduates ( P<0.05). Correlation study showed that the professional identity was significantly positively correlated with the total score of professional competency and mentoring function ( P<0.001). Further interview survey showed that the role of supervisor and employment prospects also played an important role in the elevation of professional identity. Conclusion:The overall degree of professional identity of academic and professional postgraduates is good and closely related to professional competency and mentoring function and for professional postgraduates, the overall level of professional identity of senior students is better. It is suggested that besides focusing on their professional competency, it is necessary to further optimize the employment policy of academic postgraduates and the training of tutors for professional postgraduates.

Objective:To screen the key genes related to the prognosis,diagnosis,and immune infiltration of the hepatocellular carcinoma(HCC)patients by bioinformatics analysis methods,and to analyze their potential therapeutic drugs.Methods:The HCC gene expression profile data and corresponding clinical informations of the HCC patients were downloaded from the Gene Expression Omnibus(GEO)database and The Cancer Genome Atlas(TCGA)database.The R software package limma was used to screen the differentially expressed genes(DEGs)in HCC.Gene Ontology(GO)functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis were performed on the DEGs.The STRING database was used to construct the protein-protein interaction(PPI)network;the Cytoscape software was used to visualize the PPI network and screen the key genes;Kaplan-Meier survival curve and LASSO regression algorithm were used to identify the key genes related to the HCC prognosis;external data sets were used to validate their expressions and analyze the diagnostic efficacy;CIBERSORT algorithm was used to detect the relationship between the expression of prognosis-related key genes and HCC immune cell infiltration.The MiRNet and Network Analyst databases were used to construct the microRNA(miRNA)-key gene mRNA and transcription factors(TFs)-key gene mRNA molecular regulatory networks;CMap database was used to screen the potential small molecule drugs for HCC treatment.Results:A total of 146 DEGs were screened,including 30 upregulated genes and 116 downregulated genes.The GO functional enrichment analysis and KEGG pathway enrichment analysis results showed that the DEGs were significantly enriched in biological processes(BP)such as steroid,alkene compound,and hormone metabolism,as well as signaling pathways such as retinol metabolism,drug metabolism-cytochrome P450(CYP450),complement and coagulation cascades.The PPI network analysis identified 14 key genes,among which formimidoyltransferase cyclodeaminase(FTCD),secreted phosphoprotein 2(SPP2),thrombin-antithrombin complex(TAT),complement C6(C6),and cytochrome CYP450 family member 2C9(CYP2C9)were significantly associated with the prognosis,clinical pathological stage,and histological grade of the HCC patients and also had high diagnostic efficacy for HCC and were closely related to immune cell infiltration in HCC.Hsa-mir-182-5p,CUT-like homeobox 1(CUX1),early growth response 1(EGR1),SMAD family member 4(SMAD4),and tumor protein P53(TP53)were identified as the important regulators targeting the above-mentioned prognosis-related key genes.DL-thiorphan,promethazine,and apigenin may have the therapeutic effects on HCC.Conclusion:FTCD,SPP2,TAT,C6,and CYP2C9 may be the potential targets for the diagnosis,prognosis,and treatment of HCC.Three predicted small molecule drugs,DL-thiorphan,promethazine,and apigenin,may provide the references for the development of therapeutic drugs for HCC.