High-mobility group box 1 ( HMGB1 ) is a conserva-tive nuclear protein and plays an essential role in maintaining nu-cleosome stability, DNA recombination, replication, repair and transcription. It can be passively released by necrotic cells or ac-tively secreted into extracellular under appropriate stimulus. Re-cent studies show that the activation of HMGB1 signaling is closely related to the progress of lung diseases including lung in-jury, pulmonary fibrosis and lung cancer, while blocking HMGB1 signaling inhibits the pathological process, indicating the therapeutic potential of HMGB1 inhibition in treating these diseases. This review summarizes the role and mechanisms of HMGB1 in such diseases, in order to provide novel evidence for the diagnosis and treatment.

OBJECTIVE:To provide reference for the medication safety in elderly patients with chronic diseases. METHODS:Elderly inpatients with chronic diseases and nursing staff in affiliated hospital of shaoyang medical college,from Mar. 2014 to May 2015 were randomly selected for a questionnaire survey to analyze the influential factors of drug safety and health education de-mand,and the difficulty sources of nursing staff in developing health education was explored. RESULTS:Totally 500 questionnaire was sent out to elderly patients with chronic diseases,500 were effectively received with effective recovery of 100%;and totally 200 were sent out to nursing staff,200 were effectively received with effective recovery of 100%. In the 500 surveyed patients, 193 had ADR,which was affected by age,educational background,monthly income,disease course,whether received health edu-cation,etc.(P<0.05),patients with older age,lower educational background and monthly income,longer disease course and no receiving health education showed higher incidence of ADR;the influential factors for health education demands included education-al background,occupational status,disease course,quality evaluation of nursing staff,etc.(P<0.05),patients with higher educa-tional background,lower disease course,higher occupational status and quality evaluation of nursing staff showed stronger health education demands. The difficulty sources of surveyed nursing staff in developing health education were busy work,being afraid of misunderstanding,embarrassing,cognitive and skill deficits. CONCLUSIONS:The drug safety of elderly patients with chronic dis-eases is related to many influential factors,as well as the health education demands. Nursing staff should continuously improve their ability and quality,combined with the above influential factors,carry out health education with physicians and pharmacists to ensure the medication safety.

Background Mutant C57BL/6 mouse with corneal opacity (B6-Co) appears eye open at birth (EOB) phenotype,which is a good animal model in the study of developmental mechanism of eyelid.Investigating the relationship between serum response factor (SRF) and EOB phenotype can provide theoretical support for the research on the mechanism of innate defects in eyelid development in humans.Objective This study was to assess the dynamic expressions of SRF in eyelid of embryonic B6-Co mouse.Methods Total RNA was extracted from B6 and B6-Co mice eyelid tissue at embryonic day 16.5 (E16.5 d),E17.5 d and E18.5 d.The relative expression levels of SRF mRNA and protein in the eyelid tissue of B6 and B6-Co embryonic mice were assayed by real-time quantitative PCR and Western blot,respectively.In situ expressions of SRF protein in eyelid of B6-Co mice and B6 mice were detected using immunofluorescence technique.The use and care of the animals complied with the Regulation for the Administration of Affair Concerning Experimental Animals of Nantong University.Results The relative expression levels ofSRF mRNA in the eyelids were 0.41±0.06 and 0.24±0.17 in E16.5 d and E17.5 d of B6-Co mice,showing a significant decline in comparison with 1.03 ±0.17 and 1.01 ±0.09 in the B6 mice (P =0.025,0.017).The expression levels of SRF protein in the eyelids of E16.5 d and E17.5 d B6-Co mice were 0.08±0.01 and 0.08± 0.01,which were significantly lower than 0.12 ±0.03 and 0.13 ± 0.02 of B6 mice (P =0.036,0.024).However,there were no significant differences in the expression levels of SRF mRNA and protein in E18.5 d between the B6-Co mice and B6 mice (P =0.387,0.774).Immunofluorescence assay displayed that SRF was expressed in the keratinocytes of eyelids in both mice,but the fluorescence intensity was weaker in the B6-Co mice.Conclusions SRF probably interrupts the developing process of eyelid in early embryo of B6-Co mice.

Objective To investigate the imaging findings and key diagnostic points of Brunner’s gland adenoma on CT.Methods The CT imaging findings and pathological features of 9 cases of Brunner’s gland adenoma confirmed by pathology were retrospec-tively analyzed,including the lesions number,site,size,shape,margin,density and the enhancement pattern.Results Of the 9 ca-ses,1 case located in the antrum and 8 cases in the duodenaum [6 cases in the duodenal bulb (75%)and 2 in the papillary (25%)]. Of the 6 cases of duodenal lesions,3 were found at the anterior wall and 3 at the posterior wall.Except 1 case which complicated with enteritis and had an obscure margin,the other 8 cases were clear margined ,and were round or nodular in shape.The maximum size of tumors ranged 1 5-68 mm in diameters (mean 35.0 mm ± 1 6.2 mm).The density of tumors was homogeneous on CT scan without necrosis or hemorrhage.In the arterial phase after administration of contrast agent,the lesions were similar to the adjacent intestinal wall enhancement,and mucosal annular enhancement (halo sign)showed in 6 cases,and the dot-shape non-enhancement area within the lesion (black star sign)showed in 5 cases,and the thickening or tortuous enhanced blood vessel showed in 6 cases.In the venous phase,9 cases were progressive enhancement,and the “black star sign”or “the black line sign”showed more clearly in 5 cases.In the pathology,the lesions were polypoid-like,solid or cystic.Under the microscope,the hyperplasic Brunner’s glands were covered with normal duodenal mucosa and separated by bundles of smooth muscle cells with dilated duct,cyst,and adipose cells,1 case with atypical hyperplasia of the glandular epithelium and 1 case with ectopic pancreas.Conclusion There are some spe-cific CT imaging features in Brunner’s gland adenoma,which is of important clinical value in accurate preoperative diagnostic.

Objective To study the clone sequencing and expression of fibroblast growth factor 10(Fgf10) gene in corneal opaci-ty (B6-Co) mouse .Methods Normal mice mate with B6-Co mice ,the skin tissue separation from B6 and B6-Co mice at embryo 16 . 5 d ,total RNA extraction and reverse transcription ,the target gene was fragment amplification by RT-PCR ,connection with T vec-tor ,transformed to competent cells ,selection positive clone ,sequencing analysis .The gene expression in B6-Co mice was detected by real-time PCR .Results The base A inserted between 1 914 and 1 915 in Fgf10 gene by sequencing .The expression of Fgf10 was significant down regulation in B6-Co mice by real-time PCR(P< 0 .05) .Conclusion Fgf10 is relevant with phenotype of B6-Co mouse ,and the regulation mechanism was expected further study .

Objective:To investigate the characteristics of urinary stones composition in children and the differences in their distribution among different sexes and age groups.Methods:The clinical data of 592 children with urinary stones who underwent stone composition analysis using infrared spectroscopy at Hunan Children's Hospital from October 2015 to October 2019 were retrospectively analyzed. There were 430 males and 162 females.The median age was 4.0 (0.3 to 18.0) years old. The stone composition and the differences in its distribution in different sex and age groups were analyzed.Results:A total of 643 urinary stones were analyzed in 592 cases, with 419 (65.2%) single-component stones and 224 (34.8%) mixed-component stones. The main stone components were calcium oxalate in 361 cases (56.1%), ammonium hydrogen urate in 130 cases (20.0%), cystine in 56 cases (8.7%), calcium phosphate in 33 cases (5.1%), uric acids in 33 cases (5.1%), magnesium ammonium phosphate in 25 cases (3.9%), and xanthine in 5 cases (0.8%). The percentage of calcium oxalate stones was higher in women than in men [65.6% (118/180) vs. 52.5% (243/463), P<0.05]. The proportion of upper urinary tract stones was higher in girl than in boy[93.4%(168/180) vs. 73.2%(339/463), P<0.05]. The differences in the composition ratios of calcium oxalate stones, ammonium hydrogen urate, cystine, and magnesium ammonium phosphate stones in different age groups were statistically significant ( P<0.05), with the highest proportion of calcium oxalate stones (35.6%) at 6 to 10 years of age, ammonium hydrogen urate and cystine stones at 1 to 2 years of age (45.4% and 42.9%), and magnesium ammonium phosphate stones at 3 to 5, 6 to 10, and 11 to 18 years of age, the percentage of urinary stones in children was 24%. Conclusions:The main component of urinary stones in children is calcium oxalate, followed by ammonium hydrogen urate and cystine. Age and gender correlate with the distribution of stone components. Calcium oxalate stones are common in females and in children aged 6 to 10 years, ammonium hydrogen urate and cystine stones are common in children aged 1 to 2 years, and magnesium ammonium phosphate stones are more common in children aged 3 to 5 years, 6 to 10 years, and 11 to 18 years.

Objective To evaluate the effect of angiotension-converting enzyme (ACE) gene poly-morphism on dexmedetomidine-induced inhibition of responses to extubation in the patients with hyperten-sion. Methods A total of 180 patients with primary hypertension, aged 50-63 yr, weighing 54-69 kg, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, scheduled for elective abdominal surgery under general anesthesia, in whom ACE genotypes were detected using polymerase chain reaction-restriction fragment length polymorphism, were divided into 6 groups (n = 30 each) according to whether dexmedeto-midine was applied: DD genotype group (DD group), ID genotype group (ID group), Ⅱ genotype group (Ⅱ group), dexmedetomidine +DD genotype group (DEX+DD group), dexmedetomidine +ID genotype group (DEX+ID group) and dexmedetomidine+Ⅱ genotype group ( DEX+Ⅱ group). Dexmedetomidine 0. 5 μg·kg-1 ·h-1 was intravenously infused starting from 30 min before the end of surgery until the end of surgery in DEX+DD, DEX+ID and DEX+Ⅱ groups. Immediately before infusing dexmedetomidine (T1 ), at 30 min of dexmedetomidine infusion (T2 ), immediately after extubation (T3 ) and at 1. 5, 5 and 15 min after extubation (T4-6 ), systolic blood pressure, diastolic blood pressure, heart rate and ECG were recor-ded, and rate-pressure product was calculated. The development of myocardial ischemia and responses to extubation was recorded within 15 min after extubation. Results Compared with the baseline at T1 , each parameter of hemodynamics was significantly increased at T3-6 in DD, ID and Ⅱ groups (P<0. 05), and no significant change was found in each parameter of hemodynamics at T2-6 in Dex+DD, Dex+ID and Dex+Ⅱ groups (P> 0. 05). Each parameter of hemodynamics was significantly lower at T3-6 , and the inci-dence of myocardial ischemia and responses to extubation was decreased in group Dex+DD than in group DD and in group Dex+ID than in group ID (P<0. 05). Compared with group Ⅱ, each parameter of he-modynamics at T3-6 and incidence of responses to extubation were significantly decreased in group Dex+Ⅱ, and each parameter of hemodynamics was significantly increased at T3-6 , and the incidence of myocardial ischemia and responses to extubation was increased in DD and ID groups (P<0. 05). There was no signif-icant difference in each parameter of hemodynamics or incidence of myocardial ischemia and responses to extubation among group Dex+DD, group Dex+ID and group Dex+I (P>0. 05). Conclusion ACE gene polymorphism does not affect dexmedetomidine-induced inhibition of responses to extubation in the patients with hypertension.

Objective:To evaluate the effect of angiotensin-converting enzyme (ACE) gene polymorphism on dexmedetomidine-induced inhibition of responses to endotracheal intubation in the patients with hypertension.Methods:One hundred and eighty patients with essential hypertension, aged 48-61 yr, weighing 51-66 kg, of American Society of Anesthesiologists physical status Ⅱ or Ⅲ, in whom ACE genotype was determined using polymerase chain reaction-restriction fragment length polymorphisms method before operation, were divided into 6 groups ( n=30 each) according to whether dexmedetomidine was applied: DD genotype group (DD group), ID genotype group (ID group), II genotype group (II group), dexmedetomidine plus DD genotype group (DEX+ DD group), dexmedetomidine plus ID genotype group (DEX+ ID group), and dexmedetomidine plus II genotype group (DEX+ II group). Dexmedetomidine 0.8 μg/kg was intravenously infused over 15 min before induction of anesthesia in DEX+ DD group, DEX+ ID group and DEX+ II group.Systolic and diastolic pressure (SP, DP) and heart rate (HR) were measured before dexmedetomidine (T 0), immediately before tracheal intubation (T 1), immediately after tracheal intubation (T 2), and at 1.5 and 5.0 min after tracheal intubation (T 3, 4). The rate-pressure product (RPP) was calculated.The occurrence of myocardial ischemia and cardiovascular responses within 5 min after tracheal intubation was recorded.Blood samples from the internal jugular vein were collected at T 0 and T 2-4, and plasma concentrations of epinephrine (E) and norepinephrine (NE) were determined by high performance liquid chromatography-electrochemical detection assay. Results:Compared with group DD, the SP, DP, HR and RPP were significantly decreased at T 2-4, plasma NE and E concentrations were decreased at T 2, 3, and the incidence of myocardial ischemia and cardiovascular reactions was decreased in group Dex+ DD ( P<0.05). Compared with group ID, SP, DP, HR and RPP were significantly decreased at T 2-4, plasma NE and E concentrations were decreased at T 2, 3, and the incidence of myocardial ischemia and cardiovascular responses were decreased in group Dex+ DD ( P<0.05). Compared with group II, SP, DP, HR and RPP were significantly decreased at T 2, 3, plasma NE and E concentrations were decreased, HR and RPP were decreased at T 4, and the incidence of myocardial ischemia and cardiovascular reactions was decreased in group Dex+ II ( P<0.05). There was no significant difference in the above parameters among group Dex+ DD, group Dex+ ID and group Dex+ II ( P>0.05). Conclusion:ACE gene polymorphism does not affect dexmedetomidine-induced inhibition of responses to endotracheal intubation in the patients with hypertension.

The authors introduced a pharmaceutical care mode by establishing a medication management platform(" Smart Pharmacists" platform), automatically and regularly sending personalized medication reminders for out-of-hospital patients. In virtue of the medication consultation service built on mobile internet technology, the hospital information system was seamlessly connected with the WeChat public account of the hospital, hence broadening pharmaceutical care. The " Smart Pharmacists" platform covered such six parts as medication reminder, medication record, voice broadcast, medication consultation, prescription query, and package insert inquiry. It serves as a reminder of taking medicine for patients out of the hospital and provides an accessible " pharmacist-patient interaction" service window, which will guarantee the safety and effectiveness of medication for out-of-hospital patients.

Objective:To assess the clinical significance of next-generation sequencing (NGS)-based IGH/ IGK gene rearrangement analysis versus flow cytometry (FCM) in diagnosing minimal residual disease (MRD) of children with acute B-cell lymphoblastic leukemia (B-ALL). Methods:Clinical data, NGS-MRD and FCM-MRD findings at the initial diagnosis and after induction chemotherapy of 85 children diagnosed as B-ALL in Children′s Hospital of Nanjing Medical University from July 2019 to July 2021, were retrospectively analyzed.The sensitivity of the two methods, and the positive rate were compared by χ2 test or Fisher′ s test.The correlation was identified by Spearman correlation analysis. Results:Dominant clone sequences were detected in all children at the initial diagnosis by NGS, while selection markers were identified by FCM in 75(88.2%) patients.Positive MRD rate detected by NGS-MRD was significantly higher than that of FCM-MRD at the same time point after induction chemotherapy[31.8%(27/85) vs.9.4%(8/85), P<0.001]. Compared with those of FCM-MRD, NGS-MRD had good sensitivity (100.0%), specificity (75.3%) and negative predictive value (100.0%), and the positive predictive value was 29.6%.MRD results detected by NGS were consistent with that of FCM ( r=0.569, P<0.001). By July 27, 2022, 2 patients with NGS-MRD (+ )FCM-MRD (-)relapsed during maintenance chemotherapy. Conclusions:NGS is highly consistent with FCM in the detection of MRD in children with B-ALL, which is more sensitive.The combination of NGS-MRD and FCM-MRD benefits more in monitoring MRD in children with B-ALL after induction chemotherapy.