Objective To improve theu nderstanding of the characteristci s of death in hospitail zed hc ildren and provide clinical cautionary information to professional healthcarep rovdie rs.Methods A retro-spective analysis was undertaken on thed ata of all children aged 1 month to 11 years who died at the Xinhua H ospital between 2007 and 2014.Demographic details,main causes of deaths,and chronic underyl ingd iseases were reviewed.Results Case fatality rate was 0.58%( 451/77 838 ) .Overall, the most common causes fo deathni hospitalized childer n were pneumo nia 38.80%(175/451),tumor 13.75%(62/451),sepsis 11.97%(54/451),central nerve system infection 8.00%(36/451) and accident 7.32%(33/451).Infectious disea-ses were the maoj r causes of deathi n children younger than 5ye ars of age(66.86%,230/344).In oc ntrast, noninfectious diseases accuo tn ed for mo re deathsni children more than 5 years old(52.34%,56/107).There were 343d eath cases comp licated wiht chronic undelr ying diseases.Congentia la bnormality was the most fre-quent chronic underlying disease observed in infants(59.90%,115/192) and tumor was the main chronic nu -derlying dsi easei not ddlers and elder children(34.36%,89/259).Conclusion Infectious diseasse were the major causes of deta hs,and teh mortality in the study popual tion decreased with age.Tumors and accidents accounted for more deaths in elder children.Chronic underlying diseases were found in most deaths of children.Efficient evaluation and effective intervention of these vulnerable children might save more lives.

Objective To learn 2009~2014 Shaanxi Province sentinel surveillance six classes of HIV infection focus groups, and estimates of HIV-1 new infection.Methods Used enzyme-linked immunosorbent assay (ELISA)and Western blot (WB)experiments for the 2009~2014 HIV sentinel surveillance Shaanxi Province Category 6 focus groups conducted a total of 77 778 HIV antibody screening and confirmatory testing estimates of HIV-1 new infection.Results 2009~2014 men who had sex with men and people with HIV infection rate were 3.75%,8.77%,3.50%,5.00%,6.20% and 5.75%,and a slow upward trend;HIV-1 new infection were 5.04%,8.96%,5.01%,5.95%,4.68% and 6.39%,the overall downward trend. Young students,drug addicts,sex workers,pregnant women,and male STD clinic attenders five people with HIV infection and HIV-1 new infection were emerging to remain low.But male STD clinic attenders of HIV infection and HIV-1 new in-fection was emerging slowly rising trend.Conclusion Shaanxi MSM HIV infection and HIV-1 new infection were high,but HIV-1 new infection had decreased slowly.Emerging trend should continue to increase the population of the intervention ef-forts.The infection rate in other monitoring population was relatively low but a few people on the rise,the need to take the necessary coping methods.

Objective To evaluate the treatment outcome and prognostic factors in patients with grade Ⅲ/Ⅳ glioma following postoperative chemoradiotherapy.Methods A retrospective analysis was performed on the medical records of 119 patients with grade Ⅲ/Ⅳ glioma who received treatment in our hospital from January 2007 to April 2012.Of the 119 patients,49 received radiotherapy alone,21 received radiotherapy combined with nitrosoureas,and 49 received radiotherapy combined with temozolomide.The Kaplan-Meier method was used to calculate overall survival (OS) rates and recurrence rates.The Cox regression model was used for multivariate prognostic analysis.Results The follow-up rate was 94.1％.Fifty-three patients were followed up for at least 1 year,and 10 for at least 2 years.The overall recurrence rate was 69.7％.The 1-and 2-year OS rates were 44.5％ and 8.4％,respectively.The multivariate analysis showed that age,presence or absence of seizures before surgery,extent of tumor resection,and radiotherapy plus concurrent and adjuvant temozolomide were the main prognostic factors for tumor recurrence (P =0.002,0.005,0.000,and 0.000).The above factors and the pathological grade of tumor were the independent prognostic factors for patients' survival (P =0.006,0.010,0.000,0.000,and 0.001).Conclusions Postoperative radiotherapy plus concurrent and adjuvant temozolomide produce a good clinical effect in patients with grade Ⅲ/Ⅳ glioma.Age of ＜ 60 years,no seizures before surgery,total tumor resection,and pathological grade Ⅲ of tumor are the favorable prognostic factors for the long-term survival in patients with malignant glioma.

Objective:To identify genes interacting with the ubiquitin-conjugating enzyme E2S (UBE2S) in melanoma, and to explore the molecular mechanisms regulating the biological behavior of melanoma cells by UBE2S.Methods:Cultured A375 melanoma cells were divided into 2 groups to be transfected with LV-UBE2S-RNAi (14011-1) -containing lentivirus (gene knockdown group) and a negative control lentivirus CON053 (negative control group), respectively, and the UBE2S gene-knockdown cell line and negative control cell line were established. RNA was extracted from the two cell lines, purified, fragmented, and hybridized with GeneChip probes, followed by washing and dyeing, and then microarray data were obtained. Ingenuity pathway analysis (IPA) software was used to further analyze the gene expression profiling data to identify potential genes interacting with UBE2S. Western blot analysis was performed to verify the downstream molecules regulated by UBE2S. A two-tailed t test was used to screen for differentially expressed genes. Results:A total of 512 differentially expressed genes with a|fold change| > 2 and a P value < 0.05 were screened out between the gene knockdown group and negative control group, including 247 upregulated genes and 265 downregulated genes. IPA of differentially expressed genes revealed that interferon signaling and liver X receptor (LXR) /retinoid X receptor (RXR) activation pathways were significantly activated, while eukaryotic initiation factor-2 (EIF2) signaling and nuclear factor-κB (NF-κB) signaling pathways were inhibited. Among the upstream regulators, IFNA2 was predicted to be strongly activated, and NF-κB (complex) to be strongly inhibited. Based on the above bioinformatics analysis results, it was suggested that the UBE2S gene may exert some effects in melanoma cells by regulating the expression of IFITM1, STAT1, ISG15 and TNFRSF11B genes. Western blot analysis showed that IFITM1 protein was not expressed in A375 cells before and after the UBE2S gene knockdown. After the UBE2S gene knockdown, ISG15 protein expression was upregulated by 19.94 times, STAT1 protein expression was upregulated by 1.47 times, and TNFRSF11B protein expression was downregulated by 79.1%. Conclusion:UBE2S may interact with STAT1, ISG15 and TNFRSF11B to regulate the biological behavior of melanoma cells.

Objective:To evaluate the correlation between the timed up and go(TUG)test and fall risks in elderly frail patients.Methods:From July to September 2019, elderly frail patients who were treated at the cardiovascular department of our hospital were enrolled.Basic clinical data and fall-related information of patients were collected.Patients were divided into the fall group and the non-fall group.Results on the body mass index(BMI), TUG, 4-meter maximum walking speed(4 m MWS)and Barthel index were compared between the two groups.The correlation between TUG and each indicator was examined.Multivariate Logistic regression analysis was used to analyze the correlation between the TUG and falls in elderly patients.Results:A total of 96 eligible patients were enrolled, including 35 in the fall group and 61 in the non-fall group.The average TUG time was longer in the fall group than in the non-fall group(16.45±6.44 s vs.10.17±2.91 s, t=-6.556, P<0.001). The correlation analysis results showed that the TUG was correlated with falls and 4 m MWS( r=0.582 and 0.875, both P<0.001). Multivariate Logistic regression analysis showed that the TUG( OR=1.201, 95% CI: 1.111-1.470, P=0.004)and 4 m MWS( OR=1.146, 95% CI: 1.063-1.244, P=0.015)were risk factors for falls. Conclusions:The TUG is correlated with fall risks in elderly frail patients and should be recommended as a routine test in clinical practice.

Objective: To explore the relationship between parent child relationship and rebelliousness of junior middle school students in boarding schools and to provide a scientific basis for preventing the occurrence of youth rebellion. Methods: A cluster sampling method was used to investigate parent child separation, family intimacy, and rebellion among 1 790 junior high school students in one boarding middle school in Lujiang County, Hefei City, Anhui Province in January 2020, and the influence of parent child relationship on students rebelliousness was analyzed by Chi square test and binary Logistic regression. Results: The detection rate of rebelliousness among participants was 21.45%(384/ 1 790 ). Junior middle school students who were in senior grade (second and third grades), reported higher household economic status and no communication with parents during the past month were more likely to have rebelliousness( OR=1.83, 1.89, 1.80, 1.77 , P <0.05); Junior middle school students with higher parental warmth and intimacy were less likely to have rebelliousness( OR=0.52, 0.71, P <0.05); Gender, length of boarding, maternal education, frequency of meeting parents during boarding, and childhood experience of separation with parents showed no statistical significance on rebelliousness( P >0.05). Conclusion The detection rate of rebellious psychology among junior high school students in boarding schools is high, and good parent child relationship is the protective factor of rebellious psychology. Parents should pay attention to contact with their boarding children and strengthen communication to reduce rebelliousness among them.

Objective To determine the expression of ubiquitin-conjugating enzyme E2S (UBE2S) in malignant melanoma (MM),and to evaluate its effect on the biological behavior of melanoma cells.Methods Immunohistochemical study was performed to determine the UBE2S expression in 128 primary MM tissue chips,64 metastatic MM tissue chips,16 non-tumor tissue chips (8 paralesional normal skin tissues and 8 normal epidermal tissues).Real-time quantitative RCR was conducted to determine the UBE2S mRNA expression in the melanoma cell lines A375,MUM-2B and MUM-2C.The melanoma cell lines A375 and MUM-2B were divided into 2 groups separately:interference group transfected with a lentiviral vector carrying UBE2S RNA interference sequence,and control group transfected with a lentiviral vector carrying control sequence.After 72 hours,real-time quantitative RCR was performed to determine the UBE2S mRNA expression in the melanoma cell lines A375 and MUM-2B.Caspase-3/7 activity in the groups was assessed by using kits,and cell apoptosis and cell cycle distribution were detected by flow cytometry.The effect of UBE2S knockdown on the migratory and invasive abilities of and N-cadherin expression in A375 cells were evaluated by Transwell assay and Western blot analysis respectively.Statistical analysis was carried out with SPSS 22.0 software by using independent sample t-test for the comparison of normally distributed data between two groups,chi-square test for enumeration data,MannWhitney U test for the comparison of non-normally distributed data,and Spearman's coefficient for assessment of the correlation of UBE2S expression with T staging of melanoma.Results UBE2S was highly expressed in 98 (51.0％) MM tissues,but lowly expressed in 16 non-tumor tissues,and the UBE2Sexpression rate significantly differed between the above two kinds of tissues (x2 =11.905,P ＜ 0.01).UBE2S expression was negatively correlated with T staging of melanoma (ρ =-0.210,P =0.043).The relative mRNA expression of UBE2S significantly differed among the A375,MUM-2B,and MUM-2C cells (F =817.228,P ＜ 0.01).After UBE2S knockdown,the caspase-3/7 activity was significantly up-regulated in the A375 interference group (t =17.572,P ＜ 0.01) and MUM-2B interference group (t =24.552,P ＜0.01) compared with the A375 and MUM-2B control groups respectively.Compared with the control group,the A375 interference group showed significantly increased proportion of A375 cells at G1 phase (t =7.365,P ＜ 0.01),decreased proportion at S phase (t =-9.190,P ＜ 0.01),and no change in the proportion of A375 cells at G2/M phase (t =-0.227,P ＞ 0.05).The MUM-2B interference group showed significantly increased proportions of MUM-2B cells at G1 (t =12.676,P ＜ 0.01) and G2/M phases (t =13.045,P ＜0.01),but significantly decreased proportion at S phase (t =-15.718,P ＜ 0.01) compared with the control group.Transwell assay revealed decreased migratory and invasive abilities of A375 cells in the interference group compared with the control group (t =-35.727,-125.000,P ＜ 0.05,＜ 0.01,respectively).Western blot analysis showed down-regulated expression of N-cadherin protein in A375 cells in the interference group compared with the control group.Conclusions UBE2S is over-expressed in melanoma tissues,whose expression is associated with the T staging of melanoma.Knockdown of UBE2S affects the apoptosis,cell cycle,migration and invasion of melanoma cells,and may promote the metastasis of MM cells by regulating N-cadherin expression.

Objective To investigate the current status of HIV infection and the related factors in HIV antibody positive clients of female sex workers (FSWs) recently reported in Shaanxi province.Methods The HIV/AIDS cases newly diagnosed in males living in Shaanxi from January 1th of 2013 to June 30th of 2014 were selected and those infected through "commercial heterosexual behavior" were identified.The information about their demographic characteristics,previous unprotected heterosexual sex and the sample sources were collected,and serum or plasma samples were collected from them and tested with BED-CEIA.The proportion of recent HIV infections and associated factors were investigated.Results The proportion of recent HIV infection and HIV-antibody detection rate in 212 HIV antibody positive male clients of FSWs were 25.5％ and 6.6％ respectively.The cases who had the educational level of junior middle school or high middle school were wore likely to have long term HIV infections than those with lower educational level (aOR=0.28,95％ CI:0.08-0.93).Compared with patients identified by hospitals or sexually transmitted diseases clinics,recent HIV infections were more likely to be found through preoperative test or blood transfusion test (aOR=3.14,95％ CI:1.06-9.30) and blood donation test (aOR=4.19,95％ CI:1.01-17.42).Compared with the cases who had commercial sex only in Xi'an or other province or both in Xi'an and other province,the cases who had commercial sex in other cities in Shaanxi were more likely to be infected recently (aOR=0.19,95％CI:0.07-0.57).Compared with the cases had temporary heterosexual sex partner,those who had no temporary sex partners were more likely to be infected recently (aOR=9.03,95％CI:3.00-27.18)(P＜0.05).Conclusions The proportion of recent HIV infections among HIV antibody positive clients of FSWs was high and the HIV-antibody detection rate among them was low.The educational level,sample source,geographic area and temporary heterosexual partner were related factors for recent HIV infection.The HIV infection in the clients of FSWs,especially those with lower educational level,was serious in Shaanxi.It is necessary to strengthen behavior intervention and improve HIV defection according to the characteristics of this population

Objective:To explore the application of endoscopic narrow-band imaging(NBI) in the early diagnosis of throat malignant tumors.Methods:From January 2014 to December 2019, 512 patients with suspected benign or malignant diseases of the throat in the First People's Hospital of Wenling were selected, and all patients were performed white light endoscopy and NBI endoscopy.The biopsies were taken for pathological examination.The histopathological results were seemed as gold standard for diagnosis.Results:NBI endoscopy was superior to white light endoscope in terms of microvascular morphology and lesion outline(χ 2=457.497, 293.209, all P<0.05). The diagnostic coincidence rate, sensitivity and negative coincidence rate of NBI endoscope for malignant tumors were higher than those of white light endoscope(χ 2=10.131, 6.197, 4.084, all P<0.05). The sensitivity of NBI endoscope type Ⅰ-Ⅱ in the diagnosis of benign lesions was 90.65%, and the specificity was 96.88%.The sensitivity and specificity of NBI endoscope type Ⅲ-Ⅳ in the diagnosis of mild-moderate dysplasia were 80.99% and 97.52%, respectively.The sensitivity and specificity of NBI endoscopy type Va in the diagnosis of severe atypical hyperplasia were 15.18% and 98.54%, respectively.The sensitivity and specificity of NBI endoscope Va-c in the diagnosis of invasive cancer were 93.24% and 96.93%, respectively. Conclusion:Compared with white light endoscope, NBI endoscope can more clearly show the outline of lesions and submucosal blood vessels, and can more accurately diagnose malignant tumors in the throat, especially can more recognized the pre-cancerous lesions and early malignant tumors.It has important clinical application value in early diagnosis of malignant tumor in the throat.

Objective:To observe the clinical efficacy of Qigui Tangtongning Granules in the treatment of diabetic peripheral neuropathy (DPN) with qi deficiency and blood stasis.Methods:Prospective cohort study. A total of 80 DPN patients with Qi deficiency and blood stasis in Endocrinology Department of the First Affiliated Hospital of Anhui University of Chinese Medicine from May 2021 to May 2022 who met the inclusion criteria were divided into 2 groups by random number table method, with 40 cases in each group. The control group was treated with epalrestat on the basis of routine hypoglycemia, and the treatment group was treated with Qigui Tangtongning Granules on the basis of control group. Both groups were treated for 8 weeks. TCM syndromes were scored before and after treatment. Disease severity was assessed using the Toronto Clinical Scoring System (TCSS). The motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of median nerve and common peroneal nerve were detected by electromyography/induced potentiometer. Serum CRP, TNF-α and IL-6 were detected by ELISA, fasting blood glucose (FPG) and two hours post-meal blood glucose (2 hPG) were detected by automatic biochemical analyzer, and glycosylated hemoglobin (HbA1c) was detected by automatic HBA1C analyzer. Adverse reactions were recorded and clinical efficacy was evaluated.Results:The total effective rate was 95.0% (38/40) in the treatment group and 77.5% (31/40) in the control group, the difference between the two groups was statistically significant ( χ2=5.17, P=0.023). After treatment, the TCM syndrome score and TCSS score of the treatment group were significantly lower than those in the control group ( t=-3.19 and -7.63, P<0.01); Median nerve SNCV [(47.90±4.51) m/s vs. (44.76±3.72) m/s, t=3.40], MNCV [(53.79±3.65) m/s vs. (51.32±4.25) m/s, t=2.79] and common peroneal nerve SNCV [(44.21±2.08) m/s vs. (40.51±2.49) m/s, t=7.23], MNCV [(44.63±4.72) m/s vs. (41.36±4.87) m/s, t=3.05] were significantly higher than those in the control group ( P<0.01); FPG [(5.05±0.63) mmol/L vs. (7.05±1.23) mmol/L, t=-9.17], 2 hPG [(9.10±1.64) mmol/L vs. (12.19±2.61) mmol/L, t=-6.35], HbA1c [(6.79±0.90) % vs. (7.22±1.02) %, t=-2.02] were significantly lower than those in the control group ( P<0.01 or P<0.05); TNF-α [(15.75±5.44) ng/L vs. (32.01±5.33) ng/L, t=-13.51], hs-CRP [(2.58±0.80) mg/L vs. (3.79±1.04) mg/L, t=-5.83], IL-6 [(18.20±4.92) ng/L vs. (29.97±5.18) ng/L, t=-10.41] were significantly lower than those in the control group ( P<0.01). No obvious adverse reactions were observed in 2 groups during treatment. Conclusion:Qigui Tangtongning Granules combined with conventional Western medicine can improve nerve conduction velocity, reduce inflammation and improve clinical efficacy in DPN patients with Qi-deficiency and blood-stasis syndrome.