Objective To investigate the relationship between risk factors and recurrent respiratory tract infections( RRTI) in children. Methods A case-control study was carried out in 204 children with RRTI,com-pared with 400 children without RRTI in control group. Results Second-hand smoking,breastfeeding,malnutri-tion,zinc deficiency,pet at home,home decoration and use of glucocorticoid were associated with RRTI in chil-dren. But the association between breastfeeding and RRTI was only found in children less than 5 years old. The second hand smoking was associated with RRTI only among boys,rather than girls. Home decoration,zinc defi-ciency,malnutrition and breastfeeding were associated with RRTI only among girls,but not among boys. Conclu-sion Recurrent respiratory tract infections are associated with multiple factors. Different risk factors have differ-ent affections on RRTI on gender.

Objective:To summarize the clinical nursing practice of mitral valvuloplasty combined with coronary artery bypass grafting in a patient with hemophilia A who suffered acute mitral valve tendon rupture and coronary heart disease.Methods:Individualized care plans were developed for patients with hemophilia A who need mitral valvuloplasty and coronary artery bypass grafting. Nursing measures were conducted from anticoagulatiaon care, bleeding care, hypoxemia care, multimodal analgesic care, psychological care, discharge guidance and discharge follow-up.Results:After multidisciplinary comprehensive treatment and standardized, individualized nursing, the patient recovered well and discharged after surgery on the 13th day.Conclusions:Implement personalized anticoagulation programs and care for this patient's individual situation to ensure the patient's smooth perioperative period Effective implementation of various postoperative care measures to promote early recovery of patients and reduce the pain caused by the disease during their hospitalization, also to improve the patient's quality of life.

Objective To investigate whether maternal antibody to hepatitis B surface antigen (anti-HBs)in infants may interfere with the antibody response to hepatitis B vaccine. Methods Infants from singleton pregnant mothers,who delivered at full term at the Affiliated Drum Tower Hospital of Nanjing University Medical School from October 2006 to January 2007,were divided into two groups based on their mothers'status of anti-HBs(43 positive and 29 negative).All infants were vaccinated with hepatitis B vaccine at birth and one month thereafter.Serum anti-HBs were quantitatively determined for the mothers before delivery and for infants in cord blood at delivery and in serum at the age of 1 and 3.5 months. Results Anti-HBs of all 43 newborns in the positive group were positive in cord blood with the coefficiency of 0.98 to the maternal serum anti-HBs level(t=39.05,P<0.01).Forty-two out of the 43 infants remained anti-HBs positive at the age of 1 month.Anti-HBs was negative both at birth and 1 month old in infants of the negative group.However,all infants in both groups were anti-HBs positive at 3.5 months of age,while the average concentration of anti-HBs in infants of the negative group was significantly higher than that of the positive group [(466.9±86.7)mIU/ml vs(151.2±23.1)mIU/ml,t=2.72,P=0.011].Among the 5 infants whose maternal anti-HBs level>1000 mIU/ml,3 did not produce active antibodies against two doses of hepatitis B vaccination. Conclusions Passively acquired maternal anti-HBs in infants can inhibit the active antibody response to hepatitis B vaccine,and the extent of this effect is associated with maternal anti-HBs level.

Objective: This study aimed to compare and analyze the functional differences between peripheral blood mono-cyte-derived dendritic cells (DCs) of Helicobacter pylori-positive and H. pylori-negative patients with gastric cancer. Methods:H. py-lori infection was detected in 84 patients with gastric cancer in our hospital from January 2011 to October 2012 by the 14C-urea breath test. DCs were generated from monocytes isolated by an adherent method from the two groups of patients and cultured in the presence of rhIL-4, rhGM-CSF, and rhTNF-α. Furthermore, the expression of surface marker molecules was determined by fluorescence-activat-ed cell sorting analysis. The cytotoxicity of DCs pulsed T cells against gastric carcinoma cell was assessed by the lactate dehydroge-nase-releasing assay. The secretion of IL-12 and IFN-γin the supernatant was determined by enzyme-linked immunosorbent assay. Re-sults:No difference was observed in the morphological change of the maturation process. The mean expression of CD1a, CD80, CD83, CD86, and HLA-DR molecules in DCs of H. pylori-infected patients was higher than that in DCs of H. pylori-negative group, and the differences were statistically significant except for CD1a and HLA-DR. The cytotoxicity activities, IL-12 release, and IFN-γrelease in the H. pylori-positive group were significantly higher than those in the H. pylori-negative group (P<0.05). Conclusion:H. pylori infec-tion has no effect on the morphological change of the maturation process of monocyte-derived DCs. These data clearly demonstrate that monocyte-derived DCs of H. pylori-infected patients with gastric cancer can induce stronger maturation and activation than those of H. pylori-negative patients.

In view of the characteristics of the computerized system,the key points in the quality assurance (QA) of the computerized system was discussed and summarized combined with the requirements of the GLP laboratory in Europe and America.The validation of computerized system,the control during the use of computerized system,period maintenance and safety protection of computerized system,archives of electronic data was discussed,expecting to provide reference for the management of computerized system in Chinese GLP laboratory which is generally not high currently.The experiences were obtained as follow:Through repeated inspection and review,the problem was found and set as the risk point;a targeted QA inspection plan was made focusing on the risk-based inspection and the QA inspection plan was timely adjusted according to the problems,which ensures the pertinence and validity of the QA inspection.

Pain is a prevalent symptom in both cancer and non-cancer end-stage diseases, often being the most feared by patients and significantly impacting their quality of life.Hospice care aims to address physical, psychological, spiritual, and other needs of patients and their families during this stage, with a focus on alleviating pain and discomfort.Effective pain management is a crucial component of hospice care, particularly given the increasing prevalence of cancer and chronic diseases in China and the growing elderly population.To provide analgesic management for hospice patients, a thorough assessment of pain is essential to identify its type and characteristics.Treatment approaches may include etiological interventions, pharmacotherapy, interventional therapy, physiotherapy, psychotherapy, and comfort care, all aimed at achieving comprehensive pain management.The use of opioid should be carefully guided by scientific principles to minimize adverse effects and optimize pain relief, ultimately enhancing patients' end-of-life quality of life.

Pain is one of the most common and unendurable symptoms in cancer patients and a major factor affecting their quality of life.Patient-controlled analgesia(PCA) is an important palliative measure in additional to conventional pharmacological control of pain.Nurses play the primary role in the management of PCA for cancer pain, and their knowledge, attitude and practice about PCA for cancer pain directly affect the effectiveness of cancer pain management.This article summarizes and analyzes the current status of nurses' knowledge, attitude and practice and associated influencing factors, aiming to improve nursing management of PCA, reinforce specialized nursing training, propose recommendations for an expert consensus on PCA for cancer pain and provide a reference for nursing practice in PCA for cancer pain.

Objective:To develop an artificial intelligence (AI) quality control model of fetal heart in the first trimester and verify its effectiveness.Methods:A total of 18 694 images of the four-chamber view(4CV) and three-vessel and tracheal view(3VT) of fetal heart in the first trimester were selected from Shenzhen Maternal and Child Health Hospital Affiliated to Southern Medical University since January 2022 to December 2022. A total of 14 432 images were manually annotated. The one-stage target detection algorithm YOLO V5 was used to train the AI quality control model in the first trimester of fetal heart, and 4 262 images (golden standard set by expert group) were used to evaluate the application effectiveness of AI quality control model. Kappa consistency test was used to compare the results of section classification and standard degree judgment from AI quality control model, Doctor 1(D1) and Doctor 2(D2).Results:①Precision of the AI quality control model was 0.895, recall was 0.852, mean average precision (mAP 50) was 0.873.The average precision(AP) of the AI quality control model for section classification was 0.907 (4CV) and 0.989 (3VT), respectively. ②Compared with the gold standard, the overall coincidence rate and consistency of section classification of AI quality control model, D1 and D2 were 99.91% (Kappa=0.998), 100% (Kappa=1.000), 100% (Kappa=1.000), respectively. The coincidence rate and consistency of the plane standard degree evaluation from the AI quality control model, D1 and D2 were 97.46% (Weighted Kappa=0.932), 93.73% (Weighted Kappa=0.847), and 93.12% (Weighted Kappa=0.832), respectively. Strong consistency was displayed. Moreover, AI quality control model showed the highest coincidence rate and the strongest consistency in judging section standard degree, which was superior to manual quality control. The time-consuming of AI quality control (0.012 s/sheet) was significantly less than the way of manual quality control (4.76-6.11 s/sheet)( Z=-8.079, P<0.001). Conclusions:The use of artificial intelligent fetal heart quality control model in the first trimester can effectively and accurately control the image quality.

White matter hyperintensity refers to spots or patches changes of white matter in the paraventricular or subcortical regions, which is closely related to the occurrence of cognitive impairment and dementia. This article reviews the neuroimaging examination and imaging evaluation scale of white matter hyperintensity.

Objective To investigate the effect of Mysm1 on the differentiation of neural stem cells(NSCs)into astrocytes and the possible mechanism.Methods NSCs were prepared from E12.5 cortices of wild-type C57BL/6 mice,cultured in vitro and induced to differentiate into astrocytes.Immunofluorescence staining,real-time quantitative PCR and Western blot assay were used to detect the expressions of Mysm1 during the differentiation of NSCs into astrocytes in vitro.Lentivirus was used to knock down Mysm1 expressions in NSCs before real-time quantitative PCR and Western blot assay were used to detect the knockdown efficiency.Immunofluorescence staining and Western blot assay were used to compare the differentiation of NSCs into astrocytes before and after Mysm1 knockdown in vitro.Transcriptomics was adopted to detect the differential gene after knockdown of Mysm1 in NSCs in vitro.Western blot assay was used to verify the changes of proteins associated with the differential gene.Cut-Tag was used to detect the enrichment of Mysm1 in the promoter region of glial fibrillary acidic protein(GFAP)genes during the differentiation of NSCs into astrocytes in vitro.After overexpression of GFAP following knockdown of Mysm1,immunofluorescence staining and Western blot assay were used to compare the differentiation of NSCs into astrocytes before and after overexpression in vitro.Results The expression of Mysm1 was gradually increased when NSCs were induced to differentiate into astrocytes in vitro.Mysm1 knockdown inhibited the differentiation of NSCs into astrocytes in vitro.Mysm1 affected the differentiation of NSCs into astrocytes by regulating the expression of GFAP.Overexpression of GFAP after Mysm1 knockdown partially rescued the ability of NSCs to differentiate into astrocytes.Conclusion Mysm1 regulates the differentiation of NSCs into astrocytes by epigenetically controlling GFAP transcription.