Objective To explore the down-regulation of advanced receptor for advanced glycation end products(RAGE)on expression of high mobility group protein B1(HMGB1)in glioma cells line and the volume change of transplanted tumor in nude mice. Methods HMGB1 expression in glioma LN229 cells line (divided into a control group and a study group) was observed by immunohistochemical assay and Western blot. The control group received normal saline,whereas the study group received RAGE receptor blocking agent FPS-ZM1. Expression of HMGB1 protein was detected by the same methods. The difference of the expression was examined by independent sample t test. 30 Nu/Nu nude mice were randomly divided into two groups;the above two kinds cell lines were injected into the same area of the left back of nude mice. Six weeks after injection ,the volume size was measured six times ,and the variance of repeated measurement data was used to analyze the difference of the volume change. Results HMGB1 protein was mainly expressed in the cytoplasm and nucleus. As compared with the control group,HMGB1 protein expression levels were decreased in the study group(P < 0.05),the growth rate of transplanted tumor in nude mice was significantly faster in the control group than in the study group ,the difference was statistically significant(P < 0.05). Conclusions The growth and invasion of HMGB1 protein may be involved in glioma by RAGE receptor. RAGE receptor blocker FPS-ZM1 can significantly reduce the expression of HMGB1 protein and inhibit the growth of transplanted tumor volume. It is expected to be used for the research on glioma cell apoptosis.

Abstract During the peirod of Republic of China, the rural economy in China was in a state of decline, with poor hygiene conditions and extremely low levels of physical health among children. Under such circumstances, Professor Chen Zhiqian established the first rural health pilot zone in China and created the Dingxian Model,and explored a path suitable for the development of rural school health services by conducting health education courses, cultivating good hygiene habits,examining and improving students physical health status, and carrying out health surveys among teachers and students. The above actions has accumulated valuable experiences for the exploration and practice of contemporary rural school health services.

Objective To explore the status of depression in patients with advanced schistosomiasis and its influencing fac-tors,so as to provide the evidence for improving psychological interventions. Methods A total of 206 patients with advanced schistosomiasis were investigated with the self-designed general information questionnaire,the Self-Rating Depression Scale,and WHOQOL-BREF Form. Results Among the 206 cases,the incidence of depression was 69.4%,and depression was negatively related to the quality of life(P = 0.000). The multiple logistic regression analysis showed that the times of hospitalization(β=0.442,P=0.007)was a risk factor for depression,while the high education levels(β=-0.583,P=0.011)and the history of por-tal hypertension operation(β=-0.917,P=0.000)were the protective factors. Conclusion The incidence of depression in ad-vanced schistosomiasis patients is high,and it is influenced by various factors. Therefore,we should take corresponding interven-tions to reduce its occurrence.

Objective:To analyze the characteristics of occupational diseases in Bao'an District of Shenzhen from 2006 to 2019, so as to provide scientific basis for formulating occupational disease prevention policies and measures.Methods:In September 2020, the information of new occupational disease cases in Bao'an District of Shenzhen from 2006 to 2019 was collected through the national occupational disease and occupational health information monitoring system, and the classification, disease type distribution, population distribution and industry and enterprise scale distribution of new occupational disease cases were analyzed.Results:From 2006 to 2019, a total of 762 new occupational diseases were reported in Bao'an District of Shenzhen, of which the top three were occupational ear, nose, throat and oral diseases (233 cases, accounting for 30.58%) , occupational chemical poisoning diseases (219 cases, accounting for 28.74%) , occupational pneumoconiosis and other respiratory diseases (127 cases, accounting for 16.67%) . The classification composition of occupational diseases was different in different years, and the difference was statistically significant ( P<0.05) . New occupational diseases are mainly distributed in the manufacturing industry (394 Eaterprises, caccouling 93.59%) , concentrated in (346 cases, accounting for 47.66%) and medium-sized enterprises (199 cases, accounting for 27.4%) small enterprises. Conclusion:New occupational diseases in Bao'an District of Shenzhen should focus on small and medium-sized manufacturing enterprises, carry out risk assessment of occupational hazards, implement classified and hierarchical supervision of occupational health, and implement occupational health protection.

Objective:To analyze the characteristics of occupational diseases in Bao'an District of Shenzhen from 2006 to 2019, so as to provide scientific basis for formulating occupational disease prevention policies and measures.Methods:In September 2020, the information of new occupational disease cases in Bao'an District of Shenzhen from 2006 to 2019 was collected through the national occupational disease and occupational health information monitoring system, and the classification, disease type distribution, population distribution and industry and enterprise scale distribution of new occupational disease cases were analyzed.Results:From 2006 to 2019, a total of 762 new occupational diseases were reported in Bao'an District of Shenzhen, of which the top three were occupational ear, nose, throat and oral diseases (233 cases, accounting for 30.58%) , occupational chemical poisoning diseases (219 cases, accounting for 28.74%) , occupational pneumoconiosis and other respiratory diseases (127 cases, accounting for 16.67%) . The classification composition of occupational diseases was different in different years, and the difference was statistically significant ( P<0.05) . New occupational diseases are mainly distributed in the manufacturing industry (394 Eaterprises, caccouling 93.59%) , concentrated in (346 cases, accounting for 47.66%) and medium-sized enterprises (199 cases, accounting for 27.4%) small enterprises. Conclusion:New occupational diseases in Bao'an District of Shenzhen should focus on small and medium-sized manufacturing enterprises, carry out risk assessment of occupational hazards, implement classified and hierarchical supervision of occupational health, and implement occupational health protection.

Objective To observe the effects of Siweiyuganzi prescription on anti-peroxidation and blood lipid levels in experimental rats with hyperlipidemia. Methods Sixty male Sprague-Dawley (SD) rats were divided into normal control group, hyperlipidemia model group, Xuezhikang group, Siweiyuganzi prescription large, medium and small dose group according to the random number table method, with 10 rats in each group. The hyperlipidemia rat model was established by intragastric feeding with high fat emulsion everyday 10 mL·kg-1·d-1; normal saline 10 mL/kg was given to the normal control group, twice a day by intragastric feeding; 3 dosages of Siweiyuganzi suspended fluid 12.8, 6.4, 4.3 g·kg-1·d-1 intragastric administrations were given to Siweiyuganzi prescription large, medium and small dose groups respectively; Xuezhikang suspended fluid 0.3 g·kg-1·d-1 was given to Xuezhikang group intragastrically;the same volume of normal saline was given to hyperlipidemia model group. After 4 weeks, the level changes of blood lipid, serum superoxide dismutase (SOD), malonaldehyde (MDA), hydroxymethylglutaryl Coenzyme A (HMG-CoA) were observed. Results Compared to those in the normal control group, the levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), MDA, content and positive expression of HMG-CoA, alanine aminotransferase (ALT) were all higher in hyperlipidemia model group [TG (mmol/L): 6.59±0.72 vs. 4.32±0.36, TC (mmol/L): 7.10±0.25 vs. 5.98±0.40, LDL-C (mmol/L): 4.18±1.30 vs. 2.33±0.35, MDA (μmol/L): 26.05± 5.99 vs. 10.08±1.98, HMG-CoA content (ng/L): 54.60±2.90 vs. 48.73±3.09, HMG-CoA positive expression in liver tissue:(57.80±12.30)% vs. (22.00±4.92)%, ALT (U/L): 106.83±15.75 vs. 81.97±13.18]; SOD and high-density lipoprotein cholesterol (HDL-C) in hyperlipidemia model group were significantly decreased [SOD (kU/L): 295.47±37.51 vs. 345.13±19.76, HDL-C (mmol/L): 2.32±0.49 vs. 4.84±0.45, both P < 0.05]. Compared with the hyperlipidemia model group, the TG, TC, LDL-C, MDA, contents and positive expression of HMG-CoA in each group were significantly reduced, and the SOD and HDL-C were obviously increased, and the changes in the Siweiyuganzi high dose group were more significant than those of the Siweiyuganzi middle-and low-dose groups [TG (mmol/L): 4.70±0.46 vs. 5.40±0.31, 5.70±0.41, TC (mmol/L): 5.80±0.23 vs. 6.14±0.20, 6.56±0.32, LDL-C (mmol/L): 2.56±0.45 vs. 2.93±0.33, 3.28±0.32, HDL-C (mmol/L): 4.58±0.28 vs. 3.89±0.30, 3.59±0.08, SOD (kU/L): 381.45±20.68 vs. 360.60±30.16, 325.49±32.13, MDA (μmol/L): 16.98±5.39 vs. 17.89±5.37, 21.03±6.01, HMG-CoA content (ng/L): 50.58±0.77 vs. 52.16±0.66, 52.90±0.91, HMG-CoA positive expression in liver tissue: (27.90±6.03)% vs. (32.20±7.00)%, (43.00±8.39)%, all P < 0.05]. In the normal control group, there were positive cells scattered in the central vein area and loosely distributed around the portal area in the rat liver; in the hyperlipidemia model group, the positive cells were increased in the central vein area and the cells in relatively great number were seen around the portal area. While the positive cells in Xuezhikang group and in the high, medium and low dose Siweiyuganzi groups were decreased. Conclusion Siweiyuganzi prescription can regulate the levels of blood lipids, prevent and treat the lipid peroxidation caused by hyperlipidemia, and inhibit excessive expression of HMG-CoA in experimental rats with hyperlipidemia.

Objective To study the clinical effect of evidence-based prevention strategies of ventilator-associated pneumonia (VAP) in newborns with endotracheal intubation in neonatal intensive care unit (NICU).Method A retrospective analysis was carried out in neonates undergoing mechanical ventilation,who were admitted to the NICU of the hospital from 2016 to 2017.Intubated newborns from January 2016 to December 2016 were conducted with traditional method of preventing VAP and included as control group.While intubated newborns admitted from January 2017 to December 2017 with newly developed evidence-based prevention strategy for VAP were included as observation group.The positive rates of culture from swab or sputum or endotracheal intubation tube ends obtained within 48 hours after intubation and 48 hours after extubation were compared between groups.The neonates whose swab or sputum culture was negative before intubation were included.The positive rate was presented as the number of positive cases/1 000 intubation days.Result A total of 1 221 intubated infants were included,with 632 cases in the control group which were intubated 798 times,and 589 cases in the observation group which were intubated 720 times.The gestational age and birth weight of the observation group was lower than the control group.The rate of extremely low birth weight infant of the observation group was higher than that of the control group.The mechanical ventilation days were also longer in the observation group.The differences were statistically significant (P ＜ 0.05).In the control group,the number of positive cases was 112 and the total intubation days were 3 079 days,the positive rate was 36.4 cases/1 000 intubation days.In the observation group,the number of positive cases was 72 and the total intuhation days were 3 475 days,the positive rate was 20.7 cases/1 000 intubation days.The positive rate of observation group was lower than the control group,the differences was statistically significant (x2 =4.060,P =0.044).Conclusion Evidence-based neonatal VAP bundle can reduce the invasion of respiratory pathogenic bacteria in NICU.In the future work of NICU nursing,we should use bundle strategy to care for babies more and more,and the bundle should be supported by evidence.

Objective:To investigate the relationship between inherited dysplasminogenemia and cerebral infarction (CI) by phenotype and gene mutation analysis of 2 inherited dysplasminogenemia pedigrees.Methods:Retrospective analysis was carried out on clinical data of 2 patients diagnosed with CI who were treated in the Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University in January and March 2021, and peripheral venous blood samples were collected from proband 1 and his family members (8 subjects, 4 generations in total) and proband 2 and her family members (5 subjects of 3 generations in total), and their plasminogen (PLG) activity (PLG:A), protein C activity, protein S activity, antithrombin activity and the content of PLG antigen (PLG: Ag), fibrinogen, D-dimer and fibrinogen degradation products were measured for definite diagnosis. All 19 exons,5′ and 3′ untranslated regions of PLG were amplified with polymerase chain reaction, and the amplification products were analyzed by direct DNA sequencing. The results were compared with human PLG reference sequences published in the National Center for Biotechnology Information database using Chromas software to find the mutation sites, and confirmed by reverse sequencing.Results:Both of the 2 patients with confirmed CI had a young onset, and PLG: A was reduced to 21% in the proband 1 and to about 50% in 4 family members; PLG: A was reduced to about 50% in the proband 2 and 2 family members; PLG:Ag and the above tests were essentially normal in both probands and family members. Gene analysis showed that the proband 1 had the homozygous mutation of c.1858G>A in exon 15, the 4 family members of the proband 1, proband 2 and her 2 family members had the heterozygous mutation of c.1858G>A in exon 15, which resulted in a mutation of alanine at position 620 in PLG to threonine (p.Ala620Thr).Conclusions:The decrease of PLG:A was caused by the p.Ala620Thr missense mutation of PLG gene. Proband having CI may be related to the inhibition of fibrinolytic function in the organism due to the p.Ala620Thr missense mutation.

Objective:To analyze the clinical characteristics of patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR), and to explore the risk factors leading to poor prognosis.Methods:The clinical data of 95 patients with ECPR admitted to the First Affiliated Hospital of Zhengzhou University from January 2020 to May 2023 were retrospectively analyzed. According to the survival status at the time of discharge, the patients were divided into the survival group and death group. The difference of clinical data between the two groups was compared to explore the risk factors related to death and poor prognosis. Risk factors associated with death were identified by Binary Logistic regression analysis. Results:A total of 95 patients with ECPR were included in this study, 62 (65.3%) died and 33 (34.7%) survived at discharge. Patients in the death group had longer low blood flow time [40 (30, 52.5) min vs. 30 (24.5, 40) min ] and total cardiac arrest time[40 (30, 52.5) min vs. 30(24.5, 40) min], shorter total hospital stay [3 (2, 7.25) d vs. 19 (13.5, 31) d] and extracorporeal membrane oxygenation (ECMO) assisted time [26.5 (17, 50) h vs. 62 (44, 80.5) h], and more IHCA patients (56.5% vs. 33.3%) and less had spontaneous rhythm recovery before ECMO (37.1% vs. 84.8%). Initial lactate value [(14.008 ± 5.188) mmol/L vs.(11.23 ± 4.718) mmol/L], APACHEⅡ score [(30.10 ± 7.45) vs. (25.88 ± 7.68)] and SOFA score [12 (10.75, 16) vs. 10 (9.5, 13)] were higher ( P< 0.05). Conclusions:No spontaneous rhythm recovery before ECMO, high initial lactic acid and high SOFA score are independent risk factors for poor prognosis in ECPR patients.

The widespread application of medical artificial intelligence （AI） has brought technological breakthroughs to traditional diagnosis and treatment and has also altered the traditional doctor-patient interaction mode and formed a new doctor-patient relationship of “doctor-medical AI-patient” which faces a series of challenges. The intervention of AI may form a new “paternalistic style，” affecting the shared decision-making model. When its recommendations lack explanation， it may lead to clinical decision-making paralysis and affect the doctor-patient trust relationships. There may be confusion between the roles and responsibilities of AI and doctors in the process of medical practice， affecting the establishment of an emotionally responsible doctor-patient relationship. Through an in-depth analysis of the impact and causes of medical AI on the doctor-patient relationships， this paper proposed that a collaborative mechanism should be established between AI and professional doctors to complement each other， clarifying the auxiliary status of AI， reinforcing the dominant role of doctors， enhancing the regulatory mechanism， and dynamically improved the doctor-patient relationships to promote the healthy and orderly development of smart healthcare.