Background:Excessive immune cell activation-inflammatory factor theory is one of the most important pathogenic mechanisms of acute pancreatitis(AP). As the release of inflammatory factors is associated with systemic inflammatory response syndrome,seeking of serum cytokine markers for severity assessment of AP is of great clinical importance. Aims:To determine the dynamic changes of interleukin-6(IL-6),hepatocyte growth factor(HGF),and angiopoietin-2(Ang-2) in peripheral blood of AP patients in the first week after admission,and investigate preliminarily the clinical significance of these markers in AP. Methods:Seventy-two AP patients were prospectively recruited from Apr. 2014 to Oct. 2014 at the First Affiliated Hospital of Soochow University and were assigned into three groups:mild AP(MAP,n = 54),moderately severe AP(MSAP,n = 12)and severe AP(SAP,n = 6)according to the Atlanta classification of AP-2012. Thirty healthy subjects were served as controls. Serum levels of IL-6,HGF and Ang-2 were determined by ELISA on the 1st,3rd and 7th day after admission. Results:In the first week after admission,serum levels of IL-6,HGF and Ang-2 were significantly higher in AP patients than in controls(P < 0. 05). In MAP group,all three markers were gradually decreased in the first week;while in MSAP group,IL-6 was gradually increased,Ang-2 was gradually decreased,and HGF decreased after reaching the peak;in SAP group,IL-6 decreased after reaching the peak and HGF and Ang-2 increased again after a decrease. Serum levels of IL-6,HGF and Ang-2 were higher in MSAP group and SAP group than in MAP group at all the time points,but no statistically significant differences were observed between MSAP group and SAP group(P > 0. 05). Conclusions:IL-6,HGF and Ang-2 might play important roles in the pathogenesis of AP,and being the promising serum markers for severity assessment and dynamic monitoring of AP.

The paper introduces an overview of Shanghai medical security system, analyzes its effectiveness and challenges, and put forward overall goals and key tasks in the future. Shanghai has formed a multiple, medical security system and basically achieved the short-term goal of medical security system establishment which was requested to put forward in national health system reform. Shanghai medical insurance system has played a positive role in promoting economic and social development and reducing the burden of medical expenses. To further implement requirements of national health system reform, Shanghai will be conducting the integration of different schemes , narrow down the gap of benefit packages, improvement of health care management and the initiatives of nursing care insurance to further improve the medical security system, and strive to cover 98% of household population and 90% resident population in 2012.

OBJECTIVETo investigate the facial aging analysis of 1200 Han adult people in Dalian with iris diameter, so as to provide reference for facial rejuvenation in Han people.

METHODS1200 facial digital photographs from the second-generation ID card of China were stratified randomly selected as the research sample, excluding facial deformity, tattooing eyebrow, tattooing lid margin, ptosis, lip grain and eyebrow deformity cases, as well as the cases whose join point of upper eyelid and lower eyelid not exposed at the nasal side. These photos were divided into six cohorts: female aged 18, 38, and 68 years old; and male aged 18, 38, and 68 years old, with 200 cases in each cohort. The individual iris diameter was divided into 20 equal parts in each photograph, with each part marked one unit as individual iris diameter ruler. Ten values were made from a horizontal plane between the medial canthus to ten points at one face ( the line between two medial canthus is used as the horizontal line, circumocular and facial soft tissue were measured with individual iris diameter ruler on the photographs), then the results were analyzed with Adobe Photoshop software.

RESULTSThere are statistically significant differences in eyebrow height (36.42 ± 4.22 unit in 18 years old male group, 40.22 ± 6.90 unit in 38 years old male group, 34.83 ± 9.39 unit in 68 years old male group; 37.59 ± 6.72 unit in 18 years old female group, 41.09 ± 5.15 unit in 38 years old female group, 36.84 ± 9.45 unit in 68 years old female group), palpebral fissure height, physiognomic external canthus height, palpebral fissure width, pupil height and other items (P < 0.05).

CONCLUSIONS(1) The brow position rises to the peak level at middle age (38 years old group), then drops down gradually with aging. (2) The physiognomic external canthus moves towards the nasal side and caudal side with aging. (3) Eyeball moves towards caudal side with aging. (4) The soft tissue around bilateral angle of mouth, nasal tip and submaxilla moves towards caudal side with aging. (5) The measurement of individual iris diameter ruler can apply to analyze the aging changes of facial soft tissue, and is more suitable for the case when facial photographs are taken at different distances.

Adolescent ; Adult ; Age Factors ; Aged ; Aging ; China ; ethnology ; Cohort Studies ; Eye ; anatomy & histology ; Eyebrows ; anatomy & histology ; Face ; anatomy & histology ; Female ; Humans ; Iris ; anatomy & histology ; Lip ; anatomy & histology ; Male ; Nose ; anatomy & histology ; Photography ; Rejuvenation ; Sex Factors

Objective:To explore the clinical characteristics of juvenile-onset ankylosing spondylitis.Methods:Clinical data of 350 cases of ankylosing spondylitis diagnosed in Beijing Jishuitan Hospital from January 2014 to December 2019 were collected. There were 75 cases with the symptom onset in age ≤16 years (juvenile-onset ankylosing spondylitis, JoAS), and 275 cases with the symptom onset in age>16 years (adult-onset ankylosing spondylitis, AoAS). The clinical characteristics of two groups were analyzed.Results:Compared with AoAS, JoAS had a higher proportion of males [98.7% (74/75) vs. 79.6% (219/275); χ 2=15.65, P<0.01] and longer course of disease [11(8,15) vs. 8(4,15) years; Z=-3.09, P<0.01]. Compared with AoAS, JoAS was more prone to have peripheral joint swelling and pain [45.3%(34/75) vs. 18.9%(52/275), χ 2=22.20, P<0.01], hip pain [26.7%(20/75) vs. 15.3%(42/275), χ 2=5.25, P=0.03] or heel pain [9.3%(7/75) vs. 2.9%(8/275), χ 2=5.93, P=0.02] as the first clinical manifestation. Compared with AoAS, JoAS had a higher incidence of radiological hip involvement [77.3%(58/75) vs. 43.3%(119/275), OR=4.71, Wald=25.60, P<0.01], lower bone mineral density than peers [34.7%(26/75) vs. 23.3%(64/275), OR=2.23, Wald=7.20, P<0.01], higher incidence of malnutrition [25.3%(19/75) vs. 13.8%(38/275), OR=2.16, Wald=5.84, P=0.02] and higher incidence of acute uveitis [17.3%(13/75) vs. 6.5%(18/275), OR=2.72, Wald=6.24, P=0.01] after adjusting the course of disease. Conclusion:Compared with adult-onset ankylosing spondylitis, juvenile-onset ankylosing spondylitis is more prone to have peripheral joint swelling or hip pain as the first clinical manifestation; the radiological hip involvement, lower bone mineral density than peers, malnutrition and uveitis are more likely to occur.

Scientific and rigorous selection of theories,models or frameworks is the premise of high-quality nursing research.This work introduces the development process,basic information,application in nursing of T-CaST(Theory Comparison and Selection Tool,T-CaST),and shows the specific application process of this tool through examples,to provide evaluation methods for nursing scholars to choose appropriate guiding theories in the research process,and has guiding significance for developing high-quality nursing research under the guidance of theories,models or frameworks.

To investigate the effects of ultrasound combined with microbubbles on intracellular Ca2+ homeostasis in carboplatin ( CBP )‐treated A549 cell and its possible mechanisms of inhibiting A549 cell line activity . Methods According to whether SonoVue was used or not ,and the different dose of CBP ,the groups A‐F were arranged as the ultrasound( US) group( group A ) ,the ultrasound combined with microbubbles ( USMB) group( group B) ,the low dose CBP ( 100 μg/ml) + US group( group C) ,the low dose CBP+USMB group( group D) ,the high dose CBP ( 200 μg/ml)+ US group ( group E) and the high dose CBP+USMB group( group F) .A549 cells were bathed and washed by a calcium‐free buffer , loaded with Ca2+ indicator fluo‐4 AM . Real‐time images were acquired using laser confocal microscopy . T he fluorescence intensity of intracellular calcium ion concentration ( [ Ca 2+ ] i ) in individual living cell was observed and the calcium overload was analyzed . Results After ultrasound irradiation ,the normalized fluorescence intensity of [ Ca2+ ] i increased rapidly ,then returned to a new homeostasis ( selected cells in groups A ,B ,E ,F ) or experienced a second calcium oscillation ( some cells in group C and D ) . All the selected cells in group B and some cells in group C and D exhibited superimposed oscillations . T he calcium overloading time in group D was longer than those of any other groups . Four cells in group A experienced delayed calcium oscillations . Compared with group A ,the selected cells in other groups exhibited a larger amplitude of calcium oscillation ( all P ＜ 0 .05 ) and the selected cells in group B and D exhibited calcium oscillation for a longer period of time( all P ＜0 .05) . Conclusions In the calcium‐free buffer ,US ,USMB , CBP+ US ,CBP + USMB are direct stimuli of calcium overload in A 549 cells . SonoVue ,CBP ,CBP +SonoVue are all synergistic stimuli of calcium overload in A 549 cells irradiated by ultrasound .US ,USMB and CBP may synergistically induce calcium release from intracellular store sites in A 549 cells . Calcium overload is a possible mechanism of ultrasound combined with microbubbles in assisting CBP chemotherapy .

Objective To investigate the effects of ultrasound combined with microbubbles on intracellular Ca2+ homeostasis in carboplatin ( CBP )-treated A549 cell and its possible mechanisms of inhibiting A549 cell line activity . Methods According to whether SonoVue was used or not ,and the different dose of CBP ,the groups A-F were arranged as the ultrasound(US) group(group A) ,the ultrasound combined with microbubbles ( USMB) group( group B) ,the low dose CBP ( 100 μg/ml) + US group( group C) ,the low dose CBP+USMB group( group D) ,the high dose CBP ( 200 μg/ml)+ US group ( group E) and the high dose CBP+USMB group( group F) .A549 cells were bathed and washed by a calcium-free buffer , loaded with Ca2+ indicator fluo-4 AM . Real-time images were acquired using laser confocal microscopy .The fluorescence intensity of intracellular calcium ion concentration ([Ca2+ ]i) in individual living cell was observed and the calcium overload was analyzed . Results After ultrasound irradiation ,the normalized fluorescence intensity of [Ca2+ ]i increased rapidly ,then returned to a new homeostasis (selected cells in groups A ,B ,E ,F) or experienced a second calcium oscillation ( some cells in group C and D) . All the selected cells in group B and some cells in group C and D exhibited superimposed oscillations . The calcium overloading time in group D was longer than those of any other groups . Four cells in group A experienced delayed calcium oscillations . Compared with group A ,the selected cells in other groups exhibited a larger amplitude of calcium oscillation( all P < 0 .05) and the selected cells in group B and D exhibited calcium oscillation for a longer period of time( all P <0 .05) . Conclusions In the calcium-free buffer ,US ,USMB , CBP+ US ,CBP + USMB are direct stimuli of calcium overload in A 549 cells . SonoVue ,CBP ,CBP +SonoVue are all synergistic stimuli of calcium overload in A 549 cells irradiated by ultrasound .US ,USMB and CBP may synergistically induce calcium release from intracellular store sites in A 549 cells . Calcium overload is a possible mechanism of ultrasound combined with microbubbles in assisting CBP chemotherapy .

OBJECTIVE：To establ ish artificial neural netw orks（ANN）model to predict the interferon in the treatment of chronic hepatitis B （CHB），and to provide evidence for selecting suitable CHB therapy plan in clinic. METHODS ：The clinical data of 92 CHB patients treated by interferon ，from Guangzhou Eighth People ’s Hospital were retrospectively analyzed from Jul. 2011 to Dec. 2019. The basic information ，biochemical indexes ，blood routine indexes and virological markers of patients were collected. According to the effect of interferon ，the patients were divided into response group （73 cases）and non-response group （19 cases）. Minitab 18.0 software was used for multivariate Logistic regression analysis to screen the factors influencing the efficacy of interferon. Neurosolutions 5.0 software was used to randomly select 30％ of patients with CHB （27 cases）as the test group to establish and verify the ANN model. RESULTS ：The mean platelet volume ，platelet distribution width ，direct bilirubin ， hepatitis B e antigen and hepatitis B virus DNA more than 4×107 IU/mL had significant effect on interferon response （P＜0.05）. The accuracy ，specificity and area under characteristic curve of ANN test group were significantly higher than those of Logistic regression（P＜0.05）. CONCLUSIONS ：ANN model is accurate in predicting the efficacy of interferon in the treatment of CHB.

ObjectiveTo investigate the efficacy and safety of cryoablation combined with Camrelizumab monoclonal antibody in the treatment of hepatocellular carcinoma （HCC）. MethodsA total of 103 HCC patients who were admitted to our hospital from June 2020 to June 2023 were enrolled and randomly divided into combined treatment group with 53 patients and control group with 50 patients. The patients in the control group received percutaneous argon-helium cryoablation， and those in the combined treatment group received percutaneous argon-helium cryoablation combined with Camrelizumab monoclonal antibody. The two groups were compared in terms of short-term response， changes in T lymphocyte subsets after treatment， changes in liver function and alpha-fetoprotein （AFP） after treatment， and progression-free survival and overall survival during follow-up. The t-test was used for comparison of normally distributed continuous data between groups， and the chi-square test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot survival curves， and the log-rank test was used for comparison of survival time between the two groups. ResultsThe combined treatment group had significantly higher overall response rate and disease control rate than the control group （χ²=4.156 and 4.348， P=0.042 and 0.037）. After treatment， the combined treatment group had significant increases in the percentages of CD3⁺ and CD4⁺ T lymphocytes and CD4⁺/CD8⁺ ratio （P<0.05） and a significant reduction in the percentage of CD8⁺ T lymphocytes （P<0.05）， while the control group had no significant changes in T lymphocyte subsets after treatment （P>0.05）， and compared with the control group after treatment， the combined treatment group had significantly higher percentages of CD3⁺ and CD4⁺ T lymphocytes and CD4⁺/CD8⁺ ratio （all P<0.05） and a significantly lower percentage of CD8⁺ T lymphocytes （P<0.05）. After treatment， both groups had significant reductions in the levels of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， and AFP （all P<0.05） and a significant increase in the level of albumin （Alb） （P>0.05）， and compared with the control group after treatment， the combined treatment group had significantly lower levels of ALT， AST， and AFP （all P<0.05） and a significantly higher level of Alb （P<0.05）. There were no significant differences in the incidence rates of grade Ⅲ‍—‍Ⅳ （moderate to severe） adverse reactions between the two groups （P>0.05）. Compared with the control group， the combined treatment group had significantly better median progression-free survival （21.32 months vs 15.31 months， χ²=4.689， P=0.030） and median overall survival （28.36 months vs 20.75 months， χ²=5.030， P=0.025）. ConclusionArgon-helium cryoablation combined with Camrelizumab monoclonal antibody can effectively improve short-term response， enhance immune function， and prolong survival time， with a favorable safety profile.

The biofilms formed by pathogenic microorganisms seriously threaten human health and significantly enhance drug resistance, which urgently call for developing drugs specifically targeting on biofilms. Chitooligosaccharides extracted from shrimp and crab shells are natural alkaline oligosaccharides with excellent antibacterial effects. Nevertheless, their inhibition efficacy on biofilms still needs to be improved. Spirulina (SP) is a microalga with negatively charged surface, and its spiral structure facilitates colonization in the depth of the biofilm. Therefore, the complex of Spirulina and chitooligosaccharides may play a synergistic role in killing pathogens in the depth of biofilm. This research first screened chitooligosaccharides with significant bactericidal effects. Subsequently, Spirulina@Chitooligosaccharides (SP@COS complex was prepared by combining chitooligosaccharides with Spirulina through electrostatic adsorption. The binding of the complex was characterized by zeta potential, z-average size, and fluorescence labeling. Ultraviolet-visible spectroscopy (UV-Vis) showed the encapsulation efficiency and the drug loading efficiency reached up to 90% and 16%, respectively. The prepared SP@COS2 exhibited a profound synergistic inhibition effect on bacterial and fungal biofilms, which was mainly achieved by destroying the cell structure of the biofilm. These results demonstrate the potential of Spirulina-chitooligosaccharides complex as a biofilm inhibitor and provide a new idea for addressing the harm of pathogenic microorganisms.
Humans ; Spirulina ; Anti-Bacterial Agents/chemistry* ; Chitosan/pharmacology* ; Biofilms ; Chitin/pharmacology*