Voltage-gated sodium channels (NaV1.1-NaV1.9) play important roles in the generation and maintenance of electrical excitability. NaV1.7 is preferentially expressed in peripheral somatic sensory neurons and sympathetic ganglion neurons. ln humans, gain-of-function mutations of SCN9A gene, which encodes NaV1.7, cause inherited neuropathic pain, whereas loss-of-function mutations result in a congenital indifference to pain without motor, cognitive and cardiac deficits. The effects of some analge-sics are associated, at least in part, with the NaV1.7 and selective NaV1.7 inhibitors have also been demonstrated to be analgesic in animal models. NaV1.7 has emerged as a potential target for the treat-ment of pain.

Objective To compare changes in indexes and analyze their values in prognosis of severe burn patients with sepsis.Methods A retrospective analysis was conducted. The patients with severe burn sepsis admitted to the Third Affiliated Hospital of Soochow University from August 2014 to December 2016 were enrolled. The blood culture was positive in the clinical diagnosis of sepsis. According to the prognosis, the patients were divided into death group and survival group. Their general information, vital signs, blood routine examination, serum sodium (Na+), serum glucose (Glu), C-reactive protein (CRP) and arterial partial pressure of carbon dioxide (PaCO2) at the time of admission and diagnosis of sepsis as well as the level of serum procalcitonin (PCT) at admission, diagnosis of sepsis and 1-8 days of post diagnosis were also compared. Receiver operating characteristic curve (ROC) was used to analyze the prognostic value of each index, and multivariate Cox regression analysis was used to analyze the influence of each index on the survival time, and the survival curve of Kaplan-Meier was analyzed for dead patients.Results There were 25 cases of severe burn patients with sepsis, which were admitted to hospital within 12 hours after injury; the time of diagnosis of burn sepsis was (14±6) days; 8 cases of survival; 17 cases died, the mortality rate was 68.0%, the time from diagnosis of sepsis to death was (28±14) days. The age of the death group was significantly higher than that of the survival group (years: 41±12 vs. 29±9,t = 2.598,P = 0.016), but there was no significant difference in the gender, total burn area,Ⅲ degree area, and the time of diagnosis of sepsis between the two groups. The platelet count (PLT) at the diagnosis of sepsis in death group was significantly lower than that of the survival group (×109/L: 69±43 vs. 180±108,t = -2.773, P = 0.023), and the PCT at 1-8 days of post-diagnosis in the death group was significantly higher than that of survival group [μg/L: 4.4 (2.2, 9.0) vs. 1.6 (0.7, 2.3),Z = -2.521,P = 0.012], but there was no significant difference in body temperature, heart rate, white blood cell count (WBC), percentage of neutrophils (Neu), Na+, Glu, CRP, PCT, PaCO2 at the time of admission and diagnosis of sepsis and PLT at the time of admission between the two groups. ROC curve analysis showed that the area under ROC curve (AUC) of age, PLT at the time of diagnosis and PCT at 1-8 days of post-diagnosis of sepsis was 0.808, 0.779, 0.825, respectively, for predicting the prognosis of patients with severe burn sepsis (allP < 0.05). At the cut-off age of 32, the sensitivity was 73.3% and the specificity was 75.0%. As the cut-off of PLT was 138×109/L at the time of diagnosis, the sensitivity was 92.3% and the specificity was 75.0%. As the cut-off of PCT was 2.39μg/L at 1-8 days of post-diagnosis of sepsis, the sensitivity was 73.3% and the specificity was 87.5%. Multivariate Cox regression analysis showed that age and PLT at the time of diagnosis were the favorable factors for the survival time of patients with severe burn sepsis (β value were -1.834, -0.029, respectively, bothP < 0.05). Kaplan-Meier survival analysis for patients in the death group showed that the median survival time of patients ≥32 years old was longer than that of patients < 32 years old (days: 32 vs. 9); 18-day cumulative survival rate was significantly higher than that of patients < 32 years old [83.3% (10/12) vs. 25.0% (1/4),χ2 = 9.705,P = 0.003].Conclusion Age, PLT at diagnosis of sepsis and PCT at 1-8 days after diagnosis of sepsis could be used as prognostic indexes for severe burn patients with sepsis.

Objective To investigate the visual spatial attention of occipital stroke patients with hemianopia during the acute phase.Methods Eight occipital stroke patients with homonymous hemianopia of left side in the acute stage and 10 age-matched healthy controls were recruited to examine the capability of visual spatial attention.The cue-target paradigms were applied in this behavioral research.Results In the repeated measures analysis of variance,the difference of group and cue range had distinct main effect in reaction time and accuracy rate,while the difference of target location only had main effect in reaction time.Compared with the control group,the patients exhibited longer reaction time ((1 628.26 ± 183.97) ms vs (839.79±61.29) ms,F(1,16) =163.706,P＜0.05) and lower accuracy rate (73.40％ ±3.12％ vs 92.99％ ±0.76％,F(1,16) =371.850,P ＜ 0.05).The patients displayed lower accuracy rate under large cue than small cue (71.38％ ±3.35％ vs 75.42％ ±4.23％,F(1,7) =6.706,P ＜0.05),while that of healthy controls did not vary under different cue range(93.01％ ± 0.50％ vs 92.96％ ± 1.42％,F(1,9) =0.010,P ＞ 0.05).The patients showed longer reaction time in blind-side target than healthy-side target ((1 664.17±196.57) msvs (1 594.35±174.45) ms,F(1,7) =14.157,P＜0.05),while that of control group in two target location had no statistically significant difference ((839.67 ± 60.41) ms vs (839.91 ±73.54) ms,F(1,9) =0.000,P ＞0.05).Furthermore,the mean reaction time of stroke patients had a negative correlation with the binocular vision field index (r =-0.824,P ＜ 0.05).Conclusions The extent of vision field loss in occipital stroke patients with hemianopia can reflect impairment of visual spatial attention during the acute phase.The rehabilitation training should emphasize promoting recovery of visual spatial attention in the blind side under large cue.

Objective To study the iodine nutritional status and thyroid function of adults in urban and rural areas of Wuwei City Gansu Province.Methods A cross-sectional survey was performed in 200 adults aged 18-45 who had lived more than six months in Wuwei City from April 2009 to January 2010.A random urine and fasting blood samples were collected.Urinary iodine content was measured with arsenic cerium catalytic spectrophotometry.The thyroid-stimulating hormone (TSH),free thyroid hormone (FT4) and three free triiodothyronine (FT3) were quantified by direct chemiluminescence immunoassay.Thyroglobulin antibodies (TGAb) and thyroid microsomal antibodies (TMAb) were detected by radioimmunoassay.Results A total of 99 and 98 copies of urine samples of urban and rural groups were tested,respectively.The median of urinary iodine of urban and rural groups was 189.0 and 258.2 μg/L,respectively,and rural group was higher than urban group (Z =-4.020,P ＜ 0.01).A total of 104 and 95 copies of blood samples of urban and rural groups were detected; mean value of FT4 in urban group [(16.8 ± 3.0)pmol/L] was higher than that of rural group [(15.4 ± 2.4)pmol/L,t =3.539,P ＜ 0.01].The positive rates of TGAb of urban and rural groups were 11.5％ (12/104) and 15.8％ (15/95),respectively; the positive rates of TMAb of urban and rural groups were 13.5％ (14/104) and 14.7％ (14/95),respectively; the positive rates of TGAb of male and female were 5.5％ (6/109) and 23.3％ (21/90),respectively; the positive rates of TMAb of male and female were 6.4％ (7/109) and 23.3％ (21/90),respectively.The positive rates of TGAb and TMAb were lower in male than in female (x2 =13.362,11.661,all P ＜ 0.01).The rates of thyroid function disorders of urban and rural groups were 16.3％ (17/104) and 8.4％ (8/95),of male and female 11.9％ (13/109) and 13.3％ (12/90),respectively.Subclinical hypothyroidism in all thyroid function disorders was the most common,which was 14.4％ (15/104) and 7.4％ (7/95) in urban and rural groups,11.0％ (12/109) and 11.1％ (10/90) in male and female,respectively.Conclusions Iodine nutrition level is appropriate for adults in urban areas,but in rural areas iodine nutrition is high or excessive; subclinical hypothyroidism in all thyroid function disorders is the most common; we should be concerned about the risk of iodine overdose,especially the risk of illness in women.

ObjectiveTo investigate mutations in exons 19, 20 and 21 of epidermal growth factor receptor (EGFR) gene in elderly patients with non-small cell lung cancer (NSCLC). MethodsEGFR gene mutations in exons 19, 20 and 21 were detected by nested PCR amplification and DNA sequencing in 46 elderly patients with non-small cell lung cancer. The relationship between mutations and clinical characteristics of these patients was analyzed. ResultsEGFR gene mutations were found in 56.5% (26/46) patients and 41.3% (19/46)were non-silent mutations. Mutation of exon 19 was detected in 6 cases (13.0%), mutation of exon 20 in 13 cases(28.2%) and that of exon 21 in 14 cases (30.4%). Seven patients among them had double mutations and the rest only had a single mutation. The incidence of EGFR gene mutations was higher in non-smokers than in smokers(P＜ 0.01). Higher EGFR mutation rate in exon 19, 20 and 21 were found in patients with clinical benefit who were treated with tyrosine kinase inhibitor(TKl)(P＜0.05). There was no difference in EGFR mutation rate between 60～69 age group and 70～85 age group. ConclusionsThe data suggest that the characteristics of EGFR gene mutations in elderly patients with NSCLC is the same as in the general NSCLC patients. The forecast informations of TKI treatment can be obtained by gene detection in elderly NSCLC patients.

Objective To build a case database of endemic cretinism,investigate the distribution of existing cretinism,and provide suggestions for prevention of iodine deficiency disorders.Methods In 2011,an existing endemic cretinism case database was established in Gansu Province by verifying and registering the historical cases before 1985,and searching and diagnosing the cases between 1985-2011 in history cretinism areas and IDD high-risk areas according to endemic cretinism and endemic sub-clinical cretinism diagnosis (WS 104-104) and the IDD monitoring program of the central transfer fund at the same time,and analysis the distribution of existing cretinism.Results In 1985 and 2011,cretinism areas were 53 and 41 in Gansu Province,and the endemic cretinism cases werel9 696 and 4 715,respectively;18 cases of endemic cretinism were born between 1985 to1997,7 new cases were born after 1997;nerve cretinism,myxedematous and mixed types among existing cases were 58.8％ (2 766/4 708),9.8％ (461/4 708) and 31.4％ (1 481/4 708),males and females were 69.3％ (3 261/4 708)and 30.7％ (1 481/4 708),respectively.Cases older than 45 accounted for 73.2％ (3 444/4 708);the 7 new cases were all nerve cretinism and 5 cases distributed in ethnic minority areas.Conclusions There are potential dangers of endemic cretinism in the high-risk areas of iodine deficiency disorders due to multiple factors in Gansu Province;the nervous cretinism is the majority which is caused by insufficient iodine intake in early maternal pregnancy.To prevent new endemic cretinism,it is necessary to strengthen measures of emergency iodine supplementation for pregnant women and nursing mothers in the high-risk areas.

Objective:To investigate the effect and mechanism of Wogonin on CD3AK cell proliferation and cytotoxicity to SMMC-7721.Methods:CD3AK cells were cultured from peripheral blood mononuclear cells ( PBMC) in vitro by a variety of cytokines for 7 d,and treated with different concentrations of Wogonin for 48 h.CD3AK cells proliferation was measured by CCK-8 assay.SMMC-7721 cell growth was detected by MTT.The expression of perforin (PFP),granzyme B (GrB) and CD107a on CD3AK cells were measured by flow cytometry ( FCM).The cytotoxicity to SMMC-7721 cells was detected by LDH release assay.The expression of ERK1/2 on CD3AK cells was detected by Western blot.The mobility of SMMC-7721 cells was detected with transwell chambers.The merge of SMMC-7721 cells were measured with Wound healing assay.Results:Wogonin could significantly promote CD3AK cells proliferation, especially at 3.2 mg/L (23%higher than that of control group,P<0.05).The highest cytotoxicity to SMMC-7721 was also at the con-centration 3.2 mg/L (60.4%).The expression of PFP,GrB,CD107a were significantly higher than that of control group( P<0.05).The expression of ERK1/2 was obviously improved,especially at 12.5-0.8mg/L.After treated with Wogonin 50,12.5,3.2,0.8,0.2 mg/L for 48 h,the lowest transwell cell was at 12.5 mg/L and lowest merge rate was at 3.2 mg/L.Conclusion:Wogonin could promote CD3AK cell proliferation and enhance the cytotoxicity to SMMC-7721.Wogonin could also inhibit SMMC-7721 cell growth,migration and cell merge.The mechanism may be related to activated ERK1/2 and increase the expression of PFP,GrB,CD107a.

Objective:To evaluate the iodine level of drinking water in different ecological regions in Gansu Province, and to provide a basis for preventing iodine deficiency disorders in accordance with local conditions.Methods:In May to July 2017, according to different topography, landforms and climatic conditions, Gansu Province was divided into six ecological regions: desert area, Hexi Corridor gobi area, Loess Plateau hilly area, Qinling Zhongshan gorge area, Gannan Plateau grassland and meadow area, and Loess Plateau gully area. One county was selected from each of the five districts in the east, west, south, north, and central areas in each ecological regions. Drinking water samples were collected in each county based on the township, and the water iodine content was determined by arsenic-cerium catalytic spectrophotometry.Results:A total of 4 037 water samples were collected in 527 townships of six ecological regions, the water iodine range was 0.10 - 97.60 μg/L, with a median of 2.10 μg/L. Among them, the medians water iodine of the six ecological regions were less than 40 μg/L, the difference between different ecological regions was statistically significant ( H = 1 007.440, P < 0.01); the unified centralized, partially centralized and dispersed water supply water samples were 157, 2 263 and 1 617, and the medians water iodine were 1.61, 2.42, and 1.83 μg/L, respectively, and there was statistically significant difference among different water supply methods ( H = 37.164, P < 0.01). Stratified by water supply method, the differences in water iodine between different ecological regions of the same water supply method were statistically significant ( H = 32.628, 580.630, 391.070, P < 0.01); stratified by ecological region type, the differences of different water supply methods in desert area, Hexi Corridor gobi area, Qinling Zhongshan gorge area, Gannan Plateau grassland and meadow area were statistically significant ( Z = - 2.770, H = 6.369, 9.936, 12.666, P < 0.05). Conclusions:The six ecological regions in Gansu Province are all iodine-deficient areas. The water iodine content varies among different ecological region types and different water supply methods. Surveys on water iodine content and the operating status of water supply facilities should be carried out regularly, and measures should be adjusted in time to prevent and control iodine deficiency disorders in accordance with local conditions.

Objective:To investigate the association of Subclinical Carotid AtheroSclerosis (SCAS) and prediabetes or Diabetes Mellitus (DM)in the healthy people.Methods:From September 2018 to June 2019, participants who underwent physical examination in the Health Management Center of Beijing Tiantan Hospitial were enrolled consecutively. The baseline characters were collected prospectively. Carotid Ultrasound was evaluated by radiologists according to the standard operating protocol. Univariable analysis and multivariable logistic analysis were used to estimate the association of prediabetes or DM with SCAS.Results:Totally 401 participants were eligible and enrolled. The mean age was (52.2±10.4) years and 43.7% (252/401) of them were females. The prevalence of DM and SCAS were 16.4% (66/401) and 48.9% (196/401) respectively. In the univariate analysis, elder age (≥60 years old) ( OR=5.93, 95% CI: 3.86-9.09, P<0.001), hypertension ( OR=2.76, 95% CI: 1.84-4.15, P<0.01), prediabetes( OR=1.67, 95% CI: 1.08-2.58, P<0.05) and DM ( OR=3.60, 95% CI: 1.97-6.58, P<0.01), cigarettes smoking ( OR=2.64, 95% CI: 1.82-3.81, P<0.001), lower HDLlevel<1.04 mmol/L ( OR=1.58, 95% CI: 1.04-2.42, P<0.001) and hyperhomocysteinemia (≥15 μmol/L)( OR=1.69, 95% CI: 1.17-4.04, P<0.01) were associated with higher prevalence of SCAS. On the contrary, female sex ( OR=0.53, 95% CI: 0.39-0.74, P<0.001) was associated with lower prevalence of SCAS. In the multivariable logistic analysis, elder age(≥60 years old) ( OR=6.04, 95% CI: 3.13-11.7, P<0.01), hypertension ( OR=2.14, 95% CI: 1.13-3.87, P<0.05), cigarettes smoking ( OR=2.19, 95% CI: 1.21-3.98, P<0.05) and DM ( OR=2.32, 95% CI: 1.16-4.67, P<0.05) were associated with SCAS independently. The association between prediabetes and SCAS was not statistically significant. Conclusions:DM is independently associated with SCAS in neurological healthy people, while prediabetes tended to increase the risk of SCAS.

Objective To explore the expression levels of immune-related microRNA-146b (miR-146b),microRNA-155 (miR-155) and microRNA-30b(miR-30b) in human breast milk and its relationship with maternal and infant's health.Methods One hundred and thirty-four mothers and their infants from obstetrical department were recruited in the study after delivery.The subjects were divided into 2 groups,breast feeding group(n =86) and formula-feeding group(n =48),and were followed up 3 months after delivery.Breast milk samples were collected at 2-5 days after delivery(colostrum) and 3 months after delivery(mature milk).The expression levels of microRNAs in milk samples were detected by real-time PCR.The relationship between levels of microRNAs and maternal and infant-related factors was analyzed.Results 1.MiR-146b,miR-155 and miR-30b expressions were abundant both in human colostrums (5.950 ± 0.823,3.899 ± 0.920,4.057 ± 0.604) and mature milk (4.840 ± 0.805,2.128 ± 0.969,4.929 ± 0.566).The levels of miR-146b and miR-155 were higher in colostrum than that of mature milk (t =7.716,10.215,all P ＜ 0.01),while the level of miR-30b was higher in mature milk than that of colostrums(t =-8.626,P ＜ 0.0l).2.Additionally,the level of miR-30b was negatively correlated with maternal pre-pregnancy body mass index (r =-0.298,P ＜ 0.01).3.The levels of miR-146b and miR-30b were higher in mothers giving birth by vaginal delivery than those who underwent cesarean section(t =2.356,3.108,all P ＜0.05).4.The levels of miR-146b and miR-155 were higher in colostrum-fed girls than boys (t =-2.204,-2.985,all P ＜ 0.05).5.The level of miR-146b in mature milk was negatively correlated with 3-month-old infant' s Z score of body weight (r =-0.425,P ＜ 0.05) and body length (r =-0.569,P ＜ 0.01).6.During follow-up,the incidence of baby eczema in breast feeding group (8.82％,3/34 cases) was lower than that in formula milk feeding group(29.17％,14/48 cases) (x2 =5.012,P =0.025).Conclusions The levels of immunocompetent microRNAs in human milk are influenced by the lactation period,maternal prepregnancy body mass index,mode of delivery and infant sex.The immune-related microRNAs in human milk could be involved in the regulation of infant's immunity and growth.