Objective To investigate the predictive value of IL-9 cytokines in the patients with acute respiratory distress syndrome (ARDS).Methods According to Berlin definition of ARDS published in 2012,data of 28 patients with ARDS and another 22 healthy subjects as control were collected for prospective study from June,2013 to July,2014.Of them,there were 23 patients with severe pneumonia,1 patient with acute mercury poisoning,2 patients with severe acute pancreatitis,2 patients with acute paraquat poisoning.The survivors of ARDS patients were followed up.The ARDS patients were divided into moderate group (n =18) and severe group (n =10) as per the severity of the disease diagnosed at the first day after admission.And the ARDS patients were also divided into non-survival group (n =15) and survival group (n =13) according to the ARDS patients survived for 28 days.Three mLs of peripheral venous blood were collected in the early morning from fasted ARDS patients on the first and the third day after diagnosis of ARDS confirmed,and those of healthy subjects were collected on the first day after admission.The IL-9 cytokine level of peripheral venous blood detected by using enzyme linked immunosorbent assay (ELISA).The comparisons of levels of IL-9 cytokine were carried out between ARDS group and control group on the first day after diagnosis of ARDS established,between moderate group and severe group on the first day and the third day,and between survival group and non-survival group.The receiver operating characteristic (ROC) curve was used to evaluate the performance of IL-9 as a prognostic indicator in the early stage of ARDS.Data were analyzed by using SPSS 19.0 software.Results On the first day after diagnosis of ARDS,there were no statistically significant differences in age,APACHE Ⅱ score,procalcitonin (PCT),C-reactive protein (CRP),white blood cell count,lactate,and albumin between survival group and non-survival group (P ＞ 0.05).PH value in non-survival group was significantly lower than that in survival group (P＜0.05).IL-9 cytokine level of peripheral venous serum in ARDS group was significantly higher than that in healthy control group (P ＜ 0.05).There were no statistically significant differences in IL-9 level of peripheral venous serum both between moderate group and severe group and between survival group and non-survival group (P ＞ 0.05).On the third day,IL-9 level in severe group was significantly higher than that in moderate group (P ＜ 0.05),and that in survival group was significantly lower than that in non-survival group (P ＜ 0.05).The ROC of IL-9 at the first day for predicting mortality had all area under curve (AUC) to be 0.579 (95％ CI 0.361-0.798,P ＞ 0.05).The ROC of IL-9 on the third day for predicting mortality had AUC of 0.769 (95％ CI 0.592-0.947,P ＜ 0.05).When the cut-off value of IL-9 for the death followed up for 28 day' s was 2.88 pg/mL,the sensitivity was 86.7％,and the specificity was 61.5％.Conclusions IL-9 levels of in patients with ARDS were significantly higher,and IL-9 level can be helpful for the assessment of ARDS severity in the early stage,and for prognosis as well.

Objective:To observe the effect of mulberry leaf extract on blood glucose and islet β cell proliferation in pregnant diabetic rats.Methods:The rat model of gestational diabetes mellitus was prepared. The 32 model rats were randomly divided into the model group, metformin group, low dose mulberry leaf extract group and high dose mulberry leaf extract group, 8 rats in each group. Eight normal pregnant mice were selected as the control group. The low and high dose groups received gavage of mulberry leaf extract 0.5 and 1.5 g/kg, respectively, the rats in the metformin group received gavage of 200 mg/kg metformin hydrochloride suspension, and the model group and the normal group received gavage of sterile normal saline of equal volume. The intervention continued for 4 weeks. The HE staining was used to observe rat pancreatic tissue pathology change. The fasting blood glucose level was measured by blood glucose meter. The TC, TG, LDL-C and HDL-C levels were measured by automatic biochemical detector. The fasting insulin level was measured by enzyme-linked immunosorbent assay, and the islet resistance index and insulin sensitivity index were calculated. The activity of SOD, CAT, GSH-pX and MDA level in serum were detected by radioimmunoassay. The MTT method was used to detect islet β cell proliferation, and the Western blot method was used to detect CDK4, pRB, E2F1 protein expression.Results:Compared with the model group, the low-dose and high-dose groups showed that the levels of FBG, TC, TG and LDL-C significantly decreased ( P<0.05), and the HDL-C levels significantly increased ( P<0.05). Compared with the model group, the low-dose and high-dose groups showed that fasting insulin and islet resistance index significantly decreased ( P<0.05), and insulin sensitivity index significantly increased ( P<0.05). Compared with the model group, the low-dose and high-dose groups showed that the levels of SOD (360.62 ± 27.96 U/ml, 401.62 ± 25.66 U/ml vs. 293.45 ± 31.36 U/ml), CAT (10.26 ± 2.07 U/ml, 12.26 ± 0.96 U/ml vs. 8.26 ± 2.44 U/ml), GSH-Px (790.23 ± 47.87 U/ml, 880.63 ± 40.62 U/ml vs. 716.62 ± 45.62 U/ml) significantly increased ( P<0.05), MDA (30.89 ± 3.28 mmol/ml, 40.42 ± 2.06 mmol/ml vs. 44.85 ± 5.33 mmol/ml) level significantly decreased ( P<0.05). After 48 h and 72 h of modeling, compared with the model group, the islet proliferation rate of the low-dose group and the high-dose group significantly increased ( P<0.01). Compared with the model group, the low-dose and high-dose groups showed that the CDK4 (1.15 ± 0.42, 1.35 ± 0.59 vs. 0.75 ± 0.22), pRB (1.11 ± 0.58, 1.54 ± 0.64 vs. 0.67± 0.20), E2F1 (1.06 ± 0.39, 1.27 ± 0.18 vs. 0.48 ± 0.12) protein expression significantly increased ( P<0.05). Conclusions:Mulberry leaf extract can effectively improve blood sugar, lipid and insulin levels in gestational diabetic rats, and promote the proliferation of pancreatic beta cells by regulating CDK4-pRB-E2F1 pathway-related proteins.

Elder financial exploitation is an important subtype of elder abuse, which has become a global social problem. Financial exploitation of the elderly will not only damage their physical and mental health, reduce the quality of life, but also bring huge financial losses to society. The research on the elder financial exploitation in foreign countries started earlier, while the research on the elder financial exploitation in China is still in its infancy. Therefore, this paper summarizes the concept, theoretical framework, current situation and countermeasures of elder financial exploitation, with a view to providing reference for the study of elder financial exploitation in China.

Objective:To evaluate the value of mechanical ventilation combined with ultrasound in evaluating the volume reactivity of patients with septic shock.Methods:A prospective study was performed, and 59 patients with septic shock who were admitted to the Emergency Intensive Care Unit of the First Affiliated Hospital of Xinjiang Medical University from October 2016 to February 2018 were included according to the established inclusion and exclusion criteria. First, end-expiratory block test (EEO) and end-inhalation block test (EIO) were performed, followed by volume expansion test (VE) (intravenous infusion of 250 mL saline for 10 min), with cardiac index (CI) change value after VE (ΔCI)≥15% for volume-responsive group (37 cases), ΔCI<15% for volume-free group (22 cases), Vigileo-FloTrac system was used to continuously monitor EEO, EIO, and VE before and after changes in hemodynamic parameters, such as central venous pressure (CVP), mean arterial pressure (MAP), stroke volume variation (SVV), CI, and improved inferior vena cava diameter (IVCD) and respiratory variability index (RVI). The values of predicted capacity reactivity such as changes in CVP, MAP, SVV, CI, and RVI before and after EIO were evaluated, and the relationship between EEO, EIO, and capacity reactivity was analyzed by ROC curve.Results:There was no significant difference between MAP and CI in the response group and non-response group after EEO, EIO and VE intervention ( P>0.05). EEO-ΔSVV, EEO-ΔRVI, EEO-ΔCVP, EIO-ΔSVV and EIO-ΔRVI were compared between the reaction group and the non-reaction group, and the difference was statistically significant ( P<0.05); In the correlation analysis, EEO-ΔRVI and EIO-ΔRVI were correlated with VE-ΔRVI ( r=0.695, P<0.01; r=-0.489, P<0.01); EEO-ΔCVP and VE-ΔCVP were correlated ( r=0.566, P<0.01); EEO-ΔSVV, EIO-ΔSVV are related to VE-ΔSVV ( r=0.842, P<0.01; r= -0.727, P<0.01), and the ROC curve showed ( AUCEEO-ΔSVV=0.890, 95% CI: 0.792-0.988), showed AUCEEO-ΔSVV> AUCEEO-ΔRVI> AUCEIO-ΔSVV> AUCEIO-ΔRVI> AUCEEO-ΔCVP. Conclusions:EEO and EIO combined with ultrasound have certain clinical value in the evaluation of volume responsiveness in patients with septic shock, and the evaluation value of SVV and RVI is superior to CVP, MAP, and CI.

Objective To investigate the influence of Wechat follow-up on the treatment compliance and quality of life for young adult patients with type 2 diabetes mellitus.Methods A total of 120 cases, who were able to use Wechat independently,were selected as the research objects from patients with type 2 diabetes mellitus during February 2015 to December 2015. They were randomly divided into control group (60 cases) and intervention group (60 cases). Patients in control group received routine nursing and health education,while patients in intervention group received knowledge about type 2 diabetes mellitus and nursing care through Wechat. Data of the patients in these two groups were obtained after 6 months. And the parameters including treatment compliance,blood glucose control,the incidence of complications,sleeping quality (PSQI), depression (SDS),and anxiety (SAS) of these patients were analyzed.Results After intervention,the score of treatment compliance in intervention group (12.7±1.5) was higher than (8.7±1.7) of control group (t=-3.056, P<0.05). The compliance of reasonable diet,standardized medication,moderate exercise,benign psychology and regular blood glucose monitoring for intervention group were significantly improved than that of control group (P<0.05). The infection,glycopenia,diabetic eye diseases,acute complications in the intervention group were lower than that of control group (P<0.05),but neuropathy and rate of nephropathy in intervention group were better than that of control group,but there were no statistical significance (P>0.05). Before intervention, there were no statistical significance between two groups in the levels of fasting blood glucose,postprandial 2 h plasma glucose and glycosylated hemoglobin,as well as PSQI,SDS and SAS (P>0.05). However,the levels of fasting blood glucose,postprandial 2h plasma glucose and glycosylated hemoglobin,as well as PSQI,SDS and SAS were significantly decreased compared with the control group with statistical significance (P<0.05). Conclusions Follow-up by Wechat can effectively improve the treatment compliance of young adult patients with type 2 diabetes mellitus,and improve the quality of life and patients' satisfaction.

In traditional Chinese medicine， it is believed that the disease of tubal infertility is located in the uterus vessels， with stasis blocking uterus vessels as the core mechanism， and according to the characteristics of pathological changes in the course of treatment， the "three-stage advanced method" is proposed as the treatment plan. In the first stage of eliminating evil， the disease mechanism is characterized by externally-contracted heat toxin combined with endogenous dampness， stagnation and stasis in the uterus vessels， and the treatment is to clear heat and promote dampness， move qi and activate blood， and the self-prescribed Penyan Xiao Formula （盆炎消方）. In the second stage of dissolving fixed abdominal mass， the disease mechanism is characterized by qi and blood stagnation and uterus vessels obstruction， and the treatment is to break up the stagnation of blood and move qi， drive away blood stasis and clear the channels， with self-prescribed Tongguan Formula （通管方）. In the third stage of reinforcing healthy qi to support pregnancy， the disease mechanism is characterized by stasis of uterus vessels for a long period， and loss of kidney essence， therefore the treatment is to warm up the kidneys and eliminate the stasis， boost qi and nourish yin， with self-prescribed Yulin Zhuyun Formula （毓麟助孕方）. At the same time， attention should be paid to the synergistic diagnosis and treatment of traditional Chinese medicine and Western medicines， and combination of syndrome differentiation with the identification of diseases.

Objective:To analyze the epidemiological characteristics of hospitalized children with burns who developed nosocomial infection, and screen their independent risk factors, based on which, a risk prediction model was established and evaluated.Methods:A retrospective cohort study was conducted. From May 2010 to April 2023, 417 children with burns who met the inclusion criteria were admitted to the First Affiliated Hospital of the Air Force Medical University, including 248 males and 169 females, aged ≤14 years. Statistics on the composition and source distribution of pathogenic bacteria in children were detected. According to the occurrence of nosocomial infection, the children were divided into infected group (216 cases) and uninfected group (201 cases), and the children gender, age, total area of burns, presence of full-thickness burns, cause of the injury, and season of the injury of the children in the 2 groups were collected, as well as presence of an abnormal serum albumin level, delayed resuscitation, combination of inhalation injury at admission, and early shock, tracheotomy, admission to the intensive care unit, and deep venous catheterization after post-hospitalization, and more or less times (>2 times being more and ≤2 times being less) of surgeries, indwelling catheter days, and length of hospitalization stay on post-hospitalization. The burned children were divided into modeling group (291 cases) and validation group (126 cases) according to the ratio of 7∶3, and the data of the 2 groups were recorded as before. Data were statistically analyzed with Mann-Whitney U test, chi-square test, and Fisher's exact probability test. The least absolute value selection and shrinkage operator (LASSO) regression analysis was used to reduce the risk factors of nosocomial infection in the children in modeling group. Multivariate logistic regression analysis was used to further screen the above screened risk factors, and the nomogram prediction model was drawn based on the further screened independent risk factors. The Bootstrap method was used for internal validation of the aforementioned predictive models, and the receiver operator characteristic (ROC) curves, calibration curves, and clinical decision curves of the predictive models were plotted in modeling group and validation group in order to assess its discriminative power, calibration, and clinical utility, respectively. Results:A total of 245 strains of pathogenic bacteria were detected, with Staphylococcus aureus (101 strains, accounting for 41%), Pseudomonas aeruginosa (54 strains, accounting for 22%), and Acinetobacter baumannii (33 strains, accounting for 13%) dominating, and the wound secretions were the most frequent source of pathogenic bacteria (211 strains, accounting for 86%), followed by blood (10 strains, accounting for 4%), and sputum (5 strains, accounting for 2%). There were statistically significant differences between infected group and non-infected group in the total burn area, indwelling catheter days, length of hospitalization stay, presence of full-thickness burns, combined with inhalation injury, and deep vein catheterization, and more or less times of surgeries (with Z values of -2.32, -3.29, and -3.85, respectively, with χ2 values of 26.36, 7.03, 10.13, and 10.53, respectively, P<0.05); there was statistically significant difference in cause of the injury between the two groups ( P<0.05). All clinical characteristics of children with burns in the modeling and validation groups were similar ( P>0.05). The six risk factors obtained from the LASSO regression analysis were full-thickness burns, deep vein catheterization, abnormal serum albumin level, multiple surgeries, indwelling catheter days, and length of hospitalization stay; the multivariate logistic regression analysis showed that full-thickness burns, abnormal serum albumin level, deep vein catheterization, and multiple surgeries were the independent risk factors for the occurrence of nosocomial infection in burned children (with odds ratios of 2.27, 2.66, 4.08, and 2.92, respectively, with 95% confidence intervals of 1.22-4.21, 1.03-6.87, 1.07-15.49, and 1.15-7.42, respectively, P<0.05). The ROC curves of the prediction models showed that, the areas under the ROC curves of the modeling and validation groups were 0.81 (with 95% confidence interval of 0.78-0.84) and 0.81 (with 95% confidence interval of 0.76-0.85), respectively; the calibration curves showed that, the calibration curves of the prediction models of modeling and validation groups were around the ideal curves; the clinical decision curves showed that, the threshold probability values of the prediction models in modeling and validation groups were in the ranges of 5% to 70% and 1% to 46%, respectively. Conclusions:The main pathogen of infection in children with burns is Staphylococcus aureus from wound secretions. A nomogram risk prediction model constructed based on independent risk factors such as full-thickness burns, abnormal serum albumin level, deep venous catheterization, and multiple surgeries has good accuracy and can be easily used to predict the occurrence of nosocomial infections in hospitalized children with burns.

Objective:To explore the influence and its mechanism of allogeneic dermal papilla cells (DPCs) on the wound healing of full-thickness skin defects in mice.Methods:This study was an experimental study. DPCs were isolated from the whisker follicles of five 6-week-old male C57BL/6J mice by combining microdissection with collagenase digestion and were successfully identified. Eighteen 8-week-old male C57BL/6J mice were divided into phosphate buffer solution (PBS) group and DPC group according to the random number table, with 9 mice in each group, and the full-thickness skin defect wound model was created on the back of all mice. On day 2, 4, and 6 after injury, the mice in DPC group were administered 100 μL of cell suspension containing 1×10 6 DPCs of the 4 th passage by subcutaneous injection around the wound, and the mice in PBS group was administered an equal volume of PBS. On day 3, 7, 10, and 14 after injury, the wound healing and hair growth of mice in two groups were observed, and the residual wound area was measured, and the hair coverage area on the wound of mice in two groups was measured on day 14 after injury. On day 14 after injury, the wound tissue samples of mice in two groups were collected. Hematoxylin-eosin staining was performed to observe the condition of newborn hair follicles and the number was counted, Masson staining was performed to observe the collagen deposition in the dermis and the collagen deposition area was measured, the immunofluorescence method was used to detect the protein expressions of Wnt/β-catenin signaling pathway related molecules β-catenin and lymphoid enhancer binding factor 1 (Lef1), and Western blotting and real-time fluorescence quantitative reverse transcription polymerase chain reaction were used to detect the protein and mRNA expressions of β-catenin and Lef1, respectively. The number of samples in each experiment was 3. Results:Compared with those in PBS group, the mice in DPC group had accelerated wound re-epithelialization at each time point after injury, and more hair growth on day 10 and 14 after injury. On day 7, 10, and 14 after injury, the residual wound areas of mice in DPC group were (13.92±2.90), (3.69±1.78), and (1.09±0.14) mm 2, respectively, which were significantly smaller than (26.19±2.06), (10.84±3.59), and (6.75±2.11) mm 2 in PBS group, respectively (with t values of 5.85, 3.09, and 4.63, respectively, P values all <0.05). On day 14 after injury, the hair coverage area on the wound of mice in DPC group was (62±7) mm 2, which was significantly larger than (35±6) mm 2 in PBS group ( t=2.89, P<0.05). On day 14 after injury, compared with those in PBS group, the number of newborn hair follicles in the wound tissue of mice in DPC group was significantly increased ( t=5.43, P<0.05), and the dermal collagen deposition area was significantly reduced ( t=3.56, P<0.05). On day 14 after injury, both the immunofluorescence method and the Western blotting detection showed that the protein expressions of β-catenin (with t values of 5.49 and 4.25, respectively, P values all <0.05) and Lef1 (with t values of 7.50 and 11.54, respectively, P values all <0.05) in the wound tissue of mice in DPC group were significantly higher than those in PBS group; the mRNA expressions of β-catenin and Lef1 in the wound tissue of mice in DPC group were significantly higher than those in PBS group (with t values of 7.68 and 9.67, respectively, P<0.05). Conclusions:DPCs can accelerate the re-epithelialization of full-thickness skin defect wounds in mice by activating Wnt/β-catenin signaling pathway and promote hair follicle regeneration during the process of wound healing.