OBJECTIVE To evaluate the effect of neuromedin U(NMU) in lymph node metastasis of laryngocarcinoma and provide a new biomarker of metastasis. METHODS Samples of 120 cases of laryngocarcinoma were collected from the Otolaryngology Department of the First Affiliated Hospital of Jinzhou Medical University from 2013 to 2015. Patients were divided into two groups: metastasis group and non-metastasis group. Immunohistochemistry was performed to analyze the NMU expression in primary tumor and lymph node. An independent tissue microassay was used to analyze the relationship between NMU expression and T, N stages. RESULTS Expression of NMU in metastasis group was higher than that in non-metastasis group, NMU was positively correlated with N stages, but not with T stages. CONCLUSION The expression of NMU is higher in metastasis tissue of laryngocarcinoma, It could be used as a biomarker of lymph node metastasis of laryngocarcinoma.

Objective To study the changes of serum markers of hepatic fibrosis in patients with fatty liver,and to provide clinical diagnosis and treatment for patients with fatty liver.Methods Three hundred and sixty-one patients with fatty liver were divided into light,medium and heavy three degrees according to the intrahepatic echo and structure.Serum markers of hepatic fibrosis-hyaluronic acid (HA),laminin (LN),procollagen Ⅲ (PC Ⅲ) and type Ⅳ collagen (C-Ⅳ) were examined by enzyme linked immunosorbent assay (ELISA),and the ordinal logistic regression model was used to analyze,regarding the grade of fatty liver as dependent variable.Results The levels of serum fibrosis markers HA,LN,PC Ⅲ and C-Ⅳ in patients with mild,moderate and severe fatty liver were (94.53 ± 16.21),(101.38 ± 20.42),(127.34 ± 26.54) μg/L,(107.25±22.63),(117.38±24.84),(136.62±32.27) μg/L,(110.27±23.15),(121.55±27.36),(138.62± 30.62) μg/L,(72.61 ± 15.46),(82.06 ± 18.28),(92.96 ± 21.35) μg/L respectively,there was significant difference in serum fibrosis markers among mild,moderate and severe fatty liver patients (F =675.719,398.771,303.960,840.570;P＜0.05),while the markers of patients with severe fatty liver were higher than normal.The ordinal logistic regression model showed that the serum fibrosis indexes of HA,LN,PC Ⅲ and C-Ⅳ had significant effects on the grading of fatty liver(P＜0.05),whose odds ratio were 1.322,1.229,1.899,3.935,that was the higher the HA,LN,PC Ⅲ,C-Ⅳ,the more severe fatty liver.Conclusion There were liver fibrosis trend in patients with severe fatty liver.Detection of serum markers of hepatic fibrosis can be used as an important basis for monitoring and diagnosis of fatty liver disease.

Objectives To investigate the characteristics of changes in serum metabolic profile before and after resection of carcinoma tissues to establish a disease distinguishing model,to analyze the changing trend of characteristic metabolites,and to determine the molecular mechanism and potential clinical value of characteristic metabolic markers for HBV-related liver cancer.Methods Ultraperformance liquid chromatography-mass spectrometry (UPLC-MS) was used to analyze the serum metabolites of 15 patients with hepatocellular carcinoma (HCC) before and after partial hepatectomy and on 25 healthy volunteers.The pattern recognition method and nonparametric test analyzes were used to analyze the data and to identify the specific metabolites and their changes after resection of carcinoma tissues.Results We established the principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) disease distinguishing model for HCC patients before and after operation as against the healthy volunteers.To distinguish between the liver cancer group and the normal control group,27 characteristic metabolites were selected from the patients before and after resection of carcinoma tissues.Eight moved towards the normal control after resection of carcinoma tissues.This indicated that liver carcinoma was an important impacting factor for these metabolites.Finally,7 metabolites were identified,and these metabolites had high diagnostic value as shown on ROC curves.Conclusions Through serum metabolic profiling of patients before and after resection of carcinoma tissues,a high correlation between metabolism and hepatocellular carcinoma was found.Researches on endogenous metabolites and pathways in liver diseases will provide a better understanding of the molecular mechanisms and provide further directions for clinical diagnosis and treatment.

Objective To analyze the influencing factors of severe pneumonia in children with mycoplasma pneumonia.Methods A total of 307 children with mycoplasma pneumonia hospitalized in Shanxi Children′s Hospital from March 2021 to February 2022 were se-lected as the study subjects and divided into severe group(200 cases)and non-severe group(107 cases).The differences of the clinical data between the two groups were compared,and a nomogram prediction model was established,and the model was internally validated.Results The severe group had more patients aged≤3 and<6 years,≥6 and≤10 years and autumn and winter(P<0.05).There were significant differences in the course of disease,peak body temperature,abnormal electrocardiogram findings,three concave signs positive,perioral cyanosis,extrapulmonary manifestations,and involvement of other systems between the two groups(P<0.05).There were significant differences between the two groups in 15 indicators including epstein-barr virus infection,antibody titer levels,and C-reactive protein among the laboratory test indicators(P<0.05).The Logistic regression analysis showed that long disease duration and el-evated platelet count,lactate dehydrogenase,and Th cell levels were positively correlated with the occurrence of severe pneumonia,and elevated NK cell levels were negatively correlated with the occurrence of severe pneumonia(P<0.05).The nomogram results showed that the probability of severe pneumonia was 92.8%,the calibration curve was basically consistent with the ideal curve,the area under the re-ceiver operating characteristic curve was0.819,and the decision curve showed a high net benefit value when the threshold probability was 4%-89%.Conclusion The nomogram model is helpful for early detection of severe pneumonia in children with mycoplasma pneumoni-a,and has important significance for preventing the development of severe pneumonia.

OBJECTIVETo assess the value of genetic testing for Fragile X syndrome (FXS).

METHODSA domestically made diagnostic kit based Tri-primer-PCR method was used to detect mutations of the FMR1 gene among 6 pedigrees with unexplained intellectual disability. The results were verified by methylation PCR and Southern blotting.

RESULTSPedigrees 1 and 6 were positive for the screening. In pedigree 1, a full-mutation allele with methylation was identified in the proband and his mother, which was passed on to the fetus. In pedigree 6, the proband was mosaic for a full-mutation allele and a pre-mutation allele. His sister was asymptomatic with a full-mutation. His mother carried pre-mutation allele, while his father and sister's baby were normal. The number of CGG repeats of the pedigrees 2 to 5 were in the normal range.

CONCLUSIONGenetic testing can provide an effective way to prevent FXS caused by FMR1 mutations and enable prenatal diagnosis for families with a high risk for the disease.

A wireless wearable sleep monitoring system based on EEG signals is developed.The collected EEG signals are wirelessly sent to the PC or mobile phone Bluetooth APP for real-time display.The system is small in size,low in power consumption,and light in weight.It can be worn on the patient's forehead and is comfortable.It can be applied to home sleep monitoring scenarios and has good application value.The key performance indicators of the system are compared with the industry-related medical device measurement standards,and the measurement results are better than the special standards.

Objective To investigate the relationship of procollagen?lysine 2?oxoglutarate 5?dioxygenase 2 ( PLOD2 ) expression and the clinical characteristics of osteosarcoma, and explore the potential mechanism of tumour metastasis promoted by PLOD2. Methods The expression of PLOD2 in osteosarcoma tissues and paired adjacent tissues were detected by immunohistochemistry and qRT?PCR. Correlation of PLOD2 expression in osteosarcoma with the clinical pathologic features was analyzed by Chi square test and Kaplan?Meier analysis.Fibrillar collagen formation and collagen deposition in the tumor tissues were detected by picrosirius red staining. We transfected U?2OS cells with LV?vector, LV?over／PLOD2, sh?NC and sh?PLOD2. The expression of PLOD2 was detected by qRT?PCR. The impact of POLD2 on U?2OS cell invasion was determined by wound?healing assay and Transwell migration assay. The expressions of PLOD2／FAK／JAK2?STAT3 signal pathway related proteins were detected by western blotting. Results The high expression level of PLOD2 in osteosarcoma tissues was 72.5%, significantly higher than 0% in paired adjacent noncancerous tissues ( P＜0.01), the expression of PLOD2 was positively correlated with lymph node metastasis, pulmonary metastasis and poor outcome (P＜0.01). The same results were also observed in qRT?PCR assay. The median survival time of patients with high expression of PLOD2 protein was 13 months, significantly shorter than 32 months of patients with low expression of PLOD2 ( P＜0.05). The result of picrosirius red staining showed that the percentage of collagen fiber deposition in the osteosarcoma tissue with high level of PLOD2 was (74.43+9.63)%, significantly higher than ( 9.67± 1.28)% in tissue with low expression of PLOD2 (P＜0.001).The result of wound?healing and Transwell migration assay showed that over?expression of PLOD2 markedly promoted the invasion, however, knockdown of PLOD2 suppressed the invasion of U?2OS cells ( both P＜0.01).The result of western blotting showed that over?expression of PLOD2 significantly increased the expression levels of p?FAK, p?JAK2, p?STAT3, but knockdown PLOD2 decreased the levels of p?FAK, p?JAK2, p?STAT3 in U?2OS cells. Conclusions Up?regulation of PLOD2 in osteosarcoma is correlated with lymphatic and distant metastasis. PLOD2 promotes invasion and metastasis of osteosarcoma might through FAK／JAK2?STAT3 signal pathway.

Objective To investigate the relationship of procollagen?lysine 2?oxoglutarate 5?dioxygenase 2 ( PLOD2 ) expression and the clinical characteristics of osteosarcoma, and explore the potential mechanism of tumour metastasis promoted by PLOD2. Methods The expression of PLOD2 in osteosarcoma tissues and paired adjacent tissues were detected by immunohistochemistry and qRT?PCR. Correlation of PLOD2 expression in osteosarcoma with the clinical pathologic features was analyzed by Chi square test and Kaplan?Meier analysis.Fibrillar collagen formation and collagen deposition in the tumor tissues were detected by picrosirius red staining. We transfected U?2OS cells with LV?vector, LV?over／PLOD2, sh?NC and sh?PLOD2. The expression of PLOD2 was detected by qRT?PCR. The impact of POLD2 on U?2OS cell invasion was determined by wound?healing assay and Transwell migration assay. The expressions of PLOD2／FAK／JAK2?STAT3 signal pathway related proteins were detected by western blotting. Results The high expression level of PLOD2 in osteosarcoma tissues was 72.5%, significantly higher than 0% in paired adjacent noncancerous tissues ( P＜0.01), the expression of PLOD2 was positively correlated with lymph node metastasis, pulmonary metastasis and poor outcome (P＜0.01). The same results were also observed in qRT?PCR assay. The median survival time of patients with high expression of PLOD2 protein was 13 months, significantly shorter than 32 months of patients with low expression of PLOD2 ( P＜0.05). The result of picrosirius red staining showed that the percentage of collagen fiber deposition in the osteosarcoma tissue with high level of PLOD2 was (74.43+9.63)%, significantly higher than ( 9.67± 1.28)% in tissue with low expression of PLOD2 (P＜0.001).The result of wound?healing and Transwell migration assay showed that over?expression of PLOD2 markedly promoted the invasion, however, knockdown of PLOD2 suppressed the invasion of U?2OS cells ( both P＜0.01).The result of western blotting showed that over?expression of PLOD2 significantly increased the expression levels of p?FAK, p?JAK2, p?STAT3, but knockdown PLOD2 decreased the levels of p?FAK, p?JAK2, p?STAT3 in U?2OS cells. Conclusions Up?regulation of PLOD2 in osteosarcoma is correlated with lymphatic and distant metastasis. PLOD2 promotes invasion and metastasis of osteosarcoma might through FAK／JAK2?STAT3 signal pathway.

Objective To systematically integrate the experience of medical staff participating in remote home palliative care,and to provide a reference for further promoting the development of remote home palliative care and improving the service quality in China.Methods PubMed,Web of Science,CINAHL,Cochrane Library,Embase,CNKI,Wanfang Database,VIP Database,and Chinese Biomedical Literature Database were searched to collect qualitative studies on the experience of medical staff participating in remote home palliative care,and the search time was from inception to November 2023.The quality of the included literature was evaluated according to the 2016 edition of the Qualitative Research Quality Evaluation Criteria of the Joanna Briggs Institute for Evidence-Based Health Care in Australia,and the results were summarized by meta-synthesis method.Results A total of 11 studies were included,and 40 research results were extracted,and 11 categories were formed,which were summarized into 3 integrated results.① Medical staff perceived the benefits of participating in remote home palliative care:improving the efficiency of medical services,breaking through the limitations of time and space,enhancing job satisfaction,and improving the continuity of palliative care.②Medical staff recognized the challenges of participating in remote home palliative care:poor stability of remote working environment,complex equipment operation,insufficient theoretical knowledge and professional skills,inability to meet the special care needs of patients,and difficulty in defining service time.③Medical staff believe that remote home palliative care services need to be improved:pay attention to the importance of family participation,use remote palliative care as an auxiliary method,and pay attention to establishing a doctor-patient trust relationship.Conclusion There are many benefits and challenges for medical staff to participate in remote home palliative care,and hospital managers should provide multi-faceted support for medical staff,strengthen the construction of remote home palliative care team,establish an online and offline linkage mechanism,and continuously improve the quality of remote home palliative care in China.

Objective To systematically evaluate the incidence rate of low-level viremia(LLV)in chronic hepatitis B(CHB)patients and related influencing factors,and to provide evidence-based medicine evidence for effective intervention and prevention of LLV in clinical practice.Methods This study was conducted according to the PRISMA guideline,with a PROSPERO registration number of CRD42023455304.CNKI,Wanfang Data,VIP,SinoMed,PubMed,Embase,Web of Science,and the Cochrane library were searched for observational studies on LLV and related influencing factors in CHB patients published up to July 21,2023.Stata 16.0 software was used to perform the meta-analysis.Results A total of 12 articles were included,with a total sample size of 3408 cases,among whom there were 1181 patients with LLV.The meta-analysis showed that the incidence rate of LLV was 32.8%(95%confidence interval[CI]:27.6%—38.3%)in treatment-experienced CHB patients.High HBsAg quantification(odds ratio[OR]=2.107,95%CI:1.782—2.491,P<0.001),positive HBeAg(OR=3.258,95%CI:2.629—4.038,P<0.001),high HBV DNA level at baseline(OR=1.286,95%CI:1.157—1.430,P<0.001),and history of entecavir treatment(OR=3.089,95%CI:1.880—5.074,P<0.001)were risk factors for LLV;duration of antiviral therapy≥3 years(OR=0.175,95%CI:0.093—0.331,P<0.001)and high alanine aminotransferase level at baseline(OR=0.985,95%CI:0.978—0.992,P<0.001)were protective factors against LLV.The sensitivity analysis showed no significant change in effective value,suggesting that the results of the meta-analysis were relatively stable.The funnel plot of the studies included was basically symmetrical,and the results of the Egger's test and the Begg's test suggested that there was no obvious publication bias in the articles included.Conclusion Clinicians should guide decision making based on the influencing factors for LLV and related clinical evidence,so as to reduce long-term clinical risks and avoid adverse outcomes.