Objective To explore the correlation analysis of plasma TNF-?,D-lactate levels and serious case score and clinical significance.Methods Plasma TNF-?,D-lactate levels and results from serious case'score was contrastingly studied in 120 cases of serious sick children during hospitalization in our PICU.Results The study findings showed that the plasma TNF-? and D-lactate levels had produced an obviously influence on score.Conclusions The more high plasma TNF-? and D-lactate levels,the lower score and the more dangerous condition in children with serious disease.

This paper summarizes that to strengthen the construction of national key disciplines Clinical Laboratory Diagnostic and build professional post-graduate education platform for innovation,the exploration and practice of reform have been done in Chongqing Medical University,in the teaching ranks and exercise disciplinary research direction to enhance the level of scientific research and laboratory construction.

Objective To analyze the complete genome sequence of Guangxi HEV isolate swGX32 and to compare it with other HEV isolates. Methods The overlapping fragments of HEV isolate swGX32 were amplified with reverse-transcription nested polymerase chain reaction (RT-nPCR),and the 5′ and 3′ ends of viral genome were amplified with rapid amplification of cDNA ends (RACE). The PCR products were cloned and sequenced. The sequence and phylogenetic analysis of swGX32 was performed. Results The genome of swGX32 consisted of 7240 nt excluding the polyA tail, with 4 nt overlapping between ORF1 and ORF2. ORF3 is contained in the sequence of ORF2. The complete genome sequence of swGX32 shared identity of 73%-74%, 73%, 74%-75%,83%-94% with HEV genotype 1,2,3 and 4, respectively. Among all these HEV reference sequences, swGX32 showed the highest identity with the human isolate JKO-ChiSai98C (94%). Phylogenetic tree showed that swGX32 belonged to genotype 4 and clustered with JKO-ChiSai98C in the branch of HEV subtype 4a. Conclusion The swine HEV isolate swGX32 is closely related to human strain JKO-ChiSai98C genetically and phylogenetically, which further provides molecular biology evidence of hepatitis E as a zoonosis.

Objective To determine the frequency of Th22 cells and expression of their related cytokines in peripheral blood of patients with alopecia areata(AA), to investigate their significance, and to explore the role of T lymphocytes in the occurrence of AA. Methods A total of 38 patients with AA were enrolled from Central Hospital of Minhang District in Shanghai between January 2015 and May 2016, and served as the case group. At the same time, 38 healthy people served as the control group. Peripheral blood samples were obtained from these patients and controls. Flow cytometry was performed to determine the percentage of Th22 cells, and enzyme?linked immunosorbent assay(ELISA)to measure serum levels of interleukin?22(IL?22)and IL?17. Results Compared with the control group, the case group showed significantly increased percentages of Th22 cells, Th17 cells, IL?17+IL?22+CD4+T cells and IFN?γ+IL?22+CD4+ T cells(all P < 0.01), as well as serum levels of IL?22 and IL?17(both P < 0.05). A significant increase was observed in percentages of Th22 cells, Th17 cells, IL?17+IL?22+CD4+T cells and IFN?γ+IL?22+CD4+T cells, as well as serum levels of IL?22 and IL?17, in patients with severe AA compared with those with mild AA, and in patients with active AA compared with those with stable AA (all P < 0.05). Conclusion Th22 cells and their related cytokines may participate in the occurrence, development and prognosis of AA.

Objective To investigate the safety and effectiveness of endovascular embolization combined with two-stage stereotacticradiosurgery (SRS)for the treatment of intracranial arteriovenous malformation (AVM). Methods From January 2010 to December 2012,the clinical data of 66 patients treated with endovascular embolization combined with two-stage SRS AVM comprehensive therapy at the Department of Neurosurgery,Changhai Hospital,the Second Military Medical University were analyzed retro-spectively. They were followed up by imaging. The followed-up time was 7 to 96 months. DSA revealed that the complete disappearance of vascular flow void shadow was regarded as a cure. The patients were divided into either a cured group (n = 29)or a not cured group (n = 37)according whether they were cured or not. The effects of different factors,such as AVM rupture or not,the volume size before embolization,and the degree of embolization on the cure rate of AVM with the comprehensive therapy were observed in both groups,and logistic regression was used to analyze the factors affecting the cure rate of comprehensive therapy. Results (1)There were 22 patients (75. 9%)had ruptured AVMs and 7 (24. 1%)had unruptured AVMs in the cured group. The diameters of the aneurysms < 3 cm and ≥3 cm were in 26 (89. 7%)and 3 (10. 3%)cases respectively. Spetzler-Martin (SM)grades of patients were Ⅰ to Ⅲ. In the not cured group,20 patients (54. 1%)had ruptured AVMs and 17 (45. 9%)had unruptured AVMs. The diameters< 3 cm and ≥3 cm were 18 (48. 6%)and 19 patients (51. 4%)respectively. The SM grade in 34 cases were Ⅰ to Ⅲ. (2)During the follow-up period,29 patients (43. 9%)achieved cure on imaging. The modified Rankin scale (mRS)scores in 64 cases (97%)were 0 to 1. Six patients had complications. (3)Multivariate logistic regression analysis showed that the size of AVM (OR,0. 141,95% CI 0. 035 -0. 570,P < 0. 01)and the degree of interventional embolization (OR,2. 414,95% CI 1. 038 -5. 613,P <0. 05)were the influencing factor of the cure rate. Conclusions Vascular interventional embolization in combination with SRS for the treatment of intracranial AVMs was both effective and safe. The diameter of AVM < 3 cm was the beneficial factor of cure rate of comprehensive therapy. The degree of interventional embolization not reaching cure on imaging was a risk factor for the cure rate of comprehensive therapy.

Objective: To investigate prevalence of overweight, obesity and sleep duration and its associations among university students in Jiangxi Province, and to provide the basis for developing strategies for prevention and treatment of overweight and obesity among university students. Methods: Using the stratified random cluster sampling, 2 605 university students in 11 districts of Jiangxi Province were investigated with physical examination and questionnaire survey during September to October in 2019. Results: The detection rates of overweight obesity，obesity of university students in Jiangxi Province were 13.0% and 3.6%, respectively. The detection rates of overweightobesity，obesity of boys（20.8%, 6.0%） were higher than girls（8.4%, 2.1 %）（ χ 2=82.34，25.79， P < 0.01 ）. Significant differences were found in prevalence of overweightobesity and obesity by economic areas,with highest overweight obesity in high economic area(15.8%),followed by moderate(13.6%) and poor economicareas(10.3%),and highest obesity in high economic areas(5.6%),followed by poor(3.6%) and moderate economic areas(2.1%)（ χ 2=11.57，14.62， P <0.01）.The average sleep duration was (7.48±1.26) h/d.The rates of adequate sleep, insufficient sleep and excessive sleep were 69.1%,17.6% and 13.3 %, respectively .The average sleep time of boys[(7.61±1.46)h/d]was more than that of girls[(7.41±1.11)h/d]（ t =4.00， P ＜0.01）.The rate of insufficient sleep of boys (15.6%) was lower than that of girls (18.8%) ,the rate of insufficient sleep of boys ( 16.1 %) was higher than that of girls (11.6%) ,and the differences were statistically significant（ χ 2=12.38， P ＜0.01）.The results of multivariate Logistic regression analysis showed that the risk of overweight and obesity，obesity in those with insufficient sleep was 1.41 times and 1.69 times that in those with sufficient sleep, respectively（ P ＜0.05）. Conclusion The problem of overweight and obesity of university students in Jiangxi Province is serious, and the problem of insufficient sleep is worrying, and insufficient sleep is a related factor for overweight and obesity among university students in Jiangxi Province. They should develop good sleep habits and ensure normal sleep time to reduce the risk of overweight and obesity.

OBJECTIVETo investigate the actual condition of the sexual physiological and psychological development of the high school students in Yibin in order to get a reliable basis for sexual education of the teenagers.

METHODSWith a proportion of 1% to the whole, 2,770 students were randomly selected from eight high schools in the urban and rural areas of the city. We devised a questionnaire and asked each student to fill in his or her answers presently.

RESULTSSo far as sexual physiological and psychological development was concerned, the high school students of Yibin were found rather precocious, with very little sexual knowledge and psychological endurance in sexual affairs and a relative lack of sexual education.

CONCLUSIONIt is imperative to extend the scope of puberty sexual education in high schools. Teenagers must be taught different kinds of sexual knowledge at different periods of growth as well as how to avoid sexually transmitted diseases and gestation. The sexual knowledge level of the teachers must also be raised. It is a must to establish service or specialist consultation hot lines about sexual knowledge for teenagers. Parents are expected to change their traditional views and assume an active role in the joint efforts of sexual education for their children.

Adolescent ; Child ; China ; Female ; Humans ; Male ; Menarche ; Psychology, Adolescent ; Psychosexual Development ; Rural Population ; Sexual Development ; Students ; psychology ; Surveys and Questionnaires

Objective:To investigate the clinicopathological characteristics of papillary thyroid microcarcinoma in the isthmus (PTMCI) and the independent risk factors of central lymph node metastasis.Methods:58 consecutive patients with PTMCI admitted from Jan. 2016 to Dec. 2018 (isthmus group) were retrospectively analyzed, including 15 males and 43 females,age (42.93±12.69) years old; According to the specific location of papillary thyroid microcarcinoma (PTMC) in isthmus, PTMCI were subdivided into the right PTMCI and the left PT-MCI 67 patients with a single PTMC located in the unilateral lobe were randomly selected as a control (lobe group) , including 13 cases of male and 54 cases of female, age (47.18±11.34) years old. Index included the patient’s age, gender, tumor diameter, TPOAb, aspect ratio, microcalcification, capsular invasion, lymph node metastasis, surgical methods, operation method, and scope of lymph node dissection. SPSS 21.0 software was used for statistical analysis. The quantitative data of normal distribution was expressed as ± s,and the difference between the two groups was compared by chi-square test.The risk factors of CLNM of the isthmus group were analyzed with univariate chi-square test and multivariate Logistic regression analysis.The difference was statistically significant if P<0.05. Results:Compared with PTMC, PTMCI showed a higher rate of capsule invasion ( P=0.003) ,lymph node metastasis ( P=0.049) ,lymph node metastasis in central region ( P=0.033) ,and surgical methods between the two groups were statistically significant ( P<0.05) ;But PTMCI was significantly lower than PTMC in aspect ratio>1 ( P<0.05) . Univariate analysis showed that capsule invasion ( P=0.001) and microcalcification ( P=0.012) were risk factors for PTMCI lymph node metastasis. Multivariate Logistic regression analysis showed that capsule invasion ( P=0.016) and microcalcification ( P=0.046) were independent risk factors for central lymph node metastasis in PTMCI. Conclusions:Compared with PTMC,PTMCI indicates a higher rate of capsular invasion,lymph node metastasis in prelaryngeal and central lymph node;Compared with PTMC, PTMCI indicates a lower rate of aspect ratio>1; Capsule invasion and microcalcification are independent risk factors for central lymph node metastasis in PTMCI. For patients with the right PTMCI or the left PTMCI and also without capsular invasion and calcification,ipsilateral central lymph node dissection should be considered.

Objective To explore the feasibility and clinical outcome of lateral cervical incision via sternocleidomastoid intermuscular approach(SMIA)in the treatment of primary hyperparathyroidism.Methods The clinical data of 64 patients with primary hyperparathyroidism who underwent unilateral parathyroid surgery in the First Affiliated Hospital,School of Medicine of Zhejiang University from January 2019 to June 2022 were retrospectively analyzed.They were divided into lateral cervical incision via sternocleidomastoid intermuscular approach group(SMIA group)and linea alba cervicalis approach group(LACA group)based on the surgical incision and access route.The differences in clinical features,surgery-related outcomes and postoperative functions of the anterior cervical region were compared between the two groups.The EQ-5D-5L scale was used to assess the subjective feeling of postoperative neck discomfort,while the Hollander Wound Assessment Scale was used to assess the clinical outcome of incision healing.Results There were no statistical differences between the two groups of patients in terms of age,gender,intraoperative bleeding,parathyroid hormone or blood calcium levels before and after surgery(P＞0.05).The duration of surgery was significantly shorter in the SMIA group than in the LACA group[(39.77±5.69)min vs.(54.41±4.66)min].There was a statistical difference between the two groups in functional protection of the anterior cervical region at 1 month and 12 months after surgery(1 month,84.67±3.74 vs.79.47±5.38,P＜0.001;12 months,93.80±2.52 vs.89.94±2.39,P＜0.001),and the SMIA group was better than the LACA group.The Hollander Incision Assessment Scale scores of the SMIA group were better than those of the LACA group at 6 months and 12 months after surgery,and the difference was statistically significant(6 months,1.93±0.58 vs.2.41±0.66,P=0.003;12 months,1.03±0.67 vs.1.74±0.62,P＜0.001).Conclusion Parathyroidectomy via sternocleidomastoid intermuscular approach through lateral cervical incision is a simple,safe and effective surgical procedure,which makes it easier to search for parathyroid lesions and shortens the surgical time compared with the traditional incision,and has obvious advantages in the protection of anterior cervical region function.

Objective Hypothyroidism(HypoPT) is one of the most common complications of thyroid reoperation,and hypocalcemia caused by HypoPT is a difficult problem in clinical practice.This study aims to investigate the risk factors for hypoealcemia after reoperation of thyroid cancer.Methods Data of 106 patients who underwent reoperation for thyroid cancer from 2013 to 2018 were retrospectively analyzed.According to the parathyroid area involved in the reoperation,the reoperation was graded:low-risk group,intermediate-risk group and high-risk group.Parathyroid hormone(PTH) and total calcium(Ca) levels were monitored at 12 to 24 hours after surgery.The follow-up period was at least 6 months.The PTH cut-off values of postoperative hypocalcemia were analyzed by ROC curve.The chi-square test and logistic regression analysis were used to analyze the risk factors of postoperative hypocalcemia.Results The incidence of transient HypoPT after reoperation was 35％,and the permanent HypoPT was 1.9％.The grade of reoperation was positively correlated with postoperative HypoPT.The ROC curve showed that the PTH cut-off values of postoperative hypocalcemia was 15 pg/ml and area under curve(AUC) was 0.636(95％ CI:0.530-0.742,P＜0.017).Univariate and multivariate analysis showed that reoperation grade and postoperative PTH＜15 pg/ml were independent risk factors for postoperative hypocalcemia.Conclusion The grade of reoperation and postoperative PTH value ＜15 pg/ml can predict postoperative hypocalcemia.