Objective To study clinical characteristics of bacterial pneumonia with normal procalcitonin (PCT) and C-reactive protein (CRP) in infants and toddlers. Methods Retrospective analysis of clinical data of infants and toddlers with bacterial pneumonia was performed from January 1, 2013 to March 30, 2015. Of them, there were 92 cases with normal PCT and CRP (case groupe) and 95 cases with signiifcantly higher PCT and CRP (control group). Results The median age was 9.25 months in the case group, which was signiifcantly younger than that in the control group (16.55 months) (P<0.05). The median of the course before admission was 5.17 days in the case group, which was signiifcantly longer than that in the control group (3.5 days) (P<0.05). The proportions of fever, dyspnea, and hypoxemia were signiifcantly lower in the case group than those in the control group (P<0.05). Administration of antibiotics before admission was found in 83.69%of cases in the cases group, which was higher than that in the control group (P<0.05). The most common pathogens in the case group was Haemophilus inlfuenza, while Streptococcus pneumonia was the most common in the control group. Conclusion The possibility of bacterial infection cannot be ruled out in pneumonia with normal CRP and PCT in infants and toddlers.

Objective:To investigate the relative expression of matrix metalloproteinases-2, 3 (MMP-2, 3) and tissue inhibitors of metalloproteinases-1, 2 (Tissue Inhibitor of Metalloproteinase-1, 2, TIMP-1, 2) in ovarian cancer cell line A2780 under different pressures controlled by carbon dioxide (CO2) changes at different time points and their meaning.Methods:Cell model was established by culture and grouping of A2780 ovarian cancer cell line in vitro.By simulation of laparoscopic CO2pneumoperitoneum environment under different pressure in vitro the pressure of carbon dioxide is controlled at 0 mmHg, 7 mmHg and 15 mmHg respectirely, the cells were collected at 0, 12, 24 and 48 hours after the CO2pressure was controlled for 3 hours.Total RNA was extracted and RT-qPCR was performed to detect the relative expression of MMP-2, 3, TIMP-1 and 2 mRNA in each group.Results:After CO2pressure control, the relative expression of MMP-2 mRNA in each sample under the same pressure decreased with the duration of culture.After CO2pressure control, the relative expression of MMP-2 in ovarian cancer cells decreased with the increase of CO2pressure at the same time point.After CO2pressure control, the relative expression of MMP-3 mRNA in each sample underthe same pressure decreased with the culture time.After CO2pressure control, the relative expression of MMP-3 in ovarian cancer cells decreased with the increase of CO2pressure at the same time point.There was no significant difference in the relative expression of TIMP-1 and TIMP-2 mRNA between the control group and the experimental group at different time points orunder different CO2pressures (P＞0.05).Conclusions:The simulated CO2pneumoperitoneum environment could inhibit the invasive ability of ovarian cancer cell line A2780.The relative expression of MMP-2 and MMP-3 decreased astime and pressure increasing.The simulated CO2pneumoperitoneum environment had no significant effect on the expression of A2780 TIMP-1 and 2 mRNA in ovarian cancer cell line A2780.

Objective To monitor the immediate effect of Passi-Muir speaking valve (PMV) on patients with tracheostomy after acquired brain damage.Methods Twelve patients with tracheostomy after acquired brain damage were recruited.All of them underwent the high resolution manometry to measure the pressure in pharynx and upper esophagus during swallowing before and immediately after wearing PMV.The parameters including the pharyngeal peak pressure,increasing rate of the pharyngeal pressure,pharyngeal pressure duration,upper esophageal sphincter (UES) residual pressure and UES relaxation duration were recorded.Results No significant differences were found in all the measurements before and immediately after wearing PMV (P＞0.05).Conclusion PMV has no instant impact on the swallowing function of patients with tracheostomy after acquired brain damage.

Objective:To explore the clinical technique and method of reconstruction large soft tissue defect of plantar by skin soft tissue dilatation combined with thigh cross leg flap to improve the weight-bearing function of plantar standing.Methods:From February 2015 to June 2019, 8 cases with plantar soft tissue defects were repaired with cross leg flap expanded from the healthy side of the thigh. Right foot in 4 cases, left foot in 3 cases and bilateral in 1 case. There were 5 males and 3 females. Ages ranged from 16 to 56, with an average age of 31. Clinical features: scar ulcer in 4 cases, bone-sticking scar in 4 cases, bone exposure in 1 case. After debridement, the area of skin and soft tissue defect was 9 cm×16 cm-12 cm×29 cm, the area of harvest expanded flap was 11 cm×18 cm-14 cm×30 cm. All flaps were fixed by cross-leg with pedicle. The pedicle division were performed one month after the skin flap transmission.Results:Of the 9 flaps transferred, 8 survived, 1 died in the distal part of the flap and was repaired by secondary expanded flap, and the donor site healed in linear scar stage. After 6-24 months follow-up, the plantar flap was in good shape and could walk with weight-bearing, without ulceration, and the protective tactile sensation was gradually restored in 12 months.Conclusions:The large-area soft tissue defect of plantar was repaired with the expanded cross leg flap in the healthy thigh, which also provide sufficient thickness of soft tissue to increase the ability of bearing weight and wearing resistance of the sole. It is a good alternative method to repair large area soft tissue defect of plantar under the condition of limited transfer of perforator flap and free flap.

Objective:To explore the clinical technique and method of reconstruction large soft tissue defect of plantar by skin soft tissue dilatation combined with thigh cross leg flap to improve the weight-bearing function of plantar standing.Methods:From February 2015 to June 2019, 8 cases with plantar soft tissue defects were repaired with cross leg flap expanded from the healthy side of the thigh. Right foot in 4 cases, left foot in 3 cases and bilateral in 1 case. There were 5 males and 3 females. Ages ranged from 16 to 56, with an average age of 31. Clinical features: scar ulcer in 4 cases, bone-sticking scar in 4 cases, bone exposure in 1 case. After debridement, the area of skin and soft tissue defect was 9 cm×16 cm-12 cm×29 cm, the area of harvest expanded flap was 11 cm×18 cm-14 cm×30 cm. All flaps were fixed by cross-leg with pedicle. The pedicle division were performed one month after the skin flap transmission.Results:Of the 9 flaps transferred, 8 survived, 1 died in the distal part of the flap and was repaired by secondary expanded flap, and the donor site healed in linear scar stage. After 6-24 months follow-up, the plantar flap was in good shape and could walk with weight-bearing, without ulceration, and the protective tactile sensation was gradually restored in 12 months.Conclusions:The large-area soft tissue defect of plantar was repaired with the expanded cross leg flap in the healthy thigh, which also provide sufficient thickness of soft tissue to increase the ability of bearing weight and wearing resistance of the sole. It is a good alternative method to repair large area soft tissue defect of plantar under the condition of limited transfer of perforator flap and free flap.

The thought of the way of heaven is the core philosophy of the Book of Changes， aiming to achieve the “pursuing good fortune and avoiding disaster” of human affairs or “seeking benefits and avoiding harm” in technology. The embedded value orientations， such as “continuous life”， “utmost sincerity”， and “correct desire”， provide ethical considerations for “seeking benefits and avoiding harm” in human gene editing technology. Among them， the thought of “continuous life” affirms the potential value of gene editing technology for human reproduction， diagnosis and treatment， or prevention of diseases and disabilities from two aspects of human reproduction and individual body and mind， while adopting a cautious attitude towards the risks of technology. The thought of “utmost sincerity” advocates that gene editing should be studied and applied following objective laws. The thought of “correct desire” puts forward the norm of human desire in human gene editing. In terms of the issue of offspring autonomy， the thought of the way of heaven provides some ethical support for parents to implement gene editing for their offspring for the sake of the offspring’s physical and mental development. In conclusion， the application of the thought of the way of heaven in the Book of Changes hopes that human gene editing technology will benefit mankind and provide it with broader prospects and a better future.

Cancer cell membrane (CCM) derived nanotechnology functionalizes nanoparticles (NPs) to recognize homologous cells, exhibiting translational potential in accurate tumor therapy. However, these nanoplatforms are majorly generated from fixed cell lines and are typically evaluated in cell line-derived subcutaneous-xenografts (CDX), ignoring the tumor heterogeneity and differentiation from inter- and intra- individuals and microenvironments between heterotopic- and orthotopic-tumors, limiting the therapeutic efficiency of such nanoplatforms. Herein, various biomimetic nanoplatforms (CCM-modified gold@Carbon, i.e., Au@C-CCM) were fabricated by coating CCMs of head and neck squamous cell carcinoma (HNSCC) cell lines and patient-derived cells on the surface of Au@C NP. The generated Au@C-CCMs were evaluated on corresponding CDX, tongue orthotopic xenograft (TOX), immune-competent primary and distant tumor models, and patient-derived xenograft (PDX) models. The Au@C-CCM generates a photothermal conversion efficiency up to 44.2% for primary HNSCC therapy and induced immunotherapy to inhibit metastasis via photothermal therapy-induced immunogenic cell death. The homologous CCM endowed the nanoplatforms with optimal targeting properties for the highest therapeutic efficiency, far above those with mismatched CCMs, resulting in distinct tumor ablation and tumor growth inhibition in all four models. This work reinforces the feasibility of biomimetic NPs combining modular designed CMs and functional cores for customized treatment of HNSCC, can be further extended to other malignant tumors therapy.
Animals ; Humans ; Squamous Cell Carcinoma of Head and Neck/therapy* ; Heterografts ; Photothermal Therapy ; Biomimetics ; Disease Models, Animal ; Head and Neck Neoplasms/therapy* ; Cell Line, Tumor ; Tumor Microenvironment