The PIWI family members are defined as conserved PAZ and PIWI domains and play important roles in stem-cell self-renewal,spermatogenesis,RNA interference and translational regulation.Recent researches have showen that some PIWI are specifically expressed in tumors and associated with tumor development and growth.PIWI is likely to be a new significante index for tumor diagnose and prognosis,the feasibility of PIWI acting in tumor gene theropy could be in vestigated by studying the mechanism of PIWI expression and regulation.

Objective:To investigate the characteristics of serum immunoglobulin and complement levels in centenarians in Hainan.Methods:Fasting venous blood samples from 969 centenarians in Hainan province were collected and from 364 seniors serving as the control group.Levels of serum immunoglobulin A, G, M and E, immunoglobulin light chain κ and λ, and complement C3 and C4 were measured.Serum immunoglobulin and complement levels were analyzed in subjects based on age, sex, ethnicity, diet and smoking.Results:Serum levels of immunoglobulin G and E, and immunoglobulin light chain κ were higher in the centenarian group than in the control group[15.9(13.8, 18.3)g/L vs.14.9(13.1, 16.9)g/L; 270.0(85.5, 851.0) vs.180.5 kU/L(58.0, 556.2)kU/L, 4.1(3.5, 4.9)g/L vs.4.0(3.1, 4.6)g/L, P<0.05]. Serum levels of immunoglobulin M, and complement C3 and C4 were lower in the centenarian group than in the control group[1.0(0.7, 1.4)g/L vs.1.1(0.8, 1.5)g/L, 1.0(0.9, 1.2) vs.1.1(1.0, 1.3), 0.2(0.2, 0.3) vs.0.3(0.2, 0.3), P<0.05]. Serum levels of immunoglobulin M and complement C3 were higher in female centenarians than in male centenarians[1.1(0.7, 1.4) vs.1.0(0.7, 1.3), 1.0(0.9, 1.1) vs.1.0(0.8, 1.1), P<0.05]. There were significant differences in immunoglobulin A, G and E, and immunoglobulin light chain κ and λ between centenarians of different ethnicities( P<0.01). Serum immunoglobulin M levels were higher in centenarians with a long history of milk-drinking than in those without the history[1.2(0.8, 1.5) vs.1.0(0.7, 1.4), P<0.01]. Conclusions:Serum levels of immunoglobulins and complements are different among centenarians of different ages, genders, ethnicities and diet habits.Factors such as advanced age, female gender, ethnic minority and milk drinking tend to promote the expression of immunoglobulins and complements.

Objective To explore the clinical outcomes of xenogenic acellular dermal matrix in immediate implant-based breast reconstruction following nipple/skin sparing mastectomy.Methods From January 2015 to June 2017,patients that underwent immediate implant-based breast reconstruction following nipple/skin-sparing mastectomy were retrospectively studied.Results 43 female patients with breast cancer were enrolled.A retrospective review was performed on patients that were reconstructed with either alloplastic reconstruction (group A,18 breasts) or xenogenic acellular matrix dermal (group B,25 groups).Differences in the average age,body mass index,numbers of diabetic patients,numbers of active smoker,and volume of implant between the two groups were not statistically significant (P＞0.05).All patients were followed up from 3 to 28 months,with the middle time of 18,7 months.Complications in both groups of patients were clinically recorded after operation.When comparing clinical outcomes,group A had fewer drain (523.17±62.18) ml vs (639.56±54.34)ml,and fewer days before drain removal (7.83±1.58) d vs (10.2±1.44) d.No significant difference was seen in terms of seroma,hematoma,delayed healing,infection,nipple necrosis,capsular contracture,or tumor recurrence.Conclusions The use of xenogenic acellular matrix dermal in immediate implant-based breast reconstruction following nipple/skin-sparing mastectomy is as safe and effective as alloplastic reconstruction.

Objective To analyze the causal relationship between Sjogren's syndrome(SS)and primary biliary cholangitis(PBC)and abnormal liver function by two-sample Mendelian randomization.Methods From the ge-nome-wide association study,single nucleotide polymorphisms of SS,PBC,alkaline phosphatase,alanine amin-otransferase,aspartate aminotransferase,γ-glutamyltransferase,direct bilirubin and total bilirubin levels were extrac-ted as instrumental variables.Inverse-variance weighted(IVW)analysis was used as the main analysis,supplemen-ted by weighted median,MR-Egger,weighted mode,and simple mode.And a series of sensitivity analyses were car-ried out to verify the robustness of the results.Results The IVW analysis results of PBC on SS were as follows:P=8.57E-11,OR=1.185 9,95％CI=1.126 4-1.248 5;IVW analysis of PBC on SS(P＞0.05).IVW analysis results of SS on alkaline phosphatase were as follows:P=0.041 5,Beta=-0.007 2,95％CI=-0.014 0--0.000 3;IVW analysis results of SS on alanine aminotransferase,aspartate aminotransferase,γ-glutamyltransferase,direct bilirubin,total bilirubin levels showed no statistically significant difference.Conclusion PBC can significantly increase the risk of SS,but SS cannot be proved to have a causal effect on the occurrence of PBC.SS has a potential effect on re-ducing alkaline phosphatase levels,but it is not proved that SS has causal relationship with alanine aminotransferase,aspartate aminotransferase,γ-glutamyltransferase,direct bilirubin,total bilirubin levels.

Parkinson's disease (PD) is a kind of neurodegenerative disease based on damage of striatal nigrostriatal dopaminergic neurons, with motor dysfunction as typical clinical feature. However, PD is often accompanied by a series of non-motor symptoms (NMS) represented by depression and anxiety, which not only interferes with clinical management of PD patients, but also seriously affects quality of life of patients. Pathophysiological mechanism of PD comorbid depression and anxiety is still unclear, but is closely related to the disease process, severity of motor dysfunction, and metabolic disorders of neurotransmitter cytokines. This article reviews the epidemiological characteristics, diagnostic criteria, pathophysiological mechanism and treatment strategies of PD comorbid depression and anxiety, in order to improve the NMS clinical management and quality of life of PD patients.

Objective To construct a eukaryotic expression vector for the SARS-CoV-2 Omicron BA.1 mutant S1 protein,ex-pressed in CHO-K1 cells to evaluate its immunogenicity,and investigate the adjuvant and antigen dosages.Methods The recombinant plasmid UCOE-Omi-S1 was constructed and transfected into CHO-K1 engineering cells for expression and purification.The recombi-nant S1 protein was confirmed using SDS-PAGE and Western blot.BALB/c mice were randomly divided into 12groups:PBS group,no adjuvant group(high,medium and low-dose groups),aluminum salt adjuvant control group,MF59 adjuvant control group,aluminum salt adjuvant experimental group(high,medium and low-dose groups),MF59 adjuvant experimental group(high,medium and low-dose groups).The solution in accordance with the required proportion of the group was injected intramuscular into the mice 3 times,the interval of 14days,and the blood was collected from the tail vein every 2 weeks,and the serum was separated 30days after the last immu-nization.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum antibody levels and to neutralize pseudoviruses with SARS-CoV-2 prototype and SARS-CoV-2 Omicron BA.1 variant strains.Results After the expression of the target protein in CHO-K1 engineering cells,the expressed protein was observed at a relative molecular mass of approximately 70kDa and was identified as Omi-S1 protein by Western blot.The immune induction effect of the aluminum salt adjuvant group and MF59 adjuvant group was better than that of the no adjuvant group.There was no significant difference between the aluminum salt adjuvant group and the MF59 adjuvant group,but the MF59 adjuvant took effect more quickly.The immune induction effect of the high,middle,and low-dose groups was simi-lar at the 8th week,but the effect of the high-dose group was faster.Pseudovirus neutralization experiments showed that MF59 adjuvant experimental group exhibited higher levels of neutralizing antibodies against the Omicron variants than the aluminum salt adjuvant group.Conclusion This study successfully constructed a recombinant protein of Omicron S1 with good immunogenicity and generated a strong humoral immune response in mice,inducing high levels of neutralizing antibodies against SARS-CoV-2 pseudovirus.The adjuvant and antigen dosages of SARS-CoV-2 were preliminarily studied showed that a dose of less than 10μg of antigen dosages with MF59 adjuvant was found to be effective in inducing good immunity.These findings provide the experimental basis for the development of recombinant protein vaccines against SARS-CoV-2 variants.

Objective:To explore the factors affecting the prognosis of severe pediatric acute respiratory distress syndrome (ARDS) after receiving extracorporeal membrane oxygenation (ECMO) support.Methods:It was a multicenter prospective observational study. A total of 95 children with severe ARDS who were treated with ECMO salvage therapy from January 2018 to December 2022 in 9 pediatric ECMO centers in China were enrolled in the study. The general data, disease severity, organ function, comprehensive treatment and prognosis were recorded, and they were divided into survival group and death group according to the outcome at discharge. T test, chi-square test, multivariate Logistic regression and mixed linear model were used to analyze the relationship among baseline before ECMO treatment, some important indicators (pediatric critical scores, platelet count, albumin, fibrinogen, etc) during ECMO treatment and prognosis. Results:Among the 95 children with severe ARDS who received ECMO, 55 (58%) were males and 40 (42%) were females, aged 36.9 (0.5, 72.0) months. Twelve children (13%) were immunodeficient. Sixty-eight (72%) children were treated with venous artery (VA) mode and 27 (28%) with venous vein (VV) mode. The discharge survival rates of overall, VA, and VV mode children were 51% (48/95), 47% (32/68), and 59% (16/27), respectively. The number of immunodeficient children in the death group was higher, and there were lower pediatric critical scores, platelet count, albumin, fibrinogen and arterial oxygen partial pressure/fraction of inspired oxygen (PaO 2/FiO 2), higher ventilator driving pressure (ΔP), oxygenaion index (OI), and longer ARDS duration before ECMO (all P<0.05). There were no statistically significant differences in other indicators, including age, gender, weight, and ECMO mode among different prognostic groups (all P>0.05). High ΔP, high OI, low P/F, and low albumin were high-risk factors affecting prognosis(all P<0.05). After further grouping, it was found that ΔP≥25 cmH 2O (1 cmH 2O=0.098 kPa), P/F≤67 mmHg (1 mmHg=0.133 kPa) and OI≥35 were the thresholds for predicting poor prognosis ( P<0.05). From 24 h after ECMO, there were significant differences in ΔP, P/F and OI between the dead group and the survival group (all P<0.05), and the differences gradually increased with the ECMO process. The platelet level was significant from 7 days after ECMO ( P<0.05) and gradually expanded. Blood lactate levels showed a significant difference between the 2 groups on before and after ECMO ( P<0.05) and gradually increased from 24 h after ECMO. Conclusions:The risk factors affecting the prognosis of severe ARDS in ECMO include high ΔP, high OI, low P/F and low albumin purification therapy before ECMO. The gradual decrease of ΔP, OI and increase of P/F from 24 h of ECMO predicted a good prognosis, while the gradual increase of lactate after ECMO application showed a poor prognosis.

BACKGROUND:A large number of studies have investigated the effects of whole body vibration training at different frequencies on muscle strength,but less is reported on the differences in the efficacy of vibration training at different frequencies on patellar tendinopathy. OBJECTIVE:To explore the effect of eccentric training of quadriceps combined with different frequency of whole body vibration training on patellar tendinopathy. METHODS:From April to June 2022,48 patients with patellar tendinopathy were recruited from Wuhan Sports University and randomly divided into eccentric training group(n=12),30 Hz group(n=12),40 Hz group(n=12),and 50 Hz group(n=12).The eccentric training group only completed eccentric training of the quadriceps.The 30 Hz,40 Hz and 50 Hz groups performed the whole body vibration training with the amplitude of 2 mm and frequencies of 30 Hz,40 Hz and 50 Hz respectively on the basis of the eccentric training of the quadriceps.The intervention lasted for 8 weeks,three times a week.Before and after the intervention,the patients'surface electromyography signals of the quadriceps,kinematics and dynamics data of knee joint at the time of landing in deep jump and the time of peak vertical ground reaction,Visual Analogue Scale score,Victorian Institute of Sports Assessment-Patellar score were evaluated. RESULTS AND CONCLUSION:After 8 weeks of intervention,compared with the eccentric training group,the median frequency of the lateral and medial femoris muscles were significantly higher in the 40 Hz and 50 Hz groups(P＜0.05).At the time of landing,the knee joint flexion angle and external rotation moment in the 40 Hz and 50 Hz groups were significantly lower than those in the eccentric training group(P＜0.05),while the knee joint flexion angle in the 50 Hz group was significantly lower than that in the 30 Hz group(P＜0.05).At the peak moment of vertical ground reaction,the knee extension torque in the 40 Hz group was significantly lower than that in the eccectric training group(P＜0.05);the knee flexion angle and knee extension torque in the 50 Hz group were significantly lower than those in the eccentric training group(P＜0.05).The Visual Analogue Scale scores in the 50 Hz and 40 Hz groups were significantly lower than those in the eccentric training group(P＜0.05).The Victorian Institute of Sports Assessment-Patellar score in the 50 Hz group was significantly higher than that in the eccentric training group and 30 Hz group(P＜0.05).To conclude,eccentric training of the quadriceps combined with 50 Hz whole body vibration training can significantly improve quadriceps'strength,endurance and activation rate of the vastus lateralis muscle,reduce the pain of knee joint,and improve the function of the knee joint in patients with patellar tendinopathy.

Objective:To investigate the status of cognition and clinical management of prolonged mechanical ventilation(PMV) among medical staffs in pediatric intensive care unit(PICU) in China, and in order to improve the awareness of PICU medical staffs on PMV and standardize the management of PMV.Methods:The cross-sectional study was conducted with doctors and nurses in PICUs of the collaborative group as the survey objects from July 12 to September 12, 2020.The questionnaire was issued, collected and checked by the Children′s Hospital of Fudan University.Results:(1) PMV related settings: Nine out of eleven hospitals had established PMV multidisciplinary teams, respiratory techniques such as diaphragm ultrasound and airway peak flow monitoring could be respectively executed in 72.7% and 36.4% of PICU.Pulmonary rehabilitation techniques such as airway clearance techniques, induced spirometer exercise, external diaphragm pacemaker stimulation, transfer bed exercise, balloon blowing, hyperbaric oxygen therapy could be respectively executed in 100.0%, 9.1%, 9.1%, 9.1%, 27.3% and 27.3% of PICU, respectively.(2) The cognitive status quo of children′s PMV: The most medical staffs agreed with the view that PMV referred to the children′s continuous mechanical ventilation for more than two weeks.Sixty percent of medical staffs believed that children with PMV had basic central nervous system diseases, and 62.7% of medical staffs believed that the most common causes of difficulty in PMV weaning was abnormal brain function.(3) The cognitive status quo of the children′s PMV management in PICU: Respondents believed that the most commonly used mechanical ventilation mode was synchronized intermittent mandatory ventilation+ pressure support ventilation in children′s PMV during stable disease.Ninety-two percent of medical staffs performed the spontaneous breathing test when weaning.And 58.7% of the respondents agreed to perform tracheotomy for the children during 3 to 4 weeks of mechanical ventilation.More than half of medical staffs would execute diaphragm function assessment, bedside rehabilitation training, nutritional assessment, analgesia and sedation assessment for children with PMV.(4) The cognitive status quo of the children′s PMV management of transition from hospital to family: 54.5% of PICU provided family care training to the family members before the children were discharged from the hospital.One center established the PMV specialized outpatient clinic.45.5% of PICU would follow up these discharged children one month later.Conclusion:At present, PICU medical staffs have different awareness of children′s PMV related problems in China.And children′s PMV lacks a systematic plan regarding diagnosis, treatment and management.

Objective:This study aimed to explore the status of radiological Kashin-Beck disease (KBD) among school-aged children in Chamdo City, Tibet, through a 3-year monitoring survey, providing epidemiological evidence for prevention and control strategies.Methods:The target areas for this study were Luolong, Bianba, and Basu counties in Chamdo City, Tibet Autonomous Region, identified as having the most severe historical cases of KBD. Children aged 7-12 years attending school were enrolled as study subjects. Anteroposterior X-ray films of the right-hand were taken, and radiological diagnoses were made based on the "Diagnosis of Kashin-Beck Disease" criteria (WS/T 207-2010). Two experienced researchers independently reviewed the X-rays, and intra- and inter-group consistency were assessed using weighted Kappa values and percentage agreement. Cross-sectional surveys were conducted in 2017 and 2020 to describe the X-ray detection rates of KBD, and logistic regression analysis was employed to construct a predictive model of risk factors for radiological KBD cases.Results:In 2017, a total of 5,711 children aged 7-12 years in Chamdo City, Tibet, participated in the baseline cross-sectional survey (average age 9.2 years, 48.0% female), with 28 cases of radiological KBD. The age- and gender-standardized prevalence rate was 0.527%. In 2020, 6,771 participants (average age 9.3 years, 49.5% female) underwent a second cross-sectional survey, with 9 cases of radiological KBD and a standardized prevalence rate of 0.134%. Logistic regression analysis indicated that older age [ OR=2.439, 95% CI(1.299, 4.580), P=0.006] and female gender [ OR=8.157, 95% CI(1.016, 65.528), P=0.048] were independent risk factors for radiological KBD cases. Conversely, higher residential altitude, under the premise of Tibet's high altitude, was a protective factor [ OR=0.995, 95% CI(0.990, 0.999), P=0.032). Conclusion:The radiographically positive detection rate of KBD among school-aged children in Chamdo City, Tibet Autonomous Region, is at an extremely low level and showing a declining trend, reaching the historical standard in 2020. Considering the absence of positive signs in affected children, it suggests that local KBD has been effectively eliminated.