Objective: To analyze the relationship between Toll like receptor ( TLR ) 9 and TLR 7 gene polymorphisms among children with hand-foot-mouth disease in a medical institution of Jinan City from 2020 to 2023, so as to provide reference for prevention of hand-foot-mouth disease. Methods: Data of 284 preschool children aged 3-6 with hand-foot-mouth disease, including the season pattern, clinical manifestations, pathogen distribution, were collected in department of pediatric infectious diseases of the Second Children & Women s Healthcare of Jinan from 2020 to 2023. The distribution conditions of TLR 9 and TLR 7 genotypes of enterovirus 71 (EV71) subtype and coxsackievirus A16 (CA16) subtype were compared by Chi square test. Hardy Weinberg equilibrium test was used to characteristic sample population distribution, and Logistic regression analysis in the additive genetic model was adopted to evaluate the relationship between TLR 9 and TLR 7 gene polymorphisms with hand-foot-mouth disease subtype. Results: The time to admission after symptom onset with hand-foot-mouth disease among 284 children was mostly >2-4 d ( 45.42% ), followed by ≤2 d ( 44.72% ). The season pattern was mostly in summer (58.10%). The severity was mostly mild ( 69.72% ), and the main clinical manifestations were skin rash (100.00%) and fever (65.49%). The majority pathogen was EV71 (60.56%). Hardy Weinberg equilibrium test showed good population representation ( P >0.05). Logistic regression analysis was applied to analyze the relationship between TLR9 rs 187084 locus and hand-foot-mouth disease subtypes under the additive genetic model after adjusting for age and gender of the study population, and it was found that compared with those without C allele, each additional C allele increased the risk of CA16 subtype hand-foot-mouth disease by 109% ( OR=2.09, 95%CI =1.13-3.27). Analysis of relationship between TLR 7 rs 3853839 locus and hand-foot-mouth disease subtype showed that compared with those without C allele, the risk of EV71 subtype hand-foot-mouth disease increased by 57% for each additional C allele ( OR=1.57, 95%CI = 1.10 -2.11) ( P <0.05). Conclusions From 2020 to 2023, children with hand-foot-mouth disease in a medical institution of Jinan City is mostly mild and caused by EV71 infection. The polymorphism of rs 3853839 locus of TLR 7 may be related to EV71 infection in children with hand-foot-mouth disease, and the polymorphism of rs 187084 locus of TLR 9 may be related to CA16 infection.

Objective:To investigate the clinical efficacy of Danggui Zicao ointment on diabetic pruritus caused by heat and wind in blood. Methods:A total of 197 patients with diabetic pruritus caused by heat and wind in blood who received treatment in Jinhua Hospital of Traditional Chinese Medicine from November 2020 to March 2022 were included in this randomized controlled study. They were randomly divided into a control group ( n = 99) and an observation group ( n = 98). Based on basic hypoglycemic treatment, the control group was given oral levocetirizine hydrochloride tablets, while the observation group was externally given Danggui Zicao ointment. Both groups were treated for 4 successive weeks. Pre- and post-treatment 12-Item Pruritus Severity Scale (12-PSS) score and clinical efficacy were compared between the two groups. Results:After 4 weeks of treatment, the 12-PSS score in each group significantly decreased compared with that before treatment ( t = 18.09, 11.31, both P < 0.05). The 12-PSS score in the observation group was (7.72 ± 1.64) points, which was significantly lower than (9.35 ± 2.18) points in the control group ( t = 3.52, P < 0.05). The total effective rate in the observation group was 87.8% (86/98), which was significantly higher than 76.8% (76/98) in the control group ( χ2 = 4.06, P < 0.05). Conclusion:Danggui Zicao ointment can effectively improve the clinical symptoms of patients with diabetic pruritus caused by heat and wind in blood, improve quality of life, and deserves clinical promotion.

From April 2017 to April 2018, three male patients aged 46-71 years with large area burns were treated in our hospital. Acute acalculous cholecystitis (AAC) symptoms of the patients began to appear 15-81 days after injury. AAC was diagnosed 24-81 days after injury. Ultrasound-guided percutaneous transhepatic cholecystostomy was performed 26-82 days after injury. The symptoms subsided in 2 patients, and cholecystectomy was performed in 1 patient with gallbladder perforation 94 days after injury. The patients were cured and discharged 41-118 days after injury. No recurrence of cholecystitis occurred during 8-9 months of follow-up after discharge.

Objective: To investigate the efficacy and safety of radiofrequency ablation for fetal reduction in monochorionic twin pregnancies at gestational age over 26 weeks. Methods: A retrospective study was performed based on the clinical data of 51 patients who underwent fetal reduction by radiofrequency ablation in the First Affiliated Hospital of Chongqing Medical University from May 2013 to July 2018. Clinical data including basic information, surgical data (such as ablation duration, power and the number of cycles), perinatal complications and pregnancy outcomes were collected. Differences in pregnancy outcomes were compared between the group with gestational age >26 weeks (n=17, group A) and that ≤26 weeks (n=34, group B) using t-test, rank-sum test and Chi-square test or Fisher's exact test. Results: (1) The indications of fetal reduction were malformation in one of the twins, twin-to-twin transfusion syndrome, twin reversed arterial perfusion sequence and selective intrauterine growth restriction [45.1% (23/51), 15.7% (8/51), 19.6% (10/51) and 19.6% (10/51)]. The differences in the proportion of different indications between group A and B were statistically significant [12/17, 1/17, 0/17, 4/17 vs 32.4% (11/34), 20.6% (7/34), 29.4% (10/34), 17.7% (6/34), P=0.009]. Those in the group A required longer operation duration than the group B [M(min-max), 20(7-40) vs 15(3-29) min, Z=2.550, P=0.011]. (2) The gestational age of the 51 patients was (23.7±4.7) weeks (15⁺¹-32⁺⁶ weeks), the overall survival rate of the remaining fetuses was 86.3% (44/51) and the preterm birth rate was 50.0% (22/44). The gestational age at operation was (28.9±2.5) weeks (26⁺¹-32⁺⁶ week) in group A and (21.1±3.1) weeks (15⁺¹-25⁺² weeks) in group B. The survival rate of the remaining fetuses and the preterm birth rate in group A were significantly higher than those in group B [17/17 vs 79.4% (27/34), P=0.046; 12/17 vs 37.0% (10/27), χ²=4.697, P=0.030]. Conclusions Fetal reduction at gestational age >26 weeks, of which the main surgical indication is malformation in one of the twins, may increase the risk of preterm birth, but can improve the overall survival rate of the remaining fetuses without increasing the maternal and infant morbidity. Therefore, radiofrequency ablation is a safe and effective procedure for twin pregnancies >26 weeks of gestation.

Objective To evaluate the reporting item quality of randomized controlled trials of Chinese herbal medicine as an adjunctive therapy for advanced non-small cell lung cancer. Methods The terms including Chinese medicine, Chinese herbal medicine, randomized controlled trials, and non-small cell lung cancer were searched in Chinese and English databases by computer systems to collect relevant literatures. Based on the CONSORT 2010 (consolidated standards of reporting trials 2010), the reporting item quality of the abstracts and main text in eligible papers was evaluated. Results Ninety-five eligible studies were identified from 692 potential eligible articles. None reported all of abstract and main text items in CONSORT 2010. Only 4.12％could be identified as the randomized trial in the title. More than 40％of reports showed the scientific background or rationale in the abstract but not in the main text. Three (3.16％) eligible reports defined the primary or secondary outcome measures. None reported complete information of subjects throughout the clinical trial process. Results A total of 95 eligible papers were collected, of which 0 papers reported complete abstracts and text entries according to the CONSORT. The titles of 4.12％papers were identified as randomized trials. More than 40％of the papers only reported the study purpose or hypothesis in the abstract. 3.16％of the papers reported primary and secondary efficacy index entries, and 0 papers reported complete information of subjects from enrollment to included data analysis sets. Conclusion There is a serious problem of items shortage in the literatures of randomized controlled clinical trials on Chinese herbal medicine as an adjunctive therapy for advanced non-small cell lung cancer. The randomized controlled clinical trials of Chinese herbal medicine as an adjunctive therapy for advanced non-small cell lung cancer should be reported based on the CONSORT to improve the quality of trials.

Objective? To understand the situation of disability acceptance, coping style and social support in rectal cancer patients with permanent enterostomy and to explore the correlations among them. Methods? From March 2017 to December 2017, we selected 110 rectal cancer patients with permanent enterostomy in Heilongjiang Provincial Hospital as subjects by convenience sampling. All of the patients were investigated with the Acceptance of Disability Scale (ADS), Simplified Coping Style Questionnaire (SCSQ), Social Support Rating Scale (SSRS). Results? A total of 110 questionnaires were sent out and 101 valid questionnaires were collected. The total score of ADS, the scores of positive coping and negative coping of SCSQ as well as the total score of SSRS, were (79.55±7.42), (1.69±0.37), (1.74±0.24) and (41.35±10.24) respectively among rectal cancer patients with permanent enterostomy. The total score of ADS was positively correlated with the positive coping (P＜0.05), was negatively correlated with the negative coping (P＜0.05), and it also had a positive correlation with the total score of SSRS (P＜ 0.05). Conclusions? The disability acceptance of rectal cancer patients with permanent enterostomy needs to be improved. Health care providers should take targeted intervention based on social support system so as to help patients take positive coping style to improve their disability acceptance.

Objective To explore the accuracy of endoscopic ultrasonography (EUS) for evaluating T3 esophageal squamous cell carcinoma (ESCC).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 733 patients diagnosed with T3 ESCC by preoperative EUS who were admitted to the Sun Yat-sen University Cancer Center from January 2003 to December 2015 were collected.All the patients underwent radical resection of ESCC.The postoperative pathological stage as a gold standard,the accuracy,overstaged and understaged rates of clinical staging by preoperative EUS were assessed.Observation indicators:(1) comparison between clinical T staging evaluated by preoperative EUS and postoperative pathological T staging;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect patients' diseases and postoperative survival up to December 30,2016.Overall survival time was from operation time to death or last effective follow-up.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M (range).Count data were represented as cases and percentage.The survival curve was drawn by the Kaplan-Meier method,and survival analysis was done using the Log-rank test.Results (1) Comparison between clinical T staging evaluated by preoperative EUS and postoperative pathological T staging:all the 733 patients were confirmed as T3 ESCC by preoperative EUS.Postoperative pathological diagnosis showed that 9 patients were detected in pT1b,87 in pT2,630 in pT3 and 7 in pT4a.The accuracy,overstaged and understaged rates of preoperative EUS in evaluating T3 ESCC were 85.95％(630/733),13.10％(96/733) and 0.95％(7/733),respectively.N0,N1,N2 and N3 of postoperative pathological N stage were respectively detected in 329,247,110 and 47 patients.Twenty-seven,323 and 383 patients were in stage Ⅰ,Ⅱ and Ⅲ of TNM stage,respectively.The high-,moderate-and lowdifferentiated tumors were respectively detected in 125,403 and 205 patients.(2) Follow-up and survival situations:among 733 patients,639 were followed up for 1.0-153.0 months,with a median time of 29.0 months.The median survival time,1-,3-,5-year overall survival rates were 53.0 months (range,37.7-68.3 months),85.3％,58.1％ and 48.2％ in 733 patients,respectively.The 5-year overall survival rate was 75.2％ in 9 patients with pT1b,63.0％ in 87 patients with pT2,46.3％ in 630 patients with pT3 and 0 in 7 patients with pT4a,respectively,with a statistically significant difference (x2=24.089,P＜0.05).Conclusion There is a higher accuracy of EUS for evaluating T3 ESCC,however,the stage migration should be noted.

Objective To explore the relationship between responsibility and social adaptation of the left-behind middle school students and to provide evidence for mental health education of left-behind children.Methods 290 left-behind middle school students were selected by cluster-random-sampling.All of them were assessed by the middle school students' social adaptability scale (SAS-SSS),the inventory of parent and peer attachment (IPPA) and the scale of high school students' responsibility.Results The correlation between responsibility,attachment behavior and social adaptation of left-behind middle school students were significant(r=0.39,r=0.56,P＜0.01).There were significant differences between gender on the responsibility(male(202.64±26.78) vs female(212.67±23.24)).Regression analysis showed that mother attachment,overall responsibility,general responsibility and special fault responsibility could predict the social adaptation(P＜0.05).Responsibility and its factors played a mediating role between attachment and adaptation,taking 52.1％,20.1％,30.8％,9.1％,47.9％,40.7％ proportion of the total effect.Conclusion Responsibility is an important factor affecting the social adaptation of left-behind middle school students.

OBJECTIVETo explore the efficacy of local acupuncture therapy on post-stroke pseudo-bulbar palsy and the clinical advantageous protocol of local acupuncture therapy.

METHODSEighty patients of post-stroke pseudo-bulbar palsy were randomized into a quick needle insertion group and a routine acupuncture group, 40 cases in each one. The western medicine, such as thrombolysis, lipid regulation, antiplatelet aggregation, antihypertension and hypoglycemic therapy method was all used in the two groups. On the basis of the treatment of western medicine, in the quick needle insertion group, the perpendicular needle insertion was used atpoint, about 8 to 12 mm in depth. When the emptiness feeling presented under the needle, the needle went slowly for 2 mm more depth till cough occurred, and removed afterward. The treatment was given once every day, and totally 20 treatments were required. In the routine acupuncture group, Lianquan (CV 23) was stimulated. The needle was inserted toward the tongue root, about 40 mm in depth. The needle was rotated till the patient felt soreness and distention at the tongue root, and then retained for 30 min. The treatment was given once a day, and totally 20 treatments were required. The water swallow test score and clinical efficacy were evaluated before and after treatment.

RESULTSThe curative rate was 80.0% (32/40) in the quick needle insertion group, better than 55.0% (22/40) in the routine acupuncture group (<0.05). The total effective rate was 97.5% (39/40) in the quick needle insertion group and was 90.0% (36/40) in the routine acupuncture group, indicating no significant difference in comparison (>0.05). The water swallow test scores decreased after treatment as compared with those before treatment in the two groups (both<0.01), and the water swallow test scores after treatment of the two groups had no significant difference (>0.05).

CONCLUSIONSAcupuncture at local point is effective for post-stroke pseudo-bulbar palsy.The curative rate of quick needle insertion atpoint is better than routine acupuncture at Lianquan (CV 23).

Objective To investigate the interpersonal disturbances and its related factors among college students.Methods The field questionnaire survey was conducted among 730 college students with stratified-cluster sampling method in Zhengzhou University.The self-administered anonymous survey instruments included the Interpersonal Relationships Integrated Diagnosis Questionnaire,Parental Bonding Instrument questionnaire,Self-Rating Anxiety Scale and Pittsburgh Sleep Quality Index.Results ①Detection rate of interpersonal relationship disturbance was 47.8％ in 730 college students.Severe interpersonal disturbances accounted for 16.3％.The most serious problem was communication and making friends disturbance which accounted for 58.5％ of the total.②)There were statistical differences of conversation scores ((2.15± 1.66),(2.53± 1.83),(2.22± 1.79)) among different major college students (medical,engineering,liberal arts) (P＜0.05).A statistical difference was found in making friends((2.76±1.89),(3.18± 1.92)) and getting along with opposite gender ((2.23 ± 1.82),(1.81 ± 1.66)) between male and female (P＜ 0.05).There were significant differences of conversation ((2.58 ± 1.84),(2.02 ± 1.65)),making friends ((3.28 ± 1.93),(2.78 ±1.88)) and getting along with opposite gender ((2.16± 1.75),(1.77± 1.69)) between grade one and three students(P＜0.05).③The interpersonal disturbances were significantly related to parental bonding styles,anxiety and sleep quality.④The results of logistic regression showed that anxiety was the main risk factor (B =1.42,OR=4.4,95％ CI =1.74-9.86,P＜0.01) and maternal parenting style and sleep quality were protective factors(P＜0.01)of interpersonal disturbances.Conclusion The interpersonal disturbance,which are severe and affected by multiple factors in college students,should be paid attention by school,society and family to improve their learning and growing environment in order to promote their physical and mental health.