Objective To investigate the relationships of serum procalcitonin(PCT),α1-acid glycoprotein(α1-AGP)and cluster of differentiation 64(CD64)index with the severity of illness and prognosis in patients with pulmonary Candida infection after lung cancer surgery.Methods A pro-spective study was conducted in 120 patients with pulmonary Candida infection after lung cancer sur-gery as infection group,and 60 patients without infection after lung cancer surgery in the same period were selected as control group.Baseline characteristics and laboratory indicators were compared be-tween the two groups.Differences in serum PCT,α1-AGP,CD64 index in peripheral blood,and plasma 1,3-β-D glucan test(BG)were compared among patients with different severities of illness and prognoses in the infection group.The relationship between serum indicators and prognosis as well as their predictive efficiencies were analyzed,and external validation was performed.Results The levels of serum PCT,α1-AGP,CD64 index in peripheral blood,and plasma BG in the infection group were significantly higher than those in the control group(P＜0.05).In the infection group,the levels of serum PCT,α1-AGP,and CD64 gradually decreased significantly in patients with severe,moderate,and mild illness,and the levels of these indicators in dead patients were significantly higher than those in surviving patients(P＜0.05).Survival curve analysis showed that patients with low levels of serum PCT,α1-AGP,and CD64 index before treatment had higher survival rates than those with high levels of these indicators.Receiver operating characteristic(ROC)curve analysis revealed that the combined prediction of PCT,α1-AGP,and CD64 index for mortality was superior to individual indicators or their pairwise combinations,and external validation confirmed the good predictive efficacy of the combined prediction.Conclusion PCT,α1-AGP,and CD64 index are closely related to pulmonary Candida infection after lung cancer surgery,and the combined detection of these indicators has certain predictive value for 28-day prognosis.

Objective To investigate the relationship between serum interleukin-1β(IL-1β),C-reactive pro-tein to albumin ratio(CAR)and heparin-binding protein(HBP)levels and secondary pulmonary Candida albi-cans infection during chemotherapy in patients with lung cancer.Methods A total of 175 patients with lung cancer admitted to this hospital from January 2018 to April 2022 were selected,and all patients were treated with chemotherapy.According to whether they had secondary pulmonary Candida albicans infection,they were divided into infection group(37 cases)and non-infection group(138 cases).The clinical data,serum levels of IL-1β,HBP and CAR were compared between the two groups.Multivariate Logistic regression analysis was used to analyze the influencing factors of secondary pulmonary Candida albicans infection in patients with lung cancer during chemotherapy.The receiver operating characteristic(ROC)curve was used to analyze the pre-dictive value of serum IL-1β,CAR and HBP for secondary pulmonary Candida albicans infection during chemo-therapy,and the prognosis of lung cancer patients with different serum IL-1β,HBP levels and CAR were com-pared.Results There were significant differences in smoking,pathological stage,diabetes mellitus,chemo-therapy cycle,chronic obstructive pulmonary disease and anatomical location between the infection group and the non-infection group(P＜0.05).The serum levels of IL-1β,HBP and CAR in the infection group were higher than those in the non-infection group(P＜0.05).Multivariate Logistic regression analysis showed that smoking,diabetes,anatomical site,chronic obstructive pulmonary disease,pathological stage,chemotherapy cycle and serum IL-1β,HBP,CAR were the influencing factors of secondary pulmonary Candida albicans infec-tion in patients with lung cancer during chemotherapy(P＜0.05).The area under the curve(AUC)of serumIL-1β,CAR and HBP in predicting pulmonary Candida albicans infection was 0.779,0.732 and 0.796,respec-tively.The AUC of the combination of the three was 0.931,and the sensitivity and specificity were 86.49％and 90.58％,respectively.The survival rate of lung cancer patients with high levels of IL-1β,CAR and HBP was sig-nificantly lower than that of patients with low levels of Il-1β,CAR and HBP(P＜0.05).Conclusion The in-crease of serum IL-1β,CAR and HBP levels in patients with lung cancer is related to secondary pulmonary Candida albicans infection during chemotherapy.Detection of these serum Il-1β,CAR and HBP levels is helpful to predict the risk of pulmonary Candida albicans infection and death.

In this paper, thyroid peroxidase (TPO) gene mutation was studied in a congenital hypothyroidism (CH) family with 2 patients, to explore the mechanism of c. 2268dupT homozygous mutation leading to thyroid nodules, as well as the relationship between TPO gene mutation and thyroid cancer. The result suggested that TPO gene mutation is one of the reasons for congenital hypothyroidism, TPO gene c. 2268 dupT mutations can lead to thyroid nodules, which may be related to long-term high TSH stimulation and truncated protein accumulation. TPO gene mutations have a certain correlation with thyroid cancer, the risk may increase with the increase of age, but the mechanism is not clear at present. In the future, further research on the correlation and mechanism between the two factors is needed, as well as to determine whether it is necessary to remove the thyroid gland to prevent the accarance of cancer in CH patients with TPO gene mutation with thyroid nodules.

Objective: To explore whether Integrated Early Childhood Development (IECD) program has effectively improved the nurturing care for children aged 0-35 months in rural China. Methods: IECD has been implemented by the government of China with support from the United Nations Children's Fund (UNICEF) in four poverty-stricken rural counties since 2014. The interventions targeting the five key components of nurturing care (i.e. child and caregiver health, child nutrition, early learning support, child protection and social security) were delivered through the IECD program to children aged 0 to 35 months and their caregivers. A population-based intervention trial was designed to evaluate intervention effectiveness with data collected in 2013 (baseline) and 2016 (mid-term). The changes of nurturing care in the intervention and control group were analyzed by using a difference-in-differences (DID) model. This approach provided adjustment for sociodemographic and other confounding factors. Results: The baseline and mid-term survey enrolled 1 468 and 1 384 children in the intervention group, and 1 485 and 1 361 in the control group. After two years of implementation, the prevalence of caregiver's depression in the intervention group showed a decrease of 9.1% (mid-term 34.8% (479/1 377) vs. baseline 43.9% (621/1 414)), whereas that in control group showed a decrease of 1.6% (mid-term 34.3% (464/1 353) vs. baseline 35.9% (509/1 419)). With the confounding adjusted in the difference-in-differences model, the decrease of the caregiver's depression prevalence in the intervention group was 7.0% greater than that in the control group (P=0.008). The qualified rate of minimum meal frequency in the intervention group showed an increase of 10.4% (mid-term 69.0% (532/771) vs. baseline 58.6% (481/821)), whereas the qualified rate in the intervention group showed an increase of 2.9% (mid-term 66.4% (469/706) vs. baseline 63.5% (508/800)). With the confounding adjusted in the difference-in-differences model, the increase of the qualified rate in the intervention group was 8.2% greater than that in the control group (P=0.021). The proportion of violent discipline by caregivers in the intervention group showed a decrease of 6.2% (mid-term 49.1% (478/973) vs. baseline 55.3% (554/1 001)), whereas the proportion in control group showed an increase of 4.5% (mid-term 58.4% (560/959) vs. baseline 53.9% (558/1 036)), and with the confounding adjusted in the difference-in-differences model, the difference in increase rate between two groups was 11.0% (P=0.001). The proportion of families with three or more children's books in the intervention group showed an increase of 12.7% (mid-term 42.7% (588/1 378) vs. baseline 30.0% (432/1 440)), whereas the proportion of the control group showed an increase of 4.2% (mid-term 25.7% (349/1 357) vs. baseline 21.5% (298/1 388)), and with the confounding adjusted in the difference-in-differences model, the difference in increase rate between two groups was 6.1% (P=0.007). Conclusions The IECD intervention strategy implemented in rural China effectively improved the mental health of caregivers, optimizes families' child feeding and early stimulation behaviors, while reducing violent discipline and other risk factors. IECD provides better nurturing care for the early development of children aged 0-35 months in rural China.

Objective To evaluate it' s prognosis according to the follow-up statistics of coronary reimplantation of anomalous left coronary artery originating from the pulmonary artery (ALCAPA).Methods Analyze the preoperative,peri-operative and postoperative data of 20 ALCAPA patients having undergone coronary artery reimplantation.Results After coronary reimplantation,patient' s cardiothoracic ratio was obviously decreased,the degree of myocardial ischemia was improved according to electrocardiogram,the left ventricular ejection fraction and fractional shortening showed a trend of rise,mostof the patients recover in 6 months to 1 year after coronary artery reimplantation.Left ventricular end-diastolic volume index over time gradually returned to normal,mitral regurgitation gradually.improved.Conclusion ALCAPA is rare and fatal,therefore it should be diagnosed and treated as early as possible.It is also significant to avoid missed diagnosis and misdiagnosis.After coronary reimplantation,cardiac function can be gradually restored with low mortality and good prognosis result.The left ventricularejection fraction of most patients recovers to the normal standard in six months to one year' s time.

Objective To investigate the role of mylin basic protein,S100B and arterial blood gas analysis's levels in early diagnosis of brain injury in premature infant.Methods A total of 95 premature infants treated in our hospital were enrolled in the study.Experimental group was 45 premature infants with brain injury.Control group was 50 premature infants without brain injury were the.All patients were detected with arterial blood gas analysis,MBP and S100B on the 1st day and 7th day after birth.Results The pH,PCO2,BE,lactic acid,MBP and S100B's levels in experimental group were significantly different between the 1st day and 7th day after birth.In the 1st day after birth,compared with the control group,the pH,PCO2,BE,lactic acid,MBP and S100B in the experimental group were obviously high than that of control group.Conclusion On the 1st day after birth,monitoring arterial blood gas analysis,S100B protein and MBP's levels could be useful in early diagnosis of brain injury in preterm infants.

Objective To observe the clinical efficacy of moxa stick moxibustion in treating diabetic gastroparesis (DGP) due to deficient cold of spleen-stomach, and to discuss the action mechanism.Method Seventy DGP patients were randomized into a treatment group and a control group, 35 cases each. The treatment group was intervened by moxa stick moxibustion, while the control group was given oral administration of Domperidone tablets, 7 d as a treatment course, totally for 2 courses. The DGP clinical symptoms evaluation scale, gastric emptying time and biochemical indexes (contents of glycosylated hemoglobin and serum motilin) were compared before and after the treatment, and the clinical efficacies were compared between the two groups.Result After the treatment, the DGP clinical symptoms evaluation scales, gastric emptying time, and biochemical indexes were changed significantly in both groups (P<0.05). The DGP clinical symptoms evaluation scales, gastric emptying time, and biochemical indexes in the treatment group were significantly different from those in the control group after the treatment (P<0.05).Conclusion Moxa stick moxibustion can improve the quality of life of DGP patients due to deficient cold of spleen-stomach, which is possibly related to the improvement of the glycosylated hemoglobin, serum motilin and gastric emptying time.

Objective To investigate the clinical value of the ratio of ADA and CysC in the Pleural effusion and serum for the di-agnosis of Tuberculous pleural effusion .Methods In the first half of 2014 ,50 cases from a random sample of patients with tubercu-lous pleurisy admitted in our hospital were chosen as tuberculosis group ,20 cases of patiente with lung cancer pleural effusion as malignant group and 30 cases of patiente with hepatic hydrothorax as control group .The concentrations of CysC and ADA in the pleural effusion and serum were detected ,and the ratios of these two indexes in the pleural effusion and serum were calculated .Re-sults (1)The results in three groups including PADA and SADA ,SCysC and PCysC ,PCysC/SCysC and PADA/SADA were com-pared ,and the differences were statistically significant (P<0 .05) .(2) According to the ROC curve ,the critical value of PADA/SA-DA and PCysC/SCysC were set as 1 .58 and 2 .30 ,respectively ,and area under the curve of PADA/SADA and PCysC/SCysC were 0 .880 and 0 .786 respectively .Conclusion The diagnostic value of PADA/SADA and PCysC/SCys for tuberculous pleural effusion is higher than that of PADA ,SADA ,PCysC or SCysC alone ,which can be used for the differential diagnosis of tuberculous pleural effusion index for clinical application .

Objective To establish a novel experimental model of New Zealand rabbit to assess the biocompatibility of 0.1 mm polytetrafluoroethylene (PTFE),a novel material of pulmonary valve.Methods Forty-two adult New Zealand rabbits about 3 kg were selected to give 35 mg/kg ketamine and 0.25 mg/kg dexmedetomidine intramuscularly for the anesthesia.The chest was open to expose the upper segment.The surface of right ventricular outflow tract (RVOT) was exposed after the pericardium was opened partially.The valve material (0.1 mm PTFE) was inserted into the right ventricle via the central mini-incision.Then the skin was closed and the rabbits were recoved with the oxygen inhalation.Results Forty-two adult New Zealand rabbits accepted the operation.Six rabbits died during the early period due to the inappropriate anesthesia drug (n =2),pneumothorax (n =1) and thrombosis (n =3),which occurred the 5th,7th and 8th postoperative day.The anticoagulation treatment was adjusted to solve the thrombosis problem.Thirty-six rabbits survived for several months with weight increase until the experiment was finished.Conclusions The experimental model of New Zealand rabbit is appropriate for the biocompatible assessment of 0.1 mm PTFE.The advantage is to avoid intubation and cardiopulmonary bypass (CPB) and to decrease the pneumothorax.

Objective To report the experience of the arterial switch operation(ASO) for Taussig-Bing anomaly and late outcomes.Methods From January 2001 to December 2015,57 patients were underwent arterial switch operation for Taussig-Bing anomaly in Fudan university affiliated children's hospital cardiac center,Median age and weight at operation was 63(37.5-88.5)days, 4.1(3.4-5.0)kg, respectively.29 patients with Arch anomalies(50.9%), 23 patients with unusual coronaries(40.3%),according to have arch anomaly or not and surgery time, dividing the patients into two groups, group A(have, n=29)and group B(not have, n=28), earlier experience into group 1(2001-2008, n=27), later experience into group 2(2009-2015, n=30), respectively.Results The Mortality was12.3%, the mortality of group A and group B was 13.8%, 10.7%(P>0.05),group 1 and group 2 was 22.2%, 3.3%(P<0.05) respectively, follow up was complete in 47 patients with a mean follow-up of(6.2±3.5) years , three patients lost, there was no late mortality, the actual survival at 1, 5year was 87%, 87%, respectively.Reintervention was required in 10 patients(21.3%), the aorta-PA valve diameter ratio was a risk factor for reintervention(group A P=0.02, group B P=0.04) ,and 1,2,5year free of reintervention was 95.6%, 86.6%, 77.2%, respectively.Conclusion The ASO approach can be applied to Taussig-Bing anomaly with acceptable mortality , and it is the procedure of choice at our institution.One stage to repair TBA with aortic arch abnormalities did not influence outcomes.The aorta-PA valve diameter ratio<0.5 was a risk factor for reintervention.