Objective To investigate the impact of intrauterine infection combined with perinatal antibi-otic treatment on early neonatal gut microbiota.Methods Forty-six full term neonates delivered and hospital-ized in the Pediatrics Department of Women and Children's Hospital of Chongqing Medical University from January to June 2022 were selected as the study subjects.They were divided into the observation group (hav-ing,n=22) and the control group (not having,n=24) according to whether or not the mothers having chorio-amnionitis.The fecal samples were collected from the subjects on 0-2 d and 5-7 d after birth.The high-throughput sequencing technology was applied to conduct the bacterial 16S rRNA gene sequencing analysis in the fecal samples.The diversity,classification and relative abundance of gut floras were compared.Results Compared with the control group,the antibiotics use rate in prenatal and neonatal period in the observation group was higher,the antibiotic use duration in the neonatal period was longer,and the differences were statistically sig-nificant (P<0.05).The Shannon index on 5-7 d after birth in the two groups was increased compared with that on 0-2 d,moreover the observation group was lower than the control group,and the differences were statistically significant (P<0.05).The two groups of gut floras were mainly composed of Proteobacteria,Fir-micutes,Bacteroidetes,and Actinobacteria. Compared with the control group,the relative abundance of Pro-teobacteria on 5-7 d after birth in the observation group was higher,and the relative abundance of Actinobac-teria was lower,the differences were statistical significant (P<0.05). The two groups of gut floras were mainly composed of Bifidobacterium,Enterococcus,Streptococcus,Klebsiella,Bacteroidetes,and Escherichia/Shigella genera.Compared with the control group,the relative abundance of Bifidobacterium,Streptococcus and Bacteroides on 5-7 d after birth in the observation group was lower,the relative abundance of Klebsiella,and Escherichia/Shigella was higher,the differences were statistically significant (P<0.05).Conclusion In-trauterine infection and perinatal antibiotic treatment decrease the diversity of early neonatal gut flora,and the development of specific floras is delayed.

Objective:To compare the efficacy of unilateral percutaneous kyphoplasty (PKP) and unilateral PKP combined with posterior medial branch block of the contralateral spinal nerve in the treatment of lumbar osteoporotic vertebral compression fracture (OVCF) in the elderly.Methods:A retrospective cohort study was conducted to analyze the clinical data of 161 aged patients with newly developed lumbar OVCF, admitted to Xi′an Central Hospital Affiliated to Xi′an Jiaotong University School of Medicine from January 2019 to January 2023, including 58 males and 103 females, aged 61-88 [(72.9±6.3)years]. All the patients were diagnosed with type II compression fracture based on acute symptomatic osteoporotic thoracolumbar fracture classification (ASOTLF). Seventy-eight patients underwent unilateral PKP (PKP group), while the other 83 patients underwent unilateral PKP combined with posterior medial branch block of the contralateral spinal nerve (PKP+contralateral block group). The operation time, intraoperative blood loss, and length of hospital stay were recorded. Beck index of the injured vertebra, Cobb angle of lumbar lordosis, Roland-Morris disability (RMD) score, visual analogue scale (VAS), and Oswestry disability index (ODI) were evaluated before operation, at 1 day, 1 week, 1 month, 3 months after operation, and at the last follow-up. The incidence of complications such as cement leakage was recorded as well.Results:All the patients were followed up for 6-8 months [(6.7±0.6)months]. There were no significant differences between the two groups in the operation time, intraoperative blood loss, or length of hospital stay ( P>0.05). The Beck index of the injured vertebra and Cobb angle of lumbar lordosis were not significantly different between the two groups before operation, at 1 day, 1 week, 1 month, 3 months after operation, and at the last follow-up ( P>0.05). The RMD score of the injured vertebra, VAS score, and ODI were not significantly different between the two groups before operation ( P>0.05). At 1 day, 1 week, 1 month, 3 months after operation, and at the last follow-up, the RMD scores in the PKP+contralateral block group were (11.23±1.05)points, (10.90±1.11)points, (10.10±1.06)points, (9.94±1.06)points, and (9.60±0.83)points respectively, which were all lower than (17.55±0.71)points, (15.78±0.86)points, (13.42±0.92)points, (10.67±0.78)points, and (9.78±0.72)points in the PKP group ( P<0.05 or 0.01); the VAS scores in the PKP+contralateral block group were (3.02±0.60)points, (2.96±0.55)points, (2.92±0.57)points, (2.88±0.61)points, and (2.70±0.51)points respectively, which were all lower than (3.60±0.57)points, (3.47±0.55)points, (3.32±0.46)points, (2.99±0.47)points, and (2.77±0.42)points in the PKP group ( P<0.05 or 0.01); the ODI values in the PKP+contralateral block group were 14.43±1.29, 14.54±1.24, 14.63±1.32, 14.37±1.31, and 13.42±1.45 respectively, which were all lower than 16.72±1.64, 16.09±1.49, 14.82±1.53, 14.74±1.46, and 13.69±1.75 in the PKP group ( P<0.05 or 0.01). The bone cement leakage rate was 12.0% (10/83) in the PKP+contralateral block group, similar to 11.5% (9/78) in the PKP group ( P>0.05). No other complications such as neurovascular injury, pulmonary embolism or adjacent vertebral fracture were found in either groups. Conclusion:In the treatment of lumbar OVCF in the elderly, unilateral PKP combined with posterior medial branch block of the contralateral spinal nerve is similar to unilateral PKP in terms of the operation time, intraoperative blood loss, length of hospital stay, effectiveness of reduction, and incidence of complications, but it can achieve better pain relief and more satisfactory functional recovery.

Objective:To investigate the correlation of the expression of Ephrin A receptor 2(EphA2)and its promoter region DNA hypomethylation with the occurrence of pyroptosis in invasive breast cancer. Methods:The expression level of pyroptosis-related protein EphA2 in normal breast tissue,paracancerous tissues and cancer tissues from 42 breast cancer patients was examined by Immunofluorescence staining and Western blotting.The expression level of pyroptosis related protein nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3)was analyzed by immunofluorescence staining and Western blotting.The expression levels of apoptosis related proteins Caspase 1 and inflammatory cytokine interleukin-1β(IL-1 β)were studied by Western blotting.The DNA methylation level in the promoter region of EphA2 was investigated by nested methylation-specific PCR(nMS-PCR).The expression levels of DNA methyltransferase 1(DNMT1)and DNA methyltransferase 3a(DNMT3a)were examined by Western blotting.The correlation of the protein expression and methylation level of EphA2 in cancer tissues with the expression NLRP3,Caspase 1,IL-1 β,DNMT1 and DNMT3a was analyzed by Pearson correlation coefficient. Results:Compared with normal breast tissues and paracancerous tissues,the expression level of EphA2 protein was significantly increased(P＜0.01),while that of NLRP3,Caspasel and IL-1 βwas significantly decreased(P＜0.05)in breast cancer tissues.Meanwhile,compared with normal breast tissues and paracancerous tissues,the DNA methylation level of EphA2 promoter in breast cancer tissues was significantly decreased(P＜0.05),the expression level DNMT3a protein was significantly decreased(P＜0.01,P＜0.05),and the difference in the expression level of DNMT1 protein was not statistically significant.Pearson correlation analysis showed that the expression level of EphA2 protein is negatively correlated with that of NLRP3(r=-0.651 2,P＜0.05),Caspasel(r=-0.571 2,P＜0.05),IL-1β(r=-0.654 6,P＜0.05)or DNMT3a(r=-0.537 4,P＜0.05),while the methylation level of EphA2 was positively correlated with the protein expression level of NLRP3(r=0.634 1,P=0.026 8),Caspase1(r=0.672 8,P=0.01 6 5),IL-1 β(r=0.694 0,P=0.01 2 3)and DNMT3a(r=0.687 1,P=0.01 3 6). Conclusion:The expression of EphA2 protein is upregulated in breast cancer tissues is negatively correlated with pyroptosis.DNMT3a may be involved in the process of DNA hypomethylation in the promoter region of EphA2.

Objective:Based on the research results of the national continuing medical education project "musculoskeletal ultrasound and new technology quality class" held by the Department of Ultrasound Diagnosis of Peking University Third Hospital, to explore and analyze the effect of basic and applied teaching method based on musculoskeletal ultrasound.Methods:Totally 109 participants attending the classes held on April 14-18, 2019 and on September 9-13, 2019 were selected as study objects, and the training effects of quality private classes were evaluated by questionnaires, operational tests and theoretical tests. SPSS 21.0 was used for t test. Results:The results showed that more than 80% of students were satisfied with the teaching content, teaching plan and teaching materials. Through the class training, the greatest gains of the students were that the operation ability [67 cases (30.7%)] and the theoretical level [53 cases (24.3%)] had been significantly improved. All 109 students passed the operation test. There were no statistical differences in the average scores of theoretical tests among the students with different professional titles, academic qualifications and whether they were from primary hospitals (75-80 points, P>0.05) . Conclusion:The musculoskeletal ultrasound quality private class can improve the students' operating ability and theoretical level in the musculoskeletal system. The class model can guarantee the teaching quality and provide a new direction for continuing medical education.

Objective:With the development of digital technology, network technology and mobile technology, new media aided-teaching has become a hot topic in medical teaching. However, the studies about the application of new media aided-teaching in training for professional postgraduates of neurosurgery are still less studied.Methods:In this study, 24 Batch 2015-2016 professional postgraduates of neurosurgery from Neurosurgery Department of Affiliated Hospital of Southwest Medical University were divided into the test group and control group, with 12 students in each group. From September 2016 to August 2018, students in the test group were taught with conventional teaching and various new media such as WeChat official accounts, professional video sharing websites and so on. The control group adopted conventional teaching methods. Students' theoretical knowledge, operation ability and clinical research ability were assessed between the two groups. SPSS 22.0 software was used for t test and descriptive statistics on the data.Results:The results of t test analysis showed that the scores of theoretical knowledge and general ability in test group were higher than those in control group, with significant differences ( P < 0.05). Meanwhile, the scores of teaching satisfaction, professional interest, teaching participation, knowledge mastery and scientific research ability in the test group were higher than those in the control group, with significant differences ( P<0.05). Conclusion:Conventional teaching combined with new media aided-teaching is a good new training model for professional postgraduates of neurosurgery, which has improved students' participation and motivation of study and contributed to the training of medical students' comprehensive abilities.

Objective:To evaluate a new imaging sign, named" bilateral water sign" (BWS), which can evaluate the neurovascular compression of primary trigeminal neuralgia (TN).Methods:A prospective study was conducted on 85 primary TN patients admitted to our hospital from March 2017 to March 2019. All patients accepted magnetic resonance 3D-T2W-DRIVEN sequence examination and multiplanar reconstruction (MPR) for post-processing. The sequential nerve (low signal)-cerebrospinal fluid (high signal)-vessel (low signal)-cerebrospinal fluid (high signal)-nerve (low signal) signs on the recombination plane were named as "BWS". The sensitivity, specificity, positive predictive value and negative predictive value of BWS in evaluating the neurovascular compression were calculated respectively, by combining with intraoperative situation of microvascular decompression (MVD).Results:In 85 TN patients, 46 patients (54.12%) had BWS. The sensitivity was 57.14%, the specificity was 75.00%, the positive predictive value was 95.65% and the negative predictive value was 15.38%. There was a statistically significant difference in the degree of neurovascular compression between patients with and without BWS ( P<0.05); and degree of neurovascular compression was severer in patients with BWS. Conclusion:BWS can evaluate the relation of neurovascular compression in TN patients and suggest the degree of neurovascular compression.

Objective: To explore the relationship among cognitive flexibility, depression and eating attitude of adolescents and the influencing factors of eating attitude. Methods: A total of 1 231 subjects were assessed using general information questionnaire, Kutcher Adolescent Depression Scale 11 item(KADS-11), Cognitive Flexibility Inventory(CFI), Eating Attitude Test 26(EAT-26). Data were analyzed by independent sample t-test, univariate linear regression, spearman correlation analysis and Logistic regression. Results: There were significant differences in EAT 26 among adolescents between genders and between those with or without depression(P<0.01). Statistically significant differences were observed in CFI, flexible control and KADS 11 among adolescents with or without eating disorders(P<0.01). The scores of EAT 26 was negatively correlated with CFI (r=-0.19, P<0.01) and flexible control(r=-0.23, P<0.01). And there was a significant positive correlation between EAT 26 and KADS 11(r=0.23, P<0.01). Female(OR=2.40, 95%CI=1.87-3.23), depression (OR=1.76, 95%CI=1.35-2.29) and poor flexible control (OR=1.94, 95%CI=1.48-2.54) were risk factors for eating disorders. Conclusion Female, individuals with depressive symptoms or with poor flexible control ability are more likely to have eating disorders which need more attention.

Objective To explore the clinical and genetic features of McLeod syndrome caused by XK gene mutation.Methods The clinical data of a patient who came from the Affiliated Brain Hospital of Nanjing Medical University in May 2017 and diagnosed as McLeod syndrome by gene detection were analyzed.Gene analysis was also carried out in his family to confirm the result.Results Acanthocytes in peripheral blood,systemic chorea symptom,and increased serum levels of creatine kinase were observed in this patient and his brother.The proband and his brother showed half mutations.One of the proband's sister was homozygous normal.The proband's mother,one of the proband's sister and the proband's daughter showed heterozygous mutations.The family analysis accorded with X-linked recessive inheritance trait.Genetic testing for mutations in the XK gene revealed a previously unreported hemizygous single base-pair frame shift deletion at exon 3 (c.1004G＞A).Conclusions A rare phenotype of a patient with McLeod syndrome is first described in mainland of China which was discovered coincidentally during routine blood group testing and consecutively genetically con fi rmed.One novel mutation in XK gene was found in the patient.For old male patient with multiple system disorders including dyskinetic movement disorders,cardiopathy,acanthocytes and elevated serum creatine kinase,a genetic test for XK gene mutation is highly suggested to confirm the McLeod syndrome.

Objective To investigate the influence of enteral nutrition on body weight,nutritional status,treatment toxicities,and short-term outcomes in esophageal carcinoma patients treated with concurrent chemoradiotherapy(CCRT). Methods Eligible esophageal carcinoma patients were randomly assigned(2:1) to receive either CCRT combined with enteral nutrition (study group) or CCRT alone (control group). The primary endpoint was changes in the body weight during and after radiotherapy. The secondary endpoints were nutrition-related hematological parameters,the toxicities of chemoradiotherapy,the completion rate of treatment,and short-term outcomes. The differences was using χ2 or t-test. Results Between September 2014 and June 2017,203 patients were included in the study,consisting of 139 patients in the study group and 64 patients in the control group. Compared with the control group,the study group had significantly less body weight loss during and after radiotherapy (P<0.05) and significantly less decreases in serum albumin and hemoglobin (P<0.05),but there was no significant difference in the reduction in total lymphocyte count between the two groups (P>0.05).The study group had significantly lower incidence rates of grade ≥3 myelosuppression and infection and a significantly higher completion rate of chemoradiotherapy compared with the control group (P<0.05).The incidence of radiation pneumonitis and esophagitis showed no significant difference between the two groups (P>0.05).The study group had an insignificantly higher objective response rate than the control group (P>0.05). Conclusions For esophageal carcinoma patients treated with CCRT,enteral nutrition can reduce body weight loss during and after radiotherapy,improve nutritional status and treatment tolerance,and reduce toxicities.

Objective:To study the effects of antimicrobial therapy on the maturation and function of dendritic cells(DCs) in the infected microenvironment of rabbit buccal VX-2 squamous cell carcinoma.Methods:The inflammatory models were obtained by mechanical trauma and high sugar diet on the basis of rabbit buccal VX-2 squamous cell carcinoma models which were established by particle implantation of the tumor tissue.The model rabbits were divided into 3 groups (n =6).In group A the rabbits with buccal VX-2 squamous cell carcinoma and local inflammation were given antibiotics by gavage and intramuscular injection for 3 consecutive days;the rabbits in group B with buccal VX-2 squamous cell carcinoma and local inflammation were given normal saline by gavage and intramuscular injection;the rabbits in group C with tumor and without inflammation were given normal saline by gavage and intramuscular injection.The tumor specimens were collected 3 days after treatment,and made into tissue homogenate,supernatant was collected after centrifugation.Normal rabbit peripheral blood mononuclear cells were separated and co-cultured with the supernatant obtained from the 3 groups respectively.Expressions of DCs surface markers HLA-DR,CD83 and CD86 were detected by flow cytometry.the function of DCs was tested by mixed lymphocyte reaction.Results:The positive rate of HLA-DR,CD83,CD86 and stimulate index were group C ＞ group A ＞ group B (P ＜ 0.05).Conclusion:Antimicrobial therapy can promote the maturation and function of DCs in the infected microenvironment of rabbit buccal VX-2 squamous cell carcinoma.