Objective:To explore the differences in the standardized z-score amplitude of low-frequency fluctuations (zALFFs) across different brain regions between children with global developmental delay (GDD) and healthy children (HC) using functional near-infrared spectroscopy (fNIRS), and correlating zALFF values with the subjects′ Gesell Developmental Scale (GDS) scores.Methods:Thirty-one children aged 2-4 years with GDD and 29 HC of the same age were studied. fNIRS was used to record both groups′ brain activity in response to natural stimuli and to measure any changes in oxygenated hemoglobin (HbO) levels in cerebral blood flow. zALFF values were calculated and the values of 44 channels were compared between the two groups. The correlations between zALFF values and GDS scores were computed.Results:The zALFF values of the children with GDD were significantly lower than those of the HC in the right frontal pole (channel 10) and the right pre-motor and supplementary motor areas (channel 43). In contrast, the zALFF values in the left pre-motor and supplementary motor areas (channels 24 and 26) were significantly higher in the children with GDD compared to the HC. Spearman ranked correlation analysis revealed that the zALFF values in the right pre-motor and supplementary motor areas (channel 43) were positively correlated with socialization scores on the GDS ( r=0.37, P≤0.05). Conclusions:The delays in cognitive and motor development in children with GDD may be associated with functional abnormalities in the right frontal polar region and the bilateral premotor and supplementary motor areas. zALFF values from the right premotor and supplementary motor areas are positively correlated with social skills.

Objective:To explore the differences in the standardized z-score amplitude of low-frequency fluctuations (zALFFs) across different brain regions between children with global developmental delay (GDD) and healthy children (HC) using functional near-infrared spectroscopy (fNIRS), and correlating zALFF values with the subjects′ Gesell Developmental Scale (GDS) scores.Methods:Thirty-one children aged 2-4 years with GDD and 29 HC of the same age were studied. fNIRS was used to record both groups′ brain activity in response to natural stimuli and to measure any changes in oxygenated hemoglobin (HbO) levels in cerebral blood flow. zALFF values were calculated and the values of 44 channels were compared between the two groups. The correlations between zALFF values and GDS scores were computed.Results:The zALFF values of the children with GDD were significantly lower than those of the HC in the right frontal pole (channel 10) and the right pre-motor and supplementary motor areas (channel 43). In contrast, the zALFF values in the left pre-motor and supplementary motor areas (channels 24 and 26) were significantly higher in the children with GDD compared to the HC. Spearman ranked correlation analysis revealed that the zALFF values in the right pre-motor and supplementary motor areas (channel 43) were positively correlated with socialization scores on the GDS ( r=0.37, P≤0.05). Conclusions:The delays in cognitive and motor development in children with GDD may be associated with functional abnormalities in the right frontal polar region and the bilateral premotor and supplementary motor areas. zALFF values from the right premotor and supplementary motor areas are positively correlated with social skills.

Objective:To evaluate the role of caveolin 3 (Cav-3) in diabetic cardiomyopathy and the relationship with endoplasmic reticulum stress in mice.Methods:This experiment was performed in two parts. Part Ⅰ in vivo experiment Sixteen clean-grade healthy adult male wild type mice weighing 18-20 g, were divided into 2 groups ( n=8 each) using a random number table method: control group(Control group) and diabetic cardiomyopathy group (DCM group). Another 8 Cav-3 KO mice were selected and served as Cav-3 KO + diabetic cardiomyopathy group (Cav-3 KO+ DCM group). Type 2 diabetic models were developed by high fat diet combined with intraperitoneal injection of streptozotocin (100 mg/kg). The left ventricular ejection fraction (EF), left ventricular short axis shortening rate (FS), left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic diameter (LVEDD) were measured by B ultrasound at 8 weeks. Then the mice were sacrificed, and the myocardial histomorphology was observed using HE staining. Part Ⅱ in vitro experiment HL-1 cardiomyocytes were divided into 3 groups ( n=6 each)using a random number table method: normal glucose group (NG group), high glucose group (HG group) and high glucose+ methyl-β-cyclodextrin group (HG+ β-CD group). The high glucose model was prepared by adding 50% glucose to a specialized culture medium until the final concentration reached 30 mmol/L, and HL-1 cardiomyocytes were continuously cultivated for 36 h. The cellular injury was assessed using LDH and CCK8 kits. The expression of endoplasmic reticulum stress-related proteins binding immunoglobulin protein (BiP), C/EBP-homologous protein (CHOP) and X-box binding protein 1 (XBP1-s) in myocardial tissues and HL-1 cells was detected by Western blot. Results:In vivo experiment Compared with Control group, the food intake, water intake, and heart mass/body mass were significantly increased, EF and FS were decreased, LVESD and LVEDD were increased, the expression of BiP, CHOP and XBP1-s was up-regulated, the expression of Cav-3 was down-regulated ( P<0.05), and the pathological damage was aggravated in DCM group and Cav-3 KO+ DCM group. Compared with DCM group, EF and FS were significantly decreased, LVESD and LVEDD were increased, the expression of BiP, CHOP and XBP1-s was up-regulated, the expression of Cav-3 was down-regulated ( P<0.05), and the pathological damage was aggravated in Cav-3 KO+ DCM group. In vitro experiment Compared with NG group, the cell viability was significantly decreased, LDH activity was increased, the expression of BiP, CHOP and XBP1-s was up-regulated, and the expression of Cav-3 was down-regulated in HG group and HG+ β-CD group ( P<0.05). Compared with HG group, the cell viability was significantly decreased, LDH was increased, the expression of BiP, CHOP and XBP1-s was up-regulated, and the expression of Cav-3 was down-regulated in HG+ β-CD group ( P<0.05). Conclusions:Down-regulation of Cav-3 expression aggravates myocardial injury in diabetes mellitus, and the mechanism is related to excessive activation of endoplasmic reticulum stress in mice.

Objective:To explore the clinical effect of the fractional carbon dioxide laser in the treatment of contracture scars.Methods:A retrospective before-after self-control study was conducted. From December 2016 to April 2021, 16 patients (7 males and 9 females, aged 3-49 years) with contracture scars causing impaired function of the adjacent joint were admitted to Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. Eighteen joint scars of 16 patients were treated with fractional carbon dioxide laser every 2-3 months until the joint retained its normal range of motion or the effect plateaued. The treatment times of each patient were recorded. Before the first treatment and 6 months after the last treatment, the ranges of motion of the affected joint were measured in each patient, and the difference was calculated, meanwhile, the Vancouver Scar Scale (VSS) was used to evaluate the scar of each patient. In the treatment of 1 joint scar in each of 6 patients (totally 6 times of treatments), the ranges of motion of the affected joint before the current treatment, immediately after the treatment, and at the first follow-up after the treatment were documented, and the differences between the ranges before and immediately after the treatment as well as between the ranges before and at the first follow-up after the treatment were calculated. Adverse effects after the treatment in the treatment area were documented. At the last follow-up, a self-made questionnaire was used to collect the implementation status of the physical therapy and other scar management modalities during the treatment interval and follow-up period. Data were statistically analyzed with Wilcoxon rank sum test.Results:Eighteen joint scars in 16 patients received 2 (1, 3) times of fractional carbon dioxide laser treatment. The range of motion of the affected joint of 16 patients 6 months after the last treatment was 56.5 (39.0, 128.8)°, notably higher than 38.4 (22.9, 116.3)° before the first treatment ( Z=-3.724, P<0.01), showing a remarkable improvement by 17.4 (8.0, 24.1)°. The vascular distribution, softness, and thickness scores, and total score in VSS scoring of scars of 16 patients 6 months after the last treatment were significantly lower than those before the first treatment ( Z=-2.989, -3.762, -2.814, -3.739, P<0.01), with the most obvious improvement in softness. In 6 times of treatments, the range of motion of the affected joint immediately after treatment and at the first follow-up of (2.5±0.6) months after treatment were 156.2 (148.0, 164.2)° and 160.2 (156.7, 166.4)°, both notably higher than 151.4 (145.7, 155.3)° before treatment ( Z=-2.201, -2.201, P<0.05), showing a remarkable improvement by 9.1 (4.4, 13.0)° and 13.1 (8.0, 15.7)°, respectively. No adverse effects such as blisters, infection, or hypertrophic scar formation were observed in the treatment area of 16 patients after treatment. Most patients adopted physical therapy, compression, silicone gel or sheets, and braces during the treatment interval and follow-up period. Conclusions:The fractional carbon dioxide laser can soften the scar and increase the range of motion of the affected joint, which is suitable for the clinical treatment of mild contracture scars.

Objective To evaluate the effects of N-acetycysteine on the expression of caveolin-3 (Cav-3) during myocardial ischemia-reperfusion (I/R) in diabetic rats.Methods Twenty-four pathogenfree healthy adult male Sprague-Dawley rats,weighing 230-270 g,were divided into 3 groups (n =8 each) using a random number table:myocardial I/R group (group I/R),diabetes mellitus plus myocardial I/R group (group D) and N-acetycysteine group (group NAC).Diabetes mellitus was induced by injection of streptozotocin 60 mg/kg via the tail vein and confirmed by blood glucose ≥ 16.7 mmol/L 3 days later.At 1 week after successful establishment of the model,N-acetycysteine 1.5 g · kg-1 · d-1 was injected through a gastric tube into stomach for 4 consecutive weeks in group NAC,and the equal volume of normal saline was given for 4 consecutive weeks in I/R and D groups.Myocardial I/R was then induced by 30 min ligation of the left anterior descending branch of the coronary artery followed by 2 h of reperfusion.At the end of reperfusion,the myocardial infarct size was determined by triphenyl tetrazolium chloride staining,the levels of serum creatine kinase-MB (CK-MB) and 15-F2t-Isoprostane were measured by enzyme-linked immunosorbent assay,and the expression of myocardial Cav-3,Akt,phosphor-Akt (p-Akt),endothelial nitric oxide synthase (eNOS) and phosphor-eNOS (p-eNOS) was detected by Western blot.Results Compared with group I/R,the myocardial infarct size and levels of serum CK-MB and 15-F2t-Isoprostane were significantly increased,and the myocardial Cav-3,p-Akt and p-eNOS expression and NO level were decreased in group D (P＜0.05).Compared with group D,the myocardial infarct size and levels of serum CK-MB and 15-F2t-Isoprostane were significantly decreased,and the myocardial Car-3,p-Akt and p-eNOS expression and NO level were increased in group NAC (P＜0.05).Conclusion N-acetycystein can activate Akt/eNOS/NO signaling pathway through up-regulating myocardial Cav-3 expression,thus reducing myocardial I/R injury in diabetic rats.

Objective To explore the role of miR-202 in multiple myeloma (MM) cells,and study the regulation of miR-202 on drug sensitivity of MM cells.Methods miR-202 and BAFF mRNA levels were detected by real-time PCR.U266 cells were transfected with miR-202-mimics,miR-202-inhibitor,siBAFF and their negative controls.After above treatments,protein levels of Bcl-2 family and MAPK signaling pathway were detected by Western blot analysis,and the proliferation and apoptosis ability of MM cells were examined by WST-1,Annexin Ⅴ-FLUOS assay,respectively.Results The results showed that the expression ofmiR-202 in CD138+ MM cells (0.304±0.354) and U266 cells (0.052± 0.009) were lower than in normal controls (3.550± 1.126) (P＜0.001,P=0.009),whereas BAFF mRNA levels (5.700±0.734,9.576±2.887) were higher than in normal controls (1.819±0.853) (P＜0.001,P=0.006).The proliferation ability of U266 cells transfected with miR-202 mimics was significantly inhibited than in control group [(56.04±0.021)％ vs (18.89±0.32)％,P=0.002].The result of Western blot showed that the expression of Bcl-2 decreased by about 24％,and the expression of Bax increased by about 124％ in cells transfected with miR-202 mimics.The apoptosis rate in cells transfected with miR-202 mimics was significantly more than in control group [(49.60±4.89)％ vs (26.20±1.28)％,P=0.029].The apoptosis rate in miR-202 mimics combined with Bort group (51.23±5.41)％ was higher as compared with Bort treatment alone (31.70±4.40) ％ or miR-202 mimics control combined with Bort group (27.94±4.04) ％,(P=0.047,P=0.028),whereas the apoptosis rate in miR-202 mimics combined with Thal or Dex had no significant difference compared with miR-202 mimics control [(11.66±1.91)％ vs (10.63±1.74)％,P=0.700;(16.35± 1.32)％ vs (17.43 ± 1.95)％,P=0.400].The inhibitory rate of cell growth in miR-202 mimics combined with Bort group was higher as compared with Bort treatment alone [(36.93±5.98)％ vs (18.18±4.10)％,P=0.029].The expressions of p-JNK protein decreased in U266 cells transfected with miR-202 mimics and treated with Bort.Conclusion miR-202 mimics combined with Bort could inhibit proliferation and induce apoptosis of U266 cells through negative regulating target gene BAFF,which further inhibited the JNK/ SAPK signaling pathway.

OBJECTIVETo explore the surgical strategy for postburn cervical scar contracture.

METHODSSixty-five patients with scar contracture as a result of burn injury in the neck were hospitalized from July 2013 to July 2014. Release of cervical scar contracture was conducted according to different demands of the 3 anatomic subunits of neck, i.e. lower lip vermilion border-supramaxillary region, submaxillary region, and anterior region of neck. After release of contracture, platysma was released. For some cases with chin retrusion, genioplasty with horizontal osteotomy was performed. The coverage of wound followed the principle of similarity, i.e. the skin tissue covering the wound in the neck should be similar to the characters of skin around the wound in terms of color, texture, and thickness. Based on this principle, except for the preschool children in whom skin grafting was performed, the wounds of the other patients were covered by local skin flaps, adjacent skin flaps, or free skin flaps.

RESULTSAll patients underwent release of scar and platysma, while 9 patients underwent genioplasty with horizontal osteotomy. Wounds were covered with local skin flaps in 32 patients, with adjacent skin flaps in 7 patients, with free skin flaps in 11 patients, and with skin grafts in 15 patients. All skin grafts and flaps survived. Good range of motion was achieved in the neck of all patients, with the cervicomental angle after reconstruction ranging from 90 to 120°. All patients were followed up for 6 to 24 months. Six patients who had undergone skin grafting were found to have some degrees of skin contracture, while none of the patients who had undergone flap coverage showed any signs of contracture recurrence.

CONCLUSIONSRestoration of the cervicomental angle is critical in the treatment of postburn cervical scar contracture, and the release of scar contracture should conform to the subunit principle. The coverage of wound should be based on the principle of similarity, with repair by skin flaps as the first choice, and skin grafting as the second choice. Satisfactory effect of repair would be achieved by following the above surgical principles.

Burns ; complications ; surgery ; Child ; Child, Preschool ; Cicatrix ; etiology ; surgery ; Contracture ; etiology ; surgery ; Free Tissue Flaps ; Humans ; Neck ; surgery ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; methods ; Skin ; Skin Transplantation ; Superficial Musculoaponeurotic System ; Surgical Flaps ; Treatment Outcome

Objective To investigate TORCH infections in neonatal hyperbilirubinemia ,and explore the relationship between them.Methods 644casesofneonatalhyperbilirubinemiainourhospitalfromJanuarytoDecemberin2014werechosenasneonatal hyperbilirubinemia group ,160 cases of healthy newborns in the same period were selected as control group .Chemiluminescence im‐munoassay and Enzyme‐linked immune‐sorbent assay (ELISA )were used to detect the TORCH‐IgM antibody .TORCH infections wereobservedbetweenthetwogroups.Results 58casesofpositiveTORCH‐IgMantibodywerefoundin644casesofneonatalhy‐perbilirubinemia group ,detection rate of TORCH‐IgM antibody was 9 .0% ,0 case of positive TORCH‐IgM antibody was found in 160 cases of the control group ,detection rate of TORCH‐IgM antibody was 0 .0% ,the difference was statistically significant be‐tween the two groups(P<0 .05) .The infection rate of B19 was the highest ,the positive rates of B19 ,CMV were 7 .3% ,1 .7% .Con‐clusion There would be a possible relation between TORCH infections and neonatal hyperbilirubinemia ,TORCH infection is one of the causes of neonatal hyperbilirubinemia ,and the screening of TORCH in neonatal hyperbilirubinemia is necessary .

Bartter′s syndrome(BS) is a rare renal tubular diseases and an autosomal recessive hereditary disease. The characteristic findings are hypokalemia, metabolic alkalosis, and raised serum renin and aldosterone levels. Combination of metabolic syndrome with Bartter′s syndrome has not been reported so far. Here in, we report a case in order to call attention to the diagnosis and treatment of typical Bartter′s syndrome combined with metabolic syndrome.

Keloid scars are often considered aesthetically unattractive and frustrating problems that occur following injuries. They cause functional and cosmetic deformities, displeasure, itching, pain, and psychological stress and possibly affect joint movement. The combination of these factors ultimately results in a compromised quality of life and diminished functional performance. Various methods have been implemented to improve keloid scars using both surgical and non-surgical approaches. However, it has proven to be a challenge to identify a universal treatment that can deliver optimal results for all types of scars. Through a PubMed search, we explored most of the literature that is available about the intralesional injection treatment of hypertrophic scars and keloids and highlights both current (corticosteroid, 5-fluorouracil, bleomycin, interferon, cryotherapy and verapamil) and future treatments (interleukin-10 and botulinum toxin type A). The reference lists of retrieved articles were also analysed. Information was gathered about the mechanism of each injection treatment, its benefits and associated adverse reactions, and possible strategies to address adverse reactions to provide reliable guidelines for determining the optimal treatment for particular types of keloid scars. This article will benefit practitioners by outlining evidence-based treatment strategies using intralesional injections for patients with hypertrophic scars and keloids.
Bleomycin ; Botulinum Toxins ; Cicatrix ; Cicatrix, Hypertrophic ; Congenital Abnormalities ; Cryotherapy ; Fluorouracil ; Humans ; Injections, Intralesional* ; Interferons ; Joints ; Keloid* ; Pruritus ; Quality of Life ; Stress, Psychological ; Treatment Outcome