Objective To analyze the relationship between bone mineral density (BMD) of infants over 6 months of age and exclusive breastfeeding and calcium nutrition guidance during pregnancy in Baoding area, and to provide evidence for clinical application. Methods A total of 308 infants over 6 months of age were selected from Baoding Maternal and Child Health Hospital from January 2020 to January 2023, and their BMD was measured by ultrasound. The level of 25 (OH) D3 in subjects' blood was detected. spearman correlation test was used to analyze the correlation between infant bone mineral density and exclusive breastfeeding and calcium nutritional guidance during pregnancy, and logistics regression model was used to analyze the independent factors affecting infant bone mineral density. Results The level of serum 25 (OH) D3 in normal BMD group was significantly higher than that in abnormal BMD group (P<0.05). The rate of exclusive breastfeeding and the guidance rate of calcium nutrition during pregnancy in normal BMD group were significantly higher than those in abnormal BMD group (P<0.05). There was a significant positive correlation between different bone mineral density and exclusive breastfeeding and calcium nutrition guidance during pregnancy (P<0.05). Serum 25 (OH) D3 level, exclusive breastfeeding rate and calcium nutritional guideline rate during pregnancy were independent protective factors for bone mineral density (P<0.05). Conclusion Bone mineral density (BMD) of infants over 6 months of age is positively correlated with exclusive breastfeeding and calcium nutrition guidance during pregnancy, and exclusive breastfeeding and calcium nutrition guidance during pregnancy are independent protective factors affecting BMD of infants over 6 months of age.

Objective:To review and analyze clinical data of patients with invasive pulmonary aspergillosis and mucormycosis, and to explore the surgical indication.Methods:Clinical data of 10 patients with invasive pulmonary aspergillosis and mucormycosis were analyzed retrospectively from March 2018 to November 2022 in our hospital, Department of Thoracic Surgery.Results:The age of children varied from 2.58 years old to 16.00 years old and 6 children were males while 4 females. Five patients suffer from invasive pulmonary aspergillosis. Five patients suffer from invasive pulmonary mucormycosis. The operative indication of 7 patients was the risk of massive bleeding in the airway. The surgical indication for two patients is to control infection and continue treating malignant tumors. One patient chose surgical treatment because the infection could not be cured after long-term antifungal treatment but the focus was limited. Two patients died of sudden acute hemoptysis before operation, the prognosis of 8 patients undergoing surgical treatment was good.Conclusion:The lethal rate of invasive pulmonary aspergillosis and mucormycosis is very high. Antifungal drug treatment combined with timely surgical treatment can save patients lives.

Background and objective Cystic lung cancer,a special type of lung cancer,has been paid more and more attention.The most common pathological type of cystic lung cancer is adenocarcinoma.The invasiveness of cystic lung adenocarcinoma is vital for the selection of clinical treatment and prognosis.The aim of this study is to analyze the multiple clinical features of cystic lung adenocarcinoma,explore the independent risk factors of its invasiveness,and establish a risk pre-diction model.Methods A total of 129 cases of cystic lung adenocarcinoma admitted to the Department of Thoracic Surgery of the First Affiliated Hospital of Nanjing Medical University from January 2021 to July 2022 were retrospectively analyzed and divided into pre-invasive group[atypical adenomatous hyperplasia(AAH),adenocarcinoma in situ(AIS)and minimally invasive adenocarcinoma(MIA)]and invasive group[invasive adenocarcinoma(IAC)]according to pathological findings.There were 47 cases in the pre-invasive group,including 19 males and 28 females,with an average age of(51.23±14.96)years.There were 82 cases in the invasive group,including 60 males and 22 females,with an average age of(61.27±11.74)years.Mul-tiple clinical features of the two groups were collected,including baseline data,imaging data and tumor markers.Univariate analysis,LASSO regression and multivariate Logistic regression analysis were used to screen out the independent risk factors of the invasiveness of cystic lung adenocarcinoma,and the risk prediction model was established.Results In univariate analysis,age,gender,smoking history,history of emphysema,neuron-specific enolase(NSE),number of cystic airspaces,lesion di-ameter,cystic cavity diameter,nodule diameter,solid components diameter,cyst wall nodule,smoothness of cyst wall,shape of cystic airspace,lobulation,short burr sign,pleural retraction,vascular penetration and bronchial penetration were statisti-cally different between the pre-invasive group and invasive groups(P<0.05).The above variables were processed by LASSO regression dimensionality reduction and screened as follows:age,gender,smoking history,NSE,number of cystic airspaces,lesion diameter,cystic cavity diameter,cyst wall nodule,smoothness of cyst wall and lobulation.Then the above variables were included in multivariate Logistic regression analysis.Cyst wall nodule(P=0.035)and lobulation(P=0.001)were found to be independent risk factors for the invasiveness of cystic lung adenocarcinoma(P<0.05).The prediction model was established as follows:P=e^x/(1+e^x),x=-7.927+1.476* cyst wall nodule+2.407* lobulation,and area under the curve(AUC)was 0.950.Conclusion Cyst wall nodule and lobulation are independent risk factors for the invasiveness of cystic lung adenocarcinoma,which have certain guiding significance for the prediction of the invasiveness of cystic lung adenocarcinoma.

Objective To analyze the factors influencing axillary lymph-node metastasis(ALNM)in microinvasive breast cancer(MIBC)patients,as well as to establish the risk-prediction model of ipsilateral ALNM in MIBC patients.Methods A total of 4475 primary female MIBC diagnosed by pathology from 2010 to 2015 were searched and screened from the SEER database.The obtained data were used to establish a prediction model for ALNM of MIBC.A total of 2266 primary female MIBC patients diagnosed by pathology from 2018 to 2020 in the SEER database were screened as the external validation cohort.The clinicopathological data of the enrolled MIBC patients were collected.Univariate analysis was used to screen out the factors affecting ALNM in MIBC patients.Statistically significant variables in univariate analysis were included in multivariate logistic regression analysis.The independent factors influencing ALNM in MIBC patients were screened out,and a nomogram was established.The area under the curve(AUC)was calculated by plotting the ROC curve.After plotting the calibration curve,the model was evaluated by Hosmer-Lemeshow goodness-of-fit test.Results A total of 309 patients were diagnosed with ipsilateral ALNM among the 6741 MIBC patients,accounting for about 4.58%.Univariate analysis of the modeling group showed that age,ethnicity,histological grade,pathological type,molecular subtype,and lateral side were associated with ALNM in MIBC patients(P<0.05).Results of multivariate analysis showed that the risk of ALNM was higher in MIBC patients≤40 years old,black people,histological grade Ⅱand Ⅲ,and primary right side(P<0.05).Subtype is an independent factor influencing ALNM in MIBC patients.However,the difference in ALNM risk was not statistically significant between the subtype of HR+HER2+,HR-HER2+,HR-HER2-and HR+HER2-subtypes.The AUC of the modeling group was 0.716(95%CI:0.682-0.750),the best cut-off value was 0.045,the sensitivity was 0.733,and the specificity was 0.608.The newly established nomogram model was used for the validation cohort,and its AUC was 0.722(95%CI:0.667-0.777).The P values of the Hosmer-Lemeshow goodness-of-fit test of the calibration curves in the modeling and validation groups exceeded 0.05.Conclusion The risk-prediction model of ALNM in MIBC patients established by the SEER database has good predictive ability and can thus be expected to serve as a reference for clinical practice.

Objective:To evaluate the 10-year protective effect and immunogenicity of quadrivalent human papillomavirus (HPV) vaccine in Chinese women aged 20 to 45 years.Methods:From October 2019 to April 2020, a long-term follow-up study was conducted on the subjects of the Phase III clinical trial of the quadrivalent HPV vaccine (NCT00834106). Participants underwent a questionnaire survey, venous blood sampling, gynecological examination, cervical exfoliated cell pathology examination, and serum neutralizing antibody titers for HPV-6, 11, 16, and 18 were measured using a pseudovirus neutralization assay. The results of the cytological examination and the positive rate and titers of serum antibodies of different cervical exfoliated cells were compared.Results:A total of 889 subjects were followed up, including 240 in the control group, 453 in the vaccination group and 196 in the post-trial vaccination group. The age of the control group was (40±7) years old, which was higher than that of the supplementary vaccination group and the vaccination group [(38±4) and (38±6) years old, respectively] ( P<0.05). There were no statistically significant differences in condom use and sexual frequency among all groups (all P values>0.05). The abnormal proportion of cervical exfoliation cytopathology in the vaccination group was 3.7% (17/453), which was significantly lower than that in the control group [9.6% (23/240)] and post-trial vaccination group [5.6% (11/196)] ( P<0.05). There were two cases of cervical intraepithelial neoplasia (CIN) grade 1 in the vaccination group, two cases of CIN grade 1 and three cases of CIN grade 2 and above in the control group, and no CIN grade 1 and above cases in the post-trial vaccination group. The positive rate of HPV-18 antibody was 35.5% (161/453) in the vaccination group and 76.0% (149/196) in the post-trial vaccination group, which was significantly lower than that of other types ( P<0.05). The neutralizing antibody GMT ratio between the vaccination group and the control group ranged from 2.62 to 25.33 (9.05 to 83.08). Conclusion:Protective neutralizing antibodies are sustained in Chinese women aged 20 to 45 years after ten years of vaccination with quadrivalent HPV vaccine.

Objective This study aimed to investigate the effects of silencing Ras homolog family member C(RhoC)on the proliferation,apoptosis,invasion,migration,and epithelial-mesenchymal transition(EMT)of salivary adenoid cystic carcinoma(SACC)and its molecular mechanisms.Methods A total of 27 SACC lesions and normal salivary gland tissues that were surgically resected at Qingdao Municipal Hospital from January 1,2019 to March 1,2024 were selected,and the expression levels of RhoC were detected by Western blot and immunohistochemistry.Three small interfering RNA(siRNAs)were designed to target the RhoC gene sequence,transfected into SACC-LM and SACC-83 cell lines,and evaluated for transfection efficiency.The protein expression levels of RhoC,Rho-asso-ciated protein kinase-1(ROCK1),p38 mitogen-activated protein kinase(p38MAPK),phosphorylated-p38MAPK(p-p38MAPK),twist family bHLH transcription factor 1(TWIST1),E-cadherin,N-cadherin,and Vimentin were com-pared using Western blot.CCK-8 assay,flow cytometry,transwell invasion assay,and wound healing assay were conducted to assess the differences in cell proliferation,apoptosis,invasion,and migration abilities among the groups.Bioinformatics methods were also used to predict possible upstream micro RNAs(miRNAs)of RhoC and their expression levels in SACC.Moreover,dual-luciferase reporter gene experiments were performed to verify the binding sites of miR-138-5p and RhoC.Results RhoC was highly expressed in SACC(P＜0.05).After silencing RhoC,the test group showed a significant decrease in the expression level of ROCK1,p-p38MAPK,TWIST1,N-cadherin,and Vimentin,as well as a significant increase in the expression level of E-cadherin(P＜0.05).No signifi-cant difference in the expression level of p38MAPK was observed(P＞0.05).The cell proliferation,invasion,and mi-gration ability decreased in the test group,whereas the apoptosis rates significantly increased(P＜0.05).miR-138-5p was lowly expressed in SACC,and miR-138-5p mimic can significantly downregulated the luciferase activity of 293T cells after transfection with a RhoC wild-type plasmid(P＜0.05).Conclusion RhoC is highly expressed in SACC,and RhoC silencing may target the downstream ROCK1/p38MAPK/TWISTl signaling pathway,thereby in-hibiting the proliferation,invasion,migration,and EMT of SACC while promoting its apoptosis.On the contrary,miR-138-5p is lowly expressed in SACC and is a potential upstream gene of RhoC,and there may be binding sites between the two genes.

Objective:To evaluate the 10-year protective effect and immunogenicity of quadrivalent human papillomavirus (HPV) vaccine in Chinese women aged 20 to 45 years.Methods:From October 2019 to April 2020, a long-term follow-up study was conducted on the subjects of the Phase III clinical trial of the quadrivalent HPV vaccine (NCT00834106). Participants underwent a questionnaire survey, venous blood sampling, gynecological examination, cervical exfoliated cell pathology examination, and serum neutralizing antibody titers for HPV-6, 11, 16, and 18 were measured using a pseudovirus neutralization assay. The results of the cytological examination and the positive rate and titers of serum antibodies of different cervical exfoliated cells were compared.Results:A total of 889 subjects were followed up, including 240 in the control group, 453 in the vaccination group and 196 in the post-trial vaccination group. The age of the control group was (40±7) years old, which was higher than that of the supplementary vaccination group and the vaccination group [(38±4) and (38±6) years old, respectively] ( P<0.05). There were no statistically significant differences in condom use and sexual frequency among all groups (all P values>0.05). The abnormal proportion of cervical exfoliation cytopathology in the vaccination group was 3.7% (17/453), which was significantly lower than that in the control group [9.6% (23/240)] and post-trial vaccination group [5.6% (11/196)] ( P<0.05). There were two cases of cervical intraepithelial neoplasia (CIN) grade 1 in the vaccination group, two cases of CIN grade 1 and three cases of CIN grade 2 and above in the control group, and no CIN grade 1 and above cases in the post-trial vaccination group. The positive rate of HPV-18 antibody was 35.5% (161/453) in the vaccination group and 76.0% (149/196) in the post-trial vaccination group, which was significantly lower than that of other types ( P<0.05). The neutralizing antibody GMT ratio between the vaccination group and the control group ranged from 2.62 to 25.33 (9.05 to 83.08). Conclusion:Protective neutralizing antibodies are sustained in Chinese women aged 20 to 45 years after ten years of vaccination with quadrivalent HPV vaccine.

Background::Growth retardation is a common complication of chronic kidney disease in children, which can be partially relieved after renal transplantation. This study aimed to develop and validate a predictive model for growth patterns of children with end-stage renal disease (ESRD) after kidney transplantation using machine learning algorithms based on genomic and clinical variables.Methods::A retrospective cohort of 110 children who received kidney transplants between May 2013 and September 2021 at the First Affiliated Hospital of Zhengzhou University were recruited for whole-exome sequencing (WES), and another 39 children who underwent transplant from October 2021 to March 2022 were enrolled for external validation. Based on previous studies, we comprehensively collected 729 height-related single-nucleotide polymorphisms (SNPs) in exon regions. Seven machine learning algorithms and 10-fold cross-validation analysis were employed for model construction.Results::The 110 children were divided into two groups according to change in height-for-age Z-score. After univariate analysis, age and 19 SNPs were incorporated into the model and validated. The random forest model showed the best prediction efficacy with an accuracy of 0.8125 and an area under curve (AUC) of 0.924, and also performed well in the external validation cohort (accuracy, 0.7949; AUC, 0.796). Conclusions::A model with good performance for predicting post-transplant growth patterns in children based on SNPs and clinical variables was constructed and validated using machine learning algorithms. The model is expected to guide clinicians in the management of children after renal transplantation, including the use of growth hormone, glucocorticoid withdrawal, and nutritional supplementation, to alleviate growth retardation in children with ESRD.

Objective To systematically evaluate the effect of virtual shopping on cognitive function of patients with mild cognitive impairment. Methods PubMed,EMBASE,Cochrane Library,Web of Science,and CNKI were searched for literatures on virtual shopping,mild cognitive impairment,and cognitive function published from database inception to Sep. 2023. The literatures were screened and the data were extracted in strict accordance with the inclusion criteria,and the Review Manager 5.3 was used for meta-analysis. Results A total of 12 randomized controlled trials involving 382 patients with mild cognitive impairment were included. Meta analysis showed that compared with traditional cognitive rehabilitation training,virtual shopping could improve the comprehensive cognitive function,executive function,attention and abilities of daily living of patients with mild cognitive impairment (all P<0.05),but had no significant effects on the memory,language,or visuospatial ability (all P>0.05). Conclusion Virtual shopping is beneficial for improving the comprehensive cognitive function,executive function,attention and abilities of daily living of patients with mild cognitive impairment.

Objective To explore the impact of clinical treatment decisions on the long-term survival of different molecular subtypes of locally advanced breast cancer(LABC),and to promote the development of more effective and individualized treatment regimens for LABC.Methods The cases of LABC diagnosed by pathology from 2010 to 2015 were searched in the database.Breast cancer-specific survival(BCSS)and overall survival(OS)were estimated by plotting Kaplan-Meier curves.The log rank test(Mantel-Cox)was used to analyze the difference between the groups,and the benefit population of LABC was determined after for age,TNM stage,grade,treatment methods.Results The 5-year OS and BCSS were 77.43％and 84.34％in breast-conserving,and 68.03％and 76.90％in mastectomy,respectively.The 5-year OS and BCSS of Luminal A LABC were 79.91％and 87.23％in breast-conserving,and 71.78％and 81.16％in mastectomy,respectively.The 5-year OS and BCSS of Luminal B LABC were 79.30％and 83.14％in breast-conserving,and were 70.37％and 76.92％in mastectomy,respectively.The 5-year OS and BCSS of triple-negative LABC were 60.77％and 68.13％in breast-conserving,and those of mastectomy were 47.13％and 55.94％,respectively.The 5-year OS and BCSS of HER2 positive were 75.42％,82.05％in breast-conserving,and were 67.05％and 75.01％in mastectomy,respectively;The 5-year OS and BCSS of triple-positive LABC were 86.12％and 91.63％in breast-conserving,and 74.54％and 82.56％in mastectomy,respectively.The 5-year OS and BCSS of well differentiated and N0 triple-positive LABC patients with chemotherapy were 88.24％and 76.91％,and those of patients without chmotherapy were 88.24％and 90.91％,respectively(BCSS:P=0.812;OS:P=0.311).Conclusion In the selective population,OS and BCSS of patients with LABC undergoing breast conserving surgery were significantly better than those of mastectomy.When OS and BCSS were compared for different molecular types and stages of LABC,breast-conserving surgery was still superior to total mastectomy.LABC could be considered for highly differentiated,N0 stage Triple positive without chemotherapy.