This experiment was conducted to investigate the effects of agaric polysaccharides on an-tioxidant capacity,immune function,and intestinal flora of calves.Twenty-four healthy Holstein calves of(30±3)days of age and with the similar body weight at(55.33±1.86)kg were selected and randomly divided into two groups:the control group(group C)and test group(group T)with 12 replicates in each group and one calves in each replicate.Group C was fed starter and milk repla-cer,and group T was fed starter and milk replacer with 10 g of agaric polysaccharides to each calve for 10 d.Serum antioxidant,immune indexes and intestinal flora were tested.The results showed as follows:compared with group C,the enzyme activities of SOD and GSH-Px in serum of calves in group T were significantly increased(P＜0.05),and were increased by 29.09％and 15.35％,re-spectively;compared with group C,IgA,IL-2 and TNF-α were significantly increased in T group(P＜0.05).Adding agaric polysaccharides significantly increased the relative abundance of Firmi-cutes(P＜0.05)and decreased the relative abundance of Proteobacteria in feces of calf(P＞0.05);the relative abundance of Lactobalillus and Faecalibacterium were increased(P＜0.05);the relative abundance of Butyricoccus-pullicaecorum was increased(P＜0.05).LEfSe analysis results showed that there were 11 marker species in group T,such as Firmicutes and Lactobacillus,and 9 marker species in group C,such as Proteobacteria.The results showed that agaric polysaccharides could improve the antioxidant capacity and immune function of calves,and also could improve the structure of intestinal flora.

[Objective]To study the effects of oridonin on Bel-7402/Sora cell proliferation,apoptosis,cycle and phosphatidylinositol 3-kinase/protein kinase B(PI3K/AKT)signaling pathway.[Methods]The concentration gradient increasing method was used to establish Bel-7402/Sora drug-resistant cell line.Cell counting kit-8(CCK-8)method was used to detect cell proliferation inhibition rate and calculate cell resistance reversal index,flow cytometry was used to detect the cell apoptosis and cell cycle,Real-time quantitative polymerase chain reaction(RT-PCR)method was used to detect mRNA expression level of PI3K,AKT and mammalian target of rapamycin(mTOR),Western blot method was used to detect PI3K,AKT,mTOR protein expression levels.[Results]Compared with blank control group,oridonin with final concentrations of 4,8,16,32,64 μmol·L-1 had a better proliferation inhibition on Bel-7402/Sora cells(P<0.05,P<0.01),and the effect was dependent on concentration.The resistance reversal index of oridonin on Bel-7402/Sora cells is 2.024.Compared with blank control group,the early,late and total apoptosis rate of oridonin group were significantly increased(P<0.01,P<0.05);compared with oridonin group,the early and total apoptosis rate of oridonin jointed Sorafenib group were significantly increased(P<0.05).Compared with blank control group,the proportion of G2 phase cells of oridonin group was significantly increased(P<0.01);compared with oridonin group,the proportion of G1 phases cells of oridonin jointed Sorafenib group was significantly increased,and G2 phases cells was significantly decreased(P<0.01).Compared with blank control group,PI3K,AKT and mTOR mRNA expression levels of oridonin group were significantly reduced(P<0.01);compared with oridonin group,PI3K,AKT and mTOR mRNA expression levels of oridonin jointed Sorafenib group were significantly reduced(P<0.01).Compared with blank control group,PI3K and AKT protein expression levels of oridonin group were significantly reduced(P<0.01),and mTOR protein expression levels were no statistical significance(P>0.05);compared with oridonin group,AKT protein expression levels of oridonin jointed Sorafenib group were significantly reduced(P<0.01),PI3K,mTOR protein expression levels were no statistical significance(P>0.05).[Conclusion]Oridonin can inhibit cell proliferation of Bel-7402/Sora cell,induce apoptosis,hinder cycle progression and its anti-tumor mechanism may be related to intervene in the PI3K/AKT signaling pathway.

In February 2022, the German Society of Pediatric and Adolescent Medicine published the first Evidence-based Recommendations for the Treatment and Prevention of Non-specific Back Pain in Children and Adolescents, which provides clinical evidence and recommendations for the etiology, risk factors and diagnosis of back pain in children and adolescents, and the treatment and prevention suggestions on the non-specific back pain.Although the guideline for the diagnosis and treatment of non-specific low back pain have been launched in China, a specific description of back pain in children and adolescents is lacking.With regard to increasing incidence of low back pain in children and adolescents, and differences in term of the etiology, risk factors, diagnosis and treatment of back pain between children-adolescents and adults, this article aims to interpret the guidelines to provide references and guidance for the clinical diagnosis and treatment of back pain in children and adolescents.

BACKGROUND: Emergence delirium (ED) is a kind of delirium that occured in the immediate post-anesthesia period. Lower body temperature on post-anesthesia care unit (PACU) admission was an independent risk factor of ED. The present study was designed to investigate the association between intraoperative body temperature and ED in elderly patients undergoing non-cardiac surgery. METHODS: This study was a secondary analysis of a prospective observational study. Taking baseline body temperature as a reference, intraoperative absolute and relative temperature changes were calculated. The relative change was defined as the amplitude between intraoperative lowest/highest temperature and baseline reference. ED was assessed with the confusion assessment method for intensive care unit at 10 and 30 min after PACU admission and before PACU discharge. RESULTS: A total of 874 patients were analyzed with a mean age of 71.8 ± 5.3 years. The incidence of ED was 38.4% (336/874). When taking 36.0°C, 35.5°C, and 35.0°C as thresholds, the incidences of absolute hypothermia were 76.7% (670/874), 38.4% (336/874), and 17.5% (153/874), respectively. In multivariable logistic regression analysis, absolute hypothermia (lowest value <35.5°C) and its cumulative duration were respectively associated with an increased risk of ED after adjusting for confounders including age, education, preoperative mild cognitive impairment, American Society of Anesthesiologists grade, duration of surgery, site of surgery, and pain intensity. Relative hypothermia (decrement >1.0°C from baseline) and its cumulative duration were also associated with an increased risk of ED, respectively. When taking the relative increment >0.5°C as a threshold, the incidence of relative hyperthermia was 21.7% (190/874) and it was associated with a decreased risk of ED after adjusting above confounders. CONCLUSIONS: In the present study, we found that intraoperative hypothermia, defined as either absolute or relative hypothermia, was associated with an increased risk of ED in elderly patients after non-cardiac surgery. Relative hyperthermia, but not absolute hyperthermia, was associated with a decreased risk of ED. REGISTRATION Chinese Clinical Trial Registry (No. ChiCTR-OOC-17012734).
Humans ; Aged ; Body Temperature ; Emergence Delirium ; Hypothermia ; Postoperative Complications/epidemiology* ; Prospective Studies

Objective:To observe the expression of microRNA (miRNA)-7159-5p in gastric cancer tissues, and explore its effect on the proliferation and invasion of gastric cancer cells and its molecular mechanism.Methods:The cancer tissues and adjacent tissues of 29 patients with gastric cancer who underwent surgical resection in Hubei 672 Orthopedic Hospital of Integrated Traditional Chinese and Western Medicine from March 2018 to November 2019 were collected. Fluorescence real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of miR-7159-5p in gastric cancer tissues and adjacent tissues, gastric cancer cell lines and normal gastric epithelial cell lines. Select the cell line with the lowest expression of miR-7159-5p, set the control group and the experimental group, and be transfected with control and miR-7159-5p mimics respectively. qRT-PCR was used to detect the expression of miR-7159-5p in transfected cells. The lymphocyte proliferation test (MTS method) was used to detect the proliferation of transfected cells, and the Transwell chamber method was used to detect the invasion activity of transfected cells. The miRNAMap database and dual luciferase reporter gene experiment were used to predict and verify the target genes of miR-7159-5p. qRT-PCR and Western blot were used to detect the expression of target genes in transfected cells.Results:The expression of miR-7159-5p in gastric cancer tissues was lower than that in adjacent tissues ( P<0.01), the expression of miR-7159-5p in gastric cancer cell lines was lower than that of normal gastric epithelial cells (all P<0.01), and the expression of miR-7159-5p was the lowest in SGC7901 cells ( P<0.01). After transfection, the expression of miR-7159-5p in SGC7901 cells of the experimental group was significantly higher than that in the control group ( P<0.01). After transfection, the proliferation activity and the cell invasion activity of the experimental group was significantly lower than that of the control group (all P<0.01). The target gene of miR-7159-5p was tripartite motif 26 (TRIM26). After transfection, the expression of TRIM26 mRNA in SGC7901 cells of the experimental group was significantly lower than that in the control group ( P<0.01). Western blot showed that after transfection, the expression of TRIM26, c-Myc, cyclin D1, β-catenin protein were lower than those in the control group (all P<0.05). Conclusions:The expression of miR-7159-5p is low in gastric cancer tissues, and miR-7159-5p can inhibit the proliferation and invasion of SGC7901 cells by down-regulating the expression of TRIM26.

Objective:To explore the clinical effect of antibiotic bone cement combined with delayed lateral supramolleolar perforator fascial flap in the treatment of diabetic foot(DF).Methods:From April 2020 to July 2021, a total of 6 patients with DF were treated with antibiotic bone cement combined with delayed lateral supramolleolar perforator fascial flap. The patients were 5 males and 1 female, aged from 45 to 67 years old with an average of 56.2 years old. The wounds were all located in dorsal foot, 4 in right foot and 2 in the left. The wound area was 2.4 cm×5.0 cm-6.5 cm×10.0 cm. The depth of wound were: 3 cases up to tendon layer, and 3 cases up to metatarsal bone. Two of the wound were complicated with metatarsal osteomyelitis. The wounds at Wagner grade 3 in 4 patients and grade 4 in 2 patients. The flap size was 3.0 cm×6.0 cm-8.0 cm×11.0 cm. All of the wounds were repaired with delayed supramolleolar perforator fascia flap after debridement, application of antibiotic bone cement and fumigation with Sanhuang decoction(a traditional Chinese medicine). The affected limbs were externally fixed with plaster and raised after surgery, and the colour, temperature, tension and capillary reaction of the flaps were closely observed. Stitches were removed 2 weeks after surgery and rehabilitation of the affected limb was performed. Regular follow-up was made postoperatively. The appearance of flaps and the scar of donor and recipient sites were observed. The foot and ankle function were evaluated by the American Orthopaedic Association foot and Ankle Surgery(AOFAS) score scale.Results:Six cases of DF had no recurrence of wound infection. All flaps survived well. The average follow-up time was 6(3-14) months. The postoperative follow-up revealed satisfactory appearance of the flap, only linear scars remained in the donor and recipient sites. The function of foot and ankle recovered well with full weight-bearing and normal walk. AOFAS scores ranged from 81 to 95.Conclusion:It is an effective method to treat DF by applying antibiotic bone cement combined with delayed superior lateral malleolus perforator fascial flap. The operation is simple, safe and can cut down the time of treatment, quickly control the wound infection. It deserves further trials.

Objective:To investigate the expression of long non-coding RNA (lncRNA) ALMS1-IT1 in colorectal cancer tissues and the molecular mechanism of its effect on the proliferation and migration of colorectal cancer HT-29 cells in vitro.Methods:The cancer tissue specimens and paracancerous tissue (>5 cm from the edge of the tumor) specimens were collected from 40 colorectal cancer patients who were diagnosed by pathological examination after surgical resection in Hubei 672 Orthopedic Hospital of Integrated Traditional Chinese and Western Medicine from July 2018 to November 2020. Real-time quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression level of ALMS1-IT1 in colorectal cancer tissues and paracancerous tissues, when the relative expression of ALMS1-IT1 was higher than or equal to its median relative expression, ALMS1-IT1 was highly expressed, and the correlation of ALMS1-IT1 expression with the clinicopathological characteristics of patients was analyzed. HT-29 cells were infected with the empty lentivirus and the lentivirus carrying the ALMS1-IT1 silence sequence, and named control group and si-ALMS1-IT1 group. qRT-PCR was used to detect the expression of ALMS1-IT1 in the two groups of HT-29 cells. CCK-8 method and Transwell experiment were used to detect the proliferation and migration ability of the two groups of HT-29 cells. The starBase v2.0 online database was used to predict ALMS1-IT1 interacting molecules, and qRT-PCR and Western blot were used to detect the expression of these molecules.Results:The relative expression of ALMS1-IT1 in colorectal cancer tissues was higher than that in paracancerous tissues (4.54±0.61 vs. 1.19±0.31, t = 34.89, P < 0.01). The median relative expression of ALMS1-IT1 in cancer tissues of 40 patients was 2.93, and the high expression rate of ALMS1-IT1 was 50.0% (20/40). The high expression rate of ALMS1-IT1 in cancer tissues of TNM stage Ⅲ patients was higher than that in TNM stage Ⅰ-Ⅱ patients, the high expression rate of ALMS1-IT1 in poorly-differentiated patients was higher than that in well- and moderately-differentiated patients, and the high expression rate of ALMS1-IT1 in patients with lymph node metastasis was higher than that in patients without lymph node metastasis (all P < 0.01). The cell proliferation capacity (absorbance value) of HT-29 cells in the si-ALMS1-IT1 group after cultured for 2, 3, 4, and 5 days was lower than that in the control group (all P < 0.05). The number of cell migration at 24 h in HT-29 cells of the si-ALMS1-IT1 group was less than that of the control group (45±7 vs. 112±18, t = 3.45, P < 0.05). Using starBase v2.0 online database to predict that the target gene of ALMS1-IT1 may be miRNA-889-3p (miR-889-3p), and the target gene of miR-889-3p may be ATAD2. Compared with the control group, the relative expression of miR-889-3p in HT-29 cells of the si-ALMS1-IT1 group increased (4.24±0.46 vs. 1.01±0.11, t = 6.81, P < 0.01). Compared with the control group, ATAD2 mRNA ( P < 0.01) and protein expression levels in the si-ALMS1-IT1 group were reduced. Conclusions:ALMS1-IT1 is highly expressed in colorectal cancer tissues, and the ALMS1-IT1 expression is related to the TNM stage, degree of tumor differentiation and lymph node metastasis of patients. Down-regulation of ALMS1-IT1 in vitro may inhibit the proliferation and migration of colorectal cancer HT-29 cells by regulating the miR-889-3p-ATAD2 axis. ALMS1-IT1 may be a therapeutic target for colorectal cancer.

OBJECTIVE：To evaluate therapeutic e fficacy and safety of differen t doses of Secukinumab in the treatment of medium and severe ankylosing spondylitis （AS）， and to provide evidence-based reference for clinical treatment of AS. METHODS： Retrieved from Medline ， PubMed， Cochrane Library， Embase， VIP， CJFD， Wanfang database andpu- ClinicalTrials.gov， during the inception to March 2020， xiaofeng1205@outlook.com randomized controlled trials （RCTs）about different doses of secukinumab （75， 150， 300 mg） versus placebo in the treatment of medium and severe AS were collected. After data extraction of clinical studies met the inclusion criteria ，quality evaluation with Cochrane risk bias evaluation tool 5.1.0，Rev Man 5.3 statistical software was used for Meta-analysis of therapeutic efficacy [in the international society for the evaluation of spondyloarthritis scale ，the proportion of 20％ patients improved （ASAS20）；ASAS40；among 6 routine clinical areas related to AS，the scores of at least 5 areas improved by at least 20％，and there was no patients receiving treatment due to deterioration in other areas （ASAS 5/6）；remission value of Bath ankylosing spondylitis disease activity index （BASDAI）from baseline to 16th week，the proportion of the patients with the international society for the evaluation of ankylosing spondyloarthritis （ASAS PR ） score no higher than 2 in the 4 ASAS fields within the specified time] and safety [the incidence of withdrawal from treatment due to ADR，the incidence of serious ADR ，the incidence of general ADR （nasopharyngitis，headache，diarrhea）]. RESULTS ：A total of 5 RCTs were included ，involving 1 624 patients. Meta-analysis showed that ASAS 20 [total：OR＝2.62，95％CI（2.14，3.20），P＜ 0.000 01；75 mg：OR＝2.63，95％CI（1.28，5.40），P＝0.008；150 mg：OR＝2.58，95％CI（2.01，3.32），P＜0.000 01；300 mg：OR＝2.63，95％CI（1.37，5.06），P＝0.004]，ASAS40 [total：OR＝2.82，95％CI（2.13，3.74），P＜0.000 01；75 mg：OR＝ 3.14，95％CI（1.86，5.31），P＜0.000 1；150 mg：OR＝2.79，95％CI（1.85，4.20），P＜0.000 01；300 mg：OR＝2.73，95％CI （1.33，5.58），P＝0.006]，ASAS5/6 [total：OR＝3.82，95％CI（2.61，5.59），P＜0.000 01；75 mg：OR＝5.59，95％CI（3.29， 9.49），P＜0.000 01；150 mg：OR＝3.45，95％CI（2.08，5.70），P＜0.000 01；300 mg：OR＝3.85，95％CI（1.75，8.47），P＝ 0.000 8]，ASAS PR [total ：OR＝4.69，95％CI（3.07，7.16），P＜0.000 01；75 mg：OR＝5.48，95％CI（2.50，11.99），P＜0.000 1； 150 mg：OR＝3.71，95％CI（2.19，6.29），P＜0.000 01；300 mg：OR＝20.0，95％CI（2.58，155.14），P＝0.004] in trial group was significantly higher than control group ；BASDAI improvement [total ：WMD＝－1.15，95％CI（－1.50，－0.79），P＜0.000 01； 75 mg：WMD＝－1.40，95％CI（－2.08，－0.72），P＜0.000 1；150 mg：WMD＝－1.03，95％CI（－1.52，－0.54），P＜ 0.000 1；300 mg：WMD＝－1.20，95％CI（－2.03，－0.37），P＝0.005] of trial group were significantly higher than those of control group ，with statistical significance. The total incidence of nasopharyngitis in trial group [OR ＝1.77，95％CI（1.22，2.57）， P＝0.003] and 150 mg dose subgroup [OR ＝1.84，95％CI（1.18，2.86），P＝0.007] was significantly higher than control group ， without significant difference in other safety indexes among total and different dose subgroups （P＞0.05）. CONCLUSIONS ：75 mg，150 mg and 300 mg of secukinumab are all effective and well tolerated for medium and severe AS patients ，and 150 mg of secukinumab may increase the incidence of nasopharyngitis.

Acute respiratory failure due to acute hypoxemia is the major manifestation in severe coronavirus disease 2019 (COVID-19). Rational and effective respiratory support is crucial in the management of COVID-19 patients. High-flow nasal cannula (HFNC) has been utilized widely due to its superiority over other non-invasive respiratory support techniques. To avoid HFNC failure and intubation delay, the key issues are proper patients, timely application and improving compliance. It should be noted that elder patients are vulnerable for failed HFNC. We applied HFNC for oxygen therapy in severe and critical ill COVID-19 patients and summarized the following experiences. Firstly, to select the proper size of nasal catheter, to locate it at suitable place, and to confirm the nose and the upper respiratory airway unobstructed. Secondly, an initial ow of 60 L/min and 37℃ should be given immediately for patients with obvious respiratory distress or weak cough ability; otherwise, low-level support should be given first and the level gradually increased. Thirdly, to avoid hypoxia or hypoxemia, the treatment goal of HFNC should be maintained the oxygen saturation (SpO) above 95% for patients without chronic pulmonary disease. Finally, patients should wear a surgical mask during HFNC treatment to reduce the risk of virus transmission through droplets or aerosols.
Aged ; Betacoronavirus ; isolation & purification ; Cannula ; Coronavirus Infections ; therapy ; Humans ; Oxygen ; administration & dosage ; Pandemics ; Pneumonia, Viral ; therapy

Acute respiratory failure due to acute hypoxemia is the major manifestation in severe coronavirus disease 2019 (COVID-19) induced by severe acute respiratory syndrome coronavirus 2 infection. Rational and effective respiratory support is crucial in the management of COVID-19 patients. High-flow nasal cannula (HFNC) has been utilized widely due to its superiority over other non-invasive respiratory support techniques. To avoid HFNC failure and intubation delay, the key issues are proper patients, timely application and improving compliance. It should be noted that elder patients are vulnerable for failed HFNC. We applied HFNC for oxygen therapy in severe and critical COVID-19 patients and summarized the following experiences. Firstly, to select the proper size of nasal catheter, to locate it at suitable place, and to confirm the nose and the upper respiratory airway unobstructed. Secondly, an initial flow of 60 L/min and 37℃ should be given immediately for patients with obvious respiratory distress or weak cough ability; otherwise, low-level support should be given first and the level gradually increased. Thirdly, to avoid hypoxia or hypoxemia, the treatment goal of HFNC should be maintained the oxygen saturation (SpO) above 95% for patients without chronic pulmonary disease. Finally, patients should wear a surgical mask during HFNC treatment to reduce the risk of virus transmission through droplets or aerosols.
Aged ; Betacoronavirus ; Cannula ; Coronavirus Infections ; complications ; therapy ; Humans ; Hypoxia ; etiology ; prevention & control ; therapy ; Masks ; Oxygen ; administration & dosage ; Oxygen Inhalation Therapy ; instrumentation ; standards ; Pandemics ; Pneumonia, Viral ; complications ; therapy