Objective:To observe the clinical efficacy of pediatric Tuina(Chinese therapeutic massage)plus Saccharomyces Boulardii sachets for infectious diarrhea in children.Methods:A total of 55 children with rotavirus infectious diarrhea who received pediatric Tuina and Saccharomyces Boulardii sachets were included in the combination group.A total of 43 children with rotavirus infectious diarrhea who received Saccharomyces Boulardii sachets during the same period were included as the control group.In addition,both groups were treated with routine oral rehydration salts Ⅲ and montmorillonite powder.The clinical efficacy was compared between the two groups after 1 week of treatment.Changes in clinical manifestations,immune function indicators,and inflammatory factor levels before and after treatment were collected and compared between the two groups.At the same time,the adverse reactions and satisfaction of the parents were recorded and compared between the two groups.Results:The total effective rate of the combination group was higher than that of the control group(P<0.05).After treatment,the defecation frequency,stool trait score,and levels of C-reactive protein,tumor necrosis factor-α,and interleukin-6 decreased in both groups(P<0.05).And these indicators in the combination group were lower than those in the control group(P<0.05).The remission time of fever,abdominal pain,diarrhea,and vomiting in the combination group was shorter than that in the control group(P<0.05).After treatment,the levels of CD4+and CD4+/CD8+in both groups increased(P<0.05),and the levels in the combination group were higher than those in the control group(P<0.05).The satisfaction level of parents in the combination group was higher than that in the control group(P<0.05).There were no significant adverse reactions in either group.Conclusion:Based on routine treatment,the additional pediatric Tuina plus Saccharomyces Boulardii sachets treatment has valid efficacy in the treatment of infectious diarrhea in children,helpful to improve clinical symptoms,immune function,and inflammatory reactions,with good safety.The children's parents are satisfied with the treatment results.

Objective:To investigate the clinical characteristics and independent risk factors of severe disease in patients with anti-nuclear matrix protein (NXP) 2 antibody-positive juvenile dermatomyositis (JDM).Methods:A retrospective cohort study was conducted, including 219 anti-NXP2 antibody-positive JDM patients admitted to 23 children′s hospitals across China from July 2011 to July 2023. Patients were classified into severe and non-severe groups based on classification criteria for severe dermatomyositis. Demographic characteristics, clinical manifestations, and laboratory parameters were compared between the 2 groups using independent sample t-test, Mann-Whitney U test, or χ2 test. Univariate and multivariate Logistic regression analyses were performed to identify risk factors for severe disease. The receiver operating characteristic curve was employed to calculate optimal cut-off values. Results:Among the 219 patients, 108 were male and 111 were female, with an age at onset of 6.3 (3.5, 9.4) years. The severe group comprised 69 patients, and the non-severe group 150 patients. The severe group had significantly higher rates of fever, heliotrope rash, subcutaneous edema, periorbital edema, anti-Ro52 antibody positivity, as well as elevated levels of ferritin-to-albumin ratio (FAR), creatine kinase (CK), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) (all P<0.05). Multivariate analysis identified anti-Ro52 antibody positivity ( OR=13.26, 95% CI 1.37-128.29) and elevated FAR ( OR=1.90, 95% CI 1.09-2.31) as independent risk factors for severe anti-NXP2 antibody-positive JDM (both P<0.05). Receiver operating characteristic curve analysis revealed that a FAR cutoff value of 6.82 predicted severe disease with an area under the curve of 0.87 (95% CI 0.81-0.94, P<0.001), sensitivity of 0.85, and specificity of 0.70. All patients received glucocorticoid therapy, and the severe group received higher proportions of steroid pulse therapy, cyclophosphamide, mycophenolate mofetil, intravenous immunoglobulin, biologics, and adjuvant treatments compared to the non-severe group (all P<0.05). In terms of outcomes, 2 patients (2.9%) in the severe group died (due to neurological involvement and intestinal perforation, respectively), while the remaining patients achieved complete clinical response or remission. All patients in the non-severe group achieved remission. Conclusions:The primary clinical features of anti-NXP2 antibody-positive JDM included fever, heliotrope rash, subcutaneous edema, periorbital edema, anti-Ro52 antibody positivity, and elevated levels of CK, AST, LDH, and FAR. Furthermore, anti-Ro52 antibody positivity and a FAR>6.82 were identified as independent risk factors.

Objective:To observe the clinical efficacy of pediatric Tuina(Chinese therapeutic massage)plus Saccharomyces Boulardii sachets for infectious diarrhea in children.Methods:A total of 55 children with rotavirus infectious diarrhea who received pediatric Tuina and Saccharomyces Boulardii sachets were included in the combination group.A total of 43 children with rotavirus infectious diarrhea who received Saccharomyces Boulardii sachets during the same period were included as the control group.In addition,both groups were treated with routine oral rehydration salts Ⅲ and montmorillonite powder.The clinical efficacy was compared between the two groups after 1 week of treatment.Changes in clinical manifestations,immune function indicators,and inflammatory factor levels before and after treatment were collected and compared between the two groups.At the same time,the adverse reactions and satisfaction of the parents were recorded and compared between the two groups.Results:The total effective rate of the combination group was higher than that of the control group(P<0.05).After treatment,the defecation frequency,stool trait score,and levels of C-reactive protein,tumor necrosis factor-α,and interleukin-6 decreased in both groups(P<0.05).And these indicators in the combination group were lower than those in the control group(P<0.05).The remission time of fever,abdominal pain,diarrhea,and vomiting in the combination group was shorter than that in the control group(P<0.05).After treatment,the levels of CD4+and CD4+/CD8+in both groups increased(P<0.05),and the levels in the combination group were higher than those in the control group(P<0.05).The satisfaction level of parents in the combination group was higher than that in the control group(P<0.05).There were no significant adverse reactions in either group.Conclusion:Based on routine treatment,the additional pediatric Tuina plus Saccharomyces Boulardii sachets treatment has valid efficacy in the treatment of infectious diarrhea in children,helpful to improve clinical symptoms,immune function,and inflammatory reactions,with good safety.The children's parents are satisfied with the treatment results.

Objective:To investigate the clinical characteristics and independent risk factors of severe disease in patients with anti-nuclear matrix protein (NXP) 2 antibody-positive juvenile dermatomyositis (JDM).Methods:A retrospective cohort study was conducted, including 219 anti-NXP2 antibody-positive JDM patients admitted to 23 children′s hospitals across China from July 2011 to July 2023. Patients were classified into severe and non-severe groups based on classification criteria for severe dermatomyositis. Demographic characteristics, clinical manifestations, and laboratory parameters were compared between the 2 groups using independent sample t-test, Mann-Whitney U test, or χ2 test. Univariate and multivariate Logistic regression analyses were performed to identify risk factors for severe disease. The receiver operating characteristic curve was employed to calculate optimal cut-off values. Results:Among the 219 patients, 108 were male and 111 were female, with an age at onset of 6.3 (3.5, 9.4) years. The severe group comprised 69 patients, and the non-severe group 150 patients. The severe group had significantly higher rates of fever, heliotrope rash, subcutaneous edema, periorbital edema, anti-Ro52 antibody positivity, as well as elevated levels of ferritin-to-albumin ratio (FAR), creatine kinase (CK), aspartate aminotransferase (AST), and lactate dehydrogenase (LDH) (all P<0.05). Multivariate analysis identified anti-Ro52 antibody positivity ( OR=13.26, 95% CI 1.37-128.29) and elevated FAR ( OR=1.90, 95% CI 1.09-2.31) as independent risk factors for severe anti-NXP2 antibody-positive JDM (both P<0.05). Receiver operating characteristic curve analysis revealed that a FAR cutoff value of 6.82 predicted severe disease with an area under the curve of 0.87 (95% CI 0.81-0.94, P<0.001), sensitivity of 0.85, and specificity of 0.70. All patients received glucocorticoid therapy, and the severe group received higher proportions of steroid pulse therapy, cyclophosphamide, mycophenolate mofetil, intravenous immunoglobulin, biologics, and adjuvant treatments compared to the non-severe group (all P<0.05). In terms of outcomes, 2 patients (2.9%) in the severe group died (due to neurological involvement and intestinal perforation, respectively), while the remaining patients achieved complete clinical response or remission. All patients in the non-severe group achieved remission. Conclusions:The primary clinical features of anti-NXP2 antibody-positive JDM included fever, heliotrope rash, subcutaneous edema, periorbital edema, anti-Ro52 antibody positivity, and elevated levels of CK, AST, LDH, and FAR. Furthermore, anti-Ro52 antibody positivity and a FAR>6.82 were identified as independent risk factors.

Hunan university of Chinese medicine, as a first class of colleges and universities of Chinese medicine, needs to cultivate students to become high quality talents with innovative ability. It shall give full play of the medical experimental teaching centre and the virtual simulation experiment teaching platform advantage, and utilize the visualized virtual experiment, its network and interaction, to encourage teachers and students to participate in virtual experiment of "teaching and learning", to inspire students' enthusiasm to participate in the experiment, to liberate the students' experimental thinking, and to reflect the value of digital virtual experiment courses.

Objective: To investigate the relationship between tumor-infiltrating lymphocytes (TILs) and the androgen receptor (AR) in human epidermal growth factor receptor 2 (HER-2)-positive breast cancer. Methods: Specimens of 448 patients with HER-2-positive breast cancer from the Tianjin Medical University Cancer Hospital between March 2018 and November 2018 were collected. TILs were pathologically evaluated. AR expression was immunohistochemically analyzed. The relationships among TILs, the AR, and clinicopathological parameters were determined. Results: There were 38.2% (171/448) patients with TILs non/low-infiltrated, 42.2% (189/448) with moderately infiltrated, and 19.6% (88/448) with high infiltration. AR was positive in 62.7%(281/448) of the patients. Spearman correlation analysis showed that TILs and the AR were negatively related (r=-0.140, P=0.003). TILs were significantly associated with the AR in estrogen receptor positive breast cancer (P=0.009). Conclusions: TILs and the AR were negatively related in HER-2-positive breast cancer, indicating that HER-2-positive breast cancer can be treated according to the different infiltration levels of TILs and AR expression.

Objective To investigate the effects of volatile oil from artemisia dracunculus on myocardial injury caused by viral myocarditis in mice and explore its possible mechanism.Methods Totally 160 adult male BALB/c mice were randomly divided into normal control group (10) and viral myocarditis group (150).Viral myocarditis mice models were reproduced by intraperitoneal inoculation with a solution of coxsackievirus B3 (CVB3),a viral strain with affinity to myocardium,and then randomly divided into model,astragalus group,and low-,medium-,and high-dose volatile oil from artemisia dracunculus groups.After 1 hour of viral infection,normal control group and model group mice were given normal saline by intragastric administration,astragalus group mice were injected with astragalus 0.1 mL in each mouse by intraperitoneal injection,and the mice in other three groups were given low,medium and high dose (2％,5％,10％) 0.3 mL volatile oil from artemisia dracunculus in each mouse by intragastric administration,respectively,once a day for one week consecutively.The mortality,heart/body weight ratio,the activity of natural killer cells (NK cell),virus titer in myocardial homogenate,serum cardiac troponin Ⅰ (cTnI) level and myocardial pathological changes were observed.Results ① Mortality:the mortality of model group was higher than that of the normal control group,astragalus group,low and medium dose volatile oil from artemisia dracunculus groups (60.0％ vs.0％,23.3％,20.0％,28.7％),and the difference in the mortality being of no statistical significance between model group and that of high-dose volatile oil from artemisia dracunculus group (60.0％ vs.47.6％,P ＞ 0.05);the mortality of astragalus group was obviously lower than that of high-dose volatile oil from artemisia dracunculus group (P ＜ 0.01),and the differences in comparisons between the mortalities of astragalus intervention group,and medium-and low-dose volatile oil groups were not statistically significant (all P ＞ 0.05),and the comparison of mortality between low-and medium-dose volatile oil groups were also not statistically significant (P ＞ 0.05).② Immunization parameters:on the 8th day after modeling,the activity of NK cells in the model group was significantly lower than that in the normal control group [(15.91 ± 3.87)％ vs.(38.50 ± 2.32)％],the activities of NK cells in astragalus group,medium-and low-dose volatile oil from artemisia dracunculus groups were significantly higher than that in model group [(19.38 ± 3.27)％,(18.54 ± 3.09)％,(18.36 ± 2.64)％ vs.(15.91 ± 3.87)％,all P ＜ 0.05].None of virus was detected in the myocardial homogenate in the normal control group,and the virus titers in astragalus group,low and medium dose volatile oil from artemisia dracunculus groups were significantly lower than the titer of the model group (10-9/mL:1.96 ± 0.44,1.95 ± 0.46,1.95 ± 0.48 vs.2.41 ± 0.51,all P ＜0.01).③ Myocardial injury parameters:the level of cTnI in the normal control group was less than 0.1 μg/L,obviously lower than that in the model group [(15.84 ± 3.89) μg/L],as well as the ratio of heart/body weight in model group was also significantly higher than that in normal control group (× 10-4:8.3 ± 1.3 vs.4.6 ± 0.1),and the cTnI and the ratio of heart/body weight of astragalus intervention group,low and medium dose volatile oil from artemisia dracunculus groups were markedly lower than those of model group [cTnI (mg/L):10.03 ± 2.35,10.81 ± 2.56,11.10 ± 1.89 vs.15.84 ± 3.89,ratio of heart/body weight (× 10-4):7.2 ± 0.8,7.3 ± 1.0,7.3 ± 0.6 vs.8.3 ± 1.3].In the normal control group,there were no inflammatory cell infiltration and necrosis in myocardial tissue,the scores of myocardial pathological changes were 0.In the model group,the scores of inflammatory cell infiltration (3.25 ± 0.45) and of necrosis (2.91 ± 0.51) were markedly higher than those in the normal control group.And the above scores in astragalus group,low and medium dose volatile oil from artemisia dracunculus groups were significantly lower than those of the model group (infiltration score:2.92 ± 0.39,2.95 ± 0.35,2.95 ± 0.37 vs.3.25 ± 0.45,necrosis score:2.46 ± 0.50,2.50 ± 0.51,2.54 ± 0.50 vs.2.91 ± 0.51,all P ＜0.05).Conclusions Volatile oil from artemisia dracunculus can protect cardiomyocytes by removing the virus and regulating the immune function in the body.But the protective effects of volatile oil from artemisia dracunculus is related to the dosage,and the effects of low and medium dose are better.

Objective To observe the serum levels of high mobility group box-1 protein (HMGB1)in patients with acute cholangitis (AC) and to investigate contributions of HMGB1 in AC.Methods Serum HMGB1 concentrations were determined by an enzyme-linked immunosorbent assay in 30 patients with AC of severe type (ACST) and 42 patients with mild acute cholangitis at the time of admission (within 72 h after the onset).A total of 50 healthy subjects were recruited as the control group.Fluorescent quantitative PCR (FQPCR) was used to detect the HMGB1 mRNA expression and the relationship between serum HMGB1 levels and clinical factors was analyzed.Results The serum HMGB1 levels in healthy control group,mild group and ACST group were (1.82 ± 0.64) μg/L,(10.46 ± 3.75) μg/L,(18.89 ± 6.86) μg/L,respectively.The mean value of serum HMGB1 level in mild group was significantly higher than that in control group,while significantly lower than that in ACST group (P ＜ 0.05).Compared to the control group,the HMGB1 mRNA level in patients of AC increased significantly and the level of ACST group was higher than that of mild group.The serum HMGB1 levels of patients with positive bile or/and blood cultures were higher than that of negative.After emergency endoscopic nasal biliary drainage,the serum HMGB1 levels of patients significantly decreased compared to preoperational (P ＜ 0.05).The HMGB1 levels were significantly positively correlated with white cell counts,C-reactive protein (CRP),total serum bilirubin,direct bilirubin and alkaline phosphatase (ALP).By logistic regression analysis,serum HMGB1 levels had correlation with severity of disease.Conclusion Serum HMGB1 levels significantly increased in patients with AC and the serum concentrations of ACST group were higher than those of mild group.Serum HMGB1 level has a correlation with sepsis.ENBD could lower its serum levels.Serum HMGB1 has predictive value to severity of disease.

Objective To evaluate the value of bedside index for severity in acute pancreatitis (BISAP) in predicting the severity and prognosis of acute pancreatitis (AP) by comparison with traditional scoring systems.MethodsFour hundred ninety-seven patients of AP admitted into Wuxi People's Hospital from January 2005 to December 2010 were studied retrospectively.BISAP,APACHE Ⅱ,Ranson and Balthazar CT (CTSI) scores were calculated,respectively,in order to evaluate the severity.The AUC of ROC was used to evaluate the ability of BISAP and the other scoring systems in predicting the severity of AP and the occurrence of pancreatic necrosis,organ failure and mortality.Results Among 497 patients,mild acute pancreatitis (MAP) was identified in 396 patients and severe acute pancreatitis (SAP) in 101 patients.The gender,age and etiological factors between MAP and SAP were not statistical different.The BISAP,APACHE Ⅱ,Ranson scores of the 4 9 7 patients were 1.08 ± 1.01,5.79 ± 4.00,1.69 ± 1.59,and the scores were intercorrelated(r =0.612,0.568,0.577,P ＜0.001).In addition,the BISAP,APACHE Ⅱ,Ranson scores of SAP patients were significantly higher than those in MAP patients.The AUC of BISAP for SAP was 0.762(95％ CI 0.722 ～0.799),when the cutoff value was 2,the sensitivity,specificity,positive predictive value (PPV),negative predictive value ( NPV ) were 63.39％,83.08％,48.1％,89.4％ ; the AUC of BISAP for pancreatic necrosis was 0.711 (95％ CI 0.612 ～ 0.797),when the cutoff value was 2,the sensitivity,specificity,PPV,NPV were 84.6％,46.7％,35.5％,89.7％ ; the AUC of BISAP for organ failure was 0.777( 95％ CI0.683 ～ 0.854),when the cutoff value was 2,the sensitivity,specificity,PPV,NPV were 93.1％,51.4％,43.5％,94.9％ ; the AUC of BISAP for mortality was 0.808(95％ CI 0.718 ～0.880),when the cutoff value was 3,the sensitivity,specificity,PPV,NPV were 83.3％,67.4％,25.6％,96.8％.In the cases of SAP,the ability of BISAP and the other scoring systems in predicting the prognosis showed no statistical difference.ConclusionsThe BISAP has the prediction ability for AP severity and prognosis similar to other scoring systems,and it consists of only 5 parameters and can be completed in the fast 24 h of admission,therefore it can be used for early predication of SAP,which is worth of clinical application.

Objective To report experience of minimally invasive surgery of urinary calculi caused by melamine in infants. Methods Retrospectively reviewed the treatments and outcomes of 36 cases with urinary calculi caused by melamine from November 2007 to October 2008. 13 girls and 23 boys aged 8 to 36 months after daily consumption for six month or more of milk products tainted with melamine. These infants underwent MPCNL, ureteroscopic lithotripsy and placement of ureteral stent, respectively. Results The operations were performed successfully in all patients. Five cases underwent MPCNL. Ureteroscopic lithotripsy were performed in fourteen cases. Seventeen cases were placed of ureteral stents. No major complications like hemorrhea, perforation and organic injury were noted. The postoperative hospital stays were 3 to 10 days. All cases were followed up for 1 to 12 months. Calculus had no recurrence. Hydronephrosis and hydroureterosis disappeared or lightened. Growth and development were normal. Conclusions Various kinds of minimally invasive surgical procedures is safe and effective treatments for urinary calculi caused by melamine in infants, applicable in calculi with urinary obstruction especially.