Objective:This study aims to construct a monitoring index system for early child development(ECD)that is consistent with China's actual situation,to scientifically and systematically evaluate the level of ECD and service capacity in various regions.Methods:The study was predicated on the theoretical foundation of the Nutrition Care Framework(NCF).Indicators were initially selected through a literature review and focus group interviews.The evaluation indicators were then determined through two rounds of expert consultation utilising the Delphi method.The Priority Sequence Diagram Method(PSDM)was subsequently implemented to determine indicator weights.Results:The final framework encompasses six first-level indicators(good health,adequate nutrition,responsive caregiving,opportunities for learning,security and safety,and demand and investment),12 second-level indicators,and 31 third-level indicators.Conclusion:The ECD index system constructed in this study integrates macro,meso,and micro levels,emphasises cross-sectoral collaboration and attention to child caregivers,and incorporates equity indicators to measure regional disparities.The research outcomes provide a reference for quantitatively assessing the level of ECD and service capacity across various regions in China.By leveraging mechanisms for cross-sectoral collaboration and goal-oriented approaches,the study provides a framework for the allocation of resources to key areas,thus laying the foundation for the sustained implementation and resource assurance of the child-priority development strategy.

A recombinant adenovirus(rAd)for expression of Mycobacterium tuberculosis(M.tb)c-di-AMP phosphodiesterase CnpB was constructed,and its induced humoral immune response was detected.The codon-optimized gene of M.tb CnpB was cloned into the adenoviral plasmid pcADV.The recombinant plasmid pcADV-CnpB was transfected into HEK293T cells,and expression was detected with Western blot.The recombinant plasmid pcADV-CnpB and the backbone plasmid were co-transfected into HEK293T cells to obtain the recombinant adenovirus rAd-CnpB.rAd-CnpB was amplified in HEK293T cells,and the target protein expression of rAd-CnpB was detected with Western blot and immunofluorescence.Mice were immunized with rAd-CnpB intranasally,and their sera and bronchoalveolar lavage fluid(BALF)were collected.ELISA was used to detect levels of antigen-specific antibodies.Restriction enzyme digestion and sequencing indicated that the recombinant plasmid pcADV-CnpB was successfully constructed and led to protein expression in eukaryotic cells.rAd-CnpB was packaged and produced in HEK293T cells.After amplification and purification,rAd-CnpB with a titer of 5.53×1010 PFU/mL was obtained.rAd-CnpB led to CnpB expression in HEK293T cells.Intranasal immunization with rAd-CnpB increased levels of IgG and secretory IgA in BALF and led to high levels of IgG in sera.rAd-CnpB,the recombinant adenovirus for expression of c-di-AMP phosphodiesterase CnpB was successfully constructed,and was found to induce antigen-specific humoral and mucosal immune responses through mucosal immunization.Thus,rAd-CnpB may be used in further research on new TB vaccine strategies.

This study assessed the role and mechanism of the recombinant Bacillus Calmette-Gue?rin vaccine(rBCG)with c-di-AMP adjuvant in regulating metabolism and immunity in epididymal white adipose(eWAT)in mice.Male C57BL/6 mice were intravenously immunized with BCG and rBCG,and their body weights were monitored.eWAT was isolated from the mice,and the stromal vascular fractions(SVFs)cell number was counted with a hemocytometer.Sections of mouse adipose tissue were prepared,and the size,number,and morphology of eWAT adipocytes and crown-like structure(CLS)formation were compared under a microscope after HE staining.The transcription levels of lipid metabolism-associated factors,cytokines and aging-associated genes in each group were determined with qRT-PCR.The body weights of mice gradually increased after immunization with BCG and rBCG.The proportions of eWAT increased,and the SVFs cell number decreased,in rBCG immunized mice.HE staining indicated that BCG immunization promoted hyperplasia,whereas rBCG immunization promoted hypertrophy of eWAT adipocytes;moreover,both BCG and rBCG immunization induced CLS formation in eWAT.The qRT-PCR results indicated that rBCG immunization inhibited the expression of genes associated with lipolysis and energy expenditure in eWAT.BCG immunization had little effect on cytokine transcription,whereas rBCG significantly induced the transcription of IFN-γ and IL-1Ra,and inhibited that of IL-15 and IL-2,but did not induce the expression of aging-associated genes.Thus,rBCG immunization induced eWAT adipocyte hypertrophy,which was associated with the inhibition of eWAT lipolysis and the regulation of cytokine expression.

Objective:To analyze the effects of different doses of butorphanol on prolactin, serotonin and lipid hydrogen peroxide after cesarean section.Methods:A total of 124 women who underwent cesarean section in the Affiliated Hospital of Jining Medical University from January 2023 to January 2024 were prospectatively selected as study subjects, and divided into the study group 1 (41 cases), study group 2 (41 cases) and study group 3 (42 cases) according to random number table method. All three groups underwent patient-controlled analgesia after surgery, and 0.2 mg fentanyl was used as analgesic drug. However, the doses of butorphanol were 100 mg/L in the study group 1, 120 mg/L in the study group 2, and 140 mg/L in the study group 3. The level of PRL and first lactation time before and after surgery were compared among the three groups at different time points, serotonin and LHP levels were compared among the three groups at different time points after surgery, Ramsay and visual analog scale (VAS) scores were compared among the three groups at different time points after surgery, and the occurrence of adverse reactions and satisfaction with analgesic effect were compared among the three groups.Results:At 24, 48 and 72 h after operation, the level of PRL in the study group 3 was higher than that in the study group 2 and study group 1: (383.02 ± 47.57) μg/L vs. (376.39 ± 46.83), (302.88 ± 41.38) μg/L; (412.38 ± 40.22) μg/L vs. (394.82 ± 38.30), (315.09 ± 37.93) μg/L; (434.39 ± 39.39) μg/L vs. (427.48 ± 40.27), (344.39 ± 42.78) μg/L, there were statistical differences ( P<0.05). The first lactation time in the study group 2 and study group 3 was lower than that in the study group 1: (50.31 ± 6.52), (49.54 ± 6.27) h vs. (53.91 ± 8.42) h, there was statistical difference ( P<0.05). At 2 h (T 1), 12 h (T 2), 24 h (T 3) and 48 h (T 4) after surgery, the levels of serotonin in the study group 3, study group 2 and study group 1 were increased successively, and the levels of LHP were decreased successively, there were statistical differences ( P<0.05). At 30 min after surgery (T 0), T 1, T 2, T 3 and T 4, the Ramsay score in the study group 3, study group 2 and study group 1 were increased successively, and the VAS score were decreased successively, there were statistical differences ( P<0.05). There was no significant difference in the incidence of adverse reactions among the three groups ( P>0.05). The total satisfaction of study group 3 was higher than that of study group 2 and study group 1: 92.86%(39/42) vs. 73.17%(30/41), 68.29%(28/41), there was statistical difference ( Z = 2.52, P = 0.008). Conclusions:Butorphanol 140 mg/L has a more significant analgesic effect after cesarean section, and can improve the levels of serum PRL, serotonin and LHP, reduce the occurrence of adverse reactions, and improve the satisfaction of analgesia

Objective:To investigate the value of biparametric-MRI (bpMRI) based peritumoral radiomics for preoperative prediction of extraprostatic extension (EPE) in prostate cancer (PCa).Methods:In this cross-sectional study, consecutive bpMRI of patients undergoing prostatectomy for PCa were retrospectively collected from the First Medical Center (center 1) and the Third Medical Center (center 2) of Chinese PLA General Hospital. A total of 274 patients were finally enrolled. Patients at center 1 from January 2020 to December 2022 were randomly divided into a training set (149 cases) and an internal validation set (63 cases) by stratified random sampling. Patients at center 2 from January 2023 to March 2024 were assigned to the external test set (62 cases). Patients were categorized into EPE-positive group and EPE-negative group according to pathological assessment postoperatively. In the training set, there were 49 cases in EPE-positive group and 100 cases in EPE-negative group. In the internal validation set, there were 26 cases in EPE-positive group and 37 cases in EPE-negative group. In the external test set, there were 22 cases in EPE-positive group and 40 cases in EPE-negative group. Axial T 2WI and apparent diffusion coefficient (ADC) images were manually annotated to obtain index lesion regions of interest (ROIs), with the peritumoral ROIs subsequently delineated by semi-automatic segmentation technique. Radiomics features were extracted from intra-tumoral, peri-tumoral, and intra-tumoral plus peri-tumoral ROIs. The training set data was employed to select and optimize features to build the radiomics models. The logistic regression analysis was used to develop radiomics, clinical, and integrated models. The predictive performance was assessed by the area under the receiver operating characteristic curve (AUC) in the external test set, and compared by the DeLong test. The sensitivity and specificity were compared by the exact McNemar test. Results:In the external test set, the peri-tumoral radiomics model based on bpMRI showed the highest performance in evaluating EPE, with an AUC of 0.739 (95% CI 0.611-0.842), which was identified as the optimal radiomics model. EPE grade ( OR=6.151, 95% CI 3.371-11.226, P<0.001) was incorporated into the clinical model, with an AUC of 0.780 (95% CI 0.657-0.875) in the external test set. The integrated model had an AUC of 0.817 (95% CI 0.698-0.904) in the external test set. There was no statistically significant difference in comparisons of AUCs among the three models (all P>0.05). The sensitivity of the integrated model (68.2%) showed no significant difference from those of the clinical model and the optimal radiomics model (77.3% and 86.4%, respectively; P=0.500 and P=0.289). However, the specificity of the integrated model (85.0%) was significantly higher than those of the clinical model (67.5%, P=0.016) and the optimal radiomics model (50.0%, P<0.001). Conclusion:A bpMRI-based peritumoral radiomics integrating clinical model demonstrates high performance for preoperative prediction of EPE in PCa.

AIM To compare total sugar,total protein,total phenol,total flavonoid,calycosin-7-O-β-D-glucoside,liquiritin,lobetyolin,quercetin,isoferulic acid,hesperidin,glycyrrhizic acid contents and their antioxidant activities,hypoglycemic activities of big honey pill,small honey pill,water pill,concentrated pill,granule,mixture and decoction of Buzhong Yiqi Recipe.METHODS Anthraquinone-sulfuric acid method,Coomassie brilliant blue method,Folin-phenol colorimetry method,sodium nitrite-aluminum nitrate method and HPLC were adopted in the content determination of total sugar,total protein,total phenol,total flavonoid and seven constituents,respectively,after which the scavenging capacities,reducing powers on DPPH·free radical,ABTS+free radical,hydroxyl free radical,and inhibition capacity on α-glucosidase activity were detected.Subsequently,correlation analysis was performed.RESULTS Total sugar,total protein,total phenol and total flavonoid contents demonstrated significant differences among different dosage forms(P＜0.05,P＜0.01).Calycosin-7-O-β-D-glucoside,glycyrrhizin,codonoside and quercetin displayed the highest contents in the decoction,while those of isoferulic acid,hesperidin and glycyrrhizin were observable in the mixture.The water pill exhibited the strongest antioxidant activity,while those of the concentrated pill and mixture were weak;the big honey pill exhibited the strongest hypoglycemic activity,while that of the decoction was the weakest.Total protein,total phenol,total flavonoid and liquiritin contents displayed significant positive correlations between antioxidant activity(P＜0.05,P＜0.01),while hesperidin content displayed significant negative correlation between the latter(P＜0.05);total protein,calycosin-7-O-β-D-glucoside,codonoside and quercetin contents displayed significant negative correlations between hypoglycemic activity(P＜0.05,P＜0.01).CONCLUSION Active constituent contents and their biological activities of Buzhong Yiqi Recipe with different dosage forms exist differences,total sugar,total protein,total flavonoids,calycosin-7-O-β-D-glucoside,licorice glycoside,hesperidin,codonoside and quercetin can be taken as quality control indices for this prescription.

AIM To compare the chemical constituents in traditional decoction and formula granule decoction of classical famous prescription Wendan Decoction.METHODS The HPLC fingerprints were established,after which the contents of adenosine,synephrine,liquiritin,naringin,hesperidin,6-gingerol and adenosine cyclophosphate were determined,cluster analysis,principal component analysis and multidimensional scaling analysis were adopted in the investigation of component differences,and the equivalent of formula granules was adjusted.RESULTS The similarities of HPLC fingerprints for 10 batches of traditional decoctions were higher than those of HPLC fingerprints for 9 batches of formula granule decoctions(P＜0.01).Adenosine,synephrine,liquiritin,hesperidin and cyclic adenosine monophosphate demonstrated higher contents in traditional decoctions than those in formula granule decoctions(P＜0.05),6-gingerol displayed lower content than that in the latter produced by manufacturers A,C(P＜0.05),which was higher than that in the latter produced by manufacturer B(P＜0.01).Various batches of traditional decoctions and formula granule decoctions could be obviously distinguished,adenosine,synephrine and hesperidin exhibited great influences on the classification of principal component analysis,and the quality of formula granule decoctions produced by manufacturer C was closer to that of traditional decoctions.After equivalent correction,the contents of various constituents in formula granule decoctions produced by manufacturers A,C showed no significant differences as compared with those in traditional decoction(P＞0.05).CONCLUSION The formula granules of Wendan Decoction from different manufacturers exist quality differences,so the preparation process and extraction process of this preparation should be optimized to improve quality,and equivalent ratio should be adjusted according to actual requirements to ensure its scientific and rational clinical application.

Objective:To analyze the effects of different doses of butorphanol on prolactin, serotonin and lipid hydrogen peroxide after cesarean section.Methods:A total of 124 women who underwent cesarean section in the Affiliated Hospital of Jining Medical University from January 2023 to January 2024 were prospectatively selected as study subjects, and divided into the study group 1 (41 cases), study group 2 (41 cases) and study group 3 (42 cases) according to random number table method. All three groups underwent patient-controlled analgesia after surgery, and 0.2 mg fentanyl was used as analgesic drug. However, the doses of butorphanol were 100 mg/L in the study group 1, 120 mg/L in the study group 2, and 140 mg/L in the study group 3. The level of PRL and first lactation time before and after surgery were compared among the three groups at different time points, serotonin and LHP levels were compared among the three groups at different time points after surgery, Ramsay and visual analog scale (VAS) scores were compared among the three groups at different time points after surgery, and the occurrence of adverse reactions and satisfaction with analgesic effect were compared among the three groups.Results:At 24, 48 and 72 h after operation, the level of PRL in the study group 3 was higher than that in the study group 2 and study group 1: (383.02 ± 47.57) μg/L vs. (376.39 ± 46.83), (302.88 ± 41.38) μg/L; (412.38 ± 40.22) μg/L vs. (394.82 ± 38.30), (315.09 ± 37.93) μg/L; (434.39 ± 39.39) μg/L vs. (427.48 ± 40.27), (344.39 ± 42.78) μg/L, there were statistical differences ( P<0.05). The first lactation time in the study group 2 and study group 3 was lower than that in the study group 1: (50.31 ± 6.52), (49.54 ± 6.27) h vs. (53.91 ± 8.42) h, there was statistical difference ( P<0.05). At 2 h (T 1), 12 h (T 2), 24 h (T 3) and 48 h (T 4) after surgery, the levels of serotonin in the study group 3, study group 2 and study group 1 were increased successively, and the levels of LHP were decreased successively, there were statistical differences ( P<0.05). At 30 min after surgery (T 0), T 1, T 2, T 3 and T 4, the Ramsay score in the study group 3, study group 2 and study group 1 were increased successively, and the VAS score were decreased successively, there were statistical differences ( P<0.05). There was no significant difference in the incidence of adverse reactions among the three groups ( P>0.05). The total satisfaction of study group 3 was higher than that of study group 2 and study group 1: 92.86%(39/42) vs. 73.17%(30/41), 68.29%(28/41), there was statistical difference ( Z = 2.52, P = 0.008). Conclusions:Butorphanol 140 mg/L has a more significant analgesic effect after cesarean section, and can improve the levels of serum PRL, serotonin and LHP, reduce the occurrence of adverse reactions, and improve the satisfaction of analgesia

Objective:Invasive pulmonary mucormycosis(PM)is a rare but highly lethal opportunistic infection.COVID-19 associated mucormycosis(CAM)is difficult to diagnose,often leading to misdiagnosis or missed diagnosis,and has poor treatment outcomes.This study reports a case of successfully treated CAM and explores optimized diagnostic and therapeutic strategies.Methods:A retrospective analysis of the diagnosis and treatment process in a 50-year-old female patient with COVID-19 associated with diabetic ketoacidosis(DKA)and invasive pulmonary mucormycosis was conducted.Combined with a literature review,the therapeutic efficacy of local bronchoscopic instillation in conjunction with systemic treatment using liposomal Amphotericin B(L-AmB)was specifically evaluated.Results:The patient was rapidly diagnosed with Rhizopus microsporus infection through metagenomic next-generation sequencing(mNGS).She subsequently received antifungal treatment with intravenous L-AmB combined with local bronchoscopic instillation.After treatment,the patient was significantly improved,with imaging studies showing gradual absorption of the lesions.Follow-up at six months revealed no recurrence.A literature review suggests that early diagnosis and multimodal therapy are key to improving survival rates in patients with CAM.Conclusion:mNGS can significantly improve the early diagnosis rate of CAM.The combination of local and systemic treatment with L-AmB is valuable in improving prognosis.Early diagnosis,multimodal antifungal therapy,and individualized management are key to increasing the survival rate of patients with CAM.

Objective:Invasive pulmonary mucormycosis(PM)is a rare but highly lethal opportunistic infection.COVID-19 associated mucormycosis(CAM)is difficult to diagnose,often leading to misdiagnosis or missed diagnosis,and has poor treatment outcomes.This study reports a case of successfully treated CAM and explores optimized diagnostic and therapeutic strategies.Methods:A retrospective analysis of the diagnosis and treatment process in a 50-year-old female patient with COVID-19 associated with diabetic ketoacidosis(DKA)and invasive pulmonary mucormycosis was conducted.Combined with a literature review,the therapeutic efficacy of local bronchoscopic instillation in conjunction with systemic treatment using liposomal Amphotericin B(L-AmB)was specifically evaluated.Results:The patient was rapidly diagnosed with Rhizopus microsporus infection through metagenomic next-generation sequencing(mNGS).She subsequently received antifungal treatment with intravenous L-AmB combined with local bronchoscopic instillation.After treatment,the patient was significantly improved,with imaging studies showing gradual absorption of the lesions.Follow-up at six months revealed no recurrence.A literature review suggests that early diagnosis and multimodal therapy are key to improving survival rates in patients with CAM.Conclusion:mNGS can significantly improve the early diagnosis rate of CAM.The combination of local and systemic treatment with L-AmB is valuable in improving prognosis.Early diagnosis,multimodal antifungal therapy,and individualized management are key to increasing the survival rate of patients with CAM.