Objective To explore the relationship between the ferroptosis-related molecules heme oxygenase-1(HMOX1)and mitogen-activated protein kinase 14(MAPK14)with the onset and prognosis of acute lung injury(ALI)in children with sepsis.Methods A total of 102 children with sepsis were selected,including 54 in the ALI group and 48 in the non-ALI group.Clinical data,laboratory tests,organ function scores and serum levels of HMOX1 and MAPK14 were compared between the two groups.The mortality rates of children with different levels of HMOX1 and MAPK14 at 28-day and 90-day were analyzed.Results Compared with the non-ALI group,procalcitonin(PCT),lactate(Lac),pediatric organ dysfunction Logistic-2 score(PELOD-2),pediatric risk of mortality score version 3(PRISM III)and sequential organ failure assessment(SOFA)scores were increased in the ALI group(P＜0.05).Serum levels of HMOX1 and MAPK14 were significantly higher in the ALI group than those in the non-ALI group(P＜0.05).HMOX1 and MAPK14 showed good predictive value for the occurrence of ALI in sepsis patients,with AUC values of 0.872(95%CI:0.791-0.930)and 0.825(95%CI:0.737-0.893),and the optimal cutoff values were 3.1 μg/L and 3.8 μg/L,respectively.After grouping by the cutoff values of HMOX1 and MAPK14,there were no significant differences in the 28-day and 90-day mortality rates in children with different levels of HMOX1 and MAPK14(P＞0.05).Conclusion The expression levels of serum HMOX1 and MAPK14 increase in the early stage of sepsis-related ALI,which may serve as biomarkers for the onset of ALI,and they have no significant impact on the prognosis of children.

Objective To analyze the temporal changing trend of postoperative pneumonia(POP)monitoring data in a tertiary first-class cancer hospital in Fujian Province from 2018 to 2023,and provide reference for the effective-ness of implementation of healthcare-associated infection(HAI)prevention and control measures.Methods The temporal changing trend of POP monitoring data of cancer patients in this hospital from 2018 to 2023 was analyzed by Joinpoint regression model,and the average annual percentage change(AAPC)was calculated.Results From 2018 to 2023,the POP incidences of all cancer patients and patients with different tumors in this hospital were as follows:3.46％in all cancer patients,4.77％,18.16％,11.50％,4.66％,0.85％,3.74％,and 0.46％in pa-tients with lung cancer,esophageal cancer,gastric cancer,intestinal cancer,gynecological tumors,hepatobiliary-pancreatic tumor,as well as head and neck tumors,respectively.From 2018 to 2023,the POP incidence of all can-cer patients in the hospital decreased from 5.47％to 1.73％,and POP incidences of patients with lung cancer,gas-tric cancer,and intestinal cancer decreased from 12.23％,14.93％,and 4.40％to 2.60％,3.73％,and 2.09％,respectively.Joinpoint regression model analysis showed that from 2018 to 2023,the AAPC of POP incidence of all cancer patients in the hospital was-19.78％,and the AAPCs of patients with lung cancer,gastric cancer,and in-testinal cancer were-23.69％,-27.30％,and-19.40％,respectively.The incidences of POP in all cancer pa-tients,as well as patients with lung cancer,gastric cancer,and intestinal cancer all showed downward trends,and the differences were all statistically significant(all P＜0.05).According to age,the AAPCs of the ≤60 and＞60 year old groups were-22.02％and-20.48％,respectively,both groups showed statistically significant difference in trends(both P＜0.05).In terms of gender,the AAPCs of the male and female groups were-16.56％and-28.35％,respectively,both groups showed statistically significant difference in trends(both P＜0.05).From 2018 to 2023,Klebsiella pneumoniae showed a significant upward trend in the constituent of POP pathogens in cancer patients,with an AAPC of 6.92％,and the difference was statistically significant(P＜0.05).Conclusion The incidences of POP in some cancer patients in the hospital present significant downward trends,indicating that HAI infection prevention and control measures are effective,but it is still necessary to strengthen the meticulous management of the whole perioperative process.

Objective To analyze the temporal changing trend of postoperative pneumonia(POP)monitoring data in a tertiary first-class cancer hospital in Fujian Province from 2018 to 2023,and provide reference for the effective-ness of implementation of healthcare-associated infection(HAI)prevention and control measures.Methods The temporal changing trend of POP monitoring data of cancer patients in this hospital from 2018 to 2023 was analyzed by Joinpoint regression model,and the average annual percentage change(AAPC)was calculated.Results From 2018 to 2023,the POP incidences of all cancer patients and patients with different tumors in this hospital were as follows:3.46％in all cancer patients,4.77％,18.16％,11.50％,4.66％,0.85％,3.74％,and 0.46％in pa-tients with lung cancer,esophageal cancer,gastric cancer,intestinal cancer,gynecological tumors,hepatobiliary-pancreatic tumor,as well as head and neck tumors,respectively.From 2018 to 2023,the POP incidence of all can-cer patients in the hospital decreased from 5.47％to 1.73％,and POP incidences of patients with lung cancer,gas-tric cancer,and intestinal cancer decreased from 12.23％,14.93％,and 4.40％to 2.60％,3.73％,and 2.09％,respectively.Joinpoint regression model analysis showed that from 2018 to 2023,the AAPC of POP incidence of all cancer patients in the hospital was-19.78％,and the AAPCs of patients with lung cancer,gastric cancer,and in-testinal cancer were-23.69％,-27.30％,and-19.40％,respectively.The incidences of POP in all cancer pa-tients,as well as patients with lung cancer,gastric cancer,and intestinal cancer all showed downward trends,and the differences were all statistically significant(all P＜0.05).According to age,the AAPCs of the ≤60 and＞60 year old groups were-22.02％and-20.48％,respectively,both groups showed statistically significant difference in trends(both P＜0.05).In terms of gender,the AAPCs of the male and female groups were-16.56％and-28.35％,respectively,both groups showed statistically significant difference in trends(both P＜0.05).From 2018 to 2023,Klebsiella pneumoniae showed a significant upward trend in the constituent of POP pathogens in cancer patients,with an AAPC of 6.92％,and the difference was statistically significant(P＜0.05).Conclusion The incidences of POP in some cancer patients in the hospital present significant downward trends,indicating that HAI infection prevention and control measures are effective,but it is still necessary to strengthen the meticulous management of the whole perioperative process.

Objective To explore the relationship between the ferroptosis-related molecules heme oxygenase-1(HMOX1)and mitogen-activated protein kinase 14(MAPK14)with the onset and prognosis of acute lung injury(ALI)in children with sepsis.Methods A total of 102 children with sepsis were selected,including 54 in the ALI group and 48 in the non-ALI group.Clinical data,laboratory tests,organ function scores and serum levels of HMOX1 and MAPK14 were compared between the two groups.The mortality rates of children with different levels of HMOX1 and MAPK14 at 28-day and 90-day were analyzed.Results Compared with the non-ALI group,procalcitonin(PCT),lactate(Lac),pediatric organ dysfunction Logistic-2 score(PELOD-2),pediatric risk of mortality score version 3(PRISM III)and sequential organ failure assessment(SOFA)scores were increased in the ALI group(P＜0.05).Serum levels of HMOX1 and MAPK14 were significantly higher in the ALI group than those in the non-ALI group(P＜0.05).HMOX1 and MAPK14 showed good predictive value for the occurrence of ALI in sepsis patients,with AUC values of 0.872(95%CI:0.791-0.930)and 0.825(95%CI:0.737-0.893),and the optimal cutoff values were 3.1 μg/L and 3.8 μg/L,respectively.After grouping by the cutoff values of HMOX1 and MAPK14,there were no significant differences in the 28-day and 90-day mortality rates in children with different levels of HMOX1 and MAPK14(P＞0.05).Conclusion The expression levels of serum HMOX1 and MAPK14 increase in the early stage of sepsis-related ALI,which may serve as biomarkers for the onset of ALI,and they have no significant impact on the prognosis of children.

Objective:To investigate the safety and efficiency of depilation with intense pulsed light (IPL) in congenital microtia patients during different phase of reconstruction treatment sessions.Methods:The hairy skin was treated with the M22TM system (Lumenis, German) using a filter of 695-1 200 mm. A three pluses mode of the radiant setting with a pulse width of 3.5 ms, a delay of 60 ms, and an energy density of 16-18 mJ/cm 2 was applied in the expanded patients. Depilation efficacy was evaluated as follows: excellent (hair density reduction >75%), good (50%-75%), fair (25%-50%), and poor (<25%). The depilation effect was compared between different phases. And the adverse effect was observed. Results:A total of 131 cases were included. There was no difference of the hair density reduction between patients with different expander volume after same IPL depilation treatments [15 (13-19) vs. 16 (15-19) root/cm 2, Wilcoxon rank analysis]. The hair density reduction in the expansion group was lower than the non-expansion group after two IPL depilation treatments [15 (13-19) vs. 17 (15-21) root/cm 2, P<0.05, Wilcoxon rank analysis]. The depilation efficacy was highly related with the numbers of IPL depilation treatments the patients received [Kendall′ stat b=0.74 (95% CI: 0.71-0.77), P<0.05]. There were 3 cases of folliculitis, 2 cases of blisters occurred in this study, and no expander exposure and cartilage absorption were observed. Conclusions:Hair removal with IPL is a safe and effective photo-epilation method during all stages of ear reconstruction using tissue expander. The volume of the expander does not significantly affect the hair removal efficiency. Depilation in the expansion phase is more efficient than that in the non-expansion phase, and the ideal result of " hair-free" or " less hairy" reconstructed ears can be achieved in 5 treatments, with suboptimal results in 3 treatments.

Objective To explore the mechanobiological mechanism of fluid shear force(FSF)on the protection,injury,and destruction of the structure and function of the blood-brain barrier(BBB)under normal physiological conditions,ischemic hypoperfusion,and postoperative hyperperfusion conditions.BBB is mainly composed of brain microvascular endothelial cells.Rat brain microvascular endothelial cells(rBMECs)were used as model cells to conduct the investigation.Methods rBMECs were seeded at a density of 1×105 cells/cm2 and incubated for 48 h.FSF was applied to the rBMECs at 0.5,2,and 20 dyn/cm2,respectively,simulating the stress BBB incurs under low perfusion,normal physiological conditions,and high FSF after bypass grafting when there is cerebral vascular stenosis.In addition,a rBMECs static culture group was set up as the control(no force was applied).Light microscope,scanning electron microscope(SEM),and laser confocal microscope(LSCM)were used to observe the changes in cell morphology and cytoskeleton.Transmission electron microscope(TEM)was used to observe the tight junctions.Immunofluorescence assay was performed to determine changes in the distribution of tight junction-associated proteins claudin-5,occludin,and ZO-1 and adherens junction-associated proteins VE-cadherin and PECAM-1.Western blot was performed to determine the expression levels of tight junction-associated proteins claudin-5,ZO-1,and JAM4,adherens junction-associated protein VE-cadherin,and key proteins in Rho GTPases signaling(Rac1,Cdc42,and RhoA)under FSF at different intensities.Results Microscopic observation showed that the cytoskeleton exhibited disorderly arrangement and irregular orientation under static culture and low shear force(0.5 dyn/cm2).Under normal physiological shear force(2 dyn/cm2),the cytoskeleton was rearranged in the orientation of the FSF and an effective tight junction structure was observed between cells.Under high shear force(20 dyn/cm2),the intercellular space was enlarged and no effective tight junction structure was observed.Immunofluorescence results showed that,under low shear force,the gap between the cells decreased,but there was also decreased distribution of tight junction-associated proteins and adherens junction-associated proteins at the intercellular junctions.Under normal physiological conditions,the cells were tightly connected and most of the tight junction-associated proteins were concentrated at the intercellular junctions.Under high shear force,the gap between the cells increased significantly and the tight junction and adherens junction structures were disrupted.According to the Western blot results,under low shear force,the expression levels of claudin-5,ZO-1,and VE-cadherin were significantly up-regulated compared with those of the control group(P<0.05).Under normal physiological shear force,claudin-5,ZO-1,JAM4,and VE-cadherin were highly expressed compared with those of the control group(P<0.05).Under high shear force,the expressions of claudin-5,ZO-1,JAM4,and VE-cadherin were significantly down-regulated compared with those of the normal physiological shear force group(P<0.05).Under normal physiological shear force,intercellular expressions of Rho GTPases proteins(Rac1,Cdc42,and RhoA)were up-regulated and were higher than those of the other experimental groups(P<0.05).The expressions of Rho GTPases under low and high shear forces were down-regulated compared with that of the normal physiological shear force group(P<0.05).Conclusion Under normal physiological conditions,FSF helps maintain the integrity of the BBB structure,while low or high shear force can damage or destroy the BBB structure.The regulation of BBB by FSF is closely related to the expression and distribution of tight junction-associated proteins and adherens junction-associated proteins.

ObjectiveTo investigate the effect of Stemona tuberosa alkaloids （STA） on apoptosis and phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） and c-Jun N-terminal kinase/p38 mitogen-activated protein kinase （JNK/p38 MAPK） signaling pathways in human lung cancer A549 cells. MethodA549 cells were classified into blank group and STA groups （100， 150， 200， 250， 300 mg⋅L^-1）. Thiazole blue （MTT） assay and colony formation assay were used to evaluate the proliferation of A549 cells. Apoptosis was observed based on Hoechst 33258 staining， flow cytometry， and Annexin V-FITC/PI staining. Western blot was employed to detect the expression of apoptosis-related proteins cysteine-aspartic acid protease-3 （Caspase-3）， B-cell lymphoma-2 （Bcl-2）-associated X protein （Bax）， and Bcl-2， and the expression of PI3K， phosphorylated （p）-PI3K， Akt， p-Akt， JNK， p-JNK， p38 MAPK， and p-p38 MAPK. ResultCompared with the blank group， STA groups （150， 200， 250， 300 mg⋅L^-1） demonstrated the increase in inhibition rate of cell proliferation （P<0.01） and cell clone inhibition rate， and decrease in cell clone formation rate （P<0.01）. In comparison with the blank group， STA groups showed typical characteristics of apoptosis， such as chromatin condensation and enhanced fluorescence reaction. The apoptosis rate of STA groups was significantly higher than that of the blank group （P<0.01）. Compared with the blank group， STA （150， 200， 250， 300 mg⋅L^-1） significantly up-regulated the protein expression of Caspase-3 and Bax （P<0.05， P<0.01） and down-regulated the expression of Bcl-2 protein （P<0.01）. Compared with the blank group， STA had no significant influence on the total protein expression of PI3K， Akt， JNK， and p38 MAPK. However， STA （150， 200， 250， 300 mg⋅L^-1） significantly decreased the levels of p-PI3K and p-Akt （P<0.05， P<0.01） and increased the level of p-p38 MAPK （P<0.05， P<0.01）. Compared with the blank group， STA （200， 250， 300 mg⋅L^-1） significantly raised the level of p-JNK （P<0.05， P<0.01）. ConclusionSTA can inhibit the proliferation and induce the apoptosis of A549 cells by inhibiting PI3K/Akt signaling pathway and activating JNK/p38 MAPK signaling pathway.

OBJECTIVE Histamine is a conserved neuromodulator in mammalian brains and critically involved in many physiological functions.Understanding the precise structure of histaminergic network is the cor-nerstone in elucidating its function.METHODS Herein,using novel HDC-CreERT2 mice and genetic labeling strategies,we reconstructed a whole brain 3D structure of histaminergic neurons and their outputs at 0.32×0.32×2 μm3 pixel resolution with a cutting-edge fluorescence micro-optical sectioning tomography system(fMOST).And we dissect an appetite control circuit originating from the TMN to medial septal nucleus(MS)using fiber photometry,optogenetics,and chemogenetics interfer-ence.RESULTS We quantified the fluorescence density of all brain areas and found that histaminergic fiber density varied significantly among brain regions.The density of histaminergic fiber was positively correlated with the amount of histamine release induced by optogenetic stim-ulation or physiological aversive stimulation.Moreover,we reconstructed fine morphological structure of 60 hista-minergic neurons via sparse labeling,and uncovered the largely heterogeneous projection pattern of individual his-taminergic neuron.Lastly,we found that MS-projecting histaminergic circuit is functionally inhibited during food consumption,and bidirectionally modulates feeding behavior via downstream H2,but not H1,receptors on MS glutamatergic neurons.CONCLUSION Collectively,this study reveals an unprecedented whole-brain quanti-tative analysis of histaminergic projections at the meso-scopic level,providing a foundation for future functional histaminergic study.And we also demonstrate that this MS-projecting histaminergic circuit is critically involved in feeding,and H2Rs in MS glutamatergic neurons is a promising target for treating body weight problems.

ObjectiveTo explore the effect of low frequency or high frequency repetitive transcranial magnetic stimulation (rTMS) on right Broca's homologue in stroke patients with nonfluent aphasia. MethodsFrom January, 2019 to August, 2022, 80 inpatients in Beijing Bo'ai Hospital were randomly divided into control group (n = 20), sham stimulation group (n = 20), low-frequency (1 Hz) rTMS (LF-rTMS) group (n = 20) and high-frequency (10 Hz) rTMS (HF-rTMS) group (n = 20). All the patients received routine language therapy. LF-rTMS group and HF-rTMS group received ten days of rTMS (1 Hz or 10 Hz), and the sham group received ten days of sham rTMS. The Western Aphasia Battery (WAB) was used to evaluate the language function before, after treatment, and two months after treatment. ResultsBefore treatment, there was no significant difference in the scores of WAB among four groups (P > 0.05). All the scores improved in the four groups immediately after treatment and two months after treatment (P < 0.05). Compared with immediately after treatment, all the scores of WAB improved in LF-rTMS group (P < 0.05), and the scores of recall, name and aphasia quotient (AQ) improved in HF-rTMS group (P < 0.05) two months after treatment. Immediately after treatment, the scores of content and fluency, auditory comprehension and AQ were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). Two months after treatment, the scores of content and fluency were higher in LF-rTMS group than in HF-rTMS group (P < 0.05). ConclusionBoth 1 Hz and 10 Hz rTMS could improve the language function of stroke patients with nonfluent aphasia, especially 1 Hz.

Objective:To evaluate the clinical effect of total-model fractional CO 2 laser in the treatment of atrophic acne scar. Methods:A retrospective analysis was performed on the clinical data of patients with atrophic acne scar treated by total-model fractional CO 2 laser(Deep FX+ Active FX+ CW) in Laser Aesthetic Center of Plastic Surgery Hospital, Chinese Academy of Medical Sciences from January 2017 to September 2019. CW mode and/or Active FX mode was used to fine grinding of the scar edge, and Active FX mode and Deep FX mode were used to scan the whole area acne scar involved. The treatment was performed 3-5 times with an interval of more than 3 months. Two attending physicians who were not involved in the study evaluated the photos of patients before treatment and 3-5 times after treatment with the Global Aesthetic Improvement Scale (GAIS) and the Echelle d’Evaluation Clinique des Cicatrices d’acne (ECCA). Acne scar and overall facial skin quality were assessed with GAIS, a total score of 1 to 3, with a score 1 indicating deterioration and a score 3 indicating significant improvement. The severity and density of acne scarring were assessed with ECCA, with the higher the score, the more severe it is. The international numeric rating scale (NRS) was used to rate the pain immediately after treatment (0-10 points), with 0 indicating no pain and 10 indicating extreme pain. Side effects such as the occurrence of crusts, erythema, pigmentation and acne-like rash were observed. SPSS 24.0 was used for statistical analysis, and the measurement data were expressed by Mean±SD. Paired t-test was used for ECCA scores before and after treatment, and P<0.05 was considered as statistically significant difference. Results:A total of 75 patients were included in this study, including 16 males and 59 females, aged 27.2±6.2 years (19-49 years). Among them, the improvement in acne scar and overall facial skin quality were excellent in 12 cases, significant in 34 cases, median in 24 cases and poor in 5 cases. GAIS score was 1.62±0.77. The ECCA score was 157.20±18.89 before treatment and 138.93±23.62 after treatment, showing significant difference ( t=9.41, P<0.001). The pain score was 4.65±1.52 and disappeared spontaneously about 2-4 hours after operation. The scab stage was 6.65±0.89 days, and the erythema stage was 3.09±0.70 weeks. The post-inflammatory hyperpigmentation case occurred in 1.3% (1/75) and lasted for 4 months. Acne-like rash occurred in 16.0% (12/75), which relieved by external smear of fusidic acid. No blisters, hypopigmentation, bacterial or viral infection, scar formation and other adverse reactions happened. Conclusions:The total-mode fractional CO 2 laser is effective and safe in the treatment of facial atrophic acne scar.