Objective To analyze the clinical characteristics of patients with gastrointestinal bleeding after renal transplantation and summarize the diagnostic and therapeutic experience. Methods Clinical data of 16 patients with gastrointestinal bleeding after renal transplantation admitted to the Third Affiliated Hospital of Sun Yat-sen University from January 2015 to January 2025 were collected, including clinical manifestations, laboratory tests and auxiliary examination results such as gastroscopy and colonoscopy. The bleeding sites, causes, treatment plans and outcomes of the patients were analyzed, and relevant literature was reviewed. Results Among the 16 patients with gastrointestinal bleeding, 12 had upper gastrointestinal bleeding (3 with esophageal bleeding, 7 with gastric bleeding and 2 with duodenal bleeding) and 4 had lower gastrointestinal bleeding (2 with ileal bleeding and 2 with anal bleeding). Among the 16 patients, the 4 with lower gastrointestinal bleeding all presented with hematochezia. Of the 12 with upper gastrointestinal bleeding, 2 patients only had positive fecal occult blood and decreased hemoglobin levels without hematemesis or melena, 9 patients had melena and 1 patient had hematemesis. The hemoglobin levels of the 16 patients were (71±18) g/L. One patient had symptoms of shock, 9 had symptoms of anemia such as dizziness, fatigue and chest tightness, and 6 had good general conditions. Among the 16 patients, 10 had mild gastrointestinal bleeding and stable general conditions, which were curable by drugs. Two patients with peptic ulcers and exposed vessels on gastroscopy were treated with hemostasis by titanium clips. One patient with gastroesophageal tear was treated with hemostasis by titanium clips. One patient with esophageal variceal rupture bleeding was treated with endoscopic variceal ligation. One patient with hemorrhoidal bleeding underwent selective annual resection of the superior hemorrhoidal mucosa with stapled hemorrhoidopexy. One patient with active ileal bleeding on emergency enhanced abdominal CT was treated with endovascular embolization of the mesenteric artery. One patient was discharged automatically due to coma caused by extensive cerebral infarction, and the remaining patients were all cured and discharged with good prognosis. Conclusions Gastrointestinal bleeding after renal transplantation has diverse clinical manifestations, varying severity and many causes. Early diagnosis and treatment should be actively carried out. In addition to drug therapy, endoscopic, interventional or surgical treatment may be used when necessary to improve the diagnostic and therapeutic effects and minimize the functional damage of gastrointestinal bleeding to the transplant kidney.

Objective:To investigate the sleep status of preschool children in Zhongshan City and the OSA-18 questionnaire scores among healthy preschool children. Methods:A cluster sampling method was adopted to select 2 222 students from 5 non-boarding kindergartens in Zhongshan from October 2022 to October 2023 as study subjects. Data were collected via an online questionnaire platform and analyzed using SPSS 27.0 statistical software. Results:A total of 1 317 valid questionnaires were collected, with an average sleep duration of（8.74±0.75） hours among children. The results of stepwise regression analysis showed that child age, prematurity, sleep latency, daily outdoor activity time, and activities within 30 minutes before bedtime were factors influencing children's nocturnal sleep duration（P<0.05）. The overall incidence of sleep disorder-related symptoms was 56.80%, including restless sleep（24.14%）, difficulty falling asleep（24.07%）, snoring with mouth breathing（14.20%）, bruxism（11.16%）, enuresis（10.55%）, sleep talking（6.08%）, limb twitching（2.74%）, and sleepwalking（0.53%）. Various factors influenced these symptoms, and binary logistic regression analysis identified allergic diseases and a smaller number of siblings at home as the most prevalent risk factors（P<0.05）. The overall OSA-18 score was 34.11±12.14, and binary logistic regression analysis identified males, allergic diseases, and tonsillar hypertrophy as risk factors for high OSA-18 scores（≥60）（P<0.05）. Conclusion:In Zhongshan City, the nocturnal sleep duration of preschool children decreases with age, with independent risk factors for this prematurity, longer sleep latency, shorter daily outdoor activity time, and the use of electronic devices within 30minute before bedtime. Allergic diseases and a smaller number of siblings at home increase the risk of sleep-disordered breathing symptoms. Males, allergic diseases, and tonsillar hypertrophy have higher OSA-18 scores.
Humans ; Child, Preschool ; Surveys and Questionnaires ; Male ; Female ; Sleep ; China/epidemiology* ; Sleep Apnea, Obstructive/epidemiology*

Objective To explore the mechanism of Scutellaria baicalensis(Huangqin)in ameliorating postoperative cognitive dysfunction in surgical patients through network pharmacology approaches combined with experimental validation.Methods Network pharmacology was used to screen the relevant targets and pathways of Huangqin in relation to postoperative cognitive dysfunction,followed by molecular docking to verify the affinity of core components with key targets.HT22 cell line of mouse hippocampal neurons was cultured,and an inflammation injury model was induced by LPS stimulation.Huangqin was selected for intervention treatment,divided into five groups:control group,model group,low-dose Huangqin group(10 μmol/L),medium-dose Huangqin group(50 μmol/L),and high-dose Huangqin group(100 μmol/L).After co-culturing for 24 h,the expression of key target proteins HIF1A,MAPK1(ERK2/p-ERK2),and SIRT1 were detected by Western blotting,and the mRNA expression of these proteins was measured by qRT-PCR.Results A total of 27 active components of Huangqin were screened by network pharmacology,corresponding to 379 targets,with 220 disease targets related to POCD,resulting in 35 intersecting genes.Molecular docking results showed that components like baicalein and oroxylin A had strong affinity with targets such as HIF1A,MAPK1,and SIRT1.In vitro experimental results indicated that baicalein significantly downregulated the expression and transcription levels of HIF1A and MAPK1(ERK2/p-ERK2),while upregulating the expression and transcription levels of SIRT1,effectively improved the inflammatory response in HT22 cells and reduced neuronal damage.Conclusion The traditional Chinese medicine Huangqin can reduce the occurrence and development of postoperative cognitive dysfunction by improving the expression of key proteins,controlling inflammatory responses,and protecting neuronal function.

OBJECTIVE To explore the effect and potential mechanisms of berberine on formation of biofilms of clinical methicillin-resistant Staphylococcus aureus(MRSA)isolates.METHODS Totally 95 clinical MRSA iso-lates were collected from Shanghai Eighth People's Hospital from Jan.2023 to Dec.2023.The 14 biofilm forma-tion-related genes in the strains were detected by polymerase chain reaction(PCR)and multiplex PCR,the mini-mum inhibitory concentration(MIC)of berberine was determined by microbroth dilution method,the effect of berberine on resistance of biofilm formation was evaluated by crustal violet staining,fluorescence microscope,Congo red agar plate and extracelluar DNA(eDNA).The transcription levels of 9 biofilm formation-related genes were detected by real-time fluorescent quantitative reverse transcription PCR.RESULTS All of the 95 strains of MRSA carried eno,clfA,clfB and icaA genes,the most widespread gene profile was bbp-eno-ebpS-fnbA-fib-clfA-clfB-icaA-sasG,and 29 strains had the phenotypes with strong capability of biofilm formation.The MIC score of berberine ranged between 64 and 1 024 μg/ml.Berberine with the concentration of 1/2 MIC could inhibit the biofilm formation of MRSA(P＜0.001),and the inhibiting rate of biofilm formation of the MIC ≥512 μg/ml group was higher than that of the MIC≤128 μg/ml group and the MIC 256 μg/ml group(all P＜0.05).The re-sult under the fluorescence microscope showed that the fluorescence intensity of biofilms decreased with the rise of berberine concentration.Berberine could reduce the formation of amyloid fibrils and the release of eDNA,down-regulating the transcription levels of ica A,sasG,ebpS,fib,eno,clfA,clfB,bbp and fnbA genes(P＜0.05).CONCLUSION Berberine may inhibit the biofilm formation of MRSA by downregulating expression levels of related genes,interfering the formation of amyloid fibrils and blocking the release of eDNA,which may provide experimental bases for development of drugs resisting to MRSA biofilms.

To investigate the expression level of costimulatory molecule B7-H3 in the tumor tissues and the level of soluble costimulatory molecule B7-H3 (sB7-H3) in the serum of patients with colorectal cancer (CRC), so as to evaluate the clinical value of sB7-H3 in auxiliary diagnosis of CRC. A cross-sectional study design was adopted. A total of 232 CRC patients, 87 patients with benign colorectal diseases, and 59 healthy subjects who were treated in Shanghai Eighth People′s Hospital from January 2020 to December 2022 were selected. The levels of sB7-H3, CEA, CA199, CA724 and CA50 in the serum were detected. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of sB7-H3 and the above-mentioned tumor markers for colorectal cancer (CRC). The expression levels of B7-H3 in CRC tissues and benign colorectal disease tissues were detected by immunohistochemistry. The relationship between the levels of sB7-H3 and clinicopathological features was analyzed statistically. The results showed that compared with the benign disease group or the healthy control respectively, the serum levels of sB7-H3, CEA, CA199, CA724 and CA50 in the CRC group were significantly increased, and the differences were statistically significant ( P<0.05). In the CRC group, the serum levels of sB7-H3 showed a weak positive correlation with CA50, CEA and CA724 (the r values were 0.220, 0.217 and 0.182 respectively; the P values were 0.005,<0.001 and 0.024 respectively), and there was no significant correlation with CA199 (the r value was 0.162; the P value were 0.051). The areas under the curve (AUC) of sB7-H3, CEA, CA199, CA724 and CA50 for diagnosing CRC were 0.862, 0.774, 0.646, 0.677 and 0.644 respectively, and the cut-off values were 20.67 ng/ml, 10.74 U/ml, 3.17 ng/ml, 3.16 U/ml, and 22.55 U/ml, respectively. Taking 20.67 ng/ml as the cut-off value, the positive rate of sB7-H3 in CRC was 62.9%, which was significantly higher than that in patients with benign colorectal diseases (35.6%) and the healthy control group (10%) ( χ2=81.995, P<0.001; χ2=103.56, P<0.001). The positive rates of sB7-H3 and CEA in patients with pathological stages Ⅲ and Ⅳ were significantly higher than those in patients with stages Ⅰ and Ⅱ ( χ2=82.876, P<0.001; χ2=22.617, P<0.001). The positive rate of sB7-H3 in patients with pathological stages Ⅰ and Ⅱ was 56.2%, which was significantly higher than that of CEA (38%) ( χ2=50.378, P<0.001). Immunohistochemistry showed that B7-H3 positive staining was mainly distributed in the cytoplasm. The positive expression rate of B7-H3 in CRC (75.8%) was significantly higher than that in benign colorectal diseases (15.4%) ( χ2=16.133, P<0.001). The serum level of sB7-H3 in CRC patients was positively correlated with the expression level of B7-H3 in tumor tissues ( r=0.766, P<0.001). The serum level of sB7-H3 was significantly correlated with distant metastasis and pathological stage of CRC ( W=899, P=0.002; H=10.465, P=0.015). In conclusion, serum level of sB7-H3 may have certain clinical value in the auxiliary diagnosis of CRC.

To investigate the expression level of costimulatory molecule B7-H3 in the tumor tissues and the level of soluble costimulatory molecule B7-H3 (sB7-H3) in the serum of patients with colorectal cancer (CRC), so as to evaluate the clinical value of sB7-H3 in auxiliary diagnosis of CRC. A cross-sectional study design was adopted. A total of 232 CRC patients, 87 patients with benign colorectal diseases, and 59 healthy subjects who were treated in Shanghai Eighth People′s Hospital from January 2020 to December 2022 were selected. The levels of sB7-H3, CEA, CA199, CA724 and CA50 in the serum were detected. The receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of sB7-H3 and the above-mentioned tumor markers for colorectal cancer (CRC). The expression levels of B7-H3 in CRC tissues and benign colorectal disease tissues were detected by immunohistochemistry. The relationship between the levels of sB7-H3 and clinicopathological features was analyzed statistically. The results showed that compared with the benign disease group or the healthy control respectively, the serum levels of sB7-H3, CEA, CA199, CA724 and CA50 in the CRC group were significantly increased, and the differences were statistically significant ( P<0.05). In the CRC group, the serum levels of sB7-H3 showed a weak positive correlation with CA50, CEA and CA724 (the r values were 0.220, 0.217 and 0.182 respectively; the P values were 0.005,<0.001 and 0.024 respectively), and there was no significant correlation with CA199 (the r value was 0.162; the P value were 0.051). The areas under the curve (AUC) of sB7-H3, CEA, CA199, CA724 and CA50 for diagnosing CRC were 0.862, 0.774, 0.646, 0.677 and 0.644 respectively, and the cut-off values were 20.67 ng/ml, 10.74 U/ml, 3.17 ng/ml, 3.16 U/ml, and 22.55 U/ml, respectively. Taking 20.67 ng/ml as the cut-off value, the positive rate of sB7-H3 in CRC was 62.9%, which was significantly higher than that in patients with benign colorectal diseases (35.6%) and the healthy control group (10%) ( χ2=81.995, P<0.001; χ2=103.56, P<0.001). The positive rates of sB7-H3 and CEA in patients with pathological stages Ⅲ and Ⅳ were significantly higher than those in patients with stages Ⅰ and Ⅱ ( χ2=82.876, P<0.001; χ2=22.617, P<0.001). The positive rate of sB7-H3 in patients with pathological stages Ⅰ and Ⅱ was 56.2%, which was significantly higher than that of CEA (38%) ( χ2=50.378, P<0.001). Immunohistochemistry showed that B7-H3 positive staining was mainly distributed in the cytoplasm. The positive expression rate of B7-H3 in CRC (75.8%) was significantly higher than that in benign colorectal diseases (15.4%) ( χ2=16.133, P<0.001). The serum level of sB7-H3 in CRC patients was positively correlated with the expression level of B7-H3 in tumor tissues ( r=0.766, P<0.001). The serum level of sB7-H3 was significantly correlated with distant metastasis and pathological stage of CRC ( W=899, P=0.002; H=10.465, P=0.015). In conclusion, serum level of sB7-H3 may have certain clinical value in the auxiliary diagnosis of CRC.

Objective To explore the mechanism of Scutellaria baicalensis(Huangqin)in ameliorating postoperative cognitive dysfunction in surgical patients through network pharmacology approaches combined with experimental validation.Methods Network pharmacology was used to screen the relevant targets and pathways of Huangqin in relation to postoperative cognitive dysfunction,followed by molecular docking to verify the affinity of core components with key targets.HT22 cell line of mouse hippocampal neurons was cultured,and an inflammation injury model was induced by LPS stimulation.Huangqin was selected for intervention treatment,divided into five groups:control group,model group,low-dose Huangqin group(10 μmol/L),medium-dose Huangqin group(50 μmol/L),and high-dose Huangqin group(100 μmol/L).After co-culturing for 24 h,the expression of key target proteins HIF1A,MAPK1(ERK2/p-ERK2),and SIRT1 were detected by Western blotting,and the mRNA expression of these proteins was measured by qRT-PCR.Results A total of 27 active components of Huangqin were screened by network pharmacology,corresponding to 379 targets,with 220 disease targets related to POCD,resulting in 35 intersecting genes.Molecular docking results showed that components like baicalein and oroxylin A had strong affinity with targets such as HIF1A,MAPK1,and SIRT1.In vitro experimental results indicated that baicalein significantly downregulated the expression and transcription levels of HIF1A and MAPK1(ERK2/p-ERK2),while upregulating the expression and transcription levels of SIRT1,effectively improved the inflammatory response in HT22 cells and reduced neuronal damage.Conclusion The traditional Chinese medicine Huangqin can reduce the occurrence and development of postoperative cognitive dysfunction by improving the expression of key proteins,controlling inflammatory responses,and protecting neuronal function.

OBJECTIVE To explore the effect and potential mechanisms of berberine on formation of biofilms of clinical methicillin-resistant Staphylococcus aureus(MRSA)isolates.METHODS Totally 95 clinical MRSA iso-lates were collected from Shanghai Eighth People's Hospital from Jan.2023 to Dec.2023.The 14 biofilm forma-tion-related genes in the strains were detected by polymerase chain reaction(PCR)and multiplex PCR,the mini-mum inhibitory concentration(MIC)of berberine was determined by microbroth dilution method,the effect of berberine on resistance of biofilm formation was evaluated by crustal violet staining,fluorescence microscope,Congo red agar plate and extracelluar DNA(eDNA).The transcription levels of 9 biofilm formation-related genes were detected by real-time fluorescent quantitative reverse transcription PCR.RESULTS All of the 95 strains of MRSA carried eno,clfA,clfB and icaA genes,the most widespread gene profile was bbp-eno-ebpS-fnbA-fib-clfA-clfB-icaA-sasG,and 29 strains had the phenotypes with strong capability of biofilm formation.The MIC score of berberine ranged between 64 and 1 024 μg/ml.Berberine with the concentration of 1/2 MIC could inhibit the biofilm formation of MRSA(P＜0.001),and the inhibiting rate of biofilm formation of the MIC ≥512 μg/ml group was higher than that of the MIC≤128 μg/ml group and the MIC 256 μg/ml group(all P＜0.05).The re-sult under the fluorescence microscope showed that the fluorescence intensity of biofilms decreased with the rise of berberine concentration.Berberine could reduce the formation of amyloid fibrils and the release of eDNA,down-regulating the transcription levels of ica A,sasG,ebpS,fib,eno,clfA,clfB,bbp and fnbA genes(P＜0.05).CONCLUSION Berberine may inhibit the biofilm formation of MRSA by downregulating expression levels of related genes,interfering the formation of amyloid fibrils and blocking the release of eDNA,which may provide experimental bases for development of drugs resisting to MRSA biofilms.

Objective To construct and validate a predictive model for the risk of deep vein thrombosis(DVT)after lower extremity orthopedic surgery.Methods Clinical records of hospital-ized patients who underwent lower extremity orthopedic surgery in Wuxi Traditional Chinese Medicine Hospital from January 2017 to October 2019 were collected.The univariate and multivariate analysis with the backward stepwise method were applied to screen variables and build a nomogram prediction model,and the performance of the nomogram was evaluated with respect to its discriminant capabili-ty,calibration ability,and clinical utility.Results A total of 5 773 hospitalized patients with ortho-pedic surgery of lower extremity were included in the study,with the incidence of DVT of 0.9％.Through single factor and multi-factor stepwise regression analysis,5 variables were selected from 31 variables to construct the prediction model,including age,mean corpuscular hemoglobin concentra-tion(MCHC),D-dimer,platelet distribution width(PDW),and thrombin time(TT).The receiver operating characteristic(ROC)curve showed that areas under the ROC curve in the training and vali-dation cohort were 0.859 and 0.857,respectively.The model had good calibration ability and clini-cal practicability.Conclusion The DVT risk prediction model constructed in this study has good dif-ferentiation ability,calibration ability and clinical practicability,which is helpful for doctors to classi-fy DVT patients after lower extremity orthopedic surgery and formulate early treatment plan.

Objective To construct and validate a predictive model for the risk of deep vein thrombosis(DVT)after lower extremity orthopedic surgery.Methods Clinical records of hospital-ized patients who underwent lower extremity orthopedic surgery in Wuxi Traditional Chinese Medicine Hospital from January 2017 to October 2019 were collected.The univariate and multivariate analysis with the backward stepwise method were applied to screen variables and build a nomogram prediction model,and the performance of the nomogram was evaluated with respect to its discriminant capabili-ty,calibration ability,and clinical utility.Results A total of 5 773 hospitalized patients with ortho-pedic surgery of lower extremity were included in the study,with the incidence of DVT of 0.9％.Through single factor and multi-factor stepwise regression analysis,5 variables were selected from 31 variables to construct the prediction model,including age,mean corpuscular hemoglobin concentra-tion(MCHC),D-dimer,platelet distribution width(PDW),and thrombin time(TT).The receiver operating characteristic(ROC)curve showed that areas under the ROC curve in the training and vali-dation cohort were 0.859 and 0.857,respectively.The model had good calibration ability and clini-cal practicability.Conclusion The DVT risk prediction model constructed in this study has good dif-ferentiation ability,calibration ability and clinical practicability,which is helpful for doctors to classi-fy DVT patients after lower extremity orthopedic surgery and formulate early treatment plan.