Objective To investigate the expression of spalt like transcription factor 4(Sall4)in pancreatic cancer tissues and its clinical significance,as well as the impact of inhibiting its gene expression on the migration and invasion of pancreatic cancer cells.Methods This study involved 64 patients with pancreatic cancer treated at the 2nd Affiliated Hospital of Kunming Medical University from January 2014 to January 2018.Immunohistochemical staining was used to detect the expression of Sall4 protein in adjacent non-tumor tissues and pancreatic cancer tissues,respectively.Real-time quantitative PCR was used to measure the mRNA expression levels of Sall4 in the cancerous and adjacent non-tumor tissues,respectively.The relationship between the clinicopathological data of these patients and the expression of Sall4 protein was also analyzed.The cells of high Sall4 expression were screened from the human pancreatic cancer cell lines PANC-1,Capan-1,SW 1990,HPAC,and HPAF-Ⅱ.The pancreatic cancer cells of high Sall4 expression were divided into three groups:control group,shRNA-1 group,and shRNA-2 group.The shRNA-1 and shRNA-2 groups were transfected with the corresponding Sall4 lentiviral inhibitory gene sequences,while the control group was transfected with the reagent without an interference sequence.Western blotting was used to measure the expression of Sall4,and cells with significantly reduced expression were selected for subsequent experiments.The transfected cells were then assessed for their invasive and migratory abilities.Results Among the 64 samples of pancreatic cancer tissues,28 cases(43.8％)were positive for Sall4 expression,a rate significantly higher than 5 cases(7.8％)in adjacent non-tumor tissues.Furthermore,16 cases exhibited strong positivity,while 12 cases showed moderate or weak positivity.Recurrence occurred in 11 pancreatic cancer patients.The difference was statistically significant.The expression of Sall4 was correlated with tumor differentiation,staging,and lymph node metastasis,suggesting that Sall4 positivity might be an independent risk factor affecting the prognosis of pancreatic cancer.Among the five cell lines,PANC-1 had the highest relative expression of Sall4 and was selected for further experiments.The shRNA-1 and shRNA-2 groups successfully suppressed the expression of Sall4,with the shRNA-1 group showing a more pronounced effect.Compared to the control group,the invasive and migratory abilities of SW480 cells were significantly reduced in the shRNA-1 group(P＜0.05).Conclusion Sall4 is highly expressed in pancreatic cancer tissues,and higher expression is associated with a greater likelihood of postoperative recurrence.Inhibiting the expression of Sall4 can significantly suppress the invasion and migration abilities of human pancreatic cancer cells.

Objective:To explore the coverage of influenza and pneumonia vaccination and factors influencing the vaccination in children.Methods:A cross-sectional questionnaire survey was conducted in children's parents in Beijing and Gansu by using two-stage cluster-sampling to investigate the influenza and pneumonia vaccination rates and influencing factors in children.Results:A total of 2 377 parents were included in the study, and the results indicated that the influenza vaccination coverage was 35.93% and the pneumonia vaccination coverage was 16.58% in children in survey areas, the vaccination rate of both vaccines was 11.65%. The top three reasons for vaccination for both vaccines were being aware of severity of the diseases (influenza vaccine: 36.02%; pneumonia vaccine: 49.61%), being required by school or organization (influenza vaccine: 28.76%; pneumonia vaccine: 25.45%) and being aware of the susceptibility of the diseases (influenza vaccine: 26.41%; pneumonia vaccine: 13.88%). The top three reasons for having no vaccinations were personal unwillingness, concern about vaccine and vaccine accessibility. Families with multi children, living in rural areas and lower family income were the negative factors for both types of vaccinations.Conclusions:The influenza and pneumonia vaccination coverage in children need further improvement, and rural families and families with multi children are the key concern groups for expanding vaccination coverage. Health education about influenza and pneumonia vaccinations, coordinating vaccine supply and decreasing vaccine prices play an important role in improving influenza and pneumonia vaccination coverage.

Objective:To investigate the clinical effect of low molecular weight heparin sodium combined with antivenin in the treatment of severe and critical bite by Trimeresurus stejnegeri.Methods:The clinical data of 48 patients with severe or critical bite by Trimeresurus stejnegeri admitted to emergency department of Southeast Hospital Affiliated to Xiamen University from March 2017 to May 2019 were retrospectively analyzed. On the basis of early treatment of antivenom serum, internal administration and external application of Jidesheng snake tablet, and wound incision and detoxification, the patients were divided into heparin treatment group and non-heparin treatment group according to whether the low molecular heparin sodium was used or not. The patients in the two groups were compared in terms of gender, age, clinical classification, swelling degree of injured limbs, change of coagulation function index, bleeding of skin, mucous membrane or digestive tract, blood transfusion, local symptoms of bite, length of hospital stay and prognosis.Results:There was no significant difference in terms of gender, age, clinical classification or swelling degree of injured limbs between the two groups. On the 3rd day of treatment, the platelet count (PLT) in the heparin treatment group was significantly higher than that in the non-heparin treatment group [×10 9/L: 210.0 (160.0, 252.0) vs. 136.0 (104.0, 198.5), P < 0.05]. However, there was no significant difference in the four coagulation test results between the two groups. On the 6th day of treatment, the plasma thrombin time (TT) in the heparin treatment group was significantly shorter than that on the 3rd day of treatment [s: 30.3 (20.4, 37.0) vs. 34.7 (24.0, 73.4), P < 0.05], and the fibrinogen (FIB) in the heparin treatment group was significantly higher than that in the non-heparin treatment group [g/L: 0.60 (0.31, 1.07) vs. 0.20 (0.14, 0.60), P < 0.01]. The incidence of bleeding in the heparin treatment group was significantly lower than that in the non-heparin treatment group [21.7% (5/23) vs. 64.0% (16/25), P < 0.01]; 11 patients in the heparin treatment group and 18 patients in the non-heparin treatment group received blood transfusion and prothrombin complex supplement respectively. There was no significant difference in the length of hospital stay between the heparin group and non-heparin treatment group (days: 6.91±1.92 vs. 7.48±2.27, P > 0.05). The patients in both groups were followed up for 1 week to 1 month after treatment, and no death or local necrosis of skin and soft tissue was found. Conclusions:For the patients with severe and critical bite by Trimeresurus stejnegeri, on the basis of injection of antivenom serum, internal administration and external application of Jidesheng snake tablet, and wound incision and detoxification, early application of low molecular weight heparin sodium anticoagulation and other comprehensive treatment is helpful to improve limb swelling and inflammation, reduce blood transfusion, promote the recovery of coagulation function, and shorten the length of hospitalization.