OBJECTIVE To explore the changes of microribonucleic acid(miR)-223,miR-155 and miR-125 in the neonates with sepsis and analyze the distribution of pathogens so as to provide bases for clinical diagnosis and treatment of neonates with sepsis.METHODS A total of 39 neonates with sepsis who were treated in Jinan Second Maternal and Child Health Hospital from May 2021 to May 2023 were enrolled in the study and were assigned as the study group,meanwhile,42 healthy neonates who were born in the hospital were chosen as the control group.The distribution and drug resistance of the pathogens isolated from the neonates of the study group were statistically analyzed.The relative expression levels of peripheral blood miR-223,miR-155 and miR-125 were com-pared between the two groups,and the values of the three indexes in diagnosis of neonatal sepsis were analyzed.RESULTS Totally 46 strains of pathogens were isolated from the 39 neonates with sepsis,20 of which were Escherichia coli,and 10 were Staphylococcus aureus.The E.coli strains were resistant to ampicillin,tetra-cycline,ciprofloxacin and cefazolin;the S.aureus strains were resistant to penicillin,erythromycin,cefazolin and clindamycin,with the drug resistance rates higher than 50％.The expression level of miR-223 of the study group was 2.13±0.70,higher than that of the control group,the expression level of miR-125 of the study group was 0.92±0.30,higher than that of the control group;while the expression level of miR-155 of the study group was 2.08±0.68,lower than that of the control group(P＜0.05).The area under the curve(AUC)of the joint detec-tion of miR-223,miR-155 and miR-125 was 0.945 in diagnosis of neonatal sepsis,with the sensitivity 92.31％,the specificity 88.10％.CONCLUSIONS E.coli and S.aureus are dominant among the pathogens isolated from the neonates with sepsis.The neonates with sepsis show abnormal expressions of peripheral blood miR-223,miR-155 and miR-125,and the joint detection of the three indexes has high value in diagnosis of neonatal sepsis.

OBJECTIVE To explore the changes of microribonucleic acid(miR)-223,miR-155 and miR-125 in the neonates with sepsis and analyze the distribution of pathogens so as to provide bases for clinical diagnosis and treatment of neonates with sepsis.METHODS A total of 39 neonates with sepsis who were treated in Jinan Second Maternal and Child Health Hospital from May 2021 to May 2023 were enrolled in the study and were assigned as the study group,meanwhile,42 healthy neonates who were born in the hospital were chosen as the control group.The distribution and drug resistance of the pathogens isolated from the neonates of the study group were statistically analyzed.The relative expression levels of peripheral blood miR-223,miR-155 and miR-125 were com-pared between the two groups,and the values of the three indexes in diagnosis of neonatal sepsis were analyzed.RESULTS Totally 46 strains of pathogens were isolated from the 39 neonates with sepsis,20 of which were Escherichia coli,and 10 were Staphylococcus aureus.The E.coli strains were resistant to ampicillin,tetra-cycline,ciprofloxacin and cefazolin;the S.aureus strains were resistant to penicillin,erythromycin,cefazolin and clindamycin,with the drug resistance rates higher than 50％.The expression level of miR-223 of the study group was 2.13±0.70,higher than that of the control group,the expression level of miR-125 of the study group was 0.92±0.30,higher than that of the control group;while the expression level of miR-155 of the study group was 2.08±0.68,lower than that of the control group(P＜0.05).The area under the curve(AUC)of the joint detec-tion of miR-223,miR-155 and miR-125 was 0.945 in diagnosis of neonatal sepsis,with the sensitivity 92.31％,the specificity 88.10％.CONCLUSIONS E.coli and S.aureus are dominant among the pathogens isolated from the neonates with sepsis.The neonates with sepsis show abnormal expressions of peripheral blood miR-223,miR-155 and miR-125,and the joint detection of the three indexes has high value in diagnosis of neonatal sepsis.

BACKGROUND:The development of calcium phosphate bone cement is limited due to its poor mechanical properties and weak osteogenic ability.Silicate bioactive glass is highly favored due to its excellent biological activity and osteogenic ability.Simultaneously,fiber structures can enhance the mechanical strength of materials.OBJECTIVE:To investigate the mechanical properties,biocompatibility,and osteogenic effect of silicate bioactive glass fiber composite calcium phosphate bone cement.METHODS:Different mass percentages(0％,10％,and 20％)of silicate bioactive glass fiber were added to the solid phase of calcium phosphate bone cement,mixed with the liquid phase and cured for 48 hours to obtain silicate bioactive glass fiber composite calcium phosphate bone cement.The mechanical properties,setting time,and ion precipitation of the cement were characterized.The three groups of bone cement extracts were co-cultured with MC3T3-E1 cells.The cell compatibility of the materials was evaluated by CCK-8 assay,live/dead staining,and phalloidin staining.After osteogenic induction,the osteogenic induction ability of the materials was evaluated by alkaline phosphatase staining,alizarin red staining,RUNX2 immunofluorescence staining,and RT-PCR.RESULTS AND CONCLUSION:(1)With the increase of silicate bioactive glass fiber content,the compressive strength and flexural strength of bone cement increased,and the setting time was prolonged.When bone cement was immersed in simulated body fluid,the precipitation of silicon ions,calcium ions,and phosphorus ions could be detected.Moreover,with the increase of silicate bioactive glass fiber content,the mass concentration of silicon ions and phosphorus ions released by bone cement increased,and the mass concentration of calcium ions decreased.(2)Live/dead staining and phalloidin staining results exhibited that silicate bioactive glass fiber composite calcium phosphate bone cement had no toxic effect on MC3T3-E1 cells.CCK-8 assay results showed that silicate bioactive glass fiber composite calcium phosphate bone cement could promote the proliferation of MC3T3-E1 cells.(3)With the increase of silicate bioactive glass fiber content in bone cement,the alkaline phosphatase activity and extracellular calcium deposition of MC3T3-E1 cells increased,the expression of RUNX2 protein increased,and the expression of alkaline phosphatase,osteocalcin,osteopontin,and RUNX2 mRNA expression increased.(4)The results indicate that silicate bioactive glass fibers can enhance the mechanical properties and osteogenic induction ability of calcium phosphate bone cement,among which 20％silicate bioactive glass fibers have a more obvious effect.

BACKGROUND:The development of calcium phosphate bone cement is limited due to its poor mechanical properties and weak osteogenic ability.Silicate bioactive glass is highly favored due to its excellent biological activity and osteogenic ability.Simultaneously,fiber structures can enhance the mechanical strength of materials.OBJECTIVE:To investigate the mechanical properties,biocompatibility,and osteogenic effect of silicate bioactive glass fiber composite calcium phosphate bone cement.METHODS:Different mass percentages(0％,10％,and 20％)of silicate bioactive glass fiber were added to the solid phase of calcium phosphate bone cement,mixed with the liquid phase and cured for 48 hours to obtain silicate bioactive glass fiber composite calcium phosphate bone cement.The mechanical properties,setting time,and ion precipitation of the cement were characterized.The three groups of bone cement extracts were co-cultured with MC3T3-E1 cells.The cell compatibility of the materials was evaluated by CCK-8 assay,live/dead staining,and phalloidin staining.After osteogenic induction,the osteogenic induction ability of the materials was evaluated by alkaline phosphatase staining,alizarin red staining,RUNX2 immunofluorescence staining,and RT-PCR.RESULTS AND CONCLUSION:(1)With the increase of silicate bioactive glass fiber content,the compressive strength and flexural strength of bone cement increased,and the setting time was prolonged.When bone cement was immersed in simulated body fluid,the precipitation of silicon ions,calcium ions,and phosphorus ions could be detected.Moreover,with the increase of silicate bioactive glass fiber content,the mass concentration of silicon ions and phosphorus ions released by bone cement increased,and the mass concentration of calcium ions decreased.(2)Live/dead staining and phalloidin staining results exhibited that silicate bioactive glass fiber composite calcium phosphate bone cement had no toxic effect on MC3T3-E1 cells.CCK-8 assay results showed that silicate bioactive glass fiber composite calcium phosphate bone cement could promote the proliferation of MC3T3-E1 cells.(3)With the increase of silicate bioactive glass fiber content in bone cement,the alkaline phosphatase activity and extracellular calcium deposition of MC3T3-E1 cells increased,the expression of RUNX2 protein increased,and the expression of alkaline phosphatase,osteocalcin,osteopontin,and RUNX2 mRNA expression increased.(4)The results indicate that silicate bioactive glass fibers can enhance the mechanical properties and osteogenic induction ability of calcium phosphate bone cement,among which 20％silicate bioactive glass fibers have a more obvious effect.

OBJECTIVE：To learn from the experience of foreign listed chimeric antigen receptor T lymphocyte （CAR-T） products in signing risk sharing agreements in medical insurance access ，so as to provide references for relevant decisions of medical insurance departments in China. METHODS ：Taking 9 risk sharing agreements of CAR-T products marketed in the United Kingdom，France，Italy and Germany as samples ，the international experience of medical insurance payment of CAR-T products were analyzed from six dimensions ，such as agreement types ，monitoring indicators ，data collection metho ds，agreement periods ， payment conditions and payment methods. Some suggestions were put forward for the medical insurance access of these products in China. RESULTS & CONCLUSIONS ：Four sample countries generally signed risk sharing agreements of medical insurance access （financial agreement and performance-based agreement ）with pharmaceutical enterprises ；the indicators such as progressive disease and progression-free survival were collected by using data collection system or clinical research data ，so as to monitor the efficacy and safety of CAR-T products. The agreement periods and payment conditions were determined according to different agreement types；“medical insurance advance payment ”or“pharmaceutical enterprise advance payment ”combined with “staged payments ” were adopted for risk control. Solving the risk of medical insurance funds caused by “efficacy uncertainty ”is the core issue of CAR-T product access. The induction of risk sharing agreements may be the way to solve this problem ，and the scientific design of the various elements of risk sharing agreements is a prerequisite to ensure that the agreement is operational.

Objective To investigate the short-term clinical efficacy of Jack vertebral dilator kyphoplasty bone grafting combined with minimally invasive fixation in the treatment of thoracolumbar fracture.Methods A retrospective case series analysis was made on 34 patients with thoracolumbar fracture treated by minimally invasive transpedicular bone grafting and fixation in the injury vertebrae with Jack vertebral dilator from December 2014 to December 2015.There were 20 males and 14 females,and their age was 25-27 years (mean,46.7 years).According to the AO classification,there were 16 cases of type A1 and 18 type A3.The injured levels were at T11 in one case,at T12 in 6,at L1 in 15,at L2 in 9 and at L3 in 3.The operation time,blood loss,fluoroscopy frequency,incision length,and postoperative hospital stay duration were recorded.The visual analogue scale (VAS),Oswestry disability index (ODI),height ratio of vertebrae,Cobb angle,and complications were evaluated at follow-up.Results The operation time was (91.2 ±9.8) minutes,blood loss was (42.4 ±4.3) ml,incision length was (7.2 ± 0.4) cm,intraoperative fluoroscopy frequency were five,postoperative hospital stay was (3.9 ± 0.5) days,and follow-up time was (13.8 ± 1.7) months.All the patients showed complete healing in the injury vertebra.The VAS was (6.4 ± 0.9) points preoperatively,(4.1 ± 0.8) points,(1.2 ± 0.4) points,and (1.2 ± 0.5) points at 7 days,3 months and 12 months postoperatively.The ODI was (39.2 ± 2.3) points preoperatively,(24.5 ± 1.9) points,(13.0 ± 3.0) points,and (12.3 ± 2.0) points at 7 days,3 months and 12 months postoperatively.At postoperative 7 days,the VAS and ODI were significantly decreased compared with those preoperatively (P ＜ 0.05) and further declined at postoperative 3 months (P ＜ 0.05),while there was no significant difference between 3 months and 12 months postoperatively (P ＞ 0.05).The height ratio of vertebrae was 47.8 ± 12.2 preoperatively,83.6 ±4.9,82.5 ±4.8,and 81.7 ±4.7 at 7 days,3 months and 12 months postoperatively.The Cobb angle was respective (22.4 ± 4.7) °preoperatively,(3.6 ± 2.4) °,(4.6 ± 2.6) °,and (5.0 ± 2.8) ° at 7 days,3 months and 12 months postoperatively.At postoperative 7 days,the height ratio of vertebrae was increased and Cobb angle was decreased significantly compared to those preoperatively (P ＜ 0.05),while there was no significant difference in the indicators at 3 days,3 months and 12 months postoperatively (P ＞ 0.05).No looseness or breakage of internal fixation was found at follow-up and all patients had fracture union at the last follow-up.Conclusion Jack vertebral dilator kyphoplasty bone grafting combined with minimally invasive fixation is safe and effective for treatment of thoracolumbar fractures,as the procedure can quickly relieve the pain,improve the function disability,effectively maintain the height of the vertebral body and restore the sagittal balance of spine.

Objectives To generate an orthotopic left lung transplantation model in mice, and to observe the early changes of respiratory system resistance andγδT lymphocytes infiltrated in grafts? Methods The research time was from March 2014 to May 2015? The male C57BL/6 mice ( n=35) and BALB/c mice (syngenic group,n=10) were randomly divided into five groups. Control group (n=5): wild C57BL/6 mice; syngenic transplant group ( n=10 ): C57BL/6→C57BL/6; allogenic transplant group ( allogenic group,n=10): BALB/c→C57BL/6; each transplant group was randomly divided into 3?day and 7?day subgroups ( n=5 )? Respiratory system resistance and histological features of grafts were assessed, and differences in graft infiltrating γδT lymphocytes and mRNA expression of interleukin ( IL )?17A were quantified on 3 and 7 days after transplantation? Multiple comparisons were performed using one?way analysis of variance and least significant difference analysis? Results ( 1 ) The respiratory system resistance of syngenic group and allogenic group were (2?61±0?59) cmH2O·s/ml and (2?84±0?31) cmH2O·s/ml 3 days post?operation, both of them increased compared to control group (1?39±0?17) cmH2O·s/ml (1 cmH2O=0?098 kPa) (P=0?001, 0?000). The respiratory system resistance of allogenic group were (4?33±0?67) cmH2 O·s/ml 7 days post?operation, which was significantly higher than that of syngenic 7?day subgroup (1?87±0?27) cmH2O·s/ml and control group (1?39±0?17) cmH2O·s/ml (P=0?000, 0?000)?(2) The isografts of syngenic group showed a relatively normal histological appearance with minimal infiltration of inflammatory cells, and the allografts of allogenic group infiltrated apparently by inflammatory cells, especially 7?day subgroup showed acute cellular rejection? ( 3) The percentage of γδT lymphocytes infiltrated in isografts and allografts were 3?90%± 0?86% and 4?40%± 0?57%, respectively, which were significantly increased compared to that of control lungs 2?00%±0?23% 3 days post?operation(P=0?000, 0?000);The percentage ofγδT lymphocytes infiltrated in 7 days allografts was 5?40%±0?98% , which was higher compared to that of 7 days isografts 2?60%± 0?54% and control lungs 2?00%± 0?23% ( P=0?000, 0?000)? (4) IL?17A mRNA expression levels were 3?37±0?55 and 5?23±1?50 in isografts and 6?77± 0?93 and 27?32±4?20 in allografts, on postoperative day 3 and 7 respectively? All of them were significantly upregulated compared to that of control lungs 0?99±0?08 (P=0?000, 0?000), and allografts exhibited significantly greater IL?17A transcript levels compared to isografts on postoperative day 3 and 7 ( P=0?000, 0?000) . Conclusion The rise of respiratory system resistance of lung grafts after transplantation may relate to the increased IL?17A?producing γδT lymphocytes infiltrated in the grafts.

Objectives To generate an orthotopic left lung transplantation model in mice, and to observe the early changes of respiratory system resistance andγδT lymphocytes infiltrated in grafts? Methods The research time was from March 2014 to May 2015? The male C57BL/6 mice ( n=35) and BALB/c mice (syngenic group,n=10) were randomly divided into five groups. Control group (n=5): wild C57BL/6 mice; syngenic transplant group ( n=10 ): C57BL/6→C57BL/6; allogenic transplant group ( allogenic group,n=10): BALB/c→C57BL/6; each transplant group was randomly divided into 3?day and 7?day subgroups ( n=5 )? Respiratory system resistance and histological features of grafts were assessed, and differences in graft infiltrating γδT lymphocytes and mRNA expression of interleukin ( IL )?17A were quantified on 3 and 7 days after transplantation? Multiple comparisons were performed using one?way analysis of variance and least significant difference analysis? Results ( 1 ) The respiratory system resistance of syngenic group and allogenic group were (2?61±0?59) cmH2O·s/ml and (2?84±0?31) cmH2O·s/ml 3 days post?operation, both of them increased compared to control group (1?39±0?17) cmH2O·s/ml (1 cmH2O=0?098 kPa) (P=0?001, 0?000). The respiratory system resistance of allogenic group were (4?33±0?67) cmH2 O·s/ml 7 days post?operation, which was significantly higher than that of syngenic 7?day subgroup (1?87±0?27) cmH2O·s/ml and control group (1?39±0?17) cmH2O·s/ml (P=0?000, 0?000)?(2) The isografts of syngenic group showed a relatively normal histological appearance with minimal infiltration of inflammatory cells, and the allografts of allogenic group infiltrated apparently by inflammatory cells, especially 7?day subgroup showed acute cellular rejection? ( 3) The percentage of γδT lymphocytes infiltrated in isografts and allografts were 3?90%± 0?86% and 4?40%± 0?57%, respectively, which were significantly increased compared to that of control lungs 2?00%±0?23% 3 days post?operation(P=0?000, 0?000);The percentage ofγδT lymphocytes infiltrated in 7 days allografts was 5?40%±0?98% , which was higher compared to that of 7 days isografts 2?60%± 0?54% and control lungs 2?00%± 0?23% ( P=0?000, 0?000)? (4) IL?17A mRNA expression levels were 3?37±0?55 and 5?23±1?50 in isografts and 6?77± 0?93 and 27?32±4?20 in allografts, on postoperative day 3 and 7 respectively? All of them were significantly upregulated compared to that of control lungs 0?99±0?08 (P=0?000, 0?000), and allografts exhibited significantly greater IL?17A transcript levels compared to isografts on postoperative day 3 and 7 ( P=0?000, 0?000) . Conclusion The rise of respiratory system resistance of lung grafts after transplantation may relate to the increased IL?17A?producing γδT lymphocytes infiltrated in the grafts.