Objective:To investigate the relationship between the expression of serum a proliferation inducing ligand (APRIL), C-X-C motif-chemokine ligand 14(CXCL14) and disease regression in children with severe Mycoplasma pneumoniae pneumonia (SMPP).Methods:A total of 112 children with SMPP admitted to Changzhou Maternal and Child Health Hospital from January 2021 to December 2022 were selected as study subjects. After 28 d of treatment, the children were divided into the good prognosis group ( n=87) and the poor prognosis group ( n=25) according to their disease regression, and 100 children with Mycoplasma pneumoniae pneumoniae (MPP) admitted to our hospital during the same period were selected as the control group. Serum APRIL and CXCL14 expression were measured by enzyme-linked immunosorbent assay in all children. The predictive value of serum APRIL and CXCL14 for disease regression in children with SMPP was assessed by receiver operating characteristic (ROC) curve, and the factors influencing disease regression in children with SMPP were analyzed by multifactorial Logistic stepwise regression. Results:Serum APRIL and CXCL14 levels in the study group were higher than those in the control group（all P<0.05）. Serum APRIL and CXCL14 levels of children with SMPP in the poor prognosis were higher than those in the good prognosis group（all P<0.05）. The area under the curve (AUC)（95% CI）of serum APRIL and CXCL14 for predicting the prognosis of SMPP children were 0.783（0.721-0.835）and 0.835（0.789-0.882），respectively，and the cut-off values were 34.47 ng/mL and 289.32 pg/mL，respectively. The specificity was 53.61%，65.43%，and the sensitivity was 93.20%，93.20%，respectively. The AUC（95% CI）of the combined detection of both was 0.913（0.872-0.954），with a specificity of 85.59% and a sensitivity of 86.35%. The proportions of children in the poor prognosis group with fever days> 7 d and admission National Institute of Health Stroke Scale(NIHSS) score> 30 points were higher than those in the good prognosis group（ P<0.05）. Multifactorial Logistic stepwise regression analysis showed that the fever days> 7 d（ OR=2.273，95% CI 1.403-3.681），admission NIHSS score> 30 points（ OR=2.088，95% CI 1.327-3.283），APRIL≥34.47 ng/mL（ OR=3.093，95% CI 1.711-5.590），and CXCL14≥289.32 pg/mL（ OR=5.013，95% CI 2.079-12.086）were risk factors for death in children with SMPP（ P<0.05）. Conclusion:Serum APRIL and CXCL14 are highly expressed in children with SMPP and are associated with disease regression, which may serve as potential markers for predicting the prognosis of children with SMPP.

OBJECTIVE: To analyze recurrence and progression patterns of primary central nervous system lymphoma (PCNSL) in patients without whole brain radiotherapy (WBRT) and assess the value of WBRT in PCNSL treatment. METHODS: This retrospective single-center study included 27 patients with PCNSL, who experienced recurrence/progression after achieving complete remission (CR), partial remission, or stable disease following initial treatments with chemotherapy but without WBRT. The patients were followed up regularly after the treatment for treatment efficacy assessment. By comparing the anatomical location of the lesions on magnetic resonance images (MRI) at the initial diagnosis and at recurrence/progression, we analyzed the patterns of relapse/progression in patients with different treatment responses and different initial status of the lesions. RESULTS: MRI data showed that in 16 (59.26%) of the 27 patients, recurrence/progression occurred in out-field area (outside the simulated clinical target volume [CTV]) but within the simulated WBRT target area in 16 (59.26%) patients, and within the CTV (in-field) in 11 (40.74%) patients. None of the patients had extracranial recurrence of the tumor. Of the 11 patients who achieved CR after the initial treatments, 9 (81.82%) had PCNSL recurrences in the out-field area but within WBRT target area; of the 13 patients with a single lesion at the initial treatment, 11 (84.62%) experienced PCNSL recurrence in the out-field area but within WBRT target area. CONCLUSIONS Systemic therapy combined with WBRT still remains the standard treatment for PCNSL patients, especially those who achieve CR after treatment or have a single initial lesion. Future prospective studies with larger sample sizes are needed to further explore the role of low-dose WBRT in PCNSL treatment.
Humans ; Lymphoma/radiotherapy* ; Central Nervous System Neoplasms/pathology* ; Retrospective Studies ; Prospective Studies ; Neoplasm Recurrence, Local/drug therapy* ; Combined Modality Therapy ; Brain/pathology* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Methotrexate

Objective:To investigate the effects of breast milk to total milk intake ratio during hospitalization on the duration of antibiotic therapy in preterm infants less than 34 weeks of gestation.Methods:Clinical data of preterm infants ( n=1 792) less than 34 gestational weeks were retrospectively collected in 16 hospitals of Jiangsu Province Neonatal-Perinatal Cooperation Network from January 1, 2019, to December 31, 2021. The days of therapy (DOT) were used to evaluate the duration of antibiotic administration. The median DOT was 15.0 d (7.0-27.0 d). The patients were divided into four groups based on the quartiles of DOT: Q 1 (DOT≤7.0 d), Q 2 (7.0 d27.0 d) groups. According to the breast milk intake ratio (breast milk intake to total milk intake during hospitalization×100%), they were also divided into four groups: very-low-ratio breastfeeding group (breast milk intake ratio≤25%), low-ratio breastfeeding group (25%75%). Univariate analysis ( Chi-square test and Kruskal-Wallis rank-sum test) was used to analyze the factors influencing DOT. Spearman correlation analysis and trend Chi-square test were used to explore the relationship between breast milk intake ratio and DOT. After using multiple imputations to address missing data, two models were constructed after adjusting for different factors, and multinomial logistic regression model was applied to evaluate the effects of the breast milk intake ratio on DOT. Finally, sensitivity analysis was conducted to assess the stability of the models. Results:(1) Of the 1 792 preterm infants, there were 507 (28.3%) in the Q 1 group, 422 (23.5%) in the Q 2 group, 438 (24.4%) in the Q 3 group and 425 (23.7%) in the Q 4 group. (2) The median values of DOT in the very-low-ratio, low-ratio, medium-ratio and high-ratio breastfeeding groups were 20.0 d (11.0-31.0 d), 20.0 d (11.0-32.0 d), 13.0 d (6.0-25.8 d) and 10.0 d (4.0-21.0 d), respectively. Compared with the very-low-ratio and low-ratio breastfeeding groups, the medium-ratio and high-ratio breastfeeding groups had shorter DOT (all P<0.05). (3) After adjusting for factors with P<0.1 (prenatal glucocorticoid exposure, antimicrobial use within 24 h before delivery, gestational age at delivery, birth weight, Apgar score≤7 at 1 min, neonatal respiratory distress syndrome, infectious pneumonia and early-onset neonatal sepsis) between the DOT quartile groups, it showed that medium-ratio and high-ratio breastfeeding were protective factors in contrast to very-low-ratio breastfeeding in the Q 2, Q 3 and Q 4 groups as compared with the Q 1 group [Q 2 group: OR=0.50 (95% CI: 0.30-0.85) and OR=0.36 (95% CI: 0.26-0.51); Q 3 group: OR=0.31 (95% CI: 0.18-0.55) and OR=0.20 (95% CI: 0.14-0.29); Q 4 group: OR=0.22 (95% CI: 0.12-0.42) and OR=0.17 (95% CI: 0.12-0.26)]. Conclusion:Breast milk intake accounting for over 50% of total milk intake has a positive impact on reducing DOT in premature infants requiring antibiotics, which suggests that breastfeeding should be actively encouraged.

Objective: To evaluate the occupational health risk of key posts exposed to cement dust in four cement production enterprises, and to provide reference for cement pneumoconiosis prevention and control. Methods: Four Chinese typical cement enterprises and key posts exposed to cement dust were selected to carry out occupational health investigation and detection, and three risk assessment methods were used to assess their occupational health risk levels, including semi-quantitative comprehensive index method, semi-quantitative contact ratio method and risk rating method of International Mining and Metal Commission ( ICMM ). Meanwhile, the differences and consistencies among different assessment methods were compared. Results: Dust free silica content ranged from ( 4.70±2.01 ) % to ( 5.63±2.48 ) %,and the total and respirable dust concentrations exposed by bagged cement loaders and cement baggers exceeded Chinese permissible concentration-time weighted average（ PC-TWA ）. The results of semi-quantitative comprehensive index method showed that all the types of work were at high risk of total and respirable dust, while the results of the other two assessment methods showed that bagged cement loaders and cement baggers were at a extremely high or intolerable risk. There were no significant differences among three risk assessment methods whether in terms of total dust or respirable dust ( P>0.05 ). ICMM risk rating method and contact ratio method showed highly positive correlation in term of respirable dust ( rs=0.894, P=0.016 ), but not in term of total dust ( rs=0.733, P=0.097 ). However, the correlations of comprehensive index method with the other two methods were unable to conduct. Conclusion Bagged cement loaders and cement baggers are at high occupational health risk levels. Moreover, semi-quantitative contact ratio method and ICMM risk rating method have high positive correlation in term of respirable dust, the applicability of comprehensive index method still needs further study.

Objective To explore the dynamic changes of glutamate in the cortex of cynomolgus monkeys during cerebral ischemia.Methods Proximal M1 segment of middle cerebral artery (MCA) was occluded for 1 h in 3 young cynomolgus monkeys (7.3 ± 1.5 years old) to induce cerebral ischemia.Magnetic resonance imaging and neurologic deficit scoring were used to evaluate the ischemia and observe the manifestations,respectively.Fast Analytical Sensing Technology (FAST) was applied to record the content of cortex glutamate in the same site of ipsilateral primary motor cortex in the periods of pre-,during,and post-occlusion,and at 1 and 2 weeks after surgery.Results Compared with pre-occlusion,the content of glutamate was increased significantly in the process of occluding in the MCA M1 (P =0.003);No significant difference was observed in the content during occluding and post-occlusion (P--0.877).The content in the first week was decreased obviously as compared with post-occlusion (P--0.004),but it showed no statistical difference with that in the second week (P =0.085).Conclusion Cerebral ischemia may potentially accelerate the extra-cellular glutamate release in the cortex,but reperfusion may ameliorate or balance off the glutamate release.

An "exosome" is a nano-grade biological membrane structure with a diameter of 40 nm-130 nm from cell endocytosis.Exosomes,which are enriched with a subset of proteins,nucleic acid and lipids,represent an important manner for the intercellular communication and exchanging of substances.Exosomes play a critical role at the pathological state such as tumor metastasis as well as in normal physiological state.Metastasis is the main characteristics of malignant tumors.It is the leading cause of tumor recurrence,treatment failure and death.This paper reviewed the current understanding of relationship between exosomes,tumor metastasis and their potential applications as antimetastasis strategy from biosynthesis inhibition,drug delivery system construction and metastasis related signal pathway blocking based on targeting exosomes,especially introduced the future prospects of exosome as drug vehicles for metastasis treatment.With further progress in research,this kind of strategy will be beneficial to anti-tumor metastasis treatment.

Objective To observe the clinical effect of disposable cervical balloon dilator for late pregnancy induction.Methods A total of 320 advanced pregnant women with singleton and cephalic presentation who had indications of labor induction were chosen and were randomly divided into two groups,with 160 cases per group.Women in observation group were treated with one-time cervical balloon dilator and induced by oxytocin and women in control group only used oxytocin intravenous infusion.The Bishop score,the time of labor starting,the length of total stage of labor,mode of delivery,maternal and child complications and maternal satisfaction were compared.Results The Bishop score of the observation group was better(P ＜ 0.05),the time of labor starting and the length of total stage of labor in observation group was significantly shorter than that in control group (P ＜ 0.05or P ＜0.01).The rate of vaginal delivery was significantly increased (P ＜0.01).There were no significant differences in maternal and infants complications and adverse reactions (P ＞ 0.05),but nursing satisfaction was higher in observation group than that in the control group(P ＜0.01).Conclusion Disposable cervical balloon dilator for late pregnancy induced labor can effectively promote cervical ripening,shorten the length of labor,improve vaginal delivery rate,reduce cesarean section rate,increase pregnant women satisfaction and there is no significant adverse reactions.

Objective To observe the clinical effect of disposable cervical balloon dilator for late pregnancy induction.Methods A total of 320 advanced pregnant women with singleton and cephalic presentation who had indications of labor induction were chosen and were randomly divided into two groups,with 160 cases per group.Women in observation group were treated with one-time cervical balloon dilator and induced by oxytocin and women in control group only used oxytocin intravenous infusion.The Bishop score,the time of labor starting,the length of total stage of labor,mode of delivery,maternal and child complications and maternal satisfaction were compared.Results The Bishop score of the observation group was better(P ＜ 0.05),the time of labor starting and the length of total stage of labor in observation group was significantly shorter than that in control group (P ＜ 0.05or P ＜0.01).The rate of vaginal delivery was significantly increased (P ＜0.01).There were no significant differences in maternal and infants complications and adverse reactions (P ＞ 0.05),but nursing satisfaction was higher in observation group than that in the control group(P ＜0.01).Conclusion Disposable cervical balloon dilator for late pregnancy induced labor can effectively promote cervical ripening,shorten the length of labor,improve vaginal delivery rate,reduce cesarean section rate,increase pregnant women satisfaction and there is no significant adverse reactions.

The Ebola virus is highly infectious and can result in death in ≤ 90% of infected subjects. Detection of the Ebola virus and diagnosis of infection are extremely important for epidemic control. Presently, Chinese laboratories detect the nucleic acids of the Ebola virus by real-time reverse transcription-polymerase chain reaction (RT-PCR). However, such detection takes a relatively long time and necessitates skilled personnel and expensive equipment. Enzyme-linked immunosorbent assay (ELISA) of serum is simple, easy to operate, and can be used to ascertain if a patient is infected with the Ebola virus as well as the degree of infection. Hence, ELISA can be used in epidemiological investigations and is a strong complement to detection of nucleic acids. Cases of Ebola hemorrhagic fever have not been documented in China, so quality-control material for positive serology is needed. Construction and expression of human-mouse chimeric antibodies against the nucleoprotein of the Ebola virus was carried out. Genes encoding variable heavy (VH) and variable light (VL) chains were extracted and amplified from murine hybridoma cells. Genes encoding the VH and VL chains of monoclonal antibodies were amplified by RT-PCR. According to sequence analyses, a primer was designed to amplify functional sequences relative to VH and VL chain. The eukaryotic expression vector HL51-14 carrying some human antibody heavy chain- and light chain-constant regions was used. IgG antibodies were obtained by transient transfection of 293T cells. Subsequently, immunological detection and immunological identification were identified by ELISA, immunofluorescence assay, and western blotting. These results showed that we constructed and purified two human- mouse chimeric antibodies.
Animals ; Antibodies, Monoclonal ; genetics ; immunology ; Cloning, Molecular ; Ebolavirus ; genetics ; immunology ; Hemorrhagic Fever, Ebola ; immunology ; virology ; Humans ; Immunoglobulin Heavy Chains ; genetics ; immunology ; Mice ; Nucleoproteins ; genetics ; immunology ; Viral Proteins ; genetics ; immunology

Objective To evaluate the efficacy of immediate and delayed postoperative removal of urethral catheters Methods Randomized controlled trials and quasi-experiment trails of immediate and delayed postoperative removal of urethral catheters were collected in the databases such as CENTRAL, PubMed, OVID, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), VIP, Wanfang Data, etc. Data were analyzed by RevMan 5.3 version.after heterogeneity analysis,pooled risk ratio (RR) with 95%confidence interval (95%CI) using both fixed and random effect models were estimated. Results Ten randomized controlled trials (RCTs) were included. The results of Meta-analysis indicated that immediate urinary catheter removal was associated with a lower incidence of urinary tract infections (RR=0.29, 95%CI 0.15 to 0.56, P=0.000 3), positive urinary culture (RR=0.31,95%CI 0.16 to 0.59, P=0.000 2) compared with the delayed removal group and seven studies recommended removal of the indwelling urinary catheter immediately after hysterectomy. While, there was a higher risk of re-catheterization (RR=4.56, 95%CI 2.93 to 7.08, P<0.01)in the immediate removal group. Seven studies recommended removal of the indwelling urinary catheter immediately after hysterectomy. Conclusions Removal of the indwelling urinary catheter immediately after hysterectomy was recommended.