【Objective】 To understand factors associated with children′s attendance at nursery care institutions (NCIs) and the basic characteristics of the NCIs children were enrolled in, so as to provide scientific evidence for policymakers. 【Methods】 During November 2020 and January 2021, parents who visited the Department of Child Health Care in six selected maternal and children′s hospitals, as well as nearby NCIs in Zhejiang were invited to finish an online questionnaire. Information such as children′s sociodemographic characteristics, parents′ knowledge, attitude and practice regarding nursery and feeding, etc. were collected. A total of 1 756 questionnaires were collected. 【Results】 Compared to children who were not in NCIs, children enrolled in NCIs were older (94.4% of children ≥24 months vs. 30.1%, χ²=835.27), more likely to be from the local area (87.2% vs. 81.4%,χ²=12.25), more likely to have parents with a college degree (mother: 83.6% vs. 74.2%, χ²=35.29; father: 79.9% vs. 70.0%, χ²=27.01), had a higher prevalence of family annual income >200 000 CNY (49.5% vs. 28.2%, χ²=110.49), and were less likely to have their grandparents available to take care of them (16.7% vs. 26.8%, χ²=31.4) The difference all have great significant.(P<0.05). In a multivariate Logistic regression model, the older the child, the more likely they were to attend an NCI (for children aged 6 - 23 months, OR=6.70; for children aged 24 - 35 months, OR=134.03; and for children aged 36 - 42 months, OR=699.33; P<0.05). Family annual income was positively associated with children′s attendance at NCIs (for those earning 100 000 - 200 000 CNY/year, OR=1.63; for those earning 200 000 - 500 000 CNY/year, OR=2.96; and for those earning >500 000 CNY/year, OR=4.62, P<0.05). Conversely, the higher the level of grandparent involvement in daily care, the lower the attendance at NCIs (for children cared for by both parents and grandparents, OR=0.57; for those primarily cared for by grandparents, OR=0.26, P<0.05). For children who used to stay at NCIs, 82.8% stayed at institutions that only recruited children aged 0 - 3 years, 97.4% spent their whole day in NCIs, and 71.4% spent less than 3 000 CNY per month for NCI services. Additionally, over 95% of parents were satisfied with the food and care services in NCIs, as well as their children′s physical development in NCIs. However, 32.1% of NCIs were reported by parents as having no room for breastfeeding. 【Conclusions】 Children′s age, grandparent involvement in routine care, and family annual income are the main factors associated with children′s attendance at NCIs. There is a greater need for more affordable and community-based NCIs, particularly for children under 2 years old. Additionally, more attention should be paid to the quality surveillance, assessment and management of NCIs.

AIM: To compare the effects of defocus incorporated multiple segments(DIMS)lens with highly aspherical lenslets(HAL)on delaying the progression of myopia in adolescents.METHODS: Clinical randomized controlled study. Totally 301 students aged 7-12 who underwent optometry in our hospital from January 2021 to June 2023 were randomly divided into two groups. The first group consisted of 154 patients who were fitted with DIMS lenses(DIMS group). In the second group, 147 cases were fitted with HAL(HAL group). Both groups used 0.01% atropine eye drops to control myopia and all students wore glasses for more than 12 h every day. The spherical equivalent(SE)and axial length(AL)after rapid mydriasis were recorded. The data of the right eyes were taken, and the results after fitting for 12 mo were compared between the two groups.RESULTS: Multiple linear regression analysis showed that baseline age was significantly correlated with the changes of SE and AL(all P<0.01). After controlling baseline variables, the adjusted changes in SE for 12 mo after wearing glasses in the DIMS group and HAL group were -0.41±0.18 and -0.34±0.13 D, respectively(P<0.001); the changes of AL in the DIMS group and HAL group were 0.31±0.08 and 0.27±0.06 mm, respectively(P<0.001). Patients were divided into younger group(7-9 years old)and older group(10-12 years old). The changes in SE(t=2.250, P=0.025)and AL(t=3.120, P=0.002)of the younger group who wearing DIMS lens were greater than those with HAL after 12 mo, and the same was true in the older group(t=5.931, 5.033, both P<0.001).CONCLUSION: Under the condition of combined use of 0.01% atropine eye drops, HAL is more effective than DIMS lens in controlling myopia diopter and AL of adolescents.

Purpose To investigate the clinicopathological characteristics,diagnosis,and differential diagnosis of invasive mucinous adenocarcinoma(IMA)and mixed invasive mucinous and non-mucinous adenocarcinoma(mIMA).Methods The clinical data were collected in 36 patients with primary IMA and 17 patients with mIMA,and the expression of TTF-1,CK7,CK20,SATB2,CDX2,EGFR,HNF4a,etc.was detected by immunohistochemical EnVision two-step method.The Sanger se-quencing and the FISH were used for KRAS mutation and NRG1 gene rearrangement detection.The clinicopathological character-istics were analyzed with review of relevant literature.Results There were 9 cases(25.0％)and 3(8.3％)cases of papillary and micropapillary structures in IMA,while 13 cases(76.5％)(P＜0.001)and 9 cases(52.9％)(P=0.001)were present in mIMA.There were 5 cases(13.9％)of high nuclear grade of IMA and 10 cases(58.8％)of high nuclear grade of mIMA(P=0.002).TTF-1 had a positive rate of 37.5％in IMA,but 60.0％and 80.0％in the mucinous adenocarcinoma and non-mucinous adenocarcinoma components of mIMA(P=0.021),respectively.The positive rates of CK7,CK20,and CDX2 in IMA were 90.6％,21.9％,and 9.4％,and the positive rates in mucinous adenocarcinoma and non-mucinous adenocarcinoma components of mIMA were 100％,20％,20％and 100％,6.7％,6.7％,respectively and no SATB2 expression was found in all cases.There was no significant difference in the expres-sion of total EGFR and two EGFR mutation-specific antibodies(L858R,DEL19)between IMA and mIMA.There were 3 cases of mucinous adenocarcinoma with L858R positive in mIMA,and 2 of them were negative for non-mueinous adenocarcinoma.In another case,the non-mueinous adenocarcinoma component of mIMA expressed DEL19,but the mucinous adenocarcinoma component was not expressed.The positive rate of HNF4a in IMA was 72.0％(18/25),and those of HNF4a in mucinous adenocarcinoma and non-mucinous adenocarcinoma in mIMA were 41.7％(5/12)and 33.3％(4/12),respectively(P=0.048).KRAS gene sequencing was carried out in 19 cases of IMA,among which 9 cases(47.4％)had mutations,G12D and G12V were most commonly detected,and 4 cases of mIMA were sequenced,but none of them showed KRAS mutations.FISH detection showed that 2 cases(7.1％)IMAs had NRG1 translocation rearrangement.Conclusion Pulmonary mIMA is more aggressive than IMA.For example,mIMA has significantly more papillary structure,micropapillary structure,and high nu-clear grade cases than IMA.The differences in immunohisto-chemical expression and KRAS mutation between the two are sta-tistically significant.

ObjectiveTo establish the frozen section method of Ferula ferulaeoides， and to study the histochemical localization of volatile oil and coumarins in different organs of F. ferulaeoides. MethodThe roots， stems， petioles and leaves of F. ferulaeoides were used as materials to investigate the concentration of sucrose protectant， liquid nitrogen flash-freezing time， embedding conditions， section thickness， freezing temperature and time and post-treatment methods， the most suitable section conditions were screened by comparing the integrity， microscopic effect， elongation and clarity of frozen sections. Sudan Ⅳ staining method and fluorescence microscopy were used to locate the volatile oil and coumarins of F. ferulaeoides. ResultThe optimal conditions for frozen sections of the roots， stems， petioles and leaves of F. ferulaeoides were as follows：10%， 15% and 20% gradient sucrose as the protectant for roots， 10%， 20% and 30% gradient sucrose as the protectant for stems and petioles， 20%， 25% and 30% gradient sucrose as the protectant for leaves， glue-water （2∶1） as the embedding agent， quick-freeze in liquid nitrogen for 20 s， warmed up at -25 ℃ for 30 min， sliced at -20 ℃ with the thickness of 25 μm， rinsed with the same concentration of sucrose solution （gradient sucrose solution selected the last concentration）， and the slices placed on the ice pack for a period of time and stored at room temperature. Among them， the concentration of sucrose protectant was the most important factor. The results of histochemical localization showed that volatile oil and coumarins in four organs of F. ferulaeoides were mainly distributed in resin canal. ConclusionFrozen section of F. ferulaeoides is established for the first time with high rate of slicing and simplified steps， its volatile oil and coumarins are mainly accumulated in resin canal.

Objective To investigate the clinical features and prognosis risk factors of the elderly and youth patients with acute severe poisoning.Methods Adult patients with acute severe poisoning in the emergency intensive care unit (EICU) of Nanjing Drum Tower Hospital from January 2008 to December 2017 were enrolled. The patients were divided into the elderly group (age ≥ 60 years) and the youth group (16 years≤age < 60 years), the clinical data of the two groups were analyzed. The patients were divided into survival group and death group according to the prognosis of 28-day, binary multivariate Logistic regression was used to analyze the risk factors of mortality of the elderly and youth patients; receiver operating characteristic curve (ROC) was used to assess the predictive value of acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) in mortality of youth patients.Results A total of 343 patients with acute severe poisoning were included, 89 in the elderly group and 254 in the youth group. ① Clinical features: compared with the youth group, the elderly group had higher proportion of basic diseases included hypertension, type 2 diabetes and coronary heart disease, higher the initial APACHEⅡ scores at admission, higher the proportion of invasive mechanical ventilation and respiratory failure, and longer the length of EICU stay and the length of hospital stay. The main poisoning causes of elderly and youth patients were suicide (58.43％, 83.86％) and accidents (38.20％, 13.39％). The most common poisoning types of elderly patients were sedative hypnotics (23.60％) and organophosphorus pesticides (22.47％); the youth patients were mainly paraquat (42.52％) and organophosphorus pesticide (17.32％). There were 28 patients died (31.46％) in the elderly group and the cause of death were respiratory failure (53.57％), circulatory failure (32.14％) and multiple organ dysfunction syndrome (MODS, 14.29％). There were 67 patients died (26.38％) in the youth group and the cause of death were respiratory failure (59.70％), MODS (20.90％) and circulatory failure (19.40％). ② Risk factors of deaths: the APACHEⅡ score, incidence of acute kidney injury (AKI) and MODS in the elderly death group were significantly higher than those in the elderly survival group. Logistic regression analysis showed that AKI was the independent risk factor for death in elderly patients [odds ratio (OR) = 8.449, 95％ confidence interval (95％CI) =2.347-30.410,P = 0.001]. The proportion of female, APACHE Ⅱ score, and the incidence of AKI, respiratory failure and MODS in the youth death group were significantly higher than those in the youth survival group. Logistic regression analysis showed that APACHE Ⅱ score (OR = 1.175, 95％CI = 1.081-1.277,P = 0.001), AKI (OR = 34.470, 95％CI =11.681-101.722,P = 0.001) and MODS (OR = 3.834, 95％CI = 1.264-11.636,P = 0.018) were the independent factors for death in the youth patients. ③ Predictive value: the initial APACHEⅡscore was useful for predicting prognosis of youth patients with acute severe poisoning. The APACHE Ⅱ score to predict the death of the area under the ROC curve (AUC) was 0.744 (95％CI = 0.681-0.806,P = 0.001); the cut-off was 5, the sensitivity was 92.54％, the specificity was 51.34％, the positive predictive value was 65.53％, the negative predictive value was 87.31％, the positive likelihood ratio was 1.902, and the negative likelihood ratio was 0.145.Conclusions Patients with acute severe poisoning have their own clinical characteristics. To reduce the morbidity and improve the prognosis, we should strengthen the pre-hospital management and optimize the clinical treatment process.

Objective To explore the effect of betulinic acid on NAFLD and its mechanism. Methods We used the high-fat diet animal models, with or without feeding the standard chow diet containing betulinic acid for 2 months. During this period, the body weight was monitored regularly and metabolism cage was used to monitor the energy metabolism of the animals. After killing the mice, molecular biological analysis was performed on serum and tissue related to liver. Results In diet induced obese mice animal experiments, the mice body weight had been reduced and NAFLD had been improved significantly by betulinic acid. The various indexs of serum and liver tissue had also been significantly improved. The metabolic rate increased significantly. Fatty acid synthase gene and protein levels were significantly lower. Furthermore, FAS activity was significantly lower than the control mice. Liver FAS activity of the high fat mice and the high fat mice treated with betulinic acid were (1873.6 ± 85.7) and (1181.6 ± 85.7) pmol NADPH/ min/ mg protein, respectively. Conclusion Betulinic acid inhibited FAS at expression and activity level, and improved lipid deposition in liver.

Objective To prepare gadolinium-loaded stearic acid grafted chitooligosaccharide (COSSA-DTPA-Gd) and evaluate its micelle properties,cytotoxicity,relaxation rate in vitro,and pancreatic tumor in vivo imaging.Methods Stear ic acid grafted chitooligosaccharide (COSSA) was synthesized by acetylation reaction between stearic acid and chitooligosaccharide.Diethylenetriaminepentaacetic dianhydride (DTPA) was conjugated to the residual amino groups of COSSA,then Gd3+ was chelated to obtain the final product.The micelle properties were measured using an electron microscopy and a laser particle sizer.The MTT assay was adopted to determine cytotoxicity.The in vitro relaxation rate and in vivo imaging of pancreatic tumor were evaluated using an MR scanner.Results COSSA-DTPA-Gd could self-assemble into stable micelles in aqueous solutions with a critical micelle concentration of (5.12±0.43)μg/ml.The micelles had positive charge and exhibited roughly spherical shape with a mean diameter of (58.3± 5.7)nm.The content of Gd3+ in COSSA-DTPA-Gd was 330.31 μmol/g.The nanoprobe and Magnevist,the commercial formulation,showed similar cytotoxicity (P＞0.05).The cell survival rate within 24 h were higher than 85％.The in vitro relaxation rate of COSSA-DTPA-Gd was 8.23 mM-1 ·s-1.After intravenous injection,COSSA-DTPA-Gd showed a better positive contrast-enhancing effect for pancreatic tumor than Magnevist.The MR images at the tumor periphery was rapidly enhanced,while a slow increase in image quality was observed in tumor core.Conclusion The prepared COSSA-DTPA-Gd can be used for efficient MR imaging of pancreatic tumor.

Objective To explore the effect of SIRT1 gene silencing on the radiosensitivity of diffuse large B-cell lymphoma (DLBCL) cells.Methods Immunohistochemistry was used to measure the protein expression of SIRT1 in DLBCL tissues.Western blot was used to measure the expression of SIRT1 in DLBCL cell lines (OCI-Ly3,SU-DHL-2,and SU-DHL-4) and the immortalized B cell line HMy2.CIR.After SU-DHL-4 cells were transfected with si-SIRT1 and si-NC using Lipofectamine 2000,the expression of SIRT1 was determined by Western blot.MTT assay and colony-forming assay were used to assess the cell growth and colony formation ability of SU-DHL-4 cells treated with radiation.The group t-test or univariate analysis of variance was used for comparison between groups.Results The expression rate of SIRT1 in DLBCL tissues was 72.6%(103/140),which was significantly higher than that in reactive lymphoid hyperplasia (RLH) tissues (26.5%,8/25)(P=0.001).The SIRT1 expression was significantly higher in DLBCL cells than in HMy2.CIR cells (P=0.020).After SIRT1 gene silencing by si-SIRT1,the expression of SIRT1 was significantly reduced in SU-DHL-4 cells (P=0.008).Besides,SIRT1 gene silencing significantly reduced the growth rate and colony formation ability of SU-DHL-4 cells treated with radiation (P=0.030).Conclusions SIRT1 gene silencing enhances the radiosensitivity of DLBCL cells,providing a novel target for the radiotherapy of DLBCL.

BACKGROUND:In recent years, tissue engineering technology as a new model for tissue regeneration has provided new ideas and methods for the repair of periodontal tissue defects. OBJECTIVE:To investigate the effect of human periodontal ligament cels-polyglycolic acid scaffold complex for repair of periodontal tissue defects. METHODS:Passage 4 human periodontal ligament cels at a density of 1.5×109/L were seeded onto the polyglycolic acid scaffold to prepare cel-scaffold complex. Then mongrel dogs were selected to make animal models of periodontal tissue defects and then randomly assigned into experimental group subjected to cel-scaffold complex implantation or control group subjected to direct coronal reset and suture of the gingival flap. Colagen content, new blood capilaries, new cementum, new alveolar bone and new periodontal ligament were detected within 4 weeks after operation; hematoxylin-eosin staining of periodontal tissue defects was done at 8 weeks after operation. RESULTS AND CONCLUSION:In the experimental group, the colagen content, number of newborn capilaries, amount of new cementum, new alveolar bone and new periodontal ligament tissues were significantly higher than those in the control group at postoperative 1, 2, 3, 4 weeks (P< 0.05). At 8 weeks after operation, in the experimental group, there were more vessels arranging on the connective tissue surface of new alveolar bone, the alveolar bone showed a sawtooth-like interlinking with the periodontal tissues in the presence of a thin layer of cementum; in the control group, only new alveolar bone and cementum formed below the incisure. These findings indicate that human periodontal ligament cels-polyglycolic acid scaffold complex can promote periodontal tissue regeneration.

BACKGROUND: Zein has excel ent solubility, heat resistance and biodegradability, but its biocompatibility and effect on periodontal defects repair are under discussion. OBJECTIVE: To analyze biocompatibility of zein and its effect on periodontal defect repair. METHODS: Zein scaffold was prepared by solvent casting/particulate leaching. In vitro test: Human periodontal ligament cel s were co-cultured with zein scaffold for 18 days, and cel growth was observed by scanning electron microscope. In vivo test: Eight Beagle dogs were enrol ed to establish periodontal defect models, which were randomly assigned to receive zein scaffold implantation as experimental group, or interrupted suture as control group. Afterwards, the defect region was observed by scanning electron microscope at 3 months. RESULTS AND CONCLUSION: In vitro results: Human periodontal ligament cel s adhered wel and tightly on the scaffold with a fusiform, and could grow around pores. In vivo results: In the experimental group the scaffold dissolved completely, bone trabecular arranged regularly, and mature tissues appeared, to be integrated with the surrounding tissues; in the control group, the defect region almost healed, but there were irregular fibers and obvious lacunae. Moreover, compared with the control group, the height of new alveolar bone and bone defect, as wel as the length of junctional epithelium were significantly decreased, and new cementum was significantly increased in the experimental group (P < 0.05). To conclude, zein scaffold has good biocompatibility and can promote periodontal defect repair.