AIM: To investigate the protective effect and mechanism of Danlou tablet on retinal ischemia-reperfusion injury(RIRI)in mice.METHODS: A total of 40 ApoE-/- mice were fed with high fat diet for 6 wk, and the RIRI model was established by anterior chamber infusion of pressurized saline. The mice were divided into control group(normal saline for 8 wk), RIRI model group(normal saline for 8 wk), and low-, medium-, and high-dose Danlou tablets groups [1, 2, and 4 g/(kg·d), respectively, for 8 wk]. The morphological changes of retina were observed by hematoxylin-eosin(HE)staining, retinal cell apoptosis was detected by terminal-deoxynucleoitidyl transferase mediated Nick-End Labeling(TUNEL)staining. The Western-blot assay was used to detect the expression of retinal tissue sample Kelch-like ech-associated protein 1(Keap1), nuclear factor E2 related factor 2(Nrf2), heme oxygenase 1(HO-1), and superoxide dismutase(Sod2)proteins.RESULTS: Compared with the control group, the mouse retina was atrophic with thinning thickness and increasing cell apoptosis, down-regulation of Sod2 protein expression, and up-regulation of Keap1 protein expression in the RIRI model group(all P<0.01). Compared with the RIRI model group, the retinal thickness increased in the medium- and high-dose of Danlou tablets groups(all P<0.01), and the cell apoptosis of retina decreased in the low-, medium- and high-dose of Danlou tablets groups(all P<0.05). There were no significant differences in the expression of Keap1 and HO-1 proteins of mouse retina tissue in the low-dose of Danlou tablets group(P>0.05). The expression of Sod2, Nrf2 and HO-1 proteins up regulated, and the expression of Keap1 protein down regulated in the medium- and high-dose of Danlou tablets groups(all P<0.05).CONCLUSION: Danlou tablet can alleviate RIRI-induced atrophy and thinning of retina and retinal cell apoptosis by regulating Keap1-Nrf2/HO-1 signal pathway and reducing oxidative stress.

Thermal ablations are rapidly developing techniques for minimally invasive treatment,including laser ab-lation,radiofrequency ablation,and microwave ablation.Such remarkable success has been achieved in treatment malig-nant neoplasms,for instance,hepatocellular carcinoma and renal cell adenocarcinoma.In recent years,the practice has been gradually adopted into the treatment of papillary thyroid microcarcinoma(PTMC).Many reports have stated that ther-mal ablations have distinctive advantages over traditional thyroidectomy owing to its efficacy and safety for treatment pri-mary PTMC,meanwhile there are many controversial issues which hotly debated regarding to first-line treatments.Re-cently,indications and contraindications of thermal ablation for PTMC have been successively proposed by guidelines and consensuses.Many follow-up reports related to thermal ablation in the treatment of PTMC have been reported in clinical practice as well.In this review,we summarized the principles,indications and contraindications,and the efficacy and safety of thermal ablation in the treatment of PTMC,and compared it with traditional surgery.

Objective: To explore positive psychological wellbeing of outstanding impoverished college students, and to provide reference for targeted mental health education. Methods: By using in depth interview, twenty two outstanding impoverished college students from an undergraduate university in Dongguan were recruited and interviewed during April to May 2021. Results: Qualitative analysis showed 9 characteristics in positive psychological wellbeing among these outstanding impoverished college students:gratitude( n =20), independence( n =15), sincerity( n =13), hard working( n =12), friendliness( n =11), studious( n =11), self cognitive adjustment( n =11), self discipline( n =11) and persistence( n =11), among which gratitude and independence were the core attributes. Factors associated with these positive psychological wellbeing mainly included the following aspects:family related factors [family function( 72.7 %), family teaching(63.6%), family emotional support(59.1%), parental attention in education( 36.4 %)], and family function scored the highest; peer related factors [peer influence(45.5%) and peer emotional support( 45.5 %)]; and teacher related factors [teachers emotional support(40.9%) and teachers teaching(27.3%)]. In addition, other factors such as personal practical experience, national policy support and school atmosphere also had certain impacts. Conclusion Outstanding impoverished college students demonstrate positive psychological wellbeing. It should pay more attention to the positive psychological characteristics of impoverished college students, to explore factors associated with positive psychological qualities from various aspects, to pay attention to the role of social and emotional support, and to implement education to enhance positive psychological traits among impoverished college students.

Purpose: Progressive familial intrahepatic cholestasis (PFIC) is a rare genetic autosomal recessive disease caused by mutations in ATP8B1, ABCB11 or ABCB4. Mutational analysis of these genes is a reliable approach to identify the disorder. Methods: We collected and analyzed relevant data related to clinical diagnosis, biological investigation, and molecular determination in nine children carrying these gene mutations, who were from unrelated families in South China. Results: Of the nine patients (five males, four females) with PFIC, one case of PFIC1, four cases of PFIC2, and four cases of PFIC3 were diagnosed. Except in patient no. 8, jaundice and severe pruritus were the major clinical signs in all forms. γ-glutamyl transpeptidase was low in patients with PFIC1/PFIC2, and remained mildly elevated in patients with PFIC3. We identified 15 different mutations, including nine novel mutations (p.R470HfsX8, p.Q794X and p.I1170T of ABCB11 gene mutations, p.G319R, p.A1047P, p.G1074R, p.T830NfsX11, p.A1047PfsX8 and p.N1048TfsX of ABCB4 gene mutations) and six known mutations (p.G446R and p.F529del of ATP8B1 gene mutations, p.A588V, p.G1004D and p.R1057X of ABCB11 gene mutations, p.P479L of ABCB4 gene mutations). The results showed that compared with other regions, these three types of PFIC genes had different mutational spectrum in China. Conclusion The study expands the genotypic spectrum of PFIC. We identified nine novel mutations of PFIC and our findings could help in the diagnosis and treatment of this disease.

Objective:To confirm the possible pathogen causing an outbreak of respiratory infectious disease in Beijing.Methods:Oropharyngeal swabs were collected from 14 cases with fever and detected by RT-PCR for respiratory viruses and bacteria. For specimens positive for adenoviruses, Fiber, Hexon and Penton gene fragments were amplified with specific primers and sequenced. BLAST and phylogenetic tree were used for sequence analysis.Results:All of the 14 specimens were adenovirus-positive. BLAST analysis of the sequences of Fiber, hexon and Penton genes showed that the 14 cases were all caused by adenovirus 3. The phylogenic tree analysis indicated that this adenovirus was closely related to an adenovirus of 3a51 genotype (GenBank No: KF268123) isolated in the USA in 2007.Conclusions:Human adenovirus genotype 3a51 caused this outbreak of respiratory infectious disease in Beijing.

As a common clinical syndrome, portal hypertension can cause severe complications including gastroesophageal varices, ascites, and hepatic encephalopathy in patients with chronic liver diseases, which indirectly affects the prognosis of cirrhotic patients. At present, hepatic venous pressure gradient (HVPG) is the gold standard for the evaluation of portal hypertension, but its clinical application is limited by invasiveness and high cost. Therefore, the development of noninvasive and accurate measurements for portal pressure is crucial in the diagnosis, risk stratification, outcome monitoring, and prognosis prediction. This article reviews the latest advances in noninvasive examinations of portal hypertension in clinical practice and emphasizes the research and development of noninvasive techniques, HVPG standardization, and precise risk stratification management.

Objective To evaluate the sensitivity and specificity of enzyme assays,and to provide disease spectrum of lysosomal storage diseases (LSDs).Methods Three thousand three hundred and sixty-four high risk individuals were screened for 24 LSDs at Guangzhou Women and Children's Medical Center between January 2009 and December 2016.Twenty-two kinds of enzyme activities from peripheral blood leucocytes or plasma were measured by using the fluorometry or colorimetry of corresponding artificial substrates,screening for 24 LSDs diseases.Measurement data were represented by (x) ± s,and count data were expressed as a percentage or composition ratio.Results A total of 283 subjects were diagnosed with 18 different kinds of LSDs,and the positive rate of high-risk screening was 8.4％.Among the identified patients,172 cases (60.8％) were mucopolysaccharidosis (MPS),79 cases (27.9％) were sphingolipidoses,18 cases (6.4％) were Pompe diseases,10 cases (3.5％) were affected with mucolipidoses,3 cases (1.1％) were glycoprotein storage diseases,and 1 case(0.4％) was Wolman disease.Of the MPS cases,there were 75 cases of MPS Ⅱ (43.6％),45 cases of MP5 ⅣA (26.2％),24 cases of MPS Ⅵ (14.0％) and 20 cases of MPS Ⅰ (11.6％).Gaucher disease (23/79 cases,29.1％) and metachromatic leukodystrophy (MLD) (21/79 cases,26.6％) were common in sphingolipidoses group.Both the sensitivity and specificity of enzyme assays on peripheral blood leucocytes for LSDs were 100％.Conclusions The most common kinds of LSDs are MPS Ⅱ,MPS Ⅳ A,MPS Ⅵ,Gaucher disease,MLD and Pompe disease.Leukocyte enzymology analysis of high-risk screening LSDs has high sensitivity and specificity.

Objective: To explore the association between the 21-gene recurrence score (RS) and clinicopathologic characteristics as well as prognosis in patients with axillary lymph node negative, hormone receptor (HR) positive breast cancer. Methods: The clinicopathologic data of 439 early breast cancer patients who underwent 21 gene RS testing was retrospectively analyzed. According to the 21 gene RS, the patients were divided into low risk (295 cases), intermediate risk (111 cases) and high-risk (33 cases) group. The relationship between the 21 gene RS and clinicopathological characteristics, treatment, recurrence and metastasis was analyzed. Univariate and multivariate statistical analyses were used to analyze the risk factors for relapse free survival (RFS). Results: Tumor grade, estrogen receptor (ER), progesterone receptor (PR) and Ki-67 index were significantly different among the 3 risk cohorts (P<0.001 for all). After a median follow-up of 32 months, the recurrence rate in low risk group (3.7%) was significantly lower than that in the intermediate-high risk group (9.0%), the locoregional recurrence (LRR) rate of low, intermediate and high risk group was 2.4%, 6.3% and 9.1%; and the distant metastasis (DM) rate in low risk group was 1.4% and 2.1% in the intermediate-high risk group. Univariate analysis showed RS, ER status and endocrine therapy were prognostic factors for RFS (P<0.05 for all). Multivariate analysis showed that RS was an independent significant predictor for RFS (P=0.04). Conclusions The 21-gene RS is related to tumor grade, ER, PR and Ki-67 index. RS is an independent risk factor for RFS in patients with hormone receptor positive early-stage breast cancer.

Objective To explore the safety and cosmetic effect of nipple-sparing modified radical mas tectomy and immediate tissue expander implantation with single circumaereolar incision.Methods 30 patients were enrolled in Peking Union Medical College Hospital between Jan.2014 and Dec.2015.All the patients were categorized according to surgical incision (single circumaereolar incision group vs double incisions group).Data on clinicopathological parameters,average hospital stay,complications and overall cosmetic effect were retrospectively collected.Data was performed with Chi-square test,Fisher exact test and t-test.Statistical significance was defined as P＜0.05.Results 19 patients were enrolled in single circumaereolar incision group,and 11 patients in double incisions group.There was no significant difference for operation duration (P=0.093) and average hospital stay (P=0.339).After follow-up for 19.1 months,ranging from 8 to 31 months,no patients developed seroma or arm lymphedema.There was no statistical significance between the two groups in terms of sensation in nippleaereolar area (P=0.973),bilateral symmetry (P=0.650) and overall cosmesis (P=0.483).Conclusion single circumaereolar incision nipple-sparing modified radical mastectomy and immediate tissue expander implantation can be one of the preferable surgical procedures with benefits of minimal invasiveness,reliable oncological safety and decent cosmetic effect.

Objective To investigate the value of the E-selectin,IL-6 and TNF-α for the diagnosis of myocardial damage in children.Methods The E-selectin,IL-6 and TNF-α levels were detected in 62 patients with myocardial damage and 62 children without myocardial damage.The values of the E-selectin,IL-6 and TNF-α for the diagnosis of myocardial damage were analyzed by the receiver operating characteristic (ROC) curve.Results E-selectin levels were (45.16 ± 5.34) and (15.37 ± 4.65) μg/L,respectively in the patients with myocardial damage and the control group,and the difference between the two groups was significant(P ＜ 0.001).IL-6 levels were (21.31 ± 5.28) ng/L and (17.09 ± 4.62) ng/L,TNF-α levels were (27.22 ± 8.56) ng/L and(21.46 ± 8.08) ng/L,showing no significant difference (P ＞ 0.05).ROC curve analysis showed that AOC of E-selectin in the diagnosis of myocardial damage was 0.945 with 95％ CI 0.899 ～0.991 (sensitivity:0.801,specificity:0.999,Youden Index:0.800),and the cutoff value was 29.93 μg/L.Conclusion E-selectin can be used as one of the diagnostic indices for myocardial damage in children,which has great diagnostic value.IL-6 and TNF-α are of limited value in the diagnosis of myocardial damage.