Objective:We aimed to develop a novel visualized model based on nomogram to predict postoperative overall survival.Methods:This was a multicenter, retrospective, observational cohort study, including participants with histologically confirmed gastric and colorectal cancer who underwent radical surgery from 11 medical centers in China from August 1, 2015 to June 30, 2018. Baseline characteristics, histopathological data and nutritional status, as assessed using Nutrition Risk Screening 2002 (NRS 2002) score and the scored Patient-Generated Subjective Global Assessment, were collected. The least absolute shrinkage and selection operator regression and Cox regression were used to identify variables to be included in the predictive model. Internal and external validations were performed.Results:There were 681 and 127 patients in the training and validation cohorts, respectively. A total of 188 deaths were observed over a median follow-up period of 59 (range: 58 to 60) months. Two independent predictors of NRS 2002 and Tumor-Node-Metastasis (TNM) stage were identified and incorporated into the prediction nomogram model together with the factor of age. The model's concordance index for 1-, 3- and 5-year overall survival was 0.696, 0.724, and 0.738 in the training cohort and 0.801, 0.812, and 0.793 in the validation cohort, respectively.Conclusions:In this study, a new nomogram prediction model based on NRS 2002 score was developed and validated for predicting the overall postoperative survival of patients with gastric colorectal cancer. This model has good differentiation, calibration and clinical practicability in predicting the long-term survival rate of patients with gastrointestinal cancer after radical surgery.

Objective:To understand the current clinical practice status of evidence on blood glucose management in ICU patients with insulin intravenous infusion, analyze barriers and formulate action strategies, so as to provide reference for the translation of evidence into clinical practice.Methods:Based on the clinical evidence application model of the Joanna Briggs Institute (JBI) Evidence-Based Health Care Center, clinical nursing problems were identified, literature search, evaluating and summarizing evidence were carried out, and review indicators and methods were developed. From July to August 2023, convenience sampling was used to select 42 nurses and 80 patients with insulin intravenous infusion from the comprehensive ICU of Wuxi Second People's Hospital as participants for baseline review. Barriers were analyzed and change strategies were developed based on baseline review results.Results:A total of 16 pieces of evidence were introduced regarding blood glucose management in ICU patients with insulin intravenous infusion. Nineteen review indicators were formulated, of which 13 had a compliance rate of less than 60%. Analysis identified 18 barriers and 13 facilitators. Sixteen change strategies were developed based on barriers and facilitators.Conclusions:There is still a significant gap between the evidence of ICU insulin intravenous infusion blood glucose management and clinical practice. Evidence-based practice programs should be constructed based on intervention strategies to effectively promote the application of evidence in clinical practice.

Objective:To investigate the characteristics of thalassemia gene types in children in Liuzhou,Guangxi.Methods:A total of 822 children suspected thalassemia aged from 1 day to 14 years who were admitted to our hospital from January 2019 to April 2022 were collected.Gap-PCR and PCR combined with reverse dot blot hybridization were used to detect α-and β-thalassemia genes.Results:Among 822 children,561 thalassemia carriers were detected,with a detection rate of 68.25％.Among them,303 cases were detected with α-thalassemia,and the most common genotype was--SEA/αα(163 cases),followed by-α3.7/αα(37 cases)and αcsα/αα(26 cases),44 cases with HbH disease.240 cases were detected with β-thalassemia,with a detection rate of 29.20％,and the most common genotype was βCD41-42/β N(112 cases),followed by βCD17/βN(75 cases)and βIVS-Ⅱ-654/β N(11 cases),11 cases with moderate to severe β-thalassemia.18 cases were detected with α β-thalassemia,with a detection rate of 2.19％,and--SEA/αα complex βCD41-42/βN was the most common genotype(4 cases).In Zhuang and Han populations,the detection ratio of-α3.7α/αα in α-thalassemia was the same(both 12.50％).While,the other main types such as--SEA/αα,αCSα/αα and-α4.2α/αα had certain differences.In β-thalassemia,CD41-42 and CD17 were the main genotypes detected in Han and Zhuang.Conclusion:In Liuzhou of Guangxi autonomous region,α-thalassemia is the main type in children,with a detection rate of 68.25％,and--SEA/αα is the most common genotype in mild thalassemia,followed by βCD41-42/βN.The detection rate of moderate to severe α-and β-thalassemia is relatively high.There are certain differences in the distribution of thalassemia among different ethnic groups.

Objective:To observe the effect of auricular pressure beans(APN)combined with Compound Tung-Leaf Burn Oil(CTBO)on perioperative anxiety and pain in patients undergoing circumcision.Methods:This study included 100 patients undergo-ing circumcision with the disposable circumcision anastomosis stapler in our hospital from August 2023 to November 2023,of whom 50 received routine circumcision nursing care(the control group)and other 50 APN combined with compound CTBO in addition(the ob-servation group).We compared between the two groups the anxiety scores before any intervention,30 minutes before and 24 hours and 10 days after operation,the pain scores 24 hours postoperatively and at the first change of wound dressing,the frequency of 3-day post-operative sleep awakenings,the incidence of complications,and the satisfaction of the patients.Results:Totally,94 patients com-pleted the study,46 in the observation and 48 in the control group.The anxiety scores exhibited no statistically significant difference between the two groups of patients before any intervention(P>0.05),but were markedly lower in the observation than in the control group at 30 minutes before and 24 hours and 10 days after surgery(P<0.05),and so were the pain scores24 hours after surgery and at the first change of wound dressing(P<0.05),and the frequency of 3-day postoperative sleep awakenings(P<0.05).The satis-faction rate of the patients was remarkably higher(P<0.05)while the incidence of complications significantly lower in the observation group than in the control(P<0.05).Conclusion:Auricular pressure beans combined with Compound Tung-Leaf Burn Oil can ef-fectively alleviate perioperative anxiety,reduce postoperative pain and improve satisfaction of the patients undergoing circumcision.

AIM To investigate the effects of Sanshiliudang Kange Powder on airway inflammation in bronchial asthma remission of mice.METHODS Seventy-eight BALB/c mice were randomly divided into the blank group,the model group,the dexamethasone group(0.5 mg/kg)and the low-dose,medium-dose and high-dose Sanshiliudang Kange Powder groups(9.3,18.6 and 37.2 g/kg).Except for those of the blank group,the mice of the other groups were sensitized by intraperitoneal injection of ovalbumin(OVA)and aluminum hydroxide mixture,and induced into models of asthma remission followed by 28 days consecutive corresponding drug administration which was initiated on the 77th day of modeling.The mice had their pulmonary pathological changes observed by HE staining;their levels of IL-1β,IL-6,TNF-α,HMGB1 and NF-κB in serum and alveolar fluid determined by ELISA;and their pulmonary protein expressions of TLR4,MyD88,NF-κB p65 and p-NF-κB p65 determined by Western blot.RESULTS Compared with the model group,each group intervened with a drug displayed significantly reduced pulmonary pathological injury and inflammation;decreased levels of IL-1β,IL-6,TNF-α,HMGB1,NF-κB in serum and BALF(P＜0.01);and decreased pulmonary protein expressions of TLR4,MyD88,p-NF-κB p65/NF-κB p65(P＜0.01).Generally,the medium-dose Sanshiliudang Kange Powder group demonstrated a very good efficacy,which was only inferior to that of the dexamethasone group.CONCLUSION Sanshiliudang Kange Powder has a good inhibitory effect on airway inflammation in bronchial asthma remission of mice,and its mechanism may be related to the inhibited activation of HMGB1/TLR4/MyD88 signal pathway.

Objective:To investigate the effect of long non-coding RNA (lncRNA) H19 regulating miRNA-675 (miR-675) and phosphatase and tensin homologue-deleted chromosome ten gene (PTEN) on the cell proliferation of glioma.Methods:Glioma cell lines U87-MG and U251 were chosen. The siRNA online design tool wad used to design small interfering RNA (siRNA) targeting H19. U87-MG and U251 cell lines with the stable knockdown of H19 were constructed (the stable knockdown of H19 group), and the cells randomly transfected with siRNA plasmid were taken as the control group, and normal cultured cells were treated as the blank group. Additionally, miR-675 and control microRNA were transfected into U87-MG and U251 with the stable knockdown of H19 (the overexpressing miR-675 group and the corresponding control group). Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the relative expression levels of miR-675 and H19 in each group; the methyl thiazolyl tetrazolium (MTT) assay was used to detect the cell proliferation ability; the dual luciferase reporter gene assay was used to verify the targeting relationship between miR-675 and PTEN; Western blot was used to detect the relative expression level of PTEN protein.Results:The MTT assay results showed that the proliferation ability of U87-MG and U251 cells in the stable knockdown of H19 group was lower than that of the corresponding control group; and the differences in cell proliferation ability of all the groups after 48 h of culture were statistically significant (all P < 0.05). qRT-PCR detection results showed that the relative expression level of miR-675 in U251 cells in the stable knockdown of H19 group and the corresponding control group was 0.329±0.009 and 1.043±0.087, respectively, and the difference was statistically significant ( t = 14.15, P < 0.001); the relative expression level of miR-675 in U87-MG cells in the stable knockdown of H19 group and the corresponding control group was 0.299±0.009 and 1.027±0.106, respectively, and the difference was statistically significant ( t = 11.85, P < 0.001); the relative expression level of miR-675 in U87-MG and U251 cells in the stable knockdown of H19 group was lower than that of the corresponding control group. The dual luciferase reporter gene assay verified that miR-675 could bind to the 3'-UTR of PTEN. Western blot detection results showed that the relative expression level of PTEN protein in U87-MG and U251 cells in the stable knockdown of H19 group was higher than that of the corresponding control group and the blank group; in the U87-MG and U251 cells in the stable knockdown of H19 group, the relative expression level of PTEN in the overexpressing miR-675 group was lower than that of the corresponding blank group and the control group. In the U87-MG and U251 cells in the stable knockdown of H19 group, the cell proliferation ability of the overexpressing miR-675 group was higher than that of the corresponding blank group and the control group; the differences in cell proliferation ability of all the groups after 48 h of culture were statistically significant (all P < 0.05). Conclusions:lncRNA H19 may regulate the cell proliferation of glioma cells through the miR-675-PTEN signaling pathway.

Objective To study the in vitro expression of three phenylalanine hydroxylase(PAH)mutants(p.R243Q,p.R241C,and p.Y356X)and determine their pathogenicity.Methods Bioinformatics techniques were used to predict the impact of PAH mutants on the structure and function of PAH protein.Corresponding mutant plasmids of PAH were constructed and expressed in HEK293T cells.Quantitative reverse transcription polymerase chain reaction was used to measure the mRNA expression levels of the three PAH mutants,and their protein levels were assessed using Western blot and enzyme-linked immunosorbent assay.Results Bioinformatics analysis predicted that all three mutants were pathogenic.The mRNA expression levels of the p.R243Q and p.R241C mutants in HEK293T cells were similar to the mRNA expression level of the wild-type control(P>0.05),while the mRNA expression level of the p.Y356X mutant significantly decreased(P<0.05).The PAH protein expression levels of all three mutants were significantly reduced compared to the wild-type control(P<0.05).The extracellular concentration of PAH protein was reduced in the p.R241C and p.Y356X mutants compared to the wild-type control(P<0.05),while there was no significant difference between the p.R243Q mutant and the wild type control(P>0.05).Conclusions p.R243Q,p.R241C and p.Y356X mutants lead to reduced expression levels of PAH protein in eukaryotic cells,with p.R241C and p.Y356X mutants also affecting the function of PAH protein.These three PAH mutants are to be pathogenic.[Chinese Journal of Contemporary Pediatrics,2024,26(2):188-193]

IgA nephropathy is a common primary glomerular disease,and autophagy plays an important role in maintaining the homeostasis of the internal environment.Dysfunction of cellular autophagy can affect the occurrence and development of IgA nephropathy.This article focused on the molecular mechanism of TCM regulating autophagy in renal intrinsic cells,and found that TCM extracts and formulas mainly regulate autophagy through PI3K/Akt/mTOR,TLR4/NF-κB,MAPK,Nrf2/HO-1,NLRP3 and other signaling pathways.Furthermore,it could intervene in pathological damage such as renal fibrosis,inflammation,and oxidative stress,delaying the progression of IgA nephropathy,in order to provide reference for the clinical treatment and new drug development of IgA nephropathy.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

ObjectiveTo describe the epidemic characteristics of COVID-19 after policy adjustment from “Category B notifiable disease with category A management” to “Category B notifiable disease with category B management”， and to explore the protective effect of previous infection with SARS-CoV-2 on common symptoms of reinfection. MethodsHealthcare workers infected with SARS-CoV-2 in a grade A tertiary hospital in Shanghai were included in the study from December 4， 2022 to January 11， 2023. Data on demographic characteristics， clinical symptoms， medical history， and COVID-19 vaccination history were collected. We determined the epidemiological curve and characteristics， and then compared the difference in the severity of clinical symptoms between primary and reinfection subjects. ResultsA total of 2 704 cases were included in the study， of which 45 had reinfection， 605 （22.4%）were males， 608 （22.5%）were doctors， 1 275 （47.2%） were nurses， and 2 351 （86.9%） received ≥3 doses of COVID-19 vaccination. The average age of these healthcare workers was （34.9±9.1） years old. The number of cases with mild/moderate illness， asymptomatic infection， fever， headache， dry cough， expectoration， and chest tightness were 2 704 （100.0%）， 92 （3.4%）， 2 385 （88.2%）， 2 066 （76.4%）， 1 642 （60.7%）， 1 807 （66.8%）， and 439 （16.2%）， respectively. Reinfection was a protective factor for fever （OR=0.161， P<0.001）， headache （OR=0.320， P<0.001）， and peak body temperature （β=-0.446， P<0.001）. ConclusionFollowing the COVID-19 policy adjustment as a category B notifiable disease， healthcare workers at a grade A tertiary hospital in Shanghai predominantly experiences mild to moderate COVID-19 symptoms. Reinfection results in milder clinical manifestations， with a lower proportion of being asymptomatic.