AIM:To observe the effect of folic acid(FA)on C2C12 myoblast proliferation and differentia-tion,and to explore its mechanism.METHODS:During the proliferation stage,C2C12 myoblasts were treated with vari-ous concentrations of FA(0,2.5,5,10 and 20 μmol/L).The cell status was observed under a microscope,cell viability was detected using the MTT method,and cell proliferation was assessed using the EdU method.In the differentiation stage,C2C12 cells were divided into control(Ctrl)group(0 μmol/L FA)and FA group(10 μmol/L FA).On day 2 or 4 of differentiation,immunofluorescence staining and Western blot were employed to detect the expression of myoblast differen-tiation-related proteins,myoblast determination protein 1(MyoD),myogenin(MyoG)and myosin heavy chain(MyHC).The myotubule formation in each group was analyzed.On day 4 of differentiation,C2C12 cells were treated with FA for 0,1,3 and 6 h,and the protein levels of p-JNK,JNK,p-p38 MAPK and p38 MAPK at each time point were detected by Western blot.Additionally,C2C12 cells after 4-day differentiation were divided into Ctrl group,FA group,FA+ SP600125(specific inhibitor of JNK)group,and FA+SB203580(specific inhibitor of p38)group.The cells in FA+ SP600125 and FA+SB203580 groups were treated with 10 μmol/L SP600125 or SB203580 for 1 h,followed by treatment with 10 μmol/L FA for 24 h.The cells in FA group were treated with 10 μmol/L FA for 24 h,while the cells in Ctrl group were left untreated.The protein levels of p-JNK,JNK,p-p38 MAPK,p38 MAPK and MyHC were detected by Western blot.RESULTS:(1)Compared with 0 μmol/L FA group,the number of the cells in other concentration groups in-creased,cell viability was raised(P＜0.05 or P＜0.01),and the rate of EdU positive cells increased(P＜0.05).(2)Com-pared with Ctrl group,the expression levels of MyoD,MyoG and MyHC in FA group were increased(P＜0.05),and the myotube fusion index was raised(P＜0.05 or P＜0.01).(3)Compared with 0 h group,the ratios of p-JNK/JNK and p-p38 MAPK/p38 MAPK were elevated after FA treatment for 1,3 and 6 h(P＜0.05 or P＜0.01),and showed a trend of gradual increase with the extension of treatment time.(4)After FA treatment,the ratios of p-JNK/JNK and p-p38 MAPK/p38 MAPK,and the expression of MyHC were elevated(P＜0.01).Treatment with SP600125 decreased the ratio of p-JNK/JNK and the expression of MyHC(P＜0.05),while SB203580 intervention cut down the ratio of p-p38 MAPK/p38 MAPK and the expression of MyHC(P＜0.05 or P＜0.01).CONCLUSION:Folic acid can promote the differentiation of C2C12 myoblasts by activating the JNK/p38 MAPK signaling pathway.

BACKGROUND:A pathophysiological feature of septic organ failure is endothelial dysfunction in sepsis(EDS).The physiological and pathological mechanism of sepsis is considered to be vascular leakage caused by endothelial dysfunction.These pathological changes lead to systemic organ injury.However,an analysis using bibliometric methods has not yet been conducted in the field of EDS.This study was conducted to provide an overview of knowledge structure and research trends in the field of EDS. METHODS:Based on previous research,a literature search was performed in the Web of Science Core Collection(WoSCC)for publications associated with EDS published between the year 2003 and 2023.Various types of data from the publications,such as citation frequency,authorship,keywords and highly cited articles,were extracted.The"Create Citation Report"feature in the WoSCC was employed to calculate the Hirsch index(h-index)and average citations per item(ACI)of authors,institutions,and countries.To conduct bibliometric and visualization analyses,three bibliometric tools were used,including R-bibliometrix,CiteSpace(co-citation analysis of references),and VOSviewer(co-authorship analysis of institutions,co-authorship analysis of authors,co-occurrence analysis of keywords). RESULTS:After excluding invalid records,the study finaly included 4,536 publications with 135,386 citations.Most of these publications originated in the USA,China,Germany,Canada,and Japan.Harvard University emerged as the most prolific institution,while professor Jong-Sup Bae and his research team at Kyungpook National University emerged as authors with the greatest influence.The"protein C","tissue factor","thrombin","glycocalyx","acute kidney injury","syndecan-1"and"biomarker"were identified as prominent areas of research.Future research may focus on molecular mechanisms(such as as vascular endothelial[VE]-cadherin regulation)and therapeutic interventions to enhance endothelial repair and function. CONCLUSION:Our findings show a growing interest in EDS research.Key areas for future research include signaling pathways,molecular mechanisms,endothelial repair,and interactions between endothelial cells and other cell types in sepsis.

ObjectiveTo investigate the trends in diabetes mortality rate and the characteristics of decreased population in Fengxian District, Shanghai from 2012 to 2021. MethodsData from the death registration records of the residents in Fengxian District between 2012 and 2021, sourced from the Shanghai Death Surveillance System, were analyzed. Indicators such as the crude mortality rate due to diabetes, the standardized mortality rate, years of life lost (YLL), and the probability of premature death were estimated. Annual percentage change (APC) was used to analyze the temporal trends of mortality and the probability of premature death due to diabetes. Rate decomposition analysis was used to assess the contributions of demographic and non-demographic factors to diabetes mortality. ResultsFrom 2012 to 2021, there were 1 471 deaths due to diabetes in Fengxian District, with a crude mortality rate of 27.51/100 000 and a standardized mortality rate of 17.58/100 000. The crude mortality rate showed an overall increasing trend (APC=4.58%, Z=3.49, P<0.05). The potential years of life lost (PYLL) due to diabetes over this period amounted to 9 715 person-years, with a PYLL rate of 1.82 ‰, and the average years of life lost (AYLL) was 11.94 years. The probability of premature death was 0.41% (APC=3.36%, t=2.33, P<0.05). Both population aging and non-aging factors contributed to the increase in diabetes mortality, with overall contribution rates of 67.99% and 32.01%, respectively. Among men, the contribution rates were 60.57% and 39.43%, while among women, they were 79.43% and 20.57%, respectively. ConclusionFrom 2012 to 2021, both the crude mortality rate and the probability of premature death due to diabetes showed an upward trend among the residents in Fengxian District, with a higher YLL. Population aging was the main factor causing the increase in mortality rate, while non-demographic factors had a greater impact on the rise in diabetes mortality among men than that in women. Therefore, the management on male diabetes patients should be strengthened.

Objective:To evaluate the accuracy and applicability of detection tube method for quantitative detection of hydrogen sulfide in workplace air.Methods:In September 2021, the lower limit of quantification, accuracy, precision, environmental factors, interfering gases and other performance indicators of the method for determining hydrogen sulfide in the air of workplace were verified by the detection tube, and the results were compared with those of GB 11742-89 "Standard method for hygienic examination of hydrogen sulfide in air of residential areas-methylene blue spectrophotometric method" to evaluate the application effect of the detection tube method for quantitative detection of hydrogen sulfide in workplace air.Results:There was no significant difference in the results of 2.83 mg/m 3, 4.25 mg/m 3 and 17.00 mg/m 3 hydrogen sulfide concentration between the two methods ( P>0.05) , but there was significant difference in the results of 8.50 mg/m 3 concentration ( P<0.05) . The lower limit of quantification of hydrogen sulfide in workplace air was 2.83 mg/m 3, the accuracy was 96.0%-111.0%, and the precision was 0.70%-6.64%. Under the condition of 4 ℃, the measured results decreased by 3.39%-13.10%. When the humidity was 50%-80%, the relative error of the average measured value was -1.67%-4.44%. Interference gases that may exist in the workplace (including carbon dioxide, carbon monoxide, mercaptans, nitrogen oxides, sulfur dioxide, etc.) did not interfere with the results of the test tube. Conclusion:The accuracy and precision of the detection tube method meet the detection requirements. The method is simple, rapid and easy to be popularized, and can be used for the rapid detection of hydrogen sulfide gas concentration in the workplace.

Objective:To evaluate the accuracy and applicability of detection tube method for quantitative detection of hydrogen sulfide in workplace air.Methods:In September 2021, the lower limit of quantification, accuracy, precision, environmental factors, interfering gases and other performance indicators of the method for determining hydrogen sulfide in the air of workplace were verified by the detection tube, and the results were compared with those of GB 11742-89 "Standard method for hygienic examination of hydrogen sulfide in air of residential areas-methylene blue spectrophotometric method" to evaluate the application effect of the detection tube method for quantitative detection of hydrogen sulfide in workplace air.Results:There was no significant difference in the results of 2.83 mg/m 3, 4.25 mg/m 3 and 17.00 mg/m 3 hydrogen sulfide concentration between the two methods ( P>0.05) , but there was significant difference in the results of 8.50 mg/m 3 concentration ( P<0.05) . The lower limit of quantification of hydrogen sulfide in workplace air was 2.83 mg/m 3, the accuracy was 96.0%-111.0%, and the precision was 0.70%-6.64%. Under the condition of 4 ℃, the measured results decreased by 3.39%-13.10%. When the humidity was 50%-80%, the relative error of the average measured value was -1.67%-4.44%. Interference gases that may exist in the workplace (including carbon dioxide, carbon monoxide, mercaptans, nitrogen oxides, sulfur dioxide, etc.) did not interfere with the results of the test tube. Conclusion:The accuracy and precision of the detection tube method meet the detection requirements. The method is simple, rapid and easy to be popularized, and can be used for the rapid detection of hydrogen sulfide gas concentration in the workplace.

Objective:Lung ultrasound (LUS) has been used in the diagnosis of neonatal respiratory distress syndrome(RDS) successfully, but there have been no multicenter prospective studies to verify its reliability or determine how to grade RDS with LUS findings.This study aimed to discuss the necessity and feasibility of using LUS findings to determine RDS grades through a multicenter prospective study.Methods:Every researcher participated in the National Neonatal Lung Ultrasound Training Course and receiving 3-6 months of lung ultrasound system training at the National Neonatal Lung Ultrasound Training Center.Patients between June 2018 and May 2020 who met the RDS ultrasound diagnostic criteria and had full available clinical data were included in this study.The LUS examination was completed immediately after the patients were admitted to the hospital.Some of them also underwent chest X-ray examination.Arterial blood gas analysis was completed immediately before or after the LUS ultrasound examination.RDS grading was performed according to the LUS findings and whether the patient had serious complications.Results:A total of 275 qualifying cases were included in this study, which included 220 premature infants and 55 full-term infants, and the primary RDS occurred in 117 cases (42.5%), and secondary RDS occurred in 158 cases (57.5%). LUS manifestations of RDS patients can be divided into three categories: (1)A ground-glass opacity sign: which could be found among 50 infants when they were admitted to the hospital (that was, at their first LUS examination). Twenty-eight of these infants were considered to have wet lungs and were not sent for special management on admission, but LUS showed typical snowflake-like lung consolidation within 0.5 to 4 hours.Twenty-two of them were given mechanical ventilation with exogenous pulmonary surfactant; Eighteen cases were controlled within 6-12 hours, but the lung lesions became more severe in the other 4 infants (due to severe intrauterine infection). (2)Snowflake-like lung consolidations: the first LUS on admission showed typical snowflake-like lung consolidation involving areas ranging from 1-2 intercostal spaces to 12 lung divisions in 204 cases.Thirty-eight infants among them the lung consolidation only had involvement of 1-2 intercostal spaces at the time of admission; Fifteen of them received invasive respiratory support and recovered within 4-12 hours.Twelve patients received noninvasive respiratory support; Seven of them recovered, while five cases developed severe lung illness.The remaining 11 patients who were not given any form of ventilator support developed severe conditions within 1-4 hours.Thirty of them showed snowflake signs involving 12 lung regions at admission.The remaining 136 patients had lung consolidation degree between the two degree above condition.(3)Snowflake-like sign with complications: Twenty-one patients had severe complications such as pneumothorax, pulmonary hemorrhage or/and persistent pulmonary hypertension of the newborn or large area atelectasis, etc, although snowflake lung consolidation did not involve all lung regions.Conclusion:(1) LUS is reliable and accurate for diagnosing RDS.RDS has the same characteristics on ultrasound for both preterm and full-term infants, both primary and secondary RDS.(2) To facilitate the management of RDS, it is necessary to classify RDS according to the ultrasound findings and the presence of severe complications.(3) Based on the results of this study, it is recommended that RDS can be divided into mild, moderate and severe degrees.The exact standards for grading are as follows: Mild RDS: the early stage of RDS, in which lung consolidation shows as a ground-glass opacity sign on ultrasound; Moderate RDS: lung consolidation shows a snowflake sign on ultrasound, not all of the lung fields are involved; Severe RDS meets one or more of the following criteria: lung consolidation shows as a snowflake sign on ultrasound and all lung regions are involved, or regardless of its degree and extent, lung consolidation has caused serious complications, such as pulmonary hemorrhage, pneumothorax, persistent pulmonary hypertension of the newborn, or/and a large area of pulmonary atelectasis.

OBJECTIVE: To analyze the status and influencing factors of the health literacy(HL) of college students in a comprehensive university. METHODS: A total of 3 360 students from in a comprehensive university of Xinjiang Production and Construction Corps was selected using multi-stage stratified cluster random sampling method. The HL level of college students was investigated and evaluated with self-edited Xinjiang Construction Corps College Students Health Literacy Questionnaire. RESULTS: The HL level of college students was 17.1%. The HL level of medical students was higher than that of non-medical students(35.4% vs 10.0%, P<0.01). Logistic regression analysis results showed that among the medical students in grade three or four, those with medium and excellent academic achievement, and Han nationality had a positive effect on their HL level(P<0.01). Among the non-medical students, female and medicine related optional courses had a positive effect on their HL level(P<0.05). Students in the sophomore year had a negative effect on their HL level(P<0.05). CONCLUSION: There is a big difference in the level of HL between medical students and non-medical students. Medical college students and non-medical college students have different factors affecting HL, medical education is related to improving HL.

Objective:To observe the changes in acromiaohumeral distance(AHD) in patients undergoing the modified arthroscopic double-button Latarjet procedure for recurrent anterior shoulder dislocation complicated with glenoid bone defect.Methods:A retrospective study was performed of the 52 patients who had undergone the modified arthroscopic double-button Latarjet procedure from October 2014 to October 2016 at Department of Sports Medicine, The First Affiliated Hospital to Shenzhen University for recurrent anterior shoulder dislocation complicated with glenoid bone defect. They were 33 males and 19 females, having 30 left and 22 right shoulders affected. Their ages ranged from 19 to 45 years(mean, 29.6 years). Their glenoid bone defects ranged from 17% to 30%(mean, 23.4%). CT scans were performed on the surgery side to observe the healing and reshaping of the bone grafts and to measure the AHDs of healthy shoulder, immediately, 6, 18 and 36 months after operation. Their American Shoulder and Elbow Surgeons(ASES), Rowe and Walch-Duplay scores were recorded before operation and at the final follow-up for comparison.Results:The follow-up time for this series ranged from 37 to 44 months (mean, 40.6 months). The AHDs at immediate postoperation(9.6 mm ± 0.7 mm), 6 months postoperation(8.6 mm ± 0.9 mm), 18 months postoperation (8.0 cm ± 0.8 cm) and 36 months postoperation(7.9 cm ± 0.8 cm) were significantly wider than the healthy side value (7.8 mm ± 0.8 mm)( P<0.05). The ASES, Rowe and Walch-Duplay scores at the final follow-up (93.9±3.2, 94.5±2.7 and 95.7±3.6) were significantly improved than the preoperative values (67.3±9.1, 40.1±4.2 and 63.5±9.0) ( P<0.05). The final follow-ups observed no symptoms or signs of chronic shoulder pain, rotator cuff injury or acromion impingement. Conclusion:As the AHD becomes wider rather than narrower after arthroscopic double-button Latarjet procedure for recurrent anterior shoulder dislocation complicated with glenoid bone defect, no subsequent rotator cuff injury may happen due to the uplift of the humeral head after the modified arthroscopic double-button Latarjet procedure.

Objective To evaluate the clinical and technical effects of self-expanding VENA stent in the treatment of iliofemoral vein obstruction.Methods The clinical data of 58 patients(61 limbs) with symptomatic iliofemoral vein obstructive disease treated by VENA stent from February 2017 to June 2018 were collected and analyzed.The patency of the vein was assessed by the results of intraoperative angiography and postoperative symptoms relief changes in leg circumference.Follow up included relief of symptoms,Doppler ultrasound.Results A total of 63 VENA stents (43 in the left limb and 20 in the right limb) were implanted,sizes ranging from 12 mm to 16 mm,surgical technique success rate was 100％.The median follow-up time was 8.6 months.The primary patency rate of one month,three months,six months and 12 months was 96％,94％,92％ and 92％,respectively.Leg circumference fall down from(48 ±0.4) cm to (37 ± 0.3) cm (P ＜ 0.05).Conclusion Self-expanding nitinol stent implantation is a safe and effective treatment method for symptomatic iliofemoral vein obstruction disease.

Objective To evaluate the feasibility of the novel staining protocol based on protein L in flow cytometry to detect the expression of chimeric antigen receptor (CAR) on the surface of T cells from patients.Methods The peripheral blood mononuclear cells(PBMCs) were collected from 2 patients with CD19 + lymphoma by hemapheresis and T cells were purified by magnetic bead selection.CAR was transfected with retroviruses targeting CD19 and CD22 into T cells to induce chimeric antigen receptor-modified T cells (CAR-T cells).The single-chain fragments of antibody molecules on the surface of CAR-T cells were labeled by biotinylated protein L-streptavidin-PE system.The proportions of activated CD19-CAR and CD22-CAR positive T cells in the culture were detected by flow cytometry.The results were compared with those detected by conventional flow cytometry method based on Anti-IgG staining.Results The expression of CAR on the surface of CAR-T cells was successfully detected by flow cytometry protocol based on the staining of single-chain variable fragment (scFv)-biotinylated protein L-streptavidin-PE.The percentages of CD19-CAR-T cells from the 2 patients were 71.6％ vs 64.2％ and 49.3％ vs 43.8％ in the protein L group and the Anti-IgG control group respectively,and the percentages of CD22-CAR-T cells were 53.1％ vs 46.3％ and 56.5％ vs 64.0％.The results of the both groups were similar.Conclusion The staining protocol based on protein L could be used as a routine staining method in flow cytometry for the detection of CAR-T cells.