Objective: To explore the clinical application value of neural network technology,and to screen the clinical early warning indicators of severe hand-foot-mouth disease(HFMD) by constructing a back propagation neural network(BPNN) model. Methods: The clinical data of children with HFMD admitted to the Department of Infectious Diseases and Pediatrics of the First Affiliated Hospital of Xinxiang Medical University from January2019 to January 2023 were collected.The data were divided into 70% training samples and 30 % test samples using SPSS Modeler 18.0.The BPNN model and Logistic model were constructed to compare and evaluate the prediction accuracy and screening effect of the model. Results: The clinical data of 589 children were collected and analyzed,including 324 cases in the mild group and 265 cases in the severe group.The prediction accuracy of the test set(n=178) of BP neural network model and Logistic regression model was 82.02% and 84.83%,respectively.The area under the ROC curve(95% CI) was 0.791(0.749-0.834) and 0.625(0.577-0.674),respectively.Among the predictive variables output by the BPNN model,the top five factors that had the greatest impact on the grouping were highest body temperature,duration of fever,glutamyl transpeptidase,aspartate aminotransferase,and globulin.There were 3 of the top 10 overlaps in the importance of the predictive variables output by the two models,which were the highest body temperature,duration of fever and limb shaking. Conclusion The BPNN model and Logistic regression model perform well in screening and verifying the risk factors of severe hand-foot-mouth disease,but the comprehensive prediction performance of BP neural network model is better.The top five influencing factors of severe HFMD screened by the BPNN model are the highest body temperature,duration of fever,glutamyl transpeptidase,aspartate aminotransferase and globulin.

The testis is pivotal for male reproduction, and its progressive functional decline in aging is associated with infertility. However, the regulatory mechanism underlying primate testicular aging remains largely elusive. Here, we resolve the aging-related cellular and molecular alterations of primate testicular aging by establishing a single-nucleus transcriptomic atlas. Gene-expression patterns along the spermatogenesis trajectory revealed molecular programs associated with attrition of spermatogonial stem cell reservoir, disturbed meiosis and impaired spermiogenesis along the sequential continuum. Remarkably, Sertoli cell was identified as the cell type most susceptible to aging, given its deeply perturbed age-associated transcriptional profiles. Concomitantly, downregulation of the transcription factor Wilms' Tumor 1 (WT1), essential for Sertoli cell homeostasis, was associated with accelerated cellular senescence, disrupted tight junctions, and a compromised cell identity signature, which altogether may help create a hostile microenvironment for spermatogenesis. Collectively, our study depicts in-depth transcriptomic traits of non-human primate (NHP) testicular aging at single-cell resolution, providing potential diagnostic biomarkers and targets for therapeutic interventions against testicular aging and age-related male reproductive diseases.
Animals ; Male ; Testis ; Sertoli Cells/metabolism* ; Transcriptome ; Spermatogenesis/genetics* ; Primates ; Aging/genetics* ; Stem Cells

Objective To analyze the distribution characteristics of injuries among students in Songjiang district, Shanghai, and to provide data support for preventing injuries among students. Methods Data of injury cases among school students in Songjiang from 2017 to 2019 were collected from the National Injury Surveillance System (NISS), and the demographic characteristics, injury occurrence and clinical characteristics of injuries were analyzed. Results A total of 13 877 cases of injuries in school students were reported from 2017-2019, with a sex ratio of 1.94:1. The education level of the injured students was mainly primary school. The peak incidence months of student injuries were May (9.97%) and November (9.67%). Falls (50.83%) were the leading cause of student injuries, and the top three places of student injuries were at home (30.08%), in schools and public places (28.11%) and on roads/streets (22.97%). The top three activities at the time of the injury were leisure activities (34.62%), sports activities (18.50%), and taking transportation（17.68%）. The top three injury types were bruise/scratch (42.94%), sprain/strain (28.67%) and sharps/bite/open injury (13.53%). The common injury parts were lower limbs (38.39%), head (27.82%) and upper limbs (24.88%). Conclusion The prevention of injuries in school students in Songjiang should focus on male students and low age students, and targeted injury prevention and control work for students of different ages should be carried out.

OBJECTIVE To explore the mechanism of Yishen tongluo formula （YSTLF） in improving abnormal lipid metabolism based on the sterol regulatory element binding proteins （SREBPs） pathway. METHODS Using C57BLKS/J （db/db） mice as model and C57BLKS/J （db/m） mice as normal control， the mechanism of 1， 2.5 and 5 g/kg YSTLF improving abnormal lipid metabolism of db/db mice was investigated by determining the liver coefficient， the contents of serum total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein （LDL） and high-density lipoprotein （HDL）， observing steatosis and lipid accumulation in liver tissue of mice， detecting the protein expressions of SREBP-1 and SREBP-2 as well as mRNA transcription levels of Srebp- 1c， Srebp-2 and their downstream lipid metabolism-related target genes （Fasn， Acc1， Scd5， Fads1， Hmgcr， Dhcr24， Insig-1， Fdps） in liver tissue of mice. Using low-fat cultured human liver cancer cell HepG2 as an in vitro cell model for abnormal lipid metabolism， and 25-HC （SREBPs inhibitor， 10 μmol/L） as the control， the effects of 125， 250 and 500 μg/mL YSTLF on protein expressions of SREBP-1 and SREBP-2 as well as mRNA transcription of SREBP-1c， SREBP-2 and their downstream lipid metabolism-related target genes were investigated to verify the mechanism in vitro. RESULTS 1， 2.5， 5 g/kg YSTLF significantly reduced the levels of TC， TG and LDL， the percentage of lipid droplet-positive region in liver tissue and liver coefficient， significantly down-regulated protein expressions of Pre-SREBP-1， n-SREBP-1， Pre-SREBP-2 and n-SREBP-2， and mRNA transcription of Srebp-1c， Srebp-2 and their downstream target genes in liver tissue， while significantly increased HDL level， with statistical significance （P＜0.05 or P＜0.01）. In the cell experiment in vitro， the expressions of the above-mentioned proteins and genes in the cells treated with YSTLF at 125， 250 and 500 μg/mL for 24 hours were consistent with those in the animal experiment； there was no significant difference in the expressions of the above-mentioned proteins and genes between inhibitor control group and 250， 500 μg/mL YSTLF groups （P＞0.05）. CONCLUSIONS YSTLF can regulate the expression of transcription factor SREBPs， so as to inhibit the high expression of fatty acid and cholesterol synthesis-related genes， promote the degradation of TC and TG， improve the abnormality of lipid metabolism and inhibit lipid accumulation， thus playing the role of lipid-lowering.

OBJECTIVE:To investigate the effects of Qigong pills decoction combined with chemical drugs on hormone levels of polycystic ovarian syndrome(PCOS)patients complicated with infertility. METHODS:A total of 98 PCOS patients complicated with infertility selected from gynaecology department of our hospital during Jul. 2015-Jun. 2016 were divided into observation group and control group according to random number table,with 49 cases in each group. Control group was given Clomiphene ci-trate tablet 50 mg orally,qd,for consecutive 5 d;B-ultrasonography for follicle development was monitored at the 11th day of menstruation,and then they were given Chorionic Gonadotropin for injection 2000 U intramuscularly,qod,if there was not domi-nant follicle >10 mm till the diameter of follicle reached 18 mm. Observation group was additionally given one dose of Qigong pills decoction,every day 400 mL after decocted with water,each 200 mL for morning and night,on the basis of control group. After 3 months of treatment,the levels of FSH,LH,PRL,E2,T,DHEA-S and SHBG,the endometrial thickness,the number of mature follicle and pregnancy rate were compared between 2 groups. RESULTS:Before treatment,there was no statistical signifi-cance in the levels of FSH,LH,PRL,E2,T,DHEA-S or SHBG between 2 groups(P>0.05). 3 months after treatment,the lev-els of PRL,T and DHEA-S in 2 groups were decreased and E2,SHBG were increased significantly;the levels of FSH,PRL,T and DHEA-S in observation group were significantly lower than control group,while the levels of E2 and SHBG were significantly higher than control group,with statistical significance (P<0.05). Endometrial thickness of observation group were significantly higher than that of control group;pregnancy rate (18.37%) was significantly higher than control group (4.08%),with statistical significance (P<0.05). CONCLUSIONS:Qigong pills decoction combined with chemical drugs can help to improve pregnancy rate and regulate serum hormone level in the treatment of PCOS complicated with infertility.

Objective To explore the effects of the online health management platform on cancer patients with peripherally inserted central catheter (PICC) at interval of chemotherapy. Methods Totally 120 patients at interval of chemotherapy who received PICC maintenance in the Section for Outpatients, Wuxi No.2 People's Hospital between January 2016 and February 2017 were selected by convenience sampling, and divided into an observation group (57 patients) and a control group (63 patients) according to the random number table. Patients in the control group received conventional health education and follow-up visits after being discharged, while patients in the observation group received health tracking management with communication and management groups on WeChat, PICC blog and BBS integrated in the online health management platform. Results Totally 3 patients in the observation group (5.26%) and 12 patients in the control group (19.04%) showed phlebitis, and the patients in the observation group showed lower severity than the patients in the control group (Z/χ2=-2.171, 5.199; P<0.05). No patients in the observation group showed obstruction, lower than the patients in the control group (χ2=3.885, P<0.05). The patients in the observation group showed higher scores in knowledge related to self-care, monitoring behavior and psychological belief as well as a total score than the patients in the control group (P<0.05). Conclusions The PICC online medical management platform makes intervals of chemotherapy more scientific and standardized, and effectively enhances patients' ability to manage catheter by themselves outside hospital.

BACKGROUND:Hepatic fibrosis in chronic liver disease can be reversed. Studies have shown that Periplaneta americana extract has anti-fibrosis effect, and has protective effect on the experimental hepatic fibrosis rats.
OBJECTIVE:To observe the effect of Periplaneta americana extract sticky sugar amino acid on hepatic fibrosis, and to primarily explore the mechanism of sticky sugar amino acid against hepatic fibrosis.
METHODS:Rat models of immune hepatic fibrosis were induced by pig serum and intragastricaly administered 0.5, 0.25, 0.10 g/kg sticky sugar amino acid. Four indexes of hepatic fibrosis were detected by radioimmunoassay. Immunohistochemical staining wasused to measure transforming growth factor beta 1, tissue inhibitor of metaloproteinase protein expression intensity and positive cel rate, to determine the correlation of different concentrations of sticky sugar amino acid, transformation growth factorbeta 1 and tissue inhibitor of metaloproteinase.
RESULTS AND CONCLUSION:(1) The Periplaneta americana extract sticky sugar amino acid reduced the levels of laminin, type III procolagen, type IV colagen and hyaluronidase (P< 0.01) and reduced the expression of transformation growth factor beta 1 and tissue inhibitor of metaloproteinase 1 in liver tissue (P< 0.01). (2) Sticky sugar amino acid concentration and transformation growth factor beta 1 and tissue inhibitor of metaloproteinase 1 protein expression showed a significant negative correlation (|r| > 0.9). (3) Results confirmed that the Periplaneta americana extract sticky sugar amino acid can change the reversal of hepatic fibrosis. Its mechanism of action is associated with expression of transforming growth factor beta 1 and tissue inhibitor of metaloproteinase 1 inhibited by sticky sugar amino acids.

Objective:To analyze the implementation and effectiveness of primary health care reform in Feixi county, Anhui province. Methods: This paper uses data analysis of interviews with key insiders, policy documents and archives, as well as institutional questionnaire survey and other methods to collect information, and then it com-bines qualitative and quantitative research to arrive at research findings through cross-analysis and interpretation. Re-sults:From 2010 to 2014, the reform enhanced the capacity of primary health care in four main aspects, including capacity building of primary health care personnel, network construction of primary health care system, improvement of working conditions, and system construction of institutional management. Accordingly, the human capacity of pri-mary health care personnel was improved, their enthusiasm for work increased, their income was raised, the working conditions were improved, the cooperation mechanism for vertical and horizontal health care services was established, and the consultation rate and primary health care utilization in Feixi county increased. Conclusion:Both the“bottom-up” exploration approach and “from point to area” implementation strategy adopted by Feixi county have not only been the core content of primary health care system’s comprehensive reform, but also effectively leveraged the other aspects of the reform. They have played an important role in deepening medical reform and establishing institutional mechanism of health care system.

Objective:The paper aims to explore the structure and effectiveness of three health service systems in Anhui province and provide policy recommendations to promote the integration of health care systems. Methods:By using typical sampling method, this paper conducts case study analysis of health service system in Ma’anshan, Feidong and Feixi county of Anhui province. The data mainly come from questionnaires for the institutions, doctors and patients, as well as from interviews with key informants. By integrating quantitative and qualitative data analysis, this paper uses social network analysis method to analyze the system structure and its degree of integration. Results:The degree of integration of health service structure in Ma’anshan is the highest, followed by Feixi, and Feidong is the lowest. The system effectiveness is same as the degree of integration. All three health service systems have advantages and disadvantages regarding to system integration. Conclusion:The effectiveness of health service system integration and its implementation is the product of combined effects of internal and external environment of each health service system. The reforms in Ma’anshan and Feixi health service systems have not only integrated health care structures, but also had a positive impact on the effectiveness of the health service systems.

Objective:To analyze reverse effects induced in the implementation process of“primary health care strengthening” policies, and the innovative initiatives and countermeasures raised in primary health care system’s comprehensive reform of Feixi county. Method:Based on the principles of Critical Discourse Analysis ( CDA) , this paper designs its analytical framework for policy analysis. Results:Many reverse effects appeared in the implementa-tion process of “primary health care strengthening” policies. However, through improvements in terms of manpower upgrading, network building, working conditions and management mechanisms, Feixi county has successfully strengthened the capacity building for primary health care institutions. Conclusions:The expected and unexpected re-sults should be evaluated systematically when the policies are being implemented, and local governments need to pro-ceed according to local conditions in order to prevent unintended reverse effects from happening.