Objective To investigate the association between microRNA(miR)-23a,miR-150,and miR-150-5p levels and diabetic osteoporosis(DOP)through correlation analysis.Methods A total of 200 patients with diabetes who visited the hospital between March 2020 and March 2022 were selected and followed up for a duration of 2 years.Patients who developed DOP and those who did not were respectively assigned to the DOP group and the non-DOP group.The general information and serum levels of miR-23a,miR-150,and miR-150-5p between these two groups were compared.Pearson correlation analysis was conducted to examine the relationship between serum levels of miR-23a,miR-150,and miR-150-5p,as well as bone density.Logistic regression model was employed to identify factors influencing DOP.Results The incidence rate of DOP was 28.89%.The serum levels of miR-23a,miR-150,and miR-150-5p were significantly elevated in the DOP group compared to the non-DOP group(P＜0.05).Pearson correlation analysis revealed a negative association between the serum levels of miR-23a,miR-150,and miR-150-5p in diabetic patients and bone density(P＜0.05).Logistic regression model analysis demonstrated that age,body mass index(BMI),as well as miR-23a,miR-150,and miR-150-5p were influential factors contributing to the development of DOP(P＜0.05).Conclusion The levels of serum miR-23a,miR-150,and miR-150-5p are elevated in patients with DOP,and all three exhibit a negative correlation with bone density.Furthermore,these factors collectively contribute to the development of DOP.

Neural tube defects are a common neurodevelopmental disease,which can be divided into open and closed types.The main symptoms are anencephaly,encephalocele and cranial spina bifida.The relationship between Wnt signaling and neurogenesis has been a popular area in recent years.The Wnt signaling pathway includes Wnt/β-catenin,planar polar cell pathway and Wnt/Ca2+pathway,which plays an important role in neural tube development.This article reviews the current state of research on the Wnt signaling pathway and elucidates the role it plays in the process of neural tube closure,providing insights for the development of drugs related to the prevention and treatment of neural tube defects.

Objective:To investigate the distribution characteristics and clinical significance of aeroallergen sensitization in children with airway allergic diseases.Methods:The information of children who were diagnosed with airway allergic diseases and performed with skin prick test(SPT)of aeroallergens was collected and retrospectively analyzed from Beijing Children′s Hospital from January to December, 2019.A total of 2557 patients were divided into ≤5 years of age group, 6-11 years of age group and ≥12 years of age group according to age, and allergic rhinitis group, asthma group, allergic rhinitis combined with asthma group according to diseases.The differences in the distribution of positive rates of 18 kinds of aeroallergens in age group and disease group were compared.Results:The positive rates of SPT in 2557 children from high to low were weeds pollens in summer and autumn, molds, trees pollens in spring, dust mites, etc..The top five strong positive rates from high to low were Artemisia pollen, Humulus pollen, Dermatophagoides farina, Betula pollen and Fraxinus pennsylvanica pollen.The positive rate was 71.5%(539/754)in the ≤5 years of age group, 78.5%(1241/1581)in 6-11 years of age group, and 81.1%(180/222)in ≥12 years of age group.The difference in positive rates of SPT among different age groups was statistically significant( χ2=16.825, P<0.05). In the group of ≤5 years of age group, the main aeroallergens were Chenopodium pollen(310/754, 41.1%), Alternaria alternate(307/754, 40.7%), Humulus pollen(295/754, 39.1%), Artemisia pollen(293/754, 38.9%)and Fraxinus pennsylvanica pollen(258/754, 34.2%). The main aeroallergens in the 6-11 years of age group were Chenopodium pollen(853/1581, 54.0%), Humulus pollen(769/1581, 48.6%), Artemisia pollen(768/1581, 48.6%), Alternaria alternate(751/1581, 47.5%)and Fraxinus pennsylvanica pollen(724/1581, 45.8%). The main aeroallergens in the ≥12 years of age group were Chenopodium pollen(131/222, 59.0%), Humulus pollen(119/222, 53.6%), Artemisia pollen(113/222, 50.9%), Alternaria alternate(112/222, 50.5%)and Dermatophagoides farina(103/222, 46.4%). The positive rate of allergic rhinitis group was 73.6%(1164/1582), asthma group was 72.4%(234/323), allergic rhinitis combined with asthma group was 86.0%(561/652). The positive rate of SPT was significantly different among different disease groups( χ2=43.408, P<0.05). The main aeroallergen of allergic rhinitis, asthma and allergic rhinitis combined with asthma was Chenopodium pollen.The positive rates of 18 kinds of aeroallergens were significantly different among the three disease groups(all P<0.05). The positive rate of each aeroallergen in allergic rhinitis combined with asthma was higher than that in single airway allergic disease. Conclusion:In children with airway allergic disease, the sensitization spectrum of aeroallergen varies among different age groups and disease groups.Clinicians should monitor allergens regularly and give preventive treatment to children with airway allergic disease.

Objective:To discuss the treatment strategies and experiences of total anomalous pulmonary venous connection (TAPVC) and study the risk factors for postoperative pulmonary venous obstruction (PVO).Methods:Clinical data of 125 children with TAPVC in the Children Heart Center of Fuwai Central China Cardiovascular Hospital from January 2018 to December 2020 were included in this study and analyzed retrospectively.Of the 125 cases, 116 were treated surgically.They were divided into 2 groups according to whether PVO appeared after repair of TAPVC.The t-test or chi- square test was used to compare the clinical data of the 2 groups, and Logistic regression analysis was adopted to analyze the risk factors for postoperative PVO. Results:Among the 116 patients undergoing surgery, including 73 males (62.9%) and 43 females (37.1%), and according to Darling′s classification, there were 58 cases (50.0%) of supracardiac, 35 cases(30.2%)of intracardiac, 15 cases(12.9%) of infracardiac and 8 cases (6.9%) of mixed.The median age and body weight during surgery were 3.0 (1.2, 7.0) months and 5.0 (4.0, 6.8) kg.There were 13 deaths (11.2%), and recurrent PVO was observed in 18 patients (15.9%). Statistically significant diffe-rences were observed in terms of Darling′s classification (supracardiac 27.8% vs.56.6%, intracardiac 27.8% vs.31.6%, infracardiac 27.8% vs.10.5%, mixed 16.6% vs.5.3%, χ2=8.571, P=0.036) of PVO group and non-PVO group after operation preoperative PVO (83.3% vs.21.1%, χ2=25.293, P<0.01), with confluence (55.6% vs.81.1%, χ2=6.049, P=0.014), preoperative critical state (83.3% vs.31.6%, χ2=12.938, P<0.01), cardiopulmonary bypass time[ (128.800±47.254) min vs.(106.700±37.288) min, t=-2.094, P=0.039 ], delayed thoracic closure(27.8% vs.5.3%, χ2=6.227, P=0.013), and anastomotic velocity at 1 day after operation[1.0(0.9, 1.4) m/s vs.0.9(0.8, 1.1) m/s, Z=-2.004, P=0.045], anastomotic velocity at 1 week after operation[1.4 (1.3, 1.8) m/s vs.0.9 (0.7, 1.1) m/s, Z=-4.446, P<0.001], and mechanical ventilation time[121.0 (76.8, 246.9) h vs.91.5 (60.4, 135.9) h, Z=-1.989, P=0.047]. All of these data were included in the Logistic regression analysis.The results showed that preoperative PVO ( OR=797.179, 95% CI: 8.074-78 712.270, P=0.004) and increased anastomotic flow velocity at 1 week after operation ( OR=11 848.376, 95% CI: 23.746-5 912 017.803, P=0.003) were associated with postoperative PVO. Conclusions:Surgical correction in patients with TAPVC with a biventricular anatomy in this center is satisfactory.Preoperative PVO and early anastomotic flow velocity increase after operation are the high risk factors for postoperative PVO.

Objective:To investigate the relationship between serum Betatrophin levels and metabolic parameters in patients with polycystic ovary syndrome (PCOS) .Methods:98 patients with PCOS (PCOS group) treated in Zhengzhou People’s Hospital from Dec. 2017 to Sep. 2019 were selected. They were divided into non-obese group ( n=45) and obese group ( n=53) according to BMI value; They were divided into non-IR group ( n= 21) and IR group ( n=77) according to HOMA-IR value; They were divided into non-hyperandrogen group ( n=24) and hyperandrogen group ( n=74) according to TT level; Another 90 healthy women were taken as the control group. The baseline data, lipid metabolism indexes, hormone indexes, glucose metabolism indexes and Betatrophin levels of the two groups were recorded. Pearson test and logisitc regression model were used to analyze the influencing factors related to the increase of serum Betatrophin level in patients with PCOS. Results:Compared with the control group, PCOS group had higher level of BMI, body fat, WHR, VLDL, LDL, TG, TC, FAI, TT, LH, DHEA-S, 17-OHP, FSH, FBG, FINS, and HOMA-IR, while the HDL level was significantly lower. The difference was significant ( P<0.01). Serum Betatrophin level in obese group was significantly higher than that in the control group (163.99±126.97 vs 110.99±102.97), and the difference was statistically significant ( t=3.21, P<0.001) ; serum Betatrophin level in IR group was higher than that in the control group (160.26±136.80 vs 133.17±112.06), and the serum Betatrophin level in IR group was higher than that in the control group (173.51±147.85 vs 144.26±124.56), but the difference was not statistically significant ( P>0.05). Serum Betatrophin levels in PCOS group were positively correlated with BMI, WHR, TG, FAI, FBG, FINS ( P<0.05), and negatively correlated with HDL ( P<0.05). Logistic analysis showed that BMI, WHR and TG were independent factors affecting the increase of serum Betatrophin level. Conclusion:Serum Betatrophin levels of PCOS patients are significantly increased, and BMI, WHR, TG, HDL, FAI, FBG, FINS may play an important role in the occurrence and development of PCOS and obesity, insulin resistance, blood lipids and androgen metabolism disorders.

In the emergency department, open endotracheal suctioning for mechanically ventilated patients with endotracheal intubation will lead to the spread of respiratory droplets and aerosols, polluting the surrounding environment and medical staff. The traditional heat-and-moisture exchanger has the effect of warming and humidifying, and can block pathogenic microorganisms, but it does not have the function of inserting a sputum suction tube. When the heat-and-moisture exchanger is pulled out for sputum suction, it is easy to cause sputum splash, which pollutes the surrounding environment and medical personnel. The addition of closed sputum suction devices will increase the economic burden on patients. Thus, the medical staff of emergency department of the First People's Hospital of Tongxiang City of Zhejiang Province designed a new type of heat-and-moisture exchanger with anti-splash sputum suctioning function and obtained the National Utility Model Patent of China (ZL 2021 2 0017615.0). The new heat-and-moisture exchanger is mainly composed of a receiving cavity, a connecting tube, a sputum suction tube intubation tube, a sealing valve, etc. The disposable sputum suction tube can be used to insert sputum suction, and at the same time, it can prevent the secretion from splashing to ensure sealing. The patent combines the humidification and pathogen blocking functions of the heat-and-moisture exchanger with the anti-splash sputum suctioning function, which is suitable for use in the emergency and critical care medicine departments and has clinically practical value.

Objective:To explore the role and molecular mechanism of hepatocyte nuclear factor 4γ (HNF4γ) in proliferation and stemness of gastric cancer.Methods:A total of 102 cases of paraffin-embedded gastric cancer tissues and matched adjacent gastric tissues and 42 cases of fresh-frozen tissues derived from gastric patients who received radical gastrectomy were collected from the First Affiliated Hospital of Zhengzhou University between 2012 to 2015. The expression of HNF4γ was tested by immunohistochemical staining, quantitative real-time polymerase chain reaction (qRT-PCR). HNF4γ overexpressed (AGS-HNF4γ) and shRNA silenced (HGC27-shHNF4γ) gastric cell lines were established. The effects of HNF4γ on cell proliferation and stemness were verified by XTT, clone formation and sphere formation assay. The expression of CD44 was detected by western blot.Results:The mRNA expression level of HNF4γ in fresh-frozen gastric cancer tissue was (12.43±2.702), which was significantly higher than (3.639±1.109) in normal tissue ( P<0.001). The high protein expression rate of HNF4γ in paraffin-embedded gastric cancer tissues was 41.2% (42/102), which was significantly higher than 8.8% (9/102) in normal gastric mucosa tissue ( P< 0.001). The protein expression of HNF4γ was closely related to the tumor differentiation, infiltration depth, lymph node metastasis and tumor stage ( P<0.05). The median survival interval of patients with HNF4γ high expression was 25 months, the 3-year survival rate was 4.8% (2/42), significantly lower than 38 months and 51.7% (31/60) of patients with normal HNF4γ expression ( P<0.001). The proliferation and CD44 protein expression of AGS-HNF4γ cells were significantly higher than those of the AGS-Vector cells. The number of clone formation, sphere formation rate of AGS-HNF4γ cells were 243.5±24.5 and (83.5±3.9)%, significantly higher than 81.0±16.0 and (21.8±5.6)% of AGS-Vector cells ( P=0.030 and P=0.010, respectively). The proliferation and CD44 protein expression of HGC27-shHNF4 cells were significantly lower than those of the HGC27-vector cells. The number of clone formation, sphere formation rate of HGC27-shHNF4 cells were 26.0±1.0 and (20.8±8.4)%, significantly higher than 83.5±4.5 and (72.5±4.8)% of HGC27-vector cells ( P=0.006 and P=0.030, respectively). Conclusions:HNF4γ is upregulated in the gastric cancer tissues and related with the poor prognosis of patients with gastric cancer. Overexpression of HNF4γ promotes the proliferation and remains the stemness of gastric cancer cells by upregulating the expression of CD44.

Objective:To explore the role and molecular mechanism of hepatocyte nuclear factor 4γ (HNF4γ) in proliferation and stemness of gastric cancer.Methods:A total of 102 cases of paraffin-embedded gastric cancer tissues and matched adjacent gastric tissues and 42 cases of fresh-frozen tissues derived from gastric patients who received radical gastrectomy were collected from the First Affiliated Hospital of Zhengzhou University between 2012 to 2015. The expression of HNF4γ was tested by immunohistochemical staining, quantitative real-time polymerase chain reaction (qRT-PCR). HNF4γ overexpressed (AGS-HNF4γ) and shRNA silenced (HGC27-shHNF4γ) gastric cell lines were established. The effects of HNF4γ on cell proliferation and stemness were verified by XTT, clone formation and sphere formation assay. The expression of CD44 was detected by western blot.Results:The mRNA expression level of HNF4γ in fresh-frozen gastric cancer tissue was (12.43±2.702), which was significantly higher than (3.639±1.109) in normal tissue ( P<0.001). The high protein expression rate of HNF4γ in paraffin-embedded gastric cancer tissues was 41.2% (42/102), which was significantly higher than 8.8% (9/102) in normal gastric mucosa tissue ( P< 0.001). The protein expression of HNF4γ was closely related to the tumor differentiation, infiltration depth, lymph node metastasis and tumor stage ( P<0.05). The median survival interval of patients with HNF4γ high expression was 25 months, the 3-year survival rate was 4.8% (2/42), significantly lower than 38 months and 51.7% (31/60) of patients with normal HNF4γ expression ( P<0.001). The proliferation and CD44 protein expression of AGS-HNF4γ cells were significantly higher than those of the AGS-Vector cells. The number of clone formation, sphere formation rate of AGS-HNF4γ cells were 243.5±24.5 and (83.5±3.9)%, significantly higher than 81.0±16.0 and (21.8±5.6)% of AGS-Vector cells ( P=0.030 and P=0.010, respectively). The proliferation and CD44 protein expression of HGC27-shHNF4 cells were significantly lower than those of the HGC27-vector cells. The number of clone formation, sphere formation rate of HGC27-shHNF4 cells were 26.0±1.0 and (20.8±8.4)%, significantly higher than 83.5±4.5 and (72.5±4.8)% of HGC27-vector cells ( P=0.006 and P=0.030, respectively). Conclusions:HNF4γ is upregulated in the gastric cancer tissues and related with the poor prognosis of patients with gastric cancer. Overexpression of HNF4γ promotes the proliferation and remains the stemness of gastric cancer cells by upregulating the expression of CD44.

OBJECTIVE： To explore the role of clinical pharmacist in individualized treatment for osteosarcoma patients with periprosthetic joint infection （PJI）. METHODS： An osteosarcoma patient was admitted to our hospital and then suffered from PJI after operation. Clinical pharmacist adjusted the initial anti-infection plan and carried out pharmaceutical care according to the results of patients’ etiology and drug sensitivity. According to the PK-PD principle， combined with the therapeutic drug monitoring （TDM）， the dose of antibiotics was adjusted. With the occurrence of ADR， the antibiotic therapeutic regimen was adjusted again. RESULTS： The patient was administrated cefotiam for empiric therapy initially after the diagnosis of PJI. After obtaining the results of etiology and drug sensitivity， the clinical pharmacist suggested that vancomycin sensitive to penicillin-resistant Staphylococcus epidermidis should be used for targeted anti-infection treatment. After adjusting the dosage according to the steady-state valley concentration， the patient had slight liver function damage， accompanied with chest tightness and shortness of breath. After analysis， the clinical pharmacist considered the adverse drug reactions related to vancomycin， and again suggested that the patient should be treated with teicoplanin. After the doctor adopted the treatment plan recommended by the clinical pharmacist， PJI of the patient was effectively controlled， and the adverse reaction symptoms disappeared. The patient was effectively cured for PJI and discharged eventually. During the treatment period， the clinical pharmacist also carried out medication education for the drugs used by the patient. CONCLUSIONS： Clinical pharmacist should master the principle of antibiotic drug PK-PD theory and evaluate the clinical efficacy and safety of anti-infective drugs dynamically based on the guidance of TDM， so as to develop individualized anti-infection therapeutic regimen for osteosarcoma patient with PJI， improve the effect of clinical treatment and guarantee the safety of drug use.

Objective: To explore the role of microtubule actin cross-linking factor 1(MACF1) in the metastasis of gastric cancer. Methods: From 2009 to 2012, at The First Affiliated Hospital of Zhengzhou University, the paraffin blocks of gastric cancer and normal tissue adjacent to cancer of 107 patients who received radical gastrectomy were collected. The expression of MACF1 in tissues at protein level was detected by immunohistochemical staining. In 2017, at The First Affiliated Hospital of Zhengzhou University, fresh specimens samples of gastric cancer and normal tissue adjacent to cancer of 42 patients who received radical gastrectomy were also collected. The expression of MACF1 at mRNA level was determined by quantitative real-time polymerase chain reaction (PCR). MACF1 knockout gastric cell line was established. The effects of MACF1 on cell migration and invasion were verified by wound-healing test and Transwell assay. The effects of MACF1 on cell microtubule and actin were analyzed by filamentous actin (F-actin) staining. T-test, chi-square test and multivariate analysis were used for statistical analysis. Results: The positive expression rate of MACF1 in gastric carcinoma tissues was 71.0%(76/107), which was significantly higher than that of the corresponding normal tissues adjacent to cancer (22.4%, 24/107), and the difference was significant (t=4.145, P=0.016). The expression of MACF1 at mRNA level in cancer tissues of 42 patients with gastric cancer was 6.463±0.672, which was significantly higher than that of corresponding normal tissue adjacent to cancer (1.727±0.331), and the difference was statistically significant (t=6.326, P<0.01). The differences in positive expression rate of MACF1 in different tumor infiltration depth, different TNM stage and lymph nodes metastasis were statistically significant (χ²=1.170, 7.959 and 5.288; all P<0.01). The five-year survival rate of patients with high expression of MACF1 was 32.9% (25/76), which was significantly lower than that of patients with normal MACF1 expression (64.5%, 20/31), and the difference was statistically significant (χ²=25.093, P=0.034). The high expression of MACF1 was an independent prognostic factor affecting overall survival rate in patients with gastric cancer after surgery(hazard ratio (HR)=0.513, 95%confidence interval (CI): 0.411 to 0.922, P=0.038). The results of wound-healing assay showed that at 24 hour after wound the migration ability of MACF1 knockout AGS- MACF1^-/- cells was (18.77±3.82)%, which was lower than that of wild type AGS cells ((76.24±5.36)%), and the difference was statistically significant (t=6.249, P=0.014). The migration ability of MACF1 knockout HGC27-MACF1^-/-cells was (42.48±7.37)%, which was lower than that of wild type HGC27 cells ((82.35±4.28)%), and the difference was statistically significant (t=5.938, P=0.017). The results of Transwell assay indicated that the number of migration cells of MACF1 knockout AGS-MACF1^-/- cells was 87.0±11.0, which was less than that of wild type AGS cells (200.0±16.0), and the difference was statistically significant (t=5.820, P=0.028). The number of migration cells of MACF1 knockout HGC27-MACF1^-/-cells was 151.0±13.0, which was less than that of wild type HGC27 cells (268.5±20.5), and the difference was statistically significant (t=4.840, P=0.040). The results of F-actin staining demonstrated that the number of actin filaments of MACF1 knockout AGS-MACF1^-/- cells was 216.60±18.09, which was less than that of wild type AGS cells (491.30±5.02), and the difference was statistically significant (t=14.630, P=0.005). Conclusions The abnormally high expression of MACF1 in gastric cancer tissues may be correlated with the poor prognosis of patients with gastric cancer. MACF1 promotes the invasion and metastasis of gastric cancer cells by affecting the formation of F-actin and cell skeleton.