BackgroundNowadays， idolatry is an important part of the spiritual life of secondary school students， making a significant impact on their physical and mental development. Previous research has examined the two-by-two relationship between idolatry， peer attachment， life satisfaction and perceived social support， but the potential mediating mechanisms between these variables remain to be explored. ObjectiveTo explore the mediating role of peer attachment and life satisfaction between idolatry and perceived social support， so as to provide references for mental health education for secondary school students. MethodsIn June 2022， 1 059 students currently enrolled in secondary school in Qiannan State， Guizhou Province were selected according to stratified random sampling method. In this study， assessment was performed using Celebrity Attitude Scale （CAS）， Peer Attachment Subscale from Revised Inventory of Parent and Peer Attachment （IPPA-R）， Satisfaction with Life Scale （SWLS） and Perceived Social Support Scale （PSSS）. Pearson correlation analysis was used for correlation test. Model 6 in the SPSS Macro Process 3.3 was used to examine the mediating effect of peer attachment and life satisfaction between idolatry and perceived social support in secondary school students. Results①CAS score indicated positive correlation with scores of IPPA-R Peer Attachment Subscale， SWLS and PSSS （r=0.117， 0.097， 0.115， P<0.01）. IPPA-R score indicated positive correlation with scores of SWLS and PSSS （r=0.279， 0.421， P<0.01）. SWLS score was positively correlated with PSSS score （r=0.552， P<0.01）. ②The direct effect of idolatry on perceived social support was significant （β=0.059， P<0.05）. Both separate and chain mediating effects of peer attachment and life satisfaction between idolatry and perceived social support were significant （95% CI： 0.007~0.130， 0.004~0.054， 0.001~0.016， P<0.01）. The three effects above respectively accounted for 33.56%， 13.54% and 3.93% of the total effect. ConclusionIdolatry can affect secondary school students' perceived social support both directly and indirectly through peer attachment and life satisfaction.

Intensive cancer treatment with drug combination is widely exploited in the clinic but suffers from inconsistent pharmacokinetics among different therapeutic agents.To overcome it,the emerging nanomedicine offers an unparalleled opportunity for encapsulating multiple drugs in a nano-carrier.Herein,a two-step super-assembled strategy was performed to unify the pharmacokinetics of a pep-tide and a small molecular compound.In this proof-of-concept study,the bioinformatics analysis firstly revealed the potential synergies towards hepatoma therapy for the associative inhibition of exportin 1(XPO1)and ataxia telangiectasia mutated-Rad3-related(ATR),and then a super-assembled nano-pill(gold nano drug carrier loaded AZD6738 and 97-110 amino acids of apoptin(AP)(AA@G))was con-structed through camouflaging AZD6738(ATR small-molecule inhibitor)-binding human serum albumin onto the AP-Au supramolecular nanoparticle.As expected,both in vitro and in vivo experiment results verified that the AA@G possessed extraordinary biocompatibility and enhanced therapeutic effect through inducing cell cycle arrest,promoting DNA damage and inhibiting DNA repair of hepatoma cell.This work not only provides a co-delivery strategy for intensive liver cancer treatment with the clinical translational potential,but develops a common approach to unify the pharmacokinetics of peptide and small-molecular compounds,thereby extending the scope of drugs for developing the advanced com-bination therapy.

Objective:To summarize the clinical features and experience in diagnosis and treatment of subglottic cysts in children.Methods:The clinical data of 5 children with subglottic cysts admitted in Qilu Children′s Hospital of Shandong University from April 2018 to June 2019 were retrospectively analyzed.Results:Among the 5 patients, 2 cases were premature infants and 3 cases were full term infants.All patients had an endotracheal intubation history.One patient was asymptomatic.Four patients had laryngeal stridor, 2 cases of whom were accompanied by hoarseness and dyspnea.These 2 patients were used to be misdiagnosed with laryngomalacia, laryngitis, etc.Bronchoscopy revealed subglottic gray-white cyst-like lesions, and enhanced CT showed low density without enhancement.All patients were treated with laser and forceps, and bronchoscope was applied in the follow up period for 5-12 weeks.There was no recurrence or subglottic stenosis.Conclusions:Laryngeal stridor in children with a history of endotracheal intubation must be examined by bronchoscopy in time to find out whether there is subglottic cysts.Laser therapy is an effective treatment for subglottic cysts.

Objective:To compare the efficacy of individualized PEEP determined by lung electrical impedance tomography (EIT) and dynamic lung compliance (Cdyn) during lung-protective ventilation strategies in the patients undergoing general anesthesia.Methods:Sixty patients of both sexes, aged 18-64 yr, of American Society of Anesthesiologists physical status Ⅰor Ⅱ, with body mass index of 18.5-28.0 kg/m 2, undergoing elective surgery with general anesthesia and endotracheal intubation in the Second Affiliated Hospital of Soochow University, were selected.Lung-protective ventilation strategy was applied in supine position after general anesthesia.The peak value of PEEP did not exceed 10 cmH 2O, with an increment/decrement of 2 cmH 2O for titration.The corresponding Cdyn value and lung EIT data were collected during titration.The patients were divided into 2 groups ( n=30 each) using a random number table method: titration first increased and then decreased group (group A) and titration first decreased and then increased group (group B). The determination method of individualized PEEP: Cdyn method was the PEEP corresponding to the maximum Cdyn value; EIT method was obtained through PV500 PC software analysis.The level and success rate of individualized PEEP determined by the Cdyn and EIT methods were compared, and the ICC consistency analysis of the determined individualized PEEP was performed. Results:Compared with the Cdyn method, the success rate of individualized PEEP determined by EIT method was significantly increased, and the level of individualized PEEP was decreased in the two group ( P<0.05). In group A, the individualized PEEP titrated by the EIT and Cdyn methods showed good agreement (the ICC value of the increment-Cdyn and increment-EIT methods was 0.761, P<0.05; the ICC value of the decrement-Cdyn and decrement-EIT methods was 0.763, P<0.05). In group B, the individualized PEEP titrated by the EIT and Cdyn methods showed good agreement (the ICC value of the increment-Cdyn and increment-EIT methods was 0.809, P<0.05; the ICC value of the decrement-Cdyn and decrement-EIT methods was 0.797, P<0.05). Conclusion:The agreement between the individualized PEEP determined by lung EIT method and Cdyn method during lung-protective ventilation is good in the patients undergoing general anesthesia, and the success rate of EIT method is higher, and the level of individualized PEEP is lower.

Targeted protein degradation (TPD) technology facilitates specific and efficient degradation of disease-related proteins through hijacking the two major protein degradation systems in mammalian cells: ubiquitin-proteasome system and lysosome pathway. Compared with traditional small molecule-inhibitors, TPD-based drugs exhibit the characteristics of a broader target spectrum. Compared with techniques interfere with protein expression on the gene and mRNA level, TPD-based drugs are target-specific, efficaciously rapid, and not constrained by post-translational modification of proteins. In the past 20 years, various TPD-based technologies have been developed. Most excitingly, two TPD-based therapeutic drugs have been approved by FDA for phase Ⅰ clinical trials in 2019. Despite of the early stage characteristics and various obstructions of the TPD technology, it could serve as a powerful tool for the development of novel drugs. This review summarizes the advances of different degradation systems based on TPD technologies and their applications in disease therapy. Moreover, the advantages and challenges of various technologies were discussed systematically, with the aim to provide theoretical guidance for further application of TPD technologies in scientific research and drug development.
Animals ; Proteasome Endopeptidase Complex/metabolism* ; Protein Processing, Post-Translational ; Proteins/metabolism* ; Proteolysis ; Technology

Endotracheal intubation is used to relieve upper airway obstruction, assist ventilation in case of respiratory failure, and airway management and surgical anesthesia.However, tracheal intubation may cause many airway complications, especially the prolongation of intubation time, especially including mucosal edema, hematoma, ulcer, cyst, granulation, glottic (inferior) stenosis, arytenoid joint dislocation, vocal cord paralysis and so on.This study mainly introduces complications related with airway and its related management.

Long non-coding RNAs(lncRNAs)is a functional RNA molecule with a sequence length greater than 200 nucleo-tides that is not translated into a protein. LncRNA is of great value in the clinical application of malignant tumors and is closely related to the diagnosis,prevention,treatment and prognosis of tumors. CCAT1(human colon cancer associated transcript-1)can play a carci-nogenic role by promoting cell proliferation,invasion and migration. CCAT1 can be used as a biomarker for tumor prognosis. In this re-view,the research progress on the relationship between CCAT1 and digestive system malignant tumors is reviewed in recent years,the current status and prospects of malignant tumor treatment by CCAT1 are discussed.

Objective To investigate the effect of high-fat diet(HFD)on liver damage caused by autoimmune hepatitis(AIH)in mice.Methods Fifty C57BL/6 male mice were divided randomly into four groups:standard chow(SC)group,HFD group,AIH + SC group and AIH+ HFD group.AIH model was built after feeding for one week and all mice were sacrificed after four weeks.Liver and spleen tissues and serum were collected. Liver histopathology was detected by HE staining. Serum alanine aminotransperase(ALT)and aspartate aminotransferase(AST)levels were measured.Western blot analysis and real-time polymerase chain reaction(PCR)analysis were used to test the expressions of NLR pyrin domain containing 3(NLRP3)and cysteinyl aspartate specific proteinase 1(Caspase-1).The concentrations of interleukin(IL)-6,IL-1β and tumor necrosis factor(TNF)-α were analyzed using enzyme linked immunosorbent assay technology.The amount of Th17 cells in spleen was analyzed by FACS.Means among groups were analyzed with one-way ANOVA.SNK-q analysis was used for groups with homogeneity of variance, while nonparametric test was used for groups with variance nonhomogeneity.Results Histologically,the H&E staining of liver tissue from HFD group showed adipose degeneration,and there was inflammation around vessel in AIH+SC group.Moreover,in AIH+HFD group,the inflammation was more serious with mildly adipose degeneration.Compared with SC group,serum levels of ALT and AST increased in HFD group and AIH +SC group,and greatest increase was observed in AIH+ HFD group.The differences were statistically significant(F=57.12 and 37.58, both P<0.05).The proportions of Th17 cells in SC group,HFD group,AIH+ SC group and AIH+HFD group were(2.98 ± 0.90)%,(6.89 ± 0.99)%,(6.47 ± 1.08)% and(9.96 ± 0.83)%, respectively.The differences among all groups were statistically significant(F=54.05,P<0.05).The concentrations of IL-1β,IL-6 and TNF-α in each group were as follows:SC:IL-1β[(7.62 ± 2.81)ng/L],IL-6 [(106.54 ± 53.08)ng/L],T NF-α[(107.26 ± 36.20)ng/L];HFD:IL-1β[(25.06 ± 7.09)ng/L],IL-6 [(220.11 ± 47.41)ng/L],TNF-α[(273.77 ± 33.62)ng/L];AIH+SC:IL-1β[(17.49 ± 5.68)ng/L],IL-6 [(260.73 ± 50.29)ng/L],TNF-α[(250.49 ± 81.63)ng/L];AIH+ HFD:IL-1β[(52.04 ± 10.22)ng/L], IL-6[(785.93 ± 70.91)ng/L],TNF-α[(913.97 ± 64.57)ng/L].The differences were statistically significant(F=44.66,242.15 and 233.49,respectively,all P<0.05).The expressions of NLRP3 and Caspase-1 were significantly increased in AIH+ HFD group than the other three groups(all P<0.05). Conclusions High-fat diet potentiates liver damage induced by autoimmune hepatitis,which might relate to the secretion of pro-inflammatory cytokines,the activation of Th17 cells and the NLRP3 inflammasome as well as pyroptosis.

Objective To study the immunoregulatory effect of sodium butyrate(NaB)on T helper cell 17(Th17)and the effect on toll-like receptor 4(TLR4)signal pathway in autoimmune hepatitis (AIH).Methods Fifty male C57BL/6 mice(6 weeks of age)according to the random number table method divided into control group(n=10),AIH group(n=10),NaB group(n=10)and high roughage diet(HRD)group(n=10),and the other ten mice were used to extract hepatic sytosolic S-100.After the establishment of AIH model,mice in NaB group were given sodium butyrate 500 mg/(kg·d)by gavage and those in HRD group were fed with high-fiber stuff.After 3 weeks of treatment,all the mice were sacrificed.The pathological change was observed.The serum levels of alanine aminotransferase(ALT), aspartate transaminase(AST),IL-17A and TNF-α,the proportion of Th17 in spleen,the expression levels of TLR4 and myeloid differentiation factor 88(MyD88)in liver were observed in each group.The tests of normality and homogeneity of variance were used to compare the means of each group.One-way analysis of variance and multiple comparative analyses were used in the statistical analysis.Results HE staining showed that inflammatory cell infiltration and hepatocyte necrosis were significantly reduced in mice treated with NaB and HRD compared to AIH group.Serum ALT levels in control group,AIH group,NaB group and HRD group were(24.833 ± 2.229),(88.333 ± 9.543),(27.167 ± 3.189)and (29.833 ± 6.113)U/L,respectively,while AST levels in each group were(97.00 ± 14.953),(285.000 ± 35.434),(139.500 ± 38.976)and(127.167 ± 28.687)U/L,respectively.The differences among groups were all statistically significant(F=156.49 and 44.118,respectively,both P<0.01).The proportion of Th17 in spleen and the expressions of the transcription factors retinoid-related orphan receptor gamma t in the spleen of the NaB group and HRD group were significantly lower than those of AIH group.The differences were statistically significantly(F=21.780 and 68.283,respectively,both P<0.05).The expressions of TLR4 and MyD88 in liver of AIH group were significantly higher than control group,but those were inhibited in NaB group and HRD group.The differences were statistically significantly(F= 26.235 and 28.293,respectively,both P<0.01).The expressions of IL-17 and TNF-α in liver and serum decreased in NaB group and HRD group.Conclusion NaB exerts an immunoregulatory effect in AIH and improves inflammatory reaction in liver.

Objective To analyze the distribution characteristics and risk factors of extended stay over 30 days at tertiary comprehensive hospitals, and explore methods of shortening average length of stay(LOS).Methods Homepage of all inpatients discharged from October 2014 to October 2015 of 31 tertiary comprehensive hospitals in Shanxi province were collected.39 234 cases of these inpatients stayed over 30 days and their case information was complete.A generalized linear model was used for risk factors analysis.Results With the extension of LOS, most of the inpatients with extended stay were found during their 30th-40th days, accounting for 50.21% of all and constituting the highest daily costs as well.The ratio of inpatients decreases with their LOS, and its distribution presents a positive skew in entirety.Distribution of inpatients over 30 days identified urban employees under medical insurance accounting for the highest ratio among all payment categories,and those from the department of orthopedics for the highest ratio among all departments, while those of diseases from injury and poisoning accounting for the highest ratio among all disease categories.The findings indicated ten important factors for extended stay, namely gender, medical payment category, ICD, inter-department transfer, nosocomial infection, and clinical pathway.Conclusions To strengthen management of specific departments and inpatients, focus on key process of medical quality, and accelerate medical insurance payment reform can effectively control extended stay.