Objective:To explore the clinical characteristics and risk factors of pediatric kidney transplantation (KT).Methods:From January 1, 2010 to September 30, 2022, retrospective analysis was performed for the relevant clinical data of 81 pediatric recipients of primary KT at Organ Transplant Center of Shanghai Changzheng Hospital. The occurrences of acute rejection (AR) ,delayed graft function (DGF), infection, myelosuppression, tumor and other complications were observed within 1 year post-KT. They were grouped according to whether or not AR/DGF occurred. Univariate analysis speculated the effect of AR and DGF on renal function at 1 year after transplantation. Binary Logistic regression was employed for examining the risk factors related to AR/DGF.Results:During follow-ups, transplanted kidney was removed due to an embolization of renal vessels and dialysis resumed (n= 5). One child had failed graft due to the recurrence of original disease and dialysis resumed. The remaining 75 children had an excellent recovery of graft function. At the end of follow-ups, survival for transplant recipients and transplanted kidneys was 100% (81/81 ) and 92.6% (75/81) respectively. 23 patients (28.4%) developed DGF, including 20 child recipients of C-I donors. Among DGF recipients, 21 (91.3%) were immune induced with anti-CD25 humanized monoclonal antibody and 2 (8.7 %) with porcine antihuman lymphocyte immunoglobulin (pALG). Within the first year post-KT, 13 patients (16.1%) developed AR, including 11 child recipients of C-I donors. Induction was made with anti-CD25 humanized monoclonal antibody (n=8), pALG (n=4) and anti-human T lymphocyte rabbit immunoglobulin (n=1). And 12 cases were reversed with MP (methylprednisolone) shock therapy while another ineffective case was rescued by an intravenous infusion of rATG (rabbit anti-human thymocyte immunoglobulin). During postoperative follow-ups, 14 (17.3 %) KT recipients had an onset of pulmonary infection (n=7), upper respiratory tract infection (n=3), urinary tract infection (n=5), gastrointestinal infection (n=2) and abdominal cavity infection (n=1). The causative pathogens were bacteria (n=14) and viruses (n=4). Among 7 cases (8.6%) of myelosuppression, there were leukopenia (n=6) and thrombocytopenia (n=1 ). During 1-year follow-ups, no malignancy occurred. At the last follow-up, blood creatinine was (72.79±21.07) μmol/L in non-AR/DGF recipients. For AR/DGF recipients, blood creatinine levels were (68.83±10.78) and (74.20±18.70) μmol/L. There was no significant inter-group difference ( F=0.14, P=0.87). In groups with and without DGF, the incidence of bone marrow suppression in the children with DGF was significantly higher (21. 74 %) than that in the untreated group (3.45%), with a statistically significant difference ( P=0.02). However, there was no statistically significant difference in the age, sex, donor source, infection, and types of immune-induced drugs in AR, DGF occurrence and no occurrence group. logistic Regression analysis showed that immunoinduction therapy with lymphocyte inhibitor ( OR=0.074, 95 %CI: 0.009-0.0643, P=0.018) and bone marrow suppression ( OR=0.045, 95%CI: 0.004-0.515, P=0.013) were risk factors for DGF. Conclusion:KT in children may obtain decent outcomes. Immunoinduction therapy with lymphocyte inhibitors and occurrence of myelosuppression are risk factors for postoperative DGF. The occurrence of AR/DGF in early postoperative period does not affect the level of kidney function in children at 1 year post-KT. It is recommended to closely follow up and accumulate experiences for optimizing long-term outcomes.

Artificial intelligence has shown broad application prospects in the field of nursing management, and is expected to become an important breakthrough point in improving the efficiency and level of nursing management. This study reviewed the current research status of artificial intelligence in the field of nursing management, summarized the progress of artificial intelligence in nursing personnel scheduling, disease risk management and optimizing nursing management processes, analyzed the opportunities and challenges of artificial intelligence application in nursing management, and provides reference for the development and application of artificial intelligence in nursing management in the future.

OBJECTIVE To compare t he diff erences of the fingerprint and in vitro antioxidant activity between decoction pieces of Polygonum cuspidatum by integrated technology of habitat processing and processing （short for IPDP ）and traditional processing decoction pieces （short for TPDP ）. METHODS Ten batches of IPDP and ten batches of TPDP were prepared by integrated technology and traditional technology ，respectively. HPLC method was used to establish and compare the fingerprints of IPDP and TPDP. The scavenging rates of DPPH free radical ，ABTS free radical ，superoxide free radical and hydroxyl free radical and reducing activity of Fe 3+ were detected for IPDP and TPDP. In vitro antioxidant activities were compared between IPDP and TPDP. RESULTS There were 11 common peaks in the fingerprints of IPDP and TPDP ，among which 17 came from IPDP and 13 came from TPDP. The peak heights of peak 6（polydatin）and peak 15（emodin-8-O-β-D-glucoside）in IPDP were significantly higher than those in the TPDP ，and the peak heights of peak 13（resveratrol），peak 17（emodin）and peak 19（physcion）in the TPDP were significantly higher than those in the IPDP. The results of in vitro antioxidant test showed that IPDP and TPDP had a certain scavenging capacity on DPPH free radical ，ABTS free radical ，superoxide free radical and hydroxyl free radicals ，and also had a certain reducing capacity on Fe 3+. CONCLUSIONS The integrated processing technology of P. cuspidatum has a good retention effect on the glycosides in P. cuspidatum ，and the in vitro antioxidant activity of IPDP is stronger than that of TPDP.

Objective:To explore the clinical characteristics, diagnosis and treatment of cryptococcal infection after renal transplantation.Methods:The clinical data were analyzed retrospectively for 17 hospitalized cases of cryptococcal infection after kidney transplantation from January 2003 to December 2019. The relevant parameters included site of infection, clinical manifestations, complications, comorbidities, treatments and outcomes. The average time to infection after transplantation was (7.9±5.4) years, the median baseline level of creatinine was 137(75-741) μmol/L. Concurrent conditions included hypertension (n=15, 88.2%), diabetes (n=6, 35.3%) and chronic hepatitis (n=9, 52.9%). The most common site of infection was central nervous system (88.2%), followed by lungs (29.4%) and skin (17.6%).Results:The clinical manifestations were diverse. Most patients received amphotericin B liposome and/or fluconazole as an initial option. The outcomes were curing (n=17, 58.8%), death from cryptococcal infection (n=5, 29.4%), partial relief (n=1, 5.9%) and stable disease (n=1, 5.9%). Among 10 curative cases, 2 cases died from other causes and 4 cases returned to hemodialysis with graft loss.Conclusions:Cryptococcosis is typically a late-occurring infection in kidney transplant recipients. Many factors, such as complications, nonstandard antifungal treatment, immune dysbalance, have adverse prognoses. Strengthening follow-ups, dealing with complications, validating the diagnosis early, interdepartmental cooperations, standardizing antifungal therapy and balancing immune status may improve the outcomes of cryptococcosis after kidney transplantation.

Objective To measure the reliability and validity of the Chinese version of the compre-hensive assessment of ACT processes(CompACT)in financial staffs. Methods A total of 3 735 valid ques-tionnaires were obtained from financial staffs.The valid questionnaires were randomly allocated into two groups,of which one subset(n=1 873)was used for exploratory factor analysis(EPA),and the other(n=1 845)for confirmatory factor analysis(CFA).Criterion and convergent validity were tested by Pearson corre-lation respectively.Incremental validity was tested by hierarchical regression analysis. Results The EFA suggested theoretically-coherent three-factor structure for a 15-itemed version of the CompACT.The three fac-tors named as acceptance and cognitive defusion,mindfulness and self as context,value and committed ac-tion,and explained 73.75% of the total variance and factor loadings ranged from 0.67 to 0.90.The CFA con-firmed the hypothesized three-factor mode(χ2/df=5.91,CFI=0.98,TLI=0.98,RMSEA=0.05). Conclu-sion The research suggests that the Chinese version of the CompACT has acceptable psychometric in prop-erties,so it can be applied in the assessment of the psychological flexibility and mental health in China.

Objective To study the clinical efficacy and safety of microwave ablation (MWA) in the treatment of autonomous functional thyroid nodules(AFTN) . Methods Sixty-seven nodules of 53 AFTN patients who refused or were not suitable for surgical resection and 131I therapy were enrolled in the study . All the nodules were evaluated by ultrasound ,color Doppler flow imaging ( CDFI) and contrast enhanced ultrasound(CEUS) ,and all of them were benign and confirmed by pathology . And then ,percutaneous MWA was performed . Fluid isolation and mobile ablation were used to completely inactivate the nodules ,and CEUS was used to evaluate the efficacy of the treatment . The following items included thyroid hormone level ,nodule volume ,nodular blood supply ,thyroid radionuclide imaging ,conscious symptom ,beauty score and complication . Finally ,the factors influencing the curative effect were analyzed . Results The follow-up period was at least 12 months . Compared with before treatment ,the differences of thyroid hormone level , the volume of nodules ,the nodule blood supply were statistically significant ( P ＜ 0 .01) . The 61 hot nodules" changed to cold or warm nodules" . The differences between the improvement ratio of conscious symptoms and beauty scores were statistically significant( P ＜ 0 .05) . The cure ratio in this study was 81 .13% ,and the incidence of complications was 11 .32% ,and the recurrence ratio was 4 .48% . The nodule volume≥14 .04 ml or in a dangerous position were the main factors affecting the curative effect . Conclusions MWA can inactivate the AFTN in situ ,make it lose the secretory function and reduce the volume of nodules . Therefore ,percutaneous MWA guided by ultrasound and CEUS treatment of AFTN can be regarded as another safe and effective treatment besides surgical resection or 131I therapy .

OBJECTIVETo study biological effect of recombinant human erythropoietin (RhEPO) on the expression of oligodendrocyte in the neuron glia antigen 2(NG2), Nogo receptor-interacting protein 1(LINGO-1), myelin basic protein (MBP) and myelin associated glycoprotein (MAG), and to explore the protective mechanism of RhEPO for oligodendrocyte after cerebral infarction.

METHODSExperimental rats were randomly divided into the treatment group (RhEPO at a dose of 3 000 U/kg) or saline control group. Both groups received intraperitoneal injection of RhEPO after cerebral ischemia in 30 min, 3 h, 6 h, 12 h and 24 h, which was administered daily for 7 days. The modified neurological severity score (mNSS) and histology were analyzed, and immunohistochemistry was used to detect the protein expression of NG2, MAG, MBP and LINGO-1.

RESULTSThe overall mNSS of RhEPO treatment group significantly decreased compared with the saline control group on the seventh day after cerebral infarction (P<0.05). Such treatment effect was more obvious in the treatment group at 30 min and 3 h (P<0.01). Compared with the saline control group, the numbers of NG2 positive cells increased in RhEPO treatment group. In contrast, the expression of LINGO-1 protein significantly decreased (P<0.05), with a dramatic decrease observed at 30 min and 3 h (P<0.01). However, the expression of MBP protein decreased more significantly in saline control group, while the level of the MAG protein expression increased. The differences were statistically significant (P<0.05), especially at 30 min (P<0.01).

CONCLUSIONSAfter cerebral ischemia, RhEPO promotes the proliferation of NG2 positive cells, and inhibits the expression of LINGO-1 and MAG proteins. RhEPO improves the proliferation and differentiation of oligodendrocyte precursor cells, which in turn protects neuronal function, particularly at the early phase of ischemia.

Objective To study biological effect of recombinant human erythropoietin ( RhEPO) on the expression of oligodendrocyte in the neuron glia antigen 2 ( NG2 ) , Nogo receptor-interacting protein 1 (LINGO-1), myelin basic protein (MBP) and myelin associated glycoprotein (MAG), and to explore the protective mechanism of RhEPO for oligodendrocyte after cerebral infarction.Methods Experimental rats were randomly divided into the treatment group ( RhEPO at a dose of 3 000 U/kg) or saline control group.Both groups received intraperitoneal injection of RhEPO after cerebral ischemia in 30 min, 3 h, 6 h, 12 h and 24 h, which was administered daily for 7 days.The modified neurological severity score ( mNSS) and histology were analyzed, and immunohistochemistry was used to detect the protein expression of NG2, MAG, MBP and LINGO-1.Results The overall mNSS of RhEPO treatment group significantly decreased compared with the saline control group on the seventh day after cerebral infarction ( P<0.05 ).Such treatment effect was more obvious in the treatment group at 30 min and 3 h ( P<0.01).Compared with the saline control group, the numbers of NG2 positive cells increased in RhEPO treatment group.In contrast, the expression of LINGO-1 protein significantly decreased (P<0.05), with a dramatic decrease observed at 30 min and 3 h ( P<0.01).However, the expression of MBP protein decreased more significantly in saline control group, while the level of the MAG protein expression increased.The differences were statistically significant ( P<0.05), especially at 30 min (P<0.01).Conclusions After cerebral ischemia, RhEPO promotes the proliferation of NG2 positive cells, and inhibits the expression of LINGO-1 and MAG proteins.RhEPO improves the proliferation and differentiation of oligodendrocyte precursor cells, which in turn protects neuronal function, particularly at the early phase of ischemia.

Objective To investigate the relevance between protein expression and methylation of MG-MT and hMSH2 in glioma patimts.Methods Immunohistochemical and methylation specific PCR were adopted respectively to test on 275 cases of glioma patients for the protein expression and methylation situation of MGMT and hMSH2.Results The negative protein expression rate of MGMT and hMSH 2 in the tissue of brain golima were 47.2% and 62.5% respectively;the occurrence of methylation in gene promoter region were accordingly 41.8% and 22.4%.Statistical analysis revealed that MGMT promoter methylation in peripheral blood gene groups was related with the protein negative expression of tumor tissue (P<0.05),while there was no relationship between the protein expression of hMSH2 and its gene promoter methylation(P>0.05).Conclusion The meth-ylation of MGMT is a common molecular situation in the generation of brain glioma ,which may be connected with that of tumor.However,hMSH2 promoter methylation might not the main reason for inactivation of hMSH 2 pro-tein,there may be other important factors affecting its expression .

AIM: To investigate the effects and mechanisms of swainsonine-induced apoptosis on SGC-7901 cells. METHODES: After being treated with swainsonine, effective dose and median inhibition concentration (IC50) of swainsonine to SGC-7901 cells were examined by MTT assay. Cell cycle distribution and apoptotic rates were analyzed by flow cytometry. Expression of p53, c-myc and Bcl-2 were determined by immunocyto- chemical method, and the concentration of Ca2+ intra-cellular ([Ca2+]i ) was measured by the laser scanning confocal microscope (LSCM). RESULTS: Swainsonine inhibited cell growth of SGC-7901 in vitro, IC50 of 24 h was 0.84 μg·ml-l, and complete inhibition concentration of swainsonine was 6.2 μg·ml-l. Treated with swainsonine at the concentrations of 0.5, 1.5 and 4.5 μg·ml-l for 24 h, the expression of apoptosis inhibiting gene p53 and bcl-2 decreased, and apoptotic trigger gene c-myc increased (P<0.05), as well as [Ca2+]i overloading, SGC-7901 cell was induced to apoptosis in the end. The percentage of S phase were 38.8%, 39.7% and 29.6%, respectively (20.0% in control group and 23.2% in 5-Fu group), the percentage of G2/M phase were 4.5%, 1.7% and 5.3%, respectively (5.5% in control group and 9.0% in 5-Fu group), and the percentage of G1/M phase was not altered. SGC-7901 cells were treated by swainsonine at the concentrations of 0.5, 1.5 and 4.5 μg·ml-l for 24 h. Compared with the control group, the percentage of S phase were increased and that of G2/M cells were decreased significantly in treatment groups (P<0.01). CONCLUSION: Swainsonine can inhibit the cell proliferation and induce apoptosis of SGC-7901 cells, the mechanisms of swainsonine-induced apoptosis may related with [Ca2+]i overloading and expression of apoptosis-related genes.