Objective:To investigate the clinical significance and possible mechanisms of elevated homocysteine(Hcy) levels in peripheral blood of children with sepsis.Methods:The clinical data of 51 children with sepsis (sepsis group) admitted to PICU at Xuzhou Children′s Hospital from January 2019 to December 2019 were analyzed, and the levels of Hcy in plasma were compared with 50 non-septic children (common infection group) and 50 healthy children (healthy control group) during the same period.The possible mechanism of metabolic disorders about Hcy was analyzed by detecting the levels of the key rate-limiting enzymes cystathionine-β-synthase(CBS) and cystathionine-γ-lyase(CSE), which were in the downstream of metabolism in septic mouse model induced by lipopolysaccharide.Results:The level of Hcy in plasma was (12.62±5.46)μmol/L in sepsis group, which was significantly higher than those in common infection group[(9.42±2.28) μmol/L] and healthy control group[(8.14±1.60) μmol/L]( P<0.05). The level of Hcy in plasma of 12 children with acute kidney injury in sepsis group was significantly higher than that of 39 children without acute kidney injury in sepsis group[(16.48±5.87)μmol/L vs.(11.62±4.74) μmol/L, P<0.05]. The level of Hcy in plasma of six children with acute liver failure in sepsis group was significant higher than that of 45 children without acute liver failure in sepsis group[(18.35±7.10) μmol/L vs.(11.84±4.78) μmol/L, P<0.05]. The level of Hcy in serum significantly increased in septic mouse models ( P<0.01). The transcription and protein expression levels of key rate-limiting Hcy transcription enzymes CBS and CSE in liver and kidney tissues of septic mouse were significantly down-regulated ( P<0.05). Conclusion:The level of Hcy in peripheral blood of children with sepsis increases, which is more obviously in children with acute kidney injury or acute liver injury.When patients developed sepsis, the expression of CBS and CSE will be restrained, leading to disorders related to transsulfuration metabolism and elevated level of Hcy in peripheral blood.

Objective This study aims to explore the formation of the dilemma of"giving care"for disabled elderly people in nursing homes from the perspective of active health.Methods Purposive sampling was used to select caregivers and disabled elderly people from a nursing home in Chongqing as research subjects from July 2022 to December 2022.One-on-one in-depth interviews were conducted and Colaizzi's 7-step thematic analysis method was employed to collect and analyze the interview data.Results 4 themes were identified:①the dominance of the"giving"care concept,including the cultural thoughts of filial piety,passive acceptance of care characteristics and consumer psychology regarding paid services;②insufficient"participation"care ability,including lack of knowledge regarding active health and a weakening of skills to promote participation;③the hindrance to"transformation"of care models,including objective limitations in terms of human resources and delays in adapting aging environments;and ④the decline in"utilization"of internal abilities,including excessive avoidance of potential risks,a heavy workload of care and poor quality of individual care.Conclusion The formation of the dilemma of"giving care"for disabled elderly people in nursing homes is affected by multiple factors such as social background,service system,supply resources,and management mode.Transforming disabled elderly individuals from a state of"passive giving care"to"active participation in their health"is an important measure to realize the concept of positive aging and healthy aging.

Objective: To make a preliminary assessment on the immunogenicity of a quadrivalence recombinant human papillomavirus (HPV) vaccine (6, 11, 16 and 18 types) (Hansenulapolymorpha) in healthy women aged 18-45 years in phaseⅠclinical study. Methods: It was a single-center, double-blind, randomized, placebo-controlled phaseⅠ clinical study. Women aged 18-45 years were randomized (2∶1) to receive HPV vaccine (n=60) or placebo control (n=30) at months 0, 2 and 6. Antibodies against HPV6/11/16/18 were detected by pseudovirus-based neutralisation assay in serum samples collected at 0 d, 180 d and 210 d. Seroconversion rates and geometric mean titres (GMT) of antibodies against the four types of antigens were calculated. Results: Seroconversion rates of the vaccination group at 180 d (before the third dose) and 210 d (one month after the third dose) were generally similar and between 85%-100% for all types of antibodies. The GMT of antibodies at one month after the last dose improved significantly compared with those before immunization. Conclusions These results showed that the HPV vaccine had good immunogenicity in the population of healthy women aged 18-45 years. Higher antibody titers were elicited by the vaccine compare with the tites before the first dose and in the placebo control group.

Objective To observe the clinical efficacy of electroacupuncture plus moxibustion in treating infantile cerebral palsy. Method Eighty eligible patients with infantile cerebral palsy were randomized into a treatment group of 42 cases and a control group of 38 cases. The control group was intervened by physiotherapy (PT), while the treatment group was given electroacupuncture at scalp acupoints, body acupuncture, and moxibustion along the Governor Vessel in addition to the treatment given to the control group. The two groups were treated once a day, 6 months in total. The comprehensive ability and the Gross Motor Function Measure (GMFM) were evaluated before and after the interventions in the two groups, and the clinical efficacies were compared.Result After 6-month treatment, the total effective rate was 92.9% in the treatment group versus 78.9% in the control group, and the total effective rate of the treatment group was superior to that of the control group (P<0.05). The motor function and activities of daily living were significantly improved in both groups after the interventions (P<0.05,P<0.01); after the treatment, there were significant differences in comparing the motor function and activities of daily living between the two groups (P<0.05). The GMFM scores of each domain were significantly changed after the treatment in both groups (P<0.05); after the treatment, there were significant differences in comparing the GMFM scores of each domain between the two groups (P<0.05).Conclusion Compared with being used alone, conventional PT can more significantly benefit the improvement of motor function of cerebral palsy patients when electroacupuncture and moxibustion were added.

Vasculogenic mimicry (VM) is a brand-new tumor vascular pattern with the ability to form vessellike networks without participation of endothelial cells and independent on angiogenesis.It can provide adequate blood supply for tumor growth.The formation of VM involves multiple molecule mechanisms and signal pathways,including cancer stem cell and epithelial-mesenchymal transition.As a unique blood-supply pattern,VM is associated with cancer invasion,metastasis and poor prognosis.Because of its important role in cancer progression,VM will become a new target for therapy of cancers.

Objective:To study the effect of totally endoscopic surgery and Miccoli surgery for papillary thyroid microcarcinoma. Methods Totally 64 patients with papillary thyroid microcarcinoma from April 2013 to April 2014 in our hospital were divided into the ob-servation group and the control group according to a random number table.And the intraoperative and postoperative situation of the two groups were compared.Results The number of lymph node dissection,postoperative hospital stay,hospital costs of the two groups had no sig-nificant difference (P >0.05).The blood loss,operative time,drainage time,amount of drainage,incision length,time of postoperative recov-ery of the observation group were significantly less than those of the control group with statistical significance (P <0.05).But the cosmetic score of observation group after operation was lower than that of the control group,and there was a significant difference (P <0.05).Postop-erative pain grade of the observation group was better than the control group with statistical significance (P <0.05).The complication rate of control group was significantly higher than the observation group (P <0.05).Conclusion Miccoli surgery for papillary thyroid microcarci-noma has more advantages compared with totally endoscopic surgery in terms of blood loss,operative time,drainage time,amount of drainage, incision length,time of postoperative recovery,and degree of pain.Moreover,it has a lower complication rate and high security,which should be the first choice in clinic surgery.

Objective To discuss the effect of syphilis treatment during pregnancy on serological test results in infants born to syphilis mothers.Methods Data of pregnant women with syphilis and their infants in Zhejiang Province between January 2013 and December 2014 were retrospectively analyzed and the effect of syphilis treatment during pregnancy on non-treponemal antigen serological test results in infants were compared.x2 test was used for positive rate of serological tests,incidence of congenital syphilis,and neonatal mortality in infants with syphilis,and rank sum test was used to compare the titers of rapid plasma reagin (RPR) test and tolulized red unheated serum teat (TRUST).Results A total of 3 953 infants were born to 3 901 mothers with syphilis.Of which 3 262 were tested,including 2 226 by RPR and 1 036 by TRUST.The rate of infants with positive RPR was significant lower in treated mothers (45.02％)compared with untreated mothers (55.04％;x2 =12.88,P＜0.01).The significant differences of titers of RPR or TRUST were observed among mothers with or without treatment (RPR:Z=-2.45,P=0.01;TRUST:Z=-2.65,P=0.01),different course of treatment (RPR:Z=-2.33,P=0.02;TRUST:Z=-2.60,P=0.01).Fifty-seven infants were diagnosed with congenital syphilis.The rate of congenital syphilis was 3.50％(27/772) born to untreated mothers,which was dramatically higher than treated mothers (0.96 ％,30/3 129,x2 =27.72,P＜ 0.01).Forty-two infants died.Neonatal mortality was also higher in the untreated group (2.59 ％,20/772) than the treated group (0.70％,22/3 129,x2 =20.72,P＜ 0.01).Conclusion Adequate treatment for women with syphilis during pregnancy could decrease serological tests of RPR and TRUST among new infants and improve the infants their outcomes.

Objective To investigate the risk factors for HIV and HCV infections in patients receiving methadone maintenance treatment (MMT) in Kaiyuan,Yunnan province.Methods Patients receiving MMT in June 2014 in Kaiyuan were included in this study.The prevalence of HIV and HCV infections were calculated and logistics regression analysis was conducted to identify related risk factors.Results In June 2014,275 patients received MMT,their average duration of MMT was 4.0 ± 2.4 years.The overall HIV infection rate was 51.6％ (142/275).All the HIV infection occurred before MMT.In 275 patients,222 were infected with HCV before MMT,and 17 new HCV infections occurred during MMT.And the HIV/HCV co-infection rate was 49.1％.The results from multivariate logistic regression analysis indicated that the risk of HIV infection was higher in those who were unmarried/divorced/widowed (adjust OR=2.39,95％CI:1.29-4.43) and injecting drug users (adjust OR=5.52,95％CI:2.69-11.35),sharing needles with others (adjust OR=2.32,95％CI:1.04-5.18) and had longer history of drug use.For HCV infection,injecting drug use was the independence risk factor(adjust OR=11.54,95％CI:4.79-27.80).Conclnsion The prevalence of HIV,HCV infections and HIV/HCV co-infection in patients in MMT clinic were higher in Kaiyuan than in other areas in Yunnan.More intervention should be given to the patients who had history of injecting drug use.

To explore the dual regulatory effects of Shuanghuang Shengbai Granule, a compound traditional Chinese herbal medicine, on cell cycle in Lewis-bearing mice with chemotherapy-induced myelosuppression.

BACKGROUND:Alterations in secondary hemodynamics around the stent edge can be caused by stent planted. Is there different effect of shear stress on platelet growth factors-A, B (PDGF-A, B) and basic fibroblast growth factor (bFGF) of endothelial cells around stent edge after stent planted?OBJECTIVE: To explore the effect of shear stress on growth factors of endothelial cells around stent edge.DESIGN: Observational comparative study.SETTING: Department of Cardiology, Yijishan Hospital, Wannan Medical College; Laboratory of Biomechanics (National Laboratory), Medical College of Shanghai Jiao Tong University.MATERIALS: The experiment was carried out in the Laboratory of Biomechanics, Medical College of Shanghai Jiaotong University from April to October 2006. The main reagents were detailed as follows: trypsin (Hyclon Company); M-199 medium (Gibco BRL Company); fetal bovine serum (Hangzhou Sijiqing Bioengineering Material Institute); aFGF, Heparin and Hepes (Sigma Company); thymide, Ⅷ factor monoclonal antibody (Rabbit anti-human),biotinylated horse anti-rabbit IgG and propidium lodide (Sigma Company); neonate belly band (Delivery Room of Shanghai the Fifth People's Hospital); trizol (Invitrogene Company); reverse transcription polymerase chain reaction (RT-PCR) kit (Fermentas Company); penicillin/streptomycin (AB/M), objective gene primer (Shanghai Bioengineering Company).METHODS: Traditional parallel-plate streaming cavity was modified into rectangular and gradient shear stress models;while static group was established at the same time. Two shear stress groups were subjected to 11.37 dyne/cm2 and 5.66-14.38 dyne/cm2 shear stress, respectively for 3 hours, 6 hours and 12 hours.MAIN OUTCOME MEASURES: The expressions of PDGF-A, B and bFGF mRNA of human umbilical endothelial cells (HUVECs) were measured by RT-PCR at different time points.RESULTS: Compared with static group, the maximal expression of PDGF-A, B and bFGF mRNA was reached peak at 3 hours in gradient shear stress group and this level of PDGF-A mRNA expression remained till 12 hours. in rectangle shear stress group, the peak value of mRNA expression of these growth factors was all reached at 6 hours, and then gradually decreased.CONCLUSION: Over-expressions of PDGF-A, B and bFGF induced by gradientshear stress after stent planted may play an important role in stent restenosis through intimal hyperplasia.