Objective To analyze the PLCβ4 gene mRNA expression and its clinical significance in hepatocellular carcinoma (HCC) based on TCGA database. Methods Based on the data on 424 clinical samples (including 374 cases of HCC tissues and 50 cases of nontumor liver tissues) in the TCGA database, Kaplan–Meier method, Cox regression analysis, and immune infiltration analysis were performed to evaluate the relationship between PLCβ4 gene and the clinical characteristics and survival prognosis of HCC patients. Correlation analysis between PLCβ4 gene and 24 types of immune cells was applied to investigate the relationship between PLCβ4 gene and immune cell infiltration and mRNA expression level of TP53 gene, a high-frequency mutation gene in HCC. In addition, paraffin sections of highly, moderately, and poorly differentiated tumor tissues and normal liver tissues from HCC patients were collected. The histopathological observation was carried out via HE staining method, and the expression levels of PLCβ4 and Ki-67 proteins in each clinical sample were verified through the immunohistochemical method. Results The expression level of PLCβ4 gene in HCC was significantly higher than that in normal tissues (P<0.01), and all patients in the PLCβ4 high-expression group had a significantly longer overall survival than those in the low-expression group (P<0.05), which suggested that PLCβ4 substantially affected the prognosis of HCC patients. Correlation analysis showed that the expression level of PLCβ4 gene was highly correlated with immune cell infiltration and the expression level of TP53 gene. As verified by clinical sample experiments, HE staining experiments and immunohistochemical results revealed that PLCβ4 gene expression in HCC tissue samples was significantly higher than that in normal tissues (P<0.001), and it was negatively correlated with the degree of differentiation. Conclusion PLCβ4 may serve as an independent prognostic factor in HCC and is expected to be a novel molecular target for HCC treatment.

AIM: To provide references for the non-clinical evaluation of therapeutic targets or drugs for retinoblastoma, fluorescently labeled Y79 cells are injected into the vitreous body of BALB/c-nu mice to establish a retinoblastoma model, and the Melphalan treatment group is used as a positive control, which is verified by fluorescence imaging technology.METHODS: BALB/c-nu mice were intravitreous injected with GFP transfected Y79 cells(1.0×107 cell/mL, 3 μL)to establish the model. On the 27th day, the mice were randomly divided into model control group and different doses of Melphalan groups(1, 3, 10 μg/eye groups)according to the fluorescence value of in vivo imaging, with vitreous body single administrated and ocular symptoms observed daily. Slit-lamp examination was performed at 12, 20, 29, 35, 42, 48, 55, 76, and 83 d after modeling. In vivo imaging was performed on 12, 20, 27, 41, 48, 55, 62, 69, 76, and 83 d. At the last treatment, the eyeball, brain and cerebellum tissues were removed for histopathological examination.RESULTS: From the sixth day of modeling, cloud-like substances could be seen in the eyes of the animals, and the cloud-like substances occupied the whole eyeball of the mice in the model control group at the later stage, accompanied by irregular growth of blood vessels. After 27 days of modeling, the fluorescence value was detected in all the animals, and the fluorescence value continued to increase with the extension of modeling time. The fluorescence value of the tumor reached the peak after 69-83 days of modeling. Histological examination showed severe proliferation of intraocular tumor cells in the model control group, and tumor cells were observed in the brain of 1 model animal. In the 10 μg/eye Melphalan group, the fluorescence value was significantly decreased at 17 d after administration. The fluorescence value of the 3 μg/eye Melphalan group was significantly inhibited at 59 d after administration. No tumor cells were found in the brain tissue of animals in all Melphalan groups.CONCLUSION: After vitreous injection of Y79/pCDH-LUC-copGFP cells in BALB/c-nu mice, significant ocular lesions and proliferation of tumor cells were observed in the eyes. Meanwhile, Melphalan intervention significantly inhibited tumor cells in a dose-dependent manner, indicating that the mouse model of retinoblastoma was successfully constructed.

ObjectiveTaking the oligosaccharides in Rehmanniae Radix（RR） as the research object， the content determination method based on high performance liquid chromatography-evaporative light scattering detection（HPLC-ELSD） and thin layer chromatography（TLC） identification method were established to explore the content and distribution of oligosaccharides in different RR herbs and decoction pieces. MethodA total of 10 batches of fresh and raw RR， 12 batches of RR decoction pieces and Rehmanniae Radix Praeparata（RRP） were collected. A TLC identification method for fructose， sucrose， manninotriose， raffinose and stachyose in RR was established by using silica gel G thin-layer plates with ethyl acetate-water-anhydrous formic acid-glacial acetic acid（12∶6∶5∶4） as the developing agent and 10% sulfuric acid-ethanol solution as chromogenic agent. A HPLC-ELSD was used to determine the contents of fructose， glucose， sucrose， melibiose， raffinose， manninotriose and stachyose in different RR herbs and decoction pieces. Then principal component analysis（PCA） and partial least squares-discriminant analysis（PLS-DA） were used to analyze the contents of 7 kinds of saccharides in RR herbs and decoction pieces， and the differential components were screened with the value of variable importance in the projection（VIP）>1. ResultThe results of TLC identification showed that fresh RR， raw RR and its decoction pieces showed spots of the same color on the corresponding positions with the control products of stachyose， raffinose and sucrose， while the TLC of RRP showed spots of the same color at corresponding positions to manninotriose and fructose controls. The results of methodological investigations of 7 analytes met the requirements of determination. Only glucose， sucrose， raffinose and stachyose were detected in 10 batches of fresh RR and 10 batches of raw RR herbs， the average contents of which were 0.84%， 4.62%， 2.42% and 57.90% in fresh samples， while those were 3.16%， 9.36%， 7.05% and 38.10% in raw samples， respectively. In 12 batches of RR decoction pieces， the contents of the above seven sugars（fructose， glucose， sucrose， melibiose， raffinose， manninotriose and stachyose） were 1.68%， 4.27%， 9.96%， 0.53%， 6.85%， 3.05% and 37.52%， respectively. In 12 batches of RRP， the contents of the above seven sugars were 10.62%， 11.01%， 1.25%， 3.35%， 1.12%， 28.16% and 6.39%， respectively. The results of multivariate statistical analysis showed that fresh RR， raw RR and RRP could be distinguished from each other by the contents of the 7 sugars， and the main differential components were stachyose， sucrose， raffinose and manninotriose. ConclusionIn terms of oligosaccharides， the contents and types of saccharides in different herbs and decoction pieces of RR are quite different， and the TLC identification method based on this can be used to distinguish raw RR from RRP， which can lay a foundation for improving the quality standard of RR and developing and applying oligosaccharides in different processed products of RR.

Objective To construct the medical risk comprehensive assessment system based on big data,and to evaluate its consistency and efficiency.Methods Aiming at the current situation of risk assessment of inpatients,based on the means of big data,the medical natural language processing was used to design a medi-cal risk comprehensive assessment system.The system can automatically capture various data of patients,au-tomatically generate the scores by data mining and machine learning technology and send the risk data to med-ical staff,so as to realize the automation and intellectualization.The randomized controlled analysis was used to conduct the manual scoring and machine scoring for included the score scale.The visual risk matrix diagram was automatically generated by comparing the scoring.Results The Kappa values of the scoring system in the included study of the system were as follows:the Kappa value in Caprini scale(surgery)and Padua scale(internal medicine)was 1.00,NNIS Kappa value was 1.00,Nomogram Kappa value was 0.87,Kappa value in the Morse assessment scale/Hendrich model was 0.83,Braden Kappa value was 0.80,ASA 2023 Kappa was 1.00 and NRS 2002 Kappa value was 0.90.The taking time in the machine scoring all were shorter than those in the manual scoring,and the difference was statistically significant(P＜0.05).Conclusion The risk matrix graph constructed by this system could sharply increase the evaluation efficiency and accuracy,which not only provide the accuracy diagnosis and treatment regimen,but also shorten the hospitalization duration and reduce the medical costs.

Objective: To analyze physical fitness of students aged 6-22 years old from seven ethnic groups in Yunnan Province, and to provide reference for physical fitness intervention measures. Methods: The nationality, gender, grade, body shape, vital capacity, exercise quality of students were derived from the 2019 Yunnan Student Physical Health Survey Database. Comprehensive physical fitness score was calculated according to the National Student Physical Fitness Standards(revised in 2014). t test, ANOVA, and χ 2 test were used to analyze physical fitness score and level among students with different ethnic groups, gender, and school stages. Results: The average comprehensive score of physical fitness among students from 7 ethnic groups in Yunnan Province was (70.02±9.69）, with the pass rate being 88.91%. The proportion of excellent was 0.93%, good was 17.90%, pass 70.09 %, and failed was 11.09%. Physical fitness score was highest in BMI (94.99 points), followed by 50 meter running (74.13 points), sitting forward bend (72.63 points), endurance running (70.43 points), standing long jump (67.77 points), sit ups ( 65.71 points) , 1 minute skipping rope (65.25 points), vital capacity (62.97 points), pull up (29.04 points). Physical fitness score and pass rate and evaluation level varied significantly by ethnicity and school stage( F =293.53，452.85， χ 2/ χ 2 trend =466.65， 412.57 ； 1 553.22 ，1 045.36， P <0.01). Conclusion The excellent rate of physical fitness among students in Yunnan Province is relatively low. Physical fitness promotion requires specific guidance and training based on ethnicity and school stage.

Objective: To explore the associations of Hand-Foot-Mouth disease (HFM) among children of different age groups in kindergartens, and to provide scientific evidence for HFM prevention and control. Methods: Cluster sampling was used to select 9 912 children from 40 kindergartens. The major caregivers of children were invited to participate into the study and fulfill a self-administered questionnaire that consisted of general background, hand washing and the history of HFM among children in the recent 1 year. Chi-square and binary logistic regression were applied,to analyze the influencing factors of HFM among children of different age groups. Results: In the 2 year-old-group, children who were male (OR=1.76, 95%CI=1.24-2.50), had the major caregiver with high school educational background or below (OR=1.54, 95%CI=1.06-2.24), had family income more than 100 000 yuan or more per year(OR=1.49, 95%CI=1.01-2.20), children whose major caregiver seldom wash hands immediately after coming home(OR=2.10, 95%CI=1.05-4.19)，and 3-5 times per week(OR=2.07, 95%CI=1.26-3.41) were more likely to have HFM. In the 3 year-old-group, the more time children spent in the outdoors, the less likely they got HFM(3-5 times per week: OR=0.58, 95%CI=0.43-0.81; ≥6 times per week: OR=0.45, 95%CI=0.29-0.70). Children whose major caregiver did not use soap were more likely to have HFM(OR=1.67, 95%CI=1.11-2.49). In the 4 year-old-group, children who occasionally took toys when going out were less likely to get HFM (vs always, OR=0.57, 95%CI=0.38-0.88). No significant factors were found in the 5 year-old-group. Conclusion The behaviors and activities of major caregivers and children could influence the HFM incidence.To prevent HFM, it was advised that the major caregivers should wash hands immediately after coming home, and develop the habit of using soap for handwashing together with children at the earlier age, and encourage children to take more outside-door activities according to the age characteristics. Attention should be paid to avoid contaminating takeout snacks, and to clean the takeout toys timely.

Objective To analyze clinical outcome of high-grade squamous intraepithelial lesion (HSIL) half a year after loop electrosurgical excision procedure (LEEP) and explore the high risk factor of residual cervical HSIL.Methods The retrospective study was carried out on 1 502 patients who underwent LEEP,with HSIL in the LEEP histopathology from January 2011 to December 2013 at Obstetrics and Gynecology Hospital of Fudan University to confer the difference between residual group and non-residual group after 6 months of the leep conization.Patients were followed with ThinPrep cytologic test (TCT),high risk HPV (HR-HPV) test,colposcopy guided biopsy (CBD) and endocervical curettage (ECC).The high risks of residual cervical HSIL was analyzed.Results Among 1 502 cases,48 (3.20％,48/1 502) cases suffered HSIL residual disease.Forty cases were diagnosed by CBD,4 cases were diagnosed by ECC.The other 4 cases were both positive in CBD and ECC.Residul rate were different among different age groups.The residual rate was higher in the age ≥50 years old compared to the age below 50 [9.70％ (16/165),2.39％ (32/1 337);x2=25.33,P＜0.01].For post-LEEP specimens,both circumference (2.5,2.8 cm;Z=-3.17,P＜0.01) and width [0.6,0.6 cm;Z=-2.88,P＜0.01) were less in HSIL lesion residual group than those in non-residual group,though length showed no obvious difference [1.5,1.5 cm;Z=-1.55,P＞0.05).The residual rate of leep positive margin was obviously higher than that in the negative margin group [6.77％ (18/266) vs 2.43％(30/1 236);x2=13.30,P＜0.01].Different positive margin had diverse residual rate,as positive endocervical margin was 16.07％ (9/56),positive margin undetermined was 7.29％ (7/96) and positive ectocervical margin was 3.33％ (4/120).Both positive endocervical margin and positive margin undetermined had a higher residual rate than residual rate (x2=26.99,P＜0.01;x2=4.24,P＜0.05).Abnormal cytology showed higher residual rate than the non-residual with significant difference [6.00％ (6/100) vs 1.29％ (14/1 083),x2=9.50,P＜0.01].In terms of the post-LEEP HR-HPV test follow-up,HR-HPV positive's residual rate was higher than that in the negative group [2.91％ (6/206) vs 0.96％ (7/727)],while there was no statistical significance (x2=3.10,P＞0.05).Multivariate logistic analysis showed that abnormal cytology in 6 month's follow-up post-LEEP conization was an independent risk factor on residual lesion (OR=3.75,P＜0.05).Conclusions Patient with age ≥50 years old and positive endocervical margin are high risk factors for the residual HSIL lesion after LEEP conization,especially for abnormal cytology during follow up is independent risk factor for residual lesion.Colposcopy directed biopsy and (or) ECC still play an indispendsable role in finding the HSIL residual lesion.

Objective To explore the application effect of typical case tracking two-way evaluation in the clinical practice teaching. Methods A number of 126 nursing students from July 2014 to June 2015 were included in the control group and received traditional teaching evaluation mode. Other 126 nursing students from July 2015 to June 2016 were recruited in the observation group and adopted typical case tracking two-way evaluation mode. Self-evaluation of clinical practice behavior, evaluation of comprehensive clinical practice ability of students and teachers and satisfaction in both groups were evaluated. Results In the clinical practice performances self-evaluation, scores of five dimensions including communication, profession and self-development, management, teaching guidance and clinical nursing in the observation group were significantly higher than those in the control group (P<0.05); there were no statistically significant differences in other two dimensions including scientific research and critical thinking between two groups (P>0.05). The comprehensive clinical practice ability evaluation scores and satisfaction degree of nursing students and teachers in the observation group were significantly better compared to the control group (P<0.05). Conclusions Application of typical case tracking two-way evaluation in the clinical practice teaching can help to pay attention to the link management, timely feedback information, reach the true interaction of teaching and learning, and arouse the enthusiasm of both sides.

Objective To evaluate the effect of health education on preventing birth defects in community in terms of knowledge, attitude and practice (KAP) for married women in reproductive age. Method A self-designed general information form and a questionnaire on KAP of married women′s preventing birth defects were used to investigate the KAP among 300 married nulliparous women. Result The average rate of cognitive knowledge of birth defects was 60.8%, the average rate of cognitive behaviors was 59.2%, and the average rate of cognitive attitude was 67.4%. Conclusion In order to reduce the rate of birth defects and improve the quality of births, we should implement three-level prevention education system, enrich the health education methods to enhance the knowledge, attitude and behavior of married women.

Cochlear Implantation ; Cochlear Implants ; Guidelines as Topic