Objective: To investigate the status and influencing factors of influenza vaccination among the elderly, so as to provide insights into improving the strategies for influenza vaccination among the elderly. Methods: Elderly people aged 60 years and above were recruited from one community each in five sub-districts of Shihezi City, Xinjiang Uygur Autonomous Region using a random sampling method. Demographic information, knowledge about influenza and influenza vaccines, vaccine literacy and influenza vaccination status in the past year were collected through questionnaire surveys. Factors affecting influenza vaccination among the elderly were analyzed using a multivariable logistic regression model. Results: Totally 1 121 valid questionnaires were recovered, with an effective recovery rate of 95.08%. There were 417 males (37.20%) and 704 females (62.80%). The majority were aged 60-<81 years, accounting for 80.37% (901 individuals). The awareness of knowledge about influenza and influenza vaccines was 78.86%. Low vaccine literacy was observed in 786 individuals, representing 70.12%. The influenza vaccination rate was 20.96%. Multivariable logistic regression analysis showed that age (71-<81 years, OR=1.607, 95%CI: 1.041-2.479; ≥81 years, OR=1.719, 95%CI: 1.040-2.842), educational level (middle school/technical secondary school, OR=0.616, 95%CI: 0.416-0.911), medical expense payment (employee medical insurance, OR=6.531, 95%CI: 2.030-21.010; resident medical insurance, OR=3.385, 95%CI: 1.095-10.466; public expense, OR=4.828, 95%CI: 1.700-13.712), vaccination willingness (yes, OR=6.237, 95%CI: 3.277-11.871), influenza vaccination history (yes, OR=14.600, 95%CI: 8.733-24.408) and vaccine literacy (medium and above, OR=2.412, 95%CI: 1.636-3.555) were associated with influenza vaccination among the elderly. Conclusion The influenza vaccination rate among the elderly was relatively low, and was mainly affected by age, educational level, medical expense payment, vaccination willingness, influenza vaccination history and vaccine literacy.

Objective We systematically analyze the changes in the count and function of platelet at the early sepsis based on clinical study and single cell sequencing.Methods Clinical data of sepsis patients at the early stage were collected and had been compared between different prognostic groups in the prospective case-control study.The independent risk factors of death were analyzed by logistic regression,and the predictive efficacy of clini-cal indicators was evaluated by receiver operating characteristic(ROC)curve.The healthy volunteers and sepsis patients were recruited.Clinical researchers collected peripheral venous blood samples for sorting cell samples to carry out single-cell RNA sequencing(sc-RNA seq).Through bioinformatics techniques,we analyzed the changes in platelet count,the significantly differential-expressed genes and its enriched functional signaling pathways in the early stages of sepsis.Results(1)A total of 224 patients were enrolled,with a 90 day survival rate of 70.5%.Compared with the survival group,the count of platelet and MAP in the death group at the early stage of sepsis were significantly lower,but the plasma lactate content and SOFA score were significantly higher.(2)Based on single cell sequencing technology,cells are annotated as six groups.The proportion of innate immune cells(neutrophils,monocytes,and dendritic cells)was significantly increased in the early stage of sepsis compared to the healthy volun-teers(2.15∶1),while platelets significantly decreased(0.31∶1).(3)Through bioinformatics technology,CD41/CD42a/CD61 was identified as platelet specific molecules,with significantly increased expression levels in sepsis.Three molecules can distinguish platelets together.(4)771 genes were significantly upregulated and 1101 genes were significantly downregulated in platelets of patients with sepsis,including core molecules involved in physiological functions such as cell adhesion,chemotaxis,and immune response.Functional analysis suggests that differentially expressed genes are enriched in coagulation,immune functions and cell death,participating in oxidative phosphory-lation,leukocyte chemotaxis,iron death,and NOD like receptor signaling pathways.Conclusion Reduced platelet count is associated with poor prognosis in the early stage of sepsis.The specific high expression molecules CD41/CD42a/CD61 that are significantly upregulated in platelets can serve as biomarkers for platelets.Platelets not only mediate cell adhesion and coagulation cascade,but also participate in functional changes such as immune cell chemotaxis,inflammatory response,and the pathological death of inflammatory cells.

Objective:To compare the predictive efficacy of different versions of Briganti nomogram in predicting lymph node metastasis in Chinese patients with prostate cancer.Methods:From October 2012 to April 2021, 583 cases with prostate cancer who underwent radical prostatectomy and pelvic lymphadenectomy by a single surgeon were retrospectively collected. For all 583 patients, the median age was 67 (63, 72)years old, median BMI was 24.39(22.58, 26.35)kg/m 2, median PSA was 22(12, 43)ng/ml. There were 65 cases, 357 cases, 140 cases and 21 cases with clinical stage T 1, T 2, T 3 and T 4. There were 30 cases, 109 cases, 104 cases, 160 cases and 180 cases for ISUP 1 group, 2 group, 3 group, 4 group and 5 group. The median percentage of positive biopsy cores was 50%(33%-83%). The validated nomograms were Briganti's 2006, 2012 and 2017. Compared with the 2006 edition, the new variables in the 2012 edition and 2017 edition were the percentage of positive biopsy cores, the percentage of the highest grade positive biopsy cores and the percentage of the lower grade positive biopsy cores, respectively. The validation patients for the 2006, 2012 and 2017 versions of nomogram were 560, 513 and 357, respectively, which were used as the differential validation cohorts. A total of 357 patients were validated for all three versions of nomogram, which was considered as the general validation cohort. The area under the receiver operating characteristic (ROC) curve (AUC), calibration curve and clinical decision curve analysis were used to evaluate the predictive efficacy of the three versions of nomograms. Results:In the differential validation cohort, the AUC values of the 2006, 2012 and 2017 versions of the nomogram were 0.738(95% CI 0.690-0.785), 0.765(95% CI 0.717-0.814) and 0.779(95% CI 0.724-0.834), respectively. There was no significant difference in AUC values among versions ( P>0.05). In the general validation cohort, the AUC values of the three versions of the nomogram were as follows 0.744(95% CI 0.682-0.805), 0.759(95% CI 0.700-0.818) and 0.779(95% CI 0.724-0.834), respectively. There was no significant difference in AUC values among the three versions ( P>0.05). The calibration curve showed that the prediction probability of 2012 and 2017 editions was in good agreement with the actual risk within the prediction probability of 0-40%. Analysis of the clinical decision curve showed that the clinical benefit of the 2012 version was greater than that of the other two versions in the prediction threshold of 0-33%. Conclusion:Briganti nomogram is suitable for predicting pelvic lymph node metastasis in Chinese patients with prostate cancer. The 2012 and 2017 versions of the nomogram have good predictive performance, and the versions can be selected according to the predictive variables that can be provided.

Objective:To investigate the relationship between neutrophil chemotactic function and chemokine receptor in the early stage of deep second- and third-degree burns.Methods:Twenty patients with severe burns (burn group) who received treatment within 6 hours after burns in Yantai Yeda Hospital from January 2019 to June 2020 were included in this study. Twenty healthy controls (healthy group) who concurrently received physical examination in the same hospital were also included. The general data and laboratory examination indexes in each group were analyzed. The correlation between neutrophil chemotactic function and chemokine receptor was evaluated.Results:There were no significant differences in general data between the two groups (all P > 0.05). At 1, 3 and 5 days after admission, the number of neutrophils, the number of white blood cells, and procalcitonin, C-reactive protein, interleukin-6, interleukin-10, and tumor necrosis factor-α levels in the burn group were significantly higher than those in the healthy control groups ( F = 12.56, 13.45, 15.78, 17.83, 22.56, 13.39, 10.82, all P < 0.05). At 1, 3 and 5 days after admission, neutrophil migration distance in the burn group was (1 510.22 ± 108.45) μm, (1 380.90 ± 115.67) μm, (1 026.10 ± 95.48) μm, respectively, which were significantly shorter than (1 944.67 ± 139.20) μM in the healthy control group ( t = 23.44, 25.67, 27.52, all P < 0.05). At 5 days after admission, chemokine receptors 1 and 2 positive rates in the burn group were (47.40 ± 1.76)% and (75.33 ± 2.42)%, respectively, which were significantly lower than (95.24 ± 4.89)% and (97.78 ± 2.10)% in the healthy control groups ( t = 4.92, 5.67, both P < 0.05). Correlation analysis showed that neutrophil migration distance was positively correlated with chemokine receptor expression in patients with deep second- and third-degree burns ( r = 0.72, 0.61, both P < 0.05). Conclusion:Neutrophil chemotactic function and chemokine receptor expression decrease in the early stage of deep second- and third-degree burns.

Objective:By analyzing the clinical and pathologic manifestations of systemic mastocytosis (SM) to improve the recognition of the disease.Methods:Clinical manifestations, diagnosis and treatment of a middle-aged male patient with SM was reported with multidisciplinary discussions.Results:A middle-aged man with bone pain, thyroid nodules and lymphadenectasis came to our clinic. Thyroid cancer with lymph node and bone metastasis was suspected by imaging examination. The pathological results showed cell proliferation with transparent cytoplasm and irregular nuclear in the trabecular bone. Toluidine blue staining showed the proliferated cells were mast cells(+). Immunohistochemistry showed proliferating mast cells stained with CD117 and CD2. SM with extensive bone marrow involvement was diagnosed and treated with thalidomide and calcitriol.Conclusion:Knowing the characteristics of SM is helpful for accurate diagnosis and treatment.

Background: Although bone tissue engineering has already been applied clinically, its regeneration efficacy is not always sufficient. Local inflammatory cytokines are considered as the major factors that induce apoptosis of transplanted cells, thus leading to insufficient new bone formation. In this study, we focused on the effects of interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α) on differentiation and apoptosis of compact bone-derived cells (CBDCs). Methods: CBDCs were obtained from mouse legs and cultured. The effects of TNF-α and/or IL-6 on the osteogenic differentiation and apoptosis of CBDCs were analyzed in vitro. To confirm the expression of local inflammatory cytokines in vivo, CBDCs were transplanted to the back of immunocompetent mice. Results: IL-6 exerted inconsistent effects on the expression of the different osteogenic markers tested, while significantly upregulating Fas. By contrast, the addition of TNF-α dramatically reduced the expression of all tested osteogenic markers and increased Fas expression. The highest dose of IL-6 could partially reverse the repressive effect of TNF-α, while the addition of IL-6 further increased Fas expression in CBDCs compared to TNF-α alone. The results from in vivo experiments showed the presence of transplants with and without new bone formation. The transplants without bone formation were characterized by higher IL-6 and lower IL-10 expression than those with bone formation, while the expression of TNF-α did not show notable difference. Conclusion The results of this study suggest an important role for IL-6 in modulating the efficacy of bone tissue engineering, which can affect osteogenic cells both positively and negatively.

Background: Although bone tissue engineering has already been applied clinically, its regeneration efficacy is not always sufficient. Local inflammatory cytokines are considered as the major factors that induce apoptosis of transplanted cells, thus leading to insufficient new bone formation. In this study, we focused on the effects of interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α) on differentiation and apoptosis of compact bone-derived cells (CBDCs). Methods: CBDCs were obtained from mouse legs and cultured. The effects of TNF-α and/or IL-6 on the osteogenic differentiation and apoptosis of CBDCs were analyzed in vitro. To confirm the expression of local inflammatory cytokines in vivo, CBDCs were transplanted to the back of immunocompetent mice. Results: IL-6 exerted inconsistent effects on the expression of the different osteogenic markers tested, while significantly upregulating Fas. By contrast, the addition of TNF-α dramatically reduced the expression of all tested osteogenic markers and increased Fas expression. The highest dose of IL-6 could partially reverse the repressive effect of TNF-α, while the addition of IL-6 further increased Fas expression in CBDCs compared to TNF-α alone. The results from in vivo experiments showed the presence of transplants with and without new bone formation. The transplants without bone formation were characterized by higher IL-6 and lower IL-10 expression than those with bone formation, while the expression of TNF-α did not show notable difference. Conclusion The results of this study suggest an important role for IL-6 in modulating the efficacy of bone tissue engineering, which can affect osteogenic cells both positively and negatively.

Objective:To analyze the genetic landscape of multiple fusion genes in patients with de novo acute myeloid leukemia (AML) and investigate the characteristics of immunophenotypes and mutations.Methods:The results of multiple fusion genes from 4192 patients with de novo AML were retrospectively analyzed from 2016 to 2020. In addition, the immunophenotypical data and the mutational results from high-through put method were statistically investigated and correlated as well.Results:①Among the 52 targets, 29 different types of fusion genes were detected in 1948 patients (46.47%) with AML, which demonstrated an "exponential distribution" . ② As the age increased, the number of patients with fusion gene increased first and then decreased gradually. The total incidence rate of fusion genes and MLL rearrangment in children were significantly higher than those in adults (69.18% vs 44.76%, 15.35% vs 8.36%) . ③The mutations involving FLT3 and RAS signaling pathway contributed most in patients with MLL rearrangment. ④No specific immunophenotypic characteristics were found in AML patients with MLL or NUP98 rearrangements. Conclusion:Nearly half of AML patients were accompanied by specific fusion gene expression, the proportions of different fusion genes in pediatric and adults patients were different by multiple PCR. The gene mutations and immunophenotype of these AML patients have certain rules.

Objective:To evaluate the promoting surgery incision healing effect of recombinant human acidic fibroblast growth fac-tor ( rh-aFGF) in the treatment of children with open fractures. Methods:A multicenter, randomized and controlled clinical trial was conducted to study the efficacy of rh-aFGF. Totally 120 cases of injured children (age<14y) were randomly divided into two groups, the treatment group (n=60) was given rh-aFGF washing during the operation and spraying after the operation, and the control group ( n=60) was treated with normal saline. Both groups were given traction, screw or Kirschner wire fixation. The healing time, healing status and delayed healing were observed and compared in the two groups. Results:Stage I healing rate, the complete healing time and delayed healing rate in the treatment group was 86. 6%, (20. 3 ± 5. 6)d and 3. 3%, respectively, while that in the control group was 56.7%, (23.4 ±6.2)d and 15.0%, respectively. The differences between the two groups were significant (P<0.05 or 0.01). Conclusion:Rh-aFGF can effectively promote wound healing and shorten the healing time. For all these positive aspects,rh-aFGF de-serves wider clinical application in postoperative rehabilitation after open fractures.

Objective To investigate the effect of antisense oligonucleofide(PCNA ASON)and vascuiar endothelial growth factor (VEGF) gene traneduction on restenosis after balloon angiopasty.Memods chinese rabbits were randomly divided into control group(I),PCNA ASON(II),VEGF only (Ⅲ),PCNA ASON+VEGF(Ⅳ)groups.Each group included 7 rabbits.Restenosis wasevaluated by pathology immunohistochemistry and Western-blotting for the expression of PCNA,and the depth and area oftunica media and tunicca intima were measured. Results All rabbits experienced restenosis on different severities,especially in control group.Lesions were less severe in PCNA ASON and VEGF groups than in controls.The proliferation of smooth muscle and intima significantly ameliorated in PCNA ASON and VEGF combination group that in PCNA ASON or VEGF groups(P<0.01).But the difference between the PCNA ASON and VEGF group was not significant(P>0.7). Conclusion PCNA ASON and VEGF gene transductionn are effective in preventing restenosis after balloon angioplasty caused vessel injury in rabbits.