BACKGROUND:There is controversy regarding the need for marrow reaming in intertrochanteric fractures of the femur.Some believe that unreaming shortens operative time,reduces bleeding,and decreases intraoperative risk in elderly patients,but there is no basis for whether this move reduces the effectiveness of intramedullary nail support.Others believe that reaming allows for the selection of thicker diameter intramedullary nails for better mechanical support,but basic studies have shown that this approach carries risks such as fat embolism and destruction of bone(especially in elderly patients with osteoporosis). OBJECTIVE:To analyze the mechanical distribution characteristics of reamed and unreamed proximal femoral nail antirotation-Ⅱ in the treatment of type 31-A3 intertrochanteric fractures by finite element analysis. METHODS:A healthy volunteer was included,and CT scans of his femur were obtained in DICOM format,and the files were sequentially imported into Mimics,Geomagic Wrap,SolidWorks,Hypermesh,and Ansys software for processing.The A3.1,A3.2,and A3.3 intertrochanteric fracture models were obtained and assembled with 9 mm,11 mm diameter,and 170 mm length intramedullary nails,respectively,followed by assigning material properties,setting the interaction relationship of each contact surface and defining the load and boundary conditions,and then solved.The femoral stress distribution,internal fixation stress distribution,femoral displacement,and internal fixation displacement were observed in different models. RESULTS AND CONCLUSION:(1)The femoral stress was less than that of unreamed intramedullary nail fixation for each type of fracture,and the maximum stress value of the femur for A3.3 fracture was greater than that of A3.1 and A3.2.(2)The internal fixation stress was greater than that of unreamed intramedullary nail fixation for each type of fracture,and the maximum stress value of internal fixation for A3.3 fracture was greater than that of A3.1.(3)Reamed versus unreamed intramedullary nailing has less effect on femoral and internal fixation displacement and more effect on stress.(4)It is indicated that the use of reamed intramedullary nail fixation results in a reduction in femoral stress,an increase in the stress borne by the internal fixation as a whole,and a reduction in the stress borne by the distal locking nail.The use of reamed intramedullary nail fixation may provide better treatment results compared to unreamed intramedullary nail fixation.

The diagnosis and treatment of sepsis-induced coagulopathy（SIC）and disseminated intravascular coagulation（DIC）are very difficult in clinical practice.It also increases the mortality of sepsis in children.This article reviewed the latest pathophysiological mechanism of endothelial molecular in the occurrence and development of SIC and DIC in sepsis，so as to provide new theoretical basis for the clinical treatment of SIC and DIC in sepsis.

Objective:To investigate the effect of long non-coding RNA (lncRNA) H19 regulating miRNA-675 (miR-675) and phosphatase and tensin homologue-deleted chromosome ten gene (PTEN) on the cell proliferation of glioma.Methods:Glioma cell lines U87-MG and U251 were chosen. The siRNA online design tool wad used to design small interfering RNA (siRNA) targeting H19. U87-MG and U251 cell lines with the stable knockdown of H19 were constructed (the stable knockdown of H19 group), and the cells randomly transfected with siRNA plasmid were taken as the control group, and normal cultured cells were treated as the blank group. Additionally, miR-675 and control microRNA were transfected into U87-MG and U251 with the stable knockdown of H19 (the overexpressing miR-675 group and the corresponding control group). Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the relative expression levels of miR-675 and H19 in each group; the methyl thiazolyl tetrazolium (MTT) assay was used to detect the cell proliferation ability; the dual luciferase reporter gene assay was used to verify the targeting relationship between miR-675 and PTEN; Western blot was used to detect the relative expression level of PTEN protein.Results:The MTT assay results showed that the proliferation ability of U87-MG and U251 cells in the stable knockdown of H19 group was lower than that of the corresponding control group; and the differences in cell proliferation ability of all the groups after 48 h of culture were statistically significant (all P < 0.05). qRT-PCR detection results showed that the relative expression level of miR-675 in U251 cells in the stable knockdown of H19 group and the corresponding control group was 0.329±0.009 and 1.043±0.087, respectively, and the difference was statistically significant ( t = 14.15, P < 0.001); the relative expression level of miR-675 in U87-MG cells in the stable knockdown of H19 group and the corresponding control group was 0.299±0.009 and 1.027±0.106, respectively, and the difference was statistically significant ( t = 11.85, P < 0.001); the relative expression level of miR-675 in U87-MG and U251 cells in the stable knockdown of H19 group was lower than that of the corresponding control group. The dual luciferase reporter gene assay verified that miR-675 could bind to the 3'-UTR of PTEN. Western blot detection results showed that the relative expression level of PTEN protein in U87-MG and U251 cells in the stable knockdown of H19 group was higher than that of the corresponding control group and the blank group; in the U87-MG and U251 cells in the stable knockdown of H19 group, the relative expression level of PTEN in the overexpressing miR-675 group was lower than that of the corresponding blank group and the control group. In the U87-MG and U251 cells in the stable knockdown of H19 group, the cell proliferation ability of the overexpressing miR-675 group was higher than that of the corresponding blank group and the control group; the differences in cell proliferation ability of all the groups after 48 h of culture were statistically significant (all P < 0.05). Conclusions:lncRNA H19 may regulate the cell proliferation of glioma cells through the miR-675-PTEN signaling pathway.

Objective : To explore the nucleotide variation and protein amino acid changes of E4 and L2 genes of Human Papillomavirus 16 (HPV16) , and to analyze the evolutionary characteristics of HPV16 virus. Methods : 40 HPV16 infection⁃positive cervical exfoliated cells samples and tissue cell samples were collected from hospital , viral DNA was extracted , Sanger sequencing perform in cervical exfoliated cells DNA and high⁃throughput sequencing technology sequenced in cervical tissues DNA for E4 and L2 genes of HPV16 , HPV16 E4 and L2 gene phylogenetic evolution trees were constructed , and variation of HPV16 E4 and L2 genes were analyzed. Results : There were 72 HPV16 E4 variant samples with nucleotide variants (4 missense mutations and 7 synonymous mutations) at 10 sites , HPV16 L2 gene variants in 74 samples , and nucleotide variants (23 missense mutations and 18 synonymous mutations) at 40 sites. The variation frequency of T4177C , A4288C and A4654C in cervical cancer was significantly higher than that in non⁃cervical cancer, and the difference was statistically significant (P < 0. 05) . Conclusion ① The main HPV16 virus strains in Xinjiang are European strains , and a few are Asian strains. ② The mutation frequency of T4177C , A4288C and A4654C in HPV16 L2 gene is higher than that in non⁃cervical cancer, and G4181A is related to the Asian strain.

Lipid Droplets/metabolism* ; Bacteria ; Lipid Metabolism

Objective: To explore the possible mechanism of moxibustion in myocardial protection of rats undergoing long-term fatigue exercise based on observing the classical pyroptosis pathway mediated by nuclear factor kappa-B (NF-κB)/nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3)/cysteinyl aspartate specific proteinase 1 (Caspase-1).Methods: A total of 50 specific-pathogen-free male Sprague-Dawley rats were bought. Ten unqualified rats were excluded, and the remaining 40 rats were divided into a normal group, a normal + Shenque (CV8) group, a model group, a model + non-meridian non-point group, and a model + Shenque (CV8) group according to the random number table method, with 8 rats in each group. Except for rats in the normal group and the normal + Shenque (CV8) group, rats in the other three groups were trained with an incline running table exercise protocol to create a long-term fatigue exercise model, 1 h/time, once a day for 5 d with 2 d off, for a total of 8 weeks. Rats in the normal group received no modeling or intervention. Rats in the normal + Shenque (CV8) group were not modeled but received mild moxibustion at Shenque (CV8); those in the model group were modeled only without intervention; those in the model + non-meridian non-point group received moxibustion at non-meridian and non-point spots after the modeling; those in the model + Shenque (CV8) group received moxibustion at Shenque (CV8) after modeling. The above moxibustion interventions were performed for 15 min/time once daily, for 5 d with 2 d off per week and a total of 8 weeks. Blood was collected from the femoral artery 4 h after the last exercise, and the serum interleukin (IL)-1β and IL-18 levels were measured. The NF-κB, NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), Caspase-1, and gasdermin D (GSDMD) expression levels were detected by Western blotting. Myocardial morphology and pyroptosis were observed by hematoxylin-eosin (HE) staining and electron microscopy. Results: The HE staining results showed that the myocardial cells in the model group and the model + non-meridian non-point group were disorganized with blurred transverse lines, widened interstitial spaces, interstitial edema, and inflammatory cell infiltration. The structure of myocardial cells in the model + Shenque (CV8) group was clearly visible, with slightly widened interstitial spaces and occasional infiltration of inflammatory cells in the interstitium. Compared with the normal group, the serum IL-1β and IL-18 levels were increased, and myocardial NF-κB, NLRP3, ASC, Caspase-1, and GSDMD expression levels were elevated in the model group and the model + non-meridian non-point group (P<0.01). Compared with the model group, the above indicators did not change significantly in the model + non-meridian non-point group, while all the above indicators were decreased in the model + Shenque (CV8) group (P<0.01). Compared with the model + non-meridian non-point group, all the above biochemical indicators were decreased in the model + Shenque (CV8) group (P<0.01). Transmission electron microscopy showed that the mitochondria number was increased in the model group and the model + non-meridian non-point group, some of the mitochondrial lumen was irregularly enlarged, the cell membrane structure was unclear, and chromatin was aggregated. The mitochondria number was increased, the swelling was reduced, and the nuclear membrane structure was more intact in the model + Shenque (CV8) group. Conclusion: Moxibustion at Shenque (CV8) regulates the NF-κB/NLRP3/Caspase-1 pathway and reduces the pyroptosisin the myocardium of rats with long-term fatigue exercise, thus reducing the myocardial injury caused by long-term fatigue exercise.

Objective:To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test.Methods:This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ2 test. A kappa test was used to compare the consistency between groups. Results:After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea ( Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences ( P < 0.001). Conclusion:The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.

Objective: To understand health literacy and its associated factors among middle school students in Shenzhen, to provide scientific basis for further formulating targeted intervention measures. Methods: From October to December, 2019, 7 423 middle school students in 10 districts of Shenzhen were selected by multistage stratified random cluster sampling. Multivariate linear regression was used to analyze factors affecting health literacy and scores in each dimensions. Results: The total score for health literacy was(107.39±22.31), including physical activity(16.81±5.28), interpersonal relationship(20.69±4.10), stress management(21.64±5.53), spiritual growth(14.93±3.96), health awareness (15.61±4.96) and nutrition(17.71±4.65). According to the multivariate linear regression analysis, girls, general and vocational high schools, educational level of parents and boarding in school were significantly associated with health literacy of middle school students( B=-3.04, -7.72, -9.99, 1.56, 2.78, -3.85, P < 0.05 ). Conclusion Middle school students in Shenzhen have a high level of health literacy, which is related to school type and parental educational background. It is suggested that measures should be taken to improve the health literacy of middle school students.

Objective　To investigate the changes and clinical significance of serum caspase-cleaved cytokeratin-18 (CCCK-18) and complement 1q tumor necrosis factor-related protein 3 (CTRP3) levels in patients with acute ischemic stroke (AIS).Methods　A total of 163 AIS patients were selected as the AIS group.According to the National Institutes of Health Stroke Scale (NIHSS),the patients were divided into the mild defect group (49 cases),moderate defect group (76 cases),severe defect group (38 cases),after 3 months of treatment,patients were divided into poor prognosis group (66 cases) and good prognosis group (97 cases) according to the modified Rankin scale (mRS),in addition,72 healthy individuals who had physical examination during the same period were selected as the control group.Enzyme-linked immunosorbent assay was used to determine serum CCCK-18 and CTRP3 levels.Results　The serum CCCK-18 level in the AIS group was significantly higher than that in the control group,and the CTRP3 level was significantly lower than that in the control group (P＜0.05).The serum CCCK-18 level in the mild,moderate,and severe defect groups gradually increased,and the CTRP3 level gradually decreased (P＜0.05).The serum CCCK-18 level was positively correlated with NIHSS score,and CTRP3 level was negatively correlated with NIHSS score (P＜0.05).Multivariate logistic regression analysis showed that large area infarction,high NIHSS score,high CCCK-18 level were an independent risk factor for poor prognosis in AIS patients,and high CTRP3 level was an independent protective factor (P＜0.05).The ROC curve showed that the AUC of CCCK-18 combined CTRP3 predicting poor prognosis of AIS patients was significantly greater than that of CCCK-18,CTRP3 alone predicted(P＜0.05),the sensitivity and specificity were 86.36% and 81.44%.Conclusion　The serum CCCK-18 level in AIS patients is up-regulated,and the CTRP3 level is down-regulated,which is related to the severity of the disease and poor prognosis.Combined detection of the two can improve the predictive value of poor prognosis.

Objective:To explore the expression and clinical significance of S100A8 and S100A9 in Helicobacter pylori ( H. pylori) associated gastritis. Methods:A total of 101 patients with chronic gastritis diagnosed in the First Hospital of Shanxi Medical University from October 2018 to May 2019 were selected. The expression levels of S100A8 and S100A9 in the gastric mucosa tissues of 101 patients with chronic gastritis were determined by immunohistochemistry (in absorbance), and the mRNA expression levels of S100 A8 and S100 A9 in the gastric mucosa tissues of 48 patients were detected by reverse transcription-polymerase chain reaction. And the results combined with pathological diagnosis of routine staining and clinical H. pylori infection data were analyzed. Mann-Whitney U test, Kruskal-Wallis H test and Spearman rank correlation were used for statistical analysis. Results:Among 101 patients, there were 59 cases of chronic atrophic gastritis (CAG group) and 42 cases of chronic non-atrophic gastritis (NAG group); 59 cases were H. pylori positive ( H. pylori positive group) and 42 cases were H. pylori negative ( H. pylori negative group). There were statistically significant differences in the expression levels of S100A8 and S100A9 between CAG group and NAG group (0.10, 0.07 to 0.13 vs. 0.09, 0.06 to 0.10 and 0.13, 0.08 to 0.15 vs. 0.09, 0.07 to 0.10, respectively), and between H. pylori positive group and H. pylori negative group (0.11, 0.10 to 0.13 vs. 0.07, 0.06 to 0.08 and 0.13, 0.10 to 0.15 vs. 0.07, 0.07 to 0.08, respectively) ( U=754.00, 602.00, 5.00 and 40.00, all P<0.01). There were statistically significant differences in the expression levels of S100A8 and S100A9 between H. pylori positive patients (34 cases) and H. pylori negative patients (25 cases) in CAG group (0.13, 0.11 to 0.14 vs. 0.07, 0.07 to 0.08 and 0.15, 0.14 to 0.16 vs. 0.08, 0.08 to 0.09, respectively), similarly, there were significant differences in the expression levels of S100A8 and S100A9 between H. pylori positive patients (25 cases) and H. pylori negative patients (17 cases) in NAG group (0.10, 0.09 to 0.10 vs. 0.06, 0.05 to 0.07 and 0.10, 0.10 to 0.11 vs. 0.07, 0.06 to 0.07, respectively) ( U=1.00, 0.00, 0.00 and 0.00, all P<0.01). The results indicated that the expression levels of S100A8 and S100A9 were high in H. pylori positive patients in CAG group, the expression levels of S100A8 and S100A9 were low in H. pylori negative patients in NAG group, and the differences were statistically significant ( H=84.78 and 89.64, both P<0.01). There were statistically significant differences in the expression of S100 A8 and S100 A9 at mRNA level between CAG group (24 cases) and NAG group (24 cases) (0.12, 0.06 to 1.31 vs. 0.05, 0.03 to 0.08; 0.19, 0.03 to 0.43 vs. 0.03, 0.01 to 0.09), and the expression of S100 A8 and S100 A9 at mRNA level was significant between H. pylori positive patients (24 cases) and H. pylori negative patients (24 patients) (0.45, 0.10 to 1.90 vs. 0.05, 0.03 to 0.08 and 0.36, 0.24 to 0.81 vs. 0.03, 0.01 to 0.04) ( U=55.00, 74.00, 19.00 and 2.00, all P<0.05). There were statistically significant differences in the expression of S100 A8 and S100 A9 at mRNA level between H. pylori positive patients (12 cases) and H. pylori negative patients (12 cases) of CAG group (0.85, 0.27 to 2.28 vs. 0.06, 0.03 to 0.09 and 0.39, 0.25 to 0.87 vs. 0.03, 0.02 to 0.05), and the expression of S100 A8 and S100 A9 at mRNA level was significant between H. pylori positive patients (12 cases) and H. pylori negative patients (12 cases) of NAG group (0.09, 0.05 to 0.28 vs. 0.04, 0.03 to 0.07 and 0.20, 0.09 to 0.65 vs. 0.01, 0.01 to 0.03) ( U=5.00, 2.00, 0.00 and 0.00, all P<0.01). The results showed that the expression of S100 A8 and S100 A9 at mRNA level was high in H. pylori positive patients in CAG group, the expression of S100 A8 and S100 A9 at mRNA level was low in H. pylori negative patients in NAG group, and the differences were statistically significant ( H=20.43 and 24.15, both P<0.01). The expression levels of S100A8 and S100A9 were positively correlated at both protein level and mRNA level ( r=0.899 and 0.903, both P<0.01). Conclusions:S100A8 and S100A9 may involve in the inflammation process of H. pylori-infected gastric mucosa and promote the proliferation of gastric epithelial cells, which may be one of mechanisms of intrinsic glands reduction and CAG genesis. S100A8 and S100A9 are expected to be potential biomarkers for diagnosis and follow-up and potential targets for treatmert of CAG.