Objective:To investigate the early recognition of coronary artery lesions(CAL)in Kawasaki disease(KD)and its relationship with monocyte/high-density lipoprotein cholesterol(HDL-C)ratio(MHR).Methods:A total of 216 children with KD who were hospitalized in Affiliated Hospital of Nantong University from June 2019 to June 2022 were selected as the research subjects,and divided into training set(162 cases)and test set(54 cases).The clinical data of the children were collected,and the children in the training set were divided into the CAL group(45 cases)and the NCAL group(117 cases)according to the diagnostic results of echo-cardiography,and the differences in clinical data and laboratory test results were compared between the two groups;Logistic regres-sion analysis was used to analyze the risk factors of CAL in children with KD;Pearson was used to analyze the correlation between MHR and CAL in children with KD.According to the MHR quantile,the children in the CAL group were divided into low MHR group(≤0.28),medium MHR group(0.29～0.42)and high MHR group(≥0.43),and they were analyzed and compared.Cox regression model was used to analyze the relationship between MHR and CAL risk in children with KD,and a predictive model was constructed based on the independent risk factors of CAL in children with KD.Results:There were 162 KD children with fever,and summer was a high incidence period;compared with the NCAL group,the CAL group had statistically significant differences in age,gender,fever time,KD type,MHR,WBC,PLT,NLR,and CRP(all P<0.05);Pearson correlation analysis showed that MHR was positively cor-related with the degree of coronary artery dilatation in children with CAL(r=0.743,P=0.001).and the risk of CAL in the KD children in the high MHR group was significantly higher than that in the low MHR group(HR=2.857,95%CI:1.329～6.431,P=0.003);Logis-tic regression analysis showed that gender,fever time,MHR,WBC,NLR and CRP were independent risk factors for CAL in children with KD.A prediction model was constructed based on the independent risk factors of CAL:Logit(P)=1.342+0.359×gender+0.181×ever time+1.064×MHR+0.459×WBC+0.146×NLR+0.211×CRP,P=e logit(P)/1+e logit(P),the AUC of this model was 0.874(95%CI:0.799～0.892),compared with the test set(AUC was 0.881,95%CI:0.785～0.913),the difference was not statistically sig-nificant(P>0.05);the AUC of MHR for predicting CAL in children with KD was 0.796,the sensitivity was 0.896,and the specificity was 0.824,which could be used as an early predictor of CAL in children with KD.Conclusion:MHR has a certain predictive value in the diagnosis of CAL in children with KD,and can reflect the degree of CAL in children with KD to a certain extent.Therefore,it is necessary to pay attention to the changes of MHR in children with KD in clinical practice.

Objective:To investigate the epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with maintenance hemodialysis (MHD) in Jiangsu province during SARS-CoV-2 pandemic in China from December 7, 2022 to January 27, 2023, and to analyze the influencing factors of all-cause death.Methods:It was a multi-center cross-sectional investigation. Structured questionnaire was used to collect patient information by medical staff of each hemodialysis center (room) as investigators. Part of the demography data and laboratory examination data came from the Jiangsu Province Hemodialysis Data Information System. MHD patients from hemodialysis centers (rooms) at all levels of medical institutions and independent hemodialysis institutions in Jiangsu province during the outbreak of SARS-CoV-2 infection were included, and the clinical characteristics and all-cause mortality of confirmed and suspected cases of SARS-CoV-2 infection were analyzed.Results:Questionnaire surveys and data analysis on 57 278 patients in 407 hemodialysis centers (rooms) were completed, accounting for 90.41% of the total number of MHD patients (63 357 cases) in Jiangsu province during the same period. There were 24 038 cases (41.97%) of SARS-CoV-2 infection and 14 805 cases (25.85%) of suspected infection, which were widely distributed in all dialysis centers in Jiangsu province. After clinical classification of 38 843 confirmed and suspected SARS-CoV-2 infection cases, 3 662 cases were severe and critical cases, accounting for 9.43% of the infected and suspected cases. Among the patients who had completed the questionnaires, there were 1 812 all-cause deaths, with an all-cause mortality rate of 3.16%. Multivariate logistic regression analysis showed that elderly (taking ≤50 years as a reference, 51-59 years: OR=1.583, 95% CI 1.279-1.933, P=0.001; 60-69 years: OR=3.972, 95% CI 3.271-4.858, P<0.001; 70-79 years: OR=7.236, 95% CI 5.917-8.698, P<0.001; ≥80 years: OR=11.738, 95% CI 9.459-14.663, P<0.001), male ( OR=1.371, 95% CI 1.229-1.529, P<0.001), and co-infection with hepatitis B virus (HBV) (positive serum HBV surface antigen, OR=0.629, 95% CI 0.484-0.817, P<0.001) were independent influencing factors for all cause mortality. Receiver-operating characteristic curve analysis showed that the area under the curve for male, age and current HBV infection prediction of all-cause death was 0.529 ( P<0.001), 0.724 ( P<0.001) and 0.514 ( P=0.042), respectively, and the cut-off value for age prediction of all-cause death was 65.5 years old. Compared with patients without HBV infection, MHD patients with HBV infection significantly reduced the proportion of severe and critically ill patients, all-cause hospitalizations and all cause deaths when infected with SARS-CoV-2 (4.99% vs. 6.41%, χ2=6.136, P=0.013; 8.90% vs. 11.44%, χ2=11.662, P<0.001; 2.01% vs. 3.37%, χ2=10.713, P=0.001, respectively). Conclusion:The MHD patients in Jiangsu province are susceptible to SARS-CoV-2. Elderly age and male gender are independent risk factors for death in MHD patients during the epidemic, while the HBV infection may be a protective factor for death of MHD patients infected with SARS-CoV-2.

The potential medicinal value of Ma bamboo (Dendrocalamus latiflorus), one of the most popular and economically important bamboo species in China, has been underestimated. In the present study, we found that D. latiflorus leaf extract (DLE) reduced fasting blood glucose levels, body weight, and low-density lipoprotein cholesterol with low liver toxicity in db/db mice. In addition, gene expression profiling was performed and pathway enrichment analysis showed that DLE affected metabolic pathways. Importantly, DLE activated the AKT signaling pathway and reduced glucose production by downregulating glucose-6-phosphatase (G6PC) and phosphoenolpyruvate carboxykinase 1 (PCK1) expression. Moreover, network pharmacology analysis identified rutin as an active component in DLE through targeting insulin growth factor 1 receptor (IGF1R), an upstream signaling transducer of AKT. Due to its hypoglycemic effects and low toxicity, DLE may be considered an adjuvant treatment option for type 2 diabetes patients.

Objective:To explore the value of plasma soluble leukocyte differentiation antigen 14 subtype(Presepsin) combined with neutrophil gelatinase associated lipocalin(NGAL) in the early diagnosis and prognosis of sepsis in children.Methods:A total of 94 children with sepsis admitted to our hospital from June 2017 to October 2020 were selected, 41 children with shock were classified as septic shock group, and 53 children without shock were classified as sepsis group.Another 41 healthy children in our hospital during the same period were selected as the control group.The plasma levels of Presepsin, NGAL, procalcitonin(PCT) and C-reactive protein(CRP)were detected in three groups.The pediatric critical illness score and sequential organ failure(SOFA)score of children with sepsis were recorded.According to the mortality of the children within 28 days of admission, they were divided into survival group( n=75)and death group( n=19). The plasma levels of Presepsin, NGAL, PCT and CRP, pediatric critical illness score and SOFA score were compared between the survival group and the death group.Pearson test and receiver operating characteristic curve were used to analyze the correlation between plasma Presepsin, NGAL and pediatric critical illness score, SOFA score, and the predictive value of early diagnosis and prognosis of sepsis in children. Results:The levels of plasma Presepsin, NGAL, PCT and CRP in sepsis group and septic shock group were higher than those in control group, and those in septic shock group were higher than those in sepsis group( P<0.05). The plasma levels of Presepsin, NGAL, PCT, CRP and SOFA scores in death group were higher than those in survival group, and the pediatric critical illness score in death group was lower than that in survival group( P<0.05). Plasma Presepsin and NGAL were negatively correlated with pediatric critical illness score( r=-0.676, P<0.001; r=-0.664, P<0.001), and positively correlated with SOFA score( r=0.781, P<0.001; r=0.749, P<0.001). When the plasma Presepsin level was 468.91 ng/L, the sensitivity of area under curve(AUC) for sepsis diagnosis was 85.6% and the specificity was 77.5%.When the plasma NGAL level was 38.94 ng/mL, the sensitivity of AUC for sepsis diagnosis was 82.4%, and the specificity was 65.8%.The AUC of plasma Presepsin combined with NGAL for early diagnosis of sepsis was 0.912(95% CI 0.865 to 0.959), which was higher than of plasma Presepsin of 0.857(95% CI 0.785 to 0.928) and the AUC of NGAL of 0.761(95% CI 0.680 to 0.841). When the plasma Presepsin level was 816.92 ng/L, the sensitivity for predicting the prognosis of sepsis was 73.2% and the specificity was 76.1%.When the plasma NGAL level was 51.27 ng/mL, the sensitivity for predicting the prognosis of sepsis was 67.4% and the specificity was 68.0%.The AUC of plasma Presepsin combined with NGAL to predict the prognosis of sepsis was 0.891(95% CI 0.816 to 0.966), which was higher than the AUC of plasma Presepsin of 0.795(95% CI 0.698 to 0.892) and NGAL of AUC 0.714(95% CI 0.577 to 0.851). Conclusion:Clinical detection of plasma Presepsin and NGAL levels is helpful to early diagnosis of sepsis and judge the severity of the disease in children, which has guiding significance in evaluating the prognosis, and is beneficial to improve the prognosis.

The study is designed to explore new methods of evaluation for teachers′ comprehensive ability in general medicine. In the whole education process of resident aiming at general practitioner (GP) residency post competency, the authors made comprehensive evaluation of GP faculty, and created a comprehensive GP faculty evaluation model of result orientation. The efforts aim at exploring and introducing faculty evaluation methods and promoting education quality, in order to develop outstanding GP residents of strong post competency.

Objective: To investigate the feasibility and efficacy of percutaneous closure of paravalvuar leak (PVL) in patients after heart valve replacement surgery using Amplatzer vascular plug Ⅲ (AVP Ⅲ). Methods: In this retrospective study, consecutive PVL patients after heart valve replacement surgery receiving percutaneous closure with AVP Ⅲ in Beijing Anzhen hospital between March 2017 and October 2018 (n=21) were enrolled.The preoperative and intraoperative data and short-and mid-term outcome results were analyzed. Results: Theage of patients in this cohort was (54.9±11.7) years, and there were 12 (57.1%) male patients. There were 8 patients (38.1%) post mitral valve replacement, 4 patients (19.0%) post aortic valve replacement and 9 patients (42.9%) post double valves replacements.There were 14 cases (66.7%) of mitral valve PVL,6 cases (28.6%) of aortic valve PVL, and 1 case (4.8%) of double valves PVL.Successful device deployment was accomplished in 18 defects from 17 PVL patients. Technical successful rate of mitral valve PVL closure and aortic valve PVL closure was 12/15 and 6/7,respectively. One patient received surgical repair due to procedure-induced femoral pseudoaneurysm.There were 17 cases of severe PVL and 1 case of moderate PVL before procedure, and there were 2 cases of moderate PVL, 6 cases mild PVL, and PVL disappeared in 10 cases after procedure (P<0.01 vs. pre-procedure). The follow-up time was (8.3±4.7) months. There were 10 cases (58.8%) of New York Heart Association (NYHA) function grade Ⅲ and 7 cases (41.2%) of NYHA function grade Ⅳ before procedure, and there were 12 cases of NYHA function grade Ⅰ(70.6%) and 5 cases (29.4%) of NYHA function grade Ⅱ post procedure (P<0.01). Post procedure, there was no displacement of the occluder and heart valve movement was not affected,and there was no new hemolysis or hemolysis worsening. Conclusion Percutaneous closure of PVL in patients after heart valve replacement surgery with AVP Ⅲ is feasible, and associated with favorable short-and mid-term clinical outcomes.

Abstracts Using Saccharomyces cerevisiae lysate, two in-solution trypsin digestions (chloroform-methanol-water precipitation and RapiGest) were compared to the recently reported gel-aided sample preparation (GASP) workflow. Our proteomic results showed that GASP afforded the highest number of overall protein identifications and peptide spectrum matches without systematic bias towards peptide or protein size.

Objective Myofascial pain syndrome (MPS) is a common muscle function disturbance.This study was to investigate the clinical value of acoustic radiation force impulse (ARFI) imaging in assessing the therapeutic effect of acupuncture for patients with trapezius MPS.Methods A total of 116 patients diagnosed with trapezius MPS received acupuncture therapy once a day for 10 days in Pudong Hospital from August 2015 to June 2016.Using ARFI imaging, we recorded the shear wave velocity (SWV) of the trapezius and obtained the short-form McGill Pain Questionnaire (SF-MPQ) scores of the patients before, at the end of, and at 7, 15 and 30 days after treatment.Then, we analyzed the interaction and correlation between the SWV values and SF-MPQ scores of the patients at different time points.Results Both the SF-MPQ scores and SWV values were first decreased, falling to lowest values (5.19 points and 1.43 m/s) at 7 days after treatment, and then increased again.The interaction between the SF-MPQ scores and SWV values were significantly different at different time points (Finteraction=2.553, Pinteraction=0.038), and there was a strong linear correlation between the two indexes (r=0.755, P=0.000).Conclusion ARFI imaging combined with SF-MPQ has a certain clinical value in assessing the effect of acupuncture on trapezius MPS.

In this paper, the common errors in medical devices test reports are classified and analyzed. And then the main 11 influence factors for these inspection report errors are summarized. The hierarchy model was also developed and verified by presentation data using MATLAB. The feasibility of comprehensive weights quantitative comparison has been analyzed by using the analytic hierarchy process. In the end, this paper porspects the further research direction.
Equipment Failure Analysis ; Equipment and Supplies ; standards ; Models, Theoretical

Objective:To analyze morphological character of lateral tibial plateau fracture fragment, and its correlation to the presence of a meniscus injury in tibial plateau fractures.Methods:A total of 79 consecutive patients of the simple lateral tibial plateau fractures from July 201 1 to July 2015 were inclu-ded in this study,with 65 males and 14 females with an average age of (34.3 ±7.2)years and 22-61 years.According to Schatzker classification,21 cases were of Type Ⅰ,41 cases Type Ⅱ,and 17 cases Type Ⅲ.The characteristics of lateral tibial plateau fractures were evaluated by plain X-ray and magnetic resonance imaging (MRI ).The type and severity of meniscus injury were diagnosed by MRI scan. Three-dimensional measurements of the lateral fragment width (LFW),the lateral plateau depression (LPD),the coronal angulation of lateral fragment (CALF),and tibial plateau widening (TPW)were measured with Picture Archiving and Communication Systems(PACS)software.The patients with and without meniscus injuries were divided into different groups and analyzed respectively.Comparison of the above measurements between the two groups was analyzed by independent t test.Results:In all the 79 lateral tibial plateau fracture patients,26 cases (32.9%)of meniscus injuries were detected by MRI. Among all the meniscus injury cases,3 were of SchatzkerⅠ,16 SchatzkerⅡ,and 7 SchatzkerⅢ.In meniscus intact group,the average LFW was (22.0 ±2.8)mm while in meniscus injury group it was (21.3 ±3.3)mm (t =-1.008,P =0.317).The average LPD of non meniscus injury group was (5.4 ±2.8)mm,while in meniscus injury group was (8.7 ±2.8)mm (t=4.98,P=0.001).The average CALF of the two groups were 9.1°±6.1°and 10.6°±7.1°,and there was no significant dif-ference between the two groups (t=0.38,P=0.831).The average TPW was (3.0 ±1.1)mm,and (4.8 ±1 .7 )mm of the two groups.There were significant differences between the two groups (t =5.216,P=0.001).Conclusion:There was no obvious correlation between the LFD and meniscus inju-ry.The CALF of lateral tibial plateau fracture had no significant correlation with meniscus injury either. The degree of LPD and TPW may indicate injury of the meniscus in tibial plateau fractures.