Objective: To explore the mediating role of psychological and physical aggression in the association between maternal emotional symptoms with emotional and behavioral problems in preschool children, so as to provide references for effective intervention of risk factors related to childrens emotional and behavioral problems. Methods: A longitudinal study was conducted to select 12 kindergarten children and their mothers in Wuhu City, Anhui Province by using stratified clustering sampling. The baseline survey was carried out in June 2021, followed up every six months, and a total of 3 followups were administered. Totally 853 valid questionnaires of junior class children were included by the survey data from baseline, second and thirl followups. The Depression Anxiety and Stress Scale-21 (DASS-21), the Parent-Child Conflict Tactics Scales (CTSPC) and the Strength and Difficulties Questionnaire (SDQ) were used to measure maternal emotional symptoms, psychological and physical aggression, and childrens emotional and behavioral problems, respectively. Results: The physical aggression of mothers towards children in boys was higher than in girls (t=3.53, P<0.05). The results of correlation analysis showed that maternal depressive symptoms were positively correlated with psychological aggression, physical aggression and childrens SDQ scores (r=0.20, 0.21, 0.18, P<0.01), maternal anxiety symptoms were positively correlated with psychological aggression, physical aggression and childrens SDQ scores (r=0.24, 0.22, 0.10, P<0.01), respectively; maternal stress symptoms were positively correlated with psychological aggression, physical aggression. The SDQ scores were positively correlated (r=0.26, 0.25, 0.18, P<0.01), and the scores of maternal psychological aggression and physical aggression were positively correlated with the SDQ scores of children (r=0.12, 0.16, P<0.01). The mediating analysis showed that after controlling for related confounding factors, psychological aggression played a partial mediating effect in the association between maternal depressive symptoms and childrens emotional and behavioral problems, and the mediating effect ratio was 8.05%. Physical aggression played a partial mediating effect in the association between maternal depression, anxiety and stress symptoms and childrens emotional and behavioral problems, which were 15.94%, 11.73% and 12.54% (P<0.05), respectively. Conclusions Psychological and physical aggression play mediating roles in the association between maternal emotional symptoms and childrens emotional and behavioral problems, and actively improving maternal emotional symptoms and their childrens discipline methods can help reduce the occurrence of emotional and behavioral problems in preschool children.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Aim To study the role of Cx43 hemichannel in rats with acute incision pain. Methods Adult male rats were randomly divided into normal saline group(C group), incision pain group(I group), Gap19 group. Western blot was used to determine the expression of Cx43 and GFAP at 6 h, 3 d and 7 d after paw incision surgery of rats. The rats were intrathecal injected with Gap19 30 min before incision surgery, followed by the measurement of the paw withdrawal threshold to mechanical stimuli at several time points. Immunofluorescence was used to detect the expression of Cx43 and GFAP. ELISA was performed to detect the different inflammatory cytokine levels in rats after surgery. Results Compared with group C, the expression of Cx43 and GFAP of rats increased significantly 6 h after incision surgery in group I, while their expression at postoperative 3 d and 7 d showed no obvious alteration. Compared with the preoperative baseline, the mechanical paw withdrawal threshold in I group and Gap19 group rats was significantly reduced at 2 h, 6 h, 24 h and 3 d post-incision(P<0.01), but it had no obvious change on postoperative 7 d. Compared with group I, the mechanical paw withdrawal threshold in rats of Gap19 group increased 2 h, 6 h, 24 h post-incision, while it showed no statistical difference on 3 d and 7 d post-incision. Compared with group C, immunofluorescence results showed that the expression of GFAP and Cx43 in spinal cord dorsal horn astrocytes also increased significantly in Group I 6 h after incision surgery. Compared with group I, GFAP and the expression of Cx43 were markedly reduced in Gap19 group. There was no statistical difference on 7 d post-incision. Compared with those in group C, the inflammation factors including IL-1β, IL-6 and TNF-αobviously increased in group I. However, in contrary to the rats in group I, the rats pretreated with gap19 showed increased expression of Cx43 and GFAP in spinal cord dorsal horn. Conclusions Specific inhibition of Cx43 hemichannel significantly suppresses astrocyte activation and alters the inflammatory microenvironment in the spinal cord dorsal horn and reduces postoperative hyperalgesia in rats with acute incision pain.

OBJECTIVE: To analyze the changes in the gene expression profile of T cells in CML patients after TCRζ up-regulation expression, and to explore the molecular mechanism of T cell reactivation after transgenic up-regulation of TCRζ. METHODS: The peripheral blood mononuclear cells(PBMCs) from 3 newly untreated chronic-stage CML patients were collected, and the CD3 RESULTS: A total of 2248 differentially-expressed genes were obtained, including 553 up-regulated genes and 1695 down-regulated genes in experimental group as compared with those in control group (P<0.05) . The GO and KEGG enrichment analyses showed that differentially expressed genes involved in the biological processes related to T cell immune function, such as TCR signaling pathway, T cell proliferation and activation. Some of core genes involved in promoting the TCR signaling pathway, T cell proliferation, activation and apoptosis pathways were significantly up-regulated, while some core genes involved in inhibiting T cell activation were significantly down-regulated. CONCLUSION The molecular mechanism of the significantly improved T cell activation and proliferation ability in CML patients after TCRζ up-regulation may be related to the differential transcripts mediated signaling pathways of T cell activation, proliferation and apoptosis.
Humans ; Leukocytes, Mononuclear ; Lymphocyte Activation ; Receptors, Antigen, T-Cell/genetics* ; T-Lymphocytes ; Up-Regulation

Objective: Hepatitis B surface antigen (HBsAg) loss is seldom achieved with nucleos(t)ide analog (NA) therapy in chronic hepatitis B patients but may be enhanced by switching to finite pegylated-interferon (Peg-IFN) alfa-2a. We assessed HBsAg loss with 48- and 96-week Peg-IFN alfa-2a in chronic hepatitis B patients with partial response to a previous NA. Methods: Hepatitis B e antigen (HBeAg)-positive patients who achieved HBeAg loss and hepatitis B virus DNA < 200 IU/mL with previous adefovir, lamivudine or entecavir treatment were randomized 1:1 to receive Peg-IFN alfa-2a for 48 (n = 153) or 96 weeks (n = 150). The primary endpoint of this study was HBsAg loss at end of treatment. The ClinicalTrials.gov identifier is NCT01464281. Results: At the end of 48 and 96 weeks' treatment, 14.4% (22/153) and 20.7% (31/150) of patients, respectively, who switched from NA to Peg-IFN alfa-2a cleared HBsAg. Rates were similar irrespective of prior NA or baseline HBeAg seroconversion. Among those who cleared HBsAg by the end of 48 and 96 weeks' treatment, 77.8% (14/18) and 71.4% (20/28), respectively, sustained HBsAg loss for a further 48 weeks. Baseline HBsAg < 1 500 IU/mL and week 24 HBsAg < 200 IU/mL were associated with the highest rates of HBsAg loss at the end of both 48- and 96-week treatment (51.4% and 58.7%, respectively). Importantly, extending treatment from 48 to 96 weeks enabled 48.3% (14/29) more patients to achieve HBsAg loss. Conclusion Patients on long-term NA who are unlikely to meet therapeutic goals can achieve high rates of HBsAg loss by switching to Peg-IFN alfa-2a. HBsAg loss rates may be improved for some patients by extending treatment from 48 to 96 weeks, although the differences in our study cohort were not statistically significant. Baseline and on-treatment HBsAg may predict HBsAg loss with Peg-IFN alfa-2a.

AIM:To observe the expression of Snail1 and insulin-like growth factor-1 (IGF-1) in NRK-52E cells induced by high glucose,and to investigate the relationship of Snail1 and IGF-1 in the mechanism of epithelial to mesenchymal transition (EMT) in diabetic kidney disease (DKD).METHODS:The NRK-52E cells were treated with Snail1 siRNA and IGF-1 siRNA after cultured with high glucose medium for 72 h,and divided into control group,high glucose group,non-targeting (NT) siRNA group,Snail1 RNAi group and IGF-1 RNAi group.The cells were harvested at 48 h and 72 h.Real-time PCR was used to detect the mRNA expression of Snail1,IGF-1,E-cadherin and fibronectin (FN),and the protein levels were determined by immunofluorescence staining.RESULTS:Compared with control group,the expression of E-cadherin at mRNA and protein levels declined after stimulation with high glucose (P ＜ 0.01),while that of FN was elevated (P ＜0.01).Meanwhile,the mRNA and protein levels of Snail1 and IGF-1 were markedly increased (P ＜0.01).The expression of E-cadherin at mRNA and protein levels was improved in Snail1 RNAi group as compared with high glucose group (P ＜ 0.01),while that of FN,IGF-l and Snail1 was significantly down-regulated (P ＜ 0.01).The same changes were observed in IGF-1 RNAi group (P ＜0.01).The protein expression of each factor in NT group had no significant change as compared with high glucose group (P ＞ 0.05).Pearson correlation analysis showed a close positive relationship between the expression of Snail1 and IGF-1 protein (r =0.852,P ＜ 0.01).CONCLUSION:Snail1 may facilitate DKD development by regulating IGF-1 in the process of EMT.

Objective To investigate the clinical and immunological features,therapeutic response as well as prognosis of adult onset Still's disease (AOSD).Methods AOSD was diagnosed in 137 patients referred to our department.Clinical and immunological data were retrospectively analyzed.Therapeutic response and prognosis were systemically reviewed during the follow-up period.Intergroup incidence divergence was analyzed by chi-square test.Cox regression analysis was adopted to determine factors related with relapse.Results Fever,rash and arthritis were the cardinal clinical features of AOSD patients.Elevated inflammatory indices including ferritin (128 suhjects,97.1％ ) along with neutrophilia and liver dysfunction were the main laboratory findings.Ninety-eight patients were followed up and 75％ (73 subjects) had achieved complete remission after 4 weeks treatment.Forty-one patients (42％) who had achieved remission relapsed during follow-up period.Combination of glucocorticoid steroid and disease modifying antirheumatic drugs (DMARDs) were more effective than glucocorticoid steroid only in inducing remission and preventing relapse.More patients received glucocorticoid combined with methotrcxate and hydroxychloroquine achieved remission (8 of 8 patients) than patients who were treated with glucocorticoid and methotrexate (25 of 28 patients,89％ ) and those treated with glucocorticoid and hydroxychloroquine (14 of 16 patients,88％ ).Patients with glucocorticoid were more likely to suffer disease recurrence than those who took glucocorticoid combined with DMARDs (61％ vs 29％,P=0.004).Cox regression analysis suggested that methotrexate had protec-tive effect against recurrence [RR=0.418,95％CI (0.192-0.909),P=0.028].5％ of patients were diagnosed to other diseases during the follow up period.Conclusion Initial treatment with combined glucocorticoid and DMARDs is beneficial to induce remission and prevent reoccurrence.Methotrcxate has a protective effect against recurrence.

Background Goldmann applanation tonometry (GAT) is a gold standard of intraocular pressure measurement.But its utilization iS limited because of its complexity and high requirement of cooperation.iCare rebound tonometer (iCare RBT) is a new type of applanation tonometry,and its accuracy and safety in clinical application need to be evaluated.Objective Present study was to investigate the reproducibility and tolerability of iCare RBT and its measurement agreement with GAT over a wide intraocular pressure (IOP) range. Methods The IOP were measured in bilateral eyes of 36 glaucoma and glaucoma suspect patients by 2 examinees with iCare RBT at the 1-minute interval to assess the interobserver reproducibility.Then the IOP of both eyes from 56 Subjeets and other 52 subjects were separately measured twice for each by two operators with iCare RBT for the evaluation of intraobserver reproducibility.Finally.IOP of 182 eyes of 92 glaucoma and glaucoma suspect patients was obtained by examiner 2 with RBT first and examiner 1 with GAT subsequently at a 2.minute interval in a masked fashion to perform an agreement evaluation of two readings by using Bland-Ahman method.The tolerance of subjects to iCare RBT measurement were surveyed.Oral informed consent was obtained prior to the IOP measurement. Results Concerning the iCare RBT readings.interobserver correlation coefficients were 0.937 in the right eye and 0.887 in the left eye.Intraobserver correlation coefficients of examiner 1 were 0.986 in the left eyes and 0.969 in the fight eyes.And those of examiner 2 were 0.990 and 0.979.Mcan values of iCare RBT readings and GAT were(18.74±8.36)mmHg and(19.33±8.20)mmHg and the mean difference values(iCare-GAT)was(-0.59 4±2.60)mmHg with the 95%confidence interval of -5.80-4.60 mmHg.The correlation coefficient between two modalities of IOP measurement WaS 0.95 1.No severe pain and discomfort were complained in all the subjects during or after measurement of iCare RBT. Conclusion iCare RBT has good interobserver and intraobserver reproducibility and good tolerance.It was proved that this is a good correlation between iCare RBT readings and GAT readings.

OBJECTIVETo study the degree and changes of cervical spinal canal stenosis by MRI scans in flexion and extension of the cervical vertebrae.

METHODSThirty cases of cervical stenosis included 13 male and 17 female with an average age of 39 years ranging from 28 to 66 years. The sagittal diameter of cervical spinal canal were below 10 mm (absolute stenosis) in 12 cases,within 10 to 12 mm (correspondence stenosis) in 18 cases. MRI scans in neutrality, flexion, extension performanced and the degree of cervical spinal canal stenosis and the changes of spinal cord compression were evaluated after MRI scans obtained.

RESULTSNineteen patients of extension occurrenced stenosis more serious, 8 patients of flexion occurrenced (P < 0.05).

CONCLUSIONFor the cervical stenosis imaging diagnostic, flexion and extension of cervical MRI scan can be used to supplement conventional MRI examination neutral position, and the extension of MRI is more sensitivity than neutral position and flexion bit.

Adult ; Aged ; Cervical Vertebrae ; diagnostic imaging ; physiopathology ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Radiography ; Spinal Stenosis ; diagnosis ; diagnostic imaging ; physiopathology

OBJECTIVETo investigate the contents of lead, cadmium, zinc and manganese in the follicular fluid and semen of infertile couples that are not professionally exposed to the four heavy metallic elements.

METHODSIn vitro fertilization pre-embryo transfer (IVF-ET) was carried out in wives, and follicular fluid collected after routine oocyte retrieval. Semen was obtained from husbands by masturbation. The contents of zinc in the follicular fluid and semen were determined by the flame atom absorption method and those of lead, cadmium and manganese by graphite furnace atomic absorption spectrometry.

RESULTSThe average concentrations of lead, cad- mium, zinc and manganese were 151.06 microg/L, 2.02 microg/L, 0.54 mg/L and 28.54 microg/L in the follicular fluid, and 250.23 microg/L, 7.42 microg/L, 189.11 mg/L and 82.15 microg/L in the semen. The follicular fluid samples in which lead, cadmium, zinc or manganese was detected constituted 43.8% (21/48), 22.9% (11/48), 75.0% (36/48) and 50.0% (24/48), and the semen samples accounted for 70.2% (33/47), 31.9% (15/47), 100.0% (47/47) and 46.8% (22/47), respectively.

CONCLUSIONThe results suggest that the average contents of lead, cadmium, zinc and manganese are higher in the semen than in the follicular fluid in the non-professionally exposed infertile couples, and so is the percentage of the samples containing each of the elements, with the exception of manganese.

Adult ; Cadmium ; analysis ; Environmental Exposure ; analysis ; Female ; Follicular Fluid ; chemistry ; Humans ; Infertility, Female ; metabolism ; pathology ; Infertility, Male ; metabolism ; pathology ; Lead ; analysis ; Male ; Manganese ; analysis ; Metals, Heavy ; analysis ; Semen ; chemistry ; Spectrophotometry, Atomic ; Zinc ; analysis