The incidence rate of abdominal trauma is increasing year by year in pediatric trauma， and traumatic pancreatic injury should be taken seriously by clinicians. The pancreas is located behind the peritoneum， and it is difficult to make an early diagnosis of pancreatic injury， especially in children with grade ‍Ⅰ‍/Ⅱ injury. Through a literature review， this article analyzes the application value of endocrine indices and abdominal ultrasound in the early diagnosis of pediatric pancreatic injury， so as to improve the rate of early diagnosis and avoid the onset of related complications. Changes of the endocrine indices such as serum insulin and C Peptide have certain advantages in diagnosing and evaluating the degree of pediatric pancreatic injury and can thus be used as early warning indices for pediatric pancreatic injury. Ultrasound elastography provides a new method for the diagnosis and differentiation of pancreatic injury； contrast-enhanced ultrasound， which has no radioactive damage， has relatively high specificity and sensitivity in identifying pediatric pancreatic injury， and therefore， it is expected to become an alternative to CT examination.

Background The substantial health damage attributed to heat waves, along with their increasing intensity and frequency in the context of global warming, highlights the importance of exploring the health effects of heat waves. Objective To calculate the excess heat stroke cases during heat waves in the summer of 2013—2023 in Shanghai, analyze the association between heat waves and heat stroke, and to further explore the modifying effects of heat wave characteristics on heat stroke. Methods Using a retrospective ecological study design, data on heat stroke cases were collected from the heat stroke case reporting system of the Chinese Center for Disease Control and Prevention, and concurrent meteorological data from Xujiahui Meteorological Station. A heat wave was defined as at least 3 consecutive days with daily maximum temperature meeting or exceeding 35 ℃ in this study, excess heat stroke cases related to heat waves were assessed as the difference between the numbers of heat stroke cases observed on a given day and the corresponding 31 d (15 d before and after that day) moving average, and statistical analyses using generalized linear model based on time series study were performed to assess the impact of heat waves on heat stroke. Results Overall 25 heat waves during the study period were observed, leading to a total of estimated 792.6 extra heat stroke cases. The risk of heat stroke significantly increased during heat waves (RR=2.60, 95%CI: 2.08, 3.26), but no statistically significant differences in heat wave effects were observed among different genders, ages, or regions. In terms of the timing of heat waves, the risk of heat stroke was highest during the first heat wave (RR=3.58, 95%CI: 2.82, 4.55), which was significantly higher than that during the second heat wave (RR=2.19, 95%CI: 1.66, 2.90), and no significant effect was observed during the third or subsequent heat waves. The impact of heat waves on heat stroke persisted for more than 4 d, with the risk higher on the fourth day and beyond (RR=2.95, 95%CI: 2.28, 3.83), significantly higher than on the first day of heat wave (RR=1.74, 95%CI: 1.18, 2.56). Conclusion Heat waves had a substantial effect on heat stroke in Shanghai from 2013 to 2023, and special attention need to be paid to heat waves with early onset and long duration.

Functional membrane microdomains (FMMs) that are mainly composed of scaffold proteins and polyisoprenoids play important roles in diverse cellular physiological processes in bacteria. The aim of this study was to identify the correlation between MK-7 and FMMs and then regulate the MK-7 biosynthesis through FMMs. Firstly, the relationship between FMMs and MK-7 on the cell membrane was determined by fluorescent labeling. Secondly, we demonstrated that MK-7 is a key polyisoprenoid component of FMMs by analyzing the changes in the content of MK-7 on cell membrane and the changes in the membrane order before and after destroying the integrity of FMMs. Subsequently, the subcellular localization of some key enzymes in MK-7 synthesis was explored by visual analysis, and the intracellular free pathway enzymes Fni, IspA, HepT and YuxO were localized to FMMs through FloA to achieve the compartmentalization of MK-7 synthesis pathway. Finally, a high MK-7 production strain BS3AT was successfully obtained. The production of MK-7 reached 300.3 mg/L in shake flask and 464.2 mg/L in 3 L fermenter.
Bacillus subtilis/metabolism* ; Vitamin K 2/metabolism* ; Bioreactors/microbiology* ; Membrane Microdomains/metabolism*

Background Non-occupational carbon monoxide (CO) poisoning is a public health problem that seriously affect people’s health and lives. Objective To describe the prevalence of non-occupational CO poisoning during 2007—2018 in Shanghai, analyze its epidemiological characteristics and potential influencing factors, and explore effective prevention and control measures. Methods Daily reported non-occupational CO poisoning cases and meteorological factors from 2007 to 2018 were collected in Shanghai, epidemiological characteristics were analyzed by descriptive epidemiology methods, and a distributed lag nonlinear model was used to assess the association between temperature and non-occupational CO poisoning. Results A total of 2264 non-occupational CO poisoning events and 3866 cases from 2007 to 2018 were reported in Shanghai, including 59 death cases. More than half of the poisoning cases were female (56.3%), and young adults accounted for more cases than any other age group (54.8%). The poisoning events mainly occurred in winter (from December to next February); however, cases reported in summer increased in recent years. The peak period of the events was from 20:00 to 24:00. Households (85.2%) and restaurants (8.0%) were the common places of non-occupational CO poisoning events, and the main cause was improper use of gas water heater (36.9%). A nonlinear curve was found between daily average temperature of current day and the occurrence of non-occupational CO poisoning. Temperature was negatively associated with the risk of non-occupational CO poisoning when the temperature was lower than 9.6 ℃, while a positive association was found during 9.7-26.0 ℃. Conclusion Winter is a high season for non-occupational CO poisoning in Shanghai, rising cases reported in summer is also worthy of attention. Supervision should be strengthened to ban sales of unqualified gas water heaters, and health education on CO poisoning prevention and control should be conducted through multiple channels, in order to reduce the incidence of CO poisoning.

Objective: To explore the related factors of death from severe heat stroke in Shanghai from 2013 to 2017. Methods: The data of 1 152 patients with severe heat stroke who were divided into survival (n=1 037) and death (n=115) groups including gender, age and heat stroke type (heat cramp, heat exhaustion, heat apoplexy and the mixed type) were collected from meteorological bureau and case report system for high temperature heat stroke in Shanghai from 2013 to 2017. Meanwhile, the meteorological data of the onset date of severe heat stroke cases were collected, including maximum temperature, minimum temperature, daily temperature, relative humidity, air pressure, precipitation and wind speed. The differences of individual and meteorological factors between the two groups were compared, and multivariate logistic regression model was used to analyze the related factors of death from severe heat stroke. Results: Among 1 152 cases, the mean±SD of age was (56.29±18.95) years old, 843 (73.18%)were male, 962 (83.51%) were in the heat wave period; 322 cases (27.95%) were heat cramp, 170 cases (14.76%) were heat exhaustion, 533 cases (46.27%) were heat apoplexy and 114 cases (9.90%) were the mixed type. Daily average temperature ((32.81±1.99) ℃), daily maximum and minimum temperatures ((38.20±2.24) ℃ and (29.22±1.94) ℃) in survival group were lower than those in death group (all P values<0.001), which were (33.76±1.17) ℃, (39.19±1.31) ℃ and (29.72±1.66) ℃. Daily average relative humidity ((60.36±9.75)%) and daily minimum relative humidity ((41.26±9.71)%) in survival group were higher than those in death group(allP values <0.05), which were (54.59±6.89)% and (35.60±7.24)%. The results of logistic regression analysis suggested that compared with the cases with daily average humidity <60% and a mixed type heat stroke, the death OR (95%CI) values of cases with daily average humidity >60%, heat cramp, heat exhaustion and heat apoplexy were 0.31 (0.18,0.54), 0.13 (0.05,0.34), 0.68 (0.58,2.30) and 0.87 (0.48,1.58). Conclusion The temperature, relative humidity and the type of heat stroke were the main related factors affecting the prognosis of severe heat stroke.

Objective To explore the value of abdominal computed tomography (CT) in evaluating extramural vascular invasion of gastric cancer. Methods Totally 98 patients with primary gastric cancer were selected and conducted with abdominal CT examination. The value of abdominal CT in the diagnosing extramural vascular invasion of gastric cancer was analyzed based on the results of surgical pathology as the gold standard. TNM staging, tumor size and growth pattern were compared between extramural vascular invaders and non-invaders. Results Abdominal CT for diagnosis of extramural vascular invasion of gastric cancer was highly consistent with surgical and pathological results (Kappa = 0. 953, P = 0. 001). The accuracy of abdominal CT for diagnosis of extramural vascular invasion of gastric cancer was 97. 96％ (96/98), the sensitivity was 100. 00％ (30/30), the positive predictive value was 93. 75％ (30/32), the specificity was 97. 06％ (66/68), and the negative predictive value was 100. 00％ (66/66). There were no significant differences in stage N and stage M between extramural vascular invaders and non-invaders (P＞ 0. 05). Compared with non-extramural vascular invaders, the proportion of T4 stage was significantly higher in extramural vascular invaders (P ＜ 0. 05). Compared with non-extramural vascular invaders, the proportions of patients with tumors size over 5 cm and nodular and diffuse type was significantly higher in extramural vascular invaders (P ＜ 0. 05). Conclusion Abdominal CT can improve the preoperative evaluating effect of extramural vascular invasion of gastric cancer, and can accurately judge the disease of extramural vascular invasion of gastric cancer.

Objective To explore the value of abdominal computed tomography (CT) in evaluating extramural vascular invasion of gastric cancer. Methods Totally 98 patients with primary gastric cancer were selected and conducted with abdominal CT examination. The value of abdominal CT in the diagnosing extramural vascular invasion of gastric cancer was analyzed based on the results of surgical pathology as the gold standard. TNM staging, tumor size and growth pattern were compared between extramural vascular invaders and non-invaders. Results Abdominal CT for diagnosis of extramural vascular invasion of gastric cancer was highly consistent with surgical and pathological results (Kappa = 0. 953, P = 0. 001). The accuracy of abdominal CT for diagnosis of extramural vascular invasion of gastric cancer was 97. 96％ (96/98), the sensitivity was 100. 00％ (30/30), the positive predictive value was 93. 75％ (30/32), the specificity was 97. 06％ (66/68), and the negative predictive value was 100. 00％ (66/66). There were no significant differences in stage N and stage M between extramural vascular invaders and non-invaders (P＞ 0. 05). Compared with non-extramural vascular invaders, the proportion of T4 stage was significantly higher in extramural vascular invaders (P ＜ 0. 05). Compared with non-extramural vascular invaders, the proportions of patients with tumors size over 5 cm and nodular and diffuse type was significantly higher in extramural vascular invaders (P ＜ 0. 05). Conclusion Abdominal CT can improve the preoperative evaluating effect of extramural vascular invasion of gastric cancer, and can accurately judge the disease of extramural vascular invasion of gastric cancer.

Objective:To detect and verifica the gene profile difference of microRNA-146a (miR-146a) and its role in the pro-liferation of vascular smooth muscle cells (VSMCs) by gene chip technology. Methods: Artificially synthesized miR-146a mimics(50 nmol/L) ,miR-146 inhibitor ( 50 nmol/L ) , scramble ( 50 nmol/L ) and PBS were transfected into cultured primary rat VSMCs in vitro. After transfection,Real time PCR was used to measure the levels of miR-146a and the cell counting kit 8(CCK8) was employed to investigate the proliferation of VSMCs. The VSMCs interfered by miR-146a inhibitor or miR-146a control were examined by gene chips and the profile of gene were analyzed by bioinformatics technology to detect the different genes and signal transduction pathway. The changes in mRNAs and proteins were accessed separately by Real time PCR and Western blot. Results: Compared with sham and control VSMCs,miR-146a expression level was significantly decreased in treatment with miR-146a inhibitor(P<0. 01),as well as optical density(OD) was also shown remarkably down regulated simultaneously(P<0. 05). The investigation of gene profile revealed that the p53 signal pathway was up-regulated in VSMCs interfered by miR-146a. The mRNA and protein expression levels of p53, caspase3 and PTEN in p53 signal transduction pathway didn′t show significant differences(P>0. 05),however,the mRNA and protein expression levels of cyclin D1 significantly increased in treatment with miR-146a mimics VSMCs group and decreased in miR-146a inhibitor VSMCs group ( compared with sham VSMCs group, both P<0. 05 ) . Conclusion: Our data indicated that miR-146a may promote the proliferation of rat VSMCs by up-regulating cyclin D1 expression.

Abdominal aortic aneurysms(AAAs) is the most common aneurysm,and usually characterized by less symptom.While ruptured AAAs leads to high mortality.Abdominal ultrasonography can effectively detect AAA,decrease the AAAs-related mortality.However,screening AAAs causes some adverse outcomes,including psychological distress and immediate harms in treatment.Meanwhile,the prevalence of AAAs in sex and age is significantly different.Therefore,a reasonable and effective screening strategy is very important.This article search random control trials,systematic reviews,meta-analysis and guidelines in screening AAAs to obtain a reasonable screening strategy.

Objective To find a more suitable approach for the application of tranexamic acid(TXA)on total knee arthroplas‐ty (TKA) .Methods Totally 60 patients who met the inclusion criteria from January 2014 to August 2015 in the First Affiliated Hospital of Shihezi University were selected and divided into two groups according to the different route of administration .Group A (n=30) was intravenously injected with 100 mL TXA ,and group B(n=30) was locally injected with 100 mL TXA .Three hours drainage tubes occlusion were carried out after operation in the two groups .The intraoperative and postoperative dominant blood loss ,hidden blood loss indexes and the amount of total blood loss were recorded ,and coagulation indexes and D‐2 polymer were reg‐ularly monitored ,the incidence of thrombosis and postoperative adverse events were also observed .Results The amount of total blood loss in group B[(895 .41 ± 239 .02)mL] was lower than that in group A[(1 020 .89 ± 210 .83)mL] ,and the difference was statistically significant (P<0 .05);the total drainage volume in group B[(294 .33 ± 54 .25) mL] was lower than that in group A [(373 .33 ± 48 .02)mL] ,and the difference was statistically significant (P<0 .05) .After operation ,there was no significant differ‐ence between the two groups in coagulation indexes ,D‐2 polymer and the amount of hidden blood loss (P>0 .05) .No blood trans‐fusion ,symptomatic deep venous thrombosis and fatal pulmonary embolism occurred in the two groups .Conclusion The hemostatic effect of local application of TXA is better than that of intravenous injection in patients′initial TKA .