Objective To analyze the expression levels of 25-hydroxyvitamin D3[25-(OH)D3],insulin-like growth factor 1(IGF-1)and complement C3 in children patients with Henoch-Sch?nlein purpura(HSP)and their predictive efficiency on disease progression.Methods A total of 102 children patients with HSP ad-mitted and treated in this hospital from June 2018 to June 2023 were selected as the study subjects and includ-ed in the observation group.They were divided into the mild group(35 cases),moderate group(41 cases)and severe group(26 cases)according to the severity degree.Additionally,50 healthy children undergoing physical examination during the same period served as the control group.The differences in serum 25-(OH)D3,IGF-1 and complement C3 levels were compared among the groups,as well as their correlations with the disease se-verity.Logistic regression analysis was used to determine the influencing factors of disease progression in chil-dren patients with HSP,and the value of 25-(OH)D3,IGF-1 and complement C3 in predicting disease progres-sion was assessed by using the receiver operating characteristic(ROC)curve.Results The levels of 25-(OH)D3 and C3 in the observation group were lower than those in the control group,while the level of IGF-1 was higher than that in the control group(P＜0.05).The levels of 25-(OH)D3 and C3 in the severe group were lower than those in the mild group and moderate group,moreover the moderate group was lower than the mild group(P＜0.05).The level of IGF-1 in the severe group was higher than that in the mild group and moderate group,moreover the moderate group was higher than the mild group(P＜0.05).The Spearman correlation a-nalysis results indicated that the levels of 25-(OH)D3 and complement C3 were negatively correlated with dis-ease severity(r=-0.375,-0.576,P＜0.05),while the level of IGF-1 was positively correlated with the dis-ease severity(r=0.866,P＜0.05).The ROC curve analysis results revealed that the area under the curve(AUC)of the combined detection of 25-(OH)D3,complement C3 and IGF-1 for predicting the disease pro-gression was the maximal(0.888),the sensitivity was 81.4％,the specificity was 82.0％and the Youden in-dex was 0.634.Conclusion 25-(OH)D3,IGF-1 and complement C3 have the higher sensitivity and specificity in comprehensively assessing the disease progression of children patients with HSP,and possess the higher clinical value on the risk evaluation of the disease progress in the children patients with HSP.

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.

Objective: To investigate anemia rate and to analyze related factors in maternal women in Taicang of Jiangsu province. Methods: There were 13 278 pregnant women who had prenatal care and gave birth in 25 hospitals during 2014-2016 in Taicang of Jiangsu Province. We excluded 1 179 women who registered after 12 weeks of gestation, 144 women who did not test hemoglobin during gestation, and 25 women whose gestational weeks were incorrect. Finally, data from 11 930 pregnant women were analyzed. From the electronical medical record system of maternal and child health care, we obtained basic information of these pregnant women, their hemoglobin levels and related data during gestation and postpartum. Anemia rate was descripted, and factors associated with anemia were identified using multiple unconditional logistic regression. Results: Age of the 11 930 pregnant women was (27.0±4.5) years old, and the P₅₀ (P₂₅-P₇₅) of BMI at the first trimester was 21.4 (19.6-23.7) kg/m². The anemia rate during gestation was 37.2% (4 434/11 930). The anemia rate was 5.5% (276/5 035), 24.4% (1 802/7 377), and 47.8% (3 328/6 966) at the first, second and third trimesters, respectively. Anemia rate at 42 days postpartum was 19.9% (680/3 418). Multiple unconditional logistic regression indicated that anemia during gestation was related with maternal age <21 years old at prenatal registration (OR (95%CI): 1.28 (1.07-1.53)), body mass index(BMI) <18.5 kg/m² at the first trimester (OR (95%CI): 1.14 (1.00-1.29)), non-local residence (OR (95%CI): 1.35 (1.20-1.52)), education of middle school and lower (OR (95%CI): middle school: 1.24 (1.05-1.47), primary school: 1.36 (1.01-1.82)), occupation of housewife or farmer (OR (95%CI): housewife: 1.21 (1.06-1.38), farmer: 1.21 (1.03-1.44)). Anemia at 42 days postpartum was associated with multipara (OR(95%CI): 1.59 (1.12-2.27)), anemia at the first trimester (OR(95%CI): 3.26 (1.92-5.55)), no folic acid supplementation at the first trimester (OR(95%CI): 1.34 (1.00-1.80)), and hemorrhage≥500 ml during 24 h postpartum (OR(95%CI): 2.26 (1.02-4.97)). Conclusion Anemia rate was low for maternal women in Taicang of Jiangsu Province. The factors associated with gestational anemia included pregnant women's age, BMI, local or non-local residence, occupation, and education. The factors associated with postpartum anemia included multipara, anemia at the first trimester, no folic acid supplementation at the first trimester, and hemorrhage 24 h postpartum.

Objective To determine whether a periprosthetic joint infections (PJI) patient derived S.aureus is an appropriate candidate tool bacterium for studying the pathogenesis of S.aureus-induced PJI.Methods Whole genome sequencing data of ST1792 was obtained using the Illumina Hiseq platform of a Staphylocuccal.aureus(S.aureus) strain derived from a PJI prosthesis,and gene functional enrichment analysis based on gene ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) database was performed.Besides,its biofilm formation ability in drainage fluid,synovial fluid and human plasmin were compared to that in experimental cultures,in order to determine differences in biofilm forming ability in different environment.In addition,based on Illumina Hiseq platform,transcriptome analysis of the S.aureus in the three types of fluid above was performed to determine its gene expression profile and functional enrichment analysis of the differentially expressed genes was conducted through the GO and KEGG database.Finally,adaptability in different human fluid of the S.aureus was analyzed with the transcriptome profile and biofilm formation data.Results The genome of ST1792 consisted of 2 718 coding sequences,including main virulence encoding genes and regulation related genes.Functional enrichment showed no sign of significant missing or major recombination in the bacterial genome.The biofilm mass in plasmin was much higher than that in synovial fluid,both significantly higher than the biofilm mass in TSB.But the biofilm mass in drainage fluid was not statistically different from that in TSB.This revealed that the bacterial biofilm phenotype was significantly altered in PJI human fluid.Transcriptomics sequencing revealed that a huge number of genes were differentially expressed in drainage fluid,synovial fluid and human plasmin compared to TSB.Functional enrichment revealed that the bacterial gene expression profile was different in PJI human fluids,which showed the sophisticated adaptation of the bacterium to human fluid environment.Conclusion As a clinical S.aureus isolated from a PJI patient,ST1792 presents distinct phenotypes and adaptations in vivo,so it is a proper candidate for future studies in the pathogenesis of S.aureus induced PJI.

Objective To observe the effect of music therapy on stroke patients with depression.Methods 70 post-stroke depression patients were divided into the observation group and the control group according to the hospitalized number,the control group received conventional therapy neurology without giving antidepressants;the observation group were given music therapy group basis.Both groups were at the time of enrollment and after treatment using the Hamilton Depression Rating Scale (HAMD),Self-rating Depression Scale (SDS) for the two groups of patients assessed the degree of depression.Results After the treatment,the HAMD score of the observation group was (23.57 ± 10.33)points,compared with the control group[(28.20 ± 8.83)points],the difference was statistically significant (t =2.02,P ＜ 0.05);the SDS score of the observation group was (61.00 ± 10.67) points,compared with the control group [] (66.11 ± 10.38) points],the difference was statistically significant (t =-2.03,P ＜ 0.05).Conclusion Music therapy for depression in patients with post-stroke recovery has a positive meaning.

BACKGROUNDDiversity of orthopedic infections with various local environments affects the pattern and prevalence of pathogens. It is not well-characterized whether different pathogens have different propensity to cause different types of orthopedic infections. We aimed to investigate the frequency of different pathogens derived from orthopedic infections, and determine the relationship between the prevalence of clinical isolates and the type of orthopedic implants, especially focusing on staphylococci.

METHODSFrom January 2006 to December 2011, orthopedic infections were identified retrospectively from clinical microbiology laboratory and orthopedic medical records. The sources of orthopedic infections were divided into two main groups: those associated with implants and those not associated with implants. Implants-associated infections were further subdivided into five subgroups: arthroplasty, internal fixation, external fixation, internal and external fixation, and others. We analyzed microbiological spectrum in different groups and subgroups. Antibiotic susceptibility of staphylococci was analyzed.

RESULTSOnly coagulase-negative staphylococci (CoNS) was significantly more likely to be associated with implants-associated infections (P = 0.029). The overall pathogens prevalence of arthroplasty was significantly different from other subgroups (P < 0.05). 65% isolates from external fixation was Gram-negative bacteria. Some percentage (55%) of S. aureus and (83%) CoNS were resistant to methicillin. No resistance to glycopeptide was seen in all of staphylococci.

CONCLUSIONSStaphylococcus aureus was the most frequent isolates in orthopedic infections but was not associated with the presence or absence of implants. Only CoNS was implants-associated, especially for arthroplasty infection. Cefazolin alone is not enough for orthopedic surgery prophylaxis in settings with a high prevalence of methicillin-resistant staphylococci.

Humans ; Orthopedic Procedures ; adverse effects ; Prostheses and Implants ; microbiology ; Retrospective Studies ; Staphylococcus aureus ; pathogenicity ; physiology

BACKGROUNDSirtuin 1 (SIRT1) has been reported to have diverse roles in various biological processes through deacetylation of histone and nonhistone proteins. However, the correlations among SIRT1 protein expression, clinicopathological parameters, and survival of colorectal cancer patients remain unclear.

METHODSSIRT1 protein expression was measured by immunohistochemistry in a paraffin-embedded tissue microarray, including 120 paired colorectal cancer and normal mucosa tissues. The correlations among SIRT1 protein expression, clinicopathological features, and prognosis were analyzed.

RESULTSAll samples (100%) were positive for SIRT1, with variable staining in the cytoplasm rather than in the nucleus. There was significant difference in SIRT1 overexpression between adenocarcinomas and normal mucosal tissue (P < 0.01, χ(2) test). SIRT1 overexpression was more frequently observed in advanced-stage tumors (P = 0.046, 0.002, χ(2) test). SIRT1 overexpression was significantly correlated with poor overall survival (P = 0.013, log-rank test) and diseasefree survival (P = 0.012, log-rank test).

CONCLUSIONSSIRT1 overexpression correlated with advanced stage and poor prognosis. SIRT1 may play an important role in the progression of colorectal cancer.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; metabolism ; Colorectal Neoplasms ; metabolism ; pathology ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Sirtuin 1 ; metabolism

Aim To explore whether edaravone (EDA), a novel free radical scavenger, protects H9c2 cardiac cells against doxorubicin ( DOX )-induced car-diotoxicity. Methods H9c2 cells were treated with 5μmol·L-1 DOX to establish a model of DOX cardio-toxicity. Cell viability was examined by cell counter kit ( CCK-8 ) . Changes in morphology and amount of ap-optotic cells were detected by Hoechst 33258 staining;intracellular level of reactive oxygen species ( ROS ) was measured by DCFH-DA staining and photofluorog-raphy;mitochondrial membrane potential ( MMP) was observed by rhodamine 123 ( RH123 ) staining and photoflurograph; the expression level of caspase-3 was determined by Western blot assay. Results Pretreat-ment of H9 c2 cells with 20 , 40 and 80 μmol · L-1 EDA for 60 min markedly inhibited cytotoxicity in-duced by 5 μmol · L-1 DOX, respectively, as evi-denced by an increase in cell viability. The protective effect induced by 40 μmol · L-1 EDA was maximal. Pretreatment of H9 c2 cells with 40 μmol · L-1 EDA for 30 , 60 , 90 and 120 min significantly attenuated DOX-induced cytotoxicity, respectively, having a max-imal protection at 60 min. Furthermore, pretreatment of H9 c2 cells with 40 μmol · L-1 EDA for 60 min be-fore exposure to 5 μmol · L-1 DOX for 24 h obviously reduced cardiac injuries, as evidenced by decreases in the DOX-induced intracellular ROS generation, num-ber of apoptotic cells, and expression of cleaved caspase-3, as well as loss of MMP. Conclusions EDA can protect H9 c2 cardiac cells against DOX-in-duced cardiotoxicity, this protection may be associated with inhibition of ROS production and preservation of MMP.

Three cyclotides were isolated from the whole plant of Viola yedoensis in this study. The two, vary peptide E and cycloviolacin Y5, were previously reported, and a novel cycloviolacin VY1 was characterized according to the interpretation of MS/MS fragmentation of peptides which were produced from the reduced and alkylated parent peptide with the digestion of Endo Lys-C, trypsin and chymotrypsin, separately. The stability of remarkable resistance to proteolytic degradation by trypsin and chymotrypsin, and that of thermal denaturation was confirmed again. Besides, the IC50 value of cycloviolacin VYI against influenza A H1N1 virus was (2.27 +/- 0.20) microg x mL(-1). It is the first cyclotide reported with anti-influenza A H1N1 virus activity in vitro assay.

ObjectiveTo investigate the correlation between femoral distal medial torsion and patellofemoral joint malalignment and analyze the causes of patellofemoral joint disorders,which provide the new theory with clinical treatment.MethodsFrom May 2007 to June 2009,124 knees(95 cases) with patellofemoral joint disorders were enrolled in this study randomly.Each knee was scanned with CT in dynamic 20° -30° knee flax position.Femoral distal medial torsion angle (FMTA),patellar congruence angle (CA) and patellar tilt angle(PTA) were measured.The correlation between FMTA and CA or PTA was analyzed.Results FMTA ＜ 5° in 25 knees,≥5° in 99 knees,6 knees with trochlear dysplasia who were excluded.FMTA in 93 knees was 16.06° ± 5.68°,CA was 16.40° ± 5.48° and PTA was 19.59° ± 3.32°.The positive correlation was found between FMTA and CA when FMTA ＞ 10°through scatter diagram analysis (r =0.709,P ＜ 0.05 ).The positive correlation was found between FMTA and PTA when FMTA ＞10°( r =0.652,P ＜ 0.05),the positive trend declined when FMTA ＞ 27°.ConclusionsFemoral distal medial torsion is an important risk factor of patellofemoral joint malalignment.When FMTA ＞ 10°,FMTA and CA,PTA has positive correlation,but the positive tend between FMTA and PTA declines when FMTA ＞ 27°.