Objective:Osteosarcoma is a highly aggressive primary malignant bone tumor commonly seen in children and adolescents,with a poor prognosis.Anchorage-dependent cell death(anoikis)has been proven to be indispensable in tumor metastasis,regulating the migration and adhesion of tumor cells at the primary site.However,as a type of programmed cell death,anoikis is rarely studied in osteosarcoma,especially in the tumor immune microenvironment.This study aims to clarify prognostic value of anoikis and tumor immune microenvironment-related gene in the treatment of osteosarcoma. Methods:Anoikis-related genes(ANRGs)were obtained from GeneCards.Clinical information and ANRGs expression profiles of osteosarcoma patients were sourced from the therapeutically applicable research to generate effective therapies and Gene Expression Omnibus(GEO)databases.ANRGs highly associated with tumor immune microenvironment were identified by the estimate package and the weighted gene coexpression network analysis(WGCNA)algorithm.Machine learning algorithms were performed to construct long-term survival predictive strategy,each sample was divided into high-risk and low-risk subgroups,which was further verified in the GEO cohort.Finally,based on single-cell RNA-seq from the GEO database,analysis was done on the function of signature genes in the osteosarcoma tumor microenvironment. Results:A total of 51 hub ANRGs closely associated with the tumor microenvironment were identified,from which 3 genes(MERTK,BNIP3,S100A8)were selected to construct the prognostic model.Significant differences in immune cell activation and immune-related signaling pathways were observed between the high-risk and low-risk groups based on tumor microenvironment analysis(all P<0.05).Additionally,characteristic genes within the osteosarcoma microenvironment were identified in regulation of intercellular crosstalk through the GAS6-MERTK signaling pathway. Conclusion:The prognostic model based on ANRGs and tumor microenvironment demonstrate good predictive power and provide more personalized treatment options for patients with osteosarcoma.

Objective To explore the pain catastrophizing (PC) level of pain in patients with multiple fractures and its influencing factors. Methods Eighty patients with mandibular fracture were selected and randomly divided into control group and observation group, with 40 cases in each group. The control group was conducted with routine postoperative nursing measures, while the observation group was conducted with additional evidence-based nursing intervention. The recovery status, incidence of postoperative complications, mental health status, and nursing satisfaction degree were analyzed in both groups. Results The wound healing time was (7.90±4.21) days in the observation group and (9.43±4.29) days in the control group; the recovery efficiency of chewing function was (79.19±4.74) % in the observation group and (73.28±4.78) % in the control group; the incidence of complications was 7.5% in the observation group and 27.5% in the control group; the score of the Hamilton Anxiety Scale (HAMA) at 6 months after surgery was (10.76±1.65) points in the observation group and (13.99±1.43) points in the control group; score of the Hamilton Depression Scale (HAMD) at 6 months after surgery was (11.78±1.26) points in the observation group and (12.49±1.29) points in the control group; all the between-group differences mentioned above were statistically significant (P<0.05). Conclusion Evidence-based nursing can promote the postoperative recovery of patients with mandibular fracture, reduce the incidence of postoperative complications, alleviate patient's psychological stress, and increase nursing satisfaction degree.

Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

This article started from the definition of unavoidable stress injury, analyzed the mechanism of occurrence and the current development of unavoidable pressure injury assessment methods and assessment tools, discussed the limitations of the current differential assessment of unavoidable stress injury, and putted forward relevant suggestions to provide reference for the research on the assessment and prevention strategies of unavoidable pressure injury in China.

Objective:To evaluate the protective effect of foam dressing in preventing intraoperative acquired pressure injury (IAPI), and to provide reference basis for prevention and treatment of IAPI during clinical operation.Methods:The clinical data of 455 surgical patients admitted to Xinhua Hospital Affiliated to Shanghai Jiao Tong University from October 2020 to January 2021 were retrospectively collected. According to whether foam dressing was used at the compression site during operation, the patients were divided into dressing group (101 cases) and control group (354 cases). The two groups were matched with age, body mass index, preoperative Braden and cerebrovascular disease as covariates, and were finally divided into 89 patients in the dressing group and 162 patients in the control group. Logistic regression analysis and stratified analysis were used to comprehensively evaluate the actual effect of foam dressing on the occurrence of IAPI in the surgical patients.Results:Among the 251 patients, there were 14 (15.7%) cases with IAPI in the dressing group and 13 (8.0%) cases in the control group, and the difference was not statistically significant ( χ2=3.41, P>0.05). Among the patients in the prone position, compared to the control group, the dressing group can effectively reduce the risk of IAPI in surgical patients by 77% ( OR=0.23, 95% CI 0.05-0.98, P<0.05). There was no interaction between foam dressing and intraoperative surgical characteristics ( P>0.05). Conclusions:Foam dressing plays a protective role in preventing the occurrence of IAPI in patients undergoing surgery in the prone position. There was no significant protective effect of intraoperative foam dressing in patients with other surgical characteristics.

【Objective】 To carry out serological and molecular biological identification of B (A) subtype, and discuss the rational blood transfusion strategy. 【Methods】 Serological and direct sequencing methods were used to detect serotype and genotype of 7 cases of B (A) subtype, and cross matching was performed by saline medium and anti human globulin card to analyze the red blood cells(RBCs) transfusion strategy. 【Results】 The serology results of blood type of 7 samples were similar, with B(A)04/O01 in 3 cases, B(A)04/O02 in 2 cases and B(A)02/O01 in 2 cases. 7 cases of B (A) subtypes were matched with randomly selected blood donors of type O and B on the major side. 【Conclusion】 B(A) subtypes should be identified by genotyping techniques. Washed RBCs of type B and O can be used for B(A) blood type transfusion.

Objective:To evaluate the effect of esmketamine for labor analgesia on the occurrence of postpartum depression (PPD).Methods:Two hundred and forty-two cases of nulliparous parturients who selected natural labor and agreed to receive labor analgesia were selected and divided into conventional labor analgesia group (C-LA group, n=119) and esmketamine-based labor analgesia group (E-LA group, n=123). The epidural labor analgesia solution contained ropivacaine 100 mg and sufentanil 30 μg in 100 ml of normal saline in C-LA group. The epidural labor analgesia solution contained ropivacaine 100 mg, sufentanil 30 μg and esketamine 50 mg in 100 ml of normal saline in E-LA group. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen parturients for depression on admission to the predelivery room and at 2 h and 1, 7 and 42 days after delivery, and EPDS scores were recorded. The patients were diagnosed as having PPD when EPDS score ≥ 9 at 7-42 days after delivery. Peripheral venous blood samples were collected on admission to the predelivery room and at 1 day after delivery to determine the concentrations of serum estrogen, progesterone, 5-hydroxytryptamine and cortisol by enzyme linked inmunosorbent assay. Results:Compared with group C-LA, the EPDS scores were significantly decreased on the 1 and 42 days after delivery( P<0.01), no significant change was found in the incidence of PPD (1.7%/0.8%, P>0.05), no significant change was found in the concentrations of serum estrogen, progesterone, 5-hydroxytryptamine and cortisol on admission to the delivery room ( P>0.05), and the concentrations of serum progesterone and cortisol were significantly increased on 1 day after delivery in group E-LA ( P<0.05). Conclusions:Combination of esketamine is helpful in reducing the risk of postpartum depression when used for epidural labor analgesia, and the mechanism is related to slowing the declines in blood levels of sex hormones and stress hormones after delivery.

Objective:To prepare specific molecular probe 18F-AlF-1, 4, 7-triazacylononane-1, 4, 7-triacetic acid-(polyethylene glycol) 4-ZD2 ( 18F-AlF-NOTA-PEG 4-ZD2) for targeting extradomain-B fibronectin (EDB-FN), and evaluate its properties in vitro and in vivo. Methods:18F-AlF-NOTA-PEG 4-ZD2 was prepared by one-step chelation labeling with Al 18F. The radiochemical purity and in vitro stability were determined by high performance liquid chromatography (HPLC). The partition coefficient (logP) of 18F-AlF-NOTA-PEG 4-ZD2 was evaluated, and the cell uptake experiment was carried out (triple-negative breast cancer (MDA-MB-231) cells (1×10 6/tube) were divided into 3 groups ( n=3 per group); positive group, inhibition group, control group). MicroPET imaging was performed on MDA-MB-231 bearing nude mice ( n=3) after 18F-AlF-NOTA-PEG 4-ZD2 injection (30, 60, 90, 120 min) and compared with blocking group ( n=3, NOTA-PEG 4-ZQ 2 was preinjected at 0.5 h before 18F-AIF-NOTA-PEG a-ZD2 injection). Independent-sample t test was used to analyze the data. Results:18F-AlF-NOTA-PEG 4-ZD2 was successfully prepared. The optimized radiochemical yield was (33.8±2.1)% (undecay corrected, n=8) and the radiochemical purity was >96%. After incubating 120 min at 37 ℃, the radiochemical purity of 18F-AlF-NOTA-PEG 4-ZD2 in human serum and PBS was >93%, indicating its good stability in vitro. The specific activity was (11.1±3.2) GBq/μmol, and logP was -1.43±0.05. The uptake value of tumor cells was (1.77±0.28) percentage applied activity (%AR)/10 6 cells at 120 min post-injection in positive group, and the total uptake value of the inhibition group was (0.76±0.07) %AR/10 6 cells ( t=4.30, P=0.032). MicroPET imaging in tumor bearing nude mice showed that 18F-AlF-NOTA-PEG 4-ZD2 was mainly metabolized by the liver and kidneys. The tumor uptake value was (1.94±0.21) percentage activity of injection dose per gram of tissue (%ID/g) at 60 min post-injection and the tumor/muscle ratio was 3.80±0.25 at 90 min post-injection in the experimental group, while the tumor uptake value of tumor bearing nude mice in the blocking group was (0.43±0.09) %ID/g at 60 min post-injection ( t=3.18, P=0.006). Conclusions:18F-AlF-NOTA-PEG 4-ZD2 can be prepared simply with high labeling rate and good stability in vitro, with high tumor uptake and tumor/muscle ratio in microPET imaging, and good specificity and long tumor residence time. The probe has good application prospect in breast cancer with high expression of fibronectin subtype EDB-FN.

Objective:To analyze the genotype distribution of acute hepatitis B virus in China.Methods:A total of six hundred and twenty acute Hepatitis B cases reported to China Information System for Diseases Control and Prevention from 2015 to 2017 were selected. First, the full-length HBV genome was obtained by nested PCR amplification. In addition, the HBV genotype was determined by constructing a phylogeny tree. Finally, using primarydata, HBV genotype distribution was analyzed.Results:A total of 519 (83.71%, 519/620) sequences were obtained genotype of 620 acute hepatitis B cases, including A (0.19%, 1/519), B (27.17%, 141/519), C (62.04%, 322/519), D (9.06%, 47/519), I (0.77%, 4/519) and C/D (0.77%, 4/519); B2(95.03%, 134/141) and C2 (72.67%, 234/322) were the two major subgenotypes. Genotypes were distributed differently in seven regions of China. The proportion of genotype C appeared higher in Northeast China (94.55%, 52/55), North China (93.85%, 61/65), East China (78.87%, 56/71), and South China (58.14%, 50/86). The proportion of genotype B was higher in Central China (58.07%, 36/62) and Southwest China (52.94%, 45/85), the proportion of genotype D was the highest in Northwest China (48.42%, 46/95). A total of 515 cases were classified as serotypes, including 'adr' (57.48%, 296/515), 'adw' (30.87%, 159/515), 'ayr' (0.19%, 1/515), and 'ayw' (11.46%, 59/515). Genotype B was dominated by 'adw' serotype (92.14%, 129/140), genotype C was dominated by 'adr' serotype (91.88%, 294/320),all genotype D were 'ayw' serotype. The genotype of acute hepatitis B was correlated with serotype, 'adw' was dominant in genotype B, 'adr' was dominant in genotype C and 'ayw' was dominant in genotype D.In different gender and age group, there was no statistical significance ingenotype distribution ( P>0.05). Conclusions:The genotype of acute hepatitis B in China from 2015 to 2017 was mainly B, C, and D; genotype C was dominant in the Northeast China,North China, East China and South China; B and C were common in Central and Southwest China, and genotype B was dominant. Genotype D was primarily distributed in Northwest China. The genotype of acute hepatitis B was correlated with serotype, 'adw' was dominant in genotype B, 'adr' was dominant in genotype C and 'ayw' was dominant in genotype D. There was no difference in the distribution of acute hepatitis B genotypes among different genders and age groups.

Objectives:To understand the awareness rate and its influencing factors of their HBV infection status among HBsAg-positive persons aged 15-69 years in China.Methods:A cross-sectional design was used to conduct a questionnaire survey on the awareness of their infection status among HBsAg-positive persons aged 15-69 years who were identified in the 2020 national hepatitis B seroepidemiology survey. The awareness rate of the whole respondent and respondents with different characteristics were described, and the differences were compared with the χ2 test. The logistic regression model was used to analyze the factors influencing the awareness rate. Results:The overall awareness rate among the respondents was 43.10% (1 828/4 241). The awareness rate was lower in males than in females (41.30% vs. 44.65%). The awareness rate was lower in the 60-69-years-old age group than in other age groups (30.38% vs. 36.77%-57.58%). The awareness rate was lower in rural areas than in urban areas (39.43% vs. 47.32%). The awareness rate was lower in regions with a per capita gross domestic product (GDP) below RMB 54 000 than in regions with a per capita GDP of RMB 54 000 and above (36.81% vs. 41.61%-50.30%). The awareness rate was lower in respondents without other liver diseases than with other liver diseases (41.52% vs. 60.68%). The awareness rate was lower in respondents without a family history of hepatitis B-related disease or unknown family history than with a family history (43.58% vs. 68.26%; 24.71% vs. 68.26%). Multivariate logistic regression analysis showed that male [odds ratio ( OR)=0.841, 95% confidence interval ( CI): 0.734-0.964], high school and below [primary school and below, junior middle school, high school/technical secondary school, OR (95% CI): 0.247 (0.190-0.321), 0.451 (0.352-0.577), 0.634 (0.486-0.827)], rural areas ( OR=0.822, 95% CI: 0.715-0.945) and regions with a per capita GDP below RMB 80 000 [54 000-80 000, OR (95% CI): 0.810 (0.688-0.954), below RMB 54 000, OR (95% CI): 0.793 (0.669-0.941)] were the negative factors influencing the awareness rate. While 30-39-years-old ( OR=2.089, 95% CI: 1.626-2.683) and 40-49-years-old ( OR=1.590, 95% CI: 1.250-2.023) age groups, with other liver diseases ( OR=2.244, 95% CI: 1.754-2.871) and family history related to hepatitis B ( OR=2.688, 95% CI: 2.242-3.223) were the positive factors influencing the awareness rate. Conclusion:The overall awareness rate of their infection status among HBsAg-positive persons aged 15-69 years is 43.10% in China. Health promotion and coverage expansion on HBV screening should be further strengthened to achieve the proposed World Health Organization's target of 90% HBV infection diagnosis rate by 2030.