Objective To analyze the risk factors for catheter-associated urinary tract infection (CAUTI) in elderly critically ill patients and construct a related risk prediction model. Methods Clinical materials of 8 905 patients with catheterization in the geriatric ICU ward of Jiangsu Provincial People's Hospital from January 2014 to June 2024 were retrospectively collected. The patients were divided into infection group (n=114) and non-infection group (n=8 791) based on the occurrence of CAUTI. Multivariate Logistic regression analysis was used to identify the risk factors for CAUTI, and a Nomogram prediction model was constructed. Internal validation was performed by the receiver operating characteristic (ROC) curve, calibration curve, and Hosmer-Lemeshow goodness-of-fit test to assess the discrimination and calibration of the prediction model. Results In this study, the incidence of CAUTI in elderly critically ill patients was 2.55‰. Multivariate Logistic regression analysis showed that age, consciousness status, renal dysfunction, duration of catheterization, and the number of catheter insertions were independent influencing factors for CAUTI in elderly critically ill patients. A Nomogram model was constructed based on the results of the regression analysis. Area under the curve (AUC) of ROC curve for internal validation by the Bootstrap method was 0.802 (95%CI, 0.796 to 0.809). The calibration curve was close to the standard curve, and the predicted values were generally consistent with the actual values, demonstrating good predictive performance of the model. Conclusion Age, renal dysfunction, consciousness status, duration of catheterization, and the number of catheter insertions are independent influencing factors for CAUTI in elderly critically ill patients. Nomogram prediction model established based on these factors is simple and feasible, with reliable predictive performance.

Objective: To study the current situation of sleep quality of senior high school students and analyze the influencing factors, so as to provide a reference for targeted sleep quality improvement of high school students. Methods: A total of 4 793 senior high school students of different grades were recruited from four different regions (Shanghai, Qinghai, Macao, Henan) in 2020. The information of demographic, sleep status, mental factors, living habits and other information were collected by questionnaire. Descriptive statistics and Logistic regression were used to analyze sleep quality and its influencing factors of the senior high school students. Results: About 24.2% of senior high school students reported sleep problems and 71.4% slept less than 7 hours at night. Interpersonal sensitivity, depression, anxiety symptoms, learning, family and interpersonal stress had significant effects on sleep problems in senior high school students( χ 2=1 147.98, 1 228.35, 1 032.54, 371.05, 497.61, 475.39, P <0.01). Drinking coffee and tea, drinking alcohol, smoking (including secondhand smoke), long term use of electronic products, late sleep, bedtime diet, poor sleep environment, parents with sleep problems were the risk factors for sleep disorders of senior high school students, regular exercise was the protective factors for sleep disorders of senior high school students, the influence was significant ( χ 2=160.28, 127.73 , 108.02, 113.27, 470.91, 340.95, 72.02, 155.53, 116.30, 76.96, 28.75, 12.89, P <0.05). Conclusion The sleep quality of senior high school students needs to be improved. Schools and parents should pay attention to the mental health and living habits of senior high school students to help them improve their sleep quality and grow up smoothly.

Organophosphorus flame retardants (OPFRs) pollution and its impacts on human health are of global concern. The review briefly reviewed the current state-of-knowledge on exposure assessment and epidemiological evidence of OPFRs-related health effects. Specifically, this paper provided an overview and comparison of the levels of respiratory and gastrointestinal exposure to OPFRs and their body burden in different populations worldwide; summarized potential adverse effects of long-term low-level OPFRs exposure on children's neurodevelopment, adults' reproductive system, and thyroid function. Available epidemiological studies have revealed that the OPFRs exposure level of Chinese population is low, and rice consumption may be a potential source of exposure to OPFRs; OPFRs such as tris (1-chloro-2-propyl) phosphate (TCIPP) and tris (2-chloroethyl) phosphate (TCEP) have both neurotoxicity and reproductive toxicity, and possibly affect the thyroid function in adults and increase the risk of wheezing and eczema in children. Finally, the future research focus on population exposure and health effects of OPFRs was prospected.

OBJECTIVE: To investigate whether DNMT1 protein induces retinoblastoma proliferation by silencing MEG3 gene. METHODS: Two retinoblastoma cell lines (HXO-RB44 and SO-RB50) and a normal human retinal pigment epithelial (RPE) cell line were transfected with the plasmid pcDNA-DNMT1 or si-DNMT1 for up-regulating or interference of DNMT1 expression, and with pcDNA-MEG3 or si-MEG3 for up-regulating or interference of MEG3 expression. Western blotting was used to detect the changes in the expression of DNMT1 protein in the transfected cells, and CCK-8 and EdU assays were used to detect the changes in cell proliferation. Real-time quantitative PCR (qRT-PCR) was performed to detect MEG3 expression in SO-RB50 and HXO-RB44 cells after transfection, and the methylation level of MEG3 gene promoter after interference of DNMT1 expression was detected using methylation-specific PCR. RESULTS: SO-RB50 and HXO-RB44 cells showed significantly increased expression of DNMT1 protein as compared with normal RPE cells ( < 0.05). In HXO-RB44 cells, transfection with pcDNADNMT1 resulted in significantly increased expression of DNMT1 protein, enhanced cell proliferation ability, and significantly reduced expression of MEG3 ( < 0.05). In SO-RB50 cells, transfection with si-DNMT1 significantly reduced the expression of DNMT1 protein, suppressed the cell proliferation, and increased MEG3 expression ( < 0.05). Interference of DNMT1 significantly reduced the methylation level of MEG3 gene promoter. After reversing the regulatory effect of DNMT1 on MEG3 gene, DNMT1 protein showed significantly weakened ability to regulate retinoblastoma cell proliferation ( < 0.05). CONCLUSIONS In retinoblastoma cells, the up-regulation of DNMT1 protein induces promoter methylation and inactivation of MEG3 gene and eventually leads to abnormal cell proliferation.

Objective To evaluate the safety of morphine hydrochloride injection. Methods Ear verin injection was used to evaluate the vascular irritation using the comparison of left side with right side in rabbits. Quadriceps femoris injection was used to evaluate the muscle irritation using the comparison of left side with right side in rabbits. Guinea pigs were intravenously injected with morphine hydrochloride injection at a dose of 2.8 mg·kg-1 once daily 3 times, stimulation was performed on 14 d after the last sensitization and the booster dose was 2 times the sensitization dose. The allergic reactions were observed. The different concentrations of morphine hydrochloride injection were placed in 2％ rabbit erythrocyte suspension, and then the hemolyzation and agglutination were observed. Results There were no significant vascular or muscular irritation and injury effects of morphine hydrochloride injection in rabbits. There were no evidenceof hemolyzation and agglutination in rabbit erythrocytes in vitro. No allergic reactions on guinea pigs in vivo were observed. Conclusion After treatment of morphine hydrochloride injection, neither obvious vascular /muscle stimulation or sensitization, nor hemolyzation or agglutination appeared in rabbits. The research results provide basic reference for the clinical rational and safe application of morphine hydrochloride injection.

Objective To explore the detection rate ,types ,accompanying abnormalities and prognosis of fetal congenital heart disease(CHD) in a single center in northwest China ,in order to set up a foundation for further studying the epidemiological characteristics of fetal CHD and integrated management of fetal CHD in the prenatal and postnatal . Methods A total of 2725 CHD in 45015 fetus diagnosed by fetal echocardiography were enrolled . The fetal CHD detection rate and the composition ratio were calculated . Follow-up results between the simple CHD and complex CHD were analyzed . Results The detection rate of fetal CHD in our center was up to 6 .1％ . There were 1589 cases of complex CHD ,accounting for 58 .3％ in all the fetal CHD ,of which the most common type was single ventricle ,followed by tetralogy of Fallot , atrioventricular septal defect and double outlet right ventricle ;Simple CHD 1136 cases ,accounting for 41 .7％ in all the fetal CHD ,the most common type was ventricular septal defect . The number of abortion cases ,intrauterine and postnatal natural deaths of fetal CHD accounted for 60 .3％ ( 1357/2251) of the total follow-up ,of which complex CHD and chromosomal abnormalities accounting for the majority . 68 cases of CHD underwent surgical treatment after birth ,of which complex CHD were predominant . 37 cases of simple CHD spontaneous closure and 27 cases of simple CHD genetic test results were abnormal . Conclusions The detection rate of CHD in this group is relatively high ,which is related to the prenatal diagnosis consultation center . Fetal complex CHD is more common while the prognosis is worse than simple CHD . Prenatal and postnatal integrated management of fetal CHD has important clinical value in early treatment of complex CHD .

Objective To explore the expression of peripheral T cell subgroup (CD3+,CD4+,CD8+,CD4+CD25 high regulatory T cells) and the level and significance of serum cytokines in patients with silicosis.Methods One hundred and six cases patients with silicosis were collected in the Fifth People''s Hospital of Suzhou as study subjects and 56 healthy subjects as control group.Flow cytometry was used to detect the peripheral CD3+,CD4+,CD8+ and CD4+CD25 high regulatory T cells (Treg) of the patients and the control group,while chemiluminescence immunoassay was utilized to measure the peripheral serum soluble interleukin-2 receptor (sIL-2R),interleukin 6 (IL-6),interleukin 8 (IL-8) and tumor necrosis factor α (TNF-α).Results (1) The percentages of peripheral CD3+,CD4+ and CD8+ in the silicosis group were all lower than those in the control group (t=3.755,3.828,2.347,P<0.05);the percentage of Treg cells was higher in the silicosis group than in the control group,the difference was statistically significant (t=-8.345,P<0.05).Compared with the control group,based on the one-way analysis of variance,the differences in CD3+,CD4+,CD8+ and CD4+CD25 high cells were all statistically significant (F=5.620,8.007,26.71,P<0.05);in the silicosis group,the percentage of CD4+ T cells was lower in stage III than in stage I (t=3.424,P<0.05);compared with the control group,the percentages of Treg cells in the silicosis group were lower in all stages (t=-7.934,-9.445,-5.096,P<0.05).(2) The levels of peripheral sIL-2R,IL-6,IL-8 and TNF-α in the silicosis group were higher than those in the control group,the difference were statistically significant(t=-6.952,-4.506,-2.551,-5.670,P<0.05);compared with the control group,based on the one-way analysis of variance,the differences in sIL-2R,IL-6 and TNF-α in all stages were statistically significant (F=11.03,11.31,13.22,P<0.0001);the sIL-2R was higher in patients with stage III silicosis than that of stage I (t=-2.882,P<0.05);IL-6 was significantly higher in stage II and III silicosis group than that of stage I group (t=-3.022,-2.632,P<0.05),and TNF-α was higher in patients with stage II silicosis than patients with stage I silicosis (t=-2.322,P<0.05).(3) The level of peripheral Treg cells was negatively correlated with the percentages of CD3+ and CD8+ cells in patients with silicosis (r=-0.357,-0.508,P<0.05);sIL-R2 was positively correlated with IL-6,IL-8 and TNF-α,respectively (r=0.483,0.199,0.392,P<0.05);TNF-α was positively correlated with IL-6 and IL-8,respectively (r=0.338,0.338,P<0.05).Conclusion Patients with silicosis have abnormal expression in peripheral T cell subgroups,significantly increased Treg cell and dysfunctional cytokines,which may be associated with the pathogenesis of silicosis,the detection of these indicators may have significance of diagnosis,staging,disease monitoring and prognosis of the diseases.

Objective To investigate the development of early myocardial perfusion with myocardial contrast echocardiography (MCE) combined with dipyridamole stress echocardiography in diabetic rats . Methods The diabetes mellitus (DM) group comprised 40 male diabetic rats ,induced with streptozotocin . The control group comprised 40 normal male rats ,comparable body weights with the DM group .The DM group was divided into four subgroups (0 week ,2 weeks ,4 weeks and 8 weeks after diabetic model established) and the control group was also divided into four subgroups matched with the DM group .Each rat was performed with conventional echocardiography ,MCE at baseline and after dipyridamole stress .The reserve parameters were compared between the control group and the DM group .In addition ,the differences among four subgroups in the control group and the DM group were compared ,respectively .Results MCE demonstrated that the 4 weeks and 8 weeks DM subgroup had lower myocardial blood velocity reserve and myocardial blood flow reserve than the control subgroup .The myocardial blood volume reserve was reduced in the 8 weeks DM subgroup ,too .Conclusions The impairment of myocardial perfusion in the DM rats are detected earlier with the MCE combined with dipyridamole stress .

Objective To describe the expressions of programmed death-1 (PD-1) and its ligand PD-L1 on the surface of peripheral blood lymphocytes in patients with tuberculosis.Methods A total of 77 cases of pulmonary tuberculosis were recruited,of which 27 were single infection,41 were coincident with bacterial or fungal infection and 9 patients with diabetes mellitus.Twenty-nine healthy donors were also enrolled as control group.The expressions of PD-1/PD-L1 on the peripheral blood lymphocytes and mononuclear cells were detected using immunostaining and flow cytometry.Collected data were analyzed with t-test statistics.Results Among the three groups of tuberculosis including pulmonary tuberculosis,pulmonary tuberculosis coincident with infection and pulmonary tuberculosis with diabetes mellitus,the percentages of CD4+ CD25+ T cells as well as CD4+ CD25high T cell subsets were both significantly higher than those in healthy controls (t=4.892,4.635,4.974,5.407,4.660,5.279,all P＜0.01).The expression of PD-1 was up regulated on the surface of CD8+ T cells in the groups of tuberculosis as compared with the control group (t=6.392,8.249,7.072,all P＜0.01).The proportions of PD-L1 expressed on the monocytes in each group were (42.51 ± 7.54) ％,(49.42± 6.29) ％ and (48.46 ± 14.58)％,respectively.The difference was significant in contrast to the control group,which was (17.91 ±3.03)％ (t=5.168,6.854,5.665,all P＜0.01).PD-L1 expression was also up-regulated on B cells in each group and much higher than that of the control group (51.51±7.32)％,(50.85±7.09)％,(55.66±14.29)％ vs (40.11±4.25)％ (t=2.562,2.046,2.766,all P＜0.05).Conclusion PD-1/ PD-L1 co-inhibitory pathway could be closely related to the development of tuberculosis and its complications,which is involved in the attenuation of anti-tuberculosis and anti infection immune responses.