Objective:To investigate the value of systemic inflammatory response syndrome (SIRS), pediatric sequential organ failure assessment (pSOFA) and pediatric critical illness score (PCIS) in predicting mortality of pediatric sepsis in pediatric intensive care units (PICU) from Southwest China.Methods:This was a prospective multicenter observational study. A total of 447 children with sepsis admitted to 12 PICU in Southwest China from April 2022 to March 2023 were enrolled. Based on the prognosis, the patients were divided into survival group and non-survival group. The physiological parameters of SIRS, pSOFA and PCIS were recorded and scored within 24 h after PICU admission. The general clinical data and some laboratory results were recorded. The area under the curve (AUC) of the receiver operating characteristic curve was used to compare the predictive value of SIRS, pSOFA and PCIS in mortality of pediatric sepsis.Results:Amongst 447 children with sepsis, 260 patients were male and 187 patients were female, aged 2.5 (0.8, 7.0) years, 405 patients were in the survival group and 42 patients were in the non-survival group. 418 patients (93.5%) met the criteria of SIRS, and 440 patients (98.4%) met the criteria of pSOFA≥2. There was no significant difference in the number of items meeting the SIRS criteria between the survival group and the non-survival group (3(2, 4) vs. 3(3, 4) points, Z=1.30, P=0.192). The pSOFA score of the non-survival group was significantly higher than that of the survival group (9(6, 12) vs. 4(3, 7) points, Z=6.56, P<0.001), and the PCIS score was significantly lower than that of the survival group (72(68, 81) vs. 82(76, 88) points, Z=5.90, P<0.001). The predictive value of pSOFA (AUC=0.82) and PCIS (AUC=0.78) for sepsis mortality was significantly higher than that of SIRS (AUC=0.56) ( Z=6.59, 4.23, both P<0.001). There was no significant difference between pSOFA and PCIS ( Z=1.35, P=0.176). Platelet count, procalcitonin, lactic acid, albumin, creatinine, total bilirubin, activated partial thromboplastin time, prothrombin time and international normalized ratio were all able to predict mortality of sepsis to a certain degree (AUC=0.64, 0.68, 0.80, 0.64, 0.68, 0.60, 0.77, 0.75, 0.76, all P<0.05). Conclusion:Compared with SIRS, both pSOFA and PCIS had better predictive value in the mortality of pediatric sepsis in PICU.

Objective: To identify the lifestyle pattern of adolescents in Guangzhou and to provide a scientific basis for targeted and individualized interventions for adolescents with different lifestyle pattern. Methods: A survey was conducted by questionnaire among 12 540 students from 27 middle schools in the urban area of Guangzhou using a convenient sampling method. The latent class model (LCM) was used to identify lifestyle patterns of adolescents, and further analyses were conducted to compare differences in dietary habits and willingness to exercise among the different classes. Results: Three lifestyle patterns were identified based on the latent class model: "high sweet snacks/excessive screen time, sleep and exercise deficiency group", 3 797 people, accounting for 30.3%; "low nutrition diet/severe sleep and exercise deficiency group", 2 745 people, accounting for 21.9%; "general diet/sleep and exercise deficiency group", 5 998 people, accounting for 47.8%. Adolescents of different classes had different perceptions of their eating habits and different degrees of willingness to participate in physical exercise, these differences were statistically significant(χ 2=671.54, Z=153.16, P<0.05). Conclusion The results of the latent class model showed that the three classes of adolescents had their own unique characteristics. It is necessary to inform them of their needs, provide guidance and implement targeted interventions according to the unique characteristics of the different lifestyle patterns in empirical work.

Recently, liposomes have been widely used in cancer therapeutics, but their anti-tumor effects are suboptimal due to limited tumor penetration. To solve this problem, researchers have made significant efforts to optimize liposomal diameters and potentials, but little attention has been paid to liposomal membrane rigidity. Herein, we sought to demonstrate the effects of cholesterol-tuned liposomal membrane rigidity on tumor penetration and anti-tumor effects. In this study, liposomes composed of hydrogenated soybean phospholipids (HSPC), 1,2-distearoyl--glycero-3-phosphoethanolamine--[methoxy(polyethylene glycol)-2000] (DSPE-PEG) and different concentrations of cholesterol were prepared. It was revealed that liposomal membrane rigidity decreased with the addition of cholesterol. Moderate cholesterol content conferred excellent diffusivity to liposomes in simulated diffusion medium, while excessive cholesterol limited the diffusion process. We concluded that the differences of the diffusion rates likely stemmed from the alterations in liposomal membrane rigidity, with moderate rigidity leading to improved diffusion. Next, the tumor penetration and the anti-tumor effects were analyzed. The results showed that liposomes with moderate rigidity gained excellent tumor penetration and enhanced anti-tumor effects. These findings illustrate a feasible and effective way to improve tumor penetration and therapeutic efficacy of liposomes by changing the cholesterol content, and highlight the importance of liposomal membrane rigidity.

Objective To compare and study the two kinds of quality control methodologies related to intelligent quality management system ( iQM) and traditional quality control , and the quality control performance of iQM equivalent to traditional quality control were evaluated , ensuring the accuracy of the results of blood gas testing.Methods Beijing Chaoyang Hospital of Capital Medical University , Beijing Tiantan Hospital of Capital Medical University , Shanghai Longhua Hospital of Shanghai University of Chinese Medicine, and Sichuan Provincial People′s Hospital, these 4 medical institutions were selected to implement this study.During the period from June 2016 to December 2016, in the routine detection of total 3 712 specimen, the iQM and traditional quality control modes were used simultaneously to calculate the mean values of all blood gas parameters quality controls , SD, CV (%) and Sigma values, to evaluate the quality control performance and difference of the two quality control modes .Results During the process of testing blood gas samples from 3 712 specimen in 4 hospitals, iQM process control solution ( PCS) A, B, C ran 1 089, 7 678 and 154 quality control samples respectively , and 732 external quality control samples were run by traditional quality control mode .Considering the most sensitive parameters of blood gas testing pO 2, iQM PCS A, B, C′s Sigma value are higher than 8, however, the traditional quality control′s Sigma value are less than 6; For parameters pCO2, pO2and Na+, there exists significant difference between two quality control methods (P＝0.004 8,P＝0.000 1,P＝0.004 4,P＜0.01), other parameters pH, K+, Ca ++, Glu, Lac and Hct, there exists no significant difference between two quality control methods (P＝0.250 6, P＝0.062 3,P＝0.034 0,P＝0.346 9,P＝0.186 3,P＝0.823 1,P＞0.01).Totally 22 errors detected by iQM, includes 14 micro-clots and 8 interferences samples, which were not detected by traditional quality control .Conclusions The error in blood gas analysis mainly comes from the pre-analytical phase.iQM enhanced specimen inspection capabilities and make up for the inability of traditional quality control to monitor the quality of specimens , enabling full-scale, real-time, and dynamic monitoring of each specimen , powerful error detection capabilities , and automatic error correction capabilities . Besides, automatic documentation saves staff much time.The system can effectively ensure the accuracy of blood gas test results, meet the quality requirements of related laws and regulations and related industry standards , and also can meet the clinical intended use , providing new ideas for POCT quality management and improvement.

Objective To investigate the diurnal rhythms of fetal heart rate in third trimester of pregnancy. Methods From June 2014 and October 2017,97 cases of low-risk pregnancy women who received antenatal care and deliveried in Peking University Third Hospital were collected. Totally 130 cases of fetal heart rate and maternal holter monitoring data were analyzed. All cases were singleton pregnancy, cephalic position and had normal perinatal outcome. They were divided into three groups based on gestational age, 29 cases(22.3%,29/130)in pregnancy 28-33+6weeks, 37 cases(28.5%,37/130)in 34-36+6weeks, and 64 cases (49.2%, 64/130)in 37-40+6weeks. Fetal heart baseline (FHB), fetal heart baseline variation (FHBV), fetal heart rate acceleration area and maternal heart rate were acquired by computer, their diurnal rhythms and the differences among three groups were analyzed. Results FHB、FHBV、fetal heart rate acceleration area and maternal heart rate all presented diurnal rhythms.(1)FHB rose in daytime and decreased at night with the minimum value at 2:00-5:00, and didn′t decline further at night with the advancing of gestational age(P=0.548).(2)FHBV was similar to FHB, which rose in daytime and decreased at night, but declined smaller at night with the advancing of gestational age, especially after 37 weeks (P<0.01).(3)Fetal heart rate acceleration area reduced in daytime and enlarged at night, and enlarged more with the advancing of gestational age.(4)The diurnal rhythm of maternal heart rate was consistent with fetal heart rate. FHB lagged behind maternal heart rate for 1-2 hours when declining to the nocturnal nadir but been basically in sync with maternal heart rate when recovered. Conclusion The basic characteristics of fetal heart rate in normal pregnancy exist obviously diurnal rhythms, and change in different trends with the advancing of gestational age.

Objective To systematically evaluate the risk factors for ovarian metastasis of endometrial carcinoma(EC) to provide an evidence-based medicine basis for formulating the EC surgical mode and ovarian metastatic risk.Methods Studies about the risk factors for EC ovarian metastasis were retrieved by computer from the Pubmed,Embase,Cochrane Library,WanFang database,CNKI,China Biology Medicine(CBM) from Jan.1,1990 to Sep.1,2016.The quality evaluation of included literature was performed by using the Newcastle-Ottawa Scale(NOS).Results A total of 13 studies were included,involving 6 140 EC patients,of whom 344 cases(5.60％) had ovarian metastasis.The Meta analysis results showed that a total of 9 factors had statistical significance,which were deep myometrial infiltration(OR =0.28,95 ％ CI:0.21-0.39),cervical involvement (OR =0.27,95 ％ CI:0.16-0.45),lymph node involvement (OR =0.21,95 ％ CI:0.15-0.27),fallopian tube involvement (OR =0.05,95 ％ CI:0.02-0.10),non-endometrioid adenocarcinoma(OR=0.32,95％CI:0.24-0.43),low differentiation(OR=0.39,95％CI:0.31-0.50),positive ascites cytologic detection(OR=0.14,95％CI:0.09-0.20),high serum CA125 level(OR=0.12,95％CI:0.08-0.19) and lymphovascular cancer embolus(OR =0.34,95 ％ CI:0.23-0.50),the differences were statistically significant(P＜0.05).But the age,lesion location,lesion diameter and estrogenic receptor level had no statistical difference(P＞0.05).Conclusion Deep myometrial infiltration,cervical involvement,lymph node involvement,fallopian tube involvement,non-endometrioid adenocarcinoma,low differentiation and positive ascites cytologic detection,high CA125 level and lymphovascular cancer embolus are the risk factors for EC ovarian metastasis.

Objective:To explore the treatment effect on EMT in rats using different doses of letrozole and Medroxyprogesterone acetate (MPA) and their effects on liver,renal,skeletal and reproductive system.To provide lab evidence for treatment of EMT before menopause using letrozole.Methods:Endometriotic rat model was set up by surgical transplantation of autologous uterine tissues to ectopic site outside the uterus.70 EM model rats were randomly divided into 7 groups,each with 10:A ～C:LE 1 mg/(kg · d-1) and MPA [8、4、2 mg/(kg · d-1) respectively];D ～ F:LE 0.5mg/(kg · d-1) and MPA[8、4、2 mg/(kg · d-1) respectively];G:0.9％ saline (control group).The volume of ectopic lesion in each group was compared before and after the treatment.The expression of P450arom and Ki-67 and cell apoptosis in the endometriotic tissues of the rat models were detected.The serum levels of FSH,LH and E2 were determined and liver and renal functions were detected.Bone mineral density(BMD) was measured in the right femur.Results:①Except for group F,the volume of the endometriotic tissues of the five groups reduced significantly compared with the G group(P ＜ 0.05),and the greatest decrease in the volume were in group A and B (P＜0.01);②Compared with the G group,the expression of P450arom and Ki-67 protein decreased while the apoptotic rate increased in tissues of endometriosis (EM) on rat models among group A to group E (P＜0.05),in which group A and B were the most notable (P＜0.01);(③Compared with the G group,the level of FSH,LH and E2 reduced in group A、B and D (P＜0.05),moreover,the E2 level of group A and B was lower than that in group D (P＜0.05);④Compared with the G group,the ovarian weight in group C increased greatly,and the ovaries showed polycystic.The uterine weights decreased among group A to group E,and the endometrium presented atrophy or inhibition of proliferation;⑤There was no change on the bone density among each group(P ＞ 0.05);⑥Abnormal liver function was only detected in group A after treatment,and no ab normal renal function detected in any group(P＞0.05).Conclusions:LE 1 mg/(kg · d-1) associated with MPA 4mg/(kg · d-1) had the most effect on EM rat models.Moreover,it had no influence on liver or renal function.The mechanism may be decreasing the serum level of E2,reducing local estrogen along with increasing the apoptosis while decreasing the proliferation of the ectopic tissues.

Objective To investigate the role of p16,Ki-67 and human papilloma virus(HPV)type in the shunt treatment of cervical intraepithelial neoplasia (CIN) Ⅱ. Methods The paraffin block on file and the pathological results from loop electrosurgical excision procedure (LEEP) of 377 CIN Ⅱpatients diagnosed with colposcope examination accompanied by cervical high-risk HPV infection in the Affiliated Hospital of Inner Mongolia Medical University of Obstetrics and Gynecology Department from January 2014 to October 2016 were collected. The paraffin sections were stained with p16 and Ki-67 immunohistochemistry. The correlation between the expression of p16 and Ki-67 in biopsy tissues and the pathological results after LEEP was analyzed.HPV type and pathological results after LEEP were also analyzed.Results LEEP postoperative pathological grade in 337 cases of CINⅡpatients was divided into two groups(＜CINⅡ and ≥CINⅡ). There was no statistical difference in age between the two groups (t = 3.078, P = 0.063). There were statistical differences in the expressions of p16+and Ki-67+between the two groups[3.6 %(8/233) vs. 88.5 % (92/104), χ 2=235.54,P<0.001; 3.0 %(7/233) vs. 76.9 % (80/104), χ 2= 197.63, P< 0.001]. There was a statistical difference in HPV infection type between the two groups (χ2= 12.713, P = 0.005). The sensitivity and specificity of p16+and Ki-67+for LEEP postoperative≥CINⅡ was 88.89 % vs.77.78 % and 95.96 % vs.95.80 % respectively. There was a statistical difference in group type of p16 and Ki-67 in both groups (χ2=304.28, P< 0.001). The sensitivity of p16+Ki-67+was 90.73 % and the specificity was 98.74 % in CINⅡpatients for LEEP postoperative. Conclusions The expressions of p16 and Ki-67 can guide the colposcopic biopsy for the treatment of CINⅡ. For CINⅡpatients with p16+Ki-67+, the active treatment should be taken. Close observation needs to follow for p16 and Ki-67 single negative or double negative patients. Active treatment should be performed for CINⅡpatients with HPV16 type infection in CINII. Age can not be used as the basis for the patients with shunt CINⅡ.

Objective To construct the lentiviral RNA interference vector targeting TPX2 and to obtain the human cervical cancer HeLa cell strain stably infected by TPX2-shRNA for studying the relationship between human cervical carcinoma and TPX2 gene.Methods By targeting TPX2 gene,four double-stranded DNA hairpin structures corresponding to shRNA were designed,synthesized and connected with Pglv2-U6-Puro to construct the recombinant plasmids.Then these recombinant plasmids were transformed into DH5α competent cells.The positive clone was extracted and transfected into 293T cells for virus packages after sequenced correctly.Human cervical carcinoma HeLa cell infected by these recombinant lentiviral was screened by Puromycin,then stable cell strain was obtained.The silencing effect of TPX2 in HeLa cell was detected by RT-fluorescent quantitative PCR and Western blot.Cell cycle and cell apoptosis wer detected by Flow cytometry.Results Sequencing results confirmed that 5 lentiviral was packaged successfully.The steady cell strain transfered TPX2-shRNA was screened with 0.4 μg/mL puromycin.HeLa cells infected by recombinant lentivirus all play the gene silencing effect especially in the group of TPX2-shRNA-1.In the group of TPX2-shRNA-1,TPX2mRNA (0.21 ± 0.07) and protein (0.19 ± 0.28) rela tive expression level is lower than those in the control group (1.08±0.07) (P＜0.01) and(0.64±0.03) (P＜ 0.01)respectively;G2 and S-phase cells are higher than those in the control group (P＜0.05)and the apoptosis rate was significantly more than those in the control group (P＜0.05).Conclusions The effective TPX2 genetic interference sequence was obtained,lentiviral vectors carrying TPX2shRNA was successfully constructed,and the HeLa cell strain with TPX2 silenced was successfully screened,which lay the research foundation for the study of the role of TPX2 in cervical cancer.

Objective To compare the curative effect of laparoscopic and laparotomic operation for elderly Chinese women with cervical cancer. Methods The randomized controlled trials (RCT) and case controlled trials (CCT) were collected by searches of WanFang database, CNKI, VIP, China Biology Medicine (CBM) , PubMed. Data were extracted from these trials and data analysis was performed by RevMan 5.2.9. Results There were no RCTs, however, a total of 10 CCTs met the inclusion criteria and had data extracted for this review. The baseline characteristics of the laparoscopic group were similar to those of the laparotomic group. Comparing to laparotomic group, the laparoscopic group have longer operation time (MD =32.60, 95%CI: 5.65~59.55, P = 0.020), less amount of bleeding (MD = -94.01, 95%CI: -130.65 ~ -57.37, P = 0.000), smaller number of lymph node dissection(MD = 1.69, 95%CI: 0.67 ~ 2.72, P = 0.001), earlier anus exhaustion (MD=-17.09, 95%CI: -21.19 ~ -12.98, P = 0.000) and shorter hospital stays (MD = -4.30, 95%CI: -5.57 ~ -3.02, P = 0.000). There was significant difference between the two groups. But there was no statistical significance in postoperative indwelling catheter time (MD = -0.67, 95%CI: -1.92 ~ 0.58, P = 0.290) and surgical complications incidence (OR=0.62, 95%CI: 0.27 ~ 1.42, P = 0.260) between the two groups. Conclusion Laparoscopic management has the advantages of less traumatic and recovered quickly, and did not increase the incidence of complications. Laparoscopic operation is an ideal procedure for elderly Chinese women with cervical carcinoma.