Objective To investigate the expression of Toll-like receptor 2(TLR2)and Toll-like receptor 4(TLR4)in peripheral blood mononuclear cells(PBMC)in children with recurrent respiratory tract infection(RRTI)and its relationship with T helper cell 1(Th1)/T helper cell 2(Th2)immune response.Methods A total of 65 children diagnosed with RRTI who admitted to the hospital from December 2020 to December 2022 were enrolled in the study as the RRTI group,and 45 healthy children who underwent physical examination in the hospital during the same period were enrolled as the control group.The relative expression levels of TLR2 and TLR4 mRNA in PBMCs were detected by real-time fluorescence quantitative PCR(qPCR).The expres-sion rates of TLR2 and TLR4 protein in PBMCs were detected by flow cytometry.The levels of Th1 cytokine interferon-γ(IFN-γ),Th2 cytokine interleukin-4(IL-4)and their ratio(IFN-γ/IL-4)in plasma were detected by enzyme-linked immunosorbent assay(ELISA).Pearson correlation analysis was used to analyze the corre-lation between TLR2,TLR4 protein expression rates and plasma IFN-γ,IL-4 levels.Results The RRTI group had significantly higher plasma level of Th2 cytokine IL-4 than the control group,significantly lower plasma level of Th1 cytokine IFN-y than the control group,and significantly lower ratio of IFN-γ/IL-4 than the con-trol group,the differences were all statistically significant(P＜0.05).The relative expression levels of TLR2 and TLR4 mRNA and protein expression rates in PBMC of children in the RRTI group were higher than those in the control group,and the differences were statistically significant(P＜0.05).Pearson correlation analysis showed that the protein expression rates of TLR2 and TLR4 in PBMC of children with RRTI were both nega-tively correlated with both plasma IFN-γ levels and IFN-γ/IL-4(P＜0.05)and positively correlated with plasma IL-4 levels(P＜0.05).Conclusion The expression of TLR2 and TLR4 in PBMC and plasma Th1/Th2 cytokines in children with RRTI may be involved in the occurrence and development of the disease.Ex-cessive activation of TLR2 and TLR4 may weaken Th1 function and enhance Th2 function.

OBJECTIVE To assess the clinical profile,prognosis,and risk factors of extrapulmonary metastasis in adenoid cystic carcinoma patients.METHODS A retrospective analysis was conducted on 126 patients diagnosed with adenoid cystic carcinoma at Beijing Tongren Hospital between January 2002 and December 2020.Of these patients,21 cases had metastases outside the lungs as their initial site of metastasis,while 105 cases had lungs as the initial site of distant metastasis.In addition,clinical data of patients diagnosed with adenoid cystic carcinoma from the Surveillance,Epidemiology,and End Results(SEER)database in the United States from 2010 to 2019 were analyzed for prognosis.RESULTS Univariate analysis showed that factors such as N stage,neurological symptoms,pathological subtype,grading,Ki67,neural invasion,and p63 status were associated with extrapulmonary metastasis(χ2=5.385,9.888,20.485,15.579,8.711,5.476,5.280;all P values<0.05).Multivariate logistic regression analysis indicated that N stage,pathological grading,and neurological symptoms were correlated with an increased risk of extrapulmonary metastasis.Survival analysis indicated lower cumulative survival and progression-free survival rates in the initial extrapulmonary metastasis group(both P values<0.05).CONCLUSION The initial metastasis site in adenoid cystic carcinoma is associated with multiple factors including N stage,pathological grading,and neurological symptoms.Patients displaying a solid subtype and those accompanied by high-grade transformation are more prone to extrapulmonary metastasis.Patients with extrapulmonary metastasis as their initial diagnosis typically exhibit poorer prognosis.

Objective To study on the traits,micro-traits and microscopic identification characteristics of common cyrtomium Chinese medicines,including Dryopteridis Crassirhizomatis Rhizoma,Osmundae Rhizoma which were recorded in 2020 edition of Chinese Pharmacopoeia and their three chaotic breeds(Woodwardia unigemmata(Makino)Nakai,Woodwardia japonica(L.F.)Smith and Matteuccia struthiopteris(L.)Todaro,providing a reference for the identification and reference of cyrtomium Chinese medicine.Methods Morphological and micro-character identification methods were used in the character identification,and the normal bright field and polarized dark field contrast observation methods were used in the microscopic identification of cross-sections,combined with extended depth of field imaging and large image stitching techniques,to obtain holographic color images and local feature high definition image.The Chiral labeling methods were used to identified the images.Results The image data of the characters,micro-characters and the normal light and polarized light holographic color image data of cross-section of common cyrtomium herbs and its chaotic varieties were obtained at the first time.The main identification feature retrieval tables and correlation tables of medicinal materials,traits,micro traits and microscopic characters were made.Conclusion Common cyrtomium herbs and its three chaotic varieties can be identified by using characters,micro-characters and microscopic identification comprehensively,especially the microscopic character under polarized light of the cross-section,which has obvious identification significance.

Objective:To investigate the efficacy of Mirabegron plus microecologics for the treatment of overactive bladder(OAB)in elderly women.Methods:In this prospective study, 104 patients diagnosed with OAB in the urology department of our hospital between February 2020 and December 2021 were recruited.The participants were randomly divided into two groups, with 52 in each.Group I was treated with Mirabegron alone(50 mg, qd)and Group Ⅱ was treated with Mirabegron(50 mg, qd)plus probiotics(3.5 g, bid)for 12 weeks.The efficacy was evaluated based on results before and after treatment, using measurements including the daily frequencies of urinary urgency, nocturia, daytime urination, urge incontinence and bladder capacity.The overactive bladder symptom score(OABSS), the quality-of-life score, and the number of lower urinary tract infections during treatment were also collected.Results at different treatment stages(week 4 and week 12)were compared within each group and between the two groups by Dunnett's test.Results:The symptoms of OAB in both groups were significantly improved after 12 weeks' treatment.In the group(Group Ⅱ)receiving the combination of two drugs, results from four measurements, the frequency of 24-hour urination(6.6 ± 0.7 vs.7.1 ± 1.2), the frequency of 24-hour urinary urgency(0.6 ± 0.6 vs.1.1 ± 0.7), the frequency of daily nocturia(0.8 ± 0.7 vs.1.3 ± 0.6)and the quality-of-life score(1.2 ± 0.7 vs.2.3 ± 0.8), were all significantly more favorable than in the group(Group I)treated with Mirabegron( P<0.05).The incidence of lower urinary tract infections and constipation was significantly reduced in the group with drug combination treatment. Conclusions:The efficacy of Mirabegron combined with microecologics for the treatment of OAB is better than that of Mirabegron alone, and the incidence of adverse events such as infections and constipation is also lower.

Objective:To identify the molecular mechanisms of the effects of the Buyin Qianzheng formula (BYQZF)on the mitochondrial dynamics in a Parkin overexpression Parkinson's disease (PD) cell model.Methods:First,a stable Parkin overexpression cell model was constructed using plasmid transfection.Then,we examined the protective effect of BYQZF on the mitochondrial dysfunction of the Parkin overexpression PD cell model induced by neurotoxin 1-methyl-4-phenylpyridinium ion (MPP+).The mRNA expression level of Parkin was evaluated using real-time quantitative PCR.The cell survival rate was detected using the Cell Counting Kit-8 assay.We evaluated the cellular adenosine triphosphate (ATP)levels using luciferase assays.A laser scanning confocal microscope was used to observe the mito-chondrial morphology,activity,and mitochondrial membrane potential (ΔΨm).Western blot was con-ducted to evaluate the levels of the fusion proteins mitofusin1,mitofusin2,optic atrophy 1,dynamin-related protein 1,and mitochondrial fission protein 1.Results:Parkin overexpression attenuated MPP+-induced mitochondrial damage,increased mitochon-drial activity and AΨm.BYQZF increased the survival of MPP+-induced cells that overexpressed Parkin and upregulated the mitochondrial form factor and activity.It also inhibited a decrease in the ΔΨm and ATP levels.These findings suggested that BYQZF protected against MPP+-induced mitochondrial dysfunction and enhanced the protective effect of Parkin overexpression.Furthermore,the formula upregulated the expression of the fusion proteins mitofusin1,mitofusin2,and optic atrophy 1 (closely related to mitochondrial quality remodeling),and reduced the expression of the fission protein dynamic-related protein 1,as well as mitochondrial fission protein 1.Conclusion:The mechanism by which BYQZF increased the mitochondrial protective effect of Parkin gene overexpression in MPP+-induced cells may be related to improving mitochondrial function and regulating the balance of mitochondrial division and fusion proteins.

Objective: To analyze the trends of overweight and obesity of children and adolescents in 9 provinces of China from 1991 to 2015. Methods: A total of 14 888 children and adolescents aged 6-17 years with complete data were selected from the China Health and Nutrition Survey from 1991 to 2015. The definitions of overweight and obesity were defined using the international body mass index (BMI) cut-offs for child overweight and obesity established by the International Obesity Task Force in 2000 (hereinafter referred to as 'IOTF Standard’), the growth reference for school-aged children and adolescents established by the World Health Organization in 2007 (hereinafter referred to as 'WHO Standard’), the BMI cut-offs for screening overweight and obesity in Chinese children established by Li Hui et al. in 2009 (hereinafter referred to as 'Expert Standard’), and the screening thresholds for overweight and obesity in Chinese school-age children and adolescents released by the National Health and Family Planning Commission in 2018 (hereinafter referred to as 'Industry Standard’). Multivariable linear regression model was used to examine the trends in BMI values from 1991 to 2015, and multivariable logistic regression model was used to examine the trends in the prevalence of overweight and obesity from 1991 to 2015. Results: After adjusting for the age, sex and region, BMI values increased from 17.26 kg/m² in 1991 to 18.72 kg/m² in 2015 (P value for trend <0.001). The prevalence of overweight defined by the IOTF Standard, WHO Standard, Expert Standard, and Industry Standard increased from 4.06%, 5.37%, 5.16%, and 4.27% in 1991 to 13.58%, 16.23%, 13.30%, and 11.70% in 2015, respectively (all P values for trend <0.001), and the prevalence of obesity increased from 1.02%, 1.86%, 2.24%, and 2.41% in 1991 to 7.45%, 10.75%, 12.08%, and 12.74% in 2015, respectively (all P values for trend <0.001). Conclusion The BMI values and prevalence of overweight and obesity increased significantly in Chinese children and adolescents from nine provinces from1991 to 2015.

Objective To examine the trends in blood pressure levels and prevalence of hypertension among Chinese children and adolescents aged 7-17 years from 1991 to 2015,using the four blood pressure references for children and adolescents,in order to provide basic data for the prevention and control of hypertension.Methods A total of 14 622 children and adolescents aged 7-17 years were selected from the China Health and Nutrition Survey 1991-2015.Hypertension was defined under the four latest published references including the 2018 Health Industry pediatric blood pressure reference (Industry Reference),the 2018 Chinese Hypertension Prevention and Treatment Guideline reference (Guideline Reference),the 2016 International Child Blood Pressure Reference (International Reference),and the 2017 Blood Pressure Reference by the American Academy of Pediatrics (US Reference).Multivariable liner regression model was used to examine the trends in blood pressure levels from 1991 to 2015,and multivariable logistic regression model was used to examine the trend in prevalence of hypertension from 1991 to 2015.Results After adjusted for factors as age,sex,region,and BMI,the SBP appeared an increase,from 96.1 mmHg in 1991 to 102.7 mmHg and DBP from 62.6 mmHg to 67.4 mmHg (all P for trend ＜0.001) in 2015.The prevalence rates of hypertension defined by Industry Reference,Guideline Reference,International Reference and US Reference increased from 5.7％,8.9％,4.4％ and 8.1％ in 1991,to 12.8％,20.5％,13.1％ and 17.8％(all P for trend ＜0.001) in 2015,respectively.Conclusion Both levels of blood pressure and the prevalence of hypertension increased significantly in Chinese children and adolescents from 1991 to 2015.

Objective To identify the risk factors for postoperative cognitive dysfunction (POCD) in elderly patients undergoing total knee arthroplasty (TKA).Methods Ninety-six American Society of Anesthesiologists physical status Ⅱ or Ⅲ patients,aged 65-80 yr,with body mass index of 18-25 kg/m2,undergoing elective TKA under total Ⅳ anesthesia,were divided into POCD group and non-POCD group according to whether POCD occurred on 7th day after surgery.The patient baseline characteristics in the perioperative period,plasma concentrations of interleukin-1beta (IL-1β),tumor necrosis factor-alpha (TNFα),neuron-specific enolase (NSE) and S-100β protein,and visual analogue scale (VAS) scores at 1 and 2 days after operation were recorded.Logistic regression analysis was used to identify the risk factors for POCD.Results Thirty-eight patients developed POCD at 7 days after operation,and the incidence was 39％.The results of logistic regression analysis showed that the number of operations,VAS score during activity at 1 day after operation,and concentrations of TNF-α,IL-1β,NSE and S-100β protein in plasma were risk factors for POCD (P＜0.05).Conclusion The number of operations,VAS score during activity at 1 day after operation,and concentrations of TNF-α,IL-1β,NSE and S-100β protein in plasma are risk factors for POCD in elderly patients undergoing TKA.

Objective: To examine the relationship between obesity and carotid intima-media thickness (cIMT) in children and adolescents in order to provide scientific evidence for the prevention and control of cardiovascular diseases. Methods: A total of 289 children and adolescents aged 6 to 17 years were included in the study, and weight, height, blood pressure and cIMT were measured. Multivariable Logistic regression model was used to analyze the relationship between obesity and cIMT. Results: The level of cIMT and prevalence of high cIMT in obese males were higher than those in non-obese males(P<0.05), while there was no statistical significance between two weight groups in females (P>0.05). After adjusted for sex, age and blood pressure, compared with the non-obese children and adolescents, the odds ratios (OR s) of obesity for high cIMT in total sample, males and females were 3.03 (95%CI=1.11-8.28), 4.32 (95%CI=1.23-15.21) and 1.45 (95%CI=0.23-9.37) respectively. Conclusion Obesity may increase cIMT levels and risk of high cIMT in children and adolescents. Effective measures should be taken to prevent and control the obesity, and to reduce the risk of abnormal vascular structure in children and adolescents.

Objective To establish a clinical cytokine test method based on flow multiple microarray technology,and discuss its clinical significance by observing the change of cytokines level in the early stage of influenza.Methods 54 cases of influenza A virus positive and 20 cases of influenza A virus negative influenza like patients were selected as influenza group.Among them,influenza A virus positive patients were divided into mild group and severe group,influenza A virus negative influenza like patients were as neg-ative group.In addition,35 healthy people were selected as the control group,and the cytokine of all the whole blood samples was detected and statistically analyzed.Results Interleukin-6(IL-6),interleukin-21(IL-21),interleukin-12p70(IL-12p70),interleukin-1 β(IL-1 β)and interleukin-10(IL-10),chemokine-10(IP-10),interleukin-2(IL-2),monocyte chemoattractant protein-1(MCP-1)lev-els were significantly higher in the patients with early onset of influenza,and the difference was statistically significant(P<0.05). The difference of interferon-γ(IFN-γ)between the influenza group and the control group was not statistically significant(P> 0. 05).The levels of IL-6 and IP-10 in the severe group were higher than that of the mild group and the negative group,and the differ-ence was statistically significant(P<0.05).Conclusion IL-6,IL-21,IL-12p70,IL-1 beta,IL-10,IP-10,IL-2 and MCP-1 levels can be used as clinical biological evaluation indicators of patients with fever,of which IL-6 and IP-10 can be used as important indicators for disease progression assessment.