Objective:To investigate the risk factors associated with post-prematurity respiratory disease (PPRD) in very preterm infants.Methods:A prospective cohort study was conducted, enrolling 369 very preterm infants who were admitted to the neonatal intensive care unit of Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, within one week of birth from January 2019 to June 2023. Data on maternal and infant clinical characteristics, neonatal morbidities, and treatments during hospitalization were collected. The very preterm infants were divided into 2 groups based on whether they developed PPRD. Continuous variables were compared using Mann-Whitney U test, while categorical variables were compared using χ2 tests or continuity correction χ2 test. Multivariate Logistic regression analysis was used to identify the independent risk factors for PPRD in very preterm infants. Results:Among the 369 very preterm infants, 217 cases(58.8%) were male, with a gestational age of 30 (28, 31) weeks at birth and a birth weight of 1 320 (1 085, 1 590) g. Of these, 116 cases (31.4%) developed PPRD, while 253 cases (68.6%) did not. The very preterm infants in the PPRD group had a lower gestational age and lower birth weight (both, P<0.001). The PPRD group also had a higher proportion of males, lower Apgar scores at the 1 th minute after birth and the 5 th minutes after birth, a higher rate of born via cesarean delivery, and a higher incidence of bronchopulmonary dysplasia, more pulmonary surfactant treatment, longer durations of mechanical ventilation, longer total oxygen therapy, and lower Z-score for weight at discharge (all P<0.05). Multivariate Logistic regression analysis showed that gestational age ( OR=0.85, 95% CI 0.73-0.99, P=0.037), born via cesarean delivery ( OR=2.23, 95% CI 1.21-4.10, P=0.010), a duration of mechanical ventilation ≥7 days ( OR=2.51, 95% CI 1.43-4.39, P=0.001), and a Z-score for weight at discharge ( OR=0.82, 95% CI 0.67-0.99, P=0.040) were all independent risk factors for PPRD in very preterm infants. Conclusion:Very preterm infants with a small gestational age, born via cesarean section, mechanical ventilation ≥7 days, and a low Z-score for weight at discharge should be closely monitored for PPRD, and provided with standardized respiratory management after discharge.

Objective To investigate the inhibitory effects and mechanisms of α-hederin,an active ingredient in Fruc-tus Akebiae,on hepatocellular carcinoma(HCC)cells.Methods HCC cells were divided into four groups and treated with α-hederin(0,10,20,and 30 μmol·L-1)for 24 h and 48 h,respectively.MTT assays were used to detect the cell proliferation rate,flow cytometry(FCM)was used to detect the apoptotic rate,transcriptomics was used to screen signaling pathways in α-hederin-treated HCC cells,RNA interference was exploited to verify the underlying signaling pathway,and real-time quantitative PCR(qRT-PCR)and Western blotting(WB)were used to detect expression changes of the mRNA and protein of TP53(p53),PMAIP1(Noxa),and apoptosis-associated proteins,Caspase9 and Caspase3.Results α-Hederin induced apoptosis by activa-ting apoptosis-associated proteins,PARP,Caspase9 and Caspase3.Transcriptomics,qRT-PCR,and WB results also showed that α-hederin increased the mRNA and protein expression of p53 and Noxa.Furthermore,α-hederin inhibited the protein degradation of p53 and Noxa,reversing the apoptosis decrease in p53/Noxa siRNA-knocked-down HCC cells.In vivo results showed that α-hederin inhibited the growth of HCC tumors.Conclusion α-hederin may induce the apoptosis of HCC cells by activating and stabilizing the p53/Noxa signaling pathway.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Primary liver cancer (PLC) is one of the most common malignant tumors in China. PLC is characterized by insidious onset, rapid progress, poor quality of life, and short survival time. Notably, current treatment strategies remain unsatisfactory. Traditional Chinese medicines (TCM) have been used to treat a variety of diseases, including liver diseases, for more than 2000 years. In this study, we performed a review of the use frequency and clinical efficacy of TCM in treating PLC. Relevant literature from January 1, 2009, to January 1, 2021 was retrieved from network databases of China National Knowledge Infrastructure (CNKI), Chongqing VIP, Wanfang, PubMed, and SinoMed. The most frequently used TCM and their effi-cacy in PLC treatment were summarized. Based on the inclusion and exclusion criteria, 33 articles were selected. Overall, the efficacy of the combination of TCM and Western medicines in the treatment of PLC was higher than that in the control groups (i.e. treatment with Western medicines alone) (65.11％ vs. 44.31％, P < .05). Among the 33 selected articles, 11 were investigated for TCM preparation (marketed drugs) and 22 for TCM formulas. In total, 102 types of TCM (single herbs) were used to treat PLC. The top five most frequently used TCM were Poria (14.71％), Astragali radix (13.73％), Atractylodis Macrocephalae Rhizoma (12.75％), Bupleuri radix (12.75％), and Glycyrrhizae radix et Rhizoma (11.76％). Of the 102 types of TCM, tonics were the most frequently used categories, followed by heat-clearing medicines, blood-invigorating medicines, and stasis-resolving medicines. Of 207 papers, 174 (84.06％) could not be sub-jected to statistical analysis due to research quality. Further high-quality research on herb sources, for-mula components and dosage, toxicology, and ethics of TCM is necessary. In conclusion, TCM play a promising role in the treatment and management of PLC, although further investigations are warranted.

OBJECTIVE：To inv estigate therapeutic efficacy and safety of recombinant human interferon gel combined with Baofukang suppository in the treatment of cervical high-risk human papillomavirus （HPV）infection. METHODS ：Totally 259 patients with persistent high-risk HPV infection diagnosed and treated in gynecology department of the First Affiliated Hospital of Hainan Medical University from Aug. 2017 to Sept. 2019 were selected and divided into interferon group （n＝82），Baofukang suppository group （n＝86）and combination group （n＝91）according to random number table. The patients in interferon group and Baofukang suppository group were given Recombinant human interferon α2b gel 1 g, qd or Baofukang suppository 1 capsule，qd； the patients in combination group were given Recombinant human interferon α2b gel and Baofukang suppository 1 capsule，qd；for 3 months. Then the clinical efficacy ，negative time of HPV ，duration of abnormal secretion ，LCT test results ，cervical inflammation score ，HPV relative light unit/critical value （RLU/CO）and the incidence of ADR were recorded. RESULTS ：The total effective rate of combination group was significantly higher than that of interferon group and Baofukang suppository group ， the negative time of HPV and duration of abnormal secretion in combination group were significantly shorter than interferon group and Baofukang suppository group （P＜0.05）. Before treatment ，the normal rate of LCT of 3 groups were 0，and there was no statistical significance in cervical inflammation score and HPV RLU/CO among 3 groups（P＞0.05）. After treatment ，normal rate of LCT was increased in 3 groups，compared with before treatment （P＜0.05），and normal rate of LCT in combination group was significantly higher than interferon group and Baofukang suppository group. The cervical inflammation score and HPV RLU/CO were significantly lower than before treatment ，and the combination group was significantly lower than interferon group and Baofukang suppository group （P＜0.05）. There was no statistical significance in above indicatora after treatment betwent interferon group and Baofukang suppository group and the incidence of ADR among 3 groups during medication （P＞0.05）. CONCLUSIONS：The application of recombinant human interferon gel combined with Baofukang suppository is effective and safe way in the treatment of cervical high-risk HPV infection.

Objective: To observe the treatment effect of oral propranolol combined with topical timolol maleate for infantile maxillofacial mixed hemangioma and provide evidence for clinical treatment. Methods: Ninety-seven cases of infantile maxillofacial mixed hemangioma were enrolled. The cases were randomly divided into A and B groups: 50 cases in group A were treated with oral propranolol combined with topical timolol maleate, and 47 cases in group B were treated with oral propranolol only. The changes in the color, volume, and texture of the tumors were recorded before and after treatment, and color ultrasonography of the lesion area was performed. The follow-up time was 1-12 months. The differences in the curative effect, effective time and adverse reaction between the two groups were compared. Results : The effective rate of group A was 92.0% (46/50) and that of group B was 74.5% (35/47), with a statistical significance (P < 0.05). The mean time of treatment in group A was 4.2 months and that in group B was 5.5 months. Compared with group B, the treatment time of group B was shorter (t=3.211, P < 0.05), and no serious adverse reactions occurred in both groups. Conclusion Oral propranolol combined with topical timolol maleate is effective in the treatment of mixed hemangioma of the maxillofacial region in infants.

Objective To explore the clinical features,treatment and prognosis of malignant solid tumors in the digestive tract in children and adolescents. Methods Sixty-five children and adolescents with malignant solid tumors in the digestive tract from January 1997 to June 2017 were selected,who were treated at the Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital. The tumor site,gender,age,clinical presentations,treatment, follow-up time and their life status by deadline follow-up in 65 children and adolescents were collected respectively, and the clinical features,treatment methods and prognosis were retrospectively analyzed. The follow-up deadline was on December 31,2017. Results The most frequent sites of tumors were liver tumor(36 cases,55. 38%),followed by rectum tumor(11/65 cases,16. 92%),colon tumor(6/65 cases,9. 23%),pancreas tumor(5/65 cases,7. 69%),gas-tric(3/65 cases,4. 62%),esophagus (1/65 cases,1. 54%),gallbladder tumor (1/65 cases,1. 54%),ileum tumor (1/65 cases,1. 54%),and appendix tumor (1/65 cases,1. 54%). The prevalence rate in males and females was 1. 32:1. 00. The age of embryo tumor incidence was smaller,and the age of epithelium cancer incidence was older. The main symptoms included abdominal distension and pain (66. 15%,43/65 cases). Twenty-seven patients (41. 5%, 27/65 cases)was in stageⅣ. Radical and palliative surgery were the main treatment in 50 cases (76. 92%). The 1-year,3-year,5-year overall survival rates were 60. 7%,31. 0%,18. 8%,respectively. The overall survival rate of co-lon and rectal cancer was higher than that of hepatocellular cancer,and the differences were all statistically significant (χ2＝6. 268,P＝0. 012;χ2＝11. 772,P＝0. 001). The overall survival rate of patients who received surgery combined with chemoradiotherapy was the longest and those undergoing chemotherapy only was the shortest,but the differences had no statistical significance among 4 groups of sheer surgery,chemotherapy alone,surgery combined with chemothera-py and surgery combined with chemoradiotherapy(all P＞0. 05). Conclusion The malignant solid tumors in the di-gestive tract in children and adolescents have a poor prognosis. The unspecific presentation makes the diagnosis diffi-cult. It is very important to diagnose early and treat as soon as possible by the combination of surgery,chemotherapy and radiotherapy to improve the overall survival rate.

Objective: To evaluate the safety and efficacy of DSA-guided percutaneous application of ethanol sclerotherapy combined with lauromacrogol foam sclerotherapy for the treatment of hyper-backflow venous malformations. Methods: The clinical data of 72 cases of hyper-backflow venous malformation of head and neck from August 2012 to June 2016 by DSA-guided percutaneous puncture sclerotherapy were analyzed retrospectively. Based on the method of sclerotherapy, the patients were divided into group A and B. Group A was treated with ethanol combined with lauromacrogol foam, and Group B was treated with lauromacrogol foam alone. All patients were followed up for 12-24 months (mean 14.3 months). The curative effects and postoperative adverse responses were analyzed by comparision.SPSS 19.0 software was applied, effective rate and adverse reaction rate were examined by chi square test.P<0.05 was considered as statistically significant. Results: Group A(37 cases), cure was achieved in 10, basic cure in 21 and effective response in 3, ineffective response in 3, with a total efficiency of 91.9%(34/37). There were 3.2 average injections. The mean dose of sclerosant foam used in each patient was 220 mg and ethanol 13.6 ml. Group B(35 cases), cure was achieved in 5, basic cure in 15 and effective response in 4, ineffective response in 11, with a total efficiency of 68.6%(24/35). There were 4.8 average injection times. The mean dose of sclerosant foam used in each patient was 322 mg. There was statistically significant difference in total efficiency of 2 groups (χ²=6.245, P<0.05). The main adverse effect were tissue necrosis, nerve injury and limitation of mouth opening. There was no statistically significant difference in adverse effect of 2 groups (P>0.05). Conclusions DSA-guided percutaneous application of ethanol sclerotherapy combined with lauromacrogol foam sclerotherapy for the treatment of hyper-backflow venous malformations is safe and effective with fewer complications.This technique is especially useful for the hyper-backflow type of venous malformations.

Objective To detect the expression levels of metallothionein1 H(MT1 H)in children and adoles-cents osteosarcoma serums,and to analyze its relationship with clinicopathological features,and to explore the effect of MT1 H on cell proliferation of osteosarcoma cells and its mechanism.Methods Enzyme -linked immuno sorbent assay (ELISA)was performed to detect the expression of MT1 H in children and adolescents osteosarcoma serums and non-neoplastic disease serums.MT1 H vector was transfected into the osteosarcoma U2OS cells.Reverse transcription -poly-merase chain reaction(RT -PCR)and Western blot were used to detect the expression of the mRNA and protein of MT1 H,respectively.Methylthiazolyldiphenyl -tetrazolium bromide(MTT)was used to detect the cell growth.Western blot was performed to detect the expression of nuclear factor(NF)-κB,and inhibitor of κB (IκB)-αprotein. Results The expressions of MT1 H in osteosarcoma serums and nonneoplastic disease serums was (0.51 ± 0.52)μg/L and (2.17 ±0.78)μg/L,respectively,with a significant difference between the 2 groups(t =-8.966, P <0.05).The expression of MT1 H in stage Ⅰ -ⅡA andⅡB -Ⅲ was (1 .98 ±0.69)μg/L and (2.45 ±0.82)μg/L,respectively,showing a gradual increase depending on clinical staging(t =-2.343,P <0.05).The expressions of MT1 H mRNA and protein were elevated in osteosarcoma U2OS cells after MT1 H vector transfection(all P <0.05). MTT assay showed that,the A value in blank control group,blank vector group,MT1 H vector group were 0.38 ±0.03, 0.36 ±0.03,0.42 ±0.03,respectively,the cell proliferation in the MT1 H vector group was significantly promoted when compared with these in the blank vector group and blank control group(F =4.213,P <0.05)from the third day.West-ern blot showed that,the relative expression of NF -κB in blank control group,blank vector group,MT1 H vector group were 0.56 ±0.05,0.53 ±0.05,0.92 ±0.07,respectively,the relative expression of IκB -αprotein were 0.64 ± 0.06,0.62 ±0.09,0.34 ±0.08,respectively,the expression of NF -κB protein was up -regulated and the expression of IκB -αprotein was down -regulated in the MT1 H vector group when compared with those in the blank vector group and blank control group(F =44.581 ,14.927,all P <0.05).Conclusions The expression of MT1 H is increased in children and adolescents osteosarcoma serums compared with that in nonneoplastic disease serums.The clinical stage is later,the expression of MT1 H is higher.MT1 H promotes cell proliferation through regulating the NF -κB pathway.

Objective To establish the effect of curcumin on PTX-resistant esophageal cancer cell line EC9706/PTX and to investigate the mechanism of curcumin on the epithelial stromalization (EMT) of EC9706/PTX cells.Methods EC9706/PTX cells were established by medium concentration intermittent method.The drug resistance index and cross resistance were measured by MTT assay.The inhibitory effects of different concentrations of curcumin on EC9706/PTX cell proliferation were detected.The effects of curcumin on the morphological changes,migration and invasion of EC9706/PTX cells were examined by cytostatic staining,scratching and transwell invasion assay.The effects of curcumin on the expression of E-cadherin,N-cadherin,vimentin and fibronectin in EC9706/PTX cells at mRNA and protein levels were detected by fluorescence quantitative PCR and Western blot.The effect of curcumin on the expressions of NF-κB p65 and Snail in EC9706/PTX cells were detected by Western blot.Results The drug resistance index of EC9706/PTX was 28.4,which was cross-resistant to cisplatin and doxorubicin.Curcumin could inhibit the proliferation of EC9706/PTX cells.The migration and invasion of EC9706/PTX cells were significantly decreased under the action of curcumin at 20 μmol/L concentration.Fluorescence quantitative PCR and Western blot analysis showed that the expression of Ecadherin was down-regulated and the expression of N-cadherin was up-regulated,and curcumin reversed this phenomenon.Western blot analysis showed that the expression of NF-κB p65 and Snail protein was enhanced after PTX-resistant generated in EC cell,but curcumin reversed this phenomenon.Conclusion Curcumin can inhibit the proliferation,migration and invasion of EC9706/PTX cells.The mechanism maybe that curcumin inhibits the NF-κB-Snail pathway.