Childhood is an important period for individual health. In order to provide community child health services, Zhoujiaqiao Community Health Service Center of Shanghai Changning District has opened a pediatric clinic since July 2017. Through equipping basic facilities, personnel training, extending service items and service time, allocating resources with cooperative hospitals, optimizing internal system management and other methods, the community pediatric service under the family physician team model has been initially constructed. The article summarizes experiences in the construction and operation of community pediatric services and child health care, to provide reference for the development of a replicable and promotable urban community pediatric service system under the contracted family physician team model.

Objective This study explores the correlation between macrophage markers and NAFLD and liver fibrosis,in order to further explore the pathogenesis of NAFLD liver fibrosis,explore effective components of traditional Chinese medicine,and provide help and reference for the prevention and treatment of liver fibrosis by traditional Chinese medicine.Methods Utilizing bioinformatics methods,NAFLD gene chips were analyzed to identify differentially expressed genes.Through WGCNA co-expression network analysis and LASSO model construction,core expression genes were selected.CIBERSORT was employed for immune cell infiltration analysis,exploring the correlation between macrophage phenotypes and differentially expressed genes,as well as the degree of fibrosis.External datasets were used to identify relevant biomarkers for macrophages in NAFLD and liver fibrosis.Reverse transcription-polymerase chain reaction(RT-PCR)was conducted to validate the expression differences of core genes across different macrophage subtypes.Additionally,the Coremine medical database was utilized for ontology-based information retrieval to screen and analyze traditional Chinese medicine treatment targets for NAFLD.Results A total of 15 core genes related to NAFLD and liver fibrosis were screened out in this study.CIBERSORT algorithm analysis results showed that the occurrence of NAFLD was related to various immune cells,among which M1 macrophages were significantly elevated in the NAFLD group,with a significant difference(P<0.01).M1 macrophages demonstrated a positive correlation with the degree of liver fibrosis,while M2 macrophages exhibited a negative correlation.The correlation analysis between core genes and macrophages revealed that KDM4A,MED30,IKBKG,ENO1,and HSPA8 were negatively correlated with total macrophage count.The expression of IL-6,FOS,EDN2,and NR4A2 displayed a negative correlation with M1 macrophage count,whereas it showed a positive correlation with M2 macrophage count.The results of external dataset validation and in vitro RT-PCR validation indicated that the expression levels of FOS and NR4A2 mRNA in M2 macrophages were higher than those in M1 macrophages(P<0.001).This expression was negatively correlated with M1 macrophages and positively correlated with M2 macrophages.Based on the core target through Coremine medical database,according to the drug efficacy and meridian,we screened out the related traditional Chinese medicine such as Salvia miltiorrhiza,Cortex moutan,Radix Rehmanniae,Angelica sinensis,Alisma,Semen Hoveniae,Ginseng,Dogwood,Hawthorn and so on.The efficacy analysis of these Chinese medicines mainly focused on clearing heat and detoxification,removing dampness and removing phlegm,activating blood circulation and removing blood stasis.Among these,Cortex moutan was identified as the most frequently selected medicine.Conclusion Liver macrophages are target cells for treating liver diseases.Regulating the M2 polarization of macrophages contributes to the treatment of NAFLD and related liver fibrosis.c-Fos and NR4A2 are potential key target points,and traditional Chinese medicines like Moutan Cortex have hepatoprotective effects.This provides new insights for further researching the pathogenesis and treatment methods of NAFLD and liver fibrosis.

Objective:To explore the core medication law of constipation in the Yi Zong Jin Jian using data mining techniques; To provide idea for the clinical treatment of constipation. Methods:The prescriptions related to constipation in the Yi Zong Jin Jian were summarized, and the frequency statistics, the efficiency statistics of the properties and tastes, correlation analysis and complex network analysis were carried out on the data set using the TCM Inheritance Cloud Platform V1.0, and the visualization was carried out. Results:A total of 106 prescriptions for constipation were included, involving 169 kinds of Chinese materia medica, with a total frequency of 894 times. The high-frequency Chinese materia medica included Rhei Radix et Rhizoma, Glycyrrhizae Radix et Rhizoma, Scutellariae Radix and Angelicae Sinensis Radix, etc. Chinese materia medica was mainly composed of purging drugs, tonifying drugs and clearing heat drugs. The main tastes were pungent, sweet and bitter, while the main properties were cold and warm, and the main meridians were lung, spleen, stomach and liver meridians. 10 drug combinations such as Rhei Radix et Rhizoma-Scutellariae Radix, Rhei Radix et Rhizoma-Natrii Sulfas were obtained by second-order analysis, 9 drug combinations such as Rhei Radix et Rhizoma-Angelicae Sinensis Radix-Glycyrrhizae Radix et Rhizoma, Scutellariae Radix-Coptidis Rhizoma-Rhei Radix et Rhizoma were obtained by third-order analysis, and 12 categories were obtained by community cluster analysis.Conclusions:In the treatment of constipation in the Yi Zong Jin Jian, it follows the academic thought of "warming, clearing and tonifying". It focuses on the method of tonifying and lowering, and takes warming and tonifying deficiency, clearing heat and defecating as the basic treatment, with cold and warm drugs, based on syndrome differentiation and treatment of zang-fu organs. When treating, it is required to prioritize the disease and treat it according to the syndrome.

Objective:To evaluate the feasibility and applicability of using phospholipid-hybridization method for preparing biomimetic microbubbles (Bio-MBs) ultrasound contrast agents.Methods:Leukocyte biomimetic microbubbles (MB leu), platelet biomimetic microbubbles (MB pla) and erythrocyte biomimetic microbubbles (MB ery) were prepared by multiple steps: film-hydration, phospholipid-hybridization, mechanical oscillation. The size and zeta potential of Bio-MBs were measured by dynamic light scattering. A laser scanning confocal microscopy experiment was performed to confirm the presence of membrane proteins on the shell of Bio-MBs. The fluorescence of FITC-labeled typical membrane protein was evaluated using a flow cytometer. Sodium dodecyl sulfate polyacrylamide gel electrophoresis was used to characterize the membrane protein. Biosafety of Bio-MBs was evaluated by CCK-8 counting kit, blood and major organs. The contrast enhancement effect and stability were observed in vitro and in vivo. An in vivo fluorescence imaging system was performed to evaluate the distribution of Bio-MBs. The application value of biomimetic microbubbles was measured by ultrasound molecular imaging by using ischemia-reperfusion rat models and acute hepatitis rat models. Results:Bio-MBs with spherical shape distributed homogenously, without obvious aggregation. The membrane proteins were successfully integrated into the shell of Bio-MBs.The diameter of three Bio-MBs was similar to that of control microbubbles (MB con) ( P>0.05), three Bio-MBs had a lower zeta potential than MB con ( P<0.05). The Bio-MBs had an appreciable performance in vitro and in vivo biosafety. The Bio-MBs retained the main proteins inherited from cell membrane. Contrast enhanced ultrasound imaging in vitro and in vivo showed that the Bio-MBs had a stable imaging ability.MB leu and MB pla have good targeted imaging effect in two disease models. Conclusions:A series of Bio-MBs ultrasound contrast agents, which have high stability, biosafety and targeted imaging efficiency, were successfully prepared by using phospholipid-hybridization method. This fabrication method for obtaining Bio-MBs can be applied to different clinical scenarios with different cell types in the future.

Objective:To compare the numerical rating scales (NRS) and Oswestry disability index (ODI) of denosumab in Chinese postmenopausal osteoporosis patients after 3 months, and analyze the early adverse reactions to provide reference for clinical diagnosis and treatment.Methods:Using a prospective study method, 260 patients with postmenopausal osteoporosis who were outpatients and inpatients in the Second Affiliated Hospital of Soochow University from September 2020 to October 2021 were selected, and general information, including age, height, weight, bone mineral density, history of fragility fractures, and use of anti-osteoporosis drugs. All subjects received denosumab 60 mg subcutaneously, and were given calcium and vitamin D at the same time. Pain was scored by NRS before treatment and 3 months after treatment, and functional improvement was assessed by ODI.Results:After 3 months of denosumab treatment in postmenopausal women with osteoporosis, among patients with different age groups, different degrees of osteoporosis, history of fragility fractures, and history of use of anti-osteoporosis drugs, NRS score and ODI score were lower than those before treatment, and the difference was statistically significant ( P<0.05). In addition, in patients with a history of fragility fractures (mainly vertebral fractures), the NRS scores and the ODI score decreased more significantly, and the difference was statistically significant ( P<0.05); the NRS score and ODI score decreased more significantly in patients with severe osteoporosis than in patients with osteoporosis, and the difference was statistically significant ( P<0.05); the BMD value of lumbar spine was negatively correlated with the reduction of NRS score before and after treatment ( P=0.042). In this study, 260 patients had musculoskeletal pain in 6 (2.3%), fatigue in 5 (1.9%), rash in 4 (1.5%), urinary tract infection in 2 (0.7%), and dizziness in 2 (0.7%), 2 case of fever (0.7%), 1 case of hypocalcemia (0.4%), a total of 22 cases of adverse reactions were reported, and the overall adverse reaction rate was 8.5%. Conclusion:Denosumab can improve pain symptoms and functional disability early in the clinical application of Chinese postmenopausal women with osteoporosis, and the incidence of adverse reactions is low. Especially for postmenopausal female osteoporosis patients with severe osteoporosis, low lumbar spine bone density, and a history of fragility fractures (mainly vertebral fractures), the application effect is more significant.

For the ideal preclinical animal model of hepatitis B virus (HBV), its hepatocytes should allow HBV entry and cccDNA generation and have both innate and adaptive immune systems. However, HBV only naturally infects humans and chimpanzees due to highly restricted species specificity, and no effective model has been established so far to truly reflect the immune mechanism and pathogenesis of HBV infection. This article reviews five commonly used mouse models, i.e., HBV transgenic model, HBV plasmid DNA hydrodynamic injection model, AAV-HBV transfection model, cccDNA surrogate model, and human-mouse chimeric liver model, and looks forward to the new models that will appear in the future, such as hNTCP transgenic cynomolgus monkey, rhesus monkey, or pig models, so as to provide a reference for researchers to select these models, accelerate the process of drug screening, validate new therapies, and better solve the problems of HBV biological pathogenesis.

Objective: To explore the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection who received entecavir alone or in combination with anluohuaxianwan for 78 weeks. Methods: Patients with chronic HBV infection were randomly treated with entecavir alone or in combination with anluohuaxian for 78 weeks. Ishak fibrosis score was used for blind interpretation of liver biopsy specimens. The improvement in liver fibrosis condition before and after the treatment was compared. Student's t test and non-parametric test (Mann-Whitney U-Test and Kruskal-Wallis test) were used to analyze the measurement data. The categorical variables were analyzed by Chi-square test method and Spearman’s rank correlation coefficient was used to test bivariate associations. Results: Liver fibrosis improvement rate after 78 weeks of treatment was 36.53% (80/219) and the progression rate was 23.29% (51/219). The improvement of liver fibrosis was associated to the degree of baseline fibrosis and treatment methods (P < 0.05). The improvement rate of hepatic fibrosis in patients treated with anluohuaxianwan combined with entecavir at baseline F < 3 (54.74%, 52/95) was significantly higher than that in patients treated only with entecavir (33.33%, 16/48), P = 0.016 and the progression rate of hepatic fibrosis (13.68%, 13/95) was lower than that in patients treated alone (18.75%, 9/48), P = 0.466. In patients with baseline F < 3, the proportion of patients with improved and stable liver fibrosis in the combined treatment group (68.1%, 32/47) was higher than that in the treatment group alone (51.7%, 15/29). Conclusion Combined anluohuaxianwan and entecavir treatment can significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection. Furthermore, it has the tendency to improve the stability rate and reduce the rate of progression of liver fibrosis.

Objective To investigate the value of the signal intensity of portal vein at hepatobiliary phase on gadoxetic acid liver enhancement imaging for accessing the liver function. Methods Ninety five subjects who underwent gadoxetic acid enhanced liver MR imaging due to suspicion of liver diseases between January 2015 and June 2016 at the First Hospital of Soochow University were retrospectively analyzed. Patients were classified into 4 groups based on their liver function: cirrhosis patients with Child-Pugh class A(n=50),B(n=19),C(n=6)and control group(n=20).All the patients had underwent the abdominal non-enhanced and gadoxetic acid enhanced MR imaging. The signal intensity (SI) of the portal vein at non-enhanced phase and hepatobiliary phase(delayed 20min)were recorded.The ratio of the portal vein to spleen were calculated.The nonparametric Kruskal-Wallis test was used to compare the differences in the SI of portal vein at non-enhanced and the ratio of portal vein to spleen at hepatobiliary phase among the four groups.Multiple regression analysis was applied to analyze the correlated predicting factors of the ratio of the portal vein to spleen at hepatobiliary phase. Results At non-enhanced phase, the SI ratio of portal vein had no significant difference(P>0.05).The ratio of the portal vein to spleen at hepatobiliary was significantly different (P<0.05). The ratio of the portal vein to spleen at hepatobiliary constantly and significantly decreased as the severity of liver dysfunction increased. The serum levels of albumin and platelet count were independent predictors of the ratio of the portal vein to spleen at hepatobiliary phase(P=0.002 and 0.007).Conclusions The ratio of the portal vein to spleen at hepatobiliary phase on gadoxetic acid enhanced MR imaging indicates the severity of liver dysfunction.It might be used as a tool to assess the liver function.

Objective: To investigate the effects of silk fibroin on the immobilization of thrombin. Methods: The immobilized thrombin was prepared using silk fibroin as the carrier and glutaraldehyde as the crosslinking agent. With activity yield as the index, the process conditions of silk fibroin immobilized thrombin were determined by an orthogonal test. Results:The optimum process con-ditions of immobilized thrombin treated with silk fibroin were as follows:the immobilization time was 6 h, the enzyme dosage was 2 400 NIH·g-1 casein, the temperature was 25℃ and pH was 7. 6. The activity recovery of immobilized thrombin was 67. 22%. Conclu-sion:Silk fibroin has the positive immobilization effect on thrombin.

Animals ; Cell Line ; Cytological Techniques ; methods ; Embryonic Stem Cells ; cytology ; Interleukin Receptor Common gamma Subunit ; genetics ; Male ; Mice ; Mice, Inbred NOD ; Mice, SCID ; Mutation