Objective To investigate the protective effects and mechanisms of soybean phospholipid powder on nerve cells in vitro and rats neural tissues.Methods In the cell experiments, the cytotoxicity of soybean phospho-lipid powder with different concentrations on mouse microglia cells (BV2) and rat adrenal pheochromocytoma (PC12) cells was observed by cell counting kit-8(CCK-8) assay.The effect of soybean phospholipid powder on the NO level of BV2 cells was analyzed by NO determination experiment, and the synaptic growth of PC12 cells was observed under the microscope.In the animal experiment, the cognitive dysfunction of rat was simulated by scopol-amine rat model.Then the learning and memory abilities of rat were tested by Morris water maze experiment;hipp-ocampal tissue morphology and nerve cell density of scopolamine model mice were observed by hematoxylin-eosin staining (HE) staining.Results Soybean phospholipid powder had no obvious cytotoxicity on BV2 cells and PC12 cells within the concentration of 1000μg/ml.Compared with the control group, the NO secretion of BV2 cells pre-treated with soybean phospholipid powder significantly decreased (P<0.01) , and the neuronal synapse growth of PC12 cells significantly increased (P <0.01) .In comparison to the model group, soybean phospholipid powder significantly improved the learning and memory ability of scopolamine model rats (P<0.05) , reduced the neuronal damage in dentate gyrus (DG), cornu ammonis3 (CA3), cornu ammonis1 (CA1) areas of hippocampus, and in-creased the density of nerve cells (P<0.001).Conclusion Soybean phospholipid powder can play a neuropro-tective role by reducing neuroinflammation and promoting neuronal synapse growth at the cellular level, and im-prove the learning and memory ability of rats with cognitive impairment, reduce hippocampal tissue damage.

BackgroundSibling relationships play a critical role in shaping anxiety symptoms in firstborn children. Anxiety symptoms often originate in early childhood and can persist into adolescence and adulthood. However， there is insufficient research on anxiety symptoms in preschool children， especially firstborn preschool children. ObjectiveTo explore the influencing factors of anxiety symptoms among firstborn preschool children， so as to provide references for the intervention of anxiety symptom for children in families with multiple children. MethodsFrom October to December 2021， a total of 8 449 children from 234 kindergartens in Longhua District of Shenzhen were included using a cluster sampling method. Sibling Inventory of Behavior （SIB） and Spence Preschool Anxiety Scale （SPAS） were used to investigate. Logistic regression analysis was used to identify influencing factors of anxiety symptoms in firstborn preschool children. ResultsA total of 8 419 （99.64%） valid questionnaires were collected. Anxiety symptoms were detected in 344（4.09%） firstborn preschool children. Statistically significant differences were observed between anxiety group and non-anxiety group in terms of household registration， monthly family income， maternal age， maternal education level， paternal education level， family living conditions and whether they are left-behind children （χ²/t=9.906， 33.490， 5.136， 13.485， 9.690， 17.332， 21.975， P<0.05 or 0.01）. Compared with non-anxiety group， children in the anxiety group scored higher on the SIB dimensions of rivalry， aggression and avoidance （t=165.322， 74.471， 286.419， P<0.01）， and lower on companionship， empathy and teaching （t=59.133， 42.417， 39.112， P<0.01）. Risk factors for anxiety symptoms in firstborn preschool children included left-behind children， as well as negative sibling relationships characterized by rivalry and avoidance （OR=1.195， 1.143， 1.260， P<0.05 or 0.01）. ConclusionFirstborn preschool children who are left-behind are more susceptible to anxiety symptoms. Negative sibling relationships， characterized by competition and avoidance， may also contribute to the emergence of anxiety symptoms in firstborn preschool children.

Objective To systematically retrieve and integrate the clinical randomized controlled trials(RCTs)and systematic reviews/Meta-analyses of traditional Chinese medicine in the treatment of diabetic peripheral neuropathy(DPN)in recent 10 years,aiming to summarize the overall evidence distribution of traditional Chinese medicine in the treatment of DPN.Methods CNKI,WANFANG,VIP,CBM,PubMed,Web of Science,Embase and the Cochrane Library were used as retrieval database.The retrieval time was from January 1,2012 to October 23,2022.RCTs and systematic reviews/Meta-analyses were included.The distribution of evidence was displayed in the form of charts.AMSTAR-1 was used for the methodological quality evaluation of systematic reviews/Meta-analyses.Results A total of 1648 RCTs and 59 systematic reviews/Meta-analyses were included.The overall number of RCTs were on the rise,but most of the scale of the RCTs were relatively small,with 68％of the samples size of a single study concentrated between 50-100;The Duration of intervention was 4-8 weeks;Multi-therapy was the most commonly used intervention,among which the most involved intervention was the combination of TCM decoction;Traditional Chinese medicine monotherapy was mainly oral traditional Chinese medicine decoction.The evaluation indexes of clinical efficacy paid much attention to the total effective rate,nerve conduction velocity,TCM diseases and syndromes;economic index,quality of life,long-term efficacy and other indicators had attracted less attention of researchers.The overall methodological quality of systematic reviews/Meta-analyses was not high,most of which show good clinical efficacy,but lack sufficient evidence support.Conclusion The research results show that the treatment of diabetes peripheral neuropathy with TCM have good characteristics and advantages,the shortcomings are mainly reflected in the low quality of the overall methodology of systematic reviews/Meta-analyses.Suggesting that more high-quality clinical RCTs with breadth and depth are still needed in the future to verify the characteristics and advantages of traditional Chinese medicine in the treatment of diabetic peripheral neuropathy and provide data information support for evidence-based medicine.

Objective : To investigate the protective effect and mechanism of Hudi Enteric capsules in ionizing radiation injury to small intestinal crypt cells (IEC⁃6 cells) in rats. Methods : IEC⁃6 cells were irradiated with 6 mega electron volt X ⁃rays (2 , 4 , 6 , 8 and 10 Gy) , cell clone formation assay was used to detect cell proliferation , and the 6 Gy ionizing radiation was selected to establish a cellular radiation damage model according to the cell survival rate. The effect of each concentration ( 12. 5 , 25 , 50 , 100 and 200 μg/ml) of Hudi enteric extract on the viability of IEC⁃6 cells was examined by cell counting kit⁃8(CCK⁃8) method , and the effect on the viability of IEC⁃6 cells after irradiation at ( 10 , 20 , 40 and 80 μg/ml) concentrations was examined according to the results. After obtaining the optimal irradiation dose and extract concentration , the cells were divided into control group , model group and Hudi extract group (80 μg/ml) , the control group was pseudo⁃irradiated and the other two groups received 6 Gy of ionizing radiation , and the Hudi enteric extract group was pre⁃treated with drugs 2 h before irradiation. Apoptosis was detected by Annexin V ⁃PI double staining; cell senescence was detected by β ⁃galactosidase (β⁃Gal) staining; reactive oxygen species was detected by DCFH⁃DA fluorescent probe ; the corresponding protein expression of p16 , p21 , Catalase (CAT) and Superoxide dismutase ( SOD2) was detected by Western blot. Results : The proliferation of IEC⁃6 cells was inhibited by radiation doses ranging from 4 Gy to 10 Gy(P < 0. 001) ; (P < 0. 001) , and the apoptosis rate , β ⁃Gal positivity rate and DCFH⁃DA fluorescence intensity in the Hudi enteric extract group were lower than those in the model group (P < 0. 05) . The protein expressions of CAT and SOD2 in the Hudi extract group were higher than those in the model group ( P < 0. 05) , and the protein expressions of p16 and p21 were lower than those in the model group (P < 0. 05) . Conclusion The mechanism of action of Hudi enteric capsules that attenuate radiation damage in IEC⁃6 cells may be related to the inhibition of reactive oxygen species production , reduction of oxidative stress , and attenuation of cellular senescence and apoptosis.

Objective    To investigate the effect of optimized arterial perfusion strategy on total arch replacement for acute type A aortic dissection (AAAD) with malperfusion syndrome (MPS). Methods    From 2017 to 2019, 51 patients with AAAD and MPS who had received total arch replacement with optimized arterial perfusion strategy in our hospital were included in the optimized perfusion group, including 40 males and 11 females, with an average age of 47.43±13.39 years. A total of 40 patients with AAAD and MPS who had been treated with traditional Sun's surgery were taken as the traditional control group, including 31 males and 9 females, with an average age of 50.66±12.05 years. The perioperative clinical data of the two groups were compared. Results    The preoperative baseline data of the two groups were basically consistent (P>0.05). The comparison of operative data between the optimized perfusion group and the traditional control group showed that in the optimized perfusion group, the extracorporeal circulation time, aortic occlusion time, and circulation-out cerebral perfusion time were significantly less than those in the traditional control group (223.64±65.13 min  vs. 266.77±87.04 min, 114.48±27.28 min vs. 138.20±39.89 min, 8.28±3.81 min vs. 50.53±23.60 min, all P≤0.05). The lowest intraoperative nasopharyngeal temperature in the optimized perfusion group was significantly higher than that in the traditional control group (27.10±1.18℃ vs. 23.6±3.30℃, P=0.000). Postoperative wakefulness time of the optimized perfusion group was earlier than that of the traditional control group (4.50±1.35 h vs. 5.27±1.15 h, P=0.019). The volume of blood transfusions in the optimized perfusion group was significantly less than that in the traditional control group (13.25±9.06 U vs. 16.95±7.53 U, P=0.046). There was no significant difference in ICU time and invasive ventilation time between the two groups (P>0.05). Postoperative complications of the two groups showed that the incidence of postoperative continuous renal replacement therapy in the optimized perfusion group was significantly lower than that in the traditional control group, with a statistically significant difference (21.6% vs. 42.5% P=0.003). The incidence of postoperative delirium, coma, low cardiac row syndrome and limb ischemia in the optimized perfusion group was lower than that in the traditional control group, but the difference was not statistically significant (P>0.05). The incidence of postoperative hemiplegia, sepsis, and secondary thoracotomy in the optimized perfusion group was higher than that in the traditional control group, and the difference was not statistically significant (P>0.05). Postoperative mortality in the optimized perfusion group was significantly lower than that in the traditional control group (13.7% vs. 27.5%), but the difference was not statistically significant (P=0.102). Conclusion    Optimized arterial perfusion strategy and its related comprehensive surgical technique reduce surgical trauma, shorten the operation time, reduce perioperative consumption of blood products. Postoperative wakefulness is rapid and the incidence of complications of nervous system, kidney and limb ischemia is low. Optimized arterial perfusion strategy is suitable for operation of AAAD with MPS by inhibiting the related potential death risk factors to reduce operation mortality.

Type Ⅰ sialidosis is a neurosomatic disorder related to the storage of lysosomal and induced by shortage of neuraminidase. It is an autosomal recessive disorder, maybe heterogeneous in its onset, clinical manifestations and prognosis. A case of type Ⅰ sialidosis with a missense mutation in the α-N-acetyl-neuraminidase (NEU1) gene is reported. The patient was characterized by reduced visual acuity, ataxia and subcortical myoclonus. Although the macular cherry red spots were not detected in the male patient, his bilateral visual evoked potential showed severely prolonged latencies of P100, which was consistent with continuous decline of his visions. Finally, he was treated with carbamazepine and clonazepam with moderate improvement in the symptom of myoclonus. In order to make the definite diagnosis, the importance of a clinical history integrating all the patient′s clinical manifestations and the mutation in NEU1 gene was highlighted. Regardless of being an uncommon disorder, the burden for those patients with sialidosis was significant. Therefore, this diagnosis in the relevant setting should always be considered.

SAM pointed domain containing E26 transformation-specific transcription factor (SPDEF) plays dual roles in the initiation and development of human malignancies. However, the biological role of SPDEF in head and neck squamous cell carcinoma (HNSCC) remains unclear. In this study, the expression level of SPDEF and its correlation with the clinical parameters of patients with HNSCC were determined using TCGA-HNSC, GSE65858, and our own clinical cohorts. CCK8, colony formation, cell cycle analysis, and a xenograft tumor growth model were used to determine the molecular functions of SPDEF in HNSCC. ChIP-qPCR, dual luciferase reporter assay, and rescue experiments were conducted to explore the potential molecular mechanism of SPDEF in HNSCC. Compared with normal epithelial tissues, SPDEF was significantly downregulated in HNSCC tissues. Patients with HNSCC with low SPDEF mRNA levels exhibited poor clinical outcomes. Restoring SPDEF inhibited HNSCC cell viability and colony formation and induced G0/G1 cell cycle arrest, while silencing SPDEF promoted cell proliferation in vitro. The xenograft tumor growth model showed that tumors with SPDEF overexpression had slower growth rates, smaller volumes, and lower weights. SPDEF could directly bind to the promoter region of NR4A1 and promoted its transcription, inducing the suppression of AKT, MAPK, and NF-κB signaling pathways. Moreover, silencing NR4A1 blocked the suppressive effect of SPDEF in HNSCC cells. Here, we demonstrate that SPDEF acts as a tumor suppressor by transcriptionally activating NR4A1 in HNSCC. Our findings provide novel insights into the molecular mechanism of SPDEF in tumorigenesis and a novel potential therapeutic target for HNSCC.
Carcinogenesis ; Cell Proliferation ; Head and Neck Neoplasms ; Humans ; Nuclear Receptor Subfamily 4, Group A, Member 1 ; Proto-Oncogene Proteins c-ets ; Squamous Cell Carcinoma of Head and Neck ; Transcription Factors

Objective:To explore the value of a radiomics nomogram based on T 1WI for prediction of the relapse of osteosarcoma after surgery within 1 year from multicenter data. Methods:The imaging and clinical data of 107 patients with pathologica1ly confirmed osteosarcoma who received neoadjuvant chemotherapy before surgery from 6 hospitals from January 2009 to October 2017 were retrospectively analyzed. A training cohort consisted of 75 patients from firstly enrolled 4 hospitals and an independent validation cohort of 32 patients from other 2 hospitals. Pretreatment T 1WI was used to extract radiomics features. Least absolute shrinkage and selection operator (LASSO) regression was applied to reduce the dimension and then the radiomics signature was constructed to predict the relapse of osteosarcoma after surgery within 1 year in training cohort. Independent clinical risk factors were screened using one-way logistic regression, and then a radiomics nomogram incorporated the radiomics signature and MRI characteristics was developed by multivariate logistic regression. The predictive nomogram was evaluated using receiver operating characteristic (ROC) curve in the training cohort, and validated in the independent validation cohort. The calibration curve was used to evaluate the agreement between prediction and actual observation and the decision curve was used to demonstrate the clinical usefulness. Results:Based on T 1WI from multicenter institutions, the radiomics signature was built using 2 valuable selected features that were significantly associated with relapse within 1 year. Two selected features included 1 gray-level co-occurrence matrices (GLCM) feature (L_G_1.0_GLCM_homogeneity1, LASSO coefficient 3.122) and 1 gray-level run length matrix (GLRLM) feature (GLRLM_RP, LASSO coefficient -2.474). The prediction nomogram including radiomics signature and MRI characteristics (joint invasion and perivascular involvement) showed good discrimination with the area under the ROC curve of 0.884 and 0.821 in the training and validation cohorts, respectively. The calibration curve showed that the nomogram achieved good agreement between prediction and actual observation. Decision curve analysis demonstrated that the radiomics nomogram was clinically useful when the threshold probability was greater than 21%. Conclusion:The radiomics nomogram based on T 1WI can be used as a non-invasive quantitative tool to predict relapse of osteosarcoma within 1 year before treatment, which provides support for clinical decision-making in osteosarcoma.

Objective To study the pulmonary valve replacement(PVR) operation indications and timing,the choice of prosthetic valve,and the anticoagulation methods.Methods Between June 2006 and April 2017,10 patients(median age 22.5 years,range 10 to 46) underwent PVR at our hospital.These issues above were discussed by analysing data from the patients and literature review.Results The 10 patients were all diagnosed with congenital heart disease(CHD),6 with CHD and infective endocarditis and 4 with postoperation of complex CHD like tetralogy of Fallot or pulmonary artery atresia.Five patients had prior cardiac operations.Bioprosthesis valve was implanted in 2 cases,while mechanical valve in 8.The international normalized ratio(INR) was maintained between 1.8 and 2.5 for patients with mechanical valve.There was one in-hospital death,and the other 9 patients were all followed up.The median follow-up was 65 months(range,3-110 months).During follow-up,there was no death,and reoperation was undertaken in one patient who had ceased anticoagulation for 2 years with a mechanical valve,and bioprosthesis valve was chosed in reoperation,Except of this patient,no valve thrombus or severe bleeding complication happened.All prosthetic valves demonstrated normal function by cardiac color ultrasound.The mean peak transvalvular pressure gradient for the mechanical valves was 12.0 mmHg(range,8.7-14.0 mmHg),while for the bioprosthesis valves was 24.7 mmHg(1 mmHg =0.133 kPa) (range,22-27 mmHg) (P ＜ 0.01).Overall actuarial survival at 7 years for patients receiving bioprosthesis valve PVR was 100％,while for mechanical valve was 85 ％ (P =0.617);Overall actuarial freedom from reoperation at 7 years for patients receiving bioprosthesis valve PVR was 100％,while for mechanical valve was 71％ (P =0.414).The findings of literature review were as follows:the risk of valve thrombus or severe bleeding complication for mechanical pulmonary valve was not higher than bioprosthesis pulmonary valve under standard anticoagulant therapy;the durability of bioprosthesis pulmonary valves was unsatisfactory,while the medium and long term effects of mechanical valves were good;the hemodynamic properties of mechanical pulmonary valve were better than bioprosthesis pulmonary valve;the lowintensity anticoagulation method was safe and effective for Chinese people.Conclusion PVR is a safe and effective treatment for patients with severe pulmonary valve regurgitation or stenosis,and the medium and long term effects of mechanical valve are satisfactory.PVR is recommended as early as meeting the operation indications.The choice of a prosthetic valve should be careful and individual.At present,the bioprosthesis valves are implanted in pulmonery valve position more than mechanical valves.However,in select patients and by standard anticoagulant therapy,mechanical pulmonry valves will bring better benefit.The low-intensity anticoagulation method(INR 1.8-2.5) is safe and effective,and recommened for Chinese people.

Objective: To observe the effect of edaravone combining ulinastatin on brain protection in patients of type A aortic dissection (AAD) after total arch replacement. Methods: A total of 60 AAD patients with total arch replacement in our hospital from 2014-09 to 2016-01 were prospectively studied. Based on peri-operative application of edaravone and ulinastatin, the patients were divided into 2 groups: EU group: 1) the patients received ulinastatin 300000 U/8h and edaravone 0.5mg/Kg/12h from administration to 3 days post-operation, 2) during cardiopulmonary bypass, the patients received ulinastatin 300000 U/2h and edaravone 0.5mg/Kg; Control group, the patients had no such treatment.n=30 in each group. The following items were observed:①operative condition;②blood levels of speciifc brain injury markers as S-100 and neuron speciifc enolase (NSE) at different time points: beginning of surgery (T0), opening aorta clamp (T1), right after cardiopulmonary bypass (T2), entering ICU (T3), 24h post-operation (T4) and 3 days post-operation (T5); ③post-operative condition. Results:①Durations of operation, cardiopulmonary bypass, cardiac arrest and bilateral antegrade selective cerebral perfusion (BACP), the frequency of BACP and UACP (unilateral antegrade selective cerebral perfusion), the lowest rectal temperature and blood levels of S-100, NSE at T0 were similar between 2 groups.②Compared with Control group, EU group had decreased S-100 and NSE from T1 to T5,P<0.05.③The in-hospital and ventilation time, frequency of PND and TND, the patients with CSS score≥16 before discharge and the in-hospital death rate were similar between 2 groups,P>0.05. Conclusion: Edaravone combining ulinastatin had brain protective effect in AAD patients after total arch replacement;it may reduce blood speciifc brain injury markers while the clinical signiifcance should be further investigated.