Objective:To explore the optimization of the standardized assessment tool for clinical diagnosis of Chinese developmental dyslexia (DD).Methods:A cross-sectional study was conducted from May to December 2023, in which 130 primary school children in grades 1 to 3 with clinical signs of literacy lag and positive screening results on the screening scales were recruited from the outpatient clinic of Child Health Care Medical Division, Shanghai Children′s Hospital, Shanghai Jiao Tong University School of Medicine. Chinese dyslexia screening behavior checklist for primary students (CDSBC) was used as the screening scales, and supplemented by dyslexia checklist for Chinese children. Referring to the standard procedure of the"expert advice on diagnosis and intervention of Chinese developmental dyslexia", the developmental dyslexia scale for standard mandarin (DDSSM) was used to evaluate the children′s literacy-related cognitive abilities and conduct the diagnostic assessment, and divided the children into learning backward group and the DD group. The t-test and &chi;2 test were used to compare the differences in the distribution of intelligence, literacy and attention deficit hyperactivity disorder between the two groups. Spearman′s correlation was used to analyze the correlation between the scores for each cognitive ability in the DDSSM and the CDSBC. Results:Of the 130 children, 90 were male, aged (8.3±1.0) years; 40 were female, aged (8.1±0.9) years. A final diagnosis of DD was made in 59 cases, of which 41 were males. There was no statistically significant difference in operational intelligence quotient (101±15 vs.100±15, t=0.53, P>0.05) and statistically significant difference in literacy of DDSSM (32±5 vs.21±4, t=11.56, P<0.001) between the learning backward group and the DD group. Eighteen cases (25.4%) of the learning backward group were children with attention deficit subtype attention deficit hyperactivity disorder (ADHD-I), and 16 cases (27.1%) in DD group, the difference in incidence between the two groups was not statistically significant ( &chi;2=0.05, P>0.05). There were correlations between the DDSSM (for oral vocabulary, morphological awareness and orthographic awareness) and the CDSBC total score ( r=-0.42, -0.32, -0.35, all P<0.01), but the correlations for visuospatial perception and rapid automatized naming with CDSBC total score were not statistically significant ( r=-0.09 and -0.20,both P>0.05). Conclusion:For literacy-related cognitive abilities, screening scales CDSBC are not sufficiently useful for assessment, so the introduction of standardized assessment tools DDSSM is an optimization of the clinical diagnosis of Chinese DD, which is crucial for achieving accurate diagnosis and intervention.

Objective:To investigate the efficacy and safety of cedilanid in the treatment of severe pneumonia in infants and the value of preventing heart failure.Methods:A total of 80 children with severe pneumonia admitted to Dezhou Maternal and Child Health Hospital from January 2019 to December 2020 were selected and randomly divided into the control group and the observation group, with 40 cases in each group. The control group received comprehensive treatment, while the observation group was treated with cedilanid (0.01 mg/kg, one-time intravenous injection) on the basis of the control group. The efficacy of both groups was observed after 5 d of treatment. The incidence of heart failure, correction time of heart failure, improvement time of symptoms and signs, and length of hospitalization time were compared between the two groups; the inflammatory markers, myocardial markers and arterial blood gas indexes were compared between the two groups before and after the treatment.Results:The total effective rate in the observation group was higher than that in the control group, and the incidence of heart failure in the observation group was lower than that in the control group: 90.0% (36/40) vs. 72.5% (29/40), 32.5%(13/40) vs. 10.0%(4/40), the differences were statistically significant ( &chi;2 = 4.02, 4.10, P<0.05). The improvement time of symptoms and signs (restlessness elimination, respiratory improvement, heart rate improvement and disappearance of rhonchus in lung) in the observation group were less than those in the control group ( P<0.05). The levels of procalcitonin (PCT) and N-terminal pro-brain natriuretic peptide (NT-ProBNP), myocardial troponin I(cTnI), and creatine kinase isoenzyme (CK-MB) in the observation group after treatment were lower than those in the control group: (6.15 ± 1.03) μg/L vs. (10.85 ± 2.12) μg/L, (112.02 ± 30.09) ng/L vs. (215.39 ± 55.08) ng/L, (0.68 ± 0.17) μg/L vs. (1.12 ± 0.34) μg/L, (19.05 ± 6.11) U/L vs. (28.97 ± 7.82) U/L, P<0.05. The levels of oxygen partial pressure (PaO 2), blood oxygen saturation (SaO 2) and oxygenation index (PaO 2/FiO 2) in the observation group after treatment were higher than those in the control group: (6.15 ± 1.03) μg/L vs. (10.85 ± 2.12) μg/L, (112.02 ± 30.09) ng/L vs. (215.39 ± 55.08) ng/L, (0.68 ± 0.17) μg/L vs. (1.12 ± 0.34) μg/L, (19.05 ± 6.11) U/L vs. (28.97 ± 7.82) U/L, P<0.05. Conclusions:Early application of small dose of cedilanid in infants with severe pneumonia can effectively reduce the occurrence of heart failure, improve the clinical symptoms and blood gas indicators, with significant curative effect, which is worthy of promotion.

Cryptogenic stroke (CS) is a type of stroke that can not find the exact cause after using the standard clinical examination procedure of stroke. In recent years, many studies have shown that patent foramen ovale (PFO) is closely associated with CS, and its main pathogenesis is paradoxical embolism. In clinical practice, ultrasound is often used for PFO screening. In the context of PFO, the secondary prevention of CS includes drug therapy and PFO closure, but the choice of treatment is still controversial. Screening and evaluation of possible PFO will help to develop secondary prevention strategies for patients with CS, especially those who can benefit from PFO closure.

Objective:To investigate the potential risk factors for cryptogenic stroke (CS) in patients with patent foramen ovale (PFO).Methods:Patients underwent PFO closure in the Department of Cardiovascular Surgery, the Second Hospital of Hebei Medical University from June 2018 to December 2021 were enrolled retrospectively. Transesophageal echocardiography was used to evaluate the morphological characteristics of foramen ovale and right-to-left shunt (RLS). Multivariate logistic regression analysis was used to determine the independent risk factors for CS in patients with PFO. Results:A total of 203 patients with PFO were enrolled. Their age was 41.9±14.3, and 116 patients (57.1%) were male. There were 102 patients in CS group and 101 patients in non-stroke group. The age, body mass index, systolic blood pressure and diastolic blood pressure, and the constituent ratios of male, hypertension, diabetes, hyperlipidemia and smoking of the CS group were significant higher than those of the non-stroke group (all P<0.05). The PFO channel of the CS group was longer, wider and more combined with resting RLS (all P<0.05). Multivariate logistic regression analysis showed that systolic blood pressure (odds ratio [ OR] 1.065, 95% confidence interval [ CI] 1.022-1.111; P=0.003), PFO length ( OR 1.124, 95% CI 1.004-1.258; P=0.043) and resting RLS ( OR 5.449, 95% CI 2.283-13.004; P<0.001) were the independent risk factors for CS in patients with PFO. Conclusion:Systolic blood pressure, PFO length and the presence of resting RLS are the independent risk factors for CS in patients with PFO.

Objective: To investigate the expression of zinc finger with KRAB and SCAN domains 3 (ZKSCAN3) in breast cancer tissues and its clinical significance. Methods: The expression of ZKSCAN3 in 120 specimens of human breast cancer tissues and 60 specimens of adjacent para-cancerous tissues was detected by immunohistochemistry, and its correlation with clinicopathological parameters and overall survival was analyzed. The real-time fluorescent quantitative PCR and Western blotting were used to further detect the expressions of ZKSCAN3 mRNA and protein in breast cancer tissues and the adjacent para-cancerous tissues. Results: The positive expression rate of ZKSCAN3 protein in breast cancer tissues [74% (89/120)] was higher than that in the adjacent para-cancerous tissues [37% (22/60)] (P < 0.001). The expression of ZKSCAN3 protein was correlated with tumor size, lymph node metastasis, tumor differentiation and clinical stage of breast cancer (all P < 0.05). The overall survival rate of patient with ZKSCAN3-positive breast cancer was significantly lower than that of patient with ZKSCAN3-negative breast cancer (P = 0.040). The expression levels of ZKSCAN3 mRNA and protein in breast cancer tissues were higher than those in the adjacent para-cancerous tissues (both P < 0.01). Conclusion: ZKSCAN 3 is associated with the occurrence, progression and metastasis of breast cancer, so it may be an oncogene of breast cancer.

Objective:To investigate the expression of transmembrane 4 super family 1 (TM4SF1)in breast cancer tissue,and to elucidate its clinical significance and explore the related molecular biological mechanisms. Methods:A total of 190 cases of human breast cancer,110 cases of paracancerous tissue and 110 cases of normal breast tissue were collected.Immunohistochemistry was used to detect the expression levels of TM4SF1 mRNA in breast cancer tissue,paracancerous tissue,and normal breast tissue;Western blotting method was used to detect the expression levels of TM4SF1 in breast cancer tissue,paracancerous tissue,and normal breast tissue;RT-PCR method was used to detect the expression levels of TM4SF1 mRNA in breast cancer tissue,paracancerous tissue, and normal breast tissue.The positive expression rates of TM4SF1 in breast cancer tissue of the breast cancer patients with different clinicopathological features were detected.Results:The positive expression rate of TM4SF1 in the breast cancer tissue was significantly higher than those in paracancerous tissue and normal breast tissue (P <0.05);there was no significant difference in the positive expression rates of TM4SF1 between paracancerous tissue and normal breast tissue (P = 0.531);the expression of TM4SF1 was not correlated with age,but was closely correlated with tumor size,differentiation degree,lymph node metastasis and tumor stage (P <0.05);the positive expression rate of TM4SF1 in basal like breast cancer tissue was higher than those in the other three types of tissues (P <0.05).The results of Western blotting showed that the expression level of TM4SF1 in breast cancer tissue was higher than those in paracancerous tissue and normal breast tissue (P < 0.05 ), but there was no significant difference in the expression level of TM4SF1 between paracancerous tissue and normal breast tissue (P >0.05). The results of RT-PCR showed that the expression level of TM4SF1 mRNA in breast cancer tissue was higher than those in the paracancerous tissue and normal breast tissue (P <0.01);there was no significant difference in the expression level of TM4SF1 mRNA between paracancerous tissue and normal breast tissue (P > 0.05 ). Conclusion:The TM4SF1 is highly expressed in breast cancer tissue. TM4SF1 may affect the occurrence, development and distant metastasis of breast cancer through various mechanisms.TM4SF1 may be a potential target for the treatment of breast cancer.

OBJECTIVETo disclose the impact of Trp1707Ser mutation on the binding mechanism of rFVIII light chain (rFVIII LC) with VWF.

METHODSUsing long-chain PCR technique, we constructed rFVIII LC plasmids of both wild type and Trp1707Ser mutant type. BL21 competent cells were used for protein expression. Gradient renaturation was employed to refold protein. SDS-PAGE and Western blot were performed to identify the molecular weight of expressed protein. GST-Sefinose was used for protein purification and surface plasmon resonance (SPR) was employed to detect binding of B-domain-deleted rFVIII (BDD-rFVIII), wild and mutant rFVIII LC with VWF, respectively.

RESULTSThe results of SDS-PAGE and Western blot showed a molecular weight of 110×10(3) of expressed proteins, which were consistent with objective proteins. The expression quantity of wild type was higher than that of mutant type. A concentration-dependent combination of the 3 testing proteins with VWF was found. The KD value of BDDrFVIII (12.2) was lower than that of both rFVIII LCs (wild type 48.9 and mutant type 46.3), whereas there was no discrepancy between wild rFVIII LC and mutant rFVIII LC.

CONCLUSIONTrp1707Ser mutation didn't impact the binding of rFVIII LC expressed by BL21 competent cells with VWF. The heavy chain played a more important role in impacting the binding of FVIII with VWF.

OBJECTIVETo compare the shear bond strength(SBS) of cast Co-Cr alloys and selective laser melting(SLM) Co-Cr alloys with those of dental porcelain.

METHODSA dental porcelain (Vita) was applied on cast and SLM Co-Cr alloy specimens (n = 10). SBS test was conducted, and fracture mode analysis was determined. Student's t-test by SPSS 13.0 software was employed to analyze the data.

RESULTSThe SLM Co-Cr alloy specimens had lower SBS values than the cast Co-Cr alloy specimens (P > 0.05). The metal-porcelain bond strength value of the cast group was (33.11 +/- 4.98) MPa, and that of the SLM group was (30.94 +/- 5.98) MPa. The specimens in both test groups exhibited mixed failure.

CONCLUSIONThe metal-porcelain system processed by SLM exhibit a bond strength that is similar to that of the cast group. This system also display a high precision.

Objective To investigate the molecular types of carbapenem-non-susceptible Esche-richia coli ( E.coli) isolates and their mechanism of carbapenem resistance .Methods Twenty-two carbap-enem-non-susceptible E.coli strains were isolated from 3 hospitals in Hangzhou from 2007 to 2011.The mini-mum inhibitory concentrations ( MICs) of antimicrobials to those isolates were determined by agar dilution method and E-test.The molecular mechanisms of carbapenem resistance of E.coli isolates were analyzed by conjugation experiment,PCR and DNA sequencing.Pulsed-field gel electrophoresis (PFGE),multilocus se-quence typing ( MLST ) , and phylogenetic typing were performed to analyze the molecular epidemiology of those isolates.Results The MICs of imipenem and meropenem to 22 E.coli isolates were ranged from 1 μg/ml to 16 μg/ml,and the MICs of ertapenem were 2 μg/ml to 64 μg/ml.All E.coli isolates produced the KPC-2 carbapenemase and various β-lactamases , and some of them also produced plasmid-mediated AmpC enzymes.Carbapenem resistance was transferred by conjugation and transformation from 22 E.coli iso-lates to E.coli EC600 strains.The E.coli transconjugants or transformants acquired the blaKPC-2 gene and showed similar antibiotic susceptibility patterns in comparison with donor strains .Only a few isolates were in-distinguishable or closely related as indicated by PFGE .Four sequence types including ST131 (9 isolates), ST648 (5 isolates),ST38 (2 isolates) and ST405 (2 isolates) were identified by MLST.Phylogenetic analy-sis indicated that 9 ST131 isolates belonged to phylogenetic group B 2 and the other isolates belonged to group D (11 isolates),group B1 (1 isolate) and group A (1 isolate),respectively.Conclusion The sequence type of prevalent E.coli isolates producing KPC-2 from Hangzhou was ST131,which is an international epi-demic,multidrug-resistant clone,followed by ST648.

BACKGROUND:Colagen sponges are applied for hemostatic use, wound healing, and residual cavity filing, which have great values in clinical application and scientific research.
OBJECTIVE:To investigate the biological properties, biocompatibility and biodegradability of colagen spongesin vivo.
METHODS: The spatial structure, pore diameter and porosity of colagen sponges were characterized by scanning electron microscopy. Transmission electron microscopy was used to observe the conformation of colagen sponges. The secondary structure and thermal denaturation temperature of colagen sponges were
analyzed by circular dichroism spectrum. Colagen sponges were implanted intramuscularly into the spinal cord of New Zealand rabbits to observe the degradation and absorption and histological changesin vivo.
RESULTS AND CONCLUSION: Colagen sponges had porous structure with varying pore sizes ranging
40-150 μm, the mean pore size of 100 μm, the thickness wal of 1 μm, and a porosity of approximately 95.8%. Colagen sponges had a typical porous structure and periodic light and dark zones. The solution of colagen
sponges had a weak positive band near 220 nm and an intense negative band near 206 nm, which indicated a classic triple helix. And the secondary structure and thermal stability of colagen sponges were similar to that of
liquid colagen. Colagen sponges began to degrade at 4 weeks, and remained 20% at 12 weeks. These sponges had been associated with foreign body response and inflammation within 2 weeks after implantation. With wound healing, inflammatory reactions gradualy reduced and disappeared. During the implantation and degradation of sponges, no significant fibrous capsule formed and no tissue necrosis occurred at implantation site, indicating that colagen sponges have good performance in bioactivity, biocompatibility and degradation.