Objective:In this study, the role of IL-17 in the pathogenesis of idiopathic myositis (IIM) was preliminarily investigated by detecting the expression of IL-17 in the muscle tissues of patients with idiopathic inflammatory myositis (IIM) and normal controls.Methods:Twenty-eight patients (20 in DM group with dermatomyositis and 8 in ASS group with anti-synthase syndrome) who were diagnosed with IIM after muscle biopsy and autoantibody detection in our hospital for the first time from October 2019 to August 2021 were included. Twelve cases with normal muscle tissue matched for age and sex were included as the control group. Western blot and immunohistochemical techniques were used to detect the expression level of IL-17 in muscle tissue, and enzyme-linked immunosorbent assay (ELISA) was used to detect serum IL-6. Mann-Whitney U rank sum test was used to compare the difference of IL-17 expression in muscle tissue between the two groups, and non-parametric test was used for comparison between multiple groups. Chi-square test and Spearman rank correlation analysis were used, and P<0.05 was considered statistically significant. Results:① The expression level of IL-17 in IIM muscle tissue[1.63(1.30, 2.05)pg/ml was higher than that in control group[1.00(0.96, 1.00)pg/ml, and the difference was statistically significant ( Z=-3.52, P<0.001). The difference be-tween DM[1.94(1.58, 2.14)pg/ml] and ASS[1.22(1.04,1.55)pg/ml was statistically significant ( Z=-3.20, P=0.001). ② Compared with healthy control group [4.08(3.01, 5.67)pg/ml, the expression of IL-6 in ⅡM serum[8.88(4.93, 13.64) was high ( Z=-3.01, P=0.003), which was positively correlated with the expression of IL-17 ( r=0.42, P=0.027). ③ The ex-pression of IL-17 in muscle tissue was higher in IIM associated with muscle weakness[1.91(1.56, 2.14) pg/ml vs 1.50(1.04, 2.00)pg/ml] ( Z=-1.38, P=0.020), dysphagia [2.06(1.99, 2.14)pg/ml vs 1.62(1.52, 2.04)pg/ml] ( Z=-2.74, P=0.010) and skin involvement[1.98(1.57, 2.14)pg/ml vs 1.04(0.86, 1.61)pg/ml] ( Z=-3.20, P<0.010), and the differences were statistically significant ( P<0.05). ④IL-17 was positively correlated with Myoact-total activity ( r=0.51, P=0.006), Myoact-muscle symptom ( r=0.45, P=0.016), erythrocyte sedimen tation ( r=0.48, P=0.020), and myoenzyme increase ( r=0.56, P=0.002). Conclusion:IL-17 and IL-6 are synergistically involved in the pathogenesis of IIM, suggesting that IL-17 is the therapeutic target of IIM.

Objective:To investigate the effect of pelvic motion in late pregnancy on the outcome of first trimester delivery.Methods:A total of 127 first-borns admitted to the midwifical clinic of Nanjing Maternal and Child Health Hospital from November 1, 2019 to March 10, 2020 were selected as the research objects, and they were divided into the walking group and the pelvic motion group according to the random number table method. In the end, 62 cases were included in the walking group and 65 cases in the pelvic motion group. The walking group did brisk walking in the third trimester. In the pelvic motion group, the motion in the third trimester consisted of the combined pelvic motion involving the two planes of the upright spine and the horizontal spine, and multiple peripelvic joints. The changes of fertility, birth canal and fetus before and after exercise were observed, and the outcomes of childbirth were compared between the two groups.Results:Indicators reflecting productivity: persistence time of "air bike" on the day before delivery was (27.12±7.73) seconds in the pelvic motion group and (20.56±6.60) seconds in the walking group, the difference was statistically significant ( t value was 5.12, P<0.01). The time of contractions after exercise before delivery was (269.38±123.70) seconds in the pelvic motion group and (591.29±201.82) seconds in the walking group, the difference was statistically significant ( t value was 10.89, P<0.01). The indicators reflecting the situation of the maternal birth canal were as follows: "sitting forward flexion level", pelvic motion group was (33.64±5.91) cm, walking group was (29.50±5.28) cm, the difference was statistically significant ( t value was 4.15, P<0.01). The cervical score during regular contractions was 8.01±1.69 in the pelvic motion group and 7.30±1.40 in the walking group, the difference was statistically significant( t value was 2.56, P<0.05). At the beginning of regular contractions, the proportion of fetal "occipital position" was 93.85% (61/65) in the pelvic motion group and 72.58%(45/62) in the walking group, the difference was statistically significant ( χ2 value was 10.41, P<0.01). The "no pain rate after exercise the day before delivery" was 72.31% (47/65) in the pelvic motion group and 29.03% (18/62) in the walking group, the difference was statistically significant ( χ2 value was 25.30, P<0.01). Time of the first labor was (395.84±165.24) min in the pelvic motion group and (574.35±152.23) min in the walking group, the difference was statistically significant ( t value was 6.32, P<0.01). The second stage of labor was (25.98±9.88) min in the pelvic motion group and (33.62±13.94) min in the walking group, the difference was statistically significant ( t value was 3.57, P<0.01). Conclusions:Pelvic motion in middle and late pregnancy can affect labor force, birth canal, fetus and other delivery factors, reduce movement pain and shorten the time of labor.

Objective To investigate the influence of gestational abnormal glucose metabolism on the birth outcome and long-term weight of neonates.Methods Thirty pregnant women with gestational diabetes mellitus (GDM) were enrolled in this study.30 pregnant women with gestational impaired glucose tolerance (GIGT) were selected,and 30 normal pregnant women(NGT) were selected as control group.The weight,length and weight index (PI) of the three groups were collected.The incidence rates of adverse outcomes were collected in the three groups.The long-term weight of the newborns was investigated.According to whether breastfeeding,they were divided into breastfeeding group and non-breastfeeding group.The body mass index (BMI) was compared between 42 days,3 months,6 months and 12 months,respectively.Results There were statistically significant differences in body weight and PI of neonates except length between the control group and the GDM group (t =1.60,P =0.06;t =5.09,P =0.00;t =6.94,P =0.00).There were statistically significant differences in body weight and PI of neonates except length between the control group and the GIGT group(t =1.57,P =0.06;t =4.21,P =0.01;t =5.88,P =0.00).There were no statistically significant differences in the above indices between the GDM group and the GIGT group(all P ＞ 0.05).The incidence rate of macrosomia in the GDM group and the GIGT group was significantly higher than that of the control group (x2 =10.59,P =0.00).The incidence rates of respiratory failure syndrome,cardiovascular disease,hyperbilirubinemia and birth injury among the three groups had no statistically significant differences(x2 =1.23,P =0.54;x2 =2.09,P=0.35;x2 =2.02,P=0.36;x2 =2.09,P=0.35;x2 =4.03,P=0.13).At the birth of 42 days,3 months,6 months,12 months,the BMI of neonates in the GDM group and the GIGT group were slightly higher than those in the control group,but there were no statistically significant differences in BMI index among the three groups of breasffed newborns (F =0.71,P =0.28;F =0.97,P =0.12;F =0.98,P =0.12;F =0.77,P =0.22).At the birth of 42 days,3 months,6 months,12 months,the BMI of neonates in the GDM group and the GIGT group were slightly higher than those in the control group,but there were no statistically significant differences in BMI index among the three groups of breasffed newborns (F =0.77,P =0.34;F =0.89,P =0.10;F =1.12,P =0.09;F =0.55,P =0.67).Conclusion Abnormal glucose metabolism in pregnant women can lead to a significant increase in the incidence of neonatal macrosomia.The body weight and PI of neonates are higher than those without abnormal glucose metabolism in pregnant women,but the abnormal maternal glucose metabolism in pregnant women has no significant influence on the long-term body weight of neonates,and there is no significant difference between NGT and neonates.

Objective To observe the curative effect of head hypothermia combined with mouse nerve growth factor in the treatment of neonatal moderately severe hypoxic ischemic encephalopathy (HIE).Methods 50 cases of severe HIE were randomly divided into observation group and control group,with 25 cases in each group.Both two groups were given the conventional treatment.The observation group was given head hypothermia treatment in 6 hours after born,to maintain the nasopharyngeal temperature (34.0 ±0.5)℃,anal temperature (35.5 ±0.5)℃,72 hours continuously.At 96 hours after the birth,the nerve growth factor was given.The control group did not give the head mild hypothermia treatment.At 96 hours after birth,the nerve growth factor (methods,dosage and treatment were the same as the observation group)was treated with nutrition and brain nerve.After treatment,the improvements of heart rate,muscle tension,convulsions and disturbance of consciousness were observed in two groups.After 3 days,2 weeks and 4 weeks,the neonatal behavioral neurological assay (NBNA),1 and 3 months after birth,the outfit cranial MRI plain scan and brainstem auditory evoked potential (BAEP)were evaluated.Results NBNA scores of the two groups were compared in 3 days,2 weeks and 4 weeks after birth,the differences were statistically significant (t=2.53, 2.89,3.23,all P<0.05).In the observation group,the abnormal brain MRI was significantly less than the control group,the difference was statistically significant (χ2 =24.125,P<0.05).In the observation group,the number of abnormal auditory evoked potential was significantly less than that of the control group,the difference was statistically significant (χ2 =21.312,P<0.01 ).Conclusion Head hypothermia combined with mouse nerve growth factor therapy for the treatment of neonatal moderately severe HIE has protective effect,it can improve the treatment efficacy, reduce the long-term neurological sequelae,and without adverse reaction.

Objective The results of repair for TOF with anomalous coronary artery(ACA) were studied to determine the incidence of coronary anomalies and evaluate surgical strategy choicesas well as postoperative outcomes.Methods From January 2008 to August 2014,1142 consecutive patients underwent repair of TOF including 44 patients with TOF and ACA:single coronary artery in 15,dual anterior descending coronary in 15,single left anterior descending coronary arising from the rightcoronary artery in 3 and the other ACA in 5.The median age was 5.7 years (range,1 month-27 years),and the median weight was 16.0 kg(range,4.5-51.0 kg).Surgical procedure was selected according to the extent of right ventricular outflow tract (RVOT) obstruction and distribution of the ACA.Results There was one operative death.No deaths during the follow-up period in the other 37 patients.Single patch techniquewasperformed in 15.RVOT residual obstruction detected in 7 who without transannular patch,and one need reoperation;Two patch technique was performed in 6,and 3 of them required an additional RV-PA(pulmonary artery) tube because of RVOT residual obstruction during the operation;Double oullet technique was in 6.No tube stenosis occurred in follow-up period time;PA translocation technique was in 11.The right PA stenosis was detected in 4;ACA was ligated and divided in 3,then RVOT reconstruction was performed.Conclusion The combination of ACA is not a contraindication to primary repair of TOF.But there are many anatomiacal variations of ACA,and the accuracy of preoperative diagnosis is low.So proper selection of surgical approach should be individualized based on the careful intraoperative identification of the distribution of the ACA as well as the location and degree of the RVOT obstruction.

Objective To evaluate the distribution and drug resistance of bacteria causing neonatal infectious pneumonia in Jiaxing,and to provide a therapy for clinical doctor to make a correct diagnosis,choose reasonable anti-biotics and avoid abuse of antibiotics.Methods Took expectoration from trachea in condition of asepsis to conduct culture and perform drug-sensitive test from 3025 cases.Results Totally 1 156 strains of aerobic bacteria were iso-lated.875 strains were gram negative bacilli(75.7%),269 strains were gram positive cocci(23.3%),and 12 strains were fungi(1.0%).Klebsiella pneumoiae,Escherichia coil,Acinetobacter baumanni,Enterobacter cloacae were com-mon in gram negative bacilli( respectively 178 cases,151 cases,87 cases,113 cases) .The proportion of the Staphylo-coccus aureus was the largest in gram positive cocci(245 cases) .The results showed that gram-negative bacilli were resistant to cefazolin, ampicillin, piperacillin and sensitive to meropenem, imipenem, piperacillin-tazuobatanna and cefoperazone-sulbactam.The drug resistance was severe of ESBL-positive.Staphylococcus aureus was resistant to penicillin, ampicillin, erythrocin, clindamycin and sensitive to linezolid, vancomycin, nitrofurantoin.Conclusion Gram-negative bacilli are the main bacteria in neonatals with infectious pneumonia.The drug resistance is severe.It is important to make a standard management and isolation.

Objective To construct a eukaryotic expression plasmid carrying the PKCI-1/HINT1 gene,to investigate its expression in A375 melanoma cells after transfection,and to evaluate its effects on apoptosis and autophagy of A375 cells.Methods The PKCI-1/HINT1 gene sequence was amplified by reverse transcription PCR (RT-PCR) with total RNA extracted from A375 cells as the template,then inserted into the eukaryotic expression plasmid PCDNA3.1 (+) to construct a recombinant plasmid,PCDNA3.1 (+)-PKCI-1/HINT1.Some A375 cells were classified into two groups to be transiently transfected with the recombinant plasmid (PCDNA3.1 (+)-PKCI-1/HINT1 group) or the empty plasmid PCDNA3.1 (+) (control group).After additional 48-hour culture,RT-PCR and Western blot analysis were performed to quantify the mRNA and protein expressions of PKCI-1/HINT1 respectively,Hoechst 33342 staining was conducted to detect apoptosis of A375 cells,Western blot analysis to detect the expressions of intracellular caspase-3 and autophagy-associated protein beclin1,and cell autophagy was observed by using the green fluorescent protein (GFP)-microtubule-associated protein 1 light chain 3 (LC3) labelling method combined with confocal laser scanning microscopy.Methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferative activity of A375 cells at 24,48,72 and 96 hours after transfection.Results Enzyme digestion and sequencing analysis confirmed that the eukaryotic expression plasmid PCDNA3.1 (+)-PKCI-1/HINT1 was successfully constructed and effectively expressed in the transfected A375 cells.MTT assay showed that PKCI-1/HINT1 could obviously inhibit the proliferation of A375 cells,and the number of live cells was decreased by 17.0％,25.6％ and 29.4％ in the PCDNA3.1 (+)-PKCI-1/HINT1 group at 48,72 and 96 hours,respectively,compared with the control group (all P ＜ 0.05).Hoechest 33258 staining revealed that PKCI-1/HINT1 could promote the formation of apoptotic bodies in A375 cells.Confocal laser scanning microscopy demonstrated that the overexpression of PKCI-1/HINT1 increased GFP-LC3 puncta formation in A375 cells.In addition,Western blot analysis indicated that PKCI-1/HINT1 up-regulated the protein expressions of caspase-3 and beelin1 in A375 cells.Conclusions The eukaryotic expression plasmid PCDNA3.1 (+)-PKCI-1/HINT1 was successfully constructed,and PKCI-1/HINT1 could be effectively expressed in A375 cells.High-level expression of PKCI-1/HINT1 could suppress cellular proliferation,promote apoptosis,and induce autophagy,of A375 cells.

Objective To investigate clinical and pathological features of primary cutaneous CD30 + anaplastic large cell lymphoma(PC-ALCL). Methods Clinical and pathological data were collected from 7 patients with PC-ALCL and analyzed retrospectively. Results Of the 7 patients, 6 were male and 1 was female, with an average age of 52 years. PC-ALCL was characterized by solitary (n = 3)or multiple (n = 4)erythematous nodules, lumps and/or plaques with (n = 6)or without (n = 1)ulceration. Systemic involvement was observed in none of the 7 patients. Histopathological examination showed diffuse distribution of tumor cells in the dermis, which were large with rich cytoplasm and atypical nuclei. Mitotic figures were seen. An immunohistochemical study of tumor cells showed positive staining for CD30 and cytotoxic protein, but negative staining for CD20, CD56,anaplastic lymphoma kinase(ALK). Epstein-Barr virus-encoded RNA in situ hybridization was negative. Conclusions PC-ALCL is a rare primary cutaneous low-grade malignant T-cell lymphoma, which can be confirmed by clinical manifestations as well as histopathological and immunohistochemical examinations. It usually has good prognosis with rare systemic involvement and metastasis.

Objective To investigate the clinical significance of serum procalcitonin (PCT),C reactive pro-tein(CRP),and lymphocyte subsets CD +19 CD +23 in children with Kawasaki disease (KD).Methods From August 2013 to July 2015 in hospital,30 cases of acute phase KD were selected.According to cardiac color Doppler ultra-sound results,30 patients were divided into coronary artery disease (CAL)group and non coronary artery disease (NCAL)group.The intravenous immunoglobulin (IVIG)before and after treatment,serum PCT,CRP,CD +19 CD +23 were detected.And 30 healthy children were selected as normal control group.Serum PCT was detected by chemilumines-cence immunoassay,CRP was determined by immune latex ratio method,CD +19 CD +23 was measured by flow cytometry. Results The levels of PCT,CRP and CD +19 CD +23 were (1.37 ±0.39)μg/L,(52.24 ±12.99)mg/L,(25.45 ± 11.06)% respectively in KD before IVIG treatment,which were significantly higher than those of KD after treatment [(0.49 ±0.24)μg/L,(37.48 ±6.27)mg/L,(17.23 ±1.97)%]and the control group[(0.05 ±0.00)μg/L, (16.08 ±5.21)mg/L,(15.76 ±2.39)%],the differences were statistically significant (t =6.108,5.983,8.172, all P <0.01).In CAL group,PCT[(1.75 ±0.53)μg/L,(65.95 ±14.55)mg/L]and CRP[(0.93 ±0.42)μg/L, (26.18 ±6.71)mg/L]were higher than NCAL group,the differences were statistically significant (t =5.504,5.621, all P <0.05).While CAL group CD +19 CD +23 [(24.70 ±11.86)%]and NCAL group[(25.79 ±10.59)%]had no statistically significant difference (t =0.559,P >0.05 ).Conclusion PCT,CRP and CD +19 CD +23 can be used as important index for early diagnosis and prediction of KD,the levels of CRP and PCT have clinical significance in the assessment of coronary artery lesions.

Objective To investigate the diagnosis and differential diagnosis of dermatofibrosarcoma protuberans (DFSP). Methods Totally, 50 patients with DFSP visiting the Institute of Dermatology, Chinese Academy of Medical Sciences from 1998 to 2014 were enrolled. The clinical manifestations, histopathological and immunohistochemical features, treatment and prognosis of DFSP were retrospectively reviewed. Results The average age at onset of DFSP was (29.5 ± 15.9)years in the 50 patients, with a mean disease duration of 9.57 years. Skin lesions most frequently occurred on the trunk(n = 33, 66.0%), followed by the extremities, head and neck. DFSP was characterized by atrophic patches or plaques in 13 cases (26.0%), multiple nodules varying in size and arising on atrophic plaques or patches in 30 cases (60.0%), single or multiple nodules arising on normal skin in 7 cases (14.0%). Histologically, the tumor consisted of uniform infiltrative spindle cells arranged in a storiform or cartwheel pattern. In addition, the tumor cells expressed CD34 and vimentin. Twenty patients experienced recurrence at the primary site after resection of skin lesions with a recurrence rate of 43.5%. No distant metastasis or death occurred in these patients. Conclusions DFSP usually has various skin manifestations, is easily misdiagnosed, and can be confirmed based on histopathological and immunohistochemical findings. Local recurrence of DFSP is common, and may occur for many times after surgical excision, but lymphatic and distant metastases are rare.