Objective To explore the characteristics of blood lipid metabolism indicators and risk factors of prognosis in children with systemic lupus erythematosus (SLE). Methods A total of 54 children who were diagnosed with SLE and hospitalized in Chengdu Women and Children’ s Central Hospital from January 2013 to August 2022 were selected. Clinical data of all children were collected and blood lipid metabolism indicators and biochemical indicators were detected , and binary logistic regression was used to analyze the prognosis risk factors in children with SLE. Results Among the 47 cases (87.04%) had abnormal blood lipid metabolism at admission, and is mainly manifested as elevated levels of LDL-C, TG and TC and decreased level of HDL-C. The proportion of cardiovascular system damage, hematological system damage, urinary protein positivity, and SLEDAI-2000 score in the group with good prognosis were lower than those in the group with poor prognosis, while the proportion of dsDNA positivity was higher in the group with poor prognosis. Binary Logistic regression analysis showed that the cardiovascular system damage and positive urinary protein were risk factors for poor prognosis, with statistically significant differences (P<0.05). Conclusion Abnormal blood lipid metabolism is common in children with SLE, and cardiovascular system damage and positive urinary protein may increase the risk of poor prognosis in young children.

[Objective] To investigate the inhibitory effect of quercetin on cisplatin-resistant human colorectal cancer (CRC) cells SW480 and SW620 and its possible mechanism. [Methods] Cisplatin-resistant subtypes of SW480 and SW620 cells were first cultured and the effects of quercetin on cell proliferation and chemosensitivity were determined by MTT assay. Flow cytometry was used to detect apoptosis and protein blotting was used to detect the expressions of relevant proteins. [Results] MTT assay showed that quercetin at the concentrations of 80 μmol/L and 160 μmol/L significantly inhibited the proliferation of SW480 and SW620 cells. Flow cytometry results showed that the apoptosis rate was significantly higher in the cisplatin combined with quercetin group than in the other three groups. Protein blotting showed that cleaved-caspase-3 and caspase-9 expressions were significantly increased in the cisplatin combined with quercetin group. The chemotherapeutic drug sensitivity assay showed that the elevated IC50 of drug-resistant cells was decreased significantly after quercetin administration (P<0.05). [Conclusion] The present study clarifies that quercetin can increase the sensitivity of human CRC cells to cisplatin. This effect may be related to its mechanism of action in affecting cell proliferation, apoptosis and autophagy.

Objective To investigate the role and action mechanism of rosemarinic acid(RA)on the malignant behavior of colorectal cancer(CRC)SW480 cells.Methods We collected tumor tissues from patients with primary untreated CRC who underwent surgery in People's Hospital of Rugao from January 2019 to December 2020,as well as colon tissues from normal individuals.The expression of β-catenin was detected by immunohistochemistry and Western blotting to analyze its relationship with the clinical stage,prognosis,and immune infiltration.CCK-8 was used to detect the effects of 10,15 and 20 μmol/L of RA on the proliferation of SW480 cells;flow cytometry detected apoptosis;Transwell and scratch assay detected changes in the invasion and migration ability of the cells,respectively.Western blotting detected the expressions of proteins related to apoptosis,epithelial-mesenchymal transition(EMT),and Wnt/β-catenin pathway.A mouse model of CRC transplant tumor was established,and the effect of RA on the growth of transplant tumor was investigated by gavage administration.The levels of inflammatory factors were detected by ELISA.Results The expression of β-catenin was low in normal colon tissues and significantly higher in CRC tissues.In the CRC patients with high expression of β-catenin,the number of patients with tumors larger than 5 cm was significantly higher than that in the low expression group,whereas the overall survival of the patients was significantly smaller than that in the low expression group(P＜0.05).Cell proliferation was significantly inhibited and decreased in a concentration-dependent manner in the RA group at all concentrations(P＜0.05).In animal experiments,the expression of apoptotic proteins Bax and Bad was significantly increased and the expression of anti-apoptotic protein Bcl-2 was significantly decreased in the RA-treated group compared with the control group(P＜0.05).It was also found that the invasive and migratory ability of SW480 cells was significantly inhibited(P＜0.05),the expression of E-cadherin protein was significantly increased,the expression of Snail,N-cadherin and Vimentin was significantly reduced(P＜0.05),the expression of Axin and GSK-3β was increased,and the expression of β-catenin was reduced(P＜0.05).Conclusion RA may inhibit the biological activity of SW480 by interfering with Wnt/β-catenin pathway-mediated EMT.

Objective:To investigate the association between congenital hypothyroidism (CH) and the adverse outcomes during hospitalization in very low birth weight infants (VLBWI).Methods:This prospective, multicenter observational cohort study was conducted based on the data from the Sino-northern Neonatal Network (SNN). Data of 5 818 VLBWI with birth weight <1 500 g and gestational age between 24-<37 weeks that were admitted to the 37 neonatal intensive care units from January 1 st, 2019 to December 31 st, 2022 were collected and analyzed. Thyroid function was first screened at 7 to 10 days after birth, followed by weekly tests within the first 4 weeks, and retested at 36 weeks of corrected gestational age or before discharge. The VLBWI were assigned to the CH group or non-CH group. Chi-square test, Fisher exact probability method, Wilcoxon rank sum test, univariate and multivariate Logistic regression were used to analyze the relationship between CH and poor prognosis during hospitalization in VLBWI. Results:A total of 5 818 eligible VLBWI were enrolled, with 2 982 (51.3%) males and the gestational age of 30 (29, 31) weeks. The incidence of CH was 5.5% (319 VLBWI). Among the CH group, only 121 VLBWI (37.9%) were diagnosed at the first screening. Univariate Logistic regression analysis showed that CH was associated with increased incidence of extrauterine growth retardation (EUGR) ( OR=1.31(1.04-1.64), P<0.05) and retinopathy of prematurity (ROP) of stage Ⅲ and above ( OR=1.74(1.11-2.75), P<0.05). However, multivariate Logistic regression analysis showed no significant correlation between CH and EUGR, moderate to severe bronchopulmonary dysplasia, grade Ⅲ to Ⅳ intraventricular hemorrhage, neonatal necrotizing enterocolitis in stage Ⅱ or above, and ROP in stage Ⅲ or above ( OR=1.04 (0.81-1.33), 0.79 (0.54-1.15), 1.15 (0.58-2.26), 1.43 (0.81-2.53), 1.12 (0.70-1.80), all P>0.05). Conclusion:There is no significant correlation between CH and in-hospital adverse outcomes, possibly due to timely diagnosis and active replacement therapy.

With the course of Clinical Skill Training as an example, this article integrates hierarchical teaching and peer teaching, adopts the problem-based learning (PBL) teaching model and famous traditional Chinese medicine (TCM) teaching clinics, connects the assessment criteria for standardized residency training, and pays attention to cultivating a reasonable teacher team, so as to improve the overall teaching quality of the course and the enthusiasm for the course among students. The application of the teacher inheritance model combined with case-based learning (CBL) teaching can help medical students to learn and inherit the clinical experience and skills, communication methods, and academic ideas of famous old TCM doctors and inherit and carry forward the essence of TCM culture. At the same time, CBL teaching is adopted to promote the integrated and people-oriented teaching concept of TCM, with medical students as the main body and teachers as the supporting role. The training with this model can effectively improve the clinical skills and development potential of TCM students.

Objective:To explore the current situation of knowledge, attitude and practice in the prevention and treatment of lymphedema after tumor treatment among nurses in cancer hospitals, and analyze its influencing factors.Methods:This study is a cross-sectional study. From October to November 2021, convenience sampling was used to survey 478 nurses from Hunan Cancer Hospital using the self-made Lymphedema Prevention and Treatment Knowledge, Attitude and Practice Questionnaire, which included 41 items from three dimensions of knowledge, attitudes and practice. The influencing factors of nurses' knowledge, attitude and behaviors related to lymphedema were studied using univariate analysis and multiple linear regression analysis.Results:The knowledge, attitude and practice scores and the total score of nurses in the cancer hospital regarding the prevention and treatment of lymphedema after tumor treatment were (17.05±9.81) , (49.96±6.03) , (30.51±11.03) , and (97.53±21.52) , respectively. The score rate of knowledge dimension was the lowest at 42.63%, while the score rate of attitude dimension was the highest at 90.84%. Multiple linear regression showed that working with lymphedema patients, participation in lymphedema training, training forms (on-the-job continuing education, school studies, self-study) , and the nurses' department being the breast or gynecological oncology department were the influencing factors for the nurses' knowledge, attitude, and practice in the prevention and treatment of lymphedema ( F=15.801, P<0.01) . Conclusions:Nurses in the cancer hospital generally have a moderate level of knowledge, attitude and practice in the prevention and treatment of lymphedema after tumor treatment. They have poor knowledge mastery and need to improve their behavioral, but their attitude is relatively positive. Nursing managers in cancer hospitals should strengthen training on lymphedema related knowledge among nurses from departments other than breast and gynecological oncology, strengthen nurses' knowledge and behavior in the prevention and treatment of lymphedema, and cultivate lymphedema therapists and specialized nurses. At the national level, policies should be introduced to establish a complete lymphedema rehabilitation training system, and improve nurses' ability to prevent and treat lymphedema in clinical practice.

OBJECTIVE To eval uate the cost-util ity of regimen containing bortezomib in the treatment of newly diagnosed multiple myeloma in China. METHODS From the perspective of China ’s health system ，Markov model was constructed based on SWOG S 0777 clinical trial. The simulation time limit was 10 years，and the cycle was set with reference to the treatment cycle. Taking quality adjusted life years （QALYs）as the utility index ，the utility and cost were discounted at a discount rate of 5％；the willingness to pay （WTP）threshold was set to be 3 times of China ’s per capita gross domestic product （GDP）in 2021（242 928 yuan/QALY）. The incremental cost-utility ratio （ICER）of dexamethasone combined with bortezomib and lenalidomide （VRD） versus dexamethasone combined with lenalidomide （RD）were compared with cost-utility analysis. The sensitivity analysis was performed for the uncertainty of the model. RESULTS Results of baseline analysis showed that VRD regimen could obtain 0.65 more QALYs than RD scheme ，but its treatment cost was 135 782.77 yuan more than RD regimen ，ICER was 206 623.35 yuan/ QALY，which was lower than the WTP threshold set in this study ，VRD regimen was cost-effective. Single factor sensitivity analysis showed that the health utility value in progressive free survival had the greatest impact on the results ，the decrease of utility value would make the ICER higher than the WTP threshold ，and VRD regimen would no longer have advantages. Under the WTP threshold of 3 times of China ’s per capita GDP in 2021，the probability of VRD regimen being cost-effective was 86.5％； with the increase of WTP threshold ，the possibility of VRD regimen becoming more cost-effective than RD regimen would increase. CONCLUSIONS Under the WTP threshold of 3 times of China ’s per capita GDP in 2021，compared with RD regimen，VRD regimen is cost-effective in the treatment of newly diagnosed multiple myelo ma in China.

Objective:To investigate outcomes and safety of doxycycline-moxifloxacin sequential regimen in the treatment of Mycoplasma genitalium urethritis/cervicitis. Methods:From June 2019 to December 2020, patients with Mycoplasma genitalium urethritis/cervicitis confirmed by nucleic acid amplification testing were successively recruited at Department of Sexually Transmitted Diseases, Hospital of Dermatology, Chinese Academy of Medical Sciences, and received sequential therapy with oral doxycycline for 7 days followed by oral moxifloxacin for 7 days. Clinical and/or etiological assessment was conducted 2 to 3 weeks after the end of treatment. Fisher′s exact test was used to analyze factors influencing the treatment outcome. Results:Totally, 36 eligible subjects were enrolled, including 30 males and 6 females. Among them, 18 (50%) patients completed post-treatment etiological assessment, which showed that 12 achieved microbiological cure, and treatment failures occurred in 6; another 18 patients achieved clinical cure. The overall response rate to doxycycline-moxifloacin sequential therapy was 83.3% (30/36, 95% confidence interval[ CI]: 70.5%, 96.1%) . The treatment outcome showed no significant association with the patients′ age, gender, marital status, number of sexual partners in the past 1 month, history of sexually transmitted diseases, history of antibiotic use in the past 1 month, or co-infections (all P > 0.05) . Conclusion:The efficacy of doxycycline-moxifloacin sequential regimen is limited in the treatment of Mycoplasma genitalium infections in Nanjing area, and clinicians should be alerted to the possibility of treatment failure in clinical practice.

Objective:To explore the expression of programmed death ligand-1 (PD-L1) protein in grade Ⅲ non-special type invasive breast cancer and its related factors, so as to provide a basis for immunotherapy.Methods:A total of 63 surgically resected specimens of grade Ⅲ non-special type invasive breast cancer diagnosed by pathology in Cancer Hospital & Shenzhen Hospital of Chinese Academy of Medical Sciences from February 2017 to February 2021 were collected. The HE-stained sections were reviewed, and the proportion of immune cells (IC) in all invasive active tumor cells in the tumor sections was calculated. The expression of PD-L1 (SP142) protein in all specimens was detected by immunohistochemistry. The relationship between the positive expression of PD-L1 protein and the clinicopathological parameters was analyzed, and the Pearson correlation test was used to analyze the relationship between the expression of PD-L1 (SP142) and the degree of IC infiltration.Results:Among 63 patients, 19 patients (30.2%) were triple-negative type, 34 patients (53.9%) were luminal type, and 10 patients (15.9%) were human epidermal growth factor receptor 2 (HER2) overexpression type. The positive rate of PD-L1 (SP142) in grade Ⅲ non-special type invasive breast cancer was 77.8% (49/63). The positive rate of PD-L1 (SP142) in triple-negative type was 94.7% (18/19), the positive rate in non-triple-negative type was 70.5% (31/44), and the difference between the two groups was statistically significant ( P = 0.047). The positive rate of PD-L1 (SP142) in estrogen receptor (ER)-negative patients or progesterone receptor (PR)-negative patients was both 90.3% (28/31), which was higher than that of ER-positive patients or PR-positive patients (65.6%, 21/32), and the difference was statistically significant ( P = 0.018); the positive rate of PD-L1 (SP142) was not related to the patient's age, tumor site, tumor maximum diameter and number, vascular tumor thrombus, nerve invasion, lymph node metastasis, HER2 status and Ki-67 positive index (all P > 0.05). The expression of PD-L1 was positively correlated with the degree of IC infiltration ( r = 0.716, P<0.001). Conclusion:In grade Ⅲ non-special type invasive breast cancer, the patients with triple-negative type has a high positive rate of PD-L1, and the patient with negative ER or PR has a high positive rate of PD-L1; the tumor IC infiltration is positively correlated with the expression of PD-L1.