【Objective】 To analyze the association between the composition of gut microbiota and blood pressure in children aged 6 - 9 years, in order to provide new ideas for childhood hypertension prevention and treatment. 【Methods】 A total of 411 children aged 6 - 9 years were recruited in Guangzhou from December 2015 to March 2017. The gut microbiota was characterized by 16S ribosomal RNA amplicon sequencing. The multivariate methods with unbiased variable selection in R (MUVR) were performed to identify the significant OTUs. Spearman correlation as well as multiple linear regression were used to explore the relationship between gut microbiota and blood pressure in children. 【Results】 Significant difference in β diversity index was observed between children with normal blood pressure and those with abnormal blood pressure (R²weighted=0.015,Pweighted=0.01; R²unweighted=0.027, Punweighted=0.001). After adjustment for covariates and controlling the false discovery rate (FDR), multiple linear regression analysis showed that blood pressure level in children decreased with the increasing abundance of OTU_3 (genus Blautia), OTU_131 (genus [Clostridium]_innocuum_group), OTU_1776 (genus Blautia), OTU_2159 (genus Prevotella) and OTU_91 (species Bifidobacterium_breve) (β:-0.18 --0.14; PFDR<0.05. In contrast, blood pressure in children increased with the increasing abundance of OTU_108(genus Sutterella), OTU_1(species Faecalibacterium_prausnitzii)、OTU_8(genus Roseburia), OTU_48 (genus Lachnoclostridium), OTU_81 (genus Coprococcus), OTU_401 (family Lachnospiraceae), OTU_1284 (family Lachnospiraceae) and OTU_2793 (family Lachnospiraceae)(β: 0.14 - 0.21; PFDR<0.05. The influence of gut microbiota on systolic pressure and diastolic pressure may be mediated by the increase of body mass index (BMI). 【Conclusions】 Pediatric blood pressure level is associated with the composition of gut microbiota, while BMI partially plays a mediating role in the relationship. It is recommended to modulate the abundance of microbiota as genus Blautia, Sutterella and so on to prevent hypertension in children.

Objective:To investigate the effect of interleukin-12(IL-12)on liver lesions and oxidative stress pathway in Sjo-gren's syndrome mice,and to clarify the possible mechanism of liver lesions in Sjogren's syndrome.Methods:Saliva flow rate,liver function,liver pathology and IL-12 level were measured in NOD,IL-12 knockout(IL-12KO)NOD and C57BL/6(B6)mice.Different concentrations of IL-12 and JAK2,TYK2 inhibitors were applied to mouse hepatoma cells.The oxidative stress index of mouse serum and cell culture supernatants of each group were determined.Results:Compared with the other two groups of mice,the NOD mice had significantly higher GOT and GPT(P<0.05),and decreased serum GSH-PX,SOD and CAT(P<0.05).CAT,GSH,GSH-PX and SOD were decreased,while MDA was increased in mice treated with different concentrations of IL-12.JAK2/TYK2 inhibitors reversed regulatory effects of IL-12 on SOD,GSH and MDA in hepatoma cells(P<0.05).Conclusion:IL-12 may aggravated liver damage of Sj?gren's syndrome through promoting oxidative stress of hepatocytes.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective: To observe the interventional effects of human amniotic mesenchymal stem cells (hAMSCs) transfected with angiotensin converting enzyme 2 (ACE2) gene on monocrotaline-induced pulmonary arterial hypertension (PAH) in rats． Methods : ① HAMSCs were transfected with lentivirus carrying ACE2 gene，and the expression of ACE2，insulin-like growth factor (IGF-1) ，granulocyte chemoattractant protein-2 ( GCP-2) gene，cell migration and tube formation ability was detected before and after transfection. ② Male，healthy，6-week-old SD rats were randomly divided into normal Control group ( Control group ) ，pulmonary hypertension group ( PAH group) ，human amniotic mesenchymal stem cell treatment group ( hAMSCs group) and ACE2-transfected human amniotic mesenchymal stem cell treatment group ( ACE2-hAMSCs group) ．The mean pulmonary arterial pressure ( mPAP) and right ventricular hypertrophy index (RVHI) were measured 2 weeks after the model was established. The lumen size of pulmonary arterioles and the thickness of vessel wall were observed by HE staining．The mRNA expression levels of GCP-2 ，ACE2 ，α-actin and angiotensin Ⅱ ( Ang Ⅱ ) in lung tissue were determined by QPCR . Results : In vitro cell experiments showed that the cell migration ability and tube formation ability of ACE2- hamscs were higher than those of pure hAMSCs (P＜0. 05) ．Ace2-hamscs up-regulated the mRNA expressions of ACE2 and pro-angiogenic factors IGF-1 and GCP-2 (P＜ 0. 01) ．After 2 weeks of intervention，the mPAP and cardiac RV/ LV + S of the PAH group significantly increased compared with the normal control group (P＜0. 01) ，and the mPAP and cardiac RV/ LV + S of the ACE2-hAMSCs group significantly decreased compared with the PAH and hAMSCs groups (P ＜0. 01 ) ． Compared with PAH group，the mRNA expression level of ACE2 significantly increased in the lung tissue of ACE2-hamscs group． Conclusion ACE2-hAMSCs can significantly reduce the mean pulmonary arterial pressure of monocrotaline (MCT) -induced PAH rat model，and significantly improve pulmonary vascular and right ventricular remodeling．The therapeutic effect of ACE2-hamscs is significant in hAMSCs group. It is considered that ACE2-hAMSCs may not only promote the paracrine effect of hAMSCs，The expression of provascular growth factors GCP2 and IGF-1 can repair the injured pulmonary vascular endothelial cells and reduce the high pressure of pulmonary artery．Moreover，the high expression of ACE2 in hAMSCsis related to the regulation of RAS.

Objective:To analyze clinical characteristics of patients of Tibetan nationality with vitiligo in the Tibet autonomous region.Methods:Clinical data were collected from 527 patients of Tibetan nationality with vitiligo, who visited Department of Dermatology, People′s Hospital of Tibet Autonomous Region from January 2018 to December 2019, including age, gender, seasons at onset, involved body sites, classification and stages of vitiligo, concomitant diseases and laboratory test results.Results:Among the 527 patients of Tibetan nationality with vitiligo, the ratio of male to female was 0.97∶1, and vitiligo usually occurred at 10 - 30 years of age. As for clinical staging, 335 (63.6%) patients were diagnosed with progressive vitiligo, and 192 (36.4%) with stable vitiligo; as for clinical classification, there were 97 (18.4%) patients with segmental vitiligo, 293 (55.6%) with vitiligo vulgaris, 79 (15%) with mixed vitiligo and 58 (11%) with unclassified vitiligo; vitiligo lesions were mainly located on the face and neck (253 cases, 48%) , followed by the trunk (148 cases, 28%) , upper limbs (64 cases, 12%) , lower limbs (46 cases, 9%) , and perineal and perianal mucosa (16 cases, 3%) ; vitiligo usually occurred in summer (198 cases, 37.6%) and spring (154 cases, 29.2%) , followed by autumn (98 cases, 18.6%) and winter (77 cases, 14.6%) ; 140 (26.6%) patients suffered from other diseases such as thyroid diseases (85 cases, 16.1%) , and 74 (14.0%) suffered from subclinical thyroid diseases; one or more serological abnormalities were observed in 22 patients, including 18 with progressive vitiligo. Compared with the patients with stable vitiligo, those with progressive vitiligo showed significantly increased thyroid stimulating hormone (TSH) levels ( P = 0.004) . Spearman rank correlation analysis showed that altitude was weakly correlated with the stage of vitiligo ( rs = -0.18, P < 0.001) , the stage of vitiligo was weakly negatively correlated with the TSH level ( rs = -0.12, P = 0.005) and complement C3 level ( rs = -0.09, P = 0.041) , and the classification of vitiligo was weakly correlated with the TSH level ( rs = -0.11, P = 0.011) . Conclusion:In this study, the patients of Tibetan nationality with vitiligo were mostly aged at 10 - 30 years, vitiligo lesions were mainly located on the face and neck, and usually occurred in spring and summer, and the prevalence of comorbid thyroid dysfunction was relatively high.

Epithelial Cells ; Humans ; Nasal Mucosa ; Sinusitis

AIM: To investigate whether the microgravity environment is related to retinal damage.METHODS: Hanging-tail mice tests were used to simulate weightlessness. Light microscopy, and transmission electron microscopic examinations of the retinal tissue structure were used to observe morphological changes. Immunohistochemistry and Western blot analyses were performed to detect the molecular changes associated with the observations.RESULT: Light microscopy and transmission electron microscopy demonstrated that more dead cells were detected in the ganglion layer and inner nuclear layer cells. TNF-α and caspase-3 protein expression in the retinas of simulated microgravity groups were up-regulated compared with the ground-based control group.CONCLUSION: The results demonstrated that simulated microgravity produced severe pathological damage in the retinas of mice.

Objective: To investigate the current status of humanistic care ability of burn specialist nurses and to analyze the influencing factors. Methods: A single-center cross-sectional research method was conducted. From May to August 2020, 63 burn specialist nurses who met the inclusion criteria in Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine were selected. Self-made general data questionnaire was used to investigate 17 indexes, including gender, age, professional title, working years, whether received humanistic care training, academic qualification, and caring ability inventory (CAI) was used to evaluate their humanistic care ability. After the nurses were classified by the general data, independent sample t test and one-way analysis of variance were performed on the data to analyze the total score of CAI. The CAI total scores and scores of cognition, courage, and patience of the nurses were compared with the international norm. The factors with statistically significant differences in unvariate analysis were selected for multiple linear regression analysis to screen the independent influencing factors of humanistic care ability of burn specialist nurses. Results: A total of 63 questionnaires were collected in this survey, all of which were valid. Among the 63 nurses, there were 4 males and 59 females, with the age mainly ranging from 20 to 30 years (30 nurses, 47.62%), the professional titles mainly being nurse practitioner (36 nurses, 57.14%), the working years mainly being more than 10 years (28 nurses, 44.44%), 32 nurses not receiving humanistic care training, and academic qualifications mostly being junior college (37 nurses, 58.73%). There were significant differences in the total scores of CAI among nurses with different ages, professional titles, working years, whether received humanistic care training, and academic qualifications (with F values of 53.95, 49.14, and 75.42, t values of 6.08 and -2.82, respectively, P<0.01). The scores of cognition, courage, and patience and the total scores of CAI of nurses in this group were significantly lower than those of international norm (with t values of -2.02, -2.04, -6.19, and -3.89, respectively, P<0.05 or P<0.01). Multiple linear regression analysis showed that age, working years, professional title, and whether received humanistic care training were the independent influencing factors of humanistic care ability of burn specialist nurses (with 95% confidence intervals of 1.91-23.23, 16.25-31.48, 1.05-19.09, and 6.72-31.82, unstandardized coefficient values of 12.57, 23.86, 10.07, and 19.27, respectively, P<0.05 or P<0.01). Conclusions: The humanistic care ability of burn specialist nurses is relatively weak. Age, professional title, working years, and whether received humanistic care training are the independent influencing factors of humanistic care ability of burn specialist nurses.
Male ; Female ; Humans ; Young Adult ; Adult ; Cross-Sectional Studies ; China ; Humanism ; Surveys and Questionnaires ; Burns/therapy*

Objective: To estimate the effectiveness of the primary screening strategy for liver cancer in rural areas to provide basic information for the optimization and perfection of the technical program for the early detection and treatment of liver cancer. Methods: Residents including males aged 35-64 and females aged 45-64 from 9 counties in rural China between 2013 and 2015 were selected as the target population. The participant was classified into a high-risk and non-high-risk group based on the standardized questionnaire or HBsAg, and the Chi-squared test was applied to compare differences between the two groups. The Cox proportional hazard regression models were applied to assess hazard ratio (HR) and its 95% confidence interval (CI). Results: 358 348 participants were recruited from 2013 to 2015. 1 196 individuals were identified with liver cancer until December 31, 2021, with an incidence density of 52.0/10(5) person-years. Of the participants, 54 650 were assessed as high risk (15.3%) based on the questionnaire and the status of HBsAg. The high-risk population had a higher incidence density (168.3/10(5) person-years vs 31.5/10(5) person-years) and higher risk of developing liver cancer (HR=2.98, 95% CI=2.64-3.35), compared to the non-high-risk group. Based on the questionnaire-based high-risk assessment system, 47 884 (13.4%) individuals were identified as high risk, who showed statistical differences in terms of incidence density and incidence risk, in comparison to the low-risk population (all P<0.05). HBsAg can screen out a higher proportion of high-risk individuals who are women, non-smokers, non-drinkers, and individuals without a family history of liver cancer (all P<0.05). The sensitivity analysis of the effectiveness of the whole primary screening method is stable, and high-risk individuals still had a higher risk of liver cancer. Conclusions: The primary screening method of the questionnaire-based risk assessment system and HBsAg can achieve satisfactory effectiveness. The questionnaire-based risk assessment system could identify high-risk individuals to some extent, however, it still needs to be improved to meet the actual requirements.
China/epidemiology* ; Early Detection of Cancer ; Female ; Hepatitis B Surface Antigens ; Humans ; Incidence ; Liver Neoplasms/epidemiology* ; Male ; Mass Screening ; Risk Factors

The organ-system-centered medical integrated teaching mode has become the trend of modern medical education. This model combines basic medicine with clinical medicine closely. It has been widely conducted domestically and abroad for training qualified clinicians as the main task. This paper summarized the experience of integrated curriculum reform of the digestive system in Chongqing Medical University, analyzed the performance of students involved in curriculum reform, explored the problems in the curriculum reform combined with the actual situation of Chongqing Medical University, and investigated possible solutions to accumulate the experience for further deepening the integrated curriculum reform.