Objective To understand the current situation of breastfeeding duration in children aged 0-5 years in Yunnan Province,and to explore the influencing factors of breastfeeding duration.Methods Using the data of the 6th National Health Service Survey in Yunnan Province,1582 children aged 0～5 years in Yunnan Province were selected as the research subjects,and the Kaplan-Meier method and Cox regression were used to analyze the influencing factors of breastfeeding duration.Results The mean duration of breastfeeding for children aged 0～5 years in Yunnan Province was 9.29 months,and region,time of complementary food addition,time of suckling and family income were the main factors influencing the duration of breastfeeding.Conclusion The duration of breastfeeding for children aged 0～5 years in Yunnan Province deviates significantly from the recommendations provided by both the World Health Organization(WHO)and China's child breastfeeding guidelines.Given the current situation,the relevant departments must enhance their focus on this issue.

Objective:To explore the application of medical dialectics combined with problem-oriented teaching based on textbooks in hematology internship teaching.Methods:A total of 100 undergraduate students who practiced in the Department of Hematology of the First Hospital of Jilin University from 2022 to 2023 were selected as the research subjects. Students were randomly assigned to a control group and an observation group, with 50 students in each group. The control group received traditional teaching, while the observation group received medical dialectics combined with textbook-based problem-oriented teaching. We assessed the theoretical and operational scores, classroom performance, comprehensive abilities, and teaching satisfaction of two groups of students using t-test and χ 2 test in SPSS 22.0. Results:The theoretical and operational scores of the observation group were (94.26±5.35) points and (92.68±4.72) points, respectively. The theoretical and operational scores of the control group were (86.16±5.42) points and (81.52±5.28) points, respectively. The differences between the two groups were statistically significant ( P<0.001). The recognition rates were significantly higher by students in the observation group than in the control group ( P<0.05) in terms of improving learning efficiency, self-learning ability, understanding and comprehensive analysis of diseases, problem-solving ability, language and organizational expression ability, integration of theory and practice, clinical thinking ability, and independent thinking ability. The satisfaction with teaching was higher in the observation group than in the control group ( P<0.05) in terms of teaching attitudes, teaching methods, teaching arrangements, practicality of teaching content, clear explanation of teaching theories, and outstanding teaching objectives. Conclusions:The medical dialectics combined with textbook-based problem-oriented teaching can improve the assessment scores of medical students, while helping to cultivate their comprehensive abilities and develop good clinical diagnosis and treatment thinking.

OBJECTIVE To heterologously express and purify bioscavenger organophosphorus hydrolase(OPH),and evaluate its ability to resist ethyl paraoxon poisoning in vivo.METHODS The Escherichia coli expression strain of OPH was constructed and purified by Ni-column affinity chroma-tography and gel filtration chromatography,and the purified product was identified by mass spectrometry.The enzyme activity and kinetic constants(Km,Vmax,kcat and kcat/Km)were measured using ethyl paraoxon as the substrate.Twelve SD rats were randomly divided into the experimental group and control group.The experimental group was given 1 mg·kg-1 of OPH solution by iv administration while the control group was given the same volume of normal saline.After administration,the two groups were immedi-ately sc administration with 2×LD50 ethyl paraoxon(0.86 mg·kg-1).The state of the rats was observed and the poisoning symptoms were scored.The survival rats were given 2×LD50 ethyl paraoxon every 24 h,and the survival curve and symptom score chart were drawn according to survival and poisoning symp-toms of the rats to evaluate the anti-organophosphorus poisoning ability of OPH.RESULTS The expres-sion strain of OPH in E.coli was successfully constructed.After two-step purification,a single band of OPH was obtained by sodium dodecyl sulphate-polyacrylamide gel electrophoresis,indicating that OPH had high purity,and the prepared protein sequence was consistent with the target protein.For OPH,Km=7.5×10-5 mol·L-1,Vmax=2.2×10-7 mol·L-1·s-1,kcat=158.4 s-1,kcat/Km=2.1×106 L·mol-1·s-1.The rats in the control group showed obvious poisoning symptoms after being given 2×LD50 ethyl paraoxon,and all rats died with in 15 min.The rats in the experimental group did not show poisoning symptoms after the first exposure,and the poisoning symptoms gradually deepened after continuous exposure until all the rats died on the 4th day.CONCLUSION OPH with high purity is successfully prepared in this study,and OPH could effectively resist ethyl paraoxon poisoning in rats.

Objective:To investigate the clinical effect of CAG stimulating regimen for refractory adult early T cell precursor acute lymphoblastic leukemia (ETP-ALL) complicated with fusarium infection and the clinical features as well as antifungal strategy of cutaneous fusarium infection.Methods:The diagnosis and treatment of 1 adult patient diagnosed as ETP-ALL complicated with cutaneous fusarium infection in the First Hospital of Jilin University in September 2020 were retrospectively analyzed, and related literatures were reviewed.Results:VICP chemotherapy regimen showed no effectiveness in this patient who was presented with persistent agranulocytosis complicated with cutaneous fusariosis infection. After amphotericin B therapy for infection, he achieved the stable disease and successfully underwent CAG stimulating regimen salvage treatment. The minimal residual disease turned into negative after consolidation chemotherapy based on the myeloid regimen. Finally this patient survived from haploid allogeneic hematopoietic stem cell transplantation after consolidation chemotherapy and fusarium was under the control by using posaconazole as secondary prevention therapy.Conclusions:CAG stimulating regimen can be recommended as reinduction therapy for relapsed/refractory ETP-ALL. Sequential therapy of amphotericin B followed by posaconazole can be a useful antifungal strategy for fusarium infection.

【Objective】 To explore the efficacy of transurethral columnar balloon dilation of prostate (TUCBDP) and transurethral bipolar plasmakinetic resection of prostate (TUPKP) for patients with small volume (≤30 mL) benign prostatic hyperplasia (BPH) and the effects on urinary control and sexual function. 【Methods】 Clinical data of BPH patients who underwent surgical treatment during Jun.2021 and Jan.2022 were reviewed. A total of 95 patients with prostate volume ≤30 mL and regular sexual life were selected as subjects, including 45 patients who received TUCBDP as the TUCBDP group and 50 patients who received TUPKP as the TUPKP group. The patients were followed up for 12 months, and the perioperative data and follow-up results were analyzed. 【Results】 The TUCBDP group had shorter operation time, less intraoperative blood loss, less postoperative hemoglobin loss and sodium concentration loss, shorter bladder irrigation time, lower pain score, shorter urinary tube indwelling time and shorter hospital stay than the TUPKP group (P<0.05). Twelve months after surgery, the International Prostate Symptom score (IPSS), quality of life score (QoL), residual urine volume (PVR) and maximum urine flow rate (Qmax) were significantly improved in both groups (P<0.05). The International Index of Erectile Function-5 (IIEF-5), Erection Hardness Grading Score (EHS), Sexual Function Score in Patients with Premature Ejaculation-5 (CIPE-5) score had no significant differences compared with those before surgery (P>0.05). The TUPKP group had worse ejaculation function score and ejaculation disturbance score after surgery (P<0.05), while the TUCBDP group had no significant change (P>0.05), and the two indexes were superior in the TUCBDP group than in the TUPKP group. The TUCBDP group had significantly lower complication rate than the TUPKP group (P<0.05). 【Conclusion】 TUCBDP is safe and effective in the treatment of small volume (≤30 mL) BPH, less trauma, less biochemical interference, less pain, fewer complications, and shorter course of disease. It has little effect on the ejaculation function and erectile function, and is more suitable for patients requiring retention of sexual function. It has a good application prospect in the treatment of small volume BPH.

Objective:To investigate the diagnostic value of circular RNA circ_100367 in thyroid cancer (THCA) and its relationship with immune-related factors.Methods:According to the data chip provided by the National Center for Biotechnology Information (NCBI) website, the differentially expressed circRNAs in THCA were analyzed, then circ_100367 was included in this study. The serum of 175 THCA patients and healthy people were collected, and the expression levels of circ_100367 and its linear transcript DCAF8 mRNA in serum samples were detected by qRT-PCR, and the correlation between circ_100367 and DCAF8 was calculated. The correlation between the expression of circ_100367 and the clinicopathological characteristicsof the patients, immune infiltration level and immunosuppressive factor PD-1 was analyzed.Results:Compared with serum of healthy people (1.00±0.37) , expression level of circ_100367 in serum of THCA patients was significantly increased (1.37±0.41) ( t=8.80, P<0.001) , and there was no significant difference in DCAF8 mRNA expression ( t=1.67, P=0.095) , but circ_100367 was positively correlated with DCAF8 mRNA expression ( r=0.17, P=0.028) . Analysis of expression and clinicopathological characteristics of circ_100367 showed that compared with patients in M0 group (1.26±0.40) , circ_100367 was overexpressed in M1 and Mx patients (1.43±0.40) ( t=2.63, P=0.009) ; compared with N0 patients (1.24±0.36) , circ_100367 was overexpressed in serum of N1 and Nx patients (1.45±0.42) ( t=3.48, P=0.001) ; compared with serum of patients with negative lymph node detection (1.28±0.36) , circ_100367 was overexpressed in serum of positive patients (1.42±0.43) ( t=2.14, P=0.034) ; compared with T1+T2 stage patients (1.30±0.37) , circ_100367 expression was overexpressed in serum ofT3+T4 patients (1.40±0.43) ( t=2.22, P=0.028) . Analysis of the expression and immune infiltration levels of circ_100367 found that highly expressed circ_100367 was associated with CD8+ T cells ( r=0.25, P=0.024) , macrophages ( r=0.22, P=0.038) , CD4+ T cells ( r=0.25, P=0.020) and B cell ( r=0.23, P=0.033) levels. The expression of circ_100367 was also positively correlated with the immunosuppressive factor PD-1 ( r=0.19, P=0.011) . Conclusion:circ_100367 can be used as a marker for the diagnosis of THCA and its expression is strongly correlated with immune-related factors.

Objective:To explore a new method of diagnosing and identifying renal transplantation clinical almost tolerance through a diagnostic model using plasma proteomics.Methods:From November 2011 to November 2012, plasma samples from 43 subjects were collected and divided into the groups of clinical almost tolerance(18 cases), rejection(12 cases)and healthy control(13 cases). Protemic analysis of plasma samples was performed by surface enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS). Differential mass spectrometry peaks were screened and diagnostic model was established by Biomarker Wizard and Biomarker Pattern software. Identification of mass spectrometric peaks of nodes in the diagnostic model was carried out by searching the databases of SWISS-PROT and TrEMBL using ExPASy's TagIdent tool.Results:A total of 21 differential proteins peaks were obtained( P<0.05). Diagnostic model was composed of five mass spectrum peaks of 2 565.15, 1 966.28, 6 674.78, 1 103.27, 1 716.69 and 1 966.28.The sensitivity, specificity and area under the ROC curve of model were 83.3%, 92.0% and 0.951 respectively for diagnosing clinical almost tolerance.Bioinformatic identification results of mass spectrometric peaks of nodes in model were proteins of ANFB, MCH, TFF1, PDYN and PSME3. Conclusions:Establishing a diagnostic mode by plasma proteomics may be effectively employed for diagnosing clinical almost tolerance in kidney transplant.

Pheochromocytoma/paraganglioma(PPGL) was a kind of neuroendocrine tumor that derived from chromaffin tissue, which seems to be an important etiology of secondary hypertension. With the development of molecular detection technology, at least 17 kinds of pathogenic genes of PPGL has been discovered, which is related to 35%-40% PPGL, and about 40% malignant PPGL is associated with SDHB gene mutation. In this study, we reported a case with a novel splicing mutation of SDHB gene induced paraganglioma.

Objective:To investigate the effect of thoracoscopy combined with laparoscopy on lung function and tumor micrometastasis in patients with thoracic esophageal cancer.Methods:109 patients with thoracic esophageal cancer admitted from Mar. 2018 to Jul. 2019 in our hospital were divided into study group (60 cases) and the control group (49 cases) . The study group underwent thoracoscopy and laparoscopy assisted surgery, while the control group underwent traditional surgical resection of esophageal cancer. The differences of lung function, RBC immune function and the expression of invasive gene in the lesions between the two groups were compared.Results:Three days after the operation, maximum ventilation per minute (MVV) , forced expiratory volume for 1 s (FEV1) and vital capacity (VC) of the two groups were all decreased ( P<0.01) , but they were significantly higher in the study group than in the control group[ (69.90±7.07) vs (48.62±5.09) , (75.12±7.93) vs (42.99±4.81) , (74.57±7.30) vs (41.37±4.69) ( P<0.01) ]. mRNA of matrix metalloproteinase 9 (MMP9) and tumor necrosis factor receptor-related protein 1 (TRAP1) in the two groups were all decreased ( P<0.01) , while they were significantly higher in the study group than in the control group [ (0.54±0.09) vs (0.42±0.06) , (0.52±0.08) vs (0.41±0.06) ( P<0.01) ]. mRNA of Krüppel-like factor 4 (KLF4) and E-cad-herin in the two groups were all increased ( P<0.01) , while it was significantly lower in the study group than in the control group[ (2.87±0.30) vs (3.17±0.36) , (2.92±0.32) vs (3.19±0.38) ( P<0.01) ]. RBC immune complex rosette rate (RBC-ICR) in the study group was higher than that on the first day before operation ( P<0.01) , and gradually decreased from the first day after operation, and recovered to the preoperative level on the third day after operation. At the end of operation, red blood cell C3b receptor rosette rate (RBC-C3bRR) and red blood cell adhesion tumor cell rosette rate (TRR) in the study group were all decreased compared with those on the first day before operation ( P<0.01) , and gradually increased on the first day after operation in the study group, and recovered to the preoperative level on the third day after operation. Except for the first day before surgery, there were statistically significant differences in red blood cell immune function indexes at other time points between the study group and the control group[At the end of the operation: (30.29±4.80) vs (34.68±5.47) , (16.02±1.58) vs (12.03±1.17) , (17.50±2.86) vs (12.59±2.26) ; 1 d after operation: (29.13±4.19) vs (35.01±5.29) , (20.98±2.86) vs (16.23±2.40) , (22.50±2.56) vs (17.39±2.34) ; 3 d after operation: (26.01±3.80) vs (31.50±5.01) , (23.30±3.37) vs (18.02±2.79) , (25.80±2.10) vs (21.19±2.60) ( P<0.01) ]. Conclusion:In patients who need radical surgery for thoracic esophageal cancer, the application of thoracoscopy combined with laparoscopy has little effect on lung function, red blood cell immunity, and tumor micrometastasis, which is worth promoting.

Objective: To analyze ¹⁸F-fluorodeoxyglucose(FDG) PET/CT imaging manifestations in patients with peritoneal carcinomatosis (PC) from colorectal cancer (CRC) and investigate its clinical significance. Methods: From May 2016 to August 2018, 46 patients (25 males, 21 females; age range: 36-82(62.0±10.4) years) with PC from CRC who underwent ¹⁸F-FDG PET/CT imaging in Affiliated Hospital of Nantong University and had complete clinical data were retrospectively analyzed. The peritoneal carcinomatosis index (PCI) grading system was used to evaluate the PC lesions. Independent-sample t test and Kruskal-Wallis H test were used for data analysis. Results: There were various CT manifestations of PC, while FDG metabolism on PET was observed in all 46 patients. Patients were divided into different groups according to the location of the primary CRC lesion. The diameter of PC lesion in the left colon group was (2.46±1.26) cm, which was significantly different from that of the rectum group ((3.19±1.72) cm; t=-2.77, P<0.01). The maximum standardized uptake value (SUV_max) in the right colon group were significantly higher than that in the left colon group (9.16±4.79 vs 6.99±3.50; t=2.92, P<0.01). The PCI score ranged from 1 to 30 in 46 patients, and there was no significant difference in PCI score distribution (≥20 vs <20) among the right colon group, left colon group and rectum group (H=0.242, P>0.05). Ten patients had abdominal and pelvic effusion. Conclusion ¹⁸F-FDG PET/CT can well display the PC in patients with CRC, and the combination of PCI and ¹⁸F-FDG PET/CT plays an important role in the diagnosis and treatment of PC.