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Invasive fungal infections play an important factor threatening human health.In recent years, the number of the susceptible population of invasive fungal infections has increased rapidly, leading to a significant increase in the disease burden of human fungi.In 2022, the World Health Organization released a list of key fungal pathogens, aiming to promote global research and investment in fungal infection and antifungal resistance.At present, antifungal drugs are preferred for anti-fungal infection treatment, although the efficacy is limited by the adverse events and drug resistance.Improving the damaged host immune response is a reasonable way to improve the effectiveness of antifungal drugs.This article briefly described the epidemiology of fungal infections, summarized how hosts mediate the clearance of fungi by initiating innate and adaptive immune responses, and discussed the prospects and clinical evidence supporting immunomodulatory therapy for invasive fungal infections.

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Objective:To compare the therapeutic efficacy between femoral neck system (FNS) and cannulated compression screws (CCS) in the fixation of femoral neck fractures in the elderly patients aged 65 to 75 years old.Methods:A retrospective study was conducted to analyze the data of 39 patients aged 65 to 75 years old who had been treated for femoral neck fractures at Department of Trauma Surgery, Hospital Affiliated to Qingdao University from January 2015 to September 2022. The patients were divided into 2 groups according to their internal fixation methods. In the FNS group of 18 cases subjected to FNS fixation, there were 8 male and 10 females with an age of (71.1±2.8) years. In the CCS group of 21 cases subjected to CCS fixation, there were 7 males and 14 females with an age of (70.1±2.9) years. The 2 groups were compared in terms of intraoperative fluoroscopy frequency, surgical time, intraoperative bleeding, hospitalization costs, fracture healing time, internal fixation failure, and Harris hip score, changes in neck shaft angle, and femoral neck shortening at 1 year after surgery.Results:The differences were not statistically significant in the preoperative general data or follow-up time between the 2 groups, indicating comparability ( P>0.05). In the FNS group, the intraoperative fluoroscopy frequency [(15.1±2.3) times] was significantly lower than that in the CCS group [(19.5±3.5) times], the surgical time [(49.2±5.2) minutes] was significantly shorter than that in CCS group [(62.4±11.2) minutes], and the intraoperative bleeding [(74.2±15.6) mL] and hospitalization costs [(39,928.7±1,438.3) yuan] were significantly higher than those in the CCS group [(53.1±17.3) mL and (23,527.9±2,126.3) yuan] (all P<0.05). The difference in fracture healing time was not statistically significant between the 2 groups ( P>0.05). In the FNS group, the decreased neck shaft angle (2.65°±1.66°) and femoral neck shortening (3.9±1.3 mm) were significantly smaller than those in the CCS group [4.18°±2.13° and (6.3±2.5) mm] at 1 year after surgery, and the Harris hip score [(82.2±7.2) points] was significantly higher than that in the CCS group [(76.4±5.9) points] (all P<0.05). Internal fixation failure occurred in 1 case in the FNS group and in 4 cases in the CCS group, respectively, showing no statistically significant difference ( P>0.05). Conclusions:Compared with CCS fixation, FNS fixation may lead to better therapeutic efficacy in patients with femoral neck fracture aged 65 to 75 years old. However, the risk of internal fixation failure should also be taken into consideration.

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Objective:To compare the efficacy between locking plate internal fixation combined with iliac bone graft and separate locking plate internal fixation in the treatment of comminuted proximal humeral fracture in the elderly.Methods:A retrospective cohort study was conducted to analyze the clinical data of 42 elderly patients with comminuted proximal humeral fracture admitted to Affiliated Hospital of Qingdao University from January 2018 to January 2020. There were 20 males and 22 females, aged 65-75 years [(69.5±8.5)years]. According to Neer classification, there were 26 patients with three-part fracture and 16 with four-part fracture. Eighteen patients were treated by locking plate internal fixation combined with autologous iliac bone grafting (bone grafting group), and 24 patients were treated by locking plate internal fixation alone (non-bone grafting group). The operation time, intraoperative blood loss, postoperative drainage volume, hospitalization time, and fracture healing time were documented. Shoulder joint range of motion (forward flexion, extension, internal rotation and external rotation) and degree of humeral head height loss were measured at 1, 6, 12 months after operation and at the last follow-up. The Neer score and visual analogue score (VAS) of shoulder joint were evaluated at 12 months after operation and at the last follow-up. The complications were observed.Results:All patients were followed up for 12-24 months [(18.5±3.8)months]. There were no significant differences in operation time, intraoperative blood loss, postoperative drainage volume and hospitalization time between the two groups (all P>0.05). The fracture healing time in bone grafting group was (3.1±0.7)months, shorter than (4.2±0.9)months in non-bone grafting group ( P<0.05). In the two groups, the postoperative shoulder joint range of motion and degree of humeral head height loss increased significantly over time (all P<0.05). At 1, 6, 12 months after operation and at the last follow-up, the shoulder forward flexion range of motion in bone grafting group was (136.2±7.4)°, (139.3±6.9)°, (146.6±6.1)° and (148.4±4.7)°, higher than that in non-bone grafting group [(134.5±6.7)°, (136.5±7.0)°, (137.9±9.2)° and (138.3±7.9)°]; the shoulder extension range of motion in bone grafting group was (37.1±6.3)°, (40.5±4.4)°, (43.1±3.1) ° and (46.6±4.2)°, higher than that in non-bone grafting group [(35.5±4.6)°, (37.9±5.1)°, (41.3±2.5)° and (43.9±3.1)°]; the shoulder internal rotation range of motion in bone grafting group was (50.5±3.2)°, (54.1±5.6)°, (56.6±4.2)° and (58.9±3.6)°, higher than that in non-bone grafting group [(46.9±5.1)°, (50.3±4.2)°, (53.5±2.7)° and (55.4±5.1)°]; the shoulder external rotation range of motion in bone grafting group was (52.2±3.6)°, (55.6±4.3)°, (58.7±4.4)° and (60.2±5.6)°, higher than that in non-bone grafting group [(50.1±4.7)°, (52.6±5.7)°, (55.3±3.2)° and (57.3±4.1)°] ( P<0.05 or 0.01). At 1, 6, 12 months after operation and at the last follow-up, the degree of humeral head height loss in bone grafting group was (0.8±0.1)mm, (1.1±0.2)mm, (1.4±0.3)mm and (1.6±0.3)mm, smaller than that in non-bone grafting group [(1.1±0.2)mm, (1.4±0.3)mm, (1.7±0.6)mm and (2.0±0.5)mm] ( P<0.05 or 0.01). In the two groups, the postoperative shoulder joint range of motion and degree of humeral head height loss increased significantly over time (all P<0.05). There was no significant difference in Neer score of shoulder joint between the two groups before operation ( P<0.05). At 1, 6, 12 months after operation and at the last follow-up, the Neer score of shoulder joint in bone grafting group was (80.2±5.4)points, (82.1±5.0)points, (85.4±5.8) points and (90.3±4.6)points, higher than that in non-bone grafting group [(75.6±5.1)points, (80.4±5.5)points, (83.5±2.2)points and (87.4±4.8)points] ( P<0.05 or 0.01). There was no significant difference in VAS between the two groups before operation, at 1, 6, 12 months after operation or at the last follow-up (all P>0.05). The complication rate was 11.1% (2/18) in bone grafting group and was 20.8% (5/24) in non-bone grafting group ( P<0.05). Conclusions:For comminuted proximal humeral fractures in the elderly, locking plate internal fixation combined with autogenous iliac bone grafting can accelerate fracture healing, improve shoulder joint range of motion, promote functional recovery, and reduce complications in comparison with locking plate internal fixation alone.

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Objective:To evaluate the clinical outcomes of internal fixation using double reverse traction reducers in the treatment of tibial plateau fractures.Methods:This study retrospectively examined the medical records of 48 patients who underwent surgical intervention for tibial plateau fractures at the Affiliated Hospital of Qingdao University between January 2021 and September 2022. The cohort, aged between 35 to 68 years (mean: 53.0±7.9 years), included 23 males and 25 females. Fractures were classified according to the Schatzker system, with 9 type III, 23 type IV, 11 type V, and 5 type VI fractures recorded. Patients were divided into two groups based on the surgical approach: the minimally invasive group underwent treatment with double reverse traction reducers for reduction and internal fixation in 24 cases, while the open group received conventional open reduction and internal fixation in 24 cases. Comparative parameters included operation duration, intraoperative blood loss, hospital stay, early postoperative knee mobility, and weight-bearing timelines. Postoperative radiographic images were appraised using the Rasmussen imaging score, and knee functionality was assessed at the final follow-up with the Hospital for Special Surgery (HSS) score and the International Knee Documentation Committee (IKDC) score.Results:The preoperative general data were statistically indifferent between groups ( P>0.05). All patients were followed for 13.5±4.3 months (range, 9.5-24 months). In the minimally invasive group, operative time was 88.96±19.04 minutes, intraoperative blood loss was 65±32 ml, and hospital stay was 11.8±3.9 days. Early postoperative knee joint activity commenced at 8.96±2.84 days, significantly earlier compared to the open group, which recorded 178.63±67.75 minutes of surgery, 114.16±65.05 ml blood loss, a 15.3±4.8 days hospital stay, and 16.83±4.09 days to knee joint movement. The difference was statistically significant ( P<0.05). No significant variation was observed in the time to bone healing between the minimally invasive group at 12.6±3.8 weeks and the open group at 13.21±4.98 weeks ( P>0.05). Rasmussen imaging criteria revealed 21 excellent and 3 good outcomes in the minimally invasive group, and 19 excellent and 5 good in the open group, with no statistical significance in the excellent-good rate differentiation ( P>0.05). Bone healing occurred within 3.2±0.8 months (range, 2.5-6.0 months), with 79% (19/24) in the minimally invasive group and 75% (18/24) in the open group achieving healing within 3 months. The open group had one incidence of superficial skin infection, and one patient in the minimally invasive group developed deep vein thrombosis (DVT); no other related complications were documented. Conclusion:Minimally invasive treatment of tibial plateau fractures using double reverse traction reducers offers significant benefits, including reduced surgical time, minimal blood loss, less soft tissue trauma, and enhanced joint function recovery. This approach is particularly advantageous in managing complex tibial plateau fractures compared to traditional open reduction and internal fixation methods.

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ObjectiveTo investigate effect of lyophilized powder of modified Huangqi Gancaotang on proliferation， apoptosis， invasion， migration， and epithelial-mesenchymal transition of human non-small cell lung cancer cells （A549， PC9） and possible mechanism. MethodEffect of 1.0， 2.0， 4.0， 8.0， 12.0 g·L-1 modified Huangqi Gancaotang on the proliferation of non-small cell lung cancer cells was detected by cell counting kit-8 （CCK-8） assay. A549 and PC9 cells were classified into the blank group and the low-， medium-， and high-dose Huangqi Gancaotang groups （2.0， 4.0， 8.0 g·L-1）. Plate cloning assay was used to examine the effect of modified Huangqi Gancaotang on cell cloning ability. Hoechst 33342 staining and flow cytometry were employed to detect the apoptosis， and scratch assay and Transwell migration assay were applied to examine cell migration and invasion abilities， respectively. Mammosphere assay was used to examine the sphere-forming ability of tumor cells， and real-time polymerase chain reaction （Real-time PCR） to detect the mRNA expression of stemness-related molecules octamer-binding transcription factor 4 （Oct-4）， human sex-determining region Y-box 2 （Sox2）， and homeobox transcription factor （Nanog） to assess cancer stem cell activity. The protein expression of B-cell lymphoma 2 （Bcl-2）， Bcl-2-associated death promoter （Bad）， Bcl-2-associated X protein （Bax）， cleaved Caspase-3， Caspase-3， E-cadherin， N-cadherin， vimentin， matrix metalloproteinase-2 （MMP-2）， β-catenin， c-Myc， Cyclin D1， and zinc-finger transcription factor （Slug） was determined by Western blot. ResultThe proliferation ability of A549 and PC9 cells was significantly inhibited after 24 h and 48 h treatment with 1.0， 2.0， 4.0， 8.0， and 12.0 g·L-1 lyophilized powder of modified Huangqi Gancaotang compared with that in the blank group and the inhibition was dose- and time-dependent （P<0.05， P<0.01）. Compared with the blank group， the low-， medium-， and high-dose modified Huangqi Gancaotang suppressed the cloning ability of A549 and PC9 cells （P< 0.05， P<0.01）， and high-dose modified Huangqi Gancaotang induced apoptosis of A549 and PC9 cells （P<0.01）. In comparison with the blank group， the low-， medium-， and high-dose modified Huangqi Gancaotang inhibited the invasion and migration of A549 and PC9 cells （P<0.05， P<0.01）. Compared with the blank group， the low-， medium-， and high-dose modified Huangqi Gancaotang significantly decreased volume of the microspheres of A549 cells and the mRNA expression of Oct-4， Sox2， and Nanog in A549 and PC9 cells （P<0.05， P<0.01）. Compared with the blank group， the medium- and high-dose modified Huangqi Gancaotang down-regulated the expression of the anti-apoptotic protein Bcl-2 （P<0.05， P<0.01）， up-regulated the expression of pro-apoptotic proteins Bad， Bax， and cleaved Caspase-3/Caspase-3 （P<0.05， P<0.01） in A549 and PC9 cells， decreased the expression of MMP-2， N-cadherin， and vimentin （P<0.05， P< 0.01）， and raised the E-cadherin expression （P<0.05， P<0.01）. Moreover， the medium-dose and high-dose modified Huangqi Gancaotang all reduced the expression of β-catenin， c-Myc， Cyclin D1， and Slug in A549 and PC9 cells （P<0.01）. ConclusionModified Huangqi Gancaotang can inhibit the proliferation， invasion， migration， activity of cancer stem cells， and epithelial-mesenchymal transition of human non-small cell lung cancer （A549， PC9） cells and induce apoptosis， and the mechanism is the likelihood that it regulates Wnt/β-catenin signaling pathway.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the ongoing coronavirus disease 2019 (COVID-19) pandemic. Understanding the influence of mutations in the SARS-CoV-2 gene on clinical outcomes and related factors is critical for treatment and prevention. Here, we analyzed 209,551 high-coverage complete virus sequences and 321 RNA-seq samples to mine the mutations associated with clinical outcome in the SARS-CoV-2 genome. Several important hotspot variants were found to be associated with severe clinical outcomes. Q57H variant in ORF3a protein were found to be associated with higher mortality rate, and was high proportion in severe cases (39.36%) and 501Y.V2 strains (100%) but poorly proportional to asymptomatic cases (10.04%). T265I could change nsp2 structure and mitochondrial permeability, and evidently higher in severe cases (20.12%) and 501Y.V2 strains (100%) but lower in asymptomatic cases (1.43%). Additionally, R203K and G204R could decrease the flexibility and immunogenic property of N protein with high frequency among severe cases, VUI 202012/01 and 484K.V2 strains. Interestingly, the SARS-CoV-2 genome was more susceptible to mutation because of the high frequency of nt14408 mutation (which located in RNA polymerase) and the high expression levels of ADAR and APOBEC in severe clinical outcomes. In conclusion, several important mutation hotspots in the SARS-CoV-2 genome associated with clinical outcomes was found in our study, and that might correlate with different SARS-CoV-2 mortality rates.

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A male infant, whose weight was 1 120 g at 28

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Objective To analyze the clinical diagnosis and treatment of a child with hemorrhagic plastic bronchitis, and to explore the etiology of hemorrhagic plastic bronchitis with review of relevant literature,so as to improve the clinicians′understanding of plastic bronchitis.Methods Clinical data of a female children with hemorrhagic plastic bronchitis was retrospectively reviewed.The patient had congenital heart disease,with repeated cough and hemoptysis as the first symptom.Chest CT scan showed cylindrical bronchiectasis of the right lower lobe and the bloodly bronchial cast was removed by bronchoscopy.The related literatures were review.Results After treatment,the symptoms of cough and cough were improved significantly.Conclusion When patients with recurrent hemoptysis and conventional treatment has no effective,it should be alert to the possibility of plastic bronchitis.The bronchoscopy can identify the causes and remove the casts,also need to pay attention to rebleeding.

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Objective To investigate the prevalence and distribution of deafness gene mutations by the joint screening of deafness-related genes and hearing in Wuhan .Methods A total of 117930 newborns born in 2014 and 2015 volunteered to participate in this study .Besides traditional hearing screening ,heel blood of all subjects were collected to detect four sites of three common deafness genes GJB 2 (235delC ) ,SLC26A4 (919 -2A > G ) ,and DNA 12SrRNA(1555A>G ,1494C> T) .Results The total mutation rate of deafness gene was 3 .00％ in 117930 newborns .The highest spots were GJB2235delC and SLC26A4919-2 mutation .A total of 109036 newborns pas-sed the combined screenings ,and 5353 newborns passed the gene screening ,but failed hearing screening .A total of 32131 newborns passed the hearing screening with gene mutation ,while 310 newborns failed in both .Newborns with gene mutation were more likely to fail hearing screening .Conclusion This study indicates that neonatal deafness gene screening in combination with hearing screening not only can effectively improve the detection rate of hearing loss or high risk children ,but also can provide detailed genetic information to promote the popularization and application of such concurrent screenings .

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OBJECTIVE: To investigate the epidemiology of cerumen impaction among children of municipal kindergartens in Wuhan. METHODS: The ear canal of children of municipal kindergartens in Wuhan was examined using an electric otoscope by the same otologist in 2005, 2006 and 2012, with age, gender, ears and the nature of cerumen (dry cerumen or wet cerumen) recorded. A chi-square test was performed to investigate for significant differences between cerumen impaction rates and the recorded variables. RESULTS: A total of 1,214, 1863 and 5205 children were examined in 2005, 2006 and 2012, and cerumen impaction prevalence rates for each year were 17.2%, 15.4% and 10%, respectively. Prevalence of cerumen impaction was significantly lower in 2012 than in 2005 or 2006. In 2005, dry cerumen impaction accounted for 22.2% of the total dry cerumen, while wet cerumen impaction only accounted for 5% of the total wet cerumen, showing a statistically significant difference. CONCLUSION: The prevalence of cerumen impaction among children of kindergartens in Wuhan is higher than 10%, and children with dry cerumen are more prone to cerumen impaction. Annual otological examination of kindergarten children is recommended. And improved community ear health promotion activities should reduce the avoidable prevalence of cerumen impaction in pediatric population.

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Objective To explore the causes and solutions of rehospitalization of the high-risk neonates. Methods The data collection form was designed based on the literature reviewing and the discussion of the nursing quality management team. Results The samples were retrospectively collected from January 2015 to October 2015. There were 106 cases readmitted among the 3012 discharged cases with the ratio of 3.52%. The average interval of readmission were (4.92±4.0) days, most of the cases were readmitted in 7 days after the first discharge with a ratio of 83.95%, the ratio of readmission within 3 days was 38.68%and that was 45.28%for the readmission within 4~7days. For the Preterm infants, the ratio of readmission within 3 days was 21.69%which was higher than that of the full term (16.98%), there was no statistically significant difference between the two groups(chi-square= 1.45, P>1.45). While the ratio of readmission within 7 days for premature infants was 49.06%(52/106), which was higher than that of full term infants [34.91%(37/106)], and there was statistically significant difference between the two groups(chi-square = 5.45, P3.58). But when compared between preterm infants and full term, a higher ratio was found in preterm infants (16.04%), and there was statistically significant difference (chi-square = 5.83, P< 0.05). Conclusion One week after discharge was the peak time of readmission.Jaundice was the main factor of readmission. Premature babies were more likely to have readmission due to feeding problems.

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Objective To observe the changes of mechanical pain thresholds and autophagy related proteins microtubule-associated protein 1 light chain 3 (LC3) and sequestosome 1 (SQSTM1 also known as p62) expression levels in the C57BL/6 mouse models of chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS),and provide animal experimental evidence for CP/CPPS pain and autophagy study.Methods 36 male C57BL/6 mice were randomly divided into three groups: the model group,control group and na(i)ve group.The CP/CPPS model was established by subcutaneous injection in the lower abdomen region with suspension liquid,containing protein extract of male SD rat prostate gland and complete Freund adjuvant.At 1month and 6 months after modeling,the mice were sacrificed and prostate tissues were harvested for histological examination using HE staining.Mechanical tactile hyperalgesia was measured with von Frey filaments.The autophagy-related proteins LC3 and p62 expression levels were detected by immunohistochemistry,respectively.The average IOD was measured by Image Pro Plus 6.0,and the statistical analysis was performed with GraphPad Prism 5 software.Results The histopathology showed the appearance of chronic prostatitis in the model group,representing hyperplasia and lymphocytic infiltration to a different degree and lasted for 6 months after modeling.Moreover,prostate intraepithelial neoplasia (PIN) appeared in the model group at 6 months after modeling,characterized by the disappearence of basement membrane and obvious nuclear abnormality,while the control and na(i)ve groups showed normal histology during the 1-6 months.Compared with the control and na(i)ve groups,the mechanical pain threshold in the model group was significantly decreased along with the time from (0.353±0.154) g at 0 week to (0.008±0.00) g at 22 weeks (P<0.05).The average IOD of LC3 and p62 expression in the model group was significantly increased with timing from [(2.767±0.464)%,(2.872±1.642)%] at 1month to [(13.501±1.900)%,(9.07±0.49)%] at 6 month,P<0.05.Conclusions A CP/CPPS model is successfully established in C57BL/6 mice.For the model group,the mechanical pain threshold is decreased and autophagy levels are increased gradually with time.These phenomena show that chronic inflammation microenvironment may promote pain and autophagy activity in the prostate,which is closely related with the occurrence and development of prostatic intraepithelial neoplasia.

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BACKGROUND:Articular cartilage injury is often complicated by subchondral bone damage to form osteochondral defects, and its treatment remains a pressing problem in orthopedics. Osteochondral composite grafts fabricated by tissue engineering technology provide a new way to repair osteochondral defects. OBJECTIVE:To explore the feasibility of fabricating osteochondral composite grafts in an independently designed double-chamber stirring bioreactor. METHODS: Goat bone marrow mesenchymal stem cels were seeded into β-tricalcium phosphate scaffolds. The cel/scaffold constructs were subjected to chondrogenic and osteogenic induction simultaneously in the double-chamber stirring bioreactor. According to the applied shear stress, they were divided into dynamic and static culture groups. The proliferation of bone marrow mesenchymal stem cels was detected by MTT test and scanning electron microscope examination. Osteogenesis and chondrogenesis related genes were detected by RT-PCR for the evaluation of chondrogenic and osteogenic differentiation. RESULTS AND CONCLUSION:The bone marrow mesenchymal stem cels in both dynamic and static culturegroups demonstrated satisfactory proliferation and differentiation. Better proliferation and differentiation ability were found in the dynamic culture group. Fabrication of osteochondral composite grafts in the independently.designed double-chamber stirring bioreactor is feasible, which is better under the mechanical stimulus environment than the static environment.

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Objective To study whether the usage of antibiotics and white -blood -cell counts affect the effects of 2~12-year-old children with acute otitis media (AOM ) .Methods A total of 126 children (2~12 years old)with AOM ,from Jan 2013 to Dec 2013 ,were retrospectively analyzed .Usage of antibiotics and white -blood-cell count were recorded at first ,and the relationships between two factors and outcomes of children with AOM were studyed in one week ,one month and three months after treatment ,respectively .Results White blood cell counts were higher than normal in 59 .52% (75/126) 2~12 -year -old children with AOM ,and antibiotics were used in 73 .81% (93 /126) .Ninty three cases were followed -up until 3 month or more .Antibiotics were used in 74 cases ,and watchful waiting were used in the other 19 patients .The effective rates of two groups were 59 .45% and 52 .63% ,75 .68% and 84 .21% ,85 .14% and 78 .95% in one week ,one month and 3 months after treatment ,re‐spectively .There were no statistically significant differences(χ2 values were 0 .295 ,0 .903 ,0 .799 ,P>0 .05) .But the effective rates were signifantly higher in 1 and 3 months than that of in one week (P0 .05) between one and three months .Whether white-blood-cell count higher than normal or not ,the difference in efficacy was not statistically significant in 1 week ,1 month and 3 months after treatment (P >0 .05) .Conclusion In 2~12-year-old children with acute otitis media (AOM ) ,the final outcomes were inde‐pendent of the usage of antibiotics and white -blood-cell count .

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OBJECTIVE@#To study the results of TEOAE and AABR hearing screening and follow-up in NICU.@*METHOD@#Total 574 cases in NICU were included in this study, all cases received both TEOAE and AABR hearing screening while admission and rescreening when one-month-old. The cases that were abnormal on either test in rescreening were asked to return for diagnostic tests at 3 moths old. The patients who didn't return as required in 3 months were surveyed by call and analyzed.@*RESULT@#Among 574 cases, 472 cases passed both TEOAE and AABR hearing screening while admission. While 102 cases had abnormal test results in either screening test. Thirty-three cases returned for follow-up, 13 of which passed rescreening test one month after discharge, the other 20 cases had ABR diagnostic tests after 3 months. Among them, 8 cases had normal hearing, 12 cases had various degree of hearing loss. Sixty-nine cases lost follow-up. The reason of lost follow-up was as follows, parents changed phone number/contact information, parents didn't understand the screening results, parents believe that their children having no need for further testing; parents had retest in other hospitals, parents didn't pay attention to hearing loss because of other severe complicated comorbidities.@*CONCLUSION@#The passing rate (normal) of TEOAE and AABR hearing screening in NICU was 82.2%, non- passing rate wass 17.8%, and the prevalence of hearing loss was high in those followed cases. Hyperbilirubinemia was the main risk factors of hearing loss in our NICU patients. We reviewed the reason for high rate (67.6%) of losing follow-up.

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Objective To compare the curative effect and complication of traditional open thyroid operation and minimally invasive laryngeal endoscopic thyroid operation.Methods 80 cases with thyroid disease were randomly divided into group I and groupⅡof 40 cases in each group,the group Ⅰ received the minimally invasive laryngeal endoscopic thyroid operation, while the Ⅱ group was treated with traditional open thyroid operation.The operation time,intraoperative amount of bleeding,postoperative drainage,hospitalization time and complications of two groups were compared.Results The operation time,hospitalization time of groupⅠwere (63.1 ±0.2)min,(5.7 ±0.6)d, which were significantly shorter than those of the control group[(90.4 ±1.1) min,(8.4 ±0.2) d].Amount of bleeding,postoperative drainage volume after operation in groupⅠwere (19.2 ±0.9) mL,(30.4 ±2.6) mL,which were significantly less than those of the control group[(42.1 ±1.8)mL,(46.2 ±1.2)mL] (t=9.819,12.168, 11.182,9.928,all P <0.05);The incidence of postoperative complications of group Ⅰ was 2.5%,lower than 15.0%of groupⅡ,the difference was statistically significant between the two groups(χ2 =13.197,P <0.05). Conclusion Minimally invasive laryngeal endoscopic thyroid operation has advantages in little trauma,short opera-tion time,rapid postoperative recovery.

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Objective To investigate the role of a transcription factor p 53 in dengue virus infec-tion.Methods A plasmid expressing siRNA specific for p 53 gene was constructed and then used to prepare HepG2 cell line with a suppressed expression of p 53 protein.The expression of p53 protein was detected by Western blot assay .A wild type control group and a siRNA group were set up by infecting wildtype HepG 2 cells and p53 low expressing HepG2 cells with type 2 dengue viruses,respectively.The virus titers in two dif-ferent cells were determined by plaque forming assay using Vero cells .Indirect immunofluorescence assay was performed to detect virus multiplication .The apoptosis of virus infected cells were analyzed by flow cytome-try.ELISA was performed to analyze the levels of IFN-βsecreted by infected cells from two groups .Results Compared with wildtype control group ,the cells in siRNA group showed a suppressed expression of p 53 pro-tein,suggesting that the HepG2 cell line with low p53 protein expression was successfully established .The vi-rus titer in supernatants of the cells from siRNA group was about 100-fold higher than that of wildtype control group at 24 hours after viral infection .Fluorescence activated cell sorting analysis showed that the numbers of green fluorescence labeled cells were remarkably increased in siRNA group .We speculated that p53 protein might play a role in the inhibition of dengue virus infection as indicated by the observed results .The numbers of apoptotic cells showed no significant difference between two groups .However,the level of IFN-βsecreted by wildtype HepG2 cells was six times higher than that of the cells in siRNA group .Conclusion p53 pro-tein might inhibit dengue virus infection through the activation of type Ⅰ interferon signaling pathway rather than enhance cell apoptosis .

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Objective To investigate the effect of early airway bundle intervention on prevention ventilator-associated pneumonia(VAP) in ICU patients.Methods One hundred and twenty-eight patients with invasive mechanical ventilation in ICU were randomly divided into the control group (64 cases) and observation group(64 cases).Patients in the control group were given conventional airway intervention,and in the observation group were given airway bundle intervention within 4 h including dumping of condensed water in tubing of breathing machine in time,keeping pressure of artificial airbags from 20 to 30 cm H2 O,chest physical therapy 2 h/time,continuous aspiration of subglottic secretion,using moisture exchanger in breathing machine,and mouth rinse by chlorhexidlne 4 h/time.Incidence of VAP,duration of mechanical ventilation,duration of stay in the ICU and mortality within 28-day were recorded.Clinical Pulmonary Infection Score (CPIS) and APACHE Ⅱ at 0,3rd,5th,7th,14th day were recorded respectively.Results The incidence of VAP,duration of mechanical ventilationand duration of stay in the ICU in observation group were 18.75％,(6.26 ± 2.89) d,(11.88 ± 3.97) d respectively,lower than those in control group (35.94％,(10.54 ± 4.36) d,(16.55 ±5.22) d)),and the differences were significant (x2=4.758,t =6.546,t =6.546,P＜0.05 orP＜0.01).At 3rd,5th,7th,14th day after diagnosed VAP,CPIS of patients with confirmed VAP in observation group were 7.01 ±2.24,5.67 ±2.14,4.36 ± 1.44,2.75 ± 1.37 respectively,lower than those in control group(8.74 ± 2.33,7.51 ± 2.27,6.95 ± 2.98,6.53 ± 2.88,and the differences were significant (Finter group =27.22,P ＜ 0.001 ; Fbetween group =29.41,P ＜ 0.001 ; Finteraction =4.35.P ＜ 0.01).APACHE Ⅱ were 17.02 ± 7.06,15.01 ± 6.06,12.40 ± 4.17,8.40 ± 2.57 respectively,significant lower than those in control group ((22.48 ±7.31,19.67 ± 7.14,16.13 ± 5.33,13.10 ± 4.93),and the differences were significant (Finter group =47.43,P ＜ 0.001 ; Fbetween group =45.36,P ＜ 0.001 ; Finteraction =4.25,P ＜ 0.01).Conclusion Early using airway bundle interventions on ICU patients can reduce the incidence of VAP,improve the condition and prognosis.

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BACKGROUND: Many studies have been carried out to test the hypothesis that the NQO1 C609T polymorphism might be associated with the risk of esophageal cancer. However, the results are poorly consistent, partly due to genetic or other sources of heterogeneity. To investigate the association between this polymorphism and the risk of esophageal cancer, a meta-analysis was performed. METHODS: We used odds ratios (ORs) with 95% confidence intervals (CIs) to assess the strength of association. The frequency of the putative risk allele in the controls was estimated by the inverse-variance method. Cochran's Q statistic and the inconsistency index (I2) were used to check heterogeneity. Egger's test and an inverted funnel plot were used to assess the publication bias. RESULTS: Our study included eight published case-control studies about the NQO1 C609T polymorphism and esophageal cancer, including a total of 1,217 esophageal cancer patients and 1,560 controls. Overall, a significant association was found between the NQO1 C609T variant and esophageal cancer under a recessive model (OR = 1.647; 95% CI = 1.233-2.200). Regarding histological type, more significant evidence was found for esophageal squamous cell carcinoma (ESCC) (OR = 2.03; 95% CI = 1.29-3.19) than esophageal adenocarcinoma (EAC) (OR = 1.61; 95% CI = 1.01-2.56) under a recessive model. CONCLUSIONS: The meta-analysis suggests that the NQO1 C609T polymorphism considerably increases the risk of esophageal cancer.

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BACKGROUND: Recurrent pregnancy loss (RPL) had said to be related to the angiotensin converting enzyme insertion/deletion polymorphisms (ACE I/D) gene polymorphisms. But the conclusions were controversial. This meta-analysis was conducted to investigate the real association in ACE I/D polymorphisms and RPL firstly. METHODS: Combine Pubmed Embase and HuGENet database in data analysis for this meta-analysis from October 2000 to November 2011. The metagen system was used to select the models and effects. Odds ratio (OR) with 95% confidence interval (CI) was used to assess the strength of this association. RESULTS: 9 studies from six countries with 1264 RPL and 845 controls were included according to our criterion. Following the metagen system, we used the dominant model with random effects. The summary OR =1.61 (95% CI: 1.10-2.36, I (2) = 59.0%), which suggested the ACE D allele might increase the RPL risk in Asia (OR=1.97, 95% CI: 1.31-2.98, I (2) = 44.4%), among Asians (OR=1.69, 95% CI: 1.06-2.36, I (2) =32.7%). In additional, after conducting sensitivity analysis, the results had no differences except for Caucasian subgroup reached to the significance (OR=2.059, 95% CI: 1.455-2.914), so we couldn't ignore the relationship between the polymorphisms of ACE D/I gene and Caucasians yet. There seemed no publication bias in our eligible studies with Begg's test (P = 0.867). CONCLUSIONS: Results in this meta-analysis presented the positive function of the ACE I/D polymorphism in increasing the RPL risk. Furfure prospective studies were needed to confirm the precise relationship between the ACE I/D and RPL.

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