Search

Objective: To explore causal relationship between atopic diseases (asthma and atopic dermatitis) and osteoarthritis (OA) by using mendelian randomization(MR)., Methods: Asthma and atopic dermatitis as instrumental variables were selected, searched them through IEU database, and selected the latest data with a large number of cases and single nucleotide polymorphism (SNP). Data were collected and processed using R language, inverse varianceweighted (IVW) method was adopted as main MR Evaluation method. Single linear regression was performed to estimate causality based on pooled knee and hip data from genome-wide association studies (GWAS). The forest map was drawn to visualize the results, and gene pleiotropy and sensitivity were analyzed by scatter plot and funnel plot. At the same time, asthma, atopic dermatitis, body mass index (BMI), osteoporosis and OA were selected for multivariate MR Analysis to exclude the effect of horizontal pleiotropy on the results in GWAS data., Results: Analysis of MR-IVW results showed asthma was positively correlated with causal effect of OA [ OR =1.41, 95% CI (1.07, 1.85), P =0.02], multivariate Mendelian randomization (MVMR) adjusted for BMI and osteoporosis and a direct causal effect on OA was observed [ OR =1.57, 95% CI (1.03, 2.39), P =0.03)]. MR Results of two samples of atopic dermatitis and OA were [ OR =1.01, 95% CI (0.97, 1.04), P =0.76], and MVMR results were [ OR =1.02, 95% CI (0.99, 1.05), P =0.25], indicating no clear causal relationship between two samples., Conclusion: Asthma could increase risk of OA, atopic dermatitis has no obvious relationship with OA, and the relationship between atopic diseases and OA still needs to be discussed.

Objective: To explore the clinical phenotype and genetic etiology for seven children with CHARGE syndrome (CS)., Methods: Clinical data of seven children with CS diagnosed between March 2020 and December 2022 at the Children's Hospital Affiliated to Zhengzhou University were analyzed. Genomic DNA was extracted from peripheral blood samples from the children and their parents, and subjected to whole exome sequencing. Candidate variants were verified by Sanger sequencing and pathogenicity analysis., Results: The ages of the children had ranged from 1 day after birth to 12 years old, and all of them had shown growth retardation. The reasons for their admission had included postnatal breathing, swallowing and feeding difficulties in five cases. One child was found to have abnormal external genitalia in conjunct with hearing impairment, whilst another child had shown no secondary sexual characteristics during puberty. All of the children were found to harbor CHD7 gene variants, which included 3 nonsense variants, 2 frameshifting variants and 2 missense variants, i.e., c.6292C>T (p.R2098*), c.2754G>A (p.W918*), c.469C>T (p.R157*), c.3308T>A (p.V1103D), c.7111delC (p.Q2371Kfs), c.6023delA (p.D2008Vfs) and c.3565C>T (p.R1189C). All of the variants were de novo in origin. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), the c.3308T>A (p.V1103D) and c.3565C>T (p.R1189C) variants were rated as likely pathogenic (PS2+PM2_Supporting+PP3), whilst the remainders were rated as pathogenic (PVS1+PS2+PM2_Supporting)., Conclusion: There is strong clinical and genetic heterogeneity in CS. Early genetic testing may facilitate accurate diagnosis. The detection of novel variants has expanded the phenotypic spectrum of CS and the mutational spectrum of the CHD7 gene.

Objective: To predict the 3-year cancer-specific survival (CSS) of patients with non-metastatic T 3a renal cell carcinoma after surgery., Methods: A total of 336 patients with pathologically confirmed T 3a N0-1M0 renal cell carcinoma (RCC) who underwent surgical treatment at the Department of Urology, Peking University Third Hospital from March 2013 to February 2021 were retrospectively collected. The patients were randomly divided into a training cohort of 268 cases and an internal validation cohort of 68 cases at an 4 ∶ 1 ratio. Using two-way Lasso regression, variables were selected to construct a nomogram for predicting the 3-year cancer-specific survival (CSS) of the patients with T 3a N0-1M0 RCC. Performance assessment of the nomogram included evaluation of discrimination and calibration ability, as well as clinical utility using measures such as the concordance index (C-index), time-dependent area under the receiver operating characteristic curve [time-dependent area under the curve (AUC)], calibration curve, and decision curve analysis (DCA). Risk stratification was determined based on the nomogram scores, and Kaplan-Meier survival analysis and Log-rank tests were employed to compare progression-free survival (PFS) and cancer-specific survival (CSS) among the patients in the different risk groups., Results: Based on the Lasso regression screening results, the nomogram was constructed with five variables: tumor maximum diameter, histological grading, sarcomatoid differentiation, T 3a feature, and lymph node metastasis. The baseline data of the training and validation sets showed no statistical differences ( P >0.05). The consistency indices of the column diagram were found to be 0.808 (0.708- 0.907) and 0.903 (0.838-0.969) for the training and internal validation sets, respectively. The AUC values for 3-year cancer-specific survival were 0.843 (0.725-0.961) and 0.923 (0.844-1.002) for the two sets. Calibration curves of both sets demonstrated a high level of consistency between the actual CSS and predicted probability. The decision curve analysis (DCA) curves indicated that the column diagram had a favorable net benefit in clinical practice. A total of 336 patients were included in the study, with 35 cancer-specific deaths and 69 postoperative recurrences. According to the line chart, the patients were divided into low-risk group (scoring 0-117) and high-risk group (scoring 119-284). Within the low-risk group, there were 16 tumor-specific deaths out of 282 cases and 36 postoperative recurrences out of 282 cases. In the high-risk group, there were 19 tumor-specific deaths out of 54 cases and 33 post-operative recurrences out of 54 cases. There were significant differences in progression-free survival (PFS) and cancer-specific survival (CSS) between the low-risk and high-risk groups ( P < 0.000 1)., Conclusion: A nomogram model predicting the 3-year CSS of non-metastatic T 3a renal cell carcinoma patients was successfully constructed and validated in this study. This nomogram can assist clinicians in accurately assessing the long-term prognosis of such patients.

Objective: To develop an intelligent model for differential diagnosis of atrioventricular nodal re-entrant tachycardia (AVNRT) and atrioventricular re-entrant tachycardia (AVRT) using 12-lead wearable electrocardiogram devices., Methods: A total of 356 samples of 12-lead supraventricular tachycardia (SVT) electrocardiograms recorded by wearable devices were randomly divided into training and validation sets using 5-fold cross validation to establish the intelligent classification model, and 101 patients with the diagnosis of SVT undergoing electrophysiological studies and radiofrequency ablation from October, 2021 to March, 2023 were selected as the testing set. The changes in electrocardiogram parameters before and during induced tachycardia were compared. Based on multiscale deep neural network, an intelligent diagnosis model for classifying SVT mechanisms was constructed and validated. The 3-lead electrocardiogram signals from Ⅱ, Ⅲ, and Ⅴ 1 were extracted to build new classification models, whose diagnostic efficacy was compared with that of the 12-lead model., Results: Of the 101 patients with SVT in the testing set, 68 were diagnosed with AVNRT and 33 were diagnosed with AVRT by electrophysiological study. The pre-trained model achieved a high area under the precision-recall curve (0.9492) and F1 score (0.8195) for identifying AVNRT in the validation set. The total F1 scores of the lead Ⅱ, Ⅲ, Ⅴ 1 , 3-lead and 12-lead intelligent diagnostic models in the testing set were 0.5597, 0.6061, 0.3419, 0.6003 and 0.6136, respectively. Compared with the 12-lead classification model, the lead-Ⅲ model had a net reclassification index improvement of -0.029 ( P =0.878) and an integrated discrimination index improvement of -0.005 ( P =0.965)., Conclusion: The intelligent diagnostic model based on multiscale deep neural network using wearable electrocardiogram devices has an acceptable accuracy for classifying SVT mechanisms.

Objective To evaluate the effects of heme oxygenase-1 (HO-1) gene deletion on immune cell composition and inflammatory injury in lung tissues of mice with lipopolysaccharide (LPS)-induced acute lung injury (ALI). Methods C57BL/6 wild-type (WT) mice and HO-1 conditional-knockout (HO-1 -/- ) mice on the same background were randomly divided into four groups (n=5 in every group): WT control group, LPS-treated WT group, HO-1 -/- control group and LPS-treated HO-1 -/- group. LPS-treated WT and HO-1 -/- groups were injected with LPS (15 mg/kg) through the tail vein to establish ALI model, while WT control group and HO-1 -/- control group were injected with an equivalent volume of normal saline through the tail vein, respectively. Twelve hours later, the mice were sacrificed and lung tissues from each group were collected for analysis. Histopathological alterations of lung tissues were assessed by HE staining. The levels of mRNA expression of tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and IL-6 were determined by PCR. The percentages of neutrophils (CD45 + CD11b + Ly6G + Ly6C - ), total monocytes (CD45 + CD11b + Ly6C hi ), pro-inflammatory monocyte subsets (CD45 + CD11b + Ly6C hi CCR2 hi ) and total macrophages (CD45 + CD11b + F4/80 + ), M1 macrophage (CD45 + CD11b + F4/80 + CD86 + ), M2 macrophage (CD45 + CD11b + F4/80 + CD206 + ), total T cells (CD45 + CD3 + ), CD3 + CD4 + T cells, CD3 + CD8 + T cells and myeloid suppressor cells (MDSCs, CD45 + CD11b + Gr1 + ) were detected by flow cytometry. Results Compared with the corresponding control groups, HE staining exhibited increased inflammation in the lung tissues of both LPS-treated WT and HO-1 -/- model mice; mRNA expression levels of TNF-α, IL-1β and IL-6 were up-regulated; the proportions of neutrophils, total monocytes, pro-inflammatory monocyte subsets, MDSCs and total macrophages increased significantly. The percentage of CD3 + , CD3 + CD4 + and CD3 + CD8 + T cells decreased significantly. Under resting-state, compared with WT control mice, the proportion of neutrophils, monocytes and pro-inflammatory monocyte subset increased in lung tissues of HO-1 -/- control mice, while the proportion of CD3 + and CD3 + CD8 + T cells decreased. Compared with LPS-treated WT mice, the mRNA expression levels of TNF-α and IL-1β were up-regulated in lung tissues of LPS-treated HO-1 -/- mice; the proportion of total monocytes, pro-inflammatory monocyte subsets, M1 macrophages and M1/M2 ratio increased greatly; the percentage of CD3 + CD8 + T cells decreased significantly. Conclusion The deletion of HO-1 affects the function of the lung immune system and aggravates the inflammatory injury after LPS stimulation in ALI mice.

Objective: To investigate the distribution of malaria vector Anopheles in Sichuan Province from 2011 to 2021, so as to provide the scientific evidence for improving the surveillance of malaria vector Anopheles and preventing re-establishment of imported malaria in Sichuan Province., Methods: The density and species of Anopheles mosquitoes were investigated using human-bait trapping and light trapping techniques in malaria vector surveillance sites of Sichuan Province from 2011 to 2021. The number, population and density of captured Anopheles mosquitoes were collected and descriptively analyzed, and the geographical distribution map of malaria vectors was plotted using the software ArcGIS 10.7 in Sichuan Province., Results: A total of 152 243 Anopheles mosquitoes were captured in malaria vector surveillance sites of Sichuan Province from 2011 to 2021, including 150 987 An. sinensis (99.18%) and 1 256 An. anthropophagus (0.82%), and no other Anopheles species were captured. The annual densities of An. sinensis and An. anthropophagus were 0.64 to 1.27 mosquitoes/(person-hour) and 0 to 0.07 mosquitoes/(person-hour) by the human-bait trapping technique, and 6.46 to 26.50 mosquitoes/(light-night) and 0 to 0.82 mosquitoes/(light-night) by the light trapping technique in malaria vector surveillance sites of Sichuan Province from 2011 to 2021. A relatively higher density of An. anthropophagus was seen in Renshou County, Jianyang City, Weiyuan County and Mabian Yi Autonomous County [> 0.40 mosquitoes/(person-hour)] by the human-bait trapping technique, and in Cuiping District and Gaoxian County in Yibin City [> 1.00 mosquito/(light-night)] by the light trapping technique in Sichuan Province from 2011 to 2018, with no An. anthropophagus captured from 2019 to 2021, and a relatively higher density of An. sinensis was detected in Emeishan City, Lushan County, Luojiang District, Tongchuan District and Zhaohua District [> 4.00 mosquitoes/(person-hour)] by the human-bait trapping technique, and in Huili County, Yuexi County, Dechang County, Langzhong City, Pingchang County and Xuanhan County [> 40.00 mosquitoes/(light-night)] by the light trapping technique in Sichuan Province from 2011 to 2021., Conclusions: Malaria vectors were still widespread in Sichuan Province from 2011 to 2021, and An. sinensis was the dominant species of malaria vectors. There is still a risk of local re-establishment of imported malaria in Sichuan Province, and it is needed to continue to improve the surveillance of imported malaria cases and malaria vectors.

Objective: To understand the use of post-exposure prophylaxis (PEP) and analyze related factors among men who have sex with men (MSM) in Qingdao, and provide a reference for the AIDS prevention and control in this population. Methods: A cross-sectional survey conducted from April 2022 to February 2023. Relying on MSM social groups in Qingdao, a snowball sampling method was applied to recruit research subjects who met the inclusion criteria of age ≥18 years old, having had homosexual anal or oral sex in the past six months, and HIV-negative or infection status unknown. The sample size was estimated at 566. Data on demographic characteristics, sexual behavior characteristics, PEP use, and others of the research subjects was collected through on-site questionnaires. The logistic regression model was used to analyze the factors associated with using PEP. Results: A total of 811 participants were recruited, mainly aged 25-34 (53.6%, 435/811), unmarried (74.7%, 606/811), with an average monthly income of ≥5 000 yuan (52.2%, 423/811), and having lived in Qingdao for ≥10 years (75.6%, 613/811). The proportion of those who knew the HIV status of their sexual partners in the last six months was 67.1% (544/811), and those with HIV-positive partners were 3.6% (29/811). In the last six months, the proportion of participants who had group sex (86.4%, 701/811), unprotected anal sex (98.2%, 796/811), and use of club drugs (80.3%, 651/811) was high. Moreover, 28.4% (230/811) had used PEP. The multivariate logistic regression analysis showed that the factors related to the use of PEP included divorced or widowed (a OR =5.46,95% CI :1.96-15.17), average monthly income ≥5 000 yuan (a OR =2.04,95% CI :1.44-2.89), same-sex sexual orientation (a OR =0.40,95% CI :0.22-0.71), having HIV-positive sexual partners in the last six months (a OR =2.54,95% CI :1.13-5.71) and having been tested for HIV ≥3 times in the last six months (a OR =1.46,95% CI :1.04-2.06). Conclusions: The prevalence of risk behaviors among MSM in Qingdao was high, and the use of PEP was low. In the future, it is essential to increase HIV/AIDS prevention education among MSM, promote MSM to know the HIV status of their sexual partners, and reduce the prevalence of risk behaviors among this population. Additionally, explore medical insurance reimbursement plans for PEP to reduce utilization costs and promote the use of PEP by MSM after HIV exposure occurs as soon as possible.

Objective: To understand and analyze the incidence of HIV infection in club drug abusers among men who have sex with men (MSM) in Qingdao and provide a reference for the prevention and intervention of this population. Methods: From March 2017 to July 2022, club drug abusers among MSM who are HIV-negative were recruited by snowball sampling of MSM social organizations in Qingdao, a prospective cohort was established, and a follow-up survey was conducted every six months, with the sample size estimated to be 436. The survey contents included demographic characteristics, sexual characteristics, AIDS knowledge awareness, club drug abuse, HIV testing, and other information. HIV infection was the outcome-dependent variable, and the interval between the recruitment into the cohort and the HIV infection was the time-dependent variable. Cox proportional hazards regression analysis was conducted to identify the related factors for HIV infection. Results: A total of 987 participants of club drug abusers among MSM were recruited during the baseline survey and 826 eligible participants were enrolled in this cohort. A total of 46 HIV infection cases were found, and the cumulative follow-up time was 1 960.68 person-years. The incidence of HIV infection was 2.35/100 person-years. The multivariate Cox regression analysis showed that <30 (a HR =3.04, 95% CI : 1.62-5.71) non-Shandong residents (a HR =2.29,95% CI :1.20-4.39) found their partners through offline (a HR =4.62,95% CI :2.05-10.41), homosexual sexual partners >4 (a HR =3.06,95% CI :1.59-5.88), condom broken during sex (a HR =2.24,95% CI :1.21-4.17) and hemorrhage sexual intercourse (a HR =2.56,95% CI :1.31-5.03) were significantly associated with HIV infection in this cohort. Conclusions: The incidence of HIV infection in club drug abusers among MSM in Qingdao is generally low, but knowledge and practice have separated, and the risk of HIV infection is high. The related factors of HIV infection included younger age, non-Shandong residents, finding their partners offline, multiple sexual partners, condom break during sex, and hemorrhage sexual intercourse; HIV-related behavioral intervention should be strengthened.

Objective: To carry out Sanger sequencing for MMACHC gene variants among 65 Chinese pedigrees affected with combined methylmalonic aciduria and homocysteinemia, and summarize their genetic and clinical characteristics and prognosis., Methods: Clinical characteristics of the 65 children identified with Methylmalonic acidemia and homocysteinemia at the Children's Hospital Affiliated to Zhengzhou University (Zhengzhou Children's Hospital) from April 2017 to April 2022 were selected as the study subjects. Potential variants of the MMACHC gene were detected by direct sequencing of the PCR products., Results: The median age of the 65 children was 3 months (14 days to 17 years old). These included 28 cases (43.08%) from neonatal screening, 11 cases (16.92%) with a history of jaundice, and 9 cases (13.85%) with various degrees of anemia. The main clinical symptoms included development delay, slow growth, epilepsy, hydrocephalus, lethargy, feeding difficulty, regression or decline in motor ability, recurrent respiratory infections, anemia, jaundice, respiratory and heart failures, hydrocephalus, limb weakness, and hypertension. Blood and urine tandem mass spectrometry screening has revealed increase of methylmalonic acid, propionyl carnitine, propionyl carnitine/acetylcarnitine ratio, and propionyl carnitine/free carnitine ratio to various extents, and blood homocysteine was increased in all patients. The detection rate of genetic variants was 98.46% (128/130), and in total 22 types of MMACHC gene variants were detected. The most common ones have included c.609G>A (W203X) (58/128), c.658-660del (K220del) (19/128), and c.80A>G (Q27A) (16/128). Two novel variants have been identified, namely c.565C>T (p.R189C) and c.624&#95; 625delTG (p.A208Afs), which were respectively predicted as likely pathogenic (PM2&#95;Supporting+PM3+PP2+PP3) and pathogenic (PVS1+PM2&#95;Supporting+PM3+PP2) based on the guidelines from the American College of Medical Genetics and Genomics (ACMG). Exon 4 had the highest frequency for the detection., Conclusion: Identification of MMACHC gene variants has confirmed the diagnosis in the children, among which the c.609G>A variant has the highest frequency. Discovery of the new variants has enriched the mutational spectrum of the MMACHC gene.

Objective: To analyze the composition and metabolites of gut microbiota in septic rats by fecal 16s rRNA sequencing and untargeted metabolomics, and to preliminarily explore the effect and potential mechanism of gut microbiota and its metabolites on inflammatory response and multiple organ damage in sepsis., Methods: Ten males healthy male Wistar rats were randomly divided into a sham operated group (Sham group) and sepsis model group (CLP group) using a random number table method, with 5 rats in each group. A rat sepsis model was established by cecal ligation and perforation (CLP) method. The animals were sacrificed 24 hours after modeling, the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in peripheral blood were detected by enzyme-linked immunosorbent assay (ELISA). Hematoxylin-eosin (HE) staining was used to observe the pathological changes of lung and kidney tissues, and the pathological scores were evaluated. Fecal samples were collected, and 16s rRNA high-throughput sequencing and non-targeted metabolomics were used to screen microbiota, metabolites and potential signal pathways that may play an important role in disease outcomes. Spearman correlation analysis was conducted to jointly analyze the gut microbiota and non-targeted metabolism., Results: Compared with the Sham group, the degree of pathological damage to lung and kidney tissues in the CLP group was significantly increased (lung tissue score: 3.60±0.80 vs. 0.00±0.00, kidney tissue score: 2.40±0.80 vs. 0.00±0.00, both P < 0.01), the level of IL-6 and TNF-α in peripheral blood significantly increased [TNF-α (ng/L): 248.12±55.98 vs. 143.28±36.57, IL-6 (ng/L): 260.26±39.47 vs. 116.01±26.43, both P < 0.05], the species diversity of intestinal flora of rats in the CLP group was significantly reduced, the relative abundance of Morganella, Bacteroides and Escherichia-Shigella were significantly increased, and the relative abundance of Lachnospiraceae NK4A136, Ruminococcus, Romboutsia and Roseburia were significantly reduced. In addition, the biosynthesis and bile secretion of phenylalanine, tyrosine, and tryptophan in the gut microbiota of the CLP group were significantly increased, while the biosynthesis of secondary bile acids was significantly reduced. There was a significant correlation between differential metabolites and differential microbiota., Conclusions: Sepsis can cause significant changes in the characteristics of gut microbiota and fecal metabolites in rats, which provides a basis for translational research to seek new targets for the treatment of sepsis.

Objective: To investigate the clinical features and short-term prognosis of patients with SARS-CoV-2 infection associated acute encephalopathy (AE). Methods: Retrospective cohort study. The clinical data, radiological features and short-term follow-up of 22 cases diagnosed with SARS-CoV-2 infection associated AE in the Department of Neurology, Beijing Children's Hospital from December 2022 to January 2023 were retrospectively analyzed. The patients were divided into cytokine storm group, excitotoxic brain damage group and unclassified encephalopathy group according to the the clinicopathological features and the imaging features. The clinical characteristics of each group were analyzed descriptively. Patients were divided into good prognosis group (≤2 scores) and poor prognosis group (>2 scores) based on the modified Rankin scale (mRS) score of the last follow-up. Fisher exact test or Mann-Whitney U test was used to compare the two groups. Results: A total of 22 cases (12 females, 10 males) were included. The age of onset was 3.3 (1.7, 8.6) years. There were 11 cases (50%) with abnormal medical history, and 4 cases with abnormal family history. All the enrolled patients had fever as the initial clinical symptom, and 21 cases (95%) developed neurological symptoms within 24 hours after fever. The onset of neurological symptoms included convulsions (17 cases) and disturbance of consciousness (5 cases). There were 22 cases of encephalopathy, 20 cases of convulsions, 14 cases of speech disorders, 8 cases of involuntary movements and 3 cases of ataxia during the course of the disease. Clinical classification included 3 cases in the cytokine storm group, all with acute necrotizing encephalopathy (ANE); 9 cases in the excitotoxicity group, 8 cases with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) and 1 case with hemiconvulsion-hemiplegia syndrome; and 10 cases of unclassified encephalopathy. Laboratory studies revealed elevated glutathione transaminase in 9 cases, elevated glutamic alanine transaminase in 4 cases, elevated blood glucose in 3 cases, and elevated D-dimer in 3 cases. Serum ferritin was elevated in 3 of 5 cases, serum and cerebrospinal fluid (CSF) neurofilament light chain protein was elevated in 5 of 9 cases, serum cytokines were elevated in 7 of 18 cases, and CSF cytokines were elevated in 7 of 8 cases. Cranial imaging abnormalities were noted in 18 cases, including bilateral symmetric lesions in 3 ANE cases and "bright tree appearance" in 8 AESD cases. All 22 cases received symptomatic treatment and immunotherapy (intravenous immunoglobulin or glucocorticosteroids), and 1 ANE patient received tocilizumab. The follow-up time was 50 (43, 53) d, and 10 patients had a good prognosis and 12 patients had a poor prognosis. No statistically significant differences were found between the two groups in terms of epidemiology, clinical manifestations, biochemical indices, and duration of illness to initiate immunotherapy (all P >0.05). Conclusions: SARS-CoV-2 infection is also a major cause of AE. AESD and ANE are the common AE syndromes. Therefore, it is crucial to identify AE patients with fever, convulsions, and impaired consciousness, and apply aggressive therapy as early as possible.

Objective: To understand HIV self-testing and related factors in men who have sex with men (MSM) in Shijiazhuang. Methods: From August to September 2020, convenient sampling was used to recruit MSM in Shijiazhuang. Online questionnaires were used to collect information about their demographic characteristics, sexual behaviors and HIV self-testing. logistic regression model was used to analyze the related factors associated with HIV self-testing. Results: In the 304 MSM respondents, 52.3% (159/304) had HIV self-testing in the past 6 months, and 95.0% (151/159) used fingertip blood HIV detection reagent. Self-purchase was the main way to obtain HIV testing reagents (45.9%, 73/159), followed by supply from MSM social organization (44.7%, 71/159). The reasons for having HIV self-testing were non-specific testing time (67.9%, 108/159) and privacy protection (62.9%,100/159), the reasons for having no HIV self-testing included inability of using (32.4%, 47/145), being unaware of HIV self-testing reagent (24.1%, 35/145), and worry about inaccurate self-testing results (19.3%, 28/145). Multivariate logistic regression analysis showed that being 18-29 years old (a OR =2.68, 95% CI : 1.20-5.94), obtaining free HIV self-testing kits in recent 6 months (a OR =8.61, 95% CI : 4.09-18.11) and making friends through Internet and social software (a OR =2.68, 95% CI : 1.48-4.88) were positive factors for having HIV self-testing. Conclusion: HIV self-testing is a more flexible and convenient way to detect HIV in MSM, and the promotion of HIV self-testing in MSM should be strengthened to further increase the HIV detection rate in this population.

Objective: To understand and analyze the incidence of club drug abuse and influencing factors in men who have sex with men (MSM) in Qingdao, and provide reference for the AIDS prevention and intervention in this population. Methods: From March 2017 to July 31, 2022, MSM who did not abuse club drug were recruited by snowball sampling of MSM social organizations in Qingdao, a prospective cohort was established, and a follow-up survey was conducted every 6 months. The survey collected the information about the MSM's demographic characteristics, sexual characteristics, club drug abuse and others. The incidence of club drug abuse was the outcome dependent variable and the interval between the recruitment into the cohort and the incidence of club drug abuse was the time dependent variable. Cox regression analysis was conducted to identify the influencing factors for club drug abuse. Results: A total of 509 MSM were recruited at baseline survey, and 369 eligible MSM were enrolled in this cohort. A total of 62 MSM began to abuse club drug during the study period, and the cumulative follow-up time was 911.54 person-years, the incidence of club drug abuse was 6.80/100 person-years. All the club drug abusers shared drugs with others in the first club drug abuse, and 16.13% (10/62) had mix-use of club drugs. The multivariate Cox proportional risk regression analysis showed that being students (a HR =2.17, 95% CI : 1.15-4.10), receiving no HIV testing or receiving 1 HIV testing during past 6 months (a HR =4.57, 95% CI :1.80-11.60; a HR =5.15, 95% CI : 2.83-9.36), having sex only with regular sexual partners during past 6 months (a HR =4.75,95% CI :2.32-9.75), having more than 4 homosexual partners (a HR =1.70, 95% CI :1.01-2.87) and abuse of club drug of sexual partners during past 6 months (a HR =12.78, 95% CI :3.06-53.35) were significantly associated with club drug abuse in the MSM. Conclusions: The incidence of club drug abuse was at a high level in the MSM cohort in Qingdao, indicating a high risk for HIV infection. Being student, receiving less HIV testing, having sex only with regular sexual partners, having more homosexual partners and abuse of club drug of sexual partners during past 6 months were risk factors for the incidence of club drug abuse in the MSM. Targeted surveillance and intervention measures should be strengthened to reduce the risk of club drug abuse in MSM.

L-homoserine and its derivatives (O-succinyl-L-homoserine and O-acetyl-L-homoserine) are precursors for the biosynthesis of L-methionine, and various C4 compounds (isobutanol, γ-butyrolactone, 1, 4-butanediol, 2, 4-dihydroxybutyric acid) and L-phosphinothricin. Therefore, the fermentative production of L-homoserine and its derivatives became the research hotspot in recent years. However, the low fermentation yield and conversion rate, and the unclear regulation mechanism for the biosynthesis of L-homoserine and its derivatives, hamper the development of an efficient production process for L-homoserine and its derivatives. This review summarized the advances in the biosynthesis of L-homoserine and its derivatives by metabolic engineering of Escherichia coli from the aspects of substrate uptake, redirection of carbon flow at the key nodes, recycle of NADPH and export of target products. This review may facilitate subsequent metabolic engineering and biotechnological production of L-homoserine and its derivatives.

Objective: To explore the clinical phenotype and genetic basis for a fetus suspected for Coffin-Siris syndrome., Methods: Chromosomal microarray analysis (CMA) and whole exome sequencing (WES) were carried out for the fetus. Candidate variant was verified by Sanger sequencing., Results: Prenatal ultrasound at 23rd gestational week has revealed fetal ventriculomegaly. No abnormality was found by CMA, while WES revealed that the fetus has harbored a de novo heterozygous c.2851G>A (p.G951R) variant of the SMARCA4 gene, which was predicted to be pathogenic., Conclusion: Genetic testing should be considered for fetuses featuring progressive widening of lateral cerebral ventricles.

Objective: To analyze the characteristics of etiology and clinical indicators of hepatitis B virus (HBV) and non-HBV liver failure, and to evaluate their potential roles in reflecting disease outcomes., Methods: The clinical data of 369 patients with liver failure admitted to the intensive care unit (ICU) of the Fifth People's Hospital of Wuxi which was the designated hospital for treatment of liver failure from January 2018 to December 2020 were retrospectively analyzed. The classification and comparison of etiology of non-HBV and HBV liver failure patients were performed according to the Guidelines on the Diagnosis and Treatment of Liver Failure (2018 edition). The indicators of liver failure related etiologies, including gender, age, anticoagulant enzyme III (AT III), total bilirubin (TBil), length of ICU stay, hepatic encephalopathy, underlying disease (liver cirrhosis and liver cancer, etc.) and usage of artificial liver were analyzed. According to the 6-month follow-up results after discharge, the differences in the etiological indicators of died and survival patients and the outcome of patients with different types of liver failure were analyzed., Results: A total of 369 patients were enrolled, including 134 (36.3%) with liver failure not caused by HBV and 235 (63.7%) with liver failure caused by HBV. The male with HBV-related liver failure was 4.34 times higher than female (cases: 191 vs. 44), which was higher than non-HBV-related liver failure (1.03 times, cases: 68 vs. 66). The 6-month follow-up showed that the proportion of male with HBV-related liver failure who died and survived was significantly higher than that of female (78.76% vs. 21.24% in died patients, 92.86% vs. 7.14% in survival patients, both P < 0.01). The age of died patients in the non-HBV-related liver failure group was significantly higher than that of the survival patients (years: 58.53±0.15 vs. 54.38±3.01, P < 0.05), and the AT III level was significantly lower than that of the survival patients [(32.20±6.43)% vs. (38.63±2.74)%, P < 0.05]. The length of ICU stay of the died HBV-related liver failure group was significantly shorter than that of the survival patients (days: 23.77±11.74 vs. 35.51±2.85, P < 0.01). The 6-month mortality after discharge of HBV-related liver failure combined with liver cancer was significantly higher than that of non-HBV-related liver failure (12.34% vs. 2.24%, P < 0.01), but there was no significant difference in 6-month mortality after discharge of patients receiving artificial liver and those with hepatic encephalopathy and cirrhosis between different types of liver failure groups., Conclusions: HBV is the main cause of liver failure. Patients with HBV-related liver failure were younger and had a longer hospitalization period, which was conducive to the recovery of the disease. HBV-related liver failure accompanied with liver cancer is the main factors of death. The AT III has the potential value to reflect the disease outcome.

This paper introduced the Quality Assessment of Diagnostic Accuracy Studies-Comparative (QUADAS-C), illustrated the comparison with the QUADAS-2, and using QUADAS-C together with QUADAS-2 to present QUADAS-C results through systematic reviews. Like the domain for QUADAS-2, QUADAS-C retained four domains, including patient selection, index test, reference standard, flow, and timing, and comprised additional questions for each QUADAS-2 part. Unlike the QUADAS-2 tool, the starting question of each domain for QUADAS-C was designed to summarize the risk of biased information captured by QUADAS-2. QUADAS-C only dealt with the risk of bias but did not include the part of concerns regarding applicability. The answers to signaling questions for each domain of QUADAS-C would lead to a 'low''high' or 'unclear' risk of biased judgment for the original study.

Objective: To address the limitations of existing methods and tools for evaluating clinical practice guidelines, we aimed to develop a comprehensive instrument focusing on the three main dimensions of guideline development: scientificity, transparency, applicability. We will use it to rank the guidelines according to the scores. We abbreviated it as STAR, and its reliability, validity and usability were also tested. Methods: A multidisciplinary expert working group was set up, including methodologists, statisticians, journal editors, medical professionals, and others. Scoping review, Delphi methods and hierarchical analysis were used to determine the final checklist of STAR. Results: The new instrument contained 11 domains and 39 items. Intrinsic reliability of each domain was indicated by Cronbach's α coefficient, with a average value of 0.646. The Cohen's kappa coefficients for methodological evaluators and clinical evaluators were 0.783 and 0.618. The overall content validity index was 0.905. The R 2 for the criterion validity analysis was 0.76. The average score for usability of the items was 4.6, and the mean time spent to evaluate each guideline was 20 minutes. Conclusion: The instrument has good reliability, validity and evaluating efficiency, and can be used for evaluating and ranking guidelines more comprehensively.

Avicel is made of a mixture of microcrystalline cellulose (MCC) and carboxymethyl cellulose (CMC), and used for virus plaque assay. The avicel in common use is produced by FMC Biopolymer. Due to the relatively fixed proportion of MCC and CMC, avicel in common use is not suitable for plaque determination experiment of all types of viruses. In this study, we evaluated the effect of avicel made of different proportions of MCC and CMC on virus plaque assay, and developed an improved avicel virus plaque assay featured with simple and convenient operation, good practicability and high stability. To generate avicel overlays with different proportions of MCC and CMC, twelve different 2×avicel solutions were prepared. Their overall viscosity and bottom viscosity were measured to evaluate the ease of operation. The results showed that most of the 2×avicel solutions (except the 4.8% MCC+1.4% CMC and 4.8% MCC+1.0% CMC group) were easy to absorb and prepare nutrient overlap than 2×CMC solution. In order to find the best scheme to detect the titer of porcine epidemic diarrhea virus (PEDV), these avicel overlay solutions with different proportion of MCC and CMC were used as a replacement in the standard plaque assay. By comparing the size, clarity, stability and titer accuracy of virus plaque, we identified that 0.6% MCC and 0.7% CMC was the most preferable composition of avicel overlay for PEDV plaque assay. In conclusion, we developed an improved virus plaque assay based on avicel, which may facilitate the research of virus etiology, antiviral drugs and vaccines.

Objective: To re-examine the diagnosis results of reported malaria cases in Sichuan Province from 2014 to 2020, so as to assess the malaria diagnostic capability of Sichuan Provincial Malaria Diagnostic Reference Laboratory., Methods: The blood and blood smear samples from reported malaria cases were collected by Sichuan Provincial Malaria Diagnostic Reference Laboratory from 2014 to 2020, and subjected to re-examinations using microscopy and nested PCR assay. The re-examination results were compared., Results: A total of 1 710 samples from reported malaria cases were re-examined by Sichuan Provincial Malaria Diagnostic Reference Laboratory from 2014 to 2020, and 1 634 samples were identified positive, with a positive coincidence rate of 95.56% (1 634/1 710) and a 92.29% (1 508/1 634) total coincidence rate of the Plasmodium species. The coincidence rates with P. falciparum , P. vivax , P. malariae and P. ovale were 99.48% (961/966), 97.07% (430/443), 83.05% (98/118) and 67.86% (19/28), respectively, and the coincidence rate was 91.81% (1 513/1 648) between microscopic and nested-PCR results., Conclusions: The capability of microscopists remains weak at grassroot medical institutions in Sichuan Province. Further training is required among microscopists to improve the malaria surveillance capability in Sichuan Province during the post-elimination stage.

Based on literature research and Delphi expert consensus method, the important acupoints for cancer pain was summarized to provide evidence basis for the formulation of Clinical Practice Guide of Acupuncture in the Treatment of Cancer Pain . Through systematic search of Chinese and English databases, 28 clinical studies regarding acupuncture for cancer pain were included. The acupoint selection methods and high-frequency acupoints were summarized and analyzed. Based on this, a Delphi questionnaire was designed and two rounds of questionnaire survey on 30 experts in acupuncture and tumor related fields in China and abroad were conducted. As a result, it was suggested that the individualized acupoint selection should be adopted for acupuncture treatment of cancer pain, with Zusanli (ST 36), Hegu (LI 4), Taichong (LR 3), Sanyinjiao (SP 6), Yanglingquan (GB 34) and ashi points as the main acupoints. Combined with clinical research evidence and expert consensus, the important acupoints for cancer pain were identified. However, clinical acupoint selection still needed further research and refinement.

In order to standardize the clinical diagnosis and treatment decision-making with traditional Chinese medicine for pa-tients of coronavirus disease 2019(COVID-19) and put the latest clinical study evidence into clinical practice, the international trust-worthy traditional Chinese medicine recommendations( TCM Recs) working group started the compilation of Living Evidence-based Guideline for Combination of Traditional Chinese and Western Medicine for Treatment of COVID-19 on the basis of the standards and re-quirements of WHO handbook, GRADE and RIGHT. This proposal mainly introduces the formulation methods and processes of the living guidelines in details, such as the composition of the working group, the collection and identification of clinical issues and out-comes, the production of the living systematic review and the consensus of recommendations. The guidelines will continue to monitor the clinical study evidences of TCM in the prevention and treatment of COVID-19, and conduct regular evidence updating, retrieval and screening. When there is new study evidence, the steering committee will evaluate the possibility of the evidence to change clinical practice or previous recommendations, so as to decide whether the recommendations for the guidelines shall be implemented or upda-ted. The main criteria considered in the guideline updating are as follows:(1) There are new high-quality randomized controlled trial(RCT) evidences for TCM uninvolved in the previous edition of the guidelines;(2) as for the TCM involved in the guidelines, living sys-tematic review shows that new evidence may change the direction or strength of the existing recommendations. The specific implementation of the living evidence-based guidelines will take this proposal as the study basis and framework, in order to ensure the standardization of the formulation process and methods. This will be the first exploration of the methodology for living guidelines in the field of TCM.

Objective: To detect variants of NF1 gene among thirteen patients with neurofibromatosis type 1., Methods: Genomic DNA was extracted from peripheral blood samples of the patients. High-throughput sequencing was employed to detect potential variants of the NF1 and NF2 genes., Results: Thirteen pathogenic variants were identified among the patients, which included one NF1 deletion, three missense variants, three nonsense variants and six frameshifting variants. Among these, 10 variants have been associated with neurofibromatosis type 1. c.4180A>T (p.Asn1394Tyr), c.4217dupT (p.Leu1406fs) and c.1753dupT(p.Leu585Phefs*3) were unreported previously. Based on the guidelines of the American College of Medical Genetics and Genomics, c.4180A>T (p.Asn1394Tyr) was predicted to be likely pathogenic (PS2+PM1+PM2+PP2), while c.4217dupT (p.Leu1406fs) and c.1753dupT (p.Leu585Phefs*3) were predicted to be pathogenic (PVS1+PS2+PM2)., Conclusion: Variants of the NF1 gene probably underlay the disease among these children. Above findings have enriched the the spectrum of NF1 gene variants.

Objective: At present, though the laparoscopic delta-shaped anastomosis and overlapping delta-shaped anastomosis have been gradually applied to complete laparoscopic radical resection of left hemicolon cancer, the comparative evaluation of their efficacy has not been mentioned in the published literatures. This study aims to explore the safety, feasibility and short-term efficacy of overlapping delta-shaped anastomosis (ODA) in totally laparoscopic left hemicolectomy. Methods: A retrospective cohort study was performed. The clinical and pathological data of patients who underwent totally laparoscopic left hemicolectomy at Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College from May 2017 to October 2020 were retrospectively analyzed. The case inclusion criteria were as follows: (1) age of 18-75 years; (2) body mass index (BMI) of 18.5-30 kg/m(2); (3) descending colonic and proximal sigmoid colonic adenocarcinoma was confirmed by preoperative colonoscopy and pathology. The exclusion criteria: (1) multiple primary colorectal cancers; (2) uncontrolled or poorly controlled diabetes mellitus, immune system diseases, or hematological diseases; (3) severe intestinal obstruction; (4) left transverse colonic or splenic flexure colonic adenocarcinoma; (5) distant metastasis of liver, lung and other viscera determined by enhanced computed tomography in the chest, abdomen and pelvis. According to the above criteria, a total of 115 patients with left hemicolon cancer were enrolled. All the patients underwent totally laparoscopic left hemicolectomy. Patients who underwent laparoscopic traditional delta-shaped anastomosis were selected as the control group. Patients who underwent laparoscopic ODA were selected as the ODA group. Effects of these two laparoscopic reconstruction methods on postoperative recovery and perioperative complications were analyzed and compared. Results: A total of 60 patients were enrolled in the ODA group, including 32 males and 28 females, with mean age of (57.3±10.4) years and body mass index (BMI) of (25.0±3.1) kg/m(2). While mean 55 patients were enrolled in the control group, including 31 males and 24 females, with mean age of (56.7±9.9) years and BMI of (24.4±2.9) kg/m(2). There was no statistically significant differences between the two groups in gender, age, BMI, American Society of Anesthesiologist (ASA) classification, TNM staging, preoperative abdominal surgery history, neoadjuvant chemotherapy and nutritional status (levels of hemoglobin, lymphocyte count, prealbumin, and albumin) (all P >0.05). All the patients in both groups received R0 resection without conversion to open laparotomy or conversion to extra-abdominal anastomosis. The digestive tract reconstruction time of the ODA group was significantly shorter than that of the control group [(15.1±1.7) minutes vs. (15.9±2.4) minutes, t =-2.053, P =0.042]. There were no statistically significant differences in the total operation time, intraoperative blood loss, length of skin incision, tumor size, proximal and distal margins, harvested lymph nodes, postoperative first ambulatory time, and postoperative hospital stay (all P >0.05). However, the time to the first flatus and the first defecation in the ODA group was significantly shorter as compared to control group [(1.5±0.5) days vs. (1.7±0.5) days, t =-2.028, P =0.045; (3.1±0.6) days vs. (3.4±0.7) days, t =-2.095, P =0.039], indicating faster intestinal function recovery in patients with ODA. The morbidity of postoperative complication was 6.7% (4/60) in the ODA group and 7.3% (4/55) in the control group and no significant difference was found (χ(2)=0.016, P =0.898). Two cases of incision infection, 1 case of lung infection, and 1 case of intra-abdominal infection occurred in the ODA group, while 3 cases of lung infection and 1 case of intra-abdominal infection occurred in the control group. All these complications were resolved after conservative treatment, and no secondary operation was performed due to complications. Conclusion: Compared with the traditional delta-shaped anastomosis, ODA is associated with a faster recovery of postoperative intestinal function without increasing the morbidity of postoperative complications, and has the satisfactory short-term efficacy.

Objective: To examine the safety and feasibility of using fusion indocyanine green fluorescence imaging (FIGFI) technique for intraoperative evaluation of colorectal perfusion in the totally laparoscopic left colectomy. Methods: A retrospective cohort study was conducted to collect the clinical data of 58 patients with left colon cancer who underwent totally laparoscopic surgery at the Colorectal Surgery Department, Cancer Hospital, Chinese Academy of Medical Sciences from October 2016 to December 2019. There were 39 males and 19 females, aging (57.0±10.1)years(range:28 to 75 years). According to whether the FIGFI was used during the operation, they were divided into 36 cases in the study group and 22 cases in the control group. The clinical pathological characteristics, operative and postoperative recovery of the two groups were compared by t test, χ 2 test, and Fisher exact test. Results: All the 58 patients underwent R0 resection with totally laparoscopic surgery. In the study group, due to poor bowel blood flow after cutting the mesentery (Sherwinter score = 1), 1 patient had to be expanded the resection range until the blood flow was rich(Sherwinter score≥3), and 1 patient in the control group had the complication of postoperative anastomotic leakage of grade A. Compared with the control group, the operation time in the study group was shorter ((156.3±43.5) minutes vs. (180.4±41.3) minutes, t =-2.083, P =0.042). However, there were no significant differences in the amount of blood loss, postoperative hospital stay, postoperative time of anal exhaust, length of bowel resection, number of lymph nodes dissected, and in the incidence of postoperative complications between the two groups. Median follow-up period was 23 months (range: 18 to 37 months). There were no long-term postoperative complications such as ischemic enteritis and anastomotic stenosis in both groups. Conclusions: The FIGFI is safe and feasible to assess the blood supply of intestinal segment and anastomosis during totally laparoscopic left hemicolectomy, and is easy to operate. It is expected to reduce the incidence of anastomotic leakage.

Objective: To analyze the tends on HIV/syphilis prevalence and sexual behaviors using the HIV/AIDS sentinel surveillance data of young students in China from 2015 to 2019 and provide evidence for the formulation of HIV/AIDS prevention and control measures among young students. Methods: From 2015 to 2019, a nationwide continuous cross-sectional survey was conducted in cities where colleges and technical schools were concentrated in each province. Multi-stage cluster sampling with the simple size 800, anonymous questionnaire, and blood sample collection were implemented to achieve general demographic information, sexual behavior, and serological information, analyze the trends and influence on HIV/syphilis infection and behaviors. Results: During 2015-2019, there was no linear trend on the antibody-positive rate of HIV[2019, 0.03% (17/54 110)], and there was a weak correlation on the antibody-positive rate of syphilis [2019, 0.08%(41/54 110)]. In 2019, the proportion of the respondents ever had sex was 8.71%(4 731/54 339), of those having regular sex partner in the last year was 3.96% (2 153/54 339), of those having a temporary partner was 1.81%(984/54 339), of a commercial sex partner was 0.19% (101/54 339), and of homosexual partners was 0.19% (101/54 339), who they were all stable. Multivariate logistic regression analysis showed that the young students who had male homosexual partners were most likely to be infected by HIV. The young students who had multiple sexual partners, including homosexual partners, were foreigners or minorities were most likely to be infected by syphilis (all P <0.05). Conclusions: The antibody-positive rates of HIV and syphilis remained low and stable among young students from 2015 to 2019 in China. However, the risk of sexual transmission of HIV and syphilis still remains among young students.

An analytical method for the simultaneous rapid screening and accurate confirmation of 415 pesticide residues in red cabbages was established using liquid chromatography-quadrupole-time of flight-mass spectrometry (LC-QTOF/MS) with single acquisition. In the established method, the pesticides in red cabbage were extracted using acetonitrile-acetic acid (99∶1, v/v) and salted-out using anhydrous magnesium sulfate and sodium chloride. The resultant solution was then cleaned-up by automatic solid phase extraction using a Carbon/NH 2 cartridge. The SPE cartridge was activated with 4 mL acetonitrile-toluene (3∶1, v/v) and the effluents were discarded. The resultant solution was transferred to the Carbon/NH 2 cartridge, using 3×2 mL acetonitrile-toluene (3∶1, v/v) to wash the test sample concentrate bottle, and waited until the surface of the test sample concentrate liquid reached the top layer of anhydrous Na 2 SO 4 before transferring the washing liquid to the cartridge. A 30-mL reservoir was attached to the upper part of the SPE cartridge and 25 mL acetonitrile-toluene (3∶1, v/v) was used to wash the SPE cartridge again. The eluent was evaporated in the glass tube in a water bath at 37 ℃ and shaking speed 150 r/min to reduce the volume to 0.5 mL. Nitrogen was used to dry the concentrates, and the residues were dissolved in 1.0 mL acetonitrile-water (3∶2, v/v), homogenized by ultrasonication, and passed through 0.22-μm filtering membrane before determination. The dissolved sample solution was loaded onto a ZORBAX SB-C18 column (100 mm×2.1 mm, 3.5 μm) and separated under gradient elution using 0.1% (v/v) formic acid aqueous solution containing 5 mmol/L ammonium acetate and acetonitrile as the binary mobile phase. The eluent from the column was further detected by QTOF/MS under electrospray positive ionization in the MS/MS scanning mode. A matrix-matched external calibration method was used for quantitation. By optimizing the different parameters under Auto MS/MS and All Ions MS/MS acquisition modes, the optimal conditions for All Ions MS/MS under each acquisition mode were obtained, which were then compared for selection of a better mode. The results demonstrated that the developed method can be used to accurately screen and quantify all 415 pesticides in red cabbage. The linear regression correlation coefficients ( r 2 ) for the 415 pesticides were all greater than 0.990 in the corresponding linear concentration range. In addition, the screening detection limits (SDL) of 411 pesticides were no more than 5 μg/kg, and the limits of quantification (LOQs) of 413 pesticides were no more than 10 μg/kg. At the spiked levels of LOQ, two-fold LOQ, and 10-fold LOQ, the recoveries were in the ranges of 65.7%-118.4%, 72.0%-118.8% and 70.2%-111.2%, with relative standard deviations (RSDs) in the ranges of 0.9%-19.7%, 0.2%-19.9% and 0.6%-19.9%, respectively. The method was applied to detect pesticide residues in the red cabbage samples provided by the 2019 European proficiency test project for unknown pesticide screening (EUPT-SM-11) and accurate quantitation (EUPT-FV-21). For EUPT-SM-11, all the spiked and incurred pesticides in red cabbage were qualified accurately, without false positives or false negatives. This is completely consistent with the final results published by the EU official. For EUPT-FV-21, there were 19 non-volatile pesticides that can be detected by LC-MS, which were then accurately quantitated with the corresponding pesticide standard. The results demonstrate that the proposed method is accurate and reliable. It is also rapid and time-saving, and can be used for high-throughput screening and quantitative determination of pesticide residues in cabbage. It can also be extended to other fruits and vegetable matrices.

Objective: To evaluate the safety and efficacy of stent-assisted coil embolization in patients with recurrent intracranial bifurcation aneurysms,after initial simple coiling or microsurgical clipping. Methods: Clinical data of 20 patients with recurrent intracranial bifurcation aneurysms who initially underwent simple coiling or surgical clipping and subsequently re-treated by stent-assisted coiling embolization at the Radiology Intervention Department of Huashan Hospital between March 2009 and November 2019 were collected and analyzed retrospectively.There were 9 males and 11 females,with a median age of 55.5 years (range:33 to 71 years),including 17 aneurysms initially treated with simple coiling and 3 treated with surgical clipping.All cases were re-treated with stent-assisted coiling,15 using a single stent and 5 employing two stents in a Y-configuration.Peri-and post-operative complications and outcomes were evaluated.Mann-Whitney U tests were performed to compare the follow-up duration between initial treatment and re-treatment.Student's t tests were used to compare the parent artery angles before re-treatment, after re-treatment and at the last follow-up. The parent artery angle was defined using the proximal main trunk and the stented branch. Results: Immediate complete occlusion (Raymond Ⅰ) was achieved in 18 aneurysms (90.0%) while 2 aneurysms (10.0%) had a residual neck (Raymond Ⅱ).The median follow-up time( M ( Q R )) was 8.5(16.3)months,which had no significantly different from the initial treatment follow-up duration (15.5(27.0)months)( U =157.7, P =0.25). During the follow-up period,2 aneurysms (10.0%) with immediate post-operative residual necks recanalized again,including 1 aneurysm re-treated with the Y-configuration stent.Symptomatic thromboembolic complications occurred in 6 patients,including 4 re-treated with the Y-configuration stent.No peri-operative hemorrhagic complications occurred,along with no operation-related permanent disability or death. The parent artery angle increased significantly from pre-operative(90.1±21.1)°to post-operative and the last follow-up ((115.4±28.9)° and (132.6±26.8)°); t =5.14, P <0.01; t =7.78, P <0.01). Conclusion: For recurrent intracranial bifurcation aneurysms after initial surgical clipping or simple coiling,stent assisted coil embolization is proved to be safe and can decrease recurrence rate.

Objective: In laparoscopic-assisted left hemicolectomy, previous studies have suggested that preserving the inferior mesenteric artery (IMA) may improve intestinal blood flow and reduce the incidence of anastomotic leakage. However, whether IMA should be retained is controversial currently. This study aims to investigate the short-term efficacy of the inferior mesenteric artery preservation (IMAP) and the inferior mesenteric artery resection (IMAR) on the laparoscopic-assisted radical resection of left hemicolon cancer. Methods: A retrospective cohort study was conducted to collect the clinical data of 195 patients with left colon cancer who underwent laparoscopic surgery in the Colorectal Surgery Department of Cancer Hospital of Chinese Academy of Medical Sciences from October 2012 to February 2019. After D3 radical resection for left semicolon cancer, they were divided into the IMAR group (91 cases), and the IMAP group (104 cases). In IMAR group, the left colon artery (LCA) and 1-2 branches of sigmoid artery (SA) were identified about 5 cm away from the root of the IMA, then the main IMA trunk was transected at the distal end. In IMAP group, the main trunk of IMA was dissected and the lymph nodes around IMA were cleaned. After the LCA and the first branch of SA (SA1) were separated, the LCA and SA1 were closed and cut off at the root. The intraoperative and postoperative data were compared between two groups, including the morbidity of complications within 30 days after operation, postoperative follow-up recovery, operation time, intraoperative blood loss, number of harvested lymph nodes, length of specimens, postoperative passage of gas and hospital stay. Results: The operation was successfully completed in all the cases without any death related to the operation. Compared with the IMAP group, the operation time was shorter [(161.8±48.0) minutes vs. (182.9±49.4) minutes, t =2.985, P= 0.003], the intraoperative blood loss was less [(38.5±30.8) ml vs.(52.9±32.2) ml, t =2.088, P= 0.038], the length of the resected bowel was longer [(19.2±6.0) cm vs.(17.2±5.4) cm, t= -2.447, P =0.015] in the IMAR group, whose differences were statistically significant (all P <0.05). There were no significant differences in the number of harvested lymph nodes, time of postoperative passage of gas and postoperative hospital stay between two groups (all P >0.05). There was no significant difference in overall morbidity of postoperative complications between the two group [6/91 (6.6%) vs. 7/104 (6.7%), χ(2)=0.001, P =0.969]. In the IMAR group, one case developed postoperative abdominal infection, two cases developed incision infection, one case developed lung infection, two cases developed intestinal obstruction, and no anastomotic bleeding occurred. In IMAP group, one case developed postoperative lung infection, one case developed incision infection, one case developed abdominal bleeding, two cases developed intestinal obstruction and two cases developed anastomotic bleeding. There was no anastomotic leakage in either group. All complications were treated by conservative treatment successfully. After a median follow-up of 12 (range 3-24) months, patients in the two groups had good intestinal blood supply after surgery, and there was no clear manifestation of congestive or ischemic enteritis under colonoscopy. Conclusion: Laparoscopic-assisted left hemicolectomy with IMA resection in patients with left hemicolon cancer provides better short-term efficacy safely and feasibly, including shorter operative time, less intraoperative bleeding and without increasing postoperative complications.

Objective: Using the changing patterns of CD(4)(+) lymphocytes (CD(4)) counts of HIV/AIDS cases, we tried to estimate the number of newly infected HIV in Honghe Hani and Yi autonomous prefecture (Honghe prefecture) Yunnan province, and to provide reference for evaluating the trend of local HIV epidemic. Methods: Among diagnosed HIV infections, those who were at ≥15 years old, having available initial CD(4) records of testing, initiating antiviral therapy before the end of 2018, were selected from the case reporting system of Honghe prefecture, Yunnan province. Both Depletion model of the square root on CD(4) and the time of infection were used to back-calculate the seroconversion time of each individual. Both direct probability distribution method and life table method were used to calculate the distribution rates of diagnosis and the weight of delay. The number of diagnoses over the years was used to reversely estimate the total number of newly HIV infections. Results: At the end of 2018, the total number of HIV infections was estimated 35 977 with the rate of diagnosis as 77.50 % in Honghe prefecture of Yunnan province. The number of new HIV infections appeared as 23 792 in 2008-2018. Cumulatively, the number of new HIV infections was 12 185 up to 2007. The estimated number of new HIV infections decreased from 2 602 in 2008 to 1 480 in 2018. The weight of diagnostic delay decreased from 5.49 in one year to 1.00 in 20 years, and the diagnosis rate increased from 18.2 % to 100.0 % during 20 years. Conclusion: In Honghe prefecture of Yunnan province, the number of newly infection showed a declining trend but the diagnostic rate was still far from reaching the "first 90 % target" . It is expected to expand the timeliness on detection and case-finding so as to reduce the risk of HIV transmission.

Objective: To verify the secretory ability of the hypoxic response protein 1 (HRP1) encoded by Mycobacterium tuberculosis (Mtb) Rv 2626 c ., Methods: The target gene attached with His tag was amplified from the genome of Mtb standard virulence strain H37Rv. The recombinant plasmid contained the above amplified product was constructed and electroporated into Mycobacterium smegmatis (Ms) (MC 2 155) to construct a recombinant strain. Protein expression was induced under heat condition, and the expression of protein from the culture filtrates and the bacterial lysates was detected afterward. The 10 kDa culture filtrate antigen (CFP-10) (Ms) and CFP-10 (Mtb) were used as positive controls, and the cytoplasmic protein heat shock protein 65 (GroEL2) (Mtb) was used as negative controls., Results: The HRP 1, GroEL 2 (Mtb), CFP -10 (Mtb) and CFP -10 (Ms) were successfully amplified by PCR from recombinant plasmid, and sequencing results of the recombinant plasmid is right, confirming the successful construction of the recombinant plasmid. The recombinant Ms was successfully constructed and it could express the proteins GroEL2 (Mtb), HRP1, CFP-10 (Mtb) and CFP-10 (Ms). The target protein HRP1 was detected in both of the lysate and the culture filtrate of the recombinant strain by Western blot, which was consistent with the positive control CFP-10. The negative control GroEL2 (Mtb) was only detected in the bacterial lysate, but not detected in the culture filtrate., Conclusion: The protein HRP1 encoded by Mtb Rv 2626 c can be secreted out of Ms by the secretion system of Ms. It may be a secreted protein and play an important role in the pathogenesis of Mtb., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Science Edition).)

Objective: To evaluate the safety, feasibility and short-term efficacy of totally laparoscopic left colectomy for left colon cancer by using overlapped delta-shaped anastomosis technique for digestive tract reconstruction. Methods: A retrospective cohort study was conducted to collect the clinical data of 86 patients with left colon cancer who underwent laparoscopic surgery in Cancer Hospital of Chinese Academy of Medical Sciences from October, 2017 to February, 2019. The patients were divided into totally laparoscopic left-sided colectomy (TLLC) (treatment group, n =25 cases) and laparoscopic-assisted left-sided colectomy (LALC) (control group, n =61 cases). The intraoperative and postoperative data were compared between the two groups. Results: There were no surgical-related deaths in both groups. All the patients in the TLLC group underwent laparoscopic resection, while one patient in the LALC group transfer to open surgery. The operation time in TLLC group and LALC group were (164.5±42.3) min and (171.0±43.1) min, respectively, without statistically significant difference ( P =0.516). However, the intraoperative blood loss of patients in the TLLC group was (36.4±22.7) ml, which was significantly less than (52.9±32.2) ml in the LALC group ( P =0.026). The anastomosis time in the TLLC group was (39.1±6.5) min, which was significantly longer than (24.9±5.4) min in the LALC group ( P <0.001). Postoperative exhaust time in the TLLC group was (2.6±0.5) days, which was significantly shorter than (3.3±0.8) days in the LALC group ( P <0.001). The incision length in the TLLC group was (4.2±2.2) cm, significantly shorter than (7.0±2.5) cm in the LALC group ( P <0.001). The length of the resected bowel was (21.0±7.3) cm in the TLLC group, which was significantly longer than (17.5±5.4) cm in the LALC group ( P =0.037). The length of hospital stay in the TLLC group was (6.2±1.9) days, which was significantly shorter than (7.9±1.5) days in the LALC group ( P <0.001). The incidences of postoperative complications in the TLLC group and LALC group were 0 and 4.9% (3/61), respectively, without statistically significant ( P =0.553). No anastomotic complications occurred in both groups. During the follow-up period, neither group of patients was hospitalized again, and no tumor metastasis or recurrence occurred. Conclusions: It is safe and feasible to apply the TLLC with overlapped delta-shaped anastomosis in patients with left colon cancer. It has better short-term effects such as shorter incisions, faster recovery, and shorter postoperative hospital stays, and is worthy of further promotion.

Objective: To understand the progression of CD(4)(+) T cells (CD(4)) declining rate in different age groups among MSM and to further explore the pathogenesis of HIV infection. Methods: Data regarding MSM who were diagnosed as HIV positive, aged ≥15 years, with homosexual route of transmission and with more than two records of CD(4) count retained before antiretroviral therapy (ART), were collected from the National AIDS Comprehensive Prevention Information System until May 31, 2019. Linear mixed effect model was used to fit the linear elimination relationship between the square root of CD(4) cell count and infection time before taking up the ART. To get the intercept estimation, we used the results from CD(4) count which containing the dates of last negativity and first positivity on HIV antibody testing. Both t test and Z test were used to test the model parameters. Median intervals from HIV seroconversion to CD(4)<500, <350, <200 cells/μl were estimated. Results: A total of 26 754 individuals were included in the study including 146 of them having records on the last date of being test negative. Their median age was 27 years old ( M =27, P ( 25 )- P ( 75 ):23-35). The intercept of the liner mixed models among 15-, 25- and ≥35 year olds were 24.84 (95 %CI : 23.76-25.92), 23.94 (95 %CI : 22.86-25.02), 23.44 (95 %CI : 21.91-24.96) and the slope of the liner mixed models among the 15-24, 25-34, 35-44 and ≥45 year olds were -1.31 (95 %CI : -1.33--1.25), -1.37(95 %CI : -1.40--1.33), -1.53 (95 %CI : -1.58--1.47) and -1.59 (95 %CI :-1.68--1.51), respectively. Estimation on the median intervals from HIV seroconversion to CD(4) <500, <350, <200 cells/μl counts were 1.29 (95 %CI : 0.79-1.81), 3.92 (95 %CI : 3.36-4.48) and 7.21 (95 %CI : 6.58-7.81), respectively. The median time of 15-24 age group from HIV seroconversion to reach the three CD(4) thresholds appeared the longest, as 1.89 (95 %CI : 1.05-2.85), 4.68(95 %CI : 3.80-5.77) and 8.17 (95 %CI : 7.23-9.42) years, respectively, the median time of ≥45 age group from HIV seroconversion to reach the three CD(4) thresholds appeared the shortest, as 0.68 (95 %CI : 0.00-1.72)、2.98 (95 %CI : 1.91-4.14)、5.85 (95 %CI : 4.62-7.16) years, respectively. Conclusions: Our findings suggested that the CD(4) declining rate had been accelerated along with ageing. Progression time from HIV seroconversion to different CD(4) thresholds appeared different, which was shorter in the older age group. Again, these findings showed the great impact of HIV infection among older age groups in the MSM population. Early diagnosis and treatment were bound to delay the progression of the disease.

Objective: To explore the clinical, pathological and genetic characteristics of early-onset facioscapulohumeral muscular dystrophy type 1 (FSHD1), in order to increase awareness of the disease. Methods: In this retrospective study, the history of 3 patients, who were diagnosed with early-onset FSHD1 by molecular genetic test in Pediatric Outpatient Department of Peking University First Hospital from 4(th) June 2012 to 4(th) June 2018, were collected. Their clinical data, genotypes, phenotypes and pathological features of muscle biopsy were analyzed. Results: All the three patients were males at the age of 14 years, 11 years and 9 years 11 months, respectively, whose onset age was between infancy and early childhood and they got confirmed diagnosis within 4 to 10 years after the onset of illness. Their molecular genetic testing indicated that the number of D4Z4 repeat arrays located in 4qA were 2, 3 and 4, which was consistent with the characteristics of early-onset FSHD1. Their common clinical manifestations were facial, scapular and proximal lower limb muscle progressively and asymmetrically weakness. All patients had different severity of spine deformity and high-frequency dominant sensorineural hearing loss, however, the phenotype of the third patient with 4 D4Z4 repeats was significantly the most severe. Conclusions: Early-onset FSHD1 usually concealed onset and is difficult to diagnose. Its precise diagnosis depends on molecular genetic techniques, but the genotypes of 3 patients here are not corresponding to phenotypes strictly and it is necessary to accumulate more cases for further analysis in order to provide a more reliable basis for the relationship of genotype-phenotype and prognosis evaluation of the disease.

Objective: To explore the clinical characteristics and genetic variants in a child with tyrosine hydroxylase-deficient infantile Parkinsonism with motor delay., Methods: Clinical feature of the patient was summarized. Genomic DNA was extracted from peripheral blood samples taken from the child and her family members. All exons of GCH1, TH and SPR genes were subjected to targeted capture and next-generation sequencing. Suspected variants were verified by Sanger sequencing., Results: The child could not sit alone at 7 month and 11 days. Physical examination suggested motor retardation and hypotonia, limb stiffness, head nodding, slight torticollis, and language and intellectual developmental delays. She developed involuntary shaking of limbs at 3 month old, which lasted approximately 10 seconds and aggregated with excitement and before sleeping. Cranial MRI revealed widening of subarachnoid space on the temporomandibular and particularly temporal sides. Genetic testing revealed that she has carried a nonsense c.457C>T (p.R153X) variant, which was known to be pathogenic, and a novel missense c.720C>G (p.I240M) variant of the TH gene. The two variants were derived from her father and mother, respectively., Conclusion: The child was diagnosed as tyrosine hydroxylase-deficient infantile Parkinsonism with motor delay due to compound heterozygous variants of the TH gene. Above finding has enriched the spectrum of TH gene variants.

Objective: To explore the characteristics of humor in young adult epileptic patients and examine the relationship between humor and depression. Methods: We recruited 55 young adult epileptic patients who visited outpatient clinic of the Department of Neurology of Yijishan Hospital of Wannan Medical College between October 2018 and March 2019 and 44 healthy controls to complete the multidimensional humor scale (MSHS), humor style questionnaire (HSQ) and Beck depression scale-Ⅱ (BDI-Ⅱ), and compared their differences between the two groups. Results: The results showed that the young adult patients with epilepsy (PWEs) were affected in humor creation, coping with humor and the totally scores of MSHS. The scores of humor creation, coping with humor and the totally scores of MSHS in the young epilepsy patients were 25.3±5.9, 16.7±5.0 and 61±10, which were significantly lower than those in the control group 29.8±6.1, 21.1±2.6 and 71±8. As for the humor style, self-defeating humor scores in PWEs were higher than controls 14±5 vs 9±3, and the self-enhancing humor scores were lower than controls 18±7 vs 23±6. The scores of BDI-Ⅱ in PWEs were significantly higher than those of normal controls 13±7 vs 6±4. Pearson's correlation test showed that the scores of BDI-Ⅱ were negatively correlated with humor creation, coping with humor, the totally scores of MSHS and self-enhancing humor scores ( r= -0.566--0.721, P< 0.05), while it was positively correlated with self-defeating humor scores ( r= 0.818, P< 0.05). Among the clinically relevant factors, the scores of BDI-Ⅱ were correlated with seizure control and gender. Multiple stepwise linear regression showed that coping with humor, self-defeating and self-enhancing humor scores were closely related with depression in young epileptic adults. Conclusion: The young adults with epilepsy are affected in sense of humor and humor style, which are closely related with depression.

Objective: To explore the genetic basis for a child featuring delayed language development., Methods: The patient was subjected to conventional G-banding chromosomal karyotyping and single nucleotide polymorphism microarray (SNP array) analysis., Results: The karyotype of the child was 46, XY, r(22)(p11.2q13). SNP array analysis has identified a hemizygous 1.67 Mb deletion at 22q13 (arr [Hg19]22q13.33 (49 531 302-51 197 766)×1)., Conclusion: The child has carried a ring 22 in addition with a 22q13 microdeletion. The results may provide clues for her condition and genetic counseling for the family.

Previous studies have shown that postoperative cognitive dysfunction (POCD) is related to multiple factors including age, postoperative trauma, inflammation, postoperative pain, and anesthesia, among which postoperative pain is thought to play an important role in the development of POCD. This review summarizes the recent findings in the study of the role of postoperative pain in the pathogenesis of POCD in light of nerve injuries, neural remodeling and stress, and the progress in the prevention and treatment of POCD in elderly patients. It is of vital important to assess the postoperative pain and formulate adequate analgesic regimens for effective prevention and management of POCD to protect the brain functions of elderly patients.

Objective: To explore the genetic basis of a child with chronic kidney disease featuring renal shrinkage and creatinine increase., Methods: Peripheral venous blood samples were taken from the child, his brother and two parents and subjected to whole exome sequencing. Suspected mutations were verified by Sanger sequencing. Bioinformatic analysis was carried out to predict the influence of mutations on the structure and function of the protein product., Results: High-throughput and Sanger sequencing revealed that the child has carried compound heterozygous mutations of the COL4A4 gene, namely c.4550T>G in exon 47 (inherited from his mother) and c.199C>T in exon 5 (inherited from his father). Neither mutation was reported previously. Bioinformatic analysis showed that both mutations have located in highly conserved regions. The same mutations were not found in his brother., Conclusion: The compound heterozygous c.4550T>G and c.199C>T mutations probably underlie the disease in this child. The findings have enriched the mutation spectrum of the COL4A4 gene.

Objective: To know condom use negotiation with clients and regular sex partners and condom use in female sex workers (FSWs), and provide reference for the development of comprehensive HIV/AIDS intervention for FSWs. Methods: The cross sectional survey was conducted in Jianshui county and Mengzi county in Honghe Hani and Yi autonomous prefecture. A total of 476 FSWs aged 16 years and above were recruited from entertainment venues, and the information about their demographic characteristics, condom use negotiation and condom use were collected by using questionnaires. Logistic regression model was used to analyze related factors of condom use after negotiation between FSWs and clients unwilling use condom. Results: A total of 852 FSWs who aged (24.29±8.44) years old participated in the survey. In past month, 499 FSWs had negotiation for condom use with unwilling clients (58.6 % , 499/852), after negotiation, 441 FSWs (88.4 % , 441/499) had consistent condom use in each sex with the clients. In the past one month, 99 FSWs had negotiation for unwilling use condom with regular sex partners (14.4 % , 99/687), after negotiation, 54 FSWs (54.5 % , 54/99) had consistent condom use in each sex with regular sex partners. Among the FSWs, 266 (53.3 % , 266/499) reported that they could say "It is a mandatory requirement" to persuade clients who were unwilling to use condom. 97(19.4 % , 97/499) reported that they could say "There is risk for infection" to persuade clients who were unwilling to use condoms. 115 (23.1 % ,115/499) reported that they could say "It is a mandatory requirement" and "there is risk for infection" to persuade their unwilling clients to use condoms. 21 (4.2 % , 21/499) reported that they used other strategies. 22 (4.4 % , 22/499) felt that it was difficult to persuade clients to use condoms. Multivariate logistic regression analysis showed that compared with FSWs who felt difficult in persuading clients to use condoms, FSWs who felt moderate difficulty were more likely to have consistent condom use after negotiation ( OR =4.00, 95 %CI : 1.55-10.32) and FSWs who felt easy in persuading clients to use condoms were also more likely to have consistent condom use ( OR =30.17, 95 %CI : 3.22-282.44). Compared with FSWs used other strategies to persuade their clients to use condoms, FSWs who said it was a mandatory requirement were more likely to have consistent condom use after negotiation ( OR =4.44, 95 %CI : 1.41-14.01) and FSWs who said it was a mandatory requirement and there was risk for infection were also more likely to have consistent condom use ( OR =5.52, 95 %CI : 1.55-19.73). Conclusions: Negotiation for condom use increased the rate of condom use in FSWs in sex with clients who were unwilling to use condom. The negotiation strategy of "It is a mandatory requirement" would promote condom use in FSWs in sex with clients who were unwilling to use condom. Besides, the negotiation strategy of saying "there is risk for infection" had additional effects.

Objective: To investigate the prevalence of high-risk HPV subtypes in different pathological types of cervical cancer, and analyze the attribution of carcinogenic HPV subtypes in different pathological types. Methods: A total of 1 541 patients with cervical cancer were treated between February 2009 and October 2016 in Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. The median age at diagnosis was 49 years (ranged 20-82 years old). The numbers of patients with cervical cancer from North China, Northeast China, East China, Central China and other regions (including Northwest, Southwest and South China) were 961, 244, 175, 87 and 74 cases, respectively. Pathological types: 1 337 cases of squamous cell carcinoma (SCC), 87 usual adenocarcinoma (ADC), 23 adenosquamous carcinoma (ASC), 20 mucinous carcinoma (MC), 19 clear cell carcinoma (CCC), 12 endometrioid carcinoma (EC), 25 neuroendocrine carcinoma (NEC), 9 serous carcinoma (SC), 5 villous adenocarcinoma (VADC) and 4 minimal deviation adenocarcinoma (MDAC). The prevalence of high-risk HPV in different regions, age groups at diagnosis and pathological types in cervical cancer were analyzed. The attribution of 13 high-risk HPV subtypes in different pathological types of cervical cancer based on proportional attribution method, and the attribution of high-risk HPV subtypes prevented by 9-valent HPV vaccine in SCC and ADC were calculated. Results: (1) The prevalence of high-risk HPV in 1 541 patients with cervical cancer was 86.6% (1 335/1 541). The multiple high-risk HPV infection rate in patients with SCC ≥60 years old (23.0%, 37/161) was significantly higher than those in patients aged 45-59 years old and ≤44 years old [11.4% (85/747) vs 11.7% (50/429), P <0.01], and the high-risk HPV infection rates of patients with cervical cancer in North China, Northeast China, East China, Central China and other regions were respectively 86.8% (834/961), 87.7% (214/244), 83.4% (146/175), 83.9% (73/87) and 91.9% (68/74). SCC (86.8%, 1 337/1 541) and ADC (5.6%, 87/1 541) were the most common pathological types in cervical cancer. The high-risk HPV prevalence of SCC, ADC, ASC, MC, NEC and VADC were 90.1% (1 205/1 337), 74.7% (65/87), 87.0% (20/23), 65.0% (13/20), 72.0% (18/25) and 5/5 respectively. The high-risk HPV infection rates of SC, EC, CCC and MDAC were 4/9, 3/12, 2/19 and 0/4 respectively. (2) According to proportional attribution, HPV 16 (69.5%), HPV 18 (5.6%), HPV 58 (2.2%), HPV 31 (1.9%), HPV 52 (1.4%) and HPV 33 (1.3%) were the six common high-risk HPV subtypes in SCC. While, HPV 18 (44.1%), HPV 16 (20.5%), HPV 52 (2.3%), HPV 58 (1.2%) and HPV 51 (1.2%) were the main carcinogenic subtypes in ADC. The main carcinogenic high-risk HPV subtypes of ASC, NEC and MC were HPV 18 and HPV 16. The total attribution of HPV 16, 18, 31, 33, 45, 52 and 58 prevented by 9-valent HPV vaccine in SCC and ADC were 82.6% and 68.1% respectively; the attribution of HPV 45 in SCC and ADC were only 0.8% and 0. Conclusions: SCC and ADC are the main pathological types in cervical cancer. SCC, ADC, ASC, MC, NEC and VADC are closely related to high-risk HPV infection. HPV 16 is the main carcinogenic genotypes of SCC. HPV 18 maybe play an important role in the pathogenesis of ADC.

The data mining method was used to analyze and summarize the prescription and medicate regularities of chief physician Jiang Quan in the treatment of rheumatoid arthritis,in order to provide references for the clinical treatment of rheumatoid arthritis. Totally 121 prescriptions of rheumatoid arthritis treated by chief physician Jiang Quan from 2007 to 2017 were collected and input into the Chinese medicine inheritance auxiliary system. The " prescription statistics" function of the software " statistical report" system,and the " prescription analysis" function of the " data analysis" system,the data mining methods such as rule analysis,integration correlation,complex system entropy clustering,and unsupervised entropy hierarchical clustering,were used to analyze the prescription regularity of chief physician Jiang Quan. A total of 121 prescriptions were included,involving 144 herbs,in which 30 herbs had a higher frequency of more than 20 times,20 two-herb combinations had a frequency of more than 59 times; after evolution,14 core combinations and 7 new prescriptions were obtained. Among the prescriptions in the treatment of rheumatoid arthritis,those for clearing heat and dampness,promoting blood circulation and removing blood stasis had a higher frequency,and the core prescriptions were modified " Qingre Huoxue Decoction" and modified " Ermiao Pills". The newly evolved prescriptions not only reflected director Jiang Quan' s method of treating rheumatoid arthritis by clearing away heat and dampness and promoting blood circulation by the,but also included the treatment methods of removing wind and removing dampness,dredging collaterals and removing phlegm,nourishing Yin and clearing heat,nourishing Yin and nourishing kidney,nourishing blood and nourishing Qi. The method can be used to analyze the pathogenetic changes of the mutual knot of phlegm and blood stasis,injury of Qi and blood,long-term implication on liver and kidney. At the same time,it also reflects the treatment principles of treating phlegm and strengthening the evil.

Objective: To collect intestinal lactobacilli in healthy infants and to characterize them biochemically for further studies., Methods: Lactobacilli were isolated from the fecal samples collected from total 41 of 1-4 month old healthy infants with culture method by selective medium. After morphological observation and oxygen test, the isolates were tested for their abilities to use 50 carbohydrate and identified with API 50 CHL system and 16 S RNA sequencing. The isolates were also detected for their 19 enzyme activities with API ZYM system., Results: A total of 71 Lactobacillus strains were successfully isolated and well identified, including L. paracasei( 42. 3%), L. gasseri( 18. 3%), L. salivarius( 14. 1%), L. brevis( 5. 6%), L. rhamnosus( 4. 2%), L. fermentum( 1. 4%), L. plantarum( 1. 4%) and other species( 12. 7%). The seven species of Lactobacillus had strong ability of utilizing carbohydrate. Except for 14 carbohydrates that could not be fermentable, 4 kinds of carbohydrates could be metabolized by all lactobacilli from the seven species, and the other 31 kinds of carbohydrates were metabolized differently among species. Most lactobacilli were active on Leucine arylamidase, Galactosidase and Glucosidase, while other enzyme activities were species-specific and strains-specific., Conclusion: L. paracasei, L. gasseri and L. salivarius could be considered as dominant species of 1-4 months healthy infants. However, the carbohydrate utilization and enzyme activities of the fecal lactobacilli might be species and strain dependent.

Objective: To investigate the association between intestinal bifidobacteria and allergic diseases in infants by comparing the composition of intestinal bifidobacteria between healthy infants and infants with allergic diseases., Methods: A total of 48 infants were enrolled, and fecal samples were collected on days 0, 2, 7, and 15 and at months 1, 6, and 12 after birth. Among these infants, 22 who experienced allergic diseases before the age of 1 year were enrolled as allergic group and 26 healthy infants were enrolled as healthy group. Quantitative real-time PCR was used for the qualitative and quantitative analyses of Bifidobacterium and 8 species of bifidobacteria in fecal samples., Results: There was a difference in the composition of intestinal bifidobacteria between the two groups within 1 month after birth: the healthy group showed a reduction in bifidobacteria on day 2, while this feature was not observed in the allergic group. Compared with the healthy group, the allergic group had a significantly lower detection count of Bifidobacterium at month 1 (P<0.05) and a significantly lower detection rate of B.breve on day 15 (P<0.05), with delayed colonization of B.infantis., Conclusions: Intestinal bifidobacteria and their composition within 1 month after birth may be associated with the development of allergic diseases, and this period of time may be a critical period for the prevention and treatment of allergic diseases in infants.

Objective: To understand the characteristics of new-type drug consumption, sexual behaviors and the prevalence of HIV infection among male new-type drug users in Qingdao, Shandong province. Methods: A cross sectional survey was conducted from 2015 to 2016. Participants were recruited from MSM community-based organizations (CBO) and general community through snowball method, relying on volunteers and male peer educators who were on new-type drugs themselves. Face-to-face interview was carried to collect information on drug use and sexual behaviors. Blood samples were collected to test HIV, syphilis and HCV antibodies. Urine samples were collected to test the evidence of new-type drugs. Qualitative variables and quantitative variables were analyzed using Chi-square test/Fisher's exact test and Student's t -test respectively. Multivariate logistic regression was used to analyze related factors of binary variables. Results: A total of 1 034 newtype drug users were recruited, including 431 (41.7 % ) MSM population and 603 (58.3 % ) who were not MSM. Compared with the the group of people who were not MSM, people in the the MSM group were younger, unmarried and with higher level of education. The proportion of methamphetamine users were 49.7 % (214/431) and 100.0 % (603/603) among the groups of MSM or not MSM, respectively. People in the MSM group, 66.8 % (288/431) used 5-Methoxy-N, N-diisopropyltryptamine (5-MeODIPT, "foxy" ) in the last six months. However, none from the not-MSM group ever used 5-MeO-DIPT. In the last six months, proportions of sharing new-type drugs with more than two people in the MSM or not groups were 87.9 % (379/431) and 97.7 % (588/602), respectively ( χ (2)=39.84, P <0.01). Proportions of unprotected sexual behavior among the MSM or not groups were 47.5 % (285/600) and 7.4 % (32/430) respectively ( χ (2)=190.10, P <0.01). The proportions of 'group sex' after using drugs among the two groups were 78.1 % (335/429) and 5.5 % (33/600) respectively ( χ (2)=573.73, P <0.01). The prevalence rates of HIV, syphilis and HCV antibody positive among the MSM or not groups were 2.1 % and 0.2 % , 3.3 % and 6.3 % , 0.0 % and 0.3 % , respectively. Conclusion: The prevalence of sharing new-type drugs with more than two people was high among male new-type drug users in Qingdao city. Male new-type-drug-users who were MSM, presented both high prevalence of group sex and HIV infection, and with less condom use. Intervention measures towards this sub-population should be strengthened.

Objective: To investigate the possible relationship between the gut microbiota and hyperlipidemia,hyperglycemia in middle-aged and elderly people in Chengdu., Methods: 51 of middle-aged and elderly people participated in this study. The concentration of blood glucose and lipid,and the other physiological parameters of the subjects were analyzed,and their fecal microbiota was also profiled by Illumina high-throughput sequencing technique., Results: The fecal microbiota in the middle-aged and elderly were mainly Firmicutes,Bacteroidetes,Proteobacteria,Fusobacteria,Actinobacteria,Verrucomicrobia. The diversity offecalmicrobiota was significantly lower in the subjects with higher blood glucose ( P <0.05),while it did not exhibited relationship with changes in blood lipids. At the bacterial phyla: Proteobacteria and Bacteroidetes were respectively significantly higher in middle-aged and elderly women with higher blood glucose ( P <0.05). At the bacterial genus: Faecalibacterium was significantly lower in the hyperglycemic subjects ( P <0.05),its abundance and blood glucose levels were negatively correlated ( r =⁻0.278, P =0.048); Prevotella and Paraprevotella were significantly lower in the high blood lipids group ( P <0.05),and both of them were negatively correlated with blood lipid levels ( r =⁻0.357, P =0.10; r =⁻0.365, P =0.008)., Conclusion: The fecal microbiota in the tested middle-aged and elderly subjects varied with blood glucose and blood lipid concentration. Intestinal microbes might posses close relationship with blood glucose and lipid metabolism in middle-aged and elderly people., (Copyright© by Editorial Board of Journal of Sichuan University (Medical Science Edition).)

Objective: To investigate the safety and efficacy of rotational atherectomy in the interventional treatment of coronary chronic total occlusion lesions. Methods: In this retrospective study,a total of 31 consecutive patients with coronary chronic total occlusion(CTO) lesions underwent rotational atherectomy in our hospital from February 2004 to December 2016 were enrolled,and the clinical features were analyzed. Coronary atherectomy was performed if balloon failed to cross the CTO lesions or balloon could not be fully dilated in the CTO lesions after wire crossing. The definition of procedure success was defined as residual stenosis less than 20% after implantation of drug eluting stent and rotational atherectomy. After the procedure, the patients were followed up to observe major adverse cardiac and cerebral vascular events which including cardiogenic death, myocardial infarction, cerebrovascular accident, and target lesion revascularization. Results: The 1.25 mm diameter burr was firstly selected in 80.6% (25/31) patients,and 96.8%(30/31) patients used only 1 burr to complete the rotational atherectomy procedure. The complication rate was 9.8% (3/31) including 1 patient with coronary dissection and 3 patients with slow flow or no flow. There was 1 patent with both coronary dissection and slow flow. The procedure success rate was 96.8%(30/31). Interventional treatment related myocardial infarction occurred in 3 patients during hospitalization.The 30 patients with procedure success were followed up 36(11, 96) months. The incidence rate of major adverse cardiac and cerebral vascular events was 13.3% (4/30), of which the cardiogenic death rate was 3.3% (1/30), the myocardial infarction rate was 6.7% (2/30), cerebrovascular accident rate was 3.3%(1/30),and the target lesion revascularization rate was 6.7% (2/30). Conclusion: Rotational atherectomy is safe and effective in the interventional treatment of coronary CTO lesions.

Objective: Under hypoxic conditions, the survival and apoptosis of human amniotic mesenchymal stem cells (hAMSCs) were observed by transient transfection of hypoxia-inducible factor 1α (HIF-1α) gene, to investigate the effect of HIF-1α on hypoxic tolerance of hAMSCs., Methods: The hAMSCs were isolated and cultured from amniotic membrane tissue from voluntary donors who were treated with cesarean section. And the morphological observation by inverted phase contrast microscope and immunofluorescence detection of the expressions of stem cell markers OCT-4 and NANOG were performed to identify the cultured cells. The third generation hAMSCs were treated with 200 μmol/L CoCl 2 , and transient transfection of plasmids were added according to the following grouping: group A was hAMSCs blank group; group B was pcDNA3.1 negative control group; group C was short hairpin RNA (shRNA) negative control group; group D was shRNA-HIF-1α interference group; group E was pcDNA3.1-HIF-1α over expression group. Cell survival rate of each group was measured by cell counting kit 8 (CCK-8) at 12, 24, 48 hours after hypoxia treatment. Flow cytometry was used to detect apoptosis rate of each group at 24 hours after hypoxia treatment. The expression levels of HIF-1α, vascular endothelial growth factor (VEGF), B-cell lymphoma 2 (Bcl-2), Bax, and cleaved Caspase-3 (C-Caspase-3) proteins were detected by Western blot at 24 hours after hypoxia treatment., Results: CCK-8 assay showed that the cell survival rate of group D was significantly lower than those of groups A and C at all time points after hypoxia treatment; while the cell survival rate in group E was significantly increased than those in groups A and B, and the diffrences at 24 hours were significant ( P <0.05). In group E, the cell survival rate at 24 hours was significantly higher than those at 12 and 48 hours ( P <0.05). The results of flow cytometry showed that the apoptosis rate in group D was significantly higher than those in groups A and C ( P <0.05), and the apoptosis rate in group E was significantly lower than those in groups A and B ( P <0.05). Western blot showed that the expressions of HIF-1α, VEGF, and Bcl-2 proteins in group D were significantly decreased when compared with those in groups A and C, and the expressions of Bax and C-Caspase-3 proteins were significantly increased ( P <0.05). On the contrary, the expressions of HIF-1α, VEGF, and Bcl-2 proteins in group E were significantly higher than those in groups A and B, and the expressions of Bax and C-Caspase-3 proteins were significantly decreased ( P <0.05)., Conclusion: Overexpression of HIF-1α gene can significantly improve hAMSCs tolerance to hypoxia, the mechanism may be related to up-regulation of VEGF and Bcl-2 expressions, and down-regulation of Bax and C-Caspase-3 expressions.