Relationship between cerebrovascular variation and the occurrence and recurrence of cerebral infarction / 中华行为医学与脑科学杂志

Objective:To investigate the relationship between cerebrovascular variation and the occurrence and recurrence of cerebral infarction, and provide a theoretical basis for the precise prevention and treatment of cerebral infarction.Methods:Totally 13 939 patients who underwent magnetic resonance imaging(MRI) and magnetic resonance angiography(MRA) examination at the Second Affiliated Hospital of Shandong First Medical University from January 2020 to December 2021 were grouped according to clinical symptoms combined with the imaging report, including 4 412 cases in the cerebral infarction group and 9 527 cases in the control group.2 048 patients in the cerebral infarction group were eventually enrolled in the study according to the inclusion and exclusion criteria, including 1 479 cases of initial cerebral infarction and 569 cases of recurrent cerebral infarction.SPSS 25.0 statistical software was used for data analysis.The χ2 test was used to compare the incidence of cerebral infarction with different cerebrovascular variations.Univariate analysis of suspected risk factors for recurrent cerebral infarction was performed with χ2 test, nonparametric test and t test.The binary logistic regression was used to analyze independent risk factors of recurrent cerebral infarction. Results:The incidence of cerebral infarction in the dual-system cerebrovascular variant patients, the single-system cerebrovascular variant patients, and the non-cerebrovascular variant patients were 40.9%, 30.7% and 31.8% respectively.The incidence of cerebral infarction in the dual-system cerebrovascular variant patients was the highest compared with those in the single-system cerebrovascular variant patients and the non-cerebrovascular variant patients (both P<0.05). The incidence rates of embryonic posterior cerebral artery, vertebral artery dominance, and bilateral common origin anterior cerebral arteries were 14.09%, 10.76% and 5.32%, respectively.The incidence of bilateral common origin anterior cerebral arteries in the cerebral infarction group was significantly higher than that in the control group and the difference was statistically significant.Patients with cerebral infarction who were familial aggregation ( OR=2.207, 95% CI=1.591-3.062), hyperhomocysteinemia ( OR=1.262, 95% CI=1.014-1.570), hypertension ( OR=1.461, 95% CI=1.114-1.918), diabetes mellitus ( OR=1.348, 95% CI=1.072-1.694), coronary heart disease ( OR=1.491, 95% CI=1.196-1.858) were more likely to recurrent cerebral infarction ( P<0.05), and patients with cerebral infarction had a significantly increased risk of recurrent cerebral infarction with age ( OR=1.031, 95% CI=1.020-1.042, P<0.05). Conclusion:Dual-system cerebrovascular variation and bilateral common origin anterior cerebral arteries are risk factors for cerebral infarction.

Mechanism of Bcl-2 BH4 selective inhibitor BDA-366 on NK/T cell lymphoma cells / 国际肿瘤学杂志

Objective:To investigate the inhibitory effect and killing mechanism of Bcl-2 BH4 selective inhibitor BDA-366 on NK/T cell lymphoma (NK/TCL) .Methods:Human NK cell leukemia cell line YT and human NK/TCL cell line NK92 cells were treated with 0, 0.05, 0.10, 0.20, 0.30, 0.40, 0.50 μmol/L BDA-366. CCK-8 assay was used to calculate the half inhibitory concentration (IC 50) value of BDA-366 on these cells. The apoptosis levels of cells in control group and IC 50 BDA-366 treated group were detected by flow cytometry. Western blotting was used to detect the expression levels of apoptosis-related proteins in cells of control group and 1/2 IC 50, IC 50, 2× IC 50 BDA-366 treated groups. TMRE and Fluo-3 fluorescent probe were used to detect mitochondrial membrane potential of control group and IC 50 BDA-366 treated group, and the intracellular Ca 2+ concentration of control group, IC 50, 2× IC 50 BDA-366 treated groups. NOD-SCID mice in control group and 10 mg/kg BDA-366 intraperitoneal injection group were weighed and HE staining was performed to evaluate the toxicity of BDA-366 in vivo. Results:The IC 50 of BDA-366 for YT and NK92 cells were 0.065 and 0.086 μmol/L respectively. The apoptosis rates of YT cells in the control group and 0.065 μmol/L BDA-366 group were (6.62±1.59) % and (34.60±3.06) % respectively. The apoptosis rates of NK92 cells in the control group and 0.086 μmol/L BDA-366 group were (5.57±0.88) % and (29.18±0.90) % respectively, both with statistically significant differences ( t=14.05, P<0.001; t=32.58, P<0.001). The relative expression of Bax in NK92 cells of the control group, 0.043, 0.086 and 0.172 μmol/L BDA-366 groups were 0.85±0.00, 1.26±0.04, 1.51±0.18, 1.15±0.10 ( F=20.70, P<0.001), the relative expression of Bax in BDA-366 groups were higher than that in the control group (all P<0.05). The fluorescence intensity of TMRE of YT cells in the control group and 0.065 μmol/L BDA-366 group were 8 372.00±330.47 and 6 419.67±311.34, and that of NK92 cells in the control group and 0.086 μmol/L BDA-366 group were 9 169.00±535.72 and 7 311.67±295.52 respectively, and there were statistically significant differences ( t=7.45, P=0.002; t=5.26, P=0.006). In YT cells, the intracellular Ca 2+ concentrations of 0.065 and 0.130 μmol/L BDA-366 groups were significantly higher than that of the control group (5 791.67±220.45, 6 729.33±585.39, 4 874.67±112.61, F=19.16, P=0.003) ( P=0.039; P=0.002). In NK92 cells, the intracellular Ca 2+ concentrations of 0.086 and 0.172 μmol/L BDA-366 groups were significantly higher than that of the control group (4 553.67±17.62, 4 740.33±254.50, 4 185.67±17.67, F=10.96, P=0.010) ( P=0.039; P=0.007). There was no statistically significant difference in body weight change on day 12 compared with day 0 of NOD-SCID mice between BDA-366 group and control group [ (3.18±0.01) g vs. (2.73±0.58) g, t=0.60, P=0.570], and HE staining showed no abnormal morphology of heart, liver, spleen, lung and kidney in BDA-366 group. Conclusion:BDA-366 promotes NK/TCL cells apoptosis in vitro, but does not cause weight loss and morphological changes of organs by HE staining in vivo. The inhibitory effect of BDA-366 on NK/TCL cells may be achieved by increasing Bax expression, inducing Ca 2+ release and reducing mitochondrial membrane potential.

Effect of improved nursing strategy on prognosis of older immunosuppressed patients with pneumonia and sepsis / 中华危重病急救医学

OBJECTIVE@#To investigate the effect of improved nursing strategy on prognosis of older immunosuppressed patients with pneumonia and sepsis.@*METHODS@#A prospective study was conducted. The older immunosuppressed patients with pneumonia and sepsis admitted to the department of intensive care medicine and emergency intensive care unit (ICU) of Peking Union Medical College Hospital from January 2017 to July 2022 were enrolled. In the first stage (from January 2017 to December 2019), patients received the original nursing strategy (original nursing strategy group), including: (1) nurses were randomly assigned; (2) routine terminal cleaning; (3) ICU environmental cleaning twice a day; (4) oral care was performed with chlorhexidine twice a day; (5) original lung physiotherapy [head of bed elevated at 30 degree angle-45 degree angle, maintaining a Richmond agitation-sedation scale (RASS) -2 to 1, sputum aspiration as needed]. After 1 month of learning and training of the modified nursing treatment strategy for nurses and related medical staff, the patients in the second stage (from February 2020 to July 2022) received the improved nursing strategy (improved nursing strategy group). The improved nursing strategy improved the hospital infection prevention and control strategy and lung physical therapy strategy on the basis of the original nursing strategy, including: (1) nurses were fixed assigned; (2) patients were placed in a private room; (3) enhanced terminal cleaning; (4) ICU environmental cleaning four times a day; (5) education and training in hand hygiene among health care workers was improved; (6) bathing with 2% chlorhexidinegluconate was performed once daily; (7) oral care with a combination of chlorhexidine and colistin was provided every 6 hours; (8) surveillance of colonization was conducted; (9) improved lung physiotherapy (on the basis of the original lung physiotherapy, delirium score was assessed to guide early mobilization of the patients; airway drainage was enhanced, the degree of airway humidification was adjusted according to the sputum properties, achieving sputum viscosity grade II; lung ultrasound was also used for lung assessment, and patients with atelectasis were placed in high lateral position and received the lung recruitment maneuver). Baseline patient information were collected, including gender, age, underlying diseases, source of admission, disease severity scores, vital signs, ventilatory parameters, blood gas analysis, life-sustaining treatments, clinical laboratory evaluation, indicators of infection and inflammation, pathogens and drug therapy. The primary outcome was 28-day mortality, and the secondary outcomes were duration of mechanical ventilation, length of ICU stay, and ICU mortality. Multivariate Logistic regression analysis was used to determine the risk factors for 28-day death in older immunosuppressed patients with pneumonia and sepsis.@*RESULTS@#Finally, 550 patients were enrolled, including 199 patients in the original nursing strategy group and 351 patients in the improved nursing strategy group. No significant differences were found in gender, age, underlying diseases, source of admission, disease severity scores, vital signs, ventilatory parameters, blood gas analysis, life-sustaining treatments, clinical laboratory evaluation, indicators of infection and inflammation, coexisting pathogens or drug therapy between the two groups. Compared with patients in the original nursing strategy group, those in the improved nursing strategy group had significantly fewer duration of mechanical ventilation and length of ICU stay [duration of mechanical ventilation (days): 5 (4, 7) vs. 5 (4, 9), length of ICU stay (days): 11 (6, 17) vs. 12 (6, 23), both P < 0.01], and lower ICU mortality and 28-day mortality [ICU mortality: 23.9% (84/351) vs. 32.7% (65/199), 28-day mortality: 23.1% (81/351) vs. 33.7% (67/199), both P < 0.05]. Multivariate Logistic regression analysis showed that the improved nursing strategy acted as an independent protective factor in 28-day death of older immunosuppressed patients with pneumonia and sepsis [odds ratio (OR) = 0.543, 95% confidence interval (95%CI) was 0.334-0.885, P = 0.014].@*CONCLUSIONS@#Improved nursing strategy shortened the duration of mechanical ventilation and the length of ICU stay, and decreased ICU mortality and 28-day mortality in older immunosuppressed patients with pneumonia and sepsis, significantly improving the short-term prognosis of such patients.

Repurposing non-oncology small-molecule drugs to improve cancer therapy: Current situation and future directions

Drug repurposing or repositioning has been well-known to refer to the therapeutic applications of a drug for another indication other than it was originally approved for. Repurposing non-oncology small-molecule drugs has been increasingly becoming an attractive approach to improve cancer therapy, with potentially lower overall costs and shorter timelines. Several non-oncology drugs approved by FDA have been recently reported to treat different types of human cancers, with the aid of some new emerging technologies, such as omics sequencing and artificial intelligence to overcome the bottleneck of drug repurposing. Therefore, in this review, we focus on summarizing the therapeutic potential of non-oncology drugs, including cardiovascular drugs, microbiological drugs, small-molecule antibiotics, anti-viral drugs, anti-inflammatory drugs, anti-neurodegenerative drugs, antipsychotic drugs, antidepressants, and other drugs in human cancers. We also discuss their novel potential targets and relevant signaling pathways of these old non-oncology drugs in cancer therapies. Taken together, these inspiring findings will shed new light on repurposing more non-oncology small-molecule drugs with their intricate molecular mechanisms for future cancer drug discovery.

Epidemiological trends and features of syphilis in China, 2014—2019 / 中华皮肤科杂志

Objective:To investigate epidemiological trends and characteristics of syphilis in China from 2014 to 2019, and to provide evidence for developing prevention and control strategies.Methods:A descriptive epidemiological study was conducted to analyze personal, spatial and temporal distribution of syphilis cases reported in China from 2014 to 2019.Results:The reported incidence rate of syphilis in China increased from 30.93 per 100 000 in 2014 to 38.37 per 100 000 in 2019, with an average annual increase rate of 4.41%. From 2014 to 2019, the average annual rates of decrease in primary and secondary syphilis and congenital syphilis were 10.95% and 26.16% respectively, and the average annual rates of increase in tertiary syphilis and latent syphilis were 1.61% and 10.75% respectively. The reported incidence rate was high in Xinjiang, Qinghai, Zhejiang, Hainan and Fujian, etc. From 2014 to 2019, the reported annual incidence rate of syphilis was slightly lower in males than in females, and the male-to-female ratio ranged from 0.86∶1 to 0.96∶1. The population aged 15-19 years showed a rapid yearly increase in the reported incidence rate, with an average annual increase rate of 13.54%. The reported annual incidence rate of syphilis peaked in the population aged 25-34 years during 2014-2018, and in the population aged 20-24 years in 2019. Syphilis cases were reported in all occupational groups, the largest proportion of cases was found in farmers and migrant workers (41.19%-46.80%) , and the highest average annual increase rate of 20.72% was observed in students. Among all stages of syphilis, the proportions of primary syphilis and secondary syphilis decreased yearly, while the proportion of latent syphilis increased year by year, and went up to 82.95% in 2019.Conclusion:There was a yearly increase in the total reported incidence rate of syphilis in China from 2014 to 2019, but the reported incidence rates of primary syphilis and secondary syphilis decreased yearly; a rapid increase in the reported incidence rate of syphilis was observed among young people; farmers and migrant workers were the most affected populations; some regions in northwest China and southeastern coastal provinces showed relatively high reported incidence rates.

Prohibitin regulates mTOR pathway via interaction with FKBP8 / 医学前沿

The ability of tumor cells to sustain continuous proliferation is one of the major characteristics of cancer. The activation of oncogenes and the mutation or inactivation of tumor suppressor genes ensure the rapid proliferation of tumor cells. The PI3K-Akt-mTOR axis is one of the most frequently modified signaling pathways whose activation sustains cancer growth. Unsurprisingly, it is also one of the most commonly attempted targets for cancer therapy. FK506 binding protein 8 (FKBP8) is an intrinsic inhibitor of mTOR kinase that also exerts an anti-apoptotic function. We aimed to explain these contradictory aspects of FKBP8 in cancer by identifying a "switch" type regulator. We identified through immunoprecipitation-mass spectrometry-based proteomic analysis that the mitochondrial protein prohibitin 1 (PHB1) specifically interacts with FKBP8. Furthermore, the downregulation of PHB1 inhibited the proliferation of ovarian cancer cells and the mTOR signaling pathway, whereas the FKBP8 level in the mitochondria was substantially reduced. Moreover, concomitant with these changes, the interaction between FKBP8 and mTOR substantially increased in the absence of PHB1. Collectively, our finding highlights PHB1 as a potential regulator of FKBP8 because of its subcellular localization and mTOR regulating role.

The application of three-dimensional breath-hold gradient and spin-echo sequence in the MR cholangiopancreatography / 中华放射学杂志

Objective:To evaluate the clinical feasibility and image quality of three-dimensional breath-hold gradient and spin-echo (3D BH-GRASE) sequence in magnetic resonance cholangiopancreatography (MRCP).Methods:In this prospective study, 59 patients with clinically suspected pancreaticobiliary duct disease performed MRCP with both 3D BH-GRASE and 3D respiration-triggered turbo spin-echo (3D RT-TSE) sequences on 3.0 T scanner in the Affiliated Zhangjiagang Hospital of Soochow University from November 2017 to December 2018. The overall image quality was scored independently by 3 experienced radiologists based on the visibility of different anatomical features of the pancreaticobiliary duct. For comparing the 2 sequences, the statistical difference in scan time was assessed with a paired t test; while subjective scores, signal-to-noise ratios (SNR), contrast ratios (CR) and contrast noise ratios (CNR) were compared with Wilcoxon signed rank test. Results:The scan time of 3D BH-GRASE sequence was 16.4 s while that of 3D RT-TSE was (258.6±42.2) s. Their difference was statistically significant ( t=44.073, P<0.001), with the scan time for 3D BH-GRASE shortened by 94%. The overall quality scores of 3D BH-GRASE images were better than those of 3D RT-TSE ( Z=-6.595, P<0.001). There was no statistical difference ( P>0.05) in the scores regarding the visibility of the upper, middle and lower parts of common bile duct and the first and second branches of left and right hepatic ducts. For visualizing the bottom, body, neck and duct of gallbladder, the 3D BH-GRASE sequence received a higher score than the 3D RT-TSE sequence ( P<0.001). For displaying the proximal, middle and distal segments of main pancreatic duct, the 3D RT-TSE sequence was scored higher than the 3D BH-GRASE sequence ( P<0.05). There was no significant difference of SNR between the two sequences ( Z=0.403, P=0.687), whereas CR and CNR of 3D RT-TSE MRCP were better than those of 3D BH-GRASE MRCP ( Z=6.215, P<0.001 and Z=3.046, P=0.002, respectively). Conclusion:Under the prerequisite of ensuring image quality, a proper use of 3D BH-GRASE sequence can significantly shorten the scan time and thus greatly improve the working efficiency of MRCP examination.

Relationship between early factors life stress and college students’ risk-taking behaviors: gender difference and situational influence / 中华行为医学与脑科学杂志

Objective:To explore the differences in risk-taking behaviors of individuals with early life stress between different genders under the control of social situation.Methods:A total of 160 college students including 78 males and 82 females were selected by the child psychological abuse and neglect scale.Then the subjects were divided into the early life stress group ( n=80) and the non-early life stress group ( n=80) according to the scores of the above scales.According to the presence or absence of peers, the subjects in the two groups were randomly assigned to peer presence group ( n=80) or no peer presence group ( n=80). The study adopted an experimental design of 2 (early life stress, non-early life stress) ×2 (peer presence, no peer presence) ×2 (male, female) among the subjects.All subjects performed the task of simulating risky behavior, and the number of times they chose "forward" and did not crash in the task was used as the measurement index of risky behavior.Three-factor ANOVA and Bonferroni simple effect test were carried out using SPSS 22.0 software under various conditions. Results:There were significant differences in the main effects of early life stress ( F(1, 152)=162.06, P<0.01, η2=0.52). In the simulated risk behavior task, the risk behavior of the early life stressed individuals was higher than that of the non-early life stressed individuals (no peer presence: (59.11±11.48) vs (34.91±7.42), P<0.01); peer presence: (59.24±8.59) vs (55.08±10.32), P<0.01). The interaction between early life stress and the presence of peers was statistically significant ( F(1, 152)=65.35, P<0.01, η2=0.30), for non-early life stressed individuals, the risk-taking behaviors in the peer presence group was significantly higher than that in the no peer presence group ((55.08±10.32) vs (34.91±7.42), P<0.01, but the difference was not significant for early life stressed individuals ((59.24±8.59) vs (59.11±11.48), P>0.05). The interaction of early life stress, peer presence and gender was statistically significant ( F(1, 152) =5.92, P=0.016, η2=0.04). In the presence of companions, female early-life stressed individuals exhibited higher risk behaviors than non-early life stressed individuals ((53.91±5.12) vs (46.30±4.57), P<0.01), while the difference between male early life stressed individuals and non-early life stressed individuals was not statistically significant ((65.75±7.42) vs (62.27±7.78), P>0.05). Conclusion:The influence of early life stress on individual risk-taking behavior is related with presence and gender.

Correlation between the changes of macular structure and visual acuity in patients with type 2 diabetes mellitus / 中华眼底病杂志

Objective:To observe the correlation between the changes of area foveal avascular zone (FAZ), central foveal thickness (CFT), the thickness of the macular ganglion cell-inner plexiform layer (GCIPL) and the BCVA in type 2 diabetic mellitus patients with different fundus lesions.Methods:A prospective clinical study. Eighty-three eyes of 51 patients with type 2 diabetic mellitus were collected in Shengjing Hospital of China Medical University from January 2018 to January 2019, including 31 males and 20 females. The average age was 53.4±7.8 years. According to the diabetic retinopathy international clinical staging criteria, the patients were divided into the non-diabetic retinopathy (NDR) group with 17 patients (31 eyes), and the non-proliferative diabetic retinopathy (NPDR) group with 34 patients (52 eyes). And 13 control eyes of 8 age- and sex-matched healthy physical examination subjects (control group) were selected in this study. The BCVA examination was performed using the international standard visual acuity chart, which was converted intoIogMAR visual acuity. OCT was used to measure the CFT, the mean and the minimum thickness of GCIPL. OCT angiography (OCTA) examination was applied to obtain blood flow density scan images in macular area of 3 mm × 3 mm size. The superficial FAZ area was measured by Photoshop software. The differences of the superficial FAZ area, BCVA, CFT, the mean and the minimum thickness of GCIPL in each group were statistically analyzed, and to explore the correlation between the parameters. Analysis of variance was used to compare measurement data among three groups, and chi-square test was used for the comparison of counting data among three groups. The statistical correlation was evaluated using Pearson’s correlation coefficient.Results:The average area of superficial FAZ area in the control group, NDR group and NPDR group were 0.314±0.103, 0.349±0.102, 0.416±0.148 mm 2; the mean logMAR BCVA were 0.015±0.038, 0.029±0.059, 0.129±0.133; the mean CFT were 247.46±13.35, 244.13±25.09, 263.12±24.96 μm; the mean GCIPL thickness were 89.00±4.98, 86.06±4.43, 82.61±14.32 μm; the mean minimum GCIPL thickness were 84.85±3.18, 80.68±5.39, 71.19±19.94 μm, respectively. The superficial FAZ area, logMAR BCVA, CFT and the minimum thickness of GCIPL showed significant differences ( F=4.660, 11.708, 6.891, 6.333; P=0.012, 0.000, 0.002, 0.003) among these three groups. Correlation analysis showed that the logMAR BCVA was positively correlated with the superficial FAZ area ( r=0.335, P=0.001), negatively correlated with the mean GCIPL thickness ( r=-0.348, P=0.001) and the minimum GCIPL thickness (r=-0.416, P=0.000), no significant correlated with the CFT ( r=0.171, P=0.095). The superficial FAZ area was negatively correlated with the CFT ( r=-0.262, P=0.010) and the minimum GCIPL thickness ( r=-0.213, P=0.037), no significant correlated with the mean GCIPL thickness ( r=-0.179, P=0.081). Conclusions:With the aggravation of fundus lesions in patients with type 2 diabetic mellitus, the superficial FAZ area gradually expands, the minimum GCIPL thickness gradually becomes thinner and the BCVA gradually decreases. Both the superficial FAZ area and the GCIPL thickness are correlated with BCVA. The superficial FAZ area is correlated with CFT and the minimum GCIPL thickness.

Epidemiological trends and features of gonorrhea in China, 2015—2019 / 中华皮肤科杂志

Objective:To investigate epidemiological trends and characteristics of gonorrhea in China in recent years, and to provide evidence for developing prevention and control strategies.Methods:A descriptive epidemiological study was conducted to analyze personal, spatial and temporal distribution of gonorrhea cases reported in China from 2015 to 2019.Results:The reported incidence rate of gonorrhea in China increased from 7.36 per 100 000 in 2015 to 10.06 per 100 000 in 2017, and decreased to 8.45 per 100 000 in 2019, with an average annual increase rate of 3.51%. From 2015 to 2019, the reported annual incidence rate in males was about 5 times that in females. During the 5 years, the reported incidence rate rapidly increased year by year in the groups aged 15 - 19 years and 20 - 24 years, with average annual increase rates of 33.67% and 22.77% respectively, but decreased or kept stable in the remaining age groups. High reported incidence rates were observed in the groups aged 25 - 29 years and 30 - 34 years from 2015 to 2018, but in the groups aged 20 - 24 years and 15 - 19 years in 2019. Gonorrhea cases were reported in all occupation groups, the largest proportion of cases was found in farmers and migrant workers (29.81% - 33.36%), and the highest average annual increase rate of 31.09% was observed in students. The reported incidence rate was high (> 12 per 100 000) in Shanghai, Zhejiang, Fujian, Guangdong, Hainan, etc., but low (< 3 per 100 000) in Hebei, Tianjin, Tibet, etc.Conclusions:In general, the reported incidence rate of gonorrhea in China had been slightly increasing in the past 5 years, and was markedly higher in males than in females. The population with high incidence of gonorrhea tended to be younger, farmers and migrant workers were the most important affected populations, and the southeast coastal areas in China showed a relatively high reported incidence rate.

Epidemiologic features of genital Chlamydia trachomatis infection at national sexually transmitted disease surveillance sites in China, 2015—2019 / 中华皮肤科杂志

Objective:To investigate epidemiological trend and characteristics of genital Chlamydia trachomatis (Ct) infection in China in recent years, and to provide evidence for making Ct infection prevention and control strategies. Methods:A descriptive epidemiological study was conducted to analyze personal, spatial and temporal distribution of genital Ct infection cases reported from 105 national sexually transmitted disease (STD) surveillance sites in China from 2015 to 2019.Results:The reported incidence rate of genital Ct infection increased from 37.18 per 100 000 in 2015 to 55.32 per 100 000 in 2019, with the average annual rate of increase being 10.44%. The reported incidence rates at national STD surveillance sites ranged from 0 to 1 309.38 per 100 000, which were relatively high in Zhejiang, Guangdong, Guangxi and Hainan provinces. Increasing trends in the reported incidence rate were observed among both females and males. From 2015 to 2019, the reported annual incidence rate in males was lower than that in females, and the male-to-female reported incidence rate ratio decreased from 0.43 (22.57 per 100 000 vs. 52.74 per 100 000) in 2015 to 0.32 (27.35 per 100 000 vs. 84.55 per 100 000) in 2019. The reported incidence rates increased yearly in the groups aged more than 15 years, and the average annual rate of increase was highest in the group aged 20 - 24 years (25.81%) , followed by the group aged 15 - 19 years (22.55%) ; the sexually active population aged 20 - 34 years showed the highest reported incidence rate among all the age groups, and the reported incidence rate was up to 184.70 per 100 000 in this age group in 2019. Genital Ct infection cases were reported among all occupation groups, and the largest proportion of cases was found in unemployed population (32.86% - 38.50%) , followed by commercial service population (25.29% - 27.84%) . General hospitals reported the largest number of genital Ct infection cases (68.30% - 74.59%) , followed by maternal and child health hospitals. Conclusions:The reported incidence rate of genital Ct infection was high with an increasing trend in China from 2015 to 2019, and the southeastern coastal provinces of China showed a relatively high repoted incidence rate. Genital Ct infection affected a wide range of people in different occupations. The reported incidence rate in females was higher than that in males, and the population with a high incidence tended to be younger.

Diagnostic and prognostic value of peripheral lymphocyte subtyping for invasive candidiasis infection in critically ill patients with non-neutropenic sepsis / 中华内科杂志

Objective:To assess the diagnostic and prognostic value of lymphocyte subtyping for invasive candidiasis infection (ICI) in critically ill patients with non-neutropenic sepsis.Methods:A prospective observational cohort study was performed at Peking Union Medical College Hospital (PUMCH), 377 patients with non-neutropenic sepsis admitted to Department of Critical Care Medicine from January 2017 to November 2019 were enrolled. There were 9.0% (34/377) patients diagnosed as ICI. Vital signs, supportive care therapy and microbiological specimens were collected. Peripheral blood lymphocyte subtypes, serum globulin, complements, inflammatory factors such as interleukin(IL)-6, IL-8, IL-10 and tumor necrosis factor were detected within 24 hours after sepsis was diagnosed. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value and prognostic significance of immunological indicators for ICI. Multiple logistic regression was used to analyze the independent risk factors for ICI. Kaplan-Meier analysis was used to analyze survival.Results:The acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score was 17.0 (13.0, 21.0) in all 377 patients. The sequential organ failure score (SOFA) was 11.0 (8.0, 13.0), and the 28-day mortality rate was 27.6% (104/377). Peripheral blood CD8 +absolute T lymphocyte count≤177 cells/μl, CD28 +CD8 +T-cell count≤81 cells/μl and 1, 3-β-D-glucan (BDG) ≥88.20 ng/L were closely correlated with the diagnosis of ICI (AUC=0.793,95 %CI 0.749-0.833, P<0.000 1;AUC=0.892,95 %CI 0.856-0.921, P<0.000 1;AUC=0.761, 95 %CI 0.715-0.803, P<0.000 1, respectively), with sensitivity of diagnosis 94.12%, 100.00%, and 88.24%; the specificity of diagnosis 81.34%, 62.39%, 63.56% respectively. Multivariate logistic regression analysis identified CD8 +T-cell count≤139 cells/μl ( OR=7.463, 95 %CI 1.300-42.831, P=0.024) and CD28 +CD8 +T-cell counts≤52 cells/μl ( OR=57.494, 95 %CI 3.986-829.359, P=0.003) as independent risk factors for higher mortality. Kaplan-Meier survival analysis suggested that CD8 +T-cell count ≤139 cells/μl ( P=0.0159) and CD28 +CD8 +T-cell count≤52 cells/μl ( P=0.000 1) were associated with higher mortality within 28 days (68.8%, 91.7%). Conclusions:Low CD28 +CD8 +T cell count in peripheral blood is closely related to the development and clinical outcome of ICI in sepsis patients, which could be used as an effective indicator for the diagnosis and prognosis prediction of ICI.

Correlation between acute stress hyperglycemia and hemoglobin A1c in patients with cerebral infarction / 中华老年医学杂志

Objective:To investigate whether the basal blood glucose level before cerebral infarction has an impact on acute stress hyperglycemia.Methods:A total of 366 patients with cerebral infarction admitted into the neurology department of our hospital from February 2008 to May 2012 were enrolled in this study. Acute stress hyperglycemia was reflected by stress-induced glucose up-regulation ratio (SIGUR), and the basal glucose before cerebral infarction was reflected by glycosylated hemoglobin A1c (HbA1c). The correlation between SIGUR and HbA1c was analyzed in the different populations. The difference in SIGUR was compared among the non-diabetic group, diabetes with poor blood glucose control group (HbA1≥6.5%) and diabetes with well blood glucose control group (HbA1c<6.5%). The relationship between high level of SIGUR (Q4) and HbA1c was performed through logistic regression analysis.Results:SIGUR was correlated with HbA1c, no matter in the non-diabetic, diabetic or total populations ( r=-0.200, 0.195 and 0.324, P=0.010, 0.011 and 0.000). The level of SIGUR was higher in diabetes with poor blood glucose control group than in the non-diabetes and diabetes with well blood glucose control group ( F=25.842, P=0.000), but there was no significant difference between the non-diabetic group and diabetes with well blood glucose control group ( P>0.05). Logistic regression analysis showed that the high level of SIGUR was correlated to HbA1c in the total populations ( OR=1.460, P=0.000). In the diabetic group, the probability of higher SIGUR level was increased along with the increased HbA1c level ( OR=1.237, P=0.021), while the probability of higher SIGUR level was decreased along with the increased HbA1c level in the non-diabetic group ( OR=0.233, P=0.010). Conclusions:Acute stress hyperglycemia is correlated to the basal blood glucose before cerebral infarction, and blood glucose increases more prominently in those patients with high basal blood glucose level, especially in the diabetic patients.

Correlation between brainstem infarction and stress induced glucose up-regulation ratio / 中国医师进修杂志

Objective To investigate the relationship between the stress induced glucose up-regulation and brainstem infarction. Methods Three hundred and sixty-six patients of cerebral infarction in the department of neurology were included in this study. Stress induced glucose up-regulation was reflected by stress induced glucose up-regulation ratio (SIGUT), and the level of SIGUT was compared between groups of brainstem and non-brainstem infarction. SIGUT was categorized into 4 groups according to the quartiles, and relative variables were compared among 4 groups. The level-risk relationship between high level of SIGUT and brainstem infarction was performed through logistic regression. Results The level of SIGUT was higher in group of brainstem infarction than that in group of non-brainstem infarction: 1.060 ± 0.272 vs.1.159 ± 0.301(P＝0.020). The percent of male, diabetes, brainstem infarction and level of FBG, HbA1c, NIHSS was obviously different in the 4 groups of SIGUT according to the quartiles (P<0.05). High level of SIGUT was correlated to brainstem infarction in the single-factor or multivariable logistic regression adjusted for relative variable (P < 0.05). Conclusions Stress induced glucose up-regulation is correlated to the brainstem infarction, which is prone to happen in brainstem infarction, and the magnitude is more prominent.

Research advances on auxiliary diagnosis and treatment of diabetic retinopathy / 中国医师进修杂志

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes, which severely affects the visual function and quality of life of patients, and can lead to irreversible blindness in later stages. In recent years, some progress has been made in DR treatment, but the effect is limited. The effective prevention and treatment of DR is still the focus of current research. This article reviews the recent advances in DR auxiliary diagnosis, clinical treatment, emerging drugs, and new treatment strategies.

Support vector machine based MRI radiomics to identify primary hepatic carcinomas with different pathological types / 中华放射学杂志

Objective To investigate the value of support vector machine based MRI-radiomics in the differential diagnosis of primary hepatic carcinomas (PHCs). Methods PHCs patients were retrospectively collected from July 2013 to February 2017 in the First Affiliated Hospital of Zhejiang University.All patients underwent unenhanced and enhanced MRI liver scan before surgery,and confirmed by pathology. A total of 294 PHCs patients (305 lesions), including 96 cases (97 lesions) of massive type cholangiocarcinoma (mCC), 107(107 lesions)of hepatocellular carcinoma (HCC), and 91 (101 lesions) of mixed hepatocellular and cholangiocellular carcinomas(HCC-CC).All patients underwent unenhanced and dynamic enhanced MRI liver scan including arterial, portal venous and equilibrium phases. Two hundred and three lesions (65 mCC, 71 HCC, 67 HCC-CC) were assigned into the training set, the remaining 102 lesions(32 mCC,36 HCC,34 HCC-CC)into the validation set,according to a ratio of 2:1.The entire lesions were delineated manually using a region of interest on equilibrium phase of enhanced MRI by using a home-made dedicated software(Analysis Kit,AK,General Electrics,US).Then the least absolute shrinkage and selection operator (LASSO) regression was used to select image features with a method of 10 fold cross-validation, and to reduce the dimensionality. The spearman method was used afterwards to condense the image features by removing redundant.A predictive model of diagnosing the different types of PHCs was established based on support vector machines(SVM),and the accuracy of applying the model in the data sets was used to evaluate the diagnostic efficacy of the model. Results A total of 280 quantitative imaging features were extracted in the training set.Thirty one imaging features were selected after LASSO regression and dimensionality reduction,and 21 features were remained after redundancy removing.The SVM showed the best generalization ability when the first 11 imaging features were used due to the Hughes effect.The 11 imaging features include 4 parameters of histogram,2 of textures,4 of gray-level co-occurrence matrix and 1 of gray-level run length matrix. A predictive model for PHCs was established after the study of the 11 imaging features and a regression analysis using SVM.The accuracy of the predictive model was 80.3% (163/203) in differentiating PHCs in the training set. The accuracy of the model was 75.5% (77/102) after applying it in the validation set. The diagnostic accuracy for HCC-CC, HCC and mCC was 85.3% (29/34), 77.8% (28/36) and 62.5% (20/32), respectively, in the validation set. For HCC-CC, 3 cases were misdiagnosed as mCC and 2 cases as HCC.For HCC,3 cases were misdiagnosed as HCC-CC and 5 cases as mCC.For mCC,9 cases were misdiagnosed as HCC-CC and 3 cases as HCC.The model showed the highest accuracy in predicting HCC-CC.Conclusion Radiomics method based on SVM may have a high accuracy in predicting different pathologic types of PHC,with the highest accuracy for HCC-CC.

The expression of triggering receptor expressed on myeloid cells receptor-1 in Aspergillus infected mice / 中华内科杂志

Objective To investigate the expression of triggering receptor expressed on myeloid cells receptor-1 (TREM-1) in plasma and bronchoalveolar lavage fluid (BALF) and its correlation with Galactomannan,IFN,IL-6 and IL-10 in Aspergillus infected mice.Methods Cyclophosphamide (CTX) was intraperitoneally injected and fumigatus spore suspension was inhaled by nose to establish the immunocompromised invasive pulmonary aspergillosis (IPA) mouse model.Healthy controls,immunocompromised only and IPA only groups were also established.Each group had 6 mice.After inoculation,mice were sacrificed.Lung tissue specimens,BALF,and plasma samples were collected.Plasma and BALF soluble TREM-1 (sTREM-1),Galactomannan,IFNγ,IL-6,and IL-10 were detected by ELISA.Results Positive Aspergillus fumigatus was found by tissue culture in the lung.Infiltration of inflammatory cells,blood congestion and interstitial lung tissue injury were observed in histological sections of both IPA and immunocompromised IPA mice.Compared to IPA group [(453.78 ± 74.18) ng/L,P ＜ 0.001;(10.21±1.46) ng/L,P＜0.001] and control group [(245.16 ±65.85) ng/L,P＜0.001;(6.60 ± 3.74) ng/L,P ＜ 0.001],the plasma and BALF sTREM-1 significantly increased in immunocompromised IPA group [(1 537.64 ± 359.52) ng/L;(20.12-± 2.72) ng/L].Compared to control group,both the BALF sTREM-1 in IPA group (P =0.041) and the plasma and BALF Galactomannan,IFNγ,IL-6,and IL-10 levels in IPA and immunocompromised IPA groups were significantly higher (P ＜0.01).Pearson correlation analysis showed that plasma and BALF sTREM-1 were significantly correlated with Galactomannan (r =0.83,P ＜ 0.001;r =0.82,P ＜ 0.001),IFNγ (r =0.79,P＜0.001;r=0.61,P＜0.01),IL-6 (r=0.81,P＜0.001;r=0.66,P＜0.01),andIL-10 (r=0.70,P =0.001;r =0.54,P =0.02).Conclusions Plasma and BALF sTREM-1 appears highly expressed in Aspergillus infected mice.sTREM-1 in mice plasma and BALF is closely correlated with Galactomannan,IFNγ,IL-6,and IL-10 levels,which suggests that sTREM-1 has great diagnostic value during invasive fungal infection.

Sclerostin expression in periodontal ligaments during movement of orthodontic teeth in rats / 华西口腔医学杂志

<p><b>OBJECTIVE</b>This study aims to observe the expression of Sclerostin during movement of orthodontic teeth and determine the effect of this protein on remodeling of periodontal tissues.</p><p><b>METHODS</b>Twenty-four Wistar rats were chosen. Orthodontic forces were applied between the bilateral incisor and first molar to achieve mesial movement. Rats in each group were executed at different time points (0, 1, 3, 5, 7, 14 d). Morphology of periodontal tissue was observed by hematoxylin-eosin (HE) staining. The number of osteoclasts were observed by tartrate-resistant acid phosphatase (TRAP) staining. Sclerostin expression were observed by immunohistochemical staining.</p><p><b>RESULTS</b>HE staining revealed that the resorption of alveolar bone intensified with prolonged movement. Results of immunohistochemical and TRAP staining revealed that Sclerostin expression and number of osteoclasts were related to duration of movement of orthodontic tooth. After staining for 5 days, the number of osteoclasts and Sclerostin expression reached their peak and then began to decline. The numbers of osteoclasts and the expression level of Sclerostin were higher at the compressive side than those at the tensive side.</p><p><b>CONCLUSION</b>Sclerostin affected orthodontic tooth movement by inhibiting the Wnt signaling pathway and by indirectly or directly controlling bone morphogenetic protein.</p>

Research advances in the treatment of non-melanoma skin cancer using photodynamic therapy / 实用肿瘤学杂志

Non-melanoma skin cancers( NMSC) are one of the most common malignancy in humans.A-mong NMSC types,basal cell carcinoma(BCC)has the highest incidence and squamous cell carcinoma(SCC)is less common although it can metastasize.Over 30 years ago,Photodynamic therapy( PDT) was applied for the stud-y of human tumor,it showed the advantage of being a non-invasive option,and capable of field treatment,provi-ding optimum cosmetic outcomes.Numerous clinical research studies have shown the efficacy of PDT for treating NMSC.The purpose of this systematic review is to summarize the previous results,current evidence and the possi-bilities for PDT in patients with NMSC.

Correlation Study Between Aspirin Resistance and COX1, COX2, TBXA2R Gene Polymorphisms in Patients With Coronary Artery Disease / 中国循环杂志

Objective: To explore aspirin resistance (AR) phenomenon in patients with coronary artery disease (CAD) for secondary prevention and to study the relationships between AR and COX1, COX2, TBXA2R gene polymorphisms. Methods: A total of 2881 CAD patients taken aspirin (100 mg/day) in 7 consecutive days were enrolled. Among them, 2 groups were established as AR group, n=166 and Control group, n=200 aspirin sensitive patients. Platelet aggregation function was induced by arachidonic acid (AA), COX1, COX2 and TBXA2R gene polymorphisms were examined by polymerase chain reaction-restricted fragment length polymorphisms (PCR-RFLP) method. Results: The occurrence rate of AR was 5.76% (166/2881). There were 8 tagSNPs locus in 3 genes as in COX1:(rs3842788), (rs4273915), (rs7866582); in: COX2 (rs3218625); in TBXA2R: (rs2238630), (rs2238631), (rs2238633), (rs3786989). The frequencies of wild type, heterozygous genotype and homozygous genotype were similar between 2 groups. Conclusion: The incidence rate of AR is not high in CHD patients with regular aspirin medication; single nucleotide gene polymorphisms of COX1, COX2 and TBXA2R have no obvious correlation to AR.