Estimation of the consumption level of four drugs in Beijing using wastewater-based epidemiology / 中华预防医学杂志

Objective: To estimate the consumption level of four drugs in Beijing using wastewater-based epidemiology (WBE). Methods: The primary sludge from one large wastewater treatment plants (WWTPs) was collected in Beijing from July 2020 to February 2021. The concentrations of codeine, methadone, ketamine and morphine in the sludge were detected through solid-phase extraction-liquid chromatography-tandem mass spectrometry. The consumption, prevalence and number of users of four drugs were estimated by using the WBE approach. Results: Among 416 sludge samples, codeine had the highest detection rate (82.93%, n=345) with a concentration [M(Q1, Q3)] of 0.40 (0.22-0.8) ng·g-1, and morphine had the lowest detection rate (28.37%,n=118) with a concentration [M(Q1, Q3)] of 0.13 (0.09, 0.17) ng·g-1. There was no significant difference in the consumption of the four drugs on working days and weekends (all P values>0.05). Drug consumption was significantly higher in winter than that in summer and autumn (all P values<0.05). The consumption [M(Q1, Q3)] of codeine, methadone, ketamine and morphine in winter was 24.9 (15.58, 38.6), 9.39 (4.57, 26.72), 9.84 (5.18, 19.45) and 5.67 (3.57, 13.77) μg·inhabitant-1·day-1, respectively. For these drugs, there was an upward trend in the average drug consumption during summer, autumn and winter (the Z values of the trend test were 3.23, 3.16, 2.19, and 3.32, respectively and all Pvalues<0.05). The prevalence [M(Q1, Q3)] of codeine, methadone, ketamine and morphine were 0.0056% (0.0034%, 0.0092%), 0.0148% (0.009%, 0.0267%)、0.0333% (0.0210%, 0.0710%) and 0.0072% (0.0038%, 0.0117%), respectively. The estimated number of drug users [M(Q1, Q3)] was 918 (549, 1 511), 2 429 (1 578, 4 383), 5 451 (3 444, 11 642) and 1 173 (626, 1 925). Conclusion: Codeine, methadone, ketamine and morphine have been detected in the sludge of WWTPs in Beijing, and the consumption level of these drugs varies in different seasons.

Estimation of the consumption level of four drugs in Beijing using wastewater-based epidemiology / 中华预防医学杂志

Objective: To estimate the consumption level of four drugs in Beijing using wastewater-based epidemiology (WBE). Methods: The primary sludge from one large wastewater treatment plants (WWTPs) was collected in Beijing from July 2020 to February 2021. The concentrations of codeine, methadone, ketamine and morphine in the sludge were detected through solid-phase extraction-liquid chromatography-tandem mass spectrometry. The consumption, prevalence and number of users of four drugs were estimated by using the WBE approach. Results: Among 416 sludge samples, codeine had the highest detection rate (82.93%, n=345) with a concentration [M (Q1, Q3)] of 0.40 (0.22-0.8) ng·g-1, and morphine had the lowest detection rate (28.37%,n=118) with a concentration [M (Q1, Q3)] of 0.13 (0.09, 0.17) ng·g-1. There was no significant difference in the consumption of the four drugs on working days and weekends (all P values>0.05). Drug consumption was significantly higher in winter than that in summer and autumn (all P values <0.05). The consumption [M (Q1, Q3)] of codeine, methadone, ketamine and morphine in winter was 24.9 (15.58, 38.6), 9.39 (4.57, 26.72), 9.84 (5.18, 19.45) and 5.67 (3.57, 13.77) μg·inhabitant-1·day-1, respectively. For these drugs, there was an upward trend in the average drug consumption during summer, autumn and winter (the Z values of the trend test were 3.23, 3.16, 2.19, and 3.32, respectively and all P values<0.05). The prevalence [M (Q1, Q3)] of codeine, methadone, ketamine and morphine were 0.0056% (0.003 4%, 0.009 2%), 0.0148% (0.009 6%, 0.026 7%),0.0333% (0.0210%, 0.0710%) and 0.0072% (0.003 8%, 0.011 7%), respectively. The estimated number of drug users [M (Q1, Q3)] was 918 (549, 1 511), 2 429 (1 578, 4 383), 5 451 (3 444, 11 642) and 1 173 (626, 1 925),respectively. Conclusion: Codeine, methadone, ketamine and morphine have been detected in the sludge of WWTPs in Beijing, and the consumption level of these drugs varies in different seasons.

Dynamic changes and predictive values of routine laboratory parameters in patients with hemorrhagic fever with renal syndrome / 中华传染病杂志

Objective:To investigate the dynamic changes of routine laboratory parameters during the course of hemorrhagic fever with renal syndrome (HFRS) and estimate the predictive value for the severity of the disease.Methods:A retrospective cohort study was conducted, which enrolled 394 HFRS patients admitted to the Second Affiliated Hospital of Air Force Medical University (374 cases) and the Second Affiliated Hospital of Xi′an Jiaotong University (20 cases) from January 2019 to January 2022. The patients were divided into mild (mild and moderate) and severe (severe and critical) groups.The basic information, personal history, past history, treatment, complications and other clinical data of patients were collected and the results of the laboratory examinations in the morning at day 1, 2, 3, 4, 5, 7, 10, 15, 20 and 25 of hospitalization and before discharge were recorded. The dynamic changes of the patients′ routine laboratory indicators and the dynamic predictive values of each indicator for severe condition were analyzed. Mann-Whitney U test and chi-square test were used for comparison, and receiver operator characteristic (ROC) curve was used for predictive value evaluation. Results:The age of 212 patients in the mild group was 38(27, 61) years, and that of 182 patients in the severe group was 49(32, 64) years, the difference was statistically significant ( Z=-2.24, P=0.025). The incidences of acute pancreatitis, acute respiratory distress syndrome, multiple organ dysfunction syndrome, the utilization rates of blood purification and mechanical ventilation in the severe group were 6.0%(11/182), 12.6%(23/182), 19.8%(36/182), 89.6%(163/182) and 22.5%(41/182), respectively, and those in the mild group were 0(0/212), 0(0/212), 0(0/212), 15.6%(33/212) and 0.5%(1/212) respectively, and the differences were all statistically significant ( χ2=13.18, 28.45, 46.15, 214.48 and 50.02, respectively, all P<0.05). The levels of white blood cell count, lymphocyte count, monocyte count and neutrophil count were all increased rapidly after onset and peaked at days 4 to 6 of illness, with the counts of 14.2(9.7, 20.7)×10 9/L, 4.2(2.3, 6.2)×10 9/L, 1.5 (0.8, 3.3)×10 9/L and 8.3(4.3, 11.4)×10 9/L, respectively. Aspartate aminotransferase peaked (102(66, 178) U/L) within three days after onset and then decreased rapidly, returned to normal level by day 12. Blood urea nitrogen and creatinine both increased steadily after onset, peaked at day 9 to 10, with the levels of 13.2(7.7, 19.1) mmol/L and 255.4(122.9, 400.9) μmol/L, respectively. Prothrombin time, activated partial thromboplastin time, fibrinogen degradation products and D-dimer levels at day 3 after onset were 12.7(12.0, 13.2) s, 38.7(33.5, 51.9) s, 12.6(6.9, 32.0) mg/L and 4.9(2.2, 13.7) mg/L, respectively.Platelet count at day 4, neutrophil count at day 5, creatinine at day 11 and blood urea nitrogen at day 14 after onset had decent predictive values for estimating severity, of which the area under curve (AUC) values were 0.801(95% confidence interval (95% CI) 0.727 to 0.875), 0.824(95% CI 0.770 to 0.878), 0.862(95% CI 0.805 to 0.919) and 0.810(95% CI 0.722 to 0.897), respectively. Conclusions:Routine blood count, liver function and coagulation are important reference indicators for early warning of severe disease of HFRS, while with the progress of the disease, renal function indicators are effective in differentiating the severity of the disease. The platelet count at day 4, neutrophil count at day 5, creatinine at day 11 and blood urea nitrogen at day 14 after onset have predictive values for severe HFRS.

Clinical epidemiological characteristics and prognostic risk factors in 2 245 patients with hemorrhagic fever with renal syndrome / 中华传染病杂志

Objective:To analyze the clinical epidemiological characteristics and the prognostic risk factors of patients with hemorrhagic fever with renal syndrome (HFRS).Methods:A total of 2 245 HFRS patients who were admitted to the Second Affiliated Hospital of Air Force Medical University from September 2008 to December 2021 were enrolled. Clinical epidemiological data (including gender, age, onset season, onset region, case fatality rate, et al) of HFRS patients were analyzed. The clinical epidemiological characteristics of patients with HFRS in the 2008 to 2012, 2013 to 2017, and 2018 to 2021 groups were compared. Statistical comparisons were performed using chi-square test. The Bonferroni adjusted P-value method was used for pairwise comparisons between groups, and logistic regression analysis was used to screen and evaluate the risk factors associated with the prognosis of HFRS patients. Results:The age of 2 245 HFRS patients was (42.3±15.9) years old. Most of them were male (79.24%(1 779/2 245)), and the main incidence area was Xi′an City (69.53%(1 561/2 245)). There were 132 deaths with an overall case fatality rate of 5.88%. There were 1 088 patients (48.46%) from 2008 to 2012, 647 patients (28.82%) from 2013 to 2017, and 510 patients (22.72%) from 2018 to 2021, with a mortality rate of 7.17%(78/1 088), 5.10%(33/647) and 4.12%(21/510), respectively. From 2008 to 2021, both the number of HFRS cases and the case fatality rate had shown a fluctuating downward trend. There were significant differences in case fatality rate, age distribution, onset season, and onset region among patients in the different year groups ( χ2=6.84, 49.22, 83.47 and 19.29, respectively, all P<0.05). The results of pairwise comparisons showed that the proportion of patients aged >60 years in the 2018 to 2021 group (23.33%(119/510)) was higher than those in the 2008 to 2012 group (12.13%(132/1 088)) and the 2013 to 2017 group (12.36%(80/647)), and the differences were statistically significant (both P<0.05). The proportions of patients at large peak (October to December) were 62.35%(318/510) in the 2018 to 2021 group and 56.26%(364/647) in the 2013 to 2017 group, which were both lower than that in the 2008 to 2012 group (75.18%(818/1 088)), and the differences were both statistically significant (both P<0.05). The case fatality rate of patients aged >60 years was 9.67%(32/331), which was higher than those of patients aged <30 years (2.86%(16/559)) and patients aged 30 to 60 years (6.20%(84/1 355)), with statistically significant differences (both P<0.05). Univariate analysis showed that age 30 to 60 years, age >60 years, smoking, complicated with hypertension, hypotensive shock and hypoxemia were significantly correlated with the prognosis of HFRS patients (odds ratio ( OR)=2.243, 3.632, 1.484, 3.532, 79.422 and 143.955, respectively, all P<0.05). The results of multivariate logistic regression analysis indicated that complicated with hypertension ( OR=2.467, P=0.004), hypotensive shock ( OR=11.658, P=0.001), and hypoxemia ( OR=67.767, P<0.001) were the independent risk factors affecting the prognosis of HFRS patients. Conclusions:The prevalence of HFRS has shown new changing characteristics from 2008 to 2021. The numbers of HFRS patients and the case fatality rates show a downward trend, and the proportion of HFRS patients aged >60 years increases. Complicated with hypertension, hypotensive shock and development with hypoxemia are the independent risk factors for the prognosis of HFRS.

Preparation and in vitro release of quercetin nanocrystals self-stabilized Pickering emulsion / 中国中药杂志

A new quercetin nanocrystals self-stabilized Pickering emulsion(QT-NSSPE) was prepared by high-pressure homogenization combined with probe ultrasonic method. The influences of oil fraction, quercetin(QT) concentration, and pH of water phase on the formation of QT-NSSPE were investigated. On this basis, the QT-NSSPE prepared under optimal conditions was evaluated in terms of microstructure, stability, and in vitro release and the droplet size and drug loading were 15.82 μm and 4.87 mg·mL~(-1), respectively. The shell structure formed by quercetin nanocrystals(QT-NC) on the emulsion droplet surface was observed under a scanning electron microscope(SEM). X-ray diffraction(XRD) showed that the crystallinity of adsorbed QT-NC decreased significantly as compared with the raw QT. There were not significant changes of QT-NSSPE properties after 30 days of storage at room temperature. The in vitro release experiment confirmed that QT-NSSPE has a higher accumulative release rate than the raw QT. All these results indicated that QT-NSSPE has a great stability and a satisfactory in vitro release behavior, which is a promising new oral delivery system for QT.

The Use of Lipoprotein-Associated Phospholipase A2 in a Chinese Population to Predict Cardiovascular Events / 生物医学与环境科学（英文）

Objective@#To explore associations between lipoprotein-associated phospholipase A2 (Lp-PLA2) and the risk of cardiovascular events in a Chinese population, with a long-term follow-up.@*Methods@#A random sample of 2,031 participants (73.6% males, mean age = 60.4 years) was derived from the Asymptomatic Polyvascular Abnormalities Community study (APAC) from 2010 to 2011. Serum Lp-PLA2 levels were determined by enzyme-linked immunosorbent assay (ELISA). The composite endpoint was a combination of first-ever stroke, myocardial infarction (MI) or all-cause death. Lp-PLA2 associations with outcomes were assessed using Cox models.@*Results@#The median Lp-PLA2 level was 141.0 ng/mL. Over a median follow-up of 9.1 years, we identified 389 events (19.2%), including 137 stroke incidents, 43 MIs, and 244 all-cause deaths. Using multivariate Cox regression, when compared with the lowest Lp-PLA2 quartile, the hazard ratios with 95% confidence intervals for developing composite endpoints, stroke, major adverse cardiovascular events, and all-cause death were 1.77 (1.24-2.54), 1.92 (1.03-3.60), 1.69 (1.003-2.84), and 1.94 (1.18-3.18) in the highest quartile, respectively. Composite endpoints in 145 (28.6%) patients occurred in the highest quartile where Lp-PLA2 (159.0 ng/mL) was much lower than the American Association of Clinical Endocrinologists recommended cut-off point, 200 ng/mL.@*Conclusion@#Higher Lp-PLA2 levels were associated with an increased risk of cardiovascular event/death in a middle-aged Chinese population. The Lp-PLA2 cut-off point may be lower in the Chinese population when predicting cardiovascular events.

Research progress on chemical constituents and quality control methods of Succus Bambusae / 中国中药杂志

Through the investigation of a large number of both domestic and overseas literatures and related quality standards, chemical compositions, quality evaluation system and quality control methods of Succus Bambusae were systematic summarized in this study. There were abundant chemical constituents in Succus Bambusae, mainly including volatile ingredients, amino acids, flavonoids, trace elements and vitamins, with high medicinal and edible value. The quality control methods involved traditional morphological identification, spectroscopy, chromatography and other techniques. However, the current quality standards of Succus Bambusae are relatively low, lacking safety indicators, and cannot effectively ensure its quality, seriously affecting the safety and effectiveness of its clinical use. Therefore, it is particularly important to establish a set of highly sensitive and specific quality evaluation system for Succus Bambusae. In this paper, the current research status of the chemical compositions and quality standards of Succus Bambusae were reviewed, with the purpose of providing a basis for further improvement of its quality evaluation system.

Single-cell analysis of angiotensin-converting enzyme II expression in human kidneys and bladders reveals a potential route of 2019 novel coronavirus infection / 中华医学杂志(英文版)

BACKGROUND@#Since 2019, a novel coronavirus named 2019 novel coronavirus (2019-nCoV) has emerged worldwide. Apart from fever and respiratory complications, acute kidney injury has been observed in a few patients with coronavirus disease 2019. Furthermore, according to recent findings, the virus has been detected in urine. Angiotensin-converting enzyme II (ACE2) has been proposed to serve as the receptor for the entry of 2019-nCoV, which is the same as that for the severe acute respiratory syndrome. This study aimed to investigate the possible cause of kidney damage and the potential route of 2019-nCoV infection in the urinary system.@*METHODS@#We used both published kidney and bladder cell atlas data and new independent kidney single-cell RNA sequencing data generated in-house to evaluate ACE2 gene expression in all cell types in healthy kidneys and bladders. The Pearson correlation coefficients between ACE2 and all other genes were first generated. Then, genes with r values larger than 0.1 and P values smaller than 0.01 were deemed significant co-expression genes with ACE2.@*RESULTS@#Our results showed the enriched expression of ACE2 in all subtypes of proximal tubule (PT) cells of the kidney. ACE2 expression was found in 5.12%, 5.80%, and 14.38% of the proximal convoluted tubule cells, PT cells, and proximal straight tubule cells, respectively, in three published kidney cell atlas datasets. In addition, ACE2 expression was also confirmed in 12.05%, 6.80%, and 10.20% of cells of the proximal convoluted tubule, PT, and proximal straight tubule, respectively, in our own two healthy kidney samples. For the analysis of public data from three bladder samples, ACE2 expression was low but detectable in bladder epithelial cells. Only 0.25% and 1.28% of intermediate cells and umbrella cells, respectively, had ACE2 expression.@*CONCLUSION@#This study has provided bioinformatics evidence of the potential route of 2019-nCoV infection in the urinary system.

Systemic Inflammatory Biomarkers, Especially Fibrinogen to Albumin Ratio, Predict Prognosis in Patients with Pancreatic Cancer / Journal of the Korean Cancer Association, 대한암학회지

Purpose@#Systemic inflammatory response is a critical factor that promotes the initiation and metastasis of malignancies including pancreatic cancer (PC). This study was designed to determine and compare the prognostic value of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and fibrinogen-to-albumin ratio (FAR) in resectable PC and locally advanced or metastatic PC. @*Materials and Methods@#Three hundred fifty-three patients with resectable PC and 807 patients with locally advan-ced or metastatic PC were recruited in this study. These patients were classified into a training set (n=758) and a validation set (n=402). Kaplan-Meier survival plots and Cox proportional hazards regression models were used to analyze prognosis. @*Results@#Overall survival (OS) was significantly better for patients with resectable PC with low preoperative PLR (p=0.048) and MLR (p=0.027). Low FAR, MLR, NLR (p < 0.001), and PLR (p=0.003) were significantly associated with decreased risk of death for locally advanced or metastatic PC patients. FAR (hazard ratio [HR], 1.522; 95% confidential interval [CI], 1.261 to 1.837; p < 0.001) and MLR (HR, 1.248; 95% CI, 1.017 to 1.532; p=0.034) were independent prognostic factors for locally advanced or metastatic PC. @*Conclusion@#The prognostic roles of FAR, MLR, NLR, and PLR in resectable PC and locally advanced or metastatic PC were different. FAR showed the most prognostic power in locally advanced or metastatic PC. Low FAR was positively correlated with OS in locally advanced or metastatic PC, which could be used to predict the prognosis.

Advances in formation and application of self-assembled nanoparticles from traditional Chinese medicine / 中国中药杂志

Due to the diverse sources and unique structures, the chemical components of Chinese medicinal materials are easy to self-assemble to form nanoparticles. The formation of self-assembled nanoparticles(SAN) can not only affect the absorption and distribution of the effective ingredients in Chinese medicinal materials but also may improve the biological activity of the effective ingredients or their simple mixtures, which is of great significance for revealing the compatibility mechanism of Chinese medicine prescription, developing new Chinese medicine products, and producing new nanomaterials. This paper reviews the formation, isolation, characterization, and application of SAN of Chinese medicines, and discusses the problems and development trends of the relevant research, which can provide reference for the further study and promote the innovation and application of such SAN.

Analysis of Predictive Value of Laboratory Indexes for Malignant Lymphoma Patients with Bone Marrow Involvement / 中国实验血液学杂志

OBJECTIVE@#To analyze the influence of bone marrow involvement (BMI) in patients with malignant lymphoma (ML) on laboratory indexes, and evaluate the laboratory markers that can be used to predict/diagnose BMI.@*METHODS@#The clinical characteristics and laboratory indexes of 137 ML patients were analyzed retrospectively, from which the indexes of BMI in ML patients was studied. The logistic regression analysis and receiver operating curve (ROC) were used to evaluate independent risk factors and predictors of BMI diagnosis in ML patients.@*RESULTS@#Compared with non-BMI group, the red blood cell distribution width, C-reactive protein, erythrocyte sedimentation rate, D-dimer, lactate dehydrogenase, alkaline phosphatase, β@*CONCLUSION@#PLT and sIL2R show good diagnostic value for ML patients with BMI.

Research progress of pesticide residues in Chrysanthemum / 中国中药杂志

Chrysanthemum is widely used as a type of edible flower and also considered as the important materials of many beverages in China. Due to the occurrence of diseases and pests, and the lack of regulations for species, frequency, dose of pesticides in Chrysanthemum, pesticides have become one of the main pollutants in Chrysanthemum. The pesticide residues in Chrysanthemum were detected frequently and worth noting. This paper focused on the types of pesticides, pesticide residue detection techniques, and risk assessment methods for Chrysanthemums on the basis of relevant literatures. The pesticide residues of traditional Chinese medicine are mainly organochlorines, organophosphorus and pyrethroids, and the detection techniques include gas chromatography(GC), liquid chromatography(LC) or both combined with mass spectrometry(MS). With the increasing use of traditional Chinese medicine, Chrysanthemum is widely circulated in the market. Therefore, it is important to understand the current situation of pesticide residues in different varieties of Chrysanthemum, so as to provide theoretical reference for the control of quality and safety of Chrysanthemum and the formulation of the maximum residue limit.

Shikonin Affects Uterine Leiomyoma in Rats by Regulating ERK Signaling Pathway / 中国实验方剂学杂志

Objective:To investigate the effect of shikonin on uterine leiomyoma in rats and its molecular mechanism. Method:Sixty female SD rats， of SPF grade and weighing 200-250 g， were randomly divided into the control group， model group， low-， medium-， and high-dose （5， 10， 20 mg·kg^-1） shikonin groups， and mifepristone group. A rat model of uterine leiomyoma was established， and the changes in uterine wet weight， uterine coefficient， and smooth muscle thickness were detected after drug administration for four successive weeks. The pathological changes in uterine tissue were observed by hematoxylin-eosin （HE） staining. The contents of estrogen receptor （ER） and progesterone receptor （PR） in serum and uterus were measured by enzyme-linked immunosorbent assay （ELISA）， and the protein expression levels of ER， PR， phosphorylated extracellular signal-regulated kinase （p-ERK）， and ERK in the uterine tissue were assayed by Western blot. Result:Compared with the control group， the model group exhibited significantly increased uterine wet weight， uterine coefficient， and smooth muscle thickness （<italic>P</italic><0.01）， uterus deformity， focal smooth muscle cell necrosis and hyperplasia， neutrophil infiltration. elevated serum and uterine ER and PR （<italic>P</italic><0.01）， and up-regulated p-ERK protein expression in the uterine tissue （<italic>P</italic><0.01）. Compared with the model group， shikonin at the middle and high doses and mifepristone significantly reduced the uterine wet weight， uterine coefficient， and smooth muscle thickness （<italic>P</italic><0.01）， relieved the pathological changes in uterus，and lowered serum and uterine ER and PR， and down-regulated the p-ERK protein expression in the uterine tissue （<italic>P</italic><0.05）. In addition， the uterine wet weight， smooth muscle thickness， serum ER， and uterine PR and p-ERK protein expression in the low-dose shikonin group were significantly lower than those in the model group （<italic>P</italic><0.05）. Conclusion:Shikonin produces the anti-uterine leiomyoma activity possibly by inhibiting the activation of ERK pathway.

Progress of researches on symbionts in the management of mosquito-borne infectious diseases / 中国血吸虫病防治杂志

Mosquitoes are the main vectors of many infectious diseases, including malaria and yellow fever, which seriously threaten human health across the world. In addition to the use of chemical insecticides, genetic control is a new attempt to currently available interventions used for mosquito vector control. In terms of ecological safety, however, symbiotic control as a novel approach has been proposed for mosquito control. Since there are multiple symbiotic microflora inhabiting in a variety of tissues of mosquitoes, including the digestive tract, they may affect the transmission of mosquito-borne infectious diseases through affecting the lifespan, reproductive competence, and vector competence of the host. In this review, the interactions between symbionts in mosquitoes were summarized, and the research progress of mosquito-associated symbionts in the management of mosquitoborne infectious diseases was reviewed.

Epidemiological investigation on a cluster epidemic of COVID-19 in Taizhou， Zhejiang Province / 上海预防医学

Objective:To analyze the epidemiological characteristics of a family and workplace clustering of COVID-19， identify the source of infection and the transmission chain， and provide evidence for prevention and control of COVID-19 pandemic. Method:Field epidemiological method was used to conduct the investigation of confirmed cases and close contacts in this cluster. Data were analyzed with descriptive method. Real-time fluorescent quantitative PCR （RT-PCR） was used to detect the novel coronavirus nucleic acid in the collected respiratory tract samples. Results:A total of 18 epidemiological related cases were collected including 16 confirmed cases and 2 cases of asymptomatic infections. The involved places included 1 beauty clinic workplace and 3 families. Seven cases were males and 11 cases were females， with the minimum， maximum and median age of 3， 65 and 32 years old， respectively. Among them， the employees attack rate was 9.80% （10/102）， the family attack rate was 7.70% （5/78）， and the customer attack rate was 0.58% （1/173）. Positive nucleic acid test result in the respiratory tract sample of asymptomatic infection lasted for more than 2 months. Conclusions:The cause of this clustered COVID-19 epidemic is that the workplace environment is relatively closed with clustering crowds， and the source of imported infection is not discovered in time， which lead to a point-source outbreak and spread through family close contacts and clustering.

Contrast-enhanced ultrasound imaging features and clinical characteristics of combined hepatocellular cholangiocarcinoma: comparison with hepatocellular carcinoma and cholangiocarcinoma

Purpose@#The purpose of this study was to retrospectively compare the clinical characteristics and imaging features on (CEUS) of combined hepatocellular cholangiocarcinoma (CHC) with those of hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). @*Methods@#The clinical information and CEUS features of 45 patients with CHC from 2015 to 2019 and 1-to-1-matched control subjects with HCC and CC (45 each) were compared. @*Results@#Simultaneous elevation of α-fetoprotein (AFP) and cancer antigen (CA) 19-9 was more common in CHC than in HCC and CC. In the arterial phase, hyperenhancement (homogeneous and heterogeneous) was more common in CHC (73.3%) and HCC (100%), while peripheral rimlike enhancement was more common in CC (55.6%). In the portal phase, marked washout was significantly more frequent in CHC and CC than in HCC (42.2% and 53.3% vs. 6.7%). In the delayed phase, marked washout was more common in CHC (82.2%) and CC (93.3%) than in HCC (40.0%). The washout time (WT) was much shorter in CHC and CC than in HCC (33.8±13.1 seconds and 30.1±11.6 seconds vs. 58.4±23.5 seconds). Using the combination of simultaneous elevation of AFP and CA 19-9 with marked washout in the delayed phase and a WT <38 seconds or arterial hyperenhancement to differentiate CHC from HCC or CC, the accuracy, sensitivity, and specificity were 74.4%, 93.3%, and 55.6% and 71.1%, 80.0%, and 62.2%, respectively. @*Conclusion@#Although some CEUS imaging features of CHC, HCC, and CC overlap, the combination of tumor markers and CEUS features can be helpful in differentiating CHC from HCC and CC.

Study on the correlation between the arc height of cervical endplate and osteophyte in posterior margin of intervertebral space / 中国骨伤

OBJECTIVE@#To study the correlation and clinical value of the arc height of upper and lower endplates, the height of intervertebral space and osteophyte of posterior edge of intervertebral space in patients with cervical spondylosis.@*METHODS@#A total of 108 patients with cervical spondylosis who underwent cervical spondylosis surgery from September 2017 to September 2018 were included in the study. Including 48 males with an average age of 52 years (30 to 72) and 60 females with an average age of 54 years (37 to 79). Among them, C of 6 cases, C of 15 cases, C of 32 cases, C of 42 cases, C of 13 cases. X-ray films of cervical spine were taken before and after operation. The images were accessed by PACS (Picture Archiving and Communication Systems) system. The lower and upper endplate arc heights (L, L), intervertebral space height (L), and posterior osteophyte width (L) were measured. Spearman was used to analyze the correlation between them.@*RESULTS@#L was negatively correlated with L (r=-0.34, 0.05), L and L (>0.05).@*CONCLUSION@#The arc height of the lower endplate is negatively correlated with the width of osteophyte in the posterior margin of the intervertebral space. The cervical degeneration degree can be determined by measuring the arc height of the lower endplate, which has guiding significance for the early prevention and treatment of cervical spondylosis.

Survey of Schistosoma japonicum infections in wild animals in hilly transmission-controlled areas of Jiangxi Province / 中国血吸虫病防治杂志

Objective To understand the situation of Schistosoma japonicum infections in wild animals in transmission-controlled schistosomiasis-endemic areas in Jiangxi Province, so as to provide scientific evidence for implementing precision control interventions and achieving the goal of transmission interruption and elimination of schistosomiasis. Methods Five endemic villages from Ruichang City and Pengze County that were heavily endemic for schistosomiasis in Jiangxi Province, were selected as the study villages. Wild animals like wild mice were captured, and the livers of wild animals were purchased from the snail habitats in the study villages for detection of S. japonicum infections. In the study villages, S. japonicum human infections were screened using indirect hemagglutination assay (IHA) followed by parasitological examinations with miracidial hatching test and Kato-Katz method, and the S. japonicum infection in livestock was tested using a miracidial hatching test with a plastic tube. In addition, snail survey was conducted in the study villages by means of systematic sampling combined with environmental sampling, and the S. japonicum infection in snails was detected using a loop-mediated isothermal amplification (LAMP) assay. Results A total of 240 liver specimens were sampled or purchased from 5 species of wild animals in the study villages, including wild mice, weasels, pigs, deer and rabbits. A total of 172 wild mice were captured, with a 2.91% rate of S. japonicum infection, and there was no S. japonicum infection detected in other wild animals. The prevalence of Capillaria hepatica infection was 12.21%, 1.96% and 12.50% in wild mice, deer and pigs, respectively. In addition, there was no S. japonicum infection found in either humans or livestock in the study villages, and the mean snail density varied from 0.13 to 0.80 snails/0.1 m2 in the study villages. LAMP assay detected S. japonicum infection in 2 tubes in a study village. Conclusions The role of wild animals in schistosomiasis transmission and their potential risks can not be neglected in hilly schistosomiasis-endemic areas of Jiangsu Province after transmission control. Intensified surveillance and targeted control measures should be implemented to consolidate schistosomiasis control achievements.

Survey of Schistosoma japonicum infections in wild animals in hilly transmission-controlled areas of Jiangxi Province / 中国血吸虫病防治杂志

Objective To understand the situation of Schistosoma japonicum infections in wild animals in transmission-controlled schistosomiasis-endemic areas in Jiangxi Province, so as to provide scientific evidence for implementing precision control interventions and achieving the goal of transmission interruption and elimination of schistosomiasis. Methods Five endemic villages from Ruichang City and Pengze County that were heavily endemic for schistosomiasis in Jiangxi Province, were selected as the study villages. Wild animals like wild mice were captured, and the livers of wild animals were purchased from the snail habitats in the study villages for detection of S. japonicum infections. In the study villages, S. japonicum human infections were screened using indirect hemagglutination assay (IHA) followed by parasitological examinations with miracidial hatching test and Kato-Katz method, and the S. japonicum infection in livestock was tested using a miracidial hatching test with a plastic tube. In addition, snail survey was conducted in the study villages by means of systematic sampling combined with environmental sampling, and the S. japonicum infection in snails was detected using a loop-mediated isothermal amplification (LAMP) assay. Results A total of 240 liver specimens were sampled or purchased from 5 species of wild animals in the study villages, including wild mice, weasels, pigs, deer and rabbits. A total of 172 wild mice were captured, with a 2.91% rate of S. japonicum infection, and there was no S. japonicum infection detected in other wild animals. The prevalence of Capillaria hepatica infection was 12.21%, 1.96% and 12.50% in wild mice, deer and pigs, respectively. In addition, there was no S. japonicum infection found in either humans or livestock in the study villages, and the mean snail density varied from 0.13 to 0.80 snails/0.1 m2 in the study villages. LAMP assay detected S. japonicum infection in 2 tubes in a study village. Conclusions The role of wild animals in schistosomiasis transmission and their potential risks can not be neglected in hilly schistosomiasis-endemic areas of Jiangsu Province after transmission control. Intensified surveillance and targeted control measures should be implemented to consolidate schistosomiasis control achievements.

ROS play an important role in ATPR inducing differentiation and inhibiting proliferation of leukemia cells by regulating the PTEN/PI3K/AKT signaling pathway

BACKGROUND: Acute myeloid leukemia (AML) is an aggressive and mostly incurable hematological malignancy with frequent relapses after an initial response to standard chemotherapy. Therefore, novel therapies are urgently required to improve AML clinical outcomes. 4-Amino-2-trifluoromethyl-phenyl retinate (ATPR), a novel all-trans retinoic acid (ATRA) derivative designed and synthesized by our team, has been proven to show biological anti-tumor characteristics in our previous studies. However, its potential effect on leukemia remains unknown. The present research aims to investigate the underlying mechanism of treating leukemia with ATPR in vitro. METHODS: In this study, the AML cell lines NB4 and THP-1 were treated with ATPR. Cell proliferation was analyzed by the CCK-8 assay. Flow cytometry was used to measure the cell cycle distribution and cell differentiation. The expression levels of cell cycle and differentiation-related proteins were detected by western blotting and immunofluorescence staining. The NBT reduction assay was used to detect cell differentiation. RESULTS: ATPR inhibited cell proliferation, induced cell differentiation and arrested the cell cycle at the G0/G1 phase. Moreover, ATPR treatment induced a time-dependent release of reactive oxygen species (ROS). Additionally, the PTEN/PI3K/Akt pathway was downregulated 24 h after ATPR treatment, which might account for the anti-AML effects of ATPR that result from the ROS-mediated regulation of the PTEN/PI3K/AKT signaling pathway. CONCLUSIONS: Our observations could help to develop new drugs targeting the ROS/PTEN/PI3K/Akt pathway for the treatment of AML.