[Effect of peripheral blood inflammatory indicators on the efficacy of immunotherapy in patients with advanced non-small cell lung cancer and chronic obstructive pulmonary disease].

Objective: To investigate the impact of peripheral blood inflammatory indicators on the efficacy of immunotherapy in patients with advanced non-small cell lung cancer (NSCLC) complicated with chronic obstructive pulmonary disease (COPD). Methods: A retrospective cohort study was performed to include 178 patients with Ⅲ-Ⅳ NSCLC complicated with COPD who received at least 2 times of immunotherapy in Xinqiao Hospital of the Army Medical University from January 2019 to August 2021. Baseline peripheral blood inflammatory indicators such as interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α) were collected within 2 weeks before the first treatment, with the last one being on or before February 7, 2022. X-tile software was used to determine the optimal cut-off value of peripheral blood inflammatory indicators. The Cox multivariate regression models were used to analyze the factors affecting progression free survival (PFS) and overall survival (OS). Results: Among the 178 patients, there were 174 males (97.8%) and 4 females (2.2%); the age ranged from 42 to 86 (64.3±8.3) years old.There were 30 cases (16.9%) of immunotherapy monotherapy, 114 cases (64.0%) of immunotherapy combined with chemotherapy, 21 cases (11.8%) of immunotherapy combined with antivascular therapy, and 13 cases (7.3%) of immunotherapy combined with radiotherapy. The median follow-up period was 14.5 months (95%CI: 13.6-15.3 months). The objective response rate (ORR) and disease control rate (DCR) were 44.9% (80/178) and 90.4% (161/178) for the whole group, the median PFS was 14.6 months (95%CI: 11.6-17.6 months), and the median OS was 25.7 months (95%CI: 18.0-33.4 months). The results of Cox multivariate analysis showed that IL-6>9.9 ng/L (HR=5.885, 95%CI: 2.558-13.543, P<0.01), TNF-α>8.8 ng/L (HR=3.213, 95%CI: 1.468-7.032, P=0.003), IL-8>202 ng/L (HR=2.614, 95%CI: 1.054-6.482, P=0.038), systemic immune inflammatory index (SII)>2 003.95 (HR=2.976, 95%CI: 1.647-5.379, P<0.001) were risk factors for PFS, and advanced lung cancer inflammation index (ALI)>171.15 was protective factor for PFS (HR=0.545, 95%CI: 0.344-0.863, P=0.010). IL-6>9.9 ng/L(HR=6.124, 95%CI: 1.950-19.228, P<0.002), lactate dehydrogenase (LDH)>190.7 U/L (HR=2.776, 95%CI: 1.020-7.556, P=0.046), SII>2 003.95 (HR=4.521, 95%CI: 2.241-9.120, P<0.001) were risk factors for OS, and ALI>171.15 was a protective factor for OS (HR=0.434, 95%CI: 0.243-0.778, P=0.005). Conclusion: Baseline high levels of IL-6, TNF-α, IL-8, SII, LDH, and low levels of ALI are risk factors for poor prognosis in patients with advanced NSCLC-COPD receiving immunotherapy.

Development of a clinical prediction model for diabetic kidney disease with glucose and lipid metabolism disorders based on machine learning and bioinformatics technology.

OBJECTIVE: In this study, we investigated the internal relationship between the pathogenesis of diabetic kidney disease (DKD) and abnormal glucose and lipid metabolism to identify potential biomarkers for diagnosis and treatment and investigated the role of the immune microenvironment of glucose and lipid metabolism disorders in the occurrence and progression of DKD. MATERIALS AND METHODS: The chip datasets GSE104948 and GSE96804 from the Gene Expression Common Database (GEO) were merged using the "lima" and "sva" software packages in R Software (4.2.3), and the merged dataset was used as the validation set. The intersection between the differential genes of DKD and the glucose and lipid metabolism genes in the MSigDB database was identified, and a nomogram of the incidence risk of DKD was built using three machine learning methods, namely LASSO regression, support vector machine (SVM), and random forest (RF), to validate the accuracy of the prediction model. Immune scores were conducted using the unsupervised clustering method, and patients were divided into two subgroups. The two subgroups were screened for differential genes for enrichment analysis. The differential genes of patients diagnosed with DKD were clustered into two gene subgroups for co-expression analysis. In this study, we utilized the Cytoscape software to construct a network of interactions among key genes. RESULTS: Using machine learning, a diagnostic model was developed with G6PC and HSD17B14 as key factors. Enrichment analysis and immune scoring demonstrated that the development of DKD was related to the imbalance in the microenvironment brought about by glucose lipid metabolism disorders. CONCLUSIONS: G6PC and HSD17B14 may be potential biomarkers for DKD, and the established predictive model is more helpful in predicting the incidence of DKD.

[Analysis of gene characteristics and core genome characteristics of carbapenem-resistant Enterobacter cloacae in rural residents of Weifang City, Shandong Province].

Objective: To investigate the drug-resistant gene characteristics and core genome characteristics of carbapenem-resistant Enterobacter cloacae (CR-ECL) in rural residents of Weifang City, Shandong Province. Methods: Fecal samples were collected from rural community residents in Weifang City, Shandong Province in 2017. Drug-resistant strains were screened using a carbapenem-resistant enterobacter chromogenic medium. CR-ECL positive strains were acquired via Matrix Assisted Laser Desorption Ionization Time of Flight Mass Spectrometry(MALDI-TOFMS) analysis. The antibiotic resistance phenotype of CR-ECL was determined using a microbroth dilution assay. Whole genome sequencing (WGS) and analysis were conducted, along with an examination of the immediate vicinity of the blaNDM gene and phylogenetic analysis of the strains. Results: A total of 628 fecal samples were collected and tested, of which 6 were CR-ECL positive (detection rate 0.96%), all exhibiting multiple drug resistance (MDR) phenotypes. Six CR-ECL strains had four MLST genotypes (ST), all of which carried multiple drug resistance genes (blaNDM-1, blaNDM-5, etc.) and virulence genes (acrA, acrB, entB, fepC, etc.). There were mobile genetic elements ISAba125, TN3-IS3000, TN3 and IS5 in the genetic environment surrounding the blaNDM gene. The phylogenetic tree showed that the multi-locus sequence typing of the core genome (cgMLST) was consistent with the single nucleotide polymorphism (SNPs) results. The cgMLST results showed that the allele differences between strains 2BC0101B and 2BC0251B, 2BG0561B and 2BI0221B were 2 and 1, respectively. The SNPs results showed that the above two pairs of bacteria also clustered together. It was found that the strains of chicken fecal samples in the National Center for Biotechnology Information (NCBI) database were located in the center of the evolutionary tree, and the local sequences could be traced back to American human sequences. Conclusion: Multidrug-resistant CR-ECL is detected in rural community residents in Weifang City, Shandong Province.

[Progress in research of long-term protective efficacy of human papillomavirus vaccine].

The efficacy of HPV vaccine in preventing cervical cancer has been demonstrated in numerous clinical trials and clinical uses. The follow-up after clinical trials usually last for 5-6 years to evaluate the long-term efficacy, and a series of long-term follow-up studies have been conducted in some regions. The literature retrieval of HPV vaccine long term efficiency research both at home and abroad indicated that the protective efficacy of the vaccine against vaccine-type-related cervical intraepithelial neoplasia grade 2 and above is higher than 90%.

[Pathological features and clinicopathological significance of TERT promoter mutation in breast fibroepithelial tumors without definite diagnosis].

Objective: To investigate the pathological features and the clinicopathological significance of TERT detection in those tumors that were difficult to diagnosis. Methods: A total of 93 cases of fibroepithelial tumors without definite diagnosis were collected from the Affiliated Hospital of Qigndao University between 2013 and 2021. The clinical details such as patients' age and tumor size were collected. All slides were re-reviewed and the pathologic parameters, including stromal cellularity, stromal cell atypia, stromal cell mitoses, and stromal overgrowth were re-interpreted. Sanger sequencing was used to detect TERT promoter status, and immunohistochemistry was performed to detect TERT protein expression. The relationship between TERT promoter mutation as well as protein expression levels and the clinicopathological parameters were also analyzed. Results: The patients' ages ranged from 30 to 71 years (mean of 46 years); the tumor size ranged from 1.2 to 8.0 cm (mean 3.8 cm). These tumors showed the following morphologic features: leafy structures in the background of fibroadenoma, or moderately to severely abundant stromal cells. The interpretations of tumor border status were ambiguous in some cases. The incidence of TERT promoter mutation was high in patients of age≥50 years, tumor size≥4 cm, and stromal overgrowth at ×4 or ×10 objective, and these clinicopathologic features were in favor of diagnosis of phyllodes tumors. TERT protein expression levels was not associated with the above clinicopathologic parameters and its promoter mutation status. Conclusions: The diagnostic difficulty for the breast fibroepithelial tumors is due to the difficulty in recognition of the leafy structures or in those cases with abundant stromal cells. A comprehensive evaluation combined with morphologic characteristics and molecular parameters such as TERT promoter may be helpful for the correct diagnosis and better evaluating recurrence risk.

[Molecular epidemiology of drug resistance genes and carbapenem resistance of Pseudomonas aeruginosa in rural well water].

Objective: To analyze molecular epidemiological characteristics of drug resistance genes and carbapenem resistance of Pseudomonas aeruginosa (PA) in rural well water. Methods: According to Citation of Natural Mineral Water Inspection (GB 8538-2016), a total of 112 well water samples were tested in Juye county of Shandong province, and PFGE and drug susceptibility test were conducted for the identified PA strains. After PCR identification of carbapenem resistance genes, S1-PFGE and Southern blotting were used to determine the location of drug resistance genes, and combined experiments were used to determine gene transferability. Results: The detection rate of PA in rural well water samples in Juye county of Shandong province was 54.46% (61/112). The 61 strains could be divided into 56 PFGE types. There were 2 strains with 100.00% consistent band types, and there was no obvious predominant band type. The results of drug susceptibility experiments showed that 93.44% (57/61) were multi-drug resistant strains, and there were 2 strains carrying blaVIM-2, both of which were located on the plasmid, and both of them were transferred horizontally with the plasmid. Conclusion: PA carrying carbapenem resistance genes was detected in well water of rural communities in Juye country, and there is the possibility of horizontal transmission of such resistance genes.

[Proximal incisal edge length and recent clinical observation of Siewert type â ¡ advanced esophagogastric junction adenocarcinoma].

Objective: To investigate the clinical effect of the radical resection with a proximal incisal edge length of 20-25 mm and 30-35 mm in Siewert type Ⅱ advanced esophagogastric junction adenocarcinoma, to shorten the minimum safe distance of the proximal incisal edge to 20-25 mm. Methods: A retrospective cohort study method was used. The clinical data of 166 patients with Siewert type Ⅱ advanced esophagogastric junction adenocarcinoma who underwent total gastrectomy from January 2017 to August 2020 in the Department of Gastrointestinal Surgery, Heji Hospital Affiliated to Changzhi Medical College were retrospectively collected. According to the proximal incisal edge length, the patients were divided into two groups: the proximal incisal edge length of 20-25 mm group (69 cases) and 30-35 mm group (97 cases). The perioperative conditions and the 6-month follow-up after the operation were compared between the two groups. Results: There was no statistically significant difference in baseline information between the patients in the two groups (P>0.05). The operations of both groups were completed. The intraoperative operation time of the proximal incisal edge length of 20-25 mm group was shorter than that in the proximal incisal edge length of 30-35 mm group ((172±24)and(206±27)min, P<0.001). There were no significant differences in the amount of intraoperative blood loss, the treatment of the diaphragm during the operation and the positive rate of intraoperative freezing of the upper incisal edge between the patients in the two groups (all P>0.05). And there was no significant differences in the first exhaust time, gastric tube removal time, first feeding time and hospital stay after the operation of the two groups (all P>0.05). There was no significant differences in the incidence of anastomotic leakage, anastomotic stenosis, reflux esophagitis and intestinal obstruction after the operation between the patients in the two groups (all P>0.05). And there was no anastomotic leakage case among the 69 cases in the proximal incisal edge length of 20-25 mm group. Postoperative pathological treatment showed no significant differences in the vascular tumor thrombus and nerve infiltration between the two groups (both P>0.05). During the 6-month follow-up, there was no death or tumor recurrence in the two groups, and there was no significant difference in body weight loss at 6 months after the operation between the two groups (P=0.178). Conclusion: When radical resection of Siewert type Ⅱ advanced esophagogastric junction adenocarcinoma is performed, it is feasible to shorten the minimum safe distance of the proximal incisal edge to 20-25 mm under the premise of ensuring R0 resection. The operation time is shortened. Due to the shortening the incisal edge distance, the anastomotic tension is decreased, and the incidence of postoperative anastomotic leakage is also reduced.

Vitamin A with L-ascorbic acid sodium salt improves the growth performance, immune function and antioxidant capacity of weaned pigs.

Vitamin A is easily degraded by environmental factors. Therefore, it is very important to add antioxidants during Vitamin A production. In the past, ethoxyquin (EQ) was widely used, but recent studies have found that it has potential toxicity. Therefore, in this study, we evaluated the antioxidant activities of 4 antioxidants in vitro: EQ, butylated hydroxytoluene, α-tocopherol and L-ascorbic acid sodium salt (Vitamin C sodium). In vitro experiments showed that Vitamin C sodium had better antioxidant capacity. Then, we explored the effects of different antioxidant types of Vitamin A on the growth performance, immune function and antioxidant capacity of weaned pigs. In total, 288 weaned piglets with an initial mean BW of 8.34 ±â€¯0.02 kg at 30 days old were randomly divided into three groups with four replicates and 24 piglets per replicate for 35 days of feeding. The experimental diets were as follows: i) basal diet without external Vitamin A (NC); ii) basal diet supplemented with 12000 IU/kg EQ Vitamin A and iii) basal diet supplemented with 12000 IU/kg Vitamin C sodium Vitamin A. On day 36, two pigs from each replicate were selected to collect serum samples. The in vivo results showed that pigs in the EQ Vitamin A and Vitamin C sodium Vitamin A groups had significantly higher final weight and average daily gain (P < 0.05). During the trial, the levels of IgG and glutathione peroxidase in the EQ Vitamin A and Vitamin C sodium Vitamin A groups were significantly higher than those in the NC group (P < 0.05), and the malondialdehyde content was significantly lower (P < 0.05). On the 36th day, the levels of IgA and total antioxidant capacity in the Vitamin C sodium Vitamin A group were significantly higher than those in the EQ Vitamin A and NC (P < 0.05) groups. Thus, Vitamin C sodium Vitamin A can significantly improve the growth performance, antioxidant capacity and immune function of weaned pigs. Meanwhile, Vitamin C sodium may replace EQ as an antioxidant additive for Vitamin A.

[Ticks of Cattle (Bos taurus and Bos indicus) and Grasscutters (Thryonomys swinderianus) in Savannas District of Côte-d'Ivoire]. / Tiques des bovins (Bos taurus et Bos indicus) et des aulacodes (Thryonomys swinderianus) dans le district des Savanes de Côte-d'Ivoire.

During dry season of 2014, some ticks were collected on cattle (Bos taurus and Bos indicus) and grasscutters (Thryonomys swinderianus) in sugar complex areas of Savanna District of Côte-d'Ivoire. Two localities were concerned; SUCAF 1 in Ferkessédougou and SUCAF 2 in Komborodougou. The main objective was to inventory tick species that parasite cattle and grasscutters in this region, then, to identify the shared species between these two groups of animals. To this end, ticks were collected from 70 cattle (35 females and 35 males) and 50 grasscutters (30 females and 20 males). Four tick species were found on cattle: Amblyomma variegatum, Hyalomma truncatum, Rhipicephalus annulatus and Rhipicephalus microplus. On grasscutters, three species of ticks were found: A. variegatum, Ixodes aulacodi and Rhipicephalus simpsoni. The species A. variegatum dominated cattle infestation and was the only tick present in the two groups of animals. But, only immature forms were found on grasscutters. This later specie was mainly infested by adults R. simpsoni.

Pendant la saison sèche de l'année 2014, des tiques ont été collectées sur des bovins (Bos taurus et Bos indicus) et sur des aulacodes (Thryonomys swinderianus), respectivement à Ferkessédougou et Komborodougou au niveau des complexes sucriers SUCAF 1 et 2, dans le district des Savanes de Côte-d'Ivoire. L'objectif principal recherché était d'inventorier les espèces de tiques parasitant les bovins et les aulacodes sauvages dans cette région puis de déterminer les espèces communes à ces deux groupes d'animaux. Au total, les prélèvements de tiques ont été effectués sur 70 bovins et 50 aulacodes. Après identification morphologique, quatre espèces ont été trouvées chez les bovins : Amblyomma variegatum, Hyalomma truncatum, Rhipicephalus annulatus et Rhipicephalus microplus, et trois espèces chez les aulacodes : A. variegatum, Ixodes aulacodi et Rhipicephalus simpsoni. La tique A. variegatum, la seule espèce commune aux deux types d'animaux, était majoritaire chez les bovins. Chez les aulacodes par contre, seules les formes immatures d'A. variegatum ont été trouvées, et les adultes de l'espèce R. simpsoni ont été trouvés en majorité.

Suppression of adriamycin resistance in osteosarcoma by blocking Wnt/ß-catenin signal pathway.

Since this article has been suspected of research misconduct and the corresponding authors did not respond to our request to prove originality of data and figures, "Suppression of adriamycin resistance in osteosarcoma by blocking Wnt/ß-catenin signal pathway, by B.-Q. Wu, Y. Cao, Z.-G. Bi, published in Eur Rev Med Pharmacol Sci 2017; 21 (14): 3185-3192-PMID: 28770967" has been withdrawn. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/13139.

Chicory fibre improves reproductive performance of pregnant rats involving in altering intestinal microbiota composition.

AIM: Chicory fibre (CF) is rich in fructan, which always functions as a quality dietary fibre source during mammalian pregnancy; however, its effect on reproductive performance remains unclear. METHODS AND RESULTS: 40 pregnant SD rats were randomly allotted to receive one of four diets: basal diet (control group), basal diet + 5% CF, basal diet + 10% CF, and basal diet + 15% CF, respectively. We found that CF significantly increased the number born alive and total litter birth weight (P < 0·05), increased the expression of intestinal tight junction proteins, mucins and antimicrobial peptides, accompanied by the increase of villi height and the decrease of crypts depth of pregnant SD rats (P < 0·05). We also observed that CF markedly increased the acetic acid, propanoic acid, butyric acid and total SCFAs concentrations in caecum contents and promoted the expression of SCFAs-related receptors (P < 0·05). Notably, rats fed CF increased the relative abundance of Bacteroidetes (P < 0·001), decreased the relative abundance of Firmicutes and Proteobacteria, while markedly lowered the Firmicutes/ Bacteroidetes ratio (F/B ratio) (P < 0·05). Intriguingly, the number born alive and total litter birth weight were positively correlated with some probiotics and negatively correlated with other harmful bacteria by Pearson correlation analysis. CONCLUSION: Collectively, CF can enhance intestinal barrier function and maintain intestinal health, and may improve reproductive performance by altering intestinal microbiota composition. SIGNIFICANCE AND IMPACT OF THE STUDY: Adding suitable dietary fibre to the diet can improve the reproductive performance of sows. Indeed, there exist various problems in the application of traditional dietary fibres, including high insoluble fibre content and anti-nutritional factor level, and mycotoxin contamination. This study demonstrates that dietary CF supplementation improves reproductive performance and intestinal health. Thus, CF can be applied in pregnancy animals as a new dietary fibre additive in animal husbandry.

[Detection rate, antimicrobial resistance and molecular types of Klebsiella pneumoniae from stool samples of outpatients with diarrhea-syndrome in Tai'an].

Objective: To investigate the isolation rate, antimicrobial resistance phenotype, and molecular type characteristics of Klebsiella pneumoniae from infectious diarrhea outpatients in Tai'an. Methods: A total of 866 stool samples were collected from infectious diarrhea cases in sentinel hospitals in 6 counties of Tai'an from 2013 to 2017. The strains were isolated from stool samples of the cases and identified by biochemical test. Micro broth dilution method was used to detect the drug resistance of the strains. The molecular typing was conducted by using pulsed field gel electrophoresis (PFGE). Results: The detection rate of Klebsiella pneumoniae in the stool samples was 7.97% (69/866), with significant differences among the 6 counties (χ(2)=39.627, P=0.000). Sixty- eight out of the 69 strains were resistant to 15 antibiotics with resistance rate 98.55%(68/69). The resistance to ampicillin (AMP) was highest (84.06%) (58/69), followed by sulfamethoxazole (SOX) (72.46%)(50/69). There were 40 drug resistance profiles, and the predominant resistance profile was AMP-SOX detected (n=10). The multi-drug resistant (MDR) strains accounted for 33.33% (23/69). The 69 strains could be divided into 65 PFGE patterns, and no predominant PFGE pattern or cluster was observed. Conclusions: Klebsiella pneumoniae was detected in the stool samples of diarrhea- syndrome outpatients, indicating the risk for community-acquired infection; the strains were resistant to multiplex antibiotics, with wide drug-resistance profiles and high multi-drug resistance rates. The PFGE patterns were diverse, which showed no correlation with drug resistance profiles. Our study indicated that it necessary to strengthen the surveillance and detection of Klebsiella pneumoniae from diarrhea outpatients, which could facilitate the prevention of the emergence and spread of drug resistance strains and the protection of susceptible population.

[Challenges to prevent and control the outbreak of COVID-19].

An outbreak of severe pneumonia of unknown cause was reported in December 2019 in Wuhan, Hubei province, China. The infectious virus was soon identified and named as 2019 novel coronavirus (2019-nCoV). The name of the COVID-19 was given by WHO on 11 February 2020. It has so far caused about 118 000 cases in 114 countries including China ending March 10, and was characterized as a pandemic by WHO on March 11. We still face great challenges in control of the epidemic: uncertain initial source of infection, infected populations widely scattered, complex routs of transmission, populations generally susceptible, high contagiousness of the virus, and finally vaccines unlikely available in the near future.

[Clinical study of psychological changes and post traumatic stress disorder in elderly patients with hip fracture].

Objective: To explore the psychological state and affected factors of elderly patients with hip fractures. Methods: A retrospective analysis of 156 elderly hip fracture patients(>65 years) admitted to the Department of Orthopaedics, the First Affiliated Hospital of Harbin Medical University from January 2016 to August 2019 was performed. General and psychological information were collected by questionnaire.General information included age, gender, education, whether surgery, length of stay.SCL-90, a self-assessment scale, was chosen as the psychological test to analyzed the elderly hip fracture patients' psychological status during hospitalization and the norms of SCL-90 in Chinese which were established in 1986 were used as the control group. The prognostic factors were examined by univariate and multivariate analysis. Results: Somatization, interpersonal sensitivity, depression, anxiety, paranoid factor scores, and total scores of the elderly hip fracture patients were significantly higher than control group(all P=0.00).Univariate analysis and logistic regression analysis showed that non-surgery treatment and more than 10 days of hospitalization were independent prognostic factors that affected the psychological state of elderly hip fracture patients (all P=0.00). Conclusion: Elderly patients hospitalized with osteoporosis and hip fractures are prone to have negative emotional and psychological changes.The length of hospitalization and the choice of treatment can affect patients' psychological state, suggesting that effective psychological intervention is necessary.

[Etiology and epidemiological characteristics of gastroenteritis virus in food-borne diarrhea from three cities in Shandong Province, 2017].

Objective: To analyze the etiology and epidemiological characteristics of gastroenteritis virus in foodborne diseases from three cities in Shandong. Methods: From January to December 2017, six sentinel hospitals in Jinan, Yantai and Linyi city of Shandong Province were selected as the research sites. Stool samples of 1 397 diarrhea patients were collected, as well as basic information and clinical symptoms. Duplex quantitative RT-PCR was used to detect Norovirus genogroupⅠ (Nov GⅠ) and genogroupⅡ (Nov GⅡ), Sapovirus (SAV) and Human astrovirus (HAstV), respectively, quantitative RT-PCR was used to detect group A Rotavirus (RVA), and quantitative PCR was used to detect Enteric adenovirus (EAdV). The specific gene of the virus were sequenced and typed. It was compared that the gastroenteritis virus rate in cases with different characteristics and the clinical symptoms difference between the virus positive and negative cases. Results: The median age (P(25), P(75)) was 23 (1, 42) , mainly male, 57.48% with 803 cased and children under 5 years old, 36.36% with 508 cases. The positive rate of gastroenteritis virus was 33.93% (474 cases), and that of Jinan, Linyi and Yantai City were 32.03% (147/459), 41.54% (189/455) and 28.57% (138/483), respectively (P<0.001). Nov GⅡ had the highest positive rate, 16.54% (231 cases), which, mainly GⅡ.P16/GⅡ.2 (48.28%, 56/116), peaked in May (24.75%, 50/202) and June (19.59%, 38/194). In patients of gastroenteritis virus positive, 44.51% (211/474) had vomiting symptoms, higher than that of patients of gastroenteritis virus negative (34.13%, 315/923). The difference was statistically significant (P<0.001). Conclusion: In Shandong Province, the majority of gastroenteritis patients were male and children under 5 years old. Nov GⅡ possessed highest epidemic intensity, and peaked in spring and summer. Viral gastroenteritis had atypical clinical symptoms.

[Reviewing the surgery strategy for fracture neck of femur].

Femoral neck fracture is a frequently occurring and dangerous disease of elderly patient, whose morbidity is increasing gradually with the aging of population and has become a serious social problem. Prosthetic joint replacement can relief pain and restore joint function effectively, so that more and more doctors consider it a main option for the treatment of displaced femoral neck fractures in the elderly. However, the extensive operation and high cost are burdens for patients and society. As medical technology development, the surgery strategy for fracture neck of femur should be redefined. The choice of treatment should be varied individually depend on therapeutic indication and patients' clinical condition. The treatment of aged patients with femoral neck fractures should be developed into personalized therapeutic strategies.

[A new exploration and consideration of Type A fracture of distal femur based on finite element biomechanical analysis].

Objective: To investigate the changes of internal fixation stress under different angles of interior fracture line and different screw placement modes in the case of A-type distal femoral fracture. Methods: A 24-year-old healthy male volunteer was recruited to collect the right femur data. CATIA V5R21 software produced a 10 mm fracture gap at the external side of the femur 6.5 cm proximal to the joint line and different angle fracture lines were generated on the internal of the femur at the same height. Based on the actual measured dimensions, the three-dimensional (3D) model of the locking plate and screw was reconstructed using CATIA V5R21 software, ignoring the screw surface threads and then the assembly of the internal fixation of the titanium plate, screws and femur was done. All models were meshed using Hypermesh 13.0 software. The assembled 3D model was input into ABAQUS 6.14 to generate a finite element model. Preliminary finite element biomechanical analysis was performed using the four medial fracture line angles and the stress distribution of the internal fixation under the three screw placement modes, and then the analysis was continued after the optimal screw placement method was re-determined. Results: Under an axial loading of 700 N, with the increase of the angle of the fracture line, the stress of the lateral internal fixation gradually increased, and the displacement of the proximal end of the fracture gradually increased. The sequential screw placement method was superior to the leaping screw placement method. The placement of the first screw at the proximal end of the fracture was critical to the distribution of the internal fixation stress. Conclusions: The operation plan of the type A of distal femoral fracture needs to be confirmed according to the internal and external fracture's condition. When the fracture line is at a excessive positive angle or a negative angle, a simple lateral fixation may not provide a stable fracture fixation so that other fixation methods are needed.

[Multi locus sequence typing and antibiotic susceptibility of extended-spectrum beta-lactamases producing Enterobacteriaceae in rural residents in villages with pig-breeding farms in Shandong province].

Objective: To analyze the antimicrobial resistance and multilocus sequence typing (MLST) results of extended-spectrum ß-lactamase (ESBLs)-producing Escherichia coli in rural residents in villages with pig breeding farms in a county of Shandong province. Methods: Antimicrobial susceptibility testing was performed with agar dilution method by using 360 ESBLs-producing E. coli strains from fresh stool samples of rural residents in villages with pig breeding farms in a county of Shandong. PCR was conducted to amplify the CTX-M, TEM, SHV genes and capillary electrophoresis was used to screen positive strains in July, 2016. MLST was performed for molecular typing analysis, and eBURST v3.0 software was used for cluster analysis. Results: Among 360 strains of ESBLs-producing E. coli, the resistance rates to cefotaxime, tetracycline, trimethoprim-sulfamethoxazole and florfenicol were 100.0% (360/360), 82.2% (296/360), 81.1% (292/360) and 80.3% (289/360), respectively. The positive rate of CTX-M gene was 99.2% (357/360), in which the positive rate of CTX-M-9 was 35.6% (128/360) and the positive rate of CTX-M-1 was 24.4% (88/360). The positive rate of TEM gene was 26.9% (97/360). A total of 132 STs were identified through MLST. The predominant ST was ST10, accounting for 12.5% (45/360). Cluster analysis showed that CC10 was the most important clone group, including 39 ST clones, involving 148 strains (41.1%). Conclusions: The drug resistances of ESBLs-producing E. coli to cefotaxime, tetracycline, trimethoprim-sulfamethoxazole and flurfenicol are serious in this rural area. There is a small-scale clustering of CC10 and transmission mode from animals to humans might exist.

[Introduction of papillomavirus rapid interface for modelling and economics (PRIME) and an example of China's data analysis].

Cervical cancer has become an important disease that jeopardizes women's health, causing hundreds of thousands of new cases annually. Human papillomavirus (HPV) is the leading cause for cervical cancer. Since the world's first HPV vaccine was licensed in 2006, 92 countries around the world have introduced them in national immunization programs. The WHO recommends that scientific economic evaluation should be achieved before the introduction, but this is more difficult for low-and middle-income countries. Therefore, this article introduces a mathematical model recommended by WHO in 2014 to quickly and easily accomplish economic evaluation of HPV vaccine -the PRIME, and take the China's 2018 data published by International Agency for Research on Cancer (IARC) as an example. The evaluation result shows that the introduction of HPV vaccine in Chinese 12-year-old women is cost-effective.

Understanding m6A Function Through Uncovering the Diversity Roles of YTH Domain-Containing Proteins.

N6-methyladenosine (m6A) is the most abundant-internal modification of eukaryotic mRNA. m6A can be installed and removed by specific enzymes. The "writer," "eraser," and "reader" of m6A modification have been reported. These discoveries facilitate our understanding of the functional significance of m6A. m6A plays an essential role in diverse biological processes by recruiting the corresponding YTH domain-containing proteins, as well as recruiting additional translation initiation factors. Here, we provide an update on the various aspects of YTH domain-containing proteins, including an introduction to the YTH domain, the categories, distribution in cells, and biological roles of YTH proteins. Then we focus on the mechanisms that YTH proteins recognize m6A and mediate the fate of methylated-RNAs in eukaryotic cells.