[Expert consensus on the application of critical care ultrasonography in invasive procedures].

The evolution of critical care medicine is inextricably linked to the development of critical care procedures. These procedures not only facilitate diagnosis and treatment of critically ill patients, but also provide valuable insights into disease pathophysiology. While critical care interventions offer undeniable benefits, the potential for iatrogenic complications necessitates careful consideration. The recent surge in critical care ultrasound (US) utilization is a testament to its unique advantages: non-invasiveness, real-time bedside availability, direct visualization of internal structures, elimination of ionizing radiation exposure, repeatability, and relative ease of learning. Recognizing the need to optimize procedures and minimize complications, critical care utrasound study group of Beijing critical care ultrasound research assocition convened a panel of critical care experts to generate this consensus statement. This document serves as a guide for healthcare providers, aiming to ensure patient safety and best practices in critical care.

[Clinical features of post-neurosurgical bacterial meningitis in children].

Objective: To understand the characteristics of bacterial meningitis after pediatric neurosurgical procedures. Methods: This was a retrospective observational study. From January 2016 to December 2022, 64 children diagnosed with post-neurosurgical bacterial meningitis based on positive cerebrospinal fluid (CSF) culture in Department of Neurosurgery of Shanghai Children's Medical Center were selected as the study population. The clinical characteristics, onset time, routine biochemical indexes of cerebrospinal fluid before anti infection treatment, bacteriology characteristics and sensitivity to antibiotics of bacteria cultured from cerebrospinal fluid were analyzed. Based on the CSF culture results, the patients were divided into the Gram-positive bacteria infection group and the Gram-negative bacteria infection group. The clinical characteristics of the two groups were compared using t-tests or Wilcoxon rank-sum tests, and chi-square tests. Results: There were 64 children,42 boys and 22 girls, with onset age of 0.83 (0.50, 1.75) years. Seventy cases of post-neurosurgical bacterial meningitis occurred in the 64 children, of which 15 cases (21%) in spring, 23 cases (33%) in summer, 19 cases (27%) in autumn, and 13 cases (19%) in winter. The time of onset was 3.5 (1.0, 10.0) months after surgery; 15 cases (21%) occurred within the first month after the surgery, and 55 cases (79%) occurred after the first month. There were 38 cases (59%) showing obvious abnormal clinical manifestations, fever 36 cases (56%), vomiting 11 cases (17%). Forty-eight cases (69%) were caused by Gram-positive bacteria, with Staphylococcus epidermidis 24 cases; 22 cases (31%) were caused by Gram-negative bacteria, with Acinetobacter baumannii the prominent pathogen 7 cases. The Gram-positive bacterial infection was more common in summer than the Gram-negative bacterial infection (20 cases (42%) vs. 3 cases (14%), χ2=5.37, P=0.020), while the Gram-negative bacterial infection was more in autumn and within the first month after surgery than the Gram-positive bacterial infection (11 cases (50%) vs. 8 cases (17%), 15 cases (67%) vs. 5 cases (33%), χ2=8.48, 9.02; P=0.004, 0.003). Gram-positive bacteria resistant to vancomycin and Acinetobacter baumannii resistant to polymyxin were not found. However, Acinetobacter baumannii showed only 45% (10/22) susceptibility to carbapenem antibiotics. Conclusions: The clinical presentation of post-neurosurgical bacterial meningitis in children is atypical. Gram-positive bacteria are the main pathogens causing post-neurosurgical bacterial meningitis; Gram-negative bacterial meningitis are more likely to occur in autumn and within the first month after surgery. Acinetobacter baumannii has a high resistance rate to carbapenem antibiotics, which should be taken seriously.

[Expert consensus on late stage of critical care management].

We wished to establish an expert consensus on late stage of critical care (CC) management. The panel comprised 13 experts in CC medicine. Each statement was assessed based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) principle. Then, the Delphi method was adopted by 17 experts to reassess the following 28 statements. (1) ESCAPE has evolved from a strategy of delirium management to a strategy of late stage of CC management. (2) The new version of ESCAPE is a strategy for optimizing treatment and comprehensive care of critically ill patients (CIPs) after the rescue period, including early mobilization, early rehabilitation, nutritional support, sleep management, mental assessment, cognitive-function training, emotional support, and optimizing sedation and analgesia. (3) Disease assessment to determine the starting point of early mobilization, early rehabilitation, and early enteral nutrition. (4) Early mobilization has synergistic effects upon the recovery of organ function. (5) Early functional exercise and rehabilitation are important means to promote CIP recovery, and gives them a sense of future prospects. (6) Timely start of enteral nutrition is conducive to early mobilization and early rehabilitation. (7) The spontaneous breathing test should be started as soon as possible, and a weaning plan should be selected step-by-step. (8) The waking process of CIPs should be realized in a planned and purposeful way. (9) Establishment of a sleep-wake rhythm is the key to sleep management in post-CC management. (10) The spontaneous awakening trial, spontaneous breathing trial, and sleep management should be carried out together. (11) The depth of sedation should be adjusted dynamically in the late stage of CC period. (12) Standardized sedation assessment is the premise of rational sedation. (13) Appropriate sedative drugs should be selected according to the objectives of sedation and drug characteristics. (14) A goal-directed minimization strategy for sedation should be implemented. (15) The principle of analgesia must be mastered first. (16) Subjective assessment is preferred for analgesia assessment. (17) Opioid-based analgesic strategies should be selected step-by-step according to the characteristics of different drugs. (18) There must be rational use of non-opioid analgesics and non-drug-based analgesic measures. (19) Pay attention to evaluation of the psychological status of CIPs. (20) Cognitive function in CIPs cannot be ignored. (21) Delirium management should be based on non-drug-based measures and rational use of drugs. (22) Reset treatment can be considered for severe delirium. (23) Psychological assessment should be conducted as early as possible to screen-out high-risk groups with post-traumatic stress disorder. (24) Emotional support, flexible visiting, and environment management are important components of humanistic management in the intensive care unit (ICU). (25) Emotional support from medical teams and families should be promoted through"ICU diaries"and other forms. (26) Environmental management should be carried out by enriching environmental content, limiting environmental interference, and optimizing the environmental atmosphere. (27) Reasonable promotion of flexible visitation should be done on the basis of prevention of nosocomial infection. (28) ESCAPE is an excellent project for late stage of CC management.

[Status of personal information sharing on HIV between sexual partners among men who have sex with men who met casual sexual partners on the internet in Zhejiang province].

Objective: To identify the status and determinants of sharing personal HIV information with sexual partners among men who have sex with men (MSM) meeting their casual sexual partners on the internet. Methods: A cross-sectional study was conducted in five cities (Hangzhou, Ningbo, Wenzhou, Taizhou and Shaoxing) in Zhejiang province. The recruitment was enrolled by MSM social organization and in voluntary counseling and testing clinics, with a sample size of 793. A self-designed network questionnaire collected essential characteristics, HIV knowledge, sexual behavior, and sharing personal HIV status. SPSS 20.0 software was used for statistical analysis. Results: Among 767 MSM enrolled 302 MSM who reported finding casual sexual partners on the internet were enrolled in the analysis. MSM reported finding casual partners on the internet only, finding sexual partners online and in places were 62.6% (189/302) and 37.4% (113/302), respectively. Among those reporting web-based sexual behavior in the last six months, 54.6% (165/302) informed their partners of their HIV status, 49.2% (146/297) inquired about HIV status, and 42.9% (82/191) knew HIV status before sex intercourse, 75.8% (113/149) reported consistent condom use with HIV negative partners. The multivariable logistic regression analysis showed that related factors of inconsistent inquired HIV status of partners included 25-34 years old (aOR=2.17, 95%CI: 1.20-3.91), >2 partners on the internet in the last six months (aOR=2.13, 95%CI: 1.27-3.57), low-risk perception of HIV infection with online partners (aOR=1.96, 95%CI:1.14-3.35), numbers of HIV testing >1 times (aOR=0.38, 95%CI: 0.22-0.66). Conclusions: The willingness to know the HIV status of partners among MSM who met sexual partners on the internet was high but with a low rate of knowing their sex partner's HIV status in Zhejiang province. However, the successful implementation proportion was low. Therefore, it is necessary to pay attention to people who are elderly, with less conscience about the risk of the sex partners on the internet, have more sex partners, and have received few HIV tests. In addition, peer education was needed to promote related intervention programs.

Visible imaging system with changeable field of view on the HL-2A tokamak.

A new visible imaging system characterizing a flexible optical design and delivering high resolution frames is established on the HL-2A tokamak. It features a modular configuration, consisting of a front-end imaging lens, a set of bilateral telecentric relay lenses, and a camera. To avoid the effects of plasma radiation (x and gamma-rays) and magnetic field variation on the camera, it should be away from the coils. Therefore, the length of the relay lenses determines the total size of the imaging system. The main feature of this imaging system is to realize the variation of field of view (FOV) by interchanging the front-end prime lenses or by using a zoom lens directly rather than designing the optical system afresh, which lowers the cost drastically. The primary purpose of varying FOV is to enrich the versatility of this system, i.e., focusing on a narrow FOV such as gas puff imaging or a wide FOV such as the plasma cross sections. During the HL-2A experiments, this visible imaging system is used to provide high quality pictures of the plasma-wall interaction, divertor detachment, pellet injections, and so on. The frames confirmed that a strong radiation close to the X point is correlated with the completely detached inner target.

[Study on the diagnostic value of transient elastography, APRI and FIB-4 for liver fibrosis in children with non-alcoholic fatty liver disease].

Objective: To evaluate the diagnostic value of transient elastography, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis index based on 4 factors (FIB-4) for liver fibrosis in children with non-alcoholic fatty liver disease (NAFLD). Methods: A retrospective study was conducted on 100 cases of nonalcoholic fatty liver disease in Hunan Children's Hospital between August 2015 to October 2020 to collect liver tissue pathological and clinical data. The receiver operating characteristic curve (ROC curve) was used to analyze the diagnostic value of liver stiffness measurement (LSM), APRI and FIB-4 in the diagnosis of different stages of liver fibrosis caused by NAFLD in children. Results: The area under the ROC curve (AUC) value of LSM, APRI and FIB-4 for diagnosing liver fibrosis (S≥1) were 0.701 [95% confidence interval (CI): 0.579 ~ 0.822, P = 0.011], 0.606 (95%CI: 0.436 ~ 0.775, P = 0.182), and 0.568 (95%CI: 0.397 ~ 0.740, P = 0.387), respectively. The best cut-off values were 6.65 kPa, 21.20, and 0.18, respectively. The AUCs value of LSM, APRI, and FIB-4 for diagnosing significant liver fibrosis (S≥ 2) were 0.660 (95% CI: 0.552 ~ 0.768, P = 0.006), 0.578 (95% CI: 0.464 ~ 0.691, P = 0.182) and 0.541 (95% CI: 0.427 ~ 0.655, P = 0.482), respectively. The best cut-off values were 7.35kpa, 24.78 and 0.22, respectively. The AUCs value of LSM, APRI and FIB-4 for the diagnosis of advanced liver fibrosis (S≥ 3) were 0.639 (95% CI: 0.446 ~ 0.832, P = 0.134), 0.613 (95% CI: 0.447 ~ 0.779, P = 0.223) and 0.587 (95% CI: 0.411 ~ 0.764, P = 0.346), respectively. The best cut-off values were 8.55kpa, 26.66 and 0.27, respectively. Conclusion: The transient elastography technique has a better diagnostic value than APRI and FIB-4 for liver fibrosis in children with NAFLD.

[Effect of lipopolysaccharide-stimulated exosomes from human dental pulp stem cells combined with stromal cell-derived factor-1 on dental pulp regeneration].

Objective: To investigate the effect of exosomes from mild-inflammation- stimulated human dental pulp stem cells (hDPSC) combined with stromal cell-derived factor-1 (SDF-1) on dental pulp regeneration in rats. Methods: Primary hDPSCs were isolated, cultured and then stimulated by using lipopolysaccharide (LPS). The exosomes from the hDPSCs with (L-EXO) or without (N-EXO) LPS were extracted by overspeed differential centrifugation and were identified by transmission electron microscopy and Western blotting. Forty SD rats, aged 6-8 weeks, were equally divided into S group (SDF-1 alone), L+S group (L-EXO combined with SDF-1), N+S group (N-EXO combined with SDF-1) and blank control group (no substance implanted into the root canal) by random number table method. Bilateral mandibular first molars were used as the experimental teeth to establish pulpless root canal models and different contents were implanted into the root canals according to the groups. All rats were over-anesthetized and sacrificed at the 30th day after content implantation. Bilateral mandibular tissues were taken for histological evaluation by means of HE, Masson and immunohistochemical stainings. Results: The HE staining showed new pulp-like tissue in the root canals of all three experimental groups. The amount of new tissues and the number of cells in the tissues were greatest in L+S group and least in S group. Masson staining showed that the mineralized tissue in L+S group was arranged longitudinally along the root canal wall and the collagen fibers were arranged in an orderly fashion, while those in N+S group showed an irregular and disordered distribution. Quantitative analysis of the area of neovascularization in each group showed that the density of vessels in the L+S group [(2.03±0.65)%] was significantly higher than that in the S group [(0.65±0.05)%] and the N+S group [(1.06±0.38)%] respectively (F=5.879, P<0.05). Immunohistochemical staining showed that the expression of CXC chemokine receptor 4 (CXCR4) was significantly lower in S and L+S groups than in N+S group, with a statistically significant difference (F=8.633, P<0.01). Conclusions: Exosomes secreted by hDPSCs combined with SDF-1 might increase the amount of new tissue in the root canal and the density of blood vessels in the tissue. L-EXO showed a stronger effect than N-EXO did. The combination of L-EXO with SDF-1 might result in more regular arrangement of mineralized tissue and collagen fibers in the regenerative tissues.

[Willingness of post-exposure prophylaxis and possible related factors in men who have sex with men].

Objective: To analyze the willingness of post-exposure prophylaxis (PEP) to prevent HIV transmission and related factors in men who have sex with men (MSM). Methods: Cross sectional survey design was used in this study. After informed consent, MSM aged 18 years or above and having had homosexual anal or oral sex in the past 6 months were recruited through "i WeChat" official account between September and November, 2019. Results: Of 1 517 MSM were surveyed, the proportion of MSM who had ever heard of PEP were 72.5% (1 100/1 517) and 87.9%(1 333/1 517) of the MSM said they would like to use PEP if it is needed.Multivariate logistic regression analysis suggested that aged above 25 year (OR=1.807, 95%CI: 1.090-2.995), HIV test history (OR=1.953, 95%CI: 1.171-3.256) and being aware of PEP (OR=2.163, 95%CI: 1.468-3.186) were the positive factors for PEP use, but an aware of the HIV status of sexual partner was the negative factor for PEP (OR=0.602, 95%CI: 0.407-0.890). Among MSM who had ever heard of PEP, the positive factors for PEP use included living in Zhejiang (OR=1.942, 95%CI: 1.097-3.438), aged above 25 years (OR=2.431, 95%CI: 1.331-4.439), being aware of PEP (OR=3.714, 95%CI: 1.532-9.007) obtaining information about PEP service from MSM organization/volunteer/health organization. Conclusions: MSM's willingness to use PEP services was relatively high. Age, awareness of PEP related knowledge, and awareness of sexual partner's HIV infection status were the related factors. MSM organization/volunteer/health organization were the main forces for PEP promotion in MSM.

[Prediction of the vaulting after posterior chamber intraocular lens implantation].

Objective: To investigate the influencing factors on the vaulting one month after implantable collamer lens (ICL) implantation, and to develop and verify a prediction formula. Methods: The first half of this study was retrospective case series study, and the second half was cross-sectional stydy. A total of 83 eyes of 83 patients who underwent ICL implantation in the Lixiang Eye Hospital of Soochow University were included in the first half of the study, with an average age of (27±5) years, from August 1, 2019 to December 30, 2019. All patients underwent a complete preoperative examination, including axis length, anterior chamber depth, comprehensive optometry, intraocular pressure, central corneal thickness, white-to-white diameter, horizontal and vertical sulcus-to-sulcus diameter (STS), crystalline lens thickness (LT), corneal curvature, and bright and dark pupil diameter. Multiple linear regression (stepwise) was used to develop a prediction formula. In the validation part, a total of 65 people (65 eyes) were included, with an average age of (26±5) years, from March 1, 2020 to June 1, 2020. The accuracy and reliability of the formula were verified by the intergroup correlation coefficient and Bland-Altman consistency test. Results: At 1 month after surgery, ICL size had the greatest impact on the vaulting (ß=0.942, P<0.001), followed by horizontal STS (ß=-0.517, P<0.001), LT (ß=-0.376, P<0.001), and vertical STS (ß=-0.257, P=0.017). The influence of other factors was not statistically significant (all P>0.05). The regression equation was as follows: the vaulting (µm)=-1 369.05+657.12×ICL size-287.41×horizontal STS-432.50×LT-137.33×vertical STS (the fitting degree R=0.813, R2=0.660, and corrected R2=0.643). In the verification part, the predicted average vaulting was (497.31±102.75) µm, while the actual vaulting was (514.62±152.99) µm. About 96.92% (63/65) of the patients were fitted in the moderate vault, and 3.08% (2/65) were in the high vault. The intergroup correlation coefficient was 0.581. According to the Bland-Altman test, the actual vaulting was 17.31 µm, higher than the predicted value, and the 95% confidence interval of the difference was -260.28 to 294.90 µm. Conclusion: The ICL size, horizontal and vertical STS and LT are the factors that affect and predict the vaulting one month after ICL implantation, and our prediction formula has good accuracy and reliability. (Chin J Ophthalmol, 2021, 57: 519-525).

[Diagnosis and treatment of anastomotic leak after low anterior resection for rectal cancer: current status and future prospect].

Anastomotic leak is one of inevitable postoperative complications of rectal cancer. With the improvement of surgical techniques, the enhancement of the cognization of rectal cancer, and the development of surgical instruments, surgical procedures of rectal cancer are getting more sophisticated. The anastomosis is performed lower and lower, however the incidence of anastomotic leak is not significantly decreased. In addition, different from intraperitoneal anastomotic leak, the low rectal anastomotic leak after low anterior resection has many special issues in the diagnosis and treatment in clinic. The incidence of peritonitis caused by low anastomotic leak is low, the onset time is late, and symptoms of peritonitis are mild. So most low anastomotic leak is treated conservatively, second surgical repair or resection of anastomotic site is rarely performed, and proximal intestinal diversion is commonly performed. In the prevention of low anastomotic leak, some techniques and precautions during the perioperative period and identification of high risk factors might play important roles. Combined our clinical experiences, we introduced the diagnosis, treatment, prevention and research progression of low anastomotic leak after anterior resection of low rectal cancer, we hope it would be helpful.

[Preliminary practice of multidisciplinary cooperative vaccination management model for pediatric patients with hematological and oncological diseases].

Objective: To preliminarily establish the multidisciplinary cooperative vaccination management model for pediatric patients with hematological and oncological diseases, and to explore its feasibility. Methods: In this prospective study a total of 150 children with hematological and oncological diseases visited immunization clinic of Shanghai Children's Medical Center from March 2017 to August 2018 were enrolled in this study. After establishing the multidisciplinary team, designing vaccination plan, staff training, implementation and quality control, a multidisciplinary immunization clinic was set up and the vaccination plan were implemented. The implementation rate of vaccination immunization, the HBsAb level and serum hepatitis B surface antibody (HBsAb) level before and after treatment, the HBsAb level and serum immunoglobulin G antibody (IgG) levels of measles, mumps, rubella (MMR) before and 6 months after immunization, the vaccine-related adverse reactions were assessed prospectively. Chi-square test or Fisher exact test was used to compare the differences of antibody level. Results: A total of 124 cases had been vaccinated as planned, with a coverage rate of 82.7%. Among these cases, the difference of HBsAb positive rate before and after treatment was significant (62.9% (78/124) vs.13.7% (17/124), χ²= 63.489, P<0.01). In 64 cases that completed three doses of hepatitis B immunization, there was a significant difference in HBsAb positive rate before and 6 months after immunization (6.3% (4/64) vs. 98.4% (63/64), P<0.01). In 40 cases that completed MMR immunization, the IgG antibody positive rate for measles (22.5% (9/40) vs. 82.5% (33/40), χ²=31.746,P<0.01), mumps (22.5% (9/40) vs.82.5% (33/40), χ²=28.872,P<0.01), rubella (25.0% (10/40) vs.62.5% (25/40), χ²=11.429, P<0.01) before and 6 months after immunization were significantly different. Of the 421 doses of immunization, 25 (5.9%) doses reported controlled systemic or local adverse event. Conclusions: The immunization of pediatric patients with hematological and oncological diseases is of great importance. The newly-developed multidisciplinary cooperation immunization model for Chinese children with hematological and oncological diseases is feasible, and the immunization protocol is safe and has a certain effect.

[Efficacy and safety of hepatitis B re-vaccination in children after completion of chemotherapy and(or) hematopoietic stem cell transplantation].

Objective: To assess the anti-hepatitis B surface antibody (HBsAb) titers in children after completion of chemotherapy and (or) hematopoietic stem cell transplantation (HSCT), evaluate the efficacy and safety of the current hepatitis B re-vaccination schedule. Methods: A total of 239 children who completed their chemotherapy and (or) HSCT and visited the vaccination clinic of Shanghai Children's Medical Center from March 2017 to July 2019 were enrolled in this study. According to the previous diseases, patients were divided into leukemia group (85 cases), lymphoma group (30 cases), solid tumor group (49 cases) and non-malignant hematological disease group (75 cases). According to the treatment of previous diseases, the patients were divided into chemotherapy group (126 cases), HSCT group (89 cases) and chemotherapy plus HSCT group (24 cases). HBsAb titers were assessed both at the time of diagnosis and after completion of treatment and some children who were HBsAb seronegative were re-vaccinated with 3 doses of hepatitis B vaccine, the vaccine-related adverse reactions were monitored. HBsAb titers were measured again one month after the completion of inoculation. HBsAb titers were defined as negative at levels <10 U/L and positive at ≥ 10 U/L. Chi-square test or Fisher exact test was used to compare the difference of negative conversion rate of hepatitis B antibody between groups, and Logistic regression was used to explore the risk factors of hepatitis B antibody negative conversion. Results: Among 239 patients, there were 143 males and 96 females. At the time of diagnosis, 179 patients (74.9%) were HBsAb seropositive and 60 patients (25.1%) were HBsAb seronegative. After completion of chemotherapy and (or) HSCT, 133 of 179 children with HBsAb seropositive (74.3%) at diagnosis became HBsAb seronegative. Univariate analysis showed significant differences at the negative conversion rates of HBsAb between different disease groups (χ²=10.211，P=0.015), different treatments groups (χ²=14.899，P<0.01) and different HBsAb titers groups before treatment (χ²=32.117，P<0.01). Logistic regression showed that HSCT (chemotherapy group as the reference, odds ratio (OR）=2.999, 95% confidence interval (CI) 1.276-7.050，P=0.012) and HBsAb titers<328.2 U/L before treatment (HBsAb titers≥328.2 U/L group as the reference, OR=6.397， 95% CI3.159-12.954，P<0.01) were risk factors for negative conversion of HBsAb. Among 48 patients whose HBsAb was seronegative after completion of chemotherapy and (or) HSCT and re-vaccinated with hepatitis B vaccine, 47 (97.9%) cases became HBsAb seropositivie. No serious adverse effects or complications were reported among these patients. Conclusions: After completion of chemotherapy and (or) HSCT, most children completely lose their protective humoral immunity against hepatitis B. Hepatitis B re-vaccination schedule can be efficiently and safely applied in those patients.

[The role of large-scale testing platform in the prevention and control of the COVID-19 pandemic: an empirical study based on a novel numerical model].

Objective: China adopted an unprecedented province-scale quarantine since January 23rd 2020, after the novel coronavirus (COVID-19) broke out in Wuhan in December 2019. Responding to the challenge of limited testing capacity, large-scale (>20 000 tests per day) standardized and fully-automated laboratory (Huo-Yan) was built as an ad-hoc measure. There is so far no empirical data or mathematical model to reveal the impact of the testing capacity improvement since quarantine. Methods: Based on the suspected case data released by the Health Commission of Hubei Province and the daily testing data of Huo-Yan Laboratory, the impact of detection capabilities on the realization of "clearing" and "clearing the day" of supected cases was simulated by establishing a novel non-linear and competitive compartments differential model. Results: Without the establishment of Huo-Yan, the suspected cases would increase by 47% to 33 700, the corresponding cost of quarantine would be doubled, the turning point of the increment of suspected cases and the achievement of "daily settlement" (all newly discovered suspected cases are diagnosed according to the nucleic acid testing result) would be delayed for a whole week and 11 days. If the Huo-Yan Laboratory could ran at its full capacity, the number of suspected cases could start to decrease at least a week earlier, the peak of suspected cases would be reduced by at least 44%, and the quarantine cost could be reduced by more than 72%. Ideally, if a daily testing capacity of 10 500 tests was achieved immediately after the Hubei lockdown, "daily settlement" for all suspected cases could be achieved. Conclusions: Large-scale, standardized clinical testing platform, with nucleic acid testing, high-throughput sequencing, and immunoprotein assessment capabilities, need to be implemented simultaneously in order to maximize the effect of quarantine and minimize the duration and cost of the quarantine. Such infrastructure, for both common times and emergencies, is of great significance for the early prevention and control of infectious diseases.

[Situation of anal sex among low-tier female sex workers in the Demonstration Areas of Comprehensive AIDS Responses in Zhejiang province].

Objective: To analyze the prevalence of anal sex and related factors in low-tier female sex workers (FSWs) in the demonstration areas of comprehensive AIDS responses (DACAR) in Zhejiang province. Method: In 2013, a survey on low-tier FSWs was carried out in 21 Demonstration Areas of AIDS Responses in Zhejiang. Experience of having anal sex with clients in the last month was taken as dependent variable while independent variables would include perception and characteristics related to behavior of the FSWs. The multivariate logistic regression analyses were conducted to identify the factors related to anal sex in low-tier FSWs. Results: A total of 2 645 low-tier FSWs were interviewed. Among these FSWs, 67.9% (1 796/2 645) were over 26 years old, 89.9% (2 378/2 645) were with education level of junior high school or below, 58.4% (1 546/2 645) were married, 78.2% (2 068/2 645) were from other provinces, 68.6% (1 814/2 645) had income level less than 4 000 Yuan, and rates of anal sex with client in the last month were 5.03% (133/2 645). Results from the multivariate logistic regression analysis of related factors of anal sex with client in the last month showed that among the low-tier FSWs, the venues of having commercial sex were in hair salons/massage parlors (OR=7.31, 95%CI: 2.27-23.59), roadside shops (OR=7.89, 95%CI: 2.27- 27.40) or other places (OR=4.65, 95%CI: 1.23-17.53), when compared with the street-women service. FSWs often engaged in commercial sex business in three or more counties (OR=1.68, 95%CI: 1.01-2.81), when compared with FSWs often engaged in commercial sex business just one county. FSWs had sex with only middle-aged and the elderly clients (OR=0.45, 95%CI: 0.30-0.66), when compared with FSWs had sex with young or middle-aged and the elderly clients. FSWs had risk perception for sexually transmitted disease (STD) (OR=2.00, 95%CI: 1.20-3.32), when compared with FSWs with no risk perception. FSWs had oral sex experience with their clients in the last month (OR=7.29, 95%CI: 4.78-11.12), when compared with the ones without oral sex. The above said factors were all related to the incidence of anal sex. Conclusions: Certain numbers of low-tier FSWs had anal sex experiences with their clients, especially those who had oral sex were more likely to have anal sex in DACAR in Zhejiang province. Attention should be paid to anal sex behavior when conducting behavior-related intervention programs, targeting on the low-tier FSWs.

Circ-ABCB10 acts as an oncogene in glioma cells via regulation of the miR-620/FABP5 axis.

OBJECTIVE: This study aims to investigate the biological function of circular RNA ABCB10 (circ-ABCB10) in regulating the progression of glioma and to study the possible underlying mechanisms. PATIENTS AND METHODS: The expression levels of circ-ABCB10, miR-620 and FABP5 mRNA in glioma tissues, normal surrounding tissues and glioma cell lines were measured by Real-time PCR (RT-PCR). Circ-ABCB10 was silenced by siRNA in glioma cell lines (U87, T98G). The proliferation, migration and invasion of glioma cells were measured by MTT, wound healing and transwell assays, respectively. The relationship between circ-ABCB10, miR-620 and FABP5 was tested by Dual-Luciferase assay. The expression of proteins was measured by Western blot. The cell cycle distribution and apoptosis were measured by flow cytometry. RESULTS: The expression levels of circ-ABCB10 and FABP5 in glioma tissues and cells were significantly higher than those in their normal counterparts. Moreover, the expression of miR-620 was lower in glioma tissues. Silencing of circ-ABCB10 in glioma cells significantly inhibited the proliferation, migration and invasion of glioma cells. Moreover, downregulation of circ-ABCB10 induced cell cycle arrest and apoptosis in glioma cells. Furthermore, inhibition of miR-620 showed the opposite effects to silencing circ-ABCB10 on glioma cells. Dual-Luciferase reporter assays demonstrated that circ-ABCB10 could bind to miR-620 and that FABP5 was a direct target of miR-620. Western blot results showed that circ-ABCB10 could stabilize the expression of FABP5, while miR-620 decreased the expression of FABP5. Furthermore, overexpression of FABP5 abrogated the silencing effects of circ-ABCB10 in glioma cells. CONCLUSIONS: These data suggest that circ-ABCB10 affects glioma progression by regulating the miR-620/FABP5 axis, and circ-ABCB10 might be used as a potential target for the treatment of glioma.

Fast charge exchange recombination spectroscopy on HuanLiu-2A tokamak.

A Fast Charge eXchange Recombination Spectroscopy (CXRS) diagnostic with eight radial channels has been implemented on a HuanLiu-2A (HL-2A) tokamak with a time resolution of up to 10 kHz monitoring helium II spectra or 1 kHz monitoring carbon VI spectra. The crucial aspects of the fast CXRS are to improve the spectral intensity and the acquisition frequency. The spectral intensity has been greatly enhanced by customized fiber bundles. The main boost in optimizing the acquisition frequency is achieved by binning more pixel rows of the charge coupled device (CCD) representing one radial channel and by reducing the effective image area of the CCD. Consequently, the sawtooth oscillations of ion temperature and rotation velocity are continuously observed for the first time in the HL-2A tokamak.