Volume reduction rate of radiofrequency ablation in ≤ 2 cm Bethesda IV thyroid nodules.

OBJECTIVE: This prospective observational study aimed to evaluate the efficacy of radiofrequency ablation (RFA) in treating ≤ 2 cm thyroid nodules with Bethesda IV cytology and C-TIRADS 4A categorization. Additionally, the factors influencing the completed absorption of ablation (CAA) were examined. METHODS: A total of 62 cases with 62 nodules underwent ultrasound-guided RFA and were included in the study. The volume reduction rate (VRR), CAA, and incomplete absorption of ablation (IAA) were assessed at the 1st, 3rd, 6th, and subsequent 6-month follow-ups. Clinical and ultrasound features were compared between the CAA and IAA groups at the 12th month follow-up. RESULTS: The average VRR at the 1st, 3rd, 6th, 12th month, and last follow-up were -88.6%, 16.0%, 59.7%, 82.0%, and 98.2%, respectively. More than half of the nodules achieved a 90% VRR after 1 year of RFA, with 88.7% demonstrating CAA at the end of the study (follow-up duration of 14 to 63 months). Nodules with grade 3 vascularity and those associated with chronic thyroiditis showed delayed CAA at the 12th month follow-up (p = 0.036 and 0.003, respectively). CONCLUSION: RFA is an effective technique for treating ≤ 2 cm thyroid nodules with Bethesda IV cytology and C-TIRADS 4A categorization. Nodules with grade 3 blood supply and patients with chronic thyroiditis exhibited an impact on the completed absorption following RFA. CLINICAL RELEVANCE STATEMENT: Our study has shown that radiofrequency ablation is an effective treatment for ≤ 2 cm thyroid nodules classified as Bethesda IV cytology. However, we identified that high vascularity of the nodule and chronic thyroiditis are adverse factors affecting the completed absorption of the ablation. KEY POINTS: •Radiofrequency ablation (RFA) is an effective technique for treatment of ≤ 2 cm Bethesda IV category thyroid nodules. •Higher blood supply and chronic thyroiditis influence the completed absorption after RFA.

Synthesis of Fluoromethylated Chromones and Their Heteroatom Analogues via Sodium Fluoromethanesulfinate-Enabled Direct Fluoromethylation.

An array of biologically interesting tri/difluoromethylated chromones and their heteroatom analogues were conveniently synthesized from the reaction of chromones and their heteroatom analogues with CF3SO2Na or HCF2SO2Na in the presence of tert-butyl hydroperoxide under mild conditions. A mechanistic pathway involving the generation of the electrophilic tri/difluoromethyl radical, followed with the radical substitution of chromones and their heteroatom analogues, was postulated.

DMSO/SOCl2-Enabled Synthesis of 3-Chloroindoles via Desulfonylative Chlorocyclization of N,N-Disubstituted 2-Alkynylanilines.

The application of the DMSO/SOCl2 system enabled the intramolecular cyclization/chlorination of N,N-disubstituted 2-alkynylanilines, leading to the synthesis of a series of 3-chloroindoles with moderate to good yields. Differing from the previously reported interrupted Pummerer reaction featuring the introduction of SMe moiety, the current approach adopted an alternative pathway that realized the incorporation of chlorine atom to the indole skeleton via a desulfonylative chlorocyclization process.

A metallic two-dimensional b-BS2 monolayer as a superior Na/K-ion battery anode.

Two-dimensional (2D) materials with light weight and ultra-high electrical conductivity are expected to exhibit high capacity as anodes of batteries. We have explored the curved square lattice BS2 (b-BS2) monolayer possessing a space group similar to the transition metal chloride (space group: P4̄M2). The electrochemical performance of the b-BS2 monolayer as the anode for various metal-ion batteries (Li, Na, K, Mg, Ca, and Al) has been investigated. It exhibits low diffusion energy barrier, high theoretical capacity, and low open circuit voltage for Na/K-ion batteries (SIBs/PIBs). The ultrahigh energy densities of 2146.08 and 715.36 mA h g-1 can be achieved with the stoichiometries BS2Na6 and BS2K2, respectively. Furthermore, the b-BS2 monolayer may be synthesized on the surfaces of metal substrate materials (Ag(111), Al(111), and Au(111)). These results indicate that the b-BS2 monolayer is a good candidate for the anode material of SIBs/PIBs.

Synthesis of 2-Fluoroalkylated Oxazoles from ß-Monosubstituted Enamines via Fluoroacyloxylation and Cyclization Mediated by Fluoroalkyl-Containing Hypervalent Iodine(III) Species Generated In Situ.

A metal-free synthesis of a series of fluoroalkyl-containing oxazoles from ß-monosubstituted enamines was developed. This fluoroacyloxylation/cyclization cascade process was mediated by fluoroalkyl-containing hypervalent iodine(III) species formed in situ from the reaction of phenyliodine(III) diacetate (PIDA) and RCF2CO2H (R = H, Cl, Br, F, CF3, CH3, Ph, SAr, OAr).

Serelaxin Inhibits Lipopolysaccharide-induced Inflammatory Response in Cardiac Fibroblasts by Activating Peroxisome Proliferator-activated Receptor-γ and Suppressing the Nuclear Factor-Kappa B Signaling Pathway.

ABSTRACT: Serelaxin (sRLX) has an inhibitory effect on fibrosis. However, whether the antifibrotic effects of sRLX are achieved by inhibiting the inflammatory response has not been clarified. This study aimed to investigate the role of sRLX in lipopolysaccharide (LPS)-induced inflammation in cardiac fibroblasts and elucidate the underlying mechanisms. Cardiac fibroblasts were isolated from adult rat hearts. The effect of sRLX on the inhibition of the inflammatory response after LPS induction was examined. Cell viability was measured by MMT assay. Cell proliferation was determined using the Cell Counting Kit-8. The levels of inflammatory cytokines IL-1ß, IL-6, TNF-α, and IL-10 were measured using an enzyme-linked immunosorbent assay. The mRNA levels of α-smooth muscle actin (α-SMA), collagen I/III, MMP-2, MMP-9, IL-1ß, IL-6, TNF-α, IL-10, IκBα, p-IκBα, p65 subunit of nuclear factor-kappa B (NF-κB), and peroxisome proliferator-activated receptor-γ (PPAR-γ) were assessed by real-time quantitative PCR. The protein levels of α-SMA, collagen I/III, MMP-2, MMP-9, IκBα, p-IκBα, p65, p-p65, and PPAR-γ were examined by western blotting. sRLX inhibited LPS-induced IL-1ß, IL-6, TNF-α, α-SMA, and collagen I/III, and elevated the expression of IL-10, MMP-2, and MMP-9. Moreover, LPS-induced activation of NF-κB pathway was suppressed by sRLX treatment. Further studies showed that sRLX did not significantly increase the expression of PPAR-γ mRNA and protein, but activated PPAR-γ activity, and the PPAR-γ inhibitor GW9662 reversed the inhibitory effect of sRLX on IL-1ß, IL-6, and TNF-α production. These results suggest that sRLX alleviates cardiac fibrosis by stimulating PPAR-γ through a ligand-independent mechanism that subsequently abolish the expression of NF-κB signaling pathway.

SCX-tip-aided LC-MS detection of active ricin via oligonucleotide substrates for depurination kinetics.

The accurate and sensitive detection of active biotoxin proteins and the determination of their kinetics are vital for the upsurge of chemical attacks but still limited. Herein, we report a liquid chromatography-tunable ultraviolet spectroscopic-quadrupole mass spectrometric detection (LC-TUV-QDa) method of active ricin. This method has the advantage of the accurate quantification of active ricin in decreased oligonucleotide (oligo) substrates as well as the produced adenine, in which the QDa detection offers the confirmative evidence of oligo and adenine products. We invented a strong cation exchange (SCX)-tip sample pretreatment way to facilitate the requirement of clean product injection without any fouling proteins. After full-method validation, a wide linear range of 1-5000 ng mL-1 was obtained with a high sensitivity of 1 ng mL-1 active ricin based on the most preferable deoxynucleobase-hybrid RNA (Rd) substrate, Rd12, and without any enrichment. We also fully depicted the kinetic parameters of ricin and its six Rd or RNA substrates and evaluated 11 nucleobase-modified oligos as substrates based on Rd12. Further, we fulfilled an improved molecular docking analysis and revealed that the binding of Rd12 to ricin was more likely to occur at pH 7.4 (typical in vitro and in vivo conditions) than at pH 4.0 (typical ex vitro conditions). With the aid of SCX-tip as a microenzymatic reactor, we can exert the catalytic activity of ricin as N-glycosidase in pH 7.4 toward its Rd12 substrate, with a comparable catalytic efficiency at pH 4.0. This is the first successful implementation of an ex vitro experiment toward oligo substrates at neutral pH, standing on the shoulder of plenty of previously reported efforts all performed under acidic conditions. This method will provide a new and powerful way to detect active ricin when tackling relevant problems in public safety and security.

B3S2 monolayer as an anode material for Na/K-ion batteries: a first-principles study.

Two-dimensional (2D) materials used as anodes in metal-ion batteries have attracted increased attention due to their high specific surface area, abundant active sites and good electronic properties. Searching for 2D materials with high storage capacities and low diffusion energy barriers is one of the most effective ways to design novel anode materials. In this work, based on first-principles calculations, we design a new 2D B3S2 monolayer with high thermodynamic and dynamic stability. The obtained B3S2 monolayer has a high cohesive energy, ensuring the feasibility of experimental synthesis. These characteristics of the B3S2 monolayer prompt us to explore its application as an anode material. The B3S2 monolayer exhibits not only a metallic nature but also a low diffusion energy barrier (0.037 eV) and open-circuit voltage (0.09 V). More importantly, the B3S2 monolayer shows a very high theoretical capacity of 1658 mA h g-1 as an anode material for sodium-ion batteries, which is comparable to other similar or common 2D materials. All of these intriguing properties make the B3S2 monolayer a promising 2D anode material for sodium-ion batteries.

Identification and functional analysis of isopentenyl pyrophosphate isomerase genes in the whiteflies Bemisia tabaci (Hemiptera: Aleyrodidae).

The juvenile hormone (JH) plays a vital role in the regulation of a number of physiological processes, including development, reproduction, and ovarian maturation. Isopentenyl pyrophosphate isomerase (IPPI) is a key enzyme in the biosynthetic pathway of JH. In this study, we identified an isopentenyl pyrophosphate isomerase protein from Bemisia tabaci and named it BtabIPPI. The open reading frame (ORF) of BtabIPPI is 768 bp and encodes a protein of 255 amino acids that contains a conserved domain of the Nudix family. The temporal and spatial expression profiles showed that BtabIPPI was highly expressed in the female adults.RNA interference (RNAi)-mediated silencing of BtabIPPI reduced JH titers and the relative expression of vitellogenin receptor (VgR) and JH signaling pathway genes, resulting in a dramatic reduction in fecundity and hatchability. These results indicate that the BtabIPPI gene plays an important role in the female fecundity of B. tabaci. This study will broaden our understanding of the function of IPPI in regulating insect reproduction and provide a theoretical basis for targeting IPPI for pest control in the future.

A TRIM-like protein restricts WSSV replication in the oriental river prawn, Macrobrachium nipponense.

Tripartite motif (TRIM) proteins are a multifunctional family of ubiquitin E3 ligases involved in multiple biological processes. Studies have shown that many TRIM proteins in mammals play vital roles in the host defense against viral pathogens. In the present study, we identified a novel TRIM gene (MnTrim-like) from the oriental river prawn, Macrobrachium nipponense. Predicted MnTrim-like protein contains the characteristic RING finger domain. MnTrim-like was abundantly distributed in hepatopancreas, intestine, stomach, and gills. Upon white spot syndrome virus (WSSV) challenge, transcripts of MnTrim-like in the stomach were significantly up-regulated. Knockdown of MnTrim-like increased the expression of VP28 and decreased the synthesis of several antimicrobial peptides, including two crustins and one anti-lipopolysaccharide factor. Besides, silencing of these three antimicrobial peptides (AMPs) led to an increase in the expression of VP28 and WSSV copies. Moreover, it was found that injection of recombinant MnTrim-like protein with WSSV could decrease the transcription of VP28 and the number of virus particles. These results suggest that this MnTrim-like may restrict WSSV infection by positively regulating the expression of AMPs with antiviral activities and directly interacting with viral components. This study will broaden our understanding about the function of TRIM in crustacean during viral infection.

Judicious design functionalized 3D-COF to enhance CO2 adsorption and separation.

The effects of functional groups (including OH, OCH3 , NH2 , CH2 NH2 , COOH, SO3 H, OCO(CH2 )2 COOH(E-COOH), and (CH2 )4 COOH(c-COOH)) in 3D covalent organic frameworks (3D-COFs) on CO2 adsorption and separation are investigated by grand canonical Monte Carlo (GCMC) simulations and density functional theory calculations. The results indicate that interaction between CO2 and the framework is the main factor for determining CO2 uptakes at low pressure, while pore size becomes the decisive factor at high pressure. The binding energy of CO2 with functionalized linker is correlated to CO2 uptake at 0.3 bar and 298 K on 3D-COF-1, suggesting functional groups play a key role in CO2 capture in microporous 3D-COFs. Moreover, CO2 selectivity over CH4 , N2 , and H2 can be significantly enhanced by functionalization, where CH2 NH2 , COOH, SO3 H, and E-COOH enhance CO2 adsorption more effectively at 1 bar. Among them, SO3 H is the most promising functional group in 3D-COFs for CO2 separation.

3D integrated wavelength demultiplexer based on a square-core fiber and dual-layer arrayed waveguide gratings.

We present a 3D integrated wavelength demultiplexer using a square-core fiber (SCF) and matched dual-layer arrayed waveguide gratings (AWGs). The SCF works as a 3D fiber multimode interference device, which splits the input light into symmetric four spots. The spots are then coupled to a pitch-matched 4-waveguide network, each connecting an AWG. Interface waveguides are designed to improve the coupling efficiency between the SCF and the dual-layer chip. The four AWGs are designed with different central wavelengths and a large free spectral range (FSR) of 120 nm. To reach a small and uniform insertion loss among different channels, only the central channels of each AWG are used for demultiplexing. The device is fabricated on a polymer platform. The upper and lower layers of the chip are fabricated using the same photolithography mask but rotated 180° so that 4 different AWG designs can be mapped to a single chip. The measured transmission spectra of the four AWGs cover a bandwidth of 112 nm. The insertion loss variation is smaller than 1.4 dB. The designed device can find applications in fiber optic sensing, communication, and astronomy.

First-principles study of borophene/phosphorene heterojunction as anode material for lithium-ion batteries.

It is urgent to explore high-capacity and efficient anode materials for rechargeable lithium-ion batteries. For borophene and phosphorene, two configurations are considered to form a heterojunction: twist angles of 0° (I) and 90° (II). There is a less degree of mismatch and larger formation energy in the formation of a B/P heterojunction, implying that borophene and phosphorene form the stable heterojunction. The heterojunctions of these two configurations demonstrate good conductivity, and the electrons near the Fermi level are mainly provided by borophene. Very importantly, the low energy barrier for interlayer migration of Li is observed in configuration I (0.14eV) and II (0.06 eV), and the migration of Li on the borophene and phosphorene side of the heterojunction still maintains its original energy barrier in bare monolayer. Moreover, the two configurations show the theoretical capacity as high as 738.69 and 721.86 mA h g-1, respectively, which is comparable to bare phosphorene. Furthermore, compared with bare phosphorene, the average voltage is greatly reduced after the formation of heterojunction. Hence, the overall electrochemical properties of the B/P heterojunction have been enhanced by combining the advantages of the individual phosphorene and borophene monolayers, which guarantees the B/P heterojunction as a good candidate for the anode material used in Li-ion batteries.

Increased expression of hypoxia inducible factor-1 alpha and vascular endothelial growth factor is associated with diabetic gastroparesis.

BACKGROUND: Gastroparesis is a recognized complication of diabetes but its pathogenic mechanism incompletely understood. Our aim was to determine whether HIF-1α and VEGF are secreted from gastric tissue is a fundamental factor that drives diabetic gastroparesis. METHODS: Diabetes was induced in Sprague-Dawley by a single intraperitoneal injection of 65 mg/kg streptozotocin. After 4 and 12 weeks, rats were euthanized for assaying body weight, blood glucose, gastric acid secretion and gastric emptying. Morphologic changes in gastric mucosa were observed by the light microscope. Expression of HIF-1α and VEGF were assessed using immunohistochemistry, RT-PCR and Western blot analyses. RESULTS: Compared with control group, blood glucose were significantly increased and body weight were markedly decreased in streptozotocin-induced diabetes. Gastric emptying was significantly decreased in diabetic rats compared to the control group at different times. The number of parietal cells was obviously decreased, and vacuolated degeneration in diabetic rats. Gastric acid secretion in diabetic group was significantly decreased, and expression of HIF-1α and VEGF were significantly increased in the diabetic group. CONCLUSION: These results indicated that overexpression of HIF-1α and VEGF in the gastric mucosa and played a pivotal role in the progression of diabetic gastroparesis.

Investigation of two-dimensional hf-based MXenes as the anode materials for li/na-ion batteries: A DFT study.

Density functional theory calculations are performed to investigate electronic properties and Li/Na storage capability of Hf3 C2 and its derivatives (uniform passivated: Hf3 C2 T2 [T = F, O, OH] and hybrid passivated: Hf3 C2 Fx O2-x and Hf3 C2 Ox (OH)2-x [x = 1.0, 1.5]). For Hf3 C2 monolayer, it has excellent performance, such as good conductivity, low diffusion energy barrier, low open circuit voltage, and high storage capacities (Li(1034.70 mAh g-1 ), Na(444.90 mAh g-1 )), providing the most prospective as anode material. However, due to the unsaturated dangling bonds of surface Hf, so it is easily passivated. For the uniform passivated ones, Hf3 C2 T2 , show higher diffusion barriers and lower storage capacities than bare monolayer Hf3 C2 . Nevertheless, compared with uniform passivated ones, the hybrid passivated derivative, Hf3 C2 F1.5 O0.5 and Hf3 C2 OOH possess a lower energy barrier and a better storage capacity. Therefore, Hf3 C2 F1.5 O0.5 and Hf3 C2 OOH are deemed to be a suitable candidate as anode electrode material for Li-ion batteries. © 2019 Wiley Periodicals, Inc.

[A modified method for spermatogonial cell sorting].

OBJECTIVE: To improve the method of sorting undifferentiated and differentiated spermatogonial cells by magnetic bead sorting with specific antibodies. METHODS: Using the magnetic bead sorting technique combined with Thy1 and c-Kit specific antibodies, we sorted Thy1+ and c-Kit+ cells in the testis of 7-postnatal-day male mice as undifferentiated and differentiated spermatogonia, respectively. We determined the purities of the two types of spermatogonial cells by immunofluorescence and flow cytometry, identified them via the differential expressions of Gfrα1, Plzf, c-Kit and Sohlh2 by real-time quantitative PCR, and cultured the Thy1+ cells primarily. RESULTS: The purities of the Thy1+ and c-kit+ cells were as high as (85.65 ± 8.35)% and (89.40 ± 2.77)%, respectively (P < 0.01). The relative expressions of the Gfrα1 and Plzf genes were 9.47 ± 1.29 and 4.40 ± 0.59 times higher in the Thy1+ than in the c-Kit+ cells, and those of the kit and sohlh2 genes 7.38 ± 1.07 and 3.88 ± 0.28 times lower in the former than in the latter (P < 0.01). After primary culture, the cells were seen in a normal state, proliferating smoothly with the characteristics of the proliferation of spermatogonial stem cells. CONCLUSIONS: The magnetic bead sorting technique with Thy1 and c-Kit specific antibodies can be used to effectively identify undifferentiated and differentiated spermatogonia and culture undifferentiated Thy1+ cells in vitro.

GP73 promotes epithelial-mesenchymal transition and invasion partly by activating TGF-ß1/Smad2 signaling in hepatocellular carcinoma.

The transforming growth factor-ß1 (TGF-ß1) signaling pathways contribute to cell metastasis and epithelial-mesenchymal transition (EMT). Golgi protein 73 (GP73), a type II transmembrane protein in the Golgi apparatus, was initially regarded as a potential biomarker for the diagnosis of hepatocellular carcinoma (HCC). Recently, it was reported that GP73 acts as a key oncogene by promoting HCC growth and metastasis. However, the role of GP73 in metastasis, especially when involving signaling pathways, is uncertain. Here, we report that GP73, which is upregulated in HCC tissues and cell lines, is associated with tumor size, tumor node metastasis stage, distant metastasis and vascular invasion. The ectopic overexpression of GP73 increased HCC cell invasion, EMT and metastasis both in vitro and in vivo. Conversely, GP73 knockdown inhibited invasion and EMT. Moreover, GP73 enhanced p-Smad2 and p-Smad3 levels by mediating TGF-ß1, thus leading to the promotion of EMT and invasion in HCC cells. In contrast, we used SB431542 (SB) to repress p-Smad2 and p-Smad3 expression, which resulted in a reversion of EMT. Furthermore, when the TGF-ß1/Smad pathway was blocked, upregulation of GP73 still caused an enhanced EMT and invasion, and downregulation of GP73 resulted in a decreased in EMT and invasion. In clinical HCC samples, GP73 positively correlated with TGF-ß1/Smad2, which was upregulated in HCC. Taken together, our findings highlight the important role of GP73 in regulating EMT and metastasis in HCC partly by targeting TGF-ß1/Smad2 signaling, suggesting that GP73 may represent a novel potential therapeutic target and prognostic marker for the treatment and diagnosis of HCC.

Bifunctional Separator Coated with Hexachlorocyclotriphosphazene/Reduced Graphene Oxide for Enhanced Performance of Lithium-Sulfur Batteries.

Although extensive research has been performed in the field of Li-S rechargeable batteries, commercial applications are still hindered by the dissolution of the reaction intermediates of lithium polysulfides (LiPSs). Through the combination of experimental and theoretical results, a bifunctional separator has been designed by coating hexachlorocyclotriphosphazene (HCCP)-decorated reduced graphene oxide (rGO), which provides effective anchor sites for immobilizing the LiPSs. LiPSs can be adsorbed on the HCCP/rGO surface with moderate binding strength, and their structures and the electrical conductivity of HCCP/rGO are well maintained. The synergetic effect of the effective barrier and good electrical conductivity within the HCCP/rGO sheets efficiently anchors LiPSs and achieves enhanced electrochemical performance. More importantly, different substituents can be used to tune the immobilization of LiPSs by HCCP derivatives. Therefore, it is expected that HCCP and its derivatives can be utilized as a promising anchoring material for high-performance Li-S batteries.

Elevated soluble CD23 level indicates increased risk of B cell non-Hodgkin's lymphomas: evidence from a meta-analysis.

The aim of the present study was to determine whether circulating soluble CD23 (sCD23) was associated with B cells non-Hodgkin's lymphomas (B-NHL). PubMed, EMBASE, and ISI Web of Science were extensively searched without language restriction. Data was extracted in a standardized data collection sheet after two reviewers scanned studies independently. The association between sCD23 and NHL was indicated as odds ratio (OR) along with its related 95% confidence interval (95% CI). Meta-analysis was conducted via RevMan 5.3. A total of five studies, which included 964 B-NHL patients and 1243 matched controls without B-NHL, among which 257 were HIV-positive donors and 986 were general controls, were included in our study. Meta-analysis revealed a significant association between peripheral sCD23 level and B-NHL in HIV-positive samples (OR 1.66, 95% CI 1.25, 2.20; P = 0.0005) as well as the general population (OR 2.51; 95% CI 1.71, 3.86; P < 0.00001). Meta-analysis, stratified by sampling time prior to diagnosis, indicated potential HIV-NHL patients are 2.34-folds more likely to have higher blood sCD23 level, although this association is statistically meaningful only during 3-5 years prior to diagnosis (95% CI 1.27, 4.33). Subgroup analysis based on B-NHL type demonstrated a significant association between sCD23 level and diffuse large B cell lymphoma (DLBCL), chronic lymphocytic leukemia (CLL), and follicular lymphoma (FL). The findings of our study indicate a positive association of circulating sCD23 level and B-NHL risks and highlight the possibility of sCD23 as a predictive marker of B-NHL. However, to better understand the underlying mechanism, further studies are needed.

Monetary incentives for provision of syphilis screening, Yunnan, China.

PROBLEM: Early detection of syphilis-infected people followed by effective treatment is essential for syphilis prevention and control. APPROACH: Starting in 2010 the local health authority in Yunnan province, China, developed a network of 670 service sites for syphilis testing, diagnosis and treatment or for testing-only with referral for further diagnosis and treatment. Point-of-care tests for syphilis and syphilis interventions were integrated into the existing human immunodeficiency virus (HIV) prevention and control programme. To improve the syphilis services, a pay-for-performance scheme was introduced in which providers were paid for testing and treating patients. LOCAL SETTING: Yunnan province is the region hardest hit by HIV infection and disproportionately burdened with syphilis cases in China. RELEVANT CHANGES: The proportion of attendees at voluntary counselling and testing clinics who were tested for syphilis increased from 46.2% (32 877/71 162) in 2010 to 98.2% (68 012/69 259) in 2015. Syphilis-infected cases treated with the recommended therapy increased from 26.6% (264/993) in 2010 to 82.5% (453/549) in 2015 at designated testing, diagnosis and treatment sites. LESSONS LEARNT: The strategy greatly increased the uptake of syphilis testing and treatment among people at risk. Introduction of point-of-care tests for syphilis increased coverage of the testing services. Introduction of a pay-for-performance scheme seemed to motivate health-care providers to undertake syphilis intervention services.