[Clinical significance of IL-18 and IL-18-binding protein in bone marrow of patients with myelodysplastic syndrome].

Objective: To analyze the level and clinical significance of IL-18 and IL-18-binding protein (BP) in the bone marrow of patients with myelodysplastic syndrome (MDS) . Methods: A total of 43 newly diagnosed patients with MDS who were admitted to the Department of Hematology, Tianjin Medical University General Hospital, from July 2020 to February 2021 were randomly selected. The control group consisted of 14 patients with acute myeloid leukemia (AML) and 25 patients with iron-deficiency anemia (IDA). The levels of IL-18 and IL-18 BP in the bone marrow supernatant were measured, and their correlations with MDS severity, as well as the functionality of CD8(+) T cells and natural killer cells, was analyzed. Results: The levels of IL-18, IL-18 BP, and free IL-18 (fIL-18) in the bone marrow supernatant of patients with MDS were higher than in the IDA group. The level of fIL-18 was linearly and negatively correlated with the MDS-International Prognostic Scoring System (IPSS) score. IL-18 receptor (IL-18Rα) expression on CD8(+) T cells in the MDS group was lower than in the IDA group, and the levels of fIL-18 and IL-18Rα were positively correlated with CD8(+) T-cell function in the MDS group. Conclusion: IL-18 BP antagonizes IL-18, leading to a decrease in fIL-18 in the bone marrow microenvironment of patients with MDS, affecting CD8(+) T-cell function, which is closely related to MDS severity; therefore, it may become a new target for MDS treatment.

[Safety evaluation of simultaneous administration of quadrivalent influenza split virion vaccine and 23-valent pneumococcal polysaccharide vaccine in adults aged 60 years and older].

Objective: To evaluate the safety of simultaneous administration of quadrivalent influenza split virion vaccine and 23-valent pneumococcal polysaccharide vaccine in adults aged 60 years and older. Methods: From November 2021 to May 2022, eligible participants aged 60 years and older were recruited in Taizhou City, Jiangsu Province, China, and a total of 2 461 participants were ultimately enrolled in this study. Each participant simultaneously received one dose of quadrivalent influenza split virion vaccine and one dose of 23-valent pneumococcal polysaccharide vaccine. The safety was observed within 28 days after vaccination. Safety information was collected through voluntary reporting and regular follow-ups. Results: All 2 461 participants completed the simultaneous administration of both vaccines and the safety follow-ups for 28 days after vaccination. The mean age of the participants was (70.66±6.18) years, with 54.61% (1 344) being male, and all participants were Han Chinese residents. About 22.51% (554) of the participants had underlying medical conditions. The overall incidence of adverse reactions within 0-28 days after simultaneous vaccination was 2.07% (51/2 461), mainly consisting of Grade 1 adverse reactions [1.83% (45/2 461)], with no reports of Grade 4 or higher adverse reactions or vaccine-related serious adverse events. The incidence of local adverse reactions was 0.98% (24/2 461), primarily presenting as pain at the injection site [0.93% (23/2 461)]. The incidence of systemic adverse reactions was 1.42% (35/2 461), with fever [0.85% (21/2 461)] being the main symptom. In the group with underlying medical conditions and the healthy group, their overall incidence of adverse reactions was 2.53% (14/554) and 1.94% (37/1 907), respectively. The incidence of local adverse reactions in the two groups was 1.62% (9/554) and 0.79% (15/1 907), respectively, and the incidence of systemic adverse reactions was 1.44% (8/554) and 1.42% (27/1 907), respectively, with no statistically significant differences between them (all P>0.05). Conclusion: It is safe for adults aged 60 years and older to receive quadrivalent influenza split virion vaccine and 23-valent pneumococcal polysaccharide vaccine at the same time.

Radiomics nomogram integrating intratumoural and peritumoural features to predict lymph node metastasis and prognosis in clinical stage IA non-small cell lung cancer: a two-centre study.

AIM: To investigate the value of a radiomics nomogram integrating intratumoural and peritumoural features in predicting lymph node metastasis and overall survival (OS) in patients with clinical stage IA non-small-cell lung cancer (NSCLC). MATERIALS AND METHODS: This study retrospectively enrolled 199 patients (training cohort: 71 patients from Affiliated Tumour Hospital of Nantong University; internal validation cohort: 46 patients from Affiliated Tumour Hospital of Nantong University; external validation cohort: 82 patients from the public database). CT radiomics models were constructed based on four volumes of interest: gross tumour volume (GTV), gross and 3 mm peritumoural volume (GPTV3), gross and 6 mm peritumoural volume (GPTV6), and gross and 9 mm peritumoural volume (GPTV9). The optimal radiomics signature was further combined with independent clinical predictors to develop a nomogram. Univariable and multivariable Cox regression analysis were applied to determine the relationship between factors and OS. RESULTS: GPTV6 radiomics yielded better performance than GTV, GPTV3, and, GPTV9 radiomics in the training (area under the curve [AUC], 0.81), internal validation (AUC, 0.79), and external validation cohorts (AUC, 0.71), respectively. The nomogram integrating GPTV6 radiomics and spiculation improved predictive ability, with AUCs of 0.85, 0.80, and 0.74 in three cohorts, respectively. Pathological lymph node metastasis, nomogram-predicted lymph node metastasis, and pleural indentation were independent risk predictors of OS (p<0.05). CONCLUSIONS: The nomogram integrating GPTV6 radiomics features and independent clinical predictors performed well in predicting lymph node metastasis and prognosis in patients with clinical stage IA NSCLC.

[Bioinformatics analysis of primary biliary cholangitis key genes and molecular mechanisms].

Objective: To extract the differentially expressed key genes of primary biliary cholangitis (PBC) using bioinformatics methods, so as to provide information for further study into the mechanism. Methods: The GSE119600 dataset was downloaded from the GEO database to obtain differentially expressed genes. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were performed for differentially expressed genes. Protein-protein interaction (PPI) network reconstruction, Cytoscape software visualization, and core gene screening were performed. The area under the receiver operating characteristic curve (ROC AUC) was used to assess the diagnostic effectiveness of genes and plot the pROC software package. The x-Cell software was used to calculate the enrichment score of 34 immune cells in each sample. Finally, four key genes (PSMA4, PSMA1, PSMB1, and PSMA3) were selected. Blood samples were analyzed using the qPCR method. Results:: A total of 373 immune-related differentially expressed genes were identified. Eight genes (PSMC6, PSMB2, PSMB1, PSMA3, PSMA4, PSMA1, PSMD7, and PSMB5) were screened from the 178 nodes and 596 edges as hub genes of the PPI network, which were significantly related to amino acid metabolism, hematopoietic stem cell differentiation, cell cycle, and immune processes. PSMA4, PSMA1, PSMB1, and PSMA3 were defined as immunological biomarkers for PBC with an AUC value of the ROC curve > 0.7. Immunoinfiltrating cell analysis showed that the proportion of eosinophils was significantly higher in PBC patients compared to the control group, whereas the proportion of CD4+ memory T cells, plasma cells, Th2 cells, and cDC cells was significantly lower in PBC patients than the control group. Plasma cells were associated with all four immunological biomarkers. Seven PBC patients and seven healthy subjects were selected for peripheral blood qPCR validation, which demonstrates that PSMB1, PSMA3, PSMA1, and PSMA4 levels were significantly lower in PBC patients than healthy subjects, with a statistically significant difference. Conclusion:: Bioinformatics screened eight key genes, of which four were key immunological markers and may serve as a basis for clinical diagnosis and mechanism exploration.

[Human chorionic gonadotropin-secreting gonadoblastomas in a girl of 45, X Turner syndrome: a case report and literature review].

Objective: To summarize the experience in diagnosis and treatment of 45, X Turner syndrome (TS) with gonadal Y chromosome mosaicism and bilateral gonadoblastoma (Gb) secreting human chorionic gonadotrophin(HCG). Methods: A female patient aged 5 years and 3 months was admitted to the hospital with a complaint of "enlarged breasts for 27 months, and elevated blood ß-HCG for 8 months". The clinical data were summarized, and related literature up to March 2022 with the key words"Turner syndrome" "Gonadoblastoma" "Y chromosome" "human chorionic gonadotropin" "precocious" in PubMed, CNKI and Wanfang databases were reviewed. Results: The girl went to the local hospital for 2-month breast development at age of 3 years, and was found with a heart murmur diagnosed with "pulmonary venous malformation and atrial septal defect (secondary foramen type)". Surgical correction was performed. She experienced the progressive breast development, rapid linear growth and markedly advanced skeletal age, which cannot be explained by partial activation in the hypothalamic-pituitary-gonadal axis determined at the age of 3 years and 7 months in local hospital. Then whole-exome sequencing revealed chromosome number abnormality 45, X, which was confirmed by Karyotyping. At the age of 4 years and 6 months, serum ß-HCG was found to be elevated (24.9 U/L) with no lesion found at the local hospital. On physical examination, she was found with breast development, pubic hair development and clitoromegaly with elevated serum testosterone (1.96 µg/L) and ß-HCG (32.3 U/L). Sex determining region Y(SRY) gene was negative in peripheral blood sample. Thoracic and abdominal CT, head and pelvic magnetic resonance imaging were normal. Exploratory laparotomy confirmed the presence of a left adnexal tumor and a right fibrous streak gonad. During surgery, simultaneous samples of bilateral gonadal and peripheral venous blood were obtained and serum ß-HCG, estradiol and testosteron concentrations was higher to lower from left gonadal venous blood, right gonadal venous blood, to peripheral venous blood. Bilateral gonadectomy was performed. Histopathology revealed bilateral gonadoblastomas. SRY was positive in bilateral gonadal tissues. After surgery, serum E2, testerone and ß-HCG returned to normal. So far 4 cases of HCG-secreting gonadoblastoma had been reported worldwide. The phenotypes of the 4 cases were all female, with virilization or amenorrhea, and the preoperative peripheral blood ß-HCG concentrations were 74.4, 5.0, 40 456.0, and 42.4 U/L, respectively. Conclusions: There is a high risk of Gb in TS with Y chromosome components. Gb is infrequently presented with breast development, and Gb associated with HCG secretion is rare. Karyotyping should be performed in a phenotypic female with masculinization, and virilization in TS indicates the presence of Y chromosome material with concurrent androgen secreting tumors.

[Application of locating supratrochlear artery and supraorbital artery in combined transfrontal and intranasal endoscopic approaches].

Objective: To investigate the localization methods of supratrochlear artery (STA) and supraorbital artery (SOA), and to explore the clinical benefit of locating nerve via accompanying vascular localization in combined transfrontal and intranasal endoscopic approaches. Methods: From June 2019 to May 2021, 14 patients, including 11 males and 3 females, aging from 18 to 69 years old, were underwent frontal sinus surgery through the combined transfrontal and intranasal endoscopic approaches in the Department of Otorhinolaryngology Head and Neck Surgery of the Third Affiliated Hospital of Sun Yat-sen University. Before the surgery, localization of STA and SOA was determined by color doppler flow imaging (CDFI), computerized topographic angiography (CTA) and contrast enhanced magnetic resonance angiography (CE-MRA) respectively, and the distances between STA and SOA from facial midline were measured on 28 eyebrows. The position of external incision was determined according to the preoperative localization of STA and SOA. The examination time, cost and postoperative complications of the three methods were recorded. The accuracy of localization at 14 sides was verified by the surgery. GraphPad Prism 8.3 software was used for statistical analysis. Results: STA and SOA could be located by CDFI, CTA and CE-MRA. There was no significant difference in the measurement of the distance between STA and SOA from the facial midline among 3 methods (all P>0.05). Determining the position of external incision according to the localization of STA and SOA could protect both the blood vessels and accompanying nerves. No postoperative complications such as numbness of the forehead skin occurred. The measurement time of CDFI, CTA and CE-MRA was 22.50 (15.75, 30.00), 30.00 (28.00, 34.25) and 48.00 (44.00, 52.75) min (M (Q1, Q3)), respectively (all P<0.05). CDFI incurred the lowest costs and took the shortest time. Conclusions: CDFI is an efficient and economic localization method. The localization of STA and SOA facilitates the precise selection of the position of external incision, protects the accompanying nerve and reduces postoperative complications.

[Epidemiological characteristics of severe fever with thtrombocytopenia syndrome in China, 2011-2021].

Objective: To analyze the epidemiological characteristics of severe fever with thrombocytopenia syndrome (SFTS) in China from 2011 to 2021, and provide evidence for the prevention and control of SFTS. Methods: The incidence data of SFTS were collected from the National Disease Reporting Information System of Chinese Center for Disease Control and Prevention for a descriptive epidemiological analysis and Cochran-Armitage trend test was used to evaluate the association between age and the morbidity rate and case fatality rate (CFR) of SFTS. Results: From 2011 to 2021, a total of 18 902 laboratory confirmed cases of SFTS, including 966 deaths, were reported in 533 counties (districts) of 154 prefecture-level cities in 27 provinces. The annual average morbidity rate was 0.125/100 000, and the annual average CFR was 5.11%. From 2011 to 2021 the overall morbidity rate of SFTS was in increase with an average annual percentage change (AAPC) of 14.80% (P=0.001). Most cases (99.23%) occurred in 7 provinces, including Shandong, Henan, Anhui, Hubei, Liaoning, Zhejiang and Jiangsu, with 70.28% of the cases in 11 prefecture-level cities. The average annual CFRs in the 7 provinces varied greatly from 1.30% to 11.27%. In 2011, SFTS cases were reported in 108 counties (districts) of 51 prefecture-level cities in 13 provinces, but SFTS cases were reported in 277 counties (districts) of 88 prefecture-level cities in 19 provinces in 2021, the disease spread from central area to the northeast and from the west and the south. SFTS mainly occurred in summer and autumn in both southern and northern China, and 96.63% of the cases were reported from April to October, and the incidence peak was during May-June. The cases mainly occurred in age group 50-74 years (69.46%), and the deaths mainly occurred in age group ≥60 years (79.71%). Both the morbidity rate and the CFR increased with age. The morbidity rate increased from 0.040/100 000 in age group 0-4 years to 4.480/100 000 in age group ≥80 years in males (χ²=13 185.21, P<0.001) and from 0.038/100 000 in age group 0-4 years to 3.318/100 000 in age group ≥80 years in females (χ²=12 939.83, P<0.001); the CFR increased from 0.70% in age group 30-34 years to 11.58% in age group ≥80 years in males (χ²=115.70, P<0.001) and from 1.56% in age group 35-39 years to 8.98% in age group ≥80 years in females (χ²=103.42, P<0.001). Conclusion: From 2011 to 2021, the incidence of SFTS increased in China, and the spread and obvious spatiotemporal distribution of SFTS were observed. The reported CFR varied greatly with area, and both the morbidity and mortality risk were high in the elderly.

[Time distribution of positive nucleic acid detection in imported cases infected with SARS-CoV-2 in China].

Objective: To analyze the time distribution of the first positive nucleic acid detection in imported cases infected with SARS-CoV-2 reported nationwide in China and provide references for further improvement of the prevention and control of COVID-19 in international travelers. Methods: The data of imported cases infected with SARS-CoV-2 reported by provinces from 24 July 2020 and 23 July 2021 were collected for the analysis on the time distribution of the first positive nucleic acid detection after entering China. Results: A total of 7 199 imported cases infected with SARS-CoV-2 were reported in 28 provinces during 24 July 2020 to 23 July 2021. The median interval (Q1, Q3) from the entry to the first positive nucleic acid detection of SARS-CoV-2 was 1 (0, 5) day. The imported cases who had the first positive nucleic acid detections within 14 days and 14 days later after the entry accounted for 95.15% (6 850/7 199) and 4.85% (349/7 199) respectively. Among these cases, 3.65% (263/7 199), 0.88% (63/7 199) and 0.32% (23/7 199) had the first positive nucleic acid detections within 15-21 days, 22-28 days and 28 days later after the entry respectively. The proportion of asymptomatic infections were 47.24% (3 236/6 850) and 63.61% (222/349) among the cases who had the first positive nucleic acid detections within 14 days and 14 days later after the entry respectively. A total of 39.54% (138/349) of cases infected with SARS-CoV-2 with the first positive nucleic acid detections 14 days later after the entry had inter-provincial travel after the discharge of entry point isolation. Conclusions: About 5% of the imported cases infected with SARS-CoV-2 were first positive 14 days later after the entry. In order to effectively reduce the risk of domestic COVID-19 secondary outbreaks caused by imported cases, it is suggested to add a nucleic acid test on 8th -13th day after the entry.

[Effect factors of collateral blood supply of patients with early trimester cesarean scar pregnancy].

Objective: To investigate the characteristics and effect factors of collateral blood supply of patients with early trimester cesarean scar pregnancy(CSP). Methods: This study was a multicenter case-control study, with 219 inpatients with CSP in First People's Hospital of Zhengzhou, Zhengzhou Central Hospital, Third People's Hospital of Zhengzhou and Henan No3 Provincial People's Hospital from January 1, 2017 to June 30, 2020 who were selected to obtain their clinical data. Double-blind method was performed in digital subtraction angiography imaging analysis. The patients were divided into collateral blood supply group and non-collateral blood supply group, and the incidence of collateral blood supply of patients with early trimester CSP was calculated. Multivariate binary logistic regression analysis was performed to find the independent risk factors of collateral blood supply of patients with early trimester CSP. As well, clinical outcomes after uterine artery embolization (UAE) were compared between the two groups. Results: A total of 219 patients with early trimester CSP have average age of (32.4±5.0) years old and average pregnancy of (51.0±10.6) days. The incidence of collateral blood supply was 12.3% (27 cases), of which16 cases were on the left, 6 on the right and 5 in both sides. A total of 43 collateral vessels were found, with 1.59 vessels per patient on average. Bladder artery was the most common source of collateral blood supply, accounting for 74.4% (32/43), followed by internal pudendal artery for 18.6% (8/43). Multivariate binary logistic regression analysis showed that gestational weeks ≥8 weeks, maximum diameter of gestational sac ≥50 mm and rich blood supply of gestational sac are independent risk factors for collateral blood supply of patients with early trimester CSP, with OR (95%CI) 3.68 (1.06-12.76), 7.00 (1.52-32.19)、9.96 (3.59-27.58), respectively, all P<0.05. The success rates of UAE were 100% in both groups. The reduction in serum ß-Human chorionic gonadotropin (ß-HCG) level at 24 hours after UAE, vaginal bleeding during uterine curettage, hysterectomy and menstrual recovery time were not found to have significant difference between groups (all P>0.05). Conclusions: Early trimester CSP leads to a certain occurrence of collateral blood supply, which may have adverse impact on the efficacy of UAE and patient safety. Gestational weeks, the maximum diameter of gestational sac and the degree of vascularization of gestation sac have certain value in suggesting the collateral blood supply of patients with early trimester CSP, which is helpful for the complete embolization of gestational sac in the process of UAE.

[Distribution and infectious characteristics of re-positive cases infected with SARS-CoV-2].

Domestic and foreign literatures related to the persistence of SARS-CoV-2 and the re-positive cases infected with SARS-CoV-2 were reviewed, and the characteristics and infectivity of the re-positive cases were analyzed to provide scientific evidence for the improvement of case management and the development of measures to stop the spread of SARS-CoV-2. Existing studies have shown that re-positive rate of SARS-CoV-2 ranged from 2.4% to 19.8%, the median of interval between re-positive detection and discharge was 4-15 days. Following the second course of the disease, the anti-SARS-CoV-2 IgM, IgG and IgA positive rates of the cases were 11.11%-86.08%, 52.00%-100.00% and 61.54%-100.00% respectively, the total antibody and neutralizing antibody positive rates were 98.72% and 88.46%. The viral load of the re-positive cases was lower than that in the initial infection. At least 3 380 re-positive cases have been reported globally. SARS-CoV-2 strains were isolated from the samples of 3 re-positive cases (1 immunodeficiency case and 2 cases with abnormal pulmonary imaging). There were close contacts that were infected by an asymptomatic case taking immunosuppressive agents. In conclusion, the infectivity of re-positive cases infected with SARS-CoV-2 is generally very low. Rare re-positive cases infected with SARS-CoV-2 might cause further transmission. The management approach for the re-positive cases can be based on the assessment of the individual transmission risk according to the pathogen detection results.

[Impact of trigger timing of gonadotropin-releasing hormone antagonist regimen for infertility patients of various ages].

Objective: To investigate the impact of trigger timing of gonadotropin- releasing hormone (GnRH) antagonist regimen for infertility patients of various ages. Methods: This was a retrospective study, 1 529 infertility patients who receiving GnRH antagonist regimen in Chongqing Health Center for Women and Children from January 2017 to December 2018 were divided into the advance trigger group and the standard trigger group, and further divided into three subgroups according to age:<35 years, 35-40 years,>40 years. The number of retrieved oocytes and transplantable embryos, the clinical pregnancy rate and the live birth rate among patients in the advance trigger group and standard trigger group in various age subgroups were compared. Results: (1) The gonadotropin (Gn) days among the three age subgroups were significantly shorter in the advance trigger group compared to the same-aged standard trigger group (all P<0.01), but only in the 35－40 years and >40 years subgroups, the Gn doses in the advance trigger group [(2 702±551) and (2 780±561) U] were significantly less than those in the standard trigger group (all P<0.01). In the <35 years subgroup, the number of oocytes retrieved and transplantable embryos of the advance trigger group (6.6±4.8 and 2.6±2.7) were significantly less than those of the standard trigger group (all P<0.01), but there was no difference in the number of top-quality embryos (P=0.580); however, in the 35－40 years and >40 years subgroups, there were no significant differences between advance and standard trigger groups in terms of the afore mentioned 3 indicators (all P>0.05), only the numbers of top-quality embryos in the advance trigger group (0.6±1.0 and 0.6±0.9) were significantly higher than those in the standard trigger group (all P<0.01). (2) In the <35 years and 35－40 years subgroups, no significant differences were noted between the advance trigger group and standard trigger group with regard to the clinical pregnancy rate and live birth rate (all P>0.05); but in the >40 years subgroup, the clinical pregnancy rate of the advance trigger group was significantly higher than that of the standard trigger group [33.0% (30/91) vs 19.2% (25/130), P=0.020], and there was no statistical difference in the live birth rate (P=0.064). (3) Multivariate logistic regression analysis showed that trigger timing was an independent predictor of clinical pregnancy rate in the >40 years subgroup (OR=0.334, 95%CI: 0.119-0.937, P=0.037), but not an independent predictor of live birth rate (P>0.05). Conclusions: Advance trigger in the GnRH antagonist protocol for infertility patients >40 years old could effectively reduce Gn times and Gn dosage, increase the number of top-quality embryos, and improve the clinical pregnancy rate. Therefore, compared with patients ≤40 years of age, patients >40 years might benefit more from advance trigger.

[Study on the safety and clinical efficacy of osteotomy after halo pelvic traction in severe scoliosis accompanied with split cord malformation].

Objective: To investigate the safety and clinical efficacy of osteotomy after halo pelvic traction in severe scoliosis accompanied with split cord malformation. Methods: The clinical data of 14 patients with severe scoliosis accompanied with split cord malformation admitted to the Department of Spinal Surgery, Guizhou Orthopedic Hospital from August 2015 to August 2019 were retrospectively analyzed.There were 6 males and 8 females, aged (19.8±5.0) years (range:13 to 34 years). All patients received spinal orthopedic surgery after halo pelvic traction for 3 to 7 weeks.The data of traction time, height, Cobb angle in the main curved coronal plane and sagittal plane, lung function and nutritional status of the patient were collected before and after the treatment. Paired t test was used to compare the evaluation indexes. Results: The traction time of the 14 patients was (35.2±8.3)days (range:20 to 49 days), and the height of them increased from (156.7±7.6)cm (range:141 to 166 cm) before traction to (167.0±6.4)cm (range:154 to 177 cm) after traction（t=-10.49，P<0.01）. The Cobb angle on the main curved coronal plane decreased from (117.4±17.2) ° (range: 91°to 176°) before traction to (56.4±8.1) ° (range:44°to 68°) after traction（t=13.90，P<0.01）. The sagittal Cobb angle decreased from (92.5±11.6) ° (range:62°to 132°) before traction to (41.7±7.7) °(range:29°to 51°) after traction（t=12.11，P<0.01）. No complications such as loosening of nailing and infection occurred during traction, and no decrease of nerve function occurred. Nine patients underwent single segment acromial transpedicle osteotomy and five underwent double segment adjacent asymmetric shortening osteotomy. None of the patients underwent longitudinal fracture resection. The lung function and nutritional status were improved after traction and surgery(all P<0.01). Postoperative follow-up was (22.5±9.1)months (range:12 to 36 months). At the last follow-up, the coronal Cobb angle was (56.3±7.1) °, and the sagittal Cobb angle was (37.7±6.5) °, showing no statistically significant difference from the angle after traction(t=0.16,P=0.88; t=2.28,P=0.32). There was no loss of orthopedic angle. None of the patients had internal fixation displacement, loosening or fracture. Conclusion: The treatment of severe scoliosis with accompanied with split cord malformation by halo pelvic traction is safe and effective, which is worthy of further confirmation by large sample study.

[Spatial-temporal analysis on imported dengue fever in six provinces of China, 2016-2018].

Objective: To explore the spatio-temporal patterns and epidemic characteristics of imported dengue fever cases in six provinces (Yunnan, Guangxi, Guangdong, Hainan, Fujian and Zhejiang) of China from 2016 to 2018. Methods: In this study, we collected the surveillance data of imported dengue fever cases from 2016 to 2018 in six southern provinces of China. The risk intensity, spatio-temporal distribution and epidemiological characteristics of imported dengue fever cases in the six provinces were analyzed from the perspective of space, time and population. Results: Among the imported cases of dengue fever in China from other countries in the world, most of them were from Southeast Asia. In Zhejiang, Fujian and Guangdong provinces, there were greater number of imported cases with wide range of sources. While in Yunnan, Guangxi and Hainan provinces, the imported cases were almost from Southeast Asia. The incidence of imported dengue fever increased during the past three years, and the annual incidence peak was during August-November, but slight differences were observed among provinces. The age of the imported cases in Hainan[(37.0±19.6) years] was higher than that in southeastern coastal provinces[(36.0±11.7) years] and in southwestern provinces[(32.0±16.3) years]. The male-female ratio of the cases in southeastern coastal provinces (2.18∶1) were higher than those in southwestern provinces (1.04∶1) and Hainan (1.38∶1). The occupations of the cases were mainly workers and unemployed people in southeastern coastal provinces and farmers in southwestern provinces, but commercial personnel was the population with high incidence in both southeastern and southwestern provinces. Less imported dengue fever cases were reported in Hainan, the population distribution varied. Conclusions: There were differences in incidence pattern of imported dengue fever between southeastern coastal provinces and southwestern provinces as well as Hainan in China. Different prevention and control measures should be carried out in different areas to implement more precise prevention strategies.

[Epidemiological characteristics of dengue fever outbreaks in China, 2015-2018].

Objective: To analyze the epidemiological characteristics of outbreaks of dengue fever in China from 2015 to 2018, and provide evidence for the prevention and control of dengue fever. Methods: We extracted the incidence data of dengue fever from China Disease Prevention and Control Information System, Public Health Emergency Reporting Management Information System and Vector Biological Monitoring System, and explored the epidemiological characteristics of the outbreaks in the past four years. Excel 2010 software and SPSS 20.0 software were used for data processing and analysis, ArcGIS 10.5 software was used for mapping. Results: A total of 111 outbreaks of dengue fever were reported nationwide from 2015 to 2018, involving 12 490 cases, accounting for 73.7% of the total cases in China. These outbreaks occurred in 85 counties and districts of 4 provinces, namely Guangdong (77 outbreaks), Yunnan (14 outbreaks), Zhejiang (8 outbreaks) and Fujian (8 outbreaks). The outbreaks occurred during May-November. Small-scale outbreaks with no more than 10 cases ended within 30 days (28/34, 82.4%) and larger-scale outbreaks lasted for several months. Dengue virus type 1 and type 2 were the main epidemic pathogens of dengue fever outbreaks in China. The outbreaks mainly occurred in areas with high population density and poor sanitary environment. There were significant differences in the age and occupational composition of the cases in the main outbreak provinces. Conclusions: Outbreaks of dengue fever can been seen in more areas in China, even in high latitudes areas. The epidemiologic characteristics of the outbreaks were different among provinces, showing as port type, rural type and urban type. Each province should adjust the control strategies accordingly.

[Early containment strategies and core measures for prevention and control of novel coronavirus pneumonia in China].

In December 2019, novel coronavirus pneumonia epidemic occurred in Wuhan, Hubei Province, and spread rapidly across the country. In the early stages of the epidemic, China adopted the containment strategy and implemented a series of core measures around this strategic point, including social mobilization, strengthening case isolation and close contacts tracking management, blocking epidemic areas and traffic control to reduce personnel movements and increase social distance, environmental measures and personal protection, with a view to controlling the epidemic as soon as possible in limited areas such as Wuhan. This article summarizes the background, key points and core measures in the country and provinces. It sent prospects for future prevention and control strategies.

Prognostic and predictive values of CXCL10 in colorectal cancer.

BACKGROUND: The role of CXCL10 in progression and prognosis of colorectal cancer (CRC) has been studied for years, yet results remain controversial. AIM: This study aims to explore the relationship between CXCL10 and CRC progression and prognosis. METHODS: We evaluated plasma CXCL10 in CRC patients using ELISA. We also performed a meta-analysis of the associations between CXCL10 and overall survival (OS), disease-free survival (DFS), disease-specific survival (DSS), relapse-free survival (RFS), and clinicopathological features. Finally, correlations between CXCL10 and methylation or immune infiltration were performed using TCGA data. RESULTS: ELISA analysis showed that CXCL10 was associated with age, red blood cells, blood platelets, and blood urea nitrogen. A separate analysis of 3,763 patients from 24 studies revealed that there were significant associations between low CXCL10 expression and OS (HR 1.25, 95% CI 1.01-1.53), DFS (HR 1.65, 95% CI 1.17-2.34), and RFS (HR 1.43, 95% CI 1.20-1.71) in CRC. Additionally, downregulated CXCL10 expression was significantly correlated with age [odds ratio (OR) 1.31, 95% CI 1.13-1.52], metastasis (OR 1.34, 95% CI 1.11-1.63), recurrence (OR 1.46, 95% CI 1.16-1.83), tumor location (OR 1.88, 95% CI 1.58-2.24), differentiation (OR 0.57, 95% CI 0.35-0.93), microsatellite instability (OR 0.23, 95% CI 0.15-0.35), BRAF mutation (OR 1.62, 95% CI 1.25-2.08), p53 mutation (OR 0.28, 95% CI 0.16-0.47), and CIMP (OR 0.27, 95% CI 0.17-0.43). Furthermore, significant associations were observed between CXCL10 and methylation and immune infiltration. CONCLUSIONS: The study suggests that CXCL10 might be a potential target for the treatment of CRC. TRIAL REGISTRATION: NCT03189992. Registered 4 June 2017, https://www.clinicaltrials.gov/ct2/show/study/NCT03189992?term=NCT03189992&rank=1 .

[Expert consensus on rabies exposure prophylaxis].

Rabies is a zoonotic infectious disease caused by lyssavirus and characterized by central nervous system symptoms. The fatality rate of rabies is almost 100%. About 59 000 cases die of rabies worldwide every year, mainly in Asia and Africa. China is an epidemic country of rabies. Grade II and III exposures are the main types of rabies exposures in China. Standardized post-exposure prophylaxis (PEP) can prevent rabies almost 100%. Human Rabies Vaccine Technical Working Group, National Immunization Advisory Committee and invited experts reached an expert consensus on PEP by referring to the World Health Organization's position paper on rabies vaccine in 2018 and related research progress in recent.

DUSP facilitates RPMI8226 myeloma cell aging and inhibited TLR4 expression.

OBJECTIVE: Myeloma severely threatens public health, and molecular targeting treatment becomes the future perspective. Dual specificity phosphatases (DSUP) protein has multiple functions including modulating cell proliferation, differentiation, aging, and apoptosis. Whether DUSP can regulate myeloma cell is unclear. This study thus aimed to investigate the effect of DUSP on myeloma cell line RPMI8226 cell aging and provide evidence for the clinical treatment of myeloma. MATERIALS AND METHODS: H2O2-induced aging model of myeloma cell line RPMI8226 was generated. DUSP over-expression plasmid or specific siRNA was transfected by liposome. Western blot was used to detect the expression of DUSP in RPMI8226 cells. Cell aging condition was evaluated by ß-galactosidase assay. Aging proteins P53 and P16 expression levels, the activation of TLR4 signal pathway were tested by immunoblotting. TLR4 signal pathway was then suppressed by Verteporfin for testing RPMI8226 cell aging. RESULTS: Growing levels of DUSP, aging proteins P53 and P16, with inhibition of TLR4 signal pathway were found in the H2O2-induced aging model of myeloma cell line RPMI8226. Transfection of DUSP over-expression plasmid or siRNA potentiated or inhibited the aging of RPMI8226 cells induced by H2O2 and suppressed or enhanced TLR4 signal pathway, respectively. Verteporfin, an inhibitor of TLR4, increased the level of P53 and aging of RPMI8226 cells. CONCLUSIONS: DUSP facilitates H2O2-induced aging of myeloma cell line RPMI8226 and suppresses TLR4 expression, which provides academic basis for clinical intervention.