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Screening and preventive treatment for latent tuberculosis infection (LTBI) are important measures to reduce the incidence of active tuberculosis (TB) and its global burden. This paper discusses the current status of LTBI prevalence and preventive treatment, risk of incidence in high-risk groups, screening methods, and other interventions, emphasizing the importance of prevention and control as early as possible in a scientific strategy, so as to lay a solid foundation for eliminating TB by 2030.
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Objective:To learn about the iodine nutrition level and its spatial distribution status in key populations in Hubei Province, so as to provide a basis for adjustment of iodine supplementation policy and the realization of scientific and accurate iodine supplementation.Methods:In 2020, a sampling was carried out in Hubei Province according to the "National Iodine Deficiency Disorders Monitoring Plan (2016 Edition)" to monitor the concentration of salt iodine and urinary iodine of key populations (children ages 8 - 10 years old and pregnant women). The spatial distribution of iodine nutrition levels was analyzed by spatial epidemiology.Results:The median salt iodine of 17 263 children's family salt samples was 25.0 mg/kg, and the median urinary iodine (MUI) was 217.0 μg/L. There was significant spatial aggregation in the distribution of urinary iodine level in children at the county level ( Moran's Index = 0.36, P < 0.001). The significant hot spot areas with high urinary iodine level among children were located in Shiyan City and Xiangyang City, while the significant cold spot areas with low urinary iodine level were mainly concentrated in Yichang City. The median salt iodine of 8 618 pregnant women's family salt samples was 25.1 mg/kg, the MUI was 176.3 μg/L. The urinary iodine level among pregnant women at the county level was spatially clustered ( Moran's Index = 0.22, P = 0.003) . The significant hot spot areas with high urinary iodine level among pregnant women were mainly in Enshi Tujia and Miao Autonomous Prefecture, the significant cold spot areas were mainly concentrated in Yichang City. Conclusions:In 2020, the iodine nutrition of children in Hubei Province is at a super appropriate level (200 - 299 μg/L), and the iodine nutrition status of pregnant women is more sensitive, which is close to the lower limit of the appropriate level (150 μg/L). The urinary iodine level of children and pregnant women has significant spatial aggregation at the county level. Targeted intervention will be needed in counties (dictricts) where the urinary iodine level is lower or higher than the normal range, to achieve accurate and scientific iodine supplementation.
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Objective:To explore the application of Balint group activities in the doctor-patient communication skills training for standardized residency training of internal medicine.Methods:The students from Batch 2018 and some from Batch 2019 participating in the standardized residency training in Renmin Hospital of Wuhan University were selected as the research subjects. SPSS 22.0 was used to perform paired t test for comparison before and after training, and the SEGUE scale was used to evaluate the doctor-patient communication ability of the physicians before and after the training of the Balint group. A questionnaire survey was performed to collect their understanding of doctor-patient communication status and evaluate the training activities. Results:All the residents recognized the importance of doctor-patient communication and clarified the main reasons for the communication of doctors and patients. After receiving the training of doctor-patient communication focusing on group activities, the total score of SEGUE scale increased from (15.40±5.65) to (19.84±1.92), and the residents significantly improved their ability in such five dimensions as stopping inquiry, understanding patients, passing information, collecting information and ready to start ( P<0.001), with a satisfaction rate of 92.00% (69/75) for training methods and contents. Conclusion:The doctor-patient communication ability of the residents needs to be further improved. Balint group activities have enriched the form of doctor-patient communication training, which is helpful for doctors to strengthen their professional confidence and build a harmonious doctor-patient relationship.
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【Objective】 To evaluate the protective effect of siNLRP3-loaded nanosystem on diabetic cardiomyopathy (DCM) via silencing NLRP3 under ultrasound-targeted microbubble blasting (UTMD). 【Methods】 After synthesis of polyethylene glycol polylysine block copolymer (mPEG-b-PLLys), siNLRP3-loaded hetero-assembled nanosystem system (siNLRP3-NBs) was constructed and characterized. Subsequently, a DCM rat model was established to investigate the protective effect of siNLRP3-NBS on the heart. Cardiac function of the rats was observed by small animal ultrasonography. HE and Masson staining were used to observe the degree of myocardial fibrosis change; the protein expression of NLRP3 and cell pyroptosis indexes were detected by Western blotting. 【Results】 1H NMR indicated that the structure of mPEG-b-PLLys was correct. The results of agarose electrophoresis showed that NBs could protect naked siNLRP3 from RNAase degradation, and the particle size and zeta potential of siNLRP3-NBs were (379.7±14.8) nm and (8.73±1.93) mV, respectively. The shape of NBs was almost spherical. siNLRP3-NBs combined with UTMD could enhance the protective effect on cardiac function and improve myocardial fibrosis in DCM rats. Protein expression indicated that UTMD could enhance the inhibitory effect of siNLRP3-NBS on cardiomyocyte pyroptosis. 【Conclusion】 UTMD-mediated ultrasonic response combined nanosystem can enhance the therapeutic effect of siNLRP3 on DCM, suggesting that ultrasonic response siNLRP3-loaded nanosystem is a potentially effective strategy for the treatment of heart disease.
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Objective To investigate the causes of misdiagnosis related to rheumatism diseasecases.Methods A search was performed in database WanFang to identify the misdiagnosed clinical cases reports which were published in Chinese Journal and a retrospective analysis was conducted.All data were analyzed by chi-square test and Fisher's exact test.Results We screened 705 citations and identified 215 articles on the rheumatic diseases,finally,187 reports and 195 cases in total with definite diagnosis were included,accounting for 25.5% of the total number of misdiagnosed cases.Primary vasculitis (72 cases),rheumatoid arthritis (25 cases),spondyloarthropathy (17 cases),polymyositis (14 cases),systemic lupus erythematosus (13 cases) and Sj(o)gren's syndrome (SS) (12 cases) were amongst the top misdiagnosed rheumatic diseases.There was no difference between 1998-2006 and 2007-2015 in the overall misdiagnosis cases.Single disease comparison,polymyositis,spondyloarthropathy and IgG4 related disease were increased (P=0.002;P=0.034;P=0.060;respectively),while polymyositis was delayed (P=0.002).Rheumatism misdiagnosed cases reported mainly came from tertiary hospitals and the department of rheumatology.Conclusion Misdiagnosed rheumatism are common in clinic.Strengthen the physicians' continuous education,the validity of clinical thinking mode and rational use of diagnostic criteria are important to make correct diagnosis.
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Objective To analyze the antimicrobial resistance, distribution of resistance genes and staphylococcal cassette chromosome mec ( SCCmec) in 99 strains of mecA gene-positive Staphylococcus epi-dermidis strains isolated from early pregnancy cervical swabs and external environment in Beijing Chaoyang District from 2015 to 2016. Methods Kirby-Bauer disk diffusion method was performed to detect the sus-ceptibility of the 99 Staphylococcus epidermidis strains to cefoxitin. Microbroth dilution method was used to test their susceptibility to vancomycin, daptomycin, penicillin, erythromycin, compound sulfamethoxazole, tetracycline, ciprofloxacin, clindamycin, gentamicin and chloramphenicol. PCR was used to detect drug re-sistance genes of ermA, ermB, ermC, msrA, norA1, norA2, sul1, sul2, sul3, aac(6')/aph(2″), ant(4', 4″), ant(6) and tetM and to analyze the SCCmec types ofⅠ, Ⅱ, Ⅲ, Ⅳa, Ⅳb, Ⅳc, Ⅳd and Ⅴ. The results were compared with those of capillary electrophoresis. SPSS was used for data analysis. Results All of the 99 mecA-positive Staphylococcus epidermidis strains were sensitive to vancomycin and 93. 94% of them were sensitive to datomycin. The resistance rates to penicillin, erythromycin, cefoxitin, compound sulfame-thoxazole, tetracycline, ciprofloxacin, clindamycin, gentamicin and chloramphenicol were 97. 98%, 85. 86%, 79. 80%, 52. 54%, 27. 27%, 43. 43%, 36. 36%, 23. 23% and 11. 11%. The strains that car-ried the genes of norA1, norA2, ermA, ermB, ermC, msrA, sul1, sul2, sul3, aac(6')/aph(2″), ant(4', 4″), ant(6) and tetM accounted for 100%, 93. 94%, 0. 00%, 3. 03%, 17. 17%, 57. 58%, 50. 51%, 12. 12%, 4. 04%, 30. 30%, 8. 08%, 4. 04% and 25. 26%, respectively. Among the 99 strains, 5. 05%, 0%, 43. 43%, 10. 10%, 0. 00%, 3. 03%, 3. 03% and 19. 19% belonged to SCCmecⅠ, Ⅱ, Ⅲ, Ⅳa,Ⅳb,Ⅳc,Ⅳd andⅤ, respectively, and 4. 04% (4/99) were positive to two SCCmec types. The types of 12. 12% (12/99) of the strains were unidentified. Conclusions All of the 99 strains of mecA-positive Staphylococcus epidermidis were sensitive to vancomycin. Among them, the strains carrying multidrug resist-ance genes accounted for 89. 90%. The main mechanisms of resistance to macrolides, sulfonamides and ami-noglycosides in local strains were related to the resistance genes of msrA, sul1 and aac ( 6')/aph ( 2″) . SCCmec Ⅲ was the prevalent type. There were 88. 37% of SCCmec Ⅲ type strains and 75% of unknown type strains carrying multiple resistance genes. Apart from that, the isolated strains of other SCCmecⅢtypes all carried multiple resistance genes.
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Objective@#To investigate the inhibitory effects and mechanism of Triticum aestivum (TA) on anaphylaxis in ovalbumin (OVA)-sensitized mice.@*Methods@#Twenty-five female BALB/c mice were randomly divided into five groups (n=5), including control group, OVA group, 100 mg/kg TA group, 200 mg/kg TA group and DEX (dexamethasone) group. OVA (20 μg) and aluminum hydroxide (1 mg) were dissolved in 100 μl of PBS solution and injected into the abdominal cavity of each experimental mouse, while the mice in the control group were injected with 100 μl of 0.9% normal saline. All mice were given drinking water. The above processes were repeated two weeks later, and different concentrations of experimental drugs were diluted in 1% CMC (carboxymethyl cellulose) solution to feed mice. Allergic symptoms and behaviors of each mouse were scored in the process of feeding. On the 12th day after first sensitization, mice in the control and experimental groups were subcutaneously injected in the auricle with 20 μl of 0.9% saline solution and OVA, respectively. The thickness of each mouse′s auricle was measured 6 and 24 hours later. Histopathologic changes in auricle tissues were observed by hematoxylin-eosin(HE) staining 24 hours later. The mice were euthanized by cervical dislocation in the 6th week after first sensitization. Abdominal aorta serum samples were collected and tested for specific inflammatory cytokines (IgE, IgG1, TNF-α, IL-4) and anti-OVA antibodies (IgE, IgG1) by ELISA. ELISA and RT-PCR were used to detect the expression of IFN-γ, IL-4, IL-5, IL-12 and IL-13 after spleen lymphocytes were stimulated with different concentrations of drugs.@*Results@#Both the score of allergic symptoms and behavior and the thickness of the auricle of the OVA group were the highest among all groups (P<0.05). A TA dose-dependent decrease was found in both of the two parameters, which was confirmed by histopathological analysis. ELISA results showed that the plasma levels of IgE, IgG1, IL-4 and TNF-α in the experimental groups were significantly higher than those in the control group, but all of them were decreased in a TA dose-dependent manner. TA at the high concentration of 200 mg/kg was similar to DEX in inhibiting the expression of IgE and TNF-α. RT-PCR results showed that Th1 cytokines (IFN-y and IL-12) in the experimental groups increased significantly as compared with those in the control group (P<0.05). Expression of IFN-y and IL-12 was not significantly affected by TA at various concentrations, but markedly inhibited by DEX. The levels of Th2 cytokines (IL-4, IL-5 and IL-13) in the experiment groups were significantly higher than those in the control group (P<0.05). Compared with the OVA group, the levels of IL-4, IL-5 and IL-13 were significantly reduced in TA groups, especially in the TA 100 μg/ml group in which the expression of the three cytokines was decreased by about 60%, 18% and 20%, respectively.@*Conclusion@#TA helps to maintain immune balance by selectively inhibiting the expression of Th2 cytokines (IL-4, IL-5, IL-13), IgE and IgG and not influencing Th1 cytokines (IFN-γ and IL-12). It has an anti-allergic effect as it effectively suppresses allergic responses. This research provides both theoretical and experimental basis for further development of novel anti-anaphylactic treatment with TA.
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Radiomics and radiogenomics are used to provide comprehensive tumor biological characte-ristics and further clinical information by extracting,screening and analyzing the most valuable quantitative ra-diomics features. In recent years,numerous studies have shown that radiomics plays a role in the diagnosis, treatment and predicting efficacy and prognosis of lung cancer. Radiogenomics shows a great value in the pre-diction of lung cancer gene phenotype and individualized precision treatment by combining radiomics features with genomics,proteomics and so on. Radiomics and radiogenomics are non-invasive,quantitative,and repro-ducible,and they can provide multidirectional tumor biological characteristics,which are expected to be widely used in the precise medical treatment of lung cancer in the future.
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Tumorous cells are characterized by distinctive metabolic reprogramming and living conditions. Understanding drug metabolizing features in tumor cells will not only favor the estimation of metabolic rate, elimination half life and the assessment of potency, but also facilitate the optimal design of anti-tumor drugs/prodrugs. This article reviewed the expression and activity features of major drug metabolizing enzymes (DMEs) in solid tumorous tissues, such as liver, intestine, breast and lung, and the difference from the correspondingly normal tissues, exemplified by the metabolic properties of some classic antitumor-agents in tumorous tissues. In combination with the data retrieved in vitro tumor cell lines, we discussed the similarities and differences of DMEs expression and function between tumor tissues (in vivo) and tumor cells (in vitro), and proposed the possible factors that cause the differences.
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Objective To investigate the use of laryngeal mask airway (LMA) ProSeal for airway management during open heart surgery performed under CPB in children. Methods Seventy-six ASA Ⅱ and NYHA class Ⅰ or Ⅱ patients aged 3 months-8 yr, weighing 3.3-34.5 kg undergoing open heart surgery under CPB were randomly divided into 2 groups ( n = 38 each): tracheal intubation group (group T) and ProSeal LMA group (group P1). Tracheal tube and LMA were inserted after induction of anesthesia with 8% sevoflurane. The rate of successfultracheal intubation and LMA placement, placement time, peak airway pressure and side effects during and after surgery including hypoxemia, tachycardia, bradycardia, hypotension and hypertension, laryngesl edema, dysphagia, bucking, dyspnea and hoarseness were recorded. Results There were no significant differences in the rate of successftl tracheal intubation and LMA placement, peak airway pressure, bucking, dyspnea and hoarse voice between the two groups (P> 0.05). The LMA placement time was significantly shorter than tracheal intubation time and the incidence of laryngeal edema and dysphagia lower in group P than in group T ( P < 0.05). Conclusion The LMA ProSeal can provide adequate ventilation during operation with less complications and can be used effectively for cardiac surgery performed under CPB in children.
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This study was aimed to shed light on the biological and pharmaceutical characterization of the complexes of FUS1/hIL-12 double gene with cationic liposome, and to assess such complexes' transfection efficiency, stability and cytotoxicity; for they have the potential for use as drugs in gene therapy of lung cancer. Gel retardation assay, diameter measurement, and surface charge by photon correlation spectroscopy (PCS) were employed to select the appropriate ratio of "cationic liposome to DNA" of the double-gene and liposome complexes. The plasmid EGFP and plasmid PVITO2-hIL12-FUS1 mediated by cationic liposome were transfected into A549 lung cancer cells respectively, and the expression levels of EGFP and FUS1 and hIL-12 were determined by inverted fluorescence microscope and immunohistochemical and enzyme linked immunosorbent assay (ELISA) respectively. Agarose gel electrophoresis was performed to detect the stability of the double-gene and liposome complexes, after they were incubated with serum and Dnase I respectively. After the erythrocytes being incubated with the complexes of FUS1/hIL-12 with cationic liposome, the morphology of erythrocyte was observed by microscopy. The result of this study provides a basis for the use of the complexes of FUS1/hIL-12 with cationic liposome in gene therapy of lung cancer.