Objective To infer its transmission origin and route through studying the feature of molecular epidemiology of an HCV outbreak in Guangzhou.Methods Serum samples 192 cases in an HCV outbreak incident were analyzed for 2a and 6a subtypes.Appropriate genotypes were selected as control group.Informatics software were used in the evolutionary analysis to construct time scale trees and infer the origin time of HCV infection.Results Of 119 patients in the HCV outbreak,66 cases were 2a and 110 cases were 6a subtype.No other genotypes were found.The evolutionary analysis indicated the isolates of 2a group and 6a group both originated from 2 ～ 5 years ago.Both of 2a group and 6a group were in line with the characteristics of iatrogenic infection.Conclusion 2a and 6a were the main sub-genotypes in the Guangdong HCV outbreak investigation and they were originated from 2 to 5 years ago,which were in line with the characteristics of iatrogenic transmission.With the extension of time,a large number of cases accumulated and led to outbreak.

Objective To investigate the role and possible mechanism of P120 catenin involving in the hemodynamic changes by inducing vascular endothelial cells injury through an in vitro experiment. Methods The hemodynamic environment under the different hemodynamic conditions at the vascular bifurcations was simulated through a T-shaped flow chamber system designed by ourselves. The human umbilical vein endothelial cells (HUVEC)cultured in vitro were stimulated and used the HUVEC cells of the small interfering RNA (SiRNA)after P120ctn gene fragments being knocked out. After loading flow rate of 250 and 500 ml/ min respectively and acting on for 12 h,the HUVEC morphology,growth pattern,and expression of P120ctn and other proteins were observed. Results (1)Normal HUVEC:500 ml/ min was loaded for 12 h,the cells were fused excessively at the impinging point,the cell gaps became narrowed,the cell density decreased and the morphology was elongated in the high wall shear stress (WSS)and wall
shear stress gradient (WSSG)regions. A part of cells migrated downstreamly,and their arrangement direction was consistent with the direction of impinging flow. Compared with the unloaded impinging flow field,after the 2 kinds of impinging flows being loaded for 12 h,the expression levels of P120ctn,vascular endothelial calcium (VEC),Kaiso,α-catenin,and other proteins were decreased. The expression level of matrix metalloproteinase 2 (MMP-2)was increased. There were significant differences (all P < 0. 05). (2)HUVEC after P120ctn being knocked out:Under the impact of the impinging flow,the cell growth time was reduced to 60 min. 250 ml/ min being loaded for 60 min,the impinging point and its surrounding cells still maintained the polygon,but some cells in the high WSS and high WSSG regions began to move downstreamly and aggregated,the cell arrangement mode partly arranged along with the direction of the flow;500 ml / min being loaded for 60 min,the cell density in the high WSS and high WSSG regions were decreased significantly and the morphology was elongated. A large number of cells migrated downstreamly and aggregated. The arrangement mode was parallel and consistent with the direction of the impinging flow. Compared with the unloaded impinging flow field,after the 2 kinds of velocities being loaded for 60 min,the expression levels of VEC,Kaiso,α-catenin proteins were decreased. The expression level of MMP-2 was increased,There were significant differences (all P < 0. 05) Conclusions The hemodynamic change may induce the changes in vascular endothelial cell morphology,growth pattern,and expression of P120ctn and other related proteins, leading to the decrease of vascular endothelial cell adhesion connection stability and the expression changes of related proinflammatory factors. The knockout of P120ctn may result in a further decrease of the vascular endothelial cell adhesion connection stability.

Objective To observe the clinical effect of Chinese herbal medicine gargle on the prevention of aspiration pneumonia in elderly patients with long-term nasal feeding. Methods 93 elderly patients over 60 years old with indwelling nasogastric tube for 30 days were randomly divided into 48 cases of the experimental group and 45 cases of the control group. We compared incidence of aspiration pneumonia of the elderly patients with long-term nasal feeding in two groups of oral care solution by using the self-made traditional Chinese medicine gargle for oral nursing in the experimental group and treated with saline in the control group. Results The oral bacterial colony count and the incidence of aspiration pneumonia in the experimental group were lower than those in the control group, with two different kinds of nursing fluid. Conclusion Using the self-made traditional Chinese medicine gargle for oral care, could effectively reduce the number of oral bacteria, reduce the incidence of aspiration pneumonia, the application effect is good, and could be in clinical promotion and application.

Objective: To investigate the pathological features and clinical manifestations of mucosa-associated lymphoid tissue (MALT) lymphoma in children and adolescents. Methods: Five cases of MALT lymphoma in children were investigated by morphology and immunophenotyping along with clinical follow-up. Results: Five cases of MALT lymphoma occurred in the antrum, orbit, parotid gland and nasopharynx. All patients had no B symptoms and only one patient showed a local mass with ulcer. One case presented with cervical lymph node enlargement, and 4 cases showed no evidence of lymphadenopathy.All cases had pathological features similar to those of adult MALT lymphoma, with proliferation of monocytoid B cells orcentralcyte-like tumor cells, with plasma cell differentiation and lymphoid epithelial lesions.No specific immunophenotypic marker was found. Clonal Ig gene rearrangement was detected in two cases.One patient was treated with rituximab treatment, 1 patient was given anti-Helicobacter pylori therapy, and 2 patients had no additional treatment.The follow-up data showed that 4 patients survived without tumor recurrence. Conclusions Similar to adult patients, MALT lymphoma in children and adolescents has similar pathological features with indolent clinical course and good prognosis. It is important to note that misdiagnosis and incorrect diagnosis mightoccur because of the young age of the patients.

Objective To find out the resistant situation and drug of Mycobacteria patients in Sichuan and offer foundation for clinical.Methods Two hundred randomized clinical isolates of Mycobacterium were determined by Roche drug sensitivity and minimum inhibitory concentration (MIC) method.Results Of the 200 clinical isolates,192 stains were Mycobacterium tuberculosis(MTB) (96.0％),8 strains (4.0％) were non-tuberculosis mycobacterium(NTM).Of the 192 MTB strains,108( 57.3％ ) sensitive strains and 84 (43.7％)stains were resistant to one or more than one drugs.Among these 84 resistant strains 23 were multi-drug resistant ( MDR,12.0％ ),4 were extensively drug resistant( XDR,2.1％ ).The anti-TB drug resistance rates were:SM(16.7％),INH(20.8％),RFP(17.2％),EMB(10.9％),PI(16.1％),LFX(8.8％),AMK ( 16.7％ ),CPM ( 6.2％ ),PTA ( 33.3％ ),respectively.Conclusion The resistance rate of tuberculosis keeps at a high level in Sichuan,especially the resistance rate of multiple (≥4) drug,we should oar attention.

Objective: To investigate correlations between motor skills with focused and shifting attention among preschool children, and to provide basis for the overall development of preschool children aged 4-6 years. Methods: During March to June 2020, a total of 165 preschool children aged 4-6 years were selected and investigated with subscales of the Bruininks Oseretsky Test of Motor Proficiency 2nd Edition (BOT-2) for agility and limb bilateral coordination assessment, and subscales of the Movement Assessment Battery for Children test 2nd Edition (MABC-2) for throwing and catching skill assessment, as well as balance subscale for the assessment of limb movement coordination, hand eye coordination, agility, and balance. The Kansas Reflection Impulsivity Scale for Preschoolers for Pre schoolers (KRISP) and Dimensional Change Card Sort (DCCS) were used to assess focused and shifting attention levels. Correlation and linear regression analyses were performed for statistical analysis. Results: Except for one handed throwing skills and shifting attention, there were statistically significant gender differences between boys and girls in total score of body movement coordination, total score of hand to eye coordination, hand to hand connection, total score of agility of movement, total score of movement balance, static support, walking on tiptoe, foot to foot jump and focused attention( t =-6.86, -2.00 ,-3.15,-3.75,-3.00,-2.95,-2.18,-2.11,-3.21, P ＜0.05), and girls were better than boys; children s total score of body movement coordination, total score of hand to eye coordination, hand to hand connection, agility of movement, walking on tiptoe and focused attention improves with age( r =0.47,0.41,0.47,0.51,0.16,0.31, P ＜0.05); After excluding the interference of gender and age, total score of body movement coordination was significantly correlated with preschool children s focused attention( β=0.31,95%CI =0.08-0.39, P ＜0.01). Conclusion Limb movement coordination and focused attention are significantly and positively correlated among preschool children aged 4-6 years. Therefore, preschool education and family activities should focus on designing and developing limb movement coordination related games and courses to enhance the focused attention of and form favorable attention quality in preschool children aged 4-6 years.

Objective:To investigate the expression characteristics of SOX10 and GATA3 in breast cancer and the value of their combination.Methods:A total of 360 breast cancer specimens with SOX10 immunohistochemical staining were collected from the Department of Pathology in Shenzhen People′s Hospital from 2018 to 2021, including 268 cases with simultaneous SOX10 and GATA3 staining. The expression of SOX10 and GATA3 in primary and metastatic breast cancer was detected, and the correlations between SOX10 and GATA3 and the molecular types and clinicopathological features of breast cancer were compared, and the distribution differences among each group were statistically analyzed.Results:The overall expression of SOX10 and GATA3 in breast cancer were 25.8%(93/360) and 81.7%(219/268), and that in triple negative breast cancer (TNBC) were 83.3%(80/96) and 42.7%(32/75), respectively. SOX10 was strongly associated with TNBC ( P<0.001), whereas GATA3 was highly expressed in luminal A, luminal B and HER2 over expression breast cancers ( P<0.001). The expression of SOX10 and GATA3 was negatively correlated in TNBC, and the combined expression rates of SOX10 and GATA3 in breast cancer and TNBC could reach 97.8% (262/268) and 94.7%(71/75), respectively. In addition, the expression of SOX10 was closely correlated with high histological grade, high Ki-67 proliferation index and lymph node metastasis, and negatively correlated with AR. The expression of GATA3 was correlated with low histological grade and lymph node metastasis, and positively correlated with AR, and the difference was statistically significant. Conclusions:SOX10 is a sensitive marker of TNBC, while GATA3 is highly expressed in non-triple negative breast cancer. The two complementary, combined application of SOX10-GATA3 can improve the detection rate of breast cancer, especially TNBC. SOX10 is associated with malignant characteristics of the tumor, suggesting that SOX10 can be used as a prognostic marker and potential therapeutic target for breast cancer.

In recent years , there are increasing articles concerning Epstein-Barr virus associated lymphoproliferative disorder (EBV+LPD), and the name of EBV +LPD is used widely.However,the meaning of EBV+LPD used is not the same , which triggered confusion of the understanding and obstacles of the communication.In order to solve this problem.Literature was reviewed with combination of our cases to clarify the concept of EBV +LPD and to expound our understanding about it .In general, it is currently accepted that EBV +LPD refers to a spectrum of lymphoid tissue diseases with EBV infection , including hyperplasia , borderline lesions , and neoplastic diseases .According to this concept , EBV+LPD should not include infectious mononucleosis ( IM ) and severe acute EBV infection ( EBV +hemophagocytic lymphohistiocytosis, fatal IM, fulminant IM, fulminant T-cell LPD), and should not include the explicitly named EBV+lymphomas ( such as extranodal NK/T cell lymphoma , aggressive NK cell leukemia , Burkitt lymphoma, and Hodgkin lymphoma , etc.) either.EBV +LPD should currently include: ( 1 ) EBV +B cell-LPD:lymphomatoid granulomatosis , EBV +immunodeficiency related LPD , chronic active EBV infection-B cell type, senile EBV +LPD, etc.(2) EBV +T/NK cell-LPD:CAEBV-T/NK cell type, hydroa vacciniforme, hypersensitivity of mosquito bite, etc.In addition, EBV+LPD is classified, based on the disease process , pathological and molecular data , as 3 grades:grade1, hyperplasia ( polymorphic lesions with polyclonal cells ); grade 2, borderline ( polymorphic lesions with clonality ); grade 3, neoplasm (monomorphic lesions with clonality).There are overlaps between EBV +LPD and typical hyperplasia, as well as EBV+LPD and typical lymphomas .However , the most important tasks are clinical vigilance , early identification of potential severe complications , and treating the patients in a timely manner to avoid serious complications , as well as the active treatment to save lives when the complications happened .