[Summary] A total of 215 pregnant women at mid-gestation were enrolled, and their serum 25-hydroxyvitamin D levels were measured. Of them, 38 (17. 7%) were classified as cases with vitamin D sufficiency, 70 (32. 5%) as insufficiency, and 107 (49. 8%) as deficiency. Compared with the sufficient group, parathyroid hormone level increased and osteocalcin level decreased significantly in the deficient group. Therefore, vitamin D deficiency is highly prevalent among pregnant women and is associated with their potential disorder of bone turnover.

We analyzed genetic evolution characteristics of avian influenza A (H7N9) virus isolated in Zhaoqing,China,2014-2016.Nucleic acid were extracted and sequenced from 17 samples of H7N9 positive cases in Zhaoqing.Genetic characteristics of homology and important amino acid sites were analyzed by using BioEdit5.0 and MEGA6.0.The evolutionary trees were constructed by Neighbor-Joining and the referenced sequences were downloaded from GenBank,Eight nucleic acid fragments from 7 strains of H7N9 viruses were successfully generated.The highest homology was found in HA gene with A/chicken/Dongguan/695/2014(H7N9),and NA gene with A/chicken/Dongguan/1075/2014(H7N9).The internal genes were high homology with avian H7N9 and H9N2 virus from Dongguan and Shenzhen in Guangdong,China.The HA and NA genes were directly evolved in the Pearl River Delta evolution branch with the H7N9 sequences from the cities of Dongguan,Guangzhou and Shenzhen,while the sequences from the provinces of Anhui,Zhejiang,and Jiangsu were in the Yangtze River Delta evolution branch.There were 2 alkaline amino acids in cleavage site of HA,2 mutations (G186V and Q226L) in the crucial sites related with the receptor of HA protein,1 mutation (E627K) in PB2 protein,and 1 drug resistance mutation (S31N) in M2 protein.And no evidence of neuraminidase resistance in NA protein was found.In conclusion,the H7N9 virus for human infection in Zhaoqing may originate from avian H7N9 and H9N2 viruses,which circulated in the Pearl River Delta region of Guangdong from 2013 to 2014.The mutations of G186V,Q226L and E627 K might be related with high susceptibility to human beings.

Objective This paper expounds the present situation of the construction and probes into the development path of the medical characteristic disciplines,so as to provide guidance for the development of the characteristic disciplines of local medical colleges and universities.Methods According to the general characteristics of the discipline construction of the local medical colleges and universities,through the analysis of the current situation of the objective development and the restriction of the bottleneck,to analyze the new methods and new ways for the development of the characteristic disciplines in local medical colleges and universities.Results Medical characteristic disciplineconstruction should pursue sustainable development,mining subject characteristics;concise direction of research,enhance the level of scientific research;focus on academic exchanges,build talent echelon;integrate all kinds of resources,construction of subject group;building performance evaluation,pioneering achievement innovation.Conclusions Local educational institutions and medical colleges and universities should fully understand the importance of characteristic disciplines to meet the needs of local development and create brand culture.The characteristic disciplines with prominent advantages,reasonable structure and sustainable development should be established.

The authors described the purpose of the creation, the structure of the basic model, and the changes in the chapters of ICD-11, and analyzed its differences with ICD-10, as well as its unique advantages and current progress. The revision of ICD-11 is closely related to the development of modern medicine. It features more elaborate expression of diseases and informatization of classification tools, making it better fitting the development of medical and health information big data and facilitating the global collection and application of medical information data.

Objective: To establish a TaqMan-MGB probe-based real-time fluorescence RT-PCR assay for avian influenza H5N6 virus used in rapid diagnosis for suspected cases and surveillance for outer environment of live poultry markets. Methods: Based on the conservative sequences of avian influenza H5N6 virus for HA and NA gene published on GenBank, specific primers and TaqMan-MGB probes were designed to develop and optimize for the dual real-time RT-PCR assay. Specificity, sensitivity, repeatability and comparison tests were carried out. Results: This dual real-time RT-PCR detection can be completed within 80 minutes. There was no cross-reaction with other subtypes of influenza virus and common respiratory pathogens. The minimum detection limit could be up to 10 copies/reaction. The correlation coefficient of standard curve for the gene of H5 and N6 were 0.999 and 0.993, and the coefficients of variation for cycle threshold were range from 0.151%-0.549%and 0.213%-0.575%, respectively. The positive and negative coincidence rates of the validation test were 100%. Conclusions This TaqMan-MGB probe-based dual real-time RT-PCR for avian influenza H5N6 virus was rapid, specific and sensitive. It will have a good use in early emergency detection of suspected cases and continuous monitoring of external environment in live poultry trade market.

Objective:To explore the influencing factors of concurrent infection in elderly patients with malignant lymphoma undergoing chemotherapy, construct a risk prediction model and verify its effectiveness.Methods:A total of 92 elderly patients with malignant lymphoma admitted to Department of Hematology in the First Affiliated Hospital of Wenzhou Medical University from January 2019 to August 2021 were selected as the research objects by the convenient sampling method. The age, gender, nutritional risk, activities of daily living (ADL), comorbidities, occurrence of infection, treatment time and prognosis of the patients were collected. The independent risk factors for concurrent infection in elderly patients with malignant lymphoma undergoing chemotherapy were analyzed, and the risk prediction model and line graph were constructed for internal validation by Bootstrap.Results:Logistic regression analysis showed that ADL score, nutritional screening score and Charlson's Weighted Index of Comorbidities (CCI) score were independent risk factors for concurrent infection in elderly patients with malignant lymphoma undergoing chemotherapy ( P<0.05). The prediction model of concurrent infection in elderly patients with malignant lymphoma undergoing chemotherapy was established, namely Z=0.983×CCI score +1.075× nutritional screening score +0.645×ADL score -5.115. The C-index of the prediction model nomogram was 0.785 [95% CI (0.692-0.879) ], indicating good differentiation. According to the correction curve verified internally by Bootstrap, the absolute error of the possibility prediction of the nomogram model was 0.028, which was in good consistency. Conclusions:The risk prediction model of concurrent infection in elderly patients with malignant lymphoma chemotherapy is constructed based on ADL score, nutritional screening score and CCI score, which are easy to obtain and evaluate, and the nomogram of the prediction model is established with good differentiation and consistency.

Objective:To observe the efficacy and safety of teriprizumab combined with bevacizumab in above the second line treatment of high-level microsatellite instability (MSI-H) type metastatic colorectal cancer (mCRC) patients.Methods:From February 2019 to September 2019, 56 patients with MSI-H mCRC admitted to the Third Affiliated Hospital of Guangdong Medical University were selected and divided into control group and test group by random number table method, with 28 cases in each group. The control group was treated with bevacizumab, and the test group was treated with teriprizumab combined with bevacizumab. The objective response rate (ORR), disease control rate (DCR), progression-free survival, overall survival and incidence of adverse reactions were compared between the two groups.Results:The ORR and DCR of the test group were 60.71% (17/28) and 75.00% (21/28) respectively, higher than 28.57% (8/28) and 46.63% (13/28) of the control group, with statistically significant differences ( χ2=5.85, P=0.016; χ2=4.79, P=0.029). The median progression-free survival of patients in the control group and the test group were 3.5 months and 5.8 months respectively, with a statistically significant difference ( χ2=9.83, P=0.003). The median overall survival of patients in the control group and the test group were 12.1 months and 16.2 months respectively, with a statistically significant difference ( χ2=6.13, P=0.007). There were no significant diffe-rences in the incidences of hematological reaction (17.86% vs. 14.29%, χ2=0.13, P=0.716), cardiovascular injury (10.71% vs. 14.29%, χ2=0.16, P=0.686), liver and kidney function injury (25.00% vs. 21.43%, χ2=0.10, P=0.752), gastrointestinal reaction (28.57% vs. 35.71%, χ2=0.33, P=0.567), skin and mucosal injury (7.14% vs. 10.71%, χ2=0.35, P=0.553), nervous system disease (3.57% vs. 14.29%, χ2=2.25, P=0.134), endocrine reaction (3.57% vs. 10.71%, χ2=1.29, P=0.256), alopecia (14.29% vs. 17.86%, χ2=0.13, P=0.716) and fatigue (25.00% vs. 28.57%, χ2=0.27, P=0.605) between the control group and the test group. Conclusion:The combination of teriprizumab and bevacizumab can improve the short-term and medium-long-term efficacy of patients with MSI-H mCRC, which is safe and reliable.

Objective:To investigate the immune cell infiltration width on lesion microenvironment (LME) based on different hepatic alveolar echinococcosis lesion features to underlie referential sampling range for experimental and control tissues aiming at avoiding false negativity in basic researches.Methods:Using prospective research methods, from January 2017 to December 2019, patients with hepatic alveolar echinococcosis who were diagnosed and treated surgically at the First Affiliated Hospital of Xinjiang Medical University and met the multi-site sampling method (MSS method) were investigated. A total of 26 cases were included, aged 34 (15, 65) years old, with a gender ratio of 12/14. Lesions were classified into six groups based on heterogenic scales of calcification and liquefaction: A. non-calcified and non-liquefied; B. obvious calcified and non-liquefied; C. partial calcified and partial liquefied; D. obvious calcified and partial liquefied; E. partial calcified and subtotal liquefied; F. obvious calcified and subtotal liquefied. Liver specimens were acquired with 5 mm interval off the lesion shore in LME area using MSS method. Performed immunohistochemical staining of CD3, CD19, CD68, and Masson staining of fibrous tissue, and after pathological evaluation, the layer with a sharp decrease in immune cell infiltration abundance was determined as the maximum infiltration range (width, W value). The experimental group conservatively estimated the maximum sampling range for the integer value of Q1 of W value. The control group conservatively estimated the minimum sampling range for the integer value after Q3 rounding plus 5 mm of W value. Results were analyzed using Kruskal-Wallis H and Mann-Whitney U tests, referential ranges were concluded. Results:Median W values (interquartile) for each group were 20.0 (12.5, 22.5), 15.0 (10.0, 15.0), 10.0 (10.0, 15.0), 5.0 (5.0, 10.0), 12.5 (6.3, 15.0), and 5.0 (5.0, 10.0) mm, among which A > D, A > F, C > D, and C > F ( P≤0.05); from the perspective of calcification, A > C + E, A > B + D + F ( P < 0.05), while A + B > C + D, A + B > E + F ( P < 0.05) from the perspective of liquefaction. In these groups, the experimental group conservatively estimated the maximum distance for sampling to be 12.0, 10.0, 10.0, 5.0, 6.0, and 5.0 mm, while the control group conservatively estimated the minimum distance for sampling to be 28.0, 20.0, 20.0, 15.0, 20.0, and 15.0 mm. Conclusions:Less calcification and liquefaction implicates wider immune cell infiltration range in those lesions. Tissue sampling should be individualized based on different lesion features in basic research to avoid false negativity.

The outbreak of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 has rapidly spread globally. Cancer patients are at a higher risk of being infected with the coronavirus and are more likely to develop severe complications, as compared to the general population. The increasing spread of COVID-19 presents challenges for the clinical care of patients with gynecological malignancies. Concerted efforts should be put into managing gynecological malignancies in an orderly manner by strictly implementing the measures that are specifically developed for controlling the spread of COVID-19. We have drafted Recommendations on Management of Gynecological Malignancies during the COVID-19 Pandemic based on our experience on controlling COVID-19 pandemic in China. We recommend that patients with gynecological malignancies should be managed in hierarchical and individualized manners in combination with local conditions related to COVID-19. Medical care decision should be balanced between controlling COVID-19 pandemic spread and timely diagnosis and treatment for gynecologic oncology patients.

Objective: To evaluate the relationship between-590C/T polymorphisms of interleukin-4 gene and periodontitis by meta-analysis. Methods: Databases including PubMed, EMbase, Web of Science, CBM, CNKI, Wanfang and VIP, were searched from their establishment to December 31, 2016. Only case-control studies on the association between -590C/ T polymorphisms of interleukin-4 gene and periodontitis were selected, and the references of those selected studies were searched by hand. Assessment and data extraction were conducted by 2 reviewers independently, and the meta-analysis was performed with the R 3.3.1 software. Results : The meta-analysis showed that there was no association between the IL-4-590C/T polymorphism and periodontitis susceptibility (T vs C: OR=1.19, 95%CI=0.81~1.76, P =0.37). Subgroup analysis showed that the IL-4 -590 TT was associated with periodontitis in Caucasians (TT vs CT: OR=1.75, 95%CI=1.10 ~ 2.78, P = 0.02), but no significant association in Asians (P =0.63). Meanwhile, IL-4 gene polymorphisms were not significantly associated with the susceptibility of chronic periodontitis (CP) or aggressive periodontitis (AgP) ( e. g. T vs C, CP: P=0.45; AgP: P =0.45). Conclusion Based on current evidence, the polymorphisms of IL-4-590C/T are associated with the increased risk of periodontitis in Caucasians.