This thesis mainly expounds the design ideas and the realization methods of medical statistics question database management system.Specifically speaking,the function modules,data structure and business processes of the system are designed based on the analysis of questions,test papers and the needs of system functions.We choose Visual Basic 6.0 to develop the system interface,establish the question database with Access 2003,and make use of Word 2003 to output documents.This system can achieve the separation of teaching and testing effectively which can make examinations more normal and scientific.

ObjectiveTo assess the efficacy of low-dose intravenous cyclophosphmide (IV CTX) in treatmerit of old patients with systemic lupus erythematosus(SLE).MethodsTwenty-three old patients with newly diagnosed, untreated SLE were included.Patients received 3 times fortnightly IV CTX pulses at a fixed dose of 400mg followed by 3 monthly pulses.All patients were orally administered 0.8mg/kg of prednisone.The changes of the indexes were observed before and after 12 weeks treatment including the scores of SLE disease activity index(SLEDAI) and the levels of C3, C4 ,24-hour urinary protein and anti-dsDNA antibody.ResultsAmong 23 patients, 19 were followed up to 24 weeks, SLEDAI 4 weeks after treatment were all significantly lower than those before the treatment (P ＜0.01).At week 8, SLEDAI continued to decrease(P ＜0.05).At week 4,the level of urine protein, the levels of complements C3 and C4 and ds-DNA decreased significantly compared with that before the treatment (P ＜0.05).ConclusionIntensive low-dose CTX plus prednisone was effective in newly diagnosed, untreated old patients with SLE, and could reduce adverse effect.

Objective To explore the relationship between life events and depression of patients with primary sjgren's syndrome (PSS).Methods 80 patients with PSS complicating depressive disorder were tested by self-rating depression scale(SDS) and life event scale (LES),and compared with the control group including 80 PSS patients with non-depressive disorder matched with age and sex.Then the correlation between SDS and LES were analyzed.Results The total score of life events (32.72 ± 13.93),the score of negative life events (24.36 ±11.24),the score of SDS(58.60 ± 16.78) and the frequency of life events(91.3％) in the research group were higher than those in control group(P ＜ 0.05),but the positive life events score (7.15 ± 5.84) was lower than that in control group (9.76 ± 7.29),and there was statistically significant difference between the two groups (P ＜ 0.05),there were more negative life events,especially on the aspects of family,work and study in the research group.There was positive correlation among the negative life events score,total score of life events and SDS score in the research group(P＜ 0.01),meanwhile,negative correlation was revealed between the score of positive life events and SDS score in the research group(P ＜ 0.05).Conclusion Patients with PSS complicating depressive disorder experienced more negative life events which play an important role in depression of patients with PSS.

Objective To survey the prevalence and the related factors of depression in patients with primary Sj(o)gren's syndrome (pSS),and provide references for early mental intervention.Methods The depression state of 217 patients with pSS was screened with self-rating depression scale (SDS) first and then assessed by Hamilton depression scale (HAMD,17 index).The prevalence of depression was determined based on the diagnosis of psychiatrist based on the 3rd edition of Chinese classification of mental disorders (CCMD Ⅲ).The personality was evaluated by Eysenck personality questionnaire (EPQ),and the life events were questionnaired by life events scale (LES).The general condition was analyzed by self-designed questionnaire.Finally,step-wise multiple factor regression analysis was carried out to determine the risk factors that best accounted for the depression.Results The prevalence rate of depression in patients with pSS was 39.2％ (85/217).There were 5 factors entered the regression equation by multifactor regression analysis.They were severe pain,concerns of doctor and nurse,known of the fact by patients,adverse life events,and neuroticism of EPQ,and the concern of doctor and nurse was negatively correlated.Conclusion More attention from clinicians should be paid to the depression of pSS.Patients with severe pain,lack of attention from doctors and nurses,known of the disease itself,adverse life events and neurotic personality traits are factors related with depression.Recognizing the risk factors early can provide guidance for early psychological intervention.

Objective To investigate the prognosis of patients with Kawasaki's disease complicated with coronary artery lesion and to provide evidence for diagnosis and treatment of these patients. Methods This study was conducted during January 2002 to June 2007. All patients diagnosed as Kawasaki's disease complicated with coronary artery lesions were from the Affiliated Hospital of Guilin Medical College, the Second People's Hospital of Guangxi Province and Guilin Women and Childrens' Hospital. All cases were echocardiogram examined in month 3, 6, 12, 24 and 36 in the purpose of observing the morphology of coronary artery. The study subjects were re-categorized to the groups of mild, moderate dilatation of coronary artery and giant coronary aneurysm, based on the severity of coronary artery lesion. The results of these results of the three groups were compared. Results Eighty-four cases in the mild group, 27 cases in the moderate group and 8 cases in the giant coronary aneurysm. The recovery cases were 23 (27%), 3 (11%) and 0 in the 3 groups respectively at month 3. The above numbers were 44 (52%), 8 (30%) and 0 respectively at month 6.The numbers were 69(82%), 13 (48%) and 1 (13%) at month 12. The numbers were 78 (93%), 19 (70%), 3 (38%) at month 24. The numbers were 82(98%), 20(74%) and 4(50%) at month 36. Thirteen patients were treated with adenosine-triphosphate (ATP) stress echocardiography examiantion, 5 patients were evaluated by coronary angiography,and 4 patients were tested by 64-slice CT coronary reconstruction. Part of the patients were found to have coronary stenosis or occlusion. Conclusion Patients of Kawasaki's disease often have concurrent coronary artery lesions. Patients with mild dilatation of the coronary artery are the most commonly seen and have the best prognosis. On the contrast, patients with giant coronary aneurysm are the lest common situation and is the worst in prognosis. Part of them will develop coronary artery stenosis or occlusion in late stage which may lead to ischemic heart disease. We should stress on close follow-up of patients with Kawasaki's disease complicated with coronary artery lesion. Appropriate and timely treatment will increase their clinical outcomes.

Objective:To investigate the distributions of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) genotypes among newly reported HIV/HCV co-infected Burmese patients in Dehong Dai and Jingpo Autonomous Prefecture, Yunnan Province from 2016 to 2019.Methods:A total of 1 289 newly reported HIV/HCV co-infected Burmese patients in Dehong Dai and Jingpo Autonomous Prefecture were collected through the National Acquired Immunodeficiency Syndrome Comprehensive Prevention and Control Data Information System From January 2016 to December 2019. Among them, 996 subjects with a plasma volume of ≥200 μL were selected to perform HIV and HCV genotyping. The HIV pol gene, the HCV core protein-binding envelope protein ( CE1) gene and non-structural protein 5B ( NS5 B) gene were amplified using the nested polymerase chain reaction.The phylogenetic tree was constructed by MEGA 7.0 software to classify the genotypes. Chi-square test was used for statistical analysis. Trend chi-square test was used to analyze the trend of HIV and HCV genotypes. Results:Among the 996 cases with HIV/HCV co-infection, HIV and HCV sequences from a total of 554 subjects (55.6%, 554/996) were successfully obtained, and the genotypes of HIV and HCV were diverse. HIV genotype C (40.3%, 223/554) and BC recombinant (33.6%, 186/554) were the most prevalent, followed by genotype B (6.5%, 36/554) and circulating recombinant form (CRF)01_AE (3.6%, 20/554). HCV genotype 3b was the most prevalent (31.2%, 173/554), followed by genotype 6u (19.5%, 108/554), 1a (17.5%, 97/554), 6n (11.4%, 63/554), 3a (8.7%, 48/554) and 6xg (6.3%, 35/554). The prevalence of HIV genotype C showed a downward trend ( χtrend2=7.23, P<0.001), while the prevalence of BC recombinant showed an upward trend ( χtrend2=5.97, P<0.001), and the proportion of BC recombinant was higher than genotype C in 2019 (54.9%(101/184) vs 21.7%(40/184)). However, there were no statistically significant differences in the proportions of genotype 3b, 6u and 1a from 2016 to 2019 ( χtrend2=1.43, 1.79 and 0.39, respectively, P=0.152, 0.074 and 0.695, respectively). The HIV genotype distribution among patients with different ethnic groups were significantly different ( χ2=22.06, P=0.037). Conclusions:The diversity of HIV and HCV genotypes is high and complex among HIV/HCV co-infected Burmese patients in Dehong Dai and Jingpo Autonomous Prefecture. BC recombinant shows a trend of becoming the predominant HIV genotype among these co-infected patients. Therefore, surveillance of the prevalence of HCV and HIV genotypes in Burmese population needs to be further strengthened.

OBJECTIVE: To screen for small molecular compounds with selective inhibitory activity against cutaneous melanoma cells with BAP1 deletion. METHODS: Cutaneous melanoma cells expressing wild-type BAP1 were selected to construct a BAP1 knockout cell model using CRISPR-Cas9 system, and small molecules with selective inhibitory activity against BAP1 knockout cells were screened from a compound library using MTT assay. Rescue experiment was carried out to determine whether the sensitivity of BAP1 knockout cells to the candidate compounds was directly related to BAP1 deletion. The effects of the candidate compounds on cell cycle and apoptosis were detected with flow cytometry, and the protein expressions in the cells were analyzed with Western blotting. RESULTS: The p53 activator RITA from the compound library was shown to selectively inhibit the viability of BAP1 knockout cells. Overexpression of wild-type BAP1 reversed the sensitivity of BAP1 knockout cells to RITA, while overexpression of the mutant BAP1 (C91S) with inactivated ubiquitinase did not produce any rescue effect. Compared with the control cells expressing wild-type BAP1, BAP1 knockout cells were more sensitive to RITA-induced cell cycle arrest and apoptosis (P < 0.0001) and showed an increased expression of p53 protein, which was further increased by RITA treatment (P < 0.0001). CONCLUSION Loss of BAP1 results in the sensitivity of cutaneous melanoma cells to p53 activator RITA. In melanoma cells, the activity of ubiquitinase in BAP1 is directly related to their sensitivity to RITA. An increased expression of p53 protein induced by BAP1 knockout is probably a key reason for RITA sensitivity of melanoma cells, suggesting the potential of RITA as a targeted therapeutic agent for cutaneous melanoma carrying BAP1-inactivating mutations.
Humans ; Melanoma ; Skin Neoplasms ; Tumor Suppressor Protein p53 ; Apoptosis ; Cell Division ; Tumor Suppressor Proteins/genetics* ; Ubiquitin Thiolesterase/genetics*

OBJECTIVETo understand HIV rival suppression and drug resistance (HIVDR) among AIDS patients who were receiving antiretroviral treatment (ART) in Dehong prefecture, Yunnan province.

METHODSAll AIDS patients who were aged over 15 years and with experience more than six months on ART by the end of 2012 in Dehong prefecture, were enrolled to receive testing for HIV viral load in plasma and genetic mutations associated with HIVDR.

RESULTSA total of 4 390 AIDS patients were qualified for the study according to the selection criteria, of whom 3 964 (90.3%) finally participated in the study. Among them, 2 307(58.2%) had CD₄(+) cell counts more than 350 cells/mm³. 3 169 (79.9%) patients showed undetectable plasma HIV viral load which was lower than the detection threshold. Those who had the following factors as:resided in Ruili city, being female, older than 45 years of age, married, heterosexually infected with HIV, having received ART more than 5 years, and CD₄(+) cell counts >500 cells/mm³, were more likely to have undetectable plasma virus load, with the differences statistically significant. 402 (10.1%) patients had plasma viral load ≥ 1 000 copies/ml, of whom 353 (87.8%) were successfully amplified and examined for HIVDR. Among them, 198 (56.1% ) were identified to bear genetic mutations associated with HIVDR. Most mutations were related to the resistance to nucleotide reverse transcriptase inhibitors (NNRTIs) or non-nucleotide reverse transcriptase inhibitors (NNRTIs), with M184V and K103N most frequently seen. 12 patients (3.4%) were found to have mutations resistant to protease inhibitors (PI). Data from multiple logistic regression analysis indicated that the period of receiving ART and the initial ART regimen could both significantly predict the occurrence of HIV resistance.

CONCLUSIONViral suppression was highly achieved among ART-prescribed AIDS patients in Dehong prefecture,Yunnan province. However, among those who did not show effective viral suppression, the proportion of HIVDR was high, underscoring the needs for health education so as to improve the adherence to drugs as well as for improving testing for viral load and HIVDR among AIDS patients.

Acquired Immunodeficiency Syndrome ; drug therapy ; Adolescent ; Adult ; Anti-HIV Agents ; therapeutic use ; Drug Resistance, Viral ; genetics ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mutation ; Viral Load ; drug effects ; Young Adult

ObjectiveTo investigate the factors that influence the first CD4+T lymphocyte counts in newly reported HIV-infected cases aged 50 and above in Dehong Prefecture of Yunnan Province during 2016 to 2021， and to understand the patient immune status and disease progression so as to provide scientific basis for HIV prevention and control strategies in the future. MethodsData was collected from the national HIV/AIDS information system. Multivariate logistic regression was used for the analysis of factors affecting the first CD4+T lymphocyte counts. ResultsA total of 642 cases of HIV infection were newly reported， among them， 571 cases had CD4+T lymphocyte counts and 200 cases （35.03%） had CD4+T lymphocyte counts <200 cells·μL^-1. Patients who were in the 50-59 age group， male， divorced or widowed， and less educated were more likely to have CD4+T lymphocyte counts <200 cells·μL^-1. Compared with active testing consultants， forced reeducation through labor or drug rehabilitation cases were less likely to have CD4+T lymphocyte counts <200 cells·μL^-1. ConclusionThere is no obvious upward trend in newly reported HIV infected persons aged 50 years and above in Dehong Prefecture during 2016 to 2021. However， the situation of CD4+T lymphocyte counts <200 cells·μL^-1 is still serious. Attention should be paid to the key groups： male， Chinese nationality， farmers， Han nationality， married or divorced， junior high school education or below， and heterosexual transmission. It is necessary to strengthen the intervention in people aged 50 and above and improve the detection efficiency.

ObjectiveTo determine the trend and influencing factors of HIV subtypes in newly reported HIV/AIDS cases in Dehong Dai and Jingpo Autonomous Prefecture （Dehong Prefecture） from 2017 to 2019. MethodsRNA extraction was conducted among newly reported HIV/AIDS cases in Dehong Prefecture from 2017 to 2019 whose plasma volume was more than 200 μL. The gag， env and pol genes were amplified by using RT-PCR and then sequenced to determine the subtypes. ResultsA total of 3 287 HIV-infected cases were newly reported in Dehong from 2017 to 2019. The HIV gag， env and pol genotypes were determined in 1 813 cases. The major subtypes were subtype C （28.4%，515/1 813）， recombination form BC （22.0%，398/1 813） and CRF_01AE （18.1%，329/1 813）. Furthermore， the proportion of subtype B， subtype C and CRF01_AE decreased over years， whereas 01/BC， CRF07_BC and CRF08_BC increased over years in both Chinese and Burmese patients （χ²=75.212，P<0.001）. There were significant differences in gender， age， marital status， ethnicity， educational level and transmission route among Chinese and Burmese HIV-infected cases with diverse HIV genotypes （all P<0.05）. ConclusionHIV subtypes in Dehong change over time， which demonstrates that the proportion of BC recombinant subtypes and unique recombinant subtypes increased significantly.