Abstract: Objective　To explore the early diagnostic value of peripheral blood peroxisome proliferator-activated receptor γ (PPARγ) combined with γ-interferon (IFN-γ) release assay (IGRA) in the diagnosis of pulmonary tuberculosis in patients with end-stage renal disease (ESRD), and to provide reference for clinical diagnosis and treatment. Methods　From January 2019 to December 2021, 70 ESRD patients with suspicious symptoms of pulmonary tuberculosis were treated at Hebei Chest Hospital were selected as the research objects. According to the examination results, they were divided into ESRD group (40 cases) and ESRD complicated by pulmonary tuberculosis (40 cases, comorbidity group). In addition, 40 cases with pulmonary tuberculosis were used as the PTB group. All three groups of patients underwent IGRA test, and the peripheral blood PPARγ level was detected by enzyme-linked immunosorbent assay, and the diagnostic value of PPARγ combined with IGRA test for ESRD patients with pulmonary tuberculosis was explored. Results The expression level of PPARγ and IFN-γ content in the PTB group and the comorbidity group were obviously higher than those in the ESRD group (P<0.05), while the differences in PPARγ expression level and IFN-γ content between the PTB and comorbidity groups were not statistically significant (P>0.05). The ROC curve showed that the areas under the curve (AUC) of PPARγ and IGRA in the diagnosis of end-stage renal disease combined with tuberculosis were 0.823 (95%CI: 0.722-0.925) and 0.773 (95%CI: 0.662-0.883), respectively, and the AUC of combined detection was 0.928 (95%CI: 0.871-0.984), which was better than that of PPARγ and IGRA alone (Z/P=2.057/0.039, 2.843/0.005). The Kappa values of serum PPARγ and IGRA test compared with the clinical gold standard results in the diagnosis of ESRD complicated with pulmonary tuberculosis were 0.557 and 0.444 (P<0.05). The combined screening of ESRD with pulmonary tuberculosis was consistent with the clinical gold standard (Kappa=0.661, P<0.05). Among the 30 ESRD patients complicated with pulmonary tuberculosis, the sensitivity of PPARγ combined with IGRA test in diagnosis of ESRD complicated with pulmonary tuberculosis was 93.33% (28/30), which was higher than 70.00% (21/30) of PPARγ and 66.67% (20/30) of IGRA test alone (P<0.05). Conclusions Peripheral blood PPARγ and IGRA tests have certain diagnostic value for ESRD complicated with tuberculosis, and the combined detection of the two can improve the sensitivity and reduce the rate of missed diagnosis, which is worthy of clinical promotion.

A 25-year-old woman complaining of dyspnea on exertion, coughing, fever and chills was admitted in January, 1998. Her clinical, radiological, and pathological findings were compatible with hypersensitivity pneumonitis and precipitin antibody to Trichosporon cutaneum was detected in her serum. Although some cases of T. cutaneum-induced hypersensitivity pneumonitis developed during the winter season were reported in Japan, there had been no report of such a case in Korea. This case suggests that T. cutaneum-induced hypersensitivity pneumonitis can develop beyond the summer season in certain environments.
Adult ; Alveolitis, Extrinsic Allergic* ; Chills ; Cough ; Dyspnea ; Female ; Fever ; Humans ; Hypersensitivity* ; Japan ; Korea ; Seasons ; Trichosporon*

Objective To further understand potential mechanism of miRNAs in bladder cancer .Mtehods Human microarray was used to analyze the expression of miRNAs in four pair human BC cancer tissues and adjacent normal tissues.Then RT-Qpcr was used to verified that the expression of two most up -regulated miRNAs and target genes for results of miRNA/Mrna microarray.Subsequently, it was deduced that miR-130b-3p could target at PTEN through a bioinformatics approach and dual-luciferase reporter assay.CCK8, EDU, flow cytometry, wound healing, Transwell and cytoskeleton assay were applied to prove that miR-130b could affect proliferation, apoptosis, migration and invasion of BC cells.The effects of PTEN regula-ted by miR-130b-3p on the key target protein expression of PI 3K/AKT and integrin β1/FAK signaling pathway were determined by Western blot.Resulst miR-130b-3p was significantly up-regulated and nega-tively correlated with PTEN expression in clinical bladder cancer specimens as compared with normal urothelial tissue.miR-130b-3p mimics could down-regulate PTEN expression, which leads to the activation of PI3K/AKT and integrinβ1/FAK signaling pathway related to cell proliferation , migration and invasion in bladder cancer EJ cells.When the cells were transfected with miR-130b-3p inhibitors, they could be sur- veyed with rearranging cytoskeleton.Conclusions miR-130b/PTEN may be used as a marker for bladder cancer.

Objective To investigate the relationship between epidermal growth factor receptor (EGFR) gene mutation and computed tomography (CT) features and clinical features in non-small cell lung cancer (NSCLCs) patients. Methods The clinical data of 187 patients with NSCLCs admitted in our hospital from September 2014 to July 2016 were retrospectively analyzed. All the patients accepted the EGFR mutated gene detection, and they were divided into effective mutation group (n=67) and non-effective mutation group (n=120). The clinical data and lung CT imaging data were complete in the two groups. The univariate and multivariate Logistic regression analysis were used to analyze the differences of imaging and clinical features between the two groups. Results Comparing with the non-mutation group, there were higher proportion of women and lower smoking index in the EGFR effective mutation group. Lesions in the lung tissue showed a clear edge, leaf and burr, and containing ground-glass opacity (GGO) component, usually accompanied by airway bronchogram and pleural indentation, and associated with cancer lymphatic inflammation and lung metastasis in mutation group (all P < 0.05). There were no significant differences in the proportion of necrosis, cavitation, calcification, halo sign and vacuole sign between the two groups (P > 0.05). Logistic regression analysis showed that female, GGO containing composition, burr, air bronchogram, carcinomatous lymphangitis and lesion density showed obvious airway involvement were the predictive risk factors in patients with EGFR effective mutation. Conclusion The EGFR mutation occurs more oftern in female. The reliable predictive signs of CT include GGO composition, burr, airway bronchogram and carcinoid lymphangitis. In critical patients who are not easy to obtain clinical pathology, it has a guiding significance to radiographic assessment for EGFR effective mutation.

OBJECTIVE Angiogenesis therapy has attracted interest as a potential treatment for hepatocellular carcinoma (HCC). In this study, we investigated the anti-proliferative activities and anti-angiogenesis effects of saikosaponins (SS)-b on hepatocellular carcinoma (HCC) and its regulation on VEGF/ERK/HIF-1α signal pathway. METHODS H22 hepatoma-bearing mice model and HepG-2 cells were used to study the anti-tumor and anti-angiogenesis effects of SS-b in vivo and in vitro. Pathological change of tumor tissue was observed by HE staining, the microvascular changes were detected by immunohistochemical method. The effects of SS-b on angiogenesis were examined by using the chick embryo chorioallantoic membrane (CAM) model. The effects of SS- b on proliferation, migration and invasion were investigated by MTT assay, scratch wound healing assay and transwell assay inhuman umbilical vein endothelial cell (HUVEC) and HepG2 cells in vitro. Vascular endothelial growth factor (VEGF), matrix metalloproteinase-2/9(MMP-2/9), hypoxia-inducible factor-1α (HIF-1α) expression and the phosphorylation of extracellular regulated kinase(ERK) were analyzed using RT-PCR and Western-blot. RESULTS SS-b effectively inhibited the tumor growth of H22 mice in vivo. The inhibitory rate of tumor was 49.1%, 50.7%, 66.1% in SS-b 5, 10 and 20 mg·kg-1 group respectively. HE staining results showed that SS-b induced tumor necrosis and nuclear dissolution in H22 mice. Moreover, SS-b also reduced the number of microvessels of tumor tissue in H22 mice significantly and suppressed the angiogenesis of CAM induced by b-FGF. SS-b had an obvious inhibitory effect on cell proliferation, migration and invasion of HUVEC cells and HepG-2 cells. These effects were associated with down-regulation of the expression of MMP2/9 and suppression of VEGF/ERK/HIF-1α signaling in H22 mice and Hep-G2 cells. CONCLUSION Our findings showed that SS-b exerts anti-tumor effects by inhibit?ing tumor angiogenesis via regulating VEGF/ERK/HIF-1α signal pathway in vivo and in vitro.

Objective To preliminarily verify the feasibility of utilizing TG119 report to commission the volumetric modulated arc therapy (VMAT) plans.Methods Based on the test cases mentioned in TG119 report,7-/9-field intensity-modulated radiation therapy (IMRT) and dual-arc VMAT plans were devised by using two types of beam energy (6 MV and 10 MV) in the Eclipse TPS system according to the requirement of this report.All the plans were verified using 0.125cc semiflex thimble ionization chamber,MatriXX and Delta 4,respectively.The final results were statistically compared with the results measured by multiple institutions in the TG119 report.Results The resuhs of both IMRT and VMAT plans met the requirement of the TG119 report.The discrepancy of point dose in the high/low dose region of VMAT plans using different photon beams was ranged from-2.55％ to 2.55％,and ± 1.85％ for the IMRT plans.The percentage of γ passing points (±3％/3 mm) for the IMRT plans using 6 MV and 10 MV photon beams was 99.38％ and 99.53％,99.32％ and 99.46％ for the VMAT plans.The γ passing rate of the compound field exceeded 98％.Conclusions The VMAT plans with 6 MV and 10 MV photon beams meet the requirement of the TG119 report.TG119 report provides certain guidance for establishing a benchmark for dosimetry verification of the VMAT plans.

Objective To evaluate the methods in early warning of schistosomiasis and elimination of snails in an ecological public forest in Yexie Town of Songjiang District, and provide the basis for monitoring and controlling snails in forest land in the future. Methods The monitoring data of snails, schistosomiasis and snail elimination in the public forest were collected to evaluate the effect of controlling snails. Results The area with existence of snails was found to be 10.47 hm², and it was decreased by 98.28% after three times of snail elimination.A total of 1 904 serological tests was performed (test rate of 88.76%) with the positive rate of 0.16%.Pathogenic test result was negative in 3 subjects examined.Serological samples of 11 dogs and 1 sheep were all negative for the test.None of the 1 480 live snails tested was found to be positive in infection.The awareness rate of schistosomiasis control knowledge and behavior formation in 275 students were 98.2% and 95.3%, respectively. Conclusion The snails in the public forest in Yexie Town have been effectively controlled, but there are still scattered living snails.The measures in eliminating and monitoring of snails should be continued and strengthened.

Objective To investigate the level of health literacy of residents in Jing′an District of Shanghai, providing basis for the intervention programs of health literacy. Methods By using Probability Proportionate to Size Sampling method, 1 760 residents aged 15-69 were surveyed through face-to-face interviews. Results The overall level of adjusted health literacy of Jing′an District was 31.89%.The health literacy level of basic health concepts and knowledge, health lifestyle and behaviors, and health related skills were 46.30%, 27.02%, 43.44%, respectively.The 6 health issues regarding awareness of health literacy from high to low were safety and first aid (65.49%), scientific attitude towards health(60.75%), health information literacy(56.86%), chronic diseases prevention (34.22%), basic medical care(31.10%), and infectious diseases prevention (24.28%).People of 65-69 years old had the lowest health literacy level (χ²=22.03, P < 0.05).Those with collage degree or above had higher health literacy level (χ²=43.54, P < 0.05).In terms of occupation, civil servant had higher health literacy level(χ²=22.78, P < 0.05). Conclusion The level of health literacy in Jing′an District is on a steady rise, however, intensive intervention is needed for residents with lower health literacy.

Background::Helicobacter pylori ( H. pylori) infection is an infectious disease with a prevalence rate of up to 50% worldwide. It can cause indigestion, gastritis, peptic ulcer, and gastric cancer. H. pylori eradication treatment can effectively control disease progression and reduce the risk of the above conditions. However, the escalating trend of antibiotic resistance presents a global challenge for H. pylori eradication. We aim to provide guidance on pharmacological treatment of H. pylori infection. Methods::This clinical practice guideline is developed following the World Health Organization’s recommended process, adopting Grading of Recommendations Assessment, Development and Evaluation in assessing evidence quality, and utilizing Evidence to Decision framework to formulate clinical recommendations, minimizing bias and increasing transparency of the clinical practice guideline development process. We used the Reporting Items for practice Guidelines in HealThcare (RIGHT) statement and The Appraisal of Guidelines for Research and Evaluation II (AGREE II) as reporting and conduct guides to ensure the guideline’s completeness and transparency.Results::Though decreasing in developed countries, the prevalence of H. pylori remains high in developing countries, causing a major public health burden. This clinical practice guideline contains 12 recommendations concerning pharmacological treatment for H. pylori eradication. Among them, it is worth highlighting that bismuth preparations are inexpensive, safe, and effective, consequently making bismuth quadruple therapy a preferred choice for initial and rescue treatment. In empirical treatment, high-dose dual therapy is equally effective compared with bismuth quadruple therapy. Conclusions::The 12 recommendations in this clinical practice guideline are formed with consideration for stakeholders’ values and preferences, resource use, feasibility, and acceptability. Recommendations are generalizable to resource limited settings with similar antibiotic resistance pattern as China, and lower middle-income countries facing comparable sociological and technical challenges.Registration::Guidelines International Network (GIN) website, https://guidelines.ebmportal.com/node/69996.

Background:Blood glucose control is closely related to type 2 diabetes mellitus (T2DM) prognosis.This multicenter study aimed to investigate blood glucose control among patients with insulin-treated T2DM in North China and explore the application value of combining an elastic network (EN) with a machine-learning algorithm to predict glycemic control.Methods:Basic information,biochemical indices,and diabetes-related data were collected via questionnaire from 2787 consecutive participants recruited from 27 centers in six cities between January 2016 and December 2017.An EN regression was used to address variable collinearity.Then,three common machine learning algorithms (random forest [RF],support vector machine [SVM],and back propagation artificial neural network [BP-ANN]) were used to simulate and predict blood glucose status.Additionally,a stepwise logistic regression was performed to compare the machine learning models.Results:The well-controlled blood glucose rate was 45.82％ in North China.The multivariable analysis found that hypertension history,atherosclerotic cardiovascular disease history,exercise,and total cholesterol were protective factors in glycosylated hemoglobin (HbA1c) control,while central adiposity,family history,T2DM duration,complications,insulin dose,blood pressure,and hypertension were risk factors for elevated HbA1c.Before the dimensional reduction in the EN,the areas under the curve of RF,SVM,and BP were 0.73,0.61,and 0.70,respectively,while these figures increased to 0.75,0.72,and 0.72,respectively,after dimensional reduction.Moreover,the EN and machine learning models had higher sensitivity and accuracy than the logistic regression models (the sensitivity and accuracy of logistic were 0.52 and 0.56;RF:0.79,0.70;SVM:0.84,0.73;BP-ANN:0.78,0.73,respectively).Conclusions:More than half of T2DM patients in North China had poor glycemic control and were at a higher risk of developing diabetic complications.The EN and machine learning algorithms are alternative choices,in addition to the traditional logistic model,for building predictive models of blood glucose control in patents with T2DM.