Objective To explore the application of submental ultrasonongraphy (SUS) in the assessment of oropharyngeal swallowing disorders in children with cerebral palsy.Methods Seventeen children with cerebral palsy and oropharyngeal swallowing difficulties (7 on nasal feeding,10 on oral feeding) constituted the treatment group while 20 normal counterparts formed the control group.SUS was applied to measure any changes in the thickness of the tongue muscle and the range of hyoid bone displacement when they swallowed 5 ml of water.The results were compared with those assessed using the functional oral intake scale to decide the best cut-off point for detecting tube-feeding-dependent dysphagia.The intraclass correlation coefficient (ICC) of the 20 children in the control group was calculated to evaluate the intra-rater and inter-rater reliability of SUS.Results The average tongue muscle thickness change and hyoid bone displacement amplitude of the children on nasal feeding were significantly smaller than those of the children without nasal feeding and the normal children.The best cut-off point for the tongue muscle thickness change data was 1.0 cm,and that of the hyoid bone displacement amplitude was 1.5 cm.All of the ICCs were above 0.4,indicating good intra-rater and inter-rater reliability for the SUS examination.Conclusion Submental ultrasonongraphy can help assess the swallowing function of children with oropharyngeal swallowing disorders.

Objective A very high prevalence of rheumatoid arthritis (RA) is observed in Minnan population in China.We aimed to explore the genetic characteristics of RA in Minnan population and genetic mechanisms of RA by studying the associations of three single nucleotide polymorphisms (SNPs) of signal transducer and activator of transcription 4 (STAT-4) (rs7574865),the cytotoxic T-lymphocyte antigen-4 (CTLA)-4 (rs3087243) and chromosome 9p21.3(rs1333049) with RA in Minnan population.Methods A case-control study of 119 RA patients and 125 normal controls from Quanzhou were enrolled.SNPs (rs7574865,rs3087243,rs1333049) were genotyped by allele-specific polymerase chain reaction (PCR) and analyzed by SPSS 18.0.x2-test was applied to compare allele and genotype frequeneies betweeen cases and controlsLogistic regression models were used to analyze the SNPs.Results The results showed the genotype distributions of STAT4 genes were significantly different between case and control groups (P＜0.01).Compared with the GT heterozygous genotype,TT and GG homozygosity carriers had a lower risk (OR=0498 and 0.300,P=0.018 and P=0.002 respectively).There was not statistical difference in genotypes and allele in CTLA-4 (rs3087243) between RA patients and healthy controls (x2=4.083,P=0.130),but compared with the AG genotyoe,GG homozygosity carriers had a lower risk on basis of statistics (OR=0.580,P=0.04).There was not statistical difference in genotypes and allele in the chromosome 9p21.3 (rs1333049) (P＞0.05),but compared with the GG genotype carriers,CC and GC genotypes carriers had a lower risk on basis of statistics (OR=0.565,P=0.0495).Conclusion Chromosome 9p21.3 (rs1333049) and CTLA-4 rs3087243 G/A may not be associated with susceptibility to RA in Minnan popula-tions.This replication study confirmes that STAT4 rs7574865 G/T polymorphism is associated with susceptibility to RA in Minnan population.

Objective To investigate the clinical features of of patients with Staphylococcus aureus blood-stream infection and risk factors for septic shock.Methods A total of 51 patients diagnosed with Staphylococ-cus aureus bloodstream infection in the hospital from January 2018 to March 2023 were enrolled in the study.According to whether the patients developed septic shock,they were divided into septic shock group and non-septic shock group.The clinical data of the patients were collected,and the clinical laboratory indicators were detected on the day of blood culture samples were collected.Bacteria isolated from blood culture specimens of patients were identified and tested for drug sensitivity.The clinical data and clinical laboratory test indicators of the two groups were compared.Multivariate Logistic regression was used to analyze the independent risk factors of septic shock in patients with Staphylococcus aureus bloodstream infection.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of clinical laboratory test indicators for septic shock in patients with Staphylococcus aureus bloodstream infection.Results Septic shock occurred in 12 of 51 patients,with an incidence of 23.5％.The proportion of patients with diabetes,gouty arthritis,the proportion of patients with long-term glucocorticoid use,the proportion of patients with respiratory tract in-fection,the proportion of patients who died,and the hospitalization cost in the septic shock group were higher than those in the non-septic shock group,and the differences were statistically significant(P＜0.05).Long-term glucocorticoid use was an independent risk factor for septic shock in Staphylococcus aureus bloodstream infection(P＜0.05).The combination of C-reactive protein(CRP),albumin(Alb),neutrophil/lymphocyte ratio(NLR)and procalcitonin(PCT)had high value in predicting septic shock in patients with Staphylococ-cus aureus bloodstream infection,and the area under the ROC curve was 0.983.Conclusion Long-term use of glucocorticoids can lead to an increased risk of septic shock in patients with Staphylococcus aureus blood-stream infection.The combined detection of CRP,Alb,NLR and PCT has a higher predictive value than single detection for septic shock in patients with Staphylococcus aureus bloodstream infection.

Objective:To establish and validate a model predicting the age at which a child with cerebral palsy will be able to walk independently.Methods:Data spanning 2016 to 2020 were collected from the cerebral palsy registration platform to build a database. Then, 70% of the patients were randomly assigned to the modeling group, while the remaining 30% were reserved for validation. Factors such as gender, bilirubin encephalopathy, neonatal asphyxia, extremely low birth weight, early pre-term birth, cerebral palsy type, magnetic resonance classification, gross motor function classification (GMFCS) score before 2 years of age, independent sitting age, ability to sit independently at 2 years of age, sections A through E of the gross motor function measure (GMFM-88), epilepsy, intellectual disability, visual impairment and surgery were analyzed applying Cox univariate regression analysis. The variables highlighted by the univariate regression analysis were included in Cox multivariate regression analyses, and a prediction model for the independent walking of children with cerebral palsy was established. It is presented as a linear graph. The C-statistic and calibration curve were used to evaluate the graph′s discrimination ability and calibration. Net reclassification improvement (NRI) was used to evaluate the linear graph′s net benefit.Results:A total of 807 cases were included in the study, with 565 and 242 in the model and validation groups, respectively. GMFCS score before 2 years of age, cerebral palsy type, independent sitting age, intellectual disability and early pre-term birth were found to be independent predictors of the age of independent walking. The C-statistics for 1-6 year-olds were all >0.8, indicating that the prediction model had good discrimination. The calibration curve showed that the predicted probability of independent walking at 1-4 years old was consistent with the observed probability, while the predicted probability of independent walking at 5-6 years old was higher than the observed probability. NRI suggested that the net benefit of the linear graph prediction model was not less than that of the full-factor model.Conclusion:A linear model was developed which can usefully predict the age of independent walking for children with cerebral palsy.

Objective:This study aimed to discover the HIV infection and associated factors among male sex workers (MSW) who provide sexual services for men. Data from this study thus can be used to provide evidence for designing related intervention programs.Methods:In this observational study, MSW were recruited from May to July, 2019 in KTV venues in Wuxi, China. A questionnaire was used to collect information with blood sample collected and tested for HIV and syphilis. EpiData 3.0 and SPSS 17.0 software were used to clean up data and statistical analysis.Results:A number of 500 MSW were involved including 243 (48.6 %) heterosexual and 257 (51.4 %) homosexual MSW. The overall HIV prevalence was 5.4 %(27/500) among all the MSW. there were significant differences between the HIV prevalence rates, the heterosexual MSW (3.3 %, 8/243) and the homosexual MSW (7.4 %, 19/257)( χ2=4.112, P=0.043). In the past 3 months, 28.0 % (72/257) of the homosexual MSW mainly engaged in receptive anal sex which was higher than 11.5 %(28/243) of the heterosexual MSW. Compared to 15.6 % (40/257) of the homosexual MSW who engaged in heterosexual behavior, a higher proportion of 98.4 % (239/243) was noticed among the heterosexual MSW. Higher percentage (44.9 %, 109/243) appeared among the heterosexual MSW who had not been tested for HIV than the homosexual MSW (20.6 %, 53/257). Results from logistic regression multivariate analysis showed that age ≥30 (a OR=7.54, 95 %CI: 2.53-37.11), having unprotected anal sexual practice (a OR=3.76, 95 %CI:1.15-12.23), having anal sex after drinking alcohol (a OR=10.91, 95 %CI: 2.29-51.87) and syphilis tested positive (a OR=8.23, 95 %CI:1.29-52.51) were risk factors associated with HIV infection among the heterosexual MSW. Having unprotected anal sexual behavior (a OR=2.94, 95 %CI: 1.17-7.37), having group anal sex (a OR=4.08, 95 %CI:1.05-15.81), without record on HIV testing (a OR=6.58, 95 %CI: 2.01-18.06) and syphilis tested positive (a OR=4.55, 95 %CI: 1.15-18.06) were risk factors associated with HIV among the homosexual MSW. Conclusions:High HIV prevalence was discovered among both heterosexual and homosexual MSW in Wuxi, China. Differences in sexual behaviors between these two groups should be considered when designing targeted HIV intervention programs for these populations.

Objective To observe the effect of ginkgobalide B (GB) on neurocyte apoptosis and protein kinase B expression in neonatal rats after hypoxic-ischemic brain damage (HIBD).Methods Ninety seven-day-old Sprague-Dawley rats were randomly divided into a sham group,an HIBD group and a GB group,each of 30.HIBD was induced in the HIBD and GB groups using the classical Rice method,while the sham group was given a sham operation.GB (10 mg/kg) was injected intraperitoneally to the rats in the GB group at 0 h and 24 h after the modeling.Then 6 rats were killed 6 h,12 h,24 h and 48 h after the modeling,and the expression of caspase-3 mRNA was detected using a real-time PCR to find the time point of maximum effectiveness.Then to further explore the role of the PI3K-AKT pathway in the anti-apoptosis effect of ginkgolide B,a a GB+LY294002 group of 6 rats,which was injected with PI3K-AKT pathway inhibitor LY294002 (1.8 mg/kg) intraperitoneally at 30 min before the modeling and with GB(10 mg/kg) at 0 h and 24 h after the modeling,was added to the experiment.Hematoxylin-eosin staining,terminal-deoxynucleotidyl transferase-mediated nick end labeling and immunohistochemical staining were then used to observe any morphological changes in the cortex,to detect neuronal apoptosis and to quantify the expression of P-AKT protein.Results The expression of caspase-3 in the HI and GB groups began to increase 6 hours after the HIBD and reached a peak after 24 hours,followed by a gradual decline.The expression of caspase-3 in the GB group was significantly lower than in the HI group throughout,while that of both of those groups was significantly higher than in the sham group.Apoptosis-positive cells and the expression of caspase-3increased had significantly in the HI,GB and GB+LY294002 groups 24 hours after the HIBD compared with the sham group,while the expression of P-AKT protein had decreased significantly.Moreover,the apoptosis-positive cells and the expression of caspase-3 of the HI and GB+LY294002 groups were significantly high-er than those of the GB group,while their expression of P-AKT protein was significantly lower after 24 hours.Conclusion Ginkgobalide B can decrease neurocyte apoptosis caused by hypoxic-ischemic brain damage,especially at 24 h after the damage.The PI3K-AKT signaling pathway plays an important role in this effect.

Objective To study the expression of hypoxia-inducible factor-1a(HIF-1α) at mRNA and protein levels in the early stage of hypoxic-ischemic brain damage (HIBD) in neonatal rats and its role.Methods (1) Experiment 1:thirty-six postnatal 7-day SD rats were divided into Sham group (n =6) and model group (HIBD,n =30) according to the random table method,then the rats in the model group were divided into 5 subgroups according to the time of sacrifice after HIBD(6 h,12 h,24 h,48 h,72 h,n =6).The expression levels of HIF-1cα mRNA and protein were detected by quantitative Real-time PCR(qPCR) and Western blot,respectively.(2) Experiment 2:forty-five postnatal 7-day SD rats were randomized into 3 groups:Sham group (n =15),HIBD group (n =15) and 2-methoxyestradiol(2ME2) group(n =15).According to the experiment 1,at the time point of the highest expression levels of HIF-1 α mRNA and protein,rats were killed and the brains were collected.The location and expression of HIF-1 α protein were detected by immunofluorescence,histopathological changes of brain were observed by HE staining,brain water content was measured by dry-wet method,cell apoptosis was detected by nick end labeling(TUNEL) method.Results At the early stage of HIBD,the expression levels of HIF-1 α mRNA and protein increased at first and then decreased,and the mRNA expression level (3.38 ± 0.21) and protein expression level (2.81 ± 0.36) were the highest at 24 h after HIBD.In Sham group,HIF-1 α protein was mainly expressed in the cytoplasm,while in HIBD group it was mainly expressed in the nucleus.The number of HIF-1α staining positive cells,brain water content and apoptosis rate were significantly different among Sham group,HIBD group and 2ME2 group (all P ＜ 0.05),and which were significantly lower in 2ME2 group than those in HIBD group (all P ＜ 0.05),and the pathological changes were also less serious than those in HIBD group.Conclusions The mRNA and protein levels of HIF-1 α are the highest at 24 h after HIBD.Inhibiting the expression of HIF-1 α can ameliorate the brain damage of neonatal rats induced by hypoxia-ischemia.Therefore,it is hypothesized that HIF-1α may cause injury in the early stage of HIBD in neonatal rats.

Objective:To understand the attitudes toward sexual health education and its correlates among community-based older adults in Shanghai, China.Methods:From June 2020 to December 2022, a cross-sectional survey was conducted among community residents aged ≥50 in Shanghai through multi-stage sampling. The estimated sample size was 735. The questionnaire included sociodemographic characteristics, health characteristics, and history of sexual health education. The multivariable logistic regression model was used to assess the correlates of attitudes toward sexual health education among community-based older adults.Results:A total of 824 participants (489 males and 335 females) with age of (65.1±8.1) years were included, whose main age distribution was 60-69 years (45.3%). The prevalence of supporting sexual health education among older adults was 49.4% (45.2% of men and 55.5% of women). Males (a OR=0.61, 95% CI: 0.44-0.83), aged 70 years and older (a OR=0.62, 95% CI: 0.40-0.94), urban residents (a OR= 2.54, 95% CI: 1.81-3.58), self-reported very good or excellent health status (a OR=1.64,95% CI: 1.04-2.58), having depressive symptoms (a OR=0.37,95% CI: 0.15-0.85), and having a history of sexual health education (a OR=8.64 ,95% CI: 4.62-17.70) were associated with their attitude toward sexual health education. Conclusions:The proportion of community-based older adults in Shanghai who support sexual health education was not high. Their attitudes toward sexual health education were associated with their self-reported health status, depressive symptoms, and history of sex education. Health professionals and institutions should focus on community-based older adults with key characteristics and tailor interventions to promote the willingness to receive sexual health education among older adults in China and to promote the popularity of sexual health education in this population.

Objective To understand the virus-carrying status and infection condition of Culicoides in Yunnan province.Methods Culicoides, cattle serum samples and pig serum samples were collected in Qujing City in Yunnan province from Sep.to Nov.in 2011; the supernatant of Culicoides was inoculated in C6/36 cells to isolate virus.Suspected isolates were identified by molecular biology techniques and titers of virus antibodies in pigs and cattles serum samples were tested by VN.Results 8 300 short tarsal Culicoides (8 300/18 160) and 7 100 Ryukyu Culicoides (7 100/18 160) were identified among 18 160 Culicoides specimens.Two suspected virus strains were isolated and designated as SC093 and SC233.The nucleotide sequence homology of VP2, VP4 and VP8 sequences with Banna virus Chinese strain ( Accession number:AF134526) is up to 99%.1 out of 200 (1/200) cattle serum samples was antibody positive against Banna virus with 0.5%positive rate.And the neutralizing antibody titers of SC093 and SC233 with above Banna virus antibody positive cattle serum were 160 and 40.10 out of 535 ( 10/535 ) pig serum samples were antibody positive against Banna virus with 1.7%positive rate.And the neutralizing antibody titers of SC093 and SC233 with above Banna virus antibody positive pig serum samples were 80-320 and 20-80 respectively.Conclusions The SC093 and SC233 virus strains isolated from Shizong were identified to be Banna virus and it could cause infection in pigs and cattles.This is the first report that Banna virus was isolated from Culicoides.

Occupational contact dermatitis (OCD) is an occupational inflammatory skin disease. According to its pathogenesis, it can be divided into irritant contact dermatitis and allergic contact dermatitis. This review introduced the high-risk occupations of OCD, its incidence, common irritants and allergens, and corresponding treatments. Agriculture workers, construction workers, production workers, hairdressers, and medical workers are high-risk occupations of OCD who should be paid attention to.