Objective To investigate the impact of reduced glutathione(GSH) on the prolifera- tion,oxidative stress and transforming growth factor?1(TGF-?1) expression of human hepatocytes and hepatic stellate cells(HSCs)(LX-2 cell line).Methods Human hepatocytes and HSCs were incubated with various concentrations of GSH(0.5—50 mmol/L or 0.5—10 mmol/L).The effects of GSH on the proliferation of hepatocytes and HSCs were studied by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphennyhera- zolium bromide colorimetric assay.Human hepatocytes and HSCs were co-cultured with GSH and ferric nitrilotriacetic acid,superoxide dismutase (SOD) activity and malondialdehyde (MDA) contents were detected.HSCs were incubated with high(5.0 mmol/L),media(2.5 mmol/L) and low (0.5 mmol/L) concentrations of GSH,the expressions of TGF-?1 mRNA and protein were detected by ELISA and real- time PCR.Results In concentration ranged from 2.5 to 10 mmol/L,the GSH could promote the pro- liferation of hepatocytes but no HSCs,significantly increased the activity of SOD and decrease the con- tents of MDA in hepatocytes and HSCs,and inhibited the expression of TGF-?1 in HSCs.Conclusions GSH can not only promote the proliferation of hepatocytes,but also protect hepatocytes and HSCs from oxidative stress,and inhibit the secretion of TGF-?1 in HSCs.GSH may play a role in hepatocellular protection,antioxidation and anti-fibrosis.

Objective:To investigate the expression of maternally expressed gene 3 (MEG3), a long non-coding RNA gene, in gastric can-cer tissues;determine the relationship of MEG3 with the prognosis of gastric cancer;and explore the relationship between MEG3 and apoptosis-associated protein P53 as well as murine double minute 2 (MDM2). Methods:Fifty-five consecutive patients with gastric cancer admitted to Qingdao Municipal Hospital for surgical treatment from September 2012 to June 2013 were included in this study. Gastric cancer and paired normal tissues were collected. The expression of MEG3 was tested through real-time quantitative poly-merase chain reaction (qRT-PCR). Western blot analysis was used to detect the expression of P53 and MDM2 in gastric cancer and eval-uate their correlations with MEG3. Results:The expression of MEG3 decreased in cancer tissues (7.98±0.19) relative to the correspond-ing normal tissues (9.47±0.18) (P<0.05). P53 and MDM2 showed negative relationships in the gastric cancer and normal tissues. A posi-tive relationship was found between P53 and MEG3 (r=0.591, P<0.05), whereas a negative relationship was found between MDM2 and MEG3 (r=?0.346, P<0.05). The median survival time was significantly prolonged in patients with high MEG3 expression compared with patients with low MEG3 expression. Conclusion:MEG3 exerts an inhibiting effect on the development of gastric cancer. MEG3, P53, and MDM2 may have important relationships in the biological mechanisms of gastric cancer development. Detecting the expression level of MEG3 may be useful for the prognosis of gastric cancer.

OBJECTIVETo understand the high risk behaviors of female sex workers (FSWs) in Yunnan province in 2013.

METHODSA cross-sectional investigation was conducted during April to June, 2013 in Yunnan province, census was used to the investigation where the number of FSWs was close to 200, while probability sampling was used where the number of FSWs was obviously over 200. A total of 25 574 cases were investigated, and data on demography and risk behaviors were obtained by questionnaires one by one.

RESULTSA total of 25 574 cases were investigated, AIDS awareness among FSWs in high-level places, middle-level places and low-level place were 98.8% (92/7 401), 98.6% (150/10 995), and 96.0% (281/6 655). FSWs from low-level place had a lower rate than those from the other two types of places (P < 0.01). The rate of condom use each time when having sex with clients within the recent one month among FESs from high-level places, middle-level places and low-level place were 93.4% (6 307/6 755), 93.8% (10 109/10 782) and 90.4% (6 053/6 697), and the FSWs working in low-level place had a lower rate than those from the other two types of places(P < 0.01). Multi-factor logistic regression analysis showed that the following had a lower rate of condom use: the FSWs working in low-level place (OR = 1.56, 95% CI:1.36-1.79; OR = 1.36, 1.16-1.59), over 30 years old (OR = 0.77, 95%CI:0.69-0.85), Yunnan citizen (OR = 0.88, 95% CI:0.77-1.00), minority (OR = 1.32, 95% CI:1.16-1.50), under senior high school (OR = 0.61, 95%CI:0.49-0.75), married (OR = 0.81, 95% CI:0.71-0.92), living together (OR = 0.70, 95% CI:0.51-0.96), divorced or lost spouses (OR = 0.81, 95% CI:0.65-1.02), worked less than 6 months in local areas (OR = 1.74, 95% CI:1.34-2.27), drug users (OR = 1.65, 95% CI:1.11-2.46), had not accepted HIV interventions (OR = 2.91, 95% CI:2.36-3.58), had no knowledge about AIDS (OR = 4.50, 95% CI:3.48-5.82). The main reasons for not using condoms were the clients' unwilling to use, which accounted for 47.62% (270/567). The total rate of drug use was 1.0% (264/25 567) and the FSWs working in middle-level places had the highest rate of injecting drugs, which accounted for 0.6% (70/11 141). The FSWs working in low-level places had a higher rate than those who worked in high-level places and middle-level places in venereal diseases, which accounted for 1.2% (85/6 934) (P < 0.01). The rate of receiving effective interventions was 96.7% (24 717/25 574), the rate of accepting treatment and clean needles among drug users was 21.6% (57/264).

CONCLUSIONHigh risk behaviors were serious among the FSWs who worked in low-level places, especially among the olders, the minorities, people who had lower educational level, the new-comer and drug users, which indicated that more attention needs to be paid among these populations.

Age Factors ; China ; Condoms ; Cross-Sectional Studies ; Demography ; Drug Users ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Marital Status ; Risk-Taking ; Safe Sex ; Sex Workers ; Sexually Transmitted Diseases ; Socioeconomic Factors ; Surveys and Questionnaires

Objective To understand the high risk behaviors of female sex workers ( FSWs) in Yunnan province in 2013.Methods A cross-sectional investigation was conducted during April to June, 2013 in Yunnan province, census was used to the investigation where the number of FSWs was close to 200, while probability sampling was used where the number of FSWs was obviously over 200.A total of 25 574 cases were investigated, and data on demography and risk behaviors were obtained by questionnaires one by one.Results A total of 25 574 cases were investigated, AIDS awareness among FSWs in high-level places, middle-level places and low-level place were 98.8%( 92/7 401 ) , 98.6%( 150/10 995 ) , and 96.0%(281/6 655).FSWs from low-level place had a lower rate than those from the other two types of places(P<0.01).The rate of condom use each time when having sex with clients within the recent one month among FESs from high-level places, middle-level places and low-level place were 93.4%(6 307/6 755), 93.8%(10 109/10 782) and 90.4%(6 053/6 697), and the FSWs working in low-level place had a lower rate than those from the other two types of places(P<0.01).Multi-factor logistic regression analysis showed that the following had a lower rate of condom use: the FSWs working in low-level place(OR=1.56,95%CI:1.36-1.79;OR=1.36,1.16-1.59), over 30 years old(OR=0.77, 95%CI:0.69-0.85), Yunnan citizen (OR=0.88, 95%CI:0.77-1.00), minority(OR=1.32, 95%CI:1.16-1.50), under senior high school (OR=0.61, 95%CI:0.49-0.75),married(OR=0.81,95%CI:0.71-0.92), living together(OR=0.70, 95%CI:0.51-0.96), divorced or lost spouses(OR=0.81,95%CI:0.65-1.02), worked less than 6 months in local areas(OR=1.74, 95%CI:1.34-2.27), drug users(OR=1.65, 95%CI:1.11-2.46), had not accepted HIV interventions(OR=2.91,95%CI:2.36-3.58), had no knowledge about AIDS(OR=4.50, 95%CI:3.48-5.82 ) .The main reasons for not using condoms were the clients′unwilling to use, which accounted for 47.62%( 270/567 ) .The total rate of drug use was 1.0%( 264/25 567 ) and the FSWs working in middle-level places had the highest rate of injecting drugs, which accounted for 0.6%( 70/11 141).The FSWs working in low-level places had a higher rate than those who worked in high-level places and middle-level places in venereal diseases, which accounted for 1.2%(85/6 934)(P<0.01).The rate of receiving effective interventions was 96.7%(24 717/25 574), the rate of accepting treatment and clean needles among drug users was 21.6%(57/264).Conclusion High risk behaviors were serious among the FSWs who worked in low-level places, especially among the olders, the minorities, people who had lower educational level, the new-comer and drug users, which indicated that more attention needs to be paid among these populations.

Objective To understand the high risk behaviors of female sex workers ( FSWs) in Yunnan province in 2013.Methods A cross-sectional investigation was conducted during April to June, 2013 in Yunnan province, census was used to the investigation where the number of FSWs was close to 200, while probability sampling was used where the number of FSWs was obviously over 200.A total of 25 574 cases were investigated, and data on demography and risk behaviors were obtained by questionnaires one by one.Results A total of 25 574 cases were investigated, AIDS awareness among FSWs in high-level places, middle-level places and low-level place were 98.8%( 92/7 401 ) , 98.6%( 150/10 995 ) , and 96.0%(281/6 655).FSWs from low-level place had a lower rate than those from the other two types of places(P<0.01).The rate of condom use each time when having sex with clients within the recent one month among FESs from high-level places, middle-level places and low-level place were 93.4%(6 307/6 755), 93.8%(10 109/10 782) and 90.4%(6 053/6 697), and the FSWs working in low-level place had a lower rate than those from the other two types of places(P<0.01).Multi-factor logistic regression analysis showed that the following had a lower rate of condom use: the FSWs working in low-level place(OR=1.56,95%CI:1.36-1.79;OR=1.36,1.16-1.59), over 30 years old(OR=0.77, 95%CI:0.69-0.85), Yunnan citizen (OR=0.88, 95%CI:0.77-1.00), minority(OR=1.32, 95%CI:1.16-1.50), under senior high school (OR=0.61, 95%CI:0.49-0.75),married(OR=0.81,95%CI:0.71-0.92), living together(OR=0.70, 95%CI:0.51-0.96), divorced or lost spouses(OR=0.81,95%CI:0.65-1.02), worked less than 6 months in local areas(OR=1.74, 95%CI:1.34-2.27), drug users(OR=1.65, 95%CI:1.11-2.46), had not accepted HIV interventions(OR=2.91,95%CI:2.36-3.58), had no knowledge about AIDS(OR=4.50, 95%CI:3.48-5.82 ) .The main reasons for not using condoms were the clients′unwilling to use, which accounted for 47.62%( 270/567 ) .The total rate of drug use was 1.0%( 264/25 567 ) and the FSWs working in middle-level places had the highest rate of injecting drugs, which accounted for 0.6%( 70/11 141).The FSWs working in low-level places had a higher rate than those who worked in high-level places and middle-level places in venereal diseases, which accounted for 1.2%(85/6 934)(P<0.01).The rate of receiving effective interventions was 96.7%(24 717/25 574), the rate of accepting treatment and clean needles among drug users was 21.6%(57/264).Conclusion High risk behaviors were serious among the FSWs who worked in low-level places, especially among the olders, the minorities, people who had lower educational level, the new-comer and drug users, which indicated that more attention needs to be paid among these populations.

Background:The incidence of gastric cancer is gradually rising in recent years,long non-coding RNA taurine up-regulated gene 1 (TUG1)may have certain effects on the occurrence and progression of gastric cancer. Aims:To study the expression TUG1 in gastric cancer tissue and its effect on prognosis of patients with gastric cancer,and study the correlation between TUG1 and p27,cyclin D1. Methods:Surgically resected gastric cancer tissues and corresponding distal normal tissues of 48 gastric cancer patients from June 2013 to December 2013 at Qingdao Municipal Hospital were collected. qRT-PCR was used to detect the mRNA expression of TUG1,and its relationship with clinicopathological features was analyzed. Protein expressions of p27 and cyclin D1 were determined by Western blotting,and correlation with expression of TUG1 was analyzed. Kaplan-Meier was used to analyze the relationship between expression of TUG1 and prognosis. Results:The mRNA expression of TUG1 in gastric cancer tissues was significantly higher than that in corresponding normal tissues (6. 18 ± 0. 19 vs. 5. 09 ± 0. 16,P < 0. 05),and was not correlated with gender,age,tumor size,but correlated with lymph node metastasis,tumor differentiation and TNM staging (P < 0. 01). The protein expression of p27 was significantly decreased in gastric cancer tissues than in normal tissues (0. 1709 ± 0. 0212 vs. 0. 3087 ± 0. 0252,P < 0. 01),while protein expression of cyclin D1 was significantly increased (0. 3417 ± 0. 0271 vs. 0. 2417 ± 0. 0173,P < 0. 01),and the expression of p27 was negatively correlated with expression of cyclin D1 in gastric cancer tissues (r = - 0. 897,P < 0. 01). The expression of TUG1 was negatively correlated with expression of p27 (r = - 0. 730,P < 0. 01),and was positively correlated with expression of cyclin D1 (r = 0. 809,P < 0. 01)in gastric cancer tissues. The median survival time was shorter in gastric cancer patients with high-expressed TUG1 than in patients with low-expressed TUG1 (P < 0. 05). Conclusions:Long non-coding RNA TUG1 plays a role of cancer gene in the development of gastric cancer through p27 /cyclin D1 pathway. Detection of expression of TUG1 has important significance on the prediction of prognosis of gastric cancer patients.

BACKGROUND:Sepsis is one of the main causes of mortality in intensive care units(ICUs).Early prediction is critical for reducing injury.As approximately 36%of sepsis occur within 24 h after emergency department(ED)admission in Medical Information Mart for Intensive Care(MIMIC-IV),a prediction system for the ED triage stage would be helpful.Previous methods such as the quick Sequential Organ Failure Assessment(qSOFA)are more suitable for screening than for prediction in the ED,and we aimed to find a light-weight,convenient prediction method through machine learning. METHODS:We accessed the MIMIC-IV for sepsis patient data in the EDs.Our dataset comprised demographic information,vital signs,and synthetic features.Extreme Gradient Boosting(XGBoost)was used to predict the risk of developing sepsis within 24 h after ED admission.Additionally,SHapley Additive exPlanations(SHAP)was employed to provide a comprehensive interpretation of the model's results.Ten percent of the patients were randomly selected as the testing set,while the remaining patients were used for training with 10-fold cross-validation. RESULTS:For 10-fold cross-validation on 14,957 samples,we reached an accuracy of 84.1%±0.3%and an area under the receiver operating characteristic(ROC)curve of 0.92±0.02.The model achieved similar performance on the testing set of 1,662 patients.SHAP values showed that the five most important features were acuity,arrival transportation,age,shock index,and respiratory rate. CONCLUSION:Machine learning models such as XGBoost may be used for sepsis prediction using only a small amount of data conveniently collected in the ED triage stage.This may help reduce workload in the ED and warn medical workers against the risk of sepsis in advance.

Objective To understand the internal quality control(IQC)situation of routine biochemical projects in Guizhou Province from 2020 to 2022,and to use the analysis batch length sigma rule to select the appropriate IQC strategy for routine biochemical projects.Methods A sum of 41,41 and 52 laboratories were selected from the laboratories participating in the first external quality assessment(EQA)program of the routine biochemical project in the Guizhou Provincial Center for Clinical Laboratory from 2020 to 2022,which uniformly used two concentration levels of internal quality control products produced by Randox Company in the UK.The coefficient of variation(CV)was calculated based on their IQC information,and then these CV values were used to compare with imprecise performance specifications such as WS/T403-2012 standards.The IQC situation of routine biochemical projects of Guizhou Province in recent years was analyzed.Randomly 15 laboratories were selected each year to report the results of the triglyceride project,and their σ values were calculated.Based on the Westgard sigma rule flowcharts of the analysis batch length,appropriate quality control strategies were selected and the quality goal index(QGI)was calculated to evaluate analytical performance of laboratory detection system.Results In the current monthly CV,the proportion of laboratories that met the WS/T403-2012 standards for Ca and TP projects was relatively low,while the pass rates for 7 projects(P,CK,LDH and other projects)were all above 80%,showing an increasing trend year by year.The proportion of laboratories with the 7 projects(P,CK,LDH and other projects)meeting the performance specifications for biomedical variation(appropriate)all reached 90%,while the proportion of laboratories with 5 projects(Na,Ca,Cl and other projects)was relatively low.The proportion of 10 projects such as P,CK,and LDH in cumulative CV of laboratories that met the performance specifications for biomedical variation(appropriate)was over 90%.For the triglyceride project,from 2020 to 2022,there were 2,5 and 13 laboratories that reached 6 σ horizontal.Compared to values of 2020 and 2021 years,the trend of σ values changes of 2022 was increasing(t=3.855,3.511,P≤0.001),indicating that the analytical performance of these laboratories was getting better and better.Conclusion The IQC levels of routine biochemical projects in Guizhou Province were increasing year by year.The Westgard sigma rule of the analysis batch length is designed with personalized quality control rules for various laboratories in Guizhou Province,thus improving laboratory testing capabilities and better severing clinics.

Objective:To investigate the prognostic value and related factors of heart-type fatty acid binding protein (H-FABP) in patients with heart failure.Methods:A total of 877 consecutive patients who were admitted to heart failure care unit of Fuwai hospital and diagnosed as heart failure from July 2015 to July 2017 were enrolled in this study. Baseline serum H-FABP concentration was measured by fluorescence lateral flow immunoassay. According to serum H-FABP levels, patients were divided into three groups: low H-FABP group (H-FABP≤4.04 ng/ml, n=292), middle H-FABP group (H-FABP 4.04-7.02 ng/ml, n=292) and high H-FABP group (H-FABP≥7.02 ng/ml, n=293). The general clinical characteristics were collected and compared among the three groups. According to whether heart failure was caused by coronary artery disease or not, patients with heart failure were divided into ischemic heart failure and non-ischemic heart failure. Multivariate linear regression analysis was performed to explore the independent risk factors of H-FABP. The primary endpoint events were the composite of all-cause death or heart transplantation. Multivariate Cox regression analyses, receiver operating characteristic (ROC) curves, risk prediction tests with multivariate Cox regression model and Kaplan-Meier analyses were conducted to investigate the relationship between H-FABP and the prognosis of heart failure. Results:Multivariate linear regression analysis showed that age, coronary artery disease, alanine aminotransferase, uric acid and N-terminal pro-B type natriuretic peptide (NT-proBNP) were positively associated with H-FABP (β=0.012, 0.238, 0.001, 0.345 and 0.063 respectively,all P<0.05), while female, hemoglobin, albumin, sodium, and estimated glomerular filtration rate (eGFR) were negatively associated with H-FABP (β=-0.184, -0.006, -0.016, -0.034 and -0.006 respectively, all P<0.05). One hundred and nineteen patients (13.6%) lost to follow-up, and 246 patients (32.5%) suffered from all-cause death or heart transplantation during the median follow-up duration of 931 (412-1 185) days. Multivariate Cox regression analysis showed that baseline H-FABP (log 2H-FABP) level was the independent predictor of all-cause death or heart transplantation in patients with heart failure ( HR=1.39, P<0.001). ROC curves showed that baseline H-FABP was a predictor of all-cause death or heart transplantation in patients with heart failure within 3 months, 1 year and 2 years (areas under the curves were 0.69, 0.69 and 0.71 respectively), and the best cut-off values were 5.85 ng/ml, 6.54 ng/ml and 6.54 ng/ml respectively. Risk prediction test with multivariate Cox regression model showed that baseline H-FABP could provide additional prognostic value in predicting all-cause death or heart transplantation for patients with heart failure on top of basic model and baseline NT-proBNP ( P<0.001). Taking 6.54 ng/ml and trisected levels of H-FABP as cut-off values respectively, Kaplan-Meier analyses showed that the survival rates were significantly different among the two or three groups ( P<0.001). Subgroup analyses showed that baseline H-FABP (log 2H-FABP) level was an independent predictor of all-cause death or heart transplantation in patients with ischemic heart failure ( HR=1.74, P<0.001), as well as in patients with non-ischemic heart failure ( HR=1.28, P=0.027). Conclusions:Age, sex, coronary artery disease, hemoglobin, albumin, alanine aminotransferase, sodium, eGFR, uric acid and NT-proBNP are associated with H-FABP level. Baseline H-FABP level is an independent predictor of all-cause death or heart transplantation in patients with heart failure. On top of basic model and baseline NT-proBNP, baseline H-FABP could provide additional prognostic value in predicting adverse events for patients with heart failure.

OBJECTIVETo understand the prevalence of high risk behaviors and influencing factors among HIV infected persons aged ≥50 years.

METHODSFace to face questionnaire interview was conducted among the HIV infected persons selected in Jianshui, Gejiu and Mengzi counties in Yunnan province through random sampling in June 2015. The sample size was 450.

RESULTSAmong the HIV infected persons surveyed, 41.2% (122/296) had sexual behaviors with their spouses during past year, and the consistent condom use rate was 66.4% (81/122). Among the HIV infected males, 8.9% (28/313) had commercial sexual behaviors during past year, and the consistent condom use rate was 17.9% (5/28). Among the HIV infected females, 0.7% were still engaged in commercial sex service during past year. Among the 450 HIV infected persons, 32 (7.1%) reported having casual sex behaviors during past years, and the consistent condom use rate was 18.7% (6/32). The rate of commercial sexual behavior in urban residents (13.4%, 19/115) was higher than that in rural residents (4.5%, 9/198), the difference was statistically significant (χ(2)=11.715, P=0.001). The risk factors for commercial sex behaviors included lack of family and social support, aged 50-59 years, living in urban area, higher income and being male. The risk factors for using no condom included living in rural area, lower education level, lack of family and social support and higher income.

CONCLUSIONSRisk sex behaviors are still prevalent in HIV infected people aged >50 years, which exacerbated HIV transmission. Further efforts should be focused on the education about AIDS prevention and control and promoting protected sexual behaviors. Additional effort should be done to improve the family and social support for HIV infected people aged >50 years. Moreover, comprehensive intervention for low-paid female sex workers also needs to be strengthened.

China ; epidemiology ; Condoms ; utilization ; Female ; HIV Infections ; epidemiology ; Humans ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Risk-Taking ; Sex Work ; psychology ; statistics & numerical data ; Sexual Behavior ; psychology ; statistics & numerical data ; Surveys and Questionnaires