10.3969/j.issn.2095-4344.2013.24.008

Objective To observe the effect and safety of home-made metallic stent implantation in the treatment of malignant esophageal stricture. Methods Among 47 cases with malignant esophageal stricture, there were 8 cases in superior esophagus, 12 cases in middle esophagus,27 cases in inferior esophagus, and 12 cases with gastric cardia carcinoma. Those cases were not suitable or willing to accept surgical operation. Before stenting, radiotherapies were not done in all cases. Different shape home-made metallic stents were used to place the segment of structure via mouth according to the positions and diameters of esophageal stricture. The follow-up periods was 5 ～ 16 months. Results 48 stents were implanted successfully in 47 patients. After operation,swallow was improved in all patients. No major complications occurred in these groups. Restenosis occurred in the third month post-operation in 1 case owing to tumor relapsed and grew at proximal stent, and another stent was implanted successfully. Conclusions Stents implantation for malignant stricture can effectively and safely relieve the dysphasia.

To investigate the effects of oxymatrine injection (OI) combined with low-dose paclitaxel on expressions of mRNAs and proteins of vascular endothelial growth factor (VEGF) and CXC chemokine receptor 4 (CXCR4) in human gastric carcinoma SGC-7901 cells.

Objective To investigate mutation patterns in core promoter(CP)region of hepatitis B virus(HBV).Methods HBV DNA was extracted from sera of patients with chronic HBV infection.The CP sequence was amplified by polymerase chain reaction(PCR)and cloned into pMD19 T vector.The positive clones were then sequenced.The sequences were compared with known HBV genome in GenBank to identify the mutation sites and patterns of patients with chronic HBV infection.Results There were 74 clones from 21 patients with chronic HBV infection which were sequenced.The sequence comparisons showed that there was a 234-nucleotide deletion in CP region of HBV genome in 54 clones and a 245-nucleotide deletion in one clone.These deletion regions included CP,HBeAg initiation codon and direct repeat sequence(DR)Ⅰ regions,which named CP deletion(CPD).A1585T replacement mutation was also found in HBV strain with CPD,which indicated that there was linkage between these two mutations.Conclusions A novel mechanism of HBeAg negative chronic hepatitis B is observed,which includes deletions of CP and HBeAg initiation codon.Meanwhile,a simple and useful PCR method is developed to detect CPD.

Objective To investigate the infection status of Mycoplasma pirum among male HIV/AIDS patients in Jiangsu and analyze the risk factors.The genome sequencing of Mycoplasma pirum was completed for the first time.Methods Male HIV infected individuals and AIDS patients confirmed in Jiangsu province were enrolled for 4 repeated cross-sectional studies by means of detecting the first flow urine sample and venous blood sample collected and questionnaire survey after informed consent.Genome sequencing was conducted for Mycoplasma pirum by using Illumina Hiseq 2000 sequencing platform.Results A total of 1 541 HIV/AIDS patients were surveyed in this study.The infection rates of Mycoplasma pirurm was 15.4％.The patients who received no HAART had higher risk to be infected with Mycoplasma pirum (OR=1.344,95％CI:1.008-1.792).Otherwise,high CD4+T counts was a protective factor for Mycoplasma pirum infection (OR=0.600,95％CI:0.444-0.810).Based on the sequencing result,the genome size of Mycoplasma pirum was 850 704 bp,the GC content was 24.21％ the genome contained 708 genes,the total length of genes was 734 085 bp,the average length was 1 037 bp,accounting for 86.29％ of genome.Conclusion More attention should be paid to the high infection rate of Mycoplasma pirum among male HIV/AIDS patients in the future AIDS prevention and control.The first genome sequencing of standard Mycoplasma pirum strain was completed in this study (registering Serial number:AZHZ00000001),which can provide evidence for the further research of gene function and pathogenic mechanism of Mycoplasma pirum.

Objective To understand the prevalence and the factors associated with depression and anxiety among patients attending the community-based methadone maintenance treatment(MMT) program.Methods 9 MMT clinics in 3 provinces were randomly selected,in which 1 301 MMT patients who met the criteria of recruitment were all interviewed.A cross-sectional study by administrative questionnaire was employed to investigate the demographics,drug abuse and MMT treatment status of the respondents.The 1301 respondents were also evaluated for depression and anxiety by SDS(Self-Rating Depression Scale) and SAS(Self-Rating Anxiety Scale) respectively.ANOVA and multivariate linear regressions analysis was used to verify the factors associated with depression and anxiety respectively.Results The prevalence of depression and anxiety among the MMT patients were 38.3%(498/1 301) and 18.4%(239/1 301).The multivariates linear regression analysis indicated that at the level of ?=0.05,gender,employment status were associated with depression,while gender,employnment status,educational level,drug abuse and methadone daily dosage were associated with anxiety.Conclusions There are certain proportions of MMT clients who suffer from depression and anxiety.The MMT clinic staff should put more emphasis on the efforts to reduce psychological disorders and its potential risks by enhancing psychological councelling,intervention and social support towards the MMT patients.

OBJECTIVES: The aims of this study were to update the latest data on the prevalence of hypertension (HTN) in the elderly Chinese population and to assess relationships between new anthropometric indices and HTN. METHODS: Data were obtained from the Basic Public Health Service (BPHS) survey for Jiangsu Province, China. A total of 944,760 people aged 65 years and older were included in this study. Blood pressure was measured by trained investigators. Body weight, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), conicity index (COI), body roundness index (BRI), and a body shape index (ABSI) were included in the analysis as anthropometric indices. Logistic regression analysis and restricted cubic splines were used to evaluate the association of anthropometric indices with HTN. RESULTS: The prevalence of HTN among elderly residents of Jiangsu Province was 64.7% (95% confidence interval, 64.6 to 64.8). After adjusting for multiple covariates, all anthropometric indices except ABSI showed significant non-linear positive dose-response associations with HTN across sex (pnonlinear<0.001). Among participants with BMI <28 kg/m2, abnormal weight, WC, WtHR, BRI, COI, and ABSI were positively associated with HTN. CONCLUSIONS The prevalence of HTN in the elderly in Jiangsu Province is gradually increasing. It is necessary to consider the combination of ABSI and COI with BMI for screening elderly individuals for HTN in follow-up prospective studies.

Objective To understand the status of recent infected and newly reported HIV cases in Jiangsu province. Methods Information including general demographic,mode of transmission and sample source of newly reported HIV infected cases was collected. Corresponding serum or plasma samples were collected and tested with BED-CEIA. Proportions of recent HIV infections among different populations were calculated,and associated factors of recent HIV infection calculated. Results Among cases infected through different channels as homosexual,heterosexual and needles sharing,the proportions of recent infections were 29.19%,17.40% and 21.75%, respectively. Statistically significant difference was seen between different populations(P<0.05). Compared with female cases,male cases were more likely to be recent infected(OR=1.569,95%CI:1.168-2.107). Compared with cases older than 35 years of age,the ones that younger than that age were more likely to be recently infected(OR=1.556,95%CI:1.289-1.879). Compared with cases who remained single,those married cases were more likely to be long-term infections(OR=0.789, 95%CI:0.649-0.960). Compared with patients identified by hospitals,the recent HIV infections were more likely to be found through voluntary counseling programs and testing(OR=2.278,95%CI:1.853-2.801),project-based surveillance programs(OR=2.409,95%CI:1.860- 3.120),and unpaid blood donation sites(OR=2.911,95%CI:2.118-4.001)(P<0.05). Conclusion Proportion of MSM ranked 1st in the newly reported HIV cases in Jiangsu province. Related HIV case-finding programs should be strengthened to reduce the secondary transmission.

Objective:To examine the relationship between sarcopenia and DNA methylation in the promoter of the growth differentiation factor 15(GDF15)gene in elderly individuals.Methods:This cross-sectional study collected data from 865 elderly individuals aged 65 years and above who underwent physical examination at the Yuetang Town Community Medical Center in Yangzhou City between May and September 2020.The verification set included 431 males and 434 females with an age range of 65-100 years and a mean age of(76.0±5.9)years.The diagnosis of sarcopenia was based on the consensus diagnostic criteria of the Asian Sarcopenia Working Group in 2019.The study included 295 cases in the non-sarcopenia group and 470 cases in the sarcopenia group.The study selected 50 non-sarcopenia patients and 50 age-gender matched sarcopenia patients as the explore set for DNA methylation sequencing of the GDF15 gene.The sequencing results were then verified using the methylation-specific polymerase chain(PCR)method in the verification center.Additionally, serum GDF15 levels were detected using the enzyme-linked immunosoradsorption method.The study analyzed the correlation between GDF15 methylation levels, serum GDF15 levels, and sarcopenia.Results:The study found that individuals with sarcopenia had lower levels of body mass index(BMI), appendicular skeletal muscle mass(ASMI), grip strength, and gait speed in both the discovery and validation sets compared to those without sarcopenia( P<0.05). Additionally, the DNA methylation of GDF15 was found to be lower in the sarcopenic group compared to the non-sarcopenic group[93.7%(79.6%, 98.0%) vs.97.7%(95.3%, 99.0%), Z=-9.294, P<0.01]. The results of the correlation analysis indicate a positive relationship between the methylation level and appendicular skeletal muscle mass( r=0.206, P<0.01), grip strength( r=0.297, P<0.01), and gait speed( r=0.383, P<0.01). Conversely, there was a negative correlation between the methylation level and serum GDF15 level( r=-0.249, P<0.05). The study conducted ROC analysis to determine the predictive ability of GDF15 methylation for sarcopenia found that the area under the curve was 0.700 with a cut-off score of 92.7%.Furthermore, binary regression analysis revealed that low GDF15 methylation( OR=1.136, 95% CI: 1.098~1.175, P<0.01)was linked to a higher risk of sarcopenia, even after adjusting for age, sex, and BMI.The serum GDF15 level was higher in the sarcopenic group compared to the non-sarcopenic group[(0.665±0.432)pg/L vs.(0.465±0.211)pg/L( t=-2.452, P<0.05)]. Additionally, it was observed that the methylation of GDF15 was negatively correlated with the serum GDF15 level( r=-0.249, P<0.05). Conclusions:A low level of GDF15 methylation has been found to be linked with a higher risk of sarcopenia, suggesting that measuring GDF15 methylation could potentially serve as a biomarker for diagnosing sarcopenia.

Objective: To understand the possible transmission route of a family cluster of COVID-19 in Zhengzhou and the potential infectivity of COVID-19 in incubation period, and provide scientific evidence for the timely control of infectious source and curb the spread of the epidemic. Methods: Epidemiological investigation was conducted for a family cluster of COVID-19 (8 cases) with descriptive epidemiological method, and respiratory tract samples of the cases were collected for the nucleic acid detection of 2019-nCoV by RT-PCR. Results: Two primary cases, which occurred on 31 January and 1 February, 2020, respectively, had a common exposure history in Wuhan. The other six family members had onsets on 30 January, 31 January, 1 February (three cases) and 3 February, 2020. Conclusions In this family cluster of COVID-19, six family members were infected through common family exposure to the 2 primary cases. Five secondary cases had onsets earlier than or on the same day as the primary cases, indicating that COVID-19 is contagious in incubation period, and the home isolation in the early phase of the epidemic might lead to the risk of family cluster of COVID-19.