Objective To understand the current status,type,and effect of training programs conducted by Health Bureau and CDC in China.Methods One person of each province was selected from China field epidemiology training network and designated as contact person who was responsible for collecting information of field practical training lasting for at least 6 months for staff of public health emergency and infectious disease control in each province from October 2001 to October 2010.Questionnaire including basic condition,organization and management,training design,faculty condition,trainee condition and training outputs was designed and filled in by contact person.Results There were 35 training programs covering over 9 provinces in China.The first province and city FETP started in 2004,including Guangdong FETP,Zhejiang FETP,Hangzhou FETP,Ningbo FETP and Guizhou FETP.Thirty-five training programs had 355 mentors,22(6％)were CFETP graduates and 57 (16％)were local FETP graduates.All program funds were paid by local governments.The training programs included two parts,theoretical lectures and field practice,which occupying 10％-20％ and 80％-90％ of the whole training time,respectively.Among 6 evaluative items including emergency investigation,surveillance analysis,surveillance evaluation,planned investigation,investigation report and paper publication,most programs(50％-94％) had less than average one person per time.Conclusions Field epidemiology training program after several years of development in china achieves the certain scale.Some provincial programs are successful,but the effect and quality of training programs in different areas are uneven.We suggest optimizing of field epidemiology training resources and further expanding China field epidemiology training network.

Objective: To explore the expression of SLAMF6 on CD8⁺ T cells in patients with severe aplastic anemia (SAA) and its correlation with disease immune status. Methods: By flow cytometry (FCM), SLAMF6 expression level in peripheral blood CD8⁺ T cells was detected in 21 patients with SAA and 15 normal controls respectively from February 2017 to April 2018. The correlation between SLAMF6 expression level and hematopoietic functions, including HGB, PLT, the neutrophil granulocyte and reticulocyte absolute value in peripheral blood, hyperplasia degree (percentage of granulocytes, erythrocytes, lymphocytes and megakaryocytes in bone marrow) and perforin, granzyme B, IFN-γ expression level in CD8⁺ T cells were evaluated. To further confirm the effect of SLAMF6 on CD8⁺ T cells, anti-SLAMF6 Ab was used to block SLAMF6 pathway (IgG as control), and FCM was used to detect the perforin, granzyme B, and IFN-γ production of CD8⁺ T cells. Results: The expression of SLAMF6 on CD8⁺ T cells in untreated SAA patients[(56.29±12.97)%]was significantly lower than that of normal controls[(80.96±7.36)%](t=-7.672, P<0.001). The expression of SLAMF6 on CD8⁺ T cells in SAA patients were positively correlated with the HGB, PLT, the neutrophil granulocyte and reticulocyte absolute value in peripheral blood, percentage of granulocytes, erythrocytes in bone marrow (all P<0.05), but they were negatively correlated with the percentage of lymphocytes in bone marrow, and the expression of perforin, granzyme B, and IFN-γ of CD8⁺ T cells (all P<0.05). After blocking SLAMF6 pathway by anti-SLAMF6 Ab, the expression levels of perforin, granzyme B and IFN-γ in SAA patients were significantly higher than those in the untreated group, and the differences were statistically significant (all P<0.05). Conclusions SLAMF6 is significantly down-regulated on CD8⁺ T cells in SAA patients, which may act as a negative immunoregulatory molecule participating in the mechanism of SAA by affecting the functional molecules secretion on CD8⁺ T cells.

Objective: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with onset in infancy. Early intervention is critical to improve the prognosis for these children. E-health interventions have tremendous potential. This review aimed to determine the status and effectiveness of family interventions for parents of children aged 0–6 years with ASD in the context of e-health. Methods: The review methodology was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. PubMed, Web of Science, and China National Knowledge Infrastructure were searched from inception to June 2022. The searches were limited to children with ASD of the age range between 0 and 6 years. We collated the available information and used descriptive statistics to analyze the synthesized data. Results: Our initial search identified 3,672 articles, of which 30 studies met the inclusion criteria. The 30 articles selected were released between 2012 and 2022. All articles are in English. Most articles reviewed were from high-income countries (27/30, 90.0%), especially from the United States (16/30, 53.3%). Four major themes emerged from the 30 studies that matched the inclusion criteria, as follows: 1) type of e-health interventions, 2) duration of interventions, 3) clinical aspects of e-health interventions, and 4) evidence for intervention effectiveness, looking into the positive, negative, and mixed findings of previous studies. Conclusion These findings suggest that a wide variety of e-health interventions may actually help support both children with ASD aged 0–6 years and their parents.

OBJECTIVE Investigating the clinical characteristics,risk factors,treatment strategies and prognosis of head and neck extramedullary plasmacytoma(HNEMP).METHODS To analyze indicators affecting survival and prognosis,retrospective study was conducted on the clinical data of 38 newly diagnosed and untreated patients with HNEMP who were admitted to Beijing Tongren Hospital from September 2008 to January 2022.RESULTS Among 38 patients,5 cases(13.2%)displayed a manifestation as cranial-nasal-orbital communication,and 8 cases(21.1%)involved a tumor with diameter≥5 cm.There were 17 patients(44.7%)who underwent surgical resection along,13 patients(34.2%)who received postoperative radiotherapy,8 cases(21.1%)who accepted chemotherapy,and 5 cases(13.2%)who experienced combined radiochemotherapy.Following treatment evaluation,32 cases achieved CR,3 cases showed PR,1 case demonstrated SD and 2 cases experienced PD.The median follow-up time was 86 months,with 5-year PFS and OS rates of 92.1%and 94.7%,respectively.Of note,the patients with cranial-nasal-orbital communication exhibited significantly unfavorable 5-year PFS and OS rates of 40%and 60%,respectively,with median PFS of 13 months,whereas the patients in other groups achieved 100%of 5-year PFS and OS rates.Additionally,tumor diameter≥5 cm and the involvement of cranial-nasal-orbital communication were adverse prognostic factors for both PFS and OS.CONCLUSION HNEMP is a rare disease and the primary treatment approach is surgery combined with radiotherapy.The prognosis for HNEMP tends to be relatively favorable,with the involvement of cranial-nasal-orbital communication and high tumor burden as the adverse prognostic indicators.

Objective To investigate the effect of serum uric acid level on outcomes after intravenous thrombolysis in patients with acute ischemic stroke. Methods From April 2014 to January 2018I, patients with acute ischemic stroke received intravenous thrombolysis at the stroke unit of Shenzhen Second People's Hospital were enrolled retrospectively. The clinical outcomes were assessed according to the modified Rankin scale at 3 months after onset, > 2 were defined as poor outcome. The demographic and clinical data were compared between the good outcome group and the poor outcome group. Multivariate logistic regression analysis was used to determine the independent influencing factors of clinical outcomes. Results A total of 155 patients were enrolled, including 92 (59. 4％) in the good outcome group and 63 (40. 6％) in the poor outcome group. The serum uric acid level in the good outcome group was significantly higher than that in the poor outcome group (365. 465 ±100. 055 μmol/L vs. 325. 958 ±114. 704 μmol/L; t = -2. 227,P = 0. 027). Multivariate logistic regression analysis showed that there was a significant positive correlation between low serum uric acid levels and poor outcomes (They were divided into 4 levels according to the quantiles. ≥416. 01 μmol/L as reference; 350. 11- 416. 00 μmol/L: odds ratio [ OR ] 1. 414, 95％ confidence interval [CI] 0. 375-5. 339, P = 0. 609; 278. 61-350. 10 μmol/L: OR 3. 020, 95％ CI 0. 878- 10. 390, P = 0. 080; ≤ 278. 60 μmol/L: OR 4. 194, 95％ CI 1. 194-14. 726, P = 0. 025; trend test P =0. 013]. Conclusion Higher serum uric acid level is independently associated with good outcomes after intravenous thrombolysis in patients with acute ischemic stroke.

Objective To investigate the value of intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) in the staging of chronic kidney disease(CKD).Methods From May 2016 to April 2017,seventy-two patients diagnosed as CKD according to the criteria of clinical diagnostic and 20 healthy volunteers (control group) underwent routine MRI and IVIM-DWI ( 8 b values, 0 to 800 s/mm2).CKD patients were divided into two groups based on their estimated glomerular filtration rate (eGFR): mild CKD group(45 cases,eGFR≥60 ml·min-1·1.73m-2)and moderate to severe CKD group(27 cases,eGFR<60 ml·min-1·1.73 m-2).The ADC,true diffusion coefficient(D),pseudo-diffusion coefficient(D*),perfusion fraction (f) were measured on both cortex and medulla. The paired-samples t test was used to compare the cortico-medullary difference of the ADC,D,D*and f values in three groups.Differences of the ADC,D, D*and f values among three groups were compared using the one-way analysis of variance (ANOVA). Correlations between eGFR and the IVIM-DWI parameters in CKD were evaluated by using Pearson correlation analysis. ROC was performed to evaluate the diagnostic efficiency of using IVIM-DWI parameters to distinguish CKD with moderate to severe renal impairment from mild renal impairment, as well as distinguish CKD with mild renal impairment from healthy volunteers.Results The cortical ADC,D, D*and f values were significantly higher than that in the medulla in healthy volunteers(all P<0.05). The cortical ADC,D*and f values were significantly higher than that in the medulla in mild CKD group(all P<0.05). The cortical ADC,D and f values were significantly higher than that in the medulla in moderate to severe CKD group (all P<0.05). The ADC,D,D*and f values of cortex and medulla showed significantly differences among three groups(all P<0.05).In CKD patients,no significant correlation was found between medullary D*,f values and eGFR, there was a significant positive correlation between eGFR and cortical ADC,D,D*and f values(r=0.475,0.362,0.625,0.276;all P<0.05),as well as between eGFR and medullary ADC,D values(r=0.427,0.615;P<0.05). The results of the ROC analysis for distinguishing the mild CKD group from the moderate to severe CKD group revealed that the cortical D*value had the highest area under the ROC curve (AUC=0.965), cortical f value showed high sensitivity(92.6%) to distinguish CKD with different degree of renal impairment, with the threshold of 32.99%, and cortical D*value showed high specificity(97.8%)with the threshold of 17.07×10-3mm2/s;the results of the ROC analysis for distinguishing the mild CKD group from healthy volunteers revealed that the cortical D*value had the highest AUC(0.885), medullary ADC value showed high sensitivity (82.2%) to distinguish mild CKD group from healthy volunteers,with the threshold of 1.83×10-3mm2/s,and medullary f value showed high specificity(100.0%)with the threshold of 21.70%,as well as medullary D value showed high specificity(100.0%)with the threshold of 1.75× 10-3mm2/s.Conclusion IVIM-DWI may be useful for CKD early diagnosis and assessing renal function.

Human coronavirus OC43 (HCoV-OC43) and severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) belong to the β-coronavirus genus. Since the discovery in 1967, HCoV-OC43 has been continuously circulating in human population and has become one of the common seasonal respiratory viruses. SARS-CoV-2, which has a higher morbidity and fatality rate, appeared at the end of 2019, followed by the emergence of a variety of variants, and the transmission and infection capacity of SARS-CoV-2 has been enhanced. HCoV-OC43 may be similar to SARS-CoV-2 in terms of genomic structure and function, species evolution, epidemic characteristics and clinical manifestations. In this review, the epidemiology, genomics, phylogenetic evolution and other aspects of HCoV-OC43 and SARS-CoV-2 were analyzed. Such an analysis would be helpful to understand the association and differences between the two viruses, and provide reference for understanding the potential threats of HCoV-OC43.

Objective:To investigate the clinical characteristics, diagnosis, treatment, and prognosis of primary thyroid lymphoma (PTL) .Methods:A retrospective analysis was conducted on the clinical and pathological data of 34 newly diagnosed PTL patients admitted to Beijing Tongren Hospital from September 2010 to February 2023. The Kaplan-Meier survival curve and Log-rank test were used for survival analysis, and the Cox regression model was applied for univariate analysis of prognostic factors.Results:All 34 PTL patients presented with cervical mass as the initial clinical manifestation. There were 9 males and 25 females. The pathological diagnosis was diffuse large B-cell lymphoma (DLBCL) in 29 patients and mucosa-associated lymphoid tissue (MALT) lymphoma in 5 patients. Among the DLBCL patients, 6 had B symptoms, 17 had an Eastern Cooperative Oncology Group (ECOG) score of ≥2, the Ann Arbor staging was stage Ⅰ-Ⅱ in 21 cases and stage Ⅲ-Ⅳ in 8 cases, the tumor diameter was ≥10 cm in 4 cases, and 14 had concurrent Hashimoto thyroiditis; 27 cases received chemotherapy, with 21 cases achieving complete remission (CR), 2 cases partial remission (PR), and 6 cases of disease progression; the 5-year progression-free survival and overall survival rates were 78.9% and 77.4%, respectively; univariate survival analysis showed that B symptoms, tumor diameter ≥10 cm, and Ann Arbor stage Ⅲ-Ⅳ were significant factors affecting patient prognosis ( P<0.05). MALT lymphoma patients were all in stages Ⅰ-Ⅱ, had an ECOG score of 0-1, and were without B symptoms. All patients underwent surgical resection, with 4 cases achieving CR and 1 case PR. Conclusion:PTL is more common in females with concurrent Hashimoto thyroiditis, with the majority of pathological types being B-cell lymphoma. The main treatment is chemotherapy, supplemented by radiotherapy and surgery, and the prognosis is relatively favorable.

Objective:The preliminary results was reported regarding the treatment of mesenteric torsion by mesenteric fixation in the last decade, especially preventing recurrence of mesenteric torsion by mesenteric fan-shaped fixation.Methods:We selected 12 patients who received emergency operation in Chongqing Hospital of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from December 2010 to March 2022. All of them were made a definite diagnose of mesenteric torsion by the preoperative CT scan or exploratory laparotomy. The recurrence of mesenteric torsion will be prevented by taking the operation of mesenteric fan-shaped fixation. This technique is suitable for the patient who is suffering total mesenteric torsion, but enteric necrosis is excluded affirmatively. The operation is consists of the following progress: (1) Exploratory laparotomy to check for necrosis of the bowel and for lesions other than torsion. (2) Mesenteric torsion derotation.(3) Mesenteric linear fixation; the right posterior lower border of the small mesentery (terminal ileal mesentery) is intermittently sutured to the posterior peritoneum of the right lower quadrant to increase the width of the base of the small mesentery. (4) Mesenteric fan-shaped fixation, which is fan-shaped to the lower left and fixed in the posterior peritoneum, shortening the length of the mesentery and further increasing the width of the mesentery and posterior peritoneal fixation.Results:A total of 12 patients with mesenteric torsion were treated by operation for 15 times in all. Among them, 3 cases received resection of most small bowel were performed without recurrence; 3 patients received only derotation for a total of 4 times, 2 cases recurred, 1 of them recurred twice; 4 cases underwent derotation and mesenteric linear fixation,and 1 case recurred. Four patients with derotation and mesenteric fan-shaped fixation recovered well without recurrence.Conclusion:Mesenteric fan-shaped fixation may be an effective operative type to reduce or avoid postoperative recurrence of mesenteric torsion.

Objective:To investigate the learning curve for a five-step procedure, namely, a transthoracic single-port assisted laparoscopic transabdominal diaphragmatic approach, for Siewert type II adenocarcinoma of the esophagogastric junction.Methods:In this retrospective cohort study, we analyzed relevant clinical data of 66 patients with Siewert type II adenocarcinoma of the esophagogastric junction who had undergone the five-step procedure performed by the same surgeon in the Gastrointestinal Surgery Department of Guangdong Provincial Hospital of Chinese Medicine from May 2017 to April 2023. The learning curve were plotted using cumulative summation analysis and selected indicators, including intraoperative blood loss, duration of surgery, time to first flatus, time to first tolerance of liquid food, length of hospital stay, and incidence of perioperative complications at different stages were compared. The data were analyzed using SPSS 24.0 statistical software. Numerical data are presented as cases (%) and data were analyzed using the χ 2 test or Fisher's exact test. Normally distributed measurement data are presented as x±s, and independent sample t-testing was performed for inter group comparison. Non-normally distributed measurement data are presented as M( Q1, Q3) and the Mann–Whitney U test was used for inter group comparison. Results:The five-step procedure had been successfully completed without switching to open surgery in all 66 study patients. There were no perioperative deaths, blood loss was 100 (50, 200) mL and duration of surgery 329.4±87.3 minutes. The equation of optimal fit for the duration of surgery was y=0.031x 3-4.4757x 2+164.97x-264.4 ( P<0.001, R2=0.9797). The cumulative summation learning curve reached a vertex when 25 surgical procedures had accumulated. Using 25 cases as the cut-off, we divided the learning curves into learning and proficiency periods and patients into learning (25) and proficiency period groups (41). There were no statistically significant differences between the two groups of patients in sex, age, body mass index, American Society of Anesthesiologists score, history of abdominal surgery, comorbidities, preoperative neoadjuvant therapy, maximum tumor diameter, surgical procedure, or T and N stage of tumor ( P>0.05). The following factors differed significantly (all P<0.05) between the learning and proficiency stages: in the latter there was less intraoperative blood loss (100 [50, 100] ml vs. 200 [100, 200] ml, U=-3.940, P<0.001), shorter duration of surgery ([289.8±50.7] minutes vs. [394.4±96.0] minutes, t=5.034, P<0.001), more mediastinal lymph nodes removed (5 [2, 8] vs. 2 [1, 5], U=-2.518, P=0.012), earlier time to first flatus (2 [2, 3] days vs. 4 [3, 6] days, U=-4.016, P<0.001), earlier time to first tolerance of liquid food (5 [4, 6] days vs. 7 [6, 8] days, U=-2.922, P=0.003), shorter duration of hospital stay (8 [8, 10] vs. 10 [9, 12] days, U=-2.028, P=0.043). The incidence of surgical complications did not differ significantly between the two groups ( P=0.238). Conclusion:Satisfactory results can be achieved with the five-step procedure for patients with Siewert type II adenocarcinoma of the esophagogastric junction once 25 procedures have been performed.