Objective:To explore the correlation between early inflammation indicators and the severity of coronavirus disease 2019 (COVID-19).Methods:A retrospective study was conducted. Patients with COVID-19 admitted to Wenzhou Central Hospital from January 17 to February 14, 2020 were enrolled. The general information, chest CT before admission, the first laboratory parameters and chest CT within 24 hours after admission were collected. Patients were followed up for 30 days after the first onset of dyspnea or pulmonary imaging showed that the lesions progressed more than 50% within 24 to 48 hours (according to the criteria for severe cases) as the study endpoint. According to the endpoint, the patients were divided into two groups: mild type/common type group and severe/critical group, and the differences in general information and inflammation index of the two groups were compared. Logistic regression was used to analyze the inflammation index and the severity of COVID-19. Receiver operating characteristic (ROC) curve was draw to evaluate the predictive value of early inflammation indicators for severe/critical in patients with COVID-19.Results:A total of 140 patients with COVID-19 were included, 74 males and 66 females; the average age was (45±14) years old; 6 cases (4.3%) of mild type, 107 cases (76.4%) of common type, and 22 cases (15.7%) of severe type, 5 cases (3.6%) were critical. There were significantly differences in ages (years old: 43±13 vs. 57±13), the proportion of patients with one chronic disease (17.7% vs. 55.6%), C-reactive protein [CRP (mg/L): 7.3 (2.3, 21.0) vs. 40.1 (18.8, 62.6)], lymphocyte count [LYM (×10 9/L): 1.3 (1.0, 1.8) vs. 0.8 (0.7, 1.1)], the neutrophil/lymphocyte ratio [NLR: 2.1 (1.6, 3.0) vs. 3.1 (2.2, 8.8)] and multilobularinltration, hypo-lymphocytosis, bacterial coinfection, smoking history, hyper-tension and age [MuLBSTA score: 5.0 (3.0, 5.0) vs. 5.0 (5.0, 7.0)] between mild/common group and severe/critical group (all P < 0.05). Univariate Logistic regression analysis showed that CRP, NLR, MuLBSTA score, age, and whether chronic diseases were associated with the severity of COVID-19 [odds ratio ( OR) and 95% confidence interval (95% CI) were 1.037 (1.020-1.055), 1.374 (1.123-1.680), 1.574 (1.296-1.911), 1.082 (1.042-1.125), 6.393 (2.551-16.023), respectively, all P < 0.01]. Further multivariate Logistic regression analysis showed that CRP and MuLBSTA score were risk factors for the development of COVID-19 to severe/critical cases [OR and 95% CI were 1.024 (1.002-1.048) and 1.321 (1.027-1.699) respectively, both P < 0.05]. ROC curve analysis showed that the area under the curve for CRP and MuLBSTA score to predict severe/critical cases were both 0.818, and the best cut-off points were 27.4 mg/L and 6.0 points, respectively. Conclusion:CRP and MuLBSTA score are related to the severity of COVID-19, and may have good independent predictive ability for the development of severe/critical illness.

Purpose: This study aimed to identify the risk factors and sonographic variables that could be integrated into a predictive model for endometrial cancer (EC) and atypical endometrial hyperplasia (AEH) in women with abnormal uterine bleeding (AUB). Materials and Methods: This retrospective study included 1837 patients who presented with AUB and underwent endometrial sampling. Multivariable logistic regression was developed based on clinical and sonographic covariates [endometrial thickness (ET), resistance index (RI) of the endometrial vasculature] assessed for their association with EC/AEH in the development group (n=1369), and a predictive nomogram was proposed. The model was validated in 468 patients. Results: Histological examination revealed 167 patients (12.2%) with EC or AEH in the development group. Using multivariable logistic regression, the following variables were incorporated in the prediction of endometrial malignancy: metabolic diseases [odds ratio (OR)=7.764, 95% confidence intervals (CI) 5.042–11.955], family history (OR=3.555, 95% CI 1.055–11.971), age ≥40 years (OR=3.195, 95% CI 1.878–5.435), RI ≤0.5 (OR=8.733, 95% CI 4.311–17.692), and ET ≥10 mm (OR=8.479, 95% CI 5.440–13.216). :A nomogram was created using these five variables with an area under the curve of 0.837 (95% CI 0.800–0.874). The calibration curve showed good agreement between the observed and predicted occurrences. For the validation group, the model provided acceptable discrimination and calibration. Conclusion The proposed nomogram model showed moderate prediction accuracy in the differentiation between benign and malignant endometrial lesions among women with AUB.

Objective: To establish a visualized nomogram with early predictive value for the severity of first-onset acute pancreatitis (AP). Methods: 706 cases of first-onset AP patients admitted to the First Affiliated Hospital of Wenzhou Medical University within 72 hours from January 2013 to January 2016 were collected. According to the revised Atlanta classification of AP in 2012, AP patients was divided into non-severe pancreatitis (NSAP, also called mild acute pancreatitis and moderately severe acute pancreatitis) group and severe acute pancreatitis (SAP) group. The demographic data (age, body mass index and admission time, etc) and laboratory tests (serum amylase, blood sugar, albumin, white blood cells, creatinine, urea nitrogen) were collected and statistically analyzed. Logistic univariate and multivariant regression analysis were performed based on the relevant clinical indicators. The statistically significant indicators were used to obtain regression equations. The R-language software was used to obtain the visualized nomogram via LR model, which was further validated by ROC curve analysis. Results: In univariate logistic regression analysis, the OR (95% CI) values of blood glucose, creatinine at admission and 24 h after admission, urea nitrogen at admission and 24 h after admission, white blood cell, albumin in NSAP group and SAP group were 1.132(1.080-1.186), 1.019(1.013-1.025), 1.026(1.020-1.033), 1.066(1.035-1.099), 1.333(1.241-1.432), 1.083(1.032-1.136), and 0.853(0.811-0.889), and all the differences were statistically significant (all P values <0.05). Multivariate logistic regression analysis showed that the regression equation of the LR model was Y=-2.657-0.116×albumin(g/L)+ 0.082×white blood cell(×10⁹/L)+ 0.118× glycemia(mmol/L)+ 0.022× 24 h after admission creatinine (μmol/L). A total score of more than 60 points on the nomogram predicted the possibility of SAP. If the total score exceeded 130, the possibility of SAP may be up to 14% or more. Furthermore, the ROC curve analysis confirmed that the sensitivity and specificity of LR model established in this study for predicting of SAP were superior to those of urea nitrogen, creatinine and BISAP score alone by AUC, respectively. Conclusions This nomogram may be a useful clinical tool for predicting the severity of the first-onset acute pancreatitis.

Objective:We isolated and identified the genotypes and molecular characteristics of the imported B3 measles virus (MeV) in Fujian province in 2018.Methods:Throat swab specimens were collected from clinically diagnosed measles patients and tested for viral RNA, using the real-time reverse transcription-polymerase chain reaction after the RNA extraction. Reverse transcription-polymerase chain reaction method was undertaken to amplify the 634 nucleotide acids of 3-terminal of the nucleoprotein gene. A phylogenetic tree was constructed and similarities in homology assessed.Results:We successfully isolated and obtained two measles virus strains and eighteen viral nucleic acid sequences. The Fujian strains were clustered within the same genotype group of WHO genotype B3 reference strains. Compared to the major circulating measles strain genotype B3 in the world, two Fujian strains MV18-41 and MV18-42 showed 100.0 % nucleic acid homology to HongKong.CHN/35.18 strain which was isolated from Hong Kong in 2018. The remaining 16 Fujian strains showed the highest homology (99.9 %) with the Mvs/Osaka.JPN/38.18/B3 strain isolated from Japan in 2018. Compared with other 23 WHO genotype reference strains, homology on both nucleotide and amino acid of the Fujian strain and the B1 genotype reference strain were the smallest, as 95.1 %-95.4 % and 95.3 %, respectively. The differences of homology between the Fujian strain and H1 genotype reference strain were the largest, as 88.7 %-89.0 % and 87.3 %, respectively. In addition, there were 13 mutation sites between the Fujian strain and the vaccine strain (Shanghai-191) at the 150 amino acid position of carboxy terminus on N protein, However, these sites did not cause functional changes in the protein region. Conclusions:In Fujian province, two strains of B3 genotype measles virus were obtained successfully, which were considered to be new genotype measles virus found in 2018. These findings showed it is necessary to strengthening the monitoring program on imported cases for better control and eliminate the measles virus.

Objective:To evaluate the effects of vaccine switch on the levels of neutralizing antibody (NA) of poliovirus in children aged<12 years.Methods:Subjects aged<12 years from 9 districts in Fujian province were chosen by stratified cluster and complete random sampling method. Blood samples were collected for testing NA of poliovirus by microcell neutralization.Results:A total of 2 134 subjects aged<12 years were selected. The positive rate of NA against PVⅠand Ⅲ were 98.64% and 95.83%; and geometric mean titers (GMTs) were 1∶259.35 and 1∶105.14, respectively. The GMTs presented a trend of decreasing as age increased. Compared to trivalent oral poliovirus vaccine (tOPV), bivalent oral poliovirus vaccine (bOPV) and inactivated poliovirus vaccine (IPV) induced higher GMTs of NA against poliovirusⅠand Ⅲ respectively. Among 182 children aged<5 years, the positive rate of NA against PVⅠ, Ⅱ, Ⅲ were 97.25%, 76.37% and 92.86%. There were statistical differences among the three types ( χ2=44.44, P=0.000). The rate of NA against PVⅡwas significantly lower than those ofⅠand Ⅲ (Ⅱ vs. I: χ2=34.65, P=0.000; Ⅱ vs. Ⅲ: χ2=18.99, P=0.000). And the GMTs of NA against PV Ⅰ, Ⅱ, Ⅲ were 1∶368.96、1∶23.06 and 1∶183.10, which were significantly different ( F=156.54, P=0.000). The GMT of PVⅠwas the highest, PV Ⅲ was the second, PVⅡ was lowest (pairwise comparison showed values of P all were 0.000). The analysis of general linear model showed that the interval between the date of last immunization and the date of sample collection would affect the GMTs of PVⅠand Ⅲ, different vaccine models would affect only the GMT of PV Ⅰ. The age maybe was a confounding factor. But no factors would affect the GMT of PV Ⅱ. Conclusions:After the vaccine switch, the level of NA against PVⅠand PV Ⅲ were still maintaining high level, but the level of PVⅡamong children<5 years was at relatively low level, which indicated that the surveillance should be strengthened.

Objective To investigate the association and interaction of heat shock proteins B1 (HSPB1) gene rs2868371 and tumor-suppressor protein p53 (TP53) gene rs1042522 polymorphisms with chromosome damage levels among coke oven workers. Methods We recruited 1 333 male workers from a state-run coke oven plant in Wuhan in September-October 2010. Among them, 949 who had worked in coke oven workplaces, including auxiliary facilities and bottom, side, and top ovens, were nominated as coke oven workers (i.e., exposed), and 384 administrative or medical staff whose workplaces were offices were used as controls. General characteristics and 5 ml of venous blood were collected from each participant. The plasma concentrations of benzo [a] pyrene-diolepoxide (BPDE)-albumin adducts and the lymphocytic micronucleus (MN) frequencies for each individual were detected by ELISA and cytokinesis-block micronucleus assay, respectively. Gene polymorphisms were genotyped using TaqMan assays via quantitative PCR (ABI Prism 7900HT), and the corresponding frequency ratios (FR) with 95%confidence intervals (CI) were computed for all assays. Results In the exposed group, the MN frequencies were higher in HSPB1 rs2868371 GC, CC, and GC+CC genotype carriers ((3.88 ± 2.88)‰, (4.00 ± 2.66)‰, and (3.91 ± 2.83)‰, respectively) than in rs2868371 GG genotype carriers ((3.52±2.67)‰;FR=1.10, 1.13, and 1.11;95%CI:1.02-1.19, 1.02-1.25, and 1.03-1.19, respectively), and the HSPB1 rs2868371C allele was associated with increased MN frequency (Ptrend=0.006). Further, in the exposed group, the MN frequencies were lower in TP53 rs1042522 CG and CG+GG genotype carriers ((3.63±2.61)‰and (3.66±2.61)‰, respectively) than in TP53 rs1042522 CC genotype carriers (3.95 ± 3.06)‰(FR=0.87 and 0.90;95%CI:0.83-0.96 and 0.84-0.97, respectively). The effect of gene-gene interaction between HSPB1, rs2868371, and TP53 rs1042522 on MN frequency was significant among coke oven workers (P=0.001). Further stratified analyses showed that the effects of the HSPB1 rs2868371C allele in increasing MN frequencies were robust in subjects aged>40 years (FR=1.07, 95% CI: 1.01-1.12), those working >20 years (FR=1.08, 95% CI: 1.02-1.14), those with BMI ≤24 kg/m2 (FR=1.07, 95% CI: 1.01-1.13), drinkers (FR=1.09, 95% CI: 1.02-1.16), and workers with higher BPDE-albumin adduct levels (FR=1.07, 95% CI: 1.01-1.13) (Ptrend=0.023, 0.013, 0.029, and 0.020, respectively). The decreasing effect of the TP53 rs1042522 G allele on MN frequencies was robust in subjects aged >40 years (FR=0.94, 95% CI: 0.89-0.99), those with BMI ≤24 kg/m2 (FR=0.94, 95% CI:0.88-0.99), and drinkers (FR=0.94, 95% CI: 0.88-1.00) (Ptrend=0.031, 0.023, and 0.038, respectively). In addition, there were interactions between HSPB1 rs2868371 and age and between HSPB1 rs2868371 and working years in terms of MN frequency (P=0.030 and 0.013, respectively). Conclusion In coke oven workers, the HSPB1 rs2868371 C and TP53 rs1042522 G alleles were associated with increased and decreased chromosome damage levels, respectively, and their interaction effect on chromosome damage levels was significant.

Objective:To explore the accuracy of a multi-task model based on vision Transformer for analyzing the three-dimensional (3D) upper airway and its subregions, and to evaluate its clinical applicability.Methods:According to the inclusion and exclusion criteria, cone-beam CT (CBCT) data of 10 patients [4 males and 6 females, (20.8±2.7) years] who had their first visit to the Department of Orthodontics in the Hospital of Stomatology, Wuhan University from January 2012 to January 2020 were retrospectively selected. The 3D slicer software was used to segment the upper airway and pharyngeal airway and measure their volumes as the gold standard. The Dolphin 3D software was used to segment the pharyngeal airway and its subregions and measure their volumes as the gold standard. A multi-task model based on vision Transformer developed by the research team for automatic segmentation and volume measurement of the upper airway and its subregions. All the measurements were conducted by the same attending physician. The Bland-Altman analysis and intraclass correlation coefficient ( ICC) were used to evaluate the consistency between the multi-task network and the gold standard in the upper airway segmentation and volume measurements, and the paired t test was used to compare the differences between the multi-tasking model and the gold standard. Results:The mean volume deviation of the upper airway segmented by multi-task model and 3D Slicer was -979.6 mm 3, and the ICC was 0.97. The mean volume deviation of the pharyngeal airway, nasopharynx, velopharynx, glossopharynx and hypopharynx segmented by multi-task network and Dolphin 3D were 2 069.5, -950.1, -823.6, -813.9 and 4 003.4 mm 3, respectively. In addition, ICC in pharyngeal airway, nasopharynx, velopharynx, glossopharynx and hypopharynx were 0.97, 0.94, 0.96, 0.96 and 0.69, respectively. Conclusions:The multi-task model based on vision Transformer produced different errors in the segmentation of 3D upper airway and its subregions. The segmentation of the nasopharynx, velopharynx and glossopharynx was in good agreement with the gold standard, while the segmentation of hypopharynx was poor, suggesting that the robustness and generalization of this model should be further enhanced.

Objective To investigate the association and interaction of heat shock proteins B1 (HSPB1) gene rs2868371 and tumor-suppressor protein p53 (TP53) gene rs1042522 polymorphisms with chromosome damage levels among coke oven workers. Methods We recruited 1 333 male workers from a state-run coke oven plant in Wuhan in September-October 2010. Among them, 949 who had worked in coke oven workplaces, including auxiliary facilities and bottom, side, and top ovens, were nominated as coke oven workers (i.e., exposed), and 384 administrative or medical staff whose workplaces were offices were used as controls. General characteristics and 5 ml of venous blood were collected from each participant. The plasma concentrations of benzo [a] pyrene-diolepoxide (BPDE)-albumin adducts and the lymphocytic micronucleus (MN) frequencies for each individual were detected by ELISA and cytokinesis-block micronucleus assay, respectively. Gene polymorphisms were genotyped using TaqMan assays via quantitative PCR (ABI Prism 7900HT), and the corresponding frequency ratios (FR) with 95%confidence intervals (CI) were computed for all assays. Results In the exposed group, the MN frequencies were higher in HSPB1 rs2868371 GC, CC, and GC+CC genotype carriers ((3.88 ± 2.88)‰, (4.00 ± 2.66)‰, and (3.91 ± 2.83)‰, respectively) than in rs2868371 GG genotype carriers ((3.52±2.67)‰;FR=1.10, 1.13, and 1.11;95%CI:1.02-1.19, 1.02-1.25, and 1.03-1.19, respectively), and the HSPB1 rs2868371C allele was associated with increased MN frequency (Ptrend=0.006). Further, in the exposed group, the MN frequencies were lower in TP53 rs1042522 CG and CG+GG genotype carriers ((3.63±2.61)‰and (3.66±2.61)‰, respectively) than in TP53 rs1042522 CC genotype carriers (3.95 ± 3.06)‰(FR=0.87 and 0.90;95%CI:0.83-0.96 and 0.84-0.97, respectively). The effect of gene-gene interaction between HSPB1, rs2868371, and TP53 rs1042522 on MN frequency was significant among coke oven workers (P=0.001). Further stratified analyses showed that the effects of the HSPB1 rs2868371C allele in increasing MN frequencies were robust in subjects aged>40 years (FR=1.07, 95% CI: 1.01-1.12), those working >20 years (FR=1.08, 95% CI: 1.02-1.14), those with BMI ≤24 kg/m2 (FR=1.07, 95% CI: 1.01-1.13), drinkers (FR=1.09, 95% CI: 1.02-1.16), and workers with higher BPDE-albumin adduct levels (FR=1.07, 95% CI: 1.01-1.13) (Ptrend=0.023, 0.013, 0.029, and 0.020, respectively). The decreasing effect of the TP53 rs1042522 G allele on MN frequencies was robust in subjects aged >40 years (FR=0.94, 95% CI: 0.89-0.99), those with BMI ≤24 kg/m2 (FR=0.94, 95% CI:0.88-0.99), and drinkers (FR=0.94, 95% CI: 0.88-1.00) (Ptrend=0.031, 0.023, and 0.038, respectively). In addition, there were interactions between HSPB1 rs2868371 and age and between HSPB1 rs2868371 and working years in terms of MN frequency (P=0.030 and 0.013, respectively). Conclusion In coke oven workers, the HSPB1 rs2868371 C and TP53 rs1042522 G alleles were associated with increased and decreased chromosome damage levels, respectively, and their interaction effect on chromosome damage levels was significant.