Chemotherapy is currently the mainstay of systemic management for triple-negative breast cancer (TNBC), but chemoresistance significantly impacts patient outcomes. Our research indicates that Doxorubicin (Dox)-resistant TNBC cells exhibit increased glycolysis and ATP generation compared to their parental cells, with this metabolic shift contributing to chemoresistance. We discovered that ALKBH3, an m¹A demethylase enzyme, is crucial in regulating the enhanced glycolysis in Dox-resistant TNBC cells. Knocking down ALKBH3 reduced ATP generation, glucose consumption, and lactate production, implicating its involvement in mediating glycolysis. Further investigation revealed that aldolase A (ALDOA), a key enzyme in glycolysis, is a downstream target of ALKBH3. ALKBH3 regulates ALDOA mRNA stability through m¹A demethylation at the 3'-untranslated region (3'UTR). This methylation negatively affects ALDOA mRNA stability by recruiting the YTHDF2/PAN2-PAN3 complex, leading to mRNA degradation. The ALKBH3/ALDOA axis promotes Dox resistance both in vitro and in vivo. Clinical analysis demonstrated that ALKBH3 and ALDOA are upregulated in breast cancer tissues, and higher expression of these proteins is associated with reduced overall survival in TNBC patients. Our study highlights the role of the ALKBH3/ALDOA axis in contributing to Dox resistance in TNBC cells through regulation of ALDOA mRNA stability and glycolysis.

Objective:To investigate the epidemiological characteristics and genotype trends of rotavirus infection among the population with diarrhea in China, from 2009 to 2020 and provide evidence for strategic surveillance and prevention.Methods:Surveillance data on diarrhea syndrome from 252 sentinel hospitals across 28 provinces (municipalities, autonomous regions) were obtained from the information management system of the Infectious Disease Surveillance Technology Platform of the National Science and Technology Major Project. Descriptive epidemiological methods were employed to analyze the distribution of rotavirus diarrhea cases in different climatic zones, populations, and times from 2009 to 2020, as well as the genotyping characteristics and changing trends of group A rotavirus diarrhea cases.Results:From 2009 to 2020, a total of 114 606 diarrhea cases were tested for rotavirus, and the positive rate was 19.1% (21 872/114 606); group A rotavirus was dominant (98.2%, 21 471/21 872). The positive rate of rotavirus was the highest in 2009 (36.9%, 2 436/6 604) and 2010 (30.6%, 5 130/16 790), fluctuated between 14.0% to 18.0% from 2011 to 2017, raised slightly in 2018 (20.3%, 2 211/10 900), and declined continuously in the following two years (15.5%, 2 262/14 611 and 9.5%, 470/4 963). The positive rate of males (20.2%, 13 660/67 471) was significantly higher than that of females (17.4%, 8 212/47 135). Children under five had the highest positive rate (28.4%, 18 261/64 300), more than four times that of adults. The positive rate peaked from December to February in the mediate temperate zone, warm temperate zone, and subtropical zone, while there were two peaks from November to January and May to June in the frigid zone of the plateau. The dominant genotype of group A rotavirus gradually changed from G3P[8] and G1P[8] to G9P[8] during 2009-2020.Conclusions:The overall rotavirus infection rate in China was on a downward trend. Meanwhile, significant variations of positive rates were observed in seasonal epidemics and different age groups from 2009 to 2020. Rotavirus diarrhea in children was still a prominent concern. Vaccination of rotavirus vaccine should be promoted, and the epidemiological characteristics and genotypes of rotavirus diarrhea should be continuously monitored.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the awareness of malaria-related knowledge, the use of mosquito nets and their influencing factors among residents in Banlao Township, Cangyuan County, Yunnan Province.. Methods In August 2020, 19 settlement sites in Banlao Township, Cangyuan County, Lincang City, Yunnan Province were selected as study areas, and permanent residents at ages of 10 years and older were enrolled for a questionnaire survey, including residents’ demographics, family economic status, malaria control knowledge and use of mosquito nets. In addition, the factors affecting the use of mosquito nets in the night prior to the survey were identified using multivariate logistic regression analysis. Results A total of 320 questionnaires were allocated, and all were recovered (a 100% recovery rate). There were 316 valid questionnaires, with an effective recovery rate of 98.75%. The 316 respondents included 152 men and 164 women and 250 Chinese respondents and 66 foreign respondents. The awareness of clinical syndromes of malaria was significantly higher among Chinese residents (71.60%) than among foreign residents (50.00%) (χ² = 11.03, P < 0.01), and the proportions of Chinese and foreign residents sleeping under mosquito nets were 46.00% and 69.70% on the night prior to the survey, respectively (χ² = 11.73, P < 0.01). Multivariate logistic regression analysis identified ethnicity group and type of residence as factors affecting the use of mosquito nets in the night prior to the survey. Conclusions The awareness of malaria control knowledge, the coverage and the use of mosquito nets were low among residents in Banlao Township, Cangyuan County, Yunnan Province. Targeted health education is recommended to improve the awareness of malaria control knowledge and self-protection ability. In addition, improving the allocation of long-lasting mosquito nets and health education pertaining to their uses and increasing the proportion of using mosquito nets correctly is needed to prevent re-establishment of imported malaria.

New threats posed by the emerging circulating variants of SARS-CoV-2 highlight the need to find conserved neutralizing epitopes for therapeutic antibodies and efficient vaccine design. Here, we identified a receptor-binding domain (RBD)-binding antibody, XG014, which potently neutralizes β-coronavirus lineage B (β-CoV-B), including SARS-CoV-2, its circulating variants, SARS-CoV and bat SARSr-CoV WIV1. Interestingly, antibody family members competing with XG014 binding show reduced levels of cross-reactivity and induce antibody-dependent SARS-CoV-2 spike (S) protein-mediated cell-cell fusion, suggesting a unique mode of recognition by XG014. Structural analyses reveal that XG014 recognizes a conserved epitope outside the ACE2 binding site and completely locks RBD in the non-functional "down" conformation, while its family member XG005 directly competes with ACE2 binding and position the RBD "up". Single administration of XG014 is effective in protection against and therapy of SARS-CoV-2 infection in vivo. Our findings suggest the potential to develop XG014 as pan-β-CoV-B therapeutics and the importance of the XG014 conserved antigenic epitope for designing broadly protective vaccines against β-CoV-B and newly emerging SARS-CoV-2 variants of concern.
Angiotensin-Converting Enzyme 2 ; Antibodies, Neutralizing ; Antibodies, Viral ; COVID-19 ; Epitopes ; Humans ; SARS-CoV-2/genetics* ; Spike Glycoprotein, Coronavirus/genetics*

Objective:To explore the correlation between enhanced CT quantitative parameters and malignant biological behavior and prognosis of colon cancer.Methods:From February 2017 to October 2019, 100 patients with colon cancer in Anhui Wanbei Coal-Electrivity Group Gernal Hospital were selected as the research subjects, and all performed enhanced CT examination. The serum tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) levels were detected. According the mean value of CEA, CA19-9, the patients were divided into different group, and CEA< 28.36 pmol/L was considered to below level, ≥ 28.36 pmol/L was high; CA19-9<40.26 pmol/L was considered to below level, ≥ 40.26 pmol/L was high. The quantitative parameters of enhanced CT in patients with colon cancer with different serum CEA and CA19-9 levels and different pathological indicators (CT scan value, enhanced value, degree of enhancement) were compared. The correlation between serum tumor marker levels, malignant biological behavior of colon cancer and quantitative parameters of enhanced CT were explored. After 12-months′ followed-up, the clinical data of patients with different prognosis and enhanced CT parameters were counted. The factors affecting the prognosis of colon cancer patients and the predictive value of enhanced CT quantitative parameters on the prognosis of patients were explored.Results:The CT scan value, enhancement value and enhancement degree of colon cancer patients with low levels of serum CEA and CA19-9 were lower than those with high levels: (30.16 ± 5.14) HU vs. (38.51 ± 5.72) HU, (55.74 ± 8.12)HU vs. (78.62 ± 8.97) HU, (25.58 ± 3.60) HU vs. (40.11 ± 3.14) HU, the differences were statistically significant ( P<0.05). There was a positive correlation between serum CEA and CA19-9 levels in patients with colon cancer and CT scan value, enhancement value, and degree of enhancement ( P<0.05). The CT enhancement value and enhancement degree of colon cancer patients were related to Dukes staging, differentiation degree, lymph node metastasis and lymphatic infiltration in colon cancer patients. The CT scan value was related to Dukes staging, lymph node metastasis and lymphatic infiltration of colon cancer patients ( P<0.05). The risk factors for death of colon cancer patients included age, Dukes staging, degree of differentiation, lymph node metastasis, lymphatic invasion, CT scan value, enhancement value, and degree of enhancement ( P<0.05). The area under the curve (AUC) of CT scan value, enhancement value, and enhancement degree combined to predict the prognosis of colon cancer patients was 0.873, which was greater than the single prediction of each parameter. The best sensitivity and specificity of combined prediction were 76.92% and 88.37%, respectively. Conclusions:There is a certain correlation between the enhanced CT quantitative parameters and the malignant biological behavior of patients with colon cancer. The increased detection value is risk factor for the prognosis.

Objective:To explore the correlation between TCM Syndromes of small pulmonary nodules (SPN) and the features of CT imaging and tumor markers in the chest.Methods:With retrospective study, the clinical data of 420 patients with small pulmonary nodules who were included from June 2016 to May 2018 from the East China Hospital Affiliated to Fudan University and Shanghai TCM Integrated Hospital were analized. The correlation between TCM syndromes and clinical high-risk indicators was analyzed by frequency analysis and Pearson correlation analysis.Results:The TCM syndromes were mainly lung qi and spleen qi deficiency syndrome (28.8%), followed by qi and yin deficiency syndrome (27.6%), lung yin deficiency syndrome (22.9%), qi deficiency and blood stasis syndrome (12.4%) and liver depression and spleen deficiency syndrome (8.3%). Compared with the patients with qi deficiency and blood stasis, the patients with liver depression and spleen deficiency had carcino embryonic antigen (CEA) level decreased significantly ( P<0.01); compared with the patients with qi and yin deficiency, CYFRA21-1 level in the patients with lung yin deficiency increased significantly ( P<0.001) and CYFRA21-1 level decreased in the patients with qi deficiency and blood stasis ( P=0.014); compared with the patients with lung yin deficiency, the level of neuron-specific- enolase (NSE) in the patients with lung qi and spleen qi deficiency. The level of NSE decreased ( P=0.044), and the level of NSE increased significantly in patients with liver depression and spleen deficiency ( P=0.005); there was no significant difference in the level of SCC between different syndromes ( F=0.825, P=0.551). The syndrome of deficiency of lung yin was moderately correlated with chronic bronchitis, smooth margin and burr ( r=0.613, -0.628, 0.755). The syndrome of qi and yin deficiency was lowly correlation to the solidity ( r=-0.421). The syndrome of lung qi and spleen qi deficiency was moderately correlation with the solidity ( r=0.540), and were low correlation with the chronic bronchitis history, ground glass, round, quasi round, and smooth edge ( r value was 0.303, -0.495, 0.376, -0.337, 0.319 respectively); liver depression and spleen deficiency syndrome were correlated with smoking history, chronic bronchitis history, left lower lobe of lung, isolated focus, multiple focus, quasi circle, NSE ( r value was -0.099, -0.150, 0.120, 0.113, -0.113, -0.107, 0.133 respectively); qi deficiency and blood stasis syndrome was moderately correlated with lobular shape ( r=0.682), and slightly correlated with irregular edge ( r=0.470). Conclusions:There is a certain correlation between TCM syndrome differentiation and clinical indexes in patients with pulmonary nodules. The level of tumor markers was different in different syndrome types. Among them, the lung yin deficiency syndrome and qi deficiency and blood stasis syndrome are at high risk of developing malignant tumors, but the lung qi and spleen qi deficiency syndrome, qi and yin deficiency syndrome and liver depression and spleen deficiency syndrome are at low risk of developing malignant tumors.

Since December 2019, novel coronavirus pneumonia (NCP) has been reported in Wuhan, Hubei Province, and spreads rapidly to all through Hubei Province and even to the whole country. The virus is 2019 novel coronavirus (2019-nCoV), never been seen previously in human, but all the population is generally susceptible. The virus spreads through many ways and is highly infectious, which brings great difficulties to the prevention and control of NCP. Based on the needs of orthopedic trauma patients for emergency surgery and review of the latest NCP diagnosis and treatment strategy and the latest principles and principles of evidence-based medicine in traumatic orthopedics, the authors put forward this expert consensus to systematically standardize the clinical pathway and protective measures of emergency surgery for orthopedic trauma patients during prevention and control of NCP and provide reference for the emergency surgical treatment of orthopedic trauma patients in hospitals at all levels.

Objective To study the influence of excessive iodine intake on the 99Tcm-pertechnetate uptake function of thyroid and explore the related mechanism.Methods A total of 150 male Wistar rats were divided into normal iodine group (NI group) and 4 high iodine (HI) groups (10HI,50HI,100HI and 500HI group) with completely random method.Each group included 30 rats.Rats in HI groups were intragastrically administrated with different concentrations of KIO3,and rats in NI group were administrated with the same amount of distilled water.After a 7 d HI diet,each group was randomly divided into 3 subgroups:7 d group (HI diet for 7 d),10 d group (HI diet for 7 d + limiting iodine for 3 d) and 14 d group (HI diet for 7 d + limiting iodine for 7 d).All rats were given 1.85 MBq 99TcmO4-,then the thyroid glands were isolated and weighed 20 min post-injection.The radioactive counts were measured and the thyroid uptake percentage activity of injected dose per gram of tissue (％ID/g) of 99TcmO4-for each sample was calculated.Sodium-iodide symporter (NIS) expression level was analyzed by Western blot.One-way analysis of variance or Welch test was used to compare the differences among groups,and Spearman rank correlation analysis was also used.Results At the same observation time,the ％ID/g of 99TcmO4-and NIS expression among different HI groups were statistically significant (F values:48.825-119.219,all P＜0.01).In NI and 10 HI groups,％ID/g of 99TcmO4-and NIS expression were not significantly different among different time subgroups (F values:0.090-4.753,all P＞0.05).Significant differences of ％ ID/g of 99TcmO4-and NIS expression were found among different time subgroups in 50HI,100HI and 500HI groups (F values:10.442-90.408,all P＜0.01).Spearman correlation analysis showed that the concentration of iodine correlated negatively with ％ID/g of 99TcmO4-and NIS expression (rs values:-0.853 and-0.950,both P＜0.01),while the ％ID/g of 99TcmO4-and NIS expression was positively correlated (rs =0.925,P＜0.01).Conclusions Excessive iodine intake can inhibit thyroid uptake of 99TcmO4-in rats,which is associated with the down-regulation of NIS expression.The degree of inhibition correlates positively with iodine concentration,and correlates negatively with NIS expression.The degree of recovery of NIS and ％ID/g of 99TcmO4-may relate to the time of limiting the iodine intake.

Objective To introduce the application of the network training on clinicians'knowledge of malaria diagnosis and treatment in Yunnan Province,and evaluate its effect. Methods Through the platform Yiboshi(www.yiboshi.com),the medi-cal and health personnel at the units of provincial,prefectural,county levels and 25 townships of 25 border counties were trained on the knowledge of malaria diagnosis,treatment,prevention and control,and the effects were evaluated by examina-tions,questionnaires and interviews. Results Totally 7152 participants were trained,the average participation,completion and pass rates of the training were 95.26%,98.55% and 97.30%,respectively. The trainees mainly learned malaria control knowledge from 3 aspects,namely policy of malaria elimination,malaria epidemiology,malaria diagnosis and treatment. The questionnaires showed that 95.94%of the participants considered that their theoretical and technical levels improved,97.30%were interested in the training content,93.24% recognized the arrangement of the training time was reasonable,and 91.89%were satisfied with the service of the platform. Conclusions The network training on knowledge of malaria diagnosis and treat-ment in Yunnan Province has achieved good effect. The network training meets the need of training a large number of clinicians in the malaria elimination and post-elimination stage.