Objective:To validate gender-related differences in patients with upper tract urothelial carcinoma (UTUC).Methods:We used a method of combination of SEER database analysis and validation in our center. We selected 2 125 men (57.8%) and 1 552 (42.2%) women who underwent radical nephroureterectomy (RNU) for UTUC between 1995 and 2015 within the surveillance, Epidemiology, and End Results registries (SEER). In male cases, the median age was 71(22-99)years old, median follow-up time was 53.0 (0-227) months, 902 (89.5%) cases were Caucasian, 1 384 cases (65.1%) were located in the renal pelvis, and 810(38.1%) cases were T 3-T 4. For female cases, the median age was 73.6(25-99)years old, median follow-up time was 53.1(0-226) months, 1 417(91.3%) cases were Caucasian, 1 043 cases (67.2%) were located in the renal pelvis, and 508 (32.7%) cases were T 3-T 4. The analysis of SEER database showed that female patients were older compared to male patients ( P=0.002), the proportion of T 3-T 4 was even lower ( P=0.028). There were no statistically significant differences in race, tumor location, and follow-up time between males and females (all P>0.05). We also enrolled 131 men (55.3%) and 106 women (44.7%) who underwent RNU for non-muscle invasive (T a/T is/T 1) UTUC between January 2000 and January 2015. These patients had no history of bladder cancer, UTUC and kidney transplantation. Preoperative cystoscopy was performed to confirm the absence of bladder tumor. The male group was (65.8±12.4)years old, with history of aristolochic acid medications in 7(5.3%) cases, 98 smoking cases (74.8%), and estimated glomerular filtration rate (eGFR) of (64.2±29.4)ml/(min·1.73 m 2). In the female group, mean age was (66.7±11.9)years, 14 (13.2%) cases had history of aristolochic acid medications, 16(15.1%) had history of smoking, eGFR (56.3±27.9) ml/(min·1.73m 2). Compared with female patients, male patients tended to had less aristolochic acids exposure (5.3% vs.13.2%, P<0.001), frequent smoking (74.8% vs. 15.1%, P<0.001) and better renal function ( P=0.036). The Kaplan-Meier test was used for time-to-event analysis. Univariate and multivariate logistic regression models were adopted to examine the effect of gender on the development of T 3-T 4 tumor. Univariate and multivariate Cox regression analyses were used to assess the roles of factors on overall survival (OS) in both SEER and cases in our center, and competing-risks regression model was used to assess the roles of factors on cancer-specific survival (CSS) in both SEER and cases in our center. Results:Multivariate logistic analysis showed that gendere represented an independent risk factor of T 3-T 4 UTUC development( OR=0.86, P=0.02). Kaplan-Meier analysis showed that better OS and CSS for females only existed in the non-muscle invasive stages(5-year OS rates were 80.4% vs.87.3%, χ 2=31.0, P<0.001; 5-year CSS rates were 82.6% vs.89.2%, χ 2=31.2, P<0.001). In multivariate competing-risks regression models, no statistically significant differences in survival were observed between males and females ( HR=0.83, P=0.115). For the patients in our center, there were also no statistically significant differences existed in the non-muscle invasive stage between two genders on OS and CSS ( HR=0.93, P=0.071; HR=0.87, P=0.064). Conclusions:Females were less likely to have advanced pathological T stage. The differences on OS and CSS between males and females only existed in non-muscle invasive stage. However, after accounting for gender related factors, gender no longer had effects on UTUC prognosis.

Objective To investigate the expression of proline rich tyrosine kinase 2 (Pyk2) in non-muscle invasive bladder cancer,and analyze its correlation to clinicopathologic features and prognosis of non-muscle invasive bladder cancer.Methods 114 surgical specimens and 50 normal bladder mucosa specimens were collected from 114 non-muscle invasive bladder cancer patients who underwent TURBT at our hospital,from June 2013 to March 2018.Of the 114 patients,63 were male and 51 were female,aged 42-87 years,average age of (63.6 ± 13.8) years,73 cases of tumor ＜3 cm,41 cases of tumor ≥3 cm,83 cases were single and 31 cases were multiple tumor,53 cases were high grade and 61 cases were low grade,59 cases were Ta and 55 cases were T1 stage.Pyk2 protein expression was detected by immunohistochemistry and western blot.The correlation of the expression of Pyk2 with clinicopathologic features,including gender,age,tumor size,the number of tumors,histological grade and clinical stage were analyzed.Survival analysis was calculated by using the Kaplan-Meier method,and the difference in survival curve was analyzed by using the log-rank test.Association of Pyk2 expression with prognosis of non-muscle invasive bladder cancer analyzed by using the Cox proportional hazards regression model.Results Compared with normal bladder tissues,expression of Pyk2 protein was increased in bladder cancer tissue significantly(0.571 ±0.230 vs.0.253 ± 0.152,P ＜0.01).The expression of Pyk2 protein was closely related to clinical stage(P =0.027) and grade(P =0.010),rather than gender (P =0.275),age (P =0.419),tumor size (P =0.317),and tumor number(P =0.208).The recurrence rate in the Pyk2 positive group and negative group were 46.1％ (35/76)and 28.9％ (11/38)respectively.The progression rate in the Pyk2 positive group and negative group were 35.5％ (27/76) and 10.5 ％ (4/38) respectively.Survival analysis suggested expression of Pyk2 in non-muscle invasive bladder cancer had a significant relation to recurrence-free survival rate(P ＜0.001) and progression-free survival rate(P =0.003).In the multivariable Cox analysis,we found that Pyk2 protein was an independent predictor of recurrence-free survival rate(HR 0.245,95％ CI 0.078-0.768,P =0.016) and progression-free survival rate (HR 0.095,95％ CI 0.012-0.764,P =0.027).Conclusions The expression of Pyk2 in non-muscle invasive bladder cancer was significantly increased.The expression of Pyk2 has a significant relation to recurrence and progression of non-muscle invasive bladder cancer.High Pyk2 expression is an independent prognostic factor in non-muscle invasive bladder cancer.

Bacteria have posed a threat to human health,and the emergence of super bacteria has made it more difficult to cure bacterial infections in clinical practice.Currently,vaccines are one of the effective means of preventing bacterial infections.With the rapid development of cutting-edge technologies in recent years in such disciplines as biology,medicine,and materials science,various innovative strategies have been provided for vaccine research and preparation.This article summarizes the status quo and prospects of innovative vaccines for treating bacterial infections in recent years,including subunit vaccines,mRNA vaccines and attenuated live vaccine in the hopes of providing data for subsequent development and research of bacterial vaccines.

Objective:To investigate the high resolution CT (HRCT) features of COVID-19 in children.Methods:A retrospective analysis was performed on the chest HRCT findings of 22 children who were diagnosed as COVID-19 by clinical and nucleic acid testing in Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 25 to February 5, 2020. There were 12 boys and 10 girls, aged from 2 months to 14 years old, with a median age of 4 years, and 14 patients were under 5 years old. The characteristics of lung lesions on HRCT such as distribution, shape, density and so on and whether there were hilar and mediastinal lymph node enlargement and pleural changes were evaluated by 2 radiologists.Results:In all of the 22 patients, the chest CT manifestations were normal in 3 patients (3/22) , meanwhile the lung involvement of the lesion was found in 19 patients (19/22). Among them, 7 patients had unilateral lung involvement, and 12 patients had bilateral involvement. The HRCT manifestations were as follows. The HRCT showed the ground glass opacity (GGO) in 6 patients, including 4 cases with light opacity and 2 with typical crazy paving sign. Four patients had lung consolidation, with local fibrous stripes and patchy hyperdensity. Six patients had mixed GGO, including 1 case with right white lung. The bronchopneumonia-like changes were seen in 3 cases with scattered spot-like or mixed patchy. The lesions in the lower lobe were more serious than those in the upper lobe, and the lesions in the lateroposterior zone of the lung were more common than those in the apical and central area of the lung. No enlarged lymph nodes and pleural effusion were seen in all patients, but 1 case had thickened interlobar pleura.Conclusions:The HRCT manifestations of COVID-19 in children are varied, and the comprehensive assessment need to be made in combination with epidemiological data, clinical manifestations and laboratory tests. However, the chest HRCT plays an important role in early diagnosis, prevention and management of COVID-19.

Objective To analyze the epidemic characteristics of varicella in Chongqing from 2014 to 2020, and to provide evidence for the development of scientific and effective varicella control strategies. Methods Data on the outbreak of varicella and vaccination in Chongqing from 2014 to 2020 were collected through the China Disease Prevention and Control Information System, and descriptive epidemiological methods were used for statistical analysis. Results A total of 181 551 cases of varicella were reported in Chongqing from 2014 to 2020, with an average annual incidence rate of 83.79 per 100 000. The incidence rate of varicella increased from 39.95 per 100 000 in 2014 to 81.88 per 100 000 in 2020 (P < 0.001). The incidence of varicella was seasonal, with the peak periods occurring from May to June and from October to December each year. The average annual incidence rate in municipal districts was 88.90/100 000, higher than 67.42/100 000 in counties and 82.50/100 000 in autonomous counties. The average annual incidence rate of varicella in males (87.13/100 000) was higher than that in females (80.38/100 000). The incidence of varicella was mainly distributed in people under 15 years old, with 143 508 cases (79.10%) reported, and the highest incidence age was 5-9 years old (37.00%). Among the affected occupations , 133 733 cases (62.6%) were students , 39 274 cases (18.40%) were children in nursery care, and 17 963 cases (8.4%) were scattered children. The actual number of doses of varicella vaccine from 2014 to 2020 was 2 302 522 doses, with the coverage rates of one-dose and two-dose vaccines being 75.56% and 32.17%, respectively. ARIMA predicted that there would be 2 604, 811, 756, 1 226, 2 405, 3 904, 2 410, 1 211, 2 034, 6 878, 10 887, and 8 955 cases of varicella from January to December 2021. Conclusion The incidence of varicella in Chongqing is on the rise, with obvious seasonal, regional and population distribution characteristics. It is necessary to strengthen the prevention and control of varicella epidemic, strengthen the prevention and control measures of key groups and key institutions in the high incidence season, strengthen the publicity of varicella vaccine, and improve the vaccination rate of two-doses of varicella vaccine for eligible children.

Objective: To investigate the high resolution CT (HRCT) features of novel coronavirus pneumonia (NCP) in children . Methods: A retrospective analysis was performed on the chest HRCT findings of 22 children diagnosed with 2019-nCov pneumonia by clinical and nucleic acid testing in Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 25, 2020 to February 5, 2020. There were 12 boys and 10 girls, aged from 2 months to 14 years old, with a median age of 4 years, and 14 patients were under 5 years old. The characteristics of lung lesions on HRCT imaging such as distribution, shape, density, etc. and whether there were hilar and mediastinal lymph node enlargement and pleural changes were observed by 2 radiologists. Results: In all of the 22 patients, 3 patients (3/22) had normal chest CT, and 19 patients (19/22) had infiltrated lesions in lung. Among them, 7 patients had unilateral lung involvement, 12 patients had bilateral involvement. The HRCT manifestations were as follows. Six patients showed ground glass shadow, including 4 cases showed light ground glass shadow and 2 had typical crazy paving sign. Four patients showed lung consolidation, with localized strip shadow and patchy high-density shadow. Six patients showed patchy lesions with surrounding ground glass shadow, including 1 case with white lung in the right. The bronchopneumonia-like changes in 3 cases, showed scattered spot-like or patchy uneven high-density shadows. The lesions in the lower lobe were more serious than those in the upper lobe, and the lesions in the lateroposterior zone of the lung were more common than those in the apical and central area of the lung. No enlarged lymph nodes and pleural effusion were seen in all patients, and 1 case had thickened interlobar pleura. Conclusions The HRCT manifestations of NCP in children are diversified, comprehensive judgments need to be made in combination with epidemiological data, clinical manifestations, and laboratory tests, but the chest HRCT can be used as an important basis for early clinical diagnosis and prevention and control interventions.