Background and purpose:Due to the lack of cost-effective pre-treatment predictors for advanced cervical squamous cell carcinomas treated with concurrent chemoradiotherapy (CCRT), both baseline circulating CD4+CD25+CD127Low/- regulatory T cell (Treg) count and serum squamous cell carcinoma antigen (SCC-Ag) level were measured for this feasibility study. Methods: Peripheral blood samples were collected from 44 patients with stageⅡB-ⅣA cervical squamous carcinomas before CCRT. Flow cytometry immunophenotyping and enzyme-linked immunosorbent assay were used for circulating CD4+CD25+CD127Low/-Treg count and serum SCC-Ag level testing,respectively. Clinical and pathological characteristics were retrospectively reviewed to analyze the predictive value of the 2 indexes. Results:The baseline circulating CD4+CD25+CD127Low/-Treg count was lower in the patient group with positive treatment response than in the group with negative response [(8.78±2.80)%vs (10.95±2.56)%, P<0.05], and the serum SCC-Ag level showed no signiifcant difference between the 2 groups. No correlation was detected between these 2 markers (Spearman’rho=-0.093, P=0.540). Determined by plotting receiver operating characteristic curves, the best cut-off points were 9.76%for circulating CD4+CD25+CD127Low/-Treg count and 9.50 ng/mL for serum SCC-Ag level, respectively. Univariate analysis showed that pretherapeutic circulating CD4+CD25+CD127Low/-Treg count (OR=1.901, 95%CI:1.112-3.219, P=0.017), but not serum SCC-Ag level (OR=0.998, 95%CI:0.001-4.253, P=0.897), was predictive of clinical response to CCRT. Multivariate Logistic regression analysis revealed that pre-treatment CD4+CD25+CD127Low/-Treg count was an independent predictor for clinical response to CCRT (OR=3.115, 95%CI:1.253-7.742, P=0.014). Conclusion:Pretherapeutic circulating CD4+CD25+CD127Low/-Treg count is a feasible method to predict clinical response to CCRT in patients with advanced cervical squamous cell carcinomas.

Objective To observe the changes of artery elasticity in patients with High-Normal Blood Pressure(HNBP) by ET, and search bound values in diagnosis by ROC. Methods Comparative analysis of artery IMT and β, Ep, AC, PWVβ with HNBP and normal group, which were analyzed by ROC. Results Compared with the normal group, β, Ep, PWVβ were increased in HNBP group, AC was lower significantly. Conclusion The peripheral artery elasticity have reduced before the artery IMT didn′t appear morphological change.

Since several dengue viruses (DENV) have been isolated in Fujian Province during the past decade, sequencing and evolution analyses of viral envelope genes are helpful in determining their possible transmission origins. In this study, viral RNA was extracted from 12 DENV strains from Fujian between 20042010. Viral envelope genes were amplified, cloned into TA vectors and sequenced, and the sequence data were subsequently analyzed by bioinformatics software. Full-length E genes of DENV-1 or DENV-2 of 1 485 bp, and DENV- 3 of 1 479 bp were obtained. It was indicated, from BLAST analysis and phylogenetic trees, that DENV strains in Fujian Province during 20042010 shared the highest similarity with Southeast Asian strains, suggesting that DENV circulating in Fujian Province between 20042010 were probably imported from Southeast Asia. Hence, extensive monitoring on passengers from this region at the entry-ports should be strengthened.

Objective To investigate the serum concentration of soluble klotho (s-kl) in systemic lupus erythematosus (SLE) and lupus nephritis (LN) ,and elucidate its role in SLE and LN .Methods A total of 34 patients ,definitely diagnosis as SLE with un-treatment firstly ,were enrolled in this study .The patient were divided into two groups ,those who complicated with LN were assigned to LN group (15 cases) ,the others were distributed to SLE group (19 cases) .At the same time ,17 cases of routine physical examination people were take as control group .24 hours urine of all the cases was collected for examining urinary protein (Upro) .Routine hemocyte analysis ,serum biochemical parameters and ANA and dsDNA were measured by routine method .ELISA was used to detect s-kl ,25-hydroxy vitamin D (25-OH-D) and fibroblast grow th factor-23 (FGF-23) .Systemic lupus erythematosus disease activity index (SLEDAI) was performed in SLE and LN group ,and the creatinine clearance rate(CCr)was calculated accord-ing to the Cockcroft-Gault formula .Pearson′s and linear regression were applied to analyisis the correlation of relevant parameters . Results As compared with the control group ,there were statistically significant differences in mean arterial pressure ,blood rou-tine ,creatine kinase (CK) and lactate dehydrogenase (LDH ) ,complement (C3 and C4 ) and dsDNA in SLE and LN group (P <0 .05) .The level of Upro/24 h ,lipids (CHOL and TG) and creatinine (Scr) in LN group was significantly higher ,while serum al-bumin (ALB) and CCr were obviously lower than those in SLE group and control goup(P< 0 .05) .Difference of s-kl ,25-OH-D and FGF-23 in serum were not observed between SLE and control gropu(P> 0 .05) ,but the serum level of s-kl ,25-OH-D and FGF-23 in LN group were showed a statistical significance when compared with SLE or control group(P< 0 .05) .Meanwhile ,the SLEDAI score was higher in LN than in SLE group(P< 0 .05) .Correlation analysis indicted that s-kl exhibited a positive relationship with 25-OH-D ,C3 and C4 ,while showed a negative correlation with FGF-23 ,SLEDAI and dsDNA(all P< 0 .05) .However ,no any corre-lationt was revealed in regression analysis between the s-kl ,25-OH-D ,FGF-23 and the lupus activity .Conclusion The decrease of s-kl maybe one of the pivotal factors that up-regulated the level of FGF-23 in SLE and LN patients ,thus lead to the deficiency of vi-tamin D and lupus activity .

To study the biological characteristics and mutations of influenza A(H1N1)pdm09 virus isolated from one case of pneumonia of unknown etiology (PUE),which would provide references for clinical treatment and disease control,the throat swab specimen from the PUE case was isolated in the Madin-Darby Canine Kidney (MDCK) cells,and then the antigenicity,pathogenicity and drug resistance of influenza A (H1N1) pdm09 virus were analyzed after sequencing.As a result,one influenza virus strain was isolated from the specimen and named as A/FujianGulou/SWL64/2016(H1N1).The similarities of nucleotide sequences and amino acids sequences compared with the vaccine strain A/California/07/2009 (H1N1) were 96.9％-98.9％ and 96.7％-99.5％,respectively.Eighteen amino acids had mutated in the HA and 4 mutations,K163Q,S185T,S203T and D222N,were involved in 3 different epitopes,which indicated that the antigenic drift had occurred in the influenza virus.The D222N mutation associated with receptor binding site made the virus infect lower respiratory tract more easily.The virus was still amantadine-resistance and oseltamivir-sensitive.In conclusion,the influenza A (H1N1) pdm09 virus in this study have occurred antigenic drift and has the molecular characterization of causing severe pneumonia,so further surveillance should be performed to prevent and control the influenza epidemic.

Objective To evaluate the value of transperineal pelvic ultrasound(TPUS) on long-term stress urinary incontinence (SUI) after total abdominal hysterectomy (TAH).Methods Thirty patients with TAH at least 2 years after operation were diagnosed as SUI according to clinical criteria and ultrasound criteria.They were divided into non-SUI group (Group Ⅱ,66 cases) and SUI group (Group Ⅲ,54 cases),72 cases of healthy patients were selected as the control group (group Ⅰ).TPUS was performed.The bladder neck rotation angle (△vBA),bladder urethral relief angle (rUJV,vUJV),urethral rotation angle (△vUIA),bladder neck mobility (BND),and the displacement of the bladder neck (vsB) were measured and recorded during the rest period and Valsalva state.Results According to the findings of ultrasound combined with pelvic floor parameters,the absolute values of △vBA,rUJV,vUJV,△vUIA,BND,vsB were increased in group Ⅱ compared with group Ⅰ (P＜0.05),which indicated that supportive function of the long-term pelvic floor tissue after TAH for a long-term was reduced.Compared with the non SUI group,the absolute values of △vBA,rUJV,vUJV,△vUIA,BND and vsB increased in the SUI group after TAH for a long term (P＜0.05).The absolute values of △vBA,rUJV,vUJV,△vUIA,BND,and vsB increased in the SUI group compared with the non-SUI group (P＜0.05),which indicated that after TAH,compared with non-SUI patients,the value of pelvic ultrasound parameters in patients with SUI increased more significantly.Conclusion The pelvic floor support function decreased after TAH,and pelvic floor function could be dynamically detected by TPUS in the early stage of TAH.

Myasthenia gravis is an autoimmune disease involving the acquired neuromuscular junction.Vast majority of patients with myasthenia gravis after conventional treatment (acetylcholinesterase inhibitors,plasmapheresis,gammaglobulin,and immunosuppressants) has significantly improved prognosis;but,there is still a small portion of patients had refractory myasthenia gravis,they did not have effective treatment,and their prognosis is poor.Some recent studies suggest that novel immunomodulatory agents,secondary thymus expand dissection,hematopoietic stem cell transplantation may be in force.

Objective: To understand the epidemiological and virological features of influenza B viruses and the difference between the vaccine strains and epidemic strains, the antigenic and genetic characteristics on hemagglutinin (HA) gene of influenza B viruses circulating in Fujian during 2010-2015. Methods: The representative strains were selected randomly according to the lineage of influenza B viruses isolated from network laboratory in Fujian, 2010-2015. Viral RNA was extracted and gene fragments were amplified by reverse transcription polymerase chain reaction (RT-PCR ) and the PCR products were sequenced. The complete HA gene sequence was obtained and analyzed via bioinformatics. Results: Compared to the vaccine strains recommended by WHO, there were significant changes in genetic and antigenic characteristics on HA gene of B Yamagata lineage viruses from 2010 to 2015, especially in 2010, 2014 and 2015. There were major five amino acid residues substitutions (116, 150, 165, 196 and 202) involved in antigenic determinants, and the variable sites gradually increased as time on over. However, the variability of B Victoria lineage viruses on HA gene was less and there was no obvious trend over time. The results showed that the B Yamagata vaccine strains of 2010 and 2015 recommended by WHO had poor protective effect on influenza virus infection, while the B Victoria vaccine strain still play a satisfactory protective effect on humans in Fujian. Conclusions With time on, influenza B Yamagata lineage viruses had gradually mutated, causing a poorly match with vaccine strains in part of year, and emerging antigenic drift phenomenon. Strengthening further surveillance of mutations of B influenza virus remains essential to allow for early warning of influenza epidemic.

[Abstract ] Objective To investigate the growth and development of children after liver transplantation.Methods Seventy children who underwent liver transplantation in Beijing Friendship Hospital and Tianjin First Central Hospital from September 2006 to May 2014 were included in the study.Height Z-scores (ZH )and weight Z-scores (ZW )of each child were respectively calculated at transplantation and 6 months,1 year,2 years,3 years,4 years and 5 years after transplantation.The change trends of ZH and ZW at each time point were analyzed.Moreover,ZH and ZW at each time point were compared with the standardized mean of growth 0 (standardized mean ) formulated according to the survey data of children's physical development in nine provinces and municipalities in 2005.Children were divided into Z≥ -2 group and Z <-2 group according to ZH and ZW at transplantation.And the change trend of ZH and ZW of each group was compared.Results The mean of ZH and ZW at the time of liver transplantation was -1.63 ± 1.35 and-1.53 ±1.52 respectively.After liver transplantation,ZH and ZW increased gradually.ZH and ZW of children before transplantation and 6 months after transplantation were significantly lower than standardized mean (all in P <0.01).ZH and ZW in other postoperative periods had no statistical significance with standardized mean (all in P >0.05).There were significant difference between ZH≥ -2 group and ZH <-2 group at transplantation and 6 months and 1 year after transplantation (both in P <0.05).Zw of Zw≥ -2 group and Zw <-2 group at transplantation and 6 months,1 year and 2 years after transplantation had difference with statistical significance (all in P <0.05).Conclusions The growth and development of children with liver transplantation recover gradually and increase significantly at 1 year after transplantation.

Objective:To establish the risk prediction models for postoperative delirium (POD) in elderly patients undergoing non-cardiac surgery and to evaluate the predictive efficacy.Methods:A total of 685 patients of both sexes, aged 65-90 yr, of American Society of Anesthesiologists (ASA) physical status Ⅰ-Ⅳ, who underwent non-cardiac elective surgery requiring tracheal intubation during general anesthesia in general surgery, orthopedics, urology, hepatobiliary and pancreatic surgery in our hospital from January 2020 to December 2020, were selected.Patients were assigned to the training set and validation set at a ratio of 7∶3 using a simple random sampling method.The clinical data of patients in the perioperative period were collected, and the patients were followed up within 1-7 days after operation (or before discharge), and the occurrence of POD was recorded.Univariate and multivariate logistic regression analysis was used to identify the independent risk factors for POD.The risk prediction model for POD was established based on the results of multivariate logistic regression analysis of the training set, a nomogram and receiver operating characteristic (ROC) curve were drawn, and the area under the curve (AUC) was calculated.The validation set was used to verify the prediction model and assess the efficacy of the risk prediction model for POD.Results:A total of 653 patients were enrolled in this study, 139 patients developed POD, and the incidence was 21.3%.The results of multivariate logistic regression analysis showed that advanced age, high ASA physical status classification, low preoperative Mini-Mental State Examination score, complication with diabetes mellitus, low years of education, high preoperative Pittsburgh Sleep Quality Index scale score, long anesthesia time and high numerical rating scale score after operation were independent risk factors for POD in elderly patients undergoing non-cardiac surgery.The risk prediction model for POD was established based on the independent risk factors mentioned above.The AUC of the training set was 0.981, the Youden index was 0.881, the sensitivity was 95.95%, and the specificity was 92.92%; the AUC of the validation set was 0.939, the Youden index was 0.795, the sensitivity was 94.44%, and the specificity was 85.09%.Conclusion:The risk prediction model for POD established based on age, ASA physical status classification, history of diabetes melittus, years of education, preoperative Mini-Mental State Examination score, preoperative Pittsburgh sleep quality index scale score, anesthesia time and postoperative numerical rating scale score has good predictive efficacy in elderly patients undergoing non-cardiac surgery.