Immune checkpoint inhibitors are effective tumor treatment agents with survival benefits.However,immune toxicity to various organs has become a new challenge in clinical practice.The cardiac involvement can be presented as heart failure,arrhythmia(atrial fibrillation,atrioventricular block,bundle branch block,ventricular tachycardia,etc.),myocardial-pericarditis,myocardiopathy,and sudden cardiac death,etc.This patient developed abnormally increased myocardial enzymes,impaired cardiac function,and atrioventricular block after 1-month treatment with tislelizumab.Endomyocardial biopsy examination confirmed the diagnosis of immune checkpoint inhibitor-associated myocarditis.Through the diagnosis,treatment,and review of relevant literatures of this case,we wish to improve the understanding of immune checkpoint inhibitor-associated myocarditis,and therefore improve the diagnosis and treatment of immune checkpoint inhibitor-associated myocarditis for clinicians.

Immune checkpoint inhibitors are effective tumor treatment agents with survival benefits.However,immune toxicity to various organs has become a new challenge in clinical practice.The cardiac involvement can be presented as heart failure,arrhythmia(atrial fibrillation,atrioventricular block,bundle branch block,ventricular tachycardia,etc.),myocardial-pericarditis,myocardiopathy,and sudden cardiac death,etc.This patient developed abnormally increased myocardial enzymes,impaired cardiac function,and atrioventricular block after 1-month treatment with tislelizumab.Endomyocardial biopsy examination confirmed the diagnosis of immune checkpoint inhibitor-associated myocarditis.Through the diagnosis,treatment,and review of relevant literatures of this case,we wish to improve the understanding of immune checkpoint inhibitor-associated myocarditis,and therefore improve the diagnosis and treatment of immune checkpoint inhibitor-associated myocarditis for clinicians.

Abstract: Objective　To investigate the molecular epidemiological characteristics of Mycobacterium tuberculosis in the southern region of Xinjiang, analyze the influencing factors of Mycobacterium tuberculosis strains clustering in the region, and provide a scientific basis for the prevention and treatment of tuberculosis in the southern region of Xinjiang. Methods Mycobacterium tuberculosis strains were randomly selected from the drug resistance monitoring sites in the southern region of Xinjiang Uygur Autonomous Region from January 2018 to December 2022 (except 2019). The DNA of the strains was extracted, and the strains were genotyped by the 24-locus VNTR method. The diversity and discriminatory power of loci were assessed, and the cluster rate and transmission differences of strains in Southern Xinjiang were analyzed. Results A total of 116 Mycobacterium tuberculosis strains were divided into 90 genotypes, including 76 unique genotypes, and the remaining strains formed 14 clusters of 2-7 strains each, totaling 40 strains, with a cluster formation rate of 34.48% and a transmission rate of 22.41%. The highest resolution index was observed at the QUB-11b (0.801) locus, with a discriminatory index of 0.801, while the lowest was at the MIRU2 locus, with a discriminatory index of 0. Beijing genotype accounted for 44.83% (52/116) of the MTB strains in southern Xinjiang. Statistical significance was found between strain clustering and resistance to isoniazid and rifampicin (χ2=6.798, P=0.009; χ2=15.544, P<0.001). Conclusions The genotypes of Mycobacterium tuberculosis in southern Xinjiang are highly polymorphic, but the Beijing genotype remains the predominant strain. The clustering rate of Mycobacterium tuberculosis in southern Xinjiang is higher, suggesting that the recent transmission of Mycobacterium tuberculosis in southern Xinjiang accounts for a certain proportion of the epidemic. In southern Xinjiang, Beijing genotype, rifampicin-resistant strains, and ethambutol-resistant strains are more likely to be clustered than non-Beijing genotype, rifampicin-resistant strains, and ethambutol-resistant strains.

Objective·To explore the role of vasohibin-2(VASH2)in the regulation of proliferation and metastasis of triple-negative breast cancer(TNBC)cells,and explore the mechanism of VASH2 in the occurrence and development of TNBC through regulation of gene expression and alternative splicing.Methods·TCGA-GTEx was used to analyze the expression of VASH2 in TNBC.VASH2 methylation levels in TNBC were also analyzed.VASH2 was overexpressed in the MDA-MB-231 human TNBC cell line and transcriptome sequencing was performed.Differentially expressed genes and alternatively spliced genes regulated by VASH2 were analyzed to explore the mechanism of action of VASH2 in TNBC.Results·VASH2 was significantly overexpressed in TNBC compared to the normal tissues.Hypomethylation of the VASH2 gene was implicated in the upregulation of VASH2 expression in TNBC.Overexpression of VASH2 caused significant differential expression of 81 genes,of which 23 genes were up-regulated and 58 genes were down-regulated.Genes with significantly altered alternative splicing levels due to VASH2 overexpressed were enriched in cell cycle and p53 signaling pathways.Conclusion·VASH2 regulates the alternative splicing of TNBC oncogenes and promotes TNBC occurrence and development.

Objective·To explore the role of vasohibin-2(VASH2)in the regulation of proliferation and metastasis of triple-negative breast cancer(TNBC)cells,and explore the mechanism of VASH2 in the occurrence and development of TNBC through regulation of gene expression and alternative splicing.Methods·TCGA-GTEx was used to analyze the expression of VASH2 in TNBC.VASH2 methylation levels in TNBC were also analyzed.VASH2 was overexpressed in the MDA-MB-231 human TNBC cell line and transcriptome sequencing was performed.Differentially expressed genes and alternatively spliced genes regulated by VASH2 were analyzed to explore the mechanism of action of VASH2 in TNBC.Results·VASH2 was significantly overexpressed in TNBC compared to the normal tissues.Hypomethylation of the VASH2 gene was implicated in the upregulation of VASH2 expression in TNBC.Overexpression of VASH2 caused significant differential expression of 81 genes,of which 23 genes were up-regulated and 58 genes were down-regulated.Genes with significantly altered alternative splicing levels due to VASH2 overexpressed were enriched in cell cycle and p53 signaling pathways.Conclusion·VASH2 regulates the alternative splicing of TNBC oncogenes and promotes TNBC occurrence and development.

Objective:To investigate the relationship between microRNA (miR)-1, miR-133b and hepatic fibrosis in patients with hepatic alveolar echinococcosis.Methods:From October 2020 to April 2021, patients who were definitely diagnosed as hepatic alveolar echinococcosis (9 cases), cirrhosis (9 cases) and hepatocellular carcinoma (5 cases) in the First Affiliated Hospital of Xinjiang Medical University were selected as the research subjects, and healthy volunteers in the same period were taken as the control (10 cases). Peripheral blood samples of all subjects were collected to prepare plasma, and the expression levels of miR-1 and miR-133b in peripheral blood were detected by quantitative real-time PCR. At the same time, tissue samples around the liver lesion (proximal), and the corresponding tissues about 5 cm from the lesion (distal) were collected from 5 patients with hepatic alveolar echinococcosis, and immunohistochemical staining was used to detect the cell activation related indicators [cyclinD1, cyclin dependent kinase 1 (CDK1), α-smooth muscle actin (α-SMA)], fibrosis indicators (Collagen Ⅰ, Collagen Ⅲ), transforming growth factor-β1 (TGF-β1) signal pathway related genes [TGF-β1, TGF-β1 receptor type Ⅰ/Ⅱ (TGF-β1RⅠ, TGF-β1RⅡ)] and its downstream related proteins (SMAD2, SMAD3).Results:The quantitative real-time PCR results showed that there were significant differences in the expression levels of miR-1 and miR-133b in the peripheral blood of patients with hepatic alveolar echinococcosis, cirrhosis, hepatocellular carcinoma and the control group ( H = 16.54, 28.40, P < 0.001); the expression levels of miR-1 and miR-133b in hepatic alveolar echinococcosis group were higher than those in control group, cirrhosis group ( P < 0.05). The expression levels of CDK1 (0.46 ± 0.02, 0.42 ± 0.01), α-SMA (0.54 ± 0.09, 0.51 ± 0.07), TGF-β1 (0.55 ± 0.15, 0.51 ± 0.13), TGF-β1RⅠ (0.58 ± 0.09, 0.57 ± 0.08), and TGF-β1RⅡ(0.40 ± 0.05, 0.39 ± 0.05) between the proximal and distal tissue of liver lesion in hepatic alveolar echinococcosis patients were statistically significantly different ( t = 5.56, 3.17, 3.18, 4.27, 5.65, P = 0.005, 0.034, 0.034, 0.024, 0.011). There was no statistically significant difference in the expression levels of CyclinD1, Collagen Ⅰ, Collagen Ⅲ, SMAD2 and SMAD3 between the proximal and distal tissue of liver lesion in hepatic alveolar echinococcosis patients ( t = 3.06, 3.06, 2.86, 1.43, 1.50, P = 0.055, 0.055, 0.064, 0.247, 0.230). Pearson correlation analysis showed that miR-1 in the patients' peripheral blood was positively correlated with TGF-β1RⅠ in the proximal tissue of the liver lesion ( P = 0.001); there was no correlation between miR-1, miR-133b and CDK1, α-SMA, TGF-β1, TGF-β1RⅡ( P > 0.05). Conclusions:The expression of TGF-β1 signaling pathway related factors in the proximal tissue of liver lesion in patients with hepatic alveolar echinococcosis is up-regulated. The expression of miR-1 and miR-133b in peripheral blood is upregulated, and miR-1 is positively correlated with TGF-β1RⅠ level in proximal tissue of liver lesion, suggesting that miR-1 may promote the occurrence of liver fibrosis in hepatic alveolar echinococcosis.

Objective: To investigate the prevalence of anemia and its influencing factors among primary school students from Kazakh ethnic groups in agricultural and pastoral areas of Altay Prefecture, Xinjiang Uygur Autonomous Region, so as to provide insights into improvements of nutrition and prevention of anemia among students. Methods: Grade 1 to 3 Kazakh ethnic students were sampled using a cluster sampling method from 7 primary schools in agricultural and pastoral areas of Altay Prefecture, Xinjiang Uygur Autonomous Region from April to June, 2022. Demographics and dietary behaviors were collected using questionnaire surveys, and the height and body weight were measured, while peripheral blood hemoglobin was detected. Factors affecting anemia were identified using a multivariable logistic regression model. Results: A total of 2 378 questionnaires were allocated, and 2 214 valid questionnaires were recovered, with an effective rate of 93.10%. The respondents included 1 123 men (50.72%) and 1 091 women (49.28%), and had a mean age of (8.12±1.41) years. The prevalence of anemia was 22.49%, and the detection rates of mild and moderate anemia were 15.31% and 7.18%, with no severe anemia detected. Multivariable logistic regression analysis identified frequency of eating eggs (0, OR=2.532, 95%CI: 2.114-3.015; 1 to 3 times/week, OR=1.926, 95%CI: 1.648-2.216), frequency of eating meat (1 to 3 times/week, OR=1.468, 95%CI: 1.256-1.689; 4 to 7 times/week, OR=2.212, 95%CI: 1.823-2.641), frequency of healthy check-up (0, OR=2.872, 95%CI: 2.523-3.231; 1 time/year, OR=1.826, 95%CI: 1.546-2.108), monthly mean household income (1 500 Yuan and lower per month, OR=1.324, 95%CI: 1.071-1.582; 1 501 to 3 000 Yuan per month, OR=1.124, 95%CI: 1.029-1.221) and caregiver (grandparents, OR=1.175, 95%CI: 1.038-1.324; others, OR=1.241, 95%CI: 1.032-1.466) as factors affecting anemia. Conclusions The prevalence of anemia is 22.49% among primary school students from Kazakh ethnic groups in agricultural and pastoral areas of Altay Prefecture, Xinjiang Uygur Autonomous Region, with mild anemia as the predominant type. Dietary behaviors, frequency of healthy check-up, economic status and caregiver may affect the development of anemia.

Objective:To construct a mortality prediction model for severe fever with thrombocytopenia syndrome (SFTS) and to evaluate its prediction ability.Methods:Clinical data of 120 hospitalized patients with SFTS at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2017 to June 2023 were retrospective analyzed. Based on clinical prognosis, patients were divided into survival group ( n=89) and fatal group ( n=31). The risk factors of SFTS mortality were analyzed with multivariate Logistic regression, based on which a mortality risk prediction model was constructed. The predictive value of the model was examined with receiver operator characteristic (ROC) curve. SPSS 23.0 software was used to process and analyze the data. Results:Logistic regression analysis indicated that skin petechiae ( OR=5.171, 95% CI 1.617-16.530, P=0.006), mental disturbance ( OR=5.481, 95% CI 1.540-19.512, P=0.009), increased serum lactate dehydrogenase level ( OR=1.002, 95% CI 1.001-1.004, P<0.001), and increased serum creatinine level ( OR=1.018, 95% CI: 1.007-1.029, P=0.002) were independent risk factors for SFTS mortality. A mortality risk prediction model was established based on the regression coefficient of risk factors: Logit( P)=-6.623+ skin petechiae×1.643+ mental disturbance × 1.701+ lactate dehydrogenase level (U/L)×0.002+ creatinine level (μmol/L)×0.018. The area under ROC curve (AUC) of the prediction model was 0.91 (95% CI 0.86-0.96, P<0.001), and its predictive ability was higher than that of skin petechiae ( Z=3.788, P<0.001), mind change ( Z=5.728, P<0.001), lactate dehydrogenase ( Z=2.309, P=0.021), and creatinine ( Z=2.064, P=0.039). Conclusion:The mortality prediction model constructed based on skin petechiae, mental disturbance, lactate dehydrogenase, and creatinine has good predictive value for the prognosis of SFTS patients.

The incidence rate of inflammatory bowel disease(IBD)in China is in a rapid rise period in recent years,and the course of the disease is repeated and prolonged.The risk of IBD combined with thromboembolism is significantly increased,and it is one of the important reasons for poor prognosis in IBD patients.However,the pathological and physiological mechanisms of thromboembolism have not been fully understood and have not received sufficient attention from clinical physicians.This article aims to provide a systematic review of the risks and mechanisms of thromboembolism in IBD,and to summarize the progress in its prevention and treatment strategies,in order to be helpful for the prevention and treatment of thromboembolism in IBD patients.

Objective: To explore the poor prognostic factors of patients with cervical stump carcinoma, aiming to provide certain reference for the clinical diagnosis and treatment. Methods: Clinical data of 48 patients with cervical stump carcinoma admitted to the Affiliated Tumor Hospital of Xinjiang Medical University from January 1, 2005 to December 1, 2016 were retrospectively analyzed. A total of 19 patients (40%) withⅠ_A-Ⅱ_A stage cervical stump carcinoma were treated with surgery+ adjuvant therapy and 29 patients (60%) in Ⅱ_B-Ⅳ stage received radiotherapy combined with chemotherapy. The median age of onset was 51 years old. Uterine fibroids were the main cause of subtotal hysterectomy. The average time interval from subtotal hysterectomy to definite diagnosis was 10.76 years. Results: The 1-, 3-, 5-year survival rate was 98%, 83% and 74%, respectively. Univariate analysis demonstrated the time interval from subtotal hysterectomy (P=0.016), tumor diameter (P=0.016), clinical stage (P=0.036), histological grade (P=0.009), lymph node metastasis (P=0.044), parametrial invasion (P=0.046), myelosuppression (P=0.013) and radical surgery (P=0.019) were the poor prognostic factors of cervical stump carcinoma. Conclusions Poor prognosis of patients with cervical stump carcinoma is correlated with tumor diameter, clinical stage, histological grade, lymph node metastasis, parametrial invasion and myelosuppression. Histological grade is an independent risk factor.