INTRODUCTION: Paediatric sexual assault (SA) victims should be assessed for post-exposure prophylaxis (PEP) to mitigate the risk of sexually transmitted infections (STIs). We describe the clinical characteristics of children and young persons (CYPs) presenting with SA at KK Women's and Children's Hospital in Singapore, viral PEP (human immunodeficiency virus [HIV] and hepatitis B virus [HBV]) prescribing practices, and STI evaluation at follow-up. METHOD: Medical records of CYPs ≤16 years who presented with SA between January 2022 and August 2023 were reviewed, including assault and assailant characteristics, baseline and follow-up STI screening, PEP prescription, adherence and follow-up attendance. CYPs with SA in the preceding 72 hours by HIV-positive or HIV-status unknown assailants with high-risk characteris-tics were eligible for HIV PEP. RESULTS: We analysed 278 CYPs who made 292 SA visits. There were 40 (13.7%) CYPs eligible for HIV PEP, of whom 29 (82.9%) received it. Among those tested at baseline, 9% and 34.9% of CYPs tested positive for Chlamydia trachomatis and Gardnerella vaginalis, respectively. None tested positive for Neisseria gonorrhoeae, Trichomonas vaginalis, HIV, HBV or hepatitis C. Majority of CYPs tested were HBV non-immune (n=167, 67.6%); only 77 (46.1%) received the vaccine. Out of 27 CYPs eligible for HBV PEP with immunoglobulin, only 21 (77.7%) received immunoglobulin. A total of 37 CYPs received HIV PEP, including 8 who were retrospectively deemed ineligible. Only 10 (27%) completed the course. Overall, 153 (57.7%) CYPs attended follow-up, and none seroconverted for HIV or HBV. CONCLUSION We report suboptimal rates of HBV post-exposure vaccination, and low compliance to HIV PEP and follow-up among paediatric SA victims. Factors contri-buting to poor compliance should be examined to optimise care for this vulnerable population.
Humans ; Post-Exposure Prophylaxis/methods* ; Female ; Child ; Adolescent ; Singapore/epidemiology* ; HIV Infections/prevention & control* ; Male ; Sexually Transmitted Diseases/epidemiology* ; Retrospective Studies ; Hepatitis B/prevention & control* ; Follow-Up Studies ; Child, Preschool ; Sex Offenses/statistics & numerical data* ; Child Abuse, Sexual

Objective To investigate the effect of miR-185-5p-mediated targeted negative regulation of transmembrane 9 superfamily member 1(TM9SF1)on proliferation,migration and autophagy in lung adenocarcinoma cells.Methods The expression of miR-185-5p in lung adenocarcinoma tissues was analyzed using dataset GSE51853 downloaded from the Gene Expression Omnibus(GEO)database.Potential target proteins of miR-185-5p were predicted using online databases(miRTargetLink,miRTarbase,and DIANA-microT-CD),and autophagy-related proteins were obtained from HADb.The intersected results from these four databases was identified,and survival curves of vascular endothelial growth factor A(VEGFA)and TM9SF1 within the overlapping candidates were analyzed using the StarBase database.TM9SF1 3'UTR wild-type(WT)or TM9SF1 3'UTR mutant(MUT)reporter plasmids were separately co-transfected with miR-185-5p control plasmid(CON)or miR-185-5p overexpression plasmid(over-miR-185-5p)into HEK-293T cells.A dual-luciferase reporter gene assay was employed to assess the binding interaction between miR-185-5p and TM9SF1 and quantify the subsequent luciferase activity.Western blotting was used to assess TM9SF1 protein expression levels in A549 cells transfected with over-miR-185-5p.A549 cells were divided into three groups:(1)CON+NC group,co-transfected with miR-185-5p control plasmid and TM9SF1 control plasmid;(2)over-miR-185-5p+NC group,co-transfected with over-miR-185-5p and TM9SF1 control plasmid;(3)over-miR-185-5p+over-TM9SF1 group,co-transfected with both miR-185-5p and TM9SF1 overexpression plasmids.EdU cell proliferation assay,wound healing assay,and Transwell migration assay were performed to validate the effects of miR-185-5p targeted binding to TM9SF1 on proliferation and migration capacities in lung adenocarcinoma.Changes in autophagic flux and mitochondrial membrane potential(MMP)of lung adenocarcinoma cells were detected using stubRFP-sensGFP-LC3 lentivirus and JC-1 assays,respectively.Results In the GSE51853 dataset,miR-185-5p expression level was significantly lower in lung adenocarcinoma tissues compared with normal lung tissues(P<0.01).qRT-PCR analysis revealed that miR-185-5p expression was downregulated in lung adenocarcinoma cell lines NCI-H1299 and A549 compared with normal lung epithelial cells BEAS-2B(P<0.01).Bioinformatics predictions using miRTargetLink,miRTarbase,DIANA-microT-CD,and HADb databases indicated that miR-185-5p could target and regulate the autophagy-related protein TM9SF1.Dual-luciferase reporter assays and Western blotting demonstrated that miR-185-5p directly bound to the 3'UTR region of TM9SF1 mRNA,and overexpression of miR-185-5p significantly reduced the expression of target protein TM9SF1(P<0.05).EdU cell proliferation,wound healing,and Transwell migration assays demonstrated that miR-185-5p overexpression inhibited proliferation and migration capacities of lung adenocarcinoma cells,whereas TM9SF1 overexpression could attenuate this inhibition effect(P<0.05).Results of stubRFP-sensGFP-LC3 for autophagic flux analysis demonstrated that overexpression of miR-185-5p enhanced autophagic flux in A549 cells,whereas co-overexpression of miR-185-5p and TM9SF1 suppressed autophagic flux.JC-1 assays showed a decreased MMP level in A549 cells after miR-185-5p overexpression,with higher MMP level observed when miR-185-5p and TM9SF1 were co-overexpressed.Conclusion miR-185-5p may suppress proliferation,migration,and autophagy capacities in lung adenocarcinoma cells by targeting TM9SF1 through negative regulation.

Objective To establish an early prediction model for the diagnosis of severe acute pancreatitis based on the improved machine learning models,and to analyze its clinical value.Methods A case-control study was conducted on 352 patients with acute pancreatitis admitted to the Gastroenterology and Hepatobiliary Surgery Departments of the Army Medical Center of PLA and Emergency and Critical Care Medicine Department of No.945 Hospital of Joint Logistics Support Force of PLA from January 2014 to August 2023.According to the severity of the disease,the patients were divided into the severe group(n=88)and the non-severe group(n=264).The RUSBoost model and improved Archimead optimization algorithm was used to analyze 39 routine laboratory biochemical indicators within 48 h after admission to construct an early diagnosis and prediction model for severe acute pancreatitis.The task of feature screening and hyperparameter optimization was completed simultaneously.The ReliefF algorithm feature importance rank and multivariate logistic analysis were used to analyze the value of the selected features.Results In the training set,the area under curve(AUC)of the improved machine learning model was 0.922.In the testing set,the AUC of the improved machine learning model reached 0.888.The 4 key features of predicting severe acute pancreatitis based on the improved Archimedes optimization algorithm were C-reactive protein,blood chlorine,blood magnesium and fibrinogen level,which were consistent with the results of ReliefF algorithm feature importance ranking and multivariate logistic analysis.Conclusion The application of improved machine learning model analyzing the laboratory examination results can help to early predict the occurrence of severe acute pancreatitis.

Objective Viral encephalitis is an infectious disease severely affecting human health.It is caused by a wide variety of viral pathogens,including herpes viruses,flaviviruses,enteroviruses,and other viruses.The laboratory diagnosis of viral encephalitis is a worldwide challenge.Recently,high-throughput sequencing technology has provided new tools for diagnosing central nervous system infections.Thus,In this study,we established a multipathogen detection platform for viral encephalitis based on amplicon sequencing. Methods We designed nine pairs of specific polymerase chain reaction(PCR)primers for the 12 viruses by reviewing the relevant literature.The detection ability of the primers was verified by software simulation and the detection of known positive samples.Amplicon sequencing was used to validate the samples,and consistency was compared with Sanger sequencing. Results The results showed that the target sequences of various pathogens were obtained at a coverage depth level greater than 20×,and the sequence lengths were consistent with the sizes of the predicted amplicons.The sequences were verified using the National Center for Biotechnology Information BLAST,and all results were consistent with the results of Sanger sequencing. Conclusion Amplicon-based high-throughput sequencing technology is feasible as a supplementary method for the pathogenic detection of viral encephalitis.It is also a useful tool for the high-volume screening of clinical samples.

Objective To study traditional Chinese medicine(TCM)syndrome pattern of astronauts in long term spaceflight,and to summarize and elucidate the characteristics and evolvement of their holistic functional status based on TCM Pattern Identification and Classification System.Methods The Digital TCM Diagnostic Instrument and TCM Syndrome Diagnosis Scale were used to collect information from 9 astronauts in three manned missions of China Space Station,through diagnostic methods of observation,palpation and inquiry according to CM theory.Data collection was performed at various stages before,during,and after spaceflight,a total of 32 person-time digital images of tongues and facial complexion and over 2 000 data were collected.Through data mining and analysis using four diagnostic feature fusion methods,the distribution characteristics of TCM pattern among astronauts at different stages of flight and with different physical constitutions were proposed,and the health status and evolution trend of astronauts were evaluated based on the health concept of TCM.Results ⑴The astronauts showed related manifestations of 8 TCM syndromes during long term flight,among which 4 syndromes had higher scores,including Liver Depression Transforming into Fire,Liver and Kidney Yin Deficiency,Heart Kidney Disharmony,and Spleen and Kidney Yang Deficiency.However,their syndrome differentiation were mainly based on Yin and Yang in equilibrium,with only a few individuals showing a brief deviation from the equilibrium state at a certain stage.After long-term adaptation and adjustment,they almost had returned to a state of Yin-Yang equilibrium reestablishment.⑵As the flight time increased,the proportion of Liver Depression Transforming into Fire and Qi and Blood Deficiency in Heart and Spleen syndrome increased month by month,indicating that the psychological and emotional changes and insufficient Qi and blood status during long term flight need to be focused on.⑶Physical constitution had a certain impact on the syndrome patterns during flight,the astronauts with biased constitutions had significantly higher total scores for all syndrome patterns than that of individuals with Normal-constitution,astronauts with Yin deficiency had slightly higher scores for Heart Kidney Disharmony than those with Yang(Qi)deficiency,indicating that personalized TCM conditioning measures should be developed based on the pathogenesis of TCM syndrome during different flight periods,combined with factors such as physical constitution,etc.Conclusion The research has verified the scientific nature and effectiveness of TCM pattern analysis based on"four diagnostic"methods,which could be used for achieving quantitative and comprehensive evaluation of astronaut health status from the perspective of TCM in long-term space flight.

Objective:To observe the effects of linalool on central and alleviating peripheral nervous system through transient receptor potential vanilloid 1 (TRPV1) pathway and its role in alleviating visceral hypersensitivity in irritable bowel syndrome (IBS).Methods:Thirty-six female newborn Sprague-Dawley (SD) rat pups in specific pothogen free was selected, among which 30 rats were used for behavioral experiments and 6 rats for electrophysiological experiment. In behavioral experiments, 30 newborn SD rats were randomly divided into normal control group (0.2 mL 0.9% sodium chloride solution was injected into the colorectal), neonatal colonic inflammation (NCI) group (0.2 mL 0.5% acetic acid was injected into the colorectal), linalool 20, 50 and 100 mg/kg groups (after NCI model successfully established, the rat were gavaged with linalool 20, 50 or 100 mg/kg at 5 weeks old). At 6 weeks old, abdominal withdrawal reflex (AWR) and pressure value of pain threshold (inflation pressure value at AWR score of 3) was observed by colorectal distention test. One hour after behavioral experiments, the expression of TRPV1 at protein level in colonic mucosa and spinal cord of each group was detected by Western blotting and immunohistochemistry. In electrophysiological experiment, female SD rats aged 6 to 7 weeks were selected to make in vitro transverse sections of the spinal cord. Five to eight neurons were randomly selected from each rat for whole-cell patch-clamp recording. The effects of linalool, tetrodotoxin and anti capsaicinand on the spontaneous excitatory postsynaptic current (sEPSC) of substantiagelatinosa neurons was recorded. Independent sample t test and paired t test were used for statistical analysis. Results:The AWR score of rats in NCI group was higher than those in normal control group, linalool 20 mg/kg group, linalool 50 mg/kg group and linalool 100 mg/kg group at 40 mmHg (1 mmHg=0.133 kPa) pressure (2.5±0.2 vs. 1.0±0.3, 1.5±0.3, 1.5±0.2, and 1.5±0.2, respectively), at 60 mmHg pressure the AWR score was higher than those in normal control group, linalool 50 mg/kg group and linalool 100 mg/kg group (3.8±0.2 vs. 2.3±0.4, 2.3±0.5, and 2.0±0.3, respectively), and the differences were statistically significant ( t=4.39, 2.45, 3.16, 3.16, 3.31, 2.88 and 5.97; P=0.001, 0.034, 0.010, 0.010, 0.008, 0.028, and<0.001). The pain threshold of rats in NCI group was lower than those of normal control group, linalool 20 mg/kg group, linalool 50 mg/kg group and linalool 100 mg/kg group ((35.8±2.0) mmHg vs. (55.8±1.5), (49.2±2.4), (53.3±2.1), and (55.0±1.8) mmHg, respectively), and the differences were statistically significant ( t=-7.91, -4.28, -6.01, and -7.06; P<0.001, =0.002, <0.001, and <0.001). The results of Western blotting showed that the relative expression of TRPV1 at protein level in colorectal tissues of rats in NCI group was higher than those of normal control group, linalool 20 mg/kg group, linalool 50 mg/kg group and linalool 100 mg/kg group (0.86±0.03 vs. 0.32±0.03, 0.68±0.01, 0.45±0.03, and 0.56±0.02, respectively), and the relative expression of TRPV1 at protein level in spinal dorsal horn was higher than those of normal control group, linalool 20 mg/kg group, linalool 50 mg/kg group and linalool 100 mg/kg group (0.91±0.02 vs. 0.34±0.03, 0.72±0.03, 0.51±0.06, and 0.63±0.05), and the differences were statistically significant ( t=12.44, 5.14, 9.68, 7.69, 19.14, 5.13, 6.72, and 5.60; P<0.001, <0.001, <0.001, <0.001, <0.001, <0.001, =0.001, and <0.001). There were no statistically significant differences in the frequency and the outward current of sEPSC in neurons of same glial region among rats with 2 mmol/L linalool gavaged for 4 minutes, 0.5 μmol/L tetrodotoxin and 2 mmol/L linalool gavaged for 4 minutes ( n=5, (23.84±4.81) Hz vs. (20.54±5.71) Hz, (7.60±0.35) pA vs. (7.62±0.75) pA, both P>0.05). The frequency of sEPSC administered with 2 mmol/L linalool gavaged for 4 minutes was higher than that of neurons in the same glial area administered with 10 μmol/L capsazepine and 2 mmol/L linalool gavaged for 4 minutes ( n=5, (20.17±2.55) Hz vs.(14.09±2.98) Hz), and the difference was statistically significant ( t=3.58, P=0.021); however there was no statistically significant difference in the outward current ((7.42±0.78) pA vs. (7.03±1.32) pA, P>0.05). Conclusion:Linalool can relieve visceral hypersensitivity in IBS partially through TRPV1 pathway, which may be related to the hyperpolarization of the membrane potential of neurons in glial region.

Objectives: To evaluate the association of illicit drug use with bone mineral density (BMD) and hip geometric parameters at the narrow neck. Methods: This is a cross-sectional matched cohort study conducted in the Hong Kong Chinese population. Associations with illicit drug use were estimated using linear regression for BMD (lumbar spine and femoral neck) and hip geometrical parameters (cross-sectional area [CSA], cross-sectional moment of inertia [CSMI], section modulus [SM], average cortical thickness [ACT] and BMD at the narrow neck) after adjusting for age, body mass index (BMI), smoking status, drinking status, physical activity, and history of antipsychotic and antidepressant use. Mean difference and 95% confidence intervals (95% CI) were calculated between 108 illicit drug users and 108 controls using an adjusted linear model and cluster-robust standard errors after matching by age and sex. The false discovery rate was used to correct for multiple testing. Results: Illicit drug users had a significantly lower BMD (g/cm2 ) at the lumbar spine (mean difference: -0.062; 95% CI: -0.108 to − 0.015), and femoral neck (mean difference: -0.058; 95% CI: -0.106 to − 0.010) in the fully adjusted model. Illicit drug users also had a significantly lower CSA (mean difference: -0.238 cm2 ; 95% CI: -0.462 to − 0.013), ACT (mean difference: -0.018 cm; 95% CI: -0.030 to − 0.006) and BMD (mean difference: -0.070 g/ cm2 ; 95% CI: -0.128 to − 0.012) at the narrow neck. Conclusions Illicit drug use is associated with lower BMD and bone strength. Future studies evaluating the risk of illicit drug use with fragility fracture are warranted.

INTRODUCTION: Three doses of SARS-CoV-2 mRNA vaccines have been recommended for cancer patients to reduce the risk of severe disease. Anti-neoplastic treatment, such as chemotherapy, may affect long-term vaccine immunogenicity. METHOD: Patients with solid or haematological cancer were recruited from 2 hospitals between July 2021 and March 2022. Humoral response was evaluated using GenScript cPASS surrogate virus neutralisation assays. Clinical outcomes were obtained from medical records and national mandatory-reporting databases. RESULTS: A total of 273 patients were recruited, with 40 having haematological malignancies and the rest solid tumours. Among the participants, 204 (74.7%) were receiving active cancer therapy, including 98 (35.9%) undergoing systemic chemotherapy and the rest targeted therapy or immunotherapy. All patients were seronegative at baseline. Seroconversion rates after receiving 1, 2 and 3 doses of SARS-CoV-2 mRNA vaccination were 35.2%, 79.4% and 92.4%, respectively. After 3 doses, patients on active treatment for haematological malignancies had lower antibodies (57.3%±46.2) when compared to patients on immunotherapy (94.1%±9.56, P<0.05) and chemotherapy (92.8%±18.1, P<0.05). SARS-CoV-2 infection was reported in 77 (28.2%) patients, of which 18 were severe. No patient receiving a third dose within 90 days of the second dose experienced severe infection. CONCLUSION This study demonstrates the benefit of early administration of the third dose among cancer patients.
Humans ; SARS-CoV-2 ; COVID-19/prevention & control* ; Treatment Outcome ; Neoplasms/drug therapy* ; Hematologic Neoplasms ; Vaccination ; RNA, Messenger ; Antibodies, Viral ; Immunogenicity, Vaccine

OBJECTIVES: To study the clinical characteristics of plastic bronchitis (PB) in children and investigate the the risk factors for recurrence of PB. METHODS: This was a retrospective analysis of medical data of children with PB who were hospitalized in Children's Hospital of Chongqing Medical University from January 2012 to July 2022. The children were divided into a single occurrence of PB group and a recurrent PB group and the risk factors for recurrence of PB were analyzed. RESULTS: A total of 107 children with PB were included, including 61 males (57.0%) and 46 females (43.0%), with a median age of 5.0 years, and 78 cases (72.9%) were over 3 years old. All the children had cough, 96 children (89.7%) had fever, with high fever in 90 children. Seventy-three children (68.2%) had shortness of breath, and 64 children (59.8%) had respiratory failure. Sixty-six children (61.7%) had atelectasis and 52 children (48.6%) had pleural effusion. Forty-seven children (43.9%) had Mycoplasma pneumoniae infection, 28 children (26.2%) had adenovirus infection, and 17 children (15.9%) had influenza virus infection. Seventy-one children (66.4%) had a single occurrence of PB, and 36 cases (33.6%) had recurrent occurrence of PB (≥2 times). Multivariate logistic regression analysis showed that involvement of ≥2 lung lobes (OR=3.376) under bronchoscopy, continued need for invasive ventilation after initial removal of plastic casts (OR=3.275), and concomitant multi-organ dysfunction outside the lungs (OR=2.906) were independent risk factors for recurrent occurrence of PB (P<0.05). CONCLUSIONS Children with pneumonia accompanied by persistent high fever, shortness of breath, respiratory failure, atelectasis or pleural effusion should be highly suspected with PB. Involvement of ≥2 lung lobes under bronchoscopy, continued need for invasive ventilation after initial removal of plastic casts, and concomitant multi-organ dysfunction outside the lungs may be risk factors for recurrent occurrence of PB.
Female ; Male ; Child ; Humans ; Child, Preschool ; Multiple Organ Failure ; Retrospective Studies ; Bronchitis/etiology* ; Dyspnea ; Pleural Effusion ; Pulmonary Atelectasis ; Plastics ; Respiratory Insufficiency

OBJECTIVE: To evaluate the feasibility and tolerability of metoprolol standard dosing pathway (MSDP) in Chinese patients with acute coronary syndrome (ACS). METHODS: In this multicenter, prospective, open label, single-arm and interventional study that was conducted from February 2018 to April 2019 in fifteen Chinese hospitals. A total of 998 hospitalized patients aged ≥ 18 years and diagnosed with ACS were included. The MSDP was applied to all eligible ACS patients based on the standard treatment recommended by international guidelines. The primary endpoint was the percentage of patients achieving the target dose at discharge (V2). The secondary endpoints included the heart rate and blood pressure at V2 and four weeks after discharge (V4), and percentage of patients experiencing bradycardia (heart rate < 50 beats/min), hypotension (blood pressure < 90/60 mmHg) and transient cardiac dysfunction at V2 and V4. RESULTS: Of the 998 patients, 29.46% of patients achieved the target dose (≥ 95 mg/d) at V2. The total population was divided into two groups: target group (patients achieving the target dose at V2) and non-target group (patients not achieving the target dose at V2). There was significant difference in the reduction of heart rate from baseline to discharge in the two groups (-4.97 ± 11.90 beats/min vs. -2.70 ± 9.47 beats/min, P = 0.034). There was no significant difference in the proportion of bradycardia that occurred in the two groups at V2 (0 vs. 0, P = 1.000) and V4 (0.81% vs. 0.33%, P = 0.715). There was no significant difference in the proportion of hypotension between the two groups at V2 (0.004% vs. 0.004%, P = 1.000) and V4 (0 vs. 0.005%, P = 0.560). No transient cardiac dysfunction occurred in two groups during the study. A total of five adverse events (1.70%) and one serious adverse event (0.34%) were related to the pathway in target group. CONCLUSIONS In Chinese ACS patients, the feasibility and tolerability of the MSDP have been proved to be acceptable.