Objective To analyze the epidemic and clinical characteristics of pertussis cases in Changping District, Beijing and improve the clinical diagnosis level, and to provide a scientific basis for pertussis prevention and control. Methods Descriptive epidemiological methods were used to analyze pertussis cases in Changping District, Beijing from 2023 to 2024. Results A total of 565 cases were reported in Changping District, Beijing from 2023 to 2024, with an average annual incidence of 12.45/100 000. There were 285 males (50.44%) and 280 females (49.56%). The top five towns and streets with the highest number of reported cases were Beiqijia (90 cases), Longzeyuan (71 cases), Shahe (57 cases), Huilongguan (48 cases) and Tiantongyuan South (46 cases), accounting for 55.22% of all cases. The top three towns and streets with the highest incidence rate were Tiantongyuan South (19.72/100 000), Longzeyuan (19.49/100 000) and Beiqijia (14.55/100 000). The incident peak period was from October 2023 to April 2024, with a total of 422 cases reported, accounting for 74.69%. The age of cases ranged from 29 days to 73 years old. There were 67 cases under 1 year old, with the highest incidence rate (263.10/100 000), followed by the 5-9 years old group (149.98/100 000). The 5-9 years old group had the highest proportion of cases, accounting for 301 cases (49.05%). A total of 513 cases (90.80%) had a history of pertussis vaccine immunization, and 455 cases (80.53%) had been vaccinated with 4 doses of pertussis vaccine. The median interval from onset to diagnosis of whooping cough was 18 days and the median duration of cough was 11 days. Conclusion The highest incidence of pertussis is among infants under 1 year old, followed by the 5-9 years old group. Children of appropriate age should be vaccinated in time according to the latest national immunization strategy. Medical institutions should improve diagnostic capability and increase monitoring sensitivity.

Objective To analyze the antibody types of autoimmune hemolytic anemia(AIHA)patients in Panyu dis-trict,Guangzhou and track the therapeutic effect of blood transfusion,so as to provide reference for clinical transfusion treat-ment strategy of AIHA patients.Methods From January 2021 to October 2023,96 ambiguous cross-matching blood sam-ples from Blood Transfusion Departments of local hospitals sent to Panyu Central Blood Station were analyzed,and 25 sam-ples of AIHA patients were identified.Then blood group identification,Rh system antigen phenotyping,antibody screening and cross-matching were further performed to analyze the correlation between antibody types and transfusion efficacy in AIHA patients.Results Among the 25 samples of AIHA patients,17 showed consistency between forward and reverse blood grouping and8 showed discrepancy.There were 19(19/25,76%)samples incompatible in cross match on the major side,of which 18(18/19,94.7%)were positive for direct Coombs test,autoantibodies and non-specific antibodies,and1(1/19,5.3%)was positive for autoantibody and alloantibody.There were 6(6/25,24%)samples compatible in cross match on the major side,of which 3(3/6,50%)were positive for autoantibodies,3(3/6,50%)were positive for au-toantibody and alloantibody.Of the 25 AIHA patients,20 received blood transfusion treatment and could be traced,and 5 patients did not receive blood transfusion treatment or transferred to other hospitals and could not be traced.Blood transfu-sion was effective in 11(11/20,55%)cases,partially effective in 6(6/20,30%)cases,and ineffective in 3(3/20,15%)cases.Among the ABO blood group incompatibility samples,transfusion was effective or partially effective in 17(17/20,85%)cases.Conclusion The transfusion efficacy of AIHA patients is not directly related to the results of cross-matc-hing.Under the premise of regulating the autoimmune environment and eliminating the ABO blood group incompatibility caused by unexpected alloantibodies,AIHA patients with incompatible cross-matching can be transfused when necessary,and transfusion of ABO and Rh system antigen homologous blood can improve the safety and efficiency of transfusion.

Objective:To investigate the current status of endoscopic treatment for gastroesophageal varices in portal hypertension in China, and to provide supporting data and reference for the development of endoscopic treatment.Methods:In this study, initiated by the Liver Health Consortium in China (CHESS), a questionnaire was designed and distributed online to investigate the basic condition of endoscopic treatment for gastroesophageal varices in portal hypertension in 2022 in China. Questions included annual number and indication of endoscopic procedures, adherence to guideline for preventing esophagogastric variceal bleeding (EGVB), management and timing of emergent EGVB, management of gastric and isolated varices, and improvement of endoscopic treatment. Proportions of hospitals concerning therapeutic choices to all participant hospitals were calculated. Guideline adherence between secondary and tertiary hospitals were compared by using Chi-square test.Results:A total of 836 hospitals from 31 provinces (anotomous regions and municipalities) participated in the survey. According to the survey, the control of acute EGVB (49.3%, 412/836) and the prevention of recurrent bleeding (38.3%, 320/836) were major indications of endoscopic treatment. For primary [non-selective β-blocker (NSBB) or endoscopic therapies] and secondary prophylaxis (NSBB and endoscopic therapies) of EGVB, adherence to domestic guideline was 72.5% (606/836) and 39.2% (328/836), respectively. There were significant differences in the adherence between secondary and tertiary hospitals in primary prophylaxis of EGVB [71.0% (495/697) VS 79.9% (111/139), χ2=4.11, P=0.033] and secondary prophylaxis of EGVB [41.6% (290/697) VS 27.3% (38/139), χ2=9.31, P=0.002]. A total of 78.2% (654/836) hospitals preferred endoscopic therapies treating acute EGVB, and endoscopic therapy was more likely to be the first choice for treating acute EGVB in tertiary hospitals (82.6%, 576/697) than secondary hospitals [56.1% (78/139), χ2=46.33, P<0.001]. The optimal timing was usually within 12 hours (48.5%, 317/654) and 12-24 hours (36.9%, 241/654) after the bleeding. Regarding the management of gastroesophageal varices type 2 and isolated gastric varices type 1, most hospitals used cyanoacrylate injection in combination with sclerotherapy [48.2% (403/836) and 29.9% (250/836), respectively], but substantial proportions of hospitals preferred clip-assisted therapies [12.4% (104/836) and 26.4% (221/836), respectively]. Improving the skills of endoscopic doctors (84.2%, 704/836), and enhancing the precision of pre-procedure evaluation and quality of multidisciplinary team (78.9%, 660/836) were considered urgent needs in the development of endoscopic treatment. Conclusion:A variety of endoscopic treatments for gastroesophageal varices in portal hypertension are implemented nationwide. Participant hospitals are active to perform emergent endoscopy for acute EGVB, but are inadequate in following recommendations regarding primary and secondary prophylaxis of EGVB. Moreover, the selection of endoscopic procedures for gastric varices differs greatly among hospitals.

Objective:The transjugular or transfemoral approach is used as a common method for hepatic venous pressure gradient (HVPG) measurement in current practice. This study aims to confirm the safety and effectiveness of measuring HVPG via the forearm venous approach.Methods:Prospective recruitment was conducted for patients with cirrhosis who underwent HVPG measurement via the forearm venous approach at six hospitals in China and Japan from September 2020 to December 2020. Patients' clinical baseline information and HVPG measurement data were collected. The right median cubital vein or basilic vein approach for all enrolled patients was selected. The HVPG standard process was used to measure pressure. Research data were analyzed using SPSS 22.0 statistical software. Quantitative data were used to represent medians (interquartile ranges), while qualitative data were used to represent frequency and rates. The correlation between two sets of data was analyzed using Pearson correlation analysis.Results:A total of 43 cases were enrolled in this study. Of these, 41 (95.3%) successfully underwent HVPG measurement via the forearm venous approach. None of the patients had any serious complications. The median operation time for HVPG detection via forearm vein was 18.0 minutes (12.3~38.8 minutes). This study confirmed that HVPG was positively closely related to Child-Pugh score ( r = 0.47, P = 0.002), albumin-bilirubin score ( r = 0.37, P = 0.001), Lok index ( r = 0.36, P = 0.02), liver stiffness ( r = 0.58, P = 0.01), and spleen stiffness ( r = 0.77, P = 0.01), while negatively correlated with albumin ( r = -0.42, P = 0.006). Conclusion:The results of this multi-centre retrospective study suggest that HVPG measurement via the forearm venous approach is safe and feasible.

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

Humans ; Computed Tomography Angiography ; Deep Learning ; Coronary Angiography ; Coronary Artery Disease ; Tomography, X-Ray Computed ; Coronary Stenosis/diagnosis* ; Retrospective Studies ; Fractional Flow Reserve, Myocardial ; Predictive Value of Tests

OBJECTIVE: To assess the association of genomic instability of epithelial cadherin 1 (CDH1) gene and clinicopathological characteristics of gastric cancer. METHODS: In total 120 paraffin-embedded gastric cancer tissue specimen were prepared, and genomic DNA was extracted. The genomic instability of the CDH1 gene was analyzed by immunohistochemistry and silver staining PCR-single-strand conformation polymorphism. RESULTS: The number of information individuals (heterozygotes) was 98 for the D16S752 locus. The detection rates for microsatellite instability (MSI) and loss of heterozygosity (LOH) at the D16S752 locus and the positive rate of CDH1 protein were 19.39%, 16.33% and 51.02%, respectively. The detection rate of MSI in TNM stages I or II was significantly higher than that in stages III or IV (P<0.05) while the detection rate of LOH was significantly lower than that in stages III or IV (P<0.05). The positive rate of CDH1 protein in TNM stages III or IV was significantly lower than that in stages I or II (P<0.05). The detection rate of MSI of cases with lymph node metastasis was significantly lower than that of without lymph node metastasis (P<0.05) while the detection rate of LOH was significantly higher than that without lymph node metastasis (P<0.05). The positive rate of CDH1 protein in patients with lymph node metastasis was significantly lower than that in patients without lymph node metastasis (P<0.05). The positive rate of CDH1 protein in MSI-positive group was significantly higher than that in MSI-negative group (P<0.05), and the positive rate of CDH1 protein in the LOH-positive group was significantly lower than that the LOH-negative group (P<0.05). CONCLUSION The genomic instability of the CDH1 gene is associated with the progression of gastric cancer. MSI at the D16S752 locus may be used as a molecular marker for early gastric cancer, while LOH at this locus mostly occurs in advanced gastric cancer and can be regarded as an effective indicators for malignancy evaluation and prognosis.
Humans ; Stomach Neoplasms/pathology* ; Lymphatic Metastasis ; Cdh1 Proteins/genetics* ; Microsatellite Instability ; Loss of Heterozygosity ; Genomic Instability ; Microsatellite Repeats ; Antigens, CD/genetics* ; Cadherins/genetics*

Objective:To seek the biomarkers of diagnostic value for an early postoperative onset of intensive care unit acquired weakness(ICUAW)in liver transplant(LT)recipients.Methods:Between September 2017 and August 2019, A total of 62 consecutive allogeneic orthotopic LT liver transplantation recipients at The First People's Hospital of Kunming between September 2017 and August 2019 are prospectively reviewedenrolled in this study. Upon After entering ICU, blood samples are assayed taken for adenosine 5'-monophosphate-activated protein kinase alpha(AMPK-α)、and glucose transporter type 4(GLUT-4)test. Clinical and bBiochemical specimens are collected. When transplant recipients are during awake and cooperative hours. Their muscle strength is recordedexamined. The score table of Medical Research Council(MRC)is utilized sed as the diagnostic standard of ICUAW. And ICUAW is diagnosed with < 48 points. Based on this, 62 subjects are divided into two groups of ICUAW group(17 cases)and non-ICUAW group (45 cases). The age, sex, mechanical ventilation time, ICU hospitalization time, partial blood oxygen pressure, systolic blood pressure, central venous pressure(CRP), blood glucose, total bilirubin, alanine aminotransferase(ALT), aspartate aminotransferase(AST), γ- Glutamyl transpeptidase(γ- GGT), blood urea nitrogen, blood creatinine and levels of AMPK-α and GLUT-4 are compared between patients in ICUAW group and non-ICUAW two groups. and levels of AMPK-α and GLUT-4 were compared between patients in ICUAW group and non-ICUAW two groups. The powers of AMPK-α And and GLUT-4 in predicting ICUAW was were evaluated by receiver operating characteristic curve(ROC)and area under the curve(AUC). Differences with P<0.05 is deemed as significant. Results:ICUAW is diagnosed in 17/62(27.42%)LT recipients. ICUAW patients had longer mechanical ventilation time(27 vs. 10h, P<0.05)and extended ICU hospitalization time(4 vs. 3d, P<0.05). No significant inter-group difference existed in AMPK-α(1.01±2.43 vs. 1.74±4.24 units/ml, 95% CI: -2.92~1.45, P>0.05). And the expression of GLUT-4 declined in ICUAW patients(137.86±127.87 vs. 419.15±267.68 ng/L, 95% CI: -417.13~-145.45, P<0.05). GLUT-4 ROC curve hint at some negative predictive value for the occurrence of ICUAW. ROC curve area was 0.88 and SE 0.05( P<0.05, 95% CI: 0.78~0.98). Conclusions:ICUAW patients have longer mechanical ventilation time and extended ICU hospitalization time. Monitoring GLUT-4 offers some predictive value for ICUAW in LT recipients. Elevated GLUT-4 is associated with a low probability of ICUAW.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Objective To investigate the effects of miR-325-3p on the EMT, invasion and metastasis of gastric cancer cells by targeting CLDN1 gene. Methods We selected human gastric epithelial cell lines GES-1 and gastric cancer cell lines HGC27, SGC-7901, MKN-45 and MGC-803, and detected the expression of miR-325-3p and CLDN1. The targeting relation between miR-325-3p and CLDN1 were verified by dual luciferase report experiments, and the expression of miR-325-3p and CLDN1 in gastric cancer cells were intervened. qRT-PCR and Western blot were adopted to detect N-cadherin, vimentin and MMP2 expression in cells. CCK-8 assay, Transwell assay, flow cytometry were utilized to detect cell proliferation activity, invasion and apoptosis, respectively. Results Compared with GES-1 cells, miR-325-3p expression was decreased while CLDN1 expression was increased in MGC-803 cells (P < 0.05). CLDN1 was a target gene of miR-325-3p. Overexpression of miR-325-3p could inhibit the proliferation, invasion and EMT of gastric cancer cells, while promote the apoptosis of gastric cancer cells. However, the inhibition of miR-325-3p had the opposite effect (P < 0.05). The overexpression of CLDN1 could reverse the effect of miR-325-3p overexpression on the biological behavior of gastric cancer cells. Conclusion miR-325-3p can suppress CLDN1, inhibit the invasion, metastasis and EMT while promote the apoptosis of gastric cancer cells. miR-325-3p is expected to be a new target in gastric cancer treatment.