Objective:To analyze the genetic characteristics of hemagglutinin（HA）and neuraminidase（NA）of influenza A（H1N1）pdm09 viruses in Kunming during the 2022-2023 influenza season.Methods:A total of 15 strains of A（H1N1）pdm09 influenza virus isolated from sentinel hospital surveillance and from outbreaks from April 2022 to March 2023 in Kunming were chosen for sequencing. The genetic analysis，which included sequence alignment，homology analysis，construction of phylogenetic tree and amino-acid mutations analysis，was carried out using MAFFT version 7，MegAlign and MEGA 11.Results:Fourteen strains isolated during the 2022-2023 influenza season in Kunming belong to clade 6B.1A.5a.2a，and A/Kunming/284/2023 belonged to clade 6B.1A.5a.2a.1. They all diverged from the northern hemisphere vaccine strain A/Wisconsin/588/2019 in clade 6B.1A.5a.2 recommended by WHO during the 2022-2023 influenza season. Comparing with the HA of the vaccine strain：A186T and Q189E，which might cause the reduction of vaccine protection，were identified in Sb of 14 strains；P137S，K142R in Ca and A186T，Q189E in Sb were identified in A/Kunming/284/2023 and two strains isolated from Thailand. The four mutations at tow antigenic sites identified immune escape at the molecular level. Q189E in the 190-helix and E224A in the 220-loop，which might change the pathogenicity of A（H1N1）pdm09 viruses，were identified in 15 strains. Comparing with NA of the vaccine strain：S200N in 14 strains and S339L in 1 strain were identified in antigenic sites. The two mutations might reduce the protection of antibodies induced by NA.Conclusion:Strengthening influenza surveillance and timely detecting new variants in Kunming contributes to preventing the importation of foreign strains and issuing early warnings for influenza outbreaks.

Objective:To analyze the genetic characteristics of hemagglutinin（HA）and neuraminidase（NA）of influenza A（H1N1）pdm09 viruses in Kunming during the 2022-2023 influenza season.Methods:A total of 15 strains of A（H1N1）pdm09 influenza virus isolated from sentinel hospital surveillance and from outbreaks from April 2022 to March 2023 in Kunming were chosen for sequencing. The genetic analysis，which included sequence alignment，homology analysis，construction of phylogenetic tree and amino-acid mutations analysis，was carried out using MAFFT version 7，MegAlign and MEGA 11.Results:Fourteen strains isolated during the 2022-2023 influenza season in Kunming belong to clade 6B.1A.5a.2a，and A/Kunming/284/2023 belonged to clade 6B.1A.5a.2a.1. They all diverged from the northern hemisphere vaccine strain A/Wisconsin/588/2019 in clade 6B.1A.5a.2 recommended by WHO during the 2022-2023 influenza season. Comparing with the HA of the vaccine strain：A186T and Q189E，which might cause the reduction of vaccine protection，were identified in Sb of 14 strains；P137S，K142R in Ca and A186T，Q189E in Sb were identified in A/Kunming/284/2023 and two strains isolated from Thailand. The four mutations at tow antigenic sites identified immune escape at the molecular level. Q189E in the 190-helix and E224A in the 220-loop，which might change the pathogenicity of A（H1N1）pdm09 viruses，were identified in 15 strains. Comparing with NA of the vaccine strain：S200N in 14 strains and S339L in 1 strain were identified in antigenic sites. The two mutations might reduce the protection of antibodies induced by NA.Conclusion:Strengthening influenza surveillance and timely detecting new variants in Kunming contributes to preventing the importation of foreign strains and issuing early warnings for influenza outbreaks.

Objective:To discuss the effect of microRNA(miR)-30c-5p on the proliferation,migration,and invasion of the human prostate cancer cells(LNCap),and to clarify its possible mechanism.Methods:The LNCap cells were divided into LNCap group(without plasmid transfection),miR-30c-5p mimic group(transfected with miR-30c-5p mimic),mimic NC group(transfected with miR-30c-5p mimic NC),sh-DNA damage inducible transcript 4(DDIT4)group(transfected with sh-DDIT4),sh-NC group(transfected with sh-DDIT4 NC),miR-30c-5p mimic+pc-DNA3.1-NC group(co-transfected with miR-30c-5p mimic and pc-DNA3.1 empty vector),and miR-30c-5p mimic+pc-DNA3.1-DDIT4 group(co-transfected with miR-30c-5p mimic and pc-DNA3.1-DDIT4 over-expression plasmid).The RWPE-1 cells were cultured normally.Real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of miR-30c-5p and DDIT4 mRNA in the cells in various groups;Western blotting method was used to detect the expression levels of DDIT4 protein in the cells in various groups;CCK-8 method was used to detect the proliferation rates of the LNCap cells in various groups;Transwell assay was used to detect the numbers of the invasion LNCap cells in various groups;Scratch assay was used to detect the scratch healing rates of LNCap cells in various groups;dual-luciferase reporter assay was used to detect the targeting relationship between miR-30c-5p and DDIT4.In the in vivo tumor formation experiment,18 male BALB/c nude mice were divided randomly into blank group,agomiR-NC group(transfected with agomiR-30c-5p NC),and agomiR-30c-5p group(transfected with agomiR-30c-5p);there were six mice in each group.The mice in agomiR-NC group and agomiR-30c-5p group were subcutaneously injected with LNCap cells,while the mice in blank group were given an equal volume of physiological saline.The volumes of tumor of the mice in various groups were detected.HE staining was used to observe the morphology of prostate cancer tissue the mice of in various groups;RT-qPCR method and immunofluorescence staining were used to detect the expression levels of miR-30c-5p and DDIT4 mRNA and the fluorescence intensities of DDIT4 protein in prostate cancer tissue of the mice in various groups.Results:The In vitro prostate cancer cell experiment results showed that compared with RWPE-1 cells,the expression level of miR-30c-5p in the prostate cancer LNCap cells was decreased(P<0.01),and the expression levels of DDIT4 mRNA and protein were increased(P<0.05 or P<0.01).After 48 of transfection,compared with LNCap group and mimic NC group,the expression level of miR-30c-5p in the LNCap cells in miR-30c-5p mimic group was increased(P<0.01).Compared with LNCap group and sh-NC group,the expression level of DDIT4 mRNA in the LNCap cells in sh-DDIT4 group was decreased(P<0.01).Compared with miR-30c-5p mimic group and miR-30c-5p mimic+pcDNA3.1 NC group,the expression level of miR-30c-5p in The LNCap cells in miR-30c-5p mimic+pc-DNA3.1-DDIT4 group was decreased(P<0.01);compared with miR-30c-5p mimic group and miR-30c-5p mimic+pcDNA3.1 NC group,the expression level of DDIT4 mRNA in the LNCap cells in miR-30c-5p mimic+pc-DNA3.1-DDIT4 group was increased(P<0.01);compared with miR-30c-5p mimic group and miR-30c-5p mimic+pcDNA3.1 NC group,the expression level of DDIT4 protein in the LNCap cells in miR-30c-5p mimic+pc-DNA3.1-DDIT4 group was increased(P<0.05).The CCK-8 method results showed that compared with LNCap group and mimic NC group,the proliferation rate of the LNCap cells in miR-30c-5p mimic group was decreased(P<0.01);compared with LNCap group and sh-NC group,the proliferation rate of the LNCap cells in sh-DDIT4 group was decreased(P<0.01);compared with miR-30c-5p mimic group and miR-30c-5p mimic+pcDNA3.1 NC group,the proliferation rate of the LNCap cells in miR-30c-5p mimic+pc-DNA3.1-DDIT4 group was increased(P<0.01).The Transwell assay results showed that compared with LNCap group and mimic NC group,the number of the invasion LNCap cells in miR-30c-5p mimic group was decreased(P<0.01);compared with LNCap group and sh-NC group,the number of invasion LNCap cells in sh-DDIT4 group was decreased(P<0.01);compared with miR-30c-5p mimic group and miR-30c-5p mimic+pcDNA3.1 NC group,the number of the invasion LNCap cells in miR-30c-5p mimic+pc-DNA3.1-DDIT4 group was increased(P<0.01).The scratch assay results showed that compared with LNCap group and mimic NC group,the scratch healing rate of the LNCap cells in miR-30c-5p mimic group was decreased(P<0.01);compared with LNCap group and sh-NC group,the scratch healing rate of the LNCap cells in sh-DDIT4 group was decreased(P<0.01);compared with miR-30c-5p mimic group and miR-30c-5p mimic+pcDNA3.1 NC group,the scratch healing rate of the LNCap cells in miR-30c-5p mimic+pc-DNA3.1-DDIT4 group was increased(P<0.01).The dual-luciferase reporter assay results showed that compared with the LNCap cells co-transfected with WT-DDIT4 and mimic NC,the luciferase activity of the LNCap cells co-transfected with WT-DDIT4 and miR-30c-5p mimic was decreased(P<0.01).The in vivo nude mouse tumor formation experiment results showed that on the 3 rd,6 th,9 th,12 th,and 15th days after cell injection,compared with blank group and agomiR-NC group,the tumor volumes of the nude mice in agomiR-30c-5p group were decreased(P<0.05).The HE staining results showed that in prostate cancer tissue of the mice in blank group and agomiR-NC group,the cell nuclei were enlarged,and nucleoli were prominent and deformed.In the mice in agomiR-30c-5p group,some regions of prostate cancer tissues results showed neatly arranged cells with normally shaped nuclei.The RT-qPCR and immunofluorescence staining showed that compared with agomiR-NC group,the expression level of miR-30c-5p in prostate cancer tissue of the mice in agomiR-30c-5p group was increased(P<0.01).Compared with blank group and agomiR-NC group,the expression level of DDIT4 mRNA in prostate cancer tissue of the mice in agomiR-30c-5p group was decreased(P<0.01).DDIT4 protein was mainly expressed in the cytoplasm.Compared with blank group and agomiR-NC group,the fluorescence intensity of DDIT4 protein in prostate cancer tissue of the mice in agomiR-30c-5p group was decreased(P<0.01).Conclusion:The expression level of miR-30c-5p in the prostate cancer LNCap cells is decreased,and it inhibits the proliferation,migration,and invasion of the prostate cancer cells by targeting downregulation of DDIT4,thereby participating in the occurrence and development of prostate cancer.

ObjectiveTo explore the differences existing in the auditory mismatch negativity （MMN） amplitude and latency between children with attention deficit hyperactivity disorder （ADHD） and normal children， and to probe into the significance of MMN latency and amplitude for assessing the auditory perception and attention level in ADHD children and normal children. MethodsOn December 1， 2022， a systematic search was performed in PubMed， Embase， Cochrane Library， China National knowledge Infrastructure （CNKI）， Wanfang Data Knowledge Service Platform and VIP databases to identify all well qualified literature focusing on MMN of ADHD children， then the valid data relevant to MMN amplitude and latency were extracted. The Newcastle-Ottawa Scale （NOS） was used to assess the quality of the included studies， and Stata 20.0 was employed for Meta-analysis. ResultsA total of 9 qualified studies comparing ADHD children （n=170） against healthy controls （n=159） were finally included. Among the included literature， there were 18 matched pairs of MMN amplitude data and 10 matched pairs of MMN latency data at different recording sites. Meta-analysis denoted that ADHD group resulted in potentials of slightly lower MMN amplitude （WMD=-0.334， 95% CI： -1.426~0.758， P=0.549） and notably longer MMN latency （WMD=14.768， 95% CI： 4.660~24.876， P=0.004） compared to control group， and the Bgger's funnel plot did not reveal any publication bias. ConclusionCompared with healthy controls， ADHD children have longer MMN latency， suggesting that the auditory perception and attention level of ADHD children may be reduced.

OBJECTIVE To evaluat e the cost-effectiveness of Keluoxin capsule combi ned with chemical medicine in the treatment of diabetic kidney disease （DKD）from the perspective of the whole society. METHODS Six-state Markov model with 1 year cycle and 40 years time horizon was constructed by means of secondary literature review ，medical record analysis of sample hospital and clinical expert consultation. The cost-effectiveness of Keluoxin capsule combined with chemical medicine versus chemical medicine alone for DKD was evaluated by taking the quality-adjusted life year （QALY）as the output index ，setting the discount rate as 5％，and taking one time domestic gross domestic product （GDP）per capita in 2020 of China as the judgement threshold of incremental cost-effectiveness ratio （ICER）. RESULTS Within 40 years，Keluoxin capsule combined with chemical medicine group spent 8 644.09 yuan per capita more than chemical medicine alone group ，and gained more 0.143 QALYs；ICER was 60 460.25 yuan/QALY，which was less than one times GDP per capita of China in 2020（72 447 yuan）. The results of sensitivity analysis showed that the annual days of using Keluoxin capsule ，the health utility value of DKD at early stage had a great influence on the results of cost-effectiveness analysis. The results of probabilistic sensitivity analysis suggested that the basic analysis results of this study were robust. CONCLUSIONS At the current price level ，Keluoxin capsule combined with chemical medicine is more cost-effective to treat DKD than chemical medicine alone. The dosage of Keluoxin capsule and health utility value should be paid attention in specific decision- bjmu.edu.cn making scenarios.

Objective:To explore the effect of PBL combined surgery video teaching in the clinical teaching of urology clerkship for foreign medical students with the help of WeChat platform.Methods:The foreign students attending clerkship in urology department in 2019 were divided into two groups, control group and experimental group. The students in control group were given traditional lecture-type clinical teaching, while the students in experimental group were given PBL combined surgery video teaching with the assistance of WeChat platform. The results of questionnaire survey on teaching feedback between the two groups were compared. SPSS 24.0 was used for t test. Results:The total score of the questionnaire results in the experimental group was higher than that in the control group ( P<0.05). The experimental group was more superior than the control group especially in the aspects of learning interest stimulation, clinical thought development, learning ability enhancement and team cooperation. Conclusion:The PBL combined surgery video teaching method based on WeChat platform can help to improve the learning effect of foreign medical students in urology clinical clerkship.

Objective:To explore the present situation of medical students' professionalism cognition and provide reference for medical personnel training and medical education.Methods:A cross-sectional survey was conducted on medical students among 2 affiliated hospitals of a medical university in H province by cluster sampling. Exploratory factor analysis and reliability and validity test were carried out and a descriptive analysis of the present situation of professionalism was conducted by SPSS 20.0. Amos21.0 software was used for a confirmatory factor analysis on the samples.Results:The measurement scale had good reliability and validity, and the Cronbach alpha coefficient of the scale was 0.901. The average professionalism score of the medical students was about 80 points. The score of "physical and mental status and self-development ability" was the highest (83.65 points), and the lowest score was "academic ability" (72.21 points). There was a little difference in the professionalism cognition between the two hospitals, with significant differences between the dimension "respect and care" and "responsibility".Conclusion:This study has initially formed a medical professionalism measurement scale with good reliability and validity. The professionalism of medical students in the 2 affiliated hospitals of a medical school in Province H is in good condition as a whole. In the future, medical education should pay more attention to the combination of basic professional knowledge and clinical practice of medical students, and change the training model of medical students in order to improve the academic ability of medical students and medical students' overall cognition of professionalism.

Temporomandibular joint osteoarthritis (OA) is the most severe type of temporomandibular joint disorder of the oral and maxillofacial region. This disorder has a high incidence, and its main characteristic is articular cartilage injury, accompanied by changes in the synovium and subchondral bone. The role of the changes in the subchondral bone in the development and progression of OA has attracted attention in recent years, and the importance of the subchondral bone has been recognized. At present, the subchondral bone has been considered a promising target for the treatment of OA. This manuscript summarizes the research progress in the pathological changes of the cartilage bone in OA, and its mechanism, which would be helpful for the treatment of this disease.

BACKGROUNDBladder cancer is widely known as the most common malignant tumor in the urinary tract, with 75%-85% of patients suffering from nonmuscle invasive bladder cancer (NMIBC). However, the optimal dose of Bacillus Calmette-Guérin (BCG) remains controversial. The aim of this study was to compare the therapeutic efficacy of full dose (FD) with the reduced dose (RD) of BCG.

METHODSRandomized controlled trials (RCTs) were selected through the Cochrane Library, PubMed and Embase and were supplemented by hand searching of bibliographies. The end points include overall survival rate, recurrence rate, progression rate and side effects.

RESULTSFive RCTs that included a total of 1 473 patients (727 in the reduced dose group vs 746 in the full dose group), with a median follow-up period from 33.5 month to 7.1 year. Disease in 80 of 687 (11.6%) patients assigned to the RD group progress to the muscular layer or distant metastasis, compared with 81 of 698 (11.6%) patients assigned to the FD group (RR = 1.02; 95% CI, 0.77-1.36; P = 0.89). The incidence of recurrence at three year was reported in all five studies to be 41.1% (299 of 727) and 36.1% (269 of 746) in the RD and FD groups, respectively (RR = 1.13; 95% CI, 1.00-1.29; P = 0.05). The 5-year survival rate was 75.9% (502 of 662) in the RD group, and 75.8% (510 of 673) in the FD group. In the RD group 41 of 655 (6.3%) patients and 56 of 663 (8.7%) patients in the FD group did not complete the treatment due to systemic or local side effects (RR = 0.75; 95% CI, 0.51-1.10; P = 0.14) CONCLUSIONS: In general, the results of our study demonstrate a trend towards a reduction of the toxicity in reduced dose group without affecting the efficacy of treatment when compared with full dose. More trials with large sample size are still necessary to explore the prognosis of the patients with high risk of tumor in different dose group.

BCG Vaccine ; therapeutic use ; Female ; Humans ; Male ; Neoplasm Recurrence, Local ; prevention & control ; Randomized Controlled Trials as Topic ; Urinary Bladder Neoplasms ; prevention & control

The inundation of Cordyceps sinensis counterfeits in the market makes it difficult to identify. In this study, 21 batches of wild C. sinensis from 3 different regions, 30 batches of naturally cultured C. sinensis and 4 kinds of counterfeits extracted by methanol and water were analyzed using NMR technology. 9 characteristic peaks were defined as quantitative criterion after comparison, and NMR fingerprints of C. sinensis were established. According to the result it is highly similar between naturally cultured C. sinensis and wild ones by comparing their NMR fingerprints. However, NMR spectra of four kinds of adulterants showed differences with C. sinensis. The result also showed that NMR fingerprint of C. sinensis are highly characteristic and specific. The NMR characteristic fingerprint of wild C. sinensis was consistent with the naturally cultured C. sinensis, and it indicated that the chemical constituents of wild C. sinensis and naturally cultured C. sinensis are nearly the same.