BACKGROUND:Multiple studies have confirmed that mitogen-activated protein kinase(MAPK)signaling pathway is involved in cell proliferation,and microRNA(miR)is involved in the occurrence and development of hypertrophic scars.Therefore,the role of miR-27a-3p and MAPK signaling pathways in pathological scar formation has been further explored. OBJECTIVE:To explore the effect of miR-27a-3p on the proliferation of human hypertrophic scar fibroblasts through the MAPK signaling pathway. METHODS:The primary fibroblasts were isolated and collected from the skin samples.The primary fibroblasts were observed by inverted microscope and verified by immunofluorescence.The relative expression level of miR-27a-3p in tissues was detected by qRT-PCR.The target genes of hsa-miR-27a-3p were predicted using the database,and then the predicted target genes were enriched by gene ontology function analysis and biological pathway enrichment analysis of the Kyoto Encyclopedia of Genes and Genomes.There were seven groups:blank control,negative control,miR-27a-3p mimic,miR-27a-3p inhibitor,miR-27a-3p mimic+p38 MAPK inhibitor,miR-27a-3p mimic+extracellular regulated protein kinase inhibitor,miR-27a-3p mimic+c-Jun N-terminal kinase inhibitor.Western blot was used to detect the levels of extracellular regulated protein kinase,c-Jun N-terminal kinase inhibitor.and p38 kinase and their phosphorylation levels.Cell counting kit-8 and EdU were used to detect cell proliferation. RESULTS AND CONCLUSION:Compared with normal skin fibroblasts,hypertrophic scar fibroblasts had stronger proliferative activity(P<0.05)and faster proliferation level(P<0.001).Compared with normal skin,miR-27a-3p was highly expressed in hypertrophic scars(P<0.001).Compared with the negative control group,overexpression of miR-27a-3p could promote cell proliferation activity(P<0.001)and proliferation levels(P<0.001).Compared with the negative control group,knockdown of miR-27a-3p could inhibit the proliferation activity(P<0.05)and proliferation levels(P<0.001).Compared with the negative control group,overexpression of miR-27a-3p promoted the phosphorylated levels of extracellular regulated protein kinase,c-Jun N-terminal kinase,and p38 mitogen-activated protein kinase(P<0.05).Compared with the negative control group,knockdown of miR-27a-3p inhibited the phosphorylated levels of extracellular regulated protein kinase,c-Jun N-terminal kinase,and p38 MAPK(P<0.05).Compared with the miR-27a-3p mimic group,specific inhibitors of extracellular regulated protein kinase,c-Jun N-terminal kinase,and p38 MAPK reversed the effects of miR-27a-3p on the proliferative activity(P<0.01)and proliferation level(P<0.001)of fibroblasts.To conclude,these results suggest that miR-27a-3p promotes the proliferation of human hypertrophic scar fibroblasts by activating the MAPK signaling pathway.

Objective:To explore the genetic etiology of congenital solitary functioning kidney (CSFK).Methods:This retrospective study included 422 fetuses diagnosed with CSFK by prenatal ultrasound who underwent invasive prenatal genetic testing at Guangdong Women and Children Hospital between January 2015 and February 2023. These CSFK fetuses were classified into different subtypes (unilateral renal agenesis and unilateral multicystic dysplastic kidney) and divided into the isolated group ( n=312) and the non-isolated group ( n=110) based on whether there were other associated abnormalities. The results of G-banding karyotyping, chromosomal microarray analysis (CMA), and whole-exome sequencing (WES) among fetuses with different subtypes or from different groups were analyzed. Statistical analysis was performed using the Chi-square (or Fisher's exact) test and rank-sum test. Results:(1) The median maternal age at the time of invasive prenatal diagnosis was 29 years (range: 18-43 years), and the median gestational age was 25 weeks (range: 17-34 weeks). Among the 422 cases, 234 underwent karyotyping and CMA, 63 underwent CMA and WES, and seven underwent all three tests. Therefore, karyotyping, CMA, and WES were completed in 257, 406, and 70 cases, respectively. (2) The detection rate of chromosomal abnormality by G-banding karyotyping was 1.6% (4/257). Among these four cases, CMA detected no abnormalities in one case with chromosomal mosaicism, while the CMA results were consistent with G-banding karyotyping in three cases with chromosomal structural rearrangements. (3) CMA results: The CNV detection was 8.9% (36/406), with 22 cases being classified as pathogenic/likely pathogenic CNVs. Common CNV loci included 17q12 (five cases), 22q11.21 (five cases), and 16p11.2 (two cases). Fifteen cases (68.2%) were associated with microdeletion syndromes. Nineteen mothers opted for pregnancy termination, two continued the pregnancies, and one was lost to follow-up. (4) Among the 241 cases that underwent both G-banding karyotyping and CMA (including seven cases with all three tests), the positive rates for G-banding karyotyping and CMA were 1.7% (4/241) and 5.8% (14/241), respectively. Compared to G-banding karyotyping, CMA provided an additional diagnostic yield of 4.1% (10/241). (5) Among the 70 cases that underwent family-based WES, 26 (37.1%) showed abnormal results, including 12 pathogenic/likely pathogenic variants and 14 variants of uncertain significance. The positive rateby WES was 17.1% (12/70). Six gene variants (mainly PKD1 and HNF1B variants) were associated with the CSFK phenotype, including five autosomal dominant and one autosomal recessive inheritance. Among the 12 WES-positive cases, six had heterozygous variants and six had compound heterozygous variants. Eight mothers chose to continue the pregnancy, two opted for termination, and two were lost to follow-up. (6) Among the 422 CSFK fetuses, 35 (8.3%) had genetic abnormalities. The highest genetic abnormality rate was observed in CSFK fetuses with isolated urinary system abnormalities (15.1%, 8/53), followed by those with additional non-urinary system abnormalities (12.3%, 7/57), and isolated CSFK fetuses (6.4%, 20/312). The differences among the three groups were statistically significant ( χ2=5.95, P=0.048), but no significant differences were found in pairwise comparisons. Conclusion:The primary genetic etiologies of CSFK fetuses include 17q12 microdeletion syndrome, 22q11.2 microdeletion syndrome, and variants in the PKD1 and HNF1B genes.

Objective:To explore the genetic etiology of congenital solitary functioning kidney (CSFK).Methods:This retrospective study included 422 fetuses diagnosed with CSFK by prenatal ultrasound who underwent invasive prenatal genetic testing at Guangdong Women and Children Hospital between January 2015 and February 2023. These CSFK fetuses were classified into different subtypes (unilateral renal agenesis and unilateral multicystic dysplastic kidney) and divided into the isolated group ( n=312) and the non-isolated group ( n=110) based on whether there were other associated abnormalities. The results of G-banding karyotyping, chromosomal microarray analysis (CMA), and whole-exome sequencing (WES) among fetuses with different subtypes or from different groups were analyzed. Statistical analysis was performed using the Chi-square (or Fisher's exact) test and rank-sum test. Results:(1) The median maternal age at the time of invasive prenatal diagnosis was 29 years (range: 18-43 years), and the median gestational age was 25 weeks (range: 17-34 weeks). Among the 422 cases, 234 underwent karyotyping and CMA, 63 underwent CMA and WES, and seven underwent all three tests. Therefore, karyotyping, CMA, and WES were completed in 257, 406, and 70 cases, respectively. (2) The detection rate of chromosomal abnormality by G-banding karyotyping was 1.6% (4/257). Among these four cases, CMA detected no abnormalities in one case with chromosomal mosaicism, while the CMA results were consistent with G-banding karyotyping in three cases with chromosomal structural rearrangements. (3) CMA results: The CNV detection was 8.9% (36/406), with 22 cases being classified as pathogenic/likely pathogenic CNVs. Common CNV loci included 17q12 (five cases), 22q11.21 (five cases), and 16p11.2 (two cases). Fifteen cases (68.2%) were associated with microdeletion syndromes. Nineteen mothers opted for pregnancy termination, two continued the pregnancies, and one was lost to follow-up. (4) Among the 241 cases that underwent both G-banding karyotyping and CMA (including seven cases with all three tests), the positive rates for G-banding karyotyping and CMA were 1.7% (4/241) and 5.8% (14/241), respectively. Compared to G-banding karyotyping, CMA provided an additional diagnostic yield of 4.1% (10/241). (5) Among the 70 cases that underwent family-based WES, 26 (37.1%) showed abnormal results, including 12 pathogenic/likely pathogenic variants and 14 variants of uncertain significance. The positive rateby WES was 17.1% (12/70). Six gene variants (mainly PKD1 and HNF1B variants) were associated with the CSFK phenotype, including five autosomal dominant and one autosomal recessive inheritance. Among the 12 WES-positive cases, six had heterozygous variants and six had compound heterozygous variants. Eight mothers chose to continue the pregnancy, two opted for termination, and two were lost to follow-up. (6) Among the 422 CSFK fetuses, 35 (8.3%) had genetic abnormalities. The highest genetic abnormality rate was observed in CSFK fetuses with isolated urinary system abnormalities (15.1%, 8/53), followed by those with additional non-urinary system abnormalities (12.3%, 7/57), and isolated CSFK fetuses (6.4%, 20/312). The differences among the three groups were statistically significant ( χ2=5.95, P=0.048), but no significant differences were found in pairwise comparisons. Conclusion:The primary genetic etiologies of CSFK fetuses include 17q12 microdeletion syndrome, 22q11.2 microdeletion syndrome, and variants in the PKD1 and HNF1B genes.

Objective　To analyze the epidemiological characteristics and infection pathways and virulence factors of one cholera outbreak in Fengxian District, Shanghai, China, in 2024, and to provide scientific basis for epidemic control and prevention. Methods　Epidemiologic data of cases of one cholera outbreak in Fengxian District in 2024 were collected using on-site epidemiologic survey methods; RT-PCR nucleic acid testing and bacterial culture were applied to carry out pathogenicity testing of cases, close contacts, environment, and food samples; and the genome sequences of the strains were obtained using second-generation gene sequencing. Results　The case was a 62-year-old woman, who presented to the doctor with diarrhea for 4 consecutive days, 4-5 times a day, with watery stools, which was not effectively relieved by self-administered medication. There was no history of traveling away from Shanghai for 5 days before the onset of the disease, and she was engaged in the preparation and delivery of food for rural banquets during the period. Vibrio cholerae O139 was detected in the anal swab sample of the case and the septic tank of the workplace on the 4th day after the onset of the disease; samples of turtle and links in the store selling turtle were cultured for Vibrio cholerae O139. The isolate carried several virulence-related genes such as ctxA, ctxB, HlyA, zot, rtxA, hapA, nanH, tdh, and T3SS. Comparison of the isolate with the O139 strain of cholera cluster within our country through the National Pathogenic Bacteria Recognition Network (NPBN) in recent years suggests that the closest environmental or aquatic animal isolate to the sequence of this strain is the turtle isolate uploaded at a place in Guangdong. Conclusion　This outbreak was a disseminated outbreak caused by the case's contact with turtle contaminated with Vibrio cholerae O139, and early detection of enteric infectious diseases such as cholera can be achieved by relying on the outpatient enteric cholera surveillance network.

Objective: To investigate the factors affecting pre-exposure prophylaxis (PrEP) use among men who have sex with men (MSM), so as to provide a basis for improving PrEP uptake among MSM and optimizing HIV prevention and control strategies. Methods: The MSM were recruited at a HIV testing site of the "Danlan Public Welfare" organization in Beijing Municipality using the convenient sampling method from March to May 2024. Sociodemographic information, awareness of basic AIDS knowledge, sexual orientation and behaviors, the use of PrEP and post-exposure prophylaxis (PEP) in the past six months were collected using the questionnaire survey. Multivariable logistic regression model and decision tree model were used to analyze the influencing factors for PrEP use among MSM. Results: A total of 414 participants were surveyed, with a mean age of (33.52±8.50) years. Among them, 345 individuals (83.33%) had a college degree and above. The predominant sexual orientation was homosexual, with 265 individuals, accounting for 64.01%. The majority reported having 1 to 2 same-sex partners in the past six months, with 182 individuals (43.96%). A total of 39 individuals (9.42%) had used PEP in the past six months. A total of 68 individuals (16.43%) had used PrEP during the same period. Multivariable logistic regression analysis revealed that educational attainment (college degree and above, OR=28.200, 95%CI: 3.162-251.519), the number of same-sex partners in the past six months (3-5 partners, OR=3.963, 95%CI: 1.065-14.755; ≥6 partners, OR=7.518, 95%CI: 1.829-30.910), and the use of PEP in the past six months (OR=18.606, 95%CI: 7.587-45.631) were significant factors associated with PrEP use among MSM. The decision tree model identified educational level, sexual orientation, and the number of same-sex partners in the past six months as factors affecting PrEP use among MSM. Among these, the number of same-sex partners in the past six months emerged as the primary influencing factor. The use of PrEP was 38.46% among MSM who had ≥3 same-sex partners in the past six months and identified as homosexual or heterosexual. Conclusion The use of PrEP among MSM is primarily associated with educational level, the number of same-sex partners in the past six months, use of post-exposure prophylaxis (PEP) in the past six months, and sexual orientation.

ObjectiveTo investigate the pathogenic spectrum and epidemiological characteristics of diarrheal disease in Fengxian District of Shanghai, and to provide scientific basis for the prevention and control of diarrheal diseases. MethodsBasic information of the initial adult cases visited diarrheal disease surveillance sentinel hospital in Fengxian District, Shanghai, was collected from August 2013 to 2023, and fecal samples were collected at 1∶5 sampling intervals to isolate and identify 5 kinds of diarrheagenic Escherichia coli (DEC), Salmonella (SAL), Vibrio parahaemolyticus, Campylobacter, Vibrio cholerae, Shigella and Yersinia enterocolitica (YE). Simultaneously, nucleic acid detection was performed for 3 kinds of rotavirus, 2 kinds of norovirus, intestinal adenovirus, astrovirus and sapovirus. ResultsA total of 1 861 cases of newly diagnosed diarrheal disease were reported, with the peak in July to August. Additionally, 704 surveillance samples were detected, with a total positive detection rate of 50.57%. The detection rates of bacterial, viral and mixed infection were 25.14%, 21.02% and 4.40%, respectively. Among the pathogens detected, DEC accounted for the highest (17.61%, 124/704), followed by norovirus (16.48%, 116/704), rotavirus (6.39%, 45/704), SAL (5.97%, 42/704) and Campylobacter (3.84%, 27/704). DEC detected were mainly enteroaggregative Escherichia coli and enterotoxigenic Escherichia coli, with no detection of Vibrio cholerae, Shigella and YE. The highest total pathogen detection rate was observed from June to September, and the detection peaks of norovirus were from March to June and from October to December, whereas that of DEC was from June to October. The detection rate of rotavirus peaked from January to February, but which was not detected between 2020‒2023. The SAL positive rate peak was in September, whereas that of Campylobacter was from July to September. ConclusionThe main pathogens detected in Fengxian District from 2013‒2019 are DEC, norovirus, rotavirus, SAL and Campylobacter. Different pathogens have different detection peaks, with bacteria predominating in summer and viruses in winter and spring. Prevention and control measures should be carried out according to the epidemiological characteristics of different seasons.

Objective To investigate the acquisition of the"standard for intubation and maintenance of nasointestinal tube in adult patients"of Chinese Nursing Association,and its influencing factors,so as to provide a basis for targeted training programs.Methods A multi-centered,cross-sectional study was performed in 31 provinces from September to November 2023,and nurses from different departments which use nasointestinal tubes like intensive care units,gastroenterology,neurology,geriatrics were included by a convenient sampling method.The tool was a self-designed questionnaire based on the group standard and the survey was conducted.Multiple linear regression analysis was used to explore the influencing factors of nurses'knowledge of nasointestinal tubes intubation and maintenance.Results 1 350 valid questionnaires were collected.Only 61.63％of the respondents knew about the publishing of the standard.The score of knowledge of tube intubation and maintenance was(61.09±13.56).The results of multiple linear regression analysis showed the influencing factors of the score of knowledge of intubation and maintenance were as follows:education level,professional title,job position,intubation experience within half a year,and corresponding achievements(P＜0.05).Conclusion The acqui-sition level of nurses for the standard calls for continuous promotion.Nursing managers should establish targeted training programs based on the related influencing factors,so as to advance the implementation of the group standard.

Objective To investigate the relationship between sleep disorders and coronary heart disease through big data combined with Mendelian randomization analysis.Methods Data from 2005 to 2018 National Health and Nutrition Examination Survey in the United States were utilized.Logistic regression analysis was employed to evaluate the association between sleep disorders and coronary heart disease,while analyzing relevant influencing factors.A two-sample Mendelian randomization approach was implemented using Genome-Wide Association Studies to establish causal relationships.Results Logistic regression analysis demonstrated a significant association between sleep disorders and coronary heart disease(P＜0.001),with the neutrophil-to-lymphocyte ratio serving as a mediating factor in this relationship(P＜0.001).Mendelian randomization analysis revealed a positive correlation between sleep disorders and coronary heart disease(OR=1.030,95％CI:1.01-1.04).Conclusion Sleep disorders can increase the risk of coronary heart disease by activating inflammatory factors.

Objective:To examine the prevalence of malnutrition and evaluate the impact of nutritional support on clinical outcomes in elderly patients diagnosed with gastric and colorectal cancer.Methods:A retrospective cohort study was conducted, analyzing elderly patients with gastrointestinal tumors who underwent surgical treatment in the general surgery department from January 2019 to June 2020.The Global Leadership Initiative on Malnutrition(GLIM)criteria were utilized to diagnose malnutrition, and the effects of malnutrition and nutritional support on clinical prognosis were investigated.Results:A total of 426 elderly hospitalized patients with gastric and colorectal tumors who underwent surgical treatment were included in this study.This cohort comprised 199 cases of gastric cancer and 227 cases of colorectal cancer, with ages ranging from 65 to 91 years(mean age: 72.05±5.99).According to the GLIM criteria, 43.7%(186/426)of the patients were diagnosed with malnutrition, of which 25.6%(109/426)were moderately malnourished and 18.1%(77/426)were severely malnourished.Among the gastric cancer patients, 73.4%(146/199)were identified as having nutritional risk, with 48.7%(97/199)being malnourished and 22.6%(45/199)experiencing severe malnutrition.In the colorectal cancer group, 63.9%(145/227)were at nutritional risk, 39.2%(89/227)were malnourished, and 14.1%(32/227)had severe malnutrition.Additionally, 60.3%(257/426)of the patients received nutritional support therapy: 25.4%(108/426)received parenteral nutrition(PN), 11.3%(48/426)received enteral nutrition(EN), 23.7%(101/426)received a combination of EN and PN, while 39.7%(169/426)did not receive any nutritional support.Regardless of the presence or degree of malnutrition, patients who received nutritional support had significantly shorter total hospital stays compared to those who did not receive nutritional support, and this difference was statistically significant( t=5.58, 3.69, 2.21, 3.03, all P<0.05). Conclusions:Providing nutritional support to malnourished patients can reduce the length of hospital stay and improve clinical outcomes.

Objective:To investigate the correlation between phase angle and malnutrition, and to determine the malnutrition cut-off point based on phase angle in elderly patients undergoing pancreatic and biliary surgery.Methods:In a case control study, we collected data from 190 elderly inpatients scheduled for pancreatic and biliary surgery at the Department of General Surgery of Beijing Hospital from December 2021 to July 2024.We recorded the subjects' baseline data, dietary survey results, and anthropometric measurements.The phase angle was calculated using the InBody 720 Body Composition Analyzer, and malnutrition was diagnosed according to the Global Leadership Initiative on Malnutrition(GLIM)criteria.Results:A total of 190 cases were included in the study, of which 111(58.4%)were male, aged 60~90(70.44±7.01) years.The prevalence of malnutrition and severe malnutrition was found to be 65.8% and 23.2%, respectively.As malnutrition worsened, the phase angle decreased( P<0.001 for trend).The phase angle in the malnutrition group was significantly lower than that in the normal group( P<0.001).Furthermore, the phase angle was positively correlated with body mass index(BMI), appendicular skeletal muscle mass index(ASMI), fat-free mass index(FFMI), total energy intake, and albumin, while it was negatively correlated with the percentage of weight loss(all P<0.05).The cut-off point of the phase angle for predicting malnutrition in elderly patients undergoing pancreatic and biliary surgery was determined to be 4.42°, sensitivity 80.0%, specificity 58.4%, area under the curve 0.698(95% CI: 0.621~0.775, P<0.001).A low phase angle(≤4.42°)was positively correlated with the occurrence of malnutrition( OR=9.133, 95% CI: 2.894~28.826, P<0.001). Conclusions:The present study suggests that phase angle may serve as a simple and valid indicator of malnutrition in elderly patients undergoing pancreatic and biliary surgery.