Objective: To investigate the infection status of group A streptococcus (GAS) among scarlet fever cases within the same class in schools experiencing clustering outbreaks and to analyze the factors associated with GAS detection, so as to provide a reference for the prevention and control of scarlet fever. Methods: All the classes with scarlet fever cases in schools reporting the clustering outbreaks of scarlet fever in Tianjin in 2023 were selected, and a total of 528 pharyngeal swab samples were collected from other students in the class for GAS isolation and identification except for the 97 patients. Conditional Logistic regression was used to analyze the influencing factors of GAS detection. Results: The overall positive rate of GAS among students in 15 classes from 12 clustering outbreaks with scarlet fever was 21.02%. There was a positive correlation between the positive rate of GAS detection in the class and the number of scarlet fever cases in the class ( r =0.82, P <0.01). The results of conditional Logistic regression analysis showed that pharyngeal pain ( OR=2.53, 95%CI =1.61-3.99) and tonsillar enlargement ( OR=1.90, 95%CI =1.15-3.14) of the sampled students were more likely to detect GAS positivity ( P <0.05). Conclusions In the clustered outbreak of scarlet fever in schools, students with sore throat and swollen tonsils who are in the same class as the case are more likely to be detected with GAS. During a school scarlet fever cluster outbreak, students with sore throat and swollen tonsils should be closely monitored and managed similarly to confirmed cases. At the same time, identifying close contacts in the affected class should not be restricted to those seated directly around the case.

Objective To investigate the expression of lncRNA SNHG8 in placenta accrete(PA)and its effect on trophoblast invasion and migration.Methods qRT-PCR was used to detect the expression of lncRNA SNHG8 in placenta tissue of 30 cases in PA group and 30 cases in control group,and the correlation between lncRNA SNHG8 expression and prenatal ultrasound score of 30 cases in PA group was analyzed.Transwell and scratch assay were used to detect the effect of lncRNA SNHG8 interference on the invasion and migration of human chorionic trophoblast cells(HTR8/SVneo cells),and western blot was used to detect the expression of MMP-2 and MMP-9.The downstream targets of lncRNA SNHG8 were predicted by StarBase software,and the expression of lncRNA SNHG8 was detected in placental tissues of the two groups.Dual luciferase reporter assay was used to detect the targeting relationship between lncRNA SNHG8 and miR-542-3p.Results Compared with that of the control group,the expression of lncRNA SNHG8 was up-regulated in the placenta tissue of the PA group(P<0.05),and it was positively correlated with prenatal ultrasound score.Interference with lncRNA SNHG8 inhibited the invasion and migration of trophoblast cells(P<0.05);the protein expression of MMP-9 and MMP-2 also decreased signifi-cantly(P<0.05).Biological prediction indicates that miR-542-3p had a binding site with lncRNA SNHG8,and miR-542-3p expression was down-regulated in PA placental tissue(P<0.05).Dual luciferase reporter assay confirmed that lncRNA SNHG8 could target miR-542-3p.Compared with si-SNHG8+inhibitor-NC,co-transfection of si-SNHG8 and miR-542-3p inhibitor enhanced the invasion and migration ability of trophoblast cells(P<0.05).Conclusion lncRNA SNHG8 is highly expressed in PA and is related to the severity of PA.LncRNA SNHG8 promotes the invasion and migration of trophoblast by regulating the level of miR-542-3p.The study suggests that lncRNA SNHG8 plays an important role in the invasion and migration of PA trophoblast cells,which is expected to be a clinical diagnostic biomarker and therapeutic target.

Objective:By studying the gait changes of patients with knee osteoarthritis (KOA), the study provided a theoretical basis for the quantitative indicators obtained from gait analysis to the diagnosis of KOA. And it provided a gait reference for the clinical diagnosis, treatment, rehabilitation, prevention and efficacy evaluation of KOA.Methods:A total of 30 patients (KOA group) with KOA hospitalized in our hospital from May 2021 to October 2021 and 30 healthy people (control group) were compared for gait changes. The t test, Mann-Whitney U test and Fisher′s exact test were used to compare differences between groups. Results:The KOA group were greater than the control group in terms of step time [(642±81) ms and (548±62) ms, t=-5.01, P<0.001], gait cycle [(1 284±168) ms and (1 076±114) ms, t=-5.61, P<0.001], double support time [(531±125) ms and (331±51) ms, t=-8.10, P<0.001], double support time period proportion (0.417±0.063 and 0.309±0.023, t=-8.50, P<0.001), total support time [(914±135) ms and (678±107) ms, t=-7.52, P<0.001], total support time period proportion (0.711±0.027 and 0.627±0.044, t=-8.87, P<0.001), and left static standing time (55.7±8.4 and 51.5±2.2, t=-2.65, P=0.012), for which the differences were statistically significant. The KOA group were lower than the control group in terms of single support time period proportion (0.287±0.030 and 0.334±0.013, t=7.80, P<0.001), right static standing time (44.3±8.4 and 48.5±2.3, t=2.65, P=0.012), step length [(36±8) cm and (52±5) cm, t=9.97, P<0.001], stride length [(70±16) cm and (103±8) cm, t=10.00, P<0.001], velocity [(0.60±0.18) m/s and (1.05±0.19) m/s, t=9.54, P<0.001], left knee range of motion [(42±17)° and (63±4) °, t=6.49, P<0.001], and right knee range of motion [(37±18) ° and (62±3)°, t=7.54, P<0.001], for which the differences were statistically significant. Conclusion:Gait analysis can quantitatively evaluate the condition of patients with KOA, making it possible to transform the diagnostic criteria of KOA from qualitative to quantitative.

Due to the overwhelming percentage of poorly water-soluble drugs, pharmaceutical industry is in urgent need of efficient approaches for solubilization and permeability improvement. Salts consisting of lipophilic fatty acid anions and hydrophilic choline cations are found to be surface active and able to form ionic co-aggregates (ICAs) in water. Choline oleate-based ICAs significantly enhance oral absorption of paclitaxel (PTX) as compared with cremophor EL-based micelles (MCs). Aggregation-caused quenching probes enable tracking of intact ICAs in in vivo transport and cellular interaction. Prolonged intestinal retention of ICAs than MCs implies stronger solubilizing capability in vivo. Ex vivo imaging of major organs and intestinal tracts suggests transepithelial transport of intact ICAs. Cellular studies support the enhanced absorption of PTX and transmembrane transport of intact ICAs. In conclusion, ICAs, consisting of lipophilic ions and hydrophilic counter-ions, are of great potential in delivery of poorly water-soluble drugs by enhancing solubility and permeability.

Beh?et′s syndrome (BS) is classified among variable vessel vasculitis with unknown etiology and extensively heterogeneous clinical features. It is easily missed or misdiagnosed due to the lack of a specific laboratory diagnosis index. Based on the evidence and guidelines from China and other countries, the Chinese Rheumatology Association developed the standardization of diagnosis and treatment of BS. The purposes are: (1) To standardize the detection and interpretation of key indicators for BS; (2) To standardize rational management for BS patients with topical and systemic organ involvement to reduce complications and improve outcomes.

Objective:To investigate the protective effect of two doses of varicella vaccine in a population at high risk for varicella.Methods:The case group involved all varicella cases in classes with no less than three patients during varicella outbreaks in Tianjin schools from 2017 to 2019. A case-control study was carried out in a 1∶3 ratio. According to the seat position of each case, three nearby students who did not suffer from varicella were selected as controls. The protective effect of two doses of varicella vaccine was evaluated.Results:The total protective effect of varicella vaccine was 46.0% (95% CI: 42.7%-49.0%). The protective effect was 44.7% (95% CI: 41.2%-48.0%) for one-dose varicella vaccine and 80.0% (95% CI: 63.1%-89.2%) for two-dose varicella vaccine. For two doses of varicella vaccine, the protective effect was 87.6% (95% CI: 52.0%-96.8%) after 0-2 years and 76.6% (95% CI: 33.6%-91.5%) after 3-5 years.Conclusions:The protective effect of two doses of varicella vaccine is better than that of one dose. However, both one-dose and two-dose vaccines show decreased protective effect over time. A booster immunization could be considered in high-risk population with longer intervals since the last vaccination.

Objective:To compare the clinical effect of perforator flap of proper palmar digital and hallex fibular flap in repair of soft tissue defect of fingers.Methods:A total of 52 patients with finger soft tissue injury were reviewed from January, 2017 to January, 2019. Twenty-seven patients were repaired by perforator flap of proper palmar digital artery, and 25 by hallex fibular flaps. Both groups of patients had only soft tissue defects without phalangeal fracture. Postoperative follow-up were conducted by phone, WeChat and visit of outpatient clinic. The recovery of finger sensory function was evaluated according to the Trial Standard for Replantation Evaluation of Severed Digit by the Hand Surgery Society of Chinese Medical Association. The flaps were evaluated according to the shape, patient satisfaction and finger function and classified in excellent, good, fair and poor. Data of the 2 groups of patients were collected and statistically analysed by SPSS 22.0. P<0.05 was statistically significant. Results:Both groups entered follow-up for 12-16 months. All flaps in both groups survived. There was statistically significant difference of TPD between the 2 groups[TPD were 4-7(5.3±1.2) mm and 6-10(8.4±1.7)mm, respectively]( t=7.642, P=0.000). According to the Evaluation Criteria of the Hand Surgery Society of the Chinese Medical Association. In the group repaired by perforator flap of proper palmar digital artery, 17 fingers were excellent, 6 good, and 4 fair, with a 85.1% of excellent and good rate. In the group repaired by hallex fibular flap, 8 fingers were excellent, 5 good, 9 fair, and 3 poor, with a 52.0% of excellent and good rate. The difference between 2 groups was statistically significant ( t=6.710, P=0.009). There was a 3.7% incidence of complications in the group repaired by perforator flap of proper palmar digital artery, and 25.9% in the group repaired by hallex fibular flap. The difference between the 2 groups was statistically significant( t=4.167, P=0.032), and there was a higher incidence of complications in the group repaired by hallex fibular flap. Conclusion:The perforator flap of proper palmar digital artery and the hallex fibular flap are good choices in the repair of finger soft tissue defect. However, the postoperative complication of the hallux fibular flap is relatively high. Therefore, it is necessary to make a decision in the choice of flap according to the actual situation in clinical work.

Lung cancer is the malignant tumor with the highest incidence in China. Early detection and identification of symptomatic lung cancer patients and timely screen out asymptomatic patients from high-risk groups require multiple cooperation. At present, although combined imaging, serology, genomics, proteomics and other methods have been combined to screen for suspected lung cancer, there are still problems such as missed diagnosis and misdiagnosis. Meanwhile, the spread of the corona virus disease 2019 (COVID-19) epidemic has brought new challenges to early lung cancer screening. Under the normalization of epidemic prevention and control, the work of early lung cancer screening should be changed accordingly: improve the population's awareness of cancer prevention and control, strengthen the management of medical procedures, improve the efficiency of tumor detection, optimize detection technology, and utilize internet and big data platforms rationally. We should establish an ideal model, combining multiple screening methods, which is streamlined and efficient for early lung cancer screening under normal epidemic prevention and control.
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COVID-19/epidemiology* ; China/epidemiology* ; Early Detection of Cancer ; Epidemics ; Humans ; Lung Neoplasms/prevention & control*

Self-microemulsifying drug delivery systems (SMEDDSs) have recently returned to the limelight of academia and industry due to their enormous potential in oral delivery of biomacromolecules. However, information on gastrointestinal lipolysis and trans-epithelial transport of SMEDDS is rare. Aggregation-caused quenching (ACQ) fluorescent probes are utilized to visualize the

Objective:To investigate the different outcomes of two types of acute kidney injury (AKI) according to standard of Kidney Disease: Improving Global Outcomes-AKI (KDIGO-AKI), and to analyze the risk factors that affect the prognosis of intensive care unit (ICU) patients in China.Methods:A secondary analysis was performed on the database of a previous study conducted by China Critical Care Clinical Trial Group (CCCCTG), which was a multicenter prospective study involving 3 063 patients in 22 tertiary ICUs in 19 provinces and autonomous regions of China. The demographic data, scores reflecting severity of illness, laboratory findings, intervention during ICU stay were extracted. All patients were divided into pure AKI (PAKI) and acute on chronic kidney disease (AoCKD). PAKI was defined as meeting the serum creatinine (SCr) standard of KDIGO-AKI (KDIGO-AKI SCr) and the estimated glomerular filtration rate (eGFR) at baseline was ≥ 60 mL·min -1·1.73 m -2, and AoCKD was defined as meeting the KDIGO-AKI SCr standard and baseline eGFR was 15-59 mL·min -1·1.73 m -2. All-cause mortality in ICU within 28 days was the primary outcome, while the length of ICU stay and renal replacement therapy (RRT) were the secondary outcome. The differences in baseline data and outcomes between the two groups were compared. The cumulative survival rate of ICU within 28 days was analyzed by Kaplan-Meier survival curve, and the risk factors of ICU death within 28 days were screened by Cox multivariate analysis. Results:Of the 3 063 patients, 1 042 were enrolled, 345 with AKI, 697 without AKI. The AKI incidence was 33.11%, while ICU mortality within 28 days of AKI patients was 13.91% (48/345). Compared with PAKI patients ( n = 322), AoCKD patients ( n = 23) were older [years old: 74 (59, 77) vs. 58 (41, 72)] and more critical when entering ICU [acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score: 23 (19, 27) vs. 15 (11, 22)], had worse basic renal function [eGFR (mL·min -1·1.73 m -2): 49 (38, 54) vs. 115 (94, 136)], more basic complications [Charlson comorbidity index (CCI): 3 (2, 4) vs. 0 (0, 1)] and higher SCr during ICU stay [peak SCr for diagnosis of AKI (μmol/L): 412 (280, 515) vs. 176 (124, 340), all P < 0.01]. The mortality and RRT incidence within 28 days in ICU of AoCKD patients were significantly higher than those of PAKI patients [39.13% (9/23) vs. 12.11% (39/322), 26.09% (6/23) vs. 4.04% (13/322), both P < 0.01], while no significant difference was found in the length of ICU stay. Kaplan-Meier survival curve analysis showed that the 28-day cumulative survival rate in ICU in AoCKD patients was significantly lower than PAKI patients (Log-Rank: χ2 = 5.939, P = 0.015). Multivariate Cox regression analysis showed that admission to ICU due to respiratory failure [hazard ratio ( HR) = 4.458, 95% confidence interval (95% CI) was 1.141-17.413, P = 0.032], vasoactive agents treatment in ICU ( HR = 5.181, 95% CI was 2.033-13.199, P = 0.001), and AoCKD ( HR = 5.377, 95% CI was 1.303-22.186, P = 0.020) were independent risk factors for ICU death within 28 days. Conclusion:Further detailed classification (PAKI, AoCKD) based on KDIGO-AKI SCr standard combined with eGFR is related to ICU mortality in critical patients within 28 days.