Objective　To analyze the current situation and influencing factors of health-care seeking delay of tuberculosis patients registered in Changsha from 2019 to 2023, and to understand the current status of health-care seeking delay after the transformation of the tuberculosis prevention and treatment service model in Changsha, so as to provide reference bases for improving the patient discovery strategy and optimizing tuberculosis control and prevention measures. Methods　The case data of 23 371 tuberculosis patients registered in Changsha City from 2019 to 2023 were collected, and the time of health-care seeking delay and the rate of health-care seeking delay were calculated. Comparison of differences between groups with different characteristics using rank sum test and chi-square test, and the Cochran-Armitage method was used to analyze the trend of health-care seeking delay rate, and multifactorial analysis was carried out with the help of logistic regression model. Results　The median health-care seeking time of tuberculosis patients in Changsha City from 2019-2023 was 16 (5, 44) days, and the overall health-care seeking delay rate was 53.5%, with an overall increasing trend (Z=-7.256, P<0.001). Between-group comparisons revealed differences in health-care seeking delay time and health-care seeking delay rate between groups of patients with different gender, age group, occupation, current address, types of household registration, medical history, complication, diagnostic triage, pathogenic results and geographic accessibility (P<0.05). The results of multifactorial analysis showed that compared to the<25 years age group, the 25-<65 years age group (OR=1.579, 95%CI: 1.490-1.669) and the ≥65 years age group (OR=2.016，95%CI: 1.918-2.113) had a higher risk of health-care seeking delay, presence of complication (OR=1.213，95%CI:1.141-1.285), positive pathology (OR=1.503, 95%CI: 1.449-1.556), and average geographic accessibility of healthcare services (OR=1.073, 95%CI:1.017-1.129) were risk factors for health-care seeking delay, and the risk was relatively lower in the migrating population (OR=0.920, 95%CI: 0.815-0.989). Conclusion　The rate of delayed health-care seeking for tuberculosis patients in Changsha City in 2019-2023 is at a moderate level in the surrounding areas, and the overall trend is increasing. It suggests that proactive screening strategies for key populations should be optimized to improve the accessibility of healthcare services and reduce the rate of health-care seeking delay.

OBJECTIVE To analyze a strain of multidrug-resistant Pseudomonas fulva by whole genome sequencing,investigate the genomic characteristics and analyze the significance in phyletic evolution.METHODS A strain of P.fulva,NY4814,was isolated from the Chinese PLA General Hospital in 2014.The genome sequence data of the strain were obtained after the purification,preservation and whole genome sequencing.The specie of the strain was identified by comparing with average nucleotide identity(ANI);the minimum inhibitory concentra-tions(MIC)of the strains were determined by VITEK2 system.All of the data regarding to the genomic se-quences of P.fulva were downloaded from RefSeq database of National Center of Biotechnology Information(NCBI)to construct the phylogenetic tree.RESULTS The P.fulva NY4814 was resistant to carbapenems and quinolones.The chromosome carried a newly discovered Tn7675 unit transposon,which mediated resistance to aminoglycosides and chloramphenicol.Simultaneously,the plasmid pNY4814-IMP drove the wide dissemination of the blaIMP resistance gene across Pseudomonas species via a highly conserved conjugative and transfer mechanism,and the Tn6485i unit transposon carried by the chromosome mediated the resistance to β-lactams.CONCLUSIONS As one of the potential carriers for the transmission of carbapenems resistance genes and other types of drug re-sistance genes,the P.fulva leads to the infection as a seldom opportunistic pathogen.The genetic structure of NY4814 and its association with genetic evolution of the species are observed in the study,which intensify the un-derstanding of the species and provide theoretical bases for prevention and monitoring of bacterial infections.

BACKGROUND:The incidence of inflammatory bowel disease has been steadily rising,accompanied by a lack of definitive therapeutic strategies.Recent research endeavors have illuminated the promising potential of mesenchymal stem cells in mitigating the symptoms of inflammatory bowel disease,offering a glimmer of hope for afflicted patients.OBJECTIVE:To review the mechanisms of action of mesenchymal stem cells derived from various sources in the management of inflammatory bowel disease,aiming to provide insights for future research endeavors.METHODS:Utilizing the keywords"mesenchymal stem cells,MSCs,exosomes,extracellular vesicles,EVs,inflammatory bowel disease,IBD,ulcerative colitis,UC,Crohn's disease,CD"in English and their Chinese equivalents in CNKI and PubMed databases,a total of 89 eligible articles were selected for this review.RESULTS AND CONCLUSION:Currently,six types of mesenchymal stem cells are being explored for inflammatory bowel disease therapy:bone marrow-derived mesenchymal stem cells,adipose tissue-derived mesenchymal stem cells,perinatal tissue-derived mesenchymal stem cells,induced pluripotent stem cell-derived mesenchymal stem cells,embryonic stem cell-derived mesenchymal stem cells,and gingival mesenchymal stem cells.Five administration routes have been adopted,with intravenous and intraperitoneal injections being the most prevalent,followed by local,mesenteric,and intra rectal injections.Their therapeutic mechanisms encompass differentiation,regeneration,anti-inflammatory effects,immune modulation,neuroprotection,antioxidant stress response,homing,modulation of gut microbiota,autophagy,ferroptosis,and endoplasmic reticulum stress.While sharing functional similarities,mesenchymal stem cells from different sources exhibit unique characteristics that confer them with distinct advantages and therapeutic potentials.Nevertheless,research into the specific properties of these mesenchymal stem cells remains limited,necessitating deeper exploration of their nuanced differences to optimize their therapeutic efficacy in inflammatory bowel disease.Additionally,the clinical safety of mesenchymal stem cells-based therapies warrants further observation and evaluation.

Objective·To retrieve and evaluate evidence related to weight management during endocrine therapy for prostate cancer patients,and summarize the best evidence available.Methods·The PIPOST model was adopted to construct evidence-based questions.Following the"6S"model of evidence resources,a systematic computer-based search was conducted to retrieve relevant evidence on weight management during prostate cancer endocrine therapy from various databases and websites,including Guidelines International Network,BMJ Best Practice,UpToDate,JBI Evidence-Based Healthcare Center Database,American Guidelines Network,Medlive,Cochrane Library,PubMed,CINAHL,Web of Science,Embase,CNKI,Chinese Biomedical Literature Database,Wanfang Database,and VIP Database,as well as the websites of the American Urological Association,European Urological Association,and Urological Branch of Chinese Medical Association.The evidence retrieved included guidelines,clinical decisions,recommended practices,expert consensuses,evidence summaries,systematic reviews,and original studies.The search period spanned from database establishment to December 2023.Two researchers independently evaluated the quality of the included literature.The included articles were read one by one and summarized according to themes.Priority was given to high-level,high-quality,and newly published authoritative literature during evidence screening and extraction.The included and extracted evidence was uniformly classified into levels 1?5 according to the JBI evidence pre-classification and evidence recommendation level system,and the evidence recommendations were divided into strongly recommended(Grade A)and weakly recommended(Grade B).Results·A total of 12 articles were retrieved,consisting of 4 guidelines,3 expert consensuses,2 evidence summaries,2 randomized controlled trials,and 1 quasi-experimental study.All 12 articles were rated as high quality and were included.The best evidence was summarized into 8 aspects:weight management assessment and monitoring,multidisciplinary collaboration,personalized support,family involvement strategies,nutrition management strategies,exercise management strategies,health education,and follow-up management.Conclusion·The best evidence for weight management during endocrine therapy for prostate cancer is summarized into eight aspects.In clinical application,specific clinical situations and patient characteristics should also be considered to improve the effectiveness of clinical interventions and the quality of care.

Gyrovirus galga1(GyVg1)and gyrovirus homsa1(GyH1)are two newly discovered cir-coviruses that can cause symptoms related to transmissible viral proventriculitis of chickens.These viruses have been reported in various regions worldwide.This research aims to establish a duplex real-time PCR assay capable of identifying and detecting GyVg1 and GyH1.Specific primers and probes were designed based on the conserved regions of GyVg1 and GyH1 respectively using all genome sequence data currently available in GenBank.After optimizing reaction conditions,the du-plex real-time PCR detection method was established and further validated by comparing it with a conventional PCR assay and sequencing results from an analysis of 256 clinical samples collected in 2023 across eight regions of Nanning,Guangxi.The results showed that GyVg1 and GyH1 could be identified in 1 h by the duplex real-time PCR assay and two pairs of primer probes can amplify effectively but there is no any cross reaction with other pathogens.Besides,the detection limit was determined to be 7.5 copies/μL.The correlation coefficient of standard curves exceeded 0.99,and CV for intra-and inter-assay was less than 0.45％.Based on clinical performance,when the quanti-ty of template was greater than or equal to 100 copies,the agreements between the duplex real-time PCR assay and the conventional PCR assay were 94.3％(GyVg1)and 100％(GyH1).In con-clusion,the newly developed duplex real-time PCR assays exhibited good specificity,sensitivity and repeatability,which could contribute to the rapid detection and differentiation of GyVg1 and GyH1.

Objective::To investigate the correlation between maternal serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and gestational duration in pregnant women with pulmonary hypertension (PH).Methods::The study included pregnant individuals with PH stemming from mitral valve stenosis and mitral valve regurgitation (post-capillary PH) or pulmonary arterial hypertension (pre-capillary PH) who were admitted to Guangdong Provincial People’s Hospital between January 1, 2014 and December 31, 2020. In this retrospective cohort study, maternal serum NT-proBNP levels during pregnancy, along with other clinical data, were obtained from structured electronic medical records. These data included gestational age at delivery, echocardiographic parameters, laboratory findings, gestational duration, delivery mode, and other relevant clinical variables. Univariate and multivariate regression analyses were conducted to assess the association between NT-proBNP levels and gestational duration. Adjustments were made for potential confounding factors, and curve fitting and threshold effect analysis were employed to identify tangent points. Furthermore, stratified analyses were performed based on tricuspid regurgitation velocity, maternal age, and parity.Results::A total of 64 patients with post-capillary PH and 74 patients with pre-capillary PH were included in this study. Among patients with post-capillary PH, the results of multivariate regression analysis indicated a significant association between maternal NT-proBNP levels and gestational duration (β = -0.03, 95% confidence interval (CI) -0.05 to 0.00, P = 0.02). The fitted curve demonstrated a negative correlation between maternal NT-proBNP levels and gestational duration, with a significant break point at 379.9 ng/L ( P < 0.05). In the post-capillary PH group, the stratified analysis revealed a regression coefficient of -0.05 (95% CI:-0.06 to -0.04, P = 0.001) in patients with a tricuspid regurgitation velocity >340 mm/s. For patients >35 years old, the regression coefficient was -0.03 (95% CI -0.06 to -0.01, P = 0.02). In multiparous women, the regression coefficient was -0.03 (95% CI-0.06 to 0.00, P = 0.03). Conclusion::In pregnant women with pulmonary hypertension, maternal NT-proBNP levels are associated with gestational duration, particularly with an increased risk of preterm labor.

To further investigate the molecular genetic characteristics of enzomatic nasal tumor vi-rus of goats(ENTV-2)in Yunnan Province,this study measured and analyzed the entire genome of ENTV-2 in Yunnan Province.The results showed that the complete genome sequence of the EN-TV-2 YN2023 strain(GenBank accession number:PP682590.1)was successfully obtained.The YN2023 strain has a total length of 7 307 bp and a typical structure of 5'-M5-gag-pro-pol-env-M3-3'.Whole genome sequence homology analysis showed that the nucleotide homology between YN2023 strain and 41 reference strains ranges from 85.3％to 95.5％.The whole genome evolution-ary tree indicates that the YN2023 strain is closely related to the prevalent strains in China,with certain genetic diversity and geographical clustering.The analysis of the gag gene evolutionary tree shows that the gag gene cluster of YN2023 strain is on a branch of the ENTV-2 gag gene,and YN2023 is clustered on the same small branch as enENTV-FJ1 and GDQY2017 strains,with the closest genetic relationship.The env gene evolutionary tree shows that YN2023 is on the same branch as GDQY2017,GDZJ2022,ENTV-2CHN1-6,ENTV-FJ1,and ENTV-FJ3,and is also on the same branch as GDQY2017,indicating a close genetic relationship.Recombination analysis showed that the YN2023 strain underwent a potential recombination event between breakpoint positions 6378-7478 bp,with the Chinese Chongqing strain enENTV-CQ1(OR669623.1)as the primary parent and the Chinese Sichuan strain BH(MT254062.1)as the secondary parent.This study enriches the genomic information of the ENTV-2 strain in Yunnan Province and provides data sup-port for the genetic variation of ENTV-2 in Yunnan Province.

Objective:To investigate the distribution of CGG repeat numbers in the FMR1 gene among reproductive-age women in China, providing data reference for carrier screening and genetic counseling of Fragile X syndrome. Methods:This cross-sectional study recruited 16 610 reproductive-age women from 12 medical institutions between July 2022 and October 2023. Peripheral venous blood samples (3 mL) were collected, and genomic DNA was extracted. The number of CGG repeats in the FMR1 gene was determined using the triplet-primed polymerase chain reaction (TP-PCR) combined with capillary electrophoresis technology. Statistical analyses were performed to assess the prevalence and distribution of CGG repeat expansions. Results:Among 16 610 women of childbearing age, 5 684 (34.220%) women had the same number of CGG repeats in the two alleles of FMR1 gene, and 10 926 (65.780%) women had different numbers of repeats in the two alleles. Among the 33 220 FMR1 alleles in 16 610 women of reproductive age, the most common CGG repeat numbers were 29 [48.645% (16 160/33 220)] and 30 [26.276% (8 729/33 220)], while the most frequent CGG genotype was CGG 29/29 [24.726% (4 107/16 610)]. The CGG repeat numbers of FMR1 gene were normal in 16 498 women (99.326%). Among the 112 women (0.674%) with CGG repeat abnormities, 96 (0.578%) women were classified as intermediate carriers, 15 (0.090%) as premutation carriers, and 1 (0.006%) as a full mutation carrier, whose CGG genotype was (36, >200). Conclusion:In the general reproductive-age female population in China, the normal CGG repeat numbers of the FMR1 gene account for 99.326%, while the intermediate carrier rate is 0.578%, and the combined carrier rate of the premutation and full mutation types is 0.096%.

Objective To screen the anti-Streptococcus pneumoniae(Spn)active ingredients in vitro from different po-lar parts of Pilea peltata,and to examine the combined antibacterial effect of the active ingredient and amoxicillin(AMX).Methods A 96-well plate microdilution method was used to determine the minimum inhibitory concentration(MIC)of different polar parts;the most active polar part was separated by preparative high-performance liquid chromatography,and the active ingre-dients were identified using spectral technology.The fractional inhibitory concentration(FIC)of active ingredients and AMX was determined by the 96-well plate chessboard microdilution method.The crystal violet method was used to investigate the effect of ac-tive ingredients on Spn biofilm.The effect of active ingredients on the appearance and morphology of Spn was investigated under the electron microscope.Results The MICs of the petroleum ether part,chloroform part,ethyl acetate part,n-butanol part,and water part were 1.000,1.000,0.500,1.000,and 2.000 mg·mL-1 respectively,among which the ethyl acetate part had the stron-gest antibacterial activity.Three compounds were isolated from ethyl acetate,namely 5,7,3',4'-tetramethoxyflavone 1,8-O-(p-coumaroyl)-1(10)E,4(5)E-humuladien-8-ol 2 and 1-O-p-coumaroyl copaborneol 3.These compounds were all isolated for the first time from Pilea peltate,their MICs against Spn were 200.000,50.000,and 25.000 μg·mL-1 respectively,and the compound 3 had the strongest antibacterial activity;the FIC value of AMX and compound 3 was 0.50,which had a synergistic antibacterial effect on Spn.Both AMX and compound 3 had inhibitory effects on Spn biofilm,but the biofilm inhibition rate of compound 3(59.10±1.04％)was significantly lower than AMX(87.38±0.84)％(P＜0.01);Moreover,there was no significant difference in biofilm inhibition rate between the combination of the two and AMX(P＞0.05).The scanning electron microscope results showed that the bacterial cells in the compound 3 group had a smooth surface but varying degrees of depression.The surface of the bacteri-al cells in the AMX group and the AMX combined compound 3 group showed severe swelling and rupture.Conclusions Fla-vonoids and sesquiterpenoids are both the anti-Spn active components of Pilea peltate.Among them,sesquiterpenoids have more potent antibacterial activity,and their antibacterial action mechanism is related to inhibiting bacterial biofilms.Compound 3 and AMX have a synergistic antibacterial effect on Spn,but its mechanism of action is not by enhancing biofilm inhibition;although compound 3 cannot destroy the cell wall of Spn,it still has a negative impact on the appearance of the bacteria.

Objective To evaluate the application of ELISA randomized quality control,and continuously improve the laboratory testing capacity and quality assurance,in order to gradually improve the application of randomized quality control to the daily testing of ELISA.Methods Collected the quality control data of KEHUA HBsAg,compared the difference between randomized quality control data and immobilized quality control data.Group comparison of randomization quality control between rows and columns.The randomized quality control data were analyzed retrospectively and the quality control chart was established by using the randomized quality control data.Analyzed and compared the lost-control situation of randomized quality control and immobilized quality control.Results Randomized quality control S/CO value(2.831±0.343)and immobilized quality control S/CO value(2.651±0.260)in the same microplate,the difference between two was statistically significant(t=5.970,P＜0.05).The differences between randomized quality control and immobilized quality control in columns 2 to 8 were statistically significant(t=2.285～5.536,all P<0.05).There were no statistically significant differences between randomized quality control and immobilized quality control in column 9 to 12(t=0.031～1.605,all P>0.05).There was no statistically significant difference in randomization quality control among all lines(F=0.858,P＞0.05).The randomized quality control data was used to establish a quality control chart.Within the time range of the collected data,the randomized quality control was out of control for 6 times,all were greater than+3s,and the loss of control rate was 4.72%(6/127).Fixed position quality control lost control 9 times during the same period,all of which were greater than+3s,with a loss of control rate of 0.61%(9/1 481).Conclusion The randomized quality control has a greater possibility to reflect the factors affecting all the samples on the microporous plate.Random quality control can be used to find possible systematic errors in testing.Randomized quality control can gradually be fully applied to daily indoor quality control,but the loss of control rate and coefficient of variation may increase.