Objective: o analyze the epidemic characteristics of five sexually transmitted diseases (STDs), including syphilis, gonorrhea, condyloma acuminatum, genital herpes and genital Chlamydia trachomatis infection in Yangzhou City, Jiangsu Province from 2019 to 2023, so as to provide the reference for the prevention and control strategies of STDs. Methods: Data of the onset time and diagnostic types of STDs cases in Yangzhou City from 2019 to 2023 were collected from the Infectious Disease Surveillance System of Chinese Disease Prevention and Control Information System. The temporal, regional and population characteristics of five types of STDs was analyzed using the descriptive epidemiological method. Results: A total of 10 895 cases of STDs were reported in Yangzhou City from 2019 to 2023, with an average annual reported incidence rate of 47.83/105. The average annual reported incidence rates of syphilis, gonorrhea, condyloma acuminatum, genital herpes and genital Chlamydia trachomatis infections were 41.11/105, 2.83/105, 2.59/105, 0.43/105 and 0.85/105, respectively. The reported incidence rate of STDs showed a decreasing trend from 2019 to 2023 (P<0.05), with an average annual growth rate of -3.44%. The reported incidence rates of syphilis and gonorrhea showed a decreasing trend (both P<0.05), with average annual growth rates of -4.26% and -6.47%, respectively. The reported incidence rate of genital Chlamydia trachomatis infection showed an increasing trend (P<0.05), with an average annual growth rate of 22.32%. Baoying County, Guangling District and Hanjiang District had the top three reported incidence rates of STDs, at 56.61/105, 55.61/105 and 46.50/105, respectively. The average annual reported incidence rate of STDs among males was higher than that among females (53.19/105 vs. 42.54/105, P<0.05). The STD cases were primarily people aged 50 years and above, with 6 641 cases accounting for 60.95%. The occupations of STD cases were mainly farmers, housekeepers and unemployed, with 4 670 and 3 273 cases accounting for 42.86% and 30.04%, respectively. Conclusions The overall reported incidence of STDs in Yangzhou City from 2019 to 2023 showed a downward trend, while the reported incidence of genital Chlamydia trachomatis infection showed an upward trend. The individuals aged 50 years and above, farmers, housekeepers and the unemployed were identified as high-risk groups for STDs.

[摘 要] 尽管基于T细胞的免疫检查点阻断（ICB）和过继性T细胞治疗已在临床上取得了显著疗效，但大多数实体瘤患者仍无法实现对免疫疗法的长期应答。其中一个重要原因是肿瘤微环境（TME）中复杂的代谢模式和抑制性信号会引发免疫细胞的代谢重编程，从而削弱其抗肿瘤效应。本文回顾不同分化状态的CD8+ T细胞的代谢偏好性，探讨CD8+ T细胞在与肿瘤细胞和TME相互作用过程中发生的代谢变化，讨论这些代谢变化如何影响CD8+ T细胞分化、功能和干性，以及如何利用代谢分子或者代谢通路来增强CD8+ T细胞的抗肿瘤能力，从而实现嵌合抗原受体基因修饰T淋巴细胞（CAR-T细胞）疗法和ICB疗法增效。

OBJECTIVES: With the accelerating aging of the population and the rising prevalence of chronic diseases, the number of patients with pressure injuries (PIs) has increased markedly, prolonging the period of disease-related care. Informal caregivers play a critical role in the daily care of patients with pressure injuries, and their care burden has become increasingly prominent. This study aims to investigate the current status and influencing factors of care burden among informal caregivers of patients with PIs, providing evidence for targeted intervention strategies. METHODS: A total of 170 informal caregivers of patients with PIs were selected by convenience sampling from the Third Xiangya Hospital of Central South University. General demographic and clinical data of both patients and caregivers were collected. The Zarit Caregiver Burden Inventory (ZBI), Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs, General Self-Efficacy Scale (GSES), and Family Caregiver Task Inventory (FCTI) were used to assess caregiving burden, knowledge-attitude-practice level, self-efficacy, and caregiving ability, respectively. Pearson correlation analysis was conducted to evaluate relationships among ZBI, Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs, GSES, and FCTI scores. Stepwise multiple linear regression analysis was used to identify factors influencing caregiving. RESULTS: Among the 170 patients with pressure injuries, the age was (65.52±15.88) years; 118 (69.41%) were male and 52 (30.59%) were female. The duration of PIs was less than 1 month in 108 (63.53%) cases and 1 to 6 months in 40 cases (23.53%). Stage II injuries were predominant (135 cases, 79.41%). A total of 193 pressure injury sites were recorded, most commonly located at the sacrococcygeal region (127 sites, 65.80%), followed by the head (3 sites, 1.55%), shoulder and back (9 sites, 4.66%), feet (24 sites, 12.44%), and other regions (30 sites, 15.55%). Informal caregivers were 48.82% aged 46 to 59 years, 54.71% female, 41.77% primarily spouses and 47.06% children of the patients, and 77.06% lived with the patients. Caregivers who received assistance from others or had higher family per-capita monthly income reported significantly lower caregiver burden scores than those without assistance or with lower income (all P<0.001). The total ZBI score was 50.89±14.95, indicating a moderate burden. The total scores of the Knowledge-Attitude-Practice Scale for Informal Caregivers, GSES, and FCTI were 50.61±7.22, 26.03±7.11, and 14.76±8.70, respectively. Pearson correlation analysis revealed that ZBI scores were correlated with scores on the Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs (r=-0.543, P<0.001), GSES scores (r=-0.545, P<0.001), and FCTI scores (r=0.800, P<0.001). The scores on Knowledge-Attitude-Practice Scale for Informal Caregivers of patients with PIs were correlated with GSES scores (r=0.500, P<0.001) and FCTI scores (r=-0.461, P<0.001); GSES scores was negatively correlated with FCTI scores (r=-0.415, P<0.001). Stepwise multiple linear regression analysis showed that assistance availability, family per-capita monthly income, total scores on the Knowledge-Attitude-Practice Scale for Informal Caregivers of Patients with PIs, total GSES score, and total FCTI score were the main influencing factors of caregiver burden, jointly explaining 79.38% of its variance. CONCLUSIONS The main factors influencing the caregiving burden of informal caregivers of patients with PIs include the availability of assistance, family per-capita monthly income, total score on the Knowledge-Attitude-Practice Scale for Informal Caregivers of PI patients, total score on the GSES, and total score on the FCTI. Developing targeted intervention strategies addressing these factors may help alleviate the caregiving burden among informal caregivers of patients with PIs.
Humans ; Caregivers/psychology* ; Pressure Ulcer/nursing* ; Female ; Male ; Middle Aged ; Cost of Illness ; Adult ; Aged ; Surveys and Questionnaires ; Health Knowledge, Attitudes, Practice ; Self Efficacy ; Caregiver Burden ; China

Andrographolide sulfonate (AS) is a sulfonated derivative of andrographolide extracted from Andrographis paniculata (Burm.f.) Nees, and has been approved for several decades in China. The present study aimed to investigate the novel therapeutic application and possible mechanisms of AS in the treatment of rheumatoid arthritis. Results indicated that administration of AS by injection or gavage significantly reduced the paw swelling, improved body weights, and attenuated pathological changes in joints of rats with adjuvant-induced arthritis. Additionally, the levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and IL-1β in the serum and ankle joints were reduced. Bioinformatics analysis, along with the spleen index and measurements of IL-17 and IL-10 levels, suggested a potential relationship between AS and Th17 cells under arthritic conditions. In vitro, AS was shown to block Th17 cell differentiation, as evidenced by the reduced percentages of CD4⁺ IL-17A⁺ T cells and decreased expression levels of RORγt, IL-17A, IL-17F, IL-21, and IL-22, without affecting the cell viability and apoptosis. This effect was attributed to the limited glycolysis, as indicated by metabolomics analysis, reduced glucose uptake, and pH measurements. Further investigation revealed that AS might bind to hexokinase2 (HK2) to down-regulate the protein levels of HK2 but not glyceraldehyde-3-phosphate dehydrogenase (GAPDH) or pyruvate kinase M2 (PKM2), and overexpression of HK2 reversed the inhibition of AS on Th17 cell differentiation. Furthermore, AS impaired the activation of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signals in vivo and in vitro, which was abolished by the addition of lactate. In conclusion, AS significantly improved adjuvant-induced arthritis (AIA) in rats by inhibiting glycolysis-mediated activation of PI3K/AKT to restrain Th17 cell differentiation.
Animals ; Th17 Cells/immunology* ; Diterpenes/pharmacology* ; Arthritis, Rheumatoid/metabolism* ; Proto-Oncogene Proteins c-akt/immunology* ; Glycolysis/drug effects* ; Cell Differentiation/drug effects* ; Phosphatidylinositol 3-Kinases/genetics* ; Rats ; Male ; Rats, Sprague-Dawley ; Humans ; Andrographis paniculata/chemistry* ; Arthritis, Experimental/drug therapy* ; Interleukin-17/immunology* ; Signal Transduction/drug effects*

Background: The function of CD69 expressed on T cells in chronic hepatitis B (CHB) remains unclear. We aimed to elucidate the roles of CD69 on T cells in the disease process and in antiviral therapy for CHB. Methods: We enrolled 335 treatment-naive patients with CHB and 93 patients with CHB on antiviral therapy. CD69, antiviral cytokine production by T cells, T-helper (Th) cells, and inhibitory molecules of T cells were measured using flow cytometry, and clinical-virological characteristics were examined dynamically during antiviral therapy. Results: CD69 expression on CD3+, CD4+, and CD8+ T cells was the lowest in the immune-active phase and was negatively correlated with liver transaminase activity, fibrosis features, inflammatory cytokine production by T cells, and Th-cell frequencies but positively with inhibitory molecules on T cells. CD69 expression on CD3+, CD4+, and CD8+ T cells decreased after 48 weeks of antiviral therapy, and patients with hepatitis B e antigen (HBeAg) seroconversion in week 48 showed lower CD69 expression on T cells at baseline and week 48. The area under the ROC curve of CD69 expression on T cells at baseline for predicting HBeAg seroconversion in week 48 was 0.870, the sensitivity was 0.909, and the specificity was 0.714 (P = 0.002). Conclusions CD69 negatively regulates T-cell immunity during CHB, and its expression decreases with antiviral therapy. CD69 expression predicts HBeAg seroconversion in week 48. CD69 may play an important negative role in regulating T cells and affect the efficacy of antiviral therapy.

Objective:To investigate the effect of Chinese Herbal Anti-Alopecia and Hair Growth Solution(CHAaHGS)on the hair growth through in vitro experiments on the human dermal papilla cells(HDPCs),in vivo experiments in the C57BL/6 mice,and human efficacy tests,and to clarify its potential mechanism.Methods:The HDPCs were divided into control group,CHAaHGS group,and minoxidil group.MTT method was used to detect the proliferation activities of HDPCs in various groups;enzyme-linked immunosorbent assay(ELISA)method was used to detect the levels of vascular endothelial growth factor(VEGF),hepatocyte growth factor(HGF),insulin-like growth factor-1(IGF-1),and transforming growth factor β1(TGF-β1)in the supernatant of HDPCs in various groups;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of VEGF,HGF,IGF-1,TGF-β1,and alkaline phosphatase(ALP)mRNA in the HDPCs in various groups;Western blotting method was used to detect the expression levels of β-catenin,dishevelled segment polarity protein 1(DVL1),glycogen synthase kinase 3β(GSK-3β),phosphorylated GSK-3β(p-GSK-3β),and wingless-type MMTV integration site family member 3a(Wnt3a)proteins in the HDPCs in various groups.A total of 18 mice were randomly divided into control group,CHAaHGS group,and minoxidil group,with 6 mice in each group.The mouse hair loss model was established using hair removal cream,and corresponding drug treatments were administered immediately after hair removal.The lengths and weights of newly grown hair on day 21 of the mice in various groups were detected;HE staining was used to observe the morphology of hair follicles in the dorsal depilated skin areas of the mice in various groups on day 7;ELISA method was used to detect the levels of VEGF,HGF,IGF-1,and TGF-β1 in the skin tissue of dorsal depilated areas of the mice in various groups.Sixty subjects were randomly divided into control group and CHAaHGS group,with 30 subjects in each group.The numbers of hair loss and hair densities of the subjects in various groups were detected at weeks 0,4,8,and 12.Results:The MTT assay results showed that compared with control group,the proliferation activity of the cells in 50 mg·L-1CHAaHGS group was significantly increased(P＜0.01).The ELISA assay results showed that compared with control group,the levels of VEGF,HGF,and IGF-1 in the cell supernatant of HDPCs in CHAaHGS group were significantly increased(P＜0.05 or P＜0.01),and the TGF-β1 level was significantly decreased(P＜0.01).The RT-qPCR results showed that compared with control group,the expression levels of VEGF,HGF,IGF-1,and ALP mRNA in the cells in CHAaHGS group were significantly increased(P＜0.05 or P＜0.01),and the TGF-β1 mRNA expression level was significantly decreased(P＜0.01).The Western blotting results showed that compared with control group,the expression levels of β-catenin,DVL1,p-GSK-3βand Wnt3a proteins in the cells in CHAaHGS group were significantly increased(P＜0.05 or P＜0.01),and the GSK-3β protein expression level was significantly decreased(P＜0.05).In animal experiments,on day 21,compared with control group,the length of newly grown hair of the mice in CHAaHGS group was significantly increased(P＜0.05),and the hair weight was significantly increased(P＜0.01).On day 7,the HE staining results showed that compared with control group,the hair follicle spacing of the mice in CHAaHGS group was significantly decreased(P＜0.05),and the number of hair follicles was significantly increased(P＜0.01);the ELISA assay results showed that compared with control group,the levels of VEGF,HGF,and IGF-1 in skin tissue of dorsal depilated area of the mice in CHAaHGS group were significantly increased(P＜0.05 or P＜0.01),and the TGF-β1 level was significantly decreased(P＜0.05).In human efficacy test,compared with control group,the number of hair loss of the subjects in CHAaHGS group was significantly decreased at week 12(P＜0.01),and the local hair density was increased(P＜0.05).Conclusion:CHAaHGS promotes hair growth,and the mechanism may be related to its ability to increase the proliferation activity of HDPCs,induce the secretion of VEGF,HGF,and IGF-1,and activate the Wnt/β-catenin signaling pathway.

The contents, application progress, application effect and optimization strategy of group pregnancy health care model were reviewed, in order to provide reference for the establishment of standardized intervention and health management practice strategies of rural women′s pregnancy care in line with China′s national conditions.

Objective To investigate the changes and clinical significance of serum 25-hydroxyvitamin D3[25(OH)D3],blood calcium and bone metabolism indexes in menopausal women with benign paroxysmal positional vertigo(BPPV).Methods A total of 103 menopausal BPPV patients from Hangzhou Ninth People's Hospital from August 2020 to August 2021 were enrolled into BPPV group.According to the one-year recurrence situation,they were divided into recurrence group(n=18)and non-recurrence group(n=85).A total of 50 healthy menopausal women during the same period were enrolled as control group.The clinical data,serum 25(OH)D3,calcium and bone metabolism indexes[procollagen typeⅠN-terminal propeptide(PINP),N-terminal midfragment of osteocalcin(N-MID),β-isomerised C-terminal telopeptide of collagen typeⅠ(β-CTX),bone alkaline phosphatase(BALP)]were collected.Logistic regression model was constructed to analyze the risk factors of BPPV in menopausal women.The predictive value of related indexes for BPPV recurrence was analyzed by receiver operating characteristic curves.Results The serum 25(OH)D3 level in BPPV group was significantly lower than that in control group(P<0.05),and the proportion of long-term irregular diet,PINP,N-MID and BALP levels were significantly higher than those in control group(P<0.05).Multivariate Logistic regression analysis showed that low 25(OH)D3,high PINP,high N-MID and high BALP were all risk factors for BPPV in menopausal women(P<0.05).The 25(OH)D3 level in recurrence group was significantly lower than that in non-recurrence group(P<0.05),and the PINP,N-MID and BALP levels were significantly higher than those in non-recurrence group(P<0.05).The area under the curve(AUC)of 25(OH)D3,PINP,N-MID,BALP and the four combined predictions for BPPV recurrence were 0.833,0.654,0.697,0.782 and 0.910,respectively,and the AUC of the four combined predictions was the largest.The sensitivity and specificity were 98.97%and 70.62%,respectively.Conclusion There is no significant change in level of serum calcium in menopausal women with BPPV.Decreased serum 25(OH)D3 and increased PINP,N-MID and BALP are risk factors of BPPV,which can be applied to predict BPPV recurrence.

Objective:To investigate the clinical value of multiparametric myocardial imaging using a dual-layer detector spectral CT in the non-invasive preoperative assessment of patients with coronary atherosclerotic heart disease (CHD) undergoing percutaneous coronary intervention (PCI).Methods:The clinical and imaging data of 90 patients who underwent coronary CT angiography (CCTA) with dual-layer spectral detector CT and invasive coronary angiography (ICA) within 30 days at the Affiliated Changshu Hospital of Nantong University from January 2021 to October 2022 were retrospectively analyzed. A total of 189 coronary arteries were included in the study cohort. The patients were divided into PCI ( n=44) and non-PCI groups ( n=46) according to whether they received PCI after evaluation with ICA. The diameter stenosis rate of the coronary arteries, myocardial iodine concentration (IC) and effective atomic number (Z eff) values were obtained from CCTA conventional and spectral images. The IC values and Z eff values of the myocardium in the areas with abnormal perfusion were compared with those in the areas with normal perfusion. The diagnostic performance of these parameters, as well as their combined model, was evaluated and compared using receiver operating characteristic (ROC) curve and area under the curve (AUC) in the pre-PCI assessment of patients with CHD. Results:Baseline patient data did not show statistically significant differences between the PCI and non-PCI groups (all P>0.05). There were statistically significant differences in IC values [(0.42±0.28) and (2.26±0.48) mg/ml] and Z eff values (7.39±0.33 and 8.50±0.25) between the myocardium areas with abnormal perfusion and the myocardium areas with normal perfusion in all patients (all P<0.001). The AUC for assessing whether patients with CHD need PCI treatment using myocardial IC and Z eff values were 0.865 and 0.853, respectively, which were significantly higher than assessment based only on lumen diameter stenosis rate (AUC=0.726, P<0.001). Conclusions:The IC and Z eff derived from myocardial spectral images can be used to diagnose myocardial perfusion abnormalities in patients with CHD. The spectral myocardial multi-parameters imaging shows promising potentials in pre-PCI assessment of patients with CHD, which can improve the efficiency of evaluation and may help to avoid unnecessarily invasive procedures.

ObjectiveTo explore the metabolic changes during the development of Tupaia belangeri breast tumors, to investigate the close relationship between the changes of serum metabolic substances and the occurrence and progression of tumors, and to screen for biomarkers reflecting the progression of breast tumors. MethodsBreast tumors in Tupaia belangeri were induced by orally administering 7,12-dimethylbenzoanthracene (DMBA) three times, with a 15-day interval between each administration, along with a high-fat and high-sugar diet. The DMBA-induced breast cancer group and the DMBA-inducedwithout breast cancer group were compared with the control group. Untargeted determination of serum metabolites was performed using gas chromatography-time-of-flight mass spectrometry (GC-TOFMS) in DMBA-induced Tupaia belangeri with breast cancer, DMBA-induced without breast cancer and the control group. Multidimensional statistical analysis including unsupervised principal component analysis (PCA), and orthogonal partial least squares analysis (OPLS-DA) were conducted. Furthermore, t-test was used for intergroup differential comparison. Differential metabolites were screened under VIP>1 and P<0.05 conditions, and significantly changing differential metabolites were identified using the HMDB online database. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway database was utilized to enrich metabolic-related gene regulatory pathways. ResultsThe incidence of breast tumors was 40% in DMBA-induced Tupaia belangeri. Compared with the control group, 30 metabolic differential products were detected in the serum of the group with breast cancer, with 18 down-regulated and 12 up-regulated (VIP>1, P<0.05). KEGG pathway analysis revealed significant changes in four metabolic pathways: glutamate metabolism, glyceride metabolism, citric acid cycle, and alanine metabolism. Compared with the group without breast cancer, 18 metabolic differential products were detected, with 7 down-regulated and 11 up-regulated (VIP>1, P<0.05). KEGG pathway analysis revealed significant changes in the citric acid cycle and glutamate metabolism. Compared with the control group, 31 metabolic differential products were detected in the serum of the groups without breast cancer, with 14 down-regulated and 17 up-regulated (VIP>1, P<0.05). KEGG pathway analysis revealed significant changes in three metabolic pathways: glutamate metabolism, glyceride metabolism, and citric acid cycle. ConclusionMetabolomics analysis can reveal the characteristics of changes in metabolites in the serum of breast tumors. The results suggest that glutamate metabolism, glyceride metabolism, citric acid cycle, and alanine metabolism pathways are associated with the occurrence and development of DMBA-induced breast tumors in Tupaia belangeri. It provides a foundation for further research into the biological mechanism of breast cancer.