OBJECTIVE: This study aimed to investigate the prevalence of HIV pretreatment drug resistance (PDR) and the transmission clusters associated with PDR-related mutations in newly diagnosed, treatment-naive patients between 2020 and 2023 in Dehong prefecture, Yunnan province, China. METHODS: Demographic information and plasma samples were collected from study participants. PDR was assessed using the Stanford HIV Drug Resistance Database. The Tamura-Nei 93 model within HIV-TRACE was employed to compute pairwise matches with a genetic distance of 0.015 substitutions per site. RESULTS: Among 948 treatment-naive individuals with eligible sequences, 36 HIV subtypes were identified, with unique recombinant forms (URFs) being the most prevalent (18.8%, 178/948). The overall prevalence of PDR was 12.4% (118/948), and resistance to non-nucleotide reverse transcriptase inhibitors (NNRTIs), nucleotide reverse transcriptase inhibitors (NRTIs), and protease inhibitors (PIs) was 10.7%, 1.3%, and 1.6%, respectively. A total of 91 clusters were identified, among which eight showed evidence of PDR strain transmission. The largest PDR-associated cluster consisted of six CRF01_AE drug-resistant strains carrying K103N and V179T mutations; five of these individuals had initial CD4+ cell counts < 200 cells/μL. CONCLUSION The distribution of HIV subtypes in Dehong is diverse and complex. PDR was moderately prevalent (12.4%) between 2020 and 2023. Evidence of transmission of CRF01_AE strains carrying K103N and V179T mutations was found. Routine surveillance of PDR and the strengthening of control measures are essential to limit the spread of drug-resistance HIV strains.
Humans ; HIV Infections/virology* ; China/epidemiology* ; Drug Resistance, Viral ; Male ; Adult ; Female ; Middle Aged ; HIV-1/genetics* ; Anti-HIV Agents/therapeutic use* ; Myanmar/epidemiology* ; Young Adult ; Prevalence ; Adolescent ; Mutation

Objective To analyze the risk factors for postoperative recurrence in patients with chronic sinusitis and nasal polyps(CRSwNP)treated by endoscopic sinus surgery(ESS),and to construct a predictive model.Methods A retrospective study was conducted on 203 patients with CRSwNP who underwent ESS in the hospital from March 2022 to February 2023.These patients were divided into a recurrence group(n=43)and an non-recurrence group(n=160)based on whether they experienced recurrence after surgery.Clinical data were collected and analyzed using univariate analysis to identify significant differences.Lasso regression was used to screen potential influencing factors.Multivariate logistic regression was employed to analyze the risk factors.A nomogram was constructed for postoperative recurrence model,and the receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the model.Results Single-factor analysis showed that disease duration,Lund-Mackay CT score,SNOT-22 score,EOS,ECP,total IgE,CRP,IL-5,and IL-1β in the recurrence group after ESS were higher than those in the non-recurrence group(P<0.05),while the UPSIT score,CD3+,CD4+,CD8+,and CD4+/CD8+were lower(P<0.05);the proportion of patients with allergic rhinitis,asthma,no preoperative glucocorticoid treatment,and surgery time≥2 hours in the recurrence group after ESS was higher than that in the non-recurrence group(P<0.05).Multivariate logistic regression analysis model showed that disease duration(OR=1.389,95%CI:1.094～1.763,P=0.007),combined asthma(OR=2.997,95%CI:1.065～8.432,P=0.038),Lund-Mackay CT score(OR=1.156,95%CI:1.027～1.301,P=0.016),EOS(OR=1.540,95%CI:1.249～1.898,P<0.001),total IgE(OR=1.005,95%CI:1.000～1.009,P=0.041),and IL-5(OR=1.165,95%CI:1.078～1.260,P<0.001)were risk factors for ESS recurrence.Based on multivariate logistic regression analysis nomogram,the area under the ROC curve(AUC)was 0.9057;the sensitivity 76.74%;the specificity 87.5%;the average absolute error(MAE)of the calibration curve 0.03;the mean square error(MSE)0.00157,and the absolute error at the 0.9 percentile 0.065.Conclusions Disease course,the presence of asthma,Lund-Mackay CT score,EOS,total IgE,and IL-5 are all risk factors for postoperative recurrence in patients with CRSwNP.Moreover,the relevant nomogram model can be used as a reliable tool for assessing the risk of postoperative recurrence in CRSwNP.

Objective To analyze the risk factors for postoperative recurrence in patients with chronic sinusitis and nasal polyps(CRSwNP)treated by endoscopic sinus surgery(ESS),and to construct a predictive model.Methods A retrospective study was conducted on 203 patients with CRSwNP who underwent ESS in the hospital from March 2022 to February 2023.These patients were divided into a recurrence group(n=43)and an non-recurrence group(n=160)based on whether they experienced recurrence after surgery.Clinical data were collected and analyzed using univariate analysis to identify significant differences.Lasso regression was used to screen potential influencing factors.Multivariate logistic regression was employed to analyze the risk factors.A nomogram was constructed for postoperative recurrence model,and the receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the model.Results Single-factor analysis showed that disease duration,Lund-Mackay CT score,SNOT-22 score,EOS,ECP,total IgE,CRP,IL-5,and IL-1β in the recurrence group after ESS were higher than those in the non-recurrence group(P<0.05),while the UPSIT score,CD3+,CD4+,CD8+,and CD4+/CD8+were lower(P<0.05);the proportion of patients with allergic rhinitis,asthma,no preoperative glucocorticoid treatment,and surgery time≥2 hours in the recurrence group after ESS was higher than that in the non-recurrence group(P<0.05).Multivariate logistic regression analysis model showed that disease duration(OR=1.389,95%CI:1.094～1.763,P=0.007),combined asthma(OR=2.997,95%CI:1.065～8.432,P=0.038),Lund-Mackay CT score(OR=1.156,95%CI:1.027～1.301,P=0.016),EOS(OR=1.540,95%CI:1.249～1.898,P<0.001),total IgE(OR=1.005,95%CI:1.000～1.009,P=0.041),and IL-5(OR=1.165,95%CI:1.078～1.260,P<0.001)were risk factors for ESS recurrence.Based on multivariate logistic regression analysis nomogram,the area under the ROC curve(AUC)was 0.9057;the sensitivity 76.74%;the specificity 87.5%;the average absolute error(MAE)of the calibration curve 0.03;the mean square error(MSE)0.00157,and the absolute error at the 0.9 percentile 0.065.Conclusions Disease course,the presence of asthma,Lund-Mackay CT score,EOS,total IgE,and IL-5 are all risk factors for postoperative recurrence in patients with CRSwNP.Moreover,the relevant nomogram model can be used as a reliable tool for assessing the risk of postoperative recurrence in CRSwNP.

Objective To analyze and compare the changes in local functional activity of the brain under different recovery times after a 90-day,-6° head down bed rest(HDBR)experiment,clarify the mechanism of brain function remodeling during gravity adaptation,and provide imaging basis and guidance for the model construction and health assessment.Methods 36 healthy male volunteers underwent resting-state functional magnetic resonance imaging(rs-fMRI)scans before HDBR(PRE),3 days after 90-day HDBR(R+3),and 26-28 days after 90-day HDBR(R+26-28),and calculated regional homogeneity(ReHo)and low-frequency amplitude(ALFF)and perform statistical analysis between different time points.Results Compared with PRE-status,ReHo value in the left inferior parietal gyrus and ALFF value in the right posterior cingulate gyrus decreased significantly in R+3 status,while ReHo value in the left calcarine,right lingual gyrus and ALFF value in the precuneus,left paracentral lobule,and right postcentral gyrus increased significantly.At R+26-28 status,more brain areas showed significant changes.Conclusion 90 days of long-term HDBR and subsequent recovery will lead to changes in the neural functional activities of the brain's default network,sensorimotor network and visual network,and obvious adaptive remodeling will occur after a longer period of gravity re-adaptation and recovery.

Objective: To establish a dynamic syndromic surveillance system in the border areas of Yunnan Province based on information technology, evaluate its effectiveness and timeliness in the response to common communicable disease epidemics and improve the communicable disease prevention and control in border areas. Methods: Three border counties were selected for full coverage as study areas, and dynamic surveillance for 14 symptoms and 6 syndromes were conducted in medical institutions, the daily collection of information about students' school absence in primary schools and febrile illness in inbound people at border ports were conducted in these counties from January 2016 to February 2018 to establish an early warning system based on mobile phone and computer platform for a field experimental study. Results: With syndromes of rash, influenza-like illness and the numbers of primary school absence, the most common communicable disease events, such as hand foot and mouth disease, influenza and chickenpox, can be identified 1-5 days in advance by using EARS-3C and Kulldorff time-space scanning models with high sensitivity and specificity. The system is easy to use with strong security and feasibility. All the information and the warning alerts are released in the form of interactive charts and visual maps, which can facilitate the timely response. Conclusions: This system is highly effective and easy to operate in the detection of possible outbreaks of common communicable diseases in border areas in real time, so the timely and effective intervention can be conducted to reduce the risk of local and cross-border communicable disease outbreaks. It has practical application value.
Humans ; Influenza, Human ; Sentinel Surveillance ; Syndrome ; China ; Cell Phone

【Objective】 To analyze the metagenomics and microbiology of voluntary blood donors in China, so as to assess the potential threats of emerging infectious diseases to the safety of blood transfusion. 【Methods】 12 300 plasma samples (10 mL each) collected by central blood stations in Chongqing, Liuzhou, Urumqi, Mianyang, Wuhan, Nanjing, Mudanjiang, and Dehong Prefecture area from 2012 to 2018 were subjected to total DNA extraction after ultracentrifugation (32 000 rpm/min, centrifugal radius 91.9 mm) in minipools of 160 donations. The metagenomic library was constructed, and deep sequencing was conducted by Illumina Hiseq 4 500. By comparing with reference sequences of bacteria, fungi, parasites and viruses, metagenomic data were analyzed, classification of microbes were identified, and potentially harmful pathogens were evaluated. 【Results】 A total of 632 GB clean data were obtained by deep sequencing, and the top three pathogens were Pseudomonas(0.561 1%), Burkholderia(0.468 7%) and Serratia(4.242 0%). Pathogens with potential threat which could be transmitted by blood transfusion or blood products were found, such as human parvovirus B19(0.126 6%), Leishmania spp(1.348 5%) and Toxoplasma gondii(0.615 8%). 【Conclusion】 Our study analyzed metagenomics of voluntary blood donors in parts of China and revealed pathogens that may cause potential harm to blood safety, which were helpful for targeted prevention and control of emerging infectious diseases.

A 35-year-old male patient was admitted in October, 2018 to Burn and Plastic Surgery Department, Sanya Central Hospital (Hainan Third People’s Hospital) with diagnosis of complex pressure ulcer, hip arthritis, urethral fistula. The patient was treated with systemic support, debridement, negative pressure drainage, bilateral gluteus maximus myocutaneous flap and scrotal flap. After the two-week treatment with this method, the wounds were healed completely.

A 35-year-old male patient was admitted in October, 2018 to Burn and Plastic Surgery Department, Sanya Central Hospital (Hainan Third People’s Hospital) with diagnosis of complex pressure ulcer, hip arthritis, urethral fistula. The patient was treated with systemic support, debridement, negative pressure drainage, bilateral gluteus maximus myocutaneous flap and scrotal flap. After the two-week treatment with this method, the wounds were healed completely.

Objective: To investigate the prognostic impact of alterations of epidermal growth factor receptor(EGFR) and MGMT in glioblastoma. Methods: The retrospective study included 161 supratentorial glioblastomas diagnosed in the Department of Pathology, Xuanwu Hospital, Capital Medical University from 2009 to 2015. EGFR and EGFRvⅢ protein expression was detected by immunohistochemistry; EGFR amplification was detected by fluorescence in situ hybridization; MGMT promoter methylation was detected by pyrosequencing. The change of molecular genetics EGFR and MGMT and outcome were assessed statistically. Results: There were 161 patients, including 85 (52.8%) males and 76 (47.2%) females. The mean age was 53 years, and the median overall survival was 13 months. The integrated classification of glioblastoma included 16 IDH-mutant, 134 wild type, and 11 NOS. The rate of overexpression of EGFR protein was 32.9%(53/161), and that of EGFR amplification was 37.5%(18/48). There was high concordance between immunohistochemistry and FISH(85.4%, Kappa=0.475, P<0.01) and between the level of EGFR protein and EGFR amplification (P<0.01). Twelve cases showed EGFRvⅢ expression, and all also showed EGFR protein overexpression; 149 cases were EGFRv Ⅲ wild type, and EGFR protein overexpression was seen in 27.5%(41/149) of cases. There was no correlation between EGFR and EGFRv Ⅲ expression. Of all cases, 70.2%(106/151) showed MGMT promoter methylation by pyrosequencing. The changes of molecular genetics of EGFR and MGMT were not related. EGFR amplification and protein overexpression had no significant relationship with prognosis. Patients with EGFRv Ⅲ-mutant had shorter survival time than the EGFRv Ⅲ-wild type(P=0.014); patients with MGMT promoter methylation had better prognosis than without (PFS:P=0.002,OS:P=0.006),and MGMT promoter methylation was an independent predictor for overall survival (HR=0.269, 95%CI 0.124-0.583, P=0.001). Conclusions EGFR protein expression by immunohistochemistry correlates with the status of EGFR amplification. Patients with EGFRv Ⅲ-mutant tumors have poorer prognosis than that with EGFRv Ⅲ-wild type tumors. MGMT promoter methylation is closely associated with prognosis and an independent predictor for overall survival.

Objective: To investigate the usefulness of loss of CIC expression as the prescreening detection of 1p/19q co-deletion in the diagnosis of oligodendroglial tumors and its prognostic implication. Methods: The retrospective study included 113 oligodendroglial tumors diagnosed in the Department of Pathology, Xuanwu Hospital, Capital Medical University. Expression of CIC protein was detected by immunohistochemistry, and the 1p/19q co-deletion by fluorescence in situ hybridization in all the tumors; and the correlation of the loss of protein and 1p/19q co-deletion with prognosis was assessed. Results: The rate of negative CIC protein expression was 59.3% (67/113) in 113 oligodendroglial tumors. CIC protein expression was differentially lost in various gliomas, 85.7% (42/49) in pure oligodendrogliomas and 39.1% (25/64) in mixed oligodendroglial tumors (P<0.01). The loss of CIC protein expression showed a sensitivity of 76.1% (54/71), specificity 71.1% (27/38), false positive rate of 16.9% (11/65), and a false negative rate of 38.6% (17/44). In 63 cases integrated diagnosis as oligodendroglial tumors with mutant IDH and 1p/19q co-deletion, the loss of CIC protein expression was 81.0% (51/63); the sensitivity and specificity were increased to 81.0% (51/63) and 76.9% (20/26), and the false positive rate and false negative rate decreased to 10.5% (6/57) and 37.5% (12/32), respectively. By using Kaplan-Meier analysis, the CIC negative group showed a trend towards better outcome than the CIC positive group, but there was no statistical difference (overall survival: P=0.218; progression free survival: P=0.249). Conclusions Detection of the lost CIC protein expression can predict the chromosome 1p/19q co-deletion. In oligodendroglial tumors with IDH mutant and 1p/19q co-deletion, there is no relation between prognosis and CIC protein expression.