Background::The prevalence of type 2 diabetes mellitus (T2DM) has been rapidly growing in Chinese populations in recent decades, and the shift in eating habits is a key contributing factor to this increase. Eating out of home (EOH) is one of the major shifts in eating habits during this period. However, the influence of EOH on the incidence of T2DM among Chinese urban workers is unknown.Methods::The cross-sectional study involved an analysis of 13,904 urban workers recruited from 11 health examination centers in the major cities of China to explore the relationship between EOH and T2DM between 2013 September and 2016 March.Results::Average weekly EOH frequency ≥10 times was positively associated with increased incidence of T2DM in the sampled population (OR: 1.31 [1.11-1.54], p < 0.01), most notably in participants ≤45 years old (OR: 1.41[1.11-1.80], p < 0.01]) and in males (OR:1.26 [1.06-1.51], p < 0.01). An EOH frequency of 5 times/week appears as a threshold for a significant increase in the odds of T2DM. Weekly EOH frequency ≥5 times was associated with increased odds of T2DM in a dose-response manner in the total population and almost all subgroups ( poverall association < 0.05 and pnonlinearity ≤ 0.05). Conclusion::This study showed that a frequency of EOH (≥5 times/week) was associated with a frequency-dependent increase in the odds of T2DM urban workers in China. More nutrition promotion is needed to improve the eating behavior of Chinese urban workers to reduce T2DM risk.

Background::The prevalence of type 2 diabetes mellitus (T2DM) has been rapidly growing in Chinese populations in recent decades, and the shift in eating habits is a key contributing factor to this increase. Eating out of home (EOH) is one of the major shifts in eating habits during this period. However, the influence of EOH on the incidence of T2DM among Chinese urban workers is unknown.Methods::The cross-sectional study involved an analysis of 13,904 urban workers recruited from 11 health examination centers in the major cities of China to explore the relationship between EOH and T2DM between 2013 September and 2016 March.Results::Average weekly EOH frequency ≥10 times was positively associated with increased incidence of T2DM in the sampled population (OR: 1.31 [1.11-1.54], p < 0.01), most notably in participants ≤45 years old (OR: 1.41[1.11-1.80], p < 0.01]) and in males (OR:1.26 [1.06-1.51], p < 0.01). An EOH frequency of 5 times/week appears as a threshold for a significant increase in the odds of T2DM. Weekly EOH frequency ≥5 times was associated with increased odds of T2DM in a dose-response manner in the total population and almost all subgroups ( poverall association < 0.05 and pnonlinearity ≤ 0.05). Conclusion::This study showed that a frequency of EOH (≥5 times/week) was associated with a frequency-dependent increase in the odds of T2DM urban workers in China. More nutrition promotion is needed to improve the eating behavior of Chinese urban workers to reduce T2DM risk.

Genomic epidemiology, based on whole-genome sequencing technology and bioinformatics analysis, can make up for the shortcomings of traditional molecular typing methods and provide a novel insight for the genetic evolution and transmission of pathogenic fungi. The combination of genetic information and epidemiological methods of pathogenic fungi can predict fungi transmission routes and risks, and provide a theoretical basis for the development of public health strategies for fungi infection prevention and control. This paper summarizes the development of molecular epidemiology and genomic epidemiology, as well as the application of genomic epidemiology methods in the analyses of genetic relationship, origin, evolution, drug resistance, virulence, and genome-wide association of pathogenic fungi, and discusses the development of pathogenic fungi genomic epidemiology.

Background::Cancer immunotherapy has emerged as a promising strategy against triple-negative breast cancer (TNBC). One of the immunosuppressive pathways involves programmed cell death-1 (PD-1) and programmed cell death ligand-1 (PD-L1), but many patients derived little benefit from PD-1/PD-L1 checkpoint blockades treatment. Prior research has shown that MYC, a master transcription amplifier highly expressed in TNBC cells, can regulate the tumor immune microenvironment and constrain the efficacy of immunotherapy. This study aims to investigate the regulatory relationship between MYC and PD-L1, and whether a cyclin-dependent kinase (CDK) inhibitor that inhibits MYC expression in combination with anti-PD-L1 antibodies can enhance the response to immunotherapy. Methods::Public databases and TNBC tissue microarrays were used to study the correlation between MYC and PD-L1. The expression of MYC and PD-L1 in TNBCs was examined by quantitative real-time polymerase chain reaction and Western blotting. A patient-derived tumor xenograft (PDTX) model was used to evaluate the influence of a CDK7 inhibitor THZ1 on PD-L1 expression. Cell proliferation and migration were detected by 5-ethynyl-2′-deoxyuridine (EdU) cell proliferation and cell migration assays. Tumor xenograft models were established for in vivo verification. Results::A high MYC expression level was associated with a poor prognosis and could alter the proportion of tumor-infiltrating immune cells (TIICs). The positive correlation between MYC and PD-L1 was confirmed by immunostaining samples from 165 TNBC patients. Suppression of MYC in TNBC caused a reduction in the levels of both PD-L1 messenger RNA and protein. In addition, antitumor immune response was enhanced in the TNBC cancer xenograft mouse model with suppression of MYC by CDK7 inhibitor THZ1. Conclusions::The combined therapy of CDK7 inhibitor THZ1 and anti-PD-L1 antibody appeared to have a synergistic effect, which might offer new insight for enhancing immunotherapy in TNBC.

Objective To investigate the clinical effect of hemorrhoid elimination agent made by our hospital for the treatment of constipation, blood in stool, pain in defecation, anal burning sensation and abdominal distension after hemorrhoids surgery. Methods A number of 120 patients from January 2017 to June 2019 undergo hemorrhoid surgery in the department of anorectal surgery in our hospital were enrolled in the study. The patients were divided into the experimental group and the control group by the random digit table. The experimental group took hemorrhoid elimination agent orally, and the control group took paraffin oil orally. The two groups were compared in terms of the clinical efficacy, symptom and sign scores before and after treatment and adverse reactions. Results The total clinical effective rate of patients in the experimental group was 95%，and the total effective rate in the control group was 81.6% . Compared withpre-treatment, the fecal character score in the experimental group was significantly improved after treatment, and the incidence of hematochezia was significantly reduced after treatment (P<0.05). There was no significant difference in fecal character score and incidence of hematochezia before and after treatment in the control group(P>0.05). After treatment, the score of symptoms and signs in the experimental group was significantly lower than that in the control group (P<0.05). The incidence of hematocele in the experimental group was 5 %，while that in the control group was 21.67%，with significant difference between them(P<0.05). Conclusion With obvious effect and high safety, hemorrhoid elimination agent can effectively relieve constipation and hemostasis after hemorrhoidectomy, which is worthy of promotion in clinic.

Objective To investigate the application effect of the sandwich teaching method in the course of Surgical Nursing . Methods Two classes of the students majoring in nursing were randomly divided into control group and observation group, with 36 students in each group. The students in the control group received the traditional teaching method, and those in the observation group received the sandwich teaching method . The teaching effect was compared between the two groups by theoretical assessment and questionnaire survey. SPSS 24.0 was used for analysis of variance and the t-test. Results Compared with the control group, the observation group had significantly higher scores of course assessment, learning atmosphere, and learning initiative. The observation group also had significantly higher good rates of learning atmosphere and learning initiative than the control group(P<0.05). Conclusion The sandwich teaching method can significantly improve students' abilities of communication and problem solving, arouse their enthusiasm of learning, and increase the interestingness of classroom, and therefore, it has a practical value in teaching.

OBJECTIVETo observe the efficacy of acupuncture on pain after replantation of severed finger.

METHODSA total of 80 patients who underwent replantation of severed finger were randomly divided into an observation group and a control group, 40 cases in each one. The patients in the control group were treated with postoperative routine care of hand surgery, while patients in the observation group, based on the regular treatment, were treated with acupuncture within first 72 h of surgery. The health side of Yanglingquan (GB 34), Xuehai (SP 10), Hegu (LI 4), Houxi (SI 3) were selected and the needles were retained for 30 min. The acupuncture was given for 6 times. The evaluation was performed by using visual analogue scale (VAS) 2 h, 4 h, 6 h, 12 h, 24 h, 48 h and 72 h after surgery. The use of analgesics after surgery was recorded in the two groups, and the blood supply and survival rate of severed finger were evaluated.

RESULTSCompared between the two groups, the VAS 4 h, 6 h, 12 h, 24 h and 48 h after surgery in the observation group was lower than that in the control group (all P<0. 05); the use frequency of analgesics in the observation group was lower than that in the control group (P<0. 05); the abnormality rate of blood supply in the observation group was lower than that in the control group (P<0. 05).

CONCLUSIONAcupuncture can significantly relieve postoperative pain of replantation of severed finger, and reduce the occurrence rate of abnormal blood supply, which is worthy of clinical promotion.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Female ; Finger Injuries ; complications ; surgery ; Humans ; Male ; Middle Aged ; Pain, Postoperative ; etiology ; therapy ; Replantation

Objective To study the therapeutic effects of acupuncture therapy for prevent pain of replantation of severed finger. Methods Totals of 80 patients were randomly divided into two groups from March 2012 to March 2014. Patients in the treatment group were treated with acupuncture therapy, and patients in the control group were treated with routine care. Results The pain scores of 4, 6, 12, 24 and 48 hours after the treatment in the treatment group were (2. 13 ± 0. 33), (2. 75 ± 0. 67), (3. 25 ± 0. 59), (3. 43 ± 0. 78) and (2.85 ±0.62), which were significantly lower than those in the control group (t =2. 421, 2. 270, 7. 223, 7. 614, 4. 106, respectively;P<0. 05). In the treatment group, one case had vascular crisis, with an incidence of 2. 5%. In the control group, four cases had vascular crisis, with an incidence of 15. 0%, there was a significant difference between the two groups (χ2 =2. 165,P<0. 05). One case in the treatment group had diclofenac sodium suppositories, with an incidence of 2. 5%. While seven cases had diclofenac sodium suppositories, with an incidence of 17. 5% in the control group, there was a significant difference between the two groups (χ2 =2. 287,P<0. 05). Conclusions Acupuncture therapy can significantly reduce postoperative pain and reduce the incidence of vascular crisis, it is worthy of promotion.

OBJECTIVETo assess the value of combined evaluation of serum follicle-stimulating hormone (FSH), inhibin B (INHB), chromosome karyotyping and AZF microdeletion of Y-chromosome (AZF-MD-Ych) in predicting the success of testicular sperm aspiration (TESA) in azoospermic patients.

METHODSA total of 262 azoospermic patients were divided into two groups with normal (n=162) and abnormal (n=100) serum FSH levels. INHB levels, INHB/FSH ratio, chromosome karyotype patterns of the peripheral lymphocytes, and AZF-MD-Ych were compared between the two groups. Among the patients receiving TESA, the success rate of the procedure was compared between the two groups after excluding abnormalities in INHB, chromosome karyotype and AZF-MD-Ych.

RESULTSSignificant differences were found between the two groups in serum INHB level, INHB/FSH and chromosome karyotypes (P<0.05), but not in AZF-MD-Ych (P>0.05). After excluding the abnormalities in chromosome karyotypes, AZF-MD-Ych and INHB, sperms were obtained successfully by TESA from 61.82% (34/55) of patients with normal FSH but from none of those with abnormal FSH (P<0.01).

CONCLUSIONA combined evaluation of serum FSH, INHB, chromosome karyotypes and AZF-MD-Ych can effectively predict the success of TESA in azoospermic patients, and abnormalities in all the 4 indices suggest a very low success rate of sperm retrieval by TESA.

Azoospermia ; Chromosome Deletion ; Chromosomes, Human, Y ; Follicle Stimulating Hormone ; blood ; Humans ; Infertility, Male ; Inhibins ; blood ; Karyotyping ; Male ; Prognosis ; Sex Chromosome Aberrations ; Sex Chromosome Disorders of Sex Development ; Sperm Retrieval ; Spermatozoa ; Testis ; Treatment Outcome

Objective To elaborate the role of hepatic inherent macrophages and monocyte-derived macrophages in acute liver injury.Methods A model of acute liver injury in mice was induced via intraperitoneally injection of CCl 4 .Af-ter CCl4 injection, analysis of the expression of CD45, F4/80, Ly6C and CD11b on the hepatic macrophage surface was performed by flow cytometry at 24, 48 and 72 h before the hepatic inherent macrophages (CD45+F4/80hi) and monocyte-de-rived macrophages ( CD45+F4/80 lo ) were sorted at the same time .The relative expression of cytokines in the two popula-tions of macrophages was detected by qRT-PCR.Results Compared with control , the number of total F4/80 +cells in the liver was markedly increased after CCl 4 injection, especially at 72 h.The number of CD45+F4/80lo cells increased signifi-cantly after CCl4 injection 24 h.The mRNA levels of MCP-1, TNF-α, TGF-β1, matrix metalloproteinase(MMP)-12 and MMP-13 were elevated significantly both in F 4/80 hi and F4/80 lo macrophages .IL-12βand IL-6 mRNA levels increased significantly only in F4/80hi macrophages, while the level of MMP-9 mRNA increased markedly only in F4/80lo macropha-ges.When compared with F4/80lo macrophages, MCP-1 and MMP-12 mRNA levels were elevated significantly , while the level of TNF-αmRNA decreased significantly in F4/80hi macrophages.Conclusion In acute liver injury, hepatic inherent macrophages and monocyte-derived macrophages both express inflammatory cytokines , promoting inflammation response and leading to liver damage .The ability to recruit inflammatory monocytes into the liver is much stronger ,the expression of in-flammatory cytokines ( IL-12βand IL-6 ) and MMP-12 is higher , but the expression of inflammatory cytokines ( TNF-α) MMP-9 is lower in hepatic inherent macrophages than in monocyte-derived macrophages .