Objective This study aims to analyze the epidemiological and etiological characteristics of hand, foot, and mouth disease (HFMD) in Urumqi City, Xinjiang from 2014 to 2022, in order to provide theoretical basis for the prevention and control of HFMD in Urumqi City. Methods We collected and analyzed the reported HFMD cases in Urumqi City from the National Information System for Infectious Diseases Reporting during the period of 2014-2022. Results A total of 17 138 cases of HFMD were reported in Urumqi City from 2014 to 2022, with an average annual incidence rate of 52.66/100 000. The overall trend showed a decrease, and the peak months were from May to July. The top three districts with the highest incidence rates were High-tech Zone, Shayibake District, and Tianshan District. The male-to-female ratio was 1.48:1，and there were statistically significant differences in the incidence rates among gender (χ²=2.28,P>0.05). The majority of cases (90.23%) were children aged 0-6 years, primarily scattered children, and other enterovirus strains became dominant after 2017. Conclusion HFMD has shown a decreasing trend in Urumqi City, Xinjiang in recent years. The disease primarily affects pre-school children, and other enterovirus strains have become the dominant strains in the area. It is recommended to develop scientifically effective prevention and control measures based on the local situation to control the spread of HFMD.

Objectives:To analyze the cardiovascular disease(CVD)burden attributable to the dietary risk factors in the Chinese population aged≥55 years from 1990 to 2019. Methods:The Global Burden of Disease(GBD)2019 database was used to analyze the impacts of 13 dietary risk factors on 11 types of CVD.The main analysis indicators were mortality and disability-adjusted life years(DALY)rate.The population aged≥55 years was divided into 7 age groups to analyze the disease burden of CVD caused by dietary risk factors in different sex and age groups. Results:The CVD mortality and DALY rate attributable to dietary risk factors in 2019 were 233.34/100 000 and 4 388.85/100 000,respectively,which were decreased by 25.97%and 35.47%compared with the respective rate in 1990.The CVD mortality and DALY rate attributable to high-sodium diet in 2019 were 102.81/10 0000 and 2 178.80/10 0000,which decreased by 37.09%and 41.62%,respectively,compared with the respective rate in 1990,but still ranked the first in dietary risk factors.The ranking of CVD disease burden attributed to diet low in vegetable,in fiber and in fruit also significantly decreased in 2019.The impact of dietary risk factors on increased burden of CVD was higher in aged groups.In 2019,the CVD mortality and DALY rate in the age group 85 years and above were 3 012.21/100 000 and 25 650.51/100 000,respectively,which were much higher than other age groups.The CVD mortality and DALY rate in males were 286.94/100 000 and 5 653.18/100 000,respectively,which were significantly higher than those in females(185.35/100 000 and 3 256.93/100 000). Conclusions:Compared with 1990,the burden of CVD attributable to dietary risk factors decreased significantly in 2019.High-sodium diet remains the most important dietary risk factor of CVD.The burden of CVD attributable to dietary risk factors changed greatly from 1990 to 2019,and targeted publicity and education on healthy diet should be enhanced to further reduce the dietary risk of CVD,especially in the elderly and male population.

Owing to incurable castration-resistant prostate cancer (CRPC) ultimately developing after treating with androgen deprivation therapy (ADT), it is vital to devise new therapeutic strategies to treat CRPC. Treatments that target programmed cell death protein 1 (PD-1) and programmed death ligand-1 (PD-L1) have been approved for human cancers with clinical benefit. However, many patients, especially prostate cancer, fail to respond to anti-PD-1/PD-L1 treatment, so it is an urgent need to seek a support strategy for improving the traditional PD-1/PD-L1 targeting immunotherapy. In the present study, analyzing the data from our prostate cancer tissue microarray, we found that PD-L1 expression was positively correlated with the expression of heterogeneous nuclear ribonucleoprotein L (HnRNP L). Hence, we further investigated the potential role of HnRNP L on the PD-L1 expression, the sensitivity of cancer cells to T-cell killing and the synergistic effect with anti-PD-1 therapy in CRPC. Indeed, HnRNP L knockdown effectively decreased PD-L1 expression and recovered the sensitivity of cancer cells to T-cell killing in vitro and in vivo, on the contrary, HnRNP L overexpression led to the opposite effect in CRPC cells. In addition, consistent with the previous study, we revealed that ferroptosis played a critical role in T-cell-induced cancer cell death, and HnRNP L promoted the cancer immune escape partly through targeting YY1/PD-L1 axis and inhibiting ferroptosis in CRPC cells. Furthermore, HnRNP L knockdown enhanced antitumor immunity by recruiting infiltrating CD8⁺ T cells and synergized with anti-PD-1 therapy in CRPC tumors. This study provided biological evidence that HnRNP L knockdown might be a novel therapeutic agent in PD-L1/PD-1 blockade strategy that enhanced anti-tumor immune response in CRPC.

Objective:To evaluate the effectiveness of perioperative fasting abbreviation in traumatic patients with orthopaedic trauma and diabetes mellitus undergoing selective surgery.Methods:The patients were selected for this prospective nonrandomized controlled study who had undergone selective surgery from June 2019 to June 2021 at Department of Orthopaedic Trauma, Beijing Jishuitan Hospital. They were divided into an intervention group and a control group according to the wards where they stayed. The intervention group was fasted for solids from 0 o'clock on the surgery day and received oral solution with 6.25% maltodextrin which had been prepared by the nutritional department 3 hours prior to surgery. The control group was fasted for either liquids or solids from the midnight before surgery. All patients were evaluated according to the wake-up score and defensive reflex score after surgery. Once they were awakened, they were allowed slag-free drinks. Normal food was allowed if there was no discomfort after 2 hours. The 2 groups were compared in terms of basic information, actual preoperative fasting time, total amount of preoperative drinking, and postoperative time for initial drinking and eating. The perioperative subjective feelings (anxiety, thirst, hunger, nausea, fatigue, dizziness, sweating, stomach discomfort, etc.), grip strength and blood glucose were observed and compared between the 2 groups. Adverse reactions in the 2 groups were also observed.Results:A total of 135 patients were included, including 52 in the intervention group and 83 in the control group. The intervention group consisted of 22 males and 30 females aged from 30 to 84 years; the control group consisted of 39 males and 44 females aged from 29 to 81 years. There was no significant difference in the basic information between the 2 groups, showing comparability ( P>0.05). The intervention group had significantly shorter preoperative fasting time [3.5 (2.5, 6.3) h versus 12.0 (9.0, 16.0) h], significantly higher water intake before surgery [300 (200, 300) mL versus 100 (100, 200) mL], significantly shorter postoperative fasting time [0.08 (0, 1.25) h versus 2.00(0, 6.00) h], and significantly reduced time to return to normal diet [2.0 (2.0, 2.3) h versus 3.0(2.0, 6.0) h] than the control group (all P<0.05). The symptoms of anxiety, fatigue, sweating, and stomach discomfort in the intervention group were significantly fewer than those in the control group throughout the evaluation period. The thirst in the intervention group was significantly alleviated than that in the control group immediately after returning to the ward after surgery, and the dizziness and hunger were significantly alleviated than those in the control group when the patients left the ward to the operation room before surgery and immediately after returning to the ward. The symptom of nausea after returning to normal diet in the intervention group was significantly relieved compared with the control group. All the comparisons above showed statistically significant differences ( P<0.05). The blood glucose in the intervention group 2 hours after taking slag-free drinks was significantly higher than that in the control group ( Z=-2.108, P=0.035). There was no significant difference in the blood glucose between the 2 groups during other measurement periods ( P>0.05). There were no serious adverse reactions in either of the 2 groups. Conclusion:The protocol of perioperative fasting abbreviation may be safe and feasible for the patients with orthopaedic trauma and diabetes mellitus undergoing selective surgery, because it shows benefits of improving the patients' subjective feelings and stabilizing the blood glucose perioperatively.

Objective:To investigate the value of neutrophil-to-lymphocyte ratio (NLR) in the diagnosis and prognosis evaluation of primary hepatocellular carcinoma.Methods:The clinical data of 100 patients pathologically diagnosed as primary liver cancer who were admitted to the First Medical Center of Chinese PLA General Hospital from January 2013 to December 2015 were retrospectively analyzed. Serum alpha fetoprotein (AFP), a conventional marker for hepatocellular carcinoma diagnosis was used as the control. The fourfold table diagnostic test was applied to analyze the sensitivity and specificity of serum NLR in the diagnosis of hepatocellular carcinoma, and the correlation with the degree of tumor differentiation was also analyzed.Results:The proportion of patients with high NLR (≥1.70) [56% (56/100)] was higher than the proportion of patients with positive AFP [44% (44/100)] in all 100 hepatocellular carcinoma patients, but the difference was not statistically significant ( χ2 = 2.88, P = 0.08). Among AFP-positive patients, the median survival time of patients with low and high NLR was 59 and 48 months, respectively, and the difference was statistically significant ( χ2 = 3.91, P = 0.048), and high NLR was an independent risk factor affecting the prognosis of hepatocellular carcinoma patients ( HR = 1.232, 95% CI 1.055-1.438, P = 0.008). Conclusions:The detection of NLR combined with AFP can improve the diagnostic rate of hepatocellular carcinoma before surgery. High NLR is an independent risk factor affecting the prognosis of patients with primary hepatocellular carcinoma.

Objective:To summarize clinical experience in the management of Abernethy malformation combined with focal nodular hyperplasia (FNH).Methods:Three patients with Abernethy malformation combined with FNH who were managed in the Department of Hepatobiliary Surgery, the First Medical Center of Chinese PLA General Hospital from January 2010 to December 2018 entered into this study. There were one male aged 35 years and two females aged 21 years and three years and nine months, respectively. Patients underwent digital subtraction angiography (DSA) with balloon dilation, shunt vasulature ligation, portal vein (PV) pressure measurement and other investigations were performed to study the changes of PV pressure before and after treatment.Results:DSA indicated that the congenital portal shunt of the patients was Abernethy deformity Ⅱ and Ⅰb, respectively, and with combined FNH diagnosed preoperatively. One patient was admitted to hospital for partial hepatectomy 5 years ago for the treatment of FNH, which presented with recurrent abdominal pain. The PV pressure increased from 8.5, 9.0, 20.0 cmH 2O(1 cmH 2O=0.098 kPa) to 15.0, 21.0, 25.0 cmH 2O after portal cavity shunt vasculature/portal vein ligation and splenic artery ligation/portal body shunt ligation, respectively. The PV blood flow into the liver increased, and DSA suggested shunt vessel occlusion. On follow-up, all patients survived well. Conclusion:Ligation or constriction of shunt vessels significantly improved the flow of PV into liver in Abernethy malformation patients with FNH. The treatment benefited long-term survival.

BACKGROUND: The use of silicate bioceramics as a tissue-engineered bone scaffold has poor ability to promote osteogenesis. Studies have shown that copper, magnesium, and other essential trace elements have obvious effects on the induction and stimulation of osteoblasts and hemangioblasts. OBJECTIVE: To investigate the effects of silicate bioactive ceramics with Cu and Mg on osteoblast proliferation and osteogenesis. METHODS: Cu-silicate bioceramics, Mg-silicate bioceramics, and Cu-Mg-silicate bioactive ceramics were prepared by the sol-gel method (molar ratio of both Cu and Mg in ceramics was 5%). Three experimental groups were CS-5Cu, CS-5Mg, CS-5Cu/5Mg groups. The silicate bioactive ceramics served as the control group (denoted as CS). X-ray diffraction (XRD) and Fourier transform infrared (FTIR) spectroscopy were used to characterize the samples. The surface crystallization of bioceramics was detected. Osteoblasts were co-cultured with four groups of ceramics for 24 hours. Osteoblast proliferation index, alkaline phosphatase secretion, osteopontin and osteocalcin gene expression, vinculin and actin protein expression were determined. RESULTS AND CONCLUSION: (1) The crystallization ability of different silicate bioceramic samples followed the order of CS-5Cu>CS>CS-5Cu/5Mg>CS-5Mg. (2) Osteoblast proliferation index followed the rule of CS-5Cu/5Mg>CS-5Cu≈CS-5Mg>CS. (3) Alkaline phosphatase secretion was in the order of CS-5Cu/5Mg>CS-5Cu≈CS-5Mg>CS. (4) Osteopontin and osteocalcin gene expression followed the rule of CS-5Cu/5Mg>CS-5Cu≈CS-5Mg>CS. (5) Vinculin and actin protein expression was in the order of CS-5Cu/5Mg>CS-5Cu≈CS-5Mg>CS. (6) These results suggest that Cu- or Mg-silicate, in particular Cu-Mg-silicate bioactive ceramics can promote the proliferation of osteoblasts and the expression of osteogenesis-related genes as well as cell adhesion and spreading.

Objective To evaluate the clinical application and effect of computerized digital sur -gical assisted design and manufacture for reconstruction of mandibular defect with vascularied iliac crest flap graft .Methods CT was used to scan the craniofacial and maxillofacial region of mandibular ameloblastoma patient ,and then the 3D model of the maxillofacial skeleton was reconstructed using the computerized digital surgical aid design to simulate the focal resection and the mandibular defect reconstruction with the iliac crest flap .Surgical guides were prepared by 3D printing to assist focal re-section and bone reshaping .Postoperatively ,clinical and CT examinations were performed to observe the restoration of the patient's facial appearance and occlusal relationship ,as well as wound healing and graft survival .Results Postoperative review results showed that the bone graft survived well ,and the anastomosed bone was formed .The wound in the surgery area healed .No recurrence of the tumor was found after clinical and CT examination .The maxillofacial appearance was well restored ,and the re-sidual occlusal relationship recovered well .Conclusions The use of computerized digital surgical aided design combined with 3D printing technology can effectively simplify the mandibular segmental defect repair and reconstruction and optimize the postoperative repair effect .

In recent years, the incidence of hepatocellular carcinoma (HCC) has risen year by year, leading to a high mortality rate. At present, surgical treatment is the major cure for HCC, and in general, HCC is diagnosed at late stages. Due to the heterogeneity of HCC and different sensitivities to drugs, the treatment efficacy of advanced HCC is poor. In this paper, we retrospectively analyzed the prog-ress of HCC treatments and reviewed important progression, which provides new view for the clinical improvement of the total surviv-al of patients with HCC.

Objective To explore the role of computer-aided design and manufacturing technology (CAD/CAM technology) in the repair of mandibular defects using the fibular osteomyocutaneous free flap.Methods Eight patients with a portion of mandible defect due to various reasons were subjected to preoperative CT scan,obtaining CT data of the mandible and the fibular bone to be transplanted.The original and the reconstructed skull model,as well as the mandible and fibula osteotomy guide plates,was printed using CAD/CAM technology.The titanium plates were preformed using the reconstructed skull model,and the operation was performed with the help of guide plates and a preformed titanium plate.The patients were followed up for 6 to 24 months to evaluate the operation effect.Results Two in 8 cases had flap necrosis caused by immune rejection of the implant,and one case had flap necrosis due to poor postoperative blood glucose control.The other 5 patients healed at the primary site and the fibular myocutaneous flap survived well.There were no serious complications in the donor and recepient site.The patients' satisfaction was high.Conclusions The reconstruction of mandible with the aid of CAD/CAM technique has the advantages of accelerating the operation process,shortening the operation time,improving the accuracy of mandibular amputation and fibular shaping,promotlng postoperative function and morphology recovery.