Objective: To delineate the epidemiologic profile of rifampicin resistant pulmonary tuberculosis (RR-PTB) among students in Chongqing, so as to provide evidence for effectively controlling RR-PTB outbreaks in schools. Methods: Individual level surveillance records of 395 student RR-PTB cases reported from 2015 to 2024 were extracted from the China Information System for Disease Control and Prevention. The Joinpoint regression analysis was employed to quantify temporal trends in the registration rate of student RR-PTB cases, and the comparison of RR-PTB registration rates with different demographic characteristics and different regions was performed using Chi-square test. Results: From 2015 to 2024, a total of 395 student RR-PTB cases were identified, with the registration rate ranged from 0.07 per 100 000 to 1.47 per 100 000, showed a fluctuating upward trend ( AAPC= 35.22%, t =4.13, P <0.01). A turning point was detected in 2017, rates rose during 2015-2017 (APC=295.23%， t =4.62， P < 0.01 ) and plateaued thereafter (APC=-0.47%， t =-0.12， P =0.91). The proportion of RR-PTB cases occurring among students increased both among all RR-PTB cases (1.54% in 2015, 7.48% in 2024) and all student pulmonary tuberculosis cases (0.20% in 2015, 7.17% in 2024), with significant linear trends ( χ 2 trend =33.55,159.98, both P <0.01). The majority of cases were enrolled in senior high school (50.38%), classified as retreatment (53.92%), of Han ethnicity (75.95%), and diagnosed with multidrug resistant tuberculosis(53.16%). There were significant differences in the composition of different ethnicity, registration category and resistance pattern between different years( χ 2=23.47, 17.23, 59.64，all P <0.05). The South-Eastern Wuling Mountainous Region exhibited the highest notification rate (3.96 per 100 000), whereas the western region had the lowest rate ( 0.47 per 100 000). County level jurisdictions reported higher rates than district level ones (2.16 per 100 000 vs 0.63 per 100 000 ). Statistically significant differences were observed in the RR-PTB reported rates among students across different districts and counties( χ 2=418.05,167.05,both P <0.01). Conclusions From 2015 to 2024, the registration rate of detected student RR-PTB cases in Chongqing showed an increasing trend. Students have become one of the key populations for drug resistant TB prevention and control. Intensified health education and active case finding should be implemented to enhance proactive surveillance capabilities.

Objective To analyze the imaging manifestations of bronchogenic cyst(BC)and summarize the causes of misdiagno-sis,in order to improve the diagnostic and differential diagnostic level for BC.Methods A retrospective analysis was performed on the imaging data of 84 patients surgically and pathologically confirmed BC.All patients underwent plain CT scans,with 66 cases further received contrast-enhanced CT scans and other 12 cases underwent plain MRI scans,6 of which underwent contrast-enhanced MRI scans.Results A1184 cases presented as solitary lesions,comprising mediastinal(n=71),intrapulmonary(n=4)and ectopic(n=9)types.The lesions were predominantly round(69 cases),flattened(5 cases),or irregular(10 cases)in shape.Gas was observed in 4 cases,with one showed air-fluid level.66 cases exhibited soft tissue density,14 cases showed water-like density,and other 4 cases displayed high density.Calcifications,either punctate or arcuate in shape,were found on the lesion margins in 2 cases.Among the 66 cases that underwent contrast-enhanced CT scans,11 showed mild enhancement,with 5 cases only mild annular enhancement of the cyst wall.MRI findings in 12 cases revealed iso-T1 signals and long or slightly long T2 signals,with no enhancement detected on contrast-enhanced scans.The misdiagnosis rate for mediastinal BC was 76.1％(54/71),while all intrapulmonary and ectopic BC were misdi-agnosed preoperatively.Conclusion BC shares similar imaging manifestations with various other diseases,resulting in a high misdi-agnosis rate.Integrating clinical symptoms with multimodal imaging features and enhancing diagnostic awareness and experience are essential for improving the diagnostic accuracy of BC.

Objective To analyze the imaging manifestations of bronchogenic cyst(BC)and summarize the causes of misdiagno-sis,in order to improve the diagnostic and differential diagnostic level for BC.Methods A retrospective analysis was performed on the imaging data of 84 patients surgically and pathologically confirmed BC.All patients underwent plain CT scans,with 66 cases further received contrast-enhanced CT scans and other 12 cases underwent plain MRI scans,6 of which underwent contrast-enhanced MRI scans.Results A1184 cases presented as solitary lesions,comprising mediastinal(n=71),intrapulmonary(n=4)and ectopic(n=9)types.The lesions were predominantly round(69 cases),flattened(5 cases),or irregular(10 cases)in shape.Gas was observed in 4 cases,with one showed air-fluid level.66 cases exhibited soft tissue density,14 cases showed water-like density,and other 4 cases displayed high density.Calcifications,either punctate or arcuate in shape,were found on the lesion margins in 2 cases.Among the 66 cases that underwent contrast-enhanced CT scans,11 showed mild enhancement,with 5 cases only mild annular enhancement of the cyst wall.MRI findings in 12 cases revealed iso-T1 signals and long or slightly long T2 signals,with no enhancement detected on contrast-enhanced scans.The misdiagnosis rate for mediastinal BC was 76.1％(54/71),while all intrapulmonary and ectopic BC were misdi-agnosed preoperatively.Conclusion BC shares similar imaging manifestations with various other diseases,resulting in a high misdi-agnosis rate.Integrating clinical symptoms with multimodal imaging features and enhancing diagnostic awareness and experience are essential for improving the diagnostic accuracy of BC.

Abstract This prospective observational study included 361 benign and malignant breast nodules from 258 women who had underwent breast grayscale ultrasound and had been confirmed pathologically. A total of 396 image features of lesion areas in ultrasonic images were extracted. The radiomic signature was developed using least absolute shrinkage and selection operator algorithms after feature selection using the minimum redundancy maximum relevance method. Receiver operating characteristic curve(ROC)and calibration curve were used to test the performance of the model. The area under the ROC curve(AUC), accuracy, sensitivity, specificity, Youden index for the training cohort were 0.84,0.761,0.840,0.715,0.603. And the AUC, accuracy, sensitivity, specificity, Youden index for the validation cohort were 0.84,0.716, 0.823, 0.654, 0.536. The diagnostic results of data from the radiomics model were basically consistent with the actual situation. Radiomics based on grayscale ultrasound performs well in the differentiation of malignant from benign breast nodules which effectively avoids the subjective diagnosis, and has good clinical application value.

Objective:To explore the effects of stepwise acute pain management on acute pain and post-traumatic stress disorder (PTSD) in children with burns.Methods:From November 2018 to December 2019, 196 children with burns who were admitted to West China Hospital of Sichuan University and met the inclusion criteria were enrolled in the prospective randomized controlled study. The children were divided into traditional pain management group (97 children, 51 males and 46 females, aged 1 to 6 years) and stepwise pain management group (96 children, 55 males and 41 females, aged 1 to 6 years) according to the random number table. Children in traditional pain management group were treated with traditional acute pain care, while the children in stepwise pain management group were treated with stepped acute pain management (moderate pain was treated with oral administration of acetaminophen sustained-release dry suspension at the dose of 10 to 15 mg/kg once every 4 to 6 hours, and severe pain was treated with morphine intravenous injection at the dose of 0.1 to 0.2 mg/kg once every 4 hours) on the basis of traditional acute pain care after admission. The COMFORT behavior scale was applied to compare the resting pain levels of children in the two groups within post injury day (PID) 3 (1, 9, and 17 o'clock each day). The adverse reactions of children in the stepwise pain management group during the treatment period were recorded. The occurrence of PTSD within one month after injury was evaluated in both groups by the revised PTSD scale. Data were statistically analyzed with independent sample t test, Bonferroni correction, analysis of variance for repeated measurement, chi-square test, Wilcoxon rank sum test, and Fisher's exact probability test. Results:The pain scores of children in stepwise pain management group were significantly lower than traditional pain management group at 1, 9, and 17 o'clock on PID 1, 1, 9, and 17 o'clock on PID 2, and 1, 9, and 17 o'clock on PID 3 ( t=2.71, 3.44, 4.05, 4.18, 4.08, 4.19, 4.25, 3.69, 3.71, P<0.05 or P<0.01). The pain scores of children in both groups showed a decreasing trend over time. Of the 96 children in stepwise pain management group, 84 children were treated with oral administration of acetaminophen sustained-release dry suspension, and 12 children were treated with morphine intravenous injection. No adverse reaction occurred during the treatment period. The incidence of PTSD of children in stepwise pain management group within 1 month after injury was 3.12% (3/96), which was significantly lower than 14.43% (14/97) in traditional pain management group, P<0.05. Conclusions:The stepped acute pain management can relieve the acute pain and reduce the incidence of PTSD in children with burns.

Objective To evaluate the diagnostic efficacy of Kwak and ACR( 2017 ) thyroid imaging reporting and data systems ( T I‐RADS ) for thyroid nodules . Methods Cases of thyroid nodule who underwent surgery from January 2015 to M arch 2018 in 15 hospitals in Sichuan province were collected and the ultrasonographic features of thyroid nodules were retrospectively analyzed by trained senior ultrasound physicians using Kwak and ACR T I‐RADS classification methods . Totally ,12 712 thyroid nodules were observed ,7 023 thyroid nodules in 7 023 cases with complete ultrasound and surgical and pathological data were eventually enrolled in the study . T hyroid nodules with solid ,hypoechoic or very hypoechoic ,tall/wide ratio ≥ 1 , margin ill‐defined and microcalcification were classified as malignant signs of ultrasound . M alignant percentage was calculated and diagnostic tests were performed . Results ① T here was a statistical difference between the benign and malignant nodules in the two types of T I‐RADS classification ( P＜0 .01) . ② T he area under ROC curve of Kwak and ACR in the diagnosis of malignant nodules were 0 .89 and 0 .84 ,respectively . T he Youden index of Kwak and ACR were 0 .66 and 0 .57 ,respectively . ③Taking Kwak T I4B and ACR T R4 as critical points for malignancy ,the sensitivity ,specificity ,positive predictive value and negative predictive value of Kwak T I 4B were 75 .0% ,90 .9% ,83 .2% ,and 85 .9% , respectively . T he accuracy of Kwak T I4B was 84 .9% ; T he sensitivity ,specificity ,positive predictive value and negative predictive value of ACR T R4 were 88 .2% ,68 .9% ,62 .9% ,and 90 .8% ,respectively . T he accuracy of ACR T R4 was 76 .2% . T he Kappa value of Kwak TI4B and ACR T R4 was 0 .52 . T he χ2 value of Kwak T I4B and ACR T R4 was 2 174 .6 ( P ＜ 0 .01 ) . Conclusions T he diagnostic values of two T I‐RADS classification methods for thyroid malignant nodules are high . T he overall efficiency of Kwak T I‐RADS classification method is better than that of ACR TI‐RADS classification method .

Objective: To establish real-time qPCR method to analyze each HLA-C allele expression level of individual.Methods:Database including exon 2&3 sequences of HLA class Ⅰalleles was built ,HLA-C allelic specific primers were designed and the real-time quantitative PCR method for analyzing HLA-C allele expression level was built .The allelic specificity of these primers were confirmed in database and 835 normal peripheral blood samples of Han population .The mRNA level of each HLA-C allele from 20 pairs of liver tumor tissues and non-tumor tissues was analyzed by the qPCR method we built .Results:20 pairs of allelic specific primers were designed to distinguish the two HLA-C alleles of each individual with frequency over 0.96%in 835 cases of Han population.Among 55%of the liver cancer tissues ,the expression levels of the two HLA-C alleles from the same tumor tissue changes differently compared to that of the relevant non-tumor tissue.Conclusion:This study provides method for HLA-C allele expression level analysis of Han population and each HLA-C allele expression level is inconsistent of liver cancer tissue .

Objective To explore the value of three-dimensional speckle tracking imaging (3D-STI)in early dectection of left ventricular myocardial dysfunction in patients with breast cancer after receiving Anthracycline.Methods A group of 63 breast cancer postoperative patients were recruited and received a six-cycle epirubicin-based chemotherapy.Electrocardiogram,conventional echocardiography and 3D-STI parameters were measured before chemotherapy and during 24-48 hours after the cumulative dose of 120 mg/m2 ,240 mg/m2 and 360 mg/m2 .The receiver operating characteristics (ROC ) curves of 3D-STl parameters,such as global area strain(GAS),global longitudinal strain(GLS),global circumferential strain (GCS),and global radial strain(GRS)were drawn to determine optimal sensitivity and specificity.Twenty-one healthy female volunteers served as control subjects.Results Compared with before chemotherapy and control subjects,GAS and GLS were significantly reduced at the cumulative dose of 240 mg/m2 ,360 mg/m2 (P <0.05).The area under ROC of GAS was 0.974,and its optimal cut-off value was -3 1 .5%,with a specificity of 87.1 % and a sensitivity of 92.9%.Moreover,correlation analysis showed GAS was significantly associated with cumulative doxorubicin dose(r = -0.834,P < 0.01 ).Conclusions During chemotherapy,GAS can detect minor LV myocardial dysfunction associated with cardiotoxicity of anthracycline.3D-STI is useful in early dectection of left ventricular myocardial dysfunction in patients with breast cancer after receiving anthracycline.

ObjectiveTo investigate the predictive value of heart rate turbulence(HRT) in patients with diabetes mellitus (DM) after acute myocardial infarction (AMI).MethodsNinety-two AMI patients combined with DM (DM group) and 120 AMI patients without DM (non-DM group) were selected.Turbulence onset (TO) and turbulence slope (TS) were two indexes of HRT.HRT was considered positive when TO was ≥0 and TS was ≤2.5 ms/R-R.The differences in clinical data between HRT-positive and HRT-negative patients were compared.And the related risk factors after AMI were analyzed.ResultsAge,left ventricular ejection fraction (LVEF) level,renal insufficiency,LVEF＜40％,standard deviation of sinus cardiac cycle (R-R interval)(SDNN),heart rate variability (HRV) positiveand HRT indexes (TO,TS) between HRT-positive and HRT-negative patients in DM group had significant differences (P ＜ 0.05 ).Age,LVEF level,SDNN and HRT indexes(TO,TS) between HRT-positive and HRT-negative patients in non-DM group had significant differences(P ＜ 0.05).Multivariate Cox regression analysis showed that renal insufficiency (OR=4.8,95％ CI:1.8 - 10.7,P=0.008) and HRT positive (OR=3.7,95％ CI:1.5 - 8.6,P=0.070) in DM group had statistical significance.And HRT positive in non-DM group had statisticalsignificance(OR=23.0,95％ CI:5.2 ～ 86.0,P ＜ 0.01 ).ConclusionsHRT,an index of dynamic electrocardiogram,can predict the risk in patients with DM or without DM after AMI.

OBJECTIVETo construct the specific stable expression and high efficiency small interfering RNA(siRNA) expression vector that can block DNMT1 gene function.

METHODSUsing vector-based RNA interference technique, the authors constructed a vector to transcribe functional short interfering RNA (RNAi). After transfection by lipofectmine (TM) reagent, the treated cells were selected by G418. The expression levels of RNA and protein of DNMT1 were analyzed by reverse transcription polymerase chain reaction(RT-PCR) and Western blotting. The status of methylation of E-cadherin was analyzed by methylation-specific PCR(MSP).

RESULTSThe expression level of endogenous DNMT1 mRNA in transfected SMMC-7721 cell lines with DNMT1 RNAi construct was 43% less than that in control cell 7721-pSU cell lines. The protein level in the former was about 10% less than that in the latter. The efficiency of the siRNA of DNMT1 was found to be higher than 90%. Demethylation of promoter of E-cadherin was obtained due to the inhibition of DNMT1.

CONCLUSIONDNMT1 siRNA stable expressing vector was obtained by gene-recombined technology. There was no complete sameness between the levels of protein and RNA in gene silenced cell lines. The efficiency of the siRNA should be confirmed by Western-blotting.

Blotting, Western ; Cell Line, Tumor ; DNA (Cytosine-5-)-Methyltransferase 1 ; DNA (Cytosine-5-)-Methyltransferases ; genetics ; metabolism ; DNA Methylation ; Genetic Vectors ; genetics ; Green Fluorescent Proteins ; genetics ; metabolism ; Humans ; Microscopy, Fluorescence ; RNA Interference ; RNA, Small Interfering ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Transfection