Avian coccidiosis, an acute parasitic disease that mainly harms chicks, is widely prevalent across the world, which poses a serious threat to poultry industry. Because of the single prophylactic formulations, veterinary clinical treatment of coccidiosis mainly relies on chemically synthesized agents, polyether ionophores and Chinese herbal medicines. The introduction of novel anticoccidial drugs is slow for a long period of time, and there is an increasing problem of anticoccidial drug resistance following long-term use, which has become an urgent problem to be solved in poultry industry. This review summarizes the levels of anticoccidial drug resistance across China from 2018 to 2023, and analyzes the resistance to various anticoccidial agents in coccidia. It is indicated that the overall prevalence of anticoccidial drug resistance is high in coccidia, and development of novel anticoccidial agents and products with reduced antibiotics use and alternatives of antibiotics is of an urgent need.

Objective:To analyze the predictive value of echocardiography combined with diaphragmatic ultrasound on the outcome of removing machine for patients who underwent cardiac valve replacement for mechanical ventilation.Methods:Retrospectively,a total of 57 patients who adopt mechanical ventilation after underwent cardiac valve replacement in the First People's Hospital of Yibin from January 2022 to March 2023 were selected as the study subjects.According to the results of removing machine,the patients were divided into failed group(11 cases)and successful group(46 cases).All patients underwent echocardiography combined with diaphragmatic ultrasound examination.The indicators of echocardiography,included left ventricular ejection fractions(LVEF),right ventricular fractional area change(RVFAC)and systolic myocardial velocity(Sa),between different groups were compared.The early diastolic mitral annular tissue velocity(e')was recorded to calculate the ratio of early diastolic transmitral flow velocity(E)to e'(E/e'),and the indicators of echocardiography and diaphragmatic ultrasound.Logistic regression analysis was performed to analyze the factors affecting the failure of removing machine.Receiver operating characteristic(ROC)curve was drawn to evaluate the predictive values of echocardiography and diaphragmatic ultrasound indicators for the failure of removing machine in mechanical ventilation.Results:The differences of the differences of LVEF,RVFAC and Sa between failed group and successful group were no significant(P>0.05).The E/e'value of the successful group was 10.06±1.30,which was significantly lower than 12.69±2.96 of the failed group,and the difference was statistically significant(t=2.084,P＜0.05).The diaphragm thickening fraction(DTF)and diaphragm excursion(DE)values of the successful group were respectively 41.34±10.74 and 13.04±1.18,which were significantly higher than 19.67±5.37 and 11.27±0.94 of the failed group,respectively,and the differences between the two groups were statistically significant(t=2.148,2.776,P＜0.05).The results of logistic regression analysis showed that low expression of DTF and DE,as well as high expression of E/e',were all influence factors for the failure of removing machine for patients adopted mechanical ventilation after underwent cardiac valve replacement.The ROC results showed that the best cut-off value of the prediction model was 0.0893,and the area under curve(AUC)values were 0.713(95%CI:0.646～0.758),0.710(95%CI:0.651～0.779),0.752(95%CI:0.657～0.805)and 0.886(95%CI:0.782～0.991).Conclusion:The combination of echocardiography and diaphragm ultrasound has better prediction for the outcome of removing machine,which high higher clinical application value.

Objective To evaluate the medium-to-long-term efficacy of parallel stenting technology in treating aortoiliac occlusive disease(AIOD).Methods The clinical data of 18 patients with symptomatic AIOD,who received parallel stenting(using metal bare stent or covered stent)to reconstruct the aortoiliac artery at the Affiliated Hospital of Southwest Medical University of China from March 2017 to May 2019,were retrospectively analyzed.The patients included 14 males and 4 females with a mean age of(64.78±9.04)years.The surgical details,clinical success,complications,and stent patency rate were recorded.Results Both technical success and clinical success were achieved in all patients.A total of 62 stents were implanted,including 52 bare metal stents,9 covered stents and one renal artery balloon dilatation stent.After stent implantation,one patient each developed lacunar cerebral infarction,brachial artery pseudoaneurysm,decreased hemoglobin level,and thrombus migration into the renal artery,and after active management the patients were well discharged.The incidence of complications was 22％(4/18).During the follow-up period,3 patients developed in-stent restenosis,and the vascular lumen returned to patency after a second time of endovascular intervention.The postoperative 12-,18-,24-,30-,and 36-month main patency rates were 100％,95％,90％,85％,and 85％,respectively.Conclusion For the treatment of AIOD,parallel stenting technology has obtained satisfactory 3-year results.For the patients with complicated AIOD,this technique also carries a high technical success rate and an acceptable medium-to-long-term patency rate.

【Objective】 To analyze the impact of preoperative anemia on perioperative red blood cell transfusion and prognosis of children undergoing septal defect repair. 【Methods】 The medical records of 208 patients under 18 years old with septal defect, i. e. ventricular septal, atrial septal, ventricular septal with atrial septal defect, in a hospital from December 2018 to March 2022 were collected. They were divided into anemic group (n=52) and non-anemic group (n=156) according to whether they were anemic before operation. The basic information, as well as preoperative, intraoperative and postoperative blood transfusion, postoperative ICU stay, postoperative infection rate and average length of stay were compared between the two groups. 【Results】 The incidence of preoperative anemia in the children with septal defect was 25.0% (52/208). The age, preoperative body weight(kg) and hemoglobin (g/L) of anemic group and non-anemic group was 0.67(0.33, 2) vs 2(1, 3), 6.5(5, 10) vs10.5(8, 14) and 102(91.5, 107) vs 127(121, 134) respectively, all P<0.05. Preoperative, intraoperative and postoperative blood transfusion rates in the anemic and non-anemic groups were 11.54% (6/52) vs 0% (0/156), 92.31% (48/52) vs 72.44% (113/156), 51.92% (27/52) vs 25.0% (39/156), all P<0.05. Postoperative ICU stay (d) and mean length of stay(d) of anemia group and non-anemia group was 3 (2, 6) vs 2 (2, 3) and 19(13, 25) vs14(11, 18) respectively, P<0.05. 【Conclusion】 Preoperative anemia is an important factor affecting perioperative red blood cell transfusion in children with septal defect repair, and also an important reason for prolonging postoperative ICU stay and hospital stay.

Objective:To analyze germline pathogenic mutations in patients with upper tract urothelial carcinoma(age≤60 years old), and to explore the clinicopathological characteristics of germline pathogenic mutation carriers.Methods:The data of 124 patients (age≤60 years old) with upper tract urothelial carcinoma who underwent germline genetic testing at Fudan University Shanghai Cancer Center from September 2008 to February 2023 were retrospectively analyzed. There were 86 males and 38 females, and the median age was 55.0(49.8, 58.0)years old. The primary tumors were located in the renal pelvis in 81 cases (65.3%), the ureter in 34 cases (27.4%), and both in 9 cases (7.3%). There were 13 patients (10.5%) with low-grade UTUC and only 8 patients (6.5%) with carcinoma in situ. Twelve patients (9.7%) had a history of bladder cancer and 12 (9.7%) had a history of malignancy other than bladder cancer. Whole gene exome sequencing or target region sequencing was performed to explore germline mutations associated with patients with UTUC. The germline genetic testing data were interpreted in accordance with the American College of Medical Genetics and Genomics/Association for Molecular Pathology (ACMG/AMP)2015 edition guideline to clarify the germline pathogenic mutation rate and elucidate the clinicopathological characteristics of germline pathogenic mutation carriers. Germline pathogenic mutation rates were further compared with those of healthy East Asian populations to analyze germline mutations associated with the risk of carcinogenesis in UTUC.Results:In this study, 31 germline pathogenic mutations were detected in 28 (22.6%) of 124 patients with UTUC. There were no statistically significant differences in age [54.0 (47.0, 58.0) years old vs. 56.0 (50.8, 58.0) years old], gender (male/female: 21/7 vs. 65/31), history of bladder cancer (0 vs. 12/96), T-stage (T 3-4: 12/28 vs. 41/96), and proportion of histologic high-level (26/28 vs. 85/96) between patients with and without germline pathogenic mutations ( P>0.05). The 31 germline pathogenic mutations were located in 22 genes, including BRCA2 (4, 12.9%), MSH2 (3, 9.7%), RAD54L (2, 6.5%), BRCA1 (2, 6.5%), BRIP1 (2, 6.5%), NOTCH3 (2, 6.5%), XRCC2 (1, 3.2%), VEGFA (1, 3.2%), TBX3 (1, 3.2%), RET (1, 3.2%), PRKN (1, 3.2%), PALB2 (1, 3.2%), NTRK1 (1, 3.2%), NCOA3 (1, 3.2%), MSH6 (1, 3.2%), LRP1B (1, 3.2%), KMT2D (1, 3.2%), KMT2A (1, 3.2%), FANCA (1, 3.2%), BARD1 (1, 3.2%), ARID1A (1, 3.2%), and AR (1, 3.2%). The germline pathogenic mutation rates of 124 patients were compared with those of the healthy East Asian population. The results showed that germline pathogenic mutations in BRCA2 ( OR = 11.9, 95% CI 3.8 - 37.7, P<0.001), MSH2 ( OR = 11.9, 95% CI 3.2-44.5, P<0.001), RAD54L ( OR=14.2, 95% CI 2.7-73.8, P=0.002) and BRCA1 ( OR=11.8, 95% CI 2.4-59.1, P=0.003) genes significantly increase the risk of developing UTUC. Conclusions:The rate of germline pathogenic mutations in ≤60 years old UTUC patients in this study was 22.6%, and germline pathogenic mutations carrying germline BRCA2, MSH2, RAD54L or BRCA1 genes significantly increased the risk of developing UTUC.

Objective:To analyze germline genetic testing in Chinese high-to very-high-risk non-metastatic prostate cancer patients.Methods:This study included 249 Chinese patients with high- to very-high-risk non-metastatic prostate cancer for germline genetic testing, in Fudan University Shanghai Cancer Center, West China Hospital and Cancer Center of Sun Yat-sen University, from January 2018 to December 2022. High risk and very-high risk are termed according to National Comprehensive Cancer Network (NCCN) Prostate Cancer Guideline (2022 V1). The mean age of the patients was (66.7±9.2) years old and median PSA level was 28.50 (ranging 2.43 - 1481.11) ng/ml. Within these 249 patients, 84 (33.7%) were T 1-2, 98 (39.3%) were T 3-4, while 67 (26.9%) were unclear in T stage. Additionally, 51 patients (20.5%) were classified into International Society of Urological Pathology(ISUP) grade group 1-3 group and 198 patients (79.5%) were in ISUP 4-5 group. Focusing on 16 genetic susceptibility genes for prostate cancer, we interpret the germline genetic testing data in accordance with the American College of Medical Genetics and Genomics and the Association for Molecular Pathology (ACMG/AMP) guideline, clarify the germline pathogenic mutation rate and elucidate the clinicopathological characteristics of germline pathogenic mutation carriers. Results:Among Chinese high-to very-high-risk non-metastatic prostate cancer patients, 7.2% (18/249) had germline pathogenic mutations. Patients with mutations had a significantly higher proportion of first-degree relatives with a history of malignancy than those without mutations (50% vs. 13%, P<0.001), but there was no difference in age of onset [(68.2±9.3)years vs. (66.6±9.2) years], PSA level (median: 40.68 ng/ml vs. 28.00 ng/ml), T stage [T 3-4: 38.9%(7/18)vs. 39.4%(91/231)] and ISUP grade [group 4-5: 88.9%(16/18) vs. 78.8%(182/231)]. Germline pathogenic mutations were observed in BRCA2 (7 patients, 38.9%), MSH2 (3 patients, 16.7%), PALB2 (2 patients, 11.1%), ATM (2 patients, 11.1%), RAD51C (1 patient, 5.6%), PMS2 (1 patient, 5.6%), MSH6 (1 patient, 5.6%) and HOXB13 (1 patient, 5.6%). By comparing with normal controls of East-Asian population, germline pathogenic mutations in BRCA2 ( OR=11.1, 95% CI 4.8-25.6, P<0.001) and MSH2 ( OR= 43.5, 95% CI 8.5-200.0, P<0.001) can significantly increase the risk of developing high- to very-high-risk prostate cancer in Chinese males. Conclusions:This study identified a germline pathogenic mutation rate of 7.2% in 249 Chinese patients with high- or very-high-risk non-metastatic prostate cancer. Carrying germline BRCA2 or MSH2 pathogenic mutations can significantly increase the risk of high- or very-high-risk prostate cancer in Chinese men.

BACKGROUND: Hepatectomy for hepatocellular carcinoma (HCC) beyond the Milan criteria is shown to be beneficial. However, a high rate of post-operative HCC recurrence hinders the long-term survival of the patients. This study aimed to investigate and compare the impacts of tenofovir (TDF) and entecavir (ETV) on the recurrence of hepatitis B viral (HBV)-related HCC beyond the Milan criteria. METHODS: Data pertaining to 1532 patients who underwent hepatectomy and received antiviral therapy between January 2014 and January 2019 were collected from five centers. Recurrence-free survival (RFS) analysis was performed using the Kaplan-Meier method. Cox proportional hazards regression analysis was performed to determine prognostic factors for HCC recurrence. RESULTS: The analysis incorporates 595 HBV-related HCC patients. The overall 5-year RFS was 21.3%. Among them, 533 and 62 patients received ETV and TDF treatment, respectively. The 1-, 3-, and 5-year RFS rates were 46.3%, 27.4%, and 19.6%, respectively, in the ETV group compared with 65.1%, 41.8%, and 37.2%, respectively, in the TDF group (P < 0.001). Multivariate analysis showed that TDF treatment (hazard ratio [HR]: 0.604, P = 0.005), cirrhosis (HR: 1.557, P = 0.004), tumor size (HR: 1.037, P = 0.008), microvascular invasion (MVI) (HR: 1.403, P = 0.002), portal vein tumor thrombus (PVTT) (HR: 1.358, P = 0.012), capsular invasion (HR: 1.228, P = 0.040), and creatinine levels (CREA) (HR: 0.993, P = 0.031) were statistically significant prognostic factors associated with RFS. CONCLUSIONS Patients with HCC beyond the Milan criteria exhibited a high rate of HCC recurrence after hepatectomy. Compared to the ETV therapy, TDF administration significantly lowered the risk of HCC recurrence.
Antiviral Agents/therapeutic use* ; Carcinoma, Hepatocellular/surgery* ; Guanine/analogs & derivatives* ; Hepatectomy ; Hepatitis B virus ; Hepatitis B, Chronic/drug therapy* ; Humans ; Liver Neoplasms/surgery* ; Retrospective Studies ; Tenofovir/therapeutic use*

OBJECTIVE:To provide reference for promoting the application ofwhole course tutorial systemin the practice teaching of medical higher vocational colleges. METHODS:Totally 106 students on internships of medical higher vocational colleg-es were selected and randomly divided into control group(n=53)and observation group(n=53). Control group received routineteaching method;observation group receivedwhole course tutorial systemteaching method on the basis of control group. Score, teaching quality and students'satisfactory degree were compared between 2 groups after the end of internship teaching. RESULTS:The scores of autonomous learning ability,comprehensive ability,communication ability,judgment ability,thinking and solving problem ability and total score in observation group were all significantly higher than control group after the end of internship teach-ing;the proportion of good teaching quality in observation group was significantly higher than control group,manifesting as high practical ability,good adaptability,caring patient,good learning condition;the satisfactory degree of students in observation group was significantly higher than control group(98.11% vs. 88.68%),there was statistical significance(P<0.05). CONCLUSIONS:The implementation ofwhole course tutorial systemteaching method in practice teaching of medical higher vocational colleges based on conventional teaching method achieves ideal effect and can improve the students'learning effect,teaching quality and stu-dents'satisfactory degree.

Aged ; Aged, 80 and over ; Humans ; Male ; Porokeratosis ; genetics ; Rectal Neoplasms ; genetics

Calcium/calmodulin-dependent protein kinase Ⅱ(CaMKⅡ),which is an important protein kinase involved in learning and memory,is found in most tissues,but it is present in especially high concentrations in neurons.The relatively high expression of CaMKⅡin nervous system suggests it plays an im-portant role in the function of nervous system.This paper re-views the research development of the molecular structure of CaMKⅡ and its autophosphorylation,subcellular localization and its role in synaptic plasticity.