Objective:To evaluate the clinical value of high-risk human papillomavirus (HPV) viral load for the cervical cancer screening and triage of high-risk HPV positive populations without additional tests.Methods:(1) This study conducted a retrospective analysis of 29 720 women aged 35-64 years who received cervical cancer screening in Quanzhou, China, in 2021. Fourteen high-risk HPV types (including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) were detected for cervical cancer primary screening using hybrid capture-chemiluminescence method. High-risk HPV positive samples were further subjected to HPV 16/18 genotyping using hybrid capture-chemiluminescence method. Among them, HPV 16/18 positive women were directly referred to colposcopy, while the other 12 high-risk HPV positive samples were further subjected to liquid based cytology test. Those with abnormal or suspicious cytology were referred to colposcopy. Biopsies were taken for histopathological examination of suspicious or abnormal individuals under colposcopy. (2) Ten cases of colposcopy loss or refusal to undergo examination were excluded, and the data from the 29 710 cases were analyzed. The HPV viral loads of the other 12 high-risk HPV positive populations were focused and evaluated their HPV viral loads for further cervical intraepithelial neoplasia (CIN) Ⅱ and above lesions (CINⅡ +) triage in cervical cancer screening. Results:(1) Among 29 720 women, 2 487 women (8.37%, 2 487/29 720) were positive for high-risk HPV, including 807 women (2.72%, 807/29 720) were positive for HPV 16/18 and 1 680 patients (5.65%, 1 680/29 720) were positive for the other 12 high-risk HPV types. Among 1 680 women who tested positive for the other 12 high-risk HPV types, 573 patients were atypical squamous cell carcinoma of unclear significance or above, 346 patients were CIN Ⅰ, 122 patients were CIN Ⅱ-Ⅲ, 9 patients were squamous cell carcinoma patients, and 4 patients were adenocarcinoma in situ. The immediate risk of CIN Ⅱ + in HPV 16/18 positive women (11.13%) was approximately four times higher than that of other 12 high-risk HPV positive women (2.74%). (2) Through the viral load analysis of the other 12 high-risk HPV types, we found that the viral load of the other 12 high-risk HPV provide a good value for the pathological results, with a clinical cutoff (CO) value of 11.21 relative light unit/CO (RLU/CO) for the CINⅡ + detection. Except for HPV 16/18 positive patients, when the viral load values of the other 12 high-risk HPV types were greater than 10 RLU/CO, these patients had a higher risk of CINⅡ +, with a positive predictive value of 31.29%. CINⅡ + was not found in any of the other 12 high-risk HPV positive with viral load values less than or equal to 10 RLU/CO. Conclusions:Using hybrid capture-chemiluminescence HPV tests for HPV 16/18 genotyping, combined with the viral loads (>10 RLU/CO) of the other 12 high-risk HPV analysis, one could triage HPV positive population without additional tests. Such triage strategy could promote the coverage of cervical cancer screening, particularly where cytology pathologists or economic resources are limited.

Intestinal flora imbalance is closely related to the pathogenesis of rheumatoid arthritis (RA). The existing studies have explored the monomer components such as tripterygium glycosides, total glycosides of Chaenomeles speciosa, and triterpenoid saponins of Clematis, Chinese materia medica such as Tripterygium wilfordii, Caulis Sinomenii, Radix Paeoniae Alba, Fructus Gardeniae, Fructus Chebulae, Radix Ginseng, Radix et Rhizoma Rhei, Rhizoma Atractylodis Macrocephalae, Pterostilbene, and Ginger, as well as the mechanisms of Danggui Sini Decoction, Danggui Niantong Decoction, Duhuo Jisheng Decoction, Yunpi Jiedu Tongluo Qushi Decoction, Qingre Huoxue Decoction, Compound Fengshining, Qingre Yangyin Chushi Decoction, Aconitum Decoction, Zhijing Powder, Jinwu Jiangu Capsule, and Fermented Chinese Medicine Qushi Chubi Decoction in intervening RA by regulating intestinal flora, suggesting that Chinese materia medica can restore intestinal homeostasis, reduce joint inflammation and play a role in the prevention and treatment of RA by regulating immune response, improving intestinal mucosal barrier and regulating intestinal metabolites.

Objective:To quantitatively analyze right ventricular reverse remodeling in patients with severe tricuspid regurgitation after transcatheter tricuspid edge-to-edge repair (T-TEER) by two-dimensional speckle tracking echocardiography, and to preliminarily evaluate the clinical efficacy of this procedure.Methods:This study was a prospective single-center cohort study. Patients diagnosed with severe tricuspid regurgitation at the Xiamen Cardiovascular Hospital Xiamen University from March 2021 to June 2023 were enrolled. All patients underwent transthoracic echocardiography and transesophageal three-dimensional echocardiography before T-TEER, and transthoracic echocardiography at 30 days, 6 months, and 9 months after T-TEER. The primary endpoint was major adverse cardiovascular and cerebrovascular events, including death, stroke, myocardial infarction, reoperation, arrhythmia, and conduction block. Other clinical evaluation indicators included New York Heart Association (NYHA) functional classification and tricuspid regurgitation grade.Results:A total of 34 patients were enrolled, aged (67.9±9.3) years, and 71% (24/34) were female. The median follow-up duration was 9 months. All patients achieved a reduction of tricuspid regurgitation by ≥2 grades at 9 months after T-TEER, with 79% (27/34) of them having mild to moderate tricuspid regurgitation. Transthoracic echocardiography at 9 months after T-TEER showed that the vena contracta width of tricuspid regurgitation ((5.42±2.33) mm vs. (11.54±4.05) mm, P<0.001), effective regurgitant orifice area ((0.24±0.09) cm2 vs. (0.52±0.14) cm2, P<0.001), regurgitant jet area ((7.95±4.02) cm2 vs. (13.93±6.10) cm2, P<0.001), inferior vena cava diameter ((19.38±2.63) mm vs. (23.56±3.31) mm, P<0.001), right ventricular end-diastolic diameter ((28.03±6.26) mm vs. (33.21±8.24) mm, P=0.001), and tricuspid annular diameter ((36.47±4.40) mm vs. (41.44±7.08) mm, P<0.001) were all reduced compared with baseline; while the tricuspid annular plane systolic excursion ((18.08±5.25) mm vs. (14.91±3.42) mm, P=0.005) and right ventricular fractional area change ((37.61±7.52)% vs. (30.79±9.06)%, P=0.004) were both increased compared with baseline. At 9 months after T-TEER, all patients had a NYHA functional classification of grade Ⅰ or Ⅱ, and no major adverse cardiovascular and cerebrovascular event occurred during the follow-up period. Conclusion:It is preliminarily confirmed that T-TEER is safe and effective in the treatment of severe tricuspid regurgitation, with significant right ventricular reverse remodeling observed in patients at 9 months after T-TEER.

Objective:To evaluate the clinical value of high-risk human papillomavirus (HPV) viral load for the cervical cancer screening and triage of high-risk HPV positive populations without additional tests.Methods:(1) This study conducted a retrospective analysis of 29 720 women aged 35-64 years who received cervical cancer screening in Quanzhou, China, in 2021. Fourteen high-risk HPV types (including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) were detected for cervical cancer primary screening using hybrid capture-chemiluminescence method. High-risk HPV positive samples were further subjected to HPV 16/18 genotyping using hybrid capture-chemiluminescence method. Among them, HPV 16/18 positive women were directly referred to colposcopy, while the other 12 high-risk HPV positive samples were further subjected to liquid based cytology test. Those with abnormal or suspicious cytology were referred to colposcopy. Biopsies were taken for histopathological examination of suspicious or abnormal individuals under colposcopy. (2) Ten cases of colposcopy loss or refusal to undergo examination were excluded, and the data from the 29 710 cases were analyzed. The HPV viral loads of the other 12 high-risk HPV positive populations were focused and evaluated their HPV viral loads for further cervical intraepithelial neoplasia (CIN) Ⅱ and above lesions (CINⅡ +) triage in cervical cancer screening. Results:(1) Among 29 720 women, 2 487 women (8.37%, 2 487/29 720) were positive for high-risk HPV, including 807 women (2.72%, 807/29 720) were positive for HPV 16/18 and 1 680 patients (5.65%, 1 680/29 720) were positive for the other 12 high-risk HPV types. Among 1 680 women who tested positive for the other 12 high-risk HPV types, 573 patients were atypical squamous cell carcinoma of unclear significance or above, 346 patients were CIN Ⅰ, 122 patients were CIN Ⅱ-Ⅲ, 9 patients were squamous cell carcinoma patients, and 4 patients were adenocarcinoma in situ. The immediate risk of CIN Ⅱ + in HPV 16/18 positive women (11.13%) was approximately four times higher than that of other 12 high-risk HPV positive women (2.74%). (2) Through the viral load analysis of the other 12 high-risk HPV types, we found that the viral load of the other 12 high-risk HPV provide a good value for the pathological results, with a clinical cutoff (CO) value of 11.21 relative light unit/CO (RLU/CO) for the CINⅡ + detection. Except for HPV 16/18 positive patients, when the viral load values of the other 12 high-risk HPV types were greater than 10 RLU/CO, these patients had a higher risk of CINⅡ +, with a positive predictive value of 31.29%. CINⅡ + was not found in any of the other 12 high-risk HPV positive with viral load values less than or equal to 10 RLU/CO. Conclusions:Using hybrid capture-chemiluminescence HPV tests for HPV 16/18 genotyping, combined with the viral loads (>10 RLU/CO) of the other 12 high-risk HPV analysis, one could triage HPV positive population without additional tests. Such triage strategy could promote the coverage of cervical cancer screening, particularly where cytology pathologists or economic resources are limited.

Objective:To quantitatively analyze right ventricular reverse remodeling in patients with severe tricuspid regurgitation after transcatheter tricuspid edge-to-edge repair (T-TEER) by two-dimensional speckle tracking echocardiography, and to preliminarily evaluate the clinical efficacy of this procedure.Methods:This study was a prospective single-center cohort study. Patients diagnosed with severe tricuspid regurgitation at the Xiamen Cardiovascular Hospital Xiamen University from March 2021 to June 2023 were enrolled. All patients underwent transthoracic echocardiography and transesophageal three-dimensional echocardiography before T-TEER, and transthoracic echocardiography at 30 days, 6 months, and 9 months after T-TEER. The primary endpoint was major adverse cardiovascular and cerebrovascular events, including death, stroke, myocardial infarction, reoperation, arrhythmia, and conduction block. Other clinical evaluation indicators included New York Heart Association (NYHA) functional classification and tricuspid regurgitation grade.Results:A total of 34 patients were enrolled, aged (67.9±9.3) years, and 71% (24/34) were female. The median follow-up duration was 9 months. All patients achieved a reduction of tricuspid regurgitation by ≥2 grades at 9 months after T-TEER, with 79% (27/34) of them having mild to moderate tricuspid regurgitation. Transthoracic echocardiography at 9 months after T-TEER showed that the vena contracta width of tricuspid regurgitation ((5.42±2.33) mm vs. (11.54±4.05) mm, P<0.001), effective regurgitant orifice area ((0.24±0.09) cm2 vs. (0.52±0.14) cm2, P<0.001), regurgitant jet area ((7.95±4.02) cm2 vs. (13.93±6.10) cm2, P<0.001), inferior vena cava diameter ((19.38±2.63) mm vs. (23.56±3.31) mm, P<0.001), right ventricular end-diastolic diameter ((28.03±6.26) mm vs. (33.21±8.24) mm, P=0.001), and tricuspid annular diameter ((36.47±4.40) mm vs. (41.44±7.08) mm, P<0.001) were all reduced compared with baseline; while the tricuspid annular plane systolic excursion ((18.08±5.25) mm vs. (14.91±3.42) mm, P=0.005) and right ventricular fractional area change ((37.61±7.52)% vs. (30.79±9.06)%, P=0.004) were both increased compared with baseline. At 9 months after T-TEER, all patients had a NYHA functional classification of grade Ⅰ or Ⅱ, and no major adverse cardiovascular and cerebrovascular event occurred during the follow-up period. Conclusion:It is preliminarily confirmed that T-TEER is safe and effective in the treatment of severe tricuspid regurgitation, with significant right ventricular reverse remodeling observed in patients at 9 months after T-TEER.

TROP-2, a tumor-associated antigen, has been implicated in the progression of various epithelial tumors. Due to its favorable expression profile, TROP-2 has emerged as a promising target for antibody-drug conjugates (ADCs) based anti-tumor therapies. Although ADCs have shown efficacy in cancer treatment, their application in solid tumors is hindered by their high molecular weight, poor tumor penetration, and release of cytotoxic molecules. Therefore, a recombinant immunotoxin was developed based on a shark-derived variable domain of immunoglobulin new antigen receptor (VNAR) antibody. VNARs are only one-tenth the size of IgG antibodies and possess remarkable tissue penetration capabilities and high stability. In this study, a shark VNAR phage display library was created, leading to the identification of shark VNAR-5G8 that targets TROP-2. VNAR-5G8 exhibited a high affinity and cellular internalization ability towards cells expressing high levels of TROP-2. Epitope analysis revealed that VNAR-5G8 recognizes a hidden epitope consisting of CRD and TY-1 on TROP-2. Subsequently, VNAR-5G8 was fused with a truncated form of Pseudomonas exotoxin (PE38) to create the recombinant immunotoxin (5G8-PE38), which exhibited significant anti-tumor activity in vitro and in vivo. Overall, this study highlights the promise of 5G8-PE38 as a valuable candidate for cancer therapy.

Objective:To explore the necessity, construction plans, and implementation methods for the establishment of a fundus disease-specific biobank are discussed.Methods:An evidence-based medicine study. "Biobank", "Disease-specific biobank", "Eye diseases", "Fundus disease" were hereby used as search terms. Literatures were retrieved related to biobank construction from PubMed, Embase, China National Knowledge Infrastructure, and Wanfang databases since their establishment until October 2023. Two researchers independently selected and analyzed literature, extracting data for further analysis.Results:After screening, 23 articles were included, comprising 11 articles in Chinese and 12 articles in English, involving 23 institutions. The disease-specific biobank has been built earlier abroad than domestically. Both domestic and foreign biobank have a scale of less than 1, 1 to 10, and more than 10 thousand samples, with the eye disease-specific biobank having less than 10 thousand samples. The majority of these disease-specific biobank focued on tumor-related diseases and consist of both physical and information components. Ethical committees were required to declare and record the construction of biobank, and dedicated personnel and information management systems are established. Quality control systems have been developed with standard operating procedures from sample collection to storage. These disease-specific biobank effectively supported research projects, but there was a lack of resource sharing domestically compared to abroad. Based on practical experience, the construction of fundus disease-specific biobank at West China Hospital of Sichuan University has been improved. Separate sample collection processes have been formulated for outpatient clinics and operating rooms. Standard operating procedures have been established for unique eye samples, including vitreous fluid, proliferative membranes of the retina, aqueous humor, tears, etc., to ensure sample quality.Conclusion:Establishing a fundus disease-specific biobank can promote basic and clinical research, advance the development of translational medicine, achieve resource sharing, and foster discipline development.

Objective To investigate changes in the intestinal flora and function in rats with antibiotic-associated diarrhea(A AD)treated with GeGen QinLian Decoction(GQD).Methods Sixty male or female SPF-grade SD rats were fed for 7 days and then divided randomly into Control(Con)and modeling groups(1∶5 ratio).Rats in the modeling group received clindamycin 250 mg/kg by gavage once a day for 7 consecutive days.After successful modeling,the rats were divided randomly into model(Mod),high-dose GQD(GQD-H,10.08 g/kg),medium-dose GQD(GQD-M,5.04 g/kg),low-dose GQD(GQD-L,2.52 g/kg),and live Bifidobacterium power(LBP,0.15 g/kg)groups(n=10 rats per group).GQD and LBP were administered by gavage,and the Con and Mod groups were given an equal volume of saline by gavage once a day.Feces were collected after 7 consecutive days of administration for macrogenomics sequencing analysis.Results α diversity and β diversity suggested that intestinal microbial diversity differed between the Mod and GQD-treated groups.GQD increased the abundance of thick-walled bacteria and decreased the abundance of Aspergillus at the phylum level,and increased the relative abundances of the intestinal mucus bacteria Blautia,Bacteroides,Thomasclavelia,and Mediterraneibacter,and decreased the relative abundances of Adlercreutzia,Muribaculum,and Escherichia at the genus level.GQD also up-regulated the amino acid,carbohydrate,and immune disease pathways.Conclusions GQD improves the abundance ratio of beneficial and pathogenic intestinal bacteria in rats with antibiotic-associated diarrhea,which in turn reduces the intestinal inflammatory response and repairs the intestinal immune system.

The eutR gene deletion mutant of Salmonella enteritidis was successfully constructed by homologous recombination.Through the study of its biochemical characteristics,motility,resist-ance to stress in vitro and survival ability in RAW 264.7 cells,it was found that the biochemical characteristics and motility of the eutR gene deletion mutant of Salmonella enteritidis had no sig-nificant change compared with the wild type of Salmonella enteritidis.The ability of eutR gene de-letion strain of Salmonella enteritidis to resist acid,alkali and oxidation was significantly reduced,while the ability to resist heat was not significantly changed;the survival ability of eutR gene dele-tion strain in RAW 264.7 cells was significantly reduced compared with the wild type.In order to further analyze the effect of eutR gene on the expression of virulence factors of Salmonella enterit-idis,the relative expression levels of invH,ssav,ssrA,xthA,orf245,sodC,lrp,mrr1 and hflk virulence genes of the deletion strain and the wild strain were detected by SYBR Green PCR.It was found that the expression of the virulence factors mentioned above in the eutR gene deletion strain of Salmonella enteritidis was significantly down-regulated compared with that in the wild-type strain.The LD50 of the eutR gene-deleted strain of Salmonella enteritidis was determined by ani-mal experiments,and the results showed that the LD50 of the eutR gene-deleted strain was higher than that of the wild-type strain,indicating that the eutR gene could affect the virulence of Salmonella.This study clarified the effect of eutR gene on the survival ability,some biological characteristics and virulence of Salmonella enteritidis in macrophages,and provided a new gene knockout target for the development of attenuated Salmonella enteritidis genetic engineering vac-cine.

To explore the application of humanistic care in children's fever clinics,the children's fever clinics of Guangzhou Women and Children's Medical Center conducted relevant research using narrative medicine as a guiding concept.This paper elaborated on the medical humanistic dilemmas and narrative care needs in children's fever clinics,and focused on exploring the practice paths of narrative medicine in pediatric with Chinese characteristics from five dimensions,including the cultivation of nursing staff's abilities of professional narrative and humanistic care,the establishment of health lectures featuring narrative patient education,the alleviation of medical anxiety for children and their families,related support of narrative nursing,and caring services.The aim was to improve the narrative care ability of nurses in children's fever clinics,develop methods for pediatric patients that can eliminate the fear of seeking medical treatment,and protect children's physical and mental health.A carrier of care,support,and emotional expression can be provided for parents.The foundation for nursing staff to achieve professional growth through narrative reflection can be laid.Thus,it can assist in establishing a life narrative community relationship between doctors and patients,and jointly explore the meaning of life.