[Purpose]To analyze the trends of incidence and age at onset of bone malignant tumors in cancer registration areas of Jiangsu Province from 2009 to 2019.[Methods]Incidence data of bone malignant tumors from 2009 to 2019 were collected from 16 consecutive and quality-con-trolled cancer registries in Jiangsu Province.The incidence rates,average age at onset,and inci-dence composition of bone malignant tumors were calculated.A birth cohort model was constructed to analyze the changes in the incidence of bone malignant tumors in the population born from 1929 to 2019.Joinpoint regression models were used to analyze the average annual percentage change(AAPC)in the incidence rates and the incidence composition of bone malignant tumors for each year in those aged 60 years old and above.A general linear regression model was used to ana-lyze the trend of the average age of onset.[Results]The crude incidence rate of bone malignant tumors in women in Jiangsu cancer registration areas decreased from 2009 to 2019,with an AAPC of-2.62％(P=0.025).After adjusting the population composition,except for urban areas,the incidence of bone malignant tumors in the whole province,men,women and rural areas all decreased significantly,with AAPC of-3.15％,-2.49％,-4.31％and-2.23％,respectively.The average age at onset of bone malignant tumors in the whole province,men and urban areas de-creased significantly yearly,with an average annual decrease of 0.365,0.504 and 0.469 years old,respectively.In the same period,the incidence of malignant bone tumors in the whole province,men,women and urban areas of age groups of 50～59,60～69 and 70～79 years old showed a decreasing trend,the AAPC ranged from-9.06％to-4.14％(all P＜0.05),and the inci-dence decreased gradually with the year of birth.The incidence of malignant bone tumors in men＜30 years old increased yearly with an AAPC of 4.30％(P＜0.05).Compared with 2009,the com-position of incidence in men aged 15～39 years old and in urban population increased in 2019,while the incidence of bone malignant tumors in the age group of 60～79 years old in the province generally decreased.After age structure adjustment,the incidence of bone malignant tumors in people over 60 years old in urban areas decreased with an AAPC of-1.42％(P＜0.05).[Conclu-sion]The incidence of bone malignant tumors in Jiangsu Province is decreasing and the age at on-set is moving forward,indicating that the prevention and control measures of bone malignant tu-mors should be adjusted accordingly.

[Purpose]To analyze the trends of incidence and age at onset of bone malignant tumors in cancer registration areas of Jiangsu Province from 2009 to 2019.[Methods]Incidence data of bone malignant tumors from 2009 to 2019 were collected from 16 consecutive and quality-con-trolled cancer registries in Jiangsu Province.The incidence rates,average age at onset,and inci-dence composition of bone malignant tumors were calculated.A birth cohort model was constructed to analyze the changes in the incidence of bone malignant tumors in the population born from 1929 to 2019.Joinpoint regression models were used to analyze the average annual percentage change(AAPC)in the incidence rates and the incidence composition of bone malignant tumors for each year in those aged 60 years old and above.A general linear regression model was used to ana-lyze the trend of the average age of onset.[Results]The crude incidence rate of bone malignant tumors in women in Jiangsu cancer registration areas decreased from 2009 to 2019,with an AAPC of-2.62％(P=0.025).After adjusting the population composition,except for urban areas,the incidence of bone malignant tumors in the whole province,men,women and rural areas all decreased significantly,with AAPC of-3.15％,-2.49％,-4.31％and-2.23％,respectively.The average age at onset of bone malignant tumors in the whole province,men and urban areas de-creased significantly yearly,with an average annual decrease of 0.365,0.504 and 0.469 years old,respectively.In the same period,the incidence of malignant bone tumors in the whole province,men,women and urban areas of age groups of 50～59,60～69 and 70～79 years old showed a decreasing trend,the AAPC ranged from-9.06％to-4.14％(all P＜0.05),and the inci-dence decreased gradually with the year of birth.The incidence of malignant bone tumors in men＜30 years old increased yearly with an AAPC of 4.30％(P＜0.05).Compared with 2009,the com-position of incidence in men aged 15～39 years old and in urban population increased in 2019,while the incidence of bone malignant tumors in the age group of 60～79 years old in the province generally decreased.After age structure adjustment,the incidence of bone malignant tumors in people over 60 years old in urban areas decreased with an AAPC of-1.42％(P＜0.05).[Conclu-sion]The incidence of bone malignant tumors in Jiangsu Province is decreasing and the age at on-set is moving forward,indicating that the prevention and control measures of bone malignant tu-mors should be adjusted accordingly.

Objective The aim of this study was to investigate the prognostic value of body composition indicators in evaluating the development risk of gestational diabetes mellitus(GDM).Methods A total of 1431 pregnant women who were registered and underwent prenatal examinations in the Clinical Nutrition Department of Guizhou Hospital of Beijing Jishuitan Hospital were selected in this study from January 2018 to September 2021.Among them,263 participants were diagnosed with GDM(GDM group),and 1168 healthy individuals underwent physical examinations were enrolled as Con group.Results The GDM detection rate was 18.38%(263/1431).Logistic regression analysis showed that age and percent body fat were risk factors for the development of GDM.The area under the ROC curve of percent body fat for GDM prediction was 0.732,with sensitivity,specificity of 67.7%,68.3%.Conclusions High percentage of body fat during pregnancy is a risk factor for the development of GDM in late pregnancy,and the risk of developing diabetes during pregnancy can be predicted by the percentage of body fat index.

Chronic active Epstein-Barr virus (CAEBV) infection with renal involvement is not common. The paper reported a child of multisystem-compromised CAEBV infection with the onset of IgA nephropathy (IgAN). The child presented with intermittent gross hematuria, and renal biopsy showed focal proliferative IgAN, administered methylprednisolone pulse followed by oral prednisolone treatment. Intermittent increase of blood Epstein-Barr virus (EBV) load and abnormal EBV antibody, pneumonia caused by EBV and Staphylococcus aureus-mixed infection, periappendiceal abscess, and pancytopenia occurred during treatment follow-up. The CAEBV infection was considered. Echocardiography suggested pulmonary hypertension. Head CT presented multiple calcifications in the bilateral basal ganglia. Bone marrow biopsy showed bone marrow EBV-DNA 6.5×10 3 copies per liter. Immunohistochemistry of renal biopsy showed about 50 CD8 + (scattered +) cells per high power field (HPF), about 40 CD4 + (focal +) cells per HPF (local), CD68 + (-), latent membrane protein 1 (-), EBV-encoded small RNA (scattered +) approximately 25 cells per HPF. The lymphocyte subsets infected with EBV showed CD4 + T cells EBV-DNA 3.4×10 4 copies per 1 million cells, CD8 + T cells EBV-DNA 3.3×10 5 copies per 1 million cells, B cells EBV-DNA 1.25×10 4 copies per 1 million cells, NK cells/NK T cells EBV-DNA 2.3×10 4 copies per 1 million cells. The clinical diagnosis was CAEBV infection and EBV-associated IgAN. The patient currently receives oral prednisone treatment, and it is recommended to undergo hematopoietic stem cell transplantation and treatment is under follow up.

Objective : To explore the role of long non-coding RNA XR_378418 (LncRNA XR_378418) in the bi- ological behavior of hepatic stellate cells line JS-1 and to probe the potential molecular mechanism of LncRNA XR _378418 involved in liver fibrosis based on transcriptome sequencing． Methods : In this study，the recombinant plasmid of pcDNA-LncRNA XR_378418 and control plasmid pcDNA-NC were constructed and transfected into JS-1 cells respectively．Then，the expression level of LncRNA XR_378418 was analyzed by quantitative real-time PCR (RT-qPCR) ．The effect of overexpression of LncRNA XR_378418 on proliferation and migration of JS-1 cells were detected by cell counting kit-8 assay ( CCK-8 ) and scratch assay，respectively． Finally，by high-throughput se- quencing analysis，the effect of XR_378418 on the transcriptomics of JS-1 cells was analyzed. Results : T-qPCR results showed that the expression level of LncRNA XR_378418 in the overexpression group was significantly higher than that in the control group (P＜0. 05) ．The results of CCK-8 and scratch experiment suggested that the prolifer- ation and migration in the pcDNA-LncRNA XR _ 378418 group significantly increased． Furthermore ，the high- throughput sequencing analysis showed that a total of 248 genes were screened by gene differential analysis ，of which 127 were up-regulated ，and 117 were down-regulated． Gene Ontology ( GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses revealed that LncRNA XR_378418 could regulate cell adhesion，autophagy and Ca2 + signaling，etc． Conclusion LncRNA XR_378418 promotes the proliferation and migration of JS-1 cells and affects the expression of genes related to cell adhesion and calcium signaling in JS-1 cells.

Objective To investigate the positive time length of nucleic acid detection in 22 confirmed cases of coronavirus disease (COVID-19) in Yangzhou and analyze the influencing factors, and to provide evidence for the prevention and control of the disease. Method A total of 22 confirmed cases were followed up for five weeks. Throat swabs were collected for nucleic acid detection. The relevant data were collected and statistical analysis was conducted on the basis of survival analysis. Results The positive rate of throat swabs was 100%, 100% and 66.67% at 1-2d, 3-4d and 5-7d, respectively, after the onset of COVID-19. The average positive time of all confirmed cases was 16.32 days, including 18.50 days for common type and 13.70 days for light type. The difference was statistically significant (χ²=4.36, P=0.037). Multivariate Cox regression analysis showed that case type (or=0.19, 95%CI:0.06-0.61) and onset visit time (or=0.70,95%CI:0.55-0.88) had an impact on the positive time length of nucleic acid detection. Conclusion The positive rate of respiratory samples is high within one week after the onset of the confirmed cases, and the positive time length of light type cases was shorter than that of common types. The positive time length of nucleic acid detection may be shortened after timely treatment with drugs.

OBJECTIVE： To study the anti-gout effect of aqueous extract from the stems and leaves of Erythropalum scandens （ASLE）. METHODS： The mice were randomly divided into normal group， model group， allopurinol group （positive control， 5 mg/kg）， ASLE low-dose， medium-dose and high-dose groups （1 300， 2 600， 5 200 mg/kg， by raw material； similarity hereinafter）， with 10 mice in each group. Except for normal group， other groups were given potassium oxonate intragastrically to induce hyperuricemia model. One hour after modeling， normal group and model group were given constant volume of normal saline intragastrically； administration group was given relevant medicine intragastrically， once a day， for consecutive 7 d. One hour after last administration， the levels of serum uric acid （SUA） and serum creatinine （Scr） were detected by colorimetry assay. Another mice were randomly divided into normal group， model group， indomethacin group （positive control， 7.5 mg/kg）， ASLE low-dose， medium-dose and high-dose groups， with 10 mice in each group. Normal group and model group were given constant volume of normal saline intragastrically； administration group was given relevant medicine intragastrically， once a day， for consecutive 7 d. After last administration， except for normal group， the mice were given sodium microcrystalline urate via toes to induce gouty arthritis model. Before and 1， 2， 4， 6， 8 h after modeling， the circumference of the same part of the inflamed limbs and toes of mice in each group was measured by wire binding method， and the degree of toe swelling was calculated. The number of white blood cell （WBC）， neutrophil （NEU） and lymphocyte （LYM） were detected by animal hematology analyzer. The levels of SUA and Scr were measured by colorimetry assay. The content of NO in toe tissue was determined by Griess method. RESULTS： The experimental results of hyperuricemia model showed that the levels of SUA and Scr in mice were significantly higher in model group than those in normal group （P＜0.01）. Compared with model group， above indexes of mice were decreased significantly in administration group （P＜0.05 or P＜0.01）. The experimental results of gouty arthritis model showed that the level of SUA， the degree of toe swelling （2-8 h）， the number of WBC， NEU and LYM， NO content in model group were increased significantly， compared with normal group （P＜0.05 or P＜0.01）. Compared with model group， the levels of SUA and Scr （ASLE groups）， the degree of toe swelling [indomethacin group， ASLE high-dose group （2-8 h）， ASLE low-dose group （2， 6 h）， ASLE medium-dose group （6 h）]， the number of WBC and NEU （administration groups）， the number of LYM （indomethacin group） and NO content （administration groups except for ASLE low-dose group） were decreased significantly in administration groups （P＜0.05 or P＜0.01）. CONCLUSIONS： The anti-gout effect of ASLE may be associated with promoting uric acid metabolism， anti-inflammatory and improving renal function.

Objective To discuss the relationships between regular pattern changes of plasma fibrinogen (Fib),D-dimer and fibrinogen degradation products (FDP) levels and the recent dissolution of thrombus in patients with pulmonary embolism (PE) in 14 days after treatment.Methods A prospective study was conducted.PE patients admitted to Departments of Respiratory Disease in 4 hospitals from January 2015 to March 2016 were enrolled and all of them were treated with thrombolysis and/or anticoagulation after admission.The computed tomographic pulmonary angiography (CTPA) was examined pre-treatment and 14 days post-treatment in PE patients.The pulmonary artery obstruction index (PAOI) was assessed according to the Mastora scoring method to estimate the thrombus load.The plasma Fib,D-dimer and FDP levels were measured before and on 1,2,3,5,7 and 14 days after treatment,and the relationships between the change regularities of these parameters and PAOI were also analyzed.Results A total of 42 PE patients were enrolled.The curve change of coagulation-fibrinolytic system parameters in 14 days after treatment showed that the Fib level was raised to its peak on the 3rd day after treatment and then decreased (g/L:4.24 ± 1.45 vs.3.83 ± 1.56),representing that its curve change was in accordance with the quadratic model (P =0.095).After treatment,the D-dimer and FDP levels were kept declining,they were reached the valley on 14th day [D-dimer (mg/L):1.58 ± 1.38vs.8.84 ± 6.35,FDP (mg/L):4.23 ± 3.63 vs.23.41 ± 16.54],and their curve changes were in accordance with the cubic model (F was 32.190 and 34.326,respectively both P =0.000).The PAOI variation before and 14 days after treatment [(18.77 ± 14.22)％] was not correlated with Fib variation [(1.20 ± 0.93) g/L,r =-0.194,P =0.219],but was positively correlated with D-dimer variation [(7.29 ± 7.10) mg/L] and FDP variation [(19.29 ± 18.67) mg/L,r was 0.556 and 0.460,respectively;P was 0.020 and 0.002,respectively].Conclusions The D-dimer and FDP levels are kept falling in PE patients after treatment,suggesting that the pulmonary artery embolus is being dissolved.

Chronic cough in children is one of the most frequent reasons for consultation in clinic. The high cough sensitivity in most patients with chronic cough is difficult for treatment. Capsaicin,as the most com-monly used material for the test of cough sensitivity,is widely used in clinic. Capsaicin provocation test is more mature in foreign country,while in our country there is a few scholars applying it with the adult who suffered chronic cough,but few with children. This article reviews the process,chemical structure,nerve conduction,clini-cal operation,influence factors and safety of capsaicin provocation test.

Objective To investigate the effects of different treatment modes on the prognosis of patients with severe trauma.Methods The general data of 396 patients with severe trauma [injurey severity scores (ISS) ≥25] in our hospital emergency for treatment from January 1,2008 to January 1,2012 was collected.The trauma patients were divided into study group and control group.In the study group,the trauma patients were cared by emergency physician of our hospital for pre-hospital treatment during transportation by ambulance since January 1,2010.In the control group,the trauma patients were served with traditional pre-hospital emergency care by the 120 and 999 before January 1,2010.The injury severity score,medical care and outcomes were recorded in trauma database and the efficiency and quality of medical care were compared between two groups.Results The emergency treatment time,length of hospital stays,ICU admission rate,prehospital mortality rate,long-term (6 months) disability rate,and complication rate in the study group were lower than those in the control group,presenting (78.23 ± 21.57) min vs.(96.45 ± 35.14) min,(23.55±12.46) dvs.(28.67±20.72) d,8.1％ (18/222)vs.65.5％ (114/174),13.3％ (34/256) vs.21.6％ (48/222),4.1％ (9/222)vs.9.2％ (16/174),8.1％ (18/222)vs.18.4％ (32/174),in which the differences were statistically significant (P ＜ 0.05).Hospital mortality in the study group was also lower than that in the control group,showing 8.1％ (18/222) vs.12.6％ (22/174),but there was no statistically significant difference (P ＜ 0.05).There was no significant difference in time from occurrence of injury to receiving treatment between the two groups.Conclusion Emergency physicians-cared mode had advantages to improve treatment success rates and reduce mortality in patients with multiple trauma compared with the current conventional emergency mode.It is a good alternative emergency mode.