Objective: To analyze the process of handling a pulmonary tuberculosis(TB) outbreak among senior high school students in a boarding school in Chongqing, as well as to investigate the underlying causes of the outbreak, so as to provide evidence to inform TB prevention and control strategies in school settings. Methods: From November 2023 to April 2024, an epidemiological investigation was conducted into the TB outbreak in a grade 12 class from a boarding high school. Suspected cases were screened using symptom screening, tuberculin skin test (TST), and chest X-ray examinations. Confirmed cases underwent individual epidemiological interviews and sputum culture; Cultured positive mycobacterial strains were subjected to whole genome sequencing after identification as Mycobacterium tuberculosis. Results: A total of 10 active pulmonary TB cases were identified, all from the same class, yielding a student attack rate of 16.67%. Three isolates were culture positive, as well as all strains were of L2 type，and the WGS analysis of the strains suggested a common transmission chain. Excluding the index case, four additional cases were detected through symptom driven health care visits. Notably, 70% of patients presented with "chest tightness and chest pain" symptoms, and 50% had "cough" symptoms,but none were detected during morning health checks or tracking of absences due to illness. A total of 326 contacts were identified and underwent three rounds of screening and one follow up examination. In the initial screening, 35 close contacts from the same class showed strong TST positivity, corresponding to a strong positivity rate of 55.56%, significantly higher than the 20.76% observed among casual contacts ( χ 2=29.80, P <0.01). Among the 35 strongly TST positivvity close contacts and five individuals with moderate TST positivity whose induration had increased by ≥10 mm over two years, none received timely preventive treatment initially; five of them were subsequently diagnosed with active TB within three months. Following this, 25 individuals initiated preventive therapy, resulting in a preventive treatment initiation rate of 62.50%. Among TST negative classmates who converted to strong positivity on repeat TST testing at three months, 75.00% started preventive treatment, but only 22.22% completed the full course. Conclusion Inadequate implementation of morning health checks and cause tracking for absenteeism due to illness, poorly standardized screening procedures, and delayed preventive treatment may have been key factors contributing to the spread of the outbreak.

Genomic imprinting refers to the phenomenon of differential expression of two alleles due to their different parental origins. Genes that produce genomic imprinting are usually called imprinted genes. The genetic effect caused by the presence of imprinted genes is called parent-of-origin effect. Parent-of-origin effect and genomic imprinting play important roles in the pathophysiological mechanism and occurrence and development of cardio-metabolic diseases. In-depth exploration of the law and potential roles of imprinted genes and parent-of-origin effects will help to better understand the mechanism of cardio-metabolic diseases, and also provide important theoretical basis for the precise treatment of diseases related to imprinted genes.

Genomic imprinting refers to the phenomenon of differential expression of two alleles due to their different parental origins. Genes that produce genomic imprinting are usually called imprinted genes. The genetic effect caused by the presence of imprinted genes is called parent-of-origin effect. Parent-of-origin effect and genomic imprinting play important roles in the pathophysiological mechanism and occurrence and development of cardio-metabolic diseases. In-depth exploration of the law and potential roles of imprinted genes and parent-of-origin effects will help to better understand the mechanism of cardio-metabolic diseases, and also provide important theoretical basis for the precise treatment of diseases related to imprinted genes.

Objective:To explore the effects of short-term particulate matter(PM)exposure and the melatonin receptor 1B(MTNR1B)gene on triglyceride-glucose(TyG)index utilizing data from Fang-shan Family-based Ischemic Stroke Study in China(FISSIC).Methods:Probands and their relatives from 9 rural areas in Fangshan District,Beijing,were included in the study.PM data were obtained from fixed monitoring stations of the National Air Pollution Monitoring System.TyG index was calculated by fasting triglyceride and glucose concentrations.The associations of short-term PM exposure and rs10830963 polymorphism of the MTNR1B gene with the TyG index were assessed using mixed linear models,in which covariates such as age,sex,and lifestyles were adjusted for.Gene-environment inter-action analysis was furtherly performed using the maximum likelihood methods to explore the potential effect modifier role of rs10830963 polymorphism in the association of PM with TyG index.Results:A total of 4 395 participants from 2 084 families were included in the study,and the mean age of the study participants was(58.98±8.68)years,with 53.90％females.The results of association analyses showed that for every 10 μg/m3 increase in PM2.5 concentration,TyG index increased by 0.017(95％CI:0.007-0.027),while for per 10 μg/m3 increment in PM1o,TyG index increased by 0.010(95％CI:0.003-0.017).And the associations all had lagged effects.In addition,there was a positive association between the rs10830963 polymorphism and the TyG index.For per increase in risk allele G,TyG index was elevated by 0.040(95％CI:0.004-0.076).The TyG index was 0.079(95％CI:0.005-0.152)higher in carriers of the GG genotype compared with carriers of the CC genotype.The inter-action of rs10830963 polymorphism with PM exposure had not been found to be statistically significant in the present study.Conclusion:Short-term exposure to PM2.5 and PM10 were associated with higher TyG index.The G allele of rs10830963 polymorphism in the MTNR1B gene was associated with the elevated TyG index.

Objective:To explore the association between polymorphisms of transforming growth factor-β(TGF-β)signaling pathway and non-syndromic cleft lip with or without cleft palate(NSCL/P)among Asian populations,while considering gene-gene interaction and gene-environment interaction.Methods:A total of 1 038 Asian NSCL/P case-parent trios were ascertained from an international consortium,which conducted a genome-wide association study using a case-parent trio design to investigate the genes affec-ting risk to NSCL/P.After stringent quality control measures,343 single nucleotide polymorphism(SNP)spanning across 10 pivotal genes in the TGF-β signaling pathway were selected from the original genome-wide association study(GWAS)dataset for further analysis.The transmission disequilibrium test(TDT)was used to test for SNP effects.The conditional Logistic regression models were used to test for gene-gene interaction and gene-environment interaction.Environmental factors collected for the study in-cluded smoking during pregnancy,passive smoking during pregnancy,alcohol intake during pregnancy,and vitamin use during pregnancy.Due to the low rates of exposure to smoking during pregnancy and al-cohol consumption during pregnancy(＜3％),only the interaction between maternal smoking during pregnancy and multivitamin supplementation during pregnancy was analyzed.The threshold for statistical significance was rigorously set at P=1.46 × 10-4,applying Bonferroni correction to account for multiple testing.Results:A total of 23 SNPs in 4 genes yielded nominal association with NSCL/P(P＜0.05),but none of these associations was statistically significant after Bonferroni's multiple test correction.How-ever,there were 6 pairs of SNPs rs4939874(SMAD2)and rs1864615(TGFBR2),rs2796813(TGFB2)and rs2132298(TGFBR2),rs4147358(SMAD3)and rs1346907(TGFBR2),rs4939874(SMAD2)and rs1019855(TGFBR2),rs4939874(SMAD2)and rs12490466(TGFBR2),rs2009112(TGFB2)and rs4075748(TGFBR2)showed statistically significant SNP-SNP interaction(P＜1.46 × 10-4).In contrast,the analysis of gene-environment interactions did not yield any significant results after being cor-rected by multiple testing.Conclusion:The comprehensive evaluation of SNP associations and interac-tions within the TGF-β signaling pathway did not yield any direct associations with NSCL/P risk in Asian populations.However,the significant gene-gene interactions identified suggest that the genetic architec-ture influencing NSCL/P risk may involve interactions between genes within the TGF-β signaling path-way.These findings underscore the necessity for further investigations to unravel these results and further explore the underlying biological mechanisms.

Objective:To investigate the diagnostic value of lung ultrasound in hospitalized children with community-acquired pneumonia (CAP).Methods:In the cross-sectional study, a total of 422 children with CAP who were hospitalized in the Second Affiliated Hospital and Yuying Children′s Hospital of Wenzhou Medical University, from February 2021 to August 2022 and completed lung ultrasound examination within 48 hours after admission were enrolled. The clinical characteristics, lung ultrasound and chest CT were collected. The patients were divided into two groups according to the signs of pneumonia indicated by chest CT, and the signs of lung ultrasound with diagnostic value were screened according to the signs of pneumonia indicated by chest CT by least absolute shrinkage and selection operator (Lasso) regression. According to severity of the disease, the children were divided into the severe group and the mild group, and the differences of lung ultrasound signs between the two groups were compared. Kruskal-Wallis test, Fisher′s exact test was selected for comparison between groups. Random forest classifier wes used to evaluate the value of lung ultrasound in the diagnosis of CAP and prediction of severe pneumonia in children. The receiver operating characteristic curve was used to evaluate the prediction effect. Use DeLong test to compare the area under the curve.Results:Among the 422 cases of CAP, there were 258 males and 164 females, and the age of onset was 2.8 (1.3, 4.3) years. The confluent B-line, consolidation and pleural effusion detected by lung ultrasound were 309 cases (73.2%), 232 cases (55.0%) and 16 cases (3.8%), respectively, and the size of consolidation was 3.0 (0, 11.0) mm. One hundred and ten children (26.1%) with CAP completed chest CT. There were 90 cases with signs of pneumonia in chest CT and 20 cases without signs of pneumonia. Lasso was used for feature selection.Lung consolidation ( OR=2.46), bilateral lung consolidation ( OR=1.16) and confluent B-line ( OR=1.34) were the main index. With random forest classifier, the accuracy of models using full variables and Lasso-selected variables were 0.79 (95% CI 0.70-0.86) and 0.79 (95% CI 0.70-0.86), the sensitivity were 0.81 and 0.81, and the specificity were 0.75 and 0.70, and the area under curve were 0.87 (95% CI 0.81-0.94, P<0.001) and 0.84 (95% CI 0.76-0.91, P<0.001), respectively. There were 97 cases in severe group and 325 cases in mild group. Compared with the mild group, the detection rate of consolidation, multiple consolidation, the size of consolidation and the size of consolidation was adjusted by body surface area (consolidation size/body surface area) in severe group were higher (66 cases (68.0%) vs. 166 cases (51.1%), 42 cases (43.3%) vs. 93 cases (28.6%), 8.0 (0, 17.0) vs. 1.0 (0, 9.0) mm, 12.5 (0, 24.6) vs. 2.1 (0, 17.6), χ2=8.59, 9.98, Z=14.40, 12.79, all P<0.05). Using lung ultrasound lung consolidation size and consolidation size/body surface area to predict the severe CAP, the optimal cut-off value were 6.7 mm and 10.2, the accuracy was 0.80 (95% CI 0.75-0.83) and 0.89 (95% CI 0.86-0.92), the sensitivity was 0.99 and 0.99, the specificity was 0.14 and 0.56, respectively, and the area under the curve was 0.66 (95% CI 0.60-0.72, P<0.001) and 0.76 (95% CI 0.70-0.83, P<0.001), respectively. The area under the curve of consolidation size/body surface area was higher than that of consolidation size ( Z=5.50, P<0.001). Conclusions:Consolidation and confluent B-line, are important index for lung ultrasound diagnosis of CAP in children. The actual consolidation size adjusted by body surface area is superior to the size of consolidation in predicting severe CAP.

Objective:To investigate the impact of hyperuricemia on the live birth rate per transfer cycle and the cumulative live birth rate per oocyte retrieval cycle in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization and embryo transfer (IVF-ET). Methods:A retrospective cohort study was conducted on data from 3 959 PCOS patients who received IVF-ET treatment at the Reproductive Centers of Henan Provincial People's Hospital and Jiangxi Provincial Maternal and Child Health Hospital between January 2016 and December 2021. The patients were divided into hyperuricemia group (>357 μmol/L, n=1 126) and normal uric acid group (≤357 μmol/L, n=2 833) based on their uric acid levels. Baseline data, clinical and laboratory indicators were compared between the two groups. Univariate and multivariate regression analyses were performed on factors influencing clinical outcomes. Multivariate logistic regression analysis was used to compare the live birth rate per transfer cycle and the cumulative live birth rate per oocyte retrieval cycle between the two groups, clarifying the impact of hyperuricemia on clinical outcomes in PCOS patients. Results:There were no significant differences between the two groups in terms of age, duration of infertility, baseline testosterone level, type of infertility, and the rate of unusable embryos (all P>0.05). Body mass index [BMI, (25.15±3.75) kg/m 2], fasting blood glucose [(4.99±0.80) mmol/L] and fasting insulin levels [17.19 (11.78, 25.30) mU/L] in hyperuricemia group were higher than those in normal uric acid group [(23.60±3.64) kg/m 2, P<0.001; (4.88±0.81) mmol/L, P<0.001;12.40 (8.59, 17.86) mU/L, P<0.001], while their baseline luteinizing hormone [7.62 (4.68, 11.18) U/L] and anti-Müllerian hormone [7.62 (5.34, 10.73) μg/L] levels were lower than those in normal uric acid group [7.88 (4.98, 11.91) U/L, P=0.024; 7.95 (5.49, 11.73) μg/L, P<0.001], with statistically significant differences. Multivariate logistic regression analysis indicated that female BMI, endometrial thickness on human chorionic gonadotropin (hCG) injection day, and the number of transferable embryos were factors influencing the live birth rate per transfer cycle ( OR=1.02, 95% CI: 1.00-1.04, P=0.044; OR=0.95, 95% CI: 0.92-0.97, P<0.001; OR=0.97, 95% CI: 0.95-0.99, P=0.006). Fasting blood glucose, endometrial thickness on hCG injection day, and the number of transferable embryos were factors influencing the cumulative live birth rate per oocyte retrieval cycle ( OR=1.14, 95% CI: 1.01-1.29, P=0.036; OR=0.92, 95% CI: 0.87-0.97, P=0.002; OR=0.70, 95% CI: 0.66-0.75, P<0.001). Compared with the normal uric acid group, the hyperuricemia group in PCOS patients had not a statistically signifcant decrease in the live birth rate per transfer cycle and the cumulative live birth rate per oocyte retrieval cycle ( OR=0.93, 95% CI: 0.72-1.19, P=0.548; OR=1.18, 95% CI: 0.87-1.60, P=0.300). Conclusion:Hyperuricemia does not affect the live birth rate per transfer cycle or the cumulative live birth rate per oocyte retrieval cycle in PCOS patients undergoing IVF-ET.

Objective:To investigate the impact of hyperuricemia on the live birth rate per transfer cycle and the cumulative live birth rate per oocyte retrieval cycle in patients with polycystic ovary syndrome (PCOS) undergoing in vitro fertilization and embryo transfer (IVF-ET). Methods:A retrospective cohort study was conducted on data from 3 959 PCOS patients who received IVF-ET treatment at the Reproductive Centers of Henan Provincial People's Hospital and Jiangxi Provincial Maternal and Child Health Hospital between January 2016 and December 2021. The patients were divided into hyperuricemia group (>357 μmol/L, n=1 126) and normal uric acid group (≤357 μmol/L, n=2 833) based on their uric acid levels. Baseline data, clinical and laboratory indicators were compared between the two groups. Univariate and multivariate regression analyses were performed on factors influencing clinical outcomes. Multivariate logistic regression analysis was used to compare the live birth rate per transfer cycle and the cumulative live birth rate per oocyte retrieval cycle between the two groups, clarifying the impact of hyperuricemia on clinical outcomes in PCOS patients. Results:There were no significant differences between the two groups in terms of age, duration of infertility, baseline testosterone level, type of infertility, and the rate of unusable embryos (all P>0.05). Body mass index [BMI, (25.15±3.75) kg/m 2], fasting blood glucose [(4.99±0.80) mmol/L] and fasting insulin levels [17.19 (11.78, 25.30) mU/L] in hyperuricemia group were higher than those in normal uric acid group [(23.60±3.64) kg/m 2, P<0.001; (4.88±0.81) mmol/L, P<0.001;12.40 (8.59, 17.86) mU/L, P<0.001], while their baseline luteinizing hormone [7.62 (4.68, 11.18) U/L] and anti-Müllerian hormone [7.62 (5.34, 10.73) μg/L] levels were lower than those in normal uric acid group [7.88 (4.98, 11.91) U/L, P=0.024; 7.95 (5.49, 11.73) μg/L, P<0.001], with statistically significant differences. Multivariate logistic regression analysis indicated that female BMI, endometrial thickness on human chorionic gonadotropin (hCG) injection day, and the number of transferable embryos were factors influencing the live birth rate per transfer cycle ( OR=1.02, 95% CI: 1.00-1.04, P=0.044; OR=0.95, 95% CI: 0.92-0.97, P<0.001; OR=0.97, 95% CI: 0.95-0.99, P=0.006). Fasting blood glucose, endometrial thickness on hCG injection day, and the number of transferable embryos were factors influencing the cumulative live birth rate per oocyte retrieval cycle ( OR=1.14, 95% CI: 1.01-1.29, P=0.036; OR=0.92, 95% CI: 0.87-0.97, P=0.002; OR=0.70, 95% CI: 0.66-0.75, P<0.001). Compared with the normal uric acid group, the hyperuricemia group in PCOS patients had not a statistically signifcant decrease in the live birth rate per transfer cycle and the cumulative live birth rate per oocyte retrieval cycle ( OR=0.93, 95% CI: 0.72-1.19, P=0.548; OR=1.18, 95% CI: 0.87-1.60, P=0.300). Conclusion:Hyperuricemia does not affect the live birth rate per transfer cycle or the cumulative live birth rate per oocyte retrieval cycle in PCOS patients undergoing IVF-ET.

Mycolic acids (MAs), i.e. 2-alkyl, 3-hydroxy long-chain fatty acids, are the hallmark of the cell envelope of Mycobacterium tuberculosis and are related with antibiotic resistance and host immune escape. Nowadays, they've become hot target of new anti-tuberculosis drugs. There are two main methods to detect MAs, ¹⁴C metabolic labeling thin-layer chromatography (TLC) and liquid chromatograph mass spectrometer (LC-MS). However, the user qualification of ¹⁴C or the lack of standards for LC-MS hampered the easy use of this method. TLC is a common way to analyze chemical substance and can be used to analyze MAs. In this study, we used tetrabutylammonium hydroxide and methyl iodide to hydrolyze and formylate MAs from mycobacterium cell wall. Subsequently, we used diethyl ether to extract methyl mycolate. By this method, we can easily extract and analyze MA in regular biological labs. The results demonstrated that this method could be used to compare MAs of different mycobacterium in different growth phases, MAs of mycobacteria treated by anti-tuberculosis drugs or MAs of mycobacterium mutants. Therefore, we can use this method as an initial validation for the changes of MAs in researches such as new drug screening without using radioisotope or when the standards are not available.
Mycolic Acids/metabolism* ; Chromatography, Thin Layer ; Mycobacterium tuberculosis ; Fatty Acids ; Antitubercular Agents/pharmacology*

Objective:To evaluate the efficacy and safety of peroral endoscopic myotomy (POEM) in achalasia of cardia (AC) patients with the long course.Methods:A total of 159 AC patients who received POEM from January 2015 to March 2022 in the First Affiliated Hospital of Soochow University were divided into the long course group (≥10 years) and the non-long course group (<10 years). The baseline information, POEM procedure and postoperative recurrence were compared and the differences between the recurrent patients and non-recurrent patients in the long course group were explored.Results:The age (57.09±14.30 years VS 42.08±15.68 years, t=5.569, P<0.001), the rate of treatment history [28.9% (13/45) VS 9.6% (11/114), χ2=9.319, P=0.020], the proportion of Henderson grade Ⅲ esophagus [17.8% (8/45) VS 6.1% (7/114), χ2=7.020, P=0.030] in the long course group were significantly higher than those in the non-long course group. The recurrence rate in the long course group was significantly higher than that in the non-long course group [33.3% (15/45) VS 14.9% (17/114), χ2=6.811, P=0.009]. In the long course group, the age (62.50 ± 16.94 years VS 53.77 ± 12.95 years, t=-2.121, P=0.040), and the rate of treatment history [53.3% (8/15) VS 16.7% (5/30), χ2=6.544, P=0.016] in the recurrent patients were higher than those in the non-recurrent patients. Conclusion:POEM is safe and effective for long-course AC patients. In patients with the long course, the aged patients with previous treatment are more likely to relapse.