Objective:To investigate the epidemic trends and spatiotemporal distribution characteristics of genital Chlamydia trachomatis infection in China in recent years, and to provide a reference for its precise prevention and control.Methods:Data on reported cases of genital Chlamydia trachomatis infection in China (not including Hongkong, Macau and Taiwan regions of China) were collected through the Infectious Diseases Surveillance System of Chinese Disease Prevention and Control Information System from 2018 to 2023. The trend in the incidence rate was analyzed using the Joinpoint 4.9.1 software. Global and local spatial autocorrelation analyses at the county level were conducted using the ArcGIS 10.5 software. Spatiotemporal scanning analysis was carried out with the SaTScan 10.1.2 software.Results:The reported incidence rates of genital Chlamydia trachomatis infection slightly declined from 12.66 per 100 000 in 2018 to 12.45 per 100 000 in 2023, with an average annual percent change of -1.42%, which was not statistically significant ( t = -1.14, P = 0.318). The reported incidence rates of genital Chlamydia trachomatis infection at the county level in China showed a significant positive global spatial autocorrelation, with the global Moran's indices ranging from 0.68 to 0.74 (all P < 0.001) ; the standardized statistic Z (G) values for the Getis-Ord general G were all greater than 1.96, indicating a high-value clustering pattern. Local spatial autocorrelation analysis revealed that hotspot areas were predominantly located in southern and eastern China. In the spatiotemporal scanning analysis, 38 statistically significant spatiotemporal clusters were identified, mainly distributed in southern and eastern China and consistent with the hotspot areas. Conclusions:From 2018 to 2023, the reported incidence rates of genital Chlamydia trachomatis infection showed a slight decline, and the epidemic exhibited spatiotemporal clustering characteristics in China. Targeted prevention and control measures need to be implemented in hotspot areas and spatiotemporal clusters.

Chronic rhinosinusitis（CRS） is an inflammatory disease involving the mucosa of the nasal and paranasal sinuses for more than 12 weeks and can be classified as CRS with nasal polyp（CRSwNP） and CRS without nasal polyp（CRSsNP） depending on the phenotype. Clinical treatments reveal significant differences in disease prognosis and improvement in quality of life in patients with the same clinical phenotype. Inflammatory cells infiltration and inflammatory mediators are important factors driving CRS endotypes. In particular, CRS with predominantly eosinophilic infiltration and type 2 CRS present severe clinical symptoms, comorbidities, and high recurrence rates. CRS endotype-oriented treatment methods may better contribute to improving patient prognosis and quality of life. This article summarizes the current progress of CRS endotype research and reviews the endotype-oriented treatment options.
Humans ; Rhinitis/therapy* ; Nasal Polyps/diagnosis* ; Quality of Life ; Sinusitis/diagnosis* ; Eosinophilia ; Chronic Disease

Objective:To analyse the effect of preoperative renal function classification on early outcomes for patients with acute type A aortic dissection(AAAD) and to estimate the risk factors of postoperative major adverse events.Methods:From January 2012 to December 2019, 226 patients with AAAD who underwent total arch replacement at our institution were retrospectively analysed, including 146 males and 80 females, aged(54.4±12.5) years old. Stages of preoperative renal function were defined as follows: Normal[estimated glomerular ltration rate(eGFR)≥90 ml·min -1·1.73 m -2, 68 cases], Mild(eGFR 60-89 ml·min -1·1.73 m -2, 73 cases); Moderate(eGFR 30-59 ml·min -1·1.73 m -2, 57 cases), Severe(eGFR<30 ml·min -1·1.73 m -2, 28 cases). The independent risk factors for postoperative death were analyzed by logistic regression analysis. The area under the receiver operating characteristic curve was used to assess the efficiency of eGFR for predicting the postoperative hemodialysis. Results:In-hospital death occurred in 24(10.6%) cases. Major complications included postoperative hemodialysis in 49(21.7%) cases, stroke in 19(8.4%) cases and tracheotomy in 15(6.6%) cases. The best cut-off value of the eGFR for predicting postoperative hemodialysis was 36.5 ml·min -1·1.73 m -2(area under the receiver operating characteristic curve was 0.793). The following variables were found to be risk factors of in-hospital mortality in multivariate logistic regression analysis: serum creatinine, eGFR<30 ml·min -1·1.73 m -2, neural malperfusion, bowel malperfusion, postoperative stroke and hemodialysis. Conclusion:Total arch replacement can be safely performed in patients with AAAD and mild renal dysfunction. Preoperative renal dysfunction is a risk factor for postoperative hemodialysis, and eGFR is useful for predicting the requirement for hemodialysis after total arch replacement. The severity of preoperative renal dysfunction could greatly influence the outcomes after total arch replacement for AAAD. More importance should be attached to the assessment of preoperative renal function during clinical risk assessment.

Objective:To summarize the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) infected with Delta variant, so as to provide further references for clinical diagnosis and treatment.Methods:A real-world study was conducted to analyze the characteristics of 166 COVID-19 patients infected with Delta variant at Guangzhou Eighth People’s Hospital, Guangzhou Medical University.Results:The study enrolled 5 asymptomatic cases, 123 non-severe cases (mild and moderate type), and 38 severe cases (severe and critical type). Among these patients, 69 (41.6%) were male and 97 (58.4%) were female, with a mean age of 47.0±23.5 years. Thirty-nine cases (23.5%) had received 1 or 2 doses of inactivated vaccine. The incidence of severe COVID-19 cases was 7.7% in 2-doses vaccinated patients, which was lower than that of 11.5% in 1-dose and 26.8% in unvaccinated patients. The proportion of severe cases in 2 dose-vaccinated patients was 7.7%, which was lower than that of 11.5% in 1-dose vaccinated patients and 26.8% in unvaccinated patients, but the difference was not significant ( P>0.05). The most common clinical symptom was fever (134 cases, 83.2%), and 39.1% of cases presented with high-grade fever (≥39 °C); other symptoms were cough, sputum, fatigue, and xerostomia. The proportion of fever in severe cases was significantly higher than that of non-severe cases (97.4% vs. 76.4%, P<0.01). Similarly, the proportion of severe cases with high peak temperature (≥39 ℃) () was also higher than that of non-severe cases (65.8% vs. 30.9%, P<0.01). The median minimal Cycle threshold (Ct) values of viral nucleic acid N gene and ORFlab gene were 20.3 and 21.5, respectively, and the minimum Ct values were 11.9 and 13.5, respectively. Within 48 h of admission, 9.0% of cases presented with decreased white blood cell counts, and 52.4% with decreased lymphocyte counts. The proportions of increased C-reactive protein, serum amyloid A, interleukin 6, and interleukin 10 were 32.5%, 57.4%, 65.3%, and 35.7%, respectively. The proportions of elevated C-reactive protein, serum amyloid A and interleukin-6 in severe cases were significantly higher than those in non-severe cases ( P<0.01). Logistic regression analysis showed that older age and higher peak temperature were associated with a higher likelihood of severe cases ( OR>3, 95% CI: 2-7, P<0.01). In terms of treatment, traditional Chinese medicine (TCM) was used in 97.6% of non-severe cases and 100% in severe cases. Other treatments included respiratory and nutritional support, immunotherapy (such as neutralizing antibodies and plasma of recovered patients). The median times from admission to progression to severe cases, of fever clearance, and of nucleic acid conversion were 5 days, 6 days and 19 days, respectively. No deaths were reported within 28 days. Conclusions:The symptoms of Delta variant infection in Guangzhou are characterized by a high proportion of fever, high peak temperature, long duration of fever, high viral load, a long time to nucleic acid conversion, and a high incidence of severe cases. The severe cases exhibit a higher percentage of elderly patients, a longer duration of fever and have a higher fever rate and a higher hyperthermia rate than non-severe cases. Age and hyperthermia are independent risk factors for progression to severe disease. The combination of TCM and Western medicine can control the progression of the disease effectively.

Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.

Genomic studies of cancer cell alterations,such as mutations,copy number variations(CNVs),and translocations,greatly promote our understanding of the genesis and development of cancers.However,the 3D genome architecture of cancers remains less studied due to the complexity of cancer genomes and technical difficulties.To explore the 3D genome structure in clin-ical lung cancer,we performed Hi-C experiments using paired normal and tumor cells harvested from patients with lung cancer,combining with RNA sequenceing analysis.We demonstrated the feasibility of studying 3D genome of clinical lung cancer samples with a small number of cells(1×104),compared the genome architecture between clinical samples and cell lines of lung cancer,and identified conserved and changed spatial chromatin structures between normal and cancer sam-ples.We also showed that Hi-C data can be used to infer CNVs and point mutations in cancer.By integrating those different types of cancer alterations,we showed significant associations between CNVs,3D genome,and gene expression.We propose that 3D genome mediates the effects of cancer genomic alterations on gene expression through altering regulatory chromatin structures.Our study highlights the importance of analyzing 3D genomes of clinical cancer samples in addition to cancer cell lines and provides an integrative genomic analysis pipeline for future larger-scale studies in lung cancer and other cancers.

Objective:To investigation and analysis of ammonia gas leakage in a meat factory.Methods:In April 2013, Enterprise managers and workers were investigated, and clinical data of 24 patients were analyzed.Results:The company caused a leak in the ammonia pipeline maintenance operation, Among the patients, 20 had stimulus response and 4 had mild poisoning.Conclusion:To prevent group occupational ammonia poisoning, it is necessary to strengthen the awareness of occupational disease prevention of enterprise owners and the awareness of self-protection of workers.

Medoggreenpit-viper bites are extremely rare in northern China. This article analyzed the clinical data, laboratory test results, treatment methods and the outcome of a case of poisoning from the Medoggreenpit-viper snake bite in the northern area. The main clinical manifestations of the patient were local swelling and bleeding. The wound was debrided immediately after the patient was admitted to the hospital, and vacuum suction was given after the debridement. After been treated with anti-Agkistrodon venom serum, anti-Gyrus serpent, anti-infection, organ protection, fluid replacement and diuresis, the patient recovered and was discharged from the hospital. The patients were generally in good condition after follow-up. This case suggested that regional poisoning treatment centers in the northern region should stock various anti-venom serums. At the same time, it is necessary to popularize knowledge of standard treatment of snake bites.

Objective:To investigation and analysis of ammonia gas leakage in a meat factory.Methods:In April 2013, Enterprise managers and workers were investigated, and clinical data of 24 patients were analyzed.Results:The company caused a leak in the ammonia pipeline maintenance operation, Among the patients, 20 had stimulus response and 4 had mild poisoning.Conclusion:To prevent group occupational ammonia poisoning, it is necessary to strengthen the awareness of occupational disease prevention of enterprise owners and the awareness of self-protection of workers.

Medoggreenpit-viper bites are extremely rare in northern China. This article analyzed the clinical data, laboratory test results, treatment methods and the outcome of a case of poisoning from the Medoggreenpit-viper snake bite in the northern area. The main clinical manifestations of the patient were local swelling and bleeding. The wound was debrided immediately after the patient was admitted to the hospital, and vacuum suction was given after the debridement. After been treated with anti-Agkistrodon venom serum, anti-Gyrus serpent, anti-infection, organ protection, fluid replacement and diuresis, the patient recovered and was discharged from the hospital. The patients were generally in good condition after follow-up. This case suggested that regional poisoning treatment centers in the northern region should stock various anti-venom serums. At the same time, it is necessary to popularize knowledge of standard treatment of snake bites.