ObjectiveTo explore the mechanism by which Buyang Huanwutang regulates the glutathione peroxidase 4 （GPX4）-acyl-CoA synthetase long-chain family member 4 （ACSL4） axis to inhibit ferroptosis and promote neurological functional recovery after spinal cord injury （SCI）. MethodsNinety rats were randomly divided into five groups： sham operation group， model group， low-dose Buyang Huanwutang group （12.5 g·kg^-1）， high-dose Buyang Huanwutang group （25 g·kg^-1）， and Buyang Huanwutang + inhibitor group （25 g·kg^-1 + 5 g·kg^-1 RSL3）. The SCI model was established by using the allen method. Tissue was collected on the 7th and 28th days after operation. Motor function was assessed by using the Basso-Beattie-Bresnahan （BBB） scale. Hematoxylin-eosin （HE）， Nissl， and Luxol fast blue （LFB） staining were performed to observe spinal cord histopathology. Transmission electron microscopy was used to examine mitochondrial ultrastructure. Immunofluorescence staining was used to detect the number of NeuN-positive cells and the fluorescence intensity of myelin basic protein （MBP）， GPX4， and ACSL4. Real-time fluorescent quantitative polymerase chain reaction （Real-time PCR） was used to analyze the mRNA expression of GPX4 and ACSL4. Enzyme linked immunosorbent assay （ELISA） was performed to measure the levels of reactive oxygen species （ROS）， malondialdehyde （MDA）， glutathione （GSH）， and superoxide dismutase （SOD）. Colorimetric assays were used to determine the iron content in spinal cord tissue. ResultsCompared to the sham operation group， the model group exhibited significantly reduced BBB scores （P<0.01）， severe pathological damage in spinal cord tissue， and marked mitochondrial ultrastructural disruption. In addition， the model group showed a decrease in the number of NeuN-positive cells （P<0.01）， reduced fluorescence intensity of MBP and GPX4 （P<0.01）， lower levels of GSH and SOD （P<0.01）， and downregulated mRNA expression of GPX4 （P<0.01）. Moreover， compared to the sham operation group， the model group had elevated levels of ROS， MDA， and tissue iron content （P<0.01）， along with increased fluorescence intensity and mRNA expression of ACSL4 （P<0.01）. Compared with the model group and Buyang Huanwutang + inhibitor group， the Buyang Huanwutang group showed significantly improved BBB scores （P<0.05， P<0.01） and exhibited less severe spinal cord tissue damage， reduced edema and inflammatory cell infiltration， increased neuronal survival， and more intact myelin structures. Additionally， mitochondrial ultrastructure was significantly improved in the Buyang Huanwutang group. Compared to the model group and Buyang Huanwutang + inhibitor group， the Buyang Huanwutang group significantly increased the number of NeuN-positive cells and the fluorescence intensity of MBP （P<0.05， P<0.01）. Furthermore， Buyang Huanwutang significantly increased the fluorescence intensity and mRNA expression of GPX4 （P<0.01） and decreased the fluorescence intensity and mRNA expression of ACSL4 （P<0.01） compared to the model group and Buyang Huanwutang + inhibitor group. Finally， the Buyang Huanwutang group significantly decreased ROS， MDA， and tissue iron content （P<0.01） and significantly increased GSH and SOD levels （P<0.01） compared to the model group and Buyang Huanwutang + inhibitor group. ConclusionBuyang Huanwutang inhibits ferroptosis through the GPX4/ACSL4 axis， reduces secondary neuronal and myelin injury and oxidative stress， and ultimately promotes the recovery of neurological function.

Objective: To explore the effects of Buyang Huanwu decoction (BYHWD) on vascular neogenesis and hemorheological parameters following cervical spinal cord injury (SCI). Methods: An acute cervical SCI model was established using 84 female Sprague–Dawley rats. Functional recovery of the rats was evaluated using the forelimb locomotor scale score, forelimb grip strength test, and Basso-Beattie-Bresnahan score. The animals were subsequently euthanized at days 7 and 28 postoperatively. The gross morphology, neuronal survival, and myelin sheath in the injured area were evaluated using hematoxylin and eosin (HE), Nissl, and luxol fast blue (LFB) staining, respectively. Immunofluorescence staining was used to observe CD31 expression 7 days post-injury. Furthermore, the expression of CD31, neuronal nuclear protein (NeuN), and myelin basic protein (MBP) were evaluated 28 days post-injury. Additionally, vascular endothelial growth factor A (VEGFA) and VEGF receptor-2 (VEGFR-2) expression was evaluated using western blotting. Whole-blood viscosity, plasma viscosity, and red blood cell aggregation were measured using a hemorheometer. Results: From postoperative days 3–28, motor function in the BYHWD group began to recover considerably compared to the SCI group. BYHWD effectively restored spinal cord histopathology. In addition, the number of NeuN-positive cells, and fluorescence intensity of CD31at 7 and 28 days and MBP significantly increased in the BYHWD group compared with the SCI group (all P < .05). Moreover, this decoction significantly upregulated the expression of VEGFA and VEGFR-2 (all P < .05). BYHWD improved the hemorheology results (i.e., except erythrocyte aggregation index in the low-dose group), revealing statistically significant differences compared with the SCI group (all P < .05). Conclusion BYHWD effectively promoted angiogenesis, improved hemorheological parameters, and protected neurons and myelin sheaths, ultimately promoting the recovery of neurological function after cervical SCI in rats. These findings suggest that BYHWD promotes vascular neogenesis through the VEGFA/VEGFR-2 pathway.

Objective: To understand the prevalence of Chlamydia trachomatis (CT) infection and its associated factors among asymptomatic outpatients attending sexually transmitted disease (STD)-related clinics in Shenzhen and provide evidence for development of future interventions. Methods: From April 15 to May 16, 2018, a cross-sectional study was conducted and patients attending STD-related Clinics were recruited from 22 medical institutions in Nanshan, Luohu, Bao'an, Longgang, Yantian, and Longhua districts of Shenzhen. After the informed consent from each participant was obtained, social-demographic information was collected through a structured questionnaire and urine samples were collected for CT nucleic acid detection. In addition, logistic regression was used to explore associated factors of CT infection. Results: In asymptomatic outpatients, the prevalence of CT infection was 7.16% (250/3 492). Being single (aOR=2.29, 95%CI:1.65-3.16), without registered Shenzhen residency (aOR=1.49, 95%CI:1.04-2.13), and without previous CT testing in the past year (aOR=2.04, 95%CI:1.03-4.05) were the risk factors of CT infection in asymptomatic outpatients. Among participants without registered Shenzhen residency, 89.25% (2 176/2 438) were college-degree or below, and 51.29% (1 255/2 447) were aged ≤30 years, and the risk of CT infection among those ≤30 years old was 1.73 times higher than those >30 years old (95%CI:1.28-2.34). Conclusions: The prevalence of CT infection was high among asymptomatic outpatients attending STD-related clinics in Shenzhen. Routine CT screening should be carried out for this population, especially for those with sexually active age, being single, with low educational level, and without previous CT testing in the past year. Also, raising their awareness of knowledge and adverse outcomes of CT infection should be considered to promote routine CT screening and timely treatment.
Adult ; Chlamydia Infections/epidemiology* ; Chlamydia trachomatis ; Cross-Sectional Studies ; Humans ; Nucleic Acids ; Outpatients

Monkeypox is a zoonotic disease caused by monkeypox virus, and human cases infected with the virus have been reported in more than 100 countries. To respond to the potential of case importation and consequent spread of the infection in the country, it is urgent for China to strengthen its comprehensive surveillance efforts consisting of case detection through country-entering check, symptom screening, and investigation among priority populations, and to implement comprehensive strategies to control the source of infection, interrupt the transmission and protect the people at risk.

Objective:To compare the efficacy of internal fixation and external fixation in the treatment of pelvic fractures.Methods:A retrospective case control study was conducted to analyze the data of 66 patients with anterior pelvic ring fracture treated from December 2015 to December 2017 at First People's Hospital of Lianyungang, including 36 males and 30 females, with an average age of 42.7 years (range, 19 to 63 years). There were 36 patients with Tile type B fractures and 30 with Tile type C fractures. Minimally invasive percutaneous internal fixation through the anterior inferior iliac spine was performed in 33 patients (internal fixation group) and external fixator was employed in another 33 patients (external fixation group). The two groups were compared in terms of the operation time, intraoperative blood loss, fracture healing time, fracture reduction assessment with Matta criteria, Majeed score and surgical complications.Results:All patients were followed up for 9-24 months (mean, 14.5 months). The operation time was (33.7±3.6)minutes in internal fixation group , and (24.5±3.5)minutes in external fixation group ( P<0.05). Intraoperative blood loss was (25.8±3.3)ml in internal fixation group and (21.8±4.3)ml in external fixation group ( P<0.05). The fractures were healed acceptably, with the healing time of (13.8±1.6)weeks in internal fixation group and (21.7±1.9)weeks in external fixation group ( P< 0.05). According to the Matta criteria, internal fixation group showed excellent results in 17 patients, good in 14, fair in 2 and poor in 0, with the excellent and good rate of 94%; external fixation group showed excellent results in 14 patients, good in 12, fair in 6 and poor in 1 , with the excellent and good rate of 79% ( P>0.05). For Majeed function score, the results in internal fixation group were excellent in 18 patients, good in 13, fair in 2 and poor in 0, with the excellent and good of 94%; the results in external fixation group were excellent in 14 patients, good in 12, fair in 7 and poor in 0, with the excellent and good of 79% ( P>0.05). After operation, frequent urinary occurred in one patient, unilateral femoral nerve partial paralysis in one, nail cap stimulation in two and incisional redness, swelling and exudation in one in internal fixation group. In external fixation group, there were 5 patients with nail rod exudation. Conclusion:Compared with the external fixator, the internal fixation for pelvic fractures is less invasive and more reliable, can accelerate fracture healing without interfering with the patient's daily life, and can be used as the final fixation.

Objective:To understand the prevalence of Neisseria gonorrhoeae (NG) infection and related factors in outpatients of sexually transmitted disease (STD) in Shenzhen and provide scientific evidence for targeted intervention. Methods:A cross-sectional study was conducted in STD outpatients who were aged 18-49 years, had had sexual intercourse, had not received antibiotics in the last 2 weeks and sought medical cares in 22 medical institutions in 6 districts of Shenzhen from 15 April, 2018 to 16 May, 2018, their basic information and urine samples were collected, and NG in urine sample was detected by nucleic acid amplification test. Logistic regression analysis was conducted to identify the related factors for NG infection.Results:The information collection and sample collection were completed for 8 324 STD outpatients, among these STD outpatients, 196 were NG positive, with a positive rate of 2.4% (196/8 324). The positive rate of NG in men (5.8%, 148/2 567) was higher than that in women (0.8%, 47/5 742) ( χ2=189.43, P<0.05). Aged 24 years or below ( OR=2.11, 95% CI: 1.44-3.09), single/divorced/widowed ( OR=1.98, 95% CI:1.38-2.84), having casual sex in the last 3 months ( OR=1.77, 95% CI:1.29-2.43) were the related factors for NG infection. Conclusions:We found that NG infection rate was high in STD outpatients in Shenzhen. The infection rates in men and in women differed obviously. It is necessary to conduct gonorrhea screening and intervention in STD outpatients with high-risk behaviors, such as extramarital and casual sex behaviors, and standardize the treatment to reduce the incidence and spread of gonorrhea and other STDs.

Objective: To investigate the effect and mechanism of G protein coupled receptor 119 (GPR119) in regulating lipid metabolism. Methods: (1) Macrophage THP-1 was induced by oxidized low density lipoprotein (oxLDL) to the formation of lipid foam cells, protein expression of GPR119, hypoxia-inducible factor-1α (HIF-1α), vascular endothelial growth factor (VEGF) were detected by Western blotting. (2) Constructing GPR119 over-expressed and low-expressed plasmids, the plasmids were transfected into THP-1 cells which induced by oxLDL. The lipid content in macrophages was observed by oil red O staining. Cholesterol efflux was detected by liquid scintillation counter. The mRNA and protein expressions of HIF-1α, VEGF were detected by reverse transcription PCR and Western blotting. (3) Constructing GPR119, HIF-1α, and VEGF over-expressed plasmids, then co-transfection of GPR119 and HIF-1α/VEGF plasmids. The lipid content in macrophages was observed by oil red O staining. Cholesterol efflux was detected by liquid scintillation counter. Results: Compared with the control group, the lipid droplets were densely distributed in macrophages, with a large number and volume. The protein expression of GPR119 was significantly decreased and HIF-1α, VEGF were significantly increased in macrophages induced by oxLDL (P<0.05). After over-expression of GPR119, the lipid droplets were sparsely distributed and the number was significantly reduced in macrophages, the lipid droplets were mostly located in the area around the cells. The cholesterol efflux was significantly increased (P<0.01). The mRNA and protein expressions of HIF-1α and VEGF were significantly decreased (P<0.01). On the contrary, in the GPR119 inhibition group, the lipid droplets were densely distributed in macrophages, with a large number and volume. The lipid droplets even covered the nuclei. The cholesterol efflux was significantly reduced (P<0.05). The mRNA and protein expression of HIF-1α, VEGF were significantly increased (P<0.05). After GPR119 were co-expressed with HIF-1α and VEGF, the number of lipid droplets was increased, lipid droplets were dense and bulky in oxLDL-induce macrophages. The cholesterol efflux was inhibited. Conclusion GPR119 can regulate lipid metabolism and possibly by down-regulating the expression of HIF-1α and VEGF.

Objective: To investigate the anti-photoaging effects of human umbilical cord mesenchymal stem cells derived extracellular vesicles (hucMSC-EVs) on dermal fibroblasts. Methods: Human fibroblasts were pretreated with hucMSC of different concentrations for 24 hours before ultraviolet B (UVB) irradiation. Immediately post irradiation, the intracellular reactive oxygen species (ROS) were analyzed using reactive oxygen detection kit. After 72 hours irradiation, cell proliferation was assessed using CCK-8 assay, and the percentage of senescent cells was evaluated by β-galactosidase (SA-β-gal) staining. Results: The UVB irradiation increased intracellular ROS level, decreased the cell proliferation from 100% to(77.33±2.89)%, and increased the percentage of SA-β-gal positive senescent cells from (6.70±0.46)% to (17.67±1.53)%. The hucMSC-EVs pretreatment decreased the intracellular ROS level, stimulated cell proliferation from (77.33±2.89)% to (90.67±2.52)% and( 96.00±5.57)% , and decreased the positive rate of SA-β-gal positive cells from (17.67±1.53)% to (8.38±0.56)% and (7.07±1.10)%. Conclusions The hucMSC-EVs preconditioning may protect dermal fibroblasts from UVB induced photoaging, by reducing intracellular ROS.

Objective To compare the value of diffusion kurtosis imaging (DKI) mode and mono-exponential mode in predicting the response to neoadjuvant chemotherapy (NAC) for locally advanced breast carcinoma using DWI.Methods From January 1,2013 to December 31,2016,eighty patients with locally advanced breast carcinoma were enrolled into this prospective clinical study.The diagnosis was confirmed on the basis of histopathological results.The clinical stage stayed at Ⅱ or Ⅲ.The patients would receive breast-conserving surgery after NAC.All the patients underwent DWI examination by using both mono-exponential mode and DKI mode before chemotherapy was initiated.The parameters included ADC,mean diffusivity (MD) and mean kurtosis (MK).Within 1 to 3 days before or after MRI examination,the patients underwent aspiration biopsy,received 4 to 8 cycles of NAC and followed by surgery.According to histologic grading before NAC,the patients were classified into well-differentiated and poor-differentiated group.According to the comparison between pathological results acquired from biopsy before NAC and specimen acquired after surgery,the patients were classified into pathologic complete response (pCR) and pathologic non-complete response (non-pCR) according to treatment effect.The imaging parameters were compared between the pCR and the non-pCR group using t test.The predicting ability of two imaging modes was compared and analyzed with ROC analysis.The relationships between multiple imaging parameters,pathologic,clinical characteristics of tumor and treatment effect were analyzed using logistic multi-variate regression analysis,and further analyzed using Wald test.Results There were 30 cases of pCR and 50 cases of non-pCR.The ADC and MD values were lower in the pCR group than in the non-pCR group (P＜0.05).MK value was higher in the pCR group than in the non-pCR group (P＜0.05).ROC analysis showed that the area under ROC curve of ADC,MD and MK in predicting treatment effect were 0.732,0.866 and 0.683 respectively.Logistic regression analysis showed that,according to predicting ability,MD,ADC and MK successively were the independent predictors for the early response to chemotherapy.Conclusion Compared with mono-exponential mode,DKI mode can reflect the real micro-environment and water diffusion restriction within the tumor area more reliably and accurately,and is more suitable to serve as an imaging technique for predicting the response to NAC for locally advanced breast carcinoma.

Objective To evaluate the application of Burnet Institute-made prototype IgA rapid test,a kind of point-of-care (POC) testing,in the diagnosis of early syphilis.Methods Totally,455 stored serum samples in the Reference Laboratory of Sexually Transmitted Disease,the Institute of Dermatology were used to evaluate the application of the prototype IgA rapid test (IgA-POC) in the diagnosis of early syphilis.According to resluts of Treponema pallidum hemagglutination assay (TPHA),rapid plasma reagin card test (RPR),and enzyme-linked immunosorbent assay for IgM antibodies (IgM-ELISA),these stored samples were divided into 3 groups:uninfected group,previously infected group and early active syphilis group.IgA-POC test was performed in the 3 groups to evaluate its diagnostic performance for active syphilis,and researchers were blind to the group information.Results The prototype IgA-POC test had a sensitivity of 92.6％ (147/163) for the early active syphilis group,a specificity of 72.22％ (104/144) for the previously infected group,and a specificity of 97.97％ (145/148) for the uninfected group.The total specificity of the prototype IgA-POC test was 85.27％,which met the minimum requirement of WHO for the POC test.The prototype IgA-POC test showed a significantly higher sensitivity for the diagnosis of early active syphilis compared with the IgM-ELISA (59.51％,Z =6.88,P ＜ 0.05),but a significantly lower specificity for the diagnosis of previous syphilis infection compared with the IgM-ELISA (98.61％,Z =6.18,P ＜ 0.05).Moreover,no significant difference in the specificity for the diagnosis of non-infection was observed between the prototype IgA-POC test and IgM-ELISA (Z =1.16,P =0.25).Conclusion The prototype IgA-POC test has better capacity for the diagnosis of early active syphilis compared with the IgM-ELISA,so it can be applied to the screening of early active syphilis.