BACKGROUND:Multiple studies have confirmed that mitogen-activated protein kinase(MAPK)signaling pathway is involved in cell proliferation,and microRNA(miR)is involved in the occurrence and development of hypertrophic scars.Therefore,the role of miR-27a-3p and MAPK signaling pathways in pathological scar formation has been further explored. OBJECTIVE:To explore the effect of miR-27a-3p on the proliferation of human hypertrophic scar fibroblasts through the MAPK signaling pathway. METHODS:The primary fibroblasts were isolated and collected from the skin samples.The primary fibroblasts were observed by inverted microscope and verified by immunofluorescence.The relative expression level of miR-27a-3p in tissues was detected by qRT-PCR.The target genes of hsa-miR-27a-3p were predicted using the database,and then the predicted target genes were enriched by gene ontology function analysis and biological pathway enrichment analysis of the Kyoto Encyclopedia of Genes and Genomes.There were seven groups:blank control,negative control,miR-27a-3p mimic,miR-27a-3p inhibitor,miR-27a-3p mimic+p38 MAPK inhibitor,miR-27a-3p mimic+extracellular regulated protein kinase inhibitor,miR-27a-3p mimic+c-Jun N-terminal kinase inhibitor.Western blot was used to detect the levels of extracellular regulated protein kinase,c-Jun N-terminal kinase inhibitor.and p38 kinase and their phosphorylation levels.Cell counting kit-8 and EdU were used to detect cell proliferation. RESULTS AND CONCLUSION:Compared with normal skin fibroblasts,hypertrophic scar fibroblasts had stronger proliferative activity(P<0.05)and faster proliferation level(P<0.001).Compared with normal skin,miR-27a-3p was highly expressed in hypertrophic scars(P<0.001).Compared with the negative control group,overexpression of miR-27a-3p could promote cell proliferation activity(P<0.001)and proliferation levels(P<0.001).Compared with the negative control group,knockdown of miR-27a-3p could inhibit the proliferation activity(P<0.05)and proliferation levels(P<0.001).Compared with the negative control group,overexpression of miR-27a-3p promoted the phosphorylated levels of extracellular regulated protein kinase,c-Jun N-terminal kinase,and p38 mitogen-activated protein kinase(P<0.05).Compared with the negative control group,knockdown of miR-27a-3p inhibited the phosphorylated levels of extracellular regulated protein kinase,c-Jun N-terminal kinase,and p38 MAPK(P<0.05).Compared with the miR-27a-3p mimic group,specific inhibitors of extracellular regulated protein kinase,c-Jun N-terminal kinase,and p38 MAPK reversed the effects of miR-27a-3p on the proliferative activity(P<0.01)and proliferation level(P<0.001)of fibroblasts.To conclude,these results suggest that miR-27a-3p promotes the proliferation of human hypertrophic scar fibroblasts by activating the MAPK signaling pathway.

Objective To analyze the current situation of healthcare-associated infection (HCAI) management of fever clinics among different levels of medical institutions in Wuhan, and to provide a scientific basis for improving hospital infection management. Methods In January 2023, a network questionnaire survey was conducted on medical institutions with fever clinics in Wuhan. Results A total of 72 medical institutions were investigated, of which 58.33% had CT, and 48.61% had fever clinics for children. The total qualified rate of HCAI management was 78.28%. The qualified rates of four primary indicators, including hospital management, diagnosis and treatment environment protection, training and education, and implementation of infection control measures, were 82.27%, 71.49%, 75.93%, and 81.31%, respectively. There were statistical differences among different levels of medical institutions (all P<0.01). Among the 13 secondary indicators, the qualified rates of 7 indicators were more than 80%, with the highest being medical item management (93.06%), medical waste disposal (89.72%), and personnel management (83.33%), and the lowest being facilities and equipment (66.32%), and patients and accompanying personnel education (66.67%). Among the 65 tertiary indicators, 30 had a pass rate great than 80%. Conclusion Wuhan actively promotes the construction of fever clinics in medical institutions, and the overall situation of HCAI management is good. However, there are still some problems to varying degrees, especially in the layout procedures, hand hygiene, and staff training of fever clinics in secondary and lower medical institutions, which should be further strengthened.

Traditional Chinese medicine has been paid more and more attention in the development of modern healthcare,and its clinical diagnosis and treatment have broad prospects and enormous potential.However,the current traditional Chinese medicine diagnosis and treatment model have serious shortcomings in service capacity and,diagnosis,and treatment effect.The rapid development of big data and artificial intelli-gence technology provides an opportunity for the iterative upgrade of traditional Chinese medicine diagnosis and treatment models.This article reviewed the current situation of artificial intelligence empowering tradi-tional Chinese medicine clinical diagnosis and treatment,clarified the problems and challenges faced by artifi-cial intelligence technology in data integration,data quality,and data analysis in traditional Chinese medicine clinical diagnosis and treatment,and proposed to empower from the aspects of disciplinary integration,data quality optimization,data privacy protection,and promotion and application,so as to provide reference for im-proving the effectiveness of traditional Chinese medicine clinical diagnosis and treatment.

Objective:To describe the prevalence of food allergy among children aged 0-5 years in China and to explore related influencing factors.Methods:Multistage stratified random sampling method was used to collect data from 275 surveillance sites of the China National Nutrition and Health Survey of Chinese children and lactating mothers programs in 31 provinces (autonomous regions and municipalities) of China in 2016-2017. A total of 70 107 participants aged 0-5 years were included in this study. The study collected information of participants' demographic characteristics and food allergies by face-to-face questionnaire. The prevalence of food allergy was analyzed, using the complex data weighting method. The logistic regression models were used to analyze the influencing factors related to food allergy.Results:The overall prevalence of self-reported food allergy among children aged 0-5 years was 4.81%. Prevalence rates in infants aged 0-5 months, and 6-23 months and preschool children aged 2-5 years were 0.81%, 4.68% and 5.26%, respectively. The results of logistic analysis showed that there was a significantly positive correlation between factors including children from 6 months to 5 years old, urban area, southwest area, first-born, mothers with college education or above, and the prevalence of food allergy in children. Shrimp, poultry eggs, crab shellfish, fruit, milk and fish appeared the common allergic foods in children aged 0-5 years, with prevalence rates of self-reported food allergy as 1.55%, 1.25%, 0.99%, 0.97%, 0.87% and 0.86%, respectively. The proportion of single food allergy in children with allergies was 69.85%.Conclusions:Among children aged 0-5 years, the prevalence of self-reported food allergy increases with age, in China. Foods that is prone to allergies include fish, shrimp, crab, shellfish, poultry eggs, milk and fruits, etc. Most allergies were only caused by single food in children, under observation.

Objective:Analyzing the epidemic trends and spatio-temporal distribution characteristics of condyloma acuminatum in China from 2018 to 2023.Methods:Data of condyloma acuminatum cases and incidence rate including 31 provinces (autonomous regions and municipalities) from 2018 to 2023 were collected through the National Notifiable Infectious Disease Reporting System of China Information System for Disease Control and Prevention. Incidence trend analysis was conducted using Joinpoint 4.9.1 software, and spatial autocorrelation analysis using ArcGIS 10.5 software. Spatio-temporal scanning analysis was carried out with SaTScan 10.1.2 software.Results:The incidence rate of condyloma acuminatum declined from 7.26 per 100 000 in 2018 to 7.19 per 100 000 in 2023. The average annual percent change was -0.26%, which was no statistically significant downward trend ( t=-0.26, P=0.806). A significant positive global spatial autocorrelation was observed in the county-level incidence rate across the country, with the global Moran's I ranging from 0.55 to 0.60 (all P<0.001); the Getis-Ord General test statistic Z( G) was all >1.96, indicating a high-value clustering pattern in the reported incidence rate of condyloma acuminatum. The local spatial autocorrelation analysis detected 256, 244, 246, 284, 308, and 315 hotspots each year, which were mainly located in the provinces of Zhejiang, Fujian, Guangdong, Guizhou, Yunnan and Chongqing. Spatio-temporal scanning analyses identified 76 statistically significant spatiotemporal clusters covering 25 provinces (autonomous regions and municipalities). Conclusions:From 2018 to 2023, the reported incidence rate of condyloma acuminata in China exhibited a mild decline. The distribution of hotspot areas and spatiotemporal clusters was largely consistent, primarily in the southeastern coastal and southwestern regions.

Objective To establish an inducible knockout mouse model of trafficking protein particle complex subunit 11 (Trappc11). Methods and results LoxP sites were introduced on both sides of exon 3-5 of Trappc11,and then the CRISPR/Cas9 technique was used to establish F0 C57BL/6J mice. The positive F0 generation mice were identified by polymerase chain reaction amplification and sequencing. After that,F0 positive mice were mated with C57BL/6J wild type mice to obtain F1 Trappc11flox/+mice. And then,Trappc11flox/+mice were mated with UBC-CreERT2 mice,and finally Trappc11 inducible systemic knockout mouse model was obtained after 2 generations. Conclusion The Trappc11 inducible knockout mouse model is established using CRISPR/Cas9 and Cre-loxP,providing an important tool for revealing the pathophysiological role of Trappc11 in multi-organ system diseases.

Objective:The outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for myelodysplastic syndromes-evolved acute myeloid leukemia (MDS-AML) were explored.Methods:A retrospective review was conducted for 54 patients with MDS-AML treated with allo-HSCT in the Institute of Hematology and Blood Disease Hospital from January 2018 to August 2022. The clinical effects after transplantation were observed, and the related risk factors influencing prognosis were explored.Results:Of the total 54 patients, 26 males, 28 females, and 53 patients achieved hematopoietic reconstruction. After a median follow-up of 597 (15-1 934) days, the 1 year overall survival (OS) rate, disease-free survival (DFS) rate, relapse rate (CIR) and non-relapse mortality (NRM) rate were 75.8%±5.8%, 72.1%±6.1%, 12.7%±4.9%, and 17.1%±5.2%, respectively. The 3 year estimated OS, DFS, CIR, and NRM rates were 57.8%±7.5%, 58.1%±7.2%, 23.2%±6.6%, and 23.7%±6.6%, respectively. The cumulative incidence of acute graft-versus-host disease (aGVHD) was 57.5%±6.9%, and the cumulative incidence of chronic graft-versus-host disease (cGVHD) was 48.4%±7.7%. Hematopoietic cell transplantation comorbidity index (HCT-CI) before transplantation was ≥2, minimal residual disease (MRD) was positive on the day of reconstitution, grade Ⅲ/Ⅳ aGVHD, bacterial or fungal infection and no cGVHD after transplantation were adverse prognostic factors for OS ( P<0.05). COX regression model for multivariate analysis showed that HCT-CI score before transplantation, bone marrow MRD on the day of response, grade Ⅲ or Ⅳ aGVHD, and cGVHD after transplantation were the independent adverse factors for OS ( P=0.001, HR=6.981, 95% CI 2.186-22.300; P=0.010, HR=6.719, 95% CI 1.572-28.711; P=0.026, HR=3.386, 95% CI 1.158-9.901; P=0.006, HR=0.151, 95% CI 0.039-0.581) . Conclusion:For patients with MDS-AML and high risk of relapse, allogeneic transplantation must be considered as soon as possible. The enhanced management of post-transplantation complications and maintenance treatment should be provided whenever possible after transplantation.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To investigate the recent epidemic trends and spatiotemporal distribution characteristics of gonorrhea in China, and to provide a reference for precise prevention and control of gonorrhea.Methods:Data on reported cases of gonorrhea in China (not including Hongkong, Macau and Taiwan regions of China) were collected from the Infectious Diseases Surveillance System of Chinese Disease Prevention and Control Information System from 2018 to 2023. The trends in reported incidence rates of gonorrhea in China were analyzed using the Joinpoint regression model. Global spatial autocorrelation analysis with the Moran's index and global G-statistic, as well as local spatial autocorrelation analysis, were employed to explore the clustering patterns and hotspot regions of gonorrhea at the county level. In the spatiotemporal scanning analysis, a Poisson distribution model was employed to identify clusters of gonorrhea cases.Results:The reported incidence rates of gonorrhea in China decreased from 9.59 per 100 000 in 2018 to 7.35 per 100 000 in 2023, with an average annual percent change of -4.9%, but this decreasing trend was not statistically significant ( P = 0.11). The reported incidence rates of gonorrhea at the county level in China exhibited a significant positive global spatial autocorrelation, with the global Moran's indices ranging from 0.39 to 0.60 (all P < 0.001) ; the Getis-Ord general G test statistic Z (G) values were all greater than 1.96, indicating a high-value clustering pattern of gonorrhea cases. The local spatial autocorrelation analysis showed that hotspot regions were predominantly distributed in southeastern coastal areas and southwestern China. A total of 70 clusters were identified through the spatiotemporal scanning analysis, and mainly located in southeastern coastal areas and southwestern China. Conclusions:In recent 6 years, the overall reported incidence rates of gonorrhea in China showed a fluctuating decline; there was a significant spatiotemporal clustering characteristic with regard to gonorrhea epidemic at the county level in China, and the hotspot regions were basically consistent with the spatiotemporal clusters, which were mainly distributed in southeastern coastal areas and southwestern China. Further investigation into the causes and precise prevention and control measures are needed.

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.