Objective To explore the changes and significane of USP20 and HIF-α expression in breast cancer.Methods Following transfection of shRNA-USP20 lentivirus into breast cancer MDA-MB-231 cells,the gene and protein expression levels of USP20 were detected using fluorescence quantitative PCR and Western Blot.Subsequently,the overexpression of USP20 was observed to determine its effect on HIF-α expression.Similarly,siRNA-USP20 was used to knock down USP20 in breast cancer MDA-MB-231 cells,followed by detection of gene and protein expression levels using fluorescence quantitative PCR and Western Blot.The subsequent changes in HIF-α expression were then examined.Rusults The positive expression rates of USP20 and HIF-α in breast cancer tissues were 69.6%and 46.83%,respectively,while they were negatively expressed in the adjacent normal tissues,with statistically significant differences(P＜0.01).The positive expressions of USP20 and HIF-α were predomi-nantly observed in the cytoplasm of breast cancer tissue,with a smaller amount present in the nucleus.There was a significant positive correlation between USP20 and HIF-α in breast cancer.Following transfection of shRNA-USP20 lentivirus into MDA-MB-231 cells,both the protein and gene expression levels of USP20 significantly increased(P＜0.01).Over-expression of USP20 did not affect HIF-α mRNA levels but led to a significant increase in HIF-α protein expression(P＜0.01).Conversely,siRNA-USP20 interference resulted in a significant decrease in both the protein and gene expression levels of USP20(P＜0.01),without affecting HIF-α mRNA levels;however,it caused a notable reduction in HIF-α protein expression(P＜0.01).Conclusion The expression of USP20 exhib-ited a significant positive correlation with HIF-α in breast cancer.Overexpression of USP20 led to a substantial increase in HIF-α protein expression,while knock-down of the USP20 gene resulted in a significant decrease in HIF-α protein levels.Therefore,it can be inferred that USP20 may exert its influence on the development of breast cancer through modulation of HIF-α expression,thereby providing crucial experimental evidence for clinical treat-ment,prognosis,and further investigations.

Objective To investigate the clinical value of extracellular volume(ECV)based on CT delayed phase in combination with pathologic indicators in predicting early recurrence of gastric mesenchymal tumors after surgery.Methods A retrospective case-control trial was conducted on the imaging,clinical and pathological data of 110 patients with gastric mesenchymal tumors who were surgically resected at the First Affiliated Hospital of Army Medical University from January 2011 to August 2022.They were 60 males and 50 females,at a mean age of 58±10 years.All of them received preoperative multiphase dynamic CT enhancement examination of the abdomen,and ECV value was calculated with the formula:ECV=(1-hematocrit)×(△HU tumor/△HU aorta).According to the postoperative recurrence within 24 months after surgery,they were divided into early recurrence group and non early recurrence group.Statistical indexes:① Consistency analysis.② The factors affecting early recurrence after resection of gastric mesenchymal stromal tumors were analyzed and a prediction model was conducted.Delong test was used to assess the predictive value of the model.Then a nomogram was plotted based on the combines model,and calibration curves were drawn to assess the efficacy of the column charts,and decision curve analysis(DCA)was adopted to assess the value of the model for clinical application.Results ① Consistency analysis.After 2 radiologists outlined the region of interest and obtained ECV value according to the above formula,The intraclass correlation coefficient(ICC)was 0.806.② For the 110 subjected patients,21 cases of them had early recurrence,and 89 one did not.Multivariate analysis showed that ECV value,risk degree,and tumor length were independent influencing factors for predicting early recurrence.Receiver operating characteristic(ROC)curve analysis indicated that the area under the curve(AUC)value of ECV,hazard degree,and tumor length diameter in predicting early recurrence was 0.838(95％CI 0.758～0.918),0.774(95％CI 0.656～0.892),and 0.700(95％CI 0.589～0.810),respectively,and the value of their combined model was 0.899(95％CI 0.811～0.987),which was higher than that of each independent model.The sensitivity and specificity of the combined model was 85.71％and 86.52％,respectively,and the optimal cutoff value was 0.19.Delong test revealed that there was statistical difference between the combined model and the clinical model established by the hazard level(Z=6.548,P＜0.001,95％CI 0.140～0.259).Calibration curve analysis suggested that the combined model had a better fit,and DCA displayed that the combined model had a better net benefit.Conclusion The model established by ECV combined with pathological indicators has good predictive performance and can be used as a more effective predictor of early recurrence of gastric mesenchymal tumors after surgery.

Objective:To discuss the comprehensive evaluation of the effectiveness of iodine deficiency disorders prevention and control in Xinjiang Production and Construction Corps (Corps for short) using technique for order preference by similarity to an ideal solution (TOPSIS) and rank-sum ratio (RSR) methods, and identify weaknesses in the prevention and control of iodine deficiency disorders in the Corps at present.Methods:The monitoring data on iodine deficiency disorders in the Corps from 2014 to 2020 were collected from the Disease Control and Prevention Center of the Corps. Six indexes were selected, including the consumption rate of qualified iodized salt, the coverage rate of iodized salt, the qualified rate of iodized salt, the appropriate percentage of urinary iodine in children, the goiter rate of children and the appropriate percentage of urinary iodine in pregnant women. The TOPSIS method and RSR method were combined to comprehensively evaluate the prevention and control effect of iodine deficiency disorders in the Corps.Results:The results of TOPSIS method showed that the control effect was from superior to inferior in the order of 2020, 2018, 2016, 2019, 2015, 2017 and 2014. Based on the RSR method, the control effect was divided into three levels: 2018 and 2020 (with an estimated RSR value of ≥0.525) in the first level (good), 2014 (estimated RSR value < 0.007) in the third level (poor), and other years (0.007≤estimated RSR value < 0.525) in the second level (medium). Referring to the monitoring data, the appropriate percentage of urinary iodine in children and pregnant women in the middle years was the weak point. Conclusions:TOPSIS method combined with RSR method can accurately and reasonably evaluate the effectiveness of prevention and control of iodine deficiency disorders in the Corps, the evaluation results are consistent with the actual situation. It is found that the appropriate iodine nutrition levels of children and pregnant women are the weak points in the prevention and control of iodine deficiency disorders in the Corps.

Objective: To analyze the epidemiological characteristics and influencing factors of COVID-19 confirmed cases with viral nucleic acid re-positive in anal and/or throat swabs after discharge during the domestic imported epidemic stage in Guangdong Province in early 2020. Methods: The COVID-19 confirmed cases with the onset time before March 1, 2020 in Guangdong Province were collected to analyze the demographic data, epidemiological characteristics, and specimen collection and testing data after discharge. Logistic regression model was used for influencing factors analysis of re-positive cases. Results: A total of 1 286 COVID-19 confirmed cases were included, the M(Q₁,Q₃) of age was 44(32,58)years, 617 cases were male, 224 cases were re-positive in anal and/or throat swabs with the re-positive rate 17.42%. The M(Q₁,Q₃) of age of re-positive cases was 35(23, 50) years, which was younger than that of re-negative cases age was those 46(33, 59) years (P<0.001). With the increase of age, re-positive rate decreased (χ²_trend=52.73, P<0.001). 85.27% (191/224) of re-positive cases were found in 14 d after discharge, the duration time of re-positive status was 13(7, 24) d, and 81.69% (183/224) of re-positive cases were re-tested negative in 28 d after re-positive date. No fever and other symptoms had been observed among re-positive cases during the whole follow-up. No secondary infectious cases had been found among close contacts after 14 d of centralized isolation and sampling screening. Univariate logistic regression model analysis revealed that the influencing factors of the re-positive cases included age, occupation, clusters, clinical types, and admission time. Multivariate logistic regression model analysis revealed that age was an independent risk factor. Conclusions: SARS-CoV-2 viral nucleic acid re-positive is found in COVID-19 confirmed cases after discharge in Guangdong Province. Most re-positive cases are confirmed among 14 d after discharge and re-test to negative among 28 d after re-positive date. Age is an risk factor for re-positive cases after discharge.
COVID-19 ; China/epidemiology* ; Epidemics ; Humans ; Male ; Nucleic Acids ; SARS-CoV-2

Objective:To fully learn about the iodine nutrition level and the status quo of prevention and control of iodine deficiency disorders (IDD) among children aged 8 - 10 years and pregnant women in Southern and Northern Xinjiang of Xinjiang Production and Construction Corps (hereinafter referred to as the Corps), and to provide a basis for consolidating the prevention and control effect of IDD and proposing sustainable prevention and control strategies.Methods:From May to November 2020, IDD monitoring was carried out within the Corps. ⑴Salt iodine monitoring: in 14 divisions of the Corps, 1 regiment was selected in each division from five directions of East, West, South, North and Middle, and 4 companies were selected from each regiment and edible salt samples were collected from the homes of 15 Corps employees to test for salt iodine. ⑵Monitoring of urinary iodine and goiter: in 13 divisions of the Corps, 1 regiment was selected from each division according to five directions of East, West, South, North and Middle, and 40 children aged 8 - 10 years (age balanced, half male and female) from one primary school and 20 pregnant women were selected as the survey subjects. Once random urine sample was collected from children and pregnant women to detect urinary iodine; the thyroid volume of children was measured and the goiter rate was calculated.Results:⑴A total of 4 149 salt samples were tested, the median salt iodine was 27.3 mg/kg, the coverage rate of iodized salt was 99.9% (4 146/4 149), the qualified rate of iodized salt was 98.1% (4 069/4 146), and the consumption rate of qualified iodized salt was 98.1% (4 069/4 149). Among them, 1 197 and 2 952 salt samples were tested in Southern and Northern Xinjiang of the Corps, the median salt iodine was 26.7 and 27.5 mg/kg, respectively; the coverage rate of iodized salt was 99.7% (1 194/1 197) and 100.0% (2 952/2 952), respectively; the qualified rate of iodized salt was 95.0% (1 134/1 194) and 99.4% (2 935/2 952), respectively; the consumption rate of qualified iodized salt was 94.7% (1 134/1 197) and 99.4% (2 935/2 952), respectively; and the differences between regions were statistically significant ( P < 0.05). ⑵A total of 2 602 urine samples of children aged 8 - 10 years were detected, and the median urinary iodine was 186.5 μg/L; the median urinary iodine of children (800 and 1 802) in Southern and Northern Xinjiang of the Corps was 181.9 and 188.5 μg/L, respectively. A total of 1 247 urine samples of pregnant women were detected, and the median urinary iodine was 192.6 μg/L; the median urinary iodine of pregnant women (397 and 850) in Southern and Northern Xinjiang of the Corps was 182.2 and 200.3 μg/L, respectively. ⑶A total of 2 602 children aged 8 - 10 years were examined for thyroid volume, and the goiter rate was 1.2% (31/2 602); the goiter rate of children in Southern and Northern Xinjiang of the Corps was 1.4% (11/800) and 1.1% (20/1 802), respectively. Conclusion:In 2020, the Corps has reached the elimination standard of IDD by divisions, and children aged 8 - 10 years and pregnant women are generally at an appropriate iodine level.

Objective:To understand the iodine content of edible salt in residents of Xinjiang Production and Construction Corps (referred to as Corps), and provide scientific evidence for prevention and treatment of iodine deficiency disorders.Methods:According to the requirements of the "National Iodine Deficiency Disorders Surveillance Program" form 2015 to 2019, in accordance with the principle of random sampling, one regiment from each of the five directions of east, west, south, north and center in the Corps was selected, and four companies were selected from each regiment. Edible salt samples from the homes of 15 residents in each company were collected, and salt iodine content was quantitatively tested and the test results were analyzed.Results:From 2015 to 2019, 21 028 household salt samples were collected, qualified iodized salt were 20 204, non-qualified iodized salt were 712, non-iodized salt were 112, iodized salt coverage rate was 99.47% (20 916/21 028), iodized salt qualified rate was 96.60% (20 204/20 916), qualified iodized salt consumption rate was 96.08% (20 204/21 028). The average salt iodine content was (27.72 ± 4.81) mg/kg. From 2015 to 2019, the iodized salt coverage rates in the whole Corps were all > 95%, and the iodized salt qualified rates and the qualified iodized salt consumption rate were all > 90%. Among the 14 divisions of the Corps, iodized salt coverage rates were all > 95%, except for the 12th and 14th divisions, where the iodized salt qualified rates and qualified iodized salt consumption rates were < 90%, all other divisions were > 90%.Conclusions:Iodized salt coverage rate, iodized salt qualified rate and qualified iodized salt consumption rate have all reached the national standard for eliminating iodine deficiency disorders from 2015 to 2019, however, non-iodized salt exists in some areas, and the qualified iodized salt consumption rate is low. We should strengthen monitoring of iodized salt in key areas and promote health education, consolidate and maintain achievements in eliminating iodine deficiency disorders.

Objective: To analyze the delay of seeking medical treatment and associated factors among students with tuberculosis in Shaanxi Province from 2015 to 2019, so as to provide scientific evidence for the early detection and control of tuberculosis epidemics in schools. Methods: Data from 6 739 students with pulmonary tuberculosis registered in Shaanxi Province from 2015 to 2019 were collected from the TB Management Information System of China Information System for Disease Control and Prevention. Univariate and multivariate Logistic regression analyses were used to analyze the characteristics and influencing factors of pulmonary tuberculosis patients. Results: Among 6 739 cases of students with pulmonary tuberculosis from 2015 to 2019 in Shaanxi Province, 3 040 patients delayed seeking medical treatment. The rate of delayed treatment was as high as 45.1%, and the median delayed treatment time was 38(24, 68) days. From 2015 to 2019, the overall delay rate of students showed a downward trend, with a significant difference(χ 2=120.45, P<0.05). Univariate analysis showed that there were statistically significant differences in delay rate between different patient sources, diagnosis results and regions(χ 2=274.19, 26.75, 24.12, P<0.05), among which for factors such as tracing, tuberculosis pleurisy, doctor delay in the northern part of Shaanxi, the rates were higher. The results of multivariate Logistic regression analysis showed that the regions of northern Shaanxi(OR=2.74), central Shaanxi(OR=2.09), and southern Shaanxi(OR=2.39), and clinical consultation(OR=1.84), recommendation(OR=2.81), tracing(OR=3.28), and tracing (OR=6.07) were risk factors for delay of consultation. A lack of etiology results(OR=0.47) was to protect delay of consultation. Conclusion From 2015 to 2019 in Shaanxi Province, a delay in seeking medical treatment was relatively common among students with tuberculosis. The region, source of patients and diagnosis results were factors that influenced the delay in finding tuberculosis patients in Shaanxi Province.

Objective:Lung ultrasound (LUS) has been used in the diagnosis of neonatal respiratory distress syndrome(RDS) successfully, but there have been no multicenter prospective studies to verify its reliability or determine how to grade RDS with LUS findings.This study aimed to discuss the necessity and feasibility of using LUS findings to determine RDS grades through a multicenter prospective study.Methods:Every researcher participated in the National Neonatal Lung Ultrasound Training Course and receiving 3-6 months of lung ultrasound system training at the National Neonatal Lung Ultrasound Training Center.Patients between June 2018 and May 2020 who met the RDS ultrasound diagnostic criteria and had full available clinical data were included in this study.The LUS examination was completed immediately after the patients were admitted to the hospital.Some of them also underwent chest X-ray examination.Arterial blood gas analysis was completed immediately before or after the LUS ultrasound examination.RDS grading was performed according to the LUS findings and whether the patient had serious complications.Results:A total of 275 qualifying cases were included in this study, which included 220 premature infants and 55 full-term infants, and the primary RDS occurred in 117 cases (42.5%), and secondary RDS occurred in 158 cases (57.5%). LUS manifestations of RDS patients can be divided into three categories: (1)A ground-glass opacity sign: which could be found among 50 infants when they were admitted to the hospital (that was, at their first LUS examination). Twenty-eight of these infants were considered to have wet lungs and were not sent for special management on admission, but LUS showed typical snowflake-like lung consolidation within 0.5 to 4 hours.Twenty-two of them were given mechanical ventilation with exogenous pulmonary surfactant; Eighteen cases were controlled within 6-12 hours, but the lung lesions became more severe in the other 4 infants (due to severe intrauterine infection). (2)Snowflake-like lung consolidations: the first LUS on admission showed typical snowflake-like lung consolidation involving areas ranging from 1-2 intercostal spaces to 12 lung divisions in 204 cases.Thirty-eight infants among them the lung consolidation only had involvement of 1-2 intercostal spaces at the time of admission; Fifteen of them received invasive respiratory support and recovered within 4-12 hours.Twelve patients received noninvasive respiratory support; Seven of them recovered, while five cases developed severe lung illness.The remaining 11 patients who were not given any form of ventilator support developed severe conditions within 1-4 hours.Thirty of them showed snowflake signs involving 12 lung regions at admission.The remaining 136 patients had lung consolidation degree between the two degree above condition.(3)Snowflake-like sign with complications: Twenty-one patients had severe complications such as pneumothorax, pulmonary hemorrhage or/and persistent pulmonary hypertension of the newborn or large area atelectasis, etc, although snowflake lung consolidation did not involve all lung regions.Conclusion:(1) LUS is reliable and accurate for diagnosing RDS.RDS has the same characteristics on ultrasound for both preterm and full-term infants, both primary and secondary RDS.(2) To facilitate the management of RDS, it is necessary to classify RDS according to the ultrasound findings and the presence of severe complications.(3) Based on the results of this study, it is recommended that RDS can be divided into mild, moderate and severe degrees.The exact standards for grading are as follows: Mild RDS: the early stage of RDS, in which lung consolidation shows as a ground-glass opacity sign on ultrasound; Moderate RDS: lung consolidation shows a snowflake sign on ultrasound, not all of the lung fields are involved; Severe RDS meets one or more of the following criteria: lung consolidation shows as a snowflake sign on ultrasound and all lung regions are involved, or regardless of its degree and extent, lung consolidation has caused serious complications, such as pulmonary hemorrhage, pneumothorax, persistent pulmonary hypertension of the newborn, or/and a large area of pulmonary atelectasis.

Objective To analyze the clinical courses and outcomes of COVID-19 cases and the influencing factors in Guangdong province and provide basis for the formulation or adjustment of medical care and epidemic control strategy for COVID-19. Methods We collected demographic data, medical histories, clinical courses and outcomes of 1 350 COVID-19 patients reported in Guangdong as of 4 March 2020 via epidemiological investigation and process tracking. Disease severity and clinical course characteristics of the patients and influencing factors of severe illness were analyzed in our study. Results Among 1 350 cases of COVID-19 cases in Guangdong, 72 (5.3%) and 1049 (77.7%) were mild and ordinary cases, 164 (12.1%) were severe cases, 58 (4.3%) were critical cases and 7 (0.5%) were fatal. The median duration of illness were 23 days ( P 25 - P 75 : 18-31 days) and the median length of hospitalization were 20 days ( P 25 - P 75 : 15-27 days). For severe cases, the median time of showing severe manifestations was on the 12th day after onset ( P 25 - P 75 : 9th to 15th days), and the median time of severe manifestation lasted for 8 days P 25 - P 75 : 4-14 days). Among 1 066 discharged/fetal cases, 36.4% (36/99) and 1.0% (1/99) of the mild cases developed to ordinary cases and severe cases respectively after admission; and 5.2% (50/968) and 0.6% (6/968) of the ordinary cases developed to severe cases, and critical cases respectively after admission. In severe cases, 11.4% developed to critical cases (10/88). The influencing factors for severe illness or worse included male (a HR =1.87, 95% CI : 1.43-2.46), older age (a HR =1.67, 95% CI : 1.51-1.85), seeking medical care on day 2-3 after onset (a HR =1.73, 95% CI : 1.20-2.50) pre-existing diabetes (a HR =1.75, 95% CI : 1.12-2.73) and hypertension (a HR =1.49, 95% CI : 1.06-2.09). Conclusions The course of illness and length of hospitalization of COVID-19 cases were generally long and associated with severity of disease clinical outcomes. The severe cases were mainly occurred in populations at high risk. In the epidemic period, classified management of COVID-19 cases should be promoted according to needs for control and prevention of isolation and treatment for the purpose of rational allocation of medical resources.

Objective:Analysis of clustering characteristics of coronavirus disease 2019 (COVID-19) in Guangdong Province.Methods:The COVID-19 cases in Guangdong Province onset from January 1 to February 29, 2020 were collected from Chinese information system for disease control and prevention and Emergency Public Reporting System. Obtain the epidemiological survey data of the cluster epidemic situation, and clarify the scale of cluster epidemic situation, the characteristics of the index cases, family and non-family subsequent cases. Calculate serial interval according to the onset time of the index cases and subsequent cases, secondary attack rate based on the close contacts tracking results, the characteristics of different cases in the clustered epidemic were compared.Results:A total of 283 cluster were collected, including 633 index cases, 239 subsequent cases. Families are mainly clustered, the total number involved in each cluster is in the range of 2-27, M( P25, P75) are 2.0 (2.0, 4.0). During January 15 to February 29, the secondary attack rate is 2.86% (239/8 363) in Guangdong Province, the family secondary attack rate was 4.84% (276/3 697), and the non-family secondary attack rate was 1.32% (61/4 632). According to the reporting trend of the number of cases in Guangdong Province, it can be divided into four stages, the rising stage, the high platform stage, the descending stage and the low level fluctuation period. The secondary attack rate of the four stages were 3.5% (140/3 987), 2.3% (55/2 399), 2.6% (37/1 435), 1.3% (7/542), respectively. The difference was statistically significant ( P=0.003). Conclusion:COVID-19 cluster mainly occurs in families in Guangdong Province. The scale of the clustered epidemic was small; the serial interval was short; and the overall secondary attack rate was low.