Objective:To analyze the cost-effectiveness of high-flux hemodialysis compared to low-flux hemodialysis in the treat-ment of End-Stage Renal Disease(ESRD)patients.Methods:Based on a literature review,a cost-effectiveness analysis model was established,using the Incremental Cost-Effectiveness Ratio(ICER)as the outcome indicator to evaluate the economic value of high-flux versus low-flux hemodialysis.One-way sensitivity analysis and probabilistic sensitivity analysis were conducted to further assess the robustness of the results.Results:In the treatment of ESRD patients,compared to low-flux hemodialysis,the ICER of high-flux hemodialysis was 234 882 yuan per QALY.The key factors influencing the model results were the cost discount rate,ef-fect discount rate,utility value of high-flux hemodialysis,and treatment costs.Conclusion:Compared to low-flux hemodialysis,high-flux hemodialysis demonstrates a cost-effectiveness advantage at a willingness-to-pay threshold of three times GDP per capita.

Objective To explore the predictive value of combined detection of serum CXC chemokine lig-and 12(CXCL12),caspase-cleaved cytokeratin 18(CCCK-18)and matrix metalloproteinase-9(MMP-9)for short-term poor prognosis in patients with acute hemorrhagic stroke.Methods A total of 138 patients with a-cute hemorrhagic stroke admitted to a hospital from October 2021 to March 2023 were selected as the study objects.Serum CXCL12,CCCK-18 and MMP-9 levels were detected after admission and before treatment.Pa-tients were followed up for 6 months after treatment and were divided into good prognosis group and poor prognosis group according to the modified Rankin scale score.Clinical data and serum CXCL12,CCCK-18 and MMP-9 levels of the two groups were compared to analyze the factors affecting the short-term poor prognosis of patients with acute hemorrhagic stroke.Receiver operating characteristic(ROC)curve was drawn to evalu-ate the predictive value of single and combined detection of serum CXCL12,CCCK-18 and MMP-9 in patients with acute hemorrhagic stroke.Results Among 138 patients,there were 52 cases in the poor prognosis group and 86 cases in the good prognosis group,and the poor prognosis rate was 37.68%.Serum CXCL12,CCCK-18 and MMP-9 levels,age,blood loss at admission,National Institutes of Health Stroke Scale(NIHSS)score at admission,systolic blood pressure and diastolic blood pressure at admission in the poor prognosis group were higher than those in the good prognosis group.The score of Glasgow Coma Scale(GCS)at admission was lower than that of good prognosis group,and the difference was statistically significant(P<0.05).Multivari-ate Logistic regression analysis showed that high level of serum CXCL12,high level of CCCK-18,high level of MMP-9,older age,large amount of blood loss upon admission,high NIHSS score and high systolic blood pres-sure were all risk factors for short-term poor prognosis of acute hemorrhagic stroke(P<0.05).High GCS score on admission was a protective factor(P<0.05).ROC curve analysis showed that the area under the combined prediction curve of serum CXCL12,CCCK-18 and MMP-9 was higher than that of the single and pairwise combined prediction of each index(P<0.05).Conclusion The combined detection of serum CX-CL12,CCCK-18 and MMP-9 has a good value in predicting the short-term poor prognosis of patients with a-cute hemorrhagic stroke.

Objective:To analyze the cost-effectiveness of high-flux hemodialysis compared to low-flux hemodialysis in the treat-ment of End-Stage Renal Disease(ESRD)patients.Methods:Based on a literature review,a cost-effectiveness analysis model was established,using the Incremental Cost-Effectiveness Ratio(ICER)as the outcome indicator to evaluate the economic value of high-flux versus low-flux hemodialysis.One-way sensitivity analysis and probabilistic sensitivity analysis were conducted to further assess the robustness of the results.Results:In the treatment of ESRD patients,compared to low-flux hemodialysis,the ICER of high-flux hemodialysis was 234 882 yuan per QALY.The key factors influencing the model results were the cost discount rate,ef-fect discount rate,utility value of high-flux hemodialysis,and treatment costs.Conclusion:Compared to low-flux hemodialysis,high-flux hemodialysis demonstrates a cost-effectiveness advantage at a willingness-to-pay threshold of three times GDP per capita.

To explore the biological characteristics related to the pathogenesis and severity of respiratory syncytial virus (RSV) bronchiolitis by RNA sequencing of white blood cells in children with RSV bronchiolitis. This study is a case-control study. A total of 87 children diagnosed with bronchiolitis and RSV antigen positive and/or RSV nucleic acid positive in the pediatric respiratory department of the Second Affiliated Hospital of Wenzhou Medical University from October 2019 to April 2022 were selected as the case group. The case group was divided into three groups based on the condition: mild, moderate, and severe, and there were two groups according to the presence or absence of atopic symptoms: the atopic group and the non -atopic group, forty healthy children in the same period were selected as the control group. The whole blood leukocyte RNA of the children in the case group and the control group was extracted for RNA sequencing, and the data were analyzed to obtain differentially expressed genes (DEGs). Then, the immunobiological pathways and genes related to the pathogenesis, disease condition, and atopy were screened through Gene Ontology (GO) annotation, Kyoto Gene and Genome Encyclopedia (KEGG) annotation, and protein interaction network (PPI) construction methods. Construct the weighted gene co-expression network analysis (WGCNA) module to identify potential biological indicators related to disease severity.Compared with the control group, the case group had a total of 1 782 DEGs, including 1 586 upregulated genes and 196 downregulated genes. The GO pathway enrichment of DEGs is mainly enriched in molecular functions such as peroxidase activity and oxidoreductase activity. In the cytological components, it is mainly enriched in cytoplasmic vesicle lumen and secretory granule lumen. In biological processes, it is mainly enriched in processes such as neutrophil activation involved in immune responses, neutrophil degranulation, and neutrophil activation. KEGG analysis is mainly concentrated in the signal pathway of the viral protein interaction with cytokine and cytokine receptor. A PPI network was constructed to screen four genes at the core position, including CCL2, IL-10, MMP9 and JUN. The DEGs obtained by comparing different disease groups with the control group are mainly enriched in retrograde endocannabinoid signaling and cell apoptosis pathways. WGCNA analysis showed that the brown module related to oxygen saturation was most closely related to the disease, and its gene was mainly enriched in the RNA helicase retinoic acid inducible gene-I (RIG-I) like receptor signal pathway. There are 230 specific DEGs in the atopic group and 444 in the non -atopic group. KEGG enrichment analysis results show that both groups are enriched to NF-κB signaling pathway, the characteristic does not cause significant changes in immune response and transcriptome characteristics in children with RSV bronchiolitis. In conclusion, neutrophil activation, degranulation pathway and signal pathway of interaction between viral protein and cytokine and cytokine receptor are involved in the immune response of RSV bronchiolitis host. CCL2, IL-10, MMP9 and JUN genes may be associated with the pathogenesis. They might be potential biomarkers related to disease severity in RIG-I like receptors, cell apoptosis, and endogenous cannabinoid related signaling pathways.

Objective To investigate antigen optimization of Shisa like protein 1 (SHISAL1) for preparing mouse anti-human SHISAL1 polyclonal antibody and to identify the specificity of the prepared antibody. Methods Bioinformatics was employed to predict the antigenic epitope region of SHISAL1 protein, and then a polypeptide composed of amino acid residues from the site of 28 to 97 of SHISAL1, termed SHISAL1-N, was selected as the antigen. The coding region of SHISAL1-N was cloned by molecular cloning technique, and then it was inserted into pET-28a to generate pET28a-SHISAL1-N recombinant plasmid. The two recombinant plasmids pET28a-SHISAL1-N and pET28a-SHISAL1 were transformed into BL21 (DE3) bacteria and induced to express by IPTG. The two proteins were purified and immunized to female Kunming mice, respectively. The specificities and sensitivities of the acquired antibodies were detected by Western blot analysis, immunoprecipitation and immunofluorescent cytochemical staining. Results pET28a-SHISAL1-N recombinant plasmid was successfully constructed, and the two fused proteins, SHISAL1 and SHISAL1-N, were induced to express. Moreover, two types of SHISAL1 mouse polyclonal antibodies, derived from SHISAL1-N and SHISAL1 antigens, were obtained. Western blot results showed that the antibody prepared from SHISAL1 antigen was less specific and sensitive compared with the antibody prepared from SHISAL1-N antigen which could specifically identify different endogenous SHISAL1 protein. Immunoprecipitation results showed that SHISAL1-N antibody could specifically pull down SHIISAL1 protein in hepatocellular carcinoma cells and immunofluorescence results demonstrated that SHISAL1-N antibody could specifically bind to SHISAL1 protein in the cytoplasm. Conclusion We have optimized the SHISAL1 antigen and prepared the mouse anti-human SHISAL1 polyclonal antibodies successfully, which can be used for Western blot analysis, immunoprecipitation and immunofluorescence cytochemical staining.
Animals ; Female ; Humans ; Mice ; Antibodies ; Antibody Specificity ; Blotting, Western ; Cloning, Molecular ; Epitopes/genetics*

Objective: To compare the effectiveness before and after the adjustment of schistosomiasis control strategies in Nanjing City, so as to provide the evidence for improving schistosomiasis control interventions. Methods: The prevalence of Schistosomasis japonicum infections in humans, livestock, Oncomelania hupensis and sentinel mice was collected in Nanjing City from 1993 to 2018, and the prevalence of S. japonicum infections in humans, livestock, sentinel mice and O. hupensis, and the areas of snail habitats, areas of infected snail habitats and snail control areas were compared before (1993-2004) and after (2005-2018) the adjustment of schistosomiasis control strategies to evaluate the effectiveness. Results: The prevalence of S. japonicum infections in humans, livestock, O. hupensis and sentinel mice was 0.77% and 0.02% (χ2=6 430.634, P<0.001), 0.46% and 0.01% (χ2=344.401, P<0.001), 0.19% and 0.11% (χ2=239.685, P<0.001), and 34.35% and 1.56% (χ2=1 856.286, P<0.001) in Nanjing City before and after the adjustment of schistosomiasis control strategies, respectively. The median areas (interquartile range) of snail habitats, infected snail habitats and snail control were 4 175.37 (1 301.65) and 2 366.44 (885.27) hm2 (Z=-3.755, P<0.001), 870.49 (1 001.75) and 0 (158.89) hm2 (Z=-3.654, P<0.001) and 1 383.23 (793.57) and 5 031.94 (629.11) hm2 (Z=-4.320, P<0.001) in Nanjing City before and after the adjustment of schistosomiasis control strategies, respectively. Conclusions After the adjustment of schistosomiasis control strategies, remarkable effects on schistosomiasis control has achieved in Nanjing City, where the transmission of schistosomiasis was interrupted. Nevertheless, the strategy requires to be continued and improved to move towards elimination of schistosomiasis in Nanjing City.

Objective:To investigate the effect of altering trigger timing on clinical outcomes of low prognosis patients with gonadotropin-releasing hormone (GnRH) antagonist.Methods:A retrospective cohort study was conducted on 1613 cycles of low prognosis patients based on POSEIDON criteria undergoing in vitro fertilization-embryo transfer (IVF-ET) with GnRH antagonist protocol between January 2017 to June 2019 in Reproductive Medicine Center, Henan Provincial People's Hospital. Patients were divided into 3 groups depending on different trigger timing criteria (conventional trigger group, n=961; advanced trigger group, n=359; delayed trigger group, n=293). Univariate analysis and multivariate logistic regression analysis were used to analyze the effect of trigger timing on clinical outcomes such as cumulative pregnancy rate (CPR) and cumulative live birth rate (CLBR) among different groups. Results:The clinical pregnancy rate of fresh cycle in advanced trigger group, conventional trigger group, delayed trigger group were 35.77% (44/123), 39.16% (150/383), 34.01% (50/147), respectively. CPR and CLBR ranked from low to high in order of advanced trigger group, conventional trigger group and delayed trigger group [CPR: 33.18% (72/217) vs. 42.23% (276/652) vs. 45.27% (91/201), P=0.024; CLBR: 22.97% (48/209) vs. 31.96% (201/629) vs. 35.90% (70/159), P=0.012]. The result of multivariate logistics regression analysis showed that there were no significant differences on clinical pregnancy rate, CPR and CLBR among three groups [delayed trigger group: the clinical pregnancy rate in fresh cycle OR(95% CI)=0.69(0.44-1.09), P=0.114; CPR OR(95% CI)=0.77 (0.51-1.16), P=0.214; CLBR OR(95% CI)=0.83(0.54-1.29), P=0.418; advanced trigger group: the clinical pregnancy rate in fresh cycle OR(95% CI)=0.98(0.60-1.60), P=0.934; CPR OR(95% CI)=0.87(0.58-1.30), P=0.513; CLBR OR(95% CI)=0.86(0.54-1.35), P=0.515]. Conclusion:Conventional trigger could obtain the ideal clinical outcomes in low prognosis patients based on P

Objective:To investigate the effect of endometrial thickness (EMT) on the clinical outcome of hormone replacement frozen-thawed embryo transfer (HRT-FET) cycle in different body mass index (BMI) groups, and to analyze the threshold and optimal EMT and EMT interval corresponding to the ideal clinical pregnancy rate.Methods:A retrospective cohort study was conducted on 10 239 HRT-FET cycles in the Reproductive Medicine Center of Henan Provincial People's Hospital from January 2013 to December 2017, and they were divided into low weight group (BMI<18.5 kg/m 2), normal weight group (BMI=18.5-24.9 kg/m 2), overweight group (BMI=25.0-29.9 kg/m 2) and obese group (BMI≥30.0 kg/m 2). Four subgroups were divided according to EMT, respectively EMT<8.0 mm, 8.0 mm≤EMT<10.0 mm, 10.0 mm≤EMT<12.0 mm, EMT≥12.0 mm. The clinical characteristics and outcome indicators of different EMT subgroups in different BMI groups were compared. To achieve the ideal clinical pregnancy rate, multiple regression analysis, curve fitting and threshold effect analysis were used to find the best EMT and thickness interval. Results:1) After adjusting for confounding factors, multiple regression analysis showed that, there were no significant differences in clinical pregnancy rate and live birth rate among subgroups with the increase of EMT (all groups P>0.05). The clinical pregnancy rate and the live birth rate increased with the increase of EMT between subgroups of normal body weight group and super-recombinant subgroups (all P<0.001 for normal body weight subgroups, P=0.123, P=0.009, P=0.016 and all P<0.001 for super-recombinant subgroups). In the obesity group, with the increase of EMT, the clinical pregnancy rate did not increase significantly except EMT≥12.0 mm subgroup ( P=0.449, P=0.279, P=0.021), while the live birth rate increased significantly ( P=0.014, P=0.005, P<0.001). 2) Curve fitting showed that in the population of low weight and obese, influence of EMT on clinical pregnancy rate was a straight line, in the population of normal weight and overweight, influence of EMT on clinical pregnancy rate was a curve, as EMT increased the clinical pregnancy rate raised and then decreased, the impact on the live birth rate appeared similar. 3) According to the curve fitting, the threshold effect analysis of the normal weight group showed that the endometrial inflection point of EMT on the clinical pregnancy rate and the live birth rate was 10.0 mm. When EMT was lower than 10.0 mm, the clinical pregnancy rate and the live birth rate increased by 20% and 19% for every 1.0 mm increase in endometrial thickness ( OR=1.20, 95% CI=1.13-1.26; OR=1.13,95% CI=1.13-1.26). In overweight group, the inflection point of EMT on the clinical pregnancy rate and the live birth rate was also 10.0 mm. When EMT was lower than 10.0 mm, the clinical pregnancy rate and the live birth rate increased by 24% and 26% for every 1.0 mm increase in EMT ( OR=1.24, 95% CI=1.13-1.26; OR=1.26, 95% CI=1.14-1.40). When EMT exceeded 10.0 mm, the clinical pregnancy rate and the live birth rate did not increase significantly with the increase of EMT. Conclusion:In HRT-FET cycle, the endometrial thickness has an effect on the clinical pregnancy rate and the live birth rate in the normal weight group and the overweight group. The clinical pregnancy rate and the live birth rate were the best when the EMT was between 10.0-13.5/10.0-12.7 mm and 10.0-14.0/10.0-12.5 mm, respectively. Whether the endometrium was too thin or too thick would affect the clinical pregnancy outcome. The influence of EMT on clinical pregnancy rate and live birth rate was linear between the low weight group and the obese group, but further study is needed.

Objective:To investigate the effect of altering trigger timing on clinical outcomes of low prognosis patients with gonadotropin-releasing hormone (GnRH) antagonist.Methods:A retrospective cohort study was conducted on 1613 cycles of low prognosis patients based on POSEIDON criteria undergoing in vitro fertilization-embryo transfer (IVF-ET) with GnRH antagonist protocol between January 2017 to June 2019 in Reproductive Medicine Center, Henan Provincial People's Hospital. Patients were divided into 3 groups depending on different trigger timing criteria (conventional trigger group, n=961; advanced trigger group, n=359; delayed trigger group, n=293). Univariate analysis and multivariate logistic regression analysis were used to analyze the effect of trigger timing on clinical outcomes such as cumulative pregnancy rate (CPR) and cumulative live birth rate (CLBR) among different groups. Results:The clinical pregnancy rate of fresh cycle in advanced trigger group, conventional trigger group, delayed trigger group were 35.77% (44/123), 39.16% (150/383), 34.01% (50/147), respectively. CPR and CLBR ranked from low to high in order of advanced trigger group, conventional trigger group and delayed trigger group [CPR: 33.18% (72/217) vs. 42.23% (276/652) vs. 45.27% (91/201), P=0.024; CLBR: 22.97% (48/209) vs. 31.96% (201/629) vs. 35.90% (70/159), P=0.012]. The result of multivariate logistics regression analysis showed that there were no significant differences on clinical pregnancy rate, CPR and CLBR among three groups [delayed trigger group: the clinical pregnancy rate in fresh cycle OR(95% CI)=0.69(0.44-1.09), P=0.114; CPR OR(95% CI)=0.77 (0.51-1.16), P=0.214; CLBR OR(95% CI)=0.83(0.54-1.29), P=0.418; advanced trigger group: the clinical pregnancy rate in fresh cycle OR(95% CI)=0.98(0.60-1.60), P=0.934; CPR OR(95% CI)=0.87(0.58-1.30), P=0.513; CLBR OR(95% CI)=0.86(0.54-1.35), P=0.515]. Conclusion:Conventional trigger could obtain the ideal clinical outcomes in low prognosis patients based on P

Objective:To investigate the effect of endometrial thickness (EMT) on the clinical outcome of hormone replacement frozen-thawed embryo transfer (HRT-FET) cycle in different body mass index (BMI) groups, and to analyze the threshold and optimal EMT and EMT interval corresponding to the ideal clinical pregnancy rate.Methods:A retrospective cohort study was conducted on 10 239 HRT-FET cycles in the Reproductive Medicine Center of Henan Provincial People's Hospital from January 2013 to December 2017, and they were divided into low weight group (BMI<18.5 kg/m 2), normal weight group (BMI=18.5-24.9 kg/m 2), overweight group (BMI=25.0-29.9 kg/m 2) and obese group (BMI≥30.0 kg/m 2). Four subgroups were divided according to EMT, respectively EMT<8.0 mm, 8.0 mm≤EMT<10.0 mm, 10.0 mm≤EMT<12.0 mm, EMT≥12.0 mm. The clinical characteristics and outcome indicators of different EMT subgroups in different BMI groups were compared. To achieve the ideal clinical pregnancy rate, multiple regression analysis, curve fitting and threshold effect analysis were used to find the best EMT and thickness interval. Results:1) After adjusting for confounding factors, multiple regression analysis showed that, there were no significant differences in clinical pregnancy rate and live birth rate among subgroups with the increase of EMT (all groups P>0.05). The clinical pregnancy rate and the live birth rate increased with the increase of EMT between subgroups of normal body weight group and super-recombinant subgroups (all P<0.001 for normal body weight subgroups, P=0.123, P=0.009, P=0.016 and all P<0.001 for super-recombinant subgroups). In the obesity group, with the increase of EMT, the clinical pregnancy rate did not increase significantly except EMT≥12.0 mm subgroup ( P=0.449, P=0.279, P=0.021), while the live birth rate increased significantly ( P=0.014, P=0.005, P<0.001). 2) Curve fitting showed that in the population of low weight and obese, influence of EMT on clinical pregnancy rate was a straight line, in the population of normal weight and overweight, influence of EMT on clinical pregnancy rate was a curve, as EMT increased the clinical pregnancy rate raised and then decreased, the impact on the live birth rate appeared similar. 3) According to the curve fitting, the threshold effect analysis of the normal weight group showed that the endometrial inflection point of EMT on the clinical pregnancy rate and the live birth rate was 10.0 mm. When EMT was lower than 10.0 mm, the clinical pregnancy rate and the live birth rate increased by 20% and 19% for every 1.0 mm increase in endometrial thickness ( OR=1.20, 95% CI=1.13-1.26; OR=1.13,95% CI=1.13-1.26). In overweight group, the inflection point of EMT on the clinical pregnancy rate and the live birth rate was also 10.0 mm. When EMT was lower than 10.0 mm, the clinical pregnancy rate and the live birth rate increased by 24% and 26% for every 1.0 mm increase in EMT ( OR=1.24, 95% CI=1.13-1.26; OR=1.26, 95% CI=1.14-1.40). When EMT exceeded 10.0 mm, the clinical pregnancy rate and the live birth rate did not increase significantly with the increase of EMT. Conclusion:In HRT-FET cycle, the endometrial thickness has an effect on the clinical pregnancy rate and the live birth rate in the normal weight group and the overweight group. The clinical pregnancy rate and the live birth rate were the best when the EMT was between 10.0-13.5/10.0-12.7 mm and 10.0-14.0/10.0-12.5 mm, respectively. Whether the endometrium was too thin or too thick would affect the clinical pregnancy outcome. The influence of EMT on clinical pregnancy rate and live birth rate was linear between the low weight group and the obese group, but further study is needed.