Objective:To study the characteristics of soil microbial composition in sheep sheds in agricultural and pastoral areas, and explore potential zoonotic pathogen species.Methods:Using cross-sectional survey method, soil samples from sheep sheds in the agricultural and pastoral areas of Darhan-Muminggan Joint County, Baotou City, Inner Mongolia Autonomous Region were collected from August to October 2023. Genomic DNA was extracted, and metagenomic second-generation sequencing was conducted. Microbial species annotation was carried out by Kaiju method, and the soil microbial composition and zoonotic pathogen species of sheep sheds in agricultural and pastoral areas were analyzed.Results:A total of 10 and 5 soil samples were collected from sheep sheds in agricultural and pastoral areas, respectively. The results of β diversity analysis showed that there was a significant separation trend in soil samples from sheep sheds in agricultural and pastoral areas, and the interpretation of principal co-ordinates analysis (PCoA) 1 and PCoA2 were 27.8% and 17.4%, respectively. There was no significant difference in the microbial composition of soil samples from sheep sheds in agricultural and pastoral areas ( R = 0.09, P = 0.242). At the phylum level, the dominant bacterial phyla were Actinobacteria, Proteobacteria, Firmicutes, and Bacteroidetes. At the genus level, the dominant bacterial genera were Corynebacterium, Luteimonas, Atopostipes, and Salinicoccus. A variety of zoonotic pathogens were detected, including Brucella melitensis, Mycobacterium tuberculosis, and Clostridium tetani in 15 soil samples. Conclusion:The soil microorganisms in sheep sheds in agricultural and pastoral areas are diverse, and zoonotic pathogens such as Brucella melitensis, Mycobacterium tuberculosis, and Clostridium tetani are detected.

Objective:To study the characteristics of soil microbial composition in sheep sheds in agricultural and pastoral areas, and explore potential zoonotic pathogen species.Methods:Using cross-sectional survey method, soil samples from sheep sheds in the agricultural and pastoral areas of Darhan-Muminggan Joint County, Baotou City, Inner Mongolia Autonomous Region were collected from August to October 2023. Genomic DNA was extracted, and metagenomic second-generation sequencing was conducted. Microbial species annotation was carried out by Kaiju method, and the soil microbial composition and zoonotic pathogen species of sheep sheds in agricultural and pastoral areas were analyzed.Results:A total of 10 and 5 soil samples were collected from sheep sheds in agricultural and pastoral areas, respectively. The results of β diversity analysis showed that there was a significant separation trend in soil samples from sheep sheds in agricultural and pastoral areas, and the interpretation of principal co-ordinates analysis (PCoA) 1 and PCoA2 were 27.8% and 17.4%, respectively. There was no significant difference in the microbial composition of soil samples from sheep sheds in agricultural and pastoral areas ( R = 0.09, P = 0.242). At the phylum level, the dominant bacterial phyla were Actinobacteria, Proteobacteria, Firmicutes, and Bacteroidetes. At the genus level, the dominant bacterial genera were Corynebacterium, Luteimonas, Atopostipes, and Salinicoccus. A variety of zoonotic pathogens were detected, including Brucella melitensis, Mycobacterium tuberculosis, and Clostridium tetani in 15 soil samples. Conclusion:The soil microorganisms in sheep sheds in agricultural and pastoral areas are diverse, and zoonotic pathogens such as Brucella melitensis, Mycobacterium tuberculosis, and Clostridium tetani are detected.

Objective To explore the correlation between skeletal muscle fat content and insulin resistance(IR)in patients with type 2 diabetes mellitus(T2DM),and to evaluate the diagnostic value of skeletal muscle fat quantitative parameters for IR.Methods During January 2018 to January 2021,150 T2DM patients as observation group(T2DM group)and 100 healthy subjects as control group(NC group)were selected.All subjects underwent magnetic resonance imaging quantitatively analyzed skeletal muscle fat content,including intermuscular fat(IMAT),adipose tissue beneath fascia(SFAT)and subcutaneous fat(SCAT).Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of skeletal muscle fat quantitative parameters for IR in T2DM patients.Results The levels of IMAT and SFAT were higher in T2DM group than those in NC group[(10.05±1.34)%vs(7.16±2.06)%,(3.64±0.54)%vs(3.40±0.75)%,P<0.05],while the level of SCAT was lower than in T2DM group than in NC group[(20.16±6.34)%vs(24.97±6.57)%,P<0.05].Pearson correlation analysis showed that IMAT and SFAT were positively correlated with HbA1c and HOMA-IR(P<0.05),while SCAT was negatively correlated with HbA1c and HOMA-IR(P<0.05).ROC curve analysis showed that the area under the curve of IMAT,SFAT,and SCAT for the diagnostic value of T2DM combined with IR were 0.716,0.667 and 0.736,with sensitivities of 75.4%,72.9%and 76.4%,and specificity of 71.4%,65.2%and 68.1%.Conclusion Skeletal muscle fat contentis associated with IR.The quantitative parameters of skeletal muscle fat have good diagnostic efficacy for T2DM complicated with IR.

Objective:To evaluate the efficacy and safety of dupilumab in the treatment of adult prurigo nodularis.Methods:A prospective study was conducted on patients with prurigo nodularis who received the treatment with dupilumab in Peking University People′s Hospital from January 2021 to November 2021. Efficacy was assessed using the Investigator′s Global Assessment (IGA) , Numerical Rating Scale (NRS) and Dermatology Life Quality Index (DLQI) at weeks 0, 4 and 16. Wilcoxon signed-rank test and paired t test were used to analyze changes in the above parameters before and after treatment. Results:A total of 17 patients were enrolled in this study, including 12 females and 5 males, aged 48.47 ± 16.26 years. After 16-week treatment with dupilumab, the pruritus NRS score decreased from 8.00 ± 1.50 at baseline to 1.29 ± 0.85 ( t = 6.98, P < 0.001) , the sleeplessness NRS score decreased from 5.18 ± 2.98 at baseline to 0.12 ± 0.49 ( t = 12.55, P < 0.001) , and the DLQI score declined from 13.29 ± 4.03 at baseline to 0.88 ± 0.70 ( t = 16.39, P < 0.001) ; at week 16, the IGA grade of all the 17 patients decreased from 3 - 4 at baseline to 0 - 2, 16 achieved IGA grades 0 - 1, and 12 achieved IGA grade 0. During the treatment, mild conjunctivitis occurred in 2 cases, local injection reaction occurred in 1, and both conditions were improved after short-term symptomatic treatment. Conclusion:Dupilumab is markedly effective and safe in the treatment of adult prurigo nodularis.

To report a case of generalized lichen amyloidosis successfully treated with dupilumab in China. A 70-year-old male patient presented with extensive itchy papules on the trunk and extremities for 23 years. Skin examination revealed diffuse millet-to mung bean-sized hemispherical brown plaques on the trunk, right anterior shank, and extensor aspect of both upper arms, with a hard texture on palpation. No abnormalities were observed in the blood eosinophil count or serum IgE level. Histopathological examination of the skin lesion on the lower limb showed epidermal hyperkeratosis and homogeneous red-stained lumpy materials in the papillary dermis. Immunohistochemical study showed positive staining with Congo red. The pruritus numerical rating scale score was 10 points. The diagnosis of generalized lichen amyloidosis was confirmed. The patient received subcutaneous injection of dupilumab at an initial dose of 600 mg, followed by an every-2-week regimen at a dose of 300 mg. At week 2 after the start of treatment, pruritus was markedly relieved; at week 14, the skin lesions began to subside markedly; at week 18, the skin lesions on the chest and abdomen nearly completely subsided, and lesions on the lower back and limbs markedly regressed. No obvious adverse reactions were observed.

Objective: To examine the prevalence of allergic diseases in schoolaged children from Shanghai and to explore related factors so as to produce epidemiological data regarding allergic diseases in children. Methods: Multistage cluster sampling was used to carry out the study in Shanghai from April to June 2019. A total of 10 686 children aged 7-12 years from 17 primary schools participated in the survey. The International Study of Asthma and Allergies in Childhood (ISAAC)Scale was used to evaluate allergic diseases. Multivariate Logistic regression analysis was performed to analyze the related factors. Results: The overall prevalence of allergic diseases among schoolaged children in Shanghai was 47.0%. A higher prevalence was observed among boys (50.4% vs 43.3% in girls, χ2=54.44, P<0.01). Common allergic diseases included asthma (13.9%), allergic rhinitis (18.2%), and atopic dermatitis (34.3%). The Logistic regression analysis showed that the common risk factors of asthma, allergic rhinitis and atopic dermatitis included the following:male gender (OR=1.52,1.44,1.22); mother has a bachelors degree or above (OR=1.26,1.77,1.84); family history of allergic diseases (OR=2.87,4.24,2.57); only child (OR=1.16,1.28,1.22); curtain cleaning frequency <1 time/month (OR=1.41,1.79,1.77); room not cleaned daily (OR=1.14,1.18,1.20); and dust exposure frequency ≥1 time/month (OR=1.45,1.56,1.42), all P<0.05. These three types of allergic diseases were also associated with unique risk factors that dependent on socialenvironmentalbehavioral factors. Conclusion Compared with previous data, the prevalence of allergic diseases among schoolaged children in Shanghai increased significantly in 2019. The related influencing factors involve multiple variables including demographics, environmental exposure and behavior, which warrant further exploration.

Objective: To investigate the sleep characteristics of children aged 3-12 years old in Shanghai, and to provide a reference for improving pediatric sleep health. Methods: From April to June 2019, 16 542 children aged 3-12 years old were randomly selected from 31 kindergartens and 17 primary schods in Shanghai, and a cross sectional epidemiological survey was conducted using multi stage cluster sampling. The Children s Sleep Habits Questionnaire (CSHQ) was used to evaluate sleep characteristics. Results: The bedtime routine of children in Shanghai was (21:27±00:36) and (21:46±00:46) on weekdays and weekends, respectively. Corresponding wake up times were (6:52±00:28) and (7:47±00:48), total sleep duration was (9.05±1.07) and (9.52±1.17)h, and the prevalence of inadequate sleep was 81.0% and 55.4%. The average score of sleep problems was (51.56±8.04), and the prevalence of disturbed sleep was 93.5%. With advancing age, the total sleep time of children in Shanghai decreased, and the difference in weekend weekday sleep patterns increased. Furthermore, two major sleep problems were observed, namely, short sleep duration and daytime sleepiness, which became increasingly more prominent. Girls usually went to bed later on weekdays and woke up later on weekends, and a greater difference in weekend weekday sleep patterns was observed. Moreover, psychological problems such as sleep anxiety were more serious among girls. Conclusion At present, children in Shanghai have insufficient sleep time and late bedtimes. Large differences in weekend weekday sleep patterns were observed, and various sleep problems were identified. Sleep related anxiety and differences in weekend weekday sleep patterns were particularly high among girls.

Objective: To explore the association between exclusive breastfeeding and sleep onset delay among school aged children, and to provide a reference for promoting childhood sleep health. Methods: A total of 10 686 children aged 7-12 years old were recruited from 17 primary schools in Shanghai using the multi stage sampling method from April to June 2019. The duration of sleep onset delay and exclusive breastfeeding were identified using the Children s Sleep Habits Questionnaire and a self designed questionnaire, respectively. The association between the duration of exclusive breastfeeding and the score and the risk of sleep onset delay were estimated using linear regression and a Logistic regression model, respectively. Results: After adjusting for confounding factors, compared with never exclusive breastfeeding, the score of sleep onset delay decreased by 0.07, 0.08 and 0.05 in cases that involved exclusive breastfeeding for less than 3 months, 3-6 months and more than 6 months, respectively; and the odds of sleep onset delay decreased by 39.0%(OR=0.61, 95%CI=0.47-0.79), 41.1%(OR=0.59, 95%CI=0.47-0.75) and 21.1%(OR=0.79, 95%CI=0.65-0.96), respectively. Similar findings were observed in analyses stratified by gender, although the association was stronger among boys. Moreover, administration of probiotics or yogurt only improved sleep onset delay in those who were exclusively breastfed for no more than 6 months. Conclusion Longer durations of exclusive breastfeeding were associated with a lower risk of sleep onset delay among school aged children. However, exclusive breastfeeding for over 6 months diminished the protective effect that was otherwise observed on sleep onset delay.

Objective:To investigate the effect of gonadotropin (Gn) on embryo aneuploidy rate and pregnancy outcome during preimplanptation genetic testing for aneuploidy (PGT-A) cycles.Methods:The clinical data of patients undergoing PGT-A cycle at the First Medical Center of the PLA General Hospital from January 1, 2013 to May 31, 2019 were retrospectively analyzed. Patients were divided into younger patient group (<35 years old) and elder patient group (≥35 years old) by maternal age, then divided into two groups in line with Gn dosage (≤2 250 U, >2 250 U), and into four groups by number of oocytes retrieved (1-5, 6-10, 11-15 and ≥16 oocytes). The embryo aneuploidy rate and pregnancy outcome between the groups were compared. Logistic regression was used to analyze the relationship between the cumulative amount of Gn, embryo aneuploidy rate and live-birth rate.Results:A total of 402 cycles (338 patients) and 1 883 embryos were included in the study. (1) In the younger patients, the aneuploidy rate was 52.5% (304/579) in the group of Gn≤2 250 U and 48.6% (188/387) in the group of Gn >2 250 U, with no significant difference between them ( P=0.232). In the elderly patients, the difference in embryo aneuploidy rate between the two Gn group [57.9% (208/359) versus 60.6% (319/526)] was not statistically significant ( P=0.420). (2) The embryonic aneuploidy rate in different protocol of ovary stimulation was analyzed,in the younger group, the embryonic aneuploidy rate in patients using antagonist long protocol was 50.3% (158/314), it was 50.0% (121/242) in agonist long protocol, 52.1% (207/397) in agonist short protocol and 6/13 in luteal phase protocol, no statistical difference was found in above groups ( P=0.923); in the elder group, embryonic aneuploidy rate was 60.8% (191/314) in antagonist protocol, 58.4% (132/226) in agonist long protocol, 59.2%(199/336) in agonist short protocol, 5/9 in luteal phase protocol, respectively,no significant difference was found ( P=0.938). (3) In the younger patients, the aneuploidy rate in 1-5 oocytes group, 6-10 oocytes group, 11-15 oocytes group and ≥16 oocytes group was 37.9% (11/29), 54.0% (94/174), 52.5% (104/198) and 50.1% (283/565) respectively, no significant difference was found between the groups ( P=0.652); while in the elder patients, the difference between aneuploidy rate in each retrieved oocytes group [73.6% (89/121), 57.5% (119/207), 56.3% (108/192), 57.8% (211/365)] was statistically significant ( P=0.046). (4) Logistic regression analysis of age, cumulative dosage of Gn, number of oocytes obtained, and embryo aneuploidy rate showed that there was no association between the amount of Gn and embryo aneuploidy rate ( P>0.05); the increase in maternal age would increase the risk of aneuploidy rate of embryos, which was statistically significant ( OR=1.031, 95 %CI: 1.010-1.054, P=0.004); the increase in oocytes retrived would significantly decrease the risk of aneuploidy ( OR=0.981, 95 %CI: 0.971-0.991, P<0.01). (5) There was no significant difference in biochemical pregnancy rate [55.6% (80/144) versus 52.1% (63/121)], clinical pregnancy rate [50.0% (72/144) versus 47.9% (58/121)] and live-birth rate [46.5% (67/144) versus 40.5% (49/121)] between different Gn dosage groups ( P=0.613, P=0.738, P=0.324). The logistic regression analysis showed that the maternal age, the cumulative dosage of Gn, the number of oocytes obtained, and the ovarian stimulation protocol had no effect on the live-birth rate (all P>0.05). Conclusions:In PGT-A cycle, the dosage of Gn has no association with the embryo aneuploidy rate and pregnancy outcome. In the patients ≥35 years old, the increase in number of oocytes obtained may decrease the risk of aneuploidy. Age is an important factor affecting the embryo aneuploidy in PGT-A cycle.

Objective To investigate the safety and efficacy of wide local excision surgery combined with 5-aminolaevulinic acid(ALA)-photodynamic therapy(PDT)in treating Paget's disease of the scrotum in elderly people.Methods Patients with an average age of 68.4 ± 4.7 years undergoing wide local excision surgery combined with ALA-PDT for Paget's disease of the scrotum from June 2014 to February 2018 were followed up.All patients underwent wide local excision surgical treatment first and were then enrolled in ALA-PDT study after the diagnosis of Paget's disease of the scrotum was confirmed.Four cases were eliminated as a result of two patients refusing photodynamictherapy for various reasons and two patients lost during follow-up after ALA-PDT.A total of 16 patients were included in the study,of whom 6 cases were in Ray stage A1,7 cases in stage A2 and 3 cases in stage B.Patients underwent 3 courses of ALA-PDT after operation.Then the efficacy,shortand medium-term complications were followed up.Results The duration of disease among the 16 patients ranged from 4 to 76 months before diagnosis,with an average of 35.7 months.Surgery was performed immediately after diagnosis.Ten patients underwent resection and suture and 6 patients were treated with skin flap transfers.Of the patients treated with surgery,3 patients received suspicious lymph node dissection and 1 patient underwent reoperation due to skin flap necrosis.Patients were followed up for 3 months to 3 years and 6 months after ALA-PDT.Recurrence and distant metastasis occurred in 2 cases,with 1 case of brain metastasis and 1 case of systemic metastasis,and the overall recurrence rate was 12.5％.During the follow-up,there were no other serious complications except for 1 case(6.3 ％)with lower limb movement disorders.Conclusions Wide local excision surgery combined ALA-PDT has good clinical outcomes,low recurrence rates and few complications for the treatment of Paget's disease of the scrotum in elderly people.