Objective To investigate the genetic characteristics of the VP1 region of Coxsackievirus A10 (CVA10) in Yunnan Province. Methods Fecal samples of suspected hand, foot and mouth disease (HFMD) were subjected to real-time fluorescent quantitative PCR for detection of enterovirus CVA10. Positive samples were subjected to VP1 gene sequence amplification and Sanger sequencing. Sequence splicing was performed with DNAstar7.1 Seqman software, and nucleotide sequence and amino acid site analysis were performed using Mega 6.0 software. Results The sequencing of VP1 gene of CVA10 obtained a sequence of 894 nucleotides, encoding 298 amino acids. Compared with the original strain, there were mainly three active amino acid mutation regions, 13-33, 141-142, and 283-285. The nucleotide difference rate between the Yunnan isolates and the reference strain ranged from 16.92% to 30.90%, and the amino acid difference rate ranged from 2.58% to 4.00%. C1 and C2 group nucleotide difference was 10.58%, and the amino acid difference rate was 1.80%. The VP1 150-176 region exhibited highly conserved characteristics. Six CVA10 strains and Sichuan strain MW178898 belonged to the C1 group of the C genotype. The other 14 CVA10 strains belonged to the C2 group. Conclusion VP1 gene mutation is active and CVA10 is an important pathogen of HFMD in Yunnan. C2 genotype of CVA10 is dominant in this study, and C1 and C2 have co-circulated in Yunnan. It is necessary to strengthen monitoring and develop multivalent vaccines containing CVA10 epidemic genotype.

Nonobstructive azoospermia (NOA), one of the most severe types of male infertility, etiology often remains unclear in most cases. Therefore, this study aimed to detect four biallelic detrimental variants (0.5%) in the minichromosome maintenance domain containing 2 ( MCMDC2 ) genes in 768 NOA patients by whole-exome sequencing (WES). Hematoxylin and eosin (H&E) demonstrated that MCMDC2 deleterious variants caused meiotic arrest in three patients (c.1360G>T, c.1956G>T, and c.685C>T) and hypospermatogenesis in one patient (c.94G>T), as further confirmed through immunofluorescence (IF) staining. The single-cell RNA sequencing data indicated that MCMDC2 was substantially expressed during spermatogenesis. The variants were confirmed as deleterious and responsible for patient infertility through bioinformatics and in vitro experimental analyses. The results revealed four MCMDC2 variants related to NOA, which contributes to the current perception of the function of MCMDC2 in male fertility and presents new perspectives on the genetic etiology of NOA.
Humans ; Male ; Azoospermia/genetics* ; Meiosis/genetics* ; Spermatogenesis/genetics* ; Adult ; Exome Sequencing ; Microtubule-Associated Proteins/genetics* ; Alleles ; Infertility, Male/genetics*

Objective:It is of great significance to analyze the expression characteristics of immune-related genes in pancreatic cancer and their relationship with prognosis,construct and verify a reliable prognostic model,and explore prognostic methods of pancreatic cancer from the perspective of immune microenvironment.Methods:GSEA enrich-ment analysis of differentially expressed genes in pancreatic cancer was performed to identify key immune-related pathways and genes.The genes involved in the immune pathway were screened through the STRING database and combined with univariate Cox regression and LASSO regression analysis.Three key genes,RIPK2,IRAK2 and CXCL11,were finally identified to construct the prognostic model.The accuracy of the model was evaluated using ROC curves and calibration curves,and verified in an independent verification set(GSE57495).At the same time,the expression pat-terns of key genes in the immune microenvironment were analyzed by single-cell RNA sequencing,and the expression levels of these genes were verified in pancreatic cancer cell lines by RT-qPCR.Results:The expressions of RIPK2,IRAK2 and CXCL11 in pancreatic cancer cell lines were higher than those in normal pancreatic cancer cells(P<0.05).The model based on these three genes divided the patients into a high-risk group(n=87)and a low-risk group(n=89),and the difference in survival time between the high-risk group and the low-risk group was statistically significant(P<0.001).Risk score was correlated with G stage,N stage and tumor residue(P<0.01).Single-cell analysis showed that the ex-pression of these genes was highest in tumor-associated macrophages(mean>0.5)and correlated with regulatory T cells and macrophage infiltration(P<0.05).Multivariate analysis showed that risk score was correlated with overall sur-vival after adjusting for clinical factors(P=0.0014).Conclusion:Based on three key immune-related genes(RIPK2,IRAK2 and CXCL11),we successfully constructed a model to accurately predict the prognosis of pancreatic cancer pa-tients,revealing the important role of these genes in the tumor immune microenvironment,and providing new insights and theoretical basis for pancreatic cancer prognosis assessment and immunotherapy research.

Objective To analyze the prescription patterns of Professor Huang Feng,a nationally renowned traditional Chinese medicine(TCM)practitioner,in treating osteomyelitis using data mining methods.Methods Prescription data from effective medical records of osteomyelitis treated by Professor Huang Feng between January 2018 and December 2022 were collected and screened.Microsoft Excel,SPSS Modeler 18.0,and SPSS Statistics 25 were used to analyze the frequency and the distribution of properties,flavors,and meridian tropism of prescribed medications,along with association rule analysis and cluster analysis of high-frequency drugs.Results A total of 137 prescriptions involving 86 Chinese medicinals were included.Eighteen high-frequency medicinals(frequency＞30 times)were identified,namely Glycyrrhizae Radix et Rhizoma,Astragali Radix,Coicis Semen,Angelicae Sinensis Radix,Smilacis Glabrae Rhizoma,Achyranthis Bidentatae Radix,Bletillae Rhizoma,Rehmanniae Radix,Paeoniae Radix Alba,Dendrobii Caulis,Polygalae Radix,Lablab Semen Album,Corydalis Rhizoma,Angelicae Dahuricae Radix,Drynariae Rhizoma,Sanguisorbae Radix,Poria,and Mume Fructus.Most of the prescribed medicinals were neutral in nature,sweet,bitter,and pungent in flavor,and had the meridian tropism of liver,spleen,and lung meridians.Association rule analysis yielded 67 drug association rules,and the high-support combinations were the drug combinations of Astragali Radix respectively with Coicis Semen,Angelicae Sinensis Radix,Smilacis Glabrae Rhizoma and Achyranthis Bidentatae Radix,reflecting the compatibility principles of supplementing and invigorating qi-blood,activating blood circulation to resolve stasis,and draining dampness to remove toxins.Cluster analysis revealed three core clusters:Cluster 1 consisted of Glycyrrhizae Radix et Rhizoma,Astragali Radix,Coicis Semen,Smilacis Glabrae Rhizoma,Angelicae Sinensis Radix,Bletillae Rhizoma,Paeoniae Radix Alba,Angelicae Dahuricae Radix,Mume Fructus,Polygalae Radix and Sanguisorbae Radix;Cluster 2 consisted of Rehmanniae Radix and Dendrobii Caulis;Cluster 3 consisted of Achyranthis Bidentatae Radix,Lablab Semen Album,Corydalis Rhizoma and Poria.Conclusion For the treatment of osteomyelitis,Professor Huang Feng follows the principle of combining supporting healthy qi with eliminating pathogens,focuses on clearing damp-heat and pathogenic toxins accompanied by activating blood circulation to resolve stasis,and lays stress on adaptation to local condition and activating spleen-stomach to reinforce vital qi.

Objective To understand the current status of knowledge-attitude-practice(KAP)regarding risk of medication safety behavior among cancer patients in western Yunnan and the related influencing factors,and to provide a basis for conducting rational medication education.Methods Using an approximate random sampling method,a KAP survey on medication safety behavior was conducted among inpatients and outpatients with cancer(aged over 18 years)in multiple hospitals in western Yunnan through online and offline questionnaires.Multiple linear regression analysis was used to explore the impact of different characteristics of the research objects on the KAP scores concerning medication knowledge,behavior,and attitude.Results A total of 512 valid questionnaires were collected.The average scores of medication knowledge,attitude,and behavior among cancer patients were(82.53±23.07),(41.98±8.64),and(67.88±10.08),respectively.Medication knowledge and behavior were at a good level,while medication attitude was at a qualified level.The multiple linear regression results showed that the educational level was a significant influencing factor of the medication knowledge and attitude scores(P＜0.001).Conclusion The overall medication safety among cancer patients in western Yunnan is in a good state,however,there is a need for improvement in medication attitudes.Educational level is the main factor affecting medication safety risk.Pharmacy services should be focused on cancer patients with lower educational levels to enhance their medication safety.

Objective:It is of great significance to analyze the expression characteristics of immune-related genes in pancreatic cancer and their relationship with prognosis,construct and verify a reliable prognostic model,and explore prognostic methods of pancreatic cancer from the perspective of immune microenvironment.Methods:GSEA enrich-ment analysis of differentially expressed genes in pancreatic cancer was performed to identify key immune-related pathways and genes.The genes involved in the immune pathway were screened through the STRING database and combined with univariate Cox regression and LASSO regression analysis.Three key genes,RIPK2,IRAK2 and CXCL11,were finally identified to construct the prognostic model.The accuracy of the model was evaluated using ROC curves and calibration curves,and verified in an independent verification set(GSE57495).At the same time,the expression pat-terns of key genes in the immune microenvironment were analyzed by single-cell RNA sequencing,and the expression levels of these genes were verified in pancreatic cancer cell lines by RT-qPCR.Results:The expressions of RIPK2,IRAK2 and CXCL11 in pancreatic cancer cell lines were higher than those in normal pancreatic cancer cells(P<0.05).The model based on these three genes divided the patients into a high-risk group(n=87)and a low-risk group(n=89),and the difference in survival time between the high-risk group and the low-risk group was statistically significant(P<0.001).Risk score was correlated with G stage,N stage and tumor residue(P<0.01).Single-cell analysis showed that the ex-pression of these genes was highest in tumor-associated macrophages(mean>0.5)and correlated with regulatory T cells and macrophage infiltration(P<0.05).Multivariate analysis showed that risk score was correlated with overall sur-vival after adjusting for clinical factors(P=0.0014).Conclusion:Based on three key immune-related genes(RIPK2,IRAK2 and CXCL11),we successfully constructed a model to accurately predict the prognosis of pancreatic cancer pa-tients,revealing the important role of these genes in the tumor immune microenvironment,and providing new insights and theoretical basis for pancreatic cancer prognosis assessment and immunotherapy research.

Objective To understand the current status of knowledge-attitude-practice(KAP)regarding risk of medication safety behavior among cancer patients in western Yunnan and the related influencing factors,and to provide a basis for conducting rational medication education.Methods Using an approximate random sampling method,a KAP survey on medication safety behavior was conducted among inpatients and outpatients with cancer(aged over 18 years)in multiple hospitals in western Yunnan through online and offline questionnaires.Multiple linear regression analysis was used to explore the impact of different characteristics of the research objects on the KAP scores concerning medication knowledge,behavior,and attitude.Results A total of 512 valid questionnaires were collected.The average scores of medication knowledge,attitude,and behavior among cancer patients were(82.53±23.07),(41.98±8.64),and(67.88±10.08),respectively.Medication knowledge and behavior were at a good level,while medication attitude was at a qualified level.The multiple linear regression results showed that the educational level was a significant influencing factor of the medication knowledge and attitude scores(P＜0.001).Conclusion The overall medication safety among cancer patients in western Yunnan is in a good state,however,there is a need for improvement in medication attitudes.Educational level is the main factor affecting medication safety risk.Pharmacy services should be focused on cancer patients with lower educational levels to enhance their medication safety.

Objective To design a novel oxygenator to solve the existing problems of extracorporeal membrane oxygenation(ECMO)machine in high transmembrane pressure difference,low efficiency of blood oxygen exchange and susceptibility to thrombosis.Methods The main body of the oxygenator vascular access flow field was gifted with a flat cylindrical shape.The topology of the vascular access was modeled in three dimensions,and the whole flow field was cut into a blood inlet section,an inlet buffer,a heat exchange zone,a blood oxygen exchange zone,an outlet buffer and a blood outlet section.The oxygenator was compared with Quadrox oxygenator by means of ANSYS FLUENT-based simulation and prototype experiments.Results Simulation calculations showed the oxygenator designed was comparable to the clinically used ones in general,and gained advantages in transmembrane pressure difference,blood oxygen exchange and flow uniformity.Experimental results indicated that the oxygenator behaved better than Quadrox oxygenator in transmembrane pressure difference and blood oxygen exchange.Conclusion The oxygenator has advantages in transmem-brane pressure difference,temperature change,blood oxygen ex-change and low probability of thrombosis.[Chinese Medical Equipment Journal,2024,45(3):23-28]

Objective To analyze the distribution and antimicrobial resistance of pathogens from wounds of burned patients,providing reference for the rational use of antimicrobial agents and healthcare-associated infection(HAI)prevention and control.Methods Clinical data of burned patients admitted to a tertiary first-class hospital from Ja-nuary 2020 to December 2022 were analyzed retrospectively,pathogens in the wound was cultured,identified,and performed antimicrobial susceptibility analysis.Results From 2020 to 2022,a total of 588 burned patients were ad-mitted,734 strains of pathogens were detected,including 415 strains(56.54％)of Gram-negative bacteria,306 strains(41.69％)of Gram-positive bacteria,and 13(1.77％)strains of fungi.The top 5 pathogens were Staphy-lococcus aureus,Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumoniae,and Enterobacter cloacae.Staphylococcus aureus had higher resistance rates(93.02％-97.37％)to penicillin G,resistance rate to oxacillin increased from 11.63％to 21.92％.Pseudomonas aeruginosa mainly exhibited resistance to ticarcillin/clavulanic acid,aztreonam,and levofloxacin,resistance rates to imipenem and meropenem were 15.00％-38.10％and 10.00％-33.33％,respectively.Susceptibility of Enterobacterales bacteria to cephalosporins enhanced with the increased of cephalosporin generations,and exhibited higher resistance to commonly used antimicrobial agents.Conclusion Over the past three years,there has been no significant change in the detection of major pathogens and antimicrobial resistance in wounds of burned patients in this hospital.Antimicrobial resistance of Staphylococcus aureus and En-terobacterales is relatively severe,and it is necessary to carry out surveillance on pathogens from burn wounds in corresponding areas.

Objective To investigate the effect of endoscopic posterior rhinoplasty in the treatment of post-radiotherapy atretorrhinia in the patients with nasopharyngeal carcinoma,and to analyze the postopera-tive recurrence influencing factors.Methods The clinical data in 60 patients with post-radiotherapy nasal atre-torrhinia due to nasopharyngeal carcinoma diagnosed and treated in this hospital from January 2019 to January 2023 were analyzed retrospectively.They were treated by endoscopic posterior rhinoplasty.The operation situ-ation and postoperative related complications occurrence were recorded.The visual arialogue scale (VAS) was used to evaluate the severity degrees of subjective symptoms before operation and on postoperative 1,3 months.The recurrence situation conducted the statistics.The univariate and multivariate logistic regression was used to analyze the influencing factors of postoperative recurrence.Results The surgical time in 60 cases was (65.12±5.23)min,and intraoperative blood loss volume was (25.02±1.46)mL.Eight cases developed recurrence after surgery.The VAS scores of subjective symptoms such as nasal congestion,rhinorrhea,mouth dryness and olfactory dysfunction on postoperative 1,3 months were decreased compared with before opera-tion (P<0.05).The multivariate logistic regression analysis revealed that postoperative nostril size,exposure of normal mucosa,use of mucoperiosteal flap and regular postoperative regular nasal endoscopic re-examina-tions were the independent influencing factors of postoperative recurrence in the patients with post-radiothera-py atretorrhinia after endoscopic posterior rhinoplasty treating nasopharyngeal carcinoma (P<0.05).Conclu-sion Using endoscopic posterior rhinoplasty for treating atretorrhinia after nasopharyngeal carcinoma radio-therapy has good effect,which could improve the subjective symptoms of the patients.The nostril size,normal mucosa exposure and regular re-examinations may affect the postoperative recurrence.