Objective To explore the prognostic impact and clinical application value of therapeutic plasma exchange(TPE)intervention timing and liver injury periodization in patients with exertional heat stroke(EHS).Methods Data of 127 EHS patients from the First Medical Center of the General Hospital of the People′s Liberation Army from January 2011 to December 2023 were collected,then divided into the death group and the survival group based on therapeutic outcomes and into 5 stages according to the dynamic changes of ALT,AST,TBIL and DBIL.According to propensity score matching analysis,11 patients in the survival group and 12 patients in the death group were included in the statistical analysis,and 20 of them were treated with TPE.The changes in indicators and clinical outcomes before and after TPE were observed,in order to evaluate the impact of intervention timing on prognosis.Results Among the 23 patients,14 had no liver injury or could progress to the repair phase,resulting in 3 deaths(with the mortality rate of 21.43%),while 9 patients failed to pro-gress to the repair phase,resulting in 9 deaths(with the mortality rate of 100%),with significant differences(P＜0.05).The mortality rate of the first TPE intervention before the third stage of liver injury was 23.08%(3/13),while that of interven-tion after reaching or exceeding the third stage was 85.71%(6/7),and the difference was statistically significant(P＜0.05).Conclusion TPE should be executed actively in EHS patients combined with liver injury before the third phase to lock its pathological and physiological processes,thereby improving prognosis and reducing mortality.

In order to relieve the problems including a lack of features in the teaching of public foreign language discipline in medical universities, the teaching concepts of college English should be innovated in the context of new medical science and integrated with the education of medical humanities, while adhering to the direction of English teaching for medical purposes and realizing the reversal to teaching services. With the teaching reform of college English characterized by English for medical humanities in Shanghai University of Medicine and Health Sciences as an example, this article explores the various ways to realize the education goals of English for medical humanities, such as establishing a whole-curriculum system for the teaching of English for medical humanities, editing and publishing academic works of medical humanities, cultivating teaching and research teams for English for medical humanities, and organizing different discipline competitions. It is concluded that the exclusively unique strengths and contributions of the foreign language discipline in medical universities should be fully exerted amid the professional medical education system, in order to make joint efforts to cultivate comprehensive medical talents in the new era.

World-renowned international journals of medicine have published tremendous amounts of medical literature on public health emergency of international concerns (PHEIC). Whereas due to language barriers, these medical research results are not translated automatically and promptly into public health knowledge, hence the effect of health communication and education remains blocked. The paper, from a transdisciplinary perspective, attempts to explore a route to translate international medical literature in foreign languages into Chinese based on the "5W" theory of health communication, aiming to break language barriers in the process of health communication and education. The paper asserts that population's level of health literacy could be improved and people's demand for various health and medical knowledge could be well satisfied by means of translating and communicating international medical literature to the public; medical translators are identified as health communicators as well; studies on foreign languages and translation are expected to actively interact and integrate with health communication; and thus make joint contributions to its growth in China.

Objective:To provide reference for the construction and development of medical colleges and universities by comparing the scientific research competitiveness of four newly-established medical universities in Shanghai, Shaanxi, Zhejiang and Fujian of China.Methods:Four young state-owned medical universities, founded successively from 2015 in Shanghai, Shaanxi, Zhejiang and Fujian provinces, were selected as the research samples. Both CNKI and WoS databases were used to conduct comparative bibliometric analysis of high-quality literature published in core Chinese and foreign journals during 2016 to 2020 from such perspectives as number of papers, discipline distribution, source titles and funding, etc.Results:All four universities have displayed an increasing trend of publishing literature in core Chinese and foreign journals, but there are relatively fewer literature published in top international journals. The university from Shaanxi leads the other three with most indexes, and the two universities from Shanghai and Zhejiang stand close, while the one from Fujian lags behind, indicating a gap of scientific research competitiveness among the four.Conclusion:The reasons for the existing gap are potentially related to different college foundation and history, orientation and objectives, as well as the strength of scientific research team. Newly-built medical universities should keep deepening the comprehensive reform of medical education and strengthening comprehensive power of scientific research competitiveness.

Objective To analyze the status of mycoplasma infection and drug resistance in the local area,and provide the ba-sis for clinical rational drug use.Methods The specimens obtained from 1 9 530 patients with urogenital tract infection were detec-ted by adopting mycoplasma culture,identification and drug sensitivity integration kit.Mycoplasma infection and drug susceptibility were analyzed.Results In the total of 1 9 530 suspected patients specimens,1 1 1 78 cases were positive with a positive rate 57.24%.The positive rate of ureaplasma urealyticum (Uu)and mycoplasma hominis (MH)was 44.63% and 0.44% respectively and the positive rate of Uu and Mh mixed infection was 12.1 7%.The positive rate of female was higher than that of male and the difference was statistically significant(P <0.05).The positive rate of mycoplasma in 2008-2014 was on the rise;The sensitive rate of mycoplasma to josamycin,doxycycline,minocycline element,clarithromycin was 88.57%,84.32%,76.09% and 71.53% respec-tively,mycoplasma was highly drug resistance to quinolone antibiotics;mixed infection resistance was higher than that of single in-fection;The number of drug resistance of Uu,MH and Uu+MH to 12 kinds of antibiotics increase.Conclusion Mycoplasma infec-tion in urogenital tract is mainly caused by Uu and Mh infection is in mixed infection way;josamycin,doxycycline is the first choice for treatment of mycoplasma in this region.Rational drug choise can be based on the drug susceptibility test.Multiple drug resist-ance of mycoplasma is serious and should be paid attention to.

OBJECTIVETo investigate the correlation between human immunodeficiency virus (HIV) and the sexual behaviors of men who have sex with men (MSM) in Guangzhou in 2010.

METHODSAnti-HIV antibody was detected in the volunteers undergoing HIV tests in the year 2010, and the differences in the sexual role, education, use of condom and complicated infection of syphilis were analyzed among these subjects.

RESULTSA total of 1526 MSM volunteered to participate in the investigation, among whom 87 (5.70%) were confirmed to have HIV infection. The positivity rate of HIV infection was 3.54%, 7.14% and 6.70% in subjects reporting active anal copulation, passive anal copulation, and both, respectively, showing a significant difference in respect of the sexual role (χ(2)=6.450, P=0.040). The positivity rate also differed significantly among married, unmarried and divorced subjects (9.45%, 4.92%, and 4.17%, respectively; χ(2)=7.184, P=0.028). The positivity rate was 21.31% among those with syphilis, significantly higher than the rate in those without syphilis (5.06%, χ(2)=25.770, P<0.001). Use of condom was not associated with a significant reduction of HIV positivity rate (P>0.05).

CONCLUSIONThe high anti-HIV positivity rate among MSM in Guangzhou indicates a high risk of unsafe sexual behaviors, especially anal copulations. The anal copulation receivers, often young and have a lower rate of condom use, constitute a high-risk group of HIV transmission.

Adolescent ; Adult ; China ; epidemiology ; HIV Antibodies ; blood ; HIV Infections ; epidemiology ; prevention & control ; transmission ; HIV Seropositivity ; epidemiology ; transmission ; Homosexuality, Male ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Prevalence ; Sexual Behavior ; Surveys and Questionnaires ; Young Adult

INTRODUCTIONRetinitis pigmentosa (RP) is the most prevalent group of inherited retinopathies and demonstrates considerable clinical and genetic heterogeneity, with wide variations in disease severity, progression, and gene involvement. We studied a large family with RP to determine the pattern of inheritance and to identify the disease-causing gene/locus.

MATERIALS AND METHODSOphthalmic examination was performed on 35 family members to identify affected individuals and carriers and to characterise the disease phenotype. Genetic linkage analysis was performed using short tandem repeat (STR) polymorphic markers encompassing the known loci for Xlinked RP (xlRP) including RP2, RP3, RP6, RP23, and RP24. Mutation screening was performed by direct sequencing of PCR-amplified genomic DNA of the RP2 and RPGR genes of the affected individuals.

RESULTSA highly penetrant, X-linked form of RP was observed in this family. Age of onset was from 5 to 8 years and visual acuity ranged from 20/25 in children to light perception in older adults. Linkage analysis and direct sequencing showed that no known loci/genes were associated with the phenotype in this kindred.

CONCLUSIONA novel disease gene locus/loci is responsible for the xlRP phenotype in this family.

Adolescent ; Adult ; Age of Onset ; Child ; Child, Preschool ; Chromosome Mapping ; DNA Mutational Analysis ; Eye Proteins ; genetics ; Female ; Genetic Diseases, X-Linked ; genetics ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; Lod Score ; Male ; Membrane Proteins ; genetics ; Pedigree ; Phenotype ; Retinitis Pigmentosa ; genetics

Beijing has been one of the epicenters attacked most severely by the SARS-CoV (severe acute respiratory syndrome-associated coronavirus) since the first patient was diagnosed in one of the city's hospitals. We now report complete genome sequences of the BJ Group, including four isolates (Isolates BJ01, BJ02, BJ03, and BJ04) of the SARS-CoV. It is remarkable that all members of the BJ Group share a common haplotype, consisting of seven loci that differentiate the group from other isolates published to date. Among 42 substitutions uniquely identified from the BJ group, 32 are non-synonymous changes at the amino acid level. Rooted phylogenetic trees, proposed on the basis of haplotypes and other sequence variations of SARS-CoV isolates from Canada, USA, Singapore, and China, gave rise to different paradigms but positioned the BJ Group, together with the newly discovered GD01 (GD-Ins29) in the same clade, followed by the H-U Group (from Hong Kong to USA) and the H-T Group (from Hong Kong to Toronto), leaving the SP Group (Singapore) more distant. This result appears to suggest a possible transmission path from Guangdong to Beijing/Hong Kong, then to other countries and regions.
Genome, Viral ; Haplotypes ; Humans ; Mutation ; Open Reading Frames ; Phylogeny ; SARS Virus ; genetics

AIM　It is difficult to identify the Chinese crude drug snake gallbladder accurately by morphological and microscopical characteristics or chemical components only. In order to solve the problem, the technique based on DNA molecular marker was introduced into the authentication of snake gallbladder. METHODS　DNA templates were extracted from the membrane or the bile of snake gallbladder, and also from the muscle of the original animal Elaphe schrenckii. About 400 bp DNA fragments of 12S rRNA gene were amplified from the templates and sequenced subsequently. RESULTS　Enough amounts of DNA templates could be extracted from a bit of membrane or bile of snake gallbladder. The sequence of amplicons from the membrane, bile and muscle of the same individual were identical completely. CONCLUSION　The technique of DNA molecular marker could be used for the authentication of snake gallbladder and bile. The results indicate that the technique could be used for the identification of crude drugs from other animal secretion. DNA sequence analysis also demonstrated that the origins of commercial snake gallbladder were complicated and more efficient quality control was necessary for supervising the crude drug in the market.

Objective To better understand the pathogenicity and evolution of Yersinia pestis, we carried out the whole genome sequencing of human-avirulent Yersinia pestis strain 91001, which was isolated from a species of rodent-Microtus brandti. Methods We utilized “whole genome shotgun” approach to get the genome sequence of 91001. Based on the finished and annotated genome sequence of 91001, as well as the previously published genome sequences of CO92 and KIM, we performed detailed comparative genomics analysis on their chromosomes and plasmids. Results The genome of 91001 consisted of one chromosome and four plasmids (pPCP1, pCD1, pMT1 and pCRY). The pPCP1 plasmid of 9 609bp was almost identical with its counterparts from reference strains, which possessed 10 CDS. Plasmid pCD1 was found to be a plasmid of the type III secretory apparatus, and its length was 70 159bp. Although its CDS are quite similar to those of the reference plasmids, there were obvious rearrangements which produced certain differences in structure among them. Another plasmid was pMT1, a 106 642bp plasmid, which showed slightly different architecture compared with the reference ones. There was no mutation in virulent-related genes of pMT1 and pMT1 of 91001, which seemed to have retained more fragments of an ancestor plasmid. pCRY was a novel plasmid discovered in this work. It was 21 742bp long and harbored a group of gene encoding type IV secretory system. pCRY seemed to be able to replicate. The length of chromosome of 91001 was 4 595 065bp, and among its 4 037 predicted CDS (coding sequences), 141 were possibly pseudogenes. There were many IS in the chromosome. Due to the rearrangments mediated by IS, the structure of 91001 chromosome showed significant differences compared with CO92 and KIM. According to the results of comparative genomics analysis, we deduced the genetic mechanisms of nitrate reduction, glycerol fermentation, arabinose and milibiose utilization in 91001. Conclusion According to the analysis of plasmids structure, pseudogenes distribution, nitrate reduction negative mechanism, gene comparison and chromosome architecture, we conclude that 91001 and other strains isolated from Microtus brandti and Microtus fuscus evolved from ancestor Y. pestis and then developed into a different lineage. The deletion of large genome fragments from 91001 chromosome and pseuogenes might contribute to its unqiue pathogenicity and host-specificity.