Objective To analyze the influencing factors of delayed postoperative bleeding(DPPB)after endoscopic submucosal dissection(ESD)for early gastric cancer and construct a Nomogram model.Methods The clinical information of 234 patients who underwent ESD treatment at our hospital and pathologically diagnosed with early gastric cancer from April 2021 to April 2023 were collected.The patients were grouped based on the presence or absence of DPPB.Logistic regression analysis was applied to screen for risk factors affecting DPPB after ESD in early gastric cancer patients.R software was applied to construct a Nomogram model for predicting the risk of DPPB in early gastric cancer patients after ESD.Receiver operator characteristic(ROC)curve,calibration curve,and Hosmer-Lemeshow goodness of fit test were plotted to evaluate the Nomogram model.Results A total of 23(9.8%)of 234 early gastric cancer patients who underwent ESD treatment developed DPPB.Multivariate Logistic regression analysis showed that the number of biopsies≥3(95%CI:2.482-20.424,P=0.000),the maximum diameter of lesions≥3 cm(95%CI:1.620-13.244,P=0.004),the depth of invasion to submucosa(95%CI:1.421-10.536,P=0.008),and intraoperative bleeding(95%CI:1.160-11.300,P=0.027)were independent risk factors for DPPB after ESD in early gastric cancer patients.The area under ROC curve(AUC)was 0.838(95%CI:0.743-0.932).The slope of the calibration curve was close to 1.Hosmer-Lemeshow goodness of fit test showed χ2=3.328,P=0.505.Conclusions The number of biopsies≥3,the maximum diameter of lesion≥3 cm,the depth of invasion to submucosa,and intraoperative bleeding are independent risk factors for DPPB after ESD in early gastric cancer patients.The Nomogram model based on these four independent risk factors can effectively predict the risk of DPPB after ESD in early gastric cancer patients.

Objective:To investigate the epidemic trend and epidemiological characteristics of human brucellosis in Chengyang District of Qingdao City, and to provide a theoretical reference for formulating scientific prevention and control measures.Methods:The data of confirmed and clinically diagnosed brucellosis cases with current address in Chengyang District of Qingdao City reported by China Disease Control and Prevention Information System from January 2016 to December 2020 were collected, and the epidemic trend, three-dimensional distribution, clinical characteristics, case consultation and disease outcome and epidemiological history of human brucellosis were descriptively analyzed.Results:From 2016 to 2020, 23 cases of human brucellosis were reported in Chengyang District of Qingdao City, with an annual incidence of 0.52/100 000, and the incidence was decreasing year by year (χ 2trend = 7.83, P = 0.005). The onset time was mainly distributed in spring and summer, of which spring (1, 5 and 5 cases respectively from March to May) accounted for 47.83% (11/23), and summer (1, 4 and 1 cases respectively from June to August) accounted for 26.09% (6/23). There were 13 cases of males and 10 cases of females, the ratio of male to female was 1.30 ∶ 1.00; the age of onset was (52.52 ± 14.67) years old, mainly from 40 to 65 years old, accounted for 65.22% (15/23); farmers accounted for 69.57% (16/23). The largest number of reported cases was in Chengyang Street (6 cases), followed by Xiazhuang Street (4 cases) and Liuting Street (4 cases), accounted for 60.87% (14/23). The main clinical manifestations were fever (21 cases, 91.30%), followed by muscle and joint soreness (18 cases, 78.26%), fatigue (18 cases, 78.26%), and hyperhidrosis (15 cases, 65.22%). The median time interval from onset to diagnosis was 27 days, and 82.61% (19/23) of the cases were diagnosed as brucellosis at the acute stage. After follow-up, 21 cases (91.30%) reached the recovery standard, and 2 cases (8.70%) improved. Verified by the epidemiological investigation, 23 cases of human brucellosis had multiple routes of infection. The main mode of infection was direct contact, including feeding suspected sick animals (8 cases, 34.78%), contacting urine, feces and other excrement of suspected sick animals (8 cases, 34.78%), delivering suspected sick animals/disposing the apoblema (5 cases, 21.74%), and slaughtering/contacting raw lamb (4 cases, 17.39%). Conclusions:From 2016 to 2020, the incidence of human brucellosis in Chengyang District of Qingdao City has decreased year by year. It occurs frequently in spring and summer, mainly in middle-aged and elderly male farmers. The main clinical manifestation is fever and there are multiple ways of infection. It is recommended to take multiple measures to strengthen health education, behavioral intervention and regular monitoring.

Hypothyroxinemia is a common subclinical thyroid dysfunction in pregnant women. Epidemiological studies have shown that the offspring of maternal hypothyroxinemia have a significantly increased risk of autism, but mechanisms remain unclear. Studies from clinical and animals suggest that thyroid hormone deficiency may lead to irreversible damage to brain development, which may contribute to autism. This review explores the clinical evidence of gestational hypothyroxinemia and autism in offspring and the underlying mechanisms that promote the development and progression of autism. It also emphasizes the importance of early diagnosis and treatment of thyroid disease in pregnancy for the prevention of neurodevelopmental abnormalities in offspring.

Objective To explore the role and mechanism of HMGB1 in the fatty acid metabolism reprogramming and mitochondrial fusion/fission of hypoxic and nutrient-poor pancreatic cancer cells. Methods The correlation between the expression level of HMGB1 in pancreatic cancer tissue and the survival rate of pancreatic cancer patients were analyzed by GEPIA database. CCK-8 assay was used to measure cell proliferation rate, and scratch test and Transwell chamber method were carried out to detect the effects of endogenous HMGB1 on the invasion and migration abilities of human pancreatic cancer cell line Patu8988 after hypoxic and nutrient-poor treatment. Laser confocal microscope was used to observe the changes of mitochondrial morphology of Patu8988 cells. Western blot was used to detect the expression levels of mitochondrial fusion/fission and de novo fatty acid synthesis-related proteins. Results GEPIA database analysis results showed that HMGB1 was highly expressed in pancreatic cancer tissues (P < 0.01), and the expression level was negatively correlated with the survival time of pancreatic cancer patients (P=0.00097). Knockdown of HMGB1 expression could inhibit the proliferation, invasion and migration abilities of Patu8988 cells under hypoxic and nutrient-poor conditions. However, mitochondrial fission in patu8988 cells was increased. Knockdown of HMGB1 in Patu8988 cells increased the expression of fission-related protein FIS1 while decreased the expression of p-DRP1(Ser637) and fusion-related protein MFN1 and MFN2 in hypoxic and nutrient-poor environment; ACLY, p-ACLY and FASN protein expression levels were down-regulated. Conclusion Endogenous HMGB1 can promote the fusion and inhibit the fission of mitochondria in hypoxic and nutrient-poor Patu8988 cells, maintain mitochondrial morphology and function, and thereby up-regulate ACLY protein expression and phosphorylation level, promote FA synthesis, and maintain the proliferation, invasion and migration abilities of pancreatic cancer cells.

Objective:To analyze the epidemiological characteristics of Chlamydia pneumoniae infection among patients with acute respiratory infection in Beijing from 2015 to 2019. Methods:The epidemiological data of acute respiratory infection patients from 35 sentinel hospitals in Beijing were collected by the respiratory pathogen surveillance system in Beijing. The clinical samples were collected to detect Chlamydia pneumoniae, and the sequence of the VD4 region of the ompA gene in positive samples was analyzed. Results:From January 2015 to December 2019, the overall positive rate of Chlamydia pneumoniae among patients with acute respiratory infection in Beijing was 0.34% (129/37 460). The positive rate of Chlamydia pneumoniae generally increased in March, reaching the peak in May, and started to drop in July, with a duration of about 5-8 months. The epidemic season in different years fluctuated by 1-2 months. The positive monthly rate of Chlamydia pneumoniae was no less than 0.30% in every epidemic season. The positive rate of Chlamydia pneumoniae was the highest in the 5-44 years old group and the highest in 10-14 year-olds. The risk of Chlamydia pneumoniae infection increased with age in patients younger than 25 years old and decreased in those older one aged than 25 years of age. The positive rates in male and female patients were 0.33% (68/20 830) and 0.37% (61/16 528), respectively, and there was no significant difference between the two groups ( χ 2=0.486, P=0.486). The positive rate of Chlamydia pneumoniae in patients with common pneumonia was higher than that in patients with upper pneumonia and severe pneumonia ( χ 2=36.797, P<0.01). Other respiratory pathogens were also detected in the Chlamydia pneumoniae samples, and the top four pathogens appeared as Haemophilus influenzae (15 cases), Streptococcus pneumoniae (13 cases), Rhinovirus (8 cases), and Stenotrophomonas maltophilia (7 cases). 101 strains of 129 Chlamydia pneumoniae positive samples were identified as type A by sequencing. Conclusions:The annual epidemic pattern of Chlamydia pneumoniae in Beijing, is unimodal, and the epidemic season generally appears from March to July. The seasonal characteristics of Chlamydia pneumoniae in Beijing can be used for the differential diagnosis of Chlamydia pneumoniae from other respiratory pathogens. Chlamydia pneumoniae is most common in people aged 5-44 years, and the primary genotype is type A. People aged 10-44 years old suffer the highest incidence. If the nucleic acid positive rate of Chlamydia pneumoniae exceeds 0.30% for two consecutive months, the high prevalence period of Chlamydia pneumoniae can be preliminarily expected. Chlamydia pneumoniae infection has a higher probability of progressing to severe pneumonia from general pneumonia.

Objective:To aralyze the clinical characteristics of Chlamydia pneumoniae infection in Beijing.Methods:Based on Beijing Respiratory Pathogen Surveillance System, acute respiratory infection patients were recruited from 35 different types of sentinel hospitals in Beijing. Their epidemiological and clinical data were systematically collected and clinical specimens were also obtained. Nuclear acid testing was performed for 30 types of respiratory pathogens (including Chlamydia pneumoniae). The identified patients of Chlamydia pneumoniae infection were divided into two groups, the acute upper respiratory tract infection (AURI) group and pneumoniae group. The differences in clinical characteristics, laboratory examination and prognosis were compared by using independent sample t test, Mann-Whitney U test, χ 2 test or Fisher′s exact probability test. Results:A total of 119 patients of Chlamydia pneumoniae infection were included, including 12 patients in the AURI group and 107 patients in pneumoniae group. Chlamydia pneumoniae infection mainly occurred in people aged from 5 to 44 years, accounting for 81.5% (97/119). The three most common clinical symptoms were cough (92.4%, 110/119), fever (88.8%, 95/107), and sputum production (76.5%, 91/119). White blood cell counts increased in 39.3% (46/117) of patients. Neutrophile granulocyte proportion increased in 39.7% (46/116) of patients. Platelet count increased in 36.9% (41/111) of patients. An increase of the creatine kinase MB isoenzyme (CKMB) was observed in 12 pneumonia patients (24.5%, 12/49). Radiological examination showed that 90.6% (87/105) of patients in the pneumoniae group had pulmonary parenchymal changes; the lesion occurred most commonly in the lower right lung lobe (34.3%, 36/105) and the lower left lung lobe (27.6%, 29/105). Although 73.8% (79/107) of patients in the pneumoniae group were hospitalized, no case received intensive care unit or mechanical ventilation. As to outcomes, one patient developed respiratory failure and 6 patients suffered myocardial injury. No death was observed in this study. The median days of hospitalization and course of illness for pneumonia patients M( P25, P75) were 10.0 (7.0, 13.0) days and 18.0 (13.5, 22.0) days, respectively. Conclusion:Generally, Chlamydia pneumoniae infections in Beijing from 2015 to 2019 were mild, and the main clinical manifestations were cough, fever and sputum. However, most patients in the pneumoniae group caused by Chlamydia pneumoniae still required hospitalization but with a better outcome.

Objective:To aralyze the clinical characteristics of Chlamydia pneumoniae infection in Beijing.Methods:Based on Beijing Respiratory Pathogen Surveillance System, acute respiratory infection patients were recruited from 35 different types of sentinel hospitals in Beijing. Their epidemiological and clinical data were systematically collected and clinical specimens were also obtained. Nuclear acid testing was performed for 30 types of respiratory pathogens (including Chlamydia pneumoniae). The identified patients of Chlamydia pneumoniae infection were divided into two groups, the acute upper respiratory tract infection (AURI) group and pneumoniae group. The differences in clinical characteristics, laboratory examination and prognosis were compared by using independent sample t test, Mann-Whitney U test, χ 2 test or Fisher′s exact probability test. Results:A total of 119 patients of Chlamydia pneumoniae infection were included, including 12 patients in the AURI group and 107 patients in pneumoniae group. Chlamydia pneumoniae infection mainly occurred in people aged from 5 to 44 years, accounting for 81.5% (97/119). The three most common clinical symptoms were cough (92.4%, 110/119), fever (88.8%, 95/107), and sputum production (76.5%, 91/119). White blood cell counts increased in 39.3% (46/117) of patients. Neutrophile granulocyte proportion increased in 39.7% (46/116) of patients. Platelet count increased in 36.9% (41/111) of patients. An increase of the creatine kinase MB isoenzyme (CKMB) was observed in 12 pneumonia patients (24.5%, 12/49). Radiological examination showed that 90.6% (87/105) of patients in the pneumoniae group had pulmonary parenchymal changes; the lesion occurred most commonly in the lower right lung lobe (34.3%, 36/105) and the lower left lung lobe (27.6%, 29/105). Although 73.8% (79/107) of patients in the pneumoniae group were hospitalized, no case received intensive care unit or mechanical ventilation. As to outcomes, one patient developed respiratory failure and 6 patients suffered myocardial injury. No death was observed in this study. The median days of hospitalization and course of illness for pneumonia patients M( P25, P75) were 10.0 (7.0, 13.0) days and 18.0 (13.5, 22.0) days, respectively. Conclusion:Generally, Chlamydia pneumoniae infections in Beijing from 2015 to 2019 were mild, and the main clinical manifestations were cough, fever and sputum. However, most patients in the pneumoniae group caused by Chlamydia pneumoniae still required hospitalization but with a better outcome.

Objective:To study the prevalence and gene variation characteristics of human coronavirus (HCoV) in Beijing and provide molecular epidemiological basis for the prevention and control of HCoV infection.Methods:This study collected 287 samples and epidemiological data of HCoV positive cases collected by respiratory multi-pathogen surveillance in Beijing from 2016 to 2017, and analyzed the HCoV detection rate, population and seasonal characteristics. HCoV pol gene fragments were amplified by RT-PCR for HCoV typing and evolutionary analysis.Results:In this study, the detection rate of HCoV was 1.89%. The co-infection rate of respiratory virus in HCoV positive samples was 20.56% (59/287). 69 strains were identified as type OC43 with nucleotide homology of 97.2%~100% and amino acid homology of 92.2%~100%. Thirty-nine strains were identified as type 229E with nucleotide homology of 99.2%~100% and amino acid homology of 99.2%~100%. Ten strains were identified as type HKU1 and 2 strains were identified as type NL63.Conclusions:OC43 and 229E are still the main types of HCoV in Beijing from 2016 to 2017, and both present certain seasonal difference. The endemic strains of the same type have high homology of nucleotide and amino acid.

Objective To investigate the expression of guanylate binding protein 5 (GBP5) and ArfGAP with SH3 domain ankyrin repeat and PH domain 1 (ASAP1) genes in pulmonary tuberculosis patients and tuberculosis latent population. Methods Forty pulmonary tuberculosis patients (pulmonary tuberculosis group), 40 latent tuberculosis infection patients (latent tuberculosis infection group) and 40 cases of healthy control (healthy control group) were selected from August 2016 to May 2017. The gene expression was detected in 4 ml peripheral anticoagulant blood by real-time fluorescent quantitative reverse transcription-polymerase chain reaction (RT-PCR) and the relative expression of two genes in three groups were compared. Results The GBP5 gene expression in three groups was significantly differentce (F=7.23, P=0.001). The GBP5 gene relative expression in pulmonary tuberculosis group was significantly higher than that in latent infection group :1.58 ± 0.80 vs. 1.09 ± 0.68, there was significant difference (t=2.93, P=0.004). The GBP5 gene relative expression in pulmonary tuberculosis group was significantly higher than that in healthy control group: 1.58 ± 0.80 vs. 1.04 ± 0.61, there was significant difference (t=3.40, P=0.010). The GBP5 gene relative expression in latent infection group and healthy control group had no significant difference (t=0.39, P=0.700). There was no significant difference in ASAP1 expression among three groups (F=0.26, P=0.770). Conclusions The expression of GBP5 in pulmonary tuberculosis patients, latent tuberculosis infection patients and healthy controls is different, and GBP5 could screen latent tuberculosis infection patients which is expected to be a potential screening marker for latent tuberculosis infection.

Objective: To analyze the prevalence and drug resistance of mycoplasma pneumoniae in patients with community-acquired pneumonia during 2011-2015 in Beijing. Methods: Totally 2 272 mycoplasma pneumoniae samples were collected from patients with community-acquired pneumonia in 5 sentinel hospitals during 2011-2015. Mycoplasma pneumoniae were detected by real-time PCR. 142 copies of positive samples with Ct value under 30 were cultured to get the strains so that the genotypes based on the P1 gene sequence and the drug resistance based on the in vitro drug resistance test could be conducted. χ² test was used to compare the detection rates of mycoplasma pneumoniae among different age groups and different onset-phase. Results: The positive rate of mycoplasma pneumoniae was 13.6%(308 cases). The positive rate in groups aging (5-14), (15-24) and ≥60 years old were separately 24.4% (67/275), 24.4% (38/156) and 3.9% (28/727) (χ²=1.22, P<0.001). The annual detection rate of mycoplasma pneumoniae in 2011-2015 were 14.6% (73/501), 10.2% (36/353), 26.4% (101/383), 10.3% (41/398), 9.0% (57/637),respectively (χ²=72.65, P<0.001). Seasonally, the peak of positive rate was between October and December (17.5%, 122/699) and the lowest positive rate was between April and June (8.6%, 43/502). 36 strains were isolated from 142 swabs and 23 (63.9%) were P1-Ⅰ and 13 (36.1%) were P1-Ⅱ by genotyping. All isolates were susceptible to the fluoroquinolones (levofloxacin, ciprofloxacin, and gatifloxacin) and tetracycline. All P1-Ⅱ strains were susceptible to macrolides while most of the P1-Ⅰ strains (22 strains) were macrolide-resistant. Conclusion People aging (5-14) and (15-24) years old were more susceptible to mycoplasma pneumoniae in patients with community-acquired pneumonia in Beijing between 2011 and 2015. The highest positive rate of mycoplasma pneumoniae was in 2013 and the case distributed in all seasons. The major popular genotype was P1-Ⅰ, whose strains were mostly macrolide-resistant.