Objective: To analyze the latent tuberculosis infection and preventive treatment in the school tuberculosis epidemic, so as to provide theoretical and technical support for tuberculosis prevention and control in schools. Methods: Information on latent infection, preventive treatment and tuberculosis incidence were collected from five tuberculosis outbreaks in schools in Hunan Province from January to December 2023. Statistical analysis was conducted by using Chisquare test and Fishers exact test. Results: The prevalence of tuberculosis patients in close contacts (7.69%) and the latent infection rate of Mycobacterium tuberculosis (31.87%) were higher than those in nonclose contacts (0.12%, 6.29%), and the differences were statistically significant (P＜0.01). The subsequent incidence of close contacts with latent infection was higher (8.62%) than that of nonclose contacts (0), the rate of close contacts receiving prophylactic treatment (63.30%) was higher than that of nonclose contacts (47.37%), and the proportion of close contacts receiving prophylactic treatment (68.12%) was higher than that of nonclose contacts (45.56%), and the differences were statistically significant (P＜0.05). The latent infection rate of Mycobacterium tuberculosis in college students (13.58%) was higher than that in middle school students (7.08%) (χ2=37.77, P<0.01). The proportion of college students receiving preventive treatment (100.00%) was higher than that of middle school students (40.34%), and the subsequent incidence of latent infection (6.67%) was higher than that of middle school students (0.54%); the rate of middle school students who should receive preventive treatment (70.41%) was higher than that of college students (30.77%), and the rate of middle school students who received preventive treatment (100.00%) was higher than that of college students (62.50%), and the differences were statistically significant (P<0.01). Among the latent infected persons, 144 who completed preventive treatment did not get sick, and 10 of the 177 who did not complete preventive treatment got sick, with an incidence rate of 5.65%. The incidence rate of close contacts (19.23%) was higher than that of nonclose contacts (0) (P<0.01). There was no significant difference in the incidence of pulmonary tuberculosis between university (8.18%) and middle school (1.49%) among latent infected persons who did not complete preventive treatment (P=0.09). Conclusion Actively promoting preventive treatment for latent infections, especially among close contacts, and ensuring that all eligible individuals receive treatment can reduce tuberculosis incidence in schools and help control the scale of school tuberculosis outbreaks.

OBJECTIVE To investigate the potential mechanism of epigallocatechin gallate （EGCG） enhancing the sensitivity of hepatocellular carcinoma （HCC） cells to lenvatinib based on the phosphoinositide 3-kinase （PI3K）/protein kinase B （Akt） signaling pathway. METHODS Five human HCC cell lines （HepG2， Huh-7， SMMC-7721， SNU-368 and SNU-739） were used to evaluate the effects of lenvatinib alone and in combination with EGCG on survival rates， clone number， proliferation rate， invasion number and the expressions of mRNAs and proteins related to the PI3K/Akt signaling pathway. The PI3K activator insulin-like growth factor-1 （IGF-1） was introduced to investigate the effect of activating the PI3K/Akt signaling pathway on the sensitization effect of EGCG. RESULTS Compared with the control group， lenvatinib （10 μmol/L） and different concentrations of EGCG+ lenvatinib （1， 5 and 10 μg/mL EGCG+10 μmol/L lenvatinib） significantly reduced the survival rates and clone numbers of all five HCC cell lines in a dose-dependent manner （P＜0.05）. Lenvatinib （10 μmol/L） and EGCG+lenvatinib （10 μg/mL EGCG+10 μmol/L lenvatinib） also markedly inhibited the proliferation rate and invasion numbers of these cells， and decreased the mRNA expressions of PI3K， Akt， mammalian target of rapamycin （mTOR）， P70S6K and 4EBP， and the phosphorylation levels of PI3K and Akt， as well as the protein expressions of mTOR and B cell lymphoma-2 （Bcl-2） in HepG2 cells or all five HCC cells； conversely， the mRNA and protein expressions of phosphatase and tensin homologue deleted on chromosome 10（PTEN）， and the protein expressions of caspase-3 and cleaved caspase-3 were significantly upregulated， with more pronounced effects observed in the EGCG+lenvatinib group than in the lenvatinib group （P＜0.05）. Compared with the lenvatinib group and the EGCG+lenvatinib group， the clone number， proliferation rate and invasion number of HepG2 cells in the EGCG+lenvatinib+IGF-1 group （10 μg/mL EGCG+10 μmol/L lenvatinib+50 ng/mL IGF-1） were significantly increased （P＜0.05）. CONCLUSIONS EGCG can enhance the sensitivity of HCC cells to lenvatinib， and its underlying mechanism may be related to the inhibition of the activation of PI3K/Akt signaling pathway activation.

Detailed characterizations of genomic alterations have not identified subtype-specific vulnerabilities in adult gliomas. Mapping gliomas into developmental programs may uncover new vulnerabilities that are not strictly related to genomic alterations. After identifying conserved gene modules co-expressed with EGFR or PDGFRA (EM or PM), we recently proposed an EM/PM classification scheme for adult gliomas in a histological subtype- and grade-independent manner. By using cohorts of bulk samples, paired primary and recurrent samples, multi-region samples from the same glioma, single-cell RNA-seq samples, and clinical samples, we here demonstrate the temporal and spatial stability of the EM and PM subtypes. The EM and PM subtypes, which progress in a subtype-specific mode, are robustly maintained in paired longitudinal samples. Elevated activities of cell proliferation, genomic instability and microenvironment, rather than subtype switching, mark recurrent gliomas. Within individual gliomas, the EM/PM subtype was preserved across regions and single cells. Malignant cells in the EM and PM gliomas were correlated to neural stem cell and oligodendrocyte progenitor cell compartment, respectively. Thus, while genetic makeup may change during progression and/or within different tumor areas, adult gliomas evolve within a neurodevelopmental framework of the EM and PM molecular subtypes. The dysregulated developmental pathways embedded in these molecular subtypes may contain subtype-specific vulnerabilities.
Humans ; Brain Neoplasms/pathology* ; Neoplasm Recurrence, Local/metabolism* ; Glioma/pathology* ; Neural Stem Cells/pathology* ; Oligodendrocyte Precursor Cells/pathology* ; Tumor Microenvironment

Objective: To understand tuberculosis screening for newly enrolled students in Hunan Province and to provide reference for scholl based tuberculosis (TB) prevention and control. Methods: During 2018 to 2020, TB screening was carried out for newly enrolled students in Hunan Province, and the screening results were statistically analyzed by descriptive analysis and χ 2 test. Results: In 2018-2020, the average incidence rate of TB among students in Hunan Province was 20.90/100 000, with a decreasing trend by year ( χ 2 trend =89.45, P <0.01), the screening rate of TB in schools was 87.30%, and the screening rate for newly enrolled students was 86.81%, with downward trend by year ( χ 2 trend =2 843.34, 83 443.77, P <0.01). The proportion of suspicious symptoms, close contact, and active pulmonary TB patients among students were 0.53%, 0.21%, and 1.73/10 000, respectively, with decreasing trends by year( χ 2 trend =8 624.05, 2 215.48, 99.14, P <0.01). The proportion of strong positive PPD/ IGRA positive, changes in imaging examination and culturepositive of mycobacterium tuberculosis were 1.52%,0.20% and 12.40%, with increasing trends by year ( χ 2 trend =529.18, 147.65, 25.89, P <0.01). There were statistically significant differences in the proportion of suspicious symptoms, close contact, strong positive PPD/positive IGRA, changes in imaging examination and the proportion of patients with tuberculosis in the regional classification and school classification ( χ 2=529.18, 8 823.13, 705.63, 2 068.03, 1 299.00, 4 318.73 , 33.12, 2 329.07, 35.80, 1 781.65, P <0.01). There was no statistically significant difference in the proportion of culture positive of mycobacterium tuberculosis in the regional classification and school classification ( P >0.05). Conclusion The screening rate of newly enrolled student showed an upward trend, and the incidence rate of tuberculosis among students showed downward trend. Newly enrolled students among fresh students in high school have the highest PPD positive/IGRA positive rate and the proportion of pulmonary tuberculosis in the student population. It is necessary to increase the screening among fresh students in high school. In areas with conditions, tuberculosis screening of senior two students can be considered.

Objective:To analyze the application value of sakubatril valsartan in the treatment of chronic heart failure (CHF) based on cardiopulmonary test system.Methods:One hundred and thirty-five CHF patients admitted to the Affiliated Hospital of Jining Medical Collegefrom January 2019 to August 2020 were divided into the observation group (67 cases) and the control group (68cases) by random number table method. Both groups were treated with bisoprolol. The observation group was treated with the combination of sakubatril valsartan, and the control group was treated with the combination of benapril. The efficacy and cardiac function indicators of the two groups were compared. The cardiopulmonary exercise test system was used to measure the patient′s maximum exercise time (Tmax), maximum exercise Watt (Wmax), peak volume oxygen (Peak VO 2) and volume of anaerobic threshold oxygen (VO 2AT), and the incidence of adverse reactions were calculated. Results:The total effective rate in the observation group was higher than that in the control group: 92.54% (62/67) vs. 77.94%(53/68), the difference was statistically significant ( χ2 = 5.70, P<0.05). After the treatment, the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and soluble ST2 (sST2) in the observation group were lower than those in the control group: (2 000.47 ± 517.85) ng/L vs. (2 777.39 ± 812.49) ng/L, (0.33 ± 0.10) μg/L vs. (0.37 ± 0.09) μg/L, and the left ventricular ejection fraction (LVEF) was higher than that in the control group: (8.12 ± 6.44)% vs. (41.93 ± 6.73)%, the differences were statistically significant ( P<0.05). After the treatment, the left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVEDs), left ventricular mass index (LVMI), left atrial volume index (LAVI) in the observation group were lower than those in the control group: (55.47 ± 6.93) mm vs. (62.00 ± 7.18) mm, (37.14 ± 6.36) mm vs. (41.35 ± 6.43) mm, (136.76 ± 7.13) mg/m 2 vs. (140.98 ± 7.47) mg/m 2, (28.23 ± 2.59) ml/m 2 vs. (31.98 ± 2.17) ml/m 2; the Tmax, Wmax, PeakVO 2 and VO 2AT in the observation group were higher than those in the control group: (619.08 ± 65.36) s vs. (58.70 ± 52.44) s, (142.96 ± 16.05) W vs. (124.19 ± 13.38) W, (20.00 ± 5.74) ml/(min·kg) vs. (18.13 ± 3.58) ml/(min·kg), (13.89 ± 3.69) ml/(min·kg) vs. (11.23 ± 2.36) ml/(min·kg), the differences were statistically significant ( P<0.05). However, there was no statistically significant in the incidence of adverse reactions between the two groups ( P>0.05). Conclusions:Sakubatril valsartan in the treatment of CHF can not only optimize the efficacy and improve cardiac function, but also benefit cardiac exercise rehabilitation of patients, and not increase the safety risk.

Objective:To compare the efficacy of sakubatril valsartan and valsartan in the treatment of patients with chronic cardiac insufficiency and the influence on zinc finger protein A20 and nuclear factor-κB (NF-κB) in peripheral bloodmononuclear cells (PBMCs).Methods:Ninety-senven patients with chronic cardiac insufficiency admitted to the Affiliated Hospital of Jining Medical College from February 2019 to January 2020 were continuously selected and randomly divided into the control group (48 cases) and the observation group (49 cases). Both groups received routine anti-heart failure according to the guidelines. The control group added with valsartan and the observation group added with sakubatril valsartan treatment. Before the treatment and after 3 months of treatment, the changes of cardiac function indexes and the changes of inflammatory markers such as hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), matrix metalloproteinase 9 (MMP-9), and N-terminal pro B-type natriuretic peptide (NT-proBNP) were compared. PBMCs was extracted to detect zinc finger protein A20 and NF-κB levels. The incidence of adverse reactions in the two groups was recorded, and the relationship between zinc finger proteins A20, NF-κB and the myocardial injury marker NT-proBNP were analyzed.Results:After 3 months of treatment, the changes of cardiac function indexes in the observation group were better than those in the control group and the levels of hs-CRP, TNF-α, MMP-9, NT-proBNP in the observation group were lower than those in the control group: (1.96 ± 0.57) mg/L vs. (2.87 ± 0.79) mg/L, (7.11 ± 1.46) μg/L vs. (8.24 ± 1.57) μg/L, (110.14 ± 10.63) μg/L vs. (129.52 ± 17.96) μg/L, (716.91 ± 105.78) ng/L vs. (965.25 ± 97.41) ng/L, there were statistical differences ( P<0.05). After 3 months of treatment, the levels of finger protein A20, NF-κB in the observation group were lower than those in the control group: (3.57 ± 1.13) % vs. (4.41 ± 1.32) %, (29.87 ± 6.58) ng/L vs. (35.71 ± 10.02) ng/L, there were statistical differences ( P<0.05). Finger protein A20 and NF-κB in patients with chronic cardiac insufficiency were positively correlated with NT-proBNP ( r = 0.487, 0.738, P<0.01). Conclusions:On the basis of conventional treatment, compared with valsartan, the addition of sakubatril valsartan, can improve the cardiac function of patients with chronic cardiac insufficiency, reduce the body′s inflammatory response, reduce the expression of myocardial injury marker NT-proBNP, inhibit the activation of PBMCs NF-κB, and reduce the level offinger protein A20.

Objective To investigate the prevalence of tuberculosis (TB) in human immunodeficiency virus (HIV) positive population and explore its influencing factors.Methods Cluster sampling was used,continuous 205 cases who were diagnosed as HIV positive from December 16,2002 to June 30,2012 in Zhuhui district and Yanfeng district of Hunan province and could be followed up and traced were enrolled in the study.All patients were screened after informed content through questionnaire,sputum smear examination,chest X-ray examination,liquid culture (BACTECTM MGITTM 960 operating system),mycobacterium species identification (for liquid culture positive) and CD4 testing.Univariate and multivariate analyses were conducted to identify the impacts of different sex,age,and TB suspect syndromes,etc.Results Of 205 cases,19 were diagnosed as tuberculosis.The rate of TB/HIV was 9.3％.Univariate analysis showed that age,annual household net income,being acquired immunodeficiency syndrome (AIDS) patients and with TB suspect syndromes had significant impacts on tuberculosis combining (P ＜ 0.05).While multivariate analysis showed that age (OR =1.443) and TB suspect syndromes (OR =3.124) were risk factors influencing TB combining in people living with HIV (PLHIVs).Conclusions TB prevalence in HIV positive population was higher in Zhuhui district and Yanfeng,those aged and with TB suspect syndromes cases had higher risk to develop tuberculosis.TB screening should be reinforced in HIV positive population.

OBJECTIVE:To establish the quality standard for Gastrodia elata hency-fired tablet. METHODS:TLC was used to identify the gastrodin and benzyl alcohol and determine the content of moisture,ash and extract;HPLC was used to determine the content of gastrodin and benzyl alcohol. Column was Diamonsil C18 with mobile phase of acetonitrile-0.05% phosphate(3:97,V/V) at flow rate of 1.0 ml/min,detection wavelength was 220 nm,column temperature was 25 ℃ and volume injection was 10 μl. RE-SULTS:The TLC of gastrodin and benzyl alcohol showed clear spots and good separation. The moisture content<35.0%,total ash contents<2.0% and extract content>40.0%. Linear range of gastrodin was 25.2-126.0,12.7-63.5 μg/ml(r=0.999 9),respectively;RSDs of precision,reproducibility and stability tests were lower than 2.0%;recovery was 99.49%-102.40%(RSD=1.09%,n=6), 98.75-102.63%(RSD=1.53,n=6),respectively. CONCLUSIONS:The method is simple and good reproducibility,and can be used for the quality control of Gastrodia elata hency-fired tablet.

OBJECTIVETo detect JAK2 V617F mutation burden and its clinical implications in patients with myeloproliferative neoplasm (MPN).

METHODSJAK2 V617F mutation burden were detected by using MGB Taqman probes and its clinical significance were retrospectively studied in 415 MPN patients.

RESULTSJAK2 V617F was found in 56.9% of all patients [83.5% in polycythemia vera (PV), 55.9% in essential thrombocythemia (ET), 41.9% in primary myelofibrosis (PMF) and 64.7% in MPN-unclassifiable)]. The majority of patients carried heterozygous JAK2 V617F mutation and homozygote was found only in 12 cases (4 in PV, 4 in MPN-U, 2 in PMF, 1 in ET, and 1 in chronic neutrophilic leukemia). Most patients (68.8%) were lower mutation burden (mutation burden<50%), but PV had the highest burden, the moderate burden in PMF and the least in ET. The patient's age and WBC count were significantly correlated with higher mutation burden in PV. WBC count was significantly related to higher mutation burden in ET. WBC count, Hb level and the platelet count were significantly related to higher mutation burden in PMF.

CONCLUSIONThe mutation burden of JAK2 V617F from high to low was PV, ET and PMF. The majority of JAK2 V617F mutation was heterozygous. JAK2 V617F mutation burden was positively correlated with age, WBC, Hb and platelet counts.

Homozygote ; Humans ; Janus Kinase 2 ; Leukocyte Count ; Mutation ; Myeloproliferative Disorders ; Platelet Count ; Polycythemia Vera ; Retrospective Studies ; Thrombocythemia, Essential

OBJECTIVE:To provide reference for the establishment of quality standard for Fresh Gastrodia elata lyophilized powder. METHODS:TLC was conducted for the qualitative identification of G. elata in preparation,and HPLC was conducted for the content determination of gastrodin in preparation. The column was Diamonsil C18 with mobile phase of acetonitrile-0.05% phos-phoric acid(3∶97,V/V)at a flow rate of 1.0 ml/min,detection wavelength was 220 nm,column temperature was 25 ℃ and vol-ume injection was 10 μl. RESULTS:TLC pots of Fresh G. elata lyophilized powder were clear and well-separated. The linear of gastrodin was 2.9-14.5 μg/ml(r=0.999 9);RSDs of precision,stability and reproducibility tests were no more than 1.00%;recov-ery was 98.07%-102.70%(RSD=1.74%,n=6). CONCLUSIONS:The method is simple,accurate and reproducible,and suitable for the quality control of Fresh G. elata lyophilized powder.