Objective To estimate the disease burden of silicosis in China from 1990 to 2021 and analyze its changing trend using the data from the Global Burden of Disease Study 2021 (GBD 2021), and to provide evidence for the prevention and control of silicosis. Methods Data on the incidence, prevalence, morbidity and death, mortality and disability-adjusted life year (DALY) of silicosis in China were extracted from the GBD 2021 to analyze the disease burden and age distribution of silicosis. The average annual percentage change (AAPC) was calculated to reflect the temporal trend of various disease burden indicators from 1990 to 2021. The results were then compared with those of the global population. Results In China, prevalent cases of silicosis increased by 116.62% from 79 075 in 1990 to 171 291 in 2021; incident cases of silicosis increased by 75.75% from 13 315 in 1990 to 23 401 in 2021; deaths of silicosis increased by 30.76% from 4 837 in 1990 to 6 326 in 2021; DALYs of silicosis increased by 14.84% from 150,729.65 person-years in 1990 to 173 091.06 person-years in 2021. The age-standardized rate of prevalence, incidence, mortality, DALY, YLL, and YLD of silicosis in China all showed a downward trend. The AAPC (95% CI) was -0.42% (-0.56% ~ -0.29%), -1.02% (-1.16 %~ -0.88%), -2.16% (-2.49% ~ -1.83%), -2.24% (-2.63% ~ -1.84%), -2.45% (-2.76% ~ -2.14%), and -0.42% (-0.54% ~ -0.29%), respectively. From 1990 to 2021, the age-standardized indicators of silicosis in China were all higher than the global level, and the differences were statistically significant (all P <0.05). The proportion of silicosis incident cases in the total incident cases of pneumoconiosis in China increased from 68.49% in 1990 to 78.58% in 2021. Conclusion The age-standardized indicators of silicosis in China showed a downward trend from 1990 to 2021, but the number of prevalent cases, incident cases, and DALYs showed an increasing trend. The age-standardized incident rate of silicosis in China remains at a high level, suggesting that further efforts should be made to prevent and control silicosis.

Dexmedetomidine displays multiple mechanisms of neuroprotection in ameliorating ischemic brain injury. In this study, we explored the beneficial effects of dexmedetomidine on blood-brain barrier (BBB) integrity and neuroinflammation in cerebral ischemia/reperfusion injury. Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) for 1.5 h and reperfusion for 24 h to establish a rat model of cerebral ischemia/reperfusion injury. Dexmedetomidine (9 µg/kg) was administered to rats 30 min after MCAO through intravenous injection, and SB203580 (a p38 MAPK inhibitor, 200 µg/kg) was injected intraperitoneally 30 min before MCAO. Brain damages were evaluated by 2,3,5-triphenyltetrazolium chloride staining, hematoxylin-eosin staining, Nissl staining, and brain water content assessment. BBB permeability was examined by Evans blue staining. Expression levels of claudin-5, zonula occludens-1, occludin, and matrix metalloproteinase-9 (MMP-9) as well as M1/M2 phenotypes-associated markers were assessed using immunofluorescence, RT-qPCR, Western blotting, and gelatin zymography. Enzyme-linked immunosorbent assay was used to examine inflammatory cytokine levels. We found that dexmedetomidine or SB203580 attenuated infarct volume, brain edema, BBB permeability, and neuroinflammation, and promoted M2 microglial polarization after cerebral ischemia/reperfusion injury. Increased MMP-9 activity by ischemia/reperfusion injury was inhibited by dexmedetomidine or SB203580. Dexmedetomidine inhibited the activation of the ERK, JNK, and p38 MAPK pathways. Moreover, activation of JNK or p38 MAPK reversed the protective effects of dexmedetomidine against ischemic brain injury. Overall, dexmedetomidine ameliorated brain injury by alleviating BBB permeability and promoting M2 polarization in experimental cerebral ischemia/reperfusion injury model by inhibiting the activation of JNK and p38 MAPK pathways.

Objective To analyze the characteristics of imported malaria epidemic from overseas in Wuhan, to explore the management mechanism of on-site cases, and to accumulate experience for the treatment of imported malaria in large cities after malaria elimination. Methods The epidemiological data on imported malaria from abroad during the period of malaria elimination (2010-2019) in Wuhan were collected. The gender, age and severe illness-related factors of the cases were analyzed. Based on the characteristics of the epidemic and the current situation of prevention and control, the content and experience of the “Municipal-District 24-7” case mechanism were discussed. Results The medical resources in Wuhan were the best in the central region, resulting in a large number of imported malaria cases, with a total of 474 cases reported from 2010 to 2019 (40.79% of the total number of cases in Hubei Province), including 359 cases of falciparum malaria, 36 severe cases and one death (the death rate was 0.28%). The patients were mainly young and middle-aged men aged 20 to 49 years old (97.26%). There were many referral cases (40.30%), and there was no seasonal clustering of cases reported. The undiagnosed proportion at the first visit was 44.85%, and the time of attack-diagnosis was 4 days or more in 61.00% of cases. The occurrence of severe cases was related to unconfirmed diagnosis at the first visit (χ²=35.46, P<0.001) and attack-diagnosis time (Z=-6.49, P<0.001). Conclusion Imported malaria occurs frequently in Wuhan, mainly falciparum malaria. However, “Municipal-District 24-7” case mechanism has effectively curbed the occurrence of severe and death cases and provided valuable experience for case management in similar cities in China.

Objective: To evaluate the feasibility and effectiveness of the application of internet-based HIV testing in men who have sex with men (MSM) in practical application and provide evidence for its application in the future. Methods: MSM who visited the internet-based intervention platform for at least one time from June to December 2020 were selected for the study. The information about platform visit, the number of self-test kits provided, the basic characteristics of the MSM and their satisfactory level were collected. And multivariable logistic regression analyses were conducted to identify the potential factors associated with the reporting of self-test results. Results: By the end of December 31^th, 2020, a total of 132 267 platform visits had been recorded, and 3 511 HIV self-test kits had been provided upon the MSM's requests, and 3 237 MSM (92.2%) reported self-test results. The HIV positive rate was 2.4% (69/2 855) and the confirmation rate of positive HIV test results was 86.7% (52/60). The MSM who asked for self-test kits online were mainly aged ≤30 years, had education level of college or above, and found their sexual partners through internet or dating software. Multivariable logistic regression analyses showed that repeat of online HIV self-test kits application (OR=3.50,95%CI:2.10-5.83), guarantee deposit of 50 yuan at application (OR=2.55,95%CI:1.33-4.89), monthly economic income 1-3 000 yuan (OR=1.54,95%CI:1.05-2.28) or no income (OR=1.71,95%CI:1.20-2.42) and online sexual partners finding (OR=1.49,95%CI:1.13-1.95) were associated with higher reporting rate of self-test results. The satisfactory rate the MSM to the service of platform was 99.5% (217/218). Conclusions: The study confirmed the feasibility and effectiveness of internet-based intervention for HIV tests in MSM, which could promote the self-test of HIV in MSM and facilitate the early detection of HIV infection through social media platforms and multi-channel promotion.
Male ; Humans ; Homosexuality, Male ; HIV Infections/prevention & control* ; Feasibility Studies ; Sexual and Gender Minorities ; HIV Testing ; Internet

Aged ; Antiviral Agents/therapeutic use* ; COVID-19/drug therapy* ; China/epidemiology* ; Cohort Studies ; Female ; Hospital Mortality ; Hospitalization ; Humans ; Male ; Middle Aged ; Patient Acuity ; SARS-CoV-2 ; Treatment Outcome

Objective To investigate the infection status of intestinal nematodes and their risk factors in rural residents of Jiangxia District, Wuhan City, so as to provide the reference for the establishment of targeted prevention and control measures. Methods According to the requirements of cross-sectional study of the national human key parasitic diseases, the residents in Shanpo Sub-district, Jiangxia District were randomly selected as the objects for the investigation of the infection status of Ascaris lumbricoides, hookworm and Trichuris trichiura. A questionnaire survey was performed simultaneously. Results Totally 236 residents received the stool tests, and only the hookworm eggs were found, with an infection rate of 7.63% (18 cases). The survey of intestinal parasitic infection status and their risk factors in 600 residents found 397 cases of suspected roundworm infection, 355 cases of suspected hookworm larvae dermatitis, 295 cases of suspected hookworm infection, and 145 cases of suspected whipworm infection, respectively. The Logistic regression analysis found that the risk factors of suspected roundworm infection included not always washing hands after toilet, using manure and fertilizer, and not often wearing shoes when doing farm work; the protective factors included knowing how roundworm infection was gained, and not using fresh dung for fertilization. The risk factors of suspected hookworm infection included using well water and pond water as the source of drinking water, eating food off the ground, using manure and fertilizers, and not washing when there was only one cutting board, and its protective factors included using tap water and well water as drinking water source, knowing how the roundworm infection was gained, and sometimes or not suing fresh feces for fertilization. The risk factors for suspected whipworm infection included eating food off the ground. Conclusions The intestinal parasite prevalence in the residents of the Shanpo Sub-district, Jiangxia District in Wuhan City is relatively high, and some risk factors associated with their infection indeed exist. Therefore, the regional government and health department should strengthen the health education to improve the residents’ knowledge about parasitic diseases and selfprotection awareness. At the same time, the residents should take physical examination regularly and take necessary deworming treatment to effectively control the prevalence and spread of intestinal parasitic diseases.

Objective To investigate the effect of high frequency (10 Hz),low frequency (1 Hz) and theta burst stimulation (TBS) mode of repetitive transcranial magnetic stimulation (rTMS) on the recovery of motor function in hemiplegic patients following acute ischemic stroke.Methods Seventy-two patients with hemiplegia after acute ischemic stroke were randomly grouped with the random number table.They were treated with low frequency (n=18),high frequency (n=18),and TBS (n=18) rTMS or sham stimulation (control group,n=18),once a day,for 2 weeks.Fugl-Meyer Assessment (FMA) and National Institutes of Health Stroke Scale (NIHSS) were used to evaluate neurological function in all patients before rTMS treatment (on the day before the first treatment) and after treatment (on the day after the last treatment).Results After treatment,the FMA and NIHSS scores in the 4 groups were significantly improved compared with before treatment (all P<0.05).After rTMS treatment,the FMA and NIHSS scores were improved significantly in the high frequency group,low frequency group and TBS group compare with the control group (all P<0.05).There were no significant differences among all the treatment groups.Conclusion sHigh frequency,low frequency and TBS rTMS can improve the recovery of motor function in hemiplegic patients following acute ischemic stroke.There were no significant differences among all the treatment modes.

OBJECTIVETo detect potential mutation in a Chinese family affected with autosomal-dominant synpolydactyly and to provide the basis for prenatal diagnosis.

METHODSInheritance pattern was determined by clinical examination and pedigree analysis. Blood samples were obtained from members of the family. Genomic DNA was extracted and sequenced following PCR amplification. Suspected mutation was confirmed by subclone sequencing and agarose gel electrophoresis.

RESULTSA 27 bp expansion mutation in exon 1 of HOXD13 was identified in all affected individuals from the family but not in unaffected members and normal controls. The mutation has caused insertion of 9 alanines in the polyalanine-expansion region of HOXD13 protein.

CONCLUSIONA polyalanine-expansion within the HOXD13 probably underlies the disease in this family.

Adult ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; DNA Mutational Analysis ; Exons ; Female ; Genes, Dominant ; Homeodomain Proteins ; genetics ; Humans ; Male ; Molecular Sequence Data ; Mutation ; Pedigree ; Syndactyly ; genetics ; Transcription Factors ; genetics

Objective To summarize diagnostic methods and surgical management experience of penetrating chest trauma . Methods The clinical data of 603 patients in our department during the past 10 years were analyzed retrospectively in respects of features of injury ,diagnostic methods ,surgical management and outcome ,etc .Results Location of the wounds :the wounds on the left anterior chest wall had 151 cases ,on the left posterior chest wall 134 cases ,on the right anterior chest 137 cases ,on the right posterior chest 108 cases ,on the bilateral chest 22 cases ,on the root of the neck 35 cases ,on the upper abdome 16 cases .In 453 ca‐ses examined by CT ,96 .03% of these cases were found to be abnormal .In 252 cases examined by X ray ,71 .03% of these cases were found to be abnormal .166 underwent thoracotomy ,26 underwent VATS(Video assisted Thoracoscopic Surgery ) .411 under‐went non operative management .583 were cured ,76 cases developed complications .20 were died .Conclusion Multi spiral CT is a rapidly and accurate diagnostic method to penetrating chest trauma .Incision of thoracotomy is employed according to the lethal damage and the most serious injury organ .

OBJECTIVETo study the clinical manifestations and identify causative mutations for a Chinese family affected with X-linked Charcot-Marie-Tooth disease.

METHODSClinical, electrophysiological and pathological features of the family were carefully analyzed by neurologists. Blood samples were obtained from the proband and other family members. Genomic DNA was extracted. Mutation analysis of GJB1 gene was analyzed with PCR and direct sequencing.

RESULTSThe family has fit with X-linked inheritance, and the affected individuals have typical clinical manifestations. A c.614A>G (p.Asn205Ser) mutation was detected in the GJB1 gene in all affected individuals in the family.

CONCLUSIONA c.614A>G (p.Asn205Ser) mutation of GJB1 gene is co-segregated with the disease phenotype in this family and probably underlies the disease.

Asian Continental Ancestry Group ; genetics ; Charcot-Marie-Tooth Disease ; genetics ; Child ; Connexins ; genetics ; Female ; Genes, X-Linked ; genetics ; Genetic Diseases, X-Linked ; genetics ; Humans ; Male ; Mutation ; Pedigree