Objective: To investigate the epidemiological characteristics of pulmonary tuberculosis (PTB) among the elderly at ages of 65 years and older in Yangzhou City, Jiangsu Province from 2017 to 2021, so as to provide the evidence for the development of PTB prevention and control measures in the elderly. Methods: Data of PTB cases at ages of 65 years and older in Yangzhou City from 2017 to 2021 were collected from the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System, including age, gender, current address, population classification and diagnosis classification. Descriptive epidemiological methods were used to analyze the temporal distribution, regional distribution, population distribution and delay in healthcare-seeking of PTB cases. Results: A total of 3 283 PTB patients at ages of 65 years and older were registered in Yangzhou City from 2017 to 2021, accounting for 41.12% of the total number of PTB cases. The incidence decreased from 112.10/105 to 66.03/105 (P<0.05), with an average annual incidence of 80.43/105. There were 1 236 cases of PTB cases from April to July, accounting for 37.65%. Guangling District had the highest annual incidence of 96.45/105, followed by Hanjiang District (89.29/105) and Jiangdu district (87.05/105). The average annual incidence of PTB in males was 134.07/105, which was higher than that in females (30.55/105, P<0.05). There were 1 070 cases of PTB cases at ages of 65-69 years, accounting for 32.59%. The highest incidence was seen in men at ages of 85 years and older (200.39/105) and in women at ages of 80-84 years (38.34/105). Farmers were the predominant occupation of PTB cases (2 488 cases, 75.78%). There were 2 365 cases of PTB with delay in healthcare-seeking, accounting for 72.04%. Conclusions The incidence of PTB in the elderly at ages of 65 years and older in Yangzhou City showed an overall downward trend from 2017 to 2021, peaked from April to July, and was higher in Guangling District, Hanjiang District and Jiangdu District. Males and farmers had higher risks of PTB.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

A total of 6 patients were treated with surface knee joint prosthesis combined with 3D-printed customized bionic tibial block for reconstruction of bone defect after giant cell tumor (GCT) in proximal tibia (1 male and 5 females, aged 50, 40, 68, 53, 35, 42, respectively). 3 patients with primary and 3 patients with recurrence of GCT. After resection of the tumor, the bone defect was filled with 3D-printed block combined with surface knee prosthesis, the surrounding ligaments were reconstructed with microporous structure and artificial mesh. All cases were followed up for 60, 90, 60, 60, 75, and 50 months, respectively. During the follow-up, there was no local recurrence, no radiolucent lines around prosthesis, and no signs of loosening. The clinical scores of the American Knee Society Score (KSS) were 87, 92, 85, 90, 95 and 78. The functional scores were 70, 100, 70, 100, 100 and 80 respectively. Musculoskeletal Tumor Society Score (MSTS) were 27, 28, 26, 26, 26, 27, respectively. Surface knee prosthesis combined with bionic block can effectively fill the bone defect after resection of GCT in proximal tibia, achieve anatomical and functional reconstruction of knee joint.

Objective:To explore the application effect of the "combination of virtuality and actuality" practical teaching on Medical Imaging Equipment. Methods:The 2018 medical imaging technology students of Qiqihar Medical University were taken as the observation group, and the study adopted teaching method of "combination of virtuality and reality" in the practical teaching of Medical Imaging Equipment, including in-kind visit teaching (8 learning hours), experimental box circuit measurement teaching (20 learning hours) and virtual simulation teaching (16 learning hours). Besides, the 2017 medical imaging major students (control group) did not conduct virtual simulation teaching. The teaching effect and student achievement were compared between the two groups, and SPSS 17.0 was used to conduct t test and chi-square test. Results:There was significantly improvement in the practical performance of the students in the observation group compared with the control group ( t=6.44, P=0.007); the teaching satisfaction of the two groups was significantly improved ( χ2=5.25, P=0.022), and the teaching satisfaction degree was 100%. Conclusion:The teaching method of "combination of virtuality and reality" can effectively improve students' hands-on ability, strengthens their cognition of abstract principles, and solves the problems of equipment failure analysis, disassembly and installation of large-scale equipment that cannot be completed in physical teaching.

Objective: Several COVID-19 patients have overlapping comorbidities. The independent role of each component contributing to the risk of COVID-19 is unknown, and how some non-cardiometabolic comorbidities affect the risk of COVID-19 remains unclear. Methods: A retrospective follow-up design was adopted. A total of 1,160 laboratory-confirmed patients were enrolled from nine provinces in China. Data on comorbidities were obtained from the patients' medical records. Multivariable logistic regression models were used to estimate the odds ratio ( Results: Overall, 158 (13.6%) patients were diagnosed with severe illness and 32 (2.7%) had unfavorable outcomes. Hypertension (2.87, 1.30-6.32), type 2 diabetes (T2DM) (3.57, 2.32-5.49), cardiovascular disease (CVD) (3.78, 1.81-7.89), fatty liver disease (7.53, 1.96-28.96), hyperlipidemia (2.15, 1.26-3.67), other lung diseases (6.00, 3.01-11.96), and electrolyte imbalance (10.40, 3.00-26.10) were independently linked to increased odds of being severely ill. T2DM (6.07, 2.89-12.75), CVD (8.47, 6.03-11.89), and electrolyte imbalance (19.44, 11.47-32.96) were also strong predictors of unfavorable outcomes. Women with comorbidities were more likely to have severe disease on admission (5.46, 3.25-9.19), while men with comorbidities were more likely to have unfavorable treatment outcomes (6.58, 1.46-29.64) within two weeks. Conclusion Besides hypertension, diabetes, and CVD, fatty liver disease, hyperlipidemia, other lung diseases, and electrolyte imbalance were independent risk factors for COVID-19 severity and poor treatment outcome. Women with comorbidities were more likely to have severe disease, while men with comorbidities were more likely to have unfavorable treatment outcomes.
Adult ; Aged ; COVID-19/virology* ; China/epidemiology* ; Comorbidity ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Treatment Outcome

Objective To investigate the effectiveness and safety of esophageal covered stent for the treatment of esophagogastric cervical anastomotic fistula. Methods Retrospective analysis of clinical and imaging data of patients with esophageal and gastric anastomotic neck fistula treated by esophageal membrane stent implantation in the Affiliated Tumor Hospital of Zhengzhou University from July 2015 to June 2018. Twenty‐one cases, 15 males and 6 females were enrolled. All patients showed fistula after esophagogastrostomy for esophageal carcinoma. All the fistulas were located in the cervical segment of esophagus and were diagnosed as anastomotic fistula 2 to 13 days after surgery. The length of esophagus residue, the position and size of the fistula were measured by esophagography. We retrospectively analyzed the data of patients with cervical anastomotic fistula treated with esophageal covered stent. Patients were followed up for more than 6 months by review and telephone follow‐up. Results In the 21 patients, 19 (90.5%) were successfully implanted stents at one time, and 2 (9.5%) were placed at a lower position. The esophageal stent was implanted for 10 to 60 days (31±19) days, and the stent was successfully removed after the fistula healed, with a procedure time of 6 to 23 minutes. No recurrence of fistula was found during follow‐up. Four patients had anastomotic scar stenosis, and eating smoothly after balloon dilatation. Conclusion Esophageal covered stent implantation is a safe and effective technique for gastroesophageal cervical anastomotic fistula.

Objective:To investigate the metal artifact reduction effect of orthopedic metal artifact reduction (O-MAR) techonology and its improvement effect on the image quality in CT examination in the patients with arthroplasty, and to elaborate the significance of the technology in clinical diagnosis and treatment of arthroplasty.Methods:The CT data of 20patients with hip or knee prostheses was collected.There were two tube voltages in each group of CT data:120and 140Kev.There were also two groups of CT data in each tube voltage group:nonO-MAR group and O-MAR group;there were four subgroups of CT data of each case:120 Kev/-O-MAR, 120Kev/+O-MAR, 140Kev/-O-MAR, 140Kev/+O-MAR.After data collection, Mimics software was applied to conduct three-dimensional (3D) reconstruction for purpose of the qualitative and quantitative analysis of CT data.Qualitative analysis mainly included the grade of severity of metal artifact and quality of data.Quantitative analysis included the volume of metal artifact, the average CT value and standard deviation (SD) in region of interest (ROI) .ROI 1and ROI 2were chosen at the location of beam hardening artifact (radial high-density metal artifact) and photon starvation artifact (band low-density metal artifact) , respectively.Results:According to the result of3D measurement, the volumes of artifact had no significant difference between 120 Kev/-O-MAR group and140Kev/-O-MAR group (P=0.062) , but there were siginificant differences in the volumes of artifact between other groups (P＜0.05) ;O-MAR technology decreased the volume of beam-hardening artifact obviously (P＜0.05) .According to the results of two-dimensional (2D) measurement, there was no significant difference in the average CT values in ROI 2between 120Kev/-O-MAR group and 140Kev/-O-MAR group (P=0.069) , but there were significant differences in the average CT values between other groups (P＜0.05) ;O-MAR technology decreased the high-density beam-hardening metal artifact and the low-density photon-starvation metal artifact in 2D measurement.Conclusion:O-MAR technology could significantly reduce the CT metal artifact of hip and knee prostheses and increase the clinical value of CT data.

OBJECTIVETo investigate the effects of metformin on the proliferation and apoptosis of human oral cancer cell line KB in vitro.

METHODSHuman oral cancer cell line KB was exposed to different doses of metformin (0, 1.25, 2.5, 5, 10, and 20 mmol/L), and the changes in cell viability were detected using MTT assay. Colony formation of the cells was observed following an 8-day metformin exposure. The changes in mitochondrial membrane potential were measured by JC-1 assay, and PI staining was used to observe the cell apoptosis. Western blotting was employed to detect the changes in the protein expressions of GRP78 and activated caspase-3.

RESULTSMetformin exposure caused time- and dose-dependent suppression of KB cell proliferation, and exposure to 5 mmol/L metformin for 24, 48 and 72 h resulted in cell survival rates of 68.0%, 36.9%, and 14.5%, respectively. Metformin significantly inhibited KB cell colony formation. Exposure of the cells to increased concentrations of metformin gradually increased the apoptotic rate and decreased mitochondrial membrane potential. Metformin caused an initial up-regulation followed by a down-regulation of GRP78 expression in KB cells and increased the expression of activated caspase-3.

CONCLUSIONMetformin can inhibit the proliferation and induce apoptosis of KB cells, the mechanism of which may involve the activation of the mitochondrial apoptotic pathway and endoplasmic reticulum stress.

Apoptosis ; drug effects ; Caspase 3 ; metabolism ; Cell Proliferation ; drug effects ; Heat-Shock Proteins ; metabolism ; Humans ; KB Cells ; Membrane Potential, Mitochondrial ; drug effects ; Metformin ; pharmacology

Objective To explore the effects of hydrogen sulfide (H2S) on apoptosis of cardiomyocytes after cardiopulmonary resuscitation (CPR) in rat models.Methods Forty-five male SD rats were randomly into sham group (n =15),CPR group (n =15) and NaHS group (n =15).Rats of CPR group and NaHS group were operated to induce cardiac arrest by transcutaneous electrical stimulation to epicardium.In NaHS group,NaHS (5 mg/kg) was administrated via the femoral venous line 1 min before CPR.Hemodynamic variables were monitored and obtained continuously.Survival rats were sacrificed at 24 h after restoration of spontaneous circulation and the hearts were removed for analysis by RT-PCR and TUNEL assays.Blood samples were collected and plasma content of cTnT was detected.Results Compared with the CPR group,animals treated with NaHS had improved left ventricular function (P ＜0.01),lower plasma cTnT levels (P ＜0.05) and decreased apoptosis index (P ＜ 0.01) 24 h after ROSC.The expressions of Caspase-3 mRNA,Bax mRNA and Bcl-2 mRNA in CPR group and NaHS group were higher compared with the control group (P ＜0.01).The NaHS group had lower expressions of Caspase-3 mRNA and Bax mRNA (P ＜0.01),but higher expression of Bcl-2 mRNA (P ＜0.05) compared with the CPR group.Conclusions Exogenous (H2S) regulated the expressions of Caspase-3,Bax and Bcl-2 mRNA,thereby preventing apoptosis of cardiomyocytes,inhibiting cTnT release and improving left ventricular function 24 h after CPR.

Objective To investigate the effects of exogenous hydrogen sulfide (H2S) on injury of rat hippocampus neurons induced by oxygen-glucose deprivation and restoration (OGD/R) and explore its mechanism.Methods Hippocampus neurons were isolated from embryonic day 16-18 (E16-18) rat embryos.Hippocampus was immediately removed and digested with 0.25％ trypsin.The neurons were isolated and cultured at 37 ℃ for 7 days and neuron-specific enolase (NSE) was detected by immunohistochemical staining method to identify neurons.At 8th day,the neurons were placed in deoxygenated glucose-free medium and exposed to 95％ N2-5％ CO2 in an air tight chamber for 1 hour,and then replaced the glucose-free medium with original medium,and returned the cultures to a standard incubator in 5％ CO2 at 37 ℃ and incubated for another 24 h.The neurons were divided into 3 groups:group Ⅰ control; group Ⅱ OGD/R,and group ⅢOGD + NaHS,the latter was further divided into 5 subgroups:groups Ⅲ1-5 with 25,50,100,200,400 μmol/L NaHS added,respectively.Then cell viability was quantified by MTT method,the level of lactate dehydrogenase (LDH) were detected,apoptosis was measured by Annexin V FITC/PI Apoptosis Kits,and RT-PCR was used to assay HIF-1 α mRNA in neurons in all groups.Results Compared with control group,the LDH level,apoptosis and expression of HIF-1α mRNA in group Ⅱ were significantly increased,the cell viability was significantly decreased (P ＜ 0.01).There were no significant differences in the LDH level,apoptosis and expression of HIF-1 α mRNA and the cell viability between group Ⅱ and group Ⅲ1 (P ＞ 0.05).Compared with group Ⅱ,the LDH level,apoptosis and expression of HIF-1α mRNA in group Ⅲ2-4 were significantly increased,the cell viability was significantly increased (P ＜ 0.01).Compared with group Ⅱ,the LDH level,apoptosis and expression of HIF-1 α mRNA in the group Ⅲ 5 were significantly decreased,the cell viability was significantly decreased (P ＜ 0.01).Conclusions H2S of low concentration has no significant effects on injury of rat hippocampus neurons induced by OGD/R.H2S of moderate doses can protect rat hippocampus neurons from OGD/R injury and H2S of high concentration can aggravate injury.The expression of HIF-1α mRNA in rat hippocampus neurons was increased after OGD/R,and the protective role of H2S is associated with increase in the expression of HIF-1α mRNA.