Objective To observe the ultrasonic manifestations and possible etiology of fetal tricuspid regurgitation(TR).Methods Totally 717 fetuses diagnosed with TR by prenatal ultrasound were retrospectively enrolled,and the prenatal ultrasonic findings were observed.Based on postpartum follow-up data,the fetuses were divided into physiological TR group(n=468)and pathological TR group(n=249),and those in the latter were further divided into right heart preload increase subgroup(n=76),right heart afterload increase subgroup(n=127)and tricuspid valve structure abnormality subgroup(n=46)according to the possible etiology,and the ultrasonic manifestations were comparatively analyzed.Results In physiological TR group,mild and moderate TR was found in 441(441/468,94.23％)and 27 fetuses(27/468,5.77％),respectively,while no severe TR was noticed.In pathological TR group,significant difference of TR degrees was found among 3 subgroups(x2=37.244,P＜0.001).Mild TR was more common in right heart preload increase subgroup,while moderate and severe TR were more common in the other 2 subgroups.In right heart preload increase subgroup,fetuses with persistent left superior vena cava were more likely to develop mild TR,while those with intact interventricular septum and pulmonary artery occlusion were more likely to develop severe TR in right heart afterload increase subgroup(both P＜0.05).No significant difference of TR degree was found among fetuses with different possible etiology in right heart preload increase subgroup nor right heart afterload increase subgroup(both P＞0.05).In tricuspid valve structure abnormality subgroup,significant differences of TR degrees were found among fetuses with different possible etiologies(P＜0.05),and fetuses with underdeveloped tricuspid valve were more prone to severe reflux(P＜0.05).There were significant differences of reflux velocity of moderate and severe TR among 3 subgroups(F=6.945,P=0.002).Conclusion Fetal TR was mostly physiological.The possible etiologies of pathological TR were variable,including pulmonary valve stenosis,persistent left superior vena cava and tricuspid valve hypoplasia,with different prenatal ultrasonic manifestations.

Objective:To evaluate the predictive value of neutrophil-to-lymphocyte ratio (NLR) for adult severe tetanus by comparing the NLR in patients with severe and mild tetanus.Methods:A total of 65 adult tetanus patients from the Linyi Central Hospital from January 2009 to December 2020 were enrolled. The patients were divided into two groups including mild group and severe group according to the Ablett classification. The general conditions, laboratory data, and NLR of patients in two group were retrospectively compared using independent samples t test. Multivariate logistic regression analysis was used for the analysis of risk factors for severe tetanus. Spearman correlation method was used for the analysis of the correlation between risk factors and Ablett grades. Receiver operator characteristic (ROC) curve was used for the evaluation of the predictive value. Results:Among the 65 tetanus cases, 34 was in mild group and 31 in severe group. The latency period of patients in severe group was (7.00±3.19) d, which was shorter than that in mild group ((9.18±2.59) d), and the difference was statistically significant ( t=3.03, P=0.004). The NLR of patients in severe group was 4.251±1.936, which was higher than that of mild group (2.533±1.026) , and the difference was statistically significant ( t=4.41, P<0.001). Multivariate logistic regression analysis showed that NLR and latency period were independent risk factors for tetanus severity (odds ratio ( OR)=2.359, 95% confidence interval ( CI) 1.415 to 3.934, P=0.001 and OR=0.748, 95% CI 0.599 to 0.936, P=0.011, respectively). In tetanus patients, the NLR level was positively correlated with Ablett grade ( r=0.644, P<0.001). The ROC curve showed that NLR had good predictive value for adult severe tetanus at a cut-off value of 2.471 (area under the curve (AUC)=0.787), with the sensitivity and specificity of 87.1% and 61.8%, respectively. When combining NLR with latency period (cut-off value of 7.5 d), predictive efficiency was further improved (AUC=0.832) with the sensitivity of 87.1% and specificity of 67.6%( Z=3.43, P<0.001). Conclusions:NLR has a good predictive value for adult severe tetanus, and the predictive efficiency is further improved when combined with latency period.

Objective:To analyze the epidemiological characteristics and tendency of hemorrhagic fever with renal syndrome (HFRS) in Xi'an, master its popular and development laws, and provide scientific basis for formulating targeted prevention and control measures.Methods:The retrospective method was used to collect HFRS epidemic data and demographic data from 2009 to 2018 in Xi'an. The descriptive epidemiological method was used to analyze the three distributions (time, region, population distributions) of HFRS.Results:There were 8 710 HFRS cases in Xi'an from 2009 to 2018, with an average annual incidence of 10.13/100 000 and an average annual mortality rate of 0.08/100 000; the incidence of HFRS had decreased year by year since the peak incidence in 2010 (19.46/100 000), and had rebounded in 2017 (9.14/100 000), 2018 (9.04/100 000). The time distribution of the onset of HFRS was bimonthly, with peak in autumn and winter (October to January of following year) each year, accounting for 74.08% (6 452/8 710) of the total number of cases; the peak in spring and summer (May to July) accounted for 14.33% (1 248/8 710). HFRS cases were mainly concentrated in Chang'an District (2 446 cases), Zhouzhi County (1 494 cases), Hu County (1 170 cases), and Lintong District (940 cases), accounting for 69.46% (6 050/8 710). The age of onset of HFRS cases was mainly concentrated in 15-59 years old, accounting for 74.06% (6 451/8 710); the incidence rate in males was 14.77/100 000, in females was 5.25/100 000, the difference was statistically significant between gender (χ 2=1 921.42, P < 0.05); the occupational distribution was mainly farmers, accounting for 68.38% (5 956/8 710). Conclusions:From 2009 to 2016, the HFRS epidemic situation in Xi'an has showed a downward trend, and the incidence of HFRS has rebounded in 2017-2018. Xi'an should continue to take active and effective comprehensive measures to intervene to further realize effective control of HFRS.

【Objective】 To explore the role of RYBP in activating PARP-1 dependent Parthanatos and promoting response to YM155 in esophageal squamous cell carcinoma. 【Methods】 CCK-8 and flow cytometry were used to analyze the inhibition ratio and cell death percentage after YM155 treatment in both RYBP overexpression group and control group. Western blotting was used to detect the expression of Parthanatos-related proteins. 【Results】 Compared with control group, RYBP overexpression group showed higher inhibition ratio and cell death percentage after YM155 treatment. Overexpression of RYBP activated PARP-1 with or without YM155 treatment. Besides, after YM155 treatment, KYSE170-RYBP showed more PAR accumulation in the nucleus, AIF translocation from mitochondria to the nucleus than control cells. 【Conclusion】 RYBP can activate PARP-1/PAR/AIF-dependent induced Parthanatos in esophageal squamous cell carcinoma and enhance response to YM155.

OBJECTIVE: To explore the expression of the RNA-binding protein tristetraprolin in lung adenocarcinoma cells and its molecular mechanism for inhibiting autophagy. METHODS: Quantitative real-time PCR and Western blotting were performed to detect the expression of autophagy-related genes (including Beclin1, LC3-Ⅱ/LC3-Ⅰ and SQSTM1/p62) in cultured lung adenocarcinoma cells at 24, 48 and 72 h after transient transfection with a tristetraprolin-overexpressing plasmid and the empty plasmid. The effects of transfection with the tristetraprolin-overexpressing plasmid and empty plasmids in the presence or absence of tumor necrosis factor- (TNF-) on the expressions of nuclear factor-κB (NF-κB) p65, c-rel, and p50 were examined in lung adenocarcinoma cells using immunofluorescence assay and Western blotting. The cells were also transfected with the IκBα-mut plasmid and the tristetraprolin-overexpressing plasmid, either alone or in combination, and the changes in the expressions of tristetraprolin and autophagy-related genes were detected using RT-qPCR and Western blotting. RESULTS: The expressions of tristetraprolin were significantly reduced at both the mRNA and protein levels in lung adenocarcinoma cells ( < 0.001). Overexpression of tristetraprolin in the cells significantly lowered the expressions of autophagy-related genes Beclin1 and the ratio of LC3-Ⅱ/LC3-Ⅰ at the mRNA and protein levels ( < 0.001), obviously lowered the expressions of NF-κB p65 and c-rel, and almost totally blocked the nuclear translocation of NF-κB p65 and c-rel ( < 0.05); the expression of p50, however, did not undergo significant changes in response to tristetraprolin overexpression ( > 0.05). The inhibitory effect of tristetraprolin overexpression on autophagy was abrogated by transfection of the cells with IκBα-mut plasmid, which blocked the NF-κB signaling pathway. Co-transfection of the cells with IκBα-mut also attenuated the inhibitory effect of tristetraprolin overexpression on Beclin1 and the LC3-Ⅱ/LC3-Ⅰ ratio at both the mRNA and protein levels ( < 0.05). CONCLUSIONS The expression of tristetraprolin is low in lung adenocarcinoma cells. Tristetraprolin overexpression causes inhibition of autophagy in lung adenocarcinoma cells possibly by blocking NF-κB p65 and c-rel nuclear translocation.
Autophagy ; Cell Line ; Humans ; Lung Neoplasms ; NF-kappa B ; Signal Transduction ; Tristetraprolin

Objective To analyze the clinical and MR features of intracranial nonspecific inflammatory granuloma and improve the accuracy of preoperative diagnosis.Methods The clinical and MR features of 9 intracranial nonspecific inflammatory granuloma cases proved by histopathology were analyzed retrospectively.Results Nine lesions were all located in the supratentorial cerebral hemisphere with large lesion range and obvious peripheral edema.On enhancement MR imaging,the lesions were obviously and irregularly enhanced.There were simple patchy enhancement in 3 cases,patchy enhancement with multiple micronodular enhancement in 4 cases,and multiple micronodular enhancement in 2 cases.None enhancement areas were noticed in all enhancement lesions.There were superficial meningeal enhancements in 4 cases.On MR plain scanning,the MR enhancement area of lesions showed similar signal to the grey matter on T1 WI and low signal similarly to the white matter on T2 WI.On MRS scan,the significant high signal of Cho was detected in 2 cases and their Cho/Cr ratio was over 4.The Cho/Cr ratio was lower than 1.3 in 5 cases.Conclusion There are some specific MR enhancement features in the intracranial nonspecific inflammatory granuloma including multiple small nodules or patchy enhancement,in which there were no enhancement areas,and some cases have meningeal enhancement.

Objective To summarize the long-term outcomes and safety of childhood Hodgkin lymphoma (HL) with protocol ABVD. Methods The clinical data of 20 children with HL admitted to the Union Hospital of Fujian Medical University from July 2010 to June 2017 were retrospectively analyzed. Among the 20 children with HL, 15 were male and 5 were female. The median age of initial diagnosis was 6.5 years old (3-12 years old). The pathological types were as follow: 1 case was nodular lymphocyte-predominant HL (NLPHL) and 19 cases were classical HL (cHL), including 9 cases of mixed cell type, 9 cases of nodular sclerosis type and 1 case of lymphocyte rich type. Basing on Ann Arbor staging system, 1 patient was evaluated as stage Ⅰ, 4 patients were stage Ⅱ, 10 patients were stage Ⅲ, and 5 patients were stage Ⅳ. There were 3 patients in the low-risk group, 7 patients in the intermediate-risk group, and 10 patients in the high-risk group. There were 9 patients with B symptoms. All patients were treated with the ABVD regimen. Results All the 20 patients completed all chemotherapy courses. After 2 courses, the effective rate was 100％(20/20), including 12 cases of complete remission (CR) and 8 cases of partial remission (PR). After the treatment, 19 cases achieved CR, and at the end of the 6 courses, the evaluation showed that 1 case had residual lesions. Follow-up to February 2018, clinical symptoms of 18 cases achieved CR, 2 cases relapsed (all high-risk group); the median follow-up time was 42 months (10.1-87.9 months), the overall survival rate was 100 ％ (20/20), the estimated 5-year rate of freedom from treatment failure (FFTF) was (89.1 ±7.3) ％.Conclusions According to the risk stratification, ABVD regimen has good safety and long-term efficacy for children with cHL. Even the patients in low-risk or intermediate-risk group do not achieve CR after 2 courses and do not receive radiotherapy, the prognosis of them is still good.

Objective To understand HIV incidence in community residents and epidemiological characteristics of newly detected HIV infection cases in Dali,Yunnan province.Methods A cohort study was conducted among 146720 community residents who were tested to be HIV negative during 2010-2011,they were followed-up from June 1,2014 to May 31,2015.Results A total of 136356 community residents received follow up (92.9％).The follow-up time was 0.23-5.40 years (medium:3.43 years),cumulatively 459675 person years,and 78 people were found to be HIV positive.The incidence rate of HIV infection was 0.170/1000 person years.The incidence rate was 0.037/1000 person years in age group 15-29 years,0.288/1000 person years in age group 30-44 years,0.210/1000 person years in age group 45-59 years,0.204/1000 person years in age ≥60 years;0.213/1 000 person years in males,0.130/1000 person years in females;0.248/1000 person years inHan ethnic group,0.149/1000 person years in Minorities;0.194/1000 in people with education level ≤junior middle school,0.046/1000 person years in people with education level ＞ junior middle school;0.070/1000 person years in the unmarried,0.194/1000 person years in the married and 0.425/1000person years in the divorced/widowed.Cox proportional hazards regression analysis showed that being male (HR=l.731),aged 30-44 years (HR=13.158),aged 45-59 years (HR=10.329),aged ≥60years (HR=8.291),unmarried (HR=3.162) and divorced/widowed (HR=2.689) were the risk factors for HIV infection,while the education level ＞ junior middle school (HR=0.132) was the protective factor for HIV infection.Conclusions By medium 3.43 years follow up,the cohort study showed that incidence rate HIV infection was 0.170/1000 person years in the community residents in Dali.Male,middle aged and old people,people with low education level,the unmarried and the divorced/widowed had relatively higher risk to be infected with HIV,Close attention should be paid to the prevention and control of AIDS in these populations.

Objective To explore the levels of autoimmune antibodies and endocrine hormones in patients with endometriosis complicated with infertiilty.Methods 158 endometriosis and infertility patients were selected as study subjects,and they were divided into endometriosis complicated with infertility group(A group,52 cases),endometriosis group(B group,50 cases) and infertility group(C group,56 cases) according to the type of disease.At the same time,93 healthy women were selected as control group.The autoimmune antibodies such as anti-endometrial antibody(EMAb),anti-chorionic gonadotropin antibody(HCGAb),anti-sperm antibody(ASAb),anti-cardiolipin antibody(ACAb) and anti-ovarian antibody(AOAb),endocrine hormones such as luteinizing hormone(LH),follicle stimulating hormone(FSH),prolactin(PRL),estradiol(E2),insulin(INS) and testosterone(T) were compared in four groups.Results There was no significant difference in the total antibody positive rate between B group and C group (χ2=2.161,P＞0.05).The total antibody positive rate of A group was significantly higher than that of B,C group and the control group,the difference was statistically significant(χ2=6.316,P＜0.05).The PRL and INS levels of A group were much higher than those of B,C group and the control group,the differences were statistically significant(F=15.625,10.431,all P＜0.05).The E2,INS and PRL levels of B group were much higher than those of C group and the control group(F=10.363,9.515,9.037,all P＜0.05).The E2,T,INS and PRL levels of A group were much higher than those of B and C group,the differences were statistically significant (F=5.029,6.225,6.631,7.106,all P＜0.05).The LH and FSH levels of the four groups had no significant differences(F=2.385,2.531,all P＞0.05).There were no significant differences in all of the endocrine hormones between C group and the control group(t=1.535,0.931,0.825,1.363,1.005,1.259,all P＞0.05).Conclusion The main factors that cause endometriosis patients complicated with infertility may be due to a endometriosis immune imbalance of T,E2 and PRL and endocrine abnormalities,through the analysis of the levels of autoimmune antibodies and endocrine hormones can provide a reliable basis for clinical.

Objective To study the risk factors of hemorrhagic fever with renal syndrome (HFRS) in children and adolescents in Xi'an City.Methods HFRS laboratory confirmed cases aged under 16 from January 2013-December 2015 were selected,which were reported by Information System of Disease Prevention and Control of the People's Republic of China.A 1:1 matched case-control study was adopted to retrospective investigate the risk factors.Logistic regression analysis was used to analyze relationships between various factors and HFRS in single factor analysis,the influence factors in the single factor analysis with statistical significances were further analyzed in the multiple factors analysis.Results Eighty-eight matched pairs were investigated.Single factor Logistic regression analysis found that non-nuclear family [odds ratio (OR) =20.25,95％ confidence interval (CI):2.32-76.80],less hand washing frequency before meals (OR =3.67,95％CI:1.40-9.62),the river or pond around the place (OR =1.55,95％CI:1.32-2.94),sit on the hay and play (OR =1.36,95％CI:1.17-1.80),eating in the snack bar (OR =8.33,95％CI:1.78-9.47),do not spray water when sweeping the floor (OR =2.22,95％CI:1.24-4.12),living in the edge of village (OR =1.55,95％CI:1.32-2.94),and keeping pets in the home (OR =12.00,95％CI:1.12-28.84) were associated with HFRS.In multiple factors Logistic regression analysis,risk factors according to the contribution value from high to low in the order were keeping pets in the home (OR =5.40,95％CI:1.78-16.32),less hand washing frequency before meals (OR =3.96,95％CI:1.89-7.23),living in the edge of village (OR =2.42,95％CI:1.82-5.50),and the river or pond around the place (OR =2.21,95％CI:1.86-2.49).Conclusion Risk factors as keeping pets in the home,less hand washing frequency before meals,living in the edge of village,the river or pond around the place are likely risk factors of HFRS.