ObjectiveTo understand the seropositivity of neutralizing antibodies (NAb) and low-level NAb against SARS-CoV-2 infection in the community residents, and to explore the impact of COVID-19 vaccination and SARS-CoV-2 infection on the levels of NAb in human serum. MethodsOn the ground of surveillance cohort for acute infectious diseases in community populations in Shanghai, a proportional stratified sampling method was used to enroll the subjects at a 20% proportion for each age group (0‒14, 15‒24, 25‒59, and ≥60 years old). Blood samples collection and serum SARS-CoV-2 NAb concentration testing were conducted from March to April 2023. Low-level NAb were defined as below the 25^th percentile of NAb. ResultsA total of 2 230 participants were included, the positive rate of NAb was 97.58%, and the proportion of low-level NAb was 25.02% (558/2 230). Multivariate logistic regression analysis indicated that age, infection history and vaccination status were correlated with low-level NAb (all P<0.05). Individuals aged 60 years and above had the highest risk of low-level NAb. There was a statistically significant interaction between booster vaccination and one single infection (aOR=0.38, 95%CI: 0.19‒0.77). Compared to individuals without vaccination, among individuals infected with SARS-CoV-2 once, both primary immunization (aOR=0.23, 95%CI: 0.16‒0.35) and booster immunization (aOR=0.12, 95%CI: 0.08‒0.17) significantly reduced the risk of low-level NAb; among individuals without infections, only booster immunization (aOR=0.28, 95%CI: 0.14‒0.52) showed a negative correlation with the risk of low-level NAb. ConclusionsThe population aged 60 and above had the highest risk of low-level NAb. Regardless of infection history, a booster immunization could reduce the risk of low-level NAb. It is recommended that eligible individuals , especially the elderly, should get vaccinated in a timely manner to exert the protective role of NAb.

There are two controversies about palliative care. One is whether the scope of palliative care should be expanded, and the other is whether the timing of palliative care intervention should be advanced. Regarding the research progress of palliative care, there are currently two consensuses: the target population of palliative care should be expanded to all patients of all ages who suffer from serious illness and serious health-related suffering, palliative care interventions should be integrated into the whole treatment process of serious illness early. However, the expansion of the scope of palliative care targets and the advancement of the timing of intervention have brought new challenges, and there is an urgent need to formulate a new strategic plan and implement it, so as to accelerate the exploration of the development of palliative care that suits China's national conditions. A new understanding of the target group of palliative care and the timing of intervention will help accelerate the development of palliative care in China. This article analyzes and discusses the history, research progress, definition updates, and existing evidence of palliative care, as well as the clinical needs, aiming to provide a reference for the practice of palliative care in China.

Objective To establish a mouse model treated with busulfan and to investigate its effects on the metabo-lism of spermatogonial stem cells(SSCs)of mouse testis.Methods C57BL/6J male mice with age of 8 weeks were injected with 10 mg/kg of busulfan intraperitoneally,then Thy1 positive cells were selected by immunomagnetic beads on day 0,day 5 and day 10 and followed by identification for purity and metabolomic analysis.Results The testis weight ratio decreased and the tissue structure of testis was damaged(P＜0.05).Based on the results of principal component analysis(PCA)and partial least squares discriminant analysis(PLS-DA),there were signifi-cant metabolic differences between the sample groups treated for 0 d,5 d and 10 d.A total of 89 differential metabolites were identified including glutathione(GSH),arginine and unsaturatedfatty acids(UFAs),and their important metabolic pathways involved glycerophospholipid metabolism,arginine and proline metabolism.Conclu-sions Affecting the specific metabolic pathway may result in obvious reproductive toxicity and lead to decrease of testicular weight as well as tissue structure damage in mice.Metabolomic analysis showed that the potential repro-ductive toxicity mechanism of SSCs may be related to the metabolic pathways such as lipid metabolism,arginine and proline metabolism.

International collaboration in education enables learning from advanced teaching experience and promotes the reform, optimization, and upgrading of medical education and teaching. We analyzed the difficulties and challenges in the education concept, curriculum system, and teaching language mode of infectious diseases under the condition of international cooperation in education in Chongqing Medical University. We tried to upgrade the teaching concepts, optimize the curriculum, and explore teaching language mode in the practice of teaching infectious diseases. We used the methods of deepening cooperation between departments, strengthening the communication between teachers and students, and emphasizing teacher training. We also adopted a variety of teaching methods and flexible teaching modes based on teaching content. With these methods, we explored teaching models of infectious diseases suitable in the context of international cooperation in education.

Objective:To summarize and analyze the clinical characteristics of hyperuricemia in adolescents, and improve the awareness of diagnosis and treatment among clinicians.Methods:Four adolescent cases of hyperuricemia with a clear family history were admitted to the Department of Endocrinology, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from November 2015 to August 2021. Their clinical manifestations, laboratory tests, gene sequencing, and therapeutic effects were analyzed.Results:Among the 4 patients, there were 2 cases with mutation in uromodulin(UMOD)gene(c.453C>T, 1 homozygous mutation in p. C151C; c. 453C>Y, 1 heterozygous mutation in p. C151C); 1 case with compound heterozygous mutation in adenosine triphosphate binding cassette transporter G2(ABCG2)gene(c.421C>A p. Q141K; c. 34G>A p. V12M); and 1 case with homozygous mutation in the ABCG2 gene(c.421C>A, p. Q141K). The blood uric acid levels of 4 patients decreased significantly after medical treatment and lifestyle interventions.Conclusions:In addition to primary etiology, the cause of hyperuricemia in the adolescent can be associated with certain acute and chronic diseases as well as genetic conditions. Genetic testing is recommended for patients with a family history. Medication safety should be stressed in the treatment of adolescents.

【Objective】 To investigate the clinical characteristics and treatment strategy of giant multilocular prostatic cystadenoma(GMPC). 【Methods】 The clinical data of a GMPC patient treated in our hospital in July 2021 were retrospectively analyzed. The patient was 73 years old. The clinical manifestations were urgent urination and frequent urination. The prostate specific antigen (PSA) increased slightly. MRI showed giant cystic solid space occupying lesion of the prostate. Domestic and foreign cases of prostate cystadenoma from 2000 to 2021 were retrieved for literature review. 【Results】 Transabdominal laparoscopic radical prostatectomy was performed successfully. The postoperative pathological diagnosis was GMPC. Two weeks after operation, the urinary catheter was removed, and there was no discomfort such as urinary frequency or urinary incontinence. After follow-up for more than 8 months, there was no tumor recurrence or metastasis. 【Conclusion】 There are still some disputes about the oncological characteristics and diagnosis and treatment of GMPC, and there is a lack of long-term follow-up results. Laparoscopic prostatectomy is safe and feasible. Most patients have a good prognosis after surgical treatment. It is necessary to formulate an individualized standard treatment plan based on surgery combined with different patients’ conditions to actively improve the prognosis.

Humans ; Benzodiazepines ; Hypnotics and Sedatives/therapeutic use* ; Intensive Care Units ; Midazolam

Environmental monitoring technologies competition can effectively improve the comprehensive quality and technical skills of technical personnel by means of professional theory exams and on-site practical assessment. In view of the undertaking work of the Second National Competition of Professional and Technical Personnel in Ecology and Environment Monitoring (special competition for radiation monitoring), this paper summarized the experience and gains in the aspects of preliminary preparation, field implementation, achievement generation, etc., analyzed the problems in national radiation environmental monitoring through the achievements of the special competition for radiation monitoring, and put forward recommendations for the next step, in order to provide reference for undertaking similar major events in the future and provide ideas and directions for national radiation environmental monitoring.

Objective:To explore the clinical characteristics, genotypes and long-term outcomes of individuals with 3-methylglutaconic aciduria.Methods:The clinical features, biochemical data, genetic test results and treatment outcomes of six children with 3-methylglutaconic aciduria admitted to the Department of Endocrinology, Genetics and Metabolism, Xinhua Hospital from February 2017 to February 2019 were retrospectively analyzed and the Gesell developmental diagnosis schedule was performed to evaluate the development of four patients.Results:Among 6 children with 3-methylglutaconic aciduria 2 were males and 4 were females.Four cases had 3-methylglutaconic aciduria type Ⅰ and 2 cases had 3-methylglutaconic aciduria with deafness,encephalopathy, and Leigh-like syndrome. Five of 6 patients were detected by newborn screening among whom 4 remained asymptomatic, and only one had a postmortem diagnosis. Among them, 4 patients remained asymptomatic, while two presented with clinical symptoms such as jaundice and dyspnea and the age of disease onset was 1 and 2 days respectively. The concentration of 3-methylglutaconic acid in urine of all affected individuals was between 22.38 and 77.09 mmol/molCr, which was above the normal value. Genetic tests were performed for all patients. Eleven variants were identified in 2 genes, of which 10 variants were novel and only c.442C>T p.(R148X) has been previously reported; Seven variants (c.656-2delA, EX5-EX6 Del, c.942+3A>G, c.373C>T p.(R125W), c.895-3C>G, c.667C>T p.(R223X) and c.894+5G>A) were in AUH gene. The others (c.548G>A p.(R138Q), c.442C>T p.(R148X), c.1339C>T p.(R447X) and c.973dupA p.(M325Nfs*5) were in SERAC1 gene. After being treated with leucine diet restriction and L-carnitine, 4 patients with AUH gene variation who were from asymptomatic phase developed normally, whereas those 2 patients with SERAC1 gene variation had a poor prognosis. During the follow-up, 2 patients exhibited varying degrees of psychomotor retardation, the rest had normal course of development.Conclusions:There are significant clinical heterogeneities among individuals with 3-methylglutaconic aciduria. The most common pathogenic variants are splicing variations, followed by nonsense, missense and frameshift mutations. Leucine-free diet and oral L-carnitine therapy are effective for some patients. Newborn screening is essential for early diagnosis and improvement of prognosis.

Objective:To investigate the impact of connexin 43(CX43) on the connection of S24 glioblastoma multiforme (S24-GBM) cellular network and to explore its role on radio-resistance.Methods:Specific lentiviral vectors were used to knockout CX43 in S24-GBM stem cells (S24-GBMSCs). Alternatively, carbenoxolone (CBX) was used to block transmission of CX43. Subsequently, the animal subjects grafted with S24-GBMSCs were monitored under a multiphoton laser scanning microscope (MPLSM). Dynamic changes of tumor microtubes (TMs) and transmission of Ca 2+ and SR101 in the cellular network were recorded. To study the radiosenstivity of S24-GBM before and after CX43 inhibition, MRI scanning of the brains was taken before and after radiation to assess the tumor sizes. Survival time of each subject was also recorded. Results:In comparison with control group, knockout of CX43 in S24-GBMSCs led to shorter TMs, less TM connected cells, lower Ca 2+ synchronicity and SR101 fluorescence, as well as decreased tumor sizes and prolonged survival time (all P<0.01), which were independent from radiation. However, CBX only demonstrated inhibition on the growth of tumors and the diffussion of Ca 2+ and SR101, without affecting TMs formation. These above-mentioned alterations could be enhanced by the combination of gap43 knockout in S24-GBMSCs with blockage of CX43 by CBX (all P<0.05). Conclusion:CX43 plays a critical role in the radioresistance of S24-GBM by influencing the formation of S24-GBM cellular network and the transmission of important signaling molecules including Ca 2+ and SR101.