Objective: To investigate the resistance to rifampicin and isoniazid and the changing trends among patients with pulmonary tuberculosis in Luohu District, Shenzhen City, Guangdong Province from 2012 to 2022, so as to provide insights into improving drug-resistant pulmonary tuberculosis control and prevention strategies. Methods: Basic information, treatment classification and drug resistance data of patients with pulmonary tuberculosis and positive pathogenic detection in Luohu District from 2012 to 2022 were collected through the Tuberculosis Surveillance System of Chinese Disease Prevention and Control Information System, and resistance rates of rifampicin and isoniazid and the changing trends were analyzed. Results: A total of 2 126 patients with pulmonary tuberculosis were collected and had a median age of 34 (interquartile range, 25) years, including 1 334 males (62.75%) and 792 females (37.25%). There were 302 patients with drug-resistance in Luohu District from 2012 to 2022, with a resistance rate of 14.21%. Among them, 60 patients were monoresistant to rifampicin (2.82%), 113 patients were monoresistant to isoniazid (5.32%), and 129 patients were multidrug resistant (6.07%). The rate of rifampicin monoresistance showed a downward trend from 2012 to 2022, while the rate of multidrug resistance showed an upward trend (both P<0.05). There was no significant tendency in the rate of isoniazid monoresistance (P>0.05). The rate of multidrug resistance among patients without Shenzhen residence was higher than that among patients with Shenzhen residence; the rates of rifampicin resistance and multidrug resistance among retreated patients were higher than those among treatment-naïve patients (all P<0.05). Conclusions The rate of rifampicin monoresistance appeared a downward trend and the rate of multidrug resistance appeared an upward trend among patients with pulmonary tuberculosis in Luohu District from 2012 to 2022. Attention should be given to non-Shenzhen residence and retreated patients.

Objective:To assess the predictive value of aspartate aminotransferase-to-alanine amino-transferase ratio (DRR) on overall survival of patients with pancreatic ductal adenocarcinoma (PDAC) who underwent radical pancreaticoduodenectomy.Methods:A retrospective analysis was performed on the clinical data of 137 patients who underwent radical pancreaticoduodenectomy and were diagnosed with PDAC postoperatively at the Chinese PLA General Hospital from January 2015 to December 2020. There were 97 male and 40 female patients, with an average age of (58±10) years old. The patients were grouped according to the optimal survival risk cutoff value of DRR, and the differences in key clinical and pathological indicators between the groups were compared. Kaplan-Meier method was used for survival analysis, and log-rank test was used for comparison of survival rates. Multivariate Cox analysis was performed to evaluate the prognostic factors affecting survival.Results:The 137 PDAC patients were divided into two groups based on the optimal cutoff value of DRR, namely 1.1: DRR≥1.1 was defined as the high-DRR group ( n=29), and DRR<1.1 was defined as the low-DRR group ( n=108). The cumulative survival rate of the low-DRR group was better than that of the high-DRR group, and the difference was statistically significant ( P=0.003). The results of the multivariate Cox regression analysis showed that DRR≥1.1 ( HR=2.485, 95% CI: 1.449-4.261, P=0.001), preoperative biliary drainage ( HR=1.845, 95% CI: 1.030-3.306, P=0.039), lymph node metastasis N2 stage ( HR=2.240, 95% CI: 1.123-4.470, P=0.022), high tumor differentiation ( HR=2.001, 95% CI: 1.279-3.129, P=0.002), and intravascular cancer emboli ( HR=2.240, 95% CI: 1.123-4.470, P=0.022) were risk factors for poor overall survival in PDAC patients who underwent radical pancreaticoduodenectomy. Conclusion:DRR has predictive value for overall survival after surgery in PDAC patients undergoing radical pancreatoduodenectomy. A DRR of 1.1 or greater is a risk factor for poor overall survival after surgery in PDAC patients.

Objective To develop an Exercise Behavior Perception Scale for Lung Cancer Patients in China,and to test its reliability and validity.Methods According to the health belief model,the first draft of the scale was formed through literature review,semi-structured interview,research group discussion,2 rounds of expert correspondence and pre-survey.A total of 842 patients with lung cancer who received treatment in a tertiary A hospital in Zhengzhou City from October 2022 to April 2023 were selected for investigation,and item analysis,validity analysis,and reliability analysis were applied to adjust the items to form a formal scale.Results The Exercise Behavior Perception Scale for Lung Cancer Patients contained 24 items,and exploratory factor analysis generated 6 common factors,including physical rehabilitation benefits,emotional and mental benefits,information disorders,disease symptom disorders,condition disorders,and psychological disorders.The cumulative variance contribution rate reached 73.916％,and the results of confirmatory factor analysis showed that the model fit was good,the x2/df was 2.371,the root mean square error of approximation was 0.057,the normed fit index was 0.924,and the comparative fit index was 0.954,the scale score was moderately positively correlated with the total score of the Frenchay activities index(r=0.529,P＜0.001).The Cronbach's α,coefficient,half reliability,and retest reliability of the scale were 0.884,0.741,and 0.889,respectively.Conclusion The Exercise Behavior Perception Scale for Lung Cancer Patients had good reliability and validity,and it can be used to effectively evaluate the exercise behavior perception status of lung cancer patients.

AIM: To compare the changes of exotropia deviation in children with basic type of intermittent exotropia before and after monocular occlusion test.METHODS: Prospective clinical study. A total of 258 children with basic type of intermittent exotropia who underwent strabismus correction in our hospital from July 2021 to September 2022 were selected, including 122 males and 136 females, aged from 5 to 12 years, with an average age of 8.0±3.1 years. The exotropia deviation was measured at distance(6 m)and near(33 cm)fixation by prism alternating occlusion method, and the exotropia deviation was checked again after covering the non-dominant eyes of children for 40 min.RESULTS: Before and after the monocular occlusion test, the exotropia deviation at distance(6 m)fixation was 28.23△±10.79△ and 29.79△±10.85△, respectively(t=-0.903, P=0.368), while the exotropia deviation at near(33 cm)fixation was 33.14△±8.89△ and 36.90△±10.76△, respectively(t=-2.377, P=0.019).CONCLUSIONS: Monocular occlusion test has a great impact on the exotropia deviation at near(33 cm)fixation in children with basic type of intermittent exotropia before surgery. It can expose the maximum exotropia deviation, reduce the rate of undercorrection after strabismus surgery, and provide a reliable surgical plan.

BACKGROUND:Root canal preparation is a key step in root canal therapy.In recent years,with the rapid development of new nickel-titanium instruments,the results of root canal shaping ability have been significantly improved.However,the shaping abilities of different nickel-titanium instruments are also different.At present,there are few reports about the influence of the shaping ability of R-phase heat treatment NIC X-FILE and DENCO Pre-Shaper in simulated curved canals. OBJECTIVE:To compare the shaping effect of NIC X-FILE and DENCO Pre-Shaper nickel-titanium instruments in preparation for simulated curved canals. METHODS:Fifty simulated resin-curved canals were selected and randomly divided into two groups(n=25).NIC X-FILE and DENCO Pre-Shaper nickel-titanium files were used for root canal preparation.The root canal preparation time was recorded.Images of pre-and post-root canal preparation were taken.Image processing and analysis software were used to measure the amount of resin removed from the inner and outer walls of the root canal at each observation point.Statistical software was used to compare the root canal preparation time and centering ability of two kinds of mechanical nickel-titanium files. RESULTS AND CONCLUSION:(1)The average root canal preparation time was(1.58±0.02)minutes in the DENCO Pre-Shaper group and(2.22±0.03)minutes in the NIC X-FILE group.There was a significant difference between the two groups(P<0.05).(2)The amount of resin removed from the inner walls of the root canal of the DENCO Pre-Shaper group at 4,5,7,8,9,and 10 mm from the apical foramen was higher than that of the NIC X-FILE group(P<0.05).The amount of resin removed from the outer walls of the root canal of the DENCO Pre-Shaper group at 3,5,6,7,and 8 mm from the apical foramen was lower than that of the NIC X-FILE group(P<0.05).(3)At 2,4,5,6,7,8,and 9 mm away from apical foramen,the centering ability of the NIC X-FILE group was better than that of the DENCO Pre-Shaper group(P<0.05),and the centering ability of the NIC X-FILE group was the best at 4 mm away from apical foramen.(4)The results show that DENCO Pre-Shaper has higher mechanical efficiency than NIC X-FILE nickel-titanium root canal files.However,the centering ability of DENCO Pre-Shaper is inferior to NIC X-FILE nickel-titanium root canal files.

Objective:To analyze the effect of montelukast combined with budesonide in the treatment of children with intermittent asthma, and the impact on airway remodeling and T helper type 1 (Th1)/T helper type 2 (Th1/Th2) related cytokines.Methods:A prospective study was conducted among 120 children with intermittent asthma admitted to Huanghua Municipal People′s Hospital from December 2021 to February 2023. The children were randomly divided into the control group (60 children treated with budesonide atomizationinhalation) and the observation group (60 children treated with montelukast on the basis of the treatment of control group). Clinical efficacy, airway remodeling indicators [total area of airway (Ao), outer diameter of airway (D) and wall area to total airway cross-sectional area (WA%)], pulmonary function [peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV 1)/forced vital capacity (FVC) and the maximum expiratory flow at 25% of vital capacity (MEF25%)], Th1/Th2 related cytokines, inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4), interleukin-6 (IL-6) and interferon-gamma (IFN-γ)], recurrence, and the incidence of adverse reactions were compared between the two groups. Results:The total effective rate in the observation group was higher than that in the control group: 90.00% (54/60) vs. 75.00% (45/60) ( P<0.05). After treatment, Ao, D and WA% in the observation group were lower than those in the control group: (17.58 ± 1.89) mm 2 vs. (19.22 ± 1.94) mm 2, (4.25 ± 0.48) mm vs. (4.48 ± 0.49) mm, (63.75 ± 6.49)% vs. (69.22 ± 7.14)% ( P<0.05). PEF, FEV 1/FVC and MEF25% in the observation group were higher than those in the control group: (3.13 ± 0.34) L/s vs. (2.86 ± 0.35) L/s, (87.45 ± 8.86) % vs. (83.59 ± 8.42) %, (87.63 ± 8.86)% vs. (82.15 ± 8.43)% ( P<0.05). The levels of Th1 and Th1/Th2 in the observation group were higher than those in the control group: (14.13 ± 1.46) % vs. (10.27 ± 1.25) %, 3.46 ± 0.39 vs. 1.88 ± 0.25, and the level of Th2 was lower than that in the control group: (3.96 ± 0.45)% vs. (5.48 ± 0.56)% ( P<0.05). After treatment, the levels of TNF-α and IFN-γ in the observation group were higher than those in the control group: (76.15 ± 7.78) ng/L vs. (66.38 ± 6.47) ng/L, (7.15 ± 0.74) ng/L vs. (6.14 ± 0.66) ng/L. The levels of IL-4 and IL-6 were lower than those in the control group: (77.85 ± 7.96) ng/L vs. (86.42 ± 8.74) ng/L, (37.25 ± 3.89) mg/L vs. (44.23 ± 4.57) mg/L ( P<0.05). The recurrence rate in the observation group was lower than that in the control group: 3.33% (2/60) vs. 15.00% (9/60) ( P<0.05). The incidence rates of adverse reactions in the two groups were without statistically significant difference between the groups ( P>0.05). Conclusions:Montelukast combined with budesonide can reduce airway remodeling in children with intermittent asthma, improve their pulmonary function, Th1/Th2 related cytokines and inflammatory response indicators, and reduce recurrence rate, with good safety.

Laboratory medicine is an important subject of auxiliary clinical diagnosis, and the postgraduate education of clinical laboratory diagnostics is the key to cultivating high-end laboratory talents. This study analyses the differences in the postgraduate education model of clinical laboratory diagnostics between China and Australia from the four aspects of academic degree system, curriculum setting, teaching methods, and autonomous learning ability training and discusses the postgraduate education reform of laboratory medicine in China. With reference to the advanced experience of countries with a well-developed education system, the education reform in China can improve the comprehensive quality of postgraduate student in laboratory medicine and enhance the medical level of China.

Osteoporosis is a systemic metabolic bone disease characterized by decreased bone mass, damage to bone tissue microstructure, increased bone fragility, and susceptibility to fractures, while sarcopenia is a syndrome characterized by progressive reduction in overall muscle mass and functional decline. Based on the common pathophysiological mechanism and close correlation between the two, the concept of "osteosarcopenia" has gradually emerged to describe the simultaneous attenuation of muscles and bones. Signaling pathways serve as important signal transmission channels between muscles and bones, and if abnormal, they can lead to osteosarcopenia. The aim of this article, therefore, is to review the signaling pathways related to osteogenesis and myogenesis, such as Hedgehog, Hippo, mTOR, MAPK, in order to provide new ideas for targeted treatment of osteosarcopenia.

Objective·To explore the molecular regulatory mechanism of neural tube defect(NTD)induced by retinoic acid(RA)in mouse embryos,and reveal the gene expression regularity of neural tube closure in mice.Methods·Based on the high-quality brain vesicle transcriptome data of mouse embryo during the critical period of neural tube closure[embryonic day 8.5(E8.5),E9.5 and E10.5],the gene expression trend data of the NTD group and the control group were obtained by using Short Time-series Expression Miner(STEM)software.Gene Ontology(GO)enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis were performed for genes with different expression trends between the NTD group and the control group.Some candidate genes were screened for validation.Pregnant mice were divided into the NTD group and control group,with 9 mice in each group.Pregnant mice in the NTD group were treated with RA and those in the control group were treated with sesame oil by gavage at E7.5.Foetal rat brain vesicle tissues were collected at E8.5,E9.5 and E10.5 for experiments.Based on the above animal tissues,the screened candidate genes were validated by quantitative real-time PCR(RT-PCR).Results·A total of 18 255 genes were detected in the transcriptome data of the control group,and the expression patterns of these genes could be summarized into 7 significant profiles.A total of 19 037 gene expression data were detected in the transcriptome data of the NTD group,and gene expression patterns could be summarized into 6 profiles with significant significance.A total of 46 genes in the control group showed an upward trend but a downward trend in the NTD group.They were enriched in the positive and negative regulation of organ development,neuronal apoptosis,oligodendrocyte proliferation,and fibroblast growth factor signaling pathway at the biological process level.At the cellular component level,they were mainly involved in the basic structure of cells and neurons;At the molecular functional level,they were mainly related to the binding of fibroblast growth factor receptor.A total of 61 genes showed a downward trend in the control group but an upward trend in the NTD group.These genes were enriched in functions such as cell lysis and amino acid/ion transport at the biological process level.At the cellular component level,they were enriched in intracellular molecules,particles,extracellular region,intercellular space,etc.At the molecular function level,they were related to the activity of a series of enzymes and transporters.The results of RT-qPCR showed that the transcriptome sequencing data were authentic and reliable.Conclusion·RA intervention causes abnormal cellular activities and stress responses during mouse embryo development,leading to abnormal embryo development,activation of signalling pathways related to organismal self-protection,and suppression of genes that maintain normal embryo development.

Objective To systematically evaluate the efficacy and safety of Kangfuxin liquid combined with conventional treatment in postoperative patients with gastrointestinal endoscopy.Methods PubMed,Embase,Cochrane Library,CNKI,WanFang Data,VIP databases were electronically searched to collect randomized controlled trials(RCTs)about Kangfuxin liquid combined with conventional treatment versus conventional treatment for postoperative complications of gastrointestinal endoscopy,from inception to December 31,2023.Two reviewers independently screened literature,extracted data and assessed the risk of bias in the included studies.Meta-analysis was then performed by using RevMan 5.3 software and Stata 14 software.Results A total of 14 RCTs involving 1 359 patients were included.The results of Meta-analysis showed that compared with the conventional treatment group,the Kangfuxin liquid combination group could improve postoperative ulcer complete healing rate(RR=1.32,95％CI 1.07 to 1.61,P=0.009)and postoperative clinical symptomatic relief rate(RR=1.20,95％CI 1.13 to 1.27,P＜0.001),but there was no statistically significant difference in the incidence of adverse reactions between the two groups(P＞0.05).Subgroup analyses showed that the ulcer complete healing rate in the Kangfuxin liquid combination group was higher than that in the conventional treatment group at 2 weeks postoperatively(RR=1.56,95％CI 1.28 to 1.92,P＜0.001),but there was no statistically significant difference in ulcer complete healing rate between the two groups at 4 weeks postoperatively(P＞0.05);the efficacy of oral administration(RR=1.19,95％CI 1.11 to 1.27,P＜0.001)and transendoscopic topical spray administration(RR=1.23,95％CI 1.09 to 1.39,P＜0.001)of Kangfuxin liquid groups were better than those of the conventional treatment group in relieving postoperative clinical symptoms.Conclusion Combining Kangfuxin liquid treatment with conventional medication after gastrointestinal endoscopy may further improve clinical efficacy,especially in promoting the ulcer complete healing within 2 weeks after surgery and relieving postoperative clinical symptoms,but there is insufficient evidence on whether it reduces the incidence of adverse effects.Due to the limitations of the number and quality of included studies,the above conclusions are yet to be validated by more high-quality studies.