Objective To analyze and evaluate the implementation effect of tuberculosis prevention and control program in Wuhan, and to provide reference for scientific formulation of tuberculosis prevention and control measures. Methods Using the National Tuberculosis Information Management System, descriptive statistical analysis was carried out on the medical record information of pulmonary tuberculosis patients registered in Wuhan , 2016 - 2021. Results A total of 34 937 cases of pulmonary tuberculosis were registered in Wuhan , with an average annual incidence rate of 49.85/100 000. The incidence rate showed a downward trend year by year, with a statistically significant difference in 2016—2021 (χ²_trend = 708.387, P<0.001). The patients mainly came from referrals, accounting for 71.86%, and the proportion of referrals varied significantly among different years (χ²=355.541, P<0.001). The diagnosis type was mainly pathogenic negative, accounting for 49.12%. The proportion of pathogenic negative had statistically significant difference among different years (χ²=1 354.830, P<0.001). The proportion of patients cured and completed the course of treatment reached 93.98%, with statistically significant differences in the proportions among different years (cured, χ²=1 080.252, P<0.001; completed the treatment course, χ²= 933.655, P<0.001). The sputum examination rate of newly diagnosed patients in each year reached over 90%, and the overall completion rate reached over 95%. The proportion of positive pathogens showed an increasing trend year by year. Conclusion The overall epidemic situation of tuberculosis in Wuhan is declining year by year, and tuberculosis prevention and control work has achieved remarkable results. Active screening in key areas and populations should be strengthened, and prevention and control strategies should be formulated by emphasizing the key and difficult points.

BACKGROUND:Critical energy release rate is a global fracture parameter that could be measured during the failing process,and its value may change under different failure modes even in the same structure. OBJECTIVE:To propose an approach to predict the critical energy release rate in the femoral cortical bone structure under different failure modes. METHODS:Three-point bending and axial compression experiments and the corresponding fracture simulations were performed on the rat femoral cortical bone structures.Different critical energy release rates were repeatedly assigned to the models to perform fracture simulation,and the predicted load-displacement curves in each simulation were compared with the experimental data to back-calculate the critical energy release rate.The successful fit was that the differences in the fracture parameters between the predicted and experimental results were less than 5%. RESULTS AND CONCLUSION:(1)The results showed that the cortical bone structure occurred tensile open failure under three-point bending load,and the predicted critical energy release rate was 0.16 N/mm.(2)The same cortical bone structure occurred shear open failure under axial compression load,and the predicted critical energy release rate was 0.12 N/mm,which indicates that the critical energy release rate of the same cortical bone structure under different failure modes was different.(3)A comprehensive analysis from the perspectives of material mechanical properties and damage mechanism was conducted to reveal the reasons for the differences in the critical energy release rate in the cortical bone structure under different failure modes,which provided a theoretical basis for the measurement of the energy release rate and the accurate fracture simulation.

Objective To predict the tissue-level failure strain of the cortical bone and discuss the effects of different running speeds on the mechanical properties of rat femoral cortical bone.Methods The threshold for cortical bone tissue-level failure strain was assigned,and fracture simulation under three-point bending was performed on a rat femoral finite element model.The predicted load-displacement curves in each simulation were compared and fitted with the experimental data to back-calculate the tissue-level failure strain.Results The cortical bone tissue-level failure strains at different running speeds were statistically different,which indicated that different running speeds had certain impacts on the micromechanical properties of the cortical bone structures.At a running speed of 12 m/min,the cortical bone structure expressed the greatest tissue-level failure strain,and at a running speed of 20 m/min,the cortical bone structure expressed the lowest tissue-level failure strain.Conclusions Based on the changing trends of tissue-level failure strain and in combination with the changes in macro-level failure load and tissue-level elastic modulus of cortical bone structures,the effects of different running speeds on the mechanical properties of cortical bone structures were discussed in this study.The appropriate running speed for improving the mechanical properties of the cortical bone was explored,thereby providing a theoretical basis for improving bone strength through running exercises.

Objective:To develop and evaluate a nomogram prediction model for the 3-month mortality risk of patients with sepsis-associated acute kidney injury (S-AKI).Methods:Based on the American Medical Information Mart for Intensive Care-Ⅳ (MIMIC-Ⅳ), clinical data of S-AKI patients from 2008 to 2021 were collected.Initially, 58 relevant predictive factors were included, with all-cause mortality within 3 months as the outcome event. The data were divided into training and testing sets at a 7∶3 ratio. In the training set, univariate Logistic regression analysis was used for preliminary variable screening. Multicollinearity analysis, Lasso regression, and random forest algorithm were employed for variable selection, combined with the clinical application value of variables, to establish a multivariable Logistic regression model, visualized using a nomogram. In the testing set, the predictive value of the model was evaluated through internal validation. The receiver operator characteristic curve (ROC curve) was drawn, and the area under the curve (AUC) was calculated to evaluate the discrimination of nomogram model and Oxford acute severity of illness score (OASIS), sequential organ failure assessment (SOFA), and systemic inflammatory response syndrome score (SIRS). The calibration curve was used to evaluate the calibration, and decision curve analysis (DCA) was performed to assess the net benefit at different probability thresholds.Results:Based on the survival status at 3 months after diagnosis, patients were divided into 7?768 (68.54%) survivors and 3?566 (31.46%) death. In the training set, after multiple screenings, 7 variables were finally included in the nomogram model: Logistic organ dysfunction system (LODS), Charlson comorbidity index, urine output, international normalized ratio (INR), respiratory support mode, blood urea nitrogen, and age. Internal validation in the testing set showed that the AUC of nomogram model was 0.81 [95% confidence interval (95% CI) was 0.80-0.82], higher than the OASIS score's 0.70 (95% CI was 0.69-0.71) and significantly higher than the SOFA score's 0.57 (95% CI was 0.56-0.58) and SIRS score's 0.56 (95% CI was 0.55-0.57), indicating good discrimination. The calibration curve demonstrated that the nomogram model's calibration was better than the OASIS, SOFA, and SIRS scores. The DCA curve suggested that the nomogram model's clinical net benefit was better than the OASIS, SOFA, and SIRS scores at different probability thresholds. Conclusions:A nomogram prediction model for the 3-month mortality risk of S-AKI patients, based on clinical big data from MIMIC-Ⅳ and including seven variables, demonstrates good discriminative ability and calibration, providing an effective new tool for assessing the prognosis of S-AKI patients.

Objective To investigate the value of derived neutrophil to lymphocyte ratio(dNLR)as a pre-dictive biomarker for immunotherapy response in advanced non-small cell lung cancer(NSCLC).Methods A total of 92 patients with advanced NSCLC who received anti-programmed cell death receptor(PD-1)combined therapy in the hospital from August 2018 to December 2019 were selected as the research objects.Peripheral blood samples were collected within 24 h before immunotherapy,complete blood cell count was measured,and dNLR was calculated.Patients with advanced NSCLC were treated with PD-1 inhibitors or combination regi-mens,and the response to immunotherapy was evaluated by objective response rate(ORR)and disease control rate(DCR).The receiver operating characteristic(ROC)curve was used to analyze the predictive value of dN-LR for the diagnosis and response to immunotherapy in advanced NSCLC.Multivariate Logistic regression model was used to analyze the relationship between dNLR and immunotherapy response in advanced NSCLC.Kaplan-Meier survival curve and Log-Rank test were used to analyze the overall survival(OS),progression-free survival(PFS)and disease-specific survival(DSS)of the low dNLR group and the high dNLR group.Re-sults The ORR and DCR of advanced NSCLC patients after immunotherapy were 32.61％and 65.22％,re-spectively,and the PFS and OS were 17.0(8.5,25.5)and 24.0(12.7,36.1)months,respectively.The dNLR of DCR group was lower than that of non-DCR group(P＜0.001).The dNLR of ORR group was lower than that of non-ORR group(P＜0.001).The area under the curve of dNLR for predicting DCR or ORR was 0.897(95％CI 0.829-0.965)and 0.874(95％CI 0.795-0.953),respectively.Multivariate Logistic regres-sion analysis showed that dNLR≥2.28 increased the risk of non-response to immunotherapy,and this inde-pendent relationship still existed after further adjustment for objective confounding factors(P＜0.05).Sur-vival curve results showed that patients with high dNLR had significantly shorter PFS,OS,and DSS(P＜0.05).Multivariate Cox regression analysis showed that high dNLR was an independent factor affecting the poor prognosis of patients with advanced NSCLC(P＜0.05).Conclusion High dNLR advanced NSCLC pa-tients are more difficult to benefit from immune therapy,and prognosis is worse.dNLR is promising as a pre-dictive biomarker for immunotherapy response in advanced NSCLC.

Objective To analyze the diagnosis status of negative etiological pulmonary tuberculosis test re-sults in Wuhan,and to provide scientific basis for improving the diagnosis strategy of etiological negative pul-monary tuberculosis.Methods From January 1 to February 28,2019,a total of 241 patients with negative eti-ological tuberculosis who were registered,reported and treated in 1 municipal and 2 district-level designated hospitals were selected.The medical record data,chest imaging examination and laboratory examination re-sults of the selected patients were reviewed and extracted,and the quality of etiological examination and ima-ging examination of patients with negative etiological pulmonary tuberculosis were analyzed.Results Among the 241 patients,88.8％(214/241)of the patients met the diagnostic criteria for negative etiological pulmona-ry tuberculosis,and 96.3％(232/241)of the patients had chest imaging examinations that were consistent with the original diagnostic results.Patients received sputum smear examination,sputum culture,and molecu-lar biology test accounted for 97.9％(236/241),73.9％(178/241)and 65.6％(158/241),respectively.Patients received anti-tuberculosis antibody test,tuberculin skin test,y-interferon release and diagnostic anti-infection treatment accounted for 54.8％(132/241),46.5％(112/241),26.1％(63/241),and 53.1％(128/241),respec-tively.The sputum culture detection rate of urban area was higher than those of central and remote urban are-as,the rate of central urban area was higher than that of remote urban areas,and the molecular biology detec-tion rate of urban area was higher than those of central and remote urban area,with statistical significance(P＜0.001).The detection rate of anti-tuberculosis antibody of urban area was lower than that of central ur-ban area,and the differences were statistically significant(P＜0.001).The rate of diagnostic anti-infective therapy of central urban area was higher than that of urban area and the remote urban area,and the rate in ur-ban area was higher than that of remote urban area,and the differences were statistically significant(P＜0.001).Conclusion It is necessary to further standardize the diagnosis of negative etiological pulmonany tu-berculosis of designated tuberculosis hospitals.The proportion of diagnostic anti-infection treatment and auxil-iary examination at the municipal level needs to be increased,and the frequency and items of laboratory etio-logical examination at the district level need to be increased.

Objective To predict the micro-level energy release rate in the rat femoral cortical bone and investigate the variation in the micro-level energy release rate with age.Methods Based on previous experimental data and numerical simulation of fracture modes for cortical bone,load-displacement curves and fracture modes measured by simulation and experiment were compared,and the micro-level energy release rates of rat femoral cortical bone at different months were predicted by back-calculation.Results It was predicted that the micro-level energy release rate of rat femoral cortical bone at 1-,3-,5-,7-,9-,11-,and 15-month age was 0.08-0.12,0.12-0.14,0.15-0.19,0.25-0.28,0.23-0.25,0.19-0.22,and 0.13-0.16 N/mm,respectively.Conclusions The decrease in the microlevel energy release rate with increasing age led to a decreasing failure load,indicating that the microlevel energy release rate is one of the main factors determining fracture occurrence;however,no significant decrease was observed at the time of fracture,indicating that the microlevel energy release rate was not linearly proportional to the fracture time.These results can help explain the mechanism of cortical bone fractures at the clinical level.

Objective: To determine the knowledge, attitudes and practices (KAP) regarding tuberculosis prevention and control among college students in Wuhan, China, while analyzing the factors affecting tuberculosis prevention behavior. Methods: Referring to the National KAP Questionnaire for Tuberculosis Prevention and Control among College Students, which was designed by China Center for Disease Control and Prevention, 22 colleges and universities in Wuhan were selected using a judgment sampling method, and a questionnaire survey was carried out through the online questionnaire platform. The formation of tuberculosis prevention and control behavior among this population was analyzed by single factor and multi factor Logistic regression. Results: The total awareness rate of KAP regarding tuberculosis prevention and control among college students in Wuhan was 79.69%; the awareness rate of core knowledge was 79.28%, and the passing rate was 92.46%. The correct attitude holding rate was 89.69%, while the passing rate was 90.56%. In respect to correct behavior, the formation rate was 72.11%, with a passing rate of 96.62%. The multivariate Logistic regression analysis showed that the following factors were more likely to promote tuberculosis prevention and control behaviors that met the target: female college students ( OR =1.86); college students whose father had a primary school education level, junior high school and equivalent, high school and equivalent, and junior high school students ( OR =2.94, 3.05, 3.17, 3.24 ); no history of tuberculosis ( OR =3.32); the passing knowledge of core knowledge ( OR =9.91), and the passing attitude holding score ( OR =7.35)( P <0.05). Conclusion The overall awareness rate of KAP regarding tuberculosis prevention and control among college students in Wuhan is acceptable,the mainly influenced factors are gender, history of tuberculosis, awareness rate of core knowledge about prevention and control, attitudes and cognition, and parents educational background.

Phage antibody display technology is currently the most widely used in vitro antibody screening technology,which uses bacteriophages as a vector,and inserts exogenous antibody library genes into phage capsid protein genes,and expresses the capsid protein on the phage surface while also displays the antibody protein.Antibody drugs play an important role in tumor immunity and microbial immunity due to their targeting advantages,which is also an important driving force for them to become a hot spot in the field of pharmaceutical research and development.Therefore,this article reviews the background,basic principles,antibody library types and antibody fragment types of phage display technology,and looks forward to the latest progress and application prospects of fully human antibodies.

Malaria remains one of the most serious public health problems in tropical and subtropical countries and regions. In the control of the vector Anopheles, insecticide-treated bed nets and indoor residual spraying, which have been promoted to interrupt malaria transmission by only preventing indoor blood-sucking by adult mosquitoes, consequently have been widely used in malaria-endemic areas. However, the efficacy of these measures in interrupting malaria transmission is gradually decreasing due to the development of mosquito resistance. In contrast, Anopheles larval source management can effectively reduce the population density of indoor and outdoor blood-sucking, wild and domestic mosquitoes. It can also be combined with adult mosquito control to become an important adjunct to existing adult mosquito control measures. In more than 70 years of malaria control and elimination in China, according to different conditions in different places, exploration and practice have been carried out in different types of control of malaria Anopheles larvae, such as habitat modification, habitat manipulation, larviciding, and biological control. These efforts have accumulated rich experience and resulted in strategies tailored to local conditions, integrated control, community involvement, and methodological innovation. This paper outlines the main practices and basic strategies of Anopheles larval source management for malaria control in China, with the aim of providing references for malaria control in other regions where malaria is still endemic.