Objective To analyze the correlation between serum soluble Klotho protein(sKL)and tendino-C(TN-C)and the severity of disease and oxidative stress in children with immunoglobulin A(IgA)nephropa-thy.Methods A total of 85 children with IgA nephropathy admitted to the hospital from July 2019 to August 2022 were selected as IgA nephropathy group,and 85 healthy patients who underwent physical examination in the hospital during the same period were selected as healthy group.Serum sKL and TN-C levels were com-pared between the two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the value of serum sKL,TN-C and their combination in predicting the occurrence of IgA nephropathy.IgA nephropathy group was divided into mild group(28 cases),moderate group(39 cases)and severe group(18 cases)accord-ing to 24 h urinary protein quantity.Serum sKL,TN-C levels and oxidative stress indexes[malondialdehyde(MDA),superoxide dismutase(SOD)and advanced oxidation protein product(AOPP)]of the three groups were compared.The correlation between serum sKL and TN-C levels and oxidative stress indexes was ana-lyzed by Spearman correlation,and the correlation between serum sKL and TN-C levels and the severity of IgA nephropathy in children was examined by Kendall's Tau-b.Results The serum sKL level in IgA ne-phropathy group was lower than that in healthy group,and the serum TN-C level was higher than that in healthy group,the difference was statistically significant(P＜0.05).ROC curve showed that the area under the curve and 95％CI of serum sKL,TNC and their combination predicted the occurrence of IgA nephropathy were 0.726(95％CI:0.648-0.803),0.853(95％CI:0.796-0.909)and 0.891(95％CI:0.845-0.937).The level of serum sKL in severe group was lower than that in moderate and mild groups,while the level of serum TN-C was higher than that in moderate and mild groups,and the difference was statistically significant(P＜0.05).The serum SOD level of severe group was lower than that of moderate group and mild group,and the serum AOPP and MDA levels were higher than those of moderate group and mild group,the difference was statistically significant(P＜0.05).Spearman correlation showed that sKL level was positively correlated with SOD(r＞0,P＜0.05),and negatively correlated with AOPP and MDA(r＜0,P＜0.05).TN-C level was negatively correlated with SOD(r＜0,P＜0.05),and positively correlated with AOPP and MDA(r＞0,P＜0.05).Conclusion The levels of serum sKL and TN-C in children with IgA nephropathy are related to the severity of disease and oxidative stress,and the combination of SKL and TN-C can effectively predict the occurrence of IgA nephropathy.

Objective To explore the value of blood inflammatory load in predicting overall survival of elderly patients with epithelial ovarian cancer(EOC).Methods Elderly patients with EOC were selected,and their clinical data and peripheral blood parameters were collected.We constructed an inflammation-related blood scoring system using univariate and multivariate Cox regression analysis.The Kaplan-Meier method was used for survival analysis.We used Cox proportional hazards analysis to identify the independent prognostic factors.A nomogram model was constructed based on independent prognostic factors,and the receiver operating characteristic curve,C-index,and calibration curve were used to evaluate the model.Results Patients with high blood inflammatory load had worse prognosis(P=0.002).Compared with the low inflammatory load group,patients with high inflammatory load had later clinical stages and larger ascites volume(P<0.05).Cox regression analysis showed that ACCI,CA125,residual lesions,and blood score were independent factors affecting overall survival(P<0.05).Conclusion The blood inflammatory load is the biomarker for the prognosis of elderly patients with EOC.Scoring the inflammatory load in the blood can assist in efficacy monitoring and treatment intervention of ovarian cancer patients.

Objective To investigate the clinical pathological characteristics,treatment methods and prognosis of the patients with uterine corpus rhabdomyosarcoma(UcRMS).Methods The data from 237 pa-tients with UcRMS during 2000-2020 were retrospectively collected from the Surveillance,Epidemiology and End Results(SEER)database.The descriptive statistical method was employed to conduct the descriptive a-nalysis on clinicopathological characteristics and prognosis of UcRMS patients.The Kaplan-Meier method was adopted to conduct the survival analysis on the patients with different pathological types and treatment meth-ods,and draw the survival curve.The Log-rank test was employed to compare the survival analyses.The uni-variate and multivariate Cox regression were performed to analyze the independent factors affecting the prog-nosis of UcRMS patients.Results Among histologically confirmed cases,the most common type was embry-onic type(44 cases,18.6％)and followed by the pleomorphic type(35 cases,14.8％).In terms of treatment,21 cases(8.9％)received the surgery combined with chemotherapy and radiotherapy(surgery+chemotherapy+radiotherapy).75 cases(31.6％)received the surgery+chemotherapy,and 23 cases(9.7％)received the sur-gery+radiotherapy.The median overall survival(OS)time in the cohorts was 13 months,the median cancer-related survival(CSS)was 14 months,the 5-year OS rate and CSS rate were only 16％.The OS rate and CSS rate for embryonic type RMS were significantly better than those for the undefined and other pathological types,with statistically significant differences(P＜0.001).In terms of treatment,the OS rate and CSS rate in the surgery+chemotherapy+radiotherapy group were superior to those in the surgery+chemotherapy group and surgery+radiotherapy group,with statistically significant differences(P=0.011,P=0.012).The histological type,stage,surgery and chemotherapy were the factors affecting the OS time and CSS time of the patients(P＜0.05,P＜0.001).Conclusion The prognosis of embryonic type UcRMS is better than that of other histological types,but the overall prognosis is still poor,the 5-year survival rate is less than 20％.The histological type,stage,surgery and chemotherapy are the important influencing factors of prognosis,and the surgery+chemotherapy+radiotherapy could improve the prognosis of UcRMS patients.

Objective:To investigate the long-term clinical value of composite biomaterial mesh in inguinal hernia repair.Methods:The prospective randomized controlled non-inferiority study was conducted. The clinical data of 172 adult patients with inguinal hernia who were admitted to 3 medical centers, including Huadong Hospital Affiliated to Fudan University et al, from July 2014 to February 2015 were selected. Based on random number table, patients were divided into two groups. Patients underwent technique of abdominal wall reinforcement with biological mesh. Patients using the electrospun composite biomaterial mesh were allocated into experimental group, and patients using the small intestinal submucosa mesh were allocated into control group. Observation indicators: (1) grouping situations of the enrolled patients; (2) endpoint of the study. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the independent sample t test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was conducted using the non-parameter rank sum test. Taking the recurrence rate of hernia at 6 years after surgery as the basis of efficacy evaluation, the Cochran-Mantel-Haenszel test was used for comparison between groups. The confidence interval method was used to conduct non-inferiority statistical analysis. If the lower limit of 95% confidence interval of the difference of recurrence rate of hernia between the experiment group and the control group was more than -10%, the experiment group was considered to be non-inferior to the control group. If the lower limit of 95% confidence interval is more than 0, the experiment group was considered to be superior to the control group. Results:(1) Grouping situations of the enrolled patients. A total of 172 adult patients with inguinal hernia were selected for eligibility. They were males, aged (61±2)years. All 172 patients were randomly divided into to the experimental group and the control group with 86 cases in each group. At 6 years after surgery, 20 patients in the experi-mental group and 19 patients in the control group was lost to follow-up. (2) Endpoint of the study. ① The primary endpoint of study. At 6 years after surgery, no patient had recurrence in the 66 patients of experimental group and 4 patients had recurrence in the 67 patients of control group. Results of non-inferiority statistical analysis showed that the 95% confidence interval of the difference of recurrence rate of hernia between the two groups was 0.27% to 14.41%, with the lower limit as 0.27%, which was more than -10% and simultaneously more than 0. ② The secondary endpoint of study. There was no significant difference in the simple verbal scale between the two groups after 6 months and 6 years at rest or cough status ( P>0.05). At a follow-up of 6 months after surgery, 2 cases of the experimental group and 5 patients of the control group had complications, showing no significant difference between the two groups( χ2=1.38, P>0.05). At a follow-up of 6 years after surgery, no complication occurred in either group. Conclusion:Composite biological mesh in inguinal repair is safe and feasible, which can have low long-term recurrence and achieve good long-term efficacy.

Basal cell carcinoma (BCC) is the most common malignant tumor in dermatology with incidence rising rapidly. Expert consensus on diagnosis and treatment of cutaneous basal cell carcinoma (2021) was published in September 2021 by Skin Tumor Research Center, Chinese Society of Dermatology and Subcommittee on Skin Tumor, China Dermatologist Association. This consensus comprehensively describes the epidemiology, pathogenesis, clinical manifestations, auxiliary examination, pathology, pretreatment assessment, treatment, prognosis, and follow-up education. It offers an important guideline for promoting the standardized diagnosis and treatment of skin BCC in China. In this work, multidisciplinary experts interpreted the main contents of the consensus, including clinicopathological findings, pretreatment assessment, and treatment advance.

Objective:To establish the biology reference interval (RI) of peripheral blood procalcitonin (PCT) for children between 3 days and 6 years old in China.Methods:Totally 3 353 reference individuals with apparent health or no specific diseases were recruited in 18 hospitals throughout the country during October 2020 to May 2021. Reference individuals were divided into four groups: 3-28 days, 29 days - 1 year, 1-3 years and 4-6 years. Vein blood or capillary blood were collected by percutaneous puncture from every reference individual. The PCT level in serum and the capillary whole blood were assayed by Roche Cobas e601 and Norman NRM411-S7 immunoanalyzer. Outliers were deleted and 95th percentiles of every group were provided as RIs. Man-Whitney U test or Kruskal-Wallis test were used performed to assess the difference among different gender, age or method groups. Results:The difference of PCT distribution between male and female is not statistically significant, but the difference between serum and capillary whole blood is statistically significant. The differences between age groups are significant too. For Roche e601, serum PCT RI of 3-28 days group is <0.23 μg/L, 29 days - 6 years are <0.11 μg/L. For NRM411, Serum PCT RI of 3-28 days group is <0.21 μg/L, 29 days - 1 year: <0.09 μg/L, 1 - 6 years: <0.10 μg/L. For whole blood PCT, RI of 3-28 days group is <0.26 μg/L, 29 days - 6 years is <0.15 μg/L.Conclusions:Serum and capillary whole blood PCT have different RIs, however, capillary whole blood PCT testing is valuable in pediatric application. Children in 3-28 days show higher PCT levels than other age group. To establish the RIs and understand the differences among different groups are essential for the interpretation and clinical application of peripheral blood PCT testing results.

Cervical cancer has become a serious threat to women's health worldwide, advanced cervical cancer has limited treatment options. 5-year survival rate is less than 20%, which is a huge challenge for the gynecologic oncology community. Immunotherapy is one of the important treatment for patients with advanced cervical cancer. including immune checkpoint inhibitors, therapeutic vaccines, and periprocedural T-cell immunotherapy, etc. However, immunotherapy resistance makes some patients non-responsive and ineffective. Therefore, there is an urgent need to study and explore the mechanism of immune resistance to improve drug resistance. The present review summarizes the relevant studies on the mechanism of immune resistance in cervical cancer in recent years, mainly divided into factors such as intrinsic tumor and altered external immune environment, and introduces the countermeasures and progresses proposed for immune resistance.

Objective To study the effect of epithelial cell transformation sequence 2 (ECT2) on the proliferation of cervical cancer cells and its mechanism. Methods We transfected cervical cancer cells HeLa (HeLa-ECT2) with the lentivirus overexpressing ECT2 and the cells SiHa (SiHa-siRNA) and C33a (C33a-siRNA) with the interfering plasmid. MTT assay was performed to detect cell proliferation ability. Flow cytometry was conducted to detect the cell cycle of each group. The IPA database was searched for the interacting proteins of ETC2, and immunofluorescence subcellular localization verified the effect between the two. qPCR and Western blot were carried out to detect the expression of Rac1, Cdc42, CDK1, and Cyclin B1 mRNA and protein in each group of cells. Results ECT2 may interact with CDK1. After ECT2 expression was upregulated, the G₂/M phase of HeLa-ECT2 cells accelerated the transformation to G₁ phase, cell proliferation ability was enhanced, and the expression levels of Rac1, Cdc42, CDK1, and cyclin B1 mRNA and protein all increased (P < 0.001); the knockdown of ECT2 expression would reverse the effect (P < 0.05). Conclusion ECT2 accelerates G₂ phase of cervical cancer cells to G₁ phase and promotes cell proliferation by co-localizing with CDK1 through the downstream Cdc42/Rac1 signaling pathway.

Objective:To explore and optimize the teaching content of clinical case discussion course based on clinical pathophysiology and therapy (CPPT), and to improve the teaching quality of this course.Methods:Self-compiled evaluation form was sent to all the students who participated in this course in 2016-2017 school year, and the teaching satisfaction and teaching characteristics were evaluated. The differences of evaluation results from students with different educational programs or teachers with different seniority were compared, and the correlation between evaluation results and teachers' seniority was analyzed.Results:The students had a high evaluation on the course, but students from different programs had significant different comments on thinking inspiring, speech encouraging, questions guiding, process holding and effective feedback, as well as the self-evaluation of mastery degree. For teachers with different seniority, there were significant differences in scores in all aspects except speech encouraging, but no differences in mastery degree. Spearman analysis showed that there was a certain correlation between scores and teachers' seniority.Conclusion:The overall situation of the CPPT case discussion course in our school is worthy of recognition, but it needs to be improved in many aspects.

Objectives:To investigate the proportion of MSM among males over 15 years old and analyze its related factors to provide a reference for estimation of MSM size.Methods:Using cross-sectional survey design, multi-stage sampling method, and street interception survey method, a survey was conducted on males over 15 years old in Kunming from October to December 2019, with an estimated sample size of 9 908.Results:Totally, 10 707 males were recruited from 30 sites in 5 counties, and 10 283 were effectively surveyed with a response rate of 96.0%. Respondents aged 16 to 40 accounted for 75.3% (7 748), senior high school or above 71.1% (7 312), and unmarried 49.8% (5 121). The proportion of homosexual behavior in the past half-year was 1.06% (95% CI: 0.86%-1.26%), and the age-adjusted rate was 0.97% (95% CI: 0.78%-1.16%). And multivariate logistic regression showed the associated factors for homosexual behavior as following: proportion of main urban area was 2.217 times (95% CI:1.004-4.895) that of the outer suburbs, registered residence outside Kunming was 0.421 times (95% CI:0.260-0.682) that of in Kunming, having been in Kunming ≤6 months was 2.282 times (95% CI:1.262-4.126) that of >6 months, senior middle school or above was 0.336 times (95% CI:0.228-0.495) that of junior middle school and below, and being married was 0.462 times (95% CI:0.303-0.705) that of unmarried. Conclusions:The proportion of over 15-year-old males who have recently practiced male-male behavior was close to 1.00% in Kunming. The relevant factors included survey areas with a permanent residency of Kumming, short-time residency, education level, and marital status. This study obtained the data and related factors, which provided a reference for estimating MSM size in Yunnan province.