Objective To investigate the capability for distinguishing between the morphology of Oncomelania hupensis and Tricula snails and its influencing factors among schistosomiasis control professionals in Yunnan Province, so as to evaluate the interference of Tricula snails with O. hupensis surveys. Methods O. hupensis and Tricula snails were sampled from 9 schistosomiasis-endemic counties (districts) in Yunnan Province. The capability for distinguishing between O. hupensis and Tricula snails was evaluated using online questionnaire surveys and field blind tests among schistosomiasis control professionals, and the proportions of correct judgment, misjudgment and missed judgment were calculated. Univariate and multivariate logistic regression models were created using the software SPSS 25.0, and factors affecting the proportion of correct judgments of O. hupensis snails were identified among schistosomiasis control professionals. Results Questionnaire surveys and field blind tests showed that the overall proportions of correct judgments of O. hupensis snails were 56.77% (2 305/4 060) and 68.28% (1 556/2 279) among schistosomiasis control professionals in Yunnan Province, respectively. Univariate logistic regression analysis of online questionnaire surveys identified gender [odds ratio (OR) = 1.244, 95% confidential interval (CI): (1.073, 1.441), P < 0.05], professional title [OR = 0.628, 1.741, 95% CI: (0.453, 0.871), (1.109, 2.734), both P < 0.05], working duration [OR = 0.979, 95% CI: (0.971, 0.987), P < 0.05] and classification of schistosomiasis epidemics in endemic foci [OR = 1.410, 0.293, 0.523, 95% CI: (1.103, 1.804), (0.237, 0.361), (0.416, 0.657), all P < 0.05] as factors affecting the proportion of correct judgments of O. hupensis snails among schistosomiasis control professionals in Yunnan Province, and multivariate logistic regression analysis after adjustments showed that the proportion of O. hupensis snail misjudgments was 1.179 times higher among male schistosomiasis control professionals than among females [OR = 1.179, 95% CI: (1.006, 1.382), P < 0.05], and 1.474 times higher among schistosomiasis control professionals in schistosomiasis-elimination areas with snails than in areas without snails [OR = 1.474, 95% CI: (1.145, 1.898), P < 0.05], and the proportions of missed judgments of O. hupensis snails were 0.284 [OR = 0.284, 95% CI: (0.225, 0.359), P < 0.05] and 0.523 times [OR = 0.523, 95% CI: (0.412, 0.664), P < 0.05] higher among schistosomiasis control professionals in transmission-interruption areas with snails and schistosomiasis-elimination areas with snails than in schistosomiasis-elimination areas without snails. Univariate logistic regression analysis of field blind tests showed age [OR = 2.381, 95% CI: (1.677, 3.381), P < 0.05], professional title [OR = 1.688, 95% CI: (1.103, 2.582), P < 0.05］, working duration [OR = 0.970, 95% CI: (0.956, 0.984), P < 0.05] and classification of schistosomiasis epidemics in endemic foci [OR = 0.262, 0.593, 95% CI: (0.188, 0.364), (0.420, 0.837), both P < 0.05] as factors affecting the proportion of correct judgments of O. hupensis snails among schistosomiasis control professionals in Yunnan Province, and multivariate logistic regression analysis after adjustments showed the proportions of missed judgments of O. hupensis snails were 0.263 [OR = 0.263, 95% CI: (0.176, 0.394), P < 0.05] and 0.604 times [OR = 0.604, 95% CI: (0.416, 0.875), P < 0.05] higher among schistosomiasis control professionals in transmission-interruption areas with snails and schistosomiasis-elimination areas with snails than in schistosomiasis-elimination areas without snails. Conclusions Schistosomiasis control professionals in Yunnan Province have a low accuracy rate for distinguishing between the morphology of O. hupensis and Tricula snails, and gender and classification of schistosomiasis epidemics in endemic foci are factors that affect their ability to distinguish. The presence of Tricula snails causes a high degree of interference with O. hupensis surveys in O. hupensis snail-infested areas of Yunnan Province. Reinforced training for distinguishing between O. hupensis and Tricula snails is required among schistosomiasis control professionals in Yunnan Province.

Objective:To summarize the successful diagnosis and treatment experience of two patients with peritoneal dialysis complicated with cholangiolithiasis and cholangitis who received endoscopic retrograde cholangiopancreatography (ERCP).Methods:A retrospective analysis was conducted on the clinical data of two patients with peritoneal dialysis combined with bile duct stones at Peking University Third Hospital who underwent ERCP combined with endoscopic sphincterotomy and were successfully transferred out of the hospital. Observe successful removal of bile duct stones and adverse events related to surgery, such as pancreatitis, summarize experience, and conduct literature review.Result:The overall success rate of stone removal in 2 patients was 100%, and they recovered well after treatment without severe postoperative bleeding. One patient developed postoperative pancreatitis and secondary peritonitis after ECRP, and active anti infection treatment did not affect peritoneal function. Regular peritoneal dialysis was maintained during the perioperative period, and postoperative close follow-up and flexible adjustment of peritoneal dialysis dose and concentration were carried out to ensure a smooth transition of patients to regular and stable peritoneal dialysis.Conclusion:ERCP is a feasible treatment for PD patients combined with choledocholithiasis, and can be well tolerated by them. The treatment of peritoneal dialysis patients requires long-term follow-up and management, and multidisciplinary cooperation is required when acute complications occur.

Objective:To explore the clinical and molecular basis for a Chinese pedigree affected with Complete androgen insensitivity syndrome (CAIS).Methods:A CAIS pedigree presented at Tianjin Medical University General Hospital between 2019 and 2021 was selected as the study subject. Clinical data of the proband was collected, along with peripheral blood samples from the proband and her family members. Chromosomal karyotyping, sex-determining region of the Y chromosome ( SRY) testing, and next-generation sequencing (NGS) were carried out for the proband, and candidate variant was verified by Sanger sequencing of her family members. Prenatal diagnosis was provided for the sister of the proband. This study was approved by Medical Ethics Committee of the Tianjin Medical University General Hospital (Ethics No. IRB2023-WZ-070). Results:The 18-year-old proband, who has a social gender of female, underwent laparoscopic examination, which showed no presence of uterus and ovaries. The karyotype of peripheral blood sample was 46, XY, with SRY gene detected. NGS indicated that the proband has harbored a heterozygous c. 1988C>G (p.Ser663Ter) variant of the AR gene. Sanger sequencing confirmed that her mother and sister had both harbored the same variant, whilst her father and younger sister were of the wild-type. Prenatal diagnosis revealed that her sister′s first fetus had harbored carried the same variant, which had led to termination of pregnancy. Her second fetus did not carry the variant, and a healthy boy was born. Based on guidelines from the American College of Medical Genetics and Genomics (ACMG), the variant was classified as likely pathogenic (PM2_Supporting+ PM4+ PP3_Moderate+ PP4). Conclusion:The c. 1988C>G (p.Ser663Ter) variant of the AR gene probably underlay the CAIS in the proband. The accurate diagnosis of sex development disorders will rely on the physicians′ thorough understanding of the clinical symptoms and pathogenic genes. Genetic testing and counseling can enable precise diagnosis, prenatal diagnosis, and guidance for reproduction

Objective To investigate the relationship of ELK-3 and epithelial-mesenchymal transition ( EMT) for ex-ploring its possible mechanism .Methods The human hepatocellular carcinoma cells ( HCC) were divided into small interference RNA transfection group and Ras-ELK-3 pathway inhibitor group .The protein level of ELK-3 target gene EGR-1 E-cadherin ,vimentin and p38 in HCC were determined by Western blot analysis .Results The protein level of ELK-3 and its target gene EGR-1 in treated human hepatocellular carcinoma cells significantly decreased as compared with the negative control group (P<0.01).The protein level of E-cadherin was significantly increased (P<0.01), while vimentin and p38 were decreased in HCC cells with ELK-3 interference (P<0.01).Conclusions ELK-3 in-terference can inhibit the epithelial-mesenchymal transition of HCC cells by down-regulating p38.

OBJECTIVE:To evaluate the dissolution curves similarity of generic and original preparation of Losartan potassium tablets,and to provide reference for improving quality evaluation of the preparation.METHODS:Using hydrochloric acid solution (pH 3.0),phosphate buffer solution(pH 4.5),phosphate buffer solution (pH 6.8) and water as medium,paddle method was adopted for dissolution test with dissolution medium volume of 900 mL and rotation speed of 50 r/min.UV-visible spectrophotometry was adopted to determine accumulative dissolution of generic and original preparation of Losartan potassium tablets with the detection wavelength of 256 um.The similarity of dissolution curves were evaluated by calculating similarity factor(f2).RESULTS:The linear range of losartan potassium was 12.11-35.96 μg/mL (r≥0.999 7).RSDs of precision,stability and reproducibility tests were all lower than 5.0％.The recoveries of 4 dissolution media were 98.66％-100.84％ (RSD=0.77％,n=9),98.91％-100.59％ (RSD=0.49％,n=9),98.33％-101.39％ (RSD=0.85％,n=9),99.46％-101.32％ (RSD=0.55％,n=9).In 4 dissolution media,f2 of the dissolution curves of 3 batches of generic and original preparation of Losartan potassium tablets were all higher than 70.CONCLUSIONS:The dissolution curves of self-made and original preparation of Losartan potassium tablets show good similarity.

OBJECTIVE:To establish a method for the simultaneous determination of paeoniflorin,cinnamaldehyde,psoralen and isopsoralen in Yaotong capsules.METHODS:HPLC method was adopted.The determination was performed on Agilent-C18 column with mobile phase consisted of acetonitrile-water (gradient elution) at the flow rate of 1.0 mL/min.The detection wavelengths were set at 240 nm (paeoniflorin,psoralen,isopsoralen) and 290 nm (cinnamaldehyde).The column temperature was 35 ℃,and sample size was 10 μL.RESULTS:The linear ranges of paeoniflorin,cinnamaldehyde,psoralen and isopsoralen were 0.004 02-0.100 6 mg/mL(r=0.999 8),0.024 50-0.612 7 mg/mL(r=0.999 8),0.005 24-0.131 0 mg/mL(r=0.999 9),0.005 11-0.127 8 mg/mL(r=0.999 9),respectively.LOQ were 37.17,1.47,21.76,25.57 ng,respectively;LOD were 11.15,0.44,6.53,7.67 ng,respectively.RSDs of precision,stability and reproducibility tests were all lower than 2.0％.The recoveries were 99.02％-100.83％ (RSD=0.68％,n=6),98.58％-100.99％ (RSD=0.83％,n=6),99.78％-101.69％ (RSD=0.89％,n=6),100.06％-102.46％ (RSD=0.92％,n=6),respectively.CONCLUSIONS:The method is simple,accurate and suitable for simultaneous determination of paeoniflorin,cinnamaldehyde,psoralen and isopsoralen in Yaotong capsules.

[Abstra ct] Objective To investigate the long-term efficacy and adverse effects of intensity-modulated radiotherapy (IMRT) for nasopharyngeal carcinoma (NPC).Methods A total of 869 patients with biopsy-proven NPC without distant metastasis who underwent the whole course of IMRT from 2009 to 2010 were enrolled.Of all the patients, 84.8%received cisplatin-based chemotherapy.The prescribed dose to the primary lesion in the nasopharynx was 66-70Gy in 30-32 fractions, and the dose to the positive lymph nodes in the neck was 66 Gy in 30-32 fractions.The Kaplan-Meier method was used to calculate survival rates, the log-rank test was used for difference analysis and univariate prognostic analysis , and the Cox proportional hazards model was used for multivariate prognostic analysis .Rseu lts The 5-year overall survival( OS ) , local recurrence-free survival, regional recurrence-free survival, distant metastasis-free survival, and disease-free survival ( DFS ) were 84.0%, 89.7%, 94.5%, 85.6%, and 76.3%, respectively.In the patients with locally advanced NPC,concurrent chemotherapy tended to reduce distant metastasis (83.6%vs.75.7%, P=0.050) and improve OS (82.6%vs.77.0 %, P=0.082).Induction chemotherapy tended to improve OS ( 80.7% vs.71.4%, P=0.057 ) , and the induction chemotherapy containing docetaxel or gemcitabine tended to improve OS (83.3%vs.72.2%, P=0.058).The patients who received a boost after the initial radiotherapy had a significantly lower DFS rate than those who did not (52.2%vs.71.1%, P=0.004).The concurrent chemotherapy increased the incidence rates of long-term xerostomia and trismus, while a high dose of cisplatin increased the incidence rates of xerostomia and hearing impairment.Conclusions IMRT for NPC provides satisfactory long-term efficacy.Concurrent chemotherapy combined with IMRT tends to reduce the incidence of distant metastasis, and other values need further investigation.The boost therapy after radiotherapy may be associated with poor prognosis.Chemotherapy increases the incidence of long-term toxicities.

Objective To translate questionnaire for urinary incontinence diagnosis (QUID) into Chinese and to test its reliability and validity. Methods The English version of QUID was translated into Chinese. The clinaical data of 95 patinents with urinary incontinence who were test by urinary dynamic study in Peking Union Medical College Hospital from May 2014 to May 2015 were analyzed prospectively. The reliability of QUID was evaluated by completing QUID twice. The validity of QUID was evaluated by the standard of urinary dynamic study. Results Internal consistency (Cronbach α) of the items that pertained to stress urinary incontinence (SUI) and to urge urinary incontinence (UUI) were 0.91 and 0.89, respectively. Test-retest reliability (Kappa) was 0.795 and criterion validity (Kappa) was 0.62. Sensitivity and specificity were 83%(43/52) and 86%(37/43), respectively, for SUI, and 72%(13/18) and 86%(66/77), respectively, for UUI. Conclusions QUID has good reliability and validity. It could be used in Chinese urinary incontinence women.

OBJECTIVETo examine the proportion and reasons of drop-out from antiretroviral therapy (ART) among 8 367 adult HIV-infected individuals in Dehong prefecture, Yunnan province.

METHODSAll adult HIV-infected patients receiving ART before September 30 of 2014 were examined for the situation of drop-out from ART.

RESULTSThe proportion of drop-out from ART among adult HIV-infected patients in Dehong prefecture was 14.4% (1 202/8 367). Results from the univariate logistic regression analyses indicated that drop-out from ART was significantly correlated with factors as: living area, gender, age, marital status, HIV transmission route, baseline CD4⁺ T cell counts and initial treatment regimen of the patients. After adjusted for potential confounding variables by multiple logistic regression model, drop-out from ART was significantly correlated with residential area, marital status, HIV transmission route, baseline CD4⁺ T cell count and initial treatment regimen of the patients. HIV-infected patients who were living in Mangshi city, Lianghe county or Yingjiang County, being married or living with partner, HIV infection through sexual contact, with baseline CD4⁺ T cell counts ≤ 200 cells/mm³, and ART included in the initial treatment regimen etc., were less likely to drop out from ART. The proportion of drop out from ART was significantly decreasing along with the increasing time of ART. Data from specific investigation revealed that among the 1 202 patients who dropped out from ART, 704 (58.6%) were lost to follow-up, 303 (25.2%) did not adhere to treatment, 74 (6.2%) moved out the region, 64 (5.3%) were Burmese that had returned to Burma, 29 (2.4%) stopped the treatment according to doctors' advice, 18 (1.5%) were incarcerated and 10 (0.8%) were under other reasons. Reasons for the drop-out varied, according to the situation of patients.

CONCLUSIONThe proportion of drop-out from ART varied significantly according to the characteristics of HIV-infected patients in Dehong prefecture that underscoring the needs for tailored responses to reduce drop-out of ART. Focus should be targeted on reducing the loss to follow-up and improving the treatment adherence.

Objective To investigate the change of serum CA724, CA242 and AFP levels before and after transcatheter artery chemoembolization (TACE) treatment of primary hepatic carcinoma(PHC)patients as well as its clinic significance. Methods Patients of PHC (n=45) and healthy adults (n=40) were enrolled. Serum samples were collected from each healthy people and PHC patients 2 days before TACE,l week and 1 month after TACE. Electrochemiluminescence Immunoassay (ECLI) was used to determine serum CA724, CA242 and AFP levels, and correlations among three indexes as well as their relationships with clinical data were also analysed., Change of serum CA724 and CA242 levels before and after TACE were compared in AFP<400μg/L group and AFP≥400μg/L group. Results Serum levels of CA724, CA242 and AFP in PHC group were significantly higher than that in healthy control groups before TACE therapy(P<0.05). Positive rates of serum CA724 and AFP were higher in PHC group(P<0.01)than that in healthy control group. AFP decreased significantly at both 1 week and 1 month upon TACE treatment compared with that at before teratment(P<0.01). CA724 was significantly lower at one month after treatment than that at before treatment(P<0.05). But there was no significant difference in CA242 before and after treatment(P>0.05). CA724 and AFP expressions are associated with tumor size(P<0.05). After one month of therapy, serum CA724 level was obviously decreased in both AFP<400μg/L and AFP≥400μg/L groups. Before and after TACE therapy, there was a positive correlation between the expression of AFP and CA724(r=0.754,P<0.05). Conclusion Serum CA724 can be used as one of the tumor markers to assist the evaluation of curative effect of TACE on PHC.