ObjectiveTo analyze the epidemiological characteristics and influencing factors of clustered influenza-like illness (ILI) outbreaks in Yangpu District, Shanghai from 2012 to 2022, and to provide a scientific basis for formulating specific prevention and control measures of influenza in this district. MethodsData on clustered ILI outbreaks from 2012 to 2022 were collected, and the epidemiological pattern of the cluster outbreaks of influenza and its influencing factors of prevalence and duration were explored using statistical methods such as descriptive epidemiology, χ² test and logistic regression analysis. ResultsA total of 60 clustered ILI outbreaks were reported in Yangpu District, Shanghai from 2012 to 2022, with a cumulative number of 543 cases and an annual average incidence rate of 16.96%. The male-to-female ratio was1.06∶1. The largest number of ILI were reported in 2019, mainly from November to January of the next year, with December being the peak of outbreaks. The Streets of Changhai Rd. in Yangpu District had the largest number of reported outbreaks, accounting for 30.00% of the total outbreaks. Influenza cluster outbreaks occurred in schools, with the majority of outbreaks and cases reported in primary schools (accounting for 65.00% and 62.06% of the total, respectively). The outbreaks were mainly caused by influenza B virus, accounting for 50% of the total number of outbreaks. The prevalence rate of influenza cluster outbreaks varied among different schools in terms of their affiliated streets, school attributes and school types, with those in Kongjiang Rd. Subdistrict, private schools, and childcare institutions being relatively high. The duration of outbreaks reported for >2 days was longer than those reported for ≤2 days (OR=8.604, 95%CI: 1.509–49.067). ConclusionThe ILI outbreaks in Yangpu District present a seasonal pattern, with primary schools and Changhai Rd. Street as the targeted places for implementing prevention and control measures. Timely detection and reporting and active disposal can prevent a further spread of the outbreaks.

This article reports a case with the chief complaint of “hepatosplenomegaly to be investigated” and a confirmed diagnosis of Niemann-Pick disease type B after various tests， and a literature review was conducted to summarize the heterogeneous manifestations of liver involvement in type B Niemann-Pick disease， in order to improve the clinical management of difficult and rare liver diseases.

Objective:To observe the utility of event-related potential P300 in diagnosing post-stroke cognitive impairment.Methods:Forty-nine stroke survivors at high risk of cognitive impairment formed the observation group, while 54 healthy volunteers were the control group. General clinical data and Montreal Cognitive Assessment Scale (MoCA) scores were compiled for all of the subjects, and the two groups′ P300 latencies, amplitudes and mean reaction times (MRTs) were compared. A total MoCA score <26 (corrected for education level) was taken as the diagnostic criterion for cognitive impairment. The receiver operating characteristics (ROC) curve was employed to analyze the diagnostic efficacy of P300 for post-stroke cognitive impairment and determine the diagnostic cutoff.Results:(1) The average MoCA score, P300 latency and P300 MRT of the observation group were all significantly different from the control group′s averages. There was, however, no significant difference between the two groups′ median P300 amplitudes. (2) According to the ROC curve analysis, the diagnostic limit of P300 latency was 376.50ms. With the area under the curve 0.795, sensitivity was 70.8% and specificity was 78.9%. The diagnosis cut-off value of P300 MRT was 423.35ms, with the area under the curve 0.695, giving a sensitivity of 80.0% and a specificity of 52.6%.Conclusions:Event-related potential P300 has useful efficacy in diagnosing post-stroke cognitive impairment.

Objective To investigate the value of age and D-dimer (D-D) combined with Model for End-Stage Liver Disease (MELD) score in predicting the prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF). Methods A total of 111 patients with HBV-ACLF who were hospitalized in The First Affiliated Hospital of Zhengzhou University from December 2019 to October 2021 were enrolled, and according to their prognosis on day 90 after confirmed diagnosis, they were divided into survival group with 49 patients and death group with 62 patients. Related clinical data were collected, including age, sex, underlying liver diseases, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), Albumin (Alb), D-D, prothrombin time (PT), plasma fibrinogen (FIB), prothrombin activity (PTA), international normalized ratio (INR), serum creatinine (SCr), and serum sodium (Na), and MELD score was calculated. Immunoturbidimetric assay was used to measure the plasma level of D-D. The t -test or the Mann-Whitney U test was used for comparison of continuous data between the two groups, and the chi-square test was used for comparison of categorical data between the two groups; a binary Logistic regression analysis was used to investigate the independent risk factors for the prognosis of patients, and the receiver operating characteristic (ROC) curve was used to predict the accuracy of variables. Results There were significant differences between the two groups in age, TBil, D-D, PT, PTA, INR, SCr, Na, and MELD score (all P < 0.05). The binary Logistic regression analysis showed that age (odds ratio [ OR ]=1.088, 95% confidence interval [ CI ]: 1.001-1.183, P =0.047), D-D ( OR =1.521, 95% CI : 1.078-2.145, P =0.017), and MELD score ( OR =1.892, 95% CI : 1.408-2.543, P < 0.001) were independent risk factors for the prognosis of HBV-ACLF patients. Age, MELD score and D-D had an area under the ROC curve (AUC) of 0.664, 0.869, and 0.887, respectively, in predicting the prognosis of HBV-ACLF, while D-D combined with age, age combined with MELD score, D-D combined with MELD score, and the combination of these three indicators had an AUC of 0.895, 0.906, 0.965, and 0.970, respectively. A combination of the three indices had a significantly increased AUC compared with other indices except D-D combined with MELD score. and the combination of these three indicators had relatively high sensitivity (0.935) and specificity (0.918). Conclusion Age, D-D, and MRLD score are independent risk factors for the prognosis of HBV-ACLF, among which D-D and MELD score have a good value in predicting prognosis, and the combination of these three indicators has a significantly better predictive value.

Objective To investigate the value of international standardized ratio-to-platelet ratio (INPR) versus aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis-4 (FIB-4) in the diagnosis of liver fibrosis in patients with primary cholangitis (PBC). Methods A retrospective analysis was performed for the patients who underwent liver biopsy and were diagnosed with PBC in The First Affiliated Hospital of Zhengzhou University from October 2013 to March 2021. Scheuer score was used to systematically evaluate the degree of liver fibrosis (S0-S4 stage). According to the results of liver biopsy, the degree of liver fibrosis was classified as significant liver fibrosis (≥S2), progressive liver fibrosis (≥S3), and liver cirrhosis (S4). Related data including general information, liver function, routine blood test results, and blood coagulation were collected, and related formulas were used to calculate the values of the noninvasive serological models INPR, APRI, and FIB-4. The Kruskal-Wallis H test was used for comparison of continuous data between multiple groups, and the chi-square test was used for comparison of categorical data between multiple groups. A Spearman correlation analysis was used to evaluate the correlation between noninvasive models and liver fibrosis stage. The receiver operating characteristic (ROC) curve was used to evaluate the efficacy of the noninvasive serological models in the diagnosis of liver fibrosis degree, and the DeLong method was used for comparison of the area under the ROC curve (AUC). Results A total of 143 patients with PBC were enrolled in the study, among whom 4 had stage S0 liver fibrosis, 50 had stage S1 liver fibrosis, 46 had stage S2 liver fibrosis, 26 had stage S3 liver fibrosis, and 17 had stage S4 liver fibrosis. There was a significant difference in INPR value between the PBC patients with different liver fibrosis degrees ( χ 2 =27.347, P < 0.001). INPR value gradually increased with the aggravation of liver fibrosis degree, and INPR was positively correlated with liver fibrosis degree ( r =0.419, P < 0.01). The ROC curve analysis showed that INPR, APRI, and FIB-4 had an AUC of 0.691, 0.706, and 0.742, respectively, in the diagnosis of significant liver fibrosis (≥S2) in PBC patients, at the corresponding cut-off values of 0.63, 0.59, and 2.68, respectively. INPR, APRI, and FIB-4 had an AUC of 0.731, 0.675, and 0.756, respectively, in the diagnosis of progressive hepatic fibrosis (≥S3) in PBC patients, at the corresponding cut-off values of 0.64, 1.23, and 4.63, respectively. INPR, APRI, and FIB-4 had an AUC of 0.820, 0.786, and 0.818, respectively, in the diagnosis of liver cirrhosis (S4) in PBC patients, at the corresponding cut-off values of 0.95, 1.26, and 4.63, respectively. In the evaluation of significant liver fibrosis, progressive liver fibrosis, and liver cirrhosis, there was no significant difference in AUC between INPR and APRI/FIB-4 (all P > 0.05). Conclusion INPR is a simple and accurate noninvasive model for the evaluation of liver fibrosis and has a certain value in the diagnosis of liver fibrosis in PBC.

Objective:To explore the clinical effect of transvaginal and laparoscopic myomectomy.Methods:A total of 40 cases treated with hysteromyomectomy in Xinhua Hospital Affiliated to Dalian University and Dalian Women′s and Children′s Medical Center from Decedmber 2018 to March 2020 were selected as the research objects. According to the random number table method, they were assigned into the observation group (20 cases) and the control group (20 cases). In the observation group, hysteromyomectomy was performed via vagina, and in the control group, hysteromyomectomy was performed via laparoscope. Then the time of operation, the amount of bleeding, the recovery time of gastrointestinal function, 24 h postoperative drainage, 12 h postoperative pain and hospitalization expenses were compared between the two groups.Results:The operation of the observation group and the control group were completed as planned. The operation time, the amount of bleeding of the observation groupwere less than those of the control group: (69.75 ± 19.43) min vs. (84.50 ± 22.4) min, (119.25 ± 56.37) ml vs. (159.00 ± 63.73) ml, the differences were statistically significant ( P<0.05). The recovery time of gastrointestinal function, 24 h postoperative drainage, 12 h postoperative pain in two groups had no significant differences ( P>0.05). The hospitalization expenses in observation group was lower than that in control group: (2.27 ± 0.12) ten thousand Yuan vs. (2.66 ± 0.10) ten thousand Yuan, the difference was statistically significant ( P<0.05). Conclusions:Compared with laparoscopic myomectomy, transvaginal myomectomy has the advantages of shorter operation time, less bleeding and less hospitalization expenses.

Amyotrophic lateral sclerosis (ALS) is a rare neurodegenerative disease affecting the upper and lower motor neurons. It is characterized by progressive muscle weakness, atrophy and ultimate death due to dysphagia and dyspnea. There are many causes of ALS, among which the genetic factors show great relevance. Imbalance of protein homeostasis in neurons, prion-like proliferation and propagation of abnormal proteins, mitochondrial dysfunction, glutamate mediated excitotoxicity, and intraneuronal substance transport disorders are recognized as the pathogenesis.The study on gene mutation related to pathogenesis will bridge the molecular and cellular research of ALS, which can deepen the understanding of the occurrence and development of ALS and the role of gene mutation in ALS, and provide new ideas and enlightenment for the treatment of ALS.
Amyotrophic Lateral Sclerosis/genetics* ; Humans ; Motor Neurons ; Mutation ; Neurodegenerative Diseases ; Proteins

To explore the role of the mutations G38R and D40G of Annexin A11 (ANXA11) in the onset of amyotrophic lateral sclerosis (ALS).
 Methods: The plasmids expressing ANXA11 wild type protein, ANXA11 G38R protein and ANXA11 D40G protein were constructed, respectively. The recombinant plasmids were then transfected into HEK293 cells respectively followed by cycloheximide (CHX) treatment for 0, 2, 4 and 8 h. The protein expressions of ANXA11 wild type, ANXA11 G38R and ANXA11 D40G mutations were determined by Western blot. Gray analysis by Image J was performed to compare the half-life of each protein. The NSC-34 cell lines constantly expressing ANXA11 wild type protein, ANXA11 G38R protein and ANXA11 D40G protein were established. The cells were treated with NP-40 lysis buffer to examine the protein solubility by Western blot.
 Results: Both ANXA11 G38R protein and ANXA11 D40G protein showed a shorter half-life than ANXA11 wild type protein (P<0.05), while there was no difference between ANXA11 G38R protein and ANXA11 D40G protein (P>0.05). There was no visible insoluble substance in the NP-40 lysates for ANXA11 wild type protein, ANXA11 G38R protein and ANXA11 D40G protein.
 Conclusion: G38R and D40G mutations reduce the stability of ANXA11 protein. G38R and D40G mutations do not alter ANXA11 solubility.
Amyotrophic Lateral Sclerosis ; genetics ; metabolism ; Annexins ; chemistry ; genetics ; metabolism ; HEK293 Cells ; Humans ; Mutation ; Plasmids ; genetics ; Protein Stability ; Solubility ; Transfection

Objective To study the relationship between liver enzymes [ alanine transaminase ( ALT), gamma-glutamyltransferase ( GGT), aspartate amino transferase ( AST)] and the incidence of impaired glucose tolerance(IGT) in middle-aged and elderly people. Methods A group of middle-aged and elderly residents who participated in the REACTION study in 2011 from Guiyang community were enrolled in our study. Of which, a total of 4228 participants with normal blood glucose detected by oral glucose tolerance test (OGTT) and serum ALT levels were investigated as baseline population. The baseline survey included questionnaire survey and physical examination (height, weight, waist circumference, blood pressure, etc. ), and the serum ALT, AST, GGT, total cholesterol ( TC ), triglyceride ( TG ), high density lipoprotein-cholesterol ( HDL-C ), low density lipoprotein-cholesterol (LDL-C), fasting blood glucose, postprandial 2h plasma glucose(2hPG) in OGTT, and fasting insulin(FINS) were tested. After 3 years of follow-up, all subjects received quartile grouping according to the basal liver enzyme levels, and the incidence of IGT was respectively calculated. One-way analysis of variance was used to compare the differences of basal liver enzyme levels between IGT and normal blood glucose groups. The risk of IGT based on quartile grouping was assessed by multivariate regression analysis, and the odds ratios (ORs) were estimated by the logistic regression model. Results After eliminating the 35 died patients, 3188 participants were followed over 3 years. Among them, 2400 subjects revealed normal blood glucose level, 61 developed into type 2 diabetes mellitus(T2DM), 91 developed into IFG, and 636 developed into IGT. The incidence of IGT increased along with the elevation of serum ALT level (P<0. 01). After adjusting the risk factors including body mass index, regular smoking, regular drinking, regular exercise, family history of diabetes,homeostasis model assessment for insulin resistant index(HOMA-IR), post-load 2h blood glucose, and GGT, the results manifested that patients in high basal ALT level group had 1. 462-fold chance of susceptibility in developing IGT compared with that in the low level group, with 95％ CI of 1. 129 to 1. 891. The analysis based on gender showed that the incidence of IGT was associated with basal ALT level in the female group. The OR value was estimated to be 1. 481(95％ CI 1. 107-1. 981) in high basal ALT level group as compared with the low level group. Basal serum GGT and AST levels were not associated with the incidence of IGT. Conclusion Even an elevated level of ALT within normal reference range also tends to be a risk factor for IGT in middle-aged and elderly women.

Objective To compare the cardiac function in patients with type 2 diabetes (T2DM) and insulin resistance(IR),and analyze the correlation between IR and cardiac function.Methods A total of 282 patients with T2DM were enrolled randomly in this study from our clinic and ward from Aug.2015 to Aug.2016.All the subjects were divided into two groups according to the level of HOMA-IR:HOMA-IR ＜2.69 group(n=153) and HOMA-IR≥2.69 group(n=129).Healthy subjects were selected as the normal control group (NC group,n=150).The clinical data and biochemical index were collected in all the subjects.The cardiac function index included LVPWTd,WsTd,LVSV,LVFS and LVEF were tested and compared among the three groups.Pearson's correlation analysis was used to evaluate the correlation between HOMA-IR and cardiac function index.Multiple stepwise linear regression was adopted to analyze the influencing factors for cardiac systolic function(LVEF) and diastolic function(E/A).Results (1) FPG,2 hPG and FIns decreased,while HOMA-β increased from HOMA-IR≥ 2.69 group,HOMA-IR＜ 2.69group to NC group (P＜0.05 or P＜0.01);(2) LVPWTd [(15.43±1.92) vs (11.38±1.78) vs (10.16±1.50) mm,P＜0.05 or P＜0.01)and WSTd [(14.35±2.00) vs (10.46±1.67) vs (9.00±1.08) mm,P＜0.05 or P＜0.01)were higher in HOMA-IR≥2.69 group and HOMA-IR＜2.69 group than in NC group.LVSV[(55.15±8.26)％ vs (60.27±8.12)％ vs (65.33±7.78)％,P＜0.05 or P＜0.01],LVEF [(62.41±8.89)％ vs (71.57±5.16)％ vs (76.35±7.80)％,P＜0.05 or P＜0.01],and E/A[(0.65±0.11) vs (0.76±0.18) vs (1.03±0.23),P＜0.05 or P＜0.01] were lower in HOMA-IR≥2.69 group and HOMA-IR＜2.69 group than in NC group.(3)Pearson correlation analysis showed that HOMA-IR was negatively correlated with LVEF and E/A(r=-0.746,-0.729,P=0.001).(4) Multiple stepwise linear regression analysis showed that HOMA-IR was an influencing factor for LVEF and E/A(P＜0.05 or P＜0.01).Conclusion With the aggravating of IR,LVEF and E/A are declined in diabetic patients.IR is a common risk factor for LVEF and E/A.