Objective: To investigate the awareness of hepatitis C prevention and control knowledge and its influencing factors among female sex workers (FSWs) in Jiaxing City, Zhejiang Province. Methods: According to the HIV/AIDS Sentinel Surveillance Plan, FSWs at ages of 15 to 65 years monitored by the national AIDS surveillance sentinel in Jiaxing City were recruited, and demographic information, awareness of hepatitis C prevention and control knowledge and related behaviors were collected by questionnaire surveys. Factors affecting the awareness of hepatitis C prevention and control knowledge were identified by a multivariable logistic regression model. Results: A total of 430 questionnaires were allocated, and 412 were valid, with an effective rate of 95.81%. The respondents had a mean age of (28.58±4.93) years, and included 258 unmarried FSWs (62.62%), 344 with registered residence outside Zhejiang Province (83.50%), 212 with junior high school education or below (51.46%) and 243 from high-end entertainment places (58.98%). The overall awareness of hepatitis C prevention and control knowledge among FSWs was 20.39%, and the awareness of "Transfusion of blood containing hepatitis C virus may acquire hepatitis C" (38.83%) and the awareness of "tattooing, eyebrow tattooing and ear piercing in streets or small shops may infect hepatitis C" (38.11%) were relatively low. Multivariable logistic regression analysis identified marital status (divorced or widowed, OR=0.161, 95%CI: 0.054-0.482), educational level (high school or technical secondary school, OR=2.568, 95%CI: 1.446-4.560; junior college or above, OR=6.110, 95%CI: 2.658 -14.045) and grade of entertainment places (high-end entertainment places, OR=2.756, 95%CI: 1.525-4.982) as factors affecting the awareness of hepatitis C prevention and control knowledge among FSWs. Conclusion FSWs in Jiaxing City have a low awareness of hepatitis C prevention and control knowledge, especially lacking of knowledge about the transmission routes and prognosis of hepatitis C.

Objective To investigate the clinical features and genetic characteristics of patients with late-onset Pompe disease(LOPD).Methods A total of 13 patients diagnosed with LOPD in the First Affilia-ted Hospital of Zhejiang University School of Medicine from September 2020 to December 2023 were selected,and all patients were subjected to clinical investigation,GAA activity detection and GAA gene testing.Results Among the 13 patients,7 were males and 6 were females;5 were family patients and 8 were sporadic patients;and the median age of onset was 17 years(8-52 years),the median age of presentation was 24 years(10-52 years),and the median age of diagnosis was 31 years(14-58 years).In terms of the first symptoms,10 pa-tients presented with limb weakness and 3 patients presented with dyspnea.The average serum creatine kinase level was 552 U/L(55-1084 U/L),and the serum creatine kinase level was normal in one patient.All pa-tients had scoliosis and different degrees of restrictive ventilatory dysfunction.Neuroelectrophysiological exami-nations of 9 patients showed myogenic damage,and 8 of them had muscle tonic discharge.The mean value of GAA activity was 0.3 μmol/(L·h)[0.17-0.5 μmol/(L·h)].A total of 13 mutations were detected in GAA gene,and the most common mutation was c.2238G＞C(p.W746C).There were five new variant sites:c.543del(p.F181Lfs*40),c.839_840insCC(p.R281Pfs*34),c.1800_1823del(p.S601_R608del),c.2296T＞C(p.Y766H)and c.995C＞A(p.S332*).Conclusions LOPD is a rare disease that tends to delay diagnosis.Proximal limb weakness,decreased respiratory function,mild-to-moderate elevation of creatine kinase,scoliosis,and clinical inferior tonic discharge on electromyography are high-risk images of LOPD.c.2238G＞C(p.W746C)is a hotspot mutation,and the discovery of five new mutations enriches the GAA gene mutations lineage.

Objective To explore the relationship between the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase p22phox subunit C242T gene polymorphism and large artery atherosclerotic cerebral infaretion(LAACI) among Han population in Songjiang district of Shanghai city.Methods The polymerase chain reaction-restrictive fragment length polymorphism analysis and gene sequencing techniques were adopted to conduct the gene type and allele frequency detection of C242T gene polymorphism loci in 310 Han patients with LAACI and 330 healthy individuals as control group in Shanghai Songjiang area.Then the correlation between C242T gene polymorphism and LAACI was analyzed.Results The level of MDA and the activity of NADPH oxidase in the LAACI group were significantly higher than those in the control group (P＜0.05).The smoking rate,alcohol drinking rate,hypertension rate,systolic pressure,diastolic pressure,and levels of blood glucose,TC,TG,LDL,ox-HDL and ox-LDL in the LAACI group were higher than those in the control group (P＜0.05),while the HDL level in LAACI group was lower than that in the control group (P＜0.05).The frequencies of CT+TT genetype and T allelic gene in the LAACI group were much higher than those in the control group (P＜0.05);the Logistic regression analysis found that smoking,hypertension,systolic pressure,diastolic pressure,blood glucose level,Lp (a),ox-HDL level,MDA level,NADPH oxiolase activity and NADPH C242T genotype were independent risk factors for LAACI.Conclusion NADPH oxidase P22phox C242T gene polymorphism has a correlation with LAACI and is another independent risk factor for LAACI except for hypertension,smoking and lipid oxidation.

Objective: To evaluate the efficacy and safety of maintenance therapy with reduced dose of rhTPO in the patients with primary immune thrombocytopenia (ITP) who attained stable platelet (PLT) counts after daily administration of rhTPO. Methods: Treatment was started with a daily administration of rhTPO (300 U/kg) for 2 consecutive weeks. Patients who attained stable PLT≥50×10⁹/L were enrolled to maintenance therapy starting with every other day administration of rhTPO, then adjusted dose interval to maintain platelet count (30-100) ×10⁹/L. Results: A total of 91 eligible patients were enrolled. Fourteen patients discontinued the study due to noncompliance (12/14) and investigator decision (2/14) . Among 77 patients who completed the study, 38 patients with the administration of rhTPO at every other day or less could maintain PLT≥30×10⁹/L for 12 weeks. The percentage of patients with a platelet response (PLT≥30×10⁹/L) at 4^th week, 8^th week and 12^th week of maintain therapy was 92.6% (63/68) , 82.7% (43/52) and 85.0% (34/40) , respectively. Median platelet counts remained in the range of (70-124) ×10⁹/L. The overall incidence of rhTPO-related adverse events was 7.7%. All the adverse events were generally mild. Conclusion Extending the dose interval of rhTPO is feasible to maintain stable platelet count in the patients with ITP, but the optimal dose interval is uncertain and might vary with individuals.

Objective: To evaluate the influence of oral hygiene on risk of oral cancer in non-smoking and non-drinking women. Methods: From September 2010 to February 2016, 242 non-smoking and non-drinking female patients with pathologically confirmed oral cancer were recruited in a hospital of Fuzhou, and another 856 non-smoking and non-drinking healthy women from health examination center in the same hospital were selected as control group. Five oral hygiene related variables including the frequency of teeth brushing, number of teeth lost, poor prosthesis, regular dental visits and recurrent dental ulceration were used to develop oral hygiene index model. Unconditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95%CI). The area under the receiver operating characteristic curve (AUROC) was used to evaluate the predictability of the oral hygiene index model. Multivariate logistic regression model was used to analyze the association between oral hygiene index and the incidence of oral cancer. Results: Teeth brushing <2 twice daily, teeth lost ≥5, poor prosthesis, no regular dental visits, recurrent dental ulceration were risk factors for the incidence of oral cancer in non-smoking and non-drinking women, the corresponding OR (95%CI) were 1.50 (1.08-2.09), 1.81 (1.15-2.85), 1.51 (1.03-2.23), 1.73 (1.15-2.59), 7.30 (4.00-13.30), respectively. The AUROC of the oral hygiene index model was 0.705 9, indicating a high predictability. Multivariate logistic regression showed that the oral hygiene index was associated with risk of oral cancer. The higher the score, the higher risk was observed. The corresponding OR (95%CI) of oral hygiene index scores (score 1, score 2, score 3, score 4-5) were 2.51 (0.84-7.53), 4.68 (1.59-13.71), 6.47 (2.18-19.25), 15.29 (5.08-45.99), respectively. Conclusion Oral hygiene could influence the incidence of oral cancer in non-smoking and non-drinking women, and oral hygiene index has a certain significance in assessing the combined effects of oral hygiene.

Objective: To investigate the effects between fish, seafood and pickled food intakes on oral squamous cell carcinoma (OSCC). Methods: A case-control study was carried out in Fujian area during September 2010 to December 2016, in which 604 newly diagnosed primary OSCC cases confirmed by pathological diagnosis were collected from hospital and 1 343 control subjects were enrolled from community and healthy hospital population. Demographic data, history of smoking drinking and tea drinking, oral hygiene status and dietary behaviors (fish, seafood and pickled food intakes) were collected by in-person interviews using a standard questionnaire.Using unconditional logistic regression to estimate adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) to assess the effects of fish, seafood and pickled food intakes on OSCC. Analysis stratified by smoking, alcohol drinking and bad prosthesis to explore the possible difference in association between subgroups. Multiplicative interactions and additive interactions between fish and bad prosthesis, seafood and alcohol drinking, pickled food and bad prosthesis were assessed by unconditional logistic regression, relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S). Results: The average age of case group and control group were separately (58.69±13.92) years old and (59.27±11.37) years old (χ²=4.75, P=0.191). The people whose fish and seafood intakes ≥3 times/week had the lower risk of OSCC, the adjusted OR (95%CI) values were 0.63 (0.52-0.77) and 0.51 (0.41-0.64); The stratified analysis indicated that the people having bad prosthesis had the lower risk of OSCC if they eating fish ≥3 times/week, and the adjusted OR (95%CI) values was 0.53 (0.39-0.71); the people having bad prosthesis had the higher risk of OSCC if they eating pickled food ≥3 times/week, the adjusted OR (95%CI) values was 1.37 (1.02-1.88). Regularly eating seafood can decrease the risk of OSCC for non-smokers, smokers, non-drinkers, drinkers, people without bad prosthesis and had bad prosthesis, the adjusted OR (95%CI) values were 0.49 (0.36-0.68), 0.52 (0.37-0.73), 0.41 (0.31-0.55), 0.77 (0.51-0.96), 0.49 (0.36-0.67), 0.59 (0.42-0.83). Crossover analysis showed fish and bad prosthesis exist multiplication interaction relationship (adjusted OR=0.66, 95%CI: 0.44-0.97) and additional interaction relationship (RERI=-0.81, 95%CI:-1.43--0.19; AP=-0.76, 95%CI:-1.35--0.17; S=0.08, 95%CI: 0.01-0.98); pickled food and bad prosthesis exist multiplication interaction relationship (adjusted OR=1.63, 95%CI: 1.06-2.51) and addition interaction relationship (RERI=0.65, 95%CI:0.08-1.22; AP=0.36, 95%CI:0.10-0.62; S=5.19, 95%CI:1.32-54.49). Conclusion Reducing the consumption of pickled food, quitting smoking and limiting alcohol consumption, and regularly eating fish and seafood can prevent the occurrence of OSCC.

Objective: To investigate the efficacy and safety of IA regimen which contains idarubicin (IDA) 8 mg/m², 10 mg/m² or 12 mg/m² as induction chemotherapy for adult patients with de-novo acute myeloid leukemia (AML) . Methods: A total of 1 215 newly diagnosed adult AML patients, ranging from May 2011 to March 2015 in the First Affiliated Hospital of Soochow University and other 36 clinical blood centers in China were enrolled in the multicenter, single-blind, non-randomized, clinical controlled study. To compare the response rate of complete remission (CR) , adverse events between different dose idarubicin combined with cytarabine (100 mg/m²) as induction chemotherapy in newly diagnosed patients of adult AML. Results: Of 1 207 evaluable AML patients were assigned to this analysis of CR rate. The CR rates of IDA 8 mg/m² group, IDA 10 mg/m² group and IDA 12 mg/m² group were 73.6% (215/292) , 84.1% (662/787) and 86.7% (111/128) , respectively (P<0.001) . After adjusted for age, blast ratio of bone marrow, FAB classification and risk stratification, the odds ratios (95% CI) of IDA 10 mg/m² group and IDA 12 mg/m² group were 0.49 (0.34-0.70) and 0.36 (0.18-0.71) , as compared with the IDA 8 mg/m² group (P<0.001, P=0.003) . In the intermediate and favorable groups, CR rates was 76.5% (163/213) , 86.9% (506/582) and 86.1% (68/79) in different doses of IDA (P=0.007) . Interestingly, IA regimen with IDA 10 mg/m² was the only beneficial factor affecting CR in this group after adjusted for age, blast ratio of bone marrow and FAB classification[OR=0.47 (95% CI 0.31-0.71) , P<0.001]. CR rates in adverse group was 50.0% (18/36) , 60.6% (43/71) and 81.8% (18/22) respectively (P=0.089) . However, the odds ratios (95% CI) of IDA 12 mg/m² when compared with the IDA 8 mg/m² was 0.22 (0.06-0.80) , after adjusted for age, blast ratio of bone marrow and FAB classification. The median time (days) of neutrophil count less than 0.5×10⁹/L in IDA 8 mg/m² group, IDA 10 mg/m² group and IDA 12 mg/m² group were 14 (11-18) , 15 (11-20) and 18 (14-22) , respectively (P=0.012) and of platelet count lower than 20×10⁹/L were 14 (7-17) , 15 (11-20) and 17 (15-21) , respectively (P=0.001) . The incidences of lung infection in the three groups were 9.8%, 13.5% and 25.2%, respectively (P<0.001) . Conclusions For young adult patients (aged 18-60 years) with AML in China, intensifying induction therapy with idarubicin 10 mg/m² is clinically superior to IDA 8 mg/m² and IDA 12 mg/m² in favorable intermediate AML subgroup. However, idarubicin 12 mg/m² is more suitable to adverse AML subgroup.

Objective To investigate the effects of hydrochloride fasudil on inflammation and secondary brain injury in rats after intracerebral hemorrhage (ICH).Methods One hundred and seventeen male Wistar rats were randomly divided into normal group (n=9),sham-operated group (n=36),ICH group (n=36) and hydrochloride fasudil treatment group (ICH/HF,n=36).ICH was caused by injecting non-anticoagulant autologous arterial blood into the right caudate nucleus,3 mg HF was dissolved in 2 mL 0.9％ saline solution and administrated intraperitioneally once daily (12 mg/kg/d) since 12 h ofICH onset.Rats in the sham-operated group and ICH group received an equal volume of normal saline.On one,3,7 and 14 d ofICH induction,Bederson method was used to score neurological deficits in rats;interleukin (IL)-6 and tumor necrosis factor (TNF)-α levels in serum were detected by enzyme-linked immunosorbent assay (ELISA).Brain edema was measured by comparing wet and dry brain weights.Inflammatory cell infiltration around the hematoma was visualized using hematoxylin and eosin,and changes in neuronal morphology were detected by Nissl staining.Immunohistochemistry method was used to detect the expressions of Caspase-3 and Bcl-2.Results (1) The neurological deficit scale scores on one and 3 d ofICH in the ICH/HF group were significantly decreased as compared with those in the ICH group (P＜0.05).(2) Serum IL-6 (except 14 d of ICH) and TNF-α levels in ICH/HF group were significantly decreased as compared with those in the ICH group (P＜0.05).(3) Brain water contents at each time point in ICH/HF group were significantly decreased as compared with those in the ICH group (P＜0.05).(4) HE staining showed the sizes of hematoma on one and 3 d ofICH in the ICH/HF group and ICH group were consistent;but ICH/HF group had smaller hematomas on 7 d of ICH,and disappeared hematoma and glial cell hyperplasia on 14 d of ICH.Mass neutrophils infiltration developed in the perihematomal areas of the ICH and ICH/HF groups;however,neutrophils infiltration in the ICH/HF group ([20.56±6.37] cells/field) was significantly decreased as compared with that in the ICH group ([41.50±8.91] cells/field) on one d of ICH (P＜0.05).(5) Nissl staining showed neuron death and loss in the perihematomal areas on one,3 and 7 d of ICH in the ICH group;but ICH/HF group had significantly increased neuron number as compared with the ICH group (P＜0.05).(6) The Caspase-3 expression on 3 and 7 d ofICH in the ICH/HF group was significantly decreased as compared with that in the ICH group (P＜0.05);the Bcl-2 expressions at each time point in the ICH/HF group was significantly increased as compared with that in the ICH group (P＜0.05).Conclusion HF exerts neuroprotective effects in ICH rat models by decreasing serum IL-6 and TNF-α levels,reducing neutrophils infiltration and neuronal necrosis around the hematoma,restraining the cell apoptosis through down-regulating Caspase-3 and up-regulating expression of Bcl-2,alleviating the brain edema,and improving the neurological outcome.

Objective To explore the relations ofnicotinamide adenine dinucleotide phosphate (NAD [P]H) oxidase p22phox C242T gene polymorphism with hyperlipidemia and cerebral infarction.Methods A case-control association study containing 207 hyperlipidemia patients (collected from Physical Examination Center from March 2014 to March 2015),185 cerebral infarction patients (collected from Department of Neurology from March 2014 to March 2015) and 183 controls (collected from Physical Examination Center from March 2014 to March 2015) was carried out.The genetypes and allele frequency were compared;the clinical data,lipoprotein oxidation level and NAD (P)H oxidase activity were performed correlation analysis between different patient groups and different genetypes.Results There were no differences in low-density lipoprotein (LDL),oxidized LDL and malondialdehyde levels,NAD (P)H oxidase activity,and frequencies of CT+TT genotype and T allelic gene between patients with hyperlipidemia and controls (P＞0.05).Group of cerebral infarction had significantly higher serum levels of oxidized high-density lipoprotein (HDL) and malondialdehyde,and NAD(P)H oxidase activity than the controls (P＜0.05);the frequencies of CT+TT genotype and T allelic gene in patients with cerebral infarction were significantly higher than those in the controls (P＜0.05).There was no difference between CC genotype patients and CT+TT genotype patients in the serum levels of triglyceride,cholesterol and HDL (P＞0.05),but CC genotype patients had significantly higher serum levels of oxidized HDL,oxidized LDL and malondialdehyde,and NADPH oxidase activity than CT+TT genetype patients (P＜0.05).Logistic regression analysis indicated that smoking,hypertension,serum levels oflipoprotein (a),oxidized HDL and malondialdehyde,NADPH oxidase activity and T allelic gene (OR=0.299,95％CI:0.102-1.879,P=0.028) were independent risk factors for cerebral infarction.Conclusion C242T polymorphism is associated with lipoprotein oxidation and cerebral infarction in Han people from Shanghai Songjiang of China,and T allelic gene and lipoprotein oxidation are independent risk factors for cerebral infarction.

OBJECTIVETo study the clinical, pathologic, immunophenotype, molecular characteristics and prognosis of HIV-negative plasmablastic lymphoma (PBL).

METHODSTwelve cases of HIV-negative PBLs diagnosed between 2005 and 2014 in Guangdong General Hospital were identified according to WHO classification of tumors of haematopoietic and lymphoid tissues (2008). The clinicopathologic features and outcome were analyzed and the relevant literatures were reviewed.

RESULTSThe patients were predominantly male (11/12) with a median age of 55.5 years. The tumor cells showed the characteristic combination of immunoblastic/plasmablastic morphology, plasma cell phenotype and high proliferation, no expression of mature B cell markers. 7/10 of the cases were EBER positive. Two cases were positive for C-myc translocation. Four of twelve patients were died.

CONCLUSIONSPBL is a rare, aggressive B-cell lymphoma. HIV-negative PBL has lower rate of oral involvement and EBER expression than HIV-positive patients, the differential diagnosis is very challenging, and the prognosis is worse.

Diagnosis, Differential ; Female ; HIV Seronegativity ; Humans ; Immunophenotyping ; Lymphoma, B-Cell ; diagnosis ; Male ; Middle Aged ; Plasma Cells ; classification ; Plasmablastic Lymphoma ; diagnosis ; pathology ; Prognosis ; Translocation, Genetic