Objective:To investigate the status of medical care seeking delay and diagnosis delay of pulmonary tuberculosis (PTB) patients in Tongzhou District and Changping District of Beijing, analyze the related factors and put forward suggestions for early detection and scientific management of PTB patients.Methods:A retrospective epidemiological survey was conducted to collect the incidence data of PTB registered in Tongzhou and Changping from January 1 to December 31, 2021 by using the Chinese Tuberculosis Information Management System, and telephone interview were used for information supplement. Multivariate logistic regression model and decision tree model were used to analyze the influencing factors of medical care seeking delay and diagnosis delay of PTB patients.Results:In 2021, the medical care seeking delay time M( Q1, Q3) in the PTB patients in Tongzhou and Changping was 11 (5, 26) days, with a delay rate of 41.71%. Results from multivariate logistic regression model analysis revealed that factors influencing the medical care seeking delay included regular health check-up ( OR=0.033, 95% CI: 0.008-0.147), coughing for less than 2 weeks or showing any symptom of PTB before medical care seeking ( OR=0.378, 95% CI: 0.215-0.665), showing other symptoms before medical care seeking( OR=2.791, 95% CI: 1.710-4.555), no work or school in medical care seeking ( OR=2.990, 95% CI: 1.419-6.298). The diagnosis delay time M( Q1, Q3) in the PTB patients was 8 (0, 18) days, with a delay rate of 35.20%. Multivariate logistic regression model analysis revealed that the factors influencing the diagnosis delay of PTB included being diagnosed at a specialized tuberculosis hospital ( OR=0.426, 95% CI: 0.236-0.767) or a tuberculosis prevention and control institution ( OR=1.843, 95% CI: 1.061-3.202) and being traced as a source of infection ( OR=2.632, 95% CI: 1.062-6.521). The overall performance of the multivariate logistic regression model was comparable to that of the decision tree model, with the decision tree model exhibiting higher sensitivity but lower specificity. Conclusions:The medical care seeking delay rate and diagnosis delay rate of tuberculosis in Tongzhou and Changping were at low levels in 2021. However, it is still necessary to strengthen the health education and active screening, improve the public awareness of PTB prevention and control, and further improve the level of medical services and medical access to reduce the medical care seeking delay and diagnosis delay of PTB patients.

Objective:To investigate the clinicopathological, immunophenotypic and molecular genetic characteristics, and differential diagnosis of NTRK-rearranged spindle cell neoplasms (NTRK-RSCNs) in the gastrointestinal tract.Methods:Two NTRK-RSCNs diagnosed at the Department of Pathology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China and one case diagnosed at Zhengzhou Central Hospital, Zhengzhou, China from 2019 to 2022 were collected. The clinical data, histopathology, immunophenotypes and prognosis were analyzed. Fluorescence in situ hybridization (FISH) and next-generation sequencing (NGS) were used to detect NTRK gene rearrangements, while relevant literature was also reviewed and discussed.Results:Two patients were male and one was female, with the age of 17, 47 and 62 years, respectively. The tumors were located in the duodenum, ascending colon and descending colon, respectively. The tumors were protuberant masses with gray and rubbery sections. Their maximum diameter was 2.5, 5.0 and 10.0 cm, respectively. Histologically, the tumors invaded mucosa, intrinsic muscle and serosal adipose tissue. Tumor cells consisted of spindle or oval shaped cells with monotonous morphology and arranged in bundles or stripes pattern. Spindle cells were mildly to moderately atypical, with slightly eosinophilic cytoplasm and inconspicuous nucleoli. Necrosis and mitotic figures were observed in one high-grade tumor. All tumors expressed CD34, S-100 and pan-TRK in varying degrees. FISH analysis showed that NTRK1 gene was break-apart in 1 case and NTRK2 gene break-apart in 2 cases. NGS technologies showed LMNA::NTRK1 fusion in one case, STRN::NTRK2 fusion in another case. All patients recovered well after the surgery without recurrence at the end of the follow-up.Conclusions:NTRK-RSCN is rarely diagnosed in the gastrointestinal tract and has significant variations in morphology. It overlaps with various other mesenchymal tumors which should be considered as differential diagnoses. Be familiar with the features of histological morphology in combination with immunophenotype and molecular genetic characteristics can not only help diagnose NTRK-RSCNs, but provide therapeutic targets for clinical treatment.

OBJECTIVE： To analyze and predict potential pharmacological effects and mechanism of flavonoids from Glycyrrhiza uralensis. METHODS： By the means of network pharmacology， according to TCM integrative pharmacology platform （TCMSP）， using oral bioavailability （OB）＞30％ and drug-likeness （DL）＞0.18 of compound as reference， flavonoids compound of G. uralensis were screened. The potential targets of flavonoids were predicted with pharmacophore matching and PharmMapper date base. DAVID V 6.8 analysis tool was used for KEGG signaling pathway analysis and GO biological process enrichment analysis （using P＜0.05 as judgement standard） of target protein. A flavonoids-targets-signaling pathways network was built through Cytoscape 3.5.1 software. RESULTS： A total of 19 flavonoids compounds （such as liquiritin， isoliquiritin and liquiritigenin， etc.） were screened， involving 78 target proteins as cellular retinoic acid-binding protein 2 and neprilysin （188 times in total）， 40 signaling pathways （among them， 8 pathways related to cancer， 8 pathways related to endocrine system， 6 pathways related to signal transduction， 5 pathways related to infectious diseases and 3 pathways related to metabolism） as insulin signaling pathway， PI3K-Akt and so on. The flavonoids-targets-signaling pathways network model showed that flavonoids compounds of G. uralensis could act on different metabolic pathways through multiple targets. CONCLUSIONS： The flavonoids of G. uralensis have therapeutic effect on diseases of cancer， endocrine system， infectious diseases， metabolism and so on. It may have potential anti-parkinson’s effect.

Objective: To investigate the clinicopathological features of gangliocytic paraganglioma(GP). Methods: Clinical data and pathological diagnosis of the 4 cases of GP were obtained through the medical record inquiry from January 2011 to December 2017 at the First Affiliated Hospital of Zhengzhou University. Routine HE staining and immunohistochemistry of CKpan, Syn, CgA, CD56, NSE and NF were performed. Clinical follow-up of the patients was obtained through telephone communication. Results: All 4 patients, including 2 male and 2 female patients, presented with intermittent abdominal pain and distention. The median age was 56 years. Preoperative CT showed local thickening of the duodenum wall with slight enhancement in all four cases. Endoscopic ultrasonography showed low level echo in the mucous layer and submucosa involved by the tumor in 3 of 4 cases. The maximal diameter of the tumor ranged from 0.6 to 1.8 cm with an average of 1.2 cm. Microscopically, the tumors consisted of epithelioid, spindle and ganglion-like cells, and the proportion of the three cell types was different among cases. Epithelioid cells expressed CKpan, Syn, CgA and CD56. Spindle cells expressed S-100 protein and SOX-10 and ganglion-like cells expressed NF, Syn, CgA and CD56.All tumour cells expressed NSE. All 4 patients had no recurrence a post-surgery follow-up period of 3 to 30 months. Conclusions GP of the duodenum is a benign tumor with excellent prognosis after endoscopic excision. Although its incidence is very low, its diagnosis should be considered for any mass lesion of the duodenum, especially involving mucosa and submucosa of the second dudenal segment.

Objective To explore the immunopathological mechanism for the imbalance between the positive signal mediated by inducible costimulator (ICOS) and the negative signal mediated by programmed death-1 (PD-1) in patients with myasthenia gravis (MG).Methods Eighty-two patients with MG,56 healthy controls (HC) and 20 non-MG (NMG) patients,collected in the First Affiliated Hospital of Suzhou University from February 2014 to December 2016,were chosen to participate in the study.The expression of ICOS and PD-1 on peripheral blood mononuclear cells was detected by immuno-fluorescence staining and flow cytometry.The levels of soluble programmed death-1 (sPD-1),soluble programmed death ligand 1 (sPD-L1),IL-4 and other cytokines were detected by enzyme-linked immunosorbent assay.Results (1) Flow cytometry analysis:The co-expression of PD-1,ICOS on CD4 + T cells from MG group (9.64％ (8.82％)) was higher than in HC (1.81％ (2.10％),Z =-7.389,P ＜0.05) and NMG group (2.86％ (1.49％),Z =-4.636,P ＜ 0.05).The expression of ICOS on CD4 + T cells,ICOS ligand (ICOSL) on CD14+ monocytes and CD19+ B cells were increased in MG group comparing with that of the control groups.The proportion of PD-1 + CD4 + T cells (MG group 16.82％ (10.66％),HC 9.34％ (9.18％),Z =-4.345,P＜0.05;NMG group 7.07％ (3.40％),Z=-4.594,P＜0.05) and PD-1 Ligand (PD-L1) + CD14+ monocytes was higher in MG patients.All of these were detected by flow cytometry.(2) ELISA analysis:Serum sPD-1 expression significantly increased in MG group compared with that in the control groups (MG group (1.87 ± 0.64) ng/ml,NMG group (1.49 ± 0.70) ng/ml,t =2.04,P ＜ 0.05;HC (1.05 ± 0.50)ng/ml,t =2.08,P ＜ 0.05),while for serum sPD-L1,there was no significant difference between MG and control groups.(3) Serum cytokines detection:The expression of IL-4 was increased in MG patients (MG group (61.88 ±5.15) pg/ml,HC (32.03 ±1.84) pg/ml,t=2.50,P＜0.05;NMG group (42.62± 3.31) pg/ml,t =2.34,P ＜0.05),and there was a negative correlation between the expression of sPD-1 and the concentration of IL-4.Conclusions The increased expression of PD-1 + ICOS + CD4 + T cells suggested the subset involved in the pathological progress of MG.sPD-1 might disturb the ligation of PD-1 on T cells and PD-L1 on antigen presenting cells,while the ligation of ICOS and ICOSL passed positive signal,leading to over activity of the subsets and the progression of disease.

Objective To explore the distributional differences of the gene frequencies of 22 short tandem repeats loci on Y Chromosome(Y?STRs) between offenders with Initiative?aggressive behavior and impulsive?aggressive behavior,and to probe into the genetic factors of initiative?aggressive behavior and im?pulsive?aggressive behavior. Methods Biological samples of 271 offenders with initiative?aggressive behav?ior and 271 offenders with impulsive?aggressive behavior were collected and PCR compound amplification was carried out with the aid of PowerPlex Y23 System. Then the PCR products were subjected to electrophoresis and gene detection with AB3500xL gene analysis system so as to calculate and compare the alleles and haplo?types of 22 Y?STRs gene frequency in the two groups. Results The distribution of allele frequency were sig?nificantly difference in locus DYS437(P=0.022) between two groups,not in the other 21 Y?STRs loci( all P>0.05) . Univarite analysis showed significant differences at allelle 14 in locus DYS437 between both groups ( initiative?aggressive behavior group:69. 37%;impulsive?aggressive behavior group:58. 67%; P=0. 009 ) . Conclusion Loci DYS437 may be associated with aggressive behavior. In the group of aggressive behavior, allelle 14 on locus DYS437 may be the susceptible factor of initiative?aggressive behavior and the resistant factor of impulsive?aggressive.

Objective To discuss the clinical significance of programmed cell death-1 (PD-1) in neuromyelitis optica spectrum disorder (NMOSD) patients by analyzing PD-1 and programmed death 1-1igand (PD-L1) expressions.Methods Sixteen patients with NMOSD,16 patients with longitudinally extensive transverse myelitis (LETM),13 patients with opticneuritis (ON),20 with other diseases of the central nervous system (OTH) and 16 health controls (CONs) were chosen in our hospital from April 2015 to July 2016;their peripheral blood was separately collected.The PD-1 expression in the CD4+r lymphocytes,and PD-L1 expressions in the CD14+ mononuclear leucocytes and CD19+B lymphocytes of peripheral blood were detected by flow cytometry.ELISA was performed to analyze the levels of soluble PD-1 and soluble PD-L1 in plasma samples.Results The PD-1 level from the peripheral blood of NMOSD patients was significantly higher than that from LETM,ON,and OTH patients and CONs (P＜0.05).The PD-L1 level of NMOSD patients was significantly higher than that of the other 4 groups (P＜0.05).ELISA indicated that levels of soluble PD-1 and soluble PD-L1 in plasma samples from NMOSD patients were significantly higher than those in LETM,ON,and OTH patients and CONs (P＜0.05).Conclusion The PD-1/PD-L1 pathway is an important immune response approach and takes part in the earlier stage of the NMOSD pathological process.

Objective To explore the current situations in self-management of cancer patients over peripherally inserted central catheter (PICC) and the influencing factors. Method Self-designed general demographic data form, disease-related questionnaire and PICC self-management ability for cancer patients were used to investigate 98 tumor patients with PICC. Results The total score on self-management ability of the cancer patient with PICC was (150.85 ± 17.35). The influencing factors of their self-management of PICC included education level, economic condition, presence or absence of long-term caregivers and cognitive disorders, all contributive to the prediction of 28.60%total variance for the patients′self-management capability. Conclusions Cancer patients have a better ability in managing PICC, but a few patients failed to grasp self-management skills, which was resulted from many factors. Nurses should pay more attention to those with less education, under poorer economic conditions and without long-term caregivers, and provide them with more care and education so as to comprehensively improve their self-management skills.

OBJECTIVETo assess the association between aggressive behaviors and 15 short tandem repeats (STRs) loci.

METHODSPeripheral blood samples from 541 army men with aggressive behaviors and 459 healthy individuals were collected. All sample were amplified with a AmpFlSTR Identifiler(TM) system and separated by electrophoresis to compare the genotypic and allelic frequencies of 15 STRs (CSF1PO, D2S1338, D3S1358, D5S818, D7S820, D8S1179, D13S317, D16S539, D18S51, D19S433, D21S11, FGA, THO1, TPOX and vWA) in the two groups.

RESULTSA significant difference was found in allelic and genotypic frequencies at loci D2S1338 and D19S433 (P< 0.01) between the two groups, but not for the remaining 13 STR loci (P> 0.05). Univarite analysis also showed a significant difference for allele 16, genotypes 19-22, 22-24 on D2S1338 and genotypes 13-14.2 on D19S433 between the two groups (P= 0.0018, P= 0.0001, P= 0.0003, P= 0.0000), with the OR values being 7.380 (95%CI: 1.701-32.028), 0.051(95%CI: 0.007-0.388), 13.933(95%CI: 1.845-105.717), 0.349 (95%CI: 0.216-0.564), respectively.

CONCLUSIOND2S1338 and D19S433 may be associated with aggressive behavior. Allele 16 and genotype 22-24 on D2S1338 may be susceptible factors for the disease, whilst genotypes 19-22 on D2S1338 and 13-14.2 on D19S433 may confer a protective effect on it.

Adult ; Aggression ; Alleles ; Genetic Predisposition to Disease ; Genotype ; Humans ; Male ; Mental Disorders ; genetics ; Microsatellite Repeats

Objective To investigate the relationship of the initiative-aggressive behavior and D2S1338,D19S433 loci.Methods PCR and electrophoresis method were used to conduct genotype analysis on D2S1338 and D19S433 in the peripheral blood of 187 male initiative-aggressive violent offenders and 459 healthy men living in Jiangsu area.Results D2S1338 and D19S433 loci in initiative-aggressive behavior group and healthy group were found to coincide with Hardy-Weinberg equilibrium (P ＞ 0.05).There were significant difference in locus D19S433 (P ＜ 0.05)between initiative-aggressive behavior group and healthy group,but not on locus D2S1338 (P＞0.05).Univariate analysis showed significant differences at allele 14.2 and genotype 14-14 on locus D19S433 between the two groups (P =0.0011,P =0.0008) with the OR values being 0.50 (95 ％ CI:0.33-0.76) and 3.49(95％ CI:1.62-7.52),respectively.Conclusion Locus D19S433 may be related to with initiative-aggressive behavior with allele 14.2 being the resistant factor and genotype 14-14 being the susceptible factor.