Objective:To understand the current status of gastroscopy in diagnosing gastric lesions in general population, and to recommend the optimal age for the first gastroscopy and intervals for repeated gastroscopy.Methods:The gastroscopy records of residents aged 18-80 years in Yinzhou District of Ningbo, Zhejiang Province, between April 2010 and December 2021 were analyzed retrospectively. The detections of gastric lesions across different years, age and genders were described. Goodness of fit tests were applied to compare the differences in detection rates of different lesions in first-time endoscopy in different age groups and different populations. Generalized additive models were used to fit the trend of age specific gastric lesion detection rate explore the optimal age for gastroscopy. The appropriate gastroscopy intervals were determined according to the progress of the gastric lesions detected in repeated gastroscopy.Results:A total of 237 751 participants with 344 398 gastroscopy records were included in analyses. A total of 5 597 cases of chronic atrophic gastritis (CAG), 9 796 cases of intestinal metaplasia (IM), 165 cases of low-grade intraepithelial neoplasia (LGIN), 52 cases of high-grade intraepithelial neoplasia (HGIN) and 435 cases of gastric cancer were detected by the first gastroscopy. The overall detection rate of gastric lesions increased significantly in age group 45-70 years, and remained stable after 70 years old, with LGIN and HGIN showing notable increases at 50 and 55 years old, respectively. Repeated gastroscopy detected CAG, IM, LGIN, and HGIN at a higher rate compared with the first gastroscopy. Normal/superficial gastritis progressed in 3-5 years, whereas CAG or more severe lesions progressed in 1-6 years.Conclusion:Gastroscopy is recommended for general population aged 45 years and above. Furthermore, gastroscopy can be performed every 3-5 years for individuals with normal endoscopy results and once a year for patients with CAG or more severe gastric lesions.

Objective:To investigate the expression of the novel immune checkpoint SIGLEC9 and SIGLEC9+T cells in cervical cancer and its clinical correlation.Methods:A total of 132 paraffin-embedded specimens of cervical tissue from patients with cervical cancer who under-went surgical treatment or pathological biopsy at The First Affiliated Hospital of Xinjiang Medical University from May 2022 to October 2023 were included for study.In addition,58 paraffin-embedded specimens of normal cervical tissue from patients with benign uterine leiomyomas who underwent total uterine excision during the same period were selected as normal controls.Furthermore,108 peripheral blood samples from patients with cervical cancer who underwent surgical treatment or pathological biopsy were collected for study,and 86 peripheral blood samples from healthy individuals during the same time period were selected as controls.Bioinformatics technology,im-munohistochemical(IHC)staining,flow cytometry,and double immunofluorescence(IF)staining were used to assess the expression of SIGLEC9 and SIGLEC9+T cells in cervical cancer,followed by correlation analysis with clinical indicators.Results:The bioinformatics,IHC,and double IF staining results showed that SIGLEC9 and SIGLEC9+T cells were highly expressed in cervical cancer tissues(P<0.05).The flow cyto-metry results showed that SIGLEC9+CD4+T and SIGLEC9+CD8+T cells were increased in the peripheral blood of patients with cervical cancer(P<0.05).SIGLEC9 expression correlated with tumor size,FIGO stage,lymph node metastasis,and human papillomavirus(HPV)infection(P<0.05).Conclusions:The novel immune checkpoint SIGLEC9 was highly expressed in cervical cancer tissues,and SIGLEC9+T cells infiltrated cervical cancer tissues.In vitro cell experiments showed that SIGLEC9 affects T cell function.In summary,SIGLEC9 provides a novel research direction for understanding the immune escape mechanism of cervical cancer and a novel therapeutic target for cervical cancer immuno-therapy.

Objective To assess the diagnostic efficacy of extracellular volume fraction(fECV)based on multi-slice spiral CT in evaluating lymph node metastasis of pancreatic ductal adenocarcinoma.Methods A total of 74 patients diagnosed as pancreatic ductal adenocarcinoma from March 2018 to March 2023 in the First Hospital of Jiaxing were retrospectively collected.All patients underwent enhanced multi-slice spiral CT examination.Hematocrit was collected before examination.CT values at the plain phase,portal phase,the equilibrium phase of the lesion and CT values of abdominal aorta at the same level were respectively measured after examination,and fECV was calculated.Using postoperative pathological results as the"gold standard",the efficacy of fECV in diagnosing lymph node metastases of pancreatic ductal adenocarcinoma was evaluated by receiver operating characteristic curve.Results There were 33 cases with lymph node metastasis in positive group and 41 cases in negative group.There was no statistically significant difference in fECV at the portal phase between lymph node metastasis positive group and negative group(t=0.80,P＞0.05).There was statistically significant difference in fECV at the equilibrium phase between positive and negative lymph node metastasis group(t=2.84,P＜0.001).The area under the curve of lymph node metastasis in portal phase and equilibrium phase were 0.517 and 0.870,respectively.Conclusion The fECV based on multi-slice spiral CT equilibrium phase can evaluate lymph node metastasis of pancreatic ductal adenocarcinoma.

Objective:To explore expression of Siglec-7 on monocytes in peripheral blood of patients with brucellosis and cor-relation between Siglec-7+monocytes and Th1/Th2 cells,and to analyze clinical significance of Siglec-7 molecule in patients with bru-cellosis.Methods:Fifty patients with newly diagnosed Brucella infection(BI group)and 46 healthy controls(control group)were in-cluded.Flow cytometry was used to detect expression of Siglec-7 on monocytes,and correlation between Siglec-7+monocytes and clini-cal indicators of patients with brucellosis were analyzed.Flow cytometry was used to detect Th1/Th2 cells levels,and CBA method was used to detect IFN-γ and IL-4 in peripheral serum.Correlation between Siglec-7+monocytes and Th1/Th2 cells,IFN-γ/IL-4 were ana-lyzed.Results:Siglec-7+monocytes level in BI group was significantly higher than that in control group(P<0.001);Siglec-7+mono-cytes level in patients with abnormal liver function and lung X-ray were higher than those in patients with normal liver function and lung X-ray(P<0.001,P<0.05);Compared with control group,Th2 cell and IL-4 levels were significantly increased(P<0.05),while Th1 cells and IFN-γ levels were significantly reduced(P<0.001);Th1/Th2 and IFN-γ/IL-4 were also significantly reduced(P<0.001).Siglec-7+monocyte level was negatively correlated with Th1 and IFN-γ(r=-0.651,r=-0.407),while was positively correlated with Th2 and IL-4(r=0.706,r=0.530).Conclusion:During Brucella infection,increased percentage of Siglec-7+monocytes may be involved in Th1/Th2 cell imbalance.

Pediatric idiopathic nephrotic syndrome (INS) is characterized by massive albuminuria, hypoproteinemia, edema and hyperlipidemia, with a long course and high probability of relapse and prolongation. Long-term complications caused by long-term usage of hormones and immunosuppressants in children with INS seriously affect their physical and mental health and quality of life. Most children with steroid-sensitive nephrotic syndrome can be cured before adulthood, while some of them relapse in adulthood. Long-term prognosis of children with steroid-resistant nephrotic syndrome is poor. There have been few studies in China followed the long-term outcomes and its related factors of children with INS over 10 years. The paper reviewed the literatures on the long-term outcomes of children with INS, including renal survival, growth, mental health, learning and work, marriage and fertility, disease recurrence and long-term related complications, to explore the factors related to the poor long-term outcomes of children with INS and to assist in clinical decision-making and follow-up management.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.

Bivalent platinum drugs [Pt(II)] represented by cisplatin are the first-line drugs in clinical application, but they have defects such as severe side-effects, poor bioavailability and drug resistance.Tetravalent platinum [Pt(IV)] complexes, derivatives of Pt(II) with different substitutions in axial positions, can be reduced to Pt(II) under the action of reductants in tumor, and can therefore act as a prodrug of Pt(II).Axial substituents can improve platinum drugs'' pharmacokinetics, selectivity and bioactivity, as well as achieve anti-tumor effect by additional cytotoxic mechanisms other than DNA damage, which can overcome the drug resistance to Pt(II).This review outlines the resistance mechanisms of platinum drugs, including platinum transport, detoxification, autophagy, and DNA repair, etc.It also summarizes the structure-activity relationship, main types and advances of tetravalent platinum prodrugs, as well as possible approach to solve platinum drug resistance.

Objective:To observe clinical outcomes of the repair of traumatic nerve defects in the proximal upper extremities by human acellular nerve allograft(hANG).Methods:Nerve defects in the upper extremities in 8 patients were repaired by hANG from March 2017 to January 2019. The patients were 6 males and 2 females with mean age of 35.4 (21-53) years old. The nerve defects were 2 radial nerve in distal upper arm, 4 median nerve in forearm, 1 interosseous dorsal nerve and 1 ulnar nerve in forearm. All injuries were acute nerve injury. Two patients had combined injury of upper arm muscle, 4 of forearm muscle and 1 of brachial artery defect. All wound were moderate to severe contaminated. The length of nerve defects was 30-60 (mean 45) mm. The surgical procedures were fixation of fracture, repair of the muscle and discovery of the broken ends of nerve and to repair with hANG. The postoperative follow-up period ranged 18 to 40 (mean 30.6) months to observe the local response of recovery. The efficacy was evaluated by the Upper Extremity Function Evaluation Standard set up by Hand Surgery Branch of Chinese Medical Association and Grading Standard of Muscle Strength.Results:No graft rejection was observed in all cases. Primarily healing was in 5 patients. Delayed healing in 2 patients and free skin grafting was performed. Local flap transfer was performed to repair the wound in 1 patient who developed a skin necrosis 10 days after surgery. Two patients with median nerve defects had nerve function restored well. The strength of finger grip and thumb opposition muscle restored to grade IV and the sensory function had restored S 3+. The interosseous dorsal nerve in 1 patient restored well. The strength of extensor digitorum tendon had restored to grade IV. Based on the evaluation criteria for the upper extremity issued by the Hand Surgery of the Chinese Medical Association, 3 patients was rated in excellent for function recovery, 1 in fair and 4 in poor. Conclusion:After throughout debridement, hANG can be applied in the repair of traumatic nerve defect in the proximal upper extremity in an emergency surgery and it can partially restore the nerve function.

The effective classification of multi-task motor imagery electroencephalogram (EEG) is helpful to achieve accurate multi-dimensional human-computer interaction, and the high frequency domain specificity between subjects can improve the classification accuracy and robustness. Therefore, this paper proposed a multi-task EEG signal classification method based on adaptive time-frequency common spatial pattern (CSP) combined with convolutional neural network (CNN). The characteristics of subjects' personalized rhythm were extracted by adaptive spectrum awareness, and the spatial characteristics were calculated by using the one-versus-rest CSP, and then the composite time-domain characteristics were characterized to construct the spatial-temporal frequency multi-level fusion features. Finally, the CNN was used to perform high-precision and high-robust four-task classification. The algorithm in this paper was verified by the self-test dataset containing 10 subjects (33 ± 3 years old, inexperienced) and the dataset of the 4th 2018 Brain-Computer Interface Competition (BCI competition Ⅳ-2a). The average accuracy of the proposed algorithm for the four-task classification reached 93.96% and 84.04%, respectively. Compared with other advanced algorithms, the average classification accuracy of the proposed algorithm was significantly improved, and the accuracy range error between subjects was significantly reduced in the public dataset. The results show that the proposed algorithm has good performance in multi-task classification, and can effectively improve the classification accuracy and robustness.
Humans ; Adult ; Imagination ; Neural Networks, Computer ; Imagery, Psychotherapy/methods* ; Electroencephalography/methods* ; Algorithms ; Brain-Computer Interfaces ; Signal Processing, Computer-Assisted

The general epidemic characteristics of seven key human parasitic diseases in Hubei Province, including schistosomiasis, malaria, filariasis, kala-azar (visceral leishmaniasis), soil-transmitted helminth infection, food-borne parasitic diseases, and echinococcosis, is reviewed in order to analyze the current epidemic situation and trend. At present, the epidemic of parasitic diseases has dropped to the lowest level in history in Hubei Province, but there still exists high risk of infections in some local areas. Along with the deepening of global economic integration and the implementation of the strategy of ^"the Belt and Road^", and the expanding of dietary spectrum for human pursuing diversified material and cultural life, we are facing the transmission risk from imported parasitic diseases and rare parasitic diseases. Current monitoring efforts have been weakened due to the decline in work supporting measures. There will be potential risks of local outbreaks if an epidemic is not effectively controlled in time. It is recommended to maintain the multi-sectoral cooperation mechanism under the leadership of the government, further improve capacity building to ensure a capable and stable professional team for the prevention and control of parasitic diseases, and to increase the monitoring of parasitic diseases during the ^"14th Five-Year Plan^" period, so as to consolidate the achievements of parasitic disease prevention and control and promote the health of people in Hubei Province.