ObjectiveTo investigate the changes in the pathogen spectrum of viral diarrhea in local pediatric inpatients as well as any variations in genotypes of major pathogens during the COVID-19 control period. MethodsFecal samples were collected from the children <5 years who were hospitalized due to acute gastroenteritis in a pediatric hospital in Shanghai. PCR test was carried out to detect rotavirus， norovirus， sapovirus， astrovirus and enteric adenovirus， and then genotyping was performed for major pathogens. ResultsOut of 546 samples， 37.55% tested positive for virus with the following positive rate ranking： norovirus GⅡ （22.16%）， group A rotavirus （16.12%）， astrovirus （2.93%）， enteric adenovirus （2.38%）， sapovirus （0.92%） and norovirus GⅠ （0.18%）. The predominant genotype within norovirus GⅡ were GⅡ.4［P31］ and GⅡ.4［P16］ with a proportion of 24.79% and 14.05% respectively. The detection rate of GⅡ.4［P31］ dropped significantly over the 2-year period （χ²＝16.140，P<0.001）. In addition， an emerging rotavirus genotype G8P ［8］， which was rarely found nationally， was discovered for the first time locally with an increasing proportion， accounting for 7.95% of all rotavirus positive cases. Phylogenic analysis demonstrated that the representative strains of this genotype were genetically closer to the DS-1-like G8P ［8］ strain found in Southeast Asia. ConclusionThe changes in the prevalence of various norovirus genotypes together with the emergence of rare rotavirus genotype in the local area illustrate the importance of continuous monitoring of viral diarrhea and genotyping of key pathogens. Increased local activity of the rare genotype also adds new parameters in the efficacy evaluation of marketed vaccines and development of potential new vaccines in near future.

Objective To explore the relationship between the polymorphism of excision repair cross-complementation group 1 (ERCC1) C8092A locus and the efficacy and prognosis of platinum-based chemotherapy for lung cancer (LC), and to provide a theoretical basis for precision treatment of LC. Methods From January 2014 to October 2017, 120 patients from two tertiary hospitals in Haikou City, and with pathologically confirmed lung cancer treated with platinum-based chemotherapy were selected as the research objects. After informed consent was obtained, peripheral blood samples were collected for DNA extraction, and the genotype of ERCC1 C8092A locus was detected by mass spectrometry. WHO's Response Evaluation Criteria in Solid Tumours (RECIST) was used to judge patients' chemotherapy efficacy and patients' survival status was obtained by telephone follow-up and other means. Results Among the 120 LC patients, the genotype frequencies of ERCC1 C8092A locus were 67 cases of CC wildtype (55.8%), 45 cases of CA heterozygous type (37.5%), and 8 cases of AA rare mutation type (6.7%), which conformed to Hardy-Weinberg equilibrium (χ2=0.140, P>0.05). The total effective rate of chemotherapy was 32.5%, with the highest effective rate in patients with the CA genotype (42.2%) at the ERCC1 C8092A locus and the lowest in patients with the CC genotype (25.4%). The overall one-year survival rate was 68.3% and the three-year survival rate was 35.8%. The patients with ERCC1 C8092A AA genotype had the lowest survival rate, with a one-year survival rate of 50.0% and three-year survival rate of only 25.0%. However, there were no statistical differences in the overall survival rate among the three genotypes of carriers of ERCC1 C8092A (χ2=0.328, P=0.849). Conclusions The polymorphism of ERCC1 C8092A locus is associated with the efficacy of platinum-based chemotherapy for LC, and patients with CA genotype have the highest efficacy. The one-year and three-year survival rates of patients with CC genotype are significantly higher than those of CA and AA genotypes.

ObjectiveTo analyze the individual monitoring results of the radiation workers in Shanghai’s Jing’an District from 2017 to 2023, to assess the occupational protection status as well as to offer scientific references for enhancing occupational health and radiation safety, and to provide support for health education initiatives targeting radiation workers. MethodsRadiation workers from several medical institutions in Jing’an District from 2017 to 2023 were selected as the subjects for this study. The individual dose of occupational external radiation exposure was monitored by using thermoluminescence dosimeters. Continuous data of seven years were statistically analyzed using SPSS 20.0. ResultsFrom 2017 to 2023, the annual collective effective dose for radiation workers in Jing’an District was 329.53 person·mSv, with an average individual annual effective dose of 0.17 mSv, and the median individual annual effective dose was 0.12 mSv. There were statistically significant differences in the individual annual effective doses across different years (H=277.131, P<0.05). The individual doses varied significantly among different levels of medical institutions (H=46.097, P<0.05), with tertiary institutions having the lowest median individual dose of 0.09 mSv, which was significantly lower than those at primary, secondary, and ungraded institutions (P<0.05). The median annual effective dose in males was lower than that in females, showing a statistically significant difference (Z=-3.438, P<0.05). There were significant differences in the individual annual effective doses among different occupational categories (H=150.727, P<0.05), with nuclear medicine workers experiencing the highest median annual dose of 0.56 mSv. ConclusionFrom 2017 to 2023, the individual dose of radiation workers in medical institutions in Jing’an District of Shanghai remained at a low level, reflecting the effective measures of radiation protection facilities in workplaces in Jing’an District, but particular attention should be given to radiological workers in nuclear medicine and workers in primary medical institutions.

Objective To observe the efficacy and safety of Morinda officinalis oligosaccharides in the continuation treatment of mild and moderate depression.Methods An open,single-arm,multi-center design was adopted in our study.Adult patients with mild and moderate depression who had received acute treatment of Morinda officinalis oligosaccharides were enrolled and continue to receive Morinda officinalis oligosaccharides capsules for 24 weeks,the dose remained unchanged during continuation treatment.The remission rate,recurrence rate,recurrence time,and the change from baseline to endpoint of Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),Clinical Global Impression-Severity(CGI-S)and Arizona Sexual Experience Scale(ASEX)were evaluated.The incidence of treatment-related adverse events was reported.Results The scores of HAMD-17 at baseline and after treatment were 6.60±1.87 and 5.85±4.18,scores of HAMA were 6.36±3.02 and 4.93±3.09,scores of CGI-S were 1.49±0.56 and 1.29±0.81,scores of ASEX were 15.92±4.72 and 15.57±5.26,with significant difference(P＜0.05).After continuation treatment,the remission rate was 54.59％(202 cases/370 cases),and the recurrence rate was 6.49％(24 cases/370 cases),the recurrence time was(64.67±42.47)days.The incidence of treatment-related adverse events was 15.35％(64 cases/417 cases).Conclusion Morinda officinalis oligosaccharides capsules can be effectively used for the continuation treatment of mild and moderate depression,and are well tolerated and safe.

Objective To make an epidemiological investigation on traditional Chinese medicine(TCM)dampness syndrome manifestations in the population at risk of cerebrovascular diseases in Guangdong area.Methods A cross-sectional study was conducted to analyze the clinical data related to the risk of cerebrovascular diseases in 330 Guangdong permanent residents.The diagnosis of dampness syndrome,quantitative scoring of dampness syndrome and rating of the risk of stroke were performed for the investigation of the distribution pattern of dampness syndrome and its influencing factors.Results(1)A total of 306(92.73%)study subjects were diagnosed as dampness syndrome.The percentage of dampness syndrome in the risk group was 93.82%(258/275),which was slightly higher than that of the healthy group(48/55,87.27%),but the difference was not statistically significant(χ2 = 2.91,P = 0.112).The quantitative score of dampness syndrome in the risk group was higher than that of the healthy group,and the difference was statistically significance(Z =-2.24,P = 0.025).(2)Among the study subjects at risk of cerebrovascular disease,evaluation time(χ2 = 26.11,P = 0.001),stroke risk grading(χ2= 8.85,P = 0.031),and history of stroke or transient ischemic attack(TIA)(χ2 = 9.28,P = 0.015)were the factors influencing the grading of dampness syndrome in the population at risk of cerebrovascular disease.Conclusion Dampness syndrome is the common TCM syndrome in the population of Guangdong area.The manifestations of dampness syndrome are more obvious in the population with risk factors of cerebrovascular disease,especially in the population at high risk of stroke,and in the population with a history of stroke or TIA.The assessment and intervention of dampness syndrome should be taken into account for future project of stroke prevention in Guangdong.

Amorphous solid dispersion (ASD) is one of the most effective formulation approaches to enhance the water solubility and oral bioavailability of poorly water-soluble drugs. However, maintenance of physical stability of amorphous drug is one of the main challenges in the development of ASD. Crystallization is a process of nucleation and crystal growth. The nucleation is the key factor that influences the physical stability of the ASD. However, a theoretical framework to describe the way to inhibit the nucleation of amorphous drug is not yet available. We reviewed the methods and theories of nucleation for amorphous drug. Meanwhile, we also summarized the research progress on the mechanism of additives influence on nucleation and environmental factors on nucleation. This review aims to enhance the better understanding mechanism of nucleation of amorphous drug and controlling over the crystal nucleation during the ASD formulation development.

AIM To study the effects and possible mechanism of Fuke Qianjin Formula and its modifications on sequelae of pelvic inflammatory disease(PID)in rats.METHODS The SD rats were randomly divided into the normal group,the sham operation group,the model group,Kangfuyan group(FYK,0.756 g/kg),Fuke Qianjin Formula group(FKQ,2.7 g/kg),Yijun Formula group(YJ,2.7 g/kg),Kangyan Formula group(KY,2.7 g/kg)and Buyi Formula group(BY,2.7 g/kg).After 28 days of corresponding administration by gavage,the rats were put to death to procure their uterus,spleen,thymus and liver for the calculation of the organs indices levels;the observation of the general morphology of uterus and oviduct and histopathological examination of uterus and oviduct;the measurement of.the serum levels of IL-1β,IL-18 and IL-6 by ELISA;the detection of the uterine expressions of TGF-β1,caspase-1,NLRP3,IL-18 and CTGF by Western blot;and the detection of the expressions of CD4+and CD8+in spleen lymphocytes by flow cytometry.RESULTS Compared with the model group,FKQ and YJ group,KY group and BY group displayed decreased indices levels of the uterus,spleen and thymus(P＜0.01);FKQ group and KY group displayed reduced uterine swelling,increased endometrial glands,and reduced inflammatory exudation(P＜0.01),and lower serum levels of IL-1β,IL-18 and IL-6(P＜0.01);FKQ group,KYgroup and BY group displayed decreased protein expressions of TGF-β1 and CTGF(P＜0.05,P＜0.01);FKQ group and KY group displayed decreased protein expressions of NLRP3,caspase-1 and IL-18(P＜0.05,P＜0.01);and FKQ group and BY group displayed increased CD4+/CD8+ratio(P＜0.01).CONCLUSION Being protective to sequelae of PID rat models,Fuke Qianjin Formula and its modifications may contribute their anti-inflammatory efficacy by inhibiting the activation of NLRP3 body to hinder the activation of caspase-1,reduce the secretion and release of pro-inflammatory factor IL-18,and thus inhibit pyroptosis.

Objective To investigate the characteristics of gut flora related to dampness syndrome in the population at risk of cerebrovascular disease and to explore their influencing factors.Methods Based on the results of epidemiological investigation of damp syndrome in at-risk population of cerebrovascular disease in Guangdong from October 2021 to February 2023,60 subjects(including 41 at-risk cases of cerebrovascular disease and 19 healthy controls)were included in the study.The identification of dampness syndrome and the risk rating of stroke were carried out for the subjects,and fecal samples were collected.High-throughput 16S rRNA sequencing technology and bioinformatics methods were used to analyze the characteristics of gut flora.Results(1)A total of 53 cases(88.33％)were identified as dampness syndrome.There was significant difference in the quantitative score of dampness syndrome between the risk group and the healthy group,and between the low-,medium-and high-risk groups(P=0.016;P=0.041).(2)There was no statistical difference in the species and abundance of gut flora between the dampness syndrome group and the non-dampness syndrome group.(3)In the population identified as dampness syndrome,there was no significant difference in Alpha diversity between the healthy group and the risk group,but there was significant difference in Beta diversity analysis;LEfSe analysis found that Fusobacterium and Lactobacillus were enriched in the risk group;correlation analysis showed that the differential bacteria were related to the three risk factors of diabetes,dyslipidemia and obesity and carotid intima-media thickness(IMT).(4)In the population identified as dampness syndrome and having the risk of cerebrovascular disease,there was no significant difference in Alpha diversity among three groups with different levels of risks,while significant difference in Beta diversity was observed;LEfSe analysis showed that Acidaminococcaceae,Phascolarctobacterium and Butyricimonas were enriched in the low-risk group,Veillonellaceae was enriched in the medium-risk group,and Ruminococcus 2 and Alloprevotella were enriched in the high-risk group;correlation analysis showed that the differential bacteria were associated with high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),white blood cell count(WBC),and neutrophil count(NEUT).Conclusion In the Guangdong population predominated by dampness syndrome,the severity of dampness syndrome is related to the risk of stroke,and the specific flora associated with sub-clinical atherosclerosis,inflammatory response and lipid metabolism are presented.

Objective To analyze the typical biomarker of cancer-related fibroblasts-fibroblast activation protein-α(FAP)expression in tumor tissue and perinephric adipose tissue and its clinical value in risk stratification of clear cell renal cell carcinoma(ccRCC).Methods A retrospective cross-sectional study was conducted on ccRCC patients who underwent nephrectomy in Dongfeng General Hospital of Sinopharm Affiliated to Hubei Medical College from June 2018 to September 2022.The expression of FAP in ccRCC renal tumor tissue(n=114),non-neoplastic renal cortex tissue(n=68)and perirenal adipose tissue(n=60)was detected by immunohistochemical staining,and immunohistochemical images were quantitatively analyzed.The benign adipose tissue around the kidneys from 19 patients with benign kidney disease were collected as a control group,and also detect FAP expression.Receiver operating characteristic(ROC)curves was used to analyze the ability of FAP expression in perirenal adipose tissue to diagnose ccRCC and predict distant metastasis.Results Compared with matched non-neoplastic renal tissues,the expression of FAP in ccRCC was not up-regulated.The receiver operating characteristic(ROC)curve analysis showed that the percentage of FAP positive staining in ccRCC tissue had good tumor clinical stage,tumor size and distant metastasis potential(P＜0.001),and the area under the curve(AUC)were 0.90(95％CI:0.81-0.98),0.79(95％CI:0.66-0.92)and 0.86(95％CI:0.74-0.99),respectively.The percentage of FAP positive staining in perinephric adipose tissue of ccRCC can predict distant metastasis,and the AUC is 0.91(95％CI:0.84～0.97).The staining intensity of FAP expression in perinephric adipose tissue of ccrcc(191.77±3.14 vs.188.90±2.89,P＜0.001)was slightly higher than that of benign renal disease,and the staining intensity of FAP in perinephric adipose tissue had a certain distinguishing value for benign and malignant renal tumors,with AUC of 0.68(95％CI:0.60～0.77).Conclusion FAP in tumor and perinephric adipose tissue is expected to be one of the effective indicators of ccrcc risk stratification.

Objective:To investigate the diagnostic performance of different thyroid imaging reporting and data systems (TI-RADS) in the diagnosis of medullary thyroid carcinoma (MTC) .Methods:A total of 160 thyroid nodules diagnosed as MTC by postoperative pathology from Aug. 2011 to Aug. 2022 at the First Affiliated Hospital of Zhengzhou University were included. Additionally, 160 papillary thyroid carcinomas (PTC) and 160 benign nodules were randomly selected as controls during the same period. Differences in gender, age, nodule diameter and various ultrasound features were observed. The nodules were classified according to American College of Radiology (ACR) TI-RADS, artificial intelligence (AI) TI-RADS and Chinese (C TI-RADS). Then, receiver operating characteristic curve (ROC) were plotted to calculate the diagnostic value. The Kendall concordance coefficient was used to evaluate the interobserver consistency of each TI-RADS system.Results:There was no statistically significant difference in gender among the three groups ( χ2=1.17, P=0.558). However, significant differences were observed in age and nodule diameter ( F=12.08,40.12, P<0.001 for both). The area under ROC (AUC) for diagnosing MTC and benign nodules using ACR, AI, and C-TIRADS were 0.762, 0.773, and 0.761, respectively, with no statistically significant differences ( Z=1.33, 0.01, 0.87, P=0.183, 0.994, 0.386). However, the sensitivity of C TI-RADS (87.5%) was lower than that of ACR and AI TI-RADS (both 95.0%) ( P=0.018). After combining the biopsy threshold, the false negative rate of C-TIRADS was lower than that of ACR (30.6% vs. 41.3%) ( P=0.048) and AI TIRADS (30.6% vs. 43.1%) ( P=0.020). The inter-observer diagnostic consistency of C-TIRADS was superior to ACR (0.884 vs. 0.819, P<0.001) and AI TIRADS (0.884 vs. 0.839) ( P<0.001) . Conclusions:AI and ACR TI-RADS have higher sensitivity in diagnosing MTC, while C TI-RADS has a lower puncture missed diagnosis rate. AI has similar diagnostic performance to ACR TI-RADS and can replace ACR TI-RADS.