Objective To perform laboratory detection and molecular traceability analysis on a case of imported kala-azar in Shenzhen to determine the infection strain. Methods Bone marrow puncture fluid and blood samples from a case of kala-azar in Shenzhen were collected for laboratory tests. The patient's bone marrow puncture fluid smears were stained with Giemsa and examined under a microscope. Blood samples were examined for antibodies using the rk39 visceral leishmania rapid diagnostic reagent. Whole blood DNA was extracted, and the ITS-1 sequence was amplified by PCR, sequenced and aligned, and a phylogenetic tree was constructed based on the ITS-1 sequence. Results Microscopic examination of the patient's bone marrow smears revealed a large number of Leishmania amastigotes without flagella, confirming the diagnosis of kala-azar. The patient's blood was tested positive with the rk39 rapid diagnostic reagent, and PCR amplification yielded an ITS-1 gene product sequence that matched the expected size. Sequence alignment with the NCBI database showed 100% sequence similarity with the ITS-1 gene sequence of Leishmania infantum, confirming the infecting strain as Leishmania infantum. Phylogenetic tree construction of the amplified ITS-1 sequence revealed clustering into a clade with Leishmania infantum , and close to KC347299, one of the reference sequence selected. Conclusions The case of kala-azar in Shenzhen was caused by Leishmania infantum. Kala-azar still occurs in China, so the diagnostic technology of medical personnel in non-epidemic areas should be strengthened so that they can actively use new diagnostic technologies to assist in diagnosis, thus improving their prevention and control ability of Leishmania parasites.

Objective To evaluate the accuracies of two-dimensional ultrasound(2D-US)and three-dimensional ultrasound virtual organ computer-aided analysis(3D-VOCAL)in measuring uterine myoma volume(UMV).Methods Forty-five patients who underwent surgical treatment for uterine myoma at Longyan First Hospital,Fujian Medical University from October 2022 to April 2023 were selected.Preoperative measurements of UMV were performed using 2D-US and 3D-VOCAL,and the measurement results were compared with the actual UMV after surgical resection to assess the accuracies and repeatabilities of the two ultrasound techniques in measuring UMV.Results The UMV measurement consistency of 3D-VOCAL(ICC=0.992)was higher than that of 2D-US(ICC=0.976),and the ICC values of 3D-VOCAL were higher than those of 2D-US in UM of different sizes(all P<0.001).Statistically significant differences among 2D-US,3D-VOCAL and postoperative measurement results was found in UM with a maximum diameter≥8 cm(P<0.05),but not in UMV and UM with a maximum diameter<8 cm(P>0.05),and the further analysis showed that in UM with a maximum diameter≥8 cm,the UMV measured by 2D-US differed from postoperative measurement results(P<0.05).The differences between 3D-VOCAL measurement results and postoperative measurement results were trivial(P>0.05).There were greater intra-and interobserver agreements by 3D-VOCAL than 2D-US in UMV measurement.Conclusion 3D-VOCAL which is superior to 2D-US in preoperative UMV measurement is a simple,efficient,and reliable method,and it can provide theoretical bases for clinical follow-up.

Alzheimer's disease(AD) is a common neurodegenerative disease with increasing incidence rate. Up to now,there is no ideal treatment for AD. It has become a public health problem worldwide. Traditional Chinese medicine (TCM) believes that kidney deficiency is the key symptomatic element of deterioration and temporal progression symptoms,accompanied by the AD process. The treatment of tonifying kidneys,supplementing essence and replenishing marrow is the fundamental method for AD in TCM. Clinical studies have shown that kidney-tonifying formula can significantly improve the cognitive function and daily ability of patients with mild and moderate AD and have no obvious adverse reactions. Its mechanism of action may be related to the protection of nerves,reduction of β-amyloid (Aβ) level in the brain,inhibition of inflammatory factors activation and anti-oxidative stress. Besides reviewing the clinical and pharmacological research progress of kidney-tonifying formula for AD,this article also discusses the advantages and shortcomings of kidney-tonifying formula in the prevention and treatment of AD based on TCM theory and modern medical research. The aim of this study is to provide references of kidney nourishing therapy in TCM for the prevention and treatment of neurodegenerative diseases.

Abstract: Objective　To analyze and understand the mutations of drug resistance genes in imported Plasmodium falciparum in Shenzhen, aiming to assess the efficacy of antimalarial drugs and guide effective drug use. Methods A total of 85 samples from individuals with imported Plasmodium falciparum confirmed by fluorescence quantitative polymerase chain reaction (PCR) in Shenzhen from 2022 to 2023 were collected and genomic DNA was extracted. Nested PCR was used to amplify resistance genes, including Plasmodium falciparum Kelch 13 (PfK13), multidrug resistance gene 1 (Pfmdr1), chloroquine resistance transporter (Pfcrt), dihydrofolate reductase (Pfdhfr), and dihydropteroate synthase (Pfdhps) genes. Bidirectional sequencing was conducted, and mutations in these resistance genes were analyzed using MEGA11.06 software. Results　The study found one missense mutation (S549P) and four synonymous mutations in PfK13. For Pfmdr1, 62.69% of the samples showed Y184F mutation, and no N86Y mutation was detected. No mutations at positions 72 and 73 were detected in the Pfcrt gene, while mutations at M74I, N75E, and K76T accounted for 17.46%, 15.87%, and 15.87%, respectively. The wild-type of Pfcrt gene is dominant (82.54%, 52), followed by the triple mutant I74E75T76 (15.87%, 10). The most common mutation type for Pfdhfr is I51R59N108 (91.78%, 67), followed by the wild type (2.74%, 2). More than half (60.32%, 38) of the Pfdhps samples were wild-type, with single mutation K540E being the most common mutation type. S436A, G437A, K540E, A581G, A613S, I431V, G556K, and G579E site mutations were detected. Among the Pfdhfr-Pfdhps combination mutations, I51R59N108-E540 was the most frequent combination mutation (11.48%), with 59.02% of samples showing solitary Pfdhfr mutations. Conclusions In this study, PfK13 mutation rates were low, with no reported resistance mutations. The Y184F mutation emerged as the dominant Pfmdr1 mutation, with no detection of N86Y. For Pfcrt, the wild-type was dominant, followed by the I74E75T76 triple mutation variant. Triple mutant I51R59N108 of Pfdhfr was very common, and our study did not find Pfdhfr Pfdhps completely resistant and super resistant mutants, but there were other quintuple and septuple mutant types. In the future, it is crucial to continue to strengthen the monitoring of malaria parasite resistance genes and to further integrate in vivo efficacy monitoring to effectively guide clinical drug use.

Background The thyroid gland is one of the organs sensitive to ionizing radiation, and there are few studies on the effects of long-term exposure to low doses of ionizing radiation on the thyroid gland of radiation workers. Objective To investigate thyroid abnormalities in workers in medical radiology departments in Guangdong Province and to identify potential influencing factors of thyroid abnormalities. Methods A total of 1657 radiation workers from 48 hospitals in Guangdong Province were selected as survey subjects using convenience sampling, and their personal dose monitoring results and health examination information were retrospectively analyzed to determine the factors affecting thyroid abnormalities. Results The M (P₂₅, P₇₅) of thyroid absorbed dose (D_T) was 1.55 (0.65, 3.96) mGy in the 1657 investigated workers. The attribute-specific medians of D_T were 1.29, 1.38, 1.99, and 3.51 mGy for departments of diagnostic radiology, interventional radiology, radiotherapy, and nuclear medicine, respectively; and 1.10, 1.55, and 1.80 mGy for job titles of nurse, technician, and physician, respectively. Differences in D_T by gender, age, years of radiological work, age of radiation exposure onset, occupational category, and job title were statistically significant (Z=−6.35, H=708.52, 918.20, 31.19, 95.64, 39.28, P<0.05). The positive rate of thyroid abnormalities in investigated workers was 46.53% (771/1657). Among them, the positive rate of abnormal thyroid function was 22.87% (379/1657), that of abnormal thyroid morphology was 33.98% (563/1657), and that of thyroid nodule was 26.55% (440/1657). The differences in thyroid abnormality rates by gender, age, years of radiation work, age of radiation exposure onset, D_T, and job title of radiation workers were statistically significant (χ²=51.89, 49.64, 20.54, 18.29, 12.07, 16.16, P<0.05). The differences in abnormal thyroid function positive rate by gender, age of radiation exposure onset, and job title were statistically significant (χ²=26.21, 6.21, 8.32, P<0.05). The differences in the positive rates of abnormal thyroid morphology and nodules were statistically significant by gender, age, years of radiological work, age of radiation exposure onset, D_T, and job title (abnormal thyroid morphology, χ²=40.24, 64.17, 37.63, 15.17, 19.28, 15.05; nodules, χ²=31.41, 77.98, 42.11, 19.16, 21.70, 13.52, P<0.05). The positive rates of thyroid abnormality, thyroid morphology abnormality, and nodules all showed a linear increasing trend with increasing age, years of radiation work, and age of radiation exposure onset (P<0.05). The results of logistic regression analysis indicated that the factors influencing thyroid abnormalities were female (OR=2.17, 95%CI: 1.72-2.74), increased years of radiological work (OR=1.04, 95%CI: 1.03-1.06), onset of radiation exposure in age groups of 30-34 and ≥35 years (OR=1.63, 95%CI: 1.12-2.37; OR=2.58, 95%CI: 1.74-3.29), and working in department of diagnostic radiology (OR=1.40, 95%CI: 1.07-1.84). Conclusion Long-term exposure to low doses of ionizing radiation has an effect on thyroid abnormalities in medical radiation workers. Among them, being female, physicians, and working in department of diagnostic radiology are at a higher risk of abnormal thyroid function; being female, increased years of radiation work, and radiation exposure onset at age ≥30 years are associated with a higher risk of reporting abnormal thyroid morphology.

OBJECTIVE: To screen for small molecular compounds with selective inhibitory activity against cutaneous melanoma cells with BAP1 deletion. METHODS: Cutaneous melanoma cells expressing wild-type BAP1 were selected to construct a BAP1 knockout cell model using CRISPR-Cas9 system, and small molecules with selective inhibitory activity against BAP1 knockout cells were screened from a compound library using MTT assay. Rescue experiment was carried out to determine whether the sensitivity of BAP1 knockout cells to the candidate compounds was directly related to BAP1 deletion. The effects of the candidate compounds on cell cycle and apoptosis were detected with flow cytometry, and the protein expressions in the cells were analyzed with Western blotting. RESULTS: The p53 activator RITA from the compound library was shown to selectively inhibit the viability of BAP1 knockout cells. Overexpression of wild-type BAP1 reversed the sensitivity of BAP1 knockout cells to RITA, while overexpression of the mutant BAP1 (C91S) with inactivated ubiquitinase did not produce any rescue effect. Compared with the control cells expressing wild-type BAP1, BAP1 knockout cells were more sensitive to RITA-induced cell cycle arrest and apoptosis (P < 0.0001) and showed an increased expression of p53 protein, which was further increased by RITA treatment (P < 0.0001). CONCLUSION Loss of BAP1 results in the sensitivity of cutaneous melanoma cells to p53 activator RITA. In melanoma cells, the activity of ubiquitinase in BAP1 is directly related to their sensitivity to RITA. An increased expression of p53 protein induced by BAP1 knockout is probably a key reason for RITA sensitivity of melanoma cells, suggesting the potential of RITA as a targeted therapeutic agent for cutaneous melanoma carrying BAP1-inactivating mutations.
Humans ; Melanoma ; Skin Neoplasms ; Tumor Suppressor Protein p53 ; Apoptosis ; Cell Division ; Tumor Suppressor Proteins/genetics* ; Ubiquitin Thiolesterase/genetics*

Objective:To investigate the exposure level of ionizing radiation in medical radiation workers in Guangdong province, as well as their abnormality in the lens of the eye, and to analyze associated influence factors.Methods:In this study, 1 501 radiation workers from 60 hospitals were selected by using convenient sampling method for retrospecotive analysis of absorbed doses ( DL) to the lens of the eye, health examination information and the relevant influence factors. Results:The median value M and the 25 th and 75 th percentile values ( P25, P75)of the distribution of absorbed doses were 4.86, 2.99 and 7.90 mGy, respectively. The median values for male and female were 5.14 and 3.94 mGy, respectively. The median values for the Levels I, Ⅱ and Ⅲ medical institutions were 2.95, 3.51 and 5.06 mGy, respectively. The median values were radiotherapy 4.05 mGy, radiodiagnosis 4.84 mGy, interventional radiology 5.39 mGy and nuclear medicine 6.71 mGy, as well as nurses 3.48 mGy, physicians 5.03 mGy and technologists 5.03 mGy, respectively. There were statistically significant differences in dose distribution for different gender, age, length of radiation service, age at the beginning of radiation exposure, level of medical institution, occupational category and post ( Z=-6.72, H=389.64, 511.17, 70.29, 53.29, 49.06, 39.89, P<0.05). The detectable rate for increased cortical density of lens was 22.45% (337/1 501) and for lens turbidity was 8.19% (123/1 501). The detectable rate of increased cortical density showed a linear increasing trend with the increase in age, age of radiation service, age at the beginning of exposure to radiation, level of medical institution and dose ( χ2=366.36, 313.77, 15.18, 21.61, 92.13, P<0.05). The detectable rate of lens opacity increased linearly with the increase in age, length of radiation service, level of medical institution and dose( χ2=69.64, 67.65, 67.65, 37.37, P<0.05), and decreased linearly with the increase in age at the beginning of radiation exposure ( χ2=4.25, P<0.05). Logistic regression analysis showed that age was the influencing factor of increased cortical density ( χ2=165.98, P<0.05), and the risk of cortical densification increased with age ( OR=1.33, 95% CI: 1.27-1.39). Age, length of radiation service and occupation were the influencing factors of lens opacity ( χ2=25.78, 4.99, 6.88, P<0.05). The risk of lens opacity increased with age ( OR=1.17, 95% CI: 1.10-1.24). The risk of lens opacity increased with age of radiation service ( OR=1.06, 95% CI: 1.01-1.12). The risk of ocular opacity was higher in interventional radiology than that in diagnostic radiology, radiotherapy and nuclear medicine ( OR=2.59, 95% CI: 1.27-5.25). Conclusions:Long-term exposure to low dose ionizing radiation has a certain correlation with the abnormal lens detectable rate of medical radiation workers. Age, length of radiation service and occupation are the influencing factors of lens opacity.

Liver cancer is one of the most common cancers in China. In recent years, liver cancer tends to be treated with comprehensive therapies, including surgery, ablation, interventional embolization, radiotherapy, chemotherapy, targeted therapy, immunotherapy, and liver transplantation. At present, the low surgical resectionrate is one of the main factors affecting the prognosis of liver cancer patients. Preoperative neoadjuvant therapy or conversion therapy for liver cancer can maximize the rate of surgical resection and improve the prognosis. With the rapid development of radiotherapy and immunotherapy in the comprehensive treatment of liver cancer, it has been gradually confirmed that the unique effects of preoperative radiotherapy and immune therapy for liver cancer can improve the prognosis of the patients. Therefore, this paper reviewed the research progress in the preoperative radiotherapy and immunotherapy for liver cancer by searching relevant literature and reports at home and abroad.

Objective:To explore the investigation level of individual monitoring for medical radiation workers.Methods:Monitoring and analysis of individual doses to the medical radiation workers in Guangdong province were performed, from 2016 to 2019, by the Individual Dose Monitoring Department of Guangdong Provincial Hospital for Occupational Disease Prevention and Control.Results:The numbers of monitored workers were diagnostic radiology 53 674, dental radiology 2 563, nuclear medicine 5 001, radiotherapy 16 687, interventional radiology 22 272 and others 2 087 from 2016 to 2019, of which the number of individuals with doses in excess of investigation level 1.25 mSv, were 76, 6, 18, 28, 133 and 2 respectively. The non-real doses made up 67.1 %, 100 %, 55.6 %, 82.1 %, 76.7 % and 100 % of their respective totals. Their 99th percentile doses P99 were 0.37, 0.39, 0.67, 0.35, 0.54 and 0.30 mSv, and the average periodic dose equivalent were 0.07, 0.06, 0.11, 0.06, 0.07 and 0.05 mSv respectively, indicating a statistically significant difference existing in the average annual effective dose between groups ( Z=-26.139--2.681, P<0.001). Conclusions:Due to non-reality of doses in excess of investigation levels and high labor cost, it is suggested to currently use 0.40 mSv per 3 months as investigation level for diagnostic radiology, dental radiology, radiotherapy and others, and 0.70 mSv per 3 months as for nuclear medicine and interventional radiology.

Objective:To investigate the method, feasibility and clinical effect of scrotal flap in the immediate repair of penoscrotal Paget disease after excision.Methods:From January 2008 to September 2018, a total of 21 patients (age 42-74) diagnosed with penile scrotal Paget disease were admitted and treated in our department. All patients underwent local expanded resection, and intraoperative frozen section examination confirmed a negative margin. All patients used the scrotal flap or scrotal flap combined with other surgical methods to repair the defect.Results:Scrotal flaps were used in ten cases, scrotal flaps combined with other flaps in seven cases, and scrotal flaps combined with skin grafting in four cases. All the scrotal flaps had good blood supply, two cases had small partial skin graft necrosis, and one case had delayed healing of the flap donor area, and all the others had good wound healing. All patients were followed up for six months to 60 months, with an average follow-up time of 30.6 months. Most of the patients (95.2%, 20/21) were satisfied with the appearance of the penis and scrotum, and all the transferred flaps showed no edema. Local recurrence occurred in four patients within two years. Local recurrence and inguinal lymph node metastasis occurred in one patient within three years with a total local recurrence rate of 23.8% (5/21). Due to the small local recurrence lesion, the recurrence lesion was successfully repaired with the adjacent scrotal flap after expanding local excision, and the patients with inguinal lymph node metastasis received ipsilateral inguinal lymph node dissection.Conclusions:The scrotal flap has the characteristics of a large cutting area, flexible design, convenient transfer of flap, enough blood supply, simple, safe, and effective. Using this method can obtain a satisfactory shape of the penis and scrotum after the operation. Those defects that are difficult to use scrotal flap for a complete repair can be repaired with other flaps or skin grafts. A good therapeutic effect can be obtained as well. For the majority of recurrent lesions, scrotal skin flap can be reapplied.