ObjectiveTo investigate the therapeutic effects of direct-acting antiviral agents (DAAs) combined regimens for hepatitis C virus (HCV) patients in Dehong Prefecture, Yunnan Province from 2022 to 2024, to analyze the characteristics of treatment failure patients, so as to provide a basis for discovering more effective treatment regimens in the future. MethodsData on HCV prevention and treatment in Dehong Prefecture was extracted from the China Disease Control and Prevention Information System. A total of 617 patients with HCV antiviral therapy were included, and the differences in variable characteristics among patients with different genotypes were analyzed using comparative statistical tests, including basic socio-demographic characteristics, biochemical testing indicators, and information on previous treatment and current treatment. In addition, the cure rate of HCV patients with diverse characteristics was compared, and the potential causes of treatment failure were explored simultaneously. ResultsThe cure rate of HCV was 96.8%, and statistically significant differences were observed in aspartate transaminase (AST) and alanine transaminase (ALT) levels, previous antiviral therapy history and initial treatment regimens among patients with different HCV genotypes (all P<0.05). Among the multi-type combination regimens, the cure rate of sofosbuvir (SOF)-containing regimens was 97.00%, that of velpatasvir (VEL)-containing regimens was 95.45%, and the cure rate of other treatment regimens, including the regimens with ribavirin (RIB) intervention, was 93.10%. Among the patients with treatment failure, 45.00% had genotype 3, 40.00% had abnormal abdominal ultrasound results, and all presented with elevated baseline AST test levels. ConclusionThe clinical treatment of HCV patients should consider the differences in genotype and biochemical test results. DAAs combined regimens for HCV have achieved a high cure rate in Dehong Prefecture and are applicable to HCV patients with diverse clinical characteristics, providing research evidence for wider application.

Objective:To analyze the epidemic characteristics and trends of newly reported HIV-infected people among Chinese and Burmese in Dehong Dai and Jingpo Autonomous Prefecture (Dehong Prefecture) of Yunnan Province, China, from 2000 to 2023, and provide evidence for formμlating AIDS prevention and control measures for the Burmese living in Dehong.Methods:The data were obtained from the Chinese Disease Control and Prevention Information System. The distribution of HIV-infected people with different population characteristics was analyzed, and the Joinpoint regression model was used to analyze the temporal trend of crude detection rate in different genders, ethnicities, and ages.Results:From 2000 to 2023, 24 989 newly HIV infections were reported in Dehong Prefecture, of which 14 594 (58.4%) were Chinese and 10 395 (41.6%) were Burmese. Compared with Chinese, Burmese women (32.9%, 3 416/10 395), those aged 20-29 (40.9%, 4 248/10 395), and Jingpo people (26.7%, 2 773/10 395) accounted for a higher proportion. The new diagnosis rate of Chinese nationals increased from 1.0/10 000 in 2000 to 15.4/10 000 in 2004, and then showed a downward trend, falling to 1.2/10 000 in 2023. Among them, compared with other age groups, Dai and other ethnic groups and women, the new diagnosis rate among 20-49 age group, Jingpo and men were relatively higher, at 1.7/10 000, 2.3/10 000 and 1.3/10 000 respectively. Regarding the method of detection, the Chinese HIV-infected people were mainly detected by key population testing (35.7%), while the Burmese HIV-infected people by key population testing (28.9%) and physical examination for entry-exit personnel (25.3%). The transmission routes of both nationalities were mainly heterosexual transmission, but compared with Chinese HIV-infected persons, the proportion of Burmese infected persons through non-marital non-commercial transmission was relatively higher (66.4% vs. 60.6%). The proportion of Chinese nationals with a first CD4 +T lymphocyte (CD4) counts of <200 cells/μl (28.9%) was higher than that of Burmese nationals (19.8%). Conclusions:The rising trend of HIV infection among Chinese and Burmese people in Dehong Prefecture from 2000 to 2023 slowed down. The new diagnosis rate was higher in the 20-49 age group, Jingpo and men. Compared with Burmese HIV-infected people, the proportion of Chinese HIV-infected people with first CD4 counts <200 cells/μl was relatively higher. Comprehensive interventions should be further carried out for Myanmar nationals, and efforts should be made to expand testing for Chinese nationals.

OBJECTIVE To compare the components of volatile oil from Gardenia jasminoides and their liver protective effect before and after stir-frying with wine. METHODS Steam distillation was used to exact the volatile oil from G. jasminoides and wine stir-fried G. jasminoides. The components of volatile oil were identified by GC-MS method， and the relative mass fraction of each component was calculated by peak area normalization method. The rats were randomly divided into normal group， model group， positive control group （bifendate suspension 35 mg/kg）， G. jasminoides low-dose and high-dose groups [1， 2 g/kg （calculated by crude drug）] and wine stir-fried G. jasminoides low-dose and high-dose groups [1， 2 g/kg （calculated by crude drug）] with 10 rats in each group. Liver injury model was established by intraperitoneal injection of 40% carbon tetrachloride in rats of each group after continuous intragastric administration of corresponding drug solution for 7 days. The status， serum biochemical indexes， liver biochemical indexes and liver pathological sections of rats in each group were compared. RESULTS Twenty-three volatile oil components from G. jasminoides and 25 volatile oil components from wine stir-fried G. jasminoides were identified； there were 18 common volatile oil components， of which the contents of 17 common components were decreased， while the content of one common component was increased due to stir-frying with wine. Compared with model group， the symptoms of depression and liver cell damage of rats in each administration group were improved to varying degrees； the serum levels of adenosine deaminase， alanine transaminase， aspartate transaminase， direct bilirubin， lactate dehydrogenase，prealbumin， total bile acid and total bilirubin were significantly decreased， while the total protein level was significantly increased； the level of malondialdehyde in liver tissue was significantly decreased， there were statistical significance （P＜0.05 or P＜0.01）. CONCLUSIONS During stir-frying with wine， the contents of 17 volatile oil components are decreased， while the content of one volatile oil component is increased. Wine stir-fried G. jasminoides shows liver protective effect. .

ObjectiveTo investigate the factors that influence the first CD4+T lymphocyte counts in newly reported HIV-infected cases aged 50 and above in Dehong Prefecture of Yunnan Province during 2016 to 2021， and to understand the patient immune status and disease progression so as to provide scientific basis for HIV prevention and control strategies in the future. MethodsData was collected from the national HIV/AIDS information system. Multivariate logistic regression was used for the analysis of factors affecting the first CD4+T lymphocyte counts. ResultsA total of 642 cases of HIV infection were newly reported， among them， 571 cases had CD4+T lymphocyte counts and 200 cases （35.03%） had CD4+T lymphocyte counts <200 cells·μL^-1. Patients who were in the 50-59 age group， male， divorced or widowed， and less educated were more likely to have CD4+T lymphocyte counts <200 cells·μL^-1. Compared with active testing consultants， forced reeducation through labor or drug rehabilitation cases were less likely to have CD4+T lymphocyte counts <200 cells·μL^-1. ConclusionThere is no obvious upward trend in newly reported HIV infected persons aged 50 years and above in Dehong Prefecture during 2016 to 2021. However， the situation of CD4+T lymphocyte counts <200 cells·μL^-1 is still serious. Attention should be paid to the key groups： male， Chinese nationality， farmers， Han nationality， married or divorced， junior high school education or below， and heterosexual transmission. It is necessary to strengthen the intervention in people aged 50 and above and improve the detection efficiency.

Objective:To understand the viral spectrum changes of respiratory tract infections in Kunming city from 2018 to 2021.Methods:Throat swab samples were collected from influenza-like cases in 2 general hospitals and 1 children’s hospital in Kunming city from 2018 to 2021. Real-time RT-PCR was used to detect 14 common respiratory viruses (including influenza virus, human adenovirus, human respiratory syncytial virus, human rhinovirus, human bocavirus, human metapneumovirus, human parainfluenza virus, human coronavirus), and the detection data before and during the epidemic were analyzed.Results:From 2018 to 2021, a total of 12 302 specimens were collected and tested, and 2 600 positive specimens were detected, with a total positive rate of 21.13%. The positive detection rate before the epidemic was 25.91%, which was significantly higher than 16.18% during the epidemic ( χ2=174.35, P<0.05), and the detection rates of Flu and HAdV decreased by 75.36% and 45.31% respectively, while the detection rates of HRV and 229E increased by 72.22% and 350% respectively. During the epidemic, the total virus detection rate of male and female cases and all age groups under 50 years old were lower than before the epidemic. Conclusions:The epidemic of SARS-CoV-2 and the implementation of corresponding prevention and control measures have an impact on the epidemic trend of common respiratory viruses in Kunming, and the monitoring of multiple respiratory viruses is of great significance.

Objective:To determine the effect of prolonging the interval of flushing on ports′ function and catheter related complications for cancer patients after completing chemotherapy.Methods:A prospective randomized controlled trial was conducted in 190 patients who undergoing ports-maintenance in outpatient clinical, the First Affiliated Hospital of Sun Yat-sen University, after they finished the chemotherapy from April 2017 to February 2018. According to the random number table, the patients were divided into 4-week group, 8-week group and 12-week group after completing chemotherapy, then returned to the hospital to maintain the port every 4 weeks, every 8 weeks and every 12 weeks, respectively. Then evaluated the function and complications of catheter among different groups.Results:After completion of chemotherapy, the rate of catheters′ patency of tumor patients in 12-week group was 98.5% (66/67), while that in 4-week group was 98.1% (53/54) and in 8-week group was 98.6% (68/69), there was no statistically significant difference on catheters′ patency among different groups ( χ 2=0.48, P>0.05). The rate of catheters′ asymptomatic thrombosis in 12-week group was 18.9% (10/53), which was not significantly different from that of 4-week group 27.0% (10/37) and 8-week group 14.0% (7/50) ( χ 2=2.33, P>0.05). Conclusions:Tumor patients maintaining port every 12 weeks after completion of chemotherapy can ensure the safety of patients using the port. It is favorable for application and promotion of port in cancer patients.

OBJECTIVE: To explore the clinical features and genetic basis for a patient diagnosed with creatine deficiency syndrome (CDS). METHODS: The patient was subjected to whole exome sequencing (WES). Candidate variant was verified by Sanger sequencing. The level of creatine was determined by using a magnetic resonance spectrum (MRS) method. RESULTS: The patient presented with development delay and poor response to stimuli. No obvious abnormality was found with his muscle tone and strength of his limbs. Borderline EEG was detected. MRI showed abnormal development of the white matter and dysplasia of corpus callosum. Urine organic acid screening has shown increased glycerin-3-phosphate. WES revealed that the patient has carried compound heterozygous variants of the GAMT gene, namely c.412C>T and IVS4-1G>A, which were respectively derived from his mother and father. MRS showed reduced creatine in bilateral basal ganglia. Functional study of the splicing site suggested that the IVS4-1G>A variant has resulted skipping of exon 5 upon splicing. CONCLUSION The compound variants of the GAMT gene probably underlay the disease in this child. Above finding has enriched the spectrum of GAMT gene variants.
Child ; Creatine ; Exons ; Humans ; Mutation ; Syndrome ; Whole Exome Sequencing

Objective:To explore the effect of SimMan 3G simulator based scenario simulation teaching method and case-based learning (CBL) in emergency medicine teaching.Methods:Sixty students from Batch 2013 eight-year program of clinical medicine were selected as subjects. They were randomly divided into an experimental group and a control group, with 30 students in each group. In the teaching of emergency medicine, the experimental group used the combination of scenario simulation with CBL teaching methods, and the control group used classic teaching methods. The test scores and the questionnaires satisfaction of the two groups were compared to evaluate the teaching effects. SPSS 17.0 was used for the statistical analysis, measurement data were compared between the groups by t test, and counting data were compared between groups by chi-square test.Results:The scores of the experimental group (94.24±1.13) were better than those of the control group (90.6±0.59), with significant differences ( t=12.85, P<0.05). The results of the questionnaires showed that the students of experimental group were more satisfied with the learning experience than those of the control group. Conclusion:The teaching method can improve the teaching effects, the students' emergency clinical thinking, skills, comprehensive analysis and judgment ability, team cooperation consciousness and leadership ability.

Objective:To explore the effect of evidence-based quality control circle activities in improving the implementation rate of enhanced recovery after surgery in gynecological tumor surgery.Methods:Gynecological tumor surgery patients admitted to the First Affiliated Hospital of Wenzhou Medical University were selected as the research object from January to March 2018 and September to December 2018, respectively. A total of 80 patients before the quality control circle activities from January to March 2018 were used as the control group, and the conventional enhanced recovery program was adopted. A total of 78 patients after the quality control circle activities from September to December 2018 were taken as the observation group, and the enhanced recovery program was implemented based on the evidence-based quality control circle. The implementation rate of enhanced recovery after surgery, postoperative rehabilitation indicators, and hospitalization satisfaction of the two groups of patients were compared.Results:The total implementation rate of the 8 enhanced recovery after surgery in observation group was 86.9% (542/624) , which was higher than 62.2% (398/640) of control group. The total incidence of complications in observation group was 6.4% (5/78) , which was lower than 22.5% (18/80) in control group. The early ambulation time, exhaust time, and hospitalization time of observation group were shorter than those of control group, and the hospitalization satisfaction of observation group was higher than that of control group. The above differences were statistically significant ( P<0.05) . Conclusions:Evidence-based quality control circle activities can standardize the practice standards for enhanced recovery, facilitate the development of enhanced recovery after surgery for gynecological tumor surgery, and promote postoperative recovery of patients.

Objective To evaluate the effect of combination of uterine artery chemoembolization and curettage in treatment of caesarean scar pregnancy(CSP),and to analyze the possible influence factors.Methods 46 cases with caesarean scar pregnancy treated by the combination of uterine artery chemoembolization and curettage were retrospectively analyzed.Univariate analysis was made on the factors that might influence the efficacy,and the Logistic regression model was constructed for the significant variables.Results All of the patients were terminated pregnancy succesfully .According to the ultrasound recheck,there were no residual gestational sac tissue in 29 patients,and some residual gestational sac tissue in 17 patients.After the application of traditional Chinese medicine or methotrexate and other symptomatic treatment, the pregnancy was terminated.The univariate analysis showed that the number of cesarean section,the gestational sac volume,the gestational weeks,the type of CSP,and the condition of the fetal heart pulsation were related to the presence of residues in the uterus after treatment (P＜0.05).The multivariate analysis showed that gestational sac volume ＞9 cm3 ,gestational weeks ＞ 7 weeks and exogenous CSP were the independent factors leading to intrauterine residual gestational sac tissue.Conclusion Uterine artery chemoembolization combined with curettage is an effective method for treatment of caesarean scar pregnancy.It is proposed that clinical treatment should pay close attention to the factors that may affect the efficacy.