Objective:To analyze the clinical features of patients with severe dengue (SD) in Guangdong Province, and to improve the understanding of the diagnosis and treatment of SD in China.Methods:The clinical data, laboratory examination and etiological test results of 257 SD cases from 29 dengue fever designated hospitals in Guangdong Province from January 1, 2013 to December 31, 2019 were respectively collected. The relevant indicators of the criteria for severe organ involvement were quantified. Logistic regression analysis was performed to analyze the risk factors for the development of multiple organ failure in SD patients.Results:Among the 257 SD patients, age was (64.1±20.1) years old, with 65.4%(168/257) of them ≥60 years old, 142 were male and 115 were female. One hundred and fifty-two (59.1%) patients had underlying conditions, including 115(44.7%) patients with hypertension. The clinical manifestations were mainly fever (98.4%(253/257)), fatigue (70.0%(180/257)), cough or expectoration (44.4%(114/257)), lethargy or irritability (39.3%(101/257)), vomiting (30.4%(78/257)), abdominal pain or tenderness (20.6%(53/257)), hepatomegaly (2.3%(6/257)), bleeding tendency (59.5%(153/257)), and pleural effusion or ascites (43.6%(112/257)). Platelet count levels were decreased in 90.9%(231/254) of the cases, and 97.1%(234/241) of patients had normal or decreased hematocrit. The most common of severe manifestations were severe organ involvement (61.1%(157/257)), followed by severe bleeding (37.0%(95/257)) and severe plasma leakage (30.0%(77/257)). Severe organ involvements were more common in the kidney (27.6%(71/257)) and heart (26.8%(69/257)). Multivariate logistic regression analysis showed that age (odds ratio ( OR)=1.051, 95% confidence interval ( CI) 1.004 to 1.100, P=0.035), hypertension ( OR=5.224, 95% CI 1.272 to 21.462, P=0.022), elevated aspartate aminotransferase (AST) level ( OR=1.002, 95% CI 1.001 to 1.003, P=0.001), blood urea nitrogen (BUN) ( OR=1.050, 95% CI 1.005 to 1.098, P=0.030), and international normalized ratio (INR) ( OR=4.604, 95% CI 1.601 to 13.238, P=0.005) were risk factors for the development of multiple organ failure in SD patients. The detection results of serum samples form 113 SD patients in acute phase showed that dengue virus (DENV)-1 accounted for 89.4%(101/113), DENV-2 accounted for 9.7%(11/113), and DENV-3 accounted for 0.9% (1/113). Conclusions:Elderly and those with co-existing conditions such as hypertension in SD patients in Guangdong Province are more common. Severe organ involvement such as kidney and heart is the main cause of SD. DENV-1 infection is predominant. Significant elevated levels of AST, BUN and INR may be related to a poor prognosis.

Objective:To investigate the associations between small diffusion-weighted imaging (DWI) hyperintensities lesions and total cerebral small vessel disease (cSVD) burden and the influence on prognosis in patients with acute intracerebral hemorrhage (ICH).Methods:Consecutive patients with acute spontaneous ICH from January 2018 to June 2021 were recruited in the Stroke Center of Zhengzhou People′s Hospital. Magnetic resonance imaging was performed to quantify DWI hyperintensities lesions and cSVD imaging markers, including white matter hyperintensities, enlarged perivascular spaces, lacunes and cerebral microbleeds, which were calculated for the total cSVD burden (0-4 points). The prognosis was assessed with the modified Rankin Scale (mRS) at discharge and 90-day. Multivariable Logistic regression models were adopted to explore the associations between DWI lesions and total cSVD burden and clinical outcome.Results:Of 283 included patients, 59 (20.8%) had small DWI lesions, 32 (11.3%) had multiple lesions. They were mostly punctate, mainly located in the cortical and subcortical regions, and scattered in multiple vascular territories. With the increase of cSVD burden, the number of DWI lesions gradually increased. Spearman correlation analysis showed that the total cSVD burden was positively correlated with the number of DWI lesions ( r=0.21, P<0.001). In multivariable regression analyses, the total cSVD burden was independently associated with DWI lesions ( OR=1.63, 95% CI 1.23-2.15, P=0.001). The 90-day poor outcome (mRS scores≥4) in patients with DWI lesions was significantly higher than those without DWI lesions (39.3% vs 16.3%, χ 2=14.38, P<0.001), while there was no statistically significant difference in the poor outcome of discharge between the two groups (26.5% vs 17.7%, χ 2=3.06, P=0.080). With the increase in the number of DWI lesions, the 90-day poor outcome increased significantly (trend chi-squared test χ 2=11.50, P=0.001). Multivariable analyses showed that DWI lesions ( OR=4.39, 95% CI 1.92-10.03, P<0.001) and their number ( OR=1.42, 95% CI 1.06-1.90, P=0.018) were independently associated with the 90-day poor outcome. Conclusions:Higher total cSVD burden is an independent risk factor for small DWI lesions in patients with ICH. Small DWI lesions were independently associated with the 90-day poor outcome, but not with the discharge outcome.

APOBEC-1 Deaminase ; genetics ; Clustered Regularly Interspaced Short Palindromic Repeats ; Codon, Terminator ; Gene Editing ; methods ; Humans ; Zygote ; beta-Globins ; genetics

Objective To summarize the effectiveness in monitoring activities for healthcare-associated infection (HAI)in China in the past 30 years,explore the changing trend in HAI monitoring,find a new model for the moni-toring of HAI in China.Methods A total of 194 comprehensive hospitals and military hospitals in 13 provinces (au-tonomous regions,municipalities)were selected,questionnaire survey was adopted to investigate the situation of HAI monitoring.Results Of 194 hospitals,184 (94.85%)had available data after being checked,incidence of HAI in secondary and tertiary hospitals were 0.78% and 1.58% respectively,difference was significant (P <0.01).Monitoring was divided into two stages,cumulative percentage of each monitoring activity before 2006 and during 2006-2016 were respectively as follows:environmental hygiene were 73.91% and 100.00%,disinfection ef-ficacy 69.57% and 97.28%,overall comprehensive monitoring 64.67% and 98.91%,surgical site infection(SSI) 13.04% and 94.57%,ICU HAI 4.89% and 87.50%,neonatal HAI 1.75% and 60.82%,multidrug-resistant or-ganisms(MDROs)5.43% and 95.65%,hand hygiene compliance 2.17% and 93.48%,antimicrobial agents 15.22% and 87.50%.The reporting rate of HAI outbreak in tertiary hospitals was higher than secondary hospitals (33.33% [n=37]vs 16.44%[n=12],P =0.01).Conclusion The monitoring of HAI in China starts late,but develops rapidly,defects still exist in HAI monitoring system,reporting rate of HAI cases is still high,reporting rate of HAI outbreak is low.

Objective ToinvestigatethementaldevelopmentsituationofpreschoolchildreninTaiyuan. Methods 1174preschoolchildrenoftwourbanareasinTaiyuanwereselected.TheyweretestedwithDenverDevel-opmentScreenTest(DDST).Results Thepassingratewas94.80%in1174children.Theirindividual-social reaction ability and movement ability were good in the three groups.In the subject-touch reaction ability,the passing rate ofvertical tilt at 30°insidewas 36.36%in 4 years old group,which was higher than the other projects.In the speaking ability,the passing rates of three right in four problems with knowing preposition were 15.88% and 27. 22% in 4 and 5 years old group,which were higher than the other projects.The culture degree of the mental retar-dation children's parents were lower than those of the normal children's parents,the difference were statistically signifi-cant(χ2=4.485,P=0.034;χ2=7.577,P=0.006).Conclusion DDSTisaquicklyscreeningmethodformental retardation children,it is suggested to be used in medical and health examination for preschool children.

Objective To prepare specific mouse monoclonal antibodies against Homo sapiens dynein,axonemal, heavy chain 2 (DNAH2). Methods Firstly, recombinant plasmid encoding His tagged immunogen, targeting N-terminal sequence of DNAH2 protein (1-300 aa), in E. coli was constructed. IPTG was used to induce the expression of His-immunogen, which was then purified and immunized in BALB/c mice. Hybridoma cells were obtained through the fusion between myeloma cells and splenocytes isolated from BALB/c mice. Finally, ELISA and Western blot assays were performed to screen the positive hybridoma. Results IPTG was used efficiently to induce the expression of DNAH2 immunogen in E. coli. DNAH2 protein bands were detected in screened positive hybridoma. Conclusion Mouse monoclonal anti-DNAH2 antibody is prepared successfully.

Objective:To localize the impacted maxillary canine and to observe the root resorption of adjacent incisor in 3 dimen-sions using cone beam computed tomography(CBCT).Methods:92 impacted maxillary canines in 63 patients were scanned by CBCT.The three-dimensional images were obtained by multiplanar reconstructions(MPR).The cusp tip of each impacted canine was localized and set to the X,Y and Z planes after the observation of sagittal,coronal and axial views.The root resorption of adjacent in-cisors was observed.Results:In the X-axis,92% of impactions were mesial by 1 0.4 to 1 5.1 mm,8% distal by 2 to 5 mm;in the Z-axis,60% of impactions were palatal by 1 to 4 mm,40% buccal by 0 to 4 mm.41 .3% of the impacted canines were without root resorption of adjacent incisor,36.5% with slight,1 4.3% with moderate and 7.9% with severe root resorption of the adjacent inci-sor.Conclusion:The most frequent location of impacted maxillary canine is palatal and mesial with high incidence of root resorption of adjacent incisor.

Objective To observe the clinical features and to identify γ-secretase gene mutations in a Chinese family with follicular occlusion triad (FOT).Methods Clinical evaluation was carried out in a family with FOT through field investigation.Peripheral blood samples were obtained from the family members and 100 unrelated healthy controls.DNA was extracted from the blood samples,and PCR was performed to amplify all the coding regions of PSEN1,PSENEN and NCSTN genes followed by DNA sequencing and comparative analysis.Results There were 14 members over 3 generations in this family,of whom,6 (4 males and 2 females) were affected by FOT.FOT was inherited in an autosomal dominant manner in this family.Clinical manifestations varied greatly among the 4 surviving affected members.DNA sequencing revealed a novel missense mutation,c.647A ＞ C (p.Q216P),in the exon 6 of NCSTN gene in the proband,which was cosegregated perfectly with affected,but not with unaffected,members in the family.The mutation was not found in any of the unrelated controls and had not been registered in the single nucleotide polymorphism (SNP) database in NCBI.Conclusions There is a novel heterozygous missense mutation,c.647A＞C in the exon 6 of NCSTN gene,which may be the molecular basis of pathogenesis of FOT in this family.

Objective To compare the biological characteristics of adipose-derived mesenchymal stem cells (ADAS) and bone marrow derived mesenchymal stem cells (BMSCs).Methods The adipose and bone marrow-derived sources of mesenchymal stem cells were separated,and their phenotype,cell doubling time and the secretion of factors were compared.They were also used to detect T-cell cycle,activation,and proliferation inhibition.Results BMSCs and ADAS were similar on the cell phenotype and the differences only existed in the expression of only CD106.For the proliferation rate,ADAS grew faster than BMSCs (doubling time 28 h vs.39 h,P＜0.05); ADAS and BMSCs also had the same ability to inhibit T cell proliferation,and dose-dependent effects existed in mitogen-stimulated Tcell proliferation and MLR: there was a strong inhibitory effect in 1:2,but this effect disappeared at 1: 100.Both ADAS and BMSCs could arrest most T cells in the G0/G1 phase,but the role of ADAS was weaker than that of the BMSCs.ADAS could not inhibit apoptosis of T cells.ADAS and BMSCs played the same roles in inhibiting the differentiation of TH0 to TH1 or TH2: mainly inhibiting differentiation of TH 0 to TH1 cells (IL-2-and IFN-γ-producing cells),but having no significant effect on TH2 cells (IL-4-and IL 10-producing cells).Conclusion ADAS and BMSC have a similar role in immune regulation.In the same volume,fat tissue has the number of more than 10 times of stem cell precursor cells than that of bone marrow,so adipose tissue is a more promising stem cells transplant source.

Objective; To evaluate the efficacy of Twin-block appliance in Class Ⅱ division 1 of adolescents. Methods: Several e-lectronic databases (PubMed, The Cochrane library, Embase, CBMdisk, CNKI, VIP)were searched. Abstract that appears to fulfill the initial selection criteria were selected by consensus and original articles were retrieved. Five Chinese journals were hand searched for possible missing articles. Randomized controlled trials(RCTs) that evaluate the efficacy of Twin-block appliance in Class Ⅱ division I adolescents without any surgical intervention or syndromic characteristics were considered. A comparable untreated control group was required to factor out normal growth changes. The quality of included studies was evaluated according to Cochrane Reviewers Handbook 4.2.6 Meta-analysis was performed by using RevMan 5.0.0 software. Results: Four RCTs including 289 patients were identified. The results of our meta-analysis showed a significant increase on SNB angle, Ar-Gn, Nasolabial angle and Labial-mental fold compared with control group(P<0.05). Whereas overjet, overbite, ANB angle and Ls-E had a significant decrease. In addition, SNA angle and Li-E didnt show statistical significant changes(P>0. 05). Conclusion; In Class II division 1 of adolescents, Twin-block appliance can effectively decrease their overjet, overbite, ANB angle, and induce anterior-posterior growth of mandible. The effect on restrain forward growth of the maxilla was unclear. More RCTs are required to evaluate the efficacy of Twin-block appliance.