ObjectiveTo understand the whole genome characteristics and the information for genetic evolution in the two coxsackievirus A2 (CVA2) strains isolated from patients with herpangina in Shanghai, and to provide a scientific basis for the prevention and treatment of herpetic angina. MethodsTwo CAV2 strains isolated from patients with herpetic angina in Shanghai were performed whole genome sequencing and analysis for phylogenetics, nucleotide homology, and evolution. ResultsA phylogenetic analysis of the VP1 region revealed that the two Shanghai strains both belonged to CVA2 genotype D, with the highest homology to OL357660, a strain from Yunnan. The average nucleotide identity (ANI) of the whole genome between the two Shanghai strains was 98.88%, and the ANI of the whole genome comparisons to other CVA2 genotype D strains and CVA2 genotypes A-C strains ranged from 84.64% to 97.42% and from 79.21% to 84.20%, respectively. The two Shanghai strains had low homology in the 3D region compared to the existing CVA2 strains. The phylogenetic analysis and sliding window nucleotide similarity analysis indicated that the two Shanghai strains and the Yunnan OL357660 strain might constitute a new genetic lineage. ConclusionThe two CVA2 strains isolated for the first time in Shanghai are assigned to genotype D (GenBank: PQ130039 and PQ130040), which is identical to the existing subtype prevalent in China. As represented by the Shanghai strains, a new CVA2 genetic lineage is been identified. This study has enriched the data on genetic evolution and genetic variation of CVA2 in Shanghai, indicating the requirement to strengthen surveillance for the epidemiological pattern of CVA2.

Objective: The clinical data involving pediatric dental trauma and the features of dental trauma in children were summarized to provide a reference for the treatment and prevention of dental trauma. Methods: A retrospective analysis was performed on 644 children with dental trauma who were admitted to the Department of Children s Stomatology, Stomatology Hospital of Xiamen Medical College from January to December 2022. Descriptive methods were used to analyze the general demographic characteristics of the children and clinical features of dental trauma. Results: The characteristics of the children with dental trauma were as follows: male-to-female ratio, 2.16∶1; mean age, (6.73±3.42) years; most frequently affected age groups, 2-4 and 7-9 years (26.09%, 33.85%); most frequent season for dental trauma, spring (27.61%) and autumn (28.55%); least common season for dental trauma, summer(18.88%); most frequent time of day for dental trauma, evening (51.47%); least common time of day for dental trauma, morning (2.68%); >24 h elapsed from dental trauma-to-treatment (42.08%); most common type of injuries; simple tooth hard tissue and pulp injury in permanent teeth(65.25%) and simple periodontal tissue injury of primary teeth( 53.35 %); most likely teeth involved, maxillary central incisors (80.10%); and number of affected teeth, 1-2. Conclusions The incidence of dental trauma in children has common features, but most children do not see a dentist timely after dental trauma occurs. Educating parents of children with dental trauma should be encouraged to reduce the incidence of dental injury.

ObjectiveTo observe the intervention effect of Huaiqihuang granules （HQH） on immunoglobulin A vasculitis nephritis （IgAVN） mice and explore the underlying therapeutic mechanism. MethodFifty SPF-grade male Kunming mice were randomly divided into a normal group， an IgAVN model group， a dexamethasone group （2.5 mg·kg^-1·d^-1）， a low-dose HQH group （4 g·kg^-1·d^-1）， and a high-dose HQH group （8 g·kg^-1·d^-1）. The mouse model was established using oral administration of gliadin combined with intravenous injection of India ink. After successful modeling， the mice were euthanized after 4 weeks of gastric gavage according to groups. The 24 h urinary total protein （24 h UTP）， urine β₂-microglobulin （β₂-MG）， serum total protein， albumin， IgA， etc. were detected in each group. Flow cytometry was used to determine the proportion of T helper 17 （Th17） cells in spleen cell suspension. Western blot was employed to detect the expression of adenosine 5'-monophosphate-activated protein kinase α （AMPKα）， phosphorylated AMPKα （p-AMPKα）， acetyl-CoA carboxylase 1 （ACC1）， and phosphorylated ACC1 （p-ACC1） in Th17 cells. Pathological changes in the spleen and kidneys were observed. ResultCompared with the normal group， the IgAVN model group showed significant increases in 24 h UTP， urine β₂-MG， total cholesterol （P<0.05）， serum interleukin-17 （IL-17）， IgA， Th17 proportion in the spleen cell suspension， and IL-17 expression in the spleen tissue （P<0.01）， and significantly decreased serum total protein， albumin， p-AMPKα/AMPKα， and p-ACC1/ACC1 expression of Th17 cells （P<0.01）. Compared with the IgAVN model group， in the 4th week， the 24 h UTP， urine β₂-MG， serum IL-17， IgA levels， and renal IgA deposition were significantly reduced in each treatment group （P<0.01）， and the Th17 proportion and IL-17 expression in spleen tissue were significantly decreased （P<0.05， P<0.01）. Serum albumin levels significantly increased （P<0.05）. Compared with the IgAVN model group， the dexamethasone group and the high-dose HQH group showed increases in serum total protein （P<0.01）， p-AMPKα/AMPKα， and p-ACC1/ACC1 expression of Th17 cells （P<0.05， P<0.01）. The high-dose HQH group showed a significant decrease in total cholesterol level （P<0.05）. Various treatment groups showed different degrees of improvement in spleen and kidney pathological changes. ConclusionHQH may affect Th17 cell differentiation by regulating the AMPK/ACC pathway， correcting immune inflammatory disorders， and exerting therapeutic effects on IgAVN.

Objective:To investigate the influencing factors of pathologic complete response (pCR) after neoadjuvant chemoradiotherapy (NCRT) in patients with locally advanced esophageal squamous cell carcinoma (ESCC), and to compare the clinical prognosis of ESCC patients with and without pCR after NCRT (40 Gy/ 20F).Methods:Among patients enrolled in a prospective clinical study, 87 ESCC patients treated with NCRT followed by surgery in Tianjin Medical University Cancer Institute & Hospital between June 2015 and October 2019 were selected. They were divided into the pCR ( n=35) and non-pCR groups ( n=52). Clinicopathological characteristics were retrospectively analyzed and subsequent follow-up was performed. Clinical prognosis and influencing factors were compared between two groups by using Kaplan-Meier and Cox regression analyses. Results:After NCRT, 40% of the ESCC patients could achieve pCR. Univariate analysis showed that patients in the pCR group had a disease-free survival (DFS) of 39.3 months and an overall survival (OS) of 64.0 months. In comparison, patients in the non-pCR group had a DFS of only 14.1 months and an OS of only 25.2 months. The differences were statistically significant (DFS: P<0.01, OS: P<0.05). Multivariate analysis revealed that whether pCR or not after NCRT, age, number of primary lesions, evaluation results after NCRT and postoperative pathological outcomes were important prognostic factors. The differences were statistically significant between two groups (all P<0.05). Conclusion:pCR after NCRT is significantly correlated with long-time survival of patients with ESCC, and pCR after NCRT has an important value in predicting clinical prognosis for long-term survival of ESCC patients.

Hearing loss is one of the common radiotherapy-induced complications of head and neck tumors, including nasopharyngeal carcinoma. These side reactions can be classified into acute or delayed types, which affect all structures of the auditory organs, resulting in conductive, sensorineural or mixed hearing loss. Up to 40% of patients develop acute middle ear side effects during radical radiotherapy, while approximately 1/3 develop late sensorineural hearing loss. The total radiation dose and tumor site appear to be the most important factors associated with the risk of hearing loss. The mechanisms of conductive and sensorineural hearing impairment are different. New radiotherapy techniques (three-dimensional conformal radiotherapy, intensity modulated radiotherapy, proton therapy) enable better dose distribution, lower dose to non-target organs, and gradually increase the feasibility of protecting normal tissues. The present article illustrates recent progress in radiotherapy-induced hearing loss, specially focusing on the occurrence, the mechanisms and related factors of ear toxicity, detection and diagnosis, and treatment.

Radiotherapy is one of the main treatment methods for malignant tumors, which can cause the radiation damage to normal tissues. Radiation-induced skin injury (RISI) is one of the main adverse reactions caused by radiotherapy. The main clinical manifestations of RISI are dermatitis, ulcer, erosion and necrosis, which seriously affect the quality of life and treatment effect of tumor radiotherapy patients, and even affect the overall survival of patients. The pathological mechanism of RISI is still unclear. Some studies have shown that inflammation and oxidative stress are the main causes of RISI. RISI can be divided into acute and chronic RISI according to the different onset time, and different treatment strategies can be formulated according to the severity of the injury. In this article, clinical manifestations, classification, pathogenesis, prevention and treatment of RISI are comprehensively summarized.

Objective To observe the value of right ventricle modified myocardial performance index(RV-Mod-MPI)for evaluating maternal obstetric antiphospholipid syndrome(OAPS)involving fetal right ventricular function.Methods Forty-five pregnant women with maternal OAPS(OAPS group)and 60 healthy pregnant women(control group)were prospectively enrolled.Fetal RV-Mod-MPI was obtained with tricuspid and pulmonary valve flow images by applying pulsed wave Doppler(PW).Late pregnancy conditions and data of newborns after delivery were recorded.The indexes were compared between groups.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was used to assess the efficacy of fetal RV-Mod-MPI for predicting adverse pregnancy outcomes in OAPS group.Results Compared with those in control group,OAPS group had higher fetal RV-Mod-MPI values,lower newborn birth weight and lower Apgar score at 1 min after birth,as well as higher probability of adverse pregnancy outcomes(all P＜0.05).The AUC of fetal RV-Mod-MPI for predicting adverse pregnancy outcome in OAPS group was 0.726.Conclusion RV-Mod-MPI could be used to evaluate maternal OAPS involving fetal right ventricular function and predict adverse pregnancy outcomes.

Single-cell or low-input multi-omics techniques have revolutionized the study of pre-implantation embryo development.However,the single-cell or low-input proteomic research in this field is rela-tively underdeveloped because of the higher threshold of the starting material for mammalian embryo samples and the lack of hypersensitive proteome technology.In this study,a comprehensive solution of ultrasensitive proteome technology(CS-UPT)was developed for single-cell or low-input mouse oocyte/embryo samples.The deep coverage and high-throughput routes significantly reduced the starting material and were selected by investigators based on their demands.Using the deep coverage route,we provided the first large-scale snapshot of the very early stage of mouse maternal-to-zygotic transition,including almost 5,500 protein groups from 20 mouse oocytes or zygotes for each sample.Moreover,significant protein regulatory networks centered on transcription factors and kinases between the MII oocyte and 1-cell embryo provided rich insights into minor zygotic genome activation.

Based on the knowledge of the metabolism of the three major nutrients, the research group designed three different ways of weight loss with reference to basic biochemical knowledge and clinical hot issues in overweight and obesity. The students were involved in the whole process of weight loss observation and the teaching methods such as Rain Classroom, DingTalk, microclass, and flipped classroom were used to improve the students' interest and enthusiasm in learning and promote their understanding and mastery of substance metabolism and its regulation. The questionnaire survey on the degree of satisfaction with teaching showed that 97.31% (217/223) of the students satisfied with this blended teaching model and 96.86% (216/223) of the students thought that this model was helpful to understand material metabolism in biochemical theory, and therefore, this teaching method can be used in future teaching of material metabolism and its regulation.

Objective:To compare the efficacy and safety of high- and standard-dose radiotherapy (HD-RT vs. SD-RT) during definitive concurrent chemoradiotherapy (dCCRT) for esophageal cancer (EC), aiming to assess the advantages and disadvantages of these two radiotherapy doses when using modern radiotherapy techniques. Methods:Literature review was conducted from PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang database, and abstracts of the American Society of Radiation Oncology (ASTRO) and the European Society of Radiotherapy and Oncology (ESTRO). Randomized controlled trials (RCT) comparing high-dose radiotherapy (HD-RT: ≥59.4 Gy,1.8 Gy per time) with standard-dose radiotherapy (SD-RT: 50 Gy, 2 Gy per time, or 50.4 Gy, 1.8 Gy per time) during dCCRT for EC were included. The retrieval time was from the establishment of the database to January 1, 2023. The meta-analysis was performed using Stata 16.0 software.Results:A total of 1 158 patients from 5 RCT that meet the inclusion criteria were finally included. In 4 RCT, subgroup analysis of 940 patients using modern radiotherapy techniques were performed. Patients in the HD-RT and SD-RT groups had similar 1-, 2-, and 3-year overall survival (OS)( RR=1.03, 95% CI=0.86-1.22, P=0.757; RR=1.05, 95% CI=0.94-1.17, P=0.433; RR=1.05, 95% CI=0.96-1.14, P=0.314; respectively) and 2- and 3-year locoregional progression-free survival (LRPFS) ( RR=0.94, 95% CI=0.82-1.08, P=0.390; RR=0.96, 95% CI=0.86-1.09, P=0.560; respectively). Patients in the HD-RT group had a higher incidence of grade ≥ 3 treatment-related adverse reactions rates ( OR=1.35, 95% CI=1.03-1.77, P=0.029) and treatment-related death rates ( OR=1.66, 95% CI=0.97-2.83, P=0.062) compared with their counterparts in the SD-RT group. In the subgroup analysis using modern radiotherapy techniques, HD-RT did not improve LRPFS compared to SD-RT, but increased the incidence of adverse reactions, and yielded no OS benefit. Conclusions:Whether modern precision radiation therapy is employed or not, SD-RT yields similar LRPFS and OS, and lower grade ≥ 3 treatment-related adverse reactions rates compared with HD-RT. Therefore, standard-dose (50 Gy, 2 Gy per time, or 50.4 Gy, 1.8 Gy per time) should be considered as the recommended dose in dCCRT for EC. Further RCT are needed to verify our conclusions.