Objective To investigate the relationship between exposure to famine in early life stage and hypertension phenotype and grade in middle and old age. Methods People born between 1951 and 1965 in the 2015 China Health and Elderly Care Follow-up Survey were included in the study, and were divided into unexposed group, fetal exposed group, childhood exposed group and adolescent exposed group according to the time of famine occurrence and birth year of the participants. Logistic regression model was used to explore the effects of different famine exposure periods in early life stage on hypertension classification （including normal high value, grade I, grade II and grade III） and phenotype （including isolated systolic hypertension[ISH], isolated diastolic hypertension [IDH] and combined systolic and diastolic hypertension [SDH]）. Results Compared with unexposed group, fetal famine exposure （OR=1.59, 95% CI :1.10-2.30）, childhood famine exposure （OR=1.67, 95% CI :1.04-2.70） and adolescent famine exposure （OR=3.42, 95% CI : 2.51-4.66） were the risk factors for ISH. Only famine exposure during adolescence （OR=1.54, 95% CI: 1.07-2.21） was a risk factor for SDH. In addition, fetal famine exposure （OR=1.41, 95% CI: 1.05-1.89） and adolescent famine exposure （OR=2.22 , 95% CI: 1.71-2.88） were risk factors for developing grade I hypertension. Famine exposure in childhood （OR=2.45, 95% CI: 1.21-4.94） and famine exposure in adolescence （OR=2.45, 95% CI: 1.44-4.19） were risk factors for grade 2 hypertension. Conclusion Famine exposure in early life stage was associated with the phenotype and grade of hypertension. Therefore, balanced nutrition in early life is important to prevent hypertension in adulthood.

Previous studies suggest that the reduction of SMAD3 (mothers against decapentaplegic homolog 3) has a great impact on tumor development, but its exact pathological function remains unclear. In this study, we found that the protein level of SMAD3 was greatly reduced in human-grade IV glioblastoma tissues, in which LAMP2A (lysosome-associated membrane protein type 2A) was significantly up-regulated. LAMP2A is a key rate-limiting protein of chaperone-mediated autophagy (CMA), a lysosome pathway of protein degradation that is activated in glioma. We carefully analyzed the amino-acid sequence of SMAD3 and found that it contained a pentapeptide motif biochemically related to KFERQ, which has been proposed to be a targeting sequence for CMA. In vitro, we confirmed that SMAD3 was degraded in either serum-free or KFERQ motif deleted condition, which was regulated by LAMP2A and interacted with HSC70 (heat shock cognate 71 kDa protein). Using isolated lysosomes, amino-acid residues 75 and 128 of SMAD3 were found to be of importance for this process, which affected the CMA pathway in which SMAD3 was involved. Similarly, down-regulating SMAD3 or up-regulating LAMP2A in cultured glioma cells enhanced their proliferation and invasion. Taken together, these results suggest that excessive activation of CMA regulates glioma cell growth by promoting the degradation of SMAD3. Therefore, targeting the SMAD3-LAMP2A-mediated CMA-lysosome pathway may be a promising approach in anti-cancer therapy.

Objective:To analyze the key genes and mechanisms of sepsis secondary to multiple trauma based on bioinformatics methods.Methods:Data set GSE70311 was downloaded from Gene Expression Omnibus database.After data set pretreatment, differentially expressed genes (DEGs) in peripheral blood of patients with sepsis secondary to multiple injuries were screened using Limma R package.ClusterProfiler R package was used for gene ontology (GO) enrichment analysis and Kyoto encyclopedia of genes and genomes (KEGG) signaling pathway analysis of DEGs.Finally, the protein-protein interaction network was constructed by using the STRING online database and Cytoscape, and the hub genes of sepsis secondary to multiple injuries were identified based on Cytohubba.Results:In the GSE70311 dataset, 328 DEGs were obtained.The results of GO enrichment analysis showed that the biological processes involved in DEGs in sepsis secondary to multiple trauma mainly included T cell differentiation, positive regulation of cytokine production, defense response to bacteria, response to virus and defense response to virus, etc.The results of KEGG pathway enrichment analysis showed that DEGs were significantly enriched in hematopoietic cell lineage, Staphylococcus aureus infection, asthma, Th1 and Th2 cell differentiation, and antigen processing and presentation etc.signaling pathways in sepsis secondary to multiple trauma.Five hub genes were further screened by protein-protein interaction analysis, including STAT1, IFIT3, ISG15, IFIT1 and MX1. Conclusions:STAT1, IFIT3, ISG15, IFIT1 and MX1 are potential hub genes of sepsis secondary to multiple trauma, involved in T cell differentiation, positive regulation of cytokine production and defense response to pathogenic microorganisms, and enriched in Th1 and Th2 cell differentiation and antigen processing and presentation etc.signaling pathways.

Osteoporotic thoracolumbar fracture in the elderly will seriously reduce their quality of life and life expectancy. For osteoporotic thoracolumbar fracture in the elderly, spinal reconstruction is necessary, which should comprehensively consider factors such as the physical condition, fracture type, clinical characteristics and osteoporosis degree. While there lacks relevant clinical norms or guidelines on selection of spinal reconstruction strategies. In order to standardize the concept of spinal reconstruction for osteoporotic thoracolumbar fracture in the elderly, based on the principles of scientificity, practicality and progressiveness, the authors formulated the Clinical guideline for spinal reconstruction of osteoporotic thoracolumbar fracture in elderly patients ( version 2022), in which suggestions based on evidence of evidence-based medicine were put forward upon 10 important issues related to the fracture classification, non-operative treatment strategies and surgical treatment strategies in spinal reconstruction after osteoporosis thoracolumbar fracture in the elderly, hoping to provide a reference for clinical treatment.

This study aimed to quantitatively assess the effectiveness of the Wuhan lockdown measure on controlling the spread of coronavirus diesase 2019 (COVID-19). : Firstly，estimate the daily new infection rate in Wuhan before January 23，2020 when the city went into lockdown by consulting the data of Wuhan population mobility and the number of cases imported from Wuhan in 217 cities of Mainland China. Then estimate what the daily new infection rate would have been in Wuhan from January 24 to January 30th if the lockdown measure had been delayed for 7 days，assuming that the daily new infection in Wuhan after January 23 increased in a high，moderate and low trend respectively (using exponential, linear and logarithm growth models). Based on that，calculate the number of infection cases imported from Wuhan during this period. Finally，predict the possible impact of 7-day delayed lockdown in Wuhan on the epidemic situation in China using the susceptible-exposed-infectious-removed (SEIR) model. : The daily new infection rate in Wuhan was estimated to be 0.021%，0.026%，0.029%，0.033% and 0.070% respectively from January 19 to January 23. And there were at least 20 066 infection cases in Wuhan by January 23，2020. If Wuhan lockdown measure had been delayed for 7 days，the daily new infection rate on January 30 would have been 0.335% in the exponential growth model，0.129% in the linear growth model，and 0.070% in the logarithm growth model. Correspondingly，there would have been 32 075，24 819 and 20 334 infection cases travelling from Wuhan to other areas of Mainland China，and the number of cumulative confirmed cases as of March 19 in Mainland China would have been 3.3-3.9 times of the officially reported number. Conclusions: Timely taking city-level lockdown measure in Wuhan in the early stage of COVID-19 outbreak is essential in containing the spread of the disease in China.
COVID-19 ; China/epidemiology* ; Cities ; Communicable Disease Control ; Humans ; SARS-CoV-2

To evaluate the impact of socioeconomic status，population mobility，prevention and control measures on the early-stage coronavirus disease 2019 (COVID-19) development in major cities of China. : The rate of daily new confirmed COVID-19 cases in the 51 cities with the largest number of cumulative confirmed cases as of February 19，2020 (except those in Hubei province) were collected and analyzed using the time series cluster analysis. It was then assessed according to three aspects，that is, socioeconomic status，population mobility，and control measures for the pandemic. : According to the analysis on the 51 cities，4 development patterns of COVID-19 were obtained，including a high-incidence pattern (in Xinyu)，a late high-incidence pattern (in Ganzi)，a moderate incidence pattern (in Wenzhou and other 12 cities)，and a low and stable incidence pattern (in Hangzhou and other 35 cities). Cities with different types and within the same type both had different scores on the three aspects. : There were relatively large difference on the COVID-19 development among different cities in China，possibly affected by socioeconomic status，population mobility and prevention and control measures that were taken. Therefore，a timely public health emergency response and travel restriction measures inside the city can interfere the development of the pandemic. Population flow from high risk area can largely affect the number of cumulative confirmed cases.
COVID-19 ; China/epidemiology* ; Cities ; Humans ; SARS-CoV-2 ; Social Class

Objective:To analyze molecular genetic characteristics of standard strains for functional antibody detection of pneumococcal polysaccharide vaccine, and provide the foundation for clinical research of pneumococcal polysaccharide vaccine. Methods:The 24 strains for functional antibody detection of pneumococcal polysaccharide vaccine were detected by PCR amplification and sequencing using standard strain 16S rRNA gene fragment, and the molecular typing of the related strains was performed by multi locus sequence analysis (MLST) and pulsed field gel electrophoresis (PFGE). Results:The result of 16S rRNA gene sequence alignment showed that the similarity between the gene sequences of the 24 strains and that of NCTC 7465 (LN831051) ranged from 98.35% to 99.86%, and the base difference was 2-23 bp. Multi locus sequence analysis showed that the ST types of 24 standard strains were different. PFGE analysis showed that 24 standard strains had good isolation effect from DNA fragments of 100 kb-1 000 kb, and each serotype had its own characteristic bands (12-15 fragments).Conclusions:This study analyzed the molecular genetic characteristics of the standard strains for the detection of pneumococcal functional antibodies for the first time, and may provide a reference for the quality control method of the standard strains for the subsequent detection of pneumococcal functional antibodies.

Objective:To investigate the characteristics of senile neurodegenerative diseases (NDDs) inpatients in south China, especially in Guangdong province, and explore the influencing factors for their medical expenses.Methods:The medical records of 7231 patients with NDDs≥65 years were collected in the electronic health database of our hospital from January 2010 to December 2019, including gender, age, admission ways, chief complaints, length of hospital stays and medical expenses. On the basis of median of the medical expenses (21 345 yuan) of these patients, they were divided into low cost (<21 345 yuan) group and high cost (≥21 345 yuan) group. Univariate Logistic analysis and multivariate Logistic regression analysis were conducted to screen the influencing factors for medical expenses and the independent influencing factors.Results:(1) The main age group of geriatric inpatients with NDDs were 70-79 years (40.96%); the admission source was mainly outpatient (56.70%), and length of hospital stays of a large percent of patients (44.50%) were 8-14 d. (2) From 2010 to 2019, the number of hospitalized geriatric patients with NDDs showed an increasing trend year by year, the overall trend of length of hospital stays was shortened, and the medical expenses showed gradual increase; the causes of hospitalization, percentages of patients caused by infection, abnormal blood pressure and water-electrolyte metabolism disturbances showed decreased trend, percentages of patients caused by heart diseases, cerebrovascular accidents and mental-psychological diseases showed increased trend, and the proportions of patients caused by fracture/trauma/wound injuries were generally stable. The proportion of patients returning home and mortality rate after hospital discharge were declined, and the proportion of patients returning to other medical or community institutions was increased. (3) Living in ICU, length of hospital stays, diabetes, nosocomial infection, chronic kidney disease, urinary tract infection, tumble, body mass index, and anticholinergic drugs were independent risk factors influencing the medical expenses ( P<0.05). Conclusions:An aging trend is noted in patients with NDDs; the number of hospitalized patients and medical expenses increase year by year, and the length of hospital stays gradually decreases. In view of the many factors that influence the medical expenses of this disease, it is suggested to develop the corresponding standardized treatment plan for the main influencing factors in clinical practice.

Objective To investigate the histological injury as well as the risk factors for the course of HBeAg-negative chronic hep-atitis B virus( HBV)-infected patients with persistently normal alanine aminotransferase ( ALT) levels ( PNAL) . Methods Ninty four patients of HBeAg-negative chronic HBV-infected with PNAL were performed liver puncturing. The ALT, HBV markers, and liver histo-logical changes were detected. The gender, age, family history, HBV-DNA and HBsAg levels were compared between different patients with liver inflammation and fibrosis. And the Logistic model was used during the analysis of independent risk factor. Results Among 94 cases, patients with inflammatory necrosis classification≥G2 accounted for 74. 5%, fibrosis grading≥S2 accounted for 27. 7%. Patients in the group of inflammatory necrosis classification≥G2 was older than the group of < G2, and the ALT level of≥G2 group was higher, as well as a higher HBV-DNA. What is more,Patients in the group of inflammatory necrosis classification ≥G2 were mainly male, and were associated with a family history of hepatitis B. Patients in the group of fibrosis stage ≥S2 was older than < S2 group, and the ALT level of fibrosis stage ≥S2 group was higher. And those patients were often associated with a family history of hepatitis B, but there was no significant difference among the HBV-DNA level and gender constitution. HBV-DNA and family history were the independent risk fac-tors of liver inflammation necrosis≥G2, and family history was the only independent risk factor of fibrosis stage≥S2. Conclusion The patients of HBeAg-negative chronic HBV-infected with PNAL, regardless of the ALT and HBV-DNA, must have a liver biopsy. The pa-tients with high level of HBV-DNA and with a family history of hepatitis B should be performed liver puncturing accordingly.

OBJECTIVETo investigate the expression level of SET gene in patients with acute myeloid leukemia (AML) and evaluate its significance.

METHODSThe expression level of SET gene in 141 de novo AML patients was determined by real time quantitative PCR (RQ-PCR), and its relationship with the clinical features and outcomes of these patients were analyzed.

RESULTSSET gene transcript level was detected in 141 AML patients with the median expression level of 0.86(range 0.02-15.69). AML patients with higher SET gene expression had a higher level of white blood cell (WBC ≥ 100 × 10⁹/L) count than of lower SET gene expression ones (31.0% vs 11.4%, P=0.005). In the 136 patients who received treatment after diagnosis, higher SET gene expression group had lower complete remission rate (50.0%) than of lower expression cohort (73.5%) after two cycles of chemotherapy (P=0.005). Survival analysis showed that patients with higher SET gene expression had significantly shorter overall survival(OS) (10 months vs 22 months, P=0.001) and event-free survival (EFS) (2 months vs 14 months, P=0.005) than of lower SET gene expression ones. Multivariate COX regression analysis showed SET overexpression was an independent prognostic factor for OS. In the patients with the normal karyotype, higher SET expression group also had significantly shorter OS (12 months vs 35 months, P=0.010) and EFS (4 months vs 14 months, P=0.026) than of lower SET expression ones.

CONCLUSIONHigh expression of SET gene was associated with poor prognosis and might be a prognostic molecular marker of AML.

Disease-Free Survival ; Gene Expression Regulation, Neoplastic ; Histone Chaperones ; genetics ; Humans ; Leukemia, Myeloid, Acute ; genetics ; Prognosis ; Remission Induction ; Transcription Factors ; genetics