Andrographolide sulfonate (AS) is a sulfonated derivative of andrographolide extracted from Andrographis paniculata (Burm.f.) Nees, and has been approved for several decades in China. The present study aimed to investigate the novel therapeutic application and possible mechanisms of AS in the treatment of rheumatoid arthritis. Results indicated that administration of AS by injection or gavage significantly reduced the paw swelling, improved body weights, and attenuated pathological changes in joints of rats with adjuvant-induced arthritis. Additionally, the levels of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and IL-1β in the serum and ankle joints were reduced. Bioinformatics analysis, along with the spleen index and measurements of IL-17 and IL-10 levels, suggested a potential relationship between AS and Th17 cells under arthritic conditions. In vitro, AS was shown to block Th17 cell differentiation, as evidenced by the reduced percentages of CD4⁺ IL-17A⁺ T cells and decreased expression levels of RORγt, IL-17A, IL-17F, IL-21, and IL-22, without affecting the cell viability and apoptosis. This effect was attributed to the limited glycolysis, as indicated by metabolomics analysis, reduced glucose uptake, and pH measurements. Further investigation revealed that AS might bind to hexokinase2 (HK2) to down-regulate the protein levels of HK2 but not glyceraldehyde-3-phosphate dehydrogenase (GAPDH) or pyruvate kinase M2 (PKM2), and overexpression of HK2 reversed the inhibition of AS on Th17 cell differentiation. Furthermore, AS impaired the activation of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signals in vivo and in vitro, which was abolished by the addition of lactate. In conclusion, AS significantly improved adjuvant-induced arthritis (AIA) in rats by inhibiting glycolysis-mediated activation of PI3K/AKT to restrain Th17 cell differentiation.
Animals ; Th17 Cells/immunology* ; Diterpenes/pharmacology* ; Arthritis, Rheumatoid/metabolism* ; Proto-Oncogene Proteins c-akt/immunology* ; Glycolysis/drug effects* ; Cell Differentiation/drug effects* ; Phosphatidylinositol 3-Kinases/genetics* ; Rats ; Male ; Rats, Sprague-Dawley ; Humans ; Andrographis paniculata/chemistry* ; Arthritis, Experimental/drug therapy* ; Interleukin-17/immunology* ; Signal Transduction/drug effects*

Objective: To explore the status and associated factors of the knowledge and health education needs about child sexual abuse of middle school students by sex, so as to provide a basis for targeted safety education of preventing child sexual abuse. Methods: From June to July 2023, 1 256 junior high school students from 2 middle schools in southern area of Shaanxi Province were selected by a convenience sampling method. A selfdesigned general information questionnaire, Childrens Sexual Assault Cognition Questionnaire, and Health Education Needs Questionnaire were used for questionnaire survey. Group comparisons were conducted using ttests, analysis of variance, and Chisquare tests. Multiple linear regression analysis was used to explore the factors related to cognitive scores of sexual assault, and binary Logistic regression analysis was used to explore the factors related to the willingness of middle school students to receive sexual assault safety education. Results: The correct response rate of the participants for knowledge of sexual assault cognition (CSA) was (80.97±12.09)%. For each item, the correct response rate ranged 46.7%-97.2%. The correct rate (78.98±12.23)% of male students knowledge of CSA was lower than female students (83.17±11.55)% statistically (t=-6.23, P<0.01). The factors influencing the participants knowledge of CSA included gender (β=0.16), mothers occupation (β=0.07) and experience of CSA safety education (β=0.10) (P<0.05). Most students (92.7%) were willing to receive CSA education. Girls (OR=1.72, 95%CI=1.06-2.77) and students who previously received CSA education (OR=6.98, 95%CI=4.44-10.96) had more willingness to receive CSA education (P<0.05). A total of 71.8% of middle school students preferred their parents as educators, while 43.4% of students chose onsite instruction as the preferred method of CSA education. Conclusions Middle school students have a strong willingness to accept CSA safety education. Knowledge of CSA and willingness to receive CSA safety education are related to gender and previous educational experience.

ObjectiveTo determine the human papillomavirus （HPV） infection status and possible influencing factors among healthy women aged 18‒45 years， and to provide a scientific evidence for the prevention of HPV infection and cervical cancer. MethodsA total of 23 HPV types were examined by PCR-reverse dot blot hybridization in 1 210 healthy women who voluntarily participated in the study. Infection status of each HPV genotype and possible factors associated with the infection were determined， including age， ethnicity， marital history， pregnancy history， number of sexual partners， and age at first sexual intercourse. ResultsA total of 1 210 healthy women were examined， of which267 tested positive for HPV， with a prevalence of 22.07%. The prevalence did not differ significantly across age groups or ethnicities （all P>0.05）. Moreover， the highest prevalence was found in the divorced/widowed participants （53.57%）， compared with other marital status （χ²=35.16， P<0.05）. Among the 1 207 participants with pregnancy history， the highest HPV prevalence was 30.58% in those with five or more pregnancies； however， it did not significantly associated with numbers of pregnancies （χ²=10.07， P=0.07）. Number of sexual partners showed a significantly positive association with HPV infection （P<0.05）. In addition， earlier age at first sexual intercourse was significantly associated with HPV infection （χ²=17.37， P<0.05）. ConclusionHealthy women in Panzhihua City were mainly infected with a single HPV type， and the dominant types were HPV 52， 81， and 53. Marital history status， higher number of sexual partners， and younger age at first sexual intercourse were influencing factors associated with HPV infection. It suggested that regular sexual partners and stable marital relationship may reduce the risk of HPV infection.

Objective: To understand the prevalence and its influencing factors of metabolic syndrome (MS) among employees in petrochemical enterprises, so as to provide insights into the prevention and control of MS among employees in petrochemical enterprises. Methods: The employees in petrochemical enterprises who underwent health examinations at the Fourth Affiliated Hospital of Gansu University of Traditional Chinese Medicine from May 2021 to December 2022 were selected as the survey subjects. Demographic information, lifestyle behaviors and occupational exposure were collected using questionnaires, and the blood biochemical indicators were measured through laboratory testing. Factors affecting MS were identified using a multivariable logistic regression model. Results: A total of 2 479 individuals were included, with a mean age of (44.84±7.87) years. There were 1 684 males (67.93%) and 795 females (32.07%). There were 905 cases of MS, with a detection rate of 36.51%. Multivariable logistic regression analysis showed that gender (male, OR=2.246, 95%CI: 1.353-3.728), age (≥40 years, OR=3.523, 95%CI: 2.003-6.194), noise exposure (OR=1.894, 95%CI: 1.272-2.821), smoking index (>0~200 cigarette-years, OR=1.907, 95%CI: 1.155-3.149; >200 cigarette-years, OR=2.257, 95%CI: 1.320-3.859), hyperuricemia (OR=3.013, 95%CI: 1.852-4.900) and γ-glutamyltransferase (abnormal, OR=2.691, 95%CI: 1.589-4.559) were the influencing factors of MS among employees in petrochemical enterprises. Conclusion The risk of MS occurrence among employees in petrochemical enterprises is related to gender, age, noise exposure, smoking index, hyperuricemia and γ-glutamyltransferase level.

【Objective】 To analyze the serological characteristics and molecular mechanism of a novel B subtype allele 803delC. 【Methods】 ABO blood group was detected by serological method. Sequence-specific primer polymerase chain reaction (PCR-SSP) was used to detect ABO blood group genes. The coding region of exon 1-7 of ABO gene was detected by Sanger sequencing to determine the mutation site. 【Results】 Serological identification of patients was with forward O-type and reverse B-type. The result of PCR-SSP genotyping was A/O. There was A gene, which was not consistent with serological results. Further Sanger double-strand sequencing revealed that the C-base was deleted at position 803 of exon 7 on the basis of ABO^*B. 01/ABO^*O. 01.01. The mutation eventually leads to the amino acid substitution of p. Ala268Gly and p. Phe269Ser and the production of new open reading frame starting at position 269, with the new open reading frame No.20 amino acid being stop codon, resulted in the termination of B gene expression. Further single-strand sequencing of the ABO gene revealed that the mutation was located in the ABO^*B. 01 gene. The mutation was submitted to the NCBI database with the number OR343908. 【Conclusion】 A new ABO allele leading to B variant has been found in Chinese population. Genetic detection can be used to identify the ambiguous blood group with discrepancy between forward and reverse blood grouping.

Objective: To understand the situation of neglect of preschool children in the urban area of Xi an under the background of multi child policy, so as to provide a reference for making effective prevention. Methods: In Novmber 2022, according to the multi stage stratified cluster sampling principle, 2 450 parents of children aged 3-6 years were randomly selected from 7 urban areas of Xi an to participate in the questionnaire survey. A questionnaire survey was conducted using the "Neglect Evaluation Norms of 3-6 Years Old (Preschool) Children in Urban Areas of China". SPSS 18.0 software was used for statistical description, Chi square test and variance analysis. Results: The total neglect rate of preschool children in the urban area of Xi an was 29.0% and the total neglect score was (37.58±8.44). There was no statistical difference in the neglect status of children in different grade groups ( χ 2/ F =1.61, 2.98, P >0.05). The neglect score of boys was higher than girls ( t =2.45, P <0.05). There was no statistical difference in the neglect rate and neglect score of boys and girls in other levels ( P >0.05); except for the significant difference in the neglect degree of medical treatment, education and safety ( t =2.01, 2.28, 2.02, P <0.05). The rate and score of neglect in multi-child families were higher than only-child families ( χ 2/ t = 13.68, -4.54, P <0.05). There were significant differences in the rate and degree of neglect of children with different birth order, which were "third and fourth-born>second-born>first-born" ( χ 2/ F = 10.84 , 2.79, P <0.05). The neglect rate and score of "single parent family" were significantly higher than that of "nuclear family" and "three-generation family" ( χ 2/ F =4.78, 2.79, P <0.05). Conclusion The neglect situation of preschool children in urban area of Xi an is still serious, especially in multi-child families. It should actively explore the risk factors and formulate effective intervention measures.

Objective:Partial stereotactic ablative boost radiotherapy(P-SABR)is a method to deliver SABR boost to the gross tumor boost volume(GTVb), followed by conventionally fractionated radiotherapy to the whole tumor area(GTV). GTVb is the max volume receiving SABR while ensuring the critical organ-at-risk(OAR)falloff to 3 GyE/f. We investigated the potential advantage of proton therapy in treating bulky non-small cell lung cancer(the tumor length greater than 8 cm).Methods:Nine patients with bulky NSCLC treated with photon P-SABR in our institute were selected. For the treatment planning of proton therapy, the GTVb target area was gradually outwardly expanded based on the photon GTVb target area until the dose to critical OARs reached 3 GyE/f. The GTV and CTV areas remained the same as photon plan. A proton intensity-modulated radiation treatment plan(proton-IMPT), a photon intensity-modulated radiation treatment plan(photon-IMRT)and a photon volumetric modulated arc therapy(photon-VMAT)were created for each patient, respectively. The dosimetric parameters of different treatment plans were compared.Results:The volume ratio of GTVb-photon and GTVb-proton to GTV was(25.4±13.4)% and(69.7±30.0)%,respectively( P<0.001). In photon-IMRT, photon-VMAT, and proton-IMPT plan groups, the mean dose of CTV was(76.1±4.9)Gy, (78.2±3.6)Gy, and(84.7±4.9)Gy, respectively; the ratio of tumor volume with Biologic Effective Dose(BED)≥ 90 Gy to GTV volume was(70.7±21.7)%, (76.8±22.1)%,and(97.9±4.0)%,respectively. The actual dose and BED to the tumor area of the proton-IMPT plan group were significantly higher than those of the photon plan group(both P<0.05). Besides, the OARs dose was significantly decreased in the proton-IMPT group, with(49.2±22.0)%, (56.8±19.0)% and(16.1±6.3)% of the whole lung V5 for photon-IMRT, photon-VMAT and proton-IMPT, respectively(all P<0.001). Conclusions:Larger GTV boost target volume, higher BED and reduced OARs dose can be achieved in proton plans compared with photon plans. Proton P-SABR is expected to further improve the local control rate of bulky NSCLC with fewer adverse effects.

We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.
Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Dactinomycin/adverse effects* ; Female ; Gestational Trophoblastic Disease/drug therapy* ; Humans ; Methotrexate/therapeutic use* ; Pregnancy ; Retrospective Studies

Objective: To explore the psychological responses and related factors of college students in Shaan’xi during the outbreak of COVID-19, in order to provide reference for the psychological intervention for college students. Methods: A self-designed general data questionnaire and Psychological Questionnaires for Emergent Events of Public Health(PQEEPH) were sent out to students in public university aged 18 to 28 years by Wechat APP from February 7th to 9th, 2020. Univariate and Logistic analysis were used to analyze the influencing factors associated with NCP. Results: The scores of the five factors on the PQEEPH scale were (0.29±0.48) for depression, (0.27±0.46) for neurasthenia, (0.92±0.60) for fear, (0.15±0.34) for obsessive-anxiety, and (0.26±0.44) for hypochondria，The score of fear factors were the highest. And 15.4% had depressive emotional deviation, accounting for the highest proportion of emotional deviation, and the proportion of compulsive anxiety emotional disorder was highest, which accounting for 6.4%. Logistic regression analysis showed that the higher grades were risk factors for depression (OR=1.61, 95%CI=1.05-2.47), obsessive anxiety (OR=1.56, 95%CI=1.05-2.31) and hypochondria (OR=2.01, 95%CI=1.16-3.47) disorders, Non-medical specialties is risk factor for fear disorders (OR=2.16, 95%CI=1.18-3.95)，not believing oneself to be in danger in the face of the epidemic was a protective factor for five types of mood disorders (OR=0.17-0.51), and residence in towns and villages was a protective factor for neurasticity disorders (OR=0.58, 95%CI=0.38-0.87), the gender of female was the protective factor of hypochondria emotional disorder (OR=0.34, 95%CI=0.19-0.62)(P<0.05). Conclusion During outbreak of COVID-19, psychological intervention counselling and health education of college students should be strengthened. Moreover, psychological problems need be screened in time for intervention, so as to reduce panic and other adverse psychological conditions of students.

Objective: To understand and explore the fear-related emotional disorder and its influencing factors among college students during the prevalence of coronavirus disease 2019 （COVID-19）, in order to provide reference for the further health education and psychological intervention. Methods: A self-designed questionnaire for general data and Psychological Questionnaires for Emergent Events of Public Health （PQEEPH） were typed in www.wjx.cn and sent out to the students of four univerties in Xi'an by WeChat from February 7th to 9th,2020. The status and influencing factors of fear-related emotional disorder in response to COVID-19 were analyzed. Results: Totally 1 546 valid questionnaire were collected. The average age of the students was （20.24±1.60）years old. There were 761 males（49.22%）and 785（50.78%）females;499 medical students （32.27%）and 1 047 non-medical students（67.72%）. The average score of fear dimension was 0.90±0.59,which was the highest in PQEEPH. Moreover, 280 students had fear-related emotional deviance,accounting for 18.11%,and 57 students had fear-related emotional disorder,accounting for 3.69%. The rate of fear-related emotional disorder was significantly higher in non-medical students（4.58%）than in medical students（1.80%,P<0.05）. The rate of fear-related emotional disorder was significantly higher in the students who considered themselves close to COVID-19（4.22%）and at risk of COVID-19（5.45%） than in the students who did not（1.94% and 0.98%,both P<0.05）. Conclusions Totally 3.69% of the students from universities in Xi'an suffer from fear-related emotional disorder in response to COVID-19. The students who do not major in medicine are prone to developing fear-related emotional disorder.