ObjectiveTo investigate the performance of fibrosis-4 （FIB-4） versus aspartate aminotransferase-to-platelet ratio index （APRI） in predicting advanced liver fibrosis and disease progression in patients with chronic HBV infection. MethodsA total of 497 patients with chronic HBV infection who underwent liver biopsy in The First Affiliated Hospital of Guangxi Medical University from February 2013 to December 2022 were enrolled， among whom 404 were enrolled in a retrospective study and 75 were enrolled in a prospective study. Related indicators were collected， including demographic features （sex and age）， biochemical indices （alanine aminotransferase ［ALT］ and aspartate aminotransferase ［AST］）， and platelet count， and FIB-4 and APRI were calculated. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups， and the Kruskal-Wallis H test was used for comparison between multiple groups； the chi-square test was used for comparison of categorical data between groups. The area under the ROC curve （AUC） was used to assess the ability of APRI and FIB-4 in evaluating liver fibrosis degree and disease progression in patients with chronic HBV infection. ResultsIn the retrospective analysis， compared with the FIB-4<2.67 group， the FIB-4≥2.67 group had a significantly higher proportion of the patients who were diagnosed with liver cirrhosis or hepatocellular carcinoma （66.19% vs 47.54%， χ²=12.75， P<0.001）. The medians of FIB-4 and APRI increased significantly with liver fibrosis degree from F0 to F4 （H=42.5 and 35.9， both P<0.001）. As for the fibrosis stage of F0-F4， the median of FIB-4 was significantly higher than that of APRI in the patients with the same fibrosis stage （H=59.71， P<0.001）. FIB-4 and APRI had a similar AUC for predicting stage F3 fibrosis （0.67 vs 0.65， Z=0.71， P=0.480）， while FIB-4 had a higher AUC for predicting stage F4 fibrosis than APRI （0.72 vs 0.64， Z=10.50， P<0.001）. In the prospective study cohort， FIB-4 and APRI showed an increasing trend over time in predicting disease progression （chronic hepatitis B to liver cirrhosis）， with an AUC of 0.718 （95% confidence interval ［CI］： 0.476‍ ‍—‍ ‍0.760） and 0.555 （95%CI： 0.408‍ ‍—‍ ‍0.703）， respectively， and FIB-4 had a significantly higher accuracy than APRI in predicting disease progression （χ²=12.44， P<0.001）. ConclusionFIB-4 and APRI can be used to evaluate advanced liver fibrosis （F3 and F4） and predict disease progression， and FIB-4 is superior to APRI in certain aspects.

Objective:To investigate the study on the diagnostic value of multimodal ultrasound technique for the lesion of extensor carpi ulnaris(ECU)tendon in patients with rheumatoid arthritis(RA).Methods:A total of 175 RA patients who were confirmed by the department of rheumatology of Yantaishan Hospital of Yantai city from December 2021 to January 2023 were selected,and them were included into the RA group.Other 50 patients without RA but with clinical symptoms of wrist were included into the non-RA group,and 50 healthy volunteers were included into the healthy control group.All subjects underwent routine ultrasound and shear wave elastography(SWE)examination on wrist,and then,the characteristics of ultrasound images of wrists and the blood flow distribution of ECU power Doppler ultrasonography(PDUS)were recorded.SWE was used to measure ECU to obtain elastic modulus index(EI)and velocity modulus index(VI).The differences between three groups were compared,and the receiver operating characteristic(ROC)value of RA patients were drawn,so as to confirm the area under curve(AUC)value and optimize cutoff value.Results:There were significant differences in EI and VI of the ECU tendon among three groups(F=61.15,61.28,P<0.05),respectively.The optimal cut-off values of EI and VI were respectively 319.35 kPa and 10.55 m/s in RA patients.In RA patients,age and disease course had significant influences on EI(r=0.19,0.21,P<0.05),and age,disease course,ultrasound score of wrist joint,and grade of power Doppler ultrasonography PDUS of the ECU tendon(ECUPDUS)had significant influences on VI(r=0.19,0.15,-0.16,-0.17,P<0.05).Conclusion:SWE is able to quantitatively and non-invasively assess the stiffness information of the ECU tendon in RA patients.After the supplement of gray-scale ultrasound and PDUS,multimodal ultrasound technique can clearly judge the correlation of the lesions of ECU tendon of RA patients.

Objective:To investigate the effect of 1M3S nursing management mode combined with transcatheter arterial chemoembolization (TACE) on intestinal microecological distribution in patients with primary liver cancer.Methods:A total of 115 patients with primary liver cancer in Hai′an people′s Hospital from January 2017 to January 2020 were enrolled. Patients were divided into two groups according to the admission time. Patients ( n=56) receiving routine nursing care from January 2017 to December 2018 were set as control group, patients ( n=59) receiving 1M3S nursing management from January 2019 to January 2020 were set as observation group. Another 34 healthy individuals were set as healthy group from January 2017 to January 2020 in Hai′an People′s Hospital. The general data were collected in all three groups, and the serum levels of endotoxin (ET), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected. Fecal samples were collected, and 16S rDNA sequencing method was used to analyze the fecal flora structure and species relative abundance among groups, and alpha diversity was analyzed. Results:At the level of phylum, the dominant phylum of the three groups were Bacteroidetes, Proteobacteria and Firmicutes. After TACE, the ET, ALT and AST levels were (9.67±2.12) ng/L, (53.24±8.47) U/L, (55.48±8.15) U/L in the control group, (4.36±2.15) ng/L, (45.31±8.36) U/L, (47.25±8.21) U/L in the observation group ( t value was 13.328, 5.052, 5.392, P<0.05). Compared with the control group, there was an increase in the relative abundance percentage of Firmicutes( t value was 16.426, P<0.01) and Lachnospiraceae in the observation group ( t value was 4.527, P<0.01), and a decrease in the relative abundance percentage of Proteobacteria ( t value was 8.462, P<0.001) after intervention. Conclusions:TACE can affect the intestinal bacteria in patients with primary liver cancer, resulting in a decrease in the relative abundance of Proteobacteria, Lachnospiraceae, and an increase in the relative abundance of Firmicutes, while application of 1M3S nursing management mode can effectively reduce the level of endotoxin, improve liver function, and reduce the imbalance of intestinal flora caused by TACE.

Objective:To observe the efficacy and safety of urokinase arterial thrombolysis in the treatment of central retinal artery occlusion (CRAO) at different time window.Methods:A retrospective study. From January 2014 to November 2019, 157 eyes (157 CRAO patients) in the Xi’an People's Hospital (Xi’an Fourth Hospital) were included in the study. There were 120 males and 37 females, with the average age of 54.87±12.12 years. The mean onset time was 65.66±67.44 h. All patients were tested with BCVA using international standard visual acuity chart, and the results were converted into logMAR visual acuity record. The arm-retinal circulation time (A-Rct) and the filling time (FT) of retinal arterial trunk-terminal filling time were measured by FFA. The mean logMAR BCVA was 2.44±0.46, the mean A-Rct and FT were 27.72±9.78 and 13.58±14.92 s respectively. According to the time window, the patients were divided into the onset 3-72 h group and the onset 73-240 h group, which were 115 patients and 42 patients respectively. There were no statistically significant difference between the 3-72 h group and the 73-240 h group in age, A-Rct and LogMR BCVA before treatment ( χ2=-0.197, -1.242, -8.990; P=0.844, 0.369, 0.369); the difference was statistically significant in FT comparison ( χ2=-3.652, P=0.000). Urokinase artery thrombolytic therapy was performed at different time window of 3-24 h, 25-72 h, 73-96 h, 97-120 h, 121-240 h after the onset of onset. Age and A-Rct of patients with different treatment time windows were compared, and the differences were not statistically significant ( χ2=6.588, 6.679; P=0.253, 0.246).In comparison of FT and logMAR BCVA, the difference was statistically significant ( χ2 =30.150, 71.378; P=0.000, 0.000). FFA was rechecked 24 hours after treatment, BCVA was rechecked 30 days after treatment. The changes of A-Rct, FT and BCVA before and after treatment were compared and analyzed. The occurrence of adverse reactions during and after treatment were observed. The two groups of measurement data were compared. The t test was used for those with normal distribution and χ2 test was used for those with non-normal distribution. Spearman correlation analysis was used to analyze the correlation between onset time and the difference of A-Rct, FT shortening time and logMAR BCVA after treatment. Results:At 24 h after CRAO treatment, A-Rct and FT of 157 cases were 19.64±6.50 and 6.48±7.36 s respectively, which were significantly shorter than those before treatment, and the differences were statistically significant ( χ2=-16.236, -14.703; P=0.000, 0.000). The logMAR BCVA at 30 d after treatment was 1.72±0.76, which was significantly higher than that before treatment. The difference was statistically significant ( χ2=-14.460, P=0.000). After CRAO urokinase arterial thrombolysis at different time window, there were statistically significant differences in A-Rct shortening time, FT shortening time, and logMAR BCVA difference ( χ2=12.408, 24.200, 104.388; P=0.030, 0.000, 0.000). There was no statistically significant difference between the 3-72 h group and the 73-240 h group ( χ2 =-1.042, P=0.297) in shortening time of A-Rct after treatment. The difference of FT shortening time was statistically significant ( χ2=-3.581, P=0.000). The difference of logMAR BCVA was statistically significant ( χ2=-9.905, P=0.000). The results of Spearman correlation analysis showed that there was no correlation between the onset time and the shortening time of A-Rct and FT after treatment ( rp=-0.040, -0.081; P=0.436, 0.115), and negative correlation with the logMAR BCVA difference ( rp=-0.486, P=0.000). One case of intracranial hemorrhage occurred after treatment, and it improved after dehydration to reduce cerebral edema, scavenging free radicals and brain protection. Conclusions:Urokinase arterial thrombolytic therapy is effective for CRAO within time window of 3-240 h, A-Rct, FT and LogMRA BCVA are all improved. However, with the prolongation of thrombolytic therapy time window, the therapeutic effect of urokinase arterial thrombolytic therapy is decreased. The therapeutic effect of Urokinase arterial thrombolytic therapy was better within 72 h.

Objective: To understand the consumption of nutritional supplements among the residents aged eighteen years and below in Tongzhou District of Beijing,so as to provide reference for supplements exposure assessment and health education. Methods: A hundred people aged 18 years and below were selected from each of the eight neighborhood committees of Tongzhou Town,Tongzhou District,Beijing. The questionnaire for the Nutritional Supplements Guidelines for Chinese Residents Study was used to collect the rate of taking nutritional supplements,influencing factors,types and frequency. Results: The rate of taking nutritional supplements was 44.16%. The rates of taking nutritional supplements in people aged 0-5 years,6-12 years and 13-18 years were 45.56%,42.86% and 41.00%,respectively,without statistically significant difference among them （P>0.05）. The rates of taking nutritional supplements in males and females were 44.82% and 43.49%,without statistically significant difference between them （P>0.05）. The Results of multivariate logistic regression analysis showed that annual per capita household income of more than 50 000 yuan （OR=1.688,95%CI: 1.171-2.435） and parents taking nutritional supplements （OR=4.104,95%CI: 3.023-5.573） were the promoting factors for the intake of nutritional supplements in people aged 18 years and below. The rates of taking calcium,vitamin D and multivitamin were 26.10%,21.56% and 8.31%,respectively. There were 272 （80.00%） people taking 1-2 kinds of supplements,and 200 （58.82%） people taking them daily. Conclusions In Tongzhou District,44.16% of the population aged 18 years and below takes nutritional supplements,mainly calcium and vitamin D. Family income and whether their parents taking or not are determinants.

ObjectiveTo investigate the clinical effect of Fuhe Beihua prescription combined with transcatheter arterial chemoembolization (TACE) in the treatment of primary liver cancer patients with liver depression and spleen deficiency and its effect on T lymphocyte subsets. MethodsA retrospective analysis was performed for the clinical data of stage Ⅲ primary liver cancer patients with liver depression and spleen deficiency who were treated in Department of Hepatology and Department of Oncology in The First Affiliated Hospital of Guangxi University of Chinese Medicine from January 2018 to January 2020. According to whether the traditional Chinese medicine Fuhe Beihua prescription was used, the patients were divided into treatment group (treated with routine TACE and oral administration of Fuhe Beihua prescription) and control group (treated with routine TACE alone), and the course of treatment was 16 weeks for both groups. The two groups were compared in terms of short-term response rate, quality-of-life score, serum alpha-fetoprotein (AFP) level, four indicators of liver fibrosis, coagulation function parameters, peripheral blood T lymphocyte subsets, and liver function parameters. The independent samples t-test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. A repeated-measures analysis of variance was used for comparison of continuous data between different groups at different time points. ResultsA total of 218 patients were selected, with 118 in the control group and 100 in the treatment group. The treatment group had an objective response rate of 33% and a disease control rate of 66% at week 8 of treatment and an objective response rate of 34% and a disease control rate of 69% at week 16 of treatment, and the control group had an objective response rate of 26.27% and a disease control rate of 68.64% at week 8 of treatment and an objective response rate of 30.51% and a disease control rate of 68.64% at week 16 of treatment; there was a significant difference in objective response rate between the two groups at weeks 8 and 16 of treatment (P＜0.05). Both groups had significant increases in Karnofsky Performance Scale (KPS) score, fibrinogen, and albumin (Alb) from before treatment to weeks 8 and 16 of treatment (all P＜0.05), and there were significant differences in KPS score, fibrinogen, and Alb between the two groups at weeks 8 and 16 of treatment (all P＜0.05). Both groups had significant reductions in AFP, the four indicators of liver fibrosis, alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin time (PT), and traditional Chinese medicine (TCM) syndrome score after treatment (all P＜0.05), and at weeks 8 and 16 of treatment, there were significant differences between the two groups in AFP, the four indicators of liver fibrosis, ALT, AST, PT, and TCM syndrome score (all P＜0.05). At weeks 8 and 16 of treatment, the treatment group had significant increases in the levels of CD3+, CD4+, and CD4+/CD8+ (all P＜0.05) and a significant reduction in the level of CD8+ (P＜0.05), and there were significant differences in the levels of T lymphocyte subsets between the two groups at weeks 8 and 16 of treatment (all P＜0.05). ConclusionFuhe Beihua prescription combined with routine TACE has a better clinical effect than TACE alone in the treatment of primary liver cancer patients with liver depression and spleen deficiency, possibly by regulating the levels of T lymphocyte subsets.

Objective:To understand the etiological characteristics of an acute gastroenteritis outbreak.Methods:Real-time polymerase chain reaction (PCR) and bacteria cultures were performed for the samples, including stool samples from patients and cooks, environmental swabs, raw food material (chicken meat), collected during the outbreak. Pulsed-field gel electrophoresis, antibiotics susceptibility test and whole-genome sequencing were performed for the Campylobacter jejuni isolates. Results:Four stool samples from patients were positive for Campylobacter jejuni by real-time PCR, in which 1 Campylobacter jejuni strain was isolated from a case who had no antibiotic treatment. Twelve Campylobacter jejuni and 7 Campylobacter coli isolates were obtained from 4 raw chicken meat samples. The Campylobacter jejuni strain isolated from the case was resistant to nalidixic acid, ciprofloxacin, chloramphenicol, florfenicol and tetracycline. The MLST analysis with the whole-genome sequences confirmed that the Campylobacter jejuni isolate from the case belonged to ST10075. Antimicrobial resistance genes cmeABCR, tetO/M and blaOXA-61 were found in the genome of the isolate from the patient by the whole-genome sequencing. No mutation in 23S rRNA was found and the C257T mutation in gyrA was identified in this isolate. Conclusion:Laboratory analysis indicated that Campylobacter jejuni infection might be the major cause of this gastroenteritis outbreak.

Objective:To summarize the clinical characteristics and prognosis of 51 patients with Waldenstr?m’s macroglobulinemia (WM) and evaluate the efficacy and adverse reactions of ibrutinib in the treatment of WM.Methods:We carried out a single-center retrospective study, including 51 patients with WM of our single center from November 2008 to October 2019.Results:The median age at diagnosis was 65 years with a male-to-female ratio of 2.64∶1. There were 9 (18%) , 21 (41%) , and 21 (41%) ISSWM stage low-, intermediate- and high-risk patients identified, respectively. A total of 27 (73%) patients harbored MYD88 L265P mutation. The median follow-up time was 38.6 (0.3-120.0) months, the median progression free survival was 46.4 months, and the median overall survival was not reached. The overall remission and major remission rates of patients who received ibrutinib were 87% and 80%, respectively. The median time to achieve at least partial remission of patients treated with ibrutinib was 8 weeks, which was earlier than those treated with other drugs ( P<0.05) . Conclusion:WM is often seen in elderly men. MYD88 L265P had a high frequency in WM. The findings of our study validate the efficacy of ibrutinib monotherapy. Even in patients with advanced age and at high risk of ISSWM, the overall remission rate and major remission rate are high. Ibrutinib is a safe and effective therapy because of its rapid onset and rare serious adverse reactions.

Objective To provide references for future government science and technology plan on providing projects for the research and development of new vaccine products.Methods Through analyzing various vaccines that have gained projects from government science and technology plan,this paper summarizes types of science and technology projects,funding proportion and characteristics of science and technology projects at national,provincial and municipal level for vaccine at different research and development stages.Results In general,the supporting categories and levels of projects at different levels are clear.Each research and development stage of new vaccine products has corresponding science and technology planning projects,which are closely linked with each other.Conclusions The government's science and technology funding plays an important role in guiding and promoting the research and development of new vaccine products.

OBJECTIVETo determine the frequency of spinocerebellar ataxia type 31 (SCA31) related mutations among patients from mainland China.

METHODSFor a cohort of molecularly unassigned patients comprised of 295 SCA patients (including 98 probands from families featuring autosomal dominant SCA and 197 sporadic cases) and 81 patients with hereditary spastic paraplegia (HSP) (including 23 probands from families with autosomal dominant HSP and 58 sporadic cases),TGGAA pentanucleotide expansion insertional mutation of the BEAN/TK2 gene was detected using repeat-primed PCR followed by capillary gel electrophoresis.

RESULTSNo TGGAA pentanucleotide insertion expansion in BEAN/TK2 gene was identified in the above cohort.

CONCLUSIONSCA31 is an extremely rare subtype of SCA and should not be included in routine genetic screening in mainland China.