Objectives The combined use of bedaquiline and delamanid(BDQ-DLM)is limited by an increased risk of prolonging the QTc interval.We retrospectively evaluated patients who received DLM/BDQ-containing regimens at a TB-specialized hospital.We aimed to present clinical efficacy and safety data for Chinese patients. Methods This case-control study included patients with multidrug-resistant tuberculosis(MDR-TB)treated with BDQ alone or BDQ plus DLM. Results A total of 96 patients were included in this analysis:64 in the BDQ group and 32 in the BDQ+DLM group.Among the 96 patients with positive sputum culture at the initiation of BDQ alone or BDQ combined with DLM,46 patients(71.9%)in the BDQ group and 29(90.6%)in the BDQ-DLM group achieved sputum culture conversion during treatment.The rate of sputum culture conversion did not differ between the two groups.The time to sputum culture conversion was significantly shorter in the BDQ-DLM group than in the BDQ group.The most frequent adverse event was QTc interval prolongation;however,the frequency of adverse events did not differ between the groups. Conclusion In conclusion,our results demonstrate that the combined use of BDQ and DLM is efficacious and tolerable in Chinese patients infected with MDR-TB.Patients in the BDQ-DLM group achieved sputum culture conversion sooner than those in the BDQ group.

Objective To observe the risk factors of ischemic mitral regurgitation(IMR)in ischemic cardiomyopathy.Methods Totally 143 patients with ischemic cardiomyopathy were retrospectively enrolled and divided into IMR+group(n=68)or IMR-group(n=75)based on IMR,while 50 healthy volunteers were taken as controls(control group).The general information,conventional ultrasonic parameters of left ventricle,three-dimensional speckle tracking imaging(3D-STI)parameters as well as mitral valve structural and functional parameters were compared among groups,and the risk factors of IMR were screened with logistic regression analysis.Results Significant differences of left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular global longitudinal strain(LVGLS),the peak systolic twist(Twist),tenting volume(VTent)and total leaflet area(TLA)/annulus area(AA)were found between IMR+group and IMR-group(all P＜0.05).Decreased LVGLS,decreased Twist and increased VTent were all independent risk factors of IMR in ischemic cardiomyopathy(all P＜0.05).Conclusion Decreased LVGLS,decreased Twist and increased VTent were independent risk factors of IMR in ischemic cardiomyopathy.

Objective To investigate the effects of AIDS and tuberculosis(TB)co-infection on CD8+T lymphocytes.Methods Serum CD8+T cells and CD4+T cells were analyzed and compared between human immunodeficiency virus(HIV)alone patients(n=200),TB alone patients(n=200),and HIV/TB co-infection patients(n=200).Results CD8+T cells were significantly higher in HIV alone group compared to HIV/TB co-infection group and TB alone group(x2=128.779,P＜0.001).The level of CD8+T lymphocytes in HIV/TB co-infection group and HIV alone group was higher than normal level(ZHIV/TB=8.343,PHIV/TB＜0.001,ZHIV=7.988,PHIV＜0.001).The CD8+T cells in TB alone group decreased significantly compared with normal levels(ZTB=8.682,PTB＜0.001).The levels of CD4+T cells in the three groups of patients were all lower than normal(ZHIV=11.088,PHIV＜0.001,ZTB=5.562,PTB＜0.001,ZHIV/TB=12.077,PHIV/TB＜0.001).The stratified analysis of CD8+T cell levels by CD4+T cell counts,showed that when CD4+T cell count was≤100 cells/μL,the level of CD8+T cells in HIV alone group was higher than that in TB alone group.HIV alone group had higher CD8+T cells than HIV/TB co-infection group,and the level of CD8+T cells in HIV/TB co-infection group was significantly lower than normal(Z0-100=1.604,P0-100=0.109).When CD4+T cells ≥101 cells/μL,HIV/TB co-infection group had higher CD8+T cells than TB alone group.HIV alone group had higher CD8+T cells than TB alone group.When CD4+T cells＞500 cells/μL,CD8+T cell levels were within the normal range in all three groups of patients.Taking the HIV alone group as a reference,with the decrease of CD4+T cell count,the CD8+T cell count decreased more significantly in TB alone group and HIV/TB co-infection group than in HIV alone group(slope was 0.344 and 0.216,respectively,P＜0.001).Conclusions With the decline of CD4+T cells,both HIV/TB co-infection and TB alone are associated with decrease in CD8+T cells,and the decrease in the TB alone group is more prominent.

Esophageal leiomyoma is the most common benign tumor of the esophagus,usually asymptomatic.With the development and widespread application of endoscopic ultrasonography technology,its detection rate has been increasing year by year.Its diagnostic methods have evolved from initial esophagography and chest electronic computed tomography,to endoscopic ultrasonography,endoscopic ultrasonography-guided fine-needle aspiration,and endoscopic ultrasonography-guided fine-needle biopsy.The technology is constantly updated,and the diagnostic accuracy is constantly improving.The treatment methods have also shifted from previous open chest surgery to thoracoscopic surgery,and in recent years,there has been a shift towards ultra minimally invasive techniques such as endoscopic mucosal resection,endoscopic submucosal dissection,endoscopic submucosal excavation,endoscopic full-thickness resection,and submucosal tunnel endoscopic resection.This article provides a review of the diagnosis and endoscopic treatment progress of esophageal leiomyoma.

Objective:To investigate the effects of serum exosomes of patients with gastric cancer on cisplatin resistance, clonal formation, migration, invasion and apoptosis of the AGS gastric cancer cells, and the corresponding molecular mechanisms.Methods:The experimental study was conducted. The exosomes of patients with gastric cancer was separated from their serum, and the expression of lncRNA HOTTIP was analyzed using the quantitative real time polymerase chain reaction (qRT-PCR). Normal gastric epithelial cell line GES1, gastric cancer cell line AGS and human embryonic kidney cell 293T were cultured in vitro. AGS cells were incubated with exosomes (Exo),with phos-phate buffered saline (PBS) treatment as control, and transfected with si-NC or si-HOTTIP-3, named as Exo group, PBS group, si-NC+Exo group, and si-HOTTIP-3+Exo group. The AGS cells were trans-fected with si-NC, si-HOTTIP-1, si-HOTTIP-2, si-HOTTIP-3, oe-HOTTIP, vector, oe-HOTTIP+miR-138-5p mimic, oe-HOTTIP+mimic NC, miR-138-5p inhibitor, inhibitor NC, miR-138-5p inhibitor+si-TJP1 and miR-138-5p inhibitor+si-NC. They were recorded as si-NC group, si-HOTTIP-1 group, si-HOTTIP-2 group, si-HOTTIP-3 group, oe-HOTTIP group, vector group, oe-HOTTIP+miR-138-5p mimic group, oe-HOTTIP+mimic NC group, miR-138-5p inhibitor group, inhibitor NC group, miR-138-5p inhibitor+si-TJP1 group and miR-138-5p inhibitor+si-NC group. The 293T cells transfected with mimic NC+HOTTIP wt, miR-138-5p mimic+HOTTIP wt, mimic NC+HOTTIP mut, miR-138-5p mimic+HOTTIP mut, mimic NC+TJP1 3'UTR wt, miR-138-5p mimic+TJP1 3'UTR wt, mimic NC+TJP1 3'UTR mut, miR-138-5p mimic+TJP1 3'UTR mut were recorded as the mimic NC+HOTTIP wt group, miR-138-5p mimic+HOTTIP wt group, mimic NC+HOTTIP mut group, miR-138-5p mimic+HOTTIP mut group, mimic NC+TJP1 3'UTR wt group, miR-138-5p mimic+TJP1 3'UTR wt group, mimic NC+TJP1 3'UTR mut group, miR-138-5p mimic+TJP1 3'UTR mut group. The cell counting kit-8 (CCK8) was used to analyze the cisplatin sensitivity of gastric cancer cells. The colony formation experiment was used to analyze the colony formation of gastric cancer cells. The Transwell experiment was used to analyzed cell migration and invasion of gastric cancer cells. The flow cytometry experiment was used to analyze cell apoptosis of gastric cancer cells. The Western bolt assay was used to analyze the expression of exosome marker proteins, including the CD63 and CD81, and the protein of TJP1, the drug-resistance related proteins, including the P-gp and MCL-1. The dual-luciferase assay was used to analyze the targeted relationships among lncRNA HOTTIP, miR-138-5p and TJP1. Observation indicators: (1) expression of lncRNA HOTTIP; (2) resistance of gastric cancer cells to cisplatin regulated by exosome-mediated lncRNA HOTTIP; (3) regulation of cisplatin resistance in gastric cancer cells mediated by miR-138-5p through lncRNA HOTTIP overexpression; (4) targeting of TJP1 gene 3′-untranslated region (UTR) by miR-138-5p; (5) regulation of cisplatin resistance in gastric cancer cells by TJP1 through miR-138-5p inhibition. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was conducted using the t test. The one-way ANOVA was used for comparison for multiple groups and the Tukey′s test was used for further pairwise compari-son. Count data were described as absolute numbers, and the chi-square test was used for comparison. Correlation analysis was conducted using the Pearson′s test. Results:(1) Expression of lncRNA HOTTIP. The expression of lncRNA HOTTIP in the serum exosome of patients with gastric cancer was higher than that in healthy volunteers, showing a significant difference ( P<0.05). Results of transmi-ssion electron microscopy examination showed that the serum exosomes were circular or oval in shape. Results of Western bolt assay showed the expression of marker proteins of CD63 and CD81 in serum exosomes. (2) Resistance of gastric cancer cells to cisplatin regulated by exosome-mediated lncRNA HOTTIP. Compared with the PBS group, the biochemical half maximal inhibitory concentra-tion (IC50), the number of clone formation, the number of invasive cell, the number of migratory cell, expression of P-gp protein, expression of MCL-1 protein in the Exo group increased, while the cell apoptosis rate decreased, showing significant differences between them ( P<0.05). Compared with the si-NC+Exo group, the IC50, the number of clone formation, the number of invasive cell, the number of migratory cell, expression of P-gp protein, expression of MCL-1 protein in the si-HOTTIP-3+Exo group decreased, while the cell apoptosis rate increased, showing significant differences between them ( P<0.05). (3) Regulation of cisplatin resistance in gastric cancer cells mediated by miR-138-5p through lncRNA HOTTIP overexpression. Compared with the vector group, the IC50, the number of clone formation, the number of invasive cell, the number of migratory cell, expression of P-gp protein, expression of MCL-1 protein in the oe-HOTTIP group increased, while the cell apoptosis rate decreased, showing significant differences between them ( P<0.05). Compared with the oe-HOTTIP+mimic NC group, the IC50, the number of clone formation, the number of invasive cell, the number of migratory cell, expression of P-gp protein, expression of MCL-1 protein in the oe-HOTTIP+miR-138-5p mimic group increased, while the cell apoptosis rate decreased, showing significant differences between them ( P<0.05). (4) Targeting of TJP1 gene 3′-UTR by miR-138-5p. Results of dual-luciferase assay showed that the luciferase activity in 293T cells treatment with mimics of control+vectors of wild type of TJP1 gene 3′-UTR and 293T cells treatment with mimics of miR-138-5p+vectors of wild type of TJP1 gene 3′-UTR was 1.00±0.09 and 0.21±0.03, respectively, showing a significant difference between them ( t=15.02, P<0.05). (5) Regulation of cisplatin resistance in gastric cancer cells by TJP1 through miR-138-5p inhibition. Compared with the inhibitor group, the IC50, the number of clone formation, the number of invasive cell, the number of migratory cell, expression of P-gp protein, expression of MCL-1 protein in the miR-138-5p inhibitor group increased, while the cell apoptosis rate decreased, showing significant differences between them ( P<0.05). Compared with the miR-138-5p inhibitor+si-NC group, the IC50, the number of clone formation, the number of invasive cell, the number of migratory cell, expression of P-gp protein, expression of MCL-1 protein in the miR-138-5p inhibitor+si-TJP1 group decreased, while the cell apoptosis rate increased, showing significant differences between them ( P<0.05). Conclusion:Serum exosomes-mediated lncRNA HOTTIP can promote cisplatin resistance, clonal formation, migration, invasion and apoptosis of gastric cancer cells and inhibit cell apoptosis of gastric cancer cells through regulating the expression of miR-138-5p/TJP1.

We aimed to investigate the relationship of dietary zinc intake with new-onset hypertension among Chinese adults. A total of 12,177 participants who were free of hypertension at baseline from the China Health and Nutrition Survey were included. Dietary intake was assessed by three consecutive 24-h dietary recalls combined with a household food inventory. Participants with systolic blood pressure ≽ 140 mmHg or diastolic blood pressure ≽ 90 mmHg or diagnosed by a physician or under antihypertensive treatment during the follow-up were defined as having new-onset hypertension. During a median follow-up duration of 6.1 years, 4269 participants developed new-onset hypertension. Overall, the association between dietary zinc intake and new-onset hypertension followed a J-shape (P for non-linearity < 0.001). The risk of new-onset hypertension significantly decreased with the increment of dietary zinc intake (per mg/day: hazard ratio (HR) 0.93; 95% confidence interval (CI) 0.88-0.98) in participants with zinc intake < 10.9 mg/day, and increased with the increment of zinc intake (per mg/day: HR 1.14; 95% CI 1.11-1.16) in participants with zinc intake ≽ 10.9 mg/day. In conclusion, there was a J-shaped association between dietary zinc intake and new-onset hypertension in general Chinese adults, with an inflection point at about 10.9 mg/day.
Adult ; Humans ; Cohort Studies ; Zinc ; Diet ; Hypertension/epidemiology* ; Eating ; China/epidemiology*

Objective:To investigate the effect of CIRc_0000267 on proliferation, migration, invasion and apoptosis of gastric cancer cells in vitro.Methods:Gastric cancer cell lines with circ_0000267 knockdown and miR-661 overexpression were constructed in vitro, and the expressions of circ_0000267, miR-661 and NGAL mRNA in gastric cancer tissues and cells were detected by qRT-PCR. Cell proliferation, migration, invasion and apoptosis were detected by clonogenesis, Transwell chamber and flow cytometry, and related protein expression was detected by Western blot. Online prediction combined with double luciferase assay and RNA pull down assay was used to verify the targeting relationship between circ_0000267, miR-661 and NGAL. Tumogenesis assay in nude mice was used to observe the effect of circ_0000267 knockout on the growth of gastric cancer cells in vivo. Results:Circ_0000267 was highly expressed in gastric cancer tissues and cells. Knockdown circ_0000267 inhibited the proliferation, migration and invasion of gastric cancer cells and promote apoptosis. Circ_0000267 targeted miR-661, and inhibition of miR-661 partially reversed the effect of circ_0000267 on gastric cancer cells. NGAL was the target gene of miR-661, and overexpression of miR-661 regulated the proliferation, migration, invasion and apoptosis of gastric cancer cells by inhibiting NGAL. Knockdown circ_0000267 targeting miR-661 inhibited NGAL expression in gastric cancer cells; Knockdown circ_0000267 inhibited the growth of gastric cancer cells in vivo.Conclusions:Circ_0000267 may regulate the proliferation, migration, invasion and apoptosis of gastric cancer cells and inhibit the growth of tumors in vivo by regulating the expression of miR-661/NGAL.

Objective:To analyze the epidemiological trends and population characteristics of inflammatory bowel disease(IBD)in China by searching keywords related to IBD through Google Trends, Baidu index, and WeChat index, so as to provide a reference for national epidemiological studies on IBD.Methods:IBD-related hot words such as "inflammatory bowel disease" , "Crohn′s disease" , "ulcerative colitis" , "gastroesophageal reflux disease (GERD)" , "irritable bowel syndrome (IBS)" and " Helicobacter pylori ( H. pylori)" were selected. The search volume and trends of the above keywords in the world and China were analyzed through Google Trends, Baidu index and WeChat index. The epidemiological characteristics of IBD in China were summarized. Descriptive methods were used for statistical analysis. Results:The results of Google Trends analysis showed that among 5 common digestive diseases (GERD, IBS, H. pylori infection, IBD and peptic ulcer), GERD was the most concerned disease, while IBD was not the focus among the common digestive diseases. When the global searching scope was limited to IBD related hot words, Crohn′s disease was the disease of primary concern among IBD-related diseases. In South America, South Asia, and parts of Africa, ulcerative colitis was mainly concerned, and in China and countries of Southeast Asia, IBD was more concerned. The searching results of Baidu index indicated that among the national search for IBD-related hot words, the 3 keywords of "inflammatory bowel disease" , "ulcerative colitis" and "Crohn′s disease" were all highly searched, the overall daily average of the search indexes of the 3 keywords were 325, 1 320 and 2 559, respectively, and the searching volume of "Crohn′s disease" was higher than "inflammatory bowel disease" and "ulcerative colitis" . The national wide trends of search volume for "inflammatory bowel disease" , "ulcerative colitis" and "Crohn′s disease" were similar, the search heat gradually decreased from the east coast to the northwest of China, which basically coincided with the three-level ladder trend of China′s economic development, suggesting that the level of economic development was related to the incidence of IBD. The results of Baidu index analysis showed that the main populations who searched IBD-related keywords were young adults and women aged from 20 to 39 years old. The results of WeChat index analysis revealed that the searching volume of "inflammatory bowel disease" , "ulcerative colitis" and "Crohn′s disease" were 205 000, 195 000 and 120 000, respectively, and the search volume for " inflammatory bowel disease" was the highest. The official account (90.27%) and the video account (7.43%) occupied the main sources of IBD-related information on mobile terminals. Conclusions:The IBD-associated internet activities reveal a global lack of public awareness of IBD. China also faces the same problem. The search trend is consistent with the epidemiology of IBD, which may be helpful for future epidemiological research of IBD in China. Mobile media will be a potential force in promoting the patient education and disease management of IBD in China.

Objective:To analyze the level and latent categories of the training needs of the nursing staff of the social volunteer teams in Jiangsu Province, and to provide basis for the targeted training.Methods:From March to July in 2018, 224 elderly care teachers from 13 social volunteer teams of 100 Red Cross societies in Jiangsu Province were surveyed for the knowledge of the care for the aged and the needs of training by the self-designed questionnaires. A total of 207 valid questionnaires were collected, with an effective recovery rate of 92.4%. SPSS 21.0 and Latent GOLD 5.1 software were used for description analysis, hierarchical clustering and latent category analysis.Results:The number of answer of "very need" to knowledge and skills among the aged care teachers for the elderly, such as psychological care, elderly volunteer services and recreational activities for the elderly, was 196, 196 and 193, with a proportion of 94.7%, 94.7% and 93.2%, respectively. Cluster analysis showed that training needs could be divided into four aspects: life care knowledge and skills, health care knowledge and skills, psychological care knowledge and skills, and spiritual comfort knowledge and skills. The results of latent category analysis showed that the aged care teachers could be divided into three groups based on their different training needs: high demand group for overall knowledge and skills, partial demand group for overall knowledge and skills, and high demand group for medical care and psychological care knowledge and skills. The corresponding latent probability of the three groups were 80.2%, 13.0%, 6.8%, respectively.Conclusion:The training for the aged care of social volunteer teams should pay attention to the teaching of spiritual comfort knowledge and skills for the elderly. The training program should be oriented to the multi-level and individualized needs of the teachers, so as to meet the needs of the aged care teachers for their own development.

Objective:To investigate the impact of oat beta-glucans on blood levels of lipids, glucose, and inflammatory factors in patients with hyperlipemia/hyperglycemia.Methods:A total of 120 patients with hyperlipemia/hyperglycemia were randomized into intervention ( n = 60) and control groups ( n = 60). In addition to the routine nutritional consultation, two groups received oral oat beta-glucan at 3 g/d (intervention) or lotus root powder at 3 g/d (control), respectively. Blood levels of lipids, glucose, insulin and inflammatory factors, body composition and bowel movement were compared between the two groups after 12 weeks of study intervention. The treatment effect was represented by intention-to-treat analysis. Results:A total of 109 participants completed the study. The total cholesterol [(5.18±0.69) mmol/L vs (5.25±0.88) mmol/L, P=0.024] and fasting plasma glucose [(5.50±0.82) mmol/L vs (5.98±1.33) mmol/L, P=0.002] in the intervention group were significantly decreased compared with the control group. Conclusion:Oral oat beta-glucans could decrease the total cholesterol and fasting plasma glucose in participants with mild hyperlipemia/hyperglycemia.