Objective: To investigate the personnel allocation, structure, and mobility situation of the disease prevention and control (CDC) institutions in Jinhua City, Zhejiang Province from 2018 to 2024, so as to provide insights into strengthening the construction of the talent team within CDC institutions. Methods: Basic information of the personnel in the CDC institutions, Jinhua City were collected through the Basic Information Subsystem of the China Disease Control and Prevention Information System. Composition of age, gender, educational background, major, professional title of the in-service and officially employed personnel, as well as the situation of personnel mobility were analyzed using descriptive methods. Results: A total of 10 CDCs were established in Jinhua City by the end of 2024, including 1 municipal CDC and 9 county (city, district) CDCs, with an approved staffing of 672 people and 621 in-service and officially employed staff. Compared with 2018, the approved number of staff positions in the CDC institutions of Jinhua City increased by 21.30% in 2024, and the number of in-service and officially employed staff members increased by 22.73%. From 2018 to 2024, the number of CDC staff per 10 000 permanent residents in the CDC institutions of Jinhua City, the municipal CDC, and the county (city, district) CDCs were 0.764 to 0.932, 0.142 to 0.173, and 0.623 to 0.759, respectively. From 2018 to 2024, the overall male-to-female ratio in both the municipal CDC and the county (city, district) CDCs decreased from 1.04∶1 and 0.84∶1 to 0.95∶1 and 0.75∶1, respectively. In the municipal CDC, the proportion of staff aged 25-<45 years old increased from 57.45% to 69.02%; the proportion of staff with a bachelor's degree or above increased from 79.79% to 93.81%; the proportion of staff majoring in public health increased from 37.23% to 49.56%; the proportions of staff with various professional titles were relatively stable; 51 staff members joined, all of whom had a bachelor's degree or above; 32 staff members left, among whom 24 retired and 6 were admitted to civil service positions or other units. In the county (city, district) CDCs, the proportion of staff aged 22-<35 years old increased from 30.59% to 37.40%; the proportion of staff with a bachelor's degree or above increased from 71.85% to 89.76%; the proportion of staff majoring in public health increased from 46.60% to 54.33%; the proportion of staff with a junior professional title or below increased from 34.47% to 43.50%; 198 staff members joined, and 194 of them had a bachelor's degree or above; 102 staff members left, among whom 67 retired and 28 were admitted to civil service positions or other units. Conclusions From 2018 to 2024, the number of in-service and officially employed staff in Jinhua CDC institutions increased the academic qualifications and professional composition continue to improve. There are still problems with the number of CDC staff per 10 000 permanent residents being lower than the standard for the personnel establishment in Zhejiang CDCs, a lack of high-level talents, and insufficient personnel stability.

Objective To explore the role of breast/ovarian cancer susceptibility gene 1 associated protein 1(BAP1)in the occurrence and progression of human malignant glioma and the feasibility of BAP1 as a clinical diagnostic marker for malignant glioma.Methods The differential expression of BAP1 in normal and glioma tissue was analyzed based on the GSE4290 and GSE90598 sub-datasets from the gene expression omnibus(GEO)database.Receiver operating characteristic(ROC)curve analysis was conducted to assess the early diagnostic value of BAP1 for malignant glioma.Primary lesion tissues from 28 nonpaired malignant glioma patients and non-tumor brain tissues removed by internal decompression surgery in 5 patients with traumatic brain injury collected independently were collected,and the expression levels of BAP1 were measured using quantitative real-time polymerase chain reaction(qRT-PCR).Specific small interfering RNAs(siRNAs)targeting BAP1 were transiently transfected into U251 cells to further evaluate their interference efficiency.Flow cytometry was employed to analyze changes in the cell cycle and apoptosis of U251 cells with BAP1 knockdown.Results The results of bioinformatics showed that the expression of BAP1 in malignant glioma tissues was lower than that in normal brain tissues(GSE 4290:1 209±18.49 vs 1 476±53.90,GSE 90598:5.19±0.10 vs 5.65±0.21),and the differences were significant(t=5.115,2.267,all P<0.05).ROC curve showed that BAP1 could efficiently differentiate malignant glioma tissue from normal brain tissue(GSE4290:AUC=0.78,GSE90598:AUC=0.75,all P<0.05).The expression level of BAP1 in primary malignant glioma tissue was lower than that in normal brain tissue(0.27±0.04 vs 1.06±0.07),and the difference was significant(t=10.22,P<0.001).After down-regulating the expression of BAP1 in U251 cells,the proportion of S phase cells increased from 17.59%to 27.21%(siBAP1-1)and 25.79%(siBAP1-2),respectively,and the differences were significant(t=6.576,6.642,all P<0.01).However,the apoptosis levels decreased from 10.17%to 2.70%(siBAP-1)and 3.00%(siBAP-2),respectively,and the differences were significant(t=10.31,9.428,all P<0.01).Conclusion Histone H2A deubiquitinase BAP1 could exert the function of tumor suppressor genes by inhibiting rapid cell cycle progression and promoting apoptosis in malignant glioma,and could serve as a potential clinical diagnostic biomarker for malignant glioma.

Both cholinergic dysfunction and protein citrullination are the hallmarks of rheumatoid arthritis (RA), but the relationship between the two phenomena remains unclear. We explored whether and how cholinergic dysfunction accelerates protein citrullination and consequently drives the development of RA. Cholinergic function and protein citrullination levels in patients with RA and collagen-induced arthritis (CIA) mice were collected. In both neuron-macrophage coculture system and CIA mice, the effect of cholinergic dysfunction on protein citrullination and expression of peptidylarginine deiminases (PADs) was assessed by immunofluorescence. The key transcription factors for PAD4 expression were predicted and validated. Cholinergic dysfunction in the patients with RA and CIA mice negatively correlated with the degree of protein citrullination in synovial tissues. The cholinergic or alpha7 nicotinic acetylcholine receptor (α7nAChR) deactivation and activation resulted in the promotion and reduction of protein citrullination in vitro and in vivo, respectively. Especially, the activation deficiency of α7nAChR induced the earlier onset and aggravation of CIA. Furthermore, deactivation of α7nAChR increased the expression of PAD4 and specificity protein-3 (SP3) in vitro and in vivo. Our results suggest that cholinergic dysfunction-induced deficient α7nAChR activation, which induces the expression of SP3 and its downstream molecule PAD4, accelerating protein citrullination and the development of RA.

Objective To explore the predictive value of artificial intelligence(AI)quantitative model for pathological subtypes of stage Ⅰ invasive lung adenocarcinoma with ground glass nodule(GGN).Methods A total of 118 cases(124 lesions)of GGN patients with stage Ⅰ invasive lung adenocarcinoma confirmed by surgery and pathology were analyzed retrospectively,and they were divided into lepidic predominant adenocarcinoma(LPA)group(46 lesions)and non-lepidic predominant adenocarcinoma(n-LPA)group(78 lesions)according to the pathological subtype results.Some relevant AI quantitative parameters were recorded,including the longest diameter,total volume,the percentage of solid volume,total mass,the percentage of solid mass,maximum CT value,minimum CT value,and average CT value.The independent predictors of n-LPA were screened by univariate and multivariate logistic regression analysis,the independent risk factors were quantified by Nomogram,and the diagnostic efficiency of the model was evaluated by using receiver operating characteristic(ROC)curve.Results Binomial logistic regression analysis showed that the percentage of solid mass[odds ratio(OR)=1.965,95％confidence interval(CI)1.515-2.549]and average CT value(OR=1.020,95％CI 1.004-1.036)were independent predictors of n-LPA(P＜0.05).The Nomogram to quantify the independent risk factors showed that the above prediction model was in good agreement with the actual results,and the C-index value was 0.872(95％CI 0.791-0.953).ROC curve analysis showed that the diagnostic performance of the combination of the above two indexes[area under the curve(AUC)=0.829]was better than that of the solid mass percentage(AUC=0.788)and the average CT value(AUC=0.765)of the single indexes,and the corresponding sensitivity and specificity were 87.2％and 84.8％,respectively,which were consistent with the pathological results(Kappa=0.667).Conclusion The percentage of solid mass and the average CT value in the AI quantitative model can effectively help predict the pathological subtypes of GGN stage Ⅰ invasive lung adenocarcinoma,and the combination of the above two indicators can improve the differential diagnosis efficiency of CT between LPA and n-LPA.

Objective:To assess the differences in multidimensional clinical manifestations between patients with irritable bowel syndrome (IBS) matching the Rome Ⅲ criteria but not matching Rome Ⅳ and IBS patients matching the Rome Ⅳ criteria, among patients diagnosed with IBS according to Rome Ⅲ criteria.Methods:From November 2016 to October 2017, a total of 472 IBS patients admitted to six hospitals were selected, which included Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology (139 cases), Sir Run Run Shaw Hospital, School of Medicine of Zhejiang University (95 cases), the First Affiliated Hospital of Dalian Medical University (96 cases), the Affiliated Hospital of Guizhou Medical University (90 cases), the People′s Hospital of Guangxi Zhuang Autonomous Region (20 cases), and the Second Affiliated Hospital of Xi′an Jiaotong University (32 cases). The 472 IBS patients were divided into the group that matching the Rome Ⅳ criteria (Rome Ⅳ group), and the group that matching the Rome Ⅲ criteria but not matching the Rome Ⅳ criteria (Rome Ⅲ group). The basic characteristics (IBS course, post-infectious IBS, history of smoking or drinking, etc.), abdominal symptoms, and defecation-related symptoms of two groups were compared and analyzed by face-to-face questionnaires. Multi-dimensional clinical manifestations assessment was completed by questionnaires, which included gastrointestinal symptom rating scale (GSRS), irritable bowel syndrome-severity scoring system (IBS-SSS), irritable bowel syndrome-quality of life (IBS-QOL), and hospital anxiety and depression scale (HADS). Independent sample t-test, rank sum test, and chi-square test were used for statistical analysis. Results:There were 344 patients (72.9%) in Rome Ⅳ group and 128 patients (27.1%) in Rome Ⅲ group. The IBS course of patients in Rome Ⅳ group was longer than that in Rome Ⅲ group (3.0 years (7.0 years) vs. 2.0 years (5.7 years)), and the difference was statistically significant ( Z=-2.73, P=0.006). The GSRS scores of loose stools and abdominal pain of IBS patients in Rome Ⅳ group were higher than those in Rome Ⅲ group, and the GSRS scores of increased exhaust and abdominal distension of IBS patients in Rome Ⅳ group were lower than those in Rome Ⅲ group (3.0(2.0) vs. 2.0(4.0), 3.0(2.0) vs.1.0(2.0), 1.5(3.0) vs. 2.0(3.0), 1.0 (3.0) vs. 2.0(3.0)), and the differences were statistically significant ( Z=-2.48, -9.90, -2.11 and -2.06, P=0.013, <0.001, =0.035 and =0.040). The proportions of fatigue and dizziness of IBS patients in Rome Ⅳ group were higher than those in Rome Ⅲ group (58.4% (201/344) vs. 43.0% (55/128), 30.8% (106/344) vs. 29.7% (38/128)), and the differences were statistically significant ( χ2=8.37 and 12.36, P=0.004 and <0.001). The scores of anxiety and depression subscales of the HADS of IBS patients in Rome Ⅳ group were higher than those in Rome Ⅲ group (6.5 (6.8) vs. 6.0 (6.0), 5.0 (6.0) vs. 3.0 (5.0)), and the differences were statistically significant ( Z=-2.58 and -2.40, P=0.010 and 0.017). The scores of IBS-SSS scale, abdominal pain severity, abdominal pain frequency, and impact on quality of life of IBS patients in Rome Ⅳ group were all higher than those in Rome Ⅲ group (249.5 (108.0) vs. 177.0 (111.8), 50.0 (25.0) vs. 20.0 (30.0), 50.0 (70.0) vs. 10.0 (30.0), 66.0 (42.0) vs. 42.5 (34.0)), and the differences were statistically significant ( Z=-7.79, -9.64, -10.65 and -2.48, P<0.001, <0.001, <0.001 and =0.013). The score of IBS-QOL for behavioral disorder of IBS patients in Rome Ⅳ group was lower than that in Rome Ⅲ group (74.5±21.6 vs. 79.2±17.7), and the difference was statistically significant ( t=-2.22, P=0.027). Conclusion:The clinical symptoms of patients mathching the Rome Ⅳ criteria are more typical and severe, as compared with those of IBS patients matching the Rome Ⅲ criteria but not matching the Rome Ⅳ criteria.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.

Objective:To investigate the efficacy of ultrasound-guided adhesiolysis combined with platelet-rich plasma in the treatment of rotator cuff injuries.Methods:The clinical data of 103 patients with rotator cuff injuries treated in The 72 nd Military Hospital of PLA from December 2017 to December 2019 were retrospectively analyzed. The patients were divided into two groups according to the treatment methods. The control group ( n = 48) was treated with ultrasound-guided adhesiolysis. The study group ( n = 55) was treated with ultrasound-guided adhesiolysis and intra-articular injection of platelet rich plasma. Therapeutic effects, pain score, shoulder function score, shoulder range of motion, healing rate, and re-tear rate were compared between the control and study groups. Results:Total effective rate was significantly higher in the study group than in the control group (96.36% vs. 81.25%, χ2 = 6.14, P < 0.05). Pain score in each group was significantly decreased after treatment compared with before treatment [study group: (1.69 ± 0.81) points vs. (6.13 ± 1.28) points; control group: (3.22 ± 1.05) points vs. (6.13 ± 1.28) points, t = 31.510, 8.33, both P < 0.001]. The University of California at Los Angeles (UCLA) shoulder score in each group was significantly increased after treatment compared with before treatment [study group: (33.26 ± 3.81) points vs. (14.03 ± 2.96) points; control group: (28.81 ± 3.20) points vs. (13.92 ± 3.03) points, t = 42.13, 33.12, both P < 0.001]. Constant-Murley Score in each group was significantly increased after treatment compared with before treatment [study group: (94.22 ± 4.15) points vs. (55.29 ± 8.18) points; control group: (82.11 ± 8.13) points vs. (56.33 ± 7.83) points; t = 46.83, 22.38, both P < 0.001]. After treatment, pain score was significantly lower in the study group than in the control group [(1.69 ± 0.81) points vs. (3.22 ± 1.05) points, t = 8.33, P < 0.001]. UCLA score and CMS were significantly higher in the study group than in the control group [(33.26 ± 3.81) points vs. (28.81 ± 3.20) points, (94.22 ± 4.15) points vs. (82.11 ± 8.13) points, t = 6.37, 9.70, both P < 0.001]. After treatment, there were improvements in flexion [study group: (159.26 ± 13.51)° vs. (85.26 ± 11.35)°; control group: (150.22 ± 14.35)° vs. (86.33 ± 11.51)°; t = 45.15, 34.23, both P < 0.001], internal rotation at 90° abduction [study group: (83.64 ± 5.29)° vs. (60.33 ± 4.12)°; control group: (76.81 ± 4.82)° vs. (60.61 ± 4.51)°; t = 36.74, 24.06, both P < 0.001], abduction [study group: (161.29 ± 10.76)° vs. (72.91 ± 5.16)°; control group: (152.81 ± 11.84) ° vs. (73.26 ± 5.22)°; t = 82.34, 64.61, both P < 0.001], external rotation at 90° abduction [study group: (87.82 ± 3.04)° vs. (4.29 ± 5.18)°; control group: (80.22 ± 4.13)° vs. (80.22 ± 4.13)°; t = 42.46, 21.55, both P < 0.001] , and external rotation in neutral position [study group: (43.18 ± 3.20)° vs. (22.85 ± 4.12)°; control group: (37.26 ± 4.12)° vs. (22.64 ± 3.95)°; t = 41.19, 25.10, both P < 0.001] in each group compared with before treatment. After treatment, range of motion of the shoulder in the above positions was significantly higher in the study group than in the control group [flexion: (159.26 ± 13.51)° vs. (150.22 ± 14.35)°; internal rotation at 90° abduction: (83.64 ± 5.29)° vs. (76.81 ± 4.82)°; abduction: (161.29 ± 10.76)° vs. (152.81 ± 11.84)°; external rotation at 90° abduction: (87.82 ± 3.04)° vs. (80.22 ± 4.13)°; external rotation in neutral position: (43.18 ± 3.20)° vs. (37.26 ± 4.12)°, t = 3.29, 6.81, 3.81, 10.72, 8.20, all P < 0.001]. There was no significant difference in healing rate between the study and control groups (1.82% vs. 16.67%, χ2 = 5.35, P < 0.05). Conclusion:Ultrasound-guided adhesiolysis combined with platelet-rich plasma is highly effective in the treatment of rotator cuff injuries because it can greatly improve shoulder function, reduce pain degree, and increase the range of motion of the shoulder.

Objective:To evaluate the efficacy and safety of linaclotide with polyethylene glycol in bowel preparation.Methods:From September 2021 to February 2022, 240 patients who visited the Department of Gastroenterology, Third People′s Hospital of Hubei Province, Jianghan University and underwent colonoscopy were selected. According to the random number table, in the ratio of 1 to 1, the patients were divided into the linaclotide with polyethylene glycol group and the simple polyethylene glycol group, with 120 cases in each group. The patients in the linaclotide with polyethylene glycol group took 580 μg linaclotide and 2 L polyethylene glycol electrolyte powder solution, and the patients in the simple polyethylene glycol group took 3 L polyethylene glycol electrolyte powder solution. The Boston bowel preparation scale(BBPS) score, the detection rate of polyps or adenomas, the insertion time of colonoscopy, the withdrawal time of colonoscopy, the time of the first defecation, the frequency of defecations, the success rate of cecal intubation, the occurrence of adverse effects and the satisfaction rate of patients were compared between the 2 groups. Independent sample t test and chi-square test were used for statistical analysis. Results:A total of 235 patients completed bowel preparation and accepted colonoscopy. There were no statistically significant differences in the BBPS score, the detection rate of polyps or adenomas, the insertion time of colonoscopy, the withdrawal time of colonoscopy, the success rate of cecal intubation and the frequency of defecations between the linaclotide with polyethylene glycol group and simple polyethylene glycol group(7.3±1.1 vs. 7.0±1.2; 58.1%, 68/117 vs. 60.2%, 71/118; 38.5%, 45/117 vs. 39.8%, 47/118; (4.2±1.9) min vs.(4.3±1.6) min; (5.9±2.7) min vs.(6.2±2.4) min; 100.0%, 117/117 vs. 100.0%, 118/118; 5.3±2.3 vs. 5.1±2.7; all P>0.05). The rate of adverse effects of the linaclotide with polyethylene glycol group was lower than that of simple polyethylene glycol group(25.6%, 30/117 vs. 39.8%, 47/118), the satisfaction rate of patients was higher than that of the simple polyethylene glycol group (93.2%, 109/117 vs. 76.3%, 90/118), and the differences were statistically significant( χ2=0.24 and 0.64, P=0.018 and 0.031). Conclusion:Compared with the 3 L polyethylene glycol regimen, 580 g linaclotide with 2 L polyethylene glycol regimen can achieve the same bowel preparation effect with higher safety and patient satisfaction, which is worthy of clinical application.

Hyperlipidemia pancreatitis in children is mostly genetic metabolic disease.The incidence of acute pancreatitis in children is only (3-13)/100 000, and pancreatitis caused by hyperlipidemia accounts for 9% of acute pancreatitis.A child suffering from V-type hyperlipidemia pancreatitis was admitted to the Children′s Hospital Affiliated to Nanjing Medical University in July 2019.The missense mutation at position c. 2770G>A of CFTR gene (nucleotide 2770 in coding region changed from guanine to adenine) in children was detected by gene sequencing, thus resulting in amino acid change p. D924N.It is extremely rare to report that CFTR gene mutation causes hereditary pancreatitis, and there is no literature report on c. 2770G>A site.This case is reported as follows, hoping to provide reference and inspiration for pediatricians.

Objective To investigate the inhibitory effect and mechanism of Metformin (Met) combined with irradiation in CT26WT cell lines or mouse models with transplanted tumors.Methods CT26WT cell line was treated with 0.5 μmol/L,1.0 μmol/L,5.0 μmol/L and 10.0 μmol/L Met,and CellTiter Glo kit was used to detect the inhibitory effect of Met at different concentrations on the viability of CT26WT cells.CT26WT cell line was treated with the control,Met (10 pmol/L),15 Gy irradiation and 15 Gy irradiation+Met (10 μmol/L).Clone formation assay was employed to detect the cell proliferation activity.Bablc mouse models of transplanted tumors (tumor size＞ 150 mm3) were established and randomly divided into the control,15 Gy irradiation,Met and 15Gy irradiation+Met groups.Mice were given with 750 mg/kg Met at 24 h before irradiation.Transplanted tumor volume was measured regularly to delineate the growth curve of transplanted tumors and survival curve.The expression levels of P-H2AX and Sting proteins in CT26WT cells and transplanted tumors were detected by Western blot.The infiltration of CD8a (+) T cells in transplanted tumor tissues was detected by immunohistochemistry.Results The relative cell survival rate was 100％,87.9％,87.8％,87.3％ and 76.5％ in the 0,0.5,1.0,5.0 and 10.0μmol/L Met groups,respectively (all P＜0.05).The inhibitory effect of 10.0 μmol/L was significantly stronger than that of 5.0 μmol/L (P＜0.001).The colone formation rate 34.0％,24.0％,22.3％ and 14.0％ in the control,Met,15 Gy irradiation,Met+ 15Gy irradiation groups,respectively (all P＜0.001).Western blot showed that compared with the control group,the expression of Sting protein was increased by 2.99-fold after Met treatment (P＜0.001),and increased by 1.37-fold and 4.41-fold in the 15 Gy irradiation and 15Gy irradiation+Met groups (both P＜0.01).Compared with the 15 Gy irradiation group,the expression of P-H2AX protein was significantly increased by 1.43 times after treatment with 15Gy+Met (P＜0.001).The transplanted tumor growth curve showed that the transplanted tumor growth in the 15 Gy+Met group was slower than that in the control group[(1007.0± 388.5) mm3 vs.(2639.0± 242.9) mm3,P＜ 0.05)].The overall survival time in the 15 Gy irradiation+Met group was 48 d,significantly longer than 32 d in the control group (P＜0.001).Compared with the control group,the expression of P-H2AX and Sting proteins in the 15 Gy+ Met group was increased by 8.8-fold and 1.6-fold (both P＜0.001).Immunohistochemical staining showed that the infiltration of CD8a (+) T cells in the 15 Gy irradiation+Met group was significantly higher than that in the control group (P＜0.01).Conclusions Met combined with radiotherapy can inhibit the proliferation and clone formation of colon cancer cells,probably by aggravating DNA damage and activating the Sting signaling pathway,eventually leading to the increase of CD8a (+) T cells in tumor tissues and enhancing the killing effect upon transplanted tumor cells.