1998年上海市719名受审人员的性传播疾病流行病学调查报告

近年来 ,上海市性传播疾病(ｓｅｘｕａｌｌｙｔｒａｎｓｍｉｔｔｅｄｄｉｓｅａｓｅ ,ＳＴＤ)的发病呈急剧上升的趋势 ,发病率由 1994年的 90 .74/ 10万上升至 1997年的2 5 4.2 5 / 10万[1] 。为了解ＳＴＤ在高危人群中的流行状况 ,我们对 1998年全市公安局性病门诊鉴定的 719名收审人员进行ＳＴＤ的流行病学调查 ,现将调查结果报告如下。一、资料与方法1.调查对象 :为 1998年全市各公安分局的部分收审人员 (公安局抓获的卖淫嫖娼和其他流氓犯罪者 )。对受检人员实施全身皮肤粘膜检查 ,重点检查外生殖器和肛门 ,采集受检者的静脉血和泌尿生…     

Integrated microRNA/mRNA expression profiling of the skin of psoriasis patients

BackgroundPsoriasis is a chronic inflammatory disease characterized by demarcated, raised, and scaling skin lesions. It often serves as a model for immune-mediated disorders. Gene expression profiling of affected skin has allowed insights into psoriasis pathogenesis. However, the mechanisms leading to specific mRNA expression alterations in psoriasis are barely understood.ObjectivesTo perform integrated microRNA-mRNA expression studies of non-lesional, peri-lesional, and lesional skin from psoriasis patients.MethodsCutaneous microRNA and mRNA expression profiles of 14 patients using Nanostring nCounter-technology and RNA sequencing as well as in vitro keratinocyte stimulation and qPCR studies.ResultsOnly 3.5 % of microRNAs manifested a robust gradual expression trend from non-lesional to paired lesional skin, with 61 % being upregulated and 39 % being downregulated. Relevance of these microRNA regulations was supported by their inverse association with 57 % of the mRNA species found to be regulated during psoriatic lesion development. Many of the involved mRNAs were downregulated and functionally related to keratinocyte metabolism, barrier function, and neuronal signaling, and were already regulated in peri-lesional skin. An integrated correlation analysis revealed a robust interaction for 134 microRNAs/mRNAs pairs. In vitro keratinocyte studies of selected microRNAs/mRNAs revealed regulations of all analyzed microRNAs in a psoriasis-like manner by IL-17A/TNF-α (e.g. hsa-miR-23a-3p), IFN-γ (e.g. hsa-miR-106a-5p/miR-17-5p), or IL-24 (e.g. hsa-miR-203a-3p). Moreover, most of their predicted target mRNAs (e.g. ID4, EPHB2) were respectively altered by the same cytokines.ConclusionOur study suggests that, during development of psoriatic lesions, defined aspects of psoriasis pathogenesis are regulated by the action of microRNAs.     

Electro-acupuncture vs. sham electro-acupuncture for chronic severe functional constipation: A systematic review and meta-analysis

ObjectivesTo assess the efficacy of electro-acupuncture (EA) relative to sham electro-acupuncture (sham EA) in treating chronic severe functional constipation (CSFC). Methods: A comprehensive search for relevant studies published between January 1, 1951 and May 14, 2020 was conducted in PubMed, the Cochrane Library, Chinese Biomedical Literature Database, Web of Science, and EMbase. Two investigators independently selected studies, extracted data, and assessed the quality of the included studies. The software Endnote X9 was used for screening articles, and the Review Manager 5.3 for analyzing data.ResultsThe meta-analyses involved 6 studies and 1457 individuals. The pooled results favored the EA group for the increase of complete spontaneous bowel movements (CSBMs) per week in the fourth week (MD = 0.80, P = 0.001) during treatment, and further improved in the eight weeks (MD = 1.25, P < 0.001). During the follow-up period, significant changes in CSBMs per week were seen in the experimental group (MD = 1.38, P = 0.008); the effect decreased in the twelfth week (MD = 0.87, P < 0.001). There was no significant difference in the Bristol stool scale score between the two groups in the fourth week (MD = 0.40, P = 0.08), but significant differences were observed in the eighth week (MD = 0.40, P = 0.03). A significant reduction in patient assessment of constipation quality of life (PAC-QOL) score were observed in the EA group during treatment (SMD = -0.83, P < 0.001). No serious adverse events were reported.ConclusionsEA had favorable effects on CSFC, and the longer the treatment duration was, the better was the effect, but the effect showed a certain period of validity. However, the results may be influenced by the clinical heterogeneity of acupuncture points, depth of needling, intensity, and frequency of EA.     

Suboptimal vancomycin levels in critically ill children with sickle cell disease and acute chest syndrome

ObjectivesThis is a pilot retrospective study to assess the effect of glomerular hyper-filtration (GHF) related to sickle cell disease (SCD) on vancomycin clearance and ultimately on therapeutic drug levels in children admitted to the pediatric intensive care unit (PICU) with acute chest syndrome (ACS).MethodThe patients’ steady-state vancomycin trough levels (VTL) and the area under the curve (AUC) were compared with those of age- and gender-matched control group; matching was made at a 1:3 ratio.ResultsTwelve SCD patients with ACS and treated with vancomycin were compared with 36 non-SCD patients (control group). Compared with the control patients, the ACS patients had significantly lower initial serum VTL (median = 6.00 mcg/mL vs. 9.75 mcg/mL) (p = 0.007), and their average VTL were still lower (median = 6.65 mcg/mL vs. 10.00 mcg/mL) post vancomycin dose adjustment (p = 0.039). The time to achieve the therapeutic vancomycin level was significantly longer for the ACS patients (median = 4.75 days) than for the control group (median = 1 day) (p = 0.009). The AUC was also significantly lower in the ACS patients (median = 293 mg*h/L) than in the control group (median = 405.5 mg*h/L) (p = 0.007). The AUC was negatively associated with creatinine clearance (Beta Coefficient = ?0.366, p-value=<0.001) even when adjusted for receiving loading dose, standard dose per weight, and severity of critical illness.ConclusionThese findings support the attributed role of the GHF associated with SCD leading to lower vancomycin level in ACS cases. Therefore, the standard dosing approach for vancomycin in ACS patients may be ineffective. We thus advocate for individualized dosing with careful monitoring of drug levels to account for GHF.     

lncRNA LINC000466 Predicts the Prognosis and Promotes the Progression of Triple‐negative Breast Cancer via Modulating miR‐539‐5p

BackgroundTriple-negative breast cancer (TNBC) is one of the most malignant subtypes of breast cancer with an unsatisfied prognosis. Effective biomarkers could predict the risk and improve patients’ survival. Whether LINC00466 possesses the potential to serve as a biomarker of the progression and prognosis of TNBC was evaluated.Materials and MethodsA total of 122 TNBC patients were included in this study and provided paired clinical tissues. The expression of LINC00466 in TNBC was evaluated by RT-qPCR and evaluated the clinical significance with a series of statistical analyses. The biological effects and the mechanism were investigated in TNBC cells with CCK8, Transwell, and luciferase reporter assays.ResultsLINC00466 was significantly upregulated in TNBC and showed close association with the clinical features of patients, which indicates the development, and severity of patients. LINC00466 functioned as a prognostic biomarker predicting the survival of patients and a tumor promoter improving the proliferation, migration, and invasion of TNBC cells through sponging miR-539-5p.ConclusionLINC00466 promotes the progression of TNBC via regulating miR-539-5p. The inhibition of LINC00466 might be a novel therapeutic strategy for TNBC.     

Can Ultrasound Elastography Help Better Manage Mammographic BI-RADS Category 4 Breast Lesions?

BackgroundTo assess the performance of conventional ultrasound (US) combined with strain elastography (SE) in the Breast Imaging Reporting and Data System (BI-RADS) category 4 lesions on mammography.Materials and MethodsWomen with breast lesions identified as having mammography BI-RADS 4 lesions and underwent US examination were included in China. US features and US BI-RADS assessment were recorded in real-time and prospectively reported. The pathological result was referred to as the gold standard. The performance of US in the mammographic BI-RADS category 4 lesions was evaluated. Diagnostic performances of US BI-RADS, SE and combined both were compared.ResultsA total of 751 women with 751 breast lesions classified as mammographic BI-RADS category 4 were included. For mammographic findings, 530 (70.6%) were true positive and 221 (29.4%) were false positive. Conventional US achieved higher positive predictive value (PPV) than mammography (78.5% vs. 70.6%, P=.001). The specificity increased from 34.4% to 47.1% (P< .001) without any loss in sensitivity and the PPV increased to 81.9% (P = .122) when conventional US was used in combination with SE. For conventional US combined with SE, it led to a correct diagnosis of no breast cancer in 104 of the 221 false-positive findings (47.1%) and achieved higher PPV than mammography regardless of patient age and lesion size.ConclusionConventional US combined with SE is a helpful tool for the noninvasive examination of breast lesions classified as BI-RADS category 4 on mammography. It helped increase the PPV and had the potential to avoid unnecessary biopsies of BI-RADS category 4 lesions detected on mammography.     

Factors Associated With the Decision to Decline Chemotherapy in Patients With Early-stage,ER+/HER2- Breast Cancer and High-risk Scoring on Genomic Assays

IntroductionThe rate of refusal of chemotherapy ranges from 3% to 19%, but varies widely by patient profile and treatment setting. Using a large national registry, we explore factors significantly associated with the decision to decline chemotherapy in patients with early-stage, HR+/HER2- breast cancer (BC) despite high risk scoring on multigene sequencing analysis for OncotypeDX (ODX) or MammaPrint (MP), in which the survival benefit of chemotherapy is clear.Patients and MethodsPatients with HR+/HER2- BC and high risk scoring on ODX (score >26) or MP were selected from the National Cancer Database (2004-2017). Only those who refused to get chemotherapy despite their physician's recommendations were included. Univariate frequency and proportion statistics were used to describe the patient cohort. Bivariate Chi-square analysis evaluated the association between refusal of recommended chemotherapy and sociodemographic characteristics. Significant variables (P < .05) were included in a multivariable logistic regression model.ResultsN = 43,533 patients were included (88.7% ODX, 11.3% MP). A total of n = 4415 (10.1%) patients declined chemotherapy despite recommendation by the patient's primary oncologist. Age >70 (OR: 3.46, 95% CI: 2.96-4.04, P < .001), black race (OR: 1.20, 95% CI: 1.07-1.36, P = .01), non-private insurance, lobular carcinoma histology (OR: 1.21, 95% CI: 1.09-1.35, P < .001), and tumor grade of I significantly predicted chemotherapy decline.ConclusionIdentifying and addressing many of the factors that contribute to under-treatment in minorities is to be key to reducing cancer disparity and improving equity in cancer care and outcome.     

The impact of watching real-time videos of flexible ureteroscopic lithotripsy on anxiety and depression in patients

International Urology and Nephrology - This study examines the effect of intraoperative doctor–patient communication with real-time videos in flexible ureteroscopic lithotripsy on...