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Mucinous ovarian cancer(MOC)is a rare pathological type different from epithelial ovarian cancer,and the clinical treatment should refer to serous ovarian cancer(SOC)guidelines.However,since the clinicopathological features of MOC are significantly different from SOC,careful differentiation is needed in diagnosis and treatment.Surgery combined with adjuvant chemotherapy is the standard treatment for MOC.However,due to the low prevalence rate,it is difficult to carry out clinical trials,hence lacking evidence-based medicine and consensus on the indications of intraoperative appendectomy and the choice of postoperative adjuvant chemotherapy.In addition,further translational preclinical studies of targeted therapy and immunotherapy are needed to facilitate the diagnosis and individualized treatment of MOC.

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Objective@#The study aims to analyze the prevalence and associated factors of myopia among 4 to 9 grade students in Guangdong Province in 2022, so as to provide a scientific basis for targeted intervention measures for myopia in children and adolescents.@*Methods@#From September to October 2022, stratified cluster random sampling was used to select 29 095 of 4 to 9 grade students from Guangzhou, Jiangmen, and Meizhou in Guangdong Province for myopia screening and questionnaire surveys. The Chisquare test was applied to compare the differences between groups, and multivariable Logistic stepwise regression analysis was used to analyze factors associated with myopia.@*Results@#The myopia detection rate of 4 to 9 grade students was 61.7%, with detection rates of 51.5% for 4 to 6 grade primary school students and 71.95% for 7 to 9 grade junior high school students. Multivariable Logistic regression analysis showed that higher myopia rates were detected among girls (OR=1.39, 95%CI=1.30-1.49), students with one (OR=1.82, 95%CI=1.69-1.96) or both parents having myopia (OR=2.86, 95%CI=2.56-3.18), and indoor sedentary time >6 h(OR=1.28, 95%CI=1.17-1.39) in the 4 to 6 grade. Lower myopia rates were detected in the county (OR=0.92, 95%CI=0.86-0.99) and outdoors at recess activities (OR=0.88, 95%CI=0.81-0.95). Meanwhile, higher myopia rates were detected among girls (OR=1.84, 95%CI=1.69-1.99), students with one (OR=1.87, 95%CI=1.71-2.04) or both parents having myopia (OR=3.03, 95%CI=2.63-3.50), and indoor sedentary time >6 h/d (OR=1.11, 95%CI=1.01-1.23) in the 7 to 9 grade. Lower myopia rates were detected in the county (OR=0.74, 95%CI=0.68-0.80), outdoors at recess activities (OR=0.83, 95%CI=0.76-0.91), and outdoor activity time ≥2 h/d(OR=0.87, 95%CI=0.80-0.95)(P<0.05).@*Conclusions@#The detection rate of myopia among 4 to 9 grade students in Guangdong Province is relatively high. Place of recess activities, daily outdoor activity and indoor sedentary duration are associated with myopia. Therefore, targeted intervention measures should be adopted, such as appropriately increasing outdoor activity to reduce the occurrence of myopia among primary and middle school students.

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Objective:To explore the clinical characteristics of deceased cases due to pregnancy complicated by systemic lupus erythematosus (SLE).Methods:A retrospective analysis was conducted on six cases of pregnancy-related deaths due to SLE from January 1, 2012 to December 31, 2021 in Beijing Maternal and Child Health Monitoring Data. Information including basic details of the pregnant women, medical histories, prenatal examinations, diagnostic and treatment processes, review opinions, and causes of death were collected from their medical records, death investigation reports, and municipal-level maternal mortality review. Descriptive methods were used to analyze the data.Results:Between 2012 and 2021, the mortality of pregnancy combined with SLE in Beijing was 0.28/100 000. Among these six cases, the primary clinical manifestations were fever, neuropsychiatric, and respiratory symptoms. All had a decreased platelet count (PLT) and exhibited hypocomplementemia. Three cases experienced elevated blood pressure during pregnancy, five had proteinuria, three had infections during pregnancy. Among the three cases without a history of SLE, the primary organ damages were in the hematological system, lungs, and kidneys. For the three cases with a history of SLE, the primary affected organs were the neuropsychiatric system, hematological system, and kidneys.Conclusions:The initial symptoms of the cases in this group primarily involved fever, neuropsychiatric, and respiratory symptoms. Hypertension and infections were common complications, and decreased PLT, proteinuria, and reduced complement levels were also significant laboratory indicators.

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Objective:To estimate the safety of myomectomy in twin pregnant women with intramural myomas during cesarean section.Methods:The clinical data of 145 cases of twin pregnancies with intramural myomas who were delivered by cesarean section in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from June 2013 to December 2021 were collected. Maternal demographics, fibroids′ characteristics, maternal and fetal outcomes were compared between groups of cesarean section with myomectomy (myomectomy group, 49 cases) and cesarean section only (non-myomectomy group, 96 cases).Results:Compared with non-myomectomy group, myomectomy group had significantly prolonged operative time [50.0 minutes (37.5-57.5 minutes) vs 40.0 minutes (35.0-50.0 minutes), respectively; P=0.007] and significantly longer postoperative hospital stay [4.0 days (3.0-4.0 days) vs 3.0 days (3.0-4.0 days), respectively; P=0.047). Other maternal and fetal outcomes such as estimated blood loss, hemoglobin difference, postpartum hemorrhage, blood transfusion, B-Lynch structure, uterine artery ligation, postoperative fever and neonatal Apgar score showed no significant differences (all P>0.05). For intramural myomas <5 cm, there were no significant differences in maternal and fetal outcomes between myomectomy group and non-myomectomy group (all P>0.05). For intramural myomas ≥5 cm, operative time [55.0 minutes (40.0-60.0 minutes) vs 42.5 minutes (40.0-50.0 minutes), respectively; P=0.019] was significantly prolonged, postoperative hospital stay [4.0 days (4.0-5.0 days) vs 4.0 days (3.0-4.0 days), respectively; P=0.048] was significantly longer in myomectomy group than non-myomectomy group, but there were no significant differences in other maternal and fetal outcomes (all P>0.05). Conclusion:For twin pregnancies with intramural myomas, it is safe and feasible to remove intramural myomas during cesarean section by experienced obstetricians.

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Objective:To explore and evaluate a appropriate suitable method for detection of Campylobacter and antibiotic sensitivity test for foodborne diarrhea in clinical laboratories. Methods:Pre-experiment:a total number of 400 fecal samples of patients with foodborne diarrhea were prospectively collected from the intestinal disease clinic of Beijing Tongren Hospital from September 2017 to January 2018. Double-hole filtration culture method and modified cefoperazone charcoal deoxycholate (CCD) agar culture method were used for fecal culture in micro-aerobic environment for 48 hours, and then suspicious colonies were identified by matrix assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry. Meanwhile, C. jejuni and C. coli were detected by real-time quantitative polymerase chain reaction(qPCR). Large sample verification: 2 062 fecal samples of patients with foodborne diarrhea in three hospitals of different levels in different areas of Beijing were collected for qPCR detection and culture from April 2018 to March 2019. The antimicrobial sensitivity test (AST) of C. jejuni and C. coli was performed according to the disk diffusion method and agar dilution method recommended by Clinical and Laboratory Standards Institute and National Antimicrobial Resistance Monitoring System for Enteric Bacteria. The results of the three detection methods and the consistency of the two antibiotic sensitivity tests were compared. Results:In the pre-experiment, the positive rates of Campylobacter ( jejuni/coli) detected of qPCR, double-hole filtration culture and modified CCD agar culture were 9.0% (36/400), 5.0% (20/400)and 3.5% (14/400), and the difference was statistically significant ( P<0.01). The samples with negative result of qPCR were negative by both culture methods. The total positive rates of Campylobacter detected by qPCR was 8.1% (168/ 2 062)including 7.0% (144/2 062) for C. jejuni and 1.2% (24/2 062) for C. coli. The samples with positive qPCR results were cultured by double-hole filtration culture method and the positive rate was 61.9%(104/168), among which, the positive rate of C. jejuni and C. coli were 58.3%(84/144) and 83.3%(20/24) respectively, which was not significantly different from the detection rate and culture positive rate in the pre-test ( P>0.1). The resistance rates of C. jejuni and C. coli to ciprofloxacin were 94.0%(94/100) and 100.0%(24/24) and to erythromycin were 6.0%(6/100) and 33.3%(8/24). The results from two antibiotic sensitivity test methods were consistent (Kappa>0.75). Conclusions:qPCR is rapid, sensitive and easy to operate, so it is suitable for routine development in clinical laboratories. The double-hole filtration culture method is beneficial to the acquisition of strains and is essential for the further study of Campylobacter. There was no significant difference between agar dilution method and disk diffusion method in antibiotic sensitivity test. Campylobacter showed a very high resistance rate to quinolones, which was no longer suitable for the treatment of Campylobacter foodborne diarrhea in Beijing area. Macrocyclic lipid antibiotics should be preferred.

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Objective@#To understand the management of tuberculosis outbreaks in middle schools in Bijie City, and to put forward suggestions to improve the quality of tuberculosis epidemic situation in schools.@*Methods@#A unified questionnaire was used to investigate the management of tuberculosis outbreaks in middle schools reported by tuberculosis information management system from August 27, 2018 to January 6, 2019 in Bijie City.@*Results@#The screening rate of close contacts was 69.72%(99/142), which significantly varied by counties(P<0.01). The time from the date of diagnosis of patients to screening of close contacts by local CDC was 3(1-10.5) days. Rate of standardized management process for close contacts aged 15 years or older (0) was lower than that for close contacts aged younger than 15 years old (23.08%)(P<0.01). 3 462 close contacts were screened for TB symptom,and chest X-ray among those suspected individuals(process 1), and 2 439 close contacts were screened with TB symptom,PPD test,and chest X-ray among those suspected individuals or those with strong positive in PPD test(process 2). The detection rate of pulmonary tuberculosis in close contacts of Grade I was lower in Process 1 (28.89/100 000) than in Process 2 (328.00/100 000)(χ2=6.56, P=0.01). The latent infection rate of the first-class close contacts (6.39%) was higher than that of the second-class close contacts(1.93%)(χ2=54.86, P<0.01).@*Conclusion@#Management of tuberculosis outbreaks in middle schools in Bijie City in 2018 is effective and timely, but the standardization needs to be improved.

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BACKGROUNDIn-depth investigations of the safety and immunogenicity of inactivated SARS-CoV-2 vaccines are needed. METHODIn a phase I randomized, double-blinded, and placebo-controlled trial involving 192 healthy adults 18-59 years of age, two injections of three different doses (50 EU, 100 EU and 150 EU) of an inactivated SARS-CoV-2 vaccine or the placebo were administered intramuscularly with a 2- or 4-week interval between the injections. The safety and immunogenicity of the vaccine were evaluated within 28 days. FINDINGIn this study, 191 subjects assigned to three doses groups or the placebo group completed the 28-day trial. There were 44 adverse reactions within the 28 days, most commonly mild pain and redness at the injection site or slight fatigue, and no abnormal variations were observed in 48 cytokines in the serum samples of immunized subjects. The serum samples diluted from 1:32 to 1:4096 and incubated with the virus did not show antibody-dependent enhancement effects (ADEs) with regard to human natural killer cells, macrophages or dendritic cells. At day 14, the seroconversion rates had reached 92%, 100% and 96% with geometric mean titers (GMTs) of 18.0, 54.5 and 37.1, and at day 28, the seroconversion rates had reached 80%, 96% and 92% with GMTs of 10.6, 15.4 and 19.6in 0, 14 and 0, 28 procedures, respectively. Seroconversion was associated with the synchronous upregulation of ELISA antibodies against the S protein, N protein and virion and a cytotoxic T lymphocyte (CTL) response. Transcriptome analysis shaped the genetic diversity of immune response induced by the vaccine. INTERPRETATIONIn a population aged 18-59 years, this inactivated SARS-CoV-2 vaccine was safe and immunogenic. Trial registrationNCT04412538 FUNDINGThe National Key R&D Program of China (2020YFC0849700), the Program of Chinese Academy of Medicine Science and the Major Science and Technology Special Projects of Yunnan Province.

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With the relatively serious global epidemic outbreak of SARS-CoV-2 infection, public concerns focus on not only clinical therapeutic measures and public quarantine for this disease but also the development of vaccines. The technical design of our SARS-CoV-2 inactivated vaccine provides a viral antigen that enables the exposure of more than one structural protein based upon the antibody composition of COVID-19 patients convalescent serum. This design led to valid immunity with increasing neutralizing antibody titers and a CTL response detected post-immunization of this vaccine by two injections in rhesus macaques. Further, this elicited immunoprotection in macaques enables not only to restrain completely viral replication in tissues of immunized animals, compared to the adjuvant control and those immunized by an RBD peptide vaccine, but also to significantly alleviate inflammatory lesion in lung tissues in histo-pathologic detection, compared to the adjuvant control with developed interstitial pneumonia. The data obtained from these macaques immunized with the inactivated vaccine or RBD peptide vaccine suggest that immunity with a clinically protective effect against SARS-CoV-2 infection should include not only specific neutralizing antibodies but also specific CTL responses against at least the S and N antigens.

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Objective:To understand the attitudes and behaviors status of injury prevention among urban residents' injury prevention in Changsha City and to provide evidence for urban residents' injury prevention.Methods:A stratified random sampling was conducted to extract 504 residents from 8 communities in 2 urban districts of Changsha City. The questionnaires were distributed on-site, and 420 valid questionnaires were got.Results:The attitudes and behavioral scores of urban residents' injury prevention were 43.35±14.29 and 38.92±3.75, while the agreement rate regarding injury prevention attitudes was 76.63% and the compliance rate of injury prevention behaviors was 43.10%. The scores of injury prevention behaviors among urban residents with different ages, family annual income, exercise frequency, and frequency of injuries were different ( F values were 2.815, 4.740, 4.153, P<0.05). There were differences in the scores of injury prevention attitudes among the residents of different ages, education background, and frequency of injuries ( F values were 3.030-8.162, P<0.01 or 0.05). Conclusion:The residents ′ attitude towards injury prevention was positive and the compliance rate of injury prevention behavior among urban residents in Changsha is low. Both injury prevention attitudes and behaviors differed in the residents with different backgrounds.

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@#Objective    To investigate the clinical effect of Maze Ⅳ in the treatment of elderly patients with valvular heart disease and persistent atrial fibrillation (AF). Methods    We retrospectively analyzed the clinical data of 78 elderly patients with cardiac valve disease combined with persistent AF in our hospital from 2017 to 2018. The patients were allocated to two groups including a trial group (n=37) and a control group (n=41). There were 21 males and 16 females aged 61 to 74 (65.2±2.5) years in the trial group. There were 23 males and 18 females aged 62 to 76 (64.8±3.3) years in the control group. The clinical effects of the two groups were compared. Results    There was no statistical difference in baseline data between the two groups (P>0.05). The aortic occlusion time, extracorporeal circulation time, and operation time of the trial group were longer than those of the control group with statistical differences (P<0.05). There was no statistical difference in postoperative ventilator assistance time, complication rate, mortality, ICU retention time, perioperative drainage, red blood cell transfusion volume, or length of hospital stay between the two groups (P>0.05). At the time of discharge, postoperaive 1-month, 3-month, 6-month, and 12-month, the maintenance rates of sinus rhythm in the control group were statistically different from those of the trial group (P<0.05). Compared with the control group, left atrial diameter, left ventricular end diastolic diameter and the decrease of pulmonary artery systolic blood pressure were statistically different (P<0.05). Conclusion    Maze Ⅳ is safe and effective in the treatment of elderly patients with valvular heart disease and persistent AF, which is conducive to the recovery and maintenance of sinus rhythm, and is beneficial to the remodeling of the left atrium and left ventricle and the reduction of pulmonary systolic blood pressure with improvement of life quality of the patients.

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Rabies is the most lethal zoonotic, vaccine-preventable viral disease in the world. Its treatment is complicated by insufficient vaccine supply and the requirement for four to five repeated injections, as commercially available inactivated rabies lack adjuvant and have low immunogenicity. In this study, we focused on the role of a Krebs cycle intermediate, succinate dehydrogenase (SDH), in the innate immune response to cytokine production. We formulated a novel nanoemulsion adjuvant, Golden03, which stabilizes mouse SDH activity and contains more coenzyme Q10 and succinic acid than the classic MF59 adjuvant. Mice were immunized on days 1, 3, and 7, with seroconversion rate results suggesting that Golden03 significantly enhanced vaccine-stimulated antibody production against the rabies virus. Neutralizing antibody concentration testing by RFFIT indicated that treatment with Golden03 could result in antibody levels of up to 0.74 IU/mL 5 days post infection (DPI). ELISPOT for IFN-γ in mouse spleen cells showed that Golden03 enhanced immune responses at 14 DPI, inducing a rapid and powerful cellular response compared to the control group. Furthermore, the Vaccine-Golden03 group displayed no obvious weight loss or death after intracranial injection with CVS-11. An additional advantage is that Golden03 allowed for a three-quarter reduction in dose, while maintaining its efficacy and rapid stimulation effect. We suggest that Golden03 could be developed as a potential adjuvant for use in human rabies vaccine.

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To analyze the effects of phenol red at various pH values on the Sabin type 2 inactivated polio vaccine (sIPV2), several biophysical techniques were used to evaluate the particle size and capsid protein for conformation. sIPV2's size was assessed via transmission electron microscopy and dynamic light scattering. The effects of various pH values (from 4.0 to 7.0) on the biophysical characters of sIPV2 particles in solution were determined by dynamic light scattering and zeta potential. The results clearly indicated that aggregation and instability occurred in the solution of sIPV2 particles at a pH of 6.0. Under similar conditions, by dynamic light scattering and zeta potential, the virus particles in solution showed more dispersion and were stable with the addition of 0.05 mM phenol red. According to circular dichroism and intrinsic tryptophan fluorescence data, it was observed that the secondary and tertiary structures of the sIPV2 particles were more stable with the protection of phenol red. At a pH below 6.0, the sIPV2 solution with phenol red had more D-antigen content, which was confirmed by enzyme-linked immunosorbent assay and rat experiments. These results strongly suggested that phenol red improved the pH stability of the sIPV2. The study indicated the potential of phenol red in preserving vaccine potency of the sIPV2 at various pH values.

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Objective To explore the establishment of a two-way referral system for the treatment of cervical diseases within a medical alliance. The two-way referral system was introduced to reduce the morbidity and mortality of cervical cancer through better management of patients'who have tested positive for cervical disease, screening effectively for early diagnosis and treatment of cervical precancerous lesions, and providing early interventions for cervical cancer patients. Methods The control group consisted of 2, 515 patients who had screened positive for cervical disease between January 2018 and December 2018 at one of four community health service centers that were not within the medical alliance. The experimental group consisted of 2, 384 patients who had screened positive for cervical disease at one of four community health service centers in the medical alliance. The control group was treated using the original management mode;the experimental group's treatment was managed within the two-way referral system, which included standardized screening, referral, follow-up, health education, and professional training. The hospital visit rates, time intervals from diagnosis to the start of interventions, detection rates, and treatment rates were observed for both groups of women. Results The hospital visit rates, detection rates, and treatment rates were higher for those in the experimental group than the control group. The time interval from receiving a diagnosis to the first hospital visit was (16.9±11.5) days for patients in the experimental group and (25.7±20.9)days for those in the control group. The difference was a statistically significant (-0.05). Conclusion The management of cases in a two-way referral system within a medical alliance facilitates patients receiving earlier diagnosis and treatment for cervical pre-cancerous lesions and malignant tumors. Such efficiency improvements may reduce morbidity and mortality as well as help control medical costs, all of which have long-term economic and social significance.

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OBJECTIVE:To provide reference for pharmacists to participate in the management of chronic disease. METHODS:A total of 259 patients with chronic airway disease [included asthma and chronic obstructive pulmonary disease (COPD)] met the inclusion criteria were selected from our hospital and 5 community health care centers of medical consortium. These patients received medication safety assessment management,which was led by clinical pharmacists of our hospital with the participation of community pharmacists,including medication safety comprehensive evaluation and risk classification management, follow-up and medication guidance, integrated prescriptions checking, establishment of shared database. 1 years after the implementation,the effectiveness were evaluated by score the relatived indicators in related groups. RESULTS:After a year of the management mode practice,compared with before intervention,the patients'safety medication cognitive ability score in high-risk and low-risk group increased from(4.49±1.26)and(7.31±1.01)to(5.40±1.56)and(7.44±0.91);medication adherence score increased from(4.96±1.21)and(7.08±1.24)to(6.66±1.08)and(7.38±0.98);ACT score from asthma patients increased from (16.15±2.58)and(21.15±1.03)to(16.80±2.57)and(21.64±1.55);CAT score from COPD patients decreased from(25.51± 4.07) and (14.90 ± 3.95) to (24.20 ± 3.96) and (13.80 ± 4.08);the rate of irrational prescription effective identification and intervention by pharmacists increased from 3.6％ and 1.4％ to 9.4％ and 7.6％,respectively. All the differences above were statistically significant (P<0.05). CONCLUSIONS:The participation of pharmacists in long-term medication safety assessment management for chronic airway disease patients can improve patients'safety medication cognitive ability,medication adherence, disease control and the pharmacists'ability of irrational drug use identification and intervention.

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Objective:To explore the new management mode of long-term medication safety assessment for chronic obstructive pul-monary disease (COPD) with the participation of pharmacist team in medical treatment alliance to provide reference for pharmacists participating in the management of chronic diseases under the new situation of new medical reform. Methods:Totally 126 patients with COPD meeting the inclusion criteria in our hospital and medical treatment alliance were selected. The patients received medication management including drug safety comprehensive evaluation,classification management,follow-up with medication guidance,integrat-ed prescriptions checking and shared database building etc with the participation of our clinical pharmacists to guide the community pharmacists in coordination with physicians. Results:After one-year management mode practice,the cognitive ability of safe medica-tion and compliance of the patients significantly increased(P<0.01) with significant improvement of control situation of COPD(CAT score) (P<0.05 or P<0.01), and the capacity of effective identification and irrational prescription intervention significantly in-creased (P<0.01). Conclusion:The management mode of long-term medication safety assessment for COPD patients with the partic-ipation of pharmacist team in medical treatment alliance has significant effects on COPD patients' safe medication and drug efficacy, which can improve the professional service of pharmacist team.

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Objective: To explore the potential risks in hospital medication management system and propose the preventive meas-ures. Methods: The medication error (ME) cases reported from Jan 1st2012 to Dec 31st2016 in our hospital were retrospectively ana-lyzed in terms of ME category, classification, occurrence link, cause, influencing factors, detecting person and the proportion of high-alert medication MEs. Results: A total of 425 ME reports were collected, and among them, 311 cases were related to western medi-cines (73. 18% ), and 114 cases were related to traditional Chinese medicines (26. 82% ). The proportion of ME in category A, B and C was 4. 24% , 89. 65% and 5. 41% , respectively; the proportion of ME in category D, E and F was 0. 24% . ME in category G, H and I was not reported. In terms of the ME classification, the proportion of drug variety error was the highest (23. 29% ) followed by the repeated medication error (9. 41% ) and the dosage error (8. 94% ). As for the ME occurrence link, the proportion of prescription error was the highest (73. 18% ) followed by the dispensing error (16. 94% ). The top factor to trigger ME was lack of knowledge (26. 82% ) followed by the similar drug name (21. 41% ). The main person who detected ME was pharmacists (93. 88% ). Among of the 425 ME reports, 81 cases were related to high-alert medication, and the top two were insulin errors (48. 15% ) and oral hypoglyce-mic agents errors (23. 46% ). Conclusion: It can partly prevent ME by improving selection and management of new drugs, improving drug information system, enhancing drug quality management and strengthening safe medication knowledge education.

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Objective@#To understand the characteristics of genotypes of Mycobacterium tuberculosis isolates in Yunnan province, and provide the molecular epidemiological evidence for prevention and control of tuberculosis in Yunnan Province.@*Methods@#Mycobacterium Tuberculosis isolates were collected from 6 prefectures of Yunnan province in 2014 and their Genetypes of Mycobacterium tuberculosis isolates were obtained using spoligotyping and multiple locus variable numbers of tandem repeats analysis (MLVA). The results of spoligotyping were entered into the SITVITWEB database to obtain the Spoligotyping International Type (SIT) patterns and the sublineages of MTB isolates. The genoyping patterns were clustered with BioNumerics (version 5.0).@*Results@#A total of 271 MTB isolates represented patients were collected from six prefectures in Yunnan province. Out of these patients, 196 (72.3%) were male. The mean age of the patients was (41.9±15.1) years. The most MTB isolates were from Puer, totally 94 iusolates(34.69%). Spoligotyping analysis revealed that 151 (55.72%) MTB isolates belonged to the Beijing genotype, while the other 120 (44.28%) were from non-Beijing genotype; 40 genotypes were consisted of 24 unique genotypes and 16 clusters. The 271 isolates were differentiated into 30 clusters (2 to 17 isolates per cluster) and 177 unique genotypes, showing a clustering rate of 23.62%. Beijing genotype strains showed higher clustering rate than non-Beijing genotype strains (29.14% vs 16.67%). The HGI of 12-locus VNTR in total MTB strains, Beijing genotype strains and non-Beijing genotype was 0.993, 0.982 and 0.995 respectively.@*Conclusion@#The Beijing genotype was the predominant genotype in Yunnan Province, the characteristics of Mycobacterium tuberculosis showed high genetic diversity. The genotyping data reflect the potential recent ongoing transmission in some area, which highlights the urgent need for early diagnosis and treatment of the infectious TB cases, to cut off the transmission and avoid a large TB outbreak.

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Objective@#To investigate the influence of maternal age on the health status of pregnant women and the pregnant outcomes.@*Methods@#Data obtained from "Beijing perinatal health management registration system" was analyzed, 263 157 pregnant women with age information were included from October 1st, 2015 to September 30th, 2016, in which 43 594 women delivered at the age of 35 or above (advanced age) . According to the age of maternal age, there were 5 groups. (1) Proper age: 219 563 (83.43%, 219 563/263 157) cases of the age of 18-34 years, including 122 735 cases (46.64%, 122 735/263 157) in the ≤29 years old group and 96 828 cases (36.79%, 96 828/263 157) in 30-34 years old group. (2) Advanced age: there were 43 594 cases (16.57%, 43 594/263 157) ≥35 years old, including 37 395 cases (14.21%, 37 395/263 157) in the 35-39 years old group, 5 790 cases (2.20%, 5 790/263 157) in the 40-44 years old group and 409 cases (0.16%, 409/263 157) in the ≥45 years old group. The trend-based chi-square test and logistic regression were used to analyze the effects of different age groups on maternal complications and pregnant outcomes.@*Results@#(1) The total incidence of high risk pregnancy (HRP) : in advanced age women, the incidence of HRP was 67.83% (29 571/43 594) which was 56.73% (124 550/219 563) in proper age women, the difference was statistically significant (χ2=1 848.91, P<0.000) . In advanced age women, the incidence of severe HRP was 7.64% (3 329/43 594) which was 6.18% (13 571/219 563) in proper age women, the difference was statistically significant (χ2=128.211, P<0.000) . In advanced age women, the incidence of very severe HRP was 1.76% (769/43 594) which was 0.84% (1 838/219 563) in proper age women, the difference was statistically significant (χ2=318.58, P<0.000) . (2) Comparison of the incidence of HRP in 5 groups:the total incidence of HRP increased through the following age group ≤29 years, 30-34 years, 35-39 years, 40-44 years, ≥45 years (53.28%, 61.09%, 67.41%、70.09%, 74.57% respectively) , the difference was statistically significant (linear by linear χ2=3 165.72, P<0.000) . The incidence of very severe HPR increased (0.66%, 1.06%, 1.66%, 2.35%, 2.93% respectively) , the difference was statistically significant (linear by linear χ2=218.31, P<0.000) . The incidence of severe HPR increased (5.77%, 6.70%, 7.48%, 8.34%, 11.49% respectively) , the difference was statistically significant (linear by linear χ2=422.20, P<0.000) . The incidence of general HPR increased (46.84%, 53.34%, 58.26%, 59.40%, 60.15% respectively) , the difference was statistically significant (linear by linear χ2=1 947.51, P<0.000) . (3) As the maternal age group increased, the incidence of adverse pregnancy outcomes increased (5.54%, 6.85%, 8.77%, 9.90%, 18.09%, linear by linear χ2=674.57, P<0.000) . The incidence of perinatal death, premature birth and low birth weight also presented the above trends (perinatal death: linear by linear χ2=34.79, P<0.000; premature birth: linear by linear χ2=692.87, P<0.000; low birth weight: linear by linear χ2=379.20, P<0.000) . (4) Logistic regression analysis with the assisted reproductive technology and multiple pregnancy considered showed the same trend (P<0.000) .@*Conclusion@#The maternal age has an impact on the maternal health status and pregnancy outcomes, and the risk of various types of pregnancy complications and adverse pregnancy outcomes increase with the maternal age group, antenatal care and management should be emphasized in women with advanced maternal age, especially for women ≥40 years old.

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Objective To evaluate the BALB/c murine infective effects in different concentrations and different aerosol challenge times by Bordetella pertussis.Methods Four experiment groups according to different concentrations and different aerosol challenge times were designed.BALB/c murines were challenged by aerosol way.Group 1: 1010cfu/mL Bordetella pertussis challenge 15 min, group 2: 1010cfu/mL challenge 30 min, group 3: 109cfu/mL challenge 30 min, group 4: 1011cfu/mL challenge 30 min, using the normal saline challenge 30 min as control.At 0d,3d,7d,14d and 21d after challenge, the WBCs of all groups were measured and lung tissues were homogenized to calculate the bordetella pertussis clone in lung.Results After 3 days of challenge, WBCs in all groups were slightly increased.The WBCs of group 1, group 2, group 3 and group 4 were significantly increased after 7 days, with the average numbers of 8.52×109 per/L, 1.74×1010per/L, 1.15×1010per/L and 5×1010per/L, respectively.After 14 days, they were 1.77×1010per/L, 1.67×1010per/L, 1.27×1010per/L and 3.84×1010per/L respectively.WBCs in all groups were dramatically declined after 21 days.The WBC of negative control group had no obvious change during the whole process with the stable number of 3.4~7.0×109per/L.Bordetella pertussis were detected in lung of all experimental groups in each sampling point.The CFU in lung wase at peak at 7d or 14d after challenge, which was obviously decreased at 21d.Conclusion This aerosol challenge method can establish a bordetella pertussis infection mouse model successfully.

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Objective To analyze the correlation between the resistance of Acinetobacter baumannii and the utilization of antimicrobial agents in the hospitalized patients of Beijng Chuiyangliu Hospital,and provide the basis for clinical rational use antimicrobial agents.Methods A retrospective analysis was conducted for the drug resistance rate and specimen source of the 2 194 strains of Acinetobacter baumannii from 2010 to 2014 in the hospital and DDDs/DUI of antimicrobial agents was analyzed by Pearson correlation.Results The resistance rate of Acinetobacter baumannii was positively correlated with the DDDs and DUI of imipenem/cilastatin(r=0.991,0.994,all P<0.01), and was positively correlated with the DDDs of cefepime(r=0.934,P=0.020).The resistance rate of Acinetobacter baumannii to amikacin was positively correlated with the DDDs of etimicin(r=0.931,P=0.022).The resistance rate of Acinetobacter baumannii was negatively correlated with the DUI of levofloxacin(r =-0.986,P =0.002). Conclusion The resistance rate of Acinetobacter baumannii was high and there was correlation between the drug resistance and the utilization of some antimicrobial agents.