Combination treatment with telitacicept,mycophenolate mofetil and glucocorticoids for immunoglobulin A nephropathy:A case report

BACKGROUND Telitacicept reduces B cell activation and abnormal immunoglobulin A(IgA)antibody production by inhibiting the activity of B lymphocyte stimulator(BLyS)and a proliferation-inducing ligand(APRIL),thereby decreasing IgA deposition in the glomeruli and local inflammatory response.This ultimately protects the kidneys from damage.This mechanism suggests that Telitacicept has potential efficacy in the treatment of IgA nephropathy.CASE SUMMARY We present the case of a 24-year-old female who was diagnosed with IgA nephropathy due to significant proteinuria and mild renal impairment.Pathologically,she exhibited focal proliferative glomerulonephritis.Treatment with angiotensin II receptor blocker,hormones,and mycophenolate mofetil did not lead to a significant improvement in her condition.However,upon the addition of telitacicept,the patient’s renal function recovered and her proteinuria rapidly reduced.Hormones were swiftly tapered and discontinued,with no occurrence of severe infections or related complications.CONCLUSION Telitacicept combined with hormones and mycophenolate mofetil may be a safe and effective induction therapy for IgA nephropathy.

Transcriptional profiling reveals multiple defense responses in downy mildew-resistant transgenic grapevine expressing a TIR-NBS-LRR gene located at the MrRUN1/MrRPV1 locus

Grapevine downy mildew(DM)is a destructive oomycete disease of viticulture worldwide.MrRPV1 is a typical TIR-NBS-LRR type DM disease resistance gene cloned from the wild North American grapevine species Muscadinia rotundifolia.However,the molecular basis of resistance mediated by MrRPV1 remains poorly understood.Downy mildew-susceptible Vitis vinifera cv.Shiraz was transformed with a genomic fragment containing MrRPV1 to produce DM-resistant transgenic Shiraz lines.Comparative transcriptome analysis was used to compare the transcriptome profiles of the resistant and susceptible genotypes after DM infection.Transcriptome modulation during the response to P.viticola infection was more rapid,and more genes were induced in MrRPV1-transgenic Shiraz than in wild-type plants.In DM-infected MrRPV1-transgenic plants,activation of genes associated with Ca^(2+)release and ROS production was the earliest transcriptional response.Functional analysis of differentially expressed genes revealed that key genes related to multiple phytohormone signaling pathways and secondary metabolism were highly induced during infection.Coexpression network and motif enrichment analysis showed that WRKY and MYB transcription factors strongly coexpress with stilbene synthase(VvSTS)genes during defense against P.viticola in MrRPV1-transgenic plants.Taken together,these findings indicate that multiple pathways play important roles in MrRPV1-mediated resistance to downy mildew.

折叠式人工玻璃体球囊植入术在眼外伤和硅油依赖眼中的疗效

目的:观察折叠式人工玻璃体球囊植入术在眼外伤和硅油依赖眼中的临床效果。方法:前瞻性病例研究。2017-10/2022-04在长沙市第一医院就诊的眼外伤和硅油依赖眼患者17例17眼,植入折叠式人工玻璃体球囊或者硅油取出术联合折叠式人工玻璃体球囊植入术。术后随访6mo,观察术前,术后1wk,6mo视力、眼压和眼轴情况,以及眼球结构及球囊情况。结果:术前残存视力患者6例,术后1wk,6mo视力与术前相比均无差异(P>0.05)。术前眼压偏低,术后1wk,6mo眼压与术前相比眼压升高。术后1wk,6mo眼轴长度没有变化。随访期内眼球外观及结构维持良好,球囊稳定,眼球没有萎缩。结论:折叠式人工玻璃体球囊植入术可保存眼球外观,阻止眼外伤后眼球萎缩,避免多次手术或摘除眼球,对眼外伤或硅油依赖眼有良好的应用价值。

结核病与糖尿病共病患者的临床治疗研究进展

结核病与糖尿病均是临床上的常见疾病,二者可相互影响。糖尿病可损伤患者的免疫功能,不仅会增加患者感染结核分枝杆菌的风险,还可导致结核病患者抗结核治疗的失败和疾病复发,甚至死亡的发生。为此,对于结核病与糖尿病共病患者,兼顾不同药物的特点,制定出更有针对性的治疗方案,对患者疾病的转归意义深远。该文从抗结核药物的选择与疗程、血糖控制、营养治疗、中医药治疗和免疫治疗等方面综述和分析了其对结核病与糖尿病共病患者的意义。

痰结核分枝杆菌DNA检测诊断肺结核的临床意义

目的评估痰结核分枝杆菌DNA检测诊断肺结核的可行性及临床意义。方法回顾性分析2016年5月—12月在我科住院的经痰结核分枝杆菌培养确诊的136例肺结核患者的临床资料,比较痰涂片找抗酸杆菌和痰结核分枝杆菌DNA检测2种方法的检出率。结果 136例确诊的肺结核患者中,痰涂片阳性的有64例(47.06%),痰结核分枝杆菌DNA检测阳性的88例(64.71%),痰结核分枝杆菌DNA检测阳性率明显高于痰涂片找抗酸杆菌(P<0.05)。72例痰涂片阴性患者中痰结核分枝杆菌DNA检测阳性29例,占痰涂片阴性肺结核患者比例的40.28%。结论痰结核分枝杆菌DNA检测优于痰涂片找抗酸杆菌,能够辅助涂阳肺结核的诊断,并提高涂阴肺结核的诊断水平,是一种快速、敏感的病原学诊断方法。

Effects of acupuncturing Tsusanli (S_T36) on expression of nitric oxide synthase in hypothalamus and adrenal gland in rats with cold stress ulcer

AIM： To study the protective effect of acupuncturing Tsusanli （ST36） on cold stress ulcer, and the expression of nitric oxide synthase （NOS） in hypothalarnus and adrenal gland. METHODS： Ulcer index in rats and RT-PCR were used to study the protective effect of acupuncture on cold stress ulcer, and the expression of NOS in hypothalamus and adrenal gland. Images were analyzed with semi-quantitative method. RESULTS： The ulcer index significantly decreased in rats with stress ulcer. Plasma cortisol concentration was up regulated during cold stress, which could be depressed by pre-acupuncture. The expression of NOS1 in hypothallamus increased after acupuncture. The increased expression of NOS2 was related with stress ulcer, which could be decreased by acupuncture. The expression of NOS3 in hypothalamus was similar to NOS2, but the effect of acupuncture was limited. The expression of NOS2 and NOS3 in adrenal gland increased after cold stress, only the expression of NOS1 could be repressed with acupuncture. There was no NOS2 expression in adrenal gland in rats with stress ulcer. CONCLUSION： The protective effect of acupuncturing Tsusanli （ST36） on the expression of NOS in hypothalamus and adrenal gland can be achieved.

Effects of Yishendaluo decoction on axonal degeneration,inflammatory reaction,and neurological function in a mouse model of experimental autoimmune encephalomyelitis

BACKGROUND： Yishendaluo decoction reduces production of inflammatory mediators, relieves damage due to inflammatory reactions, and improves neural functions during experimental autoimmune encephalomyelitis. OBJECTIVE： To investigate the effects of Yishendaluo decoction on a mouse model of experimental autoimmune encephalomyelitis. DESIGN, TIME AND SETTING： The randomized, controlled, neuropathological, and molecular biological animal study was performed at the Key Laboratory of Chinese Internal Medicine, Ministry of Education, Dongzhimen Hospital of Beijing University of Chinese Medicine and Center for Neuroinformatics, General Hospital of Chinese PLA from 2005 to 2006. MATERIALS： Yishendaluo decoction pieces consisting of prepared rehmannia root, colla comus cervi, cape jasmine fruit, and grassleaf sweetflag rhizome were purchased from the Dongzhimen Hospital of Beijing University of Chinese Medicine. Rabbit anti-mouse β-amyloid precursor protein and p38 polyclonal antibody （Zhongshan Goldenbridge Biotechnology, China）, as well interferon-y and interleukin-4 ELISA kit （Boster, China）, were used in this study. METHODS： A total of 96 healthy, female, SJL/J mice, aged 8 12 weeks, were equally and randomly assigned to normal, model, hormone, and Chinese medicine groups. A total of 0.2 mL antigen preparation, supplemented with 150 μg PLP 139-151 and 400 μg H37RA, was subcutaneously injected into the upper abdomen of mice from the model, hormone, and Chinese medicine groups. Mouse models of experimental autoimmune encephalomyelitis were established by intravenous injection of 0.1 mL Bordetella pertussis solution containing 0.6 × 10^6 Bordetella pertussis at days 1 and 3. Mice from the model, Chinese medicine, and hormone groups were respectively subjected to 0.2 mL saline, 2 g/kg Yishendaluo decoction, and 0.078 mg/kg prednisone acetate, once daily for 14 consecutive days. Mice from the normal group were left intact. MAIN OUTCOME MEASURES： Pathological changes were observed using hematoxylin-eosin staining and Luxol fast blue staining. Expression of β-amyloid precursor protein and p38 protein was determined by immunohistochemistry. Levels of interferon-y and interleukin-4 were detected by ELISA. Behavioral changes were assessed in mice according to scores of neurological function. RESULTS： A few inflammatory cell infiltration, nerve fiber breakage and slight demyelination were detected in the central nervous system of mice from the Chinese medicine and hormone groups compared with the model group. Expression of β-amyloid precursor protein and p38 protein was significantly diminished in the central nervous system of mice from the Chinese medicine and hormone groups compared with the model group （P 〈 0.05 or P 〈 0.01）, and the decrease was greatest in the Chinese medicine group. The decrease in mouse weight was not significant, and neurological function scores were less in the Chinese medicine and hormone groups compared with the model group （P 〈 0.05 or P 〈 0.01）. Interferon-y levels were significantly reduced （P 〈 0.01）, and interleukin-4 levels were significantly increased （P 〈 0.01） in the brains of the Chinese medicine and hormone groups, compared with the model group. CONCLUSION： Yishendaluo decoction improved neurological function in mice with experimental autoimmune encephalomyelitis by downregulating β-amyloid precursor protein expression, resistingaxonal degeneration, and relieving inflammatory reaction. The anti-inflammatory mechanism was regulated by inhibition of the p38 mitogen-activated protein kinase signal pathway.

Acupuncture therapy for experimental stomach ulcer and c-Fos expression in rats

AIM: To determine the role of acupuncture therapy in treating experimental gastric ulcer in rats.METHODS: Twenty-eight adult male Sprague-Dawley rats were randomly divided into four groups (pre-acupuncture group; acupuncture group; paradistance-acupuncture group;and control group), and pre-acupuncture, paradistanceacupuncture, and control groups received 5 μL acetic acid (200 mL/L HAc) injection after a same course of electroacupuncture (EA) treatment (4 Hz, 0.6 mA, 0.45 ms,45 min for 4 d). The rats in these three groups recovered within 4 d. The acupuncture group received EA therapy for 4 d, after HAc injection. The stomach was dissected to compare the pathological structures of ulcer. Also c-Fos activation in the nuclei of solitary tract (NTS) was observed under microscope after regular immunohistochemistry staining of brain stem sections.RESULTS: The number of ulcers was different among the four groups, especially between control group and paradistance-acupuncture group or pre-acupuncture group. In the latter group, the number of ulcers was much less. The gastric ulcer area was consistent with the histopathological results, indicating that pre-acupuncture had an obvious therapeutic effect on gastric ulcers.Acupuncture had a very modest effect and paradistanceacupuncture had no effect on gastric ulcers. No therapeutic effect was found in the control group. Fos-Li neurons in NTS induced by noxious gastric ulcer showed a significant difference between pre-acupuncture and control groups.CONCLUSION: Acupuncture before ulceration can obviously alleviate ulcer. The production of c-Fos proves that the vagus nerve mediates the induction of c-Fos in nuclei of solitary tract following experimental ulceration,suggesting that parasympathetic afferents promote the process of noxious visceral stimulation.

Association of level of leisure-time physical activity with risks of all-cause mortality and cardiovascular disease in an elderly Chinese population: a prospective cohort study

Background Implementing the current guidelines for leisure-time physical activity(LTPA)provides significant health benefits,especially for middle-aged adults,but it is unclear whether LTPA also translates into cardiovascular health benefits among elderly people.Therefore,we aimed to assess the association of LTPA with the risks of cardiovascular disease(CVD),including coronary heart disease(CHD)and stroke,and all-cause mortality in an elderly population.Methods In this prospective cohort study,32,942 participants aged 60 years or older who participated in a health check-up programme in China between 2010 and 2018 were included.We evaluated the morbidity and mortality risks through the Cox regression model,competing risk model and restricted cubic spline model.Results During a median of 6.84 years of follow-up,there were 6,857 elderly people with incident CVD;a total of 6,324 deaths occurred due to all causes and 2,060 deaths occurred due to CVD.Compared with the inactive group,reductions in CVD morbidity and mortality were observed,with hazard ratios(HRs)of 0.89(95%CI:0.83–0.96)and 0.81(95%CI:0.71–0.92)in the insufficiently active group,0.86(95%CI:0.80–0.92)and 0.79(95%CI:0.69–0.90)in the sufficiently active group,and 0.79(95%CI:0.70–0.89)and 0.58(95%CI:0.45–0.76)in the highly active group,respectively;but no significant reductions were observed in the very highly active group,with HRs of 0.87(95%CI:0.71–1.06)and 0.99(95%CI:0.70–1.40),respectively.Compared with the inactive group,reductions in all-cause mortality were also observed,with a HR of 0.90(95%CI:0.84–0.97)in the insufficiently active group,0.82(95%CI:0.77–0.89)in the sufficiently active group,0.77(95%CI:0.67–0.87)in the highly active group,and 0.80(95%CI:0.64–0.98)in the very highly active group.A restricted cubic spline diagram showed that there was an L-shaped association between LTPA and the risk of all-cause mortality but a U-shaped or reverse J-shaped relationship between LTPA and the risk of CVD morbidity and mortality,especially stroke.In addition,a subgroup analysis showed that elderly population who consistently performed LTPA for ten years or more had a lower risk of morbidity and mortality.Conclusions In an elderly population,even insufficient activity is associated with a decreased risk of all-cause mortality and CVD,and moderate levels of LTPA may be optimal for CVD prevention.In addition,elderly people who consistently perform LTPA over several years may experience greater health benefits.

Synaptic and blood-brain barrier structural changes in a rat epilepsy model induced by coriaria lacton Replication experiment with animals

BACKGROUND： Structural and functional synaptic changes, as well as blood-brain barrier （BBB） changes, affect the micro-environment of nervous tissue and excitation, both of which play an important role in epilepsy. OBJECTIVE： To observe synaptic and BBB ultrastructural changes in the motor cortex of a rat epilepsy model induced by coriaria lacton, and to investigate the synaptic and BBB effects on the mechanism of epilepsy. DESIGN： A randomized controlled animal experiment. SETTING： Department of Histology and Embryology, Luzhou Medical College; and Electron Microscopy Laboratory, Luzhou Medical College. MATERIALS： Twenty healthy male Sprague Dawley rats, aged 8 weeks, were chosen for this study. The rats weighed （280 ± 50） g and were supplied by the Experimental Animal Center of Luzhou Medical College. Experimentation was performed in accordance with the ethical guidelines for the use and care of animals. The animals were randomly divided into a control group and an epilepsy group, with 10 rats in each group. METHODS： This study was performed at the Department of Histology and Embryology, and Electron Microscopy Laboratory, Luzhou Medical College between February and December 2006. According to the protocol, the epilepsy group was injected with 10 μ L/100 g coriaria lacton into the lateral ventricles to establish an epileptic model. The control group rats were not administered anything. Eight days after the model was established, all rats were anesthetized with ether. The motor cortex was removed and sectioned into ultrathin sections. Synaptic and BBB ultrastructural changes were observed by electron microscopy. MAIN OUTCOME MEASURES： （1）Structural changes of three different parts of the synapses, synaptic cleft width, postsynaptic density thickness, proportion of perforation synapses, curvature of synaptic interface, and length of active zones. （2）Capillary and BBB changes （endothelium, basement membrane, pericyte, and the astrocyte endfeet）. RESULTS： （1）Curvature of synaptic interface, length of active zones, thickness of postsynaptic density, and percentage of perforation synapses increased significantly. （2）There was significant edema in the endothelium, basement membrane, and the pericyte of the epilepsy group; the electron density of the basement membrane was reduced. CONCLUSION： （1） The coriaria lacton treatment altered synaptic ultrastructure, as well as BBB characteristics, in the epileptic rat model, and also improved synaptic transmission efficiency, as well as BBB permeability; （2）Synaptic and BBB ultrastructural changes might play an important role in the mechanism of epilepsy.

加强生物医学大数据建设应用,推动健康中国战略实施

我国政府始终将人民的权益放在优先发展的地位,不断努力提高人民健康水平,主要健康指标总体上优于中高收入国家平均水平[1].2017年,“健康中国”被写入党的十九大报告,健康中国上升为国家战略[2].2019年印发的《关于实施健康中国行动的意见》(https://www.gov.cn/zhengce/content/2019-07/15/content_5409492.htm)和《健康中国行动(2019~2030年)》(https://www.gov.cn/xinwen/2019-07/15/content_5409694.htm)明确了健康中国战略的总体目标,部署了重点方向和任务.

Neuroprotective role of fibronectin in neuron-glial extrasynaptic transmission

Most hypotheses concerning the mechanisms underlying Parkinson＇s disease are based on altered synaptic transmission of the nigrostriatal system. However, extrasynaptic transmission was recently found to affect dopamine neurotransmitter delivery by anisotropic diffusion in the extracellular matrix which is modulated by various extracellular matrix components such as flbronectin. The present study reviewed the neuroprotective effect of fibronectin in extrasynaptic transmission. Fibronectin can regulate neuroactive substance diffusion and receptor activation, and exert anti- neuroinflammatory, adhesive and neuroprotective roles. Fibronectin can bind to integrin and growth factor receptors to transactivate intracellular signaling events such as the phosphatidylinositol 3-kinase/protein kinase B pathway to regulate or amplify growth factor-like neuroprotective actions. Fibronectin is assembled into a fibrillar network around cells to facilitate cell migration, molecule and ion diffusion, and even drug delivery and treatment. In addition, the present study analyzed the neuroprotective mechanism of fibronectin in the pathogenesis of Parkinson＇s disease, involving integrin and growth factor receptor interactions, and discussed the possible therapeutic and diagnostic significance of fibronectin in Parkinson＇s disease.

Association between chromosomal aberration of COX8C and tethered spinal cord syndrome:array-based comparative genomic hybridization analysis

Copy number variations have been found in patients with neural tube abnormalities.In this study,we performed genome-wide screening using high-resolution array-based comparative genomic hybridization in three children with tethered spinal cord syndrome and two healthy parents.Of eight copy number variations,four were non-polymorphic.These non-polymorphic copy number variations were associated with Angelman and Prader-Willi syndromes,and microcephaly.Gene function enrichment analysis revealed that COX8 C,a gene associated with metabolic disorders of the nervous system,was located in the copy number variation region of Patient 1.Our results indicate that array-based comparative genomic hybridization can be used to diagnose tethered spinal cord syndrome.Our results may help determine the pathogenesis of tethered spinal cord syndrome and prevent occurrence of this disease.

Four-year-old anti-N-methyl-D-aspartate receptor encephalitis patient with ovarian teratoma: A case report

BACKGROUND A population-based comparative study in United States shows that the prevalence and incidence of autoimmune encephalitis are comparable to those of infectious encephalitis and its detection is increasing over time.Some patients are complicated with ovarian teratoma.The younger the patient is,the less likely a tumor will be present.CASE SUMMARY This case report describes the successful treatment of anti-N-methyl-D-aspartatereceptor(NMDAR)encephalitis by early laparoscopic ovarian cystectomy and immunotherapy in a 4-year-old female child.And to the best of our knowledge,this detailed case report describes the youngest patient to date with anti-NMDAR encephalitis who underwent laparoscopic ovarian cystectomy.CONCLUSION Although the younger the patient is,the less likely a tumor will be detected,we still emphasize that all patients with suspected or confirmed anti-NMDAR encephalitis should be screened for ovarian tumors if possible.Prompt initiation of immunotherapy and tumor removal are crucial for good outcomes.

Association of changes in waist circumference with cardiovascular disease and all-cause mortality among the elderly Chinese population: a retrospective cohort study

BACKGROUND To examine the association of baseline waist circumference(WC)and changes in WC with cardiovascular disease(CVD)and all-cause mortality among elderly people.METHODS A total of 30,041 eligible participants were included from a retrospective cohort in China.The same questionnaire,anthropometric and laboratory measurements were performed at baseline(2010)and the first follow-up(2013).The percent change in WC between baseline and the first follow-up was calculated to evaluate three years change of WC.We collected the occurrence of CVD and all-cause death from the first follow-up to December 31,2018.Restricted cubic splines and Cox proportionalhazards regression models were used to evaluate the relationship between baseline WC/changes in WC and mortality.RESULTS The dose-response relationships between baseline WC and CVD mortality were U-or J-shaped.In low WC group,compared with stable group,the fully adjusted hazard ratio(aHR)for CVD mortality was 1.60(95%CI:1.24−2.06)in WC gain group among men.In normal WC group,the CVD mortality risk increased with WC gain(men:aHR=1.86,95%CI:1.36−2.56;women:aHR=1.83,95%CI:1.29−2.58).In moderate-high WC group,the CVD mortality risk increased with WC gain(men:aHR=1.76,95%CI:1.08−2.88;women:aHR=1.46,95%CI:1.04−2.05)and risk decreased with WC loss(men:aHR=0.54,95%CI:0.30−0.98;women:aHR=0.59,95%CI:0.37−0.96).CONCLUSIONS For the elderly population,WC gain may increase CVD mortality risk regardless of baseline WC,whereas WC reduction could decrease the risk only in the moderate-high WC group.

Inpatient disease spectrum and clinical characteristics of surgical disorders in pediatric and adolescent gynecology:A single-institute study of 12 years data from China

To the Editor:Pediatric and adolescent gynecology(PAG)is a specialized branch of gynecology that focuses on reproductive health issues of women from infancy to adolescence.[1]In 1939,the Hungarian Dobszayrst established the new branch.Since then,the PAG subject has begun to develop and gradually matured in the past 80 years.While PAG has witnessed signicant development in western countries,a substantial unmet need persists in addressing specic health concerns among children and adolescents with gynecological disorders.

Application of Laparoscopy in the Diagnosis and Treatment of Pregnancy Complicated with Uterine Myomas

To editor:Uterine myomas are the most common benign tumors of the female reproductive system,with a reported prevalence of 0.1%to 3.9%during pregnancy.1 Among these,10%to 30%cause severe pregnancy complications including miscarriage,placenta previa,fetal growth restriction,preterm labor,fetal malpresentations,and postpartum hemorrhage related to the number,volume,and location of myomas.2,3 Uterine myomas are usually asymptomatic but occasionally may cause acute abdominal pain secondary to pedunculated myoma torsion or compression of urinary and gastrointestinal organs.

A mathematical model for simulating the phase-based transmissibility of a novel coronavirus

Background:As reported by the World Health Organization,a novel coronavirus(2019-nCoV)was identified as the causative virus of Wuhan pneumonia of unknown etiology by Chinese authorities on 7 January,2020.The virus was named as severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)by International Committee on Taxonomy of Viruses on 11 February,2020.This study aimed to develop a mathematical model for calculating the transmissibility of the virus.Methods:In this study,we developed a Bats-Hosts-Reservoir-People transmission network model for simulating the potential transmission from the infection source(probably be bats)to the human infection.Since the Bats-HostsReservoir network was hard to explore clearly and public concerns were focusing on the transmission from Huanan Seafood Wholesale Market(reservoir)to people,we simplified the model as Reservoir-People(RP)transmission network model.The next generation matrix approach was adopted to calculate the basic reproduction number(R0)from the RP model to assess the transmissibility of the SARS-CoV-2.Results:The value of R0 was estimated of 2.30 from reservoir to person and 3.58 from person to person which means that the expected number of secondary infections that result from introducing a single infected individual into an otherwise susceptible population was 3.58.Conclusions:Our model showed that the transmissibility of SARS-CoV-2 was higher than the Middle East respiratory syndrome in the Middle East countries,similar to severe acute respiratory syndrome,but lower than MERS in the Republic of Korea.

A five-compartment model of age-specific transmissibility of SARS-CoV-2

Background:The novel coronavirus,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2,also called 2019-nCoV)causes different morbidity risks to individuals in different age groups.This study attempts to quantify the age-specific transmissibility using a mathematical model.Methods:An epidemiological model with five compartments(susceptible-exposed-symptomatic-asymptomatic-recovered/removed[SEIAR])was developed based on observed transmission features.Coronavirus disease 2019(COVID-19)cases were divided into four age groups:group 1,those≤14years old;group 2,those 15 to 44years old;group 3,those 45 to 64years old;and group 4,those≥65 years old.The model was initially based on cases(including imported cases and secondary cases)collected in Hunan Province from January 5 to February 19,2020.Another dataset,from Jilin Province,was used to test the model.Results:The age-specific SEIAR model fitted the data well in each age group(P<0.001).In Hunan Province,the highest transmissibility was from age group 4 to 3(median:β43=7.71×10-9;SAR43=3.86×10-8),followed by group 3 to 4(median:β34=3.07×10-9;SAR34=1.53×10-8),group 2 to 2(median:β22=1.24×10-9;SAR22=6.21×10-9),and group 3 to 1(median:β31=4.10×10-10;SAR31=2.08×10-9).The lowest transmissibility was from age group 3 to 3(median:β33=1.64×10-19;SAR33=8.19×10-19),followed by group 4 to 4(median:β44=3.66×10-17;SAR44=1.83×10-16),group 3 to 2(median:β32=1.21×10-16;SAR32=6.06×10-16),and group 1 to 4(median:β14=7.20×10-14;SAR14=3.60×10-13).In Jilin Province,the highest transmissibility occurred from age group 4 to 4(median:β43=4.27×10-8;SAR43=2.13×10-7),followed by group 3 to 4(median:β34=1.81×10-8;SAR34=9.03×10-8).Conclusions:SARS-CoV-2 exhibits high transmissibility between middle-aged(45 to 64 years old)and elderly(≥65 years old)people.Children(≤14 years old)have very low susceptibility to COVID-19.This study will improve our understanding of the transmission feature of SARS-CoV-2 in different age groups and suggest the most prevention measures should be applied to middle-aged and elderly people.

Single Port Transumbilical Laparoscopic Surgery versus Conventional Laparoscopic Surgery for Benign Adnexal Masses： A Retrospective Study of Feasibility and Safety

Background： Single port laparoscopic surgery （SPLS） is an innovative approach that is rapidly gaining recognition worldwide. The aim of this study was to determine the feasibility and safety of SPLS compared to conventional laparoscopic surgery for the treatment of benign adnexal masses. Methods： In total, 99 patients who underwent SPLS for benign adnexal masses between December 2013 and March 2015 were compared to a nonrandomized control group comprising 104 conventional laparoscopic adnexal surgeries that were performed during the same period. We retrospectively analyzed multiple clinical characteristics and operative outcomes of all the patients, including age, body mass index, size and pathological type of ovarian mass, operative time, estimated blood loss （EBL）, duration of postoperative hospital stay, etc. Results： No significant difference was observed between the the pathological results between the two groups were found to two groups regarding preoperative baseline characteristics. However, be slightly different. The most common pathological type in the SPLS group was mature cystic teratoma, whereas endometrioma was more commonly seen in the control group. Otherwise, the two groups had comparable surgical outcomes, including the median operation time （51 min vs. 52 min, P = 0.909）, the median decreased level of hemoglobin from preoperation to postoperation day 3 （10 g/L vs. 10 g/L, P = 0.795）, and the median duration of postoperative hospital stay （3 days vs. 3 days, P = 0.168）. In SPLS groups, the median EBL and the anal exsufftation time were significantly less than those of the conventional group （5 ml vs. 10 ml, P〈 0.001; 10 h vs. 22 h, P〈 0.001）. Conclusions： SPLS is a feasible and safe approach for the treatment of benign adnexal masses. Further study is required to better determine whether SPLS has significant benefits compared to conventional techniques.