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Objective To investigate the capillarization of liver sinusoidal endothelial cells (LSECs) and its association with hepatic fibrosis during the development of alveolar echinococcosis, so as to provide the basis for unraveling the mechanisms underlying the role of LSEC in the development and prognosis of hepatic injuries and hepatic fibrosis caused by alveolar echinococcosis. Methods Forty C57BL/6 mice at ages of 6 to 8 weeks were randomly divided into a control group and 1-, 2- and 4-week infection groups, of 10 mice in each group. Each mouse in the infection groups was intraperitoneally injected with 2 000 Echinococcus multilocularis protoscoleces, while each mouse in the control group was given an equal volume of phosphate-buffered saline using the same method. All mice were sacrificed 1, 2 and 4 weeks post-infection and mouse livers were collected. The pathological changes of livers were observed using hematoxylin-eosin (HE) staining, and hepatic fibrosis was evaluated through semi-quantitative analysis of Masson’s trichrome staining-positive areas. The activation of hepatic stellate cells (HSCs) and extracellular matrix (ECM) deposition were examined using immunohistochemical staining of α-smooth muscle actin (α-SMA) and collagen type I alpha 1 (COL1A1), and the fenestrations on the surface of LSECs were observed using scanning electron microscopy. Primary LSECs were isolated from mouse livers, and the mRNA expression of LSEC marker genes Stabilin-1, Stabilin-2, Ehd3, CD209b, GATA4 and Maf was quantified using real-time fluorescence quantitative PCR (qPCR) assay. Results Destruction of local liver lobular structure was observed in mice 2 weeks post-infection with E. multilocularis protoscoleces, and hydatid cysts, which were surrounded by granulomatous tissues, were found in mouse livers 4 weeks post-infection. Semi-quantitative analysis of Masson’s trichrome staining showed a significant difference in the proportion of collagen fiber contents in mouse livers among the four groups (F = 26.060, P < 0.001), and a higher proportion of collagen fiber contents was detected in mouse livers in the 4-week infection group [(11.29 ± 2.58)%] than in the control group (P < 0.001). Immunohistochemical staining revealed activation of a few HSCs and ECM deposition in mouse livers 1 and 2 weeks post-infection, and abundant brown-yellow stained α-SMA and COL1A1 were deposited in the lesion areas in mouse livers 4 weeks post-infection, which spread to surrounding tissues. Semi-quantitative analysis revealed significant differences in α-SMA (F = 7.667, P < 0.05) and COL1A1 expression (F = 6.530, P < 0.05) in mouse levers among the four groups, with higher α-SMA [(7.13 ± 3.68)%] and COL1A1 expression [(13.18 ± 7.20)%] quantified in mouse livers in the 4-week infection group than in the control group (both P values < 0.05). Scanning electron microscopy revealed significant differences in the fenestration frequency (F = 37.730, P < 0.001) and porosity (F = 16.010, P < 0.001) on the surface of mouse LSECs among the four groups, and reduced fenestration frequency and porosity were observed in the 1-[(1.22 ± 0.48)/μm2 and [(3.05 ± 0.91)%] and 2-week infection groups [(3.47 ± 0.10)/μm2 and (7.57 ± 0.23)%] groups than in the control group (all P values < 0.001). There was a significant difference in the average fenestration diameter on the surface of mouse LSECs among the four groups (F = 15.330, P < 0.001), and larger average fenestration diameters were measured in the 1-[(180.80 ± 16.42) nm] and 2-week infection groups [(161.70 ± 3.85) nm] than in the control group (both P values < 0.05). In addition, there were significant differences among the four groups in terms of Stabilin-1 (F = 153.100, P < 0.001), Stabilin-2 (F = 57.010, P < 0.001), Ehd3 (F = 31.700, P < 0.001), CD209b (F = 177.400, P < 0.001), GATA4 (F = 17.740, P < 0.001), and Maf mRNA expression (F = 72.710, P < 0.001), and reduced mRNA expression of Stabilin-1, Stabilin-2, Ehd3, CD209b, GATA4 and Maf genes was quantified in three infection groups than in the control group (all P values < 0.001). Conclusions E. multilocularis infections may induce capillarization of LSECs in mice, and result in a reduction in the expression of functional and phenotypic marker genes of LSECs, and capillarization of LSECs occurs earlier than activation of HSC and development of hepatic fibrosis.
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Facet joint is the important part of spinal biomechanical structures. The damage of facet joint will destroy the stability of spinal motion segments and accelerate the adjacent segments degeneration (ASD). The violation of cranial facet joint based on various screw insertion techniques is a common but easily overlooked factor in clinical application. The reduction of intra-operative cranial facet joint violation is essential for reduction of postoperative ASD. The rates of facet violation are related to screw insertion techniques. The insertion techniques, including robot-assisted guidance, computer-assistant navigation, and cortical bone trajectory, are used successfully well in protecting cranial facet joints, compared with the freehand pedicle screw placement technique, which has been widely utilized in clinical practice. However, the conventional X-ray guided screw insertion technique is associated with a higher rate of facet violation. The main reasons why different techniques lead to various rates of facet violation include various anatomical referenced landmarks during screw insertion, selection of assisted equipment for instruments, and resistance of soft tissues of the spine. In addition, the related risk factors, such as facet angle, screw insertion segments, lumbar degeneration, and learning curve effect, can also affect the rates of facet violation. In the present study, we compared the differences of facet joint violation when using various screw techniques, and summarized the causes of violations and related risk factor. The present review might provide references for surgeons regarding the decrease of cranial facet joint violation, optimization of insertion techniques and reduction of ASD.
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@#Health impact assessment（HIA）is an evidence-based methodology to assess the potential impacts of a policy,program or project and to make recommendations for health improvement. HIA can promote the cooperation between health and non-health sectors,raise the awareness about health in decision-makers,increase the participation of stakeholders and change health inequality. This paper reviews the international studies into HIA from 2000 to 2018,providing reference for HIA development in China.
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Objective@#To learn the human resource development of provincial,municipal and county-level centers for disease control and prevention（CDCs）in Zhejiang Province from 2010 to 2017,and to provide evidence for optimizing human resource allocation .@*Methods@#We obtained the human resource data of CDCs in Zhejiang Province from national information system for disease control and prevention,and analyzed the changes in the number of permanent staffs,the number of permanent staffs per ten thousand permanent residents as well as the composition of the age,education level,professional background and title in provincial,municipal and county-level CDCs from 2010 to 2017 .@*Results@#The number of the permanent staffs of CDCs in Zhejiang Province increased from 4 592 to 4 835 from 2010 to 2017. In 2017,the number of permanent staffs in overall,provincial,municipal and county-level CDCs per ten thousand permanent residents were 0.855,0.068,0.186 and 0.600,respectively,all of which did not meet the standard. The main age group of CDC staffs changed from 25-34 years old in 2010 to 35-44 years old in 2017. The staffs of overall,provincial,municipal and county-level CDCs mainly had Bachelor's degrees in 2010,while the staffs of provincial CDCs mainly had Master's degrees and above in 2017. The percentages of staffs who had Bachelor's degrees and above in overall,provincial,municipal and county-level CDCs in 2017 increased to 75.12%,90.36%,80.76% and 71.65%,respectively. The CDC staffs were mainly public health professionals,and the percentage increased from 2010 to 2017. The percentages of public health and laboratory medicine professionals in overall,provincial,municipal and county-level CDCs in 2017 increased to 71.56%,79.17%,70.14% and 71.15%,respectively. The CDC staffs mainly had intermediate title,and the percentage of senior title in overall,provincial,municipal and county-level CDCs in 2017 increased to 25.58%,38.80%,32.99% and 21.79%,respectively .@*Conclusion@#From 2010 to 2017,the structure of education level,professional background and title of CDC staffs in Zhejiang Province were further optimized,but there was a lack of permanent staffs and a decrease in the staffs under 35 years old.
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Objective To evaluate the implementing effects of the first round malaria control project supported by the Global Fund on malaria control in Sichuan Province so as to provide the evidence for intensifying the control strategy of malaria. Meth?ods Based on the requirements of the malaria project of Globe Fund the comprehensive malaria control measures including case identification health education and training for doctors were carried out. Results In 2007 the malaria incidence was 0.12/10 000 while it was 1.66/10 000 in 2002 with a reduction rate of 92.77%. The number of malaria endemic towns reduced from 13 to 2. The awareness rate of knowledge about malaria of the local residents rose from 26.86%to 79.83% χ2=403.00 P<0.01 with an increase rate of 197.21%. The awareness rate of knowledge about malaria of the students rose from 36.87%to 99.22% χ2=359.62 P<0.01 with an increase rate of 169.11%. Conclusions With the support of Globe Fund the trans?mission of malaria has been effectively controlled. The capacity of malaria control and the malaria control knowledge of the inhab?itants have been enhanced. The implementation of the project has significant effects on malaria control in Sichuan Province.
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<p><b>OBJECTIVE</b>To evaluate the cognition and emotional response of the public in Zhejiang province during the epidemic of human H7N9 avian influenza and provide scientific support for group psychological intervention under public health emergency.</p><p><b>METHODS</b>57 communities in 19 counties from Hangzhou, Jiaxing and Lishui district of Zhejiang province were selected as survey sites using stratified clustered sampling method from March, 2013 to April, 2014. 2 319 ordinary civilians were chosen using convenience sampling method and 390 individuals who had close contact history with H7N9 avian influenza patients, 109 family members of patients and 281 medical workers, were selected using census method. The inclusion criteria for subjects were: subjects aged over 10 years; could complete the questionnaire independently or with the help of the investigators. A total of 2 709 subjects were surveyed by avian influenza risk perception and response questionnaire, negative emotion questionnaire was also used to see their cognition and negative emotion related to the disease. Spearman correlation analysis was used to analyze the interrelationship between public risk perception, response and negative emotions.</p><p><b>RESULTS</b>95.10% (2 576)of the subjects have sensed the risk of epidemic and 91.00% (2 465) of the subjects have taken preventive measures in 2 709 subjects. The positive rate for depression, neurasthenia, fear, anxiety and hypochondriasis were 36.40% (986) , 37.21% (1 008) , 79.70% (2 159) , 33.41% (905) , 27.69% (750) respectively (χ(2)=1 935.89, P<0.001) ;the P(50)(P(25)-P(75)) of the depression scores of patients' family members, medical workers and the general public were 0.50 (0.00-0.83), 0.17 (0.00-0.67), 0.17 (0.00-0.50) (H= 7.27, P=0.03) ; the neurasthenia scores were 0.20 (0.00-0.60), 0.2 (0.00-0.40), 0.00 (0.00-0.20) (H= 64.74, P<0.001) ; fear scores were 0.83 (0.33-1.17), 0.33 (0.17-0.67), 0.33 (0.17-0.83) (H=30.03, P< 0.001) ; anxiety scores were 0.17(0.00-0.50), 0.00(0.00-0.33), 0.00(0.00-0.17) (H=51.82, P<0.001). The neurasthenia, fear, anxiety scores (P(50)(P(25)-P(75))) for females among the public were 0.00(0.00-0.20), 0.50(0.17-0.83), 0.00(0.00-0.17), which were higher than those of male's (0.00(0.00-0.20), 0.33(0.00-0.67), 0.00(0.00-0.17)) (χ(2) values were 5.26, 27.52, 8.29, P<0.05); Among medical staff, the depression, neurasthenia, fear, anxiety and hypochondriasis scores for females were 0.33(0.00-0.67), 0.20(0.00-0.40), 0.50(0.17-0.83), 0.00(0.00-0.33), 0.00(0.00-0.50) respectively, which were higher than those of males'(0.00(0.00-0.50), 0.00(0.00-0.40), 0.33(0.17-0.50), 0.00(0.00-0.17), 0.00(0.00-0.00))(χ(2) values were 7.22, 7.97, 14.46, 4.93, 5.22, P<0.05); for the family members of the patients who were in poor mental conditions when doing self-assessment, their depression and neurasthenia scores were 0.50(0.08-0.96), 0.30(0.00-0.55), which were higher than those of people in good mental conditions (0.17(0.00-0.83), 0.20(0.00-0.60)) (χ(2) values were 12.95, 11.20, P<0.05). Spearman correlation analysis showed that the subjects' risk perception level was positively correlated with depression, neurasthenia, fear, and hypochondriasis, with the correlation coefficients 0.07, 0.07, 0.08, 0.04, respectively (P<0.05) ; the subjects' risk response level was also positively related with depression, neurasthenia, fear, anxiety and hypochondriasis, and the correlation coefficients were 0.09, 0.09, 0.12, 0.05, 0.04, respectively (P<0.05).</p><p><b>CONCLUSION</b>The general public was highly concerned about the epidemic of H7N9 avian influenza and developed certain levels of negative emotions. The female, equal or over 60 years old, those with poor educational level, agricultural related occupation and poor physical and psychology health were risk factors of disease related negative emotions. The subject's risk perception and response level was positively related with depression, neurasthenia, fear and hypochondriasis.</p>
Subject(s)
Female , Humans , Male , Anxiety , China , Depression , Epidemics , Family , Fear , Hypochondriasis , Influenza A Virus, H7N9 Subtype , Influenza, Human , Psychology , Neurasthenia , Occupations , Risk Factors , Surveys and QuestionnairesABSTRACT
Objective:To evaluate the clinical therapeutic effect and mechanism of recombinant human brain natri-uretic peptide (rhBNP,Xinhuosu)in patients with acute heart failure (AHF).Methods:A total of 90 AHF patients were randomly and equally divided into rhBNP group (received intravenous injection of rhBNP based on routine treatment for 3d)and routine treatment group.Left ventricular ejection fraction (LVEF),levels of serum high sen-sitive C reactive protein (hsCRP)and matrix metalloproteinase-9 (MMP-9)were measured and compared between two groups before and after treatment.Results:Compared with before treatment,after treatment,LVEF signifi-cantly rose,levels of hsCRP and MMP-9 significantly reduced in both groups,P <0.05 or <0.01;compared with routine treatment group after treatment,there was significant rise in LVEF [(41.4±12.8)% vs.(51.3±13.9)%], and significant reductions in levels of hsCRP [(8.63±3.57)mg/L vs.(6.67±3.97)mg/L]and MMP-9 [(17.89 ±4.75)mg/L vs.(14.64±4.89)mg/L]in rhBNP group,P <0.05 or <0.01. Conclusion:The rhBNP possesses significant therapeutic effect on acute heart failure,and its mechanism may be related with reducing hsCRP and MMP-9 levels.
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Objective:To explore the role of tumor necrosis factor‐α(TNF‐α) and monocyte chemoattractant protein‐1 (MCP‐1) in pathogenesis of angina pectoris of coronary heart disease (CHD) .Methods :A total of 60 CHD pa‐tients diagnosed by coronary angiography (CAG) were selected and divided into stable angina pectoris (SAP) group (n=28) and unstable angina pectoris (UAP) group (n=32) ,and another 30 cases with normal CAG results were re‐garded as normal control group .Immune turbidity method and enzyme linked immunosorbent assay were used to measure plasma levels of TNF‐αand MCP‐1 respectively .Results:Compared with normal control group ,there were significant rise in plasma levels of TNF‐α[ (15.18 ± 4.12) ng/L vs .(18.56 ± 4.22) ng/L vs .(21.79 ± 4.43) ng/L] and MCP‐1 [(10.23 ± 3.21) pg/L vs .(14.67 ± 3.42) pg/L vs .(17.86 ± 3.51) pg/L] in SAP group and UAP group , P<0.01 all ,and those of UAP group were significantly higher than those of SAP group , P<0.01 both .Conclusion:Plasma tumor necrosis factor‐αand monocyte chemoattractant protein‐1 levels significantly rise ,it possesses impor‐tant clinical significance for predicting existence and development of coronary heart disease .
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Objective To investigate incision pathogenic bacteria after spinal surgery, and observe clinical effects of therapeutic methods. Methods A total of 30 cases of early surgical incision infection (7 cases of superficial infection and 23 cases of deep infection) after spinal surgery were retrospectively analyzed. The basic data including clinical manifes-tations, diagnosis, treatment, etiology and follow-up results were analyzed. Results It was found that the mean infection time after operation was 2-15 days in 30 patients. Thirty-three strains were isolated including 18 gram-positive cocci (54.5%, and Staphylococcus aureus account for 13, 39.4%), 15 gram-negative bacteria (45.5%, and Coli communior account for 6, 18.2%). The drug susceptibility test showed that gram-positive cocci were highly sensitive to vancomycin, rifampin, tei-coplanin and cotrimoxazole. No vancomycin-resistant Staphylococcus aureus were found. Gram negative bacteria were high-ly sensitive to imipenem (100%). Seven cases of superficial infection were cured after dressing. Twenty-three cases of deep incision wound infection were no recurrence of infection after treatment by deep wound debridement, and postoperative cathe-terization. Conclusion The early wound infection after spinal surgery is usually due to Staphylococcus aureus. It is good to perform wound debridement, continuous perfusion drainage, and treatment with vancomycin for deep wound infection.