Changing trend of sickness absenteeism among students during 2010-2017 academic years and its correlation with the incidence of acute infectious diseases in Jiading District，Shanghai / 中国学校卫生

Objective@#To describe the sickness absenteeism among primary and secondary school students in Jiading District and to analyze its correlation with the incidence of infectious diseases and associated lead or lag times, so as,to provide a scientific basis for the health and education departments to take measures.@*Methods@#The regularity and symptom composition of school sickness absenteeism among primary and secondary school students in Jiading District from the 2010-2017 were described. The Joinpoint model was applied to analyze the changing trend of absenteeism. And the rate of school sickness absenteeism and incidences of 7 acute infectious diseases were compared through visual analysis. The time lagged correlation coefficients and Granger causality tests were applied to quantitatively analyze the correlation and lead/lag patterns.@*Results@#The average rate of school sickness absenteeism among primary and secondary school students in Jiading District, Shanghai was 0.27%. Since the 2012 academic year, the overall rate of sickness absenteeism has been on the rise. Fever was the most common symptom of absenteeism (47.49%). The trend of sickness absenteeism rate was mainly consistent with the incidence of influenza, and showed a one way Granger causality. The maximum time lagged correlation coefficient was obtained in the second semester of the 2017 academic year with a value of 0.43 (95% CI =0.25-0.58). The maximum time lagged correlation coefficient between the rate of sickness absenteeism with fever and other respiratory symptoms and the incidence of influenza was also obtained in the second semester of the 2017 academic year and the maximum correlation coefficient was 0.50(95% CI =0.33-0.65).@*Conclusion@#The sickness absenteeism rate in primary and secondary school students is correlated to influenza incidence, and it has potential application value in supplementing early warning of influenza activities in the community.

Structural characteristics of lower respiratory tract microflora in patients with pneumoconiosis / 中华劳动卫生职业病杂志

Objective: To explore the composition of bacteria in lower respiratory tract of patients with pneumoconiosis and dust exposure, and to compare and analyze the difference and correlation between them. Methods: From May 2020 to January 2021, a prospective multicenter cross-sectional study was conducted to select patients with pneumoconiosis who underwent bronchoalveolar lavage treatment at the Respiratory and Critical Care Medical Department of the 920th Hospital of the Joint Support Force and the Respiratory Department of Tongren Hospital in Kunming, as well as the population of dust recipients. A total of 24 patients with pneumoconiosis (pneumoconiosis group) were included, and 16 dust exposed individuals (dust exposed group) were used as controls. Two groups of patients' alveolar lavage fluid were collected. The 16SrRNA gene V3-V4 sequencing technology and bioinformatics analysis platform were used to measure and analyze the differences in microbial structure composition and associations between bacterial communities. Results: Compared with the dust exposed group, the top 5 bacterial phyla in the alveolar lavage fluid level of patients with pneumoconiosis were the same, followed by Proteobacteria, Firmicutes, Bacteroidetes, Fusobacteria, and Actinobacteria. Compared with the dust exposure group, the pneumoconiosis group patients belong to the top 5 genera of horizontal flora abundance, which are different. The dust exposure group is respectively: Pseudomonas, Proctor, Streptococcus, Achromobacter, and Neisseria. The pneumoconiosis group is respectively: Pseudomonas, Achromobacter, Streptococcus, Ralstonia, and Proctor. The Alpha diversity analysis results showed that compared with the dust exposed group, the level of bacterial diversity in the pneumoconiosis group was difference (P<0.05), and there was no statistically significant difference in bacterial evenness (P>0.05) ; Beta diversity showed differences in microbial community structure between the two groups (P<0.05 ). Single factor microbial association network analysis showed that there was a high correlation between Firmicutes and Bacteroidetes in the pneumoconiosis and dust exposed groups and other species, showing a positive correlation; The correlation between Proteobacteria and other species is high, showing a negative correlation. Conclusion: The structure and relative abundance of bacteria in lower respiratory tract were different between patients with pneumoconiosis and dust exposure, and the diversity of bacteria in lower respiratory tract increased in patients with pneumoconiosis, which may be related to disease status.

Protective effect of melatonin against oxygen-induced retinopathy: a study based on the HMGB1/NF-κB/NLRP3 axis / 中国当代儿科杂志

OBJECTIVES@#To study the protective effect of melatonin (Mel) against oxygen-induced retinopathy (OIR) in neonatal mice and the role of the HMGB1/NF-κB/NLRP3 axis.@*METHODS@#Neonatal C57BL/6J mice, aged 7 days, were randomly divided into a control group, a model group (OIR group), and a Mel treatment group (OIR+Mel group), with 9 mice in each group. The hyperoxia induction method was used to establish a model of OIR. Hematoxylin and eosin staining and retinal flat-mount preparation were used to observe retinal structure and neovascularization. Immunofluorescent staining was used to measure the expression of proteins and inflammatory factors associated with the HMGB1/NF-κB/NLRP3 axis and lymphocyte antigen 6G. Colorimetry was used to measure the activity of myeloperoxidase.@*RESULTS@#The OIR group had destruction of retinal structure with a large perfusion-free area and neovascularization, while the OIR+Mel group had improvement in destruction of retinal structure with reductions in neovascularization and perfusion-free area. Compared with the control group, the OIR group had significant increases in the expression of proteins and inflammatory factors associated with the HMGB1/NF-κB/NLRP3 axis, the expression of lymphocyte antigen 6G, and the activity of myeloperoxidase (P<0.05). Compared with the OIR group, the OIR+Mel group had significant reductions in the above indices (P<0.05). Compared with the control group, the OIR group had significant reductions in the expression of melatonin receptors in the retina (P<0.05). Compared with the OIR group, the OIR+Mel group had significant increases in the expression of melatonin receptors (P<0.05).@*CONCLUSIONS@#Mel can alleviate OIR-induced retinal damage in neonatal mice by inhibiting the HMGB1/NF-κB/NLRP3 axis and may exert an effect through the melatonin receptor pathway.

Physical activity among senior primary school students on weekends in Beijing / 中国学校卫生

Objective@#To analyze the duration and influencing factors of moderate and vigorous physical activity(MVPA) on weekends for primary school students in grades 4 to 6 in Beijing, and to provide a reference for formulating health education and promotion measures.@*Methods@#Multi stage stratified cluster sampling method was used to randomly select 2 515 students from grades 4-6 in 14 primary schools in Beijing, and a self administered questionnaire was used to record MVPA on weekend, social demographic characteristics, other related health behaviors and knowledge. Multivariate Logistic regression analysis was used to explore the influencing factors of MVPA on weekends.@*Results@#The prevalence of insufficient MVPA on weekends in Beijing was 63.54 %, and the prevalence was higher among girls (69.92%) than boys (57.81%) ( χ 2=39.65, P <0.01). Multiple Logistic regression analysis revealed that girls ( OR =1.74), living in rural areas ( OR =1.41), participants attending general schools ( OR = 1.34 ), from divorced family ( OR =1.46), and short sleep duration ( OR =1.50) were more likely to fail to meet the MVPA recommendations( P <0.05).@*Conclusion@#It is quite common that no sufficient weekend MVPA among senior primary school students, among them, the outer suburbs and schools with relatively weak teaching resources are the key places that need attention, and girls are the key groups that need attention.

Result analysis of the 2019 national assessment of individual dose monitoring capability in Chongming District, Shanghai / 上海预防医学

Objective In 2019, Laboratory of Shanghai Chongming Center for Disease Control and Prevention participated in national assessment of individual dose monitoring capability. By analyzing the results, this report summarizes the experience and shortcomings that will help improve the individual dose monitoring capability of the laboratory. Methods According to the requirements of the national assessment scheme for individual dose monitoring capacity in 2019, the assessment process and results were sorted out and analyzed one by one. Results The single group performance deviations(Pi values)between the measured values and references of the five groups were -0.04, -0.07, -0.05, -0.04 and -0.06, respectively. The overall bias(B value)of all groups was 0.003. According to the judgment standards, both the single group performance and overall performance were all qualified. Conclusion The individual dose monitoring system of the laboratory meets the requirements of the relevant national standards. The individual dose monitoring capability can be further improved by strengthening the quality control of the relevant procedures of the assessment.

Analysis of effectiveness and influencing factors of phacoemulsification combined with IOL implantation in the treatment of PACG / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To analyze the effectiveness and influencing factors of phacoemulsification combined with intraocular lens(IOL)implantation in the treatment of primary angle-closure glaucoma(PACG). <p>METHODS: Clinical data of 75 patients(75 eyes)with PACG who received phacoemulsification and IOL implantation in our hospital from January 2017 to December 2018 were retrospectively analyzed. Postoperative intraocular pressure(IOP), best-corrected visual acuity(BCVA), changes of anterior segment and incidence of complications were counted. The patients were grouped by efficacy, and multivariate Logistic regression analysis was performed to analyze the risk factors influencing the effectiveness of phacoemulsification and IOL implantation in patients with PACG. <p>RESULTS: Postoperative IOP of patients with PACG was decreased while BCVA was increased, and there were statistically significant differences compared with those before operation(<i>P</i><0.05). Central anterior chamber depth(ACD), angle opening distance(AOD500), trabecular iris angle(TIA500)and angle recess area(ARA)were increased significantly compared with those before operation(<i>P</i><0.05). Multivariate Logistic regression analysis showed that chronic PACG and preoperative IOP were independent risk factors for efficacy of phacoemulsification and IOL implantation in patients with PACG(<i>P</i><0.05). <p>CONCLUSION: Phacoemulsification combined with IOL implantation has good efficacy and safety in the treatment of PACG. However, it is necessary to pay attention to preoperative IOP control. What's more, it should be carefully considered whether this operation is necessary for patients with chronic PACG.

A clinical analysis on 15 cases of Axenfeld-Rieger syndrome associated with secondary glaucoma / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the clinical features of Axenfeld-Rieger syndrome associated with secondary glaucoma and its surgical treatment. <p>METHODS: It was a retrospective case series study. The general clinical data and related ocular manifestations in 15 patients(26 eyes)with Axenfeld-Rieger syndrome associated with secondary glaucoma in our hospital from January 2003 to January 2016 were collected and analyzed retrospectively. <p>RESULTS: Age of the patients ranged from 3-month to 43 years old, and the median age was 11 years old. There were of all 11 patients(73%)had bilateral glaucoma and 4(27%)had unilateral glaucoma. In the aspect of clinical features, hypoplasia or deficiency of the iris was found in 20 eyes(77%), peripheral iridocorneal adhesions was found in 17 eyes(65%)in various extent, and pupil distortion or multiple-pupil was found in 14 eyes(54%); Also posterior embryotoxon was found in 14 eyes(54%)as well; And 11 eyes(42%)had anomalies in corneal size. That root of iris is located at a more anterior position than that of a normal eye was found in all affected eyes by gonioscopy, coupled with different extent of angle synechiae-closure. According to the data, in 15 patients only two had a family history of ARS, while 5 had systematic abnormalities, eyes excepted, in dental, maxillary, cardiovascular, <i>et al</i>. Anti-glaucoma surgeries including trabeculotomy, trabeculectomy, glaucoma valve implantation were performed in 20 eyes. Nine patients(11 eyes)were followed up for 59mo on average. Intraocular pressure was significantly lower than pre-operation(<i>t</i>=2.4185, <i>P</i>=0.0362), and intraocular pressure in 7 followed-up eyes was controlled ≤21mmHg. The long-term success rate of surgery was 64%. <p>CONCLUSION: The clinical features of Axenfeld-Rieger syndrome associated with secondary glaucoma were diverse. The patients might concomitant with other systematic dysplasia. Although it was tough to treat, surgery for glaucoma could reduce the intraocular pressure effectively.

Association between family factors with dietary behaviors of left-behind children in rural China / 中国学校卫生

Objective@#To find out the association between family factors and left-behind children’s dietary behaviors in rural China.@*Methods@#This cross-sectional study was implemented in four counties of medium economic level were selected in Guizhou and Anhui province and four primary schools were chosen in each county and in total 16 schools were involved. Three classes from grades 5 and 6 each were selected randomly from included primary schools; all students in these classes, as well as their caregivers, were invited to participate. Self-designed questionnaire was adopted to collect intake frequencies of vegetable, fruit, meat, egg, milk, drink and fast food. Scores were calculated to evaluate these behaviors frequencies and multi-linear regression was used to explore the association between family factors and behavioral scores.@*Results@#The proportion of fruit, eggs and milk intake more than 4 times once a week in left-behind children were 44.9%, 35.1%, and 28.5%, while they were 57.2%, 38.5%, and 38.1% in non-left-behind children. It was found that statistical significant differences existed between scores of dietary behaviors of leftbehind children’s and non-left-behind children(t=-5.83, P<0.01). The results of multi-linear regression demonstrated that family cohesion (β=0.07, P=0.05) and caregivers’ behaviors (β=0.49, P<0.01) were protective factors for left-behind children’s behaviors, while taking care by single left-behind fathers was a risk factor(β=-1.21, P=0.03).@*Conclusion@#Primary caregivers play a critical role in offering guidance to children to help them develop health behaviors.

Prevalence and associated factors of electronic products usage among primary school students of grade 4-6 in Beijing / 中国学校卫生

Objective@#To explore the prevalence and associated factors of non learning-based screen time of 4-6 grade school students in Beijing, and to provide a basic data for further research on hazard control measures such as myopia, overweight and obesity among children and adolescents in Beijing.@*Methods@#Multistage stratified random cluster sampling method was adopted. A total of 2 515 primary school students were randomly selected in from schools in Beijing, self-developed questionnaire was used to investigate on the time for each electronic products usage for non-learning purpose, the total of electronic products usage every day and other information.@*Results@#The rates of screen time >15 minutes each time and ≥1 h daily were 48.43%, 22.90%, respectively. Multiple Logistic regression analysis showed that ordinary school, 6 th grade, male, single-parent family and other types of family, and lack of moderate-to-vigorous physical activity at weekend were associated with the students’ non learning-based screen time (OR=1.66, 2.28, 1.27, 1.44, 1.87, 2.20, P<0.05).@*Conclusion@#The situation of excessive screen time of primary school students was improved in Beijing, but still be prevelent, male students of grade 4 should be given more attention, and more importance should be attached to the offect of family in children.

Effect of phacoemulsification and intraocular lens implantation on corneal endothelial cells in patients with glaucoma and cataract / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the effect of phacoemulsification and intraocular lens implantation on corneal endothelial cells(CECs)in patients with glaucoma and cataract. <p>METHODS: The clinical data of 107 patients(113 affected eyes)with glaucoma and cataract who were treated in the hospital during the period from October 2016 to October 2018 were retrospectively analyzed. Patients treated with trabeculectomy or phacoemulsification combined with intraocular lens implantation were included in the control group(<i>n</i>=52, 54 affected eyes)and the study group(<i>n</i>=55, 59 affected eyes). The changes in visual acuity, anterior chamber depth and intraocular pressure before and after surgery, CECs related indexes and incidence of postoperative complications were compared between the two groups. <p>RESULTS: There was no significant difference in visual acuity between the two groups before surgery(<i>P</i>>0.05). The visual acuity of both groups were significantly improved after surgery(<i>P</i><0.05), and the improvement in study group was better than that in control group(<i>P</i><0.05).The anterior chamber depth in both groups increased, while intraocular pressure decreased after surgery(<i>P</i><0.05). After surgery, anterior chamber depth in study group was significantly larger than that in control group(<i>P</i><0.05), but there was no significant difference in intraocular pressure between the two groups(<i>P</i>>0.05). The cell area variation coefficient, hexagonal cell ratio, average cell area and corneal center thickness in control group increased significantly, while CECs density decreased significantly after surgery(<i>P</i><0.05). However, there was no significant difference in CECs related indexes in study group before and after surgery(<i>P</i>>0.05). After surgery, changes levels of CECs related indexes in study group were significantly lower than those in control group(<i>P</i><0.05). The incidence rates of postoperative complications in study group and control group were 5.1% and 20.4%, respectively(<i>P</i><0.05).<p>CONCLUSION: The application of phacoemulsification and intraocular lens implantation in the treatment of glaucoma with cataract can improve the visual acuity and intraocular pressure of patients, maintain structural integrity of CECs, with safety.

Mental health status of the pupils from Grade Four and Fivein Jiading District / 预防医学

Objective @#To investigate the mental health status of the pupils from Grade Four and Five in Jiading District of Shanghai, and to provide evidence for mental health intervention.@*Methods @# All the students from Grade Four and Five in Jiading District, Shanghai were selected as survey objects. The MHT was used to evaluate their mental health status, and the influencing factors of mental health problems were analyzed by multivariate logistic regression model.@*Results @#A total of 3 788 questionnaires were issued, of which 3 100 ones were valid and the effective rate was 81.84%. The detection rate of mental health problems was 17.06%. The detection rates of impulse tendency, terror tendency, physical symptoms, sensitivity tendency, self-blame tendency, loneliness tendency, anxiety towards people and learning anxiety were 11.77%, 15.55%, 12.97%, 16.19%, 10.10%, 4.81%, 13.16% and 14.00%, respectively. The results of multivariate logistic regression analysis showed that female students ( OR=1.617,95%CI: 1.325-1.974 ) , poor self-rated appearance ( OR=3.683, 95%CI: 2.428-5.586 ) ,only one or two friends ( OR=1.806, 95%CI: 1.342-2.428 ) , poor academic performance ( OR=1.626, 95%CI: 1.167-2.267 ) , primary school education or below of mother ( OR=1.539, 95%CI: 1.107-2.139 ) general or poor relationship with mother ( OR=1.785, 95%CI: 1.303-2.444 ) or father ( OR=1.745, 95%CI: 1.336-2.280 ) were risk factors for mental health problems. @*Conclusion @#The fourth-to fifth-grade primary school students in Jiading District of Shanghai have high detection rate of psychological problems. Gender, the number of friends, academic performance, education level of mother and the relation with parents are associated.

Effect of long-term application of prostaglandin analogue eye drops on conjunctival flora in glaucoma patients / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effect of long-term application of prostaglandin analogue eye drops on conjunctival flora in glaucoma patients.<p>METHODS: Totally 69 patients(113 eyes)with glaucoma treated with latanoprostaglandin from June 2016 to June 2017 were selected, and the sensitivity of conjunctival flora and staphylococcus epidermidis to antibiotics was examined after admission, 3mo and 1a.<p>RESULTS: The number of bacterial eyes detected at admission, 3mo and 1a were 63, 66 and 67 respectively(χ²=2.496, <i>P</i>=0.287). There was no difference in the detection rates of staphylococcus epidermidis, streptococcus, staphylococcus aureus, staphylococcus hominis, staphylococcus hemolyticus and moraxella at the time of admission, 3mo and 1a(<i>P</i>>0.05). The ratio of MRSE at 3mo was higher than that at entry(χ²=3.063, <i>P</i>=0.062). The ratio of MRSE at 1a was higher than that at 3mo(χ²=38.945, 24.984, all <i>P</i><0.001). The susceptibility of staphylococcus epidermidis to levofloxacin, gatifloxacin, moxifloxacin, ceftazidime, tobramycin, cefmethime and erythromycin at 3mo was lower than that at the time of admission, but there was no difference(<i>P</i>>0.0167), while the susceptibility of staphylococcus epidermidis to chloramphenicol at 3mo was lower than that at entry(<i>P</i><0.0167). The sensitivity of staphylococcus epidermidis to levofloxacin, gatifloxacin, moxifloxacin, ceftazidime, cefmethime, tobramycin, chloramphenicol and erythromycin at 1a was lower than that at 3mo(<i>P</i><0.0167).<p>CONCLUSION: The long-term application of latanoprostaglandin will not affect the detection rate of conjunctival flora, but can increase the incidence of MRSE. Clinically, patients who need long-term application of latanoprostaglandin should be considered comprehensively to prevent the emergence of drug-resistant strains in order to prevent uncontrollable infection.

Awareness of pubertal knowledge and its influencing factors among primary school students in Chinese rural areas / 中国学校卫生

Objective@#To investigate the awareness of pubertal knowledge and its influencing factors among primary school students in Chinese rural areas, and to provide evidences for improving awareness level and popularizing scientific, reasonable, and suitable sex education.@*Methods@#Sixteen primary schools consisting of rural registered students in Guizhou and Anhui Province were selected by multi-stage cluster sampling method, and a questionnaire survey for 2 506 senior students (grade five and six) was conducted to explore the awareness of pubertal knowledge and its influencing factors among primary school students in Chinese rural areas.@*Results@#The total awareness rate of pubertal knowledge was 62.7% among primary school students in Guizhou and Anhui rural areas, and the awareness rates were relatively low for the questions about the difference between male and female pubertal development and understanding of sexual attitude; female students, only-child students and grade six students got a bit better awareness of pubertal knowledge than male students, non-only-child students and grade five students respectively; grade[OR=0.72(0.61-0.86)], peer acceptance [OR=0.70(0.53-0.96)], family intimacy [OR=0.75(0.63-0.88)] had effect on awareness of pubertal knowledge.@*Conclusion@#The awareness of pubertal knowledge among primary school students in Guizhou and Anhui rural areas need further improvement, especially for male students, non-only-child students and grade five students in the questions about the difference between male and female pubertal development and understanding of sexual attitude. It is necessary to improve the awareness of pubertal knowledge by enhancing peer acceptance, promoting family intimacy, and popularizing scientific, reasonable, and suitable sex education.

Comparison of the efficacy between elastic intramedullary injection and autologous bone marrow blood injection in the treatment of bone cyst in children / 中国骨伤

OBJECTIVE@#To evaluate the efficacy of autogenous bone marrow injection and elastic intramedullary injection in the treatment of bone cyst in children.@*METHODS@#From January 2012 to December 2016, 56 children with simple bone cyst were divided into two groups: autogenous bone marrow blood injection group and elastic intramedullary needle group. There were 28 cases in the autogenous bone marrow blood injection group, 16 boys and 12 girls, aged (7.7±1.9) years old, 10 cases of proximal humerus, 8 cases of proximal femur, 6 cases of proximal tibia and 4 cases of femoral shaft. In the elastic intramedullary needle group, there were 28 cases, 18 boys and 10 girls, aged(7.5±2.2) years old, 11 cases of proximal humerus, 7 cases of proximal femur, 5 cases of proximal tibia, 4 cases of femoral shaft and 1 case of distal femur. The treatment effect was evaluated by Capanna standard.@*RESULTS@#All the patients were followed up, including 17 to 35(25.6±4.2) months in the elastic intramedullary needle group and 19 to 35(27.4±4.8) months in the autogenous marrow blood injection group. According to Capanna's evaluation standard of bone cyst, 27 patients in the elastic intramedullary needle group were treated effectively(25 patients cured, 2 patients healed but some remained lesions), 1 patients recurred, 0 patient had no response to treatment; 18 patients in the autogenous bone marrow blood injection group were treated effectively(13 patients cured, 5 patients healed but some remained lesions), 8 patients of cyst recurred, 2 patients had no response to treatment; the difference between the two groups was statistically significant(<0.01). The overall cure time was calculated by the follow-up of 25 cases in the elastic intramedullary injection group and 13 cases in the autogenous marrow blood injection group. The cure time was(20.2±3.5) months in the elastic intramedullary injection group and(27.7±4.9) months in the autogenous marrow blood injection group. The difference was statistically significant(<0.05).@*CONCLUSIONS@#For the treatment of bone cyst in children, the therapeutic effect of elastic intramedullary needle is better than that of autogenous bone marrow blood injection, and the cure time is shorter.

Combination of BI-RADS for ultrasound and shear wave elastography in differential diagnosis of benign and malignant breast lesions / 上海交通大学学报（医学版）

Objective · To explore the value of the 2013 version of the ultrasound breast imaging reporting and data system (BI-RADS) classification diagnostic criteria combined with ultrasound shear wave elastography (SWE) to identify benign and malignant breast lesions. Methods · A total of 175 solid breast masses in 155 women were examined with ultrasound, and were judged to be benign or malignant by BI-RADS classification criteria. Then all the masses were examined with shear wave elastography (SWE), to obtain shear wave quantitative parameters of benign and malignant breast lesions, the pathological results were used as the gold standard to construct the receiver operating characteristic (ROC) curve of the subjects, which were used to compare the diagnostic value of the two methods alone and in combination. Results · The area under curve (AUC) of the BI-RADS classification diagnostic criteria, the Emax value, and the combination of the two methods to differential diagnosis of benign and malignant breast nodules were 0913, 0.884 and 0.957, respectively. Through pairwise comparison, there was significant difference in AUC between the two methods alone and their combination (BI-RADS classification vs. combination: Z=2.883, P=0.002; SWE vs. combination: Z=4.081, P=0.000). Conclusion · The combination of BI-RADS classification and SWE technology can improve the diagnostic accuracy of breast lesions.

Effect of Heterozygosity Loss in HLA Region before Transplantation on HLA Typing in Patients with Leukemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of loss of heterozygosity(LOH) in HLA region at initial diagnosis and remission of leukemia patient before transplantation on HLA typing.</p><p><b>METHODS</b>The HLA typing was performed in DNA extracted from peripheral blood obtained at diagnosis (Sample 1 and Sample 2) and remission (Sample 3) in one pretransplant male patient with mixedphenotype acute leukemia (MPAL). HLA typing for HLA-A, B, C, DQB1, DRB1 was performed by Sequence-based typing (SBT), Sequence-specific oligonucleotide probe hybridization (SSO) and Sequence-specific primers (SSP). To define more precisely a cutoff limit for the detection of a heterozygous DNA present in a fraction of the cells by the SBT technology, DNA mixing experiments were performed.</p><p><b>RESULTS</b>SBT results showed that Sample 1 and Sample 2 were both homozygous HLA results at five loci (lost one haplotype) although the sequencing background of Sample 1 was a little high. Except HLA-C locus was homozygous, Sample 3 was heterozygous HLA results at four loci. Based on DNA mixing experiments, a cutoff limit for the detection of heterozygous DNA was 20% by SBT technology, and a detection threshold for HLA-A, B, C, DQB1, DRB1 heterozygosity in blood samples was <75% blasts.</p><p><b>CONCLUSION</b>Because LOH may be partial, any homozygous HLA result obtained during a blast crisis, especially ≥75% blasts, would have to be confirmed by a second typing on a buccal swab or on peripheral blood from the patient in complete remission.</p>

Necessity of setting up the course on clinical healthcare-associated infection according to case-based teaching method in medical higher education / 中国感染控制杂志

Objective To explore the necessity of setting up the course on clinical healthcare-associated infection (HAI) and effectiveness of the case-based teaching method in medical higher education.Methods 198 students who underwent internship in a hospital between July 2015 and July 2016 were selected,according to whether they selected clinical HAI coures,they were divided into course selective group(n =107,adopted case-based teaching method) and unselective group(n =91),questionnaire survey on the knowledge and attitude of HAI was carried out.Results The average score on HAI in selective group was higher than that of unselective group([85.3 ± 1.6] vs [58.3 ± 1.8],t =111.72,P＜0.01).Before and after conducted case-based teaching method,21.49％ and 47.66％ of students actively studied respectively,difference was significant (x2 =16.195,P＜0.01).Conclusion It is necessary to carry out a systematic course on HAI,case-based teaching method can improve the learning enthusiasm of students.

Protective effects of C/EBPα on podocytes in diabetic nephropathy / 中华肾脏病杂志

Objective To explore the effects of C/EBPα knockout in podocyte on diabetic nephropathy and its mechanisms.Methods C/EBPαloxp/loxp mice were crossed with podocin-cre mice to obtain F1 hybrids and then propagated until homozygous mice (C/EBPαf/f) were obtained.Diabetic nephropathy (DN) models were established by low-dose streptozotocin (STZ,100 mg/kg) administration after 25 weeks of normal diet or 45％ high-fat diet treatment,and biochemical indicators of blood and urea were measured.The morphological characteristics and the proteins regulating oxidative stress and mitochondrial function were detected.Results The type 2 DN models were successfully constructed based on transgenic mice.The kidneys of 8-month-old C/EBPαf/f mice did not show obvious morphological changes,but after constructing DN models,they showed obvious renal impairment,inflammation and oxidative stress.Compared with wild-type DN mice,the protein levels of nephrin and E-cadherin in DN C/EBPαf/f mice with DN were significantly decreased (P ＜ 0.01);fibronectin and Nrf2 protein levels were all increased (all P ＜ 0.05).Keap1,phospho-AMPK and mitochondrial function related genes Pgc-1α protein levels were all decreased (all P ＜ 0.05).Conclusion Podocyte C/EBPα knockout exacerbates diabetic nephropathy by promoting fibrosis and inhibiting Pgc-1α-mediated mitochondrial antioxidant function.

Risk factor changes for chronic disease before and after healthy walking intervention in occupational population in Shanghai / 上海预防医学

[Objective]To investigate the influence of healthy walking intervention on risk factors of noncommunicable chronic disease in occupational population, and to explore the suitable mode of exercise intervention for occupational population in Shanghai. [Methods]Before and after healthy walking intervention were compared the changes of body weight, BMI, waist circumference, body fat rate, visceral fat index, over-weight and obesity rate, central obesity rate, blood-pressure controlling rate. [Results]Weight, BMI, waist circumference, body fat percentage, viscera index, SBP and DBP all reduced after100 days of healthy walking, and the results were (1.52 ± 2.75) kg (Z =-21.99, P < 0.01) , (0.55 ±1.03) kg/m2 (Z =-21.64, P<0.01) , (2.10±5.27) cm (Z =-17.62, P<0.01) , (0.31±4.59) ％ (Z=-3.48, P < 0.01) , (0.12 ± 1.99) (Z =-2.70, P < 0.01) , (2.51 ± 10.87) mm Hg (Z =-9.35, P <0.01) and (1.67±8.26) mm Hg (Z =-9.06, P < 0.01). The rate of over-weight and obesity decreased7.86％, the rate of central obesity decreased 6.92％, and the rate of blood-pressure controlling increased2.72％. There were significant difference between the three indicators before and after healthy walking (χ2= 916.48, P< 0.01; χ2= 585.90, P < 0.01; χ2= 366.37, P < 0.01). [Conclusion] Healthy walking could reduce occupational population' s over-weight and obesity rate, central obesity rate, and increase blood-pressure controlling rate. The risk factors of un-communicable chronic disease have improved significantly. Healthy walking plays a positive role in the prevention and control of chronic diseases.

Chemical constituents in green walnut husks of Juglans regia / 中草药

Objective: To study the chemical constituents in green walnut husks of Juglans regia. Methods: The chemical constituents were separated and purified by silica gel column chromatography and HPLC. Their structures were determined on the basis of spectroscopic analyses. Results: Fifteen compounds were isolated and the structures were identified as epi-dihydrophaseic acid (1), 4-butoxy-5, 8-dihydroxy-3, 4-dihydronaphthalen-1-one (2), 4-ethoxy-5, 8-dihydroxy-3, 4-dihydronaphthalen-1-one (3), myricatomento-genin (4), nodulisporone (5), 5, 8-dihydroxy-4S-methoxy-β-tethalone (6), 5-hydroxy-4-methoxy-α-naphthalen-1-one (7), isosclerone (8), 4, 5, 8-trihydroxy-1, 2, 3, 4-tetrahydronaphthalene-1-one (9), 1-ethyl malate (10), 1-buthyl malate (11), succinic acid (12), ethyl-O-β-D-glucopyranoside (13), 1α, 2α, 4β-trihydroxy-1, 2, 3, 4-tetrahydronaphthalene (14), and L-2-O-methyl-chiroinosicol (15). Conclusion: Compounds 5 and 10-14 are isolated from the green walnut husks of J. regia for the first time, and compounds 1, 4, and 15 are isolated from this plant for the first time.