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OBJECTIVE@#To prepare an injectable hydrogel/staple fiber composite loaded with combretastain A-4 disodium phosphate (CA4P) and doxorubicin (DOX) and evaluate its antitumor efficacy via intratumoral injection.@*METHODS@#DOX-loaded PELA staple fibers (FDOX) were prepared using electro-spinning and cryo-cutting, and the drug distribution on the surface of the fibers was observed using a fluorescence microscope, and the encapsulation efficiency and loading capacity of FDOX were determined with a fluorospectro photometer. The fibers were then dispersed in CA4P-loaded PLGA-PEG-PLGA tri-block polymer solution at room temperature to obtain the hydrogel/staple fiber composite (GCA4P/FDOX). The thermo-sensitivity of this composite was determined by a test tube inverting method. An ultraviolet spectrophotometer and a fluorospectrophotometer were used to detect the release profile of CA4P and DOX, respectively. We observed in vivo gel formation of the composite after subcutaneous injection in mice. The in vitro cytotoxicity of GCA4P/FDOX composite in MCF-7 and 4T1 cells was assessed using cell Counting Kit-8 (CCK-8) reagent. In a mouse model bearing breast tumor 4T1 cell xenograft, we evaluated the antitumor efficacy of the composite by monitoring tumor growth within 30 days after intratumoral injection of the composite. HE staining, immunohistochemistry for Ki67 and immunofluorescence (TUNEL) assay were used for pathological examination of the tumor tissues 21 days after the treatments.@*RESULTS@#The average length of FDOX was 4.0±1.3 μm, and its drug loading capacity was (2.69±0.35)% with an encapsulation efficiency of (89.70±0.12)%. DOX was well distributed on the surface of the fibers. When the temperature increased to 37 ℃, the composite rapidly solidified to form a gel in vitro. Drug release behavior test showed that CA4P was completely released from the composite in 5 days and 87% of DOX was released in 30 days. After subcutaneous injection, the composite solidified rapidly without degradation at 24 h after injection. After incubation with GCA4P/FDOX for 72 h, only 30.6% of MCF-7 cells and 28.9% of 4T1 cells were viable. In the tumor-bearing mice, the tumor volume was 771.9±76.9 mm3 in GCA4P/FDOX treatment group at 30 days. Pathological examination revealed obvious necrosis of the tumor tissues and tumor cell apoptosis induced by intratumoral injection of G4A4P/FDOX.@*CONCLUSION@#As an efficient dual drug delivery system, this hydrogel/staple fiber composite provides a new strategy for local combined chemotherapy of solid tumors.
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Animals , Female , Humans , Mice , Breast Neoplasms/drug therapy , Cell Line, Tumor , Delayed-Action Preparations/therapeutic use , Doxorubicin/therapeutic use , Heterografts , Hydrogels/therapeutic use , Mice, Inbred BALB C , PhosphatesABSTRACT
Objective:To explore the joint association of education attainment and sedentary with insufficient physical activity in Kunshan, Jiangsu province.Methods:Multi-stage cluster random sampling method was conducted in 2016 in Kunshan City, physical activity levels were collected according to structure questionnaire, and multivariate logistic regression was used to identify factors associated with physical activity level. Logistic model was used to estimate interaction effect by the synergy index (S), the relative excess risk of interaction (RERI) and the attributable proportion due to interaction (AP).Results:Housework, traffic and regular exercise physical activity accounted for 10.23%, 41.84%, and 28.98%, respectively. Insufficient physical activity in total, male, and female population were 50.66% (95% CI: 49.04%-52.28%), 52.29% (95% CI: 49.94%-54.64%), and 49.29% (95% CI: 47.06%-51.52%). Multivariable logistic regression analysis demonstrated that high waist to hip ratio ( OR=1.12, 95% CI: 1.02-1.23), free of family history of hypertension ( OR=1.24, 95% CI: 1.14-1.36), newly diagnosed diabetes ( OR=1.35, 95% CI: 1.09-1.68), previously diagnosed diabetes ( OR=1.34, 95% CI: 1.07-1.69), awareness of waist ( OR=1.34, 95% CI: 1.21-1.48), and lower level of high density lipoprotein ( OR=1.14, 95% CI: 1.03-1.27) were positively correlated with insufficient physical activity. Moreover, high educational attainment ( OR=1.27, 95% CI: 1.10-1.46) and sedentary duration ( OR=1.37, 95% CI: 1.20-1.57) were associated with insufficient physical activity, and additive interaction was found between two factors on insufficient physical activity (RERI=0.367, 95% CI: 0.105-0.629. AP=0.183, 95% CI: 0.060-0.306. S=1.572, 95% CI: 1.079-2.289). Conclusion:Among permanent residents whose age between 18-69 years in Kunshan, insufficient physical activity is more prevalent, high education and sedentary are jointly associated with insufficient physical activity.
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Multi-stage cluster random sampling method was conducted in 2016 in Kunshan City, Jiangsu Province. 8 529 permanent residents aged 18-69 years with completed questionnaire and physical examinations were obtained. After being weighted according to complex sampling scheme and post-stratification, the sample was used to estimate the prevalence and awareness of dyslipidemia. The associated influence factors for prevalence and awareness of dyslipidemia were evaluated through multivariate logistic regression. The results revealed that the prevalence and awareness of dyslipidemia were 35.2%(95%CI 33.7%-36.8%)and 13.0%(95%CI 11.3%-14.8%), respectively. After adjusting confounding factors, multivariate logistic regression analysis demonstrated that body mass index(BMI)≥28 kg/m2(OR=2.26, 95%CI 1.93-2.66), higher waist to hip ratio(OR=1.77, 95%CI 1.60-1.95), family history of diabetes(OR=1.19, 95%CI 1.03-1.36), hypertension(OR=1.26, 95%CI 1.11-1.44), diabetes(OR=1.83, 95%CI 1.55-2.16)were independently associated with dyslipidemia. BMI≥28 kg/m2(OR=1.71, 95%CI 1.30-2.25), higher waist to hip ratio(OR=1.65, 95%CI 1.29-2.10), hypertension(OR=1.87, 95%CI 1.47-2.38), diabetes(OR=1.64, 95%CI 1.24-2.16) were independently associated with awareness of dyslipidemia. (Chin J Endocrinol Metab, 2018, 34: 573-577)
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Objective To explore the mortality trends of cerebrovascular diseases and to quantitatively estimate the influence of population factors on cerebrovascular disease mortality between 1993 to 2016 in Kunshan city, Jiangsu province. Methods Records of cerebrovascular disease deaths were obtained from a register of all causes of death. Crude death rate and age standardized rate (ASR) were calculated, and annual percentage change (APC) based on sex and age were estimated. Difference decomposition was used to estimate the contribution of demographic and non?demographic factors to the change in cerebrovascular disease mortality. Results Between 1993 and 2013, the ASR of cerebrovascular diseases declined significantly for both sexes (APC=-4.9%, 95% CI:-5.5% to-4.3%), males alone (APC=-4.8%, 95% CI:-5.5% to-4.1%), and females alone (APC=-5.5%, 95% CI:-5.7% to-4.3%). However, from the year 2013 to 2016, the ASR of cerebrovascular diseases increased for both sexes together (APC=7.5%, 95% CI: 3.8% to 11.2%) and men alone (APC=10.2%, 95% CI: 4.3% to 16.1%), but there was no significant change for women (APC=4.3%, 95% CI:-1.2% to 9.8%). The overall decrease in mortality due to cerebrovascular disease was mainly due to non?demographic changes; the proportions of its contribution in men, women, and both sexes were 238.78%, 241.09%, and 245.89%, respectively. Conclusion The mortality due to cerebrovascular disease decreased substantially in the past two decades, and this decline was hindered by some demographic factors. It is imperative to explore the causes of this decline to decrease the burden caused by cerebrovascular disease.
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Objective This study aimed to examine temporal trends in all cancer-eliminated life expectancy and potential years of life lost (PYLL) in Kunshan city, Jiangsu province, between 1981 and 2015. Methods Data were collected from the vital records of Kunshan city. Cancer-eliminated life expectancy and PYLL were calculated by sex,and the Chinese population from the year 2000 was used to calculate age-standardized PYLL. Estimated annual percentage changes (APC) and 95% confidence intervals (CI) were used to examine temporal trends in increased cancer-eliminated life expectancy. Results Between 1981 and 2015,there was a significant decrease in age-standardized PYLL among males (APC=-2.31%, 95% CI:-2.51% to-2.11%) and females (APC=-1.91%, 95% CI:-2.26% to-1.56%). However, an increase was found in cancer-eliminated life expectancy in males and females, from 3.23 to 4.72 years in males(APC=2.42%,95% CI:1.64% to 3.20%)and from 1.10 to 2.94 years in females(APC=3.91%, 95% CI: 1.78% to 6.04%). Conclusion An overall decrease in age-standardized PYLL was observed when all cancers were considered,and an increase in cancer-eliminated life expectancy was found, suggesting that premature deaths due to cancers were reduced gradually. However, the negative effects of cancer on the health of the whole population have not been fully alleviated.
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Objective To examine the temporal trend of mortality and probability of premature death from chronic respiratory disease in Kunshan City, Jiangsu Province. Methods Records of chronic respiratory disease death were derived from the vital registry system. Crude death rates, age-standardized mortality rate, and probability of premature death were calculated. Annual percent changes (APC) were estimated to examine the temporal trend. Results The crude death rate of chronic respiratory disease decreased from 129.14/105in 1993 to 41.10/105in 2016, and its APC was-4.1% (95% CI:-5.1%--3.1%, P<0.01). Age-standardized mortality rate decreased from 107.85/105in 1993 to 14.60/105in 2016 for both sexes (APC=-7.7%, 95% CI:-8.6%--6.8%, P<0.01). Moreover, the probability of premature death from chronic respiratory disease decreased from 3.96% in 1993 to 0.28% in 2016 (APC=-13.2%, 95% CI:-14.7%- -11.7%, P<0.01). Conclusion The mortality rate of chronic respiratory disease decreased substantially from the year 1993 to 2016 in Kunshan City. Residents are less likely to die of chronic respiratory disease before 70 years of age.
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Objective:To explore therapeutic effect of rosuvastatin combined clopidogrel bisulfate tablet on patients with coronary heart disease (CHD).Methods: A total of 124 patients, who were diagnosed as CHD by coronary angiography, were selected, randomly and equally divided into routine treatment group (received routine treatment,including clopidogrel bisulfate tablet) and combined treatment group (received rosuvastatin based on routine treatment group), both groups were treated for six months.Cardiac function, serum levels of angiotensin II (Ang II), vascular endothelial growth factor (VEGF) and nitric oxide (NO), and therapeutic effect were measured and compared between two groups before and after treatment.Results: Total effective rate of combined treatment group was significantly higher than that of routine treatment group (96.77% vs.83.87%, P=0.015).Compared with routine treatment group after treatment, there were significant rise in left ventricular ejection fraction [(61.89±7.02)% vs.(68.96±8.23)%] and NO level [(75.25±9.45) μmol/L vs.(82.25±10.22) μmol/L], and significant reductions in wall motion score index [(1.35±0.39)% vs.(1.11±0.29)%], levels of Ang Ⅱ [(102.25±6.93) ng/L vs.(52.99±5.36) ng/L] and VEGF [(328.25±23.41) ng/L vs.(228.69±22.69) ng/L] in combined treatment group, P<0.01 all.Conclusion: Rosuvastatin combined clopidogrel bisulfate tablet can effectively improve heart function, serum levels of Ang II, VEGF and NO in patients with coronary heart disease, the therapeutic effect is significant, which is worth extending.
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Objective To explore the temporal trend of cancer death rates in different age and the influencing factors in Kunshan,Jiangsu province,1981 to 2015.Methods Data were derived from cancer rcgistry and vital registration system.The Chinese age structure in 2000 was used to calculate age-standardized death rates (ASR),and annual percentage changes (APC) and 95％ confidence interval (Cl) were used to estimate the temporal trend of cancer death rates.Difference decomposition method was applied to analyze the contribution of demographic and non-demographic factors for the change of cancer mortality.Results Between 1981 and 2015,the age standardized all cancers death rate decreased from 162.49 to 93.74 per 100,000 (APC=-l.6％,95％ CI:-1.8％--1.5％).However,the ASR for those aged 70 years or above was stable over time (APC=0.2％,95％ CI:-0.2％-0.5％),whereas aged 30-69 years was decreased from 240.01 in 1981 to 93.28 in 2015 (APC=-2.8％,95％ CI:-3.0％--2.6％).In addition,the proportion of leading cancers were changed obviously.The proportion of lung cancer increased from 1981 to 2015,while gastric cancer,liver cancer,esophageal cancer and colorectal cancer decreased.Compared with the crude cancer mortality in 1993,the effect of the demographic and non-demographic factors to the increased death rate in 2015 were 308.93％ and-208.93％,respectively.Conclusion The ASR death rate of all cancers was decreasing,and the rate in those aged 30 to 69 years decreased significantly,whereas stable in those aged 70 years or above.The effect of demographic characteristics on cancer mortality was significantly greater than that of non-demographic characteristics.
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OBJECTIVE@#To provide anantomical basis for the endoscope-assisted partial superficial parotidectomy via retroauricular hairline approach (EASPRHA) and assess its feasibility and safety.@*METHOD@#The surgical anatomy of retroauricular hairline region and parotid gland region were observed in 15 fresh human cadavers (30 halves). The EASPRHA was performed on 5 human cadavers (10 halves). After the procedure, the related vascular and neural structures were evaluated.@*RESULT@#The retroauricular hairline region extends between superficial musculoaponeurotic system and superficial cervical fascia. On the superficial surface of the upper sternocleidomastoid lie the lesser occipital nerve, the great auricular nerve and the external jugular vein. The bifurcation of great auricular nerve is(22.85 ± 2.01) mm from the bottom of earlobe. The parotid gland region extends between parotidomassteric fascia and parotid gland parenchyma. The facial nerve emerging from the stylomastoid foramen runs across the superficial surface of base of styloid process, passes through the interspace between cartilage of external acoustic meatus and posterior belly of digastric muscle, and enters the parotid gland. The bifurcation of facial nerve trunk is (19.10 ± 3.10)mm from the mastoidale and (39.49 ± 5.78) mm from the mandibular angle. Above the posterior belly of digastric muscle, the posterior auricular artery arises from the posterior wall of the external carotid artery with its main stem running over the superficial surface of facial nerve trunk. In all endoscope-assisted operations, the partial superficial parotidectomy was successful without the need for an additional incision. No major neurovascular damage wasobserved.@*CONCLUSION@#A thorough knowledge of the surgical anatomy of retroauricular hairline region and parotid gland region is an essential requirement in performing the safe and feasible EASPRHA.
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Humans , Male , Cranial Nerves , Endoscopes , Endoscopy , Methods , Facial Nerve , Fascia , Feasibility Studies , Neck Muscles , Parotid Gland , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To investigate the interaction of prenatal care indexes including weeks of initiation of prenatal care, number of prenatal care visits and maternal educational level on the risk of neonatal low birth weight (LBW).</p><p><b>METHODS</b>Logistic Regression Model was performed to estimate the association including the interaction with OR and 95%CI between prenatal care indexes and LBW risk in all the subjects. Three educational levels(junior high, senior high, junior college) of mothers were also assessed. New variables of the prenatal care indexes were transformed using the quartiles, according to the distribution of the original variables on pregnant women with newborns of normal birth weight.</p><p><b>RESULTS</b>Whether the pregnant women were stratified by educational level, with the increasing number of prenatal care visits, LBW risk was shown a U-type tendency in different strata of educational levels, when comparing with the reference group, respectively. Compared to the baseline group, the OR and 95% CI of the third quartile on number of prenatal care visits were 0.48 (0.35-0.64), 0.55 (0.32-0.95), 0.50 (0.32-0.80), 0.36(0.20-0.66) in all subjects who had received educational levels as junior middle school, senior middle school or junior college degree ect., respectively. A significant interaction was shown between the number of prenatal care visits and maternal educational level on the neonatal LBW risk (χ² = 4.650 2, P = 0.031 1). However, no interaction was found between the week of initiation of prenatal care and maternal educational level on the neonatal LBW risk (χ² = 0.929 7, P = 0.334 9).</p><p><b>CONCLUSION</b>Data from our study indicated that there was a protective interaction on reducing the neonatal LBW risk between maternal educational level and the number of prenatal care visits, but not the weeks on the initiation of prenatal care. More prenatal care programs should be implemented among the pregnant women with lower educational level.</p>
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Adult , Female , Humans , Infant, Newborn , Pregnancy , Young Adult , Educational Status , Gestational Age , Infant, Low Birth Weight , Logistic Models , Prenatal Care , Risk FactorsABSTRACT
Objective To investigate the interaction of prenatal care indexes including weeks of initiation of prenatal care,number of prenatal care visits and maternal educational level on the risk of neonatal low birth weight (LBW). Methods Logistic Regression Model was performed to estimate the association including the interaction with OR and 95%CI between prenatal care indexes and LBW risk in all the subjects. Three educational levels(junior high,senior high,junior college)of mothers were also assessed. New variables of the prenatal care indexes were transformed using the quartiles,according to the distribution of the original variables on pregnant women with newborns of normal birth weight. Results Whether the pregnant women were stratified by educational level,with the increasing number of prenatal care visits,LBW risk was shown a U-type tendency in different strata of educational levels,when comparing with the reference group,respectively. Compared to the baseline group,the OR and 95%CI of the third quartile on number of prenatal care visits were 0.48 (0.35-0.64),0.55(0.32-0.95),0.50(0.32-0.80),0.36(0.20-0.66)in all subjects who had received educational levels as junior middle school,senior middle school or junior college degree ect., respectively. A significant interaction was shown between the number of prenatal care visits and maternal educational level on the neonatal LBW risk(χ2=4.650 2,P=0.031 1). However,no interaction was found between the week of initiation of prenatal care and maternal educational level on the neonatal LBW risk(χ2=0.929 7,P=0.334 9). Conclusion Data from our study indicated that there was a protective interaction on reducing the neonatal LBW risk between maternal educational level and the number of prenatal care visits,but not the weeks on the initiation of prenatal care. More prenatal care programs should be implemented among the pregnant women with lower educational level.
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Objective To investigate the interaction of prenatal care indexes including weeks of initiation of prenatal care,number of prenatal care visits and maternal educational level on the risk of neonatal low birth weight (LBW). Methods Logistic Regression Model was performed to estimate the association including the interaction with OR and 95%CI between prenatal care indexes and LBW risk in all the subjects. Three educational levels(junior high,senior high,junior college)of mothers were also assessed. New variables of the prenatal care indexes were transformed using the quartiles,according to the distribution of the original variables on pregnant women with newborns of normal birth weight. Results Whether the pregnant women were stratified by educational level,with the increasing number of prenatal care visits,LBW risk was shown a U-type tendency in different strata of educational levels,when comparing with the reference group,respectively. Compared to the baseline group,the OR and 95%CI of the third quartile on number of prenatal care visits were 0.48 (0.35-0.64),0.55(0.32-0.95),0.50(0.32-0.80),0.36(0.20-0.66)in all subjects who had received educational levels as junior middle school,senior middle school or junior college degree ect., respectively. A significant interaction was shown between the number of prenatal care visits and maternal educational level on the neonatal LBW risk(χ2=4.650 2,P=0.031 1). However,no interaction was found between the week of initiation of prenatal care and maternal educational level on the neonatal LBW risk(χ2=0.929 7,P=0.334 9). Conclusion Data from our study indicated that there was a protective interaction on reducing the neonatal LBW risk between maternal educational level and the number of prenatal care visits,but not the weeks on the initiation of prenatal care. More prenatal care programs should be implemented among the pregnant women with lower educational level.
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Objective To explore the inhibition effects of CD4+CD25+/highCD127low on the EBV immortalized cells(CD23+)in children with infectious mononucleosis (IM). Methods The expression of CD3+, CD3+ CD4+ , CD3+ CD8+ , CD25+/highCD127low and CD19+ , CD19+ CD23+ were analyzed by flow cytometry in 23 children at the acute stage of IM and 10 children recovering from IM in comparison with the ones of 20 healthy controls. Results Compared with the following results in controls, CD3+, CD3+ CD8+ were significantly increased and CD3+ CD4+, CD4+/CD8+ ratio, CD4+ CD25+/highCD127low, CD19+, CD19+ CD23+ were significantly reduced in the IM patients. Compared with the ones in the IM pa-tients recovering from IM, CD3+ , CD3+ CD8+ were significantly increased and CD3+ CD4+, CD4+/CD8+ ratio, CD4+ CD25+/highCD127low, CD19+ , CD19+ CD23+ were significantly reduced in the IM patients at the acute stage. There was no obvious difference in all the marks except CD4+/CD8+ratio, CD8+ CD28+ , CD19+ , CD19+ CD23+ ratio between the children recovering from IM and the normal controls. There is a positive correlation between CD3+ and CD19+, CD19+ CD23+ during acute phase. There is a negative correlation between CD4+ CD25+/highCD127low and CD19+ , CD19+ CD23+ during acute phase. Conclusion The results indicate that the decreasing of CD4+ CD25+/highCD127low may play an important role in elimina-ting EBV immortalized cells.