Analysis of an outbreak of influenza A in a primary school in Jing an District, Shanghai / 中国学校卫生

Objective@#To investigate the epidemiological data of an outbreak of influenza A in a primary school in Shanghai, to provide reference for targeted prevention and control measures.@*Methods@#A field epidemiological method was used to investigate and collect the data of influenza A outbreak in a primary school in Jing an District from November 8 to December 6, 2022, through on site follow up and telephone return visit to health teachers and cases. The distribution characteristics of the epidemic were analyzed by descriptive epidemiology.@*Results@#The first case developed symptoms of cough, sore throat, and fever on the morning of November 8th 2022, with a maximum body temperature of 38.6 ℃. Later, the clinical diagnosis was influenza A. The total number of influenza like cases reported in this outbreak is 99, including 92 students and 7 teachers. The total incidence rate was 9.45%. The clinical symptoms of all cases were fever, sore throat, and cough; 27 cases of influenza A were diagnosed by hospital rapid diagnostic reagents. The second grade students had the highest case incidence rate(24.46%), and there was a statistically significant difference in case incidence rates among students of different grades ( χ 2=48.28, P ＜0.01). The case incidence rate on the second floor was the highest (23.47%), and there was a statistically significant difference between the case incidence rates on different floors ( χ 2=52.38, P ＜ 0.01 ). Etiological testing showed that the influenza virus causing this outbreak was type A H3N2 virus.@*Conclusion@#This outbreak is a campus cluster outbreak caused by influenza A (H3N2) virus. The health and education departments should strengthen cooperation to effectively implement prevention and control measures of infectious diseases, and timely identify the source of infection and cut off the transmission route.

Research progress on visual quality and complications after implantable collamer lens implantation / 国际眼科杂志(Guoji Yanke Zazhi)

Corneal refractive surgery and intraocular collamer lens(ICL)implantation are the mainstream refractive surgery methods at present. Many studies have proved that ICL implantation can effectively improve the postoperative visual acuity of patients. ICL implantation has gained favor among refractive doctors and patients because of its multiple advantages. Excellent postoperative visual acuity and visual quality are the key factors to improve patients' satisfaction. In order to evaluate the subjective and objective visual quality of patients after operation and avoid complications, this article reviews the visual quality and postoperative complications after ICL implantation.

Establishment of a new strategy to correct the interference of chyle blood on the detection of hemoglobin and mean red blood cell hemoglobin concentration / 中华检验医学杂志

Objective:To establish a new strategy for rapid correction of the interference of chyle blood on hemoglobin (HGB) and related indexes by reticulocyte (RET) channel research parameters (HGB-O, MCHC-O) from automatic hematological analyzer.Methods:With the diagnostic experimental design, a total of 90 impatient samples were sequential picked from Fuwai Hospital, which had routine blood testing from June 1 to July 31, 2021. The selected samples were free of hemolysis, jaundice, chylo. The age of the patients was (49.2±5.7) years, with 47 males and 43 females. Three different contents(25, 50, 75 μl) of fat emulsion injection were used to replace plasma in equal amounts to prepare chyle blood samples with mild, medium and heavy degrees of average red blood cell hemoglobin concentration (MCHC). The research parameters (HGB-O, MCHC-O) obtained by the RET channel detection of the automatic blood analyzer were used as the corrected HGB and its related index values (RET method), and the original values (the detection values before adding fat emulsion) and the formula correction values were paired with t-test or Wilcoxon signed rank test, single factor analysis of variance or Kruskal-Wallis rank-sum test, Bland-Altman and correlation analysis to evaluate the correction effect of RET method.Results:There was no significant difference ( H=0.035, P=0.983; H=0.097, P=0.953; H=0.112, P=0.945) between the RET correction values of HGB (g/L) [104.0(83.8, 132.8), 109.0(87.78, 128.25), 104.0(87.8, 131.8)] and the original values [104.0(83.0, 133.0), 107.5(86.75, 129.25), 103.5(85.8, 131.3)] and the formula correction values [104.0(84.0, 133.8), 106.0(86.75, 131.25), 102.5(86.8, 131.3)] in the samples of chythemia with varying degrees of MCHC (g/L) elevation; meanwhile, the RET correction values [366.5(325.8, 341.5), 333.5(323.8, 340.0), 333.5(327.0, 341.25)] and the original values [336.0(324.8, 342.0), 333.0(323.5, 342.3), 332.0(326.75, 340.5)] and the formula correction values [333.5(323.5, 343.3), 331.0(321.0, 338.3), 329.5(325.25, 337.25)] were also not statistically significant ( H=0.049, P=0.976; H=3.149, P=0.207; H=0.883, P=0.643). The detection values of HGB and related indexes corrected by RET method were in good agreement with the original values [96.7% (29/30) of the points were within the 95% consistency limit], and the two were positively correlated (the correlation coefficients were all higher than 0.919, P<0.01). Conclusion:The RET method based on the research parameters of RET channel of automatic hematological analyzer can serve as a new strategy to correct the interference of chyle blood on the detection of HGB and related indexes.

Impact of high-sensitivity troponin as a selection criterion for healthy people on the reference range of N-terminal pro-B-type natriuretic peptide / 中华检验医学杂志

Objective:The 97.5th percentile upper reference limit (97.5th URL) of N-terminal prob-type natriuretic peptide (NT-proBNP) is influenced by multiple factors and depends on the inclusion criteria of apparently healthy people. In this study, the reference upper limit of NT-proBNP was established on apparently healthy people in Beijing area with abnormal hs-cTn as the exclusion criterion.Methods:According to the latest expert consensus recommendation standards of natriuretic peptide in the detection and clinical application of heart failure published by the Clinical Application Group of Cardiac Bio-Markers of the International Union of Clinical Chemistry, 1 635 healthy people without abnormal appearance of routine indicators such as sex, age, glycated hemoglobin, estimated glomerular filtration rate and medical history were collected. After excluding participants with potential myocardial injury according to hs-cTnI and/or hs-cTnT concentration>99th URL, NT-proBNP 97.5th URL was established in healthy subjects aged 21-40 years ( n=205), 41-50 years ( n=535), 51-60 years ( n=556) and >60 years ( n=339) based on non-parametric statistics. Results:The level of NT-proBNP was positively correlated with age ( r=0.254, P<0.001). The levels of NT-proBNP were positively correlated with hs-cTnI, hs-cTnT in males ( r=0.377 and r=0.429, both P<0.001). The levels of NT-proBNP were also positively correlated with hs-cTnI, hs-cTnT in females ( r=0.132 and r=0.296, both P<0.001). When hs-cTn>99th URL was used as the criterion to exclude patients with potential myocardial injury, among apparently healthy people aged 21-40 years old, 41-50 years old, 51-60 years old and >60 years old, male NT-proBNP 97.5th URL was 81.9 (90% CI 60.0-588.8), 141.2 (90% CI 100.0-263.6), 272.0 (90% CI 193.0-494.0) and 547.9 (90% CI 311.2-738.6), respectively; For females, the rates were 227.5 (90% CI 81.9-360.8), 153.2 (90% CI 128.2-239.5), 300.6 (90% CI 211.0-376.4) and 395.8 (90% CI 242.3-543.5) ng/L, respectively. Conclusions:This study confirmed that hs-cTn>99th URL can be used as an apparent population screening criterion for natriuretic peptide reference interval studies, which is helpful to remove conventional means to include individuals with occult myocardial injury in apparently healthy patients, so as to establish a more rigorous healthy cohort and establishing solid normal NT-proBNP reference interval.

Predictive value of single high-sensitivity cardiac troponin Ⅰ level on the 30-day cardiovascular adverse events in patients with suspected acute coronary syndrome / 中华检验医学杂志

Objective:To explore the predictive value of single high-sensitivity cardiac troponin I (hs-cTnI) concentration of 30-day cardiovascular adverse events in patients with suspected acute coronary syndrome (ACS).Methods:This is a multicenter, prospective and observational clinical study. Patients with suspected ACS who were admitted into the emergency department of Fuwai Hospital, the First Affiliated Hospital of Sun Yat-sen University and Nanjing First Hospital from January 2017 to September 2020 were enrolled. hs-cTnI result at the time of visit was obtained from patients with suspected ACS. Patients were followed up for 30 days and patients were divided into no events group and events group according to the presence or absence of 30-day cardiovascular adverse events (acute myocardial infarction (including index), unplanned revascularization and cardiovascular death). The predictive value of single Hs-cTnI at different concentration thresholds on the adverse event was evaluated in terms of sensitivity, negative predictive value (NPV) and 95% confidence interval ( CI). The best threshold was defined as: missed diagnosis rate <2% and NPV >99%. Patients were sub-grouped according to the confounders of hs-cTnI (sex, age, chest pain duration, estimated glomerular filtration rate), and Chi-square test was used to compare sensitivity and NPV among various subgroups. Results:A total of 1 461 patients were included. Among them, 387 patients (26.5%) had 30-day adverse cardiovascular events and 1 074 patients (73.5%) had no adverse cardiovascular events. Mean age was (62±12) years old and 905 were males (61.9%). When the concentration of hs-cTnI was less than 2 ng/L (limit of detection), the missed diagnosis rate of 30-day cardiovascular adverse events was 0.8% (3/387), the sensitivity was 99.2% (95% CI 97.6%-99.8%), and NPV was 98.7% (95% CI 96.0%-99.7%). When hs-cTnI concentration was less than 6 ng/L, the missed diagnosis rate was 1.8%, the sensitivity was 98.2% (95% CI 96.1%-99.2%), and NPV was 99.0% (95% CI 97.9%-99.6%). Subgroup analysis showed that the sensitivity and NPV of single hs-cTnI concentration <6 ng/L for 30-day cardiovascular adverse events were lower in patients with chest pain less than 3 h than those with chest pain time>3 hours ( P<0.05). Conclusions:Single hs-cTnI concentration less than 6 ng/L can predict the risk of 30-day cardiovascular adverse events in suspected ACS patients, but continuous monitoring is recommended for patients with chest pain onset≤3 hours.

Advances on the toxicology and molecular mechanisms of different components of ambient fine particulate matter / 中华预防医学杂志

Ambient fine particulate matters (PM2.5) refer to particulate matters with an aerodynamic diameter less than or equal to 2.5 μm. PM2.5 enter the body through the target organ-lung, and can induce a variety of adverse health effects (such as cardiovascular diseases, diabetes, respiratory diseases, neurodegenerative diseases and adverse birth outcomes). PM2.5 are known to have complex compositions (including water-soluble/-insoluble components and biological components), diverse sources and capacity of secondary transformation. Numerous epidemiological and toxicological studies indicated that different components of PM2.5 may induce adverse health effects through different biological mechanisms. In adddition, co-exposure of different components and their interaction should also be considered. Thus here we have systematically reviewed studies in recent years about the toxicological effects and underlying mechanisms of different components of ambient fine particulate matters, including inflammatory response, oxidative stress, endoplasmic reticulum stress, activation of the NF-κB signaling pathway and so on. The information may give some insights into the prevention and treatment of adverse health effects caused by exposure to different components of PM2.5.

Effect of early external diaphragm pacing on patients with mechanical ventilation / 中华急诊医学杂志

Objective:To investigate the effect of early external diaphragm pacing on the diaphragm function and prognosis of patients with mechanical ventilation.Methods:A total of 47 patients receiving invasive mechanical ventilation in the Emergency Intensive Care Unit of Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University) from October 2019 to July 2021 were selected and randomly divided into the treatment group ( n=23) and control group ( n=24). The patients in the control group received routine clinical treatment. On this basis, the treatment group received external diaphragm pacing treatment every day from the third day of mechanical ventilation until weaning, and was followed up to 30 days after discharge. The diaphragm thickness, diaphragm excursion, diaphragm thickening fraction, mechanical ventilation time, number of weaning failures, length of hospital stay and death toll were compared between the two groups. Results:Compared with the control group, the diaphragm thickness [(0.21±0.05) cm vs. (0.16±0.05) cm], diaphragm excursion [(1.38±0.37) cm vs. (1.11±0.48) cm], and diaphragm thickening fraction [26% (19%, 32%) vs. 18.5% (10.25%, 20%)] in the treatment group increased significantly (all P<0.05). The mechanical ventilation time was shorter in the treatment group [10 (7, 15) d vs. 13 (10.25, 19) d], and the difference was statistically significant ( P<0.05). There were no significant differences in the number of weaning failures (7 vs. 9), length of hospital stay [22 (15 , 30) d vs.. 24 (17.25, 34.25) d] and deaths (8 vs. 8) (all P>0.05). Conclusions:Early application of external diaphragm pacing can improve the diaphragm function of patients with mechanical ventilation, delay the decline in diaphragm function, increase diaphragm excursion and diaphragm thickening fraction, and shorten the mechanical ventilation time.

Research on the multi-campus construction of public hospitals: Peking Union Medical College Hospital as an example / 中华医院管理杂志

Multi-campus operation is an important and effective means for high-quality development of public hospitals and balanced layout of high-quality medical resources. By way of literature review, the study identified problems encountered in the construction of multi-campus hospitals in China, with a tertiary general hospital cited as a case example. The authors introduced its multi-campus development practice from such aspects as campus discipline layout, homogeneous operation, performance assessment, management mode and cultural construction, along with suggestions for such practice in China.

Preliminary study on effects of serial passage on growth-related properties and virulence of Chlamydia muridarum / 中华微生物学和免疫学杂志

Objective:To analyze the changes in biological characteristics including infectivity, growth and pathogenicity of Chlamydia muridarum ( Cm) after serial passage in vitro in special conditions in order to provide reference for screening attenuated live vaccines and virulence-related genes. Methods:Wild-type Cm strain (G0) was cultured for several passages using conventional cell culture method under alternate unassisted and assisted culture conditions. Then, the 28th generation (G28) of Cm was selected and compared with the parental G0 strain in terms of centrifugation dependence, attaching ability, intracellular growth curve, plaque size and fallopian tube lesions after genital tract infection in a mouse model. Results:Compared with the parental G0 strain, the G28 strain showed significantly decreased dependence on centrifugation during cell infection ( P<0.05) and increased attachment capacity to cells ( P<0.05). No significant differences were observed in the growth curves 32 h after cell infection or in the plaque sizes between the parental G0 and G28 strains. In the in vivo virulence test, fallopian tube lesions were observed in 87.5% of G0-infected mice and 37.5% of G28-infected mice ( P<0.05). Conclusions:Compared with the parental G0 strain, the G28 strain showed significantly enhanced in vitro infection ability, but decreased in vivo pathogenicity, which brought hope for further identification of virulence genes, isolation of attenuated strains with single genotype and development of live attenuated Chlamydia vaccines.

miR-18a enhances the radiosensitivity of nasopharyngeal carcinoma cells through inducing autophagy / 中华耳鼻咽喉头颈外科杂志

Objective: To explore the impacts of miR-18a overexpression or depression on the radiosensitivities of nasopharyngeal carcinoma cell line CNE1 and CNE2 and underlying mechanisms. Methods: CNE1 and CNE2 were transfected with miR-18a mimics, inhibitor and the corresponding control vectors. qRT-PCR and western blot were used to determine the ataxia telangiectasia mutated (ATM) expressions in CNE1 and CNE2. CNE1 and CNE2 with stably expressing miR-18a and miR-18a siRNA were constructed. Methyl thiazolyl tetrazolium (MTT) assay was used to detect the impacts of the miR-18a overexpression or depression combined with irradiation on the cell growth. Flow cytometry was used to detect the cell apoptosis and cell cycle. Colony formation assay was used to evaluate the raodiosensitivities of cells. Acridine orange (AO) staining and western blot were used respectively to test the autophagy and the expressions of related proteins. Independent samples t test was used to compare the mean value between groups by using SPSS 16.0. Results: ATM mRNA was decreased significantly in CNE1 and CNE2 cells transfected with 100 or 200 nmol/L miR-18a mimics for 48 hours (CNE1: RQ=0.174±0.139 and 0.003±0.001, t=9.939 and 19 470.783;CNE2: RQ=0.024±0.008 and 0.019±0.012, t=270.230 and 137.746, respectively, all P<0.001). ATM proteins were also decreased after transfected with 100 or 200 nmol/L miR-18a mimics for 72 hours. While in the cells transfected with 100 and 200 nmol/L miR-18a inhibitor for 48 hours, the expressions of ATM mRNA were upregulated significantly (CNE1: RQ=9.419±2.495 and 2.500±1.063, t=-4.427 and -41.241; CNE2: RQ=7.210±0.171 and 115.875±15.805, t=-62.789 and -12.589, all P<0.05), and the expressions of ATM proteins increased after transfected for 72 hours. The growth of cells with miR-18a overexpression plus 4 Gy irradiation were obviously inhibited compared to that of cells with the 4Gy irradiation alone; while the growth of miR-18a-inhibited cells increased compared to that of cells with 4 Gy irradiation alone (all P<0.05). CNE1 transfected with 100 nmol/L miR-18a mimics plus 4 Gy irradiation showed the higher apoptosis rate than the cells with 4 Gy irradiation alone ((22.9±2.1)% vs. (16.3±1.0)%, t=-4.870, P<0.01). Compared to the cells with 4 Gy irradiation alone, miR-18a-overexpressed cells plus 4 Gy irradiation decreased their percentages in G1 phases ((20.2±3.0)% vs. (29.8±4.4)%, t=3.119) and G2/M phases ((21.5±0.9)% vs. (33.4±3.1)%, t=6.410, P<0.05 for both), and increased their percentages in S phases ((56.7±4.9)% vs. (36.8±6.4)%, t=-4.246, P<0.05), and these cells possessed less colony number after exposure to different doses of irradiation, more autophagy-lysosome number, and more expressions of LC3 proteins (all P<0.05). There were no significant differences in the expressions of p62 expressions between different groups of cells. Conclusion: Overexpression of miR-18a can enhance the radiosensitivities of NPC cells by targeting ATM to abrogate G1/S, G2/M arrest and to induce autophagy and apoptosis.

Investigation on present status and problem analysis of standardized patients and standardized patient educators in China / 中华医学教育探索杂志

Objective:To investigate the current situation of standardized patient programs and standardized patient educators in China, and to analyze the existing problems in the implementation.Methods:Questionnaire survey was used in this study. The questionnaire was made by Delphi method, and distributed via E-mails or through the internet to medical colleges, affiliated hospitals and general hospitals across the country. Microsoft Office Excel 2016 was used for data reduction and analysis and cartography.Results:A total of 94 medical colleges and hospitals of 27 provinces and municipalities participated in the survey, of which 43.62% had carried out standardized patient programs. The primary factor affecting the program implementation was the lack of standardized patient educators. The existing trainers were mainly clinicians or nurses, and the main way of training the educators was to send them to other universities for learning. A majority of respondents (94.68%) think it is necessary to establish and formulate a unified national certification system for standardized patient educators.Conclusion:The development of standardized patient program is unbalanced in China, and the lack of standardized patient educators has become the primary factor restricting the development. In order to make standardized patients a greater role in medical education, we should encourage different types of personnel to join in the standardized patient training team, to clarify the responsibilities of standardized patient educators, to standardize the process of trainers training, and to establish the certification system of standardized patient educators.

Ganoderma lucidum polysaccharides promote T lymphocyte infiltration into tumor by regulating expression of ICAM-1 in endothelial cells / 中国中药杂志

Polysaccharide is among the main active components of Ganoderma lucidum for tumor prevention and treatment. Howe-ver, it remains unclear whether it has synergy with tumor immunotherapy. This study evaluated the effect of G. lucidum polysaccharides(GLP) on the infiltration of T lymphocytes into tumor and the underlying mechanism, in order to provide a reference for its application in tumor immunotherapy. GLP were prepared by water extraction and alcohol precipitation combined with Sevag method and then given(intraperitoneal injection) to the mice bearing B16-F10 cells at 25, 50 and 100 mg kg~(-1), respectively, to evaluate the effect on tumor growth. The infiltration of CD3~+ and CD8~+ T cells and the expression of intercellular cell adhesion molecule-1(ICAM-1) in tumor were detected by immunohistochemistry. EA.hy926 cells were treated with 50, 100 and 200 μg·mL~(-1) GLP, and the expression of ICAM-1 was determined by Western blot. The adhesion of EA.hy926 cells treated with GLP was measured with fluorescence-labeled Jurkat cells. To analyze the mechanism based on NF-κB pathway, this study determined the protein levels of nuclear factor kappa-B(NF-κB) p65, alpha inhibitor of NF-κB(IκBα), p-NF-κB p65 and p-IκBα by Western blot. The results showed that GLP can significantly inhibit the tumor growth in mice bearing B16-F10 cells, promote the infiltration of CD3~+ and CD8~+ T cells in tumor, and increase the expression of ICAM-1 in tumor. Meanwhile, GLP could also enhance the expression of ICAM-1 in EA.hy926 cells, thus strengthen the adhesion to Jurkat cells, induce phosphorylation and protein degradation of IκBα, and raise the expression and phosphorylation level of NF-κB p65. These results suggested that GLP could promote the expression of ICAM-1 through NF-κB pathway and further enhance the infiltration of T lymphocytes into tumor, thereby inhibiting tumor growth. This study lays a foundation for the further application of GLP in tumor immunotherapy.

Performance verification of a time-of-flight mass spectrometry based cardiovascular drug-related polygene detection system / 中华检验医学杂志

Objective@#Toestablish and verify the method of genetic polymorphisms using time-of-flight mass spectrometry as a polygene testing platform.@*Methods@#998 cases of DNA samples and 20 cases of whole blood samples were collected from Fuwai hospital of Chinese academy of medical sciencesduring September 2017 to October 2018, including 512 cases of males and 506 cases of females.280 patients aged 18-30, 442 patients aged 31-64, and 296 patients aged ≥65.11 cardiovascular drugsrelatedgenes in 998 DNA samples were detected by time-of-flight mass spectrometry to evaluate the compliance rate compared with identifiedresults. 20whole blood samples were selected to detect 11 genes using both time-of-flight mass spectrometry and Sanger sequencing. The results were compared twice, and accuracy was evaluated according to Sanger sequencing as the gold standard. Ten cases of genomic DNA with wild-type loci were selected for specific evaluation by time-of-flight mass spectrometry. Samples containing all heterozygous genotypes were measured after gradient dilution to evaluate the detection sensitivity of the new method. Samples containing all 49 genotypes (two genotypes were not found because they are rare in Chinese population) were used in order to do the inter-assay and intra-assay precision evaluation. An anti-interference study was performed by selecting wild and homozygous mutant samples of represented heterozygous peak shape.@*Results@#The results showed that the compliancerate of the single retrospective sample was over 99.5%. The resultsof time-of-flight mass spectrometry and Sanger sequencing was the same. The minimum detection limit of DNA was 0.4 ng, the inter-assay and intra-assay precision were 100%, and the degradation ability of the UNG enzyme was 105 copies/μl in aerosol.The reaction system has a strong anti-interference ability to the genome and intermediate aerosol, and no cross-contamination between different matrices of the chip.@*Conclusions@#The time-of-flight mass spectrometry as a polygene detection system shows agood detection performance and can be applied to clinical detection. In addition, this paper established a performance verification research scheme based on the time-of-flight mass spectrometry platform polygene detection system.

Exploration of training mode for postgraduate education in local universities under the Background of "double first-class" construction / 中华医学教育探索杂志

First-class education for postgraduate is the foundation for the construction of "double first-class" education. Universities play an important role in postgraduate education. This paper explored the measures for the reform and innovation of the construction of "double first-class" education for postgraduate students in our university, which include perfecting the supervisor's responsibility and authority mechanism, deepening the reform on curriculum system, strengthening the construction of sharing platform, and improving the evaluation mechanism of training quality and so on. In conclusion, initial achievement from the reform and innovation of training mode was observed, which provides a useful reference for the construction of "double first-class" education for local universities.

Evaluation of urine free and fractionated catecholamine metabolites in the diagnosis of pheochromocytoma / 中华检验医学杂志

Objective:The diagnostic values of urine free and fractionated catecholamine metabolites (including metanephrine MN and normetanephrine NMN, usually known as MNs) were established and their clinical value was evaluated.Methods:Using high performance liquid chromatography tandem mass spectrometry(HPLC-MS/MS), urine free MNs (f-MN, f-NMN) and fractionated MNs(t-MN, t-NMN) from 180 cases of non-pheochromocytoma and 54 cases of pheochromocytoma (PCC)patients were detected respectively.Receiver operating characteristic curve (ROC) was used to establish clinical reference cut-off value for different forms of MNs, and diagnostic efficacy of free, fractionated and total MNs was evaluated.Results:(1) The cut-off values of f-MN, f-NMN, t-MN and t-NMN were 47.8 μg/24 h, 52.3 μg/24 h, 224.9 μg/24 h and 664 μg/24 h, respectively. The cut-off values of total f-MNs and total t-MNs were 126 μg/24 h and 1 070 μg/24 h, respectively. (2) The correlation between f-MN and t-MN ( r=0.976, P<0.001), f-NMN and t-NMN ( r=0.940, P<0.001) was good. The area under ROC curve(AUC)of f-MN was lower than that of t-MN(0.579 vs 0.730, P<0.001), the sensitivity was slightly lower than that of t-MN((37.01% vs 51.85%, P=0.036), and the specificity was similar (99.44% vs 96.67%, P>0.05). There was no significant difference in sensitivity (90.74% vs 92.59%, P>0.05), specificity (99.44% vs 96.67%, P>0.05) and AUC (0.944 vs 0.959, P>0.05) between f-NMN and t-NMN. The combined diagnostic value of MN and NMN (total MNs) was higher than MN (free type:0.932>0.579, fractionation type: 0.960>0.730), which was similar to NMN. Conclusions:The diagnostic performance of urine free NMN or total MNs for PCC is similar to that of fractionated typewhich can meet the clinical needs.With few influencing factors, free type MNs may be used as an alternative indicator for PCC screening in the future.

Performance verification of a time-of-flight mass spectrometry based cardiovascular drug-related polygene detection system / 中华检验医学杂志

Objective:Toestablish and verify the method of genetic polymorphisms using time-of-flight mass spectrometry as a polygene testing platform.Methods:998 cases of DNA samples and 20 cases of whole blood samples were collected from Fuwai hospital of Chinese academy of medical sciencesduring September 2017 to October 2018, including 512 cases of males and 506 cases of females.280 patients aged 18-30, 442 patients aged 31-64, and 296 patients aged ≥65.11 cardiovascular drugsrelatedgenes in 998 DNA samples were detected by time-of-flight mass spectrometry to evaluate the compliance rate compared with identifiedresults. 20whole blood samples were selected to detect 11 genes using both time-of-flight mass spectrometry and Sanger sequencing. The results were compared twice, and accuracy was evaluated according to Sanger sequencing as the gold standard. Ten cases of genomic DNA with wild-type loci were selected for specific evaluation by time-of-flight mass spectrometry. Samples containing all heterozygous genotypes were measured after gradient dilution to evaluate the detection sensitivity of the new method. Samples containing all 49 genotypes (two genotypes were not found because they are rare in Chinese population) were used in order to do the inter-assay and intra-assay precision evaluation. An anti-interference study was performed by selecting wild and homozygous mutant samples of represented heterozygous peak shape.Results:The results showed that the compliancerate of the single retrospective sample was over 99.5%. The resultsof time-of-flight mass spectrometry and Sanger sequencing was the same. The minimum detection limit of DNA was 0.4 ng, the inter-assay and intra-assay precision were 100%, and the degradation ability of the UNG enzyme was 10 5 copies/μl in aerosol.The reaction system has a strong anti-interference ability to the genome and intermediate aerosol, and no cross-contamination between different matrices of the chip. Conclusions:The time-of-flight mass spectrometry as a polygene detection system shows agood detection performance and can be applied to clinical detection. In addition, this paper established a performance verification research scheme based on the time-of-flight mass spectrometry platform polygene detection system.

Contribution of NOD2 signal pathway to Chlamydia pneumonia Cpn0423-induced inflammatory response / 中华微生物学和免疫学杂志

Objective:To understand and determine the biological properties of Chlamydia pneumonia (Cpn) hypothetical protein Cpn0423 and the mechanisms of which involved in Cpn0423-induced inflammatory response. Methods:The biological properties of Cpn0423 gene were analyzed using bioinformatic software. The subcellular localization of nucleotide-binding oligomerization domain-like receptor 2 (NOD2) in bone marrow-derived macrophages (BMDMs) was detected by confocal microscope. NOD2-siRNA was used to inhibit the expression of NOD2 at mRNA level. Cpn0423-induced macrophage inflammatory protein 2 (MIP-2) and IL-6 production in BMDMs were detected by ELISA. PCR was performed to detect Cpn0423 DNA in bronchoalveolar lavage fluid (BALF) of Cpn-positive patients.Results:The homology between Cpn0423 and other type Ⅲ secretion system effector proteins of Chlamydia ranged from 85% to 93%. NOD2-siRNA could effectively inhibit the expression of NOD2 at mRNA level in BMDMs ( P<0.001). Moreover, Cpn0423-induced production of MIP-2 [(920.5±99.1) pg/ml vs (130.1±11.5) pg/ml, P<0.001] and IL-6 [(266.2±58.4) pg/ml vs (165.7±21.5) pg/ml, P<0.001] in BMDMs were decreased following NOD2-siRNA pre-treatment. Cpn0423 DNA was detected in the BAlF of 83.3% (10/12) of Cpn-positive cases, but not in Cpn-negative cases. Conclusions:Cpn0423 induced inflammatory response in host cells through NOD2 pathway, which was closely related to the chronic inflammatory injury caused by Cpn.

Epidemiological analysis of aggregative vomiting and diarrhea outbreak in Jing'an District of Shanghai, 2017-2018 / 公共卫生与预防医学

Objective To analyze the epidemiological characteristics of aggregative vomiting and diarrhea outbreak in Jing'an District of Shanghai in 2017 and 2018，and provide data support for further development of effective prevention and control measures. Methods A descriptive epidemiological method was used to analyze aggregative vomiting and diarrhea outbreak data in Jing'an District in 2017 and 2018. Results A total of 49 outbreaks were reported in Jing'an District in 2017 and 2018，involving 565 cases，with the overall attack rate of 1.89%. The median duration of the outbreak was 5 days and outbreaks mainly occurred in spring and autumn. The attack rate in kindergartens was higher than that in primary and secondary schools, while the total number of outbreak cases in kindergartens was less. The main clinical symptoms of the cases were vomiting, with a higher proportion than that of diarrhea and fever. The vomiting proportion was higher in kindergartens and elementary schools, while the diarrhea proportion was higher in middle schools. Conclusion There were some differences in the epidemic characteristics between kindergartens and primary and secondary schools, therefore different control measures should be adopted according to the characteristics of different institutions. The outbreaks were mainly spread through human-to-human transmission. Early detection and early reporting of epidemics in collective institutions had a positive impact on the control of the spread of the epidemic.

Research on the CP-RNFL thickness and optic nerve head and macular parameters differences between ocular hypertension patients with different CCT and normal subjects using 3D-OCT / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To compare the differences of CP-RNFL, optic nerve head(ONH)and macular parameters between ocular hypertension(OHT)patients with different central corneal thickness(CCT)and normal subjects using three dimensional optical coherence tomography(3D-OCT). <p>METHODS: This is a prospective study including 124 eyes of 77 OHT patients classified as group 1(CCT<555μm)including 38 eyes of 25 patients, group 2(CCT 555-590μm)including 44 eyes of 26 patients and group 3(CCT>590μm)including 42 eyes of 26 patients according to CCT. Totally 124 eyes of 77 normal healthy subjects, matching patients with age and gender, were divided into group four. The CP-RNFL thickness,optic nerve head and macular parameters were measured by 3D-OCT. There were no significant difference in gender, age between four groups and in intraocular pressure among three OHT patients groups. <p>RESULTS: The optic rim area was significantly smaller in group one than in other three groups, and the thickness of inferior CP-RNFL was significantly thinner than group two and group three, while the thickness of the temporal inner ring of macular was thinner than group three. All the thickness of the central fovea, macular center 1mm, the temporal inner ring of macular in OHT patients were significantly thinner than healthy subjects. The CCT and the rim area in OHT patients were significantly positively correlated. <p>CONCLUSION: The OHT patients are considered to be different from normal persons in optic nerve head and macular parameters though the parameters are still in normal range. CCT<555μm may be a risk factor of OHT patients converting to POAG, so we should pay more attention to following up these patients and intervention in time.

Influence of percutaneous coronary intervention on T-wave peak-end interval in coronary heart disease patients and its warning value on sudden cardiac death / 中国基层医药

Objective@#To investigate the influence of percutaneous coronary intervention on T-wave peak-to-interval and its value of early warning of sudden cardiac death in patients with coronary artery disease.@*Methods@#From January 2013 to December 2014, 90 patients with coronary heart disease who underwent percutaneous coronary intervention in the Second Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine were selected as observation group.And at the same time, 90 patients with normal coronary angiography in our hospital were selected as control group.Tp-Te (T-wave peak to end-time limit in ECG) and Tp-Te/QT (Tp-Te) were compared between the observation group and the control group.The ratio of the period to the QT interval, Tp-Te/ (heart rate corrected T-peak period), Tp-Te, Tp-Te/QT, Tp-Te/ before and after treatment in the observation group, and treatment Tp-Te, Tp-Te/QT, Tp-Te/ in the group with and without ventricular arrhythmia and sudden cardiac death were observed.@*Results@#Before treatment, the Tp-Te[(116.47±26.81)ms], Tp-Te/QT[(0.29±0.06)] and Tp-Te/[(131.78±36.23)ms] in the observation group were higher than those in the control group -Te(78.69±22.73)ms, Tp-Te/QT (0.21±0.04), Tp-Te/ (100.49±32.96)ms] (t=10.197, 10.525, 6.061, all P<0.05). After treatment, the Tp-Te[(94.78±11.34)ms], Tp-Te/QT[(0.24±0.04)], Tp-Te/[(108.62±20.18)ms] in the observation group were lower than those before treatment (t=7.069, 6.558, 5.298, all P<0.05). At 6 months after operation, the Tp-Te and Tp-Te/ were significantly lower than postoperative 24h[(99.89±21.64)ms, (117.35±32.47)ms](t=1.984, 2.166, all P<0.05). After treatment, the Tp-Te[(118.87±30.92)ms], Tp-Te/QT [(0.29±0.08)], and Tp-Te/[(135.73±37.29)ms] in ventricular arrhythmia patients with sudden cardiac death were higher than those without sudden cardiac death[(95.13±26.38)ms, (0.25±0.06), (106.36±30.14)ms] (t=3.012, 2.171, 3.226, all P<0.05).@*Conclusion@#T-Te, Tp-Te/QT, Tp-Te/ T-peak peak-to-interphase indicators can be used to predict the degree of coronary artery ischemia and disease, but also for cardiovascular diseases such as ventricular arrhythmias and sudden cardiac death.The index adverse events play a certain role in early warning and have clinical research value.