Interpretation of the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030) / 中国血吸虫病防治杂志

On June 16, 2023, National Disease Control and Prevention Administration of the People’s Republic of China, in collaboration with other ministries, formulated and issued the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030). The implementation of this plan provides an important basis for achieving the targets set in the “Healthy China 2030” action plan and the implementation of the rural revitalization strategy. This paper describes the background, principles, targets, control strategies, safeguard measures and effectiveness evaluation of the plan, in order to guide the scientific and standardized implementation of actions for schistosomiasis elimination at the grassroots level, and facilitate the progress towards elimination of schistosomiasis in China with a high quality.

Clinicopathological Features and Prognosis of Patients Newly Diagnosed With Lung Adenocarcinoma With Both EGFR Mutation and C-MET Amplification / 中国医学科学院学报

Objective To explore the clinicopathological features and prognosis of the patients newly diagnosed with lung adenocarcinoma with both EGFR mutation and C-MET amplification.Methods The pathological sections were reviewed.EGFR mutation was detected by amplification refractory mutation system-quantitative real-time polymerase chain reaction,and C-MET amplification by fluorescence in situ hybridization.The clinicopathological features and survival data of the patients newly diagnosed with lung adenocarcinoma with both EGFR mutation and C-MET amplification were analyzed retrospectively.Results In 11 cases of EGFR mutation combined with C-MET amplification,complex glands and solid high-grade components were observed under a microscope in 10 cases except for one case with a cell block,the tissue structure of which was difficult to be evaluated.The incidence of lung adenocarcinoma in the patients with EGFR mutation combined with C-MET amplification at clinical stage Ⅳ was higher than that in the EGFR mutation or C-MET amplification group (all P<0.001),whereas the difference was not statistically significant between the EGFR mutation group and C-MET amplification group at each clinical stage (all P>0.05).There was no significant difference in the trend of survival rate between EGFR gene group and C-MET amplification group (χ2=0.042,P=0.838),while the survival of the patients with EGFR mutation combined with C-MET amplification was worse than that of the patients with EGFR mutation (χ2=246.72,P<0.001) or C-MET amplification (χ2=236.41,P<0.001).Conclusions The patients newly diagnosed with lung adenocarcinoma with EGFR mutation plus C-MET amplification demonstrate poor histological differentiation,rapid progress,and poor prognosis.The patients are often in the advanced stage when being diagnosed with cancer.Attention should be paid to this concurrent adverse driving molecular event in clinical work.With increasing availability,the inhibitors targeting C-MET may serve as an option to benefit these patients in the near future.

Core in jingjin diagnosis and treatment: yizhi weishu / 中国针灸

Jingjin (muscle region of meridian) is a distal diagnosis and treatment system of the sinew/fascia disorders on the base of the concept of jin in TCM. Jin should be a particular palpable structure rather than a single anatomic structure with a specific distributing course. Yizhi weishu refers to a idea running through the whole process of diagnosis and treatment of sinew/fascia disorders, in which, the results, obtained by the overall observation and palpation of patient's sinew/fascia structure, are taken as the criteria of treatment. Yitong weishu (taking the sites of sensitivity or tenderness as the points) verifies this idea in practice. Under the guidance of yizhi weishu, through identifying the primary from the secondary, and regulating yin and yang, the spasticity and flaccidity of sinews/fascia can be cured and the induced diseases treated. The diagnosis and treatment system of jingjin, based on yizhi weishu, develops the original jingjin theory with vague concept involved, formulates a systematic thinking of treatment for sinew/fascia disorders and provides a new approach to clinical treatment.

A Novel Early Warning Model for Hand, Foot and Mouth Disease Prediction Based on a Graph Convolutional Network / 生物医学与环境科学（英文）

Objectives@#Hand, foot and mouth disease (HFMD) is a widespread infectious disease that causes a significant disease burden on society. To achieve early intervention and to prevent outbreaks of disease, we propose a novel warning model that can accurately predict the incidence of HFMD.@*Methods@#We propose a spatial-temporal graph convolutional network (STGCN) that combines spatial factors for surrounding cities with historical incidence over a certain time period to predict the future occurrence of HFMD in Guangdong and Shandong between 2011 and 2019. The 2011-2018 data served as the training and verification set, while data from 2019 served as the prediction set. Six important parameters were selected and verified in this model and the deviation was displayed by the root mean square error and the mean absolute error.@*Results@#As the first application using a STGCN for disease forecasting, we succeeded in accurately predicting the incidence of HFMD over a 12-week period at the prefecture level, especially for cities of significant concern.@*Conclusions@#This model provides a novel approach for infectious disease prediction and may help health administrative departments implement effective control measures up to 3 months in advance, which may significantly reduce the morbidity associated with HFMD in the future.

Effect of Shaolin internal qigong exercise on the surface electromyography signals of shoulder muscle groups in patients with capsulitis of the shoulder / 针灸推拿医学（英文版）

Objective: To unveil the efficacy of Shaolin internal qigong exercise in treating capsulitis of the shoulder (CS) and explore objective outcome measures by observing the changes in the surface electromyography (sEMG) signals of shoulder muscle groups after regular practice of Shaolin internal qigong exercise in CS patients. Methods: Sixty CS patients were randomized into two groups by the random number table method, with 30 cases in each group. Patients in the qigong group practiced Shaolin internal qigong exercise on a regular basis, while patients in the electroacupuncture (EA) group received EA treatment. Before and after treatment, the sEMG signals of six muscles, i.e. biceps brachii, triceps brachii, deltoid, pectoralis major, latissimus dorsi and trapezius muscles, of the affected side were recorded at 45° abduction of the shoulder, 60° forward flexion and 90° internal rotation with the elbow flexed during maximal isometric contraction, and the integrated electromyography (iEMG) of each muscle was calculated. Results: The total effective rate was 93.3％ in the qigong group, higher than 83.3％ in the EA group (P<0.05). Intra-group comparison showed that the iEMG of biceps brachii, triceps brachii, pectoralis major and deltoid muscles in the qigong group increased significantly after intervention at 45° abduction of the shoulder, 60° forward flexion and 90° internal rotation with the elbow flexed (all P<0.05), and the iEMG of trapezius and latissimus dorsi muscles decreased (both P<0.05); in the EA group, the iEMG of biceps brachii, pectoralis major and deltoid muscles increased significantly during contraction (all P<0.05), while the iEMG of triceps brachii, trapezius and latissimus dorsi muscles had no significant changes (all P>0.05). After intervention, there were significant differences in the iEMG of most of muscles between the two groups (all P<0.05), except for the iEMG of deltoid muscle at 45° of abduction of the shoulder joint during isometric contraction (P>0.05). Conclusion: Shaolin internal qigong exercise can effectively increase the motion intensity of the biceps brachii, triceps brachii, pectoralis major and deltoid muscles and reduce the compensation of the latissimus dorsi and trapezius muscles in CS patients; compared with EA, it produces a better result in improving the coordination and stability in shoulder joint movements.

Effect of acupuncture on oxidative stress and apoptosis-related proteins in obese mice induced by high-fat diet / 中国针灸

OBJECTIVE@#To explore the effect of acupuncture on oxidative stress and apoptosis-related proteins of liver in obese mice induced by high-fat diet.@*METHODS@#A total of 45 male C57BL/6 mice were randomized into a control group (10 mice) and a model established group (35 mice). Mice in the model established group were fed with high-fat diet for 16 weeks to establish the obesity model. After model established, 30 mice were randomized into a model group, a non-acupoint group and an acupoint group, 10 mice in each one. Acupuncture was applied at "Guanyuan" (CV 4), " Zusanli" (ST 36), "Yishu" (EX-B 3) in the acupoint group and the points of 0.5 cm and 1 cm to the base of tail in the non-acupoint group, 15 min each time, once a day for 8 weeks. Mice in the control group were fed with normal diet, while mice in the other 3 groups were fed with high-fat diet continuously for 8 weeks. The body weight was measured at 0, 4th, 8th, 12th, 16th, 20th, 24th week in each group respectively. After 24-week intervention, the weight of white adipose tissue of epididymis and perirenal and liver was measured; the levels of serum alanine transaminase(ALT) and glutamic oxaloacetic aminotransferase (AST) were detected by automatic biochemical analyzer; liver homogenate was used to detect the level of malondialdehyde (MDA) and the activity of superoxide dismutase (SOD); the liver morphology was observed by HE staining; the expression of apoptosis-related proteins Bax and Bcl-2 were detected by Western blot.@*RESULTS@#Compared with the control group, the body weight of mice in the model group, the acupoint group and the non-acupoint group was decreased on 16th week into experiment (before intervention, <0.05); compared with the model group and the non-acupoint group, the body weight of mice in the acupoint group were decreased after intervention (<0.05). Compared with the control group, the weight of white adipose tissue and liver, the levels of serum ALT and AST, the level of liver MDA, the expression of liver Bax were increased (<0.05); the activity of liver SOD and the expression of liver Bcl-2 were decreased in the model group after intervention (<0.05). Compared with the model group and the non-acupoint group, the weight of white adipose tissue and liver, the levels of serum ALT and AST, the level of liver MDA, the expression of liver Bax were decreased (<0.05); the activity of liver SOD and the expression of liver Bcl-2 were increased in the acupoint group after intervention (<0.05).@*CONCLUSION@#Acupuncture at "Guanyuan" (CV 4), "Zusanli" (ST 36) and "Yishu"(EX-B 3) can improve obesity and obesity related hepatic disorder by regulating oxidative stress and inhibiting apoptosis in liver.

Network meta-analysis on the effects of the acupuncture-related therapy on ovulation rate and pregnancy rate in patients with polycystic ovary syndrome / 中国针灸

OBJECTIVE@#To review systematically the safety and effectiveness of acupuncture-related therapies on ovulation rate and pregnancy rate in patients with polycystic ovary syndrome (PCOS).@*METHODS@#From PubMed, EMbase, the Cochrane Library, China Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI), Wanfang database and VIP database, the randomized controlled trials (RCTs) on PCOS were retrieved in the period from the date of database establishment to January 8, 2018. Two researchers screened the articles, extracted the data and assessed the bias risk of the eligible trials independently. Using Stata 13.0 and WinBUGS 1.4.3 software, the data were analyzed.@*RESULTS@#A total of 39 RCTs were collected, including 4605 cases of PCOS and 14 kinds of acupuncture-related therapies and the comprehensive therapies. The short-term therapeutic effects were observed. The results of mesh meta-analysis showed: regarding the ovulation rate, the effects of the acupuncture-medication therapy were better than western medication. The top 6 therapeutic measures were the treatment with acupoint thread-embedding therapy and medication (93.3%), the treatment with moxibustion and Chinese herbal medicine (91.4%), moxibustion (74.5%), the treatment with acupuncture and medication (65.7%), the treatment with acupuncture-moxibustion and auricular point therapy (61.9%) and the treatment with acupuncture and auricular point therapy (49.6%). Regarding the pregnancy rate, the effects of the acupuncture-medication therapy were better than western medication. The top 6 therapeutic measures were the treatment with acupuncture and auricular point therapy (91.5%), the treatment with moxibustion and Chinese herbal medication (86.9%), the treatment with acupuncture-moxibustion and auricular point therapy (81.1%), the treatment with acupoint thread-embedding therapy and medication (69.4%), the treatment with acupuncture and medication (66.1%) and the treatment with placebo and western medication (58.7%).@*CONCLUSION@#Among acupuncture-related therapies, the combined treatment is more advantageous than single therapy and its safety is superior to western medication. The combined therapies are various in advantages. Because of the limitation of the present researches, it needs a large scale of RCTs with rational design, high quality and proper methods to verify this research conclusion.

Assessment of ability of professionals in parasitic disease control and prevention techniques in China, 2017 / 中国血吸虫病防治杂志

Objective To understand the professional theory, prevention and control practice, experimental diagnosis and other technical skills of parasitic diseases among technicians of all levels of disease control and prevention institutions, so as to provide the evidence for strengthening the capacity building of Chinese professional personnel. Methods According to the method of recommendation at all levels, the subjects from disease control and prevention institutions at province, prefecture or county levels were chosen to assess the theory of parasitic diseases and test operation skills by using the method of answering the questions together with on-site operations in China. A database was built consisting of subjects’ basic information and assessment scores. By using the method of hierarchical classification, the scores by gender, age, professional title, institutions and places of participants were analyzed. Results A total of 124 professions in prevention and treatment of parasitic diseases in 31 provinces (cities and regions) were evaluated in China. The average total score of all the subjects was 125.0 ± 35.2, with a passing rate of 54.8%. The average scores of male subjects and female subjects were 120.8 ± 34.2 and 126.6 ± 35.4 respectively; the average scores of the subjects aged under 30 years, between 30 and 40 years, and above 40 years were 125.6 ± 33.6, 124.9 ± 35.8, and 119.3 ± 45.9 respectively; the average scores of persons with junior, intermediate and senior professional titles were 119.8 ± 35.8, 136.0 ± 32.5 and 127.1 ± 40.9 respectively. The average theoretical assessment score of all the subjects was 67.4 ± 15.6, with a passing rate of 68.5%. The average practical skill assessment score of all the subjects was 57.6 ± 21.8, with a passing rate of 46.0%. The average detection rates of Plasmodium falciparum, P. vivax, P. ovale and P. malariae in endemic and non-endemic areas were 64.1%, 72.8%, 57.0%, 58.3% and 35.9%, 46.9%, 33.3%, 43.8%, respectively. The detection ability of professionals in endemic areas was significantly higher than that in non-endemic areas (χ2 = 767.10, 462.12, 134.97 and 360.80, respectively, all P < 0.01). The total detection rate of schistosome eggs was 48.7%, and the detection rates of schistosome eggs were 67.4% and 36.8% in endemic and non-endemic areas, respectively. The detection ability of professionals in endemic areas was significantly higher than that in non-endemic areas (χ2 = 817.74, P < 0.01). The detection rates of Ascaris lumbricoides, Trichuris trichiura, and Enterobius vermicularis were 85.7%, 78.6%, 91.7%, and 61.8%, 23.5% and 74.4% in the technicians in southern region and northern region of China, showing significant differences (χ2 = 622.58, 301.70 and 588.71, respectively, all P < 0.01). Conclusions The overall results of the subjects are good, but the technical operation capability of them is relatively low. Therefore, the specific training based on daily work needs should be enhanced. In addition, we should attach importance to talent cultivation and technical reserve, and strengthen the construction of the team, so as to meet the needs of the prevention and control of parasitic diseases.

Assessment of ability of professionals in parasitic disease control and prevention techniques in China, 2017 / 中国血吸虫病防治杂志

Objective To understand the professional theory, prevention and control practice, experimental diagnosis and other technical skills of parasitic diseases among technicians of all levels of disease control and prevention institutions, so as to provide the evidence for strengthening the capacity building of Chinese professional personnel. Methods According to the method of recommendation at all levels, the subjects from disease control and prevention institutions at province, prefecture or county levels were chosen to assess the theory of parasitic diseases and test operation skills by using the method of answering the questions together with on-site operations in China. A database was built consisting of subjects’ basic information and assessment scores. By using the method of hierarchical classification, the scores by gender, age, professional title, institutions and places of participants were analyzed. Results A total of 124 professions in prevention and treatment of parasitic diseases in 31 provinces (cities and regions) were evaluated in China. The average total score of all the subjects was 125.0 ± 35.2, with a passing rate of 54.8%. The average scores of male subjects and female subjects were 120.8 ± 34.2 and 126.6 ± 35.4 respectively; the average scores of the subjects aged under 30 years, between 30 and 40 years, and above 40 years were 125.6 ± 33.6, 124.9 ± 35.8, and 119.3 ± 45.9 respectively; the average scores of persons with junior, intermediate and senior professional titles were 119.8 ± 35.8, 136.0 ± 32.5 and 127.1 ± 40.9 respectively. The average theoretical assessment score of all the subjects was 67.4 ± 15.6, with a passing rate of 68.5%. The average practical skill assessment score of all the subjects was 57.6 ± 21.8, with a passing rate of 46.0%. The average detection rates of Plasmodium falciparum, P. vivax, P. ovale and P. malariae in endemic and non-endemic areas were 64.1%, 72.8%, 57.0%, 58.3% and 35.9%, 46.9%, 33.3%, 43.8%, respectively. The detection ability of professionals in endemic areas was significantly higher than that in non-endemic areas (χ2 = 767.10, 462.12, 134.97 and 360.80, respectively, all P < 0.01). The total detection rate of schistosome eggs was 48.7%, and the detection rates of schistosome eggs were 67.4% and 36.8% in endemic and non-endemic areas, respectively. The detection ability of professionals in endemic areas was significantly higher than that in non-endemic areas (χ2 = 817.74, P < 0.01). The detection rates of Ascaris lumbricoides, Trichuris trichiura, and Enterobius vermicularis were 85.7%, 78.6%, 91.7%, and 61.8%, 23.5% and 74.4% in the technicians in southern region and northern region of China, showing significant differences (χ2 = 622.58, 301.70 and 588.71, respectively, all P < 0.01). Conclusions The overall results of the subjects are good, but the technical operation capability of them is relatively low. Therefore, the specific training based on daily work needs should be enhanced. In addition, we should attach importance to talent cultivation and technical reserve, and strengthen the construction of the team, so as to meet the needs of the prevention and control of parasitic diseases.

Qidong Chronic Hepatitis B Cohort: participants enrollment and comparison of baseline characteristics by gender stratification / 中华流行病学杂志

Objective To establish a study cohort of chronic hepatitis B (CHB) in Qidong and evaluate its baseline characteristics. Methods CHB outpatients of the Third People's Hospital of Qidong were invited to participate in baseline survey from January 1, 2016, including questionnaire survey, liver function detection, serum detection of HBV infection and upper abdomen ultrasound detection. Anticipated sample size was at least one thousand. Baseline data were inputted by EpiData 3.1 software and then cleaned and analyzed by SAS 9.3 software. Results As of 18 July, 2016, a total of 1006 participants had been enrolled into the current study, including 615 males with an average age of (44.26±9.97) years and 391 females with an average age of (46.66±11.17) years. The difference in family history of liver disease was not significant between males and females (P>0.05), while the differences in other key information, such as age, education level, tobacco consumption, alcohol drinking, tea consumption, and antiviral intervention, were significant between males and females (P<0.05). Among the key clinical parameters, such as ALT, HBeAg, HBsAg, HBV DNA, albumin, and width of splenic vein and portal vein, only the abnormal rates of ALT and total bilirubin levels were higher in males than in females, the difference was significant (P<0.05). Conclusion Outpatient department-based CHB cohort was established successfully in Qidong, and sub-cohort could be divided according to the differences on baseline characteristics.

Qidong Chronic Hepatitis B Cohort: participants enrollment and comparison of baseline characteristics by gender stratification / 中华流行病学杂志

Objective To establish a study cohort of chronic hepatitis B (CHB) in Qidong and evaluate its baseline characteristics. Methods CHB outpatients of the Third People's Hospital of Qidong were invited to participate in baseline survey from January 1, 2016, including questionnaire survey, liver function detection, serum detection of HBV infection and upper abdomen ultrasound detection. Anticipated sample size was at least one thousand. Baseline data were inputted by EpiData 3.1 software and then cleaned and analyzed by SAS 9.3 software. Results As of 18 July, 2016, a total of 1006 participants had been enrolled into the current study, including 615 males with an average age of (44.26±9.97) years and 391 females with an average age of (46.66±11.17) years. The difference in family history of liver disease was not significant between males and females (P>0.05), while the differences in other key information, such as age, education level, tobacco consumption, alcohol drinking, tea consumption, and antiviral intervention, were significant between males and females (P<0.05). Among the key clinical parameters, such as ALT, HBeAg, HBsAg, HBV DNA, albumin, and width of splenic vein and portal vein, only the abnormal rates of ALT and total bilirubin levels were higher in males than in females, the difference was significant (P<0.05). Conclusion Outpatient department-based CHB cohort was established successfully in Qidong, and sub-cohort could be divided according to the differences on baseline characteristics.

Investigation on malaria knowledge and demands on related training for CDC staff in Qinghai Province，China / 中国血吸虫病防治杂志

@#Objective To investigate the malaria knowledge of CDC staff and their demands on related training in malaria non⁃endemic areas，so as to provide the reference for planning the appropriate curriculum. Methods All the participants who were the staff of county CDCs all over Qinghai Province and attended the provincial training workshop were surveyed. A self⁃administered questionnaire survey was carried out and the data was statistically analyzed. Results A total of 115 participants were involved in this survey. They were mostly（85.21%）from county CDCs. The general knowledge of malaria among the respondents was well，and the average rate of correct answers was 70.35%. However，the answers to the general knowledge of malaria and anti⁃malaria treatment were not well enough. The rates of correct answers were 61.96% and 48.99% respectively. The differences among the groups of job title ranking，department of working and level of CDC were not significant（F = 0.13-2.02，all P > 0.05）. The number of correct answers was significantly increased after the training course. The average score after the training was 79.20±15.16 while the pre⁃training score was 70.34±17.46（t = 3.86，P < 0.05），especially in the answers to general malaria knowledge and malaria surveillance and response（t = 4.30，4.97，both P < 0.05）. The general knowledge of malaria was considered as the most need of training as 80% of the respondents voted“Yes”，according to the demand analysis. There was no significant difference among the different groups（F = 0.61-3.11，both P > 0.05）. Conclusion The malaria knowledge is well mastered by the staff of CDCs in Qinghai Province，and the further training courses are requested and addressed in the target areas such as general malaria knowledge，anti⁃malaria treatment，malaria surveillance and response.

Cervical Infection of Oncogenic Human Papillomavirus (HPV) Types in Beijing, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This study was designed to determine the prevalence of oncogenic human papillomavirus (HPV) in cervical infections in Beijing, China, and to investigate the odds ratio (OR) of HPV single and multiple infections in abnormal cytology.</p><p><b>METHODS</b>A total of 19,018 specimens from outpatients in the department of obstetric and gynecology were collected. They were detected using high-risk HPV genotyping real-time polymerase chain reaction (PCR) kit and analyzed by ThinPrep cytology test for cervical pathological diagnosis. HPV prevalence, age-specific prevalence, and OR of each type of HPV in abnormal cytology were analyzed.</p><p><b>RESULTS</b>Overall, 19.1% (3,623/19,018) of the individuals were positive for HPV infection, 14.9% (2,833/19,018) were positive for a single HPV type, and 4.2% (790/19,018) were positive for multiple types. Among the 3,623 HPV-positive individuals, the most predominant HPV types were HPV52 (4.4%, 834/19,018), HPV16 (3.7%, 710/19,018), and HPV58 (3.4%, 644/19,018). The OR of multiple infections and single infection differed significantly among disease severities. The OR of dual infection was higher than that of each of the two single infection types, respectively.</p><p><b>CONCLUSION</b>HPV prevalence in the outpatients was 19.1%, and the most predominant HPV types in the study were HPV52, HPV16, and HPV58. Women with multiple infectionswere more likely to have abnormal cytology.</p>

Whole Genome Sequencing and Comparisons of Different Chinese Rabies Virus Lineages Including the First Complete Genome of an Arctic-like Strain in China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To learn the rabies genome molecular characteristics and compare the difference of China rabies lineages.</p><p><b>METHODS</b>The complete genomes of 12 strains from different China rabies lineages were amplified and sequenced, and all the China street strain genomes (total 43), Arctic and Arctic-like genomes were aligned using ClustalX2, the genome homologies were analyzed using MegAlign software, and the phylogenetic trees were constructed by MEGA 5.</p><p><b>RESULTS</b>First Arctic-like rabies genome in China (CQH1202D) was reported, and we supplemented the rabies genome data of China, ensuring at least one genome was available in each China lineage. The genome size of China V (11908nt) is obviously shorter than other lineages' (11923-11925nt) for the difference of N-P non-coding regions. Among different lineages, the genome homologies are almost under 90%. CQH1202D (China IV lineage) has close relationship with strains from South Korea and they share about 95% genome similarities.</p><p><b>CONCLUSION</b>The molecular characteristics of 6 different China rabies lineages were compared and analyzed from genome level, which benefits for continued comprehensive rabies surveillance, rabies prevention and control in China.</p>

Lapatinib induced cell cycle arrest and apoptosis in CNE-2z cells / 解放军医学杂志

Objective To explore the effect of lapatinib on the cell cycle and apoptosis of human CNE-2Z nasopharyngeal carcinoma (NPC) cells, and to study the related mechanisms. Methods CCK-8 assay was used to assess the proliferation of CNE-2Z cells treated by lapatinib. After PI staining, the cell cycle distribution was determined by flow cytometry. Apoptosis was analyzed using Annexin V/PI double binding assay. The mRNA expression of cell cycle related molecular Cyclin D1, P21 and P53 was assessed with real time PCR. The expression of protein Cyclin D1, P21, P53, and apoptosis related protein Mcl-1 and Bax was determined by Western blotting. The enzymatic activity of caspase-3/7 was measured by using Apo-ONE Homogeneous Caspase-3/7 Assay kit. Results Lapatinib inhibited the proliferation of CNE-2Z cells in a dose-dependent manner. Various concentrations of lapatinib induced significant G0/G1 phase arrest and promoted apoptosis of CNE-2Z cells. Lapatinib significantly down-regulated Cyclin D1 expression, but up-regulated P21 and P53 expression at mRNA and protein levels. Lapatinib also induced down-regulation of Mcl-1 with up-regulation of Bax protein expression, and activated Caspase-3/7 in CNE-2Z cells. Conclusion Lapatinib may effectively inhibit proliferation, induce cell cycle arrest and promote apoptosis of CNE-2Z cells, so it may serve as a potent therapeutic agent against nasopharyngeal carcinoma.

Pathogens and risk factors for ventilator-associated pneumonia in children with congenial heart disease after surgery / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the distribution and drug sensitivity of pathogens and risk factors for ventilator-associated pneumonia (VAP) in children with congenial heart disease (CAD) after surgery.</p><p><b>METHODS</b>According to the occurrence of VAP, 312 children with CAD who received mechanical ventilation after surgery for 48 hours or longer between January 2012 and December 2014 were classified into VAP (n=53) and non-VAP groups (n=259). Sputum samples were collected and cultured for pathogens in children with VAP. The drug sensitivity of pathogens was analyzed. The risk factors for postoperative VAP were identified by multiple logistic regression analysis.</p><p><b>RESULTS</b>The sputum cultures were positive in 51 out of 53 children with VAP, and a total of 63 positive strains were cultured, including 49 strains of Gram-negative bacteria (78%), 9 strains of Gram-positive bacteria (14%) and 5 strains of funqi (8%). The drug sensitivity test showed that Gram-negative bacteria were resistant to amoxicillin, piperacillin, cefotaxime and ceftazidime, with a resistance rate of above 74%, and demonstrated a sensitivity to amikacin, polymyxin and meropenem (resistance rate of 19%-32%). Single factor analysis showed albumin levels, preoperative use of antibiotics, duration of mechanical ventilation, times of tracheal intubation, duration of anesthesia agent use, duration of acrdiopulmonary bypass, duration of aortic occlusion and use of histamin2-receptor blockade were significantly different between the VAP and non-VAP groups (P<0.05). The multiple logistic regression showed albumin levels (<35 g/L), duration of mechanical ventilation (≥ 7 d), times of tracheal intubation (≥ 3), duration of acrdiopulmonary bypass (≥ 100 minutes) and duation of aortic occlusion (≥ 60 minutes) were independent risk factors for VAP in children with CAD after surgery.</p><p><b>CONCLUSIONS</b>Gram-nagative bacteria are main pathogens for VAP in children with CAD after surgery. The antibiotics should be used based on the distribution of pathogens and drug sensitivity test results of pathogens. The effective measures for prevention of VAP should be taken according to the related risk factors for VAP to reduce the morbidity of VAP in children with CAD after surgery.</p>

Campylobacter spp.isolation, its toxin genes detection and molecular subtyping in diarrhea patients in Shanghai in 2014 / 上海预防医学

[ Objective] To investigate the status quo of Campylobacter spp.infection in Shanghai and study its molecular characteristics and virulence and toxin genes. [ Methods ] Stool samples collected from diarrheal patients were cultured for bacterial pathogens using membrane filter method.The strains were identified by biochemical tests and PCR.PCR was applied to detect six virulence and toxin genes including flaA,cdtA,cdtB,cdtC,virB11,cadF.Pulsed-field gel electrophoresis ( PFGE) was carried out for subtyping. [Results] A total of 43 Campylobacter spp.(1.9%) were collected from 2 235 stool samples in Shanghai in 2014 including 41 Campylobacter jejuni isolates(95.3%) and 2 Campylobacter coli isolates(4.7%) .The data showed 100.0%(43/43) of the isolates were positive for flaA and cadF, and 93.0%(40/43) of the isolates positive for cdtA and cdtB.And 88.4%(38/43) of the isolates were posi-tive for cdtC.Only 7.0%(3/43) of the isolates were positive for virB11.Using PFGE, 43 Campylobacter jejuni and Campylobacter coli strains were subtyped into 6 clusters. [ Conclusion] The genes of flaA and cadF are ubiquitous on Campylobacter spp.isolates.The distribution of cdt gene cluster in Campylobacter spp.is high, while that of virB11 is low.The PFGE types of Campylobacter spp.isolated in Shanghai are of diversified and complicated features, which causes mainly sporatic diarrhea.

Analyses of Potential Predictive Markers and Response to Targeted Therapy in Patients with Advanced Clear-cell Renal Cell Carcinoma / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Vascular endothelial growth factor-targeted agents are standard treatments in advanced clear-cell renal cell carcinoma (ccRCC), but biomarkers of activity are lacking. The aim of this study was to investigate the association of Von Hippel-Lindau (VHL) gene status, vascular endothelial growth factor receptor (VEGFR) or stem cell factor receptor (KIT) expression, and their relationships with characteristics and clinical outcome of advanced ccRCC.</p><p><b>METHODS</b>A total of 59 patients who received targeted treatment with sunitinib or pazopanib were evaluated for determination at Cancer Hospital and Institute, Chinese Academy of Medical Sciences between January 2010 and November 2012. Paraffin-embedded tumor samples were collected and status of the VHL gene and expression of VEGFR and KIT were determined by VHL sequence analysis and immunohistochemistry. Clinical-pathological features were collected and efficacy such as response rate and Median progression-free survival (PFS) and overall survival (OS) were calculated and then compared based on expression status. The Chi-square test, the Kaplan-Meier method, and the Lon-rank test were used for statistical analyses.</p><p><b>RESULTS</b>Of 59 patients, objective responses were observed in 28 patients (47.5%). The median PFS was 13.8 months and median OS was 39.9 months. There was an improved PFS in patients with the following clinical features: Male gender, number of metastatic sites 2 or less, VEGFR-2 positive or KIT positive. Eleven patients (18.6%) had evidence of VHL mutation, with an objective response rate of 45.5%, which showed no difference with patients with no VHL mutation (47.9%). VHL mutation status did not correlate with either overall response rate (P = 0.938) or PFS (P = 0.277). The PFS was 17.6 months and 22.2 months in VEGFR-2 positive patients and KIT positive patients, respectively, which was significantly longer than that of VEGFR-2 or KIT negative patients (P = 0.026 and P = 0.043).</p><p><b>CONCLUSION</b>VHL mutation status could not predict the efficacy of sunitinib or pazopanib. Further investigation of VHL/VEGFR pathway components is needed.</p>

Family history of liver cancer increases the risk of liver cancer incidence: a 20-year prospective cohort study in Qidong, China / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate whether first-degree family history of liver cancer plays a role in liver cancer incidence by prospective evaluation of a patient cohort in Qidong, China over a 20-year period.</p><p><b>METHODS</b>In May 1992, 708 hepatitis B surface antigen (HBsAg) carriers and 730 HBsAg-negadve controls from Qidong city were enrolled for participation in a prospective cohort study ending in November 2012.Follow-up was carried out every 6 to 12 months, and evaluations included serum assays to measure concentrations of alpha fetoprotein (AFP), HBsAg and alanine aminotransferase (ALT), as well as abdominal ultrasound to assess liver disease.The relationship between baseline (study entry) information of patients with first-degree family history of liver cancer and liver cancer incidence during the two decades of study was statistically assessed.</p><p><b>RESULTS</b>There were 172 newly diagnosed liver cancer cases in the cohort during 25 753 person-years (py) of follow-up, representing an incidence of 667.88/100 000 py.The incidence rates of liver cancer among participants with or without liver cancer family history were 1 244.36/100 000 py and 509.70/100 000 py respectively, and the between-group difference reached the threshold for statistical significance (P less than 0.01, Relative Risk (RR):2.44, 95% Confidence Interval (CI):1.80-3.31).The incidence rates of liver cancer among participants who had a sibling with liver cancer and participants who had a parent with liver cancer were not significantly different (P > 0.05), but the liver cancer incidence among participants who had a mother with liver cancer was significantly higher than that of participants who had a father with liver cancer (P < 0.05, RR:1.86, 95% CI:1.03-3.36). Among the participants with liver cancer family history, 56.52% (39/69) were diagnosed before 50 years old, and this rate was significantly higher than that of participants without a family history of liver cancer (40.78%, 42/103, P less than 0.05).The incidence rate of liver cancer among the participants who were family history-positive and HBsAg-positive was significantly higher than that of participants who were family history-negative but HBsAg-positive (P < 0.01, RR:1.75, 95% CI:1.29-2.38), and was 59.59 times higher than for participants who were family history-negative and HBsAgnegative.Subgroup analysis of liver cancer incidence among participants who were family history-positive but HBsAg-negative and participants who were family history-negative and HBsAg-negative produced anRR of 2.60, but there was no statistically significant difference between the two subgroups (P > 0.05).At the study's end, the incidence rates of liver cancer for the different subgroups were 32.21% for the family history-positive and HBsAgpositive participants, 19.80% for the family history-negative and HBsAg-positive participants, 1.71% for the family history-positive and HBsAg-negative participants, and 0.65% for the family history-negative and HBsAg-negative participants.</p><p><b>CONCLUSION</b>First-degree family history of liver cancer is a risk factor of liver cancer in Chinese patients from Qidong, and exhibits synergism with HBsAg-positivity for incidence of liver cancer.</p>

Performance of FibroScan in evaluating the curative effects of traditional Chinese medicine on liver fibrosis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To assess the performance of FibroScan in evaluating the curative effects of traditional Chinese medicine (TCM) on liver fibrosis, and to analyze factors influencing the diagnostic accuracy.</p><p><b>METHODS</b>Data of FibroScan values, types of disease, use of drug, liver function indexes, prothrombin time (PT) and international normalized ratio (INR) were collected at both pre- (1 month prior) and post-FibroScan for 102 patients who underwent at least two FibroScan procedures. Patients were subgrouped according to presence of fibrosis, presence of cirrhosis, and TCM formulation and statistically analyzed.</p><p><b>RESULTS</b>The pre- and post-FibroScan mean liver stiffness measurements (LSMs) were significantly different when the variation of LSM was more than or equal to2 kPa for the non-fibrotic group (vs. the fibrotic group), or when the variation wasmore than or equal to4 kPa for the cirrhotic group (vs. the non-cirrhotic group). In addition, the three TCM formulation groups showed significant differences, with the most robust difference exhibited between the FuZheng HuaYu formulation group and the other treatment groups (P = 0.010). No significant differences were observed for the liver function indexes, PT, or INR. However, the post-FibroScan levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT) was significantly reduced in patients with reduced LSM.</p><p><b>CONCLUSION</b>FibroScan may be a useful non-invasive clinical tool for evaluating the comprehensive curative effect of treatments for chronic liver diseases, and its performance is not obviously impacted by ALT, AST, GGT, PT, and INR. The criteria for efficacy established by FibroScan are 2 kPa for the patients without liver fibrosis and 4 kPa for patients with liver cirrhosis.</p>