Diet related knowledge and behavior among students in Anhui Province / 中国学校卫生

Objective@#To assess diet-related knowledge and behavior among primary and middle-school students in five cities of Anhui, and to provide evidence for nutrition education and intervention strategies.@*Methods@#A multi stage stratified cluster random sampling method was used to select 2 045 students in five cities(Huaibei,Bengbu,Ma anshan,Hefei and Wuhu) of Anhui for a questionnaire survey on nutrition knowledge, diet behavior, food preferences, and diet education.@*Results@#The overall rate of good nutritional awareness was 38.3%; students had the highest rate of awareness on plain water being the healthiest drink(91.6%). The overall rate of healthy food preferences was 51.5%, with milk and dairy products being the highest rated (66.4%). The overall rate of good diet behavior was 85.8%, with eating most meals on time and in appropriate quantities being the highest rated (87.7%). The overall rate of students with good diet education was 25.0%, while the rate of table cleaning was 73.0%. Middle school students had more knowledge of nutrition(χ 2=28.8), while primary school students had better healthy food preferences and diet behaviors(χ 2=31.3，77.6), and girls were more frequently involved in setting and clearing the table(χ 2=12.2)(P<0.05).@*Conclusion@#Insufficient nutrition knowledge, clear food preferences, unhealthy dietary behaviors, and a lack of diet education were observed in primary and middle school students in Anhui. Specific nutritional education in school settings should be developed, home school cooperation should be strengthened, and diet education activities should be increased to help primary and middle school students form a healthy lifestyle.

Analysis of Clinical Characteristics and Prognosis in Children with Acute Megakaryoblastic Leukemia without Down Syndrome / 中国实验血液学杂志

OBJECTIVE@#To analyze the clinical characteristics and treatment effects of children with acute megakaryoblastic leukemia without down syndrome (non-DS-AMKL).@*METHODS@#The clinical data of 19 children with non-DS-AMKL treated in the Pediatric Hematology Ward in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from May 2008 to April 2018 were analyzed retrospectively. The clinical characteristics, laboratory test and treatment methods of the children were concluded. All patients were followed up to evaluate the effect of treatment.@*RESULTS@#The 19 cases of children included nine male and ten female, the median age of onset was 2 years old. The clinical manifestations showed nonspecific. The median white blood cell of peripheral blood was 15.88×10@*CONCLUSION@#Non-DS-AMKL was rare in children and difficult to be diagnosed. Determination of MICM classification as early as possible was helpful for diagnosis, and genetic testing played an important role for diagnosis and prognosis evaluation. Early hematopoietic stem cell transplantation in patients with CR after chemotherapy might be an effective way to cure AMKL.

Validation of fatty liver index and hepatic steatosis index for screening of non-alcoholic fatty liver disease in adults with obstructive sleep apnea hypopnea syndrome / 中华医学杂志(英文版)

Background@#Obstructive sleep apnea hypopnea syndrome (OSAHS) is a contributing factor for non-alcoholic fatty liver disease (NAFLD). Non-invasive algorithms including fatty liver index (FLI) and hepatic steatosis index (HSI) have been used as a screening test for NAFLD in epidemiologic studies. The aim of this study is to compare the diagnostic accuracy of FLI and HSI for NAFLD detection in adults with OSAHS.@*Methods@#We enrolled consecutive adult subjects who were newly diagnosed with OSAHS from March 2016 to January 2018. NAFLD was diagnosed by ultrasonography. The accuracy and cut-off point of the FLI and HSI to detect NAFLD were assessed by analyzing the area under the receiver operating characteristic (AUROC) curve and the maximum Youden index analysis, respectively.@*Results@#The 326 subjects were diagnosed as NAFLD according to ultrasound findings, while 105 subjects who had normal abdominal ultrasonography were grouped as controls. Both FLI and HSI values were significantly higher in patients with NAFLD compared with controls. The AUROC of FLI and HSI for predicting NAFLD was 0.802 (95% confidence interval [CI] 0.762-0.839) and 0.753 (95% CI 0.710-0.793), respectively. The AUROC of FLI was significantly higher than that of HSI (P = 0.0383). The optimal cut-off value of FLI and HSI was 60 (sensitivity 66% and specificity 80%) and 35 (sensitivity 81% and specificity 60%), respectively.@*Conclusions@#Both FLI and HSI can serve as screening tools for NAFLD in OSAHS adults. The FLI shows better performance in diagnosing NAFLD than HSI.@*Trial registration@#Chinese Clinical Trial Registry (No. ChiCTR-OOB-15007253), http://www.chictr.org.cn/showproj.aspx?proj=11606.

Novel mutations p.Lys327X and p.Leu424CysfsX8 underlying congenital factor Ⅺ deficiency / 中华医学遗传学杂志

OBJECTIVE@#To analyze the phenotype and genetic mutations in a pedigree affected with factor Ⅺ (FⅪ) deficiency.@*METHODS@#Activated partial thromboplastin time (APTT), FⅪ activity (FⅪ:C) and FⅪ antigen (FⅪ:Ag) were determined for the proband and his family members. All exons and exon-intron boundaries of the FⅪ gene of the proband were analyzed by direct sequencing. Suspected mutation was verified in his family members.@*RESULTS@#The proband had APTT of 82.4 s, FⅪ:C of 0.8%, and FⅪ:Ag of T (Lys327X) mutation in exon 10 and c.1325delT (Leu424CysfsX8) mutation in exon 12 of the FⅪ gene. His elder sister, son, daughter, two granddaughters and one grandson were heterozygous carriers of the c.1033A>T mutation, while his older sister and younger brother were heteozygous carriers of the c.1325delT mutation. Analysis using Mutation Taster software showed that both p.Lys327X and p.Leu424CysfsX8 may affect the function of protein and lead to the corresponding disease.@*CONCLUSION@#The novel mutations of Lys327X and Leu424CysfsX8 of the the FⅪ gene probably underlie the pathogenesis of congenital coagulation factor Ⅺ deficiency in this pedigree.

Validation of fatty liver index and hepatic steatosis index for screening of non-alcoholic fatty liver disease in adults with obstructive sleep apnea hypopnea syndrome / 中华医学杂志(英文版)

BACKGROUND@#Obstructive sleep apnea hypopnea syndrome (OSAHS) is a contributing factor for non-alcoholic fatty liver disease (NAFLD). Non-invasive algorithms including fatty liver index (FLI) and hepatic steatosis index (HSI) have been used as a screening test for NAFLD in epidemiologic studies. The aim of this study is to compare the diagnostic accuracy of FLI and HSI for NAFLD detection in adults with OSAHS.@*METHODS@#We enrolled consecutive adult subjects who were newly diagnosed with OSAHS from March 2016 to January 2018. NAFLD was diagnosed by ultrasonography. The accuracy and cut-off point of the FLI and HSI to detect NAFLD were assessed by analyzing the area under the receiver operating characteristic (AUROC) curve and the maximum Youden index analysis, respectively.@*RESULTS@#The 326 subjects were diagnosed as NAFLD according to ultrasound findings, while 105 subjects who had normal abdominal ultrasonography were grouped as controls. Both FLI and HSI values were significantly higher in patients with NAFLD compared with controls. The AUROC of FLI and HSI for predicting NAFLD was 0.802 (95% confidence interval [CI] 0.762-0.839) and 0.753 (95% CI 0.710-0.793), respectively. The AUROC of FLI was significantly higher than that of HSI (P = 0.0383). The optimal cut-off value of FLI and HSI was 60 (sensitivity 66% and specificity 80%) and 35 (sensitivity 81% and specificity 60%), respectively.@*CONCLUSIONS@#Both FLI and HSI can serve as screening tools for NAFLD in OSAHS adults. The FLI shows better performance in diagnosing NAFLD than HSI.@*TRIAL REGISTRATION@#Chinese Clinical Trial Registry (No. ChiCTR-OOB-15007253), http://www.chictr.org.cn/showproj.aspx?proj=11606.

Clinical Charcteristics and Prognostic Analysis of 28 cases of Pediatric Myelodysplastic Syndrome / 中国实验血液学杂志

OBJECTIVE@#To analyze the clinical features and prognosis of 28 children with myelodysplastic syndrome (MDS) and to screen the high risk factors affecting the prognosis so as to provide the new ideas for standard of clinical diagnosis and therapy.@*METHODS@#The clinical data of 28 children with newly diagnosed MDS treated in our hospital from March 1994 to July 2016 were analyzed retrospectively, the features of disease onset and the results of laboratory examination were summarized, all MDS children were followed up, the prognosis and the high risk factors affecting the prognosis were evaluated.@*RESULTS@#In all 28 MDS children, the ratio of male to female was 1.8∶1, the incidence of MDS was observed in boys, while the low incidence of MDS was found in older children. The clinical manifestations were mainly the decrease of three series blood cells in 16 cases (57.14%), other cases presented simple anemia (7.1%), simple thrombocytopenia (7.1%), neutropenia with anemia (14.29%), and anemia with thrombocytopenia (14.28%).The bone marrow image showed mainly hyperplasia (82.14%), and the pathological hematopoiesis, moreover the manifistation of pathological hematopoiesis was different in forma and degree; the bone marrow biopsy showed the typical abnormal localization of immature precursor(ALIP) accepted for 33.33%; the chromosome karyotype detection showed the detected rate of chronosome abnormality was 41.18%. The median follow-up time was 1.75 years. 5 children with MDS received the hematopoietic stem cell transplantation (HSCT), among them 1 dead and 4 maintained CCR; Out of other 23 patients no-received HSCT, 7 cases given up treatment after confirmed diagnosis, 16 cases received the chemotherapy (2 cases given up treatment after CR, 5 cases transformed into AML, 3 cases relapsed, 3 cases maintained CCR), 11 cases dead, 9 cases failed to be followed up. The 5-years OS rate and EFS rate in all patients were predicted as (38.2±11.3)% and (35.3±11.3)%,respectively, among them, the OS and EFS rates of patients received the HSCT allo superior to those of patients did not received HSCT ［(80.0±17.9）% vs.(22.8±11.5）%］ (P0.05).@*CONCLUSION@#The children MDS is rare and easy to be misdiagnosis, moreover displays more high heterogeneity and poor prognosis, thereby the early diagnosis is crucial, in addition, the system of prognosis evaluation is imperative to be perfected. The HSCT may be the effective method for curative treatment of childhood MDS.

Risk index and early-warning model of H7N9 human infections / 预防医学

Objective To establish the risk index of early-warning on the human infections with avian influenza A (H7N9) virus. Methods The risk index (X) was calculated by using Principal Component Analysis based on the surveillance results (including the positive rates of environmental specimens and premises) during the period from April 2013 to March 2017 in Zhejiang Province. Then, the method of Classification and Regression Trees was used to establish the early-warning model for forewarning the epidemic situation of H7N9 human infections. Results The weights of two rates (the positive rates of specimens and premises) used to establish the risk index were 0.0545 and 0.0230 respectively. In the model of Classification and Regression Trees, risk index was divided into 4 grades: X ≤0.140, 0.140<X ≤0.757, 0.757<X ≤3.285 and X>3.285. Compared to the 1st grade, the risk ratios of the 2nd, 3rd and 4th grades were 7.4, 21.7 and 29.9 respectively. The accuracy, sensitivity and specificity of prediction were 86.1％ , 80.8％ and 87.3％ respectively, and the Kappa value was 0.592 . Conclusion The established risk index can be used to forewarn the H7N9 human infections, which is helpful for emergency preparedness and disease control.

Characteristics of school public health emergencies in Zhejiang Province / 预防医学

Objective To analyze the characteristics of school public health emergencies in Zhejiang Province, and to provide current suggestions for prevention and control. Methods A descriptive epidemiological analysis was conducted for the public health emergencies occurred in schools from 2014 to 2016 in Zhejiang Province. The data was derived from Emergency Public Reporting System. Results A total of 100 public health emergencies occurred in schools and 3 784 cases were reported during 2014-2016 in Zhejiang Province, meanwhile no death occurred. There were two peak seasons every year for the emergency report. Forty percent of the emergencies were reported during November to January of the following year, and 31.00 % were during April to May. The emergencies occurred on all the municipal districts when Ningbo accounted for 50.00%. The schools and kindergartens in rural area, town and urban area reported 37, 28 and 35 emergencies respectively. The main etiology of emergencies included varicella(37.00%), hand-foot-mouth disease(29.00%), norovirus(22.00%). The median duration of varicella outbreaks was 31.67d, which was longer than others. The scale of influenza and norovirus outbreaks were larger, and the median cases were 76 and 49 respectively. The time of emergencies detecting was significantly different between different detecting patterns. Conclusion The prevention and control of school emergencies was still urgently. There were still some deficiencies in the identification and active reporting of the epidemic, which need to be solved, while taking advantage of the surveillance system for sick absence. The future strategies should focused on reinforcing immunization and improving health habits to promote school health.

Relationship of Blimp-1 Hypoexpression with Pathogenesis of Aplastic Anemia / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To study the relationship of Blimp-1 hypoexpression with abnormality of Treg level and pathogenesis of aplastic anemia (AA).</p><p><b>METHODS</b>The mouse model with AA was established by adminis tration of IFN-γ combined with busulfan. The samples were collected at different day establishing AA model, and the spleen Treg number was detected, the Treg cells were sorted and expression level of prdm-1 was detected.</p><p><b>RESULTS</b>The number of Tregs in mice with AA was lower than that in control mice, moreover, the level of Treg decrease positively correlated with the AA severity (r=0.805), the higher the expression level of prdm-1, the higher the ratio of Treg/lymphocytes, showing positive correlation between them (r=0.548).</p><p><b>CONCLUSION</b>Blimp-1 expression may promote the proliferation and differentiation of Treg. The hypoexpression of Blimp-1 mediates the pathogenesis of AA and promotes progression of AA through reducing the proliferation of Treg, and decreacing the number of Treg.</p>

Capsaicin inhibits experimental autoimmune neuritis in rats through inhibition of autophagy activity / 中国药理学通报

Aim To observe the effect of capsaicin on the experimental autoimmune neuritis (EAN) in rats and explore the mechanism.Methods To induce EAN,male Lewis rats were immunized with peripheralnerve myelin sheath antigen (P257481) peptide and complete Freund's adjuvant (CFA) mixed liquor.Rapamycin (RAPA,2.5 mg · kg-1) was administered by intraperitoneal injection 0.5 h after immunization and capsaicin (1 mg · kg-1 · d-1) was administered by intragastric administration 1.0 h after immunization for 15 days.The incidence and clinical characteristics of EAN were observed.The clinical scores of neurological signs were completed and body weight was measured.Pathological morphology of sciatic nerve was observed by HE staining and Lauck fast blue staining.Ultrastructure of sciatic nerve was observed by transmission electron microscope.Levels of serum tumor necrosis factor alpha (TNF-α),interferon gamma (IFN-γ),interleukin 1β (IL-1β) and intedeukin-6 (IL-6) were tested by enzyme linked immunosorbent assay (ELISA).Expressions of autophagy related protein were measured by Western blot.Results Compared with EAN group,the clinical scores of neurological signs significantly decreased from day 7 to day 16 of post-immunization (P ＜ 0.05),body weight significantly increased from day 3 to day 16 of post-immunization (P ＜ 0.05),demyelination obviously decreased,inflammatory cell infiltration number obviously decreased (P ＜ 0.05),the levels of TNF-α,IFN-γ,IL-1β and IL-6 significantly decreased (P ＜ 0.05),the number of autophagosome in axon of sciatic nerve significantly decreased (P ＜ 0.05),and expressions of Beclin-1 and LC3-Ⅱ and the ratio of LC3-Ⅱ and LC3-Ⅰ were significantly down-regulated,and the expression of p62 was significantly up-regulated (P ＜ 0.05) in EAN + capsaicin group.Rapamycin partially reversed the action of capsaicin.Conclusions Capsaicin inhibits EAN in rats,and the mechanism may be related with the inhibition of autophagy activity.

Clinical validation of the PCR-reverse dot blot human papillomavirus genotyping test in cervical lesions from Chinese women in the Fujian province: a hospital-based population study / 부인종양

OBJECTIVE: To determine the clinical significance of the polymerase chain reaction (PCR)-reverse dot blot (RDB) human papillomavirus (HPV) genotyping assay in cervical cancer screening. METHODS: A total of 10,442 women attending the Fujian Provincial Maternity and Children's Health Hospital were evaluated using the liquid-based cytology (thinprep cytologic test [TCT]) and the PCR-RDB HPV test. Women with HPV infection and/or abnormal cytology were referred for colposcopy and biopsy. For HPV DNA sequencing, 120 specimens were randomly selected. Pathological diagnosis was used as the gold standard. RESULTS: Using the PCR-RDB HPV test, overall HPV prevalence was 20.57% (2,148/10,442) and that of high-risk (HR)-HPV infection was 18.68% (1,951/10,442). There was 99.2% concordance between HPV PCR-RDB testing and sequencing. In this studied population, the most common HR-HPV types were HPV-16, -52, -58, -18, -53, -33, and -51, rank from high to low. HPV-16, -18, -58, -59, and -33 were the top 5 prevalent genotypes in cervical cancer but HPV-16, -18, -59, -45, and -33 were the top 5 highest risk factors for cancer (odds ratio [OR]=34.964, 7.278, 6.728, 6.101, and 3.658; all p<0.05, respectively). Among 10,442 cases, 1,278 had abnormal cytology results, of which, the HR-HPV positivity rate was 83.02% (1,061/1,278). To screen for cervical cancer by PCR-RDB HPV testing, when using CIN2+, CIN3+, and cancer as observed endpoints, the sensitivity was 90.43%, 92.61%, and 94.78% and the negative predictive value (NPV) was 99.06%, 99.42%, and 99.78%, respectively. PCR-RDB HPV and TCT co-testing achieved the highest sensitivity and NPV. CONCLUSION: For cervical cancer screening, the PCR-RDB HPV test can provide a reliable and sensitive clinical reference.

Rhubarb Monomers Protect Intestinal Mucosal Barrier in Sepsis via Junction Proteins / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Leakage of the intestinal mucosal barrier may cause translocation of bacteria, then leading to multiorgan failure. This study hypothesized that rhubarb monomers might protect the gut mucosal barrier in sepsis through junction proteins.</p><p><b>METHODS</b>Healthy male Sprague-Dawley rats (weighing 230-250 g) under anesthesia and sedation were subjected to cecal ligation and perforation (CLP). After surgical preparation, rats were randomly assigned to eight groups (n = 6 or 8 each group): sham group (Group A: normal saline gavage); sepsis group (Group B: normal saline gavage); Group C (intraperitoneally, dexamethasone 0.5 mg/kg) immediately after CLP surgery; and rhubarb monomer (100 mg/kg in normal saline)-treated groups (Group D: rhein; Group E: emodin; Group F: 3,8-dihydroxy-1-methyl-anthraquinone-2-carboxylic acid; Group G: 1-O-caffeoyl-2-(4-hydroxy-O-cinnamoyl)-D-glucose; and Group H: daucosterol linoleate). Animals were sacrificed after 24 h. Intestinal histology, lactulose, mannitol concentrations were measured, and zonula occludens (ZO)-1, occludin and claudin-5 transcription (polymerase chain reaction), translation (by Western blot analysis), and expression (by immunohistochemistry) were also measured.</p><p><b>RESULTS</b>Intestinal histology revealed injury to intestinal mucosal villi induced by sepsis in Group B, compared with Group A. Compared with Group A (0.17 ± 0.41), the pathological scores in Groups B (2.83 ± 0.41, P < 0.001), C (1.83 ± 0.41, P < 0.001), D (2.00 ± 0.63, P < 0.001), E (1.83 ± 0.41, P < 0.001), F (1.83 ± 0.75, P < 0.001), G (2.17 ± 0.41, P < 0.001),and H (1.83 ± 0.41, P < 0.001) were significantly increased. Lactulose/mannitol (L/M) ratio in Group B (0.046 ± 0.003) was significantly higher than in Group A (0.013 ± 0.001, P< 0.001) while L/M ratios in Groups C (0.028 ± 0.002, P< 0.001), D (0.029 ± 0.003, P< 0.001), E (0.026 ± 0.003, P< 0.001), F (0.027 ± 0.003, P< 0.001), G (0.030 ± 0.005, P< 0.001), and H (0.026 ± 0.002, P< 0.001) were significantly lower than that in Group B. ZO-1, occludin and claudin-5 transcription, translation, and expression in Group B were significantly lower than that in Group A (P < 0.001), but they were significantly higher in Groups C, D, E, F, G, and H than those in Group B (P < 0.05).</p><p><b>CONCLUSION</b>Rhubarb monomer treatment ameliorated mucosal damage in sepsis via enhanced transcription, translation, and expression of junction proteins.</p>

Rare thalassemia mutations among southern Chinese population / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To detect rare types of thalassemia mutations among southern Chinese population.</p><p><b>METHODS</b>Peripheral blood samples from 327 patients from various regions of southern China were collected. The patients were suspected as rare-type thalassemia for their inconsistency between hematological phenotypes and results of routine mutation screening. The samples were further analyzed with GAP-PCR and DNA sequencing.</p><p><b>RESULTS</b>One hundred and eight cases were diagnosed as rare types of thalassemia. Among whom 10 rare α-globin gene mutations including --THAI, HKα, αααanti3.7, αααanti4.2, -α2.8, -α27.6, CD74 GAC>CAC (Hb Q-Thailand), CD30 (-GAG), CD31 AGG>AAG and CD118 (+TCA), and 12 rare β-globin gene mutations including CD37 TGG>TAG, CD39 CAG>TAG/CD39 CAG>TAG, β II-2 (-T), -90(C>T), -31(A>C), -88(C>T), CD7(-A), CD138(+T), CD89-93 (--AGTGAGCTGCACTG), CD54-58 (-TATGGGCAACCCT), Chinese G γ +(A γδβ)0 and Vietnamese HPFH (HPFH-6) were identified. -88(C>T) (HBB: c.-138C>T) and CD39 CAG>TAG (HBB: c.118C>T) were discovered for the first time in Chinese population. CD7(-A) (HBB: c.23delA) and CD138(+T) (HBB: c.416_417insT) were new types of β-globin gene mutations.</p><p><b>CONCLUSION</b>The present study have enriched the mutation spectrum of thalassemia in southern China, which has provided necessary information for its diagnosis.</p>

A random digit dialing investigation on the association between different visual display terminal use and physical symptoms among adults / 预防医学

Objective To explore the association between different visual display terminal use and physical symptoms among adults.Methods Hangzhou,Jiaxing,Huzhou,Jinhua and Quzhou City were selected,where residents aged 18 years old and above were investigated using Mitofsky-Waksberg two-stage sampling.Information of demography,different visual display terminal use,eye and musculoskeletal symptoms,eye disease and eye relax were collected.Backward stepwise logistic regression was used to explore the association between different visual display terminal use and the symptoms (P value for addition ＜ 0.05,P value for removal ＞ 0.1).Results Totally 350 adults responded to the investigation,with a response rate of 48.54％.Finally,333 respondents were included in the analysis,among which 120 reported eye symptoms (36.04％) and 71reported musculoskeletal symptoms (21.32％).More time of computer use at work(0.5-4 h:OR=2.006,95％ CI:1.021-3.943;4-6 h:OR=3.578,95％ CI:1.751-7.315;＞6 h:OR=4.874,95％ CI:1.897-12.521) and eye disease (OR =4.361,95％ CI:2.465-7.714) were significandy associated with higher odds ratios in eye symptoms.Similar pattern was seen for the association on time of computer use at work with musculoskeletal symptoms (0.5-4 h:OR =3.815,95 ％ CI:1.809-8.045;4-6 h:OR =4.974,95 ％ CI:2.281-10.845;＞ 6 h:OR =5.934,95％ CI:2.347-15.005).More time of watching TV on television (＞ 2 h:OR =2.051,95％CI:1.068-3.939) and women (OR =1.884,95％ CI:1.052-3.372) were also observed to be statistically associated with musculoskeletal symptoms.However,no statistical association was observed between the two symptoms and entertainment purpose use of computer/cell phone/pad/kindle (P ＞ 0.05).Conclusion Computer use at work was significantly associated with eye symptoms,especially for those having eye diseases.It was also statistically associated with musculoskeletal symptoms,especially for women.

Clinical Auditory Phenotypes Associated withGene Mutations in Familial Hypoparathyroidism-deafness-renal Dysplasia Syndrome / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hypoparathyroidism-deafness-renal dysplasia (HDR) syndrome is an autosomal dominant disorder primarily caused by haploinsufficiency of GATA binding protein 3 (GATA3) gene mutations, and hearing loss is the most frequent phenotypic feature. This study aimed at identifying the causative gene mutation for a three-generation Chinese family with HDR syndrome and analyzing auditory phenotypes in all familial HDR syndrome cases.</p><p><b>METHODS</b>Three affected family members underwent otologic examinations, biochemistry tests, and other clinical evaluations. Targeted genes capture combining next-generation sequencing was performed within the family. Sanger sequencing was used to confirm the causative mutation. The auditory phenotypes of all reported familial HDR syndrome cases analyzed were provided.</p><p><b>RESULTS</b>In Chinese family 7121, a heterozygous nonsense mutation c.826C>T (p.R276*) was identified in GATA3. All the three affected members suffered from sensorineural deafness and hypocalcemia; however, renal dysplasia only appeared in the youngest patient. Furthermore, an overview of thirty HDR syndrome families with corresponding GATA3 mutations revealed that hearing impairment occurred earlier in the younger generation in at least nine familial cases (30%) and two thirds of them were found to carry premature stop mutations.</p><p><b>CONCLUSIONS</b>This study highlights the phenotypic heterogeneity of HDR and points to a possible genetic anticipation in patients with HDR, which needs to be further investigated.</p>

Chemical constituents from Magnolia grandiflora / 中成药

AIM To study the chemical constituents from Magnolia grandiflora L..METHODS The ethyl acetate fracion of 70％ acetone extract from M.grandiflora leaves was isolated and purified by silica,Sephadex LH-20 and MCI column,then the structures of obtained compounds were identified by spectral data.RESULTS Twelve compounds were isolated and identified as 10α-methoxyalloaromadendra-4β-ol (1),spathulenol (2),aromadendra-4β,10β-diol (3),aromadendra-4β,10α-diol (4),9-oxonerolidol (5),9-hydroxynerolidol (6),3,7-dimethylocta-1,5E-diene-3,7-diol (7),phytol (8),α-tocopherol (9),elemicin (10),syringaresinol (11),yangambin (12).CONCLUSION Compounds 1,3-6,8 are isolated from genus Magnolia for the first time,compounds 7,9,10,12 are first isolated from this plant.

Clinical Trials for Treatment of Allergic Rhinitis with Heat Sensitive Moxibustion and Its Regularity of Heat-sensitization Acupoint Distribution / 针刺研究

OBJECTIVE: To observe the clinical effect of heat sensitive moxibustion (HSM) and its regularity of acupoint heat-sensitization in the treatment of allergic rhinitis (AR) patients. METHODS: Seventy patients with AR were randomly divided into HSM and manual acupuncture groups (n＝35/group). For patients of the HSM group, acupoints Yintang (EX-HN 3), bilateral Yingxiang (LI 20), Shangxing (GV 23), Tongtian (BL 7), Feishu (BL 13), Hegu (LI 4), etc. were used, and for patients of the manual acupuncture group, bilateral LI 20 and LI 4, Bitong (EX-HN 8) and EX-HN 3 were needled and stimulated with uniform reinforcing-reducing needling method. The treatment was conducted once every other day, for 20 days, with 3 days' interval between two 10 days. The symptoms of sneezing, running nose, nasal obstruction, and nasal itching were scored as 1, 2 and 3 points according to their severity. The signs of turbinate-nose cavity bottom/nasal septum correlation, morphological state (swelling or not) of inferior nasal concha and color of nasal mucosa, appearance (deviation or polyp) of the middle turbinate and nasal septum were scored as 1, 2 and 3 points according to their severity. The total score equaled to symptom score plus nasal sign score. The distribution of heat sensitization acupoints for effectively improving AR were recorded. RESULTS: The total effective rate of 82.86%(29/35) in the HSM group had no marked difference in comparison with that of 74.29%(26/35) in the manual acupuncture group (P>0.05). After the treatment, the total scores of symptoms and nasal signs of both HSM and manual acupuncture groups were significantly reduced in comparison with their own individual pre-treatment (P<0.01), and those in the HSM group were significantly decrased than those in the manual acupuncture group (P<0.05). In 35 patients of the HSM group, among the detected 57 acupoints, the most frequently sensitive acupoints were LI 20, EX-HN 3, EX-HN 8, Shangyintang, BL 13, Shenque(CV 8), GV 23, Fengchi(GB 20), Die'e and Dazhui (GV 14) in sequence, mainly covering the Governor Vessel, Large Intestine Meridian of Hand-yangming(LI), and Bladder Meridian of Foot-taiyang(BL), and characterized by heat conduction, heat diffusion, diathermancy, non-thermal (mainly itching) sensation, thermal sensation mainly in the deep tissue and in the distant part rather than in the body surface and the local part. CONCLUSIONS: HSM has a positive effect on improvement of AR, when applied, acupoints LI 20, EX-HN 3, EX-HN 8, Shangyintang, BL 13, CV 8, GV 23, GB 20, Die'e and GV 14 are highly recommended.

An assessment of epidemiological capacity of infectious disease in institutions of disease control and prevention / 预防医学

Objective To evaluate epidemiological capacity of infectious disease in institutions of disease control and prevention,and to improve the ability of infectious disease control and prevention. Methods Questionnaires of epidemiological capacity of infectious disease evaluation in institutions of disease control and prevention which contained surveillance analysis,emergency response,plan system and so on were used to evaluate epidemiological capacity of infectious disease in all of city,district or county level of center for disease control and prevention in Ningbo,Shaoxing, Quzhou.The degree of attainment for the ability or (and)resources was divided into vary bad,bad,average,and good. Descriptive epidemiological methods were used to perform analysis and evaluation.Results The capability for monitoring notifiable infectious diseases reaching to good was 1 9 (76.00%),greater than that in non -statutory communicable diseases 2 (8.00%). Twenty four (96.00%) institutions reported that the most important factor limiting the epidemiological capacity of infectious disease was lack of human resources,and 20 (80.00%)of institutions supported infectious disease epidemiology staff to publish articles in academic journals,but scientific research ability reaching to good was 3(1 2.00%).Training subordinate institution capacity reaching to good was 1 0(40.00%),with 2 (8.00%)reporting very bad.Most abilities were not significant across different regions,only significant in non -statutory communicable diseases surveillance (χ2 =7.04,P =0.03).Conclusion Institutions of disease control and prevention had a certain epidemiological capacity of infectious disease,and almost balance in different regions.For further enhancing the ability,it is necessary to increase the number of personnel,and to improve the ability of education and training.

Regional variations of basic public health services implementation in Zhejiang Province based on the Gini coefficient / 预防医学

Objective To explore regional variations of basic public health services implementation in Zhejiang Province at prefectural,county and township level,respectively.To find key problems which obstacle the equalization of basic public health services in Zhejiang Province.Methods Descriptive analysis was made on surveillance data of basic public health services in Zhejiang Province,2014.Gini coefficient of key indicators was calculated at prefectural,county and township level,respectively.To the key indicator with higher Gini coefficient,Lorenz curve was plotted and Gini coefficient of each prefectural-level city was calculated.Results An increasing tendency from prefectural to township level was showed in Gini coefficient of all twenty-five analyzed indicators.The Gini coefficient at township level was 0.497 for the average financial fund per migrant person,and the highest prefectural -level cities were Taizhou (0.709 ),Lishui (0.838 ), Quzhou(0.918).The Gini coefficient at township level of other indicators were 0.314 and 0.235 for the children and elderly health management of traditional Chinese medicine,and lower than 0.05 for maternal &children health care, immunization,and coverage rate of electronic health record,and between 0.066 to 0.179 for health management of chronic disease and severe mental illness patients.Conclusion Average financial fund per migrant person and health management of traditional Chinese medicine are current major problems which obstacle the equalization of basic public health services in Zhejiang Province.

An analysis on the correlations between the scarlet fever and meteorological factors with generalized additive model / 预防医学

Objective To explore the correlations between the scarlet fever and meteorological factors in Zhejiang Province. Methods The data which was been analyzed including month case of scarlet fever and meteorological factors from JAN 2005 to DEC 201 4,were analyzed for the degree and characteristic of the correlations between the scarlet fever and meteorological factors with generalized additive model(GAM).Results There were negative correlation between scarlet fever and meteorological factors including water vapor pressure and hours of sunshine.There were complex nonlinear correlations between scarlet fever and meteorological factors including precipitation,average barometric pressure,average wind speed and average temperature .The relationship between scarlet fever and meteorological factors including average barometric pressure,average wind speed and average temperature showed approximate quadratic function.The precipitation above 3 500(0.1 mm),average barometric pressure above 1 0 200(0.1 hPa)and under 1 0 050(0.1 hPa),average wind speed between 1 8.7 -23.6 (0.1 m/s)and average temperature between 1 00 -250 (0.1 ℃) were the suitable meteorological condition for scarlet fever.Conclusion There were complex nonlinear correlations between the scarlet fever and meteorological factors.Precipitation,average barometric pressure,average wind speed and average temperature may be associated with the incidence of scarlet fever.