Relative bioavailability of cadmium in aquatic products and its application on the cadmium exposure risk assessment / 上海预防医学

ObjectiveTo understand the relative bioavailability （RBA） of cadmium in different aquatic products. Based on the consideration of the gender differences and the relative bioavailability of cadmium in different foods， the physiologically based toxicokinetic （PBTK） model of cadmium was further optimized and verified. The correlation between internal and external exposure in quantitative risk assessment of food safety was optimized， and the provisional tolerable daily intake （PTDI） value of cadmium was derived. MethodsThe relative bioavailability of cadmium in different aquatic products was determined in four-week-old Balb/c female mice. The PBTK model of cadmium metabolism was optimized by ABC-MCMC method using combined internal and external exposure data of cadmium in Shanghai residents， and the PTDI was calculated accordingly. ResultsExcept for scallops and squid， the RBA of aquatic samples was less than 1， indicating that the absorption rate of cadmium in aquatic products was lower than that of cadmium chloride. The higher RBA of squid and scallop may be due to the presence of cadmium in the visceral organs， which is conducive to cadmium absorption and its higher concentration of cadmium. Frying at the temperature less than 160 ℃ reduced cadmium absorption but may increase cadmium absorption at the temperature greater than 160 ℃. The optimized model parameters converged well and the model could reasonably estimate urinary cadmium level according to the external exposure of cadmium. The PTDI value was0.466 4 μg·（kg·day）-1 according to the optimized single-chamber model. ConclusionThe relative bioavailability of cadmium in different foods varies greatly， except for squid and scallops， RBA is less than 1， and cooking processing will affect the RBA of food. The construction of the PBTK model did not only consider the effects of gender differences on cadmium metabolism， but also included the relative bioavailability data to optimize and adjust the correlation coefficient of absorption rate. Compared with the model without RBA adjustment， the adjusted model has enhanced the ability to predict urinary cadmium level， which provides a new， more accurate method for the risk assessment of food safety.

Plant foods intake and risk of type 2 diabetes: Findings from a registry-based prospective cohort study / 环境与职业医学

Background Lifestyle intervention or dietary modification has been the cornerstone of primary prevention and management of type 2 diabetes (T2D). Objective To investigate the associations of plant foods intake with the risk of incident T2D. Methods Based on a general population cohort, the Shanghai Suburban Adult Cohort and Biobank (SSACB), dietary data were collected for each participant in Songjiang District of Shanghai at enrollment with a validated Food Frequency Questionnaire (FFQ), and plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI) were calculated. Incident T2D cases were identified according to physician diagnosis (fasting blood glucose ≥7.0 mmol·L−1, or 2 h value during a 75-g oral glucose tolerance test ≥11.1 mmol·L−1, or glycosylated hemoglobin ≥6.5%, or with typical symptoms of hyperglycemia or hyperglycemic crisis, accompanied by a random plasma glucose ≥11.1 mmol·L−1) or medication records, obtained from the electronic information system for residents' medical insurance. Multivariable-adjusted Cox proportional hazards models and restricted cubic splines were used to evaluate the associations of foods from different sources with the risk of incident T2D. Results A total of 29016 participants [age at baseline (55.3±11.6) years] with a median follow-up duration of 5.688 years until 21 September 2022 were included. Plant foods (unprocessed) intake was associated with a decreased risk of incident T2D [HR (95%CI): 0.983 (0.969, 0.998)]. In comparison with participants in the highest quartile (≥859.3 g) of plant foods daily intake, the risk of incident T2D for those in the lowest quartile (<500.9 g) was higher [HR (95%CI): 1.250 (1.012, 1.544)]. No significant associations of animal foods [HR (95%CI): 1.006 (0.987, 1.026)] and processed foods [HR (95%CI): 0.978 (0.944, 1.014)] intakes were found with the risk of incident T2D. Replacing 50 g animal foods [HR (95%CI): 0.982 (0.968, 0.996)] or processed foods [HR (95%CI): 0.983 (0.969, 0.998)] with 50 g plant foods was associated with significantly decreased risks of incident T2D. Additionally, non-linear associations of PDI (Pnonlinear=0.023) and hPDI (Pnonlinear=0.016) with the risk of incident T2D were found in the SSACB. Conclusion Plant foods intake, especially healthful plant foods intake, is significantly associated with a decreased risk of incident T2D.

Thyroid hormone levels in healthy adults with non-occupational exposure to cadmium， lead and perfluoroalkyl substances / 上海预防医学

ObjectiveTo assess the effects of non-occupational mixed exposure to cadmium， lead and perfluoroalkyl substances （PFASs） on thyroid hormones （TH） in healthy adult residents in Shanghai. MethodsIn November 2018， adults in Shanghai Suburban Adult Cohort and Biobank study， who visited a community health service center for examination with no history of occupational exposure， thyroid diseases or chronic diseases， were recruited. A social-demographic information questionnaire survey was conducted and urine and blood samples were collected. Inductively coupled plasma mass spectrometry （ICP-MS） was used to measure their urinary cadmium （UCd）， blood cadmium （BCd） and blood lead （BPb） concentrations. Ultra-high performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry （UPLC-Q/TOF MS） was used to measure 11 kinds of PFASs. Total and free triiodothyronine （TT3， FT3）， total and free thyroxine （TT4， FT4） and thyroid simulating hormones were measured by chemiluminescence enzyme-linked immunoassay. 436 participants were finally included and LASSO regression， multivariate regression and weighted quantile sum regression were used to evaluate the associations of these environmental pollutants with thyroid hormones. ResultsAmong the participants， 185 were male （42.5%） and the median age was 60 （P25‒P75： 50‒66）. The detection rates of urinary cadmium， blood cadmium and blood lead were all more than 95% and the detection rates of 7 PFASs （PFOS， PFOA， PFHxS， PFUnDA， PFNA， PFD， and PFBS） were more than 90%. The median exposure level of PFOA was the highest （49.6 µg‧L-1） among PFASs， followed by PFHxS （22.8 µg‧L-1） and PFOS （15.4 µg‧L-1）， and the median exposure levels of urinary cadmium， blood cadmium and blood lead were 0.7 μg‧g-1（Corrected for creatinine of urine）， 0.8 µg‧L-1， and 15.4 µg‧L-1， respectively. The results showed that UCd was negatively associated with TSH and BCd was positively associated with TT3， while PFASs mainly affected FT4， TT4， and TT3， with gender differences. In males， 7 PFASs had a significant negative mixture effect on TT3 and TT4， while the direction of effect of PFASs in females differed， with PFOS and PFUnDA having a significant positive correlation with FT4 and TT4 while PFDA having a significant negative correlation with FT4 and TT4. ConclusionIn a healthy population with no occupational exposure， co-exposure to cadmium， lead and PFASs affects different thyroid hormone indicators， and such effect could be gender-related， indicating that the effect of mixed exposure to metal and emerging compounds on thyroid functions warrants further attention.

Inhibition of activated K-opioid receptor to myocardical hypertrophy induced by ET-1 in neonatal rats by extracellular signal-regulated kinase pathway / 中国药理学通报

Aim To investigate the inhibitory effect of kappa-opioid receptor(κ-OR)stimulation on extracellular signal-regulated kinase pathway on ET-1-induced cardiomyocyte hypertrophy in vitro cultured myocardial cells from neonatal rats.Methods Myocardial cells of neonatal rats were cultured in vitro.The hypertrophic myocytes were induced by ET-1(10 nmol·L-1)before κ-OR agonist U50488H(1 μmol·L-1)was administered.The antihypertrophic effect of κ-OR stimulation was observed in the presence of U0126(1μmol·L-1), Ro-31-8220(50 nmol·L-1)and PTX(5 mg·L-1).The cardiomyocytes volume was measured by computer photographalysis system.The relative expression of ERK1/2 was determined by Western blot.The morphological changes in cardiomyocytes were observed under an inverted phase contrast microscope.The expression of mRNA of atrial natriuretic peptide(ANP)was determined by RT-PCR.Results Compared with normal control group, ET-1 could induced cardiomyocyte hypertrophy.Compared with ET-1 model group, U50488H(1 μmol·L-1)could obviously inhibit ET-1-induced increase of the cardiomyocytes volume, expression of ANPmRNA and expression of ERK1/2, which was similar to U0126(1 μmol·L-1)and Ro-31-8220(50 nmol·L-1); however, the inhibitory effects of U50488H were partly lost when preincubated with U0126(1 μmol·L-1)and Ro-31-8220(50 nmol·L-1); the inhibitory effects of U50488H, U0126(1 μmol·L-1)and Ro-31-8220(50 nmol·L-1)were lost when preincubated with NOR-BNI.Conclusion The stimulation of kappa-opiod can inhibit myocardial hypertrophy induced by ET-1, which is possibly via attenuating ERK1/2.

Relationship between DEAD-box helicase 5, transcription factor 12 and amyotrophic lateral sclerosis / 解剖学报

Objective To explore the relationship between the expression of DEAO-box helicase 5(DDX5) and transcription factor 12(TCF12) with amyotrophic lateral sclerosis ( ALS ) hippocampal lesions by detecting the expressions and the interaction of DDX5 and TCF12 in the hippocampus of SOD1-G93A mutant ALS transgenic mice. Methods Forty- two pairs of SOD1-G93A mutant ALS transgenic mice and wild-type mice were divided into three groups at the age of 95 days (early onset stage), 108 days (middle onset stage) and 122 days (late onset stage). RT-PCR, Western blotting and double immunofluorescence labeled technique were used to detect the expressions of DDX5 and TCF12 in the hippocampus. Co-immunoprecipitation assasy was used to detect the interaction between DDX5 and TCF12. Results Compared with the wild-type mice of the same age, DDX5 and TCF12 mRNA in the hippocampus of SOD1-G93A mutant ALS transgenic mice were unchanged, but DDX5 and TCF12 protein were up-regulated significantly at day 95, 108 and 122. DDX5 and TCF12 positive cells were found in both DG area and hippocampus proper, and DDX5 and TCF12 were co-localized with neurons. The immunoreactivities of DDX5 and TCF12 in the hippocampus of SOD1-G93A mutant transgenic mice were elevated compared with wild-type mice at the same time point. Co-immunoprecipitation assasys confirmed that there existed interactions between DDX5 and TCF12 protein. Conclusion DDX5 and TCF12 protein are up-regulated in the hippocampal tissues of SOD1-G93A mutant ALS transgenic mice. The abnormal expressions of DDX5 and TCF12 are involved in the hippocampal lesions of ALS.

Clinical efficacy of different treatments and their impacts on the quality of life of octogenarians with coronary artery disease / 中华医学杂志(英文版)

BACKGROUND@#Coronary artery disease (CAD) in octogenarians (age of ≥80 years) has a high risk of mortality and high medical expenses. Research shows that the prevalence of CAD is higher among octogenarians than that among younger people, but few such patients undergo percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). This study aimed to evaluate different treatments with respect to their clinical effects and impacts on quality of life of octogenarians with CAD.@*METHODS@#Data of 519 octogenarians with CAD consecutively treated at Beijing Anzhen Hospital, Capital Medical University (Beijing, China) from January 2010 to January 2016 were collected in this study. The patients were categorized into three groups based on the treatments they received: the PCI group (n = 292), CABG group (n = 110), and medical treatment group (n = 117). The followings were recorded during follow-up: clinical data, death (all-cause and cardiovascular-related), re-hospitalization time, Seattle Angina Questionnaire (SAQ) score, and occurrence of hemorrhagic events (cerebral bleeding, gastrointestinal bleeding, and dermal ecchymosis).@*RESULTS@#The median follow-up duration was 25.0 (25th, 75th percentile: 17.0, 55.5) months among 417 patients. The all-cause death rates (28.2% vs. 12.0% and 14.6%, respectively) and cardiovascular-related death rates (15.4% vs. 3.8% and 6.4%, respectively) were significantly higher in the medical treatment group than those in the PCI group and CABG group (all P < 0.05). The re-hospitalization rate for cardiovascular events was significantly lower in the CABG group than those in the PCI group and medical treatment group (3.8% vs. 12.8% and 14.9%, respectively) (χ = 8.238, P = 0.018). The SAQ scores of physical limitation, angina frequency, treatment satisfaction, and disease perception were significantly higher in the PCI group and CABG group than those in the medical treatment group (all P < 0.05). No significant difference in the angina stability score was observed among the three groups (F = 3.179, P = 0.204).@*CONCLUSION@#PCI and CABG result in reduced mortality and better quality of life in octogenarians with CAD.

Clinical efficacy of different treatments and their impacts on the quality of life of octogenarians with coronary artery disease / 中华医学杂志(英文版)

Background@#Coronary artery disease (CAD) in octogenarians (age of ≥80 years) has a high risk of mortality and high medical expenses. Research shows that the prevalence of CAD is higher among octogenarians than that among younger people, but few such patients undergo percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). This study aimed to evaluate different treatments with respect to their clinical effects and impacts on quality of life of octogenarians with CAD.@*Methods@#Data of 519 octogenarians with CAD consecutively treated at Beijing Anzhen Hospital, Capital Medical University (Beijing, China) from January 2010 to January 2016 were collected in this study. The patients were categorized into three groups based on the treatments they received: the PCI group (n = 292), CABG group (n = 110), and medical treatment group (n = 117). The followings were recorded during follow-up: clinical data, death (all-cause and cardiovascular-related), re-hospitalization time, Seattle Angina Questionnaire (SAQ) score, and occurrence of hemorrhagic events (cerebral bleeding, gastrointestinal bleeding, and dermal ecchymosis).@*Results@#The median follow-up duration was 25.0 (25th, 75th percentile: 17.0, 55.5) months among 417 patients. The all-cause death rates (28.2% vs. 12.0% and 14.6%, respectively) and cardiovascular-related death rates (15.4% vs. 3.8% and 6.4%, respectively) were significantly higher in the medical treatment group than those in the PCI group and CABG group (all P < 0.05). The re-hospitalization rate for cardiovascular events was significantly lower in the CABG group than those in the PCI group and medical treatment group (3.8% vs. 12.8% and 14.9%, respectively) (χ2 = 8.238, P = 0.018). The SAQ scores of physical limitation, angina frequency, treatment satisfaction, and disease perception were significantly higher in the PCI group and CABG group than those in the medical treatment group (all P < 0.05). No significant difference in the angina stability score was observed among the three groups (F = 3.179, P = 0.204).@*Conclusion@#PCI and CABG result in reduced mortality and better quality of life in octogenarians with CAD.

Determining "abnormal" levator hiatus distensibility using three-dimensional transperineal ultrasound in Chinese women / 医学前沿

The dimension of the levator hiatus is a possible predictor of pelvic organ prolapse (POP). This retrospective study investigated 360 women who went to urogynecological clinic for pelvic floor discomfort. Levator hiatus dimensions were obtained by three-dimensional transperineal ultrasound and results were compared between women with and without significantly objective prolapse (International Continence Society POP quantification, grade 2 or higher). Receiver operating characteristic (ROC) curve analyses were performed to determine valid screening index for detecting abnormal levator hiatus distensibility. Women with significantly objective prolapse had significantly higher levator hiatus dimensions than those without (all P < 0.001). ROC curve analyses confirmed that hiatal area (HA) of 19.5 cm during Valsalva maneuver can be used as single-screening index for abnormal levator hiatus distensibility with sensitivity of 0.80 and specificity of 0.70. In this study, we used a two-step method and achieved higher sensibility (0.80 vs. 0.87) without reducing specificity (0.70 vs. 0.71) compared with a single-screening index method. As a result, we suggest that HA ⩾ 19.5 cm during Valsalva maneuver is an indicator of abnormal levator hiatus distensibility in Chinese women and that the two-step method has higher sensitivity in detecting abnormal distensibility.

Prognostic significance of (18)F-fluorodeoxyglucose positron emission tomography in patients with diffuse large B cell lymphoma undergoing autologous stem cell transplantation / 中华血液学杂志

Objective: To evaluate the prognostic value of (18)F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) in patients with diffuse large B cell lymphoma (DLBCL) undergoing autologous hematopoietic stem cell transplantation (auto-HSCT). Methods: Forty-eight patients with DLBCL treated at Peking University Cancer Hospital between November 2010 and December 2014 were assessed. All patients underwent PET/CT scanning prior to or after auto-HSCT. Correlation analysis was done based upon patients characteristics, PET/CT scan results and survival. Results: ①Among 48 patients, 27 was male, 21 female, median age was 43 (17-59) years old. ② Patients with negative pre-auto-HSCT PET/CT assessment demonstrated significantly better 3-year progression free survival (PFS) (87.1% vs 53.3%, χ(2)=7.02, P=0.019) and overall survival (OS) (90.3% vs 60.0%, χ(2)=6.51,P=0.022) than patients with positive pre-auto-HSCT PET/CT assessment. Three-year PFS (94.1% vs 30.0%, χ(2)=22.75, P=0.001) and OS (97.1% vs 40.0%, χ(2)=21.09, P=0.002) were also significantly different between patients with negative and positive post-auto-HSCT PET/CT assessment. ③ Multivariate analysis indicated a significant association of PFS (HR=13.176, P=0.005) and OS (HR=20.221, P=0.007) with post-auto-HSCT PET/CT assessment. Number of prior treatment regimens was associated with PFS (HR=10.039, P=0.040). ④ Harrell's C index revealed that the value of combined use of number of prior treatment regimens and post-auto-HSCT PET/CT assessment was superior to either one used alone in PFS (Harrell's C values were 0.976, 0.869 and 0.927 in combined use, number of prior treatment regimens and post-auto-HSCT PET/CT assessment, respectively), and the combined use of ECOG performance status and post-auto-HSCT PET/CT assessment significantly increased the Harrell's C index in OS (Harrell's C values were 0.973, 0.711 and 0.919 in combined use, ECOG performance status and post-auto-HSCT PET/CT assessment, respectively). Conclusions: Post-auto-HSCT PET/CT assessment is the main predictor of outcomes in DLBCL patients receiving auto-HSCT. Combined use of post-auto-HSCT PET/CT assessment and number of prior treatment regimens and ECOG performance status is a better prognostic tool in patients with DLBCL undergoing transplantation.

Clinical characteristics and survival analysis of de novo grade 3 or transformed follicular lymphoma patients / 中华血液学杂志

Objective: To evaluate the clinical characteristics and survival outcomes of patients with de novo grade 3 or transformed follicular lymphoma (FL). Methods: Fifty-two patients treated at Peking University Cancer Hospital between January 2009 and September 2017 were assessed, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. Baseline characteristics, survival and prognostic factors were analyzed. Results: ① Twenty-six male and 26 female patients were enrolled, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. ②The 3-year progression-free survival (PFS) and overall survival (OS) for the entire cohort were 56.0% and 80.6%, respectively. Patients with international prognostic index (IPI) score 0-1 demonstrated significantly better 3-year PFS (80.3% vs 20.1%; t=18.902, P<0.001) and OS (95.7% vs 57.0%; t=10.406, P<0.001) than patients with IPI score 2-3. Three-year PFS (94.1% vs 37.2% vs 25.2%; P=0.002) and OS (100.0% vs 76.0% vs 59.8%; P=0.020) were also significantly different among patients with FLIPI 1 score 0-1, 2, ≥3. FLIPI 2 score was also identified as a prognostic factor for 3-year PFS (68.4%, 0, 0; P=0.001) and OS(87.5%, 76.2%, 0; P=0.003). ③Multivariate analysis indicated a significant association of PFS (HR=3.536, P=0.015) and OS (HR=15.713, P=0.015) with IPI. FLIPI 2 was associated with OS (score 0-1, HR=0.078, P=0.007; score 2, HR=0.080, P=0.022). Conclusion: De novo grade 3 or transformed FL might be a group of curable disease with current treatment strategies. IPI is still a prognostic tool in this scenario.

Effects of clonal integration on the proximal and distal ramets of Cynodon dactylon under shade stress

ABSTRACT In a pot experiment, clonal ramets of Cynodon dactylon, a stolon herbaceous plant, were treated with heterogeneous lighting. Proximal ramets (elder ramets) were subjected to shade stress at three different degrees, and stolons between proximal and distal ramets of each pair were treated in a connected or severed manner. Results showed that in moderate shade stress, the number of ramets and leaves, biomass, net photosynthetic rate (Pn), maximum quantum yield (Fv/Fm), effective quantum yield of PSII (ФPSII), and soil and plant analysis development values (SPAD) of proximal ramets were significantly reduced, regardless of whether stolons were kept intact or severed. However, the growth of distal ramets was not significantly influenced, and keeping the stolons intact also did not bring apparent benefits for the whole clonal fragments. These results show that clonal integration does not help alleviate the shade stress suffered by proximal ramets and the costs of distal ramets and does not significantly influence the whole clonal fragments. The possible reasons are that distal ramets may be at the cost of metabolism for resource transportation when the proximal ramets suffer from shade stress; thus, clonal integration is not favorable.

Evaluation of the fallopian tube patency in infertile women after recanalization with hysterosalpingo contrast sonography / 中华医学超声杂志（电子版）

Objective To evaluate the value of hysterosalpingo-contrast-sonography in assessment the patency of fallopian tube after tubal interventional recanalization. Methods A total of 56 cases of fallopian tube recanalization were performed in Shanghai Putuo Hospital from January 2015 to September 2016. Seventy-eight fallopian tubes in 40 cases were treated with hysterosalpingo-contrast-sonography and hysterosalpingography before recanalization. Totally 106 fallopian tubes in 56 cases were performed hysterosalpingography before and after recanalization. Seventy-eight fallopian tubes in 40 cases were evaluated with hysterosalpingo-contrast-sonography before recanalization. The patency of the tubal was assessed by hysterosalpingo-contrast-sonography 3 months after recanalization, and the re-occlusion rate was calculated. Chi square test was used to compare the results of hysterosalpingo-contrast-sonography and hysterosalpingography before and after recanalization, and the patency of fallopian tube at just after operation and 3 months after recanalization. Results Before recanalization, the results of hysterosalpingo-contrast-sonography showed 40 obstructed and 38 partially obstructed. The results of hysterosalpingography showed 44 obstructed and 34 partially obstructed. There was no significant difference between the results of hysterosalpingo-contrast-sonography and hysterosalpingography. Before recanalization, 106 fallopian tubes in 56 cases showed 53 obstructed and 53 partially obstructed. After recanalization, 72 unobstructed, 34 partially obstructed, and no obstruction. However, 22 fallopian tubes were re-obstructed 3 months after recanalization, and the rate of re-occlusion was 20.7% (22/106). The re-occlusion rate of unobstructed fallopian tubes was 19.4% (14/73) and the re-occlusion rate of partially obstructed fallopian tubes was 23.5% (8/34). There was no statistically significant difference between them. Conclusions Re-obstruction may be present in some cases 3 months after tubal recanalization. Hysterosalpingo-contrast-sonography can provide an objective and effective basis for guiding pregnancy plan after tubal recanalization.

Analysis on supply management system of emergency drugs in China: From the perspectives of policy network theory / 中国卫生政策研究

Objective:To analyze the supply management of emergency drugs from the perspective of policy network theory and to provide a reference for the establishment of timely,reasonable and effective emergency drug management system in China.Methods:The policy network theory was used to examine the existing problems in the current supply management system of emergency drugs in China and to optimize the policy network of emergency drug supply in China.Results:The policy network theory is applicable to the emergency drug system in China.From the perspective of policy network theory,the following aspects of supply management system of emergency drugs should be improved,including a clear government responsibility at all levels,strengthening the work of medical emergency funding and legal protection,and building up a policy network of public information platform for emergency drugs.Conclusion:Based on the findings of this analysis,optimizing the supply management system of China's emergency drugs is one of the important directions of the construction of national emergency system in China.The emergency work of the drugs needs to run benignly in a network with stable structure,balance of interests and integration of resources,so as to obtain reasonable and efficient results.

Analysis on supply management system of emergency drugs in China: From the perspectives of policy network theory / 中国卫生政策研究

Objective:To analyze the supply management of emergency drugs from the perspective of policy network theory and to provide a reference for the establishment of timely,reasonable and effective emergency drug management system in China.Methods:The policy network theory was used to examine the existing problems in the current supply management system of emergency drugs in China and to optimize the policy network of emergency drug supply in China.Results:The policy network theory is applicable to the emergency drug system in China.From the perspective of policy network theory,the following aspects of supply management system of emergency drugs should be improved,including a clear government responsibility at all levels,strengthening the work of medical emergency funding and legal protection,and building up a policy network of public information platform for emergency drugs.Conclusion:Based on the findings of this analysis,optimizing the supply management system of China's emergency drugs is one of the important directions of the construction of national emergency system in China.The emergency work of the drugs needs to run benignly in a network with stable structure,balance of interests and integration of resources,so as to obtain reasonable and efficient results.

Evaluating the short-term effect of delivery mode on female anterior compartment of pelvic floor / 中华超声影像学杂志

Objective To dynamically observe and evaluate the position and movement of anterior pelvic floor organs in vaginal delivery and selective caesarean section primipara with translabial two-dimensional 2D ultrasound and discuss the short-term effect of delivery mode on the anterior compartment of pelvic floor Methods Translabial 2D ultrasound was performed on selective caesarean section and vaginal delivery primipara in 6-8 weeks The position of bladder the existence of bladder neck funneling were observed and the mobility of bladder neck and the urethral rotation angle were measured during maximum Valsalva maneuver Results The mobility of bladder neck was larger in vaginal delivery group than selective caesarean section group during maximum Valsalva maneuver The rates of bladder neck funneling cystocele and stress urinary incontinence were higher in vaginal delivery group Conclusions Translabial 2D ultrasound could dynamically observe and evaluate the position and movement of anterior pelvic floor organ which could be used to assess the effect of delivery mode on anterior compartment of pelvic floor The short-term effect of vaginal delivery on anterior compartment of pelvic floor is greater than that of selective cesarean delivery.

Ultrasonic imaging of female cystocele subtypes:a preliminary study / 中华超声影像学杂志

Objective To investigate the pelvic floor in cystocele patients using translabial ultrasound,and discuss the ultrasound appearance.Methods Translabial 2D ultrasound was performed on 136 patients who were diagnosed or suspected as anterior vaginal wall prolapse or cystocele using pelvic organ prolapse quantitation system,the position of bladder,the retrovesical angle and urethral rotation were measured during maximum Valsalva maneuver.Cystocele subtypes were diagnosed according to the ultrasound findings.Results Translabial 2D ultrasound diagnosed 88 cases cystocele based on the position of bladder,retrovesical angle and urethral rotation,including ten cases cystocele type Ⅰ,32 cases type Ⅱ and the remaining 46 classified as type Ⅲ.Conclusions Translabial 2D ultrasound successfully acquired the ultrasonic characteristics of cystocele subtypes,which could provide imaging evidence for clinic diagnosis of this disease.

Observation of levator ani muscle contractility in postpartum women by ultrasound / 中华超声影像学杂志

Objective To evaluate the changes of levator ani muscle contractility in different postpartum periods by observing the contractility of postpartum women's levator ani muscle.Methods Forty-six postpartum women and 43 nulliparous women were included in the object.All of those went through translabial pelvic floor ultrasound examinations.Images of their levator hiatus would be recorded at the conditions of rest and contraction.The hiatal length (L)and the area (A)of levator hiatus were measured,then the differences were obtained between rest and contraction conditions,recording as ΔL andΔA.Relevant data were analyzed.Results There was no obvious statistical difference of L and A between the groups (P >0.05).The ΔL and ΔA of the 6-8 weeks were the minimum in this objective(P 0.05).Conclusions After delivery,the contractility of levator ani muscle became weaker,but could recovery effectively after about half a year.

Clinical characteristics and prognosis analysis of patients with LMP-1 positive Hodgkin's lymphoma after EBV infection / 中国实验血液学杂志

This study was purposed to investigate the expression of latent membrane protein 1 (LMP-1) and CD68 in Hodgkin's lymphoma (HL) patients with EB virus infection and to analyze the relation of LMP-1 expression and CD68(+) tumor-associated macrophage count with clinical features and prognosis of HL patients. The expression of LMP1 and count of CD68(+) TAM were detected by immunohistochemical staining in tissue specimens of 72 HL patients; their correlation with clinical features and prognosis of HL patients was analyzed by using statistical method. The results showed that among tissue specimens of 72 HL patients, the positive rate of LMP-1 expression was 18.1% (13/72), the CD68(+) TAM count was more higher in LMP-1 positive expression [250 of CD68(+) TAM/high power field (hpf) is used as demarcation point] (P = 0.003). The statistical analysis showed that the LMP-1 positive expression was more observed in mixed type HL patients (P = 0.000); the positive rate of LMP-1 expression was much high in HL patients with albumin <40 g/L and age ≥ 45 years (P < 0.05). There was no relation of LMP-1 expression and CD68(+) TAM count with the short term therapeutic efficacy of HL patients, but the overall survival time of LMP-1 positive patients among patients followed-up for ≥ 5 years was short (P < 0.05). Moveover, no correlation of CD68(+) TAM count with the overall survival time of HL patients was found. It is concluded that the high count of CD68(+) TAM is more observed in LMP-1 positive expression of HL tissue, the LMP-1 expression states relates both with the pathological types, age and albumin level of patient with HL. The HL patients with LMP-1 positive expression have poor prognosis, suggesting that LMP-1 may be a new prognostic marker for HL patients.

Preliminary study of 3D ultrasound in visualization of levator hiatus in intrapartum women / 中华超声影像学杂志

Objective To visualize the pelvic floor structures by translabial three‐dimensional(3D) ultrasonography performed during labor and immediately after delivery, and to observe the morphological changes of levator hiatus in intrapartum women. Methods Totally 62 nulliparous women with singleton pregnancy and cephalic presentation in labor ward underwent intrapartum translabial 3D ultrasound examination before cervical dilatation, at 10 cm dilatation and immediately after delivery. Volume datasets were obtained at rest, biometric measurements and observation of the morphological changes of levator hiatus in different stages were determined in the axial plane. Comparative analyses of parameters in three stages were carried out. Results Translabial 3D ultrasound demonstrated the pelvic floor structures of intrapartum women well. All biometric measurements of the hiatus before cervical dilatation were the smallest and became the largest at 10 cm dilatation, showed statistically significant differences. The measurements after delivery got smaller immediately but still significantly larger than those before cervical dilatation ( P <0 0.01). Conclusions Translabial 3D ultrasound examination of the pelvic floor during labor and within the first 2h after delivery is feasible. It seems to be an effective tool to visualize pelvic floor structures in intrapartum women. Hiatal enlargement may be a common consequence of vaginal childbirth.