Epidemiological characteristics of a 2019-nCoV outbreak caused by Omicron variant BF.7 in Shenzhen / 中华流行病学杂志

Objective: To explore the epidemiological characteristic of a COVID-19 outbreak caused by 2019-nCoV Omicron variant BF.7 and other provinces imported in Shenzhen and analyze transmission chains and characteristics. Methods: Field epidemiological survey was conducted to identify the transmission chain, analyze the generation relationship among the cases. The 2019-nCoV nucleic acid positive samples were used for gene sequencing. Results: From 8 to 23 October, 2022, a total of 196 cases of COVID-19 were reported in Shenzhen, all the cases had epidemiological links. In the cases, 100 were men and 96 were women, with a median of age, M (Q1, Q3) was 33(25, 46) years. The outbreak was caused by traverlers initial cases infected with 2019-nCoV who returned to Shenzhen after traveling outside of Guangdong Province.There were four transmission chains, including the transmission in place of residence and neighbourhood, affecting 8 persons, transmission in social activity in the evening on 7 October, affecting 65 persons, transmission in work place on 8 October, affecting 48 persons, and transmission in a building near the work place, affecting 74 persons. The median of the incubation period of the infection, M (Q1, Q3) was 1.44 (1.11, 2.17) days. The incubation period of indoor exposure less than that of the outdoor exposure, M (Q1, Q3) was 1.38 (1.06, 1.84) and 1.95 (1.22, 2.99) days, respcetively (Wald χ2=10.27, P=0.001). With the increase of case generation, the number and probability of gene mutation increased. In the same transmission chain, the proportion of having 1-3 mutation sites was high in the cases in the first generation. Conclusions: The transmission chains were clear in this epidemic. The incubation period of Omicron variant BF.7 infection was shorter, the transmission speed was faster, and the gene mutation rate was higher. It is necessary to conduct prompt response and strict disease control when epidemic occurs.

The role of preoperative TACE on hepatocellular carcinoma located in caudate lobe / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the effect of preoperative transarterial chemoembolization (TACE) on hepatocellular carcinoma located in caudate lobe.</p><p><b>METHODS</b>Totally 29 cases of caudate lobe hepatocellular carcinoma admitted from January 2001 to December 2010 were analyzed retrospectively. Among the 29 patients, 23 were male and the other 6 were female. The median age was 52 years. According to receiving preoperative TACE or not, the 29 cases were divided into two groups: preoperative TACE plus surgery (group A, n = 11) and surgery only (group B, n = 18). The surgical results and long-term survival were compared between two groups.</p><p><b>RESULTS</b>After TACE, the diameter of the tumour reduced by over 33.3% in 3 patients, 10.0% to 33.3% in 6 patients, and less than 10.0% in 2 patients. The duration of surgery and intraoperative blood loss in group A were (298 ± 39) minutes and (1031 ± 310) ml, respectively. The duration of surgery and intraoperative blood loss in group B were (281 ± 54) minutes and (868 ± 403) ml, respectively. No significant difference was found in terms of these two groups (t = 1.006, P = 0.324; t = 1.223, P = 0.232). In addition, 6 cases in group A developed complications and 4 cases in group B did so. Only one patient died because of postoperative complication, and this patient belonged to group A. No significant difference was found between two groups (χ(2) = 0.028, P = 0.868; χ(2) = 0.633, P = 0.426). The 5-year survival rate was 56.8% in group A and 34.9% in group B. The difference did not reach significant difference (P = 0.132).</p><p><b>CONCLUSIONS</b>For hepatocellular carcinoma located in caudate lobe, preoperative TACE does not significantly increase the surgical difficulty and impair the safety. In addition, preoperative TACE has the tendency to provide benefit to long-term survival.</p>

Retrospective observation of dynamic levels of serum Golgi protein 73 in patients prior to the onset of liver cancer / 中华预防医学杂志

<p><b>OBJECTIVE</b>To observe the dynamic levels of serum Golgi protein 73(GP73) in patients prior to and after the onset of liver cancer, and to explore the related factors.</p><p><b>METHODS</b>From 2007 to 2012, a periodical screening program was carried out in a group of high risk population with positive Hepatitis B surface antigens (HBsAg) , twice a year. Their serum specimens from every screening time point were kept in Qidong Biobank until liver cancer was diagnosed. Thirty-nine patients with liver cancer were recruited for the study, each of them at least had three times of specimens collected as well as B ultrasound scan (BUS) exam results at onset of disease and within 30 months before diagnosed, amongst 6 time points. In total, there were 162 specimens collected to test GP73 by double-antibody sandwich enzyme-linked immuno-sorbent assay (ELISA). Statistical analyses of time series and differences among groups were performed by stata software 10.</p><p><b>RESULTS</b>The average value of 39 patient's GP73 at the time point of liver cancer onset was (126.77 ± 73.73) µg/L, while the values at the other five time points prior to the onset were (128.32 ± 81.18) , (129.97 ± 83.62) , (127.38 ± 80.10) , (135.52 ± 97.88) and (138.24 ± 93.58) µg/L, respectively, with no significant difference (F = 0.07, P = 0.997). No obvious changing trends of GP73 were observed among the 39 liver cancer cases at the 6 time points. All 162 samples were divided into two groups: without hepatic cirrhosis (63 samples) and with cirrhosis (99 samples) according to findings of B-ultrasonic wave; whose average GP73 values were separately (97.16 ± 51.39) and (151.20 ± 91.68) µg/L. The difference showed statistical significance (F = 18.22, P < 0.01). Furthermore, if we grouped the samples by the average value of GP73 at 130.19 µg/L, then there were only 1/14 of the subjects without hepatic cirrhosis having higher GP73 values, but 12 of the 25 subjects with hepatic cirrhosis having higher GP73 values. The difference showed statistical significance (P = 0.013). The results of Linear regression model also showed that there was no correlation between GP73 and time series (t = 0.75, P = 0.455), but significant correlation between GP73 and hepatic cirrhosis (t = 4.30, P < 0.01).</p><p><b>CONCLUSION</b>No significant changes of the dynamic levels of GP73 could be found among the liver cancer patients within 30 months prior to the onset of disease. GP73 values of the patients with liver cancer may depend on their background of hepatic diseases; and hepatic cirrhosis might be one of the main influencing factors or confounding factors.</p>

Survey of the serum hepatocellular carcinoma marker Golgi glycoprotein (GP73) among Qidong residents and correlation analysis to outcome at two-year follow-up / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To survey the levels of Golgi glycoprotein (GP73), a hepatocellular carcinoma (HCC) marker, in residents of Qidong and determine the correlation of detected GP73 concentration ranges with outcome at two-year follow-up.</p><p><b>METHODS</b>A total of 12,378 individuals (age range: 35-69 years old) from Qidong were enrolled in the study. All participants were tested for hepatitis B virus (HBV) by detecting hepatitis B surface antigen (HBsAg) in serum. One-tenth of the participants were assigned to a stratified-random sample group (those with identification numbers ending with "0") to represent a "subgroup of the natural population" (HBsAgPop, n = 1227). All HBsAg carriers were stratified as a "subgroup of positivity" (HBsAgPve, n = 1025). One-tenth of all HBsAg-negative individuals were assigned to a stratified-random sample group to represent a "subgroup of negativity" (HBsAgNve, n = 1132). Enzyme-linked immunoassay was used to measure the serum GP73 and alpha-fetoprotein (AFP) levels; the distribution, medians (50th percentile), and 95th percentiles of GP73 were determined for the three subgroups. A two-year follow-up was carried out to observe the differential incidence of HCC between the HBsAgPve and HBsAgNve subgroups.</p><p><b>RESULTS</b>A positively skewed distribution of the GP73 values was observed for all three subgroups. The medians for HBsAgPve, HBsAgNve, and HBsAgPop were 67 mug/L, 54 mug/L, and 55 mug/L; the 95th percentiles were 174 mug/L, 108 mug/L, and 114 mug/L, respectively. The AFP positivity rates were 7.23% (37/512) for carriers whose GP73 values were above the median level and 0.78% (4/513) for carriers with GP73 values below the median level, with a highly significant difference between the two (P less than 0.01). A the two-year follow-up, 23 (4.49%) of the 512 carriers with GP73 more than or equal to 67 mug/L had developed HCC, while only one patient (0.19%) of the 513 carriers with GP73 less than 67 mug/L developed HCC, which yielded a relative risk value of 23.6. In the non-carriers, no HCC cases had occurred, regardless of serum GP73 level.</p><p><b>CONCLUSION</b>Serum GP73 has a higher potential as a diagnostic/prognostic marker of HCC in individuals with HBsAg positivity. In follow-up of HBsAg carriers, GP73 may help in the early detection of liver cancer.</p>

Trends in the mortality of liver cancer in Qidong, China: an analysis of fifty years / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To describe and analyze the charecteristics and trends of liver cancer mortality during the past fifty years in Qidong, China.</p><p><b>METHODS</b>Retrospective mortality survey was conducted to get the data on liver cancer death in the period of 1958-1971, and the data from 1972 to 2007 were obtained from the records of cancer registration in Qidong. The crude mortality rate (CR) of liver cancer, and age-standardized rate by Chinese population (CASR) and by world population (WASR) were calculated and analyzed. The total percent changes (PC) and annual percent changes (APC) were used for evaluating the increasing trends of the mortality. The sex-specific rate, age-specific rate, truncated rate of the age group 35 - 64, cumulative rate of the age group 0-74, cumulative risk, period-rate, and the rate for age-birth cohort were compared.</p><p><b>RESULTS</b>The natural death rate in Qidong residents for the past five-decade period experienced a wave interval of 8.62‰ in 1958 down to 5.37‰ in 1979, and up to 7.75‰ in 2007. The mortality rate for all-site cancers was increased from 56.69 per 100, 000 to 234.97 per 100, 000. The mortality rate of liver cancer, being 20.45 per 100, 100 in 1958 was increased to 49.04 per 100, 000 in 1972, and up to 69.29 per 100, 000 in 2007. According to the registration data of 1972 - 2007, the death from liver cancer was accounted for 34.88% of all deaths due to cancers, with a CR of 58.86 per 100, 000, CASR of 38.36 per 100, 000, and WASR, 49.37 Per 100, 000 in Qidong. The truncated rate for the age group 35 - 64 was 117.08 per 100, 000, and the cumulative rate for the age group 0-74 and the cumulative risk were 5.15% and 5.02%, respectively. The CRs for males was 90.52 per 100, 000 and for females was 27.93 per 100, 000, with a sex ratio of 3.24:1. For the period of 1972 - 2007, the PC for CR was 49.71%, and APC was +1.41%, showing an increasing variation tendency. The APCs for CASR and WASR, however, were decreasing, with a percentage of -1.11%, and -0.84%, respectively. The age-specific mortality rates by period showed a decreasing trend for those under age of 44. Moreover, age-birth cohort analysis showed a more rapid lowering mortality in the age groups 35-, 30-, 25-, and 15-, that is, those born after 1950's.</p><p><b>CONCLUSIONS</b>Liver cancer remains the leading death cause due to cancers in Qidong, with a continuing higher crude mortality rate. Yet the age-standardized mortality rate has presented a declining posture. The liver cancer mortality in young people in Qidong demonstrates a continuously falling trend. The campaign for the control of liver cancer in Qidong has achieved initial success.</p>

Characteristic gene expression profiles in the progression from normal gastric epithelial cells to moderate gastric epithelial dysplasia and to gastric cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Gastric cancer ranks high among the most common causes of cancer-related death worldwide. This study was designed to explore key genes involved in the progression of normal gastric epithelial cells to moderate gastric epithelial dysplasia (mGED) and to gastric cancer.</p><p><b>METHODS</b>Twelve pairs of mGED tissues, gastric cancer tissues, and normal gastric tissues were collected by gastroscopy. Total RNA was then extracted and purified. After the addition of fluorescent tags, hybridization was carried out on a Gene chip microarray slide. Significance analysis of microarrays was performed to determine significant differences in gene expression between the different tissue types.</p><p><b>RESULTS</b>Microarray data analysis revealed totally 34 genes that were expressed differently: 18 highly expressed (fold change > 2; P < 0.01) and 16 down-regulated (fold change > 2; P < 0.01). Of the 34 genes, 24 belonged to several different functional categories such as structural molecule activity, extracellular regions, structural formation, cell death, biological adhesion, developmental processes, locomotion, and biological regulation that were associated with cancer. The remaining 10 genes were not involved in cancer research. Of these genes, the expression levels of Matrix metalloproteinase-12 (MMP12), Caspase-associated recruitment domain 14 (CARD14), and Chitinase 3-like 1 (CHI3L1) were confirmed by semi-quantitative RT-PCR. A two-way clustering algorithm divided the 36 samples into three categories and the overall correct classification efficiency was 80.6% (29/36). Almost all of these genes (31/34) showed constant changes in the process of normal gastric epithelial cells to mGED to gastric cancer.</p><p><b>CONCLUSIONS</b>The results of this study provided global gene expression profiles during the development and progression from normal gastric epithelial cells to mGED to gastric cancer. These data may provide new insights into the molecular pathology of gastric cancer which may be useful for the detection, diagnosis, and treatment.</p>

Randomized-controlled study on anti-inflammation and safety of three drugs after Nd : YAG laser posterior capsulotomy / 中华实验眼科杂志

Background Nd: YAG laser posterior capsulotomy is an important way for after cataract.Usually the patient will use glucocorticoid eye drops to treat the anterior chamber inflammation after operation,but there is potential risk of elevating intraocular pressure (IOP).Objective This study was to compare the clinical effectiveness and safety of loteprednol etabonate ophthalmic suspension,tobramycin+ dexamethasone eye drops and fluorometholone eye drops following Nd: YAG laser posterior capsulotomy.Methods A randomized-controlled clinical trail was performed.One hundrcd and seventy-onc cycs of 127 paticnts who received Nd: YAG laser posterior capsulotomy for after cataract were randomly divided into four groups.Loteprednol etabonate ophthalmic suspension,fluorometholone eye drops,tobramycin+dexamethasone eye drops and systane eye drops was topically administered respectively in the four groups after laser posterior capsulotomy and 6 times per day for 5 days.IOP was measured with Goldmann tomometer 1 hour before operation and 1 hour,1 day,3 days and 7 days after operation.The ocular anterior segment inflammatory response was examined under the slit lamp and scored based on the Peizeng criteria.Written informed consent was obtained from each patient before any relevant medical procedure.Results The IOP was (18.2 ±4.7),(20.1 ±5.7),(18.7±5.5),(19.0 ±4.1),(19.5 ±3.5) mmHg in various time points in the loteprednol etabonate group; (18.7 ±5.3),(20.9±5.7),(21.3±4.5),(21.0±4.9),(22.5±6.5) mmHg in the fluorometholone eye drops group ; (17.9± 6.3),(20.3 ± 6.1),(23.0 ± 3.7),(24.7 ± 4.9),(24.5 ± 6.5) mmHg in the tobramycin +dexamethasone group and(18.4±6.3),(20.7±3.7),(22.7±6.5),(19.6±4.8),(18.5±3.5) mmHg in the systane group,showing a significant difference among the 4 groups (Fgroup =3.876,P =0.023).With the time lapse,the IOP was gradually reduced in the loteprednol etabonate group and systane group,but that in the fluorometholone group and tobramycin+dexamethasone group was elevated,showing a significant difference among them (Ftime =3.801,P =0.031).No any ocular and systemic adverse effect was found in various groups.The percentage of grade 1 and 2 of aqueous inflammatory cells was lower in the loteprednol etabonate group and tobramycin+dexamethasone group than the fluorometholone group and fluorometholone group and systane group(H =8.276,P =0.012).The percentage of Ⅰgrade of aqueous flare was 8％ in the loteprednol etabonate group,22％ in the fluorometholone group,18％ in the tobramycin+dexamethasone group and 30％ in the systane group,with a significant difference among them (H=9.305,P=0.000).Conclusions The use of corticosteroid eye drops can relieve the inflammatory response of ocular anterior chamber after Nd: YAG laser posterior capsulotomy.Loteprednol etabonate ophthalmic suspension has a better anti-inflammatory effect and less influence on IOP.

The level of peripheral circular DNA in patients with hand foot and mouth disease / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To determine the circular DNA level of patients with hand foot and mouth disease (HFMD) and evaluate its potential clinical value.</p><p><b>METHODS</b>Venous blood in 30 healthy children and 78 patients with HFMD within 3 days of onset of illness and convalescent period was collected. The level of plasma circular DNA was detected by duplex real-time polymerase chain reaction assay. Blood sugar, high-sensitive CRP(hs-CRP) and leucocyte were also detected.</p><p><b>RESULTS</b>The level of circular DNA in control group was (6.57 +/- 4.67) ng/ml. The level of circular DNA in ordinary and severe HFMD patients was (11.51 +/- 7.75) ng/ml and (20.59 +/- 10.67) ng/ml before treatment, respectively. The levels of circular DNA in ordinary and severe HFMD patients were significantly higher than that in control group (P = 0.021; 0.000); the level of circular DNA in severe HFMD patients was significantly higher than that in ordinary HFMD patients (P = 0.011). The level of circular DNA in severe HFMD patients after treatment were significantly lower than that before treatment (P = 0.033). The level of circular DNA before treatment and after treatment in ordinary HFMD patients had no significant difference. The levels of blood sugar and hs-CRP in severe HFMD patients were higher than those in ordinary before treatment (P = 0.045; 0.011). The levels of blood sugar and hs-CRP before treatment and after treatment in ordinary HFMD patients had no significant change. There was significantly positive correlation between the level of circular DNA and that of hs-CRP in HFMD patient (P = 0.021), but there was no correlation between the level of circular DNA and that of blood sugar and leucocyte.</p><p><b>CONCLUSIONS</b>The level of circular DNA not only become an early identification marker of severe HFMD patients, but also become monitoring marker of effect of treatment.</p>

Vimentin significantly promoted gallbladder carcinoma metastasis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The precise molecular mechanisms underlying the gallbladder carcinoma (GBC) metastasis has not been fully elucidated.</p><p><b>METHODS</b>In the present study, metastasis-associated proteins were identified by comparative proteomic analysis. The functional study of the candidate protein vimentin was further investigated. First, a pair of higher and lower metastatic sublines (termed GBC-SD/M3 and GBC-SD, respectively), originated from the same parental cell line, was screened by spontaneous tumorigenicity and metastasis in vivo in animal study and further characterized by metastatic phenotypes analysis in vitro. Subsequently, a proteomic approach comprised two-dimensional gel electrophoresis analysis and mass spectroscopy was used to identify and compare the protein expression patterns between higher metastatic GBC-SD/M3 and lower metastatic GBC-SD cell lines. Then twenty-six proteins were identified.</p><p><b>RESULTS</b>Among the 26 proteins identified, fourteen proteins were up-regulated and 12 proteins were down-regulated in GBC-SD/M3. Vimentin was identified and found to be overexpressed in GBC-SD/M3 as compared with GBC-SD. This result was further confirmed by quantitative PCR and Western blotting analysis. Furthermore, the cell migration and invasion potency of GBC-SD/M3 in vitro was remarkably suppressed after small interference RNA-mediated knockdown of vimentin. Moreover, immunoblot and immunohistochemical analysis on 12 human GBC specimens showed consistently increased vimentin expression in metastases compared with primary tumors.</p><p><b>CONCLUSION</b>Tumor vimentin level may reflect the pathological progression in some GBC and may be a useful marker for predicting tumor metastasis and a therapeutic target for the treatment of GBC patients with metastases.</p>

A thirty-one year prospective follow-up program on the HBsAg carrier state and primary liver cancer in Qidong, China / 中华流行病学杂志

Objective To study the relationship between hepatitis B virus (HBV) and primary liver cancer (PLC), and to assess the outcome of PLC in the carriers of HBsAg. Methods General population over age of 15 from a community in Qidong was screened for HBsAg, anti-HBs,and alanine transaminase (ALT) in 1976, and followed-up thenceforth. From January 1, 1977 through December 31, 2007, 12 351 people were enrolled in the cohort, and their occurrence, outcome of PLC and other cancers, together with all the withdrawals due to death were linked to and checked with database from Qidong Cancer Registry and Qidong Vital Registry programs. Results The total observed person-years (PYs) were 355 305.0. One hundred and seventy-three PLC cases were identified among the HBsAg carriers, with an incidence of 361.55 per 100 000 PYs, while PLC cases were only 95 for the non-carriers, with an incidence of 30.90 per 100 000 PYs. The overall relative risk (RR)was 11.70(95%CI: 9.06-15.19) ,with RR 12.30 for men and 10.46 for women. HBsAg carriers had high incidence at each age group,compared with the non-carriers for both men and women. Data from cross-over analysis showed that the incidence rates of PLC for the sub-cohorts of female non-carriers,male non-carriers, female carriers, and male carriers were 1.00,3.07, 10.46, and 37.76, respectively.The cumulative rates of PLC in the 4 groups were 0.86%, 2.73%, 10.22%, and 34.19%, respectively.Results from aon-conditional logistic regression model showed that the gender (male), age, HBsAg ( + ), and ALT( + ) were risk factors for the development of PLC while anti-HBs( + ) demonstrated a protective effect. No relationship was found among carriers and non-carriers for cancer sites such as lung, stomach, esophagus, intestine, pancreas, breast, cervix, bladder, and lymphoma, brain tumor, or leukemia. Conclusion Causation and its strength, together with specificity and persistency of the association were confirmed from this HBsAg-related cohort study in the general population in Qidong.Intervention measures on HBV should be highlighted for the control of PLC among the HBV infected individuals.

Genetic analysis of HAV strains isolated from patients with acute hepatitis in Hebei Shijiazhuang of China / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To characterize the hepatitis A virus (HAV) wild type strains circulating in Hebei Shijiazhuang of China during 2005-2007, to provide the bases for further investigation of the sources of HAV infection.</p><p><b>METHODS</b>The VP1/P2A junction regions were detected by RT-PCR from HAV IgM positives serum samples during 2005 and 2007, the 34 RT-PCR positive samples were sequenced and subjected to phylogenetic analysis by Neighbor Joining (NJ) method.</p><p><b>RESULTS</b>All the detected HAV strains were identified as sub-genotype I A, the homology of nucleotide sequence in the VP1-2A imation region ranged from 95%-100%, the amino acid sequences of HAV strains almost had no difference.</p><p><b>CONCLUSION</b>There are different HAV strains existing in Hebei Shijiazhuang of China, same HAV strain may exist in different areas; or in one area, identical or different HAV strains may be detected. This work provides the bases for further investigation of the sources of HAV infection and also for effectively control measures to prevent the spread of the disease.</p>

Epidemiological and molecular characterization of seasonal influenza A/H3N2 viruses circulating in Shenzhen, 2005 - 2007 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To determine the epidemiological characteristics of seasonal influenza in Shenzhen from 2005 to 2007 and the molecular variation of HA1 domain of influenza H3N2 viruses.</p><p><b>METHODS</b>The consultation rate for influenza-like illness (ILI) were calculated weekly for indicating the influenza activities (the Shenzhen Influenza Surveillance System mainly consisted of 16 institutions with 9 hospitals, 6 districts and one municipal centers of disease control and prevention). Pharyngeal swabs from the cases of ILI, which were collected during 2005 to 2007 from the city-wide and quality-controlled surveillance network, were used to propagate the viruses. The HA1 region of the influenza A/H3N2 viruses were detected by RT-PCR and sequenced subsequently. The analyses of pairwise amino acid variations, genetic clustering and phylogenetics was performed.</p><p><b>RESULTS</b>The activity levels of influenza showed certain changes during each year from 2005 to 2007, and there were summer peaks from May to July in 2006 and 2007. The positive rates of influenza virus were 4.78% (114/2385), 5.77% (212/3674) and 12.12% (343/2831) from 2005 to 2007 respectively. The weekly isolating rates changed accordingly with the trend of the percentages of ILI. The proportions of influenza H3N2 virus were 25.46% (28/114) and 2.83% (6/212) in 2005 and in 2006 respectively, but the proportion increased to 62.68% (215/343), which indicated that H3N2 virus became the predominant strain in 2007. Phylogenetic clustering analysis of influenza H3N2 virus revealed that there were 5 clades. The viruses which were isolated in 2005 contained in the clade I and II, the viruses in 2006 were comprised in clade III, and clade IV and V included the viruses isolated in 2007. Although the stem of cladogram developed with one accord of the time isolated viruses, the viruses which were similar to vaccine strains had circulated in Shenzhen before a given strain was determined as vaccine strain by WHO. It was also noticed that more amino acid changes at antigenic sites, especially at sites A and B in the H3N2 viruses, were found in 2007 than that in 2005 and in 2006. But the sequences at the receptor-binding sites and disulphide bond sites were conserved and no new circulating strain for genetic reassortment had been found in the period.</p><p><b>CONCLUSION</b>Shenzhen might be one of areas where the ongoing genetic drift of influenza H3N2 viruses appeared earlier in China. The changes of influenza H3N2 virus showed the active status in the population. The results suggested that monitoring seasonal influenza viruses by sequence analysis could provide important and timely information on the appearance of strains with epidemiologic significance.</p>

Study on molecular epidemiological characteristics of influenza H1N1 viruses circulating in Shenzhen,China from 2005 to 2007 / 中华流行病学杂志

Objective To study the genetic and epidemiological characteristics of HA1 of influenza H1N1 viruses circulating in Shenzhen from 2005 to 2007. Methods The HA1 region was analyzed by RT-PCR and subsequently sequenced to analyze the HA1 genetic evolution. Phylogenetic analysis was confirmed on the homology of nucleitide comparing with the reference viruses of vaccines recommended by WHO and representative virus confirmed by China CDC. Relationship between isolation rates and genetic evolutions was explored. Results The average isolation rate from 2005 to 2007 was 7.16%. Of the isolates, the proportions of influenza H1N1 viruses in 2005, 2006 and 2007 were 56.14%, 66.03%,3.61% ,respectively. Data from HA1 phylogenetic analysis showed that there were at least three clades circulated in Shenzhen. Different viruses isolated during January to April were clustered with A/New Caledonia/20/1999 viruses isolated in the latter months of 2005 clustered with A/Solomon Island/3/2006 and viruses from 2006 to 2007 were in the same clade with A/GDLH/219/2006. Results showed that most viruses had a deletion of lysine at position 130. Compared with A/New Caledonia/20/1999, the virus isolated after May of 2005 occurred T82K, Y94H, R146K, R209K, T267N amino acid substitution, while some virus isolated after May 2006 took place the amino acid substitutions of A190T, H193Y,E195D (located at antigenic site B) and R146K(antigenic site A). The sequences at the receptor-binding sites and glycosylation sites were conserved. Compared with referring viruses, A/SZ/68/2007 had 50 amino acid substitutions in the HA1 region.Of these,eleven and six were located at antigenic sites and receptor-binding sites,respectively.Four amino acid substitution resulted in the deletion of glycosylation site.Conclusion Three different genetic lineages of influenza H1N1 virus were circulated in the population in Shenzhen during 2005-2007.The special virus named A/SZ/68/2007 should be paid further attention on its antigenic and epidemiological characteristics.

Preliminary study of feasibility of whole body diffusion weighted imaging in diagnosis of metastasis of tumor / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the feasibility of whole body diffusion weighted imaging (DWI) in the diagnosis of metastatic tumor.</p><p><b>METHODS</b>Fifty-six patients (40 males and 16 females, age ranging from 29 to 84 years with a mean age of 57 years) with a variety of primary tumors were investigated by whole body DWI combined with computed tomography (CT) and/or conventional magnetic resonance imaging (MRI) scans. Twelve patients underwent positron emission tomography. The final diagnosis was made on the basis of CT or high resolution CT result for lung lesion and MRI or CT result for skull, abdomen and other parts. All tumors were classified into four groups by their diameter: below 1.0 cm, 1.0-1.9 cm, 2.0-2.9 cm, and above 3.0 cm. The sensitivity and specificity of whole body DWI in the detection of metastatic tumor were analyzed.</p><p><b>RESULTS</b>The sensitivities of whole body DWI for screening metastasis of the four groups were 38%, 75%, 97%, and 100%, respectively. Whole body DWI showed the highest sensitivity and specificity for detecting metastasis of the skeletal system. It was difficult to find metastatic tumor whose diameter was below 1.0 cm, or lymph nodes located in the pelvis with diameter below 2.0 cm.</p><p><b>CONCLUSIONS</b>Whole body DWI is a promising method in the diagnosis of metastastic tumors. With the perfection of scanning parameter, whole body DWI should be a new effective whole body technique for tumor detection.</p>

Preliminary studies on revision of the failed surgery for lumbar spondylolisthesis / 中国骨伤

<p><b>OBJECTIVE</b>To study the causes of failure in the treatment of lumbar spondylolisthesis, and revision techniques and therapeutic effects.</p><p><b>METHODS</b>Eight cases with failed spondylolisthesis surgery were treated. There were 3 male and 5 female with an average age of 54 years old,ranging from 42 to 71 years. Among them, there were 6 cases of pedicle screws breakage, 1 case of fusion cage sinking and pedicle screws breakage, 1 case of osteoporosis and pedicle screws loosening. Their clinical symptoms included deformity, local pain, leg pain and numbness. The revision surgery was performed by the posterior decompression, instrumentation,intervertebral and posterolateral bone grafting, in which large diameter or long screws were applied for pedicle screws fixation.</p><p><b>RESULTS</b>All cases were followed-up from 6 to 24 months after revision(mean, 16 months). The clinical result was satisfied and the excellent or good results were 87.5%. There was no infection and other major complications. All patients had achieved solid fusion.</p><p><b>CONCLUSION</b>Poor technique and skill are considered as the primary causes leading to surgical failure of lumbar spondylolisthesis. The satisfactory outcome could be obtained by appropriately using the revision techniques.</p>

Laboratory diagnosis and molecular characterization analysis of the H5N1 influenza virus isolated from the first human case in Shenzhen, China / 病毒学报

The tracheal aspirates and serum samples of a suspected human case of high-pathogenic avian influenza (firstly found in Shenzhen, China) were collected and tested by a series of assays. The results showed that the RNA extracted from the tracheal aspirate specimens of the patient was confirmed positive for H5N1 avian influenza virus by Real-time PCR. The H5N1 avian influenza virus was isolated from patient's tracheal aspirates on MDCK cell and was named A/Guangdong/2/06(H5N1). The viral load of tracheal aspirates collected at different time points were detected by Real-time PCR. The virus microneutralization and the antigenic ratio of human H5N1 isolated were also assayed. It was found that when the virus load decreased gradually after the disease onset, the serum neutralizing antibody titer in the patient increased to 1 : 160 and subsequently decreased gradually. By molecular analysis, the eight gene segments of A/Guangdong/2/06 revealed to be similar to that of H5N1 avian influenza viruses isolated from south China in 2005-2006. However, there were obvious differences in the gene sequence of the detected H5N1 viral RNA as compared with that of the strains isolated from Vietnam, Thailand and Indonesia.

The patterns of cancer incidence during 1972-2005 in Qidong, China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore the patterns of cancer incidence from 1972 to 2005 in Qidong, Jiangsu province.</p><p><b>METHODS</b>A population-based cancer registration system was established in Qidong region with 1.1 millions residents to collect data of cancer incident cases. 70,646 cases were registered during the years from 1972 to 2005, and ICD-10 was administrated for classification and coding, and crude rate (CR) and age-standardized rate (ASR), percent change (PC), annual percent change (APC) were calculated using annual data on population size. Changes within age-groups for different periods of incidence, and for different years of birth (birth cohort) for the leading sites of cancers were analyzed.</p><p><b>RESULTS</b>The average annual incidence for cancers during the years of 1972-2005 was 184.77 per 100,000 (ASR: 109.32 per 100,000), of which, the incidence for male was 239.22 (ASR: 136.08), and 131.58 (ASR: 79.26) per 100,000 for female. The cumulative risk of cancer occurrence was 16.31% (21.62% in males, and 11.11% in females). The most common leading sites in rank in this area were liver (CR: 60.69 per 100,000), stomach (32.97), lung (27.59), oesophagus (9.34), rectum (8.06), breast (6.48), pancreas (5.97), leukaemia (3.84), bran and CNS (3.43), and colon (2.93). Female breast cancer (12.59) and cervix cancer (4.62) were the forth and the eighth in rank among all sites for women. Liver cancer accounted for almost one third (32.84) of the malignancies. Furthermore, the cancers from digestive organs accounted for 65.85% of all sites. CR rates were rising overall, at 87.19% for PC, and at 1.85% for APC. The ASR, however, reduced by 12.14% for PC, and by 0.51% for APC. The rising trends were also observed for the ASR from cancers in lung, female breast, and colon-rectum, while the decreasing trends were observed for stomach and oesophagus cancer. Birth cohort analysis showed that there was a decline in ages under 35 for the incidence of liver cancer, in ages over 40 for stomach cancer, and in those aged over 45 for bladder cancer and over 50 for oesophagus cancer. Rising trends existed for incidence rates from lung cancer in the aged over 30, pancreas cancer in aged 45-59, and female breast cancer in those aged 40 and above.</p><p><b>CONCLUSION</b>Monitoring of cancer incidence rates through population-based cancer registration in 34 years did help to show the burden and patterns of main cancer sites and time trends, which provides some references to future aetiological study, and policy making on cancer control in Qidong.</p>

Morphological features of secundum atrial septal defect in adult and implications for transcatheter closure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To study the morphological features of secundum atrial septal defect (ASD) in adult and the implications for transcatheter closure.</p><p><b>METHODS</b>Transcatheter closure using Amplatzer duct occluder was performed in 272 adult patients with ASD from September 1997 to December 2005. The morphological features were evaluated by transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). The size, length and thickness of rims, occluder diameter, the complete closure rate, residual shunt rate and complications were compared in patients with deficient and/or thin rims (Group A, n = 135) and patients with well-developed rims (Group B, n = 137).</p><p><b>RESULTS</b>The complete closure rate was 97.8% (132/135) in group A and 99.3% (136/137) in group B. There were 74 cases with deficient rims, 39 cases with thin rims and 22 cases with both deficient and thin rims in group A. Gender distribution, age, operation successful rate, residual shunt rate and complication rate were similar between the 2 groups. The defect diameters measured by TTE (18.9 +/- 5.5 mm vs. 16.5 +/- 4.8 mm, P < 0.01), TEE (22.7 +/- 5.0 mm vs. 20.0 +/- 5.5 mm, P < 0.01) and occluder diameters used (29.1 +/- 5.7 mm vs. 26.0 +/- 5.9 mm, P < 0.01) were significantly larger in groups A than that in group B. The systolic pulmonary artery pressure was also significantly higher in groups A than that in groups B (36.9 +/- 11.9 mm Hg vs. 32.6 +/- 9.1 mm Hg, P < 0.01). There are significant correlations between occluder diameters and defects measured by either TTE or TEE in both groups (group A, TTE: r = 0.709, TEE: r = 0.850; group B, TTE: r = 0.716, TEE: r = 0.915, P all < 0.01).</p><p><b>CONCLUSIONS</b>Poor residual rims were found in around 50% of adult patients with ASD. Transcatheter closure of these defects could be successfully performed with larger occluders. The defect diameters measured by TTE and TEE, especially the latter, could guide the occluder selection.</p>

Interleukin-6 prevents cultured cerebellar granule neurons from glutamate-induced neurotoxicity / 中国应用生理学杂志

<p><b>AIM</b>To explore IL-6 neuroprotection against glutamate-induced neurotoxicity and primary mechanisms involved in this neuroprotection.</p><p><b>METHODS</b>The cerebellar granule neurons from postnatal 8-day infant rats were chronically exposed to IL-6 for 8 days, and then glutamate stimulated the cultured cerebellar granule neurons for 15 min. Methyl-thiazole-tetrazolium (MTT) assay and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) method were used to observe the changes of neuronal vitality and apoptosis, respectively. Laser scanning confocal microscope (LSCM) and reverse transcription-polymerase chain reaction (RT-PCR) were respectively employed to measure dynamic changes of intracellular Ca2+ levels and expression of gp130 mRNA, a 130-kDa intracellular IL-6 signal-transduction protein, in the neurons.</p><p><b>RESULTS</b>The chronic IL-6 (2.5, 5 and 10 ng/ml) pretreatment of the cultured cerebellar granule neurons remarkably improved the decreased neuronal vitality by glutamate in a concentration-dependent manner. The neuronal apoptosis induced by glutamate was significantly attenuated by the chronic IL-6 pretreatment. The intracellular Ca2+ overload evoked by glutamate was also inhibited by the chronic IL-6 pretreatment. The expression of gp130 mRNA was dramatically lower in the IL-6-pretreated cerebellar granule neurons than in the IL-6-untreated neurons.</p><p><b>CONCLUSION</b>IL-6 can protect neurons against glutamate-induced exciting neurotoxicity. The mechanism of IL-6 neuroprotection may be closely related to the suppression of glutamate-induced intracellular Ca2+ overload and mediated by gp130 intracellular signal transduction pathways.</p>

Several Issues Need to be Resolved in Implementing Health Management / 中国慢性病预防与控制

Health management plays an important role in the control of medical costs and in maintaining people' s health.Since the beginning of health management performance in our country,the major problems were:inadequacy of govement's support;imperfect laws;irregular marketing operation;lack of feasible health management model;controversy over long-term economic benefits;lack of awareness on health in common people and so on.To solve these problems,it is necessary to strengthen government support,and enhance people's health awareness,and explore the health management model consistent with the actual situation in China.