Population heterogeneity analysis of caries prevention service preferences among children in Anhui Province / 中国学校卫生

Objective@#To determine the heterogeneity for caries prevention service preferences among children in Anhui Province, so as to provide reference for the promotion and popularization of caries prevention services for school age children.@*Methods@#Based on a discrete selection experiment, a face to face questionnaire survey was administered using a multi stage sampling method among 785 parents with children 3-12 years of age who were hospitalized in the stomatology clinics of 7 prefectures and cities in Anhui Province from October 2021 to October 2022. A mixed Logit model was used to evaluate caries prevention service preferences for children.@*Results@#Four discrete choice experiment attributes included in the study were statistically significant for choice preference ( P <0.05). Compared with the control group, parents with a high school education or above preferred caries prevention services with 70%-<80% preventive effectiveness, 2-<5 and <2 km from the service point, and a high service cost ( β =0.38, 1.66, 1.64, 0.00); female parents preferred preventive services with 70%-<80% preventive effectiveness and a high service cost ( β =0.35, 0.01 ); parents of children <7 years of age preferred services with 70%-<80% preventive effectiveness ( β =0.75); parents of children with oral health preferred preventive services during winter and summer vacations ( β =-0.28); parents of children with caries preferred preventive services with a high cost per denticle ( β =0.00)( P <0.05).@*Conclusions@#Parents with different education levels, gender, child age, and oral health status have heterogeneity in dental caries prevention service preferences. The provision of targeted and precise services can improve the participation and coverage of caries prevention services for school age children.

Evaluating an oral health programme for the prevention of dental decay among school-aged children in China: protocol for a mixed-methods study based on the RE-AIM framework.

INTRODUCTION: The objective of the Comprehensive Intervention of Oral Disease for Children (CIODC) in China is to prevent dental decay for school-aged children and provide free prevention services in pilot areas beginning in 2008. It is a potentially affordable, acceptable and effective prevention strategy to use for more school-aged children in the future. There is a shortage of robust evidence regarding the cost-effectiveness, feasibility and scalability of prevention strategies for dental decay for school-aged children in China. This study aims to provide a comprehensive evaluation, including an economic evaluation and process evaluation, to better understand how and why the public health programme may be effective and economical. METHODS AND ANALYSIS: Mixed methods will be used in this study. Cost-effectiveness analysis (CEA) will be conducted from a societal perspective, based on a modelling study over 6 years (from age 7 to 12) in terms of the incremental cost-effectiveness ratios per dental decay averted. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework informed the process evaluation. An estimated 48-80 semistructured interviews with service providers, patient parents/caregivers and decision-makers under the logic model will be used in the progress evaluation to describe the feasibility and sustainability of CIODC. ETHICS AND DISSEMINATION: The study has all necessary ethical approvals from the Ethics Committee of Anhui Medical University (number 2021H030). All participants will provide informed consent prior to participation. Findings will be disseminated through conference presentations and scientific publications in peer-reviewed journals.

Optimizing the Practice Environment for Medical Staff in the Post-pandemic Era: A Discrete Choice Experiment.

Objective: This study aimed to elicit the stated job preferences of Chinese medical staff in the post-pandemic era and identify the relative importance of different factors in the practice environment. Methods: We used an online discrete choice experiment (DCE) survey instrument to elicit the job preferences of medical staff (doctors and nurses) in tertiary hospitals in Anhui, China. Attributes and levels were generated using qualitative methods, and four attributes were considered: career development, workload, respect from society, and monthly income. A set of profiles was created using a D-efficient design. The data were analyzed considering potential preference heterogeneity, using the conditional logit model and the latent class logit (LCL) model. Results: A total of 789 valid questionnaires were included in the analysis, with an effective response rate of 73.33%. Career development, workload, respect from society, and monthly income were significant factors that influenced job preferences. Three classes were identified based on the LCL model, and preference heterogeneity among different medical staff was demonstrated. Class 1 (16.17%) and Class 2 (43.51%) valued respect from society most, whereas Class 3 (40.32%) prioritized monthly income. We found that when respect from society was raised to a satisfactory level (50-75% positive reviews), the probability of medical staff choosing a certain job increased by 69.9%. Conclusion: Respect from society was the most preferred attribute, while workload, monthly income, and career development were all key factors in the medical staff's job choices. The heterogeneity of the medical professionals' preferences shows that effective policy interventions should be customized to accommodate these drive preferences.

[Effect of CDK1 Interferes with the Regulation of PLK1, Aurora B and TRF1 on the Proliferation of Leukemia Cells].

OBJECTIVE: To investigate the clinical characteristics, diagnosis and treatment of 1 case EBV negative extranodal NK/T cell lymphoma (ENKTL) patients. METHODS: The clinical manifestations, diagnosis and treatment of one case ENKTL patients with EBV negative were analyzed retrospectively. RESULTS: A 46-year-old woman diagnosed as positive for exosanal NK/T cell lymphoma (EBER+) in September 2016 was treated by 6 courses of CHOEP regimen chemotherapy and local nasopharyngeal radiotherapy, without regular follow-up review. On March 20, 2020, the patient was admitted to our hospital for multiple rashes and rupture of the right knee joint for morethan 2 months. Histopathology showed inflammatory exudation and necrotic tissue, atypia lymphocytes were observed, and part of them were grew around the blood vessels. Immunohistochemistry showed: heterotypic lymphocytes CD3 (partial +) , CD43+, CD20-, PAX-5-, CD4-, CD8-, CD56+, GrB+, TIA-1+, Ki-67 (10%+) , and chromogenic in situ hybridization (CISH): EBER-, the patient was diagnosed as recurrent NK/T cell lymphoma (nasal type) stage IV B group (CA stage) and skin involvement of NK/T cell lymphoma by combining PET-CT, bone marrow cell morphology, flow cytometry, chromosome karyotype analysis and TCR rearrangement, etc. On April 4, 2020, the patient was treated by CEOP-L regimen (4 courses) and central lymphoma prophylactic intrathecal chemotherapy. PET-CT re-examination showed the patient achieved PR, and the treatment regimen was changed to Gemos-L regimen. CONCLUSION: EBV negative ENKTL is rare in clinic and easy to be misdiagnosed, so it should be distinguished from peripheral T cell lymphoma. This case was treated with EBV positive ENKTL regimen, with good short-term efficacy.

[Clinical Analysis of Patient with Esophageal Granulocytic Sarcoma Derived from Chronic Myelocytic Leukemia].

OBJECTIVE: To investigate the diagnosis and treatment of esophageal granulocytic sarcoma derived from chronic myelocytic leukemia (CML). METHODS: The clinical manifestations, diagnosis and treatment of 1 case of esophageal granulocytic sarcoma secondary from chronic myelocytic leukemia were retrospectively analyzed and the related literature was reviewed. RESULTS: The patient was a 72-year-old woman with poststernal pain accompanied by general weakness. Gastroscopy was performed in a local hospital. At the same time, the increase of peripheral blood leucocytes was obvious. Under gastroscopy, 1.0 cm×0.5 cm irregular protuberance was found at 28 cm from the esophagus to the incisor teeth, and the surface was covered with erosion and a small amount of blood. Pathological results showed that heterotypic lymphoid cell infiltration, cytoplasmic red staining and more neutrophils were seen. Immunohistochemical staining results showed that AE1/AE3, CK5/6 and p63 displayed squamous epithelium (+); atypical lymphoid cells CD20-, CD23-, CD3-, CD5-, CD79a-, MP0+, Ki-67+ (80%) were observed; FISH examination showed positive expression of BCR/ABL. The patient was further examined on myelogran and was diagnosed as chronic myelocytic leukemia with esophageal granulocytic sarcoma. Imatinib was given orally and the patient was followed up in the clinic. CONCLUSION: Esophageal granulocytic sarcoma is rare in clinic, its clinical symptoms are not specific. Gastroscopy should be routinely screened for esophageal discomfort, and the esophageal granulocytic sarcoma derived from CML is treated according to the therapeutic regimen of the acute transformation of chronic myelocytic leukemia.

eIF3b regulates the cell proliferation and apoptosis processes in chronic myelogenous leukemia cell lines via regulating the expression of C3G.

OBJECTIVE: To investigate the functions of eIF3b in chronic myelogenous leukemia (CML). METHODS: The expression of eIF3b was inhibited by transfecting aspecifically designed shRNA into the CML cell lines of TK-6 and K562. The CCK8 assay was conducted to determine cell viability, and flow cytometry was used to examine the change in the cell cycle and cell apoptosis. RNAsequencing was applied to screen the candidate targets of eIF3b to identify the underlying mechanisms of eIF3b.An in vivo tumour xenograft mouse model was established by injecting shRNA transfected cells into the NCG mice. The tumour size and body weight of mice were monitored every other day. The mice were sacrificed 2 weeks after the tumour cell injection. The expression of eIF3b and target genes in the tumour tissues were determined by immunohistochemical staining and Western blotting. RESULTS: The group with inhibited expression of eIF3b led to about 50% lower cell viability compared with that of the control group (P < 0.05). Flow cytometry suggested that the percentage of increase in apoptotic cells was eight times higher than those in control group for TK-6 and K562 cells (P < 0.05). However, the difference between the cell amounts in the S phase for the experiment and control groups was not significant. After RNAsequencing and further validation via qPCR, C3G was screened as the potential target of eIF3b involved in the cell proliferation and apoptosis of CML cell lines. Subsequent in vivo analysis proved that the inhibition of eIF3b suppressed tumour formation and decreased C3G expression, thereby indicating that C3G was the potential target of eIF3b. CONCLUSION: eIF3b is correlated with the cell proliferation and cell apoptosis of CML. Moreover, eIF3b regulation most probably occurs via regulating the expression of C3G.