[Characteristics of Epiphytic Bacterial Community on Submerged Macrophytes in Water Environment Supplemented with Reclaimed Water].

Biofilms attached to submerged macrophytes play an important role in improving the water quality of the water environment supplemented with reclaimed water. In order to explore the effects of reclaimed water quality and submerged macrophyte species on the characteristics of an epiphytic bacterial community, different types of submerged macrophytes were selected as research objects in this study. 16S rRNA high-throughput sequencing technology was used on the epiphytic bacteria and the surrounding environmental samples to analyze the bacterial community structure and functional genes. The results showed that approximately 20%-35% of the nitrogen and phosphorus nutrients were absorbed and utilized in the water environment supplemented with reclaimed water. However, the COD, turbidity, and chroma of the downstream water were significantly increased. The bacterial community of the biofilms attached to submerged macrophytes was significantly different from that in the surrounding environment (soil, sediment, and water body) and in the activated sludge that was treated by reclaimed water. In terms of bacterial community diversity, the richness and diversity were significantly lower than those of soil and sediment but higher than those of plankton bacteria in water. In terms of bacterial community composition, dominant genera and corresponding abundances were also different from those of other samples. The main dominant bacterial genera were Sphingomonas, Aeromonas, Pseudomonas, and Acinetobacter, accounting for 7%-40%, respectively. Both macrophyte species and the quality of reclaimed water (BOD5, TN, NH4+-N, and TP) could affect the bacterial community. However, the effect of water quality of the bacterial community was greater than that of macrophytes species. Additionally, the quality of reclaimed water also affected the abundance of functional genes in the bacterial community, and the relative abundance of nitrogen and phosphorus cycling functional genes was higher in areas with higher nitrogen and phosphorus concentrations.

A dose optimization method of disinfection units and synergistic effects of combined disinfection in pilot tests.

The increasing requirement for reclaimed water has made it necessary to utilize multiple disinfection processes for efficient removal of organoleptic indicators, while guaranteeing microbial safety. However, there is not a proper way to appropriately distribute the operation load between different disinfection units. This study provides a new method to optimize doses of sequential ozonation, ultraviolet (UV) irradiation and chlorine disinfection units, and investigates the synergistic effects of combined disinfection on the basis of pilot tests. In this method, the minimal ozone dose is determined first for the removal of colority. The chlorine dose is then adjusted according to the required residual chlorine. At last, since it has few side effects and relatively low operating costs, UV dose is determined by the remaining requirement of microbial indicator reduction. By this method, the effluent of disinfection could meet the discharge standards of colority, residual chlorine, and microbial indicators. The operating cost was reduced by 48.7%, mainly by lowering the ozone dosage. The production of disinfection by-products (DBPs) was effectively controlled by decreasing the chlorine dosage compared with the original working conditions in the plant. Moreover, ozone pretreatment effectively improved the coliform inactivation efficiency of chlorine, and the combined disinfection method alleviated the tailing phenomenon and achieved a higher maximum log reduction of coliforms. The proposed method can help water reclamation plants reasonably determine operational loads between disinfection units with low cost and guaranteed performance.

Analysis of the clinical characteristics and risk factors of postoperative atrial fibrillation in patients with critical burns / 中华烧伤杂志

Objective: To investigate the clinical characteristics and risk factors of postoperative atrial fibrillation (POAF) in patients with critical burns. Methods: A retrospective case series study was conducted. From January 2017 to December 2021, two hundred and twenty-seven critically burned aldult patients who met the inclusion criteria were admitted to Guangzhou Red Cross Hospital of Jinan University, including 173 males and 54 females, aged 19-83 (43±14) years. The admission years of patients were collected, and the percentage of patients complicated with POAF in each year was calculated. According to whether the patients were complicated with POAF or not, they were divided into POAF group (n=17) and non-POAF group (n=210). Following data were collected in patients in POAF group, including operation methods, duration of operation, intraoperative blood loss before occurrence of POAF each time, occurrence time and times of POAF, postoperative body temperature, blood pressure, hemoglobin, blood glucose, blood lactate, sepsis, and electrolyte, and type, duration, and treatment of POAF. General data of patients in the two groups including age, gender, burn reason, total burn area, full-thickness burn area, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and sepsis-related organ failure evaluation (SOFA) scores on admission, combined with underlying diseases (hypertension, diabetes, and other types of arrhythmias), and sepsis were collected and analyzed. The mortality and factors influencing the prognosis of patients in the two groups such as mechanical ventilation time, operations times, and burn intensive care unit (BICU) length of stay were also collected and analyzed. Data were statistically analyzed with independent sample t test, Mann-Whitney U test, chi-square test or Kruskal-Wallis H test. The multivariate logistic regression analysis was performed on the general data with statistically significant differences between the two groups, and the independent risk factors influencing the onset of POAF in 227 patients with critical burns were screened. Results: From 2017 to 2021, the percentage of critically burned patients complicated with POAF increased year by year. In POAF group, eschar debridement in limbs was the main surgical procedure prior to POAF complication, with the operation time of (3.5±1.2) h and the intraoperative blood loss volume of (365±148) mL.The POAF occurred 25 times in total in patients of POAF group, mostly within one week after the injury and within 6 hours after the operation with most of these patients having POAF only once. When POAF happened, the patients were often complicated with hypothermia, anemia, hyperglycemia, high blood lactate, sepsis, and electrolyte disturbance, and few patients had complications of hypotension. The POAF lasted (5±3) h, with all being paroxysmal atrial fibrillation, and most of POAF patients were reverted to sinus rhythm after amiodarone intervention. Most patients in the two groups suffered from flame burn, and the gender, age, and SOFA score on admission of patients in the two groups were similar (P>0.05); the APACHEⅡ score on admission, total burn area, full-thickness burn area, incidence proportion of sepsis, combined with diabetes and hypertension and other types of arrhythmias of patients in POAF group were significantly higher or larger than those in non-POAF group (t=3.47, with χ2 values of 7.44, 10.86, 12.63, 14.65, 6.49, and 7.52, respectively, P<0.05 or P<0.01). The full-thickness burn area, combined with other types of arrhythmias, and sepsis were the independent risk factors for POAF in 227 critically burned patients (with odds ratios of 4.45, 0.04, and 3.06, respectively, with 95% confidence intervals of 2.23-8.87, 0.01-0.22, and 1.77-5.30, respectively, P<0.01). Compared with those in non-POAF group, the mechanical ventilation time, BICU length of stay, number of operations, and mortality rate of patients in POAF group were significantly increased (Z=3.89, Z=2.57, t=3.41, χ2=3.72, P<0.05 or P<0.01). Conclusions: POAF is a common postoperative complication in critically burned patients, and the incidence is increasing year by year, which seriously affects the prognosis of patients. The full-thickness burn area together with other types of arrhythmias and sepsis are the high-risk factors for POAF complication in patients with critical burns.

Prevention and treatment of mucocutaneous adverse reactions associated with epidermal growth factor receptor inhibitors / 中华预防医学杂志

The epidermal growth factor receptor (EGFR) signaling is aberrantly overexpressed in many solid malignancies, making it an important target for anti-cancer biologic agents. Among them, epidermal growth factor receptor inhibitors (EGFRIs), which have been widely used in clinical practice, include anti-EGFR monoclonal antibodies and tyrosine kinase inhibitors. A proportion of patients treated with EGFRIs develop specific, dose-dependent skin toxicity such as papulopustular rash, paronychia, xerosis and itch. These side effects can cause physical and psychosocial discomfort that may result in dose reduction, discontinuance, or replacement of the current EGFRIs treatment. Correct diagnosis and treatment of these skin and mucosal adverse effects associated with EGFRIs is of great significance for the tertiary prevention of malignant tumors. A review on EGFRI-related mucocutaneous adverse reactions is presented here, focusing on the pathogenesis, the various clinical manifestations, the strategies for prevention and treatment of these conditions.

Estimation of economic burden of bacillus Calmette-Guérin lymphadenitis in Shandong Province based on compensation for abnormal reaction to vaccination / 中华预防医学杂志

Objective: To investigate the economic burden of bacillus Calmette-Guérin (BCG) lymphadenitis in Shandong Province. Methods: From May 2011 to December 2019, 304 patients applying for the province-level compensation of BCG lymphadenitis was selected from Shandong Province in this study. The basic situation, vaccination, outpatient (inpatient) records, cost and relevant information of those patients were collected to calculate the direct economic burden (including direct medical costs and direct non-medical costs), indirect economic burden and total economic burden. Comparison of the difference of economic burden of cases with different characteristics was taken. Results: The M(Q1,Q3) of age of BCG lymphadenitis patients was 3 (2, 4) months, among which 239 cases (78.6%) were male, 71 cases (23.4%) had lymphadenopathy, and 227 cases (74.7%) underwent surgery.The number of outpatient only, inpatient only and outpatient then inpatient was 25.7% (78 cases), 7.2% (22 cases) and 67.1% (204 cases), respectively. The M(Q1,Q3) of direct, indirect and total economic burden of single case after discount was 9 910 (5 713, 16 074), 2 081 (1 547, 3 122) and 12 262 (7 694, 18 571) yuan, respectively.The direct medical expenses accounted for 89.4% of the direct economic burden, the direct economic burden accounted for 84.9% of the total economic burden, the total economic burden of 80.0% cases accounted for only about 20.0% of the compensation amount, and the total economic burden of only 2.3% cases accounted for more than 60.0% of the compensation amount.The direct, indirect and total economic burden of patients with inpatient only and outpatient then inpatient was higher than that of patients with outpatient only; the direct, indirect and total economic burden of patients with operation was higher than that of patients with non-operation; the direct and total economic burden of patients with unulcerated lymph node was higher than that of patients with ulcerated lymph node(all P values<0.05). Conclusion: The economic burden of BCG lymphadenitis cases in Shandong Province is influenced by the mode of diagnosis and treatment, with direct medical expenses as the predominant component.

Development and Validation of a Nomogram for Predicting the Disease Progression of Nonsevere Coronavirus Disease 2019.

BACKGROUND AND OBJECTIVES: The majority of coronavirus disease 2019 (COVID-19) cases are nonsevere, but severe cases have high mortality and need early detection and treatment. We aimed to develop a nomogram to predict the disease progression of nonsevere COVID-19 based on simple data that can be easily obtained even in primary medical institutions. METHODS: In this retrospective, multicenter cohort study, we extracted data from initial simple medical evaluations of 495 COVID-19 patients randomized (2:1) into a development cohort and a validation cohort. The progression of nonsevere COVID-19 was recorded as the primary outcome. We built a nomogram with the development cohort and tested its performance in the validation cohort. RESULTS: The nomogram was developed with the nine factors included in the final model. The area under the curve (AUC) of the nomogram scoring system for predicting the progression of nonsevere COVID-19 into severe COVID-19 was 0.875 and 0.821 in the development cohort and validation cohort, respectively. The nomogram achieved a good concordance index for predicting the progression of nonsevere COVID-19 cases in the development and validation cohorts (concordance index of 0.875 in the development cohort and 0.821 in the validation cohort) and had well-fitted calibration curves showing good agreement between the estimates and the actual endpoint events. CONCLUSIONS: The proposed nomogram built with a simplified index might help to predict the progression of nonsevere COVID-19; thus, COVID-19 with a high risk of disease progression could be identified in time, allowing an appropriate therapeutic choice according to the potential disease severity.

[Microbial Community Structure of Waste Water Treatment Plants in Different Seasons].

Wastewater treatment plants (WWTPs) have different treatment effects during different seasons due to changes in water quality and temperature. To understand bacterial community structure and diversity dynamics in the WWTPs, this study employed high-throughput sequencing technology during winter and summer. A total of 60 activated sludge samples were collected in five WWTPs in Beijing with different treatment processes in summer (temperature=28℃±2℃, water temperature=24.9℃±1.1℃) and winter (temperature=0℃±3℃, water temperature=16.8℃±1.3℃). The relative abundances of dominant bacterial genera in activated sludge varied significantly between the WWTPs but microbial community structure was typically similar between different treatment units (i.e., the anaerobic tank, anoxic tank, and aerobic tank) at each WWTP. At the same time, different bacteria dominated in winter and summer, when the relative abundance of SJA-15, Ferruginibacter, and Blasocatellaceae was 6.07%, 4.50%, and 4.44% respectively, when the relative abundance of Nitrospira, Methylotenera, and RBG-13-54-9 in winter was 10.17%, 3.96%, and 3.28%, respectively. Correlation analysis showed that temperature, total nitrogen (TN), NH4+-N, total phosphorus (TP), and chemical oxygen demand (COD) were the main environmental factors affecting microbial community structure, of which temperature had the greatest effect on species composition followed by TN. Furthermore, a predictive analysis of functional enzymes indicated that the abundance of key enzymes involved in the nitrogen cycle in the activated sludge of WWTPs is higher in winter than that in summer. These results show that temperature, water quality, and treatment process affect bacterial community structure (i.e., dominance and abundance) in WWTP activated sludge.

A Large-Scale Clinical Validation Study Using nCapp Cloud Plus Terminal by Frontline Doctors for the Rapid Diagnosis of COVID-19 and COVID-19 pneumonia in China

BackgroundThe outbreak of coronavirus disease 2019 (COVID-19) has become a global pandemic acute infectious disease, especially with the features of possible asymptomatic carriers and high contagiousness. It causes acute respiratory distress syndrome and results in a high mortality rate if pneumonia is involved. Currently, it is difficult to quickly identify asymptomatic cases or COVID-19 patients with pneumonia due to limited access to reverse transcription-polymerase chain reaction (RT-PCR) nucleic acid tests and CT scans, which facilitates the spread of the disease at the community level, and contributes to the overwhelming of medical resources in intensive care units. GoalThis study aimed to develop a scientific and rigorous clinical diagnostic tool for the rapid prediction of COVID-19 cases based on a COVID-19 clinical case database in China, and to assist global frontline doctors to efficiently and precisely diagnose asymptomatic COVID-19 patients and cases who had a false-negative RT-PCR test result. MethodsWith online consent, and the approval of the ethics committee of Zhongshan Hospital Fudan Unversity (approval number B2020-032R) to ensure that patient privacy is protected, clinical information has been uploaded in real-time through the New Coronavirus Intelligent Auto-diagnostic Assistant Application of cloud plus terminal (nCapp) by doctors from different cities (Wuhan, Shanghai, Harbin, Dalian, Wuxi, Qingdao, Rizhao, and Bengbu) during the COVID-19 outbreak in China. By quality control and data anonymization on the platform, a total of 3,249 cases from COVID-19 high-risk groups were collected. These patients had SARS-CoV-2 RT-PCR test results and chest CT scans, both of which were used as the gold standard for the diagnosis of COVID-19 and COVID-19 pneumonia. In particular, the dataset included 137 indeterminate cases who initially did not have RT-PCR tests and subsequently had positive RT-PCR results, 62 suspected cases who initially had false-negative RT-PCR test results and subsequently had positive RT-PCR results, and 122 asymptomatic cases who had positive RT-PCR test results, amongst whom 31 cases were diagnosed. We also integrated the function of a survey in nCapp to collect user feedback from frontline doctors. FindingsWe applied the statistical method of a multi-factor regression model to the training dataset (1,624 cases) and developed a prediction model for COVID-19 with 9 clinical indicators that are fast and accessible: Residing or visiting history in epidemic regions, Exposure history to COVID-19 patient, Dry cough, Fatigue, Breathlessness, No body temperature decrease after antibiotic treatment, Fingertip blood oxygen saturation [≤]93%, Lymphopenia, and C-reactive protein (CRP) increased. The area under the receiver operating characteristic (ROC) curve (AUC) for the model was 0.88 (95% CI: 0.86, 0.89) in the training dataset and 0.84 (95% CI: 0.82, 0.86) in the validation dataset (1,625 cases). To ensure the sensitivity of the model, we used a cutoff value of 0.09. The sensitivity and specificity of the model were 98.0% (95% CI: 96.9%, 99.1%) and 17.3% (95% CI: 15.0%, 19.6%), respectively, in the training dataset, and 96.5% (95% CI: 95.1%, 98.0%) and 18.8% (95% CI: 16.4%, 21.2%), respectively, in the validation dataset. In the subset of the 137 indeterminate cases who initially did not have RT-PCR tests and subsequently had positive RT-PCR results, the model predicted 132 cases, accounting for 96.4% (95% CI: 91.7%, 98.8%) of the cases. In the subset of the 62 suspected cases who initially had false-negative RT-PCR test results and subsequently had positive RT-PCR results, the model predicted 59 cases, accounting for 95.2% (95% CI: 86.5%, 99.0%) of the cases. Considering the specificity of the model, we used a cutoff value of 0.32. The sensitivity and specificity of the model were 83.5% (95% CI: 80.5%, 86.4%) and 83.2% (95% CI: 80.9%, 85.5%), respectively, in the training dataset, and 79.6% (95% CI: 76.4%, 82.8%) and 81.3% (95% CI: 78.9%, 83.7%), respectively, in the validation dataset, which is very close to the published AI model. The results of the online survey Questionnaire Star showed that 90.9% of nCapp users in WeChat mini programs were satisfied or very satisfied with the tool. The WeChat mini program received a significantly higher satisfaction rate than other platforms, especially for availability and sharing convenience of the App and fast speed of log-in and data entry. DiscussionWith the assistance of nCapp, a mobile-based diagnostic tool developed from a large database that we collected from COVID-19 high-risk groups in China, frontline doctors can rapidly identify asymptomatic patients and avoid misdiagnoses of cases with false-negative RT-PCR results. These patients require timely isolation or close medical supervision. By applying the model, medical resources can be allocated more reasonably, and missed diagnoses can be reduced. In addition, further education and interaction among medical professionals can improve the diagnostic efficiency for COVID-19, thus avoiding the transmission of the disease from asymptomatic patients at the community level.

Association between Cardiovascular Burden and Requirement of Intensive Care among Patients with Mild COVID-19

BackgroundInformation regarding the impact of cardiovascular disease (CVD) on disease progression among patients with mild coronavirus disease 2019 (COVID-19) is limited. MethodsThis study evaluated the association of underlying CVD with disease progression in patients with mild COVID-19. The primary outcome was the need to be transferred to intensive care due to disease progression. The patients were divided with and without CVD as well as stable and intensive care groups. ResultsOf 332 patients with mild COVID-19, median age was 51 years (IQR, 40-59 years), and 200 (61.2%) were female. Of 48 (14.5%) patients with CVD, 23 (47.9%) progressed to severe disease status and required intensive care. Compared with patients without CVD, patients with CVD were older, and more likely to have fatigue, chest tightness, and myalgia. The rate of requiring intensive care was significantly higher among patients with CVD than in patients without CVD (47.92% vs. 12.4%; P<0.001). In subgroup analysis, rate of requiring intensive care was also higher among patients with either hypertension or coronary heart disease than in patients without hypertension or coronary heart disease. The multivariable regression model showed CVD served as an independent risk factor for intensive care (Odd ratio [OR], 2.652 [95% CI, 1.019-6.899]) after adjustment for various cofounders. ConclusionsPatients with mild COVID-19 complicating CVD in are susceptible to develop severe disease status and requirement for intensive care. Key PointsO_ST_ABSQuestionC_ST_ABSWhat is the impact of coexisting cardiovascular diseases (CVD) on disease progression in patients with mild COVID-19? FindingsAlthough most patients with mild COVID-19 were discharged alive from hospital, approximately 47.9% patients with coexisting CVD developed severe disease status and required intensive care. CVD is an independent risk factor of intensive care among patients with mild COVID-19. MeaningCoexisting CVD is associated with unfavorable outcomes among patients with mild COVID-19. Special monitoring is required for these patients to improve their outcome.

Effects of zinc-containing magnesium alloys on proliferation of human osteosarcoma U2OS cells in vitro / 中国组织工程研究

BACKGROUND: Alloying can improve the corrosion resistance and slow the degradation of pure magnesium. In addition, increasing studies have shown that zinc has good antitumor effect. OBJECTIVE: To evaluate the effect of zinc-containing magnesium alloy on the proliferation and apoptosis of human osteosarcoma U2OS cells in vitro.METHODS: The corrosion resistance of pure magnesium and different zinc-containing (2%, 4%, 6%) magnesium alloys were observed and compared by the hydrogen release assay in the Hank's solution. MTT assay was used to examine the effects of different zinc-containing magnesium alloy extractions on the proliferation of U2OS cells (or MC3T3-E1 cells) after co-culture of 1, 3, 5 days. After 24-hour co-culture with pure magnesium, different zinc-containing magnesium alloys and titanium alloy extractions, the apoptotic rates of U2OS cells were analyzed by flow cytometry, and the expression of apoptosis-related proteins were detected by western blot assay.RESULTS AND CONCLUSION: The corrosion resistance of pure magnesium was improved after addition of Zn within the initial 100 hours, and the magnesium alloy containing 4% zinc exhibited the optimal corrosion resistance. Different zinc-containing magnesium alloy extractions obviously inhibited the U2OS proliferation in a zinc level-depended manner, and the cytotoxicity of different zinc-containing magnesium alloy extractions to MC3T3-E1 was graded 0-1. Different zinc-containing magnesium alloy extractions could also induce obvious apoptosis in U2OS cells in a zinc level-depended manner. Different zinc-containing magnesium alloy extractions, especially the magnesium alloy containing 4% zinc, up-regulated the expression of p53 and Bax proteins and down-regulated the expression of Bcl-2 protein in U2OS cells, leading to the disorder of Bcl-2/Bax. These findings suggest that different zinc-containing magnesium alloy extractions can inhibit the proliferation and induce apoptosis of U2OS cells in vitro.

Effects of zinc-containing magnesium alloys on proliferation of human osteosarcoma U2OS cells in vitro / 中国组织工程研究

BACKGROUND: Alloying can improve the corrosion resistance and slow the degradation of pure magnesium. In addition, increasing studies have shown that zinc has good antitumor effect. OBJECTIVE: To evaluate the effect of zinc-containing magnesium alloy on the proliferation and apoptosis of human osteosarcoma U2OS cells in vitro.METHODS: The corrosion resistance of pure magnesium and different zinc-containing (2%, 4%, 6%) magnesium alloys were observed and compared by the hydrogen release assay in the Hank's solution. MTT assay was used to examine the effects of different zinc-containing magnesium alloy extractions on the proliferation of U2OS cells (or MC3T3-E1 cells) after co-culture of 1, 3, 5 days. After 24-hour co-culture with pure magnesium, different zinc-containing magnesium alloys and titanium alloy extractions, the apoptotic rates of U2OS cells were analyzed by flow cytometry, and the expression of apoptosis-related proteins were detected by western blot assay.RESULTS AND CONCLUSION: The corrosion resistance of pure magnesium was improved after addition of Zn within the initial 100 hours, and the magnesium alloy containing 4% zinc exhibited the optimal corrosion resistance. Different zinc-containing magnesium alloy extractions obviously inhibited the U2OS proliferation in a zinc level-depended manner, and the cytotoxicity of different zinc-containing magnesium alloy extractions to MC3T3-E1 was graded 0-1. Different zinc-containing magnesium alloy extractions could also induce obvious apoptosis in U2OS cells in a zinc level-depended manner. Different zinc-containing magnesium alloy extractions, especially the magnesium alloy containing 4% zinc, up-regulated the expression of p53 and Bax proteins and down-regulated the expression of Bcl-2 protein in U2OS cells, leading to the disorder of Bcl-2/Bax. These findings suggest that different zinc-containing magnesium alloy extractions can inhibit the proliferation and induce apoptosis of U2OS cells in vitro.

Diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration in elderly patients with bronchogenic carcinoma / 中华老年医学杂志

Objective To evaluate the diagnostic value and safety of endobronchial ultrasoundguided transbronchial needle aspiration (EBUS-TBNA) in elderly patients with bronchogenic carcinoma.Methods From August,2013 and July,2014,31 patients aged 65 years and over with space-occupying mass and enlarged mediastinal lymph nodes detected by CT or positron emission tomography-computed tomography (PET-CT) underwent EBUS-TBNA.Rapid onsite cytology evaluation was not performed.Results There were 26 males and 5 females in this study,aged 65-77 years (70.1 years old on average).In 31 patients,70 samples were obtained from lymph nodes (LNs) and 4 samples were obtained from intrapulmonary lesions.29 cases were diagnosed as lung cancer,and 2 cases had false-negative diagnoses.The sensitivity and specificity rates of EBUS-guided TBNA method were 93.6％ and 100.0％,respectively.No major complications were observed in this series.Conclusions EBUS-TBNA is an safe and effective method in diagnosing bronchogenic carcinoma in elderly patients.

Economic burden and related factors on inpatients with HBV-related diseases in Shandong province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the economic burden of patients with acute and chronic hepatitis B, cirrhosis and liver cancer caused by hepatitis B virus (HBV).</p><p><b>METHODS</b>Cluster sampling was used on cases consecutively collected during the study period. Questionnaire survey was conducted and information on the expenses during hospitalization was collected from the hospital records and through interviewing those patients.</p><p><b>RESULTS</b>Yearly costs related to patients with acute hepatitis B, severe hepatitis B, chronic hepatitis B, cirrhosis, hepatocellular carcinoma were 66.7, 138.1, 127.4, 151.7 and 377.2 thousand Yuan, respectively.</p><p><b>RESULTS</b>from multiple linear regression model showed that the type of medical insurance scheme, annual days of hospitalization, classifications of HBV-related diseases and personal income were major influencing factors on the cost.</p><p><b>CONCLUSION</b>HBV infection caused considerable burden to families and the society, indicating that HBV infection control programs would bring huge potential benefits. The reform of insurance scheme should be administrated to promote social fairness.</p>

Investigation of skin prick test on 2707 patients with allergic rhinitis in Wuhan area / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the distribution of common allergens in patients with allergic rhinitis (AR) from 2006 to 2010 in Wuhan area, and provide the objective evidence for the prevention and treatment of AR.</p><p><b>METHODS</b>The medical records of skin prick test (SPT) performed on 2707 AR patients from 2006 to 2010 were retrospectively analysed, and the positive rate of different allergens and changing trends in this time were compared. SPSS 17.0 software was used to analyse the data.</p><p><b>RESULTS</b>There were significant differences among the Dermatophagoides pteronyssinus positive rate (χ(2) = 12.11, P < 0.05) and Dermatophagoides farinae positive rate (χ(2) = 11.11, P < 0.05) in the past 5 years. Meanwhile, there was an upward trend in the positive rate of dust mite, which the positive rate of Dermatophagoides pteronyssinus increased from 84.5% in 2006 to 90.5% in 2010 (χ(2) = 6.88, P < 0.05), positive rate of Dermatophagoides farinae increased from 81.5% in 2006 to 89.0% in 2010 (χ(2) = 9.68, P < 0.05); There were significant differences among the Mugwort and Ragweed positive rate of 5 years (χ(2) = 194.10, P < 0.05; χ(2) = 67.06, P < 0.05). There were significant differences among the mold I and mold II positive rate of 5 years between (χ(2) = 18.95, P < 0.05; χ(2) = 36.62, P < 0.05). Meanwhile, there was an upward trend in the positive rate of mold and fluctuant trend in the positive rate of spring-pollen.</p><p><b>CONCLUSIONS</b>Nearly five years, dust mites is still the most common allergens in AR patients, presenting upward trend; the positive rate of mold presenting upward trend; the positive rate of wormwood and guinea wood presenting downward trend; the positive rate of pollen presenting fluctuant trend.</p>

[Sodium hypochlorite disinfection on effluent of MBR in municipal wastewater treatment process].

Sodium hypochlorite (NaClO) used in wastewater disinfection was assessed by examining its performances in lab fed by the effluent from a MBR treatment plant. The influence of sodium hypochlorite initial concentrations (0.5-3.0 mg/L) on the presence of indicator microorganisms (total coliforms, fecal coliforms), disinfection by-products (DBPs) concentrations and the acute toxicity were evaluated. Results indicate the total coliforms and the fecal coliform were 1500-2400 and 10-40 CFU/L, which is difficult to meet the present reclaimed water quality standards. A chlorine dose of 2.0 mg/L and contact for 1 h could achieve a 3 lg indicator bacteria reduction in MBR effluent samples. THMs (trihalomethanes) analysis indicated that concentrations of THMs increase with the raise of the active chlorine dose. After adding sodium hypochlorite 1 h the concentrations of trihalomethanes (THMs) were 16.22, 7.35 microg/L respectively and chloroform (TCM) accounted for 87% of THMs, the haloacetic acids (HAAs) was involved trichloroacetic acid (TCAA) 2.01 microg/L, dichloroacetic acid (DCAA) 1.58 microg/L and under the national limits. Luminescence bacteria acute toxicity analysis showed that the chlorinated effluent has higher inhibition rate (48%) in comparison to the control with a chlorine dosage of 3.0 mg/L. The results which could provide theoretical basis to production show that NaClO disinfection not only can inactivate microbe with the DBPs and acute toxicity of the effluent under the safety limits, but also meet the requirement of health and safety.

[Analysis of twenty trace elements in ling zhi by ICP-AES].

Twenty trace elements, Al, As, Ca, Cd, Co, Cr, Cu, Fe, Ge, Hg, K, Mg, Mn, Na, Ni, P, Pb, S, Se and Zn were determined by ICP--AES with wet digestion from two kinds of different ling zhi fruitbody materials (Zhongzhi and Xianyuan), Ling Zhi root, ling zhi mixture, unbroken and broken ling zhi spore powder. The common feature about the element content showed that there were rich trace elements in different Ling Zhi materials, and the concentrations of K, Ca, Mg, Fe, Zn, P and S in all kinds of ling zhi samples were relatively high. Besides, there were trace elements, Cu, Co, Grand Ni, and potentially physiologically toxic elements, Al, As, Hg, Pb and Cd, in all samples. Elements Se and Ge with anticancer efficacy were not found in ling zhi samples. The concentrations of heavy metal elements were lower in spore powders than in other ling zhi samples. Trace element contents in the broken and unbroken spore powders showed minor difference, The concentrations of Fe and Se in ling zhi mixtures were obviously higher than in other kinds of Ling Zhi samples, due to factitious addition of these elements to Ling Zhi mixture sample. There was some difference between two kinds of Ling Zhi fruitbody from deferent plant places, which may have some relations with the soil and environment. The concentrations of Ca, Cu and Zn in ling zhi root were higher than in other ling zhi materials. According to the analyses, these elements in ling zhi were helpful to improving cardiovascular function.

Simultaneous treatment of asthma and allergic rhinitis in children with a nasally inhaled glucocorticosteroid / 中华儿科杂志

<p><b>OBJECTIVE</b>To assess the efficacy of a nasally inhaled corticosteroid (ICS) through a spacer with mask aiming at simultaneous treatment of allergic rhinitis and asthma in children and make an analysis on the costs.</p><p><b>METHOD</b>A total of 72 children with allergic rhinitis (AR) and asthma were randomized into two groups. Experimental group received budesonide inhaler (400 microg/d) through the nose using a spacer attached to a face mask, control group children orally inhaled budesonide dry powder (400 microg/d) plus a nasal spray of budesonide aquae (256 microg/d).</p><p><b>RESULT</b>The patients were observed for 12 weeks. The symptom scores of rhinitis of both experimental group and control group declined (F=6.529 and 7.014, all P<0.01), symptom scores of asthma in both group were also reduced (F=4.132 and 4.950, P<0.01). The pulmonary function PEF (L/min) in both groups continuously increased (F=2.750 and 3.282, P<0.05). But the clinical scores, PEF value and FEV1 all did not differ between the two groups at admission or at nearly all follow-up visits (P>0.05 for all). The proportion of dry nose was lower in experimental group than in the control group (5.6% vs. 19.4%), but the difference was not statistically significant. The cost in the experimental group was lower than that in the control group (P<0.01).</p><p><b>CONCLUSION</b>Nasal inhalation of ICS provides a therapeutic strategy for controlling AR and asthma in children, especially it result in higher compliance, lower costs, and fewer side effects.</p>

Activation of nuclear factor-kappaB and aberrant gene expression of interleukin 6 in middle ear cholesteatoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To establish the activation of NF-kappaB in middle ear cholesteatoma, discuss the relationship of NF-kappaB and the gene expression of IL-6 and explore the pathogenesis of middle ear cholesteatoma.</p><p><b>METHODS</b>Ten cases of cholesteatoma and 6 cases of normal external meatal skin were obtained from middle ear surgery. The NF-kappaB DNA binding activity and the mRNA level of IL-6 in these two kinds of tissues were detected by electrophoretic motility shift assay (EMSA) and Reverse transcription polymerase chain reaction (RT-PCR) respectively. The relationship of NF-kappaB DNA binding activity and the mRNA level of IL-6 were analyzed.</p><p><b>RESULTS</b>The NF-kappaB DNA binding activities of cholesteatoma [(15.9 +/- 8.2)%] were higher than those in normal skin [(1.36 +/- 0.94)%, t = 3.502, P < 0.05]. The expression of IL-6 mRNA was increased significantly in patients with cholesteatoma, as compared with that in the control specimens (t = 2.166, P < 0.05) and had a significant positive correlation with NF-kappaB DNA binding activity (r = 0.752, P < 0.05).</p><p><b>CONCLUSIONS</b>The IL-6 mRNA expression in cholesteatoma is closely related with the activity of NF-kappaB. It is tempting to speculate that NF-kappaB play a key role in the activation of cytokine in cholesteatoma.</p>

Short hairpin RNA silencing of vascular endothelial growth factor, telomerase reverse transcriptase, and Bcl-xl expression in human laryngeal squamous carcinoma xenografted in nude mice / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the biological impact of pEGFP-shVEGF-shTERT-shBcl-xl expression in human laryngeal squamous carcinomas xenografted in nude mice and the related antitumor mechanism.</p><p><b>METHODS</b>A recombinant plasmid vector containing 3 different short hairpin RNA (shRNA) segments including pEGFP-shVEGF-shTERT-shBcl-xl was constructed and directly injected into the grafted tumors of human laryngeal squamous carcinoma in nude mice. The mRNA and protein expressions were determined by real-time RT-PCR and Western blot respectively. Apoptosis was determined by TUNEL assay using a commercial kit. Intratumoral microvessel density (MVD) was assessed by immunhistochemistry.</p><p><b>RESULTS</b>On the 14th days after the final treatment, mRNA and protein expression of VEGF, TERT, and Bcl-xl were markedly suppressed. The tumor sizes were significantly smaller than those in the other two group, with an overall tumor inhibition ratio of 91.2%. MVD counts in the pEGFP-shVEGF-shTERT-shBcl-xl treated group were significantly lower than those of the other two groups, along with increased apoptotic cells.</p><p><b>CONCLUSIONS</b>The data showed that inhibition of VEGF, TERT, Bcl-xl expression by RNAi technique induces cellular apoptosis and suppresses the growth of laryngeal squamous carcinoma in vivo. VEGF, TERT and Bcl-xl may be involved in the development of laryngeal cancers. The findings suggest a synergistic tumor therapeutic effect through simultaneous inhibition of the three genes. Multi-target RNA interference may provide a powerful strategy against human laryngeal cancers.</p>

Expression and activation of nuclear factor-kappaB in middle ear cholesteatoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the expression and activation of NF-kappaB in middle ear cholesteatoma.</p><p><b>METHODS</b>The protein expression of NF-kappaB p65 in 21 middle ear cholesteatoma tissues and 8 normal external ear canal skin obtained in middle ear surgery were examined by immunohistochemistry; NF-kappaB DNA binding activity in these two kinds of tissues were also detected by electrophoretic motility shift assay (EMSA). The influence of cholesteatoma debris on the NF-kappaB DNA binding activity of HaCat cell were further analyzed.</p><p><b>RESULTS</b>All epithelial cell of cholesteatoma revealed a relatively abundant plasma expression of NF-kappaB p65 protein, among which 12 cases showed nuclear positive expression. In contrast,the normal skin epithelium only revealed a sparse plasma distribution of NF-kappaB protein. The levels of NF-kappaB p65 protein expression in the epithelium of middle ear cholesteatoma tissue and normal skin were 0.168 +/- 0.051, 0.088 +/- 0.019 (t = 4.211, P < 0.01), respectively. The NF-kappaB DNA binding activities of cholesteatoma [(16.5 +/- 10.1)%] were also higher than those in normal skin [(1.38 +/- 1.24)%, t = 3. 600, P = 0.014]. The NF-kappaB DNA binding activity of HaCat cell increased when exposed to cholesteatoma debris in a dose dependent manner.</p><p><b>CONCLUSION</b>NF-kappaB might be an important factor which was involved in the occurrence and development of cholesteatoma.</p>