Application value of 68Ga-PSMA-11 PET/CT in newly diagnosed prostatic cancer patients / 中华核医学与分子影像杂志

Objective:To explore the value of 68Ga-prostate specific membrane antigen (PSMA)-11 PET/CT in newly diagnosed prostate cancer patients with different risk stratifications, and to compare the performance of this modality with conventional imaging in detecting metastases. Methods:From June 2019 to July 2020, the clinical and imaging data of 60 patients (age range: 44-88 years, median age 69 years) who underwent 68Ga-PSMA-11 PET/CT imaging in Fudan University Shanghai Cancer Center were retrospectively analyzed. Spearman rank correlation analysis was used to explore the correlation of SUV max in primary foci with prostate specific antigen (PSA) and Gleason score (GS). Based on the D′Amico risk stratification (PSA>20 μg/L and ≤20 μg/L, GS>7 and ≤7), the detection rates of 68Ga-PSMA-11 PET/CT for metastases were evaluated by χ2 test, and the differences of SUV max were analyzed by Mann-Whitney U test. Patients were divided into high-risk (PSA>20 μg/L and GS>7), medium-risk (PSA>20 μg/L and GS≤7, or PSA≤20 μg/L and GS>7), and low-risk (PSA<20 μg/L and GS<7) groups according to PSA levels and GS. Compared with conventional imaging (bone imaging, CT or MRI), the ability of 68Ga-PSMA-11 PET/CT to detect metastatic tumors, and the utility to change the prostate cancer stage were evaluated by Fisher′s exact test. Results:High uptake of 68Ga-PSMA-11 was observed in primary lesions of 60 patients, and SUV max was positively correlated with GS or PSA ( rs values: 0.42, 0.38; P values: 0.001, 0.002). The detection rates of lymph node and bone metastases in the group with PSA>20 μg/L were 11/18 and 13/18, respectively, which were higher than those in the group with PSA≤20 μg/L (28.57%(12/42) and 35.71%(15/42); χ2 values: 6.56, 7.56, P values: 0.010, 0.006. However, there was no statistical significance in the SUV max of these lesions( z values: -1.04, -0.96; P values: 0.299, 0.337). There was a statistical difference in the detection rates of lymph node and bone metastases between the group with GS>7 and the group with GS≤7 (lymph node: 54.05%(20/37) vs 13.04%(3/23), χ2=10.09, P=0.001; bone metastases: 59.46%(22/37) vs 26.09%(6/23), χ2=8.19, P=0.004), as well as the SUV max of bone metastases( z=-2.02, P=0.044). In the high-risk group, 68Ga-PSMA-11 PET/CT had the higher detection rate of metastases than conventional imaging (16/17 vs 10/17; P=0.039) and it changed 25.0%(15/60) of the patients′ staging. Conclusions:PSA and GS affect the detection rate of 68Ga-PSMA-11 PET/CT. In patients with high-risk prostate cancer, 68Ga-PSMA-11 PET/CT is superior to conventional imaging in detecting metastases. When PSA>20 μg/L and GS>7, it is better to use 68Ga-PSMA-11 PET/CT in prostate cancer staging.

Construction of a path for optimizing the health management of HBV infections among pregnant and lying-in women based on a Delphi method / 预防医学

Objective@#To establish an optimized path for health management of HBV infections among pregnant and lying-in women based on a Delphi method, so as to provide the evidence for intensifying the interruption of the mother-to-child transmission of HBV.@*Methods@#Based on literature review and previous studies, the preliminary framework and contents of the optimized path for health management of HBV infections were constructed. Experts from epidemiology, clinical medicine and maternal and children healthcare were invited to participate in two-round Delphi consultations, and the preliminarily designed indicators were screened and revised. The score for feasibility of each indicator was calculated, and the weight of each indicator was estimated using a proportional distribution method.@*Results@#Sixteen experts participated in the consultation, including 13 women. The participants had a mean age of (45.69±5.71) years, and a mean employment duration of (23.06±7.05) years. All participants had a degree of bachelor and above, and there were 14 experts with vice senior professional titles. The mean positive coefficient was 96.88% and the mean authority coefficient was 0.790 during the two-round expert consultations. There were significant differences in the coordination coefficient of importance, necessity and feasibility of indicators at all levels (P<0.05), and the coefficient of variation of the feasibility was all less than 0.250. The final optimized path for health management of HBV infections among pregnant and lying-in women included 6 primary indicators, 17 secondary indictors and 73 tertiary indicators. Among the primary indicators, delivery management (0.173 4), screening and evaluation (0.172 8) and pregnancy management (0.172 7) had a high weight.@*Conclusion@#A scientific and reliable optimized path is created for health management of HBV infections among pregnant and lying-in women, which has a potential value for improving the interruption of mother-to-child transmission of HBV.

Research progress on the safety and efficacy of COVID-19vaccine among special populations / 预防医学

Abstract@#Inoculation of COVID-19 vaccines is an important approach to preventing SARS-CoV-2 infections and reducing the severe disease and mortality of COVID-19. The elderly, children and adolescents, pregnant women, lactating women, patients with chronic diseases and immunocompromised individuals are considered to be susceptible to and at a high risk of COVID-19. Early, safe and effective inoculation of COVID-19 vaccines is critical for the successful building of the population immune barrier against COVID-19. This review, based on data from clinical trials, summarizes the safety and efficacy and safety of COVID-19 vaccines among special populations, so as to provide insights into COVID-19 vaccination among special populations.

The expression and clinical significance of LRP8 in colorectal cancer / 中国医师杂志

Objective:To investigate the expression of low density lipoprotein receptor associated protein 8 (LRP8) in colorectal cancer and its correlation with clinicopathological features.Methods:The surgical specimens of colorectal cancer patients hospitalized in Hunan Provincial People's Hospital from January 1, 2020 to September 1, 2020 (without adjuvant treatment measures such as radiotherapy, chemotherapy and immunotherapy) and 45 corresponding adjacent normal tissues were collected. Immunohistochemistry was used to detect the expression of LRP8 in colorectal cancer and paracancer normal tissues. The relationship between LRP8 and clinical characteristics of colorectal cancer patients was determined by univariate logistic regression analysis and Spearman correlation analysis.Results:Immunohistochemical results showed that LRP8 protein was highly expressed in 37 cases (82.22%) and low expressed in 8 cases (17.78%) of 45 colorectal cancer tissues. LRP8 protein was highly expressed in 17 cases (37.78%) and low expressed in 28 cases (62.22%). The expression of LRP8 protein in colorectal cancer tissues and adjacent normal tissues was significantly different ( P<0.05). Chi-square test showed that LRP8 protein expression was correlated with colorectal cancer stage, perineural invasion, vascular invasion, carcinoembryonic antigen (CEA) and low density lipoprotein (LDL) (all P<0.05), but not correlated with gender, age, tumor differentiation, Ki67, CA199, lymph node metastasis, triglyceride, total cholesterol and high density lipoprotein (all P>0.05). Logistic regression analysis showed that tumor node metastasis (TNM) stage, vascular invasion, nerve invasion, serum CEA and LDL levels were the influencing factors of LRP8 overexpression in patients with colorectal cancer (all P<0.05). There was a weak negative correlation between ApoB and tumor stage ( rs=-0.382), lymph node metastasis ( rs=-0.316) and vascular invasion ( rs=-0.311) (all P<0.05). Conclusions:Our results indicate that there is a higher expression of LRP8 in colorectal cancer tissues. The expression of LRP8 correlates with the staging of the colorectal cancer, neurovascular invasion, CEA, and low density lipoprotein. Patients with high expression of LRP8 have worse tumor stage and are more likely to have concurrent neurologic and vascular invasion.

Development and validation of an individualized nomogram for early prediction of the duration of SARS-CoV-2 shedding in COVID-19 patients with non-severe disease / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

With the number of cases of coronavirus disease-2019 (COVID-19) increasing rapidly, the World Health Organization (WHO) has recommended that patients with mild or moderate symptoms could be released from quarantine without nucleic acid retesting, and self-isolate in the community. This may pose a potential virus transmission risk. We aimed to develop a nomogram to predict the duration of viral shedding for individual COVID-19 patients. This retrospective multicentric study enrolled 135 patients as a training cohort and 102 patients as a validation cohort. Significant factors associated with the duration of viral shedding were identified by multivariate Cox modeling in the training cohort and combined to develop a nomogram to predict the probability of viral shedding at 9, 13, 17, and 21 d after admission. The nomogram was validated in the validation cohort and evaluated by concordance index (C-index), area under the curve (AUC), and calibration curve. A higher absolute lymphocyte count (

Serological chemiluminescence immunoassay for the diagnosis of SARS-CoV-2 infection.

OBJECTIVE: Dynamic monitoring of the concentration variation of IgM and IgG in patients with SARS-CoV-2 infections and exploring their diagnostic value for coronavirus disease-19 (COVID-19). METHODS: A total of 15 patients with SARS-CoV-2 infection were enrolled as the COVID-19 group, and 50 patients were enrolled as the control group. The concentrations of SARS-CoV-2-specific antibodies (IgM and IgG) were detected by a chemiluminescence immunoassay (CLIA). RESULTS: According to the cutoff value recommended by the manufacturer (cutoff = 10 AU/mL), the sensitivity, specificity, Youden index (YI), positive predictive value (PPV), and negative predictive value (NPV) of IgM were 60%, 100%, 60%, 100%, and 89.29%, respectively; and 86.67%, 100%, 86.67%, 100%, and 96.15%, respectively, for IgG. We reassessed the cutoff value of IgM. When the cutoff value for SARS-CoV-2 IgM was 1.83 AU/mL, the sensitivity, specificity, YI, PPV, and NPV were 93.33%, 98%, 91.33%, 93.33%, and 98%, respectively. During dynamic monitoring of the concentrations of IgM and IgG in COVID-19 patients, we found the shortest times before a patient became IgM and IgG seropositive after symptom onset were 1.5 and 2 days, respectively. The longest times were 7 and 8 days, respectively. The positive rates of SARS-CoV-2 IgM and IgG both reached 100% in 8-14 days after symptom onset. CONCLUSION: The IgM cutoff value of 1.83 AU/mL for the diagnosis of COVID-19 was much better than the cutoff suggested by the manufacturer. SARS-CoV-2 infection can be ruled out if antibodies against SARS-CoV-2 are still undetectable 14 days after symptom onset.

Clinical Course and Risk Factors for Recurrence of Positive SARS-CoV-2 RNA: A Retrospective Cohort Study from Wuhan, China

BackgroundCoronavirus Disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has developed into a full-blown global pandemic. It has been reported that patients with COVID-19 meeting the criteria for hospital discharge (including two consecutive negative RT-PCR results) have experienced recurrent PCR positivity. However, the clinical course and risk factors for these patients have not been well described. MethodsIn this retrospective cohort study, consecutive patients with COVID-19 confirmed by RT-PCR from the Guanggu Branch of Hubei Province Maternity and Childcare Hospital from February 24, 2020 to March 31, 2020 were enrolled. All patients received follow-up to April 15, 2020 from discharge. The epidemiological, radiographic, laboratory, treatment, and outcome data were extracted from medical records. Univariate and multivariable logistic regression methods were used to elucidate risk factors for patients with recurrence of positive SARS-CoV-2 RNA. Results1087 COVID-19 patients were included in this study. Of these, 20 (1.8%) died and 1067 (98.2%) were discharged from the hospital. Among the discharged cases, there were 81 (7.6%) patients found to develop a repeat positive SARS-Cov-2 RNA result. Older age was obviously associated with death. For patients with recurrent RT-PCR positivity, the median duration from illness onset to onset of complete RNA negative was 33.0 days (range, 6.0-82.0 days; IQR, 20.0-41.0 days), while that from illness onset to recurrence was 50.0 days (range, 21.0-95.0 days; IQR, 36.5-59.5 days). Multivariate regression analysis identified recurrence of positive SARS-Cov-2 RNA was associated with elevated IL-6 levels (P=0.004, OR=3.050; 95% CI, 1.432-6.499), increased lymphocyte count (P=0.038, OR=2.321; 95% CI, 1.048-5.138) and CT imaging features of lung consolidation (P=0.038, OR=1.641; 95% CI, 1.028-2.620) during hospitalization. ConclusionElevated lymphocyte counts and IL-6 levels in blood, and consolidation features on CT imaging are useful risk factors for clinicians to identify patients at risk of developing recurrent positivity of SARS-CoV-2 RNA. This is speculated to be caused by a balance in immune regulation when fighting virus toxicity. For patients with a high risk of recurrent positivity, a prolonged observation and additional preventative measures should be implemented for at least 50 days after illness onset to prevent future outbreaks. Key PointsO_ST_ABSQuestionC_ST_ABSHow is the clinical course of patients with recurrence of positive SARS-CoV-2 RNA and what clinical characteristics are associated with that? FindingsIn this cohort involving 1067 COVID-19 patients discharged from the hospital, 81 (7.6%) patients found to develop a repeat positive SARS-Cov-2 RNA result. For patients with recurrent RT-PCR positivity, the median duration from illness onset to onset of complete RNA negative was 3.30 days (range, 6.0-82.0 days; IQR, 20.0-41.0 days), while that from illness onset to recurrence was 50.0 days (range, 21.0-95.0 days; IQR, 36.5-59.5 days). Risk factors associated with recurrence of positive SARS-Cov-2 RNA included elevated IL-6 levels, increased lymphocyte count and CT imaging features of lung consolidation during hospitalization. MeaningThe recurrence of positive SARS-Cov-2 RNA is speculated to be caused by a balance in immune regulation when fighting virus toxicity. For patients with a high risk of recurrent positivity, a prolonged observation and additional preventative measures should be implemented for at least 50 days after illness onset to prevent future outbreaks.

Investigation and analysis of the implementation effect of health management services for chronic diseases in basic public health service projects in Zhejiang Province / 中华健康管理学杂志

Objective@#To investigate and analyze the awareness, utilization, and satisfaction of patients with chronic diseases (hypertension and type 2 diabetes mellitus), as well as the influencing factors related to health management services for chronic diseases in basic public health service projects in Zhejiang Province, in order to promote the development of effective health management services for chronic diseases.@*Methods@#Between September and November 2017, 960 local patients with chronic diseases aged 35 years or older were randomly selected in eight counties (cities/districts) in Zhejiang province using the random number table, based on the chronic disease information from the information management system. A total of 394 (41.04%) male and 566 (58.96%) female patients, with an average age of (68.02±10.02) years, participated in this study. Face-to-face questionnaires were used to collect patients’ awareness, utilization, and satisfaction with health management services for chronic diseases. The awareness of health management services for chronic diseases and their utilization status were described and analyzed by statistical rate indicators. Possible factors affecting the awareness and utilization status were analyzed by χ2 test and logistic regression. Satisfaction scores of patients with chronic diseases were analyzed by means and standard deviation. T-test was used to compare the satisfaction level with service items (service convenience, service environment, waiting time, medical skill level, and service attitude) between urban and rural patients with chronic diseases. Finally, multivariate logistic regression analysis was conducted to determine overall satisfaction.@*Results@#The overall awareness of health management services for chronic diseases in chronic disease patients was 96.15%. Multivariate Logistic regression analysis showed that patients who lived in developed regions, rural areas, and patients who did not live alone had more awareness of health management services (OR= 0.347, 3.563, and 0.281, all P <0.05). The overall utilization rate of health management services for chronic diseases in chronic disease patients was 94.58%. Multivariate Logistic regression analysis revealed that patients who lived in developed regions and rural areas showed better utilization of health management services (OR= 0.297 and 4.145, all P<0.05). The average satisfaction score of patients for all items of health management services was above nine. The satisfaction scores of chronic disease patients in rural areas regarding service convenience, service environment, waiting time, and service attitude were better than those of chronic disease patients in urban areas (t=-2.157, -3.614, -3.164, -2.879, all P<0.05). The overall satisfaction score regarding health management services for chronic diseases was 92.95%. Multivariate Logistic regression analysis showed that patients who purchased health insurance for urban and rural residents reported higher overall satisfaction with health management services for chronic diseases compared to those patients who purchase other medical insurance (OR=2.943, P<0.05).@*Conclusion@#The current level of awareness, utilization, and satisfaction with health management services for chronic diseases among chronic disease patients in Zhejiang province should be further improved. Moreover, attention should be paid to the balanced development of urban and rural areas to further increase the equality level of basic public health services.

Research on the current situation of public health services compensation at public hospitals in Zhejiang province / 中华医院管理杂志

Objective To explore the financial compensation strategy on the basis of understanding the current situation of compensation for public health services at public hospitals in Zhejiang province.Methods From July to October,2017,an interview survey was conducted at 23 public hospitals in 7 cities in Zhejiang province to understand the current situation of financial compensation for public health services at public hospitals.At the same time,the data of income and expenditure in 2016 of every hospital were collected and analyzed by the methods of descriptive statistics.Results The average proportion of financial subsidies at the 23 public hospitals in 2016 was 6.29％,of which public health special subsidy accounted for 0.44％ of total hospital revenues.Only 9 of the 23 hospitals had surplus in 2016,accounting for 39.13％.Conclusions The public health services compensation mechanism of public hospitals in Zhejiang province calls for further reforms.The government departments should comprehensively formulate financial compensation policies at the provincial level according to the public health assignments and call into play a variety of compensation methods,to establish a long-term assessment mechanism and ensure that public hospitals can proactively carry out public health services.

Practice of situational simulation teaching in emergency ability training for Pharmacy Intravenous Admixture Services staff / 中华医学教育探索杂志

Objective To investigate the practice effect of situational simulation teaching in emergency ability training for Pharmacy Intravenous Admixture Services (PIVAS) staff.Methods A total of 93 pharmacists and nurses who worked in PIVAS of Children's Hospital of Chongqing Medical University from February 2014 to December 2016 were selected as subjects,and emergency ability training was performed using situational simulation teaching.SPSS 18.0 was used for data analysis,and the paired t-test was used to analyze the scores of professional theory,emergency operation skills,and self-assessment questionnaire before and after training.Results After training,the trainees had significant increases in the mean scores of professional theory [(95.33 ± 1.13) vs.(73.89±4.13),P＜0.01],emergency operation skills [(97.98 ± 1.04) vs.(78.79 ± 3.51),P＜0.01],and self-assessment questionnaire [(91.92 ± 1.51) vs.(73.60 ± 4.77),P＜0.01].Conclusion The use of situational simulation teaching stimulates the leaming interest of PIVAS staff and improves their emergency processing abilities,and therefore,it can promote timely and safe medication for children.

Progress of CALR gene mutation in myeloproliferative neoplasm / 白血病·淋巴瘤

Myeloproliferative neoplasm (MPN) is a kind of clone hematopoietic stem cell disease characterized by one or more myeloid cell lines hyperproliferation, including bcr-abl gene positive chronic myeloid leukemia (CML) and bcr-abl negative MPN, the later representing polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF). A big stride has been made since the discovery of JAK2 and MPL gene mutations. However, the exact genetic basis of JAK2/MPL mutation double negative in MPN patients is still unclear. It has been reported recently that a new CALR mutation is discovered in the JAK2/MPL unmutated MPN patients who show unique clinical presentations, which provides a new diagnostic and prognosis-accessing criteria. The paper reviews CALR mutation and genetic mechanism mediating MPN.

Application of intraoperative MRI combined with neuronavigation in microsurgical resection for insular glioma / 中南大学学报(医学版)

Objective:To evaluate the value of intraoperative magnetic resonance imaging (iMRI) combined with neuronavigation for the resection of insular gliomas.Methods:From August 2014 to October 2017 in the First Hospital Affiliated to Sun Yat-sen University,clinical data of 41 patients with insular glioma,who underwent the surgery assisted with 3.0T iMRI and neuronavigation,were analyzed retrospectively,and the resection extent,complications and prognosis were evaluated.Results:Subtotal tumor resection was achieved in 21 patients and partial resection was done in 20 after iMRI scanning.After further resection,total tumor resection was achieved in 16 patients,subtotal resection in 18 and partial resection in 7.There was a statistical significant difference in tumor resection between pre-iMRI and post-iMRI according to the Fisher test (P＜0.05).In the follow-up from 3 months to 3 years,the symptoms of the 41 patients had improved.Conclusion:iMRI corrected the shift of brain.Neuronavigation can accurately and timely assess the degree of resecting tumor.The combination of neuronavigation with surgery can maximally and safely resect insular glioma.

Analysis of prognostic factors of the first relapsed/refractory primary central nervous system lymphoma / 中国肿瘤临床

Objective: To analyze the clinical characteristics of patients with relapsed/refractory primary central nervous system lym-phoma (PCNSL) and to explore the factors that influence the prognosis, in order to provide evidence for the clinical diagnosis and treat-ment. Methods: Sixty-four patients with relapsed/refractory PCNSL diagnosed from October 2006 to August 2015 were selected. The clinical features, treatment plans, and laboratory examination data were retrospectively analyzed. Cox regression was used for multi-variate analysis. Results: Univariate and multivariate analyses showed that progression-free survival of first time (PFS1)≤1 year and Kar-nofsky performance status (KPS) score<70 points were independent prognostic factors in patients with first relapsed/refractory PCNSL. The median PFS2 and overall survival of second time (OS2) were 19 and 21 months, respectively, in patients with PFS1≥1 year, where-as the median progression free survival of second time (mPFS2) and OS2 were 10 and 14 months, respectively, in patients with PFS1<1 year. The median PFS2 (mPFS2) in patients with first relapse/refractory KPS score≥70 points and those with KPS score<70 points were 40 and 10 months, respectively, and the median OS2 were 43 and 12 months, respectively. The median PFS for the methotrexate (MTX) and non-MTX groups was 18 and 10 months, respectively. Multivariate analysis showed that the salvage therapy was a relevant factor influencing the patient's PFS. However, univariate analysis showed that the median OS2 in the MTX and non-MTX groups was 23 and 12 months, respectively, with significant difference but without any correlation with prognosis. Conclusions: progression-free sur-vival (PFS)≤1 year and KPS score<70 were independent prognostic factors in patients with first relapsed/refractory PCNSL. Patients with relapsed/refractory PCNSL who continuously received high-dose MTX-based treatment may have improved long-term treatment outcomes.

Characterization of intestinal microflora in WHBE rabbit and Japanese white rabbit models of diarrhea-predominant irritable bowel syndrome / 中国实验动物学报

Objective To compare the differences in the intestinal microflora of WHBE rabbit and JW rabbit models of diarrhea-predominant irritable bowel syndrome(IBS). Methods 16 WHBE rabbits and 16 JW rabbits were randomly divided into normal control(NC)group and IBS model group, respectively(n=8). The diarrhea-predominant IBS model was established by wet-heat stress combined with intragastric gavage of senna decoction. The abdominal circumference index,water content of feces and colonic transit function were observed. After sacrifice,colon tissue samples were taken for histopathological examination and colon contents for intestinal flora diversity analysis. Results Compared with the NC group,the IBS model rabbits showed an increased abdominal circumference index and fecal water content,and a shortened colon transit time, but no obvious pathological changes were observed in the colon tissues. Meanwhile, the Shannon index and Chao1 index of IBS model rabbits were significantly decreased(P<0.05). According to the result of OTU classification analysis,Firmicutes and Bacteroidetes are the dominant bacteria in the intestinal microflora of rabbits. Compared with the NC group, the Firmicutes, Verrucomicrobia, Chloroflexi, Akkermansia, and Streptococcus in the WHBE rabbit IBS model group were significantly reduced(P < 0.05, P < 0.01), while Bacteroidetes and rc4-4 significantly increased(P < 0.05, P < 0.01). However, in the JW rabbit IBS model group, Eubacterium and Subdoligranulum were significantly increased(P< 0.05),while Lactobacillus,Coprobacter,Veillonella and Streptococcus were markedly decreased(P<0.05). Compared with the JW rabbit NC group,the abundance of Firmicutes,Odoribacter, Veillonella,Streptococcus,Oscillospira and Pseudoflavonifractor were significantly decreased(P<0.05, P<0.01), but Bacteroidetes,Verrucomicrobia,Eubacterium,Akkermansia and Coprobacter were significantly increased(P<0.05,P<0.01)in the WHBE rabbit NC group. Compared with the JW rabbit IBS model group, the abundance of rc4-4, Bacteroidetes,Coprobacter and Clostridium were significantly higher(P < 0.05, P < 0.01), while the Firmicutes, Dorea, Coprococcus and Subdoligranulum were significantly lower(P <0.05)in the WHBE rabbit IBS model group. Conclusions There is an intestinal microflora imbalance in rabbits with IBS, resulting in a decrease of microflora diversity. The changes of intestinal microflora in the WHBE rabbits and JW rabbits with IBS have their own characteristics, and have apparent differences.

Spatial-temporal-multicomponent analysis of the characteristic of the incidence of hepatitis E in Zhejiang Province / 中华地方病学杂志

Objective To analyze the spatial-temporal characteristic of the incidence of hepatitis E (HEV) in Zhejiang Province.Methods Data related to HEV cases in Zhejiang Province in 2015 were collected from the Infectious Disease Reporting Information System in the Information System of Disease Prevention and Control of China.The ArcGIS (10.0) was used to analyze the spatial autocorrelation,R software was used to explore the spatialtemporal-multicomponent of the incidence based on the epidemic component,autoregressive component and endemic component.Results There were 1 738 cases identified and the incidence of HEV in Zhejiang Province in 2015 was 3.16/105.There were obvious regional clustering of the cases (P ＜ 0.05),the northwest regional of Zhejiang had higher incidence of aggregation.The impact of the epidemic component was strong in most of the districts of Hangzhou Municipality,parts of Huzhou and Jiaxing Municipality.The impact of autoregressive component was strong in the main urban area of Hangzhou Municipality,Lin'an and Wenlin.The impact of endemic component was relatively lower and autoregressive component was the same in a whole area.Conclusion The spatial-temporal characteristic of the incidence of HEV in different areas are heterogeneous,it is suggested that the risk factors maybe different and targeted strategies should be taken to control the disease.

Root cause analysis as used in China's hospital management: current research and application / 中华医院管理杂志

Objective To review the current research and application of root cause analysis (RCA) method in China's hospital management.Methods A retrospective analysis in six aspects was made by means of formulating a retrieval strategy and inclusion criteria, retrieval of databases, and literature review.Results The number of Chinese RCA researches was increasing year by year, mostly from researcher of the eastern coastal areas.These studies focused on the effects of RCA application outcomes and nursing safety.Tools in use were mainly fishbone diagram, brainstorming and 3-why method.72.24% of the root causes as found in literature were system factors, and 27.76% were human factors.Most of the researches made positive comments on RCA.Conclusions RCA is being warmly embraced by China's hospital management as it can positively change the accountability culture towards adverse events.Yet RCA has not been satisfactorily applied, and its future research and application in China's hospital management need more in-depth study and critical analysis.

Establishment of chronic myocardial ischemia model in minipigs and application of noninvasive telemetry technique / 中国比较医学杂志

In order to establish the minipig model of chronic myocardial ischemia and apply non-invasive telemetry technique, the minipig model of chronic myocardial ischemia was made induced by Vitamin D3, isoproterenol and combined with high fat diet, and the non-invasive telemetry technique was used to detect and evaluate the symptoms of minipig model of chronic myocardial ischemia.Moreover, the effects of transport stress and the risk factors of atherosclerosis (AS) induced by high fat diet among Wuzhishan minipigs, Bama minipigs and Tibetan minipigs were also evaluated.Our study has successful established the Bama minipig model of chronic myocardial ischemia and the technical specification for evaluation,.The non-invasive telemetry technique can be used to detect and evaluate the symptoms of chronic myocardial ischemia model, and defines minipigs at least need to keep for more than 4 weeks after transport stress to adaptive recovery period.In addition, the different characteristics of AS risk factors such as hyperlipidemia, hypertension and hyperinsulinemia were observed in Wuzhishan minipigs, Bama minipigs and Tibetan minipigs in high fat environment, and this provides a reference for the selection and application of minipigs in the research of cardiovascular diseases.

Observation on the sensitivity of Wuzhishan, Tibetan and Bama minipigs to exogenous fats / 中国比较医学杂志

Objective To observe the sensitivity of Wuzhishan, Tibetan and Bama minipigs to exogenous fats.Methods A total of 15 male minipigs including 5 WZS minipigs, 5 Tibetan minipigs and 5 Bama minipigs, were used in this study.The minipigs were intravenously injected with fat emulsion and fed with high-fat diet, and the changes of serum total cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C) and triglyceride (TG) levels were detected at 0.5 h, 1 h, 1.5 h, 2 h, 2.5 h and 3 h after intravenous injection of fat emulsion and at 3 h and 12 h, 24 h, 36 h, 48 h, 60 h, 72 h and 84 h after fed with high-fat diet, respectively, and calculated the changes of area under the curve (ΔAUC) values.Results The triglyceride (TG) in the three kinds minipigs were significantly increased (P Wuzhishan minipig > Bama minipig, while TC, LDL-C and HDL-C showed no significant changes (P>0.05).Moreover, TC, LDL-C, HDL-C and TG were significantly increased in the three stocks of minipigs induced by feeding with high-fat diet (P Bama minipigs > Tibetan minipigs.Conclusions The three stocks of minipigs are sensitive to TG after intravenous injection of fat emulsion, and the lipid tolerance values are in an order of Tibetan minipig > Wuzhishan minipigs > Bama minipigs.Meanwhile, the three stocks of minipigs are also sensitive to TC, LDL-C and HDL-C after feeding with high-fat diet, and the lipid tolerance values are in an increasing order of Wuzhishan minipig > Bama minipigs > Tibetan minipigs.

Functional changes of dendritic cells in the WHBE rabbits with allergic rhinitis induced by ovalbumin / 中国实验动物学报

Objective To observe and compare the function of peripheral blood derived dendritic cells (DC) in white hair black eyes (WHBE) rabbits and Japanese white (JW) rabbits with allergic rhinitis (AR) induced by ovalbumin (OVA),and to explore the mechanism of sensitivity to allergen in WHBE rabbits.Methods For the AR induction,rabbits were sensitized intraperitoneally everyday with OVA emulsified in Al(OH)3 followed from day 17 onward by 5 times nasal challenges with OVA in each nostril.General symptoms and histopathological changes of the nasal mucosa were observed.Expressions of CD86 on cell surface and antigen uptake of peripheral blood-derived dendritic cells were detected by flow cytometry at 6 days of culture.The mannose receptor (MR) mRNA expression was tested by real-time PCR.Proliferation of CFSE [5-(and 6-)-carboxyfluorescein diacetate succinimidyl ester]-labelled T cells stimulated by DC were observed by flow cytometry.Results The rabbits sensitized by OVA showed typical AR symptoms and pathological changes.Expressions of CD86 on the cell surface of dendritic cells in WHBE rabbits with AR were significantly upregulated not only compared with the normal control (NC) rabbits,but also with the JW rabbits with AR (P<0.01).The result of real-time PCR assay showed that MR mRNA expression of DC in the NC group of WHBE rabbits were significantly higher than that of the JWrabbits(P<0.01).Moreover,MR mRNA expression of DCs in the WHBE rabbits with AR were not only significantly higher than that in the NC rabbits (P<0.05),but also higher than that in the JW rabbits with AR (P<0.05).Meanwhile,OVA647 internalization percentages of DCs in the WHBE rabbits with AR were not only significantly higher than that in the NC rabbits,but also obviously higher than that in the JW rabbits with AR (P<0.01).Conclusions The sensitivity of WHBE rabbits to allergen may largely depend on the function of dendritic cells with high expression of mannose receptor and their strong ability of maturation and antigen uptake.

Effect of microRNA-29b on proliferation and migration of breast cancer cells and its molecular mechanism / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effects of microRNA(miRNA)-29b on the proliferation and migration of breast cancer cells and its molecular mechanism.</p><p><b>METHODS</b>The recombinant lentiviral expression vector (lenti-miRNA-29b) was constructed and transfected into 293T cells to obtain lentivirus particles that were used to infect breast cancer MCF-7 cells. Transfection efficiency of lenti-miRNA-29b in MCF-7 cells was identified by the expression of green fluorescent protein (GFP). The expression of miRNA-29b was detected by real-time PCR. The cell proliferation and migration were detected by CCK8 assay and Transwell assay, respectively. The bioinformatics softwares were used to predict and screen the downstream target genes regulated by miRNA-29b, which were verified by double luciferase reporter gene assay, RT-PCR and Western blot. The effects of screened target gene RTKN on the growth and migration of MCF-7 cells were verified by RTKN siRNA.</p><p><b>RESULTS</b>Recombinant lentiviral expression vector of miRNA-29b were successfully constructed. About 90% and 60% of the breast cancer cells showed green fluorescence in lenti-miRNA-29b and lenti-miRNA-NC groups, respectively. The expression of miRNA-29b in lenti-miRNA-29b group increased significantly compared with the lenti-miRNA-NC group and blank control group (all<0.05); the proliferation and migration ability of MCF-7 cells significantly reduced compared with the control group (all<0.05). The screening with bioinformatics softwares found that the 3'UTR coding region RTKN had the binding site to miRNA-29b; the dual luciferase reporter gene assay showed that the luciferase activity decreased significantly after the MCF-7 cells were co-transfected with wild type RTKN-WT-3'UTR and miRNA-29b mimics report gene vector (<0.05). The RTKN proteins in MCF-7 cells were significantly decreased after transfection with siRNA-RTKN, and the proliferation and migration ability of MCF-7 cells were significantly reduced (all<0.05).</p><p><b>CONCLUSIONS</b>MiRNA-29b can inhibit the proliferation, invasion and metastasis of breast cancer cells by inhibiting the expression of RTKN.</p>