Objective To study the effect of retinaldehyde dehydrogenase 2 (Raldh2) on the differentiation of P19 cell to cardiomyocyte-like cells and explore the potential mechanism.Methods A miRNA expression plasmid specific to Raldh2 was packaged and constructed by RNA interference (RNAi) method.The P19 stable cell line carried Raldh2 miRNA expression was selected by adding blasticidin and induced to differentiate towards cardiomyocyte-like cells.The mRNA levels of myocardium development-related markers were determined by qPCR at different stages during the differentiation process.Results The miRNA expression plasmid specific to Raldh2 could effectively suppress Raldh2 expression,and the MiRaldh2 group,a P19 stable cell line was established successfully in which the knockdown efficiency on Raldh2 was 91％ (t =25.52,P＜0.000 1,95％ CI:0.81-1.01).When compared with P19 group,the mRNA levels of cardiac transcription factors were generally decreased in the MiRaldh2 group during the whole differentiation process.In detail,on the 7th day,the relatively low expression rates of these cardiac markers including Gata4,Tef-1,N-myc,α-mhc and Ctnt was0.16±0.01 (t=17.29,P＜0.000 1),0.51 ±0.02 (t=3.564,P=0.023 5),0.23 ±0.01 (t=13.17,P =0.000 2),0.20 ± 0.02 (t=17.76,P＜0.000 1) and 0.59 ± 0.06 (t =3.642,P =0.021 9) in MiRaldh2 group when compared with the P19 group.Conversely,the mRNA levels of Nkx2.5 and Hand2 were dramatically increased in MiRaldh2 group on day 2 to 7 and the expression rates on the 7th day was 2.25 ± 0.35 (t =3.526,P =0.024 3) compared with the P19 group while Hand2 was 3.58 ± 0.20 (t =9.214,P =0.011 6).Conclusions Knockdown of Raldh2 inhibits the P19 cells differentiated into cardiomyocyte-like cells,which suggests that Raldh2 may play a potential role in early development of heart.The low expression of Raldh2 might be an explanation of the cardiac malformations associated with retinoic acid deficiency.

Objective To understand the epidemic characteristics of influenza in Minhang District of Shanghai during 2013-2016,so as to provide scientific basis for the prevention and control of influenza.Methods Surveillance data of influenza like illness (ILI) cases from the national influenza network and data of pathogen detection during 2013-2016 in Minhang District were selected to analyze the epidemic characteristics of influenza.Results The number of influenza like illness (ILI) was 37 738 from 2013 to 2016,which accounted for 0.90％ of the outpatients in monthly average.Meanwhile,4 094 samples were collected,among which 857 samples were virus positive.The total isolation rate was 20.93％.In 2013,the dominant strain was mainly seasonal influenza A (H3N2).Dominant strains of 2014 were influenza B (Yamagata) and seasonal influenza A (H3N2).In 2015,dominant strain was seasonal influenza A (H3N2) of summer peak,but the dominant strains of winter-spring peak were new type influenza H1N1 (H1N1 pdm09) and influenza B (Victoria) from December 2015 to April 2016.The dominant strain of winter peak in 2016 was seasonal influenza A (H3N2) popular.Spearman correlation analysis showed positive rate between ILI visiting rate (ILI％) and influenza virus (rs =0.460,P＜0.05).Conclusions The epidemic peaks of of influenza were winter-spring and summer in Minhang District,advantages strains were interaction pandemic with certain regulation.The characteristics of ILI visiting rate was coincident with influenza virus activity.

Objective To analyze malnutrition epidemiologic trend among students aged 6-18 years from 2010 to 2016 in Minhang district of Shanghai,and to provide reference for malnutrition prevention and treatment.Methods Physical examination data from healthy monitoring schools in Minhang District from 2010 to 2016 were used to screened out the malnutrition of students aged 6-18 years via National standard 2014 and analyzed the different type of malnutrition in different population.Results During the period of 2010 to 2016,malnutrition rate of students demonstrated a fluctuated trend.Malnutrition rate in 2010 was 4.0％ and 4.4％ in 2016.The major type of malnutrition is wasting with a proportion more than 88％ during these years.Rate of wasting increased from 3.5％ to 7.8％ in boys aged 13-18 years old and from 1.3％ to 3.9％ in girls aged 13-18 years old.Conclusions The malnutrition of students in Minhang District is under control,while the screening rate of wasting increased in students aged 13-18 years old.Intensified intervention of prevention and treatment should be administrated and integrated with obesity control in Minhang District of Shanghai.

Objective To investigate the epidemiological and pathogenic characteristics of viral diarrhea in Minhang District of Shanghai.Methods Random sampling on diarrhea was conducted in intestinal outpatient departments of 2 sentinel hospitals according to a certain sampling interval in Minhang District from 2014 to 2016.Real-time PCR was used to detect rotavirus (RV),norovirus (NV),adenovirus (AD),astrovirus (AstV) and sapovirus (SaV) in fecal samples.Results A total of 11 243 cases of diarrhea were monitored in 2 sentinel hospitals during 2014 and 2016,with 3 213,3 600 and 4 430 cases for each year,respectively.Out of 809 stool specimens,309 were tested positively,and the positive rate was 38.48％.All 5 pathogenic viruses were detected,mostly NV (207 cases,66.99％)followed by RV (77 cases,24.92％).Conclusions NV accounted for the majority of reported infection diarrhea cases in Minhang District of Shanghai from 2014 to 2016,with significant seasonal peaks.Tailored prevention and control measures should be carried out,particularly in risk seasons.

Objective To investigate the quality of life (QOL) and mental health status of patients with HIV/AIDS in Minhang District of Shanghai,and to explore the factors that affect their quality of life.Methods A cross-sectional study was conducted in Minhang District among HIV/AIDS patients.All subjects finished general situation questionnaire,Beck depression inventory (BDI),self rating anxiety scale (SAS),social support scale (SSS) and generic quality of life inventory-74 (GQOLI-74) survey.Results A total of 294 patients were recruited in this study with mean age of (39.6 ± 12.6) years old.Among the subjects,mean score of SAS was 40.5 ± 8.8,higher than national normative score (t =20.8,P＜0.001).The prevalence of anxiety was 13.9％.The mean score of BDI was 8.90 ± 8.59,and the prevalence of depression was 28.6％.The mean score of quality of life (QOL) was 66.6 ± 10.9.Multivariate logistic regression analysis showed that QOL of patients with high school or secondary school was lower than those with college and above education (OR =0.34,95 ％ CI:0.12-0.95).QOL scores of patients with moderate or severe depression were lower than those with less depressed patients,OR values were 0.14(95 ％ CI:0.06-0.34) and 0.07(95 CI:0.03-0.20)respectively.QOL of patients with anxiety was lower than the patients without anxiety (OR =0.10,95 ％CI:0.04-0.27).QOL of patients with high scores of social support was higher than the patients with low scores of social support (OR =3.95,95 ％ CI:1.82-8.59).Conclusions We should pay more attention to the psychological state of patients with HIV/AIDS.The quality of life can be improved by improving social support and reducing the occurrence of anxiety and depression.

Objective To understand the trends and epidemiological characteristics of syphilis in Minhang District of Shanghai,so as to provide scientific basis for making control strategies.Methods The data of reported cases of syphilis in Minhang District from 2005 to 2016 were analyzed with epidemiological methods.Results Overall 11 394 cases of syphilis were reported from 2005 to 2016,the incidence was 42.9 per 100 000 person-year.The incidences of Phase Ⅰ,Phase Ⅱ,Phase Ⅲ,genital and latent syphilis were 10.3,13.4,0.3,2.3 and 16.6 per 100 000 person-year,respectively.In 2009,the incidence reached 59.1 per 100 000 person-year and reach peak.The cases were constituted by local residents (62.4％) and residents from other provinces (37.6％),male patients predominated with male/female ratio of 1.1∶1.Most cases were aged from 25 to 54 years old(61.1 ％),and those people older than 54 years were more and more likely to be found infected.Local residents predominated by those who aged 25-64 years (74.2％) and other province predominated by 15-44 years (79.1％),the ratios of male/female were 1.3 ∶ 1 and 0.8 ∶ 1.Female were much younger than male,there were 50.0％ of female and 29.3％ of male who were aged between 15-34 years old.Latent syphilis was mostly reported in local male residents who were older than 55 years,female who were 25-54 years and other provinces' female aged 15-44.Phase Ⅰ and Ⅱ syphilis were mostly reported in local male residents less than 55 years old and other provinces' male less than 65 years old.There were significant difference between residence,sex,age and different kinds of syphilis with P＜0.001.Conclusions The trends of syphilis incidence was increasing before 2009 in Minhang District and then declining and slowing down in recent years.The measure of reinforcing monitor,propaganda and education,active screening syphilis in female and local old man should be taken to control and prevent the spread of syphilis.

Objective To investigate the risk of overall and site-specific cancers in Chinese patients with type 2 diabetes mellitus (T2DM) in Minhang District of Shanghai.Methods A population-based retrospective cohort study including 51 372 T2DM patients was conducted in Minhang District,Shanghai from 2004 to 2014.All T2DM patients were enrolled from the standardized management system based on local electronic information system of Shanghai.Newly-diagnosed cancer cases were identified by record-linkage with the Shanghai Cancer Registry.Standardized incidence ratios (SIR) and 95％CI were used to estimate the risk of cancers among T2DM patients.Results Overall crude incidence rate (CIR) of cancers was 969.69 per 105 person-years in men and 834.17 per 105 person-years in women.The age-standardized rate (ASR [W]) was 206.72 per 105 person-years in men and 285.80 per 105 person-years in women.Increased risk of cancer was found in both sex,with an SIR of 0.93 (95％CI:0.88-0.98) in men and 1.07 (95％ CI:1.01-1.12) in women.Conclusions Our results indicate that patients with T2DM may have an increased risk of some cancers,and the increase may vary by sub-sites of cancers.

Objective To analyze the incidence trend of malignant tumor in Minhang District of Shanghai from 2002 to 2013,in order to provide scientific evidence for making the comprehensive prevention and control strategy.Methods Incidence of cancer data (2002-2013) of Minhang District were collected.The crude rate,standardized rate,sectional shrinkage rate,accumulation rate,percentage change (PC),annual percentage change (APC) and annual change contribution rate were calculated for main malignant tumors separately.Results The total incidence of malignant tumors in Minhang District from 2002 to 2013 increased year by year,mainly showed in thyroid cancer,colorectal cancer and breast cancer,while decreased in gastric cancer,liver cancer and lung cancer.Conclusions The incidence of malignant tumor in Minhang District was increasing.The incidence of thyroid cancer,colorectal cancer and breast cancer were significantly increased,which were needed to pay more attention.The incidence of gastric cancer and liver cancer were decreased significantly,which indicated that exposure factors were controlled effectively.

Objective To investigate the effect of the third party evaluation on improving the quality of medical service as well as the degree of patient trust in hospital.Methods Discharge patients from a two-level hospital in Minhang District was enrolled to evaluate their trust for medical service.Telephone follow-up were implemented in group A by the third party evaluation team.Group B was evaluated by the in-patient department when they left the hospital.These two evaluation methods were compared for the effects.Results During the first evaluation,1 073 people in group A,the equipartition satisfaction was 3.83 ± 0.57,the satisfaction rate was 54.99％.While in group B of 1 480 people,the equalization satisfaction was 3.83 ± 0.49,the satisfaction rate was 57.03％ (P＞0.05).At the fourth evaluation,1 233 people in group A and 1 512 people in group B were evaluated.Regarding group A,the patient satisfaction scores was 4.18 ± 0.33,patients satisfaction rate was 84.43％,the equipartition of patients referral was 3.44 ± 0.83,the equipartition of patients recommends the physician was 3.52 ±0.88,the equipartition of the doctor and patient had a quarrel was 4.33 ± 0.60,the equipartition of patients will find another doctor for diagnosis was 3.31 ± 0.72,the equipartition of patients expressed fully in accordance with the doctor's order of medication was 3.45 ± 0.72,group A were better than groupB (P＜0.05).Of the28 entries in the level of trust related to medical services,15 entries of group A were higher than group B (P＜0.05).In group A,the equipartition of moderate intensity activity was 3.62 ± 0.81,the equipartition of emotional coordination refers to 3.71 ± 0.76,the equipartition of family coordination was 3.69 ± 0.58,the equipartition of friends coordination was 3.73 ± 0.74,the equipartition of overall health was 3.31 ± 0.77,all were superior to group B (P＜0.05).Conclusions The third party evaluation is a supplementation for hospital management,which has positive effects on improving medical service quality of medical institutions,the hospital performance appraisal system,patients' experiences and trust degree.

Objective To investigate the cognition and attitude towards free pneumonia vaccination among elderly people aged over 60 years old in Minhang District of Shanghai.Methods Target population was based on registered citizen over 60 years old in Minhang District.According to their willingness of pneumonia vaccineinjection,participants were divided into two groups,willing group and refused group.We randomly selected 910 people for each group.And before vaccination,a self-made "pneumonia vaccination behavior cognition and attitude questionnaire" was completed by each participant.Whether there were significant differences in the cognitive and attitude towards pneumonia vaccination between the two groups was analyzed by t test.x2 test and Logistic regression model was used to analyze main risk factors affecting the elderly attitude and behavior towards pneumonia vaccination.Results Statistical significant relations were found among following five cognition dimensions,which were benefits of vaccination (t =21.691,P＜0.01),values of vaccination (t =6.105,P＜0.01),the severity of affecting pneumonia (t =9.882,P＜0.01),vulnerable of getting pneumonia (t =5.670,P＜0.01) and obstacle towards vaccination (t =-7.114,P＜0.01).x2 test and Logistic regression analysis results suggested that among these five dimensions,cognition of vaccination benefits (B =0.610,P＜0.01) played the most important role in the attitude of elderly people between the two groups.The severity of affecting pneumonia (B =-0.452,P＜0.01) and obstacle towards vaccination (B =0.311,P＜0.01) played less important role regards elderly making decision of taking pneumonia vaccination.There was no statistically significant relations in sensitivity of getting pneumonia.In addition to the five dimensions discussed above,people who are engaged in commercial and service industry before retirement,with an annual income of between ten thousand to one hundred thousand and having chronic diseases are more likely to have a higher degree of acceptance of taking pneumonia vaccine than those without these properties.Conclusions There were significantly differences in cognitive behavior between willing to injection group and refused group among elderly.The results suggest that the benefits of pneumonia vaccination in older people with chronic diseases may have a positive effect on further increasing the rate of free pneumonia vaccination in the elderly population in Minhang District of Shanghai.