Objective Controversy exists over the effects of postoperative chemoradiotherapy or chemotherapy in the treatment of rectal cancer. This study aims to evaluate the clinical effect of chemoradiotherapy or chemotherapy following radical surgery for stage Ⅱ-Ⅲrectal cancer. Methods We retrospectively analyzed the clinical data of 125 cases of stageⅡ-Ⅲrectal cancer receiving chemo-radiotherapy ( n=69) or chemotherapy ( n=56) after radical surgery. The patients in the chemoradiotherapy group were treated by 3-di-mensional conformal or intensity-modulated radiotherapy at a total irradiation dose of 45-50 Gy/25-28 times and concurrently by XE-LOX/FOLFOX chemotherapy for 4-6 cycles. Those in the chemotherapy group underwent XELOX/FOLFOX chemotherapy only, at the same dose and for the same length of time as the former. Results The therapeutic effect on stageⅡ-Ⅲrectal cancer was not correla-ted with the gender, family history, smoking history, drinking history, high-fat intake, sedentariness, obesity or constipation of the pa-tient, nor with the TNM stage, pathological grade or differentiation degree of the disease. The 1-, 2-, and 3-year survival rates were sig-nificantly higher in the chemoradiotherapy group (86. 9%, 76. 8%, and 57. 9%) than in the chemotherapy group (71. 4%, 58. 9%, and 39. 3%) (P<0. 05), while the 1-, 2-, and 3-year recurrence rates were remarkably lower in the former (5. 8%, 11. 6%, and 18. 8%) than in the latter (17. 9%, 26. 8%, and 37. 5%) (P<0. 05). Statistically significant differences were found between the che-moradiotherapy and chemotherapy groups in the incidence of diarrhea (39. 1%vs 14. 3%, P<0. 05), but not in such adverse reactions as bone marrow suppression, nausea, or vomiting (P>0. 05). Conclusion For stageⅡ-Ⅲrectal cancer, postoperative chemoradio-therapy is a safe and effective option , which can evidently reduce local recurrence and improve 3-year survival of the patient.

Objective:This study aimed to explore the effects of trichosanthin on the proliferative inhibition and apoptosis induc-tion in human lung carcinoma A549 cells. Methods:A549 cells were treated with various concentrations of TCS. The inhibitory effects in proliferation were detected by the MTT method. The microfilament changes were observed by transmission electron microscopy. Apoptosis rate and cell cycle were determined by flow cytometry. Results:A549 cells treated with TCS presented apoptotic changes and decreased cell activity. When the concentration increased and time was prolonged, the inhibition rate increased correspondingly. Conclusion:Pharmacological doses of TCS inhibited the proliferation and differentiation in lung carcinoma A549 cells and affected the function in A549 cells by changes in the cytoskeleton.

Objective: To analyze the epidemiological characteristics of hepatitis A cases in China from 2004 to 2015. Methods: Data of hepatitis A were reported through national notifiable disease information reporting system, which covered the 31 provinces (Hong Kong, Macau and Taiwan excluded). The inclusion criteria was: date of illness onset was between January 1^st 2004 and December 31^st 2015, the status of reported card was confirmed, the case was classified as laboratory confirmed or clinical diagnosed, the disease was Hepatitis A. The information such as sex, date of birth, date of illness onset, place of residence was collected. The data was divided into three phases, 2004-2007, 2008-2011, 2012-2015, which represented the phase before expanded program on immunization (EPI), first 4 years after EPI, second 4 years after EPI. Results: From 2004 to 2015, there were totally 574 697 hepatitis A cases in China, the mean annual incidence was 3.62/100 000. The risk ratio of hepatitis A in 2015 was 0.23 when compared with 2004. Sichuan, Xinjiang and Yunnan contributed to 27.27% of the total cases in China. In 2012-2015, the incidence of western (3.46/100 000) region was significantly higher than that in central (1.21/100 000) and eastern (1.08/100 000) regions. From 2004-2015, number of cases in each age group declined greatly, with number of cases declining from 43 711 to 5 938 in the age group of 5-9 years, from 29 722 to 3 438 in 10-14, from 23 212 to 3 646 in 15-19. The number of cases declined from 24 079 to 10 304 in the age group of 0-4 (declined by 57.21%), but in 2012-2015, the incidence of 0-4 age group was still the highest, with 77.72% cases in Xinjiang and Sichuan. Famers, students and scattered children accounted for 69.95% of total cases, with student cases declined from 24.08% (2004-2007) to 8.67% (2012-2015). Conclusion The incidence of hepatitis A in China is decreasing year by year, the risk has been decreasing to a relatively low level. However, in western regions and children under age five, the risk is still high. Precision intervention is needed for further prevention and control of hepatitis A.

Objective: To analyze the changing epidemiological characteristics of hepatitis E cases in China, in order to promote in preventing and controlling hepatitis E. Methods: Data of hepatitis E and outbreaks reported through national notifiable diseases reporting system were analyzed from 2004 to 2017, but data of Hongkong, Macau and Taiwan were not included. Data of hepatitis E were divided into three phases as 2004-2007, 2008-2011 and 2012-2017, representing eight years before, four years before and years after the postmarketing of hepatitis E vaccine. Linear regression was used for analyzing the trend of hepatitis E, improved muster method was used for analyzing the seasonal intensity. Results: From 2004 to 2017, 329 519 hepatitis E cases were reported and the annual incidence were increasing from 1.27/100 000 to 2.10/100 000 (t=6.87, P<0.001). The concentrations of hepatitis E during 2004-2007, 2008-2011 and 2012-2017 were 17.43, 16.06, 11.17, respectively, with low seasonal intensity. Number of cases reported by Jiangsu, Guangdong and Zhejiang accounted for 31.54% of national cases. The incidence were lower in central (1.45/100 000) and western (1.11/100 000) region than that in eastern region (2.67/100 000), but were increasing continuously. There was an increasing trend of incidence with growing ages (t=7.85, P<0.001). The incidence was higher than 2/100 000 among cases aged ≥40, and was the highest (5.22/100 000) in the age group of 65-69 years old. Farmers, retired persons, houseworkers and unemployees accounted for 67.46% of total cases. A total of 7 outbreaks were reported, among which 3 were in nursing homes. Conclusion The incidence of hepatitis E in central and western regions were increasing continuously and the surveillance should be strengthened. There was higher risk among middle-aged population, farmers and nursing homes, so strategy for immunization among those population was in great need.

Objective To evaluate the efficacy and safety of neurokinin1 (NK1) receptor antagonist aprepitant combined with prednisone and tropisetron in prevention of nausea and vomiting (CINV) induced by R-CHOP or CHOP regimen. Methods A total of 90 patients with diffuse large B-cell lymphoma (DLBCL) who accepted R-CHOP or CHOP regimen in the People''s Hospital of Tianjin from October 2015 to January 2016 were divided into aprepitant group (45 cases) and the control group (45 cases) according to the random number table. In aprepitant group, day 1: aprepitant 125 mg 1 h before chemotherapy, prednison 100 mg, tropisetron 10 mg, and tropisetron 5 mg 2 hours after chemotherapy;day 2-3:aprepitant 80 mg and prednison 100 mg, tropisetron 10 mg; day 4-5: prednison 100 mg. In the control group, day 1: prednison 100 mg 1 h before chemotherapy, tropisetron 10 mg, and tropisetron 5 mg 2 h after chemotherapy; days 2-3: prednison 100 mg, tropisetron 10 mg; day 4-5: prednison 100 mg. Data on nausea, vomiting and remission treatment were collected every day. The complete remission (CR) rates of CINV without vomiting and remission drugs in the whole cycle were recorded. Functional living index-emesis questionnaire (FILE) was used to assess the effect of CINV on the life quality of the patients. Results CR in aprepitant group was higher than that in the control group (77.8 ％ vs. 55.6 ％, χ2= 5.000, P= 0.025). The rate of no vomiting in aprepitant regimen was higher than that in the control regimen (82.2 ％ vs. 62.2 ％, χ2 = 4.486, P= 0.034). The average scores of FILE between the two groups were (113 ±10) and (100 ±11) scores respectively, and there was a significant difference (t=12.437, P<0.001). The related adverse reactions of vomiting-stopping drugs in both groups had no statistical difference. Conclusion The aprepitant combined with tropisetron and prednisone can improve effectively nausea and vomiting induced by R-CHOP or CHOP chemotherapy regimen for DLBCL patients.

Objective: To evaluate the effect of hepatitis B prevention and control by comparative analysis on the results of HBsAg, anti-HBs and anti-HBc prevalence from national hepatitis B seroepidemiological surveys in 1992 and 2014 in different epidemic regions of China. Methods: Data was from the national seroepidemiological surveys of hepatitis B conducted in 1992 and 2014. The survey in 1992 was conducted in 145 disease surveillance points of 30 provinces (excluding Hong Kong, Macao Special Administrative Region and Taiwan province) in China. The survey in 2016 was conducted in 160 disease surveillance points of 31 provinces (excluding Hong Kong, Macao Special Administrative Region and Taiwan province) in China. In the two surveys, face-to-face interviews with the subject by door to door or on the investigation site were conducted by trained staff using standard questionnaires to obtain basic information including birth date, gender, ethnicity, resident place and so on. And then 5 ml venous blood was collected to test the sero-markers of HBsAg, anti-HBs and anti-HBc. We analyzed unweighted point prevalence and 95% CI of HBsAg, anti-HBs and anti-HBc in 1992 which had no design weighting, and analyzed weighted point prevalence and 95%CI of HBsAg, anti-HBs and anti-HBc in 2014 which had design weighting. Results: 34 291 and 31 713 people aged 1-29 years were involved in 1992 and 2014 national serosurveys of China, respectively. For the people aged 1-29 years, HBsAg prevalence was 2.64% (95%CI: 2.28%-3.06%) in 2014 and decreased by 73.92% as compared with the rate 10.13% (95% CI: 9.81%-10.45%) in 1992. Anti-HBc prevalence was 13.01% (95%CI: 12.09%-14.00%) in 2014 and decreased by 71.61% as compared with the rate 45.84% (95% CI: 45.31%-46.37%) in 1992. Anti-HBs prevalence was 57.79% (95%CI: 56.33%-59.25%) in 2014 and ascended by 127.41% as compared with the rate 25.41% (95% CI: 24.95%-25.87%) in 1992. In high, medium and low epidemic region, for the people who born during 1992-2001 when hepatitis B vaccine was introduced in routine immunization management, HBsAg prevalence was 4.74% (95%CI: 3.79%-5.69%), 1.59% (95%CI: 1.09%-2.10%) and 2.53% (95%CI: 1.66%-3.39%), respectively, and anti-HBs prevalence was 64.25% (95% CI: 62.11%-66.39%), 56.34% (95% CI: 54.50%-58.57%), 54.49% (95%CI: 51.75%-57.23%), respectively, and anti-HBc prevalence was 15.16% (95%CI: 13.56%-16.76%), 11.07% (95%CI: 9.80%-12.33%), 7.61% (95%CI: 6.15%-9.07%), respectively. In high, medium and low epidemic region, for the people who born during 2002-2013 the duration which hepatitis B vaccine was integrated in expanded immunization program born during when HBsAg prevalence was 0.88% (95%CI: 0.66%-1.11%), 0.37% (95%CI: 0.24%-0.49%)and 0.71% (95%CI: 0.48%-0.94%), respectively, and anti-HBs prevalence was 60.74% (95%CI: 59.57%-61.90%), 59.46% (95%CI: 58.44%-60.49%), 52.56% (95% CI: 51.20%-53.92%), respectively, and anti-HBc prevalence was 3.30% (95% CI: 2.87%-3.72%), 1.91% (95%CI: 1.63%-2.20%), 2.25% (95%CI: 1.85%-2.66%), respectively. Conclusion China had made great achievement in hepatitis B prevention and control. HBsAg prevalence among people aged 1-29 years old in 2014 decreased dramatically as compared with that in 1992. Since hepatitis B vaccine was integrated into expanded immunization program, China reduced HBsAg prevalence to less than 1% among people aged 1-12 years in 2014 in different epidemic region.

Objective:To evaluate and summarize the best evidence of energy and protein intake targets and calculation in adult critically ill patients, and to provide evidence-based basis for critical nutrition management.Methods:Evidence related to energy and protein intake targets and calculation of adult critically ill patients, including guideline, expert consensus, systematic review and evidence summary, were systematically searched in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Cochrane Library, UpToDate, BMJ Best Practice, Joanna Briggs Institute (JBI), Web of Science, SinoMed, Medive, China National Knowledge Infrastructure, Wanfang database, VIP database, Guidelines International Network (GIN), National Institute for Health and Care Excellence (NICE), National Guideline Clearinghouse (NGC), Registered Nurses Association of Ontario (RNAO), and Society of Critical Care Medicine (SCCM) from January 2012 to June 2022. Two researchers independently evaluated the quality of the included literatures using the JBI Evidence-based Health Care Center evaluation tool and the Appraisal of Clinical Practice Guidelines for Research and Evaluation Ⅱ (AGREE Ⅱ), extracted and summarized the best evidence for the nutritional intake goal and calculation of adult critically ill patients, and described the evidence.Results:A total of 18 literatures were included, including 5 clinical guidelines, 8 expert consensus, 3 systematic reviews and 2 evidence summaries. After literature quality evaluation, 18 articles were all enrolled. The evidence was summarized from the four aspects, including energy target calculation method, dose body weight, energy and protein intake target, and calculation method, 24 pieces of the best evidence were finally formed.Conclusions:The best evidence of energy and protein intake targets and calculation for critically ill patients was summarized based on evidence-based. Clinical medical staff can choose indirect calorimetry to calculate energy goals when equipment is available. Patient's height, body weight should be recorded accurately, dose body weight can be determined by body mass index (BMI). Meanwhile, blood urea nitrogen (BUN) loss, fat-free body weight, simple formulas and other methods should be used to continuously evaluate and adjust protein intake targets, to achieve the purpose of optimizing intensive nutrition support.

Objective:To analyze the related factors affecting the inter-arm systolic blood pressure difference (IASBPD) in a physical examination population.Methods:A total of 3 600 adults who underwent physical examination and completed the arteriosclerosis test in the first affiliated hospital of Anhui medical university from January 2019 to June 2021 were selected as the participants by systematic sampling method. Data on age, sex, and history of smoking, heavy drinking, hypertension, type 2 diabetes, and coronary heart disease were recorded. The height, weight, waist circumference, hip circumference, total muscle, total fat and body fat ratio were measured, and body mass index was calculated. The blood pressure of the limbs, ankle brachial index (ABI) were measured synchronously with the arteriosclerosis tester of the Chinese Academy of Sciences, and the IASBPD were calculated. According to the IASBPD value, the participants were divided into two groups: IASBPD<10 mmHg (1 mmHg=0.133 kPa) group and IASBPD≥10 mmHg group, The differences between the two groups were compared, and the related influencing factors of IASBPD were analyzed by multivariate logistic regression.Results:Weight, body mass index, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, total muscle, total fat, body fat rate, history of hypertension, proportion of type 2 diabetes mellitus, and proportion of history of coronary heart disease in the IASBPD≥10 mmHg group was higher than that of IASBPD<10 mmHg group [(69.1±11.2) vs (65.3±10.8) kg, (25.6±3.4) vs (24.4±3.3) kg/m 2, (91.3±11.3) vs (87.8±10.6) cm, (98.5±10.4) vs (96.5±9.8) cm, (139.7±20.0) vs (129.7±17.6) mmHg, (80.3±11.6) vs (76.7±10.1) mmHg, (47.5±9.1) vs (45.3±8.8) kg, (19.4±7.0) vs (17.6±6.4) kg, (27.9%±8.5%) vs (26.8%±8.1%), 41.1% vs 29.3%, 16.6% vs 11.7%, 13.1% vs 7.3%] (all P<0.05); ABI was lower than that in IASBPD<10 mmHg group [(1.15±0.11) vs (1.20±0.09)] ( P<0.001). There were no significant differences in height, smoking history and heavy drinking history between the two groups (all P>0.05). Multivariate logistic regression analysis showed that age, systolic blood pressure, body weight and ABI were independent influencing factors of IASBPD≥10 mmHg. Age, systolic blood pressure and body weight were positively correlated with IASBPD≥10 mmHg, while ABI was negatively correlated with IASBPD≥10 mmHg. Conclusion:Increases in age, systolic blood pressure, and body weight and a decrease in ABI are important influencing factors leading to the elevation of IASBPD.

Objective:To investigate the clusters of COVID-19 associated with a market (market Y) in Haidian District, Beijing, and analyze the chain of transmission and provide reference for effective prevention and control of COVID-19.Methods:The investigation of field epidemiology and cluster epidemic was used to describe the distributions of all COVID-19 cases. The time sequence diagram of the cases, disease onset was drawn and transmission chains were analyzed. Real-time RT-PCR assay was conducted for SARS-CoV-2 nucleic acid test by using the respiratory samples of the cases.Results:The COVID-19 epidemic, originated from a wholesale farm produce market (market X) in Fengtai District, Beijing, was introduced by a marketer in the market Y who had exposed to market X, causing 8 clusters of 20 confirmed cases of COVID-19 and one asymptomatic case, including 8 men and 13 women, in market Y, surrounding communities, food plaza, companies,families and other places. The incidence peaked during June 10-14, 2020; the median age of the cases was 45 years, ranging from 5 years to 87 years. The initial symptoms of the cases included fever (10/20) and pharynx discomfort (7/20). The median of incubation period was 5 days ( IQR:3-8). The median of serial interval between primary case and secondary cases was 5 days with a secondary attack rate of 3.7%(20/538), and the secondary attack rate in household close-contacts was 14.0% (7/50). Conclusions:The clusters of COVID-19 associated with market Y were caused by several modes of transmission, including human-to-human, contaminated material-to-human, etc. The combined public-health response measures were effective to control the COVID-19 epidemic in Haidian district of Beijing.

Objective:To explore the impact on safety and prognosis in patients with right-sided colon cancer participating in surgical clinical research.Methods:This retrospective cohort study utilized data from a randomized controlled trial (RELARC study) conducted by the colorectal surgery group at Peking Union Medical College Hospital in which laparoscopic complete mesocolic excision (CME) was compared with D2 radical resection for the management of right-sided colon cancer. The eligibility criteria were age 18–75 years, biopsy-proven colon adenocarcinoma, tumor located between the cecum and right 1/3 of the transverse colon, enhanced chest, abdomen, and pelvic CT scans suggesting tumor stage T2–T4N0M0 or TanyN+ M0, and having undergone radical surgical treatment from January 2016 to December 2019. Exclusion factors included multiple primary colorectal cancers, preoperative stage T1N0 or enlarged central lymph nodes, tumor involving surrounding organs requiring their resection, definite distant metastasis or otherwise unable to undergo R0 resection, history of any other malignant tumors within previous 5 years, intestinal obstruction, perforation, or gastrointestinal bleeding requiring emergency surgery, and assessed as unsuitable for laparoscopic surgery. Patients who had participated in the RELARC study were included in the RELARC group, whereas those who met the inclusion criteria but refused to participate in the RELAEC study were included in the control group. The main indicators studied were the patient's baseline data, surgery and perioperative conditions, pathological characteristics, adjuvant treatment, and postoperative follow-up (including average frequency of follow-up within the first 3 years) and survival (including 3-year disease-free survival rate (DFS) and 3-year overall survival rate (OS). Differences in these indicators between the RELARC and control groups were compared.Results:The study cohort comprised 290 patients, 173 in the RELARC group (RELARC-CME group, 82; RELARC-D2 group, 91) and 117 in the control group (CME control group, 72; D2 control group, 45). There was a significantly higher proportion of overweight patients (BMI ≥24 kg/m 2) in the RELARC-CME than in the CME control group (67.1% [55/82] vs. 33.3% [24/72], χ 2=17.469, P<0.001). There were no other statistically significant differences in baseline characteristics (all P>0.05). No significant disparities were found between the CME and D2 groups in terms of operation duration, intraoperative blood loss, rate of conversion to open surgery, combined organ resection, intraoperative blood transfusion, or intraoperative complications (all P>0.05). There was a trend toward Clavien–Dindo grade II or higher postoperative complications in the RELARC-CME group (24.4% [20/82]) than in the CME control group (18.1% [13/72]); however, this difference was not statistically significant (χ 2=0.914, P=0.339). Similarly, the difference in this rate did not differ significantly between the RELARC-D2 group (25.3% [23/91]) and D2 control group (24.4% [11/45], χ 2=0.011, P=0.916). The median duration of postoperative follow-up was significantly shorter in the RELARC groups than in the corresponding control groups. Specifically, the median duration of follow-up was 4.5 (4.5, 4.5) months in the RELARC-CME and 7.2 (6.0, 9.0) months in the CME control group ( Z=-10.608, P<0.001). Similarly, the median duration of follow-up was 4.5 (4.5, 4.5) months in the RELARC-D2 group as opposed to 8.3 (6.6, 9.0) months in the D2 control group ( Z=-10.595, P<0.001). The 3-year DFS rate (91.5%) and OS rate (96.3%) tended to be higher in the RELARC-CME group than in the CME control group (84.7% and 90.3%, respectively). The 3-year DFS rate (87.9%) and OS rate (96.7%) tended to be higher in the RELARC-D2 group than in the D2 control group (81.8% and 88.6%, respectively); however, these differences were not statistically significant (all P>0.05). Subgroup analysis according to pathological stage revealed that patients in the RELARC-D2 group with pN0 stage achieved a significantly superior 3-year OS rate than did those in the D2 control group (100% vs. 88.9%, P=0.008). We identified no statistically significant differences in survival rates between the remaining subgroups (all P>0.05). Conclusions:A high-quality surgical clinical trial with close follow-up can achieve perioperative safety and a trend toward improved survival outcomes.