Background Fungal keratitis has a high incidence in China and its clinical treatment is very difficult,and its etiology diagnosis and appraisal is the premise to improve the prognosis of disease.With the changes of regional environment and climate in recent years,whether the spectrum of fungal keratitis change in South China is remarkable.Objective The purpose of this study was to investigate recent pathogenic distribution of fungal keratitis in South China area.Methods The consecutive fungal culture resuhs of 3 350 purulent keratitis at Zhongshan Ophthalmic Center from January 2009 to December 2014 were retrospectively reviewed.The positive rate of fungal culture,genus or species distribution,seasonal distribution and different term distribution were analyzed.Results The culture-positive rate was 31.34％ in this study (1 050/3 350),and the average culture-positive number was 175 strains per year.In the positive fungus,the highest positive rate was Fusarium SP (32.10％,337/1 050),and followed by Aspergillus SP (25.71％,270/1 050),Heminthosporium SP (14.29 ％,150/1 050) and Mucor SP (9.14％,96/1 050).The fungal culture-positive rate was 36.05％ (367/1 018) in 2009 to 2010,32.45％ (324/1 014) in 2011 to 2012,and 26.86％ (354/1 318) in 2013 to 2014,respectively,with a significant difference among the three periods (x2 =22.37,P＜0.01),showing a decreasing tendency of incidence.Two hundreds and sixtyone strains were isolated from January to March (31.15 ％,261/838),182 strains from April to June (25.53 ％,182/713),237 strains from July to September (30.00％,237/790),370 strains from October to December (36.67％,370/1 009),showing a statistically significant difference among them (x2 =25.19,P ＜ 0.01).The number of infectious strains was most during October to December and fewest during April to June.Conclusions The leading pathogenic fungi of fungal keratitis is Fusarium SP and followed by Aspergillus SP,Helminthosporium SP,Mucor SP in turn.Fungal keratitis is usually prevalent from October to December,and its incidence is still rising in Chinese mainland recently.However,the increasing tendency in South China has been prevented in recent six years.

Public health education is the core and foundation of the development of public health.Therefore,it is an urgent problem to explore the effective ways to improve public health education and to enhance the service abilities of public health,which meets the needs of development of modern public health.On the basis of analyzing the present situation of public health education in our country,this paper discusses the necessity of introducing the concept of integrated medicine in public health education,and then puts forward the corresponding settlement measures to solve the specific problems by utilizing the concept,thinking and method of integrated medicine,which aim to provide a certain theoretical basis for cultivating high-quality public health talents and accelerating the development of public health disciplines in China.

The gamma-secretase complex mediates the final cleavage of APP to generate the principal component of amyloid plaques in the brains of Alzheimer's disease patients.Four integral membrane proteins (PS,NCT,PEN-2 and APH-1) are essential and sufficient for gamma-secretase activity.To identify the promoter of human nicastrin gene (NCT),its 5' -flanking region has been characterized and a 270 bp fragment containing the TSS (transcription start site) for the promoter activity has been identified.EMSA assays confirmed that all four AP-1 binding sites and two NFAT sites in the NCT promoter region were able to bind relative transcription factors in vitro.Mutations,as well as treatment with PDTC,which adjust the regulatory effect of AP-1 and NFAT,altered NCT promoter activity in both HeLa cells and rat cortical neurons.The results demonstrated that AP-1 and NFAT are involved in the regulation of hNCT transcription and suggest that balanced activation of AP-1 and NFAT ensures a strict temporal and tissue-specific control of NCT transcription.

Gastric cancer is one of the common malignant tumors with a high incidence in China. With the deepening of the research on tumor molecular biology, molecular targeted therapy has shown its advantages, and immunotherapy has attracted much attention. Yes-associated protein (YAP) is an effector protein that plays a major role in Hippo pathway, and it can regulate the growth of cells after binding with transcription factors in the nucleus. In recent years, many studies have shown that the high expression of YAP is closely related to the occurrence, development and metastasis of gastric cancer, and may be an important target of chemotherapy resistance. The further study can provide reference for clinical treatment.

G mutation of SLC26A4, the parents and the second child were carriers of the same mutation, while the fetus had a wild-type form. Conclusion It is feasible to identify deafness related genes by screening for GJB2 and SLC26A4 mutation, thus providing correct prenatal diagnosis and avoiding deaf delivery of baby.

Objective To systematically evaluate the effects of left ventricular global longitudinal strain (GLS) determined by two dimensional speckle tracking imaging technology (2D-STI) and left ventricular ejection fraction (LVEF) on the prognosis of patients with sepsis/septic shock.Methods Databases such as the National Library of Medicine PubMed database, Dutch medical abstracts Embase, Cochrane Library, Netherlands Elsevier, Springer and China biomedical literature database (CBMdisc), China National Knowledge Internet (CNKI), Wanfang database, China science and technology journal full-text database, Vip Chinese biomedical journal database were searched from the establishment of literature database to April 2018 to study GLS, LVEF and their relationships with mortality of septic/septic shock patients. The literatures screening and data collecting were independently conducted by two researchers, and the quality of the included literature was evaluated. The sensitivity and heterogeneity analysis were performed with RevMan 5.3 software, and the combined effects were calculated. Funnel plot was used to evaluate publication bias.Results A total of 6 articles including 5 English articles and 1 Chinese article were enrolled. There were 503 patients, 333 in the survival group and 170 in the death group. The quality of the literature was high, and the Newcastle-Ottawa scale (NOS) score was 8-9. Meta-analysis showed that short-term mortality was associated with higher GLS in patients with sepsis/septic shock [standardized mean difference (SMD) = -0.47, 95％ confidence interval (95％CI) = -0.76 to -0.18, Z = 3.16,P = 0.002], and there was no significant difference in LVEF between the survival group and the death group (SMD = 0.18, 95％CI = -0.03-0.39,Z = 1.64, P = 0.10). Sensitivity analysis was carried out for each effect index by removing each document one by one, and the results showed that there was no significant change in the combined effect before and after each document, indicating that the results were stable. The funnel plot showed that the effect points of each literature were roughly in the form of "inverted funnels" with a large symmetric distribution centered on the combined effect, but the number of studies included in this study was too small, so the publication bias could not be completely excluded.Conclusion Compared with LVEF, GLS might be a more sensitive indicator for detecting myocardial dysfunction in patients with sepsis/septic shock and might have important predictive value for short-term mortality.

Objective To analyze the conding region of hantanvirus S gene and predict the structure of nucleoprotein for diagnostic antigen study.Methods RT-PCR was used to amplify the S gene of hantanvirus Hunan03 strain after designing specific primers.The amplification product was cloned into pGM-T vector and then the recombinant vector was transformed into E.coli TOP10,gene sequencing was carried out after blue-white selection and PCR screening for positive clones.The database of NCBI and Swiss-Prot/TrEMBL were used to predict and analyze the structure,biological characteristics and protein structures of S gene.Results The amplification product was about 1290 bp,the pGM-T/S vector was constructed and successfully sequenced,the whole length of the open reading frame (ORF) was composed of 1290 nucleotide residues,among them the GC content was 44.11％ and the AT content was 55.89％,it was composed of 429 amino acids (20 kinds),the accession number of the sequence submitted to GenBank was JN712306,its homology of nucleotides to the 76-118 strain was 83％ and the homology of amino acids was 98％,ten nonspecific variation sites were found.The grand average of hydropathicity was-0.405.There were three transmembrane domains and four non transmembrane domains in the secondary structure of nucleoprotein including 55％ of helix structure,6.1％ of sheet structure and 38.9％ of loop structure.Conclusion The bioinformatics analysis of Hunan03 strain S gene might be important for provide the substructure data to reveal the significance of S gene characteristics on hemorrhagic fever renal syndrome (HFRS) prevention and control.

Objective: To understand current situation of the awareness of tobacco hazards among middle school personnel in Shanghai and to explore its influencing factors,and to provide reference for making targeted measures to control tobacco hazards in schools. Methods: A total of 30 middle schools in Shanghai were selected by stratified cluster sampling method. The questionnaires were used to investigate the smoking prevalence and tobacco hazard awareness of 3 007 faculty members. Results: The total smoking rate of school personnel in Shanghai was 8.25%; the complete correct rate on the harm of smoking and second-hand smoke was only 19.72% and 23.74%, respectively. The correct awareness rate of harm caused by tobacco, such as stroke, osteoporosis and heart disease, was less than 50%. Gender, education level, smoking behavior and tobacco control training were related with tobacco hazards perception level. Conclusion The smoking rate among middle school personnel in Shanghai has been generally improved, but the faculty and staff have an unbalanced understanding of tobacco hazards. The school's tobacco control education should be targeted. Smoking, men and personnel with relatively low education levels are the key groups in school tobacco control education.

OBJECTIVETo investigate the relationship between the molecular characteristics and phylogenetic evolution of rabies N gene.

METHODSSaliva samples were collected from rabies cases, and RT-PCR was used to amplify the N gene of rabies virus with the specific primers. The amplifying product of RT-PCR was cloned to pUCm-T vector and transformed into E.coli XL1-Blue and then the blue-white selection, PCR screening and gene sequencing were carried out to identify the positive clones. Finally, ExPASy and other bioinformatics software were used to analyze and predict the structure and biological characteristics of the N genome.

RESULTSThe amplification product of RT-PCR was 1 353 bp, the recombinant plasmid pUCm-T/N was constructed, the whole length of the N gene open reading frame was composed of 1 353 nucleotide residues to code 450 amino acids (20 kinds), the accession number submitted to the Genbank was HM756692, its sequence homology of nucleotides and amino acids compared with the vaccine strain CTN-1-V was 90% and 99% respectively. The evolutionary analysis showed that the isolated strain belonged to genotype I with certain geographic regionality.

CONCLUSIONThe characteristics investigation and bioinformatics analysis of Hunan0806 N gene will provide fundamental data to reveal the significance of the N gene characteristics for rabies epidemiology and its prevention & control.

Amino Acid Sequence ; Gene Expression Regulation, Viral ; physiology ; Humans ; Models, Molecular ; Molecular Sequence Data ; Nucleocapsid Proteins ; genetics ; metabolism ; Phylogeny ; Protein Conformation ; Rabies ; virology ; Rabies virus ; genetics ; metabolism ; Saliva ; virology

Objective: To evaluate the application of heparin-binding protein (HBP) in diagnosis of sepsis in adult patients. Methods: An extensive search for the Chinese and English literatures from the PubMed, Embase, the Cochrane Library, Wanfang data, CNKI and VIP up to July 2019 was performed. The articles regarding HBP for the diagnosing of sepsis in adult patients were enrolled. Two researchers independently extracted related literature. The quality of the studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Meta-Disc 1.4 and STATA 12.0 were used for Meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated. Summary receiver operating characteristic (SROC) curves and area under the curve (AUC) were used to evaluate the diagnostic performance of HBP for sepsis. Deek funnel plot was used to detect publication bias. Results: A total of 10 studies with 1 884 patients were included in this Meta-analysis. The quality of the literature was relatively moderate. HBP in plasma were detected by enzyme linked immunosorbent assay (ELISA) in all studies. The studies showed substantial heterogeneity, and random effect model was used for Meta-analysis. The pooled sensitivity, specificity, PLR, NLR, and DOR were 0.80 [95% confidence interval (95%CI) was 0.77-0.83], 0.80 (95%CI was 0.78-0.82), 3.96 (95%CI was 2.45-6.41), 0.28 (95%CI was 0.20-0.39) and 14.63 (95%CI was 6.83-31.30) respectively. The pooled AUC was 0.86 and the Cochran-Q was 0.79. To explore the potential sources of heterogeneity, subgroup analyses were performed based on the severity of the disease, diagnostic criteria and region. However, the results indicated that no methodological covariates affected the diagnostic accuracy of HBP, indicating that there was still unexplained heterogeneity. In addition, the sensitivity analysis by removing individual studies were performed. No outlier study was identified and the results were relatively stable and reliable. Deek funnel plot showed little publication bias. Conclusions There is preferable value of HBP for diagnosis of sepsis in adult patients. However, it needs to be further confirmed by large multicenter studies.