Objective To analyze the changes in the composition of hospitalization of thyroid disease in Lianyungang City from 2002 to 2010,to learn the impact of iodine intake on thyroid disease in Lianyungang City after implementing universal salt iodization (USI),and to get epidemiologic evidence for prevention and control of iodine deficiency disorders scientifically.Methods Medical reports of the patients with thyroid disease were collected from hospitals at county level and above institutions in Lianyungang City from 2002 to 2010.Monitoring results of household iodized salt were also collected from five counties (districts) in Lianyungang City.The changes in the composition of hospitalization of thyroid disease were analyzed,and the relationship between thyroid disease and iodized salt was studied.Results ① A total of 3 559 patients with thyroid disease were enrolled in the study,the ratio between male and female was 1 ∶ 3.36.Mean age was (46.81 ± 14.94) years old and the peak age was from 40 to 60 years old.② Among the hospitalized patients with thyroid disease,the proportion of goiter patients,hyperthyroidism patients,thyroiditis patients,hypothyroidism and other thyroid disorders was 41.64％ (1 482/3 559),40.07％ (1 426/3 559),6.83％ (243/3 559),6.21％ (221/3 559) and 5.25％ (187/3 559),respectively.③In 2002-2010,the hospitalization rate of thyroid disease showed an upward trend (x2 =460.12,P＜ 0.01),and the hospitalization rates of hypothyroidism,goiter,hyperthyroidism,thyroiditis and other thyroid disorders were all increased year by year (x2 =50.54,281.91,85.15,19.51 and 65.01,all P ＜ 0.01).④From 2002 to 2006,among the patients with thyroid disease,the proportion of hyperthyroidism was the highest,and the range of values was from 42.03％ (124/295) to 53.02％ (114/215).Followed by goiter,and the range of values was from 34.55％ (142/411) to 39.25％ (73/186).From 2007 to 2010,the proportion of goiter became the highest,and the range of values was from 42.11％ (232/551) to 49.57％ (291/587).Followed by hyperthyroidism,and the range of values was from 33.05％ (194/587) to 40.47％ (223/551).⑤From 2002 to 2010,the coverage of iodized salt and the consumption rate of qualified iodized salt both increased year by year (x2 =183.75,211.99,all P ＜ 0.01).⑥There were positive correlations between the hospitalization rates of thyroid disease,hypothyroidism,goiter,other thyroid disorders and the coverage of iodized salt,and the consumption rate of qualified iodized salt (rs =0.83,0.93,0.82,0.87,0.83,0.93,0.74 and 0.91,all P ＜ 0.05).⑦There was a positive correlation between the hospitalization rate of hyperthyroidism and the consumption rate of qualified iodized salt (rs =0.72,P ＜ 0.05).Conclusions There are some changes in the composition of hospitalization of thyroid disease in Lianyungang city from 2002 to 2010.Iodine intake may affect the hospitalization rate of thyroid disease.

Objective: To investigate the incidence and trends in incidence of stroke among residents in Lianyungang City, Jiangsu Province from 2014 to 2020, so as to provide insights into stroke control. Methods: The stroke morbidity data in Lianyungang City from 2014 to 2020 were captured from Lianyungang Municipal System for Monitoring of Cardiovascular and Cerebrovascular Diseases, and standardized by the sixth national population census data in China in 2010. The trends in stroke incidence were evaluated using average annual percentage change (AAPC), and the gender-, age-, region- and disease type-specific incidence and trends in incidence of stroke were descriptively analyzed. Results: Totally 162 423 new stroke cases were diagnosed in Lianyungang City from 2014 to 2020 new case, and the annual mean crude and standardized incidence rates were 435.32/105 and 357.28/105, which both appeared a tendency towards a rise (AAPC=12.61%, t=39.098, P<0.001; AAPC=9.91%, t=6.123, P<0.001) . The standardized incidence of stroke was significantly higher in men than in women (389.63/105 vs. 327.17/105; χ2=4.056, P=0.044). The crude incidence of stroke appeared a tendency towards a rise with age among residents (χ2trend=258.219, P<0.001), and appeared a tendency towards a rise among residents at ages of <35 (AAPC=22.52%, t=6.723, P<0.001), 35 to 64 (AAPC=9.78%, t=7.867, P<0.001) and 65 years and older (AAPC=10.24%, t=5.156, P<0.001). The crude incidence was higher in rural areas than in urban areas (437.72/105 vs. 425.31/105; χ2=20.709, P<0.001). Ischemic stroke was the predominant type (139 680 cases, 86.00% of all cases), and both the crude and standardized incidence appeared a tendency towards a rise (AAPC=13.79%, t=16.865, P<0.001; AAPC=10.88%, t=5.128, P<0.001). Conclusion The incidence of stroke appeared a tendency towards a rise among residents living in Lianyungang City from 2014 to 2020. Men, middle-age and elderly residents and rural residents are high-risk populations for stroke control.

Objective: To investigate the effect of losartan on angiotensin II (Ang II) expression and myocardial remodeling in myocardial infarction (MI) rats’ model.
Methods: A total of 32 SD male rats were divided into 4 groups, Sham operation group, MI group, MI with losartan 10mg/(kg·d) group and MI with losartan 20mg/(kg·d). n=8 in each group. MI model was established and the electrocardiogram changes before and after MI were recorded, hemodynamic indexes were detected at 4 weeks after MI, pathological changes of myocardial tissue were examined by HE staining. The myocardial mRNA and protein expressions of ACE2 and Ang II were detected by RT-PCR and Western Blot analysis.
Results: Compared with Sham operation group, MI group showed increased LVMI and decreased LVEF P<0.05;the above changes were getting better in both MI with losartan groups in a dose-dependent manner. The pathological examination presented that MI group had myocardial cell swelling, fracture, hyperplasia and inflammatory cell infiltration, those damages were less in MI with losartan groups in a dose-dependent manner, Sham operation group had no pathological changes. Compared with Sham operation group, the mRNA and protein expressions of Ang II were obviously higher in MI group, P<0.05 and the expressions were decreased in MI with losartan groups in a dose-dependent manner;the mRNA and protein expressions of ACE2 were slightly increased in MI group and the expressions were further increased in MI with losartan groups in a dose-dependent manner.
Conclusion: Losartan could increase ACE2 expression and therefore, inhibit Ang II expression and improve the ventricular remodeling in MI rats’ model.

Objective To study the recombination type of B/C genotype in hepatitis B virus.Methods The PCR was applied to amplifed the whole genes of HBV through the serums of four chronic HBV carriers who come from Jinghong distict,Yunnan province.The whole HBV genomes were ligated with pMD18-T vector and trasformed to E.coli JM109.After the positive colones were picked up,the HBV genotypes and recombinated sites were discoved through sequenced the acquired positive colones.Results All the acquired sixteen HBV sequences from the four HBV carriers were genotype B which were combinated with genotype C in some region.There are two ways of the combinations.For the first one,a 496 bp fragment from genotype C taked place the genotype B at the place of nt1825 to nt2320 of precore C/C region.For the second way,a 695 bp fragment of genotype B taked place at the both sites of nt822 to nt1020 of P gene region and nt1825 to nt2320 of precore C/C region.Conclusion A new recombination type of B/C genotype in hepatitis B virus was reported for the first time.The new Bj subgenotype was combinated with genotype C not only at the region of precore C/C but also at the place of P gene region.

Objective: To investigate the trends in the disease burden of leukemia in Jiangsu Province from 1990 to 2019, so as to provide insights into leukemia control in Jiangsu Province. Methods: The prevalence, incidence, death and disability adjusted life years (DALYs) of leukemia in Jiangsu Province from 1990 to 2019 were retrieved from the 2019 Global Burden of Disease Study (GBD 2019) database, and standardized by the age structure of Chinese populations in 2000. The trends in the disease burden of leukemia in Jiangsu Province from 1990 to 2019 were analyzed using average annual percent change (AAPC). Results : The average annual standardized prevalence, incidence, mortality and DALY rate of leukemia were 63.63/105, 9.76/105, 4.10/105 and 194.83/105 in Jiangsu Province from 1990 to 2019, respectively. The average annual standardized prevalence (AAPC=1.420%, t=5.644, P<0.001) and incidence (AAPC=0.806%, t=3.505, P<0.001) of leukemia appeared a tendency towards a rise, while the average annual standardized mortality (AAPC=-1.589%, t=-14.714, P<0.001) and DALY rate (AAPC=-1.849%, t=-9.046, P<0.001) of leukemia appeared a tendency towards a decline in Jiangsu Province from 1990 to 2019. Higher average annual standardized prevalence (65.27/105 vs. 62.38/105, P<0.001), incidence (10.32/105 vs. 9.29/105, P<0.001), mortality (4.69/105 vs. 3.57/105, P<0.001) and DALY rate of leukemia (216.94/105 vs. 172.80/105, P<0.001) were estimated among men than among women. The crude prevalence of leukemia peaked among patients at ages of 0 to 14 years and 60 to 74 years, and the crude incidence, DALY rate and mortality of leukemia peaked at ages of 0 to 14 years and 75 years and older. Conclusions The mortality and DALY of leukemia appeared a tendency towards a decline and the prevalence and incidence appeared a tendency towards a rise in Jiangsu Province from 1990 to 2019; however, there were high disease burdens of leukemia among men, children and the elderly.

Objective? To explore the roles of continuous care of medical treatment and maintenance combination in transforming the lifestyles in elderly patients with lung cancer. Methods? Totally 182 elderly patients who were discharged from the Department of Integrated Chinese and Western Medicine, Xinxiang Central Hospital and received continuous care in communities from January 2017 to November 2018 were selected and divided into experimental (n=91) and control (n=91) groups according to the random number table. Patients in the control group received conventional continuous care after discharge, while patients in the experimental group received continuous care of medical treatment and maintenance combination. The Exercise of Self-Care Agency (ESCA) and Health Promoting Lifestyle Profile II (HPLP Ⅱ) were employed to compare the self-care agency and lifestyle between the two groups before and after intervention. Results? After intervention, the total ESCA score and scores of its various dimensions in the experimental group were higher than those in the control group;the scores of HPLPⅡ various dimensions in the experimental group were higher than those in the control group, and there were statistically significant differences between the two groups (P＜ 0.05). Conclusions? The continuous care combining medical treatment and endowment can improve the self-care agency and help to transform the lifestyle of elderly patients with lung cancer.

OBJECTIVETo investigate the distribution of apolipoprotein E (apo E) polymorphism in Chinese Dehong Dai and Kunming Han ethnic groups.

METHODSAfter the process of extracting genomic DNA from 171 Chinese Dehong Dai and 71 Chinese Kunming Han subjects, the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to amplify the fourth exon of apoE, which contains site 112 and 158 in amino acid sequence, and the apoE polymorphism was detected.

RESULTSThe genotyping frequencies of apolipoproteinE epsilon 2/2, epsilon 2/3, epsilon 2/4, epsilon3/3, epsilon3/4, epsilon4/4 in Dehong Dai were 0.006, 0.111, 0.006, 0.789, 0.088 and 0.000 respectively, while the genotyping frequencies of apoE epsilon2/2, epsilon2/3, epsilon2/4, epsilon3/3, epsilon3/4, epsilon4/4 in Kunming Han were 0.000, 0.169, 0.014, 0.718, 0.099, 0.000, respectively (P>0.05). The allelic frequencies of apoE epsilon2, epsilon3 and4 in Dehong Dai were 0.064, 0.889, 0.047 respectively, while the allelic frequencies of apoE epsilon2, epsilon3 and epsilon4 in Kunming Han were 0.092, 0.852, 0.056, respectively (P>0.05).

CONCLUSIONThe results revealed that either the frequency of genotype or that of allele of apoE gene polymorphism showed statistical difference between the ethnic populations. Compared with the data from other nationalities in China, the frequency of epsilon2 allele in Dehong Dai was significantly lower than that in Zhuang nationality (P<0.01); the frequency of epsilon3 allele in Dehong Dai was significantly higher than that in Chaoxian, Hui, Mongolian,Zhuang nationalities (P<0.05) and Uygur nationality (P<0.01); the frequency of epsilon4 allele in Dehong Dai was significantly lower than that in Olunchun nationality (P<0.05) and Uygur, Owenk nationalities (P<0.01). By comparison with the data from the populations of other races, the distribution of apoE gene polymorphism in Dehong Dai population is similar to that in Japanese population (P>0.05), but different from those in Singapore,European and American populations.

Adult ; Aged ; Aged, 80 and over ; Apolipoproteins E ; genetics ; China ; Ethnic Groups ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Polymerase Chain Reaction ; Polymorphism, Genetic ; genetics

Objective: To investigate the prevalence and related factors of obesity and central obesity among 35-75 year-old population in Jiangsu Province. Methods: During 2015-2017,83 530 eligible subjects aged 35-75 years from six study sites of Jiangsu Province were interviewed and examined. The data of demography,lifestyles,disease history,height,weight and waistline were collected. Logistic regression analysis was conducted for the influencing factors for obesity and central obesity. Results: A total of 83 393 residents completed the study,with a response rate of 99.84%. The prevalence of overweight,obesity and central obesity was 43.35%（standardized rate：35.90%）,20.02%（19.48%）and 59.93%（57.03%）. The results of multivariate logistic regression analysis showed that females（OR=0.822,95%CI：0.786-0.859;OR=0.900,95%CI：0.851-0.952;OR=1.130,95%CI：1.083-1.179）,45-75 years old（OR：1.120-1.731,95%CI：1.102-1.881）,graduating from high school or above（OR：0.767-0.902,95%CI：0.721-0.943）,living in urban areas（OR：1.530-2.077,95%CI：1.284-3.007）,smoking（OR：0.724-0.855,95%CI：0.678-0.898）,drinking （OR：1.125-1.179,95%CI：1.076-1.235）,hypertension（OR：1.884-3.461,95%CI：1.821-3.613）,diabetes（OR：1.363-1.758,95%CI：1.305-1.851）, dyslipidemia（OR：1.478-1.870,95%CI：1.429-1.851）were associated with overweight,obesity and central obesity. Conclusion The standardized prevalence rates of overweight,obesity and central obesity among 35-75 year-old population in Jiangsu Province are 35.90%,19.48% and 57.03%,respectively. Gender,age,education,residence,smoking,drinking,hypertension,diabetes and dyslipidemia are related factors.

OBJECTIVE: To explore the different effect of short 7-day gonadotropin releasing hormone agonist (GnRHa) protocol and GnRHa long protocol on the insulin-like growth factor II(IGF-II) and insulin-like growth factor binding protein-4 (IGFBP-4) levels in follicular fluid. METHODS: Eighty-eight infertile patients due to tubal factors were included in this study. They were randomly divided into a short 7-day GnRHa protocol group and a GnRHa long protocol group (n = 44). Follicular fluid was obtained from dominant follicles during oocyte retrieval. Levels of IGF-II and IGFBP-4 in the follicular fluid were detected by radioimmunoassay and enzyme-linked immunosorbent assay respectively. RESULTS: Duration of controlled ovarian stimulation was significantly shorter and the injected dosages of gonadotropin were significantly lower in the short 7-day protocol group. The differences in serum levels of estradiol and estradiol per mature follicle on the day of human chorionic gonadotropin injection between the two groups were not significant. The concentrations of IGF-II and IGFBP-4 in the follicular fluid of the short 7-day protocol group were significantly lower,while the difference of the ratio of IGF-II/IGFBP-4 between the two groups was not significant. Linear correlation analysis showed that IGF-II level in the follicular fluid was positively correlated to the total dose of gonadotropin. CONCLUSION The short 7-day and long GnRHa protocols may affect the concentrations of IGF-II and IGFBP-4 in the follicular fluid. However, changes of IGF-II and IGFBP-4 concentrations do not contribute to different clinical outcomes.
Embryo Transfer ; Female ; Fertilization in Vitro ; methods ; Follicular Fluid ; chemistry ; Gonadotropin-Releasing Hormone ; administration & dosage ; agonists ; Humans ; Insulin-Like Growth Factor Binding Protein 4 ; analysis ; Insulin-Like Growth Factor II ; analysis ; Ovulation Induction ; methods

Objective:To investigate the differences in programmed death-ligand 1 (PD-L1) expression and immune cell infiltration characteristics in different molecular subtypes of endometrial cancer.Methods:A retrospective case series study was conducted. Ninety primary treated EC patients who underwent surgery without preoperative neoadjuvant therapy at the Second Hospital of Tianjin Medical University from November 2016 to May 2022 were collected. The surgical paraffin-embedded tissues were selected, and the molecular subtypes of endometrial cancer were classified according to 2020 World Health Organization (WHO) molecular subtypes using POLE gene Sanger sequencing and immunohistochemical staining. The expression of PD-L1, CD3, CD4, CD8, CD68, and CD20 proteins were detected by immunohistochemistry. Stained slides were digitally scanned for quantitative analysis of PD-L1 and immune cell infiltration density. The PD-L1-related scores were evaluated, including tumor cell score (TCS, the percentage of PD-L1 positive tumor cells among total tumor cells ≥1% was TCS positive, <1% was TCS negative), immune cell score (ICS, the percentage of PD-L1 positive tumor-associated lymphocytes and macrophages among total tumor-associated lymphocytes and macrophages ≥1% was ICS positive, <1% was ICS negative) and combined positive score [CPS, PD-L1 positive stained cells (including tumor cells, lymphocytes and macrophages)/total number of viable tumor cells ×100 ≥ 1 was CPS positive, < 1 was CPS negative]. Clinicopathological characteristics, PD-L1 scores and immune cell infiltration densities among different molecular subtypes were analyzed. Kaplan-Meier method was used to plot disease-free survival (DFS) curves for molecular subtypes, PD-L1 scores and immune cell infiltration densities, with subgroup comparisons using log-rank test. Cox proportional hazards models were used for univariate and multivariate analyses of poor DFS in endometrial cancer patients.Results:The median age of 90 patients was 58 years old (range: 33-72 years old); endometrioid carcinoma was present in 78 cases (86.7%), and non-endometrioid carcinoma was present in 12 cases (13.3%). Molecular subtyping identified POLE-mutated subtype in 6 cases (6.7%), mismatch repair deficient (MMRd) subtype in 23 cases (25.6%), p53 abnormal subtype in 14 cases (15.6%), and non-specific molecular profile (NSMP) subtype in 47 cases (52.2%). Significant differences were observed among the 4 molecular subtypes in International Federation of Gynecology and Obstetrics (FIGO) stage, histological grade, morphological subtype, tertiary lymphoid structures, estrogen receptor expression, and progesterone receptor expression (all P < 0.05). Among the 90 cases, 18 cases (20.0%) were positive for TCS, 31 cases (34.4%) were positive for ICS, and 39 cases (43.3%) were positive for CPS. Significant differences were found among the 4 molecular subtypes in PD-L1 + cell density, distribution of patients with ICS positivity, and distribution of patients with CPS positivity (all P < 0.01), but not in distribution of patients with TCS positivity ( P = 0.090); compared to NSMP subtype, the proportions of ICS-positive patients in POLE-mutated and MMRd subtypes were higher, the proportion of CPS-positive patients and PD-L1 + cell density in MMRd and p53 abnormal subtypes were higher, and the differences were statistically significant (all P < 0.05). Significant differences in immune cell densities were observed among the 4 molecular subtypes (all P < 0.01); compared to NSMP subtype, POLE-mutated, MMRd and p53 abnormal subtypes had higher densities of CD3 + and CD8 + cells, MMRd subtype had higher CD4 + cell density, and POLE-mutated and MMRd subtypes had higher CD68 + and CD20 + cell densities (all P < 0.05). The median follow-up was 43 months (range: 7-75 months). Among the molecular subtypes, p53 abnormal patients had the worst DFS, and POLE-mutated patients had the best DFS, and the difference in DFS among the 4 subtypes was statistically significant ( P = 0.046). Grouping according to the median density of immune cells in the entire group, patients with high CD8 + cell density (45 cases) had better DFS than those with low density (45 cases) ( P = 0.010), PD-L1 ICS-positive patients had worse DFS than negative patients ( P = 0.019), and NSMP subtype patients with high CD4 + cell density (24 cases) had better DFS than those with low density (23 cases) ( P < 0.001). There was no statistically significant difference in DFS among patients grouping with other PD-L1 scoring modes and other immune cell infiltration density (all P > 0.05). Cox regression analysis indicated that high CD8 + cell density ( HR = 0.335, 95% CI: 0.113-0.990, P = 0.048) was an independent protective factor for poor DFS in endometrial cancer patients, and high CD4 + cell density was an independent protective factor for poor DFS in NSMP subtype patients ( HR = 0.035, 95% CI: 0.003-0.345, P = 0.004). Conclusions:There are significant differences in PD-L1 expression and immune cell infiltration density among the different molecular subtypes of endometrial cancer, which are correlated with the prognosis of patients, and may provide reference for the selection of immunotherapy strategies and prognosis judgment.