Objective To observe the impact of rosuvastatin on serum Ang-2 and hs-CRP in patients with metabolic syndrome(MS) to collect data on safety of rosuvastatin in treating MS.Methods Eighty MS patients were enrolled and divided into the treatment group(n =40) and the control group(n =40).The treatment group received both antihypertensive therapy and rosuvastatin with a dose of 10 mg/d.While the control group were only given antihypertensive therapy and but not any lipid-lowering drugs.The levels of plasma Ang-2 and hs-CRP and liver and kidney functions were measured and compared before and after 8-week treatment.Results (1) The levels of plasma Ang-2 and hs-CRP were significantly lower after 8 weeks than before treatment in the treatment groups[Ang-2:(0.30±0.01) μg/L vs.(1.81±0.47) μg/L,t =9.02,P ＜0.01 ;hs-CRP:(2.02±0.26) mg/L vs.(6.32±1.28) mg/L,t =5.75,P ＜ 0.01].Whereas statistical difference was not found in the control group[Ang-2:(1.80±0.45) μg/L vs.(1.79±0.48) μg/L,t =0.19,P > 0.05 ; hs-CRP:(6.28±1.34) mg/L vs.(6.20±1.42) mg/L,t =0.23,P ＞ 0.05].(2) After 8 weeks'treatment,the levels of plasma Ang-2 and hs-CRP were significantly lower in the treatment group than in the control group[Ang-2:(0.30±0.01) μg/L vs.(1.79±0.48) μμg/L,t =2.34,P ＜ 0.05 ;(2.02±0.26) mg/Lvs.(6.20±1.42) mg/L,t =2.58,P ＜ 0.05].(3) The adverse reaction in the treatment group was fewer than the control group and the security of rosuvastatin treatment on MS was fine.Conclusion Rosuvastatin can reduce plasma Ang-2 and hs-CRP levels and improve insulin resistance in patients with MS.Its security is fine.

Objective To investigate the efficacy of rosuvastatin on treating patients with metabolic syndrome(MS).Methods Eighty MS patients were divided into rosuvastatin group (n =40) and atorvastatin group(n =40).Patients in rosuvastatin group were received schufftan at dose of 10 mg/d and in atorvastatin group were received lipitor at dose of 10 mg/d orally.Patients were followed-up for 12 weeks.The ratio of apolipoprotein B/apolipoprotein A1 (ApoB/ApoA1) and inflammatory factors including high-sensitivity Czreactive protein (hs-CRP),tumor necrosis factor-oα (TNF-α),interleukin-6 (IL-6),and interleukin-18 (IL-18) were measured.Meanwhile Secondary factors:blood lipids,blood glucose,fasting insulin (FIN),insulin resistance index (HOMA-IR),blood pressure,urine albumin excretion rate (UAER),body mass index (BMI).As well as safety indicators:hepatic and renal function and creatine kinase (CK) were detected.Results (1) After 12-week's treatment,the serum levels of ApoB/ApoA1,hs-CRP,TNF-α,IL-6,IL-18,ApoB,total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),triglyceride (TG),FIN,HOMA-IR,systolic blood pressure (SBP),diastolic blood pressure (DBP),and UAER significantly decreased compared to before treatment in the two groups(rosuvastatin group:1.26 ± 0.25 vs.0.63 ± 0.22,t =4.44 ; (6.89 ± 1.43) mg/L vs.(2.41 ± 0.36) mg/L,t =7.12;(27.63 ±7.12) ng/L vs.(12.98 ±3.74) ng/L,t =4.23;(26.47 ±6.59) ng/L vs.(13.16± 3.55) ng/L,t =4.45;(318.36 ±90.45) ng/L vs.(172.77 ±50.65) ng/L,t =3.92;(1.58 ±0.29) g/L vs.(0.83 ± 0.23) g/L,t =4.20; (5.78 ± 0.86) mmol/L vs.(3.53 ± 0.69) mmol/L,t =3.85 ; (3.52 ± 0.54) mmol/L vs.(2.04±0.49) mmol/L,t =3.89;(2.87 ±0.65) mmol/L vs.(1.91 ±0.57) mmol/L,t =3.78; (12.08 ± 2.87) mU/L vs.(6.87 ± 1.89) mU/L,t =3.98 ; 3.42 ± 0.57 vs.1.60 ± 0.31,t =4.65 ; (144.6 ± 13.3) mm Hg vs.(135.1 ±12.7) mm Hg,t =3.57;(93.6 ±9.5) mm Hg vs.(85.2 ±7.6) mm Hg,t =3.59; (29.86 ± 3.37) μg/min vs.(22.52 ± 2.56) μg/min,t =3.71 ; atorvastatin group:1.24 ± 0.23 vs.0.92 ± 0.24,t =3.74 ; (6.84 ± 1.37) mg/L vs.(3.50 ± 0.75) mg/L,t =4.24 ; (27.22 ± 7.36) ng/L vs.(18.70 ± 5.82) ng/L,t =3.76; (26.28 ±6.84) ng/L vs.(19.34 ± 5.96) ng/L,t =3.75 ; (311.22 ±91.98) ng/L vs.(246.50±74.73) ng/L,t=3.63;(1.56±0.27) g/L vs.(1.14±0.26) g/L,t =3.74;(5.65 ±0.76) mmol/L vs.(4.67±0.65) mmol/L,t =3.68;(3.51 ±0.55) mmol/L vs.(2.65 ±0.57) mmol/L,t =3.70; (2.86±0.68) mmol/Lvs.(2.05 ±0.54) mmol/L,t=3.78;(12.04±2.95) mU/L vs.(8.91 ±2.32) mU/L,t =3.74;3.38 ±0.54 vs.2.18 ±0.35,t =3.80;(144.0 ± 13.8) mm Hg vs.(135.7 ±12.5) mm Hg,t =3.56 ; (93.4 ± 9.3) mm Hg vs.(85.8 ± 8.9) mm Hg,t =3.58 ; (29.77 ± 3.28) μg/min vs.(23.02 ± 2.83) μg/min,t =3.67 ;P ＜ 0.01).ApoA1 and high-density lipoprotein cholesterol (HDL-C) had increase,but there was no significant difference(P ＞ 0.05).Fasting plasma glucose(FPG),2 h postprandial blood glucose (2 hPG) and BMI tended to decrease,but there were no significant differences(P ＞ 0.05).(2)The serum levels of ApoB/ApoA1,hs-CRP,TNF-α,IL-6,IL-18,ApoB,TC,LDL-C,FIN and HOMA-IR in the rosuvastatin group were significantly lower than those in the atorvastatin group at the 12th-week follow-up(t =2.11,2.10,2.09,2.12,2.08,2.07,2.05,2.04,2.04,2.06 respectively; P ＜ 0.05).The serum levels of HDL-C and ApoA1 in the rosuvastatin group tended to increase compared with the atorvastatin group after 12-week treatment (P ＞ 0.05).There were no statistically significant differences in term of TG,SBP,DBP,UAER between the two groups (P ＞ 0.05).(3) The adverse effect in the rosuvastatin group was fewer than that in atorvastatin group.Conclusion Rosuvastatin can reduce ApoB/ApoA1 ratio and the levels of inflammatory cytokines,improve insulin resistance in patients with MS and less adverse effect were seen.

BACKGROUND:In perioperative period of total knee replacement in elderly patients, it is crucial to maintain the normal function of blood coagulation. However, many factors may influence coagulation function of patients in perioperative period. Of them, anesthesia is an important factor. Different anesthesia methods wil produce different effects on blood coagulation. Appropriate anesthesia methods should be selected in the clinic to maintain the stability of coagulation function. OBJECTIVE:To explore the effect of application of general anesthesia and epidural anesthesia in elderly knee replacement and the effects on the function of blood coagulation. METHODS:A retrospective analysis was performed on clinical data of 135 elderly patients after total knee replacement in Dongying Hospital of Shandong Provincial Hospital Group from September 2012 to September 2013. Al patients were divided into control group (67 cases;general anesthesia) and observation group (68 cases;epidural anesthesia) according to the mode of anesthesia. Coagulation indexes and D-dimer levels were observed before anesthesia, 6 hours after anesthesia, and 1 day after replacement in both groups. The incidence of deep venous thrombosis was measured and compared between the two groups in 12-month fol ow-up.
RESULTS AND CONCLUSION:Through the statistics and comparison, no significant difference was detected in blood coagulation indexes at different time points in the two groups (al P>0.05). However, significant differences in D-dimer levels were detectable between the two groups at 6 hours after anesthesia and in the morning at 1 day after replacement. D-dimer levels were significantly lower in the observation group than in the control group (al P<0.05). The incidences of deep venous thrombosis were 3%and 21%in the observation and control groups, respectively, showing significant differences (P<0.05). These results suggest that epidural anesthesia during elderly totak knee replacement obtained good effects, and could maintain stable coagulation function.

MS96A type spectrum analyzer was applied to determine the spectral characteristic of near infrared radiated by moxa stick moxi-bustion, ginger-partitioned moxibustion, garlic-partitioned moxibustion and Aconium Carmichaeli-par titioned moxibustion. The spectrum of moxa stick moxibustion was relatively discrete and several wave crests are appeared. But in the spectrum of ginger-partitioned moxibustion, garlic-partitioned moxibustion or Aconium Carmichaeli-partitioned moxibustion, a specific and relatively steady wave crest formed respectively. It was concluded different indirect moxibustion could bring respective spectrum of near infrared and have the relevant physiologic and biochemical effects.

Objective To assess the clinical efficacy and safety of uniport video-assisted thoracoscopic surgery in treatment of pulmonary bulla.Methods Clinical data of 38 patients with pulmonary bulla treated with uniport video-assisted thoracoscopic surgery were analyzed.Results 30 patients under general anesthesia and double-chamber tracheal intubation anesthesia and 8 patients under general anesthesia and single-chamber tracheal intubation and tracheal plugger anesthesia underwent the resection of their pulmonary bulla through the surgery with uniport video-assisted thoracoscope, and 2 patients therein were simultaneously treated with bilateral resection of pulmonary bulla.36 patients were treated successfully;1 patient was given another exploratory thoracotomy after his unilateral surgery because of progressive hemothorax and substantial pneumothorax;and 1 patient underwent respiratory failure after his unilateral surgery and was improved in respiration 2 days after the help of a respirator.The average time of operations were 52 minutes.It averagely took 3.2 days to remove closed thoracic drainage pipes.The post-operation hospital stays took 6 days.The post-operation follow-up took 7-39 months,without relapse and other compli-cations.No death occurred in this group.Conclusion It is safe and reliable to treat pulmonary bulla by the surgery with uniport video-assisted thoracoscope,which is in line with the concept of minimally invasive surgery and therefore deserves promotion.

BACKGROUNDIntravitreal anti-vascular endothelial growth factor (anti-VEGF) drugs and corticosteroids are being widely used to treat diabetic macular edema (DME). The purpose of this study was to evaluate further the efficacy and safety of intravitreal bevacizumab (IVB) alone in comparison with intravitreal bevacizumab combined with triamcinolone acetonide (IVB/IVT) in the treatment of DME.

METHODSPertinent publications were identified through CNKI, PubMed, Medline, EMBASE, and the Cochrane Controlled Trials Register up to November 30, 2013. Two investigators independently assessed the quality of the trials, and changes in central macular thickness (CMT) and best-corrected visual acuity (BCVA) were extracted at 6 weeks and 3, 6, 12, and 24 months after the initial treatment. A meta-analysis was carried out to compare the results between the groups receiving IVB and IVB/IVT using the software RevMan 5.0.

RESULTSA total of six randomized controlled trials (RCTs) were identified and included. The meta-analysis revealed that a significant reduction of the CMT was observed at 3 months after the initial treatment in the IVB/IVT group compared to the IVB group (P = 0.001). Also, changes in CMT at 6 weeks and 6, 12, and 24 months did not vary significantly between the IVB and IVB/IVT groups (P = 0.53, 0.76, 0.34, and 0.09, respectively). Similarly, changes in BCVA at 6 weeks and 3, 6, 12, and 24 months also did not vary significantly between the two groups (P = 0.66, 0.98, 0.81, 0.07, and 0.80, respectively). The results were robust to sensitivity analyses. However, the rate of intraocular pressure (IOP) rise after intravitreal injections varied significantly between the IVB and IVB/IVT groups (P < 0.01). A publication bias was not detected by funnel plots, the Egger method, or the Begg method.

CONCLUSIONS RESULTSof this meta-analysis showed that the treatments with IVB alone and combined IVB/IVT were similarly effective in improving the visual acuity, and, to some degree; combined IVB/IVT appeared to offer a marginal advantage over IVB in decreasing CMT in patients with DME. However, the addition of IVT resulted in intraocular pressure rise in some treated patients.

Antibodies, Monoclonal, Humanized ; administration & dosage ; therapeutic use ; Bevacizumab ; Diabetic Retinopathy ; drug therapy ; Humans ; Intravitreal Injections ; Macular Edema ; drug therapy ; Randomized Controlled Trials as Topic ; Triamcinolone Acetonide ; administration & dosage ; therapeutic use

ObjectiveTo understand the current drug resistance status and bacterial multilocus sequence typing （MLST） of human and avian Campylobacter jejuni in Jinshan District， Shanghai. MethodsFecal samples were collected from diarrhea patients in the annuity mountainous area from 2021 to 2022， and poultry and related samples were collected from 2 poultry farms in the Jinshan area for detection of C. jejuni. Minimal inhibitory concentration （MIC） drug sensitivity test was performed on the detected C. jejuni， and some strains were selected for whole genome sequencing and MLST analysis. ResultsA total of 823 samples of diarrhea disease were collected， and 32 strains of C. jejuni were detected， with a detection rate of 3.89%. Out of 600 poultry related samples， 62 strains of C. jejuni were detected， with a detection rate of 10.33%. Human multidrug resistance reached 93.75% （30/32）， while avian multidrug resistance reached 100.00%（62/62）. The top four drug resistance rates of human and avian C. jejuni were azithromycin （100.00% from humans and 100.00% from birds）， naphthoic acid （93.75% from humans and 87.10% from birds）， ciprofloxacin （90.63% from humans and 98.39% from birds）， and tetracycline （84.38% from humans and 98.39% from birds）. The relatively low resistance strains of human derived C. were erythromycin， chloramphenicol， and thalithromycin. The relatively low resistance strains of avian C. jejuni were erythromycin， clindamycin， and flufenicol. MLST analysis showed that the selected 16 strains of bacteria were divided into 9 ST types， among which the evolutionary relationship of avian C. jejuni was relatively concentrated， while human C. jejuni was relatively dispersed. It was found that one strain of avian C. jejuni was closely related to two strains of human C. jejuni. ConclusionsC. jejuni infection is severe in patients with diarrhea in this region， with a detection rate second only to salmonella and Vibrio parahaemolyticus. C. jejuni infection in poultry is relatively common， and both are highly resistant. Therefore， monitoring and control should be strengthened. MLST analysis shows new ST types in both avian and human sources of C. jejuni， indicating the emergence of new mutations that require continuous monitoring to avoid the epidemics caused by new strains. The isolated strains with close genetic relationships between avian and human sources reveal the evidence of the spread of C. jejuni from poultry to humans. Therefore it is necessary to strengthen the monitoring of C. jejuni in relevant samples from breeding farms.

Objective: To improve physical activity by assessing pedometer-based physical activity during specific intervals over a week, among junior high school students,and to provide a reference for improving the level of students’ physical activity. Methods: Students (n=675) of grades 6-8 from six public junior high schools in Shanghai were recruited and instructed to wear a pedometer for a week, step counts and contents were recorded over a specific period. This period mainly included steps taken on the way to and from school, at school, at home in the evening on weekdays, and in the morning, afternoon, and evening on weekends. Results: The daily step counts recorded were 8 332 steps, with those on weekdays showing significantly higher values than step counts on weekends (9 065 steps vs. 6 392 steps)(t=22.9, P<0.01). Proportionately, the physical activity level at school contributed more to daily step counts (61.3%), followed by those on the commute to and from school(25.5%). Boys were more active than girls. For all intervals on weekdays, the step counts of students in rural districts, with overweight or obese, in grades 6 and 7, were higher than those in urban districts, with normal status, in grade 8 respectively (P<0.05). Low-activity students with physical education were more active than one without physical education(t boy=1.99,t girl=2.45,P<0.05). Conclusion These findings facilitate the implementation of effective, feasible interventions to enhance physical activity over a series of intervals during the day.

ObjectiveTo determine the drug sensitivity and molecular typing characteristics of Klebsiella pneumoniae isolated from meat and diarrhea samples in a local area. MethodsSeventy-one strains of K.pneumoniae were isolated from 118 meat food （chicken and pork） randomly sampled in the markets in Jinshan District， Shanghai， 2020‒2021， and 1 499 diarrhea samples from outpatient diarrhoea patients in hospitals in the same district. Then drug susceptibility testing was conducted by micro-broth dilution method， and sequence identity was determined by pulsed field gel electrophoresis（PFGE）. ResultsThe overall detection rate of K.pneumoniae in meat was 11.86% （14/118）， with detection rate 20.93% （9/43） in chicken and 6.67% （5/75） in pork. The difference in detection between meats was statistically significant （χ²=5.317，P<0.05）. The detection rate of K.pneumoniae in diarrhea samples was 3.80% （57/1 499）. Furthermore， the isolated strains showed the highest resistance to ampicillin at 76.06%. The multi-drug resistant strains included 5 of human origin （8.77%） and 2 of foodborne origin （14.28%）. Additionally， 1 foodborne imipenem-resistant strain was detected. A total of 71 strains of K.pneumoniae were found to have 70 banding types， with similarity ranging from 39.4% to 100%， suggesting genetic diversity. ConclusionK.pneumoniae isolated from foodborne and diarrhea samples showed multi-drug resistance in Jinshan District， . with scattered PFGE banding patterns. It is recommended to strengthen the monitoring of this pathogen in the population and animal food， and be alert to the emerging multi-drug resistant strains and risk of food chain transmission.

Objective: To explore the determinants of physical activity during leisure time among junior high school students in Jinshan District of Shanghai based on socio-ecological model, so as to provide basis for health promotion in adolescents. Methods: Six public junior high schools were randomly selected from Jinshan District and then a class was selected from every grade. The physical activity of the students in the spare time of one week was monitored. The determinants of physical activity were investigated through a self-designed questionnaire based on socio-ecological model,and were analyzed by optimal scaling regression. Results: A total of 645 questionnaires were sent out, 622（96.43%）of which were valid. The median time spent on active physical activity after school on weekdays and at weekends was 29.00 min and 45.00 min, respectively. The scores of individual, interpersonal and environmental factors were 10.53 ± 2.04, 5.10 ± 1.51 and 8.31 ± 1.85,respectively. The results of the optimal scaling regression analysis showed that residence（β=-0.117, -0.159）,individual factors（β=0.244,0.277）, interpersonal factors（β=0.113, 0.085）and environmental factors（β=-0.140, -0.120) were the influencing factors for the physical activity in extracurricular time on weekdays and at weekends. On weekdays, the influence of individual factors was the largest （62.2%）,followed by interpersonal factors（20.8%）and residence（16.8%）. At weekends, the influence of individual factors was the largest（65.4%）, followed by residence（23.6%）and interpersonal factors（10.5%）. Conclusions The physical activity level during leisure time among junior high school students in Jinshan District is most affected by individual factors, followed by interpersonal factors and residence. The time spent on physical activity at weekends is insufficient, and the influence of residence is behind individual factors.