The paper introduces the system design of internet platform in novelty assessment and selective dissemination of informa-tion of medical science and technology project in Zhejiang province, including the exploitation of environment , processing of novelty as-sessment and selective dissemination of information as well as main function design. This system has noticeable advantages, such as com-prehensive functions, multiple participation, transparent service process, which could finish the relevant work on the internet, improve the quality of information service and enhance the efficiency.

Objective To investigate the clinical curative effect of ipratropium bromide in combination with ambroxol hydrochloride (mucosolvan) on ventilator-associated pneumonia (VAP) in elderly patients.Methods From Jan 2013 to Nov 2014,a total of 46 elderly patients with VAP in our hospital were treated with ipratropium bromide 0.5 mg diluted in 5 ml saline by inhalation with ventilator,and mucosolvan 30 mg by intravenous injection,3 times/d (treatment group,n=23),and treated with ipratropium bromide 0.5 mg diluted in 5 ml saline by inhalation with ventilator,3 times/d (control group,n=23).Total clinical effective rate,ventilating time,number of sputum suction by fibre bronchoscope and white cell count were compared between the two groups.Results The total clinical effective rate was higher in treatment group than in the control group [91 ％ (21/23) vs.74％(17/23),x2=11.310,P=0.002].The indicators of ventilating time,number of sputum suction by fibre bronchoscope and white cell count were improved in treatment group as compared with control group [(8.2±1.5) d vs.(13.7±3.1) d,(3.5±0.3) vs.(6.7±1.2),(9.5±2.3) × 109/L vs.(14.2±2.7) × 109/L,t=17.510,2.750,3.810,respectively,P=0.000,0.001,0.001].Conclusions Compared with single-drug treatment,ipratropium bromide in combination with ambroxol hydrochloride (mucosolvan) could improve airway humidification,promote cilium to clean secreta,shorten the ventilating time and increase the curative rate of YAP in elderly patients.

Objective:To establish a new approach to synthesis of diethyl N-[4-[(2,4-diaminopyrido [3,2-d]pyrimidin-6-yl)methylamino]benzoyl]-L-glutamate.Methods:Target compound (5) was syn-thesized by the use of (2,4-dioxo-tetrahydropyridopyrimidin-6-yl) methyl acetate (1) as starting material via hydrolysis, chlorination, condensation with diethyl (p-aminobenzoyl)glutamate and aminolysis.Re-sults:A new approach to synthesis of diethyl N-[4-[(2,4-diaminopyrido[3,2-d]pyrimidin-6-yl)methyl-amino]benzoyl]-L-glutamatewas established .This synthetic route has hydrolysis reaction , chlorination, diethyl N-( p-aminobenzoyl )-L-glutamate condensation reaction and ammonolysis reaction .The total yield is 36.7%.The structures of those compounds have identified by 1 H nuclear magnetic resonance , 13 C nu-clear magnetic resonance and mass spectrometry .This synthetic route avoid the unstable brominated re-action product and improves the harsh condition of ammonolysis reaction .Conclusion:The new synthetic route has improved the reaction condition and the stability of the intermediate , and increased the extent of the derivative compounds , which has great significance to anti-folic acid of anti-tumor inhibitor synthesis .

Objective To investigate the mechanism of bone morphogenetic protein 4(BMP4) in the genesis of Barrett′s esophagus.Methods Human esophageal epithelial cell (HEEC) and MRC-5 were cultured.The effects of different concentration of BMP4 and different pH value of hydrochloric acid or glycocholic acid on the expression of caudal-related homeobox transcription factor 2(CDX2) in HEEC were detected by real time polymerase chain reaction.The effects of different pH value of hydrochloric acid or glycocholic acid on BMP4 expression in MRC-5 were also investigated.Independent sample t test was performed for statistical analysis.Results After HEEC stimulated by BMP4 at 0.1, 1.0, 10.0 and 100.0 ng/mL, the relative quantity expressions of CDX2 were 1.617±0.246, 2.489±0.455, 5.629±0.449 and 13.670±1.689, respectively, which were higher than those of control group (1.000±0.043, 1.029±0.094, 1.001±0.002 and 1.049±0.051, respectively), and the differences were statistically significant (t=2.47, 3.14, 10.31, 7.47;all P<0.05).After MRC-5 stimulated by acid at pH four or five, or glycocholic acid at pH four or five, the relative quantity expressions of BMP4 were 2.430±0.105, 2.394±0.145, 125.900±12.620 and 2.128±0.215, respectively, which were higher than those of control group(1.025±0.095, 0.999±0.007, 1.060±0.138 and 0.893±0.110,respectively), and the differences were statistically significant (t=9.94, 9.59, 9.89, 5.11;all P<0.01).Conclusion BMP4 can increase the expression of CDX2 in HEEC, which promote the genesis of Barrett′s esophagus.

Globally, the incidence of early-onset colorectal cancer (EOCRC) among individuals younger than 50 is escalating. Compared to late-onset colorectal cancer, EOCRC exhibits distinct clinical, pathological, and molecular features, with a higher prevalence in the left colon and rectum. However, the occurrence and development of EOCRC is a multi-factor and multi-stage evolution process, which is the result of the mutual effect of environmental, genetic and biological factors, and involves the multi-level regulation mechanism of other organisms. With the development and improvement of high-throughput sequencing technology, the application of multi-omics analysis has become an important development direction to resolve the pathogenesis of complex diseases and individualized treatment plans. This article aims to review the research progress of EOCRC at the multi-omics level, providing a theoretical foundation for earlier diagnosis and more precise treatment of this diseases.

Globally, the incidence of early-onset colorectal cancer (EOCRC) among individuals younger than 50 is escalating. Compared to late-onset colorectal cancer, EOCRC exhibits distinct clinical, pathological, and molecular features, with a higher prevalence in the left colon and rectum. However, the occurrence and development of EOCRC is a multi-factor and multi-stage evolution process, which is the result of the mutual effect of environmental, genetic and biological factors, and involves the multi-level regulation mechanism of other organisms. With the development and improvement of high-throughput sequencing technology, the application of multi-omics analysis has become an important development direction to resolve the pathogenesis of complex diseases and individualized treatment plans. This article aims to review the research progress of EOCRC at the multi-omics level, providing a theoretical foundation for earlier diagnosis and more precise treatment of this diseases.

Objective To explore the hospital ship crew's awareness of infectious diseases-related knowledge, and to propose training plans accordingly.Methods Totally 75 non-medical crew members working on the hospital ship between November and December 2013 were selected as respondents by convenience sampling, and were investigated with self-designed questionnaires.Results A total of 54 out of 75 crew members (72.0%) worked for medical support on the hospital ship for less than 2 years. Only 3 of them (4.0%) had systematically learned knowledge related to infectious diseases. 88.0% of the crew members needed training to learn relevant knowledge. The average rate of unawareness of basic theoretical knowledge about infectious diseases was 63.2%, that of prevention and protection knowledge was 90.0%, that of sterilizing and isolating techniques was 60.7%, that of professional exposure-related knowledge was 71.6%, and that of professional safety prevention and protection skills was 50.3%.Conclusions The training of knowledge and skills related to infectious diseases for the hospital ship crew is of significance, which will not only secure the subjects of rescue, but also protect themselves against infectious diseases and make sure that their mission of offshore medical support can be completed successfully.

Objective:To investigate the diagnostic value of the post-vascular phase of contrast-enhanced ultrasound in the differentiation of hepatocellular carcinoma (HCC).Methods:The contrast-enhanced ultrasound data of 115 patients who were admitted to Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology for liver space-occupying lesions from September 2020 to September 2021 were retrospectively analyzed. All patients underwent contrast-enhanced ultrasound with perfluorobutane microspheres for injection within 1 week before operation and were confirmed to be HCC by postoperative pathology. According to the pathological results, the lesions were divided into two groups—a well differentiated group and a poorly differentiated group. The time intensity curves of the regions of interest were drawn to obtain the quantitative parameters of arterial phase and the post-vascular phase. The diagnostic performance of each quantitative parameter in differentiating the two groups of lesions was evaluated and the cut-off value was calculated.Results:117 lesions from 115 patients were finally included in the study, including 70 lesions in the well differentiated group and 47 lesions in the poorly differentiated group. There were no significant differences in the initial growth time, peak time, rise time and the absolute value of peak intensity of lesions between the two groups in the arterial phase (all P>0.05). In the post-vascular phase(12 min), the absolute value of enhancement intensity, intensity ratio and intensity difference of the well differentiated group were lower than those in the poorly differentiated group, and the difference was statistically significant (all P<0.01). The sensitivity and specificity of the absolute value of enhancement intensity<56.117 dB, intensity ratio<1.212, intensity difference<9.184 dB to distinguish the HCC lesions as well-differentiated group were 48.9% and 80.0%, 87.2% and 77.1%, 89.4% and 75.7%, respectively. Conclusions:The quantitative analysis of the post-vascular phase of contrast-enhanced ultrasound is helpful to identify the differentiation degree of HCC and has certain clinical application value.

Purpose/Significance To bridge the digital service gap of the digital wellness consortium in Zhejiang province.Method/Process The study systematically reviews the evolution and development of digital elderly care theories and practices,using the digital wellness consortium in Zhejiang province as a case study,and examines it from theoretical,modeling,and practical dimensions.Result/Conclusion The digital wellness consortium has made rapid progress in recent years,however,it still faces numerous challenges in provi-ding digital elderly care services.From the perspective of digital adaptation for the elderly,the development strategies for the consortium are proposed at the government,corporate,and community levels.

Background::T-cell-mediated immunity is crucial for the effective clearance of viral infection, but the T-cell-mediated immune responses that are induced by booster doses of inactivated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines in people living with human immunodeficiency virus (PLWH) remain unclear.Methods::Forty-five PLWH who had received antiretroviral therapy (ART) for more than two years and 29 healthy controls (HCs) at Beijing Youan Hospital were enrolled to assess the dynamic changes in T-cell responses between the day before the third vaccine dose (week 0) and 4 or 12 weeks (week 4 or week 12) after receiving the third dose of inactivated SARS-CoV-2 vaccine. Flow cytometry, enzyme-linked immunospot (ELISpot), and multiplex cytokines profiling were used to assess T-cell responses at the three timepoints in this study.Results::The results of the ELISpot and activation-induced marker (AIM) assays showed that SARS-CoV-2-specific T-cell responses were increased in both PLWH and HCs after the third dose of the inactivated SARS-CoV-2 vaccine, and a similar magnitude of immune response was induced against the Omicron (B.1.1.529) variant compared to the wild-type strain. In detail, spike-specific T-cell responses (measured by the ELISpot assay for interferon γ [IFN-γ] release) in both PLWH and HCs significantly increased in week 4, and the spike-specific T-cell responses in HCs were significantly stronger than those in PLWH 4 weeks after the third vaccination. In the AIM assay, spike-specific CD4 + T-cell responses peaked in both PLWH and HCs in week 12. Additionally, significantly higher spike-specific CD8 + T-cell responses were induced in PLWH than in HCs in week 12. In PLWH, the release of the cytokines interleukin-2 (IL-2), tumour necrosis factor-alpha (TNF-α), and IL-22 by peripheral blood mononuclear cells (PBMCs) that were stimulated with spike peptides increased in week 12. In addition, the levels of IL-4 and IL-5 were higher in PLWH than in HCs in week 12. Interestingly, the magnitude of SARS-CoV-2-specific T-cell responses in PLWH was negatively associated with the extent of CD8 + T-cell activation and exhaustion. In addition, positive correlations were observed between the magnitude of spike-specific T-cell responses (determined by measuring IFN-γ release by ELISpot) and the amounts of IL-4, IL-5, IL-2 and IL-17F. Conclusions::Our findings suggested that SARS-CoV-2-specific T-cell responses could be enhanced by the booster dose of inactivated COVID-19 vaccines and further illustrate the importance of additional vaccination for PLWH.