Objective To detect the expression levels of multiple serum chemokines including IFN-inducible T cell chemoattractant (ITAC),Fractalkine,macrophage inflammatory protein (MIP)-3α,IL-8,MIP-lα,MIP-1β in patients with lung cancer and explore their association with the clinical characteristics of lung cancer as well as the correlations among these chemokines.Methods Forty newly diagnosed patients with lung cancer and thirty healthy controls were enrolled for detection of the serum levels of 6 kinds of chemokines by Luminex technology.The correlations of clinical characteristics of lung cancer with these chemokines and the correlations among these chemokines were analyzed by SPSS 17.0 software.Results The serum levels [M (QR)] of IL-8,Fractalkine and MIP-3α in patients with lung cancer were 5.16 (4.74),128.45 (141.89),10.31 (8.88) respectively,and 2.01 (0.95),61.46 (74.81),8.08 (5.87) respectively in control group,with significant differences (Z =-4.783,P ＜0.001;Z =-4.046,P ＜0.001;Z =-3.105,P =0.002).The expression of MIP-1β in lung adenocarcinoma was significantly higher than that in squamous carcinoma [18.32 (12.27) vs.13.72 (7.31),Z =-2.212,P =0.027],and of ITAC in squamous carcinoma was significantly higher than that in small cell lung cancer [24.51 (22.48) vs.9.28 (4.85),Z =-2.460,P =0.014].The expressions of MIP-3α and Fractalkine were positively correlated in the two groups (r =0.619,P＜0.001;r=0.766,P＜0.001).Conclusion The expressions of IL-8,Fractalkine and MIP-3α increase significantly in lung cancer patients,and they are may play important roles in metastatic lung cancer.

Objective: To investigate the seroprevalence and influencing factors of serum neutralizing antibodies among SARS-CoV-2 infected individuals, so as to provide the evidence for developing the health management and COVID-19 vaccination strategy among SARS-CoV-2 infected individuals. Methods: Recovered SARS-CoV-2 infected individuals from January 1st, 2020 to February 10th, 2021 in Zhejiang Province were recruited in March 2021. Participants' demographics, underlying diseases, date of definitive diagnosis and severity of clinical symptoms were collected using questionnaire surveys, and serum neutralizing antibody against SARS-CoV-2 was detected using a fluorescent immunoassay. In addition, factors affecting the seropositivity of neutralizing antibody against SARS-CoV-2 were identified using a multivariable logistic regression model. Results: A total of 559 SARS-CoV-2 infected individuals were enrolled, including 480 confirmed cases and 79 asymptomatic carriers, with an median (interquartile range) age of 47.00 (22.00) years, and all participants had never received COVID-19 vaccination. The median (interquartile range) duration from diagnosis to serum sampling was 387.00 (11.00) days, and the seroprevalence of neutralizing antibody against SARS-CoV-2 was 83.90%. The serum neutralizing antibody against SARS-CoV-2 was all positive 9 months after diagnosis, and the seroprevalence of neutralizing antibody against SARS-CoV-2 appeared no tendency towards a decline with time within 14 months after diagnosis (P>0.05). Multivariable logistic regression analysis showed that women were 1.892 times (95%CI: 1.169-3.064) more likely to produce serum neutralizing antibodies against SARS-CoV-2 than men, and mild, common and severe/critically ill SARS-CoV-2 infected cases were 2.438 (95%CI: 1.305-4.557), 4.481 (95%CI: 2.318-8.663), and 23.525 (95%CI: 2.990-185.068) times more likely to produce serum neutralizing antibodies against SARS-CoV-2 than asymptomatic carrier, respectively. Conclusions The seroprevalence of neutralizing antibody was 100.00% among SARS-CoV-2 infected individuals within 9 months after diagnosis. Individuals' gender and severity of clinical symptoms correlate with the seroprevalence of neutralizing antibody against SARS-CoV-2.

Objective: To investigate the epidemiological characteristics of influenza outbreaks in Zhejiang Province from 2013 to 2022, so as to provide insights into influenza prevention and control. Methods: Data pertaining to influenza outbreaks reported in Zhejiang Province from 2013 to 2022 were collected from National Influenza Surveillance System in China, including time, region, cases and pathogen types of influenza outbreaks. The temporal, spatial and pathogen distribution of influenza outbreaks were analyzed using a descriptive epidemiological method. Results: A total of 577 influenza outbreaks involving 448 698 individuals were reported in Zhejiang Province from 2013 to 2022, and the overall attack rate was 5.34% (23 974 cases), with no death reported. The lowest attack rate of influenza was 0.26%, and the highest was 80.00%, with a median attack rate of 10.89% (interquartile range, 24.26%). The outbreak had the shortest duration of 1.00 day, and the longest duration of 59.00 days, with a median duration of 9.00 (interquartile range, 11.00) days. There were 387 influenza outbreaks that occurred between November and January of the following year (67.07%), and the three highest numbers of outbreaks were reported in Hangzhou City (310 outbreaks), Wenzhou City (51 outbreaks) and Jinhua City (46 outbreaks). There were 395 outbreaks reported in urban regions (68.46%), 93 in counties and townships (16.12%) and 89 in rural regions (15.42%), and influenza outbreaks predominantly occurred in primary schools (487 outbreaks, 84.40%). In addition, the types of pathogens were alternately prevalent, with influenza B virus (241 outbreaks, 41.77%) and A/H3N2 virus (232 outbreaks, 40.21%) as predominant subtypes. Conclusions Influenza outbreaks mainly occurred in winter in Zhejiang Province from 2013 to 2022, and primary schools were main places of influenza outbreaks, while influenza B virus and A/H3N2 virus were predominant subtypes. It is necessary to reinforce the surveillance and report of influenza-like illness in schools and improve the coverage of influenza vaccination to prevent influenza outbreaks.

Objective To detect the expression levels of serum ITAC, Fractalkine, IL-8, IL-17A, IL-7 and TNF-α in patients with gastric cancer, and to explore correlation among them, as well as their association with different clinical characteristics.Methods The levels of the 6 kinds of cytokines in serum of 46 gastric cancer patients (gastric cancer group) and 30 healthy people (healthy control group) were detected.Results Compared with those in healthy control group, the levels of serum ITAC, Fractalkine, IL-8, IL-17A, IL-7 and TNF-α in gastric cancer group were significantly increased [22.26 (32.83) pg/ml vs 11.95 (9.99) pg/ml, P =0.001;62.21 (82.23) pg/ml vs 26.47 (50.87) pg/ml, P =0.050;4.50 (10.38) pg/ml vs 2.06 (3.17) pg/ml, P =0.002;0.83 (2.01) pg/ml vs 0.21 (0.85) pg/ml, P=0.013;3.46 (1.90) pg/ml vs 2.11 (1.48) pg/ml, P=0.001;1.21 (1.13) pg/ml vs 0.79 (0.37) pg/ml, P ＜ 0.001].There were correlations between cytokines (all P ＜ 0.05).The level of serum cytokines was no significant difference between gastric cancer patients with lymph node metastasis and those without lymph node metastasis (P ＞ 0.05).Conclusions The high level of serum ITAC, Fractalkine, IL-8, IL-17A, IL-7 or TNF-α may be related to the occurrence and development of gastric cancer.High level of serum IL-8 may be a marker of poor prognosis of gastric cancer, and interaction between the various cytokines also has a certain association with tumorigenesis.

Objective: Victims with shock-able initial arrest rhythms (ventricular fibrillation or pulse-less ventricular tachycardia, VF/VT) have much better outcomes from out-of-hospital cardiac arrest (OHCA) than those with non-shock-able initial rhythms (pulse-less electrical activities, PEA or asystole). Prompt defibrillation is believed pivotal to terminate lethal shock-able arrest rhythms. In this study, we were to identify those pre-hospital epidemiological factors which were associated with likelihood of shock-able rhythms first recorded when out-of-hospital cardiac arrest occurred. Methods: A multicenter, secondary, retrospective and observational analysis was performed on all adult non-traumatic OHCA in the Resuscitation Outcome Consortium (ROC) PRIMED study from June 2007 through November 2009. Of a total of 17 177 OHCA cases in PRIMED study, 13 421 of them were enrolled in this study when those OHCA patients with DNR order, or initial rhythms unknown, or arrest caused by obvious cause were excluded. We reported their demographics and episode characteristics for all enrolled cases. Multivariable logistic regression was employed to identify factors which were associated with likelihood of VF/VT recorded as shock-able initial rhythms. Results: Among 13 421 adult non-traumatic OHCA cases with initial rhythms recorded, 3 527 (26.3%) of them had shock-able rhythms, while 9 894 (73.7%) patients were in non-shock-able rhythms. Of the OHCA with shock-able arrest rhythms, 1 850(52.5%) obtained return of spontaneous circulation (ROSC) in the field, while 912 (25.9%) survived to hospital discharge. On the other hand, 2489(25.2%) of the OHCA with non-shock-able arrest rhythms obtained ROSC in the field, while 325 (3.3%) of them survived to hospital discharge. Multivariable regression analysis revealed those factors which indicated likelihood of shock-able rhythms recorded were: age(OR: 0.991,95%CI 0.988-0.993), male gender (OR1.887,95%CI1.718-2.073), pre-hospital Emergency Medical System(EMS) response time(OR0.950,95%CI 0.931-0.970), cardiac arrest witnessed by EMS providers(OR1.709,95%CI 1.423-2.054) or bystander(OR3.199,95%CI 2.921-3.504) and those with bystanders CPR (OR1.357,95%CI 1.239-1.487),public place of cardiac arrest (OR2.705,95%CI 2.437-3.003). Conclusions Some demographics and pre-hospital characteristics were proved associated with likelihood of shock-able arrest rhythms first recorded in OHCA victims, which might help develop corresponding strategies to deliver prompt shock on initially shock-able patients and improve their outcomes.

Objective:To investigate the clinical features of patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis misdiagnosed as mental disorder, improve the early diagnosis rate and reduce misdiagnosis.Methods:The clinical data of patients with anti-NMDA receptor encephalitis diagnosed at the First Affiliated Hospital of Zhengzhou University from 2012 to 2018 were collected. Patients misdiagnosed as mental disorders were screened out. Their psychiatric symptom characteristics, disease course characteristics, imaging and laboratory findings, treatment and prognosis were retrospectively analyzed.Results:A total of 121 cases of anti-NMDA receptor encephalitis were collected, and 43 cases of mental disorders were screened out. Sixteen of the 43 patients (37.2%) had prodromal symptoms, and all the patients had psychiatric behavioral abnormalities (100%), including 32 cases (74.4%) of seizures, 13 cases (30.2%) of decreased level of consciousness, 21 cases (48.8%) of involuntary movements, 15 cases (34.9%) of decreased memory, 8 cases (18.6%) of speech dysfunction, and 8 cases (18.6%) of other neurological symptoms (central hyperventilation, autonomic dysfunction). Memory loss was observed in 15 cases (34.9%), speech dysfunction in 8 cases (18.6%), other neurological symptoms (central hypoventilation, autonomic dysfunction) in 8 cases (18.6%), and various symptoms may appear simultaneously or successively in the same patient. Thirty-eight cases had complete resolution of symptoms or only minor physical impairment, and 5 cases had recurrent admissions with mental abnormalities and seizures. The recurrence rate accounted for 11.6% (5/43).Conclusions:The clinical manifestations of anti-NMDA receptor encephalitis are complex and varied. Most of them have mental behavior abnormalities as the first symptom, which is easily misdiagnosed as mental disorder and delayed treatment will lead to prolonged disease course and poor prognosis.

Objective: To observe the change levels of nuclear factor-kappa B (NF-κB) p65 protein in cytoplasm and nuclear, phosphorylation of inhibitor of kappa B (p-IκB) protein and cytochrome C (Cyt-c) , cleaved cysteinyl aspartate specific proteinase-3 (Cleaved caspase-3) , B-cell lymphoma/leukemia-2 (Bcl-2) in cytoplasm in the process of N, N-dimethylformamide (DMF) -induced apoptosis in H9c2 cardiomyocytes, and explore the tentative mechanism of apoptosis. Methods: H9c2 cardiomyocytes were exposed to 200 mmol/L DMF. Western blotting was used to detect the protein expression levels of p65 in cytoplasm and nuclear, p-IκB after exposure for 0, 2, 4, 6, 8, 12 h, and the protein expression levels of Cyt-c, Cleaved caspase-3, Bcl-2 in cytoplasm after exposure for 0, 2, 4, 8, 12, 24 h. Immunofluorescencecytochemistry (IFC) was used to observe the location of Cyt-c after 200 mmol/L DMF exposure for different times. Results: The levels of p65 in cytoplasm and nuclear and p-IκB among groups were statistically significant (F were 7.79, 33.11, 90.25, respectively, all P<0.01) . Compared with the control group, the levels of p65 in cytoplasm of 2, 4, 6 h group were significantly decreased (all P<0.01) ; the levels of p65 in nuclear of 2, 4, 6, 8 h were significantly increased (all P<0.01) ; the levels of p-IκB of 2, 4, 6 h group were significantly increased (all P<0.01) . The levels of Cyt-c, Cleaved caspase-3 and Bcl-2 among groups were statistically significant (F were 51.42, 503.68, 73.37, respectively, all P<0.01) . Compared with the control group, the levels of Cyt-c of 8, 12 h group were significantly increased (both P<0.01) ; the levels of Cleaved caspase-3 of 2, 4, 8, 12, 24 h were significantly increased (all P<0.01) ; the levels of Bcl-2 of 2, 4, 8, 12, 24 h group were significantly decreased (all P<0.01) . IFC showed that Cyt-c was released from the mitochondria to the cytoplasm gradually as the extension of the exposure time. Conclusion NF-κB signaling pathway and mitochondrial pathway are involved in the mechanism of DMF-induced apoptosis in H9c2 cardiomyocytes.

Objective To explore the expressions of Bcl-2 and Bax proteins in the neurons of spinal cord after tibial nerve and common peroneal nerve injuries in rats.Methods A total of 90 male SD rats were randomly divided into three groups, the group A was as control group, group B as suture of tibial nerve cut group, and group C as suture of the common peroneal nerve cut group.The L4-6 segment spinal cord of the rats were removed for HE staining and immumohistochemical staining on 3, 7, 14, 28 days after the operation.The number of motor neurons in the spinal anterior horn were calculated.The expressions differences of Bcl-2 and Bax proteins were detected by immuno-histochemistry, and values of Bcl-2/Bax were calculated.Results The number of motor neurons in the anterior horn of spinal cord in group B were less than that in group C on 1, 3, 7, 14, 28 days after the operation (P< 0.01).The expression of Bcl-2 protein in group B and group C showed an upward and then declining trend.It decreased to the lowest on the postoperative 3 d in group B and 7 d in group C, respectively.The expressions of Bax protein in group B and C showed an upward and then declining trend, and it increased to the highest on the postoperative 3 d in groups B and C.The values of Bcl-2/Bax in groups B and C were showed an decreased and then increased trend and it was lower in group B than group C on the postoperative 3, 7, 14, 28 d(P< 0.01).Conclusion Injuries of tibial nerve and common peroneal nerve of the rats would lead the apoptosis of motor neurons in the spinal cord, but compared with the injury of common peroneal nerve, tibial nerve injury would lead less apoptosis of motor neurons.

Objective To explore the expressions of Bcl-2 and Bax proteins in the neurons of spinal cord after tibial nerve and common peroneal nerve injuries in rats.Methods A total of 90 male SD rats were randomly divided into three groups, the group A was as control group, group B as suture of tibial nerve cut group, and group C as suture of the common peroneal nerve cut group.The L4-6 segment spinal cord of the rats were removed for HE staining and immumohistochemical staining on 3, 7, 14, 28 days after the operation.The number of motor neurons in the spinal anterior horn were calculated.The expressions differences of Bcl-2 and Bax proteins were detected by immuno-histochemistry, and values of Bcl-2/Bax were calculated.Results The number of motor neurons in the anterior horn of spinal cord in group B were less than that in group C on 1, 3, 7, 14, 28 days after the operation (P< 0.01).The expression of Bcl-2 protein in group B and group C showed an upward and then declining trend.It decreased to the lowest on the postoperative 3 d in group B and 7 d in group C, respectively.The expressions of Bax protein in group B and C showed an upward and then declining trend, and it increased to the highest on the postoperative 3 d in groups B and C.The values of Bcl-2/Bax in groups B and C were showed an decreased and then increased trend and it was lower in group B than group C on the postoperative 3, 7, 14, 28 d(P< 0.01).Conclusion Injuries of tibial nerve and common peroneal nerve of the rats would lead the apoptosis of motor neurons in the spinal cord, but compared with the injury of common peroneal nerve, tibial nerve injury would lead less apoptosis of motor neurons.

Objective:To investigate the epidemiological characteristics for family clusters of COVID-19 in Zhejiang Province.Methods:The data including cases information of asymptomatic infected cases of family clusters of COVID-19 in Zhejiang Province were collected from Public Health Emergencies Reporting System of China Center for Disease Control and Prevention. Calculate the case number of subsequent cases, index cases, asymptomatic infected cases, exposure cases, and then, compute family secondary attack rate (SIR) and serial interval.Results:A total of 389 cases comprised 149 family index cases and 240 subsequent cases. The clinical symptoms between family index cases and subsequent cases (exclude asymptomatic infected cases ) were similar, fever was the most common symptoms in the two groups 115 (77.18%) and 110（48.67%）respectively, the cases with diarrhea symptoms accounted for the least proportion, which were 7 (4.70%) and 6 (2.65%) respectively. The serial interval between the family index cases and the subsequent cases [ M ( P25, P75)] was 4.00 (2.00, 6.00) days. Family secondary attack rate for subsequent cases was 34.43%, subsequent cases aged between 14 and 60 have the highest SIR (43.42%) compared with other two age groups, the difference was statistically ( P<0.001); the family SIR of the spouses of the family index cases is 68.57%, and are higher than that of parents (29.03%), children (25.00%) and other family members (24.21%), the difference was also statistically ( P<0.001). Conclusion:2019 novel coronavirus has shorter serial interval and higher family SIR, the SIR of spouses is higher than other family members.