Objective To analyze the conformance between the quantitative and qualitative tests of hepatitis B surface antibody (anti-HBs).Methods The chemiluminecence microparticle enzyme immunoassay(CMIA)was adopted to quantitatively detect anti-HBs and the enzyme linked immunosorbent assay(ELISA)was adopted to qualitatively detect anti-HBs.Results With the CMIA as the reference experiment,Se ,Sp ,J ,PV+ and PV-of anti-HBs detected by ELISA were 0.95,0.53,0.48,0.74 and 0.88 respec-tively,k=0.51;when the absorbance was 0.400 9,Se ,Sp ,J ,PV+ and PV-were 0.50,0.95,0.45,0.93 and 0.43 respectively;for the samples exceeding the absorbance range of 0.104 3 -0.400 9,Se ,Sp ,J ,PV+ and PV-qualitatively detected by ELISA were 0.90,0.91,0.81,0.93 and 0.88 respectively,k =0.81.Conclusion Determining cutoff value with the absorbance value 0.105 as the ELISA detection result has the good detection sensitivity(Se =0.95)and the better negative prediction value(PV-=0.88),the negative anti-HBs detected by ELISA may be considered that the anti-HBs concentration was less than 10 mIU/mL without the conservation value;when the sample absorbance ≥0.400 9,the anti-HBs concentration is ≥10 mIU/mL,which may be considered to have the conservation value;the gray area range of anti-HBs detected by ELISA is mainly the absorbance of 0.105-0.400 9,the true anti-HBs level should be quantitatively detected.

Objective To investigate the renal function of the patients with acute myocardial infarction (AMI) and its effect on patients' outcome.Methods The renal function of 680 patients with AMI,received the conventional therapies, such as thrmbolysis, antiplatelet and antianginal therapies were investigated. According to it, 228 patients with renal dysfunction[GFR ＜90ml · min-1 · ( 1.73m2 ) -1]were divided into observation group,while the others[GFR≥90ml · min-1 · (1.73m2) -1]were divided into control group. To analyse their clinical characteristics、the inhospital mortality、one year mortality and the heart ocurrence rate in one year. Results Compared with the patients in the control group,the patients in the observation group were older、more likely to be women、and more likely to have hypertension、diabetes mellitus、coronary heart disease. The inhospital and one year mortality were higher ( 17. 8％ vs 9.74％ ,P ＜0. 01 ;25.00％ vs 14. 44％ ,P ＜0. 01 ) and the heart ocurrence rate was higher(57. 14％ vs38. 96％ ,P ＜ 0. 01 ) in one year in the observation group than that in the control group. ConclosionThe AMI patients with renal dysfunction were more likely to have concomitant diseases, worse ill condition and outcome. Renal dysfunction was an independent risk factor for the outcome in the patients with AMI.

Objective To research the reality of ELISA testing results with negative anti-HBc and positive antiHBe.Methods CMIA was carried out to retest antiHBc and antiHBe of 105 samples which were initially tested to have negative antiHBc and positive antiHBe.Results Among the 105 samples retested by CMIA,there were three different results,positive antiH-Bc with positive antiHBe,negative antiHBc with negative antiHBe and positive antiHBc with negative antiHBe,whose pro-portions were 72.38%,21.91% and 5.71% respectively;the fasle negative rates of antiHBc were 78.10% in total and 93.33%,96.15% and 47.37% in 3 subgroup with S/CO 1.00~ 1.20,1.20~2.00 and 2.00~ 3.00,respectively;the true positive rates of antiHBe were 72.38% in total and 42.86%,88.14% and 56.25% in 3 subgroups with S/CO 0.00~0.10, 0.10~0.80 and 0.80 ~ 1.00,respectively.Conclusion HBV-M results with negative antiHBc and positive antiHBe by ELISA could give suggestive value and not reflect true information about antiHBc and antiHBe with three alternatives which would be obtained through retesting by a second assay.

Objective This study was performed to investigate the levels of HSP70 in tissue in pemphigus as a possible new theoretical basis for further elucidate the pathogenesis of pemphigus.Methods The expression of HSP70 in 62 patients with pemphigus was determined by immunohistochemistry,and the normal skin was taken as control.Results The results showed that the positive cells of HSP70＞75 ％ in the blisters of pemphigus vulgaris and the positive cells of HSP70＞50％ in the inflammatory cells near the blisters,and the expression of HSP70 was significantly higher than that in normal skin,which was statistically significant(Z=5.42,4.73,P＜0.01).Conclusion The abnormal expression of HSP70 in inflammatory cells and psoriasis of pemphigus patients showed that HSP70 is involved in the pemphigus.

Objective:To investigate the current situation of cytomegalovirus (CMV) infection in infants in Lishui, and summarize the related factors of CMV infection, evaluate its influence on the growth and development of infants, and provide evidence for the prevention and control of CMV infection.Methods:In this study, 2 254 cases of infants admitted in pediatric ward in Lishui Maternal and Child Health Hospital, Qingtian County People′s Hospital, Suichang County People′s Hospital, Qingyuan County People′s Hospital from January 1, 2015 to December 31, 2017 with integral clinical data were selected. All the babies were followed up from the time when they were born to 1 year old. The serum CMV antibody and the urine CMV-DNA were screened, the general situation and clinical features of CMV infection were summarized, and the relevant factors of infants CMV infection were analyzed and screened by the single factor and multiple factors analysis. They were followed up to 1 year old to clarify the influence of CMV infection on the growth and development of infants.Results:From 2015 to 2017, the total positive infection rate of CMV-IgM in infants under 1 year old in Lishui was 10.43%(235/2 254), and CMV-IgM positive infection decreased year by year. The positive rate of CMV-IgG did not change significantly with time. The positive rate of CMV-IgM was the highest at 1—3 months, and up to 15.29% (61/399). The positive rate of CMV-IgM decreased with the age of the babies. The positive rate of CMV-IgG increased with the age of the babies. The positive rate of CMV-IgM in infants showed no significant difference in gender ( P>0.05). The positive rate of CMV-IgM was higher in men than that in women [65.43% (810/1 238) vs. 55.51% (564/1 016)], and there was significant difference ( P<0.05). The gestational age of the infected group was lower than that of the non-infected group [(37.41 ± 1.63) weeks vs. (38.97 ± 0.97) weeks], and the breast-feeding rate of the infected group was higher than that of the non-infected group [57.87%(136/235) vs. 40.00%(40/100)], and there were significant differences ( P<0.05). Thrombocytopenia, the increase of transaminase, necrotizing enterocolitis of newborn, and hepatosplenomegaly of infected group is higher that of the non-infected group [18.72%(44/235) vs. 1.00% (1/100), 29.36% (69/235) vs. 13.00% (13/100), 26.81% (63/235) vs. 10.00% (10/100), 9.79% (23/235) vs. 0], and there were significant differences ( P<0.05). Gestational age and breast-feeding were possible risk factors for CMV infection in infants under 1 year old ( P<0.05). There was no significant difference in height, weight, head circumference and intelligence score between the infected group and the non-infected group at the age of 1 year ( P>0.05). The total abnormal rate of hearing development and the abnormal detection rate of B-ultrasound in the infected group were higher than those in the non-infected group [13.62%(64/470) vs. 1.00%(2/200), 6.38%(15/235) vs. 0], and there were significant differences ( P<0.05). Conclusions:The CMV active infection rate of infants under 1 year old in Lishui is relatively high and decreases year by year. It decreases with the prolongation of birth time, and there is no gender difference. Gestational age and breast-feeding are the risk factors for active CMV infection in infants. CMV infection affects the hearing development and the brain development of infants under 1 year old, which is the main cause of hepatitis. It is necessary to pay attention to the prevention of CMV infection, strengthen maternal perinatal health care, and strengthen the screening of CMV infection in high-risk groups.

Objectives:The COVID-19 epidemic has swept all over the world. Estimates of its case fatality rate were influenced by the existing confirmed cases and the time distribution of onset to death, and the conclusions were still unclear. This study was aimed to estimate the age-specific case fatality rate of COVID-19.Methods:Data on COVID-19 epidemic were collected from the National Health Commission and China CDC. The Gamma distribution was used to fit the time from onset to death. The Markov Chain Monte Carlo simulation was used to estimate age-specific case fatality rate.Results:The median time from onset to death of COVID-19 was M=13.77 ( P25- P75: 9.03-21.02) d. The overall case fatality rate of COVID-19 was 4.1 % (95 %CI: 3.7 %-4.4 %) and the age-specific case fatality rate were 0.1 %, 0.4 %, 0.4 %, 0.4 %,0.8 %, 2.3 %, 6.4 %, 14.0 and 25.8 % for 0-, 10-, 20-, 30-, 40-, 50-, 60-, 70- and ≥80 years group, respectively. Conclusions:The Markov Chain Monte Carlo simulation method adjusting censored is suitable for case fatality rate estimation during the epidemic of a new infectious disease. Early identification of the COVID-19 case fatality rate is helpful to the prevention and control of the epidemic.

Background::Non-smokers account for a large proportion of lung cancer patients, especially in Asia, but the attention paid to them is limited compared with smokers. In non-smokers, males display a risk for lung cancer incidence distinct from the females—even after excluding the influence of smoking; but the knowledge regarding the factors causing the difference is sparse. Based on a large multicenter prospective cancer screening cohort in China, we aimed to elucidate the interpretable sex differences caused by known factors and provide clues for primary and secondary prevention.Methods::Risk factors including demographic characteristics, lifestyle factors, family history of cancer, and baseline comorbidity were obtained from 796,283 Chinese non-smoking participants by the baseline risk assessment completed in 2013 to 2018. Cox regression analysis was performed to assess the sex difference in the risk of lung cancer, and the hazard ratios (HRs) that were adjusted for different known factors were calculated and compared to determine the proportion of excess risk and to explain the existing risk factors.Results::With a median follow-up of 4.80 years, 3351 subjects who were diagnosed with lung cancer were selected in the analysis. The lung cancer risk of males was significantly higher than that of females; the HRs in all male non-smokers were 1.29 (95% confidence interval [CI]: 1.20-1.38) after adjusting for the age and 1.38 (95% CI: 1.28-1.50) after adjusting for all factors, which suggested that known factors could not explain the sex difference in the risk of lung cancer in non-smokers. Known factors were 7% (|1.29-1.38|/1.29) more harmful in women than in men. For adenocarcinoma, women showed excess risk higher than men, contrary to squamous cell carcinoma; after adjusting for all factors, 47% ([1.30-1.16]/[1.30-1]) and 4% ([7.02-6.75]/[7.02-1])) of the excess risk was explainable in adenocarcinoma and squamous cell carcinoma. The main causes of gender differences in lung cancer risk were lifestyle factors, baseline comorbidity, and family history.Conclusions::Significant gender differences in the risk of lung cancer were discovered in China non-smokers. Existing risk factors did not explain the excess lung cancer risk of all non-smoking men, and the internal causes for the excess risk still need to be explored; most known risk factors were more harmful to non-smoking women; further exploring the causes of the sex difference would help to improve the prevention and screening programs and protect the non-smoking males from lung cancers.