Objective: To compare the effectiveness before and after the adjustment of schistosomiasis control strategies in Nanjing City, so as to provide the evidence for improving schistosomiasis control interventions. Methods: The prevalence of Schistosomasis japonicum infections in humans, livestock, Oncomelania hupensis and sentinel mice was collected in Nanjing City from 1993 to 2018, and the prevalence of S. japonicum infections in humans, livestock, sentinel mice and O. hupensis, and the areas of snail habitats, areas of infected snail habitats and snail control areas were compared before (1993-2004) and after (2005-2018) the adjustment of schistosomiasis control strategies to evaluate the effectiveness. Results: The prevalence of S. japonicum infections in humans, livestock, O. hupensis and sentinel mice was 0.77% and 0.02% (χ2=6 430.634, P<0.001), 0.46% and 0.01% (χ2=344.401, P<0.001), 0.19% and 0.11% (χ2=239.685, P<0.001), and 34.35% and 1.56% (χ2=1 856.286, P<0.001) in Nanjing City before and after the adjustment of schistosomiasis control strategies, respectively. The median areas (interquartile range) of snail habitats, infected snail habitats and snail control were 4 175.37 (1 301.65) and 2 366.44 (885.27) hm2 (Z=-3.755, P<0.001), 870.49 (1 001.75) and 0 (158.89) hm2 (Z=-3.654, P<0.001) and 1 383.23 (793.57) and 5 031.94 (629.11) hm2 (Z=-4.320, P<0.001) in Nanjing City before and after the adjustment of schistosomiasis control strategies, respectively. Conclusions After the adjustment of schistosomiasis control strategies, remarkable effects on schistosomiasis control has achieved in Nanjing City, where the transmission of schistosomiasis was interrupted. Nevertheless, the strategy requires to be continued and improved to move towards elimination of schistosomiasis in Nanjing City.

Objective To investigate the prevalence of gout and its associated factors in populations in Beijing. Methods A cross-sectional study of gout was carried out in state-employees who had yearly health examination at Peking Union Medical College Hospital in Beijing,China from September to December 2005. The prevalence of gout was calculated in the population. Data were further analyzed by multivariate logistic regression models to find associated factors of gout. Results The prevalence of gout in the population was 1.0%,and were 1.5% and 0.3% for men and women respectively. Bivariate and multivariate logistic regression analysis found that male gender (OR 15.07,95%CI 1.79～127.19),hard liquor (OR 4.93,95%CI 1.41～17.31 for ≥7 beverages per week),diuretics (OR 6.72,95%CI 2.34～19.34),waist obesity (OR 4.38,95%CI 1.33～14.43),and hypercholesterolemia (OR 3.63,95%CI 1.23～10.67 for serum cholesterol 5.17～6.21mmol/L) were associated with increased prevalence of gout,whereas products of bean curd (OR 0.21,95%CI 0.07～0.59) were associated with reduced prevalence of gout. Conclusion Male gender,hard liquor,diuretics,waist obesity and hyperchol-esterolemia may be associated with the increased risk of gout,whereas products of bean curd may be associated with the reduced risk of gout.

Objective To explore the role of regulatory T cells (Tregs) in skin and heart grafts survival prolongation after different CD47 genotype donor specific splenocytes pretreatment.Methods Mouse skin plus hearts transplantation model was set up by using C57BL/6 as recipients and MHC class I-mismatched bm1 as donors.In CD47-/-DST group,recipients received CD47-/-bm1 splenocytes transfusion at 7th d before transplantation.In CD47+/+DST group,recipients received CD47+/+bm1 splenocytes transfusion at 7th day before transplantation.In control group,recipients only received bm1 skin and heart grafts.The populations of Tregs were analyzed by FACS and immunohistochemistry,respectively.The inhibitory effect of Tregs and anti-donor T cell responses was assessed by MLR.Results Result As compared with control group,the survival time of skin grafts in CD47-/-DST group was slightly longer than in non-DST group (20 days vs.17.5 days,P>0.05),but skin grafts had long-term survival in CD47+/+DST group (46.5 days,P<0.005).The survival time of heart grafts in CD47-/-DST group was similar to that in the control group,and slightly longer than non-DST group (17 days vs.15.5 days,P>0.05),but heart grafts had long-term survival in CD47+/+DST group (42.5 days vs.17 days,P<0.01).At 18th day after transplantation,immunohistochemistry showed that more Tregs infiltration could be observed in CD47-/-DST group,but not in CD47+/+DST group.The number of Foxp3+Tregs from the mice receiving CD47-/-DST increased markedly at 18th day post-transplantation compared to thot from the mice receiving CD47+/+DST (P<0.01),but the ratio of Tregs was decreased significantly (P<0.05).The number of Foxp3+Tregs in both CD47-/-and CD47+/+ DST groups was increased,but there was no significant difference between two groups (P>0.05).As compared with CD47-/-DST group,the ratio of Tregs in lymph node cells in CD47+/+DST group increased significantly (P<0.01).Compared to CD47-/-DST group and control group,anti donor specific T cell proliferation was decreased in CD47+/+DST group at 7th day after transplantation (P<0.05).The inhibitory effects of Tregs were similar among groups.Conclusion CD47 expressed on DST cells plays an important role in grafts survival prolongation.The ratio of Tregs in lymphocytes plays the key role in grafts survival prolongation.but not the number or inhibitory function of single Treg.

Objective To discuss the value of preoperative transcatheter arterial embolization (TAE) in surgery for giant pheochromocytoma. Methods During the period of Jan 2000 to July 2010,six patients with giant pheochromocytoma underwent preoperative TAE in Peking Union Medical College Hospital.The medical records were reviewed retrospectively. Results The lesions were all solitary giant pheochromocytoma.In four casesthe pheochromocytoma was located in the aderenal gland the remaining two cases were paraganglioma.The tumor size ranged from 7 cm to 16 cm.And CTA showed the masses were well vascularized and fed by diverse arteries.All six patients underwent preoperative TAE successfully and surgical removal was successfully performed within 24 hours after embolization.No major complications occurred.After surgery no patient suffered recurrence and clinical symptoms were significantly improved. Conclusions Preoperative TAE is safe and effective for giant pheochromocytoma.Preoperative pharmacological management,gastrointestinal preparation and surgical remoral performed within 24 hours after embolization markedly reduced the complications related to embolization.TAE can help achieve hemodynamic stability during operation and is very helpful to a complete resection of giant pheochromocytomas.

Objective To investigate the prevalence of nutritional risk,malnutrition(undemutrition),overweight/obesity,and application of nutritional support in hospitalized patients with endocrine disorders.Methods Adult patients in Department of Endocrine of Peking Union Medical College Hospital(PUMCH)from September to December 2008 were consecutively enrolled.Nutrional Risk Screening 2002(NRS2002)war per-formed on the next morning after admission and nutritional support evaluation was performed on the 14th day of ad-mission or on the discharge day.The relationship between nutritional risk and nutritional support Was analyzed.Nu-tritional risk was defined as NRS2002 score≥3,and body mass index(BMI)<18.5 ks/m2 defined as unclernut-rition.Results A total of 152 patients were enroled,and NBS2002 scoring was performed in all patients.The prevalence of undernutrition Was 7.9%and the nutritional risk was 27.6%.The prevalence of nutritional risk in the elderly inpotients(≥60 years old)was significantly higher than in younger patients(18-59 years old)(36.8%vs 20.2%,P=O.023).Nine patients(21.4%)with NRS2002≥3 received nutrition support,and 12patients(10.9%)with NRS2002<3 received nutritional support.The average PN:EN ratio was 1:3.2.Conclu-siom NRS2002 is afeasible nutritional risk screening tool for inpatients with endocrine disorders.A large propor-tion of inpotients were at nutritional risk or undemutrition in the Department of Endocrine of PUMCH. The application of nutritional support currently is somehow inappropriate.Evidence-based guidelines are required to improve this situation

Objective To assess the impact of respiratory motion on the displacement of target area and to analyze the discrimination between free breathing and active breathing control (ABC) in patients with gastric cancer treated with post-operative radiotherapy. Methods From January 2005 to November 2006, 22 patients with post-operatively confirmed gastric cancer were enrolled in this study. All diseases were T_3/ N +, staging Ⅱ - Ⅳ. Patients were CT scanned and treated by radiation with the use of ABC. Image J software was used in image processing, motion measurement and data analysis. Surgical clips were implanted as fiducial marks in the tumor bed and lymphatic drainage area. The motion range of each clip was measured in the resultant-projection image. Motions of the clips in superior-inferior (S-I), right-left (R-L) and anterior-posterior (A-P) directions were determined from fluoroscopy movies obtained in the treatment position. Results The motion ranges in S-I, R-L and A-P directions were 11.1 mam, 1.9 mm and 2.5 mm (F = 85.15, P = 0. 000) under free breathing, with 2.2 mm, 1.1 mm and 1.7 nun under ABC (F = 17.64, P = 0. 000), and the reduction of motion ranges was significant in both S-I and A-P directions (t = 4.36, P = 0. 000;t = 3.73,P = 0.000). When compared with under free-breathing, the motion ranges under ABC were kept unchanged in the same breathing phase of the same treatment fraction, while significant increased in different breathing phase in all three directions (t = - 4.36, P = 0. 000; t = - 3.52, P = 0.000; t =-3.79, P = 0. 000), with a numerical value of 3.7 mm, 1.6 mm and 2.8 mm, respectively (F = 19.46, P = 0. 000) . With ABC between different treatment fractions , the maximum displacements were 2.7 mm, 1.7 mm and 2.5 mm for the centre of the clip cluster (F =4.07,P =0. 019), and were 4.6 mm, 3.1 mm and 4.2 mm for the clips (F =5.17 ,P =0.007). The motion ranges were significant increased in all the three directions (t = - 4.09, P=0.000 ; t =-4.46, P = 0.000 ; t = - 3.45, P =0.000). Conclusions In the irradiation of post-operative gastric cancer, the maximum displacement of organ motions induced by respiration is in S-1 direction and the minimum in R-L direction under free breathing. The use of ABC can reduce the motions significantly in S-I and A-P directions, and the same changes exist in both inter-and intra-fraction treatment.

Objective To investigate the effect of retrograde sartorius myocutaneous flap for reparing skin defects of leg.Methods In the anatomic study,50 cadaveric lower limb were injected with red latex and the origin,diameter,course,distribution and anastomosis of sartorius's arteries were observed.Arteriographies were made in 4 sides of fresh specimens to study the arterial anastomosis in sartorius.Based on anatomic research results,we designed the retrograde sartorius myocutaneous flap for reparing skin defects of leg.Results Nutrient arteries of sartorius represented segnental distribution,Link-pattern arterial anastomosises were formed in sartorius by branches of adjacent vascular pedicles.Cutaneous arteries and musculocutaneous arteries above deep fascia formed interlocking arterial anastomosises net which provided blood supply for the skin on sartorius.The arterial branches in the distal 2/5 of sartorius came from saphenous artery,composed an arterial network around knee joint,which consist of anatomic basis for the blood supply of retrograde sartorius myocutaneous flap.Form February,2010 to April,2014,the retrograde sartorius myocutaneous flap were used to repair skin defects of leg in 2 cases.The flap size ranged from 7 cn×18 cm to 12 cm×25 cm.All flaps survived successfully with no ulcer.2 cases were followed up for 7 to 16 months.The skin color and texture were satisfactory.Conclusion the retrograde sartorius myocutaneous flap has constantly,reliable blood supply,and easily performed.It is an effective method for the reconstruction skin defects of leg.

AIM: To investigate the effects of angiotensin-converting enzyme inhibitors (ACEI), fosinopril, captopril and angiotensin II AT 1 antagonists, valsartan on tissue factor (TF) expression on monocytes induced by lipopolysaccharide (LPS). METHODS: Mononuclear leukocytes from normal delivered female umbilical veins were incubated with bacterial LPS in presence or absence of different ACE inhibitors .At the end of incubation, the cells were disrupted by 3 freeze-thaw cycles. TF procoagulant activity was assessed by a one-stage clotting assay. RT-PCR was used to check TF mRNA expression, and GAPDH mRNA was used for parallel assay. RESULTS and CONCLUSION: The results showed that increased expression of TF mRNA induced by LPS was inhibited by fosinopril, captopril and valsartan, respectively, and the procoagualant activity of monocytes was also reduced. [

Objective To study the expression changes of CD54 and CD106 in peripheral blood lymphocyte in patients with congest heart failure. Methods With FCM technique, the levels of CD54 and CD106 in lymphocyte from patients with CHF were measured , and those of patients with hypertension , patients with dilated cardiomyopathy and normal controls were measured at the same time. Cardiac function during heart failure episodes and remission stage was monitored by Color Doppler Echocardiography. Results Levels of CD54 and CD106 were significantly elevated in patients with hypertension , patients with active CHF and hypertension , patients with inactive CHF and hypertension when compared with those of normal controls. Levels of CD54 and CD106 were significantly elevated in patients of dilated cardiomyopathy , patients with active CHF and dilated cardiomyopathy , patients with inactive CHF and dilated cardiomyopathy when compared with those of normal controls. Levels of CD54 and CD106 in patients of CHF were elevated with the degree of CHF. There was significantly negative correlation between LVEF and CD54 of CHF. Conclusions CD54 and CD106 may use as the marker to monitor the progress of CHF.