Objective To evaluate the role of serine-threonine kinase (Akt)/glycogen synthase kinase-3 beta (GSK-3β) signaling pathway in isoflurane preconditioning-induced inhibition of mitochondrial permeability transition pore protein (mPTP) opening during myocardial ischemia-reperfusion (I/R) in rats.Methods Ninety-six male Sprague-Dawley rats,aged 3-4 months,weighing 200-250 g,were randomly divided into 4 groups (n =24 each) using a random number table:control group (group C);I/R group;isoflurane preconditioning group (group IPC);Akt inhibitor MK-2206 group (group MK).Myocardial I/R was induced by occlusion of the anterior descending branch of the left coronary artery for 30 min followed by 2 h of reperfusion.In group IPC,1.5％ isoflurane was inhaled for 30 min followed by 45 min washout,and then the model of myocardial I/R injury was established.In group MK,MK-2206 300 μg/kg (in dimethyl sulfoxide) was injected intraperitoneally at 30 min before isoflurane inhalation.At 2 h of reperfusion,8 rats were selected and sacrificed,and the hearts were removed for determination of myocardial infarct size.At 2 h of reperfusion,8 rats were selected,and blood samples were collected from the right internal jugular vein for determination of serum cardiac troponin Ⅰ (cTnI) concentrations.The rats were then sacrificed,and myocardial specimens were obtained for determination of the expression of phosphorylated GSK-3β (p-GSK-3β) in cytoplasm and mitochondria (by Western blot) and co-expression of p-GSK-3β with adenine nucleotide translocator (ANT),voltage-dependent anion channel or cyclophilin D in myocardial tissues (using co-immunoprecipitation).At 2 h of reperfusion,8 rats were selected and sacrificed,myocardial cells were obtained,and the opening time of mPTP was determined with a laser scanning confocal microscope.Results Compared with group C,the myocardial infarct size and serum cTnI concentrations were significantly increased,and the expression of p-GSK-3β in cytoplasm and mitochondria was up-regulated in I/R and IPC groups,the co-expression of p-GSK-3β with ANT was significantly down-regulated,and the opening time of mPTP was shortened in group I/R,and the co-expression of p-GSK-3β with ANT was significantly up-regulated,and the opening time of mPTP was prolonged in group IPC (P＜0.05).Compared with group I/R,the myocardial infarct size and serum cTnI concentrations were significantly decreased,the expression of p-GSK-3β in cytoplasm and mitochondria was up-regulated,the co-expression of p-GSK-3β with ANT was significantly up-regulated,and the opening time of mPTP was prolonged in group IPC,and the opening time of mPTP was significantly prolonged (P＜0.05),and no significant change was found in the other parameters in group MK (P＞0.05).Compared with group IPC,the myocardial infarct size and serum cTnI concentrations were significantly increased,the expression of p-GSK-3β in cytoplasm and mitochondria was up-regulated,the co-expression of p-GSK-3β with ANT was significantly down-regulated,and the opening time of mPTP was shortened in group MK (P＜0.05).No co-expression of p-GSK-3β with voltage-dependent anion channel or cyclophilin D was found in myocardial tissues.Conclusion The mechanism by which isoflurane preconditioning inhibits mPTP opening during myocardial ischemia-reperfusion is partially related to activation of Akt/GSK-3β signaling pathway in rats.

Objective To evaluate the role of c-Jun N-terminal kinase (JNK) signaling pathway in paclitaxel-induced apoptosis in hippocampal neurons of rats, and the relationship with nuclear factor kappa B (NF-κB) pathway.Methods The primarily cultured hippocampal neurons were seeded in 96-well plate at a density of 1×106 cells/ml (200 μl/hole) , and were randomly divided into 4 groups (n=8 each) using a random number table: control group (C group), paclitaxel group (P group), JNK inhibitor SP600125 group (S group), and SP600125 + paclitaxel group (S+P group).Paclitaxel 2 ml (1 μmol/L) was added to group P.SP600125 2 ml (10 μmol/L) was added to group S.In group S+P, SP600125 2 ml (10 μmol/L) was added, the cell were then incubated for 1 h, and then paclitaxel 2 ml (1 μmol/L) was added.The cells were then incubated for 24 h.At 24 h of incubation, the apoptosis in hippocampal neurons was detected by flow cytometry, and the expression of NF-κB p65 was measured by Western blot.The apoptosis rate was calculated.Results Compared with group C, the apoptosis rate was significantly increased, and the expression of NF-κB p65 was up-regulated in P and S+P groups, and the apoptosis rate was significantly decreased, and the expression of NF-κB p65 was down-regulated in group S (P＜0.05).Compared with group P, the apoptosis rate was significantly decreased, and the expression of NF-κB p65 was down-regulated in group S+P (P＜0.05).Conclusion JNK signaling pathway mediates paclitaxel-induced apoptosis in hippocampal neurons of rats, and the mechanism is likely related to inhibition of NF-κB pathway activation.

Objective To investigate the epidemiological characteristics of gonorrhea,and to analyze its temporal-spatial clustering in Zhejiang province.Methods Data on the incidence and demographic characteristics of gonorrhea in Zhejiang province from January 2004 to December 2012 were obtained from the China Information System for Disease Control and Prevention.The population,time and space distributions of gonorrhea were described.Epidemic curve and incidence maps were drawn.A space-time permutation scan statistic was used to detect space-time clusters,and spatial autocorrelation analysis was performed to calculate the Moran's I value and draw Local Indicators of Spatial Association (LISA) cluster maps.Results In Zhejiang province,a total of 199 956 cases of gonorrhea were reported with a decreasing trend in incidence rate from 2004 to 2012.The male to female ratio was 3.51:1 (155 634/44 331).People aged between 25 and 60 years accounted for 75.21％ of these patients,whereas the constituent ratio of people aged 0-1 years and ＞ 60 years increased with time.The incidence rate of gonorrhea was significantly higher in middle and north parts than in the south part of Zhejiang province,and higher in summer than in winter and spring with the peak incidence observed in August.Thirteen temporal-spatial clusters were detected,with the large clusters in Hangzhou,Huzhou,Ningbo,Shaoxing and their neighbor counties/cities/ districts,as well as some counties/cities/districts in Jinhua.All of the above clusters lasted 4.5 years.LISA maps showed an increasing trend in high-high aggregation counties/cities/districts which spread from the north to south part of Zhejiang province.Conclusion There is a temporal-spatial aggregation of gonorrhea in Zhejiang province with young and middle-aged men as the main affected population.

Clinical laboratory undergraduate program was switched from medicine to medical technology,the changes of personnel training program compel universities to adjust the curriculum system.Six domestic known as 211 universities who have laboratory and biology undergraduate programs were scrutinized and compared.Overall,the proportion of general courses covers 30％ of the credit hours in both clinical laboratory and biology programs.Ratio of these general education curriculums to professional core courses is as high as 1.90∶1 in clinical laboratory program.Also,there were very strong medical features and very weak medical technology characteristics in the basic course in clinical laboratory program.It suggested that the curriculum system nowadays cant conform to the new personnel training objective.A novel system from abroad should be adopted to optimize clinical laboratory program accord with the principles and concepts of wide caliber training model.

Objective To evaluate the effect of isoflurane preconditioning on myocardial ischemiareperfusion (I/R) injury induced by antioxidative remodeling in aged rats.Methods Fifty-six SPF aged male Sprague-Dawley rats,aged 22-24 months,weighing 420-480 g,were divided into 5 groups by a random number table method:sham operation group (S group,n=16),oxygen free radical scavenger tempol group (T group,n=16),myocardial I/R group (I/R group,n=8),tempol plus myocardial I/R group (TI group,n =8),and tempol plus isoflurane preconditioning plus myocardial I/R group (TII group,n=8).Tempol 125 mg · kg-1 · day-1 was intraperitoneally injected for 4 weeks in group T.Myocardial I/R was induced by ligation of anterior descending branch of left coronary artery for 30 min followed by 2-h reperfusion to establish myocardial I/R injury model in group I/R.The model was established after antioxidant treatment in group TI.In group TII,1.5％ isoflurane was inhaled for 30 min followed by 15-min washout,and then the model was established.Animals were sacrificed at the end of reperfusion,and the left ventricle was obtained for determination of the percentage of myocardial infarct size (by TTC staining),glutathione (GSH) and oxidized glutathione (GSSG) concentrations and superoxide dismutase (SOD) activity in S and T groups (by enzyme-linked immunosorbent assay),and expression of Cu/ZnSOD,MnSOD and nitrotyrosine in S and T groups (by Western blot).Results Compared with S and T groups,the percentage of myocardial infarct size was significantly increased in I/R,TI and TII groups (P＜ 0.05).Compared with I/R and TI groups,the percentage of myocardial infarct size was significantly decreased in group TII (P＜0.05).Compared with group S,no significant change was found in the expression of GSH or Cu/ZnSOD (P＞0.05),the expression of GSSG and nitrotyrosine was down-regulated,the GSH/GSSG ratio was increased,the activities of total SOD and MnSOD were increased,and the expression of MnSOD was up-regulated in group T (P＜0.05).Conclusion Isoflurane preconditioning can reduce myocardial I/R injury induced by antioxidative remodeling in aged rats.

OBJECTIVETo understand the temporal-spatial distribution of hand-foot-mouth disease in Zhejiang province, from May 2008 to June 2013.

METHODSThe cases number and incidence data of hand-foot-mouth disease from May 2008 to June 2013 for all the counties(cities, districts) in Zhejiang province were collected from China Information System for Disease Control and Prevention, total 511 643 cases. Temporal distribution of hand-foot-mouth disease was described, the incidence maps were drawn using Epimap software. Temporal-spatial clustering was analyzed by Satscan 9.0.1 software.Log likelihood ratio(LLR) was used to assess the clustering. The year-county (city, district)-specific relative risk(RR) of hand-foot-mouth disease were calculated. RR contour maps were drawn with Arcview GIS 3.3.

RESULTSIn Zhejiang province, from May 2008 to June 2013, the highest incidence rate was 270.81/100 000 (147 943/54 629 996) (2012 year) and the lowest incidence rate was 135.32/100 000 (69 285/51 199 987) (2009 year). The incidence in the eastern coastal areas (217.77/100 000(286 300/131 468 746)) including Ningbo, Taizhou, Wenzhou, was higher than the western mountain areas(168.11/100 000(98 016/58 304 266)) including Quzhou, Lishui, Jinhua. The epidemic curve showed two peaks, during April to July (101.15/100 000(320 144/316 497 516)) , and during October to November (23.30/100 000 (61 088/262 148 114)) .

RESULTSof temporal-spatial scan showed 10 temporal spatial aggregation areas, the strongest one was in Wenzhou city, south-east Zhejiang province, from July 2009 to June 2011(RR = 2.38, LLR = 10 650.75, P < 0.01). The relative risk maps from 2009 to 2012 were similar, the highest density areas were located in the eastern coastal Zhejiang: Longwan district, Wenzhou city (RR = 4.42 and 3.30) in 2009 and 2010 year, Pingyang county, Wenzhou city(RR = 3.04) in 2011 year, and Ninghai county, Ningbo city(RR = 2.97) in 2012.

CONCLUSIONThe eastern coastal area had a high incidence level of hand-foot-mouth disease in Zhejiang province, 2008-2013, with the peak during April to July. Temporal-spatial clustering were observed, the disease showed a distinct regional distribution feature, eastern coastal cluster areas and mid-west cluster areas were found.

ObjectiveTo analyze the characteristics of death and premature death of 4 major chronic diseases （cardiovascular and cerebrovascular diseases， malignant tumors， chronic respiratory diseases and diabetes） in Taizhou City from 2011 to 2018，and provide data basis for the government to formulate chronic disease prevention planning. MethodsThe death data of household registration residents in Taizhou City from 2011 to 2018 were derived from the Chronic Disease Surveillance Information Management System in Zhejiang Province. The death toll ratio of chronic diseases， the mortality rate of chronic diseases， the probability of premature death of chronic diseases were analyzed. The standardization rate was calculated six times in 2010. Population composition of the census. The Joinpoint Regression Program 4.2 software was used for calculating annual percent change （APC） and its statistical test results. ResultsFrom 2011 to 2018， there were 231 724 chronic disease deaths in Taizhou City， with a mortality rate of 486.52/10⁵ and a standardized mortality rate of 381.55/10⁵. The proportion of chronic disease deaths to total deaths was 79.89%， of which males were higher than females and rural areas were higher than urban areas.From 2011 to 2018， the standardized mortality and early death probability of cardiovascular and cerebrovascular diseases， malignant tumors and chronic respiratory diseases in Taizhou showed a downward trend （P<0.05）， the standardized mortality of diabetes （P=0.46） and the early death probability （P=0.22） did not decline， and the mortality of all age groups of the above four types of chronic diseases in rural areas was higher than that in urban areas. The mortality of the four types of chronic diseases from high to low are cardiovascular and cerebrovascular diseases， malignant tumors， chronic respiratory diseases and diabetes， and the mortality tends to increase with age. From 2011 to 2018， the probability of premature death from four types of chronic diseases in Taizhou City showed a downward trend， from 13.49% in 2011 to 10.49% in 2018， with an average annual decrease of 2.97%. The difference was statistically significant （t=‒5.83，P<0.05）. ConclusionChronic disease death is the main cause of death in Taizhou City. In order to reduce the mortality rate of chronic diseases， effective prevention and control measures for chronic diseases should be carried out， especially the prevention and control of diabetes and male chronic diseases.

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