Objective To explore the association between air pollution and the pregnancy outcome in a severe air pollution city and to provide the evidence for health related policy-making.Methods The subject population included the newborns from 1997 to 2004 in Taiyuan and the data of air pollution in the same time were collected.Logistic regression was used to analyze OR in the case-control design.Results Statistically,the prevalence of premature birth,birth defects and the mortality of infants and fetuses were significantly associated with PM10 air pollution.For premature birth,odds ratios were ranged from 1.17 to 1.76,the highest OR,1.76(95%CI:1.64-1.90),was found during the first 3 months of pregnancy.For birth defects,odds ratios were from 1.37 to 1.67,the highest OR,1.67(95%CI:1.28-2.17),was found in the third month.Concerning mortality of infants and fetuses,it only showed a significant association in the third trimester and the OR was 1.66(95%CI:1.26-2.19).Regarding SO2 air pollution,it only showed the significant effect on premature birth during the first and second month,the odds ratios were 1.27(95%CI:1.21-1.34)and 1.07(95%CI:1.01-1.14)respectively.Conclusion Air pollution in the investigated city had an adverse effect on the pregnancy outcome and the stringent measures should be taken to abate the air pollution and to reduce the risk for reproductive health.

Objective To observe effects of shuxuetong injection combined with edaravone injection on the neurological, sermn lipid, c-reactive protein and interleukin 6 Levels in serum in patients with acute cerebral infarction. Methods 100 patients with acute cerebral infarction were randomly recruited into a control group and a treatment group by means of random number table. The control group was treated with 30mg edaravone injection, which was added to 100 ml normal saline, twice a day, continuous therapy for 14 days, and the treatment group was treated with 6mg shuxuetong injection, which was added to 2S0 ml normal saline, once a day, continuous therapy for 14 days based on the control group. The neurological was observed, triglyceride (TG) , cholesterol (TO , low density lipoprotein cholesterol (LDL-C) , high density lipoprotein cholesterol (HDL-C) , c-reactive protein and interleukin 6 Levels in serum were detected before and after the treatment.Results Compared with the control group, neurological deficit score, c-reactive protein and interleukin 6 Levels in serum in the treatment group decreased significantly (χ2=4.351, 3.81, 3.617 respectively, P<0.05) .TG, TC, LDL-C in serum in the treatment group were lower than that of the control group (χ2=2.135,P<0.01; χ2=3.061, 3.655, P<0.05 ); HDL-C in serum was higher than that of the control group (χ2=2.762,P<0.01) . The total effective rate of the treatment group and the control group was 86.0% and 66.0% respectively, there was a significant difference (χ2=3.393, P<0.05) . Conclusion Shuxuetong injection combined with edaravone injection is better than edaravone injection to treat acute cerebral infarction.

Objective To compare the different expression patterns of survivin and caspase-3 between the larger part and the smaller part of the dissymmetric enlarged prostates in BPH patients, and to clarify the role of apoptosis in BPH etiology. Methods BPH tissues from 25 patients were embedded in paraffin. The specimens constituted of two prostate parts from each patient. One part was from the larger enlarged gland and the other was from the smaller enlarged counterpart. 50 paraf-fin blocks were cut into sections and stained with survivin and caspase-3 polyclonal antibodies against human. All the data was analyzed by SPSS13.0 software. Results Survivin immunoreactivity was localized in prostatic cell nuclei. Survivin expression in larger enlarged parts (22.08±16. 33)0% was significantly higher than the smaller parts (7. 645±5. 45)%(P<0.01). Positive nuclear or cytoplasm staining was also observed in the Caspase-3 immunoreactivity. Caspase-3 expression was higher in smaller enlarged parts (51. 525±27. 27%) than in larger enlarged parts (33. 125±21.01%) (P< 0.01). Survivin expression in larger part of the enlarged prostates was inversely correlated with caspase-3 expression (r=-0. 474, P<0. 05). However, in smaller part of the enlarged prostates, the expression of the two factors had no relation (r=-0. 313,P>0. 05). Conclusions Survivin and caspase-3 expression patterns are different in the two parts of the dissymmetric enlarged prostates. These different patterns indicate apoptosis playing an important role in BPH development.

Objective To assess the importance of initial resuscitation, prevention and management of the early complication in acute cervical spine injury. Methods Initial resuscitation of 715 early complications of 10 types and their prevention and management in 194 cases with acute cervical spinal cord injury admitted from 1996 to 1998 were reviewed. Results Mortality in early stage could be markedly reduced with routine and normal initial resuscitation, pulmonary complications were the main cause of death. Early complications delayed the possible surgical treatment, affected the treatment results, increased the cost and duration of hospitalization and difficulty of rehabilitation. Conclusions Early complications of cervical spine injury mostly occur in the first few days and can be predicted. Proper prevention and treatment of it will benefit the recovery of the neural lesion and following rehabilitation.

Aim To observe the anti-tumor activity and the mechanism of heparan sulfate proteoglycan(HSPG) on C3H mice transplanted tumors.Methods Tumor model was established and randomly divided into five groups.HSPG groups(5,10,50 mg?kg-1),positive group and control group,intraperitoneal injection was performed once a day for 22 days and the volume of tumors was measured.Mice were treated on 24th day,then tumor weight was examined,thymus index,and spleen index were calculated,the apoptosis was determined by TdT-mediated Dutp nick end labeling(TUNEL) assay in situ,the expression of vascular endothelial growth factor(VEGF) was detected by immunohistochemistry.Results The tumor volume in HSPG groups was reduced without the decrease of thymus index,spleen index.TUNEL assay in situ showed numerous heavy blue apoptosis cells in the HSPG groups significantly higher than in control groups.The tumors in HSPG groups showed significantly lower VEGF expression than those in control group.Conclusion HSPG had significant anti-tumor effects on C3H mice transplantable breast cancer.The mechanisms may be associated with the effects of inducing tumor cell apoptosis and inhibiting the VEGF expression.

Objective To detect Mycobacterium tuberculosis (MTB)and its resistance against rifampin (RIF ) by applying Xpert MTB/RIF assay in the clinical samples from patients with extrapulmonary tuberculosis,and to discuss the value of this assay in extrapulmonary tuberculosis. Methods Totally 300 clinical samples from the patients who were highly suspected with extrapulmonary tuberculosis and hospitalized in Department of Tuberculosis Section,Shanghai Public Health Clinical Center of Fudan University from May 2014 to May 2015 were collected.Smear and fluorescence staining microscopy,MGIT 960 BACTEC liquid culture,Xpert MTB/RIF assay were applied to detect MTB in these samples.Meanwhile,all the patients received the peripheral blood T-cell spot of tuberculosis test (T-SPOT.TB).The sensitivity and specificity of Xpert MTB/RIF assay for MTB and its resistance against rifampin (RIF)in extrapulmonary tuberculosis samples were evaluated.The measurement data of two independent samples were analyzed by using t test and enumeration data were analyzed by usingχ2 test.Results Totally 282 out of 300 clinical samples from patients with extrapulmonary tuberculosis were included in this study,and 62.7% were male with average age of (32.1 ±24.6 )years and 37.3%were female with average age of (37.8 ±21 .0)years.When MGIT 960 BACTEC liquid culture results were considered as standard diagnosis,the sensitivity,specificity,positive predictive value and negative predictive value of Xpert MTB/RIF assay were 53.8% (95 %CI :37.4%—69.6%),100.0% (95 %CI :86.3%—100.0%),100.0% (95 %CI :80.8%—100.0%)and 63.3% (95 %CI :48.3%—76.2%), respectively.The sensitivity of Xpert MTB/RIF assay in smear-positive/culture-positive samples was 92.3% (95 %CI :62.1 %— 99.6%),while that in smear-negative/culture-positive samples was only 34.6% (95 %CI :17.9%— 55 .6%).Xpert MTB/RIF assay had advantage for detecting MTB in fine needle aspirates,pus,stool and urine,but not in serous effusion and cerebrospinal fluid.However,the sensitivities of MGIT BACTEC 960 liquid culture,fluorescence smear and T-SPOT.TB were 25 .8%, 21 .8% and 70.2%,respectively,and the specificities were 95 .5 %,90.3% and 51 .6%,respectively. The diagnostic value of Xpert MTB/RIF assay was not significantly different from those of MGIT BACTEC 960 liquid culture and fluorescence smear (χ2 =0.61 and 3.45 ,respectively;both P >0.05 ), while it was significantly different from T-SPOT.TB (χ2 =50.58,P <0.05).The sensitivity of T-SPOT. TB was significantly superior to Xpert MTB/RIF assay,but the specificity was relatively low.The sensitivity and specificity of Xpert MTB/RIF assay in RIF resistance detection were 71 .4% (95 %CI :30.3%—94.9%)and 100.0% (95 %CI :86.7%—100.0%),respectively.Conclusions The sensitivity and specificity of Xpert MTB/RIF assay in detecting MTB in fine needle aspirates,pus,stool and urine are relatively high,but not in serous effusion and cerebrospinal fluid.However,the pros of rapid detection and the ability of detecting RIF resistance are useful for the diagnose of extrapulmonary tuberculosis in clinical settings.

Objective Comparing three screening schemes of colorectal cancer in general population to provide scientific basis for coiorectal cancer screening in communities. Methods Questionnaire screening among high-risk population and immunoassay fecal occult blood test (FOBT) were used for colorectal cancer detection. Colonescopy and pathological test were considered as gold standard of screening results. Results Nine coloreetal cancers and 796 colorectal adenomas were detected in 68 953 participants. Mean onset age of coloreetal adenoma was 7. 7 years earlier than colorectal cancer. For questionnaire and FOBT,the sensitivity was 44.4% ,77.8% and 100.0% ,while the specificity was 98.6%, 95.5% and 94.4%, respectively. The Youden index of questionnaire, FOBT, and questionnaire-FOBT sequential method was 0.4,0.7,and 0.9,and the likelihood ratio ( +/- ) was 32.7/0.6,17. 2/0.2,and 17.8/0.0,respectively. When 50 was used as initial age of screening, screening receivers accounted for 9.7% ,and 66. 7% colorectal cancer could be detected. When 40 was used as initial age of screening, screening receivers and cost increased by 57.1% ,and only 11.1% more patients with colorectal cancer could be detected. Conclusions Questionnaire-FOBT sequential method has high sensitivity and specificity of colorectal cancer screening. Screening at 50 year-old may be better for community residents. The time of colorectal adenoma developed to colorectal cancer is about 8 years.

Objective To study the expression of miR-146a in the serum of sepsis and the diagnostic value.Methods Serum miR-146a expression was detected in 98 patients diagnosed with sepsis,69 patients with severe sepsis and 30 healthy controls.ROC plots were used to evaluate the diagnostic value.Results The expression of miR-146a was decreased successively in healthy group,general sepsis group and severe sepsis group.In the diagnosis of sepsis,at the optimal expression cutoff miR-146a value of 0.805,the sensitivity was 0.967 and specificity 0.940,with an AUC of 0.983.In the diagnosis of sepsis severity degree,at the optimal expression cutoff miR-146a value of 0.530,the sensitivity was 0.796 and specificity 0.986,with an AUC of 0.943.Conclusion miR-146a can be a potential marker in diagnosis of sepsis and severity degree .

Objective: To investigate the awareness of nutrition and health knowledge among adult residents in Hangzhou City, so as to provide insights into improving human nutrition and health. Methods: The permanent residents at ages of 18 to 64 years were sampled using a multi-stage stratified random sampling method from 13 counties (districts) of Hangzhou City from June to July, 2021. Participants' demographics and awareness of nutrition and health knowledge were collected using the Questionnaire on Nutrition and Health Knowledge among Chinese Adult Residents, and the awareness of nutrition and health knowledge was analyzed among participants with different demographic features. Results: A total of 5 106 questionnaires were allocated, and 4 920 valid questionnaires were recovered, with an effective recovery rate of 96.36%. The respondents included 2 575 men (52.34%) and 2 345 women (47.66%), and had a mean age of (39.89±12.85) years. The median score of nutrition and health knowledge was 67.50 (interquartile range, 16.50) points, and the awareness of nutrition and health knowledge was 24.49%, while the awareness of dietary recommendation, food characteristics, nutrition and disease, food choice and food safety was 15.89%, 16.77%, 54.17%, 26.36% and 60.69%, respectively. The awareness of nutrition and health knowledge was significantly lower among men than among women (21.01% vs. 28.32%, P<0.05), and among urban residents than among rural residents (22.94% vs. 27.34%, P<0.05). There were significant differences in the awareness of nutrition and health knowledge among residents in terms of age, occupation and educational level (P<0.05). Conclusions Age, gender, region, occupation and educational level may affect the awareness of nutrition and health knowledge among adult residents in Hangzhou City. Health education about nutrition and health knowledge requires to be reinforced with adaptations to characteristics of residents.

Objective:This study aimed to investigate the time duration of norovirus shedding among day-care children and students during norovirus outbreaks， as well as influencing factors affecting the viral shedding. Methods:Suspected cases of norovirus infection and their close contacts were collected from child care and school settings during norovirus outbreaks in Xuhui District， Shanghai， from 2017 through 2019. Specimens were detected using real-time RT-PCR to determine whether children had been infected with norovirus. Subsequently， further specimens were collected every 3-7 days from infected children until specimens tested negative for norovirus. Results:A total of 76 outbreaks were reported involving 1 014 suspected cases. In the 421 suspected cases， 311 confirmed cases were diagnosed after examination. Furthermore， a total of 58 confirmed cases participated in this study with informed consent， with a participation rate of 18.65%. The average time duration of norovirus shedding was （16.24±13.80） days， in which 79.31% had viral shedding more than 7 days， 37.93% more than 14 days and 17.24% more than 21 days. A Cox proportional-hazards model showed that children with more severe symptoms （HR=2.06，P=0.040）， day-care children （HR=4.13，P=0.012）， and confirmed cases in 2019 （HR=0.11，P<0.001） had longer duration of viral shedding. Conclusion:Children may remain shedding norovirus after their recovery and back to class. Improvement in sanitation for these recovered children in child care and schools is especially necessary， which may avert secondary transmission.