Objective To investigate effects of thoracoscopic sternal elevation by using a steel bar(Nuss procedure) in the treatment of pectus excavatum in children.Methods Under the assistance of thoracoscopy,a substernal tunnel was created using a blunt dissector via a right thoracic incision.Then a steel bar was inserted under the sternum.After the bar was placed in position,it was turned over to elevate the deformed sternum and the anterior chest wall.Results The operation was completed successfully in all the 11 cases.The operating time ranged 50~85 min(mean, 67 min).The intraoperative blood loss ranged 5~20 ml(mean,10 ml).The surgical outcomes were classified as "excellent" in 9 cases,"good" in 1 case,and "fair" in 1.Follow-up observations for 2~15 months(mean,6.4 months) in 8 cases showed satisfactory appearance.Conclusions Thoracoscopic Nuss procedure for pectus excavatum in children is a minimally invasive technique with limited surgical trauma,minimal blood loss,simple performance,rapid recovery,and good cosmetic results,being worthy of recommendation.

OBJECTIVE To investigate risk factors and nursing protective measures controlling hospital infection in patients after neck dissection. METHODS The data of 116 patients after neck dissection from Aug 2000 to Aug 2005 were collected, and the hospital infection condition was analyzed in comparison with non-infection group. RESULTS Hospital infection rate was 18.97% (22/116) and case-time rate was 21.55%(25/116). Of 25 occasions in hospital infections, 48% were infection of operative incision and 24% were infection of respiratory tract. The risk factors for hospital infection in patients with neck dissection might be associated with patient's duration of hospitalization, history of chronic disease , age and invasive operation. CONCLUSIONS There is a high hospital infection incidence rate in patients after neck dissection , it is necessary to monitor high risk patients.

Objective To evaluate the rat model of dry eye induced by topical administration of benzalkonium chloride and compare the morphological characteristics of corneal and conjunctival tissues of the normal and model rats . Methods Topical administration of benzalkonium chloride (0.3%) twice per day for seven days to induce the rat model of dry eye.Pathology with HE and periodic acid-Schiff staining and transmission electron microscopy were performed to evaluate the corneal and conjunctival changes .Results The corneal and conjunctival epithelial cells were sloughed off , the number of goblet cells was decreased in the dry eye model .Microvilli were obviously lost in the surface epithelial cells of the dry eye rat cornea and conjunctiva compared with the normal rats , as indicated by the amount and size of microvilli . Conclusions The changes in the corneal and conjunctival epithelia of BAC-induced rat dry eye are similar to the changes in human dry eye .This rat model may play an essential role for dry eye studies in the future .

Background Studies showed that inflammation is associated with the pathogenesis and development of dry eyes,and tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) are key inflammatory factors.Thymosin β4 (Tβ4) plays a promoting effect on the migration of epithelial cells and anti-inflammatory action.However,the influences of Tβ4 on the repair of ocular surface in dry eyes are unelucidated.Objective This study was to investigate the regulation of Tβ4 to the expressions of TNF-o and IFN-γand its effect on the recovery of ocular surface in rat dry eye models.Methods The dry eye models were induced by topically administered of benzalkonium chloride (BAC) for consecutive 7 days in the left eyes of 50 SPF male SD rats,and 36 successful models were used in the experiment.Tβ4 solution (9 μg/ml),recombinant human epithelial growth factor (rhEGF)and sterile PBS at 5 μl was topically administered three times for consecutive 7 days in the Tβ4 group,rhEGF group and PBS group,and no drug was used in the model control group.The normal right eyes of rats served as the normal control group.The break-up time of tear film (BUT),corneal fluorescein staining score and Schirmer Ⅰ test (S I t)were examined and evaluated in the rats on the seventh day after administration of drugs.Then the rats were sacrificed by excessive anesthesia and the sections of the ocular surface were prepared.The morphology of the specimens was examined by hematoxylin and eosin staining,and the number of conjunctival gobelt cells was counted by periodic acidschiff staining.The ultrastructure of the corneal and conjunctival cells was examined under the transmission electron microscope.The expressions of TNF-α mRNA and IFN-γ mRNA and their proteins in conjunctiva tissue were quantified by quantitative real-time PCR and Western blot,respectively.The use and care of the animals followed by Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results The BUT was (10.42±0.66),(7.46±0.49),(8.71±0.50),(9.59±0.35) and (8.63± 0.68) seconds in the normal control group,model control group,rhEGF group,Tβ4 group and BUT group,showing a significant difference among the groups (F =5.65,P =0.00),and the BUT was evidently shortened in the model control group compared with the normal control group,while the BUT was significantly extended in the rhEGF group and Tβ4 group in comparison with the model control group (all at P＜0.05).No significant differences were found in the corneal fluorescence score and S I t among the groups (F =0.42,P =0.79;F =136.77,P =0.00).The corneal and conjunctival epithelium defect and corneal stromal edema were seen in the model control group,and the proliferation of the epithelial cells were found in the rhEGF group and Tβ4 group,with the irregulated arrangement of the cells.A considerable difference was seen in the number of conjunetival goblet cells among the groups (F=3.16,P =0.04),and the number of eonjunctival goblet cells in the rhEGF group and model control group was significantly less than that in the normal control group (all at P＜0.05),and no statistically significant difference was seen between Tβ4 group and normal control group (P ＞ 0.05).The swelling,mergence,crispation,rupture and decrease of the microvilli and micro fold were found in the model control group,and the repair of the cell microvilli was seen in the Tβ4 group.The expressions of the TNF-α mRNA,IFN-γ mRNA and their proteins in the conjunctiva were significantly different among the groups (F =43.08,371.69,34.27,43.52,all at P =0.00),the expressions of the inflammatory factors were significantly higher in the model control group compared with the normal control group,and these expressions were evidently lower in the Tβ4 group in comparison with the model control group and rhEGF group (all at P＜0.05).Conclusions The topical administration of Tβ4 solution can promote the repair of ocular surface by down-regulating the expression of TNF-α and IFN-γ in conjunctiva and stablize the tear film in rat dry eyes.

Objective To understand the prevalence of Toxoplasma gondii infection and related factors among special popu?lation in Changzhou City,so as to provide the evidence for formulating toxoplasmosis prevention measures. Methods The ve?nous blood was collected from participants in Changzhou City for detecting IgG and IgM antibodies against T. gondii by ELISA;and an epidemiological questionnaire investigation was also conducted. Results Among the total 400 respondents detected,the prevalence of T. gondii infection was 15.0%and the positive rates of IgG and IgM were 15.0%and 0.8%,respectively. The T. gondii infection rates of pregnant women,HIV/AIDS patients,patients with neoplasia,and livestock and poultry breeding and processing workers were 11.0%,11.0%,24.0%and 14.0%,respectively. As the age increased,the infection rate of T. gondii showed an upward trend,with the highest infection rate(21.6%)among the group of respondents aged above 50 years. The in?fection rates of groups with different education levels were statistically different(χ2=11.443,P<0.05),and there was a trend that the infection rate decreased with the increase of education level. The prevalence of T. gondii infection in pregnant women was not significantly associated with the number of pregnancies and gestational age. The infection rate of T. gondii in the live?stock and poultry breeding and processing workers increased with the length of their working years. Conclusions The preva?lence of T. gondii infection among the special population in Changzhou City is high. Therefore,it is necessary to enhance the health education on the knowledge and information of prevention and control of toxoplasmosis,and to improve the awareness of personal protection,the hygiene practices and diet habits. In addition,more attention should be paid to T. gondii monitoring in the special population.

Objective To investigate the prevalence of Toxoplasma gondii infection and related knowledge and behavior among special population in Changzhou City,so as to provide the evidence for formulating effective measures of toxoplasmosis prevention. Methods The pregnant women and patients with neoplasia in Changzhou hospitals,and livestock and poultry breeding or processing workers were selected as the subjects of the study. Venous blood samples were collected from each partici-pant for detecting IgG and IgM antibodies against T. gondii by ELISA. A questionnaire investigation on knowledge and behavior about T. gondii infection was conducted. Results Among the total 300 respondents investigated from March to May,2015,the prevalence of T. gondii infection was 16.3％(49/300). Totally 52 respondents knew the knowledge about the prevention and con-trol of T. gondii infection with an awareness rate of 17.3％(52/300). The proportion of participants who frequently contacted with cats/dogs(25.0％,13/52)in the group who knew the knowledge about the prevention and control of T. gondii infection was lower than that of participants(50.8％,126/248)in the group who did not know the knowledge about the prevention and control of T. gondii infection,and the difference was statistically significant(X2=11.51,P<0.05). The proportion of participants sepa-rating chopping boards for raw and cooked food(61.5％,32/52)in the group who knew the knowledge about the prevention and control of T. gondii infection was statistically higher than that of the participants(9.3％,23/248)in the group who did not know the knowledge about the prevention and control of T. gondii infection,and the difference was statistically significant (X2=78.43,P<0.001). There was a negative correlation between the awareness rate of the knowledge about the prevention and con-trol of T. gondii infection and the infection rate of T. gondii. The infection rate of T. gondii(5.8％,3/52)in the group who knew the knowledge about the prevention and control of T. gondii infection was lower than that(18.5％,46/248)of the group who did not know the knowledge about the prevention and control of T. gondii infection,and the difference was statistically significant (X2=5.14,P<0.05). Conclusions The awareness rate of the knowledge about the prevention and control of T. gondii infec-tion among special population in Changzhou City is low. The health education on the knowledge of the prevention and control of toxoplasmosis should be strengthened,in order to improve the awareness of personal hygiene and change the unhealthy lifestyles and dietary habits.

Objective:To analyze the prevalence of influenza B virus and its HA and NA genes characteristics during 2017—2020 in Songjiang district, Shanghai.Methods:Samples from suspected cases of influenza were detected using real-time fluorescence reverse transcription-polymerase chain reaction. Influenza B virus positive specimens were cultured by MDCK cells and embryonated chicken eggs. The hamagglutinin (HA) and neuraminidase (NA) genes of influenza virus B strains were sequenced and analyzed for gene evolution and amino acid variation. The sensitivity of the strains to oseltamivir and zanamivir was studied by neuraminidase inhibition assay.Results:The positive rate of influenza B virus in Songjiang district from 2017 to 2020 was 14.24% (506/3554). Influenza B virus circulated mainly in winter-spring season and alternated between B/Victoria and B/Yamagata subtypes. Subclade 1A (△3) B was the predominant Victoria lineage circulating in Songjiang district. Otherwise, the remaining strains belonged to subclade 1A(△2)and clade 1A. Compared with vaccine strain B/Brisbane/60/2008, the nucleotide homology of circulating strains HA (NA) was 97.62%~98.19% (98.11%~98.78%). The mutations of HA in 1A (△3) B subclade mainly were in 120 loop and 160 loop. All the Yamagata strains circulating in Songjiang district belonged to clade 3. Compared with vaccine strain B/Phuket/3073/2013, the nucleotide homology of HA and NA were 98.71%~99.04% and 98.69%~99.27%, respectively. No amino acid change was found in the antigenic clusters. Neuraminidase inhibition assay showed that the influenza B virus strains were sensitive to both oseltamivir and zanamivir.Conclusions:Inconsistence of the antigenicity between the vaccine strains and the circulating strains during 2017—2020, influenza B virus should be persistently monitored, including the epidemic situation and the etiological characteristics, which might be helpful in vaccine screening and drug development.

Objective:To evaluate the association between dietary pattern and type 2 diabetes mellitus (T2DM) in local residents aged 40 years and above in Songjiang district of Shanghai.Methods:Data was obtained from the baseline investigation of Shanghai Peak-Plan cohort. According to inclusion and exclusion criteria, we selected people with T2DM as the case group, and people without T2DM as controls, matched with gender, age and alcohol intake status. Dietary patterns were established by factor analysis. Conditional logistic regression model (CLRM) was used to explore the relationship between different dietary patterns and T2DM, as well as the association between multiplicative interactions of dietary patterns and T2DM.Results:We used factor analysis to obtain six dietary patterns: including meat, desserts-coarse cereals, condiment-egg, beverage, cereals-tubers and fruit-vegetable. Data from multivariate condition logistic regression suggested that condiment-egg patterns as ( OR=0.543, 95 %CI: 0.377-0.781), beverage ( OR=0.590, 95 %CI: 0.409-0.852), cereals-tubers ( OR=0.592, 95 %CI: 0.414-0.848), fruit-vegetable ( OR=0.604, 95 %CI: 0.417-0.876) were associated with the reduced risks for T2DM. After analyzing the multiplicative interactions between dietary patterns, there were three interaction items associated with T2DM with statistical significances: the multiplicative interaction between meat pattern and condiments-egg pattern was related with the increased risk for T2MD, and the multiplicative interactions between cereal-tubers pattern, meat pattern between cereal-tubers pattern and fruit-vegetable pattern were related with the reduced risks for T2MD. Conclusions:In the six dietary pattern under study, cereals-tubers pattern undwr studly, fruit-vegetable pattern might be more practical in preventing T2DM. In addition, the dietary pattern with cereals and potatos as the main ingredients, appropriate meat and reduced condiment intake might also play positive roles in reducing the risk for T2DM.

Urbanization has increased the population density and exposure to environmental risk factors, accelerated changes of people's lifestyles and aggravated population health disparities. A general population cohort in eastern China, Shanghai Suburban Adult Cohort and Biobank (SSACB), was established to understand the incidence and prevalence of chronic and non-communicable diseases, and identify environmental, lifestyle, and genetic risk factors in adults (aged 20-74 years old) living in the suburban of Shanghai, where urbanization process is rapid, and provide evidence for the precise prevention and control of chronic diseases. The cohort study was launched by School of Public Health,Fudan University depended on "Discipline Construction Project Shanghai Peak for Public Health and Preventive Medicine". Four districts in Shanghai, i.e. Songjiang, Jiading, Minhang and Xuhui, were selected. A total of 69 116 permanent residents aged 20-74 years were recruited. Epidemiological investigation, physical examination and laboratory tests were conducted to collect the basic information of the study subjects. Blood and urine samples were collected from them to establish a biobank. An information platform was established, from which the baseline data of the study subjects in electronic medical record system, chronic disease management system, cancer registry, infectious disease reporting system, and death registry can be shared. This paper introduces the design concept, process and future plan of SSACB.