Objective To analyze the epidemiological characteristics of adverse events following immunization(AEFI) ofthree types of hepatitis B vaccines(CHO, Saccharomyces cerevisiae and Hansenula polymorpha) in Fujian Province from 2019to 2023, and evaluate their safety. Methods The AEFI case data and vaccination data of hepatitis B vaccines reported inFujian Province from 2019 to 2023 were collected through the Chinese Immunization Planning Information ManagementSystem. The occurrence characteristics, incidence rates and other indicators of AEFI related to hepatitis B vaccines wereanalyzed by using descriptive analysis methods. Results In Fujian Province from 2019 to 2023, there were 677 reportedcases of AEFI related to hepatitis B vaccines, with an AEFI reported incidence of 7. 44 per 100 000 doses. The male-to-female ratio was 1. 20∶1, and the age distribution was mainly in the group of less than 1 year old. The reported incidence ofcommon adverse reactions was 6. 24 per 100 000 doses, and the reported incidence of rare adverse reactions was 0. 96 per100 000 doses. Rare vaccine reaction cases were mainly anaphylactic reaction. There were statistically significant differencesin the reported incidence of common adverse reactions and allergic skin rashes among the three types of hepatitis B vaccines(χ~2= 111. 587 and 13. 284, respectively, each P < 0. 05). Conclusion The reported incidence of AEFI related to hepatitisB vaccines in Fujian Province has been rare from 2019 to 2023, falling within the expected range of WHO, indicating goodsafety of the vaccines.

OBJECTIVE: To construct a plant effective expression vector driven by a fruit specific promoter for the expression of hepatitis B virus surface antigen (HBsAg), to further improve the expression of exogenous gene in plant, and to prepare for the development of an effective anti-hepatitis vaccine. METHODS: Tomato fruit-specific promoters' gene 2A12 and E8 were respectively introduced to pBPFOmega7 to form pB2A12 and pBE8. The DNA fragment containing HBsAg-s gene from plasmid YEP-HBs was inserted respectively into pB2A12 and pBE8 to form pB2A12-HBs and pBE8-HBs. The fragment containing "p35S+2A12+Omega+HBsAg-s+Tnos" of the pB2A12-HBs was sub-cloned into plasmid pCAMBIA1301 to yield the reconstructed plant binary expression plasmid pCAM2A12-HBs, and the fragment containing "p35S+E8+Omega+HBsAg-s+Tnos" of the pBE8-HBs was sub-cloned into plasmid pCAMBIA1301 to yield the plasmid pCAME8-HBs. The inserted gene HBsAg and fruit-specific promoters in the reconstructed plant binary expression vectors were confirmed by sequencing. Then, pCAM2A12-HBs and pCAME8-HBs were directly introduced into Agrobacterium tumefaciens strain EHA105. RESULTS: Digestion with restriction enzymes proved that all recombinant vectors had the inserts with expected length of the target fragments, and the sequencing results were confirmed correct. CONCLUSION: In this study, plant expression vector containing HBsAg gene driven by fruit specific promoter and CaMV35s promoter was successfully constructed.

Information of metabolic enzymes and transporters, physiological parameters of animals and demography of Chinese people were integrated to establish a digital liver model (DLM) based on metabolism and transporter and coded with VBA. Clearance and drug-drug interaction (DDI) of candidate drugs in animal and human could be predicted based on the pharmacokinetic data obtained from in vitro and in vivo experiments. Pravastatin and pitavastatin were selected as the samples to examine this model, where their clearance and their DDI with cyclosporine were predicted. The results showed that the predicted values of median parameters in same species were within twofold of observed values for 83.3% (5/6). The program's successful prediction in DDI tendency might indicate its application in optimizing the dosage regimen and reducing the risk of clinical trial.

Objective To introduce the clinical experience and investigate the significance and safety of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy.Methods A retrospective analysis was performed on 275 patients who underwent thyroidectomy among which 135 patients were treated by capsular dissection technique and harmonic scalpel (harmonic scalpel group),the other 140 patients were treated by electric knife and traditional ligation (traditional group).The thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications were compared between two groups.Results In harmonic scalpel group,the thyroidectomy operative time of total thyroidectomy and subtotal thyroidectomy was significantly shorter than that in traditional group [(50.0±6.9) min vs.(82.0± 14.4) min,(39.9±6.6) min vs.(73.1 ± 14.5) min](P＜0.01).The intraoperative bleeding volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(18.7 ± 10.9) ml vs.(41.9 ± 15.6) ml,(17.7 ± 9.3) ml vs.(42.2 ± 14.6) ml] (P ＜ 0.01).The postoperative drainage volume of total thyroidectomy and subtotal thyroidectomy in harmonic scalpel group was significantly lower than that in traditional group [(40.7 ± 11.7) ml vs.(53.9 ± 17.5) ml,(42.7 ± 14.5) ml vs.(61.8 ±22.9) ml](P＜0.01).The rate of temporary hypoparathyroidism and temporary recurrent laryngeal nerve palsy had no significant difference between two groups (P ＞ 0.05).Conclusions Application of harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy can significantly reduce thyroidectomy operative time,intraoperative bleeding volume,postoperative drainage volume and surgical complications.Harmonic scalpel combined with meticulous capsular dissection technique in thyroidectomy should be widely used.

Objective To explore the causes and risk factors of cerebral stroke in young adults.Method The clinical data of 392 young patients (≤45 years old) of cerebral stroke were analyzed retrospectively,and analyzed its causes and risk factors. Results The most common etiology in youth ischemic cerebral stroke was atherosclerosis (48.70%, 112/230), followed by cardiogenic cerebral embolism (13.04% ,30/230). The main cause in youth hemorrhagic cerebral stroke was hypertension (39.51% ,64/162), followed by intracranial aneurysm(14.81%,24/162) and cerebral vascular malformation(10.49%,17/162). The main risk factors for young patients with cerebral stroke were hypertension (40.31% ,158/392),smoking (36.22%, 142/392),drinking (33.93%, 133/392),prior stroke (13.78% ,54/392),hyperlipidemia (11.99% ,47/392), others were heart disease (9.69% ,38/392), family history of strokehistories (8.16%,32/392) and diabetes (5.36%,21/392) and so on. As far as 160 young patients and 110 young patients were detected separately homocysteine and anticardiolipin antibody, positive rates were 39.38%(63/160) and 3.64%(4/110) respectively. Conclusions The main etiological factor of ischemic cerebral stroke in young adults is atherosclerosis, cardiogenic cerebral embolism is followed. The main etiological factor of hemorrhagic cerebral stroke in young adults is hypertension, intracranial aneurysm and cerebral vascular malformation are followed. The order of risk factors for the young patients with cerebralstroke were hypertension, smoking,drinking, prior stroke, hyperlipidemia,heart disease, family history of stroke-histories, diabetes and hyperhomocysteinemia.

Objective To improve the diagnosis and treatment of liver trauma. Methods We retrospectively analyzed different therapeutic means on liver trauma including 79 cases with operative treatment and 27 cases with nonoperative treatment. Results In nonoperative treatment group, 25 cases were cured, 2 cases died. In operative treatment group, 73 cases were cured, 6 cases died. Cure rate was 92.5%(98/106), mortality was 7.5%(8/106). 5 cases died of major blood vessels rupture, 3 cases died on multiple organ function failure. Postoperative complications included 3 cases of subphrenic infection, 10 cases of hepatic abscess, 8 cases of pleural hydrops, 7 cases of incisional infection. Conclutions Type I of liver trauma can be treated by nonoperation, type Ⅱ～Ⅳ of blunt liver trauma can be treated by nonoperation on the condition of intensive monitoring. Type Ⅱ～ Ⅵ of liver trauma should be operated on emergently in case of massive intraabdominal bleeding and combined organ injury.

Objective To observe the effects of baicalin on forms of hepatic tissue, liver apoptosis, mRNA expressions of iNOS, NF-κB and protein expression of Caspase-3 in rats with ischemia reperfusion injury; To discuss its mechanism of action.Methods The rat models of liver ischemia reperfusion were performed according to the Pringle's method. Rats were randomly divided into sham-operation group, model group and baicalin group. Sham-operation group and model group were given normal saline for gavage, while baicalin group was given baicalin for gavage. Morphological characteristic was observed by HE staining. Hepatocyte apoptosis was determined by TUNEL. The mRNA expressions of iNOS and NF-κB were determined by RT-PCR. The protein expression of Caspase-3 was determined by Western blot.Results Compared with the sham-operation group, mRNA expressions of iNOS and NF-κB and the protein expression of Caspase-3 in the model group increased, as well as liver apoptosis rate (P<0.05,P<0.01); compared with the model group, mRNA expressions of iNOS and NF-κB and the protein expression of Caspase-3 in the baicalin group decreased, as well as liver apoptosis rate (P<0.05), and the hepatic lesion significantly improved in the baicalin group.Conclusion Baicalin can restrain Caspase-3 induced apoptosis by reducing the expressions of iNOS and NF-κB, with a purpose to realize the hepatoprotective effect for liver of rats with ischemia reperfusion injury.

Objective We investigated female patients with idiopathic inflammatory myopathy (ⅡM),including polymyositis (PM) and dermatomyositis (DM) to understand if the activity and treatment of ⅡM affected the fetus outcomes as well as the correlation between pregnancy and the pathogenesis of ⅡM.Methods Questionnaires were designed,including patients' fertility,the activity and treatment of ⅡM during pregnancy and after childbirth,and the fetal outcomes.The questionnaires were conducted on 75 female patients (22-53 years old),who once hospitalized at Peking Union Medical College Hospital from 2007 to 2013.The mutual effect between the ⅡM disease activity,pregnancy and the fetus were compared by Chi square.Results Seventy-five patients (19 PM,56 DM) had 144 pregnancies,but only 18 of them became pregnant after the onset of the disease.There were two patients had onset of DM during pregnancy,and two patients suffered from DM after delivery or abortion within one month.The rates of abnormal pregnancy in patients with pregnancy before the onset of ⅡM was significantly lower than those with pregnancy after the onset of ⅡM (x2=10.21,P=0.001).Of the 18 pregnancies after the onset of ⅡM,7 had active ⅡM during pregnancy,3 of them flareddue to pregnancy.The 5 abnormal pregnancies (5/7) were seen in seven pregnancies totally,including two spontaneous abortion,one embryo diapause and two premature births.While of the other 11 pregnanciesin stable condition had only 2 abnormal pregnancies (2/11),including one fetus ended prematurely and one embryo diapause.The fetal outcomes were significantly related to the status of illness (x2=5.103,P=0.024).Two patients became pregant after the onset of the disease,both of them had stable disease before pregnancy.However,the disease became active during the pregnancies.One of them flared with rash during two pregnancies.The fetal end in embryo diapause and premature birth (33+4 weeks),respectively.Another flared with muscle weakness at five months of gestation.The fetal ended in premature birth (36+3 weeks).Two patients had onset of DM within one month following the delivery and voluntary abortion.Patients with active disease had taken medium to large doses of prednisone (30-60 mg) orally,in combination with hydroxychloroquine (0.2 bid) or without.In addition,two patients administrated with intravenous gamma globulin (IVIG) at low dose,whose illness condition had been well controlled.Conclusion Pregnancies after the onset of ⅡM tend to end with spontaneous abortion,embryo diapause,premature birth.The fetal outcomes are significantly related to disease activity.When ⅡM flared during pregnancy,IVIG might be the most effective and safe treatment,combined with corticosteroids.

Objective To evaluate different treatment modaltities for limited (local) hepatic metastasis in patients of colonic carcinoma Methods We conducted a retrospective analysis on 81 cases of colonic cancer suffering from hepatic local metastasis from 1987 to 2000 Results The 1、3、5 year survival rate was 85%、 46% and 32% respectively for patients underwent resection of metastatic liver cancer, and 26%、 0 and 0, respectively for those not having the metastatic liver cancer resected ( P 0 05) Conclusion Resection or ablation therapy promises a much longer long term survival than do nothing in colonic cancer patients with local liver metastatic tumor

BACKGROUND: As a kind of unwounded biomagnetism technique, magnetoencephalography (MEG) relfects immediate information of cerebral function by using magnetic source imaging through recording changes of magnetic field of neurocytes under different functional status.OBJECTIVE: To investigate the practicability of magnetoencephalography (MEG) imaging in localizing sensory-motor cortex for brain tumour surgery in 36 patients.DESIGN: Observational study.SETTING: Department of Neurosurgery, Guangdong Provincial Hospital of Traditional Chinese Medicine.PARTICTPANTS: From Janury 2003 to April 2006, 36 patients (17 male and 19 female) with brain tumors selected from Deparment of Neurosurgery, Guangdong 999 Brain Hospital underwent surgery with MEG-guided neuronavigation in the region of the sensory and motor cortex. Ages of the patients ranged from 13 to 70 years. Among the 36 patients, 14 with gliomas (including 5 highly malignant gliomas), 19 with meningomas, 1 with spongy angioma and 2 with adenocarcinoma (due to the metastasis of brain tumor). All patients and relatives provided the confirmed consent and the experiment provided by the local ethics committee.METHODS: A 148-channel biomagnetometer (4-D Neuroimaging, USA) was used to determine motor and/or senory cortex with sampling rate 678.17 Hz, high-pass filter 1.0 Hz and bandwith 200 Hz. MRI images were acquired using a Philips Gyroscan Intera 1.5T MR tomography. And then, the functional maps were transfered to the neuronavigation system for the treatment of brain tumor. All patietns followed up by further consultation and telephone call in 2-26 months after operation.MAIN OUTCOME MEASURES : Operative outcome and prognosis.RESULTS: MEG demonstrated that the tumor lesion changed the sensory-motor cortex in various degrees for the 36 patients. Brain tumors were resected completely in 34 cases. At 2-26 months after surgery, neurological deficits fully recovered in 19 cases, unchanged in 15 cases and deteriorated in 2 cases.CONCLUSION: MEG was found to be practical and useful in localizing sensory-motor cortex and brain tumor. It is a valuable non-invasive method for presurgical planning in the treatment of brain tumors.