Abstract Globally, non-pharmacological interventions, such as keeping social distance and wearing masks, are the primary prevention and control strategy in the early stage of the coronavirus disease 2019 (COVID-19) pandemic. The successful development and the urgency use of the COVID-19 vaccines in some countries brings a new stage of combining immunization with non-pharmacological interventions in the fight with COVID-19. For the shortage of vaccines, the immunization strategies vary in countries. To end the pandemic, 47%-85% of the population should be immunized with effective COVID-19 vaccines, thus we should boost the yield of vaccines, formulate scientific immunization strategies, promote the mass immunization, improve the willingness of vaccination, and increase the equity of vaccine allocation; meanwhile, we should strengthen the surveillance of virus variation, vaccine effectiveness and safety, and keep on the vaccine research to copy with the potential threat of the virus variation.

Objective:To explore the pathogenesis of multiple organ dysfunction syndrome(MODS)with respect to the bal- ance of Th1/Th2.Methods:Eighteen healthy male minipigs,weighing 22-30 kg,were randomly divided into two groups: MODS group and control group.Double-hit method including hemorrhagic shock and endotoxiemia was used to establish the porcine MODS model.The peripheral vein blood samples were collected at different time-points(before bloodletting,before en- dotoxin injection,1 h,24 h,48 h and 72 h after endotoxin injection)in the two groups.The spleen samples were collected after death of the animals.Plasma levels of IFN-?and IL-4 were detected by enzyme-linked immunosorbent assay(ELISA).Real- time PCR was used to detect the expression of IFN-?,IL-4,T-bet and GATA-3 mRNA(The latter 2 were the key transcription factors associated with Th1/Th2 response)in the spleen samples.Results:The plasma levels of IFN-?and IL-4 quickly reached the peak values 1 h after the endotoxin injection,then the level of IFN-?decreased quickly.The ratio of IFN-?/IL-4 was signifi- cantly lower than the baseline value 72 h after endotoxin injection(P=0.000).The ratio of IFN-?/IL-4 mRNA in MODS group was obviously lower than that in the control group(P=0.020);the ratio of T-bet/GATA-3 was also lower in MODS group (P=0.038).Conclusion:The shift from Th1 to Th2 occurs in the progress of MODS.

Objective To evaluate the effectiveness of intern doctor training by 360 degree evaluation scale and to provide references for formulating targeted training plan. Methods A 360-degree evaluation scale with 6 subscales(Attendings, Peers, Nurse, Patients, Directors and Students) was employed to measure the status quo of medical education , represented by professional ethics and communication skills, among 129 intern doctors in medical clinical college. Cronbach's alpha was used to evaluate the reliability of the scale,one-way ANOVA was used to compare the difference of score among different scorers,and t test and Mann-Whitney test were employed to compare scores be-tween male group and female group, 5-year class and 8-year class (The significance level was set at P<0.05). Results Cronbach' α coefficients were 0.878, 0.948, 0.914, 0.908, and 0.934 for six sub-scales and 0.964 for the general scale. There were significant differences in evaluation scale scores a-mong differ-ent evaluators(P<0.01). After being adjusted by weight index, the average scores of pro-fessional ethics and communication ability & interpersonal relationship were ( 92 . 52 ± 8 . 09 ) and (93.32±8.67) respectively. No differences was observed between male and female, 5-year class and 8-year class(P>0.05). Conclusions 360 degree evaluation scale has reasonable reliability and it can provide valuable references for future similar survey in China. Meanwhile, intern doctors exhibit rela-tively good performances in professional ethics and communication ability & interpersonal relationship in the present study.

Objective The present study has been designed to investigate the impact of dietary iodine/sodium intake on blood lipid metabolism in mice. Methods According to body weight and gender, two hundred and sixty Balb/c mice were randomly divided into 2 groups including normal sodium group(Na) and low sodium group(LNa), with 130 animals per group. Each group were then randomly further divided into 5 sub-groups according to the amount of iodine intake: ① severe iodine deficiency(SID); ② mild iodine deficiency(MID); (③normal iodine (NI); ④ 10-fold high iodine ( 10HI ); (⑤ 50-fold high iodine (50HI), 10 groups in total, 26 per group.Eight months later, the body weight and the levels of urinary iodine, thyroid hormones and total cholesterol (TC),Results In Na group, the levels of TG and TC in male mice of SID group[ (1.64 ± 0.35), (3.88 ± 0.35 )mmol/L]and MID group[ ( 1.67 ± 0.31 ), (3.41 ± 0.66)mmol/L] were significantly higher than that of NI group[ ( 1.49 ± 0.42), (3.25 ± 0.47)mmol/L] and the levels of TG in female mice of SID group[(1.52 ± 0.22)mmol/L] were significantly higher than that of NI group[ (1.23 ± 0.22)mmol/L]. In addition, the levels of TG in male mice of 10HI and 50HI groups [ ( 1.16 ± 0.23 ), ( 1.21 ± 0.27 ) mmol/L ] were significantly lower than that of NI group [ ( 1.49 ± 0.42)mmol/L, all P ＜ 0.05], the levels of TC in female mice of 10HI and 50HI groups[(2.37 ± 0.49), (2.48 ± 0.37)mmol/L] were significantly lower than that of NI group[ (2.84 ± 0.37) mmol/L, all P ＜ 0.05 ]. In LNa group,the levels of TG and TC in male mice of SID group[ (1.39 ± 0.40), (3.33 ± 0.46 )mmol/L] were significantly lower than that of NI group [(1.30 ± 0.28), (3.00 ± 0.53) mmol/L, all P ＜ 0.05], the levels of TG, TC and LDL in female mice of SID group[ (1.48 ± 0.26), (2.76 ± 0.43), (0.62 ± 0.22)mmol/L], the levels of LDL in female mice of MID group[ (0.60 ± 0.17 )mmol/L] were significantly lower than that of NI group[(l.22 ± 0.36), (2.51 ± 0.38),(0.48 ± 0.08), (0.48 ± 0.08)mmol/L, all P ＜ 0.05], the levels of TG in male mice of 10HI and 50HI group [ (1.12 ± 0.22), (0.90 ± 0.11 )mmol/L] were significantly lower than that of NI group (all P ＜ 0.05 ), the levels of TC in female mice of 10HI and 50HI groups[ (2.35 ± 0.34), (2.37 ± 0.37)mmol/L], the levels of LDL in female mice of 50HI group[(0.65 ± 0.18)mmol/L], were significantly lower than that of NI group(all P ＜ 0.05). In Na group, the levels of thyroid hormones were distinctively decreased in SID group[TT4(0.00 ± 0.00)nmol/L, FT4 (0.93 ± 0.42)pmol/L, TT3(0.49 ± 0.07)nmol/L, FT3(2.86 ± 0.37)pmol/L] and MID group [TT4 (17.15 ± 15.26)nmol/L, FT4( 18.46 ± 4.31 )pmol/L, TT3(0.67 ± 0. 10)nmol/L, FT3(3.18 ± 0.24)pmol/L] compared with that of the NI group [TT4 (37.15 ± 15.26)nmol/L, FT4(28.46 ± 4.31)pmol/L, TT3(0.85 ± 0.10)pmol/L, FT3(3.87 ± 0.24)pmol/L, all P ＜ 0.05 ]. In LNa group, the levels of thyroid hormones were distinctively decreased in SID group [TT4 (0.00 ± 0.00) nmol/L,FT4(1.03 ± 0.78)pmol/L, TT3(0.51 ± 0.05)nmol/L, FT3(3.01 ± 0.17)pmol/L] and MID group[TT4(19.76 ± 12.22)nmol/L, FT4(21.46 ± 5.37)pmol/L, TT3(0.71 ± 0.21)nmol/L, FT3(3.56 ± 0.23)pmol/L] compared with that of the NI group[TT4(36.23 ± 14.72)nmol/L, FT4(30.96 ± 6.33)pmol/L, TT3(0.89 ± 0.20)nmol/L, FT3(4.05 ± 0.24)pmol/L, all P ＜ 0.05]. Conclusions Dietary iodine intake plays an important role in the blood lipid metabolism. Iodine deficiency could increase while iodine excess could decrease the levels of serum TG, TC or LDL in mice. Monitoring the amount of iodine intake during sodium restriction should have an important role in effective prevention and treatment of cardiovascular disease.

Objective To observe the effects of iodine deficiency and iodine excess on the lipid metabolism in an experimental hypothyroid model of mice and to explore the roles of iodine independent of its role in thyroid hormones. Methods Female Balb/c mice were randomly divided into 6 groups: control, severe iodine deficiency (SID), mild iodine deficiency(MID), normal iodine (NI), 10-fold high iodine (10HI) and 50-fold high iodine(50HI), 10 in each group. The mice in control group were fed with low iodine forage, other mice were fed with low iodine forage containing 0.2% methylthiouracilum. All mice drank deionic water containing different concentrations of potassium iodide(KI). The iodine content in water was 326.79, 0, 196.08,326.79, 385621, 19 542.50 μg/L, respectively. After three months, thyroid hormones in the serum were determined by radioimmunoassay.Also, the blood samples were analyzed for total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesteiol (HDL-C) and low density lipoprotein cholesterol (LDL-C) and measured enzymatically by automatic analyzer. Results①The levels of Tr4 in SID[(21.27 ± 9.63)μg/L], MID[(23.41 ± 3.93)μg/L], NI[(22.57 ±4.66)μg/L], 10HI [(21.07 ± 5.03) μg/L] and 50HI groups [(21.46 ± 5.90) μg/L] were distinctively decreased compared with control group[(42.15 ± 8.26)μg/L, all P ＜ 0.01]. There were no statistical significant differences of TT3 between different groups (F = 0.99, P > 0.05 ). ②The level of TG in 10HI group [ ( 1.17 ± 0.16)mmol/L ] was obviously decreased compared with control [(1.39 ± 0.22 )mmol/L] and NI groups[(151 ± 0.22)mmol/L, all P＜ 0.05].Both TG and TC in 50HI group[(1.18 ± 0.22), (1.78 ± 0.15)mmol/L] were significantly decreased compared with control [( 1.39 ± 0.22), (2.14 ± 0.37)mmol/L] and NI groups [(1.51 ± 0.22), (2.00 ± 0.15)mmol/L, all P ＜ 0.05].The difference of serum HDL-C and LDL-C between the groups was not significant(F = 0.55,0.54, all P ＞ 0.05 ).Conclusions Dietary iodine plays a role in the metabolism of serum lipids independent of thyroid hormones.Thus, monitoring the amount of iodine intake during sodium restriction should also be taken extremely important for effectively prevention and cure of cardiovascular disease.

Objective To observe the levels of serum leptin in Gaves disease(GD)and thyroiditis(HT)Datients and to discuss the immunological role of leptin in the pathogenesis of autoimmune thyroid disease(AITD).Methods 102 newly diagnosed female AITD patients were divided into 3 groups:GD hyperthyroid group,HT hypothyroid group and subclinical hypothyroid group.Age,sex and BMI-matched 27 euthyroid,healthy subjects served as controis.The levels of FT3,FT4 and sTSH were determined by immunofluorometrie assay.ELISA kit was aDplied to measure the levels of serum leptin.Results Serum FT3 and FT4[(19.74±15.39),(78.25±58.68)pmol/L]levels of GD hyperthyroid patients were obviously higher than those of the controls[(4.87±0.25),(15.96±3.15)pmol/L,P＜0.01],but serum sTSH and leptin levels[(0.15±0.08)mU/L,(8.73±1.92)μg/L]were obviously lower than those of the controls[(3.81±0.19)mU/L,(12.38±3.51)μg/L,P＜0.01or＜0.05].Serum FT3 and FT4[(3.36±0.26),(6.95±3.29)pmol/L]levels of HT hypothyroid patients were obviously lower than those of the controls(P＜0.05),but serum sTSH and leptin levels[(45.48±35.83)mU/L,(17.17±3.82)μg/L]were obviously higher than those of the controls(P＜0.01 or＜0.05).Serum FT3 and FT4[(4.67±0.60),(14.87±2.14)pmol/L]levels of subclinical hypothyroid patients had not statistical difference comparing with those of the controls(P＞0.05),but serum sTSH and leptin levels[(13.67±8.66)mU/L,(16.25±3.67)μg/L]were obviously higher than those of the controls(P＜0.01 or＜0.05).Conclusions Leptin might have an immuoregulation role in the pathogenesis of AITD.In addition,serum levels of leptin in AITD is also influenced by many other related hormones.

In hyperthyroid,hypothyroid and subclinical hypothyroid patients,the positive rate and level of the thyroid autoantibodies were all remarkably higher than those in the control group.The positive rate of thyroid peroxidase antibody (TPOAb) was higher than those of thyroglobulin antibody and thyroid microsome antibody in each group.In the group with restored thyroid function,the average level of TPOAb was significantly decreased, suggesting that TPOAb could be taken as an important indicator in evaluating the treatment and prognosis of autoimmune thyroid diseases.

OBJECTIVETo examine the expressions of B7-H1 and its receptor programmed death-1 (PD-1) on circulating T cells and myeloid dendritic cells (mDCs) in patients with chronic hepatitis B virus (HBV) infection and to investigate the correlation between their expressions and their disease status.

METHODSThe expressions of B7-H1 and PD-1 on mDCs and T lymphocytes in 30 patients with chronic HBV infection and 28 healthy controls were analyzed by a fluorescence-activated cell sorter (FACS). Real time-polymerase chain reaction (RT-PCR) was used to measure the serum HBV DNA load.

RESULTSBoth B7-H1 and PD-1 were significantly upregulated on T cells and mDCs in those patients. Their expressions were positively correlated with the patients serum ALT levels and HBV DNA loads.

CONCLUSIONB7-H1 and PD-1 expressions in our patients with chronic hepatitis B are closely associated with their disease status.

Adult ; Antigens, CD ; metabolism ; B7-H1 Antigen ; Case-Control Studies ; Dendritic Cells ; metabolism ; Female ; Hepatitis B, Chronic ; metabolism ; Humans ; Male ; Middle Aged ; T-Lymphocytes ; metabolism ; Young Adult

Objective To evaluate the diagnostic role of multi-slice CT(MSCT)angiography for tumors of intra-abdominal testes.Methods MSCT angiography of 5 cases with seminoma of intra-abdominal testes proved by surgery and pathology was analyzed.All patients were male,and the age ranged from 33 to 59 years with the mean of 43.6 years.Results(1)The arterial-supply of tumors completely came from the testicular artery of the same side.The arteries went into tumors from the posterior side.(2)The tumors had comparatively large volume with complete or incomplete amicula.The tumor density of 3 cases was inhomogeneous.The degree of entity augmentation of 5 patients was about 14—25 HU.Conclusion MSCT angiography can reveal the tumor vessel and is essential for the diagnosis of tumors of intra-abdominal testes.

Objective To examine the clinical manifestations and pulmonary radiological features in patients with triphosgene poisoning.Methods Clinical manifestations,laboratory tests and CT scans were analyzed retrospectively in 17 patients with triphosgene poisoning.We focused on the severity,development and repair of pulmonary impairment.Results Plain film and CT scans in five mild cases demonstrated bilateral scattered pulmonary patchy shadows.Of 12 cases with moderate to severe diseases,three showed bilateral multiple pulmonary patchy shadows and nodules with confluence of part of the lesions on plain film and CT scans;bilateral lungs were involved in nine cases with imaging findings of bilateral disseminated pulmonary round or ovary nodules with different size,ill-defined and partly-confluent patchy shadows and thickening of both interlobular septum and the wall of bronchus.Of clinical interests,imaging findings were closely correlated with clinical course and laboratory results.Conclusion Radiological examinations with plain films and CT scans could reveal the severity,evolvement of pulmonary edema in patients with triphosgene poisoning,and these are of clinical benefit in the early management and prognostic evaluation of patients with triphosgene poisoning.