Objective To explore the diagnostic value of combination detection of carcino‐embryonic antigen(CEA ) ,cytokeratin 19 fragment 21‐1(CYFR21‐1) ,neuron‐specific enolase(NSE) in bronchoalveolar lavage fluid (BALF) for early lung cancer and its correlation with clinical effects .Methods 69 cases of lung cancer were included into the lung cancer group and 50 cases of benign pulmonary disease were included into the lung benign disease group .All the patients were given bronchoalveolar lavage(BAL) .The chemiluminescence immunoassay was adopted to detect the levels of CEA ,CYFR21‐1 and NSE in BALF .The changes of tumor markers levels were compared between the two groups and among different clinical curative effects in the patients with lung cancer . Results The levels of CEA ,CYFR21‐1 and NSE in BALF of the lung cancer group were significantly higher than those of the be‐nign pulmonary disease group ,the difference was statistically significant (P < 0 .05) .The levels of tumor markers in the stage Ⅱ of lung cancer were higher than those in the stage Ⅰ of lung cancer ,the difference was statistically significant (P< 0 .05) ;the levels of CEA ,CYFR21‐1 and NSE in BALF were gradually increased with the decrease of clinical effect (P< 0 .05) ;the sensitivity and spe‐cificity of the combined detection of three tumor markers were 62 .3% and 82 .0% respectively ,which were significantly higher than those of any single tumor marker (P< 0 .05) .Conclusion The levels of CEA ,CYFR21‐1 and NSE in BALF of early lung cancer patients are obviously increased ,moreover which is closely correlated with the pathological stage of lung cancer ,the combined detec‐tion could contribute to improve the detection rate of early lung cancer and guide the evaluation of clinical effect .

Objective To analyse the prognostic value of serumal copeptin in patients with acute exacerbation of COPD compli-cated withrespiratory failure.Methods The serumal copeptin were detected in 60 hospitalized AECOPD patients before and after the treatment and in 30 healthy controls.Results Comparing with control groups,the serumal levels was significantly elevated in the patient with AECOPD before thetreatment and declinied two months later(P <0.05).The level of serum copeptin wereincreasing with the increase in the severity of the disease in acertain extent;The serumalcopeptin were positively correlated with lung function and CAT (r=0.058 and 0.821,P =0.00)and were negativelycorrelated with 6MWD(r=-0.652,P =0.00).Conclusion Serum copeptin could as-sess the incidence of acute exacerbations ofchronic obstructive pulmonary disease and its therapeutic effect;Serum copeptin can reflect the se-verity of AECOPD patients in a certain extent,and has certain clinical value to evaluate the quality of life in patients.

Objective To observe the effect of abdominal obesity on lung function in the perioperative period of complete video-assisted thoracoscopic lobectomy.Methods Collected 36 cases of peripheral lung cancer and could complete video-assisted thoracoscopic lobectomy by access conditions,18 cases in abdominal obesity group who had body mass index (BMI) ＞ 35 kg/m2 and the waist circumference ＞ 95 cm on men the waist circumference ＞ 90 cm on women,18 cases in normal weight group who had BMI ＜ 25 kg/m2 and the waist circumference ＜ 85 cm on men the waist circumference ＜ 80 cm on women.All cases had complete video-assisted thoracoscopic lobectomy and lymph node dissection with 4 holes,and recorded the operation time,before and after operation had blood gas analysis and lung function,at the same time recorded the cases of complication after operation,compared the parameters in two groups.Results The blood gas analysis had no difference before operation,but after 12 h of operation,the arterial blood oxygen partial pressure (PaO2) declined and alveolar-arterial blood oxygen partial pressure difference(PA-aO2) increased in abdominal obesity group,while the PaO2 declined and arterial blood CO2 partial pressure (PaCO2),PA-aO2 increased compared with normal weight group(P ＜ 0.05).The forced vital capacity (FVC),forced expiratory volume in 1 second(FEV1) had statistical significance in two groups before operation(P ＜ 0.05),on the third day after operation,the abdominal obesity group to himself the FVC,FEV1,maximal voluntary rentilation (MVV),functional residual capacity (FRC),carbon monoxide diffusion amount (DLCO) declined obviously except FEV1/FVC (P ＜ 0.05),compared with normal weight group,the FVC,FEV1,FRC,DLCO declined obviously (P ＜ 0.05).After operation,the lung function in abdominal obesity group,the FVC,FEV1,MVV,FRC,DLCO declined 25.8％,27.8％,20.4％,32.1％,39.1％,compared with normal weight group the FVC,FEV1,FRC,DLCO declined 31.8％,37.2％,30.2％,30.6％.The abdominal obesity group had more complication.Conclusion In the perioperative period of complete video-assisted thoracoscopic lobectomy,the abdominal obesity has more effect to lung function and must have more attentions on it,and effective weight control has important significance to operation patients.

Objective To compare the clinical effect of non-operative and operative treatment for flail chest.Methods A retrospective case control study was made on 60 cases of flail chest treated from March 2013 to April 2016.There were 42 males and 18 females,at the age range of 36-62 years [(49.8 ± 10.3)years].According to the treatment methods,the patients were divided into non-operation group (28 cases) and operation group (32 cases).Chest CT,pulmonary function and 36-item short-form health survey(SF-36) were measured in all patients 3 months and 6 months after injury.Differences in atelectasis,chest wall deformity,delayed fracture healing,pulmonary function and life quality were analyzed between the two groups.Results Compared to non-operative group at postoperative 3 months,rates of atelectasis,chest wall deformity and delayed fracture healing in operation group were obviously lower,while indices of pulmonary function pulmonary function including forced vital capacity (FVC),forced expiratory volume in one second(FEV1),one second rate (FEV1/FVC) and maximal voluntary ventilation measured value (MVV) in operation group wcre higher,and SF-36 parameters including physical functioning (PF),role-physical (RP),bodily pain (BP),general health (GH),vitality (VT),social functioning (SF) and mental health (MH) in operation group were better (all P ＜ 0.05).As to the data measured 6 months after injury,there were no significant differences between the two groups,except that the rate of chest wall deformity in non-operative group (6 cases,39％) was higher than that in operation group (11 cases,19％) (P ＜ 0.05).As to c hest CT,indices of pulmonary function and SF-36 parameters (P ＜ 0.05),there were no significant differences within operation group at postoperative 3 months and 6 months (P ＞ 0.05).Non-operation group showed better results in rate of atelectasis,rate of delayed fracture healing,indices of pulmonary function and SF-36 parameters measured 6 months after injury than the detections at postoperative 3 months (P ＜ 0.05),without difference in rate of chest wall deformity (P ＞ 0.05).Conclusions Surgical treatment of flail chest can accelerate fracture healing,reduce rate of chest wall deformity and improve life quality of patients early compared to non-operative treatment.Although there is no obvious difference in life quality of patients between operative and non-operative treatment 6 months after injury,but the chest wall deformity remains significantly different.

Objective: To investigate the AIDS-related knowledge, attitudes and practice among university students in a pilot site of AIDS health education in Zhoushan City, so as to provide the reference for AIDS health education in universities. Methods: University students were recruited from Zhejiang Ocean University using a stratified cluster sampling method in 2018 and 2020, and the AIDS-related knowledge, attitudes and practice were collected using a questionnaire survey. Results: A total of 2 862 and 2 850 students were surveyed in 2018 and 2020, including 1 429 ( 49.93% ) and 1 414 ( 49.61% ) male students, respectively. The overall awareness of AIDS-related knowledge was 86.62% and 94.11% in 2018 and 2020, respectively. There were 544 ( 19.01% ) and 394 ( 13.82% ) students that were in favor of one-night stand, 308 ( 10.76% ) and 198 ( 6.95% ) students that were in favor of commercial sexual behaviors, and there were 59 ( 2.06% ) and 34 ( 1.19% ) students that had casual sexual behaviors within one year, and 20 ( 0.70% ) and 8 students ( 0.28% ) with commercial sexual behaviors within one year. There was a significant difference in the awareness of AIDS-related knowledge among students with different years at the university ( P<0.05 ). The lowest awareness of AIDS-related knowledge was seen in freshmen in 2018 ( 81.74% ), and the highest awareness was found in freshmen in 2020 (97.17% ). The proportions of being in favor of one-night stand ( 2018: 31.35% vs. 6.70%; 2020: 22.07% vs. 5.71%; P<0.05 ), being in favor of commercial sexual behaviors ( 2018: 19.91% vs. 2.23%; 2020: 12.09% vs. 1.88%; P<0.05), having casual sexual behaviors within one year (2018: 3.71% vs. 0.42%; 2020: 2.19% vs. 0.21%; P<0.05), and having commercial sexual behaviors within one year ( 2018: 1.33% vs. 0.07%; 2020: 0.50% vs. 0.07%; P<0.05 ) were significantly greater in male students than in female students. Conclusions The pilot AIDS health education is effective to increase the awareness of AIDS-related knowledge, possess the correct attitudes towards sexual behaviors and reduce high-risk sex behaviors among university students in Zhoushan City. Intensified AIDS health education is recommended among senior and male university students.

ObjectiveTo analyze the current situation and characteristics of work-related injuries in Kunshan City. Methods Data on work-related injuries in Kunshan City from January 2016 to December 2021 was collected from the integrated management platform of Jiangsu Human Resources and Social Security Bureau. The situations and characteristics of work-related injuries were analyzed. Results A total of 46 358 work-related injuries occurred in Kunshan City from 2016 to 2021, with the incidence of 0.57% to 0.67%. The incidence showed a decreasing trend year by year (P<0.05). The work-related injuries leading to level 10 disability in workers accounted for 44.45%. The incidence of work-related injuries was highest in the sixth major risk industry category, accounted for 0.79%. The incidence of work-related injuries was the highest in July and August, both accounted for 0.60‰. The incidence of work-related injuries was the highest in the traditional manufacturing area of all regions, accounted for 0.65%. The incidence of work-related injuries was higher in males than in females (0.56% vs 0.23%, P<0.01). The incidence of work-related injuries of workers aged ≥46 years was 0.74%, which was higher than those in the other three age groups <46 years old (all P<0.008). Workers with 11 to <16 and 16 to <21 years of social insurance had relatively higher incidence of work-related injuries, accounted for 0.84% and 1.00%, respectively (both P<0.003). The incidence of work-related injuries was lower in urban workers than in rural workers (0.43% vs 0.44%, P<0.01). Work-related wrist and hand injuries had the highest incidence among all body parts, accounted for 44.67%. Contusions, crush injuries, and compression injuries were the most common types of injuries, accounted for 56.18%. Conclusion The incidence of work-related injuries in Kunshan City is lower than the national average. The incidence of work-related injuries is related to the category of risk industry, region, gender, age, years of social insurance and household registration type. Hierarchical classification should be implemented to prevent work-related injuries.

AIM:To explore the mechanism by which over-expression of enhancer of zeste homolog 2 (EZH2) in a panel of gastric cancer cell lines is involved in tumorigenesis of gastric cancer .METHODS: Real-time PCR and Western blot were employed to examine the mRNA and protein levels of EZH 2, respectively.MTS assay, cell migration and soft agar assay were performed to investigate the role of EZH 2 in the regulation of stomach cancer behaviors .The effect of EZH2 on NF-κB target gene expression was determined by Luciferase reporter and real-time PCR.Co-immunoprecipitati-on was used to analyze the interaction of EZH 2 and p65 in HEK293T cells.RESULTS: The expression levels of EZH2 were significantly increased in the gastric cancer cells compared with normal gastric epithelial cells .Pharmacological inhibi-tion by DZNep or knockdown of EZH2 significantly compromised AGS and SNU-16 cell activity , cell migration and anchor-age-independent cell growth.Moreover, siRNA knockdown of EZH2 impaired NF-κB downstream targets, such as IL-8, CXCL5 and CCL20.In addition, the interaction of EZH2 and p65 was detected.CONCLUSION: EZH2 mediates the growth of gastric cancer cells through the regulation of NF-κB downstream gene expression .

Objective:To evaluate the objective imaging markers of cognitive impairment in patients with end-stage renal disease by MRI intravoxel incoherent motion.Methods:A total of 40 patients with ESRD were enrolled in the Department of Nephrology, Changzhou Second Hospital Affiliated to Nanjing Medical University from January 2019 to August 2020, and 24 healthy controls were prospectively enrolled at the same time.All subjects performed with MRI scan were collected, and the slow apparent diffusion coefficient (ADC slow) of the corresponding brain regions were obtained .The cognitive function was evaluated by the Montreal cognitive assessment scale (MoCA). Two-sample t test was used to analyze the difference of ADC slow and cognitive score between the two groups.Pearson correlation analysis was performed among the cognitive function score of end-stage renal disease and ADC slow value. Results:(1) The score of the intelligence test scale in the ESRD group (23.30±1.76) was significantly lower than that of the healthy control group (27.92±1.00) ( P<0.01). The ADC slow values of bilateral frontal lobe, hippocampus, and insula brain areas (respectively(0.648±0.035), (0.633±0.043), (0.762±0.043), (0.756±0.042), (0.792±0.048), (0.776±0.054))in the ESRD group were significantly higher than those in the healthy control group ((0.600±0.039), 0.610±0.037, (0.725±0.059), (0.711±0.054), (0.740±0.063), (0.716±0.051)) ( P<0.01). (2) Pearson correlation analysis showed that the ADC slow values of bilateral insula and right hippocampus in the ESRD group were negatively correlated with MoCA scales ( r=-0.38, -0.38, -0.66, all P<0.05). Conclusion:ADC slow value in IVIM can better reflect the changes of cognitive function impairment in ESRD patients.

Objective: To investigate the characteristics of HIV-1 molecular transmission network among HIV/AIDS patients in Zhoushan City, Zhejing Province. Methods: The newly reported HIV/AIDS cases in Zhoushan City from 2020 to 2022 were selected. Basic information was collected and whole blood samples were obtained at the initial follow-up. The pol gene sequences of HIV-1 were amplified by RT-PCR and nested-PCR. HIV-1 subtypes were identified by Neighbor-Joining phylogenetic trees. The HIV-1 molecular transmission network was built and analyzed using Cytoscape 3.6.1 software. Results: A total of 222 HIV/AIDS cases were reported in Zhoushan City from 2020 to 2022, 200 whole blood samples were collected, and 152 sequences were obtained successfully, including 122 males (80.26%), 75 cases aged 50 years and above (49.34%), 109 cases with a junior high school education or below (71.71%), and 63 cases with commercial heterosexual contact (41.45%). The main subtypes were CRF07_BC and CRF01_AE, accounting for 45.39% and 21.05%, respectively. When the threshold of genetic distance was set to 1%, 20 molecular clusters were formed in 69 cases, with a clustering rate of 45.39%. Using the molecular network constituted by reported HIV/AIDS cases in 2020 as the baseline network, there were 2 active molecular clusters with ≥5 new cases in 2022, each with 9 cases, characterized mainly by individuals aged 50 or above, with a junior high school education or below, and transmission through commercial heterosexual sex. Conclusions The predominant HIV-1 subtypes among HIV/AIDS cases in Zhoushan City are CRF07_BC and CRF01_AE. Transmission through commercial heterosexual contact among middle-aged and elderly people is a main mode of HIV transmission.

The Hedgehog (Hh) signalling pathway is essential for cellular proliferation and differentiation during embryonic development.Gain and loss of function of Hh signalling are known to result in an array of craniofacial malformations.To determine the critical period for Hh pathway antagonist-induced frontal bone hypoplasia,we examined patterns of dysmorphology caused by Hh signalling inhibition.Pregnant mice received a single oral administration of Hh signalling inhibitor GDC-0449 at 100 or 150 mg·kg-1 body weight at preselected time points between embryonic days (E)8.5 and 12.5.The optimal teratogenic concentration of GDC-0449 was determined to be 150 mg·kg-1.Exposure between E9.5 and E10.5 induced frontal bone dysplasia,micrognathia and limb defects,with administration at E10.5 producing the most pronounced effects.This model showed decreased ossification of the frontal bone with downregulation of Hh signalling.The osteoid thickness of the frontal bone was significantly reduced.The amount of neural crest-derived frontal bone primordium was reduced after GDC-0449 exposure owing to a decreased rate of cell proliferation and increased cell death.