Objective To investigate hepatitis B virus mutation rate after the universal immunization in China. Methods DNA sequence analysis of the “a” determinant was performed on sera from 72 viral carrier children after immunoprophylaxis selected through a sampling survery. Results Four mutants were detected, the mutation rate was 5.56%. One strain showed Gly-to-Arg mutation at the 145 codon of surface antigen. Animo acid substitutions at the amino acid 126 and 140 were noted in the other three children. The epidemiological HBV serotype shifted from previous adw infection to more recent adr was also observed. Conclusions These observations indicate that vaccination is probably the cause of mutation, whereas the mutation is low and it will certainly not be a reason for doubting that the vaccination is the method of main choice for preventing hepatitis B infection that still devastates the developing countries.

BACKGROUND:It has been recently indicated that nervous factors are able to adjust and dominate bone fracture healing. Type Ⅰ collagen is a major factor to promote the differentiation of osteoblasts and enhance the adhesion of osteoblasts; while, it is also a matrix protein for composing bone framework. Type Ⅱ collagen is derived from chondrocytes. OBJECTIVE: To study changing law of type Ⅰ and Ⅱ collagen expression during denervated bone fracture healing. DESIGN, TIME AND SETTING: Randomized controlled anima study was performed at the Animal Laboratory and Cell Biology Laboratory, the Second Military Medical University of Chinese PLA between May and December 2005. MATERIALS: Forty 3-month-year healthy male SD rats were randomly divided into fracture group (tibial fracture alone) and combination group (spinal cord injury combined with tibial fracture), with 20 rats at each group. METHODS: A φ 0.8 mm Kirschner wire was inserted into anterior border of left tibial plateau to establish tibial fracture models in the fracture group. A 0.3-cm spinal cord transection was cut at T10 segment to establish tibial fracture models with entire spinal cord injury. MAIN OUTCOME MEASRUES: Type Ⅰ and Ⅱ collagen protein expressions of callus were detected using Western blot technique in week 1, 2, 4, and 5 post-injury. RESULTS: One week after injury, type Ⅰ and Ⅱ collagen was represented in callus in the two groups, while the expressions in the combination group were significantly higher than fracture group (P<0.05); two weeks after injury, type Ⅱ collagen expression reached at the peak in the combination group, and the expression was significantly higher than the fracture group (P<0.05); four weeks after injury, type Ⅰ collagen expression reached at the peak in the fracture group, and the expression was significantly higher than the combination group (P<0.05), while type Ⅱ collagen still highly expressed in the combination group; five weeks after injury, type Ⅰ and Ⅱ collagen expressions were decreased in the two groups. CONCLUSION: Secretory law of type Ⅰ and Ⅱ collagen during denervated bone fracture healing is similar to normal bone fracture healing; however, the differences at time points, in particular expression at peak, are remarkable between them.

Objective:To explore the association of physical activities,sedentary behaviors with over-weight/obesity in Chinese children aged 9 -1 1 years,analyze the gender difference and heterogeneity of the association across different provinces,and provide evidence for prevention and control of overweight and obesity.Methods:Using the data of 40 692 children aged 9 -1 1 years from Chinese National Survey on Students’Constitution and Health in 201 0,the height and weight were measured and the time spent in physical activities,screen behaviors and homework were collected.We analyzed the associations among physical activities,sedentary behaviors and overweight/obesity in boys and girls separately,and assessed the heterogeneity of associations across different provinces with Meta-analysis.Results:The prevalence of overweight/obesity of the boys (27.1 %)was higher than that of the girls (1 2.9%),compared with the rural students (1 5.6%),the situation of overweight/obesity of the urban students (23.8%)was more serious,the prevalences of overweight/obesity were separately 22.6%,1 9.2% and 1 7.5% among developed,middle-developed and undeveloped social economic status subgroups.The boys with physical activities no more than 1 hour per day were more likely to be overweight/obese,with the OR of 1 .09 (95%CI:1 .02,1 .1 7).The girls with screen time more than 1 hour per day or homework time more than 2 hours per day were more likely to be overweight/obese,with the ORs of 1 .1 3 (95%CI:1 .02, 1 .26)and 1 .1 8 (95%CI:1 .03,1 .35)respectively.The high level of sedentary behaviors (more than 1 35min per day)was associated with overweight/obese in the girls,and the OR was 1 .1 9 (95%CI:1 .08,1 .33).There was no significant heterogeneity of effect values between physical activities and over-weight/obesity in the boys and between sedentary behaviors and overweight/obesity in the girls across the different provinces (P >0.05).Conclusion:The associations among physical activities,sedentary be-haviors and overweight/obesity existed in Chinese children aged 9 -1 1 years,which were different in boys and girls.There was no statistically significant heterogeneity across different provinces.The strate-gies to prevent and control overweight/obesity in primary school students should focus on gender-specific needs.

Objective:To optimize the macroporous resin separation process for total flavonoids in papaya. Methods:The content of total flavonoids in papaya was selected as the index, and the resin model, sample solution concentration, ratio of diameter and height, the flow rate of adsorption, type and volume of eluent, type and volume of impurity removing solvent, elution velocity and the other parameters were investigated. Results:The optimal purification process was as follows: the macroporous resin type was D-140, the sample solution concentration was 0. 1 g·ml-1 , the sample volume was 2BV, the ratio of diameter and height was 1∶9, washing the impurities with 3BV water, eluting with 3BV 10% ethanol first followed by 3BV 50% ethanol with 2BV·h-1 , and collecting 50%ethanol elution. The total flavonoids content was 52%. Conclusion:The optimized process can separate and purify the total flavonoids in papaya effectively.

Objective:To explore the predictive value of renal resistive index (RRI) joint with semiquantitative power Doppler ultrasound (PDU) score to acute kidney injury (AKI) in non-septic critically ill patients.Methods:This prospective observational study enrolled non-septic critically ill patients admitted to the Emergency Intensive Care Unit of Cangzhou Central Hospital from January 2018 to August 2019. In addition to general data, RRI and PDU scores were measured with medical ultrasonic instrument within 6 h after admission. Renal function was assessed on the 5th day in accordance with kidney disease: Improving Global Outcomes criteria. The patients who progressed to AKI stage 3 within 5 days after admission were classified into the AKI 3 group, and the rest were classified into the AKI 0-2 group. The difference of each index was compared between the two groups in non-septic critically ill patients and patients with acute heart failure (AHF). Normal distributed continuous variables were compared using independent sample t-tests, whereas Mann-Whitney U tests were used to examine the differences in variables without a normal distribution. Categorical data were compared with the Chi-square test. Receiver operator characteristic curves were plotted to examine the values of RRI, PDU score, RRI-RDU/10 (subtraction of RRI and 1/10 of PDU score), RRI/PDU (the ratio of RRI to PDU score), and RRI+PDU (the prediction probability of the combination of RRI and PDU score for AKI stage 3 obtained by logistic regression analysis) in predicting AKI 3. Delong's test was used to compare the area under the curve (AUC) between predictors. Results:A total of 110 non-septic critically ill patients (51 patients with no AKI, 21 with AKI stage 1, 11 with AKI stage 2, and 27 with AKI stage 3) were recruited. Among them, there were 63 patients with AHF (21 patients with no AKI, 15 with AKI stage 1, 7 with AKI stage 2, and 20 with AKI stage 3). Among the non-septic critically ill patients as well as its subgroup of AHF, compared with the AKI 0-2 group, acute physiology and chronic health evaluation-Ⅱ score, sequential organ failure assessment score, arterial lactate concentration, mechanical ventilation rate, proportion of vasoactive drugs, 28-day mortality, serum creatinine, RRI, RRI-RDU/10, RRI/PDU, RRI+PDU, and rate of continuous renal replacement therapy were higher in the AKI 3 group, and urine output and PDU score were lower ( all P<0.05). As for non-septic critically ill patients, RRI/PDU [AUC=0.915, 95% confidence interval ( CI): 0.846-0.959, P<0.01] and RRI+PDU (AUC=0.914, 95% CI: 0.845-0.959, P<0.01) performed best in predicting AKI 3, and the AUCs were higher than RRI (AUC=0.804, 95% CI: 0.718-0.874, P<0.01) and PDU score (AUC=0.868, 95% CI: 0.791-0.925, P<0.01). The optimal cutoff for RRI/PDU was > 0.355 (sensitivity 92.6%, specificity 81.9%, Youden index 0.745). The predictive value of RRI-RDU/10 for AKI 3 (AUC=0.899, 95% CI: 0.827-0.948, P<0.01) was also better than RRI and PDU scores, but slightly worse than RRI/PDU and RRI+PDU, with statistically difference only between RRI and RRI-RDU/10 ( P<0.05). As for patients with AHF, RRI/PDU (AUC=0.962, 95% CI: 0.880-0.994, P<0.01) and RRI+PDU (AUC=0.962, 95% CI: 0.880-0.994, P<0.01) also performed best in predicting AKI 3, and the AUCs were higher than RRI (AUC=0.845, 95% CI: 0.731-0.924, P<0.01) and PDU score (AUC=0.913, 95% CI: 0.814-0.969, P<0.01) with statistically differences (all P<0.05). The optimal cutoff for RRI/PDU was > 0.360 (sensitivity 95.0%, specificity 90.7%, Youden index 0.857). The predictive value of RRI-RDU/10 for AKI 3 (AUC=0.950, 95% CI: 0.864-0.989, P<0.01) was also better than RRI and PDU score, but slightly worse than RRI/PDU and RRI+PDU, with statistically difference only between RRI and RRI-RDU/10 ( P<0.05). Conclusions:The combination of RRI and PDU score could effectively predict AKI 3 in non-septic critically ill patients, especially in patients with AHF. The ratio of RRI to PDU score is recommended for clinical application because of its excellent predictive value for AKI and its practicability.

Objective To investigate the related risk factors of hair loss in obese patients after laparoscopic sleeve gastrectomy (LSG).Methods The retrospective case-control study was conducted.The clinical data of 54 obese patients who underwent LSG in the East Hospital of Tongji University between November 2013 and June 2015 were collected.All the patients received LSG,and postoperative hair loss of patients was observed.Factors affecting postoperative severe hair loss were analyzed,including gender,age,preoperative body mass index (BMI),postoperative excess weight loss (EWL),total bilirubin (TBil),albumin (Alb),hemoglobin (Hb),iron,zinc,copper,folic acid,vitamin B12 and vitamin D.Observation indicators:(1) follow-up and postoperative hair loss situations:cases with follow-up,follow-up time,cases with hair loss,severity of hair loss,time of hair loss,treatment of hair loss;(2) univariate analysis affecting severity of hair loss after LSG;(3) multivariate analysis affecting severity of hair loss after LSG.Follow-up using outpatient examination and Wechat was performed to detect the changes of BMI and hair loss up to September 2016.Measurement data with normal distribution were represented as (x)±s and comparison between groups was done by the t test.Comparison of count data was analyzed by the chi-square test.Multivariate analysis was done using the Logistic regression model.Results (1) Follow-up and postoperative hair loss situations:all the 54 patients were followed up for 15 months.Forty-two patients had hair loss,including 21 with slight hair loss,10 with moderate hair loss and 11 with severe hair loss.A proportion of hair loss was 6/11 in male and 36/43 in female.The onset time and end time of hair loss were (3.4± 1.4) months and (9.0± 3.6) months,respectively.Of 42 patients,15 took oral medication (6 with ferrous sulfate,5 with decavitamin and 4 with zinc gluconate oral solution) against hair loss,with no obvious improvement.During the follow-up,42 patients stopped hair loss and gradually grow new hair.(2) Univariate analysis affecting severity of hair loss after LSG:gender,postoperative EWL and folic acid were factors affecting severity of hair loss after LSG (x2 =5.161,t =-5.114,4.266,P＜0.05).(3) Multivariate analysis of affecting severity of hair loss after LSG:postoperative EWL and folic acid were independent factors affecting severity of hair loss after LSG (OR=1.039,0.499,95％ confidence interval:1.011-1.068,0.300-0.802,P＜0.05).A prediction accuracy of severity of hair loss after LSG was 85.2％.Conclusion Postoperative EWL and folic acid are independent factors affecting severity of hair loss after LSG.

Objective:To study the relationship between rs 2228314 polymorphism in sterol regulatory element binding protein 2 gene (SREBP2) and obesity, serum lipid levels in children and adolescents . Methods:In our study , 2 030 children and adolescents aged from 7 to 18 years participated .Anthropo-metric measurements, including height and weight, were performed.Their serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol ( HDL-C) were detected .The matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS ) was used to detect rs2228314 genotypes.Results: The GC/CC genotypes of rs2228314 polymorphisms had lower HDL-C levels than GG genotype [(0.10 ±0.35) mmol/L vs. (0.14 ±0.36) mmol/L, P=0.020].The rs2228314 polymorphism was associated with the abnormal HDL-C level under the dominant model after adjustment for study samples , sex and age ( OR=1.400, 95%CI:1.027-1.907, P=0.033).The rs2228314 polymorphism was not associated with obesity un-der the dominant model after adjustment for study samples , sex, age and HDL-C level ( OR=1.178, 95%CI: 0 .971 -1 .430 , P =0 .096 ) . Conclusion: The GC/CC genotype carriers of SREBP2 rs2228314 polymorphism have higher risk of abnormal HDL-C level than the individuals with GG geno-type among children and adolescents .

In educating postgraduate students in aerospace medicine in our country, there are some deficiencies such as the course content lacking forward looking and systematicness, and students' mastery of technology or skills lacking professional characteristics, innovation and divergent thinking. Based on the original foundations, the School of Aerospace Medicine, Fourth Military Medical University, has been con-structing and improving the course system by modifying the course contents, reforming the practical teach-ings, expanding the academic communications, and managing the processes. Finally, they have achieved certain results.

Objective:To establish an HPLC method for the simultaneous determination of liquiritin and glycyrrhizic acid in Erxieting granule.Methods:A TechMate C18-ST(250 mm×4.6 mm,5 μm) column with a DAD detector was used.The mobile phase consisted of acetonitrile (A) and 0.05% phosphoric acids in water (B) with gradient elution.The flow rate was 1.0 ml·min-1 and the detection wavelength was 237 nm.The sample size was 5 μl and the column temperation was room temperatence.Results:Linear calibration curves were obtained within the range of 10.32-51.62 mg·L-1 for liquiritin and 79.40-397.00 mg·L-1for glycyrrhizic acid.The average spiked recovery of liquiritin and glycyrrhizic acid was 98.10(RSD=1.0%,n=6)and 97.15(RSD=1.8%,n=6),respectively.Conclusion:The method is accurate,reproducible and stable,and can be used for the quality control of Erxieting granule.

Objective To study the life style and the status of nutrition knowledge for the children of Pinggu district of Beijing,and to provide evidences for targeted education and guidance.Method Using cluster sampling method,15 118 pupils aged 7-13 yeas in Pinggu district of Beijing were investigated for their nutrition knowledge,sports and diet habits using the questionnaire investigation method.The children at grades 1-3 were defined as the junior group,those at grades 4-6 were defined as the senior group,all pupils were divided into urban and rural groups according to the distance to pinggu district town center.The Excel 2003 was used for databases.The status was analysed using SPSS13.0 statistical software.Chi-square test wcs used for comparing categorical data.Result Totally 13 192 questionnaires were returned,accouting for 87.26％; 11 364 of them were valid,accouting for 75.17％.The awareness rates about the fruits and vegetables which are rich in nutrients,the food rich in calcium,the food rich in protein,nutrient deficiency anemia was relatively low,they were respectively 58.33％,62.72％,58.83％,43.18％; the awareness rates on the relationship between diet and health,effects of obesity on the health,excessive dringking is harmful and eating more salt was harmful,were relatively high:88.82％,92.33％,94.27％,and 83.74％,the differences between gender,grade,area and students' awareness of the comparison,were statistically significant (P＜0.05).The awareness rate of the question about what is dietary pyramid was 18.77％,the differences between different gender and grade were statistically significant (P＜ 0.01).The questionnaire of eating habits:the students who do not or occasionally have breakfast accounted for 14.84％; the rate of three meals which were irregular accounted for 14.46％; children who do not like to eat grains,vegetables and fruit,respectively accounted for 18.59％,21.61％,4.23％; the number of children who do not like to drink milk and eat soy products was high,the proportion was 38.52％ and 60.17％.At the same time the differences in time between sex,grade,areas,were statistically significant (P＜0.05).The questionnaire about movement and sleeping habits:the students who like walking,playing,climbing and other way to relax after class accouted for 59.94％,the exercise time was 30 minutes or more accounted for 40.99％,51.14％; students who ride bike or walk to school,children who ensure 9-10 hours for sleeping every day accounted for 84.86％,differences between different sex,area and grade were statistically significant (P＜0.01).Conclusion The children in this district generally had lack of the nutrition knowledge.There were many bad diet habits,while sport habits were also poor.In order to improve diet and sport habits of rural school children,we should do targeted nutrition and health education to children.