The tobacco epidemic is a problem with serious consequence for public health in the whole world. Reducing the tobacco harm and protecting public health have become a crucial topic for ethics. This paper, firstly, presents some facts related to the tobacco epidemic. Based on these facts, then, it analyzes the issue from ethical perspectives. And finally, it discusses the moral responsibilities for reducing the tobacco epidemic.

Objective To study the intra- tumor basis of pleural indentation (P I) and find the influential factors correlated with PI in peripheral lung cancer . Methods Eighty-six cases of peripheral lung cancer (includin g experimental gr oup of 34 cases with PI and control group of 52 cases without PI) were subjected to identify the constitution in tumoral interstitium. And 7 variables (includin g intra-tumor fibrosis, tumor-chest wall distance, histological type, diameter o f tumor, differentiated degree, lymphatic metastases, sex, etc.) were investigat ed about PI by single factor analysis and multiple factor analysis of Logistic r egression model. Results(1)Collagenous fibers were the mai n fiber in tumoral interstitium, and were higher in experimental group than that in control group ( t=3074, P005). Conclusion Collagen Ⅰfibers are the main type of interstiti al fibers, and myofibroblasts are the main type of interstitial cells in PI asso ciated peripheral lung cancer. Intra-tumor fibrosis, tumor-chest wall distance , and histological types are the main influential factors in PI formation, and int ra-tumor fibrosis is the basic and inside factor. The histological types affect PI formation. Tumor-chest wall distance plays an important outside role in PI f ormation.

Objective To assess the effectiveness and safety of hyperthermia combined with chemotherapy(HCT)compared with chemotherapy (CT)for ovarian cancer. Methods Related literatures were searched by two independent investigators from the following electronic databases:PubMed,Cochrane Library,EMbase,VIP,WanFang Data,CNKI and CBM.Then the meta?analysis was performed by using RevMan 5.3 software. Results A total of 10 RCTs involving 546 patients were included. The results of Meta?analysis showed that the HCT group was superior to the CT group in the effective rate,tumor control rate,effective rate of CA125,ascites control rate and PD,with significant differences(P<0.05). There was no significant difference in the improvement rate of life quality and the incidences of myelosuppression,severe myelosuppression,severe nausea and vomiting,severe constipation and diarrhea,liver and renal damage(P>0.05). Conclusion Compared with CT,HCT can significantly increase short?term curative effect,ameliorate the quality of life,and it does not increase the incidence of adverse reactions. HCT is worthy of clinical applica?tion.

Objective: To explore the value of 4D-CTA based on computed tomography dynamic angiography for preoperative evaluation of meningioma. Methods: Totally 34 patients with intracranial meningioma underwent cranial dynamic volume CT scan. Then 3D-CTA and 4D-CTA related post-processing were performed. The difference of tumor size, tumor feeding artery and the relationship of tumor and skull, passing artery and peripheral venous system showed with 3D-CTA and 4D-CTA were compared. Results: There was no significant difference between 3D-CTA and 4D-CTA in evaluating tumor size and tumor feeding artery (both P> 0.05). The percentage of definite draining veins evaluated with 3D-CTA was 70.59% (24/34), lower than that with 4D-CTA (94.12% [32/34], P< 0.05). The accuracy of 3D-CTA and 4D-CTA for evaluating the relationship between tumor and skull was 91.18% (31/34) and 97.06% (33/34), and the accuracy of for evaluating the relationship between tumor and passing artery was 87.50% (21/24) and 95.83% (23/24), respectively (both P> 0.05). Conclusion: CT dynamic angiography can accurately evaluate the size of meningioma, the feeding artery and relationship with surrounding tissue, therefore providing comprehensive preoperative information of meningioma.

ObjectiveTo study the metastructure volumes of medial temporal lobe in diagnosis the patients with Alzheimer's disease (AD) using 3 dimensional MRI.Methods23 AD patients according to DSM-Ⅳ criteria and 23 normal controls (NC) were examined with 3D-MRI.Hippocampus formation,amygdala,entorhinal cortex ( EC ),perirhinal cortex ( PC),and comu temporale were measured with 3D-MRI.ResultsSensitivity and specificity of diagnosis AD were 73.9％,97％ ( Hippocampus formation) ;39.1％,95.7％ (amygdala) ;73.9％,95.7％ (EC) ;95.7％,87.0％ (PC) and 34.8％,39.1％ ( cornu temporale).Overall discriminate function =cornu temporal × 3.887 + PC × 5.960 - EC × 0.074 + amygdale × 3.489 + hippocampus formation × 6.656- 22.449.Over-all-accuracy was 91.3％.ConclusionThe total volume of PC can better diagnosis the mild to moderate AD than other structure of medial temporal lobe.The changes of the medial temporal lobe volume could be used in diagnosis the patients with Alzheimer's disease.

Objective To explore the incidence and associated factors of aortic artery calcification (AAC) by lateral lumbar X-ray score in maintenance hemodialysis (MHD) patients.Mehtods A total of 155 MHD patients with complete clinical data in our hospital were enrolled in the study.Lateral lumbar X-ray score of the abdominal aorta was used to determine AAC in MHD patients.Results Aortic calcification was most severe in front of the fourth lumbar segment and ameliorated in higher lumbar levels.63.63％ of MHD patients presented visible calcification in the abdominal aorta,and 28.39％ had severe calcification with more than three segments.Age (OR=1.094,P＜0.01),dialysis vintage (OR=1.013,P=0.022),triglyceride (OR=1.261,P=0.030) and phosphate level (OR=1.324,P=0.023) were risk factors of abdominal aorta calcification,however serum albumin level (OR =0.239,P=0.013) was protect factor of aortic calcification.Conclusions Incidence of AAC is quite high in MHD patients and associated with increasing of age,duration of hemodialysis,serum triglyceride,phosphate level and plasma albumin.The semi-quantitative X-ray method of determining vascular calcification is less expensive and may be widely available clinically.

OBJECTIVE: To describe tne regional different factors which impact on early cochlear implantation in prelingual deaf children between eastern and western regions of China. METHOD: The charts of 113 children who received the cochlear implantation after 24 months old were reviewed and analyzed. Forty-five of them came from the eastern region (Jiangsu, Zhejiang or Shanghai) while 68 of them came from the western region (Ningxia or Guizhou). Parental interviews were conducted to collect information regarding the factors that impact on early cochlear implantation. Result:Based on the univariate logistic regression analysis, the odds ratio (OR) value of universal newborn hearing screening (UNHS) was 5. 481, which indicated the correlation of UNHS with early cochlear implantation is significant. There was statistical difference between the 2 groups (P<0. 01). For the financial burden, the OR value was 3. 521(strong correlation) and there was statistical difference between the 2 groups (P<0. 01). For the communication barriers and community location, the OR value was 0. 566 and 1. 128 respectively, and there was no statistical difference between the 2 groups (P>0. 05). The multivariate analysis indicated that the UNHS and financial burden are statistically different between the eastern and western regions (P=0. 00 and 0. 040 respectively). CONCLUSION The UNHS and financial burden are statistically different between the eastern reinforced in the western region. In addition, the government and society should provide powerful policy and more financial support in the western region of China. The innovation of management system is also helpful to the early cochlear implantation.
Child ; China ; Cochlear Implantation ; statistics & numerical data ; Geography ; Hearing Tests ; statistics & numerical data ; Humans ; Infant, Newborn ; Neonatal Screening

Objective:To investigate the effects of circ_000543 derived from hypoxic exosomes on proliferation and invasion of breast cancer (BC) cells.Methods:Bioinformatic website was used to predict the abnormal expression of circ_000543 in BC tissue and the transcription factor that might regulate circ_000543. Double luciferase report experiment and ChIP assay were used to confirm the regulation relationship between YY1 and circ_000543. Exosomes were separated from normal BC cells and BC cells under hypoxic condition, and qRT-PCR was adopted to detect the expression of circ_000543 in exosomes. The expression of circ_000543 and YY1 in exosomes was intervened and the exosomes were cocultured with BC cells under normoxia. CCK8 and Transwell assay was used to detect the proliferation and invasive ability individually.Results:qRT-PCR experiment found that, compared with MCF-10A cells (1±0.11) and exosomes isolated from normoxic cells (1±0.10), circ_000543 expression was up-regulated in BC cells (1.59±0.13) and exosomes derived from cells under hypoxic condition (1.63±0.12) ( t=6.001, P=0.004; t=6.986, P=0.002). Exosomes derived from cells under hypoxic condition promoted proliferation and invasion of BC cells under normoxia. Inhibition of circ_000543 partially offset the effects of exosomes. YY1 induced the expression of circ_000543 in BC cells as a transcription factor. The expression of circ_000543 was inhibited when YY1 expression was down-regulated; at the same time, down-regulation of YY1 inhibited the effects of exosomes on proliferation and invasion of BC cells. Conclusion:The transcription factor YY1 promoted proliferation and invasion of BC cells by inducing hypoxic breast cancer-derived exosomal circ_000543.

Objective:To investigate the effect of methyltransferase like 14 (METTL14) on the proliferation and invasion of breast cancer (BC) cells by regulating cyclin L2 (Cyclin L2, CCNL2) through m6A modification.Methods:Cancer tissues and paracancerous tissues of BC patients in Yantaishan hospital were collected from Aug. 2018 to Feb. 2020. The expression levels of m6A, METTL14 and CCNL2 in tissues were detected by high performance liquid chromatography/mass spectrometry (HPLC/MS) and qRT-PCR. Dual-luciferase reporter assay, qRT-PCR, and western blot were used to verify the regulatory relationship between METTL14 and CCNL2. RIP experiments verified the regulatory relationship between YTH domain-containing family protein (YTHDF2) and CCNL2. Cell viability was detected by MTT method, and cell invasion ability was detected by Transwell.Results:Compared with normal cells (0.24±0.02) and tissues (0.18±0.02) , BC cells MCF-10A (0.47±0.03, t=11.05, P<0.001) and HS-578T (0.41±0.03, t=8.17, P=0.001) and BC tissues (0.39±0.02, t=12.86, P<0.001) m6A level increased. Compared with normal tissues (1.00±0.26) (0.84±0.07) , METTL14 mRNA (1.57±0.28, t=13.50, P<0.001) and protein levels (1.66±0.11, t=10.89, P<0.001) in BC tissues were significantly increased high. Compared with the control group (100.00±10.11) (1.00±0.12) , the BC cell invasion ability (54.15±6.21, t=6.69, P=0.003) and activity (0.64±0.06, t=4.65, P=0.010) were weakened. Compared with the control group (100±11.05) (1±0.13) , the BC cell invasion ability (175.31±13.45, t=7.49, P=0.002) and activity (2.16±0.16, t=9.75, P=0.002) in the METTL14 overexpression group were enhanced, and the effects of METTL14 on cell invasion (137.41±12.64, t=3.56, P=0.024) and activity (1.64±0.15, t=5.59, P=0.005) were partially reversed after m6A inhibitor treatment change. Compared with normal tissues, CCNL2 expression was down-regulated in BC tissues, and the interaction between CCNL2 and METTL14 was confirmed. Compared with the control group (1.00±0.1) (0.64±0.05) , knockdown of METTL14 could make CCNL2 mRNA (1.67±0.05) . 0.13, t=7.08, P=0.002) and protein (1.09±0.09, t=7.57, P=0.002) were up-regulated. METTL14 knockout enhanced the stability of CCNL2 mRNA through a YTHDF2-dependent pathway, compared with sh-METTL14 group (50.47±5.16) (0.52±0.05) , BC cell invasion ability of sh-METTL14+sh-CCNL2 group (71.69±6.41, t=4.47, P=0.011) and activity (0.64±0.05, t=2.94, P=0.042) were improved. Conclusion:METTL14 inhibits the expression of CCNL2 through m6A modification to enhance the invasion and activity of BC cells.

Objective: To compare and quantify the differences in size-specific dose estimates (SSDE) obtained by effective diameter and water-equivalent diameter from the central slice of the scan range in head CT examination. Methods: A total of 111 consecutive adult patients who underwent head CT examination were enrolled in this study. All of CTDI_vol values in the dose report were documented. The dataset was assigned into group A and group B, based on the individual size-dependent conversion factors (f) of effective diameter (d_eff) and water-equivalent diameter (d_w) at the central slice multiplied by normalized volume computed tomography dose index (CTDI_vol ) respectively. Body size, f and SSDE were calculated. With SSDE_gross served as the reference level, the performance of SSDE_deff and SSDE_dw was evaluated. Results: Statistically significant differences were found in body size (t=47.587, P<0.05) and f(z=-9.242, P<0.05) between group A and group B. Statistically significant difference also existed in SSDE (t=-46.687, P<0.05), (56.20±2.66) and (53.49±2.48) mGy for group A and group B respectively. Strongly positive correlation was shown in body size (r=0.873, R² =0.761) and SSDE (r=0.974, R² =0.949) between group A and group B(all P<0.05). Positive correlation was also found between SSDE_deff and SSDE_gross(r=0.900, R² =0.809), SSDE_dw and SSDE_gross (r=0.904, R² =0.817, all P<0.05). Mean absolute difference was 2.34 and 0.78 mGy, for SSDE_deff vs. SSDE_gross and SSDE_dw vs. SSDE_gross respectively; mean absolute relative difference was 4.38%, 1.40%; root mean square difference was 1.17 mGy (2.17%), 1.06 mGy (1.91%). Interquartile range and full range of SSDE_deff and SSDE_dw were 3.22 vs. 2.39 mGy, 13.65 vs. 12.48mGy, respectively. A less degree of variation was observed in SSDE_dw than that in SSDE_deff. Conclusions SSDE_dw values based on the water-equivalent diameter at the central slice of the scan range got better agreement with those derived from all slices, which could serve as a simpler and more valid indicator to represent the average value of size-specific dose estimates of the whole scan range in head CT examination.