Objective To evaluate the vaccination of live attenuated varicella vaccine ((VarV) in Jinshan District of Shanghai. Methods Descriptive and analytical epidemiological analysis was carried out using the information of VarV immunization of children born between November 1, 2006 and October 31, 2018 (1-12 years) in the Jinshan District Immunization Program Information System. Results There were 82 584 registered children aged 1-12 years in Jinshan District, and the vaccination rate of VarV at the first dose (VarV1) was 90.95%. The vaccination rate of children in this city was higher than that of migrant children, and the annual vaccination rate of children born in different years was between 59.81% and 99.93%. The vaccination rates in northern, central and southern Jinshan District were 89.25%, 93.27% and 91.39%, respectively. Among the 82 584 registered children, the second dose of VarV (VarV2) vaccination rate was 49.01%. The vaccination rate of children in this city was higher than that of migrant children, and the annual vaccination rate of children born in different years was between 25.94% and 77.14%. The vaccination rates in northern, central and southern Jinshan District were 28.72%, 45.88% and 66.30%, respectively. Conclusion The VarV1 vaccination rate of children aged 1-12 in Jinshan District was higher, but the VarV2 vaccination rate was relatively low. It is necessary to further strengthen publicity in key areas to improve the level of VarV2 vaccination.

BACKGROUND:In perioperative period of total knee replacement in elderly patients, it is crucial to maintain the normal function of blood coagulation. However, many factors may influence coagulation function of patients in perioperative period. Of them, anesthesia is an important factor. Different anesthesia methods wil produce different effects on blood coagulation. Appropriate anesthesia methods should be selected in the clinic to maintain the stability of coagulation function. OBJECTIVE:To explore the effect of application of general anesthesia and epidural anesthesia in elderly knee replacement and the effects on the function of blood coagulation. METHODS:A retrospective analysis was performed on clinical data of 135 elderly patients after total knee replacement in Dongying Hospital of Shandong Provincial Hospital Group from September 2012 to September 2013. Al patients were divided into control group (67 cases;general anesthesia) and observation group (68 cases;epidural anesthesia) according to the mode of anesthesia. Coagulation indexes and D-dimer levels were observed before anesthesia, 6 hours after anesthesia, and 1 day after replacement in both groups. The incidence of deep venous thrombosis was measured and compared between the two groups in 12-month fol ow-up.
RESULTS AND CONCLUSION:Through the statistics and comparison, no significant difference was detected in blood coagulation indexes at different time points in the two groups (al P>0.05). However, significant differences in D-dimer levels were detectable between the two groups at 6 hours after anesthesia and in the morning at 1 day after replacement. D-dimer levels were significantly lower in the observation group than in the control group (al P<0.05). The incidences of deep venous thrombosis were 3%and 21%in the observation and control groups, respectively, showing significant differences (P<0.05). These results suggest that epidural anesthesia during elderly totak knee replacement obtained good effects, and could maintain stable coagulation function.

Objective: To study influence of acute hypoxia on the current of voltage-gated potassium channel (IK) in pulmonary artery smooth muscle cells (PASMC) of rats. Methods: A total of 20 male SD rats were randomly and equally divided into normoxic control group and acute hypoxia group. The rats in acute hypoxia group were kept in hypoxic chamber for 8 h before experiment. Whole cell patch-clamp technique was used to record IK in PASMC. Results: Acute hypoxia significantly decreased the IK density in PASMC of rats. During -60mV to -10mV of resting membrane potential（RMP）, acute hypoxia did not significantly decrease peak IK density in PASMC of rats, P>0.05; At 0 mV, acute hypoxia significantly decreased the peak IK density in PASMC [from（38.1 ± 5.2） pA / pF decreased to（9.82 ± 2.1） pA / pF ,P<0.05], then along with RMP increase in PASMC, the decreasing amplitude of peak IK density in PASMC gradually increased（P<0.05）; From + 30 mV to+ 60 mV, the decreasing amplitude of peak IK density in PASMC further significantly increased（P<0.01）; At + 60 mV the peak IK density decreased from（38.1 ± 5.2） pA / pF to（9.82 ± 2.1） pA / pF , and the decreasing amplitude reached (46.8±3.3)%. Conclusion: Acute hypoxia can decrease Kv current in PASMC of rats, leading to hypoxic pulmonary vasoconstriction.

Objective To assess the therapeutic value of CT guided percutaneous radiofrequency thermal ablation(RFA)for peripheral lung carcinoma(PLC).Methods Forty-three patients with PLC were treated with RFA under the CT guidance.The patients included 26 males and 17 females,and the age ranged from 52 to 76 years.The CT guided percutaneous biopsies were performed to obtain the pathology before the procedures.Results The operations in all cases were successful,little amount of pneumothorax was found in 3 cases,liquid-pneumothorax in 1 case,and large amount of pneumothorax was drainaged in 1 case.The volume of the lesion in 40 cases from 43 patients was diminished gradually at 3 and 6 months follow-up after the procedures.No change in the volume of lesion with peripheral enhancement was seen in 3 cases.Conclusion CT guided percutaneous RFA for PLC is a safe,effective,and minimal invasive procedure.

Objective To explore the causes of hepatic perfusion disorders (HPD), and to analysis the CT features of this phenomenon. Methods Nine experimental pigs were randomly divided into three groups. In Group A, B and C, intrahepatic portal, arterial branches and hepatic vein were selectively embolized, respectively. Then all animals underwent contrast enhanced CT scans immediately and after one week. Results On CT images immediately after intervention, HPD were found in all animals. Multiple transient wedge-shaped hyperattenuation represented during the hepatic arterial phase and isoattenuating areas during the portal venous phase. In group A, the site of HPD was in correspondence with the area of embolization,whereas in group B, the embolized area displayed hypoattenuation and non-embolized area displayed hyerattenuation during arterial phase. In group C, the site of HPD was correspondence with the area of embolization in two pigs, but in one pig, the region of HPD was larger than the region of embolization. After one week, HPD disappeared due to sponges absorption and the vessels reopening in group A and B. In group C which hepatic vein was coagulated by laser, HPD remained partially. Conclusion Intrahepatic vascular occlusions of portal, hepatic arterial and hepatic venous branches are the main factors that cause HPD.

Objective To determine the epidemiological characteristics of measles in Jinshan District of Shanghai in 2002‒2019. Methods This study was a secondary data analysis using measles surveillance system and epidemiological case reports in Jinshan District from January 2002 through December 2019. Temporal characteristics of the disease onset was determined by a concentration method. ArcGis 10.4 and SaTScan 9.6 software were used for spatiotemporal clustering scanning analysis. Results From 2002 through 2019， a total of 289 cases of measles were reported in Jinshan District， Shanghai， with an average annual incidence of 2.24 per 10⁵. The annual incidence fluctuated from 0 to 11.27 per 10⁵. The highest incidence was recorded in 2005 （11.27 per 10⁵）， followed by a decline； however， there was a rebound in 2008 （5.26 per 10⁵） and 2015 （3.30 per 10⁵）. The concentration M was determined to be 0.62， showing a clear seasonality concentrated in February to May. The spatiotemporal scan found that spatial and temporal clusters were more likely to occur in the areas with higher population density such as Zhujing Town and Shihua Community and between 2002 and 2009. The majority of measles cases were infants and children under the age of 1 and adults aged 20‒39 years. Approximately 66.78% of measles cases reported unknown vaccination history. In addition， in children aged 8 month to 4 years， the vaccination rate of measles-containing vaccines in the domestic migrants was much lower than the local residents （χ²=4.44， P=0.035）. Conclusion The incidence of measles in Jinshan District presents a downward trend. The population affected has a "two-way displacement"， which is concentrated in the more populated areas. It is necessary to strengthen measles surveillance and implement supplementary immunization programs with measles-containing vaccines for at-risk populations.

OBJECTIVE: To compare the clinical effect of conventional acupuncture combined with pricking and cupping at Jianbo area and conventional acupuncture in the treatment of scapulohumeral periarthritis of frozen stage. METHODS: A total of 66 patients with scapulohumeral periarthritis of frozen stage were randomly divided into a combination group (31 cases) and an acupuncture group (35 cases, 1 case dropped off). Both groups were given functional exercise. Patients in the acupuncture group were treated with acupuncture at Jianyu (LI 15), Jianliao (TE 14), Binao (LI 14) and ashi point on the affected side, once every other day, three times a week, for a total of 4 weeks. On the basis of treatment in the acupuncture group, the patients in the combination group were treated with pricking and cupping at Jianbo area (the area surrounded by the 3 acupoints of Tianzong [SI 11], Naoshu [SI 10] and Jianzhen [SI 9]), once a week for 4 weeks. The University of California-Los Angeles (UCLA) shoulder joint score, visual analogue scale (VAS) score before treatment, after treatment and after 6 months of treatment completion (follow-up) and tenderness threshold before and after treatment, and the clinical effects of the two groups after treatment and in follow-up were evaluated. RESULTS: In the two groups, after treatment and in follow-up, the UCLA shoulder joint scores were higher than those before treatment (P<0.05), and the VAS scores were lower than those before treatment (P<0.05). In the combination group, after treatment and in follow-up, the UCLA shoulder joint score was higher than that of the acupuncture group (P<0.05), and the VAS score was lower than that of the acupuncture group (P<0.05). After treatment, the tenderness thresholds of the two groups were higher than those before treatment (P<0.05), and the tenderness threshold in the combination group was higher than that in the acupuncture group (P<0.05). After treatment and in follow-up, the cured and markedly effective rate of the combination group was 48.4% (15/31) and 51.6% (16/31) respectively, which was higher than 23.5% (8/34) and 23.5% (8/34) of the acupuncture group (P<0.05). CONCLUSION Pricking and cupping in Jianbo area combined with conventional acupuncture can improve shoulder joint function and relieve shoulder joint pain in patients with scapulohumeral periarthritis of frozen stage, and the curative effect is better than that of single conventional acupuncture.
Humans ; Periarthritis/therapy* ; Acupuncture Therapy ; Shoulder Pain/therapy* ; Shoulder Joint ; Acupuncture Points ; Treatment Outcome

OBJECTIVETo explore the radiosensitizing effect of erlotinib on human lung adenocarcinoma cell line A549 cells and the related mechanisms.

METHODSThe inhibitory effect of erlotinib on A549 cells was assessed by MTT assay, and its IC50 concentration was calculated. The radiosensitization was evaluated by the method of clone forming assay. Flow cytometry was used to analyze the effect of erlotinib on cell cycle and apoptosis.

RESULTSThe growth of A549 cells was inhibited after the cells were exposed to erlotinib for 48 hours. Moreover, the inhibitory rates increased with the increase of erlotinib concentrations, and IC50 was 19.26 µmol/L. In contrast to the irradiation alone group, the survival rates of the cells in erlotinib plus irradiation groups decreased, and erlotinib enhanced the radiosensitivity of the A549 cells. This effect was further increased as cells were exposed to erlotinib for a longer time. In the irradiation alone group and the two groups exposed to erlotinib for 24 hours and 48 hours before irradiation, D0 values were 3.01 Gy, 2.58 Gy and 2.45 Gy respectively, and Dq values were 2.16 Gy, 1.94 Gy and 1.61 Gy, respectively. In the last two groups, SERD0 values were 1.17 and 1.23, respectively. The flow cytometry analysis showed that erlotinib induced G2/M phase arrest and increased the apoptosis rate in A549 cells. With the increase of exposure time, the effects were more significant.

CONCLUSIONSErlotinib inhibits the A549 cell growth and enhances the radiosensitivity of A549 cells in vitro. The radiosensitizing mechanisms might be related to inhibiting repair of sublethal injury and inducing G2/M phase arrest and apoptosis.

Adenocarcinoma ; pathology ; Apoptosis ; drug effects ; radiation effects ; Cell Cycle ; drug effects ; radiation effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; radiation effects ; Dose-Response Relationship, Drug ; Erlotinib Hydrochloride ; Humans ; Lung Neoplasms ; pathology ; Particle Accelerators ; Quinazolines ; administration & dosage ; pharmacology ; Radiation Tolerance ; drug effects ; Radiation-Sensitizing Agents ; administration & dosage ; pharmacology

Objective:To investigate the effects of preoperative pre-rehabilitation on early functional recovery after knee arthroplasty under the multidisciplinary collaboration mode of accelerated rehabilitation surgery.Methods:The clinical data of 51 patients who underwent total knee arthroplasty in the Department of Orthopedics, Jinjiang Hospital from September 2019 to December 2021 were retrospectively analyzed. These patients were divided into an observation group ( n = 24) and a control group ( n = 27). The observation group received pre-rehabilitation before knee replacement surgery, while the control group did not. After completing the admission procedures, patients in the observation group underwent rehabilitation evaluation in the rehabilitation clinic and received individualized rehabilitation training. The control group did not undergo preoperative pre-rehabilitation but underwent the same individualized rehabilitation training as the observation group. The rehabilitation specialist evaluated the patients' rehabilitation scores [hospital for special surgery knee (HSS) score, visual analog scale (VAS) score] at 2 and 5 days after surgery. The main outcome measures included the range of motion (ROM) of the patient's knee joint at 2 and 5 days after surgery, HSS score at 2 and 5 days after surgery, VAS score at 5 days after surgery, the number of days from surgery to discharge, the incidence of postoperative complications, and the rate of outpatient visits after surgery. Results:There was no significant difference in postoperative ROM of the knee joint between the observation and control groups at 2 days after surgery ( P > 0.05). However, there was a significant difference in score of ROM of the knee joint at 5 days after surgery between the two groups [(100.08 ± 7.75) points vs. (88.44 ± 16.09) points, t = 3.34, P = 0.002]. There was no significant difference in HSS score between the two groups at 2 days after surgery ( P > 0.05). However, there was a significant difference in HSS score between the two groups at 5 days after surgery [(62.84 ± 5.78) points vs. (57.09 ± 6.53) points, t = 3.31, P = 0.002]. There was a significant difference in VAS score (exercise) between the two groups at 5 days after surgery [(3.42 ± 1.02) points vs. (5.37 ± 1.15) points, t = -6.39, P < 0.001]. There was no significant difference in the number of days from surgery to discharge between the two groups ( P > 0.05). There was no significant difference in the incidence of postoperative complications between the two groups ( P > 0.05). However, there was a significant difference in the rate of outpatient visits between the two groups [7/17 vs. 1/26, χ2 = 4.45, P = 0.035]. Conclusion:Preoperative pre-rehabilitation in the accelerated rehabilitation surgery model under multidisciplinary collaboration can help improve the early function of patients undergoing total knee arthroplasty, reduce the pain of postoperative rehabilitation, improve the postoperative rehabilitation compliance, and ultimately enhance patient satisfaction with the surgery.

Objective To investigate the relationship between perioperative nutritional risk and venous thromboembolism(VTE)in patients with hip fracture.Methods A total of 379 patients with unilateral hip fracture due to fall or sprain who underwent elective surgery were selected and divided into the non-VTE group(246 cases)and the VTE group(133 cases)according to whether or not VTE occurred during perioperative period.Basic information,surgical and anesthesia records,nutritional risk related indicators,inflammatory indicators and outcome indicators of patients were collected.Multiple Logistic regression was used to analyze the independent influencing factors of perioperative VTE.Receiver operating characteristics(ROC)curves were used to assess the ability to discriminate independent factors,and DeLong test was used to compare area under the curve(AUC).Results Compared with the non-VTE group,the proportion of patients in the VTE group was older,complicated with hypertension,the time to visit hospital more than 2 days,received(hollow/intramedullary nail)internal fixation,perioperative blood transfusion,ASA gradeⅢtoⅣ,and higher nutritional risk screening Table(NRS)-2002 scores on admission and higher postoperative neutrophil/lymphocyte ratio(NLR).Nutritional prognosis index(PNI),hemoglobin(Hb)and prealbumin(PA)at admission and after operation were lower in the VTE group than those in the non-VTE group(P＜0.01).Multivariate Logistic regression analysis showed that PNI was decreased,NRS-2002 scores and PA were increased,and the time of visit hospital was>2 days after internal fixation.American College of Anesthesiologists(ASA)gradesⅢ-Ⅳwere independent risk factors for perioperative VTE of hip fracture(P＜0.05).ROC curve analysis showed that the AUC(95%CI)of NRS-2002 at admission was 0.739(0.692-0.783),and that of PNI at admission was 0.720(0.672-0.765),both of which were better than other influencing factors(P＜0.01).Conclusion NRS-2002 and PNI are good predictors of perioperative VTE in patients with hip fracture.