ObjectiveTo analyze the incidence rate and mortality of acute myocardial infarction (AMI) and their changing trends among the registered residents in Xiaoshan District, Hangzhou City from 2017 to 2023, so as to provide references for formulating policies related to AMI prevention. MethodsThe morbidity and mortality data of AMI among the registered residents in Xiaoshan District from 2017 to 2023 were collected through the Hangzhou Chronic Disease and Death Cause Monitoring System. Software such as Excel 2019, SPSS 25.0 and Joinpoint 4.9.1.0 were used to calculate the incidence rate, mortality, and average annual percentage change (AAPC) of AMI. ResultsFrom 2017 to 2023, the average annual crude incidence rate, age-standardized incidence rate using China standard population (ASIRC), and the age-standardized incidence rate using World standard population (ASIRW) of AMI in Xiaoshan District were 48.25/100 000, 29.14/100 000, and 21.64/100 000, respectively, and, from which the AAPCs were 5.495%, 6.010%, and 6.533%, respectively, all showing an upward trend. The average annual crude mortality rate, the age-standardized mortality rate using China standard population (ASMRC), and the age-standardized mortality rate using World standard population (ASMRW) were 11.76/100 000, 6.52/100 000, and 4.71/100 000, respectively, from which the AAPCs were -9.669%, -10.433% and -9.615%, respectively, all showing a downward trend. The average annual crude incidence rate of AMI was higher in males (65.87/100 000) than that in females (31.31/100 000). Moreover, the average annual crude mortality rate of AMI was higher in males (14.08/100 000) than that in females (9.52/100 000), and the difference was statistically significant (all P<0.001) .After age grouping, the crude incidence rate of AMI among the residents aged 35-, 45-, 55-, and 65- years in Xiaoshan District from 2017 to 2023 showed an upward trend over time, with AAPCs of 16.993%, 17.149%, 8.523%, and 5.002%, respectively. While the crude mortality rate in residents aged 35-, 75-, and 85-102 years showed an decreasing trend over time, with AAPCs of -23.977%, -15.467%, and -17.415%, respectively, but there was no statistically significant difference in the trends in incidence rate and mortality of other age groups (all P>0.05). ConclusionThe situation of AMI prevention and control among the registered residents in Xiaoshan District is not optimistic, and targeted measures should be strengthened for the male residents aged ≥35 years old.

Objective: To analyze the incidence trend of colorectal cancer in Xiaoshan District, Hangzhou City from 2010 to 2024, and predict the incidence of colorectal cancer from 2025 to 2027, so as to provide the evidence for improving the prevention and control strategies of colorectal cancer. Methods: Colorectal cancer incidence data from 2010 to 2024 in Xiaoshan District were collected through the Hangzhou Municipal Chronic Disease Monitoring Management System. The crude incidence of colorectal cancer was calculated, and standardized using the data from the Sixth National Population Census in 2010 (Chinese standardized rate) and the Segi's world standard population (world standardized rate). The trend of colorectal cancer incidence from 2010 to 2024 was analyzed using the average annual percent change (AAPC). An exponential smoothing state space model with trigonometric seasonality, box-cox transformation, ARMA errors, trend and seasonal components (TBATS) was established to forecast the crude incidence of colorectal cancer from 2025 to 2027. Results: There were 10 726 new cases of colorectal cancer in Xiaoshan District from 2010 to 2024. The crude incidence, Chinese standardized rate, and world standardized rate of colorectal cancer were 59.25/100 000, 38.62/100 000 and 29.50/100 000, respectively. The crude incidence, Chinese standardized rate, and world standardized rate of colorectal cancer in males were 70.56/100 000, 44.44/100 000and 35.58/100 000, respectively, while those in females were 48.37/100 000, 32.69/100 000 and 23.70/100 000, respectively. The Chinese standardized rate of colorectal cancer was significantly higher in males than in females (P<0.05). The crude incidence of colorectal cancer in males, females and the whole population showed upward trends from 2010 to 2024 (AAPC=4.916%, 3.795% and 4.442%, all P<0.05). The crude incidence of colorectal cancer in the groups of 0-<35, 35-<50, 50-<75 and ≥75 years were 1.75/100 000, 19.86/100 000, 112.28/100 000 and 272.99/100 000, respectively, showing an increasing trend with age (P<0.05). From 2010 to 2024, the crude incidence of colorectal cancer in the ≥75 years group showed an increasing trend (AAPC=4.470%, P<0.05), while no significant trend was observed in other age groups (all P>0.05). TBATS model demonstrated good fitting (predictive) performance, indicating a year-by-year increase in the crude incidence of colorectal cancer across the whole population from 2025 to 2027, with an estimated rate reaching 70.45/100 000 in 2027. Conclusions The crude incidence of colorectal cancer in Xiaoshan District showed an increasing trend from 2010 to 2024, and it is predicted to continue to increase from 2025 to 2027. Males and the elderly are the key populations for colorectal cancer prevention and control.

Druggability evaluation is one of the core processes in new drug development, yet the inaccuracy and high cost of existing in vitro liver models have been a major technical bottleneck, leading to an increasing demand from the pharmaceutical industry for reliable in vitro liver models to enhance the efficiency of new drug research and development. Traditional animal models and in vitro 2D culture models have their limitations in simulating in vivo physiological and pathological conditions, making it challenging to accurately predict drug efficacy and safety. With the advancement of microfluidic technology, in vitro cell culture, and biosensor technology, liver-on-a-chip (LOC) has garnered increasing attention in the field of new drug development in recent years, and is expected to become a powerful tool for addressing the challenges in druggability evaluation. While introducing the construction technology of LOC, this article mainly summarizes the research and application of existing LOC from the perspectives of disease model construction, drug metabolism research, and drug safety evaluation. Furthermore, it analyzes the role of LOC in druggability evaluation and discusses the current challenges and prospects in this field.

Objective To explore the effect of improved total cavity endoscopy on lung function,postoperative feeding and complications in patients with chronic lung disease of esophageal cancer.Methods 120 esophageal cancer patients with chronic lung disease admitted to our hospital from September 2022 to June 2023 were randomly divided into two groups.The observation group consisted of 60 patients who underwent improved total cavity endoscopy assisted esophageal cancer resection,while the control group consisted of 60 patients who underwent traditional open surgery.The perioperative related indexes,lung function indexes[forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),maximum ventilation volume(MVV)],inflammatory level[interleukin-6(IL-6),interleukin-8(IL-8),tumor necrosis factor(TNF-α)]were compared between the two groups.Results The blood loss,operation time,number of lymph node dissection and drainage time in the observation group were(329.51±78.84)ml,(175.47±10.41)min,(29.67±17.86)pieces per case and(3.14±0.98)d respectively.In the control group,the intraoperative blood loss,operation time,number of lymph node dissection and drainage time were(372.31±99.23)ml,(148.54±10.68)min,(28.36±18.15)pieces and(6.37±1.23)d,respectively,there was statistical significance between the two groups(P＜0.05).The FEV,,FVC and MVV of the observation group were(1.88±0.53)L,(2.33±0.46)L and(32.59±11.84)L,respectively.Two weeks after operation,the control group was(1.37±0.31)L,(1.75±0.38)L and(23.68±9.41)L respectively,there was statistical significance between the two groups(P＜0.05).The inflammatory factors IL-6,IL-8 and TNF-α in the observation group were(2.17±1.62)ng/ml,(2.09±1.52)ng/ml and(1.32±0.57)ng/ml,respectively.The control group were(3.06±1.52)ng/ml,(2.75±1.29)ng/ml and(1.73±0.75)ng/ml respectively,there was statistical significance between the two groups(P＜0.05).The incidence of postoperative complications in the observation group and the control group were 6.67％and 20.00％respectively,and patients in the observation group ate earlier than those in the control group(P＜0.05).Conclusion Compared with the traditional open surgery,the improved total laparoscopic surgery has the advantages of less trauma,simpler operation,less damage to lung function,significantly lower incidence of postoperative complications,and shorter postoperative eating time.

Objective:To investigate the application effect of production-oriented approach (POA) for consulting ability teaching in general practice standardized residency training.Methods:Eighteen third-year general practice residents in the Second Affiliated Hospital of Harbin Medical University received a special training course on the consulting ability based on POA with the situational simulation teaching from September 2021 to March 2022. The consulting ability of residents was evaluated with Objective Structured Clinical Examination (OSCE) and Leichester Assessment Package (LAP) before and after the training, and the results were compared. Meanwhile, a questionnaire survey and semi-structured interviews were conducted to assess residents′ satisfaction with the course.Results:All 18 resident trainees (11 females and 7 males) aged 25 to 34 (27.3±2.4) years successfully completed the training. Both OSCE scores and LAP scores after the training were significantly higher than those before training (66.25±5.84 vs. 44.44±12.80, t=8.46, P<0.001; 65.78±7.05 vs. 38.33±14.2, t=1.47, P<0.001, respectively). The ability of medical history collection, physical examination, patient management, problem solving, doctor-patient relationship, preventive care and medical record writing were all significantly improved after the training compared with those before training ( t=2.464, 4.278, 8.997, 2.385, 10.35, 5.212, 7.578, all P<0.05). The questionnaire survey showed that all the 18 residents were satisfied with the reasonableness of the teaching content, the class time arrangement, the teaching progress arrangement and the instructors. In the dimension of training effectiveness, 18 participants all believed that the course was helpful to improve their humanistic quality and confidence in reception. In terms of self-promotion, all respondents believed that this course was able to promote their reflection ability and stimulate their learning interest. By coding and analyzing the contents of the semi-structured interviews with the residents, nine main themes were constructed, namely course deficiencies, course characteristics, course advantages, course suggestions, trainees′ deficiencies, trainees′ gains, trainees′ goals, previous teaching deficiencies, and instructor′s role. The results showed that all residents had a high degree of satisfaction with the course, and they thought the course was vivid and interesting and it is able to mobilize the enthusiasm of learning, promote learner to reflect. The residents also suggested to increase the teaching hours and to enrich teaching cases. Conclusion:The consulting ability training of general practice based on POA can effectively improve consulting ability, stimulate learning interest and improve independent learning ability of residents, which gains recognition from both faculty and trainees.

The NMGCF-19 strain is an E.coli strain isolated and identified in our laboratory from lambs manifesting severe diarrhea and meningitis.Previous analysis of the genome sequence of NMGCF-19 strain showed that the outer membrane protein A(ompA)gene was a potential viru-lent gene.In order to determine whether the ompA gene is associated with the pathogenicity of NMGCF-19 strain and the underlying mechanism,the NMGCF-19 strain with ompA knockout(NMGCF-19△ompA)was generated in this study using CRISPR/Cas9 technology and used to de-termine the role of ompA gene in mediating the encephalitis by NMGCF-19 infection and the un-derlying mechanism using the mouse model system.The results showed that the neuronal cell nec-rosis in the hippocampus in mice infected by NMGCF-19△ompA was significantly reduced and was not focal compared with that of mice infected with the wild-type NMGCF-19 strain.The number of bacteria in brain of mice infected by NMGCF-19 △ompA was significantly reduced in comparison to that of mice infected by NMGCF-19.Simultaneously,the mRNA and protein expression levels of the tight junction proteins ZO-1 and Occludin were both increased in mice infected by NMGCF-19 △ompA strain compared with the mice infected by NMGCF-19 strain.These results suggest that the ompA gene is a virulent gene and plays an important role in the invasion of the blood-brain barrier by NMGCF-19 strain in mice.

A recombinant enzyme-mediated nucleic acid amplification(RAA)technology combined with colloidal gold test strips was developed for the rapid detection of bovine enterovirus(BEV).Using the highly conserved BEV 5'UTR as the target sequence,the primers were designed and screened.Downstream primer labeled with biotin at the 5'end and the probe labeled with 6-FAM at the 5'end were used to establish the RT-RAA method.The test strips were assembled by using mouse-derived anti-6-FAM monoclonal antibody as the gold standard antibody,with a streptavidin encapsulated in the detection line and sheep anti-mouse IgG encapsulated in the quality control line.A RT-RAA-LFD method was established by combing RAA technique with the prepared later-al flow device test strips for the detection of bovine enterovirus nucleic acids.The specificity,sensi-tivity,repeatability,and clinical application of the method are also evaluated.The results showed that the optimal primer concentration of this method was 5 μmol/L,and the amplification of BEV nucleic acids was accomplished by reacting at 35 ℃ for 8 min with the lowest detection limit of 101 copies/μL.No cross-reactivity with bovine viral diarrhea virus,bovine parvovirus,and foot-and-mouth disease virus was observed.The efficacy for the prepared test strips was at least for 90 d kept at 4 ℃.Detection of 74 clinical samples yielded a similar result compared with RT-PCR method.The above results demonstrated that the BEV RT-RAA-LFD method established in this study has high sensitivity,specificity,and more convenient to use,which is suitable for clinical de-tection on-site and provides a new technical tool for the diagnosis and epidemiological investigation of BEV infection.

Objective To explore the correlation between rs207663 mutation in PARK9 gene and response to cognitive improvement in early Parkinson's disease(PD).Methods A total of 100 pa-tients with early PD treated in Department of Neurology of Handan Fourth Hospital from Octo-ber 2020 to October 2023 were enrolled and subjected as the study group,and another 100 healthy individuals taking physical examinations during the period were assigned into the control group.Their rs207663 polymorphisms of PARK9 gene were detected,and the alleles and genotype distri-bution were compared between the two groups,and the therapeutic effects of the patients with different genotypes were analyzed.Results There were three genotypes in rs207663 of PARK9 gene:GG,GA and AA.The frequencies of GG genotype and G allele were significantly higher in the study group than the control group(40.0％vs 26.0％,P＜0.05;63.0％vs 50.0％,P＜0.01).After treatment,the mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scores of the GG,GA and AA genotypes showed an increasing trend,the GG genotype had significantly lower MMSE score[(22.95±1.34)vs(23.89±1.68),P＜0.05]and MoCA score[(24.86±1.83)vs(25.12±1.48),P＜0.05]when compared with the GA genotype.The GA geno-type had notably higher total assets,larger number of safe options and elevated utilization rate of negative feedback than the GG genotype[(-1541.50±537.24)Yuan vs(-3102.00±1274.38)Yuan,P＜0.01;(9.24±3.27)vs(7.11±2.14),P＜0.05;(0.51±0.23)vs(0.35±0.15),P＜0.05].While the AA genotype obtained smaller number of risk options than the GA genotype,and the GA genotype got lower number of risk options than the GG genotype(P＜0.05).Conclusion The rs207663 polymorphism of PARK9 gene is significant associated with the response to improve-ment treatment for early PD.The patients carrying GG genotype have poor response to treatment,the patients carrying GG genotype prefer high-risk and high-reward options,and have low utiliza-tion rate of negative feedback.

Objective:This study aimed to assess left atrial function in adults across various age groups using 4-dimensional automated left atrial quantification(4D Auto LAQ)technology.The study also aimed to compare the differences in two-dimensional(2D)and four-dimensional(4D)strains of the left atrium among different age groups, with the goal of enhancing the clinical utility of 4D Auto LAQ.Methods:A total of 409 healthy volunteers were recruited for the research.Two-dimensional and four-dimensional images were obtained using a GE Vivid E95 ultrasound system with a 4Vc four-dimensional probe.The study examined variations in 2D and 4D ultrasound parameters across various age groups.Furthermore, the relationship between left atrial reservoir strain(LASr), Left atrial conduit strain(LAScd), left atrial contraction strain(LASct), and age was explored.Results:The study involved 409 volunteers, with 217 males and 192 females, who were categorized into three age groups: young(18-45 years, n=56), middle-aged(46-65 years, n=202), and elderly(>65 years, n=151).Conventional ultrasound measurements indicated changes in left atrial anterior-posterior diameter with age progression: (31.70±3.65)mm for the young group, (34.02±3.91)mm for the middle-aged group, and(35.2±4.37)mm for the elderly group( P<0.01).The 2D and 4D left atrial parameters across the age groups were as follows: LASr(2D)(%): 37.48±7.51, 30.95±8.23, 26.9±7.56( P<0.01); LA VImax(ml/m 2): 23.54±5.79, 26.33±7.6, 28.99±8.15( P<0.01); LASr(%): 31.2±17.07, 22.5±8.59, 19.49±7.47( P<0.01).Both 2D and 4D left atrial parameters exhibited significant associations with age.Specifically, the correlations between LASr(2D)(%), LAScd(2D)(%), LASr(%), LAScd(%), and age were -0.429, 0.580, -0.354, 0.298, respectively( P<0.01). Conclusions:The 4D Auto LAQ technology is efficient in assessing left atrial function across various age groups, with age playing a significant role in influencing left atrial parameters.When compared to other ultrasound parameters, both 2D and 4D left atrial strain parameters have the ability to detect differences at an early stage, making them suitable for the early screening, evaluation, and monitoring of age-related left atrial dysfunction, especially in the elderly population.

Objective:To summarize the clinical and genetic characteristics of children with Menkes disease(MD).Methods:The clinical manifestations, auxiliary examinations and genetic testing results of 15 MD children admitted to the Department of Pediatrics of the Third Affiliated Hospital of Zhengzhou University, Children′s Hospital Affiliated of Zhengzhou University and the First Affiliated Hospital of Zhengzhou University from June 2016 to October 2022 were analyzed retrospectively.These children were followed up.Results:All the 15 children were male.The age at onset was ranging from 9 days to 5.5 months.White skin, curly hair, skin laxity, hypotonia and severe developmental delay were found in all children, with epilepsy in 13 children, anemia in 11 children and granulocytopenia in 4 children.The concentration of ceruloplasmin in the serum of MD children was lower than that in healthy children of the same age.The concentration of ceruloplasmin in MD children younger than 3 months was significantly lower than that in healthy children of the same age and MD children older than 3 months.The brain magnetic resonance imaging showed abnormalities in all 15 children.Twelve children showed tortuous intracranial vessels in brain magnetic resonance angiography examinations.All the 15 children had ATP7A gene pathogenic variants, including 4 missense variants(2 cases with c. 2179G>A), 3 frameshift variants, 3 nonsense variants, 3 exon deletions and 2 splice site variants.Among these children, 1 had a novel gene variant that had not been reported so far(c.2968C>T). Conclusions:MD has early onset age and diverse clinical manifestations, but also has characteristic clinical manifestations and applicable auxiliary examinations.Its diagnosis depends on genetic testing.The c. 2179G>A and exon deletions may be hot mutations in Chinese MD patients.