Objective To discuss the uhrasonography and hemodynamic characteristics of carotid atherosclerosis in elderly patients with coronary heart disease (CHD).Methods The 548 people were divided into CHD group (n = 373) and control group (n = 175) by the coronary angiography.And the patients in CHD group were sorted into myocardial infarction (MI) group (n= 160) and non-MI group (n= 213).All patients were above 60 years of age, and underwent carotid artery ultrasound examination.The data of carotid sonography and hemodynamics were classified and analyzed using SPSS 10.0 software.Results The carotid intima-media thickness (IMT), plaque thickness and score were much more in CHD group than in control group [(0.96±0.24) mm vs.(0.78±0.11) mm, (1.90±0.36) mm vs.(1.66±0.13)mm, (2.2±0.7) vs.(1.9±0.4), t= 14.81, 27.89 and 27.83, all P=0.00].A total of 161 (43.2%) patients had atherosclerotie plaques in CHD group, and there were 7 (4.0%) people with plaques in healthy control group(χ~2 =337.18, P =0.00).And there were 81.3% of patients with plaques in MI group, it was more than non-MI group, in which there were 12.9% of patients with plaques (χ~2 =60.88, P=0.00).The carotid peak systolic velocity (PSV) and resistance index (RI) were both higher in CHD group than in control group [(77.0±11.9) cm/s vs.(65.2±3.1) cm/s and 0.77±0.06 vs.0.67±0.08, (t= 12.26 and 50.43, P=0.00)].Conclusions Carotid ultrasonography could evaluate not only CHD, but also CHD severity in the elderly.

Objective To explore the efficacy and safety of low-dose ketamine for prevention of shivering during cesarean section under subarachnoid space and epidural anesthesia.Methods Ninety pregnant women who scheduled cesarean delivery under subarachnoid space and epidural anesthesia were randomized divided into three groups:control group (30 patients) low-dose ketamine group (30 patients) and high-dose ketamine group (30 patients).0.9％ sodium chloride,0.25 mg/kg(3 ml),and 0.50 mg/kg (3 ml) ketamine were given in three groups before operation.The incidence of shivering and adverse effect were recorded respectively before anesthesia,after anesthesia 15 min and 30 min and after operation 1 h.Results The level of mean arterial pressure (MAP) in control group after anesthesia 15 main and 30 min and after operation 1 h[(62 ± 10),(58 ± 8),(61 ± 11) mm Hg(1 mm Hg =0.133 kPa)] were significantly lower than those in high-dose ketamine group [(78 ± 12),(82 ± 8),(76 ± 11)mm Hg] and low-dose ketamine group [(72 ± 10),(76 ± 6),(80 ± 7) mm Hg],there was significant difference (P ＜ 0.05).There was no shivering need treat in low-dose ketamine group and high-dose ketamine group.The rate of hallucinations and nystagmus in low-dose ketamine group [0,6.7％ (2/30)] was significantly lower than that in high-dose ketamine group [20.0％ (6/30),50.0％ (15/30)],there was significant difference (P ＜ 0.05).Conclusion The pretreatment with low-dose ketamine on shivering during cesarean section under subarachnoid space and epidural anesthesia has better preventive effectiveness,0.25 mg/kg of ketamine is more effective than 0.50mg/kg.

Objective:To investigate the expression of C-X-C chemokine ligand-14 (CXCL14) and epidermal growth factor receptor (EG-FR) in human gastric cancer and to analyze the relationship of CXCL14 with clinicopathological features. Methods:The expression of CXCL14 and EGFR was detected by Immunohistochemical SP method in 121 cases of gastric cancer tissue, 62 cases of the adjacent non-tumor gastric mucosa, and 60 cases of allogeneic non-tumor gastric mucosa. Results:The positive rates of CXCL14 and EGFR expres-sion were 80.17%and 48.76%in gastric cancer, respectively, and both were significantly higher in the adjacent non-tumor gastric mu-cosa and allogeneic non-tumor gastric mucosa. The differences were significant (P<0.01). Overexpression of CXCL14 was closely corre-lated with the depth of cancer invasion, differentiation, and clinical stage, and the differences were significant (P<0.05). Overexpres-sion of EGFR was correlated with cancer differentiation, lymph node metastasis, and clinical stage. The differences were significant (P<0.05). Based on the Spearman correlation analysis, the expression of CXCL14 and EGFR in gastric cancer was positively correlated (rs=0.195, P<0.05). Conclusion:Abnormal CXCL14 expression in gastric cancer may be associated with the occurrence and development of gastric cancer. CXCL14 expression is positively correlated with EGFR expression, suggesting that the two have a synergistic effect in gas-tric cancer development.

Objective To investigate the cross reaction characteristics of recombinant human papillomavirus 16 type L2 full-length fusion protein in HPV types of 6, 11, 18.Methods The serum samples of 108 condyloma acuminatum patients, 156 cervix cancer patients and 100 healthy control subjects were collected.The gene of full-length HPV16 L2 was amplificated from the tissue DNA of cervical cancer patient and inserted into the prokaryotic expression vector PGEX-4T-1 to construct the recombinant plasmid PGEX-4T-1-HPV16 L2.After sequencing identification, the recombinant plasmid was tranformed into E.coli BL21 (DE3).After induction by IPTG, the fusion protein containing HPV16 L2 was expressed and analyzed by both SDS-PAGE and WB.Furthermore, the specific binding capacity of the fusion protein to the HPV 6,11, 16 and 18 DNA positive patient's sera were analyzed by WB.The fusion protein was purified with NiNTA Agarose Kit and coated with ELISA reaction plates.The specific serum IgG were detected by indirect ELISA.Results The recombinant plasmid PGEX-4T-1-HPV16 L2 was constructed successfully. Highly expressed HPV16 L2 full-length fusion protein was obtained and the expression level was 27.2 %.The relative molecular mass(Mr) of the fusion protein is about 82 × 103, which matches up to the expected Mr.Meanwhile, the sera of HPV 6,11,16,18 DNA positive patients were used as the primary antibody and the Mr of the specific band was detected to be about 82 × 103 by WB.The results of indirect ELISA showed that the average levels of specific IgG in condyloma acuminatum group, cervical cancer group and healthy control subjects were 0.848 ±0.257, 0.822 ±0.247 and 0.173 ±0.143 with the positive rate of 92.6%, 94.2%and 8.0% respectively.There was no significance of the specific IgG levels between condyloma acuminatum group and cervical cancer group ( F = 0, P ＞ 0.05 ), but there was significant difference of specific IgG levels and positivity among the three groups ( F = 305.201 ,x2 = 253.178, P ＜ 0.01 ).Conclusions The HPV16 L2 full-length fusion protein has better antigenicity.However cross reactions with HPV6, 11 and 18 were found.It can be applied in serological screening reagents for HPV infection and associated cancer.

Objective To research the homology and cross reaction characteristics of human papillomavirus(HPV)16 type L2 N-terminal(1-200)protein in clinical common HPV infection types.Methods The amino acid sequences of the common HPV infection types(6,11,16,18 ,etc.)were blasted and it was found that 1-200 N-terminal sequence of L2 protein was highly homologous.The gene of HPV16 L2(1-200)was amplificated from tissue sample of cervical cancer patient and inserted into the prokaryotic expression vector PGEX-4T-1 to construct the recombinant plasmid PGEX-4T-1-HPV16 L2(1-200).After sequencing identification,the recombinant plasmid was tranformed into E.coli BL21(DE3).Induced by IPTG,the fusion protein containing HPV16 L2(1-200)was expressed and analyzed by both SDS-PAGE and Western blot.Furthermore,the specific binding capacity of the fusion protein to the HPV 6,11,16 and 18 DNA positive patient serums were analyzed by Western blot.The fusion protein was purified with Ni-NTA Agarose Kit and coated with ELISA reaction plates.The specific serum IgG of 98 condyloma acuminatum patients,135 cervix cancer patients and 96 healthy control subjects were detected respectively by indirect ELISA.Results After comparing the amino acid sequences of the common HPV infection types(HPV6,11,16,18,etc.),We found that the homology of HPV L2(1-200)reached 52.7%-74.3%.The recombinant plasmid PGEX-4T-1-HPV 16 L2(1-200)was constructed successfully.Highly expressed HPV16 L2(1-200)fusion protein was obtained and the expression level was account for up to about 22.6% of total bacterial protein.The relative molecular mass(Mr)of the fusion protein is about 49×103,which matches up to the expected Mr Meanwhile,the serums of HPV 6,11,16,18 DNA positive patients were used as the first antibody and the specific band was detected respectively at about 49 × 103 by Western blot.Indirect ELISA showed that the A490 values of the specific IgG of condyloma acuminatum group,cervical cancer group and healthy control subjects were 0.753 ± 0.262,0.756 ± 0.274 and 0.178 ± 0.157 with the positive rate were 89.8%,88.9% and 9.4% respectively.There was no significance of the specific IgG between condyloma acuminatum group and cervical cancer group(P＞0.05),but it was significant among the three groups(P＜0.001).Conclusion The N-terminal 1-200 amino acids of HPV L2 has high homology and there exits cross reaction among the most common HPV infection types.

Objective To observe the effects of family cognitive training on patients with vascular cognitive impairment but without dementia.Methods Sixty patients with non-dementia type vascular cognitive impairment were divided at random into a group which received family cognitive training (30 cases) and a control group (30 cases).The 2 groups all took routine drugs and exercise.The family cognitive training group received cognitive training additionally.Before treatment and after 1 and 6 months of treatment,all of the patients of both groups were assessed using the mini-mental state examination (MMSE),the Montreal cognitive assessment (MoCA) and the modified Barthel index (MBI).Results After 1 month of treatment there was no significant difference between the 2 groups in any of the assessments.After6 months the scores on each item of the MMSE,MoCA and MBI had improved significantly more in the family cognitive training group than in the control group.Conclusion Family cognitive training is effective in treating non-dementia type vascular cognitive impairment.It can delay disease progression and improve cognitive function and ability in the activities of daily living.

Objective To detect the prevalence of human cytomegalovirus (HCMV) in peripheral blood of patients with systemic lupus erthematosus (SLE) and explore its role in the pathogenesis of SLE.Methods HCMV DNA was isolated from the peripheral blood leucocytes (PBLs) of 60 patients with SLE and 111 healthy controls.Nested polymerase chain reaction (nPCR) technology was used to investigate the gene of HCMV glycoprotein gB (UL55) in these specimens.HCMV infections in the PBLs of SLE patients were confirmed by HCMV-UL55 detection.Two-sample t test,nonparametric test,Chi-square test and Fisher probabilities were used to analyze.Results Agarose gel electrophoresis and sequencing analysis showed that established nPCR could specifically detect HCMV-UL55 gene,the HCMV infection rate was significantly higher in patients with SLE than in the healthy controls (P＜0.01).Positive rates of HCMV infection in SLE group and controls were 41.7％ (25/60) and 1.8％ (2/111),respectively.Compared to the SLE patients with HCMV-negative PBLs,the positive rate of Rib-P [26％(9/35) vs 56％(14/25),x2=5.659,P=0.017],the positive rate of direct Coomb's test [37％(13/35) vs 72％(18/25),x2=7.096,P=0.008] and the level of antiβ2GP1 [21.3 (9.9,51.8) U/ml vs 13.6 (5.9,23.1) U/ml,U=2.017,P=0.044] were significantly higher than those in the SLE patients with HCMV-positive PBLs.Compared to the SLE patients with HCMV-negative PBLs,the number of red blood cells [(3.65±0.10)×1012/L vs (3.17±0.17)×1012/L,t=2.574,P=0.013] and lymphocytes [(1.37±0.14)×1012/L vs (0.90±0.13)×1012/L,t=2.456,P=0.017] in peripheral blood and the hemoglobin levels [(110±19) g/L vs (98±5)g/L,t=2.034,P=0.048] of the SLE patients with HCMV-positive decreased significantly.At the same time,the positive rate of hematuria [40％(14/35) vs 72％(18/25),x2=6.000,P=0.014] and 24 h proteinuria [0.80 (0.53,2.37)g vs 0.48 (0.13,1.21)g,U=2.140,P=0.032],which indicated kidney damage were also significantly increased in SLE patients with HCMV-positive PBLs.Conclusion The infection of HCMV in peripheral blood cells may take part in the development of SLE.

Objective:To investigate the expression of Galectin-7 in the bronchial mucosa of asthmatic children and its effect on the apoptosis of bronchial epithelial cells.Methods:Bronchial mucosa of asthmatic children and children with bronchial dilation were collected and the expression of Galectin-7 was detected by Western blot.Human bronchial epithelial cells were cultured in vitro,the cells were transfected with Galectin-7 siRNA to interfere the Galectin-7 expression,while siRNA control was transfected as the control group.The experiment was divided into normal group,control group,infected group and experimental group.The normal group was normal human bronchial epithelial cells,the cells in the control group was transfected with siRNA control,the infected group was infected with RSV,the experimental group was transfected with Galectin-7 siRNA and infected with RSV.After 24h culture,Galectin-7 protein expression and cell apoptosis were detected in the cells of each group.Western blot was used to detected the expression of Bcl-2,Bax,STAT3 and p-STAT3.Results:The expression of Galectin-7 in bronchial mucosa of asthmatic children was significantly higher than that of the non asthmatic children (P＜0.01).There was no significant difference in the Galectin-7 level between the normal group and the control group (P＞0.05).The levels of Galectin-7,Bax and apoptosis in the infected group were significantly higher than those in the normal group,while the levels ofp-STAT3 and Bcl-2 were significantly lower than those in the normal group (P＜0.01).The levels of Galectin-7,Bax and apoptosis in the experimental group were significantly lower than those in the infected group,while the levels of p-STAT3 and Bcl-2 were significantly higher than those in the infected group (P＜0.01).Conelusions:The expression of Galectin-7 was up-regulated in the bronchial mucosa of asthmatic children,which might promote the apoptosis of bronchial epithelial cells by activating STAT3.

Objective: To examine the associations of occupational stress and well-being with depressive symptoms among couriers. Methods: Four cities of Hangzhou, Ningbo, Jiaxing and Taizhou were sampled from Zhejiang Province according to the economic development level, and couriers were randomly sampled from 40 service stations assigned by 25 mainstream express transportation corporations in these four cities. Participants' occupational stress, well-being and depressive symptoms were evaluated using the Core Occupational Stress Scale (COSS), the World Health Organisation-Five Well-Being Index (WHO-5) and Chinese version of Patient Health Questionnaire-9 (PHQ-9). In addition, the associations of participants' occupational stress and well-being with depressive symptoms were examined using hierarchical linear regression analysis. Results: A total of 1 302 questionnaires were allocated, and 1 136 valid questionnaires were recovered, with an effective recovery rate of 87.25%. The participants included 839 males (73.86%), and 297 females (26.14%), and had a mean age of (33.34±8.17) years and a mean service length of (8.95±7.82) years. The detection rates of occupational stress, low well-being and depressive symptoms were 32.48%, 50.79%, and 31.87% among participants, respectively. After adjustment for educational level, income, marital status and smoking, hierarchical linear regression analysis showed that well-being (β=0.171), social support (β=-0.298), organization and reward (β=0.200), demand and effort dimensions of COSS (β=0.284) were statistically correlated with depressive symptoms (all P<0.001). Conclusion Occupational stress and low well-being may increase the risk of depressive symptoms among couriers.

Objective: To investigate the status of occupational health examination institutions in Zhejiang Province, so as to provide suggestions for quality control of occupational health examination institutions. Methods: The 312 occupational health examination institutions in Zhejiang Province that have completed filing before September 30, 2023 were selected. The comprehensive capability, service quality, technical capability, and information reporting status were surveyed and evaluated through on-site inspection and skill assessment. Results: There were 161 public hospitals (51.60%), 147 private organizations (47.12%), and 4 centers for disease control and prevention (CDCs)/ occupational disease prevention and control institutes (1.28%). The pass rates of comprehensive capability, service quality, technical capability and information reporting were 90.02%, 69.89%, 84.07% and 86.78%, respectively. Among the indicators of comprehensive capability, the compliance rate for staffing was the highest at 95.06%, while the qualification rate of quality control in occupational health examinations was the lowest at 84.83%. Among the indicators of service quality, the compliance rate of the physical examination report format was the highest at 95.83%, while the accuracy rate of the audiometry examination was the lowest at 76.60%. In terms of technical capabilities, the qualification rates for blood lead testing, pneumoconiosis reading, and audiogram diagnostic ability were 87.92%, 89.42% and 75.34%, respectively. In terms of information reporting, the qualification rates for reporting completeness, reporting timeliness, suspected occupational disease reporting timeliness, and reporting accuracy were 89.10%, 81.09%, 96.47% and 80.45%, respectively. Among the three types of institutions, private institutions had the lowest average qualification rates for comprehensive capability, service quality, and technical capability, which were 89.83%, 69.06% and 80.00%, respectively. Conclusions Public hospitals and private organizations were the main types of occupational health examination institutions in Zhejiang Province. However, there were deficiencies in quality control, audiogram examination and diagnosis, and the accuracy of information reporting among occupational health examination institutions.