Objective:To clarify the pathogen types, genotypes and molecular biological characteristics of an outbreak in a high school in Yantai city in 2019, and to provide evidence for epidemic prevention and control.Methods:Eleven samples were collected from a high school in Yantai city in 2019. Quantitative PCR was used for primary type identification. RT-PCR and specific primers were used to amplify the target genes, and the sequences of norovirus were compared and analyzed for phylogenetic analysis.Results:The pathogen of this cluster outbreak was norovirus. Five GII-positive samples of norovirus were detected, 4 of which were GII.13 and 1 was GII.17. Sequence analysis of polymerase-capsid region showed that the amino acid sequence of this cluster outbreak was highly conserved.Conclusions:This outbreak is a cluster of diarrhea caused by GII.13 and GII.17 norovirus infection. The analysis of this outbreak is helpful to our general understanding of the evolution, genetic diversity and distribution of norovirus, and the surveillance of norovirus in the jurisdiction should be further strengthened.

Background and Objectives: Chronic kidney disease (CKD) has a major impact on the quality of life of patients, and renal fibrosis is a critical pathological change in the disease. It is very important to control the process of renal fibrosis to improve the quality of life of patients with CKD. The pathological mechanism of renal fibrosis is very complicated, and the current treatment strategy also has many flaws. Methods: and Results: To explore a better treatment, we collected exosomes from pluripotent stem cell (PSC)-derived mesenchymal stem cells (MSC) and verified their therapeutic effect on renal fibrosis through In Vivo and In Vitro experiments. In this study, we found that PSC-MSC-derived comes could prevent the epithelial differentiation of NRK-52E cells, and with increasing exosome concentrations, the effect was improved. Furthermore, PSC-MSC-derived exosomes could reduce the pathological process of renal fibrosis, reduce inflammatory reactions and improve renal function in UUO mice. Moreover, the protective effect of exosomes against renal fibrosis may be achieved by increasing the expression of SIRT6 and decreasing the expression of β-catenin and its downstream products. Conclusions These findings suggest the possibility of PSC-MSC-derived exosomes as a new, effective therapeutic tool for kidney fibrosis.

Background and Objectives: Chronic kidney disease (CKD) has a major impact on the quality of life of patients, and renal fibrosis is a critical pathological change in the disease. It is very important to control the process of renal fibrosis to improve the quality of life of patients with CKD. The pathological mechanism of renal fibrosis is very complicated, and the current treatment strategy also has many flaws. Methods: and Results: To explore a better treatment, we collected exosomes from pluripotent stem cell (PSC)-derived mesenchymal stem cells (MSC) and verified their therapeutic effect on renal fibrosis through In Vivo and In Vitro experiments. In this study, we found that PSC-MSC-derived comes could prevent the epithelial differentiation of NRK-52E cells, and with increasing exosome concentrations, the effect was improved. Furthermore, PSC-MSC-derived exosomes could reduce the pathological process of renal fibrosis, reduce inflammatory reactions and improve renal function in UUO mice. Moreover, the protective effect of exosomes against renal fibrosis may be achieved by increasing the expression of SIRT6 and decreasing the expression of β-catenin and its downstream products. Conclusions These findings suggest the possibility of PSC-MSC-derived exosomes as a new, effective therapeutic tool for kidney fibrosis.

Objective:To study the clinical efficacy of chimeric antigen receptor T-cell (CART) treatment followed by a second allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with B-cell acute lymphoblastic leukemia (ALL) who relapsed following the first HSCT.Methods:Retrospective analysis of the clinical characteristics and prognosis of 41 patients with B-cell ALL who received a second allo-HSCT from October 2015 to June 2020 in Hebei Yanda Lu Daopei Hospital. After the first HSCT, all patients received CD19-CART, or CD22-CART treatment following a relapse of bone marrow morphology or extramedullary leukemia.Results:A total of 41 patients (male, 21; female, 20) were included in this study. The median age at the second HSCT was 16 (3-46) years. There were 31 cases of bone marrow recurrence (75.6%) , 5 cases of extramedullary recurrence (12.2%) , and 5 cases of bone marrow and extramedullary recurrences (12.2%) . After relapse, 35 patients (85.4%) received CD19-CART treatment, 2 patients received CD22-CART treatment (4.9%) , and 4 patients received CD19-CART and CD22-CART treatments (9.8%) . The expected 3-year overall survival (OS) , leukemia-free survival, cumulative relapse incidence, and non-relapse mortality (NRM) of patients after the second HSCT were 48.9% (95% CI 23.0%-70.6%) , 41.8% (95% CI 17.3%-64.9%) , 8.8% (95% CI 2.9%-26.4%) , and 51.1% (95% CI 31.2%-83.6%) , respectively. The 1-year OS of patients who relapsed ≤6 months and >6 months after the first HSCT were 45.0% (95% CI 12.7%-73.5%) and 75.0% (95% CI 51.4% -88.8%) ( P=0.017) , respectively. Conclusion:CART bridging in the second HSCT enables some B-cell ALL patients who relapsed after the first HSCT to achieve long-term survival. However, because of the high NRM, further modifications could help improve the outcome.

Objective: To investigate the accuracy of parents′ self-assessment of dental caries status of their children and to explore the relevant factors affecting accuracy. Methods: A total of 329 children in kindergarten of Science and Technology Research Institute of China Petroleum Corporation and their parents were recruited by convenience sampling method. The parents assessed their children's dental caries status and completed a questionnaire, and then children were examined by the dentists. The difference between parents and dentists′ the assessment of children's dental caries status and relevant influencing factors were analyzed. Results: 51.06%(168/329) of the parents did not agree with the doctor's diagnosis in the assessment of children's caries. The rate of parents' missed diagnosis was 94.12%. Logistic regression analysis showed that 'children brush teeth everyday' (OR value was 2.919), 'parents can help children brush their teeth' (OR value was 2.670), 'parents can check results after children brushing their teeth '(OR value was 4.508), and 'children received the treatment of dental caries' (OR value was 1.768) were significant influencing factors of parents' assessment accuracy (P<0.01). Conclusions The accuracy of parents' assessment of children′s dental caries status is low, and it is related to many factors. Attention should be paid to the implementation of oral heath behavior during oral health education, and parents' capacity of assessing children caries should be improved.

Objectives: The purpose of this study is to understand the relationships among plasma glucose, blood pressure level and Traditional Chinese Medicine (TCM) syndromes in Shanghai community residents, and provide a theoretical basis for the prevention of community chronic disease based on TCM syndrome differentiation.Methods: Residents above35 years old will attend the Type 2 Diabetes Mellitus (T2 DM) risk assessment at Community Health Center. By distributing questionnaires and performing glucose testing, we screened the residents at high risk of T2 DM, and conducted a physical examination of them. Further, a body constitution questionnaire was required to be completed by the residents. Results: In total, 933 residents were screened. The plasma glucose and blood pressure levels related to age, waist circumference, hip circumference, body mass index (BMI) and waist-to-height ratio (WHtR) . Residents with increasing blood pressure have an increased risk of T2 DM (P ＜ 0.01) . Total 529 questionnaires were completed, and 129 subjects (24.4％) have single TCM syndromes, 75 subjects (14.2％) have at least two TCM syndromes and 325 subjects (61.4％) have no TCM syndromes. Conclusion: Plasma glucose and blood pressure are associated and interacted with several physical indexes. TCM syndromes distribution was found no significant change among subjects with different plasma glucose and blood pressure.

Objective To analyze the changing rules of schistosomiasis endemic situation before and after reaching the crite-ria of schistosomiasis transmission controlled or transmission interrupted in Zhejiang Province,so as to provide scientific evi-dence for schistosomiasis contro1. Methods Xiuzhou District and Zhuji City were selected and investigated retrospectively to collect schistosomiasis epidemiological information 10 years before they reached the criteria of transmission controlled and the subsequent years until 2008. The database of retrospective investigation was established for analyzing the trends and rules of changes of Oncomelania hupensis snail status and schistosome infection status of cattle and human. Results The snail status and schistosome infection kept a steady declining before reaching the criteria of transmission controlled ,and there were positive correlations between the area of living snails and the infection rates of human and animal in two places(rhuman=0.764,P<0.01, rcatl e=0.709,P<0.01;rhuma=0.775,P<0.01,rcatl e=0.676,P<0.01);No local infection person and animal except residual snails, and found 7 cases of imported infection source were found after reaching the transmission interruption. Conclusion The epi-demic status of schistosomiasis in zhejiang is stable after reaching the criteria of transmission interruption ,and residual snail are easy to re-found and spread under some certain conditions,and some imported cases were found sometimes,which may in-crease the risks for re - emergence of schistosomiasis. The integrated solidification strategy with emphasis on control of residu-al snails and imported cases should be taken in the areas of transmission interruption in the future.

OBJECTIVE: This study was designed to develop a rating scale of quality of life (QOL) which fits laryngeal cancer patients after laryngectomy. METHOD: The item pool was developed on the definition of QOL from WHO and the principles and procedures of ddveloping a rating scale. Five methods had been used in the item selection including, such as subjective evaluation methods, discrete tendency, correlation coefficient method, stepwise regression analysis, and factor analysis. The survey was conducted in 126 laryngeal cancer patients after laryngectomy in order to assess the reliability and validity of the rating scale. RESULT: (1) A rating scale of QOL which fits laryngeal cancer patients after laryngectomy including six domains and 27 items is was developed. (2) The split-half reliability coefficient of the scale is 0.802, and the Cronbach' α coefficient is 0.794. (3) It is inferred from the correlation analysis that there are strong correlation between items and their own domains; conversely there are weak correlation between items and other domains. Correlation coefficient is 0.731 between total score and self-rating score. CONCLUSION The reliability and validity of the rating scale is proved to work well.
Aged ; Factor Analysis, Statistical ; Female ; Humans ; Laryngeal Neoplasms ; surgery ; Laryngectomy ; Male ; Middle Aged ; Postoperative Period ; Quality of Life ; Regression Analysis ; Reproducibility of Results

ObjectiveEvidence-based medicine was used to make an individualized treatment plan for rare solitary splenic metastasis of an ovarian carcinoma in a female patient. MethodsAfter clinical problems were discovered, evidence was collected from the Cochrane Library, PubMed, EMBASE, ScienceDirect, CNKI and Wanfang databases according to our predefined search strategy. The search was done until October, 2009. The validity of the evidence was assessed. The evidence, combined with the doctor experience and the patient value, was applied to the patient. ResultsA total of 15 English literature and 11 Chinese literature were identified. A rational treatment plan was made upon a critical evaluation of the data. There were 5 review articles in PubMed, EMBASE and ScienceDirect databases and no RCT in the Cochrane Library. And there was one retrospective cohort study inCNKI and Wanfang databases. The others were all case reports. After 20 month follow-up, the treatment protocol was proven correct. Conclusion The patient has rare disease, and the evidence intension for the evidence-based medicine was low. It can not present the efficacy of the evidence-based medicine treatment sufficiently, though it could provide some suggestion for rare disease which was lack of large RCT for evidence-based Methods .

OBJECTIVE: To investigate the expression and clinical pathological significance of PDCD4 in laryngocarcinoma tissue and its potential significance to clinic. METHOD: Western-blotting and immunohistochemistry ana lyse to measure the protein expression of PDCD4 in 54 cases of laryngocarcinoma tissues (studying group) and their paraneoplastic normal tissues (control group). The correlations of PDCD4 with clinical pathological parameters were analyzed. RESULT: PDCD4 protein was positively expressed in paraneoplastic normal tissue while which was lost or decreased in laryngocarcinoma tissue by Western blot and immunohistochemistry. Immunohistochemistry assay showed the location of PDCD4 protein in cells was different between the studying group and the control group. The expression level of PDCD4 was related to the pathological grades of the laryngocarcinoma. It's higher in the well-differentiated tumor group than that in the poorly differentiated ones. But the expressions of PDCD4 were no differences among other clinical parameters including sex, age, clinical classification, clinical stage and the cervical lymphonodus who had been metastases or not. CONCLUSION PDCD4 gene is anti-oncogene. It may play an important role in the pathogenesis and development of laryngeal carcinoma and it may be a new target of therapy for laryngo carcinoma.
Adult ; Aged ; Aged, 80 and over ; Apoptosis Regulatory Proteins ; metabolism ; Female ; Genes, Tumor Suppressor ; Humans ; Immunohistochemistry ; Laryngeal Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; RNA-Binding Proteins ; metabolism