Objective To investigate the health seeking intention and its influencing factors among patients with type 2 diabetes in Chongqing Chronic Disease Management System.Methods Multistage cluster random sampling was used to investigate basic information,diabetes-related treatment situation including first heal seeking and reasons for choosing medical institutions in the last year.Relative risk ratios (RRR) and its influencing factors were analyzed with the method of multi-nominal Logistic regression,as community as a reference.Results Over the past year,38.02％ of type 2 diabetes patients preferred to hospitals above the county level,36.78％ preferred to pharmacy or clinics,and 25.21％ preferred to community health service centers.Univariate analysis showed that different education levels,family income levels,health insurance and therapies were significantly different from health seeking intention.Multi-nominal Logistic regression results indicated that higher educational level (RRR =2.39,95％ CI:1.20-4.78),higher income level (RRR =3.37,95％CI:1.44 -7.88),applying to specific diseases medical insurance (RRR =3.32,95 ％CI:1.72-6.42),the use of insulin and oral hypoglycemic agents (RRR =5.02,95％CI:1.15-22.00) of respondents were more inclined to the hospitals above the county level,rather than community health services.Conclusions Health seeking intention of type 2 diabetes patients preferred to hospital above the county level in Chongqing.Type 2 diabetes was an important disease of non-infectious chronic diseases,while the patients preferred go to utilize hospitals rather than community services.

Implementing national to community-based "One Health" strategy for human,animal and environmental challenges and migrating-led consequences offer great opportunities,and its value of sustained development and wellbeing is an imperative."One Health" strategy in policy commitment,partnership and financial investment are much needed in advocacy,contextual health human-animal and environmental development.Therefore,appropriate and evidence-based handling and management strategies in moving forward universal health coverage and sustainable development goals (SDGs) are essential components to the China-Africa health development initiatives.It is necessary to understand how to strengthen robust and sustainable "One Health" approach implementation in national and regional public health and disaster risk reduction programs.Understanding the foundation of"One Health" strategy in China-Africa public health cooperation is crucial in fostering health systems preparedness and smart response against emerging and re-emerging threats and epidemics.Building the value of China-Africa "One Health" strategy partnerships,frameworks and capacity development and implementation through leveraging on current and innovative China-Africa health initiatives,but also,mobilizing efforts on climatic changes and disasters mitigation and lifestyle adaptations strategies against emerging and current infectious diseases threats are essential to establish epidemic surveillance-response system under the concept of global collaborative coordination and lasting financing mechanisms.Further strengthen local infrastructure and workforce capacity,participatory accountability and transparency on "One Health" approach will benefit to set up infectious diseases of poverty projects,and effective monitoring and evaluation systems in achieving African Union 2063 Agenda and SDGs targets both in Africa and China.

OBJECTIVE:To investigate the inhibitory effect of siRNA expression vector inhibiting human insulin-like growth factor 2(IGF2)gene on the proliferation of hepatoma cell line Huh-7. METHODS:siRNA expression vector pGL3-hAFP-hTERT-siRNA3(“siRNA3”)which inhibited IGF2 gene by dual promoter regulation of recombinant human alpha-foetoprotein(hAFP)and human telomerase reverse transcriptase(hTERT)was transfected into the Huh-7 cell and normal hepatocyte L-02,and then a nega-tive control group(vector pGL3-hAFP-hTERT)and a blank control group were set up. IGF2 mRNA expression was detected by re-al-time fluorescent quantitative polymerase chain reaction 48 h after transfection into the cells in all groups;the activity of the cells by the microplate reader 0,24,48 and 72 h thereafter;and the cell cycle and apoptosis by the flow cytometer 48 h thereafter,and the changes in the protein levels of IGF2,PCNA,Cyclin E2,Cyclin D2,Cdc2 and Bcl-2 in the cell were detected by Western blot. RESULTS:Compared with the negative control group and blank control group,IGF2 mRNA expression in the Huh-7 cell transfected with siRNA3 was obviously weaker;at 48 and 72 h after transfection,the activity of Huh-7 cell signigicantly reduced, Huh-7 cells at G1 phase obviously increased and those at S phase markedly decreased;the occurrence of early,late and total apopto-sis in Huh-7 cells apparently increased,and the protein expression of IGF2,PCNA,Cyclin E2,Cyclin D2,Cdc2 and Bcl-2 in cells significantly weakened,with statistically significance(P<0.01 or P<0.05). No obvious change in the above-mentioned index-es could be found in L-02 cells transfected with siRNA3 expression vector (P>0.05). CONCLUSIONS:siRNA which inhibited IGF2 gene by dual promoter regulation of recombinant hAFP and hTERT can specially inhibit IGF2 gene expression and the prolifer-ation of Huh-7 cells,which may be involved with down-regulated protein expression of cell proliferation-associated gene PCNA, cell cycle control-associated genes Cyclin E2,Cyclin D2 and Cdc2 and apoptosis regulation-associated gene Bcl-2 as a result of down-regulated IGF2 mRNA expression and protein expres-sion.

Objective To investigate the detection methods of atypical bcr-abl rearrangement with b3a3 fusion transcript,and to describe the characteristics of this fusion gene.Methods Karyotype analysis,FISH and RT-PCR were applied to detect the break point of bcr-abl fusion gene in a patient who was diagnosed as acute lymphoblastic leukemia.Results The karyotype of the patient was expressed as 45,XY,-7,t(9;22)(q34;q1 1).The translocation event in chromosome 9 and 22 could be successfully detected by FISH,and a rare bcr-abl rearrangement with b3a3 fusion transcript was detected by RT-PCR with specific primers.Conclusions The rare e14a3 (b3a3) fusion of bcr-abl gene is present in this patient.Clinical laboratories using commercial kits that do not cover such rare fusions are likely to generate false result,thereby declaring combination of various methods to detect fusion genes is necessary.More studies are needed to explore the function and significance of rare bcr-abl fusion genes.

Objective To analyze the application of quality control cycle (QCC) in reducing the false negative rate of minimal residual disease (MRD) of flow cytometry in patients with acute myeloid leukemia (AML). Methods In AML patients with abnormal fusion gene detected in hematology laboratory of Changhai Hospital during the year of 2014, the prevalence of AML-MRD detected both by flow cytometry (FCM) and real-time fluorescence quantitative polymerase chain reaction (FQ-PCR) were analyzed retrospectively. The possible causes of false negative rate of flow cytometric MRD referring to PCR were further deeply analyzed, and the improvement measures were adapted from January 2015 to December 2015 and further judged all according to the QCC methods. Results Pareto diagram showed that the dilution and coagulation of the specimen, the improper analysis strategy and the incomplete combination of the MRD index [composition ratio:83.3 % (60/72)] were the main factors leading to the leakage of FCM MRD in 2014. The QCC group devised measures to reduce the dilution probability of bone marrow and develop a standard operating procedures (SOP) for sampling and testing, strengthen the maintenance of the flow instrument and more importantly, focused on optimizing the antibody panels and gated strategies referring to the current two main kinds of MRD detection combination modes on the basis of the latest advances published in 2015. Finally, the undetected rate of AML-MRD was reduced by FCM from 14.8 % (72/486) in 2014 to 2.6 % (16/620) in 2015. Conclusions The QCC can effectively reduce the leakage rate of flow cytometric AML MRD, improve the ability of laboratory quality control and the ability to solve problems. Solving problems with QCC is thus worthy of being popularized.

The unprecedented globalization of trade,travel,climate change,protectionism,and geopolitical populism,as well as pandemic health threats are no longer issues for a single nation.In the field of public health,China's Belt and Road Initiative (BRI) offers immense opportunities for partnership and collective actions involving multiple countries to combat globalization-linked infectious and/or chronic diseases,emerging pandemics,and outbreaks of potential threats to both laboratory information management systems and health information management.The national and global health challenges have increasingly proved that economic prosperity cannot be achieved when huge knowledge and capacity gaps exist in health systems.There is thus a need for public health initiatives aimed at strengthening the health systems beyond sovereign borders to influence global geo-economics.We highlight situational insights that offer approaches and strategies for increasing public health investment and capacity development in the countries along the Belt and Road,enhancing public and global health cooperation alongside participation in disease control and elimination,promoting public health governance and data sharing for pandemic threats,and building shared values and benefits in public health through Sino-African cooperation and the BRI.Our approach also examines the values of the China's BRI in relation to public health,projections and initiatives for increasing new investment and development capacity in public health systems,and enhanced public and global health cooperation and participation toward the BRI's framework and scope.

OBJECTIVETo explore the involvement of hepatitis B X protein (HBx) in promoter 3 (P3)-driven mRNA overexpression of the insulin-like growth factor II gene (IGF-II) and investigate the underlying epigenetic mechanism.

METHODSLevels of P3 and HBx mRNA and status of P3 methylation were analyzed in human hepatocellular carcinoma (HCC) samples, with and without hepatitis B virus (HBV) infection, using quantitative reverse transcription-PCR and bisulfite sequencing. In addition, the levels of P3 mRNA and P3 methylation were examined in HepG2 cells stably overexpressing HBx (HepG2-HBx). Finally, P3 promoter-luciferase constructs were cotransfected into HepG2 cells along with an HBx-expressing plasmid, and the effects of HBx on transcriptional activity and methylation of P3 were analyzed. Statistical analyses of the data were conducted by chi square test, Fisher's exact test, Student's t-test, Marn-Whitney U test, and Pearson's correlation coefficient test.

RESULTSThe HBV-positive HCC specimens had significantly higher levels of P3 mRNA than the HBV-negative HCC specimens (-9.59 ± 3.22 vs. -12.97 ± 3.08 delta CT; P=0.006) but significantly lower levels of P3 methylation (mean values for the 17 CpG sites (36.9% ± 15.5% vs. 52.1% ± 19.1%; P=0.025). The P3 transcript abundance was positively correlated with the level of HBx expression and negatively correlated with the level of P3 methylation. The epigenetic results from experiments with the HepG2-HBx cells were similar. Transfection of HBx significantly decreased P3 methylation level and increased its activity.

CONCLUSIONHBx expression may promote IGF-II expression by inducing hypomethylation of its P3 promoter in hepatocellular carcinoma.

Carcinoma, Hepatocellular ; genetics ; metabolism ; DNA Methylation ; Epigenesis, Genetic ; Female ; Gene Expression ; Hep G2 Cells ; Humans ; Insulin-Like Growth Factor II ; genetics ; metabolism ; Liver Neoplasms ; genetics ; metabolism ; Male ; Promoter Regions, Genetic ; RNA, Messenger ; genetics ; Trans-Activators ; pharmacology

Global health arisen recently, but it developed rapidly and attracted great attention from global researchers and institutions. China, as a member of United Nation, actively participated in many international peacekeeping activities. Health of peacekeepers is global health and it is important to consider and dealt with health of peacekeepers with conception of global health. This article reviewed and analyzed health problems and risk factors faced by peacekeepers,and provided suggestions to strategies to protect health of peacekeepers.
China ; Global Health ; Health ; Humans ; Military Personnel ; Risk Factors

OBJECTIVE: To explore the clinical and laboratory characteristics of hematological tumors with different types of abnormalities in platelet derived growth factor β (PDGFRβ) gene. METHODS: A retrospective analysis was carried out on 141 patients with abnormal long arm of chromosome 5 (5q) and comprehensive medical history data from Changhai Hospital Affiliated to Naval Medical University from 2009 to 2020, and their clinical data were collected. R-banding technique was used for chromosomal karyotyping analysis for the patient's bone marrow, and fluorescence in situ hybridization (FISH) was used to detect the PDGFRβ gene. The results of detection were divided into the amplification group, deletion group, and translocation group based on FISH signals. The three sets of data column crosstabs were statistically analyzed, and if the sample size was n >= 40 and the expected frequency T for each cell was >= 5, a Pearson test was used to compare the three groups of data. If N < 40 and any of the expected frequency T for each cell was < 5, a Fisher's exact test is used. Should there be a difference in the comparison results between the three sets of data, a Bonferroni method was further used to compare the data. RESULTS: In total 98 patients were detected to have PDGFRβ gene abnormalities with the PDGFRβ probe, which yielded a detection rate of 69.50% (98/141). Among these, 38 cases (38.78%) had PDGFRβ gene amplifications, 57 cases (58.16%) had deletions, and 3 (3.06%) had translocations. Among the 98 cases, 93 were found to have complex karyotypes, including 37 cases from the amplification group (97.37%, 37/38), 55 cases from the deletion group (96.49%, 55/57), and 1 case from the translocation group (33.33%, 1/3). Analysis of three sets of clinical data showed no significant gender preponderance in the groups (P > 0.05). The PDGFRβ deletion group was mainly associated with myeloid tumors, such as acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) (P < 0.001). The PDGFRβ amplification group was more common in lymphoid tumors, such as multiple myeloma (MM) (P < 0.001). The PDGFRβ translocation group was also more common in myelodysplastic/myeloproliferative tumors (MDS/MPN). CONCLUSION Tumors with PDGFRβ gene rearrangement may exhibit excessive proliferation of myeloproliferative tumors (MPN) and pathological hematopoietic changes in the MDS, and have typical clinical and hematological characteristics. As a relatively rare type of hematological tumor, in addition to previously described myeloid tumors such as MPN or MDS/MPN, it may also cover lymphoid/plasma cell tumors such as multiple myeloma and non-Hodgkin's lymphoma.
Humans ; Clinical Relevance ; Hematologic Neoplasms/genetics* ; In Situ Hybridization, Fluorescence ; Multiple Myeloma ; Myelodysplastic Syndromes ; Retrospective Studies ; Translocation, Genetic

Objective To investigate the diagnosis, treatment and prognosis of acute promyelocytic leukemia (APL) with NPM_RARα fusion gene positive. Methods One APL patient with NPM_RARα fusion gene positive who was diagnosed by using morphology, immunology, cytogenetics, molecular biology and multiplex fluorescence in situ hybridization in Changhai Hospital in November 2014 was retrospectively analyzed, and the patient was induced with retinoic acid and treated with DA (daunorubicin + cytarabine) regimen, followed by 4 courses of cytarabine consolidation therapy. Results Abnormal promyelocyte accounted for 0.64 by morphology. And the group of cells expressed myeloperoxidase (MPO), CD13, CD15, CD117, and CD7, CD11c, CD79a, CD123 weakly expressed or not by immunophenotype analysis; karyotype analysis showed 45, XY, t(5;17), 7p-,-16[8]/46, idem,+20[5]/45, idem,-8,+20[2]/46, XY[5]; the fusion gene screening showed that the expression level of NPM_RARα was 416.98% compared with that of APL; molecular complete remission was obtained after the consolidation therapy, but the patient relapsed after 34 months. Finally, the patient died of abnormal coagulation and respiratory failure, with overall survival of 35 months. Conclusion APL with NPM_RARα fusion gene positive is a rare type of acute leukemia, and the main treatment method is retinoic acid combined with myeloid chemotherapy regimen, which has a favorable efficacy but a poor prognosis.