Objective To analyze the clinical features of severe pneumonia complicated with congenital heart disease (CHD) . Methods The clinical data of 270 children patients with severe pneumonia complicated with CHD (CHD group) were collected to analyze the relative medical history ,etiology ,bacterial drug resistance and clinical outcomes .Moreover ,636 age-matched children pa-tients with pure severe pneumonia were selected as the control group .Results In the CHD group ,250 cases were infants and 35 ca-ses suffered from repeated pneumonia .Compared with the control group ,the CHD group was earlier in onset and more prone to re-peated pneumonia .Among 270 cases ,totally 220 cases were checked out the pathogens ,but no statistically significant difference in the detection rates of pathogens between the CHD group and the control group was found (P>0 .05);179 cases were infected by bacteria ,in which 126 cases were Gram-negative bacteria ,the positive rate of bacterial infection and the detection rate of Gram-nega-tive bacterial were relatively higher than those in the control group ,the difference was statistically significant (P<0 .05);95 cases were infected by virus ,with respiratory syncytial virus being the most common pathogen ,30 cases were infected by fungi ,with Can-dida albicans being predominant ,the infection rates of virus and fungus had no statistical difference between two groups (P>0 .05);in the drug sensitive test ,the detection rate of extended spectrum beta lactamase (ESBLs)-producing positive bacteria in the CHD group was higher than that in the control group ,the difference was statistically significant (P<0 .05) .Main Gram-negative bacteria Pneumonia klebsiella pneumonia subspecies ,Escherichia coli and haemophilus inf luenzae were highly sensitive to imipenem ,mero-penem ,levofloxacin and ciprofloxacin ;main Gram-positive bacteria Staphylococcus aureus and streptococcus pneumoniae were highly sensitive to vancomycin and gentamicin .Especially ,pneumonia klebsiella pneumonia subspecies ,Escherichia coli and haemophilus influenzaewere100% resistanttopenicillin.TheaveragelengthofhospitalstayintheCHDgroupwas (20.9±12.5)d,207cases developed the respiratory failure ,88 cases appeared the heart failure and 205 cases were effective in treatment ;compared with the control group ,the CHD group had a longer length of hospital stay ,higher occurrence rate of heart and respiratory failure and lower treatment effective rate (P<0 .05) .Conclusion Because of the earlier onset ,more prone to repeated pneumonia ,more sensitive to bacterial infection ,esp .Gram-negative bacteria ,more ESBLs production ,longer hospital stay and more prone to complications ,com-pared with the control group ,children with severe pneumonia complicated with CHD require active treatment .

Objective To investigate the relationship of alcohol exposure during pregnancy and non-compaction cardiomyopathy (NCC) in offspring mice.Methods Pregnant mice of ED3.5-ED18.5 were given 56％ alcohol by gavage at a dose of 5 mL/kg.The ED19.5 mice were sacrificed,and the heart of the fetal mice was harvested.Transmission electron microscopy (filaments,mitochondria and sarcoplasmic reticulum) and HE staining were used to verify the changes of structure and ultrastructure of the obtained myocardial tissues.Echocardiography was used to evaluate the cardiac function and ventricular myometrium of the offspring mice after growing up.Results Alcohol exposure during pregnancy caused the disorganized and dissolved myofilaments in the fetal mice.Some offspring mice (31.25％,5/16) had NCC.The ratio of non-compacted myocardium to compact myocardium at the end of systole (N/C) was 2.49 ± 0.6 in the offspring mice of the alcohol exposure group,significantly higher than that in the control offspring mice (0.62 ± 0.23,t =10.397,P =0.000).The volume of heart was decreased in the offspring mice of the alcohol exposure group while the left ventricule was enlarged.Echocardiography showed cardiac dysfunction and thickened ventricular septal/left ventricular posterior walls in the grown-up mice of the exposure group.Conclusion Large dose of alcohol exposure during pregnancy cause trabeculations and non-compaction in ventricular myocardium,and it might be one of causers for NCC in the offspring.

Objective: To investigate the mortality and disease burden of diabetes in Hangzhou City from 2013 to 2021, so as to provide insights into improving diabetes prevention and control strategies. Methods: Data on morbidity and mortality of diabetes in Hangzhou City from 2013 to 2021 were collected through the Chronic Disease and Death Cause Monitoring System of Hangzhou Center for Disease Control and Prevention, and the crude and age-standardized mortality (standardized by the population of the Seventh National Population Census in China in 2020) were calculated. Data on the prevalence of diabetes were collected from the China Chronic Disease and Risk Factors Surveillance (CCDRFS), and the burden of disease was evaluated by calculating years of life lost (YLL), years lived with disability (YLD) and disability-adjusted years (DALY) with reference to the methodology of the Global Burden of Disease Study (GBD). The trends in mortality and disease burden of diabetes were evaluated with the average annual percent change (AAPC). Results: There were 8 686 deaths of diabetes in Hangzhou City from 2013 to 2021, with the average annual crude mortality of 13.17/105 and age-standardized mortality of 10.89/105. The crude mortality of diabetes showed a tendency towards a rise (AAPC=2.62%, P<0.05), while the trend in age-standardized mortality was not significant (P>0.05). The crude and age-standardized mortality of diabetes were higher in women than in men (14.11/105 vs. 12.21/105, 12.16/105 vs. 9.71/105; both P<0.05); however, the crude mortality in men increased more rapidly (men: AAPC=4.46%, P<0.05; women: AAPC=1.09%, P>0.05). The YLL, YLD and DALY of diabetes were 155.42, 1 246.73 and 1 402.15 thousand person-years, and the rates of YLL, YLD and DALY were 2.36, 18.90 and 21.25 person-years per thousand, respectively. The rates of YLL, YLD and DALY appeared a tendency towards a rise (AAPC=1.57%, 6.03% and 7.11%, all P<0.05). Higher rates of DALY and more remarkable increase were seen in men than in women (P<0.05; AAPC=8.37%, 5.54%, both P<0.05). Conclusions The mortality of diabetes in Hangzhou City from 2013 to 2021 is high, and the burden of disease, especially disability, is growing rapidly, with the burden of disease being more serious in men.

Objective To detect the effect of ox‐LDL on self‐renewal and Oct‐4 express of MSCs in vitro .Methods MSCs cul‐tured in vitro were divided into 4 groups :blank control(no reagents in culture system ) ,ox‐LDL (1 ,5 ,10 ,20 μg/mL ox‐LDL were added into culture system) ,ox‐LDL+NAC(corresponding ox‐LDL were added into culture system after NAC treatment ) ,negative control(corresponding nLDL were added into culture system ) .Growth curve were drawn at different time ,Oct‐4 ,a stem cell special marker ,were detected by real‐time PCR ,the production of ROS (reactive oxygen species ,ROS) in culture system were measured with electron paramagnetic resonance spectroscopy .Results proliferation of MSCs was inhibited by ox‐LDL ,when concentration of ox‐LDL was more than 5μg/mL ;apoptosis of MSCs appeared as well as attenuated expression of Bcl‐2 ,ox‐LDL generated a signifi‐cant amount of ROS in the culture system ,which was completely prevented by NAC .Conclusion The proliferation and Oct‐4 ex‐pression of MSCs were inhibited by ox‐LDL ,which may be related to increase of ROS in culture system .

Objective : To learn the association between dietary patterns and thyroid cancer in Hangzhou residents, and to provide evidence for thyroid cancer prevention. Methods: The newly diagnosed patients with thyroid cancer in Zhejiang Cancer Hospital were selected as the case group, while the healthy population matched (1∶1) by gender, age and residence were selected from community as the control group. A questionnaire survey was conducted to obtain demographic characteristics, disease history, dietary intake, lifestyle and other information. The dietary patterns were established by factor analysis. The multivariate conditional logistic regression model was conducted to explore the relationship between different dietary patterns and thyroid cancer. Results: A total of 258 pairs of cases and controls were recruited. Five dietary patterns were obtained, including vegetarian pattern, high-protein food pattern, salted vegetables and algae pattern, seafood and cereal pattern, as well as alcohol and tea pattern. The multivariate conditional logistic regression analysis suggested seafood and cereal pattern might reduce the risk of thyroid cancer (OR=0.286, 95%CI: 0.146-0.561). Conclusion More consumption of seafood and cereal may decrease the incidence of thyroid cancer.

Objective Constructing the dendritic cell (DC) vaccine loading HPV16L1 antigen,and evaluating the specific humoral and cellular immune responses induced by DC-L1.Methods The mature dendritic cells (DCs) were induced in vitro from bone marrow precursors by co-culturing with cytokines cocktail,and then transduced with a recombinant adenovirus harboring the HPV16L1 gene to obtain the DC-L1 vaccine.C57BL/6 mouse were immunized intramuscularly by single dose of DC-L1 and recombinant adenovirus vaccine Adv-HPV16L1 respectively.The specific humoral and cellular immune responses were determined by quantitative ELISA and ELISPOT at different time points.Results DC-L1 cells exhibited typical morphological features of dendritic cells,and the expression of HPV16L1 can be detected by western blot.Both DC-L1 and Adv-HPV16L1 can induce specific cellular immune response,while with distinct kinetics.Single dose of Adv-HPV16L1 induced responses immediately,and attained the peak level at the third week after immunization,then diminished gradually.While responses induced by DC-L1 elevated slowly,and eventually exceeded that of recombinant adenovirus group at the fifth week of postimmunization.As to humoral immunity,both DC-L1 and Adv-HPV16L1 vaccines can induce specific humoral immune reponses,and with similar kinetics.Conclusion The DC-L1 vaccine was constructed successfully.The DC-L1 vaccine can induce high levels of HPV16L1 specific humoral and cellular immune response.

Objectives To explore the clinical characteristics and prognosis of different degrees of noncompaction of ventricular myocardium (NVM) in children and to investigate the clinical significance of the ratio of the thickness of the non-compact myocardium to the dense myocardium (N/C). Methods The clinical data of the children with NVM were analyzed retrospectively. The differences between children with N/C > 2.0 and children with N/C 1.4~2.0 were compared. Results There were 26 children in each of the two groups. There was no significant difference in age, sex, the ratios of low birth weight and malnutrition, heart disease, and complication (P all > 0.05). When discharged, 8 cases were improved, 15 cases has no obvious improvement, and 3 cases died in N/C>2.0 group; while 18 cases were improved, 8 cases has no obvious improvement, and none died in N/C 1.4~2.0 group, and the effective rate of treatment between two groups was statistically difference (χ2=7.69,P=0.006). In 8 years of follow-up, the mortality rate in N/C > 2.0 group was higher than that in N/C 1.4~2.0 group, and the difference was statistically different (χ2=6.993, P=0.008). Conclusions The treatment efficiency was lower and the prognosis was worse when the N/C value was higher in children with NVM.