Abstract As a common critically illness among neonates and notably premature infants, respiratory failure is one of the major factors for neonatal deaths. Ventilator, an effective tool for assisted ventilation, is effective to remarkably improve respiratory failure; however, the conventional mechanical ventilation is likely to cause a series of injuries and complications. Therefore, noninvasive ventilation is commonly used in clinical practices. Noninvasive high-frequency oscillatory ventilation is an emerging noninvasive respiratory, in which tracheal intubation is replaced with nasal plug and mask to transfer high-frequency airflow to the airway. It facilities rapid correction of the imbalance of ventilation blood flow ratio, reduction of carbon dioxide retention, increase in oxygen saturation, and reduction in incidence of complications and risk of failure in ventilator withdrawal, which has been employed for the treatment of respiratory failure among neonates. The review descries the applications of noninvasive high-frequency oscillatory ventilation in respiratory support among neonates with respiratory failure, so as to provide insights into the management of respiratory failure among neonates.

Objective: To construct a core competency training indicator system for high-level public health talents using the Delphi method, so as to provide insights into optimization of high-level public health talents training. Methods: Based on review of publications pertaining to core competency training for high-level public health talents, in combination with public health priorities and development needs in China, a preliminary indicator system was constructed. Twenty public health experts were invited for two rounds of Delphi expert consultation. Indicators were screened based on the frequency of full marks, mean score and coefficient of variation (CV), and the weight of indicators was determined using the Entropy weight method. The effectiveness of the Delphi expert consultation was evaluated using the active degree, authority coefficient and the consistency degree. Results: Twenty experts participated in the consultation, including 12 men, and there were 6 experts at ages of 30 to 39 years, 8 at ages of 40 to 49 years, and 6 at ages of 50 years and older. There were 17 experts with an educational level of master and above, 19 with senior professional titles and all experts had working experiences for 10 years and longer. The active degrees were 95.24% and 100.00% for two rounds of consultations, and the overall authority coefficient was 0.87. Following two rounds of consultations, all CVs were reduced to below 0.25, and the coordination coefficients were all statistically significant (P<0.05), with a higher coordination coefficient in the second round of consultation than in the first round. The constructed core competency training indicator system for high-level public health talents included four primary indicators, including health protection, health service improvement, health promotion, and essential quality, with weights of 0.388, 0.310, 0.122 and 0.180, 11 secondary indicators, with high weights seen for protection of human health from threats (0.178), monitoring and assessment of health service utilization (0.157) and promotion of health service quality and access (0.112), and 70 tertiary indicators, with high weights seen for Chinese writing (0.038), capability for health policy suggestions (0.034) and global perspective (0.030). Conclusion The core competency training indicator system for high-level public health talents constructed in this study may provide insights into training of high-level public health talents.

The activation of NK cell , mediated by natural killer group 2 ( NKG2 ) family receptor , plays an important role in antiviral immune response and disease progression after hepatitis B virus (HBV) infection.To explore the NKG2 receptors-mediated NK cell activation and its mechanism may be of value for anti-HBV targeting immune treatment .This article reviews the recent research progress on the role of NK cells and its NKG2 family receptors in immunity of chronic HBV infection and its mechanisms .

Objective To investigate the effect of inhibiting the expression of Navl. 8 sodium channels by an antisense oligodeoxynudeotide(ODN) on visceral hypersensitivity. Methods The visceral hypersensitivity animal models induced by giving neonatal Sprague-Dawley rats colorectal distention(CRD) after postnatal days 8, 10 and 12. Animals were injected intrathecally either Navl. 8 antisense ODN (research group) or mismatch ODN (control group) twice a day for 3 days at the 8th week. After that, the expression of Navl. 8 in each group was examined by RT-PCR, and abdomiral withdrawal reflex(AWR) score and spinal c-Fos expression were evaluated to assess whether the intervention can relieve the visceral hypersensitivity. Results After intrathecal injection with the antisense ODN, the expression of Navl. 8 in each group decreased.AWR score and the number of c-Fos positive neurons in the spinal cord, especially in the area 1 and 3, decreased in the model group, while they did not change in the control group. Conclusions Interventing the expression of Nav1.8 may relieve the visceral hypersensitivity in this model of irritable bowel syndrome.

Objective To investigate the effects of percutaneous coronary intervention(PCI) and conventional drugs on autonomic nervous system and C-reactive protein (CRP)in the patients with unstable angina pectoris combined by QRS complex fragment. Methods A total of 60 patients aged (46.2± 10.3) years with unstable angina combined by QRS complex fragment were randomly divided into drug therapy group and PCI group (n=30 for each group).The changes of heart rate variability (HRV) including SDNN,SDANN,rMSSD,PNN50,HF and LF,heart rate turbulence(HRT) such as TO and TS,and CRP were measured before and 1 month after treatment. Results The values of SDNN[(88.2±20.6)ms vs.(122.5 ± 15.5)ms; (86.9± 23.4)ms vs.( 106.7± 18.8)ms],SDANN [(76.2±9.3)ms vs.(105.3±5.2)ms; (74.3±10.4)ms vs.(89.8±7.6)ms],rMSSD[(18.6±7.9)ms vs.(49.3± 4.3)ms; (19.3± 7.4)ms vs.(29.4± 5.2)ms],PNN50 [(5.5± 2.8)％ vs.(9.1 ±1.8)％; (5.3±2.1)％ vs.(7.2±3.2)％],HF[(219.4±131.6) Hz vs.(292.5±125.5) Hz;(217.2±133.2) Hz vs.(213.2±120.2 ) Hz] and LF[(459.6±135.2) Hz vs.(345.1±175.1) Hz ;(445.8± 144.3) Hz vs.(396.1 ± 182.3) Hz] were improved after treatment as compared with pretreatment in PCI group (t=9.4,15.69,8.37,4.68,3.26,3.57,P＜0.01 or 0.05) and in drug therapy group (t=7.3,12.36,6.98,2.94,4.89,5.01,P＜0.01 or 0.05),respectively.The changes of above indexes were more remarkable in PCI group than in drug therapy group(t=8.90,13.75,7.52,3.27,4.21,4.01,P＜0.01 or 0.05).The values of turbulence onset(TO) [(0.45±0.44)％ vs.(0.16±0.20)％,t=15.63,P＜0.01; (0.49±0.38)％ vs.(0.32±0.26)％,t=16.78,P=0.001] and turbulence slope (TS) [(2.12±0.13)ms/RR vs.(2.98±0.25)ms/RR,t=14.36,P=0.001; (2.15±0.19)ms/RR vs.(2.51±0.11)ms/RR,t=19.52,P=0.001] and CRP [(5.74±2.46)mg/L vs.(2.61±1.22)mg/L,t=12.49,P=0.001; (5.81±2.35)mg/Lvs.(3.56±1.43)mg/L,t=9.76,P=0.01] were also improved after treatment as compared with before treatment in PCI and drug therapy groups,respectively,and the the changes in TO (t=15.95,P＜0.001),TS (t=18.13,P=0.001) and CRP(t=10.73,P=0.001) were more obvious in PCI group than in medicine group. Conclusions PCI may obviously reduce inflammatory response,provide more myocardial blood supply and improve autonomic nervous function in the patients with unstable angina pectoris combined by QRS complex fragment.

Objective Controversies remain as to the recovery time, recovery quality, and incidence of peri-recovery adverse reactions of the patient receiving general anesthesia with remifentanil and sufentanil.This study aimed to systematically assess the qual-ity of recovery from general anesthesia with remifentanil and sufentanil. Methods Randomized controlled trials ( RCTs) were re-trieved from The Cochrane Library, PubMed, MEDLINE, EMbase, Ovid, Springer, Web of Science, CNKI, CBM, VIP, and Wan-Fang Data.According to the modified Jadad quality scale, the literature retrieved was screened and subjected to quality evaluation and meta-analysis was performed on the included studies using the RevMan 5.1 software. Results Thirty-three RCTs involving 2175 pa-tients were finally included.The results of meta-analysis showed no significant differences between the remifentanil and sufentanil groups undergoing thyroid surgery either in the recovery time to spontaneous breathing ( T1) and eye-opening ( T2) and endortracheal extubation time ( T3 ) ( P >0.05 ) or in the incidence rate of postoperative nausea and vomiting (PONV) (P>0.05).T1, T2 and T3 were significantly shorter in the sufentanil than in the remifentanil group in other types of surgery (P<0.05).The patients with level-1 Ramsay score were remarkably more in the remifentanil than in the sufentanil group ( MD =13.67, 95% CI 2.67 -69.91 ) ( P <0.05), and the VAS scores were markedly higher in the former than in the latter group at 30 minutes (MD=3.37, 95% CI 3.28-3.46) and 1 hour after extubation (MD=2.53, 95% CI 2.43 -2.63) (P<0.05). Conclusion Compared with sufentanil, remifentanil provides a quicker recovery but a weaker analgesia effect and a higher rate of post-operative agitation.However, sufentanil produces a better pain relief and a higher quality of recovery after operation.

Objective:To explore the association between different urbanization levels and non-commu-nicable diseases (NCDs)in China and provide suggestions on designing relevant health policies in the ur-banization process.Methods:We obtained health-related data from China Health and Retirement Longi-tudinal Study (CHARLS)201 1 .This study used multistage sampling in design stage and covered 1 50 districts/counties,representative at the levels of the country.Geo-information system (GIS)method was used to get district areas data,and in combination with the Sixth National Census population data,we computed the population density which was regarded as the proxy variable of urbanization level in every city.The Logistic model was used to explore the effect of urbanization level on hypertension,diabetes, smoking,drinking,overweight and obesity.Results:Compared with other cities in China,Shanghai and Shenzhen,with the population density of more than 3 000 people per km2 ,were the cities with highest urbanization level.From the map of urbanization distribution across China,it was found that the urbani-zation levels of the northwestern districts were lower than those of the southeastern and coastal districts. The hypertension rate increased with the development of urbanization but there was no statistical signifi-cance.The proportion of patients with diabetes went up first and then saw a decrease trend in the process of urbanization.Drinking rate,overweight rate and obesity rate had similar trends,falling to their lowest point when urbanization level equaled 737,1 1 86 and 1 353 people per km2 respectively and then ex-perienced upward trends.By contrast,smoking rate declined first and then went up (the turning point was 1 029 people per km2 ).Conclusion:Different urbanization levels have different effects on NCDs, health-related behavior,overweight and obesity.Low urbanization level may create negative impact on health while high level can pose positive effect and increase people’s health condition possibly due to the improvement of health care accessibility and the quality of living environment.Policy-makers should spe-cially focus on different residents’health problems in different periods of urbanization,such as the impact of environmental pollution,health resources’allocation and accessibility of health services.It is necessa-ry to reduce or avoid the negative effect of urbanization on NCDs during the local development process to face the NCDs’threat.

Objective To investigate the relationship between the mechanism of gynecomastia and serum hormone levels ,as well as liver function in male patients with liver cirrhosis .Methods Forty‐six male patients with liver cirrhosis and gynecomastia were collected as gynecomastia group from March 2013 to March 2014 ,and at the same period seventy male patients with liver cirrhosis but without gynecomastia were studied as non‐gynecomastia group . The condition of mammogenesis and maximum of breast thickness were measured by bilateral breast ultrasound .Hormones including luteinizing hormone (LH) ,follicle‐stimulating hormone (FSH) , prolactin (PRL) ,estradiol (E2) ,progesterone (PRGE) ,and testosterone (T);liver function including alanine aminotransferase (ALT) ,aspartate aminotransferase (AST) ,total bilirubin (TBil) and serum albumin (Alb);blood coagulation function including prothrombin time (PT) ,platelet count (PLT) were examined and the Child‐Pugh scores were calculated .t‐test was performed for results comparison between gynecomastia group and non‐gynecomastia groups .Chi‐square test was used to compare the difference in drinking rate between two groups . The patients of gynecomastia group and non‐gynecomastia group were further divided into Child‐Pugh Grade A ,B and C subgroups according to Child‐Pugh scores and the patients of gynecomastia group were divided into subgroups according etiology such as posthepatitic cirrhosis ,alcoholic liver cirrhosis and posthepatitic cirrhosis combined with alcoholc cirrhosis .Single factor analysis of variance was applied to compare the laboratory findings between subgroups ,and least‐significant difference mothod was used to further compared the differences between two subgroups .Results Among forty‐six male patients with liver cirrhosis and gynecomastia ,the mean thickness of breast was (7 .56 ± 2 .84) mm .All the differences of TBil ,Alb ,PT and Child‐Pugh score of Child‐Pugh grade patient were statistically significant between gynecomastia group and no gynecomastia group ((96 .72 ± 75 .86)μmol /L vs (60 .57 ± 54 .00)μmol /L ,(29 .12 ± 4 .90) g/L vs (33 .86 ± 6 .86) g/L ,(19 .06 ± 4 .76) s vs (15 .54 ± 2 .57) s ,11 .54 ± 0 .91 vs 10 .33 ± 0 .57 ,respectively ,t=2 .79 ,-4 .33 ,4 .58 ,2 .22 ,all P<0 .05) . The alcoholic drinking rate of gynecomastia group (74% (34/46) vs 53% (37/70)) increased ,and the difference was statistically significant compared with that of non‐gynecomastia group (χ2 =5 .183 , P<0 .05) .There was no statistically significant difference in E2 levels between gynecomastia group and non‐gynecomastia group (P>0 .05) .PRL and E2/T ratio ((404 .49 ± 297 .26) mU/L and 68 .74 ± 46 .37) were higher than those of non‐gynecomastia group ((279 .77 ± 111 .57) mU/L and 13 .60 ± 11 .55) ,and T was lower than that of non‐gynecomastia group ((7 .15 ± 5 .74) nmol/L vs (15 .46 ± 8 .53) nmol/L) ,and the differences were statistically significant (t=2 .72 ,7 .90、-6 .27;all P<0 .05) .Among patients with gynecomastia ,breast of patients with alcoholic liver cirrhosis was significantly thicker than that of patients with posthepatitic liver cirrhosis ((9 .25 ± 3 .59) mm vs (6 .67 ± 2 .48) mm) ,while the level of PRGE was lower than that of patients with posthepatitic liver cirrhosis ((0 .61 ± 0 .51 ) nmol/L vs (1 .49 ± 1 .47 ) nmol/L ) , and the differences were statistically significant (F= 3 .634 and 2 .674 ,both P< 0 .05) .Along with the severity of liver injury ,E2 level of gynecomastia group gradually increased ,however there was non‐statistically significant difference compared with non‐gynecomastia group (P>0 .05) .T level of gynecomastia group gradually decreased ,and those of Child‐Pugh B ,C subgroup ((8 .20 ± 7 .58) nmol/L and (4 .18 ± 3 .76) nmol/L) were siginificantly lower than that of Child‐Pugh A subgroup of non‐gynecomastia group ((17 .64 ± 9 .04) nmol/L ,F=9 .37 ,P<0 .05) .The E2/T levels of gynecomastic group gradually increased .There was significant difference in E2/T level between Child‐Pugh C subgroup of gynecomastia group (105 .49 ± 94 .42) and Child‐Pugh A grade subgroup of non‐gynecomastia group (11 .38 ± 9 .60 ,F=12 .57 ,P<0 .05) .Conclusions There are different degrees of sex hormone disorder in the serum of male patients with liver cirrhosis and gynecomastia which is more significant in PRL ,T and E2/T .T and E2/T level are correlated with the degree of liver functional impairment .Gynecomastia in alcoholic liver cirrhosis is more severe than that of posthepatitic liver cirrhosis .

Objective:To prepare poly-L-lactic acid(PLLA)electrospun nanofibers carrying icariin(ICA)(ICA /PLLA)and to evaluate the effects of the ICA /PLLA on MC3T3-E1 cells.Methods:ICA solution was dispersed into PLLA solution,and electrospun fibers were fabricated by W/O emulsion method.The morphology of ICA /PLLA was observed by SEM.The in vitro release kinetics of ICA /PLLA was examined.The attachment of MC3T3-E1 cells on ICA /PLLA was examined by propidiumiodide(PI)labling and ob-served under fluorescent microscope.The proliferation of the cells was measured by MTT assay.The differentiation of the cells was ob-served by alkaline phosphatase (ALP)assay.Results:In vitro,ICA was effectively released from ICA /PLLA for 22 days,cells were attached well on the surface in all groups,ICA did not affect the proliferation of MC3T3-E1 cells(P >0.05),but increased the ALP activity(P <0.05)of the cells.Conclusion:ICA /PLLA can effectively control the release of ICA and promote the differentiation of MC3T3-E1 cells.

Objective Lipocalin-2(LCN2) can promote the M1 approach of microglia.The study was to explore the effect of activated microglia induced by LCN 2 on depression pathogenesis in rats and its mechanism . Methods According to the chronic stress depression model created by Willner , 40 adult male SD rats were divided into 4 groups(n=10): normal control group;UCMS group;UCMS+LCN2 siRNA group;LCN2 siRNA control group .A series of stress stimulation was given on UCMS group and UCMS +LCN2 siRNA group for 21 days to create depression model .At 7 days after the stress stimulation , the rats in UCMS+LCN2 siRNA group and LCN2 siRNA control group were anaesthetized by 0.4mg intraperitoneal injection of 10% chloral hydrate , followed by intrathecal injection of LCN2 siRNA(0.015 μL/g, 3 times a week) to the rats till the end of the stress (21 days).At the same time, the same volume of isotonic saline was given to normal control group and UCMS group .The weight of rats was measured every week and the sucrose preference and the forced swimming test were applied to measure behavior of the rats after the experiment .The hippocampus of the rats were extracted and immunofluorescence and western blot were applied to detect the expressions of microglia specific markers:LCN2 and the Iba. Results At 3 week, the weight of rats in UCMS+LCN2siRNA group was higher than that of UCMS group ([262.82 ±0.01]g vs [179.98 ±0.08]g, P<0.05).The weight of rats in normal control group and LCN2 SiRNA control group increased significantly higher than the other two groups (P<0.05).The sucrose preference values of normal control group (0.82 ±0.01),UCMS+LCN2 siRNA group(0.81 ±0.01) and LCN2 siRNA control group(0.82 ±0.01) were higher than that of UCMS group (0.25 ±0.04) (P<0.05).The fixed time of the forced swimming test of UCMS+LCN2siRNA group decreased significantly compared with UCMS group ([4.64 ±0.8]s vs [23.11 ±2.63]s, P<0.05).The LCN2 expression of UCMS group was significantly greater than the other groups (P<0.05).The Iba1 expression in the hippocampus of the UCMS group increased significantly compared with other groups . Conclusion LCN2 is associated with the pathogenesis of de-pression induced by chronic stress reaction and is mechanism may be related to the activation of microglia in the central nervous system of rats.