Objective To retrieve clinical evidence for the efficacy of ceftriaxone in the treatment of early syphilis.Methods Several international and national medical databases were used to search original articles published from 1985 to 2012 and reporting the efficacy of ceftriaxone or penicillin for the treatment of early syphilis.Randomized controlled trials (RCTs) and clinical controlled trials (CCTs) were identified and retrieved.The quality of studies was assessed using the Jadad scale.Eligible studies were selected according to an established strategy.A meta-analysis was performed by the Stata software version 12.0.Results A total of 14 RCTs or CCTs were eligible for this meta-analysis,including five high-quality trials.Response rate ratios were calculated for ceftriaxone-treated patients compared with penicillin-treated patients.The meta-analysis showed no significant difference in the efficacy between ceftriaxone and penicillin at 6-,12-and 24-month follow-up visits.The response rate was 92.3％ (95％ CI:88.5％-96.1％) and 90.4％ (95％ CI:87.4％-94.4％) in ceftriaxone-and penicillintreated patients respectively at the 12-month follow-up visit.Funnel plots were approximately symmetrical,indicating little publication bias.Conclusions Ceftriaxone may serve as an alternative treatment for early syphilis with reliable efficacy.However,multi-centered RCTs with large sample sizes are still needed to optimize the therapeutic dose and course of ceftriaxone for early syphilis.

Objective To characterize the spatial distribution pattern of syphilis at the county level in China,and to provide a new method for syphilis surveillance and control.Methods A national geographic information system (GIS) database was developed based on reported cases of syphilis from all counties in China,2011.Exploratory spatial data analysis (ESDA) methods were used to study the frequency distribution of incidence,global and local spatial autocorrelation,of syphilis.Results The median incidence rate of syphilis was 21.17/100 000 (range:0.00-515.34/100 000; 25th percentile 9.28/100 000,75th percentile 43.00/100 000) in 2 925 counties in the mainland of China in 2011,with a highly positively skewed distribution (skewness =3.11).The global spatial autocorrelation analysis showed a positive spatial autocorrelation of syphilis incidence at the county level in China (global Moran's index =0.576 2,P ＜ 0.001),with the type of correlation being high-high cluster (General G index =0.033 1,P ＜ 0.001).The local spatial autocorrelation analysis delineated hot spots of syphilis (including primary and secondary syphilis,latent syphilis) at the county level.Totally,117 counties,which were mainly distributed in the Yangtze River delta region,northwest,northeastern and south China,were identified as hot spots for syphilis,with the incidence rate of primary or secondary syphilis being higher than 50/100 000.Conclusions The GIS and exploratory spatial data analysis,with the advantages of visualization and accurate localization,may serve as an important novel tool for syphilis surveillance and control.

Objective To determine the coverage of gonorrhea and syphilis case reporting in China,and provide information for managing STD case-reporting,investigating under-reporting and evaluating STD epidemic.Methods The gonorrhea and syphilis case-reporting data from 31 provinces in 2005 were collected with systematic sampling by months of February,May,August and November through National Information System for Disease Control and Prevention,and the coverage of the casereporting by county category in 31 provinces were analyzed.Results The average coverage of gonorrhea case-reporting were 56.66%,66.33%,68.90% and 68.27% in February,May,August and November in 2005,respectively,while the average coverage of syphilis were 42.61%,55.56%,59.46% and 60.59% in these months,respectively.The coverage of case reporting in developed or southeast ern areas,such as Shanghai,Beijing,Tianjin,Chongqi,Zhejiang,Jiangsu,Guangdong,Guangxi,Hainan,and Fujian provinces was higher by more than 80%.However,the coverage in economically less-developed or west ern areas,including.Hebei,Shanxi,Inner Mongolia,Shaanxi,Gansu,Yunnan,Guizhou,Qinghai and Tibet provinces,was lower by less than 50%.Conclusions Overall,the coverage of gonorrhea and syphilis case reporting in the country is relatively low,which directly compromises the accuracy of STD case reporting data.It is suggested that management,surveillance and evaluation of STD case reporting should be strengthened,especially in economically less-developed or western areas.

Objective To investigate the trends in and characteristics of syphilis epidemiology in China,and to provide a scientific basis for the development of control strategies.Methods An epidemiological study was performed on syphilis cases reported from 31 provinces,autonomous regions and municipalities between 2000 and 2013.Results The reported syphilis incidence increased yearly from 6.43 per 100 000 person-years in 2000 to 32.86 per 100 000 person-years in 2013,with an average annual growth rate of 13.37％.Syphilis was reported in most (99％) counties/districts in China mainland except for a few remote mountain areas,with a significant difference in the incidence of syphilis between different regions.The regions with a high incidence of syphilis included minority areas in Northwest China (Xinjiang,Qinghai and Ningxia),Minjiang River area,Yangtze River Delta (Zhejiang,Shanghai),Zhujiang River Delta (Guangxi,Guangdong),etc.There had been a rapid increase in the incidence of syphilis in some regions previously reported to have a low incidence (such as Guizhou,Shaanxi,Henan,etc).Among the reported cases,female patients predominated with an average male/female ratio of 0.92 ∶ 1.The incidence of syphilis was highest in the age group of 20-39 years,but increased yearly by more than 30％ in the population aged ＞ 60 years.Of 20 occupations,peasant workers accounted for the highest proportion (31.56％) of syphilis cases,and retired population showed the most rapid increase by about 27.35％ per year.The constituent ratio of primary and secondary syphilis in all the syphilis cases had declined yearly,while that of latent syphilis increased by more than 50％ after 2010.Conclusions Syphilis remains a major public health issue in China,and measures based on the epidemiological features are urgently needed to effectively control epidemic syphilis.

Mother-to-child transmission (MTCT) is a major route of transmission of syphilis,and may occur at any time during pregnancy.MTCT of syphilis can lead to many adverse pregnancy outcomes,seriously affects maternal and infant health,and has been a severe public health and social problem.The risk of MTCT of syphilis is associated with stage of syphilis in pregnancy,stage of pregnancy,receiving or not receiving treatment,and is especially high in patients with early syphilis.With the growth of incidence of syphilis,the prevention for MTCT of syphilis has been becoming more and more important.Screening for and early treatment of syphilis in pregnancy can effectively block MTCT of syphilis.To learn the epidemiology,route,risk,and associated factors of MTCT of syphilis will undoubtedly facilitate the development of strategies for syphilis prevention and control.

OBJECTIVE:To investigate the effect of liposome-encapsulated demethoxycurcumin on the proliferation of human lung adenocarcinoma cell line A549.METHODS:The in vitro cultured human lung adenocarcinoma cell line A549 was treated with liposome-encapsulated Bisdemethoxycurcumin.The bionomics including morphology and cell cycle of cell line A549 were observed by morphological analysis,MTT assay and flow cytometry assay.RESULTS:Marked morphological changes were noted in cell line A549 under microscope.Liposome-encapsulated Bisdemethoxycurcumin showed inhibitory action on the growth of A549 cell lines,with IC50 at 12.108?g/mL.The progression of cell cycle was arrested in S phase.CONCLUSION:Liposome-encapsulated Bisdemethoxycurcumin can inhibit the growth of human lung adenocarcinoma cell line A549,which has a promising future in the treatment of adenocarcinoma of lung.

Objective To study the value of MR diffusion tensor imaging(DTI) in the staging of chronic kidney disease(CKD).Method MR diffusion tensor imaging was used on 26 CKD patients.All patients were diagnosed as CKD according to the criteria of clinical diagnostic.All MR images achieved diagnostic requirements.Diethylenetriamine pentaacetic acid(99mTc-DTPA) renal dynamic imaging was used to determine the unilateral renal function.CKD patients were determined as mildly renal impairment group and moderately to severely renal impairment group based on the glomerular filtration rate(GFR).Twenty healthy volunteers underwent DTI at the same time.The cortical and medullary ADC value and FA value were measured in all subjects who underwent conventional MRI and DTI.The paired Student's t test was used to compare the cortico-medullary difference of the mean ADC and FA values in all subjects.The oneway analysis of variance(ANOVA) was carried out to assess the difference among the medullary and cortical diffusion parameters(ADC,FA) of all the three groups,and LSD was used to assess multiple comparisons.The correlation of GFR and ADC value of the patients,and FA value of the patients were tested by Pearson correlation analysis.Results The cortical and medullary ADC values of 46 subjects were(2.25±0.25) × 10-3 and(2.10±0.20) × 10-3 mm2/s respectively,FA of them were(3.48±0.61) and(4.27±0.75) respectively(t =6.754,10.043 respectively; P＜0.01).The cortical ADC values of volunteers,mild renal impairment group,severely renal impairment group were(2.25±0.22) ×10-3,(2.31±0.19) ×103,(2.18±0.32) ×10-3mm2/s respectively.The medullary ADC value of the three groups were(2.09±0.19) × 10-3,(2.17±0.17) × 10-3,(2.06±0.24) × 10-3mm2/s respectively(F=0.968,0.882 respectively; P＞0.05).The cortical FA values of the three groups were 3.85± 0.47,3.18±0.62,3.20±0.52 respectively.The medullary FA of the three groups were 4.92±0.38,3.93±0.57,3.62 ± 0.53(F=8.725,33.705 respectively; P＜0.01).There was no correlation between cortical ADC,medullary ADC,cortical FA of the patients and GFR [(30.14±15.79) ml· min-1 · 1.73 m-2](r =0.243,0.197,0.196 respectively; P＞0.05).There was a positive correlation between medullary FA of the patients and GFR (r=0.556,P=0.003).Conclusion FA value has certain value in evaluating CKD early diagnosis and renal function.

Objective To learn the various clinic characteristics of newly T tuberculosis (TB) patients ,investigating the preven-tion and treatment knowledge of TB patients ,in an effort to provide scientific evidence for targeted prevention and control meas-ures .Methods Retrospectively analyzing the common demographic characteristics of 648 newly and 434 old TB patients from Sep-tember 2011 to September 2012 ,diagnostic information ,the awareness on the prevention and treantment ,drug use situation and so on .Results Among these patients ,most of them were males(60 .2% ) ,the middle age and the young were the majority (77 .8% ) , the disease areas were mainly rural ones (61 .6% ) ,and manual workers (65 .4% ) ,secondary pulmonary TB was in the majority (72 .8% ) ,40 .0% (52/130) of the patients with TB pleuritis were accompanied by pulmonary TB .TB patients usually combined with pneumonoconiosis(8 .0% ) ,diabetes(3 .6% ) ,asthma(4 .3% ) and some other fundamental diseases .The old TB patients had more prevention and treatment knowledge about TB than those newly patients (P<0 .05) .The major source of newly patients about the knowledge were mainly from their relatives and friends (30 .3% ) ,whereas the old patients from teaching of medical care (36 .9% ) .The main reasons for irregular usage of medicine came from the lack of knowledge about the course period of treatment (45 .3% ) ,and the disappearing of TB symptoms (30 .8% ) .Conclusion In the less developed rural areas ,the young and middle aged males who mainly done physical work were the majority patients .These newly patients have little prevention and treatment knowledge about TB .Comprehensive hospitals played an important role in transmission of TB knowledge .In the process of educa-tion ,we should pay special attention on the following less known but essential points :mode of transmission ,protective measures , course period of treatment ,monitoring side effect ,giving out free medicine ,and the prognosis of TB .

Objective To evaluate the value of contrast-enhanced uhrasound(CEUS)for liver fibrosis.Methods Ninty-two chronic hepatitis B patients with histology diagnosis and fifteen health control were detected by CEUS,dynamic images and the time-intensity curve were analyed.Results Hepatic veinartery transit(HV-ATT)became shorter in the early hepatic cirrhosis patients [(7.5±2.1)s]compared to the control[(11.8±2.7)s].However,there was no difference between the fibrosis patients [(13.0±2.2)s]and the control.Furthermore,HV-ATT of the fibrosis patients with S1 to S3 stage were(11.7±2.7)s(S1),(11.8±3.0)S(S2),(11.8±2.3)s(S3)without significant difference.Conclusions CEUS is valuable in diagnosing earlier hepatic cirrhosis,but not fibrosis.

Objective To investigate epidemiological characteristics and trends of gonorrhea in China, and to provide a scientific basis for the development of control strategies. Methods An epidemiological study was performed on gonorrhea cases reported from 31 provinces, autonomous regions or municipalities directly under the central government between 2000 and 2014. Results The reported incidence rate of gonorrhea decreased from 22.92 per 100 000 in 2000 to 7.25 per 100 000 in 2014, with the average annual rate of decrease being 7.89%. There was a significant difference in the incidence of gonorrhea between different regions. The regions with the highest incidence rate of gonorrhea were Yangtze River Delta region(Zhejiang, Shanghai, Jiangsu)and Zhujiang River Delta region(Guangdong, Guangxi, Hainan), followed by northwest China (Xinjiang, Ningxia, Inner Mongolia). The incidence of gonorrhea was higher in males than in females, and the average male/female ratio increased from 1.96 ∶ 1 in 2000 to 4.52 ∶ 1 in 2014. The population aged 20 - 44 years showed high incidence of gonorrhea, and the highest incidence rate of gonorrhea was observed in the age group 25 - 29 years in both men and women. The incidence of gonorrhea decreased in all the age groups from 2000 to 2014 except the age group 15 - 19 years with an annual growth rate of 4.18%. Of 20 occupations, peasant workers accounted for the highest proportion (26.00%)of reported gonorrhea cases, and the number of reported gonorrhea cases showed a decreasing trend in all the occupations. Conclusions Gonorrhea remains a major public health issue in China, and effective measures based on epidemiological features are urgently needed to control gonorrhea.