Objective To inhibit the gene expression of signal transducer and activator of transcription factor 1 (STAT1) in human esophageal squamous cell carcinoma cell line Eca109 by RNA interference and investigate its effect on the radiosensitivity and cell cycle of Eca109 cells.Methods Interference vector pSTAT1-shRNA for STAT1 gene was designed and constructed.After being mixed with lentiviral packaging plasmids,the interference vectors were used to transfected 293T cells.Virus solution was collected to infect ECA109 cells.Real-time PCR and Western blot were used to measure the mRNA and protein expression levels of STAT1 in Eca109 cells.Colony formation assay and flow cytometry were used to evaluate the radiosensitivity and cell cycle distribution of Eca109 cells.Results All Eca109 cells were divided into blank control group,transfection-positive group,and transfection-negative group.The transfection-positive group showed significantly lower mRNA and protein expression levels of STAT1 than the other two groups.The values of D0,SF2,and Dq of transfection-positive group were 2.03 Gy,0.83,and 1.20 Gy,respectively,lower than those of blank control group (2.98 Gy,0.88,and 1.39 Gy) and those of transfection-negative cells (3.02 Gy,0.88,and 1.57 Gy).At 12 h,24 h,and 48 h after 4 Gy-irradiation,the transfection-positive group showed significantly higher percentage of G0 + G1 than the blank control group and transfection-negative group (34.13％ vs 22.03％ vs 22.27％,F =7.56,P =0.023 ; 43.80％ vs 28.40％ vs28.63％,F=10.01,P=0.012;53.20％ vs42.2％ vs41.83％,F＝10.73,P=0.010) and significantly lower percentage of G2 + M than the blank control group and transfection-negative group (14.33％ vs 32.23％ vs 32.23％,F=16.86,P=0.003;27.73％ vs 43.53％ vs 44.00％,F=26.62,P=0.001;14.23％ vs27.97％ vs27.93％,F=40.34,P=0.000).Conclusions RNAinterference of STAT1 in Eca109 cells does not affect the proliferation ability of Eca109 cells,and it can increase the radiosensitivity of Eca109 cells probably by regulating cell cycle after irradiation.

Objective To explore the prognosis and its related factors of three-dimensional conformal radiotherapy (3D-CRT) for elderly patients with esophageal carcinoma. Methods From January 2001 to August 2007, 89 elderly patients aged 65 years or more with esophageal carcinoma were treated with 3D-CRT. And the local control rates, survival rates and its related prognostic factors were evaluated retrospectively, using SSPS11.5 software. Results The 1-, 2-, 3-and 4-year local recurrence-free survival rates were 65.2%, 43.0%, 27.3% and 22.3%, respectively. The 1-,2-, 3-and 4-year overall survival rates were 68.5%, 48.8%, 36.8% and 25.2%, respectively. And the median survival time was 21.5 months. With univariate analysis, the significant prognostic factors included the different diet before radiotherapy (χ~2=6.26, P=0. 012), T stage (χ~2=8. 80, P=0. 003), N stage (χ~2=4.33, P=0. 038), clinical stage (χ~2=7.88, P=0. 005), the largest diameter of tumor in CT scanning image (χ~2=10.88, P=0.004), recent efficacy (χ~2=5.28, P=0. 022) and chemotherapy (χ~2=5.49, P=0.019). And the factors which were not related with prognosis included gender (χ~2=0.74, P=0. 390), age (χ~2=1.89, P=0. 170), lesion length showed by esophageal angiography (χ~2=2. 38, P=0.123), lesion length showed by CT (χ~2=2.69, P=0.101),primary tumor site (χ~2=2.12, P=0. 146), coexistent disease (χ~2=0. 03, P=0. 874), exposure mode (χ~2=0.04, P=0.847) and radiation dose (χ~2=0. 24, P=0. 627). Multivariate analysis revealed that the different diet before treatment (P=0. 002), the clinical stage (P=0. 007) and chemotherapy (P=0. 011) were independent prognostic factors. Radiation induced esophagitis was observed in 20 cases in grade 0, 30 cases in grade 1, 32 cases in grade 2, 7 cases in grade 3. And acute radiation pneumonitis was observed in 89 patients, with 57 in grade 0, 20 in grade 1, 8 in grade 2, 2 in grade 3 and 2 in grade 5. Until the end date of follow-up, 60 patients had died: 29 cases died of local recurrence or uncontrolled disease, 11 cases died of metastasis, 5 cases died of local recurrence with metastasis, and 15 cases died of other reasons. Conclusions 3D-CRT can be considered as an effective and feasible approach for elderly patients with esophageal cancer. The 3D-CRT provides them with less obstruction of diet, early clinical stage and longer survival time. 3D-CRT combined with chemotherapy may improve survival rate.

Objective: To perform a cost-benefit analysis of the occupational disease reporting system in China, and to provide a basis for effective resource allocation. Methods: The data on the cost of occupational diseases were collected from China Health Statistics Yearbook 2013, the estimated benefit data were collected from published articles in China and foreign countries, and the probability data were collected from the occupational diseasereports published by health and family planning administrative departments. Adecision-making tree was used for the cost-benefit analysis. Results: The estimated cost of occupational disease reporting was about 102.47 million yuan/year, consisting of a cost of reporting in national medical institutions of 1.25 million yuan/year, a management cost of 30.35 million yuan/year, a management cost in local public health institutions of 69.80 million yuan/year, a management cost in national public health institutions of 370 thousand yuan/year, and a cost of construction and maintenance of reporting system of 700 thousand yuan/year. The results of the decision tree analysis showed that when an occupational disease monitoring system was established, the incremental input for occupational disease monitoring and prevention/control was 2.1 billion yuan/year, the output was 6.5 billion yuan/year, and the benefit of occupational disease reporting system was 4.4 billion yuan/year. Conclusion The benefit of occupational disease reporting system depends on the cost-benefit of occupational disease prevention and control measures, and proper prevention and control measures are extremely important for improving the benefit of occupational disease reporting system.

Objective To investigate the effects of acute fatigue on the outcome of aged patients with cerebral infarction. Methods The Fatigue Severity Scale was used to investigate the incidence of fa-tigue in 240 elderly patients with acute cerebral infarction,to assess the outcome of the patients at discharge and one year after discharge,and to analyze the effect of acute fatigue on the functional recovery and survival of patients. Results Totally 89 patients (37. 1%) suffered from acute fatigue. Multivariate Logistic regres-sion analysis showed that high admission NIHSS score(OR=2. 472,95%CI= 1. 931-3. 164) and acute post-stroke fatigue(OR=4. 820,95%CI=2. 281~10. 187) were the influencing factors for functional recovery of elderly patients with cerebral infarction at discharge(P<0. 01). High admission NIHSS score( OR=1. 674, 95%CI=1. 411-1. 985),acute post-stroke fatigue( OR=2. 123,95%CI=1. 187-3. 796),mRS score≥ 2 at discharge(OR=9. 822,95%CI=4. 899-19. 693) and recurrence( OR=6. 146,95%CI=2. 596-14. 553) were independent risk factors for functional recovery of elderly patients with cerebral infarction one year after dis-charge ( P<0. 05). Multivariate Cox regression analysis showed that age (OR=1. 096,95% CI=1. 027-1. 169),post-stroke fatigue in acute phase OR=5. 233, 95% CI=1. 051-6. 053) and recurrence ( OR=13. 983,95%CI=2. 821-49. 307) were independent predictors of mortality for elderly patients with cerebral infarction (P<0. 05). Conclusion Fatigue after acute stroke can effect the functional recovery and survival of elderly patients with cerebral infarction.

Objective:To observe any effect of moderate-intensity exercise on left ventricular remodeling (such as cardiomyocyte hypertrophy, apoptosis and proliferation) in spontaneously-hypertensive rats (SHRs) and explore the possible mechanisms.Methods:Thirty 4-month-old female SHRs were randomly divided into a sedentary group ( n=15) and an exercise group ( n=15). Fifteen Wistar Kyoto rats served as the control group. The exercise group underwent daily 60-min moderate-intensity treadmill exercise 5 days per week for 12 weeks, while the sedentary and control groups were raised quietly in cages for the same period. After the 12-week intervention, the caudal artery blood pressure was measured using a non-invasive blood pressure monitor. The rats were then sacrificed and their hearts were sampled for morphometric measurement. Cardiomyocytes were isolated and underwent DAPI staining to measure their length, width and area. Apoptosis cardiomyocytes was detected by using terminal-deoxynucleoitidyl transferase mediated nick end labeling and their proliferation was assessed using immunofluorescent staining. The number of cardiac progenitor cells was detected by flow cytometry, while the expression of the cardiac calcineurin Aβ subunit (CNAβ) and phosphorylated Akt (p-Akt) protein were measured using western blotting. Results:Compared with the control group, a significant increase was observed in the heart weight, heart mass index (HMI), systolic blood pressure, diastolic blood pressure, myocardial thickness of the left ventricular wall (anterior wall, posterior wall and septal wall), cardiomyocyte morphology (length, width and area), cardiomyocyte apoptosis rate, proliferation rate, number of cardiac progenitor cells and protein expression of CNAβ in the sedentary group. Compared with the sedentary group, the average heart weight, HMI, myocardial thickness of the left ventricular wall (anterior wall, posterior wall and septal wall), cardiomyocyte morphology (length, width and area), cardiomyocyte proliferation rate, number of cardiac progenitor cells and p-Akt protein expression had increased significantly in the exercise group. The average systolic blood pressure, diastolic blood pressure, apoptosis rate and CNAβ protein expression had decreased significantly.Conclusions:Moderate-intensity exercise can induce physiological cardiac hypertrophy in SHRs, relieve apoptosis, increase the number of cardiac progenitor cells and promote cell proliferation, thereby inhibiting cardiac remodeling.

Objective To evaluate the safety and efficacy of SilverHawk directional atherectomy device in the treatment of femoropopliteal occlusive disease. Methods From August 2012 to June 2014,46 patients(58 limbs)with femoropopliteal occlusive diseases in the treatment by SilverHawk directional atherectomy device were analyzed retrospectively . The mean lesion length and degree of diameter stenosisin the femoropopliteal stenoses(52 limbs) were (4.6 ± 2.3) cm and (85.6 ± 11.3)％.The mean lesion length in the femoropopliteal occlusions(6 limbs)was(6.3 ± 3.2)cm. Rutherford score was 3 ～ 5. Mean ABI was 0.45 ± 0.36. Patency was evaluated with color duplex sonography,CTA and DSA postoperatively. Results 46 patients(58 limbs)were recanalizated suc-cessfully via intraluminal approach. The overall technical success rate was 100％. The procedural success rate was 93.10％. Postoperative residual stenosis and ABI were(10.3 ± 6.2)％and 1.05 ± 0.32,which had statistical diff erence compared with preoperative(t=5.83,P=0.02). The average period of follow-up was 22 months. Mean ABI during the follow-up was 0.96 ± 0.15,which had statistical difference compared with preoperative(t = 5.09,P =0.03). The 6-month and 1-and 2-year primary patency rate was 94.83％、91.38％、84.48％,and secondary patency rate was 98.28％、96.55％、93.10％,respectively. Conclusion SilverHawk directional atherectomy device is safe and effective in treament offemoropopliteal occlusive disease ,with satisfactory early-middle results.

Objective: To learn about the construction and staffing of the school health system in Chinese institutions for disease prevention and control, and to provide basic information for the school health system, team capacity building and work development. Methods: Electronic questionnaire was used to collect the setting and staffing of school health departments (including school health centers and departments/rooms) at the provincial, prefecture and county (district) levels in the centers for disease control and prevention. Statistical analysis was made on the proportion of school health, the number of staff and the characteristics such as age, education, major and working years in the provincial, prefecture and county (district) levels. Results: Among the 3 313 institutions, the proportion of independent school health departments was 10.8%, and those of the provincial, prefecture and county (district) levels were 74.2%, 15.0%, and 9.6%, respectively. Among the institutions with separated department, the average number of staff members was 4.4, while the number of staff was 2.5. The average age of school health workers was 40.4 years old, and the proportion of male and female employees was 45.2% and 54.8%. The proportion of personnel who have been engaged in school health work for less than 5 years on average was as high as 65.1%. The majors of the staff were mainly public health ( 40.4 %), 54.0% of the provincial staff had a master s degree or above, and 47.8% and 58.7% of the staff at the prefecture and county (district) levels were junior college or below respectively.The proportion of provincial level personnel with intermediate and senior titles was 69.6%, and the proportion of municipal and countylevel personnel at the junior level and below was 52.2% and 56.2% respectively. Conclusion The proportion of independent school health departments within centers of disease control and prevention across China was low. There is a serious shortage of school health personnel, and there are problems such as low levels of education and professional titles, especially in county (district) level institutions. It is urgent to strengthen the construction of the school health system of the centers for disease control and prevention in China.

Objective: To understand the current status of main professional work in independent school health departments of Chinese centers for disease control and prevention, so as to provide reference and suggestions for the further development of school health work in China. Methods: Electronic questionnaire was used to collect the basic work of school health, the monitoring work, the intervention action of common diseases and the development of health intervention among students in independent school health departments of centers for disease control and prevention in China. Results: Among the 357 institutions that have set up independent school health departments, the implementation rates of school mental health work, safety emergency and risk avoidance health intervention were low, which were 11.8% and 11.5%, respectively. Relying on the project "national monitoring and intervention of common diseases and health influencing factors of students", the overall implementation of health monitoring in schools nationwide was successful, but the overall implementation rate of students nutritional status monitoring and "healthy parents action" were low, accounting for 44.5% and 24.4%, respectively. At the same time, there were still as many as 27.2% institutions that had not carried out the intervention action for common diseases of students which advocated in the monitoring program. The failure rate of county level institutions was higher than that of provincial level and prefecture level institutions, and the failure rate of the central and western institutions was much higher than that of the eastern institutions; the difference was statistically significant( χ 2=30.1, 41.6, P <0.05). Conclusion We should increase support including policy preference, fund guarantee, technical guidance and so on for the school health work of disease control institutions at the grass roots level and in economically underdeveloped areas, so as to ensure the healthy growth of children and adolescents in all respects.

Objective To study the incidence of acute renal injury ( AKI), related clinical risk factors and recent prognosis in critically ill neonates. Methods The study was a retrospective analysis from January 2016 to December 2016 in the neonatal care department of General Hospital of Shenyang Military Region and the First Hospital Affiliated to China Medical University. We collected the perinatal data,clinical data,biochemical indexes and short-term prognosis. Logistic regression analysis was used to identify the risk factors. Results The incidence of AKI in critically ill neonates was 13. 11%(32/244),and the probability of poor prognosis was 62. 50%(20/32). Gestational age,birth weight,1 min and 5 min Apgar score,con-sciousness,mechanical ventilation,blood pH,blood glucose,blood urea nitrogen,white blood cell and red cell distribution width were the related factors for AKI in critically ill neonates. Logistic regression analysis showed that consciousness(OR=4. 542,95%CI 1. 176-17. 539,P=0. 028),mechanical ventilation(OR=0.267,95%CI 0.101-0.705,P = 0.008),5 min Apgar score(OR = 0.750,95% CI 0.605-0.930,P =0. 009),blood urea nitrogen value(OR=1. 074,95%CI 1. 006-1. 146,P=0. 030)were identified as the inde-pendent risk factors of AKI. ConclusionThe incidence of AKI is high in critically ill neonates. Consciousness,mechanical ventilation,5 min Apgar score,blood urea nitrogen value are identified as independent risk factors for AKI.

Objective To investigate the efficacy of drug-coated balloon in treatment of femoropopliteal artery occlusive disease.Methods The clinical data of 49 patients with femoropopliteal artery occlusive disease from Feb 2016 to Oct 2017 were retrospectively analyzed.25 cases underwent drugcoated balloon treatment (DCB group),and 24 cases received plain balloon angioplasty (POBA group).Results The procedures were successful in all cases.There were no amputation or death occurred.In DCB group compared to POBA group,the patency rate at postoperative 3 months were not significantly different (96.0％ vs.87.5％,P ＞ 0.05),while it was significantly different at postoperative 6 and 12 months (88.0％ vs.66.7％;80.0％ vs.50.0％,both P ＜0.05).Minimal lumen diameter (MLD) changes and late lumen loss(LLL):The MLD in preoperative,immediate postoperative was not statistically significant between the three group(P ＞ 0.05).At 6 months and 12 months after operation,MLD of DCB group was higher than POBA group (P ＜ 0.05).At 12 months after surgery,LLL in DCB group was significantly lower than the POBA group (P ＜ 0.05).Conclusion DCB is the effective method to treat femoropopliteal artery occlusive disease,which has better short and mid-term efficacy than POBA.