Objective To provide reference for improving the performance of public health by establishing performance evaluation framework of public health in rural areas of China.Methods The performance evaluation framework of public health in rural areas is established by literature research,theoretical derivation and Delphi method.The results of expert consultation are tested by W test of Kendall coordination coefficient and chi-square test.Results The performance evaluation framework of public health in rural areas contains four conceptual modules,ten performance goals and twenty-eight performance evaluation indexes.The positive coefficient of experts is 0.889.The average values of authoritative grade of experts are between 0.681～0.715.The Kendall W uniformity coefficients of the necessity,sensitivity and maneuverability of the indexes are respectively 0.167,0.209 and 0.185.The P values are less than 0.01.Conclusion The performance evaluation framework of public health in rural areas has certain application value.It is necessary to pay attention to scientific nature and applicability in developing performance evaluation of public health in rural areas.

Objectlve To investigate the value of basic and contrast-enhanced ultrasound in the diagnosis of superficial cervical lymph nodes.Methods Five hundred and forty-five cases of superficial cervical lymph nodes were sacned by basic ultrasound,in which 52 cases were also scaned by contrast-enhanced ultrasound.All cases were performed ultrasound-guided biopsy.Lymph nodes were divided into benign group and malignant group according to pathology reports.The differences of the two groups were analysed,and statistical analysis was performed.Results Two hundred and thirty cases were benign,315 cases were malignant.S/L(P＜0.01),RI(P＜0.01),vascular pattern(P＜0.01)and contrast enhancement pattern(P＜0.01)between benign and malignant group showed statistical significant differences,while no statistical difference in coefficient correlation of the time-intensity curve between the two groups was found.Conclusions A combination of basic and contrastenhanced ultrasound can significantly enhance the ability to identify malignant lymph nodes from benign lymph nodes.

Reduced radiosensitivity of lung cancer cells represents a pivotal obstacle in clinical oncology. The hypoxia-inducible factor (HIF)-1α plays a crucial role in radiosensitivity, but the detailed mechanisms remain elusive. A relationship has been suggested to exist between hypoxia and autophagy recently. In the current study, we studied the effect of hypoxia-induced autophagy on radioresistance in lung cancer cell lines. A549 and H1299 cells were cultured under normoxia or hypoxia, followed by irradiation at dosage ranging from 0 to 8 Gy. Clonogenic assay was performed to calculate surviving fraction. EGFP-LC3 plasmid was stably transfected into cells to monitor autophagic processes. Western blotting was used to evaluate the protein expression levels of HIF-1α, c-Jun, phosphorylated c-Jun, Beclin 1, LC3 and p62. The mRNA levels of Beclin 1 were detected by qRT-PCR. We found that under hypoxia, both A549 and H1299 cells were radio-resistant compared with normoxia. Hypoxia-induced elevated HIF-1α protein expression preferentially triggered autophagy, accompanied by LC3 induction, EGFP-LC3 puncta and p62 degradation. In the meantime, HIF-1α increased downstream c-Jun phosphorylation, which in turn upregulated Beclin 1 mRNA and protein expression. The upregulation of Beclin 1 expression, instead of HIF-1α, could be blocked by SP600125 (a specific inhibitor of c-Jun NH2-terminal kinase), followed by suppression of autophagy. Under hypoxia, combined treatment of irradiation and chloroquine (a potent autophagy inhibitor) significantly decreased the survival potential of lung cancer cells in vitro and in vivo. In conclusion, hypoxia-induced autophagy through evaluating Beclin1 expression may be considered as a target to reverse the radioresistance in cancer cells.

The recurrence rate of primary hepatocellularcarcinoma is very high,and repetitive resection is still the besttreatment for operable recurrent hepatocellular carcinoma.Indocyanine green(ICG) has been widely used andpopularized in resection of hepatocellular carcinoma,providesmore possibilities and diversity for the surgical treatment ofrecurrent hepatocellular carcinoma. Combined withpreoperative imaging,three-dimensional imaging technologyand intraoperative ultrasound,ICG can effectively improve theradical and accuracy of the operation for recurrent hepatocellular carcinoma. ICG-guided hepatectomy isappropriate for the new concept and technical system of liversurgery advocated by modern medical model, and realizesfunctional and anatomical hepatectomy for recurrenthepatocellular carcinoma.

Blood Coagulation ; Blood Coagulation Disorders ; virology ; Coronavirus Infections ; complications ; Humans ; Pandemics ; Pneumonia, Viral ; complications

Objective To investigate the clinical significance of serum total bile acid(TBA)and cholyglycine(CG)detection in the early diagnosis of intrahepatic cholestasis of pregnancy(ICP)and perinatal adverse outcomes.Methods Chose 67 ca-ses of ICP pregnant women diagnosed and treated in Chang'an Hospital from June 2015 to June 2017 and they were selected as observation group.According to the 2015 edition of the diagnostic guidelines for the diagnosis and treatment of intrahe-patic cholestasis of pregnancy.The patients were divided into mild ICP group and severe ICP group,and 60 healthy pregnant women were selected as the control group.The serum TBA concentration was measured by fifth generation cyclic enzyme method and the concentration of serum CG was detected by latex enhanced turbidimetric immunoassay.The serum TBA,CG test results and the rate of abnormal test results,the incidence rate of perinatal adverse outcomes were compared between groups.Evaluation of serum TBA and CG detection of pregnancy early diagnosis of intrahepatic cholestasis and clinical value of perinatal adverse outcomes.Results The detection results of serum TBA and CG in the control group,mild ICP group and severe ICP group,there were significant differences between the three groups,the difference was statistically significant (P<0.01),the detection results in the CG group,serum TBA,ICP slightly higher than the control group,the difference was statistically significant(t=22.27,39.68,P<0.05).Weight of serum TBA and ICP group,the results of CG was higher than that of patients with mild ICP group,the difference was statistically significant(t=10.24,70.87,P<0.05).And in the con-trol group,mild ICP group,severe ICP group pregnant women serum TBA,CG test results increased with the aggravation of the disease.Serum TBA and CG abnormal results in 60 cases of the control group were not detected.In 67 cases of group ICP(mild ICP group and severe ICP group)were 63 cases and 61 cases,two groups of abnormal results rate comparison,and the difference was statistically significant(χ2=29.35,31.27,P<0.01).Perinatal premature labor,fetal distress,perinatal death and stillbirth incidence of adverse perinatal outcomes in the control group,mild ICP group and severe ICP group were significantly different between the three groups(χ2=39.17,56.31,13.02,6.92,P<0.01).Conclusion Intrahepatic chole-stasis of pregnancy,serum TBA and CG increased significantly,can be used as a sensitive indicator of ICP diagnosis,improve the detection rate of ICP,and effectively predict perinatal outcome.For intrahepatic cholestasis of pregnancy early detection and early diagnosis,it has important clinical significance.

OBJECTIVEFragile X syndrome (FXS) may be identified by many methods, such as PCR assay and Southern blot. However, each method has its limits or shortcomings. This study explored the reliability of the rapid, convenient and inexpensive hair root fragile X mental retardation protein (FMRP ) assay in the identification of FXS.

METHODSFMRP in hair roots was determined by immunohistochemistry assay in 80 healthy children, in 40 children with mental retardation of unknown etiology and in 12 family members in one pedigree of FXS. FXS was confirmed by 7-deza-dGTP PCR.

RESULTSThere was a high expression of FMRP in hair roots (> or =80%) in healthy children. Two children were confirmed with FXS by 7-deza-dGTP PCR in 40 children with mental retardation of unknown etiology. FMRP expression was 10% and zero respectively in the two children. The other 38 children had FMRP expression of more than 80%. FMRP was not expressed in the two cases of FXS from the pedigree of FXS.

CONCLUSIONSInexpensive, rapid and convenient hair root FMRP assay is reliable for the diagnosis of FXS and may be widely applied for screening and diagnosing FXS in children with mental retardation.

Adolescent ; Child ; Child, Preschool ; Female ; Fragile X Mental Retardation Protein ; analysis ; Fragile X Syndrome ; diagnosis ; genetics ; Hair ; chemistry ; Humans ; Infant ; Male ; Polymerase Chain Reaction

BACKGROUNDGreat advances have been made in the diagnosis, molecular pathogenesis and treatment of acute lymphoblastic leukemia (ALL) in the past decade. Due to the lack of large population-based studies, the recent trends in the incidence and geographic variations of ALL in Shanghai, China have not been well documented. To better understand the incidence and epidemiological features of ALL in Shanghai, we conducted a retrospective survey based on the database from the Shanghai Center for Disease Control and Prevention (CDC) and the medical records in all large-scale hospitals in Shanghai, especially those 30 major hospitals with hematology department.

METHODSAccording to the data from Shanghai CDC, 544 patients, with a median age of 32 years (ranging 1.2 - 89 years), were diagnosed as de novo ALL from January 1, 2002 to December 31, 2006, and they were followed up until December 31, 2007.

RESULTSThe average annual incidence of ALL in Shanghai was 0.81/100 000. The incidence in men (0.86/100 000) was slightly higher than that in women (0.75/100 000). The age-stratified incidence showed that the incidence was 2.31/100 000 in patients ≥ 17 years old, 0.54/100 000 in those 18 - 34 years old, 0.46/100 000 in those 35 - 59 years old, and 0.94/100 000 in those ≥ 60 years old. Moreover, there were substantial geographic variations in the incidence of ALL, with the incidence in Chongming county, an island in the east of Shanghai city being 0.60/100 000, much lower than those of other districts. Both French-American-British (FAB) and World Health Organization (WHO) classification systems were applied in the present study. Eighty-eight patients were diagnosed as L1 (26.2%), 193 L2 (57.4%), and 55 L3 (16.4%). For 302 patients with immunophenotypic results, 242 were identified as B cell origin (80.1%), 59 as T cell origin (19.5%), and 1 as biphenotype (0.4%). The leukemia cells in 61 patients co-expressed one or two myeloid antigen (20.2%). For 269 patients with cytogenetic results, the incidences of t(9;22) in patients aged < 10, 11 - 17, 18 - 44, 45 - 59 and ≥ 60 years old were 4.2%, 11.4%, 19.2%, 23.1% and 5.3%, respectively.

CONCLUSIONCompared with the previous data, the incidence of ALL is increased in Shanghai, and has a geographic distribution characteristic.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Data Collection ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; epidemiology ; Young Adult

The mutations of BLM gene may result in Bloom's syndrome which includes immunodeficiency, predisposition to malignant tumors and so on, and enhances sister chromati exchange (SCE), DNA replication failure, genome instability, and increases cancer susceptibility. This study was aimed to investigate the variability of mRNA expression level and cDNA structure of BLM gene in tumor cell strains so as to look for a new cancerogenic mechanism and to find a new therapeutic target. The expression level of mRNA and the structure of cDNA of BLM gene in six tumor cell strains and the normal human bone marrow mononuclear cells were detected with RT-PCR and DNA sequencing was performed. The results indicated that these tumors cells expressed BLM mRNA higher than the normal human bone marrow mononuclear cells (P < 0.01), but no cDNA sequence abnormality of BLM gene in these tumors cells was observed. It is concluded that the increase of expressing level of BLM mRNA may play an important role in the development of these tumors.
Base Sequence ; Cell Line, Tumor ; DNA Helicases ; genetics ; Gene Expression Regulation, Neoplastic ; HL-60 Cells ; Humans ; Jurkat Cells ; Molecular Sequence Data ; RNA, Messenger ; biosynthesis ; genetics ; RecQ Helicases ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Analysis, DNA

OBJECTIVETo investigate the mechanism and the suppression effect of human cytomegalovirus (HCMV) on hematopoietic system.

METHODSSemi-solid culture system was used to observe the effect of HCMV AD169 strain on colony forming unit granulocyte/macrophage (CFU-GM), CFU-erythroid (CFU-E), CFU-multipotent (CFU-Mix) and CFU-megakaryocyte (CFU-MK) growth. The techniques of in situ polymerase chain reaction (IS-PCR) and polymerase chain reaction (PCR) were used to demonstrate the existence of HCMV DNA in the colony cells of cultured CFU-GM, CFU-Mix, CFU-MK and CFU-E, respectively. The immediate early antigen (IEA) mRNA in CFU-MK and late antigen (LA) mRNA in CFU-E were detected by reverse transcriptase-polymerase chain reaction (RT-PCR). HCMV early protein P52 was detected with immunohistochemical technique.

RESULTSHCMV AD169 suppressed the differentiation and proliferation of CFU-GM, CFU-E, CFU-Mix and CFU-MK in vitro significantly (P < 0.05). The suppression was dose-dependent. HCMV DNA was successfully detected in CFU-GM, CFU-Mix, CFU-MK colony cells from viral infection groups by IS-PCR, and was detected in CFU-E by PCR, while it was negative in blank control or mock control groups. CFU-MK colony cells expressed HCMV IEA mRNA with the size of 340 bp in virus infection groups of 10(3) plague forming unit (PFU), 10(4) PFU and 10(5) PFU, respectively. The HCMV LA mRNA was detected by RT-PCR and was 263 bp long in positive control group of HCMV-infected human embryonic fibroblasts. The expression of HCMV LA mRNA in CFU-E was negative. The early protein P52 of HCMV in 10(4) PFU group was also identified by immunohistochemical staining.

CONCLUSIONHCMV AD169 strains inhibited the differentiation and proliferation of CFU-GM, CFU-E, CFU-Mix and CFU-MK by the infection of the hematopoietic progenitors. HCMV might cause the suppression of hematopoiesis by direct infection, which is thought to be one of the reasons of HCMV infection associated with thrombocytopenia, neutropenia and anemia.

Colony-Forming Units Assay ; Cytomegalovirus ; genetics ; DNA, Viral ; genetics ; Erythrocytes ; virology ; Hematopoietic System ; cytology ; virology ; Humans ; Megakaryocytes ; virology ; Multipotent Stem Cells ; virology ; Polymerase Chain Reaction