Objective To investigate the feasibility of evaluating the pancreatic fat deposition with ultrasound,and analyze the relationship of pancreatic fat deposition with the risk factors for diabetes.Methods Two hundred and ninety-four subjects were recruited in the diabetes epidemic survey of Shanghai Sixth Peoples' Hospital,Shanghai Jiaotong University from Oct 2015 to Jan 2016,including 111 diabetes mellitus (DM) cases,54 sugar metabolic abnormalities (IGR) cases,and 129 healthy cases as control group.The general data were collected.Biochemical indicators including ALT,AST and insulin in fasting blood samples were detected,and insulin resistance index (HOMA2-IR) and insulin secretion index (HOMA-IS) were calculated.The pancreatic fat deposition was evaluated by the ultrasound,and pancreas echoes were divided into three levels (1,2,3),by comparing with the echo of the rectus.The Chi-square test was used to analyze the pancreatic fat deposition rate,while the Logistic regression was used to figure out the diabetes high-risk factors influencing the pancreatic fat deposition.Results Forty-two subjects were found to have the pancreatic fat deposition in the healthy group (33.3％),of whom 19 cases,16 cases and 8 cases were categorized into level 1,2 and 3,respectively.Thirty subjects were found to have the pancreatic fat deposition in the IGR group (55.6％),of whom 14 cases,11 cases and 5 cases were categorized into level 1,2 and 3,respectively.Sixty-seven subjects were found to have the pancreatic fat deposition in the DM group (60.4％),of whom 37 cases,18 cases and 12 cases,were categorized into level 1,2,3,respectively.The pancreatic fat deposition rates of the 3 groups were statistically significantly different (P＜0.01).Multivariate Logistic regression analysis showed that body mass index (BMI),HOMA2-IR,high triglycerides (TG),and total cholesterol (TC) may be the-risk factors for the pancreatic fat deposition in IGR and T2DM patients.Conclusions The ultrasound evaluation on pancreatic fat deposition was feasible,and the pancreatic fat deposition was related to multiple high-risk factors for diabetes.

Six years' English teaching in department of obstetrics and gynecology in Wenzhou Medical College were reviewed. Language and cultural differences are the main reasons hindering teaching quality. Rational use of a variety of teachers,preparing for lessons adequately,adoption of English image data,supplying and revising English teaching materials,using network auxiliary teaching and forming ef-fective education mode are conducive to improving English teaching quality in department of obstetrics and gynecology for foreign students.

Objective To explore and integrate the key techniques used in the surveillance and forecast of schistosomiasis in the water regions along the Yangtze River,so as to provide technical support for identifying rapidly the risk of schistosomiasis transmission and implementing control measures targeting the risk. Methods According to the distribution of water systems and water regions along the Yangtze River in Jiangsu Province,the demonstration sites for surveillance and forecast of schistoso? miasis were set across the province,where the integration and demonstration of the techniques regarding monitoring of Schistoso?ma japonicum infection in sentinel mice,human and animal activities,release of forecast information,and emergency treat?ment of water regions at risk of infection were performed. The pattern of human and animal activities was compared with the S. ja?ponicum infection in sentinel mice in the demonstration sites,and the operability of the release of information and emergency treatment of the risk of S. japonicum infection was evaluated. Results A total of 50 demonstration sites for surveillance and forecast of schistosomiasis were set in fixed anchor points,opening of the navigation lock to the Yangtze River,freight terminal, agritainment places,ferry,large construction places,and places for guaranteeing the Youth Olympic Games in 23 counties(dis?tricts)of 5 cities,Jiangsu Province. During the period between May and September,2014,the infectivity of water body was monitored by using 5 batches of sentinel mice,with a 99.06%(4 954/5 001)gross recovery rate of mice. S. japonicum infection was detected in a demonstration site,and an infected mouse was found,with a 0.02%(1/4 933)gross positive rate of sentinel mice. The field survey showed 2 088 person?times contacting water,including 91.95%(1 920/2 088)contacting water due to the production such as capturing fish,harvesting and cultivating crops,and repairing and building boats,and 8.05%(168/2 088)contacting water due to the life activity,such as fishing,washing vegetables and playing with water. The people contacted water predominantly in August and September(49.57%). A total of 859 boats containing 1 877 boatmen were observed,68.22%(586/859)of which were fishing boats containing 1 306 fishermen(69.58%). There were 32 sheep found in 4 demonstration sites,and 3 sheep were seen in the demonstration site with infected sentinel mouse. Four blue forecasts(emergence of water con?tact)and one orange forecast(S. japonicum?infected sentinel mouse detected)were released across the province,with one fore?cast map released which showed 5 sites with fishing and one site with sheep grazing,one emergency response system initiated, mollusciciding implemented in 10 hm2 high?risk regions,120 sheep grazed in fence,and 35 fishermen given health?education materials,schistosomiasis examination and preventive therapy. In addition,no acute schistosomiasis occurred in the demonstra?tion site with S. japonicum?infected sentinel mice. Conclusions The integration and demonstration of the techniques regarding monitoring of S. japonicum infection in sentinel mice,human and animal activities,release of forecast information,and emer?gency treatment of water regions at risk of infection provides an effective approach for the large?scale surveillance and forecast of schistosomiasis.

Objective To investigate the relationship between various loop electrosurgical excision procedure (LEEP) margin status and residual high grade squamous intraepithelial lesion (HSIL) or worse at hysterectomy following conization. Methods The relevant clinicopathological data were collected in the Obstetrics and Gynecology Hospital, Fudan University from Jan. 2014 to Dec. 2015, including 947 cases who underwent hysterectomy within 6 months of LEEP. The residual HSIL or worse at hysterectomy were analyzed among the groups. (1) Clear margins, involved margins, and without 1 mm negative margins. (2) Only one positive margin, two positive margins and three positive margins. (3) A positive margin of internal ostium of cervix, of external ostium of cervix and of the basement. Results (1) The histological evaluation of the uterine specimens showed residual HSIL or worse in 234 cases (24.7％, 234/947). The proportion of residual lesions was 7.3％ (21/286) in population with clear margins, 33.2％ (211/635) with involved margins, 7.7％ (2/26) without 1 mm negative margins, respectively. The positive margins group had significant difference at the aspect of residual rate in contrast to the negative margins group and the without 1 mm negative margins group (P<0.01). Further studies conclusively showed that the proportion of residual lesions was very similar between the negative margins group and the without 1 mm negative margins group (P>0.05). (2) The involved margins were interpretable in 621 cases. This was detected in 25.3％(111/438) patients with only one positive margin, 47.4％(74/156) with two positive margins and 77.8％(21/27) among three positive margins, respectively (P<0.01). (3) Furthermore, there were 418 cases only one positive margin was definite, and the proportion of residual lesions was 31.0％(62/200) in population with a positive margin of internal ostium of cervix, 18.2％(31/170) of external ostium of cervix and 33.3％(16/48) of the basement. The residual rates were higher in the endocervical and basal margin groups than that in the ectocervical margin group, and the differences were significant (P<0.05). Conclusions The risk of residual HSIL or worse is significantly greater with involved margins at hysterectomy following LEEP. Both the positive endocervical and basal margin are excellent predictors of residual diseases, while the without 1 mm negative margin may be not. Clinicians should avoid treating it as positive margin and prevent overtreatment.

Objective:To investigate the clinicopathological and molecular characteristics of pulmonary enteric adenocarcinoma (PEAC).Methods:The clinical and pathological data of 19 cases of PEAC in the Affiliated Cancer Hospital of Zhengzhou University were retrospectively collected from 2015 to 2019. Immunohistochemistry (IHC) was used to detect the relevant immunophenotypes, amplification refractory mutation system (ARMS) and fluorescence in situ hybridization (FISH) were used to detect the expression of EGFR, KRAS and ALK genes. The patients were followed up, and the relevant literature was reviewed and analyzed.Results:There were 19 cases, including 10 males and 9 females, with a mean age of 58 years (range 33-71 years). Microscopically, the tumors showed moderately to highly differentiated adenoid and/or papillary growth patterns. The tumor cells were highly columnar and sometimes showed pseudostratification. Inflammatory necrosis and scattered nuclear fragmentation were seen in some glandular lumens. IHC showed variable expression of CK7 (19/19), TTF1 (8/19), Napsin A (6/19), villin (17/19), CK20 (16/19) and CDX2 (10/19). Molecular testing showed KRAS mutation in nine cases (9/19), EGFR mutation in one case (1/19), and positive ALK split signal in one case (1/19). In the literature, the reported mutation rate of KRAS in PEAC was much higher than that of EGFR and ALK. All 19 cases underwent surgical resection and 11 cases were subjected to chemotherapy or radiotherapy.Conclusions:PEAC is a rare variant of invasive pulmonary adenocarcinoma, and has similar histological and cytological features to that of colorectal adenocarcinoma. However, detailed medical history, histologic heterogeneity, an IHC combination of CK7 +/villin + and high KRAS mutation rate are the key points of diagnosis. The prognosis needs long-term follow-up and big data statistics.

Objective? To expLore the appLication and effects of information extraction technoLogy in pressure injury management. Methods? From January 2017 to December 2017, we used the information extraction technoLogy to extract data on pressure injury in He'nan ProvinciaL PeopLe's HospitaL, and we compared the report process of pressure injury, Labor Loss, recognition of nurses with different LeveLs on pressure injury management process, accuracy rate of pressure injury stage and integrity rate of wound record before and after appLication. ResuLts? After the appLication of information extraction technoLogy in pressure injury management, the report process of pressure injury reduced from 5 steps to 2 steps per case; Labor Loss changed from 8 peopLe to 2 peopLe; the convenience evaLuation of nurses on pressure injury management process was 92.9% higher than that (81.0%) before appLication, and the timeLiness evaLuation was 95.8% higher than that (87.4%) before appLication with statisticaL differences (P＜0.01);compared with those before appLication, the accuracy rate of pressure injury stage was 93.2% increased by 20.2%, and the integrity rate of wound record was 89.7% increased by 18.5% with statisticaL differences (P＜0.01). ConcLusions? The appLication of information extraction technoLogy couLd improve the effectiveness of pressure injury management, raise the recognition of nurses with different LeveLs on pressure injury management process as weLL as management capacity and optimize the process of information coLLection which couLd effectiveLy serve cLinicaL nursing management.

We conducted in-depth analysis on the use of a popular Chinese social networking and microblogging site, Sina Weibo, to monitor an avian influenza A(H7N9) outbreak in China and to assess the value of social networking sites in the surveillance of disease outbreaks that occur overseas. Two data sets were employed for our analysis: a line listing of confirmed cases obtained from conventional public health information channels and case information from Weibo posts. Our findings showed that the level of activity on Weibo corresponded with the number of new cases reported. In addition, the reporting of new cases on Weibo was significantly faster than those of conventional reporting sites and non-local news media. A qualitative review of the functions of Weibo also revealed that Weibo enabled timely monitoring of other outbreak-relevant information, provided access to additional crowd-sourced epidemiological information and was leveraged by the local government as an interactive platform for risk communication and monitoring public sentiment on the policy response. Our analysis demonstrated the potential for social networking sites to be used by public health agencies to enhance traditional communicable disease surveillance systems for the global surveillance of overseas public health threats. Social networking sites also can be used by governments for calibration of response policies and measures and for risk communication.

OBJECTIVE：To compare the chemical constituents of petroleum ether fraction from ethanol extract of Aconitum sinomontanum before and after processing. METHODS ：After A. sinomontanum was purified with water ，the raw product decoction pieces were prepared ；the raw decoction pieces were steamed with licorice juice under high pressure to prepare processed decoction pieces of A. sinomontanum . The petroleum ether fractions of raw product and processed product were obtained after ultrasonic extraction with 95％ ethanol. The chemical constituents in the samples were analyzed by GC-MS. NIST 2014 mass spectrometry database was used to compare and match the components . The peak area normalization method was used to determine the relative percentage content of each component. RESULTS ：Before and after processing ，fatty acids and esters were the main components in the petroleum ether fraction from ethanol extract. Totally 18 chromatographic peaks were detected in the detection pieces of raw product，and 13 compounds were identified ，accounting for 94.60％ of the total content of volatile components. The components with relatively high content were （Z，Z，Z）-9，12，15-octadecatrienoic acid （26.13％），hexadecanoic acid ethyl ester （25.27％）， palmitoleic acid （10.84％），ethyl linoleic acid （10.67％），（Z，Z）-9，12-octadecenoic acid methyl ester （6.66％），pentadecanoic acid（5.11％）and so on. Totally 25 chromatographic peaks were detected in the decoction pieces of processed products，and 18 components were identified ，accounting for 82.40％ of the total content of volatile components. The components with relatively high content were palmitoleic acid （18.95％），（Z，Z）-9，12-octadecenoic acid methyl ester （17.93％），hexadecanoic acid ethyl ester（11.94％），（Z，Z，Z）-9，12，15-octadecatrienoic acid （10.54％），（Z，Z）-9，12-octadecenoic acid （5.51％），（Z）-11-hexadecanoic acid（5.30％）and so on. After processing ，7 new components were added ，5 of which were identified as （－）-eucalyptus globulus alcohol，ethyl 2-methyltetrade-canoate，6-methyl-4-phenylcoumarin，β-sitosterol，heptadecane. After processing ，no components disappeared，and the content of some components increased or decreased. CONCLUSIONS ：After processing ，the volatile components in the petroleum ether fraction from ethanol extract of A. sinomontanum are different ，and（－）-eucalyptus globulus alcohol and other components are added after processing.

Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.