Objective To investigate the relationship between the intercellular adhesion molecule-1(ICAM-1) and lymphocyte function associated with antigen-1( LFA-1) and acute rejection of liver transplantation in rats. Methods SD rats and Wistar rats were randomly divided into normal control group, isograft group, and allograft group. Liver biopsies from the recipients were obtained on the day 2,4, and 7 postoperatively to examine the expression level of ICAM-1 and LFA-1 in liver grafts. Samples were firstly stained with specific monoclonal antibodies using immunohistochemistry stain and then applied to image semiquantitive analysis. Results The expression levels of ICAM-1 and LFA-1 in allograft group were obviously higher than those in both isograft group and normal group. Moreover, the expression levels of ICAM-1 and LFA-1 were correlated positively with the degree of acute liver rejection. Conclusions Detecting the expressions of ICAM-1 and LFA-1 in liver graft tissue may be helpful to the diagnosis of acute rejection after liver transplantation.

【Objective】To investigate the relationship between the expression of lymphocyte function-associated antigen-1 (LFA-1) on peripheral lymphocytes and acute rejection after orthotopic liver transplantation (OLTx) in rat.【Methods】Adult male rats were divided into 2 groups.In the non-rejection group,40 SD rats were used as both donors and recipients.In the rejection group,20 Wistar rats were used as donors and 20 SD rats as recipients.Blood samples were collected through the tail vein 1 day before transplantation and on days 1、3、5、7 after OLTx.The expression of LFA-1 (CD11a) on peripheral lymphocytes was analyzed by using indirect immunofluorescent marker-flow cytometry.【Results】The expression level of LFA-1 on peripheral lymphocytes in recipient rats after orthotopic liver transplantation was markedly lower than that before operation (P<0.01);The expression level of LFA-1 on peripheral lymphocytes in rats with acute liver rejection was significantly higher than that in the non-rejection group (P<0.01).【Conclusion】Monitoring the expression level of LFA-1 on peripheral lymphocytes may be helpful to the diagnosis of acute graft rejection.

Objective · To investigate the smoking hypertensive elderly, find out the status of smoking in this population, and explore effective system intervention. Methods · The smoking hypertensive elderly in Waigang Town of Shanghai who received free antihypertensive drugs were recruited to investigate and descriptively analyze the smoking status of them with questionnaires. Results · There were 77.6% of the smoking hypertensive elderly who began to smoke in the age of 13 to 25, and nearly 70% smoking for more than 40 years. There were 59.5% of these people smoking 11 to 29 cigarettes daily in recent 3 years, and 41.6% spending 200-299 yuan on smoking monthly. Conclusion · Currently almost 70% of the smoking hypertensive elderly, who receives free antihypertensive drugs, have been smoking for more than 40 years, and the average number of cigarettes smoked daily is big. It is clear that the health education attached to the policy of providing free antihypertensive drugs has not changed the behavior. Therefore, medical personnel still needs to contact the illness and smoking hazards to help the elderly reduce smoking. Besides, it proves that tobacco control should be implemented in the young population to control epidemic at the early stage.

Objective · To investigate the prevalence of passive smoking among pregnant women in Shanghai and to analyze its influencing factors and to provide the basis and suggestion for making related intervention measures to reduce the harm of secondhand smoke on the health of pregnant women. Methods · From July to October 2014, pregnant women and their spouses were recruited for a questionnaire investigation at the antenatal care clinics of 3 maternity hospitals and 3 community hospitals in Shanghai. The questionnaire included demographic information, family basic situation and cognitive status of passive smoking. Results · The passive smoking rate before pregnancy in the 2831 pregnant women, who were involved in the investigation, was 17.1%. The passive rate during pregnancy was 7.8%. The difference between these two rates was statistically significant (P<0.05). 71.0% of the pregnant women have passive smoking for 15~59 min each day. Relative to home and work place, the passive smoking rate of pregnant women in public place was the highest (P<0.05). The passive smoking rate of pregnant women was significantly associated with the educational level of smoking spouses and the attitude of pregnant women when they faced the smokers. Conclusion · The passive smoking rate of pregnant women is influenced by the educational level of their spouses and the pregnant women's feedback to the smokers face to face. Public places are the most important exposure places to secondhand smoke for pregnant women. In order to reduce the harm from passive smoking to pregnant women and their fetuses, the related measures of smoking control at home education and smoking ban in public place should be made.

Objective: To understand the changing trend and influencing factors of health literacy among residents in Hangzhou from 2016 to 2020, so as to provide basis for health literacy promotion. Methods: The monitoring data of health literacy of residents in Hangzhou from 2016 to 2020 were collected. The five year cumulative growth and average growth rate were used to reflect the changing trend. The multivariate logistic regression model under complex survey design was used to analyze the influencing factors for health literacy. Results: From 2016 to 2020, the health literacy levels of Hangzhou residents were 26.91%, 29.49%, 31.83%, 34.73% and 38.00%, respectively. The five year cumulative growth was 11.09% and the average growth rate was 9.01%. Among three aspects of health literacy, the levels of basic knowledge and concept as well as healthy lifestyle and behaviors increased year by year (P<0.05), with the average growth rates of 15.12% and 2.92%. Among six types of health problems, the levels of chronic disease prevention and treatment, basic medical treatment, scientific view, health information as well as safety and first aid increased year by year ( P<0.05 ), with the average growth rates of 32.76%, 15.82%, 8.41%, 7.12% and 1.53%, respectively. The multivariate logistic regression analysis showed that education level ( junior high school, OR=5.359, 95%CI: 1.151-24.953;high school/vocational high school/technical secondary school, OR=9.214, 95%CI: 2.906-29.213; college or above, OR=29.977, 95%CI: 9.689-92.741 ) and occupation ( students, OR=2.564, 95%CI: 1.113-5.907 ) were the influencing factors for health literacy. Conclusion The health literacy levels of Hangzhou residents from 2016 to 2020 have been increasing year by year. The residents with higher education levels and students may have higher health literacy levels.

Objective: To analyze knowledge, attitudes and practice regarding protection against COVID-19 among primary and middle school students in Hangzhou and to provide a scientific basis for schools to carry out targeted prevention and control measures. Methods: Anonymous network sampling survey was carried out through the questionnaire star, and a total of 14 216 subjects from primary and middle school in Hangzhou were recruited to fill in the questionnaire regarding knowledge, attitudes and practice of COVID-19 from March 3 to March 7, 2020. Results: Primary and middle school students showed high awareness rate of transmission (85.83%) and incubation period (77.44%), but lower awareness on symptoms (44.70%) of COVID-19. The practice of wearing masks, cough etiquette and correct hand washing were 97.27%, 88.01% and 91.82%, respectively. The protective practice among primary and middle school students were generally good, 91.21% of them were at moderate level or above. 83.91% of primary and secondary school students reported worries about infection of COVID-19, and 55.42% of primary and secondary school students were anxious about returning to school. Primary school students and rural students were more anxious about returning to school(χ 2=46.66, 26.70, P<0.05). Conclusion The primary and middle school students in Hangzhou have a relatively good level of knowledge and practice concerning COVID-19. Yet, it is necessary to carry out targeted health education and strengthen mental health education for primary and middle school students.

Hilar cholangiocarcinoma(HCCA) is a hotpot and a difficult point in the field of hepatobiliary surgery. HCCA is the most common type of cholangiocarcinoma and is characterized by atypical early clinical manifestations, rapid progression and poor prognosis. There is no specific marker for HCCA and its preoperative diagnosis and evaluation mainly relies on imaging examination. Surgical treatment is still the main treatment, but most patients have lost the opportunity of surgical resection by the time of treatment. In recent years, a large number of studies have been conducted on the diagnosis and treatment of HCCA at home and abroad, and the efficacy of HCCA has been improved. Perioperative management, including the selection of preoperative drainage and perioperative chemoradiotherapy and others, improved postoperative survival. Among them, the application of preoperative radiotherapy and chemotherapy in the field of liver transplantation has achieved quite good results. Targeted therapy and immunotherapy have provided new treatment methods for HCCA. This paper reviews the diagnosis and multimodal treatment of HCCA.

Objective:To optimize the best molding process of Jinpuju Qingrelishi Granules.Methods:Based on the single factor test, the relative density of clear ointment and the amount of diluent (dextrin∶lactose=2∶1) are used as investigating factors, and the overall evaluation of the molding rate and angle of repose overall desirability (OD) is used as the evaluation index. The effect surface method is used to optimize the best molding process of Jinpuju Qingrelishi Granules.Results:The best molding process conditions: the relative density of the clear paste is 1.20 (60 ℃) and the amount of diluent is 3 times that of the clear paste. After mixing the clear paste and diluent, make soft material, pass through a 14-mesh sieve to granulate, dry in an oven (55 ℃) for 1 hour, and sizing to obtain. The molding rates of the three batches of verification test granules were 93.73%, 93.03%, 95.59%, respectively, the predicted OD value was 0.928, the verification value was 0.936, and the deviation from the predicted value was -0.86%.Conclusion:The molding process of this experiment is stable and reliable, with good repeatability, which can provide a reference for the follow-up research of Jinpuju Qingrelishi Granules.

ObjectiveTo explore the association between total iron， iron supplements， dietary total iron， heme iron intake and the risk of gestational diabetes mellitus（GDM）. MethodsA total of 668 pregnant women who gave birth in one hospital in Shanghai during January 2020 to July 2021 were included in a retrospective cohort study. Baseline characteristics and data of iron supplements in second trimester were collected through a questionnaire. A simplified dietary frequency questionnaire was used to quantify the food intake in second trimester. Total iron， iron supplements， dietary total iron， and heme iron intake was classified into groups by quintile and median. The association between iron intake from different sources and risk of GDM was determined using logistic regression analysis. ResultsAfter correction for age， family history of diabetes， overweight / obesity before pregnancy， hemoglobin（Hb）in first trimester， energy， carbohydrate energy， protein， and free sugar， it showed no association between total iron intake and risk of GDM （P>0.05）， while elevated risk of GDM among women with high iron supplements intake （OR=1.65； 95%CI： 1.14‒2.39）， and decreased risk of GDM among those with high dietary total iron intake （OR=0.53； 95%CI： 0.35‒0.81）. However， no association was found between heme iron intake and risk of GDM （P>0.05）. ConclusionHigh dietary total iron intake may be a protective factor， while high iron supplements may be a risk factor for GDM. It suggests that pregnant women should carefully choose high-dose iron-containing supplements in the absence of iron deficiency， as dietary iron intake should be the priority.

Objective: To investigate the distribution of various types of screen time and examine the association of screen time with psychological and behavioral development problems in children aged 3-6 years, so as to provide scientific basis for children s screen use and mental health promotion. Methods: A total of 3 875 mother child dyads who completed the follow up in Shanghai Maternal-Child Pairs Cohort were included. The daily usage time of children s tablet, mobile phone, TV, projectors, and other types of screens were obtained in questionnaire survey. Children s psychological and behavioral development problems were evaluated by Age-Stage Questionnaire, Third Edition (ASQ-3) and Strengths and Difficulties Questionnaire (Parent version) (SDQ). The Chi-square test, Mann Whitney U and Kruskal Wallis rank sum test were used to compare the detection rate of psychological and behavioral development problems and screen time in children with different characteristics. Multivariate binary Logistic regression was used to analyze the association of screen time with psychological and behavioral development problems. Results: There were 49.91% of children having screen time more than 1 h/d. Children s TV, tablet and mobile phone screen time were 0.39(0.25, 0.96 ), 0.25(0,0.61) and 0.18(0,0.25) h/d. The detection rates of suspected developmental delay in fine motor, problem solving and personal-social domains and pro social behavior deficiency and externalizing behaviors in boys (8.54%, 6.77%, 5.46%, 30.07 %, 27.39%) were higher than that in girls (4.64%, 4.85%, 2.48%, 22.10%, 22.36%) ( χ 2=23.76, 6.49, 22.37, 31.81, 13.06, P <0.05). There were statistically significant differences in the detection rates of suspected developmental delay in communication, fine motor and problem solving, as well as internalizing behavior and externalizing behavior of children with different parents educational levels ( χ 2=14.37, 15.18, 21.10, 11.66, 9.27; 16.34, 26.75, 32.89, 16.97, 6.37, P <0.05). There were significant differences in the detection rates of suspected developmental delay in problem solving, prosocial behavior deficiency, internalizing behavior and externalizing behavior of children whose mothers had anxiety/depression symptoms during pregnancy ( χ 2= 5.61 , 9.05, 21.90, 7.17; 8.75, 6.06, 12.76 , 5.55, P <0.05). The average total screen time of boys was longer than that of girls (1.07, 1.00 h/d, Z=-2.08, P =0.04). Compared with children with other educational levels of their parents, the total screen time, mobile phone and TV screen time of children whose parents had college education or above were short (father: H =42.01, 44.49 , 21.24, mother: H =42.31, 39.21 , 26.47, P <0.01). Among all types of screen time, mobile phone screen time had the most impact on psychological and behavioral development. More mobile phone screen time increased the risk of suspected developmental delay and abnormal emotional behavior ( P < 0.05). Screen time of tablet, mobile phone and TV were positively correlated with externalizing behavior ( OR=1.36, 1.57, 1.27 , P <0.05). Conclusions Screen time is related to children s psychological and behavioral development problems and mobile phones affect the most. Parents should limit their children s screen time to avoid excessive screen time affecting their psychological and behavioral development.