Objectives:To analyze the status and temporal changes of disability-adjusted life year (DALY) for stomach and colorectal cancers among registered permanent residents in Changning District of Shanghai Municipality, and provide scientific basis for the prevention and treatment of stomach and colorectal cancers in this district.Methods:Using the cancer registration data of stomach and colorectal cancers from 2002 to 2019, we estimated the indices such as the DALYs, the DALY crude rates, the age-standardized DALY rates, etc. Then we used the Joinpoint regression model to calculate the average annual percent change (AAPC) and annual percent change (APC) to explore the temporal variations in different periods.Results:The DALYs of stomach and colorectal cancers in Changning District from 2002 to 2019 were 55 931 person years and 65 252 person years, respectively. The crude rates of DALY were 512.16/10 5 and 597.51/10 5, respectively. We observed a higher disease burden in men than in women, and the peak rate of DALY in stomach cancer was in the 75-79 years age group, while in colorectal cancer the rate was in the 85-years-or-older age group. Joinpoint regression analysis showed that from 2002 to 2019, the age-standardized DALY rate of stomach cancer showed a downward trend (AAPC=-3.86%, P＜0.05), while the trend of colorectal cancer was not statistically significant(AAPC=-0.08%, P＞0.05). However, the trends in the age-standardized DALY rates of colorectal cancer were different between males and females, with males showing an upward trend (AAPC=1.24%, P＜0.05) and females showing a downward trend (AAPC=-1.67%, P＜0.05). Conclusions:The DALY of stomach and colorectal cancers in Changning District of Shanghai showed a decreasing trend. Males and the middle-aged and elderly populations are still the key targets for disease prevention and control in this district.

Objectives:To analyze the status and temporal changes of disability-adjusted life year (DALY) for stomach and colorectal cancers among registered permanent residents in Changning District of Shanghai Municipality, and provide scientific basis for the prevention and treatment of stomach and colorectal cancers in this district.Methods:Using the cancer registration data of stomach and colorectal cancers from 2002 to 2019, we estimated the indices such as the DALYs, the DALY crude rates, the age-standardized DALY rates, etc. Then we used the Joinpoint regression model to calculate the average annual percent change (AAPC) and annual percent change (APC) to explore the temporal variations in different periods.Results:The DALYs of stomach and colorectal cancers in Changning District from 2002 to 2019 were 55 931 person years and 65 252 person years, respectively. The crude rates of DALY were 512.16/10 5 and 597.51/10 5, respectively. We observed a higher disease burden in men than in women, and the peak rate of DALY in stomach cancer was in the 75-79 years age group, while in colorectal cancer the rate was in the 85-years-or-older age group. Joinpoint regression analysis showed that from 2002 to 2019, the age-standardized DALY rate of stomach cancer showed a downward trend (AAPC=-3.86%, P＜0.05), while the trend of colorectal cancer was not statistically significant(AAPC=-0.08%, P＞0.05). However, the trends in the age-standardized DALY rates of colorectal cancer were different between males and females, with males showing an upward trend (AAPC=1.24%, P＜0.05) and females showing a downward trend (AAPC=-1.67%, P＜0.05). Conclusions:The DALY of stomach and colorectal cancers in Changning District of Shanghai showed a decreasing trend. Males and the middle-aged and elderly populations are still the key targets for disease prevention and control in this district.

Objective To investigate the change of infusion particles and PH value of rifampicin for injection under dif-ferent configuration and application conditions,and to provide the best configuration method and the best infusion quality control strategy for rifampicin for injection.Methods The particle number and PH value of rifampin for injection were investigated and measured under different configuration and application conditions,and the factors affecting the formation of particles were ana-lyzed.Results The stable pH value of Rifampicin for injection was 7.2-8.1,and the number of particles was the least in the light filtering and 5%glucose 500 mL,and the number of particles was the least in 1～4 h after the configuration.Conclusion The optimal infusion quality control strategy is to filter rifampicin for injection by blocking light,500 mL of solute 5%glucose,1～4 h after configuration,and use of disposable precision filter infusion set.

Due to the special physiological and pathological characteristics of gliomas, most therapeutic drugs are prevented from entering the brain. To improve the poor prognosis of existing therapies, researchers have been continuously developing non-invasive methods to overcome barriers to gliomas therapy. Although these strategies can be used clinically to overcome the blood‒brain barrier (BBB), the accurate delivery of drugs to the glioma lesions cannot be ensured. Nano-drug delivery systems (NDDS) have been widely used for precise drug delivery. In recent years, researchers have gathered their wisdom to overcome barriers, so many well-designed NDDS have performed prominently in preclinical studies. These meticulous designs mainly include cascade passing through BBB and targeting to glioma lesions, drug release in response to the glioma microenvironment, biomimetic delivery systems based on endogenous cells/extracellular vesicles/protein, and carriers created according to the active ingredients of traditional Chinese medicines. We reviewed these well-designed NDDS in detail. Furthermore, we discussed the current ongoing and completed clinical trials of NDDS for gliomas therapy, and analyzed the challenges and trends faced by clinical translation of these well-designed NDDS.

Objective To analyze the secular trends of pancreatic cancer incidence and mortality in Changning district of Shanghai from 1974 to 2013. Methods We calculated the age-standardized rates of incidence and mortality and the average annual percent changes for pancreatic cancer using Segi's world standard population and the data from Shanghai Cancer Registry. Age-period-cohort model was constructed to further assess the effect of age, diagnosis period and birth cohort on the secular trends of pancreatic cancer incidence and mortality. Results During 1974-2013, the age-standardized incidence and mortality rates were 6.49/10⁵ and 6.01/10⁵ in male, 4.83/10⁵ and 4.57/10⁵ in female, respectively. The age-standardized incidence was increased by 0.8% per year in male during past 40 years, while there was no change in mortality. The age-standardized incidence and mortality rates were increased by 1.6% and 1.3% per year in female. After adjusting the effects of diagnosis period and birth cohort, the incidence and mortality rates of pancreatic cancer increased by about 11% every 5 years older in both male and female. Diagnosis period and birth cohort had no statistical impact on the incidence and mortality of pancreatic cancer. Conclusion The age-standardized incidence of pancreatic cancer shows significantly rising trends during 1974-2013 in both male and female in Changning district of Shanghai, as well as the age-standardized mortality in female. The incidence and mortality rates also increase with age.

Objective: To explore the clinical value of 3D-DSA technology in the diagnosis and treatment guidance of hepatic artery chemoembolization. Methods: Liver cancer patients in the treatment groups were collected to receive 3D-DSA imaging guidance at the Affiliated Hospital of Xuzhou Medical University between March and May 2017. In addition, routine 2D-DSA imaging was selected for treatment-received group. Intra-operative blood vessels and tumor-like lesions were observed. The total exposure dose (CAK, unit mGy), cumulative irradiation intensity per unit area (DAP, unit mGy.cm2) and dosage of contrast agent (ml) were calculated separately for two groups of patients. The same senior physicians and technicians operated both groups of patients. Comparisons of measurement were analyzed by t-test and chi-square test was used for count data. Results: Data of twenty patients were collected from the two groups. Tumor location, target vessels structure and shape of development were clear in all patients in the treatment group. The control group had 17 cases of tumor development and the target vascular structure was clear in 16 cases. CAK mean treatment group was lower than control group (554.11 + 38.87) mGy and (644.53 + 26.70) mGy, and DAP mean treatment group was lower than the control group (125.25 + 7.54) mGy·cm² and (143.49 + 6.18) mGy·cm². The two groups were compared (P value < 0.05), and the differences were statistically significant. The mean dose of contrast agent in the two groups were lower than control group (64.42 + 3.92) ml, (70.79 + 4.47) ml, and the differences between the two groups were statistically significant (P < 0.05). Conclusion 3D-DSA imaging technology can provide effective diagnosis and guidance in the treatment of hepatic artery chemoembolization. It can effectively reduce the radiation exposure dose and radiation intensity, and it is of high clinical value for interventional embolization of liver cancer.

Objective To investigate the detection of IMP andVIM metallo-β-lactamases (MβLs)genes in clinically iso-lated gram-negative bacteria as well as bacterial resistance toβ-lactam antimicrobial agents.Methods 113 clinically isolated bacteria were performed antimicrobial susceptibility testing by Kirby-Bauer method ,drug-resistant genes IMP and VIM were detected by polymerase chain reaction (PCR),PCR products were sequenced and aligned with BLAST software. Results VIM gene was detected in 1 Pseudomonas fluorescens strain ,IMP gene was detected in 15 strains ,they were Klebsiella pneumoniae (n=6),Acinetobacter baumannii (n=3),Escherichia coli (n=2),Ralstonia picket-tii (n=1),Pseudomonas aeruginosa (n=1 ),Citrobacter amalonaticua (n=1 ),and Enterobacter cloacae (n=1 ). BLAST results showed that VIM gene was VIM-2 subtype,similarity with gene bank was 99%;all IMP genes were IMP-1 subtype,which were highly homologous ,similarity was 98%-99%.Resistant rates of IMP positive strains to ceftriaxone,cefotaxime,cefoxitin,aztreonam and imipenem were all significantly higher than negative strains (all P <0.05).Conclusion IMP genes of different strains are highly homologous,all are IMP-1 type,indi-cating that IMP genes are highly transmissible and can spread among different species of bacteria.IMP genes are related with resistance ofβ-lactam antimicrobial agents.

Objective To investigate the use of In-Fusion technology in the sequencing of hepatitis B virus genome and analyzing the sequence of 23 strains of isolates.Methods Twenty-three strains of type B HBV genome were amplified by PCR from the serum collected in Zhejiang,China,and were inserted into the vector of pMD18T in the ways of In-Fusion technology,and the sequence of it was analyzed.Results The strains of the HBV isolates were types B and C,which were most common in China,and one isolate of YMDD mutation was found.Conclusion It was proven that the In-Fusion technology is an effective way to construct recombinant plasmid,avoiding self-connection of vector.The finding of this research provides a reference to the study of the genotype and evolution of hepatitis B virus in China.

Objective To evaluate the effect of different tube voltages on the radiation dose and image quality of a full field digital mammography system.Methods Both experiments were performed under manual exposure mode.In one experiment,the tube voltages were kept constant at 25,28 and 31 kVp,and the CIRS 015 phantom was exposed at three target/filter combinations molybdenum/molybdenum (Mo/Mo),molybdenum/rhodium (Mo/Rh),and rhodium/rhodium (Rh/Rh) and at tube current-exposure time products of 32-140mAs.The entrance skin exposure (ESE) and average glandular dose (AGD) were recorded,the signal-to-noise ratio(SNR) and contrast-to-noise ratio (CNR) and figure of merit (FOM) were measured to evaluate the influences of different tube voltages on dose and image quality at same target/filter combination.The univariate of randomized completed block-design was used for statistics.In second experiment,the phantom were exposed using Mo/Rh combination when the tube current-exposure time product was kept constant at 56 mAs,and the tube voltage varied between 23 and 33 kVp in 1-kVp increments.The ESE and AGD were recorded,the SNR,CNR and FOM were measured for plotting the curves against tube voltages.Results At Mo/Mo combination,the AGD,ESE,SNR,CNR and FOM of 25,28 and31 kVp were(1.25 ±0.56) mGy,(6.46±2.86) mGy,71.52±8.37,1.91 ±0.26,3.21 ± 0.68; (1.94 ±0.85) mGy,(9.18±4.07) mGy,144.46 ± 11.31,2.41 ±0.28,3.37 ±0.96 and (3.01 ±1.38) mGy,(12.60±5.59) mGy,128.89 ±15.29,2.47 ±0.31,2.31 ±0.76 respectively; at Mo/Rh combination were (1.23 ±0.55) mGy,(5.26 ±2.33) mGy,67.31 ±4.11,1.82 ±0.19,3.01 ± 0.82; (1.86 ±0.84) mGy,(7.57 ±3.34) mGy,139.54 ± 12.16,2.30 ±0.25,3.23 ±0.92 and (2.81 ±1.24) mGy,(10.48 ±4.62) mGy,127.77 ±15.14,2.59 ±0.31,2.67 ±0.68; and at Rh/Rh were(1.09 ±0.48) mGy,(4.89 ±2.16) mGy,67.46 ±2.23,1.48 ±0.72,3.08 ± 1.69; (1.75 ± 0.78) mGy,(6.88 ±3.03) mGy,137.74 ± 14.65,2.37 ±0.26,3.62 ± 1.07 and (2.59 ± 1.13) mGy,(9.32 ± 4.12) mGy,117.91 ± 19.05,2.51 ± 0.31,2.74 ± 0.84.Both experiments indicated that,for a given target/filter combination,the AGD,ESE and CNR increased,but the ESE/AGD decreased with the tube voltage increasing; The first experiment indicated both SNR and FOM of 28 kVp were higher than that of 25 kVp and 31 kVp; the second experiment showed both SNR and FOM decreased with tube voltages increasing.The differences of AGD、ESE、ESE/AGD、SNR、CNR and FOM among the three tube voltages were significant (F =4.391-528.848,P ＜ 0.05) ; but the difference of CNR between 28 and 31 kVp at Mo/Mo and Rh/Rh had no statistical significance (P ＞ 0.05) ; and the differences of FOM between 25 and 28 kVp at the three target/filter combinations were not statistically significant (P ＞ 0.05).Conclusion For a breast with 4.2 cm thickness and 50％ adipose 50％ glandular composition,different tube voltages have significant effects on the radiation dose and image quality.

Objective To construct cyclic clinical skill training system and to evaluate its application effect in clinical practice in department obstetrics and gynecology.Methods Cyclic clinical skill training system was established in department obstetrics and gynecology.Totally 104 eight-year program clinical medicine students of grade 2005 and 2006 in people's hospital of Peking university were enrolled as the research object and were divided into control group ( n =54,grade 2005) and experimental group (n =50,grade 2006 ).Students of control group were taught by normal teaching method and contacted with patients in clinical practice while those in experimental group were taught by cyclic clinical skill training system. (theoretical test before practice-simulated training-real practicetheoretical test after practice).Results of theoretical test after practice were compared between the two groups,using statistical t test.Results At the end of internship,students in experimental had higher scores in theoretical test than those in control group,with statistical differences (88.70 vs.85.02,P ＜0.05).Students' skill test scores were (77.04 ± 10.35 ) and (45.61 ± 14.42) before practice while (84.59 ± 10.10) and (68.78 ± 10.83) after practice,with statistical differences ( P ＜ 0.01 ).Conclusions Cyclic clinical skills training system can promote students' skills of obstetrics and gynecology,therefore worth promoting.