Objective To investigate the associations between homocysteine(Hcy),high sensitivity C-reactive protein(hs-CRP)and testosterone levels and elderly male cerebral atherosclerosis(AS).Methods A total of 118 elderly male patients with cerebral AS admitted to our department from May 2020 to May 2022 were recruited and served as AS group.The group were further divided into an unstable plaque subgroup(37 cases)and a stable plaque subgroup(81 cases)ac-cording to the plaque property.Another 118 healthy elderly males who taking health checkup in our hospital during the same period were subjected and served as the non-AS group.The levels of serum Hcy,hs-CRP and testosterone were measured in all participants.The relationship between Hcy,hs-CRP and testosterone levels and cerebral AS was analyzed.Results The AS group had significantly larger proportion of hyperlipidemia and higher levels of Hcy and hs-CRP,but lower testosterone level when compared with the non-AS group(P＜0.01).Multivariate logistic regres-sion analysis identified hyperlipidemia(OR=4.651,95％CI:1.790-12.080,P=0.002),Hcy(OR=1.592,95％CI:1.112-2.279,P=0.011)and hs-CRP(OR=2.951,95％CI:1.412-6.165,P=0.004)were risk factors,while testosterone was a protective factor(OR=0.661,95％CI:0.450-0.971,P=0.035)for occurrence of cerebral AS in elderly males.The levels of Hcy and hs-CRP were notably higher,and that of testosterone was remarkably lower in the unstable plaque subgroup than the stable plaque subgroup(P＜0.05,P＜0.01).ROC curve analysis indicated that the AUC value of Hcy,hs-CRP and testosterone in evaluating plaque stability in elderly male patients with cerebral AS was 0.806,0.795 and 0.712,respectively.Conclusion The abnormal lev-els of Hcy,hs-CRP and testosterone are related to the risk of cerebral AS in elderly males,and their levels have certain predictive value in predicting the plaque stability.

Objective To investigate the associations between homocysteine(Hcy),high sensitivity C-reactive protein(hs-CRP)and testosterone levels and elderly male cerebral atherosclerosis(AS).Methods A total of 118 elderly male patients with cerebral AS admitted to our department from May 2020 to May 2022 were recruited and served as AS group.The group were further divided into an unstable plaque subgroup(37 cases)and a stable plaque subgroup(81 cases)ac-cording to the plaque property.Another 118 healthy elderly males who taking health checkup in our hospital during the same period were subjected and served as the non-AS group.The levels of serum Hcy,hs-CRP and testosterone were measured in all participants.The relationship between Hcy,hs-CRP and testosterone levels and cerebral AS was analyzed.Results The AS group had significantly larger proportion of hyperlipidemia and higher levels of Hcy and hs-CRP,but lower testosterone level when compared with the non-AS group(P＜0.01).Multivariate logistic regres-sion analysis identified hyperlipidemia(OR=4.651,95％CI:1.790-12.080,P=0.002),Hcy(OR=1.592,95％CI:1.112-2.279,P=0.011)and hs-CRP(OR=2.951,95％CI:1.412-6.165,P=0.004)were risk factors,while testosterone was a protective factor(OR=0.661,95％CI:0.450-0.971,P=0.035)for occurrence of cerebral AS in elderly males.The levels of Hcy and hs-CRP were notably higher,and that of testosterone was remarkably lower in the unstable plaque subgroup than the stable plaque subgroup(P＜0.05,P＜0.01).ROC curve analysis indicated that the AUC value of Hcy,hs-CRP and testosterone in evaluating plaque stability in elderly male patients with cerebral AS was 0.806,0.795 and 0.712,respectively.Conclusion The abnormal lev-els of Hcy,hs-CRP and testosterone are related to the risk of cerebral AS in elderly males,and their levels have certain predictive value in predicting the plaque stability.

In order to achieve high-efficiency expression of the porcine circovirus type 3 Cap protein in recombinant Escherichia coli,dissolved oxygen(DO)control strategy,oxygen uptake rate(OUR)control strategy and combined control strategy of DO and OUR were selected to investi-gate their effect on the expression of target protein in a 10 L fermenter.The high-density fermenta-tion process of recombinant E.coli was determined by investigating the best control range of OUR.The recombinant protein was identified by SDS-PAGE and Western blot,and the immunoge-nicity of the protein was evaluated by the animal experiment.The results showed that when the DO control strategy and OUR control strategy were used,the expression of target protein was low.Acetic acid was the key factor affecting the expression of target protein.When acetic acid concen-tration reached 1.02 g/L,Cap protein yield was reduced by 55.8％.In order to reduce the produc-tion of acetic acid,DO was selected to control oxygen supply before feeding,and OUR was selected as the parameter to control oxygen supply after feeding.When OUR value was maintained at 140-160 mmol/(L·h),the Cap protein yield was up to 650 mg/L.Western blot analysis confirmed that PCV3 Cap possessed antigenicity and specificity.Animal experiment showed that the antibody pos-itive rate was 100％after the second immunization,indicating that the target protein had better immunogenicity.The high density fermentation controlled by the combined control strategy of DO and OUR could achieve efficiently soluble expression of PCV3 Cap in the fermenter,which laid the foundation for the vaccine development.

In order to achieve high-efficiency expression of the porcine circovirus type 3 Cap protein in recombinant Escherichia coli,dissolved oxygen(DO)control strategy,oxygen uptake rate(OUR)control strategy and combined control strategy of DO and OUR were selected to investi-gate their effect on the expression of target protein in a 10 L fermenter.The high-density fermenta-tion process of recombinant E.coli was determined by investigating the best control range of OUR.The recombinant protein was identified by SDS-PAGE and Western blot,and the immunoge-nicity of the protein was evaluated by the animal experiment.The results showed that when the DO control strategy and OUR control strategy were used,the expression of target protein was low.Acetic acid was the key factor affecting the expression of target protein.When acetic acid concen-tration reached 1.02 g/L,Cap protein yield was reduced by 55.8％.In order to reduce the produc-tion of acetic acid,DO was selected to control oxygen supply before feeding,and OUR was selected as the parameter to control oxygen supply after feeding.When OUR value was maintained at 140-160 mmol/(L·h),the Cap protein yield was up to 650 mg/L.Western blot analysis confirmed that PCV3 Cap possessed antigenicity and specificity.Animal experiment showed that the antibody pos-itive rate was 100％after the second immunization,indicating that the target protein had better immunogenicity.The high density fermentation controlled by the combined control strategy of DO and OUR could achieve efficiently soluble expression of PCV3 Cap in the fermenter,which laid the foundation for the vaccine development.

Objective:To investigate the effect of fascial iliaca compartment block (FICB) continuous analgesia in the early stage after admission on early postoperative cognitive and motor function in elderly patients with hip fractures.Methods:A total of 80 elderly patients with hip fractures admitted toThe First Affiliated Hospital of Tsinghua University from June 2018 to June 2020 were selected and randomly divided into the control group and the observation group, with 40 cases in each group. The control group adopted the routine postoperative analgesia regimen, while the observation group adopted FICB analgesia immediately after admission to the hospital until before the operation. Postoperative analgesia pattern was consistent with that of the control group, and both groups were given postoperative analgesia for 48 h. The scores of visual analogue scale (VAS), mini mental state assessment scale (MMSE), Harris hip score (Harris) and surgical indexes, stress indexes and incidence of adverse reactions were compared between the two groups.Results:The levels of postoperative blood glucose, cortisol, angiotensin Ⅱin the observation group were lower than those in the control group: (5.21 ± 1.03) mmol/L vs. (7.03 ± 1.06) mmol/L, (643.08 ± 77.28) nmol/L vs. (747.96 ± 82.80) nmol/L, (41.03 ± 5.22) ng/L vs. (57.15 ± 8.16) ng/L, there were statistically differences ( P<0.05). The dosage of sufentanil in the observation group was lower than that in the control group: (27.48 ± 3.25) mg vs. (58.54 ± 4.86) mg, there was statistically difference ( P<0.05). The scores of VAS score at 12 h before surgery, 12 h and 48 h after surgery in the observation group were lower than those in the control group, and the scores of MMSE score were higher than those in the control group, there were statistically differences ( P<0.05). After the surgery, the Harris scores in the observation group was higher than that in the control group: (76.09 ± 6.11) scores vs. (65.62 ± 6.13) scores, there was statistically difference ( P<0.05). The incidence rate of postoperative cognitive dysfunction (POCD) in the observation group was lower than that in the control group: 2.5%(1/40) vs. 15.0%(6/40), there was statistically difference ( χ2 = 3.91, P<0.05). Conclusions:FICB continuou sanalgesic in the early stage after admission of elderly patients with hip fracture is satisfactory, which can effectively relieve postoperative pain, while the stress response is relatively mild, the recovery of postoperative cognitive function and hip function is good.

Objective To explore the biological exposure limit of blood system damage caused by long-term exposure to polycyclic aromatic hydrocarbons (PAHs) in non-occupational population by using the benchmark dose method, and to provide relevant reference for further improving the assessment of PAHs-induced health damage effects. Methods Adult residents living in downwind direction of a coke-oven plant in Shanxi Province were selected as the research subjects, and the information collected from baseline was used as the control. The metabolites of PAHs in urine were used as exposure biomarker, and the abnormal rate of red blood cell index was used as response biomarker. The relationship between urinary OH-PAHs and the erythrocyte damage rate was analyzed, and the benchmark dose (BMD) and the lower confidence limitation for the benchmark dose (BMDL) were calculated using Bayesian dose-optimizing software. Results The urinary PAH metabolites were mainly naphthalene and fluorene. The detection concentrations of 2-OHFlu and 1-OHPhe in the final year were higher than those in the baseline (P<0.05). With the increase of exposure years, the abnormal rate of red blood cells in the final year was higher than that in the baseline (P<0.05). In addition, the abnormal rate of red blood cells increased with the increase of the concentrations of five metabolites of PAHs in urine, and the chi-square trend test was significant (P<0.05). The benchmark dose (BMD) of OH-PAHs was 0.67 μmol/mol Cr, 0.82 μmol/mol Cr, 1.40 μmol/mol Cr and 0.78 μmol/mol Cr, respectively. The BMD of 2-OHNap in people with barbecue diet habits was 0.23 μmol/mol Cr. The BMD of 2-OHNap in people without barbecue diet habits was 1.44 μmol/mol Cr. Conclusion There is a dose-response relationship between the concentration of PAHs metabolites in urine and the damage of red blood cells. Long-term exposure to PAHs can lead to hematological damage. It is suggested that targeted public health interventions should be formulated to reduce the exposure of the general population to PAHs.

Objective:To study the epidemiological characteristics and spatio-temporal aggregation of hemorrhagic fever with renal syndrome (HFRS) in Shandong Province, and to provide reference for formulating reasonable prevention and control strategies.Methods:Retrospective analysis was used to collect HFRS surveillance data and confirmed case data in Shandong Province from 2017 to 2020 in the "China Disease Prevention and Control Information System Infectious Disease Surveillance System". Geoda 1.18 software was used for global and local spatial autocorrelation analysis, SaTScan 9.6 software was used for spatio-temporal scanning analysis, and ArcGis 10.7 software was used for map drawing and visual display.Results:A total of 3 753 cases of HFRS were reported in Shandong Province from 2017 to 2020, including 56 deaths. The annual incidence rate was 1.26/100 000, 1.22/100 000, 0.75/100 000 and 0.53/100 000, respectively, with an average annual incidence rate of 0.94/100 000. The incidence of HFRS was obviously seasonal, mainly concentrated in autumn and winter from October to December, accounting for 50.41% (1 892/3 753). The age of onset was mainly 30-59 years old, accounting for 61.68% (2 315/3 753). The male to female ratio was 2.76 ∶ 1.00 (2 756 ∶ 997). The occupation distribution was mainly farmers, accounting for 81.99% (3 077/3 753). The global spatial autocorrelation analysis showed that HFRS showed spatial aggregation areas in each year from 2017 to 2020 (Moran' I = 0.38, 0.33, 0.59, 0.46, Z = 7.47, 7.23, 10.69, 8.66, P < 0.001). The local spatial autocorrelation analysis showed that "high-high" aggregation areas were mainly concentrated in central and southeast of Shandong Province, while "low-low" aggregation areas were mainly concentrated in northwest of Shandong Province. Spatio-temporal scanning analysis revealed 1 type Ⅰ agglomerations and 2 type Ⅱ aggregation areas. The type Ⅰ aggregation areas occurred from October to November 2018, covering 22 counties (districts) of 5 cities in Qingdao, Yantai, Weifang, Weihai and Rizhao. The first type Ⅱ aggregation area occurred from October to November 2017, involving 23 counties (districts) of 8 cities in Jinan, Zibo, Zaozhuang, Weifang, Jining, Tai 'an, Rizhao and Linyi. The second type Ⅱ aggregation area occurred in Jinxiang County, Jining City from February to March 2017. Conclusion:The incidence of HFRS in Shandong Province from 2017 to 2020 has obvious spatio-temporal aggregation, and the hot spots are concentrated in central and southeast of Shandong Province, which should be regarded as a key area for prevention and control of HFRS.

Objective:To analyze the survival benefits and treatment related toxic effects of simultaneous integrated boost intensity-modulated radiotherapy (SIB-RT) for non-operative esophageal squamous cell carcinoma patients.Methods:The data of 2 132 ESCC patients who were not suitable for surgery or rejected operation, and underwent radical radiotherapy from 2002 to 2016 in 10 hospitals of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG) were analyzed. Among them, 518 (24.3%) cases underwent SIB (SIB group) and 1 614 (75.7%) cases did not receive SIB (No-SIB group). The two groups were matched with 1∶2 according to propensity score matching (PSM) method (caliper value=0.02). After PSM, 515 patients in SIB group and 977 patients in No-SIB group were enrolled. Prognosis and treatment related adverse effects of these two groups were compared and the independent prognostic factor were analyzed.Results:The median follow-up time was 61.7 months. Prior to PSM, the 1-, 3-, and 5-years overall survival (OS) rates of SIB group were 72.2%, 42.8%, 35.5%, while of No-SIB group were 74.3%, 41.4%, 31.9%, respectively ( P=0.549). After PSM, the 1-, 3-, and 5-years OS rates of the two groups were 72.5%, 43.4%, 36.4% and 75.3%, 41.7%, 31.6%, respectively ( P=0.690). The univariate survival analysis of samples after PSM showed that the lesion location, length, T stage, N stage, TNM stage, simultaneous chemoradiotherapy, gross tumor volume (GTV) and underwent SIB-RT or not were significantly associated with the prognosis of advanced esophageal carcinoma patients who underwent radical radiotherapy ( P<0.05). Cox model multivariate regression analysis showed lesion location, TNM stage, GTV and simultaneous chemoradiotherapy were independent prognostic factors of advanced esophageal carcinoma patients who underwent radical radiotherapy ( P<0.05). Stratified analysis showed that, in the patients whose GTV volume≤50 cm 3, the median survival time of SIB and No-SIB group was 34.7 and 30.3 months ( P=0.155), respectively. In the patients whose GTV volume>50 cm 3, the median survival time of SIB and No-SIB group was 16.1 and 20.1 months ( P=0.218). The incidence of radiation esophagitis and radiation pneumonitis above Grade 3 in SIB group were 4.3% and 2.5%, significantly lower than 13.1% and 11% of No-SIB group ( P<0.001). Conclusions:The survival benefit of SIB-RT in patients with locally advanced esophageal carcinoma is not inferior to non-SIB-RT, but without more adverse reactions, and shortens the treatment time. SIB-RT can be used as one option of the radical radiotherapy for locally advanced esophageal cancer.

Objective:To analyze the survival benefits and treatment related toxic effects of simultaneous integrated boost intensity-modulated radiotherapy (SIB-RT) for non-operative esophageal squamous cell carcinoma patients.Methods:The data of 2 132 ESCC patients who were not suitable for surgery or rejected operation, and underwent radical radiotherapy from 2002 to 2016 in 10 hospitals of Jing-Jin-Ji Esophageal and Esophagogastric Cancer Radiotherapy Oncology Group (3JECROG) were analyzed. Among them, 518 (24.3%) cases underwent SIB (SIB group) and 1 614 (75.7%) cases did not receive SIB (No-SIB group). The two groups were matched with 1∶2 according to propensity score matching (PSM) method (caliper value=0.02). After PSM, 515 patients in SIB group and 977 patients in No-SIB group were enrolled. Prognosis and treatment related adverse effects of these two groups were compared and the independent prognostic factor were analyzed.Results:The median follow-up time was 61.7 months. Prior to PSM, the 1-, 3-, and 5-years overall survival (OS) rates of SIB group were 72.2%, 42.8%, 35.5%, while of No-SIB group were 74.3%, 41.4%, 31.9%, respectively ( P=0.549). After PSM, the 1-, 3-, and 5-years OS rates of the two groups were 72.5%, 43.4%, 36.4% and 75.3%, 41.7%, 31.6%, respectively ( P=0.690). The univariate survival analysis of samples after PSM showed that the lesion location, length, T stage, N stage, TNM stage, simultaneous chemoradiotherapy, gross tumor volume (GTV) and underwent SIB-RT or not were significantly associated with the prognosis of advanced esophageal carcinoma patients who underwent radical radiotherapy ( P<0.05). Cox model multivariate regression analysis showed lesion location, TNM stage, GTV and simultaneous chemoradiotherapy were independent prognostic factors of advanced esophageal carcinoma patients who underwent radical radiotherapy ( P<0.05). Stratified analysis showed that, in the patients whose GTV volume≤50 cm 3, the median survival time of SIB and No-SIB group was 34.7 and 30.3 months ( P=0.155), respectively. In the patients whose GTV volume>50 cm 3, the median survival time of SIB and No-SIB group was 16.1 and 20.1 months ( P=0.218). The incidence of radiation esophagitis and radiation pneumonitis above Grade 3 in SIB group were 4.3% and 2.5%, significantly lower than 13.1% and 11% of No-SIB group ( P<0.001). Conclusions:The survival benefit of SIB-RT in patients with locally advanced esophageal carcinoma is not inferior to non-SIB-RT, but without more adverse reactions, and shortens the treatment time. SIB-RT can be used as one option of the radical radiotherapy for locally advanced esophageal cancer.

Objective:To investigate the epidemiological characteristics and relevant factors among individuals characterized by their longevity in multiple regions of Guangxi Zhuang Autonomous Region, and provide a valuable scientific perspective for the research in health and longevity of the elderly in Guangxi.Methods:Registration and face-to-face questionnaire on a door-to-door basis were adopted to collect the demographic characteristics of the long-lived individuals (≥90 years old) in Bama of Hechi city, Yongfu of Guilin city, Dongxing of Fangchenggang city, Guangxi. Then, among the local general population, individuals within the age group between 40 and 85 years old were selected randomly as controls. Correlations were then analyzed between the relative health and longevity of the subjects and their gender, ethnicity, family history, disease history, marital status, the number of family generations, the number of children, smoking, drinking, outdoor activities, sleep and other health-related factors, then the result was subject to further analysis by comparing the long-lived population and the control population respectively.Results:Among 691 500 of the permanent residents of Bama, Yongfu and Dongxing city, 1 005 cases were 90 years old and over with a ratio of 145.34 out of 100 000 persons; within the 1 005 cases, 944 were aged between 90 and 100 (longevity rate: 136.51/100 000) with an average age of (93.28±2.57); 61 cases were aged 100 or over, arriving at a centenarian rate of 8.82/100 000 with an average age of (102.00±3.05) years. Significant differences were found just among three particular factors — regional distribution ( P=0.014), history of disease ( P=0.002), four generations of family ( P=0.008) between nonagenarians and centenarians ( P<0.05), while the other 15 indicators did not show anything noteworthy. The result indicated that longevity and centenarians might be the same group and then we combined both groups into one. By cross-comparison between the longevity-plus- centenarians and the control group in the region, factors listed below exhibited significant correlation with health and longevity: marital status ( OR=26.469, 95% CI: 13.208-53.045), number of generations within the family ( OR=5.419, 95% CI: 3.418-8.592), number of male offspring ( OR=2.013, 95% CI: 1.555-2.607), number of female offspring ( OR=1.380, 95% CI: 1.122-1.696), and the frequency of outdoor activities ( OR=10.226, 95% CI: 3.164-33.045). Conclusions:The longevity rate is higher in the general natural population in Bama, Yongfu and Dongxing of Guangxi. The phenomenon may owe to favorable family structure, atmosphere within or out of the family or other elements related with social surrounding. Among them all, mentality, inclination to physical exercise and regular rhythm of life may all exert tremendous contributory influence here.