ObjectiveTo compare colonoscopy compliance rates under different screening strategies, to explore ways to enhance colonoscopy compliance among residents with colorectal carcinoma. MethodsResidents aged between 50‒80 years were recruited through extensive community outreach and voluntary participation. A total of 210 630 residents who participated in the colorectal carcinoma screening program in Jiading District, Shanghai, between 2013 and 2019 were selected as the research subjects. All subjects underwent a colorectal carcinoma risk assessment questionnaire survey and two fecal occult blood tests (FOBT). Positive results in the initial screening were defined as a positive questionnaire survey or a positive result in at least one FOBT. Participants with positive initial screening results were advised to undergo colonoscopy screening in a hospital. Colonoscopy results were collected from hospital reports and physician follow-ups. Compliance with colonoscopy was analyzed under different screening strategies to identify possible factors influencing residents’ willingness to undergo the procedure. ResultsA total of 21 403 individuals (10.16%) were identified as positive with the questionnaire survey, 31 595 individuals (15.00%) tested positive with at least one FOBT. Combined questionnaire and FOBT positivity was observed in 3 501 individuals (1.66%). Among the 48 453 individuals with positive initial screening results, 17 230 (35.56%) underwent colonoscopy, and a total of 315 cases of colorectal cancer were detected. The sensitivity, specificity value of FOBT initial screening were 83.81% and 84.66%, respectively. According to the combined risk assessment and FOBT initial screening preliminary screening, the lowest colonoscopy compliance rate (25.63%) was observed among individuals with only a positive questionnaire, and the highest compliance rate (52.55%) was among those with both positive questionnaire survey and two positive FOBT results. Multivariate analysis revealed that FOBT positivity had the greatest impact on colonoscopy compliance. Those with one positive FOBT test result were 2.64 times more likely to undergo colonoscopy screening than those with negative FOBT results, while individuals with two positive FOBT results were 3.18 times more likely to do so. After adjusting for FOBT results, individuals with positive questionnaire survey results were 1.43 times more likely to undergo colonoscopy screening than those with negative results (95%CI: 1.34‒1.52). Compared to questionnaire-based risk assessment, FOBT results were more influential in determining compliance with colonoscopy. ConclusionThe choice of initial screening method significantly impacts residents’ compliance with colonoscopy. While implementing colorectal carcinoma screening programs, it is necessary to strictly adhere to screening protocols, including risk assessment and FOBT. Additionally, efforts should be made to raise public awareness, encouraging residents to actively participate in risk assessments and FOBT, thereby improving their compliance with colonoscopy.

Objectives:To evaluate the cost-effectiveness of typical pharmaceutical smoking cessation intervention strategies in China in the context of primary cancer prevention.Methods:Markov cohort simulation models were established to simulate the burden of 12 smoking caused cancer, including lung cancer, oral cancer, nasopharyngeal cancer, laryngeal cancer, esophageal cancer, gastric cancer, pancreatic cancer, liver cancer, kidney cancer, bladder cancer, cervical cancer, and acute myeloid leukemia. Taking incremental cost effectiveness ratio (ICER) as the main indicator, the model sets one year as the cycling period for 50 periods and simulates the cohort of 10 000 thirty-five-year-old current smokers with various smoking cessation strategies. To ensure the robustness of conclusion, univariate sensitivity analysis, probability sensitivity analysis, and age-group sensitivity analysis were conducted.Results:The results showed that varenicline intervention was the most cost-effective intervention. Compared to the next most effective option, incremental cost of each additional quality-adjusted life year is 11 140.28 yuan, which is below the threshold of willingness to pay (1 year GDP per capita). The value of ICER increased as the increasing age group of adopting intervention, but neither exceeded the threshold of willingness to pay. One-way sensitivity analysis showed that the value of discount rate, the hazard ratio and cost of intervention strategy had a greater impact on the result of ICER.Conclusion:In China, the use of varenicline to quit smoking is highly cost effective in the context of cancer primary prevention, especially for younger smokers.

Objective:To observe the clinical effect of free perforator flap of deep medial plantar artery and with sensory nerve in reconstruction of soft tissue defect in heel.Methods:From May 2022 to June 2023, a total of 15 patients with soft tissue defect of heels that caused by various reasons were admitted to the Department of Orthopedics, Zhengzhou Orthopaedic Hospital. The patients were 6 males and 9 females aged 21 to 45 years old, at 32 years old in average. The size of defects was 5 cm×8 cm-10 cm×14 cm. Free perforator flaps of deep medial plantar artery with cutaneous medial plantar nerve were used, at 5 cm×8 cm-11 cm×14 cm in size. Cover the first phase of VSD dressing in the supply site, remove it after 1 week, fill the wound with granulation tissue, and then perform full-thickness skin graft.Results:All 15 flaps survived after surgery. Postoperative outpatient follow-up lasted for 8 to 15 (average 12)months. Appearance and texture of the reconstructed heels were satisfactory, the affected feet were able to bear normal weight without obvious tenderness or ulcer formation. The reconstructed heals were resistant to wear and cold with good sensation. TPD of the flaps achieved 5 mm to 7 mm, without sense of heterotopia after rehabilitation. There was no obvious pigmentation or cicatricial contracture.Conclusion:It is satisfactory to apply a free perforator flap of deep medial plantar artery with sensory nerve in reconstruction of soft tissue defect of heel.

In order to overcome the challenges of insufficient restriction enzyme sites, and construct a fusion-expression vector with flexible fusion direction, we designed an LB cloning system based on the type IIS and type IIT restriction enzymes LguⅠ and BbvCⅠ. The LB cloning system is constructed by inserting the LB fragment (GCTCTTCCTCAGC) into the multiple cloning site region of the broad-host plasmid pBBR1MCS-3 using PCR. The LB fragment contains partially overlapped recognition sites of LguⅠ and BbvCⅠ. Therefore, the same non-palindromic sequence will be generated by these two restriction endonucleases digestion. This feature can be used to quickly and flexibly insert multiple genes into the expression vector in a stepwise and directed way. In order to verify the efficacy of the cloning system, two glycosyltransferase genes welB and welK of Sphingomonas sp. WG were consecutively fused to the LB cloning vector, and the recombinant plasmid was transferred into Sphingomonas sp. WG by triparental mating. The results showed that gene fusion expression has little effect on sphingan titer, but enhanced the viscosity of sphingan. The viscosity of the sphingan produced by recombinant strain Sphingomonas sp. WG/pBBR1MCS-3-LB-welKB was 24.7% higher than that of the wild strain after fermentation for 84 h, which would be beneficial for its application. In conclusion, the application of LB cloning system were verified using Sphingomonas sp. WG. The LB cloning system may provide an efficient tool for fusion expression of target genes.
Base Sequence ; Cloning, Molecular ; Fermentation ; Plasmids/genetics* ; Sphingomonas/metabolism*

Objective:To study the predictive value of the amplitude-integrated electroencephalography (aEEG) within 6 hours and 3 days after birth and magnetic resonance imaging(MRI) on the adverse neurobehavioral development of asphyxiated preterm infants at the correction age of 6 months.Methods:From December 2017 to June 2019, 50 asphyxiated preterm infants who were delivered at the obstetrical department transferred to the division of neonatology in the Third Affiliated Hospital of Anhui Medical University were monitored by aEEG within 6 hours after birth, then once a day for at least 4 h. MRI was administered at 40 weeks of corrected age, neuromotor developmental function of the infants was assessed by the Geisel developmental diagnostic scale at 6 months of corrected age, then the infants were divided into good prognosis group and poor prognosis group according to the assessment results. SPSS 19.0 software was used for statistical analysis.The software of SPSS 19.0 was used to analyze the data.Independent sample t-test and χ 2 test were used to analyze the difference between the two groups.The relationship between aEEG grading and MRI, and their predictive value for adverse neurobehavioral development were analyzed at 6 months of corrected age. Results:The degree of white matter damage( H=24.896) and intracranical hemorrhage( H=29.245) of premature infants with different aEEG clinical grades were different (both P<0.01) on MRI. The sensitivity of aEEG within 6 hours and 3 days after birth on predicting poor prognosis was 96.2% and 97.8%, the specificity was 56.2% and 62.5%, the negative predictive value was 98.2% and 99.0%, the positive predictive value was 37.8% and 52.3%, the correct index was 52.4% and 60.3%, respectively. The aEEG was combined with MRI, the sensitivity (90.0%, 97.0%), specificity (89.0%, 99.0%), negative predictive value (99.2%, 99.5%), positive predictive value (80.6%, 88.5%), and correct index (79%, 96%) were all improved. Conclusion:The combination of aEEG grading and MRI can improve the prognostic value on neurodevelopmental prognosis, and provide a better evaluation basis for clinical follow-up and intervention of asphyxiated premature infants with brain injury.

Objective ToinvestigatethediagnosticvalueofADC withhigherbvaluefortheaggressivenessofprostatecancer. Methods 52patientswithpathologicallyprovedprostatecarcinomawerestudiedretrospectively.AllpatientsunderwentroutineMRI andDWIwithbvalueof1000and2000s/mm2.Accordingtothelocationoflesionfrombiopsyreport,aROIwasdrawnonADC mapatcancerousfociwithlowT2WIandhighDWIsignalintensityrespectivelyandtheADCvalueswerecalculated.Fociwereclassifiedinto highriskgroup(Gleasonscore≥8)andlow-intermediateriskgroup(Gleasonscore≤7).TheADCvaluesatb=1000or2000s/mm2between thetwogroupswerecomparedbyttest.ROCcurvewasusedtodeterminetheabilityofdifferentb-values.Relationshipsbetween meanADCvaluesinfociatb=1000or2000s/mm2andtumorGleasonscorewereassessedusingthe S pear m an test.Results Thereweresignificantdifferencesbetweenthehigh-riskgroupandthelow-intermediategroup(P<0.05)undertwob-values(b=1000s/mm2 andb=2000s/mm2).TheareaundertheROCcurveofb=1000s/mm2andb=2000s/mm2 ADCvaluesindifferentiatingthetwo groupswas0.858(P<0.05)and0.902(P<0.05)respectively,andnosignificantdifferencewasobservedintheAUCofbothgroups(P=0.222). ADCvaluesoftumorregionswerenegativecorrelatedwithtumorGleasonscoreat1000s/mm2(r=-0.709,P<0.05)and2000s/mm2 (r=-0.814,P<0.05)respectively.Although,nosignificantdifferencewasobservedinthecorrelationcoefficient(ρ)betweentwo groups(P=02.09).Conclusion ADCvaluesofbothb=1000and2000s/mm2havecorrelationwithGleasonscores.Thediagnosticperformanceof highb-value(2000s/mm2)ADCissuperiortonormalb-value(b=1000s/mm2)ADCinassessmentoftumoraggressiveness.

Objective To explore the relationship between cognitive function and sleep disturb-ance,depression and anxiety. Methods Totally 333 medical staff were investigated using the repetitive neu-ropsychological status questionnaire (RBANS),the Pittsburgh sleep quality index ( PSQI),the depression self-rating scale (SDS) and the anxiety self-rating scale ( SAS). Results ①The difference of visual span in gender(male:(81. 87±13. 48) vs female:(77. 12± 13. 09)) was statistically significant ( t=2. 928,P<0. 05).②Differences in immediate memory,language function,attention function and total score of RBANS among patients of different ages were statistically significant ( F=9. 654,8. 370,11. 465,11. 112, all P<0. 01).③There were significant differences in the RBANS,immediate memory,visual span,attention function and delayed memory between doctor and nurse(t=5. 374,4. 730,3. 389,4. 359,5. 675,all P<0. 01).④There were significant differences in the RBANS,immediate memory,and delayed memory between different PSQI levels ( F=3. 475,4. 892,4. 087, all P<0. 05). ⑤There were significant differences in RBANS ((88. 87±12. 47) vs (83. 69±13. 03)),immediate memory ((86. 18±16. 09) vs (80. 56±15. 38)),visual span ((79. 39±13. 32) vs (73. 47±12. 46)),and delayed memory ((89. 03±10. 26) vs (85. 49±11. 41)) between the depressive symptoms and not depressive symptoms groups( t=2. 794,2. 380,3. 042,2. 295,all P<0. 05) .⑥The total score of medical staff's RBANS was significantly negatively correlated with their PSQI,SDS and SAS scores (r=-0. 158,-0. 233,-0. 117,all P<0. 05).⑦SDS,age,occupation,education, time of sleep and PSQI entered multiple stepwise regression equations,which explain 39. 9% variation in cog-nitive function of medical staff. Conclusion The cognitive function of medical staff is affected by gender, age,occupation,education,depression,and sleep disturbance. The worse the sleep quality,the higher the de-gree of depression and anxiety,and the poorer the cognitive function.

Objective: To present the evolutionary path of Chinese Medical Ethics, analyze the development vein of periodical, explore the journal' s research focuses, and provide reference for related personnel to understand the development of the current research status in the field through visualization technology. Methods:Using biblio-metric method,taking "China National Knowledge Infrastructure" as source of data collection, we used the visual-ization software CiteSpace to draw scientific knowledge maps and analyzed literatures published from 1990 to 2014 in Chinese Medical Ethics. Results:The annualvolume of journal articles fluctuated upwards,with peaks in 1992, 2000 and 2009, and of which the most was in 2009, with 393 articles. "Medical Ethics" and "Doctor-patient Relationship" were hotwords in this field. The publications of domestic and foreign scholars promoted the interna-tional exchange and the development of Chinese medical ethics, and the most productive institutions were often col-leges or universities. Conclusion:Chinese Medical Ethics has effectively promoted the development of bioethics in China, more and more scholars are involved in the relative research of medical ethics, and the old, middle and young scientists and research teams inherit, cooperate and develop with each other. The cross-regional, inter-a-gency and interdisciplinary collaboration remains very limited, whichwill become the important factorinfluencingthe development of the field of Chinese medical ethics in the future.

Objective In order to understand the chondrogenesis differentiation of mesenchymal stem cells in either hydrogel or pellet culture,we applied the two methods and reveal the possible mechanism and for further investigation.Methods In C3H10T1/2 chondrogenic differentiation,we apply extracellular matrix hydrogel mixed the cell suspensions of freshly prepared (including scaling chondroitin sulfate,sodium hyaluronate synthesis and cross-linking agent) co-culture system and high cell density pellet formed by centrifugation.Chondrogenic differentiation of C3H10T1/2 was induced by treatment with TGF-β3 (10 ng/ml),dexamethasone (100 nmol/L),ascorbic acid (50 ug/ml),1 ∶ 100 dilution ITS+Premix and high glucose-DMEM medium with 0.2 volume fraction fetal bovine serum.And high glucose-DMEM medium with 0.2 volume fraction fetal bovine serum is for control group.Histochemistry staining was utilized to identify extracellular proteoglycan and real-time PCR was performed to assess gene expression of SOX9,collagen Ⅱa1/Ⅹa1 and aggrecan for the 1st,2nd and 3rd week respectively.Results In the hydrogel model for 3 weeks chondrogenic differentiation,the expression of master transcription factor SOX9 was upregulated in both culture models.While the marker genes of collagen Ⅱa1 and collagen Ⅹa1 were all promoted in hydrogel culture,the aggrecan gene expression was peaked in pellet culture.In addition,immunocytochemistry analysis of the hydrogel and pellet for 3 week illustrated the expression of extracellular matrix and more obviously in the hydrogel model.Conclusion In compared with pellet culture,the MSCs in the hydrogel were more likely promoted chondrogenesis leading to the eventual expression of marker genes.And the hydrogel would be applied in regeneration of cartilage injury.