Objective: To investigate the prevalence of depressive symptoms and their associated factors among students in Zhejiang Province, so as to provide evidence for targeted prevention strategies. Methods: A stratified cluster random sampling method was used to select 23 829 college students and primary and secondary school students aged 11-22 years in Zhejiang Province from December 2019 to February 2020. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale (CES-D). Three machine learning algorithms, including Logistic regression, random forest, and eXtreme Gradient Boosting (XGBoost), were applied to construct predictive models, and key associated factors were identified by comparing model performance. Results: The detection rate of depressive symptoms among students in Zhejiang Province was 19.92%; the rates were 17.20% in boys and 22.87% in girls( χ 2=164.89, P <0.05). The CES-D total score was 9.00(4.00,13.00). Multiple Logistic regression analysis revealed that loneliness had the strongest association with depressive symptoms ( AOR =9.58, 95% CI =8.90-10.30), while bullying exposure ( AOR =4.39, 95% CI =4.02-4.80), female students( AOR =1.81, 95% CI =1.68-1.94)，never eating breakfast ( AOR = 2.34，95% CI =2.00-2.67) and overweight/obesity( AOR =1.10，95% CI =1.08-1.12) were significant associated factors of depressive symptoms among students (all P <0.05). Analysis based on the XGBoost model produced highly consistent results, identifying the above 5 factors as the core features with the highest correlation strength (all P <0.05). Conclusions Female, loneliness, bullying exposure, frequency of weekly breakfast and BMI are strongly associated with depressive symptoms among students. Mental health education for high risk groups should be strengthened, and coordinated prevention efforts between families and schools are recommended.

The construction of "Curriculum Civics" in medical schools needs to go in the same direction as "Civics Curriculum" and "Liberal Studies Education" , and explore the realization path of shaping noble souls through positive ideological and political leadership and mutual collision of hearts and minds.The integration of Wuliande’s spirit into medical education is an all-round exploration from the perspectives of value connotation, contemporary meaning and path exploration, which has important contemporary significance and application value, and is also a practical requirement for inheriting and innovating Wuliande’s spirit and constructing a "Great Thought and Politics" work system under the pattern of "Great Health" in the new era. Based on the above background, this paper explored and interpreted how to fully follow the law of talent growth and the law of education to cultivate new-age medical and health talents who are red and professional, benevolent, health guardian and public health fighter from the perspective of collaborative education of medical ethics education and ideological and political education.

The oncolytic virus(OV)therapy utilizes natural or genetically modified viruses to specifically target and infect tumor cells,leading to the destruction of cancer cells by the replication of the virus itself.This process also alters the immune microenvironment of the tumor transforming"cold"into"hot",and mobilizes the body's immune system.The effectiveness of oncolytic viruses in anti-tumor therapy depends on factors such as the type of virus,host immunity and route of administration.Immunotherapy aims to activate the immune system and exert anti-tumor effect by relying on autoimmune function.With the development of genetic engineering technology,oncolytic viruses can enhance the anti-tumor effect through gene editing reconstruction,and can be used to treat tumors alone or in combination with other therapies.In view of the limited efficacy of single application of oncolytic virus therapy in clinic,the combination of oncolytic virus therapy and immunotherapy provides a new strategy for tumor treatment.This review started from the types of oncolytic viruses approved in the clinic,characteristics and its anti-tumor mechanisms.At the same time,it combed through the treatment of oncolytic viruses in the clinical trial stage,summarized the combined treatment strategies of oncolytic viruses,especially the combination of tumor immunotherapy represented by immune checkpoint inhibitor(ICI)and adoptive cell therapy(ACT),and put forward some thoughts and prospects of oncolytic viruses in the anti-tumor treatment in combination with the experience accumulated by the project team in the research of oncolytic viruses.

In order to improve the management level of medicine list of medical institutions in China ，and help medical institutions build a medicine list of medical institutions with reasonable drug use structure ，standardized adjustment procedures ， convenient operation and application and scientific evaluation methods ，so as to meet the needs of clinical rational drug use to the greatest extent ，with the support of the Pharmaceutical Care Professional Committee of the Chinese Pharmaceutical Association ， China-Japan Friendship Hospital and the First Affiliated Hospital of University of Science and Technology of China （Anhui Provincial Hospital ）jointly initiate and complete Guideline for the Evaluation of Medicine List in Chinese Medical Institutions jointly with a number of medical institutions. In strict accordance with the methodological requirements of World Health Organization standard guidelines ，based on the Delphi method ，the guideline formulation working group has constructed the quality evaluation index system and quantitative scoring table of medicine list management in medical institutions from the 5 dimensions of organization and management ，structure，adjustment，application and e valuation of the list. It is used to help medical institutions evaluate the quality of their medicine list management ，so asto play a positive role in the fine management of medicine list in medical institutions.

The construction of "Curriculum Civics" in medical schools needs to go in the same direction as "Civics Curriculum" and "Liberal Studies Education" , and explore the realization path of shaping noble souls through positive ideological and political leadership and mutual collision of hearts and minds.The integration of Wuliande’s spirit into medical education is an all-round exploration from the perspectives of value connotation, contemporary meaning and path exploration, which has important contemporary significance and application value, and is also a practical requirement for inheriting and innovating Wuliande’s spirit and constructing a "Great Thought and Politics" work system under the pattern of "Great Health" in the new era. Based on the above background, this paper explored and interpreted how to fully follow the law of talent growth and the law of education to cultivate new-age medical and health talents who are red and professional, benevolent, health guardian and public health fighter from the perspective of collaborative education of medical ethics education and ideological and political education.

Objective: To explore the value of serum microRNA-494 (miR-494) expression in predicting the prognosis of acute renal injury (AKI) after cardiac surgery in children. Methods: 116 children with AKI after cardiopulmonary bypass for congenital heart disease admitted to Sanya People's Hospital from January 2016 to March 2019 were enrolled. The expression of miR-494 in serum was detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR), and the levels of serum neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) were detected by enzyme linked immunosorbent assay (ELISA) of all the children. The children were divided into survival group and death group according to 28-day survival. Serum levels of miR-494, NGAL and KIM-1 were measured in two groups. Multivariate Logistic regression was used to analyze the risk factors of death in children with AKI after cardiac surgery. The receiver operating characteristic (ROC) curve analysis of serum levels of miR-494, NGAL and KIM-1 in predicting prognosis of children with AKI after cardiac surgery was performed. Pearson correlation analysis was used to analyze the correlation between serum levels of miR-494 and NGAL, KIM-1. Results: After cardiopulmonary bypass in 116 children with AKI, 27 cases died and 89 cases survived during the 28-day observation. Compared with the survival group, the proportion of cyanosis in the death group was significantly increased, the proportion of blood perfusion was significantly decreased, the time of cardiopulmonary bypass and postoperative mechanical ventilation were significantly prolonged, and the blood glucose level was significantly increased after operation. There was no significant difference in other general data. The serum levels of miR-494, NGAL and KIM-1 in the death group were significantly higher than those in the survival group [miR-494 (2^-ΔΔCt): 3.75±1.28 vs. 1.48±0.71, NGAL (mg/L): 583.60±52.72 vs. 320.52±31.84, KIM-1 (μg/L): 30.53±6.38 vs. 17.40±3.72, all P < 0.01]. Multivariate Logistic regression analysis showed cyanosis [odds ratio (OR) = 1.716, 95% confidence interval (95%CI) was 1.184-2.982, P = 0.039], postoperative blood glucose (OR = 1.925, 95%CI was 1.262-3.387, P = 0.005), serum miR-494 (OR = 2.527, 95%CI was 1.706-5.148, P < 0.001), NGAL (OR = 2.473, 95%CI was 1.620-4.935, P < 0.001) and KIM-1 (OR = 1.805, 95%CI was 1.213-3.106, P < 0.001) were independent risk factors for death in children with AKI after cardiac surgery. ROC curve analysis showed the area under the curve (AUC) to predict the death of children with postoperative AKI was 0.868, 0.857 and 0.819 respectively, AUC of serum miR-494, NGAL and KIM-1 levels combination to predict the death of children with postoperative AKI was the largest (0.964, 95%CI was 0.908-0.997), with a high sensitivity and specificity of 97.0% and 91.8%. The correlation analysis showed the expression level of serum miR-494 was positively correlated with NGAL and KIM-1 in the death group (r₁ = 0.902, r₂ = 0.873, both P < 0.01). Conclusion Serum levels of miR-494 increased significantly in children with AKI after cardiac surgery, which is an independent risk factor for death in children with AKI after cardiac surgery, and the combination of NGAL and KIM-1 levels had a high value in predicting the prognosis of children with AKI after cardiac surgery.

OBJECTIVE: To explore the value of serum microRNA-494 (miR-494) expression in predicting the prognosis of acute renal injury (AKI) after cardiac surgery in children. METHODS: 116 children with AKI after cardiopulmonary bypass for congenital heart disease admitted to Sanya People's Hospital from January 2016 to March 2019 were enrolled. The expression of miR-494 in serum was detected by real-time fluorescence quantitative polymerase chain reaction (RT-qPCR), and the levels of serum neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule-1 (KIM-1) were detected by enzyme linked immunosorbent assay (ELISA) of all the children. The children were divided into survival group and death group according to 28-day survival. Serum levels of miR-494, NGAL and KIM-1 were measured in two groups. Multivariate Logistic regression was used to analyze the risk factors of death in children with AKI after cardiac surgery. The receiver operating characteristic (ROC) curve analysis of serum levels of miR-494, NGAL and KIM-1 in predicting prognosis of children with AKI after cardiac surgery was performed. Pearson correlation analysis was used to analyze the correlation between serum levels of miR-494 and NGAL, KIM-1. RESULTS: After cardiopulmonary bypass in 116 children with AKI, 27 cases died and 89 cases survived during the 28-day observation. Compared with the survival group, the proportion of cyanosis in the death group was significantly increased, the proportion of blood perfusion was significantly decreased, the time of cardiopulmonary bypass and postoperative mechanical ventilation were significantly prolonged, and the blood glucose level was significantly increased after operation. There was no significant difference in other general data. The serum levels of miR-494, NGAL and KIM-1 in the death group were significantly higher than those in the survival group [miR-494 (2^-ΔΔCt): 3.75±1.28 vs. 1.48±0.71, NGAL (mg/L): 583.60±52.72 vs. 320.52±31.84, KIM-1 (g/L): 30.53±6.38 vs. 17.40±3.72, all P < 0.01]. Multivariate Logistic regression analysis showed cyanosis [odds ratio (OR) = 1.716, 95% confidence interval (95%CI) was 1.184-2.982, P = 0.039], postoperative blood glucose (OR = 1.925, 95%CI was 1.262-3.387, P = 0.005), serum miR-494 (OR = 2.527, 95%CI was 1.706-5.148, P < 0.001), NGAL (OR = 2.473, 95%CI was 1.620-4.935, P < 0.001) and KIM-1 (OR = 1.805, 95%CI was 1.213-3.106, P < 0.001) were independent risk factors for death in children with AKI after cardiac surgery. ROC curve analysis showed the area under the curve (AUC) to predict the death of children with postoperative AKI was 0.868, 0.857 and 0.819 respectively, AUC of serum miR-494, NGAL and KIM-1 levels combination to predict the death of children with postoperative AKI was the largest (0.964, 95%CI was 0.908-0.997), with a high sensitivity and specificity of 97.0% and 91.8%. The correlation analysis showed the expression level of serum miR-494 was positively correlated with NGAL and KIM-1 in the death group (r₁ = 0.902, r₂ = 0.873, both P < 0.01). CONCLUSIONS Serum levels of miR-494 increased significantly in children with AKI after cardiac surgery, which is an independent risk factor for death in children with AKI after cardiac surgery, and the combination of NGAL and KIM-1 levels had a high value in predicting the prognosis of children with AKI after cardiac surgery.
Acute Kidney Injury/diagnosis* ; Acute-Phase Proteins ; Biomarkers ; Cardiac Surgical Procedures ; Child ; Humans ; Lipocalin-2 ; MicroRNAs/blood* ; Predictive Value of Tests ; Prognosis ; Proto-Oncogene Proteins

Objective To compare the contents and features of licensed pharmacist qualification examination papers between those in abroad and domestic in order to provide the informations for the reforming the examination in our country.Method The characteristics of licensed pharmacist qualification examination among USA、UK、Australia and China were analysed and compared with classified statistic by using excel software.Results The scene questions are the main type in the three examination papers(＞50％).There were fewer questions examining the memory ability of examinees in abroad examinations,than that of ours.There were one question just had objects of pharmaceutical care (0.18％) in our examination.In the inspection of pharmaceutical knowledge application ability for the practice test(＞60％),covering all aspects of pharmaceutical care; And Chinese licensed pharmacists exam basic no object and pharmaceutical care link information feedback(＞60％),and the others are theoretical knowledge(＞20％).And in the three abroad examinations other common questions were about clinical drug therapy (＞90％),while they were the knowledge of pharmaceutical analysis and pharmaceutics in domestic examination papers (41.97％).Conclusion Licensed pharmacist qualification examination in our country ignored the ability of employing pharmaceutical knowledge and developing pharmaceutical care.The reformation of the licensed pharmacist qualification examination in our country is extremely urgent.

OBJECTIVE: To investigate the association of the polymorphism of angiotensin-converting enzyme (ACE) gene and pregnancy-induced hypertension (PIH) in Chinese Women. METHODS: We systematically searched CNKI, Wanfang database, VIP and PubMed from database construction to March 2012 to collect case-control studies. Stata 11.0 was used for meta analysis after evaluating the quality of studies and collecting the data. The association was assessed by odds ratio (OR) with 95% confidence intervals (CIs). Publication bias was analyzed by Begg's funnel plot and Egger's regression test. RESULTS: We identified 11 case-control studies on association between ACE gene polymorphism and PIH, which included 806 PIH patients and 900 controls. Overall, significant association was found between ACE gene polymorphism and PIH risk [for D vs I: OR=2.73, 95% CI (1.64, 4.24), P<0.001; for DD+DI vs II: OR=3.11, 95% CI (1.98, 4.90), P<0.001; for DD vs II: OR=5.00, 95% CI (2.30,10.88), P<0.001; for DI vs II: OR=1.97, 95% CI(1.53, 2.53), P<0.001]. CONCLUSION Chinese women with D allele gene deletion have a higher risk of suffering pregnancy induced hypertension syndrome.
Adult ; Alleles ; Female ; Genetic Predisposition to Disease ; Humans ; Hypertension, Pregnancy-Induced ; genetics ; INDEL Mutation ; Peptidyl-Dipeptidase A ; genetics ; Polymorphism, Genetic ; Pregnancy ; Randomized Controlled Trials as Topic ; Risk Factors

Objective To evaluate effectiveness of prevention and treatment for patients with chronic obstructive pulmonary disease (COPD) for one year at community health-care service (CHS)centers. Methods A quasi-experiment design was used to evaluate effectiveness of community management for patients with COPD who visited and registered at Xiaokunshan and Xinbang CHS centers in Songjiang district of Shanghai in 2008, with COPD patients from Xiaokunshan community CHS center as management group and those from Xinbang as control. Measures for community management included training for local general practitioners in essential knowledge of COPD prevention and treatment, allocation of necessary drugs for COPD treatment, and health education for COPD patients and their family members. No special measures were taken for control group except routine treatment. Results A total of 132 patients were diagnosed as COPD according to their pulmonary function on 2008, 61 at Xiaokunshan and 71 at Xinbang CHS canters.One hundred and two patients, 47 at Xiaokunshan and 55 at Xinbang, finished one-year follow-up. Five patients from Xiaokunshan who were smokers at their first visits and three of them quitted smoking after oneyear management. Meanwhile, none of nine smoked patients from Xinbang quitted smoking in the same period. There was no statistically significant difference in symptom scores, pulmonary function, and forced expiratory volume at the first second (FEV1) between patients in the two groups during one-year follow-up.Average score of quality of life in patients at Xiaokunshan dropped to 39. 12 after one-year management from 46. 96 at their first visits, and that in patients at Xinbang increased to 62. 11 from 56. 55 (P＜0.01).Average six-minute walking distance (6-MWD) in patients at Xiaokunshan reduced to 354. 26 meters after one-year management from 361.66 meters at their first visits, meanwhile that in patients at Xinbang reduced to 351.18 meters from 398.07 meters (P =0. 008). Scores of functional dyspnea in patients at Xiaokunshan fell to 0.34 from 0.40 at their first visit, meanwhile that in patients at Xinbang increased to 1.00 from 0.95(P =0.038). During the one-year follow-up, 13 patients at Xiaokunshan and 53 at Xinbang visited emergency departments for treatment, and four at Xiaokunshan were hospitalized and none died, and five at Xinbang were hospitalized due to acute exacerbation of COPD and four of them died. Conclusions The study suggests that strengthening prevention and treatment for COPD patients at community level by general practitioners, patients themselves and their family members can improve their quality of life, reduce emergency visits and hospitalization, alleviate dyspnea symptoms and delay the decline of 6MWD.