Objective To analyze and compare the change of disease burden attributed to high temperature in the Chinese population in 2019 compared with 1990. Methods Based on the global burden of disease study data in 2019, the number of deaths, mortality, disability-adjusted life years (DALY) and DALY rate attributable to high temperature in Chinese population of different ages and genders in 1990 and 2019 were extracted to analyze the changing trend of disease burden attributable to high temperature exposure in Chinese population and its main causes. The Joinpoint regression model was used to analyze the trend of changes in standardized attributable DALY rates. Results Compared with 1990, the number of disease deaths attributable to high temperature in China in 2019 increased from 10 700 to 13 900, and the attributable DALY decreased from 532,200 to 276 100 person-years. The standardized mortality and DALY rates decreased by 35.25% and 65.20%, respectively. The burden attributable to high temperature was higher in males than in females, and the burden was relatively heavier in the population aged 70 and above. In 2019, chronic non-communicable diseases were the main cause of the attributable burden of high temperature exposure, and ischemic heart disease had the highest DALY burden, with an age-standardized DALY rate of 4.64/100 000. Conclusion The absolute death burden attributable to high temperature exposure in Chinese population is still increasing. It is necessary to pay more attention to high-risk groups such as men and the elderly, continue to strengthen environmental protection, and formulate relevant interventions in a targeted way to further reduce the disease burden caused by high temperature exposure.

Objective To retrospectively analyze the distribution and drug resistance of pathogenic bacteria in urinary tract infection in Xiangyang Central Hospital from 2017-2019, so as to provide a basis for clinical treatment of urinary tract infection and rational use of antibiotics. Methods The pathogenic bacteria isolated from clinical urine culture in Xiangyang Central Hospital from January 2017 to December 2019 were collected, and BD Phoenix^TM 100 was used for the identification of pathogens and antimicrobial sensitivity test. The WHONET 5.6 and GraphPad Prism 5.0 software were used for data analysis. Results A total of 3 056 strains of pathogens were isolated from 15 672 urine specimens (19.50%). Gram-negative bacteria accounted for 77.95%, of which E. coli was the most common (52.45%). Gram-positive bacteria accounted for 12.63%, including E. faecalis (4.80%) and E. faecium (4.80%). Fungi accounted for 9.50%. The clinical departments with the highest rates of urinary culture submission and positive detection were Urology (26.20%) and Endocrinology (41.90%), respectively. E. coli and K. pneumoniae had high resistance rates to piperacillin, compound trimethoprim, cefuroxime, ceftriaxone and cefazolin, all exceeding 50.00%, while P. aeruginosa was relatively sensitive to various antibiotics. The resistance rates of these three gram-negative bacteria to carbapenem antibiotics increased year by year. The isolated gram-positive cocci were mainly enterococcus faecalis and enterococcus faecalis. They were highly sensitive to linazolamide, vancomycin and teicoplanin, but the resistance rates to other types of antibiotics were quite different. The average detection rates of ESBLs-producing E. coli and K. pneumoniae were 52.90% and 59.00%, respectively. Conclusion The pathogens of urinary tract infections in Xiangyang Central Hospital from 2017 to 2019 are mainly gram-negative bacteria, and the resistance rate to carbapenem drugs is increasing year by year. The ESBLs-producing strains of E. coli and K. pneumoniae are highon should be strengthened in patients with high DOB value and smoking.

Objective:To explore the correlation between CCAAT enhancer binding protein beta (CEBPB) expression and clinical characteristics in ccRCC, and to investigate the effect of CEBPB on proliferation and invasion of ccRCC cells.Methods:Between March 2020 to December 2020, the transcriptome and clinical data of 537 ccRCC cases were downloaded from TCGA database, and the correlation of CEBPB expression with clinical characteristics of ccRCC were analyzed. Univariate and multivariate Cox regression analysis were used to determine the effect of CEBPB expression on the prognosis of ccRCC patients. The correlation between CEBPB expression and immunocyte infiltration in ccRCC was investigated via TIMER database. The expression levels of CEBPB mRNA and protein in human renal tubular epithelial cell line HK2 and ccRCC cell lines (Caki-1, ACHN, 786O, 769P and A498) were determined by real-time PCR and western blot, respectively. After transfected with NC siRNA or CEBPB siRNA for 48 h, the proliferation and invasion of ACHN cells and 786O cells were determined by using MTT assay and invasion assay, respectively.Results:TCGA databases analysis revealed that, compared with normal kidney tissue, the expression of CEBPB mRNA in ccRCC was up-regulated by 2.55-fold ( P<0.05). CEBPB expression was positively correlated with age, tumor grade, tumor stage, lymph node metastasis and distant metastasis ( P<0.05). The tumor grade ( HR=1.703, P=0.040), tumor stage( HR=1.773, P=0.026), distant metastasis ( HR=3.080, P<0.001) and the high expression of CEBPB ( HR=1.874, P=0.003) were independent poor prognostic factors for ccRCC patients. The analysis results by using TIMER database showed that CEBPB expression was positively correlated with infiltrating levels of B cells (Rho=0.168), M2 macrophages (Rho=0.373), Tregs (Rho=0.348), neutrophils (Rho=0.194), and natural killer T cell (Rho=0.421) in ccRCC. The expression level of CEBPB mRNA in Caki-1, ACHN, 786O, 769P and A498 cells was (9.43±1.25)-fold, (5.44±0.82)-fold, (4.50±0.52)-fold, (4.88±0.73)-fold and (7.50 ± 1.04)-fold of HK2 cells, respectively. The expression level of CEBPB protein was (6.22±0.45)-fold, (5.84±0.85)-fold, (6.51±0.55)-fold, (6.23±0.62)-fold and (3.84±0.45)-fold of HK2 cells, respectively ( P<0.05). MTT assay showed that the proliferation rates of ACHN cells and 786O cells at 24, 48, 72, 96 h were (98.4±1.7)% and (99.0±1.4)%, (97.8±2.1)% and (98.5±1.5)%, (101.3±1.2)% and (97.6±1.7)%, (97.5±2.0)% and (99.1±1.3)% in NC siRNA group, and (68.8±5.8)% and (79.5±6.2)%, (57.9 ± 6.1)% and (70.8±5.1)%, (50.9±4.6)% and (66.8±4.9)%, (43.2±5.0)% and (60.5±5.3)% in CEBPB siRNA group. Compared with NC siRNA group, the proliferation activity of ACHN cells and 786O cells was significantly inhibited in the CEBPB siRNA group ( P<0.05). Cell invasion assay showed that the invasion activity of ACHN cells and 786O cells were (95.0±5.2)% and (97.3±4.4)% in NC siRNA group, (35.2±5.4)% and (26.7±3.3)% in CEBPB siRNA group, respectively ( P<0.05). Compared with NC siRNA group, the invasion activity of ACHN cells and 786O cells were significantly inhibited in the CEBPB siRNA group ( P<0.05). Conclusions:CEBPB was highly expressed in ccRCC, which was closely related to the prognosis and immunocyte infiltration of ccRCC patients. Silencing the expression of CEBPB significantly inhibited the proliferation and invasion of ccRCC cells

Objective Analyze the distribution and influencing factors of inpatients with extra-long hospital stay in Hubei Province. Methods Length of stay≥30 days was defined as the extra-long hospital stay, and logistic regression was used to determine the risk factors. Results There were 26 043 cases with extra-long hospital stay, which accounting for 2.88% of the total cases. Proportion of extra-long hospital stay was increased with age, the proportion of the group aged 65 and above was the highest (3.25%), and which were higher in males than that of females, the sex ratio was 1.58. Patients with extra-long hospital stay mainly had injury/poisoning and certain other consequences of external causes (16.88%), circulatory system disease (12.72%), neoplasms (11.23%), genitourinary system diseases (8.13%), mental and behavioral disorders (6.27%), and the proportion totaled up to 52.23%. Multivariate logistic regression analysis indicated that gender, age, type of disease, surgery or not and hospital grade were the influencing factors of extra-long hospital stay. Conclusions There are differences in the distribution of extra-long hospital stay in different individuals, diseases and medical treatment, targeted measures should be taken to shorten the length of stay.

To analyze epidemical features, distribution and time trend for nasopharynx cancer deaths in China from 1987 to 2015.
 Methods: Negative binomial regression model was used to explore population-level risk factors for nasopharynx cancer deaths and a joinpoint regression model was used to estimate annual changes in nasopharynx cancer mortality in various populations.
 Results: A falling trend in age-standardized nasopharynx cancer mortality rates was observed among Chinese residents with the average annual percent change (AAPC) at -2.97% among urban female residents and -2.60% among rural female residents (P<0.05), -2.01% among urban male residents, and -1.68% among rural male residents (P<0.05), respectively. It decreased yearly for urban male aged over 85 years with AAPC at -1.54% and the age-specific mortality rates decreased yearly for the urban female aged over 85 years with AAPC at -0.60%, the age-specific mortality rates decreased yearly for rural male residents aged more than 65 years with AAPC at -0.56% and for rural female residents aged more than 85 with AAPC at 1.17%, with no significant difference (P<0.05). The nasopharynx cancer deaths risks were higher in urban residents than those in rural residents (OR=1.11, P<0.01), and they were also higher in male residents than those in female residents (OR=2.34, P<0.01). A 5-year increment in age was associated with a 23% increase in nasopharynx cancer mortality (OR=1.23, P<0.01) and a one year increment in calendar year was related to a 2% decrease in mortality (OR=0.98, P<0.01). 
 Conclusion: There was a significant gender and age difference in a decreased trend of nasopharynx cancer mortality among Chinese residents in a long period; no increased trend was observed in the overall populations over 85 years old.
Age Distribution ; Age Factors ; Aged ; Aged, 80 and over ; China ; epidemiology ; Female ; Humans ; Male ; Mortality ; trends ; Nasopharyngeal Neoplasms ; mortality ; Rural Population ; statistics & numerical data ; trends ; Sex Distribution ; Urban Population ; statistics & numerical data ; trends

Objective: To observe the clinical efficacy of Ningmitai capsules, a traditional Chinese medicine using for clearing heat and dampness, in the treatment of residual fragments and postoperative complications following lithotripsy for upper urinary stones. Methods: During October 2016 and March 2018, patients from Wuhan 1^st Hospital, Wuhan 2^nd Hospital, Wuhan 3^rd Hospital, and Wuhan Puai Hospital having upper urinary residual fragments following minimally-invasive stone treatment were randomly assigned to control group and Ningmitai group with a proportion of 1∶3. The patients in control group were treated with antibiotics or sodium diclofenac suppository on demand, while patients in Ningmitai group took additional Ningmitai capsule orally (4 capsules per time, 3 times per day). The observation was started when a patient was enrolled in this study and continued for a maximum of 12 weeks or until stone-free status. During the observation, the stone expulsion time, stone-free time, stone-free rate were observed, and the difference in curative effect between the two groups on postoperative complications such as pain and infection were compared. Statistical analysis was done using t-test or χ² test by GraphPad Prism 5 software. Results: Totally 269 cases enrolled in this study. Eighty-six patients were from Wuhan 1^st Hospital, 69 patients from Wuhan 2^nd Hospital, 58 patients from Wuhan 3^rd Hospital, 56 patients from Wuhan Puai Hospital, respectively. There were 66 cases in control group and 203 cases in Ningmitai group. The residual fragments expulsion time in Ningmitai group was significantly earlier than that in control group ((4.5±0.4) days vs. (7.5±1.3) days, t=2.877, P=0.004), the residual fragments clearance time in Ningmitai group was significantly shorter than that in control group ((13.6±1.0) days vs.(25.6±3.8) days, t=4.252, P=0.000), and the stone-free rate within 4 weeks post operation in Ningmitai group was significantly higher than control group (91.6% vs. 68.2%, χ²=22.57, P=0.000). After 12 weeks of treatment, the total effective rate of control group was 89.4%, and the total effective rate of Ningmitai group was 99.5%, with statistically significant difference (χ²=17.65, P=0.000). The proportion of caregivers that offered analgesia in Ningmitai group was significantly lower than that in control group (16.3% vs. 30.3%, χ²=6.212, P=0.013), the recovery rate of routine urinalysis following 4 weeks′ treatment was significantly higher in Ningmitai group than that in control group (88.2% vs.71.2%, χ²=10.67, P=0.001). No obvious adverse effects were observed in both groups. Conclusions Ningmitai capsule can facilitate the stone passage and increase the stone-free rate in the treatment of residual fragments and postoperative complications of upper urinary stones. It is also helpful for the prevention and treatment of postoperative pain, infection and other complications.

Objective To explore the saffety and efficacy of super-selective prostate artery embolization (PAE) combined with TURP (transurethral resection of prostate) as an alternative method for patients with severe large BPH (＞ 80 ml).Methods From March 2015 to June 2017,a total of 40 patients with large benign prostatic hyperplasia who failed in medical treatment were selected for PAE combined with TURP (18 cases)and TURP (22 cases).In the PAE combined with TURP group,the mean age was (75.0±8.7) years (ranging60-88 years) and the mean prostatic volume was (111.0 ±23.3) ml,ranged from 83 to 145 ml).The international prostate symptom score (IPSS),quality of life (QOL),maximal t rine flow rate (Qmax) and postvoid residual urine(PVR) were(25.2 ±3.6),(5.1 ± 1.0),(6.4 ± 2.3) ml/s and (107.7 ± 32.6) ml,respectively.In the TURP group,the mean age was (76.0 ± 6.9) years (ranging 62-85 years) and the mean prostatic volume was (107.5 ±27.4) ml,ranged from 80 to 150 ml).The IPSS,QOL,Q andPVRwere(24.3±4.2),(4.9 ±0.9),(6.7±2.2)ml/s and (106.6±32.2)ml,respectively.Clinical data of all of patients were analyzed retrospectively,including operative time,estimate blood loss,weight and efficacy of resected tissue,time of continuous bladder irrigation and catheterization,IPSS,QOL,PVR,Q and postoperative complications.Results There were significant differences in the operative time [(75.8 ± 25.1) min vs.(103.2 ± 27.7) min],estimate blood loss [(122.8 ± 33.9) ml vs.(447.6 ± 36.0) ml],weight of resected tissue [(99.9 ± 24.2) g vs.(82.9 ± 15.5) g],efficacy of resected tissue [(76.9 ± 20.7) g/h vs.(41.7 ± 14.2) g/h],continuous bladder irrigation time [(1.4 ± 0.5) d vs.(2.4 ± 0.8) d] and catheterization time [(2.2 ± 0.4) d vs.(3.4 ± 0.6) d] between PAE combined TURP group and TURP group (P ＜ 0.05).The postoperative complications of PAE combined TURP group and TURP group were included secondary hemorrhage (0 case vs.3 cases),secondary TURP (0 case vs.3 cases),temporary urinary incontinence (2 case vs.4 case),urinary tract infection (1 case vs.2 case).After 1-year follow up,the IPSS,QOL,Qmax and PVR of PAE combined TURP group and TURP group were (6.7 ±1.5)and(6.9± 1.5),(2.3 ±0.5) and(2.3 ±0.6),(15.6 ±2.3) ml/s and(15.0 ±2.1) ml/s,(32.8±6.5) ml and(32.3± 8.4)ml,respectively.Both goups were found to have significantly improved in IPSS,QOL,Q and PVR,as compared with preoperative indexes,respectively (P ＜ 0.05).However,there was no significant difference in those indexes between two groups (P ＞ O.05).Conclusions PAE combined TURP could be used a safe and effective therapy for treating patients with LUTS due to large volume (＞ 80 ml) BPH.It has been a priority in less blood,more efficient of resected tissue and less postoperative complications.

Objective The aim of this research was to produce apparatus of urinary diversion using silk-fibroin loading rab-bit adipose stem cells,and assess the effect of urinary diversion in a rabbit model.Methods Adipose stem cells were obtained and cultured in vitro,and flow cytometry analysis was performed to determine the adipose stem cells.These cultured adipose stem cells were used to seed on the silk-fibroin scaffolds,and after being incubated in the conditioned medium for 7 days,the a-bove compounds were made into apparatus of urinary diversion.This apparatus of urinary diversion was implanted into 20 rab-bits with radical cystectomy to develop urinary diversion.Five rabbits from each experimental group were euthanized at the spe-cific time points(1,2,3,4 months postoperatively),and the implants were harvested for histological and immunohistochemical a-nalysis.In the control group,silk-fibroins with unseeded cells(only silk-protein scaffolds)were also made into apparatus of uri-nary diversion and then used as urinary diversion on another 5 rabbits with the same process.Results Rabbits adipose stem cells were isolated and cultured successfully,and determined by flow cytometry.The silk-fibroin scaffolds were synthesized suc-cessfully.All rabbits were alive in the experimental group until the time of sacrifice.Histological and immunohistochemical anal-ysis showed multilayer uroepithelium coverage in the luminal surface of apparatus of urinary diversion,and as time went on,epi-thelial layers increased continuously.In the control group,all animals were dead within 3 weeks,and urine leakage,severe in-flammatory reaction and tissue destruction were found by autopsy.Conclusion The present experiment has successfully used silk-fibroin loading rabbit adipose stem cells to construct apparatus of urinary diversion,and demonstrates the feasibility of this kind of apparatus for urinary diversion in a rabbit model,which provides some experimental basis for clinical applications.

Objective:To analyze the current situation for the mortality of Chinese female breast cancer and the trend of change in the past thirty years,and to provide scientific basis for prevention and control of breast cancer in China.Methods:The mortality data of breast cancer in Chinese female from 1987 to 2014 were collected,the trends of age-standardized rates and age-adjusted rates were described,and the variations via Joinpoint regression models were analyzed.Results:From 1987 to 2014,the mortality for the urban female breast cancer was greater than that for the rural females.There was a downward trend for urban women with an average decrease of 0.3％ for each year (P=0.06).While the average annual change for rural females showed an upward trend (AAPC=l.26％,P＜0.01).The gap between urban and rural females is narrowing gradually.The 40-59 age-adjusted rate for urban females decreased first and then it was increased with time moving forward.The mortality for rural females was continuously increased.Conclusion:From 1987 to 2014,the breast cancer mortality for urban females was overall higher than that for rural females.The mortality for rural females was continuously increased in the past years.The gap between urban and rural females is narrowing.We should pay specific attention to the prevention and treatment of breast cancer for the rural females.

Objective: To determine total phenylethanoid glycoside and acteoside in Plantago Herba to provide reference for evaluating the quality of medicinal materials.Methods: With acteoside as the control sample, a UV visible spectrophotometric method was used to determine total phenylethanoid glycosides in Plantago Herba.An HPLC method was applied to determine acteoside in Plantago Herba , and the conditions were as follows: an ODS2 C 18 (150 mm× 4.6 mm ,5 μm) chromatographic column was used with acetonitrile-0.1% formic acid (13∶87) as the mobile phase at a flow rate of 1.0 ml·min-1 , the detection wavelength was 332nm, the column temperature was 30℃, and the sample volume was 10 μl.Results: The reference solution and the sample solution had the maximum absorption at 332 nm, and the linear relationship was good within the range of 0.003 1-0.155 0 mg·ml-1 (r=0.999 5).The content of total benzene alcohol glycosides in 3 batches of samples was 2.73% , 2.61% and 2.84% , respectively;acteoside over the range of 0.000 6-0.155 0 mg·ml-1 (r=0.999 1) showed a good linear relationship with peak area,the sample recovery was 98.5% and the RSD was 1.6% (n =6), and the acteoside content in 3 batches of samples respectively was 0.54% , 0.51% and 0.56%.Conclusion: The method is simple, accurate and reproducible, and can be used for the determination of total phenylethanoid glycosides and acteoside in Plantago Herba.