Objective To investigate the role of cathepsin B(CTSB)inhuman cervical cancer HeLa cellswith Brucella infections.Methods The ctsb knockout(KO)HeLa cell line was constructed using CRISPR/Cas9.The effects of ctsbKO on cell proliferation and survival of intracellular bacteria in case of Brucella infection were detected by CCK-8 assay and intracellular bacteria count while the molecular mechanism of ctsb regulation on Brucella infection was revealed by Western blotting.Results The ctsbKO cell line was constructed.CCK-8 results showed that KO of ctsb had no impact on cell proliferationwith or without Brucella infection.The results of intracellular bacteria count showed a significant decrease in intracellular Brucella four days after infection in the KO cell line.Western blotting assay suggested that the expression levels of autophagy-related proteins were significantly down-regulated in the KO cell line with long-term Brucella infection.Conclusion KO of ctsb inhibits the intracellular survival of Brucella in long-term infections,providing a potential target for the treatment of chronic brucellosis.

Objective:To explore a better indicator that can predict septic shock induced acute kidney injury (AKI) by combining renal resistive index (RRI) and central venous pressure (CVP).Methods:A prospective observational study was conducted. Patients with septic shock admitted to department of critical care medicine of Hebei General Hospital from November 2017 to October 2018 were enrolled. Baseline characteristics such as age, gender, underlying diseases, infection sites, acute physiology and chronic health evaluation Ⅱ(APACHEⅡ) in the first 24-hour, sequential organ failure assessment (SOFA) were recorded; Doppler-based RRI was obtained on the first day when hemodynamics was relatively stable, meanwhile the dose of norepinephrine and hemodynamic parameters were assessed. Urine output per hour, the total duration of mechanical ventilation, the length of intensive care unit (ICU) stay and 28-day mortality were also collected. Observational end point was death at discharge or the 28th day after ICU admission, whenever which came first. The patients were divided into AKI and non-AKI groups according to the 2012 Kidney Disease: Improving Global Organization (KDIGO) clinical practice guideline. The baseline and prognostic indicators, variables potentially associated with AKI were compared between the two groups. The variables independently associated with septic shock induced AKI were identified using multivariable Logistic regression. The predictive value of RRI and RRI combining CVP for AKI were analyzed by the receiver operating characteristic (ROC) curve.Results:A total of 107 patients were enrolled, with 59 patients in AKI group and 48 patients in non-AKI group. There was significant difference in RRI, CVP, percentage of norepinephrine dosage ≥0.5 μg·kg -1·min -1, procalcitonin (PCT), lactate (Lac), and serum creatinine (SCr) between the two groups. Logistic regression analysis showed that high CVP, RRI, Lac and PCT were independent risk factors for septic shock induced AKI [CVP: odds ratio ( OR) = 1.20, 95% confidence interval (95% CI) was 1.03-1.40, P = 0.022; RRI: OR = 3.02, 95% CI was 2.64-3.48, P = 0.006; Lac: OR = 2.43, 95% CI was 1.32-4.50, P = 0.005; PCT: OR = 1.20, 95% CI was 1.05-1.38, P = 0.009]. ROC curve analysis showed that the area under ROC curve (AUC) values of CVP≥9.5 mmHg (1 mmHg = 0.133 kPa) and RRI≥0.695 for predicting septic shock induced AKI were 0.656 and 0.662 respectively. The AUC value of the combination of RRI and CVP was greater compared with either RRI or CVP alone in predicting septic shock induced AKI, which AUC value was 0.712, 95% CI was 0.615-0.809, the sensitivity was 59% and the specificity was 75%. Conclusions:High CVP and RRI were independent risk factors for septic shock induced AKI. The combination of RRI and CVP performs poorly in predicting septic shock induced AKI. Further studies are needed to describe factors influencing Doppler-based assessment of RRI, which may help clinicians to prevent AKI early.

Objective:To understand the rate of spirometry examination and its related factors among chronic obstructive pulmonary disease (COPD) patients aged ≥40 years in China from 2014 to 2015, and provide evidence for diagnosis, treatment and management of COPD patients normatively.Methods:Data were obtained from 2014-2015 COPD surveillance, China. The previous lung function examination status and other information of the subjects were collected by face-to-face survey. We defined COPD as a post-bronchodilator FEV 1: FVC less than 70%. A total of 9 130 COPD patients were included in the analysis of this study. The rate of spirometry examination and its 95% confidence interval ( CI) were estimated in COPD patients aged ≥40 years with complicated sampling weights. Meanwhile, the spirometry examination related factors were analyzed. Results:The estimated rate of spirometry examination among COPD patients was 5.9% (95% CI: 4.9%-6.9%), 6.1% (95% CI: 5.2%-7.1%) for men and 5.3% (95% CI: 4.0%-6.6%) for women. The rate was significantly higher in urban population than in rural ( P<0.001). With the increase of education level, the rate of spirometry examination among COPD patients increased gradually ( P<0.001). The rate of spirometry examination was 4.0% (95% CI: 3.1%-4.9%) among COPD patients in agricultural industry. The rate of spirometry examination among COPD patients with awareness of pulmonary function test was 32.3% (95% CI: 26.4%-38.1%). The rate of spirometry examination among COPD patients with previous chronic respiratory disease and respiratory symptoms were 13.7%(95% CI:11.5%-15.9%), 8.8%(95% CI:7.2%-10.4%), respectively. The rate of spirometry examination among COPD patients exposed to occupational dust and/or harmful gases was 5.7% (95% CI: 4.6%-6.9%). The rate of spirometry examination in former smokers among COPD patients was 10.2% (95% CI: 8.0%-12.4%), higher than those in current smokers (4.2%, 95% CI: 3.3%-5.1%) and non-smokers (6.3%, 95% CI: 5.1%-7.6%). Conclusion:The rate of spirometry examination is extremely low among COPD patients aged ≥40 in China, and the standardized diagnosis, treatment and management of COPD patients need to be improved urgently.

Objective:To understand the medication treatment rate and its associated factors among chronic obstructive pulmonary disease (COPD) patients aged ≥40 years in China, and to provide basic data for targeted interventions to improve the diagnosis and treatment of COPD patients.Methods:Data were from COPD surveillance of Chinese residents in 2014-2015. Questionnaire and pre-bronchodilator and post-bronchodilator spirometry were performed on all respondents. Individuals with post-bronchodilator FEV 1/FVC<70% were diagnosed as COPD patients. A total of 9 120 COPD patients were included in the analysis. Based on the complex sampling design, the medication treatment rate and 95% CI among COPD patients were estimated, and the associated factors were analyzed. Results:The medication treatment rate for COPD patients aged ≥40 years was 11.7% (95% CI: 10.2%-13.0%), the treatment rate with inhaled medication was 3.4% (95% CI: 2.9%-4.0%), and the treatment rate with oral or intravenous medication was 10.4% (95% CI: 9.0%-12.0%). All treatment rates were higher in patients who knew that they had COPD before the investigation. The rate of medication treatment in patients aged ≥60 years was higher than that in patients aged <60 years. Medication treatment rate, and oral or intravenous medication treatment rate among women were higher than those among men. These two treatment rates in patients with harmful occupational exposure were higher than those in patients without exposure. The medication treatment rate, and oral or intravenous medication treatment rate in former smokers were higher than those in current smokers and never smokers. Patients who knew that they had COPD before the investigation had higher rates of three treatments than those who were not aware of their disease conditions. Those with respiratory symptoms had higher three treatments rates than those without symptoms. Conclusion:In China, the rate of medication treatment for COPD patients aged ≥40 years old, especially the rate of inhaled medication treatment was very low. Being aware of their own COPD status and the emergence of respiratory symptoms were important factors associated with COPD medication treatment. Early diagnosis of COPD should be strengthened and the level of standardized treatment for patients should be improved.

Objective: To assess the impact of Chinese Cervical Cancer Screening Program for Rural Area (NACCSPRA) on population-based screening rates. Methods: The subjects were selected from 2013-2014 Chinese Chronic Diseases and Risk Factors Surveillance (CDRFS2013), which adopting multi-stage stratified cluster sampling from 31 provinces. A total of 169 632 participants aged 18 years and older in 297 surveillance points were interviewed, of whom 65 476 women aged 35-64 years were included in the analysis. The surveillance points in CDRFS 2013 were divided into the screening areas and the control areas by matching points in CDRFS2014 with counties in NACCSPRA. The difference in socioeconomic status between areas was compared. The screening rates and 95% confidence interval (95%CI) were estimated by Tylar series variance method. The Propensity Score was evaluated for individuals by multivariate logistic regression and the greedy matching method based on propensity score value was used to conduct 1∶1 matching sample for the screening areas and the control areas. After matching, multivariate conditional logistic regression model was fitted to assess the impact of national cervical cancer screening intervention on the likelihood of undergoing cervical cancer screening at population level. Results: Among 65 476 subjects, 48.6% (n=31 794) was in the screening areas. Before matching, in the rural area the screening rate in the screening areas (24.0% (4 763/19 838), 95%CI: 21.8%-26.3%) was higher than that in the control areas (15.6% (2 331/14 942), 95%CI: 13.4%-17.8%); whereas in the urban area the screening rate in the screening areas (28.5% (3 413/11 956), 95%CI: 26.1%-31.0%) was similar to that in the control areas (26.3% (4 923/18 740), 95%CI: 24.1%-28.4%). After matching, in rural area the screening rate in the screening areas (23.2% (3 454/14 875), 95% CI: 20.9%-25.5%) was higher than that in the control areas (15.6% (2 315/14 875), 95% CI: 13.3%-17.8%); in urban area the screening rate in the screening areas (28.7% (3 202/11 146), 95% CI: 26.2%-31.2%) was higher than that in the control areas (23.1% (2 571/11 146), 95%CI: 20.9%-25.3%). Multivariate conditional logistic regression model showed that the cervical cancer screening rates in intervention areas significantly increased among women aged 35-64 years both in urban areas (OR=1.44, 95%CI: 1.34-1.54) and rural areas (OR=1.78, 95%CI: 1.67-1.90) as compared with those in control areas. Conclusion The implementation of Chinese cervical cancer screening program during the five years substantially increased the population-based screening rates both in urban and rural areas.

Objective To analyze the clinical effect of comprehensive intervention for viral meningitis children.Methods Seventy-eight children with viral meningitis were randomly divided into control group(n =36) and observation group (n =42),given routine intervention,and comprehensive intervention,respectively.The clinical efficacy,symptom relief time,discharge time,complication rate and satisfaction were compared between the two groups.Results The effective rate of the observation group was significantly higher,symptom relief time,hospitalization time and complication rate were significantly lower,and satisfaction was higher than that of the control group (P ＜0.05).Conclusion The comprehensive intervention has a significant clinical effect on pediatric viral encephalitis,and it can enhance patients'satisfaction,reduce time for symptom relief and improve the prognosis of complications.So it is worth promoting.

Objective To analyze the clinical effect of comprehensive intervention for viral meningitis children.Methods Seventy-eight children with viral meningitis were randomly divided into control group(n =36) and observation group (n =42),given routine intervention,and comprehensive intervention,respectively.The clinical efficacy,symptom relief time,discharge time,complication rate and satisfaction were compared between the two groups.Results The effective rate of the observation group was significantly higher,symptom relief time,hospitalization time and complication rate were significantly lower,and satisfaction was higher than that of the control group (P ＜0.05).Conclusion The comprehensive intervention has a significant clinical effect on pediatric viral encephalitis,and it can enhance patients'satisfaction,reduce time for symptom relief and improve the prognosis of complications.So it is worth promoting.

OBJECTIVETo compare design-based and model-based methods in descriptive analysis of complex sample.

METHODSA total of 1 000 samples were selected and a multistage random sampling design was used in the analysis of the 2010 China chronic disease and risk factors surveillance. For each simulated sample, cases with probability proportional age were randomly deleted so that sample age structure was deviated systematically from that of the target population. Mean systolic blood pressure (SBP) and prevalence of raised blood pressure, as well as their 95% confidence intervals (95%CI) were determined using design-based and model-based methods (routine method and multi-level model). For estimators generated from those 3 methods, mean squared error(MSE) was computed to evaluate their validity. To compare performance of statistical inference of these methods, the probability of 95%CI covering the true parameter(mean SBP and raised blood pressure prevalence of the population) was used.

RESULTSMSE of mean estimator for routine method, design-based analysis and multilevel model was 6.41, 1.38, and 5.86, respectively; and the probability of 95%CI covering the true parameter was 24.7%, 97.5% and 84.3%, respectively. The routine method and multi-level model probably led to an increased probability of type I error in statistical inference. MSE of prevalence estimator was 4.80 for design-based method, which was far lower than those for routine method (20.9) and multilevel model (17.2). Probability of 95%CI covering the true prevalence for routine method was only 29.4%, and 86.4% for multilevel model, both of which were lower than that for design-based method (97.3%).

CONCLUSIONCompared to routine method and multi-level model, design-based method had the best performance both in point estimation and confidence interval construction. Design-based method should be the first choice when doing statistical description of complex samples with a systematically biased sample structure.

OBJECTIVE: To evaluate the efficacy of personal sublingual immunotherapy (SLIT) with dermatophagoides to study the efficacy of dermatophagoides farinae drops for allergic rhinitis (AR) of different age groups. METHOD: The current study had analyzed the efficacy of SLIT in 150 patients with AR who were sensitized to house dust mites. All patients were treated with dermatophagoides farinae drops and combined with symptomatic treatment. The patients were divided into groups 1-5, group 1:17 patients (4-7 years old), group 2: 38 patients (> 7-12 years old), group 3:31 patients (> 12-18 years old), group 4: 38 patients (> 18 - 40 years old), group 5: 26 patients (> 40-63 years old). The total nasal symptom scores (TNSS) and total medicine scores (TMS) were recorded at each visit. Before and after SLIT for 0.5 year, 1 year and 1.5 to 2.0 years, the TNSS and TMS of each patient were evaluated. The dosage adjustment of immunotherapy according to the patient's symptoms were performed. RESULT: The TNSS and TMS had continuously improved significantly after SLIT for half year, 1 year and 1.5 to 2.0 years in all groups as compared with baseline (P < 0.05). There were no significant differences in the different age groups for TNSS and TMS during all time points. CONCLUSION Individualized SLIT with dermatophagoides farinae drops for 1.5-2.0 years is the most effective in the patients with allergic rhinitis of different age groups. And equivalent efficacy could be achieved for different age groups.
Adolescent ; Adult ; Age Factors ; Animals ; Antigens, Dermatophagoides ; administration & dosage ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic ; therapy ; Sublingual Immunotherapy ; Treatment Outcome ; Young Adult

Objective To investigate effects of ACUMED self-orientated elbow plate system in treatment of comminuted distal humeral fractures (type C) in adults.Methods Thirty-two adult cases of comminuted distal humeral fractures treated by open reduction and internal fixation with parallel dual plates from May 2009 to October 2010 were enrolled in the study.There were 17 males and 15 females,at average age of 60 years (range,21-85 years).All cases were subjected to closed fractures,involving left side in 15 cases and right side in 17.Besides,two cases had associated ulnar nerve injury.According to AO classification,there were 12 cases of type C1,12 of type C2 and eight of type C3 fractures.The time from injury to operation averaged 5.6 days.Distal humeri were exposed through posterior median incision of elbow and V shape osteotomy of olecroanon.Muscular contractile and relaxant functional exercise was taken within 24 hours postoperatively.Clinical results were assessed based on Mayo elbow performance score (MEPS) and X-ray films.Results X-ray films showed that all cases obtained primary bone healing in the follow-up (mean 12 months).Three cases of type C3 fractures had heterotopic ossification.All cases had no complications like infections or implant loosening postoperatively.Range of motion in elbow flexion and extension averaged 85° (range,8°-140°).MEPS was average 90 points (range,60-100 points),including excellent outcomes in 13 cases,good in 15,fair in one and poor in three,with excellence rate of 88％.Conclusion ACUMED parallel dual plate fixation technique based on stability theory of arch structure achieves solid fixation of adult comminuted distal humeral fractures,successfully reconstructs bone structure of distal humeri,and effectively restores elbow joint function in response to early rehabilitation exercise.