Objective:In order to understand the changing trends of gastric cancer incidence and mortality in early-onset and late-onset in China from 2000 to 2019.Methods:The Global Burden of Disease research data was collected, and Excel and R 4.2.1 softwares were used to examine the incidence rate, mortality rate, and disability-adjusted life years (DALY) of Chinese people from 2000 to 2019, with a focus on gender, age, and year.Results:In 2019, the crude incidence rates were 7.06/100 000 (95% UI: 6.63/100 000-7.59/100 000) and 114.52/100 000 (95% UI: 108.79/100 000-121.63/100 000) for early- and late-onset gastric cancer, respectively. The crude mortality rate for early-onset gastric cancer was 3.29/100 000 (95% UI: 3.11/100 000- 3.50/100 000), while the crude mortality rate for late-onset gastric cancer was 81.88/100 000 (95% UI: 78.15/100 000-86.04/100 000). Additionally, the crude DALY rates for these two types of gastric cancer were 156.48/100 000 (95% UI: 148.82/100 000-165.84/100 000) and 1 750.13/100 000 (95% UI: 1 661.21/100 000-1 852.99/100 000). The standardized incidence of early-onset gastric cancer decreased from 5.49/100 000 in 2000 to 4.76/100 000 in 2019, and that of late-onset gastric cancer decreased from 143.45/100 000 in 2000 to 123.02/100 000 in 2019.The standardized mortality rate of early-onset gastric cancer decreased from 4.16/100 000 in 2000 to 2.18/100 000 in 2019, and that of late-onset gastric cancer decreased from 140.82/100 000 in 2000 to 91.49/100 000 in 2019. The standardized DALY rate for early-onset gastric cancer in 2019 was 105.87/100 000 (95% UI: 87.98/100 000 -125.60/100 000), lower than 198.84/100 000 (95% UI: 179.47/100 000- 219.83/100 000) in 2000. The standardized DALY rate for late onset gastric cancer in 2019 was 1 821.11/100 000 (95% UI: 1 509.42/100 000-2 158.53/100 000), lower than 2 932.52/100 000 (95% UI: 2 665.92/100 000-3 252.60/100 000) in 2000. Conclusions:The standardized mortality rate of early-onset gastric cancer in China showed a decreasing trend from 2000 to 2019. The standardized mortality rate of late onset gastric cancer showed a trend of first increasing and then decreasing. Notably, the incidence, mortality, and DALY of late-onset gastric cancer were significantly higher than those of early-onset gastric cancer during this period. Additionally, male incidence, mortality, and crude DALY rates were higher than female.

Objective: To explore the effects of melatonin(MT) on the fertilization of in vitro matured oocytes in controlled ovarian hyperstimulation(COH) cycles and the development of subsequent embryos. Methods: Imma-ture human oocytes from COH cycles were collected for in vitro maturation(IVM) culture and intracytoplasmic sperm injection( ICSI) insemination,and then the cleavage embryo and blastocyst culture medium supplemented with 0,10-11,10-9,10-7or 10-5mol/L MT were used in order to perform embryo culture in vitro,next the formed high-quality blastocysts were picked up and cryopreserved via vitrification,finally,array-CGH technology was used to detect aneuploidy of rewarmed high-quality blastocysts. Results: The blastocyst rate of 10-9mol/L group was significantly higher than that of 10-11,10-7,10-5and 0 mol/L groups( P<0. 05,P<0. 01,P<0. 000 1,P<0. 01),respectively; the high-quality blastocyst rate of 10-9mol/L group was higher than that of other groups,but there were only significant differences compared with 10-5mol/L and 0 mol/L groups( P<0. 01,P<0. 05); the incidence of aneuploidy in MT group( 17. 6%) was lower than that in non-MT group( 33. 3%),but no significant difference was found. Conclusion The addition of MT to human embryo culture medium can promote the in vitro development of embryo,which is related to concentration,and 10-9mol/L is the optimal concentration.

Objective : To investigate whether the application of melatonin (MT) in embryo culture in vitro can improve the treatment effect of in vitro fertilization embryo transfer(IVF⁃ET) in patients with decreasing ovarian reserve (DOR) . Methods : 128 DOR patients receiving assisted reproductive therapy were collected. All patients were treated with an antagonist scheme of super⁃ovulation. Patients were divided into melatonin group (n = 56) and control group (n = 72) according to whether melatonin ( melatonin concentration 10 - 9 mol/L) was added into embryo culture medium. Results : There was no statistically significant difference in oocytes fertilization rate and cleavage rate between the two groups during later embryo culture , but blastocyst formation rate ( 65. 22% vs 56. 16% ) and high⁃quality blastocyst rate (52. 96% vs 40. 94% ) in the melatonin group were higher than those in the control group , and the differences were statistically significant ( P < 0. 05 ) . There were no significant differences in the implantation rate (50. 00% vs 38. 67% ) and clinical pregnancy rate (48. 39% vs 46. 00% ) of blastocysts after freezing⁃thawing between the two groups , but the cycle number of high⁃quality blastocysts obtained in the melatonin group was higher than that in the control group (85. 71% vs 69. 44% ) , and the difference was statistically significant (P < 0. 05) . Conclusion In a way , the application of melatonin in the in vitro culture of early embryos can promote the development of oocytes in patients with DOR , improve the quality of embryos , and finally substantially improve the therapeutic effect of such patients.

Objective:The diagnostic values of urine free and fractionated catecholamine metabolites (including metanephrine MN and normetanephrine NMN, usually known as MNs) were established and their clinical value was evaluated.Methods:Using high performance liquid chromatography tandem mass spectrometry(HPLC-MS/MS), urine free MNs (f-MN, f-NMN) and fractionated MNs(t-MN, t-NMN) from 180 cases of non-pheochromocytoma and 54 cases of pheochromocytoma (PCC)patients were detected respectively.Receiver operating characteristic curve (ROC) was used to establish clinical reference cut-off value for different forms of MNs, and diagnostic efficacy of free, fractionated and total MNs was evaluated.Results:(1) The cut-off values of f-MN, f-NMN, t-MN and t-NMN were 47.8 μg/24 h, 52.3 μg/24 h, 224.9 μg/24 h and 664 μg/24 h, respectively. The cut-off values of total f-MNs and total t-MNs were 126 μg/24 h and 1 070 μg/24 h, respectively. (2) The correlation between f-MN and t-MN ( r=0.976, P<0.001), f-NMN and t-NMN ( r=0.940, P<0.001) was good. The area under ROC curve(AUC)of f-MN was lower than that of t-MN(0.579 vs 0.730, P<0.001), the sensitivity was slightly lower than that of t-MN((37.01% vs 51.85%, P=0.036), and the specificity was similar (99.44% vs 96.67%, P>0.05). There was no significant difference in sensitivity (90.74% vs 92.59%, P>0.05), specificity (99.44% vs 96.67%, P>0.05) and AUC (0.944 vs 0.959, P>0.05) between f-NMN and t-NMN. The combined diagnostic value of MN and NMN (total MNs) was higher than MN (free type:0.932>0.579, fractionation type: 0.960>0.730), which was similar to NMN. Conclusions:The diagnostic performance of urine free NMN or total MNs for PCC is similar to that of fractionated typewhich can meet the clinical needs.With few influencing factors, free type MNs may be used as an alternative indicator for PCC screening in the future.

Objective: To investigate the relationship between UGT1A1*6, UGT1A1*28, UGT1A1*60 and UGT1A1*93 polymorphisms and irinotecan-induced severe adverse reactions(grade 3-4 delayed diarrhea and neutropenia) in Chinese cancer patients. Methods: A total of 141 cancer patients treated with irinotecan were enrolled in this study. Peripheral venous blood was collected and genomic DNA was extracted. The genetic polymorphisms of UGT1A1*6, UGT1A1*28, UGT1A1*60 and UGT1A1*93 were analyzed by PCR and direct sequencing. The adverse reactions during chemotherapy were observed and recorded. The incidence of severe adverse reactions was compared among patients with different genotypes. Results: Among 141 patients, the cases with UGT1A1*6 GG, GA and AA genotypes were 71, 54 and 16, while those with UGT1A1*28 TA6/6, TA6/7 and TA7/7 genotypes were 105, 33 and 3, respectively. The cases with UGT1A1*60 AA, AC and CC genotypes were 52, 80 and 9, while those with UGT1A1*93 GG, GA and AA genotypes were 105, 32 and 4, respectively. The patients with grade 3-4 delayed diarrhea and neutropenia were 23 and 56, respectively. Multivariate logistic regression analysis showed that UGT1A1*6 and UGT1A1*60 genetic polymorphisms were independent factors influencing the occurrence of grade 3-4 delayed diarrhea. The risk of grade 3-4 delayed diarrhea in homozygous AA carriers of UGT1A1*6 increased 3.79 times compared with that in wild-type GG carriers (95%CI: 1.35-10.67). Moreover, the risk of grade 3-4 delayed diarrhea in homozygous CC carriers of UGT1A1*60 was 20.42 times compared with that in wild-type AA carriers (95%CI: 3.52-118.33). In addition, UGT1A1*28 genetic polymorphism was an independent factor of the occurrence of grade 3-4 neutropenia. The patients with homozygous TA7/7 carriers of UGT1A1*28 had an 1.61 times higher risk of grade 3-4 neutropenia compared with those with wild-type TA6/6 carriers (95%CI: 1.44-12.65). There was no correlation between UGT1A1*93 genetic polymorphism and severe adverse reactions caused by irinotecan. Conclusion The cancer patients who carried UGT1A1*6, UGT1A1*28 and UGT1A1*60 gene polymorphisms have high risk of severe adverse events caused by irinotecan-based chemotherapy.

Objective To validate the analytical performance of a cardiac troponin I(cTnI)assay AccuTnI+3 on chemiluminescnet analyzer DXI800 and Access2;and to establish the 99th percentile of cTnI in an apparently healthy Chinese population.Methods The subjects are composed of 1 369 apparently healthy people and 20 acute myocardial infarction(AMI)patients from Wuhan Asian Heart Hospital and Fuwai Hospital from October 2014 to June 2015.The healthy people include 680 males and 689 females;with 340 subjects aged 18-30,674 subjects aged 31-64, and 355 subjects aged ≥65.The detection limits and imprecision of AccuTnI +3 assays were validated according to CLSI EP 15-A2 and EP17-A2 documents;the same samples were analyzed on DXI800 and Access2 to assess the consistency between the two analyzers using Bland Altman plot and Passing-Bablok regression.The correlation between different sample types (lithium heparin plasma, EDTA plasma & serum)were assessed using linear regression analysis.The lithium heparin plasmasamples from 1 369 apparently healthy people were analyzed to calculate the 99th percentile of cTnI.The cTnI concentrations were compared among age and sex groups.The 99th percentile of cTnI were also calculated for each group.The detection rate of cTnI in apparently healthy people was calculated using SPSS23.0.Results The limit of blank(LoB), limit of detection(LoD), and limit of quantification(LoQ)where CV%=10% were 0.007 ng/ml,0.010 ng/ml and 0.016 ng/ml on DXI800;0.008 ng/ml,0.012 ng/ml and 0.026 ng/ml on Access2,respectively.The cTnI measurements on DXI800 and Access2 were consistent and comparable.The cTnI concentrations of lithium heparin plasma, EDTA plasma and serum samples were linearly correlated pairwise: EDTA plasma measuremen t =0.76 heparin plasma measurement, R2=0.999(n=40, P<0.001); serum measuremen t =1.05 heparin plasma measurement,R2=0.996(n=40,P<0.001); serum measuremen t=1.38 EDTA plasma measurement, R2=0.993(n=40,P<0.001).The 99th percentiles were 0.030 ng/ml and 0.035 ng/ml on DXI800 and Access2,respectively,from 1 369 apparently healthy Chinese people.cTnI is significantly higher in elder group than in younger group.The 99th percentiles in 18-30 years old group,31-64 years old group,and≥65 years old group are:0.011 ng/ml,0.029 ng/ml,and 0.035 ng/ml respectively for DXI800;0.023 ng/ml,0.034 ng/ml, and 0.045 ng/ml respectively for Access2.cTnI is significantly higher in men than in women.The 99th percentiles in men and women are: 0.034 ng/ml and 0.032 ng/ml respectively for DXI800;0.043 ng/ml and 0.031 ng/ml respectively for Access2.cTnI was measurable in 62%and 87%of healthy subjects on DXI800 and Access2 systems,respectively.Conclusions The analytical performance of AccuTnI+3 assay fulfills the need of clinical use and the criteria of high-sensitive cardiac troponin assay.

Objective To analyze the distribution and antibiotic resistance of the microorganisms isolated from blood samples in the Cardiovascular Institute,Beijing Fuwai Hospital,for clinicians to improve antimicrobial therapy.Methods Blood samples were cultured and bacterial isolates were identified and tested for their susceptibility to antimicrobial agents.Results A total of 2 017 (8.3％) strains of microorganisms were isolated from 24 348 blood samples.Finally,1 009 nonduplicate strains were analyzed,including gram positive cocci (n=574,56.9％),gram negative bacilli (381,37.8％),and Candida species (54,5.4％).The top gram positive cocci were coagulase-negative Staphylococcus (31.8％),Streptococcus (11.0％),Staphylococcus aureus (5.5％),Enterococcus faecalis (4.0％),and Enterococcus faecium (1.5％).The top gram negative bacilli were Acinetobacter baumannii (6.7％),Pseudomonas aeruginosa (6.0％),Escherichia coli (5.7％),Klebsiella pneumoniae (4.3％),Stenotrophornonas maltophilia (3.5％),and Enterobacter cloacae (3.3％).Candida albicans was the most frequently isolated Candida species.Staphylococcus isolates were sensitive to linezolid,vancomycin,tigecycline,and quinupristin-dalfopristin.Enterococcusfaecalis were sensitive to linezolid,tigecycline,high level streptomycin,high level gentamicin,penicillin,ampicillin,and vancomycin.Enterococcus faecium were less sensitive than Enterococcus faecalis.All Enterococcus strains were sensitive to linezolid,tigecycline,high level streptomycin,high level gentamicin,and vancomycin.Gram negative bacilli were relatively sensitive to cefoperazone-sulbactam,piperacillin-tazobactam,cefepime,amikacin and carbapenems.A.baumannii and P.aeruginosa isolates showed lower susceptibility to carbapenems than E.coli,K.pneumoniae and E.cloacae.Conclusions The distribution of the pathogens isolated from blood samples was relatively stable in the past five years in our hospital.Gram positive cocci are more prevalent than gram negative bacilli in blood samples.Clinicians should select antimicrobial agents according to the distribution of pathogens and the antimicrobial resistance profile.

As a necessary diagnostic criteria for acute myocardial infarction ,the sensitivity of cardiac troponin is of great significance in clinical diagnosis and treatment .Commercial kits also experienced several generations , and gradually entered the era of high sensitivity . High sensitivity era has brought us opportunities and challenges , the higher sensitivity greatly promotes the efficiency of early diagnosis , highlights the risk assessment and prognostic value , but it also leads to the reduction of diagnostic specificity, we must understand the application features so we can meet the challenges better .In this article we elaborated the application value of high-sensitivity troponin and some matters needing attention .

Objective??To?evaluate?the?effects?of?Icariin?(ICA)?on?the?proliferation?and?osteogenic?differentiation?of?human?periodontal?ligament?stem?cells?(hPDLSCs)?in vitro and?in vivo. Methods??An?enzymatic?digestion?block?was?used?in vitro?to?culture?hPDLSCs,?which?were?separated?and?purified?by?limited?dilution?cloning.?The?hPDLSCs?were?identified?using?cell-surface?markers?and?cocultured?with?1×10?7 mol·L?1 ICA?solution.?The?proliferation?ability?of?these?cells?was?determined?by?thiazolyl?blue?tetrazolium?bromide?(MTT)?assay.?After?staining?with?alkaline?phosphatase?(ALP),?osteogenesis?was?detected?by?enzyme-linked?immunosorbent?assay.?Osteoblast-related?genes?were?analyzed?by?reverse?transcription-polymerase?chain?reaction.?Alizarin?red?staining?was?performed?to?measure?the?level?of?calcium?deposition.?The?hPDLSCs?were?cocultured?with?1×10?7 mol·L?1 ICA?and?nano-hydroxyapatite?scaffolds?in vivo?before?transplantation?into?subcutaneous?tissues?of?nude?mice.?Osteogenic?abilities?were?histochemically?analyzed?after?30?days?of?induction.?Results??The?hPDLSCs?were?affected?by?1×10?7 mol·L?1 ICA,?and?MTT?assay?showed?that?the?proliferation?of?the?groups?treated?with?ICA?in vitro?was?better?than?that?of?the?control?groups?on?the?second?day.?The?ALP?activity?of?the?treated?hPDLSCs?was?significantly?enhanced?after?cell?culture?for?3,?5,?and?7?days.?The?gene?expression?of?osteoblastic?markers?was?also?significantly?enhanced?after?7?days.?The?deposition?of?mineralization?after?incubation?with?1×10?7 mol·L?1?ICA?increased?compared?with?the?control?after?cell?culture?for?14,?21,?and?28?days.?Furthermore,?the?bone?expression?of?the?treatment?groups?in vivo?was?significantly?enhanced?com-pared?with?that?of?the?control?groups.?Conclusion??Treatment?with?1×10?7 mol·L?1 ICA?can?significantly?promote?proliferation?and?differentiation?of?hPDLSCs?in vitro?and?in vivo.?ICA?can?effectively?function?as?a?bioactive?growth?factor?in?periodontal?tissue?engineering?to?replace?traditional?growth?factors.

Objective To study the impact of thalidomide on the immunological liver injury animal model in mice .Methods The immunological liver injury animal model was established in mice by injection of Bacillus Calmette-Guerin(BCG) and lipopolysaccha-ride (LPS) .These mice were randomly divided into five groups :normal control group ,model group ,positive medicine group (cyclo-phosphamide 100 mg/kg ,ip ,1 ,3 and 5 days after inoculation) ,Salle Lenalidomide (low ,medium and high dose group) ,and all of the mice were continuously administrated for 15 days ,the index of liver and spleen were detected ;Spectrophotometric was used to detect the levels of serum ALT ,AST and the content of MDA ,SOD ,GSH-Px in liver homogenates ;HE stain was used to exanimate the liver histopathology for the pathological grading and scoring of liver injury ;ELISA was used to measure the expression of TGF-β1 , IL-6 in liver homogenates ;RT-PCR was used to detect the mRNA expression of TNF-αin liver tissue .Results Thalidomide can re-duce the ALT ,AST ,MDA contents in these mice model ,increase the SOD ,GSH-Px activities and significantly reduce the index of liver and spleen of the mice with immunological liver injury (P<0 .05 or P<0 .01);also it can reduce the TGF-β1 ,IL 6 expression , inhibit TNF-αmRNA expression ,and reduce the damage degree of liver pathology .Conclusion Thalidomide can relieve the liver fi-brosis after immunological liver injury ,playing a protective role in the immunological liver injury mice model ,and its mechanism may be related to the inhibition of TGF-β1 and TNF-αexpression and the balance of cytokines .