ObjectiveTo identify the key issues in emergency response to public health emergencies in the Yangtze River Delta region， and to provide a basis for the formulation of relevant policies. MethodLiterature on emergency response to public health emergencies in the Yangtze River Delta region was systematically reviewed and collected， and 18 main problems were identified after collecting and organizing the problems. A questionnaire survey and cluster analysis were used to identify the key issues. ResultsThe study of 18 major problems revealed that "insufficient reserve of emergency medical supplies"， "insufficient financial investment to meet the needs of emergency response"， "lack of a sound mechanism for the deployment of supplies， resulting in the untimely deployment of materials"， were the key issues of emergency response to public health emergencies in the Yangtze River Delta region. ConclusionFuture development of the emergency response system in the Yangtze River Delta region should focus on accelerating the integration process of the Yangtze River Delta， establishing and improving information systems， optimizing the material storage and deployment network， prioritizing the fund investment and utilization mechanism， and improving the effectiveness of public health emergency response.

Objective To investigate the effects of Osteoking on hyperglycemia and regulating gut microbiota in db/db mice.Methods Wildtype mice were used as the control group,and db/db mice were randomly divided into model and Osteoking groups.After intragastric administration for 12 weeks,fasting blood glucose and serum glycosylated hemoglobin and insulin levels were measured,changes in intestinal microflora were determined,and functional pathways related to intestinal microflora in mice were predicted by 16S rDNA sequencing.Results Compared with the model group,Osteoking decreased fasting blood glucose(P<0.01),serum glycosylated hemoglobin(P<0.01),and the insulin resistance index(P<0.01),and increased insulin content(P<0.01)in db/db mice.Osteoking increased the abundance of beneficial intestinal microflora and decreased the abundance of harmful bacteria.Moreover,the abundance of Marvinbryantia was increased.Osteoking alleviated the decrease in metabolism of D-arginine and D-ornithine,sphingolipid,and galactose metabolism(P<0.05)and inhibited lysine degradation,the sulfur relay system,and propanoate metabolism(P<0.05).Conclusions Osteoking has hypoglycemic properties and improves the intestinal microflora imbalance in db/db mice.

Objective     To investigate the early and long-outcomes of coronary artery bypass grafting(CABG) in acute myocardial infarction (AMI) patients with coronary artery disease(CAD)(age≤45 years). Methods     Data of 596 adult CAD patients (include AMI and Angina) who underwent CABG in our hospital were collected retrospectively from May 2010 to October 2018. In an AMI group, 234 were male patients with an average age of 41.59±3.79 years; 26 were female patients with an average age of 41.64±3.03 years. In an angina group, 280 were male patients with an average age of 42.19±2.90 years; 56 were female patients with an average age of 41.54±3.52 years. Preoperative baseline variables, perioperative mortality, major adverse cardiac and cerebrovascular events (MACCE) were compared between two group.  Results    There was no significant difference in all preoperative variables. Seven patients were died and the hospital mortality rate was 1.23% (1.54% vs. 0.89%, P=0.477). The complications including reoperation for bleeding, cerebral infarction, renal failure and atrial fibrillation arrhythmia were without significant difference between two group  (P>0.05). The intensive care unit stay duration (30.66±27.46 h vs. 23.96±15.11 h), intubation duration (22.54±22.31 h vs. 18.64±11.81 h) and hospitalization costs (97 186±33 741¥ vs. 90 081±24 537¥, P=0.003) were greater in the AMI group. The hospital mortality rate and complications rate were without significant difference between STEMI (ST segment elevated myocardial infarction) and NSTEMI (non-ST-segment elevated myocardial infarction) subgroups (P>0.05). The follow-up rate was 92.6% (546 patients) and the follow-up time was 4 (0.5 to 8.5) years. All cause-mortality rate was 3.85%(21 patients), and freedom MACCE was 72.2%. The freedom from MACCE, recurred angina and cerebral infarction were without significant difference, but AMI was associated with higher rate of PCI procedure.  Conclusion     CABG procedure in CAD patients under 45 years accompanied AMI is safety and reliable both in early and the long-term outcomes.

Objective To investigate the outcomes of coronary artery bypass grafting(CABG) in insulin-treated diabetes mellitus(DM) patients with coronary artery disease(CAD) (age≤45 years old),and analyze the risk factors of major adverse cardiac and cerebrovascular events(MACCE) by logistic regression.Methods Data on 239 CAD patients combined with DM aged ≤45 who underwent CABG in our hospital were collected retrospectively from October 2007 to October 2016.There were 216 males and 23 females,the mean age was (42.15 ±2.59) years old.The mean LVEF was 0.59 ±0.09.43 patients (18.0％) had left main stenosis,and the average diseased vessel number was 3.20 ± 0.76.Results One patients (0.4％)in-hospital died of heart failure.Patients received (3.12 ±0.81) bypass grafts overall,12 patients (5.0％) were total artery revascularization.3 patients (1.3％) needed reoperation for bleeding and the perioperative atrial fibrillation rate was occured in 23 patients (9.6％).The follow-up rate was 95％ (226 cases),the median follow-up time was 5 years (1-9 years).8 patients (3.3％) died of all cause-mortality,and 183 patients (81.0％) were freedom from MACCE.The higher level of BMI、cholesterol and creatinine,LVEF ≤0.35,postoperative blood loss ≥ 1 000 ml and ventricular arrhythmia were the independent risk factors of MACCE.Conclusion CABG procedure in CAD patients under 45 years old accompanied DM is safety and reliable both in early and long-term outcomes.

Objective: The aim of this study was to investigate the effect of co-culture with AEC (amniotic epithelial cell) on the biological characteristics of AMSC (amniotic mesenchymal stem cell), and to investigate the roles of SDF-1/CXCR4 axis in the homing and migration of AMSC. Methods: AMSC andAEC were isolated from human amnion, and then cultured, amplified and identified, respectively. TheAMSC were divided into three groups:AEC co-cultured group, serum-free cultured group and serum cultured group.After culture for 24 h, 48 h, and 72 h, the proliferation viability ofAMSC was measured by CCK-8 assay and trypan blue staining; the expression of CXCR4 mRNAwas analyzed by flow cytometry and Real-time RT-PCR, and the migration ability ofAMSC in vitro was observed by migration assay. Results: Cell viability (48 h and 72 h) and survival rate in the co-culture and serum groups were higher than those in the serum-free group (all P<0.05). The mRNA and protein expressions of CXCR4 in AMSC of the co-culture and serum-free groups were significantly higher than those of the serum group (P<0.05). The migration ability of AMSC in the co-culture and serumfree groups, which increase with the SDF-1 (stromal cell derived factor-1) concentration gradient, were higher than that in the serum group (P<0.05). Conclusion: AMSC co-cultured with AEC still have the basic biological characteristics of MSC, and showed good growth activity. Co-culture withAEC can up-regulate CXCR4 onAMSC surfaces and enhance the migration ability ofAMSC in vitro.

OBJECTIVETo evaluate the application of multidisciplinary treatment (MDT) in patients with liver metastasis of colorectal cancer(CLM).

METHODSClinical data of 118 patients with liver metastasis of colorectal cancer, including 32 patients with MDT (MDT group) and 86 patients without MDT (control group), from February 2014 to April 2015 in PLA General Hospital were analyzed retrospectively. Compliance of preoperative examination and adjuvant therapy, and efficacy-associated indexes were compared between the two groups.

RESULTS(1) As compared to control group, statistically significant increase in imaging examination ratio was found in MDT group: chest CT [87.5%(28/32) vs. 40.7%(35/86), P=0.0000], abdominal MRI [84.4%(27/32) vs.61.6%(53/86), P=0.019], pelvic MRI [63.7%(7/11) vs. 24.3%(8/33), P=0.017]. The preoperative assessment of TNM staging was also higher in MDT group [100%(32/32) vs. 20.9%(18/86), P=0.0000], while there was no significant difference in accuracy rate of TNM staging between the two groups [81.3%(26/32) vs. 66.7%(12/18), P=0.2465]. (2) Rates of preoperative chemotherapy and chemotherapy completion were also higher in MDT group than those in control group [90.6%(29/32) vs. 62.8%(54/86), P=0.0033; 82.8% (24/29) vs. 57.4% (31/54), P=0.000], but conversion rate of unresectable CLM showed no significant difference [24.0% (6/25) vs. 14.3% (7/49), P=0.299 ]. (3) Rate of one-stage resection or ablation was higher in MDT group compared to control group [76.9%(10/13) vs. 36.0%(9/25), P=0.038], and resection rate of metastasis nidus was also higher in MDT group [77.0%(20/26) vs. 44.9%(13/29), P=0.015]. No significant differences were observed in rates of R0 resection, positive surgical margin, lymph node clearance, ablation of metastasis nidus, pathological complete response, postoperative chemotherapy or postoperative complications (all P>0.05).

CONCLUSIONMDT has the advantages on standardization of preoperative examination and perioperative chemotherapy, and can improve the rate of one-stage resection or ablation, as well as resection of metastasis nidus.

Aged ; Colorectal Neoplasms ; pathology ; Combined Modality Therapy ; Female ; Hepatectomy ; Humans ; Liver Neoplasms ; secondary ; therapy ; Lymph Nodes ; Male ; Middle Aged ; Neoplasm Staging ; Postoperative Complications ; Retrospective Studies ; Tomography, X-Ray Computed ; Treatment Outcome

Objective Using the scientific thinking mode,applied the standardized training in zero-based assistant of laparoscopic gastrointestinal surgery,observe and explore the effect of shorten learning curve.Methods Took 40 students studied in our hospital from February 2013 to December 2014 as object of our study,who were randomly divided into Group Ⅰ and Group Ⅱ.Group Ⅰ was given standardized training,group Ⅱ was given regular training.After total 200 cases of laparoscopic assisted colectomy,5cases each doctor,we analyzed the two teams outcome of surgery cooperation.Results Compared with the control group,doctors from observation group were better in the surgery cooperation and the examination.Conclusions Standardized training is very meaningful for the zero-based assistant of laparoscopic gastrointestinal surgery.

Objective:To study the changes of Th17,regulatory T(Treg) cells and IL-17,IL-23 levels at acute phase and recovery phase in children with Henoch-Schonlein purpura(HSP) in order to further understand the immunological pathogenesis and provide help for treating HSP. Methods:The vein blood samples were collected from 65 children with HSP and 30 normal children. The proportion of Th17 cells and regulatory T cells were tested by FCM and concentration of IL-17 and IL-23 in plasma were tested by ELISA. Results:Compared with normal children,the levels of Th17,Th17/Treg and IL-17,IL-23 were in increase at acute phase in children with HSP(P<0. 05). At recovery phase,that were in decrease compared with the acute phase(P<0. 05),but still higher than the normal children(P<0. 05). Compared with normal children,the level of Treg was in decrease at acute phase in children with HSP (P<0. 01). At recovery phase,that was in increase compared with the acute phase(P<0. 01),but still lower than the normal children (P<0. 01). Among the simplex,abdominal and other type of children with HSP,the levels of Th17,Treg,Th17/Treg and IL-17,IL-23 were same( P>0. 05 ) . At acute phase in children with HSP, Th17 cells percentage had positively correlated with IL-17 levels ( r=0. 880,P<0. 01),IL-23 levels had positively correlated with Th17 cells percentage and IL-17 levels (r=0. 838 or 0. 877,P<0. 01). Conclusion:Th17,Treg,Th17/Treg,IL-17 and IL-23 are involved in the course of the immunological pathogenesis in children with HSP,but the levels of that have no significant difference among simplex,abdominal and other types,further researches need to be done.

OBJECTIVETo explore the present contamination status and profile of toxaphene in fish, chicken and meat samples in Pearl River Delta area.

METHODSTotally 60 independent samples including fish, chicken, meat were collected from Huizhou,Guangzhou,Dongguan,Jiangmen of Pearl River Delta area in Guangdong by purposive sampling from Oct 2010 to Jun 2011. Toxaphene monomer Parlar26, Parlar50 and Parlar62 levels in three various categories of foods were quantitatively and qualitatively analyzed referencing international authoritative standard methods by utilizing isotope dilution high-resolution gas chromatography/high-resolution double-focusing magnetic mass spectrometry (HRGC-HRMS). The levels of pollution and characteristics were compared.

RESULTSThe concentration of toxaphene median(M) in fish, chicken and meat were 12.87, 5.8 and 1.89 ng/kg (gross weight) , respectively and the difference was significant(H = 14.29, P = 0.001). The toxaphene level in seafish (M = 32.07 ng/kg) was significantly higher than that in freshwater fish (M = 10.63 ng/kg, Z = -2.52, P = 0.012). The profile analysis showed that Parlar50 and Parlar26 were the predominant characteristic monomers in fish, which contributed about 44% (9.91/22.60, ng/kg) and 39% (8.89/22.60, ng/kg) to total concentration, and Parlar62 and Parlar26 were the two predominant congeners in poultry products, the two congeners accounted for 42% (5.03/11.90, ng/kg) and 38% (4.58/11.90, ng/kg). Furthermore Parlar26 and Parlar62 made up about 57% (3.45/6.08, ng/kg) and 26% (1.58/6.08, ng/kg) of total concentration in livestock meat respectively.

CONCLUSIONToxaphene levels in all tested food samples are far lower than the limited standard stipulated by the European Food Safety Authority (EFSA) in 2002, which was 0.1 mg/kg. The congener characteristic difference in the three categories food indicated that the different enrichment ability in Toxaphene in different animal species.

Animals ; Chromatography, Gas ; Fishes ; Food Contamination ; Insecticides ; Meat ; Poultry ; Toxaphene

Objective To explore the present contamination status and profile of toxaphene in fish, chicken and meat samples in Pearl River Delta area.Methods Totally 60 independent samples including fish,chicken,meat were collected from Huizhou,Guangzhou,Dongguan,Jiangmen of Pearl River Delta area in Guangdong by purposive sampling from Oct 2010 to Jun 2011.Toxaphene monomer Parlar26,Parlar50 and Parlar62 levels in three various categories of foods were quantitatively and qualitatively analyzed referencing international authoritative standard methods by utilizing isotope dilution high-resolution gas chromatography/high-resolution double-focusing magnetic mass spectrometry ( HRGC-HRMS ) .The levels of pollution and characteristics were compared.Results The concentration of toxaphene median(M) in fish,chicken and meat were 12.87,5.8 and 1.89 ng/kg(gross weight),respectively and the difference was significant(H=14.29,P=0.001).The toxaphene level in seafish(M=32.07 ng/kg)was significantly higher than that in freshwater fish(M=10.63 ng/kg,Z=-2.52,P=0.012).The profile analysis showed that Parlar50 and Parlar26 were the predominant characteristic monomers in fish,which contributed about 44%(9.91/22.60, ng/kg) and 39%(8.89/22.60, ng/kg) to total concentration,and Parlar62 and Parlar26 were the two predominant congeners in poultry products,the two congeners accounted for 42%(5.03/11.90, ng/kg) and 38%(4.58/11.90, ng/kg).Furthermore Parlar26 and Parlar62 made up about 57%(3.45/6.08, ng/kg) and 26% ( 1.58/6.08, ng/kg ) of total concentration in livestock meat respectively.Conclusion Toxaphene levels in all tested food samples are far lower than the limited standard stipulated by the European Food Safety Authority(EFSA) in 2002,which was 0.1 mg/kg.The congener characteristic difference in the three categories food indicated that the different enrichment ability in Toxaphene in different animal species.