Objective: To analyze the strengths, weaknesses, opportunities and threats of the construction on intelligent vaccination clinics in Zhejiang Province, so as to provide countermeasures for promoting the construction of intelligent vaccination clinics in Zhejiang Province. Methods: By reviewing the annual reports of Zhejiang immunization planning, survey data from Zhejiang Centers for Disease Control and Prevention and Immunization Intelligent Service System, data of human resources of immunization planning, vaccine procurement, construction progress of intelligent vaccination clinics and vaccination were collected. The relevant literature was searched to gather information on the construction standards and norms of intelligent vaccination clinics. The analysis of the strengths, weaknesses, opportunities and threats (SWOT) of the construction of intelligent vaccination clinics was conducted, and corresponding countermeasures and suggestions were proposed. Results: The National Immunization Program reported vaccine rate in Zhejiang Province is more than 99%, and standardized vaccination clinics have been popularized throughout the province. The vaccination staff are professional, and a province-wide intelligent immunization service information system has been established, providing the resources and conditions for the construction of intelligent vaccination clinics. However, there are problems such as low data quality and matching efficiency in vaccination, insufficient data interoperability and sharing, unbalanced regional capabilities in intelligent transformation, and uneven distribution of talent and resources. It is crucial to seize the opportunities presented by the development of big data and artificial intelligence, rely on the regional development of the Internet and health industry, seize the opportunity of rapid growth in demand for intelligent vaccination services and high public acceptance, accelerate the construction of intelligent vaccination clinics, and establish intelligent vaccination service standards as soon as possible. Conclusion We should seize the opportunities presented by the digital reform and development, fully utilize the existing vaccination resources and strengths, address the shortcomings, and accelerate the construction of intelligent vaccination clinics in Zhejiang Province.

Objective:To explore the mechanism of dendritic cells(DCs),novel regulatory B cells(B10 cells)and Th17/Treg imbalance in the pathogenesis of patients with chronic obstructive pulmonary disease(COPD)and their correlation with lung function.Methods:According to the"Guidelines for the Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease"a total of 93 COPD patients were prospectively selected from the Ninth People's Hospital of Suzhou from May 2019 to December 2021,and 50 healthy subjects were selected as the control group.The patients were followed up for 1 year to observe the occurrence of acute exacer-bation COPD(AECOPD),and divided them into stable COPD group and AECOPD group.The course of disease,modified British Medical Research Society dyspnea index(mMRC)classification,COPD assessment test(CAT)score,BODE index score,6 min walking distance(6MWD),arterial partial pressure of oxygen(PaO2),arterial carbon dioxide Partial pressure(PaCO2)were com-pared between the two groups;compared the levels of FEV1,FVC,FEV1/FVC,and the percentage of FEV1 to predicted value(FEV1/Pred)in the three groups with peripheral blood DCs,B10 cells,Th17 cells,Treg cells and Th17/Treg,IL-12,IL-10,IL-17A and TGF-β1 levels.To analyze the correlation between peripheral blood DCs cells,B10 cells and Th17/Treg imbalance and pulmonary function indexes in AECOPD group.Logistic regression analysis of independent risk factors for AECOPD.Results:A total of COPD pa-tients had AECOPD events(40.86%).The course of disease,mMRC grade,CAT score,BODE index score,and PaCO2 in AECOPD group were significantly higher than those in COPD stable group(P<0.05),6MWD and PaO2 were significantly lower than those in COPD group.The levels of FEV1,FVC,FEV1/FVC and FEV1/Pred in the AECOPD group were significantly lower than those in the stable COPD group and control group(P<0.05);the levels of FEV1,FVC,FEV1/FVC and FEV1/Pred in the stable COPD group were significantly lower than those in control group(P<0.05).DCs,B10 cells and Treg cells in AECOPD group were significantly lower than those in stable COPD group and control group,while Th17 expression level and Th17/Treg were significantly higher than that in stable COPD group and control group(P<0.05).DCs,B10 cells and Treg cells in stable COPD phase were significantly lower than those in control group,while Th17 expression level and Th17/Treg were significantly higher than control group(P<0.05).The ex-pression levels of IL-12,IL-10 and TGF-β1 in the AECOPD group were significantly lower than those in the stable COPD group and control group(P<0.05),while IL-17A was significantly higher than that in the stable COPD group and control group.The expression levels of IL-12,IL-10 and TGF-β1 in patients with stable COPD were significantly lower than control group,while IL-17A was signifi-cantly higher than control group(P<0.05).Pearson analysis showed that peripheral blood DCs,B10 cells were positively correlated with FEV1,FVC,FEV1/FVC and FEV1/Pred levels(P<0.05),while Th17/Treg was positively correlated with FEV1,FVC,FEV1/FVC and FEV1/Pred levels all were negatively correlated(P<0.05).Logistic regression analysis found that mMRC grade and Th17/Treg were independent risk factors of AECOPD(P<0.05).Conclusion:With the progression of COPD,DCs,B10 cells,Th17 cells,Treg cells and Th17/Treg gradually become unbalanced,resulting in disordered expression levels of pro-inflammatory and anti-inflamma-tory factors.Peripheral blood DCs and B10 cells were positively correlated with lung function levels,while Th17/Treg were negatively correlated with lung function levels.mMRC grade and Th17/Treg are independent risk factors of AECOPD.Therefore,actively inter-vening in the imbalanced state of immune function in patients has specific and important clinical significance in reducing the immune damage of lung tissue and promoting the improvement of lung function.

Objective:The decision tree Chi-square automatic interactive detection (CHAID) algorithm and binary Logistic regression analysis were used to construct the risk prediction model of premature ovarian failure (POF) in patients with uterine fibroids complicated with hypertension after surgery, and the results of the risk prediction model were compared and analyzed.Methods:Patients with uterine fibroids complicated with hypertension admitted to Taizhou Hospital of Zhejiang Province from Jan. 2019 to Sep. 2022 were retrospectively analyzed as the research objects. CHAID algorithm and Logistic regression analysis were used to establish risk prediction models, respectively. The area under the curve (AUC) of receiver operating characteristic curve (ROC) was used to compare and evaluate the prediction effects of the two models.Results:A total of 860 patients were collected, including 56 patients with premature ovarian function failure after operation, and the incidence of premature ovarian function failure was 6.51%. CHAID method and Logistic regression analysis showed that uterine myoma surgery, hypertension, smoking or passive smoking, family history of premature ovarian failure, sleep status, physical exercise and history of induced curettage were important influencing factors of premature ovarian failure. The accuracy of risk prediction of decision tree model was 88.2%, and the fitting effect of the model was good. The Logistic regression model Hosmer-Leme-show goodness of fit test showed that the model fit was good. The AUC of Logistic regression model was 0.893 (95% CI: 0.862-0.899), and the AUC of decision tree model was 0.882 (95% CI: 0.856-0.899). The predictive value of the two models was moderate, and there was no significant difference between them ( Z=0.254, P>0.05) . Conclusions:The combination of decision tree and Logistic regression model can find the influencing factors of premature ovarian function failure in patients with uterine fibroids complicated with hypertension after operation from different levels, and the relationship between the factors can be more fully understood. The establishment of a risk model for premature ovarian function failure in patients with uterine fibroids complicated with hypertension after surgery can provide a reference for postoperative intervention in patients with uterine fibroids complicated with hypertension, and more effectively help patients actively prevent and slow down the occurrence and development of POF.

Objective:To study the relationship and the role of leptin in children with biliary atresia and hepatic fibrosis to provide a treatment basis for these patients.Methods:The clinical data of children with biliary atresia or congenital biliary dilatation (CBD) who underwent surgical treatment at the Department of General Surgery of Tianjin Children's Hospital from August 2019 to August 2021 were retrospectively analyzed. Of 31 children included in this study, there were 14 males and 17 females, with age of 60 (30, 63) d. Children with biliary atresia served as the study group ( n=26) and children with CBD served as the control group ( n=5). Leptin protein, α-smooth muscleactin (α-SMA) and phosphorylation of extracellular-regulated protein kinase 1/2 (p-ERK1/2) in liver tissues were detectd by immunohistochemistry (IHC). The expression level of leptin mRNA in liver tissues were detected by quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR). Results:The average optical density values of leptin protein, α-SMA protein and p-ERK1/2 protein in the liver tissues of children in the study group were significantly higher than the control group ( P<0.05). The expression levels of leptin, α-SMA and p-ERK1/2 in liver tissues of children with biliary atresia significantly increased with increase in fibrosis degree ( P<0.05). The expression level of leptin in liver tissues of children with biliary atresia was positively correlated with the liver fibrosis grade ( rs=0.876), α-SMA ( r=0.723) and p-ERK1/2 ( r=0.725) ( P<0.01). The results of qRT-PCR showed that the content of leptin mRNA in liver tissues of children with biliary atresia was significantly higher than that of children with CBD ( P<0.05). Conclusion:Expressions of leptin increased with aggravation of degrees of hepatic fibrosis in biliary atresia. Leptin may be involved in activation of HSCs through the ERK1/2 signaling pathway in the process of hepatic fibrosis due to biliary atresia.

Objective:To carry out the monitoring of H5N6 subtype avian influenza virus (AIV) in the population infection and live poultry markets (LPMs) environmental pollution in Changsha city from 2016 to 2018. Laboratory data were provided to prevent human infection with H5N6 subtype AIV.Methods:A total of 6 909 throat swab specimens from the population and 1 719 environmental specimens from LPMs were collected in Changsha city from 2016 to 2018. The real-time RT-PCR method was used for the detection of influenza virus in type A, H5, H7, H9 and N6 subtypes. Eighty-two AIV nucleic acid-positive specimens were subjected to high-throughput nucleotide sequencing, and then BLAST similarity and amino acid (aa) key site analyses were performed on the sequencing results.Results:One H5N6 subtype AIV nucleic acid was detected from 6 909 population throat swab specimens, 927 (53.93%) positive specimens of A-type AIV nucleic acids and 193 (11.23%) positive specimens of both H5 and N6 subtypes were detected from 1 719 LPMs environmental specimens. Fourteen genomic sequences of H5N6 subtype AIV were obtained with high-throughput nucleotide sequencing, and aa key site analyses showed that there were 6 basic aa in 338-347 aa of viral HA protein-linked peptide, which was highly pathogenic to birds. Receptor binding site (RBS) 238-240 aa (corresponding to H3 type influenza virus 226-228 aa) is QSG or QRG, and the receptor is characterized by avian origin. The 290th resistance gene locus of NA protein did not show R290K mutation, and was sensitive to NA inhibitor (Duffy/osoterosine phosphate). The E627K and D701N(I) mutations in the viral PB2 protein indicate that the virus is pathogenic.Conclusions:Human infected with H5N6 subtype AIV in Changsha city is sporadic, and the H5N6 subtype AIV of LPMs is seriously polluted. It is necessary to further strengthen the AIV surveillance of LPMs.

Objective:To retrieve and obtain the relevant evidence for in-hospital exercise rehabilitation in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) and to summarize the best evidence.Methods:By applying evidence-based nursing method, the relevant evidence of in-hospital exercise rehabilitation in AMI patients after PCI in domestic and foreign databases was retrieved by combining computer and manual methods, including guidelines, evidence summary, clinical practice guidelines, systematic reviews, randomized controls test and so on. The retrieval time was from the establishment of the database to December 1, 2019. A total of 4 evidence-based groups independently conducted literature quality evaluation, and the controversial content was ruled by the hospital evidence-based group, and the evidence was extracted. Appraisal of guidelines research and evaluation (AGREEⅡ) and literature evaluation criteria and evidence grading system of Australia Joanna Briggs Institute (JBI) Evidence-based Health Care Center were respectively used to evaluate quality of literature and grade the various studies.Results:A total of 15 articles were included, including 4 guidelines, 1 evidence summary, 1 systematic evaluation and 9 randomized controlled trials. Finally, 20 pieces of best evidence of in-hospital exercise rehabilitation in AMI patients after PCI were summarized.Conclusions:This study summarizes best evidence for in-hospital exercise rehabilitation of AMI patients after PCI, which can provide an evidence-based basis for clinical practice. However, in the actual implementation process, it should be carried out step by step on the premise of ensuring the safety of patients by combining the cultural background of patients and the level of medical institutions.

Objective:To investigate the labial surface angle and Collum angle of anterior teeth using cone-beam computed tomography (CBCT), and to provide guidance for proper setting of torque for avoiding alveolar fenestration and dehiscence.Methods:CBCT data of 200 patients (66 males, age ranging from 18 to 40 years, with average 26.7 years) were screened and imported into Invivo 5.4, the middle labio-lingual sections of anterior teeth were obtained, and the Collum angle and labial surface angle were measured respectively. One-way ANOVA was used to analyze the discrepancies of the two measurements among teeth. Pearson correlation analysis was performed to detect the association between the two measurements.Results:The Collum angles (labial surface angles) in upper central incisor, lateral incisor, canine and lower central incisor, lateral incisor and canine were 0.17±5.11° (15.50±2.91°), -5.67±5.74° (15.52±3.50°), -5.56±4.67° (20.07±3.66°), -3.97±4.49° (14.40±3.20°), -6.50±4.03° (14.76±3.25°), -3.70±4.91° (18.27±3.07°) respectively; the positive Collum angles indicated the lingually bent root relative to crown, while the negative indicated the labially bent root. The labial surface angles in upper and lower canine were significantly larger than that of intra-arch central and lateral incisors ( P<0.001). On the contrary, no significant differences were detected between central and lateral incisors in the maxilla and mandible ( P>0.05, P>0.05). Moreover, except for the maxillary central incisor, the Collum angle and labial surface angle were positively correlated. Conclusions:The values of Collum angle among anterior teeth are significantly different, and the obvious lingual-bent root are more likely accompanied with the greater labial surface curve, which might cause variable torqueing and be necessary to elevate before treatment.

Objective To analyze pathological and ultrasound imaging features of breast cancer in young women. Methods The pathological and ultrasound imaging data of 42 young female breast cancer patients(≤35 years old,the young group)between January 2016 and October 2017 from the Fourth Affiliated Hospital of China Medical University were retrospectively analyzed. Meanwhile, 62 elder female breast cancer patients (> 60 years old, the elder group) simultaneously diagnosed by pathology (age≥60 years) were randomly selected as the control group. Results The vessel carcinoma embolus rate and lymph node metastasis positive rate in the young group were higher than those in the elder group [31.0 % (13/42) vs. 29.0 %(18/62),59.5 %(25/42)vs.38.7 %(24/62)],and there was no difference between the two groups(χ2=16.187, χ2= 5.749, both P< 0.05). Compared with the elder group, the expression of estrogen receptor (ER) in the young group was lower (χ2= 11.598, P = 0.001). The positive rates of Ki-67 and human epidermal growth factor receptor-2 (HER-2) in the young group were higher (χ2= 5.396, P = 0.024; χ2= 5.166, P =0.026). Inhomogeneous internal echo of breast cancer, microcalcifications, flow classification (grade Ⅱ-Ⅲ) and resistance index (RI) ratio in the young group were higher than those in the elder group [83.3 % (35/42) vs. 59.7 % (37/62), P = 6.576; 57.1 % (24/42) vs. 22.6 % (14/62), P = 12.899; 78.6 % (33/42) vs. 58.1 % (36/62), P = 4.716; 83.3 % (35/42) vs. 59.7 % (37/62), P= 6.578], and the differences were statistically significant (all P < 0.05). Conclusion The young female breast cancer patients have a higher rate of malignancy,invasion and metastasis rate compared with the elder breast cancer patients.

This study was aimed to analyze the major protein composition of centipedes (Scolopendra subspinipes mutilans L.Koch.), and the ACE inhibitory activity of its hydrolysis. Albumins, gulbulins, coixins and glutelins were sequentially extracted from centipedes flour with corresponding buffer and then quantified by Kjeldahl method and Brandford. Hydrolysation of four kinds of proteins of centipedes and the residues were conducted with pepsin. The hydrolysis was ultrafiltrated (MWCO=3 000) and lyophilized. The peptides (≤3 kD) were obtained to evalu-ate the ACE inhibitory activity by RP-HPLC. The results showed that the total protein content of centipedes was (62.69±1.41)%. Among which the contents of albumins, globulins, coixins, glutelins and residual were account-ing for (6.42±0.31)%, (7.94±0.24)%, (4.31±0.34)%, (40.66±0.56)% and (25.78±0.60)%, respectively. The inhibition rate of hydrolysis of four kinds of protein and residual were 50.28%, 57.37%, 31.15%, 58.99%, 80.81%, respectively. It was concluded that centipedes were rich in protein and the hydrolyzate of all proteins manifested ACE inhibitory activity at different extent. The residual and glutelins indicated strong ACE inhibitory potential by hydrolysis. This research provided valuable sights for exploring hypotensive activity and functional food from centi-pedes.

Objective: TO explore the effect of VEGF-C gene transfection on the expression of VEGF-C in human cervical carcinoma HeLa cells and the mechanisms of its anti-apoptosis effect. Methods: The con-structed pcDNA3.1(+)NEGF-C vector was transformed into human cervical cancer HeLa cells and was select-ed by G418. The changes in the expression level of VEGF-C mRNA and protein were determined by semi-quantitive RT-PCR and ELISA. HeLa cells with overexpression of VEGF-C were named as HeLa/S1. The expression level of NF-KB and bcl-2 mRNA was determined by RT-PCR in transfected cells. Results: After transfection by liposome, the VEGF-C mRNA level and the expression of VEGF-C protein in transfected cells were higher than those in the control groups. HeLa/S1 cell line was successfully established. In HeLa/S1 cells, the expression of NF-κB (2.06±0.09 vs 1.35±0.02 vs 1.38±0.02 P<0.05) and bcl-2 gene mRNA (2.02± 0.67 vs 0.41±0.06 vs 0.37±0.06, P<0.05) level were higher than those in the control groups. Conclusion: VEGF-C gene transfection by liposome can increase the expression of VEGF-C in human cervical cancer HeLa cells. NF-κB is stimulated and induces the overexpression of bcl-2 gene in HeLa/S1 cells.