ObjectiveTo analyze the epidemiological characteristics of scarlet fever in Putuo District， Shanghai from 2015 to 2020， and provide a basis for formulating effective prevention and control measures. MethodsThe data of scarlet fever cases from January 1， 2015 to December 31， 2020 in Putuo District， Shanghai were obtained from the Infectious Disease Reporting Information Management System of the Chinese center for disease control and prevention （CDC）. Descriptive epidemiological method was used to analyze the epidemiological characteristics of scarlet fever cases in Putuo District， Shanghai by time， population， and region. ResultsA total of 586 scarlet fever cases were reported in Putuo District from 2015 to 2020， with an average annual reported incidence of 7.39 per 10⁵， an average age of onset of 6.2±1.8 years， and a male/female ratio of 1.6∶1. The incidence of scarlet fever has declined significantly in 2020， which was 5.44 per 10⁵ lower than the average reported incidence in 2015‒2020. The incidence peak was from April to June and November to January of the following year， which was characterized by high incidence in spring and winter. The age distribution of cases was concentrated at the age of 4‒9 years， mainly children in kindergarten and primary school students. Areas with high reported incidence rates were Wanli Street， Changzheng Town， Taopu Town and Changfeng New Village Street. ConclusionThe peak incidence of scarlet fever in Putuo District is from April to June and November to January of the following year， with children in kindergartens and students in primary school as the key populations. We should strengthen epidemic monitoring and guidance of prevention and control for in kindergartens and schools before the high incidence season of scarlet fever， so as to effectively prevent the epidemic of the disease.

Objective:To investigate the application value of triangular modal construed for planning approach of laparoscopic local resection of liver tumors located in superior part of central liver lobe.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 10 patients who underwent local laparoscopic resection of liver tumors located in superior part of central liver lobe at the Affiliated Hospital of Qingdao University from January to June 2020 were collected. There were 6 males and 4 females, aged from 41 to 63 years, with a median age of 54 years. Preoperative triangular model was constructed for all patients to plan approach of laparoscopic local resection of liver tumors located in superior part of central liver lobe. Observation indicators: (1) preoperative general situations of patients; (2) surgical situations; (3) follow-up. Follow-up was conducted by outpatient examination or telephone interview to detect tumor recurrence and survival of patients up to February 2021. Measurement data with normal distribution were expressed as Mean± SD. Count data were expressed was absolute numbers. Results:(1) Preoperative general situations of patients: hepatocellular carcinoma was found in 7 cases, inthahepatic cholangiocarcinoma was found in 2 cases and ovarian cancer with liver metastasis was found in 1 case. Three cases had tumors located in S4a segment, 2 cases had tumors located in ventral subsegment of S8 segment, 2 cases had tumors located in dorsal subsegment of S8 segment, and 3 cases had tumors across the ventral segment of S4a+S8. The diameter of tumors was (3.4±1.0)cm. (2) Surgical situation: all the 10 patients underwent R 0 resection successfully, with no intraoperative blood transfusion or conversion to open surgery. The operation time of 10 patients was (149±59)minutes, the volume of intraoperative blood loss was (294±163)mL, the minimum surgical margin of specimen was (1.1±0.2)cm. The alanine aminotransferase was (324±151)U/L on the postoperative first day, the aspartic aminotransferase was (401±113)U/L on the postoperative first day, and the duration of postoperative hospital stay was (9±4)days. No bile leakage, hemorr-hage, reoperation or other complications occurred in all patients. (3) Follow-up: 10 patients were followed up for 7?13 months, with a median follow-up time of 11 months. All patients had no margin recurrence or distant metastasis. Conclusion:It is safe and feasible to construct triangular modal for planning approach of local laparoscopic resection of liver tumors located in superior part of central liver lobe.

【Objective】 To establish and evaluate a nephelometric assay for the determination of immunoglobulin A (IgA) residues in human intravenous immunoglobulin(IVIG). 【Methods】 BN ProSpec^© automatic protein analyzer and its supporting immunoglobulin A determination kit (nephelometry) produced by German Siemens and the national standard of human IgA were used to establish the nephelometric assay to determine IgA residue in test products and verify the methodology. The test products include IVIG (pH4) prepared by low-temperature ethanol protein separation process and a novel IVIG prepared by chromatography. 【Results】 The average deviation of three calibration curves for IgA residues determination by the nephelometric assay were 1.08%, 0.95% and 1.54%,, and the three deviations of the quality control were 4.00%, -2.30% and -0.20%, respectively, which indicated good calibration and quality control. In the specificity test, the average recovery rates of IgA for reference substance 1 containing 100g/L maltose and reference substance 2 containing 20g/L glycine were 102.7% and 105.8%, respectively. The relative standard deviation (RSD) values of the repeatability tests of the two test products were 3.9% and 1.9%, and the RSD values of the intermediate precision test were 3.6% and 2.3%, respectively.The difference values at each time point in the durability test of test products′ storage time were all less than 10%, and the RSD values of the two test products in the durability test of kits of different batches were 2.8% and 2.2%, respectively. In the accuracy test, the average recovery rates of IVIG (pH4) added to the standard were 94.2%, 101.7% and 96.2%, respectively, and the average recovery rates of the novel IVIG added to the standard were 102.8%, 106.3% and 99.7%, respectively. The average recovery rate of the limit quantification test was 101.0%, and the RSD was 4.0%. 【Conclusion】 Nephelometric assay has the advantages of strong specificity, high precision and accuracy, good repeatability, simple and rapid operation, and automation, and can be used for the determination of IgA residue in IVIG (pH4) and novel IVIG products.

OBJECTIVE:To provide reference for confirming the protective effect of the establishment of PIVAS on antineoplastic drugs(ADs)occupational exposure to nursing staff in clinical departments,and to provide the basis for the formulation of ADs dispensing guideline and occupational exposure protection regulations. METHODS:By questionnaire survey and deriving data of lab examination index,the occurrence of abnormal menstruation,bad birth outcome,alopecia,blood toxicity, liver and renal toxicity in nursing staff of clinical departments with different ADs contact frequencies(non-exposure group as group A,low-exposure group as group B,high-exposure group as group C)were investigated and analyzed in our hospital before and after the establishment of PIVAS. The residual of ADs [methotrexate(MTX)and 5-Fluorouracil(5-FU)] in PIVAS environment were investigated by HPLC. RESULTS:A total of 160 questionnaires were sent out before the establishment of PIVAS,and 151 were effectively collected with effective recovery of 94.38%. After the establishment of PIVAS,150 questionnaires were sent out,and 144 were effectively collected with effective recovery of 96.00%. Questionnaire results showed that the incidence of abnormal menstruation,abnormal menstruation period,dysmenorrhea,spontaneous abortion,infertility and offspring low birth weight,the severity of hair loss in group C were significantly higher than group A,with statistical significance(P<0.05 or P<0.01). The incidence of above 6 conditions in group C were 5.14,6.10,3.81,4.04,6.15,8.08 times higher than in group A.At same time, the incidence of the offspring low birth weight and the severity of hair loss in group B were significantly higher than group A,with statistical significance(P<0.05 or P<0.01);the incidence of the former in group B was 6.21 times higher than in group A.After the establishment of PIVAS,the incidence of abnormal menstruation,abnormal menstruation period,dysmenorrhea,spontaneous abortion,infertility and offspring low birth weight,the severity of hair loss were decreased significantly in group C,with statistical significance(P<0.05). The severity of hair loss in group C was significantly higher than group A,and there was no statistical significance in above indexes,compared with group A(P>0.05). At the same time,there was no statistical significance in the incidence of the offspring low birth weight and the severity of hair loss between group B and A(P>0.05). Results of lab examination index investigation showed that before the establishment of PIVAS,WBC and PLT of group C were significantly lower than group A,and the incidence of abnormal liver function was significantly higher than group A,with statistical significance(P<0.05 or P<0.01). After the establishment PIVAS,WBC,PLT and RBC of group C,and PLT of group B were increased significantly compared to before the establishment PIVAS;the incidence of abnormal liver function in group C was decreased significantly compared to before the establishment PIVAS,with statistical significance(P<0.05 or P<0.01). There was no statistical significance in above indexes between group C and A(P>0.05),and PLT of group B was even significantly higher than group A(P<0.05). Results of investigation of ADs residues in PIVAS environment showed that there were different degrees of MTX and 5-FU residue on the surface of different objects. The residues of ADs from high to low were biological safety cabinet worktops,the floor just below biological safety cabinet,transfer box,transfer window and door handle and infusion bags. CONCLUSIONS:Nursing staff of clinical department with high ADs contact frequency face higher relevant health risks. The establishment of PIVAS can effectively protect the ADs occupational exposure of nursing staff in clinical departments,thereby reducing the above risks.At the same time,there are still different degrees of ADs residues on the surface of different objects in the PIVAS environment,and transshipment out of PIVAS is possible. It is suggested that the awareness of protection against occupational exposure risk caused by ADs residues in PIVAS environment should be improved;unified guideline for ADs dispensing and occupational exposure protection regulations should be formulated as soon as possible,so as to reduce occupational exposure risk associated with ADs for nursing staff in PIVAS and clinical departments.

Objective To investigate the safety and efficacy of transarterial chemoembolization (TACE) combined with implantation of irradiation IVC stent in treating hepatocellular carcinoma (HCC)complicated by inferior vena cava tumor thrombosis (IVCTT).Methods The clinical data of 61 consecutive patients with HCC complicated by IVCTT were retrospectively analyzed.Irradiation IVC stent was prepared by strapping 125I particles on the bare stent,and it was employed in 33 patients (group A).Bare stent was adopted in 28 patients (group B).Propensity score matching method was used to conduct randomized analysis of the original data in order to reduce the selection bias.The survival time,remission rate of symptom and procedure-related adverse events of both groups were calculated and the results were compared between the two groups.Results The incidence of adverse reactions was similar in the two groups,and symptomatic treatment with internal medicine was adopted.The survival time in group A was superior to that in group B.The median survival time in group A was (203.0±28.1) days,which was (93.0±24.3) days in group B (P=0.006).Propensity score matching (24 pairs in total) cohort analysis showed that the median survival time was (200±31) days in group A and (66±23) days in group B (P=0.019).The edema remission rates in group A and in group B were 97.0％ and 96.4％ respectively.Multiple factor analysis revealed that irradiation stent implantation and objective tumor response were independent factors predicting a good prognosis.Conclusion For the treatment of HCC associated with IVCTT,TACE combined with irradiation stent implantation is safe and effective,this therapy can prolong the patient's survival time

Objective Preparation of aqueous reference materials for cholesterol and glycerol.Methods Study on reference materials.The certified reference materials GBW09203b and GBW09149 were weighed accurately and dissolved into 20% of methyl cyclodextrin aqueous solution to prepare six kinds of candidate reference materials of cholesterol and glycerol according to the concentration.The materials were tested for homogeneity and stability using routine methods.The reference methods of isotope dilution liquid chromatography tandem mass spectrometry (ID-LC/MS/MS) were used to determine the concentration of cholesterol and glycerol to evaluate the accuracy of the certified values.Meanwhile, the blank verification test was carried out.The expanded uncertainty was the combination of standard uncertainty of measurement, unhomogeneity and instability.Results It showed that the six candidate reference materials were homogeneous and stable for at least 1 year at-70 ℃ and-20 ℃.The certified values (reference value ± expanded uncertainty,mmol/L) were as follows,for cholesterol:0.65±0.01,1.31 ±0.01,2.57±0.02,5.21±0.06,7.71±0.08,10.24±0.06;for glycerol:0.29±0.01,0.58±0.01,1.22±0.02,2.24±0.02,3.46±0.04,4.52 ±0.04.The results of reference methods were consistent with the certified values.Blank validation tests showed that the concentration of the analytes would not be affected by the reagent and the blank matrix.Conclusions Certified reference materials for cholesterol and glycerol in aqueous solution have been prepared successfully.These materials are homogeneous and stable, and the certified values are reliable.Therefore the materials have been approved to be the Certificate Reference Materials of GBW 09823, GBW 09824, GBW 09825, GBW09826, GBW09827 and GBW 09828.

Objective To investigate the silencing effect of RNA interference on MSTN gene ( myostatin, MSTN) expression, and detect the effects on the downstream genes in Schizopygopsis pylzovi. Methods To construct the recombi?nant adenovirus vector 1P3 (DSP MSTN 273+250+1737) and 1P2 (DSP MSTN 195+ 1670) for RNA interference of the MSTN gene in Schizopygopsis pylzovi, and to conduct the RNA interference in vivo experiment by injecting the vector in?to the muscle tissue of Schizopygopsis pylzovi. Real?time PCR and Western blotting were used to evaluate the silencing effects on MSTN gene expression, and to detect the regulatory function of M?CK at gene transcription level after RNA inter?ference of the MSTN gene. Results The result of real?time PCR showed that compared with the HK team ( Virus general negative control group) and N team (blank control group), the 1P3 had significant interference effect on the MSTN gene transcription in Schizopygopsis pylzovi (P<0?05), with an inhibition rate of 53?5%, but the 1P2 had no significant inter?ference effect on the MSTN gene transcription. The result of Western blotting was consistent with the results of real?time PCR. At the same time, after the 1P3 interference, the level of MSTN gene transcription was declined, and the level of M? CK gene expression was significantly increased. Conclusions Our results demonstrate that the expression of MSTN gene can be effectively suppressed, and the expression of M?CK gene can be up?regulated through the RNA interference. There?fore, it proves that MSTN gene can inhibit the transcription of M?CK gene in Schizopygopsis pylzovi, and reveals the regula?tory role of MSTN gene in the muscle growth and development in the plateau fish Schizopygopsis pylzovi.

ObjectiveTo investigate the risk factors of patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS) complicated with Yangming Fushi syndrome.Methods A prospective study was conducted. From August 2009 to July 2013, 206 patients with Yangming Fushi syndrome combined with ALI/ARDS were enrolled in the intensive care units ( ICUs ) of the following five hospitals: Tianjin Nankai Hospital, Dongzhimen Hospital Affiliated to Beijing Traditional Chinese Medicine University, General Hospital of Tianjin Medical University, the First Affiliated Hospital of Dalian Medical University, and Wuxi Third People's Hospital in Jiangsu Province. According to the mortality occurring in ICU, the patients were divided into death group and survival group. The gender, age, acute physiology and chronic health evaluation Ⅱ ( APACHE Ⅱ ) score within the first 24 hours after admission, the length of invasive mechanical ventilation, usage of vasoactive agents, ratio of operative intervention, the length of stay in ICU, application of continuous renal replacement therapy ( CRRT ), amount of blood transfusion, the level of C-reactive protein ( CRP ), lactulose/mannitol ( L/M ) ratio, the number of organs with dysfunction, oxygenation index ( PaO2/FiO2 ), levels of lactate and serum creatinine ( SCr ) of both groups were recorded. Logistic regression analysis was used to look for the independent risk factors of death of patients. Results There were 124 cases with severe acute pancreatitis ( SAP ), which was the most common disease with manifestation of Yangming Fushi syndrome combined with ALI/ARDS, accounting for 60.19% of all the patients. During the period of hospitalization in ICU, 171 patients survived and 35 died, and the mortality rate was 16.99%. The risk factors of the two groups were analyzed by variable analysis, and it was shown that compared with those in survival group, the age ( years: 57.26±16.23 vs. 48.07±13.48, t = 3.544, P = 0.000 ), APACHE Ⅱ score ( 20.83±9.73 vs. 12.61±6.63, t = 4.777, P = 0.000 ), the length of invasive mechanical ventilation ( days: 10.97±7.71 vs. 6.91±2.48, t = 2.555, P = 0.015 ) and the number of dysfunction organs ( 3.11±1.21 vs. 1.60±1.34, t = 6.222, P = 0.000 ) in death group were significantly higher. The level of PaO2/FiO2 [ mmHg ( 1 mmHg = 0.133 kPa ): 218.56±64.90 vs. 244.58±85.10, t = -2.024, P = 0.044 ] in the death group was significantly lower than that of the survival group, while the length of ICU stay ( days: 14.33±10.81 vs. 9.11±7.37, t = 2.600, P = 0.010 ), the usage rates of CRRT [ 28.57% ( 10/35 ) vs. 15.20% ( 26/171 ), χ2 = 3.968, P = 0.046 ], vasoactive agents [ 28.57% ( 10/35 ) vs. 12.28% ( 21/171 ), χ2 = 6.511, P = 0.011 ], and blood transfusion ratio [ 42.86% ( 15/35 ) vs. 23.39% ( 40/171 ), χ2 = 7.042, P = 0.008 ] were all obviously higher in the death group than those in the survival group. There were no statistically significant differences in gender, number of operation, the levels of CRP, L/M ratio, lactate and SCr between the two groups ( all P > 0.05 ). Multivariate logistic regression analysis showed that age [ odds ratio ( OR ) = 0.938, 95% confidence interval ( 95%CI ) = 0.898-0.980, P = 0.004 ], APACHE Ⅱ score ( OR = 0.914, 95%CI = 0.839-0.996, P = 0.041 ), the number of dysfunction organs ≥ 3 ( OR = 0.223, 95%CI = 0.066-0.754, P = 0.016 ), and the level of PaO2/FiO2 ( OR = 0.990, 95%CI = 0.982-0.998, P = 0.015 ) were independent risk factors for mortality. Conclusions The age, APACHE Ⅱ score, number of dysfunction organs ≥ 3 and the level of PaO2/FiO2 are of significance in predicting the prognosis of patients with Yangming Fushi syndrome combined with ALI/ARDS. Patients with risk factors of high mortality should be more carefully monitored and treated aggressively.

Based on the Android platform, a portable electrochemical analyzer was designed for the detection of heavy metal ions. Its output voltage range was ±3 V with accuracy of 0. 1% and resolution of <1 mV. The current acquisition range was±10 mA with accuracy of 0. 1% and the minimum resolution of 10 pA. With the human-computer interaction advantage of Android smart devices, professional and fast detection mode which could meet the needs of professional and ordinary users respectively were developed to simplify the complex process of electrochemical detection and analysis. Some common heavy metal ions including copper, cadmium, lead and mercury were detected with this detector. The results of linearity, repeatability and accuracy were satisfactory.

Objective To investigate the level of nurses' work engagement and analyze the relevance to the professional values in tertiary level 1st class general hospitals of Shandong province.Methods Totally 960 nurses from 7 tertiary level 1st class hospitals of Shandong province were surveyed by the questionnaires,including the Utrecht Work Engagement Scale,Nurses Professional Values Scale and the nurses' general information.Results The total score of nurses' work engagement was (33.91 ± 11.06); Professional values was correlated with work engagement.Conclusions Nurses' work engagement in tertiary level 1st class hospitals of Shandong province is at middle level.Professional values is the main influencing factor and ward atmosphere,chance of promotion and the professional titles can also influence the work engagement.