Enterotoxigenic Escherichia coli（ETEC）infection can induce watery diarrhea，leading to dehydration，electrolyte disturbance，and even death in severe cases. Recombinant B subunit/inactivated whole-cell cholera（rBS/WC）vaccine is effective in preventing ETEC infectious diarrhea. On the basis of the latest evidence on etiology and epidemiology of ETEC，as well as the effectiveness，safety，and health economics of rBS/WC vaccine，National Clinical Research Center for Child Health（The Children’s Hospital，Zhejiang University School of Medicine）and Zhejiang Provincial Center for Disease Control and Prevention invited experts to develop expert consensus on rBS/WC vaccine in prevention of ETEC infectious diarrhea. It aims to provide the clinicians and vaccination professionals with guidelines on using rBS/WC vaccine to reduce the incidence of ETEC infectious diarrhea.

OBJECTIVES: The aim of this study was to evaluate the disease burden of prostate cancer (PC) and assess key influencing factors associated with the disease expenditures of PC in the United States. METHODS: The total deaths, incidence, prevalence, and disability-adjusted life-years of PC were obtained from the Global Burden of Disease Study 2019. The Medical Expenditure Panel Survey was used to estimate healthcare expenditures and productivity loss and to investigate patterns of payment and use of healthcare resources in the United States. A multivariable logistic regression model was conducted to identify key factors influencing expenditures. RESULTS: For patients aged 50 and older, the burden for all age groups showed a modest increase over the 6-year period. Annual medical expenditures were estimated to range from US$24.8 billion to US$39.2 billion from 2014 to 2019. The annual loss in productivity for patients was approximately US$1,200. The top 3 major components of medical costs were hospital inpatient stays, prescription medicines, and office-based visits. Medicare was the largest source of payments for survivors. In terms of drug consumption, genitourinary tract agents (57.0%) and antineoplastics (18.6%) were the main therapeutic drugs. High medical expenditures were positively associated with age (p=0.005), having private health insurance (p=0.016), more comorbidities, not currently smoking (p=0.001), and patient self-perception of fair/poor health status (p<0.001). CONCLUSIONS From 2014 to 2019, the national real-world data of PC revealed that the disease burden in the United States continued to increase, which was partly related to patient characteristics.

Objective:To study the results of using a sequential menagement of conservative treatment, percutaneous transhepatic cholangial drainage(PTCD), laparoscopic cholecystectomy(LC) combined with laparoscopic common bile duct exploration(LCBDE) and primary duce closure(PDC) in patients with cholecystolithiasis and common bile duct stone(CBDS) who presented with acute cholangitis.Methods:The clinical data of 397 patients with CBDS and cholecystolithiasis who presented with acute cholangitis from January 2015 to August 2020 were retrospectively analyzed, including 230 patients from the West Campus, Beijing Chaoyang Hospital, Capital Medical University, 95 patients from the Second People's Hospital of Binzhou and 72 patients from Rizhao Central Hospital. Conservative treatment, PTCD and LC+ LCBDE+ PDC were used sequentially. The interval between PTCD and LCBDE, the decrease of serum total bilirubin and alanine aminotransferase after PTCD, the operative time of LC+ LCBDE+ PDC, and the intraoperative blood loss were analyzed. Postoperative indwelling time of abdominal drainage tube and PTCD tube time, postoperative hospital stay, postoperative complications, etc.Results:These were 15 males and 18 femals with the mean age of 57.5 years old. The mean serum total bilirubin and alanine aminotransferase levels decreased from (148.3±36.8) μmol/L and (172.6±26.9) U/L before PTCD to (32.6±5.9) μmol/L and (45.7±7.2) U/L after PTCD, respectively. The interval between PTCD and LCBDE was (25.3±2.6) d. The operation time of LC+ LCBDE+ PDC was (95.4±14.2) min. The intraoperative blood loss was (35.2±9.5 )ml and the mean postoperative hospital stay was (12.4±3.5) d. The postoperative indwelling time of abdominal drainage tubes and PTCD tubes were (10.6±2.3) d and (25.8±4.7) d, respectively. After surgery, bile leakage occurred in 3 patients (9.1%), abdominal hemorrhage in 1 patient (3.0%), biliary bleeding in 1 patient (3.0%), navel incision infection in 1 patient (3.0%), lower common bile duct stenosis in 2 patients (6.1%). All complications responded well to conservation treatment.Conclusions:Sequential treatment using conservative treatment, PTCD combined with LC+ LCBDE+ PDC in patients with cholecystolithiasis and CBDS who presented with acute cholangitis was safe, and efficacious using the minimally invasive approach. This approach is worth promoting to other centers.

Objectives To investigate the effects of ethanol on neural development and kainate receptor expression in young mice. Methods Fetal alcohol spectrum disorder model was established by administration of 20% ethanol solu?tion to 7-day-old Kunming mice and control animals received physiological saline (The number of treatment and control were 80 and 40, respectively ). Body weight and general biological features were observed every day. Morris water maze was used to test learning and memory ability. Fluoro-Jade B was used to examine neural cells 24 hours after treatment in additional thirty 7-day-old Kunming mice which were further divided into two groups:a treatment group receiving 20%ethanol solution (n=15) and a control group receiving physiological saline (n=15). The development of neural cells and expression levels of kainite receptors were examined by using immunofluorescence staining. Results The body weight was significantly lighter in treatment group than in control group(control:21.13 ± 1.72g,treatment:13.96 ± 2.98g,P<0.05). Morris test showed that model group had longer latency than control group to find hidden platform(control:21.05± 5.31s,treatment:34.15±3.26s,P<0.05). Spatial probe test revealed that the number of passing through the platform were significantly smaller in model group than in control group(control:2.70 ± 1.25 times,treatment:0.93 ± 0.80 times,P<0.05). Astrocyte development anomaly was evident after ethanol treatment for 7 days. The expression levels of kainite re?ceptor GluR-6 and KA2 were up-regulated in the CA region of the hippocampus after ethanol treatment for 7 days. Con?clusion Kainite receptor GluR-6 and KA2 in CA region of the hippocampus may contribute to ethanol-induced hippo?campal neural development anomaly.

Objective To analyze the molecular characteristic and trace the resource of dengue virus in Zhuhaidistrict of Guangzhou during 2012-2015.Methods Collected the cases data of dengue fever in Zhuhai district from 2012-2015 and analyzed the epidemical characteristic.DENV strains were isolated by C6/36 cells,the E gene was amplified from the positive specimen by RT-PCR.The PCR products were sequenced and then analyzed by bio-information software.Results Total of 6 260 DENV infection cases were reported,and the cases happened in every age group;57.78％ of the cases occurred in October.16 virus strains were isolated from 48 samples and the whole E genes were successfully amplified,the virus strains from 2013 and 2014 were the same one and the nucleotide sequence 99.93％ identify with DENV-1 in 2009.Phylogenetic analysis showed that DENV-1 belonged to the G1 genotype,genetically close to the strains from Thailand;strains from 2015 were the same one and belonged to the Cosmopolitan genotype of DENV-2,most similar with the strains from India.Conclusions The DENV-1 outbreak in Haizhu district of Guangzhou during 2012-2015 were belonged to G1 that originated from Thailand and might indigenous in 2009;DENV-2 was belonged to Cosmopolitan genotype which was imported.

Objective To assess the safety and efficacy of radiofrequency ablation (RFA) for the treatment of large (≥5 cm in diameter) hepatic hemangiomas.Methods Clinical data of 50 patients with large hepatic hemangiomas (≥5 cm in diameter) treated with RFA between October 2007 and December 2012 were analyzed.Patients were divided into two groups (5-10 cm and ≥ 10 cm) according to tumor size.Results Thirty-two patients had 36 hemangiomas of 5-10 cm in diameter and 18 patients had 19 hemangiomas of ≥ 10 cm in diameter.Technical success,complications related to RFA,completed ablation,symptom relief,change in size of ablation zone and recurrence of the residual tumor were analyzed.The average diameters of the two groups were 7.1 ± 1.2 cm and 13.2-± 2.4 cm separately (t =-12.57,P ＜ 0.01) ; the technical achievement ratios of the two groups were both 100％ ; Seven of 32 patients with hemangiomas 5-10 cm and all the 18 patients with hemangiomas ≥ 10 cm had 13 and 61 complications related to RFA,the incidence of complications were 21.88％ and 100％ respectively (x2 =28.13,P ＜ 0.01); 94.55％ hemangiomas (52/55) acquired complete ablation,the complete ablation rates of 5-10 cm hemangiomas and ≥10 cm hemangiomas were 100％ (36/36) and 84.21％ (16/19) respectively (P =0.014).The mean diameters of ablation zone were respectively decreased to 5.3 ± 1.0 cm and 10.62±1.8 cm (t =-14.30,P ＜0.01).Conclusions RFA for hepatic hemangiomas 5-10 cm in diameter is safe and effective; while its complication for ablation of hemangiomas ≥ 10 cm is high.

The aim of the study was to investigate the population ecology of medical shellfish and the infection of An-giostrongylus cantonensis in Longhai ,Fujian Province ,China .Aquatic and terrestrial shellfish were collected in survey points according to different types of breeding grounds .Then ,lung-microscopy method was involved in the detection of the lung tis-sue in Ampullaria gigas .Other shellfishes were mashed to detect the third-stage larvae of Angiostrongylus cantonensis .Hom-ogenization and lung microscopy were compared in the detection of the larvae of A .cantonensis in Achatina snails .Factors re-lated to the environment and influence of shellfish hosts were also included .Results showed that 8 species of molluscans were found ,including Pila gigas ,Bellamya aeruginosa ,Bellamya lithophaga ,Melanoides tuberculata ,Achatina fulica ,Vag-inulus alte ,Philomycus bilineatus ,and Bradybaenasimilaris with 1 673 specimens in 27 survey points from 9 townships .The infectionratewas19.78% inaverage.TheinfectionrateinV.altewas56.63% (47/83);theinfectionratesforA.fulicaand P .gigas were 39 .32% (92/234) and 27 .14% (130/234) ,respectively .The infection rate of each survey point was closely re-lated to the distances from the residents living area .Morever ,A .cantonensis larvae were detected in M .tuberculata .Lung mi-croscopy and homogenization method detection rate was 87 .1%and 100 .0% ,respectively .The difference was statistically sig-nificant .In conclusion ,V .alte ,A . fulica and P .gigas were A . cantonensist infection dominant population . The infection rate was closely related to micro-ecological environment for all kinds of shellfish .M .tuberculata was the new host of A .can-tonensis .Lung microscopy method should not be used in the qualitative screening detection of A . f ulica infected with A .can-tonensist .

Objective To establish A1E3 and B1C4 monoclonal antibody-based ELISA for detecting circulating antigen of Schistosoma japonicum and explore its application value in the field. Methods The characteristics of A1E3 and B1C4 monoclonal antibodies were analyzed by SDS-PAGE and Western blotting. The SEA-based ELISA was used to evaluate the titers of A1E3 and B1C4. The orthogonal test was used to determine the best concentration of coating antibody B1C4 and optimal working concentra-tion of A1E3-HRP. Under the optimal conditions,the serum samples of 20 acute schistosomiasis cases,46 chronic schistosomiasis cases,and 20 control sera were tested to evaluate its detection sensitivity and specificity. Seventy-two antibody positive serum sam-ples from Jiangling County of Hubei Province were detected and compared to a commercially available ELISA kit,to evaluate the detection effects of this method. Results The results of SDS-PAGE demonstrated that the purified A1E3 and B1C4 contained a clear heavy chain with molecular weight of 88 000 and 52 000 respectively and had the same light chain with molecular weight of 20 000;while Western blotting demonstrated that A1E3 and B1C4 could be recognized by SEA and serum samples of acute schis-tosomiasis cases. The SEA-based ELISA demonstrated the titers of B1C4 and A1E3 were 1∶105 and 1∶30 000,respectively. The serum samples from all the acute cases and 86.9% of the chronic cases showed a positive reaction. All of the control sera from healthy persons gave a negative response. The positive rates of the double monoclonal antibody ELISA and commercial ELISA for detecting the circulating antigen were 45.8%and 43.1%respectively,and there was no significant difference between the results of the two methods. Conclusion A1E3 and B1C4 monoclonal antibody-based ELISA is established successfully. It exhibits a high sensitivity and specificity in detecting circulating antigen of Schistosoma japonicum.

OBJECTIVETo investigate the differential expression pattern of hsa-miR-9 between EBV-positive and -negative Burkitt lymphoma cell lines and its association with BCL-6.

METHODSThe expression of hsa-miR9 and BCL-6 mRNAs in EBV(+) Raji and EBV-Ramous cells in mRNA levels were detected using fluorescence quantitative PCR (QRT-PCR). The two cells lines were transiently transfected with hsa-mir9-inhibitor and hsa-mir9-minicsvia Oligofectamine 2000, and the changes in BCL6 expressions was detected using QRT-PCR and Western blotting. Annexin V/PI staining was used to analyze the apoptosis and morphological changes of the transfected cells.

RESULTSThe expression of Hsa-miR9 and BCL-6 was significantly higher in EBV(+) Raji cells than EBV(-) Ramous cells (P<0.01). BCL-6 mRNA and protein expression was reduced in EBV(+) Raji cells after transfection with hsa-miR9-inhibitor but up-regulated in EBV(-) Ramous cells transfected with hsa-miR9-minics. Flow cytometry revealed a significantly decreased apoptosis rate in EBV(+) Raji cells transfected with hsa-miR9-inhibitor but an increased rate in EBV(-) Ramous cells transfected with hsa-miR9-minics, and the results were confirmed by microscopic observations.

CONCLUSIONHsa-miR9 positively regulate the expression of BCL-6 and apoptosis of EBV(+) Raji cells and EBV(-) Ramous cells.

Apoptosis ; Burkitt Lymphoma ; genetics ; pathology ; virology ; Cell Division ; Cell Line, Tumor ; DNA-Binding Proteins ; genetics ; metabolism ; Gene Expression Regulation, Neoplastic ; Herpesvirus 4, Human ; Humans ; MicroRNAs ; metabolism ; Proto-Oncogene Proteins c-bcl-6 ; Transfection

Objective To get a MR imaging protocol for coronary arterial wall in vitro. Methods MR examinations were performed in 10 fresh porcine hearts. Three dimensional fast imaging employing steady state acquisition (3D FIESTA) was used to delineate left anterior descending artery (LAD), while 2D spin-echo T1W was performed with 8-channel head surface coil, temporomandibular surface coil and knee coil with the same parameters. T1WI was obtained with 384×256 and 512×512 in matrix using temporomandibular surface coil, and then T1WI, PDW and T2WI with fat saturation were obtained with different NEX using temporomandibular surface coil after injecting Resovist in LAD. Signal of the LAD wall, lumen, fat tissue adjacent to LAD, myocardium of anterior part of interventricular septum and noise were respectively measured. Signal-to-noise ratio (SNR) of image, contrast to noise ratio (CNR) between the wall and lumen (CNR1), CNR between the wall and surrounding fatty tissue (CNR2) were calculated. Results The SNR and CNR1, CNR2 of SE T1WI with temporomandibular coil were higher than those with 8-channel head surface coil and knee coil. SNR and CNR1, CNR2 of SE T1WI with 384×256 matrix were higher than those with 512×512 matrix. SNR and CNR1, CNR2 using 3 NEX were the highest. Conclusion Good SNR and CNR of porcine coronary wall can be achieved using temporomandibular surface coil, 384×256 in matrix and NEX of 3.