Background Formaldehyde is a common air pollutant in residential buildings, and the health risks caused by formaldehyde in residential buildings can not be ignored. Objective This study aims to evaluate the air concentration of formaldehyde in non-newly decorated houses in Ningbo and its possible health risks. Methods A total of 72 houses without any decoration in the past one year in Ningbo were selected by multi-stage random sampling method. From July 2018 to January 2019, the air samples of living rooms and bedrooms were collected and their temperature and humidity were also measured. The concentrations of formaldehyde were detected by AHMT method according to Standred method for hygienic examination of formaldehyde in air of residential areas — Spectrophotometric method (GB/T 16129—1995) , the health risk assessment model of U.S. Environmental Protection Agency was used to evaluate the non-carcinogenic risk and carcinogenic risk of formaldehyde, and Monte Carlo simulation was used for sensitivity analysis. Results The median (P₂₅, P₇₅) of formaldehyde concentration in the 72 houses was 0.019 (0.012,0.026) mg·m⁻³. Only one house showed a formaldehyde concentration that exceeded the national standard in the living room, and the total qualified rate of formaldehyde concentration was 98.61%. The median (P₂₅, P₇₅) of formaldehyde concentration in the bedroom was 0.019 (0.011, 0.031) mg·m⁻³, which was higher than that in the living room, 0.015 (0.010, 0.024) mg·m⁻³, and the difference was statistically significant. The median and 90th percentile of non-cancer risk (hazard quotient, HQ) of the 72 houses were 1.35 and 2.80, respectively, and the proportion of the houses with HQ>1 was 62.50%. The median and 90th percentile of cancer risk (CR) of the 72 houses were 1.12×10⁻⁴ and 2.32×10⁻⁴, respectively, and the proportions of the houses with CR>1×10⁻⁶, CR>1×10⁻⁵, and CR>1×10⁻⁴ were 100.00%, 100.00%, and 54.20%, respectively. After using Monte Carlo simulation, the median (90th percentile) of non-carcinogenic risk was reduced to 0.91 (1.94), where the median was lower than the national limit, and the proportion of samples with HQ>1 was 44.73%; the carcinogenic risk was reduced to 7.52×10⁻⁵ (1.79×10⁻⁴), and the proportions of samples with CR>1×10⁻⁶, CR>1×10⁻⁵, and CR>1×10⁻⁴ were 100.00%, 98.96%, and 34.37%, respectively. Conclusion The concentration of formaldehyde in non-newly decorated houses in Ningbo basically meets the national requirements, but it is still necessary to pay attention to the non-carcinogenic risk and carcinogenic risk caused by indoor formaldehyde, among which the carcinogenic risk is more important. Residents should prevent the harm of formaldehyde from its source by considering clean decoration materials and environmentally friendly furniture.

Objective:To develope a self-adjustable automatic planning method of intensity modulated radiotherapy based on predicted dose, in order to enhance the robustness of automatic planning.Methods:After the patients′ dose by 3D U-Res-Net_B network was predicted, the current dose was calculated based on the last iteration result, then the predicted dose was combined to calculate the target dose and optimized. With all iterations completed or exit conditions satisfied, final treatment plannings would be acquired. A total of 30 cases of rectal cancer were tested to verify the effectiveness of the algorithm.Results:The mean value of planning target volumes′ V100% was (95.03±0.91)% for clinical plans, close to (94.67±1.96)% for automatical plans( P>0.05), and better than (92.90±2.13)% for predicted dose with the statisically significant difference ( t=29.0, P<0.05). Automatic planning′s indexes such as V35 of small intestines, V40 of bladders and V20 - V40 of femoral heads were lower than predicted and clinical ones, with the statisically significant difference( t=4.5-118.0, P<0.05). Discrepancy in other indexes of organs at risk was not statistically significantly different( P>0.05). Conclusions:This method made automatic planning processes more robust and more adaptive to difficult clinical situations.

BACKGROUND: After general thoracic surgery, a chest tube is usually placed for closed drainage to expel gas accumulation in the thoracic cavity and fluid accumulation to promote lung re-expansion. It can also be observed whether there is active bleeding after the operation and whether there is a pulmonary leak. The conventional drainage of the chest cavity is connected with a water-sealed drainage bottle, and the patient condition is judged by observing the drainage situation and the fluctuation of the water column, which is a very classic method. However, the water-sealed bottle has the disadvantages of being easy to overturn and inconvenient to carry, which is not conducive to the early activities of patients. Under the concept of accelerated rehabilitation, our center applied a new type of anhydrous thorax negative pressure drainage device and achieved good results. The purpose of this study was to observe the effect of a new type of anhydrous thoracic negative pressure drainage device in patients after thoracic surgery. METHODS: Retrospective analysis of patients who underwent lung surgery in the First Affiliated Hospital of Zhejiang University Medical College from January 2018 to December 2019, patients were divided into two groups. One group of patients used a traditional closed-chest drainage water-sealed bottle as a control group, and the other group used a new type of anhydrous negative-pressure drainage bottle as an experimental group. Patients' gender, age, hypertension, diabetes, smoking history, surgical incisions and surgical methods, and the length of hospital stay and postoperative hospital stay were calculated. RESULTS: There were no statistical differences in age, gender, comorbidities (hypertension, diabetes, smoking history), scope of surgery, and duration of surgery between the two groups of patients, but there were statistical differences in surgical incisions between the two groups of patients (P=0.01). We found that patients using the new waterless negative pressure drainage device were shorter than patients with water negative pressure drainage device in terms of postoperative hospital stay and total hospitalization time, and the difference was statistically significant (P=0.02, P=0.04). CONCLUSIONS The new type of anhydrous thoracic negative pressure drainage device has a good effect on the rapid recovery and advancement after thoracic surgery.

ObjectiveTo investigate the association of complement C3 with clinical and serological features of patients with systemic lupus erythematosus.MethodsData was collected by the same methods in the past ten years in fifteen hospitals in Jiangsu Province and then data weres summarized for retrospective analysis.Clinical and laboratory data were selected and then analyzed by Chi-square test,Wilcoxon rank sum test and Logistic regression.ResultsOne thousand four hundred and five patients were investigated.One thousand and forty two had low serum complement C3 level.In this case control study,hospitalization age,disease course,admission times,pleurisy,gastrointestinal involvement,general lymphadenopathy/hepatosplenomegaly,white blood cell count, haemoglobin level,platelet count, serum C-reactive protein level,serum albumin level,serum creatinine level,Urine protein quantification,anti-nuclear antibodies (ANA),anti-dsDNAantibodies, anti-SmantibodiesandSLEDAIscore were possible factors associatedwith complement C3 reduction(P＜0.05).Logistic regression analysis showed that CRP (OR=0.396,0.254-0.617,P=0.000),ANA (OR=2.907,1.267-6.670,P=0.012),urine protein level(OR=1.702,1.043-2.779,P=0.033) and SLEDAI score (OR-0.930, 0.886-0.975,P-0.003) were correlated with complement C3 reduction.Conclusion Complement C3 level is valuable for lupus flare assessment.The complement C3 reduction is a risk factor for renal impairment.

Objective To investigate the initial manifestation and disease onset feature of systemic lupus erythematosus(SLE) in the past ten years in fifteen hospitals in Jiangsu Province.Methods Data was collected by the same Methodsin all the participated hospitals and then it was summarized for retrospective analysis.Two groups were compared by chi-square test.Results ① One thousand nine hundred and fifty eight patients were investigated and the male-to-female ratio was 1∶15.0.② One thousand seven hundred and ninty eight patients had clear initial manifestations.The most common initial manifestations were skin and mucosal lesions(769 cases,42.8％ ) and arthritis (697 cases,38.8％ ).The main skin lesion was malar rash (706 cases).Arthritis was found to be more common in female than male.③ All hospitalized patients at their first admission showed multiple organ/system involvement:the most common involvement was skin and mucous membrane (82.3％),hematologic damage (74.0％),in which at least one series of blood cells were involved,arthritis (1156 cases,56.5％ ) much more than myositis (51 cases),proteinuria 1046 cases and hematuria in 385 cases.Renal biopsy pathology showed type Ⅳ glomerulonephritis.Conclusion ① SLE patients are mainly female and the male to female ratio is 1∶15.0.② The most common initial manifestations are skin and mucosal lesions.③ The most commonly involved organ/system are skin and mucous membrane,blood,joint and kidney.The most common pathological changes shown in renal biopsy is type Ⅳ glomerulonephritis.

Objective To explore the relationship between the impairment of hematological system and disease activity,immunological parameters,and the prognosis of systemic lupus erythematosus (SLE).Methods The clinical and laboratory data of in-patients with SLE in Jiangsu Province were investigated and all patients were hospitalized between 1999-2009.The impairment of hematological system was assessed and the relationship between hematological system damage and disease activity,immunological parameters,mortality rate of patients with SLE were analyzed.Statistic method used was X2 test.Results One thousand nine hundred and fifty eight cases of SLE were included in the study,in which,1836 were female and 122 were male.One thousand five hundred and forty nine (79.1%) patients complicated with hematological system damage,62.3% were anemia,45.5% with leucopenia and 29.4% with thrombocytopenia.There were significant differences in hematological system damage rate among patients with mild activity group,moderate activity group,severe activity group and almost no activity group,compared respectively with almost no activity group.The P values were P=0.01 and P＜0.01 respectively.The incidence of hematological system damage in elevated ESR,low complement C3 level,anti-dsDNA antibody group was higher than that in patients who had normal ESR,complement C3 level and anti-dsDNA group.(P＜0.01).During follow-up,166 patients died,of which the mortality rate(91.6%) in patients had hematological system damage,was obviously higher than those without hematological damage(8.4%)(P＜0.01 ).Among the 166 deceased patients,38.6% died of severe infection,22.9% died ofrenal failure,15.1% died ofnervous system damage,10.2% died of cadiovascular damage and 13.3% died from other causes.Conclusion Hematological system is one of the most commonly involved system in patients with SLE,of which anemia is the most common,and the incidence of leukopenia follows.The impairment of hematological system is closely related to lupus activity.Patients with abnormal immune parameters tend to have secondary hematological system damage.Severe infection is the main cause of death in patients with lupus,followed by nervous system damage and kidney damage.The mortality rate in patients with lupus that complicated hematological system damage is higher than patients who have no hematological system damage.

The main aim of this study was to transform the enhanced green fluorescent protein gene (egfp) into biocontrol fungus Paecilomyces lilacinus strain 9410. We constructed the expression vector pUPNGT of the fusion gene nptII-egfp using pcDNA3.1(-) as a helper plasmid. The egfp gene was then transformed into P. lilacinus strain 9410 via Agrobacterium tumefaciens-mediated transformation. PCR and Southern blotting analysis showed that the egfp gene was integrated into the genomes of the tested transformants and the integration manner was single-copy. The transformants could generate green fluorescence when they were excited by 488 nm blue laser. These results indicated that the egfp gene had been successfully transformed into P. lilacinus 9410 and expressed in the tested transformants. Our work may provide a new approach to assess environmental safety and practical biocontrol efficacy ofP. lilacinus under different conditions.
Agrobacterium tumefaciens ; genetics ; Green Fluorescent Proteins ; genetics ; Paecilomyces ; genetics ; metabolism ; Polymerase Chain Reaction ; methods ; Transformation, Genetic

ObjectiveTo study B-cell activating factor(BAFF)/a proliferation inducing ligand (APRIL)protein and mRNA expression levels in patients with primary Sj(o)gren's syndrome(pSS)and its contribution to the pathogenesis of pSS.Methotis The levels of serum BAFF and APRIL were tested by ELISA method in 32 pSS patients and compared with 23 healthy control sabjects.BAFF/APRIL protein levels of labial salivary glands were examined in 17 pSS patients by immunohistochemical staining and compared with 8 healthy controls.BAFF/APRIL mRNA expression relative levels to GAPDH of PBMC were also detected in 18 pSS patients by real time RT-PCR and compared with 20 healthy controls.The relationship between BAFF/APRIL levels and several clinical manifestations in pSS patients were analyzed.Results The median level of serum BAFF in pSS were markedly higher than that in healthy controls[(7.4±3.9)ng/ml vs(3.7±1.1)ng/ml,P＜0.01].Serum APRIL levels were also significantly elevated compared to healthy controls[(26±15)ng/ml vs(16±15)ng/ml,P=0.039].The higher levels of BAFF were associated with higher levels of IgG,ESR.total globulin and the titer of ANA(P＜0.05).There was a positive correlation between serum APRIL levels and ESR and labial salivary gland lymphocyte focus scores(P＜0.05).The two cytokines levels inversely correlated with the count of peripheral white blood cells and platelets in pSS(P＜0.05).When comparing serum Ievels of APRIL and BAFF in patients with pSS,a positive correlation could be found(r=0.534,P=0.002).The BAFF/APRIL protein levels were higher in infiltrating lymphocytes of labial salivary glands from pSS patients than from the controls(P＜0.05).The BAFF mRNA[(0.023±0.024)vs(0.245±0.188),P＜0.01]and APRIL mRNA[(0.047±0.035)vs(0.130±0.097),P=0.002]levels of PBMC were significantly lower in pSS patients than in the normal controls.Conclusion The BAFF/APRIL levels of serum and labial salivary glands are significantly elevated in patients with pSS and correlate with clinical parameters.These indicate that BAFF and APRIL may be involved in the pathogenesis of pSS.The low BAFF mRNA and APRIL mRNA levels of PBMC in pSS may reveal that the production and regulation of this system is complicated.

Objective To study the association of serum cartilage oligomeric matrix protein (COMP)with disease activity and early joint destruction of rheumatoid arthritis (RA). Methods The serum levels of COMP were measured with ELISA in 94 patients with RA and 40 controls. The serum level of erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (ACCP) and hand X-ray were examined at the same time. Results Significantly increased serum level of COMP was found in RA patients (11.3±5.2) U/L as compared to that in healthy controls (9.2±1.7) U/L (P=0.017).Serum level of COMP was higher in 64 active patients (14±6) U/L than that in 30 inactive disease (9±4) U/L(P=0.005). COMP level was positively correlated with the number of the affected joints, X-ray stage, CRP and ESR level (P<0.05); but had no correlation with age, disease course, grade of joint function, RF and ACCP levels. Thirty patients were followed for two years and their radiographic changes were evaluated at the baseline and the end of this study. Sixteen of 18 patients with high concentration serum COMP level had radi-ologic progression, but only 5 of 12 patients with no increase of serum COMP had radiologic progression. A significant difference (P=0.013) was founded in the two groups. Conclusion The present data suggests that the level of COMP is high in patients with RA. High serum levels of COMP indicate high disease activity and early progressive of bone destruction in RA patients. We can us COMP as a laboratory marker of RA.

Objective To explore the association between serum cartilage oligomeric matrix protein (COMe) levels and joint destruction in rheumatoid arthritis (RA) and inflammatory arthritis patients. Methods Serum level of COMP was measured with ELISA in 154 arthritis patients.The results of serum COMe were compared with clinical parameters and the modified SHARe scores after 2 years in RA patients. Results Serum COMP level of RA patients was higher than that of normal controls and patients with other forms of arthritis in which only synovial membrane was involved (P＜0.05).We found a significant difference between sCOMP in osteoarthritis (OA) and psoriatic arthritis (PSA) patients with normal controls ,but not with other forms of arthritis.There was no difference of sCOMP between RA,OA or PSA patients.We found a positive correlation between baseline sCOMP and deterioration of modified SHARP scores after 2 years (P＜ 0.001,r=0.848),but did not find correlation between the baseline sCOMP and the titer of anti-CCP,RF, grade of joint function and modified SHARP scores at baseline.We also found a significant correlation between sCOMP and ESR or CRP levels,duration of morning stiffness,joint swelling scores and tenderness scores re spoctively (P＜0.05).Conclusion Serum COMP level is elevated in arthritis patients whose joint cartilage is also involved,particularly in patients with RA.The results of this study indicate that serum COMe may be used as a diagnostic and prognostic marker for cartilage destruction in established RA patients.