Taking the Chinese city of Xiamen as an example, simulation and quantitative analysis were performed on the transmissions of the Coronavirus Disease 2019 (COVID-19) and the influence of intervention combinations to assist policymakers in the preparation of targeted response measures. A machine learning model was built to estimate the effectiveness of interventions and simulate transmission in different scenarios. The comparison was conducted between simulated and real cases in Xiamen. A web interface with adjustable parameters, including choice of intervention measures, intervention weights, vaccination, and viral variants, was designed for users to run the simulation. The total case number was set as the outcome. The cumulative number was 4,614,641 without restrictions and 78 under the strictest intervention set. Simulation with the parameters closest to the real situation of the Xiamen outbreak was performed to verify the accuracy and reliability of the model. The simulation model generated a duration of 52 days before the daily cases dropped to zero and the final cumulative case number of 200, which were 25 more days and 36 fewer cases than the real situation, respectively. Targeted interventions could benefit the prevention and control of COVID-19 outbreak while safeguarding public health and mitigating impacts on people's livelihood.
COVID-19/prevention & control* ; China/epidemiology* ; Humans ; Machine Learning ; Pandemics/prevention & control* ; Policy ; Reproducibility of Results ; SARS-CoV-2

Objective To investigate the effects of bolus thickness and use frequency on skin dose in postmastectomy intensity-modulated radiotherapy. Methods We retrospectively reviewed 20 cases receiving postmastectomy fixed-field intensity-modulated radiotherapy, to analyze the homogeneity index (HI) and conformity index (CI) of the target volume and the skin dose (D_max, D_mean, and D_min) of radiotherapy plans with 0.5 cm-thick bolus or 1 cm-thick bolus alone at a use frequency of 5 F, 10 F, 15 F, 20 F, and 25 F versus a combination of 0.5 cm and 1 cm-thick bolus, and fit the relationship between skin dose and bolus use frequency. Results As the bolus use frequency increased, the skin dose increased, the hot spot of the target volume decreased, and the low-dose volume decreased. The HI of the target volume with the 1 cm bolus was better than that with the 0.5 cm bolus at all use frequencies (P < 0.05), and HI decreased with the increase of bolus use frequency. For both 0.5 cm and 1 cm bolus, the CI of the target volume increased initially and then decreased, reaching the maximum value at a frequency of around 15 F; the CI showed significant differences only at 20 F and 25 F between the two types of bolus (P < 0.05). The skin D_max and D_mean were significant higher with the 0.5 cm bolus than with the 1 cm bolus (P < 0.05). The equation for the relationship between skin dose (D) and bolus use frequency (F) was D = A × F + B × F² + C. The D_max and HI with the combination of 0.5 cm bolus (6 F) plus 1 cm bolus (8 F) fell between those with the 0.5 cm bolus (15 F) and those with the 1 cm bolus (15 F) (P < 0.05). Conclusion In postmastectomy fixed-field intensity-modulated radiotherapy, skin dose can be calculated based on bolus use frequency. Mixed use of bolus may be more suitable than use of 0.5 cm bolus or 1 cm bolus alone.

Objective: To investigate the incidence and treatment of perioperative anemia in patients with gastrointestinal neoplasms in Hubei Province. Methods: The clinicopathological data of 7 474 patients with gastrointestinal neoplasms in 62 hospitals in 15 cities (state) of Hubei Province in 2019 were collected in the form of network database. There were 4 749 males and 2 725 females. The median age of the patients was 62 years (range: 17 to 96 years). The hemoglobin value of the first time in hospital and the first day after operation was used as the criterion of preoperative anemia and postoperative anemia. Anemia was defined as male hemoglobin <120 g/L and female hemoglobin <110.0 g/L, mild anemia as 90 to normal, moderate anemia as 60 to <90 g/L, severe anemia as <60 g/L. The t test and χ² test were used for inter-group comparison. Results: The overall incidence of preoperative anemia was 38.60%(2 885/7 474), and the incidences of mild anemia, moderate anemia and severe anemia were 25.09%(1 875/7 474), 11.37%(850/7 474) and 2.14%(160/7 474), respectively. The overall incidence of postoperative anemia was 61.40%(4 589/7 474). The incidence of mild anemia, moderate anemia and severe anemia were 48.73%(3 642/7 474), 12.20%(912/7 474) and 0.47%(35/7 474), respectively. The proportion of preoperative anemia patients receiving treatment was 26.86% (775/2 885), and the proportion of postoperative anemia patients receiving treatment was 14.93% (685/4 589). The proportions of preoperative anemia patients in grade ⅢA, grade ⅢB, and grade ⅡA hospitals receiving treatment were 26.12% (649/2 485), 32.32% (85/263), and 29.93% (41/137), and the proportions of postoperative anemia patients receiving treatment were 14.61% (592/4 052), 22.05% (73/331), and 9.71% (20/206). The proportion of intraoperative blood transfusion (16.74% (483/2 885) vs. 3.05% (140/4 589), χ²=434.555, P<0.01) and the incidence of postoperative complications (17.78% (513/2 885) vs. 14.08% (646/4 589), χ²=18.553, P<0.01) in the preoperative anemia group were higher than those in the non-anemia group, and the postoperative hospital stay in the preoperative anemia group was longer than that in the non-anemia group ((14.1±7.3) days vs. (13.3±6.2) days, t=5.202, P<0.01). Conclusions: The incidence of perioperative anemia in patients with gastrointestinal neoplasms is high. Preoperative anemia can increase the demand for intraoperative blood transfusion and affect the short-term prognosis of patients. At present, the concept of standardized treatment of perioperative anemia among gastrointestinal surgeons in Hubei Province needs to be improved.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anemia/epidemiology* ; Blood Transfusion ; Female ; Gastrointestinal Neoplasms/surgery* ; Humans ; Length of Stay ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

Objective To explore parental confidence on immunization and its influential factors and provide scientific basis for immunization management and confidence enhancement strategy in Jinhua. Methods A questionnaire survey was conducted among 1 865 parents in the district, and the cumulative Logit regression model was used to analyze the influential factors of parental confidence on immunization. Results It was found that 96.41% of the children′s parents believed immunization was necessary, 70.03% believed immunization was safe, 93.51% was willing to be vaccinated, and parental confidence on immunization was 90.89%.The sequence of influential factors of confidence was satisfaction of immunization services, cognitive level of immunization knowledge, immunization about route and age obtained through medical staff. Conclusion By strengthening health education and health promotion, improving the cognitive level of parents′ immunization knowledge and elevating the quality of daily immunization service, the parental confidence can be improved effectively in immunization.

Objective: To systemically investigate the volatile organic compounds (VOCs) of Viola yedoensis, and to compare the VOCs differences of V. yedoensis obtained by the needle trap, static headspace and hydrostillation methods. Method: The needle trap, static headspace and hydrostillation methods coupled with gas chromatography-mass spectrometer (GC-MS) were developed for isolation and identification of the VOCs in V. yedoensis. The relative content of each component was obtained by peak area normalization with a triple-bed needle packed with Tenax, Carbopack X and Carboxen 1000 sorbents. Result: The 112 compounds were trapped by using needle trap, mainly moderate volatile components, including aldehydes, ketones, alcohols, monoterpenes, sesquiterpenoids and aromatic compounds. The static headspace and hydrodistillation methods were allowed to obtain 37 (mainly the high-volatile components) and 78 compounds (mainly low-volatile components), respectively. Only 13 common volatile components were detected in all these three methods. Conclusion: The results clearly demonstrated that the needle trap method is an alternative method for sampling VOCs of herbs, characterized by fast analysis, simple operation, good enrichment effect and high sensitivity.These three methods for VOCs analysis are complementary for each other.

Objective To evaluate the significance of liver biopsy and B ultrasonograpgy in the diagnosis of fatty liver. Methods The results of 62 patients with liver steatosis diagnosed by liver puncture biopsy but not by B-ultrasonograpgy were contrastively analyzed and combined with liver function, blood lipids, blood glucose, and body mass index. Results The 62 cases which were not diagnosed as fatty liver by B-ultrasonograpgy were proved to be 5％-33％liver steatosis after liver puncture biopsy. Among the 62 cases, 23 cases were indicated by the B-ultrasonograpgy that the liver parenchyma echo did not see abnormalities, 18 cases showed the liver parenchyma echo slightly was enlarged, 17 cases showed the liver parenchyma echo density was a bit enhanced and 4 cases were diffuse liver damage,which respectively were 37.01％、29.03％、27.42％and 6.45％. Pathologically it indicated that 45 cases were 5％≤liver steatosis≤19％. Among the 45 cases, 18 cases were indicated by the B-ultrasonograpgy that the liver parenchyma echo was not seen abnormalities, 8 cases showed the liver parenchyma echo slightly was enlarged, 17 cases showed the liver parenchyma echo density was a bit enhanced, and 2 cases were diffuse liver damage, and the change of ultrasound was mainly showed by the liver parenchyma echo not seen abnormalities and the enhanced liver parenchyma echo density. Pathologically it indicated that 17 cases were 20％≤liver steatosis≤33％, 6 cases were indicated by the B-ultrasonograpgy that the liver parenchyma echo did not see abnormalities, 5 cases showed the liver parenchyma echo slightly was enlarged, 5 cases showed the liver parenchyma echo density was a bit enhanced, and 1 case was diffuse liver damage, and the change of ultrasound was mainly showed by the liver parenchyma echo not seen abnormalities, the slightly enlarged liver parenchyma echo and the enhanced liver parenchyma echo density. By analyzing the influence to the ultrasound changes by patients' liver function, body mass index, blood fat and blood sugar, and with logistic regression analysis through a disorderly classification, it was found that the larger value of the glutamine transferase, alkaline phosphatase, body mass index, triglyceride and low density lipoprotein cholesterol, the higher possibility of diffuse liver damage, and the higher level of fatty degeneration, the higher possibility of diffuse liver damage. Conclusion In the diagnosis of fatty liver, when the fatty degeneration is below 1/3, B-ultrasonic examination can't show characteristic changes of fatty liver. It should be closely observed or take liver puncture biopsy to make a definite diagnosis of fatty liver.

Objective To observe the effect of nicorandil on slow-flow phenomenon in percutaneous coronary intervention (PCI) in patients with acute non-ST segment elevated myocardial infarction (NSTEMI). Methods A total of 159 NSTEMI patients were enrolled. Based on the TIMI flow of target lesion blood vessels after PCI, patients were divided into two groups. There were 31 cases in no flow/slow flow group (TIMI≤2), and 128 cases in normal group (TIMI=3). The general clinical data, immediate TIMI flow grade of infarct-related artery (IRA) after PCI treatment, post-operative corrected TIMI frame count (CTFC), TIMI myocardial perfusion grade (TMPG), thrombolysis in myocardial infarction signs of a blood clot, number of diseased vessels and major adverse cardiac events were compared between the two groups. The patients in no flow/slow flow group were given nicorandil, and changes of blood flow before and after treatment were observed. The influence factors of no flow/slow flow were analyzed by multifactor Logistic regression. Results The proportions of patients with history of smoking, the proportion of patients with diabetes history, the proportion of patients with hyperlipidemia, the proportion of patients with low blood pressure in operation, and the number of implanted stents, the proportions of patients took tirofiban in operation, post-operative CTFC, the proportions of patients with thrombosis signs were significantly higher in no flow/slow flow group than those in the normal group (P<0.05). There were no significant differences in heart rates in operation, IRA distribution and the number of lesion vessels between the two groups. There were also no significant differences in the incidence of MACE and left ventricular ejection fraction between the two groups. After the application of nicorandil, the proportion of patients with TIMI blood flow 3 and proportions of cTFC and TMPG were significantly higher than before treatment (P<0.05). Results showed that smoking history, history of diabetes, multiple stents (more than 3), hypotension in PCI, and signs of blood clot were factors influencing the slow flow of coronary arteries. Conclusion Nicorandil can significantly improve the no flow/slow flow in PCI in patients with NSTEMI.

Objective To investigate the role of rho-associated coiled-coil containing protein kinase 1 (ROCK1) and the relative signal molecules in sensing the mechanical stimulation from tensile strain and regulating the proliferation of vascular smooth muscle cells (VSMCs). Methods Physiological cyclic strain with magnitude of 10% and at frequency of 1.25 Hz was applied to VSMCs in vitro by using strain loading system. The proliferation level of VSMCs was analyzed by BrdU ELISA; the expression level of ROCK1, phosphorylations of protein kinase C (PKC) α/β II, protein kinase D (PKD) and extracellular regulated protein kinase (ERK) in VSMCs modulated by cyclic strain were detected with Western blotting; the expression of ROCK1 was specifically repressed by using RNA interference (RNAi). Results Compared with the static control, 10% cyclic strain significantly decreased the expression of ROCK1 and phosphorylations of PKD and ERK. The phosphorylation of PKCα/βII was decreased significantly under 10% cyclic strain for 12 h, but returned to normal level after 24 h-loading. Repressed expression of ROCK1 with RNAi significantly down-regulated VSMC proliferation, suppressed phosphorylations of PKCα/βII and PKD, but no obvious change was found in phosphorylation of ERK. Conclusions Physiological cyclic strain with magnitude of 10% may repress the phosphorylation of PKCα/βII and PKD via inhibiting the expression of ROCK1, which subsequently affect VSMC proliferation and maintain vascular hemostasis. The investigation on intracellular mechanotransduction network of VSMCs under mechanical stimulation of cyclic strain may contribute to the physiological and pathological mechanisms of cardiovascular diseases.

Objective To investigate the role of Rho-associated coiled-coil containing protein kinase 1 (ROCK1) and the relative signal molecules in sensing the mechanical stimulation from tensile strain and regulating the proliferation of vascular smooth muscle cells (VSMCs).Methods Physiological cyclic strain with magnitude of 10％ and at frequency of 1.25 Hz was applied to VSMCs in vitro by using the strain loading system.The proliferation level of VSMCs was analyzed by BrdU ELISA;the expression level of ROCK1,phosphorylations of protein kinase C (PKC) α/β Ⅱ,protein kinase D (PKD) and extracellular regulated protein kinase (ERK) in VSMCs modulated by cyclic strain were detected with Western blotting;the expression of ROCK1 was specifically repressed by using RNA interference (RNAi).Results Compared with the static control,10％ cyclic strain significantly decreased the expression of ROCK1 and phosphorylations of PKD and ERK.The phosphorylation of PKCα/βⅡ decreased significantly under 10％ cyclic strain for 12 h,but returned to normal level after loading for 24 h.Repressed expression of ROCK1 with RNAi significantly down-regulated VSMC proliferation,suppressed phosphorylations of PKCα/βⅡ and PKD,but no obvious changes were found in phosphorylation of ERK.Conclusions Physiological cyclic strain with magnitude of 10％ may repress the phosphorylation of PKCα/βⅡ and PKD via inhibiting the expression of ROCK1,and subsequently affects VSMC proliferation and maintains vascular hemostasis.The investigation on intracellular mechanotransduction network of VSMCs under mechanical stimulation of cyclic strain may contribute to studying the physiological and pathological mechanisms of cardiovascular diseases.

This cohort study was designed to evaluate the association of transcription factor 7-like 2 (TCF7L2) and proglucagon gene (GCG) variants with disordered glucose metabolism and the incidence of type 2 diabetes mellitus (T2DM) in a rural adult Chinese population. A total of 7,751 non-T2DM participants ⋝18 years old genotyped at baseline were recruited. The same questionnaire interview and physical and blood biochemical examinations were performed at both baseline and follow-up. During a median 6 years of follow-up, T2DM developed in 227 participants. After adjustment for potential contributory factors, nominally significant associations were seen between TT genotype and the recessive model of TCF7L2 rs7903146 and increased risk of T2DM [hazard ratio (HR)=4.068, 95% confidence interval (CI): 1.270-13.026; HR=4.051, 95% CI: 1.268-12.946, respectively]. The TT genotype of rs7903146 was also significantly associated with higher fasting plasma insulin level and the homeostasis model assessment of insulin resistance in case of new-onset diabetes. In addition, the TCF7L2 rs290487 TT genotype was associated with abdominal obesity and the GCG rs12104705 CC genotype was associated with both general obesity and abdominal obesity in case of new-onset diabetes.
Adult ; Cohort Studies ; Diabetes Mellitus, Type 2 ; complications ; genetics ; Female ; Humans ; Insulin ; secretion ; Insulin Resistance ; genetics ; Male ; Middle Aged ; Obesity ; complications ; genetics ; Polymorphism, Single Nucleotide ; Proglucagon ; genetics ; Transcription Factor 7-Like 2 Protein ; genetics