Objective:To investigate the status of hepatitis E virus infection in unpaid blood donors in Wenzhou.Methods:A total of 5 241 blood samples were selected from donors who successfully donated blood between October 2022 and March 2023. These samples were tested for hepatitis E virus (HEV) through HEV-IgG antibodies, HEV-IgM antibodies, and nucleic acid tests (HEV RNA). Samples that tested positive for HEV RNA underwent quantitative detection and sequencing. Data regarding the blood donors were collected, the positive rates of each test result were recorded, and the HEV infection status among different populations was analyzed.Results:The positive rate of the HEV-IgG antibody test was 23.60% (1 237/5 241), while the positive rate of the HEV-IgM antibody test was 0.29% (15/5 241). The positive rate of the HEV RNA test was 0.08% (4/5 241). The positive rate of the HEV-IgG test increased with age ( χ2 = 379.493, P < 0.05), and males had a higher positive rate than females ( χ2 = 5.12, P < 0.05). Both the positive rates of HEV-IgG and HEV-IgM tests increased as the number of blood donations increased ( χ2 = 40.87, 8.30, both P < 0.05). Furthermore, the positive rates were significantly higher in 2023 than in 2022 ( χ2 = 51.03, 13.35, both P < 0.05), and they were also significantly higher in spring than in winter ( χ2 = 51.03, 13.35, both P < 0.05). Only one HEV RNA-positive blood donor tested positive for both HEV-IgG and HEV-IgM antibodies, while the remaining three donors tested negative. Only one case was genotyped, and it belonged to genotype Ⅳ. Conclusion:The incidence of HEV infection among unpaid blood donors in Wenzhou of Zhejiang Province is relatively high, with the prevalent HEV genotype being type Ⅳ. Characteristics such as sex, age, and the number of blood donations can be utilized as auxiliary screening reference indicators.

Objective:To determine the relative correction factor of pre-vitamin D and simplify the calculation method of vitamin D assay.Methods:By studying the calculation method of vitamin D content in drug standards of various countries,HPLC was used to determine the relative correction factor of pre-vitamin D,and the influencing factors of determination were investigated.Results:The relative correction factors of pre-vitamin D at 254 nm and 265nm wavelength were determined by statistical analysis of 7 laboratories in China.Conclusion:Using the pre-vi-tamin D relative correction factor method to calculate the total amount of vitamin D simplified the experimental steps can be simplified by the pre-vitamin D relative correction factor method to calculate the total amount of vitamin D and the random operating errors can be avoided.The method is rapid and accurate,and lay a solid foundation for further improving the standard of vitamin D preparations.

Objective:To construct an evaluation index system for continuous nursing outcomes of patients undergoing knee arthroplasty.Methods:From January to May 2022, a preliminary draft of the index system was developed based on literature research, semi-structured interviews, and group discussions. We developed a questionnaire and conducted two rounds of consultation with 15 experts using the Delphi expert consultation method to construct the final index system. The positivity of experts was expressed by the effective recovery rate of the questionnaire. The expert authority coefficient was represented by the arithmetic mean of the expert's judgment basis and familiarity with the indicator. The coordination of expert opinions was represented by the Kendall's W. Results:Around two rounds of consultation, the effective recovery rates of the questionnaire were 100.0% (15/15) and 93.3% (14/15), respectively, and the expert authority coefficients were 0.815 and 0.860, respectively, and the expert Kendall's W were 0.297 and 0.121 ( P<0.01). The final evaluation index system for continuous nursing outcomes of patients undergoing knee arthroplasty included 3 primary indicators, 7 secondary indicators, and 47 tertiary indicators. Conclusions:The evaluation index system for continuous nursing outcomes of patients undergoing knee arthroplasty is strongly scientific and reliable, and has guiding significance for standardizing the continuous nursing of knee arthroplasty patients.

Bacterial antitumor therapy has great application potential given its unique characteristics, including genetic manipulation, tumor targeting specificity and immune system modulation. However, the nonnegligible side effects and limited efficacy of clinical treatment limit their biomedical applications. Engineered bacteria for therapeutic applications ideally need to avoid their accumulation in normal organs and possess potent antitumor activity. Here, we show that macrophage-mediated tumor-targeted delivery of Salmonella typhimurium VNP20009 can effectively reduce the toxicity caused by administrating VNP20009 alone in a melanoma mouse model. This benefits from tumor-induced chemotaxis for macrophages combined with their slow release of loaded strains. Inspired by changes in the tumor microenvironment, including a decrease in intratumoral dysfunctional CD8⁺ T cells and an increase in PDL1 on the tumor cell surface, macrophages were loaded with the engineered strain VNP-PD1nb, which can express and secrete anti-PD1 nanoantibodies after they are released from macrophages. This novel triple-combined immunotherapy significantly inhibited melanoma tumors by reactivating the tumor microenvironment by increasing immune cell infiltration, inhibiting tumor cell proliferation, remodeling TAMs to an M1-like phenotype and prominently activating CD8⁺ T cells. These data suggest that novel combination immunotherapy is expected to be a breakthrough relative to single immunotherapy.

Objective:To explore the efficacy and influencing factors of radiofrequency ablation (RFA) in the treatment of colorectal cancer liver metastases (CRLM).Methods:The clinical and imaging data of 281 patients (477 intrahepatic metastatic tumors) who received percutaneous RFA treatment in Sir Run Run Shaw Hospital, Zhejiang University School of Medicine from December 2009 to December 2020 were retrospectively analyzed. Factors that may affect the efficacy of RFA were recorded, including carcinoembryonic antigen (CEA), differentiation, extrahepatic metastasis, tumor location and size, complications and other information. Patients were followed up through hospital admissions, telephone, etc. The primary endpoints were overall survival (OS) and local tumor progression-free survival (LTPFS). Univariate and multivariate logistic regression models were used to identify predictors of residual tumor. Univariate and multivariate Cox proportional hazards regression were used to identify the influencing factors of LTPFS and OS. The median LTPFS and OS were estimated by the Kaplan-Meier curve and compared by the log-rank test.Results:After RFA, 68 (14.3%) tumor residues were observed. Multivariate logistic regression showed that the risk factors for residual tumor were size ≥20 mm, high-risk and perivascular location, and minimal ablative margin<5 mm. During the follow-up period, the main complication rate was 4.3% (12/281) and the fatality rate was 31.3% (88/281). At the same time, local tumor progression was found in 167 (35.0%) lesions post-RFA. The median time of LTPFS and OS estimated by the Kaplan Meier method were 35.0 (95%CI 26.53-43.48) and 44.0 (95%CI 29.70-58.30) months, respectively. The cumulative proportion of LTPFS and OS were 37.2% and 40.4% respectively in the 5th year. Multivariate Cox proportional hazard regression showed that CEA≥30 ng/ml, tumor size ≥20 mm, and minimal ablative margin<5 mm were risk factors for LTPFS; extrahepatic metastasis, tumor burden>30 mm, and lesion with minimal ablative margin<5 mm were independent risk factors for OS; re-intervention was an independent protective factor for OS.Conclusions:Adequate ablative margin and less tumor burden were beneficial to local tumor control and long-term survival of patients in the RFA treatment; the existence of extrahepatic metastasis was an important risk factor for OS, and re-interventional therapy was beneficial to extend OS.

Sodium-calcium exchanger 1 (NCX1) is a type of two-way translocator with cell membrane structure. It is involved in the transport of Ca²⁺, regulates a variety of physiological and pathological processes, and is closely related to the growth and metastasis of tumors. This article reviews the progress of the relationship between NCX1 and tumor development.

Objective To investigate the effects of silkworm excrement ironing on blood levels of glucose,lipids and Hcy in diabetic peripheral neuropathy patients with cold coagulation and blood stasis.Methods A total of 260 diabetic peripheral neuropathy patients with cold coagulation and blood stasis were randomly divided into the control group(n=130)and the observation group(n=130).Both groups were treated with oral methylcobalamin(500 μg,tid),and in addition,the observation group was given silkworm excrement ironing on areas of the limb with numbness and pain.Patients underwent one single course of treatment lasting 4 weeks.Blood levels of glucose,lipids and Hcy preand post treatment were analyzed.Results Blood lipid profiles and hemorheology improved in both groups after treatment,compared with pre-treatment data,and greater improvement was seen in the observation group than in the control group(all P＜0.05).Plasma Hcy levels decreased in both groups after treatment,compared with pre-treatment levels,and deeper decline was seen in the observation group than in the control group after treatment(all P＜0.05).Conclusions Silkworm excrement ironing can effectively improve the blood glucose profile and lipid metabolism,reduce plasma Hcy levels and may exert beneficial preventive and therapeutic effects on diabetic peripheral neuropathy.

Objective To compare and analysis clinicopathological characteristics,and to investigate progno-sis factors of gastric cancer in young patients.Methods Clinicopathological data of 103 gastric cancer in young patients (YGC,18-44 years) who underwent surgery,endoscopic and pathology diagnosis in the affiliated Jincheng Coal General Hospital of Shanxi Medical University from January 2010 to December 2014 were analyzed retrospective-ly.A total of 315 gastric cancer in older patients ( OGC,≥60 years) during the same period patients were selected and compared to the young gastric cancer patients.Results The male to female ratios was 1 1.5 and the percentage of female patients was predominant in the 103 YGC patients,and there was statistically significant different (χ2 =32.03,P<0.01).The first clinical symptoms were upper abdominal pain and hemorrhagic anemia in most of the YGC group.Gastric antruma was most common in the occurrence site of the tumor of the YGC group.The incidence of the BorrmannⅢtype andⅣtype in YGC patients was statistically higher than that of the OGC group.With regard to his-tological type,the most frequency type in the YGC group was diffuse adenocarcinoma (83%),which was statistically significant different.As compared with the OGC patients,poorly differentiated adenocarcinoma and ring cell carcinoma were predominant pathological type in YGC (χ2 =41.51,P<0.01).Nothing can be compared with T3 stage and T4 stage of the depth of invasion,and clinical stage wereⅢstage andⅣstage in most of the YGC group (χ2 =48.78, P<0.01).Patients with a family history of cancer in YGC were higher than OGC,which was statistically different (χ2 =17.39,P<0.05).There were no statistical significant difference in tumor size,Hp infection rate,level of albu-min,level of serum CEA,vascular cancer embolus and incisal edge between the two groups.On univariate and multiva-riate analysis showed that the depth of invasion,degree of differentiation,lymph node metastasis,clinical stage and sur-gical methods were the independent risk factors associated with the prognosis of YGC.Conclusion The YGC patients are usually female,obviously hereditary tendency,and tumor most locate at gastric antruma.The first clinical symptoms are lacking in specific,but upper abdominal pain and hemorrhagic anemia in most of the YGC patients.Ⅲstage andⅣstage was most common of clinical stage.The YGC patients are usually poorly differentiation,highly ma-lignant,early metastasis and poorer prognosis.

Objective To investigate the life quality changes and influencing factors of acute coronary syn -drome after stent implantation .Methods 100 cases with acute coronary syndrome received stent implantation were selected .SF-36 life quality questionnaire was used to survey the patients′life quality before operation and 6 months af-ter operation,and the life quality changes and influence factors were analyzed .Results 6 months after operation,the physical activity ,mental health ,social activities ,physical pain ,physical function ,physical role ,energy and health score of the patients were higher than before operation (P<0.05).According to Logistic regression analysis ,female,type 2 diabetes,underwent percutaneous coronary intervention ,ST-T segment elevation myocardial infarction were the im-portant factors affecting patients′recovery(P<0.05).Conclusion 6 months after stent implantation,the life quality of the patients with acute coronary syndrome were improved obviously;the female and underwent percutaneous coro-nary intervention have positive influence on patients′recovery,while type 2 diabetes,ST-T segment elevation myocar-dial infarction affect patients′recovery in negative way .

Objective Base on the neighborhood activation model(NAM), to develop the Mandarin monosyllable lexical neighborhood test(M-LNT-monosyllable), which is expected to be useful for evaluating speech perception performance in children with hearing loss. Methods Test items were based on the lexical characteristics of word frequency and neighborhood density which addressed in the neighborhood activation model (NAM). M-LNT -monosyllable consisted of two parts: Lexically "easy" words with high word frequency, which were low phonemically similar to the target word and lexically "hard" words with low word frequency, which were high phonemically similar to the target word. 34 children of 3～5 year old with normal hearing were choosed as subjects to verify easy word and hard word lists. Results 1 979 words for children contained 487 easy words and 419 hard words. Three easy word lists and three hard word lists were developed to estimate the performance of word recognition among normal- hearing children. There were no differences among scores of three easy words lists(P＞0.05), and no difference among scores of three hard words lists(P＞0.05). But there were significant differences between scores of easy and hard words lists(P＜0.01). Conclusion The development of the lexicon was affected by the lexical characteristics. Normal-hearing children with some lexical techniques were affected by the lexical characteristics when they recognized the spoken words, but children with less lexical technique didn't show the same result because the recognition was processed on the phonetic level.