Objective: Compare and analyze the results of the domestic Lanyi AH600 glycated hemoglobin analyzer and other different detection systems to understand the comparability of the detection results of different detectors, and establish the best cut point of Lanyi AH600 determination of haemoglobin A1c (HbA1c) in the diagnosis of diabetes. Methods: Multi center cohort study was adopted. The clinical laboratory departments of 18 medical institutions independently collected test samples from their respective hospitals from March to April 2022, and independently completed comparative analysis of the evaluated instrument (Lanyi AH600) and the reference instrument HbA1c. The reference instruments include four different brands of glycosylated hemoglobin meters, including Arkray, Bio-Rad, DOSOH, and Huizhong. Scatter plot was used to calculate the correlation between the results of different detection systems, and the regression equation was calculated. The consistency analysis between the results of different detection systems was evaluated by Bland Altman method. Consistency judgment principles: (1) When the 95% limits of agreement (95% LoA) of the measurement difference was within 0.4% HbA1c and the measurement score was≥80 points, the comparison consistency was good; (2) When the measurement difference of 95% LoA exceeded 0.4% HbA1c, and the measurement score was≥80 points, the comparison consistency was relatively good; (3) The measurement score was less than 80 points, the comparison consistency was poor. The difference between the results of different detection systems was tested by paired sample T test or Wilcoxon paired sign rank sum test; The best cut-off point of diabetes was analyzed by receiver operating characteristic curve (ROC). Results: The correlation coefficient R² of results between Lanyi AH600 and the reference instrument in 16 hospitals is≥0.99; The Bland Altman consistency analysis showed that the difference of 95% LoA in Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180) was -0.486%-0.325%, and the measurement score was 94.6 points (473/500); The difference of 95% LoA in the Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant II) was -0.727%-0.612%, and the measurement score was 89.8 points; The difference of 95% LoA in the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT) was -0.231%-0.461%, and the measurement score was 96.6 points; The difference of 95% LoA in the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT) was -0.469%-0.479%, and the measurement score was 91.9 points. The other 14 hospitals, Lanyi AH600, were compared with 4 reference instrument brands, the difference of 95% LoA was less than 0.4% HbA1c, and the scores were all greater than 95 points. The results of paired sample T test or Wilcoxon paired sign rank sum test showed that there was no statistically significant difference between Lanyi AH600 and the reference instrument Arkray HA8180 (Z=1.665,P=0.096), with no statistical difference. The mean difference between the measured values of the two instruments was 0.004%. The comparison data of Lanyi AH600 and the reference instrument of all other institutions had significant differences (all P<0.001), however, it was necessary to consider whether it was within the clinical acceptable range in combination with the results of the Bland-Altman consistency analysis. The ROC curve of HbA1c detected by Lanyi AH600 in 985 patients with diabetes and 3 423 patients with non-diabetes was analyzed, the area under curve (AUC) was 0.877, the standard error was 0.007, and the 95% confidence interval 95%CI was (0.864, 0.891), which was statistically significant (P<0.001). The maximum value of Youden index was 0.634, and the corresponding HbA1c cut point was 6.235%. The sensitivity and specificity of diabetes diagnosis were 76.2% and 87.2%, respectively. Conclusion: Among the hospitals and instruments currently included in this study, among these four hospitals included Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180), Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant Ⅱ), the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT), and the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT), the comparison between Lanyi AH600 and the reference instruments showed relatively good consistency, while the other 14 hospitals involved four different brands of reference instruments: Arkray, Bio-Rad, DOSOH, and Huizhong, Lanyi AH600 had good consistency with its comparison. The best cut point of the domestic Lanyi AH600 for detecting HbA1c in the diagnosis of diabetes is 6.235%.
Pregnancy ; Child ; Humans ; Female ; Glycated Hemoglobin ; Cohort Studies ; Diabetes Mellitus/diagnosis* ; Sensitivity and Specificity ; ROC Curve

Objective: To investigate the dynamic expression pattern of carcinoembryonic Wnt3a and its early monitoring value using a hepatocellular carcinoma model. Methods: Forty-eight Sprague Dawley (SD) rats were fed with pellet feed containing 2-acetylaminofluorene (2-AAF, 0.05%) to induce hepatocarcinogenesis, and control rats were fed a pellet diet. Liver tissue and blood samples were collected every two weeks. Liver tissues were pathologically examined using HE staining and grouped. The gene and Wnt3a mRNA expression were analyzed by genome-wide microarray. The expression and distribution of Wnt3a in liver tissue were analyzed by immunohistochemistry. Wnt3a concentration in liver tissue and serum was quantified by enzyme-linked immunosorbent assay. Statistical methods such as χ² test, Mann-Whitney test and analysis of variance were used to analyze the differences between groups. Results: According to the pathological examination results, the rat livers were divided into four groups: control, hepatocyte degeneration, precancerous lesions and hepatocellular carcinoma. Genome-wide expression profiling analysis and comparison with the control group revealed that 268 and 312 genes were up-regulated and 57 and 201 genes were down-regulated in the precancerous and cancerous group when signal logarithm ratio (SLR) was >8 log₂^cy5/cy3, and these significantly altered genes mainly involved in cell proliferation, signal transduction, tumor metastasis, and apoptosis. The expression of Wnt3a at mRNA level was significantly increased in all stages of cancer induction, including degeneration group (1.15±0.24, q=8.227), precancerous group (1.85±0.18, q=12.361) and cancerous group (2.59±0.55, q=18.082). Compared with the control group (0.25±0.11, F=121.103, P<0.001), the degeneration group, the precancerous group and the liver cancer group were up-regulated by 4.6, 7.4 and 10.4-folds, respectively. Immunohistochemistry showed that compared with the control group, the positive rate of Wnt3a in the degeneration group was 66.7% (12/18, χ²=10.701, P=0.001), and both the precancerous and liver cancer groups were positive (9/9, χ²=17.115, P<0.001). Wnt3a expression was gradually increased in liver and blood samples during the process of carcinogenesis, and the difference between two groups was statistically significant (F=176.711, P<0.001). Wnt3a overexpression was secreted into blood stream via cancerous liver tissue, and there was a linear correlation between Wnt3a levels in blood and liver samples (r=0.732, P<0.001). Conclusions: Wnt3a overexpression is closely related with hepatocellular carcinogenesis, and thus may become a new monitoring marker.
Rats ; Animals ; Carcinoma, Hepatocellular/pathology* ; Liver Neoplasms/pathology* ; Rats, Sprague-Dawley ; Carcinogenesis/metabolism* ; 2-Acetylaminofluorene ; RNA, Messenger/metabolism* ; Precancerous Conditions

OBJECTIVE: To explore the relationship between lumbar degenerative spondylolisthesis and T2WI high signal in the interspinous ligament in MRI in order to improve the understanding of the signal changes of the interspinous ligament. METHODS: The clinical data of 43 patients with clinically diagnosed lumbar degenerative spondylolisthesis were collected from March 2018 to March 2020, there were 19 males and 24 females, aged 50 to 92 years with an average of 69 years old. Using picture archiving and communication systems (PACS) to access images and record the distribution and incidence of T2WI high signal in the interspinous ligament between the slipped and non-slipped segments. Using Spearman correlation analysis to explore the relationshipbetween the T2WI high signal of the interspinous ligament and the degree of lumbar spondylolisthesis. RESULTS: Except for 8 ligaments that were not included in the statistical results due to poor image quality, 43 patients with a total of 207 lumbar vertebrae and interspinous ligaments were included in the study. According to the Meyerding classification method, 43 patients had a total of 48 segments with spondylolisthesis, 41 segments in grade Ⅰ and 7 segments in grade Ⅱ. There were 30 cases of MRI T2WI high signal in the interspinous ligament corresponding to spondylolisthesis segment, including 3 cases on L CONCLUSION In patients with degenerative lumbar spondylolisthesis, the MRI T2WI hyperintensity is more common in the interspinous ligament. The occurrence of T2WI high signal is positively correlated with the degree of spondylolisthesis, which should be payed enough attention in imaging diagnosis.
Aged ; Aged, 80 and over ; Female ; Humans ; Ligaments, Articular ; Lumbar Vertebrae/diagnostic imaging* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Spondylolisthesis/diagnostic imaging*

With the rapid development of Internet technology and the continuous advancement of medical informatization, big data in healthcare has gradually become an important resource to innovate health management and meet the growing health needs of people and the application of big data in healthcare has been one of the indispensable parts of national big data strategy in China. Based on the established healthcare big data platform and the application of big data technology, Yinzhou district has made innovative efforts to explore a new model driven by big data for the prevention and control of communicable and non-communicable diseases and the management of vaccination programs. It is expected that the "Internet plus healthcare" model will strengthen the disease prevention and control and public health management in local area, create a new business form and provide strong support for Healthy China 2030. This article introduces this new model driven by big data in Yinzhou and discusses the preliminary efficiency of this model in public health practice.

Adaptation, Psychological ; Adult ; Age Factors ; Aged ; Beijing/epidemiology* ; Breast Neoplasms/psychology* ; Case-Control Studies ; Educational Status ; Female ; Humans ; Middle Aged ; Risk Factors

During the prevention and control of the COVID-19 epidemic, identifying and controlling the source of infection has become one of the most important prevention and control measures to curb the epidemic in the absence of vaccines and specific therapeutic drugs. While actively taking traditional and comprehensive "early detection" measures, Yinzhou district implemented inter-departmental data sharing through the joint prevention and control mechanism. Relying on a healthcare big data platform that integrates the data from medical, disease control and non-health sectors, Yinzhou district innovatively explored the big data-driven COVID-19 case finding pattern with online suspected case screening and offline verification and disposal. Such effort has laid a solid foundation and gathered experience to conduct the dynamic and continuous surveillance and early warning for infectious disease outbreaks more effectively and efficiently in the future. This article introduces the exploration of this pattern in Yinzhou district and discusses the role of big data-driven disease surveillance in the prevention and control of infectious diseases.

Objective:To analyze the status quo and development of the Hope Houses for individuals with spinal cord injury (SCI) in Shanghai. Methods:In June, 2018, the organizers and managers of Hope Houses from 16 districts in Shanghai were investigated with the self-designed questionnaires, which covered the personal characteristics, knowledge of related policy, development of projects and obstacles, and rehabilitation recognition. The descriptive analysis and correlational analyses were conducted. Results:Totally, eleven organizers and 16 managers were investigated. The knowledge of related policy for organizers was not good enough. Eight Hope Houses in 16 districts in Shanghai were operated by social organizations. The average implementation rate of projects in Hope Houses was 60.6%, and the highest was rehabilitation knowledge education (96.3%). There was insufficient provision in legal services, job skills training, rehabilitation nursing guidance, job referral, medical referral and education referral, etc. The main related factors limiting the development of the Hope Houses were lacks of budgets, social consensus and professionals. The rehabilitation cognition of organizers and managers was generally good, but the cognition of rehabilitation principles and rehabilitation value needed to be strengthened. Conclusion:The Hope Houses for individuals with SCI in Shanghai work well, and the rehabilitation cognition of organizers and managers is satisfactory. It should be strenghened in resource input, comprehensive rehabilitation and standard of management, to expand the service timely.

OBJECTIVETo investigate the tumor inhibition effect of Yangfei Kongliu Formula (YKF), a compound Chinese herbal medicine, combined with cisplatin (DDP) and its action mechanisms.

METHODSC57BL/6 mice with Lewis lung carcinoma were divided into six groups: control group (C), DDP group (2 mg/kg, DDP), low-dose YKF group (2.43 g/kg, L), high-dose YKF group (24.3 g/kg, H), low-dose YKF combined with DDP group (L + DDP) and high-dose YKF combined with DDP group (H + DDP). Transforming growth factor-β1 (TGF-β1), mothers against decapentaplegic homolog 3 (Smad3) and Smad7 levels were measured with quantitative real-time polymerase chain reaction (qPCR), Western blotting and immunohistochemistry. An enzyme-linked immunosorbent assay was used to analyze the expressions of interleukin-2 (IL-2) and tumor necrosis factor-α (TNF-α).

RESULTSYKF combined with DDP significantly inhibited the growth and metastasis of tumors relative to the control group, and YKF groups (P < 0.05). There was no significant difference between high-dose YKF group and low-dose YKF group (P > 0.05). We also found that the expression levels of TGF-β1 and Smad3 were both significantly decreased by YKF relative to the control group (P < 0.05). Furthermore, after treatment with YKF combined with DDP, the expression levels of TGF-β1 and Smad3 were decreased but the expression level of Smad7 was increased relative to the DDP group (P < 0.05). Compared to the DDP group, the combination of YKF and DDP enhanced the effect of tumor inhibition (P < 0.05), showing obvious synergy between YKF and DDP. Treatment with DDP or YKF decreased serum levels of IL-2 and TNF-α relative to the control group (P < 0.05). Furthermore, the expression levels of IL-2 and TNF-α were significantly decreased when treated with YKF in combination with DDP. Co-treatment with YKF and DDP significantly inhibited tumor growth, decreased the expressions of TGF-β1, Smad3, IL-2 and TNF-α and increased the expression of Smad7; these differences were significant relative to both YKF groups and the control group (P < 0.05).

CONCLUSIONYKF can inhibit tumor growth synergistically with DDP, mainly through the TGF-β1 signaling pathway.

Objective This experiment aimed to find out the feasibility of applying 3D printing technology to anato-my education. Methods We constructed 3D printed skull using a cadaveric skull as template.26 participants were recruited from Peking Union Medical College. All participants studied cranial anatomy with 3D printed skulls as teaching materials,and then assessed practicability of 3D printed skulls by subjective assessment questionnaires. Results 57% participants considered that 3D printed skulls can present defined cranial anatomical structures.More than 90% participants agreed that 3D printed models helped spatial comprehension and study of anatomy.88% par-ticipants suggested 3D printing can solve the problem of ethics.84% participants agreed to apply 3D printed models into cranial anatomy education. Conclusions The efficacy of 3D printing had been confirmed in anatomical educa-tion. Further application of 3D printing technology in medical education needs carrying out.

Objective This experiment aimed to find out the feasibility of applying 3D printing technology to anato-my education. Methods We constructed 3D printed skull using a cadaveric skull as template.26 participants were recruited from Peking Union Medical College. All participants studied cranial anatomy with 3D printed skulls as teaching materials,and then assessed practicability of 3D printed skulls by subjective assessment questionnaires. Results 57% participants considered that 3D printed skulls can present defined cranial anatomical structures.More than 90% participants agreed that 3D printed models helped spatial comprehension and study of anatomy.88% par-ticipants suggested 3D printing can solve the problem of ethics.84% participants agreed to apply 3D printed models into cranial anatomy education. Conclusions The efficacy of 3D printing had been confirmed in anatomical educa-tion. Further application of 3D printing technology in medical education needs carrying out.