Objective:To study the expression and prognostic impact of secretory carrier membrane protein 3 (SCAMP3) in hepatocellular carcinoma (HCC) and its gene set enrichment analysis.Methods:SCAMP3 expression and its prognosis were analyzed using The Cancer Genome Atlas (TCGA) database. The cancer tissue and paracancerous tissue were collected from four patients with HCC undergoing surgery in Lishui Central Hospital to detect the expression of SCAMP3. Based on TCGA database, univariate and multivariate Cox regression was performed to analyze the relevance of SCAMP3 with prognosis of HCC. Gene set enrichment analysis was utilized to clarify the biological role of SCAMP3.Results:In TCGA database, SCAMP3 expression was higher in HCC tissues than that in normal liver tissues ( Z=-8.38, P<0.001). Patients were divided into the low-expression group ( n=185) and high-expression group ( n=185) based on the median SCAMP3 expression, and the overall survival rate was lower in patients with high SCAMP3 expression. In our four patients. The expression of SCAMP3 mRNA and protein in cancer tissues was higher than that in paracancerous tissues ( t=8.55, 6.24, both P<0.001). In multivariate Cox regression analysis, the higher SCAMP3 expression was associated with a higher risk of death ( HR=1.466, 95% CI: 1.143-1.881, P<0.001). Gene set enrichment analysis in patients with high SCAMP3 expression, the coagulation cascade and three signaling pathways involving the complements, retinol metabolism, and peroxisome proliferator-activated receptor were identified. Conclusion:SCAMP3 expression elevated in HCC, patients with a higher expression of SCAMP3 might have a worse prognosis. High SCAMP3 expression is a risk factor for the survival of patients with HCC. High SCAMP3 expression is associated with the coagulation cascade and the complements, retinoid metabolism, and peroxisome proliferator-activated receptor pathways.

Objective:To investigate the epidemiological characteristics, diagnosis, treat-ment and prognosis of gallbladder cancer in China from 2010 to 2017.Methods:The single disease retrospective registration cohort study was conducted. Based on the concept of the real world study, the clinicopathological data, from multicenter retrospective clinical data database of gallbladder cancer of Chinese Research Group of Gallbladder Cancer (CRGGC), of 6 159 patients with gallbladder cancer who were admitted to 42 hospitals from January 2010 to December 2017 were collected. Observation indicators: (1) case resources; (2) age and sex distribution; (3) diagnosis; (4) surgical treatment and prognosis; (5) multimodality therapy and prognosis. The follow-up data of the 42 hospitals were collected and analyzed by the CRGGC. The main outcome indicator was the overall survival time from date of operation for surgical patients or date of diagnosis for non-surgical patients to the end of outcome event or the last follow-up. Measurement data with normal distribu-tion were represented as Mean±SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3) or M(range), and com-parison between groups was conducted using the U test. Count data were described as absolute numbers or percentages, and comparison between groups was conducted using the chi-square test. Univariate analysis was performed using the Logistic forced regression model, and variables with P<0.1 in the univariate analysis were included for multivariate analysis. Multivariate analysis was performed using the Logistic stepwise regression model. The life table method was used to calculate survival rates and the Kaplan-Meier method was used to draw survival curves. Log-rank test was used for survival analysis. Results:(1) Case resources: of the 42 hospitals, there were 35 class A of tertiary hospitals and 7 class B of tertiary hospitals, 16 hospitals with high admission of gallbladder cancer and 26 hospitals with low admission of gallbladder cancer, respectively. Geographical distribution of the 42 hospitals: there were 9 hospitals in central China, 5 hospitals in northeast China, 22 hospitals in eastern China and 6 hospitals in western China. Geographical distribution of the 6 159 patients: there were 2 154 cases(34.973%) from central China, 705 cases(11.447%) from northeast China, 1 969 cases(31.969%) from eastern China and 1 331 cases(21.611%) from western China. The total average number of cases undergoing diagnosis and treatment in hospitals of the 6 159 patients was 18.3±4.5 per year, in which the average number of cases undergoing diagnosis and treatment in hospitals of 4 974 patients(80.760%) from hospitals with high admission of gallbladder cancer was 38.8±8.9 per year and the average number of cases undergoing diagnosis and treatment in hospitals of 1 185 patients(19.240%) from hospitals with low admission of gallbladder cancer was 5.7±1.9 per year. (2) Age and sex distribution: the age of 6 159 patients diagnosed as gallbladder cancer was 64(56,71) years, in which the age of 2 247 male patients(36.483%) diagnosed as gallbladder cancer was 64(58,71)years and the age of 3 912 female patients(63.517%) diagnosed as gallbladder cancer was 63(55,71)years. The sex ratio of female to male was 1.74:1. Of 6 159 patients, 3 886 cases(63.095%) were diagnosed as gallbladder cancer at 56 to 75 years old. There was a significant difference on age at diagnosis between male and female patients ( Z=-3.99, P<0.001). (3) Diagnosis: of 6 159 patients, 2 503 cases(40.640%) were initially diagnosed as gallbladder cancer and 3 656 cases(59.360%) were initially diagnosed as non-gallbladder cancer. There were 2 110 patients(34.259%) not undergoing surgical treatment, of which 200 cases(9.479%) were initially diagnosed as gallbladder cancer and 1 910 cases(90.521%) were initially diagnosed as non-gallbladder cancer. There were 4 049 patients(65.741%) undergoing surgical treatment, of which 2 303 cases(56.878%) were initially diagnosed as gallbladder cancer and 1 746 cases(43.122%) were initial diagnosed as non-gallbladder cancer. Of the 1 746 patients who were initially diagnosed as non-gallbladder cancer, there were 774 cases(19.116%) diagnosed as gallbladder cancer during operation and 972 cases(24.006%) diagnosed as gallbladder cancer after operation. Of 6 159 patients, there were 2 521 cases(40.932%), 2 335 cases(37.912%) and 1 114 cases(18.087%) undergoing ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) examination before initial diagnosis, respec-tively, and there were 3 259 cases(52.914%), 3 172 cases(51.502%) and 4 016 cases(65.205%) undergoing serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis, respectively. One patient may underwent multiple examinations. Results of univariate analysis showed that geographical distribution of hospitals (eastern China or western China), age ≥72 years, gallbladder cancer annual admission of hospitals, whether undergoing ultrasound, CT, MRI, serum carcinoembryonic antigen, CA19-9 or CA125 examination before initially diagnosis were related factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.45, 1.98, 0.69, 0.68, 2.43, 0.41, 1.63, 0.41, 0.39, 0.42, 95% confidence interval as 1.21-1.74, 1.64-2.40, 0.59-0.80, 0.60-0.78, 2.19-2.70, 0.37-0.45, 1.43-1.86, 0.37-0.45, 0.35-0.43, 0.38-0.47, P<0.05). Results of multivariate analysis showed that geographical distribution of hospitals (eastern China or western China), sex, age ≥72 years, gallbladder cancer annual admission of hospitals and cases undergoing ultrasound, CT, serum CA19-9 examination before initially diagnosis were indepen-dent influencing factors influencing initial diagnosis of gallbladder cancer patients ( odds ratio=1.36, 1.42, 0.89, 0.67, 1.85, 1.56, 1.57, 0.39, 95% confidence interval as 1.13-1.64, 1.16-1.73, 0.79-0.99, 0.57-0.78, 1.60-2.14, 1.38-1.77, 1.38-1.79, 0.35-0.43, P<0.05). (4) Surgical treatment and prognosis. Of the 4 049 patients undergoing surgical treatment, there were 2 447 cases(60.435%) with complete pathological staging data and follow-up data. Cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb were 85(3.474%), 201(8.214%), 71(2.902%), 890(36.371%), 382(15.611%), 33(1.348%) and 785(32.080%), respectively. The median follow-up time and median postoperative overall survival time of the 2 447 cases were 55.75 months (95% confidence interval as 52.78-58.35) and 23.46 months (95% confidence interval as 21.23-25.71), respectively. There was a significant difference in the overall survival between cases with pathological staging as stage 0, stage Ⅰ, stage Ⅱ, stage Ⅲa, stage Ⅲb, stage Ⅳa and stage Ⅳb ( χ2=512.47, P<0.001). Of the 4 049 patients undergoing surgical treatment, there were 2 988 cases(73.796%) with resectable tumor, 177 cases(4.371%) with unresectable tumor and 884 cases(21.833%) with tumor unassessable for resectabi-lity. Of the 2 988 cases with resectable tumor, there were 2 036 cases(68.139%) undergoing radical resection, 504 cases(16.867%) undergoing non-radical resection and 448 cases(14.994%) with operation unassessable for curative effect. Of the 2 447 cases with complete pathological staging data and follow-up data who underwent surgical treatment, there were 53 cases(2.166%) with unresectable tumor, 300 cases(12.260%) with resectable tumor and receiving non-radical resection, 1 441 cases(58.888%) with resectable tumor and receiving radical resection, 653 cases(26.686%) with resectable tumor and receiving operation unassessable for curative effect. There were 733 cases not undergoing surgical treatment with complete pathological staging data and follow-up data. There was a significant difference in the overall survival between cases not undergoing surgical treatment, cases undergoing surgical treatment for unresectable tumor, cases undergoing non-radical resection for resectable tumor and cases undergoing radical resection for resectable tumor ( χ2=121.04, P<0.001). (5) Multimodality therapy and prognosis: of 6 159 patients, there were 541 cases(8.784%) under-going postoperative adjuvant chemotherapy and advanced chemotherapy, 76 cases(1.234%) under-going radiotherapy. There were 1 170 advanced gallbladder cancer (pathological staging ≥stage Ⅲa) patients undergoing radical resection, including 126 cases(10.769%) with post-operative adjuvant chemotherapy and 1 044 cases(89.231%) without postoperative adjuvant chemo-therapy. There was no significant difference in the overall survival between cases with post-operative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.23, P=0.629). There were 658 patients with pathological staging as stage Ⅲa who underwent radical resection, including 66 cases(10.030%) with postoperative adjuvant chemotherapy and 592 cases(89.970%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemotherapy and cases without postoperative adjuvant chemotherapy ( χ2=0.05, P=0.817). There were 512 patients with pathological staging ≥stage Ⅲb who underwent radical resection, including 60 cases(11.719%) with postoperative adjuvant chemotherapy and 452 cases(88.281%) without postoperative adjuvant chemotherapy. There was no significant difference in the overall survival between cases with postoperative adjuvant chemo-therapy and cases without post-operative adjuvant chemo-therapy ( χ2=1.50, P=0.220). Conclusions:There are more women than men with gallbladder cancer in China and more than half of patients are diagnosed at the age of 56 to 75 years. Cases undergoing ultrasound, CT, serum CA19-9 examination before initial diagnosis are independent influencing factors influencing initial diagnosis of gallbladder cancer patients. Preoperative resectability evaluation can improve the therapy strategy and patient prognosis. Adjuvant chemotherapy for gallbladder cancer is not standardized and in low proportion in China.

ObjectiveTo determine the epidemiological characteristics of norovirus infections in Lin’an District， Hangzhou City from 2012 to 2020， and provide scientific evidence for improving preventive and control measures. MethodsDescriptive epidemiological methods were used to characterize the epidemic and conduct statistical analysis to determine related factors. ResultsA total of 37 clustered outbreaks of norovirus infection were reported in Lin’an District of Hangzhou from 2012 to 2020， including 8 outbreaks in kindergartens， 15 ones in elementary schools， 8 ones in middle and high schools， 2 ones in universities， and 4 other ones. The total number of cases with norovirus infection was 1 194， with the average attack rate of 3.76%. The incidence of norovirus was higher in winter and spring. It was also higher in urban areas， followed by suburban and mountainous areas neighbored to traffic lines. Moreover， attack rates differed significantly by transmission routes， including mixed contact and aerosol transmission， contact transmission， food-borne transmission， and water-borne transmission （χ²=186.91，P<0.001）. There was significant difference in the incidence among kindergartens， schools， and universities （χ²=980.15，P<0.001）. In the 37 outbreaks， norovirus were mainly classified as GⅡ in the 34 ones （accounting for 91.89%）， and GⅠ in the remaining 3 ones. ConclusionThe epidemic of norovirus infection in Lin’an District， Hangzhou City is characterized by certain population， time， space， transmission routes， and strains. It warrants enhanced health education and promotion， preparedness and response plan， syndromic surveillance， early alerting， school closure， and environmental disinfection for further prevention and control of norovirus infection.

Interstitial fluid (ISF) flow through vascular adventitia has been discovered recently. However, its kinetic pattern was unclear. We used histological and topographical identification to observe ISF flow along venous vessels in rabbits. By magnetic resonance imaging (MRI) in live subjects, the inherent pathways of ISF flow from the ankle dermis through the legs, abdomen, and thorax were enhanced by paramagnetic contrast. By fluorescence stereomicroscopy and layer-by-layer dissection after the rabbits were sacrificed, the perivascular and adventitial connective tissues (PACTs) along the saphenous veins and inferior vena cava were found to be stained by sodium fluorescein from the ankle dermis, which coincided with the findings by MRI. The direction of ISF transport in a venous PACT pathway was the same as that of venous blood flow. By confocal microscopy and histological analysis, the stained PACT pathways were verified to be the fibrous connective tissues, consisting of longitudinally assembled fibers. Real-time observations by fluorescence stereomicroscopy revealed at least two types of spaces for ISF flow: one along adventitial fibers and another one between the vascular adventitia and its covering fascia. Using nanoparticles and surfactants, a PACT pathway was found to be accessible by a nanoparticle of <100 nm and contained two parts: a transport channel and an absorptive part. The calculated velocity of continuous ISF flow along fibers of the PACT pathway was 3.6‒15.6 mm/s. These data revealed that a PACT pathway was a "slit-shaped" porous biomaterial, comprising a longitudinal transport channel and an absorptive part for imbibition. The use of surfactants suggested that interfacial tension might play an essential role in layers of continuous ISF flow along vascular vessels. A hypothetical "gel pump" is proposed based on interfacial tension and interactions to regulate ISF flow. These experimental findings may inspire future studies to explore the physiological and pathophysiological functions of vascular ISF or interfacial fluid flow among interstitial connective tissues throughout the body.

Objective: To investigate the independent and joint associations of physical activity and sedentary behavior with 20 m shuttle run test (20 m SRT) performance among children. Methods: Using cluster random sampling method, a total of 1 144 children aged 6-12 years from 1 urban primary school in Guangzhou were selected and completed the questionnaire survey, physical examination, and 20 m SRT. Physical activity and sedentary behavior were collected through questionnaire. Poor performance on 20 m SRT run test was defined as standard Z score ≤0, which was calculated according to gender, age-specific mean and standard deviation. Based on moderate-to-vigorous physical activity (MVPA) (≥60 min/d, 30-<60 min/d, or <30 min/d) and sedentary behavior levels (cut-off point: the gender, age-specific 50th percentile value), all participants were divided into six subgroups. Multiple linear regression and Logistic regression were used to analyze the independent and joint associations of physical activity and sedentary behavior with 20 m SRT performance, respectively. Results: Low level of physical activity (β=-2.99, P<0.05) and high sedentary behavior (β=-1.75, P<0.05) were independently correlated with lower 20 m SRT performance. Compared with the reference group (MVPA≥60 min/d and low sedentary behavior), the risk for low performance on 20 m SRT was higher in those with MVPA<30 min/d, or those with high sedentary behavior. The risk for poor performance on 20 m SRT was gradually elevated with decreased physical activity levels in combination with higher level of sedentary behavior(P<0.05). Conclusion Physical activity and sedentary behavior were independently related to 20 m SRT performance among children. There is a clear does-response association, with elevated risks for poor performance on 20 m SRT with decreased physical activity levels in combination with higher level of sedentary behavior.

Objective: To investigate the different patterns of 24-h movement behaviors, and their associations with sociodemographic factors in a nationally representative sample of Chinese children aged 6-13 years. Methods: This study was based on a national multi-centered cluster intervention study involving 31 362 children aged 6-13 years from 7 provinces in China. Questionnaires were used to collect moderate to vigorous physical activity (MVPA), screen time (ST) and sleep duration, as well as sociodemographic variables including age, gender, area of residence, parents’ education level and family income. Generalized linear mixed model (GLMM) analyses were conducted for the 24-hour movement behaviors according to sociodemographic variables. Results: The proportions of individuals meeting the MVPA, ST, and sleep guidelines were 32.2%, 78.5%, 30.1%, respectively. The proportion that meet 0, 1, 2 and 3 recommended items was 9.6%, 47.7%, 35.0% and 7.7%, respectively. Age, gender, parents’ education levels and family income showed associations with PA, ST and sleep. Compared with low parents’ education group, the risk for unhealthy behavioral patterns was lower in those with high parents’ education level(P<0.05). Conclusion The current status of 24-hour physical activity for children aged 6-13 in China is not ideal, and social demographics should be considered when designing targeted interventions to promote children’s health.

Abstract With the continuous growth in economics and science, physical activity in children and adolescents is gradually decreasing while the sedentary time, such as electronic video screen time, is increasing, which is defined as sedentary lifestyle. Research suggests that sedentary behavior, especially electronic video behavior, is harmful to all dimensions of children and adolescent’ health. Since 2016, the publication of international children’s and adolescents’ physical activity guideline has tended to be a 24-hour movement guideline with more comprehensive dimensions, detailed indicators and operationalities. However, the 24-hour movement guideline for children and adolescents still lacks sufficient evidence, and quite low target achievement rate, which seems to be an ideal goal for the vast majority of children. The purpose of this paper is to explore the current situation of physical activity and sedentary behavior of children and adolescents, as well as the development and evolution of comprehensive guideline. Through literature analysis, it focuses on the independent and combined effects of physical activity and sedentary behavior on children’s health, analyzes and implies the significance of 24-hour movement guideline for children and adolescents’ health, and provides inspiration and reference for future health promotion and behavior intervention among children and adolescents.

Objective To summary the nursing methods of patients who use ultrasound-guided thermal ablation to treat severe secondary hyperparathyroidism.Methods Retrospective analysis was used to analyze the nursing process of 10 patients who use ultrasound-guided thermal ablation to treat severe secondary hyperparathyroidism. Ultrasound-guided thermal ablation was applied to patients with significant cardiopulmonary dysfunction and cannot undergo general anaesthesia operation, and patients suffering from recurrent forearm grafting after parathyroidectomy. So, in the nursing of these patients, we should pay special attention to the observation and management of specific complications in thermal ablation including dyspnea, apnea, laryngeal and recurrent laryngeal nerve injury and hemorrhage, besides the routine psychological care, diet nursing and medication nursing.Results Ten patients in the study who underwent ultrasound-guided thermal ablation, the intact serum parathyroid hormone ( intact parathyroid hormone, iPTH ) , calcium and phosphorus were all decreased, and symptoms like itching, general bone pain also were released. The frequency of precordial pain was reduced and we gain good therapeutic effect.Conclusions Rigorous nursing after ultrasound-guided thermal ablation can promote the recovery of patients with severe secondary hyperparathyroidism.

OBJECTIVE:To establish a method for the dissolubility determination of Manidipine Hydrochloride tablet and eval-uate the quality consistency of generic and original preparation. METHODS:HPLC was performed on the column of Waters Sym-metry C18 column with mobile phase of potassium phosphate monobasic solution (potassium phosphate monobasic 6.8 g was well-mixed with water 1 000 ml,and pH was adjusted to 4.6 by potassium hydroxide solution)-acetonitrile (49∶51,V/V) at flow rate of 1.0 ml/min,detection wavelength was 228 nm,column temperature was 25℃,and the injection volume was 20μl. The dis-solution mediums were 0.1 mol/L hydrochloric acid solution,acetic acid-sodium acetate buffer solution(pH 4.0)and phosphate buf-fer solution [pH 6.8,adding into 0.5% sodium dodecyl sulfonate(SDS)],volume of dissolution medium was 900 ml and rotating rate was 50 r/min,and the dissolubility of Manidipine hydrochloride tablet generic and original preparation was investigated and the similarity of dissolution profile was evaluated by calculating similar factor (f2). RESULTS:The linear range of manidipine hydro-chloride was 0.625-20 μg/ml;RSDs of instrument precision and stability tests were lower than 2.0%;recoveries of 3 dissolution mediums were 92.86%-102.97%(RSD=1.9%,1.8% and 2.7%,n=9),respectively. The dissolubility of 3 batches of Manidipine hydrochloride tablet generic and original preparations was higher than 85% in 0.1 mol/L hydrochloric acid solution in 15 min;f2 was >50 in acetic acid-sodium acetate buffer solution (pH 4.0) and phosphate buffer solution (pH 6.8,adding into 0.5% SDS). CONCLUSIONS:The method is suitable for the dissolubility determination of Manidipine hydrochloride tablet;meanwhile,the dis-solution profile in vitro of Manidipine hydrochloride tablet generic and original preparations has similarities,so the quality consis-tency is good.

Objective To measure the clivus-axial angle (CAA) of Chinese,provide a normal value,and explore the correlation between CAA with cervico-medullary angle (CMA).Methods The CAA was measured on the CT of cervical spine in 225 Chinese with normal cranio-vertebral junction (CVJ).Both the CAA and the CMA were measured on the MRI of cervical spine in 117 subjects.All measurements were performed under a bone window (window level,300 Hu; window width,1 000 Hu) with an accuracy of 0.01°.A regression analysis was used for analyzing the correlation between CAA and CMA.The angle between the clivus plane and the straight line parallel to that of the posterior margin of the C2 vertebral body was defined as CAA; moreover,the angle between the strajght line parallel to the ventral side of the cervical spinal cord and the straight line parallel to that of the ventral side of the medulla oblongata was defined as CMA.Two experienced spinal surgeons performed the measurements.The CAA and CMA were measured three times,and the mean value was considered as the result.Results The CAA of 225 subjects was 133.52°-172.16° (156.93°±6.53°).The 95％ confidence interval was 145.10°-170.19° in male and 142.67°-168.47° in female.If the patients were divided into five groups according to their age,a comparison of these groups showed that there were no significant differences among the groups with respect to CAA.It showed that there was consistency between the CAAs measured with MRI and CT.The CMA for 117 patients ranged from 130.38° to 168.75° with a mean value of 154.17°±6.54°,and its 95％ confidence interval ranged from 141.35° to 166.99°.If the patients were distributed according to their gender or to their age,there were no significant differences among the groups.The relationship between CAA and CMA was linearity,and the regression coefficient was as high as 0.95 (P=0.007).Conclusion The normal CAA of Chinese is from 133.52° to 172.16°.The 95％ confidence interval goes from 145.10° to 170.19° in male,and 142.67° to 168.47° in female,close to CMA.It is valuable for measuring the compression of spinal cord,which can be accessed easily during the procedure.