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As an emerging infectious disease, the COVID-19 threatened the safety of personnel in the prevention and control during the COVID-19 pandemic. Beijing Association of Preventive Medicine organizes the Beijing CDC and other organizations drafted the group standard entitled "Guidelines for personal protection against coronavirus disease 2019 for diseases control person (T/BPMA 0002-2020)" , according to years of scientific research on personal protection. Based on the principles of emphasizing the scientific, normative and safe nature, the standard was drafted to put forward the reasonable selection and correct use of personal protective equipment for disease control personnel, as well as the procedures for personal protective equipment. The standard provided a standardized basis for ensuring the safety of disease control personnel in contacting and handling of the new coronary pneumonia outbreaks with high risks.

Objective: To prospectively explore the associations between total and different types of physical activities and gestational diabetes mellitus (GDM) in the first trimester of pregnant women, in Beijing. Methods: Data of 909 participants from the Chinese Pregnant Women Cohort study were extracted and studied. Four types of physical activities, including household/care-giving, occupational, sports/exercise and outdoor ways of transportation (walking/cycling/E-biking) in early pregnancy were studied by using the pregnancy physical activity questionnaire (PPAQ). All the participants were followed up and related data on GDM collected. Logistic regressions were conducted for data analysis on the associations of interests. Results: A total of 206 pregnant women (22.7 % ) were diagnosed with GDM. After adjusting for age, pre-pregnancy BMI, family history of diabetes and other types of physical activities, results from the logistic regression showed that women with moderate level of household/care-giving activities were with the lower odds on GDM ( OR =0.654, 95 %CI : 0.436-0.980). Women who had met the guideline of exercise were less likely to have GDM ( OR =0.518, 95 %CI : 0.287-0.934). There was no significant association appeared between total physical, occupational and outdoor ways of transportation (walking/cycling/E-biking) activities with GDM. Conclusions: Sports/exercise and household/care-giving activities in early pregnancy appeared important on GDM prevention. Pregnant women are encouraged to wisely arranging their sports/exercise activities and engaging in moderate household/care-giving activities in the first trimester of pregnancy, to prevent GDM.

Objective: To investigate the effect of changes in physical activities on depressive symptoms in the second trimester of pregnancy. Methods: Data from the Chinese Pregnant Women Cohort Study, from July 25, 2017 to November 26, 2018, were used. Women who had effectively completed the survey of physical activity and depressive symptoms in the first and second trimesters of pregnancy, were recruited. Both International Physical Activity Questionnaire-short and Edinburgh Postnatal Depression Scale were used, respectively. Pregnant women who had completed two surveys were included in our study and were divided into two groups according to the depressive symptoms, measured at the baseline. Among the pregnant women without depressive symptoms at the baseline, logistic regression was used to analyze the effects of changes in physical activity on the prevention of depressive symptoms. Effect on the reduction of depressive symptoms was analyzed, using the same method. Results: The prevalence rates of depressive symptoms were 23.83 % and 20.57 % in the baseline and second trimester, respectively. After adjusting for age, education level, occupation, family annual income and pre-pregnancy BMI, data from the logistic regression showed that women without depressive symptoms and with increased and adequate physical activities in the baseline, were with lower risks to develop depressive symptoms in the second trimester ( OR =0.479, 95 %CI : 0.335-0.684; OR =0.566, 95 %CI : 0.394-0.815). Among women with depressive symptoms in the baseline survey, association between physical activity and depressive symptoms was not statistically significant ( P >0.05). Conclusions: Increased and adequate physical activities showed preventive effects on depressive symptoms during pregnancy, but the remission effect was not obvious in women with depressive symptoms. Pregnant women should be encouraged to increase their physical activities while screening programs should also be carried out to reduce the depressive symptoms during pregnancy.

Objective: To investigate sleep quality in pregnant women during their first and second trimester and to identify risk factors. Methods: Data was from the Chinese Pregnant Women Cohort Study. A total of 3 618 pregnant women were included, with the exclusion 346 women who had missing information. Sociodemographic, health-related behavior, depression and sleep quality information were collected and analyzed. Logistic regression analysis were used to explore the influencing factors of sleep quality in pregnant women. Results: Among the 3 618 pregnant woman 28.2% had poor sleep quality in their first trimester and 28.7% in the second trimester. 15.2% pregnant women had progressively worse sleep and 13.0% had persistently poor sleep had pregnant women were generally suffered from poor sleep quality, difficulty falling asleep, sleep disorders and daily fatigue. Regular diet ( OR =0.75, 95% CI : 0.62-0.92) and work ( OR =0.84,95% CI : 0.71-0.99) in the first trimester were protective factors of sleep quality in pregnant women. Age ≥30 year old ( OR =1.19, 95% CI: 1.03-1.37), passive smoking ( OR =1.18, 95% CI : 1.02-1.36) and depression ( OR =2.25, 95% CI : 1.95-2.61) in the first trimester were risk factors. Conclusions: The rate of poor sleep quality are high among Chinese pregnant woman during their first and second trimester. The risk factors of sleep quality are multiple. Regular diet and work, reduction of tobacco exposure, alleviation of depression symptom may help improve sleep quality among pregnant women.

Objective: To investigate the prevalence of Work-related musculoskeletal disorders(WMSDs) and identify associated risk factors and provide evidence of taking measures for prevention. Methods: By Cluster sampling, 1 920 employees of 35 manufacturing enterprises were selected as study subjects from May to December 2017. The questionnnaire were including population characteristics、related factors of ergonomics、job burnout、insomnia and WMSDs. Results: The prevalence of waist was the highest among 9 body parts, with 52.0%, followed by the prevalence of neck 50.6%, more than 1 muscle diseases were by the prevalence of 74.7%. Single factor analysis showed that different levels of labor intensity, daily standing time (h) , daily sitting time(h) , daily bending time (h) , daily lifting of 5kg object time (h) group waist disease and prevalence of more than one musculoskeletal disease were different, The difference was statistically sig- nificant ( P <0.05). More than 5 years of working year, labor intensity of Class III, daily bending time ≥2 h, depression, disorders ( P <0.05). life satisfaction, job burnout, and insomnia are all risk factors for waist and musculoskeletal. The daily sitting time ≥2 h and the high life satisfaction were protective factors for waist and WMSDs ( P <0.05). Conclusion: The prevalence rate of WMSDs among manufacturing workers is strong, and Manager should take the aspects of ergonomics and psychological factors meassure to reduce WMSDs, These meassure were including increasing sitting time, reducing bending time.

Objective: To investigate the relationship between SNP and noise-induced hearing loss (NIHL) susceptibility in occupational noise exposure population in China. Methods: From 6297 for a certain steel works in contact with noise, contact length of 3 years or more and workplace noise exposure intensity of 80 dB (A) , ears or high frequency (3 000, 4 000, 6 000 Hz) average of hearing acuity 40 dB (HL) , or high frequency loss in both ears, on the basis of single whisper frequency (500, 1, 000, 2 000 Hz) average threshold of 26 dB (HL) or object as case group. A case-control study was designed with 1:1 matching. Subjects with the same gender, the same type of work, age ±5 years old, and working age ±2 years after noise exposure were selected as the control group. Subjects with any whisper frequency (500, 1, 000, 2, 000 Hz) whose hearing threshold in any frequency band was ≤25 dB (A) and whose average high-frequency hearing threshold in pure tone hearing test was <35 dB (A) were selected as the control group. Four sites of PON2 gene were genotyped by medium-and high-throughput SNP genotyping. Univariate logistic regression was used to analyze the relationship between single SNP polymorphism and NIHL. Results: A total of 286 case-control pairs were included. Smoking was statistically significant difference between cases and controls ( P <0.001) . Conclusion: No statistical difference has been found between single SNP polymorphism and NIHL. At the level of greater than 92 dB of high noise exposure, rs7785846 (CT+TT) genotype is a risk factor for occupational noise deafness, and its OR is 2.74 (95% CI : 1.09-6.89) compared with wild homozygous type (CC) . Conclusion. The rs7785846 (CT+TT) genotype carriers of PON2 gene are more susceptible to hearing impairment when exposed to high noise intensity.

Objective: To calculate both the epidemic and intensity thresholds for different levels in Beijing and to establish a tiered alert system in the 2018-2019 influenza season as well as to evaluate the performance of calculated thresholds. Method: Weekly count of influenza-like illness and percentage of influenza-like illness (ILI % ) of the last five influenza seasons were modeled by 'moving epidemic method' (MEM) to calculate the influenza epidemic and intensity thresholds at different levels. A cross-validation procedure was used to evaluate the performance. Indicators of Matthew correlation coefficient, Youden's index, sensitivity and specificity were calculated. Results: For weekly count of influenza-like illness, data showed that the epidemic threshold for 2018-2019 influenza season was 12 984 and the medium, high and very high intensity thresholds were 22 503, 37 589, 47 157, respectively. Matthew correlation coefficient of the epidemic threshold was 62 % and youden's index as 60 % , sensitivity as 69 % , specificity as 91 % . Data on weekly ILI % , the epidemic threshold for 2018-2019 influenza season was 1.66 % , with medium, high and very high intensity thresholds as 2.46 % , 3.84 % and 4.66 % , respectively. The overall Matthew correlation coefficient of the epidemic threshold was 59 % , with 54 % for the Youden's index, sensitivity as 60 % and specificity as 94 % . Conclusions: MEM produced a good specific signal for detecting the influenza epidemics and the accuracy of the method was acceptable. The early warning performance regarding the application of weekly count on influenza-like illness was slightly better than ILI % . This method could be applied in the practical influenza epidemic alert "work in Beijing" .

Objective: The aim of this study was to investigate the role of LINC01296 in the progression of liver cancer (LCa) and to explore its possible molecular mechanisms., Patients and Methods: TCGA database was used for information mining to verify the expression of LINC01296 in liver tumor tissues and normal tissues. The levels of LINC01296 in 40 pairs of LCa and adjacent tissues, as well as normal liver cell lines and liver cancer cell lines, were detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The Chi-square test was performed to analyze the clinical characteristics of tumor samples and LINC01296 expression. Meanwhile, the Chi-square test was used to explore the relationship between different clinical indicators and the expression of LINC01296. The liver cancer cell lines were screened and transfected with siRNA-LINC01296 and microRNA-760 inhibitor, as well as corresponding negative controls, respectively. Cell counting kit-8 (CCK-8) and Transwell assays were used to determine the effects of LINC01296 on the proliferative and invasive capacities of cells. Furthermore, the regulatory association between LINC01296 and microRNA-760 was verified by the Dual-Luciferase reporter assay., Results: LINC01296 expression was remarkably higher in LCa tissues than that of normal liver tissues. Meanwhile, LINC01296 expression was associated with poor prognosis of LCa. Patients with high LINC01296 expression were more likely to have lymph node metastasis. In vitro experiments showed that the knockdown of LINC01296 significantly inhibited the proliferation and migration of HCC cells. Meanwhile, microRNA-760 was remarkably lowly expressed in LCa tissues and cells. Subsequent experiments indicated that LINC01296 was regulated by miR760 in LCa tissues, and high expression of linc0129 could limit microRNA-760 expression. Furthermore, the inhibition of microRNA-760 in HCC cells reversed the effect of LINC01296 knockdown on cell proliferation and invasion., Conclusions: LINC01296 could promote the proliferative ability and invasiveness of hepatoma cells by inhibiting the expression of microRNA-760. Moreover, its expression was closely related to lymph node metastasis and poor prognosis of LCa.

The precise measurement of the spectrum of protons, the most abundant component of the cosmic radiation, is necessary to understand the source and acceleration of cosmic rays in the Milky Way. This work reports the measurement of the cosmic ray proton fluxes with kinetic energies from 40 GeV to 100 TeV, with 2 1 / 2 years of data recorded by the DArk Matter Particle Explorer (DAMPE). This is the first time that an experiment directly measures the cosmic ray protons up to ~100 TeV with high statistics. The measured spectrum confirms the spectral hardening at ~300 GeV found by previous experiments and reveals a softening at ~13.6 TeV, with the spectral index changing from ~2.60 to ~2.85. Our result suggests the existence of a new spectral feature of cosmic rays at energies lower than the so-called knee and sheds new light on the origin of Galactic cosmic rays., (Copyright © 2019 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works. Distributed under a Creative Commons Attribution NonCommercial License 4.0 (CC BY-NC).)

Objective: To study the relationship between exposure factors in early pregnancy and preterm birth (PB), low birth weight (LBW) and small for gestational age (SGA) of neonates. Methods: A total of 3 172 pregnant women who were enrolled in the project of Chinese Pregnant Women Cohort Study-Peking Union Medical College (CPWCS-PUMC) from July 25, 2017 to July 24, 2018 and delivered before December 31, 2018 were selected as subjects in this study. The relationship between exposure factors in early pregnancy and adverse outcomes of neonatal delivery was analyzed by using binary logistic regression analysis. Results: The incidence rates of PB, LBW and SGA were 4.76 % , 3.53 % and 5.74 % , respectively. In terms of PB, the analysis results showed that the gestational weight gain (GWG) and living in northern China were protective factors, while premature rupture of membranes, gestational hypertension, dental examination or treatment within 1-3 years and family with 3-4 members were risk factors. In the respect of LBW, GWG and daily consumption of milk and dairy products were the protective factors, while premature rupture of membranes, gestational hypertension, sedentary working time more than 6 hours, dental examination or treatment within 1-3 years and passive smoking were risk factors. For SGA, baby girl, passive smoking, peanut oil consumption and unsalted taste were risk factors, while folic acid supplementation was protective factor. Conclusion: The risk factors for PB, LBW and SGA were multifactorial, and relevant specific measures should be taken to reduce the occurrence of adverse neonatal outcomes.

The objective of this paper was to study the effects of PYR-ARG-PRO-ARG-LEU-SER-HIS-YSGLY-PRO-MET-PRO-PHE-OH (APELIN-13) on the expression of inflammatory factors interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) in rats with experimental autoimmune neuritis (EAN). A total of 30 rats were divided into a control group, an EAN group, and an APELIN-13 group. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of IL-6, TNF-α, and IFN-γ in rat plasma. Real-time quantitative Polymerase Chain Reaction (PCR) and Western blot were used to detect the protein and mRNA expression of IL-6, TNF-α, and IFN-γ in rat lymph nodes. In the EAN group, the infiltration of various types of inflammatory cells and focal demyelination were observed near the nerve fascicles of sciatic nerves. Compared with the EAN group, the infiltration of inflammatory cells and demyelination in the APELIN-13 group decreased significantly. The levels of plasma IL-6, TNF-α, and IFN-γ in the EAN group were significantly higher than those in the control group (P < 0.05) but significantly lower than those in the APELIN-13 group (P < 0.05). Compared with the control group, the mRNA and protein expression of IL-6, TNF-α, and IFN-γ increased significantly (P < 0.05) in the EAN group but decreased significantly in the APELIN-13 group (P < 0.05). In conclusion, APELIN-13 exerted a protective effect against EAN in rats., (Copyright 2019 Biolife Sas. www.biolifesas.org.)

Objective: To explore the predictive value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) on admission on left ventricular ejection fraction (LVEF) and the in-hospital major adverse cardiac and cerebrovascular events (MACCE) in hospitalized patients with unstable angina (UA). Methods: Data of 2 972 consecutive hospitalized patients with UA in Beijing Friendship Hospital from January 2013 to September 2017 were retrospective analyzed. Patients were divided into 4 groups according to the level of NT-proBNP on admission: 733 cases with NT-proBNP lower than 61 ng/L, 749 cases with NT-proBNP between 61 and 133 ng/L, 747 cases with NT-proBNP between 133 and 326 ng/L, and 743 cases with NT-proBNP higher than 326 ng/L. LVEF and in-hospital MACCE were compared among 4 groups and the predictive value of NT-proBNP on admission on LVEF and in-hospital MACCE was determined by multiple logistical regression analysis. Results: LVEF value became lower with increasing on admission NT-proBNP value ((68.4±4.8)%, (68.2±5.2)%, (67.2±6.7)% and (62.6±10.4)%, F= 77.98, P< 0.01), while in-hospital MACCE was higher with increasing on admission NT-proBNP value (3.4% (25/733), 3.5% (26/749), 5.5% (41/747) and 7.3% (54/743), χ(2)=16.23, P< 0.01) in NT-proBNP lower than 61 ng/L, NT-proBNP between 61 and 133 ng/L, NT-proBNP between 133 and 326 ng/L, and NT-proBNP higher than 326 ng/L group. Multiple logistic regression analysis showed that on admission NT-proBNP was an independent predictor for LVEF < 50% ( Exp (β)=5.875, 95 %CI 3.382-10.207, P< 0.001), but not predictor for in-hospital MACCE ( Exp (β)=0.783, 95 %CI 0.400-1.996, P= 0.783). Conclusion: The on admission NT-proBNP level is an independent predictor of left ventricular systolic dysfunction (LVEF < 50%), but not an independent predictor of total in-hospital MACCE in hospitalized patients with UA.

Objective: To analyze the characteristics of super-antigen (SAg) of group A Streptococcus pyogenes (GAS), isolated from patients with scarlet fever or pharyngeal infections in Beijing between 2015-2017. Methods: Throat swab specimens from patients with scarlet fever or pharyngeal infections were collected and tested for GAS. Eleven currently known SAg genes including Spe A , spe C , spe G , spe H , spe I , spe J, spe K , spe L , spe M , sme Z and ssa were tested by real-time PCR while M protein genes ( emm genes) were amplified and sequenced by PCR. Results: A total of 377 GAS were isolated from 6 801 throat swab specimens, with the positive rate as 5.5%. There were obvious changes noticed among spe C, spe G, spe H and spe K in three years. A total of 45 SAg genes profiles were observed, according to the SAgs inclusion. There were significant differences appeared in the frequencies among two of the highest SAg genes profiles between emm 1 and emm 12 strains ( χ (2)=38.196, P <0.001; χ (2)=72.310, P <0.001). There also appeared significant differences in the frequencies of spe A, spe H, spe I and spe J between emm 1 and emm 12 strains ( χ (2)=146.154, P <0.001; χ (2)=52.31, P <0.001; χ (2)=58.43, P <0.001; χ (2)=144.70, P <0.001). Conclusions: Obvious changes were noticed among SAg genes including spe C, spe G, spe H and spe K from patients with scarlet fever or pharyngeal infections in Beijing between 2015-2017. SAg genes including spe A, spe H, spe I and spe J appeared to be associated with the emm 1 and emm 12 strains. More kinds of SAg genes profiles were isolated form GAS but with no significant differences seen in the main SAg genes profiles, during the epidemic period.

Purpose: Compression socks are frequently used in the treatment and prevention of lower-limb pathologies; however, when combined with endurance-based exercise, the impact of compression socks on haemostatic activation remains unclear., Objectives: To investigate the effect of wearing compression socks on coagulation and fibrinolysis following a marathon., Methods: Sixty-seven participants [43 males (mean ± SD: age: 46.7 ± 10.3 year) and 24 females (age: 40.0 ± 11.0 year)] were allocated into a compression (SOCK, n = 34) or control (CONTROL, n = 33) group. Venous blood samples were obtained 24 h prior to and immediately POST-marathon, and were analyzed for thrombin-anti-thrombin complex (TAT), tissue factor (TF), tissue factor pathway inhibitor (TFPI), and D-Dimer., Results: Compression significantly attenuated the post-exercise increase in D-Dimer compared to the control group [median (range) SOCK: + 9.02 (- 0.34 to 60.7) ng/mL, CONTROL: + 25.48 (0.95-73.24) ng/mL]. TF increased following the marathon run [median (range), SOCK: + 1.19 (- 7.47 to 9.11) pg/mL, CONTROL: + 3.47 (- 5.01 to 38.56) pg/mL] in all runners. No significant post-exercise changes were observed for TAT and TFPI., Conclusions: While activation of coagulation and fibrinolysis was apparent in all runners POST-marathon, wearing compression socks was shown to reduce fibrinolytic activity, as demonstrated by lower D-Dimer concentrations. Compression may reduce exercise-associated haemostatic activation when completing prolonged exercise.

Objective: To establish a classified evaluation system for recognizing the levels of influenza epidemics and to explore the new reporting system on influenza epidemics. Methods: The following 3 indicators, including 1) the number of influenza-like illness, 2) positive rate of detection on influenza virus nucleic acids, and 3) the number of influenza outbreaks were chosen to calculate the synthetic index and to classify the grades of evaluation. Results: 209 weeks during 2013-2017 were classified into 5 grades: Grade 1 were 110 weeks (52.63%), Grade 2 were 47 weeks (22.49%), Grade 3 were 44 weeks (21.05%), Grade 4 were 8 weeks (3.83%), and Grade 5 were 0 week. Conclusion: This classified evaluation system provided simple, comprehensive and comparable reference indicators and used for the evaluation on influenza epidemics, also providing suggestions for influenza prevention and control accordingly.

Objective: To explore the expression and prognostic significance of miR-223 in patients with mantle cell lymphoma (MCL) and to investigate the possible mechanism. Methods: Twenty-one newly diagnosed MCL patients with bone marrow involvement were enrolled in the present study, 20 healthy donors as normal control. The expression level of miR-223 and SOX11 mRNA was determined by RQ-PCR. CCK-8 and flow cytometer assays were used to analyze cell proliferation, cell cycle and apoptosis of the constructed miR-223 overexpressing MCL cell line, Granta519 cells. SOX11 protein expression level was determined by Western blot. The target gene of miR-223 was confirmed by dual luciferase reporter assay. Results: ①Of the 21 newly diagnosed MCL patients, 15 were male and 6 female, the median age was 58 (37-72) years. The expression level of miR-223 was significantly down regulated in MCL patients compared with that of healthy donors (14.7±10.5 vs 1 244.1±1 935.2, P <0.001). The lower expression of miR-223 was inversely correlated with high-risk mantle international prognostic index ( P =0.001), elevated LDH ( P =0.001), ECOG score ≥2 ( P =0.035). ②Using the median relative expression level of miR-223 as the cutoff value, 21 MCL patients were divided into high-expression group ( n =10) and low-expression group ( n =11) and found that the high-expression group had a significantly superior OS (median OS: 36 vs 12 months, P =0.021). ③In vitro results showed that compared with the control group, the proliferation of miR-223 overexpressed Granta519 cells was inhibited (the most significant reduction on 96h, P <0.001), manifested by lower proportion of cells in G2/M phase ( P <0.001) and increased apoptosis ( P <0.001), and the expression level of SOX11 protein in Granta519 cells was significantly lower than that of the control group. ④miR-223 could inhibited the 3' untranslated region of SOX11, and the expression level of miR-223 was significantly negatively correlated with mRNA level of SOX11 in MCL patients ( r =-0.81, P <0.001). Conclusions: The expression of miR-223 was repressed in MCL and was associated with poor clinical outcomes, which may be probably attributed to its direct targeting SOX11.

Objective: The objective was to identify the incidence of influenza-like syndromes and related health behavior factors among Beijing residents. Methods: From December 6, 2013 to January 16, 2014, we selected 150 villages or communities from 30 towns or streets as survey locations using a multi-stage random sampling method, and then conducted a cross-sectional study among 7 354 residents who aged 18 years or above and had live in Beijing for more than a half year using self-administered anonymous questionnaires, and totally 7 327 valid questionnaires are collected. The questionnaire consisted of demographic information, self-reported influenza-like syndromes in the past two weeks, and health behaviors. Multiple logistic regression models were used to identify the factors associated with self-reported influenza-like syndromes. Results: The mean (SD) age of the partcipants was 44.6 (15.2) years. Among them, 6.9% (506 cases) reported having influenza like illness during the past two weeks. The multiple logistic regression analysis indicated that regular physical exercise, optimal hand hygiene, and avoidance of going to the crowded places during respiratory infectious disease epidemics were significantly associated with a lower likelihood of reporting influenza-like syndromes, compared with those without regular physical exercises, without optimal hand hygiene, and not avoiding going to the crowded places, and the OR (95 %CI ) were 0.80 (0.66-0.97), 0.75 (0.57-0.99) and 0.80 (0.65-0.98), respectively. Conclusion: Personal health behaviors were associated with the incidence of respiratory infectious diseases such as influenza in Beijing, and future interventions to improve personal hygiene behaviors are needed to prevent the spread of respiratory infectious diseases.

Objective: To investigate the clinical curative effect of C(1)-C(2) pedicle screw fixation for pediatric atlantoaxial dislocation after a long-term follow-up. Methods: From March 2005 to April 2011, a total of 12 male and 9 female patients were included, with age from 3 to 9 years old (mean, 6.1 years old). Among them, 14 cases (67%) had typeⅠinstability atlantoaxial dislocation, 7 cases (33%) had type Ⅱ reducible atlantoaxial dislocation. All 21 pediatric patients with atlantoaxial dislocation underwent posterior pedicle screw fixations. Frankel Grade was used to evaluate function before and after treatment. Furthermore, the information of C(1)-C(2) bony fusion, cervical spine alignment, angle of sagittal curvature, and instability of the subaxial spine were collected from all patients preoperatively, immediately postoperatively and during follow-up period. Results: All 21 patients had regular follow-up with an average duration of 96.4 months (range, 65 to 127 months). All children had good bony fusion within 6 months after treatment. There were 9 patients with lordotic alignment and 12 patients with straight alignment before surgery. After surgery, there were 12 patients with lordotic alignment and 9 patients with straight alignment. At the time of the last follow-up, 17 patients had lordotic alignment and 4 patients had straight alignment. No difference was found between pre- and post-operation ( P =0.354). The same result was found between post-operation and last follow-up ( P =0.095). Neither kyphotic nor swan-neck deformity was found in any of the 21 patients. The mean angle of sagittal curvature decreased from 31.7°±4.3°preoperatively to 15.5°±2.5°postoperatively ( P <0.001). The mean angle of sagittal curvature increased from 15.5°±2.5°postoperatively to 19.1°±2.7°at the final follow-up ( P =0.343). No spinal deformities or subaxial instabilities were found. Of the four patients with preoperative neurological defects, Frankel Grade was significantly improved at 3 months follow-up compared with pretreatment values. None of the patients experienced worsening neurological symptoms or injury to the vertebral artery. Conclusion: The results demonstrate that C(1)-C(2) pedicle screw fixation could achieve satisfactory clinical effects for the management of pediatric atlantoaxial dislocation with long-term follow-up.

Objective: To investigate human exposure to live poultry (poultry feeding and purchasing) in the residents in Beijing and related factors during the second wave of avian influenza A(H7N9) epidemic during 2013-2014, and provide scientific evidence for avian influenza prevention and control. Methods: A total of 7 366 adults aged ≥18 years were selected through multi-stage stratified sampling in Beijing for a questionnaire survey. Logistic regression model was used to analyze the influence factors of human exposure to live poultry. Results: The live poultry feeding rate and live poultry purchasing rate in residents in Beijing in the past year were 5.3% (95 %CI : 4.8%-5.8%) and 6.0% (95 %CI : 5.5%-6.5%) respectively. Logistic regression analysis indicated that lower educational level of primary school and below, ( OR =1.82, 95 %CI : 1.22-2.72); being farmer ( OR =2.49, 95 %CI :1.89-3.29) or being unemployed ( OR =1.65, 95 %CI : 1.08-2.52); being non local resident ( OR =1.54, 95 %CI : 1.10-2.16); living in suburban area ( OR =2.36, 95 %CI : 1.77-3.16); having one child ( OR =1.76, 95 %CI : 1.42-2.17) or ≥2 children ( OR =2.15, 95 %CI : 1.43-3.22) in the family were the risk factors associated with feeding poultry compared with higher educational level of college and above, being employed, being local resident, living in urban area and having no child. And being farmer ( OR =1.61, 95 %CI : 1.27-2.02); being non local resident ( OR =1.76, 95 %CI : 1.31-2.35); living in suburban area ( OR =2.05, 95 %CI : 1.61-2.61); having one child ( OR =1.24, 95 %CI : 1.02-1.52) or ≥2 children ( OR =1.78, 95 %CI : 1.21-2.63) were the risk factors for purchasing live poultry. Conclusion: Some residents living in Beijing still have exposure to live poultry, and targeted measures should be taken to reduce the exposure to poultry.

This paper introduces the revised Cochrane bias risk assessment tool for individual randomized, cross-over trials (RoB2.0), comparing RoB2.0 of cross-over design with RoB2.0 of parallel design, and illustrating the application of RoB2.0 for cross-over trials in a published clinical trial. As a comprehensive tool specially designed for cross-over design, it provides more information on risk of bias in systematic reviews for the evidence synthesis.

Objective: To analyze the prevalence and drug resistance of mycoplasma pneumoniae in patients with community-acquired pneumonia during 2011-2015 in Beijing. Methods: Totally 2 272 mycoplasma pneumoniae samples were collected from patients with community-acquired pneumonia in 5 sentinel hospitals during 2011-2015. Mycoplasma pneumoniae were detected by real-time PCR. 142 copies of positive samples with Ct value under 30 were cultured to get the strains so that the genotypes based on the P1 gene sequence and the drug resistance based on the in vitro drug resistance test could be conducted. χ(2) test was used to compare the detection rates of mycoplasma pneumoniae among different age groups and different onset-phase. Results: The positive rate of mycoplasma pneumoniae was 13.6%(308 cases). The positive rate in groups aging (5-14), (15-24) and ≥60 years old were separately 24.4% (67/275), 24.4% (38/156) and 3.9% (28/727) (χ(2)=1.22, P< 0.001). The annual detection rate of mycoplasma pneumoniae in 2011-2015 were 14.6% (73/501), 10.2% (36/353), 26.4% (101/383), 10.3% (41/398), 9.0% (57/637),respectively (χ(2)=72.65, P< 0.001). Seasonally, the peak of positive rate was between October and December (17.5%, 122/699) and the lowest positive rate was between April and June (8.6%, 43/502). 36 strains were isolated from 142 swabs and 23 (63.9%) were P1-Ⅰ and 13 (36.1%) were P1-Ⅱ by genotyping. All isolates were susceptible to the fluoroquinolones (levofloxacin, ciprofloxacin, and gatifloxacin) and tetracycline. All P1-Ⅱ strains were susceptible to macrolides while most of the P1-Ⅰ strains (22 strains) were macrolide-resistant. Conclusion: People aging (5-14) and (15-24) years old were more susceptible to mycoplasma pneumoniae in patients with community-acquired pneumonia in Beijing between 2011 and 2015. The highest positive rate of mycoplasma pneumoniae was in 2013 and the case distributed in all seasons. The major popular genotype was P1-Ⅰ, whose strains were mostly macrolide-resistant.

Objective: To investigate the clinical significance of expression level of thyroid hormone receptor interactors 13 (TRIP13) gene to probe its function and downstream molecular mechanism in chronic lymphocytic leukemia (CLL) . Methods: Real-time quantitative PCR method was used to detect the expression levels of TRIP13 mRNA of CD19(+) B lymphocytes in 30 cases of patients with CLL and 12 cases of peripheral blood hematopoietic stem cell donors (normal control group) . Lentivirus mediated shRNA was used to interference the mRNA and TRIP13 protein in CLL cells JVM-2. Scramble sequence was used as control. Methyl thiazolyl tetrazolium colorimetric assay (MTT) and flow cytometry was used to detect the cell proliferation and apoptosis in TRIP13 knocked-down and negative control JVM-2 cells. Results: TRIP13 mRNA level was significantly higher in 30 cases of CLL patients (2(-△Ct)= 0.014 89) compared with 12 healthy donors (2(-△Ct)= 0.000 19) ( P <0.001) . Validated TRIP13 shRNA target was achieved in JVM2 cell. Compared with the control group, down-regulation of TRIP13 expression could significantly inhibit the proliferation of JVM-2 cells and induce apoptosis. The expressions of Myc and Bcl-2 protein in JVM-2 cells decreased significantly after interference with TRIP13 ( P <0.001) , and the expressions of Bax, caspase 3 and Bad protein increased significantly ( P <0.001) . Conclusion: TRIP13 mRNA significantly over-expressed in CLL patients CD19(+) B lymphocytes. TRIP13 could influence JVM2 cell proliferation and apoptosis through proliferation- and apoptosis-related proteins.

Objective: To analyze the influence of growing experience on non-heterosexual orientation among male college students. Methods: From October to November in 2015, a total of 2 535 male students from 96 classes in 14 colleges/departments were recruited from two colleges that participated in the experimental work of AIDS prevention by cluster random sampling method. A structured questionnaire was administered in this study, including general demographic information, growing experience and Kinsey scale (to evaluate sexual orientation). Out of 2 500 questionnaires distributed in this study, 2 332 effective copies were withdrew, with the effective rate at 93.3%. Chi square test was used to analyze the differences of non-heterosexual orientation among the individuals with different social demographic characteristics. Multivariate logistic regression model was used to analyze the influencing factors of non-heterosexual orientation. Results: Among the 2 332 individuals, the proportion of self-reported non-heterosexual was 6.2% (144).The proportions of male students who identify as non-heterosexual from freshman to junior year were 5.2%(63/1216),6.9%(65/941),11.7%(13/111) and 4.7%(3/64), respectively (χ(2)=9.06, P= 0.029). Compared with the individuals of very good relationship with parents, those with bad relationship ( OR= 3.3, 95 %CI: 1.7-6.5) and general relationship ( OR= 1.7, 95 %CI: 1.0-2.9) with parents had a higher risk of non-heterosexual orientation, respectively. Those encountered sexual assault had a higher risk of non-heterosexual orientation than those without encountered sexual assault ( OR= 5.9, 95 %CI: 3.2-10.9). Conclusions: This study reported a high proportion of self-reported non-heterosexual among college male students in Nanjing, and highlighted the importance of targeting students with poor parental relationships and who subjected to sexually abused.

Objective: This study aimed to explore the incidence trends and onset features of scarlet fever during the years of epidemic, from 2006 to 2015, in Beijing. Methods: Spatial, temporal and population distributions, prognosis of the reported cases and surveillance data on scarlet fever and other streptococcal infections (including the patients of streptococcal infection, tonsillitis and isthmitis) were analyzed by the descriptive epidemiological methods. Results: A total of 27 987 scarlet fever cases were reported from 2006 to 2015, with the incidence rates as 7.04 to 18.53 per 100 000 persons during these years, except for 2011. A total of 6 152 cases were reported in 2011, with the incidence of 31.37 per 100 000 persons, significantly higher than the average levels of the other years. There were more cases reported in rural-urban continuum, in summer and winter, with most of the cases were children in primary schools and infant-institutes. From May to December in 2011, 4 332 cases were interviewed three weeks after the disease onset, and their conditions improved or recovered, with no death or complication appeared at the follow-up period. There were 2 725 cases of scarlet fever and 104 013 clinical cases of streptococcal infections reported in 36 surveillance hospitals during the same period. The ratio between numbers of scarlet fever cases and streptococcal infection was 1 ∶ 38.17. The weekly numbers of scarlet fever were remarkably correlated to the streptococcal infections, with a Pearson's correlation coefficient as 0.729 ( P <0.001). Accordingly, we estimated that about 21.4 thousand clinical cases of streptococcal infections that were caused by Group A streptococcus in 2011, in Beijing. Conclusions: Incidence of scarlet fever in 2011 was significantly higher than the average levels of other years in Beijing, but characteristics on spatial, temporal and population distributions of scarlet fever remained the same, with good prognosis of the reported cases. A large number of culture-positive Group A streptococcus infections among all the clinical cases of streptococcal infection might have been served as important source on septic infection, of scarlet fever.

Neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) had been analysed in many kind of tumours, but its role of predict the oesophageal squamous cell carcinoma (ESCC) patients' prognosis was not reach a consensus. Relationship between NLR, PLR and ESCC located in the middle or lower segment was evaluated. 317 patients with ESCC who underwent attempted curative oesophagectomy were analysed in this study. 157 and 98 patients had elevated NLR and PLR respectively (NLR >3.3 and PLR >150). The median overall survival time (OS) and disease-free survival (DFS) was 34.1 and 19.2 months respectively. Multivariate analysis found PLR >150 (P = 0.018, HR 1.426, 95%CI 1.063-1.912) accompanied by male, lymphatic metastases, tumour size more than 3 cm, tumour located at middle segment and poor differentiation were associated with significantly worse DFS. Meanwhile, gender, lymphatic metastases, tumour location and differentiation along with PLR >150 (P = 0.003, HR 1.595, 95% CI 1.172-2.170) and NLR>3.3 (P = 0.039, HR 1.367, 95% CI 1.015-1.840) were all independent prognostic factors for OS. Preoperative NLR and PLR might be used as predictive factors in patients with ESCC. For DFS, elevated PLR compared to NLR may have an advantage to indicate poor prognosis., (© 2016 John Wiley & Sons Ltd.)

Objective: To investigate the situation of recreational drug nitrous acid ester inhaler-rush poppers use in men who have sex with men (MSM). Methods: From April to June in 2014, October to December in 2014, April to June in 2015, three round cross-sectional surveys were conducted in MSM recruited in Nanjing by means of serum test and questionnaire survey. Results: Of the 1 721 MSM surveyed in three round, 19.3% (332/1 721) had ever used rush poppers, the proportions of MSM who used rush poppers in three round surveys showed an increasing trend (liner by liner χ (2)= 14.879, P =0.000), which was 12.6% (86/681), 27.6% (121/439) and 20.8% (125/601) respectively. Rush poppers use was associated with HIV infection significantly ( OR =1.676, 95 %CI : 1.201-2.339, P =0.002). Compared with MSM without rush poppers use, the MSM with rush poppers use were mainly aged <30 years, unmarried, received college and higher education, had lived in Nanjing for less than 2 years, seek sex partners through internet and identified themselves as homosexual orientation. Multivariate logistic analysis showed that less than 30 years old, living in Nanjing for less than 2 years, with college and higher education level, more than 2 sex partners in the past 6 months, being diagnosed with STDs in the previous one year and using traditional drugs were the risk factors associated with rush poppers use. Conclusion: Rush poppers use was related with HIV infection in MSM in Nanjing.

Objective: To investigate the current status of hearing loss and related influencing factors in workers with noise exposure in refining and chemical industry. Methods: From August 2015 to March 2016, the investigation method of collecting the data of past occupational health examinations and measuring noise in working environment was used to enroll 8 672 male workers. Results: Of all workers, 11.6% were diagnosed with hearing loss. There were significant differences in the distribution of hearing impairment among workers exposed to noise at different ages, device types and types of work (χ(2)=17.80, 77.80 and 30.53, all P <0.05) . The level of noise exposure≥85 dB (A) ( OR =5.79, 95% CI 3.70-8.81) , working years with noise exposure ( OR =1.57, 95% CI 1.05-2.43) , and 25 years ( OR =3.29, 95% CI 2.08-5.71) were risk factors for hearing loss in workers with noise exposure in refining and chemical industry. Conclusion: The level of noise exposure and working years with noise exposure are main influencing factors for hearing loss in workers with noise exposure in refining and chemical industry.

Objective: To investigate the association between cadherin-23 (CDH23) gene polymorphisms and susceptibility to noise-induced hearing loss (NIHL) in the Chinese population through a meta-analysis. Methods: In June 2016, CNKI, VIP, Wanfang Data, and PubMed were searched for studies on the association between CDH23 gene polymorphisms and susceptibility to NIHL in the Chinese population. The articles were screened according to inclusion and exclusion criteria and related data were extracted. RevMan 5.3 was used for the meta-analysis. Results: A total of three Chinese articles were included. For CDH23-rs1227049, the risk of NIHL in people with C allele was 0.82 times (95% CI 0.39-1.73) that in people with G allele, the risk of NIHL in people with CG+CC genotype in the dominant model was 0.70 times (95% CI 0.34-1.43) that in people with GG genotype, the risk of NIHL in people with CC genotype in the recessive model was 1.23 times (95% CI 0.28-5.43) that in people with CG+GG genotype, and the risk of NIHL in people with CC genotype in the additive model was 1.05 times (95% CI 0.20-5.44) that in people with GG genotype (all P >0.05) . For CDH23-rs1227051, the risk of NIHL in people with T allele was 0.98 times (95% CI 0.71-1.37) that in people with C allele, and the risk of NIHL in people with CT+CC genotype in the dominant model was 1.09 times (95% CI 0.75-1.57) that in patients with TT genotype (both P >0.05) . Conclusion: There is still no enough evidence for the determination of CDH23-rs1227049 and CDH23-rs1227051 to be the susceptibility gene loci of NIHL.

Objective: To analyze the protein expression profile and the potential virulence factors of Porphyromonas endodontalis (Pe) via comparison with that of two strains of Porphyromonas gingivalis (Pg) with high and low virulences, respectively. Methods: Whole cell comparative proteomics of Pe ATCC35406 was examined and compared with that of high virulent strain Pg W83 andlow virulent strain Pg ATCC33277, respectively. Isobaric tags for relative and absolute quantitation (iTRAQ) combined with nano liquid chromatography-tandem mass spectrometry (Nano-LC-MS/MS) were adopted to identify and quantitate the proteins of Pe and two strains of Pg with various virulences by using the methods of isotopically labeled peptides, mass spectrometric detection and bioinformatics analysis. The biological functions of similar proteins expressed by Pe ATCC35406 and two strains of Pg were quantified and analyzed. Results: Totally 1 210 proteins were identified while Pe compared with Pg W83. There were 130 proteins (10.74% of the total proteins) expressed similarly, including 89 known functional proteins and 41 proteins of unknown functions. Totally 1 223 proteins were identified when Pe compared with Pg ATCC33277. There were 110 proteins (8.99% of the total proteins) expressed similarly, including 72 known functional proteins and 38 proteins of unknown functions. The similarly expressed proteins in Pe and Pg strains with various virulences mainly focused on catalytic activity and binding function, including recombination activation gene (RagA), lipoprotein, chaperonin Dnak, Clp family proteins (ClpC and ClpX) and various iron-binding proteins. They were involved in metabolism and cellular processes. In addition, the type and number of similar virulence proteins between Pe and high virulence Pg were higher than those between Pe and low virulence Pg. Conclusions: Lipoprotein, oxygen resistance protein, iron binding protein were probably the potential virulence factors of Pe ATCC35406. It was speculated that pathogenicity of Pe was more similar to high virulence Pg than that to low virulence strain.

Objective: To understand the current status of HIV infection in men who have sex with men (MSM) in Nanjing, explore the associated factors with HIV infection, and provide information for the intervention in MSM. Methods: Data collected in the consecutive sentinel surveillances among MSM during 2011-2015 includes MSM's social-demographic information, sexual behavior histories, access to HIV prevention services and HIV testing in the past year. The infection trend was analyzed with χ 2 test and the factors associated with HIV infection were identified through multivariate logistic regression analysis. Results: From 2011 to 2015, 712, 670, 656, 681 and 601 MSM were surveyed respectively. The HIV infection rates were 7.4%, 13.7%, 9.8%, 12.0% and 12.0% respectively, with an increasing trend ( P =0.044). Syphilis prevalence rates were 9.1%, 11.5%, 6.0%, 10.6% and 5.8% respectively, with a decreasing trend ( P =0.042). From 2011 to 2015, the percentage of MSM who failed to consistently use condoms for anal sex in the past 6 months increased significantly from 46.4%(260/560) to 55.7%(257/461) the percentage of those having commercial sex with males increased significantly from 1.2%(8/692) to 3.0%(18/593) in 2015, while the percentage of those receiving HIV test in the past year decreased significantly from 67.7%(482/712) to 57.6%(346/601). Those who were aged >25 years, lived in Nanjing for less than 2 years, had a high school or below educational level, failed to consistently use condoms at anal sex in the past 6 months, failed to have HIV test in the past year and were infected with syphilis had higher risk for HIV infection. Conclusion: Given the increasing trend of HIV infection and high risk sexual behavior in MSM in Nanjing, it is necessary to strengthen the comprehensive HIV prevention and intervention through expanding HIV test coverage and promoting condom use to curb HIV epidemic in MSM.

We present results of numerical modeling and direct calorimetric measurements of the powder absorptivity for a number of metals. The modeling results generally correlate well with experiment. We show that the powder absorptivity is determined, to a great extent, by the absorptivity of a flat surface at normal incidence. Our results allow the prediction of the powder absorptivity from normal flat-surface absorptivity measurements.

Objective: To investigate the association between the polymorphisms of genes involving in drug metabolism and transport as well as immunological reaction and the risk of anti-tuberculosis drug-induced liver injury(ATLI)in Chinese., Methods: This 1∶4 matched case-control study was conducted by using the data from a cohort study of Anti-tuberculosis Drugs Induced Adverse Reactions in National Tuberculosis Prevention and Control Progtam of China. Genes involving in three phase of drug metabolism and transport as well as related immunological reaction were chosen and single nucleotide polymorphisms(SNPs)were genotyped by TaqMan allele discrimination technology. Lasso regression and multivariate conditional logistic regression analysis were used to select susceptible genes., Results: A total of 33 genes with 75 SNPs were tested. The combined results of Lasso and regression logistic regression analysis showed that genetic polymorphism of SLCO1B1 rs4149014, HSPA1L rs2227956, STAT3 rs1053023 and IL-6 rs2066992 were significantly associated with the risk of ATLI(P<0.05)., Conclusion: SLCO1B1, HSPA1L, STAT3 and IL-6 might be the susceptibility genes of drug induced liver injury in patients receiving anti-tuberculosis treatment.

Objective: To systematically review the effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on two common respiratory system adverse events (RSAE: nasopharyngitis and upper respiratory tract infection) among type 2 diabetes (T2DM)., Methods: Medline, Embase, Clinical trials and Cochrane library were searched from inception through May 2015 to identify randomized clinical trials(RCTs) assessed safety of GLP-1RAs versus placebo or other anti-diabetic drugs in T2DM. Network meta-analysis within a Bayesian framework was performed to calculate odds ratios for the incidence of RSAE., Results: In the study, 50 RCTs were included, including 13 treatments: 7 GLP-1RAs (exenatide, exenatide-long-release-agent, liraglutide, lixisenatide, taspoglutide, albiglutide and dulaglutide), placebo and 5 traditional anti-diabetic drugs(insulin, metformin, sulfonylureas, sitagliptin and thiazolidinediones ketones). Compared with insulin, taspoglutide significantly decreased the incidence of nasopharyngitis (OR=0.67, 95%CI: 0.46-0.96). Significant lowering effects on upper respiratory tract infection were found when taspoglutide versus placebo (OR=0.57, 95%CI: 0.34-0.99) and insulin (OR=0.39, 95%CI: 0.23-0.73). The result from the network meta-analysis based on Bayesian theory could be used to rank all the treatments included, which showed that taspoglutide ranked last with minimum risk on nasopharyngitis and upper respiratory tract infection., Conclusion: Taspoglutide was associated with significantly lowering effect on RSAE.

Setting: Evidence indicates that the polymorphisms in genes involved in bile acid metabolism may play an important role in the development of anti-tuberculosis drug-induced hepatotoxicity (ATDH) in tuberculosis (TB) patients treated with anti-tuberculosis drugs., Objective: To investigate the association between genetic variants of CYP7A1, BAAT and UGT1A1 and the risk of ATDH in a Chinese cohort., Design: In this nested case-control study, 89 TB patients with ATDH and 356 matched ATDH-free TB patients constituted cases and controls, respectively. Genetic polymorphisms of CYP7A1, BAAT and UGT1A1 were determined using the TaqMan single-nucleotide polymorphism genotyping assay. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using a conditional logistic regression model., Results: Significant differences were found in genotype distributions of rs1457043 in CYP7A1 between patients with and those without ATDH (P = 0.014). Genotype and haplotype analysis showed that patients carrying an AG genotype of rs1457043 and G-C or G-A haplotypes of rs1457043-rs8192870 in CYP7A1 were at a higher risk of ATDH than those with GG genotype and A-C haplotype, with ORs of respectively 2.05 (95%CI 1.18-3.15) and 2.40 (95%CI 1.62-3.57)., Conclusion: Genetic polymorphisms of CYP7A1 may be associated with susceptibility to ATDH in the Chinese population.

Objective: Examine the correlates of Health Related Quality of Life (HRQL) in a large cohort of Parkinson's disease (PD) patients from National Parkinson Foundation (NPF) Centers of Excellence (COEs)., Background: Improving outcomes for PD will depend upon uncovering disease features impacting HRQL to identify targets for intervention and variables for risk-adjustment models. Differences in HRQL outcomes between COEs could uncover modifiable aspects of care delivery., Methods: This cross-sectional study examined the relative contribution of demographic, social, clinical and treatment features potentially related to HRQL, as measured by the PDQ-39, in 4601 consecutive subjects from 18 COEs. Stepwise linear regression was utilized to identify correlates of HRQL., Results: The variability in the PDQ-39 summary index score correlated with H&Y stage (R(2) = 22%), Timed up and Go (TUG) (17%), disease duration (11%), comorbidities (8%), cognitive status (8%), antidepressant use (6%) and center at which a patient received care (5%). Stepwise regression reordered the importance of the variables, with the H&Y first and TUG and the center becoming equal and the second most important variables determining the PDQ-39 total score. All independent variables together accounted for 44% of the variability in HRQL., Conclusions: We confirmed many but not all HRQL associations found in smaller studies. A novel observation was that the site of care was an important contributor to HRQL, suggesting that comparison of outcomes and processes among centers may identify best practices., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

To identify complementary laboratory indices for determining the disease status of patients with hepatitis B virus. Subjects were divided into six groups: hepatitis B virus carrier, mild chronic hepatitis B, moderate chronic hepatitis B, severe chronic hepatitis B, fulminant hepatitis B and healthy controls. Serum alanine aminotransferase, total bilirubin and direct bilirubin were measured by an automatic analyser. The levels of T-cell immunoglobulin domain and mucin-domain-containing molecule-3, macrophage inflammatory protein 2, neutrophil gelatinase-associated lipocalin and inducible nitric oxide synthase were measured by ELISA. T-cell immunoglobulin domain, mucin-domain-containing molecule-3, macrophage inflammatory protein 2 and inducible nitric oxide synthase levels were significantly higher in patients with severe chronic hepatitis B compared with those in patients with mild and moderate chronic hepatitis B or fulminant hepatitis B (P < 0.05). When normal or abnormal alanine aminotransferase was present, significant differences between macrophage inflammatory protein 2 and T-cell immunoglobulin domain and mucin-domain-containing molecule-3 levels between patients with mild, moderate, severe chronic hepatitis B or fulminant hepatitis B were observed (P < 0.05). Our results suggest that T-cell immunoglobulin domain and mucin-domain-containing molecule-3 and macrophage inflammatory protein 2 could serve as alanine aminotransferase, direct bilirubin or total bilirubin complementary indices for determining the status of patients with hepatitis B., (© 2013 John Wiley & Sons Ltd.)

This article describes the certification pathways for Physiatrists in the United States, reviews the licensure, certification and accreditation pathways for rehabilitation facilities in the United States, examines the evolving models of health care in the United States, evaluates the impact of health care reform within the United States with particular emphasis on the intrinsic value of Physiatric services, and discusses how the intersection of certification, accreditation and emerging models of care in the United States present opportunities for Physiatrists instead of threats. These principles and practices should be relevant to Physiatrists and physiatric programs globally.

In order to improve the quality of frozen spermatozoa of Yunnan semi-fine wool sheep, 1, 4-cyclohexanediol (1, 4-CHD) as a synthetic ice blocker was used for cryopreservation of ram spermatozoa in this study. Briefly, following collection by electric stimulation, equilibration at 5℃ following dilution with the freezing extender, and pre-freezing in liquid nitrogen vapor, the ram spermatozoa were preserved in liquid nitrogen for one month. In addition, the effects of osmolarity of the diluting extenders used for evaluation of frozen spermatozoa quality were also assessed. The results indicated addition of 1, 4-CHD could not increase the motility of ram spermatozoa after cryopreservation and thawing. With the elevation of the concentrations of 1, 4-CHD, the motility and moving velocity of frozen ram spermatozoa showed a steady decrease. Additionally, the presence of 1, 4-CHD cannot increase the percentage of frozen spermatozoa with intact acrosome and membrane. When the isotonic binding buffer was used to dilute the thawed spermatozoa, the percentage of cells labeled with propidium iodide (PI) after cryopreservation in the presence of 1, 4-CHD was significantly higher than that of spermatozoa frozen in the absence of 1, 4-CHD (P < 0.05). However, the percentage of frozen-thawed spermatozoa with exposed PS in the presence of 1, 4-CHD was significantly less than that of spermatozoa frozen in the absence of 1, 4-CHD (P < 0.01). When the basic extenders with an osmolarity of 404mOsm, 528mOsm, 648mOsm, or 853mOsm were used to dilute the frozen-thawed spermatozoa respectively, there is no significant difference between the four groups with respect to the moving velocity and membrane integrity (P > 0.05). In conclusion, the presence of 1, 4-CHD cannot improve the motility, moving velocity, acrosome staus, and membrane integrity of frozen ram spermatozoa. However, 1, 4-CHD may inhibit apoptosis caused by freezing and thawing.

Survivin and vascular endothelial growth factor (VEGF) are newly discovered tumor markers closely correlated with bladder cancer. We analyzed the expression of survivin and VEGF in paraffin-embedded tumor tissues from 78 patients with bladder transitional cell carcinoma (BTCC) using an immunohistochemistry method. Normal bladder mucosae from 10 non-BTCC cases were also included as a control group. All patients were closely followed up for tumor recurrence after undergoing transurethral resection of bladder tumor procedures. The positive expression rates of survivin and VEGF in superficial BTCC were 66.7% (52/78) and 69.2% (54/78), respectively, which were significantly higher than those in the control group, 0% (0/10). A positive correlation was found between survivin and VEGF expression (r = 0.283, P < 0.01). Thirty-two of 78 patients (41.0%) displayed recurrence during follow-up (median: 47; range: 7-62 months). The tumor recurrence rate in survivin(+) patients was 53.8% (28/52), which was significantly higher than that in survivin(-) patients [15.4% (4/26); P < 0.05]. The recurrence rate in VEGF(+)/ VEGF(-) patients was 50.0% (27/54) and 20.8% (5/24), respectively (P < 0.05). The sensitivity for predicting the relapse of superficial BTCC was 87.5% in the survivin(+) group, 84.4% in the VEGF(+) group, and 78.1% in the survivin(+)/VEGF(+) group, and the specificity was 47.8, 41.3, and 65.2%, respectively. Survivin and VEGF interact and jointly regulate the biological behavior of bladder cancer. Our results suggest that overexpression of survivin and VEGF accompany a higher risk of BTCC recurrence, making survivin and VEGF biomarkers for predicting the relapse of bladder cancer.

The contribution of the three core components of working memory (WM) to the development of mathematical skills in young children is poorly understood. The relation between specific WM components and Numerical Operations, which emphasize computation and fact retrieval, and Mathematical Reasoning, which emphasizes verbal problem solving abilities in 48 2nd and 50 3rd graders was assessed using standardized WM and mathematical achievement measures. For 2nd graders, the central executive and phonological components predicted Mathematical Reasoning skills; whereas the visuo-spatial component predicted both Mathematical Reasoning and Numerical Operations skills in 3rd graders. This pattern suggests that the central executive and phonological loop facilitate performance during early stages of mathematical learning whereas visuo-spatial representations play an increasingly important role during later stages. We propose that these changes reflect a shift from prefrontal to parietal cortical functions during mathematical skill acquisition. Implications for learning and individual differences are discussed.

Although the inferior parietal cortex (IPC) has been consistently implicated in mathematical cognition, the functional roles of its subdivisions are poorly understood. We address this problem using probabilistic cytoarchitectonic maps of IPC subdivisions intraparietal sulcus (IPS), angular gyrus (AG), and supramarginal gyrus. We quantified IPC responses relative to task difficulty and individual differences in task proficiency during mental arithmetic (MA) tasks performed with Arabic (MA-A) and Roman (MA-R) numerals. The 2 tasks showed similar levels of activation in 3 distinct IPS areas, hIP1, hIP2, and hIP3, suggesting their obligatory role in MA. Both AG areas, PGa and PGp, were strongly deactivated in both tasks, with stronger deactivations in posterior area PGp. Compared with the more difficult MA-R task, the MA-A task showed greater responses in both AG areas, but this effect was driven by less deactivation in the MA-A task. AG deactivations showed prominent overlap with lateral parietal nodes of the default mode network, suggesting a nonspecific role in MA. In both tasks, greater bilateral AG deactivation was associated with poorer performance. Our findings suggest a close link between IPC structure and function and they provide new evidence for behaviorally salient functional heterogeneity within the IPC during mathematical cognition.

Variation in and amplification conditions for eight polymorphic microsatellite loci initially identified from Bulimulus akamatus, a pulmonate land snail from Galápagos, are described. Intraspecific polymorphism and heterozygosity of the eight markers were studied in 19 populations of Bulimulus reibischi, a closely related species of B. akamatus. Furthermore, the eight loci were also cross-amplified in six other closely related bulimulid species. The number of alleles across populations of B. reibischi at six loci is moderate (three to 10), but considerable for two other loci (19 and 20). There is no strong evidence for linkage among any of the loci examined., (© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd.)

Objective: To determine whether an intra-articular injection of recombinant human bone morphogenetic protein-2 (rhBMP-2) alleviates cartilage degradation in a rat model of osteoarthritis (OA) of the lumbar facet joint., Method: The right-side facet joint OA model was created by an intra-articular injection of collagenase (type II) 2 weeks before treatment. The OA rats were divided into four groups: (1) no treatment, or intra-articular injection of either (2) saline, (3) rhBMP-2 10 ng, or (4) rhBMP-2 100 ng. The left-side facet joint served as the normal control. At 3 and 6 weeks after treatment, histological analyses were performed on the cartilage, synovium, subchondral bone and bone marrow. The cartilage and synovium were graded using a modified Mankin score and a synovium score system. Extracellular type II collagen was evaluated by immunohistochemistry., Results: Intra-articular injection of collagenase causes OA-like changes in the facet joint. OA rats treated with rhBMP-2 at both dosages tested showed reduced severity of their cartilage lesions compared with untreated and saline-treated groups. There was a statistically significant difference in the modified Mankin score compared to the untreated and saline-treated groups. However, some rhBMP-2-treated rats at the higher dose (100 ng) showed, as a side effect, joint space obliteration caused by cartilage overgrowth. Also OA rats treated with 100 ng of rhBMP-2 displayed a significant synovium reaction at 3 weeks compared with that in other groups. Immunohistochemical analysis showed that treatment with rhBMP-2 significantly increased the content of type II collagen., Conclusion: This study demonstrates the potential efficacy of rhBMP-2 in the alleviation of arthritic changes in a rat model of OA of the lumbar facet joint. However, treatment with a high dosage of rhBMP-2 caused adverse side effects in some animals.