[Progress in research of avian influenza virus and human monoclonal antibody and vaccines against H7N9 virus]

Avian influenza virus (AIV) is a kind of zoonotic virus which can cause acute respiratory infectious diseases. Since the report of the world's first human infection case of avian influenza A (H7N9) virus in China in 2013, close attention has been paid to the virus. AIV spreads widely around the world, and human infection with different types of AIV continues to occur, causing huge economic losses. At present, there are no specific treatment and drugs against the disease, and vaccination is considered as the most promising and effective method to control the human infection with AIV. So far, there are many kinds of veterinary and human vaccines for H7N9 AIV, among which four types of human H7N9 AIV vaccines have entered the clinical trial stage, including virus-like particles vaccine, attenuated live vaccine, inactivated vaccine and DNA vaccine, which have shown good safety and immunogenicity. However, the true efficacies of the AIV vaccines remain unknown because no human vaccines are currently available in the market. In addition, although the existing influenza vaccine has good safety and immunogenicity in the human population, there is no cross-antibody response to H7N9 AIV. This paper summarizes the research progress of AIV etiology and epidemiology, the occupational exposure population investigation, the infection prevention and control strategies, and H7N9 AIV vaccine and H7N9 AIV anthropogenic monoclonal antibody, and discuss the remained problems, challenges and future trends in the research of AVI to improve the understanding of the disease and the prevention and control of global spread of AIV.

[Management of major complications in surgical treatment of mandibular osteoradionecrosis by using vascularized free flaps]

Objective: To retrospectively analyze of the prevention and management of major complications in surgical treatment of osteoradionecrosis (ORN) of the mandible by using vascularized free flaps and to provide a reference for improving clinical treatments. Methods: All cases diagnosed as mandibular ORN and received surgical treatment in the Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University from August 2014 to March 2019 were included. The patients' clinical data, mainly including general information, primary tumor, interval time between radiotherapy and osteoradionecrosis, surgical methods and postoperative complications, were collected. The data of surgical methods and postoperative complications of these patients were compared with the similar data of patients with malignant tumor surgically treated by using vascularized free flaps during the same period. Results: The postoperative follow-up data of 104 patients with mandibular ORN, who underwent surgery in our hospital, were collected. In the control group, surgeries of vascularized free flap transfer were performed in 430 patients with malignant tumor. Among the 34 ORN cases (34/104, 32.7%) of segmental resection with vascularized free flap transfer, there were 13 cases (13/34, 38.2%) of postoperative local infection in maxillofacial area, 6 cases (17.6%) of pulmonary infection, 2 cases (5.9%) of venous thrombosis, 3 cases (8.8%) of anastomotic artery rupture and 5 cases (14.7%) of vascular crisis. One case died of depression and misanthropy. Meanwhile, among 430 patients with malignant tumor who underwent surgeries of vascular free flap reconstruction, 25 cases (5.8%) had postoperative local infection and 29 cases (6.7%) had pulmonary infection. Vascular crisis occurred in 12 cases (2.8%) and anastomotic artery rupture in 1 case (0.2%). No venous thrombosis and misanthropy occurred. The incidence of postoperative complications in mandibular ORN was much higher than that of vascularized free flap transfer surgeries in malignant tumor cases (P<0.05). Conclusions: Compared with patients with malignant tumors undergoing vascularized free flap transfer surgeries, patients with mandibular ORN undergoing same surgeries are more likely to have postoperative complications. This study may help clinicians to fully understand the local, general and psychological conditions during the perioperative period of ORN patients.

[Characteristics of Sludge and Associated Risk Assessment of Urban Sewage Treatment Plants]

In urban solid waste management, the scientific and reasonable disposal and utilization of sewage sludge is becoming more and more important. It can be said that the pollution status and chemical properties of sewage sludge in urban sewage treatment plants can provide a basis for the scientific disposal and utilization of sludge. In this study, the characteristics of pH, moisture content, Cd, Cr, Cu, Zn, Pb, As, Hg, Ni, mineral oil, volatile phenol, PAHs, organic matter, nitrogen, phosphorus, and potassium were evaluated in sewage sludge collected from 49 sewage treatment plants in a certain city. The pollution status of heavy metals and organic pollutants, the frequency distribution of pollutant concentrations, and changes in the nutrient content were analyzed. The Nemero index and Hakanson potential ecological hazard index were used to assess the potential ecological risks of heavy metals in the agricultural utilization process of sludge. The results showed that under the condition of neutral pH values and high moisture content, the order of heavy metal content was Zn > Cu > Cr > Pb > Ni > As > Hg > Cd. The principal component analysis (PCA) results indicated that Cd, Pb, Hg, Ni, and As constituted the main load factors of the first main component of heavy metal sources. The most concentrated contents of 8 heavy metal frequency distributions among the 49 samples were 38.9-1380.0, 62.6-182.7, 63.6-181.3, 0.0-97.8, 19.3-68.4, 0.8-29.2, 0.3-8.7, and 0.01-0.96 mg·kg^-1. In addition, the most concentrated frequency distribution of mineral oil, volatile phenol, and PAH concentration were 87.0%, 87.9%, and 77.6%, respectively. Moreover, the nutrient content of sludge was higher than the average level in China, and the organic matter content was 67.4%, 75.9%, and 92.5% of that of pig manure, cow dung, and chicken manure, while the content of nitrogen, phosphorus, and potassium was not very different. The Nemero index and Hakanson ecological hazard index results showed that the sludge of urban sewage treatment plant in the city has certain ecological risks. However, four sewage treatment plants were heavily polluted or highly ecologically hazardous among the 44 plants in this study, which were in line with the Standards for pollutant control of agricultural sludge. In summary, there are certain potential ecological risks for the agricultural utilization of sludge in the city, and it is necessary to reduce the heavy metal content before resourcing. More importantly, on the premise that the sludge meets the agricultural standards, a comprehensive ecological risk assessment is required to select a reasonable sludge recycling method.

[VOCs Removal and Emission Monitoring of Beijing Bulk Gasoline Terminals in 2012-2019]

Bulk gasoline terminals are an important emission source of volatile organic compounds (VOCs) in cities. Beijing started to promote the installation of oil and gas recovery devices at oil storage terminals in 2006 to reduce VOCs emissions, since then VOCs emissions from the terminals have been monitored by the municipal government every year. This paper analyzes the VOCs emission characteristics of oil storage terminals in Beijing from 2012 to 2019. We found that the VOCs import concentration was 165.3 g·m^-3 in 2019 and had experienced a decline-rise-decline pattern during 2012-2019. The emission concentration was 7.3 g·m^-3 in 2019 and had declined continuously during the preceding eight years. The removal efficiency of VOCs of the gas recovery devices tended to be stable and ranged from 45.5% to 100%. Although the emission concentration had decreased significantly, the removal efficiency of the recovery unit at the oil storage terminals had decreased. Therefore, this paper proposed to strengthen process management, the inspection of the service life of the oil and gas recovery units, and check and maintain records. In addition, the removal efficiency index should be included in the scope of law enforcement and "double index" requirements should be implemented This paper will provide a scientific basis for the future development of atmospheric improvement measures.

[Cardiovascular disease risk in diabetes patients aged 40 years old and above in China]

Objective: To evaluate the incidence of cardiovascular disease (CVD), ischemic and hemorrhagic cardiovascular events among Chinese diabetic patients aged 40 years and above with different CVD risk levels. Methods: This study enrolled participants aged 40 years and above in 15 provinces from a prospective cohort study, the China-PAR project (Prediction for Atherosclerotic Cardiovascular Disease Risk in China). Participants were categorized into two groups according to the presence or absence of diabetes at baseline. Individuals were further classified into low (0-4.9%), moderate (5%-9.9%) and high risk groups (≥10%), based on predicted ten-year CVD risk using the China-PAR equations. Two followed-up surveys were conducted between 2007 and 2015 to identify CVD events, which were defined as nonfatal acute myocardial infarction, or death due to coronary heart disease, or stroke. Ischemic cardiovascular events included nonfatal acute myocardial infarction, or death due to coronary heart disease, or ischemic stroke. Hemorrhagic cardiovascular events included subarachnoid hemorrhage and intracerebral hemorrhage. The incidences of CVD, ischemic and hemorrhagic cardiovascular events were compared in diabetes and non-diabetes population with different CVD risk levels. Results: This study included 89 209 participants aged 40 years and above, the average follow-up period was 8.5 years. The age was (54.8±9.4) years, and 36 794 (41.2%) were men, and 5 730 (6.4%) were diabetic patients. In diabetes patients aged 40 years and above, 53.7% (3 075/5 730) were at high risk of CVD. Age-and sex-adjusted incidence of CVD, ischemic and hemorrhagic cardiovascular events (1 066.93/100 000 person-years, 824.23/100 000 person-years, and 211.56/100 000 person-years) were significantly lower in diabetes patients than those in non-diabetes population with high CVD risk (1 773.73/100 000 person-years, 1 228.18/100 000 person-years, and 446.49/100 000 person-years) (all P<0.001). Among high CVD risk populations, incidence of ischemic events was significantly higher in diabetic patients than in non-diabetes population (1 638.47/100 000 person-years vs. 1 228.18/100 000 person-years, P<0.001), but incidence of hemorrhagic events tended to be lower in diabetic patients than in non-diabetes population (415.70/100 000 person-years vs. 446.49/100 000 person-years, P=0.635). Incidence of ischemic and hemorrhagic events were similar between diabetes patients and non-diabetes population at low or moderate CVD risk groups (all P>0.05). Conclusions: More than half of diabetes patients aged 40 years and above in China have high CVD risk. The incidence of CVD, ischemic and hemorrhagic cardiovascular events are different in diabetic patients with different CVD risk levels.

[Thyroid disruptor p, p'-DDE inhibited the expression of LHX4 and DIS3L protein in Nthy-ori-3-1 cells]

Objective: To observe the changes of LHX4 and DIS3L mRNA and protein expression in Nthy-ori-3-1 cells after the treatment of thyroid disruptor p, p'-DDE. Methods: Nthy-ori-3-1 cells in logarithmic growth phase were treated with 0, 0.5, 1.0, 2.0 and 5.0 μg/ml p, p'-DDE solution. The growth state and morphology of the cells were observed by microscope. The mRNA levels of LHX4 and DIS3L were detected by real-time fluorescent quantitative PCR, and the protein expression levels of LHX4 and DIS3L were detected by Western blot. Results: when the concentrations of p, p'-DDE were 0, 0.5, 1.0 and 2.0 μg/ml, Nthy-ori-3-1 cells grew normally. There were 33 differential genes in 2.0 μg/ml group, among which 13 genes were down regulated and 20 genes were up-regulated. Compared with the control group, the protein expression levels of LHX4 and DIS3L in 1.0 and 2.0 μg/ml groups were significantly decreased (P<0.05) , and the relative expression levels of LHX4 and DIS3L protein mRNA in 1.0 μg/ml group were significantly decreased (P<0.05) . Conclusion: p, p'-DDE can affect the protein expression of LHX4 and dis3l in nthy-ori-3-1 cells.

[Clinical feature changes of a COVID-19 patient from mild to critical condition and cardiopulmonary pathological results]

Objective: To analyse the clinical history, laboratory tests and pathological data of a patient who suffered from novel coronavirus pneumonia(COVID-19) and provide reference for the clinical treatment of similar cases. Methods: Data of clinical manifestation, laboratory examination, bronchoscopy, echocardiography and cardiopulmonary pathological results were retrospectively reviewed in a case of COVID-19 with rapid exacerbation from mild to critical condition. Results: This patient hospitalized at day 9 post 2019 novel coronavirus(2019-nCoV) infection, experienced progressive deterioration from mild to severe at day 12, severe to critical at day 18 and underwent extracorporeal membrane oxygenation(ECMO) and continuous renal replacement therapy(CRRT) as well as heart lung transplantation during day 28-45 post infection, and died at the second day post heart and lung transplantation. The patient had suffered from hypertension for 8 years. At the early stage of the disease, his symptoms were mild and the inflammatory indices increased and the lymphocyte count decreased continuously. The patient's condition exacerbated rapidly with multi-organ infections, and eventually developed pulmonary hemorrhage and consolidation, pulmonary hypertension, right heart failure, malignant ventricular arrhythmias, liver dysfunction, etc. His clinical manifestations could not be improved despite viral RNAs test results became negative. The patient underwent lung and heart transplantation and finally died of multi organ failure at the second day post lung and heart transplantation. Pathological examination indicated massive mucus, dark red secretions and blood clots in bronchus. The pathological changes were mainly diffused pulmonary hemorrhagic injuries and necrosis, fibrosis, small vessel disease with cardiac edema and lymphocyte infiltration. Conclusions: The clinical course of severe COVID-19 can exacerbate rapidly from mild to critical with lung, liver and heart injuries.

Disrupting a phospholipase A2 gene increasing lipid accumulation in the oleaginous yeast Yarrowia lipolytica

AIMS

Phospholipase A₂ (PLA₂ ) is a diverse superfamily that hydrolyzes fatty acyl ester bonds at the sn-2 position of phospholipids. The correlation between phospholipid metabolism and the anabolism of neutral lipids remains unclear in yeasts. This study aims to explore the effects of PLA₂ on lipid accumulation in the oleaginous yeast Yarrowia lipolytica.

METHODS AND RESULTS

This study identified an actively expressed phospholipase A₂ gene (PLA2-3, YAIL0_E16060g) in Y. lipolytica by quantitative PCR analysis. The gene PLA2-3 was disrupted in the strain po1gΔKu70 by homologous recombination and in the strain po1g-G3 by a CRISPR-Cas9 system, which caused an increase in stress sensitivity while the cell growth was not altered under fermentative conditions. Lipid production was performed in both flasks and bioreactors. The results showed that the lipid titre and lipid content were improved over 25% and 8-30%, respectively, in PLA2-3 disrupted strains compared to the controls.

CONCLUSIONS

Disruption of the phospholipase PLA2-3 gene could effectively improve lipid production in Y. lipolytica.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study presented a strategy on improving the lipid production of oleaginous yeasts and a similar strategy might be used in other oleaginous microbes.

[Predictors for perioperative blood loss in pediatric patients with congenital scoliosis]

Objective: To identify predictors of massive blood loss after posterior hemivertebra resection for patients with congenital scoliosis. Methods: The data of 106 children with congenital scoliosis were collected from June 2017 to June 2019 in Beijing Children's Hospital. All the cases received posterior hemivertebra resection and internal fixation. The blood volume was estimated by weight and height. The visible blood loss was recorded according to medical record, and the hidden blood loss was calculated by OSTHEO formula. Perioperative information including age, gender, height, weight, Cobb and kyphosis angle, level fused, number of screws, operative time, and laboratory examinations was collected. Then multivariable linear regression was performed to determine the independent risk factors of blood loss. Results: All the surgeries were completed successfully. The mean age of the children was (7.3±2.3) years and the operative time was (162±56) min. The mean fused levels were 3 and the correction rate for deformity was 78.4%. The amount of blood loss was (568±208) ml which accounted for 42.3% of total blood volume. The visible and hidden blood loss was (334±193) ml and (234±199) ml, respectively, and which accounted for 58.8% and 41.2% of total blood loss. Multivariable linear regression analysis indicated that age, preoperative Cobb angle, the time of surgery and the number of fused levels were independent risk factors of total blood loss. Preoperative Cobb angle ≥40°, spinal fusion ≥4 levels and operative duration ≥140 min indicated more blood loss (all P<0.05). Conclusions: The perioperative blood loss of congenital scoliosis is massive with a high percentage of hidden blood loss. The patients with severe deformity, more fused levels and increased operative time brings higher risk of massive blood loss.

[Research on the main factors influencing influenza vaccine effectiveness]

Effectiveness of seasonal influenza vaccines varies greatly during the different flu seasons. Although the WHO assesses and updates influenza vaccine strains every year, the effectiveness of vaccine is sometimes not good. This review explores the various factors that influencing influenza vaccine effects in order to improve the effectiveness of influenza vaccines and provide a scientific basis for influenza vaccination. The results reveal that the degree of matching between epidemic strains and vaccine strains, pre-exposure (natural infection, vaccination), age, and immune status could all affect the vaccine effectiveness.

[Application of test-negative design in vaccine efficacy evaluation]

Vaccine efficacy can be assessed by a randomized placebo-control trial prior to marketing. However, after the marketing of a vaccine, if a placebo-randomized control trial is used to evaluate the efficacy of the vaccine, ethical issues will arise. Therefore, the evaluation of the efficacy of a vaccine after marketing has become a difficult problem in the public health field. In recent years, the research method of test-negative design has been widely used in the world for the evaluations of the efficacies of different post-marketing vaccines, such as influenza vaccine, rotavirus vaccine, cholera vaccine, pneumonia vaccine and EV71 vaccine. However, there are limited reports in the domestic literature on the test-negative design. Therefore, we summarize the basic principles, application steps, advantages and disadvantages of the test-negative design to provide theoretical methods and basis for the future study of test-negative design in China.

[Soil phosphorus forms and phosphorus solubilizing bacteria distribution after restoration from seriously burning in Greater Khingan Mountain areas, China]

To understand the contents of various phosphorus forms, phosphorus solubilizing bacte-rial community structure and the relationship between them in soils after restoration from the seriously burning, we collected soil samples from artificial restoration (Pinus sylvestris var. mongolica plantation, Larix gmelinii plantation), artificial accelerated natural restoration (secondary forest) and natural restoration (natural secondary forest) stands in Greater Khingan Mountain area. Using methods of Sui et al. modified from Hedley phosphorus fractionation, we measured the contents of different phosphorus forms in rhizosphere soil and bulk soil (0-10, 10-20 cm). Abundances of phosphorus solubilizing bacteria were quantified by high-throughput sequencing method. The results showed that the contents of H₂O-P_i, NaHCO₃-P_i and NaHCO₃-P_oin 0-10 cm bulk soil and NaHCO₃-P_o in rhizosphere soil followed the order of L. gmelinii plantation : P. sylvestris var. mongolica plantation : natural secondary forest : secondary forest. The contents of H₂O-P_i, NaHCO₃-P_i, NaHCO₃-P_o in 10-20 cm bulk soil and H₂O-P_i, NaHCO₃-P_i in rhizosphere soil followed the order of L. gmelinii plantation : P. sylvestris var. mongolica plantation : secondary forest : natural secondary forest. The ratios of contents of H₂O-P_i, NaHCO₃-P_i and NaHCO₃-P_o in rhizosphere to those in bulk soil (R/S) were higher than 1 in all forest stands. The moderately labile NaOH-P included NaOH-P_i and NaOH-P_o. The content of NaOH-P was in order of L. gmelinii plantation : natural secondary forest : secondary forest : P. sylvestris var. mongolica plantation in 0-10 cm layer of bulk and rhizosphere soil, and ranked as L. gmelinii plantation : P. sylvestris var. mongolica plantation : secondary forest : natural secondary forest in 10-20 cm layer of bulk soil. There was rhizosphere effect of NaOH-P in the soil. The stable HCl-P included HCl-P_i and HCl-P_o. The content of HCl-P followed the order of L. gmelinii plantation : natural secondary forest : P. sylvestris var. mongolica plantation : secondary forest in 0-10 cm layer of bulk soil,and ranked as L. gmelinii plantation : P. sylvestris var. mongolica plantation : natural secondary forest : secondary forest in the 10-20 cm layer. The content of residual-P in the soil was not sensitive to restoration methods. Bradyrhizobium, Streptomyces, Burkholderia and Bacillus were the main phosphorus solubilizing bacteria across all forest stands. The abundances of phosphorus solubilizing bacteria in soil of L. gmelinii plantation and P. sylvestris var. mongolica plantation were significantly higher than that of secondary forest and natural secondary forest. Results of redundancy analysis showed that the correlation between phosphorus solubilizing bacteria and various phosphorus forms was different. Our results showed that artificial afforestation was more conducive in improving the availability of phosphorus in soil and the abundance of phosphorus solubilizing bacteria.

[Years of potential life lost due to premature death of cardiovascular diseases among residents in Suzhou from 1987 to 2017]

From 1987 to 2017, cardiovascular disease (CVD) had been ranking the first cause of death in Suzhou, and the mortality rate showed an upward trend annual percentage changes (APC=0.62%, P=0.001), while the standardized mortality rate showed a downward trend (APC=-2.65%, P<0.001). The probability of premature death of CVD declined consistently from 7.06% in 1987 to 2.00% in 2017 (APC=-4.45%, P<0.001). When the life expectancy was set at 70, the potential years of life lost rate (PYLLR) decreased from 6.35‰ in 1987 to 3.30‰ in 2017, and the standardized PYLLR decreased from 7.30‰ to 2.68‰. When the life expectancy was set at 75, the PYLLR decreased from 10.12‰ to 5.19‰, and the standardized PYLLR decreased from 11.44‰ to 3.88‰. With the increase of years, all PYLLR and standardized PYLLR showed a significantly downward trend (APC=-2.51%--3.89%, P<0.001).

[Research progress of the surrogate of protection of pneumococcal conjugate vaccine]

There are many limitations in evaluating vaccine efficacy by comparing the incidence of clinical endpoint events (such as morbidity, bacterial colonization) between the vaccine group and the control group. Therefore, the researchers put forward the concept of Surrogate of protection to predict vaccine protection with immunological indicators. In 2012, WHO put forward the immunological substitution endpoint of pneumococcal vaccine, using 0. 35 μg/ml as the protective antibody level of pneumococcal vaccine. But subsequent studies have found that using this threshold to assess all vaccine serotypes may not be accurate.

[Expression and prognosis effect of methylation-regulated SLIT3 and SPARCL1 genes in smoking-related lung adenocarcinoma]

Objective: To investigate the expression and prognosis effect of methylation-regulated SLIT3 and SPRCL1 genes in smoking-related lung adenocarcinoma. Methods: The expression levels of SLIT3 and SPARCL1 in cigarette smoke-induced malignant transformed cell (S30) and lung adenocarcinoma (LUAD) cell lines were measured by real-time fluorescence quantitative PCR (qPCR). Datasets of mRNA expression, DNA methylation and patient information data were obtained from The Cancer Genome Altas (TCGA) database. The mRNA expression levels of SLIT3 and SPARCL1 were validated in LUAD tissues. The 10-year survival curve of LUAD patients with different smoking history was plotted, and the correlation between mRNA expression level and DNA methylation level of LUAD patients was further analyzed. S30 cells were treated with 5-azacytidine (5-aza), an inhibitor of DNA methyltransferase, to analyze the methylation regulatory mechanism of SLIT3 and SPRCL1. Results: The qPCR results showed the significant down-regulation of SLIT3 and SPARCL1 in S30 cell and four LUAD cell lines (SLIT3: 0.493±0.134 and 0.041±0.014, 0.161±0.023, 0.277±0.055, 0.035±0.005; SPARCL1: 0.507±0.131 and 0.453±0.045, 0.420±0.040, 0.153±0.035, 0.430±0.050; all P<0.01). Bioinformatics analysis showed that SLIT3 and SPARCL1 were low expressed in LUAD tissue (8.12±1.58 vs 10.84±0.69 and 11.46±1.06 vs 13.57±0.67; both P<0.001) compared with adjacent peritumoral tissues, and expression levels of SLIT3 and SPARCL1 were significantly correlated with smoking history (both P<0.001). Non-smoker with high expression of SLIT3 and SPARCL1 was associated with better prognosis among LUAD patients. There was a significant negative correlation between promoter methylation and mRNA expression level of the two genes (r=-0.208, -0.574; both P<0.001). 5-aza treatment significantly up-regulated the expression levels of SLIT3 and SPARCL1 genes in S30 cells (2.137±0.281, 3.657±0.882; both P<0.01). Conclusion: SLIT3 and SPARCL1 can be regulated by DNA methylation and down-regulated in LUAD tissue, which has important prognostic significance on the smoking-induced LUAD patients.

[Research progress of maternal immunization]

Maternal immunization is an immune strategy that protects both mothers and early-life infants from disease by the vaccination of pregnant women. The effect of maternal immunization is influenced by the types of vaccines, the timing of vaccination, the subtypes of antibodies induced by vaccines, and the health status of mothers themselves. Inactivated influenza vaccination during pregnancy and DPT vaccination during the third trimester of pregnancy have been widely used in the world, while Hepatitis B vaccine, pneumococcal and meningococcal vaccines also show good efficacy and safety in pregnant women. This article reviews the research progress of Maternal Immunization in order to provide a reference for Maternal Immunization planning and policymaking in China.

[Research progress in immunization status and immunization effect of preterm infants]

Due to immature development of the immune system, preterm infants are at increased risk of infections from vaccine-preventable diseases. But at the same time, premature vaccination may not induce a good immune response because of the incomplete development of the neonatal immune system, and may cause serious adverse reactions risk due to the poor immune tolerance, thus vaccination of preterm infants at the appropriate time is the key to reducing the risk of infectious disease and obtaining vaccine protection. At present, it is generally recommended that the gestational age and birth weight should be considered in the vaccination of preterm infants. The timing, type and even the immunization schedule of the vaccine should be differ from that of the full term infants. However, there is a lack of research results and data on immunization program in preterm infants in China, and there is still no provided universal guidelines for their vaccine immunization. This article aims to summarize the guidelines and clinical trials of vaccination of preterm infants in foreign countries, and to provide reference for the formulation and implementation of immunization strategies for preterm infants in China.

[Observation of electroacupuncture intervention on cell apoptosis and Bax and Bcl-2 expression in cerebral and myocardial tissues in cerebral ischemia rats based on "heart-brain correlation" theory]

OBJECTIVE

To compare the effect of electroacupuncture (EA) of "Neiguan" (PC6) of the Pericardium Meridian, "Shenmen" (HT7) of the Heart Meridian，"Shuigou" (GV26) of the Governor Vessel and "Zhaohai" (KI6) of the Kidney Meridian on myocardial and cerebral cell apoptosis in cerebral ischemia (CI) rats, so as to explore its mechanism underlying improvement of CI based on the theory of "Heart-brain Correlation".

METHODS

Forty-eight SD rats (half male and half female) were randomly divided into normal control, model, PC6, HT7, GV26 and KI6 groups (n＝8 in each one). The CI model was established by occlusion of the middle cerebral artery (MCAO). EA (4 Hz/20 Hz, 1.5 mA) was applied to the right PC6, HT7, GV26 or KI6 respectively for 30 min, once every 12 h for 5 times. The cell apoptosis of the ischemic myocardial and cerebral tissues was detected by TUNEL method, and the expression of cerebral and myocardial Bax and Bcl-2 was determined by using immunohistochemistry.

RESULTS

Following modeling, the cell apoptosis percentages and Bax-positive cells of both myocardial and cerebral tissues were significantly increased in the model group in comparison with the control group (P<0.01). After EA intervention, the cerebral apoptotic percentage and cerebral Bax-positive cells in the cerebral tissue of the PC6, HT7 and GV26 groups, and the myocardial apoptosis percentage in the PC6 and HT7 groups, as well as the myocardial Bax-positive cells in the PC6 group were obviously decreased (P<0.05, P<0.01), while the cerebral Bcl-2 positive cells in the PC6, HT7 and GV26 groups, and the myocardial Bcl-2 positive cells in the PC6 and HT7 groups were significantly increased relevant to the model group (P<0.01, P<0.05). No significant changes were found in the KI 6 group in the cell apoptosis index and percentages and Bax- and Bcl-2-positive cells of both myocardium and cerebral cortex tissues compared with the model group (P>0.05)．.

CONCLUSION

EA stimulation of PC6 and HT7 can inhibit CI injury induced cell apoptosis of cerebral and myocardial tissues in CI rats, which is possibly associated with its effects in down-regulating Bax expression and up-regulating Bcl-2 expression of both myocardial and cerebral tissues.

[Results of microscopic examinations and blood slide re-examinations of malaria elimination evaluation in ten prefectures of Yunnan Province]

OBJECTIVE

To understand the laboratory technicians' abilities in blood slide making and reading in 10 prefectures of Yunnan Province which have passed the provincial malaria elimination evaluation, so as to provide the evidence for improving the malaria elimination surveillance and parasite examination.

METHODS

Thirty negative blood slides were randomly sampled to evaluate coating, dyeing and clean quality and reading results, and 4 laboratory technicians were sampled to evaluate their reading abilities from each prefecture level and its 2 subordinate counties (districts) respectively, and then the results were analyzed.

RESULTS

A total of 869 negative blood samples were evaluated. The coincidence rate was 100%. The proportions of good coating, dyeing and clean quality were 96.09%, 91.71% and 96.89%, respectively. Totally 576 blood slides were used to evaluate the reading ability. The number of correct reading was 505, and the correct rate was 87.67%. Among them, the Plasmodium vivax correct reading rate was 87.76%, the P. falciparum correct reading rate was 87.50%, and the correct reading rate of mixed infections was 47.62%. The laboratory technicians' ability to the mixed infections was significantly lower than the ability to the others (χ² = 37.169, P < 0.05), however, in the laboratory technicians' abilities, there was no significant difference among the center (s) for disease control and prevention, general hospitals and township hospitals (χ² = 2.782, P > 0.05), and the prefecture, county and township levels (χ² = 0.358, P > 0.05) .

CONCLUSIONS

The 10 prefectures have passed the provincial evaluation in blood slide making and microscopic examination skill indicators requested, but the medical and public health institutions at all levels still should further improve their laboratory technicians' abilities in blood slide making and microscopic examination skills.

[Progress in assessment of vaccine on herd protection]

The importance of vaccine on public health is related to the herd protection related to the levels of vaccine coverage, which directly influences the vaccinated individuals as well as the unvaccinated community. Reaching the level of herd protection by increasing vaccine coverage is the basic strategy to eradicate related infectious diseases. Again, herd protection has played an important role in public health practices. With the increasing interests in estimating the vaccine herd protection, we however, have seen only few relevant papers including observational population-based and cluster-randomized clinical trials reported in China. We hope to discuss the study designs for evaluating the vaccine herd protection in order to generate evidence-based related research in this field.

[The exploration of gene promoter methylation profiling in nasal polyp]

Objective:To explore the gene promoter methylation profiles of nasal polyp, and to analysis the promoter methylation differences between the nasal polyp and the normal nasal mucosa.Method:Total DNA of the nasal polyp tissues and normal nasal mucosa were extracted. After immunoprecipitation and whole genome amplification, the DNA was labeled with Cy3/5 and hybridized in NimbleGen hybridization chamber. For array hybridization, Roche Nimblegen CpG Promoter array was used. The slides were scanned using the Axon GenePix 4000B microarray scanner. The different genes were analyzed through pathway and verified by Real-time PCR.Result:3010 genes were found to have promoter hypermethylation in normal nasal mucosa or nasal polyp.2,62%(79/3010) of the genes had promoter hypermethylation in all the nasal polyps, which were negative in normal nasal mucosa.10.66%(321/3010) of the genes had promoter hypermethylation in normal nasal mucosa, which were negative in all the nasal polyps. Three pathways were found in the promoter hypermethylation of the nasal polyps. Fourteen pathways were found in the negative hypermethylation of the nasal polyps.Conclusion:Genes promoter methylation plays an important role in the development of nasal polyps, and the gene promoter methylation profiling may yield new some clues on the mechanism of nasal polyps.

[Nasal acinar cell carcinoma：a case report]

Acinar cell carcinoma is a rare type of low-grade malignant tumor of the parotid gland epithelium. The progression of the disease is slow, and its tissue type and cell morphology are diverse. The diagnosis of tumor is difficult so that it is easy to cause missed diagnosis and misdiagnosis. A 72-year-old patient, without the history of surgery and trauma, complained of nasal congestion, bloody sputum, and loss of olfactory. CT and MRI suggested that the nasal cavity and sinuses were occupied with soft tissue. An endoscopic nasal cavity and sinus mass resection was performed under general anesthesia. No recurrence was observed after 1 year of follow-up. The nasal symptoms disappeared and the recovery effect was good.

[The treatment of nose-eye correlated diseases with external nasal incision combined with nasal cavity approach surgery through endoscope]

Objective:To explore the indications and characteristics for the treatment of nose-eye correlated diseases with endoscopic surgery through external nasal incision combined with nasal cavity approach.Method:The clinical data of 13 patients whom hospitalized in our department and treated by endoscopic surgery through external nasal incision combined with nasal cavity approach since October 2011, were retrospectively analyzed and the characteristics of different pathological changes, clinical manifestations, surgical approach and follow-up results were summarized.Four cases of patients underwent endoscopic surgery through nasal cavity and lacrimal caruncle conjunctival incision, 4 cases received bone fracture reduction and DCR with endoscope through double path of nasal cavity and the original trauma wound, 2 cases with endoscopic bone tumor resection through nasal cavity and external nasal incision, the rest of the 3 cases with endonasal endoscopic and peri-orbit incision surgery.Result:Two cases of tumor patients showed no recurrence followed up for 1.5 to 2 years; the diplopia disappeared in 2 cases of orbital medial wall fracture; surgeries of 4 cases of orbital wall fracture with lacrimal duct obstruction patients, 3 cases succeeded, 1 case failed and change into dacryocystorhinotomy with external nasal incision, and epiphora of all patients vanished; all of the patients of sinus osteoma, foreign bodies and abscess were cured and symptoms disappeared; the symptoms of ectopic meningioma patient gradually died down with eyebrow scars left.Conclusion:The surgery with external nasal incision combined with nasal cavity approach through endoscope to treat noseeye correlated diseases can effectively deal with relevant pathological changes, with the advantages of clear operation field and less damage, but its exact indications and surgical methods still need to be further explored.

[Progress in research of influence of gene polymorphisms on immune response]

Genes play an important role in the immune system response, and different gene loci may result in different vaccine immune response rates. This review focuses on the correlation between gene polymorphisms and vaccine immune response in order to investigate the influence of gene polymorphisms on the immune response to vaccines. It discusses the effect of an individual's immune response after vaccination at genetic level and provides a scientific basis for individualized immune development strategies. It reveals that human leukocyte antigen genes, various cytokines and their receptor genes, and Toll-like receptor genes all affect the vaccine immune response.