Search

In this study, we have studied the influence of nitrogen content on the mechanical properties of nanostructure medium entropy (TiVCrAl)Nx films prepared by magnetron sputtering. A transition from body-centered cubic nanocrystalline phases to an face-centered cubic columnar crystal structure has been observed in the medium entropy films as the nitrogen flow increases. With increasing nitrogen flow, the lattice constant of the film first increases and then decreases due to the change of composition from substoichiometric to overstoichiometric, resulting in the different bond length of Metal-N. The hardness of the films first increases and then decreases with the increase of nitrogen flow. When the nitrogen flow was 25 sccm, the hardness reached the maximum value of 23.1 GPa. Moreover, the film has shorter cracks length and a higher hardness/modulus ratio, exhibiting enhanced fracture toughness. The increased hardness primarily results from the formation of bonds between metals and nitrogen and the strengthening of a solid solution and a grain boundary. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Coronavirus disease 2019 (COVID-19) is a highly contagious infectious disease caused by the newly discovered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Severe COVID-19 infection causes complications in the respiratory tract, which results in pulmonary failure, thus requiring prolonged mechanical ventilation (MV). An increase in the number of patients with COVID-19 poses numerous challenges to the healthcare system, including the shortage of MV facilities. Despite continued efforts to improve COVID-19 diagnosis and treatment, no study has established a reliable predictive model for the risk assessment of deteriorating COVID-19 cases. MATERIALS AND METHODS: We extracted the expression profiles and clinical data of the GSE157103, GSE116560 and GSE21802 cohorts from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were identified as the intersection of the resulting differential genes as analysed via limma, edgeR and DESeq2 R packages. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed using the R package 'clusterProfiler'. Variables closely related to MV were examined using univariate Cox regression analysis, and significant variables were subjected to least absolute shrinkage and selection operator regression (LASSO) analysis for the construction of a risk model. Kaplan- Meier analysis and receiver operating characteristic (ROC) curves were generated to verify the predictive values of the risk model. RESULTS: We identified 198 unigenes that were differentially expressed in COVID-19 samples. Moreover, a five-gene signature (BTN3A1, GPR35, HAAO, SLC2A6 and TEX2) was constructed to predict the ventilator-free days of patients with COVID-19. In our study, we used the five-gene signature to calculate the risk score (MV score) for each patient. The results revealed a statistical correlation between the MV score and the scores of the Acute Physiology and Chronic Health Evaluation and Sequential Organ Failure Assessment of patients with COVID-19. Kaplan-Meier analysis revealed that the number of ventilator-free days was significantly reduced in the low-MVscore group compared to the high-MVscore group. The ROC curves revealed that our model had a good performance, and the areas under the ROC curve were 0.93 (3-week ROC) and 0.97 (4-week ROC). The 'Limma' package analysis revealed 71 upregulated genes and 59 downregulated genes in the high- MV score group compared to the low-MV score group. These DEGs were mainly enriched in cytokine signalling in immune system and cellular response to cytokine stimulus. CONCLUSIONS: T his s tudy i dentified a fi vegene signature that can predict the length of ventilator-free days for patients with COVID-19. [ABSTRACT FROM AUTHOR]

An efficient and convenient protocol for the synthesis of γlactams has been developed. The selective C–N bond cleavage of aza-bridged pyridoazepines in the presence of NaIO4 and acetic acid smoothly proceeded to give the desired γlactams in good yields. This strategy possesses several advantages such as operational simplicity, safety, and environmental friendliness and therefore constitutes a promising tool for the synthesis of biologically active compounds. [ABSTRACT FROM AUTHOR]

In order to reduce dynamic loss and improve the performance of low-pressure turbines, the technology of active flow control of a dielectric barrier discharge plasma actuator was used to control the internal flow of a low-pressure turbine using a numerical simulation method. In this paper, the effect of plasma actuation on the cascade flow field with different actuator positions and applied voltages was studied. The results show that the closer the plasma actuator is to the leading edge of the cascade, the better the control effect of the plasma actuation. When the actuator is aligned with the leading edge of the cascade, the total pressure loss at the outlet is reduced by 4.5%. Plasma actuation has a greater ability to restrain outlet loss at higher voltage, but the control effect tends to saturation as the applied voltage increases. Total pressure loss is reduced by 8.2% for U0 = 15 kV. The plasma actuation decreases the lateral pressure gradient in the cascade passage thus suppresses the lateral movement of low energy fluids from the pressure side to the suction side. The height of the passage vortex and total pressure loss are restrained, which is an important reason for decreasing outlet loss. [ABSTRACT FROM AUTHOR]

In order to study the influence of the plasma actuator on the air flow in more detail, the effect of the plasma actuator on the flow field was simplified to the volume force of the electric field. Reynolds Average Navier-Stokes method and transition SST turbulence model were used to simulate the air flow field at different loading voltage, power frequency and inflow velocity. The results show that the higher the loading voltage and power frequency of the plasma actuator, the stronger the effect of the actuator on the flow field. The induced velocity increases non-linearly with increasing loading voltage, however, the increasing rate is getting slower and slower. When the voltage rises to about 30 kV, the acceleration effect of the actuator to air reaches the limit. The induced velocity increases linearly with the increase of the power frequency, but the change of the power frequency does not affect the operating range of the actuator in the vertical direction. Provided that parameters such as loading voltage and power frequency are constant, the higher the inflow velocity, the weaker the actuator’s effect on the flow field. And the higher velocity inflow obviously suppresses the range of the actuator in the vertical direction. [ABSTRACT FROM AUTHOR]

We investigated the structural, electronic, chemical bonding, and optical properties of β-AgBiS2 crystal by using the Perdew-Burke-Ernzerhof (PBE) functional and the hybrid functional Heyd Scuseria Ernzerhof (HSE) within the DFT formalism. The electronic band structures obtained by both methods indicate that β-AgBiS2 is an indirect band gap semiconductor with band gap of 0.571 and 1.025 eV, respectively. The electron density difference and Mulliken overlap population show that the Ag-S bonds and Bi-S bonds are both ionic bonds. The calculated optical absorption spectrum prove that β-AgBiS2 is a promising material for solar photovoltaic conversion. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the cost-effectiveness of typical pharmaceutical smoking cessation intervention strategies in China in the context of primary cancer prevention. Methods: Markov cohort simulation models were established to simulate the burden of 12 smoking caused cancer, including lung cancer, oral cancer, nasopharyngeal cancer, laryngeal cancer, esophageal cancer, gastric cancer, pancreatic cancer, liver cancer, kidney cancer, bladder cancer, cervical cancer, and acute myeloid leukemia. Taking incremental cost effectiveness ratio (ICER) as the main indicator, the model sets one year as the cycling period for 50 periods and simulates the cohort of 10 000 thirty-five-year-old current smokers with various smoking cessation strategies. To ensure the robustness of conclusion, univariate sensitivity analysis, probability sensitivity analysis, and age-group sensitivity analysis were conducted. Results: The results showed that varenicline intervention was the most cost-effective intervention. Compared to the next most effective option, incremental cost of each additional quality-adjusted life year is 11 140.28 yuan, which is below the threshold of willingness to pay (1 year GDP per capita). The value of ICER increased as the increasing age group of adopting intervention, but neither exceeded the threshold of willingness to pay. One-way sensitivity analysis showed that the value of discount rate, the hazard ratio and cost of intervention strategy had a greater impact on the result of ICER. Conclusion: In China, the use of varenicline to quit smoking is highly cost effective in the context of cancer primary prevention, especially for younger smokers.

Hypertensive disorder of pregnancy (HDP) involves two major public health issues: mother-infant safety and prevention and controlling major chronic disease. HDP poses a serious threat to maternal and neonatal safety, and it is one of the leading causes of maternal and perinatal morbidity and mortality worldwide, as well as an important risk factor for long-term cardiovascular disease (CVD). In order to explore effective strategies to prevent and control the source of CVD and reduce its risk, we have established a cohort of HDPs in Shenzhen for the primordial prevention of CVD. The construction of the HDP cohort has already achieved preliminary progress till now. A total of 2 239 HDP women have been recruited in the HDP cohort. We have established a cohort data management platform and Biobank. The follow-up and assessment of postpartum cardiovascular metabolic risk in this cohort has also been launched. Our efforts will help explore the pathophysiological mechanism of HDP, especially the pathogenesis and precision phenotyping, prediction, and prevention of pre-eclampsia, which, therefore, may reduce the risk of adverse pregnancy outcomes, and provide a bridge to linking HDP and maternal-neonatal cardiovascular, metabolic risk to promote the cardiovascular health of mothers and their infants.

Objective: To analyze the epidemiological characteristics of reinfection of 2019-nCoV and influencing factors, and provide evidence for effective prevention and control of COVID-19 epidemic. Methods: The incidence data of COVID-19 in Ningbo from January 1, 2020 to November 30, 2022 were collected from the infectious disease surveillance system of Chinese information system for disease control and prevention. The incidence of reinfection of 2019-nCoV was investigated by using questionnaire. logistic regression analysis was used to analyze the influences of gender, age, time interval from the first infection, history of underlying disease, 2019-nCoV vaccination dose and disease severity on the reinfection. Results: A total of 897 previous 2019-nCoV infection cases were investigated, of which 115 experienced the reinfection of 2019-nCoV, the reinfection rate was 12.82%. The interval between the two infections M ( Q 1 , Q 3 ) was 1 052 (504, 1 056) days. Univariate analysis showed that age, 2019-nCoV vaccination dose, history of underlying disease, type of 2019-nCoV variant causing the first infection, time interval from the first infection and severity of the first infection were associated with the reinfection rate (all P <0.05). Multivariate logistic regression analysis showed that the risk for reinfection in age group 30- years was higher than that in age group ≥60 years ( OR =2.10, 95% CI : 1.11-3.97). No reinfection occurred in those with time interval from the first infection of <6 months, and the risk for reinfection was higher in those with the time interval of ≥12 months than in those with the time interval of 6- months ( OR =6.68, 95% CI : 3.46-12.90). The risk for reinfection was higher in the common or mild cases than in the asymptomatic cases ( OR =2.64, 95% CI : 1.18-5.88; OR =2.79, 95% CI : 1.27-6.11). Conclusion: The time interval from the first infection was an important influencing factor for the reinfection of 2019-nCoV, and the probability of the reinfection within 6 months was low.

The prerigor salting effect is known to provide superior meat processing quality. Based on the urgent need for low salt meat products, the present study was undertaken to evaluate the prerigor salting effect when basic amino acids were introduced at 1% NaCl level. Ground chicken breast meat was salted with NaCl and basic amino acids at 30 min, 60 min, and 90 min postmortem for prerigor treatments. Compared to the 1% NaCl (w/w) treatment, the introduction of 0.06% basic amino acids (w/w) in the prerigor significantly led to an increase in myofibril fragmentation, myofibrillar protein solubility, emulsion activity, storage modulus change rate, gel water-holding capacity and hardness (P < 0.05). Furthermore, smaller and more uniformly sized droplets were produced in emulsion by basic amino acids. Individual basic amino acids had different prerigor salting effects, and it was indicated that basic amino acids could play a positive role in the prerigor salting effect when NaCl was reduced., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: To analyze the influencing factors of futile recanalization after endovascular therapy (EVT) in acute ischemic stroke patients with large vessel occlusions (AIS-LVO). Methods: AIS-LVO patients who underwent EVT with successful recanalization between January 2019 and December 2021 in Neurovascular Center of Changhai Hospital of Naval Medical University were retrospectively selected. Modified Rankin scale (mRS) score 3 months after EVT was used as the prognostic evaluation index, and patients with mRS scores≤2 were classified as the meaningful recanalization group and mRS scores 3-6 as the futile recanalization group. The risk factors, National Institutes of Health stroke scale (NIHSS) score, Glasgow coma scale (GCS) score, Alberta Stroke Program Early CT (ASPECT) score, core infarct volume, etc. in both groups were analyzed, and the influencing factors of futile recanalization after EVT were analyzed by multivariate logistic regression. Continuous variables that do not conform to the normal distribution are represented by [ M ( Q 1 ,Q 3 )]. Results: A total of 368 patients meeting the inclusion criteria were collected, including 228 males and 140 females, and aged 68 (61, 77) years. There are 196 patients and 172 patients in the meaningful recanalization and futile recanalization groups, respectively, with the rate of futile recanalization 3 months after EVT of 46.74% (172/368). Comparing the general information and risk factors between the two groups found that the age of patients in the futile recanalization group [71 (65, 79) years] was higher than that in the meaningful recanalization group [65 (59, 72) years]. The baseline NIHSS score [18 (14, 22)] and the rate of not achieving modified Thrombolysis in Cerebral Ischemia grade 3 (mTICI 3) reperfusion (36.1%) were higher in the futile recanalization group than those in the meaningful recanalization group [12 (7, 17) and 19.9%]. The baseline GCS score [11 (9, 13)] was lower in the futile recanalization group than that in the meaningful recanalization group [14 (11, 15)]. The core infarct volume in the futile recanalization group [28 (7, 65) ml] was larger than that in the meaningful recanalization group [6 (0, 17) ml]. The ASPECT score [7 (5, 9)] was lower in the futile recanalization group than that in the meaningful recanalization group [9 (7, 10)]. In addition, the proportion of hypertension, atrial fibrillation, general anesthesia, and symptomatic intracranial hemorrhage was higher in the futile recanalization group (all P <0.05). The time from symptom onset to puncture and from symptom onset to reperfusion was longer in the futile recanalization group (both P <0.05). There were statistically significant differences in trial of Org 10172 in acute stroke treatment (TOAST) classification and the site of occluded blood vessels between the two groups (both P <0.05). Multivariate logistic regression indicated that age ≥80 years( OR =1.935,95% CI : 1.168-3.205), baseline NIHSS score ( OR =1.999,95% CI : 1.202-3.325), GCS score ( OR =2.299,95% CI : 1.386-3.814), previous stroke history ( OR =1.977,95% CI : 1.085-3.604), general anesthesia ( OR =1.981,95% CI : 1.143-3.435), not achieving grade 3 recanalization ( OR =2.846, 95% CI : 1.575-5.143), ASPECT score<6 ( OR= 2.616, 95% CI : 1.168-5.857), and core infarct volume>70 ml ( OR =2.712, 95% CI : 1.130-6.505) were risk factors for futile recanalization. Conclusion: Age≥80 years, previous stroke history, baseline NIHSS score≥20, GCS score≤8, general anesthesia, ASPECT score<6, core infarct volume>70 ml, and failure to achieve Grade 3 recanalization are independent influencing factors for futile recanalization after endovascular therapy in AIS-LVO patients.

Pruritus is one of the common symptoms after burn injury, which seriously affects the wound healing and quality of life of burn patients, but its diagnosis and treatment are often neglected. The pathophysiological mechanism of post-burn pruritus has not been elucidated, and it is currently believed that post-burn pruritus is caused by the neuropathic factors. In addition, there is no consensus on the standard evaluation methods and treatment protocols for post-burn pruritus. This paper reviewed the research advances on the pathophysiological mechanism, disease evaluation, and treatment of post-burn pruritus.

High surface ozone (O 3 ) levels affect human and environmental health. The Fenwei Plain (FWP), one of the critical regions for China's "Blue Sky Protection Campaign", has reported severe O 3 pollution. This study investigates the spatiotemporal properties and the causes of O 3 pollution over the FWP using high-resolution data from the TROPOspheric Monitoring Instrument (TROPOMI) from 2019 to 2021. This study characterizes spatial and temporal variations in O 3 concentration by linking O 3 columns and surface monitoring using a trained deep forest machine learning model. O 3 concentrations in summer were 2-3 times higher than those found in winter due to higher temperatures and greater solar irradiation. The spatial distributions of O 3 correlate with the solar radiation showing decreased trends from the northeastern to the southwestern FWP, with the highest O 3 values in Shanxi Province and the lowest in Shaanxi Province. For urban areas, croplands and grasslands, the O 3 photochemistry in summer is NO x -limited or in the transitional regime, while it is VOC-limited in winter and other seasons. Reducing NO x emissions would be effective for decreasing O 3 levels in summer, while VOC reductions are necessary for winter. The annual cycle in vegetated areas included both NO x -limited and transitional regimes, indicating the importance of NO x controls to protect ecosystems. The O 3 response to limiting precursors shown here is of importance for optimizing control strategies and is illustrated by emission changes during the 2020 COVID-19 outbreak., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier B.V.)

Objective: To investigate a SARS-CoV-2 epidemic reported in Rongcheng City, Weihai, Shandong Province. Methods: The SARS-CoV-2 nucleic acid positive patients and their close contacts were investigated, and the whole genome sequencing and genetic evolution analysis of 9 variant viruses were carried out. An infection source investigation and analysis were carried out from two sources of home and abroad, and three aspects of human, material and environment. Results: A total of 15 asymptomatic infections were reported in this epidemic, including 13 cases as employees of workshop of aquatic products processing company, with an infection rate of 21.67% (13/60). Two cases were infected people's neighbors in the same village (conjugal relation). The first six positive persons were processing workers engaged in the first process of removing squid viscera in the workshop of the company. The nucleic acid Ct value of the first time were concentrated between 15 and 29, suggesting that the virus load was high, which was suspected to be caused by one-time homologous exposure. The whole genome sequence of 9 SARS-CoV-2 strains was highly homologous, belonging to VOC/Gamma (Lineage P.1.15). No highly homologous sequences were found from previous native and imported cases in China. It was highly homologous with the six virus sequences sampled from May 5 to 26, 2021 uploaded by Chile. The infection source investigation showed that the company had used the squid raw materials captured in the ocean near Chile and Argentina from May to June 2021 over the last 14 days. Many samples of raw materials, products and their outer packages in the inventory were tested positive for nucleic acid. Conclusion: This epidemic is the first local epidemic caused by the VOC/Gamma of SARS-CoV-2 in China. It is speculated that the VOC/Gamma, which was prevalent in South America from May to June 2021, could be imported into China through frozen squid.

Cancer is a major public health issue that seriously endangers the public health and social development of China. Future initiatives for cancer prevention and control should continue to adhere to the principle of prioritizing prevention, and comprehensively implement related prevention activities nationwide. This is critical to reducing cancer burden in Chinese residents, especially in the low- and middle-income populations and those living in areas that are less economically developed. In the past several decades, the international community has significantly reduced the incidence of related cancers through primary prevention measures such as tobacco control, improved occupational hygiene, and vaccination. China has also implemented a series of exploratory primary prevention measures among high-risk groups of cancer in specific areas including Xuanwei, Qidong, and Linxian, and achieved encouraging results. However, due to the low level of systematic awareness of cancer risk factors and the lack of awareness and ability of self-health management in Chinese residents, it is urgent to develop novel research tools and methods to further reveal the causes of cancer, and establish innovative mechanisms and systems of primary prevention of cancer at population and individual levels. Based on current status of the transformation of cancer spectrum and the development of digital intelligence, it would be beneficial to establish a smart digital system for primary cancer prevention service that can cover the entire population, integrating authoritative popular science education on primary prevention of cancer, individualized cancer risk assessment, and personalized health management assistant. This will improve primary cancer prevention among the Chinese general population and can help the sustainable development of cancer prevention and control in China.

Objective: To investigate the relationship between vitamin D receptor ( VDR ) gene polymorphisms and gestational diabetes mellitus (GDM) and provide evidence for the study of the mechanism of GDM. Methods: A case-control study design was used to study pregnant women who delivered in the obstetrics department of the First Hospital of Shanxi Medical University from March 1, 2012 to July 30, 2014. Of these, 334 cases were diagnosed with GDM and were matched 1∶1 by age, gestation time and residence to corresponding healthy controls. DNA genotyping was performed for the study subjects, and those with genotyping deletions >10% were excluded. Finally 323 cases and 320 controls were included in the study. Under co-dominant, dominant, recessive, and allele genetic models, unconditional logistic regression analysis on the relationship between VDR gene locus polymorphism and GDM was conducted. And software Haploview was used to analyze the relationship between haplotype and GDM. Results: At the genetic level, VDR gene was associated with the risk of developing GDM ( P <0.05). After adjusting for pre-pregnancy body mass index, family history of diabetes, it was found that rs7967152 loci was associated with an increased risk of developing GDM (AC vs. AA, OR =1.58, 95% CI : 1.13-2.21; AC+CC vs. AA, OR =1.58, 95% CI : 1.15-2.18; C vs. A, OR =1.41, 95% CI : 1.10-1.82) and rs2238140 loci was associated with an increased risk of developing GDM (AA vs. GG, OR =2.24, 95% CI : 1.19-4.20; GA+AA vs. GG, OR =1.48, 95% CI : 1.07-2.03; A vs. G, OR =1.43, 95% CI : 1.11-1.83). Carrying rs2853564 locus AG genotype and AG+GG genotype ( OR =1.46, 95% CI : 1.04-2.05; OR =1.45, 95% CI : 1.05-2.00) compared with carrying AA genotype and carrying rs2853566 locus AG genotype and AG+GG genotype ( OR =1.43, 95% CI : 1.03-2.00; OR =1.41, 95% CI : 1.02-1.94) compared with carrying AA genotype were risk factors for GDM. Haplotype block consisting of rs1544410, rs7967152 in the VDR gene with GC haplotype was a risk factor for GDM( OR =1.50, 95% CI : 1.15-1.97). Conclusions: VDR gene rs7967152, rs2238140, rs2853564, rs2853566 locus polymorphisms and block (rs1544410, rs7967152) GC haplotype were associated with an incrased risk of developing GDM.

Objective: To understand the epidemiological characteristics of a local clustered epidemic caused by 2019-nCoV Delta variant in Ningbo and provide reference for the improvement of COVID-19 epidemic prevention and control. Methods: Case finding was conducted based on case definitions, and field epidemiological investigation of COVID-19 cases was carried out. In which Nasal and oropharyngeal swabs of the cases were collected for pathogen testing, and the results were analyzed with descriptive epidemiological methods. Results: A total of 74 COVID-19 cases were reported in this epidemic, and the cases were mainly mild ones, accounting for 87.84% (65/74), and there were no severe or critical cases. The epidemic curve showed a human-to-human transmission mode, indicating that a transmission for at least six generations had occurred. The age of the COVID-19 patients ranged from 2 years to 80 years, and 27.03% (20/74) of the cases were older than 60 years. The cases were mainly workers (55.41%, 41/74) and housework/the unemployed (27.03%, 20/74). The COVID-19 epidemic was limited, and no further spread to other areas occurred. The transmission chain among the cases was clear, and the gene sequencing results confirmed that the current epidemic was caused by 2019-nCoV Delta variant, which was highly homologous to the strains from other province. Conclusion: The local COVID-19 epidemic in Ningbo was caused by imported cases of COVID-19 from other province, and local community spread occurred through daily contacts between cases and contacts.

Objective: To study the infection rate of secondary close contacts of COVID-19 patients, and assess the infection risk in the contacts. Methods: COVID-19 patients' close contacts (with a clear exposure time to index case) with negative nucleic acid test results and secondary close contacts were surveyed in continuous isolation and medical observation in this prospective study. The dynamic nucleic acid test results of the close contacts and secondary contacts of COVID-19 patients were collected to assess their risk of infection. Results: A total of 4 533 close contacts were surveyed, in whom 14 were confirmed as COVID-19 patients with overall secondary attack rate of 0.31%, and 4 201 secondary contacts were tracked, in whom no subsequent infections occurred. Conclusion: Close contacts of COVID-19 patients entered in centralized isolation for medical observation with negative nucleic acid tese results,the secondary close contacts of COVID-19 patients have no risk of infection.

Objective: To investigate the effect of the degrees of myelosuppression on the curative effect and prognosis of triple-negative breast cancer with neoadjuvant chemotherapy. Methods: The clinical, pathological and follow-up data of 206 patients with triple negative breast cancer who received neoadjuvant chemotherapy with docetaxel combined with epirubicin combined with cyclophosphamide regimen in the Department of Breast Surgery in the Third Affiliated Hospital of Zhengzhou University from January 2013 to December 2018 were collected retrospectively. All were female, aged 28-71 (47.8±10.7) years. According to the WHO classification standard of acute and subacute toxicity of anticancer drugs, the patients were divided into 98 cases in the mild group (0-Ⅱ degree) and 108 cases in the severe group (Ⅲ-Ⅳ degree) according to the degree of bone marrow suppression after chemotherapy. The baseline clinicopathological features, pathological complete remission rate (PCR) and objective remission rate (ORR) of the two groups were compared. The survival curve was drawn by Kaplan Meier method, and the differences of disease-free survival (DFS), local recurrence free survival (LRFS), distant metastasis free survival (DMFS) and overall survival (OS) between the two groups were analyzed by log rank test. Cox regression risk model was used to analyze the related factors affecting the survival of the patients. Results: There were no significant differences in baseline clinicopathological characteristics of patients between the two groups, such as age, physical status score, menopausal status, body mass index, histological grade, clinical T stage, clinical N stage and Ki-67 index (all P >0.05). The severe group had higher PCR, longer median DFS and median DMFS than the mild group [50.9%(55/108) vs 36.7%(36/98); not reached vs 72 months; not reached vs 84 months] (all P <0.05). There was no significant difference in ORR, LRFS and OS between the two groups [89.8%(97/108) vs 81.6%(80/98); both not reached; both not reached] (all P >0.05). The degree of bone marrow suppression after neoadjuvant chemotherapy was an influential factor of DFS in TNBC patients ( P =0.025). Compared with mild myelosuppression group, severe myelosuppression group had better disease-free survival prognosis ( HR =0.571, 95% CI : 0.349-0.934). Conclusion: The prognosis of grade Ⅲ/Ⅳ myelosuppression is better than grade 0/Ⅰ/Ⅱ myelosuppression in patients with triple-negative breast cancer during neoadjuvant chemotherapy with TEC regimen, which is helpful for judging efficacy.

Objective: To assess the cost-effectiveness of influenza vaccination among people aged 60 years and older in Shenzhen. Methods: A Markov state transition model was constructed to evaluate the cost-effectiveness of annual influenza vaccination for preventing influenza infection compared with no vaccination among the elderly from the social perspective. Allowing seasonal variation of influenza activity, the model followed a five-year cohort using weekly cycles. We employed once the Chinese gross domestic product (GDP) per capita in 2019 (70 892 yuan) as the willingness-to-pay (WTP) threshold and calculated the net monetary benefit (NMB) with costs and quality-adjusted life-years (QALYs) discounted at 5% annually. The impact of parameter uncertainty on the results was examined using one-way and probabilistic sensitivity analyses (PSA). Results: The base case amounted to approximately 35 yuan of cost-saving and a net gain of 0.007 QALYs. Correspondingly, the NMB was 529 yuan per vaccinated person. One-way sensitivity analyses showed that the NMB was relatively sensitive to changes in the attack rate of influenza and vaccine effectiveness. Based on the results of PSA with 1 000 Monte Carlo simulations, influenza vaccination had a probability of being cost-effective in 100% of the repetitions. Conclusions: The present study provides evidence that influenza vaccination is a cost-saving disease prevention strategy for people aged 60 years and older in Shenzhen.

Objective: To investigate the infection rate in close contacts of COVID-19 patients before and after the last negative nucleic acid test, evaluate the effect of dynamic nucleic acid test in determining the infectivity of COVID-19 patients. Methods: Dynamic nucleic acid test results of COVID-19 cases were collected in a retrospective cohort study. COVID-19 cases with negative nucleic acid test results before their first positive nucleic acid tests were selected as study subjects. Close contacts of the index cases and the secondary close contacts were kept isolation for medical observation to assess their risk of infection. Results: This study included 89 confirmed cases from two local COVID-19 epidemics in Ningbo. A total of 5 609 close contacts were surveyed, the overall infection rate was 0.20%. No close contacts of the COVID-19 cases before the last negative nucleic acid test were infected, and the infection rate in the close contacts of the COVID-19 cases after the last negative nucleic acid test was 1.33%, all of these close contacts lived together with the index cases. No secondary close contacts were infected. Conclusion: COVID-19 patient becomes infectious after the last nucleic acid is negative, and has no infectivity before the last nucleic acid negative.

Objective: To explore the molecular mechanism of cleft palate in mice induced by 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin (TCDD). Methods: The pregnant mice were randomly divided into TCDD-treated group ( n =42) and control group ( n =42). TCDD-treated group was given by gavage a single dose of TCDD (64 μg/kg) at 8: 00 AM on gestation day 10 (GD10) and the control group was given by gavage the isopyknic corn oil. At GD13-GD15, the fetal mice palate development was observed by HE staining. The mouse embryonic palatal mesenchymal cell proliferation was detected by 5-bromo-2-deoxyuridine (BrdU) immunofluorescence. The localization and expression of maternally expressed gene3 (MEG3) in mouse embryonic palatal mesenchymal cells was detected by situ hybridization and real-time PCR (RT-PCR). The key protein expressions of transforming growth factor-β (TGF-β)/Smad signaling pathway in mouse embryonic palatal mesenchyme were analyzed by Western blotting. The interaction of MEG3 and TGF-β receptor Ⅰ (TGF-βRⅠ) was examined by RNA binding protein immunoprecipitation (RIP). Results: At GD13 and GD14, compared with the control group, the ratio of BrdU-positive cells in the palatal mesenchyme of TCDD-treated fetuses decreased significantly (GD13, t= 6.66, P =0.003; GD14, t= 6.56, P =0.003). However, at GD15, the ratio of BrdU-positive cells was significantly increased ( t=- 5.98, P =0.004). MEG3 was mainly expressed in the nuclei of fetal mouse palatal mesenchymal cells, and the expression of MEG3 in TCDD group was significantly increased at GD13, GD14 and GD15(GD13, t= 39.28, P =0.012; GD14, t= 18.75, P =0.042; GD15, t= 28.36, P =0.045). At GD14, TCDD decreased the levels of p-Smad2 and Smad4 in embryonic palate mesenchymal cells (p-Smad2, t= 9.48, P =0.001;Smad4, t= 63.10, P =0.001), whereas the expression of Smad7 was significantly increased at GD14 ( t= 30.77, P <0.001). The results of the RIP experiment showed that the amount of TGF-βRⅠ-bound MEG3 in mouse embryonic palatal mesenchymal cells in the TCDD group (23.940±1.301) was higher than that in the control group (8.537±1.523)( t= 24.55, P <0.001). Conclusions: MEG3 is involved in the suppression of mouse embryonic palatal mesenchymal cell proliferation, functioning at least in part via interacting with the TGF-βRⅠ protein and thereby suppressing Smad signaling in the context of TCDD induced cleft palate.

Objective: To explore the effects of maternal pre-pregnancy body mass index (BMI) and gestational weight gain and its subtypes on the risk of preeclampsia. Methods: Pregnant women delivered in the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Shanxi Medical University from March 2012 to September 2016 were selected as the research subjects. According to the inclusion and exclusion criteria, 9 274 pregnant women were included. 901 preeclampsia pregnant women were selected as the case group, and 8 373 non-preeclampsia pregnant women were selected as the control group. General demographic characteristics, pre-pregnancy weight, height, lifestyle during pregnancy, reproductive history, and disease history of pregnant women were collected, and pre-pregnancy BMI and gestational weight gain were calculated. Unconditional logistic regression was used to analyze the relationship between pre-pregnancy BMI and weight gain during pregnancy and PE and its clinical subtypes. Results: Among the 901 preeclampsia after inclusion and exclusion, 401 cases were diagnosed as early-onset PE (EOPE), 500 cases were late-onset PE (LOPE), 178 cases were Mild PE (MPE), and 723 cases were severe PE (SPE). There were statistically significant differences between PE and non-PE pregnant women in terms of maternal age, residence, parity, family history of gestational diabetes and hypertension ( P <0.05). After adjusting for the above factors, the logistic regression analysis results showed that pre-pregnancy BMI<18.5 kg/m 2 and inadequate gestational weight gain were protective factors for PE ( OR =0.74, 95% CI : 0.56-0.98; OR =0.78, 95% CI : 0.62-0.99), while pre-pregnancy BMI≥24.0 kg/m 2 and excessive gestational weight gain were risk factors for PE ( OR =1.82, 95% CI : 1.54-2.14; OR =1.82, 95% CI : 1.54-2.15). After subtype analysis on PE, the results showed that pre-pregnancy BMI<18.5 kg/m 2 was a protective factor for EOPE and MPE ( OR =0.52, 95% CI : 0.32-0.83; OR =0.47, 95% CI : 0.23-0.97), while pre-pregnancy BMI≥24.0 kg/m 2 and excessive gestational weight gain were risk factors for clinical subtypes of PE. After stratification according to pre-pregnancy BMI, excessive gestational weight gain was the risk factor for PE ( OR =1.86, 95% CI : 1.51-2.30; OR =1.90, 95% CI : 1.39-2.60) in pregnant women 18.5 kg/m 2 ≤BMI<24.0 kg/m 2 and ≥24.0 kg/m 2 . Inadequate gestational weight gain ( OR =0.55, 95% CI : 0.34-0.89) was a protective factor for PE in pregnant women with pre-pregnancy BMI≥24.0 kg/m 2 . Excessive gestational weight gain ( OR =4.05, 95% CI : 1.20-13.69) was a risk factor for EOPE in pregnant women with pre-pregnancy BMI<18.5 kg/m 2 . Excessive gestational weight gain was a risk factor for the clinical subtype of PE in pregnant women 18.5 kg/m 2 ≤BMI<24.0 kg/m 2 before pregnancy. Inadequate gestational weight gain was a protective factor for EOPE and MPE ( OR =0.39, 95% CI : 0.19-0.80; OR =0.29, 95% CI : 0.11-0.77) in pregnant women with pre-pregnancy BMI≥24.0 kg/m 2 . Excessive weight gain was a risk factor for EOPE, LOPE and SPE ( OR =1.60, 95% CI : 1.06-2.42; OR =2.20, 95% CI : 1.44-3.37; OR =2.28, 95% CI : 1.58-3.29). Conclusions: Pre-pregnancy BMI and gestational weight gain affect the risk of preeclampsia and its clinical subtypes. In contrast, the influence of gestational weight gain on preeclampsia varies among different pre-pregnancy BMI groups. Therefore, it is recommended to pay attention to the changes in pre-pregnancy BMI and gestational weight gain simultaneously to reduce preeclampsia.