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Objective: To investigate the altered function of the semicircular canal and otolith graviceptive pathway in patients diagnosed with motion sickness disorder (MSD) based on the diagnostic criteria of the Bárány society, and explore its relevance to the pathogenesis of MSD. Methods: This is a case-control study. Twenty patients with MSD and age-and sex-matched healthy controls without a history of MSD from the Department of Neurology of Aerospace Center Hospital between March and August 2022 were recruited. All subjects completed the motion sickness susceptibility questionnaire-short version (MSSQ-short) and the motion sickness assessment questionnaire (MSAQ). Canal function was evaluated using caloric stimulation test and video head impulse test (vHIT), and subjective visual vertical/horizontal (SVV/SVH) and vestibular evoked myogenic potential (VEMP) were employed to assess otolith graviceptive function. Differences in vestibular function and correlations between the two groups were analyzed. Results: Each group consisted of 20 cases (9 males and 11 females). The mean age of the MSD and control groups was (26.9±3.9) years and (27.0±3.4) years, respectively. The scores of MSSQ-short [27.0 (22.5, 38.8) vs 1.2 (0, 3.2), P <0.001] and MSAQ [70.1 (54.5, 78.1) vs 11.8 (11.1, 13.9), P <0.001] were significantly higher in the MSD group compared with those of the control group. Evaluation of canal function revealed a significantly higher incidence of caloric stimulation intolerance in MSD patients (60.0%, 12/20) compared with that of the control group (20.0%, 4/20) ( P =0.010). Evaluation of otolith graviceptive pathway indicated no significant difference in SVV, SVH and cervical VEMP (cVEMP) abnormality rates between the two groups (all P >0.05). The ocular VEMP (oVEMP) abnormality rate was significantly higher in the MSD group (55.0%, 11/20) than that of the control group (10.0%, 2/20) ( P =0.002), with a delayed P1-wave latency compared with the control group [(18.4±1.2) ms vs (17.6±0.8) ms, P =0.018]. Further correlation analysis revealed that P1-wave latency in oVEMP was positively correlated with MSSQ-short ( r =0.486, P =0.002) and MSAQ ( r =0.391, P =0.015) scores, and duration of caloric intolerance symptoms ( r =0.377, P =0.004). Conclusion: The presence of hypersensitivity to caloric stimulation and delayed latency of otolith function in patients with MSD suggests a "separation" between semicircular canal and otolithic function, which may be related to sensory conflict.

Objective: To analyze the direct economic burden caused by measles cases in Shanghai from 2017 to 2019 and its influencing factors. Methods: A total of 161 laboratory-confirmed measles cases reported from January 1, 2017, to December 31, 2019, in Shanghai were included in the study through the "Measles Surveillance Information Reporting and Management System" of the "China Disease Surveillance Information Reporting and Management System". Through telephone follow-up and consulting hospital data, the basic information of population, medical treatment situation, medical treatment costs and other information were collected, and the direct economic burden of cases was calculated, including registration fees, examination fees, hospitalization fees, medical fees and other disease treatment expenses, as well as transportation and other expenses of cases. The multiple linear regression model was used to analyze the main influencing factors of the direct economic burden. Results: The age of 161 measles cases M ( Q 1 , Q 3 ) was 28.21 (13.33, 37.00) years. Male cases (56.52%) were more than female cases (43.48%). The largest number of cases was≥18 years old (70.81%). The total direct economic burden of 161 measles cases was 540 851.14 yuan, and the per capita direct economic burden was 3 359.32 yuan. The direct economic burden M ( Q 1 , Q 3 ) was 873.00 (245.01, 4 014.79) yuan per person. The results of multiple linear regression model analysis showed that compared with other and unknown occupations, central areas and non-hospitalized cases, the direct economic burden of measles cases was higher in scattered children, childcare children, students, and cadre staff in the occupational distribution, suburban areas and hospitalized, with the coefficient of β (95% CI ) values of 0.388 (0.150-0.627), 0.297 (0.025-0.569), 0.327 (0.148-0.506) and 1.031 (0.853-1.209), respectively (all P values<0.05). Conclusion: The direct economic burden of some measles cases in Shanghai is relatively high. Occupation, area of residence and hospitalization are the main factors influencing the direct economic burden of measles cases.

Since the Global Polio Eradication Initiative was launched by the World Health Assembly in 1988, significant progress has been made in global polio prevention and control. But the occurrence of vaccine-associated paralytic poliomyelitis cases and vaccine-derived poliovirus related cases have become a major challenge during the post-polio era. While coronavirus disease 2019(COVID-19) has brought serious disease burden and economic burden to all countries in the world, prevention and control of vaccine-preventable infectious diseases such as polio should not be neglected under the background of the global common fight against COVID-19. Taking the type Ⅲ VDPV cycle event in Shanghai as an example, the paper discussed how to do a good job of routine inoculation under the prevention and control of COVID-19 to strictly prevent the outbreak of vaccine-preventable infectious diseases.

Review the literature on the economic evaluation of PCV-10, PCV-13 and PPSV-23 for providing references for decision-making and research in China. A total of 17 literatures were included, and the basic information to descriptive characteristics, methodology, modeling and the results were extracted. The 14 studies adopted Markov model, 2 studies adopted decision tree model and 1 study adopted probabilistic model. The cost including vaccine price and administration costs, direct medical expenses and indirect lost. All the 17 studies use QALY as the outcome, some studies also use LYG as the outcome. 9 of 13 studies (69.2%) involving people over the age of 50 concluded that pneumococcal vaccination was cost-effective. To provide effective references for decision-makers, China should collect the relevant epidemiological parameters, vaccine effect of pneumococcal disease in the Chinese population and carry out the economic evaluation of pneumococcal vaccination.

From 2018 to 2019, 3 453 cases of high-risk population were screened by the Cancer Screening Program in Urban China (CanSPUC) in Hebei Province, with the age of (53.94±8.00). 147 and 686 cases of breast cancer positive and suspicious positive patients were found, with the positive rate and suspicious positive rate of 4.26% and 19.87% respectively. The suspicious positive rate of 45-49 years old age group was the highest (28.32%), and the positive rate of over 70 years old age group was the highest (7.32%). The positive detection rate of mammography combined with ultrasound was 5.16%, which was higher than that of ultrasound alone (2.46%) (χ²=30.28, P <0.001) or mammography alone (3.06%) (χ²=14.56, P <0.001).

Objective: To evaluate the efficacy of 23 valent pneumococcal polysaccharide vaccine (PPV23) inoculation against community-acquired pneumonia (CAP) among the elderly aged 60 years old and above in Shanghai. Methods: A prospective cohort study was conducted using a stratified random sampling from October 2013, in which 1 214 and 2 387 elderly people aged 60 and above were selected as the inoculation group and control group, respectively. And a unified questionnaire was used to investigate the basic information of the subjects in the inoculation group and the control group. From October 2013 to December 2018, the subjects were followed up at home or by telephone for a total of 20 times, mainly for whether they had CAP during the observation period. Multivariate logistic regression model was used to calculate RR and 95% CI of CAP incidence between inoculation group and control group for comparing. Results: There were 556 males (45.8%) in the inoculation group and 1 012 males (42.4%) in the control group. And the incidence density of CAP in the inoculation group was lower than that of the control group (0.848/100 person-years vs. 1.452/100 person-years), and the vaccine protection rate was 41.6%, with a statistically significant difference ［ RR (95% CI )= 0.584 (0.428-0.790), P <0.001］. After adjusting for age, RR (95% CI ) was 0.699 (0.507-0.956), and the difference was still statistically significant ( P =0.025).Further stratified analysis showed that the vaccine protective rates of PPV23 in the 60-69 year-old group, the 70-79 year-old group and the ≥80 year-old group were 36.7%, 21.6% and 26.0%, respectively, but only in the 60-69 year-old group showed statistical difference ( RR =0.633, 95% CI =0.399-0.990, P =0.045). Conclusion: To a certain extent, the incidence of CAP can be reduced by inoculation of PPV23 in elderly population aged 60 and above in Shanghai, and it should be further recommended in elderly population of low age.

Objective: To investigate the relationship between smoking and insulin resistance in non-obese male patients with CAD., Methods: 414 consecutive non-obese male patients with angiographically-documented CAD (luminal diameter narrowing > 50%) were recruited, including 113 nonsmokers and 301 smokers. With 99 mild smokers (< 400 packs/year), 95 medium smokers (400 - 799 packs/year) and 107 heavy smokers (≥ 800 packs/year). Insulin resistance index (IRI) was expressed by homeostasis model assessment for insulin resistance (HOMA-IR) calculated by the formula of [fasting serum glucose (mmol/L) × fasting plasma insulin (mU/L)]/22.5. IRI ≥ 2.69 was defined as insulin resistance, while IRI < 2.69 was insulin sensitive. Fasting glucose, fasting insulin and IRI were recorded and odds ratio for the incidence of insulin resistance was calculated., Results: Fasting glucose was higher in heavy smokers (5.86 mmol/L) than that in nonsmokers (5.51 mmol/L, P = 0.037) and mild smokers (5.33 mmol/L, P = 0.014). Fasting insulin and IRI were also significantly higher in heavy smokers (10.25 mU/L) than those in non-smokers (8.72 mU/L, P = 0.0231, respectively) and mild smokers (8.67 mU/L, P = 0.0231). Compared with nonsmokers, the odds ratio for the incidence of insulin resistance was 1.53 (95%CI 0.55 - 2.94; P = 0.027) in medium smokers and 1.89 (95%CI 0.49 - 3.14; P = 0.018) in heavy smokers., Conclusions: The relationship between smoking and insulin resistance is highly dose dependent in non-obese male patients with CAD.

Objective: To study the effect of fasudil on inhibiting the Rho/ROCK signaling pathway under high glucose in human mesangial cells (HMCs) inflammation and fibrosis., Methods: Synchronized HMCs were divided into following groups: (1) Normal glucose control group (NG, 5.5 mmol/L glucose); (2) High glucose group (HG, 30 mmol/L glucose); (3) Mannitol group (Man, 5.5 mmol/L glucose + 24.5 mmol/L mannitol); (4) High glucose + fasudil group (HG + F, the concentrations of fasudil were 25, 50 and 100 µmol/L, respectively). Collect the supernatant and cells at 0, 12, 24, 36, 48 and 72 h respectively, and determine the concentration changes of the RhoA, ROCK-I, connective tissue growth factor (CTGF)mRNA with real-time PCR method in the cells, then used the ELISA method to check the protein content of the fibronectin (FN), CTGF, TNFα in the supernatant., Results: (1) RhoA, ROCK-I and CTGF mRNA of the HMCs cultured under the high glucose expressed significantly higher than those in the normal group, and there was certain time-dependence. Besides, there was no statistic significance by comparing Man and NG. (2)Under the high glucose situation, after the fasudil pretreatment with different concentrations and 24 h or 48 h culture with high glucose, RhoA, ROCK-I, CTGF mRNA expression was significantly decreased in HG + F, compared with HG, and there was certain concentration-dependence. (3) High glucose increased the FN, CTGF, TNFα protein secretion of HMCs in a time-dependent manner, but normal glucose and mannitol had no such effect. (4) After the fasudil pretreatment with different concentrations and culture with high glucose for 12, 24, 36, 48, 72 h, the FN, CTGF, TNFα protein secretion was significantly reduced compared with HG., Conclusion: Fasudil can reduce the secretion of downstream inflammatory factors and cytokines by inhibiting high glucose-activated HMCs Rho/ROCK signaling pathway, and reduce the inflammation and fibrosis of HMCs. This provides a new basis for the therapeutic target in the treatment of diabetic nephropathy.

Objective: To evaluate a colorectal cancer screening program by tumor detection rate and discussing its application values., Method: In total, 43 713 subjects were recruited in the screening program who were the registered people aged 40 - 74 in Xiacheng and Jiashan during year 2007 - 2009. The first screening involved questionnaire survey of colorectal cancer related risk factors and fecal occult blood test (FOBT), colonoscopy was performed when a positive result was observed in the first screening. If polyps were found during colonoscopy, biopsy and pathological diagnosis were carried out. The screening data were analyzed and the tumor detection rate was calculated according to age or sex., Results: 6489 subjects (14.85%) belonged to the high risk group of colorectal cancer in the first screening, in which 4701 subjects finished complete colonoscopy. Finally, 569 colorectal neoplasm were diagnosed, the detection rate was 12.10% (95%CI: 11.17% - 13.04%). It included 52 colorectal cancer (1.11%, 95%CI: 0.81% - 1.41%), 183 advanced adenoma (3.89%, 95%CI: 3.34% - 4.45%), 334 non-advanced adenoma (7.10%, 95%CI: 6.37% - 7.84%). The highest detective rate was observed in male group that aged 70 - 74 (22.81%, 95%CI: 16.98% - 28.70%), the lowest detective rate was observed in female group aged 40 - 44 (2.49%, 95%CI: 0.79% - 4.20%)., Conclusion: The current colorectal cancer screening program in China works well, but the revision of the program is necessary.

Objectives: To access the prevalence of HIV infection and the associated factors among urban MSM in China., Methods: Participants were recruited using respondent driven sampling and snowball sampling method in Beijing, Harbin, Zhengzhou and Chengdu city. A face-to-face questionnaire was administrated to collect relevant demographic and ethological data; 5 ml venous blood sample was taken from each subject to measure HIV antibody in serum (samples were first screened by colloidal gold, latex chromatographic and double-antigen sandwich ELISA method, positive samples were further confirmed by immunoblotting method). The characteristics of HIV infection was described and the risk factors were analyzed., Results: A total of 1864 MSM were recruited and the prevalence of HIV was 6.7% (125/1864). It was 9.5% (24/252) among MSM older than 39 years and it was 1.9% (2/105) among those less than 20 years old. The prevalence was 8.4% (31/371) among MSM with junior level education and was 4.8% (41/858) among those with college level education. It was 10.3% (35/340) among MSM with sexual partner old than him for over 10 years while it was 5.0% (58/1168) among those having sexual partner within 10 years older. The prevalence of HIV infection was 8.9% (61/695) among MSM with unprotected receptive anal sex and it was 5.5% (64/1169) among those without unprotected receptive anal sex. The risk factors independently associated with HIV infection included being older than 39 years (OR = 6.5, 95%CI: 1.5 - 28.7), with junior or lower level education (OR = 1.8, 95%CI: 1.2 - 2.7), having sexual partner older than himself for over 10 years (OR = 2.1, 95%CI: 1.3 - 3.3) and having unprotected receptive anal intercourse (OR = 1.6, 95%CI: 1.1 - 2.4)., Conclusion: MSM had a high rate of HIV infection. Older age, lower level education, having older sexual partner and unprotected receptive anal intercourse were related to HIV infection.

Objective: To study the anti-influenza A virus effects of traditional Chinese medicine Kanggan granules in chicken embryo and BALB/c mice., Methods: The influenza A virus (H(1)N(1), FM1) was used in the experiments. FM1 was cultured in chicken embryo and the anti-FM1 activity of Kanggan granules was evaluated through the post-medication hemagglutination titer of FM1. In animal test, 120 healthy BALB/c mice were randomly divided into six groups, normal control, virus control, ribavirin, high-dosage, middle-dosage and low-dosage. The FM1 infection model was established by dripping FM1 into nasal cavity and then the appropriate treatments were prescribed. The effective anti- FM1 indices of Kanggan granules included survival status, protective percentage of death and life elongation percentage of mice infected with FM1., Results: The high and middle doses of Kanggan granules could inhibit the replication of FM1 remarkably in chicken embryo, and could reduced hemagglutination titer to 5 and 3 times. In animal experiments, all mice treated with Kanggan granules could improve the general status of infected mice, the protective percentages of death were 35.0% to 55.0%, the life elongation percentages were 73.0% to 88.9% and the minimal effective dose was 3.00 g/kg., Conclusion: Kanggan granules can inhibit the replication of influenza A virus and protect the mice infected with FM1.

Objective: To investigate the changes of external rotation stability of the knee after the breaking and reconstruction of the posterolateral structure (PLS) of knee joint., Methods: The femurs of 16 fresh cadaveric lower limbs were fixed to the base of rotating holders with the knee joints in full extension, or at an angle of 30 degrees , 60 degrees , or 90 degrees ; while the tibia was attached to a free rotary holder. The external rotation of the tibia was measured with a 5 kg x m x s(-2) tibial torque. The external rotation angle of the tibia was measured after the transectioning of the popliteus tendon (PT), popliteus muscle (PM), popliteofibular ligament (PFL), fibular collateral ligament (LCL), or popliteus tendon (PT). Autogenous hamstring tendon was used to reconstruct the PCL, and the Achilles tendon was used to reconstruct the PFL and PT, then the external rotation angle of the tibia was measured again., Results: The isolated sectioning of PCL did not increase the tibial external rotation angle. When the knee was flexed the external rotation angle was 14.1 degrees in the intact knee and was 14.57 degrees in the PCL transectioning group (q = 0.47, P > 0.05). After the PFL was sectioned, when the knee joint was flexed at 60 degrees the external rotation angle was 16.94 degrees (q = 2.84, P < 0.05). After the PT was sectioned (PCL + PFL + PT), when the knee joint was flexed at 60 degrees the external rotation angle was 28.1 degrees (q = 14.01, P < 0.05). After isolated PCL reconstruction the external rotation angle was still bigger than that of the normal knee: for example, when the knee joint was at the angle of 60 degrees the external rotation angle was 27.67 degrees (q = 0.425, P < 0.05). There was a significant decrease in external rotation compared with PT section (P < 0.05). After the combined PCL + PLS reconstruction when the knee joint was at the angle of 60 degrees the external rotation angle of the knee was 14.51 degrees (q = 0.412, P < 0.05), however, the range of change was less than 1 degree., Conclusion: Isolated PCL section produces no change in external rotation. Complex injury of PCL and PSL can produce instability in external rotation. PT has the greatest important role to resist external rotation, then the greatest increase in external rotation can be found after PT is sectioned. Isolated PCL reconstruction can not completely restore the posterolateral stability of the knee. PCL reconstruction can partly restore the stability of the external tibial rotation. Only the combined PC + PLS reconstruction can reset the knee to physiological stability of external rotation.

Objective: To investigate the differences on the diabetic foot problems and its risk factors in south and north of China., Methods: Patients with foot problems were surveyed from January 1 to December 31, 2004 in 14 teaching hospitals located in different cities in China, including demographic data, present and past history of the foot problems and peripheral artery disease (PAD), the classification of the foot ulcers based on the Wagner' system, control of the hyperglycemia and lipids disorder, medical cost in hospital and the diabetic complications. All the patients were divided into two groups due to their geographical data, south and north., Results: There were 285 and 349 patients for the group south and group north. No significant differences were found for duration of diabetes or foot problems, fasting or post-meal glucose, total cholesterol, triglycerides, HDL-C, and the numbers of patients with smoke, hypertension, nephropathy or neuropathy between the two groups. There were significant differences for the age (70 yrs vs 66 yrs), percentage of the patients with average person income with over RMB 1000 per month (57.7% vs 45.6%), coronary heart disease (42.6% vs 61.0%) and retinopathy (35.7% vs 49.5%), HbA1c (7.90% vs 8.80 %), LDL-C (2.75 mmol/L vs 2.98 mmol/L), WBC (6.70 x 10(9) vs 7.40 x 10(9)/L), HCT (0.37 vs 0.38), creatinine (87 micromol/L vs 76 micromol/L) and uric acid (333 mmol/L vs 271 mmol/L), and amputation rate (2.6% vs 9.7%) between south and north groups. Logistic analysis showed that severity of the foot problems was associated with ABI and WBC in south group, and with ABI, PLT and HCT in north group., Conclusion: Diabetic foot problems were more severe, with more risk factors and with more medical cost in north patients.

Objective: To investigate the medical cost of diabetic patients with foot problems and peripheral artery disease., Methods: Type 2 diabetic patients with foot problems admitted into the endocrinology departments of 14 teaching hospitals from Jan. 1 to Dec. 31, 2004 were surveyed for their type and phase of foot ulcers, diabetic complications, medical cost and general personal characteristics., Results: The average medical cost of the hospitalization of these patients was RMB yen 14,906 +/- 7072 (about US $ 1640 +/- 873); medication and examination cost was separately 56% and 19% of the total cost. There was obviously higher medical cost for these patients with longer diabetes duration of over 20 years and with the occupation of laborer and retired worker. Patients with kidney disease had significantly higher medical cost than those without (RMB yen 11 690.7 vs yen 9493.0; P = 0.0013), even if the hospital stay was nearly the same (21 days vs 20 days). The medical cost increase with the severity of diabetic foot problems based on the classification of Wagner System or Texas System. Patients with infection, ischemic foot and gangrene foot stayed in the hospitals longer and had much higher medical cost., Conclusion: The medical cost is higher for diabetic patients with foot problems and is related with the presence of complicating kidney disease, infection and ischemia as well as the severity of foot ulcers.

Objective: To investigate the characteristics of diabetic foot with neuropathy and its related factors., Methods: 530 out- and in-patients in 14 grade A class 3 comprehensive hospitals in China with foot problems were surveyed. 337 of the 500 patients (63.58%) suffered from neuropathy, 172 (32.45%) with diabetic foot with simple neuropathy and 165 (31.13%) with simple neuropathy combined with peripheral artery disease (PAD). 193 of the 500 patients (36.42%) suffered from peripheral artery disease (PAD). 77.7% of ulcer were caused by physical factors. Questionnaire survey was conducted to collect the demographic data, present and past history, history of the hyperglycemia and lipid disorders, classification and phases of the foot ulcers based on Wagner' system and Texas system, characteristics of neuropathy and other diabetic complications, and relative risk factors. Detailed physical examination was performed, including 10 g nylon filament sensation examination., Results: The duration of diabetic foot of the patients with simple neuropathy was 3 (1, 60) months, significantly shorter than that of the diabetic foot patients with PAD [5 (1, 96) months, P < 0.001]. The Wagner degree of ulcer was related to the duration of diabetes, economic income, foot deformity, nerve reflection, diapason vibration sensation of foot, sensation point of 10 g nylon filament, ankle/brachial index (ABI), foot artery pulse, fasting blood sugar (FBS) and glycated hemoglobin (HbA1c). Stepwise regression analysis revealed that ABI of left posterior tibial artery, vibration detection threshold and economic income were the most significant influencing factors of the degree of ulcer., Conclusion: Neuropathy ulcer is common in diabetic foot patients. The prognosis of healing in diabetic foot with neuropathy is prior to that of diabetic foot with PAD. The neuropathy and PAD of foot influence each other and aggravate the condition of diabetic foot. The examinations of diapason vibration sensation of foot, sensation point of 10 g nylon filament, and Achilles tendon reflex are simple and practical, and are worth recommending.

Objective: To investigate PstI allelic variants of cytochrome P450 2E1 (CYP2E1), the interaction effect on salted food and their role in risk for colorectal cancer., Methods: The genotypes of CYP2E1 PstI restriction fragment length polymorphism were analyzed in 126 colorectal cancer cases and 343 normal controls. The unconditional logistic regression was applied to estimate the OR and its 95% CI., Results: The CYP2E1 C1/C1, C1/C2 and C2/C2 genotypes were found respectively in 61.8%, 35.8% and 2.4% of normal control, similar to rectal cancer cases. The percentage of PstI variant genotype (54.9%: 52.9% C1/C2 and 2.0% C2/C2) in colon cancer cases was significantly higher than that in controls (adjusted OR1.979, 95% CI 1.090 approximately 3.595). Stratified analysis suggested an interaction between CYP2E1 C2 allele and salted food. The odds ratio (OR) for the CYP2E1 variant genotype, salted food eaten weekly or biweekly and eaten every day or every other day were 1.935, 2.122 and 2.315, respectively, while those of salted food combined with variant genotype eaten weekly or biweekly and eaten every day or every other day were 2.272 and 3.127. The role in risk for rectal cancer was different from that for colon cancer. Whatever the CYP2E1 genotype is, the risk for rectal cancer came to marked when salted food was consumed weekly or biweekly (OR = 2.646 and 2.297, respectively). However, none but the combined effect of variant genotype and salted food eaten every day or every other day had the notably risk for colon cancer and the odds ratio suddenly increased to 4.262 (95% CI 1.395 approximately 13.017), 1.69-fold higher than that of wild genotype (P = 0.072)., Conclusion: The CYP2E1 C2 allele is a susceptibility factor for colorectal cancer, especially for colon cancer, and there is an apparent gene-environment interaction between the susceptible genotype and salted food.