Hypothyroidism Modeling in Wistar Rats: Comparison of Two Surgical Methods.

In this study we present 2 surgical models of hypothyroidism in male Wistar rats (n=80) based on total thyroidectomy. Animals weighing 180-200 g were randomly divided into sham-operated group and 2 experimental groups. Thyroidectomy was performed by 2 different methods: primary ligation of either thyroid artery (TE-I) or vein (TE-II). The success of the model was verified through general postoperative conditions, serum hormone levels, histological study, and neck ultrasound. Hypothyroidism was successfully reproduced in both TE-I and TE-II models. TE-I was characterized by lower intra- and post-operative mortality, while TE-II provided better surgical exposure to the key anatomical sites.

[Study on the relationship between nonalcoholic fatty liver disease and hepatocellular carcinoma in patients with prior hepatitis B virus infection].

Objective: To explore the role of nonalcoholic fatty liver disease (NAFLD) in the development of hepatocellular carcinoma (HCC) in patients with prior hepatitis B virus infection (HBsAg-negative and anti-HBC-positive). Methods: 1605 hospitalized patients who were first diagnosed with HCC at Nanfang Hospital between 2015 to 2017 were retrospectively studied. Patients who developed HCC on the basis of active HBV infection (HBsAg-positive, anti-HBc positive) were used as control. Multivariate logistic regression model was used to analyze the relationship between NAFLD and HCC in patients with prior hepatitis B virus infection. Results: Among HCC patients with both HBsAg and anti-HCV negative, the proportion of prior HBV infection accounted for 86.7%. NAFLD prevalence was higher in patients with HCC based on prior HBV infection than active HBV infection (19.7% vs. 8.5%, P < 0.001). After adjusting for gender, age, hypertension, alanine aminotransferase, and liver cirrhosis, patients with HCC based on prior HBV infection were more likely to develop NAFLD (OR: 2.29, 95% CI: 1.40-3.74), and this phenomenon was observed only in patients with non-cirrhosis (OR: 5.26, 95% CI: 2.53-10.96) and aged≥50 years (OR: 2.36, 95% CI: 1.33-4.20). Conclusion: NAFLD may be a risk factor for HCC in a previously infected patients with HBV, especially in non-cirrhotic and population aged≥50 years.

[A novel attention fusion network-based multiple instance learning framework to automate diagnosis of chronic gastritis with multiple indicators].

Objective: To explore the performance of the attention-multiple instance learning (MIL) framework, an attention fusion network-based MIL, in the automated diagnosis of chronic gastritis with multiple indicators. Methods: A total of 1 015 biopsy cases of gastritis diagnosed in Fudan University Cancer Hospital, Shanghai, China and 115 biopsy cases of gastritis diagnosed in Shanghai Pudong Hospital, Shanghai, China were collected from January 1st to December 31st in 2018. All pathological sections were digitally converted into whole slide imaging (WSI). The WSI label was based on the corresponding pathological report, including "activity" "atrophy" and "intestinal metaplasia". The WSI were divided into a training set, a single test set, a mixed test set and an independent test set. The accuracy of automated diagnosis for the Attention-MIL model was validated in three test sets. Results: The area under receive-operator curve (AUC) values of Attention-MIL model in single test sets of 240 WSI were: activity 0.98, atrophy 0.89, and intestinal metaplasia 0.98; the average accuracy of the three indicators was 94.2%. The AUC values in mixed test sets of 117 WSI were: activity 0.95, atrophy 0.86, and intestinal metaplasia 0.94; the average accuracy of the three indicators was 88.3%. The AUC values in independent test sets of 115 WSI were: activity 0.93, atrophy 0.84, and intestinal metaplasia 0.90; the average accuracy of the three indicators was 85.5%. Conclusions: To assist in pathological diagnosis of chronic gastritis, the diagnostic accuracy of Attention-MIL model is very close to that of pathologists. Thus, it is suitable for practical application of artificial intelligence technology.

[Higher proportion of hepatitis B-related hepatocellular carcinoma combined with metabolic diseases in patients receiving antiviral therapy].

Objective: To investigate the proportion of hepatitis B-related hepatocellular carcinoma (HCC) patients who have received antiviral therapy and compare the clinical characteristics of HCC patients who have received antiviral therapy with those who have not received antiviral therapy. Methods: Data of 2590 newly diagnosed hepatitis B-related HCC cases who were hospitalized in Nanfang Hospital from 2015 to 2017 were collected. Two independent sample t-tests, Mann-Whitney U test, and χ(2) test were used to compare the clinical characteristics of hepatitis B-related HCC patients who had received antiviral therapy and those who had not received antiviral therapy. Propensity score was used to match some clinical characteristics of the two groups of patients, and the differences in clinical characteristics of the two groups of patients after matching were further compared. Patients with HCC who had not received antiviral therapy were used as reference, and then the clinical characteristics of HCC patients who had received antiviral treatment were analyzed using multivariate logistic regression. Results: Among the 2 590 patients with hepatitis B-related HCC, only 18.10% of patients had received antiviral therapy, while 82.20% of patients who did not receive antiviral therapy met the treatment criteria. HCC patients who had received antiviral therapy were older (P < 0.05), had a higher proportion of liver cirrhosis (P < 0.001), and lower levels of platelets and alanine aminotransferases and smaller maximum tumor diameter (P < 0.001). In terms of metabolic disease, patients who had received antiviral treatment had higher prevalence of diabetes (14.50% vs. 7.70%, P < 0.001), hypertension (16.60% vs. 11.20%, P < 0.05), obesity (28.50% vs. 22.30%, P < 0.05), overweight (53.80% vs. 43.50%, P < 0.001) and non-alcoholic fatty liver disease (18.30% vs.8.00%, P < 0.001). After matching other different clinical characteristics, the prevalence of diabetes, hypertension, and non-alcoholic fatty liver disease in patients who received antiviral therapy was still higher than that of patients who did not receive antiviral therapy (14.50% vs. 9.80%, P < 0.05; 16.60% vs. 10.20%, P < 0.05; 18.30% vs. 7.00%, P < 0.001). Multivariate logistic regression analysis showed that HCC patients who had received antiviral therapy had a higher risk of developing non-alcoholic fatty liver disease (OR: 2.054, 95% CI: 1.404~3.004) than those who had not received antiviral therapy. Conclusion: Among patients with hepatitis B-related HCC, the proportion of patients who have received antiviral therapy is significantly low (under 20%), which suggests that the popularization and promotion of antiviral therapy has a long way to go. Compared with HCC patients who have not received antiviral therapy, the proportion of HCC patients who have received antiviral therapy combined with metabolic diseases is higher; therefore, it is necessary to pay more attention to the role of metabolic factors in the pathogenesis of hepatitis B-related HCC.

Relationship between the status of phospholipase A2 receptor and prognosis of idiopathic membranous nephropathy.

AIM: Serum levels of phospholipase A2 receptor antibody (PLA2R; SAb) and glomerular deposits of PLA2R antigen (GAg) have been detected in patients with idiopathic membranous nephropathy (IMN). However, the correlation between these immunologic factors and their associations with the status and prognosis of IMN remain uncertain. METHODS: Fifty-one patients with biopsy-proven IMN diagnosed between March of 2015 and December of 2016 were enrolled in this study. All the patients were followed until March of 2017.We used enzyme-linked immunosorbent assay and immunofluorescence to measure the SAb and GAg, respectively. RESULTS: The positive rate of GAg was significantly higher than SAb in patients with IMN (88.24 vs 66.77%, P = 0.017). Compared with SAb- patients, SAb+ patients had a higher baseline proteinuria (6.21 vs 3.40 g/24 h), lower serum albumin (22.49 ± 6.59 vs 29.09 ± 7.40 g/L) and poorer renal function (88.96 ± 21.17 vs 107.25 ± 20.04 mL/min per 1.73 m2 ), as well as a higher renal IgG4 level (P < 0.05). A comparison of SAb+/GAg+ and SAb-/GAg+ tissues yielded similar results (P < 0.01). Regarding prognosis, SAb- patients had a higher rate of complete remission after immunosuppressive treatment than SAb+ patients (P = 0.042). CONCLUSION: The disease status and prognosis correlated more closely with the SAb than with the GAg in our cohort of patients with IMN. Furthermore, SAb+ patients had more severe clinical symptoms and a worse prognosis, which was probably associated with increased IgG4 deposition.

[Jiangsu Province Coronary Artery Bypass Grafting Registry study: a report of 4 661 patients in 13 centers].

Objective: To examine the overall status of the Jiangsu Province Coronary Artery Bypass Grafting Registry database. Methods: The patients date of Jiangsu Province Coronary Artery Bypass Grafting Registry database from October 2017 to December 2019 was collected retrospectively.Risk factors, history, cardiac function (New York Heart Association class), extent of coronary artery lesion, European system for cardiac operative risk evaluation Ⅱ (EuroSCORE Ⅱ), cardiopulmonary bypss, arterial grafts, the numbers and flow of grafts and postoperative major adverse cardiac and cerebrovascular event(MACCE) information were analyzed. The clinical data of patients underwent on-pump CABG(ONCABG) or off-pump CABG (OPCAB) were compared by t test or χ(2) test. Results: Up till December 2019, the database enrolled 7 138 patients, in which 4 661 patients receiving primary isolated CABG. There were 3 486 males and 1 175 females with the age of (64.6±8.1) years (range:31 to 87 years). There were coronary left main disease in 960 patients, triple vessel disease in 3 934 patients, both left main and triple vessel disease in 837 patients, ejection fraction>50% in 3 841 patients, cardiac function class Ⅲ to Ⅳ in 1 664 patients. EuroSCORE Ⅱ was (2.3±0.7)% (range: 0.5% to 35.8%). There were 2 731 patients (58.59%) underwent ONCABG and 1 930 patients (41.41%) underwent OPCAB. There were 4 144 patients (88.91%) for whom the left internal thoracic artery was harvested. Seven centers (2 centers routinely) used left radial artery, 5 centers (3 centers routinely) used the transit time flow meter. The graft was 3.4±0.7 (range:1 to 7), the aortic crossclamp time was (65.0±20.4) minutes (range: 21 to 196 minutes), the cardiopulmonary bypass time was (90.0±24.2) minutes (range: 33 to 227 minutes). In-hospital death ocurred in 84 patients(1.80%), while re-operation in 93 patients (2.00%), myocardial infarction in 71 patients (1.52%), cerebral infarction in 33 patients (0.71%) and dialysis in 56 patients (1.20%). There were 2 936 patients prescribed with secondary prevention drugs(62.99%).Comparing with OPCAB group, ONCABG group had younger age, more female, more diabetes mellitus, more history of myocardial infarction and percutaneous transluminal coronary angioplasty, poorer cardiac function and coronary lesions, higher EuroSCORE Ⅱ, preoperatively (all P<0.05), and was associated with higher MACCE (135/2 731 vs. 71/1 930, χ(2)=4.280, P=0.039), and of more grafts, transfusion and intra-aortic balloon counterpulsation application (all P<0.05). Conclusions: Jiangsu Province Coronary Artery Bypass Grafting Registry database is generally in good operation, and some parameters still need to be improved. Comparing with OPCAB group, ONCABG has more severe preoperative general conditions, while the outcomes is acceptable.

[Fundus imaging features of purified protein derivative and T-spot positive tubercular serpiginous-like choroiditis].

Objective: To summarize the clinical and fundus imaging features of purified protein derivative and T-spot positive tubercular serpiginous-like choroiditis (PTP-SLC) patients. Methods: This retrospective study consecutively enrolled 13 PTP-SLC patients (21 eyes) in Beijing Tongren Hospital from November 2015 to November 2017. There were 8 males and 5 females with an average age of (45.2±12.1) years. Medical history and results of systemic and ophthalmological examinations, such us fundus autofluorescence photography, optical coherence tomography (OCT), fluorescein fundus angiography (FFA) and indocyanine green angiography, were evaluated. Results: Eight patients had binocular disease with an average interval time of (8.4±7.9) years. The average visual acuity of all patients was 0.3, and 4 patients had a clear history of exposure to tuberculosis. The active lesions in the PTP-SLC patients were homogeneous and creamish-yellow with unclear boundaries. Fundus autofluorescence showed an ill-defined, diffuse hyperautofluorescent zone. OCT showed punctate hyperreflexes between the choroidal stroma, destruction of the outer retinal structure with intraretinal edema and discrete vitreal hyper-reflective spots. FFA showed hypofluorescence in the active lesion at early stage and diffuse hyperfluorescence with leakage. Indocyanine green angiography showed persistent hypofluorescence. Conclusions: PTP-SLC fundus lesions are mainly manifested as homogeneous creamish-yellow lesions with unclear boundaries and high in autofluorescence. The involvement of the choroid and the outer layer of the retina can be observed on OCT. FFA can find more retinal vascular inflammatory changes. It is difficult to distinguish PTP-SLC from serpiginous choroiditis simply based on clinical and epidemiological characteristics. The pathogenic examination of tuberculosis is still the key to differential diagnosis (Chin J Ophthalmol, 2020, 56: 914-919).

Research on characteristics of symmetric optothermal microactuators.

This paper proposes and studies symmetric optothermal microactuators (OTMAs) which are directly controlled by a laser beam. Based on the principle of thermal flux, a theoretical model is established to describe the laser-induced temperature rises and optothermal expansions of the OTMAs' expansion arms. Temperature rise distributions of the arms with lengths of 590, 990, and 2260 µm are simulated separately, which reveals that, under 2 mW laser irradiation, the maximum temperature rises are invariably less than 75.9°C. Simulations are also made to consider optothermal expansions of the arms caused by laser irradiation, which turns out that expansion increases considerably when the arm's length increases from 250 to 1000 µm, while insignificantly between 1250 and 2500 µm. Under a laser beam of 2 mW power, experiments on three microfabricated OTMAs have been further conducted, which demonstrate that the OTMAs are capable of generating maximum deflections of 7.3, 11.3, and 13.6 µm, and that the growth of deflection is comparatively obvious in the case when the total length changes from 750 to 1200 µm, while insignificant for the range between 1200 and 2380 µm. With regard to simulations and experiments, it has been proved that the OTMAs are capable of implementing direct laser-controlled microactuation in which only about 2 mW laser power is demanded. Moreover, it has been proved that twofold total length or arm length does not correspondingly result in doubling the deflection, nor the expansion. Therefore, total length/expansion arm's length around or less than 1200/1000 µm is more appropriate for obtaining satisfactory characteristics of OTMAs, which may be potentially applied in MEMS/MOEMS and micro-/nano-technology.

In vitro bioassessment of the immunomodulatory activity of Saccharomyces cerevisiae components using bovine macrophages and Mycobacterium avium ssp. paratuberculosis.

The yeast Saccharomyces cerevisiae and its components are used for the prevention and treatment of enteric disease in different species; therefore, they may also be useful for preventing Johne's disease, a chronic inflammatory bowel disease of ruminants caused by Mycobacterium avium ssp. paratuberculosis (MAP). The objective of this study was to identify potential immunomodulatory S. cerevisiae components using a bovine macrophage cell line (BOMAC). The BOMAC phagocytic activity, reactive oxygen species production, and immune-related gene (IL6, IL10, IL12p40, IL13, IL23), transforming growth factor ß, ARG1, CASP1, and inducible nitric oxide synthase expression were investigated when BOMAC were cocultured with cell wall components from 4 different strains (A, B, C, and D) and 2 forms of dead yeast from strain A. The BOMAC phagocytosis of mCherry-labeled MAP was concentration-dependently attenuated when BOMAC were cocultured with yeast components for 6 h. Each yeast derivative also induced a concentration-dependent increase in BOMAC reactive oxygen species production after a 6-h exposure. In addition, BOMAC mRNA expression of the immune-related genes was investigated after 6 and 24 h of exposure to yeast components. All yeast components were found to regulate the immunomodulatory genes of BOMAC; however, the response varied among components and over time. The in vitro bioassessment studies reported here suggest that dead yeast and its cell wall components may be useful for modulating macrophage function before or during MAP infection.

[Human umbilical cord mesenchymal stem cell transplantation for the treatment of two noncontinuous segments spinal cord compression injury in rabbits].

Objective: In order to explore the effects of human umbilical cord mesenchymal stem cells (UCMSC) transplantation on the treatment of two noncontinuous segments spinal cord compression injury and to investigate whether repeated intravenous injection UCMSC was more beneficial for the recovery of spinal cord function. Methods: A total of 30 adult rabbits were randomly divided into three groups: control group (received PBS), single injection group, repeated injection group with 3 days intervals. A noncontinuous two segments SCI model was established by using the 2F Fogarty balloon catheter. Rabbits were infused with either a single total dose or three divided doses of 2×10(6) UCMSC (3 intervals) at first day post-decompreesion. Behavioral scores, somatosensory evoked potentials (SSEP) and histopathological were used to evaluate therapeutic effects. The rates of stem cell homing were studied by immunofluorescence test and the apoptosis of the spinal cord was evaluated by TUNEL test. Results: Behavior alanalyses showed that the rabbits in the UCMSC injection groups showed better motor performance than those in the control group (P<0.01), and the motor performance in the repeated transplantation group was better than that in the single transplantation group (P<0.01). The SSEP latencies were (22.53±0.75) ms, (24.52±0.45) ms and (26.31±0.69) ms in the repeated injection group, single injection group and control group (all P<0.01), respectively. Treatment with UCMSC increased ventral horn motor neurons preservation and decreased the number of TUNEL-positive cells compared with control group (P<0.01). The rates of stem cell homing in the repeated injection group was significantly higher than that in single injection group (P<0.01). Conclusion: Transplantation of UCMSC after spinal cord compression injury of two noncontinuous segments can promote functional recovery through enhancement anti-apoptotic and neuroprotective effects, and the recovery was more pronounced in the rabbits repeatedly injected at 3-day intervals.

Short communication: Ovine leukocyte telomere length is associated with variation in the cortisol response to systemic bacterial endotoxin challenge.

Stress has been associated with biological aging and numerous age-related diseases. This may be due, in part, to accelerated shortening of telomeres, which are critical genomic structures that cap and protect chromosomal ends. Dysfunction of the hypothalamic-pituitary-adrenal axis may indirectly contribute to telomere shortening if an animal reacts too strongly or weakly to a stressor, leading to accelerated biological aging. In this study, outbred Rideau-Arcott sheep were stress challenged with Escherichia coli endotoxin and classified as high, middle, or low cortisol responders to investigate a potential relationship between cortisol response and age, and telomere length. In the present study, no association was found between age and telomere length. The study, however, revealed shorter telomeres in high and low cortisol responders compared with the middle cortisol responders, which suggests that health and longevity may be compromised in extreme high- and low-stress-responding sheep.

Association of TLR4 polymorphisms with Mycobacterium avium subspecies paratuberculosis infection status in Canadian Holsteins.

Mycobacterium avium ssp. paratuberculosis (MAP) causes chronic enteritis in cattle that results in substantial financial losses to the cattle industry worldwide. Given that susceptibility to MAP infection is determined in part by genetics, marker-assisted selection may help in the breeding of animals that are more resistant to MAP infection. The toll-like receptor 4 gene (TLR4) was selected as a potential candidate gene because of its role in innate immunity and its involvement in MAP recognition and infection. The objective of this study, therefore, was to identify associations between TLR4 polymorphisms and susceptibility to MAP infection in Canadian Holstein cows. Two biologically relevant SNPs, including c.-226G>C in the 5'-untranslated region and the non-synonymous SNP c.2021C>T in the potential TIR domain, were selected for an association analysis with MAP infection status in 409 Canadian Holsteins. The haplotype C-T from these combined SNPs yielded significant association with susceptibility to MAP infection, supporting the involvement of TLR4 in susceptibility to MAP infection.

Isothermal cross-priming amplification implementation study.

UNLABELLED: Cross-priming amplification (CPA) was evaluated for the early detection of norovirus (NV), rotavirus A (RV-A), enteric adenovirus (EAdV) and astrovirus (AstV). The analytical sensitivity of the CPA assay was 10(3) copies ml(-1) for NV, RV-A and AstV detection and 10(4) copies ml(-1) for EAdV detection. For each of the four pathogens, the positive detection rate by CPA was similar to real-time PCR methods and higher than the rate observed in an ELISA. The detection coincidence rates of CPA and RT-PCR for NV, RV-A, EAdV and AstV were 98, 99, 99 and 100%, respectively. All CPA assays were negative in 89 healthy control samples. These results demonstrate the high analytical sensitivity and specificity of the CPA assay. CPA assays are relatively straightforward to perform, and such assays represent a potential detection method for locations in which resources are limited. SIGNIFICANCE AND IMPACT OF THE STUDY: Over one billion people suffer from diarrhoeal diseases every year. This leads to significant morbidity and mortality, particularly the children under five. Rapid and specific detection of the pathogens that cause diarrhoeal diseases would be advantageous, enabling rapid treatment and management of the spread of pathogens. Here, a fast, cross-contamination-proof and user-friendly nucleic acid isothermal amplification method called cross-priming amplification (CPA) was used to test four pathogens with high analytical sensitivity and specificity. The results indicate that CPA has great potential for improving medical diagnostics, particularly in resource-limited areas.

IGFBP-3 A-202C and C2133G polymorphisms and colorectal cancer risk: a meta-analysis of case-control studies.

Recent evidence suggests that genetic variations in the IGFBP-3 gene may impact susceptibility to colorectal cancer, but individually published results are inconclusive. Our meta-analysis was aimed at providing a more precise estimation of these associations. An extensive literature search was conducted for appropriate articles published before May 1, 2013. This meta-analysis was performed using the STATA 12.0 software. The crude odds ratios (OR) with 95% confidence interval (CI) were calculated. Eleven case-control studies were included with a total of 11,895 colorectal cancer patients and 17,147 healthy controls. Our meta-analysis indicated that the G variant of IGFBP-3 C2133G polymorphism may be associated with increased colorectal cancer risk. However, no statistically significant association was noted between IGFBP-3 A-202C polymorphism and colorectal cancer risk. No publication bias was detected in this meta-analysis. The current meta-analysis suggests that the IGFBP-3 C2133G polymorphism may confer susceptibility to colorectal cancer. The G variant of the IGFBP-3 C2133G polymorphism may serve as a useful biomarker for predicting the risk of colorectal cancer.

HIF1A gene Pro582Ser polymorphism and susceptibility to digestive tract cancers: a meta-analysis of case-control studies.

Many existing studies have demonstrated that common polymorphisms in the hypoxia inducible factor-1α (HIF-1A) may contribute to the development of digestive tract cancers, but individually published studies showed inconclusive results. This meta-analysis aimed to derive a precise estimation of the relationships between HIF1A Pro582Ser polymorphism and the risk of digestive tract cancers. We searched CISCOM, CINAHL, Web of Science, PubMed, Google Scholar, EBSCO, Cochrane Library, and CBM databases from inception through May 1, 2013. Meta-analysis was performed using the STATA 12.0 software. We assessed 6 case-control studies that included a total of 911 digestive tract cancer patients and 2774 healthy controls. Our meta-analysis indicated that HIF1A Pro582Ser polymorphism was associated with an increased risk of digestive tract cancer. Subgroup analysis by ethnicity suggested that HIF1A Pro582Ser polymorphism might increase an individual's susceptibility to digestive tract cancer in Asian populations. However, similar association was not observed in Caucasian populations. In conclusion, our findings suggest that HIF1A Pro582Ser polymorphism may contribute to the risk of digestive tract cancers, especially in Asian populations.

Outcome and prognosis for patients younger than thirty with primary lung cancer.

AIM: Aim of the present study was to investigate the clinical and pathological features of surgical treatment for primary bronchogenic carcinoma in adolescent patients. PATIENTS: We retrospectively reviewed the clinico-pathological records documenting surgical outcomes and prognostic factors in 68 lung cancer patients aged less than 30 years old enrolled in our hospital between March 1980 and December 2009. RESULTS: Sixty-eight patients were identified (38 male, 30 female) with a mean age of 22±5 years (range 8 to 29 years). Preoperative clinical manifestations were present in 82.4% (56/68) of the patients and 26.5% (16/68) of patients were initially misdiagnosed. Fifty-two patients had undergone radical surgery, 4 palliative surgery, 9 had exploratory thoracotomies, and 3 had thoracoscopic lung biopsies. Eight patients were classified (TNM) stage Ia, 7 stage Ib, 9 stage IIa, 13 stage IIb, 17 stage IIIa, 10 stage IIIb, and 4 stage IV. Postoperative atelectasis was observed in 4.41% (3/68) of the patients, and 1.47% (1/68) died of respiratory failure 5 days after exploratory thoracotomy. The overall 5-year survival rate in very young people was 31%, while those who underwent radical surgery was slightly higher at 36.7%. Five-year survival rates were correlated with the surgical procedures and pTNM stage (P <0.05). Multivariate analysis indicated that the TNM stage is the only independent prognostic factor (P=0.000). CONCLUSION: We conclude that radical surgeries, the predominant comprehensive therapies are the best choice for primary lung cancer patients younger than 30 years of age.

[Changes in epidemic intensity of influenza during 2014-2020 in Shanghai].

Objective: To evaluate the performance of the influenza surveillance network and compare the epidemic intensity of influenza during 2014-2020 in Shanghai. Methods: Based on the weekly reports of influenza-like illness (ILI) and laboratory-confirmed influenza cases from January 1, 2014 to December 31, 2020. This study first evaluated the data reporting and specimen collection of ILI cases for each sentinel hospital, and then calculated the percentage of ILI (ILI%), the proportion of specimens tested positive for influenza, and the incidence of influenza among all ILI outpatient and emergency visits to measure the epidemic intensity of influenza. Finally, seasonal autoregressive integrated moving average (ARIMA) model was applied to quantify the changes in epidemic intensity of influenza in 2020. Results: The proportion of influenza surveillance sentinel hospitals with a score of less than 5 in the evaluation of ILI data reporting and samples collection were 9.68% and 21.05% in 2020 in Shanghai, respectively. ILI% was estimated to be 1.51% (95%CI: 1.50%-1.51%) and 2.31% (95%CI: 2.30%-2.32%), respectively for 2014-2019 and 2020; the proportion of specimens tested positive was 24.27% (95%CI: 24.02%- 24.51%) and 7.15% (95%CI: 6.78%-7.54%), respectively; and the incidence of influenza was 3.66‰ (95%CI: 3.62‰-3.70‰) and 1.65‰ (95%CI: 1.57‰-1.74‰), respectively. ARIMA model showed that ILI% was increased by 45.25% in 2020 in Shanghai, and the proportion of specimens tested positive and the incidence of influenza were reduced by 78.45% and 51.80%, respectively. Conclusions: In 2020, the performance of influenza surveillance system has changed, ILI% has increased, the proportion of specimens tested positive and the incidence of influenza has decreased in Shanghai. The change in the quality of influenza surveillance is also a potential factor affecting the epidemic intensity of influenza. In the future, the quality control of influenza surveillance network still needs to be further strengthened.

Subcutaneous administration of modified vaccinia virus Ankara expressing an Ag85B-ESAT6 fusion protein, but not an adenovirus-based vaccine, protects mice against intravenous challenge with Mycobacterium tuberculosis.

Recombinant virus-based tuberculosis (TB) vaccines that are strongly immunogenic and elicit robust cellular immunity are considered ideal vaccine candidates. Here, we engineered a poxvirus-based vaccine, MVA85B-E6, and an adenovirus-based vaccine, AD85B-E6, both of which express the fusion protein Ag85B-ESAT6. Subcutaneous vaccination of AD85B-E6 generated strong interferon (IFN)-γ production by both CD4 and CD8 T cells and CD8 cytotoxic T lymphocyte activity; these results indicate that strong T-helper type 1 immune responses were elicited in mice, which is in contrast to the moderate responses induced by vaccination with MVA85B-E6. However, MVA85B-E6 given subcutaneously led to levels of protection comparable with that induced by the bacillus Calmette-Guérin vaccine in the lungs and spleens, whereas AD85B-E6 given subcutaneously did not show any protective efficacy after intravenous challenge of BALB/c mice with Mycobacterium tuberculosis H37Rv. Our study emphasizes that more efficient biomarkers for vaccine efficacy and more appropriate routes of vaccine administration are necessary for the development of a successful TB vaccine.