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ObjectiveTo analyze the spatiotemporal characteristics and prevention and control measures of the pandemic caused by the SARS-CoV-2 Omicron variant in Shanghai in 2022， aiming to optimize future prevention and control strategies. MethodsDescriptive statistical method was used to analyze data on daily infections released by the Shanghai Municipal Health Commission from March 1 to June 30， 2022. ResultsAs of 30 June， a total of 627 110 infections and 588 deaths had been reported in Shanghai. Most of the cases were in Pudong New Area （35.47%）， Minhang District （10.18%） and Huangpu District （9.27%）. The cumulative infection rate was 8.78% in Huangpu District， which was the highest among all the districts. With the progress of the pandemic， the prevention and control measures were strengthened from a “precise prevention and control” strategy to “block and grid” screening， and then upgraded to city-wide lockdown. All daily new infections were identified from the quarantined population on April 29， 2022， reaching the goal of “clearance of community transmission”. ConclusionThe cumulative infections in Shanghai exceeded any previous epidemics in mainland China. Given the enhanced transmissibility and vaccine-induced immune escape of the Omicron variant， timely and strong public health measures are needed to suppress the pandemic under the general policy of "Dynamic zero-COVID".
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ObjectiveTo explore the impact of primiparas’ intention to have a second child on their delivery mode. MethodsDuring March 1st， 2019 and November 30th， 2020， the enrolled pregnant women were investigated by questionnaires at two points， first trimester pregnancy registration and post-natal visit at maternal and child healthcare community centers of Xuhui District. Logistic regression analysis was used to examine the association of willingness of a second birth and their mode of delivery. Results2 000 questionnaires were distributed and 1 664 valid questionnaires were analyzed. The overall cesarean delivery rate in nulliparous women was 40.08% （667/1 664）， with 8.95% （149/1 664） of non-medical indication cesarean delivery. Multiple Logistic regression analysis of overall delivery rate showed that age， willingness to have more children in the future， plan of vaginal delivery at first questionnaire， and complications during pregnancy were associated with overall cesarean delivery rate， and women without the willingness to have more children in the future were more likely to undergo cesarean delivery （OR=1.350， 95%CI： 1.052-1.732）. Age， whether to have a second child in the future， plan of vaginal delivery at first questionnaire， and complications during pregnancy were all factors associated with increased risks of non-medical indicated cesarean delivery， while women with no plan of a second child in the future had nearly 2 times of risk of non-medical indicated cesarean delivery （OR=1.909， 95%CI： 1.117-3.262）. ConclusionThe mode of delivery is affected by many factors， among which willingness to have more children in the future is an important factor associated with increased risks of overall cesarean delivery and non-medical indicated cesarean delivery.
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ObjectiveThe outbreak of novel coronavirus disease 2019 (COVID-19) imposed a substantial health burden in mainland China and remains a global epidemic threat. Our objectives are to assess the case fatality risk (CFR) among COVID-19 patients detected in mainland China, stratified by clinical category and age group. MethodsWe collected individual information on laboratory-confirmed COVID-19 cases from publicly available official sources from December 29, 2019 to February 23, 2020. We explored the risk factors associated with mortality. We used methods accounting for right-censoring and survival analyses to estimate the CFR among detected cases. ResultsOf 12,863 cases reported outside Hubei, we obtained individual records for 9,651 cases, including 62 deaths and 1,449 discharged cases. The deceased were significantly older than discharged cases (median age: 77 vs 39 years, p<0.001). 58% (36/62) were male. Older age (OR 1.18 per year; 95%CI: 1.14 to 1.22), being male (OR 2.02; 95%CI: 1.02 to 4.03), and being treated in less developed economic regions (e.g., West and Northeast vs. East, OR 3.93; 95%CI: 1.74 to 8.85) were mortality risk factors. The estimated CFR was 0.89-1.24% among all cases. The fatality risk among critical patients was 2-fold higher than that among severe and critical patients, and 24-fold higher than that among moderate, severe and critical patients. ConclusionsOur estimates of CFR based on laboratory-confirmed cases ascertained outside of Hubei suggest that COVID-19 is not as severe as severe acute respiratory syndrome and Middle East respiratory syndrome, but more similar to the mortality risk of 2009 H1N1 influenza pandemic in hospitalized patients. The fatality risk of COVID-19 is higher in males and increases with age. Our study improves the severity assessment of the ongoing epidemic and can inform the COVID-19 outbreak response in China and beyond.
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BackgroundThe COVID-19 epidemic originated in Wuhan City of Hubei Province in December 2019 and has spread throughout China. Understanding the fast evolving epidemiology and transmission dynamics of the outbreak beyond Hubei would provide timely information to guide intervention policy. MethodsWe collected individual information on 8,579 laboratory-confirmed cases from official publically sources reported outside Hubei in mainland China, as of February 17, 2020. We estimated the temporal variation of the demographic characteristics of cases and key time-to-event intervals. We used a Bayesian approach to estimate the dynamics of the net reproduction number (Rt) at the provincial level. ResultsThe median age of the cases was 44 years, with an increasing of cases in younger age groups and the elderly as the epidemic progressed. The delay from symptom onset to hospital admission decreased from 4.4 days (95%CI: 0.0-14.0) until January 27 to 2.6 days (0.0-9.0) from January 28 to February 17. The mean incubation period was estimated at 5.2 days (1.8-12.4) and the mean serial interval at 5.1 days (1.3-11.6). The epidemic dynamics in provinces outside Hubei was highly variable, but consistently included a mix of case importations and local transmission. We estimate that the epidemic was self-sustained for less than three weeks with Rt reaching peaks between 1.40 (1.04-1.85) in Shenzhen City of Guangdong Province and 2.17 (1.69-2.76) in Shandong Province. In all the analyzed locations (n=10) Rt was estimated to be below the epidemic threshold since the end of January. ConclusionOur findings suggest that the strict containment measures and movement restrictions in place may contribute to the interruption of local COVID-19 transmission outside Hubei Province. The shorter serial interval estimated here implies that transmissibility is not as high as initial estimates suggested.
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Objective:To investigate the effect of PTS on the related pathophysiological changes and serum IL-6 level at different time points after the middle cerebral artery occlusion (MCAO) in rat’s brain.Methods:The model of focal cerebral ischemia of rat was established by the suture-occluded method.The effect of PTS on the behavioral disturbance,the pathological change of ischemia tissue and the level of serum IL-6 at different time points(3d,7d,28d) after MCAO and cerebral ischemia in rats were studied.ResultsAfter MCAO,different degrees of motion disturbances were observed in all rats.The infarct spot can be observed in all groups except the normal.The nerve cell necrosis can be found in all rats after 24 hour of MCAO.The result showed that PTS could improve the degree of motion disturbance,reduce the infarct spot obviously;after MCAO,the serum IL-6 were increased obviously but could be reduced by PTS.Conclusion:PTS can protect the neurons,reduce and eliminate the infiammatory reaction of cerebral ischemia cascade reaction effectively,which may relate to its inhibiting effect on cell factors such as IL-6 production after cerebral ischemia.
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Objective To investigate the effect and mechanism of boron neutron capture therapy(BNCT) in C6 glioma cell line.Methods C6 cells in exponential phase were divided into 6 groups: untreated control,(~(60)Co?)(4 Gy),~(60)Co? 8 Gy,nuclear reactor exposure without boronophenylalanine(BPA) 3 Gy,BNCT(4 Gy) and BNCT 8 Gy.Cellular morphological change was observed by an inverted microscope,light microscope,fluorescence microscope and electronic microscope.Flow cytometry was used to determine the percentage of apoptosis,necrosis and normal cells 48h after irradiation.Colony forming assay was used to calculate cell surviving fraction.Results Typical morphological changes of apoptosis were observed early after irradiation in BNCT group,with a significant increase in apoptotic rates was observed 48 h after irradiation with 63.2% and 88.3% for BNCT(4 Gy) and 8 Gy group,respectively(P
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BACKGROUND: There have been reports at home and abroad about effects of estrogen upon the dopamine amount in substantia nigra in the midbrains while the neuroprotective effects of estrogen are still being studied.OBJECTIVE: To observe the effects of estrogen on dopaminergic neurons and explore the feasibility of preventing and treating Parkinson disease with estrogen.DESIGN: A randomized controlled study based on the experimental animals.SETTING: General neurosurgery institute in a hospital of a military medical university of Chinese PLA.MATERIALS: The trial was conducted in the General Neurosurgery Institute of Xijing Hospital,the Fourth Military Medical University of Chinese PLA from October 2003 to February 2004 with 50 healthy,first-grade Wistar rats as subjects. INTERVENTIONS: The rats were randomly assigned into 5 groups with 10in each group. Group 1 was normal control,group 2 sham-operation group,and groups 3,4,5 were ovariectomy groups. In group 3,10 μg of estradiol was administered twice a day ineach rat after ovariectomy. Each rat in group 4 was administered with estrogen antagonist,5 μg tamoxifen twice a day as well as estrogen. In group 5,only ovariectomy was performed. After stereotaxic injection of 6-hydroxydopamin into substantia nigra in the midbrains,the TH positive neurons were labeled and counted with immunohistochemic method and the rat's behavior was observed.MIAN OUTCOME MEASURES:①the circles of rat's rotation provoked by apomorphine.②the TH positive neuron count in the middrains of rat's substantia nigra 30 days after ovariectomy.RESULTS: Baseline characteristics among the groups were no difference ( P ＞ 0.05). The result of group 3 was different from that of group 5 ( P＜ 0.05 ). The result of group 4 was also different from that of group 3 and group 5 (P ＜ 0.05) . The TH positive neuron count in the midbrains ingroup 3 also differed from that in other groups( P ＜ 0.05).CONCLUSION: Estrogen acts as a neuroprotectant of the nigral dopaminergic neurons in the midbrains not only through estrogen receptor-dependent pathways but probably also through others.
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Objective To study the effect of vascular endothelial growth factor (VEGF) containing fibrin glue(FG) on re-endotheliazation, cell proliferation and intimal hyperplasia in a canine model of carotid artery endothelium injury. MethodsThe effect of FG/VEGF/heparin versus FG alone treatment was evaluated at the time point of 10, 30, and 90 days by measuring the intima/media (I/M) ratio and cell proliferation by BrdU incorporation using immunohistochemistry. EC coverage was determined by SEM. ResultsCompared with normal saline control, FG/VEGF/heparin treatment significantly increased EC coverage at day 10 and at day 30 (P
