Objective: By analyzing the prevalence and influencing factors of thyroid nodules (TN) among a population undergoing physical examinations in Nantong region, this study aims to provide theoretical basis for early prevention and intervention of TN. Methods: A cross-sectional study was conducted, including 6 950 participants who underwent physical examinations at the Affiliated Hospital of Nantong University from January 2017 to April 2020. All participants underwent high-resolution ultrasound examination of the thyroid, and measurements of height, body mass index (BMI), blood pressure. Fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C), uric acid (UA), homocysteine (HCY) and other metabolic indicators were detected. Data analysis was performed using SPSS 26.0 statistical software. The numerical variables with normal distribution were expressed as mean±standard deviation (x¯±s), and the t-test was used for comparison between the two groups. Numerical variables with non-normal distribution were expressed as median (interquartile range), namely M (Q1, Q3). The Mann-Whitney U test was used for comparison between two groups, and the Kruskal-Wallis test was used for comparison between multiple groups. Results: The prevalence of thyroid nodules among the 6 950 participants was 53.97% (3 751/6 950), with a rate of 47.08% (2 218/4 711) in males and 68.47% (1 533/2 239) in females, which was significantly higher in females than in males (χ2=278.575, P<0.001). The prevalence of TN increased with age both overall (χ2=552.145, P<0.001), in males (χ2=304.086, P<0.001), and in females (χ2=202.178, P<0.001). The prevalence of TN was higher in females than in males across different age groups (P<0.05). In the comparison between males in the TN and non-TN groups, significant differences were found in terms of alcohol consumption history, BMI, blood pressure, HCY, and FBG (all P<0.05). In the comparison between females in the TN and non-TN groups, significant differences were found in terms of BMI, blood pressure, HCY, FBG, TC, TG, LDL-C, and UA (all P<0.05). Univariate logistic regression model showed that FBG<6.1 mmol/L (P<0.001) and TC<5.2 mmol/L (P=0.013) were protective factors for TN. Normal UA (P=0.013) was a risk factor for TN. After adjusting for gender, smoking, alcohol consumption, BMI, and blood pressure, multivariate logistic regression analysis revealed that FBG<6.1 mmol/L (OR: 0.713, 95%CI: 0.621-0.817, P<0.001) was a protective factor against TN. Conclusion: The prevalence of TN is relatively high in the Nantong region. Gender, age, blood pressure, BMI, and FBG are important influencing factors for TN. Health screening and management should be strengthened for the physical examination population with abnormal indicators.

To explore the predictive value of preoperative serum CYFRA 21-1 in colorectal cancer (CRC) resection patients. In this retrospective study, 456 patients with CRC who received surgical treatment in the Department of General Surgery, Affiliated Hospital of Nantong University from January 2016 to February 2018 were analyzed. Preoperative CYFRA 21-1, CEA, CA19-9 and pathological data of the study subjects were collected. Determine the cut-off value of CYFRA 21-1 based on the X-tile. Chi-square test or Fisher exact probability test were used to compare clinicopathological features in different CYFRA 21-1 level groups. Univariate and multivariate regression analysis of factors affecting 5-year overall survival (OS) and disease-free survival (DFS). Kaplan-Meier survival curves were used to analyze 5-year differences in OS and DFS in CRC patients with different levels of CYFRA 21-1, CEA and CA19-9. Receiver operating characteristic(ROC) was adopted. ROC curves were used to analyze the prognostic efficacy of CYFRA21-1 for CRC, and nomogram maps were used to predict 1, 3, and 5-year survival rates. The results showed that the optimal cut-off values of serum CYFRA 21-1, CEA and CA19-9 were 4.9 ng/ml, 29.2 ng/ml and 72.8 U/ml, respectively. Different gender, tumor size, location, degree of differentiation, depth of invasion, lymph node metastasis and tumor node metastasis (TNM) classification stage were significantly different between the two groups with high and low CYFRA 21-1, the P-values were 0.018,<0.001,<0.001,<0.001, 0.002, 0.001, 0.003, respectively. CYFRA 21-1 (≥4.9 ng/ml) was an independent risk factor for 5-year OS (HR: 4.008, 95%CI: 2.309-6.958, P<0.001) and DFS (HR: 3.75, 95%CI: 2.227-6.314, P<0.001) in CRC patients. CYFRA 21-1 predicts a 5-year AUC of 0.725 and 0.720 for OS and DFS, respectively, and 0.804 and 0.827 for the combination of CEA and CA19-9. Based on the results of multivariate Cox regression analysis, nomogram graphs of OS and DFS were established, the C-indexes were 0.799 and 0.803, respectively. In conclusion, preoperative serum CYFRA 21-1 level may be an independent risk factor affecting the prognosis of patients with colorectal cancer. The prognostic model established by CYFRA 21-1 combined with CEA, CA19-9 and TNM stages may provide references for the prevention of CRC recurrence and clinical decision-making.

To investigate the relationship between serum uric acid to creatinine ratio (SUA/Cr) and metabolic syndrome (MS) and other indexes on physical examination population in Nantong area. Using the method of cross-sectional study, 8 148 physical examiners in the physical examination center of the Affiliated Hospital of Nantong University from January 2017 to April 2020 were used as the research objects, and the clinical data and serum biochemical indicators such as smoking and alcohol addiction, physical examination and so on were collected. According to the standard diagnosis of MS of Diabetes Society of Chinese Medical Association, the patients were grouped according to the quartile of SUA/Cr and the clinical data of each group were compared. Pearson correlation analysis and logistic regression analysis were used to explore the correlation between SUA/Cr and clinical indicators and the relationship between SUA/Cr and the risk of MS. The results showed that UA and SUA/Cr were the lowest in normal metabolism group, followed by abnormal metabolism group and the highest in MS group, The difference between the two groups was statistically significant (H=919.21 and 629.34, P<0.001). According to the SUA/Cr quartile, the population was divided into four groups. After adjusting for gender, age, smoking history and drinking history, SUA/Cr in group Q1 was positively correlated with BMI and TG (r=0.061 and 0.080, P<0.05), but negatively correlated with HDL-C (r=-0.057, P<0.05). Multivariate logistic regression results showed that after adjusting for age, sex, smoking history and drinking history, the risk of MS for BMI, SBP, DBP, FBG, TG, HDL-C and SUA/Cr [OR (95%CI)] were: 1.44 (1.41-1.47), 1.07 (1.06-1.07), 1.10 (1.10-1.11), 1.83 (1.73-1.92), 1.89 (1.79-1.99), 0.08 (0.06-0.10) and 1.54 (1.47-1.62). Compared with SUA/Cr group Q1, the risk of MS in group Q2, Q3 and Q4 increased by 75%, 162% and 346%, respectively. In conclusion, there was an independent positive correlation between SUA/Cr and MS risk in Nantong area.

In order to improve the lean level of the distribution network and lead the high-quality and high-efficiency development of the distribution network from the perspective of precise planning, it is an inevitable trend for future planning technology development to set planning goals differentiated according to actual conditions. In view of the insufficient selection of capacity-load ratio in the current technical principles of distribution network planning and design, this paper proposes a differential optimization planning method for capacity-load ratio of distribution network based on maximum load utilization hours. Firstly, we convert the equivalent utilization hours of the maximum load based on the actual annual power consumption. Then we determine the optimal load rate range under the economic operation of the transformer in the planned area. Finally, we combine the average annual load growth rate to obtain the capacity-load ratio of the area optimal range. Taking a typical area in Anhui Province as an example, the planning method proposed in this paper is verified. The results show that the planning results of this method are consistent with the current situation of the distribution network, which improves the lean level of distribution network planning and can improve the quality of the distribution network.

High Voltage Direct Current(HVDC) transmission projects has been playing crucial role in China Southern Power Grid(CSG). These projects transmit the numerous hydro electricity from Yunnan to Guangdong and Guangxi. Keeping these HVDC projects stabilized operating is important to the whole power grid. Different from Alternate Current(AC) transmission projects, 78% of debugging and checking work for HVDC devices is proceeding before being service as estimated, the commission work actually. The Lugaozhao HVDC project is ±500kV three-terminal HVDC project, which is updated from Gaozhao HVDC project. The multi-terminal project keeps operating normally in the following year after well designed field commission. The paper analyzed the rationality of field commission for multi-terminal HVDC project through the principles, contents and unexpected action in commission.

As the basic control unit of thyristor, the reliability of thyristor control unit (TCU) is a fatal device for the reliability of HVDC transmission system. However, the defects of TCU frequently occurred in ±500kV Gui Zhong converter station, such as IP loss, IP oscillation, protective triggering and other abnormal phenomena. Meanwhile, standard of test method and system specially designed for TCU neither existed in Chinese discipline nor in IEC-60700-1. So it is necessary to design special tests on TCU which aim to recover the fault and find out the causes before being put into use. The paper presented the TCU test method, which is used to analyze the fault part of TCU in the converter station. The defeated components are successfully proved to be clipped triode inside the TCU. The test method is necessary supplement for test standard, operation and overhaul of HVDC transmission projects.

To evaluate the one-year clinical outcomes and identify its associated factors in patients with acute coronary syndromes (ACS) in Tianjin, China. Data were obtained from Tianjin Urban Employee Basic Medical Insurance database (2011-2015). Adult patients who were discharged alive after the first ACS-related hospitalization (index hospitalization) during 2012.01.01-2014.12.31 and had continuous enrollment during 12-month pre- (baseline) and 12-month post- (follow-up) index hospitalization were included. Clinical outcomes were measured by subsequent major adverse cardiovascular events (MACE) including hospitalization for myocardial infarction (MI) or stroke, all-cause mortality, or their composite endpoint. Cox model was used to explore the factors associated with MACE. 22,041 patients (64.7±10.7 years; 54.4% male) were identified. 9.5% (N=2,099) experienced MACE during follow-up with a mean number of 1.3±0.8. 3.1% (N=680) had MI, 5.7% (N=1,253) had stroke and 1.4% (N=298) had all-cause death. Among patients who experienced MACE, average time from index discharge to the 1st MACE was 143.2±118.8 days, and 42.1% (N=883) experienced MACE within 90 days after discharge. Being older (age 55-64: Hazard Ratio [95% CI]=1.28 [1.06-1.54]; age 65-74: HR=1.57 [1.27-1.92]; age ≥75: HR=1.91 [1.56-2.35], respectively, vs. age ≤54), male (HR=1.47 [1.34-1.61] vs. female) or patients who had higher Charlson Comorbidity Index (CCI) (HR=1.09 [1.05-1.14]) were more likely to experience MACE. Patients who had prior stroke (HR=1.77 [1.59-1.96]) and prior all-cause hospitalization (HR=1.36 [1.22-1.53]) were more likely to experience MACE, whereas prior angina (HR=0.81 [0.72-0.90]), prior β-blockers utilization (HR=0.82 [0.75-0.91]) and received percutaneous coronary intervention (PCI) during index event (HR=0.73 [0.64-0.82]) were less likely to experience MACE. Stroke is the most common type of MACE among ACS patients in Tianjin. Almost half of the 1st MACE occur within the 3 months after ACS. Patients older, male, having higher CCI and with prior stroke are at higher risk of MACE.

To investigate the treatment pattern and associated factors of antiplatelet medication use in patients with acute coronary syndromes (ACS) in Tianjin, China. Data were obtained from Tianjin Urban Employee Basic Medical Insurance database (2011-2015). Adult patients who were discharged alive after the first ACS-related hospitalization (index hospitalization) between January 2012 to December 2014, and had continuous enrollment during 12-month pre- (baseline) and 12-month post- (follow-up) index hospitalization were included. Initial treatment patterns were classified as aspirin monotherapy, clopidogrel monotherapy and dual antiplatelet (DAPT, i.e., aspirin & clopidogrel) according to the first prescription within the initial 30-day follow-up period. Subsequent changes of treatment patterns, including discontinuation (with ≥30 days gap) and switch, were further described. Logistic model was used to explore the associated factors of the initiation with DAPT. A total of 22,041 patients (64.7±10.7 years; 54.4% male) were identified, among which 22.1% (N=4,874) initiated with aspirin monotherapy, 22.7% (N=4,994) with clopidogrel monotherapy, 24.9% (N=5,494) with DAPT, and 30.3% (N=6,679) were left untreated within the initial 30-day follow-up period. Among patients who initiated with DAPT, 8.6% (N=473) discontinued their initial therapy, 51.1% (N=2,808) switched to clopidogrel monotherapy, and 36.4% (N=2,002) switched to aspirin monotherapy. Being older (age 55-64: Odds Ratio [95% CI]=1.20 [1.06-1.36]; age 65-74: OR=1.43 [1.24-1.65]; age ≥75: OR=1.45 [1.24-1.68], respectively, vs. age ≤54), male (OR=1.33 [1.23-1.44]), patients who had prior myocardial infraction (MI) (OR=1.21 [1.09-1.35]) , had prior antiplatelet agents use (OR=1.25 [1.14-1.36]) and received percutaneous coronary intervention (PCI) during baseline (OR=1.34 [1.16-1.54]) or index hospitalization (OR=8.30 [7.70-8.93]) were more likely to initiate with DAPT. Only a quarter of ACS patients initiated with DAPT and more than half of them switched to clopidogrel monotherapy during follow-up period. Patients older, male, having prior MI, having prior antiplatelet agents use, and receiving prior PCI are more likely to initiate with DAPT.

To investigate the adherence and persistence with antiplatelet agents and their associated factors among patients with new episode of acute coronary syndrome (ACS) in Tianjin, China. Data were obtained from Tianjin Urban Employee Basic Medical Insurance database (2011-2015). Adult patients who initiated antiplatelet agents within 30 days after discharge with a hospitalization for ACS (index hospitalization) during 2012.01.01-2014.12.31, and had continuous enrollment during 12-month pre- (baseline) and 12-month post- (follow-up) index hospitalization were included. Patients who had previous evidence of ACS or prescription of antiplatelet agents during baseline period or had major adverse cardiovascular events within the initial 30 days after discharge were excluded. Patients who had a ≥80% proportion of days covered (PDC) were considered adherent, while patients who had no gaps of ≥30 days in antiplatelet therapy were considered persistent. Logistic and Cox models were used to explore the associated factors for adherence and persistence, respectively. 5,486 patients (63.2±10.8 years; 60.2% male) were identified. Only 10.9% (N=600) of them were adherent to antiplatelet agents during follow-up, and the mean PDC was 0.39±0.29 for the total cohort. 90.1% (N=4,942) patients discontinued antiplatelet agents during follow-up and the average time to discontinuation was 103.89±110.27 days. Male, patients who received percutaneous coronary intervention (PCI) or those who had longer stay during index hospitalization had better adherence (Odds ratio [95% CI]=1.88 [1.49-2.37]; OR=3.77 [3.11-4.57]; OR=1.03 [1.01-1.05]) and persistence (Hazard Ratio [95% CI]=0.82 [0.77-0.88]; HR=0.41 [0.39-0.44]; HR=0.99 [0.98-1.00]). Patients with prior use of calcium channel blocker (CCB) (OR=0.73 [0.55-0.97]) had lower adherence, while those with prior use of β-blockers (HR=1.08 [1.00-1.17]) had lower persistence. Adherence and persistence with antiplatelet agents was unsatisfactory among patients with new episode of ACS in Tianjin, China. Male, receiving PCI and longer stay during index hospitalization were associated with better adherence/persistence.

The objective of this study was to observe the infection of human cytomegalovirus (HCMV) to human umbilical vein endothelial cells, and its effect on the expression of single-stranded DNA-binding protein (SSBP1) and on lipid metabolism in endothelial cells. We screened the differential expression of mRNAs after HCMV infection by suppression subtractive hybridization and the expression levels of SSBP1 mRNA and protein after HCMV infection by real-time PCR and western blot. After verification of successful infection by indirect immunofluorescent staining and RT-PCR, we found a differential expression of lipid metabolism-related genes including LDLR, SCARB, CETP, HMGCR, ApoB and LPL induced by HCMV infection. The expression levels of SSBP1 mRNA and protein after HCMV infection were significantly down-regulated. Furthermore, we found that upregulation of SSBP1 inhibited the expression of atherosclerosis-associated LDLR, SCARB, HMGCR, CETP as well as the accumulation of lipids in the cells. The results showed that the inhibition of SSBP1 by HCMV infection promotes lipid accumulation in the cells.

To evaluate healthcare resource utilization and cost among patients with acute coronary syndromes (ACS) in Tianjin, China. Data were extracted from Tianjin Urban Employee Basic Medical Insurance database (2011-2015). Adult patients with primary discharge diagnosis of ACS during 2012-2014, and with insurance coverage of at least 12 months before index hospitalization and after index discharge were included. Optimal medical therapy (OMT) was defined as receiving antiplatelets, statins, ACEIs/ARBs and β-blockers. ACS-related hospitalization and outpatient visit were defined as those with ACS diagnosis, and ACS-related cost as sum of ACS-related hospitalization/outpatient cost and OMT cost from services without ACS diagnosis. Patients were divided into two cohorts according to OMT use at discharge. Propensity-score matching was employed to adjust baseline difference. Generalized linear model (GLM) was conducted to assess the effect of OMT. 22,041 patients (64.7±10.7 years; 45.4% male) were identified, of which 15.1% received OMT at discharge. Within 1 year after discharge, each patient experienced an average of 11.24 ACS-related outpatient visits and 0.24 ACS-related hospitalizations. The ACS-related total cost per patient was ￥8,531, among which OMT cost was ￥2,037 while hospitalization cost was ￥4,666. After matching for baseline of OMT vs. non-OMT patients, there were 3,336 patients in each cohort. During 1-year follow up, OMT patients had more frequent outpatient visits than non-OMT patients (14.24 vs. 13.62, P<0.001), while OMT patients experienced less ACS-related hospitalization (0.21 vs. 0.24, P<0.001) as well as less ACS-related total cost (￥9,759 vs. ￥10,374, P=0.005). GLM result also indicated that OMT was associated with lower ACS-related total cost (coefficient: -0.12, P=0.039). Hospitalization cost was the driver even after index discharge. OMT at discharge was associated with less hospitalizations and lower costs. Further strategies are needed to improve the optimal medical care of ACS.

Objective: To explore the role of miR-202 in multiple myeloma (MM) cells, and study the regulation of miR-202 on drug sensitivity of MM cells. Methods: miR-202 and BAFF mRNA levels were detected by real-time PCR. U266 cells were transfected with miR-202-mimics, miR-202-inhibitor, siBAFF and their negative controls. After above treatments, protein levels of Bcl-2 family and MAPK signaling pathway were detected by Western blot analysis, and the proliferation and apoptosis ability of MM cells were examined by WST-1, Annexin V-FLUOS assay, respectively. Results: The results showed that the expression of miR-202 in CD138+ MM cells (0.304±0.354) and U266 cells (0.052± 0.009) were lower than in normal controls (3.550 ± 1.126) (P<0.001, P=0.009), whereas BAFF mRNA levels (5.700 ± 0.734, 9.576 ± 2.887) were higher than in normal controls (1.819 ± 0.853) (P<0.001, P= 0.006). The proliferation ability of U266 cells transfected with miR-202 mimics was significantly inhibited than in control group [(56.04±0.021)% vs (18.89±0.32)%, P=0.002]. The result of Western blot showed that the expression of Bcl-2 decreased by about 24%, and the expression of Bax increased by about 124% in cells transfected with miR-202 mimics. The apoptosis rate in cells transfected with miR-202 mimics was significantly more than in control group [(49.60±4.89)% vs (26.20±1.28)%, P=0.029]. The apoptosis rate in miR-202 mimics combined with Bort group (51.23±5.41)% was higher as compared with Bort treatment alone (31.70±4.40)% or miR-202 mimics control combined with Bort group (27.94±4.04)%, (P=0.047, P= 0.028), whereas the apoptosis rate in miR-202 mimics combined with Thal or Dex had no significant difference compared with miR-202 mimics control [(11.66±1.91)% vs (10.63±1.74)%, P=0.700; (16.35± 1.32)% vs (17.43 ± 1.95)%, P=0.400]. The inhibitory rate of cell growth in miR-202 mimics combined with Bort group was higher as compared with Bort treatment alone [(36.93±5.98)% vs (18.18±4.10)%, P= 0.029]. The expressions of p-JNK protein decreased in U266 cells transfected with miR-202 mimics and treated with Bort. Conclusion: miR-202 mimics combined with Bort could inhibit proliferation and induce apoptosis of U266 cells through negative regulating target gene BAFF, which further inhibited the JNK/SAPK signaling pathway.

Nanocomposites of polyphenylene oxide (PPO) that are obtained through modification of PPO have been used for a few decades and are well established among engineering plastics. Modified PPO (MPPO) is known for its higher heat resistance, higher thermal and dimensional stability, better gas permeability, and lower water absorption. Because of these attractive performances, the research on PPO nanocomposites has surprisingly blossomed during recent decades, and many practical materials based on MPPO with potential applications in gas separation and in automotive and battery industries have been generated. In this chapter, we give a systematic, balanced, and comprehensive summary of the main aspects of these nanocomposites with PPO related to its synthesis methodologies, filler–polymer compatiblization, thermal and dimensional stability, phase and surface morphology, and its applications in different areas.