Construction of spvD gene deletion mutant and compensation strains in Salmonella enteritidis and its effects on Caco-2 cells / 中华预防医学杂志

Objective: To analyze the effects of spvD gene on invasion and intracellular proliferation of Caco-2 cells and in order to provide insight into the function of that gene and the underlying mechanism of Salmonella caused infection. Methods: Functional verification of spvD gene deletion mutant and compensation strain. The deletion mutant strain was constructed through a suicide plasmid-mediated homologous recombination. The compensation plasmid constructed by cloning the coding sequence of spvD by PCR into plasmid pBAD33 was mobilized into the deletion mutant by conjugation and the pBAD33 was introduced into wild strains and deleted mutant strains as control. The relative expression of spvD mRNA was detected by quantitative reverse transcription PCR. In order to analyze the virulence of spvD against Caco-2 cells, Caco-2 cells was cocultured with wild type Salmonella enteritidis carrying spvD gene, the deletion mutant strain and compensation strain respectively. The expression level of spvD mRNA and the the number of Salmonella enteritidis after Caco-2 cells intervention were compared between the three groups by LSD-t test, and the invasion rate was compared by χ2 test. Results: The expression level of spvD mRNA in wild type Salmonella enteritidis was set as unit "1", the deletion mutant strain was "0.00", and the compensation strain was "2.60" (LSD-twild, deleted=1.11, P=0.31; LSD-twild, compensation=-1.77, P=0.13; LSD-t deleted, compensation=-2.88, P=0.03), which confirmed the successful construction of the deletion mutant strain and the compensation strain. The invasion experiment results of the above three Salmonella enteritidis strains on Caco-2 cells showed that the invasion rate of wild strain was 0.23%, the invasion rate of deleted mutant strain was 0.16%, and the invasion rate of compensation strain was 0.16%, with no statistical significance (χ2=1.13, P=0.570). By comparing the number of Salmonella enteritidis at different time points after Caco-2 cells intervention, it was discovered that the number of Salmonella enteritidis in wild strains (6.50×106 CFU/ml) and compensation strains (7.25×106 CFU/ml) was significantly increased than that in deletion mutant strain (1.90×106 CFU/ml) after 16 h coculture (LSD-twild, deleted=7.95, P=0.00; LSD-twild, compensation=-1.27, P=0.25; LSD-t deleted, compensation=-9.22, P=0.00). Conclusion: It is not considered that spvD gene can affect the invasion of Salmonella enteritidis on Caco-2 cells, but the gene can promote the reproduction of Salmonella enteritidis in Caco-2 cells.

Clinical trials and evaluation of Chinese patent medicine for stroke / 中国中药杂志

To systematically collect and analyze clinical randomized controlled trial(RCT) of Chinese patent medicine treatment for stroke in 2020, in order to provide basic information for clinical decision-making and related research. On the basis of the collection in the Traditional Chinese Medicine(TCM) Clinical Evidence Database System(EVDS), CNKI, Wanfang, SinoMed, Cochrane Library, PubMed, EMbase were searched for RCTs of Chinese patent medicine for stroke in 2020. The publication, sample size, intervention and control measures, course of treatment, outcome indicators, methodological quality and other contents were statistically analyzed.A total of 68 RCTs studies on Chinese patent medicine for stroke were included in 2020, of which 29(42.60%) were RCTs with sample size>100 cases. A total of 41 kinds of proprietary Chinese medicines were involved, including 23 kinds of oral proprietary Chinese medicines and 18 kinds of injections. A total of 18 intervention/control cases were included in RCTs, and 19 cases(Chinese patent medicine+Western medicine vs Western medicine) were applied in RCTs, accounting for 27.90%. The duration of treatment was reported in 91.18% of the studies, and the intervention duration was 8-14 days in 50.00% of the studies. Evaluation indexes were widely used, among which physical and chemical testing indexes(49.36%) were the most widely used. According to the methodological quality evaluation, the overall methodological quality of the study is not high, especially the implementation of the allocation hidden, blind method is not accurate, and the registration, ethics and other links are often missing. In conclusion, 2020 implementation of proprietary Chinese medicine in the treatment of stroke research methodology problems is outstanding, the similar function scale large range of optional, no specification selection criteria, reliability and practicability of the impact study, need to further standardize the proprietary Chinese medicine in the treatment of stroke study design, implementation and quality control, and highlight the value of proprietary Chinese medicine in the treatment of stroke and improve the quality of the evidence.

Clinical evidence analysis report of Chinese patent medicine in 2020 / 中国中药杂志

The present study collected, collated, analyzed, and evaluated randomized controlled trial(RCT) of Chinese patent medicine published in Chinese and English journals in 2020, and summarized clinical evidence of Chinese patent medicine in stages, providing references for follow-up clinical research and evidence transformation and application. On the basis of the collection in the Traditional Chinese Medicine(TCM) Clinical Evidence Database System(EVDS), CNKI, Wanfang, SinoMed, Cochrane Library, PubMed, and EMbase were searched for RCTs of Chinese patent medicine published in 2020, and their research characteristics and methodological quality were analyzed and evaluated. A total of 1 285 research papers on Chinese patent medicine(1 257 in Chinese/28 in English) were included, involving 146 054 patients and 639 Chinese patent medicines, including 526 oral drugs, 68 injections, and 45 external drugs. A total of 412 diseases in 23 types were involved, which were dominated by circulatory system diseases and respiratory system diseases, specifically, cerebral infarction and angina pectoris. The sample size ranged from 20 cases to 2 673 cases, and 57.67% of RCTs had samples sizes less than 100. Single-center trials were the main ones, and multi-center trials only accounted for 4.75%(n=61). In terms of methodological quality, 52.91% of the RCTs had unclear descriptions or incorrect application of randomization methods, and the implementation of allocation concealment and blinding methods has not been paid much attention. In conclusion, compared with the conditions in 2019, the number of RCTs published in 2020 has decreased, and the research interest in respiratory diseases has increased, while the quality control in the process of research design and implementation has not been improved. Therefore, it is necessary to strengthen the methodological training of researchers and promote the output of high-quality research evidence.

Current application of chimeric antigen receptor T cell immunotherapy and related laboratory examinations / 中华检验医学杂志

Chimeric antigen receptor (CAR)-T cell immunotherapy is a revolutionary advancement in cancer treatment, and is highly effective in treatment of B cell leukemia, lymphoma, and multiple myeloma. However, it has some deficiencies such as antigen escape, antigen heterogeneity, toxic and side effects, which also pose challenges for therapy of other hematological malignancies and solid tumors. Comprehensive and continuous laboratory monitoring before and after CAR-T cell immunotherapy plays an important role in early warning of toxic and side effects, as well as theraputic evaluation. In the future, new breakthroughs for tumor therapy. Should be focused on improving CAR-T cells design, enhancing their anti-tumor activity, and optimizing therapeutic regimen.

Supplementing massage with dry needling can better relieve facial pain / 中华物理医学与康复杂志

Objective:To observe any effect of dry needling of myofascial trigger points on substance P and synaptophysin expression in the spinal dorsal horn.Methods:Sixty-four Sprague-Dawley rats were randomly divided into a control group ( n=16) and a model group ( n=48). Myofascial trigger points were induced in the model group by a blunt strike and eccentric running. That group was then randomly divided into a no-treatment group ( n=15), a massage group ( n=16), and a dry needling group (16 rats). The rats in the two treatment groups received 4 weeks of dry needling or Chinese massage. Pressure pain thresholds were recorded before the experiment and after the 4 weeks. The content of substance P and synaptophysin in the spinal dorsal horn were measured using immunoblotting and immunohistochemistry. Results:After the treatment 14 rats (93%) in the model group had trigger points, significantly higher than the 8 rats (50%) in the massage group and the 7 rats (44%) in the dry needling group. After treatment, the average pressure pain thresholds of the no-treatment and massage groups was significantly lower than the control group′s average, while the difference between the dry needling group and the control group was not significant. The average pressure pain threshold had improved significantly in the no-treatment group, the massage group and the dry needling group, and the averages of the massage group and the dry needling group were significantly higher than that of the no-treatment group. The level of substance P was significantly higher in the no-treatment group than in the other three groups and the ratio of substance P to Glyceraldehyde 3-phosphate dehydrogenase (GAPDH)was significantly higher. The substance P: GAPDH ratio of the massage group was significantly higher than that of the control group.Conclusions:Dry needling and massage are effective in relieving myofascial pain, at least in rats. Both can reduce the content of substance P in the spinal dorsal horn.

Spatio-temporal aggregation of hemorrhagic fever with renal syndrome in Shandong Province from 2017 to 2020 / 中华地方病学杂志

Objective:To study the epidemiological characteristics and spatio-temporal aggregation of hemorrhagic fever with renal syndrome (HFRS) in Shandong Province, and to provide reference for formulating reasonable prevention and control strategies.Methods:Retrospective analysis was used to collect HFRS surveillance data and confirmed case data in Shandong Province from 2017 to 2020 in the "China Disease Prevention and Control Information System Infectious Disease Surveillance System". Geoda 1.18 software was used for global and local spatial autocorrelation analysis, SaTScan 9.6 software was used for spatio-temporal scanning analysis, and ArcGis 10.7 software was used for map drawing and visual display.Results:A total of 3 753 cases of HFRS were reported in Shandong Province from 2017 to 2020, including 56 deaths. The annual incidence rate was 1.26/100 000, 1.22/100 000, 0.75/100 000 and 0.53/100 000, respectively, with an average annual incidence rate of 0.94/100 000. The incidence of HFRS was obviously seasonal, mainly concentrated in autumn and winter from October to December, accounting for 50.41% (1 892/3 753). The age of onset was mainly 30-59 years old, accounting for 61.68% (2 315/3 753). The male to female ratio was 2.76 ∶ 1.00 (2 756 ∶ 997). The occupation distribution was mainly farmers, accounting for 81.99% (3 077/3 753). The global spatial autocorrelation analysis showed that HFRS showed spatial aggregation areas in each year from 2017 to 2020 (Moran' I = 0.38, 0.33, 0.59, 0.46, Z = 7.47, 7.23, 10.69, 8.66, P < 0.001). The local spatial autocorrelation analysis showed that "high-high" aggregation areas were mainly concentrated in central and southeast of Shandong Province, while "low-low" aggregation areas were mainly concentrated in northwest of Shandong Province. Spatio-temporal scanning analysis revealed 1 type Ⅰ agglomerations and 2 type Ⅱ aggregation areas. The type Ⅰ aggregation areas occurred from October to November 2018, covering 22 counties (districts) of 5 cities in Qingdao, Yantai, Weifang, Weihai and Rizhao. The first type Ⅱ aggregation area occurred from October to November 2017, involving 23 counties (districts) of 8 cities in Jinan, Zibo, Zaozhuang, Weifang, Jining, Tai 'an, Rizhao and Linyi. The second type Ⅱ aggregation area occurred in Jinxiang County, Jining City from February to March 2017. Conclusion:The incidence of HFRS in Shandong Province from 2017 to 2020 has obvious spatio-temporal aggregation, and the hot spots are concentrated in central and southeast of Shandong Province, which should be regarded as a key area for prevention and control of HFRS.

Biomechanical Characteristics of Lower Limbs for the Youth with Different Body Mass Index Performing Baduanjin Exercise Based on AnyBody Simulation / 医用生物力学

Objective To compare the biomechanical characteristics of lower limbs of young people with different body mass index (BMI) before and after the intervention of Baduanjin exercise, so as to provide references for scientific exercise and sport prescription for young Baduanjin practitioners with different BMIs. Methods Young volunteers with different BMI were divided into standard group, overweight group and obesity group. The BTS SMART 3D infrared motion capture system was used to capture the motion parameters and electromyography (EMG) parameters, the KISTLER dynamometer was used to collect the dynamic parameters, the AnyBody simulation software was used to calculate the kinematic parameters and dynamic parameters, and BTS SMART Analyzer was used to compare the different integral electromyography values. Results There was no significant difference in each parameter before the intervention of Baduanjin. After the intervention, the angle and angular velocity of the knee joint during extension and flexion in standard group, overweight group and obesity group, and the angular acceleration of the knee joint during extension and flexion in standard group significantly increased. Baduanjin significantly increased the knee flexion force and moment in standard group, overweight group and obesity group, and increased the hip flexion force and moment as well as ankle metatarsal flexion force and moment in standard group. Compared with obesity group, the knee flexion force and moment in standard group were significantly different. The knee joint force and moment were positively correlated with BMI. Baduanjin significantly increased muscle strength of iliopsoas, gluteus medius, piriformis, gluteus maximus, rectus femoris, sartorius, tibialis anterior, biceps femoris longhead, flexor digitorum longus, flexor pollicis longus, musculus peroneus longus and musculus peroneus brevis. Baduanjin significantly increased the integrated electromyogram (iEMG） of rectus femoris, tibialis anterior, biceps femoris. Conclusions Baduanjin can improve muscle strength and neuromuscular control ability of young people. The larger the BMI, the greater the flexion force and moment of the knee joint.

Randomized controlled trials of acupuncture and moxibustion in China in past 45-year (1975-2019): hotspots and trends / 中国针灸

By searching the randomized controlled trials (RCTs) of acupuncture and moxibustion from CNKI since its inception date to december 31 of 2019, the development status and hot trend of RCTs of acupuncture and moxibustion in China were summarized. The CiteSpace and VOSviewer software were used to perform keyword co-occurrence analysis, clustering analysis, time-zone analysis and citation-burst analysis, and visual map was drawn. As a result, a total of 60 995 articles were included, which were published in 1027 academic journals with 1787 keywords. The publication date was from 1975 to 2019. During the past 45 years, the publications of RCTs on acupuncture and moxibustion had shown an overall growth trend with characteristics of the times. The RCTs of manual acupuncture ranked the top, and its proportion of publications every 5 years was stable in the past 30 years. Since 1994, the hot words such as electroacupuncture, warming needling, auricular point sticking and various acupoint therapies had emerged; meanwhile, the spectrum of diseases had broadened, and an evolutionary trend corresponding to therapies and disease systems had been formed. In recent decade, the RCTs using moxibustion therapy have increased significantly, and the hot words such as "sub-health" "winter diseases being treated in summer" and "acupoint application/ moxibustion during the dog days" had indicated that acupuncture clinical research was further inclined to the field of chronic disease prevention and health services, which was in line with social development and the needs of the times.

Characteristics of Different Tai Chi Step Types Based on AnyBody Simulation / 医用生物力学

太极拳； AnyBody仿真； 下肢； 动力学； 运动学

Progress in Gait Measurement and Evaluation: Application of Gait Index (review) / 中国康复理论与实践

The objective data from the three-dimensional gait analysis equipment test is complex and difficult to explain in the actual evaluation. In order to solve it, the gait index is proposed. The purpose of this review is to analyze the most commonly used gait evaluation index in clinical practice and discuss its calculation methods, advantages and limitations. The results showed that Gait Deviation Index (GDI) and Gait Profile Score (GPS) were the two most widely used indexes, but the operation of GDI was complex; the selection of parameters of Gillette Gait Index (GGI) was poor in objectivity, and the application was limited; the electromyography data is very important in the complete evaluation of gait mode, but the combination with gait indices was not close at present. The influence of gait speed has not been discussed in researches about indices except GGI.

Biomechanical characteristics on ball games for male youth with different body mass index based on anybody simulation and electromyogram test / 中国组织工程研究

BACKGROUND: Anybody’s musculoskeletal modeling system simulates the relationship between human skeleton, muscle and environment by using mathematical modeling technology. It can study the reverse dynamics of human body and obtain the maximum muscle strength of three lower limb joints. OBJECTIVE: To study the lower extremity muscle strength values of 24 male college students with different body mass indexes in one cycle of sitting Swiss ball, and to compare the mean root-mean-square of the subjects in sitting Swiss ball and bench. METHODS: Twenty-four male college students were divided into normal group, overweight group and obesity group according to body mass index. BTS 3D infrared motion capture system, Kistler 3D dynamometer and BTS surface electromyography system were used to record the dynamic and electromyographic parameters simultaneously. The differences in muscle force and electromyographic parameters between different groups were qualitatively compared by one-way analysis of variance, and the mean differences were compared by quantitative difference analysis. RESULTS AND CONCLUSION:(1) In terms of muscle strength, from sitting to standing, compared with the obese group, the normal group showed significant differences in rectus femoris, semimememial muscle, biceps femoris longhead, popliteal muscle, soleus muscle and tibial anterior muscle (P < 0.05, 0.47 ≤ QD < 0.80), and the quadratus femoris muscle and pectineus muscle showed significant differences (P < 0.01, QD ≥ 0.80). There was a significant difference in muscle strength of quadratus femoris between the obese group and the overweight group (P < 0.05, 0.47 ≤ QD < 0.80). From standing to sitting, there were significant differences in muscle strength of sartorus, extensor pollicis, and gastrocneum between the normal group and the obese group (P< 0.05, 0.47 ≤ QD < 0.80). (2) In terms of root-mean-square electromyogram value, from sitting to standing, the biceps femoris and gastrocnastus muscles in the normal group were significantly different from those in the obese group (P < 0.05, 0.47 ≤  QD < 0.80); from standing to sitting, rectus femoris muscles in the normal group were significantly different from those in the obese group (P < 0.05,  0.47 ≤ QD < 0.80). In the Swiss ball sitting state, from sitting to standing, the tibial anterior muscle and biceps femoris were significantly different between the normal group and the obese group (P < 0.05, 0.47 ≤ QD < 0.80). From standing to sitting, the electromyogram values of gastrocnemius muscle and right erector spine muscle were significantly different between the normal group and the obese group (P < 0.05, 0.47 ≤ QD < 0.80). These findings indicated that (1) In each group of BMI, the dominant muscle generation from sitting to sitting was gluteus medius muscle, vastus lateralis muscle, biceps longus muscle, rectus femoris muscle, gastrocnemius muscle, tibia anterior muscle and soleus muscle; and from standing to sitting, gluteus medius muscle, vastus lateralis muscle, biceps longus muscle, gastrocnemius muscle, tibia anterior muscle and soleus muscle. (2) Compared with the sitting stool, the subjects had higher root-mean-square of tibial anterior muscle, rectus femoris muscle, biceps femoris muscle and gastrocnemius muscle when sitting Swiss ball.

Preliminary establishment of reference interval for non-fasting serum triglycerides among healthy middle-aged and elderly people in some communities Beijing / 中华检验医学杂志

Objective:To establish the reference interval of serum triglyceride (TG) for 4 hours after meal in healthy middle and old people of Beijing community, and to provide the diagnostic basis for the judgment of dyslipidemia after meal.Methods:Selected 369 elderly people from January to October 2018 in the health examination of Guang′anmen Hospital of the Chinese Academy of Traditional Chinese Medicine. The subjects collected fasting venous blood samples in the morning the next day after fasting for 12 hours, then ate a standard breakfast that conformed to the local dietary habits, and collected venous blood samples again 4 hours after eating. Serum TG levels were measured 4 h after meal using AU5822 fully automatic biochemical analyzer and matching reagents. The comparison of postprandial TG between different age and sex groups was statistically significant using the nonparametric test of two independent samples, and the comparison between postprandial and fasting TG using the nonparametric test of two paired samples with P<0.05 as the difference. The 95% confidence interval was calculated using a nonparametric method according to the relevant requirements of the CLSI EP28-A3c file, and the reference interval was expressed as P2.5, P97.5. Results:The median 4-hour post-prandial TG of the middle-aged and elderly aged 45-59 years and those aged ≥ 60 years at health checkups were 1.65 (1.25, 2.13) mmol/L and 1.58 (1.25, 2.00) mmol/L, there was no significant difference between the two groups ( Z=-1.040, P>0.05). There was no statistical difference between males 1.69 (1.22, 2.31) mmol/L and females 1.63 (1.26, 2.12) mmol/L at 4 hours postprandial TG levels in the 45-59 year-old group ( Z=-0.179, P>0.05),there was also no statistical difference between 1.64 (1.22, 2.06) mmol/L for men and 1.53 (1.28, 1.99) mmol/L for women aged 60 years or older ( Z=-0.256, P>0.05).Compared with the median fasting TG of 1.05 (0.87, 1.29) mmol/L, the median serum TG of 1.61 (1.25, 2.09) mmol/L at 4 hours after meal was significantly increased ( Z=-16.449, P<0.01). The difference between postprandial and fasting was 0.52 (0.30, 0.85) mmol/L.The reference range of serum TG at 4 hours after meal was 0.82 to 3.02 mmol/L. Conclusion:In this study, the reference range of serum triglycerides for 4 hours after meal was established in some healthy elderly population groups in Beijing.

Advance in Gait Stability, Gait Assessment and Fall Risk in Old Adults (review) / 中国康复理论与实践

It is important to predict fall risk for the old adults. Gait and imbalance are generally considered as the greatest risk for falls. Largest Lypunov Exponent (LyE) reflects the gait stability, and it needs to improve in standardization and acceptable algorithms for clinical use. Gait indices are correlated with each other, with their own advantages and limitations. Gait Deviation Index is representative and reliable, and easy to calculate. Gait variability can predict the possibility of falls in the old adults. The combination of all the indices may improve the accuracy of falls risk prediction for the old adults.

Prediction of syncope with nonlinear dynamic analysis during head-up tilt in vasovagal syncope patients / 北京大学学报(医学版)

OBJECTIVE@#To quantify the relationship between cerebral blood flow velocity and peripheral blood pressure during hypotension period, aiming to predict the brain hypotension before symptomatic occurrence.@*METHODS@#Twenty vasovagal syncope (VVS) patients who had a previous clinical history were selected in groups and 20 pair-matched control subjects underwent 70° tilt-up test. The subjects remained supine for 30 minutes before recordings when Doppler probes, electrodes and Finapres device were prepared. After continuous baseline recordings for 10 min, the subjects underwent head up tilt (HUT) test (70°), and were standing upright for 30 minutes or until syncope was imminent. For ethical reasons, the subjects were turned back to supine position immediately after SBP dropped to ≥20 mmHg, when their consciousness persisted. The point of syncope was synchronized for all the subjects by the point SBP reached the minima. Their beat-to-beat blood pressures (BP) were recorded continuously and bilateral middle cerebral artery (MCA) flow velocities were obtained with two 2 MHz Doppler probes from a transcranial Doppler ultrasonography (TCD) system. A nonlinear dynamic method--multimodal pressure flow (MMPF) analysis was introduced to access cerebral autoregulation during different time intervals. We introduced a new indicator--syncope index (SI), which was extracted from blood flow velocity (BFV) signal to evaluate the variation of cerebral vascular tension, and could reflect the deepness of dicrotic notch in BFV signal.@*RESULTS@#Compared with the syncope index of the baseline value at the beginning of the tilt test, SI in VVS group showed significantly lower when the VVS occurred (0.16±0.10 vs.0.27±0.10,P<0.01),while there was no significant difference in syncope index between the control group at the end of the tilt test and the baseline value at the beginning of the tilt test. For those VVS patients, pulse index and resistance index had no significant change. Syncope index decreased significantly 3 minutes before the point of syncope (0.23±0.07 vs.0.29±0.07,P<0.01).@*CONCLUSION@#Dynamic regulation is exhausted when vasovagal syncope occurred. Tension decrease of small vessels could have some relationship with loss of the cerebral autoregulation capability. The proposed syncope index could be a useful parameter in predicting syncope of VVS patients since it decreased significantly up to 3 minutes earlier from the point of syncope.

Comparison and evaluation of laboratory test techniques for severe fever with thrombocytopenia syndrome / 中华实验和临床病毒学杂志

Objective@#Compare the detection result of blood samples of severe fever with thrombocytopenia syndrome (SFTS) patients using different detection techniques, and observe the dynamic characteristics of the virus specific RNA, IgM antibody and IgG antibody, to provide theoretical basis for selection of diagnostic methods of disease.@*Methods@#Acute phase serum of suspected SFTS cases and convalescent serum samples of lab-confirmed cases were collected. Real-time fluorescence quantitative PCR and enzyme-linked immunosorbent assay (ELISA) were used to detect the virus specific RNA, IgM antibody and IgG antibody. The detection results of different methods, the relationship between positive results and the acquisition time, and the dynamic characteristics of viral nucleic acid and antibodies were analyzed.@*Results@#A total of 87 serum samples of the suspected SFTS patients were collected, the positive rate of virus specific RNA, IgM antibody and IgG antibody were 53.41%, 31.03% and 3.41%, respectively. Among 55 confirmed cases of SFTS, the consistent rate of virus specific RNA and IgM antibody detection methods was 36.36%, and the difference between the two methods was significant (χ2=6.82, P=0.009), kappa=-0.257. The sampling intervals of RNA positive samples were all within 12 days, of which the positive detection rate was highest after 7-9 days, and the difference was statistically significant (χ2=10.35, P=0.016). In 34 SFTS convalescent serum samples, all the nucleic acid tests were negative, the positive rate of IgM antibody was 41.18%, which was not significantly different from the acute phase serum samples (P=1.00). The positive rate of IgG antibody was 94.12%, which was significantly higher than that of acute IgG antibody (0%). The dynamic characteristics of IgM and IgG antibody showed that IgM antibody could be detected on the second day after onset, the latest detection time was 74 days after onset, and the highest absorbance value and antibody detection rate occurred in 30-60 days. The earliest detection time of IgG antibody was 12 days after onset, and the last detection time was 100 days.The detection rate of IgG antibody and absorbance value increased rapidly after 30 days, and maintained in a high level. The detection rate of IgG antibody was 100% in 30-60 days.@*Conclusions@#Blood samples taken from SFTS suspected patients within two weeks of onset may be prioritized for detection of viral nucleic acids using Real-time fluorescence PCR or for detection of IgM antibodies by ELISA. Although IgM antibody can be detected 2 days after the onset, the peak appeared much later, so the negative result can’t rule out the diagnosis. IgG antibody has a high seroconversion rate in convalescent samples, and can be used as an auxiliary tool for disease diagnosis.

Survey of RBRVS-based performance appraisal methods at 12 public hospitals / 中华医院管理杂志

Objective To learn the initial application of RBRVS related performance appraisal at public hospitals in China. Methods 12 tertiary public hospitals which took the lead to introduce RBRVS models, via third-party cooperation, in medical stuff performance assessment over one year were surveyed. The study summarized their design emphases of RBRVS performance appraisal, covering such aspects as appraisal level, accounting method, conceptual design, points setup and items charged as cost. Descriptive statistics was used to analyze the data so acquired. Results As shown in the performance appraisal level, most hospitals were found with defects in refining levels, as eight hospitals only appraise down to the department level, three to diagnostic group level, and only one hospital to individuals. Of these hospitals, over eight hospitals used RBRVS to elevate the efficiency and inventiveness of employees, while half of these hospitals reported the method can improve service, reduce cost and enhance quality of care. Conclusions Public hospitals enjoy advantages via third-party cooperation RVRBS method in RVRBS-related reforms. Introduction of this method calls for localization design based specifics and management goals of public hospitals.

RBRVS-based performance appraisal: application at a hospital / 中华医院管理杂志

With the resource based relative value scale (RBRVS) application at a hospital cited as an example, the paper covered its use in performance appraisal for optimal performance-based distribution as follows. In view of hospital specifics, such appraisal indexes as the quantity, quality, technical difficulty and cost control are quantified as key indicators, to form its own RBRVS scores and weights. In combination of the case mixed index as well, such factors as specific appraisal, quality of care and research/teaching work are taken into account for the purpose of rational and optimal pay for performance.

Effect of phage lysin on infection and biofilm formation in rabbit after knee joint prosthesis implantation / 中华骨科杂志

Objective To investigate the effect of local injection of phage lyase LysGH 15 into rabbits' knee joint on the systemic inflammation,local infection around knee joint prosthesis and biofilm formation on the prosthesis surface after their knee joint prosthesis implantation surgeries.Methods Models of Staphylococcus aureus infection on rabbits' knee joint prosthesis after prosthesis implantation were built and divided into experimental group for intra-articular injection with lyase and control group for injection with saline into their joint cavity.The phage lysin LysGH15 was synthesized and purified.On the 1st,2nd and 3rd day after the inoculation with Staphylococcus aureus bacteria into the rabbits' knee joint cavity of the prosthesis implanted side,0.5 ml diluted solution of LysGH15 was injected into the knee joint cavity with infection around the prosthesis for the experimental group rabbits and 0.5 ml saline was injected into the corresponding joint cavity for control group rabbits as blank contrast.On the 1st,3rd,7th and 14th day,blood samples were collected from their ear vein to make plasma procalcitonin test for evaluation of rabbits' systemic infection.After the last time for collection of venous blood samples,these rabbits were killed instantly and their knee joints of prosthesis implantation side were dissociated.Tissue around the prosthesis was processed with HE staining to observe and evaluate the local infection and tissue necrosis around the prosthesis.The biofilm formation on the prosthesis surface was evaluated with semi quantitative method after the observation of samples under scanning electron microscope (SEM).Results After the injection of LysGH15 in experimental group,their serum procalcitonin level,which worked as the systemic inflammatory marker,decreased rapidly especially on the 3rd day after lysin injection.Compared with the control group,the infection degree of experimental group significantly decreased.In the experimental group,the infection and necrosis degree of the tissue surrounding the prosthesis were significantly lower in the experimental group than those in the control group.The semi quantitative scores were conducted for these samples and graded to make rank sum test.The difference between the two groups was statistically significant (U=2.4948,P=0.0126).There was a statistically significant difference in the rank sum test between the two groups in the quality of biofilm formation (U=2.2539,P=0.0242).Conclusion Phage lysin LysGH15 can alleviate the rabbits'systemic inflammation caused by Staphylococcus aureus bacteria after their knee joint prosthesis implantation,reduce the extent of damage caused by infection and inflammation to the tissue around the prosthesis,and inhibit the formation of bacterial biofilm on the surface of implanted prosthesis.

Evaluation of early macular retinal microcirculation in diabetic patients using optical coherence tomography angiography / 眼科新进展

Objective To observe the early changes in the area of the foveal avascular zone (FAZ) and macular vascular density (MVD) in diabetic patients using optical coherence tomography angiography (OCTA) and its clinical significance.Methods This was a retrospective study.Totally 33 patients with diabetes mellitus were enrolled,including 13 patients with no-diabetic retinopathy (NDR group) and 20 patients with nonproliferative diabetic retinopathy (NPDR group) according to the international clinical grading criteria of diabetic retinopathy.Additional 26 healthy subjects with matched age were enrolled in the control group.All the subjects underwent the 3 mm ×3 mm scanning of macular retina by OCTA for obtaining 4 levels of macular vascular density map.And the area of the FAZ and the MVD were measured.Results The area of FAZ was(0.392 ± 0.028) mm2 in the NDR group and (0.410 ± 0.019) mm2 in the NPDR group,respectively,and the difference was statistically significant compared with the control group (0.314 ± 0.025) mm2 (all P =0.000),and there was statistically significant difference between the NDR group and NPDR group (P =0.010).The MVD in the superficial retinal layer,deep retinal layer,outer retinal layer and choroidal capillary layer was 0.500 ±0.012,0.553 ±0.007,0.393 ±0.005,0.651 ±0.006 in the NDR group,and 0.484 ± 0.012,0.522 ± 0.007,0.397 ± 0.007,0.642 ± 0.007 in the NPDR group,respectively,and the difference was statistically significant compared with the control group (0.518 ±0.014,0.572 ±0.008,0.385 ±0.005,0.666 ±0.007) (all P =0.000);there were statistically significant differences in MVD between the NDR group and NPDR group in the superficial retinal layer,deep retinal layer and choroidal capillary layer (all P =0.000),but not in the outer retinal layer (P =0.065).Conclusion OCTA suggested that the early retinal microcirculation impairment in the macula in patients with diabetes,which changes with the progression of the disease.

Efficacy of intravitreal ranibizumab combined with laser photocoagulation for the treatment of macular edema induced by ischemic branch retinal vein occlusion / 眼科新进展

Objective To observe the therapeutic efficacy of intravitreal ranibizumab combined with laser photocoagulation for the treatment of macular edema associated with ischemic branch retinal vein occlusion (BRVO).Methods Together 60 patients (60 eyes) with BRVO in Anshan City Central Hospital were included and divided into three groups,20 patients with intravitreal ranibizumab treatment as A group,20patients with retinal laser photocoagulation treatment as B group,and another 20 patients with intravitreal ranibizumab combined with retinal laser photocoagulation therapy as C group,followed by the preoperative observation of the best corrected visual acuity (BCVA),slit lamp,fundus and intraocular pressure examination,fundus fluorescein angiography (FFA),optical coherence tomography (OCT).One day after the surgery,BCVA,slit lamp and intraocular pressure examination were conducted,and 1 month,2months,3 months after the surgery,observation of BCVA,slit lamp,fundus and intraocular pressure examination were performed.Then,OCT was used to determine the status of macular edema.And finally,BCVA and central macular thickness (CMT) in the three groups were statistically analyzed by observing the above indicators.Results The BCVA at 1 month,2 months,and 3 months after treatment was higher than before treatment in all three groups,and the differences were statistically significant (all P ＜ 0.05).The BCVA of A group was 0.26 ±0.14 and 0.26 ±0.14 at 2 and 3 months after treatment,respectively,which was significantly better than that of B group (0.39 ±0.10 and 0.40 ±0.10) (all P ＜0.05).At 3 months after treatment,the BCVA in C group was 0.14 ±0.11,which was significantly higher than that in A group (0.26 ±0.14) (P＜0.05).The BCVA of C group was 0.30 ±0.13,0.20 ±0.12,0.14 ± 0.11 at 1 month,2 months and 3months after treatment,respectively,which was better than that of B group (0.43 ±0.10,0.39 ± 0.10,0.40 ± 0.10),and the differences were statistically significant (all P ＜0.05).The postoperative CMT was significantly reduced when compared with preoperation in all three groups (all P ＜ 0.05).The CMT at 1 month,2 months and 3 months after treatment in C group was (318.85 ± 71.48)μm,(287.15 ± 56.71) μm and (255.05 ± 60.90)μm,respectively,which was better than that in A group [(347.00 ± 67.59) μm (305.10 ± 47.44) μm and (282.40 ± 36.26) μm],and B group [(417.05 ± 63.94) μm,(394.80 ±57.18) μm,and (375.90 ± 55.10) μm],with significant differences (all P ＜ 0.05).At 2 months and 3 months after treatment,CMT in A group was better than that in B group,and the difference was statistically significant (P ＜ 0.05).Conclusion The efficacy of retinal laser photocoagulation combined with intravitreal ranibizumab in the treatment of BRVO macular edema is better than simple retinal laser photocoagulation and simple intravitreal ranibizumab.