Seroprevalence of neutralizing antibody among SARS-CoV-2 infected individuals / 预防医学

Objective@#To investigate the seroprevalence and influencing factors of serum neutralizing antibodies among SARS-CoV-2 infected individuals, so as to provide the evidence for developing the health management and COVID-19 vaccination strategy among SARS-CoV-2 infected individuals.@*Methods@#Recovered SARS-CoV-2 infected individuals from January 1st, 2020 to February 10th, 2021 in Zhejiang Province were recruited in March 2021. Participants' demographics, underlying diseases, date of definitive diagnosis and severity of clinical symptoms were collected using questionnaire surveys, and serum neutralizing antibody against SARS-CoV-2 was detected using a fluorescent immunoassay. In addition, factors affecting the seropositivity of neutralizing antibody against SARS-CoV-2 were identified using a multivariable logistic regression model. @*Results@#A total of 559 SARS-CoV-2 infected individuals were enrolled, including 480 confirmed cases and 79 asymptomatic carriers, with an median (interquartile range) age of 47.00 (22.00) years, and all participants had never received COVID-19 vaccination. The median (interquartile range) duration from diagnosis to serum sampling was 387.00 (11.00) days, and the seroprevalence of neutralizing antibody against SARS-CoV-2 was 83.90%. The serum neutralizing antibody against SARS-CoV-2 was all positive 9 months after diagnosis, and the seroprevalence of neutralizing antibody against SARS-CoV-2 appeared no tendency towards a decline with time within 14 months after diagnosis (P>0.05). Multivariable logistic regression analysis showed that women were 1.892 times (95%CI: 1.169-3.064) more likely to produce serum neutralizing antibodies against SARS-CoV-2 than men, and mild, common and severe/critically ill SARS-CoV-2 infected cases were 2.438 (95%CI: 1.305-4.557), 4.481 (95%CI: 2.318-8.663), and 23.525 (95%CI: 2.990-185.068) times more likely to produce serum neutralizing antibodies against SARS-CoV-2 than asymptomatic carrier, respectively.@*Conclusions@#The seroprevalence of neutralizing antibody was 100.00% among SARS-CoV-2 infected individuals within 9 months after diagnosis. Individuals' gender and severity of clinical symptoms correlate with the seroprevalence of neutralizing antibody against SARS-CoV-2.

Epidemiological investigation of a case with SARS-CoV-2 infection associated with overseas countries at an international harbor / 预防医学

Objective@#To investigate the origin of infection and risk factors of a case with SARS-CoV-2 infection associated with overseas countries in the Ningbo-Zhoushan Port, Zhejiang Province, so as to provide the evidence for improving the COVID-19 control measures at ports.@*Methods@#Ningbo Center for Disease Control and Prevention ( CDC ) and Beilun CDC conducted case finding and epidemiological surveys immediately after being informed. The general information, history of vaccination and the travel during the latest 14 days were collected from the positive case, and all close contacts were tracked. Saliva samples were collected for SARS-CoV-2 nucleic acid testing and whole-genome sequencing, and the sequencing results were aligned with the GISAID's EpiCoV database. The origin of infection and transmission route of the positive case was investigated.@*Results@#A case was identified positive for SARS-CoV-2 nucleic acid during company M's routine screening in the Ningbo-Zhoushan Port on August 10, 2021, and was confirmed positive for SARS-CoV-2 nucleic acid by Beilun CDC and Ningbo CDC on August 11. Whole-genome sequencing showed SARS-CoV-2 B.1.617.2 ( Delta ) variant, which shared the highest homology with the virus sequence uploaded by Russia on June, 2021 ( Russia/MOW-RII-MH27356S/2021 ). The case was a bundling worker for overseas container ships, and reported communicated with foreign boatmen and contacted materials without protected interventions on the SINOKOR AKITA Container Ship between August 4 and 5, 2021. This ship anchored at Vladivostok, Russia from July 27 to 29, anchored at Ningbo Harbor on August 4, and departed on August 5. Then, 11 boatmen from this ship were tested positive for SARS-CoV-2 nucleic acid on August 8. One asymptomatic case was reported in this epidemic; 254 close contacts and 617 secondary close contacts were identified, and all were tested negative for SARS-CoV-2 nucleic acid. No new cases with SARS-CoV-2 infections were detected until August 25, 2021, and the emergency response was therefore terminated.@*Conclusions@#The infection was a sporadic COVID-19 epidemic associated with overseas countries, which was caused by Delta variant infection through contacts with foreign boatmen or materials by a bundling worker in Ningbo-Zhoushan Port; fortunately, no epidemic spread occurred. Intensified closed-loop management and increased frequency of SARS-CoV-2 nucleic acid test among high-risk populations, and improving the precision and rapid emergency treatment of COVID-19 epidemics are required for the containment of COVID-19 at ports.

Influenza-associated excess mortality in Zhejiang Province from 2016 to 2019 / 预防医学

Objective@#To estimate the influenza-associated excess mortality (IEM) in Zhejiang Province from 2016 to 2019, so as to provide insights into estimates of mortality burden due to influenza. @* Methods@#The data pertaining to all-cause death and influenza surveillance in Zhejiang Province from 2016 to 2019 were retrieved from Zhejiang Provincial Cause of Death Registration System and Influenza Surveillance System to create distributed lag non-linear models (DLNMs). The year-, influenza subtype- and age-specific IEM rates were estimated.@*Results@#The overall IEM was 18.67/105 (95%CI: 15.32/105-21.97/105) in Zhejiang Province from 2016 to 2019, with the lowest in 2016 (14.19/105, 95%CI: 12.00/105-16.37/105) and the highest in 2018 (22.92/105, 95%CI: 19.23/105-26.56/105). The IEM rates of influenza A (H1N1), influenza A (H3N2) and influenza B were 9.32/105 (95%CI: 7.65/105-10.98/105), 5.68/105 (95%CI: 4.24/105-7.11/105), and 3.66/105 (95%CI: 2.13/105-5.18/105). The greatest IEM was seen among residents at ages of 65 years and older (142.91/105, 95%CI: (115.99/105-169.55/105, followed by among individuals at ages of 15 to 64 years (2.74/105, 95%CI: 1.87/105-3.61/105), and the lowest was seen among individuals under 15 years of age (0.41/105, 95%CI: -0.33/105-1.14/105). @*Conclusions@#From 2016 to 2019, the highest IEM was seen in Zhejiang Province in 2018, and the elderly residents at ages of 65 years and above presented the greatest IEM, with influenza A (H1N1) as the predominant influenza subtype. Influenza surveillance and vaccination is recommended to be reinforced.

Risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children: a Meta analysis / 中国当代儿科杂志

OBJECTIVES@#To systematically assess the risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children.@*METHODS@#PubMed, Web of Science, China National Knowledge Infrastructure Database, Wanfang Data, China Biology Medicine disc were searched to obtain the articles on risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children published up to May 31, 2021. RevMan 5.3 software was used to perform the Meta analysis.@*RESULTS@#A total of 13 articles were included, with 1 501 samples in total. The Meta analysis showed that indwelling gastric tube (OR=4.91), tracheal intubation (OR=5.03), central venous catheterization (OR=3.75), indwelling urinary catheterization (OR=4.11), mechanical ventilation (OR=3.09), history of hospitalization in the intensive care unit (OR=2.39), history of surgical operation (OR=3.22), previous use of third-generation cephalosporins (OR=2.62), previous use of carbapenem antibiotics (OR=3.82), previous use of glycopeptide antibiotics (OR=3.48), previous use of β-lactamase inhibitors (OR=2.87), previous use of antifungal drugs (OR=2.48), previous use of aminoglycoside antibiotics (OR=2.54), and Apgar score ≤7 at 1 minute after birth (OR=2.10) were risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children (P<0.05).@*CONCLUSIONS@#Invasive operations, history of hospitalization in the intensive care unit, previous use of antibiotics such as carbapenem antibiotics, and Apgar score ≤7 at 1 minute after birth are risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children.

Analysis of surveillance data of animal plague from 2006 to 2020 in Zhejiang Province, China / 中华地方病学杂志

Objective:To investigate the epidemic characteristics and current situation of animal plague in Zhejiang Province, in order to provide data support for prevention and control of the plague in the whole province.Methods:A retrospective study was carried out to collect surveillance data of animal plague in Zhejiang Province from 2006 to 2020 from the "Pubonic Plague Control Management Information System". Descriptive epidemiological methods were used to analyze the density of domestic and wild rodents, the distribution of rodent species and flea species, and the serological and pathogenic test results of host animals.Results:From 2006 to 2020, the annual average density of domestic rodent in Zhejiang Province was 3.99%, which was lower than that in 2006, 2007, 2008, 2009, 2019 and 2020. The annual average density of wild rodents was 4.52%, which was lower than that in 2013, 2016, 2017, 2018, 2019 and 2020. From 2006 to 2020, a total of 173 432 rodents were captured, belonging to 3 orders, 5 families, 12 genera and 17 species; in the composition of rodent species, Rattus norvegicus was the most, accounting for 32.15% (55 765/173 432). A total of 107 736 rodents were examined, the number of flea-infected rodent was 3 885, and the flea-infested rate was 3.61%; the total number of flea collected was 9 039 and the total flea index was 0.083 9. A total of 172 235 serological samples were tested at various monitoring sites in Zhejiang Province, and 10 positive samples were detected, there were 7 copies of Apodemus agrarianus, 2 copies of Smelly Shrew and 1 copy of Rattus norvegicus, with titers ranging from 1 ∶ 40 - 1 ∶ 320; a total of 163 618 copies of rodent liver and spleen organs were cultured, and no Yersinia pestis was isolated. Conclusions:Positive host animals have been detected in Zhejiang Province for many years. It is necessary to further standardize plague surveillance and make emergency preparations to prevent relapse and import of the epidemics.

Practice of joint base training of traumatic brain injury in standardized training of neurosurgery specialists / 中华医学教育探索杂志

The diagnosis and treatment of traumatic brain injury (TBI) are basic skills that should be mastered by neurosurgery specialists during the standardized training. In view of the lack of TBI patients in our center, TBI training was entrusted to a joint base with more TBI patients. Based on clinical training and practice experience of the authors in recent years, including joint base introduction, basic requirement, theory and skill training, research training, humanity accomplishment improvement, inter-base communication and evaluation standard, we discuss the appropriate joint base training mode of TBI in standardized training of neurosurgery specialists, so as to provide reference for cultivating qualified and comprehensively developed neurosurgery specialists.

Finite element analysis of the effects of periodontal tissue temperature by continuous wave technique / 华西口腔医学杂志

OBJECTIVES@#The safety of root canal filling with 200 °C hot gutta-percha was investigated to study the effect of continuous wave technique combined with high-temperature injectable gutta-percha condensation technique on the surface temperature of periodontal tissue.@*METHODS@#CT technique and Mimics, Geomagic, and Solidworks software were utilized to build the entity models of alveolar bone, dentin and root canal, periodontal ligament, and blood flow, respectively, which were then assembled in Solidworks into a finite element model of tooth with blood flow. By utilizing ABAQUS collaborative simulation platform, fluid-structure coupling was analyzed on the whole process of root canal filling. Consequently, the surface temperature of the periodontal tissue was obtained.@*RESULTS@#In the absence of blood flow, the temperature of the periodontal ligament surface reached 50.048 ℃ during root canal filling with 200 ℃ gutta-percha. Considering blood flow, the temperature of periodontal ligament surface was 39.570 ℃.@*CONCLUSIONS@#The temperature of the periodontal ligament surface increased when the continuous wave root canal was filled with 200 ℃ gutta-percha, and the periodontal tissue was not damaged.

Role of osteopontin in diet-induced brown gallstone formation in rats / 中华医学杂志(英文版)

BACKGROUND@#Although osteopontin (OPN) is expressed in the liver and pigment gallstones of patients with hepatolithiasis, its role in pigment gallstone formation remains unclear. This study aimed to explore the function of OPN in pigment gallstone formation.@*METHODS@#Rats were fed a chow diet (CD) or lithogenic diet (LD) for 10 consecutive weeks; blocking tests were then performed using an OPN antibody (OPN-Ab). Incidence of gallstones and levels of several bile components, OPN, tumor necrosis factor alpha (TNF-α), and cholesterol 7 alpha-hydroxylase (CYP7A1) were analyzed. To determine TNF-α expression in hepatic macrophages and both CYP7A1 and bile acid (BA) expression in liver cells, recombinant rat OPN and recombinant rat TNF-α were used to treat rat hepatic macrophages and rat liver cells, respectively. Chi-square or Fisher exact tests were used to analyze qualitative data, Student t-test or one-way analysis of variance were used to analyze qualitative data.@*RESULTS@#Incidence of gallstones was higher in LD-fed rats than in CD-fed rats (80% vs. 10%, P < 0.05). BA content significantly decreased in bile (t = -36.08, P < 0.01) and liver tissue (t = -16.16, P < 0.01) of LD-fed rats. Both hepatic OPN protein expression (t = 9.78, P < 0.01) and TNF-α level (t = 8.83, P < 0.01) distinctly increased in the LD group; what's more, CYP7A1 mRNA and protein levels (t = -12.35, P < 0.01) were markedly down-regulated in the LD group. Following OPN-Ab pretreatment, gallstone formation decreased (85% vs. 25%, χ2 = 14.55, P < 0.01), liver TNF-α expression (F = 20.36, P < 0.01) was down-regulated in the LD group, and CYP7A1 expression (F = 17.51, P < 0.01) was up-regulated. Through CD44 and integrin receptors, OPN promoted TNF-α production in macrophage (F = 1041, P < 0.01), which suppressed CYP7A1 expression (F = 48.08, P < 0.01) and reduced liver BA synthesis (F = 119.4, P < 0.01).@*CONCLUSIONS@#We provide novel evidence of OPN involvement in pigmented gallstone pathogenesis in rats.

Serious adverse events associated with chemotherapy in children with acute lymphoblastic leukemia / 中国当代儿科杂志

OBJECTIVE@#To study the occurrence of serious adverse events (SAEs) related to chemotherapy with CCCG-ALL-2015 regimen in children with acute lymphoblastic leukemia (ALL) and the risk factors for death after the SAEs.@*METHODS@#A retrospective analysis was performed on the medical data of 734 children with ALL. They were treated with CCCG-ALL-2015 regimen from January 2015 to June 2019. The occurrence of SAEs during the treatment was investigated. The children with SAEs were divided into a death group with 25 children and a survival group with 31 children. A multivariate logistic regression analysis was used to analyze the risk factors for death after the SAEs.@*RESULTS@#Among the 734 children with ALL, 56 (7.6%) experienced SAEs (66 cases) after chemotherapy, among which 41 cases occurred in the stage of remission induction therapy. Of all 66 cases of SAEs, 46 (70%) were infection-related SAEs, including 25 cases of septic shock (38%), 20 cases of severe pneumonia (30%), and 1 case of severe chickenpox (2%), and 87% of the children with infection-related SAEs had neutrophil deficiency. The most common infection sites were blood and the lungs. The most common pathogens were Gram-negative bacteria, viruses, fungi, and Gram-positive bacteria. There were 16 cases (24%) of hemorrhage-related SAEs, with 11 cases of gastrointestinal bleeding (17%), 4 cases of pulmonary bleeding (6%), and 1 case of intracranial bleeding (2%). Of all 734 children with ALL, 66 (9.0%) died, among whom 25 died due to SAEs. The treatment-related mortality rate was 3.4%, and infection (72%) and bleeding (24%) were the main causes of death. Severe pneumonia was an independent risk factor for treatment-related death in ALL children (OR=4.087, 95%CI: 1.161-14.384, P=0.028).@*CONCLUSIONS@#SAEs often occur in the stage of remission induction therapy, and infection-related SAEs are more common in ALL children accepting chemotherapy with CCCG-ALL-2015 regimen. The development of severe pneumonia suggests an increased risk for death in these children.

Effect and Mechanism of Chaihu Yueju Decoction on Depression Model Rats Induced by CUMS / 中国实验方剂学杂志

Objective:To explore the therapeutic effect and mechanism of Chaihu Yueju decoction on model rats induced by chronic unpredictable mild stress （CUMS）. Method:The 60 SD rats were randomly divided into normal group， model group， Chaihu Yueju decoction low， medium and high-dose groups（0.3， 0.6， 1.2 g·kg-1） and fluoxetine hydrochloride group（0.2 mg·kg-1）， 10 for each group. The model rats was established by chronic unpredictable mild stress for 5 weeks， and then Chaihu Yueju decoction and fluoxetine hydrochloride were given to the corresponding treatment group by gavage for 3 weeks. In the last week of gavage， Morris water maze training and testing were conducted. After the last day of gavage， sugar water preference and other behavioral experiment were tested. The sugar water preference test was used to detect the degree of pleasure deficiency in rats before and after treatment， the open field test was used to detect the depression of rats before and after treatment， the spatial memory ability was tested by Morris water maze. Western blot was used to detect the levels of tumor necrosis factor-α（TNF-α）， 5-hydroxytryptamine receptor 1A （5-HT1A）， extracellular signal-regulated kinase （ERK） and synapse associated protein in hippocampus of each group， Gloji and Nissl staining was used to observe the changes of dendritic spines and Nissl bodies in the hippocampus CA3. Result:Compared with normal group， the weight， sugar water preference rate， the scores of horizontal and vertical movement were significantly reduced （P<0.05）， and the immobility time was significantly prolonged in model group （P<0.05）. Meanwhile， the ability of learning and memory in model group decreased （P<0.05）. Western blot results showed that the levels of TNF-α was significantly increased （P<0.05）， and the levels of 5-HT1A， p-ERK， cyclic adenosine phosphate reactive element binding protein （CREB）， p-CREB， Synapsin-1，Synaptophysin， glutamate receptor subtype-1（GluR-1）and postsynaptic membrane protein-95（PSD-95） in model group were significantly decreased （P<0.05）. Gloji and Nissl staining results showed that the density of dendritic spines and the number of Nissl body in the hippocampal CA3 of the model group was obviously attenuate （P<0.05）. The results show that the neurons were evidently damaged. Compared with model group， the weight， sugar water preference rate， the scores of horizontal and vertical movement were clearly increased （P<0.05） and the immobility time was significantly shortened in fluoxetine hydrochloride group， middle dose and high dose Chaihu Yueju decoction group （P<0.05）. Western blot results showed that the levels of synaptophysin， GluR-1 and PSD-95 were significantly increased in fluoxetine hydrochloride group， middle dose and high dose Chaihu Yueju decoction group. The level of TNF-α was significantly decreased （P<0.05）， the levels of 5-HT1A， p-ERK， CREB， p-CREB and Synapsin-1 were remarkably increased （P<0.05）， especially the high dose group of Chaihu Yueju decoction. Gloji and Nissl staining results showed that the density of dendritic spines and the number of Nissl body in the hippocampal CA3 of high dose group were similarly increased in a dose-dependent manner. Conclusion:Chaihu Yueju decoction could improves the weight， the depressive despair， autonomous activity ability and learning and memory ability of DP model rats. Its mechanism is closely related to attenuating the inflammatory reaction and enhancing the levels of 5-HT1A receptor protein， ERK and synapse related protein， then activating 5-HT/CREB and ERK/CREB signaling pathways， increasing the number and distribution of dendritic spines and repairing damaged neurons in the DP model rat's hippocampus.

Advances in photodynamic therapy based on tumor hypoxia / 药学学报

Photodynamic therapy (PDT) has attracted wide attention due to its unique advantages such as minimal invasiveness, high efficiency and high selectivity, and its ability to induce anti-tumor immune response. However, the treatment process is heavily dependent on the oxygen content of the treatment site, and the widespread oxygen deficiency in malignant tumors severely limits its efficacy. In addition, PDT-mediated oxygen depletion exacerbates tumor hypoxia, which further reduces its therapeutic effect. In recent years, many researches have been devoted to overcoming this problem. This paper summarized various strategies based on tumor hypoxic PDT in recent years, discussing the advantages and disadvantages of these strategies, and analyzing the main challenges and future directions of PDT in the treatment of tumors, so as to provide references for the in-depth study of photodynamic therapy of tumors.

Epidemiological investigation of the first reported case of coronavirus disease 2019（COVID-19）in Zhejiang Province / 预防医学

Objective@# To conduct an epidemiological investigation on the first reported case of coronavirus disease 2019 （COVID-19） in Zhejiang Province, so as to provide reference for prevention and control of the disease.@*Methods @#According to the COVID-19 Diagnosis and Treatment Program （Trial） and the COVID-19 Prevention and Control Program （Trial） issued by National Health Commission of China, a field investigation was employed on a case of fever from Wuhan reported by Wenzhou in January 15, 2020; the real-time reverse transcription polymerase chain reaction （RT-PCR） assay was performed to detect the nucleic acid of severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） from the sputum specimens or throat swabs of the case; the close contacts of the case were tracked down; relevant prevention and control measures were implemented. @*Results @#The case had lived in Wuhan for long. On January 4 of 2020, he felt cold and uncomfortable without obvious inducement, and drove back to Wenzhou with his wife. He had fever （up to 39 ℃）, cough and expectoration on the next day. On January 9, the chest computed tomographic （CT） scan showed bilateral high-density patchy shadowing with blurred edges. On January 16, his throat swab and sputum samples were collected and sent to Zhejiang Provincial Center for Disease Control and Prevention （CDC） for detection of SARS-CoV-2. The result turned out to be positive on January 17, then was rechecked and confirmed by Chinese CDC on January 20. Two weeks before the onset of the disease, the patient was engaged in the door-to-door persuasion of installing elevators in an old residential area of Wuhan, and he denied any connection with other COVID-19 cases,markets,（sick or dead） poultry or poultry products. Totally 26 close contacts were identified and kept in quarantine. During this period,three of them developed fever or respiratory symptoms, but were excluded from COVID-19. On the afternoon of January 16,the health system of Zhejiang Province and Wenzhou City launched an emergency plan and implemented a series of prevention and control measures such as isolation and treatment of cases,screening and isolation of close contacts,and public health education. @*Conclusion @#According to the epidemiological history,clinical features and laboratory test Results,the patient was identified as the first reported case of COVID-19 in Zhejiang Province.

Correlation study between accumulation of triterpenoids and expression of relative genes in Alisma orientale / 中国中药杂志

To research the correlation between accumulation of triterpenoids and expression of key enzymes genes in triterpenoid biosynthesis of Alisma orientale,the study utilized UPLC-MS/MS method to detect eight triterpenoids content in the tuber of A. orientale from different growth stages,including alisol A,alisol A 24 acetate,alisol B,alisol B 23 acetate,alisol C 23 acetate,alisol F,alisol F 24 acetate and alisol G,and then the Real time quantitative PCR was used to analyze the expression of key enzymes genes HMGR and FPPS in triterpenoid biosynthesis. Correlation analysis showed that there was a significant positive relation between the total growth of these eight triterpenoids and the average relative expression of HMGR and FPPS(HMGR: r = 0. 998,P<0. 01; FPPS: r = 0. 957,P<0. 05),respectively. Therefore,the study preliminarily determined that HMGR and FPPS genes could regulate the biosynthesis of triterpenoids in A. orientale,which laid a foundation for further research on the biosynthesis and regulation mechanism of triterpenoids in A. orientale.

Comparison of the minimally invasive treatments of laparoscopic and endosopic for common bile duct stones after gastrojejunostomy / 北京大学学报(医学版)

OBJECTIVE@#To explore the feasibility and to compare the merits and demerits of laparoscopic and endoscopic approach in removing common bile duct stones in patients with gastrojejunostomy after gastrectomy.@*METHODS@#Between January 2012 and December 2016, 25 patients with common bile duct stones after gastrojejunostomy received laparoscopic or endoscopic treatment in our centers. They were divided into laparoscopic group and endoscopic group based on treatment approaches for common bile duct stones, including 15 patients in laparoscopic group and 10 in endoscopic group. The clinical characteristics and outcomes between the two groups were retrospectively analyzed.@*RESULTS@#Among the 25 patients with gastrojejunostomy, the method of reconstruction was Billroth II in 21 patients and Roux-en-Y in 4 patients. Six patients received laparoscopic or endoscopic treatment during the acute cholangitis state. Among the laparoscopic group, 5 patients with stones more than 1 cm, 7 patients with multiple stones, while in the endoscopic group, 3 patients with stones more than 1 cm and 4 patients with multiple stones. Fourteen patients in the laparoscopic group with coexisting gallbladder stones, and 6 of their common bile duct stones were successfully removed by transcystic approach without T tube drainage. Stone removals were successful in 4 patients of the endoscopic group by a single performance, including 3 patients with single small stone and one patient with multiple small stones. Two patients in the laparoscopic group were converted to open surgery for severe adhesion and one patient in the endoscopic group turned to laparoscopic operation for failing of finding papilla in the Roux-en-Y anastomotic status. The median hospital stays were 12 d and 10 d, respectively in the laparoscopic and endoscopic group. There were 3 patients with postoperative complications, including one patient with paralytic ileus in the laparoscopic group and 2 patients with biliary pancreatitis or bacteremia in the endoscopic group, and all of them recovered uneventfully with conservative treatment.@*CONCLUSION@#Both laparoscopic and endoscopic approaches are feasible for removing stones in the common bile duct in patients with gastrojejunostomy after gastrectomy, and they complement each other. In addition, both techniques are difficult to conduct, and a technical competence should be considered in selection of each method.

Genetic diversity of Aedes albopictus populations in the coastal areas of southern China, using the microsatellite markers / 中华流行病学杂志

Objective@#To analyze the genetic diversity of Aedes albopictus populations in the coastal areas of southern China by using the microsatellite markers to provide a basis for the control of vectors.@*Methods@#Genetic diversity and clustering analysis of Aedes albopictus populations were studied in the 7 microsatellite loci, in Hangzhou, Ningbo and Yiwu of Zhejiang province, Longyan of Fujian province, Guangzhou of Guangdong province, Nanning of Guangxi Zhuang Autonomous Region and Haikou of Hainan province.@*Results@#Numbers of different alleles (5.429-7.571), effective alleles (2.897-3.632), allele richness (5.236-7.170) and expected heterozygosity (0.538- 0.637) were detected from each of the Aedes albopictus population by using 7 microsatellite markers. The inbreeding coefficients appeared as 0.008-0.332, with heterozygote deficiency, in these populations. Fixation index of the whole populations was 0.058, suggesting that the genetic variation among the 7 populations was 5.8%. Data from the Neighbor-Joining clustering analysis showed that populations from Hangzhou and Yiwu belonged to one branch while Longyan and Guangzhou populations constituted another branch. Aedes albopictus populations of Nanning and Haikou showed great genetic variation but formed a single branch. Bayesian analysis on Aedes albopictus populations showed that the possible number of clusters was 3.@*Conclusions@#Based on 7 microsatellite loci, relatively high genetic diversity and medium level of genetic differentiation that increasing with the geographical distances, were found in these Aedes albopictus populations, from the coastal areas in southern China.

Effect of Notch Signaling Pathway on Differentiation of Mouse Embryonic Stem Cells into Hematopoietic Stem Cells or Hematopoietic Progenitor Cells by VEGF / 中国实验血液学杂志

OBJECTIVE@#To investigate the effect of Notch signaling pathways on differentiation of mouse embryonic stem cells(ESC) into haematopoietic stem cells or haematopoietic progenitors cells(HSC/HPC).@*METHODS@#Mouse embryonic stem cells were proliferated in vitro to form embryoid bodies; the differentiation of embryoid bodies should be induced in vitro, the experiments were divided into BE, control, VEGF, DAPT and VEGF-DAPT groups; HSC/HPC ohenotype: CD117D34Sca1 was detected by flow cytometry; the related gene expression was detected by RT-PCR.@*RESULTS@#The number of VEGF-induced HSC/HPC in VEGF group was significantey higher than that in the control and EB group (P<0.05), suggesting that VEGF promotes ESC differentiation to HSC/HPC; the number of DAPT-induced HSC/HPC in DAPT group was significanty higher than that in the Control and EB groups(P<0.05), suggesting that DAPT promotes ESC differentiation to HSC/HPC; the number of VEGF+DAPT-induced HSC/HPC in VEGF-DAPT group was significantly higher than that in VEGF and DAPT groups(P<0.05), suggesting that DAPT and VEGF play a synergistic role to promote differentiation of ESC into HSC/HPC.@*CONCLUSION@#Notch signal pathway inhibits differentiation of ESC into HSC / HPC by VEGF.

Antidepressant effect of dextromethorphan and its mechanism / 中国病理生理杂志

AIM:To investigate the antidepressant effect of dextromethorphan(DXM)and its mechanism. METHODS:The antidepressant effect of DXM was observed by the methods of forced swimming test,tail suspension test and open field test.The N-methyl-D-aspartate(NMDA)receptor activity in brain,and the effects of total nitric oxide syn-thases(NOS)and various types of NOS were examined by molecular biology methods.The mice pretreated with NMDA re-ceptor antagonist MK-801(MK),NMDA,NO precursor L-arginine(L-ARG),endothelial NOS(eNOS)inhibitor Nω-ni-tro-L-arginine methyl ester(L-NAME),inducible NOS(iNOS)inhibitor aminoguanidine(AG),neuronal NOS(nNOS) inhibitor 7-nitroindole(7-NI)or phosphodiesterase 5 inhibitor sildenafil were given DXM to explore the mechanism of DXM as an antidepressant.RESULTS: DXM had a dose-dependent antidepressant effect.DXM inhibited the activity of brain NMDA receptor in a dose-dependent manner, and inhibited the expression of eNOS and nNOS.MK, L-NAME and 7-NI were able to promote the antidepressant effect of DXM.NMDA,L-ARG and sildenafil were able to inhibit the antidepres-sant effect of DXM.AG did not influence the antidepressant effect of DXM.CONCLUSION:DXM has an antidepressant effect,and NMDA receptor and L-ARG-NO-cGMP signaling pathways are involved in this process.

Training practice of neurocritical care in standardized training of neurosurgical specialists / 中华医学教育探索杂志

The training of neurocritical care is an important component in standardized training of neurosurgical specialists. As a subspeciality of neurosurgery, as well as with the characteristics of critical care medicine, neurocritical care carries its own discipline features. Based on clinical training and practice experiences, the training mode and practice experience were summarized, including basic requirement, theory training, skill training, research training, humanity accomplishment improvement and evaluation stan-dard, in order to discuss the appropriate training mode of neurocritical care in standardized training of neurosurgical specialists, improve the training methods and advance the training effectiveness, and provide reference for cultivating qualified and comprehensively developed neurosurgical specialists.

The neurosurgery residency training at Brigham and Women's Hospital of United States: what can we learn / 中华医学教育探索杂志

By taking the neurosurgery residency program of Brigham and Women's Hospital as an example,the neurosurgery residency training system of United States is introduced,which emphasizes on the progressive gaining of the trainee with regard to medical knowledge,surgical skills,decision-making strategy,humanity,professionalism,inter-human communication ability and updated neuroscience research.This training system can shed some light on our own neurosurgery residency program,which only begins to take shape in recent years.

A meta-analysis on therapeutic efficiency of self-ligating versus conventional brackets for orthodontic correction / 中国组织工程研究

BACKGROUND: The type of brackets is closely related to the efficiency of orthodontic treatment. A self-ligating bracket is characterized by low friction, simple operation, mild pain and discomfort, and it has been an issue of concern in orthodontics. In recent years, studies on the therapeutic efficiency of self-ligating brackets versus conventional brackets for orthodontic correction have been reported, but there is no conclusion. OBJECTIVE: To systematically compare the conventional and self-ligating brackets concerning treatment efficiency. METHODS: A computer-based search of PubMed, EMBASE, MEDLINE, WanFang, VIP and CNKI was performed for randomized controlled trials concerning self-ligating brackets versus conventional brackets for orthodontic correction. The keywords were "orthodontic brackets/ self-ligating, random" in English and "appliance/self-ligating/ conventional/orthodontic correction efficiency" in Chinese. The retrieve time was set from inception to December 2017. Stata12.0 software was used for meta-analysis following literature screening, data extraction and risk assessment of bias. RESULTS AND CONCLUSION: A total of 9 randomized controlled trials involving 603 patients were included. The results of meta-analysis on the efficiency of the two groups showed that there was no significant difference in overall treatment time, number of visits, time of alignment and time of space closure (P ＞ 0.05). Only the time of chairside operation showed significant difference between the two groups (P ＜ 0.05). These findings indicate that compared with the conventional bracket, the self-ligating bracket has no obvious advantage in the therapeutic efficiency.