Implementation of the healthy school construction plan to promote students health and well being / 中国学校卫生

Abstract@#With the development of society, the health and well being of children and adolescents are receiving increasing attention from the government and scholars. The implementation of the health (promoting) school construction plan has a significant effect on promoting students health and well being, which is especially important in the normalized stage of COVID-19 epidemic prevention and control. The study summarizes the importance of health (promoting) schools for students health and well being, reviews the development of health (promoting) school construction in China, and proposes countermeasures and recommendations to further promote health (promoting) school construction in China in the light of the new era.

Investigation and analysis of indoor radon concentration of urban residents in Shiyan, China / 中国辐射卫生

@#<b>Objective</b> To monitor the indoor radon concentration of urban residents in Shiyan, China, and to analyze the related influencing factors. <b>Methods</b> From April to July, 2019, RSKS standard detectors were used to measure the indoor radon concentration of 125 households in Shiyan, and the results were analyzed. <b>Results</b> The indoor radon concentration of residents in Shiyan showed a skewed distribution, ranging from 13.8 to 145 Bq/m³, and <i>M</i> (<i>P</i>₂₅,<i>P</i>₇₅) was 38.3 (29.0,62.0) Bq/m³. The estimated annual effective dose of radon and radon daughters from inhalation was 0.52-5.50 mSv, and <i>M</i> (<i>P</i>₂₅,<i>P</i>₇₅) was 1.45 (1.10, 2.36) mSv, which was consistent with literature. Building structure (<i>H</i> = 14.10, <i>P</i> < 0.001), floor (<i>H</i> = 24.41, <i>P</i> < 0.001), and geographical region (<i>H</i> = 8.963, <i>P</i> < 0.05) were influencing factors of indoor radon concentration, and the differences were significant. <b>Conclusion</b> The indoor radon concentration of urban residents in Shiyan is lower than the national standard limit. However, in daily life, it is still necessary to take appropriate measures to reduce the concentration of indoor radon as much as possible.

Relationship between interpregnancy interval and neurodevelopment among 6-month-old infants / 预防医学

Objective@#To examine the relationship between interpregnancy interval (IPI) and neurodevelopment among 6-month-old infants, so as to provide insights into the prevention of neurodevelopmental abnormalities among infants.@*Methods@#Puerparas with full-term delivery at Anhui Province Maternity and Child Health Hospital from April 2017 to July 2018 and their babies were recruited. The demographic features, behaviors during pregnancy, IPI and birth outcomes were collected through questionnaires and medical records. The neurodevelopment was evaluated using the Ages and Stages Questionnaire (third edition) among infants at 6 months of age. The association between IPI and neurodevelopment was examined using multivariable logistic regression analysis.@*Results @#Totally 485 maternal-newborn pairs were investigated, and the puerparas had a mean age of ( 29.43±4.40 ) years. There were 330 puerparas ( 68.04% ) with normal pre-pregnancy body mass index, 325 puerparas ( 67.01% ) with eutocia, 233 puerparas (48.04%) with the first delivery, 44 puerparas ( 9.07% ) with IPI of less than one year and 208 puerparas ( 42.89% ) with IPI of one year and greater. There were 246 male babies ( 50.72% ) and 437 babies ( 90.10% ) with normal birth weight. A total of 148 newborns were diagnosed with neurodevelopmental abnormalities, with a detection rate of 30.52%. Of all newborns with neurodevelopmental abnormalities, there were 45 babies with communication abnormalities ( 9.28% ), 87 babies with gross motor abnormalities ( 17.94% ), 73 babies with fine motor abnormalities ( 15.05% ), 68 babies with abnormalities of solving problems ( 14.02% ) and 60 babies with personal-social abnormalities ( 12.37% ). Multivariable logistic regression analysis showed a reduced risk of infant's communication abnormalities ( OR=0.273, 95%CI: 0.090-0.833 ), gross motor abnormalities ( OR=0.340, 95%CI: 0.150-0.770 ), fine motor abnormalities ( OR=0.266, 95%CI: 0.106-0.670 ), personal-social abnormalities ( OR=0.321, 95%CI: 0.121-0.851 ) and neurodevelopmental abnormalities ( OR=0.353, 95%CI: 0.171-0.730 ) among puerparas with IPI of one year and greater as compared to those with IPI of less than one year, and no significant difference was seen in infant's neurodevelopmental abnormalities between puerparas with the first delivery and with IPI of less than one year.@*Conclusion@#IPI is associated with neurodevelopmental abnormalities among 6-month-old infants.

Effect of miR-204 targeted regulation of DVL3 gene in silica-induced mouse lung epithelial cells / 中华劳动卫生职业病杂志

Objective: To construct a recombinant lentiviral vector for mouse miR-204 overexpression, and to verify the targeted regulation of miR-204 and DVL3 in silica (SiO(2)) -induced mouse lung epithelial cells (MLE-12 cells) . Methods: In October 2019, the pre-miR-204 gene was amplified from the mouse genome by the polymerase chain reaction (PCR) method. After sequencing, the amplified product was cloned into the pLenti-CMV-EGFP lentiviral vector. The positive clones were identified by PCR screening and sequencing. The miR-204 overexpressed lentiviral vector was transfected into 293T cells, and lentiviral packaging and titer determination were performed. The experiment was divided into SiO(2) control group, virus control group, and miR-204 virus group, and the expressions of miR-204 and DVL3 gene were detected by real-time PCR. Results: The miR-204 lentiviral expression vector Lv-miR-204-5p was constructed and identified correctly by PCR and sequencing, and a virus dilution with a titer of 9.57×10(8) IU/ml was obtained. The results of real-time PCR showed that the expression of miR-204 in MLE-12 cells of the miR-204 virus group was higher than that of SiO(2) control group and virus control group, and the expression of DVL3 gene was lower than that of SiO(2) control group and virus control group, the differences were statistically significant (P<0.05) . Conclusion: Overexpression of miR-204 by lentiviral vector may inhibit the expression of DVL3 gene in silica-induced mouse lung epithelial cells.

Analysis on the detection of suspected occupational diseases and occupational contraindications for benzene workers in Tianjin / 中华劳动卫生职业病杂志

Objective: To investigate the detection of suspected occupational diseases and occupational contraindications for benzene workers in Tianjin. Methods: In June 2020, the occupational health inspection data of 16113 benzene workers in 514 enterprises with benzene hazards in 16 municipal districts in Tianjin from January to December 2019 were included in the analysis. Enterprise information included the employer's region, economic type, industry classification and enterprise scale. Occupational health inspection data for benzene workers during their on-the-job period included routine inspection indicators and benzene special inspection indicators. Multivariate unconditional logistic regression was used to analyze the relationship between personal general information, occupational history, enterprise information and suspected benzene poisoning and occupational contraindications of benzene workers. Results: There were 16073 benzene workers in the normal group and 24 in the suspected benzene poisoning group. The detection rate of suspected benzene poisoning in females was higher than that in males (χ(2)=8.26, P=0.004) . There was no significant difference in the detection rates of suspected benzene poisoning among different dimensions such as age, length of service, occupational health inspection institution location, employer location, industry classification, economic type, and enterprise scale (P>0.05) . There were 16073 benzene workers in the normal group and 16 in the benzene contraindication group. The detection rate of benzene contraindications for workers in suburban areas where occupational health inspection institutions were located was higher than that in urban areas (χ(2)=9.71, P=0.002) , and there was no significant difference in the detection rates of contraindications for benzene in other dimensions (P>0.05) . Multivariate logistic regression analysis showed that female benzene workers were more likely to detect suspected benzene poisoning (OR=3.53, 95%CI: 1.57-7.94, P=0.002) ; benzene workers who received physical examination in suburban occupational health inspection institutions (OR=5.81, 95%CI: 1.94-17.42, P=0.002) , the employer's area was in the suburbs (OR=9.68, 95%CI: 1.23-76.07, P=0.031) , and female workers (OR=3.07, 95%CI: 1.13-8.37, P=0.028) , it was easier to detect occupational contraindications. Conclusion: Female benzene workers with employers located in the suburbs have a higher risk of detecting occupational contraindications, and women are more likely to detect suspected benzene poisoning. The management of benzene operations in the production environment of enterprises in the suburbs of Tianjin and the occupational health monitoring of female workers should be strengthened.

Artificial intelligence-based literature data warehouse for vaccine safety / 中华流行病学杂志

Objective: To establish a sustainable updated literature data warehouse for global vaccine safety assessment, and provide data support for evidence-based vaccine safety assessment. Methods: Semi-automated construction and updating of a literature data warehouse were achieved through the continuous integration of standard operating steps of evidence-based reviews with artificial intelligence technologies. Following the standard procedure of a systematic literature review, the literatures about vaccine safety assessment published before November 29, 2020 were retrieved from 9 databases including OVID, Scopus, Web of Science, Cochrane Library, and ClinicalTrails.org in English and Wanfang, CNKI, VIP, and SinoMed in Chinese. Literatures were screened for two rounds in a semi-automatic manner (by artificial intelligence literature processing system and manual work) according to the inclusion/exclusion criteria. Furthermore, the literatures were classified according to the types of vaccines and adverse events. The updating strategy was established, and the literature data warehouse was updated regularly. Experts were organized to select specific vaccine safety topics and carry out special demonstration studies. Results: More than 0.41 million articles were retrieved. According to the inclusion/exclusion criteria, 23 304 articles were included after two rounds of screening. At present, we have selected and completed three prior topics as demonstration studies, including the systematic review of "DPT (diphtheria, pertussis and tetanus) vaccine and encephalopathy/encephalitis", and the classified management of literatures about allergic purpura and brachial plexus neuritis. Conclusions: The sustainable updated literature data warehouse of vaccine safety can provide high-quality research data for vaccine safety research, including evidence support for immunization related policy-making and adjustment and vaccine safety-related methodological research or clinical tool development; and further demonstration studies can provide references for building a new methodological framework system for timely and efficient completion of the evidence-based assessment of vaccine safety.

A severe acute intermittent porphyria patient: Successful treatment and management / 中华内分泌代谢杂志

Acute intermittent porphyria(AIP) is a rare inherited metabolic disease that can cause severe and fatal acute attacks. This article shares the treatment and management of a severe AIP patient. It is proposed that (1) avoiding incentives is essential; (2) emotional problems easily overlooked should be paid attention; (3) long-term follow-up and patient education can improve the prognosis. The patient underwent renal biopsy during the remission period. We found a red-brown-yellow-white refractive index crystal under a polarized light microscope that had not been reported in the previous literature, which was speculated to be a porphyrin crystal.

Schisandrae Fructus oil-induced elevation in serum triglyceride and lipoprotein concentrations associated with physiologic hepatomegaly in mice

Objective: To investigate hypertriglyceridemia and hepatomegaly caused by Schisandrae Sphenantherae Fructus (FSS) and Schisandra chinensis Fructus (FSC) oils in mice. Methods: Mice were orally administered a single dose of Schisandrae Fructus oils. Serum and hepatic triglyceride (TG), triglyceride transfer protein (TTP), apolipoprotein B48 (Apo B48), very-low-density lipoprotein (VLDL), hepatocyte growth factor (HGF), alanine aminotransfease (ALT) and liver index were measured at 6-120 h post-dosing. Results: FSS and FSC oil caused time and dose-dependent increases in serum and hepatic TG levels, with maximum increases in the liver (by 297% and 340%) at 12 h post-dosing and serum (244% and 439%) at 24-h post-dosing, respectively. Schisandrae Fructus oil treatments also elevated the levels of serum TTP by 51% and 63%, Apo B48 by 152% and 425%, and VLDL by 67% and 38% in mice, respectively. FSS and FSC oil treatments also increased liver mass by 53% and 55% and HGF by 106% and 174%, but lowered serum ALT activity by 38% and 22%, respectively. Fenofibrate pre/ co-treatment attenuated the FSS and FSC oil-induced elevation in serum TG levels by 41% and 49% at 48 h post-dosing, respectively, but increased hepatic TG contents (by 38% and 33%, respectively) at 12 h post-dosing. Conclusions: Our findings provide evidence to support the establishment of a novel mouse model of hypertriglyceridemia by oral administration of FSS oil (mainly increasing endogenous TG) and FSC oil (mainly elevating exogenous TG).

Influencing factors of learned helplessness in patients with primary liver cancer treated by interventional therapy / 中国实用护理杂志

Objective:To investigate the influencing factors of learned helplessness in patients with primary liver cancer treated by interventional therapy.Methods:This study was a cross-sectional study. The 221 patients with primary liver cancer treated by interventional therapy in the Second Affiliated Hospital of Air Force Military Medical University from August 2020 to October 2021 were selected as the subjects. General data statistics, Learned Helplessness Scale and Support in Intimate Relationships Rating Scale were used for questionnaire survey.Results:The total score of learned helplessness in the 221 patients with primary liver cancer treated by interventional therapy was 74.12 ± 6.55. Gender, education level, family per capita monthly income, number of interventions and perceived spouse support were the main influencing factors of learned helplessness in patients with primary liver cancer treated by interventional therapy (adjusted R2=0.891, F=65.65, P<0.05). Conclusions:The sense of learned helplessness of patients with primary liver cancer treated by interventional therapy is at a high level. According to patients with features of male, lower education level, lower family per capita monthly income, more number of interventional therapy or lower perceived spouse support, medical staff can use dialectical behavior therapy, symptom group intervention, spouse support intervention and other methods to reduce learned helplessness of patients.

Application of progressive case teaching based on Omaha system in practical teaching of geriatric nursing / 中华医学教育探索杂志

Objective:To study the application effect of progressive case teaching based on Omaha system in practical teaching of geriatric nursing.Methods:A total of 84 college students nursing students of Beijing Chaoyang Hospital (West Branch) from June 2019 to October 2020 were selected as the research objects, and they were randomly divided into an observation group (conventional teaching) and a control group (progressive case teaching based on the Omaha system) in average. The clinical thinking ability of the two groups before and after teaching were compared, and the satisfaction of the two groups' teaching effect was compared. SPSS 22.0 was performed for chi-square test and independent sample t test. Results:After teaching, the critical thinking ability, systematic thinking ability, and evidence-based thinking ability of the observation group were significantly higher than those of the control group before and during the same period ( P<0.05). The teaching satisfaction of the observation group was significantly higher than that of the control group ( P<0.05). Conclusion:The progressive case teaching based on the Omaha system has a good application effect on the practical teaching of geriatric nursing, which can improve students' clinical thinking ability and increase teaching satisfaction.

In situ activity analysis of two-step labeling probiotics with double fluorescent probes in intestinal tract / 药学学报

Effective supplementation of probiotics can be beneficial to intestinal health, but in situ analysis of probiotics activity has rarely been reported. In this study, by coupling fluorescein 5-isothiocyanate (FITC) and 5(6)-carboxytetramethylrhodamine N-succinimidyl ester (5(6)-TAMRA-SE) with D-lysine, two fluorescent D-amino acids (FDAAs) probes were obtained: green probe (fluorescein-D-lysine, FDL) and red probe (TAMRA-D-lysine, TDL). Then, we tried to label the three kinds of probiotics, Lactobacillus acidophilus (LA), Lactobacillus casei (LC) and Veillonella atypica (VA) in vitro. FDAAs was applied to the labeling of intestinal flora in mice, and a method was established to investigate the oral survival rate of three commonly used probiotics. All animal experiments were approved by the Animal Ethics Committee of Guangzhou University of Chinese Medicine. The results show that the two synthetic FDAAs can be non-toxic and 100% for the in vitro labeling of the three probiotics. Known by FDAAs two-step labeling of oral probiotics, the high survival rate of LA was 92.30% ± 1.67%. The survival rates of VA and LC are similar, 84.13% ± 4.06% and 82.27% ± 2.43%, respectively. This study can quickly compare the changes of colonization survival rate of different probiotics in vivo, provide theoretical support for the in situ colonization activity of probiotics in the intestine, and guide the rational drug use of clinical probiotics.

Role of DNA methyltransferase in acute lung injury in septic mice / 中华麻醉学杂志

Objective:To evaluate the role of DNA methyltransferase in acute lung injury in septic mice.Methods:Forty-eight healthy male C57BL/6 mice, aged 6-8 weeks, weighing 20-25 g, were divided into 4 groups ( n=12 each) using a random number table method: sham operation group (group Sham), sham operation+ DNA methyltransferase inhibitor group (group Sham+ 5-Aza), sepsis group (group Sepsis) and sepsis+ DNA methyltransferase inhibitor group (group Sepsis+ 5-Aza). Sepsis model was developed by cecal ligation and puncture (CLP) in anesthetized mice.Mice were sacrificed at 24 h after CLP, and lung tissues were obtained, DNA was extracted to determine the global DNA methylation by colorimetry, and RNA was extracted to detect the expression of DNA methyltransferase (DNMTl, DNMT3a, DNMT3b) mRNA by real-time fluorescent quantitative polymerase chain reaction, the wet/dry lung weight ratio (W/D ratio) was measured, the histopathological changes of lung tissues were determined by HE staining, the contents of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), high-mobility group box 1 protein (HMGB1) and malondialdehyde (MDA) and activities of superoxide dismutase (SOD) and catalase were measured by enzyme-linked immunosorbent assay. Results:Compared with group Sham, the global DNA methylation was significantly increased, the expression of DNMT1 and DNMT3a mRNA was up-regulated, the lung injury score, W/D ratio, and contents of IL-6, TNF-α, HMGB1 and MDA were increased, and activities of SOD and CAT were decreased at 24 h after CLP in group Sepsis and group Sepsis+ 5-Aza ( P<0.05), and no significant change was found in the indexes mentioned above in group Sham+ 5-Aza ( P>0.05). Compared with group Sepsis, the global DNA methylation was significantly decreased, the expression of DNMT1 and DNMT3a mRNA was down-regulated, the lung injury score, W/D ratio, contents of IL-6, TNF-α, HMGB1 and MDA were decreased, and the activities of SOD and CAT were increased in group Sepsis+ 5-Aza ( P<0.05). Conclusions:DNA hypermethylation mediated by DNMT1 and DNMT3a is involved in the process of acute lung injury in septic mice.

Role of Nrf2/HO-1 signaling pathway in dexmedetomidine-induced reduction of oxygen-glucose deprivation and restoration injury to microglia / 中华麻醉学杂志

Objective:To evaluate the role of nuclear factor erythroid 2-related factor/ heme oxygenase-1 (Nrf2/HO-1) signaling pathway in dexmedetomidine-induced reduction of oxygen-glucose deprivation and restoration (OGD/R) injury to microglia.Methods:BV-2 microglia were cultured in high-glucose DMEM culture medium supplemented with 10% fetal bovine serum in an normal culture incubator at 37 ℃ (5%CO 2-21%O 2-74 %N 2). The cells were seeded in 96-well plates at a density of 1.5×10 4 cells/ml (200 μl/well) or 6-well plates at a density of 2×10 5 cells/ml (2 ml/well) and divided into 5 groups ( n=30 each) using a random number table method: control group (group C), dexmedetomidine group (group D), group OGD/R, OGD/R+ dexmedetomidine group (group OGD/R+ D) and OGD/R+ dexmedetomidine+ ML385 group (group OGD/R+ D+ ML). The cells in group C were continuously cultured in a normal culture incubator for 26 h. In group D, dexmedetomidine at the final concentration of 10 μmol/L was added, cells were incubated for 2 h, and then were continuously incubated in a normal culture incubator for 26 h. In OGD/R, OGD/R+ D and OGD/R+ D+ ML groups, the culture medium was replaced with glucose-free DMEM culture medium, cells were cultured for 2 h in an incubator at 37 ℃ (5%CO 2-1%O 2-94 %N 2), the culture medium was replaced with high-glucose DMEM culture medium containing 10% fetal bovine serum and then the cells were cultured for 24 h in a normal incubator.Dexmedetomidine at the final concentration of 10 μmol/L was added at 2 h before OGD in OGD/R+ D and OGD/R+ D+ ML groups.Nrf-2 inhibitor ML385 at the final concentration of 4 μmol/L was added at 30 min before dexmedetomidine was added in group OGD/R+ D+ ML.Cells in 6 wells in each group were selected randomly for assessment of cell viability (by methyl thiazolyl tetrazolium assay) and apoptosis (using flow cytometry), and for determination of the concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-10 in the supernatant (using enzyme-linked immunosorbent assay), the expression of Nrf2 in nucleus, Nrf2 and HO-1(by Western blot ) and the expression of HO-1 mRNA (by real-time polymerase chain reaction). Results:Compared with group C, the cell viability was significantly decreased, cell apoptosis rate and concentrations of TNF-α, IL-6 and IL-10 in the supernatant were increased, and the expression of Nrf2 in nucleus, Nrf2, HO-1 and its mRNA was up-regulated in OGD/R and OGD/R+ D groups ( P<0.05), and no significant change was found in each parameter mentioned above in group D ( P>0.05). Compared with group OGD/R, the cell viability and IL-10 in the supernatant concentration were significantly increased, cell apoptosis rate and concentrations of TNF-α and IL-6 in the supernatant were decreased and the expression of Nrf2 in nucleus, Nrf2, HO-1 and its mRNA was up-regulated in group OGD/R+ D ( P<0.05), and no significant changes were found in the parameters mentioned above in group OGD/R+ D+ ML ( P>0.05). Compared with group OGD/R+ D, the cell viability and concentration of IL-10 in the supernatant were significantly decreased, cell apoptosis rate and concentrations of TNF-α and IL-6 in the supernatant were increased and the expression of Nrf2 in nucleus, Nrf2, HO-1 and its mRNA was down-regulated in group OGD/R+ D+ ML ( P<0.05). Conclusion:The mechanism by which dexmedetomidine alleviates OGD/R injury to microglia may be related to promoting the activation of Nrf2/HO-1 signaling pathway and inhibition of inflammatory responses.

Advances in the research of enterobacterial common antigen / 生物工程学报

The enterobacterial common antigen (ECA) is a polysaccharide composed of polysaccharide repeats that are located in the outer membrane of almost all Enterobacteriaceae bacteria and has diverse biological functions. ECA is synthesized by the synergistic action of multiple genes that are present in clusters on the genome of Enterobacteriaceae bacteria, forming the ECA antigen gene cluster, an important virulence factor that plays a role in host invasion and survival of Enterobacteriaceae in vivo. ECA also plays an important role in the maintenance of the bacterial outer membrane permeability barrier, flagella gene expression, swarming motility, and bile salts resistance. In addition, ECALPS, anchored in the core region of bacterial lipopolysaccharide, is an important surface antigen for bacteria, stimulating high levels of antibody production in the host and could be a target for vaccine research. This review summarizes ECA purification, genes involved in ECA biosynthesis, its immunological characteristics, biological functions and clinical applications.

Trend analysis of Helicobacter pylori resistance to clarithromycin and levofloxacin in Wenling area from 2014 to 2018 / 上海预防医学

Objective:To understand the trend of Helicobacter pylori （Hp） resistance to clarithromycin and levofloxacin and to provide guidance for Hp eradication therapy. Methods:From January 2014 to December 2018， a total of 66 515 patients with gastrointestinal symptoms were enrolled in the First People's Hospital of Wenling. The patients were divided into the following groups： childhood （0 to 6 years old）； juvenile （7 to 17 years old）； youth （18 to 40 years old），middle age （41 to 65 years old），and old age （≥66 years old）. All patients received gastroscopy， gastric mucosal biopsy， Hp culture and drug sensitivity test of clarithromycin and levofloxacin. Results:The Hp positive rate showed a significant downward trend in 2016， 2017 and 2018 （χ2=14.317， 47.079， 88.054， all P<0.05）. The average resistance rate of Hp to clarithromycin from 2014 to 2018 was 22.72% （4 732/20 831） showing an increasing trend， but the increase was slower after 2017. The average resistance rate to levofloxacin was 30.55% （6 364/20 831）， and the overall trend showed a sharp rise from 2015 to 2017 （χ2=38.383， 49.569， both P<0.05）， and a significant decline was detected after 2017 （χ2=18.841， P<0.05）. The resistance rate of Hp to levofloxacin in patients increased with age. The clarithromycin resistance rate first decreased and then increased with age， and the resistance rate in old age （32.52%， 763/2 346） was higher than that in youth （22.09%， 1 086/4 916） and middle age patients （21.21%， 2 854/13 458）， and the differences were significant （χ2=991.071， 144.968， both P<0.05）. The resistance rate of Hp rose from 12.73% （14/110） in juvenile to 43.31% （1 016/2 346） in old age （χ2=228.867， P<0.05）. Conclusion:In recent years， the positive rate of Hp infection in Wenling area has a decreasing trend. Although the resistance rate of Hp to clarithromycin and levofloxacin has been rising slowly or decreasing， it is still at a high level. In the selection of Hp eradication program， the differences between patients in different age groups should be considered with particular attention on the minors.

Simultaneous Determination of 6 Components in Volatile Oil from Citrus medica by GC-QAMS / 中国药房

OBJECTIVE：To establish a metho d for simultaneous determinat ion of α-pinene，β-pinene，myrcene，limonene， γ-terpinene and α-terpineol in volatile oil from Citrus medica . METHODS ：GC-QAMS method was adopted. The determination was performed on Agilent DB- 17 capillary column. Flame ionization detector was adopted with nitrogen as carrier gas （purity 99.999％） at the flow rate of 0.5 mL/min. The flow rate of nitrogen （make-up gas ）was 25 mL/min，the flow rate of hydrogen was 30 mL/min， and the flow rate of air was 400 mL/min. The inlet temperature was 250 ℃，and the detector temperature was 280 ℃（programmed temperature），and injection volume was 0.5 μL with split ratio of 35 ∶ 1. Using limonene as internal reference ，relative correction factors of α-pinene，β-pinene，myrcene and γ-terpinene were calculated. The contents of 4 components in the samples were calculated according to the relative correction factors. The results were compared between QAMS and internal standard method （ISM，using dodecane as internal substance ，6 components to be determined ）. RESULTS ：The linear range of α-pinene，β-pinene， myrcene，limonene，γ-terpinene and α-terpineol were 0.030 5-0.213 8，0.066 6-0.466 0，0.021 8-0.152 3，0.765 2-5.356 4，0.387 3- 2.710 8，0.034 2-0.239 6 mg/mL（all r＞0.999）. The limits of detection were 4.82，7.89，4.01，4.54，5.53，2.47 µg/mL，and the limits of quantification were 15.34，25.91，13.69，15.70，18.68，8.36 µg/mL，respectively. RSDs of precision ，repeatability and stability tests （24 h）were all less than 2％. The average recovery rates were 96.08％，97.48％，100.90％，101.22％，100.54％， 95.84％（all RSD ＜3％，n＝6）. The average relative correction factors of α-pinene，β-pinene，myrcene and γ-terpinene were 0.997 8， 1.530 7，0.952 4 and 1.025 5 （all RSD ＜1％）. The contents of α-pinene，β-pinene，myrcene，limonene，γ-terpinene and α-terpineol by ISM were 3.296 9-20.994 1，11.300 6-39.440 9，3.684 2-11.291 4，174.857 8-511.611 8，0-285.127 3，0-48.858 6 mg/g， respectively. The contents of α-pinene，β-pinene，myrcene and γ-terpinene determined by QAMS were 3.296 8-20.994 0，11.300 3- 39.439 7，3.684 1-11.291 1，0-285.126 6 mg/g，respectively. Relative content errors of 4 components as α-pinene determined by 2 methods were all less than 1％ . CONCLUSIONS ： The Δ 基金项目：四川省科技厅应用基础研究项目（No.2021YJ0114）； established GC-QAMS method is simple ，rapid，accurate and 泸州市重点科技项目 [No.2011-S-31（3/3）]；合江县人民政府—西南医 科大学战略合作项目（No.2018-HJXNYD-2） repeatable，and can be used for quantitative analysis and ＊硕士研究生 。研究方向 ：中药制备工艺及质量评价 。电话： quality control of volatile oil from C. medica . 0830-3162291。E-mail：493359958@qq.com

Relationship between seizure cluster of temporal lobe epilepsy with hippocampal sclerosis and cortisol rhythm change / 中华神经科杂志

Objective:To explore the relationship between seizure cluster of temporal lobe epilepsy with hippocampal sclerosis (TLE-HS) and cortisol (COR) rhythm, and understand its mechanism from the perspective of neuroendocrine.Methods:Fifty-seven patients with unilateral TLE-HS were recruited from the Qinghai Provincial People′s Hospital from May 1st 2012 to December 31st 2020. According to the history of seizure clusters one month before admission, 27 patients were enrolled in seizure clusters group (SC group), 30 patients were included in without seizures cluster group (NSC group). The clinical characteristics were systematically analyzed and compared between the SC and NSC groups. Plasma COR levels were measured at 8:00, 16:00 and 24:00 (COR8, COR16 and COR0) on the same day, and bilateral magnetic resonance spectroscopy (MRS) diagnosis was performed in two groups. Independent sample t test, chi-square test, repeated analysis of variance, covariance analysis, and multivariate Logistic regression were used for statistical analysis. Results:Time effect, grouping effect and the interaction effect of the time and grouping in the level of COR were statistically significant. Covariance analysis excluded age as an influential factor, COR16, COR0 and the slope of COR8-16 in the SC group [(126.22±19.98) μg/L, (51.63±21.43) μg/L, -7.78±4.54] were higher than the NSC group [(97.70±18.55) μg/L, (31.90±10.73) μg/L, -12.40±4.16], and the difference was statistically significant ( F=5.587, 4.320, 4.013, all P<0.05). The slope of COR0-8 in the SC group (17.11±6.32) was lower than that in the NSC group (20.62±6.54), and the difference was statistically significant ( F=-2.065, P<0.05). There was no significant difference in lateralization of hippocampal sclerosis between the two groups, and there was no significant difference in the ratio of N-acetyl aspartic acid(NAA)/[choline(Cho)+creatinine(Cr)] in the unilateral hippocampal sclerosis zone of the two groups, but the NAA/(Cho±Cr) ratio of the contralateral hippocampus in the SC group (0.71±0.03) was lower than that in the NSC group (0.76±0.06),and the difference was statistically significant ( t=4.999, P=0.029). Multivariate Logistic regression analysis showed that COR16 ( OR=1.328, 95% CI 1.073-1.642, P=0.009), COR8-16 ( OR=3.657, 95% CI 1.404-9.525, P=0.008) were independent risk factors of seizure clusters in TLE-HS. Conclusion:COR rhythm disturbance may be the neuroendocrine basis of seizure clusters in patients with TLE-HS.

Clinical features and management strategies of infection after lumbar transpedicular dynamic stabilization / 中华骨科杂志

Objective:To investigate the clinical features and treatment strategies of infection after lumbar transpedicular dynamic stabilization.Methods:A total of 1 623 cases with lumbar transpedicular dynamic stabilization conducted from January 2010 to June 2020 were retrospectively analyzed, including 854 males and 769 females and aged 47.56±12.76 years old. There were 1 150 cases with Dynesys fixation, 235 cases with K-Rod, 181 cases with Isobar, 52 cases with Fule and 5 cases with Waveflex. The primary diseases were as following, 984 cases (60.63%) with lumbar disc herniation, 280 cases (17.25%) with lumbar spinal stenosis, 174 cases (10.72%) with lumbar spondylolisthesis, 98 cases (6.04%) with lumbar degenerative scoliosis and 87 cases (5.36%) with discogenic low back pain. Some baseline indicators, such as the overall incidence of infection, the age, gender, smoking, drinking, diagnosis, previous operation history, concomitant disease, the number of fenestration, the number of discectomy, the number of fixed segments, operation duration, blood loss, blood transfusion, the number of the dura mater rupture, postoperative infection duration from primary operation, inflammation indicators (leukocytes, neutrophils, C-reactive protein, erythrocyte sedimentation rate and procalcitonin) of the infected patients, were recorded. According to the time when the infection occurred, the cases were divided into the early infection group (within 3 months after surgery) and the late infection group (more than 3 months after surgery). The clinical indicators and treatment strategies were compared between the two groups.Results:The overall infection rate was 1.66% (27/1 623), including 2.17% (25/1 150) in Dynesys fixation, 1.92% (1/52) in Fule fixation and 0.55% (1/181) in Isobar fixation. The follow-up duration was 51.89±32.55 months. The number of fenestrations was 1(1, 2). The number of discectomy was 1(1, 2), and that of fixed segments was 2(1, 3). The operation duration was 186.30±81.33 minutes, with the blood loss 200 (200, 500) ml and the blood transfusion volume 0(0, 345) ml. There was 1 case of cerebrospinal fluid leakage in early infection group. Thirteen cases of pathogenic bacteria were identified, included 5 cases of Staphylococcus epidermidis, 2 cases of Staphylococcus aureus and 1 case each of Salmonella, Escherichia coli, Pseudomonas aeruginosa, Enterobacter aerogenes, Acinetobacter baumannii, and Streptococcus lactis. A total of 21 patients underwent secondary surgery, including 10 cases of debridement and suturing, 2 cases of internal fixation replacement and 9 cases of internal fixation removal. The other 4 cases underwent puncture and irrigation, while 2 cases received only antibiotic treatment. There were 16 cases with early infection and 11 cases with late infection. There were no significant differences between the two groups in the number of fenestrations, discectomy, operation duration, blood loss, and blood transfusion ( P>0.05). The inflammation indexes of early infection group were higher than those of late infection group with significant difference ( P<0.05), except for procalcitonin. The detection rates of pathogenic bacteria in early and late infection group were 62.5% (10/16) and 27.3% (3/11), respectively. The main infection sites in early infection group were the incision (50.0%, 8/16) and around the internal fixation (18.8%, 3/16). However, the main infection sites in late infection group were around the internal fixation (90.9%, 10/11). In the early infection group, the main treatments including debridement and suturing were conducted in 9 cases, puncturing in 2 cases and internal fixation replacement in 2 cases. In the late infection group, internal fixation removal was performed in 8 cases and puncturing in 2 cases. Conclusion:The overall infection rate after lumbar transpedicular dynamic stabilization was 1.66%. The incidence of early infection was 0.99%, while that of late infection was 0.68%. The incidence of Dynesys fixation was 2.17%. In early infection, the internal fixation could be retained through some treatments as debridement and internal fixation replacement. In most late infection cases, removal of the internal fixation could be helpful to control the infection.

Comparison between discectomy combined with transpedicular dynamic stabilization and transforaminal lumbar interbody fusion in the treatment of single-level lumbar disc herniation / 中华骨科杂志

Objective:To compare the clinical effects of discectomy combined with transpedicular dynamic stabilization and transforaminal lumbar interbody fusion (TLIF) in treating single-level lumbar disc herniation.Methods:From November 2012 to November 2015, a total of 96 patients with single-level lumbar disc herniation (disc height decreased more than 1/3, the width of the basilar part of the herniated disc >6 mm, massive disc herniation or Modic type I endplate changes) treated by discectomy combined with Dynesys dynamic stabilization (Dynesys group, n=48) or TLIF (fusion group, n=48) were enrolled. Clinical assessments included operation duration, intraoperative blood loss, MacNab score, visual analogue scale (VAS), Oswestry disability index (ODI) and rate of complications. Radiographs were evaluated for lumbar mobility, intervertebral height, etc. Results:A total of 86 patients were included in the final analysis (44 in Dynesys group and 42 in fusion group) and were evaluated after 5 years follow-up. The operation duration of Dynesys group (159.61±37.29 min) was less than that of the fusion group (177.42±39.90 min) significantly ( t=2.140, P=0.035). Intraoperative blood loss in Dynesys group (151.78±50.88 ml) was less than that in fusion group (197.74±76.55 ml) with significant difference ( t=3.293, P=0.001). At 5 years follow-up, there were 2 cases with screw loosening and 5 cases with adjacent segmental degeneration in Dynesys group without symptom. In fusion group, there were 12 cases with adjacent segmental degeneration and two of them with symptom. There were significant differences in the incidence of adjacent segment degeneration between the two groups ( χ2=4.012, P=0.045). According to the MacNab criteria, excellent or good cases accounted for 95% in Dynesys group and 93% in fusion group without significant differences ( Z=0.425, P=0.671). VAS back, VAS leg and ODI scores were improved significantly in both groups after 2 years and 5 years ( P<0.05). However, there were no significant differences between the two groups ( P<0.05). The activity of the surgical segment was 4.59°±0.48° in Dynesys group and 1.00°±0.42° in fusion group at 5 years after surgery. The height of intervertebral space in Dynesys group decreased from 11.19±2.07 mm before surgery to 9.98±2.02 mm at 2 years after surgery and to 9.86±1.64 mm at 5 years after surgery ( F=6.462, P=0.002). However, there was no statistically significant difference between the 2 and 5 years follow-up ( q=0.415, P>0.05). At 5 years after surgery, the activity of the first proximal segment in the two groups was 9.74°±3.29° and 11.69°±3.89°, respectively ( t=2.514, P=0.014). Conclusion:Both discectomy combined with dynamic stabilization and TLIF can achieve satisfied clinical effects in treating single-level lumbar disc herniation. Dynamic stabilization preserves the intervertebral activity of surgical segments and results in a lower incidence of adjacent segment degeneration compared with that in fusion surgery. Furthermore, discectomy combined with dynamic stabilization is a less invasive intervention with shorter operation duration and less blood loss compared with TLIF.