The Effects of Bronchoalveolar Lavage Combined with Microbiological Rapid on-site Evaluation in the Maintenance of Potential Donor Lung / 昆明医科大学学报

Objective To explore the effects of bronchoalveolar lavage combined with microbiological rapid on-site evaluation in potential donor lung maintenance.Methods Brain death patients who met the inclusion criteria and were admitted to the Intensive Care Unit(ICU)of Calmette Hospital Affiliated to Kunming Medical University from September 2020 to December 2022 were selected for bronchoalveolar lavage(BAL)and(BAL)and the lavage fluid were collected for M-ROSE to compare the pathogen detection rate and initial diagnosis time.According to the positive results of the microbiological rapid on-site evaluation,patients with the brain death were treated with empirical anti-infective therapy,and the oxygenation index,chest X-ray score,and the infection index(WBC,CRP,PCT)of anti-infective treatment 48 hours were evaluated.Results 1.Comparison of the detection rate of pathogenic microorganisms:The results of M-ROSE were highly consistent with a routine microbiological smear(Kappa = 0.921,P<0.001).2.Comparison of diagnostic time:The initial diagnosis time of M-ROSE was significantly lower than routine microbiological smear time and microbial culture time(P<0.001).3.Comparison of therapeutic effects of anti-infective therapy for 48 hours:There was no significant difference in oxygenation index,white blood cells and hypersensitive C-reactive protein before and after the anti-infective treatment(P>0.05).There were significant differences in procalcitonin and chest X-ray before and after the anti-infective treatment(P<0.05).Conclusion Bronchoalveolar lavage combined with microbiological rapid on-site evaluation has the high timeliness in the diagnosis of potential donor pulmonary infection,which can provide a preliminary basis for the early anti-infective therapy of donor lung maintenance.

Role of 5-hydroxytryptamine type 3 receptors in the regulation of anxiety reactions / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

5-Hydroxytryptamine (5-HT) type 3 receptor (5-HT3R) is the only type of ligand-gated ion channel in the 5-HT receptor family. Through the high permeability of Na+, K+, and Ca2+ and activation of subsequent voltage-gated calcium channels (VGCCs), 5-HT3R induces a rapid increase of neuronal excitability or the release of neurotransmitters from axon terminals in the central nervous system (CNS). 5-HT3Rs are widely expressed in the medial prefrontal cortex (mPFC), amygdala (AMYG), hippocampus (HIP), periaqueductal gray (PAG), and other brain regions closely associated with anxiety reactions. They have a bidirectional regulatory effect on anxiety reactions by acting on different types of cells in different brain regions. 5-HT3Rs mediate the activation of the cholecystokinin (CCK) system in the AMYG, and the γ‍-aminobutyric acid (GABA) "disinhibition" mechanism in the prelimbic area of the mPFC promotes anxiety by the activation of GABAergic intermediate inhibitory neurons (IINs). In contrast, a 5-HT3R-induced GABA "disinhibition" mechanism in the infralimbic area of the mPFC and the ventral HIP produces anxiolytic effects. 5-HT2R-mediated regulation of anxiety reactions are also activated by 5-HT3R-activated 5-HT release in the HIP and PAG. This provides a theoretical basis for the treatment of anxiety disorders or the production of anxiolytic drugs by targeting 5-HT3Rs. However, given the circuit specific modulation of 5-HT3Rs on emotion, systemic use of 5-HT3R agonism or antagonism alone seems unlikely to remedy anxiety, which deeply hinders the current clinical application of 5-HT3R drugs. Therefore, the exploitation of circuit targeting methods or a combined drug strategy might be a useful developmental approach in the future.

Effects of different formulations of high-fat diet on establishment of a non-alcoholic fatty liver model in rats / 中国临床药理学与治疗学

AIM:To improve the success rate of experimental modeling of non-alcoholic fatty liver(NAFLD)in rats by high-fat diet through comparing three different formulations of high-fat diets in con-structing non-alcoholic fatty liver rats model,so as to provide a reliable animal model for the study of non-alcoholic fatty liver disease.METHODS:SPF-grade male SD rats were divided into four groups randomly:control group,high-fat diet group1(HFD1),high-fat diet group2(HFD2),high-fat diet group3(HFD3).Each group was given the corre-sponding feed for 8 weeks while modeling.The da-ta on general observation,body weight changes,and ingestion of the rats were recorded during the modeling period.After 8 weeks'feeding,liver ultra-sound,CT and MRI examination were performed for the rats of each group to check the status.Blood and liver samples were collected.Changes in liver function(ALT,AST),blood lipids(TC,TG,HDL-C,LDL-C),and inflammatory indexes(IL-1β,IL-6,TNF-α)were detected.The morphology of the liv-ers was observed with the naked eyes,and the liv-er index and Lee's index were calculated at the end of 8 weeks.The effects of different high-fat diets on the establishment of NAFLD model in SD rats were comprehensively evaluated by comparing the difference of above indexes among the groups.RE-SULTS:Compared with the control group,rats in the HFD1,HFD2 and HFD3 groups showed poor mental deterioration,decreased activity,severe hair loss,decreased food intake,increased body weights,and significantly increased liver index and Lee's in-dex,along with increased liver volume,blunt edge,steatosis and lipid deposition,and the trend was even more pronounced in the HFD3 group.Com-pared with the control group,the serum levels of ALT,AST,TC,TG,LDL-C,IL-1β,IL-6 and TNF-α were significantly increased,while the contents of HDL-C was significantly decreased in the HFD1,HFD2 and HFD3 group,especially in the HFD3 group.Com-pared with the control group,the B ultrasonogra-phy showed an enlarged liver with enhanced paren-chymal echo and pipe unsharpness,CT showed that the liver and spleen CT ratio decreased obvi-ously,and the MRI images showed obvious differ-ence of liver signal intensity between in/out of phase image in the HFD1,HFD2 and HFD3 group,and the most significant imaging changes was ob-served in the HFD3 group.CONCLUSION:The above three kinds of high-fat diets can establish NAFLD model in SD rats after 8 weeks'feeding,the models induced by HFD3 was better than those in-duced by the other two groups.NAFLD lesion is rel-atively serious and expected to last longer in HFD3 group,which are more suitable for investigating the underlying mechanisms of non-alcoholic fatty liver disease and development of lipid-lowering drugs.

Bone density and bone metabolism in plasmapheresis donors / 中国输血杂志

【Objective】 To investigate the level of serum bone metabolism and biochemical markers and bone density of plasmapheresis donors, and to provide scientific basis for ensuring the health and safety of plasmapheresis donors in China. 【Methods】 A total of 437 plasmapheresis donors from Linwu plasmapheresis station in Hunan Province from July 1 to September 30, 2022 were recruited to determine the levels of total serum calcium, albumin, serum 25-hydroxyvitamin D (25OHD), serum type I procollagen N-terminal propeptide (P1NP), and collagen type 1 crosslinked carboxyl-terminal peptide (β-CTX). Dual-energy X-ray method was used to measure the bone density of the anteroposterior lumbar spine (L1-L4) and bilateral femoral neck bone density of plasmapheresis donors. Plasmapheresis donors were grouped according to the type of plasma donation (first-time and repeat plasmapheresis donors) and the total number of plasma donations to assess the differences in bone density and serum bone metabolism biochemical markers between groups. The dose-response relationship between the total number of plasmapheresis donations and biochemical indexes was analyzed by limiting cubic spline, and the influencing factors of different indexes were explored by multiple linear regression. 【Results】 A total of 437 plasmapheresis donors were included in this study, including 187 first-time plasmapheresis donors and 250 repeat plasmapheresis donors. There were no significant differences in bone density and prevalence of osteoporosis between first-time donors and repeat donors (P>0.05). There was also no significant difference in bone density levels between groups of total number of plasmapheresis donations. The levels of albumin and 25OHD decreased with the increase of the total number of plasma donations, while the serum P1NP level was positively correlated with the total number of plasma donations. The results of the restriction cubic spline showed that the total number of plasmapheresis donations had a nonlinear dose-response relationship with 25OH and P1NP (P<0.05). The results of multiple linear regression showed that the frequency of plasmapheresis donation was the influencing factor of 25OHD, and the total number of plasmapheresis donation was the influencing factor of P1NP. 【Conclusion】 Plasmapheresis donation does not affect the bone health of donors and increase the risk of osteoporosis due to the use of long-term anticoagulants, but it will increase the osteogenic activity of plasmapheresis donors. It is recommended that middle-aged and elderly plasmapheresis donors supplement vitamin D appropriately.

Research progress into the mechanisms of exosome immunoregulation of bacterial infection / 中国比较医学杂志

Exosomes are small endosomally derived extracellular vesicles with a lipid bilayer structure,and they contain substances,such as proteins,lipids,DNA,RNA,micro(mi)RNA,and long non-coding(lnc)RNA.Exosomes participate in pathogen recognition,antigen presentation,autophagy regulation,immune activation and immunosuppression in bacterial infections.Studies have shown that miRNA,lncRNA,and proteins in exosomes play important roles in regulating antibacterial reactions in organisms.We reviewed the immunomodulatory effects of exosomes on several intracellular and extracellular bacterial infections to provide a reference for those studying the interactions between exosomes and bacterial infections.

Diagnostic Value of Peripheral Blood Systemic Immune Inflammatory Index in Histological Chorioamnionitis and Prediction of Adverse Pregnancy Outcomes / 实用妇产科杂志

Objective:To investigate the diagnostic value of peripheral blood systemic immune inflammatory in-dex(SII)in histological chorioamnionitis(HCA)and the predictive value of adverse pregnancy outcomes.Meth-ods:A total of 138 pregnant women with suspected HCA were included from January 2021 to June 2022 in Peo-ple's Hospital of Zhengzhou as the research objects.According to the results of placental pathology examination,they were divided into non-HCA group(66 cases)and HCA group(72 cases).The general clinical data,laboratory indicators and adverse outcome indicators of the two groups were compared,and the relationship between the a-bove indicators and HCA was analyzed by multivariate Logistic regression.ROC curve was used to analyze the predictive value of SII for HCA and adverse pregnancy outcomes.Results:①Logistic regression analysis showed that increased neutrophil percentage(Neut％)and SII could increase the risk of HCA(OR＞1,P＜0.05),and in-creased lymphocyte percentage(Lym％)was beneficial for reducing the risk of HCA(OR＜1,P＜0.05).②ROC curve analysis showed that the area under the curve(AUC)of Neut％and Lym％for diagnosing HCA were 0.628 and 0.638,respectively,while the AUC of SII was higher(0.722),and the diagnostic threshold of SII was 974.49 ×109/L.③The rates of postpartum hemorrhage,neonatal infection and premature delivery in high SII group(SII＞974.49 ×103/L)were higher than those in low SII group(SII ≤974.49 ×109/L),and the difference was statistically significant(P＜0.05).The value of SII in predicting postpartum hemorrhage(AUC 0.708)and neonatal infection(AUC 0.848)were higher than that in preterm birth(AUC 0.637).Conclusions:Abnormal Neut％and Lym％levels increase the risk of HCA to some extent,but the diagnostic value of HCA is average.Peripheral blood SII has high diagnostic value in HCA,and has good predictive value for postpartum hemorrhage and neonatal infection,which is expected to be a new indicator for prenatal diagnosis and prognosis prediction of adverse pregnancy outcomes in HCA.

Application of concept of enhanced recovery after surgery in the training of hepatic surgery specialists / 中华医学教育探索杂志

Objective:To investigate the application effect of the concept of enhanced recovery after surgery (ERAS) in the training of hepatic surgery specialists.Methods:Sixty attending physicians who had received 6 months of specialist training in the Hepatopancreatobiliary Surgery of the First Affiliated Hospital, School of Medicine, Zhejiang University, China in 2017-2019 were randomly divided into the control group and research group. The control group adopted the traditional training mode of hepatic surgery specialists, and the research group adopted the training mode of hepatic surgery specialists integrating the concept of ERAS. At the end of the training, the two groups were evaluated through theoretical examination and clinical practice. SPSS 25.0 was used for t test and Chi-square test. Results:The scores in theoretical knowledge [(91.70±2.87) vs. (89.60±2.88), P = 0.006], clinical thinking [(93.17±2.78) vs. (86.33±3.70), P < 0.001], and surgical simulation [(92.83±2.84) vs. (89.50±3.31), P = 0.013] were significantly better in the research group than in the control group. The questionnaire results showed that the satisfaction of specialists in the research group was better than that in the control group [(91.50±3.26) vs. (84.67±3.46), P < 0.001]. The results of clinical practice assessment showed that the patients managed by the specialist in the research group had faster postoperative recovery compared with the control group (length of stay: 6.10±1.80 vs. 9.90±1.60, P < 0.001). Conclusion:The training mode of hepatic surgery specialists integrating the concept of ERAS enables specialists to better master the theoretical knowledge and practical operation skills of hepatic surgery, and ultimately benefits patients.

Expert consensus on antiviral therapy of COVID-19 / 中华临床感染病杂志

COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.

Current status of surgery for portal hypertension in China: a national multi-center survey analysis / 中华器官移植杂志

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

Progress of circulating tumor DNA in cervical cancer / 肿瘤研究与临床

Cervical cancer is a leading cause of cancer death in women. There are no reliable noninvasive indicators to predict the recurrence, metastasis and prognosis of cervical cancer. Circulating tumor DNA (ctDNA) is a kind of DNA fragment released from tumor cells into the blood circulation, which has the advantages of being non-invasive, real-time, and of reflecting the genetic characteristics of tumors. With the improvement of ctDNA detection technology and in-depth research on ctDNA, ctDNA has shown more obvious advantages in early diagnosis, tumor molecular typing, treatment monitoring and recurrence prediction of cervical cancer compared with traditional histological, serological and imaging detection methods. This paper reviews the detection methods of ctDNA and its latest research progress of ctDNA in cervical cancer.

Internal drainage tube versus T tube in laparoscopic common bile duct exploration / 中华肝胆外科杂志

Objective:To study the effect of internal drainage tube and T tube in laparoscopic common bile duct exploration.Methods:The data of 103 patients who underwent laparoscopic common bile duct exploration for the treatment of choledocholithiasis from January 2016 to April 2021 in Dongguan Kanghua Hospital were analyzed, including 50 males and 53 females, aged (50.3±17.2) years old, the age range was 15 to 90 years old. A total of 103 patients were randomly divided into T tube group ( n=60), who received laparoscopic cholecystectomy + choledocholithotomy and stone removal+ T tube drainage, and self-dropping stent group ( n=43), who received laparoscopic cholecystectomy + choledocholithotomy and stone removal + placed with self-dropping stent. The operation time, intraoperative blood loss, postoperative drainage, postoperative hospital stay and incidence of postoperative complications were compared between the two groups. Results:The operation time of self-dropping stent group was (107.2±26.1) min, intraoperative blood loss 10(5, 10) ml, and postoperative hospital stay (6.5±3.5) d, which were better than those of T tube group (143.5±52.7) min, 10(10, 20) ml, (8.8±3.8) d, the differences were statistically significant (both P<0.05). There were no significant difference in postoperative drainage volume and postoperative complications between the two groups (both P>0.05). Conclusion:The internal drainage tube in laparoscopic common bile duct exploration is a safe and reliable surgical method for the treatment of choledocholithiasis, which can significantly shorten the hospitalization time of patients.

Safety and clinical efficacy of invasive treatment for portal vein thrombosis after splenectomy or devascularization / 中华普通外科杂志

Objective:To analyze the safety and clinical efficacy of invasive treatment for portal vein thrombosis after splenectomy or devascularization.Methods:Invasive treatment was retrospectively analyzed from Jan 2016 to Jan 2020. In 319 cases who met the inclusion criteria.Result:There were complications in 41 cases and no death;The average portal vein pressure before and after thrombus clearance treatment was (25.6±4.9) mmHg and (14.7±4.1) mmHg respectively ( t=2.53, P<0.05); Thrombus decreased significantly in most patients. Conclusion:Invasive therapy is a safe and effective method for patients complicated with portal vein thrombosis after splenectomy or devascularization.

Development of a blocking ELISA based on a single-domain antibody target the S1 protein of porcine epidemic diarrhea virus / 生物工程学报

The aim of this study was to develop a blocking enzyme-linked immunosorbent assay (bELISA) based on a biotinylated nanobody target the S1 protein of porcine epidemic diarrhea virus (PEDV) for detecting the anti-PEDV antibodies and evaluating the immune effect of the vaccine. The gene encoding the single-domain antibody sdAb3 target the PEDV S1 protein was amplified and the Avitag sequence was fused at its 3'-end. The PCR product was cloned into the expression vector pET-21b for expression and purification of the sdAb3-Avitag protein. The purified sdAb3-Avitag fusion protein was biotinylated and its activity was determined. Using the recombinant S1 protein as a coating antigen, a bELISA was established and optimized. Serum samples were tested in parallel by the bELISA and a commercial kit. The recombinant vector pET21b-sdAb3-Avitag was constructed to express the tagged sdAb3. After induction for expression, the biotin-labeled sdAb3 (sdAb3-Biotin) with high purity and good activity was obtained. For the optimized bELISA, the coating concentration of the S1 protein was 200 ng/well, the serum dilution was 1:2 and incubated for 2 h, the dilution ratio of the biotinylated sdAb3 was 1:8 000 and incubated for 30 min, the dilution of the enzyme-labeled antibody was 1:5 000 and incubated for 30 min. The bELISA had no cross reaction with the sera of major porcine viruses including transmissible gastroenteritis virus, porcine reproductive and respiratory syndrome virus and showed good specificity and reproducibility. For a total of 54 porcine serum samples tested, the overall compliance rate of the bELISA with a commercial kit was 92.56%. This study developed a rapid and reliable bELISA method, which can be used for serosurveillance and vaccine evaluation for PEDV.

Application on different contrast media concentration in the pancreatic CT angiography scanning / 中国辐射卫生

Objective To compare the effects of the different contrast media concentration on the visualization of pancreatic arteries using 64-Detector Spiral CT. Methods 120 cases who underwent abdominal enhancement CT scanning were randomly divided into group A (n = 60) and B (n = 60). The contrast media concentration was 300 mgI/ml for group A and 370 mgI/ml for group B respectively, both groups shared the same contrast media dose algorithm and injection speed, with 0.5 gI/kg body weight and 4 ml/s respectively. Reformating the pancreatic arteries via MIP (maximum intensity projection), VR (volume rendering) and MPR (multi-planar reconstruction). Results The CT value of the abdominal aortic celiac opening of group B is significantly higher than A (P < 0.01). The visualization scores of pancreatic arteriesin Group B are significantly higher than A (P < 0.05). The visualization ratios of pancreatic arteriesin Group Bare higher than A, the differences of AIPDA、PIPDA、DPA、TPA、PMA、CPA between the 2 Groups have statistically significant (P < 0.05). Conclusion Pancreatic arteries could have a better visualization by using 370 mgI/ml contrast media in pancreatic artery scanning.

Experiment on Inhibiting NEK7 to Promote Apoptosis of Hepatocellular Carcinoma Cells / 肿瘤防治研究

Objective To use in vitro experiments to verify the changes of proliferation, senescence and apoptosis of hepatocellular carcinoma cells after inhibiting the expression of NEK7, and to explore the related molecular mechanism. Methods Western blot and RT-PCR were used to detect the expression of NEK7 in hepatocellular carcinoma cells and THLE-2 cells. A viral vector was designed to inhibit the expression of NEK7 based on the gene sequence. After hepatocellular carcinoma cells were transfected, we observed the changes of proliferation activity, cell senescence, cell apoptosis and cell cycle in vitro. Western blot was used to detect the expression of cell cycle-related factors. Results Compared with THLE-2 cells, NEK7 was highly expressed in hepatocellular carcinoma cells. After inhibiting the expression of NEK7 with shRNA, the proliferation of hepatocellular carcinoma cells was inhibited, the proportions of cell senescence and apoptosis were increased, meanwhile, the cell number in stage S and G2/M was significantly reduced, the cell cycle progression was blocked, the expression levels of C-myc, c-Fos, cyclin D1 and cyclin E were inhibited, P16 and P27 expression were increased, and CDK2, CDK4 and CDK6 expression were not significantly changed. Conclusion After inhibiting the expression of NEK7, the proliferation ability of hepatocellular carcinoma cells is reduced, cell senescence is promoted and apoptosis is induced; meanwhile, the cell cycle progress is blocked.

Cognition on diagnosis and treatments of bronchiectasis among respiratory specialists / 中华健康管理学杂志

Objective:To investigate the cognition of the diagnosis and management of bronchiectasis among respiratory specialists.Methods:Between May and June 2020, a questionnaire survey based on expert consensus and guidelines was conducted among respiratory specialists from 50 hospitals from Sichuan and Yunnan provinces. Total 691 questionnaires were distributed and 641 were received. 601 valid questionnaires were chosen for further analysis with an effective recovery rate of 87.0%. The respondents were required to finish the e-questionnaires independently in terms of cognition of diagnosing, severity assessment, treatments and Chinese medicines of bronchiectasis. The responses were collected online and the cognitive levels were evaluated by calculating the correct rates of corresponding questions.Results:540 (89.9%) of the respondents agreed that high-resolution computed tomography (HRCT) was the gold standard for diagnosing of bronchiectasis, but 318 (52.9%) had an incomplete understanding of common radiographic manifestations of bronchiectasis, and different cognitive degrees of common radiographic manifestations of bronchiectasis existed among respondents with different qualifications or working in different levels of hospitals ( P<0.05). Only 118 (19.6%) of the respondents were familiar with severity assessments of bronchiectasis, but 65 (55.1%) of the 118 respondents said they won′t apply these severity assessments to patient during their clinical works. For the treatment of patients with stable bronchiectasis, airway clearance techniques were most recommended by specialists surveyed [410 (68.2%)], among which, postural drainage was the most known method [559 (93.0%)]. For patients undergoing an acute exacerbation, most respondents recommended antibiotics [600 (99.8%)] as the primary treatment, and examinations such as sputum culture [544 (90.5%)], inflammatory markers [523 (87.0%)] should be performed as well. 504 (83.9%) thought that pseudomonas aeruginosa was the most common conditioned pathogen for bronchiectasis. For patients with frequent exacerbations (≥3 per year), 385 (64.1%) of the respondents supported the therapeutic effect of long-term antibiotics, however, among the 385 respondents supporting long-term antibiotics, only [113 (29.4%)] were willing to recommend long-term antibiotic treatment actively during their clinical practice. Besides, 304 (50.6%) respondents held a positive attitude to the clinical effect of traditional Chinese medicine therapies. Among 304 respondents holds the point of supporting, only 86 (28.3%) were willing to recommend traditional Chinese medicine to patients actively, differences about the attitude and clinical behaviors were found between respondents working in different levels of hospitals ( P<0.05). Conclusions:Respiratory specialists′ cognition on diagnosis and treatments of bronchiectasis remains inadequate, and cognitive levels differ among respondents working in different levels of hospitals. There is a gap between respondents′ cognition and clinical practice. Further education and trainings are necessary for improving respiratory specialists′ knowledge for timely diagnosis and standard treatment of bronchiectasis.

A tetravalent single-chain variable fragment antibody for the detection of staphylococcal enterotoxin A / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Staphylococcal enterotoxin A (SEA) synthesized by

Chlorophyll content for millet leaf using hyperspectral imaging and an attention-convolutional neural network / Estimativa do teor de clorofila para folhas de milheto usando imagens hiperespectrais e uma rede neural atenção-convolucional

ABSTRACT: Chlorophyll is a major factor affecting photosynthesis; and consequently, crop growth and yield. In this study, we devised a chlorophyll-content detection model for millet leaves in different stages of growth based on hyperspectral data. The hyperspectral images of millet leaves were obtained under a wavelength range of 380-1000 nm using a hyperspectral imager. Threshold segmentation was performed with near-infrared (NIR) reflectance and normalized difference vegetation index (NDVI) to intelligently acquire the regions of interest (ROI). Furthermore, raw spectral data were preprocessed using multivariate scatter correction (MSC). A correlation coefficient-successive projections algorithm (CC-SPA) was used to extract the characteristic wavelengths, and the characteristic parameters were extracted based on the spectral and image information. A partial least squares regression (PLSR) prediction model was established based on the single characteristic parameter and multi-characteristic parameter fusion. The determination coefficient (Rv 2) and the root-mean-square error (RMSEv) of the validation set for the multi-characteristic parameter fusion model were reported to be 0.813 and 1.766, respectively, which are higher than those obtained by the single characteristic parameter model. Based on the multi-characteristic parameter fusion, an attention-convolutional neural network (attention-CNN) (Rv 2 = 0.839, RMSEv = 1.451, RPD = 2.355) was established, which is more effective than the PLSR (Rv 2 = 0.813, RMSEv = 1.766, RPD = 2.167) and least squares support vector machine (LS-SVM) models (Rv 2 = 0.806, RMSEv = 1.576, RPD = 2.061). These results indicated that the combination of hyperspectral imaging and attention-CNN is beneficial to the application of nutrient element monitoring of crops.

RESUMO: A clorofila é um fator importante que afeta a fotossíntese e, consequentemente, o crescimento e o rendimento das culturas. Neste estudo, um modelo de detecção de conteúdo de clorofila é construído para folhas de milheto em diferentes estágios de crescimento, com base em dados hiperespectrais. As imagens hiperespectrais dos diferentes estágios de crescimento das folhas de milheto foram obtidas para 380-1000 nm, utilizando um gerador de imagens hiperespectrais. Uma segmentação de limiar foi realizada com refletância no infravermelho próximo (NIR) e índice de vegetação com diferença normalizada (NDVI) para adquirir de forma inteligente as regiões de interesse (ROI). Além disso, os dados espectrais brutos foram pré-processados usando o método de correção de dispersão multivariada (MSC). Um algoritmo de projeção de coeficiente de correlação sucessivo (CC-SPA) foi utilizado para extrair os comprimentos de onda característicos, e os parâmetros característicos foram extraídos com base nas informações espectrais e de imagem. O modelo de previsão de regressão parcial dos mínimos quadrados (PLSR) foi estabelecido com base nos parâmetros de característica única e na fusão de parâmetros de característica múltipla. O coeficiente de determinação (Rv2) e o erro quadrático médio da raiz (RMSEv) do conjunto de validação para o modelo de fusão de parâmetros com várias características foram obtidos como 0,813 e 1,766, sendo melhores do que os do modelo de parâmetro de característica única. Com base na fusão de parâmetros com várias características, foi estabelecida uma rede neural atenção-convolucional (atenção-CNN) (Rv2 = 0,839, RMSEv = 1,451, RPD = 2,355) mais eficaz que o PLSR (Rv2 = 0,813, RMSEv = 1,766, RPD = 2,167) e mínimos quadrados que suportam modelos de máquina de vetores (LS-SVM) (Rv2 = 0,806, RMSEv = 1,576, RPD = 2,061). Estes resultados indicam que o modelo atenção-CNN atinge uma previsão efetiva do teor de clorofila nas folhas de milheto usando os dados hiperespectrais. Além disso, esta pesquisa demonstra que a combinação de imagens hiperespectrais e a atenção-CNN se mostra benéfica para a aplicação do monitoramento dos elementos nutricionais das culturas.

Research updates on the mechanism and preogress of portal vein thrombosis prevention after splenectomy and esophagogastric devascularization / 中华肝胆外科杂志

At present,splenectomy and extensive esophagogastric devascularization is one of the effective treatments for relieving hypersplenism in patients with cirrhosis,relieving portal hypertension,and reducing upper gastrointestinal bleeding caused by rupture of esophagogastric varices.However,portal vein thrombosis is one of the most common serious complications of splenectomy and devascularization in patients with cirrhosis.Because of its high incidence and mortality of PVT,it has become the focus of disputes in the surgical field.In recent years,with the improvement of medical technology,many domestic and foreign scholars have conducted high-quality researches on the prevention of PVT in the perioperative period of splenectomy and devascularization.This paper summarized the research progress during recent years in combination with relevant literature.

Technical advancement in surgical treatment of portal hypertension / 中华肝脏病杂志

Recently, there have been many developments and improvements in portal hypertension surgery, but there are still many controversies regarding the surgical indications, the timing of surgery, and the choice of surgical procedures. Minimally invasive laparoscopy and robotics are the leading direction for the development of surgical techniques for portal hypertension. Surgical selection procedures should be based on evidence-based, but guidelines should not be blindly followed. Surgical development needs to strengthen multidisciplinary cooperation, and surgical reform is the driving force for surgical development.