Comparison of clinical effects of endoscopic thyroidectomy using the modified gasless transsubclavian approach and traditional open surgery for cN0 unilateral papillary thyroid carcinoma / 中华外科杂志

Objective: To compare the clinical effects of endoscopic thyroidectomy using a modified gasless transsubclavian approach and the traditional neck approach for unilateral papillary thyroid carcinoma (cN0). Methods: The clinical data of 135 patients with cN0 papillary thyroid carcinoma who underwent unilateral thyroidectomy in the Department of Thyroid Surgery, the First Hospital of Jilin University from October 2020 to November 2022 were retrospectively analyzed. There were 37 males and 98 females, aging (43.2±8.8) years (range: 21 to 59 years). There were 51 cases using the modified gasless transsubclavian approach (TS group) and 84 cases using the traditional neck approach (TN group). Comparative analyses were performed between the operative results of the 2 groups by t-test, Wilcoxon rank sum test, and χ2 test. Results: All endoscopic operations were successfully completed without conversion to the traditional neck approach. Compared to the TN group, the TS group had a longer operation time (M(IQR)) (73.5 (22.5) minutes vs. 90.0 (30.0) minutes, Z=-5.831, P<0.01), more postoperative drainage (60 (25) ml vs. 95 (45) ml, Z=-6.275, P<0.01), higher hospitalization costs (22 687 (3 488) yuan vs. 26 652 (2 431) yuan, Z=-6.944, P<0.01), and a higher rate of parathyroid autotransplantation (15.5% (13/84) vs. 60.8% (31/51), χ2=29.651, P<0.01). There was no significant difference in the total exposure rate of the central compartment, postoperative hospitalization time, the number of dissected lymph nodes, the number of metastatic lymph nodes, C-reactive protein ratio before and after operation, and preoperative and postoperative parathyroid hormone (all P>0.05). Conclusions: Endoscopic thyroidectomy using the modified gasless transsubclavian approach is safe for cN0 papillary thyroid carcinoma, with longer operating time, more postoperative drainage, higher hospitalization costs, and moredifficulty in preserving the inferior parathyroid gland in situ compared to traditional open surgery.

Discussion on how to optimize active surveillance for low-risk papillary thyroid microcarcinoma in China / 中华外科杂志

Active surveillance, as a first-line treatment strategy for low-risk papillary thyroid microcarcinoma, has been recommended by guidelines worldwide. However, active surveillance has not been widely accepted by doctors and patients in China. In view of the huge challenges faced by active surveillance, doctors should improve their understanding of the "low risk" of papillary thyroid micropapillary cancer, identify some intermediate or high-risk cases, be familiar with the criteria and methods of diagnosis for disease progression, and timely turn patients with disease progression into more active treatment strategies. By analyzing the long-term cost-effectiveness of active surveillance, it is clear that medical expense is only one cost form of medical activities, and the health cost (thyroid removal and surgical complications) paid by patients due to"over-diagnosis and over-treatment" is the most important. Moreover, the weakening of the patients' social function caused by surgical procedures is a more hidden and far-reaching cost. The formulation of health economic policies (including medical insurance) should promote the adjustment of diagnosis and treatment behavior to the direction which is conducive to the long-term life and treatment of patients, improving the overall health level of society and reducing the overall cost. At the same time, doctors should stimulate the subjective initiative of patients, help them fully understand the impact of various treatment methods on their psychological and physical status, support patients psychologically, and strengthen their confidence in implementing active surveillance. By strengthening multi-disciplinary treatment team and system support, doctors can achieve risk stratification of papillary thyroid microcarcinoma, accurate judgment of disease progress, timely counseling for psychological problems, and long-term adherence to active surveillance. Improving the treatment level of advanced thyroid cancer is the key point of improve the prognosis. It is important to promote the development of active surveillance for low-risk papillary thyroid microcarcinoma. In the future, it is necessary to carry out multi-center prospective research and accumulate research evidence for promoting the standardization process of active surveillance. Standardized active surveillance will certainly benefit specific papillary thyroid microcarcinoma patients.

Etiological analysis and epidemiological significance of plague in Qinghai, 1980-2011 / 中国热带医学

@#Abstract: Objective　To analyze the pathogenic characteristics and epidemiological significance of human plague related strains in Qinghai Province in recent 30 years, so as to provide scientific basis for on-the-spot disposal and prevention and control measures of plague outbreak in Qinghai Province. Methods　A total of 35 strains of Yersinia pestis isolated from 29 typical human plague outbreaks in Qinghai Province from 1980 to 2011 were selected and studied by biochemical fermentation experiments. Virulence factors detection of Fraction 1 antigen (Fra1), virulence antigen (VW), pigmentation (Pgm) and Yersinia pestis Ⅰ (PstⅠ), determinants and genotyping of differential regions (DFRs) were used to study the pathogenic characteristics. At the same time, according to the epidemic situation of human and animal plague in Qinghai Province in recent years, the current situation of plague prevention and control and epidemic characteristics were analyzed. Results　The biotypes of 35 strains of Yersinia pestis were classical, and the biotypes of 29 strains (82.86%) were of Qinghai-Tibet Plateau type, mainly distributed in southern Qinghai and around lake areas, 2 strains (5.71%) belonged to Qilian Mountains type, mainly distributed in Qilian mountains, and 6 genotypes were identified by DFR. Among them, 16 were type 5, 12 were type 8, 2 were type 10, 1 was type 36, 3 were type 30 and 1 was type 1b, the strains of type 5 and 1b were mainly distributed around the lake and the southern foot of Qilian Mountains, while the strains of type 8, 10, 36 and 30 were mainly distributed in the southern part of Qinghai. Conclusions　The pathogen of Yersinia pestis in Qinghai Plateau has complex biochemical types, the epidemic situation among animals is continuous year after year, the situation of prevention and control is serious, the occurrence and prevalence of plague seriously endanger people's health and social development, so it is necessary to do a solid job in the prevention and control of plague to ensure the safety of people's lives.

Prevalence and factors influencing depressive symptoms among children with dyslexia in China / 中国学校卫生

Objective@#To investigate the prevalence and factors influencing depressive symptoms among children with dyslexia in China.@*Methods@#A total of 6 298 children in grades 3-5 were recruited from eight primary schools in Baoan, Shenzhen. The Questionnaire for Children s Reading Ability, the Dyslexia Checklist for Chinese Children, the Pupil Rating Scale Revised Screening for Learning Disabilities, and the Children s Depression Inventory short version were used.@*Results@#The prevalence of dyslexia was 2.76%( n =174). The rate of depressive symptoms in children with dyslexia (37.36%) was higher than children without dyslexia (18.17%)( χ 2=40.94, P ＜0.01). Compared with children without dyslexia, children with dyslexia had an increased risk of depressive symptoms ( OR=2.65, 95%CI=1.87-3.75, P ＜0.01). In addition, the average time that a mother spent with her child every day was one of the factors influencing depressive symptoms. The risk of depressive symptoms was lower in children who spent ≥3 h with their mothers than children who spent <1 h(3-4 h: OR=0.54, 95%CI=0.36-0.81； 5-6 h: OR=0.51, 95%CI=0.34-0.78 ; ≥7 h: OR=0.47, 95%CI=0.32-0.69, P ＜0.01).@*Conclusion@#The rate of depressive symptoms in children with dyslexia was shown to be high. Increasing the time that mothers spend with their children every day is helpful in preventing the occurrence of depression in children.

Clinical value of PCR-flow Fluorescence Hybridization in Prenatal Genetic Diagnosis of Thalassemia / 中国实验血液学杂志

OBJECTIVE@#To explore the value of PCR-flow fluorenscence immunmicrobeads assay in prenatal gene diagnosis of thalassemia.@*METHODS@#A total of 1001 pregnant women and their couples checked in the First Affiliated Hospital of Sun Yat-Sen University from January 2016 to August 2019 were selected. Both pregnant women and their spouses were the carriers of thalassemia gene. Samples such as amniotic fluid, were used to extract genomic DNA at the right time. Parallel detection of α- and β- thalassemia genes to samples should be carried out by PCR-flow cytometric fluorescence hybridization and traditional multiple Gap-PCR and PCR-RDB techniques. The consistency of two methods in gene diagnosis of thalassemia was evaluated by analyzing the results of detection.@*RESULTS@#389 normal genotypes (38.86%, 389/1001) and 59 abnormal genotypes (61.14%, 612/1001) was cheked out by the two methods, including 416 cases of α-thalassemia, 162 cases of β-thalassemia and 34 cases of αβ- complex thalassemia. The main genotypes of α-thalassemia were --@*CONCLUSION@#Guangzhou is a area with high incidence of thalassemia, and the genetic types of thalassemia are complex and diverse. Prenatal diagnosis is the final barrier to the prevention of thalassemia. PCR flow-cytometric fluorescence hybridization, as a simple and fast technique, combined with traditional techniques in parallel contributed to the accuracy of prenatal gene diagnosis of thalassemia.

Retrospective Analysis of Hematological Phenotypes in Patients with Gene Mutation and Deletion α-Thalassemia / 中国实验血液学杂志

OBJECTIVE@#To explore the differences between hematological phenotypes of patients with different genotypes in gene mutations and deletion α- thalassemia.@*METHODS@#By screening the α- thalassemia gene test results in the First Affiliated Hospital, Sun Yat-Sen University from January 2015 to April 2020, the patients with mutation and deletion α- thalassemia were obtained, then the differences between hematological phenotypes of patients with different genotypes were analyzed.@*RESULTS@#There were 96 patients with mutation combined with deletion α- thalassemia from the results of 24 054 α- thalassemia patients screened out, including 79 patients with non-deletion Hb H disease (α@*CONCLUSION@#The hematological phenotype changes caused by α

Epidemiological investigation and follow-up study of indeterminate HIV antibody test results in Jiading, Shanghai / 上海预防医学

Objective To investigate the rate and the population distribution of subjects with indeterminate result of HIV antibody test and to understand the relationships between the western blot(WB)banding patterns and HIV infection through follow-up reexamination. Methods Samples with indeterminate results of HIV antibody test were collected by Jiading Center for Disease Control and Prevention from 2013 to 2017. They were used for analysis of the source, the distribution of Western blotting band pattern and the follow-up results. Results Among 698 samples required to be re-tested for confirmation of HIV infection, 151(21.63%)showed indeterminate WB test results. There were 18 types of WB band in 151 HIV antibody-indeterminate samples. The most common band types, accounting for 79.47%, were p24, gp160, and gp160p24. One hundred(among 151)subjects were followed up and the success follow-up rate was 50.00%. Among them, 28(56.00%)samples were still with indeterminate results of HIV antibody, 11(22.00% turned to be negative and 11(22.00%)turned to positive. The follow-up confirmatory tests showed that 67.86% of the samples with p24 band were still with indeterminate results and 40.00% of the samples with gp160 band became HIV antibody-negative. The samples with one of the three band patterns of gp160gp120p24, gp160p24p17 and gp160gp120p66p51 all became HIV antibody-positive. Conclusion The detection rate of indeterminate HIV antibody results varies in different populations. Positive conversion rates with different WB band patterns are different. Follow-up of the populations with specific WB band patterns should be strengthened to detect HIV infection cases as early as possible.

Spatial and temporal distribution characteristics of varicella epidemic in Jiading District in Shanghai from 2015 to 2018 / 上海预防医学

Objective To investigate the spatial-temporal distribution characteristics of varicella outbreak in Jiading District in Shanghai from 2015 to 2018. Methods Varicella epidemic report data was collected from the national system of disease control and prevention and analyzed by spatial-temporal scanning statistic methods. Results There were 5 889 varicella cases reported from the year 2015 to 2018, and the annual average incidence rate was 91.68 per 100 000.The incidence rate for children below 3 years old was found to be the highest, reaching 621.45 per 100 000, which was significantly higher than that for the group of 18 years old and above (χ2=16 616.788, P < 0.001).There were 5.41% and 5.31% of the cases in September and February, respectively, which were lower than other months, and the peak incidence occurred in December and November, accounting for 13.41% and 11.95%, respectively.The highest and lowest incidence rates were 151.80 per 100 000 occurring in central urban area and 59.89 per 100 000 in rural area, respectively.The spatial-temporal scanning showed that the low population density area had a wide cluster range and a low effect value.The high population density area has small cluster range and high effect value. Conclusion The incidence of vanicella presents a trend of population, seasonal and regional clustering.Therefore, targeted measure should be taken to prevent varicella in focus population.

Antibody levels against diphtheria monitored in Jiading District, Shanghai / 上海预防医学

Objective To investigate the antibody levels against diphtheria among healthy population in Jiading District of Shanghai, and to make evaluation of the effect of diphtheria toxoid vaccination strategy. Methods Serum samples were collected from healthy population in Jiading District of Shanghai in 2010-2013.Antibody against diphtheria was tested by the enzyme-linked immunosorbent assay (ELISA).Geometric mean titer (GMT) of diphtheria antibody was compared between different population characteristics. Results A total of 1 029 serum samples were collected from the healthy population.With 1 003 of 1 029 diphtheria antibody titer of IgG (over 0.01 IU/mL), the positive rate was 97.47%, reaching the level of security protection (over 0.1 IU/mL) that accounted for 70.36%, and achieving the long-term protection level (over 1 IU/mL) that accounted for 35.57%;IgG GMT 0.325 IU/mL.There was significant difference in the positive rates and antibody levels between city residents and floating population in the field of diphtheria antibodies (χ2=4.708, P < 0.05;t=2.787, P < 0.05).There were statistically significant differences between different age groups in diphtheria antibody positive rates (χ2=30.262, P < 0.001) and statistically significant differences in GMT diphtheria antibody levels between different age groups (F=99.500, P < 0.001), GMT ranged in 0.029 IU/mL (30 years age group)~1.526 IU/mL (5 years age group). Conclusion The investigation of diphtheria antibody levels in Shanghai Jiading District truly reflects the effect of routine diphtheria immunization in Jiading District.DT (diphtheria & tetanus) vaccination for third grade junior is effective.We suggest a booster dose of diphtheria-containing vaccine for adolescents or adults so as to maintain immune levels.

Incidence and epidemiological characteristics of hand injuries in Jiading District of Shanghai / 上海预防医学

Objective To understand the incidence and epidemiological characteristics of hand injuries among registered population in Jiading District of Shanghai, so as to provide evidence for scientific prevention and control. Methods Anting town, Huangdu town and Huating town were selected for investigation.Incidence of hand injuries among registered population was investigated by questionnaires. Results A total of 10 083 registered population was included in the study, with the average age being 57.1 ± 10.4 years old.Of them, 4 039 were male and 6 044 were female, 92.2% were married and 7.8% had college degree or above.The 26.8% of the subjects smoked at least one cigarette per day for more than six months, 13.1% drank at least three times per week for more than six months, and 43.7% exercised at least 10 minutes per week.The 37.9% had hypertension, 8.6% had diabetes, and 14.5% had hyperlipidemia.The incidence of hand injuries was 2.1%, of which 61.8% occurred at home and workplaces.Multivariate analysis showed that hypertension was the risk factor and smoking was the protective factor associated with hand injuries. Conclusion The incidence of hand injuries is low in Jiading District.Household hand injuries may be crucial for prevention; in addition, patients with hypertension might be a key population for prevention.

Effects of scaffold microstructure and mechanical properties on regeneration of tubular dentin / 华西口腔医学杂志

Tubular dentin is of great significance in the process of tooth tissue and tooth regeneration, because it is not only the structural feature of primary dentin, but also can affect the tooth sensory function, affect the differentiation of dental pulp cells and provide strong mechanical support for teeth. Scaffold is one of the three elements of tissue engineering dentin regeneration. Most experiments on dentin regeneration involve the study of the microstructure and mechanical properties of the scaffold. The microstructure and mechanical characteristics of scaffold materials have important effects on the differentiation and adhesion of odontoblast, it can directly affect the tissue structure of regenerated dentin.

Combined detection of urine specific gravity and BK viruria on prediction of BK polyomavirus nephropathy in kidney transplant recipients / 中华医学杂志(英文版)

BACKGROUND@#BK polyomavirus (BKPyV)-associated nephropathy (BKPyVAN) is an important cause of dysfunction and failure of renal transplants. This study aimed to assess the diagnostic performance of morning urine specific gravity (MUSG) in diagnosing BKPyVAN in kidney transplant recipients.@*METHODS@#A total of 87 patients, including 27 with BKPyVAN, 22 with isolated BKPyV viruria, 18 with T cell-mediated rejection (TCMR), and 20 with stable graft function, were enrolled in the First Affiliated Hospital of Sun Yat-Sen University from March 2015 to February 2017. MUSG at biopsy and during a follow-up period of 24 months after biopsy was collected and analyzed. Receiver operating characteristic (ROC) curve analysis was used to determine the ability of MUSG to discriminate BKPyVAN.@*RESULTS@#At biopsy, the MUSG of BKPyVAN group (1.008 ± 0.003) was significantly lower than that of isolated BK viruria group (1.013 ± 0.004, P < 0.001), TCMR group (1.011 ± 0.003, P = 0.027), and control group (1.014 ± 0.006, P < 0.001). There was no significant difference in MUSG among the isolated BK viruria group, TCMR group, and control group (P = 0.253). In BKPyVAN group, the timing and trend of MUSG elevate were consistent with the timing and trend of the decline of viral load in urine and plasma, reaching a statistical difference at 3 months after treatment (1.012 ± 0.003, P < 0.001) compared with values at diagnosis. ROC analysis indicated that the optimal cut-off value of MUSG for diagnosis of BKPyVAN was 1.009, with an area under the ROC curve (AUC) of 0.803 (95% confidence interval [CI]: 0.721-0.937). For differentiating BKPyVAN and TCMR, the optimal MUSG cut-off value was 1.010, with an AUC of 0.811 (95% CI: 0.687-0.934).@*CONCLUSION@#Combined detection of MUSG and BKPyV viruria is valuable for predicting BKPyVAN and distinguishing BKPyVAN from TCMR in renal transplant recipients.

Surveillance of cockroach population and evaluation of control effects in households from 2017 to 2019 in Jiading District of Shanghai / 上海预防医学

Objective To learn the population and infestation rates of cockroaches from 2017 to 2019 in Jiading District of Shanghai, to evaluate the effect of cockroach termination in household, and to provide information for cockroach control. Methods Cockroaches were controlled by dinotefuran baits and clean-up in households.Sticky trap and visual method were employed for density monitoring in farmers markets, supermarkets, hotels, restaurants, hospitals, and residential areas.Visual method was used in households before and after using the insecticide. Results Sticky trap result showed the room infestation rate was 3.24%, mean adhesion rate was 3.29%, the density was 0.06 per board, and the density peak appeared in May.Rate of invasion and density decreased year by year.Blattella germanica was the dominant species, counting for 71.88%.The density, and rate of infestation, as determined by sticky trap method, were the highest in the farmers markets, followed by hospitals and residential areas.Determined by visual method, room infestation rate was 1.16%, and the infestation rate was 4.44%.The peak appeared in January.Infestation rate of the farmers markets was the highest, followed by hospitals and residential areas.By visual method, the room infestation rate was 59.01%, and 48.45% for nymphs.The room infestation and ootheca rates were 54.04% and 17.39%.The rate decreased more than 80% in 30 days after use of the insecticide. Conclusion Infestation rate of cockroach remains at low level in Jiading District.The effect of bait combined with environmental cleaning is remarkable.Future work should strengthen monitoring and control in farmers markets, hospitals and residential areas.

A study on urinary iodine levels and influencing factors of urban and rural residents in some areas of Gansu Province / 中华地方病学杂志

Objective To analyze the urinary iodine status of urban and rural residents in some areas of Gansu Province and its related influencing factors,and to provide certain references for scientific iodine intake of urban and rural residents in Gansu Province.Methods Subjects in Gansu Province with normal thyroid function were recruited in the investigation of thyroid diseases and iodine nutritional status,conducted a questionnaire survey and measured height,weight,waist circumference,collected 1 urine sample,and tested their urinary iodine levels.The urinary iodine levels of different groups were compared based on different gender,region,age,body weight,the waist,and salt intaking.The affecting factors of urinary iodine levels were analyzed by multiple linear regression models.Results Totally 1 964 subjects were recruited,including 1 099 males,and 865 females.The age was (41.23 ± 14.75) years old.The median urinary iodine of the selected group was 225.60 (158.80,311.58) μg/L.The urinary iodine level of rural residents was significantly higher than that of urban residents [μg/L:249.80 (180.58,336.88)vs 206.25 (148.03,280.33),Z=-8.015,P ＜ 0.05],and there was no significant difference between the urinary iodine levels of male and female [μg/L:222.40 (161.60,298.90) vs 230.60 (158.00,326.40),P ＞ 0.05].The composition ratio of ＜ 100 μg/L group in rural areas was lower than that in urban areas (5.14％ vs 8.27％,x2 =7.45,P ＜0.05),and the composition ratio of ≥300 μg/L group was higher than that in urban areas (34.93％ vs 21.51％,x2 =43.87,P ＜ 0.05).The composition ratio of ≥300 μg/L group in male was lower than that in female (24.57％ vs 31.21％,x2 =10.73,P ＜ 0.05).The multiple linear regression analysis showed that lived in rural areas,age,moderate and severe salt intaking,student,and weight were independently correlated with urinary iodine levels (β =0.074,-0.001,0.059,0.034,0.096,-0.003,P ＜ 0.05).And the urinary iodine levels were decreased with age and weight increased (P ＜ 0.05).Conclusions At present,the iodine nutrition level of urban and rural residents in some areas of Gansu Province is generally over the adequate level.The urinary iodine level of rural residents is higher than that of urban residents.In the future,we should pay attention to the impact of different living areas,salt intaking and body weight on urinary iodine levels to prevent thyroid diseases.

A study on urinary iodine levels and influencing factors of urban and rural residents in some areas of Gansu Province / 中华地方病学杂志

Objective@#To analyze the urinary iodine status of urban and rural residents in some areas of Gansu Province and its related influencing factors, and to provide certain references for scientific iodine intake of urban and rural residents in Gansu Province.@*Methods@#Subjects in Gansu Province with normal thyroid function were recruited in the investigation of thyroid diseases and iodine nutritional status, conducted a questionnaire survey and measured height, weight, waist circumference, collected 1 urine sample, and tested their urinary iodine levels. The urinary iodine levels of different groups were compared based on different gender, region, age, body weight, the waist, and salt intaking. The affecting factors of urinary iodine levels were analyzed by multiple linear regression models.@*Results@#Totally 1 964 subjects were recruited, including 1 099 males, and 865 females. The age was (41.23 ± 14.75) years old. The median urinary iodine of the selected group was 225.60 (158.80, 311.58) μg/L. The urinary iodine level of rural residents was significantly higher than that of urban residents [μg/L: 249.80 (180.58, 336.88) vs 206.25 (148.03, 280.33), Z=-8.015, P < 0.05], and there was no significant difference between the urinary iodine levels of male and female [μg/L: 222.40 (161.60, 298.90) vs 230.60 (158.00, 326.40), P > 0.05]. The composition ratio of < 100 μg/L group in rural areas was lower than that in urban areas (5.14% vs 8.27%, χ2= 7.45, P < 0.05), and the composition ratio of ≥300 μg/L group was higher than that in urban areas (34.93% vs 21.51%, χ2= 43.87, P < 0.05). The composition ratio of ≥300 μg/L group in male was lower than that in female (24.57% vs 31.21%, χ2= 10.73, P < 0.05). The multiple linear regression analysis showed that lived in rural areas, age, moderate and severe salt intaking, student, and weight were independently correlated with urinary iodine levels (β= 0.074, -0.001, 0.059, 0.034, 0.096, -0.003, P < 0.05). And the urinary iodine levels were decreased with age and weight increased (P < 0.05).@*Conclusions@#At present, the iodine nutrition level of urban and rural residents in some areas of Gansu Province is generally over the adequate level. The urinary iodine level of rural residents is higher than that of urban residents. In the future, we should pay attention to the impact of different living areas, salt intaking and body weight on urinary iodine levels to prevent thyroid diseases.

Effect of ulinastatin on programmed necrosis in hippocampal neurons in a rat model of global cerebral ischemia-reperfusion / 中华麻醉学杂志

Objective To evaluate the effect of ulinastatin on programmed necrosis in hippocampal neurons in a rat model of global cerebral ischemia-reperfusion (I/R).Methods Forty-eight clean-grade healthy adult male Sprague-Dawley rats,aged 8 weeks,weighing 280-320 g,were divided into 3 groups (n=16 each) using a random number table method:sham operation group (Sham group),global cerebral I/R group (I/R group) and ulinastatin group (UT group).Global cerebral I/R was produced by 4-vessel occlusion method in chloral hydrate-anesthetized rats in I/R and UT groups.Ulinastatin 100 000 U/kg was injected via the tail vein at the onset of ischemia in group UT,and the equal volume of normal saline was given instead in Sham and I/R groups.Neurological deficit score (NDS) was estimated at 6,12 and 24 h of reperfusion.Animals were sacrificed at 24 h of reperfusion,brains were removed and the hippocampi were obtained for examination of pathological changes (with a light microscope) and for determination of the malondialdehyde (MDA) content and superoxide dismutase (SOD) activity (by spectrophotometry),and expression of receptor-interacting protein kinase 1 (RIPK1),RIPK3,and mixed lineage kinase domain-like protein (MLKL) in hippocampal tissues (by Western blot).Results Compared with Sham group,the NDS was significantly increased at each time point,the MDA content was increased,the SOD activity was decreased,and the expression of RIPK1,RIPK3 and MLKL was up-regulated in I/R and UT groups (P＜ 0.05).Compared with I/R group,the NDS was significantly decreased at each time point,the MDA content was decreased,the SOD activity was increased,and the expression of RIPK1,RIPK3 and MLKL was down-regulated in UT group (P＜0.05).The pathological changes of hippocampi were significantly attenuated in UT group when compared with I/R group.Conclusion The mechanism by which ulinastatin ameliorates global cerebral I/R injury is related to inhibiting programmed necrosis in hippocampal neurons of rats.

Epidemiological and pathogenic characteristics of hand-foot-mouth disease in Jiading District of Shanghai from 2007 to 2016 / 上海预防医学

[Objective]To explore the prevalence trend and pathogenic characteristics of hand-food-mouth disease (HFMD) in Jiading District of Shanghai from 2007 to 2016. [Methods] Information on cases of hand-food-mouth disease in Jiading District from 2007 to 2016 was collected and analyzed. [Results]There were 37 520 reported cases from 2007 to 2016 with average age of 2.81 years old, in which 92.05％ cases were aged 5 years old or below. The incidence rate showed fluctuation over years was from the lowest incidence of 217.03/105 in 2015 to the highest of 461.83/105 in 2016. There were 55.95％ of reported cases from the period of April to July and 94.98％ were from rural and urban-rural areas. Samples from 799 patients as pharynx swab and anal swab, etc. were found to be enterovirus 71 (EV71) , the dominant pathogen, accounting for 44.56％ of total isolation. There were 0.59％ severe cases, 96.23％ of which were positive of EV71. [Conclusion] The HFMD prevalence in Jiading District of Shanghai showed periodicity and seasonality. Children aged 5 years old below and living in non-urban areas showed higher incidence risk. EV71 is the dominant pathogen, especially for the severe cases. These findings suggested that targeted measures should be carried out according to the prevalence and pathogenic characteristics, strengthening the prevention and control of HFMD among preschool children in rural and urban-rural areas.

Characteristics of sexual partner network and high-risk sex behaviors among men who have sex with men / 上海预防医学

[Objective]To ascertain characteristics of sexual partner network and high-risk sex behaviors among men who have sex with men (MSM) , providing references for intervention of high risk behavior in MSM. [Methods] Face-to-face questionnaire interview was conducted among MSM recruited by voluntary counseling and testing clinics, peer mobilization, internet mobilization, outreach intervention, and so on.Descriptive statistics, χ2test, logistic regression analysis were applied for statistical analysis. [Results]A total of 334 MSM was investigated. Over the past 6 months, proportion of female partners, fixed male partners, multiple male partners, occasional and business male partners was 37.13％, 43.11％, 52.69％, 56.29％, and 4.19％ respectively. Logistic regression analysis showed that respondents who were married, less educated, non-Shanghai domicile, and non-homosexual had more female partners in proportion, those with high income and homosexuality had more fixed male partners in proportion, and those who were married, non-Shanghai domicile had more multiple or occasional male partners in proportion. In the past 6 months, MSM who had unprotected sexual behaviors with female partners, fixed male partners, multiple or occasional male partners accounted for 75.21％, 65.97％, 59.66％, and 48.40％respectively. And analysis showed that respondents had more high-risk sexual behaviors with multiple male partners with their age increasing. [Conclusion] Sexual partner network of MSM is complex. MSM has a variety of sexual partners. Multiple sexual partners and unprotected sexual behaviors exist extensively among MSM. Related factor of sexual behaviors with multiple sexual partners is age.

Chinese medicine as complementary therapy for female infertility / 中国结合医学杂志

Chinese medicine (CM) has been used in clinical treatment for thousands of years in China, Japan, Korea, and other countries. CM is at present attracting many attentions around the world for reproductive health care and disease prevention, including treatment of female infertility. This review focuses on the CM treatment for female infertility patients, and supplies a summary on the efficacy, safety, and mechanism of some Chinese herbal medicines, herbal medicine-derived active compounds, and acupuncture. A large number of researches have reported that CM could alleviate or even cure female infertility by regulating hormone, improving reproductive outcome of in vivo fertilization, affecting embryonic implantation, curing polycystic ovarian syndrome, endometriosis, pelvic inflammatory disease, relieving mental stress, and regulating immune system. Meanwhile, a few studies claimed that there was little adverse reaction of CM in randomized controlled trials. However, up to present there is a lack of adequate evidences with molecular mechanistic researches and randomized controlled trials to prove the CM as an effective and safe treatment for infertility. Thus, utility of CM as a complementary medicine will be a feasible method to improve the outcome of female infertility treatment.

Effect mechanism study of butylphthalide on renal interstitial fibrosis / 重庆医学

Objective To explore the rule of the Nrf2-ARE in renal interstitial fibrosis and the mechanism of butylphthalide on renal protective effect.Methods Seventy-two male CD-1 mice were divided into 4 groups,Sham group,UUO group,NBP group,ACEI group.The Sham group and UUO group were gavaged with physiological saline.The NBP group was gavaged with butylphthalide.The ACEI group was gavaged with benazepril.After 3,7,14 days,6 mice were executed and collection of kidney tissue.The expression of Nrf2,γ-GCS and type Ⅰ collagen were detected by immunohistochemisty,RT-PCR and Western blot.The correlation of Nrf2 and γ-GCS was assessmented by linear regression.Results The expression of type Ⅰ collagen in UUO group was increased compared with the Sham group,However,the expression of Type Ⅰ collagen in NBP group or ACEI group were reduced compared with the UUO group.Compared with Sham group,the expression of Nrf2mRNA,γ-GCSmRNA and type Ⅰ collagen mRNA in uuogroup were increased in 3,7,14 days after surgery.Compared with UUO group at 7th,14u day,the lelve of Nrf2 mRNA were apparently increased in NBP group (P＜0.05).It was a positive correlation between the Nrf2 and γ-GCS and negative correlation between the γ-GCS and Type Ⅰ collagen.Conclusion The renal protective effect of butylphthalide in the renal interstitial fibrosis was more predominant than benazepril.The roles maybe occurred through increased the expression of Nrf2 and γ-GCS and alleviated the expression of Type Ⅰ collagen in nephridial tissue.