There are a wide variety of spiders on the earth and most them can secrete venom,which contains a variety of chemi-cal compositions that have multiple influences on organism be-sides toxic effects.The pharmacological efficiency includes cardi-ovascular and cerebrovascular activities,analgesic activities,an-tibacterial and anticancer activities etc.Ion channels are one of the important targets of spider toxins.They act on different ion channels,such as potassium channel,calcium channel and differ-ent subtypes of sodium channels.Therefore the spider toxins pres-ent different pharmacological activities and potential medicinal value.The venoms of spiders are less well studied than those from other venomous taxa such as conotoxin,scorpions and snakes etc. However,in recent years,spider toxins are turning to a new hot subject in related research areas.This review summarizes the lat-est progress in biological activities of spider toxins as well as its application in medical practice and development.

Objeetive To analyze the causes and to explore prevention and management of bile leakage after laparoscopic common bile duct exploration with choledochoscopy followed by primary suturing of choledochal incision.Methods The clinical data of 52 patients with bile leakage after laparoscopic common bile duct exploration choledochoscopy and primary suturing of choledochal incision carried out for choledocholithiasis between June 2011 to June 2013 were retrospectively studied.Results All the 52 patients successfully underwent the laparoscopic surgery and left hospital.The operation time was (101 ± 26) minutes (range 55～ 145 minutes).The intraoperative blood loss was (36±28) ml (range 10～ 100 ml).All the patients were ambulatory after the first postoperative day.The recovery time of postoperative gastrointestinal function was (49.8 ± 12.5) hours (range 37 ～ 74 h).The total hospitalization time was (10.8 ± 2.5) days (range 7 ～ 15 days).The average hospitalization days after surgery was (5.7 ± 1.7) days.The average hospitalization cost was (24 827 ± 3 776) yuan.There were two patients who developed intraoperative bile leakage which was treated with further suturing.Five patients developed postoperative bile leakage and they were cured after unobstructed drainage for 5 days through conservative treatment.After a follow-up of 1 ～ 2years,there was no recurrent lithiasis.The stone clearance rate was 100％.There was no bile duct stricture or other complications.Conclusion In expert hands and with proper selection of patients,laparoscopic common bile duct exploration,choledochoscopy and primary suturing of choledochal incision were safe,effective and feasible for choledocholithiasis.

Objective To explore the association of galactose-deifcient IgA1 levels with clinical features, and further to provide guidance for individualized treatment of HSP. Methods According to the clinical symptoms and curative effect, 57 children with HSP were divided into four groups:non-HSPN group (n=26), HSPN group (n=7), refractory HSP group (n=7) and remission group (n=17). In non-HSPN group, 12 cases received glucorticoid therapy and 14 cases did not. Serum galactose-de-ifcient IgA1 (Gd-IgA1) concentrations were detected using a Helix aspersa-lectin-based enzyme-linked immunosorbent assay (ELISA), and the total IgA1 levels were measured by ELISA. Results The serum Gd-IgA1 level was signiifcantly higher in 40 HSP children who were not cured than that in remission group and control group (P<0.05). However, there was no difference in Gd-IgA1 level between remission group and control group (P>0.05). Compared with the control group, the serum Gd-IgA1 level was signiifcantly higher in HSPN group, non-HSPN group and refractory HSP, and children with refractory HSP had signiifcantly higher Gd-IgA1 level than children in non-HSPN group (P<0.05). No signiifcant difference in Gd-IgA1 level was found either between HSPN group and refractory HSP group or between HSPN group and non-HSPN group (P>0.05). Furthermore, in non-HSPN group, the serum Gd-IgA1 level in HSP children who were not treated with glucorticoid was signiifcantly higher than that in HSP children treated with glucorticoid (P<0.05). Conclusions The serum Gd-IgA1 level is associated with the disease activ-ity and curative effect of HSP, especially in children with refractory HSP, and it is thus likely to be a new non-invasive disease activity marker for guiding the proper usage of glucocorticoid and immunosuppressants in HSP children.

Southern rice black-streaked dwarf virus(SRBSDV)is a novel Fijivirus prevalent in rice in southern and central China, and northern Vietnam. Its genome has 10 segments of double-stranded RNA named S1 to S10according to their size. An isolate of SRBSDV, JNi4, was obtained from naturally infected maize plants from Ji'ning, Shandong province, in the 2008 maize season. Segments S7 to S10 of JNi4 share nucleotide identities of 72.6%-73.1%, 72.3%-73%, 73.9%-74.5% and 77.3%-79%, respectively, with corresponding segments of Rice black-streaked dwarf virus isolates, and identities of 99.7%, 99. 1%-99.7%, 98.9%-99.5%, and 98.6%-99.2% with those of SRBSDV isolates HN and GD. JNi4 forms a separate branch with GD and HN in the phylogenetic trees constructed with genomic sequences of S7 to S10. These results confirm the proposed taxonomic status of SRBSDV as a distinct species of the genus Fijivirus and indicate that JNi4 is an isolate of SRBSDV. Shandong is so far the northernmost region where SRBSDV is found in China.

Listeriamonocytogenes is a facultative intracellular bacterium that enters professional antigen presenting cells , presents passenger antigens to the major histocompatibility complex class I and II pathways ,then elicits CD+4 and CD+8 T-cell-mediated immune responses .It was demonstrated that attenuated Listeriamonocytogenes as a novel live vaccine vector in deliv-ering tumor antigens of cervical cancer and melanoma etc .,could induce strong protective immune response ,and shows effec-tive antitumor immunotherapeutics .This review discussed the characteristics of immune responses elicited by Listeria monocy-togenes ,and the progress of its antitumor immunotherapeutics as delivery vaccine vector .

The prevalence of human and animal listeriosis for nearly 11 years in China was investigated in this study . The literature information about listeriosis in China from 2002 to 2012 was collected through retrieval system to make clinical and epidemiological statistical analysis of listeriosis .Cases of listeriosis were reported in 27 (79% ) provinces of China .The re-sult showed that animal listeriosis was reported for 123 times ,among these reports ,most were from pigs (39% ) ,and the sheep was in second place .Central nervous system infection was the main clinical manifestation of listeriosis in animals (72% ) . For human listeriosis ,84 clinical cases of listeriosis were reported ,including 35% cases in non-perinatal stage and 65% cases in perinatal stage .The main clinical manifestation of listeriosis was septicemia (51% ) .According to the result of investigation about listeriosis based on literatures information ,Listeriamonocytogenes caused humans and animals listeriosis annually ,which were reported in most provinces of China .The epidemic characteristics for listeriosis suggested that it was essential to strength-en the prevention and control of listeriosis .

Objective To evaluate the clinical performance of the BACTEC Plus aerobic,BACTEC Lytic anaerobic,BacT/Alert aerobic and anaerobic blood culture media in detection of bloodstream infections.Methods Retrospective study was conducted.A total of four blood culture bottles from each inpatient with suspected bloodstream infections were collected and analyzed from June 2013 to September 2015 in Peking University People's Hospital.The four bottles,including BACTEC Plus aerobic,BACTEC Lytic anaerobic,BacT/Alert FA aerobic and BacT/Alert FN anaerobic media,and was incubated for 5 days in the BacT/Alert 3D and BACTEC FX instruments,respectively.Time to detection (TTD) and positive rate in detecting bacteria of the two systems were evaluated by Wilcoxon test and Chi-square test.Results Among 2 189 total cultures collected,20 were excluded because of blood shortage and 201 (9.27％) were positive for pathogens.The positive rates of BACTEC Plus aerobic media and BacT/Alert FA aerobic media were 75.3％ (140/186) and 69.4％ (129/186) (x2 =1.625,P=0.202),respectively.While,the positive rates of BacT/Alert FN anaerobic media and BACTEC Lytic anaerobic media were 81.8％ (99/121) and 63.6％ (77/121) for total organisms,respectively (x2 =10.083,P =0.001).A significant difference in TTD was detected in BACTEC Plus aerobic media[11.0 (8.0-16.0) h] and BacT/Alert FA aerobic media[13.9 (10.4-18.7) h] (Z =-5.240,P ＜ 0.001).BACTEC Lyric anaerobic media[8.0(7.0-10.0) h] had a shorter TTD (Z =-4.299,P ＜ 0.001) than BacT/Alert FN anaerobic media[11.3(9.3-12.7) h].The positive rates of BACTEC and BacT/Alert system were 74.13％ (149/201) and 74.63％ (150/201),respectively,compared with taking one set from each system.Conclusions BACTEC media has a shorter TTD and almost the same bacterial recovery,and lower false positive rate than the BacT/ Alert media.

Objective:To investigate the value of SFRP1 gene promoter methylation in PTC tissues, to eanalyze its correlation with clinical characteristics and biochemical indicators and its effect on mRNA expression, and to explore its value in clinical applications.Methods:97 patients with first-onset PTC were selected as the research subjects, and the patients’ PTC tissues (observation group) and adjacent tissues (control group) were taken. Methylation-specific PCR (MSR) was used to detect the methylation status of the SFRP1 gene promoter region, and mRNA expression was measured by fluorescent quantitative PCR. The methyltransferase inhibitor 5-Azacytidine was used to treat thyroid papillary cancer cell lines, detection of biochemical indicators and collection of clinical characteristics.Results:The positive rate of methylation of SFRP1 gene promoter region (70.1%) in PTC tissues was significantly higher than that of adjacent tissues (33.0%) ( χ2=26.747, P<0.001) ; the expression of SFRP1 gene mRNA in PTC tissues was significant MRNA expression in tissues adjacent to cancer ( t=2.886, P=0.007) , mRNA expression in methylated positive PTC tissues was also significantly lower than that in methylated negative PTC tissues ( t=2.065, P=0.038) ; with the concentration of 5-Azacytidine increased, the expression of SFRP1 gene mRNA in CGTHW-3 cells also gradually increased. In addition, the positive methylation rate in PTC tissues was related to the TNM stage ( χ2=5.487, P=0.019) and whether there was lymph node metastasis ( χ2=4.659, P=0.031) . The levels of TSH and TGAb in the methylation group were higher than those in the unmethylated group (TSH: t=2.234, P=0.023; TGAb: t=2.312, P=0.021) . Conclusion:High DNA methylation in the promoter region of SFRP1 gene can participate in the occurrence and development of PTC by down-regulating the mRNA expression of genes.

Objective:To evaluate the effectiveness of inspiratory muscle training in middle-aged and elderly patients with obstructive sleep apnea(OSA).Methods:The randomized controlled trials (RCT) on the effect of inspiratory muscle training in middle-aged and elderly patients with OSA were collected using the databases of PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database and Wanfang database, the time was from the construction of the database to December 2020. The literature quality was evaluated and data were extracted from the included literature. RevMan5.3 software was used to analyze the collected data.Results:A total of 8 RCTs were included. Meta-analysis showed that inspiratory muscle training could reduce apnea hypopnea index(AHI)( P<0.05), Epworth Sleepiness Scale(ESS)( P<0.01) and Pittsburgh Sleep Quality Index(PQSI)( P<0.01), but had no effect on lowest oxygen saturation ( P>0.05). Conclusions:Inspiratory muscle training is a safe and feasible training method that can decrease AHI, ESS and PSQI in middle-aged and elderly patients with OSA.

Objective To study the alterations of renal function in patients with acute ischemic stroke and diabetes and to analyze the risk factors of contrast-induced nephropathy (CIN) after digital subtraction angiography (DSA).Methods Eight hundred and seventy-one cerebral infarction patients with diabetes who underwent DSA were selected in the Third Affiliated Hospital of Chongqing Medical University and Nanjing Brain Hospital Affiliated to Nanjing Medical University from August 2012 to August 2016.The patients were divided into diabetic group (n =178) and non-diabetic group (n =693).The alterations of renal function and the incidence rate of CIN were observed between two groups 3 days after DSA.Univariate analysis and multi-factor Logistic regression analysis were used to analyze the independent risk factors of CIN.Results The levels of estimated glomerular filtration rate (eGFR,ml · min-1 · 1.73 m-2) in diabetic group at 1,2 and 3 days after DSA(81.94 ±9.38,75.36 ±8.21,84.43 ±9.72) were lower than that in non-diabetic group (84.62 ± 10.06,79.08 ±9.84,87.62 ± 10.15,t =3.213,4.645,3.772,all P ＜ 0.05).The levels of serum creatinine (Scr) and cystatin (CysC) in diabetic group at 1,2 and 3 days after DSA (Scr:85.63 ±9.83,92.37 ±10.07,83.43 ±9.07;CysC:1.08 ±0.12,1.35 ±0.14,0.95 ±0.10) were higher than that in non-diabetic group (Scr:81.36 ± 8.98,87.84 ± 9.85,80.31 ± 8.64,t =5.548,5.448,4.253;CysC:0.97 ±0.11,1.21 ±0.12,0.88 ±0.09;t =11.677,13.400,9.043;all P ＜ 0.05).The incidence rate of CIN in diabetic group (25.84％ (46/178)) was higher than that in nondiabetic group (7.07％ (49/693),x2 =51.358,P =0.001).Multi-factor Logistic regression analysis showed allergies,plasma brain natriuretic peptide,heart failure,the original renal insufficiency,NIHSS score,contrast agent dosage,preoperative eGFR,preoperative Scr and preoperative CysC were the independent risk factors of CIN in cerebral infarction patients with diabetes.Conclusions The renal function decreased significantly and the incidence rate of CIN was high in cerebral infarction patients with diabetes after DSA.Allergies,plasma brain natriuretic peptide,heart failure,the original renal insufficiency,contrast agent dosage,preoperative eGFR,preoperative Scr and preoperative CysC were the independent risk factors of CIN in cerebral infarction patients with diabetes.