ObjectiveTo research the hepatitis B virus (HBV) replication and immune tolerance status of transgenic mice for elucidating the pathogenesis of hepatitis B and evaluating new drugs against HBV.Methods SPE grade HBsAg negative nontransgenic and transgenic mice with the same genetic background were recruited in this study.HBsAg,HBeAg and HBV DNA were detected by chemiluminescent method.Pre-S1 and HBcAg were detected by enzyme linked immunosorbont assay (ELISA).Liver pathology was examined and HBsAg expressions at different stages were determined by immunohistochemical staining.The lymphocyte proliferation of mice was detected by flow cytometry and interferon (IFN)γ-producing T lymphocytes was determined by enzyme linked immunospot (ELISPOT).The expressions of Toll-like receptor (TLR)2 and TLR9 in splenocyte suspension and splenic dendrite cells (DC) were determined by double-labeling immunofluorescence.The data were analyzed by t test and F test.ResultsHBsAg,preS1,HBeAg,HBcAg were expressed and HBV DNA was replicated in HBV transgenic mice,while anti-HBs,anti-HBc,and anti-HBe were all negative.There were no obvious pathological changes in liver tissues.HBsAg was expressed in cytoplasm and HBcAg in nucleus of hepatocytes.After stimulated with HBsAg,T lymphocyte proliferation capacity of HBV transgenic mice was (697.6±67.3) cpm,which was much lower than that of nontransgenic mice [( 1315.5 ±191.6) cpm].The number of spot forming cells of IFNγ-producing splenocytes from transgenic mice after HBsAg stimulation was 8.25 ± 1.10,which was obviously lower than that of nontransgenic mice (28.50±4.21) (F=155.967,P=0.000).The expressions of CD11c+,TLR2 and TLR9 on DC from both HBV transgenic and nontransgenic mice were not different significantly (all P＞0.05).The HBsAg expressions in liver tissues were observed in 18-day-old fetal mice and 1-day-old newborn mice.ConclusionsThe HBV transgenic mice can express HBV-related antigens,and are immune tolerant to the antigens.The innate and acquired immunity of the HBV transgenic mice are normal,which is similar to chronic asymptomatic HBV carriers of human.Therefore,HBV transgenic mouse is an ideal animal model.

OBJECTIVE:To explore the method for promoting drug circulation management of online pharmacies. METH-ODS:Hazard analysis and critical control point (HACCP) was applied to identify the critical control points (CCPs) and explore the effective method for drug circulation management of online pharmacies. RESULTS & CONCLUSIONS:According to the HAC-CP principle,four CCPs of drug circulation management of online pharmacies are supplier qualification,acceptance method,main-tenance and storage scheme and distribution system. It is suggested to adopt correct measures of drug circulation quality manage-ment of online pharmacy. Firstly,the supplier’s legal qualification should be determined and the quality of the drug should be regu-larly checked;secondly,drug retailers should improve the acceptance method of drugs and improve the sampling rate of drug;then,the three three four scientific conservation which required the medicine to be divided into three parts according to the pro-portion of 30%,30%,40% and checked monthly should be implemented to improve the storage and maintenance program;finally, the independent distribution system should be established to ensure the full process of the appearance inspection.

Objective To study the differences and the features of thinking styles among undergrad-uates in Beijing University of Chinese Medicine. Methods The thinking styles of a total of 120 under-graduates of grade 3 and 4 were investigated with Sternberg Thinking Style Scale (Chinese version) by ran-dom cluster sampling. All statistical analyses were performed with SPSS software (version 20.0) by means of t-test, analysis of variance and rank sum test. Results The score of oligarchic style in traditional Chinese medicine, traditional Chinese medicine and management students was (4.09±0.67), (3.64±0.50) and (3.72± 0.56) respectively, and the difference was statistically significant (P<0.01). The score of legislative style was (5.14±0.63) in boys and (4.90±0.62) in girls, and the difference was statistically significant (P<0.05). The score of judicial style was (4.46 ±0.56) and (4.23 ±0.62) respectively, and the difference was statistically significant (P<0.05). The score of monarchic style was (4.22±0.52) and (3.79±0.57) respectively, and the difference was statistically significant (P<0.001). The score of global style was (4.36 ±0.48) and (4.00 ± 0.63) respectively, and the difference was statistically significant (P<0.01). The score of internal style was (4.48 ±0.74) and (4.18 ±0.76) respectively, and the difference was statistically significant (P<0.05). The score of liberal style was (4.79 ±0.71) and (4.49 ±0.68) respectively, and the difference was statistically significant (P<0.05). The score of judicial style in undergraduates with and without parents engaged in health industry was (3.97±0.64) and (4.35±0.59) respectively, and the difference was statistically significant (P<0.05). The score of anarchic style was (4.39 ±0.32) and (4.06 ±0.50) respectively, and the difference was statistically significant (P<0.05). Conclusion Correlated with undergraduate majors, gender and parents' background, Medical students differ in legislative style, judicial style, monarchic style, oligarchic style, anarchic style, global style, internal style and liberal style, which correlates with gender, major and parents' background.

Objective:To understand the status quo and impact of Beijing Standardized Residency Training program following three years of the medical education synergy policy from the perspective of residents.Methods:Online questionnaire was used from April to May 2018 to investigate two types of residents who had completed the program in Beijing in 2018, and a comparison was made with the 2014 training program, activities, evaluation, and support conditions. Statistical descriptions and Wilcoxon signed-rank test were used for analysis.Results:A total of 3 293 residents completed the Beijing Standardized Residency Training, of which 54.75% were resident physicians, and 45.25% were graduate students in clinical medicine. Compared with 2014, the completion rate of the disease types and quantity, clinical operation types and quantity required by the training plan has been significantly improved, with the proportions being 93.77% and 92.80%, respectively. The implementation rate of examinations in 7 departments including Internal Medicine was greater than 90%, which is significantly higher than that in 2014; The conditions for training support had improved significantly.Conclusions:The impact of Beijing Standardized Residency Training Program was already emerging since the medical education synergy policy in place. It was recommended that various measures be taken to steadily improve the quality of the " dual-track system" .

Objective: To explore the influence of three-level collaboration network of pediatric burns in Anhui province on treatment effects of burn children. Methods: The data of medical records of pediatric burn children transferred from Lu′an People′s Hospital and Fuyang People′s Hospital to the First Affiliated Hospital of Anhui Medical University from January 2014 to December 2015 and January 2016 to September 2017 (before and after establishing three-level collaboration network of pediatric burns treatment) were analyzed: percentage of transferred burn children to hospitalized burn children in corresponding period, gender, age, burn degree, treatment method, treatment result, occurrence and treatment result of shock, and operative and non-operative treatment time and cost. Rehabilitation result of burn children transferred back to local hospitals in 2016 and 2017. Data were processed with t test, chi-square test, Mann-Whitney U test, and Fisher′s exact test. Results: (1) Percentage of burn children transferred from January 2014 to December 2015 was 34.3% (291/848) of the total number of hospitalized burn children in the same period of time, which was close to 30.4% (210/691) of burn children transferred from January 2016 to September 2017 (χ²=2.672, P>0.05). (2) Gender, age, burn degree, and treatment method of burn children transferred from the two periods of time were close (χ²=3.382, Z=-1.917, -1.911, χ²=3.133, P>0.05). (3) Cure rates of children with mild, moderate, and severe burns transferred from January 2016 to September 2017 were significantly higher than those of burn children transferred from January 2014 to December 2015 (χ²=11.777, 6.948, 4.310, P<0.05). Cure rates of children with extremely severe burns transferred from the two periods of time were close (χ²=1.181, P>0.05). (4) Children with mild and moderate burns transferred from the two periods of time were with no shock. The incidence of shock of children with severe burns transferred from January 2014 to December 2015 was 6.0% (4/67), and 3 children among them were cured. The incidence of shock of children with severe burns transferred from January 2016 to September 2017 was 3.9% (2/51), and both children were cured. The incidences and cures of shock of children with severe burns transferred from the two periods of time were close (χ²=0.006, P>0.05). Incidence of shock of children with extremely severe burns transferred from January 2014 to December 2015 was 57.1% (32/56), significantly higher than that of burn children transferred from January 2016 to September 2017 [34.5% (10/29), χ²=3.925, P<0.05]. Shock of 25 children with extremely severe burns transferred from January 2014 to December 2015 were cured, and shock of 9 children with extremely severe burns transferred from January 2016 to September 2017 were cured. The cures of shock of children with extremely severe burns transferred from the two periods of time were close ( χ²=0.139, P>0.05). (5) Time of operative treatment of children with moderate, severe, and extremely severe burns transferred from January 2014 to December 2015 was obviously longer than that of burn children transferred from January 2016 to September 2017 (t=2.335, 2.065, 2.310, P<0.05). Time of operative treatment of children with mild burns transferred from the two periods of time was close (Z=-0.417, P>0.05). Costs of operative treatment of children with moderate and severe burns transferred from January 2014 to December 2015 were significantly more than those of burn children transferred from January 2016 to September 2017 (Z=-3.324, t=2.167, P<0.05). Costs of operative treatment of children with mild and extremely severe burns transferred from the two periods of time were close (t=0.627, 0.808, P>0.05). (6)Time of non-operative treatment of children with mild, moderate, and severe burns transferred from January 2014 to December 2015 was obviously longer than that of burn children transferred from January 2016 to September 2017 (t=2.335, Z=-2.095, t=2.152, P<0.05). Time of non-operative treatment of children with extremely severe burns transferred from the two periods of time was close (t=0.450, P>0.05). Costs of non-operative treatment of children with moderate and severe burns transferred from January 2014 to December 2015 were obviously higher than those of burn children transferred from January 2016 to September 2017 (Z=-2.164, t=2.040, P<0.05). Costs of non-operative treatment of children with mild and extremely severe burns transferred from the two periods of time were close (t=0.146, 1.235, P>0.05). (7) Sixty-seven burn children transferred from January 2016 to September 2017 were transferred back to local hospitals for rehabilitation under the guidance of experts of the First Affiliated Hospital of Anhui Medical University, with 25 patients in 2016 and 42 patients in 2017. Effective rehabilitation rates of burn children transferred back to local hospitals for rehabilitation in 2016 and 2017 were both 100%. Conclusions The three-level collaboration network of pediatric burns treatment in Anhui province can effectively increase cure rate of children with mild, moderate, and severe burns, reduce incidence of shock of children with extremely severe burns, shorten time of operative treatment of burn children with moderate, severe, and extremely severe burns, and time of non-operative treatment of children with mild, moderate, and severe burns, reduce treatment costs of children with moderate and severe burns, and improve rehabilitation effectiveness of children transferred from Lu′an People′s Hospital and Fuyang People′s Hospital to the the First Affiliated Hospital of Anhui Medical University.

CRISPR-Associated Protein 9 ; Gene Editing ; CRISPR-Cas Systems/genetics*

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.