Chinese donation after citizen's death (CDCD) is an important way to solve the donor shortage problem,but if we can't effectively control warm ischemia time of CDCD donor,it's easy to cause grafts primary nonfunction,early grafts dysfunction and biliary complications.Nowadays,with the development of surgical techniques,the definition of warm ischemia continues has been continuously updated.The understanding on different definitions may lay the foundation for improving the survival rate of liver and kidney and effectively protect liver and kidney function after transplantation.This paper overviewed the significance of different definitions of warm ischemia and its effect on liver and renal function,which could provide a reference for further experimental study and clinical practice.

Objective: To investigate the spatial clustering characteristics of varicella public health emergency events in Nanjing City from 2017 to 2022, so as to provide the evidence for the development of varicella prevention and control strategies. Methods: Data of varicella public health emergency events in Nanjing City from 2017 to 2022 were collected through Emergency Public Health Management Information System of Chinese Disease Prevention and Control Information System. The software ArcGIS 10.2 was employed for trend-surface analysis, spatial autocorrelation analysis and hotspot analysis to understand the spatial clustering characteristics of varicella public health emergency events. Results: A total of 84 varicella public health emergency events were reported in Nanjing City from 2017 to 2022, with an average attack rate of 2.53% (2 558 cases). Ⅳ-level events were predominant, accounting for 90.48% (76 events). The trend-surface analysis showed lower incidence of varicella public health emergency events in the west of Nanjing City and higher in the east, and lower in the north and higher in the south. The global spatial autocorrelation analysis showed that there was a positive spatial correlation in varicella public health emergency events in 2017 and 2019, indicating spatial clustering (P<0.05). The hot spots were Jiangning District, Gaochun District, Yuhuatai District and Jianye District. Conclusion The incidence of varicella public health emergency events in Nanjing City from 2017 to 2022 has spatial aggregation, with a concentration in suburban areas such as Jiangning District and Gaochun District.

Objective This study aims to investigate the clinical value of percutaneous vertebroplasty (PVP)combined with strontium-89 (89 Sr)on patients with spinal malignant tumor.Methods Seventy four patients who were diagnosed as spinal malig-nant tumor were divided into two groups randomly.37 patients of the control group were treated by PVP only,and 37 patients of joint group were treated by PVP and 89 Sr together.Then the clinical effect of the joint group and control group was compared after treatment.Results After treatment,the quality of life,ratio of pain relief,clinical effect and survival time in joint group were dis-tinctly better than control group (P <0.05).Conclusion PVP combined with 89 Sr can be an effective and safe treatment for pa-tients with spinal malignant tumor.

Objective To observe the prevalence and risk factors of chronic low back pain in puerperas after childbirth.Methods Eight hundred and eighty-one puerperas were selected,among whom 459 cases had uterine-incision delivery,and 422 cases had spontaneous delivery.The age,height and weight of pregnant women,birth weight of newborn,history of preoperative low back pain,parity and mode of delivery were recorded.The rate of chronic low back pain occurring within 1 month after childbirth and continuing for 3 months was recorded by telephone.The factors with P values less than 0.05 would enter the Logistic regression analysis to screen the risk factors of chronic low back pain.Results Two hundred and fifty-nine puerperas (259/881,29.4％) appeared chronic low back pain,of whom 157 puerperas (157/459,34.2％)delivered by uterine-incision and 102 puerperas (102/422,24.2％) delivered spontaneously,and the difference was statistically significant (P ＜ 0.01).Six hundred and fifty-eight puerperas had no history of preoperative low back pain,and 150 puerperas (150/658,22.8％) appeared newly developed chronic low back pain.Logistic regression analysis showed that mode of delivery,parity and history of preoperative low back pain were the risk factors of chronic low back pain.Condusions The rate of chronic low back pain in puerperas after childbirth is 29.4％,and the newly developed chronic low back pain is 22.8％.Uterineincision delivery,multiparity and history of preoperative low back pain are the risk factors of chronic low back pain for puerperas after childbirth.

OBJECTIVETo establish objectively biomechanical criteria for temporomandibular joint disc tissue engineerings.

METHODSEight temporomandibular joint discs from a four-month-old goat were separated completely. A cylindrical sample with diameter of 3 mm in the anterior, intermediate, and posterior bands was obtained, and the samples underwent pre-compression test with three cycles under a speed of 0.025 mm · s⁻¹. With the end condition for the maximum load of less than 4.9 N and 1.5 mm compression displacement, the formal compression test was performed with the same speed. Moreover, this test obtained the stress-strain relationship and elastic modulus of each disc band. Ultrastructure and collagen fiber orientation of the district zone were observed by scanning electron microscope and polarized light microscope.

RESULTS1) The physiological strain range of an articular disc was within 10%, and the quasilinear constitutive equation of articular disc tissues can be fitted with the polynomial function: y = ax + bx² + cx³. 2) The elastic modulus of the intermediate disc zone was the largest (P < 0.05). No significant difference existed between the anterior and posterior bands (P = 0.361). 3) Scanning electron microscope and polarized light microscope showed an annular disc collagen network structure, which was the internal part of the goat temporomandibular joint disc. The collagen arrangement of intermediate bands was tensely arranged anterior-posteriorly. The collagen of anterior and posterior bands went through mediolaterally with intersection of anterior-posterior branch fibersd.

CONCLUSIONAnnular collagen network structure is the basis for goat temporomandibular joint disc compression resistance properties. The intermediate band demonstrated higher compression resistance performance than the anterior and posterior bands.

AIM: To probe into the anti-epilepsy action of artificial Calculus Bovis,by observing its effect on the behavioral of the experimental epileptic rats,neuron loss in the hippocampus and hilus,and GAD positive cell alteration in the hippocampus.METHODS: SD rats were divided into three groups: group A(artificial Calculus Bovis treatment group);group B(acute epilepsy group) and group C(control group).A model of acute epilepsy rats was established by PTZ.The rat's behavioral alteration was observed by the Racine' scale.The neurons in the hippocampus and hilus were calculated by Nissl staining.The GAD positive cells were observed by immunohistochemical staining.RESULTS: The latency of the first seizure in group A was longer than that in group B,while the seizure times in group A was less than that in group B.Besides,in group A,both the neuron loss amount in the hippocampus and hilus and the GAD positive cell loss amount in the hippocampus were less than those in group B.CONCLUSION: The artificial Calculus Bovis prolonged the latency of the first seizure time,decreased the frequency of seizure,and prevented the neuron loss and protected the GAD positive cells.

Objective To evaluate the role of heat shock protein 70 (HSP70) in ozone preconditioning-induced reduction of hepatic ischemia-reperfusion (I/R) injury in rats.Methods Twenty-four pathogen-free healthy male Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were divided into 4 groups (n=6 each) using a random number table:sham operation group (group S),group I/R,ozone preconditioning group (group OP) and HSP70 inhibitor quercetin group (group Q).Hepatic I/R injury was induced by clamping the branches of hepatic artery supplying left and middle lobes of the liver,portal vein and bile vessel for 45 min,followed by 2 h of reperfusion.In group OP,the mixture of ozone and oxygen was intraperitoneally injected at the concentration of ozone 50 μg/ml and bolus dose 1 mg/kg once a day for 5 consecutive days before operation.In group Q,quercetin 7 mg/kg was intraperitoneally injected at 1 h before injecting the mixture of ozone and oxygen.Blood samples from the abdominal aorta were collected at 2 h of reperfusion for determination of serum alanine transaminase (ALT) and aspartate transaminase (AST) activities and concentrations of interleukin-1beta (IL-1β),IL-6 and tumor necrosis factor-alpha (TNF-α) in serum (by enzyme-linked immunosorbent assay).The animals were sacrificed after blood sampling,and hepatic tissue specimens were collected for detection of activated caspase-3 expression (by Western blot) and cell apoptosis (by TUNEL).Apoptotic index (AI) was calculated.Results Compared with group S,the serum ALT and AST activities,concentrations of IL-1β,IL-6 and TNF-α in serum and AI were significantly increased,and the expression of activated caspase-3 was up-regulated in group I/R (P＜0.05 or 0.01).Compared with group I/R,the serum ALT and AST activities,concentrations of IL-1β,IL-6 and TNF-α in serum and AI were significantly decreased,and the expression of activated caspase-3 was downregulated in group OP (P＜0.05 or 0.01).Compared with group OP,the serum ALT and AST activities,concentrations of IL-1β,IL-6 and TNF-α in serum and AI were significantly increased,and the expression of activated caspase-3 was up-regulated in group Q (P＜0.05 or 0.01).Conclusion The mechanism by which ozone preconditioning reduces hepatic I/R injury is related to activating HSP70 and inhibiting inflammatory responses and cell apoptosis in rats.

Objective To investigate the clinical characteristics and therapeutic methods of bac-terial colonization and infection of Acinetobacter baumannii on the wound of earthquake induced patients. Methods A retrospective study was done on 42 Wenehuan earthquake induced patients with positive wound germiculture of Acinetobacter baumannii. There were 24 males and 18 females, at mean age of 37 years (12-96 years). Open injury was located at the upper arm in one patient, at the forearm in four, at the thigh in 12, at the calf in 23 and at the trunk in two. The time between injury and treatment varied from 3 to 7 days. The clinical characteristics including the bacteria identification and drug sensitivity test were studied to compare drug resistance to 15 antibiotics. Results Bacterial colonization of Acineto-bacter baumannii was found in 31 patients (8.2%) and infection of Acinetobacter baumannii in 11 (2.9%). After debridement, pruphylactic antibiotics and nutrition support, 15 patients with bacterial colonization were managed with Ⅱ stage suture or skin grafting. The other 16 patients were transferred to hospitals of other provinces after germiculture turned negative. Through debridement and drainage, antibi-otic therapy and nutrition support, the infection was controlled and the wound eliminated in six patients through Ⅱ stage suture but four were concomitant with pulmonary infection and one with septicemia. Drug sensitivity test showed that sensitive rate to imipenem, amikacin, levofloxacin, ticarcillin-clavulanic acid, tobramycin were 59.5%, 21.4%, 21.4%, 19.5% and 19.0% respectively. Conclusions The risk factors of infection of Acinetobacter baumannii include severe tissue trauma, severe wound contamination, delayed treatment and weak body resistance. During treatment, the bacterial colonization and infection of Acinetobacter baumannii should be distinguished and treated respectively. Correct wound treatment, suit-able antibiotic therapy and increased body resistance are key to improvement of clinical curative effect.

Group B streptococcus ( GBS) is the most common cause of neonatal invasive infections in western countries , leading to severe pneumonia , sepsis and meningitis with high mortality and morbidity . Neonatal GBS infections are mainly transmitted from mother to baby .Since the end of 1990 s, prevention strategies of antenatal GBS screening and intrapartum antibiotic prophylaxis ( IAP) have been implemented by European and American area , decreasing the incidence of neonatal GBS disease significantly .The harm of GBS to neonates has been recognized and valued in recent years in China , but the authorized prevention measures are still lacking.Efficacy of IAP-based prevention depends on the accuracy of GBS screening results during pregnancy .Here, the GBS prevention guideline or consensus recommended by European and American CDC, including the screening strategies , detection methods, sample collection, storage and transportation were interpreted .

Objective To investigate the clinical characteristics,antibiotic susceptibilities and serotypes of Group B Streptococcus(GBS)isolated from neonatal meningitis to provide references for the prevention and treatment of neonatal GBS meningitis. Methods From June 2013 to June 2016,we surveyed the GBS strains iso-lated from purulent meningitis of < 90 days infants from Guangzhou Women and Children′s Medical Center. The GBS isolates were identified and the minimum inhibitory concentration of the antibiotics was determined by Vitek 2 Compact automatic bacterial identification system.GBS serotyping was performed using Strep-B-Latex?rapid latex agglutination test kit. Results A total of 46 cases of neonatal GBS meningitis,15 cases of early-onset infection and 31 cases of late-onset infection were diagnosed. 78.3% of GBS meningitis with varying degrees of complica-tions.Among 41 survivors with 3~24 months follow-up,50% of the early-onset and 44.8% of the late-onset GBS meningitis with varying degrees of neurological sequelae.Four capsular types were identified among the 46 isolates, serotype-Ⅲwas the most prevalent(73.9%),followed by Ib(19.6%),V(4.3%)and Ia(2.2%).All the isolates were susceptible to penicillins,cephalosporins,linezolid and vancomycin. Conclusion The highly pathogenic serotype-Ⅲ was the predominant serotype among neonatal GBS meningitis in Guangzhou,Therefore,it is neces-sary to strengthen the epidemiological surveillance of GBS invasive infection and the effective implementation of pre-ventive measures.