ObjectiveThe pre-hospital data of 839 emergency patients who were admitted to Naxiang Emergency Center of Shanghai from Dec 11 2006 to Jun 11 2007 were analyzed.The first five causes of emergency call were trauma,diseases of newborns,neuron-system diseases.eardio-vascuIar diseases and digestive diseases.The epidemiological data including gender,age of patients,distance to emergency site,duration of ambulance dispatch,results of first aid.etc were also presented in the paper.These data would be helpful for improving pre-hospital medical care of emergency patients.

Objective To systematically review the effect of ω-polyunsaturated fatty acids-supplemented nutrition support on the immune function and nutritional status of patients with gastrointestinal malignancies.Methods Databases of MEDLINE,EMBASE,Cochrance Central register of controlled trials,China National Knowledge Infrastructure (CNKI),China Biology Medicine disc (CBM) were searched.The search words were omega-3 polyunsaturated fatty acids,fish oil,cancer,turmor,neoplasms in English or Chinese.All the high quality randomized controlled trials were included after assessed with Jadad scale.RevMan 5.2 was used for statistical analysis.Results Altogether 12 studies were included.Meta-analysis results showed that CD4+％ (I2 =0％,95％ CI=3.44～6.93,Z=5.82,P＜0.00001),CD8+％ (I2 =0％,95％ CI=2.44～7.13,Z=4.00,P＜0.000 1),CD4+％/CD8+％ (I2 =74％,95％ CI=0.16～0.83,Z=2.87,P=0.004),IgA (I2=14％,95％ CI=0.21 ～0.43,Z=5.84,P＜0.00001),prealbumin (I2 =0％,95％CI =0.02 ～ 0.05,Z =3.94,P ＜ 0.000 1) in the treatment group were higher than in the control group,C-reactive protein (I2 =76％,95％ CI =-21.33 ～-5.03,Z =3.17,P =0.002) in the treatment group was lower than in the control group,the differences were all statistically significant.But there were no statistically significant differences in CD3 + ％ (I2 =0％,95％ CI =-3.50 ～ 2.56,Z =0.31,P =0.76),IgG (I2 =92％,95％ CI=-0.32 ～5.54,Z=1.74,P=0.08),IgM (I2 =99％,95％ CI=-0.52～1.89,Z=1.11,P=0.27),total protein (I2 =0％,95％CI=-4.08 ～1.77,Z=0.78,P=0.44),albumin (I2 =29％,95％ CI=-0.87 ～1.45,Z=0.49,P=0.63),transferrin (I2 =0％,95％ CI=-0.23～0.19,Z =0.19,P =0.85) between treatment and control groups.Conclusion Omega-3 polyunsaturated fatty acids can improve the perioperative immune function of patients with gastrointestinal malignant tumor,reduce inflammatory and stress reactions,but have no obvious effect on the improvement of the nutritional status.

Coronaviruses (CoVs) are a group of common viruses that can infect humans and pose a great threat to global public health. Mounting evidence has shown that seven zoonotic CoVs can infect human through cross-species transmission. These continuously occurring yet unpredictable events of CoVs repeatedly crossing species barriers have attracted special attention to CoVs and caused panic worldwide. It is generally believed that the spike (S) protein is the key factor determining the cross-species transmission and the invasion potential of CoVs. This review focused on the new-found coronaviruses with potential cross-species transmission capabilities, and summarized and analyzed the research progress in S protein-mediated viral invasion as well as the potential mechanisms, aiming to provide reference for developing effective prevention and control strategies against potential cross-species transmission of CoVs in the future.

Objective To explore the characteristics of cognitive impairments in euthymic patients with early-on?set or late-onset bipolar I disorder (BD-I). Methods Ninety-four with onset age less than 21 (early onset group), 41 eu?thymic patients with onset age above 35 (late onset group) and 135 normal controls with matched education and age were enrolled. Seven classical neuropsychological tests were used to assess attention, processing speed, working memory and executive functions. Results The early-onset group was significantly worse than its corresponding normal controls in 14 indexes of all tests, including digital symbol, digital span, visual graphic reproduction (c1 and c2), time of TMT-A and TMT-B, verbal fluency, number of sorting, error and preserved error in WCST, as well as total score, completed missions, planning time and executing time in TOH (P<0.05). Moreover the effect size of difference were more than 0.4 in verbal fluency, time of TMT-A and TMT-B, and executing time in TOH. Compared with its matched control group, the late-on?set group was significantly impaired in 9 indexes, including digital span, visual graphic reproduction (c1,c2 and total), time of TMT-A, number of error and preserved error in WCST, as well as total score and completed missions in TOH (P<0.05), merely two indexes of TOH with effect size more than 0.4, while the late-onset group was no significantly impaired in digital symbol, TMT-B and verbal fluency. Conclusions There are significant cognitive impairments in euthymic BD-I patients with no matter early-onset or late-onset. But it seems that the cognitive impairments in early-onset bipo?lar disorder are more extensive and serious.

Objective To study the influence of mobile management software education to the young and middle-aged type 2 diabetes patients′ knowledge and behavior. Methods 130 cases of diabetes patients was selected in 2015.10 to 2016.04 which came from the endocrine ward of the center hospital of Dalian ,68 males and 62 females.63 cases were divided into experimental group and 67 cases in control group, according to the random number table method. The control group was given the regular out-of- hospital management mode, and the experimental group was managed by the diabetes mobile management software. Six months after the intervention, the effects of two groups on blood glucose, metabolic index, diabetes knowledge, self-management efficacy and self-management behavior were observed. Results There was no significant difference in fasting blood glucose, postprandial 2 h bloodglucose and glycosylated hemoglobin between the two groups before the intervention (P > 0.05).After intervention for three months, the date in control group respectively (8.81 ± 2.02) mmol/L, (12.44 ± 2.53) mmol/L, (8.41±1.40)%. experimental group respectively (7.91±2.29) mmol/L, (10.65±2.87) mmol/L, (7.83± 1.25)%. The difference was statistically significant (t=2.320, 3.691, 2.416, P < 0.05 or 0.01). After intervention for six months, these numbers in control group were (7.96±1.79)mmol/L,(10.61±2.12) mmol/L,(7.85±1.24)%. The experimental group were (7.00±2.00) mmol/L, (8.93±2.16) mmol/L, (7.20±1.25)%. The difference was statistically significant(t=2.805, 4.368, 2.914, P < 0.01).Compared the related knowledge scores (Good, general, poor) before intervention ,the difference was not statistically significant (P>0.05).After 3 months of intervention, the cases in control group was 5, 57 ,1 respectively, the experimental group were 15,46,0 respectively. After 6 months intervention, the control group was 40, 32, 0. The experimental group were 48, 14, 0. After 3 months and 6 months intervention. There was significant difference between the two groups, (Z=2.637, 2.055, P<0.01 or 0.05). scores of diabetes mellitus (high level, medium level, low level)in the two groups was no significant difference (P > 0.05), before the intervention. After 3 months intervention ,cases in control group were 49,131respectively, the experimental group were 54,5,0 , after 6 months intervention ,control group were 59,4,0 ,respectively , the experimental group were 61,0,0. After 3 months and 6 months intervention, there was significant difference between the two groups (Z=2.103, 1.992,P<0.05). Diabetes self- management effectiveness score(good, moderate, poor) was compared in two groups. There was no significant difference between the two groups before and after 3 months intervention (P>0.05). After 6 months of intervention, cases in the control group was 9,54,0,respectively, the experimental group were 43, 18, 0, the difference was statistically significant (Z = 6.315, P < 0.01). Conclusions The education model of diabetes mobile management software can help to improve the standard rate of glucose and other metabolic indexes, at the same time also improve the level of knowledge and behavior of middle-aged and young patients with type 2 diabetes, but it′s long-term effect needs further study.

Objective To evaluate the efficacy of selective laser trabeculoplasty (SLT) as treatments of secondary glaucoma after intravitreal silicone oil injection. Methods Forty-five cases(45 eyes) of silicone oil glaucoma (SOG) from June 2014 to April 2016 were enrolled and divided into two groups according random digits table. The SLT treatment group had 21 cases (21 eyes), and drug treatment group had 23 cases(23 eyes).Intraocular pressure(IOP)changes were recorded 1 d, 1 week, 3 weeks, 1 month, 2 months, 3 months,4 months,5 months and 6 months after treatment.Results The decrease of IOP in SLT group was (11.47 ± 2.23), (11.27 ± 2.59), (10.43 ± 2.55), (11.93 ± 2.71), (13.75 ± 2.57),(13.93 ± 2.65),(10.45 ± 2.53)and(12.73 ±2.86)mmHg(1 mmHg=0.133 kPa).IOP of the control group decreased respectively (7.53 ± 3.29), (9.57 ± 3.49), (8.78 ± 4.21), (8.74 ± 3.86), (6.12 ± 4.41),(7.84 ± 3.26),(8.84 ± 4.25),(8.24 ± 3.56)mmHg.There was significant difference between the two groups 1 week, 1 month, 2 months, 3 months,4 months,5 months and 6 months after treatment (t = 4.17, 1.38, 2.89, 6.32, 3.89, 5.32, 5.19, P < 0.05 or < 0.01). Conclusions SLT is a safe and effective option for the treatment of patients with SOG.

Objective To examine the heritability of neurocognitive functions in bipolar I disorder(BD-I)families and BD-associated cognitive endophenotypes. Methods Seventy-nine nuclear families consisting of euthymic BD-I probands and their healthy parents were recruited. Cognitive functions including attention, working memory, processing speed and executive function were evaluated by 7 classic neurocognitive tests, and the heritability of neuroconitive functions in these families was estimated using parent-offspring regression indexes of quantitative traits.Furthermore,the heritable cognitions were compared between 79 BD probands and 140 normal controls. Results After adjusted by age and education,mistake numbers of Trail Making Test A(TMT-A),total score and completed mission numbers of Tower of Hanoi (TOH) were significantly heritable (P<0.05). The comparison of these heritable cognitions between patients and normal controls showed that TOH total score and TOH completed mission numbers were significantly impaired in the patient group (P<0.05). Conclusion Processing speed and executive function are probably heritable in BD nuclear families. Executive function impairments may be disease-related which could be candidate endophenotypes for bipolar disorder.

Objectives To analyze the clinical characteristics, treatment and prognosis of necrotizing pneumonia caused by Mycoplasma pneumoniae (MP) infection in children. Method The clinical data of children with necrotizing pneumonia cause by MP infection from October 2016 to October 2017 were retrospectively analyzed. Results A total of 26 children (10 males and 16 females) with an average age of (5.76±2.60) years, were enrolled in the study. All children were characterized by fever and cough. High fever ( ≥ 39.0 ℃) was seen in 23 cases (88.5％) and the total duration of fever was (16.88±7.42) days. Pulmonary auscultation showed a reduction in respiratory sounds in all children. The range of peripheral blood leukocytes were (9.0～36.8) ×109/L, mean peak neutrophil ratio was (69.2±13.2) ％, and the range of C-reactive protein (CRP) was (1～202.5) mg/L. The mean value of lactic dehydrogenase (LDH) was (448±247) U/L. At the beginning of the disease, the chest images showed homogeneous solid high-density images over the whole lung lobe and 20 cases (76.9％) were complicated with pleural effusion. At the later stage, lung CT showed thin-walled cavities or multiple air-containing cysts on the basis of lung consolidation. Fiberoptic bronchoscopy showed lumen obstruction caused by mucus plugs in 23 cases (88.5％) . All the children were treated with methylprednisolone. The dose of 2 mg/ (kg·d) was effective in 21 cases and the fever was relieved in 5 cases after the dose was adjusted to 4 mg/ (kg·d) , and the average hormone application time was (13.08 ± 8.38) d. The median length of hospital stay was [16.5 (7～32) ] d. Two cases were lost to follow-up and 24 cases finished 6-month follow-up. Lung CT showed almost complete recovery of the lungs in 16 cases, residual pleural hypertrophy in 5 cases, and bronchiectasis in 1 case and bronchiolitis obliterans in 2 cases. Conclusion Necrotic pneumonia in children caused by MP infection is characterized by persistent high fever, decreased respiratory sounds, lung consolidation and mucus plugs induced lumen obstruction. The prognosis is relatively good after active anti-infection and hormone therapy.

Objective:To observe the effects of Xiaoqinglong Decoction and Tingli-Dazao-Xiefei Decoction in treating chronic heart failure with syndrome of cold phlegm obstructing lung. Methods:Eighty-six chronic heart failure patients from January of 2017 to December of 2018 in our hospital who met the inclusion criteria were selected and divided into 2 groups according to the random number table method with 43 patients in each group. The control group was treated with conventional therapy, and the observation group was orally treated with Xiaoqinglong Decoction and Tingli-Dazao-Xiefei Decoction. Both groups were treated for 3 months. Then scored the symptoms of cold phlegm obstructing lung from four aspects: palpitations, cough and asthma, uria and edema, and sputum. The ultrasonic cardiogram was used to detect the left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF). The ELISA method was used to measure levels of vascular pseudohemophilia factor (vWF),endothelin-1 (ET-1) and serum levels of total antioxidant capacity (TAC), lipid peroxide (LPO), SOD, MDA. The efficacy was evaluated. Results:The total effective rate of the observation group was 90.7% (39/43), significantly higher than that of the control group as 69.8% (30/43), and the difference between the two groups was statistically significant ( χ2=4.692, P=0.030). After the treatment, scores of palpitation, cough and asthma, urine and sputum in the observation group were obviously lower than those of the control group ( t value were 7.621, 7.033, 6.831, 6.635, respectively, all Ps<0.01); the LVEDD (51.41 ± 5.69 mm vs. 58.49 ± 6.77 mm, t=9.809), LVESD (40.04 ± 4.48 mm vs. 43.25 ± 5.21 mm, t=6.776) of the observation group were significantly lower than that of the control group, and while LVEF (50.16% ± 5.89% vs. 45.87% ± 5.16%, t=7.761) was significantly higher than that of the control group ( P<0.01). Plasma levels of vWF (103.55% ± 11.98% vs. 138.11% ±15.71%, t=41.453) and ET-1 (67.05 ± 7.18 pg/ml vs. 81.72 ± 10.03 pg/ml, t=18.990) in the observation group were significantly lower than that of the control group ( P<0.01). The serum levels of TAC and SOD levels in the observation group were significantly higher ( t value were 4.662, 13.331, respectively, all Ps<0.01), while LPO and MDA levels were significantly lower than the control group ( t value were 4.982, 4.031, all Ps<0.01). Conclusions:The Xiaoqinglong Decoction and Tingli-Dazao-Xiefei Decoction in treating chronic heart failure can improve the heart function and symptoms with syndrome of cold phlegm obstructing lung, and increaseclinical efficacy.

Objective:To investigate the effects of early sleep deprivation(SD) on depressive-like behavior and hippocampus synaptic plasticity in adult mice with chronic unpredictable mild stress(CUMS) model.Methods:Thirty 2-week-old clean grade male mice were randomly divided into control group (CON group), CUMS group and SD + CUMS group according to the random number table, with 10 mice in each group. The mice in SD + CUMS group were subjected with sleep deprivation for 4 hours once a day during puberty (3 ~ 6 weeks old), and then were stimulated by CUMS after adulthood (9 weeks old). The mice in CUMS group were subjected with CUMS at the age of 9 weeks. And the mice in CON group were not given any intervention.The depressive-like behavior was evaluated by body weight, sugar water preference, tail suspension test and forced swimming test.The density of dendritic spines of basal and apical neurons in hippocampal CA1 was measured by Golgi staining, the frequency and amplitude of miniature excitatory postsynaptic current(mEPSC) of pyramidal neurons in the hippocampal CA1 region of mice were measured by electro-physiological patch clamp technique.Graphpad prism 7.0 software was used for statistical analysis and mapping. One-way ANOVA was used for comparison among multiple groups, and Tukey test was used for further pairwise comparison.Results:(1) After stress modeling, there were significant differences in body weight, sugar water preference percentage, forced swimming immobility time and tail suspension time among the three groups ( F=71.63, 39.82, 44.13, 43.07, all P<0.01). Compared with CON group, the mice in CUMS group and SD+ CUMS group had lower body weight ((25.51±0.37) g, (22.92±0.31) g, (20.12±0.27) g, both P<0.01), lower sugar water percentage preference ((87.40±1.65) %, (63.42±3.33) %, (49.68±3.70)%, both P<0.01), longer immobile time of forced swimming ((34.30±5.32) s, (119.20±12.03) s, (153.80±9.17) s, both P<0.01) and longer immobile time of tail suspension test((115.20±8.19)s, (156.80±4.35) s, (192.00±4.12) s, both P<0.01). Compared with CUMS group, SD+ CUMS group had lower body weight ( P<0.01), lower sugar water preference percentage ( P<0.05), longer immobile time in forced swimming test( P<0.05) and longer immobile time in tail suspension test( P<0.01). (2) Golgi staining results showed that the densities of dendritic spines of apical neurons and basal neurons in hippocampal CA1 area of the three groups were significantly different ( F=38.41, 41.34, both P<0.01). The densities of dendritic spines of basal and apical hippocampal neurons in CUMS group and SD+ CUMS group were lower than those in CON group ((7.74±0.22)/10 μm, (6.58±0.27)/10 μm, (5.00±0.13)/10 μm, both P<0.01), ((8.90±0.23)/10 μm, (7.63±0.30)/10 μm, (6.01±0.14)/10 μm, both P<0.01). Compared with CUMS group, the mice in SD+ CUMS group had lower densities of dendritic spines of basal and apical hippocampal neurons(both P<0.01). (3) Electrophysiological results showed that there were significant differences in the frequency and amplitude of mEPSC in hippocampal pyramidal neurons of the three groups ( F=38.90, 63.37, both P<0.01). Compared with CON group, the frequency and amplitude of mEPSC in pyramidal neurons of CA1 in CUMS group and SD+ CUMS group were significantly lower ((0.39±0.03)Hz, (0.20±0.02)Hz, (0.07±0.02)Hz, both P<0.01; (9.98±0.31)pA, (7.74±0.21)pA, 6.36±0.13)pA, both P<0.01). Compared with CUMS group, the frequency and amplitude of mEPSC in SD+ CUMS group were lower (both P<0.01). Conclusion:Adolescent sleep deprivation aggravates depressive behavior and hippocampus synaptic plasticity impairment in adult CUMS model mice.