Abstract: Objective　To investigate the distribution, seasonal ebb and flow, and influence factor of tick populations in Huangpu District, Shanghai, clarify the popularity and dominant tick species in Huangpu District, Shanghai, and provide a foundational basis for comprehensive monitoring and control of ticks and tick-borne diseases. Methods　From January to December 2023, the seasonal fluctuation of free ticks was investigated by flagging method twice a month in People's Park of Huangpu District. In May 2023, a free ticks cross-sectional survey was conducted in all park green spaces in Huangpu District, with simultaneous recording of environmental meteorological factors on site. Results　From January to December 2023, a total of 25 tick surveys were conducted, with a total drag distance of 6 810 meters, capturing 1 019 ticks, all morphologically identified as Haemaphysalis flava. Seasonal ebb and flow analysis found a bimodal distribution of overall tick density, peaking on June 26 and September 21, 2023, with tick densities of 216.00 and 67.33 ticks/(flag·100 m), respectively. The total tick density at monitoring points in grassland was lower than that in withered leaves, with tick densities of 3.11 and 23.22 ticks/(flag·100 m), respectively. Spearman rank correlation analysis showed that total tick density was positively correlated with measured surface temperature (rs=0.88), daily low temperature (rs=0.80), monthly average low temperature (rs=0.79), daily high temperature (rs=0.77), monthly average high temperature (rs=0.81), measured surface relative humidity (rs=0.86), monthly rainfall day (rs=0.43), and monthly average sunshine time (rs=0.58), average wind speed (rs=0.53); the total tick density was negatively correlated with air pressure (rs=-0.65, P<0.05). The cross-sectional survey in Huangpu District found tick activity only in Nanjing East Road Street and Ruijin Second Road Street, with densities of 0.05 and 0.14 ticks/(flag·100 m), respectively. Conclusions　The dominant tick in City Park, Huangpu District, Shanghai is Haemaphysalis flava. Tick density is highest in June, and the density of ticks in the withered leaves is higher than that in the grassland. Targeted tick control measures should be taken during the peak period of tick activity according to survey results.

Network Meta-analysis was used to compare the efficacy and safety of Chinese patent medicines in the treatment of unstable angina pectoris. PubMed, Cochrane Library, CNKI, Wanfang, VIP and other databases were retrieved by computers from the establishment of the databases to June 2020. Randomized controlled trials(RCTs) of Chinese patent medicines for the treatment of unstable angina pectoris were collected. Two investigators independently screened out the literatures, and extracted data according to the inclusion and exclusion criteria. The quality of the included RCTs was evaluated according to the bias risk assessment tool recommended by the Cochrane System Reviewer Manual, and the Stata 13.0 software was used for data analysis and mapping. Through screening, 28 eligible studies were finally included, with the sample size of 2 885 cases, involving 8 Chinese patent medicines. The results of the network Meta-analysis showed that in terms of total effective rate for angina symptom improvement, the order was as follows: Shenshao Capsules > Naoxintong Capsules > Ginkgo Ketone Ester Dripping Pills > Compound Danshen Dripping Pills > Ginkgo Leaf Tablets > Shexiang Baoxin Pills > Tongxinluo Capsules > Yindan Xinnaotong Soft Capsules; in terms of total effective rate for ECG curative effect, the order was as follows: Ginkgo Ketone Ester Dripping Pills>Compound Danshen Dripping Pills > Tongxinluo Capsules > Shenshao Capsules > Shexiang Baoxin Pills > Yindan Xinnaotong Soft Capsules; in terms of hypersensitivity-C-reactive protein curative effect, the order was as follows: Tongxinluo Capsules > Shenshao Capsules > Ginkgo Leaf Tablets>Compound Danshen Dropping Pills> Shexiang Baoxin Pills > Naoxintong Capsules > Yindan Xinnaotong Soft Capsules > Ginkgo Ketone Ester Dropping Pills. Chinese patent medicine combined with conventional therapy can improve the clinical efficacy of unstable angina pectoris. Due to the differences in the quantity and quality of the included studies, the order results of Chinese patent medicines need to be further verified.
Angina, Unstable/drug therapy* ; China ; Drugs, Chinese Herbal ; Humans ; Medicine, East Asian Traditional ; Network Meta-Analysis ; Nonprescription Drugs

Tetanus consists of neonatal tetanus and non-neonatal tetanus. Non-neonatal tetanus remains a serious public health problem, although neonatal tetanus has been eliminated in China since 2012. Non-neonatal tetanus is a potential fatal disease. In the absence of medical intervention, the mortality rate of severe cases is almost 100%. Even with vigorous treatment, the mortality rate remains 30%-50% globally. These specifications aim to regulate non-neonatal tetanus diagnosis and treatment in China, in order to improve medical quality and safety. These specifications introduce the etiology, epidemiology, pathogenesis, clinical manifestations and laboratory tests, diagnosis, differential diagnosis, grading and treatment of non-neonatal tetanus.

Tetanus consists of neonatal tetanus and non-neonatal tetanus.Non-neonatal tetanus remains a serious public health problem,although neonatal tetanus has been eliminated in China since 2012.Non-neonatal tetanus is a potential fatal disease.In the absence of medical intervention,the mortality rate of severe cases is almost 100％.Even with vigorous treatment,the mortality rate is still 30％-50％ globally.These specifications aim to regulate non-neonatal tetanus diagnosis and treatment in China,in order to improve medical quality and safety.These specifications introduce the etiology,epidemiology,pathogenesis,clinical manifestations and laboratory tests,diagnosis,differential diagnosis,grading and treatment of non-neonatal tetanus.

Tetanus consists of neonatal tetanus and non-neonatal tetanus. Although neonatal tetanus in China has been eliminated since 2012, non-neonatal tetanus remains a serious public health problem. Non-neonatal tetanus is a potential fatal disease, and the mortality rate of severe cases is almost 100% in the absence of medical intervention. Even with vigorous treatment, the mortality rate is still 30~50% globally. In order to standardize the diagnosis and treatment of non-neonatal tetanus in China, this specification is hereby formulated. This standard includes etiology, epidemiology, pathogenesis, clinical manifestations, laboratory tests, diagnosis, differential diagnosis, classification, grading and treatment of non-neonatal tetanus.

Objective Pathophysiology has high comprehensiveness and practical characteristics. Developing analytical capacity is a major teaching aim of Pathophysiology. This study was aimed to build up the basic knowledge of pathophysiology and develop a critical approach through comparative case learning in medical students. Methods A pair of related cases were chosen in this study. Comparative case learning was performed in our lecture. Case analysis was tested before and after comparative case learning,and a self-evaluation was accessed after comparative case learning. The scores of case-analyzing test and self-evaluation assessment were statistically analyzed. Results Using“comparative case learning”in pathophysiology could improve medical students' case-analyzing score,especially in clinical syndrome analyzing examination questions(difficult examination questions). There was a significant correlation between high score of clinical syndrome analyzing examination and students' self-evaluation. ConclusionComparative case learning could improve the analytical,data searching and comprehensive abilities,thereby enhancing a case-analyzing ability in medical students.

AIM:To assess whether the expression of tight junction (TJ) proteins, occludin/zonula occludins (ZO)-1, and regional cerebral blood flow (rCBF) link to brain edema in tree shrews during thrombotic cerebral ischemia and ischemic postconditioning (PC), and to explore how TJ affects brain edema and cerebral infarction .METHODS:Tree shrews were randomly grouped into control , ischemia and cerebral ischemia +PC (n=23), and the remaining 3 ani-mals were used for magnetic resonance imaging ( MRI) .The local cerebral thrombosis were induced by photochemical reac-tion in the tree shrews , and ischemic PC was established at 4 h after induction of cerebral ischemia followed by clipped ipsi-lateral common carotid artery (5 min ×3).The changes of the neural ultrastructure were observed under electron micro-scope.The neuronal apoptosis was analyzed by the method of TUNEL .Laser Doppler brain flowmetry was used to monitor the rCBF.The protein levels of occludin/ZO-1 were determined by immunochemistry and Western blot .The cerebral in-farction volume was detected by MRI .The brain water content was measured by dry-wet weight method .RESULTS: In-duction of cerebral ischemia led to a significant reduction of the normal neuron numbers in the hippocampal CA 1 area, and conversely, the number of neurons with abnormal ultrastructure was increased .The TUNEL positive cells were increased significantly (P<0.01) in ischemia group.Moreover, the rCBF decreased significantly (P<0.01), and occludin/ZO-1 protein expression decreased ( P<0.01 ) .The brain water content and cerebral infarction volume were significantly in-creased (P<0.01).Ischemic PC increased the rCBF and the occludin/ZO-1 expression, but reduced the brain water con-tent, the TUNEL positive cells, and the infarction volume (P<0.01).CONCLUSION:Ischemic PC increases the rCBF but not the local water content , suggesting that reduced cerebral infarction volume after ischemia PC is associated with the attenuation of cerebral edema by the enhancement of occludin /ZO-1 protein expression .

OBJECTIVE:To investigate the effect of α-interferon on long-term survival rate and tumor recurrence after radical hepatic resection. METHODS:104 patients with primary hepatocellular carcinoma underwent radical hepatic resection were divided into observation group(62 cases)and control group(42 cases). Observation group was treated with IFN-α for 18 months 4-6 weeks after surgery;control group received rountine treatment. Total survival rate and disease-free survival rate after surgery were com-pared between 2 groups. RESULTS:In observation group after surgery,1-year survival rate was 82.26%(51/62),3-year survival rate 61.29%(38/62),and 5-year survival rate 24.19%(15/62);in control group after surgery,1-year survival rate was 41.94%(26/62),3-year survival rate 28.57%(12/42)and 5-year survival rate 9.52%(4/42);there was statistically significant difference in postoperative survival rate between 2 groups (P<0.05). In observation group after surgery,1-year disease-free survival rate was 61.29%(38/62),3-year disease-free survival rate 40.32%(25/62),and 5-year disease-free surial rate 17.74%(11/62);in control group after surgery,1 year disease-free survival rate was 43.55%(27/62),3 year disease-free survival rate 22.58%(14/62),and 5-year disease-free surial rate was 0(0/62);there was statistically significant difference in postoperative disease-free survival rate be-tween 2 groups (P<0.05). CONCLUSIONS:The application of α-interferon after radical hepatic resection can significantly inhibit the recurrence of postoperative tumor,improve the long-term survival rate,and is worthy of clinical research.

To discuss the situation of country doctors' training in Honghe State of Yunnan Province and to search the more useful training methods, the 171 trainees were surveyed by self-designed questionnaire. It appeared that most students improved knowledge and clinical skills obviously and they wanted more knowledge and case analysis and training of clinic skills.

Objective To summarize the therapeutic experience of 23 patients of traumatic head injuries with a score of 3 on GCS,Methods 23 most severe head injuried patients with a score of 3 on GCS who admitted were analyzed retrospectively.Results 8 cases(34%)survived in which 5 cases(21%)had a good recovery or moderate disability,and other 3 cases(13%)with severe deficits.The other 15 cases(66%)dead after therapy.Conclusion The prognosis of most severe head injured patients with a score of 3 on GCS could be improved by early evacuation of intracranial hematoma with large decompressive cranietomies,early moderate hypothermia therapy,early assistant ventilation and effective prevention and treatment of complications.