Objective To explore the value of Nacotrend and the degree and prognosis of disturbance of consciousness in craniocerebral injured patients. Methods Forty craniocerebral injured patients were observed and Nacotrend index (NI) and Glasgow Coma Scale (GCS) were evaluated 24 h after the operation. After followed up for 3 months, the patients with Glasgow coma scale (GOS) 4-5 scores were enrolled into in good recovery group and the patients with GOS 1-3 scores were enrolled into bad recovery group. The correlation of NI and prognosis was analyzed. Results There were 17 cases in the good recovery group, and 23 cases in the bad recovery group. Pearson correlation coefficient of NI and GCS was 0.721, P<0.01. The level of NI in good recovery group was 64.26±12.73, in bad recovery group was 29.57±8.12, and there was significant difference (P<0.05). Conclusion NI can be used in coma patients for consciousness grading assessment and also can correctly evaluate the prognosis.

OBJECTIVE:To excavate and evaluate the security alert signals of linezolid after marketing,and to provide refer-ence for rational drug use in clinic. METHODS:The reporting odds ratio(ROR)method was used to excavate the security alert signals from the adverse drug events(ADE)data in the OpenFDA platform of FDA during second quarter of 2004-2016. The low-er limit of 95%CI >1 was regarded as suggestive of ADE alert signal. RESULTS:A total of 6828534 reports were extracted, among which there were 7224 reports mainly induced by linezolid. Top 10 ADE reports were thrombocytopenia,drug interac-tion,thrombocytopenia,nausea,anaemia,serotonin syndrome,diarrhoea,pyrexia,drug ineffective,vomiting. After the detec-tion of top 200 ADE reports by ROR method,120 signals related to 18 system organ class(SOC)were identified. Top 5 ADE sig-nals in turn by SOC were medical examination,nervous system disorders,blood and lymphatic system disorders,metabolism and nutrition disorders,cardiac disorders. The high risk signals with clinical reference value included 42 cases of optic neuropathy (ROR=56.33),350 cases of serotonin syndrome(ROR=52.86),162 cases of lactic acidosis(ROR=18.30),31 cases of endo-carditis (ROR=15.38),566 cases of thrombocytopenia (ROR=14.29),122 cases of bone marrow failure (ROR=14.20),261 cases of panhematopenia (ROR=11.92),86 cases of disseminated intravascular coagulation (ROR=10.91),58 cases of toxic epidermal necrolysis(ROR=9.06),etc. As for ADE reports,male was slightly higher than female,and the patients in age group of ≥45 reported evidently more compared to younger age group. CONCLUSIONS:By detecting and evaluating alert signals of li-nezolid through OpenFDA platform,we could effectively lay the foundation for further research of pharmacovigilance.

Objective To explore the protective effect of miconazole on white matter damage (WMD) in neonatal rats. Methods Three-day-old neonatal SD rats were randomly divided into sham group, WMD model group, 10 mg/(kg·d) miconazole group and 40 mg/(kg·d) miconazole group with 15 rats each. Rats in WMD model group were subjected to the ligation of right carotid artery, and then kept in a chamber with 6% oxygen and 94% nitrogen for 80 min to establish the white matter damage model. The rats in miconazole group were intraperitoneally injected with different doses (10 and 40mg/kg) of miconazole, dissolved in dimethyl sulfoxide (DMSO), for five consecutive days, and rats in WMD model group were injected with the same volume of DMSO. Myelin basic protein (MBP) of white matter was detected by immunofluorescence staining and western blot. Myelin sheaths of corpus callosum were observed by transmission electron microscopy. Weight changes of rats were compared among groups. Results Immunofluorescence staining and western blot showed that, after treatment with miconazole, the MBP expression level of corpus callosum was higher than in WMD model group (P<0.05). In WMD model group, the myelin sheath of corpus callosum had loose structure and a large number of small vacuoles with decreased thickness of myelin sheath. After treatment with miconazole, myelinolysis induced by anoxia and ischemia could be improved significantly. The increase in weight of rats in WMD model group was significantly less than that in sham group. And after miconazole treatment, the rate of weight gain of rats was increased. Conclusion Miconazole can significantly reduce the brain white matter damage induced by anoxia and ischemia through promoting myelination, and then improves the growth and development in rats.

BACKGROUND:Olfactory ensheathing cells (OECs) have been shown to possess the potential of repairing injured spinal cord, but their biological characteristics after transplantation in vivo are not well understood.OBJECTIVE: To investigate the migration of OECs after transplantation into the injured spinal cord of adult rats.DESIGN: Randomized and controlled experiment.SETTING: Department of Orthopedics, Guangdong Provincial People's Hospital; Experimental Animal Center of the North Campus of Sun Yat-sen UniversityMATERIALS: Totally 38 2-month-old male SD rats with body mass of (350 ±20) g were used in this study.METHODS: This experiment was conducted in the Experimental Animal Center, North Campus of Sun Yat-sen University between February 2004and May 2004. Two SD rats were used to extract the OECs, which were stained with Hoechst 33342. Totally 36 SD rats were subsequently randomized into 3 groups, namely rostral transplantation group, caudal transplantation group and control group with 12 rats in each group. The rats in the rostral and caudal transplantation groups subjected to operations to establish thoracic spinal cord injury model and OEC suspension was injected; in the control group, the rats were spared of thoracic spinal cord injury with only OEC suspension injection.MAIN OUTCOME MEASURES: Distribution of OECs in the spinal cord was observed under fluorescence microscope 1, 2, 4 and 6 weeks after operation, respectively.RESULTS: Of the rats in the 3 groups, 1 died in the rostral group, and 2in each of the caudal transplantation and control groups, leaving 29 rats for result analysis. The OECs in the rostral and caudal transplantation groups migrated longitudinally along the long axis of the spinal cord to a farthest distance of 8 mm and penetrating the scar tissues, but very few cells could reach the contralateral side. The OECs in the control group diffused locally without migration.CONCLUSION: OECs mainly migrate along the axons in white matter of the injured spinal cord, and their rostral and caudal migration does not differ in speed or amount. Only a small amout of OECs can across the transected gap of the spinal cord.

Objective To observe the effect of Herba Hedyotis Diffusae(HHD) on expression of heat shock protein 70(HSP70) and P16 anti-oncogene protein in mice with H22 cell transplanted tumor. Methods The mice were immunized with hepatoma-lines-H22 cells which were treated by Chinese herbs firstly. According to the pretreatment of the Chinese herbs and whether the H22 cells being blocked by HSP70 monoclonal antibody,the mice were divided into 5 groups:HHD non-blocking group,HHD-blocking group,Radix Codonopsis(RC)-blocking group,RC non-blocking group,and RPMI-1640 control group. Then the treated H22 Cells were translated into the mice. The expression of HSP70 and P16 anti-oncogene protein in mice with transplanted H22 liver carcinoma was detected by immunohistochemical marking method. Results The expressions of HSP70 was up-regulated in HDD non-blocking group and RC non-blocking group,in particular in RC non-blocking group,and the difference was significant as compared with HHD-blocking group,RC-blocking group and control blank group.The expression of P16 anti-oncogene protein was up-regulated in the treatment groups,and the difference was significant in comparison with the control group. The effect on P16 anti-oncogene protein expression was stronger in HDD groups than that in RC groups,but the difference was insignificant between the blocking group and the non-blocking group of each herb. Conclusion The anti-tumor effect of HDD may be achieved by inducing HSP70 expression in transplanted H22 neoplasia and by enhancing the immunogenicity. The up-regulation of P16 anti-oncogene expression by HHD and RC has no direct relationship with the induction of HSP70,and the related mechanism needs further research.

Abstract Vaccine-hypervariable poliovirus type Ⅲ was detected in an acute flaccid paralysis infant at age of 6 months in Zhejiang Province in June, 2021, and the isolated and incubated virus had six nucleotide variations in the VP1 region as compared to the poliovirus Sabin vaccine strain. The infant had a history of three-dose poliovirus vaccination, and grade 2 muscle strength of the left upper limb upon onset. He was clinically diagnosed with cellulitis of the left shoulder, and recovered to normal following treatment. No abnormality was detected in the nervous system, and the infant was cured and discharged from hospital. No vaccine-hypervariable poliovirus was detected in subsequent infant' clinical samples or in close contacts, and no similar cases were identified during the active case detection by county/district medical institutions and among community populations. Since the infant did not present poliomyelitis-related clinical symptoms caused by vaccine-hypervariable poliovirus, poliomyelitis was excluded. The vaccine-hypervariable poliovirus was not spread because of timely identification and effective responses, suggesting the urgent need to maintain the sensitivity of the acute flaccid paralysis surveillance system and improve the coverage of poliovirus vaccination, so as to inhibit the transmission of poliovirus.

Objective: To investigate the serum levels of anti-measles antibody among residents in Zhejiang Province in 2018, so as to provide insights into measles control. Methods: Permanent residents aged 0 to 59 years were recruited using the stratified multistage random sampling method in Zhejiang Province in 2018, and subjects' demographic features, medical history of measles and history of immunization with measles-containing vaccine (MCV) were collected using a questionnaire survey. The serum level of anti-measles IgG antibody was detected, and the geometric mean concentration (GMC) of anti-measles IgG antibody was estimated. The seroprevalence, protective rate and GMC of anti-measles IgG antibody were compared among residents at different age groups and regions. Results: A total of 4 189 residents were enrolled, including 1 939 males and 2 250 females, with a male to female ratio of 1∶1.16. There were 3 858 residents positive for anti-measles IgG antibody, with seroprevalence of 92.10%, and there were 2 072 residents with protective antibodies against measles, with a protective rate of 49.46%. The median GMC of anti-measles IgG antibody was 798.33 (interquartile range, 1 024.06) mIU/mL, and the protective rate of anti-measles IgG antibody appeared a tendency towards a decline with age ( χ2trend=18.067, P<0.001 ). There were significant differences in the seroprevalence ( χ2=45.090, P<0.001 ), protective rate ( χ2=57.432, P<0.001 ) and GMC of anti-measles IgG antibody (χ2=88.624, P<0.001 ) among residents at different regions, with the lowest seroprevalence of anti-measles IgG antibody in Ningbo City ( 85.19% ), the lowest antibody-protective rate (38.98%) and the lowest GMC [632.89 ( 909.04 ) mIU/mL] in Zhoushan City, the highest seroprevalence ( 95.16% ), antibody-protective rate (58.48%) and GMC [1 035.84 ( 1 301.77 ) mIU/mL] in Huzhou City. Conclusions The protective rate of anti-measles antibody was low and appeared a tendency towards a decline among residents in Zhejiang Province in 2018. There was a region-specific serum level of anti-measles antibody in Zhejiang Province in 2018.

Objective: To establish an optimized path for health management of HBV infections among pregnant and lying-in women based on a Delphi method, so as to provide the evidence for intensifying the interruption of the mother-to-child transmission of HBV. Methods: Based on literature review and previous studies, the preliminary framework and contents of the optimized path for health management of HBV infections were constructed. Experts from epidemiology, clinical medicine and maternal and children healthcare were invited to participate in two-round Delphi consultations, and the preliminarily designed indicators were screened and revised. The score for feasibility of each indicator was calculated, and the weight of each indicator was estimated using a proportional distribution method. Results: Sixteen experts participated in the consultation, including 13 women. The participants had a mean age of (45.69±5.71) years, and a mean employment duration of (23.06±7.05) years. All participants had a degree of bachelor and above, and there were 14 experts with vice senior professional titles. The mean positive coefficient was 96.88% and the mean authority coefficient was 0.790 during the two-round expert consultations. There were significant differences in the coordination coefficient of importance, necessity and feasibility of indicators at all levels (P<0.05), and the coefficient of variation of the feasibility was all less than 0.250. The final optimized path for health management of HBV infections among pregnant and lying-in women included 6 primary indicators, 17 secondary indictors and 73 tertiary indicators. Among the primary indicators, delivery management (0.173 4), screening and evaluation (0.172 8) and pregnancy management (0.172 7) had a high weight. Conclusion A scientific and reliable optimized path is created for health management of HBV infections among pregnant and lying-in women, which has a potential value for improving the interruption of mother-to-child transmission of HBV.

OBJECTIVE:To investigate the general regularity and characteristics of propylthiouracil (PTU)-associated small vasculitis (ASV),and to provide reference for rational drug use in the clinic. METHODS:ADR/ADE case reports of PTU-ASV published during 1990-2016 were retrieved. The data of 118 ADR cases were analyzed statistically. RESULTS:The incidence of PTU-ASV was higher in female and was highest in 18-59 age group. Drug dose of 87 patients were within 600 mg/d,and the inci-dence of PTU-ASV was the highest within 1-5 years after medication. Main clinical manifestations were renal and lung function in-jury. After drug withdrawal,59 patients received hormone therapy,and 30 patients received hormone combined immunosuppressive agent. Finally,115 patients were recovered and 3 patients died. CONCLUSIONS:In older to reduce or avoid the occurrence of ADR,it is necessary to regularly check antineutrophil cytoplasmic antibody related indexes and evaluate the symptoms of ADR.

Objective: To analyze the strengths, weaknesses, opportunities and threats of the construction on intelligent vaccination clinics in Zhejiang Province, so as to provide countermeasures for promoting the construction of intelligent vaccination clinics in Zhejiang Province. Methods: By reviewing the annual reports of Zhejiang immunization planning, survey data from Zhejiang Centers for Disease Control and Prevention and Immunization Intelligent Service System, data of human resources of immunization planning, vaccine procurement, construction progress of intelligent vaccination clinics and vaccination were collected. The relevant literature was searched to gather information on the construction standards and norms of intelligent vaccination clinics. The analysis of the strengths, weaknesses, opportunities and threats (SWOT) of the construction of intelligent vaccination clinics was conducted, and corresponding countermeasures and suggestions were proposed. Results: The National Immunization Program reported vaccine rate in Zhejiang Province is more than 99%, and standardized vaccination clinics have been popularized throughout the province. The vaccination staff are professional, and a province-wide intelligent immunization service information system has been established, providing the resources and conditions for the construction of intelligent vaccination clinics. However, there are problems such as low data quality and matching efficiency in vaccination, insufficient data interoperability and sharing, unbalanced regional capabilities in intelligent transformation, and uneven distribution of talent and resources. It is crucial to seize the opportunities presented by the development of big data and artificial intelligence, rely on the regional development of the Internet and health industry, seize the opportunity of rapid growth in demand for intelligent vaccination services and high public acceptance, accelerate the construction of intelligent vaccination clinics, and establish intelligent vaccination service standards as soon as possible. Conclusion We should seize the opportunities presented by the digital reform and development, fully utilize the existing vaccination resources and strengths, address the shortcomings, and accelerate the construction of intelligent vaccination clinics in Zhejiang Province.