Objective To investigate the clinical efficacy of cetylpyridinium chloride gargle in the treatment of oral candidiasis.Methods Collected 45 cases of oral candidiasis patients admitted in our hospital from April 2015 to April 2017.Among them, 24 patients were treated with cetylpyridinium chloride gargle and treated as observation group.Rinse treatment in 21 cases, set as the control group.The oral pain score, mucosal atrophy score and mucosal erythema score were compared between the two groups.The HAMA anxiety scale and HAMD depression scale were used to evaluate the psychological stress.The HAMA score, HAMD score, blood glucose and blood glucose were compared between the two groups.Insulin levels were compared between the two groups of patients after oral mucosal examination positive rate and the incidence of adverse reactions.Results After treatment, the oral pain score, mucosal atrophy score and mucosal erythema score were significantly lower in the observation group than in the control group, the difference was statistically significant(P<0.05).The HAMA score, HAMD score and blood glucose level were significantly lower in the observation group than in the control group, the insulin level was higher than the control group, the difference was statistically significant(P<0.05).The positive rate was 20.83%(5/24)in the observation group and 52.38%(11/21)in the control group.The positive rate of oral mucosal examination in the observation group was significantly lower than that in the control group, the difference was statistically significant(P<0.05).There were no obvious adverse reactions during the treatment group.In the control group, only one case of oral mucosal congestion was found, but it was tolerable and disappeared after treatment.There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion The use of cetylpyridinium chloride gargle in the treatment of oral candidiasis can relieve oral pain, mucosal atrophy, erythema symptoms and stress state, effective control of oral infection, and no significant adverse reactions、high safety.

Objective To investigate the relationship of Toll-like receptors (TLRs) 2 and 4 with the occurrence of chloasma.Methods Peripheral blood samples were collected from 40 patients with chloasma and 40 healthy human controls,and skin samples were also collected from the lesions of 10 of the patients and normal skin of 10 of the healthy controls.Real time (RT)-PCR was performed to measure the mRNA expressions of TLR2 and TLR4 in skin lesions and blood samples.An immunohistochemical test was conducted to observe the expressions of TLR2 and TLR4 in skin lesions.Statistical analysis was carried out by t test.Results The expressions of TLR2 and TLR4 mRNAs were both significantly higher in skin lesions of the patients than in normal skin of the controls (9.72 ± 2.93 vs.5.10 ± 2.69,t =3.67,P＜ 0.01; 9.52 ± 2.88 vs.4.77 ± 1.90,t =4.36,P＜ 0.01),while no significant difference was found in the mRNA expressions of TLR2 or TLR4 in peripheral blood between the patients and controls (both P ＞ 0.05).As the immunohistochemical test revealed,TLR2 was absent in both the epidermis and vascular endothelial cells in 6 normal control skin samples,weakly expressed in the basal layer of the epidermis but absent in vascular endothelial cells in 4 normal skin samples,and no TLR4 expression was observed in either the epidermis or vascular endothelial cells in these control skin samples.Among the 10 skin samples from chloasma lesions,3 showed TLR2 expression in the whole epidermis,7 in both basal cell layer and prickle cell layer but not in vascular endothelial cells in the superficial dermal layer,all showed strong TLR4 expression in the basal cell layer and weak TLR4 expression in the prickle cell layer,and 3 exhibited TLR4 expression in vascular endothelial cells in the superficial dermal layer.Conclusion TLR-mediated immune responses in local skin might be related to the occurrence of chloasma.

Objective:To study the antidepressant effect of Baihe Zhimu decoction (BZD)and its influence in the key factors (CaM,CaMKⅡ,CREB)of CaM signaling pathway in hippocampus of the rats with depression,and to explore the antidepressant effect of BZD. Methods:Fifty rats were divided into control group,model group, fluoxetine group,low and high doses of BDZ groups (n = 10).Expect for control group,all the rats in other groups were made depression models by means of chronic unpredictable mild stress along with isolated raising,for 21 d.Then the rats were fed with NS, fluoxetine (1.8 mg · kg-1 ), and BZD (1.5 and 3.0 g · kg-1 ), respectively;for 28 d.The learning and memory ability,autonomous activities and the fixed time in 5 min of the rats were tested by Morris water amaze,Open-field Test and Forced Swimming Test respectively. The damage and repair status of hippocampal neurons were observed by Nissl staining method;the expression levels of CaM,CaMKⅡ protein,CREB mRNA in hippocampus of the rats were detected by Western blotting and RT-PCR method. Results:Compared with model group,the total time of rats in the platform quadrant of Morris water maze in BZD groups and fluoxetine group,the total distance and the number of crossing platform were increased (P <0.05 or P <0.01),and the time of first crossing platform were shortened (P <0.01);the total scores in open field test were increased (P <0.01),the fixed time with 5 min in the forced swimming test was shortened (P <0.05 or P <0.01).Compared with fluoxetine group,the fixed time within 5 min of the rats in swimming test was shortened (P <0.05).The result of Nissl staining showed that the hippocampal neuron injury in BZD groups and fluoxetine group was improved compared with model group.The molecular test results showed that the CaM and CaMKⅡprotein expression levels in hippocampus of the rats in BZD groups and fluoxetine group were increased compared with model group (P < 0.05 or P < 0.01).Compared with model group,the CREB mRNA expression levels in fluoxetime group and BZD groups were increased (P < 0.05 or P < 0.01).Conclusion:BZD has antidepressant effect and can improve the hippocampal neuron injury of the rats with depression and its mechanism is related to increasing the expression levels of CaM,CaMKⅡ and CREB in hippocampus CAM signaling pathway of the rats.

Objective To explore the relation of early time secretion function of Beta cell in newly diag-nosed type 2 diabetic patient and the changes of body weight following intensification therapy of insulin. Methods 237 newly diagnosed type 2 diabetic patients were divided into 1 kg lower group, the 1-5 kg group, the 5 kg above group. The maximum body weight and waist circumference were recorded. The present body weight and waist circum-ference were measured according to OGTT study, meanwhile,30 minuets blood sugars, the insulin and the C-peptide (C-P) level and the blood pressure(BP) and the insulin resistance index (HOMA-IR), the early insulin secretion index (△I30/△G30) was calculated. All cases were treated for 14 days. Results Early time secretion function of Beta cell in the group keeping above lose weight 5 kg was the worst, after treatment insulin secretion level were in-creased 1.12 times and 1.86 times in 1 kg lower group than in the 1-5 kg group and above 5 kg group. Conclusions Early time secretion function of Beta cell in newly diagnosed type 2 diabetic patient is correlated with the maxi-mum body weight decrease.

With the accelerated urbanization process, there are growing interests in the potential impact of neighborhood built-environment on residents’ physical activity and dietary habits. In this paper, we introduced the concept of the built environment and the ways to assess the built-environment related to physical activity and dietary habits. We reviewed papers on the association of the built-environment with physical activity and dietary habits. Improvement of the built-environment is expected to reduce the health burden caused by insufficient physical activity and unhealthy dietary habits. As this field is still at its initial stage, there are many questions to be explored. We then discussed the challenges for this field and made some suggestions for future study.

Objective: To investigate the effect of caffeine citrate administering at different time on outcome and neurodevelopment of premature infants. Methods: A total of 113 preterm infants with gestational age less than 32 weeks and birth weight less than 1 500 g who were hospitalized and treated in the neonatal intensive care unit from January 2018 to June 2018 were enrolled.According to the time when caffeine citrate treatment was started, they were divided into early treatment group(≤1 days) with 53 infants and late treatment group(1 to 10 days) with 60 infants.A retrospective analysis was performed for their clinical data.The perinatal conditions, treatment process and clinical outcomes of the two groups were compared and the neurological development was followed up at 12 months old. Results: Compared with the late treatment group, the early treatment group had a significantly shorter durations of mechanical ventilation time, oxygen therapy time, hospitalization days and a significantly lower incidence of bronchopulmonary dysplasia, patent ductus arteriosusand intraventricular hemorrhage or periventricular leukomalacia, and there were significant differences between two groups(P<0.05, respectively). The neonatal behavioral neurological assessment score in the early treatment group was higher than that in the late treatment group at 40 weeks of gestational age, and there was significant difference between two groups(P<0.05). The mental developmental index at 3 months of corrected age, the mental developmental index and psychomotor developmental index at 12 months were significantly better in the early treatment group than those in the late treatment group, and there were significant differences between two groups(P<0.05, respectively). Conclusion Early use of caffeine citrate can improve the outcome of premature infants and improve the prognosis of nervous system.

Objective:To investigate the mortality and causes of death in neonates from different medical institutions in Henan province.Methods:A retrospective analysis was performed on the death cases of 62 different medical institutions in 18 cities of Henan province in 2018, in order to compare the differences of neonatal mortality, age of death and the causes of death between maternal and child health care hospitals and general hospitals.Results:(1) A total of 80 780 newborns were admitted to 62 hospitals and 311 neonates died with a mortality rate of 3.85‰.A total of 33 339 newborns were admitted to 24 maternal and child health care hospitals, and 102 neonates died with a mortality rate of 3.06‰.Among them, 54 cases(52.9%) were premature infants and 48 cases(47.1%)were full-term infants.A total of 47 441 newborns were admitted to 38 general hospitals, and 209 neonates died with a mortality rate of 4.41‰.Among them, 111 cases(53.1%) were premature infants and 98 cases (46.9%) were full-term infants.Neonatal mortality in general hospitals was higher than that in maternal and child health care hospitals( P<0.05). (2) Neonatal death mainly occurred within one week after birth, especially within the first day.There were 67 cases of death(65.7%) in 24 maternal and child health care hospitals within the first day, including 34 cases (50.7%) of full-term infants and 33 cases (49.3%)of premature infants.And there were 87 cases of death(41.6%) in 38 general hospitals within the first day, including 50 cases (57.5%) of premature infants and 37 cases (42.5%) of full-term infants.Neonatal mortality within the first day after birth in maternal and child health care hospitals was higher than that in general hospitals( P<0.05). (3) The leading causes of neonatal death were non-infectious pulmonary diseases(128 cases, 41.2%), followed by birth asphyxia(73 cases, 23.5%) and infection(51 cases, 16.4%), but the causes of death in sequence varies from maternal and child health care hospitals and general hospitals.(4) For early death (within one week after birth) in both general hospitals and maternal and child health care hospitals, the main causes were birth asphyxia for full-term neonates, and pulmonary diseases(mainly respiratory distress syndrome)and birth asphyxia for premature infants.For late-stage death (2-4 weeks after birth) of neonates, infection was the leading cause in both term and preterm infants in general hospitals.For maternal and child health hospitals, the main causes of death for full-term infants were infection, and pulmonary diseases (mainly pulmonary hemorrhage and respiratory distress syndrome) for premature infants. Conclusion:There are some differences between maternal and child health care hospitals and general hospitals in neonatal mortality, mortality within the first day after birth, and causes of death.Therefore, it is necessary to strengthen the corresponding software and hardware constructions for newborns in different medical institutions to further reduce the neonatal mortality rate.

Objective: To explore the value of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA) enhanced MRI T₁ mapping in diagnosing and distinguishing dysplastic nodule (DN) and hepatocellular carcinoma (HCC) with different degrees of differentiation. Methods: A retrospective study in the first affiliated Hospital of Guangxi Medical University from September 2015 to December 2017 was conducted. Seventy-one patients with HCC or DN (a total of 79 lesions) that confirmed by biopsy or surgical pathology findings. Seventy-nine lesions were divided into DN (n=10), well differentiated HCC (n=15), moderately differentiated HCC (n=36) and poorly differentiated HCC (n=18) according to histopathology. All the patients underwent plain MRI scan and Gd-EOB-DTPA-MRI T₁ mapping before surgery or needle biopsy. The T₁ values of each lesion and non-tumorous liver parenchyma were measured on 20 min hepatobiliary phase (HBP) T₁ mapping after Gd-EOB-DTPA administration, respectively. The increment rate of T₁ value in lesions relative to non-tumorous liver parenchyma were calculated. One-way ANOVA was used to compare the differences of T₁ value and the increment rate of T₁ value of DN and 3 groups of HCC with different degrees of differentiation. Spearman correlation was used to evaluate the correlation between T₁ mapping parameters and the malignancy degree of DN and HCC. Area under the receiver operating characteristic (ROC) curves were used to evaluate the efficacy of T₁ mapping parameters in the differential diagnosis of DN and HCC with different degree of differentiation. Results: Significant differences were found in T₁ value and increase rate of T₁ value of DN and HCC with different degrees of differentiation (P< 0.05). The T₁ value and increase rate of T₁ value showed an increasing trend from DN to poorly differentiated HCC after enhancement. The T₁ value and increase rate of T₁ value were positively correlated with the malignancy of DN and HCC (r=0.418 and 0.634, P<0.01). There were significant differences in the increase rate of T₁ value between well-differentiated HCC and moderately-differentiated, well-differentiated HCC and poorly-differentiated HCC, respectively (P<0.05). The area under ROC curve of T₁ value and the increase rate of T₁ value for differentiating DN from well-differentiated, moderately differentiated and poorly differentiated HCC was 0.933, 0.928, 0.939 and 0.867, 0.961, 0.961, respectively. The area under ROC curve of the increase rate of T₁ value for differentiating well-differentiated HCC from moderately-differentiated, well-differentiated HCC from poorly-differentiated HCC was 0.770 and 0.844, respectively. Conclusions Gd-EOB-DTPA enhanced MRI combined with T₁ mapping can provide valuable diagnostic information for identifying DN and HCC with different degrees of differentiation.

Objective:To investigate the genetic and evolutionary characteristics of hemagglutinin (HA) and neuraminidase (NA) genes of influenza B/Victoria (BV) virus in Xi′an city from 2019 to 2023.Methods:Twenty-five BV strains isolated from the Xi′an influenza surveillance network laboratory between 2019 and 2023 were collected. The HA and NA genes were sequenced using MiniSeq high-throughput sequencing platform. An evolutionary tree was constructed using bioinformatics software to analyze homology and mutation sites, and to predict N-glycosylation sites online. The antigenicity of the strains was analyzed through hemagglutination inhibition tests.Results:The BV influenza in Xi′an exhibited a distinct seasonal transmission pattern from 2019 to 2023, with peak prevalence occurring during the winter and spring seasons. The evolutionary analysis of the HA genes shows that the strains from Xi′an in 2019 belong to the V1A.3 branch, and the strains from 2021 to 2023 belong to the V1A.3a.2 branch. Analysis of antigenic sites showed that there were variations in 6 sites of 3 antigenic determinants in the HA proteins of the BV strains from 2021-2022 compared to 2019, and 2 sites of 1 antigenic determinant changed in the HA proteins in 2023 compared to 2021-2022. The evolutionary analysis of the NA genes indicates that the BV strains from Xi′an in 2019 belong to the A. 1.1 branch. By 2021 and 2022, it had evolved into the A. 1.2 clade, and by 2023, it had further evolved into the B clade and its derivatives, with no strains showing mutations associated with resistance to NA inhibitors. Antigenic analysis indicated that the majority of BV strains in Xi′an were similar to the strains included in the vaccine composition. Furthermore, glycosylation analysis showed that the potential N-glycosylation sites in the HA proteins of BV strains from 2021-2023 were reduced by one compared to those from 2019, and only a few strains from 2023 displayed alterations in the potential N-glycosylation sites of the NA proteins.Conclusions:The HA and NA genes of the BV strains from 2019 to 2023 are continuously mutating and evolving into new branches. Since 2021, V1A.3a.2 has become the dominant evolutionary branch of the HA genes, while the evolutionary branches of the NA genes from 2019 to 2023 have been continuously changing.

Objective:To estimate physical activity level in residents in Suzhou and explore the association between community environment and physical activity level in local residents.Methods:Through multistage stratified random sampling, residents aged 25-64 years in Suzhou were surveyed by face-to face interview in 2017. Physical activity levels were assessed by the international physical activity questionnaire-long version (IPAQ-L). Perceptions of community environment were assessed by Neighborhood Environment Walkability Scale-Abbreviated (NEWS-A).Results:Among the local residents surveyed in Suzhou,the median of weekly total physical activity level was 3 610.42 MET-min/w. The level of occupational physical activity was higher than that of transportation, household and leisure-time related physical activity levels. After controlling for socio-demographic factors, public service access was negatively associated with the overall physical activity level ( OR=0.522,95% CI:0.329-0.830), land-use mix-diversity was negatively associated with the level of occupational physical activity level ( OR=0.701,95% CI: 0.492-0.999), infrastructure of walk and cycle ways was positively associated with occupational physical activity level ( OR=1.603,95% CI:1.004-2.559); traffic hazards were negatively associated with the transportation physical activity level ( OR=0.642,95% CI: 0.416-0.990); residential building density was positively associated with leisure-time physical activity level ( OR=1.001,95% CI: 1.000-1.002), and the perceptions level of community environment were positively associated with the occupational, transportation, household and overall physical activity levels ( OR=1.889,95% CI: 1.176-3.033; OR=1.671,95% CI: 1.120-2.495; OR=1.775,95% CI: 1.143-2.756; OR=1.593,95% CI: 1.079-2.350). Conclusion:Improving infrastructure of walk and cycle ways and beautifying community environment play an important role in increasing the physical activity level of the residents.