To analyze the epidemiological factors of the open patient cases admitted to the clinic of Fujian CDC in 2007 for the purpose of prevention of rabies. The descriptive research methods in this study was used, including the gender, age, time admitted to out-patient department(OPD), level of exposure, treatment for the bitten wound, timeliness of inoculating rabies vaccine and therapy with human rabies immunoglobulins ,and the species of attacking animal . Data analysis showed that, in 2007, the OPD for dog injury of Fujian CDC had accepted 4128 cases bitten by dogs, among which children under 10 years old and adults of 21-41 years old constituted majority of cases who were bitten and injured by animals. The exposed cases which were sent to hospitals or OPD within 5 hours only 14.22%;while the percentage of cases received human rabies immunoglobulins was only 14.27%. However, the percentage of cases which were bitten and hurt by pet dogs was 64.27%. Those results indicate the need of strengthen people's knowledge and public education on rabies control and prevention, and the dog feeding management, includes cleaning of wound immediately after bitten by animals, especially the immediate use of rabies immunoglubulins and inoculation with rabies vaccine.

OBJECTIVE: There exists a close relationship between drying of a fresh herb and its preservation and extraction of efficient components. In order to investigate the influences of different drying methods on extraction and separation of ginsenosides, three drying processes, such as drying in the sun, drying in oven and microwave drying, were used to dry fresh ginsengs. METHODS: The ginsenosides of the dry ginsengs were extracted by poaching and microwave heating, and were separated by foam separation. The concentrations of ginsenosides were measured. RESULTS: Microwave drying saved both time and labor, and was favorable for release of ginsenosides. The ginsenosides could be extracted from the dry ginsengs in a shorter time by microwave heating than poaching. The ginsenosides Rb1, Rb2, Rd could be observably concentrated by foam separation. CONCLUSION: Microwave drying and microwave assisted extraction are efficient and economic methods with a high recovery yield of ginsenosides.

Objective To study the changes of IL 2 and IL 6 levels and lymphocyte DNA damage in peripheral blood of dog intoxicated by sulfur mustard. Methods Chongqing dogs were subcutaneously injected with sulfur mustard at the dose of 16 mg/kg. Lymphocytes and serum were isolated from dog peripheral blood at different time points as designed. The IL 2 and IL 6 levels in blood serum were measured by radioimmunoassay and lymphocyte DNA damage represented as comet tail length was determined by single cell gel electrophoresis (SCGE). Results Four hours after administration of sulfur mustard, the serum IL 2 and IL 6 levels dogs injected with sulfur mustard decreased and reached the lowest level at 72 h. A significant recovery was found at the time point of 120 h. SCG revealed sulfur mustard induced DNA fragmentation (comet) in dog peripheral lymphocytes. The rate of the damaged lymphocytes and the degree of DNA fragment migration began to increase at 4 h and progressively increased from 24 h to 72 h after sulfur mustard treatment. Conclusion Sulfur mustard intoxication induces early and long lasting decreases in serum IL 2 and IL 6 levels and lymphocyte DNA fragmentation in dog peripheral blood.

Objective To explore the clinical effect of posterior pedicle screw internal fixation in the treatment of multiple level noncontiguous thoracolumbar fractures.Methods Thirteen patients with multiple level noncontiguous thoracolumbar fractures were treated by posterior pedicle screw internal fixation.The Frankel score,percentage of vertebral compression and Cobb angle of the injured vertebral segment were analyzed to evaluate the surgery efficacy.Results All patients were followed up from 12 to 24 months ( averaged 15 months ).All cases achieved bone fusion with no implant failure.The Cobb angle of the injured vertebral segment was corrected from preoperative(22.2 ±5.3) degree to postoperative(5.3 ±3.5) degree and(6.2 ±3.6) degree at the last follow up.The percentage of vertebral compression was corrected from preoperative (45.7 ± 14.1 )％ to postoperative ( 6.1 ± 3.8 ) ％ and ( 7.2 ± 3.9 ) ％ at the last follow up.All improvements showed significant differences when compared statistically( t =15.03,t =12.05,Ps ＜0.05 ).The spinal cord function was improved 1 to 2 degree in all patients except 2 patients of grade A.Conclusion The posterior fixation with pedicle screw is a secure,safe and effective method in treating multiple level noncontiguous thoracolumbar fracture.

Objective:To investigate the risk factors of citrate accumulation in patients with liver failure treated with regional citrate anticoagulated continuous renal replacement therapy (RCA-CRRT).Methods:The clinical data of liver failure patients with RCA-CRRT admitted to department of intensive care unit (ICU) of Nantong Third People's Hospital from January 2017 to June 2020 were retrospectively analyzed. The selected patients were divided into citrate accumulation group and control group according to whether there was citrate accumulation (serum total calcium/free calcium ratio ≥ 2.4) during CRRT. The age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), mean arterial pressure (MAP), norepinephrine (NE) dose, blood lactic acid (Lac) concentration, liver function status, citrate dose, filter time and prognosis of the patients were compared between the two groups. Unconditional Logistic regression was used to analyze the risk factors for citrate accumulation.Results:Among 48 patients with RCA-CRRT and liver failure, 20 patients had citrate accumulation (accumulation group), and a total of 96 CRRTs were performed; the remaining 28 patients did not have citrate accumulation (control group), a total of 106 CRRTs were performed. There were no significant differences in age and APACHEⅡ score between the two groups. Compared with the control group, the MAP in the accumulation group was lower [mmHg (1 mmHg = 0.133 kPa): 66.9±13.6 vs. 86.4±8.3, P = 0.032], and the dosage of NE (μg/min: 16.3±8.4 vs. 5.9±2.8, P = 0.015) and lactic acid level (mmol/L: 4.89±1.45 vs. 2.98±0.87, P = 0.004) were higher, the damage of liver function was more serious [total bilirubin (TBil, μmol/L): 220.4±45.2 vs. 163.4±43.8, P = 0.012; Child-Pugh score: 12.0±2.5 vs. 8.8±1.4, P = 0.029; model for end-stage liver disease (MELD) score: 31.30±8.22 vs. 21.78±6.40, P = 0.041], hourly citric acid dosage (mmol/h: 27.4±6.9 vs. 19.3±4.9, P = 0.032) and total citric acid dosage (mmol: 3 393±809 vs. 1 819±502, P = 0.039) were higher. Although there were no significant differences in the length of ICU stay, total length of hospitalization stay and cost of hospitalization between the two groups, the 28-day mortality of the accumulation group was higher than that of the control group (60.0% vs. 28.6%, P = 0.039). Unconditional Logistic regression analysis showed that MAP [odds ratio ( OR) = 2.901, 95% confidence interval (95% CI) was 0.921-19.493, P = 0.019], NE dosage ( OR = 2.098, 95% CI was 1.923-12.342, P = 0.002), Lac level ( OR = 5.201, 95% CI was 3.211-9.433, P = 0.012), Child-Pugh score ( OR = 1.843, 95% CI was 0.437-7.420, P = 0.018), MELD score ( OR = 3.012, 95% CI was 0.384-12.843, P = 0.031), hourly citric acid dosage ( OR = 4.254, 95% CI was 1.734-11.839, P = 0.011) and total citric acid dosage ( OR = 4.109, 95% CI was 1.283-18.343, P = 0.001) were risk factors for citrate accumulation. Conclusion:In patients with tissue hypoperfusion and severe liver function damage, citrate anticoagulation should be avoided or the dosage of citric acid should be reduced, in order to avoid citrate accumulation.

Objective:To observe the effect of emotional stimulation on the formation process of atherosclerosis ( AS) ,and explain the role of hydrogen sulfide ( H2 S) in atherosclerotic lesions. Methods:Twenty-four Sprague-Dawley rats were randomly divided into AS group, qi-stagnation and blood-stasis AS group and the control group. The AS group was fed with special diets, the qi-stagnation and blood-stasis AS group was fed with special diets and emotional stimulation, and the control group was fed with normal diets. During the experiment, the indicators including the characterization score, H2 S content, four items of the natural bleeding and blood coagula-tion, tissue blood flow and blood lipid were respectively detected in the 4 th, 8 th and 12 th week. Results:Compared with those in the AS group, since the 4 th week, the rats in qi-stagnation and blood-stasis AS group were with significantly decreased activity, slow re-sponse, lackluster fur and dark purple tongue (P<0. 01);the level of plasma lipid increased significantly, and increased further with time extension(P<0. 05 or P<0. 01);since the 8 th week, APTT and FIB changed significantly (P<0. 05),the blood flow to skin, liver and kidney decreased significantly (P<0. 05);the content of H2S was significantly higher in the 12 th week (P<0. 01). Con-clusion:Emotional stimulation promotes the formation of AS model,and the gas molecule system of H2 S plays a regulatory role in the qi-stagnation and blood-stasis AS animal model.

BACKGROUNDTissue microarray provides a convenient shortcut for immunohistochemical staining. The aim of this study is to investigate the clinicopathologic and prognostic values of survivin and cyclooxygenase-2 (COX-2) expression level in patients with non-small cell lung cancer (NSCLC).

METHODSExpression of survivin and COX-2 was detected in 88 cases of NSCLC and 5 cases of normal lung samples by immunohistochemical staining on tissue microarray sections. All cases were followed up for more than 5 years.

RESULTSCytoplasmic and nuclear expression rate of survivin in NSCLC was 94.3% and 79.5%, respectively, and positive expression rate of COX-2 was 71.6%, however, neither survivin nor COX-2 expression was observed in normal lung tissues (P < 0.005). Nuclear expression of survivin was markedly higher in smokers than that in non-smokers (P=0.002). The positive expression of COX-2 was significantly related to gender, smoking, histologic subtype and lymph node metastasis (P < 0.05). Univariate analysis showed that patients with positive expression of COX-2 had worse overall survival (P=0.014), however, survivin expression was not related to survival. Multivariate analysis showed that neither survivin nor COX-2 was independent prognostic factor for survival.

CONCLUSIONSThe results indicate that survivin highly expresses in NSCLC, so the ubiquitous expression makes it a potential novel parameter for diagnosis of NSCLC. Aberrant expression of COX-2 is related to worse overall survival, which may be useful to predict prognosis for NSCLC.

Objective:To prepare lansoprazole enteric-coated pellets and compress them into orally disintegrating tablets , and e-valuate the acid resistance in the acid stage and the in vitro dissolution in the buffer stage .Methods:Lansoprazole enteric-coated pel-lets were prepared by fluid bed coating technology , and the effects of the ratio of methacrylic acid copolymer dispersion to ethyl acrylate–methyl methacrylate copolymer dispersion , the concentration of triethyl citrate and the main pressure on the acid resistance in the acid stage and the in vitro dissolution in the buffer stage were evaluated .The similarity of the self-prepared orally disintegrating tablets and the reference preparation was evaluated by using f 2 similarity factor method .Results:The average particle size of microcrystalline cellulose core was 150-180 μm, the ratio of methacrylic acid copolymer dispersion to ethyl acrylate –methyl methacrylate copolymer dispersion was adjusted to 8:2, the enteric-coated weight was 30％, 20％triethyl citrate was used and the main pressure was controlled within the range of 10-16 kN.Lansoprazole enteric-coated pellets had sufficiently flexibility and stability against the compression force . The enteric coating did not break , showing good acid resistance .The dissolution similarity factor of the self-prepared orally disintegra-ting tablets and the reference preparation was greater than 50.Conclusion: Lansoprazole enteric-coated pellets orally disintegrating tablets have good acid resistance and high similarity for the in vitro dissolution, which can be further amplified .

Objective:To investigate the effect of sarcopenia on physical performance and nutritional status in elderly patients with gastrointestinal tumors.Methods:a total of 120 eligible in-patients were enrolled from gastrointestinal surgery department of a Grade A tertiary hospital in Ningbo city from September 2021 to January 2022. General clinical data were collected, nutritional risk was screened using Nutritional Risk Screening 2002 (NRS 2002), physical performance was assessed by Short Physical Performance Battery (SPPB), skeletal muscle index at the third lumbar vertebra level (L3 SMI) was calculated using abdominal CT scan, and grip strength/muscle strength, gait speed by 6 Meter Timed Walk Test and calf circumference were measured. Subjects were divided into sarcopenia and non-sarcopenia group according to the diagnostic criteria of the Asian Working Group for Sarcopenia (AWGS). Impacting factors of sarcopenia and the correlation between muscle mass and physical performance in elderly patients with gastrointestinal tumors were analyzed.Results:The overall prevalence rate of sarcopenia in elderly patients with gastrointestinal tumors was 28.3% (34/120) and it was 28.9% (22/76) and 27.3% (12/44) in males and females respectively. There were statistically significant differences in age, tumor stage, nutritional risk, body mass index, calf circumference, L3 SMI, grip strength/muscle strength, gait speed and SPPB score between patients with and without sarcopenia (P<0.05). Muscle strength/grip strength, L3 SMI and gait speed were closely correlated with the occurrence of sarcopenia in elderly patients with gastrointestinal tumors (P<0.05). The L3 SMI was positively correlated with physical performance as assessed with SPPB in both groups.Conclusions:Sarcopenia is a common complication in elderly patients with gastrointestinal tumors with multiple influencing factors. Timely nutritional intervention and exercise intervention should be incorporated into the treatment of elderly gastrointestinal tumor patients with sarcopenia in order to improve nutrition status.

Objective:To preliminarily study the effect of Q self-traction endoscopic submucosal dissection (Q-ESD) on treatment of large early esophageal cancer (EEC).Methods:A retrospective analysis was performed on the data of 82 cases of large EEC (single lesion>1/2 cross-section diameter or longitudinal diameter length >5 cm) who underwent ESD on Fujian Provincial Hospital between January 2015 and December 2018. According to the treatment schedule, patients were divided into the conventional ESD group (n=44) and the Q-ESD group (n=38). The procedural area, time, and speed, en bloc resection rate, complete resection rate and complications of the two groups were analyzed.Results:All of the 82 lesions were resected completely under endoscope. There was no statistical difference in the procedural area [779.8 (329.9-2 552.5)mm 2 VS 875.7 (417.8-1 914.8)mm 2, U=155, P=0.636], procedural time [63 (41-177)min VS 59 (42-169)min, U=171, P=0.167] and complete resection rate [94.7% (36/38) VS 93.2% (41/44), χ2=0.086, P=0.769] between the Q-ESD group and the conventional ESD group. Compared with the conventional ESD group, the Q-ESD group had a faster dissection speed [14.9 (5.4-20.8) mm 2/min VS 9.0 (5.0-19.5) mm 2/min, U=142, P=0.035], lower muscularis propria injury rate [7.9% (3/38) VS 27.3% (12/44), χ2=5.123, P=0.023], and a lower stricture rate [5.3% (2/38) VS 20.5% (9/44), χ2=4.051, P=0.044]. No other adverse events occurred except for one case of perforation in the conventional ESD group. Conclusion:The new traction technique of Q-ESD is a safe and effective treatment for large EEC.