SHG was sulfated by chlorosulfonic acid-pyridine method, and six samples which we got were prepared in different reaction conditions. There is a characteristic absorption peak near 260 nm in UV spectra and there are two characteristic absorption peaks near 1240 cm(-1) and 810 cm(-1) in the FT-IR. Degree of sulfation (DS) was calculated by elemental analysis and turbidimetry. Under the same conditions the absorption peaks become strong with the DS increase. The anticoagulant activity of SHG and sulfated modification samples was evaluated by the classic coagulant assays of prothrombin time (PT), activated partial thrombin time (APTT) live enzymes, and plasma thrombin time (TT). Results show that sulfated SHG has a good anticoagulant activity in vitro, and DS increased activity within a certain range.

At present,there are the following problems in the country doctors' professionalism education,the lack of country doctors' understanding of physician professionalism,the impact of the market economy and the neg-lect of the current physician professionalism education.On the basis of this,this paper suggested to improve the so-cial status and treatment of country doctors,to strengthen the education and training of professionalism-related subjects,to embody the humanistic idea and criterion in the rich specialized course teaching,and to promote the implementation of country doctors' professionalism education and training.

Objective To produce human papillomavirus type 6(HPV-6)virus-like particles with Escherichia coli expression system and study its immunogenicity.Methods HPV-6 L1 gene was inserted into pmkaryotic expression vector pTO-T7 and then expressed in Escherichia coli ER2566.The HPV-6 L1 protein was purified by ammonium sulfate precipitation,ion-exchange chromatography,and hydrophobic interaction chromatography.Then the purified HPV-6 L1 self-assembled into virus-like particle after removing 1,4dithiothreitol(DTr).The morphology of the virus-like particles was investigated with dynamic light scatter and transmission electron microscopy,and the immunogenicity was determined with in vitro pseudownons neutralization as8ay.Results HPV-6 L1 was expressed in soluble form in Escherichia coli.Following the removal of DTT,purified HPV-6 L1 protein could assemble into virus-like particles as 25 am in the radius.And the animal immunization test showed HPV-6 virus-like particles can elite hish titer neutralizing antibodies.Conclusion The bacterially expressed HPV-6 L1 VLP is highly immunogenieity and easy to produce.And it can be good candidate of HPV-6 vaccine.

Objectives To identify ABO blood type from a child having discrepant results in forward and reverse ABO blood grouping by serological identification and genetic testing.Methods After routine serological detection with ABO blood group,the ABO gene and ABO blood group-A subgroup genotype were tested by PCR-SSP method.Results The Serological results showed that the specimen was positive type A (anti-A:1 +w),the reverse type is O type (Ac:2 +,Bc:4 +);PCRSSP A-subtype typing showed that the genotype of the child was Ax14/O2.Conclusion Difficult blood type identification sometimes need to combine serology and molecular biology methods to confirm.In this case,the phenotype of the child was Ax,and the genotype was Ax14/O2.

Objective To analyze the viability of extended distal pancreatectomy and the associated prognostic factors.Methods The data of 57 patients with pancreatic adenocarcinoma who underwent standard distal pancreatectomy (DP) or extended distal pancreatectomy (EDP) from January 2011 to December 2014 were reviewed retrospectively.Thirty-five patients were performed with DP and 22 with EDP.Operation safety and survival benefit between DP and EDP were compared by t-test or x2 test.Cox regression analysis was used to explore the prognostic indicators.Results Compared to DP group,operation time((255 ±91)min vs.(208 ±80)min)(t =2.066,P =0.044) and ratio of blood transfusion (50.0％ vs.17.1％) (x2 =12.836,P =0.008) were greater in EDP group,respectively.There were no significant differences in amount of intraoperative blood loss and postoperative duration of hospitalization.Delayed gastric emptying was greater in EDP(22.7％ vs.2.9％) (Z =-2.251,P =0.027),while other complications had no differences.Mortality and ratio of relaparotomy also showed no differences.Median survival following DP was 13.1 months compared to 8.2 months following EDP.There was no difference in survival between DP and EDP.According to the results of multivariate analysis,tumor size (RR =1.275,P =0.03) and perioperative blood transfusions(RR =2.673,P =0.04) were independent prognostic factors.Conclusions Though patients with pancreatic adenocarcinoma who undergo EDP have a worse pathologic staging,they will gain a comparable long-term survival to the patients undergo DP.Tumor size and perioperative blood transfusions are independent prognostic factors.

Crohn’s disease is a chronic intestinal inflammatory disorder of unknown etiology. Although the pharmacotherapies for Crohn’s disease are constantly updating, nutritional support and adjuvant therapies have recently gained more attention. Due to advancements in clinical nutrition, various clinical nutritional therapies are used to treat Crohn’s disease. Doctors treating inflammatory bowel disease can now offer several diets with more flexibility than ever. The Crohn’s disease exclusion diet is a widely used diet for patients with active Crohn’s disease. The Crohn’s disease exclusion diet requires both exclusion and inclusion. Periodic exclusion of harmful foods and inclusion of wholesome foods gradually improves a patient’s nutritional status. This article reviews the Crohn’s disease exclusion diet, including its structure, mechanisms, research findings, and clinical applications.

Objective To analyze the viability of extended distal pancreatectomy and the associated prognostic factors.Methods The data of 57 patients with pancreatic adenocarcinoma who underwent standard distal pancreatectomy (DP) or extended distal pancreatectomy (EDP) from January 2011 to December 2014 were reviewed retrospectively.Thirty-five patients were performed with DP and 22 with EDP.Operation safety and survival benefit between DP and EDP were compared by t-test or x2 test.Cox regression analysis was used to explore the prognostic indicators.Results Compared to DP group,operation time((255 ±91)min vs.(208 ±80)min)(t =2.066,P =0.044) and ratio of blood transfusion (50.0％ vs.17.1％) (x2 =12.836,P =0.008) were greater in EDP group,respectively.There were no significant differences in amount of intraoperative blood loss and postoperative duration of hospitalization.Delayed gastric emptying was greater in EDP(22.7％ vs.2.9％) (Z =-2.251,P =0.027),while other complications had no differences.Mortality and ratio of relaparotomy also showed no differences.Median survival following DP was 13.1 months compared to 8.2 months following EDP.There was no difference in survival between DP and EDP.According to the results of multivariate analysis,tumor size (RR =1.275,P =0.03) and perioperative blood transfusions(RR =2.673,P =0.04) were independent prognostic factors.Conclusions Though patients with pancreatic adenocarcinoma who undergo EDP have a worse pathologic staging,they will gain a comparable long-term survival to the patients undergo DP.Tumor size and perioperative blood transfusions are independent prognostic factors.

Objective:To investigate the clinical advantages of absorbable barbed wires in laparoscopy combined with choledochoscopy treatment of gallbladder polyps.Methods:The clinical data of 103 patients with gallbladder polyps who received laparoscopy combined with choledochoscopy treatment in The First People's Hospital of Lianyungang from February 2016 to March 2018 were retrospectively analyzed. Sixty-five patients in the observation group underwent gallbladder wall sutures with absorbable barbed wires, and thirty-eight patients in the control group underwent gallbladder wall sutures with common absorbable wires. The operative time, gallbladder wall suture time, intraoperative blood loss, average hospitalization time, and postoperative bile leakage were compared between the two groups.Results:There were no significant differences in intraoperative blood loss and average hospitalization time between the two groups ( P = 0.312, P = 0.114). In the observation group, gallbladder wall suture time and operative time were (5.58 ± 1.14) minutes and (60.71 ± 11.03) minutes, respectively, which were shorter than (6.32 ± 1.04) minutes and (68.24 ± 9.61) minutes in the control group ( t = 3.23, 3.50, P = 0.002, 0.001). No bile leakage occurred in the observation group and bile leakage occurred in four (10.5%) patients in the control group. There was a significant difference in bile leakage between the observation and control groups ( χ2 = 4.57, P = 0.032). Conclusion:Absorbable barbed wires for gallbladder wall sutures during operation in laparoscopy combined with choledochoscopy treatment of gallbladder polyps is safe and feasible. It can markedly shorten gallbladder wall suture time and operative time, decrease the incidence of bile leakage, and has a clinical advantage over common absorbable wires.

Objective:To evaluate the characteristics of vaginal flora between normal and abnormal pregnant women throughout pregnancy.Methods:Vaginal swab specimens were collected from pregnant women in the first (<14 gestation weeks, GW), second (14~28 GW) and third trimester (>28 GW) in Anqing, Anhui Province from February 2018 to February 2020. Pregnant women were divided into normal and abnormal groups according to all clinical diagnosis. The sequences of 16S rRNA gene (V3-V4) from vaginal swabs were analyzed using QIIME2 platform. The differences in the dominance of Lactobacillus, community state type (CST) transition, Alpha diversity and Beta diversity were analyzed. Diversity data after log transition were used in the analysis of linear mixed model. Results:A total of 34 pregnant women (10 normal and 24 abnormal) with 102 samples were included for analysis. The composition of vaginal flora between two groups: the relative abundance of Lactobacillus was the highest at the genus level and Lactobacillus crispatus and Lactobacillus iners was the top two species with high relative abundance. The dominance of Lactobacillus, Alpha diversity and transition of CST were also similar. Both groups had a gradually decreased trend of Alpha diversity with GW, and the Chao1, Observed species and Faith′s PD indexes′ were different in different GW ( P<0.05). All Beta diversity metrics in normal group had descending trend, with lower value of the index of first distance which implied a higher microbiota stability, while Bray-Curtis, Weighted UniFrac distance had ascending trend in abnormal group, indicating lower stability. Jaccard distance′s first distance was statistically differed among GW and Unweighted UniFrac distance′s differed between normal and abnormal groups. Conclusions:The first distance of Unweighte UniFrac distance in abnormal pregnant women is higher than that of normal pregnant women and the vaginal flora in abnormal group has lower stability.

Objective To explore the therapeutic mechanism of maggot for psoriasis-like lesions in mice from the perspective of immune stress and complement activation regulation.Methods Thirty-six male C57BL/6 mice were randomly divided into control group,model group,maggot(1.25%,2.5%,and 5%)groups,and Benvitimod(1%)group.Psoriasis-like lesions were induced by application of imiquimod cream,and the severity of skin lesions was assessed using the modified Psoriasis Area and Severity Index(MPASI)score.Auricular swelling of the mice was observed,and histopathological changes of the skin lesions were examined with HE staining.Scratching behavior of the mice was observed and the spleen index was calculated.Toluidine blue staining was used to detect mast cells in the skin lesions,and serum levels of IgG,IgM,the complements CH50,C1s,C3,C3a,C5 and C5a,and the inflammatory factors IL-23,IL-17A and TNF-α were determined with ELISA.Results In mice with imiquimod-induced psoriasis-like skin lesions,treatment with the maggot at the 3 doses significantly decreased MPASI score,alleviated auricular swelling and pathologies in the skin lesions,reduced scratching behaviors,spleen index,and the number of mast cells in the lesions.Treatment with high-dose maggot significantly lowered serum levels of IgG,C1s,C3a,C5a,IL-23,IL-17A and TNF-α and the levels of C1s,C3,C3a,C5 and C5a in the lesion tissue,and increased serum levels of CH50,C3,and C5.The therapeutic effect of maggot showed a dose-effect dependence.Conclusion Maggot can alleviate psoriasis-like skin lesions in mice by inhibiting immune stress and complement activation.