BACKGROUND: Clinical observation has been proved that acupuncture has effect on antiinflammation and immunoloregulation, which is the basis for preventing and curing immune disturbance and active chronic inflammation. OBJECTIVE: To observe the effect of electropumcture on antiinflammation, analgesia and subgroup of T cells of adjuvant-arthrosis rats at Jiaji acupoint.DESIGN: Completely randomized grouping and controlled study.SETTING: Basic Laboratory of Acupuncture and Moxibustion, Shandong University of Traditional Chinese Medicine. MATERIALS: A total of 30 Wistar rats were selected in this study. Five days after feeding, all rats were randomly divided into 3 groups: normal control group, model group and electropumcture group with 10 in each group. METHODS: ① The experiment was completed at Basic Laboratory of Acupuncture and Moxibustion of Shandong University of Traditional Chinese Medicine from January to May 2005. Freund's complete adjuvant (FCA) was used to establish adjuvant-arthrosis models in model group and electropumcture group. On the modeling day, the 3rd and the 5th Jiaji acupoints of bilateral lumbar vertebrae of rats in electropumcture group were acupunctured with 28-sized stainless-steel milli-needle of 0.5 inch.The needle was stimulated 0.3 cm from the 3rd and the 5th spinous process of lumbar vertebra which was counected to G6805-2A multiple functional electropumcture meter for sparse-tight waves (frequency of sparse wave: 4 Hz, frequency of tight wave: 60 Hz, intensity: t mA) 30 minutes each time,once a day for 7 days. Rats in normal group and model group were fixed with the same way for 7 days. (Rats were fixed with cloth-rope at fixing apparatus.) ② Pain threshold was measured before modelling, 1 and 7 days after modelling. Foot pad was exposured with strong light by hot-pain stimulation meter, and paw withdrawal latency was regarded as pain threshold. ③ Right hindfoot bulk of rats was assayed with foot bulk determinator (bulk draining method) before modelling, 1 and 7 days after modelling to calculate swelling rate (％) [(foot bulk after modelling-foot bulk before modelling)/ foot bulk before modelling × 100％ ]. ④ Expressional rates of serum CD4+ and CD8+ were assayed with FACSCalibur flow cytometer and the ratio between CD4+ and CD8+ was calculated 8 days after modelling. ⑤ Average value of multiple samples were compared with single-factor analysis of variance and t test.MAIN OUTCOME MEASURES: Effect of electropumcture at Jiaji acupoint on pain threshold, swelling rate and subgroup of serum T cells of adjuvant-arthrosis rats.RESULTS: A total of 30 rats were involved in the final analysis. ① One day after modeling, bulk of right hindfoot in model group and electropumcture group was bigger than that in normal control group and that before modeling (P ＜ 0.01), and swelling rate was higher than that in normal control group (P ＜ 0.01); 7 days after modeling, bulk and swelling of right hindfoot in model group were higher than those in normal control group (P ＜ 0.01), and bulk was bigger than that before modeling (P ＜ 0.01);bulk and swelling of right hindfoot in electropumcture group were lower than those in model group (P ＜ 0.05). ② Pain threshold of both rear feet of normal rats were not changed after modelling. One day after modelling,pain threshold at inflammatory side was decreased in model group and electropumcture group (P ＜ 0.01) and it was lower than that in normal control group (P ＜ 0.01); 7 days after modeling, pain threshold at inflammatory side was still lower than that before inflammation (P ＜ 0.05),and it in electropumcture group was higher than that in model group (P＜ 0.05). ③ Percentages of CD4+ T lymphocyte and CD8+ T lymphocyte in model group were lower than those in normal control group (P ＜ 0.01), and ratio of CD4+/CD8+ was also higher than that in normal control group (P＜ 0.05). Percentage of CD4+ in electropumcture group was higher than that in model group, but there was no significant difference. Percentage of CD8+ in electropumcture group was higher than that in model group (P ＜ 0.01),but ratio of CD4+/CD8+ was lower than that in model group (P ＜ 0.05).CONCLUSION: Electropumcture at Jiaji acupoint has obvious effect on anti-inflammation and analgesia, and can also regulate cellular immunity of adjuvant-arthrosis rats.

Objective To construct a geometric skull model by using three-dimensional reconstruction, computer tomography scanning and rapid prototyping technology and evaluate its significance in treatment of complex oral and maxillofacial deformities. Methods A cranial and a goldenhar syndrome patient with complex oral and maxillofacial deformities bone received continuous volumetric scanning of skull and the data acquisition was done by an electron computed tomography, by which reconstruction was performed and the obtained images saved as STL files. Then the data were input into rapid prototyping machine to make three-dimensional geometric model. Direct measurement, designation and surgery simulation could be done on this three-dimensional model. Then the mandibular mirror physical model was manufactured using rapid prototyping according to the normal side. Results A computer-aided model according to CT data could represent the three-dimensional anatomic structures and their relationships precisely. The replica exhibited dimensional errors ranging 0.02 mm to 0.53 mm. Which provided strong basis for accurate understanding of disease status and reasonable surgical plans and helped improve the curative effect of surgery. Conclusion Rapid prototyping can help surgeons in many ways for therapy of the complex oral and maxillofacial deformities.

Objectives Through analyzing the published scientific papers from 2001 to 2010 by the professionals of the 31 provincial Center for Disease Control and Prevention in China,offer reference for making plan about scientific research,disciplinary areas,personnel training.Methods Literature quantitative analysis and health statistics methods were used to analyze these papers.Results The professionals in 31 provincial CDC published a total of 22079 papers,Zhejiang 1669(7.56％),Guangxi 1579 (7.15 ％),Jiangsu 1410 (6.39 ％) are the top 3 provinces.The ratio of published papers in Zhonghua medical journal among all the papers are 1366(6.19％),the first three provinces Tianjinlll (13.67％).Beijing160 (13.57％).Shaanxi34 (10.59％).Average papers published by the eastern,central and western regions are 1131,452,444,eastern above western regions (P =0.0065.P =0.0028).Conclusion In recent ten years,the quantity and quality of papers published by the professionals of provincial CDC in China were improved.The unbalanced development exist among eastern,central and western regions,But the majority CDC's papers should be strengthened further.

Objective To evaluate the of feasibility of Roche e601 for detecting hepatitis B virus surface antigen(HBsAg).Meth-ods To evaluate the feasibility of Roche e601 for detecting hepatitis B virus surface antigen(HBsAg).Results The coefficient of variation(CV)of inter-run and between-run from low and high value specimens was lower than the requirements of manufacturers;the negative and positive coincidence rates in detecting 60 external quality assessment controls were 100%(40/40)and 100%(20 /20),respectively;the detection threshold values of the system was 0.01 IU/mL;the results detected by this detecting system in 40 samples,in which the concentration of HBsAg was 0.8

Objective To analyze the early outcomes of the Sun' s procedure,which is an approach integrating total arch replacement using a 4-branched graft with implantation of a special stented graft in the descending aorta,and observe the mortality,morbidity and mid-term clinical results of postoperative in patients with acute type A aortic dissection (AAAD).Methods Clinical data of 61 consecutive AAAD patients undergoing the Sun' s procedure were analyzed.There were 53 male and 8 female,aged (54 ± 12) years.61 patients had postoperative follow-up and the clinical effect of Sun' s procedure were retrospectively analyzed.Results Cardiopulmonary bypass time was (229 ± 46) min,aortic clamping time was (147 ± 37) min and unilateral selective cerebral perfusion time was (35 ± 9) min.Reoperation for excessive bleeding in 5 cases (8.2％),acute renal failure in 3(4.9％),tracheotomy patients for pulmonary infection in 3(4.9％),and spinal cord injury in 2 (3.3％),delayed thoracic incision healing in 1 (1.6％),and osteofascial compartment syndrome of the right lower limb in 1 (1.6％).The 30 day mortality is 8.2％,and the leading causes was low cardiac output syndrome in 2(3.3％),multi-organ failure in 1 (1.6％),pulmonary infection in 1 (1.6％) and ruptured of abdominal aortic dissection in 1 (1.6％).The average follow-up time is(5.1 ± 0.7) years.Postoperative 1 year survival rate was 91.8％,5 year survival rate was 83.6％.Conclusion The Sun' s procedure has generated a relatively lower mortality rate in 61 patients with AAAD.Postoperative survival rate is high,and the reoperation rate is low.

Objeetive: To evaluate the imported risk of COVID-19 cases from aboard to Zhejiang Province,so as to provide reference for control strategies. Methods: The epidemic data of COVID-19 in 9 foreign countries（US,UK,Italy,etc.）and Zhejiang Province were collected,as well as the number of entry persons. The imported risk values of COVID-19 cases to 90 counties（cities or districts）of Zhejiang Province and from the 9 countries during March 7th and 30th were calculated and normalized to the imported risk indexes. The imported risk indexes were classified into five levels from high to low according to percentiles. The imported risk of 90 counties（cities or districts）,the developing trend and the source were analyzed. Results : A total of 39 confirmed cases and 24 asymptomatic cases were imported to Zhejiang Province untill March 30th. There were 10,13,22,21 and 24 counties（cities or districts）with high,medium high,medium,medium low and low imported risk,respectively. Qingtian had the highest imported risk（0.43）,followed by Ruian（0.32）and Wencheng（0.29）. The imported risks in 80（88.89%）counties（cities or districts）showed increased trend. The highest imported risk came from Italy（0.51）,followed by US（0.14）and Spain（0.11）. The imported risk in Wenzhou and Lishui mainly came from Italy and Spain,while that in the other areas mainly came from US,Germany and UK. Conclusions The risk of imported COVID-19 cases from aboard to Zhejiang Province showed an upward trend since March. The areas at high and medium high risk lay in southeast Zhejiang and the downtown of Hangzhou. The source of imported risk were maimly from Italy,US and Spain,but varied in counties.

Objective : To learn the epidemiological characteristics of coronavirus disease 2019 (COVID-19) cases reported from January 21 to February 20,2020 in Zhejiang Province,so as to provide basis for formulating and implementing effective control measures. Methods : The COVID-19 cases reported by Zhejiang Province were extracted from the National Diseases Prevention and Control Information System. A descriptive analysis was adopted for the epidemiological characteristics of COVID-19 cases,including time,spatial and population distribution,severity of symptoms, and exposure history. Results : Totally 1 284 cases were reported,of which 1 176 were confirmed cases (91.59%) and 108 were asymptomatic cases (8.41%). The first confirmed case was reported on January 21. The curve of the disease onset peaked from January 22 to 29, with 87 cases as the biggest number a day. The curve of the disease reported peaked from January 28 to 30, with 130 cases as the biggest number a day. Then the number of the cases showed a declining trend. By February 4, totally 79 counties (cities, districts) had confirmed cases, covering 87.78% of Zhejiang Province, and it has not increase since then. A male to female ratio of 1.02∶1 was reported among 1 284 cases,1 021 were 30-69 years old (79.52%) and 339 (26.40%) were business service providers. There were 11 health workers reported to be infected,but not by occupational exposure. Among the confirmed cases, 1 010 (85.88%) were clinically mild cases. One case died. Before January 23, the cases were mainly imported from Hubei Province, local cases were predominant by the end of January. Conclusions The COVID-19 epidemic has spread widely in Zhejiang Province and people are generally susceptible. Most cases were clinically mild, and were aged 30-69 years. No health workers infected were due to occupational exposure. The incidence of COVID-19 in Zhejiang Province has turned into a lower level,suggesting that the early prevention and control measures have achieved initial results. With people returning from holiday, precise prevention and control should be put into effect.

Objective:To observe the morphological characteristics of lungs in patients with critical corona virus disease 2019 (COVID-19), and to analyze the clinical-pathological relationship.Methods:Two critical patients with COVID-19 who died in Beijing You′an Hospital, Capital Medical University on February 13 and 14, 2020, respectively, were examined by bilateral lungs biopsy. The obtained samples were dehydrated, paraffin embedded, sectioned, stained with hematoxylin-eosin as routine methods, and then observed under light microscope.Results:The pulmonary morphology changes of patients with COVID-19 showed diffuse alveolar damage. Case one was an elderly patient with underlying diseases and her lesions were mainly exudation and hyaline membrane formation, which showed an acute exudation stage of diffuse alveolar damage. Case two was a patient without underlying diseases and his pathological changes were diffuse inflammatory cell infiltration, extensive fibrosis of alveolar wall, filling of necrotizing inflammatory cellulosic exudate in alveolar airspace, extensive destruction of alveoli and pulmonary consolidation, which was characterized by organized stage of diffuse alveolar damage complicated with bacterial pneumonia. The injury of paracronchial submucosal gland was not observed in the two patients.Conclusions:Diffused alveolar damage is the main pathological feature of critical COVID-19. Diffused alveolar damage can induce or aggravate the underlying diseases of elderly patients in the early stage. Extensive destruction of alveoli, pulmonary consolidation and secondary infection are the main causes of respiratory failure in the late stage.

Objective:To explore the application effect of the goal-oriented and task checklist-driven method based on higher-order thinking in operating room nursing teaching.Methods:We assigned 240 nursing students who interned in the operating room of China-Japan Union Hospital of Jilin University from March 2019 to January 2023 were into control group and observation group according to the order of admission. The control group received traditional teaching, while the observation group received goal-oriented and task checklist-driven teaching based on higher-order thinking. At the end of the internship, the two groups were compared in terms of theory and skill assessment scores, comprehensive teaching feedback, and nursing quality assessment scores. SPSS 22.0 was used to perform the t-test and χ2 test. Results:In the observation group, the scores of basic theory assessment, surgical nursing assessment, basic nursing skill assessment, and operating room nursing skill assessment were (92.69±7.90) points, (93.42±7.62) points, (92.05±7.41) points, and (94.14±7.53) points, respectively, while in the control group, the scores were (85.63±7.71) points, (84.41±6.16) points, (83.86±7.53) points, and (85.05±8.13) points, respectively, showing significant differences between the two groups ( P<0.001). The observation group had significantly higher percentages of positive teaching feedback than the control group ( P<0.05). The total score and the scores of individual domains of nursing quality were significantly higher in the observation group than in the control group ( P<0.001). Conclusions:The application of the goal-oriented and task checklist-driven learning model based on higher-order thinking in operating room nursing teaching can effectively enhance the core professional competencies and higher-order clinical thinking ability of student nurse interns, thereby improving nursing quality.

Objective: To perform an epidemiological survey of the first case with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Pinghu City of Jiaxing City, Zhejiang Province on March 13, 2022, so as to provide insights into the management of coronavirus disease (COVID-19) epidemics. Methods: According to the requirements of the Protocol on Prevention and Control of COVID-19 (8th Edition), epidemiological investigations were performed among 39 cases with SARS-CoV-2 infections in Pinghu City from March 13 to 20, 2022. Cases' demographics, clinical symptoms, history of immunization and exposure were collected, and close contacts were identified. Pharyngeal swabs were sampled from infected cases for detection of SARS-CoV-2 nucleic acid and whole-genome sequencing, and the source of infection and transmission route were investigated. Results: The index case for this COVID-19 epidemic was an imported case from Shanghai Municipality, who infected 6 persons via aerosol transmission when playing in the badminton venue of Pinghu National Fitness Center on March 9; subsequently, one of these infected cases infected another 18 persons when playing in the badminton venue of Jiadian Village Resident's Fitness Center in Zhapu Township on March 12. Sixteen confirmed cases were reported, and all cases were mild; another 23 asymptomatic cases were diagnosed, with no death reported. This epidemic occurred from March 11 to 20, with 3 generations of spread and a median incubation period of 3 days. The SARS-CoV-2 infected cases had a median age of 33.5 (interquartile range, 12.0) years and included 36 cases with a history of COVID-19 vaccination. There were 16 cases with fever, cough, runny nose and sore throat, and 13 cases with imaging features of pneumonia. The effective reproductive number (Rt) of the COVID-19 epidemic was 7.73 at early stage, and was less than 1 since March 21. Whole-genome sequencing identified Omicron BA.2 variant among 33 cases, which had high homology with the index cases. Conclusion This epidemic was a cluster of COVID-19 caused by imported Omicron BA.2 variant infection from Shanghai Municipality, and the COVID-19 transmission was mainly caused by indoor aerosols.