Objective To observe the clinical efficacy of ganciclovir in treatment of children with viral encephalitis.Methods 80 children with viral encephalitis were randomly divided into observation group and control group.All patients received the comprehensive treatment including anti-spasm,dehydration,control of body temperature,decreased intracranial pressure and drugs of improving brain metabolism.40 children in the observation group received intravenous ganciclovir.40 patients in the control group received intravenous ribavirin.The clinical effect of the two groups was compared.Results The total effective rate of observation group was 92.5％,that of the control group was 70.0％,the difference was statistically significant (x2 =6.721,P ＜ 0.05).In the observation group,the main clinical symptoms including fever,headache,vomiting,convulsions and the disappearance time of unconsciousness were significantly shorter than the control group(t =5.270,9.730,5.749,5.903,5.421,all P ＜ 0.05).The incidence rate of adverse reactions in the observation group was 7.5％,which was lower than 17.5％ in the control group,but the difference was not statistically significant (all P ＞ 0.05).Conclusion Ganciclovir in the treatment of children with viral encephalitis can improve clinical symptoms in a short time,and adverse reactions are mild,which can be used as the ideal choice for treatment of children with viral encephalitis.

Objective:In the process of fat grafting, there is no good solution to achieve delicate filling while retaining the viability of fat particle. There was still no research on the composition and activity of delicate fat particle. In this study, two different methods for delicate fat process were established to explore the feasibility and clinical efficacy.Methods:From December 2015 to June 2016, 5 patients (22-31 years old, with average 26.2 years) with abdominal liposuction in Shanghai Ninth People's Hospital were inclueded. The fat particles were obtained by floating method and filtration method respectively, and compared with emulsified fat/nanofat and traditional fat grafts. The cell viability and composition of adipose tissue were compared in each group through cell viability test, flow analysis and tissue staining.Results:The fat particles obtained by floating and filtration methods, emulsified fat could pass through OT needle. Cell viability test revealed the presence of living cells in the fat obtained by both methods, but not in the emulsified fat. Flow analysis showed that the expression of CD90 in floating group was higher than that in control group ( P=0.048). Conclusions:The delicate fat particle can be obtained by floating or filtration method, which can preserves the tissue integrity and cell viability; meanwhile it can achieve fine needle injection and clinical application.

Objective: The study aimed to explore the recommended treatment for toxicosis of botulism toxin type A. Methods: From January 2016 to August 2017, 8 patients with toxicosis of botulism toxin type A were hospitalized in Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine. All patients were female, 21-33 years of age, with an average age of 26.4 years. All patients showed progressive myasthenia and abnormal electromyography. The clinical manifestations and treatment outcomes of 8 patients in antitoxin group or non-antitoxin group were retrospectively analyzed. Five patients treated in plastic and reconstructive surgery department were included in the antitoxin group. They received skin test before injection, followed by intramuscular injection of 10 000-20 000 U antitoxins once a day for 2-3 days. Three patients treated in neurology department were included in the non-antitoxin group. They received only intravenous drip of neurotrophic drugs. After treatment, the improvement of clinical symptoms such as myasthenia and blepharoptosis was observed, and the electromyogram was followed up. Results: The symptoms of myasthenia of the 5 patients in antitoxin treatment group were significantly improved, and the electromyogram signal returned to normal. However, for the 3 patients in non-antitoxin group, the symptoms of myasthenia did not significantly improve, and their electromyogram signal did not return to normal, even after 5 days′continuous treatment. Conclusions To regulate the cosmetic medical market is the key to prevent the accident of toxicosis of botulism toxin type A. It is necessary to make a definite diagnosis and medical intervene in time for the toxicosis. Antitoxin has a better curative effect, but further research is needed, to verify its safety and effectiveness.

Livestock husbandry is vital to economy of the Tarim Basin, Xinjiang Autonomous Region, China. However, there have been few surveys of the distribution of ixodid ticks (Acari: Ixodidae) and tick-borne pathogens affecting domestic animals at these locations. In this study, 3,916 adult ixodid ticks infesting domestic animals were collected from 23 sampling sites during 2012-2016. Ticks were identified to species based on morphology, and the identification was confirmed based on mitochondrial 16S and 12S rRNA sequences. Ten tick species belonging to 4 genera were identified, including Rhipicephalus turanicus, Hyalomma anatolicum, Rh. bursa, H. asiaticum asiaticum, and Rh. sanguineus. DNA sequences of Rickettsia spp. (spotted fever group) and Anaplasma spp. were detected in these ticks. Phylogenetic analyses revealed possible existence of undescribed Babesia spp. and Borrelia spp. This study illustrates potential threat to domestic animals and humans from tick-borne pathogens.

Medical ethics has a long history and rich connotations.It has developed from the simple "medical morality" of ancient times to the modem medical ethics.The basic principles of medical ethics include autonomy,non-maleficence,beneficence,justice,and so on.Researchers often conduct clinical researches in the balance between achievements and ethical norms.Clinical researchers of surgery should have a deep understanding of medical ethical principles and strictly abide by medical ethics.Ethics committee should strictly perform their duties and play the role of inspection and supervision.Modem medical knowledges should be popularized throughout the society to make clinical research correctly understood.Adhering principles of ethics first,people orientation and cooperation practice,with patients' benefit as evaluation criteria,balance of surgical "Dao" and "Shu" can be achieved.

BACKGROUND:Heterotopic ossification is a dynamic growth process.Diverse heterotopic ossification subtypes have diverse etiologies or induction factors,but they exhibit a similar clinical process in the intermediate and later phases of the disease.Acquired heterotopic ossification produced by trauma and other circumstances has a high incidence. OBJECTIVE:To summarize the molecular biological mechanisms linked to the occurrence and progression of acquired heterotopic ossification in recent years. METHODS:The keywords"molecular biology,heterotopic ossification,mechanisms"were searched in CNKI,Wanfang,PubMed,Embase,Web of Science,and Google Scholar databases for articles published from January 2016 to August 2022.Supplementary searches were conducted based on the obtained articles.After the collected literature was screened,131 articles were finally included and summarized. RESULTS AND CONCLUSION:(1)The occurrence and development of acquired heterotopic ossification is a dynamic process with certain concealment,making diagnosis and treatment of the disease difficult.(2)By reviewing relevant literature,it was found that acquired heterotopic ossification involves signaling pathways such as bone morphogenetic protein,transforming growth factor-β,Hedgehog,Wnt,and mTOR,as well as core factors such as Runx-2,vascular endothelial growth factor,hypoxia-inducing factor,fibroblast growth factor,and Sox9.The core mechanism may be the interaction between different signaling pathways,affecting the body's osteoblast precursor cells,osteoblast microenvironment,and related cytokines,thereby affecting the body's bone metabolism and leading to the occurrence of acquired heterotopic ossification.(3)In the future,it is possible to take the heterotopic ossification-related single-cell osteogenic homeostasis as the research direction,take the osteoblast precursor cells-osteogenic microenvironment-signaling pathways and cytokines as the research elements,explore the characteristics of each element under different temporal and spatial conditions,compare the similarities and differences of the osteogenic homeostasis of different types and individuals,observe the regulatory mechanism of the molecular signaling network of heterotopic ossification from a holistic perspective.It is beneficial to the exploration of new methods for the future clinical prevention and treatment of heterotopic ossification.(4)Meanwhile,the treatment methods represented by traditional Chinese medicine and targeted therapy have become research hotspots in recent years.How to link traditional Chinese medicine with the osteogenic homeostasis in the body and combine it with targeted therapy is also one of the future research directions.(5)At present,the research on acquired heterotopic ossification is still limited to basic experimental research and the clinical prevention and treatment methods still have defects such as uncertain efficacy and obvious side effects.The safety and effectiveness of relevant targeted prevention and treatment drugs in clinical application still need to be verified.Future research should focus on clinical prevention and treatment based on basic experimental research combined with the mechanism of occurrence and development.

Objective:To explore the current status of surgery for portal hypertension to grasp current status and future development of surgery in China.Methods:This study is jointly sponsored by China Hepatobiliary & Pancreatic Specialist Alliance & Portal Hypertension Alliance in China (CHESS).Comprehensive surveying is conducted for basic domestic situations of surgery for portal hypertension, including case load, surgical approaches, management of postoperative complications, primary effects, existing confusion and obstacles, liver transplantation(LT), laparoscopic procedures and transjugular intrahepatic portosystemic shunt(TIPS), etc.Results:A total of 8 512 cases of portal hypertension surgery are performed at 378 hospitals nationwide in 2021.Splenectomy plus devascularization predominated(53.0%)and laparoscopy accounted for 76.1%.Primary goal is preventing rebleeding(67.0%) and 72.8% of hospitals used preventive anticoagulants after conventional surgery.And 80.7% of teams believe that the formation of postoperative portal vein thrombosis is a surgical dilemma and 65.3% of hospitals practiced both laparoscopy and TIPS.The major reasons for patients with portal hypertension not receiving LT are due to a lack of qualifications for LT(69.3%)and economic factors(69.0%).Conclusions:Surgery is an integral part of management of portal hypertension in China.However, it is imperative to further standardize the grasp of surgical indications, the handling of surgical operation and the management of postoperative complications.Moreover, prospective, multi-center randomized controlled clinical studies should be performed.

ObjectiveTo investigate a cluster epidemic of coronavirus disease 2019 （COVID-19） infections in a school in Longchuan County， Yunnan Province， and further guide the prevention and control of COVID-19 in the border area. MethodsAccording to the Protocol on Prevention and Control of Novel Coronavirus Pneumonia （8th Edition）， an epidemiological investigation was performed on all COVID-19 cases to collect the information on demographics， onset， diagnosis and treatment， prognosis， and epidemiological history. Close contacts were also tracked to determine the transmission chains. ResultsIn this cluster epidemic， a total of 37 COVID-19 cases were identified， including 32 females and 5 males aged from 13 to 25 years， who were 35 students and 2 teachers. The student cases were found in four classes of two grades. Furthermore， gene sequencing showed that all cases had been infected with delta variants， belonging to the same transmission chain that was not related to the previous epidemics in Dehong Prefecture. In additionally， a total of 2 127 close contacts were found. After 21 days of centralized quarantine for medical observation， all close contacts tested negative for SARS-CoV-2. In the COVID-19 cases， only one case remained positive for SARS-CoV-2， while the other 36 cases were successfully treated and became negative. ConclusionThis school cluster is caused by the border villagers who contacted the water polluted with SARS-CoV-2. It warrants more strict management of students from border villages and their belongings to prevent similar epidemics in school settings.