Objective To establish a simple, efficient and low-cost method for the detection of Salmonella typhimurium carrying SSeC gene. Methods In this study, a nano-biosensor ( FAM-P/GO) was successfully established based on the noncovalent assembly of carboxy-fluorescein ( FAM)-labeled probe and graphene oxide ( GO) . The target gene at different concentrations and SSeC gene-harbored bacterium sam-ples were detected by the FAM-P/GO nano-biosensor to evaluate its sensitivity. The specificity of the estab-lished nano-biosensor was evaluated by using DNAs with mismatched base pairs and single-stranded DNAs ( ssDNAs) extracted from various species. Results The established strategy for SSeC gene detection showed a good linear range of 0. 05-1. 0 μmol/L (R2=0. 992 1) with a lower limit of 0. 05 μmol/L. Moreover, the lower detection limit for target bacterium samples was 103 CFU/ml and the fluorescence intensity increased linearly with the concentration from 103 CFU/ml to 108 CFU/ml. The signal-to-noise ( S/N) of the experi-mental group was much greater than that of the control group, which indicated that the establish method was highly specific. Conclusion The FAM-P/GO nano-biosensor was successfully established in this study, which provided a new and possible way for the rapid detection of Salmonella typhimurium harboring SSeC gene.

Objective To investigate the characteristics and risk factors of central lymph node metastasis in clinically node negative (cN0) papillary thyroid carcinoma (PTC) (T1 or T2 stage) coexisting with Hashimoto' s thyroiditis (HT).Methods A total of 398 patients undergoing thyroidectomy with central lymph node dissection were enrolled in the study.Patients were divided into the trial group (PTC with HT)and the control group (PTC without HT).The difference of the clinicopathological characteristics between the 2 groups and risk factors for central lymph node metastasis were analyzed.Results Among the total 398 patients,98 (24.6％)had coexistent HT.Central lymph node metastasis rate was similar in the 2 groups (40.8％ vs 41.3％).The number of dissected central lymph nodes was significantly more in the trial group than in the control group (4.9 vs 2.9,P＜0.01) while the number of metastatic lymph nodes had no statistical significance between the 2 groups (1.0 vs 1.0).Univariate analysis showed that tumor size＞1 cm was significantly associated with central lymph node metastasis in the trial group (P＜0.01).Male,＜45 years,tumor size＞1 cm,and tumor located in the middle/lower third of lobe were all significantly associated with central lymph node metastasis in the control group (P＜0.01).Multivariate analysis showed that tumor size＞1 cm was independent predictor for central lymph node metastasis in the trial group,while female,＜45 years,tumor size＞1 cm,and tumor located in the middle/lower third of lobe were all independent predictors for central lymph node metastasis in the control group.Conclusions The number of central lymph nodes was larger in cN0 PTC coexisting with HT patients than that in PTC patients,but there was no statistical difference in the number of metastatic lymph nodes between cN0 PTC with and without HT.Central lymph node dissection is recommended when tumor size 1 cm in cN0 PTC coexisting with HT patients.

Objective To investigate the clinical effects of therapeutic hypothermia on the mortality and neurological function recovery in patients with acute large hemispheric infarction (LHI).Methods Seventy-three acute LHI patients (within 24 hours of symptom onset) admitted to our hospital from February 2015 to July 2016 were randomized to the hypothermia group (37 patients)and the control group (36 patients).Patients in the hypothermia group were given standard medical treatment and the surface cooling with a target temperature between 32-35 ℃ lasting for 5-7 days.Patients in the control group were given standard medical treatment and maintained a target temperature of normothermia.All patients were observed the primary end points including mortality and the modified Rankin Scale (mRS) score at 3 months.Results At three months,nine patients of survivors in the hypothermia group had good outcome (mRS score 0-3),whereas only five patients of survivors in the control group,though there was no significant difference (9/17 vs 5/19,x2 =2.676,P＞ 0.05)between the two groups.Twenty patients (54.1％)died in the hypothermia group,while 17 patients(47.2％) in the control group(x2 =0.341,P ＞0.05).Conclusion Therapeutic hypothermia is safe and feasible to patients with acute LHI,but may neither reduce mortality nor improve the neurological outcome in survivors.

Objective:To investigate the characteristics of cognitive impairment caused by solitary cerebellar infarction.Methods:From January 2017 to January 2019, 76 inpatients with acute cerebellar infarction treated at our hospital were continuously enrolled as the infarction group and 88 outpatients without cerebral infarction at our hospital during the same period were collected as the control group.The patients in the two groups were evaluated by the Montreal Cognitive Assessment Scales(MoCA)and Mini-Mental State Examination(MMSE)Scale at 14 days, 1 month and 3 months after the onset of solitary cerebellar infarction, respectively.Results:The MoCA and MMSE scores were lower in the infarction group than in the control group at 14 days, 1 month and 3 months after the onset of solitary cerebellar infarction(MoCA: 23.9±6.13 vs.28.1±2.51, 22.6±6.07 vs. 28.2±2.28 and 22.5±6.19 vs. 28.2±2.15, t=5.88, 8.03 and 8.09, P<0.001; MMES: 25.7±4.54 vs.28.3±2.25, 24.9±4.63 vs.28.2±2.14 and 24.6±4.43 vs.28.3±2.16, t=4.74, 5.99 and 6.94, all P<0.001). Cognitive function scores showed that three major recognition domains of visual space and executive function, attention and memory had statistically significant difference between the two groups( P<0.05), and the differences in three recognition domain of naming, calculating force, directional force between the two groups were not statistically significant( P<0.05). Conclusions:There is a clear correlation between cerebellar infarction and cognitive impairment, which is mainly manifested in three aspects of visual space and executive function, attention and memory.The great attention should be paid to screening and intervention on the three aspects in clinical work, which is of great significance for improving the quality of life and prognosis of patients.

Objective:To explore the risk factors of early infection patients after heart transplantation(HT)and provide references for preventing and treating early infection.Methods:From April 2018 to May 2021, clinical data were retrospectively reviewed for 95 HT recipients treated at Zhengzhou Seventh People's Hospital.They were divided into two groups of infected(n=34)and uninfected(n=61). Gender, age, disease type, preoperative IABP implantation, postoperative intra-aortic balloon pump(IABP)implantation, postoperative extracorporeal membrane oxygenation(ECMO)implantation, preoperative mechanical ventilation, preoperative leukocyte, preoperative lymphocyte, preoperative serum C-reactive protein(CRP), operative approach, APACHEⅡscore, NYHA grade, hemoglobin, cardiopulmonary bypass time, donor heart cold ischemia time, postoperative thoracic drainage tube indwelling time, postoperative gastric tube indwelling time, postoperative urinary tube indwelling time, postoperative acute rejection, postoperative ventilator assisted treatment time and postoperative ICU time.The risk factors of early infection were analyzed by univariate and multivariate Logistic regression analysis.Results:There were 34 cases of early infection after HT and 8 cases died.In infection group, preoperative hemoglobin(female <110 g/L or male <120 g/L), ECMO post-operation, 24-48 h post-operation, APACHE post-operation(>6), postoperative intrathoracic drainage tube indwelling time(≥7 d), postoperative gastric tube indwelling time(≥4 d), postoperative urinary tube indwelling time(≥5 d), postoperative acute rejection(positive), postoperative ventilator assisted treatment time(≥2 d)and postoperative ICU time(≥10 d)were 18 cases(52.94%), 8(23.53%), 30(88.24%), 22(64.71%), 18(52.94%), 20(58.82%), 4(11.76%), 21(61.76%)and 19(55.88%); uninfected group: 16 cases(26.23%), 3(4.92%), 32(52.46%), 24(39.34%), 15(24.59%), 31(34.43%), 1(1.64%), 21(34.43%)and 4(6.56%). Significant inter-group differences existed( χ2=6.778, 5.68, 12.326, 5.623, 7.740, 5.297, 4.489, 6.615, 28.947, P<0.05). Multivariate Logistic regression analysis indicated that 24-48h post-operation, APACHEⅡ score >6(β=1.024, Wald χ2=7.653, OR=2.141, OR95% CI=1.323~4.215), ECMO post-operation(β=1.783, Wald χ2=6.186, OR=5.949, OR95% CI =1.459~24.25), postoperative intrathoracic drainage tube indwelling time ≥7 d(β=0.712, Wald χ2=5.745, OR=1.054, OR95% CI=1.183~6.753), postoperative gastric tube indwelling time(β=0.832, Wald χ2=6.756, OR=1.132, OR95% CI=1.416~8.406), postoperative ventilator assisted treatment time(β=0.745, Wald χ2=6.563, OR=1.212, OR95% CI=1.289~7.346)and postoperative ICU time=1.28(β=1.325, Wald χ2=9.752, OR=2.435, OR95% CI=1.426~6.354)were independent risk factor for early infection after HT( P<0.05). Conclusions:Early infection after HT remains higher.It is significantly correlated with 24-48 h post-operation APACHE II score, ECMO post-operation, postoperative intrathoracic drainage tube indwelling time, postoperative gastric tube indwelling time, postoperative ventilator assisted treatment time and postoperative ICU time.Targeted interventions should be adopted for lowering the incidence of early infection after HT.

Objective:To compare the safety and efficacy of dabigatran and warfarin in the treatment of cerebral venous thrombosis (CVT).Methods:The medical records of patients with CVT admitted to the Department of Neurology, Henan Provincial People's Hospital from January 2017 to December 2018 were analyzed respectively. According to the drug use, they were divided into dabigatran group and warfarin group. The main outcome measure was good functional outcome at 6 months after treatment, defined as the modified Rankin Scale score of 0-2. The secondary outcome measures included the rate of recanalization of the affected venous sinus and the incidence of bleeding.Results:A total of 152 patients with CVT were included, including 34 in the dabigatran group and 118 in the warfarin group. There were no significant differences in demographic and baseline data between the two groups. At 6 months after treatment, the rate of good functional outcomes (94.1% vs. 93.2%; χ2=0.043, P=0.836) and the affected venous sinus recanalization (94.1% vs. 93.2%; χ2=0.043, P=0.836) in the dabigatran group and the warfarin group were not statistically significant. The bleeding rate of the dabigatran group was significantly lower than that of the warfarin group (8.8% vs. 27.1%; χ2=4.985, P=0.026). There was no significant difference in the incidence of minor bleeding between the two groups (8.8% vs. 16.1%; χ2=0.618, P=0.432), but the incidence of severe bleeding in the dabigatran group tended to be lower than that in the warfarin group (0% vs. 11.0%; Fisher's exact test P=0.074). There were no deaths in the dabigatran group and 2 deaths in the warfarin group, of which 1 pregnant woman died of recurrence of CVT at 4 months after treatment, and 1 male patient died of acute myocardial infarction at 2 months after treatment. There was no significant difference in mortality between the two groups (0% vs. 1.7%; Fisher's exact test P=1.000). Conclusions:Dabigatran is as effective as warfarin in the treatment of CVT, and the risk of bleeding complications is lower.

Objective:This study is to understand the hot spots and trends in the recruitment of clinical trial subjects in China over the past 20 years, explore the existing problems and countermeasures, and provide scientific ideas for domestic clinical trial institutions to effectively solve the problem of subject recruitment.Methods:Bibliometric analysis was used to study the relevant literature from three major domestic databases from 2001 to 2021, analyzing key indicators such as annual publication volume, journal distribution, institutional distribution, regional distribution, and high-frequency keyword co-occurrence.Results:A total of 162 articles were selected. The results showed that the overall publication volume in this field showed an upward trend, and the research institutions were diversified, with a concentration of medical and pharmaceutical institutions and universities. The current research hotspots in this field focused on quality and efficiency improvement of subject recruitment, with themes of subject protection, ethical review, regulation development, standardized management, etc.Conclusions:The research in this field has made significant progress, but the overall research level is still relatively weak. Therefore, it is suggested that the country should play a role in macro-regulation, on the one hand, starting with top-level design, promoting the construction of a standardized management system for subject recruitment, continuously strengthening subject protection, and enhancing the effectiveness of scientific recruitment. On the other hand, releasing the potential of grassroots institutions and giving full play to the volume advantage by promoting the sinking of advantageous resources. Meanwhile, great importance should be attached to the development of Phase I clinical trials, giving full play to the strong internal energy of traditional medicine and promoting the development of Chinese traditional medicine. These multi-measures should provide a theoretical basis for exploring the transformation of ′clinical research hospitals′, and promote the high-quality development of new drug research and development in China.

Objective:To evaluate the safety and efficacy of bipolar plasmakinetic endoscopic enucleation of the prostate (BEEP) in the treatment of benign prostatic hyperplasia (BPH) in a day surgery mode.Methods:The clinical data of 162 BPH patients admitted to the First Affiliated Hospital of Anhui Medical University from January 2021 to June 2022 were analyzed retrospectively. The patients were divided into day group(80 cases) and conventional group(82 cases) according to hospitalization mode. In the day group, preoperative screening and anesthesia evaluation was completed during the pre-hospitalization period, and the patient was discharged within 24 hours. The two groups were treated with BEEP, the urethral mucosa was cut at a " Ω" 5 mm proximal to the external sphincter ring in front of the verumontanum. Following the standard of anatomical enucleation of the prostate, the gland tissue was cut out after enucleation. There were no significant differences in age [(63.6±8.9) years vs. (67.5±7.1) years], body mass index [(24.3 ±2.6) kg/m 2vs. (23.0±3.2) kg/m 2], prostate volume [(55.8±16.9) ml vs. (53.7±20.7) ml], preoperative prostate-specific antigen [3.8(1.2, 5.3)ng/ml vs. 3.5(2.1, 5.6)ng/ml], the international prostate symptom score (IPSS) [(25.9±5.2) vs. (26.3±5.9)], the quality of life score (QOL) [(5.0±0.7) vs.(5.0±0.6)], the maximum urine flow rate (Q max) [(8.2±4.5) ml/s vs. (7.9±4.1) ml/s] and residual urine volume (PVR) [49(0, 131) ml vs. 45(11, 106) ml] between the two groups ( P>0.05). The waiting time before admission was [(2.6±1.2) d vs. (5.3±1.5) d], and the difference between the two groups was statistically significant ( P<0.05). The perioperative efficacy indicators, total hospitalization expenses and short-term postoperative complications were compared between the two groups. Results:In this study, all patients successfully completed the operation. There were no statistical significances in the perioperative indicators between the day group and the conventional group including the operation time [(38.4±15.2) min vs. (40.4±13.9) min], enucleated tissue weight [(34.6±9.6) g vs. (35.4±10.8) g], the decrease value of hemoglobin [(13.0±2.5) g/L vs. (12.0±3.7) g/L] and the decrease value of blood sodium [(2.2±0.9) mmol/L vs. (2.4±1.3) mmol/L]( P>0.05). The significant differences were observed in bladder irrigation time [(16.9±2.1)h vs. (22.7±12.1)h], catheterization time [(18.8±5.1) h vs.(65.6±13.0)h], postoperative hospital stay [(16.8±2.4)h vs. (64.8±6.3)h] and the total hospitalization expenses [(13 282.2±2 236.3) yuan vs. (15 969.3±2 420.6) yuan] between the day group and the conventional group ( P < 0.01). In the day group, 1 case was transferred to the general ward for observation for 1 day. There were no significant differences in the incidence of complications as urinary retention [6.3% (5/80) vs. 3.7% (3/82)], temporary incontinence [2.5% (2/80) vs. 2.4%(2/82)], urethra stricture [7.5% (6/80) vs. 6.1% (5/82)], and hematuria for intervention [1.3% (1/80) vs. 1.2% (1/82)]between the day group and the conventional group ( P > 0.05). After 6 months of follow-up, there were no significant differences in IPSS[(6.7±2.8) vs. (6.1±2.5)], QOL[(1.8±0.9) vs. (2.0±0.8)], Q max [(26.4±5.5)ml/s vs. (25.8±4.6)ml/s] and PVR [7(2, 11)ml vs. 5(4, 8)ml] between the two groups at 6 months after operation ( P > 0.05), but there were significant improvements when compared with those items of preoperation ( P < 0.01). Conclusions:The treatment of BPH with BEEP in the day surgery mode is as safe and effective as that in the conventional surgery mode, with little bleeding, high resection efficiency, definite therapeutic effect and low incidence of complications. BEEP can shorten the length of hospital stay and reduce medical expenses in the day surgery mode, and can be carried out in hospitals with conditions.

Daochisan is a pediatric famous classical formula in traditional Chinese medicine（TCM） specializing in clearing the heart， disinhibiting water and enriching Yin， which has been inherited and developed by medical experts of successive generations. The formula can be traced back to Xiaoer Yaozheng Zhijue written by QIAN Yi from Song dynasty， and most of the later-developed Daochisan（Daochitang） is based on this formula with additions and subtractions. So as to promote the literature excavation of this formula， this paper conducts a thorough textual research and analysis of the composition， processing， preparation methods， clinical applications of Daochisan based on a systematic collation of relevant ancient and modern literature in the method of bibliometrics. A total of 127 pieces of data involving 86 antient TCM books were collected. Statistical analysis showed that the drug origin of Daochisan is basically clear， we suggest that Rehmanniae Radix is the root tuber of Rehmannia glutinosa of Scrophulariaceae， Akebiae Caulis is the dry stem of Akebia quinata of Lardizabalaceae， Glycyrrhizae Radix et Rhizoma is the dry root and stem of Glycyrrhiza uralensis of legume， bamboo leaf is the dry leaves of Phyllostachys nigra var. henonis of gramineous plants. Four herbs are recommended to use its raw products. The key information of the dosage and decocting method is supposed to be "4.13 g each of raw Rehmanniae Radix， raw Glycyrrhizae Radix et Rhizoma， Akebiae Caulis， adding 300 mL of water， and then adding 4.13 g of bamboo leaf， decocting together to 150 mL， taking warmly after meal". Daochisan has the effect of clearing the heart and enriching Yin， disinhibiting water and relieving stranguria， and is widely used in treating symptoms such as heart vexed hotness， hydrodipsia and reddish complexion. Modern studies have showed that Daochisan are frequently used in treating oral ulcer， herpetic stomatitis， urinary tract infection， herpes zoster and other diseases. The above research results can provide scientific reference for the future development and research of Daochisan.