Objective To compare the effects of heat-sensitive moxibustion and ginger-partition moxibustion on refractory peripheral facial paralysis. Methods Fifty-five patients with refractory peripheral facial paralysis were randomized into heat-sensitive moxibustion group (N=28) and ginger-partition moxibustion group (N=27). For two cases dropped out during the treatment, a total of 25 cases were finally enrolled into the ginger-partition moxibustion group. Two groups received oral use of mecobalamin tablets and conventional acupuncture, and heat-sensitive moxibustion group was given heat-sensitive moxibustion and ginger-partition moxibustion group was given ginger-partition moxibustion additionally. The moxibustion was performed once a day and ten times constituted one course, the treatment covered 6 courses. The clinical effect of the two groups was evaluated by 40-score method, House-Brackmann facial neurological function evaluation standard, blink reflex ( BR) , electromyogram and electroneurography. Results ( 1) Symptoms integral was increased in both groups after treatment ( P<0.01) , and the scores of heat-sensitive moxibustion group were higher than those of ginger-partition moxibustion group ( P<0.01). ( 2) The markedly effective rate of heat-sensitive moxibustion group was 75.00% and that of ginger-partition moxibustion group was 44.00%, and there was statistically significant difference between them ( P<0.05). ( 3) The results of electrophysiological examination showed that the difference values of ipsilateral and contralateral BR R1, R2, R2’ in both groups after treatment were less than those before treatment ( P<0.01) , and the abnormal rate of electromyography for heat-sensitive moxibustion group was improved obviously after treatment ( P<0.01) . The amplitude of compound muscle action potentials ( CMAP) of orbicularis oculi/orbicularis oris at the affected side of both groups showed a decreasing trend, but the differences were insignificant between the two groups after treatment ( P>0.05). Conclusion The curative effect of heat-sensitive moxibustion for the treatment of refractory peripheral facial paralysis is better than that of ginger-partition moxibustion.

Objective To study the molecular characters of porA and porB genes which encode outer membrane proteins (OMP), and predominated clonal complex of Neisseria meningitidis isolates from Guangdong province. Methods Eighteen Neisseria meningitidis isolates from Guangdong province during year 1967 to 2007 were recovered and reconfirmed by API NH biochemical system, and serogrouped by antiserum. The characters of porA and porB gene were analyzed by DNA sequencing. The allele profiles and the sequence types (ST) were determined by multilocus sequence typing (MLST). Based on their allelic profiles, the evolution relationship was analyzed by PHYLIP software. The predominant clonal complex was determined through comparing with the information of reference strains from the PubMLST database. Results For porA gene, type 20 was more frequently in the variable region (VR) 1 and type 9 in VR2 before year 2004. However, for porB gene, type 4 was more frequently in VR Ⅰ, type7 in VR Ⅳ, type 11 in VR Ⅴ,and type 10 in VR Ⅵ, respectively. The multi-types character was presented in VR Ⅴ and VR Ⅵ after2004. VR Ⅶ and VR Ⅷ can not be found among all the isolates except for one W135 isolate in 2007. Among the seven housekeeping genes, the polymorphism of abcZ was the lowest one with 4 allele numbers, while pgm was the highest one with 13 allele numbers. The predominant clonal complex was ST-5 before 2004. The ST-4821 clone complex appeared in 2004 and caused cases every year since then. More important, highly invasive ST-11 clonal complex firstly appeared in Guangdong in 2007. Conclusion The molecular characteristic of OMP genes presents polymorphism for the Neisseria meningitidis isolates from patients in Guangdong province during 1967 to 2007. ST-5 is the predominant clonal complex before 2004 and the highly invasive clonal complex is circulating in recent 3 years. It suggests that the surveillance based on laboratory should be further enhanced.

Objective To evaluate the changes in the expression of aquaporin 1 (AQP1) and aquaporin4 (AQP4) in lung tissues during one-lung ventilation in patients undergoing pulmonary lobectomy.Methods Forty ASA physical status Ⅰ or Ⅱ patients,aged 30-64 yr,weighing 45-79kg,undergoing pulmonary lobectomy,were randomly divided into 2 groups(n=20 each):two-lung ventilation group (group T) and one-lung ventilation group (group O).Anesthesia was induced with iv injection of midazolam,fentanyl,vecuronium and propofol.In group T,the patients were intubated with a single-lumen endotracheal tube and two-lung ventilation was performed.In group O,double-lumen endobranchial tube was inserted,and two-lung ventilation was performed followed by onelung ventilation after chest opening.PET CO2 was maintained at 5.3-24.0 kPa and SpO2 was maintained ＞ 92％.Anesthesia was maintained with iv infusion of remifentanil,propofol and vecuronium.The normal lung tissues were obtained from the site near the pathologic changes for microscopic examination (with light microscope) and examination of the ultrastructure (with transmission electron microscope),and for determination of W/D lung weight ratio,the expression of AQP1 mRNA and AQP4 mRNA (by RT-PCR) and the expression of AQP1 protein and AQP4 protein (by Western blot).Results Compared with group T,W/D lung weight ratio was significantly increased,the expression of AQP1 mRNA and protein was down-regulated in group O (P ＜ 0.05),and no significant changes were found in the expression of AQP4 mRNA and protein in group O (P ＞ 0.05).Pathological changes were observed in group O.Conclusion Down-regulation of AQP1 expression may be involved in the acute lung injury induced by one-lung ventilation in patients undergoing pulmonary lobectomy,however,AQP4 has no such effect.

Objective:To detect the value of utilizing bpMRI in prostate biopsy in the detection of prostate cancer with PSA≤20ng/ml.Methods:The clinical data of 394 patients who underwent prostate biopsy in the First Affiliated Hospital of Nanjing Medical University from November 2017 to October 2019 were retrospectively analyzed. Of all the patients, 177 underwent modified systematic biopsy, named TRUS group, 217 patients accepted pre-biopsy bpMRI examination, undergoing modified systematic biopsy if Prostate Imaging Reporting and Data System (PI-RADS) score < 3 or MRI-TRUS cognitive fusion targeted prostate + systematic biopsy if PI-RADS score ≥ 3, named MRI group. The median age of TRUS group was 66 (61, 74) years old, prostate specific antigen (PSA) was 9.52 (7.26, 12.30) ng / ml, and prostate volume (PV) was 36.84 (28.95, 57.72)ml. The median age of MRI group was 66 (59, 72) years old, PSA was 8.84 (6.65, 12.16) ng/ml, and PV was 39.45 (29.25, 58.69)ml. There was no difference in above parameters between the two groups. The χ 2 test was used to compare the detection rate of prostate cancer and clinically significant prostate cancer (CsPCa) between the two groups. Results:There was no significant difference in the detection rates of prostate cancer between TRUS group and MRI group [51.41% (91/177) vs. 48.39% (105/ 217), P = 0.550], but the detection rates of CsPCa were significantly different [26.55% (47/177) vs. 36.41% (79/217), P = 0.037]. In patients with PSA ≤ 10 ng / ml, there was no significant difference in the detection rates of prostate cancer between the two groups [43.62% (41/94) vs. 43.08% (56/130), P = 0.936], but there was a significant difference in the detection rates of CsPCa [17.02% (16/94) vs. 28.46% (37/130), P = 0.047]. There was no significant difference in the detection rates of prostate cancer [60.24% (50/83) and 56.17% (48/87), P= 0.504] and the detection rates of CsPCa [37.35% (31/83) vs. 48.28% (42/87), P = 0.150] between the two groups. The total detection rates of the last two needles in TRUS group and MRI group were 23.16% (41/177) and 36.63% (86/217), respectively, with significant difference ( P=0.001); the detection rates of CsPCa in the last two needles were 11.86% (26/177) and 29.03% (63/ 217), respectively, with significant difference ( P < 0.001). In MRI group, the detection rates of prostate cancer in patients with PI-RADS score <3, 3, 4, 5 were 21.21% (7/33), 25.84% (23/89), 73.24% (52/71), 95.83% (23/24), respectively; the detection rates of CsPCa were 12.12% (4/33), 17.98% (16/89), 54.93% (39/71), 83.33% (23/24), respectively. Conclusions:In patients with PSA ≤ 20 ng / ml, prostate biopsy based on bpMRI may improve the detection of CsPCa, especially in patients with PSA ≤ 10 ng/ml.

Objective: To investigate the change in expression of anti-senescence marker protein calmodulin (RGN) in liver tissues of rats with immune hepatic fibrosis, and to observe the effect of compound glutathione inosine injection (CGII) on it. Methods: Rat liver fibrosis model was induced by intraperitoneal injection of porcine serum, and CGII intervention was administered at the appropriate time. Rat liver tissues were stained with HE and Masson. RGN and protein expression at mRNA in liver tissues was detected by fluorescence quantitative PCR and immunohistochemistry. One-way Anova was used for measurement data. LDS test was used for two-way comparison, and pathological semi-quantitative results were analyzed by rank-sum test. Results: The relative expression of RGN mRNA and protein in liver tissue of fibrotic rats was 82.23 ± 15.21 and 12.52 ± 3.23, respectively, which were significantly lower than that of normal rats 176.39 ± 11.35 and 59.23 ± 9.13 (P < 0.01). The degree of liver fibrosis in fibrotic rats after CGII intervention was significantly lower than fibrotic rats. The relative expression of RGN mRNA and protein in the intervention group was 168.78 ± 21.31 and 46.42 ± 4.71, respectively, which were significantly higher than fibrosis and spontaneous recovery group. The difference was statistically significant (P < 0.01). The relative expression of RGN mRNA and protein in the spontaneous recovery group was 86.23 ± 17.16 and 14.34 ± 5.16, which was higher than model group. The difference was not statistically significant (P > 0.05). Conclusion The expression of RGN in liver tissue of rats with hepatic fibrosis induced by porcine serum is decreased, while the expression of RGN increases with the decrease of fibrosis after CGII intervention, suggesting that the protein may play an important role in the development of liver fibrosis.

Objective: To investigate the effect and mechanism of XTP4 gene in apoptotic hepatoblastoma HepG2 cell line. Methods: HepG2 cells were transiently transfected with small interfering RNA of XTP4 genes, plasmid pcDNA3.1/myc-His(-) A-XTP4, and hepatitis B virus X protein transactivated x gene 4 (HBX protein trans-activate gene4, XTP4) and their respective negative controls. After 48h, the overexpression and interference expression condition of XTP4 in HepG2 cells were detected by Western blot. HepG2 cells apoptosis was detected by flow cytometry. The expression levels of apoptosis-related proteins P53, Bcl-2, Bax and Caspase-3 in HepG2 cells were detected by Western blot, and Bcl-2/Bax ratio was calculated. The chemiluminescence assay was used to detect activity of caspase-3 in HepG2 cells. The measured data were presented as ( ± s), and independent sample t-test was used for comparison between the two groups. Results: HepG2 cells had successfully achieved the overexpression and interference expression of XTP4 protein. Compared with the control group, the overexpression of XTP4 in HepG2 cells had significantly decreased the number of apoptotic cells (P < 0.05), and increased Bcl-2/Bax (P < 0.05) ratio, but decreased the expression of P53 protein (P < 0.05). The protein expression of Caspase-3 and activity of caspase-3 was decreased (P < 0.05). However, interference with XTP4 expression in HepG2 cells had significantly increased the number of apoptotic cells (P < 0.05) and decreased Bcl-2/Bax (P < 0.05) ratio, but increased the expression of P53 protein (P < 0.05). The protein expression of Caspase-3 and activity of caspase-3 was increased (P<0.05). Conclusion In HepG2 apoptosis XTP4 has inhibitory effect, and its effect on inhibiting HepG2 apoptosis may be achieved by regulating the Bcl-2/Bax ratio, and the P53 protein may be involved.

Objective To understand the status of infection and epidemic trend of Dengue fever and Chikungunya in Guangdong.Methods Retrospective survey and literature review were used to obtain data on the incidence,etiology of Dengue and Chikungunya.Serological survey was conducted to detect the specific-antibodies in healthy individuals for both Dengue virus (DENV) and Chikungunya virus (CHIKV).Results Three epidemics of Dengue fever were observed during 1990-2012,with the annual incidence rates as 9.75/100 000 in 1995,1.76/100 000 in 2002 and 1.25/100 000 in 2006,respectively.The predominant epidemic strains appeared to be DENV-2 and DENV-4 during 1990-1994.Since 1995,DENV-1 had become the predominant transmission strain which lasted for almost 13 years.Co-existence of multiple serotypes of DENV started in 2009.Of the 7 718 sera from healthy population during 2003-2012,180 specimens were detected positive for specific DENV-IgG antibody,ended with a sero-prevalence rate of 2.33％.All 2 132 sera in 2012 were detected negative for CHIKV-IgG antibody.Conclusion The overall exposure level to Dengue was considered to be low in Guangdong province.However,the predominant transmission mode caused by DENV-1 had been gradually changed into the co-existence of multiple serotypes with the endemic signs appeared in some part of the areas.Chikungunya was a newly emerging disease in Guangdong since local people were lack of basic immunity barrier.Surveillance and control programs thus seemed important.

Visual endotracheal intubation technique was applied in the endotracheal intubation teaching for standardized resident training as a routine teaching appliance.The residents were divided into two groups,the anesthetic speciality group and the non-anesthetic speciality group.According to the different teaching targets,teaching periods and basic abilities,the differentiated teaching Settings were built and the different teaching schemes,evaluation index and teachers were applied for the two groups respectively for fulfilling the advantages of visual laryngoscope.Until now,more than a hundred residents were educated with the endotracheal intubation,and the teaching efficiency and quality were significantly improved,which also reduced the incidence of the complications related to endotracheal intubation.

Objective:To explore the efficacy of single-plane bi-parameter magnetic resonance imaging (bpMRI) in the diagnosis of prostate cancer.Methods:The clinical data of 343 patients who underwent transperineal template prostate magnetic resonance-transrectal ultrasound (MRI-TRUS) cognitive fusion biopsy at the First Affiliated Hospital of Nanjing Medical University from January 2020 to July 2021 were retrospectively analyzed, with median age of [65.0(59.0, 72.0)] years, median body mass index (BMI) of [24.1(22.2, 25.6)]kg/m 2, median prostate volume (PV) of [41.7(29.1, 53.3)]ml, median PSA[6.9 (5.5, 8.4) ng/ml], median PSAD of[0.17(0.12, 0.22) ng/ml 2], and abnormal rate of digital rectal examination (DRE) [6.4%(22/343)]. All patients underwent initial biopsy and bi-parameter magnetic resonance imaging (bpMRI) examination before biopsy, and the images were interpreted using prostate image reporting and data system version 2.1 (PI-RADS v2.1). The detection rates of prostate cancer and clinically significant prostate cancer (csPCa) were compared between single-plane bpMRI and bpMRI. When PI-RADS≥3 score, MRI results were positive; when PI-RADS ≤2 score, MRI results were negative. Results:In the single-plane bpMRI group, 121 MRI results were negative and 222 were positive. Positive patients included 95 with PI-RADS 3 score, 94 with PI-RADS 4 score, and 33 with PI-RADS 5 score. In bpMRI group, 141 MRI results were negative and 202 were positive. Among the positive patients, 67 patients with PI-RADS 3 score, 102 patients with PI-RADS 4 score, and 33 patients with PI-RADS 5 score. The detection rates of single-plane bpMRI and bpMRI for prostate cancer were 22.3% (27/121) and 15.6% (22/141) in MRI negative cases[22.3% (27/121) and 15.6% (22/141), P=0.17], and PI-RADS scores with 3 points [35.8% (34/95) vs. 44.8% (30/67), P=0.25], 4 points [89.4% (84/94)vs. 90.2% (92/102), P=0.85] and 5 points [90.9% (30/33) vs. 93.9% (31/33), P=1.00] showed no significant difference in stratification. The detection rate of csPCa in the single-plane bpMRI group and bpMRI group was significantly different in the MRI negative cases [7.4% (9/121) and 2.1% (3/141), P=0.04]. PI-RADS scores with 3 points [22.1% (21/95) vs. 29.9% (20/67), P=0.27], 4 points [80.9% (76/94) vs. 79.4% (81/102), P=0.80] and 5 points [84.9% (28/33) vs. 90.9% (30/33), P=0.71] showed no significant difference in stratification. Conclusions:For those suspected of prostate cancer patients with PSA 4-10 ng/ml and PI-RADS score ≥3, single-plane bpMRI or bpMRI examination has the same efficacy in term of the detection rate of prostate cancer and csPCa.

Objective:To explore the optimal core numbers in targeted prostate biopsy (TB).Methods:The clinical data of 138 patients with prostate cancer diagnosed by six needle trans-perineal TB combined with system biopsy in the First Affiliated Hospital of Nanjing Medical University from October 2018 to March 2020 were retrospectively analyzed. Their age was (69.07 ± 7.97) years old, the PSA value was 9.15 (6.66, 12.95) ng/ml, the prostate volume was 35.01 (27.65, 43.27) cm 3and the PSA density was 0.25 (0.17, 0.36) ng/(ml ·cm 3). All patients accepted bi-parametric magnetic resonance imaging examination and had regions of interests (ROIs) with prostate imaging reporting and data system (PI-RADS) version 2.0 scores ≥ 3. The detective rate of prostate cancer (PCa), clinically significant PCa (CsPCa) and clinically insignificant PCa (CIPCa), along with the Gleason score upgrading rate after radical prostatectomy were compared between different numbers of prostate TB cores. Results:The detective rates for present PCa or CsPCa for the first 1-, 2-, 3-, 4-, 5- and 6-core TB were 74.64%(103/138), 85.51%(118/138), 94.20%(130/138), 98.55%(136/138) and 100.00%(138/138) compared with the total number of cores taken, respectively. The detective rates for CsPCa for the first 1-, 2-, 3-, 4-, 5- and 6-core TB were 67.52%(79/117), 77.78%(91/117), 88.89%(104/117), 93.16%(109/117) and 98.29%(115/117) compared with the total number of cores taken, respectively. Additionally, 20.72%(23/111) patients had Gleason score upgrade after RP. Compared with 6-core TB, the rates of postoperative upgrading for the first 1-, 2-, 3-, 4- and 5-core TB were 50.00%(44/88), 67.05%(59/88), 81.82%(72/88), 88.64%(78/88) and 95.45%(84/88), respectively. For the ROIs with PI-RADS score of 3, 4 and 5, the CsPCa detected by 5, 4 and 3 needles of TB were 95.00% (19/20), 94.92% (56/59) and 94.74% (36/38) respectively. Postoperative upgrading rates were 11.11% (2/18), 9.30% (4/43) and 7.41% (2/27) respectively.Conclusions:For ROIs with PI-RADS score of 3, 4 and 5, TB with 5, 4 and 3 cores respectively is enough to obtain higher diagnostic efficiency and accuracy.