Objective To clarify the efficacy and safety of cyclosporine A CsA) as salvage therapy in patients with severe active ulcerative colitis (UC) and refractory to steroids.Methods A total of 24 severe active UC patients refractory to steroids and hospitalized from 2006 to 2012,were retrospectively enrolled.Data including demographic features,clinical manifestations,laboratory tests and medications were collected.Results CsA was effective in 15 (62.5％) patients,who did not receive colectomy during 12-week administration.This regimen was tolerable in most patients.Twelve (50.0％) patients reported 16 adverse events,but only one patient withdrew CsA due to intolerance.The rates of adverse events in initial intravenous CsA including 4 mg · kg-1 · d-1,3 mg · kg-1 · d-1 and 2 mg· kg-1 · d-1 were 2/2,9/17 and 1/5 respectively.Responders had higher white blood cell count compared with non-responders (P =0.045).Conclusions CsA could be an effective alternative regimen to colectomy in severe active UC patients who are refractory to steroids.

Objective To evaluate early dynamic contrast enhancement CT on multiple organ failure in acute pancreatitis.Methods 333 cases of acute pancreatitis identified by clinical and early dynamic contrast enhancement CT were collected.Patients were divided into organ failure group(OF group,124 cases) and non-organ failure group (notn-OF group,209 cases).All variables including duration of hospitalization,need for intensive care unit,infection,need for operation,mortality and MCTSI,EPIC score were analyzed by U test and x2 test firstly.The variables with significance (P＜0.05) were analyzed by Stepwise Logistic regression further.Results On U test and x2 test,there were significant differences(P＜0.001) between two groups in duration of hospitalization,need for intensive care unit,infection,need for operation,mortality,MCTSI score and EPIC score and APFC + ANC＞ 100 mL,and bilateral pleural effusion/ pulmonary atelectasis.The Stepwise Logistic regression analysis demonstrated that increased MCTSI and EPIC score,APFC+ANC＞ 100 mL and bilateral pleural effusion/pulmonary atelectasis were 4 independent risk factors of multiple organ failure in acute pancreatitis.Conclusion Multiple organ failure in acute pancreatitis can be judged with early dynamic contrast enhancement CT for improved treatment.

Objective To solve the problem of fast locating primary radiation in dental panoramic tomography apparatus by designing a linear model-based positioning die body. Methods By applying the mathematical principle of solving the linear equation,the two-dimensional plane coordinates were mapped to the detector plane of dental panoramic tomography apparatus, and the horizontal coordinate position was determined by determining the vertical coordinate value through X-ray imaging in the detector plane. Finally, the position of primary radiation in the detector plane was determined. Results The longitudinal characteristics of the image were determined by analyzing the images taken after the application of the model, and the final position of the primary radiation in the detector plane was accurate. By comparing the detection results of die body method and film method, the localization results by the die body method fell within 90% of the image center by the film method. There was no significant difference in the localization results between the two methods by Shapiro-Wilk normality test and paired-samples t test (P > 0.05). Conclusion For narrow-beam devices, the positioning die body designed based on the linear model method can locate the position of the primary radiation in the detector plane quickly and effectively and replace the film method.

Background Research on the relationship between ambient temperature and preterm birth has received increasing attention, but the conclusions of the previous literature are inconsistent. Objective To explore the impact of environmental temperature exposure in Ningbo on premature delivery of pregnant women. Methods The birth information, preterm birth data, and age of pregnant women from January 2016 to September 2020 were collected by the electronic medical record system of Ningbo Women’s and Children’s Hospital. Meteorological data for the same period were obtained through Ningbo Meteorological Bureau, including daily average temperature, daily average relative humidity, and daily average air pressure. Daily concentrations of SO₂, NO₂, and PM₁₀ were derived through the air quality real-time release system on the website of Ningbo Environmental Protection Bureau. A distributed lag nonlinear model was used to analyze the impact of environmental temperature on preterm birth by stratifying pregnant women’s age and birth delivery mode. Results The incidence rate of preterm birth in Ningbo from 2016 to 2020 was 5.91%. The exposure-response curve between environmental temperature and preterm birth presented a “U” shape. Taking 22.5 ℃ as a reference, the cumulative effect of 31 ℃ (the 95th percentile) and 32 ℃ (the 99th percentile) over a 21-day lag on preterm delivery was statistically significant, and the related RR (95%CI) values were 1.67 (1.05-2.65) and 1.85 (1.09-3.14) respectively. The results of stratified analysis showed that among pregnant women ≥30 years old, the 21-day cumulative effects of 31 ℃ and 32 ℃ on preterm delivery were statistically significant, and the related RR (95%CI) values were 2.09 (1.08-4.05) and 2.36 (1.11-5.03) respectively; among pregnant women with natural delivery, the 21-day cumulative effect of 32 ℃ on preterm delivery was statistically significant, and the RR (95%CI) was 1.95 (1.02-3.74). Conclusion Exposure of pregnant women to high temperature during pregnancy could increase the risk of preterm birth, and there is a delayed cumulative effect.

Objective: To evaluate the effect of six-character formula breathing exercises combined with long-term home oxygen therapy in the rehabilitation of patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 200 COPD patients in Shanghai First People′s Hospital were divided into control group and observation group by odd and even numbers with 100 cases each. The patients in control group received routine long-term home oxygen therapy and the patients in observation group received six-character formula breathing exercises as an adjunct to long-term home oxygen therapy. The patients completed the Modified Medical Research Council (mMRC) score at 1 month, 3 months and 9 months respectively. At 6 months and 12 months, the patients completed the mMRC score, the frequency of acute exacerbation of chronic obstructive pulmonary disease (AECOPD), the number of re-admissions, the partial pressure of carbon dioxide in arterial blood (PaCO₂) and St. George′s Respiratory Disease Questionnaire (SGRQ) scores. At 12 months, the patients were evaluated for the six-minute walking test. Results: The duration of oxygen in observation group was (6.3 ± 1.7) h/d, was shorter than control group (7.5 ± 2.1) h/d (t=2.040, P=0.043). The frequency of AECOPD in observation group at 12 months was (3.12 ± 0.49) times/case, was lower than control group (4.95±0.65) times/case (t= 22.482, P <0.01). The frequency of re-admission in observation group was (1.09 ± 0.41) times/case, was lower than control group (1.22 ± 0.39) times/case (t= 2.215, P=0.028). The mMRC scores in observation group at 3 months and 9 months was (2.733±0.750), (2.749 ± 0.938), was lower than control group (3.186 ± 0.734), (3.197 ± 0.848) (t=4.317, 3.543, P<0.01). The SGRQ scores in observation group at 6 months and 12 months was (54.678 ± 9.318), (56.656 ± 7.294), was lower than control group (61.603 ± 8.989), (63.006 ± 7.387) (t=5.349, 6.117, P<0.01). PaCO₂ in observation group at 12 months was (6.422 ± 0.864) kPa, was better than control group (6.856 ± 0.904) kPa (t=3.471, P=0.01). The walking distance of 6 minutes in observation group was (265.483 ± 19.277) meters, was longer than control group (232.966 ± 18.883) meters (t= 12.050, P < 0.01). Conclusions Six-character formula breathing exercises assisted with long-term home oxygen therapy can reduce the use of oxygen, reduce the frequency of AECOPD and readmission, improve the symptoms of COPD patients, and delay the pathological process of COPD.

Objective: To investigate the effect of high flow nasal catheter (HFNC) respiratory support flow and temperature on the comfort of patients with acute hypoxemic respiratory failure (AHRF), and the AHRF subgroup with severe hypoxemia (FiO₂ ≥ 45%), improve HNFC flow to improve patient comfort. Methods: A prospective, randomized, crossover study of 40 patients with AHRF who underwent HFNC respiratory support (PaO₂/FiO₂ ≤ 300 + pulmonary infiltration + exclusion of cardiogenic pulmonary edema) was performed to assess patient comfort changes in HFNC flow and temperature changes. Results: When the HFNC flow rate was 30 L/min and 60 L/min, the patient′s comfort at 31 °C was significantly improved (P < 0.01), and the change in flow was not related to patient comfort. In the subgroup of patients with FiO₂ ≥ 45%, lower temperature (31 °C) and higher HFNC flow (60 L/min) improved patient comfort (P < 0.01). Conclusion The temperature of HFNC respiratory support significantly affects the comfort of patients with AHFP. Patients with lower temperature are more comfortable, and comfort is not related to flow. For patients with severe hypoxemia (FiO₂ ≥ 45%), high flow rates provide better comfort.

Objective To provide valuable insights for improving China’s special drug approval system by conducting an in-depth analysis of the practices of the U.S. Food and Drug Administration （FDA） in granting Emergency Use Authorizations （EUAs） for drugs. Methods A retrospective analysis was conducted on the FDA’s EUA decision-making process for COVID-19 therapeutics between January 2020 and June 2023. Results During the COVID-19 pandemic, the FDA adopted a series of regulatory science approaches to facilitate rapid approval of COVID-19 therapeutic drugs. The FDA granted EUA for a total of 15 COVID-19 therapeutic drugs and 4 COVID-19 vaccines, including expanded indications for marketed drugs, EUA for investigational drugs, revocation of EUA, and marketing after EUA. The main mechods for the rapid approval of EUA drugs by the FDA included the use of existing clinical trial data, omission of animal efficacy testing, merging of phase 1 and phase 2 clinical trials, and the use of clinical outcomes as surrogate endpoints, among other regulatory science methods. Conclusion The practices of the FDA in Emergency Use Authorization (EUA) of drugs, particularly its incorporation of regulatory scientific methods into the EUA process and the establishment of proactive monitoring mechanisms for drugs granted EUA, are worthy of emulation by China. It is suggested that China consider the experience of the FDA in the EUA system for drugs to further optimize and improve its special approval system for drugs.

Laboratory testing plays an important role in the diagnosis and treatment of patients with Novel Coronavirus pneumonia. However, the lack of understanding of the virus in the early stage led to great difficulties in biosafety protection for clinical laboratories. Based on the latest researches and findings about the virus, this paper provides some personal opinions on the biosafety prevention in clinical laboratorians under epidemic condition for the reference of laboratory workers.

Objective To perform a visual bibliometric analysis of hot spots as well as areas of Brucella disease research by searching brucellosis related literature. Methods A thematic search was conducted in the web of science core set database using Brucella disease or brucellosis as keywords to retrieve literature between January 1985 and December 2021. CiteSpace was used to visualize the countries, institutions, authors, and keywords in the retrieved relevant literatures. Results A total of 4 495 eligible articles studies were included, with the United States being the most populous country and the University of Sao Paulo being the most influential. Jilin University and Shihezi University in Xinjiang, China were relatively influential in this field. For the key words analysis, the top 3 of high-frequency words were infection, diagnosis, abortion, and in the 12 clusters formed, the clusters formed by #1, #4 were larger and the research hotspot continued. Keywords in the last five years including human brucellosis, immunity, zoonotic disease, were highlighted. Conclusion Study analysis suggested that human brucellosis with zoonosis was a research hotspot, more scholars focused on the infectious route and other exposure risks of cattle as intermediate hosts, epidemiological studies on brucellosis or will be new trends.

OBJECTIVE：To provide reference f or the qualit y sta ndard establishment of Amaranthus retroflexus. METHODS ： Taking 7 batches of A. retroflexus medicinal materials as the research object ，the appearance properties of the medicinal materials were investigated ，and the microscopic characteristics of the medicinal powders were observed. TLC method was adopted to qualitatively identify rutin ，valine and leucine in A. retroflexus medicinal materials. According to the relevant methods of the 2015 edition of Chinese Pharmacopoeia （part Ⅳ），water content ，total ash content ，acid-insoluble ash content and water-soluble extract content were determined. HPLC method was used to determine the content of rutin in the medicinal material of A. retroflexus . The determination was performed on Agilent 5 TC-C18（2）column with mobile phase consisted of methanol- 0.3％ phosphoric acid solution（40∶60，V/V），at the flow rate of 1.0 mL/min. The detection wavelength was set at 358 nm，and the column temperature was 30 ℃. The sample size was 10 μL. RESULTS：The appearance and microstructure characteristics of the medicinal materials were consistent with the existing description. The identification results of TLC meth od showed that 7 batches of medicinal materials and each reference substance （rutin，valine，leucine）showed spots of the same color at the same position. The moisture content of 7 batches of A. retroflexus medicinal materials was 7.43％-8.72％，the total ash content was 11.82％-13.78％，the acid-insoluble ash content was 0.15％-0.55％，and the water-soluble extract content was 17.27％-24.74％. The linear range of rutin was 10-200 μg/mL（R 2＝1.000 0）. RSDs of precision test ，stability test （24 h）and repeatability test were all less than 2.0％ （n＝6）. The average recovery rates of rutin were 99.14％，97.98％ and 98.80％ in low ，medium and high concentration of samples，and RSDs were 0.97％，0.95％，0.96％（n＝3）. The contents of rutin in 7 batches of A. retrophylla were 0.314-1.102 mg/g. CONCLUSIONS：In this study ，character observation ，microscopic identification ，moisture content ，total ash content ，acid- insoluble ash content and water-soluble extract content of A. retroflexus are investigated ；TLC method was established for qualitative identification of leucine ，valine and rutin in A. retroflexus ，and the HPLC method was established for content determination of rutin. It provides reference for the quality standard establishment of A. retroflexus .