Dengue (DEN) virus is a member of the family flaviviridae which consists of a group of enveloped viruses with a single-stranded positive-sense RNA genome. DEN virus infection is initiated by the binding of envelope protein E to cellular receptor,followed by replication in cytoplasm which associated with a range of induced membrane structures. Further characterization of the DEN replication complex (RC) showed the involvement of NS1, NS2A, NS3, NS4A, and NS5 proteins as the viral replicase. The DEN virion maturation is associated with the cleavage of precursor of protein C by NS2B/NS3 protease and the glucosylase-mediated N-linked oligosaccharide trimming of prM, E protein. This review summarizes recent advance in research on DEN virus life cycle, emphasizing cellular receptor, RNA replication and virion assembly.

Objective To provide a powerful and conclusive result for the association between the GGN polymorphic repeats in androgen receptor (AR)gene and prostate cancer (PCa)risk.Methods CNKI,VIP,Wanfang,PubMed/Medline,Embase and The Cochrance Library electronic database were used to retrieve the eligible publications addressing the association between the AR gene GGN polymorphic repeats and prostate cancer risk.16 GGN polymorphism repeats were used as cut off value,meta-analysis was ap-plied to the study on the association between the length of polymorphism repeats and prostate cancer risk.Results 9 cases of con-trol studies were included in this meta-analysis and a total of 2 438 cases and 1 968 controls were included.People with ≤16 GGN polymorphism repeats displayed a higher risk of prostate cancer(OR =1.15,95%CI :1.00 -1.31,P =0.04).Conclusion ≤16 GGN polymorphism repeats polymorphism associated with increased risk of prostate cancer.

The ongoing health reform is bringing reforms of public hospitals under spotlight in China, attracting growing attention onto its progress and roadblocks. Probing into the "three steps" of public hospital system reform in Wuxi, this article analyzed such a reform in the city. It described the measures and initial outcomes gained in such fields as the hospital trusteeship reform, the separation of hospital regulation from its administration, and the hospital board system. Citing the case of Wuxi No. 2 People's hospital as an example, the authors introduced the innovative efforts made in hospital internal mechanism, management innovation, medical service model, hospital connotation construction, and talents cultivation.

By means of comparative analysis and literature review,the paper identified differences of private non-profit hospitals at home and abroad in terms of their historical background,fund-raising,tax-free qualification,and governance structure.On such basis,an analysis was made on the development paths of such hospitals in China,for theoretical references and decision support for their development.

Objective:To evaluate the diagnostic and therapeutic value of bedside severe ultrasound in children with shock.Methods:Children who were diagnosed shock in the PICU of Shengjing Hospital of China Medical University from May 1, 2019 to April 31, 2020 were included in this study.Rapid ultrasound in shock (RUSH) exam was used to evaluate the morphology and function of heart, lung and abdomen of children with shock, so as to assist the diagnosis and treatment of shock.Results:Twenty-six children with shock were evaluated immediately according to the RUSH exam when they were admitted to hospital.Eight cases were diagnosed as septic shock, six cases as cardiogenic shock, six cases as hypovolemic shock and six cases as mixed shock.The left ventricular ejection fraction (LVEF) of children with cardiogenic shock was (26.5±8.24)%, and the width of inferior vena cava was greater than 10 mm.After the shock was corrected, LVEF increased to (32.17±26.11)%.However, the LVEF of children with septic shock was (73.25±1.28)% at admission and (50.12±31.41)% at shock correction.Nine cases (34.6%) found more B-lines in the lungs after fluid resuscitation for one hour in 26 children with shock.Among them, about 50% of the children with cardiogenic shock found more B-lines in their lungs one hour after fluid resuscitation, and 11 cases(57.9%) of the surviving children showed more B-lines after shock correction, but only six children could hear blisters after physical examination.Conclusion:According to RUSH exam, we can evaluate the volume status, cardiac function, volume responsiveness and focus on infection in children with shock, distinguish the type of shock earlier and more accurately, assist in guiding fluid resuscitation, and facilitate accurate and individualized fluid management and treatment of patients.

Objective:To see the influence of different antiplatelet therapies on stroke patients’ readmission by performing a deep data-mining into Beijing Healthcare Insuring Database,based on a large sample size.Methods:Aretrospective cohort study,was adopted to extract patients primarily diag-nosed as ischemic stroke from healthcare database.The first hospital records were considered as the pa-tient’s baseline in this study,who were divided into MAPT (aspirin)and DAPT (aspirin and clopi-dogrel)according to the patient’s baseline medications.A follow-up was conducted to see whether the patients would have rehospitalization record because of major result events after medication.The major re-sult events,included:(1 )recurrence of ischemic stroke;(2)hemorrhagic transformation of ischemic stroke;(3)myocardial infarction;(4)the digestive hemorrhage.The Kaplan-Meier figure was used to compare the survival situations between these two groups,the log-rank test was used to test the difference of the survival curve,and 1 ∶1 propensity score matching was calculated from the patients’baseline da-ta.Cox proportional hazards model was used to calculate the hazard ratio (HR).Results:A total of 27 695 patients From January 201 0 to September 201 3 were included,4 047 with DAPT,and 23 648 with MAPT.Because the baseline characteristics of the patients was disequilibrium,so we used 1 ∶1 pro-pensity score matching,after which,the number of the two groups was 4 046 each.Adjusted for the gen-eral demographic characteristics such as age,sex,nationality,complication and drug combination,no statistical significance was observed between the survival curves of the two groups (P =0.06).HR value of major result events between the groups was 0.91 (0.82 -1 .01 ,P =0.07),which was not statistically significant.The covariate gender HR =1 .36 (1 .20 -1 .55,P <0.05),accompanied by diabetes HR =1 .36 (1 .20 -1 .54,P <0.05 ),dyslipidemia HR =1 .1 3 (1 .00 -1 .27,P =1 .1 3),heart disease HR =1 .39 (1 .22 -1 .58,P <0.05)was statistically significant.Drug combination with other antiplate-let agents HR =1 .05 (0.95 -1 .1 7,P >1 .05)did not increase the risk of readmission.Conclusion:There was no difference in prevention of readmission between patients with DAPT and MAPT.Patients with complications should actively treat the complications at the same time as they prevent recurrence after first attack.

Objective To explore the perioperative efficiency and safety of different regimen of tranexamic acid (TXA) in total knee arthroplasty (TKA).Methods From February 2013 to May 2013,150 female patients with knee osteoarthritis underwent unilateral TKA were randomly divided into three groups,50 cases in each group.Patients received 10 mg/kg TXA by fast intravenous infusion before closing the wound in first group (single dose group),patients in second group received two doses of 10 mg/kg TXA before closing the wound and 3 hours postoperation (repeated dose group),patients in the third group didn't receive TXA (control group).The postoperative blood loss via drainage,the total blood loss,the hidden blood loss,the postoperative hemoglobin concentration at different times and the numher of patients need blood transfusion were recorded.All patients were observed for detecting deep vein thrombosis (DVT) by the color doppler ultrasonography within 5 days postoperation,and the symptomatic DVT and pulmonary embolism (PE) were observed within 90 days postoperation.Results The blood loss via drainage was significantly less in the single dose group (273.6±99.6 ml) and repeated dose group (168.5±80.8 ml) compared with the control group (447.2±101.9 ml),and it was significantly less in the repeated dose group than the single dose group; the total blood loss was significantly less in the single dose group (959.1±291.7 ml) and repeated dose group (818.7±206.9 ml) compared with the control group (1 100.8±288.3 ml),and it was significantly less in the repeated dose group than in the single dose group; there was no differ ences about the hidden blood loss among the three groups.The hemoglobin concentration was significantly higher in the single dose group and repeated dose group than in the control group in day 1,3 and 5 postoperation; and it was significantly higher in the repeated dose group compared with the single dose group.The ratio of transfusion was significantly less in the single and repeated dose groups than in the control group,but no differences exists between the single dose group and repeated dose group.There was no DVT in all of the three groups within 5 days postoperation,and there was no symptomatic DVT and PE in all of the three groups within 90 days.Conclusion 10 mg/kg of TXA infused intravenous before closing the wound is effective and safe in TKA,another dose 3 hours postoperation is much more effective and will not increase the danger of DVT and PE.

Objective:To compare the taxol content in different parts of Taxus madia and Taxus chinensis var. mairei to provide reference for the future researches. Methods:The active ingredients were extracted by a mixed solvent (50% acetone and 50% ethyl acetate) , the target compound taxol was separated by a neutral Al2 O3 solid phase column, and then the taxol content was analyzed and compared among the different parts of Taxus madia and Taxus chinensis var. mairei by HPLC. Results:Taxol in velamen of Taxus ma-dia had the highest content among all the samples, which was 0. 0439% and 88 times as high as that in the bark of Taxus chinensis var. mairei. Conclusion:Among all the samples of Taxus madia and Taxus chinensis var. mairei, velamen of Taxus madia has the highest taxol content.

Objective:To investigate the distribution of four polyphyllins in different parts of paris polyphylla by means of compa-ring the contents of relative constituents in paridis rhizome and fibril to provide reference for comprehensive exploitation and utilization of paris polyphylla. Methods:Paris polyphylla samples were collected from Wudang mountain area and Shennongjia forest area. The contents of main secondary metabolites including polyphillinⅠ,Ⅱ,Ⅵ andⅦin paridis rhizome and fibril were evaluated by HPLC. Results:The four polyphyllins contents had obvious differences in different parts of polyphylla. The total content of four polyphillins in fibril was significantly higher than that in rhizome. Diosgenin compositions had no significant difference in the two parts, and the con-tents of pennogenin compositions in fibril showed significantly higher than those in rhizome. Conclusion:As for the main chemical com-positions contained in polyphylla, there is chemistry equality between fibril and rhizome, thus both of them can be used for medicine. However, as for the contents of four steroidal saponins, the distribution of secondary metabolites has obvious difference between fibril and rhizome, and the result may be caused by steroidal saponins transferred to rhizome for storage after the synthesis in fibril.

Background Dominant eye is one of the functional asymmetric organ,and the dfference between dominant eye and undominant eye is a researching hotspot.But the study about accommodation in adult myopia is less.Objective This study was to determine the association between ocular dominances and accommodative factors in the subjects with adult myopia.Methods This study used prospective descriptive research method.Thirty-five subjects aged from 18 to 35 years with the myopia ranged from-2.00 D to-10.00 D and anisometropia less than 1.5 D,BCVA≥ 1.0 were recruited consecutively in this study.Ocular dominance was determined using the hole-inthe-card test and thumb test.Refractive error was measured with objective and subjective optometry,and amplitude of accommodation was measured by push-up test.Fusion cross cylinder(FCC) was used to measure the accommodative lag,and flipper test was applied to determine the accommodative facility.Oral informed consent was obtained from each subject before any relevant examination.Results No significant differences were found in the amplitude of accommodation (D),accommodative facility (cpm) and accommodative lag (D) between the dominant eye and undominant eye (accommodative amplitude:9.69 D±2.30 D vs.9.60 D±2.37 D,P =0.294 ;accommodative facility: 11.08 D±4.20 D vs.10.63 D± 4.60 D,P=0.260;accommodative lag:P=0.141).In the patients with the right eyes as dominance eyes,the accommodative amplitude of both eyes were (9.48±2.29) cpm and (9.33 ± 2.49) cpm,and accommodative facility were (10.50 ± 4.70) cpm and (9.99 ± 4.90) cpm.There were no significant differences between the right and left eyes in the accommodative amplitude,accommodative facility and accommodative lag (P =0.319,0.116,0.590).In the patients with the left eyes as dominant eyes,the accommodative amplitude of both eyes were (9.91±2.35)D and (9.88±2.26) D,and accommodative facility were (10.70±3.77)cpm and (11.25 ±4.27) cpm.No significant differences were seen between the right eyes and left eyes in the accommodative amplitude,accommodative facility and accommodative lag (P =0.749,0.295,0.238).Conclusions The amplitude of accommodation of the dominant eye is not significantly enhanced,and less accommodative lag and better accommodative facility also are found in the demonstrate eye in myopia adults with low anisometropia.