Objective To establish a method for determining oxalate and citrate in urine simultaneously by capillary electrophoresis.The components,the concentration and pH of the buffer solution,the separation voltage and the injection time on theseparation were studied in detail.Methods The separations were carried out using potassium dihydrogen phosphatebuffer ina fused-silica capillary tubeby capillary zone electrophoresis (CZE) and the detection were monitored by UV.24 h-urine samples from patients (n =5) and health control (n =5) were collected from Zhongshan Hospital of Fudan University for systematically validating the method developed.Results The optimized separations were carried out using a 50 mmol/L potassium dihydrogen phosphatebuffer solution (pH 6.5) in a fused-silica capillary tube of 50 cm × 50 μm I.D.Injections were made by using the pressure mode for 10 s at 34 mbar.The detections were monitored by a UV at 200 nm after samples were separated at avohage of 30 kV.Under the seconditions,urinary oxalate and citrate were separated completely within 5 min.The relative standard deviations of migration time and peak area within-run foroxalate and citrate were less than 1％ and 3.0％ and the betweenrun relative standard deviations were less than 2.0％ and 4.0％,respectively.The detection limits were 1 mg/L for both oxalate and citrate.The linearity ranges of oxalate and citrate were both 0-500 mg/L with the correlation coefficient between 0.999 5 and 0.995 4 (P ＜ 0.05),respectively.The average recoveries were 102.38％ for oxalate and 92.74％ for citrate.Conclusion This method is proved to be simple,sensitive and accurate,and also applied to determine oxalate and citrate in urine samples with satisfactory results.

Objective To explore the influence of the scores and weights of the regular grade on the evaluation of students' learning effect.Method To compare the impact of the regular grade before and after adjustment on the total mark,analyze the problems exposed during scoring and search for the solutions according to Medical Microbiology results of four grades including Grade 2010 to 2013.SPSS 13.0 software was used for statistical analysis and Pearson method was used for correlation analysis and theory achievement scores.Results The regular grade of four grades scored highly,with the average (95.00 ± 3.80),(96.00 ± 4.55),(95.00 ± 2.84) and (95.00 ±-2.82) respectively.What was more,it had randomness.The correlation coefficient between regular grade and total mark were 0.069,0.149,0.984 and 0.285 respectively.The regular grade of Grade 2010 was the same as Grade 2013 and the theoretical score of Grade 2013 was 4 points lower than Grade 2010(71 vs.75),however the total mark of Grade 2013 was 1 point higher than Grade 2010 (80 vs.79),which showed the more the regular grade weights,the greater it impacted on the total mark.Conclusion The appropriate score and weight of the regular grade is important to evaluate the students' learning effect objectively.

Literatures on acupuncture-moxibustion treatment of chemotherapy-induced peripheral neuropathy (CIPN) in the recent decade were searched in the databases of Pubmed, MEDLINE, Biological Abstracts, EMBASE, Sinomed, CNKI, Wanfang, VIP, et al. The general situation was comprehensively analyzed and reviewed from experimental design, treatment method, efficacy evaluation, mechanism research and so on. The results showed that acupuncture has a certain therapeutic effect, but the research is still in the preliminary stage, the relative literatures are insufficient and in a low quality. There is still a controversy on the efficacy of acupuncture in the treatment of CIPN. High quality, large sample and multicenter randomized controlled trials and systematic reviews are needed to verify the efficacy of acupuncture. The mechanism of acupuncture treatment of CIPN is still unclear and needs further research and exploration.

Objective: To observe hypoglycemic effects of Yunu Decoction, Zuogui Pill and Shenqi Pill, three compound traditional Chinese herbal medicines, in treatment of diabetes mellitus induced by alloxan in rats, and to compare the therapeutic effects among the three recipes for nourishing yin, clearing away heat, and nourishing yin and warming yang. Methods: Diabetes mellitus was induced in rats with alloxan at a dose of 60 mg/kg via tail vain injection. The diabetic rats were randomly divided into four groups: alloxan model group, Yunu Decoction-treated group, Zuogui Pill-treated group and Shenqi Pill-treated group. Rats in the three recipe groups were administered intragastrically with water extraction of Yunu Decoction, Zuogui Pill, and Shenqi Pill accordingly for 10 days. Then the level of blood glucose was measured by glucose oxidase method and the glucose tolerance was determined. Results: Compared with the normal rats, blood glucose level in the alloxan model group was obviously increased (P<0.05). Glucose levels in the three recipe groups were obviously decreased as compared with the alloxan model group (P<0.05), and glucose level in the Yunu Decoction-treated group after treatment was significant lower than before treatment (P<0.05). The glucose tolerance test indicated that rats in the alloxan model and three recipe groups revealed impaired glucose tolerance as compared with the normal rats, and there were no significant differences between the alloxan model group and the three recipe groups. Conclusion: Yunu Decoction, Zuogui Pill and Shenqi Pill can effectively decrease the glucose level of the rats with diabetes mellitus induced by alloxan, and Yunu Decoction showed the best therapeutic effects. The glucose tolerance test shows that the three recipes cannot correct the abnormal metabolism of glucose.

The current clinical efficacy evaluation system and evaluation methods of acupuncture have several limitations, and the application status is not optimistic. According to long-term observation, minimum clinically important difference (MCID) is consistent with the characteristics of clinical acupuncture, and has objective quanti- tative standard and wide applicability. Incorporating MCID into acupuncture clinical efficacy evaluation of tradition- al Chinese medicine can truly reflect the clinical effect of acupuncture and improve the disadvantages and shortcom- ings of acupuncture clinical evaluation, which could provide certain reference for building clinical efficacy evaluation system featured with TCM.
Acupuncture Therapy ; standards ; Clinical Trials as Topic ; standards ; Humans ; Moxibustion ; standards

Background and purpose: Uridine diphosphoglucu-ronosyl transferase 1A1 (UGT1A1) is an important enzyme for metabolism of irinotecan. The activity of UGT1A1 enzyme was significantly affected by the gene polymorphism. This study aimed to investigate the correlation of UGT1A1*28 and *6 gene polymorphisms with irinotecan-based chemotherapy in colorectal cancer(CRC). Methods: Analysis of UGT1A1*28 and *6 gene polymorphisms was performed in 160 gastrointestinal cancer patients admitted to Zhongshan Hospital Fudan University from Apr. 2013 to Dec. 2013 by amplifying the gene fragments using PCR, STR and Sanger sequencing. Eighty-two cases with CRC treated with irinotecan were chosen to observe the adverse events during chemotherapy. The incidence of different genotypes was compared. Results:The distribution of the genotypes in 160 gastrointestinal cancer patients was as followed:UGT1A1*28 wild-type genotype TA6/6 (124, 77.5%), heterozygous genotype TA6/7 (33, 20.5%), and homozygous genotype TA7/7 (3, 2.0%);UGT1A1*6 wild-type genotype GG (105, 65.6%), heterozygous genotype GA (48, 30.0%), and homozygous genotype AA (7, 4.4%). In the 82 CRC cases, the incidences of grade 3 and 4 neutropenia in the patients carrying UGT1A1*28 (TA6/7+TA7/7 ) were higher than those in the WT genotype (TA6/6) (58.3%vs 0.0, P<0.001), and increased the total incidence of adverse events (76.0%vs 45.6%, P<0.001). There was no signiifcant relevance between UGT1A1*6 genotype, age, gender chemotherapy and adverse events. Conclusion:In the CRC cases with irinotecan-based chemotherapy, the UGT1A1*28 (TA6/7+TA7/7) genotype signiifcantly increased the risk of grade 3 and 4 neutropenia. Detecting UGT1A1 gene polymorphisms may guide individualized treatment and predict adverse events.

Objective:To investigate the application value of pelvic floor ultrasound in screening early postpartum stress urinary incontinence (SUI).Methods:A total of 220 postpartum women, who were admitted by the Department of Gynecology and Obstetrics of The People's Hospital of Hechi from January 2018 to June 2019, were selected for this study. These women were divided into SUI ( n = 52) and no SUI ( n = 168) groups according to whether SUI occurred within 42 days after delivery. Pelvic floor ultrasound parameters and clinical data were compared between the two groups. The effects of each ultrasound parameter on postpartum SUI were assessed. The receiver operating characteristic (ROC) curve was plotted for each parameter. The area under the ROC was calculated. The risk factors for postpartum SUI were investigated using the logistic regression analysis. Results:The number of deliveries (≥ 2 times), the proportion of women subjected to vaginal delivery, and neonatal weight in the SUI group were significantly higher than those in the no SUI group [ χ2 = 4.13, 3.30, t = 4.43, all P < 0.05]. There were significant differences in the bladder neck position and levator hiatus area in the resting state between the two groups ( t = 2.29, 3.09, both P < 0.05). There were significant differences in the bladder neck position, levator hiatus area, urethral rotation angle, and bladder neck mobility during the Valsalva movement between the two groups ( t = 13.14, 4.27, 15.64, 8.54, all P < 0.05). The areas under the ROC of bladder neck position and levator hiatus area in the resting state and the areas under the ROC of bladder neck position, levator hiatus area, urethral rotation angle, and bladder neck mobility during the Valsalva movement were 0.707, 0.725, 0.730, 0.771, 0.813, and 0.836, respectively. The area under the ROC of parameters used in combination was 0.849. Logistic regression analysis results revealed that the number of deliveries (≥ 2 times), bladder neck position (> 27.286 mm) and levator ani hiatus area in resting state (> 16.663 cm 2), and bladder neck position (< -2.774 mm), levator hiatus area (> 21.915 cm 2), urethral rotation angle (> 80.445°), and bladder neck mobility (> 30.501°) during the Valsalva movement were the risk factors for postpartum SUI. Conclusion:Combined use of pelvic floor ultrasound parameters is valuable for the diagnosis of postpartum SUI. Abnormal changes in the bladder neck position, levator ani hiatus area, urethral rotation angle, and bladder neck mobility are closely related to the occurrence of postpartum SUI. Therefore, combined use of pelvic floor ultrasound parameters can be preferred to screen early postpartum SUI.

Objective To explore the feasibility and clinical outcome of lateral cervical incision via sternocleidomastoid intermuscular approach(SMIA)in the treatment of primary hyperparathyroidism.Methods The clinical data of 64 patients with primary hyperparathyroidism who underwent unilateral parathyroid surgery in the First Affiliated Hospital,School of Medicine of Zhejiang University from January 2019 to June 2022 were retrospectively analyzed.They were divided into lateral cervical incision via sternocleidomastoid intermuscular approach group(SMIA group)and linea alba cervicalis approach group(LACA group)based on the surgical incision and access route.The differences in clinical features,surgery-related outcomes and postoperative functions of the anterior cervical region were compared between the two groups.The EQ-5D-5L scale was used to assess the subjective feeling of postoperative neck discomfort,while the Hollander Wound Assessment Scale was used to assess the clinical outcome of incision healing.Results There were no statistical differences between the two groups of patients in terms of age,gender,intraoperative bleeding,parathyroid hormone or blood calcium levels before and after surgery(P＞0.05).The duration of surgery was significantly shorter in the SMIA group than in the LACA group[(39.77±5.69)min vs.(54.41±4.66)min].There was a statistical difference between the two groups in functional protection of the anterior cervical region at 1 month and 12 months after surgery(1 month,84.67±3.74 vs.79.47±5.38,P＜0.001;12 months,93.80±2.52 vs.89.94±2.39,P＜0.001),and the SMIA group was better than the LACA group.The Hollander Incision Assessment Scale scores of the SMIA group were better than those of the LACA group at 6 months and 12 months after surgery,and the difference was statistically significant(6 months,1.93±0.58 vs.2.41±0.66,P=0.003;12 months,1.03±0.67 vs.1.74±0.62,P＜0.001).Conclusion Parathyroidectomy via sternocleidomastoid intermuscular approach through lateral cervical incision is a simple,safe and effective surgical procedure,which makes it easier to search for parathyroid lesions and shortens the surgical time compared with the traditional incision,and has obvious advantages in the protection of anterior cervical region function.

Objective:To analyze the epidemiological characteristics of imported COVID-19 cases in early phase in Shanghai, introduce measures and provide reference for prevention and control of imported COVID-19 cases.Methods:Data of imported COVID-19 cases in Shanghai reported as of 30 March, 2020 were obtained from National Notifiable Disease Report System of China CDC and field epidemiological investigation reports by CDCs in Shanghai. The information about measures of prevention and control was collected from official websites and platforms of the governments. Data cleaning and statistical analysis were performed with softwares of EpiData 3.1, Excel 2019 and SAS 9.4.Results:A total of 171 imported COVID-19 cases had been reported as of 30 March, 2020 in Shanghai, including 170 confirmed cases and 1 asymptomatic infection case. Among them, cases of Chinese nationality accounted for 71.3% (122/171) and cases of foreign nationality accounted for 28.7% (49/171). The median age of the cases was 23 years ( P 25, P 75: 18, 35 years), and the male to female ratio of the cases was 1.3∶1. Students accounted for 56.6% (97/171). About 45.6% (78/171) of the cases fell ill before arriving in Shanghai. The cases with mild or common clinical manifestation accounted for 96.5% (165/171) and no significant difference in clinical type was observed between overseas Chinese cases and foreign cases. The epidemic curve by diagnosis date reached peak on March 24, and the number of the cases gradually declined due to the closed-loop management process of joint port prevention and control mechanism. The 171 imported COVID-19 cases were mainly from 24 countries and regions, including the United Kingdom (64 cases, 37.3%), the United States (32 cases, 18.6%), France (19 cases, 11.0%) and Italy (16 cases, 9.4%). About 40.4% of the cases (69/171) planned to continue travelling to 21 other provinces and municipalities in China. Customs quarantine and community observation/detection points identified 43.9% (75/171) cases and 31.0% (53/171) cases, respectively. Conclusions:The imported COVID-19 cases in early phase in Shanghai were mainly young population and students accounted for high proportion. The imported risk of COVID-19 was consistent with the severity of the epidemic in foreign countries. The closed-loop management model of the joint port prevention and control mechanism plays an important role in the identification and management of the imported COVID-19 cases.

Objective:To analyze the epidemiological characteristics of a cluster of 5 confirmed COVID-19 cases related with the transmission in incubation period of initial case, and find out the infection source and transmission chain.Methods:According to "The Prevention and Control Protocol for Coronavirus Disease 2019 (Third Edition)" issued by the National Health Commission, a field epidemiological survey was conducted for the 5 cases in January 2020. Nasopharyngeal swabs and sputum samples were collected from them for the detection of 2019-nCoV by real time RT-PCR. Multi prevention and control measures were taken, such as tracking and screening close contacts, medical isolation observation, investigating the epidemiological link, analyzing transmission chain.Results:Case 1, who had common environmental exposure with other COVID-19 cases, got sick on 20 January, 2020 and was confirmed on 1 February. Case 2 became symptomatic on 22 January and was confirmed on 27 January. Case 3 got sick on 25 January and was confirmed on 30 January. Case 4 had illness onset on 20 January and was confirmed on 1 February. Case 5 got sick on 23 January and was confirmed on 31 January. Among the 5 cases, case 2 died and the illness of other cases were effectively controlled. After exclusion of other common exposure factors, case 1 had a 6-hour meeting with case 2 and case 3 on 19 January. Case 2 and case 3 might be infected by case 1 during the incubation period. It is the key point for epidemiological investigation.Conclusion:The epidemiological investigation indicates that the transmission might occur in the incubation period of COVID-19 case, close attention should be paid to it in future COVID-19 prevention and control.