Objective To evaluate the short-term and mid-to-long-term clinical effectiveness of endovascular isolation technique with covered-stent in treating Stanford type B aortic dissection. Methods A total of 183 patients with Stanford type B aortic dissection, who were admitted to authors’ hospital during the period from January 2005 to December 2013 to receive endovascular isolation treatment with covered-stent under general anaethesia, were enrolled in this study. The clinical data, including post-operative symptoms, complications, retention time in ICU, hospitalization days, 30-day mortality, etc. were retrospectively analyzed. After discharged from hospital, the patients were followed up to check the situation, position and shape of the stent, the diameter of dissection false lumen, the internal leakage, etc. The survival rate and the quality of life were determined. Results Endovascular isolation procedure with covered-stent was successfully accomplished in all the 183 cases. The retention time in ICU was (3.08 ± 1.93) days, the mean hospitalization time was (3.08 ± 1.93) days, and the 30-day mortality was 1.09%. After discharged from hospital, the patients were followed up regularly, and no collapse or displacement of stent was observed, and the stent remained in its normal shape. No recurrence of dissection, rupture or reversal tear was observed. No long existing internal leakage could be detected. During the follow-up period 4 patients died, among them three died from cerebral infarction and one died of natural death. The 5-year survival rate was 97.82% and the patient’s quality of life did not become apparently worse. Conclusion For the treatment of Stanford type B aortic dissection, endovascular isolation therapy with covered-stent has excellent short-term effect and stable mid-to-long-term result.

Objective To establish a capillary electrophoresis method to separate ephedrine and psedudoephedrine. Methods RM-β-CD and HP-β-CD were set as additives. A capillary electrophoresis method was set up. The effects of types and concentrations of additives, the concentrations and pH values of buffered solution, running voltage and organic solvent on the separation of ephedrine and psedudoephedrine were investigated.Results Ephedrine and pseudoephedrine could be successfully separated by using either RM-β-CD or HP-β-CD as additives. When RM-β-CD was used as additive, the best separation conditions were as follows: separation voltage 10 kV, 25 mmol/L Tris-H3PO4 (pH 2.42), 20 mg/mL of RM-β-CD. Under the conditions, the resolution of ephedrine and pseudoephedrine was 1.56 and they were separated successfully within 13 min. When HP-β-CD was used as additive, the best separation conditions were as follows: separation voltage 10 kV, 25 mmol/L Tris-H3PO4 (pH 3.00), 50 mg/mL of HP-β-CD. Under the conditions, the resolution of ephedrine and pseudoephedrine was 2.73 and they were separated successfully within 15 min.ConclusionThis method is reliable, rapid and repeatable. It can be used as separation determination method for ephedrine and pseudoephedrine.

Objective:To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the hippocampal lipidome in a rat model of chronic unpredictable stress(CUS).Methods:Twenty-four SD rats were randomly assigned to the following 3 groups ( n=8 for each group): sham group, CUS group and CUS+ rTMS group. The sham group received only sham stimulation and rats in the CUS and CUS+ rTMS group were subjected to CUS stimulation. Then, rats received 5 Hz rTMS (5 Hz, 1.26 Tesla) or sham rTMS for 7 days. After the last stimulation, all rats underwent sucrose preference test, open filed test and forced swimming test so as to observe the effect of rTMS on depressive behavior. Then, rats were sacrificed, and the levels of lipid composition in hippocampus were determined by high performance liquid chromatography mass spectrometry and analyzed by lipid search software version 4.1 and SIMCA-P 14.1.The software of SPSS 19.0 was used for statistical analysis. Univariate analysis of variance was used for comparison among groups, and Tukey test was used for multiple comparison. Results:(1)There were significant differences in open field test, sugar preference test and forced swimming test among the three groups( F=6.853-7.466, all P<0.05). In the open field experiment, the exploring time and percentage of movement distance in central area of rats in CUS group((50.72±6.38)s, (11.41±1.55)%) was significantly less than that of sham group ((86.06±7.31)s, (18.60±1.21)%) and CUS+ rTMS group((79.87±7.87)s, (16.74±1.27)%)(all P<0.05). The results of sucrose preference test showed that the percentage of sucrose intake of rats in CUS group ((37.63±6.06)%) was significantly lower than that in sham group ((68.30±6.39)%) and CUS+ rTMS group ((62.68±5.50)%)(both P<0.05) . In forced swimming test, the immobility time of rats in CUS group ((137.60±13.36)s) was significantly longer than that of sham group ((80.57±10.36)s)) and CUS+ rTMS group ((86.14±11.49)s) (both P<0.05). (2)The levels of lipid composition in hippocampus were significantly different in the three groups( F=3.826-15.440, all P<0.05). The contents of phosphatidylethanolamine (PE) ((20 850±956.56)×10 7, (24 133.33±1 242.04)×10 7), phosphatidylinositol (PI) ((788.78±136.11)×10 7, (953.65±131.26)×10 7), lysophosphatidylcholine (LPC) ((340.29±35.66)×10 7, (275.32±35.78)×10 7), creatine phosphate (CerP) ((239.65±18.14)×10 7, (293.82±38.28)×10 7), sphingosine (So) ((22.96±4.04)×10 7, (15.36±3.87)×10 7), diglyceride (DG) ((3.35±0.85)×10 7, (4.57±1.02)×10 7) and monoglyceride (MG) ((6.71±0.82)×10 7, (7.94±0.91)×10 7)in hippocampus of rats in CUS group were significantly higher than those of sham group(all P<0.05), while the phosphatidic acid(PA) ((424.52±33.38)×10 7, (509.22±42.09)×10 7) and acyl carnitine(AcCa) ((2.68±0.33)×10 7, (3.39±0.33)×10 7) decreased(both P<0.05). Compared with CUS group, the contents of PE(21 816.67±928.26)×10 7, PI(83.16±91.52)×10 7, LPC(323.59±33.91)×10 7, CerP(236.39±32.02)×10 7, So(23.35±4.46)×10 7, DG(3.16±0.85)×10 7 and MG(7.03±0.26)×10 7 in the hippocampus of CuS+ rTMS group decreased, while the contents of PA(421.55±44.28)×10 7 and ACCA(2.56±0.32)×10 7 in the hippocampus of CUS+ rTMS group increased (all P<0.05). Conclusion:The levels of glycerophospholipids, glyceroglycerides, sphingolipids, fatty acids and other lipids in the hippocampus of CUS model rats are abnormal. And the 5 Hz rTMS intervention can ameliorate the depression like behavior and the disturbances of lipid in hippocampus of CUS model rats.

Objective:To study the expression and regulation of TLR2/4 in mycobacterium tuberculosis heat shock proteins 16. 3 (mycobacterium tuberculosis heat shock proteins 16. 3,MTB Hsp16. 3) effect on mouse bone marrow-derived macrophages in vitro. Methods:Bone marrow cells were isolated from tibia and femurs of BALB/c mice and incubated with GM-CSF,then detected the expression of CD11b and F4/80 with flow cytometry and observed morphology. The M0 macrophages were stimulated with MTB Hsp16. 3 for 0 h,12 h,24 h,36 h,48 h and 72 h. Real-time PCR detected the expression of TLR2/4 in intracellular at different time point. Silencing macrophages cell surface TLR2/4 molecules by siRNA technology which stimulated with MTB Hsp16. 3 for 0 h,12 h,24 h,36 h,48 h and 72 h. Real-time PCR detected the expression of TLR2/4,Ym-1,Fizz1,IL-10,TNF-α,iNOS and TGF-βin intracellular at different time point. Results:Morphology analysis showed that MTB Hsp16. 3 stimulated macrophages were round cells stretching out pseudopodia,whereas MTB Hsp16. 3 stimulated silencing TLR2/4 macrophages had elongated fibroblastoid. Real time PCR detected the expression of TLR2/4 were upregulated after MTB Hsp16. 3 stimulated M0 macrophages. MTB Hsp16. 3 stimulated silencing TLR2/4 macrophages the expression of IL-6, TNF-α, iNOS were upregulated, whereas IL-10, TGF-β, Ym-1 and Fizz1 were downregulated. Conclusion:MTB Hsp16. 3 may stimulated M0 macrophages to M2 macrophages and suppress M1 macrophages through binding with TLR2/4 receptor,which may be involved the progresss of MTB evaded macrophage phagocytosis.

Objective:To observe the clinical effect of wheat grain-sized cone moxibustion combined with fire needle therapy in the treatment of dorsal wrist ganglion (DWG). Methods:A total of 63 patients with DWG were randomized into a treatment group (n=32) and a control group (n=31). Cases in the control group were treated with fire needle therapy. Based on the therapy given to the control group, cases in the treatment group were additionally given wheat grain-sized cone moxibustion therapy. Then the therapeutic efficacies and recurrence rate were evaluated. Results:After treatment, the overall effective rate was 93.8% in the treatment group, versus 77.4% in the control group, and the between-group comparison showed a statistical significance (P<0.05); 6 months after the treatment, the recurrence rate in the treatment group was obviously lower than that in the control group (P<0.05). Conclusion:The long-term and short-term effects of wheat grain-sized cone moxibustion combined with fire needle therapy in the treatment of DWG are better than those of fire needle therapy alone, and therefore, worth popularizing.

Long non-coding RNAs (lncRNAs) play important roles in several cellular biogenic activities, including the virus-host interaction as well. Virus infection could induce aberrant expression of multiple lncRNAs, and some of these lncRNAs could facilitate or suppress the virus infection via diverse mechanisms. In this paper, we enumerate the differentially expressed lncRNAs induced by different types of viruses and summarize the potential mechanism of interaction between viruses and these lncRNAs.

Objective:To analyze the nursing efficiency of clinical departments in general hospitals under the background of medical insurance payment reform, and to explore the methods of rational allocation of resources and improvement of service efficiency.Methods:The relevant data of Qingdao Municipal Hospital from January to December 2020 were selected. The nursing efficiency of 20 clinical departments in the hospital was evaluated by data envelopment analysis (DEA) and Malmquist index. The input indexes were the number of nurses, the number of hours, the number of open beds. The output indicators were number of discharges, average length of stay, and case mix index.Results:In 2020, the average comprehensive efficiency, pure technical efficiency and scale efficiency of 20 clinical departments in the hospital were 0.845, 0.913 and 0.923, respectively.The total factor production efficiency index of the hospital from February to April, from May to September and from October to November were all greater than 1, but the total factor production efficiency index from January to December was less than 1. There were 5 departments with total factor production efficiency index greater than 1.Conclusions:The comprehensive nursing efficiency of clinical departments needs to be improved, and diagnosis related groups (DRG) poses a more severe challenge to the efficiency management of internal medicine nursing. The COVID-19 epidemic has a great impact on the efficiency of nursing services.It is feasible to evaluate the nursing efficiency with DEA model and DRG related indicators.Combined with the disease characteristics and nursing work characteristics of patients admitted to the department, the deep causes should be explored, comprehensive measures should be taken to improve nursing efficiency, precise nursing service transformation based on the reform of medical insurance payment mode should be explored, Internet + nursing service should be promoted, and the improvement of nursing resource efficiency under the status of normal epidemic prevention and control should be paid attention to.

Objective To observe the rate of iris vessels exposure and analyze its relevant factors in normal full-term neonates.Methods A retrospective study.1855 normal full term neonates,including 947 boys and 908 girls,were enrolled.The mean gestational age (GA) was (38.84±1.10) weeks and mean birth weight (BW) was (3 396.52±402.08) g.There were 1235 neonates from normal term vaginal delivery,402 cases of cesarean delivery and 218 cases of forceps delivery.All neonates were examined with hand-held portable slit lamp biomicroscopy within 1 to 3 days after birth by two trained ophthalmologist respectively.Iris vessels exposure was defined as radial red blood vessels along iris fibers.Infants were divided into iris vessels exposure group and iris vessels unexposed group according to the findings of slit lamp biomicroscopy.78 infants with iris vessels exposure were followed up for 42 days after birth till the iris vessels can't be seen under microscope.The differences between the two groups were compared for gender,mode of delivery (MOD),GA,BW and body length (BL).Multiple logistic regressions were used to determine the factors related to iris vessels exposure.Results There were 298 neonates with iris vessels exposure among 1855 neonates and the rate was 16.1％.1557 neonates (83.9％) had unexposed iris vessels.There were no different in gender (x2=0.551) and MOD (x2=3.036) between iris vessels exposure group and unexposed group (P＞0.05),while the differences in GA (x2=47.216),BW (t=4.603) and BL (t=3.936) between the two groups were statistically significant (P=0.000).Multiple logistic regression analysis revealed that only GA (β=-0.291,odds ratio=0.747,95％ confidence interval:0.656-0.85 1,P=0.000) was correlated to iris vessels exposure significantly.The iris vessels couldn't be seen in 77 of 78 infants with iris vessels exposure when followed up to 42 days.Conclusions The iris vessels exposure in normal full-term neonates is frequently observed.There is a significant inverse correlation between GA and iris vessels exposure.

Objective To prepare monoclonal antibodies (mAb) against the type Ⅳ secretion system protein VirB5 of Brucella melitensis and to provide a basis for pathgenic diagnosis and research of brucellosis.Methods Four SPF female BALB/c mice were subcutaneously immunized with purified VirB5 protein at a dose of 60 μg/mice,and immunization was strengthened every 2 weeks at a dose of 30 μg/mice,three times in total.Two weeks later,the orbital venous blood of mice was taken to determine the antibody titer,and then intraperitoneally injected for the fourth time to strengthen immunization.Three days later,mouse spleen cells were fused with mouse myeloma SP2/O cells in a ratio of 5:1.After 3 times of cell screening and monoclonal cloning,the hybridoma cell lines with stable secretion of VirB5 antibody were established;one BALB/c mouse was intraperitoneally injected with hybridoma cells,and ascites were collected and antibody was purified when the mouse abdomen was significantly enlarged.The immunological characteristics of mAbs were identified by indirect enzyme-linked immunosorbent assay (ELISA) and Western blotting.Results A total of 6 monoclonal cell lines (2-2,2-12,2-19,2-25,2-31 and 2-40) capable of secreting VirB5 antibody were established.Among them,the cell line 2-19 can stably secrete an antibody that specifically recognized the VirB5 protein,and the VirB5 antibody secreted by the cell line was identified as an IgG1 subtype,a kappa light chain,a mAb affinity constant of 1.6 × 108.The titer of ascites antibody of mouse intraperitoneally injected with hybridoma cell 2-19 was 1:51 200.Conclusion The high-affinity mAb of type Ⅳ secretion system protein VirB5 is successfully prepared,and the antibody can rapidly bind specifically to pathogens,providing an alternative material for establishment of brucellosis pathogen diagnostic method.

Objective:To investigate the correlation between right-to-left shunt (RLS) and infarct pattern in patients with cryptogenic stroke.Methods:Young and middle-aged patients with acute cryptogenic stroke admitted to the Department of Neurology, Xiaogan Central Hospital from May 2016 to January 2020 were enrolled retrospectively. The demographic data, vascular risk factors, baseline blood pressure, laboratory findings, stroke severity, infarct location and distribution pattern were documented. The patients were divided into RLS group and non-RLS group according to the findings of the transcranial Doppler ultrasound foaming test. They were divided into single lesion group and multiple-lesion group according to the findings of diffusion-weighted imaging. Multivariate logistic regression analysis was used to identify the correlation between RLS and infarct pattern. Results:A total of 68 patients with acute cryptogenic stroke were included, 37 of them were male (54.4%), and their age was 47.63±6.57 years (range, 31-59 years). Thirty patients (44.1%) had RLS, including 22 (73.3%) with mild shunt and 8 (26.7%) with severe shunt. The proportions of men, cortical-subcortical infarction and multiple blood supply area lesions in the RLS group were significantly higher than those in the non-RLS group, while triacylglycerol, body mass index, the proportions of patients with subcortical infarction and single lesions in the single vessel blood supply area were significantly lower than those in the non-RLS group ( P<0.05). The proportions of patients with anterior circulation+ posterior circulation infarction, cortical-subcortical infarction, and RLS in the multi-lesion group were significantly higher than those in the single-lesion group, while the proportion of patients with subcortical infarction was significantly lower than that in the single-lesion group (all P<0.05). Multivariate logistic regression analysis showed that RLS was an independent risk factor for multiple infarctions (odds ratio 6.681, 95% confidence interval 1.206-37.019; P=0.030). Conclusion:RLS is independently associated with multiple infarctions in patients with cryptogenic stroke.