Objective To investigate the application value of low kilovolt technique combined with lower contrast in the head and neck angiography by the second-generation dual source CT.Methods From October 2013 to January 2015,120 patients undergoing head and neck computed tomography angiography (CTA) were randomly divided into groups A,B,C,D.Each group was given a different tube current and different dose of contrast agent and saline solution 50 ml.Group A received current 100 mA and contrast agent 50 ml,group B received current 100 mA and contrast agent 40 ml,group C received current 80 mA and contrast agent 50 ml,and group D received current 80 mA and contrast agent 40 ml.CT values of aortic arch,bilateral common carotid artery bifurcation,double sided M1 segment of middle cerebral artery,basilar artery enhanced degree of the straight sinus were measured in each group.Residual artifacts caused by contrast agent in brachiocephalic vein and subclavian vein were observed.5-score method was used to assess the quality of reconstructed image,and the radiation exposure dose was calculated.Results The mean effective dose was reduced by 29％ in group C as compared with group A [(0.53±0.17) mGy vs.(0.74±0.04) mGy].There was no significant difference in developing strength in cerebral arteries angiography between group C and group A (P=0.247),but the inage noise was slightly larger in group C than group A,without significant differences (P=0.203).The average effective dose in group A was almost the same as that in group B [(0.74 ± 0.04) mGy vs.(0.73 ± 0.05) mGy].Structure display of cerebral arteries on CT volume rendering (VR) and multiplane reformation (MPR) images had no significant differences between group A and group B (P=0.114).The average effective dose in group C was almost the same as that in group D[(0.53 ± 0.17) mGy vs.(0.53 ±0.01) mGy].Structure display of cerebral arteries on CT volume rendering (VR) and muhiplane reformation (MPR) images had no significant differences between group C and group D (P=0.109).The mean effective dose was reduced by 28％ in group D as compared with group B[(0.53±0.01)mGy vs.(0.73±0.05) mGy].There was no significant difference in developing strength in cerebral arteries angiography between group C and group A (P=0.236),but the image noise was sligbtly larger in group C than group A (P =0.212).Conclusions Application of low tube current combined with low concentration of contrast agent in the head and neck dual-source CT angiography is feasible in clinical diagnosis,with good clinical value.It can not only get better image quality,but also meet the needs of clinical diagnosis.

The standardized training of resident physicians of Chinese medicine specialized graduate students (standardized training) is a great reform of clinical postgraduate education and a major initiative to improve professional degree graduates education. It contributes to higher professional qualities of clinicians in China. At this stage, the standardized training in our school just started and some problems existed such as department arrangement, training and checking system, curriculum and tutors instruction. Here, taking the standardized training in our school as an example, this paper discussed some issues on the training and put forward suggestion. This will help standardize our training, improve the training quality of our graduate students and develope medical professional talents.

Objective Developing an index system to evaluate the community teaching bases of general practice, for the purpose of identifying and completing at least one demonstration teaching base for general practice in each city in 2010. Methods Initial building of the index system by means of Delphi method and experts interview, followed by selection of experts for consultation, statistical analysis on the results of letter inquiries, and rounded up by the establishment of the index system for evaluation in the end. Results The recovery rates of a two-round Delphi questionnaire response are 94.12% and 100.00%respectively. Expert's authority degrees of five indexes are all over 0.8, which suggests high expert's authority. The average coordination coefficient of two-round Delphi experts consultation is 0.262and 0.534 respectively, showing good experts coordination. In the end, the study established four first-class indexes, ten second-class indexes, 41 third-class indexes and five additional indexes. Conclusions The index system is established in view of the current development of community teaching bases. It focuses on evaluating teachers, the teaching process and base's function. The evaluation system provides reference for selecting demonstration community teaching bases of general practice.

Due to abundant availability of shale gas and biogas, methane has been considered as one of the most potential carbon sources for industrial biotechnology. Methanotrophs carrying the native methane monooxygenase are capable of using methane as a sole energy and carbon source, which provides a novel strategy for reducing greenhouse gas emission and substituting edible substrates used in bioconversion processes. With the rapid development of genetic engineering tools and biosynthesis techniques, various strategies for improving the efficiency of methane bioconversion have been achieved to produce a variety of commodity bio-based products. Herein, we summarize several important aspects related with methane utilization and metabolic engineering of methanotrophs, including the modification of methane oxidation pathways, the construction of efficient cell factories, and biosynthesis of chemicals and fuels. Finally, the prospects and challenges of the future development of methane bioconversion are also discussed.
Biofuels ; Biotechnology ; Metabolic Engineering ; Methane ; Oxidation-Reduction

The penetrating moxibustion technique is proposed based on experience of the ancients and clinical practice for many years. From the aspects of definition, action characteristics and technique at different parts, the advantage and application experience of penetrating moxibustion have been discussed. The adequate dose of moxibustion is necessary in penetrating moxibustion; in addition, moxibustion sensation should be penetrating; therefore, with a temperature of 43℃ for more than 20 min, sweating, flushing, speckle appearing after penetrating moxibustion. Due to individual differences of age, gender and constitution factors, the effects of penetrating moxibustion are different, in clinical practice the body reaction and patient's feelings should be deliberately focused on other than does or sore and blister of moxibustion. The technique is common used in the abdomen, waist and knee joint, etc.

ObjectiveTo analyse the clinical characteristics of different traditional Chinese medicine （TCM） syndromes in patients with heart failure based on information from electronic medical record. MethodsA cross-sectional study was conducted to collect clinical data of all inpatients with heart failure in the Department of Cardiology， Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from January 1， 2019 to December 31， 2020. A database of clinical TCM data was established to explore the characteristics of clinical data of basic information， syndromes and syndrome element types， and biochemical indexes. The distribution of TCM syndromes and syndrome elements in heart failure patients were also analysed， and the basic information and biochemical indexes of the patients with top 7 different TCM syndrome types were compared. ResultsA total of 1676 inpatients with heart fai-lure were included. The top 7 TCM syndromes of heart failure were syndrome of phlegm turbidity and blood stasis （477 cases， 28.46%）， syndrome of qi deficiency and blood stasis （439 cases， 26.19%）， syndrome of qi deficiency and blood stasis with water retention （274 cases， 16.35%）， syndrome of yang deficiency with water retention （145 cases， 8.65%）， syndrome of qi and yin deficiency （104 cases， 6.21%）， syndrome of qi and yin deficiency with blood stasis （80 cases， 4.77%）， syndrome of heart yang deficiency （59 cases， 3.52%）. Among the 1676 patients， 6 syndrome elements accounted for more than 5%. Blood stasis accounted for the highest proportion of TCM syndrome element type （1292 cases， 77.09%）， followed by qi deficiency （919 cases， 54.83%）， phlegm （498 cases， 29.71%）， water retention （434 cases， 25.89%）， yang deficiency （215 cases， 12.82%） and yin deficiency （191 cases， 11.40%）. Among the 1676 patients， 1308 cases of acute heart failure mainly showed syndrome of phlegm turbidity and blood stasis （386 cases， 29.51%）， and 368 of chronic heart fai-lure mainly showed syndrome of qi deficiency and blood stasis （118 cases， 32.07%）. Patients with syndrome of phlegm turbidity and blood stasis had the shortest disease duration of 0.3 months， while those with syndrome of heart yang deficiency had the longest disease duration of 15 months. The proportion of syndrome of phlegm turbidity and blood stasis was the highest in patients with heart failure combined with coronary artery disease， the proportion of syndrome of qi deficiency and blood stasis with water retention was the highest in patients with heart failure combined with atrial fibrillation， and the proportion of patients with syndrome of qi deficiency and blood stasis with water retention and syndrome of yang deficiency with water retention in those applying diuretics during the hospital stay was the highest with more than 86%. The different 7 TCM syndromes showed statistically difference in patients with complications including coronary artery disease， old myocardial infarction， atrial fibrillation， pre and post-admission medication usage including intravenous vasodilators， cardiac stimulants， diuretics， and level of blood chloride， blood urea， blood creatinine， blood bicarbonate， blood albumin， and blood total bilirubin （P＜0.05）. ConclusionThe most common TCM syndromes in patients with heart failure are syndrome of phlegm turbidity and blood stasis and syndrome of qi deficiency and blood stasis. Different TCM syndromes have different characteristics in gender， disease complications， medication before and after admission， and blood indexes.

OBJECTIVETo evaluate the efficacy and safety of transumbilical single-site laparoscopic surgery for congenital duodenal obstruction (CDO) in neonates.

METHODSA retrospective analysis of clinical data of 15 patients with CDO undergoing transumbilical single-site laparoscopic treatment during November 2017 and January 2018 (single-site group), and 20 patients with CDO undergoing conventional three-hole laparoscopic treatment during August 2017 and October 2017 (three-hole group) was performed. All patients were from the Children's Hospital, Zhejiang University School of Medicine. The operation time, time of initial feeding, time of adequate feeding, length of hospital stay after operation and postoperative complications were compared between two groups.

RESULTSThe operations were completed in all patients. No patient converted to laparotomy, and no massive hemorrhage was observed during operation. The operation time of single-site group was (90±10) min for patients with duodenal diamond-shaped anastomosis and (81±15) min for patients with Ladd operation, while those of three-hole group were (85±9) min and (72±11) min, respectively. Postoperative initial feeding time of single-site group was (5.0±1.0) d, and that of the three-hole group was (4.8±0.8) d. The adequate feeding time was (9.0±1.2) d in the single-site group, and (9.3±0.8) d in the three-hole group. The length of hospital stay after operation was (11.2±2.5) d in the single-site group, and (11.5±2.8) d in the three-hole group. There was no significant difference in operation time, postoperative initial feeding time, adequate feeding time and length of hospital stay after operation between two groups (all >0.05).

CONCLUSIONSTransumbilical single-site laparoscopic surgery for CDO in neonates is safe and effective, and the postoperative abdominal scar is more hidden.

Via an insufficient coat protein complex I (COPI) retrieval signal, the majority of SARS-CoV-2 spike (S) is resident in host early secretory organelles and a tiny amount is leaked out in cell surface. Only surface-exposed S can be recognized by B cell receptor (BCR) or anti-S therapeutic monoclonal antibodies (mAbs) that is the trigger step for B cell activation after S mRNA vaccination or infected cell clearance by S mAbs. Now, a drug strategy to promote S host surface exposure is absent. Here, we first combined structural and biochemical analysis to characterize S COPI sorting signals. A potent S COPI sorting inhibitor was then invented, evidently capable of promoting S surface exposure and facilitating infected cell clearance by S antibody-dependent cellular cytotoxicity (ADCC). Importantly, with the inhibitor as a probe, we revealed Omicron BA.1 S is less cell surface exposed than prototypes because of a constellation of S folding mutations, possibly corresponding to its ER chaperone association. Our findings not only suggest COPI is a druggable target against COVID-19, but also highlight SARS-CoV-2 evolution mechanism driven by S folding and trafficking mutations.

The fall armyworm (FAW), Spodoptera frugiperda, is a destructive pest native to America and has recently become an invasive insect pest in China. Because of its rapid spread and great risks in China, understanding of FAW genetic background and pesticide resistance is urgent and essential to develop effective management strategies. Here, we assembled a chromosome-level genome of a male FAW (SFynMstLFR) and compared re-sequencing results of the populations from America, Africa, and China. Strain identification of 163 individuals collected from America, Africa and China showed that both C and R strains were found in the American populations, while only C strain was found in the Chinese and African populations. Moreover, population genomics analysis showed that populations from Africa and China have close relationship with significantly genetic differentiation from American populations. Taken together, FAWs invaded into China were most likely originated from Africa. Comparative genomics analysis displayed that the cytochrome p450 gene family is extremely expanded to 425 members in FAW, of which 283 genes are specific to FAW. Treatments of Chinese populations with twenty-three pesticides showed the variant patterns of transcriptome profiles, and several detoxification genes such as AOX, UGT and GST specially responded to the pesticides. These findings will be useful in developing effective strategies for management of FAW in China and other invaded areas.
Animals ; China ; Genomics ; Humans ; Male ; Pesticides ; Spodoptera/genetics* ; Transcriptome