Objective To observe the levels of cAMP and adenylyl cyclase(AC) in hippocampus of mice with vascular dementia(VD) and the effect of Dihydroergocriptine(DHE),and to explore the molecular pathogenesis of VD.Methods The mice were subjected for ischemia-reperfusion three times on bilateral common carotid arteries by knots to establish models of VD and the changes of learning and memory were tested on d29/d30 after operation.DHE was administrated to another group of mice,which was taken as treatment group.The cAMP level was evaluated by the radioimmunoassay;AC mRNA positive neurons of hippocampus CA1 area were examined through in-situ hybridization.Results Compared with shamed-operation group,the learning and memory of model group was worse(P

Objective:To investigate the contrast-enhanced ultrasound (CEUS) features of inflammatory hepatocellular adenoma (I-HCA).Methods:The contrast-enhanced ultrasound features I-HCA of 28 cases from April 2009 to November 2019 in Zhongshan Hospital, Fudan University were retrospectively analyzed, including arterial phase enhancement pattern, the homogeneity of enhancement, subcapsular enhancement, and the internal perfusion defect. All I-HCA lesions were divided into >5 cm group( n=9) and ≤5 cm group( n=19), the CEUS features between the two groups were compared. Results:All I-HCA lesions were hyper-enhanced in the arterial phase, among which 39.3% (11/28) showed diffuse filling, 39.3%(11/28) showed centripetal filling, and 21.4%(6/28) showed centrifugal filling pattern. Twenty-five percent (7/28) of I-HCAs showed heterogeneous enhancement, 10.7% (3/28) revealed unenhanced areas within the lesions. Subcapsular vessels were observed in 67.7 (21/31) of I-HCA lesions. Heterogeneous enhancement and unenhanced areas were more frequently detected in lesions >5 cm ( P=0.020, 0.026, respectively), while there was no difference in the enhancement pattern and subcapsular vessels between the two groups ( P>0.05). Inportal venous phase, 42.9%(12/28) of I-HCAs showed hypo-enhancement, and 57.1%(16/28) of lesions showed washout in late phase. According to "hyper-enhancement in arterial phase, sustained hyper- or iso-enhancement in portal venous and late phase" by CEUS, the diagnostic accuracy of benign lesion was 42.9%(12/28). According to any of hyper-enhancement pattern in arterial phase, subcapsular vascular enhancement, and sustained hyper- or iso-enhancement in portal venous and late phase, the diagnostic accuracy of I-HCA was 71.4% (20/28). Conclusions:CEUS is valuable in the diagnosis of inflammatory hepatocellular adenoma.

Objective To investigate the reasons and the methods of prevention and cure for serious complications of radiofrequency ablations in the treatments of hepatocellular carcinomas. Methods A total of 410 patients with BCLC at A or B stage of hepatocellular carcinomas in our hospital were enrolled between November 2014 and June 2009. These patients underwent a total of 504 times radiofrequency ablations for the treatments of liver lesions. This retrospective study analysed the reasons and the strategies of prevention and cure for the serious complications. Results In the patients with a total of 504 times radiofrequency ablations, 2 patients had massive hemorrhage caused by puncture injuries, 2 patients had the tumors which were close to the liver capsules and 1 patient had bile peritonitis caused by the injury of thermal ablation on the gallbladder. The maximum diameter of tumor was 5 cm. That tumor was close to the gallbladder. 2 patients had needle tract metastases caused by incompletely needle path ablations. 1 of the 2 patients had a tumor near the liver capsule, and the other patient had un-enough temperature for needle path ablation. Tumor outbreaks were happened in 2 patients. 1 of the 2 patients had a tumor which was located in the liver capsule and close to the portal vein. The other patient had a 12 cm diameter tumor with rich blood supplement. 2 patients had liver abscesses. 1 of the 2 patients had a tumor near the ascending colon, and the other patient had diabetes. 1 patient had colonic perforation caused by thermal ablation. The tumor in that patient was located in the right hepatic lobe segment and adjacent to the ascending colon. The incidence of serious complications was 1.98% (10/504). Conclusions The incidence of the serious complications of radiofrequency ablations for the treatments of hepatocellular carcinomas is relatively low. The main reasons for the serious complications were direct injuries caused by punctures, heat radiation injuries, tumors adjacent to large blood vessels, gallbladders and intestines, tumors with abundant blood supplement, needle paths fail to cross normal liver tissues, low scores of liver function, weak immune system and diabetes. The key points for avoiding and reducing the serious complications are preoperative evaluations of patients' basic situations, choices of appropriate puncture channels and control ranges of ablations when tumors are close to important blood vessels, intestines and gallbladders.

Objective To investigate the epidemiological characteristics of outpatients exposed to rabies and to analyze the post-exposure prophylaxis in Weinan City in 2017 in order to provide a scientific basis for the prevention of rabies. Methods Clinical data of all outpatients with exposure to rabies in Wei-nan were collected. Ecxcel 2007 was used for data entry and SPSS13. 0 for Chi-square test. Results A total of 32 094 cases were reported with an annual exposure rate of 625. 64/100 000 in Weinan in 2017. Animal bites mainly occurred in spring and summer,accounting for 47. 47% of the total cases in 2017. There were statistically differences in exposure rate among different age groups (χ2=15. 858,P=0. 003). Farmers ac-counted for the largest proportion of the outpatients exposed to rabies (52. 34% ). Among 31 435 outpatients, 28 181(89. 65% ) received wound care and rabies vaccination. The vaccination rate of rabies immunoglobu-lin for patients with gradeⅢ exposure was 46. 93%. Conclusion Comprehensive measures with focuses on compulsory vaccination for domestic dogs and adoption of stray dogs should be implemented to prevent human rabies. Meanwhile,health education rabieson prevention and control should also be strengthened.

Objective To analyze the influencing factors on AIDS-related deaths among HIV/AIDS patients in Guangzhou,Guangdong province.Methods A retrospective cohort was formed,based on available data of HIV/AIDS patients between 1991 and 2013 in Guangzhou,that were gathered from the Chinese AIDS Prevention and Control Information System.Cox proportional hazard model was used to identify the influencing factors for AIDS-related deaths.Results Data showed that factors as:existence of full-bloom AIDS when HIV infection was diagnosed (HR =2.717,95％ CI:2.039-3.621),diagnose of AIDS was made in the hospitals (HR=1.516,95％ CI:1.159-1.981),never received no CD4 count testing (HR=4.866,95％CI:3.674-6.444),no drugs were provided to those who met the criteria for treatment (HR=12.213,95％CI:8.467-17.616),and patients at aged ≥40 years when HIV infection was diagnosed etc.,were related to the risk for AIDS deaths.The risk of AIDS-related death was also high in those who did not meet the treatment criteria or receiving no treatment,when compared to those who had received the antiviral treatment (HR=1.936,95％ CI:1.145-3.272).Conclusion Factors as:earlier diagnosis of HIV/AIDS cases,provision of CD4 count testing and antiviral treatment to more cases etc,could decrease the risk for AIDS-related deaths and improve the survival rate on HIV/AIDS cases.

Objective:To perform two-step clustering analysis based on urodynamics in patients with neurogenic bladder (NB) and exploring characteristics affecting success rate of sacral neuromodulation (SNM).Methods:The data of 174 NB patients who received SNM therapy in our hospital from September 2018 to August 2023, were retrospectively analysed. There were 94 males and 80 females, with average age of (50.4±17.9)years, median duration of 2 (1, 3)years, and body mass index of 21.5 (20, 25) kg/m 2. Among them, 50 patients had chronic diseases (hypertension or diabetes). Additionally, 77 patients (44.3%) presented with voiding symptoms, 47 patients (27.0%) with storage symptoms, and 50 patients (28.7%) with mixed symptoms. The etiologies included spinal cord lesions in 110 patients (63.2%), brain lesions in 21 patients (12.1%), peripheral nerve lesions in 36 patients (20.7%), and other causes in 7 patients (4.0%). All patients underwent urodynamics and SNM phase 1 test. If patient's subjective symptoms or objective indicators improved > 50%, it is defined as treatment success and feasible to received second stage of SNM. The success rate was analyzed. Clinical indicators and urodynamic parameter were collected for exploring the difference of the above indicators between two groups (with or without conversion). The 174 patients were grouped using two-step clustering analysis, dividing them into two groups. The differences in clinical data, urodynamic parameters, and the conversion rate of SNM phase II between the two groups were compared. Results:Among these patients, 126 (72%) underwent the second stage of SNM. Compared with the non-conversion group, patients in the conversion group exhibited the following characteristics: high proportion of female[51.6% (65/126) vs. 31.2% (15/48)], younger[(48.1± 18.3)year vs. (56.4±15.4) year], lower proportion of history of chronic disease[23.9% (30/126) vs. 41.7% (20/48)], storage predominant symptoms predominant[33.3% (42/126) vs. 10.4% (5/48)], sensitive bladder sensation[50.0% (63/126) vs. 11.1% (14/48)], normal detrusor contractility [26.2% (33/126) vs. 10.4% (5/48)] and detrusor-sphincter dyssynergia [21.4% (27/126) vs. 4.2% (2/48)]and lower post-void residual [105.5(49.3, 231.3) ml vs. 197.9(114.8, 284.8) ml], ( P<0.05). After excluding multicollinearity, patients were divided into two group mainly based on coordination, detrusor stability, and detrusor contractility through two-step clustering analysis: 98 patients in Group 1 and 76 patients in Group 2. The success rate was higher in Group 2 [82.9% (63/76) vs. 64.3% (63/98), P=0.006]. Compared with Group 1, Group 2 exhibited the following characteristics: higher proportion of storage symptoms [43.4% (33/76) vs. 14.3% (14/98)], sensitive bladder sensation [67.1% (51/76) vs. 26.5% (26/98)], detrusor overactivity [46.1% (35/76) vs. 3.1% (3/98)], normal detrusor contractility [43.4% (33/76) vs. 5.1% (5/98)], and detrusor-sphincter dyssynergia [38.2% (29/76) vs. 0] ( P all<0.05). Additionally, group 2 had lower post-void residual [69.0 (23.8, 136.6) ml and 197.9 (123.2, 287.4) ml] and smaller bladder capacity [(281.9±144.9) ml vs. (430.4±176.7) ml] ( P all<0.01). Conclusions:Patients with storage symptoms, low post-void residual, sensitive bladder sensation, detrusor overactivity, normal contractility, or detrusor-sphincter dyssynergia indicate a higher conversion rate to second stage, making them more suitable for SNM testing.

Objective:To investigate the diagnostic value of prenatal MRI in the detection of abnormal placental cord insertions (APCIs) comparing with prenatal ultrasound and pathological examination.Methods:A retrospective data collection was conducted on 440 patients who underwent both prenatal placental ultrasound and MRI at the Foshan Women and Children Hospital from December 2013 to December 2021. Among them, 37 cases were APCIs confirmed by surgery or pathology. The prenatal placental MRI findings were analyzed and compared with prenatal ultrasound diagnosis. The diagnostic efficacy of prenatal MRI and ultrasound in diagnosing APCIs was calculated.Results:Among the 37 cases of APCIs confirmed by surgery or pathology, 17 cases had marginal cord insertion (MCI), 13 cases had velamentous cord insertion (VCI), 5 cases had vasa previa (VP), and 2 cases had VCI combined with VP. The sensitivity and specificity of ultrasound diagnosis for APCIs were 59.5% (22/37) and 97.8% (394/403), respectively. The sensitivity and specificity of MRI diagnosis for APCIs were 86.5% (32/37) and 98.5% (397/403), respectively. Among the 37 cases of APCIs, prenatal MRI missed diagnosis of 2 cases of MCI, 2 cases of VCI, and misdiagnosed 1 case of VCI as an accessory placenta. MRI identified 10 cases of APCIs missed by ultrasound, including 5 cases of MCI, 2 cases of VP, 2 cases of VCI, and 1 case of combined VCI with VP. Additionally, ultrasound misdiagnosed 4 cases of APCIs, including 2 cases of VCI misdiagnosed as MCI and 2 cases of MCI misdiagnosed as VCI.Conclusions:For APCIs complicated with abnormalities of placental location or morphology, or placental accretion spectrum disease in late pregnancy, MRI has a higher diagnostic efficacy than ultrasound.

Objective To establish a highly sensitive,stable,and universally applicable ultra-high-performance liquid mass spectrometry tandem method(UPLC-MS/MS)for simultaneous determination of nirmatrelvir and ritonavir blood concentrations in human plasma.Methods The separation was performed on an ACQUITY UPLC BEH C18 column(2.1 mm× 50 mm,1.7 μm)with gradient elution,and the mobile phase consisted of 0.1％formic acid-water and 100％acetonitrile at the flow rate of 0.3 mL·min-1.The column temperature was 45℃,and the injection volume was 2 μL.Electrospray ionization as ion source(ESI+)was used as the ion source and multiple reactions monitoring mode(nirmatrelvir m/z 500.20→319.10,nirmatrelvir-D9 m/z 508.59→328.10,ritonavir m/z 721.30→426.10,13C,2H3-ritonavir m/z 725.30→426.10)was adopted.Thirty patients with coronavirus disease 2019(COVID-19)treated with nirmatrelvir and ritonavir at the People's Hospital of Changxing County in Jan.2023 were selected to measure their steady-state trough concentrations of nirmatrelvir and ritonavir after 3 days of treatment.Results The linear range of nirmatrelvir was 0.100-10.0 μg·mL-1(R2=0.997 2),and the linear range of nirmatrelvir was 0.050-5.00 μg·mL-1(R2=0.995 2).The recovery rates of nirmatrelvir and lopinavir were both＞90％and the intra-batch and inter-batch precision relative standard deviations(RSDs)were both＜10％.Additionally,the recovery ranges for nirmatrelvir and lopinavir were 91.5％-97.0％,and the matrix effects ranged from 92.4％to 97.7％.The results of clinical samples showed that the plasma concentrations of nirmatrelvir and ritonavir in patients with COVID-19 varied greatly among individuals.Conclusion The method for simultaneous determination of nirmatrelvir and ritonavir concentrations in human plasma established in this study is convenient,highly specific,highly accurate,with high precision,which is suitable for monitoring the concentrations of nirmatrelvir and ritonavir in patients.

Objective To introduce the development strategy of“Internet Plus”AIDS prevention services and its implementation results from 2010 to 2015 in Guangzhou, China. Methods A gay men's health column was created for an active website aimed at men who have sex with men (MSM), in collaboration with local community organizations and the Guangzhou CDC. We designed intervention tools (including scenario-based applications and HIV risk self-assessment systems) and an online HIV testing service platform, integrated with applied psychology and behavioral theory as well as the“Internet Plus”concept, to intervene in HIV infection risk factors among MSM. Data of clients who accessed the“Internet Plus”AIDS services from 2010 to 2015 were used to evaluate service operation. Six-year consecutive surveys, conducted between April and July of each service year, were collected using a national AIDS sentinel surveillance questionnaire. For each year of surveillance, information on HIV prevalence, HIV interventions received during the past year, unprotected anal intercourse in the past 6 months, and HIV testing in the past year were compared using the chi-squared (χ2) test, to roughly reflect the effect of“Internet Plus”AIDS prevention services. Results As of 31 December 2015, a total of 34 395 MSM had received“Internet Plus”services and HIV testing. The number of MSM tested increased from 2 338 in 2010 to 8 054 in 2015. From 2010 to 2015, newly identified HIV cases in each year were 59, 166, 312, 283, 291, and 270, which accounted for 25.0%, 32.8%, 38.8%, 35.1%, 30.5%, and 23.2% of MSM HIV cases of Guangzhou, respectively. Sentinel surveillance data showed that during the study period, 3 047 MSM were investigated, with 405, 400, 401, 633, 608, and 600 each year, respectively. The proportion of participants who had received any HIV intervention during the past year was 74.3% (301), 70.8% (283), 83.3% (334), 85.0%(538), 69.1%(420), and 83.8%(503) each year, respectively (trend χ2=6.53, P=0.011). HIV testing done during the past year accounted for 44.0%(178), 44.3%(177), 49.4%(198), 53.4%(338), 56.1%(341), and 60.2%(361) each year, respectively (trendχ2=40.83, P<0.001). Unprotected anal intercourse in the past 6 months accounted for 59.3% (240), 62.0% (248), 56.6% (227), 57.0% (361), 48.4% (294), and 43.7%(262) each year, respectively (trend χ2=42.21, P<0.001). Conclusion The“Internet Plus”AIDS prevention services in this study represent a manner to enhance traditional HIV prevention strategies. We found these services to be effective in implementation of the national AIDS control and prevention strategy, especially for the expansion of intervention, testing, and case identification among high-risk populations.

Objective To introduce the development strategy of“Internet Plus”AIDS prevention services and its implementation results from 2010 to 2015 in Guangzhou, China. Methods A gay men's health column was created for an active website aimed at men who have sex with men (MSM), in collaboration with local community organizations and the Guangzhou CDC. We designed intervention tools (including scenario-based applications and HIV risk self-assessment systems) and an online HIV testing service platform, integrated with applied psychology and behavioral theory as well as the“Internet Plus”concept, to intervene in HIV infection risk factors among MSM. Data of clients who accessed the“Internet Plus”AIDS services from 2010 to 2015 were used to evaluate service operation. Six-year consecutive surveys, conducted between April and July of each service year, were collected using a national AIDS sentinel surveillance questionnaire. For each year of surveillance, information on HIV prevalence, HIV interventions received during the past year, unprotected anal intercourse in the past 6 months, and HIV testing in the past year were compared using the chi-squared (χ2) test, to roughly reflect the effect of“Internet Plus”AIDS prevention services. Results As of 31 December 2015, a total of 34 395 MSM had received“Internet Plus”services and HIV testing. The number of MSM tested increased from 2 338 in 2010 to 8 054 in 2015. From 2010 to 2015, newly identified HIV cases in each year were 59, 166, 312, 283, 291, and 270, which accounted for 25.0%, 32.8%, 38.8%, 35.1%, 30.5%, and 23.2% of MSM HIV cases of Guangzhou, respectively. Sentinel surveillance data showed that during the study period, 3 047 MSM were investigated, with 405, 400, 401, 633, 608, and 600 each year, respectively. The proportion of participants who had received any HIV intervention during the past year was 74.3% (301), 70.8% (283), 83.3% (334), 85.0%(538), 69.1%(420), and 83.8%(503) each year, respectively (trend χ2=6.53, P=0.011). HIV testing done during the past year accounted for 44.0%(178), 44.3%(177), 49.4%(198), 53.4%(338), 56.1%(341), and 60.2%(361) each year, respectively (trendχ2=40.83, P<0.001). Unprotected anal intercourse in the past 6 months accounted for 59.3% (240), 62.0% (248), 56.6% (227), 57.0% (361), 48.4% (294), and 43.7%(262) each year, respectively (trend χ2=42.21, P<0.001). Conclusion The“Internet Plus”AIDS prevention services in this study represent a manner to enhance traditional HIV prevention strategies. We found these services to be effective in implementation of the national AIDS control and prevention strategy, especially for the expansion of intervention, testing, and case identification among high-risk populations.